Vincristine and intestinal pseudo-obstruction in children: report of 5 cases, literature review, and suggested management.

Summary: Intestinal pseudo-obstruction is a rare complication resulting from a variety of disorders. Symptoms include abdominal pain, nausea, vomiting, diarrhea, constipation, and malnutrition. Vincristine-related pseudo-obstruction has been reported in the literature, but its description in children and recommendations for management are lacking. A review of the literature revealed 21 reported pediatric cases of vincristine-related pseudo-obstruction. Most have, however, been attributed to a drug interaction with itraconazole, accidental vincristine overdose, or liver failure. Potential genetic causes are rarely addressed. We present here 5 cases of pseudo-obstruction related to vincristine without any identifiable predisposing factors, and a suggested algorithm for management

L'entretien motivationnel, une nouvelle "panacée" dans la prise en charge de patients toxicodépendants ? Une revue de littérature [Motivational interviewing, the new "panacea" for treatment of substance use disorders ? A review of literature]

Cet article aborde l'entretien motivationnel (EM), considéré comme un style thérapeutique centré sur le client et directif, visant à développer la motivation au changement par l'exploration et la résolution de l'ambivalence (Miller, W.R., Rollnick, S., 2002. Motivational interviewing: preparing people for change. The Guilford Press, New York, p. 25). Après une brève présentation théorique de ce style thérapeutique, nous présentons un survol des principaux résultats empiriques relatifs à la question de son efficacité dans la prise en charge des troubles liés à l'utilisation de substances psychoactives. Malgré un corpus important de travaux qui mettent en évidence les effets de l'EM, la question des « ingrédients actifs » reste encore relativement peu explorée. Quelques hypothèses permettant de mieux comprendre le succès de l'EM sont évoquées.

Spectrum of digoxin-induced ocular toxicity: a case report and literature review.

BACKGROUND: Digoxin intoxication results in predominantly digestive, cardiac and neurological symptoms. This case is outstanding in that the intoxication occurred in a nonagenarian and induced severe, extensively documented visual symptoms as well as dysphagia and proprioceptive illusions. Moreover, it went undiagnosed for a whole month despite close medical follow-up, illustrating the difficulty in recognizing drug-induced effects in a polymorbid patient. CASE PRESENTATION: Digoxin 0.25 mg qd for atrial fibrillation was prescribed to a 91-year-old woman with an estimated creatinine clearance of 18 ml/min. Over the following 2-3 weeks she developed nausea, vomiting and dysphagia, snowy and blurry vision, photopsia, dyschromatopsia, aggravated pre-existing formed visual hallucinations and proprioceptive illusions. She saw her family doctor twice and visited the eye clinic once until, 1 month after starting digoxin, she was admitted to the emergency room. Intoxication was confirmed by a serum digoxin level of 5.7 ng/ml (reference range 0.8-2 ng/ml). After stopping digoxin, general symptoms resolved in a few days, but visual complaints persisted. Examination by the ophthalmologist revealed decreased visual acuity in both eyes, 4/10 in the right eye (OD) and 5/10 in the left eye (OS), decreased color vision as demonstrated by a score of 1/13 in both eyes (OU) on Ishihara pseudoisochromatic plates, OS cataract, and dry age-related macular degeneration (ARMD). Computerized static perimetry showed non-specific diffuse alterations suggestive of either bilateral retinopathy or optic neuropathy. Full-field electroretinography (ERG) disclosed moderate diffuse rod and cone dysfunction and multifocal ERG revealed central loss of function OU. Visual symptoms progressively improved over the next 2 months, but multifocal ERG did not. The patient was finally discharged home after a 5 week hospital stay. CONCLUSION: This case is a reminder of a complication of digoxin treatment to be considered by any treating physician. If digoxin is prescribed in a vulnerable patient, close monitoring is mandatory. In general, when facing a new health problem in a polymorbid patient, it is crucial to elicit a complete history, with all recent drug changes and detailed complaints, and to include a drug adverse reaction in the differential diagnosis.

Verrucous Carcinoma of the Vulva: A Case Report and Review of the Literature.

Verrucous carcinoma of the vulva is a rare lesion (1). Affecting essentially postmenopausal women, this lesion is a distinct and particular entity in vulval carcinoma classification and its scalability is uncertain and unpredictable. Here, we present a case concerning a 48-year-old patient, without follow-up after a condyloma acuminate of the vulva (large left lip). The origin of this case will be discussed in this article. The treatment decided was only surgical. A review of literature shows the rarity of this lesion of the female genital tract.

