Patients who attend a private practice vs a university outpatient clinic: how do they differ?

Although interpersonal continuity is commonly assumed to be essential for care, some patients prefer to attend a university outpatient clinic where physicians change regularly and interpersonal continuity of care is not ensured. The aim of this exploratory study was to evaluate the differences between patients attending a university outpatient clinic and patients frequenting a private practice, explore their patterns of care-seeking and their understanding of continued care. We conducted a cross-sectional study of patients attending the university medical outpatient clinic (OC) in Lausanne, Switzerland and ten randomly selected private general practices (PP). Eligible patients were >30 years, Swiss nationals or long term residents, with one or more chronic conditions and attending the same practice for >3 years. They were asked to complete a questionnaire on sociodemographic data, use of medical resources and reasons for choosing and remaining at the same practice. Semi-structured interviews were conducted with a randomly selected subset of 26 patients to further explore their preferences. 329 patient questionnaires were completed, 219 by PP and 110 by OC patients. OC patients tended to be of lower socioeconomic status than PP patients. The main reason for choosing a PP were personal recommendation, while a higher percentage of patients chose the OC because they could obtain a first appointment quickly. A higher percentage of PP patients accorded importance to physician communication skills and trust, whereas a higher percentage of OC patients favoured investigation facilities. Qualitative data suggested that although OC and PP patients reported different reasons for consulting, their expectations on the medical and relationship level were similar. Our study suggests that the two groups of patients belong to different social backgrounds, have different patterns of care-seeking and attach importance to different aspects of care continuity. However, patients' expectations and perceptions of the physician-patient relationship are similar.

Gender bias in the Trends in Mathematics and Science Study 2003 (TIMMS) for Canadian students /

This study is a secondary data analysis of the Trends in Mathematics and Science Study 2003 (TIMSS) to determine if there is a gender bias, unbalanced number of items suited to the cognitive skill of one gender, and to compare performance by location. Results of the Grade 8, math portion of the test were examined. Items were coded as verbal, spatial, verbal /spatial or neither and as conventional or unconventional. A Kruskal- Wallis was completed for each category, comparing performance of students from Ontario, Quebec, and Singapore. A Factor Analysis was completed to determine if there were item categories with similar characteristics. Gender differences favouring males were found in the verbal conventional category for Canadian students and in the spatial conventional category for students in Quebec. The greatest differences were by location, as students in Singapore outperformed students from Canada in all areas except for the spatial unconventional category. Finally, whether an item is conventional or unconventional is more important than whether the item is verbal or spatial. Results show the importance of fair assessment for the genders in both the classroom and on standardized tests.

Level and precision of behavioural thermoregulation in the bearded dragon, Pogona vitticeps : effects of hypoxia and environmental thermal quality /

Most metabolic functions are optimized within a narrow range of body temperatures, which is why thermoregulation is of great importance for the survival and overall fitness of an animal. It has been proposed that lizards will thermoregulate less precisely in low thermal quality environments, where the costs associated with thermoregulation are high; in the case of lizards, whose thermoregulation is mainly behavioural, the primary costs ofthermoregulation are those derived from locomotion. Decreasing thermoregulatory precision in costly situations is a strategy that enhances fitness by allowing lizards to be more flexible to changing environmental conditions. It allows animals to maximize the benefits of maintaining a relatively high body temperature while minimizing energy expenditure. In situations where oxygen concentration is low, the costs of thermoregulation are relatively high (i.e. in relation to the amount of oxygen available for metabolic functions). As a result, it is likely that exposures to hypoxic conditions induce a decrease in the precision of thermoregulation. This study evaluated the effects of hypoxia and low environmental thermal quality, two energetically costly conditions, on the precision and level of thermoregulation in the bearded dragon, Pogona vitticeps, in an electronic temperature-choice shuttle box. Four levels of hypoxia (1O, 7, 5 and 4% 02) were tested. Environmental thermal quality was manipulated by varying the rate of temperature change (oTa) in an electronic temperature-choice shuttle box. Higher oT a's translate into more thermally challenging environments, since under these conditions the animals are forced to move a greater number of times (and hence invest more energy in locomotion) to maintain similar temperatures than at lower oTa's. In addition, lizards were tested in an "extreme temperatures" treatment during which air temperatures of the hot and cold compartments of the shuttle box were maintained at a constant 50 and 15°C respectively. This was considered the most thermally challenging environment. The selected ambient (T a) and internal body temperatures (Tb) of bearded dragons, as well as the thermoregulatory precision (measured by the central 68% ofthe Ta and T b distribution) were evaluated. The thermoregulatory response was similar to both conditions. A significant increase in the size of the Tb range, reflecting a decrease in thermoregulatory precision, and a drop in preferred body temperature of ~2 °C, were observed at both 4% oxygen and at the environment of lowest thermal quality. The present study suggests that in energetically costly situations, such as the ones tested in this study, the bearded dragon reduces energy expenditure by decreasing preferred body temperature and minimizing locomotion, at the expense of precise behavioural thermoregulation. The close similarity of the behavioural thermoregulatory response to two very different stimuli suggests a possible common mechanism and neuronal pathway to the thermoregulatory response.

