An Exploration of the Current Orientation Practices for Clinical Instructors at Ontario University Nursing Programs

The Joint Provincial Nursing Committee in Ontario in 2015 set forth recommendations to improve clinical nursing education. This thesis was conducted to explore the current orientation processes for new clinical instructors within nursing programs at Ontario universities. Qualitative methodology, more specifically case study design, was chosen to guide the research process. Eight participants from six universities in Ontario were recruited, using purposeful sampling, and participated in semi-structured interviews. Four themes emerged from the data: (a) the process of orientation starts with the hiring process; (b) training methods and content of orientation programs; (c) completion of the orientation process; (d) clinical instructors as part-time employees. Findings indicated that there is a lack of a standardized orientation process across Ontario, resulting in inconsistencies in how clinical instructors teach across the province. It is recommended that an evidence-informed, standardized orientation model be developed to provide consistency in clinical education across Ontario

Economic Hedging Portfolios

In this paper we study portfolios that investors hold to hedge economic risks.Using a model of state-dependent utility, we show that agents economic hedging portfolios can be obtained by an intuitively appealing, risk aversion-weighted approximate replication of the economic risk variables using the investment opportunity set, as opposed to the unweighted hedging demand obtained in the traditional mean-variance framework.We find that agents across a broad range of levels of risk aversion are willing to pay significant compensations for hedges against inflation risk, real interest-rate risk, and dividend-yield risk.Furthermore, our results show that all economic risk variables we consider require significant, often risk aversion-dependent hedging adjustments with respect to one or more securities.Moreover, we analyze investors speculative positions and find that hedges against economic risks may potentially explain the anomalies found in stock markets as well as the term and default premiums in bond markets.hedging;risk;investment

Raynaud’s phenomenon: a mirror of autoimmune disease

Raynaud’s phenomenon is a discoloration of the hands and feet provoked by cold or emotional stress. In some patients it is the first symptom of an underlying autoimmune disease (secondary), however, in most patients it is without an underlying disease (primary). Because it is important to treat patients with an autoimmune disease in an early stage, it is important to differentiate between the primary and secondary Raynaud’s. Furthermore, Raynaud’s can give complaints such as pain, which can reduce the patients’ quality of life.In this thesis the mechanisms which lead to this phenomenon are addressed, differentiators between primary and secondary Raynaud’s are assessed, and treatment options are studied. The most important conclusions are that there is a relation between damage to the nailfold capillaries and the degree of the attacks, and also with body mass index. Furthermore, changes in the capillaries seem to predict the presence of abnormal pulmonary function tests in patients with different autoimmune diseases. When the thumb is uninvolved and after a Raynaud’s attack there is a quick recovery, an underlying disease is unlikely. Regarding to treatment, bosentan seems to improve the stiffness of the forearm arteries. Lastly, the ‘SPTS’, a procedure to treat Raynaud’s, seems to be effective on short-term and has minimal burden

Long-term effects of a weight loss intervention with or without exercise component in postmenopausal women: a randomized trial

The aim of this study was to determine the long-term effects of a weight loss intervention with or without an exercise component on body weight and physical activity. Women were randomized to diet (n = 97) or exercise (N = 98) for 16 weeks. During the intervention, both groups had achieved the set goal of 5-6 kg weight loss. All women were re-contacted twelve months after study cessation for follow-up where body weight and physical activity were measured (PASE questionnaire and ActiGraph accelerometer). At follow-up, body weight and physical activity (measured by the PASE questionnaire and accelerometer) were measured again. At follow-up, both mainly exercise (- 4.3 kg, p < 0.001) and diet (- 3.4 kg, p < 0.001) showed significantly reduced body weight compared to baseline. Both the mainly exercise and diet group were significantly more physically active at one year follow-up compared to baseline (PASE: + 33%, p < 0.001 and + 12%, p = 0.040, respectively; ActiGraph: + 16%, p = 0.012. and + 2.2%, p = 0.695 moderate-to-vigorous activity, respectively). Moreover, the increase in physical activity was statistically significantly when comparing exercise to diet (+ 0.6%, p = 0.035). ActiGraph data also showed significantly less sedentary time in mainly exercise group compared to baseline (- 2.1%, p = 0.018) and when comparing exercise to diet (- 1.8%, p = 0.023). No significant within group differences were found for the diet group. This study shows largely sustained weight loss one year after completing a weight loss program with and without exercise in overweight postmenopausal women. Although the mainly exercise group maintained more physically active compared to the diet group, maintenance of weight loss did not differ between groups

Role of interleukin-7 in degenerative and inflammatory joint diseases

IL-7 is known foremost for its immunostimulatory capacities, including potent T cell-dependent catabolic effects on bone. In joint diseases like rheumatoid arthritis and osteoarthritis, IL-7, via immune activation, can induce joint destruction. Now it has been demonstrated that increased IL-7 levels are produced by human articular chondrocytes of older individuals and osteoarthritis patients. IL-7 stimulates production of proteases by IL-7 receptor-expressing chondrocytes and enhances cartilage matrix degradation. This indicates that IL-7, indirectly via immune activation, but also by a direct action on cartilage, contributes to joint destruction in rheumatic diseases