As with many other disciplines, the study of medicine is being influenced by the change in the cultural make-up of our country. On occasion, conflicts may develop between the personal beliefs of medical students and the training they must undertake in order to become competent and caring physicians. What are the implications for medical school training in terms of the increasing diversity of the individuals applying to, and being accepted into, medical schools across this country? How much should we allow the personal beliefs and values of physicians-in-training to modify the medical education experience as it currently exists? Do we need to accommodate these individual student differences (religious and cultural) when designing and modifying the medical school curriculum? This thesis looks at the requirement for accommodation (as established in human rights legislation) and the rights of individuals entering into medical school training (as guaranteed by the Canadian Charter of Rights and Freedoms) and attempts to balance these individual rights against the goal of a medical school to develop a generic physician who is prepared, at completion of medical school training, to enter into many different post-graduate training programs. Medical school training involves a number of different types of learning including: knowledge acquisition, procedural competence, and the ability to interact in an intimate, yet wholly professional, manner with complete strangers. Current accreditation requirements demand that each medical student achieves a requisite level of knowledge, and the ability to perform certain physical examinations and associated procedures, by the completion of medical school training. Three distinct examples of possible requests for accommodation are examined during this thesis in order to determine if, and when, accommodation is reasonable and achievable. Although it is possible to allow some degree of modification of the medical school training process in order to accommodate religious or cultural beliefs of particular students, this accommodation is currently not possible if bona fide educational requirements are undermined during this accommodation or if accommodation of students would require undue hardship on the part of the particular medical school, staff or other students involved in the training process. Creating a standard process whereby students can request a modification of their involvement in the medical school curriculum (in order to accommodate religious or cultural differences) will facilitate unbiased and reasonable decision-making. This will allow students and faculty to have reasonable expectations about the ability of each individual to be successfully integrated into the medical school training program. It would also be useful and responsible to make it clear to students applying to be admitted to medical school where the limits are with respect to what degree of modification of medical school training is possible. The knowledge and clinical abilities that a student will be expected to master, within a Canadian medical school curriculum, must be consistent with the expectation of non-discrimination, as identified by provincial and national human rights legislation, and with the rights and freedoms as guaranteed by the Canadian Charter of Rights and Freedoms.

Down syndrome (DS) is the most common genetic cause of mental challenge in individuals and is associated with many ocular disorders. One of these anomalies which is frequently present in this population is reduced accommodation and many studies have reported this. Accommodation is the ability of the crystalline lens in the eye to focus for objects at different distances. Prescribing bifocals could potentially help in correcting the resultant inaccurate focus, although this modality of treatment is not very commonly practiced. The impact of bifocals on reading and literacy skills (academic skills) as well as visual-perceptual skills in individuals with DS has not been studied previously. The aim of this study was to investigate the impact of bifocals on the educational attainment of children and young adults with DS who have reduced accommodation and monitor their performance longitudinally. This is the first time that the impact of bifocal provision on the functional performance of children and young adults with DS has been studied. Also for the first time in children with DS, frequent measures of performance have been used to control for progression with time before and after bifocal prescription. A battery of tests comprising early literacy and visual-perceptual skills was administered before and after bifocal prescription. Accommodation and printing skills were also measured periodically. It was expected that the prescription of bifocals would help to improve near visual acuity and that the improved near acuity would result in educational achievements at school. Compliance with spectacle wear and school reports were also considered. A longitudinal observational study design was utilized with each child acting as his/her own control. Fourteen children and teenagers aged 8-18 with DS were recruited and underwent a basic optometric exam including measurement of their accommodative ability and a cycloplegic refraction. Seventy nine percent required a change in their spectacle prescription and were prescribed single vision (SV) lenses. One hundred percent had reduced accommodation both before and after new SV glasses were prescribed. Distance visual acuity did not significantly