Nurses’ Acceptance of an Internet-Based Support System in The Care of Adolescents with Depression

The overall goal of the study was to describe nurses’ acceptance of an Internet-based support system in the care of adolescents with depression. The data were collected in four phases during the period 2006 – 2010 from nurses working in adolescent psychiatric outpatient clinics and from professionals working with adolescents in basic public services. In the first phase, the nurses’ anticipated perceptions of the usefulness of the Internet-based support system before its implementation was explored. In the second phase, the nurses’ perceived ease of computer and Internet use and attitudes toward it were explored. In the third phase, the features of the support system and its implementation process were described. In the fourth phase, the nurses’ experiences of behavioural intention and actual system use of the Internet-based support were described in psychiatric out-patient care after one year use. The Technology Acceptance Model (TAM) was used to structure the various research phases. Several benefits were identified from the nurses’ perspective in using the Internet-based support system in the care of adolescents with depression. The nurses’ technology skills were good and their attitudes towards computer use were positive. The support system was developed in various phases to meet the adolescents’ needs. Before the implementation of the information technology (IT)-based support system, it is important to pay attention to the nurses’ IT-training, technology support, resources, and safety as well as ethical issues related to the support system. After one year of using the system, the nurses perceived the Internet-based support system to be useful in the care of adolescents with depression. The adolescents’ independent work with the support system at home and the program’s systematic character were experienced as conducive from the point of view of the treatment. However, the Internet-based support system was integrated only partly into the nurseadolescent interaction even though the nurses’ perceptions of it were positive. The use of the IT-based system as part of the adolescents’ depression care was seen positively and its benefits were recognized. This serves as a good basis for future IT-based techniques. Successful implementations of IT-based support systems need a systematic implementation plan and commitment from the part of the organization and its managers. Supporting and evaluating the implementation of an IT-based system should pay attention to changing the nurses’ work styles. Health care organizations should be offered more flexible opportunities to utilize IT-based systems in direct patient care in the future.

Vancomycin-resistant enterococcus outbreak in a pediatric intensive care unit: report of successful interventions for control and prevention

The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE) outbreak in a tertiary-care pediatric intensive care unit (PICU) of a University Hospital. After identification of the outbreak, interventions were made at the following levels: patient care, microbiological surveillance, and medical and nursing staff training. Data were collected from computer-based databases and from the electronic prescription system. Vancomycin use progressively increased after March 2008, peaking in August 2009. Five cases of VRE infection were identified, with 3 deaths. After the interventions, we noted a significant reduction in vancomycin prescription and use (75% reduction), and the last case of VRE infection was identified 4 months later. The survivors remained colonized until hospital discharge. After interventions there was a transient increase in PICU length-of-stay and mortality. Since then, the use of vancomycin has remained relatively constant and strict, no other cases of VRE infection or colonization have been identified and length-of-stay and mortality returned to baseline. In conclusion, we showed that a bundle intervention aiming at a strict control of vancomycin use and full compliance with the Hospital Infection Control Practices Advisory Committee guidelines, along with contact precautions and hand-hygiene promotion, can be effective in reducing vancomycin use and the emergence and spread of vancomycin-resistant bacteria in a tertiary-care PICU.

The Midnight express phenomenon : a historical materialist approach to the reception of the film Midnight express /

This thesis examines the Midnight Express phenomenon focusing on the film's reception by audiences in Europe, North America, and Turkey between 1978-2003. Using and enhancing the "historical materialist approach" to film reception developed by Janet Staiger, the thesis considers the historical determinants of the film's nationally and culturally differential readings in different periods and of the transformations in those readings. The thesis argues that while Midnight Express was most likely read in the late 1970s as an attempt to reaffirm American social identity by projecting Turks as an instance of the negative Other, there has been an important shift in the reception of the film in the West during the 1990s due to the changes in the discursive contexts in which the film has been circulating. One does not observe any specific reference to Turkish prisons as a part of the issue of human rights violations in Turkey in the initial reception of the film by European and American critics, whereas these issues appear to be important constituents of a particular reception of the film in the West in the present. The thesis explains this shift by pointing to the constitution of a particular discourse on human rights violations in Turkey after 1980, and especially throughout the 1990s, which has become a part of the discursive repertoires of the Western audience. Therefore, the thesis argues that today, Midnight Express functions as a more legitimate political statement about Turkey in the eyes of some Western audiences than it had been in the 1970s. On the other hand, parallel to the increasing desire of Turkey to connect itself to the West, particularly to become a member of the European Union, one observes an immense increase in the belief in and defense against the negative effects of Midnight Express on Turkey's international representation since the 1990s. The historical and current discourses that audiences, both in Turkey and abroad, bring into play suggest that these audiences engage with Midnight Express by assuming or denying not only the subject positions constructed by the film text but also certain history-specific extra-filmic subject positions produced by other social and discursive formations.

