DEVELOPING BETTER PARTNERSHIPS IN A FAMILY HEALTH TEAM

This organizational improvement plan (OIP) considers the experience of an Ontario family health team whose growing portfolio of partnerships requires evidence-based structure. A brief review of the literature suggests that partnerships are best understood as social constructs, shared spaces that are co-created through the multiple perspectives of their contributors. Synthesis of competing perspectives, integration, is a recurring theme throughout the OIP. Two well-known organizational change models are integrated to create a system change model (SCM) more applicable to the system-level change inherent to healthcare partnerships and this OIP. SCM is supported by an integrated approach to leadership, the incorporation of two leadership theories that value different types of relationships, one within systems (complexity), and the other between people (authentic). Four potential solutions are presented, and a preferred option identified: adopting and adapting a partnership framework for multi-sectoral collaboration by integrating Relational Coordination where communication and relationship-building could support task integration across partner organizations. A test of change partnership using one of the family health team’s most ambitious collaborations is identified, and a supporting change implementation plan described using the SCM framework. The OIP was authored during a time of significant transformation in Ontario’s healthcare system, sometimes giving the writing process the feel of field reporting. As such, it is likely that the healthcare landscape will change again, rendering the concepts of this OIP more applicable to the author’s practice than any specifics in the implementation plan

Soul Journey: Rediscovering the Sacred Paths for Body, Heart, and Mind

The spiritually thirsty are leaving the church in the West. They do not find the church to be a place of spiritual wisdom and nourishment. This dissertation follows various ancient guides within Christianity to recover a life-giving spirituality for the Western Church in the twenty-first century. Chapter 1 draws on the desert monastics as it explores the lack of a transformational spirituality in the modern Church. It defines spirituality in terms of eros, clarifies the aim of spirituality as union, and explores the common reductions that have led the Church astray. Chapter 2 connects the three spiritual paths outlined in Bonaventure’s The Soul’s Journey Into God (outward, inward, and upward) with the three centers of intelligence articulated by Gurdijeff (body, heart, and mind) that form the basis of the Enneagram. Each of these paths and centers of intelligence are explored in successive chapters using a different saint or spiritual tradition as a guide. Chapter 3 follows Celtic Christianity on the outward journey to learn the wisdom and spirituality of the body. Chapter 4 follows John of the Cross on the inward journey to recover the wisdom and spirituality of the heart. Chapter 5 follows Gregory of Nyssa in the upward journey to uncover the spirituality of the mind. Each chapter ends with particular spiritual practices to engage the intelligence centers in the journey of awakening to our union with God. Chapter 6 concludes by reimagining the calling of the Church and pastor as spiritual guide. When the Church learns to navigate the three essential paths of Christian spirituality, it will become enflamed with the life of God, transforming the world

Changing needs and challenging perceptions of disabled people with acquired impairments

The point at which individuals acquire impairments can be a challenging one, for instance people may encounter shifts in financial circumstances, a need to find information, support and services while negotiating with physical changes and for some the ‘stigma’ of disability. The study adopts an individualised diary method combined with semi-structured interviews to collate in depth qualitative data, organised and presented using participants’ voices to chart the experiences and challenges encountered in relation to finding appropriate help at this time. A critical realist perspective is applied to identify what factors affect the participants’ successes and limitations in getting needs met in relation to recently acquired impairments. The data collection method ensures that this material presents the people involved holistically and looks beyond simple representations of disability and identity. It explores how perceptions of identity shift and how participants negotiate these changes over time. The model of the ‘Process of Disillusionment’ is developed as a key finding and consideration given as to how individuals can break free of such a process. Recommendations are then made as to ways in which this cycle of frustration may be resolved both on a collective and individual basis

RACS: Rapid Analysis of ChIP-Seq data for contig based genomes

Background: Chromatin immunoprecipitation coupled to next generation sequencing (ChIP-Seq) is a widely used technique to investigate the function of chromatin-related proteins in a genome-wide manner. ChIP-Seq generates large quantities of data which can be difficult to process and analyse, particularly for organisms with contig based genomes. Contig-based genomes often have poor annotations for cis-elements, for example enhancers, that are important for gene expression. Poorly annotated genomes make a comprehensive analysis of ChIP-Seq data difficult and as such standardized analysis pipelines are lacking. Methods: We report a computational pipeline that utilizes traditional High-Performance Computing techniques and open source tools for processing and analysing data obtained from ChIP-Seq. We applied our computational pipeline "Rapid Analysis of ChIP-Seq data" (RACS) to ChIP-Seq data that was generated in the model organism Tetrahymena thermophila, an example of an organism with a genome that is available in contigs. Results: To test the performance and efficiency of RACs, we performed control ChIP-Seq experiments allowing us to rapidly eliminate false positives when analyzing our previously published data set. Our pipeline segregates the found read accumulations between genic and intergenic regions and is highly efficient for rapid downstream analyses. Conclusions: Altogether, the computational pipeline presented in this report is an efficient and highly reliable tool to analyze genome-wide ChIP-Seq data generated in model organisms with contig-based genomes. RACS is an open source computational pipeline available to download from: https://bitbucket.org/mjponce/racs --or-- https://gitrepos.scinet.utoronto.ca/public/?a=summary&p=RACSComment: Submitted to BMC Bioinformatics. Computational pipeline available at https://bitbucket.org/mjponce/rac