improve with SV lenses (p>0.05) but near visual acuity showed a significant improvement (p-=0.015) from 0.64±0.25 logMAR to 0.54±0.20 logMAR. A high prevalence of high refractive errors, including both hyperopia and myopia, was observed t andnear visual acuity even with a habitual correctionwas reduced compared to distance VA. A full battery of reading and visual-perceptual tests was administered with SV lenses. Thereafter the participants were followed for 6 months and monthly subtests (probes) of literacy skills and printing tasks were administered. These “probes” acted as immediate indicators of the child’s performance with his/her correction and change in performance over this time period was monitored. Over the 6 months the participants showed no noteworthy progression in their literacy skills. The group of participants performed at an age-equivalent between 3-10 years. The quality of printing formation in this population has been studied for the first time and showed no significant change over time. It was observed that some aspects of visual-perceptual and early literacy skills could be measured in all the participants. Chronological age and receptive vocabulary were significantly correlated with visual motor integration and Word Identification. Eighty five percent of the participants were prescribed bifocals with additions ranging from +1.00D to +3.50D at the 6th month after the provision of SV lenses. Post-bifocal measures of visual acuity, accommodation, visual-perceptual and early literacy skills were taken 1-2 weeks, and finally 5 months, after bifocal correction. Throughout the pre- and post-bifocal period, verbal compliance with spectacle wear was assessed through school and parental reports. The mean near logMAR VA improved with bifocals (p=0.007) compared to SV lenses. Accommodative accuracy improved with bifocals (less accommodative lag) compared to SV lenses (p=0.002) but there was no change in the accommodation exerted through the distance portion of the lens compared to SV lenses (p=0.423). There was a main effect of bifocals on sight words (p=0.013), Word Identification (p=0.047), and 2 out of 3 tests of visual perception (p<0.05). It was observed that bifocals have a positive impact on the children’s visual and school performance and this was supported by reports of improved performance in school for nine out of eleven individuals who were prescribed bifocals. The children adapted to bifocals more readily than the SV glasses, wearing them for the majority of their waking time. All the sessions of early literacy and visual-perceptual skills administered throughout the duration of the study were videotaped and were then analyzed by a naïve examiner. The time taken to perform each task was calculated and compared between the main single vision and bifocal visits. There was a significant decrease in the completion times on the test battery with bifocals for Word Identification (p=0.0015) and the Dolch sight words (p=0.048). All participants who completed the monthly probes took less time to complete the Dolch sight words (p= 0.025) and the number writing task (p=0.001) with bifocals. Similar results were not observed for the visual-perceptual tests. Performance in the monthly probes was compared before and after bifocal prescription in terms of the average raw scores and time taken. The rate of improvement in performance with bifocals was calculated by plotting the test scores against time and determing the regression lines. There was an overall significant improvement in the monthly probe scores of Word Identification (p=0.050), Dolch sight words (p=0.025) and the number test (p=0.023) with bifocals. The rate of progression in scores increased with bifocals for the Word Identification (p=0.008). Evidence of improved and faster performance with bifocals on some literacy skills was seen. It was concluded that bifocals, which result in improved near focusing, help individuals with DS to maximize their educational potential. It is suggested that more children and teenagers with DS will benefit from bifocal prescription, as they were observed to improve near visual acuity and enable better focusing for near. This thesis has provided a comprehensive analysis of the some tests of literacy, visual- perceptual and early printing skills before and after a bifocal prescription in a group of children and teenagers with Down syndrome. This is the first study to longitudinally monitor the educational impact of bifocals in a population with Down syndrome. Furthermore, the quality of printing formation in this population is a previously unstudied area and was studied longitudinally prior to and after bifocal intervention. The impact of bifocals on printing skills is also discussed. Another novel approach was that all the literacy, writing and visual-perceptual tasks sessions were videotaped to calculate the time taken to complete each task pre- and post-bifocals. This thesis is an addition to the existing literature on bifocal prescription in Down syndrome populations. From the findings in this thesis, the following recommendations are made in order to improve the standard of clinical eye care in this population. Measurement of accommodation should be considered a routine test in the clinical ocular examination for young individuals with DS, now that it is known that many of them present with accommodative deficits. When accommodation is found to be reduced, prescription of bifocals is indicated and should also become the standard of care in this population.

