Exploring the relationship between ethnicity and hypertension in Canada

Background: Previous work examining differences in hypertension across ethnic groups employ race as the principal variable. While differences in hypertension have been identified across racial groups, there is great variation between ethnic groups amongst racial groupings that could mask differences in hypertension and cardiovascular disease (CVD) risk. In light of Canada's ethnic diversity, research aimed at identifying specific groups that are at a health disadvantage is essential for understanding the health of the overall population. In addition, this research would be beneficial for creating programs and policies aimed at reducing or eliminating these disparities. Since CVD is the leading cause of mortality in Canada and hypertension is one of the most significant and modifiable risk factors for CVD, it is important to move past crude classifications based on race and examine ethnic group differences. The purpose of this study is to examine the relationship between ethnicity and hypertension in Canada, while employing more narrow classifications for ethnicity than previous studies. In addition, because ethnicity has been shown to be representative of an individual's social experience, this study also aims to investigate whether this relationship can be explained by one or all of the following variable: socioeconomic status, physical activity, body mass index, smoking status, daily alcohol consumption or acculturation. Methods. This study used the 2004 Canadian Community Health Survey, cycle 2.1 to compare 29 different ethnic groups in Canada on whether they had high blood pressure that had been diagnosed by a health professional. Associations were examined using logistic regression. Subsequent logistic regression analyses included socioeconomic status, physical activity, body mass index, smoking status, daily alcohol consumption and acculturation to test for the effect of each of these variables on the relationship between ethnicity and hypertension. Results. Ukrainians, Chinese, Portuguese, South Asians, Aboriginals, Blacks, Filipinos and South East Asians were found to have significantly higher odds of having high blood pressure than Canadians (OR's = 1.50, 1.56, 2.72, 1.38, 1.36, 1.66, 2.21 & 2.24 respectively, p<.001). In addition, the only significant mediating effects were between SES and Aboriginals as well as obesity and Aboriginals. None of the other independent variables accounted for >10% of the risk experienced by the ethnic groups that were significantly associated with hypertension. Interpretation: The odds of having high blood pressure in Canada varies considerably across ethnic groups within racial groups indicating previous research is not specific enough to inform policy and program development. Because this study was not able to explain this relationship using the sociodemographic and lifestyle factors mentioned above, future research should be done to determine what places certain ethnic groups at a greater risk in order to tailor interventions aimed at reducing high blood pressure that are suited to the specific needs of each cultural group.

Changing roles of nurse educators employed in acute and chronic care settings : the impact of professional and statutory mandates in Ontario at four sites of one hospital corporation /

The role of the hospital-employed nurse educator is evolving. Factors influencing this change include the introduction of standards for nurse educators by the College of Nurses of Ontario (CNO), a change in the way nurses are educated, the emergence of nursing as a profession, and hospital restructuring as a result of budgetary constraints. Two of these influencing factors: the introduction of the updated Standards of Practice for Registered Nurses and Registered Practical Nurses (1996) and hospital restructuring occurred over the last 7 years at several hospitals in southern Ontario. Current literature as well as the Standards of Practice (1996) were utilized to examine the current roles and responsibilities of nurse educators and subsequently develop a questionnaire to study the impact of these influencing factors on the role of the nurse educator. This questionnaire was piloted and revised before its distribution at 4 hospitals in southern Ontario. Twenty-five of the 41 surveys (61%) distributed were returned for analysis. The data reflected that the Standards of Practice had a positive influence on the role of the nurse educator, while hospital restructuring had a negative impact. In addition, many of the roles and responsibilities identified in the literature were indeed part of the current role of nurse educators, as well as several responsibilities not captured in the literature. The predictions for the future of this role in its current state were not positive given the financial status of the health care system as well as the lack of clarity for the role and the current level ofjob satisfaction among practicing nurse educators. However, a list of recommendations were generated which, if implemented, could add clarity to the role and improve job satisfaction. This could enhance the retention of current nurse educators and the possibility of recruiting competent nurse educators to the role in the future.

Private versus public : how one gay professor negotiates the boundaries between his personal and professional lives /

This study examined how one university professor negotiated the boundaries between his personal life as a gay man and his professional life as a teacher. Using his sexual orientation as a focal point, the study explored the circumstances and underlying assumptions that influenced this professor's decisions to disclose information of a personal nature. Data collection was solicited from a number of sources: (a) In-depth interviews with the participant, his colleagues, students, and friends; (b) Field observation of the participant teaching over a 3 -day period; and (c) A document review of lesson plans, course outlines, student feedback forms, and the participant's teaching portfolio. The researcher maintained both observation journals and reflective journals during this process. Data analysis using the constant comparative method elicited several themes. The participant engaged in a variety of strategies in disclosing his sexual orientation that included: (a) no disclosure at all, (b) assuming people knew, (c) casually mentioning it in conversation, and (d) deliberately planning to tell someone. The participant also engaged in an ongoing assessment of his environment that included evaluating the level of risk in disclosing his sexual orientation and assessing the listener's ability to receive the information. The participant cited numerous reasons for disclosing his sexual orientation. Further inquiry revealed a number of belief systems that underlined these reasons. These belief systems included beliefs around privacy, authenticity, teaching, manners, professionalism, and homosexuality. The conclusions suggested that the participant utilized a consistent process in both his personal and professional lives to determine what information was kept private and what information was made public. While the process used to determine the degree of disclosure was consistent, the actual disclosures themselves varied widely in nature.

