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Background: Blended online courses, which combine synchronous and asynchronous online activities, have expanded rapidly in higher education. How to enhance student engagement in such courses is unclear, although it is recognized that student engagement is malleable through instructional strategies. Objectives: Given the above, this study aims to examine the influence of categories of strategies on student engagement in blended online courses. Methods: A conceptual framework of instructional strategies indicated as fostering student engagement in the relevant literature was first presented, divided in eight categories (structure, pace, relevance, active, choice, relationships, explanations, guide). Then a research framework linking the categories of strategies to student engagement dimensions (emotional‐cognitive, social, behavioral) was built and tested in blended online courses. Data collected in various disciplines and university levels at four universities (n = 482) were examined using partial least squares structural equation modeling. Results and Conclusions: The structural model examination confirmed the combined effects of categories of instructional strategies on student engagement in such courses in all disciplines. Particularly, this study revealed that 1) establishing trusting relationships, 2) demonstrating the relevance of activities, content, and resources, and 3) maintaining a sustained course pace significantly impacted student engagement in blended online courses in all disciplines. Takeaways: This study draws upon the blended learning literature to bring together key instructional strategies that foster student engagement while highlighting empirical quantitative evidence of their effects on student engagement in blended online courses. Detailed measures of categories of instructional strategies and student engagement dimensions also provide reliable instruments for future research. Lay Description: What is currently known about the subject matter?: Student engagement has important repercussions on perseverance, in‐depth learning, satisfaction, and academic success.Blended online courses merge the benefits of synchronous interactions and online flexibility in terms of time, place, or even study pace.Student engagement is influenced by contextual variations like course modalities and instructional strategies.The literature lacks a quantitative large‐scale portrait of how instructional strategies influence student engagement in blended online courses in higher education. What does this paper add to the existing body of research?: Partial least squares structural equation modelling was used to examine the effects of eight categories of instructional strategies on emotional‐cognitive, social, and behavioural dimensions of student engagement.Emotional‐cognitive engagement is largely affected by instructional strategies, while social and behavioural engagement are moderately affected by these.Establishing trusting relationships; demonstrating the relevance of activities, content, and resources; and maintaining a sustained course pace have the most significant effects on student engagement in blended online courses. Implications of study findings for practitioners: Teachers should explicitly support students in the process of developing interpersonal relationships in blended online courses to foster student social engagement, that is, interactions and sense of connectedness between them.Ensuring a sustained pace, dynamism, and a diversity of teaching and learning activities, both synchronously and asynchronously, promotes student engagement in blended online courses.Highlighting or demonstrating the relevance of activities and contents fosters emotional‐cognitive and behavioural student engagement. [ABSTRACT FROM AUTHOR]

With the human papillomavirus (HPV) vaccine positioned as the "right tool" to protect girls' health and sexual health, public discourse positions parents as "responsible" if they vaccinate, "irresponsible" if they do not. The problem with this binary, however, is that it cannot account for the full spectrum of responsibilities and social norms that parents enact in vaccine decisions. In this paper, and in the context of low HPV vaccination rates, I confront this binary and encourage a fuller view of adolescent health and sexual health. Using data from qualitative semi‐structured interviews with 28 Canadian mothers tasked with consenting to the HPV vaccine, I examine the complexity of this responsibility. I find HPV vaccine‐consenting mothers have normative conceptualisations of responsibility aligned with dominant interpretations of public health. Rather than expressing irresponsibility, some non‐HPV vaccine‐consenting mothers articulated alternate responsibilities, aligned with broad efforts to manage their teens' sexual health and sexuality. They extend responsibility beyond cancer protection vis‐à‐vis vaccines to a general responsibility for daughters' sexual health and self‐esteem. In conclusion, I recommend the need for a broader public health approach to HPV, which includes, and goes beyond vaccination. Moreover, I suggest that some of these alternate responsibilities be viewed as complementary to vaccination. [ABSTRACT FROM AUTHOR]

Hermeneutics, also referred to as interpretive phenomenology, has led to important contributions to nursing research. The philosophy of Charles Taylor has been a major source in the development of contemporary hermeneutics, through his ontological and epistemological articulations of the human sciences. The aim of this paper is to demonstrate that Taylor's ideas can further enrich hermeneutic inquiry in nursing research, particularly for investigations of ethical concerns. The paper begins with an outline of Taylor's hermeneutical framework, followed by a review of his key ideas relevant for ethics research. The paper ends with a discussion of my empirical research with critically ill children in Canada and France in relation to Taylor's ideas, chiefly Social Imaginaries. I argue that Taylor's hermeneutics provides a substantive moral framework as well as a methodology for examining ethical concerns. [ABSTRACT FROM AUTHOR]

