A substantive theory of the realization of stroke patients’ dignity in hospital care

Dignity is seen important in health care context but considered as a controversial and complex concept. In health care context, it is described as being influenced by for example autonomy, respect, communication, privacy and hospital environment. Patient dignity is related to satisfaction with care, reduced stress, better confidence in health services, enhanced patient outcomes and shorter stay in a hospital. Stroke patients may struggle for dignity as being dependent on other people has impact on the patients’ self-image. In all, stroke patients are very specific patient group and considered vulnerable from emotional aspect. Therefore study findings from other patient groups in the area of ethical problems cannot be transferred to the stroke patients. This master’s thesis consists of two parts. The first part is the literature review of patients’ dignity in hospital care. The literature defined dignity and described factors promoting and reducing it. The results were ambiguous and thus a clear understanding was not able to create. That was the basis for the second part of the master’s thesis, the empirical study. This part aimed to develop theoretical construction to explore the realization of stroke patients’ dignity in hospital care. The data of the second part was collected by interviewing 16 stroke patients and analyzed using the constant comparison of Grounded Theory. The result was ‘The Theory of Realization of Stroke Patients’ Dignity in Hospital Care’ which is described not only in this master’s thesis but also as a scientific article. The theory consists of the core category, four generic elements and five specific types on realization. The core category emerged as ‘dignity in a new situation’. After a stroke, dignity is defined in a new way which is influenced by the generic elements: life history, health history, individuality and a stroke. Stroke patient’s dignity is realized through five specific types on realization: person related dignity type, control related dignity type, independence related dignity type, social related dignity type and care related dignity type. The theory points out possible special characteristics of stroke patients’ dignity in control related dignity type and independence related dignity type. Before implementing the theory, the relation between the core category, generic elements and specific types on realization needs to be studied further.

Onko yrityksen taloudellisella tilalla vaikutusta Tekes-rahoitusta saaneen yrityksen menestymiseen

Tämän tutkielman tavoite on yrityksen tulevan menestymisen tai epäonnistumisen ennustaminen. Tutkimuksen kohteena ovat tutkimus ja kehitys rahoitusta vuosina 2007- 2012 Tekesiltä saaneet mikro- ja pk yritykset. Ennustusta pyrittiin tekemään näille yrityksille niiden rahoitusprojektien alkuhetkeltä (hakemushetki). Tutkimus toteutettiin toimeksiantona Tekesille ja se jatkaa aikaisempaa tutkielmaa, ”Onko projektin henkilöriskitasolla tai talousriskitasolla yhteyttä t&k- projektin onnistumiseen?”. Tämän tutkimuksen johtopäätös oli, ettei varsinkaan talousriskillä ja projektin onnistumisella ole yhteyttä ja sen vuoksi niistä tarvittiin lisää tietoa. Teoreettisessa osuudessa käsitellään yrityksen kasvua ja onnistumisen tai epäonnistumisen ennakointia. Teoria pohjautuu aiheen aikaisempaan kirjallisuuteen ja sen tarkoitus on pohjustaa tutkielmassa tehtyjä valintoja yrityksien menestymisen ennustamiseksi. Tutkimus on toteutettu kvantitatiivisena tutkimuksena. Aineisto koostuu 430 Tekesin t&k- rahoitusta saaneista mikro- ja pk yrityksistä. Empiirisen osuuden tarkoitus oli selvittää, voidaanko koko yrityksen, menestystä ennustaa, jotta rahoitus voidaan kohdistaa paremmin, eli selvittää minkälaisia yrityksiä tulisi rahoittaa, jotta rahoitus kohdistuisi menestyjille. Tämän lisäksi tutkimuksessa haluttiin löytää oikeat muuttujat, joiden avulla yrityksen menestymisen ennustaminen on mahdollista. Menestymisen haluttiin kuvaavan koko yrityksen liiketoiminnan menestymistä. Menestymisen mittariksi valittiin liikevaihdon kasvu ja tarkasteltavaksi ajanjaksoksi aika yrityksen t&k- projektin hakemusvaiheesta, kolmen vuoden päähän projektin päättymisestä. Yritykset jaettiin menestyjiin liikevaihdon kasvun mukaan, ja niistä luotiin neljä koria: “Huiput”, “Kasvut”, “Hiipujat” ja “Konkurssit” ja koreja lähdettiin tutkimaan erilaisten mittarien avulla. Valitut mittarit olivat Tekesin riskiarvio (talousriski, henkilöriski, kehitysriski ja markkinariski), tilinpäätöksen tunnusluvuista kannattavuuden, maksuvalmiuden ja vakavaraisuuden tunnusluvut (liikevoittoprosentti ja sijoitetun pääoman tuottoprosentti, quick ratio ja omavaraisuusaste), projektin omarahoitus (yrityksen hakemusvaiheessa ilmoittama muun rahoituksen lähde, joka voi olla vieraanpääoman ehtoista, oman pääomanehtoista tai tulorahoitusta), sekä muut mittarit (uutuusarvo, jalostusarvo, tuottavuus ja lainojen perimättäjättöhakemukset). Riippumattomuutta testattiin ristiintaulukoinnilla, khiin neliötestillä ja kontingenssikerroin C:n avulla omavaraisuusasteen tunnusluvun osalta yhdistämällä ”Huiput”, ”Kasvut” ja ”Hiipujat” yhteen kotiin ja vertaamalla niitä konkurssiin menneisiin yrityksiin. Lopuksi konkurssiennusteista testattiin pienille yrityksille tarkoitettua Laitisen yhdistelmälukua. Tutkimuksessa havaittiin seuraavaa. Parhaiten yrityksen tulevan kasvun tai konkurssin ennakoivat havainnot seuraavissa muuttujissa: onko hanke rahoitettu lainalla vai avustuksella sekä mikä yrityksen hakemusvaiheen omavaraisuusaste, omarahoitusosuus tai tuottavuus on. Yrityksen hyvä rahatilanne projektin hakemusvaiheessa ei ennusta yrityksen liikevaihdon kasvua. Täydellistä ennustetta kasvulle ei voida tehdä. Laitisen yhdistelmäluku koettiin heikoksi tunnusluvuksi konkurssia ennustettaessa. Tämän takia, sitä muokattiin eri tavoin parhaan mahdollisemman ennusteen saamiseksi. Paras lopputulos saatiin muuttamalla tunnusluvun kriittistä arvoa pienemmäksi.

