Supporting and maximizing communication between individuals with intellectual disabilities and health care providers

The goal of the present study was to examine the barriers to access in health services faced by individuals with intellectual disabilities (ID), as well as the nature of communication between people with ID and those who are directly involved in supporting their health and well being. The study included in-depth interviews with five adults who have been identified as having ID and are supported by a community agency, five community agency support staff and four physicians who are specialists in supporting people who have ID. A qualitative content analysis approach facilitated the comparative exploration of key themes that each participant group saw as positive or negative influences on health care access and on effective health care communication. Themes drawn from the findings emphasize the unique roles each of these groups plays within the dialogical framework of the health care encounter. Of particular importance to informants was the issue of people with ID being seen as full participants in their own health care who, like all people, are unique individuals and not simply members of an identified or marginalized group. Participants across groups emphasized the need for the health care recipient to be known as an individual who is an expert in her/his own health and well being and, therefore, entitled to full participation with the support of but not control by others.

The impact of tobacco control policies on university students' smoking in Ontario

Objective. Despite steady declines in the prevalence of tobacco use among Canadians, young adult tobacco use has remained stubbornly high over the past two decades (CTUMS, 2005a). Currently in Ontario, young adults have the highest proportion of smokers of all age cohorts at 26%. A growing body of evidence shows that smoking restrictions and other tobacco control policies can reduce tobacco use and consumption among adults and deter initiation among youth; whether young adult university students' smoking participation is influenced by community smoking restrictions, campus tobacco control policies or both remains an empirical question. The purpose of this study is to examine the relationship among current smoking status of students on university campuses across Ontario and various tobacco control policies, 3including clean air bylaws of students' home towns, clean air by-laws of the community where the university is situated, and campus policies. Methods. Two data sets were used. The 200512006 Tobacco Use in a Representative Sample of Post-Secondary Students data set provides information about the tobacco use of 10,600 students from 23 universities and colleges across Ontario. Data screening for this study reduced the sample to 5,114 17-to-24 year old undergraduate students from nine universities. The second data set is researcher-generated and includes information about strength and duration of, and students' exposure to home town, local and campus tobacco control policies. Municipal by-laws (of students' home towns and university towns) were categorized as weak, moderate or strong based on criteria set out in the Ontario Municipal By-law Report; campus policies were categorized in a roughly parallel fashion. Durations of municipal and campus policies were calculated; and length of students' exposure to the policies was estimated (all in months). Multinomial logistic regression analyses were used to examine the relationship between students' current smoking status (daily, less-than-daily, never-smokers) and the following policy measures: strength of, duration of, and students' exposure to campus policy; strength of, duration of, and students' exposure to the by-law in the university town; and, strength of, duration of, and students' exposure to the by-law in the home town they grew up in. Sociodemographic variables were controlled for. Results. Among the Ontario university students surveyed, 7.0% currently use tobacco daily and 15.4% use tobacco less-than-daily. The proportions of students experiencing strong tobacco control policies in their home town, the community in which their university is located and at their current university were 33.9%,64.1 %, and 31.3% respectively. However, 13.7% of students attended a university that had a weak campus policy. Multinomial logistic regressions suggested current smoking status was associated with university town by-law strength, home town by-law strength and the strength of the campus tobacco control policy. In the fmal model, after controlling for sociodemographic factors, a strong by-law in the university town and a strong by-law in students' home town were associated with reduced odds of being both a less-than-daily (OR = 0.64, 95%CI: 0.48-0.86; OR = 0.80, 95%CI: 0.66-0.95) and daily smoker (OR = 0.59, 95%CI: 0.39-0.89; OR = 0.76, 95%CI: 0.58-0.99), while a weak campus tobacco control policy was associated with higher odds of being a daily smoker (OR = 2.08, 95%CI: 1.31-3.30) (but unrelated to less-than-daily smoking). Longer exposure to the municipal by-law (OR = 0.93; 95%CI: 0.90-0.96) was also related to smoking status. Conclusions. Students' smoking prevalence was associated with the strength of the restrictions in university, and with campus-specific tobacco control policies. Lessthan- daily smoking was not as strongly associated with policy measures as daily smoking was. University campuses may wish to adopt more progressive campus policies and support clean air restrictions in the broader community. More research is needed to determine the direction of influence between tobacco control policies and students' smoking.

