The development of an online neonatal intensive care unit family education

Background: British Columbia’s Fraser Health Authority (FHA) neonatal intensive care units (NICUs) value family centered care (FCC). Nevertheless, there is limited evidence that FCC is actually incorporated into practice, as well as some concern that FHA NICU education is inaccessible, inconsistent, or disorganized. Purpose: The mission of this project is to support the principles of FCC throughout the development of an FHA online NICU family education guide by reflecting upon the needs of families throughout their NICU journey. Methods: A needs assessment was initially completed and included literature reviews, consultations, and an environmental scan. This data informed development of an online NICU family education guide which plots current education materials along key stages of the NICU journey: prenatal, admission, early days, growing and developing, discharge and at home. For the purposes of this practicum, only the prenatal stage was fully developed and will serve as a template for other stages following a formative evaluation. A pamphlet and revised FHA Neonatal Checkpoint will also be developed to augment teaching by health care professionals. Implementation and evaluation plans were adapted from the Center for Disease Control Framework for Program Evaluation in Public Health. Results: The needs assessment validates and directs the development, implementation, and evaluation of the online guide illustrating an FCC approach. The online guide centralizes and organizes education by selecting education topics that relate to each stage of the NICU journey. This family-directed design enables families’ access to consistent and reliable information and offers them an opportunity to learn at their own pace. Conclusion: The process of creating, implementing, and evaluating an online family education program for FHA NICUs elucidates the intricacies and the advantages of integrating FCC into NICU practice.

The expression of tradition: perennial gardening in St. John's, Newfoundland

In order to understand the processes which effect the individual realization of garden design, I have studied the practise of perennial gardening in St. John's, Newfoundland. I begin with an examination of the practical constraints on design intentions resulting from difficult growing conditions, and a limited market of plant materials, relevant gardening literature and skilled· garden workers. I establish the local repertoire of design models within which individual gardens are executed. Finally, I record the "text" of six ·perennial gardens and the commentary of their principal designers in order to examine both the implicit and explicit considerations informing the structure of the gardens. A sample of gardens has been examined in order to represent two principal performance contexts -- the public garden and the private garden -- and a characteristic selection of garden style and plant material is observed. The public gardens typically recall the "traditional" use of perennials in Newfoundland gardens through the selection of "old fashioned" plant species and through the overall design of the bed. In contrast, the private gardeners have generally adopted the style of the more recently fashionable "perennial border". However, below the level of design the private gardeners continue to express a sense of tradition in the _repetition of conventions of behaviour and expression among the gardeners' families and friends, in the propagation of individual plants grown by the gardeners' parents, and in the maintenance of a family interest in gardening. This examination of the practise of gardening, thus, leads away from the folklorists' traditional focus on the continuity of the traditional "item" towards an understanding of tradition as an expression of continuity which is given tangible shape according to the avenues of shared communication within particular performance contexts.