http://hdl.handle.net/1974/290 2013-05-23T20:50:41Z http://hdl.handle.net/1974/8037 Title: Ontario’s Home First Approach, Care Transitions, and the Provision of Care: The Perspectives of Home First Clients and Their Family Caregivers Authors: English, Christine Abstract: Home First is an Ontario transition management approach that attempts to reduce the pressure on hospital and Long Term Care (LTC) beds through early discharge planning, the provision of timely and appropriate home care, and the delay of LTC placement. The purpose of this qualitative descriptive study was to obtain descriptions from South Eastern Ontario Home First clients and their family caregivers of their experiences with and thoughts about care transitions, the provision of care, and the Home First approach. The goal was to enable insight into the Home First approach, care transitions, and the provision of care through access to the perspectives of study participants. Nine semi structured interviews (and one or more follow-up calls for each interview) with Home First clients discharged from hospitals in South East Ontario and their family caregivers were conducted and their content analyzed. All participating Home First clients were pleased to be home from hospital and did not consider LTC placement a positive option. All had family involved with their care and used a mix of formal and informal services to meet their care needs. Four general themes were identified: (a) maintaining independence while responding (or not) to risks, (b) constraints on care provision, (c) communication is key, and (d) relationship matters. Although all Home First clients participating in the study were discharged home successfully, a sense of partnership between health care providers, families, and clients was often lacking. The Home First approach may be successfully addressing hospital alternative level of care issues and getting people home where they want to be, but it is also putting increasing demands on formal and informal community caregivers. There is room for improvement in how well their needs and those of care recipients are being met. Health professionals and policy makers must ask caregivers and recipients about their concerns and provide them with appropriate resources and information if they want them to become true partners on the care team. Description: Thesis (Master, Rehabilitation Science) -- Queen's University, 2013-05-23 16:10:53.323 2013-05-23T04:00:00Z http://hdl.handle.net/1974/8036 Title: ORGANOHALOGENATED PERSISTENT ORGANIC POLLUTANTS IN AMERICAN EEL (ANGUILLA ROSTRATA) CAPTURED IN EASTERN CANADA Authors: Byer, Jonathan D Abstract: Recruitment of American eels (Anguilla rostrata) to Lake Ontario has declined rapidly over the past few decades. The commercial yellow eel fishery in Lake Ontario was closed in 2004 due to a lack of eel abundance. Researchers have been attempting to ascertain the reasons for the decline, although thus far, without definitive answers. In this thesis, the question of chemical contamination is addressed as it relates to female eel spawner quality. Spatial concentration trends of halogenated persistent organic pollutants (POPs) are described in eels collected from across eastern Canada, as well as temporal concentration trends in eels collected from a historically important area of northeastern Lake Ontario, Canada. Chlorinated POPs in eels, namely, organochlorinated pesticides, polychlorinated biphenyls, polychlorinated dibenzo-p-dioxins and dibenzofurans are all significantly less than historic values which peaked in the 1960-70s. Measured concentrations of chlorinated POPs in eels from Lake Ontario have decreased by up to 3-fold over the past three decades, and exceeded toxicity thresholds historically for surrogate species (European eel and lake trout). Thus, chlorinated POPs may have had an effect on spawner quality. Concentrations of legacy POPs in eels were dependent on their origin, with eels from highly urbanized and industrialized areas having significantly higher concentrations than eels captured in less developed regions. Similar trends were observed for polybrominated diphenyl ethers and chlorinated norbornene flame retardants. A number of emerging brominated compounds were also measured in these eels by non-target analysis including bromophenols, bromobenzenes, and bromoanisoles. This thesis demonstrates that eels are an ideal species to investigate local sources of pollution, and provide chemical data that may be used in the future, when more toxicity information is available for eels, to assess the health risks posed by accumulated chemical contaminants. Description: Thesis (Ph.D, Chemistry) -- Queen's University, 2013-05-23 09:27:59.593 2013-05-23T04:00:00Z http://hdl.handle.net/1974/8034 Title: THROMBOSPONDIN-1 ANALOG, ABT-898, INHIBITS ENDOMETRIOTIC LESION VASCULARIZATION WITHOUT AFFECTING FERTILITY OR PREGNANCY