Background Over the past two decades, there is increasing emphasis being placed upon providing family-centred care (FCC) in paediatric oncology settings. However, there is a lack of knowledge of FCC in paediatric oncology from the perspectives of immigrant parents. The purpose of this paper is to describe Chinese and South Asian immigrant parents' experiences of FCC in paediatric oncology settings in Canada. Methods This study adopted a constructivist grounded theory approach. Fifty first generation Chinese and South Asian parents of children with cancer who were at least 6 months post-diagnosis were recruited from six Canadian paediatric oncology centres. Interviews were conducted in English, Cantonese, Mandarin, Urdu, Punjabi or Hindi, and transcribed into English. Analysis involved line-by-line, focused and theoretical coding, and the use of the constant comparison method. Results Findings indicated that overall parents were highly satisfied with the care and services they received, and their experiences were reflective of the key elements of FCC. However, there were some areas of concern identified by participants: parents not perceiving themselves as a member of the medical team; inconsistency in the quality and co-ordination of services among healthcare providers; disrespectful and mechanical manner of a few healthcare providers; and parents' discomfort with healthcare providers communicating sensitive health-related information directly with their child. Conclusions In order to successfully provide family-centred services to immigrant parents of children with cancer, better communication of the elements of FCC between healthcare staff and families is needed to negotiate a clear role for the parents as partners of the healthcare team. Moreover, a better understanding of how family relationships are structured in immigrant families will assist healthcare providers to balance the best interests of the child with that of the family as a unit. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Janjua et al. (2012) Transmission dynamics and risk factors for pandemic H1N1-related illness: outbreak investigation in a rural community of British Columbia, Canada. Influenza and Other Respiratory Viruses 6(3), e54-e62. Objective To characterize the first-wave epidemiologic features of influenza-like illness (ILI) associated with the novel pandemic A/H1N1 [A(H1N1)pdm09] virus. Methods We used generalized linear mixed models (GLMM) to assess risk factors and non-parametric and/or parametric distributions to estimate attack rates, secondary attack rates (SAR), duration of illness, and serial interval during a laboratory-confirmed community outbreak of A(H1N1)pdm09 clustered around on-reserve residents and households of an elementary school in rural British Columbia, Canada, in late April/early May 2009. ILI details were collected as part of outbreak investigation by community telephone survey in early June 2009. Results Overall, 92/408 (23%) of participants developed ILI and 36/408 (9%) experienced medically attended ILI (MAILI). The overall SAR in households was 22%: highest among participants 1-4 years of age (yoa) (50%) followed by <1 yoa (38%), 5-8 yoa (20%), 10-19 yoa (13%), 20-49 yoa (20%), and 50-64 yoa (0%). The median serial interval was estimated at 3·5 days (95% CI: 2·1-5·1). In multivariable GLMM analysis, having a chronic condition (OR: 2·58; 95% CI: 1·1-6·04), younger age [1-8 yoa: OR: 4·63; 95% CI: 2·25-9·52; 9-19 yoa: OR: 1·95; 95% CI: 0·97-3·9 (referent: ≥20 yoa)] and receipt of 2008-2009 influenza vaccine (OR: 2·68; 95% CI: 1·37-5·25) were associated with increased risk of ILI. Median duration of illness was 9 days, longer among those with chronic conditions (21 days). Median time to seeking care after developing illness was 4·5 days. On-reserve participants had higher chronic conditions, household density, ILI, MAILI, and SAR. Conclusions During a community outbreak of A(H1N1)pdm09-related illness, we identified substantial clinical ILI attack rates exceeding 20% with secondary household attack rates as high as 50% in young children. The serial interval was short suggesting a narrow period to prevent transmission. [ABSTRACT FROM AUTHOR]