A classroom-based investigation of reciprocal teaching at the grade seven level

This study assessed the effectiveness of a reciprocal teaching program as a method of teaching reading comprehension, using narrative text material in a t.ypical grade seven classroom. In order to determine the effectiveness of the reciprocal teaching program, this method was compared to two other reading instruction approaches that, unlike rcciprocal teaching, did not include social interaction components. Two intact grade scven classes, and a grade seven teacher, participated in this study. Students were appropriately assigned to three treatment groups by reading achievement level as determined from a norm-referenced test. Training proceeded for a five week intervention period during regularly scheduled English periods. Throughout the program curriculum-based tests were administered. These tests were designed to assess comprehension in two distinct ways; namely, character analysis components as they relate to narrative text, and strategy use components as they contribute to student understanding of narrative and expository text. Pre, post, and maintenance tests were administered to measure overall training effects. Moreover, during intervention, training probes were administered in the last period of each week to evaluate treatment group performance. AU curriculum-based tests were coded and comparisons of pre, post, maintenance tests and training probes were presented in graph form. Results showed that the reciprocal group achieved some improvement in reading comprehension scores in the strategy use component of the tests. No improvements were observed for the character analysis components of the curriculum-based tests and the norm-referenced tests. At pre and post intervention, interviews requiring students to respond to questions that addressed metacomprehension awareness of study strategies were administered. The intelviews were coded and comparisons were made between the two intelVicws. No significant improvements were observed regarding student awareness of ten identified study strategies . This study indicated that reciprocal teaching is a viable approach that can be utilized to help students acquire more effective comprehension strategies. However, the maximum utility of the technique when administered to a population of grade seven students performing at average to above average levels of reading achievement has yet to be determined. In order to explore this issue, the refinement of training materials and curriculum-based measurements need to be explored. As well, this study revealed that reciprocal teaching placed heavier demands on the classroom teacher when compared to other reading instruction methods. This may suggest that innovative and intensive teacher training techniques are required before it is feasible to use this method in the classroom.

Evaluating the Norfolk physical education program with respect to fitness-level improvement

The grades seven and eight physical education program of the Norfolk Board of Education was evaluated with respect to fitnesslevel improvement, an objective of the Ministry of Education for the province of Ontario. The Canada Fitness Award battery of fitness tests was used to measure fitness levels. It was established that in September the students were unfit, and in May they were fit. This indicated that the Norfolk physical education program was effective, with respect to the criterion used for this research. In addition, it was discovered that fitness-level improvement was significantly related to certain variables: teacher qualifications, teaching experience, school, and participation in extracurricular physical activity. Considering the results of the research, it was recommended that the Norfolk Board of Education hire young, qualified physical education teachers; create the position of Physical Education Consultant; and strive to create equitable resources for physical education instruction, in order that the school to which a student belongs no longer will be a determinant of fitness improvement.

