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.

Comprehensive school health, the social determinants of health, and the health status of children

As children are becoming increasingly inactive and obese, there is an urgent need for effective early prevention and intervention programs. One solution is a comprehensive school health (CSH) program, a health promotion initiative aimed at educating students about healthy behaviours and lifestyles, which also provides a link between the school, students, families, and the surrounding community. The purpose of this study was to explore the relationship between different components of CSH programs, as well as three determinants of health (gender, social support, socio-economic status), and physical activity, on the aerobic fitness and body mass index (BMI) of children. A newly developed and pilot-tested survey derived from Health Canada's fourpart CSH model (instruction, social support, support services, and a healthy physical environment) was sent to elementary school principals. Data on the gender, physical activity, parental education, and social support levels of students from these schools were gathered from a previous study. Multiple regression procedures were conducted to estimate the relationships between CSH components, the social determinants of health, physical activity, and BMI and aerobic fitness. Results showed that three CSH components were significantly associated with both BMI and aerobic fitness values in children, but accounted for less than 5% of the variance in both variables. Physical activity partially mediated the relationship between the significant CSH components, BMI, and particularly aerobic fitness. Furthermore, the social determinant and physical activity variables played independent roles in aerobic fitness values. No moderating effects of the social determinants were discovered.

"I might be a duck, but I'm human" : an analysis of clothing in Disney cartoons

Mickey Mouse, one of the world's most recognizable cartoon characters, did not wear a shirt in his earliest incarnation in theatrical shorts and, for many years, Donald Duck did not wear pants and still rarely does so. Especially when one considers the era in which these figures were first created by the Walt Disney Studio, in the 1920s and 1930s, why are they portrayed without full clothing? The obvious answer, of course, is that they are animals, and animals do not wear clothes. But these are no ordinary animals: in most cases, they do wear clothing - some clothing, at least - and they walk on two legs, talk in a more or less intelligible fashion, and display a number of other anthropomorphic traits. If they are essentially animals, why do they wear clothing at all? On the other hand, if these characters are more human than animal, as suggested by other behavioral traits - they walk, talk, work, read, and so on - why are they not more often fully clothed? To answer these questions I undertook three major research strategies used to gather evidence: interpretive textual analysis of 321 cartoons; secondary analysis of interviews conducted with the animators who created the Disney characters; and historical and archival research on the Disney Company and on the times and context in which it functioned. I was able to identify five themes that played a large part in what kind of clothing a character wore; first, the character's gender and/or sexuality; second, what species or "race" the character was; third, the character's socio-economic status; fourth, the degree to which the character was anthropomorphized; and, fifth, the context in which the character and its clothing appeared in a particular scene or narrative. I concluded that all of these factors played a part in determining, to some extent, the clothing worn by particular characters at particular times. However, certain patterns emerged from the analysis that could not be explained by these factors alone or in combination. Therefore, my analysis also investigates the individual and collective attitudes and desires of the men in the Disney studio who were responsible for creating these characters and the cultural conditions under which they were created. Drawing on literature from the psychoanalytic approach to film studies, I argue that the clothing choices spoke to an idealized fantasy world to which the animators (most importantly, Walt Disney himself), and possibly wider society, wanted to return.

Predicting Physical, Verbal, Social, Racial, and Sexual Bullying with Individual and Environmental Factors from an Evolutionary Ecological Framework

Evidence exists for subtypes of bullying, but there is a lack of studies simultaneously investigating the factors that influence each subtype. The purpose of my thesis was to investigate how individual and environmental factors independently and interactively predict physical, verbal, social, racial, and sexual bullying using an evolutionary ecological framework. Adolescents (N = 225, M = 14.05, SD = 1.54) completed self-reports on demographics, HEXACO personality, Rothbart’s temperament, parenting, friendship quality, school connectedness, and socio-economic status. Subtypes were predicted by low Honesty-Humility in addition to other personality and demographic factors with the exception of physical bullying, which was predicted by environmental factors. Results suggest adolescents adaptively and selectively use bullying to exploit victims and obtain resources, although the subtype used may depend on individual factors bullies possess within Bronfenbrenner’s microsystem, instead of the meso- and exo- systems. Anti-bullying efforts should target these factors and reinforce alternative strategies to obtain resources.

Self-reported health status and lifestyle behaviours of the residents of the Town of Fort Erie, Ontario, as related to the Canadian Community Health Survey

The purpose of this cross sectional survey design was to examine self-reported health status and lifestyle behaviours of the residents of the Town of Fort Erie, Ontario, as related to the Canadian Community Health Survey. Using a mail-out survey, entitled the Fort Erie Survey of Health (FESH), a probability cluster sampling technique was used to measure self-reported health status (present health, health conditions, health challenges, functional health limitations) and lifestyle behaviour (smoking, alcohol use, drug use, physical activity, fruit and vegetable consumption, body weight, and gaming). Each variable was described and analyzed in relation to socio-economic variables, age and gender. The findings from this study were compared to the Canadian Community Health Survey 2000/2001. Overall, 640 surveys were completed. The majority of Fort Erie residents rated their present health as good and were satisfied with their overall health and quality of life. The main chronic conditions reported were arthritis, back pain and heart disease. Other main health problems reported were vision, sleeping and chronic pain. Overall, 14.6% smoke; 58.8% engaged in physical activity either occasionally or never as opposed to regularly engaging in physical activity; 52.1% did not eat the required daily fruits and vegetables; and 40.0% were in the overweight category. Persons who practiced one healthy lifestyle behaviour were more likely to practice other healthy promoting behaviours. Therefore, health promotion programs are best designed to address multiple risk factors simultaneously. The ffiSH was generally consistent with the Canadian Community Health Survey in the overall findings. A small number of inconsistencies were identified that require further exploration to determine if they are unique to this community.