Understanding space, place and leisure of women over 85 living in the community

There is an increase in the number of older adults 85 and over, who are choosing to live alone within the community. Moreover, older adults who live alone are reportedly spending an extensive amount of time alone within the home environment. In an effort to provide additional support and resources to older adults living in the community, a compliment of services are being offered through public and private organizations. These in-home supports focus on the instrumental or functional tasks of daily living, such as personal and rehabilitative care, nourishment, maintenance and upkeep of the home, as well as volunteer social visitation. However leisure resources and programs are not included among these services. Consequently, this creates a gap in leisure provision among this segment of the population. Throughout the life course, an individual's identity, role and purpose are developed and sustained through instrumental work roles in the formal and informal sector, as well as through personally meaningful leisure pastimes and experiences. Although roles shift post retirement, participation in instrumental and expressive activities can provide opportunities through which older adults are able to fulfill their need for agency (individuality and autonomy) and affiliation (social relatedness). Therefore barriers that inhibit instrumental or leisure experiences can negatively impact older adults' quality of life. This study explored the leisure lifestyles of four older adults, all of whom were over 85, lived alone within the community and were oriented to person, time and place. It became apparent that participants ordered their lives around a routine that consisted of instrumental, expressive and socially integrated tasks and activities. Moreover participants purposely chose to remain at home because their home environment facilitated freedom, choice and independence. As a result all four participants viewed their independence within the home as a critical determinant to their overall quality of life. Challenges associated with the home environment, participants' personal capacities and relationships were negotiated on a daily basis. Failure to positively adapt to these challenges inhibited meaningful engagement and personal fulfillment. Traditionally, leisure service delivery has been offered within institutions and through various community based venues. As a result leisure provision has been focused on the needs of the frail elderly who reside in institutions or the well elderly who are able to access leisure amenities within the community. However the growing number of older adults electing to live alone is on the rise. As individuals age the home becomes the preferred context for leisure experiences. If older adults are choosing to live alone, then both their instrumental and leisure needs must be addressed. As a result, it is imperative that leisure professionals extend the scope of service delivery to include home centered older adults.

A black-focused school : black Canadian youth and the mainstream curriculum

ABSTRACT When asked about the proposal for a black-focused school, black youth from the Greater Toronto Area (GTA) voiced their agreement with elements of the proposal, but resisted the idea of implementing the proposal by creating a separate school. Although media representations and Dei (1996, 2006) provide insight into what Torontonians' reactions are to the proposed blackfocused school there has been no such information documented on what black youth in the GTA think about the project. This is the first known study that attempts to fill that gap by providing a representation of black youths' voices obtained via focus groups. The study examines what black youth know and think about the proposal, and why they largely disagree with the blackfocused school proposal. While the findings of this study indicate that the participants saw many positive elements of the proposal, they did not support the implementation of a black-focused school as they saw the creation of a separate space for the school as a negative thing. The youth had trouble conceptualizing 'black-focused schooling' as an alternative approach to mainstream education, which had an impact on whether they choose to, or could, respond to questions that precisely related to the black-focused school project. The study concludes that the youth could not visualize what the school would look like and how it would operate because they draw on liberal racist discourses (e.g. colour-blindness, blaming the victim, and equal opportunity) when thinking about their educational experiences; however, there was a clear contradiction in the way the youths' voices reflected an awareness of the role of race in education experiences. It was evident when they talked about fear of stigmatization, but when using liberal discourses the youth discounted the role of race, and seemed not to be aware of its role in educational experiences. These findings pose important implications for educators, would-be educators, administrators, the TDSB and proponents of the black-focused school.

Association between adolescent leisure, peer social capital and academic performance among Canadian youth

Previous research shows discrepant findings between youth leisure programming (before and after school programs, structured summer program, day camp, overnight camp), academic performance and other youth developmental outcomes. Studies underscores the importance of family, community and school social capital in educational success of youth, investigation of peer social capital in the leisure context and academic performance outcomes is limited. This study uses a sample of 10 and 11 year olds (N=1764) from the Canadian National Longitudinal Survey of Children and Youth (NLSCY) Cycle 6, to study the association between youth leisure programming, peer social capital and academic performance. Ordinal logistic regression models consistently showed a positive association between overnight camp and academic performance even after controlling for determinants of health, and measures of family, school and community social capital. Similarly, the measure of peer social capital was positively associated with academic performance. Most importantly, the interaction between overnight camp participation and peer social capital was significantly associated with academic performance. Study findings, highlight overnight camp opportunities and peer social

A needs assessment of public health professionals: supporting the implementation of Ontario 2010 revised elementary health and physical education curriculum

