117 resultados para harm minimization
Resumo:
The assessment of parenting capacity continues to engender public concern in cases of suspected harm to children. This paper outlines a model for approaching this task based on the application of three key domains of knowledge in social work relating to facts, theory and practice wisdom. The McMaster Model of Family Assessment is identified out of this process and reworked to give it a sharper focus on parenting roles and responsibilities. Seven formative dimensions of parenting are then elicited and combined with an analytical process of identifying strengths, concerns, prospects for growth and impact on child outcomes. The resulting assessment framework, it is argued, adds rigour to professional judgements about parenting capacity and enhances formulations on risk in child protection.
Resumo:
Background: This study assessed the association between adolescent ecstasy use and depressive symptoms in adolescence. Methods: The Belfast Youth Development Study surveyed a cohort annually from age 11 to 16 years. Gender, Strengths and Difficulties Questionnaire emotional subscale, living arrangements, parental affluence, parent and peer attachment, tobacco, alcohol, cannabis and ecstasy use were investigated as predictors of Short Mood and Feelings Questionnaire (SMFQ) outcome. Results: Of 5371 respondents, 301 (5.6%) had an SMFQ > 15, and 1620 (30.2) had missing data for SMFQ. Around 8% of the cohort had used ecstasy by the end of follow-up. Of the non-drug users, ∼2% showed symptoms of depression, compared with 6% of those who had used alcohol, 6% of cannabis users, 6% of ecstasy users and 7% of frequent ecstasy users. Without adjustment, ecstasy users showed around a 4-fold increased odds of depressive symptoms compared with non-drug users [odds ratio (OR) = 0.26; 95% confidence interval (CI) = 0.10, 0.68]. Further adjustment for living arrangements, peer and parental attachment attenuated the association to under a 3-fold increase (OR = 0.37; 95% CI = 0.15, 0.94). There were no differences by frequency of use. Conclusions: Ecstasy use during adolescence may be associated with poorer mental health; however, this association can be explained by the confounding social influence of family dynamics. These findings could be used to aid effective evidence-based drug policies, which concentrate criminal justice and public health resources on reducing harm.
Resumo:
We present an implementation of quantum annealing (QA) via lattice Green's function Monte Carlo (GFMC), focusing on its application to the Ising spin glass in transverse field. In particular, we study whether or not such a method is more effective than the path-integral Monte Carlo- (PIMC) based QA, as well as classical simulated annealing (CA), previously tested on the same optimization problem. We identify the issue of importance sampling, i.e., the necessity of possessing reasonably good (variational) trial wave functions, as the key point of the algorithm. We performed GFMC-QA runs using such a Boltzmann-type trial wave function, finding results for the residual energies that are qualitatively similar to those of CA (but at a much larger computational cost), and definitely worse than PIMC-QA. We conclude that, at present, without a serious effort in constructing reliable importance sampling variational wave functions for a quantum glass, GFMC-QA is not a true competitor of PIMC-QA.
Resumo:
We present results for a variety of Monte Carlo annealing approaches, both classical and quantum, benchmarked against one another for the textbook optimization exercise of a simple one-dimensional double well. In classical (thermal) annealing, the dependence upon the move chosen in a Metropolis scheme is studied and correlated with the spectrum of the associated Markov transition matrix. In quantum annealing, the path integral Monte Carlo approach is found to yield nontrivial sampling difficulties associated with the tunneling between the two wells. The choice of fictitious quantum kinetic energy is also addressed. We find that a "relativistic" kinetic energy form, leading to a higher probability of long real-space jumps, can be considerably more effective than the standard nonrelativistic one.
Resumo:
Although child maltreatment due to abuse or neglect is pervasive within our society, less
is known about fabricated or induced illness by carers (FII), which is considered to be a
rare form of child abuse. FII occurs when a caregiver (in 93% of cases, the mother)
misrepresents the child as ill either by fabricating, or much more rarely, producing
symptoms and then presenting the child for medical care, disclaiming knowledge of the
cause of the problem. The growing body of literature on FII reflects the lack of clarity
amongst professionals as to what constitutes FII, the difficulties involved in diagnosis,
and the lack of research into psychotherapeutic intervention with perpetrators. This lack
of clarity further complicates the identification, management and treatment of children
suffering from FII and may result in many cases going undetected, with potentially lifethreatening
consequences for children. It has been suggested that there is a national
under-reporting of fabricated or induced illness. In practice these cases are encountered
more frequently due to the chronic nature of the presentations, the large number of
professionals who may be involved and the broad spectrum including milder cases that
may not all require a formal child protection response. Diagnosis of fabricated disease
can be especially difficult, because the reported signs and symptoms cannot be confirmed
(when they are being exaggerated or imagined) or may be inconsistent (when they are
induced or fabricated). This paper highlights and discusses the controversies and
complexities of this condition, the risks to the child and how it affects children; the
paucity of systematic research regarding what motivates mothers to harm their children
by means of illness falsification; how the condition should be managed and treated for
both mother and child; and implications for policy and practice.