Analysis of the feeding behaviour of the mosquito Culex pipiens L. (Diptera: Culicidae) in relation to West Nile virus

The goal ofthis literature review is to inform the reader on several aspects of West Nile Virus (WNV) transmission by its mosquito vector, Culex pipiens and to elucidate how Cx. pipiens and WNV are intertwined. The first few sections of the literature review describe the life cycle and blood feeding behaviours ofmosquitoes so that baseline data ofmosquito biology are established. In addition to explaining how and why a mosquito blood feeds, the section on "Blood Meal Analysis" describes the different methods for determining the vertebrate source of mosquito blood meals and a brief history of these testing methods. Since this thesis looks at the feeding behaviour of Cx. pipiens, it is important to know how to determine what they are feeding upon. Discussion on other mosquito-borne diseases related to WNV gives a broader perspective to the thesis, and examines other diseases that have occurred in Ontario in the past. This is followed by background information on WNV and theories on how this virus came to North America and how it relates to Cx. pipiens. The final sections discuss Cx. pipiens and give background information to how this species of mosquito exists and behaves within North America.

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.

Microstructural and geochemical investigation of North American lower-middle Paleozoic trilobites and recent arthropods

Trilobites ¥tere collected from Ordovician and Devonian formations of Ontario} New York} Ohio} Oklahoma} and Indiana. Diversity was generally low} but 19..?telllS and Ph..~tY>ps ¥tere the most abundant species from the Ordovician and Devonian} respectively. Recent marine arthropods ¥tere collected from the Atlantic shore of the middle Florida Keys} and from the Pacific and lagoonal waters at Cape Beale} B. C. Fresh-water arthropods were collected along the shore of the Severn River in northcentral Ontario. Cuticles ¥tere analyzed for major} minor and trace elements, 180 and 13C isotopes, as ¥tell as examined by scanning electron micr?scope to identify original and diagenetic fabrics. Examination of trilobite cuticles by scanning electron microscope revealed several microstructures consistent with those observed in Recent arthropods. Microstructures} such as setae and tegumental gland duct openings} in like sized Lim/IllS and Isoteline trilobites may indicate common ancestral origins for these organisms, or simply parallel cuticle evolutions. The dendritic microstructure, originally' thought to be a diagenetic indicator, was found in Recent specimens and therefore its presence in trilobites may be suggestive of the delicate nature of diagenesis in trilobites. The absence of other primary microstructures in trilobites may indicate alteration, taxonomic control} or that there is some inherent feature of S EM examination which may' not allow detection of some features} while others are apparently visit·le onl~1 under SH.·1. The region of the cuticle sampled for examination is also a major influence in detecting pristine microstructures, as not all areas of trilobite and Recent arthropod cuticles will have microstructures identifiable in a SEM study. Subtleties in the process of alteration, however} ma~·· leave pristine microstructures in cuticles that are partial~/ silicified or do 10m itized, and degree and type of alteration may vary stratigraphically and longitudinally within a unit. The presence of fused matrices, angular calcite rhombs, and pyrite in the cuticle are thought to be indicative of altered cuticles, although pyritization may not affect the entire cuticle. t-~atural processes in Recent arthropods, such as molting, lead to variations in cuticle chemistries, and are thought to reflect the area of concentration of the elements during calcification. The level of sodium in Recent arthropods was found to be higher than that in trilobites, but highly mobile when sUbjected to the actions of VY'€'athering. Less saline water produced lovy'€'r magnesium and higher calcium values in Recent specimens .. and metal variations in pristine Ordovician trilobite cuticle appears to follow the constraints outlined for Recent arthropods, of regulation due to the chemislry of the surrounding medium. In diagenetic analysis, sodium, strontium and magnesium proved most beneficial in separating altered from least altered trilobites. Using this criterion, specimens from shale show the least amount of geochemical alteration, and have an original mineralogy of 1.7 - 2.4 mole % MgC03 (8000 t(> 9500 ppm magnesium) for both /s>..?/e/11S lJA'i.riff!11S and PseIAit'11J17ites I..itmirpin..itl/~ and 2.8 - 3.3 mole % MgC03 (5000 to 7000 ppm magnesium) for Ph.i{).?PS This is Slightly lower than the mineralogy of Recent marine arthropods (4.43 - 12.1 mole % MgC03), and slightly higher than that of fresh-water crayfish (0.96 - 1.82 mole % MgC03). Geochemically pristine trilobites were also found to possess primary microstructures. Stable isotope values and trends support the assertion that marine-meteoriclburial fluids were responsible for the alteration observed in a number of the trilobite specimens. The results of this stUdy suggest that fossil material has to be evaluated separately along taxonomic and lithological lines to arrive at sensible diagenetic and e nvironmenta I interpretations.