“Liderazgo Transformador” Sostenibilidad empresarial en medio de la crisis.

En la conferencia se habló sobre el liderazgo que se debe llevar para lograr la sostenibilidad de las empresas en el tiempo, teniendo siempre una visión hacia el futuro con una respectiva planeación ligada a los valores y objetivos estratégicos para poder enfrentar las crisis que se presenten en el tiempo. Su objetivo fue motivar a las empresas para que tengan una visión más amplia de cómo llegar a ser sostenibles y tener en cuenta su responsabilidad social. Conferencista: Doctora Rose Marie Saab Faour, Presidente de Independence Drilling S.A.

Variational Monte Carlo study of core-valence separation schemes for first-row atoms and positive ions /

All-electron partitioning of wave functions into products ^core^vai of core and valence parts in orbital space results in the loss of core-valence antisymmetry, uncorrelation of motion of core and valence electrons, and core-valence overlap. These effects are studied with the variational Monte Carlo method using appropriately designed wave functions for the first-row atoms and positive ions. It is shown that the loss of antisymmetry with respect to interchange of core and valence electrons is a dominant effect which increases rapidly through the row, while the effect of core-valence uncorrelation is generally smaller. Orthogonality of the core and valence parts partially substitutes the exclusion principle and is absolutely necessary for meaningful calculations with partitioned wave functions. Core-valence overlap may lead to nonsensical values of the total energy. It has been found that even relatively crude core-valence partitioned wave functions generally can estimate ionization potentials with better accuracy than that of the traditional, non-partitioned ones, provided that they achieve maximum separation (independence) of core and valence shells accompanied by high internal flexibility of ^core and Wvai- Our best core-valence partitioned wave function of that kind estimates the IP's with an accuracy comparable to the most accurate theoretical determinations in the literature.

