The purpose of this study is to investigate whether a prolonged delay in diagnosis of bladder cancer will result in worse outcomes for those patients, compared to those patients with a shorter diagnostic time interval. Data was collected on 247 patients newly diagnosed with transitional cell carcinoma of the bladder from January 1996 to December 2006 (10 years). The medical records of these patients were reviewed for demographics, pathological stage, date of consultation to the genitourinary (GU) service, and date of diagnosis by transurethral resection of bladder tumor (TURBT). The specialty delay was calculated as the time between the date of consultation to the GU service to the establishment of a diagnosis by TURBT. Univariate analyses were performed to test the association of specialty delay with clinical features and all-cause mortality. The median specialty delay in this study was 100 days. There was a trend towards a longer specialty delay for muscle-invasive disease (T2-T4) in comparison to superficial disease (Ta and T1). There was a significant correlation between all-cause mortality and increasing clinical stage (p=0.01). There was a paradoxical finding that patients with a specialty delay greater than 100 days had a significant reduction in all-cause death in comparison to patients with a specialty delay of 100 days or less (relative risk=0.59; 95% CI 0.36-0.90; p=0.01). In conclusion, this study did not confirm the hypothesis that a prolonged specialty delay in patients diagnosed with bladder cancer would result in a worse prognosis. In fact, there was a paradoxical finding that patients with a specialty delay greater than the median delay of 100 days had a better prognosis.

Adolescent survivors of childhood cancer are a growing population with unique needs as they face a combination of challenges associated with normal development and returning to life after treatment completion (Wakefield et al., 2010). One specific need identified in the research literature includes the effective delivery of transitional care and planning (Hewitt, Greenfield, & Stovall, 2005). It has been suggested that the provision of transition care and planning can help facilitate the shift from one phase of care to another and promote positive transition experiences (National Cancer Institute, 2008). The shift from off-treatment to post-treatment and school reintegration have been identified in the literature as significant transitions for adolescent survivors of childhood cancer (Cabat & Shafer, 2002; MacLean, Foley, Ruccione, & Sklar, 1996). However, limited research has been conducted to explore these transitions from the perspectives of adolescent survivors of childhood cancer. An exploratory, qualitative study was conducted with eight adolescent survivors of childhood cancer between the ages of 14 and 17. A multiple case study research design was used to explore adolescent cancer survivors' perceptions of these transition processes, challenges associated with these transitions, and their beliefs about what supports/services were or would be beneficial during these transitions. Data collected for analysis included questionnaires, transcribed interviews and follow-up meetings, direct observation, documents, and parent feedback. These data were analyzed using a combination of a template organizing style, immersion/crystallization (I/C) approach, and multiple case study strategies (Borkan, 1999; Crabtree & Miller, 1999, Stake, 2005; Yin, 2008). Results indicated that adolescents perceived that change was occurring on some level during the shift from off-treatment to post-treatment and school reintegration but did not necessarily define this time as a "transition." They defined these times in personalized terms that reflected more subtle changes in their lives. The focus was placed on returning to a sense of "normalcy" and capitalizing on opportunities to regain some control over one's life. The improvement and/or absence of treatment residuals along with re-engagement in activities and roles served as signs, or indicators, that life was returning back to "normal" and provided feedback to the adolescent on their transition progress. Conversely, the presence of these signs continued to impact their lives as they restricted participation in desired activities and served as reminders that the effects of cancer and treatment extended beyond treatment completion. In addition to the presence of treatment residuals, fear of relapse also was a concern associated with the transition from off to post-treatment. However, adolescents tended not to let this be the focus of their lives. School reintegration challenges included disruption of school life and routines as well as academic and social concerns. Academic challenges included falling behind/catching up with work, maintaining motivation to do work, and readjusting to school demands and routines. Social challenges included answering peer questions, adjusting to peer awkwardness/discomfort, and managing peer reactions to their physical side effects. These challenges were not perceived by adolescents as sources of significant distress and, often times, they adapted and employed coping strategies to address these concerns in the school setting. Adolescents also varied in their perceived need for transitional care and support during these transitions. Support received during the shift from off-treatment to post-treatment included advice from health care team members as well as relationships with peer cancer survivors across school, community, hospital, and camp settings. They received a variety of academic and social support during school reintegration. Teachers, family members, and peers provided academic support across home, hospital, and school settings. Teachers were a particularly important source of academic assistance. Accommodations and modifications also were provided to these adolescents at school. Peers, teachers, and other school staff provided social support. Based on the findings of the study, suggestions for future research and practical implications are offered.