Teacher professional growth in an authentic learning environment

The last several decades have been marked by tremendous changes in education - technological, pedagogical, administrative, and social. These changes have led to considerable increments in the budgets devoted to professional development for teachers ~ with the express purpose of helping them accommodate their practices to the new realities oftheir classrooms. However, research has suggested that, in spite of the emphasis placed on encouraging sustained change in teaching practices, little has been accomplished. This begs the question of what ought to be done to not only reverse this outcome, but contribute to transformational change. The literature suggests some possibilities including: a) considering teachers as learners and applying what, is known about cognition and learning; b) modifying the location and nature ofprofessional development so that it is authentic, based in the classroom and focusing on tasks meaningful to the teacher; c) attending to the infrastructure underlying professional development; and d) ensuring opportunities for reflective practice. This dissertation looks at the impact of each ofthese variables through an analysis ofthe learning journeys of a group ofteachers engaged in a program called GrassRoots in one midsized school board in Ontario. Action research was conducted by the researcher in his role as consultant facilitating teacher professional growth around the use of Web sites as culminating performance tasks by students. Research focused on the pedagogical approach to the learning of the teachers involved and the infrastructure underlying their learning. Using grounded theory, a model for professional development was developed that can be used in the future to inform practices and, hopefully, lead to sustained transformational school change.

Exploring the personal and professional lives of teachers in the search for authenticity /

"We teach who we are" (Palmer, 1998, p. 2). This simple, yet profound, statement was the catalyst that began my thesis journey. Using a combination of self-study and participant narratives, Palmer's idea was explored as search for authenticity. The self-study component of this narrative was enhanced by the stories of two other teachers, both women. I chose to use narrative methodology to uncover and discover the relationship between the personal and professional lives of being a teacher. Do teachers express themselves daily in their classrooms? Do any lessons from the classroom translate into teachers' personal lives? The themes of reflection, authenticity, truth, and professional development thread themselves throughout this narrative study. In order to be true to myself as a teacher/researcher, arts-based interpretations accompany my own and each participant's profile. Our conversations about our pasts, our growth as teachers and journeys as individuals were captured in poetry and photographic mosaics. Through rich and detailed stories we explored who we are as teachers and how we became this way. The symbiotic relationship between our personal and professional lives was illustrated by tales of bravery, self-discovery, and reflection. The revelations uncovered illustrate the powerful role our past plays in shaping the present and potentially the friture. It may seem indulgent to spend time exploring who we are as teachers in a time that is increasingly focused on improving student test scores. Yet, the truth remains that, "Knowing myself is as crucial to good teaching as knowing my students and my subject" (Palmer, 1998, p. 2).

The teaching practicum as an opportunity for professional growth: perceptions of three associate-teachers /

The purpose of this study was to examine the student-teaching practicum as an opportunity for professional growth for associate-teachers. Three associate-teachers from one school board in southern Ontario were purposefully selected to participate in the study. Participants were interviewed before and after one 4-week teaching practicum. They were asked to keep a reflective journal during the practicum, and provided with questions to guide their reflection. The literature suggests that meaningful professional development is contextual and requires reflection on practice. For example, Schon's (l987b) hall of mirrors phenomenon occurs when teachers reflect on their own practice while observing and guiding the practice of others. Findings from this study suggest the teaching practicum has the potential to be a valuable professional development opportunity for associateteachers, but that the university and the school board affiliated with the participants do not conceptualize it as such. As well, the research suggests that although all participants found the teaching practicum valuable, the extent to which they were able to grow professionally depended on their professional personality. In addition, it was found that the reflective journal enhanced opportunities for associate teacher reflection. This research suggests that universities and school boards may wish to consider the studentteacher practicum as a professional development opportunity.

