The Hybrid Approach for Palliation of Hypoplastic Left Heart Syndrome: Intermediate Results of a Single-Center Experience

INTRODUCTION: Hypoplastic left heart syndrome (HLHS) is a major cause of cardiac death during the first week of life. The hybrid approach is a reliable, reproducible treatment option for patients with HLHS. Herein we report our results using this approach, focusing on its efficacy, safety and late outcome. METHODS: We reviewed prospectively collected data on patients treated for HLHS using a hybrid approach between July 2007 and September 2014. RESULTS: Nine patients had a stage 1 hybrid procedure, with seven undergoing a comprehensive stage 2 procedure. One patient completed the Fontan procedure. Five patients underwent balloon atrial septostomy after the hybrid procedure; in three patients, a stent was placed across the atrial septum. There were three deaths: two early after the hybrid procedure and one early after stage two palliation. Overall survival was 66%. CONCLUSIONS: In our single-center series, the hybrid approach for HLHS yields intermediate results comparable to those of the Norwood strategy. The existence of dedicated teams for the diagnosis and management of these patients, preferably in high-volume centers, is of major importance in this condition.

Use of multi-sensory marketing techniques and its influence on brand experience in retail and HORECA sector

Double degree. A Work Project presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA- School of Business and Economics and Warsaw School of Economics

The lived experience of women with recurrent ovarian cancer /

The purpose of this study was to understand the Hved experience of 6 women with recurrent ovarian cancer. Six women were interviewed 2-20 weeks after the recurrence of their ovarian cancer. Interview questions focused on the meaning of the recurrence and their communication with others. Women were asked about the information and support that they felt they needed at that time, van Manen's method of reflection and writing guided the inquiry. Analysis of the data revealed the themes of: my cancer is back; it means that I will die; talking about it; we are people, we are not a disease; information; and life has changed/life hasn't changed. This study revealed the perspectives of these 6 women with recurrent ovarian cancer. It provided an understanding and knowledge about the lives of these women. Future research should explore the experiences of a larger group of women with recurrent ovarian cancer in order to address their unique needs.

A qualitative narrative inquiry of the experience of accessing community supports among women who have experienced trauma

Abuse related trauma can have serious consequences on individuals' health and their state of well-being and may result in decreased access to different determinants of health. The purpose of this qualitative narrative inquiry using secondary data was to explore the experience of accessing community supports among eight women who had experienced abuse-related trauma. A conceptual framework drawn from the literature on social inclusion and social exclusion and a narrative inquiry method were used to explore epiphanies, customs, routines, images, and everyday experiences (Clandinin & Connelly, 2000) among the women. A Three-Dimensional Space Narrative Structure was used to explore the participants' personal or internal conditions, feelings, hopes and reaction as well as their social experiences in interaction with others in community. The participants described experiencing the impact of trauma in their past and present circumstances, a lack of accommodation of difference, challenges in maintaining a sense of self in a world of assumption and labels, impact of trauma on the determinants of health, and uncertainty about the future. The findings from the study demonstrate experiences of social exclusion among the participants in the past, further isolation and social exclusion in the present when personal life issues were ignored by community support services, and uncertainty about what the future will bring for them. The findings indicate close relationships between the women's personal lives and their social connections which need to be considered to mitigate social exclusion and enhance social inclusion.

A journey into narrative inquiry : one teacher's lived experience with eating disorders /

In "A Journey Into Narrative Inquiry: One Teacher's Lived Experience With Eating Disorders," an elementary teacher searches for answers regarding how education can help prevent eating disorders by journeying into her own experience of having had such a disorder. This qualitative study is a personal narrative based on an individual's experience, a method appropriate to the sharing of personal voices and stories told in education research. It is an attempt to address the gap found in the research on this topic by offering a subjective and unique perspective of what it is like to live within the nightmare of an eating disorder and by sharing the wisdom gained from having survived such an experience. This narrative inquiry explains how a teacher found herself at a stage where she was willing and ready to share her experience for the sake of research. The story of having had an eating disorder, consisting of both anorexia and bulimia, for over a decade is shared in a genuine, reflective manner. The researcher then shares the analysis of her own story, unpacking the themes of journeying toward voice, self-esteem, self-acceptance, and self and the completion of an M.Ed. degree. Bridges are made which connect these themes to the personal and professional life of the researcher, to the schools in terms of both curriculum and climate, to research directions, and to the larger culture. Suggestions are made for possible changes in educational settings that may help teachers in providing students with some tools and strategies to prevent turning to eating disorders as coping mechanisms. A literature review of eating disorders is included as well, as a guide for others to use when undertaking such qualitative studies.

