Canadian Respondents Research Articles

An empirical examination of leadership styles' impact on innovative behaviour and entrepreneurial orientation in Canadian firms: a cross-cultural perspective

In the small and medium-sized enterprise, cross-cultural and entrepreneurial leadership research, there has been an assumption that one's leadership style modus operandi is one size fits all. In the current research, Canadian leadership styles and leadership differences between Canadian and North American business entrepreneurial leaders were tested. New empirical results are substantive and add to the cross-culture entrepreneurial theory. There are limited Canadian-based entrepreneurial studies: the expected corollary was that there were no differences between Canadian and American leadership styles; however, the results reported otherwise. Data were obtained from 145 Canadian respondents located in Toronto, Ontario in Canada. Data were analysed with hierarchical regression analyses and multivariate analysis of variance in testing seven hypotheses. The analyses reported a statistically significant difference in Canadian and North American leadership styles employed in an entrepreneurial context.

Understanding Placentophagy

ObjectiveTo evaluate the knowledge, attitudes, and beliefs of women during pregnancy and the postpartum period related to placentophagy. DesignMixed methods study (cross-sectional survey and online discussions). SettingWe used social media to advertise the study to mother/parenting groups. Online discussion groups were conducted through Google Groups. ParticipantsWomen during pregnancy and in the postpartum period and placenta encapsulation specialists with Internet access. MethodsWe summarized descriptive data and analyzed subgroups with the use of chi-square tests. We conducted a binary logistic regression to compare placentophagy with demographic variables and used constant comparative analysis to analyze online discussion group themes. ResultsOverall, 271 of 1,088 (24.9%) respondents consumed their placentas. Canadian respondents and those who experienced pregnancy/birth-related complications were significantly (p < .05) less likely to consume their placentas than respondents from the United States (odds ratio = 0.48, 95% confidence interval [0.28, 0.82]) and those who had no complications (odds ratio = 0.56, 95% confidence interval [0.37, 0.85]). Increased iron stores (521/1,030, 50.6%), prevention of postpartum depression (519/1,030, 50.4%), and increased energy/decreased fatigue (460/1,030, 44.7%) were the most commonly listed perceived benefits. Infection and improper handling/preparation of the placenta were important concerns, and hospital policy was noted as a barrier to placentophagy. ConclusionRespondents who engaged in placentophagy were primarily motivated by unproven benefits, such as the prevention of postpartum depression and anemia, for which there are other management alternatives. Although placentophagy is gaining popularity, it remains unregulated, and safety and efficacy data are limited. A safe, standardized preparation process is needed to minimize potential harm before further efficacy studies can be done. Targeted educational material surrounding placentophagy is needed to improve woman-centered care.

Leisure Time Use, Meaning of Life, and Psychological Distress: Comparing Canadian and Korean Older Adults

&lt;p&gt;&lt;em&gt;Older adults’ day-to-day leisure time activities both reflect and stimulate physical, cognitive, and social capacities that contribute to their quality of life. To better understand how leisure activity choices and possible impacts vary across two cultures, this questionnaire-based study compared leisure time use, perceived meaning of life, and psychological distress for 617 older adults in Canada (n=298) and the Republic of Korea (Korea) (n=319). Compared to Koreans, Canadian respondents spent more time overall in leisure activities and devoted a higher percentage of their total leisure time to active, rather than passive, activities. They spent significantly more of their time on cognitively active activities, while Koreans preferred socially and physically active ones and scored significantly higher on both meaning of life and psychological distress. Both groups spent more of their time watching television than on any other single reported activity. Age group, retirement status, health, education, and income varied across the two countries and were significantly associated with aspects of leisure time use for each group. The results identify areas for improvement if Canadian and Korean older adults’ leisure time use is to effectively support their aging well.&lt;/em&gt;&lt;/p&gt;

Self-confidence, commitment and goal-setting in Czech athletes at different performance levels