A study of self-directed learning at an Ontario college of applied arts and technology

Ontario Colleges of Applied Arts and Technology (CAATs) are currently in the process of restructuring to ensure quality, accountability, and accessibility of college education. References to learner involvement and self-directed learning are prevalent. "Alternative delivery" and "paradigm shift" are current buzzwords within the Ontario CAAT system as an environment is created supportive of change. Instability of funding has also dictated a need for change. Therefore, a focus has become quality of learning with less demand on public resources. This qualitative case study was conducted at an Ontario CAAT to gather descriptive, perceptual data from post-secondary community college educators who were identified as supportive of self-directed learning and from post-secondary, traditional-aged college students who were perceived by their educators to be selfdirected learners. This college was selected because of initiatives to modify its academic paradigm to encourage what was reputed in the Ontario CAAT system to be self-directed learning. The purpose of this study was to investigate how postsecondary, traditional-aged college students and their educators perceive self-directed learning as part of the teaching-learning experience within a community college setting. Educator participants of the study were selected based on the results of a teaching and learning survey intended to identify educators supportive of self-directed learning. A total of 317 surveys were distributed to every full-time educator at the sample college; 192 completed surveys were returned for a return rate of 61 %. Of these, 8% indicated instructional beliefs and values supportive of self-directed learning. A purposive sample of six educators was selected using a maximulp variation sampling strategy. A network selection sampling strategy was used to select a purposive sample of seven post-secondary students who were identified by the sample educators as selfdirected learners. The results of the study show that students and educators have similar perspectives and operating definitions of self-directed learning and all participants believe they either practice or facilitate self-directed learning. However, their perspectives and practices are not consistent with the literature which emphasizes learner autonomy or control in course structure and content. A central characteristic of the participants represented in this study is the service-oriented professions with which each is associated. Experientiallearning opportunities were highly valued for the options provided in increasing learner independence and competencies in reflective practice. Although there were discrepancies between espoused theory and theory in practice in terms of course structure, the process of self-directed learning was being practiced and supported outside the classroom structure in clinical settings, labs and related experiences.

Changes in education and student-centred learning as related to senior secondary school English

The main purpose of this thesis is to t r ace broadly the educational changes in the past two decades showing a shift of emphasis from a teacher-directed, content-centred philosophy of teaching to a self-directed, student-centred mode of learning. The major justification for an Independent or an Individualized Learning programme with emphasis on "the response to literature approach" is 2 to produce the independent learner. Comprehensive r eading and t he use of t he ERIC system reveal widespread educational thought and practice related t o Individualization and Independent Study as a really democratic way of learning with freedom, independence and responsibility.

Therapeutic riding : learning and recovery for people with disabilities

The purpose ofthis study was to explore the process oftherapeutic riding as an experiential and holistic approach to learning and recovery for people with disabilities as perceived by the providers oftherapeutic riding. To enhance the connection between theory and practice and to suggest future research, the researcher endeavoured to develop a theory that contributed to the knowledge base oftherapeutic riding, animal-assisted therapy and education, experiential education, and experiential therapy in addition to contributing to connections among them. This topic was investigated because ofthe lack ofresearch about the process of therapeutic riding, particularly from learning and a recovery perspective. Few studies have addressed how therapeutic riding outcomes are achieved or how the therapeutic riding process actually works. This study was identified as grounded theory using qualitative data through interviews and narrative reflections with therapeutic riding providers, a researcher's journal, field notes, and written documents. Grounded theory analysis was used to analyze the qualitative data. This consisted ofdoing open, axial, and selective coding. This study provided detailed descriptions ofthe research approach, researcher's involvement, participant and site selection, data collection and analysis, methodological assumptions and limitations, credibility established, and ethical considerations. The findings ofthe data analysis revealed the theme ofrelationships as central to the learning and recovery process oftherapeutic riding for people with disabilities. The significance ofthe team relationships, the horse and rider relationship, and the providers and rider relationship was found. The essential components ofthe learning and recovery process were presented in a diagram in the selective coding phase. Goals oftherapeutic riding included psycho-education; behavioural and social; physical; and equestrian. Parts ofthe process ofhow outcomes were achieved included motivation; "opens new doors;" risk; task analysis; control; communication; and environmental factors. Outcomes of therapeutic riding included independence and mobility; confidence; and transfer abilities or skills. The implications ofthese findings for theory, practice, and further research were also. explored.

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.