Experiences with cultural capital in education : exploring the educational life stories of first-generation postsecondary students

This study used a life history research design to explore first-generation university students' educational life stories and experiences with cultural capital. The project sought to examine how 3 first-generation university students experience cultural capital that is privileged in Ontario's education system and how the interactions between capital acquired through experiences within the home and school and capital privileged by the education system affect these students' educational experiences and perceptions. Using Pierre Bourdieu's (1984; 1986) theory of cultural capital as a framework, 3 firstgeneration, first-year university students participated in two 1- to 2-hour interviews. A focus on each participant's experiences with culture, capital, and education revealed themes corresponding to navigating, utilizing, and confronting familial, institutional, economic, and embodied forms of cultural capital. The study highlights the importance of recognizing how cultural capital influences the education system and how firstgeneration students can recreate normative pathways and achieve academic success despite challenges posed by the cultural capital privileged within the education system. Given cultural capital's effect on academic success, understanding first-generation students' educational life stories sheds light on the complex challenges facing students who confront and deal with privileged culture in the education system.

Developing Life Skills through Physical Activity: A Teaching Personal and Social Responsibility Model Approach

Ethnographic methods were used to study a weekly after-school physical activity program over an eight-month period. Based on Hellison’s Teaching Personal and Social Responsibility (TPSR) model, the program sought to foster positive life skills amongst youth. The study investigated how the developed program influenced this life skills education experience. Several themes were identified from the data revolving around culture, life skills, pedagogy, and lessons learned. Data suggests that the positive environment developed within the program positively influenced youths’ life skill education experience. The topic of ethnicity as it relates to the experience of marginalized youth in physical activity settings is also discussed. This study supports TPSR literature and suggests that effort to establish caring relationships and empower youth contribute to the establishment of a positive atmosphere where life skills education can occur. Beyond this, practical tools were developed through this study to help others deliver life skill education.

Utilizing a Phenomenological Approach to Examine the Experience of Sexuality for Women Concerned about Urinary Incontinence following Spinal Cord Injury

Sexuality after spinal cord injury (SCI) is a complex issue that is influenced by a number of social, psychological and physiological factors, one of which is urinary incontinence (UI). Using a phenomenological approach, seven mixed methods interviews combining both the interview guide and standardized open-ended approaches were conducted to examine the experience of sexuality for women who are concerned about UI following SCI. Sexual function was one of the top priorities for the women after SCI, and UI was one of the main concerns the women had regarding sexuality. The findings of this study demonstrate that various dimensions of intimacy and the sexual experience as a whole were affected by UI, and the women discussed both physical and psychological concerns. The main issues regarding sexuality included concerns related to relationships, frustrations with limited sexual activities and the difficulty of being sexually satisfied, the number of unanswered questions and concerns, and a fear of being hurt or injured while participating in sexual activities. The main concerns regarding UI were embarrassment, the work and inconvenience involved with the clean-up of UI, bladder infections, the lack of accessible washrooms, and the negative effects of UI medications. When examining sexuality and UI together, the major issues were the constant comparison to the way things were before SCI, as well as the new concerns that the women did not have to worry about previously, worrying about how their partner would react if UI were to occur during sexual activity, and the impact of their own feelings toward UI on sexuality, a connection between pleasurable sexual sensations and UI as well as difficulty differentiating between the sensation of UI with the sensation of UI, dealing with infected urine during sexual activity, having to discuss UI with a new potential sexual partner, and a fear of rejection. Other identified issues included those related to body image, a lack of resources, Doctors who were inadequately educated regarding SCI, and issues related to both having and raising children. There is a significant shortage of information available for women with SCI to use as a resource regarding sexual function in general, and sexual function as it relates to UI. It is necessary that future work focus on creating resources to assist in this area, and that the dissemination of those resources becomes both appropriate and effective. Addressing sexual function and UI which are among the top concerns for this population has the opportunity to greatly improve quality of life (QOL) for these individuals.

Developing an Understanding of Cultural Diversity: How an Experience Living in a Multicultural Nation and an Experience Teaching Abroad Contribute to Southern Ontario Teachers' Identities

This is a narrative design study focusing on the understandings that a group of 6 Southern Ontario teachers have of cultural diversity and how these understandings integrated into their development of teacher identity. Given the high culturally diverse population of Canada and its national multicultural values, conducting this study on Canadian pre-service and in-service teachers offers an interesting contribution to the field. In efforts to explore the participants’ understandings, the research examined a teaching abroad experience. The aim was to investigate how these participants gained insight from their experiences with cultural diversity and whether these insights stimulated a greater culturally conscious teacher identity. Narratives provided a description of the lived experiences of these 6 teachers and identified meanings made from these experiences. Participants included 2 pre-service teachers who were in a teacher education program at the time of the interview, and 4 certified teachers who graduated from a teacher education program within the past 5 years. One on one interviews focused on lived experiences within a participant’s home, school community, and teaching abroad. The researcher used grounded theory during the data analysis to assist in identifying themes, and then compared these themes among participants. Overall, this study suggests that even though these participants live in a multicultural nation, experiences varied greatly based on contributing factors such as heritage and exposure to cultural diversity through their home and school life. Despite their varying level of cultural competence, all participants gained insight from their teaching abroad experience, contributing to a teacher identity that considered inclusive practices. This study suggests that there are some important factors to consider when preparing teachers to teach in a multicultural society.

