The implications of being an international medical graduate (IMG) in Canadian society : a qualitative study of foreign-trained physicians' resettlement, sense of identity and health status

This qualitative research study used grounded theory methodology to explore the settlement experiences and changes in professional identity, self esteem and health status of foreign-trained physicians (FTPs) who resettled in Canada and were not able to practice their profession. Seventeen foreign-trained physicians completed a pre-survey and rated their health status, quality of life, self esteem and stress before and after coming to Canada. They also rated changes in their experiences of violence and trauma, inclusion and belonging, and racism and discrimination. Eight FTPs from the survey sample were interviewed in semi-structured qualitative interviews to explore their experiences with the loss of their professional medical identities and attempts to regain them during resettlement. This study found that without their medical license and identity, this group of FTPs could not fully restore their professional, social, and economic status and this affected their self esteem and health status. The core theme of the loss of professional identity and attempts to regain it while being underemployed were connected with the multifaceted challenges of resettlement which created experiences of lowered selfesteem, and increased stress, anxiety and depression. They identified the re-licensing process (cost, time, energy, few residency positions, and low success rate) as the major barrier to a full and successful settlement and re-establishment of their identities. Grounded research was used to develop General Resettlement Process Model and a Physician Re-licensing Model outlining the tasks and steps for the successfiil general resettlement of all newcomers to Canada with additional process steps to be accomplished by foreign-trained physicians. Maslow's Theory of Needs was expanded to include the re-establishment of professional identity for this group to re-establish levels of safety, security, belonging, self-esteem and self-actualization. Foreign-trained physicians had established prior professional medical identities, self-esteem, recognition, social status, purpose and meaning and bring needed human capital and skills to Canada. However, without identifying and addressing the barriers to their full inclusion in Canadian society, the health of this population may deteriorate and the health system of the host country may miss out on their needed contributions.

Collaborative learning in a Japanese as a foreign language classroom /

This study examined the influence of training on Asian learners' beliefs, interaction, and attitudes during collaborative learning (CL) and explored the processes of their CL in pairs. The literature contains few studies on the effect of collaborative training in language learning. In addition, it shows gaps between SLA theory and practice resulting from learners' cultural differences. Although second/subsequent language acquisition (SLA) theory assumes that CL contributes to language learning, implementing CL in a multicultural classroom is often considered to be unsuccessful by teachers. The research questions designed to address this gap explore: (a) the extent to which tra~ng affects Asian learners' attitudes towards and interaction during CL; (b) how Asian learners accomplish collaborative tasks in pairs. In the quasi-experimental research design, the learners in the treatment group received special training in CL for 5 weeks while the learners in the comparison group did not receive similar training. Data were collected from 45 McMaster University students through pre- and posttests, pre- and postintervention questionnaires, student information, and informal classroom observations. To detennine the influence of training, the frequency of communication units (c-units), Language Related Episodes (LREs), Collaborative Dialogue (CD) from audio-taped data, and the fmal draft scores were compared between pre- and posttests. The learners' pre- and postintervention questionnaires were also compared. Transcripts from audio-taped data, students' information, their responses and comments from questionnaires, and informal observations served to investigate the processes of Asian learners' CL. Overall, this study found that training had significant influence on the frequency of c-units and CD, and considerable impact on the draft scores, although little influence on the frequency of LREs was observed. The results from the questionnaires in the treatment group showed positive changes in the learners' beliefs on pair work after training. On the other hand, analyses of the transcription data showed that the learners did not conduct enough discussion for a resolution of problems with peers. In conclusion, results suggested the need for teacher intervention, a longer period of collaborative training, and an implementation of self-evaluation into the course grade to encourage the learners to succeed in collaborative learning.