Background: Numerous studies rank self-confidence, commitment and goal-setting among the foundation mental skills in athletes, conditioning the development of elite performance and also contributing to achieving first rate results during competition. Their quality is, therefore, essential for top performance. Objective: The goal of this study is a comparison of self-confidence, commitment and goal-setting in Czech athletes performing at different performance levels. The secondary aim is to compare the values gathered in Canadian and Czech populations. Methods: The Czech version of the OMSAT-3* questionnaire was distributed to 241 athletes at regional (n = 63), national (n = 115) and international levels (n = 63). Only the part of the questionnaire focusing on the selected mental skills (3 out of 12 scales) was used. Subsequently, the data were compared with the Canadian population (N = 335) used for standardization of the original questionnaire. Results: The values among Czech athletes manifest that the differences in mean values is statistically significant in all mental skills (goal-setting p = .03, self-confidence p < .01, commitment p = .03). Differences among groups dependent on the current level of performance are significantly higher in goal-setting (p = .05, d = 0.46) self-confidence (p < .01, d = 0.63), and commitment (p < .01, d = 0.55) of athletes at international level compared to regional level and in self-confidence (p < .01, d = 0.46) and commitment (p < .01, d = 0.49) of athletes at national level compared to regional level. There is no significant difference among national and international athletes. Canadian respondents show statistically significant higher mean values than Czech athletes in all selected mental skills. Conclusions: The level of self-confidence, goal-setting, and commitment in Czech athletes differs according to performance level. Czech athletes show lower values in all mental skills considered compared to the Canadian sample.

Testing the Assumption of Population Homogeneity in the Measurement of Dispositional Optimism: Factor Mixture Modeling Analysis

The assumption of population homogeneity in the measurement of dispositional optimism was examined. U.S. and Canadian respondents (N = 591) completed an optimism scale. Possible population heterogeneity was analyzed using factor mixture modeling. Two major results emerged. First, population homogeneity was not supported: A large class of participants had trouble giving consistent answers to optimism items, optimism and pessimism items, or, especially, pessimism items. Second, after the removal of this problematic class, the correlation between optimism and pessimism was found to be .94, a magnitude large enough to support the assumption of unidimensionality. Although psychometric problems with the measurement of optimism have not been identified previously, this study suggests that the typical measurement of dispositional optimism requires substantial revision. The findings showcase the importance of factor mixture modeling in evaluating the psychometric properties of a measurement scale.

A Canadian replication of Telep and Lum’s (2014) examination of police officers’ receptivity to empirical research

ABSTRACTResearch conducted in the United States (U.S.) suggests that many police professionals are unaware of, or resistant to, empirical research, and see little value in adopting evidence-based approaches for tackling policing issues. To determine whether similar views are held by Canadian police professionals, 598 police professionals (civilians and officers) from seven police services across Canada were surveyed. The survey was designed by Lum and Telep (n.d. Officer receptivity survey on evidence-based policing. Fairfax, VA: Center for Evidence-Based Crime Policy, George Mason University) to determine respondents’ knowledge of, and support for, evidence-based policing (EBP). Using their survey allowed us to compare our results to the data they collected in the U.S. Although Canadian respondents had similar concerns regarding EBP as those in the U.S., in several ways, Canadian police professionals were more open to the idea of EBP. The results are encouraging, but still suggest a lack of buy-in from some police professionals in certain regards. Potential reasons for the cross-national discrepancies, and the consequences of the findings, are discussed.

Promoting frontline employee customer orientation in China: a replication and a comparison

