The role of molecular, clinical and socioeconomic factors in the long-term survival of axillary node negative breast cancer patients

The overall objective of this study was to investigate factors associated with long-term survival in axillary node negative (ANN) breast cancer patients. Clinical and biological factors included stage, histopathologic grade, p53 mutation, Her-2/neu amplification, estrogen receptor status (ER), progesterone receptor status (PR) and vascular invasion. Census derived socioeconomic (SES) indicators included median individual and household income, proportions of university educated individuals, housing type, "incidence" of low income and an indicator of living in an affluent neighbourhood. The effects of these measures on breast cancer-specific survival and competing cause survival were investigated. A cohort study examining survival among axillary node negative (ANN) breast cancer patients in the greater Toronto area commenced in 1 989. Patients were followed up until death, lost-to-follow up or study termination in 2004. Data were collected from several sources measuring patient demographics, clinical factors, treatment, recurrence of disease and survival. Census level SES data were collected using census geo-coding of patient addresses' at the time of diagnosis. Additional survival data were acquired from the Ontario Cancer Registry to enhance and extend the observation period of the study. Survival patterns were examined using KaplanMeier and life table procedures. Associations were examined using log-rank and Wilcoxon tests of univariate significance. Multivariate survival analyses were perfonned using Cox proportional hazards models. Analyses were stratified into less than and greater than 5 year survival periods to observe whether known markers of short-tenn survival were also associated with reductions in long-tenn survival among breast cancer patients. The 15 year survival probabilities in this cohort were: for breast cancerspecific survival 0.88, competing causes survival 0.89 and for overall survival 0.78. Estrogen receptor (ER) and progesterone receptor (PR) status (Hazard Ratio (HR) ERIPR- versus ER+/PR+, 8.15,95% CI, 4.74, 14.00), p53 mutation (HR, 3.88, 95% CI, 2.00, 7.53) and Her-2 amplification (HR, 2.66, 95% CI, 1.36, 5.19) were associated with significant reductions in short-tenn breast cancer-specific survival «5 years following diagnosis), however, not with long-term survival in univariate analyses. Stage, histopathologic grade and ERiPR status were the clinicallbiologieal factors that were associated with short-term breast cancer specific survival in multivariate results. Living in an affluent neighbourhood (top quintile of median household income compared to the rest of the population) was associated with the largest significant increase in long-tenn breast cancer-specific survival after adjustment for stage, histopathologic grade and treatment (HR, 0.36, 95% CI, 0.12, 0.89).

Synthesis of Chiral Benzimidazolylidenes from 1,10-Phenathrolines and 1,10-Phenathroline-2,9-dione /

A^-heterocyclic carbenes (NHCs) have become the focus of much interest as ancillary ligands for transition metal catalysts in recent years. Their structural variability and strong cy-donation properties have led to the preparation of demonstrably useful organometallic catalysts. Among the three general structural types of NHCs (imidazolylidenes, imidazolinylidenes, and benzimidazolylidenes), benzimidazolylidenes are the least investigated because of the limitation of current synthetic approaches. The preparation of chiral analogues is even more challenging. Previously, our group has demonstrated an alternative approach to synthesizing benzimidazolylidenes with a tetracyclic framework in three steps from 1,10-phenanthroline. This thesis is focused on approaches to chiral benzimidazolylidenes derived from substituted 1,10-phenanthrolines. A key step in the preparation of these ligands involves a reduction of the pyridyl rings in 1,10-phenanthrolines. Chirality can be introduced to phenanthrolines before, during, or after the reduction as illustrated by three approaches: 1) de novo construction of the phenanthroline from chiral ketones with endo and exo faces to provide a degree of diastereoselectivity during subsequent reduction; 2) introduction of substituents into the 2- and 2,9- position of phenanthroline by nucleophilic aromatic substitution, followed by a reduction-resolution sequence; and 3) use of the protected octahydrophenanthroline as a substrate for chiral induction a to nitrogen.