Scott Misener Steamships Co. Ltd. Records, 1965, 1967, 1972-1977, 1987, n.d.

Ontario Editorial Bureau (O.E.B.)

Rittermere Farm Craft Studio Fonds, 1951-2006

During the 1950’s, the Rittenhouse family of Vineland in the Niagara Peninsula opened a craft store and studio. Within a short period of time, they realized that resources for the craft of rug hooking were in demand and they began to build their business around this niche. Edna Rittenhouse, the mother, was the wool dyer; Margaret Rowan, the daughter, was the pattern designer; Ted Rowan, the son-in-law, changed careers and became the manager of the family business. The 1960’s were a prosperous time, not only in the Niagara Peninsula, but also for the Rittenhouse business. Edna Rittenhouse had been hooking rugs for decades but she and her family worked at developing and sharing newer techniques with newer materials. Shading manuals were authored and published; students became teachers; creativity abounded in the demand for and the creation of new designs. Instead of using woolen yarn, they were using pure woolen fabric; instead of using a standard cutter, they began using a uniquely designed cutter; instead of using frames, they employed a table top method. The new material and technique resulted in a rug with a smooth, uniform texture and a soft nap. Since many crafters belonged to crafters guilds, Margaret and Ted Rowan began promoting the idea of a guild for rug hookers and in time the Ontario Hooking Craft Guild was also a reality. A joint project between Chatelaine magazine and the Rittermere studio for Canada’s centennial year of 1967 was extremely well received within the circle of hooking crafters and the Rittermere Farm Craft Studio became a North American landmark for crafters. From this point onward the studio had a large customer base not only in North America but also overseas. The studio remained popular until 1984 when Margaret and Ted Rowan decided to retire. The Rittermere name has been preserved in the name of Rittermere-Hurst-Field which is a similar business located in Aurora which is just north of Toronto.

Upper Lakes Shipping Ltd. fonds 1955-1990, n.d. (non-inclusive)

In March 1931, Captain Bruce Angus was sent to Sarnia by Gordon C. Leitch, general manager of Toronto Elevators. He was sent to inspect the Sarnian to ensure it was still seaworthy. Leitch was a savvy business man, who had been active in the business community for a number of years. Leitch began his career with a partner in the lumber business. When that went under he moved into graineries and worked for the Winnipeg Wheat Pool for 12 years. After Winnipeg he moved to Toronto, which was closer to his home town of Ridgetown, Ontario. In Toronto Leitch became manager of the Toronto branch of the Canadian Wheat Pool. While managing the wheat pools in Toronto Leitch became aware of huge costs associated with shipping the grains from the praries into the Toronto area. He felt that there was no need for such costs and decided to do something to make them better and cheaper for the business. Originally the grain was loaded onto Lakers that would bring the grain from the praries to Lake Huron and Georgian Bay. It was stored there until needed by the Toronto graineries and then hauled across land by either truck or train. The land journey was the most expensive and the one which Leitch wanted to eliminate. This was a fine plan except for 2 obstacles that were quickly overcome. First of all the Welland canals were not large enough to accommodate the large carriers that were bringing in the grain. This was changing as the expansion and widening of the canals was already underway. The second issue was the lack of storage in Toronto for the grain. The grain elevators had been destroyed by fire in the late 1880s and never replaced. Leitch propsed his company built its own storage elevators along the water front to allow not only for easier access to the grain, and more timely production of products. The elevators would aslo create a reduction in shipping costs and an overall more competitoive price for the customers of the grainery. The company refused, so Leitch went elsewhere to friends and contacts within the grain industry. The elevators were built and Leitch quit his job with the Canadian Wheat Pool and became the general manager of the elevators. Although the elevators were built and ready for storage the next issue was filling them. None of the carriers wanted to do business with Leitch because the competition in Georgian Bay threatened to cancel their contracts if they did. Leitch saw no way around this, but to provide his own transportation. This is when he sent Captain Bruce Angus to scout out potential ships. The ship was purchased for $37,000 and after another $30,000 was spent to fix it up, it was ready for business. The need for transportation and the finding of a seaworthy ship, lead to the beginnings of the Northland Steamship Company. The Sarnian proved to not be enough for the business underway. Leitch decided another ship was necessary. He joined forces with James Norris the owner of the Norris Grain Company. He proposed they join forces to create a more economical means of transportating their products.