In 1990, a case came before the Ontario Human Rights Commission involving the collision of a religious rights policy enshrined in the Ontario Human Rights Code 1981 and a Peel Board of Education disciplinary policy prohibiting weapons including the kirpan, a dagger-like article of religious faith worn by baptized Sikhs. Harbhajan Singh Pandori claimed infringement of his religious rights as a Sikh under the Code. In a joint complaint, the Ontario Human Rights Commission alleged the Code had been violated in a Peel Board policy restricting the religious rights of Sikhs by prohibiting the kirpan. Attempts to mediate between complainant Sikhs and the Peel Board failed. The dispute went before an Ontario Human Rights Commission tribunal adjudicated by Rabbi W. Gunther Plaut who ruled that the kirpan was a religious symbol and could be worn to school subject to restrictions. The Pandori kirpan case illustrates the complexity of resolving issues of cultural and religious conflict in public institutions undergoing demographic change. Significant to the kirpan case were Canadian immigration policy changes which eliminated race and ethnicity from admission criteria. As a result, the Region of Peel witnessed significant intake of immigrants including Sikhs, some of whom insisted on their right to wear a kirpan. The extensive public debate that followed afforded valuable insight on the political process of policy-making in education and accommodating diversity in public educational institutions. The debate also set the stage for the development of the Peel Board’s equity policy documents--Manifesting Encouraging and Respectful Environments and The Future We Want launched in 2000. Despite the new equity documents, some observers have remarked that institutional change is slow unless pressure is applied by the courts or the Ontario Human Rights Commission. While the kirpan issue has been put to rest in Canada, issues of competing rights continue to challenge Canadians. The kirpan case demonstrates that balancing competing rights in a multicultural society is an ongoing struggle with no final resolution. In the twenty-first century, as Canada continues to diversify, debates concerning accommodation continue to be reflected in the public schools.

In 1990, a case came before the Ontario Human Rights Commission involving the collision of a religious rights policy enshrined in the Ontario Human Rights Code 1981 and a Peel Board of Education disciplinary policy prohibiting weapons including the kirpan, a dagger-like article of religious faith worn by baptized Sikhs. Harbhajan Singh Pandori claimed infringement of his religious rights as a Sikh under the Code. In a joint complaint, the Ontario Human Rights Commission alleged the Code had been violated in a Peel Board policy restricting the religious rights of Sikhs by prohibiting the kirpan. Attempts to mediate between complainant Sikhs and the Peel Board failed. The dispute went before an Ontario Human Rights Commission tribunal adjudicated by Rabbi W. Gunther Plaut who ruled that the kirpan was a religious symbol and could be worn to school subject to restrictions. The Pandori kirpan case illustrates the complexity of resolving issues of cultural and religious conflict in public institutions undergoing demographic change. Significant to the kirpan case were Canadian immigration policy changes which eliminated race and ethnicity from admission criteria. As a result, the Region of Peel witnessed significant intake of immigrants including Sikhs, some of whom insisted on their right to wear a kirpan. The extensive public debate that followed afforded valuable insight on the political process of policy-making in education and accommodating diversity in public educational institutions. The debate also set the stage for the development of the Peel Board’s equity policy documents--Manifesting Encouraging and Respectful Environments and The Future We Want launched in 2000. Despite the new equity documents, some observers have remarked that institutional change is slow unless pressure is applied by the courts or the Ontario Human Rights Commission. While the kirpan issue has been put to rest in Canada, issues of competing rights continue to challenge Canadians. The kirpan case demonstrates that balancing competing rights in a multicultural society is an ongoing struggle with no final resolution. In the twenty-first century, as Canada continues to diversify, debates concerning accommodation continue to be reflected in the public schools.