Exploring critical-care nurses' perceptions about critical thinking /

The influx of nurses to the critical-care environment is continuous. In many workplaces, the nurses who are new to critical care are also newly graduated nurses. These new critical-care nurses and their critical-care nursing colleagues, who may have worked in critical care for many years, need to demonstrate expert judgment in order to optimize the potential for positive patient outcomes. The purpose of this study was to explore critical-care nurses' perceptions about critical thinking and expert nursing judgment. Using grounded theory research design, I collected data from 1 1 critical-care nurses through focus groups, an interview, and postparticipation questionnaires. I have articulated a Critical-thinking Modelfor Expert Nursing Judgment. The educational model is directly relevant to practicing critical-care nurses and nursing leaders who guide critical-care nursing practice. The Critical-thinking Modelfor Expert Nursing Judgment contributes to educational theory by objectifying the substantive topic of critical thinking and expert judgment. The model has broad applicability within the domain of education and specific applicability within the domain of nursing education.

Web based content and hybrid teaching: student perceptions of the effectiveness of using web based content and hyper-linked teaching units in teaching hybrid business and marketing post secondary classes /

This exploratory, descriptive action research study is based on a survey of a sample of convenience consisting of 172 college and university marketing students, and 5 professors who were experienced in teaching in an internet based environment. The students that were surveyed were studying e-commerce and international business in 3^^ and 4*'' year classes at a leading imiversity in Ontario and e-commerce in 5^ semester classes at a leading college. These classes were taught using a hybrid teaching style with the contribution of a large website that contained pertinent text and audio material. Hybrid teaching employs web based course materials (some in the form of Learning Objects) to deliver curriculimi material both during the attended lectures and also for students accessing the course web page outside of class hours. The survey was in the form on an online questionnaire. The research questions explored in this study were: 1. What factors influence the students' ability to access and learn from web based course content? 2. How likely are the students to use selected elements of internet based curriculum for learning academic content? 3. What is the preferred physical environment to facilitate learning in a hybrid environment? 4. How effective are selected teaching/learning strategies in a hybrid environment? The findings of this study suggest that students are very interested in being part of the learning process by contributing to a course web site. Specifically, students are interested in audio content being one of the formats of online course material, and have an interest in being part of the creation of small audio clips to be used in class.

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.

A narrative journey of teacher reflexivity and authenticity in technological environments /

This qualitative narrative inquiry was driven by my desire to further explore my personal discovery that my utilization of educational technologies in teaching and learning environments seemed to heighten a sense of creativity, which in turn increased reflective practice and authenticity in my teaching. A narrative inquiry approach was used as it offered the opportunity to uncover the deeper meanings of authenticity and reflection as participants' personal experiences were coconstructed and reconstructed in relationship with me and in relationship to a social milieu. To gain further insight into this potential phenomenon, I engaged in 2 conversational interviews with 2 other teachers from an Ontario College in a large urban centre who have utilized educational technologies in their teaching and learning communities and I maintained a research journal, constructed during the interview process, to record my own emerging narrative accounts, reflections, insights and further questions. The field texts consisted of transcriptions of the interviews and my reflective journal. Research texts were developed as field texts were listened to multiple times and texts were examined for meanings and themes. The educational technologies that both women focused on in the interview were digital video of children as they play, learn and develop and the use of an audible teacher voice in online courses. The invitation given to students to explore and discover meaning in videos of children as they watched them with the teacher seemed to be a catalyst for authenticity and a sense of synergy in the classroom. The power of the audible teacher voice came through as an essential component in online learning environments to offer students a sense of humanness and connection with the teacher. Relationships in both online and face to face classrooms emerged as a necessary and central component to all teaching and learning communities. The theme of paradox also emerged as participants recognized that educational technologies can be used in ways that enhance creativity, authenticity, reflection and relationships or in ways that hinder these qualities in the teaching and learning community. Knowledge of the common experiences of college educators who utilize educational technologies, specifically digital video of children to educate early childhood educators, might give meaning and insight to inform the practice of other teachers who seek authentic, reflexive practice in the classroom and in on line environments.