Based on the Comprehensive School Health framework, Ontario's Foundations for a Healthy School (2009) outlines an integrated approach to school health promotion. In this approach the school, community and partners (including public health) are fully engaged With a common goal of youth health. With the recent introductions of the Ontario Public Health Standards (2009) and the revised elementary health and physical education curriculum (2010), the timing for a greater integration of public health with schools is ideal. A needs assessment was conducted to identify the perceived support required by public health professionals to implement the mandates of both policy documents in Ontario. Data was collected for the needs assessment through facilitated discussions at a provincial roundtable event, regional focus groups and individual interviews with public health professionals representing Ontario's 36 public health units. Findings suggest that public health professionals perceive that they require increased resources, greater communication, a clear vision of public health and a suitable understanding of the professional cultures in which they are surrounded in order to effectively support schools. This study expands upon these four categories and the corresponding seventeen themes that were uncovered during the research process.

Locating home : the diverse experiences of recent newcomer youth and first generation youth within Ontario's education system

This study has found that youth who or whose parents had left their home country for fear-based reasons were less involved within their school and wider community than youth who left or whose parents left for reasons concerning their social mobility. Many existing studies focus on the challenges newcomer youth experience within the education system (see Anisef, Brown, Phythian, & Sweet, 2010), however through the use of qualitative methodologies this study expanded on the current literature by further examining why it is some youth are successful in overcoming such challenges, while others are not. This study supported what has been demonstrated in the literature regarding challenges faced by newcomer youth and resources to address such challenges. Despite challenges experienced within the education system, youth planned to complete secondary school and attend a postsecondary institution. However, not all youth anticipated remaining in Canada upon completion of their education, with youth or youth whose parents left their home country for fear-based reasons frequently discussing the possibility of returning to their or their parents' home country. Thus, perhaps these youth were less involved within their school, as their goal was not necessarily to establish or maintain connections within their community as they may have viewed residing in Canada as temporary. This finding has important implications, as there are benefits to involvement in extracurricular activities, which may assist youth in overcoming challenges encountered within the education system. Therefore, it would seem that youth who had or whose parents had left their home country for reasons concerning their social mobility may have be at an advantage within the education system with respect to their involvement in school. Perhaps then this differential involvement may at least partially explain why it is some newcomer youth are able to overcome challenges they experience in the education system, while others are not. Both policy and theoretical implications are discussed.

Psychotropic medication use by adults with intellectual disabilities living in community settings

This study examined the variables related to psychotropic medication use among 73 adults with intellectual disabilities living in community residential settings in Ontario, Canada over a one-year period based on staff reports. Despite only 16% percent having a documented psychiatric diagnosis, 84% of these individuals were receiving psychotropic medications, and 74% were receiving two or more psychotropic medications (polypharmacy). Anti-psychotics, anti-anxiety medications, and anti-convulsant medications were the most frequently reported drug classes. While problem behaviour was reported for 60% of the participants, only 33% had a formal behaviour plan. There was a significant relationship between the reported number of problem behaviours and the reported number of prescribed psychotropic medications. Reported medication reviews did not adhere to the Canadian 'Consensus Guidelines for the Primary Care of Adults with Developmental Disabilities' (Sullivan et aI., 2006). Results, based on staff reports, suggested incongruence with recommended best practices, and raised concern about over-reliance on psychotropic medication with these individuals. Keywords: intellectual disabilities, psychotropic medication, problem behaviour

Youth Involvement in Organizational Decision Making: The Connection to Youth Initiative and Organizational Functioning

