Exploring the effects of change on nursing practice in acute ambulatory care settings : a qualitative study

As a result of the current changes taking place in the delivery of acute care services, the emergence of acute ambulatory care (AAC) settings is expanding. According to a literature review, the volume, acuity, and complexity of patient care in these settings is increasing while the time the patients spend under the care of nurses is decreasing. Two forces, hospital downsizing and advancing technology, are identified as the major contributors to the shift in acute care delivery. The effects that these changes are having on the clinical nursing practice of registered nurses working in AAC settings are not known. Given that AAC settings are rapidly expanding, it can be anticipated that the delivery of nursing care will continue to be compressed into a shorter time frame. Therefore, the following qualitative research question was formulated: What are the problems and issues related to clinical nursing practice in acute ambulatory settings? The purpose of this study was to explore the problems and issues associated with change and clinical nursing practice including the educational needs of nurses working in MC settings. Specific objectives of the study included the following: (a) to explore the problems and issues related to nursing practice in select AAC settings; (b) to explore the similarities and differences in perspectives related to role expectation between nurse managers, nurse educators, and staff nurses; and (c) to develop a conceptual framework that will guide the construction of an instrument needed for further research. This study used semistructured individual interviews and focus group sessions to collect data from the three categories of registered nurses. More specifically, data were collected from one nurse manager, two charge nurses, two nurse educators and fifteen staff nurses, working in three different MC settings of a major teaching hospital. Collected data were separately analyzed by the researcher and an external rater following grounded theory methodology. By using open and axial coding, the problems and issues identified by nurses were grouped into several major and minor themes. In final analysis, by using selective coding, the four core themes (intensification, moderation, frustration, and adaptation) were extracted. Each core theme was presented and discussed in relation to hospital downsizing and advancing technology. The relationships among the four core themes were discussed and depicted in a model termed the "Impact and Consequence Model on Nursing Practice in MC Settings." Implications for further research are discussed and research hypotheses, based on the research findings, are presented.

Perceptions of leadership in adolescent girls, members of the Girl Guides of Canada

Twenty-eight young women who were members of the Girl Guides of Canada as Rangers and Cadets from a convenience sample chose to participate in this case study. They were from four separate locations in Southern Ontario. The interviews and observations at unit meetings allowed an indepth look into the perceptions of leadership of these young women. The amount of time observing and interacting with each participant provided a snapshot of what they thought and how they responded to the questions asked at that particular time. Each girl responded to the question, "Are you a leader?" They then gave examples of their own leadership and described leaders they knew. Their responses are reported in relation to their definitions. Their identifications of effective and ineffective leaders were examined, as well as their views of the best and worst things a leader can do. This information is reported by unit, as some patterns in their responses emerged which were unique to each group. The responses of all of the girls to the leadership of Guiders, Rangers and Cadets and the hypothetical effect of male leaders and male Rangers in Guiding are reported. For these, the participants' views were sorted based on the common themes/ and regardless of their group affiliation, since many of the same themes emerged when examining these questions. The information collected was extensive and allowed for trends and parallels to become evident 0 All of the participants identified themselves as leaders. A diversity of views exists in their perceptions of leadership. For many, age makes a difference in leadership. The majority identified the single-sex aspect of the organization as comfortable and stated that it should remain so. Gender profoundly affects who is listened to and what opportunities are available.

Quantum Monte Carlo : some theoretical and numerical studies

In Part I, theoretical derivations for Variational Monte Carlo calculations are compared with results from a numerical calculation of He; both indicate that minimization of the ratio estimate of Evar , denoted EMC ' provides different optimal variational parameters than does minimization of the variance of E MC • Similar derivations for Diffusion Monte Carlo calculations provide a theoretical justification for empirical observations made by other workers. In Part II, Importance sampling in prolate spheroidal coordinates allows Monte Carlo calculations to be made of E for the vdW molecule var He2' using a simplifying partitioning of the Hamiltonian and both an HF-SCF and an explicitly correlated wavefunction. Improvements are suggested which would permit the extension of the computational precision to the point where an estimate of the interaction energy could be made~

Mothers' experiences in the elementary school education of their children of mixed heritage /

This study explores the perceptions and experiences of middle-class women, mostly mothers, regarding the elementary school education of their children of mixed heritage. Because it endeavours to provide a forum in which the voices of women are considered a source of valuable information for educators, this study contributes to the fields of feminist and mothering research. Participants assign meanings to their lived experiences (Schon, 1983; van Manen 1997) and contemplate the various ways in which a mixed heritage mayor may not affect a child's schooling. Four main participants were interviewed who are mothers whose children of mixed heritage presently attend public elementary schools in Ontario, Canada. The study had an emergent design, thus allowing the researcher to make decisions as the study progressed. Three additional participants were included in the study to provide a wider perspective on the topic. These 3 additional women were the researcher herself as she explored her self-conceptual baggage (Kirby & McKenna. 1989); the researcher's mother in an attempt to consider the motherline (Lowinsky, 1992); and a volunteer non-mother of mixed ethnicity. The study involved a total of 12 individual interviews of approximately 2 hours in length. The 4 main participants and the researcher were each interviewed twice; the researcher's mother and the volunteer non-mother were each interviewed once. The researcher also attempted a focus group and kept a journal throughout the research process. Much of the analysis centers on women's interpretations of the mixed heritage experience and on their suggestions for elementary school educators. It concludes pondering on the invisibility (Chiong, 1998) of such children within the school system and calling for increased teacher education as a way to bring the mixed heritage experience out of the shadows.