A Mind of its Own: The Lived Experience of Adult Students who are ADHD

Despite the growing trend towards recognizing that attention deficit hyperactive disorder occurs beyond childhood, the experience of adult students who are ADHD remains little researched or understood. Given the losses in efficiency and productivity in academic performance from adult ADHD, researching ADHD’s experiential aspects is significant for both educators and students in its potential to develop better strategies for accommodating those with the disorder. This study used hermeneutic phenomenology and existential psychology to describe the lived experience of adult students who are ADHD. Five adult students participated in the study, which involved two in-depth conversations with guiding questions such as: What is it like to be ADHD?; and What led to your perception that you have ADHD? Conversations were transcribed and thematic statements developed, using the life-world existentials of lived space, lived time, lived relationships and lived corporeality to deepen considerations of meaning.

Flourishing in the face of mental illness: A heuristic examination of the contribution of leisure to creating a meaningful life

The purpose of this research was to examine the ways in which individuals with mental illness create a life of purpose, satisfaction and meaning. The data supported the identification of four common themes: (1) the power of leisure in activation, (2) the power of leisure in resiliency, (3) the power of leisure in identity and (4) the power of leisure in reducing struggle. Through an exploration of the experience of having a mental illness, this project supports that leisure provides therapeutic benefits that transcend through negative life events. In addition, this project highlights the individual nature of recovery as a process of self-discovery. Through the creation of a visual model, this project provides a benchmark for how a small group of individuals have experienced living well with mental illness. As such, this work brings new thought to the growing body of mental health and leisure studies literature.

Informing the structure of subjective well-being through examining changes in life satisfaction, positive affect, and negative affect

Subjective well-being (SWB) refers to how individuals evaluate and experience their lives in positive ways, and encompasses global judgments of life satisfaction (LS), as well as the frequency of positive and negative affect (PA and NA, respectively) in one’s life. To inform the current ambiguity concerning the structure of SWB, the aim of this Masters thesis was to evaluate the structure of SWB based on whether the three components of SWB change together or independently naturally, over time and following experimental manipulation. In Study 1, associations among changes in LS, PA, and NA were evaluated using a longitudinal approach tracking natural changes in the components over periods of three months and three years. Results indicated that change in one component was related to change in the other two components. In Study 2, an experimental design was used to manipulate each SWB component individually, and evaluate changes in all three components following each manipulation. Manipulation materials designed to target LS only were effective (i.e., led to heightened focus on LS, and not PA or NA) and created an increase in both LS and PA. Manipulation materials designed to target PA and NA only were not effective (i.e., led to heightened focus on the target component, as well as on LS). Furthermore, in both studies the strength of an individual’s SWB (assessed in terms of structural consistency and structural ambivalence in Study 1 and Study 2, along with subjective ambivalence in Study 2) did not consistently moderate the degree to which changes in the components were associated with one another. Together, these findings indicate that the structure of SWB may be complex and dynamic, rather than static. Alternatively, the components of SWB may not be easily manipulated in isolation of one another. Implications for existing structural models of SWB are discussed.

Removing Oneself from the Shadows: A Heuristic Inquiry to Understand the Lived Experience of Epilepsy in Young Adult Women and their Epilepsy Disclosure

Epilepsy is a chronic neurological disorder characterized by recurrent seizures (Stein & Kanner, 2009). The purpose of this study was to understand the essence of being a young woman living with epilepsy using heuristic inquiry (Moustakas, 1990). The research was built upon the assumption that each experience is unique, yet commonalities exist. Five women aged 22 to 28 years living with epilepsy were interviewed. Additionally, the researcher described her life with epilepsy. Participants characterized life with epilepsy as a transformative journey. The act of meeting and interacting with another woman living with epilepsy provided an opportunity to remove themselves from the shadows and discuss epilepsy. Three major themes of seizures, medical treatment, and social relationships were developed revealing a complex view of an illness requiring engaged advocacy in the medical system. Respondents frequently make difficult adjustments to accommodate epilepsy. This study provides a complex in-depth view of life with epilepsy.

The Influence of Parental Socialization of Emotions on Emotional Experience in Adulthood: An Exploratory Study.

Essai doctoral présenté à la Faculté des arts et des sciences en vue de l’obtention du grade de doctorat en psychologie clinique (D.Psy.)

End-of-Life Decisions and Advanced Old Age

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