Exploring the impact of a hands-on intervention on grade 7 girls and their feelings about self, mathematics, science, technology and related careers

Forty-five 12- and 13-year-old females attending Grade 7 in North York, Ontario were randomly selected from a group of 100 females who had volunteered to participate in a oneday hands-on workshop called It's Your Choice at Seneca College. The goals of this intervention were to broaden the career horizons of these students and to help them realize the need to continue mathematics and science through high school in order to keep occupational options unlimited. The young women were given a pre- and post-attitude survey to provide background information. In the month following participation in the workshop the students were interviewed in small groups (S students per group) to discover their perceptions of the impact of the workshop. The interviews revealed that participants felt that after the workshop their feelings of self-confidence increased, specifically with respect to working with their hands. Participants felt more aware of the usefulness and importance of the study of mathematics, science and technology, They also felt that It's Your Choice increased their interest in careers in these domains and helped them to see that these careers are viable choices for females. The interviews also revealed that many of the participants felt that in this society their roles and their choices were influenced and probably limited by the fact that they are female.

Teachers' perceptions of effects of terminal examinations on teaching and learning at the secondary school level in Zimbabwe

This study was particularly aimed at the examinations and the effect they have on schooling at the secondary school level in Zimbabwe. The views and opinions of teachers on the use of terminal examinations for certification and the influence they are seen to have on teachers' approach to the curriculum were examined. The literature has shown that there is widespread criticism of the justice and effects of terminal examinations. It is argued that they lead to an over-emphasis of that which is measured, knowledge and intellectual ability, at the expense of that kind of education progress which is almost impossible to measure in an end-of-the-course assessment. Three hundred and six secondary school teachers responded to a survey which asked for teachers' perceptions of examinations and the curriculum. The findings of this study indicated that teaching is structured towards examinations. Although teachers are trying to teach and develop reasoning skills and other activities, the pressure of examinations and the importance of doing well in them force teachers to restrict themselves to examination requirements.

The effectiveness of explicit strategy instruction on the top level structure of a text

Thesis (M.Ed.)-- Brock University, 1995.

The effects of day care at the kindergarten level : day care centre versus in-home care

Two groups of nonmaternal day care providers, one made up of in-horne caregivers, and the other of providers of day care in centres, were asked to focus on their goals for the children in their care. A group of kindergarten teachers was asked to consider any differences they noticed in children in· the two types of day care mentioned above. It was found that in-horne caregivers, through flexibility, meet the developmental goals of the children in their care. Providers of tlay care in centres used a more structured and social program in order to meet the overall developmental goals for the children in their care. It was found that the kindergarten teachers noticed differences in the children in their classes in terms of their attitude and social behaviour. The type and quality of care were seen as possible influences on this outlook of young children in kindergarten. The one common element that each group highlighted with respect to the effects of day care at the kindergarten level was the important role of the family in the child's development not only in day care, but also in kindergarten class. There is still a strong need to determine the effects of various types of day care at all levels, and specifically at the kindergarten level. The more the kindergarten teacher is able to understand about the child's day care experience, and his or her own life,the better off these children in day care will be. This study confirmed both the importance of quality in child care, and the important role of the family in the child care decision.

The effects of teaching a mathematics problem solving strategy on the problem solving ability of grade nine students

Forty grade 9 students were selected from a small rural board in southern Ontario. The students were in two classes and were treated as two groups. The treatment group received instruction in the Logical Numerical Problem Solving Strategy every day for 37 minutes over a 6 week period. The control group received instruction in problem solving without this strategy over the same time period. Then the control group received the treat~ent and the treatment group received the instruction without the strategy. Quite a large variance was found in the problem solving ability of students in grade 9. It was also found that the growth of the problem solving ability achievement of students could be measured using growth strands based upon the results of the pilot study. The analysis of the results of the study using t-tests and a MANOVA demonstrated that the teaching of the strategy did not significaritly (at p s 0.05) increase the problem solving achievement of the students. However, there was an encouraging trend seen in the data.