PurposeThe purpose of this paper is to test the influence of managerial coaching on frontline employee customer orientation, sales orientation and performance in a Chinese context. Further to this first goal, the authors also aim to compare these results with those obtained with a sample of Canadian bank employees in order to understand to what extent differences between Eastern and Western cultures affect business practices and employee responses in both environments.Design/methodology/approachThis paper replicates a study from 2014 that used a sample of Canadian financial advisors to test the impact of managerial coaching on customer orientation, sales orientation and performance. In this new study, 185 frontline employees from a large insurance company in Chongqing (China) answered a paper-and-pencil questionnaire in Mandarin providing information about the coaching received from their managers, their own customer and sales orientation, as well as performance. Data were analyzed using structural equation modeling in AMOS as well as multigroup confirmatory factor analysis to evaluate cross-cultural differences.FindingsThe authors found that for the Chinese respondents managerial coaching is positively related to employee performance both directly and through the mediation effect of customer orientation. The authors found no support for the mediation of sales orientation between coaching and performance. These results suggest that managerial coaching might be a good strategy to promote relational behaviors in frontline employees, but not to reduce manipulative behaviors. The authors also found that these results are statistically equivalent for Chinese and Canadian respondents, suggesting that cultural differences are less prevalent than expected in this business sector.Research limitations/implicationsThe study makes several contributions to research. First, it suggests that managerial coaching can help employees develop their customer orientation–a central construct for commercial organizations working under a relational marketing approach. Second, it presents one of the first studies that evaluate the efficiency of managerial coaching in an Eastern country. And finally, results underline the equivalence of results for Eastern (China) and Western (Canada) respondents suggesting that in a global environment (like the financial industry) the business logic guiding the development of good customer relationships and employee customer-oriented behaviors prevails over potential cultural differences and makes leader and employee behaviors more similar and comparable across different regions in the world.Practical implicationsFirst, the use of managerial coaching seems to increase frontline employee relational behaviors, like customer orientation. Accordingly, managerial coaching seems to be a link that can help financial institutions bridge the formulation of a marketing relational strategy in the boardroom and the implementation of such a strategy at the customer interface between frontline employees and customers. Second, given the equivalence of results between the Canadian and the Chinese sample, it seems that the similarities between business models and business logics within the financial services sector are more important—and supersede—the potential cross-cultural differences between Eastern and Western countries.Originality/valueThe study makes a contribution to the limited literature on the use of managerial coaching in financial institutions to increase frontline employee relational behaviors. At the same time, it presents one of the few cross-cultural studies comparing results obtained from Chinese and Canadian respondents.

Comparison of Canadian and Dutch Urban Parents and Grandparents in Terms of Knowledge of Children’s Cognitive and Social–Emotional Development

Knowledge of child development influences parental expectations of, and interactions with, children. Studies have shown that maternal knowledge supports cognitive and social–emotional development of young children and can have long-lasting benefits. Level of developmental knowledge of parents and grandparents has seldom been investigated on a population level. Our aim was to compare Canadian and Dutch samples of urban parents and grandparents in terms of normative knowledge of children’s cognitive and social–emotional development. Urban parents ( n = 379) and grandparents ( n = 174) from the province of Alberta, Canada ( N = 553) and parents ( n = 634) and grandparents ( n = 96) of the city of The Hague in the Netherlands ( N = 730) answered questions related to knowledge of cognitive and social–emotional development of young children, including topics such as “do children have stronger bonds with parents who stay at home instead of working outside the home?” and “do children learn more from hearing someone in the same room talk than hearing someone on TV?” Overall, the Canadian respondents were more likely to answer these questions correctly. In both samples, women were more likely than men to answer correctly. No significant relationship between age or role (parent or grandparent) and knowledge was identified, but there was a positive correlation between knowledge and level of education. Little is known about international differences in caregivers’ knowledge about normative child development. This study suggests that differences exist. Understanding differences between countries in parental knowledge may provide insight into cross-cultural variability in child behavioral and developmental outcomes.

