Implementation of hospital-wide computer information system :a case study of this change process

This case study examines the impact of a computer information system as it was being implemented in one Ontario hospital. The attitudes of a cross section of the hospital staff acted as a barometer to measure their perceptions of the implementation process. With The Mississauga Hospital in the early stages of an extensive computer implementation project, the opportunity existed to identify staff attitudes about the computer system, overall knowledge and compare the findings with the literature. The goal of the study was to develop a greater base about the affective domain in the relationship between people and the computer system. Eight exploratory questions shaped the focus of the investigation. Data were collected from three sources: a survey questionnaire, focused interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. Instrumentation in the study consisted of a survey distributed at two points in time to randomly selected hospital employees who represented all staff levels.Other sources of data included hospital documents, and twenty-five focused interviews with staff who replied to both surveys. Leavitt's socio-technical system, with its four subsystems: task, structure, technology, and people was used to classify staff responses to the research questions. The study findings revealed that the majority of respondents felt positive about using the computer as part of their jobs. No apparent correlations were found between sex, age, or staff group and feelings about using the computer. Differences in attitudes, and attitude changes were found in potential relationship to the element of time. Another difference was found in staff group and perception of being involved in the decision making process. These findings and other evidence about the role of change agents in this change process help to emphasize that planning change is one thing, managing the transition is another.

Hurry up and slow down : education to close the ingenuity gap /

To explore the idea of education to close the ingenuity gap I use Thomas Homer-Dixon's work to define ingenuity. The notion that the supply of ingenuity to solve our technical and social problems is not keeping pace with the ingenuity required to solve those problems is called the ingenuity gap. Man-made technological developments are increasing the density, intensity, and pace of globalisation. People must reorganise decision-making organisations and problem-solving methods to pragmatically combat the growing ingenuity gap. John Dewey's work illustrates the fundamental attitudes for the thinking and judgment associated with educating for ingenuity. Howard Gardner's idea that truth, beauty, and morality ought to form the core values and tenets of the philosophy of educating for ingenuity is integral to this thesis. The act of teaching facilitates the invitation to the communication necessary to foster ingenuity. John Novak-discusses the five relationships of educational leadership that enhance an environment of ingenuity. The International Baccalaureate (IB) is an existing model of global education, one that defines some of the school experiences and academic development of core values of educating for ingenuity. Expanding upon the structure of the IB and other research within this thesis, I speculate upon what my school, where educating for ingenuity so as to close the ingenuity gap is the goal, would be like.

Closing the summer learning gap for vulnerable junior kindergarten students

Under current academic calendars across North America, summer vacation creates a significant gap in the learning cycle. I t has been argued that this gap actually decreases student achievement levels over the course of the summer. In a synthesis of 39 studies Cooper, Nye, Charlton, Lindsay, & Greathouse (1996) indicated that summer learning loss equaled at least one month of instruction as measured by grade level equivalents on standardized test scores whereby children's test scores were at least one month lower when they returned to school in the fall than scores were when students left in the summer. Specifically, Cooper et aI., (1996) found that the summer learning loss phenomena may be particularly troublesome for less advantaged children including those with speech and language delays, children at-risk for reading disabilities, children from lower socio-economic backgrounds, and children learning English as a second language. In general, research illustrated clearly that the summer learning gap can be particularly problematic for vulnerable children and furthermore, that literacy skills may be the area of achievement that is most affected. A foundational pillar to this research project is including primary caregivers as authentic partners in a summer literacy program designed to support their children's literacy needs. This pillar led the research team to use the Learning Begins at Home: A Research-Based Family Literacy Program Curriculum designed by Antoinette Doyle, Kathleen Hipfner-Boucher, and Janette Pelletier from the Ontario Institute for the Studies of Education. The LBH program is designed to be flexibly adapted to suit the needs of each individual participating family. As indicated by Timmons (2008) literacy interventions are most powerful when they include authentic family involvement. Based on this research, a requirement for participating in the summer literacy program was involvement of a child and one of their primary caregivers. The participating caregiver was integrally involved in the program, participating in workshop activities prior to and following hands-on literacy work with their child. By including primary caregivers as authentic partners, the research team encouraged a paradigmatic shift in the family whereby literacy activities become routine within their household. 5 Participants in this study were 14 children from junior kindergarten classrooms within the Niagara Catholic District School Board. As children were referred to the program, they were assessed by a trained emergent literacy specialist (from Speech Services Niagara) to identify whether they met the eligibility requirements for participation in the summer program. To be eligible to participate, children demonstrated significant literacy needs (i.e. below 25%ile on the Test of Preschool Early Literacy described below). Children with low incidence disabilities (i.e. profound sensory impairments, severe intellectual impairments, developmental disabilities, etc) were excluded as participants. The research team used a standard pre- and posttest design whereby all participating children were assessed with the Test of Preschool Early Literacy (Lonigan et aI., 2007), and a standard measure of letter names and sounds. Pretests were administered two weeks prior to the commencement of the program and the first set of posttests was administered immediately following the program. A second set of posttests was administered in December 2009 to measure the sustainability of the program. As a result of the program, all children scored statistically significantly higher on their literacy scores at the post-program assessment point immediately following the program and also at the Dec-post-program assessment point. These results in general indicated that the summer family literacy program made an immediate impact on the emergent literacy skills of participating children. All participating children demonstrated significant increases in print and phonological awareness as well as their letter sound understanding.