Between 1994 and 2012, the Zapatista Army of National Liberation (EZLN) established a contested zone of exception to neoliberal governance in southern Mexico and women's-rights-as-human-rights universalism reshaped international development and activist discourse. Within this context, Ana, Beatriz, and Celia González Pérez pressed claims against a group of Mexican Federal Army soldiers for rape at a military checkpoint in 1994. A rare instance of first-person denunciation of rape warfare, the Tseltal-Maya sisters' own powerful representation of the physical and procedural violations committed against them forms the starting point of this analysis, which proceeds from there, chapter by chapter, through communal, national, and international representations. Centering the women's speech, then moving to what are conventionally understood as broader fields of discourse produces new ways of understanding violence in relation to nation, culture, and gendered sociality. Though in 2001 the human rights commission of the Organization of American States upheld the women's claims, as of this writing (2012) the Mexican state has neither awarded reparations nor prosecuted the accused. I argue here that the women's unmet demands for collective and individual justice produce a novel language of protest which I call denuncia (denouncement) rather than testimony. Denuncia, I argue, puts the physical and the social body at the center of claims against sexual violation; enacts coraje (courage, rage) rather than petitions for recognition of truth; exposes the nationalist ideology of racial mixing that informs the production of testimony in Mexico, and establishes new audiences for its own reception despite the regimes of everyday violence it foregrounds. Formulated amid military occupation, denuncia exposes the gendered intimacy--control of the food supply, inhabitation of public-private architectural spaces, colonization of local enmities--that gave rise to military rape, which I call here "domestic violence." Denuncia emerges to refute the neoliberal discourse that links indigenous culture, gender, and violence just when the material basis of indigenous livelihood is under siege. This dissertation's method would not have been possible without almost twenty years' engagement with Tseltal and Tojolabal-Maya men and women who have formed part of the Zapatista movement. This long-range perspective has engendered a form of feminist scholarly accountability that cultivates listening to ground critique on the terrain of self-determination. / text

I situate Škvorecký’s novel as both a primary document in the historical record of transitional justice and as a literary creation in the author’s larger oeuvre. In creating this work of autobiographical fiction, Škvorecký deals with the ambiguities of a tumultuous historico-political moment and creates an appropriately complex work of art. I combine social science research with close-reading of the text in the tradition of new historicism. In the introduction I explain the historico-political background, specifically transitional justice and lustration in Czech Republic in the early 1990s, that engendered Two Murders. In my first chapter, I examine the book reviews, Czech and English, that appeared following the two language-respective publications of Two Murders. In the remaining three chapters I present my analysis of the novel based on close-reading and applied historical information. Chapters two and three discuss different but interconnected manifestations of distance. Chapter two examines memory as the temporal distance of the mind, while chapter three explores exile as spatial distance. Škvorecký invests memory and exile with enormous significance, and uses both concepts to depict his characters’ isolation. In the final chapter, I discuss rumor and reputation in the novel’s two distinct story-lines, demonstrating how they come together to create a cohesive artistic work. Approaching the novel as both a historical document and a work of art, I hope to critically examine this complicated historical moment and appraise Škvorecký’s contribution to the post-communist Czech dialogue. / text

Happy Hearts Automatic Referral (HHAR) was a program that referred heart failure (HF) patients to Transitional Care (TC) at Banner Health. The purpose of the human subject’s research was to examine the use of the Minnesota Living with Heart Failure® questionnaire (MLHFQ) as a survey instrument to identify moderate quality of life (QOL) in patients living with HF. The most common referral to TC prior to the project was patients with poor QOL. The project explored the influence of earlier referrals to improve QOL for participants living with HF. The MLHFQ was chosen because it is a valid and reliable instrument specific to QOL. The HF population was chosen because the most commonly referred patients to interventions such as TC are those that pose the smallest risk for readmission, have the highest risk of readmission, or have the potential to demonstrate the most significant increase in QOL. By offering TC to patients with moderate QOL, an opportunity existed to reduce advancement into a population that is characteristic of high-risk readmissions. The project identified potential participants, then administered the MLHFQ, and scored it. When scores were between 26 and 45, participants were considered qualified participants for this project. Ideally, the patient would have been enrolled in TC for 30 days and the project would have administered another MLHFQ at completion of 30 days of TC to evaluate a change in QOL; however, due to the short-term nature of this project the TC content and follow-up administration of the MLHFQ was not evaluated. Also, while this project was taking place the TC team at Banner Health was not accepting new patients. A human subject’s research approach was applied and examined the responses to the MLHFQ from a small sample of five moderate QOL participants and described the expected responses for improved QOL if a second MLHFQ was to be administered following TC. Specifically items 1, 7, 8, 14, and 19 were examined to discuss how TC interventions might have improved scores on these items. The project concluded by describing how future cycles should be completed for further research.