Accent Identification in RP, CE, and GA By Native and Non-Native English Speakers

This study was conducted in order to determine various groups’ accuracy in identifying three major standard English accents. The main purpose of the experiment that was performed was to determine how well speakers familiar with these accents could tell them apart from other accents. It focused on comparing the test subjects’ recognition of Canadian English pronunciation with General American pronunciations. Received Pronunciation was used as a control as it is generally considered to differ much more from the standard North American varieties than they differ from one another.Within North America, the 'standard' accents of Canada and the US are quite similar. So similar, that one of the experiment’s hypotheses is that that despite being identified by linguists as different, many native speakers of the two dialects would have difficulty telling the difference themselves. The differences in the features of Canadian English (CE) and General American (GA) have been identified and studied by linguists before, but what this experiment sought to determine was the degree to which speakers of these dialects could tell them apart purely through listening.Canada is given some degree of stigma from the United States for its dialect, and has had fun poked at it for such Canadianisms as the use of 'eh?' and Canadian Raising- Americans will exaggerate the difference when illustrating it, saying “aboot” [ə'but] for about [əˈbʌʊt]. But how well can they perceive the difference when not already informed about the speaker's origins?An online survey was prepared, with audio clips or words in isolation and sentences, spoken by speakers of GA, CE, and RP, specifically using words that exhibited features that vary between the accents. This allowed us to examine subjects’ degree of recognition with, and without prosody, and to analyze the degree to which prosody affects accent recognition. In order to better determine how prior exposure influences accent recognition, the subjects were broken down into three groups: Native speakers of Canadian English, native speakers of American English and ESL speakers who had had prior exposure to Canadian English.One of the main findings of this experiment is that more than 80% of American respondents recognized their own national standard accent, and around 67% recognized the Canadian accent; while only 62% of the Canadian respondents recognized the Canadian accent accurately. Compared to Canadians, Americans were better at telling the North American varieties of spoken English apart.

Does Image Matter While Shopping for a Smartphone? A Cross-Cultural Study of Indian and Canadian Consumers

ABSTRACTThe purpose of this study is to examine the role of image congruence (match/mismatch between one's self-image and a product's image) and face consciousness (a person's willingness to enhance reputation in the society) in determining consumer behavior towards the use of smartphones across India and Canada. Data were collected from Indian and Canadian respondents. Confirmatory factor analysis and structural equation modeling were employed to test the proposed model. The results revealed that Indian consumers are more face conscious and give more importance to their social image and ideal social image than Canadian consumers. On the other hand, Canadian consumers are more concerned with their actual and ideal image while making smartphone purchase decisions.

Healthier food choices for children through menu pricing

PurposeThe purpose of this paper is to investigate the use of pricing (incentive and deterrent) to shift the purchase decision intent of parents when they order food for their child in a fast food restaurant.Design/methodology/approachA financial incentive and a deterrent pricing tactic was tested using an online quantitative approach with a sample of 400 Canadian parents, representative of the Canadian population based on geography, household income and education level.FindingsThe financial incentive tactic demonstrated that a strong and clearly articulated monetary discount can shift the stated purchase intent of parents into an increased number choosing a healthier side dish for a child’s fast food meal. A deterrent pricing approach was shown to also shift stated purchase intent, and had a higher consumer impact on a per dollar basis. Younger parents (<35 years old) were more likely to select healthier side dishes for their child; however, parents of all ages could potentially be influenced through motivational pricing approaches.Research limitations/implicationsThis was an exploratory study using online surveys and stated purchase intent among Canadian respondents. Examining “stated” purchase intent only through the use of a questionnaire, and without a consequence of the choice, may not reflect a consumer’s real purchase behaviour. A future study should be conducted on pricing approaches in a restaurant setting, where the parents then have the consequences of interacting with the child and the response of the child to the food decision made on their behalf.Practical implicationsThe use of pricing to shift parental food purchase decisions into ordering healthier food items for their children is a promising option, which with further exploration may lead to easily implementable restaurant-level recommendations that achieve the desired results of children eating healthier.Social implicationsAs the frequency of fast food consumption continues to rise, encouraging healthier fast food choices for children could help to combat the troubling rise of obesity in young children.Originality/valueWhile most historical research has focussed on teen or adult consumers, this paper offers insights to academics, marketers and restaurant industry influencers into the previously unexplored area of using pricing to encourage parents to make healthier food choices for children in a fast food restaurant environment.