Modeling Lake Michigan Nearshore Carbon and Phosphorus Dynamics

Dreissenid mussels, in particular quagga mussels (Dreissena rostiformis bugensis), are transforming the Lake Michigan ecosystem by clearing the water column, recycling phosphorus and modifying benthic habitat. These impacts are thought to have caused observed declines in the spring phytoplankton bloom in Lake Michigan, as well as changes to food web structure and declines in the abundance of critical invertebrate and fish species. In the nearshore zone, the resurgence of benthic Cladophora algae to nuisance levels not observed since phosphorus loading abatement policies instituted in the 1970s has also been attributed to water column clearing and phosphorus recycling by mussels. Using a long term data set collected in the Lake Michigan nearshore zone between 1980 and 2013, changes in water quality parameters are characterized, compared to those monitored in the lake offshore, and analyzed in the context of the dreissenid mussel invasion and nearshore Cladophora growth. Using this time series analysis as a historical foundation, a computer model of the Lake Michigan nearshore zone was used to identify and quantify the influence of dreissenid mussels on Cladophora growth and nearshore phosphorus and carbon pools and fluxes. This is the first study of Lake Michigan to incorporate both dreissenid mussels and Cladophora algae in a dynamic phosphorus and carbon model. Model output for the summer and fall of 2013 was validated by comparison with an extensive data set of phosphorus and carbon measurements taken at a monitoring station at 9m depth in the Lake Michigan nearshore. The monitoring station and model domain are characterized by rocky substrate and quagga mussel densities of ~5500 individuals m-2 and summer, peak Cladophora biomass of 250 gDW m-2. Following model validation, model test scenarios were simulated excluding mussels. Comparison of model simulations with and without mussels confirmed that dreissenid mussels in the Lake Michigan nearshore zone support Cladophora growth at nuisance levels by increasing light penetration and phosphorus recycling. The nearshore mussel-Cladophora complex substantially increased the storage of phosphorus and carbon in the nearshore zone, supporting the nearshore shunt hypothesis. Mussels were found to support Cladophora production at levels which produced a net autotrophic nearshore zone with Cladophora production consistently exceeding mussel respiration and phytoplankton production during the summer. Due to tissue C:P ratios that were more than twice those of phytoplankton, Cladophora was able to utilize the available light and phosphorus provided by mussel grazing and recycling of phytoplankton to support high growth rates and to produce a large biomass. Even though the nutrients available for Cladophora growth came from phytoplankton recycled by mussels, the ability of Cladophora to store phosphorus in tissue and grow at a high rate with a high tissue C:P ratio lead to a net autotrophic nearshore ecosystem. Nearshore phytoplankton were consistently mixed into the model domain from the lake offshore due to mussel grazing and water column clearing. The consistent input of offshore particulate phosphorus and carbon to the nearshore in model simulations suggested that the nearshore is dependent on offshore energy sources. Tributary loading of carbon and phosphorus can subsidize mussel grazing and therefore limit the demand of nearshore mussels for offshore carbon and phosphorus. There are large areas of Lake Michigan, however, well away from river input that sustain large populations of mussels and Cladophora. These areas are likely sourcing energy and nutrients from the lake offshore as demonstrated by the results of this study. Although there is room for model improvement, the findings of this study provide the first definitive evidence that nearshore dreissenid mussels support Cladophora growth in the Lake Michigan nearshore zone and in doing so, create a seasonal nearshore sink for phosphorus and carbon supplied by the lake offshore. The results of this research provide guidance for future monitoring and modeling work which will provide a clearer picture of the influence of nearshore dreissenid mussels and Cladophora on whole lake nutrient dynamics and energy pathways

The Shapes Game: its hard to take your eyes off it.

