Using Poetry, Story, and Reflection to Understand Professional Self After Personal Loss

This research investigated professional identity transformation after personal loss. Through autoethnographic methods, I explore how my personal experience of my sister’s breast cancer and death affected my identity as a diabetes educator in the health culture. I discover a transformation of a professional who focuses on evidence-based medicine to a professional who values connection, therapeutic alliance, and mindfulness with patients and self in the diabetes education encounter. Using a holistic perspective on transformational learning, I integrate the poem “Wild Geese” to a collection of written narratives to connect my personal loss experience to my professional life. By unpacking the generated stories and using poetry, I conduct a process of critical and self-reflection to discover how my identity as a health professional has transformed and what makes meaning in my role as a diabetes educator in the health culture. I consider concepts of a conscious self, social relations and language and discover themes of knowledge exchange, food, and empathy as forms of language expression. These language expressions are not present in my professional life as I focus on rational, logical facts of evidence-based medicine and standardized education methods. Through this reflexive process, I hope to understand how my professional practice has changed, where I place an importance on connection, therapeutic alliance, and mindfulness. I move away from always “doing” in my professional life to focus on my state of “being” in my professional world. Rather than knowledge acquisition as the only factor in professional development, this study contributes to an understanding of additional qualities health professionals may consider that focus on the patient education encounter.

Deconstructing Evidence-Based Practice and Its Application in Children to with Mental Health Disorders

This is a mixed methodology study that uses an autoethnographic approach to combine both an autobiography and a survey of practitioners who work in children’s mental health. It is largely about the implementation of Evidence-Based Practice (EBP), and the questions, concerns, experiences that I have had, and compared them with those of my fellow practitioners. In addition, it is about my journey as a mental health professional, and how I have come to recognize that in order to achieve the goals I wanted to achieve, I needed to return to university to pursue a Master’s degree. Within the research, I identify and discuss different definitions of EBP and identify several themes. I deconstruct the implementation of EBPs through the lens of Foucault and his notions of governmentality. I offer policy and practice recommendations to improve the implementation of EBP and the services received by children facing mental health issues.

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.

Attenuation of skeletal muscle FFA-induced insulin resistance by the polyphenol resveratrol. Elucidation of the mechanisms involved

Excess plasma free fatty acids (FFA) are correlated with insulin resistance and are a risk factor for the development of type 2 diabetes. In this study we examined the effect of the polyphenol resveratrol on FF A-induced insulin resistance in skeletal muscle cells and the mechanisms involved. Incubation of L6 myotubes with the FF A palmitate significantly decreased the insulin-stimulated glucqse uptake. Importantly, the effect of palmitate was ameliorated by resveratrol. Palmitate significantly increased serine phosphorylation of IRS..; 1 and reduced insulin-stimulated Akt phosphorylation, an effect that was abolished by resveratrol. We then investigated the effect of palmitate and resveratrol on the expression and phosphorylation of JNK, mTOR, p70-S6K, and AMPK kinases. The results demonstrated that our treatments had no effect on the expression of these proteins. However, palmitate increased the phosphorylation of mTOR and p70- S6K, whereas resveratrol abolished this effect and increased the phosphorylation of AMPK. Furthermore, all effects of resveratrol were abolished with sirtuin inhibitors, sirtinol and nicotinamide. These results indicate that resveratrol ameliorated FF A-induced insulin resistance by regulating mTOR and p70-S6K phosphorylation in skeletal muscle cells, through a mechanism involving sirtuins.

Understanding the Cultural Health Beliefs in Diabetes Education Amongst the Aboriginal Population within a City in the Southern Region of Ontario

This study examined the cultural health beliefs in diabetes education amongst the Aboriginal population within a city in Southern Ontario. The purpose was to contribute to the development of a culturally relevant diabetes handbook as well as to delivery styles within current diabetes education programs. To this end, a focus group was conducted with Aboriginal men and women between the ages of 18-70 years with type 2 diabetes. Participants were recruited from 2 Aboriginal community centres and an Aboriginal health centre in a city in Southern Ontario. Themes were drawn from the analysis of the focus group transcripts and combined with the findings from the research literature. The major themes that merged were drawn from Eurocentric and Aboriginal theories. The results were a set of recommendations on the type of format for diabetes educational programs such as traditional group activities, variety of electronic format, and culture specific educational resources. The emergent results appear to provide some important insights into program planning for diabetes education centres within Aboriginal communities.