Grade 9 students' perceptions of the impact of a Drop Everything and Read (D.E.A.R.) program /

Educators continually look for strategies to enhance and improve the reading practices of their students. This is an especially challenging task for secondary level teachers as high school students often lack intrinsic motivation to read for pleasure (Bucher & Manning, 2004; Horton, 2005; Wooicott, Research Pty. Ltd. 2001). The purpose of this study was to detennine the effects of the Drop Everything and Read (D.E.A.R.) program on writing, on reading, and on grades, from the perspective of eight Grade 9 students. Of particular interest were the students' perceptions of the effect that participation in the program had on their grades, their writing, their motivation to reading, and their concept of themselves as readers. The eight participants were tracked over the course of a semester. Using qualitative research techniques, data were collected from four sources: two student surveys, researcher's daily field observations, students' weekly reading logs, and three open-ended one-on-one interviews. In order to gain an understanding of the impact of the D.E.A.R program, the data were corroborated, and analyzed with NVivo: N7 (2006). From the data analysis, five themes emerged as a function of the Grade 9 students' experiences in the D.E.A.R. program: Reading Preferences, Time Spent Reading, Making Associations with Reading for Pleasure, Perceptions of Self-as-Reader, and Evaluations of the D.E.A.R Program. In the interest of supporting students' positive reading habits and for the future implementation, these five themes are presented as a series of findings together with recommendations for practice.

3D movement and muscle activity patterns in a violin bowing task

Objective: Overuse injuries in violinists are a problem that has been primarily analyzed through the use of questionnaires. Simultaneous 3D motion analysis and EMG to measure muscle activity has been suggested as a quantitative technique to explore this problem by identifying movement patterns and muscular demands which may predispose violinists to overuse injuries. This multi-disciplinary analysis technique has, so far, had limited use in the music world. The purpose of this study was to use it to characterize the demands of a violin bowing task. Subjects: Twelve injury-free violinists volunteered for the study. The subjects were assigned to a novice or expert group based on playing experience, as determined by questionnaire. Design and Settings: Muscle activity and movement patterns were assessed while violinists played five bowing cycles (one bowing cycle = one down-bow + one up-bow) on each string (G, D, A, E), at a pulse of 4 beats per bow and 100 beats per minute. Measurements: An upper extremity model created using coordinate data from markers placed on the right acromion process, lateral epicondyle of the humerus and ulnar styloid was used to determine minimum and maximum joint angles, ranges of motion (ROM) and angular velocities at the shoulder and elbow of the bowing arm. Muscle activity in right anterior deltoid, biceps brachii and triceps brachii was assessed during maximal voluntary contractions (MVC) and during the playing task. Data were analysed for significant differences across the strings and between experience groups. Results: Elbow flexion/extension ROM was similar across strings for both groups. Shoulder flexion/extension ROM increaslarger for the experts. Angular velocity changes mirrored changes in ROM. Deltoid was the most active of the muscles assessed (20% MVC) and displayed a pattern of constant activation to maintain shoulder abduction. Biceps and triceps were less active (4 - 12% MVC) and showed a more periodic 'on and off pattern. Novices' muscle activity was higher in all cases. Experts' muscle activity showed a consistent pattern across strings, whereas the novices were more irregular. The agonist-antagonist roles of biceps and triceps during the bowing motion were clearly defined in the expert group, but not as apparent in the novice group. Conclusions: Bowing movement appears to be controlled by the shoulder rather than the elbow as shoulder ROM changed across strings while elbow ROM remained the same. Shoulder injuries are probably due to repetition as the muscle activity required for the movement is small. Experts require a smaller amount of muscle activity to perform the movement, possibly due to more efficient muscle activation patterns as a result of practice. This quantitative multidisciplinary approach to analysing violinists' movements can contribute to fuller understanding of both playing demands and injury mechanisms .

The only child grows up: exploring adult only-child educators /

The purpose of this study was to examine the experiences of adult only-child educators. The researcher explored the extent to which the experiences of growing up in a one-child family influenced the participants' professional experiences. This was a qualitative study. A narrative case study approach was used, and data were collected from 4 participants through 1 -to- 1 interviews. The narratives were analyzed, and common themes were identified. The findings showed that many of the participants' only-child experiences have influenced their professional roles as educators. This was largely with respect to their interactions with students. These participants valued positive relationships founded on genuine care and concern for their students. The participants also fostered a positive educational environment that provided high levels of support for the social learning and character development of their students. There are several implications for educational practice resulting from this study. Educators and other school personnel must be critically aware of meeting the socialization needs of their students. Consideration must be given to developing schoolwide initiatives related to the social skills development and character education of students. In addition, preservice and inservice teacher education programs must ensure that educators are prepared to provide rich environments where relationships with students are central and social learning opportunities are prevalent.