The Effectiveness of Learning Portfolios: A Study of Quality Assurance Programs of Selected Health Regulatory Colleges in Ontario

Health regulatory colleges promote quality practice and continued competence through Quality Assurance (QA) programs. For many colleges, a QA program includes the use of portfolios that incorporate self-directed learning. The purpose of this study was to determine some of the issues surrounding the effectiveness of QA portfolio programs. The literature review revealed that portfolios are valuable tools, but gaps in knowledge include a comparative analysis of QA programs and the perspective of regulatory college administrators. Data were collected through interviews with 6 administrators and a review of 14 portfolio models described on college websites. The results from the two data sources were applied to Robert Stake's responsive evaluation framework to identify issues related to the portfolio's effectiveness (Stake, 1967). The learning components of portfolios were analyzed through the humanist and constructivist lenses. All 14 portfolio models were found to have 3 main components: self-diagnosis, learning plan and activities, and self-evaluation. However, differences were uncovered in learners' autonomy in selecting learning activities, methods of portfolio evaluation, and the relationship between the portfolio and other QA components. The results revealed a dual philosophy of learning in portfolio models and an apparent contradiction between the needs of the individual learner and the organization. Paths for future research include the tenuous relationship between competence and learning, and the impact of technical approaches on selfdirected learning initiatives. A key recommendation is to acknowledge the unique identity of each profession so that health regulatory colleges can address legislative demands and learner needs.

Letters to the Honourable John H. Dunn, 1837-1838

The recipient of the letters is John Henry Dunn who was born on St. Helena (a British territory island of volcanic origin located in the South Atlantic Ocean) in 1792 to John Charles Dunn and Elizabeth Bazette. He was married to Charlotte Roberts on May 4th, 1820 and they had 6 sons and 2 daughters. He came to Canada in 1820 in which year he became the Receiver General for Canada. He held this position until 1841.Charlotte died in 1835. In 1822 he was named to the Province’s Legislative Council. He was president of the Welland Canal Company from 1825-1833. In 1836 he was named to the executive council of Upper Canada but resigned 3 weeks later with fellow counselors when lieutenant governor Sir Francis Bond refused the advice of the council. Dunn was made the Receiver General for the newly formed Province of Canada in 1841, and was elected to represent Toronto in the legislative assembly that year. He married his second wife on March 9th, 1842. Her name was Sophie-Louise Juchereau Duchsnay. They had a son and a daughter. In 1843 he resigned, and was not re-elected in 1844. He returned to England with his family and died in London on April 21, 1854. Dunn was a supporter of the Welland Canal, St. Lawrence Canals and other public improvements. Between the passage of the Canada Trade Act and the Act of the Union he had tried to insure that projects received funding despite financial constraints. He claimed that he has saved Upper Canada from bankruptcy. His son, Alexander Roberts Dunn received the Victoria Cross for his role in the Charge of the Light Brigade at Balaclava. Dunn Street in Niagara Falls is named after John Henry Dunn. The town and township of Dunnville were also named for him. Sources: http://biographi.ca/009004-119.01-e.php?id_nbr=3889 http://www.niagarafrontier.com/cityfalls.html

Challenging Weight Loss: The Effectiveness of a 12 Week Weight Loss Challenge on Weight Loss, Physical Activity and Motivation

The objective of this study was to examine the effectiveness of a 12 week weight loss intervention in a commercial fitness centre on body mass index (BMI), moderate to vigorous physical activity (MVPA) and behavioural regulations consistent with Organismic Integration Theory (OIT, Deci & Ryan, 2002). The intervention group received weekly coaching sessions and bi-weekly seminars designed to increase MVPA and improve dietary intake. The results of the mixed model analyses of variance showed a significant within-subjects main effect for BMI (F = 3.57, p = .04). Changes in MVPA were not observed over time or between conditions. Changes in behavioural regulations congruent with OIT (Deci & Ryan, 2002) favoured the intervention condition. Study results indicate that 12 week weight loss challenges in commercial fitness centres may be effective to support the internalization process of exercise behavioural regulations but ineffective at producing sustainable weight loss or behavioural changes.

Functional characterization on invertebrate and vertebrate tissues of tachykinin peptides from octopus venoms

It has been previously shown that octopus venoms contain novel tachykinin peptides that despite being isolated from an invertebrate, contain the motifs characteristic of vertebrate tachykinin peptides rather than being more like conventional invertebrate tachykinin peptides. Therefore, in this study we examined the effect of three variants of octopus venom tachykinin peptides on invertebrate and vertebrate tissues. While there were differential potencies between the three peptides, their relative effects were uniquely consistent between invertebrate and vertebrae tissue assays. The most potent form (OCT-TK-III) was not only the most anionically charged but also was the most structurally stable. These results not only reveal that the interaction of tachykinin peptides is more complex than previous structure–function theories envisioned, but also reinforce the fundamental premise that animal venoms are rich resources of novel bioactive molecules, which are useful investigational ligands and some of which may be useful as lead compounds for drug design and development.

La suspensión en el procedimiento contencioso administrativo

[Tesis] ( Maestría en Derecho Fiscal ) U.A.N.L.

De la literatura, considerada en sus relaciones con las instituciones sociales

UANL

Corina o Italia

UANL

Effect of drug utilization reviews on the quality of in-hospital prescribing: a quasi-experimental study

Affiliation: Louise Potvin: Groupe de recherche interdisciplinaire en santé, Faculté de médecine, Université de Montréal

Quality of life in multiple sclerosis: translation in French Canadian of the MSQoL-54

Affiliation: Louise Lafortune: Faculté de médecine, Université de Montréal

Stepping Stones to literature

UANL