Point of care hand hygiene—where's the rub? A survey of US and Canadian health care workers' knowledge, attitudes, and practices

Hand hygiene at the point of care is recognized as a best practice for promoting compliance at the moments when hand hygiene is most critical. The objective of this study was to compare knowledge, attitudes, and practices of US and Canadian frontline health care personnel regarding hand hygiene at the point of care. Physicians and nurses in US and Canadian hospitals were invited to complete a 32-question online survey based on evidence supporting point of care hand hygiene. Eligible health care personnel were in direct clinical practice at least 50% of the time. Three hundred fifty frontline caregivers completed the survey. Among respondents, 57.1% were from the United States and 42.9% were from Canada. Respondents were evenly distributed between physician and nurses. The US and Canadian respondents gave identical ranking to their perceived barriers to hand hygiene compliance. More than half of the respondents from both the United States and Canada agreed or strongly agreed that they would be more likely to clean their hands when recommended if alcohol-based handrub was closer to the patient. This survey demonstrates that similarities between Canada and the United States were more common than not, and the survey raises, or suggests, potential knowledge gaps that require further illumination.

Prohibiting Headgear for Safety in Amateur Boxing? Opinion of the Canadian Boxing Community: an Online Poll.

BackgroundIn 2013, the Amateur International Boxing Association (AIBA) introduced a rule banning headgear for male-senior open class boxers during competition. The AIBA has defended the rule change as motivated by safety and supported by internal unpublished studies. As a result, in 2018, the AIBA plans to universally prohibit headgear in competition: for all competitors (male and female), all ages and all levels. Within Canada, this ruling has generated controversy in the boxing community, yet there has been no overall measure of opinion.MethodsTo address this, we instituted a voluntary, anonymous, online open-access poll to allow members of the boxing community to express their stance on headgear use in competition.ResultsIn total, 636 responses were received. A total of 71.5 % of Canadian respondents believed headgear should be mandatory at all levels. Only 5.8 % agreed that headgear should be prohibited, as planned for 2018. Estimating results on a representative breakdown of boxing membership in Canada, a similar pattern emerged, whereby 68.2 % concurred with mandatory headgear while only 4.95 % supported its prohibition. Parents of boxers were almost unanimously against banning headgear, stating they would change sports as a result. Similarly, only 1.7 % of women believed headgear should be prohibited.ConclusionsThe consensus of the Canadian boxing community largely opposes the rule changes that the AIBA has implemented. The results highlight risks posed to the long-term viability of the sport, if significant grassroots safety concerns are disregarded.

Determinants of life satisfaction in Canada: A causal modeling approach

Most research studies on Life Satisfaction/Subjective Wellbeing (SWB) have focused on one main determinant and a variety of social demographic variables to delineate the determinants of life satisfaction. However, very few research studies examine life satisfaction from a holistic approach. The aim of this study was to utilize a holistic approach to construct a causal model and identify major determinants of life satisfaction. This study utilized data from the General Social Survey, with a sample size of 19,597. Several multiple regression models were run sequentially to estimate standardized path coefficients for the causal model. Overall, above average satisfaction with life was reported by Canadian respondents. Respondents who were female, younger, married, from high socioeconomic status background, born in Canada, very religious, and demonstrated high level of neighborhood interaction had greater satisfaction with life. Similarly, respondents had greater life satisfaction if they had better health, social contact, leisure activities, more time with family and friends, more enjoyment with volunteer activities, and a greater sense of belonging to the community. Our results suggest that a holistic approach is necessary for understanding the causal process of life satisfaction. A significant number of causal connections contradict some of the findings in literature today. We have provided some possible explanations for these anomalies and policy implications.

Approach to hyponatremia in congestive heart failure: a survey of Canadian specialist physicians and trainees.