Some ecological factors affecting the input and population level of total and faecal coliforms and salmonella in Twelve Mile Creek, Lake Ontario and sewage waters near St. Catharines, Ontario

Some Ecological Factors Affecting the Input and Population Levels of Total and Faecal Coliforms and Salmonella in Twelve Mile Creek, Lake Ontario and Sewage Waters Near St. Catharines, Ontario. Supervisor: Dr. M. Helder. The present study was undertaken to investigate the role of some ecological factors on sewage-Dorne bacteria in waters near St. Catharines, Ontario. Total and faecal coliform levels and the presence of Salmonella were monitored for a period of a year along with determination of temperature, pH, dissolved oxygen, total dissolved solids, nitrate N, total phosphate P and ammonium N. Bacteriological tests for coliform analysis were done according to APHA Standard Methods by the membrane filtration technique. The grab sampling technique was employed for all sampling. Four sample sites were chosen in the Port Dalhousie beach area to determine what bacteriological or physical relationship the sites had to each other. The sample sites chosen were the sewage inflow to and the effluent from the St. Catharines (Port Dalhousie) Pollution Control Plant, Twelve Mile Creek below the sewage outfall and Lake Ontario at the Lakeside Park beach. The sewage outfall was located in Twelve Mile Creek, approximately 80 meters from the creek junction with the beach and piers on Lake Ontario. Twelve Mile Creek normally carried a large volume of water from the WeIland Canal which was diverted through the DeCew Generating Station located on the Niagara Escarpment. An additional sample site, which was thought to be free of industrial wastes, was chosen at Twenty Mile Creek, also in the Niagara Region of Ontarioo 3 There were marked variations in bacterial numbers at each site and between each site, but trends to lower_numbers were noted from the sewage inflow to Lake Ontario. Better correlations were noted between total and faecal coliform population levels and total phosphate P and ammonium N in Twenty Mile Creek. Other correlations were observed for other sample stations, however, these results also appeared to be random in nature. Salmonella isolations occurred more frequently during the winter and spring months when water temperatures were minimal at all sample stations except the sewage inflow. The frequency of Salmonella isolations appeared to be related to increased levels of total and faecal coli forms in the sewage effluent. However, no clear relationships were established in the other sample stations. Due to the presence of Salmonella and high levels of total and faecal coliform indicator organisms, the sanitary quality of Lake Ontario and Twelve Mile Creek at the sample sites seemed to be impaired over the major portion of the study period.

The impact of integrated programming on student attitude and achievement in grade 9 academic mathematics and science

This research studioo the effect of integrated instruction in mathematics and~ science on student achievement in and attitude towards both mathematics and science. A group of grade 9 academic students received instruction in both science and mathematics in an integrated program specifically developed for the purposes of the research. This group was compared to a control group that had received science and mathematics instruction in a traditional, nonintegrated program. The findings showed that in all measures of attitude, there was no significant difference between the students who participated in the integrated science and mathematics program and those who participated in a traditional science and mathematics program. The findings also revealed that integration did improve achievement on some of the measures used. The performance on mathematics open-ended problem-solving tasks improved after participation in the integrated program, suggesting that the integrated students were better able to apply their understanding of mathematics in a real-life context. The performance on the final science exam was also improved for the integrated group. Improvement was not noted on the other measures, which included EQAO scores and laboratory practical tasks. These results raise the issue of the suitability of the instruments used to gauge both achievement and attitude. The accuracy and suitability of traditional measures of achievement are considered. It is argued that they should not necessarily be used as the measure of the value of integrated instruction in a science and mathematics classroom.

Elucidation of odour-potent compounds and sensory profiles of Vidal blanc and Riesling icewines from the Niagara Peninsula : effect of harvest date and crop level