Darbo sudėtinės dalys. Darbas susideda iš dviejų dalių - teorinės ir tiriamosios. Teorinėje dalyje, remiantis lietuvių ir užsienio autorių moksline literatūra išanalizuoti organizacijos kultūros aspektai, sampratos ypatumai. Tiriamojoje dalyje – aptariama tiriamų organizacijų charakteristika. Remiantis darbe pateikta tyrimo metodologija, atliktas Kauno miesto viešbučių organizacijos kultūros tyrimas. Atliekant anketinį tyrimą, apklausta 123 respondentai (60 respondentų trijų žvaigždučių viešbučiuose ir 63 – keturių žvaigždučių viešbučiuose). Remiantis gautais tyrimo pateikti gauto tyrimo rezultatai, išvados bei rekomendacijos. Darbo objektas – Kauno miesto viešbučių organizacijos kultūra. Problema. Mokslininkai iki šiol nėra ištyrę, kaip atskiros paslaugų sferos t.y. poilsio paslaugas teikiančių įmonių organizacijos kultūras. Tyrimo tikslas – ištirti Kauno miesto viešbučių organizacijos kultūrą. Šiam tikslui pasiekti buvo suformuluoti tokie uždaviniai: 1. Teoriškai pagrįsti organizacijos kultūros aspektus, organizacijos kultūros sampratą funkcijas, reikšmę. 2. Nustatyti kokią vietą viešbutis užima turizmo versle 3. Nustatyti Kauno miesto viešbučių organizacijos kultūros stiprumą bei jos poveikį darbuotojams. 4. Ištirti Kauno miesto viešbučių organizacijos kultūrą. Išvados Vieną pirmųjų, dabar jau laikomą klasikiniu, organizacijos kultūros apibrėžimų, yra pateikęs E.H.Schein (1992). Jo nuomone, organizacijos kultūra – tai kertinių įsitikinimų modelis, išugdytas ar... [toliau žr. visą tekstą] / The work consists of two parts – theoretical and practical. In the theoretical part the peculiarities of organizational culture are analysed according to the reliable scientific literature of Lithuanian and foreign authors. In the practical part – the characteristic of investigative organization is discussed. According to the repordet methodology of organizational culture the investigation in hotels was disposed.With the help of questionnaires there were asked 123 persons (60 persons in three stars hotels and 63 in four stars hotels). Acording to the received material and data anglysis received results, conclusions and gudeline are presented. Working Object - Kaunas city hotels organizational culture Problem - Scientists have so far not investigated, as the individual services ie leisure services business organizations crops The aim of work - explore the city of Kaunas hotel organization culture To achieve this objective was formulated in such tasks: 1. Theoretically, based on the cultural aspects of the organization, the organization culture concept of function, value. 2. Identify the location of the hotel occupies a tourism business 3. Set the Kaunas hotel organization of cultural strength and its impact on workers. 4. Explore the city of Kaunas hotel organization culture Conclusions The first one, now held in the classical, the organization of culture, has made EHSchein (1992). In his opinion, the organizational culture - is a cornerstone belief model, acquired or... [to full text]

This thesis develops an account of non-domination as a principle of legitimacy that ought to govern both inter-group and intra-group relations in multicultural states. It applies this principle to the question of how political institutions should respond to claims for the accommodation of controversial minority practices, using the example of the polygamous community in Bountiful, British Columbia. In developing this account, the thesis engages with three bodies of theoretical literature – of multiculturalism, of political legitimacy, and of autonomy. In the dominant normative theories of multiculturalism, answers are centered on what the limits of toleration are, what it means to recognize a collective identity, or what group rights can be claimed and how group rights are balanced with individual rights. While not rejecting the importance of these issues in a pluralistic state, my approach de-centers them by subsuming them under the broader problem of what makes a political authority morally legitimate vis-à-vis particular collective - as well as abstract individual - subjects. I argue that the most promising response to this problem lies with the concept of non-domination, conceived as a foundational principle of political legitimacy for multicultural states. This principle both demands and checks a democratic method for determining specific forms of accommodation. In some cases the advancement of non-domination between groups conflicts with the advancement of non-domination within groups. In political theory this question is often taken up by feminist scholars concerned with the ‘paradox of multicultural vulnerability’ and, more generally, with the dilemma of how to identify and critique internalized oppression while promoting full respect for individual moral agency. Borrowing from these debates, I outline a conception of the relational moral autonomy of the person and argue that it forms a necessary component of a non-domination- based analysis. The conclusion of the thesis with respect to minority social practices is that specific claims should be determined on the basis of a democratic process aimed at uncovering whether and when, all things considered, the accommodation of that particular practice is consistent with non-domination both between and within groups. / Thesis (Ph.D, Political Studies) -- Queen's University, 2011-09-29 11:13:58.516