Memory mixed with desire : a preliminary study of philosophy and literature in the works of Friedrich Nietzsche and Milan Kundera

Memory Mixed with Desire: A preliminary study of Philosophy and Literature in the works of Friedrich Nietzsche and Milan Kundera Robert Spinelli Brock University, Department of Philosophy This thesis studies intertextuality in the works of Friedrich Nietzsche and Milan Kundera through the primary themes of memory and forgetting. The thesis starts with two introductory chapters that delineate memory according to Nietzsche and Kundera respectively. From here, I move into a discussion of Nietzsche's Ubermensch as an example of the type of forgetting that Nietzsche sees as a cure for the overabundance of memory that has led to Christian morality. Next, I explore the Kunderan concept of kitsch as the polar opposite of what Nietzsche has sought in his philosophy, finishing the chapter by tying the two thinkers together in a Kunderan critique of Nietzsche. The thesis ends with a chapter devoted to the Eternal Return beginning with an exegesis of Nietzsche's idea and ending with a similar exegesis of Kundera's treatment of this thought. What I suggest in this chapter is that the Eternal Return might itself be a form of kitsch even in its attempt to revalue existence.

Home schooling in view of John Calvin : a study in education and communion of saints /

This study explores the tension that has emerged around the rise of home schooling in a faith-community strongly committed to establishing and maintaining day schools in the tradition of John Calvin. It aims to identify and understand factors that contributed to this tension and to find ways to bridge, diffuse, reduce, or eliminate it. In line with Calvin, personal convictions, and the nature of the community, the study takes a Christian epistemological and axiological stance. Its premise is that the integrity of the commvmity is more important than the manner in which its children are taught. The study reviews relevant literature and several interviews. It considers both secular and Christian literature to understand communities, community breakdown, and community restoration. It also examines literature about the significance of home, school, and community relationships; the attraction of Reformed day schools; and the appeal of home schooling. Interviews were conducted with 4 home schooling couples and 2 focus groups. One focus group included local school representatives, and the other home schoolers and school representatives from an area with reputedly less tension on the issue. Interviews were designed for participants to give their perspectives on reasons for home schooling, the existing tension, and ways to resolve the issues. The study identifies the rise of home schooling in this particular context as the initial issue and the community's deficiency to properly deal with it as the chief cause for the rising tensions. However, I argue that, within the norms the community firmly believes in, home schooling need not jeopardize its integrity. I call for personal, social, and spiritual renewal to restore the covenant community in gratitude to God.

Transforming curriculum leadership: vice principals in independent Christian elementary schools /

The literature on the vice principalship characterizes the position as one filled with clerical record keeping and student discipline and paints a picture of role conflict and general discontent. Research suggests that vice principals desire to take on a more significant role, specifically a role in curriculum leadership. Using open-ended interviews, a focus group interview, document analysis, and my research journal, I have explored the work ofa group of vice principals who have taken on the role of curriculum leader in independent Christian elementary schools in Ontario. When asked to explain their understanding of curriculum, the participants referred to written programs of study. However, their leadership activities reveal a broader understanding of curriculum as something that is in fact dynamic in nature. This leadership is enabled and shaped by their middle position on staff that combines the authority of an administrator and the credibility of a teacher. Although this dual identity creates tension, it also provides opportunities for genuine curriculum leadership. As middle leaders, the participants in this study often pull together or connect elements of the curriculum (teachers, principals, and programs) that have become separated. Such connective leadership is characterized by transformational (Van Brummelen, 2002) tendencies. This research suggests that the further along the continuum one goes from the understanding of curriculum as planned (Eisner, 1994) to acknowledging a lived curriculum (Aoki, 1993), the more transformational one's leadership style becomes.

Emptying the bell jar: an exploration of adolescent responses to a women's literature unit /

This study examines adolescent student responses to a women's literature unit taught within a grade 12 Writer's Craft course. Current research (Gilligan, 1989, Pipher, 1994 & Slack, 1999) suggests that there is a great under-representation of female authors in the high school literature curriculum. The use of women's literature may draw attention to important literary figures who are historically overlooked within the curriculum. It gives voice to a marginalized group and presents students with alternative subjects and heroes. It encourages students to develop a critical perspective and reevaluate assumptions about institutions, ideologies, language and culture. It also allows me, as a teacher, to reflect on my own teaching practices and explore alternate feminist pedagogical principles and teaching styles encouraging multiplicity of voices, deconstruction of power relations, and alternative assessment tools within the classroom. As an educator, it is important for me to teach curriculum that is relevant and meaningful to students and help them become critical, self-reflective thinkers. It is also important for me to assist students in their exploration of self and encourage them to expand their awareness of historical, social and global issues. Sylvia Plath's (1963) The belljar is used as the primary text taught within this unit. In this novel, the bell jar is a central image that signifies entrapment and isolation. "To the person in the bell jar, blank and stopped as a dead body, the world itself is the bad dream"(p.l 54). As a metaphor, the bell jar resonates with young readers in a variety of ways.