This thesis focuses on the importance of truth and memory in the process of transitional justice, within the context of the aftermath of gross violations of human rights that occurred during the military dictatorship of 1976 to 1983 in Argentina. The military junta that ruled Argentina took power under the pretext of national security, arguing that an enemy threatened to destabilize and destroy Argentine society. During the period of the military dictatorship an estimated 30,000 people "disappeared"; relatives of those disappeared mobilized and formed human rights organizations to confront the military regime for its abuses. Once the dictatorship collapsed and democratic rule was reestablished these human rights organizations changed their focus, mobilizing once again to find their missing relatives, learn the truth, and prosecute those responsible of any crimes. A series of amnesty laws and pardons protected the perpetrators of many of the crimes of the military regime through most of the 1990's, until in 2005 the Argentine Supreme Court declared those laws unconstitutional. During the period before the 2005 ruling human rights organizations worked hard to gather the truth about the crimes of the military regime and ensure these crimes were not forgotten. Their initiatives included the famous weekly march to the Plaza de Mayo by members of Madres (Mothers), one of the most important human rights organizations in Argentina; escraches (reveal what is hidden) and public protests by HIJOS (Sons and daughters of the disappeared), actions in which members of HIJOS would go to the houses of known members of the military juntas and protest at their front doors; and programs to find missing grandchildren by Abuelas (Grandmothers), a human rights organization dedicated to searching for the missing children of the disappeared; and others. Because of the structure of terror during the military junta, most Argentines did not know exactly what was happening to the missing persons, and they were afraid to ask. The truth gathering initiatives and the official report of the commission charged with investigating the junta, CONADEP, came into being in response to this lack of knowledge. They helped to inform the Argentine people and the new generations of what had happened during the military dictatorship in hopes of making sure that such abuses do not occur again.

There is a growing literature in political science that focuses on the impact that policies, or mechanisms, of transitional justice (e.g. tribunals, truth commissions, and amnesty laws) have on future human rights abuses and democratization processes. However, this literature fails to differentiate between having a policy on the books and having a policy which is actually implemented. My project attempts for the first time to measure and assess how well two distinct types of transitional justice policies, truth commissions and ad-hoc tribunals, are designed and how well they are implemented. Variation in terms of policy structure (or institutional design) and implementation are currently unknown; knowing what the level of this variation is will enable us to understand the impact these transitional justice policies have on state-level human rights behavior. To conduct this analysis, I first offer a derivation of principal-agent theory and then assemble a new dataset of measures culled from primary and secondary data sources on over 40 different courts and truth commissions. For the data on the institutional design of these transitional justice policies, I collected and translated the legal mandates which create courts or commissions. I then coded the power, authority, and resource allocations which are designated in these mandates. For the data on implementation, I collected primary commission and court reports as well as secondary analyses and tracked the various activities and forms of engagement which were utilized in the process of carrying out each policy. These data were then compiled with a full set of economic, political, and social context measures and analyzed to determine whether policies with (1) more allocated authority/power or resources or (2) better implementation produced greater improvements in respect for human rights or reduced the likelihood of having additional instances of rights violations. Overall, I find that design and implementation measures are not strongly related to greater rights improvements or the reduced likelihood of violations, indicating that whatever positive changes may exist are not likely due to transitional justice practices. However, the use of transitional justice policies following human rights abuses is correlated with more positive outcomes. The ultimate goal of this project was to determine whether these policies can deliver justice and to initiate a dialogue on whether domestic populations are well served by high-cost policies (such as courts or commissions) or whether these priorities should be tabled in favor of addressing more immediate needs of these groups. The results of this dissertation appear to support the latter claim although these findings remain preliminary.