I t was hypothesized that the freeze/thaw cycles endured by icewine grapes would change their chemical composition, resulting in unique chemical fingerprint and sensory properties, and would be affected by harvest date (HD) and crop level (CL). The objectives were: 1) to identify odour-active compounds using gas chromatographic and sensory analysis; 2) to determine the effect of CL and HD on these compounds; 3) to determine the icewine sensory profiles; 4) to correlate analytical and sensory results for an overall icewine profile. CharmAnalysis™ determined the Top 15 odour-potent compounds in Vidal and Riesling icewine and table wines; 24 and 23 compounds, respectively. The majority of the compounds had the highest concentrations in the icewines compared to table wines. These compounds were used as the foundation for assessing differences in icewine chemical profiles from different HD and CL. Vidal and Riesling icewine were made from grapes picked at different HD; HI : 19 December; H2: 29 December; H3: 18 January; H4: 11 February (Vidal only). HI wines differed from H3 and H4 wines in both Vidal and Riesling for aroma compounds and sensory profiles. - Three·CL [control (fully cropped), cluster thin at fruit set to one basal cluster/shoot (TFS), and cluster thin at veraison to one basal cluster/shoot (TV)] were evaluated for Riesling and Vidal cultivars over two seasons. Vidal icewines had the highest concentration of aroma compounds in the control and TV icewines in 2003 and in TFS icewines in 2004. In Riesling, most aroma compounds had the highest concentration in the TV icewines and the lowest concentration in the TFS wine for both years. The thinned treatments were associated with almost all of the sensory attributes in both cultivars, both years. HD and CL affected the chemical variables, aroma compounds and sensory properties of Vidal and Riesling icewines and freeze/thaw events changed their sensory profile. The most odour-potent compounds were p-damascenone, cis-rose oxide, 1- octen-3-ol, 4-vinylguaiacol, ethyl octanoate, and ethyl hexanoate. The role of Pdamascenone as a marker compound for icewine requires further investigation. This research provides a strong foundation for the understanding the odour-active volatiles and sensory profiles important to icewine.

Reading Instruction and Instructors’ Perceptions of Learners’ Needs in LINC Level 1-3 Classes

This study investigates instructors’ perceptions of reading instruction and difficulties among Language Instruction for Newcomers to Canada (LINC) Level 1-3 learners. Statistics Canada reports that 60% of immigrants possess inadequate literacy skills. Newcomers are placed in classes using the Canadian Language Benchmarks but large, mixed-level classes create little opportunity for individualized instruction, leading some clients to demonstrate little change in their reading benchmarks. Data were collected (via demographic questionnaires, semi-structured interviews, teaching plans, and field study notes) to create a case study of five LINC instructors’ perceptions of why some clients do not progress through the LINC reading levels as expected and how their previous experiences relate to those within the LINC program. Qualitative analyses of the data revealed three primary themes: client/instructor background and classroom needs, reading, strategies, methods and challenges, and assessment expectations and progress, each containing a number of subthemes. A comparison between the themes and literature demonstrated six areas for discussion: (a) some clients, specifically refugees, require more time to progress to higher benchmarks; (b) clients’ level of prior education can be indicative of their literacy skills; (c) clients with literacy needs should be separated and placed into literacy-specific classes; (d) evidence-based approaches to reading instruction were not always evident in participants’ responses, demonstrating a lack of knowledge about these approaches; (e) first language literacy influences second language reading acquisition through a transfer of skills; and (f) collaboration in the classroom supports learning by extending clients’ capabilities. These points form the basis of recommendations about how reading instruction might be improved for such clients.

Introduction to engineering : a case study of an interdisciplinary course in Mathematics, Science and Technology

This thesis research was a qualitative case study of a single class of Interdisciplinary Studies: Introduction to Engineering taught in a secondary school. The study endeavoured to explore students' experiences in and perceptions of the course, and to investigate the viability of engineering as an interdisciplinary theme at the secondary school level. Data were collected in the form of student questionnaires, the researcher's observations and reflections, and artefacts representative of students' work. Data analysis was performed by coding textual data and classifying text segments into common themes. The themes that emerged from the data were aligned with facets of interdisciplinary study, including making connections, project-based learning, and student engagement and affective outcomes. The findings of the study showed that students were positive about their experiences in the course, and enjoyed its project-driven nature. Content from mathematics, physics, and technological design was easily integrated under the umbrella of engineering. Students felt that the opportunity to develop problem solving and teamwork skills were two of the most important aspects of the course and could be relevant not only for engineering, but for other disciplines or their day-to-day lives after secondary school. The study concluded that engineering education in secondary school can be a worthwhile experience for a variety of students and not just those intending postsecondary study in engineering. This has implications for the inclusion of engineering in the secondary school curriculum and can inform the practice of curriculum planners at the school, school board, and provincial levels. Suggested directions for further research include classroom-based action research in the areas of technological education, engineering education in secondary school, and interdisciplinary education.