Studying positive adolescent development requires an examination of the mutually beneficial associations between youth and their environment. These youthcontext relations include both the contributions that youth make to others and society and the youth-context interactions that might predict positive youth outcomes. Community and youth-serving organizations, where youth may be involved in decision-making roles such as service delivery, advocacy, or on boards of directors, can provide one important context for youth contributions and for positive adolescent development. Research on the outcomes of youth involvement in organizational decision-making, however, is limited, and largely consists of exploratory qualitative studies. This dissertation is formatted as an integrated article dissertation. It begins with a review of the literature on contexts of structured youth activities and positive youth development. This review is intended to describe theory on development-context relations, in which development is considered an interactive process that occurs between individuals and their contexts, as it pertains the positive development of youth who are involved in various structured activities (e.g., volunteering). This description follows with a review of current research, and conclusions and rationale for the current studies. Following this theoretical and research background, the dissertation includes reports of two studies that were designed to address gaps in the research on youth involvement in organizational decision-making. The first was a qualitative research synthesis to elucidate and summarize the extant qualitative research on the outcomes of youth involvement in organizational decision making on adults and organizations. Results of this study suggested a number of outcomes for service provision, staff, and broader organizational functioning, including both benefits to organizations as well as some costs. The second study was a quantitative analysis of the associations among youth involvement, organizations' learning culture, and youth initiative, and relied on survey data gathered from adults and youth in community-based organizations with youth involvement. As expected, greater youth involvement in organizational decision making was associated with higher learning culture within the organization. Two dimensions of youth involvement, greater program engagement and relationships with adults, were related to greater youth initiative. A third dimension, sense of ownership, was not- .-.- associated with youth's level of initiative. Moreover, the association between relationships with adults and youth initiative was only significant in organizations with relatively low learning culture. Despite some limitations, these studies contribute to the research literature by providing some indication of the potential benefits and costs of youth involvement and by making an important contribution toward the early stages of context-level analyses of youth development. Findings have important implications for practitioners, funders, future research, and lifespan development theory.

Stakeholders' Perceptions of Culinary Programs in Ontario Community Colleges

The hospitality industry in Canada is growing. With that growth is a demand for qualified workers to fill available positions within all facets of the hospitality industry, one ofthem being cooks. To meet this labour shortage, community colleges offering culinary arts programs are ramping up to meet the needs of industry to produce workplace-ready graduates. Industry, students, and community colleges are but three of the several stakeholders in culinary arts education. The purpose of this research project was to bring together a cross-section of stakeholders in culinary arts education in Ontario and qualitatively examine the stakeholders' perceptions of how culinary arts programs and the current curriculum are taught at community colleges as mandated by the Ministry of Training, Colleges and Universities (MTCU) in the Culinary Program Standard. A literature review was conducted in support of the research undertaking. Ten stakeholders were interviewed in preliminary and follow-up sessions, after which the data were analyzed using a grounded theory research design. The findings confirmed the existence of a disconnect amongst stakeholders in culinary arts education. Parallel to that was the discovery of the need for balance in several facets of culinary arts education. The discussions, as found in Chapter 5 of this study, addressed the themes of Becoming a Chef, Basics, Entrenchment, Disconnect, and Balance. The 8 recommendations, also found in Chapter 5, which are founded on the research results of this study, will be of interest to stakeholders in culinary education, particularly in the province of Ontario.

An Exploration Into Doctoral Students' Sense of Community and its Influence on the Formation of Informal Mentoring Relationships

This exploratory mixed method research project was designed to investigate an area of doctoral education that has received little attention in the past. This research focused specifically on the non-intellectual, hoped-for by-products of doctoral education; the dynamic processes of developing and maintaining both a sense of community and informal mentoring relationships. The design of the study captured the experiences of doctoral students and alumni at various time periods in the doctoral program. Participants represented a diverse group of students with differences in professional and academic backgrounds and life stages. A pilot study for this research suggested that the presence of a sense of community and informal mentoring may provide the necessary relationships to support this diversity. The primary question at the forefront of this study was: Do doctoral students feel connected to one another? Five subquestions were developed to address this research topic: Does a sense of community already exist and flourish in doctoral education? Are the programs and resources of the doctoral program organized to nurture the creation and maintenance of a sense of community? Is a sense of community a foundational element in the formation of naturally occurring relationships among doctoral students? What educational and socio-emotional benefits are associated with informal mentoring relationships during the doctoral experience? and Do doctoral students perceive a change in their development as stewards of their discipline over time? The principal methods used to investigate these research questions combined both quantitative and qualitative techniques in a concurrent time sequence. The quantitative portion of the study involved a questionnaire, while the qualitative portion involved two approaches; face-to-face interviews and an open-ended question at the end of the questionnaire. Findings from the study indicated that the presence of both sense of community and informal mentoring enhance the overall quality of doctoral education. Program elements that enhanced or hindered connection between students were identified. Both the dynamics and the emotional, social, and academic benefits of informal mentoring were elucidated. Over time participants perceived changes in their development of the qualities assqciated with stewardship. This study brought the "hoped-for by-products" associated with doctoral education from the background shadows to an illuminated position at the forefront of inquiry.

Self-Regulated Learning and Children At-Risk for Learning Disabilities: Using Motivational Tactics to Support "Reading Rocks!"

