Families of the traumatically brian-injured : a case study approach to perceptions of quality of service, degree of satisfaction, and family needs /

The purpose of this qualitative research study was to foster an understanding of the rehabilitation counselling practice offamilies of the brain-injured. Specifically, the study explores the perceptions of stakeholders in regards to the degree of satisfaction with the quality of service received. Questionnaires were administered, and semi-structured, openended interviews were conducted, with six participating families (n=8). Preliminary data were collected via two instruments: (i) the Family Participant Questionnaire, consisting of participants' sample characteristics, information pertaining to the history of the family, details of the injury, and information relating to the type, use, and need offamily services utilized; and (ii) the Community Integration Questionnaire, a measurement of the degree of social displacementllevel of community integration of the injured family member. Utilizing the procedural steps outlined by Colaizzi's (1978) method of protocol analysis, recommendations for a future program based on related and current family needs are discussed in detail. Substantiating and supporting information are offered to rehabilitation practitioners, educational planners, and policymakers alike, concerning the degree of satisfaction with rehabilitative service, and the means of improving upon the overall quality of health care to families of the brain-injured. Implications for clinical practice and research are also raised for discussion.

The Effectiveness of Learning Portfolios: A Study of Quality Assurance Programs of Selected Health Regulatory Colleges in Ontario

Health regulatory colleges promote quality practice and continued competence through Quality Assurance (QA) programs. For many colleges, a QA program includes the use of portfolios that incorporate self-directed learning. The purpose of this study was to determine some of the issues surrounding the effectiveness of QA portfolio programs. The literature review revealed that portfolios are valuable tools, but gaps in knowledge include a comparative analysis of QA programs and the perspective of regulatory college administrators. Data were collected through interviews with 6 administrators and a review of 14 portfolio models described on college websites. The results from the two data sources were applied to Robert Stake's responsive evaluation framework to identify issues related to the portfolio's effectiveness (Stake, 1967). The learning components of portfolios were analyzed through the humanist and constructivist lenses. All 14 portfolio models were found to have 3 main components: self-diagnosis, learning plan and activities, and self-evaluation. However, differences were uncovered in learners' autonomy in selecting learning activities, methods of portfolio evaluation, and the relationship between the portfolio and other QA components. The results revealed a dual philosophy of learning in portfolio models and an apparent contradiction between the needs of the individual learner and the organization. Paths for future research include the tenuous relationship between competence and learning, and the impact of technical approaches on selfdirected learning initiatives. A key recommendation is to acknowledge the unique identity of each profession so that health regulatory colleges can address legislative demands and learner needs.

Examining Predictors of Quality of Life of Adults with Intellectual Disabilities After Deinstitutionalization

This study examined if a person’s quality of life could be predicted by six relevant factors in a sample of 114 individuals with intellectual disability who had moved from institutional settings to community living settings within Ontario. Further, two aspects of self-efficacy were tested to see if they moderated the relationship between the possible predictors and the quality of life indicator. The initial multiple regression model accounted for a very small amount of the variance in the outcome (r2 = .08). The second analysis included decision-making as a predictor (r2 = .35) but did not find it to be moderator. The third analysis used opportunities for change as a predictor (r2 = .28), and as a moderator with two significant interaction terms, health and years in an institutional setting (r2 = .35). These findings support the often-theorized influence of self-efficacy on quality of life for individuals with intellectual disability.

Conceptions of Quality and Approaches to Quality Assurance in Ontario’s Universities

Many international, political, and economic influences led to increased demands for development of new quality assurance systems for universities. Like many policies and processes that aim to assure quality, Ontario’s Quality Assurance Framework (QAF) did not define quality. This study sought to explore conceptions of quality and approaches to quality assurance used within Ontario’s universities. A document analysis of the QAF’s rationale and structure suggested that quality was conceived primarily as fitness for purpose, while suggested indicators represented an exceptional conception of quality. Ontario universities perpetuated such confusion by adopting the framework without customizing it to their institutional conceptions of quality. Drawing upon phenomenographic traditions, a qualitative investigation was conducted to better understand various conceptions of quality held by university administrators and to appreciate ways in which they implemented the QAF. Three main approaches to quality assurance were identified: (a) Defending Quality, characterized by conceptions of quality as exceptional, which focuses on administrative accountability and uses a hands-off strategy to defend traditional notions of quality inputs and resources; (b) Demonstrating Quality, characterized by conceptions of quality as fitness for purpose and value for money, which focuses on accountability to students and uses centralized engaged strategies to demonstrate how programs meet current priorities and intended outcomes; and (c) Enhancing Quality, characterized by conceptions of quality as transformation, which focuses on reflection and learning experience and uses engaged strategies to find new ways of improving learning and teaching. The development of a campus culture that values the institution’s function in student learning and quality teaching would benefit from Enhancing Quality approaches to quality assurance. This would require holistic consideration of the beliefs held by members of the institution, a clear articulation of the institution’s conceptions of quality, and a critical analysis of how these conceptions align with institutional practices and policies.