This paper deals with the initial steps of the judicial process for persons with intellectual disabilities who are suspected of a minor offense; a stage where plaintiffs, police officers, and crown attorneys make a series of decisions that will have a significant impact on the course of the judicial process. The objective of this study was twofold: (i) to document the criteria that influence dispositions by police officers and crown attorneys about persons with intellectual disabilities in the criminal justice system (CJS), (ii) to report suggested improvements to better support them throughout the judicial process. Fourteen semi-structured interviews were conducted with key informants from the CJS and from service and community organisations working in the field of intellectual disabilities. The results of this qualitative study indicate that decisions made and dispositions taken rely on a series of implicit criteria that influence the course of the subsequent judicial procedures against persons with an intellectual disability. Suggestions for improvement pertain to developing the screening of intellectual disability procedures, the provision of information to key actors about intellectual disabilities, a preference for the use of summons to appear over other types of procedures, and drafting memorandums of understanding between various organisations and police services regarding persons with intellectual disabilities. In conclusion, an emphasis must be put on screening and diversion procedures for persons with intellectual disabilities when appropriate. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper draws upon empirical research and other published sources to discuss nursing workforce issues, the challenges of using health human resource research in policy decisions and the importance of evidence-based policies and practices for nursing care and outcomes. Background. Increasing evidence points to the critical relationship between registered nurse care and improved patient outcomes. The negative impact that insufficient nurse staffing has on patient, nursing and system outcomes has influenced health human resource researchers to further examine nurses' work environments to determine factors that are amenable to policy change. Design. Survey of literature was conducted. Methods. Electronic databases were searched using keywords. Results. Sustained health human resource planning efforts by policy makers are difficult given changing governments and political agendas. The health human resource conceptual framework provides researchers and planners with a guide to decision-making that considers current circumstances as well as those factors that need to be accounted for in predicting future requirements. However, effective use of research depends on communication of findings between researchers and policymakers. Conclusions. Health care managers and other decision-makers in health care organisations often lack an understanding of the research process and do not always have easy access to current evidence. Also, managerial decisions are often constrained by organisational requirements such as resource availability and policies and procedures. Relevance to clinical practice. Unless nursing workplace issues are addressed, the physiological and psychological stress in the work environments of nurses will continue. Effective health human resource policy and planning (at the macro level) and management strategies (at the micro level) would stabilise the nursing workforce and reduce job stress. Furthermore, the efficiency and cost-effectiveness of the health system could be enhanced through improved health outcomes of care providers and health care clients. [ABSTRACT FROM AUTHOR]

Objective: : Research has shown differences in health status and health care utilization related to culture, economic status, and health care development. This paper reports on a study comparing attitudes of women in three countries, at various stages of development, about their own health and self-worth and asks if these differences account for differences in health care utilization and inequities in health status.Method: : A questionnaire, administered to 100 women in each of Yemen, Uganda and Canada, explored women's perception of their own health and health care seeking behavior.Result: : Women's perception of themselves as worthy of care was positively related to utilization. The ability to make one's own health care decisions varied with her country's development level. Implementation strategies must consider women's decision-making capacity.Conclusion: : To achieve improved health status, policies and programs must commit to encouraging appropriate social and cultural changes, using a 'cross-sectoral approach', involving both gender and development issues. [ABSTRACT FROM AUTHOR]

This paper reflects how health services research 'evidence' was used to influence decisions in the province of Ontario, Canada. The process involved interaction among a variety of stakeholders and decision-makers with researchers to reduce uncertainty and to substantiate emerging service provision issues in the province. The issues presented here focus specifically on an analysis of the nursing situation completed in 1998 for the Minister of Health's Nursing Task Force, which examined key issues in service delivery. The issues were: restructured work environments; nurse supply and declining enrollments; labour trends and utilization of the nursing workforce; patient acuity and complexity of work environments and the influence on workload; and the paucity of reliable and valid data bases for analysis of nursing's contribution to the health system. Ontarians can be confident that the Task Force recommendations were born from solid research-based evidence and now the challenge becomes to monitor the implementation of these resolutions over time. [ABSTRACT FROM AUTHOR]

In many long-term care settings, cardiopulmonary resuscitation (CPR) is regarded as an available treatment option. However, for the majority of long-term care residents the expected outcome following CPR is poor. This descriptive study explored the CPR decision-making process in two long-term care institutions. This was accomplished through the administration of questionnaires to nursing staff, residents, residents' family members and through completion of a chart review of deceased individuals. This paper primarily addresses the role of nurses in the CPR decision-making process in long-term care. Nurses were rarely explicitly involved in the CPR decision-making process. Knowledge deficits of nurses concerning the CPR policy at the institutions and the expected outcomes of CPR were identified. Also noted were inconsistencies between policy and practice, with CPR being withheld in practice more often than dictated by protocol. Strategies to facilitate the CPR decision-making process in long-term care settings are suggested, and specific roles for nurses in relation to CPR decision making are presented. [ABSTRACT FROM AUTHOR]