Šiuolaikinis švietimas remiasi kryptinga veikla, skirta mokinio įgūdžių, gebėjimų ir vertybinių nuostatų formavimui, mokinio žinių ir kompetencijos plėtotei. Nors jau dešimtmetį yra vykdoma Lietuvos švietimo pertvarka, tačiau įvairūs tyrimai rodo, kad nesėkmingo mokymosi lygis švietimo sistemoje yra aukštas. Pati nenoro mokytis problema tapo globaline pradėjus įgyvendinti privalomą mokymą nuo 7 iki 16 metų. Mokymosi motyvacijos stoka glaudžiai susijusi su mokyklos nelankymu, kurso kartojimu, dėl ko kiekviena pasaulio valstybė patiria didelius nuostolius. Žmogus, „iškritęs“ iš švietimo sistemos, negali gauti įstatymų nustatyta tvarka išduoto dokumento, patvirtinančio asmens mokymosi rezultatus, todėl toks asmuo negali sėkmingai įsilieti į darbo rinką. Neišsilavinusiam žmogui yra sunkiau dalyvauti visuomeniniame gyvenime. Iškyla tikimybė būti atstumtam, kas sąlygoja psichologines asmens problemas, socialinį ir finansinį nesaugumą. Todėl kiekvienos šalies švietimo sistemos tikslas yra siekti, kad jos visuomenės nariai būrų išsilavinę – įgytų asmens tam tikro lygio brandą liudijančią kompetenciją, žinias, įgūdžius, gebėjimus ir vertybines nuostatas. Tai sąlygoja atvirą ir demokratišką visuomenę. Lietuvos ir užsienio autoriai pabrėžia, kad mokymosi motyvacija yra vienas svarbiausių mokymosi sėkmės komponentų. Taip pat pabrėžia vidinio poreikio mokytis svarbą. Be tokio poreikio mokytis prasmingas mokymasis neįmanomas. Dalis pedagogų ir psichologų tyrė vaikų ir paauglių mokymosi... [toliau žr. visą tekstą] / Motivation is a complex and dynamic phenomena. It is a psychological process, which regulates the activity of a personality and his/her relations with the environment. Motivation is closely related to the motives which influence a person’s behaviour and activity. In order to educate desirable behaviour it is necessary to eliminate negative causes. The 4th and 5th-form pupils may be influenced by different motives, groups of motives or separate motives. Possible ways to strengthen learning motivation are expedient organization of learning process according to the pupils’ needs; formation of possibilities to establish the aims of the activities; expedient evaluation of pupils” achievements; improvement of the relationship among pupils, parents and teachers; strengthening of the internal and external learning motivation according to the pupils’ main learning motives: cognition, self-expression, future, communication, prestige and external stimuli. To summarize the results of the survey it can be stated that learning motives of the 5th-form pupils are various. The most conspicuous are future and cognition motives, less important are prestige, self-expression and communication motives and minor motives are external stimuli. Formation of learning motives depends on various factors. According to the survey, pupils in the 5th form face a lot of new things: pupils’ social environment changes. Learning process also changes. The 5th-form pupils take greater responsibility for the... [to full text]

This research examines the process of memorialisation around the Indian Residential School System in Canada to draw connections between the fields of transitional justice and professional urban planning. For over a century, government and churches in Canada operated a system of residential schools that removed Indigenous children from their families and communities. Today, many Indigenous communities struggle with the intergenerational impacts of this system, and as a society we are attempting to heal the damaged relationships that have resulted. This research presents a comparative case study of two processes of memorialisation surrounding the residential school system. Through site observations, interviews, and analyses of documents, this research examines the transformation and memorialisation of the Mohawk Institute, a former residential school, into the Woodland Cultural Centre, a First Nations-run centre located in Brantford, Ontario. I compare this example with the national Commemoration Fund, set out in the Indian Residential School Settlement Agreement (2006), which settled lawsuits filed by residential school survivors against the federal government of Canada and several church organisations. This research underlines some tensions inherent in memorialising the human rights abuses experienced in the residential schools. A significant difficulty is establishing balance between leaving ownership of stories of the residential school experiences with survivors, while acknowledging the responsibilities that the whole of society must carry if reconciliation is to be achieved. I conclude that the process established through the Commemoration Fund does not adequately reflect this balance, leaving a heavy burden on survivors and their communities without providing adequate support. I further argue that the timelines established through this fund do not allow for the longer-term evolution that may characterize effective memorialisation projects. These themes link to theories around collaborative planning, and considerations of social justice and procedural fairness. In recent decades, collaborative planning has been seen as a way to make planning practices more inclusive. However, in the context of planning with Indigenous Peoples, collaborative processes may not be a sufficient response to rights claims. This has important implications for professional planners, as we work towards decolonization, reconciliation, and establishing just-relations between Indigenous and non-Indigenous populations in Canada. / Thesis (Master, Urban & Regional Planning) -- Queen's University, 2012-09-08 13:19:55.027

This thesis explores the psychological development of liminal characters in four late-twentieth-century British novels. Studies of Julian Barnes’s Flaubert's Parrot, A. S. Byatt’s Possession, Angela Carter’s Nights at the Circus, and John Fowles’s The French Lieutenant’s Woman, by using D. W. Winnicott’s transitional-objects theory and Jessica Benjamin’s intersubjective theory, show how characters who are little more than infants socially and psychologically attempt to transcend the transitional, liminal status defined by Victor Turner. With the aid of significant objects or equal other subjects, these characters, whose subjective self-constructions at the beginning of the novels have become stalled in an immature position of emotional development or been inhibited by dominating individuals, progress psychologically towards controlling their own subjectivity.