Strategies for economic development in the Commonwealth Caribbean: a comparative study of the foreign economic policy strategies adopted by the Manley government in Jamaica and the Williams government in Trinidad and Tobago

This thesis compares the foreign economic poUcy dimension of the development strategies adopted by the governments of two Commonwealth caribbean countries: The Hardey government In Jamaica, and the· Williams government in Trlnidad and T ooago, The foreign economic policIes adopted by these governments appeared, on the surface~ to be markedly dissimilar. The Jamakan strategv on the one hand, emphasised self-reliance and national autonomy; and featured the espousal of radical oonaHgnment together with attempts to re-deftne the terms of the Islands externaa economIc relaUoos. The Trinidadian strategy 00 the other hand, featured Uberal externaUy-oriented growth poUctes, and close relatjoos with Western governments and financial institutions. Th1s study attempts to identify the explanatory factors that account for the apparent dlssimUarUy 1n the foreign economic policies of these two govemnents. The study is based on a comparison of how the structural bases of an underdeveloped ecooomYg and the foreign penetration and vulnerabUUy to external pressures asSOCiated wUh dependence, shape and influence foreign economic poUcy strategy. The framework views fore1gn ecooom1c strategy as an adaptive response on the part of the decision makers of a state to the coostralnts and opportunities provided by a particular situation. The · situat i 00' in this case being the events, conditions, structures and processes, associated wUh dependente and underdevelopment. The results indicate that the similarities and dissimHarities in the foreign economic policies of the governments of Jamaica and Trinidad were a reflecUon of the simHarities and dissimilarities in their respective situations. The conclusion derived suggests that If the foreign pol1cy field as an arena of choice, Is indeed one of opportunities and constraints for each and every state, then poHcy makers of smaU, weak, hlghW penetrated and vulnerable states enter thlS arena with constraints outweighing opportunities. This places effective limits 00 their decisional latitude and the range of policy options avaUable. Policy makers thus have to decide critical issues with few estabUshed precedents, in the face of domestic social and political cleavages, as wen as serious foreign pressures. This is a reflection not only of the trappings of dependence, but also of the Umned capabilities arising from the sman size of the state, and the Impact of the resource-gap In an underdeveloped economy. The Trinidadian strategy 1s UlustraUve of a development strategy made viable through a combination of a fortuitous circumstance, a confluence of the interests of influential groups» and accurate perception on the part of poUcy makers. These factors enabled policy makers to minimise some of the constraints of dependence. The faUure of Manlets strategy on the other hand, 15 iHustraUve of the problems involved tn the adoption of poUcles that work against the interest of internal and external political and economic forces. It is also tUustraUve of the consequences of the faUure 00 the part of policy makers to clarify goals, and to reconcile the values of rapid economic growth with increased self-reliance and national autonomy. These values tend to be mutuany Incompatible given the existing patterns of relations in the jnternational economy.

Enhancing teaching and learning speech acts: action research of Japanese as a foreign language /

This action research observes a second year Japanese class at a university where foreign language courses are elective for undergraduate students. In this study, using the six strategies to teach Japanese speech acts that Ishihara and Cohen (2006) suggested, I conducted three classes and analyzed my teaching practice with a critical friend. These strategies assist learners toward the development of their understanding of the following Japanese speech acts and also keep the learners to use them in a manner appropriate to the context: (I) invitation and refusal; (2) compliments; and (3) asking for a permission. The aim of this research is not only to improve my instruction in relation to second language (L2) pragmatic development, but also to raise further questions and to develop future research. The findings are analyzed and the data derived from my journals, artifacts, students' work, observation sheets, interviews with my critical friend, and pretests and posttests are coded and presented. The analysis shows that (I) after my critical friend encouraged my study and my students gave me some positive comments after each lesson, I gained confidence in teaching the suggested speech acts; (2) teaching involved explaining concepts and strategies, creating the visual material (a video) showing the strategies, and explaining the relationship between the strategy and grammatical forms and samples of misusing the forms; (3) students' background and learning styles influenced lessons; and (4) pretest and posttests showed that the students' Icvel of their L2 appropriate pragmatics dramatically improved after each instruction. However, after careful observation, it was noted that some factors prevented students from producing the correct output even though they understood the speech act differences.

Message from the President of the United States, transmitting copies of a letter from the British Secretary of State for Foreign Affairs, to the Secretary of State, with the answer of the latter.--

January 6, 1814. Ordered to lie on the table.