This paper reports the results of a study conducted with 18 health care providers (HCPs) in two Toronto hospitals. The study examined and assessed how these HCPs make clinical-ethical decisions in the light of a theoretical model of clinical-ethical decision making. Nine nurses and nine doctors were interviewed through two-phased, in-depth, semi-structured interviews. The results suggest that, in relation to the two major elements of the model, namely the ethical component and the decision theory component, the HCPs did not follow a consistent and systematic pattern of ethical decision making. Differences emerged between their actual self-reported behaviour and their potential moral capability (i.e. their abstract thought process). The general picture that emerged was that decisions were made in a narrow, habitual manner, through the elimination of the most significant and demanding elements of the process. HCPs' ethical approaches affected the entire process of the decision making: their perception of the problem, their search for and selection of information and evidence, and their development of alternatives and resultant consequences. It is suggested to (a) further investigate and understand the subjective realities of the individuals involved in the decision making processes, their values and the meaning they ascribe to their choices, and (b) to establish extensive educational programmes to enhance HCPs' decision-making capacity and subsequently promote an effective and responsible professional practice. [ABSTRACT FROM AUTHOR]

In this article, we discuss how we used institutional ethnography (Institutional ethnography as practice, Rowman & Littlefield, Lanham, MD and 2006) to map out powerful ruling relations that organize nurses' wound care work. In recent years, the growing number of people living with wounds that heal slowly or not at all has presented substantial challenges for those managing the demands on Canada's publicly insured health‐care system. In efforts to address this burden, Canadian health‐care administrators and policy‐makers rely on scientific evidence about how wounds heal and what treatments are most effective. Advanced wound care exemplifies the growing authorization of particular forms of evidence that change the ways in which nurses come to know about and conduct their work. The focus of this paper's nursing inquiry is a critique of registered nurses' wound work as it arises within the established uptake of scientific evidence. [ABSTRACT FROM AUTHOR]

Organizations are using crowdsourcing to capture innovation knowledge from the crowd in the form of ideas and then using the crowd to evaluate those ideas using votes. In this paper, we investigate a crowdsourcing setting in which Canada solicited information from its citizens to develop a digital transformation strategy. Canada used a two‐phase approach. Phase 1 was used to determine which ideas had the largest number of crowd votes, whereas in Phase 2, the crowd voted on the 30 leading vote‐getting ideas to determine the three winning ideas. This research investigates the ability to use information from ideas to estimate the number of votes that the ideas generate. This approach could be used to estimate the number of ideas, before making information available to the crowd. The unstructured text information in the idea is structured by using target concept dictionaries, which are used to estimate the extent to which the dictionary words appear in the ideas (e.g., "globalism") and are related to the number of votes. Using this approach, roughly 1% of the total words are used to explain roughly 60% of the variance in the votes. Further, we also find that the variables associated with Phase 1 votes are not the same variables associated with Phase 2 votes; that is, the decision‐making variables changed. Finally, we find that votes are statistically significantly related to the content in the idea titles and the idea statements. [ABSTRACT FROM AUTHOR]

In 1974, the Liberal government of Pierre Trudeau released a "green paper" known as the Lalonde Report, after the health minister at that time. The report formulated perspectives on health and the main concepts and ideas developed in it, particularly the concept of "lifestyle," which became the foundation of public health policies in many different European countries and the United States. The concept of "lifestyle" connected personal behaviour and habits to the individual health condition; people were not dying due to a lack of access to medical care but because they lived a life prone to personal risk taking. Furthermore, what is seldom discussed is that this report not only propagated the (neo)liberal view of citizens as autonomous rational actors (homo oeconomicus), with personal responsibility for their health, but it was a first step in the transformation of Medicare and went far beyond the question of health promotion. Health was no longer something that happened to a person but was created through personal choice and, therefore, one had to assume responsibility for one's behaviour. Using Foucault's definition of government as the "conduct of conduct," we will demonstrate that the Lalonde report must be understood as a specific "technology of government" and contributed to a neoliberal transformation of health care despite the fact that the Canadian system of Medicare was based on the idea of universality, meaning citizens had equal access to health care independent of their socio‐economic situation. As we will demonstrate, the Lalonde report undermined this foundation and initiated a profound reorientation, not only of the healthcare system, but even more importantly, it radically changed the way we think about our behaviour around health‐related issues. We will also discuss how the making of the report contributed to the redefinition of politics and demonstrated a lack of concern with liberal‐democratic decision‐making processes. [ABSTRACT FROM AUTHOR]

The article discusses the graduate education opportunities in fisheries science in Canada and the U.S. as well as some of the issues that may influence students when they are making decisions about graduate schools. Some options for seeking graduate opportunities include reviewing papers of interest, contacting current graduate students, and searching the Web for online graduate postings. The main requirements of admission to a graduate program are a minimum grade point average (GPA) and approval from a potential supervisor.