Moderators of the Relationship between Family Caregiver Proxy-Ratings and Person with Dementia Self-Ratings of Quality of Life

As the dementia spectrum lacks any viable cure, quality of life is typically regarded as an essential measure of assessing the clinical course and evaluating interventions. With caregivers typically providing this rating to health professionals, the literature has noted inconsistencies between caregiver and person with dementia (PwD) ratings of quality of life and suggested several factors may moderate the rating relationship. To investigate this, an intraclass correlation coefficient was calculated to observe rating agreement and moderator regression analysis was conducted to explore potential moderators. Potential moderators of caregiver burden, caregiver age, caregiver income, PwD IADLs/ADLs, PwD education, PwD cognitive impairment, PwD depressive symptom severity, PwD behavioural symptom severity, as well as relationship between caregiver and PwD. Utilizing secondary data from 107 recruited dyads, analyses conducted found fair agreement between caregivers and those with dementia while none of the hypothesized factors were found to moderate the rating relationship.

Handwritten sheet of paper detailing the cost of transporting boxes containing the Gravatt’s level

Handwritten sheet of paper detailing the cost of transporting boxes containing the Gravatt’s level from London to St. Catharines, April 1847.

Handwritten sheet of paper detailing the cost of transporting boxes containing the Gravatt’s level

Handwritten sheet of paper detailing the cost of transporting boxes containing the Gravatt’s level from London to St. Catharines. This sheet is signed by S.D. Woodruff, Jan. 11, 1847.

Approximate cost of completing the railway from Port Dalhousie to St. Catharines and an estimate of the cost of the piers at Port Dalhousie signed by William Hamilton Merritt

Approximate cost of completing the railway from Port Dalhousie to St. Catharines and an estimate of the cost of the piers at Port Dalhousie signed by William Hamilton Merritt (5 pages, handwritten), July 8, 1854.

Approximate estimate of the cost of completing the Port Dalhousie Railway to the Grand Central Railway Station at Lock 12

Approximate estimate of the cost of completing the Port Dalhousie Railway to the Grand Central Railway Station at Lock 12. This document is badly torn and burned but most of the text is legible, July 14, 1854.

Estimated cost of the Port Dalhousie and Thorold Railway sent to George Rykert by S.D. Woodruff

Estimated cost of the Port Dalhousie and Thorold Railway sent to George Rykert by S.D. Woodruff, Aug. 5, 1854.

Approximate estimate of the cost of constructing and completing the Port Dalhousie and Thorold Railway to St. Catharines

Approximate estimate of the cost of constructing and completing the Port Dalhousie and Thorold Railway to St. Catharines signed by S.D. Woodruff (2 pages, handwritten), Jan. 8, 1855.

Cost of the railway from Port Dalhousie to St. Catharines

Cost of the railway from Port Dalhousie to St. Catharines (1 page, handwritten), Jan. 11, 1855.

Approximate estimate of the cost of extending the Port Dalhousie and Thorold Railway from Geneva Street to the Great Western Railway Station at Lock no. 12

Approximate estimate of the cost of extending the Port Dalhousie and Thorold Railway from Geneva Street to the Great Western Railway Station at Lock no. 12 (2 copies) [one appears to be a rough copy] (2 pages, handwritten), Feb. 2, 1855.

Letter of estimate sent to S.D. Woodruff for the total cost of construction and equipment of the extension of the line to Port Colborne

Letter of estimate sent to S.D. Woodruff for the total cost of construction and equipment of the extension of the line to Port Colborne [this is unsigned]. There is an envelope with this letter that suggests that it is from Mr. Shanly, Mar. 12, 1857.

Chart of estimate of cost of Port Dalhousie and Thorold Railway extension Line no. 1

Chart of estimate of cost of Port Dalhousie and Thorold Railway extension Line no. 1 signed by Mr. Shanly, Mar. 12, 1857.