Independent Chronicle Vol. XLVI No. 3477- August 8, 1814

A semi-weekly paper that was published from 1801 to 1817. It was previously called the Independent chronicle and the universal advertiser, and was later the Independent chronicle and Boston patriot (Semiweekly). Publishers were Abijah Adams and Ebenezer Rhoades. Topics of interest in this issue include: Page 1: notice from the U.S. War Department seeking proposals for the supply of rations to troops; account of the battle of Bridgewater; list of important military figures wounded in the battle; news of prisoner exchange; Americans and the British negotiate and new prisoner exchange convention; Page 2: report of more British troops sailing to North America; report of some Indian tribes signing a treaty to fight against the British; report of battle near Detroit; report of militia moving from Fredricksburg, Virginia to Baltimore, Maryland; report of troop numbers and casualties in the battle of Bridgewater; report that Commodore Chauncey has recovered from his illness; news of American Naval forces sailing from Sackett's Harbor; Indian tribes sign peace treaty with U.S.; news of U.S. relations with Indians in the southern U.S.; account of battle of Bridgewater and list of casualties; report of the number of men killed and wounded on both sides in the battle of Chippewa; Page 3: report of surprise attack on the British; news of warship movements in and out of Halifax; frigate Java launched in Baltimore; news of British ship movements; 3 companies of Massachusetts militia arrive at Fort Warren; news of ship movements in and out of the Port of Boston; various Marshal's notices alleging U.S. ships supplying goods to the British;

Independent Chronicle Vol. XLIV No. 3,273- August 24, 1812

A semi-weekly paper that was published from 1801 to 1817. It was previously called the Independent chronicle and the universal advertiser, and was later the Independent chronicle and Boston patriot (Semiweekly). Publishers were Abijah Adams and Ebenezer Rhoades. Topics of interest in this issue include: Page 1: notice from the U.S. War Department seeking proposals for the supply of rations to troops; essay in support of the war; U.S. Secretary of War requests that the Governor of Maryland order 350 militia into active service; statement from the Convention of Republican Delegates in New Jersey in support of the war; statement from U.S. President James Madison in support of the war; statement from Maj. Gen. Isaac Brock to residents of Upper Canada urging their support in the war; U.S. Secretary of war sends 1,500 reinforcement troops to Detroit; Page 2: account from U.S. Gen. Hull of a battle near Fort Malden and news of troops in other areas; editorial against the British alliance with the Indians; letter from a U.S. Officer describing military gains near Detroit; news of U.S. infantry marching from Forts Independence and Warren to Albany, N.Y.; Page 3: news of British cargo ships captured by U.S. ships; 2 reward notices for the return of deserters from the military; report of possible 60 day armistice ratified by James Madison; Page 4: notice to British subjects living in Massachusetts that they must report themselves to the marshall; 2 reward notices for return of deserters from the military;

Speeches delivered by several Indians chiefs.. also an extract of a letter from an Indian chief

Reprint of the 1810 ed. printed by Samuel Wood, New York, Reprinted by Ipswich By J. Bush, Tavern-Street

Ethics, tourists and the environmental practices of the North American cruise ship industry: a comparison study of the ethical standards of Alaskan and Caribbean cruise ship tourists

Please consult the paper edition of this thesis to read. It is available on the 5th Floor of the Library at Call Number: Z 9999 R43 S54 2005

Schooner Ranger document

A page of entries detailing the financial history of the Schooner Ranger, a Great Lakes cargo ship, from 1810-1815. The ship sustained damage in 1811 on its journey from Detroit to Black Rock, in which 3 people drowned. The ship was subsequently “destroyed by the enemy in January 1813”. In August 1815, the ship’s account was settled. The settlement acknowledged that the ship was “taken by the U.S. Navy Officers for the use of the Government”, and is signed by Porter, Barton & Co., and George Kibbe.