Report of the Committee to whom was Referred the Correspondence between Mr. Monroe and Mr. Canning, and between Mr. Madison and Mr. Rose, relative to the attacked of Chesapeake : and also a communication from the President of the United States of the 30 March last, with a letter from Mr. Erskine to the Secretary of State, and a letter from M. Champagny to Gen. Armstrong.--

April 16, 1808. Printed by Order of the Senate.

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.

Problem children with and without communication delays : the changes in their parents' report of challenging behaviour, parental hassles and family conflict over a two -year period

The goal of this study was to examine the change, over a two year period, in mothers' reports of children's challenging behaviour and family conflict as they relate to change in parenting hassles (stress) among families who have preschool children with and without communication delays. Forty-four parent-child dyads participated in this Family Resource Project study that was funded by the Canadian Language and Literacy Research Network. Thirty-one ofthese families had preschool children with communication delays and 13 children were identified as not having communication delays. Child behaviour was evaluated using the Oppositional Subscale and ADHD Index of the Conners Parent Rating Scale (CPRS-R:S), the Conflict Subscale ofthe Family Environment Scale was used to examine family conflict, and the Parent Hassles Scale was used to examine parental stress. Results showed that change in mothers' daily hassles was influenced by change in their preschool children's ADHD behaviour and change in family conflict. Change in child oppositional behaviour did not predict change in mothers' hassles scores.

Posttraumatic stress disorder symptoms might be destroying your intimacy : a test of mediational models in a community sample of couples

The present research focused on the pathways through which the symptoms of posttraumatic stress disorder (PTSD) may negatively impact intimacy. Previous research has confirmed a link between self-reported PTSD symptoms and intimacy; however, a thorough examination of mediating paths, partner effects, and secondary traumatization has not yet been realized. With a sample of 297 heterosexual couples, intraindividual and dyadic models were developed to explain the relationships between PTSD symptoms and intimacy in the context of interdependence theory, attachment theory, and models of selfpreservation (e.g., fight-or-flight). The current study replicated the findings of others and has supported a process in which affective (alexithymia, negative affect, positive affect) and communication (demand-withdraw behaviour, self-concealment, and constructive communication) pathways mediate the intraindividual and dyadic relationships between PTSD symptoms and intimacy. Moreover, it also found that the PTSD symptoms of each partner were significantly related; however, this was only the case for those dyads in which the partners had disclosed most everything about their traumatic experiences. As such, secondary traumatization was supported. Finally, although the overall pattern of results suggest a total negative effect of PTSD symptoms on intimacy, a sex difference was evident such that the direct effect of the woman's PTSD symptoms were positively associated with both her and her partner's intimacy. I t is possible that the Tend-andBefriend model of threat response, wherein women are said to foster social bonds in the face of distress, may account for this sex difference. Overall, however, it is clear that PTSD symptoms were negatively associated with relationship quality and attention to this impact in the development of diagnostic criteria and treatment protocols is necessary.

Teaching persons with intellectual disabilities and limited receptive and expressive communication how to recognize and assert their human rights

Persons with intellectual disabilities (ID) are far more likely to be abused than the general population, but there is little research on teaching people with ID about their rights. The goal of this study was to teach four participants with ID and limited communication abilities about their human rights by training them on specific rights topics. The training program included icebreaker activities, instruction on rights concepts, watching and answering questions about videotaped scenarios of rights restrictions, watching and answering questions about role pl ay scenarios of rights restrictions, and responding to brief, low risk in situ rights restrictions imposed by the researchers. Participant performance did not improve significantly or consistently from baseline to training on the questions asked about the videotaped or the role play scenarios, but two of three participants demonstrated defmite improvements in responding to in situ rights restrictions.

Sex Talk: A Multiple Case Study to Explore and Understand Parent-Child Sexual Health Communication in Chinese Immigrant Families

Parent-child sexual health communication can be beneficial. Many factors affect such communication in Chinese immigrant families. This qualitative study explored the influences of acculturation, parenting, and parental participation in the Raising Sexually Healthy Children Program (RSHC) on such communication. With a hermeneutic framework, the purpose was to develop understanding based on the topic, context, and researcher interpretations. Twelve interviews elicited data from six parent-child dyads, three from the RSHC. Analysis involved coding processes; data were compared repeatedly and organized into themes. Perceived personality differences between generations were confounded with cultural communicative differences. Parents used implicitness observed in Chinese culture to establish "open" communication; children expected explicitness observed in Western culture. Post- RSHC, parents perceived themselves as more open to talking about sex; children did not perceive such parental changes. Future research should include joint interviews and longitudinal program evaluation. Future practice should focus on cross-cultural communication and involving children in RSHC.

Clinician-Perceived Bridges and Barriers to Parental Implementation of Picture Exchange Communication System (PECS): An evaluation.