Bridging the gap between post-secondary students with disabilities and faculty members with their perceptions of access and accommodation

The purpose of this study was to identify factors related to successful university course completion for students with disAbilities including the knowledge that faculty members and students with disAbilities have about accommodation issues; the accommodations that students with disAbilities and faculty use and find effective in the university setting; faculty members' perceptions of and attitudes toward students with disAbilities; and the attitudes that students with disAbilities have toward faculty. Fiftyseven participants were involved in the research, eight students with disabilities and forty-nine faculty members. The main objective of the research was to describe how the skills, knowledge, and attitudes of students and faculty members, and organizational supports interact to support students' academic success. The utilization and effectiveness of accommodations to overcome barriers associated with disAbility in a post-secondary setting are described in relation to students' and faculty members' perceptions of academic success.

Personal soundtracks on public transit : personal listening devices and socio-spatial negotiations of students' bus journeys

One way of exploring the power of sound in the experience and constitution of space is through the phenomenon of personal listening devices (PLDs) in public environments. In this thesis, I draw from in-depth interviews with eleven Brock University students in S1. Catharines, Ontario, to show how PLDs (such as MP3 players like the iPod) are used to create personalized soundscapes and mediate their public transit journeys. I discuss how my interview participants experience the space-time of public transit, and show how PLDs are used to mediate these experiences in acoustic and non-acoustic ways. PLD use demonstrates that acoustic and environmental experiences are co-constitutive, which highlights a kinaesthetic quality of the transit-space. My empirical findings show that PLDs transform space, particularly by overlapping public and private appropriations of the bus. I use these empirical findings to discuss the PLD phenomenon in the theoretical context of spatiality, and more specifically, acoustic space. J develop the ontological notion of acoustic space, stating that space shares many of the properties of sound, and argue that sound is a rich epistemological tool for understanding and explaining our everyday experiences.

Collective violence : a study of the gendered and socio-economic factors behind early modern Italian and English witch hunts

In this study, I build upon my previous research in which I focus on religious doctrine as a gendered disciplinary apparatus, and examine the witch trials in early modem England and Italy in light of socio-economic issues relating to gender and class. This project examines the witch hunts/trials and early modem visual representations of witches, and what I suggest is an attempt to create docile bodies out of members of society who are deemed unruly, problematic and otherwise 'undesirable'; it is the witch's body that is deemed counternormative. This study demonstrates that it is neighbours and other acquaintances of accused witches that take on the role of the invisible guard of Bantham's Panoptic on. As someone who is trained in the study of English literature and literary theory, my approach is one that is informed by this methodology. It is my specialization in early modem British literature that first exposed me to witch-hunting manuals and tales of the supernatural, and it is for this reason that my research commences with a study of representations of witches and witchcraft in early modem England. From my initial exposure to such materials I proceed to examine the similarities and the differences of the cultural significance of the supernatural vis-a.-vis women's activities in early modem Italy. The subsequent discussion of visual representations of witches involves a predominance of Germanic artists, as the seminal work on the discernment of witches and the application of punishment known as the Malleus Meleficarum, was written in Germany circa 1486. Textual accounts of witch trials such as: "A Pitiless Mother (1616)," "The Wonderful Discovery of the Witchcrafts of Margaret and Philippa Flower (1619)," "Magic and Poison: The Trial ofChiaretta and Fedele (circa 1550)", and the "The Case of Benvegnuda Pincinella: Medicine Woman or Witch (1518),"and witchhunting manuals such as the Malleus Melejicarum and Strix will be put in direct dialogue with visual representations of witches in light of historical discourses pertaining to gender performance and gendered expectations. Issues relating to class will be examined as they pertain to the material conditions of presumed witches. The dominant group in any temporal or geographic location possesses the tools of representation. Therefore, it is not surprising that the physical characteristics, sexual habits and social material conditions that are attributed to suspected witches are attributes that can be deemed deviant by the ruling class. The research will juxtapose the social material conditions of suspected witches with the guilt, anxiety, and projection of fear that the dominant groups experienced in light of the changing economic landscape of the Renaissance. The shift from feudalism to primitive accumulation, and capitalism saw a rise in people living in poverty and therefore an increased dependence upon the good will of others. I will discuss the social material conditions of accused witches as informed by what Robyn Wiegman terms a "minoritizing discourse" (210). People of higher economic standing often blamed their social, medical, and/or economic difficulties on the less fortunate, resulting in accusations of witchcraft.