Medicalization and women : O, the Oprah Magazine diagnosed through critical discourse analysis

This thesis uses critical discourse analysis (COAl to explore and examine direct-toconsumer (OTC) pharmaceutical drug advertisements appearing in four issues of 0, The Oprah Magazine in 2006. The theoretical underpinnings of this thesis emerge from social scientists and feminists analyses regarding the medicalization of everyday life. The findings of this study highlight three types of discourses used by pharmaceutical companies. First, I explore the use of historical and contemporary gender norms to seJi pharmacological products; second, J examine discourses which normalize the use of chemical solutions as the first line of defense to address a wide range of everyday problems; and finally, I assess how phannaceutical advertisements provide an illusion of autonomy by responsibilizing individuals as patients, at the same time as they suggest that real independence can only be achieved with medication. My discussion of these themes also includes an analysis of why 0 Magazine, which explicitly promotes women's empowerment through holistic approaches to health and personal growthmight support such advertising. Thus I explore: how does OTC advertising benefit both pharmaceutical companies and 0 Magazine itself? I conclude through a brief discussion of the larger implications of OTC advertising for women's health.

Relation of temperament and authoritative parenting on subtypes of adolescent behaviour

Over the years, researchers have investigated direct, conditional, and meditational pathways of adolescent aggression in relation to both temperament and parenting behaviours. However, no study to date has considered these relations with respect to a measure of aggression differentiated by form (e.g., overt, relational) and function (e.g., proactive, reactive). The present study examined the differential association of adolescent temperament and authoritative parenting on four subtypes of aggression. Participants included mothers, fathers, and one adolescent (between the ages of 10-19) from 663 families, recruited through random digit dialing. Parents reported on their child's temperament and occurrence of aggressive behaviours in addition to the perception of their own authoritative parenting. Adolescents reported on their own temperament and aggressive behaviours as well as on both their mother and father's authoritative parenting. Multiple regression analyses confirmed predictions that some aspects of temperament and authoritative parenting provide motivation towards the engagement of different aggressive behaviours. For example, higher negative affect was related to reactive types of aggression, whereas a strong desire for novel or risky behaviours related to proactive aggression. However, differences in effortful control altered the trajectory for both relationships. Higher levels of self-regulation reduced the impact of negative affect on reactive-overt aggression. Greater self-regulation also reduced the impact of surgency on proactive-overt aggression when age was a factor. Structural equation modeling was then used to assess the process through which adolescents become more or less susceptible to impulsive behaviours. Although the issue ofbi-directionality cannot be ruled out, temperament characteristics were the proximal correlate for aggression subtypes as opposed to authoritative parenting dimensions. Effortful control was found to partially mediate the relation between parental acceptancelinvolvement and reactive-relational and reactive-overt aggression, suggesting that higher levels of warmth and support as perceived by the child related to increased levels of self-regulation and emotional control, which in tum lead to less reactive-relational and less reactive-overt types of aggression in adolescents. On the other hand, negative affect partially mediated the relation between parental psychological autonomy granting and these two subtypes of aggression, supporting predictions that higher levels of autonomy granting (perceived independence) related to lower levels of frustration, which in tum lead to less reactive-relational and reactive-overt aggression in adolescents. Both findings provide less evidence for the evocative person-environment correlation and more support for temperament being an open system shaped by experience and authoritative parenting dimensions. As one of the first known studies examining the differential association of authoritative parenting and temperament on aggression subtypes, this study demonstrates the role parents can play in shaping and altering their children's temperament and the effects it can have on aggressive behaviour.