Picture Exchange Communication System (PECS) is an augmentative and alternative communicative system that improves communication and decreases problem behaviors in children with Developmental Disabilities and Autism. The mediator model is a validated approach that clinicians use to train parents to perform evidence-based interventions. Parental non-adherence to treatment recommendations is a documented problem. This qualitative study investigated clinician-perceived factors that influence parental adherence to PECS recommendations. Three focus groups (n=8) were conducted with Speech Language Pathologists and Behavior Therapists experienced in providing parents with PECS recommendations. Constant comparison analysis was used. In general, clinicians believed that PECS was complex to implement. Thirty-one bridges were identified to overcome complexity. Twenty-two barriers and 6 other factors also impacted parental adherence. Strategies to address these factors were proposed based on a review of the literature. Future research will be performed to validate these findings using parents and a larger sample size.

The development of a Flanders Interaction Analysis style instrument for use in educational computer mediated communication research

Please consult the paper edition of this thesis to read. It is available on the 5th Floor of the Library at Call Number: Z 9999 E38 D56 1992

Accommodating College ESL Learner Communication Needs: Perceptions, Policies, and Practices

The purpose of this qualitative inquiry was to determine how the Practical Nursing and Pharmacy Technician programs in one southern Ontario community college could more effectively accommodate ESL learners' communication needs. The literature review examined (a) linguistic issues, such as language testing and second-language learning theories, (b) organizational matters, such as ESL curriculum and teacher training, and (c) affective issues, such as motivation for second-language learning, learning styles, and the student-teacher relationship. I gathered perceptual data from the programs' administrators, faculty members, and ESL learners. Eleven participants took part in individual interviews or a focus group session. The results suggest that ESL learners need assistance with discipline-specific vocabulary and cultural nuances. College ESL learners' weak communicative competence, together with misleading acceptance standards for ESL learners and limited support available to faculty members and to students, decrease opportunities for successful completion of the programs. The results point to re-assessment of the college's admission policies and procedures, program evaluation practices that consider the needs of ESL learners, discipline-specific language support, and strategies to enhance the ESL student-teacher relationship. The study highlights theory relating to ESL learners' self-perception and engagement, as well as the importance of including the voice of college ESL learners in educational research. The results suggest that despite ESL learners' perseverance in completing their studies, power imbalances remain. The college has yet to implement organizational strategies such as discipline-specific communications and ESL courses and extended language support that could meet the communication needs of ESL learners in the two programs.

A Narrative Study of Patient Encounter Accounts of Physicians, Nurses, and Medical Receptionists after Two Decades of a Paradigm of Patient-Centered Care

Despite recent well-known advancements in patient care in the medical fields, such as patient-centeredness and evidence-based medicine and practice, there is rather less known about their effects on the particulars of clinician-patient encounters. The emphasis in clinical encounters remains mostly on treatment and diagnosis and less on communicative competency or engagement for medical professionals. The purpose of this narrative study was to explore interactive competencies in diagnostic and therapeutic encounters and intake protocols within the context of the physicians’, nurses’, and medical receptionists’ perspectives and experiences. Literature on narrative medicine, phenomenology and medicine, therapeutic relationships, cultural and communication competency, and non-Western perspectives on human communication provided the guiding theoretical frameworks for the study. Three data sets including 13 participant interviews (5 physicians, 4 nurses, and 4 medical receptionists), policy documents (physicians, nurses, and medical receptionists) and a website (Communication and Cultural Competency) were used. The researcher then engaged in triangulated analyses, including N-Vivo, manifest and latent, Mishler’s (1984, 1995) narrative elements and Charon’s (2005, 2006a, 2006b, 2013) narrative themes, in recursive, overlapping, comparative and intersected analysis strategies. A common factor affecting physicians’ relationships with their clients was limitation of time, including limited time (a) to listen, (b) to come up with a proper diagnosis, and (c) to engage in decision making in critical conditions and limited time for patients’ visits. For almost all nurse participants in the study establishing therapeutic relationships meant being compassionate and empathetic. The goals of intake protocols for the medical receptionists were about being empathetic to patients, being an attentive listener, developing rapport, and being conventionally polite to patients. Participants with the least iv amount of training and preparation (medical receptionists) appeared to be more committed to working narratively in connecting with patients and establishing human relationships as well as in listening to patients’ stories and providing support to narrow down the reason for their visit. The diagnostic and intake “success stories” regarding patient clinical encounters for other study participants were focused on a timely securing of patient information, with some acknowledgement of rapport and emapathy. Patient-centeredness emerged as a discourse practice, with ambiguous or nebulous enactment of its premises in most clinical settings.

Oral French Communication in French Immersion Canadian and World Studies Classrooms: A Primer for Educators

This project presents a primer for secondary French Immersion teachers that facilitates the use of French oral communicative activities in secondary Canadian and World Studies courses. The primer supports collaborative and inclusive teaching strategies that invite students to speak and develop their oral French communication skills. The primer is divided into 2 main components: (a) Rationale for the Primer, and (b) the Strategies themselves, comprising succinct descriptions as well as potential uses and suggestions. A critical content analysis of various Ontario Ministry of Education documents was undertaken in order to explore the importance of oral communication in second-language learning in Ontario secondary schools. Furthermore, holistic and invitational education perspectives were examined in order to define the advantages of collaborative learning. Moreover, research in the stream of French Immersion studies was also referenced to frame the relevance of second-language learning and the significant role the French Immersion teacher plays. The aforementioned research contributes to the advancement of theory and practice regarding the importance of opportunities for oral French communication in secondary Canadian and World Studies courses.