Resumo:
Tackling food-related health conditions is becoming one of the most pressing issues in the policy agendas of western liberal democratic governments. In this article, I intend to illustrate what the liberal philosopher John Stuart Mill would have said about legislation on unhealthy food and I focus especially on the arguments advanced by Mill in his classic essay On Liberty ([1859] 2006). Mill is normally considered as the archetype of liberal anti-paternalism and his ideas are often invoked by those who oppose state paternalism, including those who reject legislation that restricts the consumption of unhealthy food. Furthermore, his views have been applied to related policy areas such as alcohol minimum pricing (Saunders 2013) and genetically modified food (Holtug 2001). My analysis proceeds as follows. First, I show that Mill’s account warrants some restrictions on food advertising and justifies various forms of food labelling. Second, I assess whether and to what extent Mill’s ‘harm principle’ justifies social and legal non-paternalistic penalties against unhealthy eaters who are guilty of other-regarding harm. Finally, I show that Mill’s account warrants taxing unhealthy foods, thus restricting the freedom of both responsible and irresponsible eaters and de facto justifying what I call ‘secondary paternalism’.
Resumo:
This article unpacks the variant meanings, perceptions, and experiences of violent enactment and stigmatic shaming among loyalists with regard to rejection, harm, and masking. What we locate is a landscape of variable emotions, experiences, neutralization techniques, dependences, and embedded forms of fatalism as well as resilience. Attending to those alternate positions and well-beings is important in considering the capacity of re-integration and the presently uneven nature of it. In adopting an account-driven format we present and analyze how involvement in violent conflict can, on the one hand, provoke persistence and senses of transitional thinking and on the other engender rejection and related fatalistic attitudes.
Resumo:
Food labelling has been overlooked in the emerging body of literature concerning the normative dimensions of food and drink policies. In this paper, I argue that arguments normally advanced in bioethics and medical ethics regarding the “right to know” and the “right not to know” can provide useful normative guidelines for critically assessing existing and proposed food labelling regimes. More specifically, I claim that food labelling ought to respect the legitimate interests and the autonomy of both consumers who seek knowledge about their food in order to make informed dietary choices and consumers who prefer to remain ignorant about the contents and effects of their food in order to avoid the emotional and psychological harm, or more simply the loss of enjoyment, which may result from receiving that information.
Resumo:
In recent years concerns over litigation and the trend towards close monitoring of academic activity has seen the effective hijacking of research ethics by university managers and bureaucrats. This can effectively curtail cutting edge research as perceived ‘safe’ research strategies are encouraged. However, ethics is about more than research governance. Ultimately, it seeks to avoid harm and to increase benefits to society. Rural development debate is fairly quiet on the question of ethics, leaving guidance to professional bodies. This study draws on empirical research that examined the lives of migrant communities in Northern Ireland. This context of increasingly diverse rural development actors provides a backdrop for the way in which the researcher navigates through ethical issues as they unfold in the field. The analysis seeks to relocate ethics from being an annoying bureaucratic requirement to one where it is inherent to rigorous and professional research and practice. It reveals how attention to professional ethics can contribute to effective, situated and reflexive practice, thus transforming ethics to become an asset to professional researchers.
Resumo:
During the past 30 years, the focus on the extent and nature of child abuse and neglect has been coupled with an increasing interest in the impact on children’s development, health and mental wellbeing. Child maltreatment is both a human rights violation and a complex public health issue, likely caused by a myriad of factors that involve the individual, the family, and the community. Child abuse includes any type of maltreatment or harm inflicted upon children and young people in interactions between adults (or older adolescents). Such maltreatment is likely to cause enduring harm to the child.
The different forms of abuse and neglect often occur together in one family and can affect one or more children. These include, in deceasing level of frequency: neglect; physical abuse and non-accidental injury; emotional abuse; and sexual abuse (Cawson et al, 2000; 2002). Recently, bullying and domestic violence have been included as forms of abuse of children.
There is a sizeable body of literature on the relationship between types of child maltreatment and a variety of negative health and mental health consequences. These include biological, psychological, and social deficits (for reviews, see Crittenden, 1998; Kendall-Tackett, 2001; 2003). Aside from the serious physical and health consequences of child maltreatment, several emotional and behavioural consequences for children have been noted in the literature.