The design, synthesis and characterization of new building blocks for the preparation of molecule-based magnetic materials /

Two new families of building blocks have been prepared and fully characterized and their coordination chemistry exploited for the preparation of molecule-based magnetic materials. The first class of compounds were prepared by exploiting the chemistry of 3,3'-diamino-2,2'-bipyridine together with 2-pyridine carbonyl chloride or 2-pyridine aldehyde. Two new ligands, 2,2'-bipyridine-3,3'-[2-pyridinecarboxamide] (Li, 2.3) and N'-6/s(2-pyridylmethyl) [2,2'bipyridine]-3,3'-diimine (L2, 2.7), were prepared and characterized. For ligand L4, two copper(II) coordination compounds were isolated with stoichiometrics [Cu2(Li)(hfac)2] (2.4) and [Cu(Li)Cl2] (2.5). The molecular structures of both complexes were determined by X-ray crystallography. In both complexes the ligand is in the dianionic form and coordinates the divalent Cu(II) ions via one amido and two pyridine nitrogen donor atoms. In (2.4), the coordination geometry around both Cu11 ions is best described as distorted trigonal bipyramidal where the remaining two coordination sites are satisfied by hfac counterions. In (2.5), both Cu(II) ions adopt a (4+1) distorted square pyramidal geometry. One copper forms a longer apical bond to an adjacent carbonyl oxygen atom, whereas the second copper is chelated to a neighboring Cu-Cl chloride ion to afford chloride bridged linear [Cu2(Li)Cl2]2 tetramers that run along the c-axis of the unit cell. The magnetic susceptibility data for (2.4) reveal the occurrence of weak antiferromagnetic interactions between the copper(II) ions. In contrast, variable temperature magnetic susceptibility measurements for (2.5) reveal more complex magnetic properties with the presence of ferromagnetic exchange between the central dimeric pair of copper atoms and weak antiferromagnetic exchange between the outer pairs of copper atoms. The Schiff-base bis-imine ligand (L2, 2.7) was found to be highly reactive; single crystals grown from dry methanol afforded compound (2.14) for which two methanol molecules had added across the imine double bond. The susceptibility of this ligand to nucleophilic attack at its imine functionality assisted via chelation to Lewis acidic metal ions adds an interesting dimension to its coordination chemistry. In this respect, a Co(II) quaterpyridine-type complex was prepared via a one-pot transformation of ligand L2 in the presence of a Lewis acidic metal salt. The rearranged complex was characterized by X-ray crystallography and a reaction mechanism for its formation has been proposed. Three additional rearranged complexes (2.13), (2.17) and (2.19) were also isolated when ligand (L2, 2.7) was reacted with transition metal ions. The molecular structures of all three complexes have been determined by X-ray crystallography. The second class of compounds that are reported in this thesis, are the two diacetyl pyridine derivatives, 4-pyridyl-2,6-diacetylpyridine (5.5) and 2,2'-6,6'-tetraacetyl-4,4'-bipyridine (5.15). Both of these compounds have been designed as intermediates for the metal templated assembly of a Schiff-base N3O2 macrocycle. From compound (5.15), a covalently tethered dimeric Mn(II) macrocyclic compound of general formula {[Mn^C^XJCl-FkO^Cl-lO.SFbO (5.16) was prepared and characterized. The X-ray analysis of (5.16) reveals that the two manganese ions assume a pentagonal-bipyramidal geometry with the macrocycle occupying the pentagonal plane and the axial positions being filled by a halide ion and a H2O molecule. Magnetic susceptibility data reveal the occurrence of antiferromagnetic interactions between covalently tethered Mn(II)-Mn(II) dimeric units. Following this methodology a Co(II) analogue (5.17) has also been prepared which is isostructural with (5.16).

Preliminary epidemiological study of latent tuberculosis in Mexican agricultural workers in the Niagara region, Canada