BackgroundHyponatremia is a recognized complication of congestive heart failure (CHF) and is associated with reduced survival. Therefore, early identification and appropriate management of hyponatremia is important. The aim of this study was to determine the general approach amongst Canadian healthcare practitioners and trainees to the identification and management of hyponatremia complicating CHF.MethodsRespondents completed 15 multiple-choice style questions in 3 case scenarios regarding the approach to management of hyponatremia complicating CHF using an online survey on UKidney.com between November 2012 and May 2013. Results were presented as a proportion of averaged correct/incorrect responses amongst Canadian nephrologists, cardiologists, internists and trainees in each of two domains; pathophysiology and management. Management was further subdivided into correct and incorrect use of diuretic therapy, hypertonic saline, oral urea tablets, vasopressin receptor antagonists (vaptans) and rate of sodium correction. Correct responses were determined by an expert panel of Canadian nephrologists and cardiologists based on review of evidence informed guidelines and current recommendations.ResultsThere were 1757 responses to our online survey amongst 455 Canadian respondents, 1139 of which were from cardiologists, nephrologists, general internists, or trainees. Overall, the pathophysiology governing hyponatremia in CHF was correctly identified 68.7 % of the time (n = 380 responses, averaged over 4 questions). Hyponatremia was managed inappropriately 43.6 % of the time, with trainees scoring best overall with correct responses 60.3 % of the time (n = 759 responses, over 11 questions). Importantly, an incorrect rate for sodium correction was selected 61.1 % of the time overall, (n = 211 responses, averaged over 3 questions).ConclusionsThis study identified that there are differences in the understanding of pathophysiology and management strategies for hyponatremia in the context of CHF amongst Canadian specialist physicians and trainees. A more consistent approach to hyponatremia is required and might best be achieved through formal knowledge translation.Electronic supplementary materialThe online version of this article (doi:10.1186/s40697-016-0094-9) contains supplementary material, which is available to authorized users.

An initial assessment of measurement invariance in sales force coaching

ABSTRACTCoaching is an essential attribute of effective managers and leaders and it is becoming progressively more important for managerial practice and research. Given the increased interdependence between countries due to global commerce and the changing demographic landscape due to migration and mobility through borders, the interest for developing multilingual research increased. However, there are no published studies offering a translation of the original English coaching scales into languages that can be relevant for research in America and Europe. This paper presents a Spanish and French translation of the Perceptions of Supervisor/Line Manager Coaching Behaviour measure (Ellinger, Ellinger & Keller, 2003. Supervisory coaching behavior, employee satisfaction, and warehouse employee performance: A dyadic perspective in the distribution industry. Human Resource Development Quarterly, 14(4), 435–458) thus offering scholars and practitioners the possibility of conducting coaching studies in English, Spanish or French using the same standardised instrument. The paper also presents an initial assessment of measurement invariance using multisample confirmatory factor analysis across two languages (French and Spanish) using two samples: one with French-speaking Canadian respondents and the other one with Spanish-speaking Argentinian respondents. Results suggest that the proposed translations present partial invariance across the samples, with six items out of eight showing invariance and only two showing non-invariance.

Abstract 19542: A North American Survey of Public Opinion on the Acceptability of Crowdsourcing Basic Life Support for Out-of-hospital Cardiac Arrest

Introduction: Performance of bystander CPR and early defibrillation following out-of-hospital cardiac arrest (OHCA) have been shown to increase the odds of survival to hospital discharge more than 3-fold. The PulsePoint Respond™ Application (App) is a novel system that can be implemented by EMS to crowdsource basic life support for victims of OHCA. The system sends cardiac arrest notifications to a user’s mobile device which includes the location of the emergency and nearby public access defibrillators to facilitate bystander CPR and AED use while EMS personnel are en route. We conducted a North American survey to evaluate public perceptions of such an application, including acceptability and willingness to respond to alerts. Methods: The web-based survey was conducted in Canada and the USA by an established external polling vendor, Ipsos Reid. Sampling was designed to ensure broad representation of gender, age, geography, and spoken language following recent census statistics. Respondents were presented with a short concept description of cardiac arrest and the Pulsepoint app in text format followed by 6 closed-ended and 4 open-ended questions. Results: A random sample of 2,415 total surveys were collected (1106 from Canada and 1309 from the US). 70% of Canadian respondents but only 47% of US respondents had been trained in CPR at some point. On average, 79.5% of respondents agreed that Pulsepoint is something they would like to see in their community and 59.5% said they would download the App. 80% of Canadians and 77% of Americans were comfortable with receiving help in a public setting (street, office, etc) and 72 and 68% respectively, indicated they would be comfortable with receiving help in a private setting (home). Less than 40% of respondents identified concerns; as expected those identified included training concerns and trust issues. An average of 89% of the sample from both countries felt it was important that responders have up-to-date CPR certification. Conclusions: Overall, the North American public find the concept of the Pulsepoint application and crowdsourcing basic life support for OHCA acceptable and would be willing to respond. This is encouraging insight to support the use of social media to increasing bystander CPR rates in North America.