Resumo:
Background: This is an update of a review last published in Issue 5, 2010, of The Cochrane Library. Reducing weaning time is desirable in minimizing potential complications from mechanical ventilation. Standardized weaning protocols are purported to reduce time spent on mechanical ventilation. However, evidence supporting their use in clinical practice is inconsistent. Objectives: The first objective of this review was to compare the total duration of mechanical ventilation of critically ill adults who were weaned using protocols versus usual (non-protocolized) practice.The second objective was to ascertain differences between protocolized and non-protocolized weaning in outcomes measuring weaning duration, harm (adverse events) and resource use (intensive care unit (ICU) and hospital length of stay, cost).The third objective was to explore, using subgroup analyses, variations in outcomes by type of ICU, type of protocol and approach to delivering the protocol (professional-led or computer-driven). Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2014), MEDLINE (1950 to January 2014), EMBASE (1988 to January 2014), CINAHL (1937 to January 2014), LILACS (1982 to January 2014), ISI Web of Science and ISI Conference Proceedings (1970 to February 2014), and reference lists of articles. We did not apply language restrictions. The original search was performed in January 2010 and updated in January 2014.Selection criteriaWe included randomized controlled trials (RCTs) and quasi-RCTs of protocolized weaning versus non-protocolized weaning from mechanical ventilation in critically ill adults. Data collection and analysis: Two authors independently assessed trial quality and extracted data. We performed a priori subgroup and sensitivity analyses. We contacted study authors for additional information. Main results: We included 17 trials (with 2434 patients) in this updated review. The original review included 11 trials. The total geometric mean duration of mechanical ventilation in the protocolized weaning group was on average reduced by 26% compared with the usual care group (N = 14 trials, 95% confidence interval (CI) 13% to 37%, P = 0.0002). Reductions were most likely to occur in medical, surgical and mixed ICUs, but not in neurosurgical ICUs. Weaning duration was reduced by 70% (N = 8 trials, 95% CI 27% to 88%, P = 0.009); and ICU length of stay by 11% (N = 9 trials, 95% CI 3% to 19%, P = 0.01). There was significant heterogeneity among studies for total duration of mechanical ventilation (I2 = 67%, P < 0.0001) and weaning duration (I2 = 97%, P < 0.00001), which could not be explained by subgroup analyses based on type of unit or type of approach. Authors' conclusions: There is evidence of reduced duration of mechanical ventilation, weaning duration and ICU length of stay with use of standardized weaning protocols. Reductions are most likely to occur in medical, surgical and mixed ICUs, but not in neurosurgical ICUs. However, significant heterogeneity among studies indicates caution in generalizing results. Some study authors suggest that organizational context may influence outcomes, however these factors were not considered in all included studies and could not be evaluated. Future trials should consider an evaluation of the process of intervention delivery to distinguish between intervention and implementation effects. There is an important need for further development and research in the neurosurgical population.
Resumo:
Due to increasing water scarcity, accelerating industrialization and urbanization, efficiency of irrigation water use in Northern China needs urgent improvement. Based on a sample of 347 wheat growers in the Guanzhong Plain, this paper simultaneously estimates a production function, and its corresponding first-order conditions for cost minimization, to analyze efficiency of irrigation water use. The main findings are that average technical, allocative, and overall economic efficiency are 0.35, 0.86 and 0.80, respectively. In a second stage analysis, we find that farmers’ perception of water scarcity, water price and irrigation infrastructure increase irrigation water allocative efficiency, while land fragmentation decreases it. We also show that farmers’ income loss due to higher water prices can be offset by increasing irrigation water use efficiency.
Resumo:
Sparse representation based visual tracking approaches have attracted increasing interests in the community in recent years. The main idea is to linearly represent each target candidate using a set of target and trivial templates while imposing a sparsity constraint onto the representation coefficients. After we obtain the coefficients using L1-norm minimization methods, the candidate with the lowest error, when it is reconstructed using only the target templates and the associated coefficients, is considered as the tracking result. In spite of promising system performance widely reported, it is unclear if the performance of these trackers can be maximised. In addition, computational complexity caused by the dimensionality of the feature space limits these algorithms in real-time applications. In this paper, we propose a real-time visual tracking method based on structurally random projection and weighted least squares techniques. In particular, to enhance the discriminative capability of the tracker, we introduce background templates to the linear representation framework. To handle appearance variations over time, we relax the sparsity constraint using a weighed least squares (WLS) method to obtain the representation coefficients. To further reduce the computational complexity, structurally random projection is used to reduce the dimensionality of the feature space while preserving the pairwise distances between the data points in the feature space. Experimental results show that the proposed approach outperforms several state-of-the-art tracking methods.
Resumo:
Using genome-wide data from 253,288 individuals, we identified 697 variants at genome-wide significance that together explained one-fifth of the heritability for adult height. By testing different numbers of variants in independent studies, we show that the most strongly associated 1/42,000, 1/43,700 and 1/49,500 SNPs explained 1/421%, 1/424% and 1/429% of phenotypic variance. Furthermore, all common variants together captured 60% of heritability. The 697 variants clustered in 423 loci were enriched for genes, pathways and tissue types known to be involved in growth and together implicated genes and pathways not highlighted in earlier efforts, such as signaling by fibroblast growth factors, WNT/I 2-catenin and chondroitin sulfate-related genes. We identified several genes and pathways not previously connected with human skeletal growth, including mTOR, osteoglycin and binding of hyaluronic acid. Our results indicate a genetic architecture for human height that is characterized by a very large but finite number (thousands) of causal variants.