A Psychosocial Approach to Understanding Causality Assessment in Early Phase Oncology Clinical Trials: A Phenomenological Study

Research Question: What are the psychosocial factors that affect causality assessment in early phase oncology clinical trials? Methods: Thirty-two qualitative interviews were explicated with the aid of “Naturalistic Decision Making”. Data explication consisted of phenomenological reduction, delineating and clustering meaning units, forming themes, and creating a composite summary. Participants were members of the National Cancer Institute of Canada’s Clinical Trial Group Investigative New Drug committee. Results: The process of assigning causality is extremely subjective and full of uncertainty. Physicians had no formal training, nor a tool to assist them with this process. Physicians were apprehensive about their decisions and felt pressure from their patients, as well as the pharmaceutical companies sponsoring the trial. Conclusions: There are many problem areas when attributing causality, all of which have serious consequences, but clinicians used a variety of methods to cope with these problem areas.

Understanding Continuance Intentions of Physicians with Electronic Medical Records (EMRS): An Expectancy-Confirmation Perspective

This thesis examines physicians’ satisfaction with electronic medical records (EMRs) in the post-adoption phase. More specifically, the study examines how physicians’ satisfaction with EMRs impacts on their intention to continue using as well as extend their adoption of additional functions of EMRs. Expectation-confirmation theory is used with the incorporation of perceived risk as the theoretical framework. The extended theoretical model is used to formulate eight hypotheses to aid in the understanding of physicians’ continuance intentions. A field survey of 135 Canadian physicians that utilize EMRs was performed to test the model empirically. The study found that physicians are willing to continue using and adopting additional components of EMRs. In addition, the empirical results suggest that physicians’ perceived usefulness and perceived risk impacts satisfaction, which in turn influences physicians’ continuance intentions. As well, perceived risk has an influence on physicians’ continuance intentions directly.

Teachers Without Borders: Exploring Experiences, Transitions, and Identities of Refugee Women Teachers from Yugoslavia

Prior to September 11 2011, Canada was recognized as a leading advocate of international refugee protection and the third largest settlement country in the world. University educated refugees were admitted to the country in part on the basis of their education, but once in Canada their credentials were often ignored. The purpose of this study was to explore, through a transnational feminist lens, immigrant and settlement experiences of refugee female teachers from Yugoslavia who immigrated to Canada during and after the Yugoslav wars; to document the ways in which socially constructed categories such as gender, race, and refugee status have influenced their post-exile experiences and identities; and to identify the government's role in creating conditions where the women were either able or unable to continue in their profession. In this study, I employed both a transnational feminist methodology and narrative inquiry. The analysis process included an emphasis on the storying stories model, poetic transcription, and concentric storying. The women’s voices are represented in various forms throughout the document including individual and collective narratives. Each narrative contributed to a detailed picture of immigration and settlement processes as women spoke of continuing their education, knowing or learning the official language, and contributing to Canadian society and the economy. The findings challenge the image of a victimized and submissive refugee woman, and bring to the centre of discourse the image of the refugee woman as a skilled professional who often remains un- or underemployed in her new country. The dissertation makes an important contribution to an underdeveloped area in the research literature, and has the potential to inform immigration, settlement, and teacher education policies and practices in Canada and elsewhere.

A DFT Guided/Experimental Approach to Asymmetric Allylation and Phase-Transfer Catalysis

The Dudding group is interested in the application of Density Functional Theory (DFT) in developing asymmetric methodologies, and thus the focus of this dissertation will be on the integration of these approaches. Several interrelated subsets of computer aided design and implementation in catalysis have been addressed during the course of these studies. The first of the aims rested upon the advancement of methodologies for the synthesis of biological active C(1)-chiral 3-methylene-indan-1-ols, which in practice lead to the use of a sequential asymmetric Yamamoto-Sakurai-Hosomi allylation/Mizoroki Heck reaction sequence. An important aspect of this work was the utilization of ortho-substituted arylaldehyde reagents which are known to be a problematic class of substrates for existing asymmetric allylation approaches. The second phase of my research program lead to the further development of asymmetric allylation methods using o-arylaldehyde substrates for synthesis of chiral C(3)-substituted phthalides. Apart from the de novo design of these chemistries in silico, which notably utilized water-tolerant, inexpensive, and relatively environmental benign indium metal, this work represented the first computational study of a stereoselective indium-mediated process. Following from these discoveries was the advent of a related, yet catalytic, Ag(I)-catalyzed approach for preparing C(3)-substituted phthalides that from a practical standpoint was complementary in many ways. Not only did this new methodology build upon my earlier work with the integrated (experimental/computational) use of the Ag(I)-catalyzed asymmetric methods in synthesis, it provided fundamental insight arrived at through DFT calculations, regarding the Yamamoto-Sakurai-Hosomi allylation. The development of ligands for unprecedented asymmetric Lewis base catalysis, especially asymmetric allylations using silver and indium metals, followed as a natural extension from these earlier discoveries. To this end, forthcoming as well was the advancement of a family of disubstituted (N-cyclopropenium guanidine/N-imidazoliumyl substituted cyclopropenylimine) nitrogen adducts that has provided fundamental insight into chemical bonding and offered an unprecedented class of phase transfer catalysts (PTC) having far-reaching potential. Salient features of these disubstituted nitrogen species is unprecedented finding of a cyclopropenium based C-H•••πaryl interaction, as well, the presence of a highly dissociated anion projected them to serve as a catalyst promoting fluorination reactions. Attracted by the timely development of these disubstituted nitrogen adducts my last studies as a PhD scholar has addressed the utility of one of the synthesized disubstituted nitrogen adducts as a valuable catalyst for benzylation of the Schiff base N-diphenyl methylene glycine ethyl ester. Additionally, the catalyst was applied for benzylic fluorination, emerging from this exploration was successful fluorination of benzyl bromide and its derivatives in high yields. A notable feature of this protocol is column-free purification of the product and recovery of the catalyst to use in a further reaction sequence.