Manuscript of James Cummings- August 28, 1860

Transcript (spelling and grammar retained): Chippawa [Chippewa] 28th August 1860 My Dear Sir I duly received your very kind letter of the 24th [June] asking me to communicate such facts of general interest connected with my career during the War with the United States. I have no objection to afford you such information as came under my own observation; nevertheless I do so, with the understanding, I have no desire to be my own trumpeter. With respect to your circular wherein you state you have been for several years collecting materials for a History of the late War between the United States & Great Britain, for which you are now gathering further materials to add to your collection, concerning the Second War for Independence. I am rather at a loss to know, what is meant by the second war; If you allude to the petty Rebellion, it could not be called a War, Those that caused the outbreak were very soon put down, by the Loyal people of the Province without the aid of Regular Troops being satisfied with the Independence they enjoyed. With respect to the several questions names in your circular: To the 1st I would say, this locality is made memorable by the battle of Chippawa [Chippewa] which took place about a mile above the village on the ground I pointed out to you, when I had the pleasure of seeing you a few days ago, with Mr Porter of the Niagara Falls, of which I believe you took sketches at the time. 2nd I have no historical documents of any value; so many years having gone past, the most of my old papers have either been lost or destroyed, I however came across two letters, one dated Queenston 9th July 1812 from Lt. Col. Nicholl Quarter Master General of Militia, the other from Lt. Col Myers Deputy Quarter Master General of the Regular Army date Fort George 23rd same month, directed to me in the hand writing of each of those officers as Deputy Quarter Master General of Militia, which letters I shall be obliged you would return at as early a day possible, as I wish to place them with tome others in the case, I have had made to hold the cocked hat & feather I wore during that eventful period, which I am sorry I did not exhibit when you was at my house; with reference to it I now enclose a letter from Lt. Col. Clark, residing at Port Dalhousie he was Captain & Adjutant of Militia in the War of 1812__ I send the letter in proof of the cock’d hat it is a lengthy one, but you may find time to turn over it, as I shall also place it in the hat case__ 3rd Where are [but] [for] traditionary [sic] witnesses residing in this vicinity – Col Clark above named Mr Merritt of St. Catharines, & Mr Kerby of Brantford are the only ones I now recollect, who could offord [sic] you any statistical information. 4th I have no pictorial sketches of any Military Movements or fortifications. As regards my own career, which you appear [ ? ] of knowing__ I was first a Lieutenant in a volunteer flank company stationed on the river side opposite [Navy] Island not far from the battle ground of Chippawa [Chippewa], I got promotion as Lieutenant of Cavalry before I got my Cavalry dress completed in three days more, I was called by General Brock to Fort George, was appointed Deputy Quarter Master General of Militia with the rank of Captain s the accompanying letters will show. I was at the battle of Stony Creek, several skirmishes at the Cross Roads, when the American army [ ? ] Fort George, at the taking of Col. Boerstler at the Beaver Dam, & had the honor of receiving Colonel Chapens sword at the surrender, who commanded a company of volunteer Horse Men was at the taking of 15 regulars & two officers at Fort Schlosser—was with Col. Bishop at the taking of Black Rock, near him when he fell, three men of the 8th Reg. more killed in the Boat I was in – I was at Chippawa battle, and the last, not the least in Lundy’s lane battle, which the Americans call the battle of Bridge [Waters]. I had forgot; there was another small affair at Corks Mill where I was. I could write a little history of events, but have not the time to do so. If what I have stated will be of any service for the purpose you require I shall feel happy. The history of the late War was published at Toronto in the Anglo American Magazine. Did you ever see it, I have the Books, there were however several errors which came under my notice, which I could have corrected. If my time would permit I could give you a more detailed statement of events. I trust however you may succeed with your publication , and I shall be most happy to hear from you at all times—I related many little occurances verbally to you when here, which I thought not necessary to repeat again as you would have a perfect recollection of them. Be pleased to return the letters for the purpose I require them. I am My Dear Sir Your respectful friend James Cummings

Independent Chronicle Vol. XLIV No. 3,273- August 24, 1812

A semi-weekly paper that was published from 1801 to 1817. It was previously called the Independent chronicle and the universal advertiser, and was later the Independent chronicle and Boston patriot (Semiweekly). Publishers were Abijah Adams and Ebenezer Rhoades. Topics of interest in this issue include: Page 1: notice from the U.S. War Department seeking proposals for the supply of rations to troops; essay in support of the war; U.S. Secretary of War requests that the Governor of Maryland order 350 militia into active service; statement from the Convention of Republican Delegates in New Jersey in support of the war; statement from U.S. President James Madison in support of the war; statement from Maj. Gen. Isaac Brock to residents of Upper Canada urging their support in the war; U.S. Secretary of war sends 1,500 reinforcement troops to Detroit; Page 2: account from U.S. Gen. Hull of a battle near Fort Malden and news of troops in other areas; editorial against the British alliance with the Indians; letter from a U.S. Officer describing military gains near Detroit; news of U.S. infantry marching from Forts Independence and Warren to Albany, N.Y.; Page 3: news of British cargo ships captured by U.S. ships; 2 reward notices for the return of deserters from the military; report of possible 60 day armistice ratified by James Madison; Page 4: notice to British subjects living in Massachusetts that they must report themselves to the marshall; 2 reward notices for return of deserters from the military;