It is well documented that the majority of Tuberculosis (TB) cases diagnosed in Canada are related to foreign-bom persons from TB high-burden countries. The Canadian seasonal agricultural workers program (SAWP) operating with Mexico allows migrant workers to enter the country with a temporary work permit for up to 8 months. Preiimnigration screening of these workers by both clinical examination and chest X-ray (CXR) reduces the risk of introducing cases of active pulmonary TB to Canada, but screening for latent TB (LTBI) is not routinely done. Studies carried out in industrialized nations with high immigration from TBendemic countries provide data of lifetime LTBI reactivation of around 10% but little is known about reactivation rates within TB-endemic countries where new infections (or reinfections) may be impossible to distinguish from reactivation. Migrant populations like the SAWP workers who spend considerable amounts of time in both Canada and TBendemic rural areas in Mexico are a unique population in terms of TB epidemiology. However, to our knowledge no studies have been undertaken to explore either the existence of LTBI among Mexican workers, the probability of reactivation or the workers' exposure to TB cases while back in their communities before returning the following season. Being aware of their LTBI status may help workers to exercise healthy behaviours to avoid TB reactivation and therefore continue to access the SAWP. In order to assess the prevalence of LTBI and associated risk factors among Mexican migrant workers a preliminary cross sectional study was designed to involve a convenience sample of the Niagara Region's Mexican workers in 2007. Research ethics clearance was granted by Brock University. Individual questionnaires were administered to collect socio-demographic and TB-related epidemiological data as well as TB knowledge and awareness levels. Cellular immunity to M tuberculosis was assessed by both an Interferon-y release assay (lGRA), QuantiFERON -TB Gold In-Tube (QFf™) and by the tuberculin skin test (TSn using Mantoux. A total of 82 Mexican workers (out of 125 invited) completed the study. Most participants were male (80%) and their age ranged from 22 to 65 years (mean 38.5). The prevalence of LTBI was 34% using TST and 18% using QFTTM. As previously reported, TST (using ~lOmm cut-off) showed a sensitivity of 93.3% and a specificity of 79.1 %. These findings at the moment cannot predict the probability of progression to active TB; only longitudinal cohort studies of this population can ascertain this outcome. However, based on recent publications, lORA positive individuals may have up to 14% probability of reactivation within the next two years. Although according to the SA WP guidelines, all workers undergo TB screening before entering or re-entering Canada, CXR examination requirements showed to be inconsistent for this population: whereas 100% of the workers coming to Canada for the first time reported having the procedure done, only 31 % of returning participants reported having had a CXR in the past year. None of the participants reported ever having a CXR compatible with TB which was consistent with the fact that none had ever been diagnosed with active pulmonary TB and with only 3.6% reporting close contact with a person with active TB in their lifetime. Although Mexico reports that 99% of popUlation is fully immunized against TB within the first year of age, only 85.3% of participants reported receiving BOC vaccine in childhood. Conversely, even when TST is not part of the routine TB screening in endemic countries, a suqDrisingly high 25.6% reported receiving a TST in the past. In regards to TB knowledge and awareness, 74% of the studied population had previous knowledge about (active) TB, 42% correctly identified active TB symptomatology, 4.8% identified the correct route of transmission, 4.8% knew about the existence of LTBI, 3.6% knew that latent TB could reactivate and 48% recognized TB as treatable and curable. Of all variables explored as potential risk factors for LTBI, age was the only one which showed statistical significance. Significant associations could not be proven for other known variables (such as sex, TB contact, history of TB) probably because of the small sample size and the homogeneity of the sample. Screening for LTBI by TST (high sensitivity) followed by confirmation with QFT''"'^ (high specificity) suggests to be a good strategy especially for immigrants from TB high-burden countries. After educational sessions, workers positive for LTBI gained greater knowledge about the signs and symptoms of TB reactivation as well as the risk factors commonly associated with reactivation. Additionally, they were more likely to attend their annual health check up and request a CXR exam to monitor for TB reactivation.

An exploratory study of nurses' perceptions of their action learning experience /

Each year, the College of Nurses of Ontario (CNO) requires all registered nurses and registered practical nurses in Ontario to complete a Reflective Practice learning activity. In doing so, nurses are expected to perform a self- assessment, identify a practice problem or issue, create and implement a personal learning plan, and evaluate the learning and outcomes accomplished. The process and components of CNO's Reflective Practice program are very similar to an Action Learning activity. The purpose of this qualitative research was to explore the perceptions of 1 1 nurses who completed at least 1 Action Learning activity. Data analysis of their comments provided insight into their perceptions of the Action Learning experience, perceptions of the negative and positive characteristics of various activities within the Action Learning process, and perceptions of barriers or challenges within this experience. The author concluded that participants perceived their Action Learning activities to be a positive experience because the process focused on practice problems and issues, enhanced thinking about practice problems, and achieved practice-relevant outcomes. However, the results indicated that self-directed learning and journal writing were difficult activities for some participants, and some experienced negative emotional responses during reflection. The research concluded that barriers to implementation of Action Learning include a lack of understanding of the process and a perceived lack of support from employers.