Two Person Exhibition. Laura White and Peter Fillingham. Carter Presents, London. Peter Fillingham and Laura White use constructivist anarcho-punk aesthetics employing reconstructive surgery to our post industrial urban detritus. Rebuilding intimate environments in a recyclical continuum, their intimate enquiries within the detached disposability of 21st century consumerism is as prevalent today in 2012 as it was intimated by Duchamp as he began work on the Large Glass in 1912 with the disposability of his Bachelors in a newly mechanised world. Both Fillingham and White are magpies and hoarders mining their own respective localities as did Rauschenberg in New York in the 1960’s finding all the source material to use in his art within a block of his studio. Exploring the language of sculpture Laura White uses a range of materials from everyday objects to constructed matter. Interested in a relationship and negotiation with the ‘stuff’ of the world, from the readymade to the handmade, cheap reproduced goods to church relics, playing with ideas of value, profile, association and meaning of individual and collections of objects. The works make both use of and referral to categories of objects, occupying a fluid space, on one hand demanding critical discourse, and on the other its own ambiguous and intuitive logic. "The works I have made for the show locate themselves within a historical context and particular sculptural languages, such as to classicism and carved marble busts, the modernist abstract sculptures of Hepworth and Gabo, to ornate symbolic religious objects/relics. Relationships are set up and questions are provoked around value and taste through my works plasticized materiality and relation to current consumer culture. It is the trail of pastiche and replica objects in the aftermath of valued objects and sculptures that I negotiate my relationship to both. A category of objects I am currently working with, are the sculptures of Barbara Hepworth, where I am making pieces that parallel some of he intentions, such as to create simplified and reductive abstract forms, but as one looking back through art history and a current commoditized market of replica Hepworth type shapes and forms that appear in all kinds of retail outlets, from garden centers to craft shops, in the form of vases and ornaments etc. It is important for me to treat the everyday object with a regard to its production and authorship, as even the cheapest item from a pound shop has been designed by someone.

Environmental Quenching of Low-Mass Field Galaxies

In the local Universe, there is a strong division in the star-forming properties of low-mass galaxies, with star formation largely ubiquitous amongst the field population while satellite systems are predominantly quenched. This dichotomy implies that environmental processes play the dominant role in suppressing star formation within this low-mass regime (${M}_{\star} \sim 10^{5.5-8}~{\rm M}_{\odot}$). As shown by observations of the Local Volume, however, there is a non-negligible population of passive systems in the field, which challenges our understanding of quenching at low masses. By applying the satellite quenching models of Fillingham et al. (2015) to subhalo populations in the Exploring the Local Volume In Simulations (ELVIS) suite, we investigate the role of environmental processes in quenching star formation within the nearby field. Using model parameters that reproduce the satellite quenched fraction in the Local Group, we predict a quenched fraction -- due solely to environmental effects -- of $\sim 0.52 \pm 0.26$ within $1< R/R_{\rm vir} < 2$ of the Milky Way and M31. This is in good agreement with current observations of the Local Volume and suggests that the majority of the passive field systems observed at these distances are quenched via environmental mechanisms. Beyond $2~R_{\rm vir}$, however, dwarf galaxy quenching becomes difficult to explain through an interaction with either the Milky Way or M31, such that more isolated, field dwarfs may be self-quenched as a result of star-formation feedback.Comment: 9 pages, 4 figures, MNRAS accepted version, comments welcome - RIP Ducky...gone but never forgotte

Taking Care of Business in a Flash: Constraining the Timescale for Low-Mass Satellite Quenching with ELVIS

The vast majority of dwarf satellites orbiting the Milky Way and M31 are quenched, while comparable galaxies in the field are gas-rich and star-forming. Assuming that this dichotomy is driven by environmental quenching, we use the ELVIS suite of N-body simulations to constrain the characteristic timescale upon which satellites must quench following infall into the virial volumes of their hosts. The high satellite quenched fraction observed in the Local Group demands an extremely short quenching timescale (~ 2 Gyr) for dwarf satellites in the mass range Mstar ~ 10^6-10^8 Msun. This quenching timescale is significantly shorter than that required to explain the quenched fraction of more massive satellites (~ 8 Gyr), both in the Local Group and in more massive host halos, suggesting a dramatic change in the dominant satellite quenching mechanism at Mstar < 10^8 Msun. Combining our work with the results of complementary analyses in the literature, we conclude that the suppression of star formation in massive satellites (Mstar ~ 10^8 - 10^11 Msun) is broadly consistent with being driven by starvation, such that the satellite quenching timescale corresponds to the cold gas depletion time. Below a critical stellar mass scale of ~ 10^8 Msun, however, the required quenching times are much shorter than the expected cold gas depletion times. Instead, quenching must act on a timescale comparable to the dynamical time of the host halo. We posit that ram-pressure stripping can naturally explain this behavior, with the critical mass (of Mstar ~ 10^8 Msun) corresponding to halos with gravitational restoring forces that are too weak to overcome the drag force encountered when moving through an extended, hot circumgalactic medium.Comment: 12 pages, 6 figures; resubmitted to MNRAS after referee report (August 25, 2015