An exploration of women elementary school teachers' perceptions of how their decision to return to teaching part-time from a maternity leave influences their professional and personal lives /

The purpose of this research was to explore women elementary teachers' perceptions of how their decision to return to teaching part-time from a maternity leave influences their professional and personal lives. The investigation focused on the decisions surrounding a mother's choice to reenter the teaching profession parttime in a field where each mother had previously been employed full-time. A collective case study was undertaken based on an in-depth interview with five mothers who had made the choice to return to the classroom part-time. The data collected in this study were analyzed and interpreted using qualitative methods. The following four major themes emerged from the interviews: decisionmaking process, challenges faced by mothers who teach part-time, the importance of support, and the enhancement of instructional practice from parenthood. Using these four themes, an analysis was conducted to examine the similarities and differences among the experiences of the participants. The mothers' reflections, my analysis, and the related literature were used at the conclusion of this report to compile implications for teaching practice, theory, and further research.

Developing and nurturing professional learning communities: principles used by elementary administrators /

This study examined the strategies used by elementary school principals to facilitate and nurture the development of professional learning communities (PLC) within their school settings. Using a reputational sample of administrators whose schools were demonstrating observable characteristics of PLCs, this study documented and described the strategies and actions taken by the principals to move their schools forward. Data collection included the use of open-ended interviews as well as observations capturing the means by which the principals addressed the areas of culture, processes, and structures within their school setting. A grounded theory approach to data analysis uncovered 4 guiding principles used by the principals to facilitate the development of the PLCs within their school: (a) protecting the purpose; (b) attending to relationships; (c) sharing the responsibility; and (d) valuing the journey. The guiding principles were used by each administrator to anchor the decisions they made and develop responsive, contextspecific strategies to support the PLC at their school. The results highlighted the complex role of the principal and the supports required to tackle the difficult work of facilitating PLCs.

Elements that contribute to staff nurses' commitment to lifelong professional development

This research explored the elements that contribute to staff nurses' commitment to lifelong professional development. This exploration has been undertaken to provide insights into those factors that motivate individuals to continue their education for professional development and for clinical practice improvement. This study was conducted in an acute care hospital in Southern Ontario, and investigated the thoughts and experiences ofhealth care staffworking within that setting. A qualitative case study was undertaken which involved the collection of interview, document, and class observation data. Two exemplary clinical nurse educators and two motivated, professionally committed staffnurses were interviewed during the study. Teaching document review and observation ofclasses involving the clinical nurse educators were conducted to facilitate triangulation of fmdingswith data sources and strategies. These participants provided rich data that were captured in field notes and coded for conceptual meaning. Emerging from the data were the identification ofthree major elements of influence that contribute to staffnurses' commitment to lifelong professional development. Identified within the three intersecting spheres of influence upon staff nurses' lifelong commitment to professionalleaming were the environment, the clinical nurse educator, and the staff nurse. This research explored the intersecting spheres of influence and the elements within the partnership model ofprofessional education for staff nurses.

Exploring the relationship between professional and organizational commitment : the attitudes of Ontario chartered accountancy students

This study was undertaken to investigate the attitudes of chartered accountancy (CA) students toward professional commitment and organizational commitment. The focus of the study was to discover if a relationship between these two constructs existed and determine which situational and individual characteristics facilitate or impede commitment. The sample included those CA students who wrote the 1995 UFE (n=423). Four instruments were used for data collection: Job Diagnostic Survey, Organizational Commitment Questionnaire, Career Commitment Questionnaire, Career Facilitation Survey, and individual demographic inquiry. The study found a significant relationship between professional commitment and organizational commitment. Situational characteristics tended to influence organizational commitment, while individual characteristics more often governed professional commitment. Specific satisfactions, general satisfaction, growth satisfaction, and satisfaction with compensation, co-workers, and supervision were found to facilitate organizational commitment. Organizational commitment was also influenced by supplemental job characteristics, internal work motivation, career facilitation, and autonomy. Implications for practice involved the cooperation and collaboration of the governing body for the CA profession and the CA firms in activities addressing pertinent issues that influence commitment. Implications for future research were also discussed.

Giving voice to lifelong learning in professional nursing practice

The purpose of this phenomenological study was to uncover the meaning of lifelong learning to nurses in an Academic Health Care setting. Six female pediatric nurses were interviewed and audiotaped in response to 2 main questions of interpretation and engagement in lifelong learning with respect to their nursing practice. Four additional probing questions elicited responses of further qualities and characteristics of the meaning of lifelong learning. The emergent themes uncovered the characteristics and nature of the journey of lifelong learning. The themes evolved into parallel characteristics developing into the concepts of personal empowerment and occupational authorship. The personal empowerment concept involved processes whereby the participants overcame or removed barriers to engage in personal lifelong learning. Participants utilized personal power and internal motivators to sustain their engagement in lifelong learning. The occupational authorship concept involved participants controlling their exploration into lifelong learning through collaboration and recognition of occupational demands to be met as a professional. The remaining themes revealed a seasoning journey. This journey entailed a process of mastery through the themes of engagement discord, discovery pilgrimage, transforming, and maturation. The engagement in this journey resulted in their lifelong learning to becoming more intuitive and a part oftheir being. The overall theme uncovered from the journeys was one of a vocation described as a call to thinking critically of nursing practice. The participants responded to lifelong learning as a call to be a good nurse by using critical thinking through reflection, transformative and constructionist learning processes. This study gave voice to the meaning of lifelong learning in their nursing practice as interpreted by -ao the nurse participants.