Hydraulic and fluvial geomorphological models for a bedrock channel reach of the Twenty Mile Creek /

Bedrock channels have been considered challenging geomorphic settings for the application of numerical models. Bedrock fluvial systems exhibit boundaries that are typically less mobile than alluvial systems, yet they are still dynamic systems with a high degree of spatial and temporal variability. To understand the variability of fluvial systems, numerical models have been developed to quantify flow magnitudes and patterns as the driving force for geomorphic change. Two types of numerical model were assessed for their efficacy in examining the bedrock channel system consisting of a high gradient portion of the Twenty Mile Creek in the Niagara Region of Ontario, Canada. A one-dimensional (1-D) flow model that utilizes energy equations, HEC RAS, was used to determine velocity distributions through the study reach for the mean annual flood (MAF), the 100-year return flood and the 1,000-year return flood. A two-dimensional (2-D) flow model that makes use of Navier-Stokes equations, RMA2, was created with the same objectives. The 2-D modeling effort was not successful due to the spatial complexity of the system (high slope and high variance). The successful 1 -D model runs were further extended using very high resolution geospatial interpolations inherent to the HEC RAS extension, HEC geoRAS. The modeled velocity data then formed the basis for the creation of a geomorphological analysis that focused upon large particles (boulders) and the forces needed to mobilize them. Several existing boulders were examined by collecting detailed measurements to derive three-dimensional physical models for the application of fluid and solid mechanics to predict movement in the study reach. An imaginary unit cuboid (1 metre by 1 metre by 1 metre) boulder was also envisioned to determine the general propensity for the movement of such a boulder through the bedrock system. The efforts and findings of this study provide a standardized means for the assessment of large particle movement in a bedrock fluvial system. Further efforts may expand upon this standardization by modeling differing boulder configurations (platy boulders, etc.) at a high level of resolution.

Armourstone revetments : will standard design criteria prevent failure? /

Bank stabilization structures are used to prevent the loss of valuable land within the urban environment and the decision for the type of structure used depends on the properties of the stream. In the urban areas of Southern Ontario there is a preference for the use of armourstone blocks as bank stabilization. The armourstone revetment is a free standing stone structure with large blocks of stone layered vertically and offset from one another. During fieldwork at Forty Mile Creek in Grimsby, Ontario armourstone failure was identified by the removal of two stones within one column from the wall. Since the footer stones were still in place, toe scour was eliminated as a cause of failure. Through theoretical, field, and experimental work the process of suction has been identified as a mode of failure for the armourstone wall and the process of suction works similarly to quarrying large blocks of rock off bedrock streambeds. The theory of lateral suction has previously not been taken into consideration for the design of these walls. The physical and hydraulic evidence found in the field and studied during experimental work indicate that the armourstone wall is vulnerable to the process of suction. The forces exerted by the flow and the resistance of the block determine the stability of the armourstone block within the wall. The design of the armourstone wall, high surface velocities, and short pulses of faster flowing water within the profile could contribute to armourstone failure by providing the forces needed for suction to occur, therefore adjustments to the design of the wall should be made in order to limit the effect.

The landscape of work engagement in brain injury rehabilitation /

This study examined work engagement among brain injury rehabilitation professionals with specific attention to how they engage with their work (the extent to which they experience vigor, dedication, and absorption while working) and how they engage with people (the degree to which they are welcoming towards others and demonstrate integrity, responsibility, transparency). This study also tested a theoretical model of work engagement that predicted a relationship between engagement and personal, interpersonal, and organizational capacity. Eighty-one staff employed in a hospital-based brain injury program participated in the study. A quantitative self-report survey was used to measure participants' levels of capacity and engagement and a qualitative question was included to identify initiatives that could be introduced to enhance job performance. As predicted by the model, there were statistically significant positive correlations among all three capacity variables and engagement with work and statistically significant positive correlations between ethical engagement and personal and interpersonal capacity. The results of the qualitative data analysis revealed three broad categories of recommendations for improving job performance (more learning opportunities, more resources to support professional development, and the need to build greater team cohesion). These findings provide initial support for a theoretical model that emphasizes the link between capacity and engagement, which could be used to guide theory-driven interventions aimed at improving the work environment.