Financial literacy and retirement planning in Canada

AbstractIn this paper, we draw on internationally comparable survey evidence on financial literacy and retirement planning in Canada to investigate how financially literate Canadians are and how financial literacy is linked to retirement planning. We find that 42% of respondents are able to correctly answer three simple questions measuring knowledge of interest compounding, inflation, and risk diversification. This is consistent with evidence from other countries, and Canadians perform relatively well in comparison with Americans but worse than individuals in other countries, such as Germany. Among Canadian respondents, the young and the old, women, minorities, and those with lower educational attainment do worse, a pattern that has been consistently found in other countries as well. Retirement planning is strongly associated with financial literacy; those who responded correctly to all three financial literacy questions are 10 percentage points more likely to have retirement savings.

Making Sense of Naturalization: What Citizenship Means to Naturalizing Immigrants in Canada and the USA

Immigrant naturalization is both a barometer of inclusiveness and immigrant incorporation and a mechanism of social reproduction of the nation. This article reports on an interview-based study in suburban Toronto and New Jersey that investigated how immigrants explain their decisions to acquire citizenship. It analyzes respondents’ understandings of naturalization in light of different theories of citizenship and different dimensions of the concept. The study contributes to the literature by showing how many American immigrants interviewed while going through the naturalization process resisted framing naturalization as identity-changing, situating it instead as a common-sense move following permanent settlement and belonging. In contrast, Canadian respondents were more likely to characterize naturalization as an active process that tied them to a positively valued nation. While immigrant respondents in both countries were interested in voting and travel benefits of citizenship, only American respondents sought the protection that citizenship would afford in an anti-immigrant policy climate. I discuss how naturalization as a tool of civic integration and political empowerment resonates with immigrants’ own understandings of the process and consider the role played by the institutional contexts around naturalization and immigration more generally.

Initial assessment of patient handoff in accredited general surgery residency programs in the United States and Canada: a cross-sectional survey.

Communication errors are considered one of the major causes of sentinel events. Our aim was to assess the process of patient handoff among junior surgical residents and to determine ways in which to improve the handoff process. We conducted nationwide surveys that included all accredited general surgery residency programs in the United States and Canada. Of the 244 American and 17 Canadian accredited surgical residency programs contacted, 65 (27%) and 12 (71%), respectively, participated in the survey. Of the American and Canadian respondents, 66% and 69%, respectively, were from postgraduate year (PGY) 1, and 32% and 29%, respectively, were from PGY 2; 85 (77%) and 50 (96%), respectively, had not received any training about patient handoff before their surgical residency, and 27% and 64%, respectively, reported that the existing handoff system at their institutions did not adequately protect patient safety. Moreover, 29% of American respondents and 37% of Canadian respondents thought that the existing handoffs did not support continuity of patient care. Of the American residents, 67% and 6% reported receiving an incomplete handoff that resulted in minor and major patient harm, respectively. These results mirrored those from Canadian residents (63% minor and 7% major harm). The most frequent factor reported to improve the patient handoff process was standardization of the verbal handoff. Our survey results indicate that the current patient handoff system contributes to patient harm. More efforts are needed to establish standardized forms of verbal and written handoff to ensure patient safety and continuity of care.