A conceptual analysis of research literature on teachers' ideology and literacy practices: extending the dialogue through a secondary analysis of high school English as an additional language contexts /

This thesis provides a conceptual analysis of research literature on teachers' ideology and literacy practices as well as a secondary analysis of three empirical studies and the ways in which the ideologies of the English as an Additional Language (EAL) (Street, 2005) teachers in these contexts impact the teaching of literacy in empowering/disabling ways. Several major theoretical components of Cummins (1996, 2000), Gee (1996, 2004) and Street (1995, 2001) are examined and integrated into a conceptual triad consisting of three main areas: power and ideology, validation of students ' cultural and linguistic backgrounds, and teaching that empowers. This triad provides the framework for the secondary analysis of three empirical studies on the ideologies of secondary EAL teachers. Implications of the findings from the conceptual and secondary analyses are examined in light of the research community and secondary school teachers of EAL.

Christian Church member at pulpit; Chapman College Chapel, Orange, California

Chapman College Chapel, Orange, California. The wooden-shingled church, constructed in 1909 for the congregation of Trinity Episcopal Church, is located on the northeast corner of East Maple Avenue and North Grand Street. Chapman College (now Chapman University) purchased the church for their chapel when the congregation moved to a new church on Canal Street.

Beamsville Baptist Church papers, n.d.

The material outlines the history of the early Baptist church in Beamsville, from its inception in 1807 until approximately 1859. This may have been the basis of a manuscript on the history of the church.

Gainsborough [Presbyterian] Church records, 1833-1836, 1841-1846, 1855-1857, 1860-1864, 1866 [photocopy]

The Gainsborough Presbyterian Church was organized prior to 1833, but no records were kept until this date. In 1809, the church was lead by Rev. Daniel Ward Eastman. In 1833 the church became part of the Niagara Presbytery of the American Presbyterian Church. The records include transfer of membership, records of marriages, lists of subscribers and session minutes. Photocopies from originals were made in 1977 by E. Phelps, University of Western Ontario, prior to their deposit with the United Church of Canada Archives, Toronto, Ont.

Grace Anglican Church (St. Catharines, Ont.) collection

Grace Anglican Church was founded as a mission church of St. Thomas', St. Catharines. A large house, originally built and owned by the William and Maria McCalla family, was donated by Colonel R.W. Leonard for this purpose. The mission was dedicated on 29 June 1921. It was not until 1938 that Grace Church became an independent parish. A church building was constructed and opened on 28 November 1939. In April 1956 part of the church was damaged by fire, was rebuilt and enlarged.

The impact of a digital children's literature program on primary students' reading motivation

This qualitative study stemmed from a concern of the perceived decline in students' reading motivation after the early years of schooling, which has been attributed to the disconnect between the media students are accustomed to using outside the classroom and the media they predominantly use within the classroom. This research documented the effectiveness of a digital children's literature program and a postreading multimedia program on eight grade 1 students' reading motivation, word recognition, and comprehension abilities. Eight students were given ten 25-minute sessions with the software program over 15 weeks. Preprogram, interim-program, and postprogram qualitative data were collected from students, teachers, and parents through questionnaires, interviews, standardized reading assessment tools, classroom observations, field notes, and student behaviour observation checklists. Findings are summarized into 3 themes. The motivational aspects and constructivist styles of instruction in the digital reading programs may have contributed to 5 student participants' increased participation in online storybook reading at home. Qualitative data revealed that the digital children's literature program and multimedia postreading activities seemed to have a positive influence on the majority of grade 1 student participants' reading motivation, word recognition, and listening comprehension skills. These findings suggest the promise of multimedia and Internet-based reading software programs in supporting students with reading andlor behavioural difficulties. In keeping with current educational initiatives and efforts, increased use of media literacy practices in the grade 1 curriculum is suggested.

British Methodist Episcopal Church Tithing Ticket, 1875

This is a quarterly tithing ticket from the British Methodist Episcopal Church, signed by R. Miller, Minister, and dated November 28, 1875. It was in the possession of the Rick Bell Family of St. Catharines, Ontario. Relatives of the Bell family include former Black slaves from the United States who settled in Canada.