Independent Chronicle Vol. XLVI No. 3470- July 14, 1814

A semi-weekly paper that was published from 1801 to 1817. It was previously called the Independent chronicle and the universal advertiser, and was later the Independent chronicle and Boston patriot (Semiweekly). Publishers were Abijah Adams and Ebenezer Rhoades. Topics of interest in this issue include: Page 1: report of Independence Day celebration including multiple toasts to the military; Page 2: report of South Carolina militia marching home; report of U.S. schooner Alligator being lost to a tornado in Port Royal; report of 10,000 militia and 2,000 regular Army troops to be used in defense of the District of Columbia and vicinity; report U.S. is to try to raise 100,000 militia for defense; news of British deserters providing information to the U.S.; report of skirmishes along the U.S. coast; statement from U.S. Navy Capt. David Porter stating he had taken possession of Sir Henry Martin's Island; report of British troops burning a militia barracks in Lewiston, N.Y.; 4 accounts of the battle of Chippewa and the taking of Fort Erie; statement from Maj. Gen. Brown in praise of his troops in the battle of Chippewa; copy of General Brown's orders to attack at Fort Erie; essay arguing against U.S. citizens boarding enemy ships; report of peace treaty rumours; Page 3: account of Capt. Porter's capture and subsequent escape from the British; list of American prisoners held on the British ship Nymph; report of British cargo ship captured by U.S. war ship; Proclamation from James Madison pardoning military deserters if they return to military service; announcement to officers and soldiers in the military offering reward for the return of military deserters; Page 4: 2 reward advertisements for return of military deserters;

The Effect of Functional Electrically Stimulated Ambulation Training on Locomotor Function and Quality of Life in Individuals With Incomplete Spinal Cord Injury

The purpose of this study was to investigate the effects of a 12-week FES-ambulation program on locomotor function and quality of life after incomplete spinal cord injury. Six individuals with incomplete SCI participated in the study. Over-ground walking endurance (6MWT), speed (10MWT), independence (WISCI II) and body-weight support were assessed. Quality of life was assessed via the SF-36, WHOQOL-BREF, Perceived Stress Scale, Center of Epidemiological Studies for Depression scale, and task self-efficacy. Participants experienced significant improvements in walking endurance (223.6±141.5m to 297.3±164.5m; p=0.03), body-weight support (55.3±12.6% to 14.7±23.2%; p= 0.005) and four of the six participants showed improvements on the WISCI II scale (1-4 points). In addition, there was a significant reduction in reported bodily pain (6.5±1.2 to 5.0±1.7; p=0.04). Therefore, FES-ambulation is an effective means for enhancing over-ground locomotor function in individuals with incomplete SCI. It may also be an effective method for reducing pain in individuals with SCI.

Exploring the Ethical Decision-Making Processes of Community Care Providers

While there has been a recent shift away from isolated, institutionalized living conditions, persons with Intellectual Disabilities (ID) may still experience restricted access to choice when it comes to making decisions about the basic aspects of their lives. A tension remains between protecting individuals from harm and promoting their right to independence and personal liberties. This tension creates complex questions and ethical concerns for care providers supporting persons with ID. This study explored the ethical decision-making processes of care providers and specifically, how care providers describe the balance of protecting supported individuals from harm while promoting their right to self-determination. Semi-structured interviews were conducted with six care providers employed by a local community agency that supports young and older adults with ID. Data were analysed using thematic analysis and broader themes were developed following phases of open and selective coding. Results indicated that care providers described ethical decision-making processes as frequent, complex, subjective, and uncomfortable. All participants described the importance of promoting independent decision-making among the individuals they support and assisting supported individuals to make informed decisions. Participants also reported work colleagues and supervisors as primary sources of information when resolving ethical concerns. This suggests that complex ethical decision-making processes are being taken seriously by care providers and supervising staff. The results of this study are well-positioned to be applied to the development of a training program for frontline care providing staff supporting individuals in community care settings.