Closing the Summer Learning Gap for Vulnerable Children: An Examination of a Summer Family Literacy Program for Junior Kindergarten Children At-Risk for Reading Difficulties

The learning gap created by summer vacation creates a significant breach in the learning cycle, where student achievement levels decrease over the course ofthe summer (Cooper et aI., 2000). In a review of 39 studies, Cooper and colleagues (1996) specified that the summer learning shortfall equals at least one month loss of instruction as measured by grade level equivalents on standardized test scores. Specifically, the achievement gap has a more profound effect on children as they grow older, where there is a steady deterioration in knowledge and skills sustained during the summer months (Cooper et aI., 1996; Kerry & Davies, 1998). While some stakeholders believe that the benefits of a summer vacation overshadow the reversing effect on achievement, it is the impact of the summer learning gap on vulnerable children, including children who are disadvantaged as a result of requiring special educational needs, children from low socioeconomic backgrounds, and children learning English as a second language, that is most problematic. More specifically, research has demonstrated that it is children's literacy-based skills that are most affected during the summer months. Children from high socioeconomic backgrounds recurrently showed gains in reading achievement over the summer whereas disadvantaged children repeatedly illustrate having significant losses. Consequently, the summer learning gap was deemed to exaggerate the inequality experienced by children from low socioeconomic backgrounds. Ultimately, the summer learning gap was found to have the most profound on vulnerable children, placing these children at an increased chance for academic failure. A primary feature of this research project was to include primary caregivers as authentic partners in a summer family literacy program fabricated to scaffold their children's literacy-based needs. This feature led to the research team adapting and implementing a published study entitled, Learning Begins at Home (LBH): A Research-Based Family Literacy Program Curriculum. Researchers at the Ontario Institute designed this program for the Study of Education, University of Toronto. The LBH program capitalized on incorporating the flexibility required to make the program adaptable to meet the needs of each participating child and his or her primary caregiver. As it has been well documented in research, the role primary caregivers have in an intervention program are the most influential on a child's future literacy success or failure (Timmons, 2008). Subsequently, a requirement for participating in the summer family literacy program required the commitment of one child and one of his or her primary caregivers. The primary caregiver played a fundamental role in the intervention program through their participation in workshop activities prior to and following hands on work with their child. The purpose of including the primary caregiver as an authentic partner in the program was to encourage a definitive shift in the family, whereby caregivers would begin to implement literacy activities in their home on a daily basis. The intervention program was socially constructed through the collaboration of knowledge. The role ofthe author in the study was as the researcher, in charge of analyzing and interpreting the results of the study. There were a total of thirty-six (36) participants in the study; there were nineteen (19) participants in the intervention group and seventeen (17) participants in the control group. All of the children who participated in the study were enrolled in junior kindergarten classrooms within the Niagara Catholic District School Board. Once children were referred to the program, a Speech and Language Pathologist assessed each individual child to identify if they met the eligibility requirements for participation in the summer family literacy intervention program. To be eligible to participate, children were required to demonstrate having significant literacy needs (i.e., below 25%ile on the Test of Preschool Early Literacy described below). Children with low incident disabilities (such as Autism or Intellectual Disabilities) and children with significant English as a Second Language difficulties were excluded from the study. The research team utilized a standard pre-test-post-test comparison group design whereby all participating children were assessed with the Test of Preschool Early Literacy (Lonigan et aI., 2007), and a standard measure of letter identification and letter sound understanding. Pre-intervention assessments were conducted two weeks prior to the intervention program commencing, and the first set of the post-intervention assessments were administered immediately following the completion of the intervention program. The follow-up post-intervention assessments took place in December 2010 to measure the sustainability of the gains obtained from the intervention program. As a result of the program, all of the children in the intervention program scored statistically significantly higher on their literacy scores for Print Knowledge, Letter Identification, and Letter Sound Understanding scores than the control group at the postintervention assessment point (immediately following the completion of the program) and at the December post-intervention assessment point. For Phonological Awareness, there was no statistically significant difference between the intervention group and the control at the postintervention assessment point, however, there was a statistically significant difference found between the intervention group and the control group at the December post-intervention assessment point. In general, these results indicate that the summer family literacy intervention program made an immediate impact on the emergent literacy skills of the participating children. Moreover, these results indicate that the summer family literacy intervention program has the ability to foster the emergent literacy skills of vulnerable children, potentially reversing the negative effect the summer learning gap has on these children.