Foreign trained teachers : the emergence of the right to practise their profession in Ontario

The purpose of this thesis is to examine the impact of 2 recent legal events, specifically the Fair Access to Regulated Professions Act (2006) and Siadat v. Ontario College of Teachers (2007) decision, with regards to the opportunity of foreign trained teachers to practice their profession in Ontario. The emphasis is on the case of Fatima Siadat, who was a teacher in Iran but was unable to satisfy all the licensing requirements of the Ontario College of Teachers and consequently was unable to practise her profession in Ontario. When the Ontario College of Teachers Appeals Committee upheld the previous decision of the Ontario College of Teachers Registrar to refuse to issue her a teacher's certificate, Ms. Fatima Siadat decided to initiate a lawsuit. Ms. Fatima Siadat challenged the decision ofthe Ontario College of Teachers Appeals Committee by raising a question of applicability of human rights legislation (i.e., The Ontario Human Rights Code, 1990) on the Ontario College of Teachers' decisions. The Ontario Superior Court of Justice decided in January of2007 in favour of Ms. Fatima Siadat (Siadat v. Ontario College of Teachers , 2007) and ordered that her licensing application be reconsidered by the Ontario College of Teachers Appeals Committee. In this thesis the author argues that the Fatima Siadat decision, together with the Fair Access to Regulated Professions Act, 2006, will likely make a significant contribution to enhancing the access of foreign trained teachers and other professionals to practice their regulated professions in Ontario.

The Albion, or British, Colonial and Foreign Weekly Gazette Vol. 5, No. 18- May 2, 1846. Article on Major General Isaac Brock and the 41st Regiment on the second (reverse) page.

A weekly paper published from 1822 to 1856.

Message from the President of the United States, transmitting copies of a letter from the British Secretary of State for Foreign Affairs, to the Secretary of State, with the answer of the latter

January 6, 1814. Ordered to lie on the table. -------------------------------------------------------------------------------- At head of title: [22]. -------------------------------------------------------------------------------- 13th Congress, 2nd Session, House. Doc. 22. Printed by Roger C. Weightman

The Effects of Drama on Oral Fluency and Foreign Language Anxiety: An exploratory study

Previous research has suggested that drama has positive effects on learners' oral communication and anxiety; however, it is unclear which dimensions, or to what extent, they are affected by drama. This research narrows the investigation by examining how a drama-based EFL program impacts three dimensions of oral communication: fluency, comprehensibility, and accentedness, and one anxiety factor - foreign language speaking anxiety (FLSA) -, over time. Speech samples were collected from EFL learners in a treatment and a control group, and subsequently assessed by untrained Canadian-born raters. FLSA levels were measured through questionnaires and interviews. Pre- and post-test analysis indicate that learners in the treatment group made significant gains in oral fluency while oral fluency among learners in the control group remained unchanged. There was a significant reduction in FLSA levels among learners in both groups. Finally, qualitative analyses suggest that drama activities, among others, enhance learners' comfort levels in speaking English.

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.

[British Parliamentary papers], Session 24 November, 1812 - 22 July, 1813. Vol. XIV, Correspondence and treaties with foreign powers.

Most of this volume consists of correspondence between high ranking U.S. and British statesmen. E.g., James Madison, James Monroe, The Marquess Wellesley (brother of Arthur Wellesley, Duke of Wellington). The discussion centers around the War of 1812. Also includes facsimilies of treaties signed between Great Britain and Sweden, Russia and Sicily.

A DYNAMIC FRAMEWORK FOR THE RELATIONS BETWEEN FOREIGN EXCHANGE RATES, SAVINGS AND INVESTMENTS

The Meese-Rogoff forecasting puzzle states that foreign exchange (FX) rates are unpredictable. Since one country’s macroeconomic conditions could affect the price of its national currency, we study the dynamic relations between the FX rates and some macroeconomic accounts. Our research tests whether the predictability of the FX rates could be improved through the advanced econometrics. Improving the predictability of the FX rates has important implications for various groups including investors, business entities and the government. The present thesis examines the dynamic relations between the FX rates, savings and investments for a sample of 25 countries from the Organization for Economic Cooperation and Development. We apply quarterly data of FX rates, macroeconomic indices and accounts including the savings and the investments over three decades. Through preliminary Augmented Dickey-Fuller unit root tests and Johansen cointegration tests, we found that the savings rate and the investment rate are cointegrated with the vector (1,-1). This result is consistent with many previous studies on the savings-investment relations and therefore confirms the validity of the Feldstein-Horioka puzzle. Because of the special cointegrating relation between the savings rate and investment rate, we introduce the savings-investment rate differential (SID). Investigating each country through a vector autoregression (VAR) model, we observe extremely insignificant coefficient estimates of the historical SIDs upon the present FX rates. We also report similar findings through the panel VAR approach. We thus conclude that the historical SIDs are useless in forecasting the FX rate. Nonetheless, the coefficients of the past FX rates upon the current SIDs for both the country-specific and the panel VAR models are statistically significant. Therefore, we conclude that the historical FX rates can conversely predict the SID to some degree. Specifically, depreciation in the domestic currency would cause the increase in the SID.