This project explored self-regulation among children impacted by leaming disabilities. More specifically, this thesis examined whether a remedial literacy program called Reading Rocks! offered by the Leaming Disabilities Association of Niagara Region, provided participating children opportunities to set goals, develop strategies to meet these goals, and provide intemal and extemal feedback- all processes associated with a model of self-regulated leaming as pioneered by Butler and Winne (1995) and Winne and Hadwin (1999). In this thesis, I triangulate the data through the combination of three different methodologies. Firstly, I describe the various elements of the Reading Rocks! program. Secondly, I analyze the data gathered through three semi-structured interviews with three parents of children that participated in the Reading Rocks! program to demonstrate whether the program provides opportunities for children to self-regulate their learning. Thirdly, I also analyze photographic evidence of the motivational workstation boards created by the tutors and children to further illustrate how Reading Rocks! promotes self-regulatory processes among children.

Precursors to successful youth-adult partnerships: The role of adult warmth and expertise

Youth-Adult Partnerships (Y-APs) have been found to foster youth engagement and positive youth development. However, existing research tends to confound the characteristics of Y-APs with their general outcomes and the existing methods of evaluating Y-APs tend to be based on correlational methodologies. I sought to create a measure of Y-AP success that did not confound the characteristics of a successful Y-AP with outcomes. Using the existing literature as a guide, three components were selected for inclusion in the Y-AP success measure: 1) perceptions of productivity; 2) positive affect; and 3) having one's contributions welcomed and considered. Using this new measure, I tested a model to assess how adult warmth and expertise interacted with task difficulty to influence three components of Y-AP success. Participants included 402 university students (M = 19.27, SD = 1.28, 89.1 % female) from Brock University and Cape Breton University. Video clips of an adult, depicting all possible combinations of warmth and expertise were created for this study, as well as a pair of hypothetical tasks designed to elicit differential degrees of perceived difficulty. Participants were exposed to one video of a hypothetical adult and two hypothetical tasks and responded to the Y-AP success measures twice, for each ofthe tasks. Results from mixed-model ANOVAs revealed that the adult and task characteristics were not consistently related to all components of Y-AP success. However, several significant interactions suggested that youth perceptions of task difficulty and their impressions of adult partners influenced the extent to which they expected a Y-AP to be successful. The results are discussed in the context of how they support or conflict with the existing literature and serve as a first step in the inference of causality within the study of Y-APs.

A Continuum of Traversing Lines: Youth Political Participation in Gaia Online

This qualitative research project uses a Deleuzo-Guattarian theoretical framework to address the question: “How are the politically oriented social forums in Gaia Online experienced as a continuum of overlapping of lines, including molar lines, lines of flight, and molecular lines?” Although smooth lines of flight may occur in Gaia, there are always mechanisms that work to re-territorialize them as more striated molar operations. Conversely, while more striated molar lines may be evident in Gaia, there are also smooth lines of flight that attempt to deterritorialize them as smooth space. Founded in 2003, Gaia is a virtual community in which members use 3D avatars to socialize with others, create content, and play games. Deleuze and Guattari (1987) have defined space with three systems: on one end is state-oriented static space, on the other end is nomadic fluid space, and situated in the middle is molecular space which contains both smooth and striating elements. While state-oriented striated space is based on routines, rules, and specifications, nomadic smooth space is flexible, always changing, and full of possibility. Some of the smoother operations that are evident in Gaia include becoming other, decentred communications, desire as resistance, and lines of flight. Some of the more striated operations include social reproduction of gender norms/expectations, capitalist mechanisms, violence and intolerance linked to categories and binaries (racism/sexism/ageism), the regulation of desire, and the organisation of bodies.

HIDING IN PLAIN SIGHT- Sustainable Physical Activity Program Development and Evaluation for Youth with Special Needs: An Evaluative Case Study

The purpose of my research was to contribute to the improvement and sustainability of the Special Needs Activity Program, and develop program implementation strategies that had practical outcomes. I conducted an evaluative case study of S.N.A.P in order to determine what a quality adapted physical activity (APA) program is, why S.N.A.P is considered a quality APA program, and what institutional policies and practices exist to support it. Data was collected via interviews, questionnaires, and observations. Data analysis involved inductive and deductive methods, and a SWOTAR evaluation. Results indicate that quality APA programs include: ‘people’, ‘environment’, and ‘expectations’; there are benefits of experiential learning; activity stations that promote creativity are valuable; several stakeholders do not know the details about S.N.A.P but recognize its value; the institution values what S.N.A.P provides, yet, there is nothing being done to sustain it. Future research should investigate the feasibility of implementing S.N.A.P in various contexts.