Using Dorothy Smith’s institutional ethnographic approach to doing research, I explore through interviews with disabled workers how workplace accommodation policies, such as the New Policy on the Duty to Accommodate Employees with Disabilities in the Federal Public Service and the Department of Fearless Advice’s Workplace Accommodation policy, work. Starting from the standpoint of disabled employees, I map out what happens when a disabled federal public service employee activates one of these policies. I also show that the audit-based compliance evaluation process developed by the Canadian Human Rights Commission to safeguard government Departments/Agencies against systemic discrimination actually facilitates discrimination. These textually-mediated ruling relations situate the problems that disabled workers encounter in the workplace in their biological makeup, rather than in the Government of Canada’s unwillingness to transform their workplaces to meet the needs of all types of workers, as legislated by the Eldridge and Meiorin Supreme Court of Canada decisions. I show, further, that the on-line recruitment process used to select employees into the federal public service encodes normality, thereby discriminating against disabled workers. I also demonstrate that, although federal public service accommodation policies accomplish the legal obligation of the employer not to discriminate against disabled workers, the individualization of accommodations forces disabled workers to take it upon themselves to find ways and means in which to fit into workplaces that have not been designed to meet their needs. I conclude by proposing that in order to change this situation and to counteract the unprecedented number of human rights complaints that have been brought against the Government of Canada for discrimination on the prohibited ground of disability, disabled workers need to follow in the militant footsteps of Canadian First Nations peoples. / Doctor of Philosophy in Interdisciplinary Studies

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Tyrimo objektas: 10–11 metų moksleivių laikysena, dauginiai raumenys, regėjimo aštrumas, akomodacija. Tyrimo problema. Daugelyje šalių didelis dėmesys skiriamas vaikų sveikatos ir gerovės klausimams. Pastaraisiais dešimtmečiais daug dėmesio skiriama augančio vaiko organizmo pokyčių tyrimams. Vaiko organizmas yra unikalus dėl savo funkcijų ir daugybės struktūrų vystimosi bei kitimų (Bačiulienė, 2006). Jaunesnis mokyklinis amžius – tai lytinio brendimo pradžia. Būtent šiuo amžiaus periodu, be kitų organizmo sistemų, labai intensyviai vystosi griaučių – raumenų sistema. Tad, atsižvelgiant į vaiko amžiaus tarpsnių ypatumus ir norint išvengti rimtų sveikatos problemų, būtina ankstyva griaučių – raumenų sistemos vystymosi sutrikimų diagnostika ir prevencija (Kasiulevičius ir Strazdienė, 2008). Prevencija turėtų prasidėti jau mokykloje, nes, pradėjęs lankyti mokyklą, vaikas susiduria su dideliu fiziniu ir psichologiniu krūviu. Sumažėjęs fizinis aktyvumas, dideli statiniai krūviai ir dėl to atsirandanti ydinga laikysena gali įtakoti struktūrinius ir funkcinius pokyčius augančiame organizme (Bačiulienė, 2006). Tikslas: įvertinti 10–11 metų moksleivių stuburo stabilizavimo ir žaidybinių pratimų poveikį laikysenai, nustatyti regos sutrikimų sąsajas su laikysena. Darbo uždaviniai: 1. Įvertinti 10–11 metų tiriamosios ir kontrolinės grupių moksleivių laikyseną, dauginio stuburo raumens skerspjūvio plotą bei jo asimetriją prieš ir po stuburo stabilizavimo ir... [toliau žr. visą tekstą] / Study object: 10–11 years schoolchildren posture, multifidus muscle, eyesight strenght, accommodation. Study problem. In many countrys health and the welfare of children are very important. In recent years big attention is focussed on growing organism and researches of children. Children organism is unique of his functions and many developing and varying structures (Bačiulienė, 2006). Younger school age – it is start of pubescense. Skeletal-muscular system is developing very intensive in this period, without other organism systems. In respect that children ages peculiarity and in order to avoid health problems, it is very important early diagnostic and prevention of skeletal-muscular systems (Kasiulevičius ir Strazdienė, 2008). The prevention should start at school, because when children start to go to school they face with big physical and psychological load. Reduced physical activity, big static loads and because of that being bad posture should effect structural and functional changes in growing organism (Bačiulienė, 2006). The goal of the study: to evaluate the posture stabilizatinion and player excercises effect of 10–11 years schoolchildren posture, to determine relation between eyesight disorders and posture. The objectives: 1. To eveluate 10–11 years old study‘s and control‘s groups posture, multifidus muscle cross-section area and asymmetry before and after stabilization and player excercises. 2. To compare study‘s and control‘s... [to full text]

The 2010 National Education Technology Plan steadily replaces paper textbooks with study materials on computers. One risk of increased computer usage is increased Computer Vision Syndrome (CVS) symptoms. I researched multiple studies to analyze the effects of computer use on dry eye and eye strain and how these symptoms can progress to musculoskeletal pain, headaches, decreased quality of life, loss of confidence and even anxiety and depression. Currently, there is not much data on tablet use so I propose two future experiments to determine if tablets can also cause CVS ocular symptoms.