A Narrative Study of Patient Encounter Accounts of Physicians, Nurses, and Medical Receptionists after Two Decades of a Paradigm of Patient-Centered Care

Despite recent well-known advancements in patient care in the medical fields, such as patient-centeredness and evidence-based medicine and practice, there is rather less known about their effects on the particulars of clinician-patient encounters. The emphasis in clinical encounters remains mostly on treatment and diagnosis and less on communicative competency or engagement for medical professionals. The purpose of this narrative study was to explore interactive competencies in diagnostic and therapeutic encounters and intake protocols within the context of the physicians’, nurses’, and medical receptionists’ perspectives and experiences. Literature on narrative medicine, phenomenology and medicine, therapeutic relationships, cultural and communication competency, and non-Western perspectives on human communication provided the guiding theoretical frameworks for the study. Three data sets including 13 participant interviews (5 physicians, 4 nurses, and 4 medical receptionists), policy documents (physicians, nurses, and medical receptionists) and a website (Communication and Cultural Competency) were used. The researcher then engaged in triangulated analyses, including N-Vivo, manifest and latent, Mishler’s (1984, 1995) narrative elements and Charon’s (2005, 2006a, 2006b, 2013) narrative themes, in recursive, overlapping, comparative and intersected analysis strategies. A common factor affecting physicians’ relationships with their clients was limitation of time, including limited time (a) to listen, (b) to come up with a proper diagnosis, and (c) to engage in decision making in critical conditions and limited time for patients’ visits. For almost all nurse participants in the study establishing therapeutic relationships meant being compassionate and empathetic. The goals of intake protocols for the medical receptionists were about being empathetic to patients, being an attentive listener, developing rapport, and being conventionally polite to patients. Participants with the least iv amount of training and preparation (medical receptionists) appeared to be more committed to working narratively in connecting with patients and establishing human relationships as well as in listening to patients’ stories and providing support to narrow down the reason for their visit. The diagnostic and intake “success stories” regarding patient clinical encounters for other study participants were focused on a timely securing of patient information, with some acknowledgement of rapport and emapathy. Patient-centeredness emerged as a discourse practice, with ambiguous or nebulous enactment of its premises in most clinical settings.

Macroeconomic News Effects and Foreign Exchange Jumps

This thesis investigates how macroeconomic news announcements affect jumps and cojumps in foreign exchange markets, especially under different business cycles. We use 5-min interval from high frequency data on Euro/Dollar, Pound/Dollar and Yen/Dollar from Nov. 1, 2004 to Feb. 28, 2015. The jump detection method was proposed by Andersen et al. (2007c), Lee & Mykland (2008) and then modified by Boudt et al. (2011a) for robustness. Then we apply the two-regime smooth transition regression model of Teräsvirta (1994) to explore news effects under different business cycles. We find that scheduled news related to employment, real activity, forward expectations, monetary policy, current account, price and consumption influences forex jumps, but only FOMC Rate Decisions has consistent effects on cojumps. Speeches given by major central bank officials near a crisis also significantly affect jumps and cojumps. However, the impacts of some macroeconomic news are not the same under different economic states.

Macroeconomic News and LOB in Foreign Exchange ECN Market

We investigate the macroeconomic news effect on the dynamics of the limit order books (LOB) for euro-dollar ECN market in different economic states between Jan. 2006 to Dec. 2009. Using a VAR-STR model on the news surprise, pure news, aggregated good and bad news, we show that news effects on the LOB dynamics vary in different states of economy. The LOB dynamics are measured by depth, spread, slope and volatility. In contract to slope and volatility, depth and spread strongly respond to news surprise and pure news during recession and expansion. These characteristics are more affected by aggregated good and bad news during expansion. News effects are robust to alternative characteristic measures, the different sides of the LOB and the different levels in the LOB.