The person inside the nurse : the professional socialization of baccalaureate nursing students

The goal ofthis research was to gain an understanding ofthe process ofprofessional socialization by accessing role meaning ofstudents engaged in a BScN program. Students from each ofthe four years and faculty members from the school ofnursing volunteered as participants. G. Kelly's (1955) Personal Construct Theory provided the framework to determine awareness and constructed meanings. A reflective tool, called LifeMapping, was adapted and utilized to relate student experiences within education that have attributed to nurse role meaning. Focus group interviews verified data interpretation. Students are informed oftheir choice to study nursing through part-time and volunteer work, secondary school cooperative placements. Descriptions reveal that choices are tested and both positive and negative aspects ofthe role observed. Bipolar images of good and bad nurses seem to be context-related. These images may establish biases in choices related to learning experiences. The person inside ofeach aspiring nurse interprets, revises and understands experiences to incorporate individual meaning into their value and belief structures. Students are aware ofchanges and descnbe them as developments that occur personally up to Year ill and role-image changes that begin in Year II. The major difficulty that students encountered was descnbed as negative attitudes towards their anticipated role. Humanistic-interactionist philosophies are echoed in student accounts of learning experiences. Growth and role development corresponds to process factors of small group, problem-base learning.

An exploration of the impact of a mandatory quality assurance program on the staff nurse's commitment to professional development /

This study explored experiences in relation to the impact of the College of Nurses of Ontario's (CNO's) mandatory Quality Assurance (QA) program on registered nurses (RNs) working in a clinical setting of an acute care hospital. A qualitative descriptive research design was used and data collection was done in 2 stages. First, a survey with open-ended questions was given to 45 nurses. Second, 8 respondents from the survey were interviewed using a semistructured format. Data were obtained from 2 groups-diploma-prepared and post diploma-prepared RNs. Findings demonstrated that the CNO's QA program had varying influences on the RNs' learning paths, and these differences appeared to be related to the educational background of the individual. The diploma-prepared nurses reported that their commitment to professional development was influenced by their level of internal motivation, the pressures associated with time, and the need for a strong external motivator, namely the obligation of management to conduct formal performance appraisals. They further reported that the QA program played a part in positively altering their commitment to continuing education. The post-diploma baccalaureate nurses reported that the QA program played a positive role in influencing their ongoing learning, along with their level of internal motivation, the work and health care environment, and the element of professionalism. Several implications for nursing practice, theory, and fiirther research also became evident.

Spreading my wings : how can I improve my practice and contribute to the professional knowledge base through narrative-autobiographical self-study?

"How can I improve my practice and contribute to the professional knowledge base through narrative-autobiographical self-study?" Through the use of Whitehead's (1989) living educational theory and examination of my stories, I identify the values and critical events that have helped me come to know my own learning and shape my professional self. Building on the premise that educational knowledge/theory is created, recreated, and lived through educational inquiry; I strive to make meaning of this data archive, collected over 7 years of teaching. I chart my journey to reexamine my beliefs and practices, to find a balance between traditional and progressive practices and to align my theory and practice. I retell, and, thus, in some way relive, my own "living contradictions." A reconceptualization of the KNOW, DO, BE model (Drake & Burns, 2004) is used to develop strategies to align my practice, including a six-step model of curriculum design that combines the backwards design process of Wiggins and McTighe (1998), the KNOW, DO, BE model (Drake & Burns) and Curry and Samara's (1995) differentiation planner.

Examining and describing professional development and continuing education in the personal training and fitness industry : sites and issues of disconnect

The following phenomenologically oriented study examines and describes the relevance and effectiveness of professional development and continuing education programs for real-world situations of personal trainers. The participants were personal trainers, facility managers, and persons involved in the accreditation process. Data collection took place in 3 phases. The first phase consisted of the participants completing the PUMP Questionnaire, followed by focus groups with personal trainers and interviews with managers. The study's 3 data sets required reduction via a content analysis by question, content analysis by existential categories, and further thematic analysis using the lived relation existential dimension. The discussion contains the salient sites and issues of disconnect between clients, personal trainers, and facility managers and how they might affect the personal training experience. The intergenerational disconnect emphasized between Boomers as clients and Millennials as personal trainers requires further exploration and dialogue and underscores the need for different approaches to content and delivery of professional development and continuing education experiences for personal trainers and managers of fitness facilities.