OUTCOMES IN A MURINE MODEL OF ENDOMETRIOSIS Authors: Nakamura, DIANE Abstract: Endometriosis is a gynecological disease defined as the growth of endometrium outside of the uterus. Although linked to 50% of female infertility cases, current medical treatments fail to maintain fecundity. Since the survival of endometriotic lesions is dependent on their early neovascularization, antiangiogenic therapies specifically targeting blood vessel growth could be a promising therapeutic option for the treatment of endometriosis. Angiogenesis, the branching of new blood vessels from existing vasculature, promotes robust vascularization of lesions. ABT-898 (Abbott Laboratories), a thrombospondin-1 analog, induces endothelial cell apoptosis while sequestering pro-angiogenic growth factors. We postulated that ABT-898 would reduce endometriotic lesion vascularization while physiological angiogenesis and pregnancy remained unaffected in a murine model of endometriosis. The antiangiogenic effect of ABT-898 was tested in a human umbilical vein endothelial cell line revealing disruption of endothelial tube branching. Two in vivo experiments were conducted in which endometriosis was induced in female alymphoid BALB/c-Rag2-/-Il2rg-/- mice by adhering sections of human endometrium to the abdominal wall. Lesions from ABT-898 treated mice contained a reduced number of CD31+ endothelial cells and a decrease in blood flow supplying the lesion compared to 5% dextrose controls. Reproductive status was evaluated through maintenance of pregnancies up to gestation day 12 revealing unaffected implantation site structure and physiological angiogenesis. In a trans-generational study, pregnant F0 generation mice received ABT-898 or 5% dextrose injections on gestation days 7, 9, 11, 13, 15, 17, and 19. F1 generation mice were raised to reproductive age and bred resulting in litters (F2 generation) comparable in size to the F0 generation litters. Chronic exposure to ABT-898 did not affect angiogenic plasma cytokine levels in F0 generation mice. In addition, physiological angiogenesis was unaffected within the uteri of ABT-898 treated mice. Histological examination of the kidney, liver, ovary, and uterus revealed no structural abnormalities in F0 and F1 generations exposed to ABT-898. These results suggest that ABT-898 inhibits pathological angiogenesis within endometriotic lesions without affecting physiological angiogenesis involved in pregnancy and organ function across three generations of mice. Further research will establish the effects of ABT-898 on embryonic development, organ toxicity, and physiological angiogenesis in all organs. Description: Thesis (Master, Anatomy & Cell Biology) -- Queen's University, 2013-05-07 15:19:10.967 2013-05-22T04:00:00Z http://hdl.handle.net/1974/8033 Title: Human Rights, Legitimacy, and Global Justice: Deconstructing the Liberal Theory of International Relations Authors: Szende, JENNIFER Abstract: This dissertation examines liberal statist and liberal cosmopolitan attempts to explain global justice. It argues that liberal statists misidentify their own commitments regarding human rights, and that once these implications are drawn out, many statist and cosmopolitan theories of global justice converge on several of their central positions. Although statists and cosmopolitans differ in their methodologies, emphasis, epistemic commitments, and some logical commitments of their respective positions, I argue that they are nonetheless committed to many of the same positions about practices in the sphere of global justice. They share elements of a logical structure, based in liberal domestic principles, which commits them to similar practical implications. Their convergence is most visible in an examination of their human rights commitments. They nonetheless differ in their analytic priorities, and hence in the ease with which they arrive at many of their insights and conclusions. In particular, despite Rawls’s denial of the desirability or feasibility of cosmopolitanism, he shares many practical commitments with cosmopolitans such as Tesón, Beitz, Buchanan, Tan and Caney. Their shared liberal egalitarian premises arising from liberal domestic theory result in convergence on what they take to be the central questions of global justice, and moreover on their answers to these central questions. Liberal theories on both sides of the cosmopolitan and statist divide endorse a practical approach to human rights that links human rights compliance with such practical global justice privileges as non-intervention, humanitarian aid, treaty relations, and even tolerance. And this convergence entails a more united liberal account of global justice than theorists on either side of the statist and cosmopolitan divide have been willing to admit. Description: Thesis (Ph.D, Philosophy) -- Queen's University, 2013-05-21 14:40:51.218 2013-05-22T04:00:00Z