Relationship between Socio-Demographic Factors and Familial and Partner Pressures to Conceive in HIV-Positive Women in Ontario

This study examined the relationship between socio-demographic factors and family and partner pressure to conceive in women living with HIV in Ontario, Canada. A total of 490 women, aged 18-52 years were included in the study. The HIV Pregnancy Planning Questionnaire was used to collect data on socio-demographic, medical, and pressure variables. Multivariate logistic regression analysis suggest that increased age, years lived in Canada, and living in Toronto were associated with lower odds, and being married and having 0-1 lifetime births were associated with higher odds of family pressure to conceive. Increased age was associated with lower odds, and being married and living in Toronto were associated with higher odds of partner pressure to conceive. Findings suggest that socio-demographic factors influence the fertility decision-making process. Health care providers should consider socio-demographic factors along with medical factors when assisting women living with HIV and their partners to make informed reproductive decisions.

A Mixed-Method Study of Educator Knowledge and Practice Related to Student Socio-moral Development

The purpose of this study was to explore elementary educators’ knowledge of moral development, how this knowledge relates to their beliefs and sense of efficacy pertaining to character education practices and the socio-moral reasoning of their students. It was hypothesized that educators’ beliefs and practices related to character education would reflect their pedagogy rather than knowledge of moral development theory. It was further hypothesized that there would be differences in student socio-moral reasoning specifically the beliefs and desires that guide actions would differ based on grade and gender. This mixed-method study employing self-report questionnaires, open response vignettes, and semi-structured educator interviews yielded quantitative and qualitative data. Findings indicated socio-moral reasoning of students differed according to grade (age) and gender. Knowledge of moral development theory was found to vary among participants however some practices employed by educators did align with a social cognitive approach to moral development. Significant variables identified consistently among educator and student participants included, autonomy, social competence, sense of school community, and supportiveness. These variables, in conjunction with a sense of fairness, have been identified elsewhere as foundational to moral development (Nucci, 2009), and intrinsic motivation (Ryan & Deci, 2000) and are relevant to educators working to develop student socio-moral reasoning as an aspect of character.

The Clinical Translation Gap in Child Health Exercise Research: A Call for Disruptive Innovation

In children, levels of play, physical activity, and fitness are key indicators of health and disease and closely tied to optimal growth and development. Cardiopulmonary exercise testing (CPET) provides clinicians with biomarkers of disease and effectiveness of therapy, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response that is hidden when the child is at rest. Yet the growth of clinical trials utilizing CPET in pediatrics remains stunted despite the current emphasis on preventative medicine and the growing recognition that therapies used in children should be clinically tested in children. There exists a translational gap between basic discovery and clinical application in this essential component of child health. To address this gap, the NIH provided funding through the Clinical and Translational Science Award (CTSA) program to convene a panel of experts. This report summarizes our major findings and outlines next steps necessary to enhance child health exercise medicine translational research. We present specific plans to bolster data interoperability, improve child health CPET reference values, stimulate formal training in exercise medicine for child health care professionals, and outline innovative approaches through which exercise medicine can become more accessible and advance therapeutics across the child health spectrum.

Socio-demographic factors, smoking, symptoms, morbidities and pulmonary function and quality of life in individuals with a heavy smoking history

Objective: To determine which socio-demographic, exposure, morbidity and symptom variables are associated with health-related quality of life among former and current heavy smokers. Methods: Cross sectional data from 2537 participants were studied. All participants were at ≥2% risk of developing lung cancer within 6 years. Linear and logistic regression models utilizing a multivariable fractional polynomial selection process identified variables associated with health-related quality of life, measured by the EQ-5D. Results: Upstream and downstream associations between smoking cessation and higher health-related quality of life were evident. Significant upstream associations, such as education level and current working status and were explained by the addition of morbidities and symptoms to regression models. Having arthritis, decreased forced expiratory volume in one second, fatigue, poor appetite or dyspnea were most highly and commonly associated with decreased HRQoL. Discussion: Upstream factors such as educational attainment, employment status and smoking cessation should be targeted to prevent decreased health-related quality of life. Practitioners should focus treatment on downstream factors, especially symptoms, to improve health-related quality of life.