20 resultados para Autism. Early intervention focused on the family. HANEN MTW

em University of Queensland eSpace - Australia


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Schistosomiasis japonica is a zoonosis of major public health importance in southern China. We undertook a drug intervention to test the hypothesis that buffalo are major reservoirs for human infection in the marshlands/lake areas, where one million people are infected. We compared human and buffalo infection rates and intensity in an intervention village (Jishan), where humans and buffalo were treated with praziquantel, and a control village (Hexi), where only humans were treated, in the Poyang Lake region. Over the four-year study, human incidence in Jishan decreased but increased in Hexi. Adjustment of incidence by age, sex, water exposure, year, and village further confirmed the decreased human infection in Jishan. Chemotherapy for buffaloes resulted in a decrease in buffalo infection rates in Jishan, which coincided with the reduction in human infection rates there in the last two years of the study. Mathematical modeling predicted that buffalo are responsible for 75% of human transmission in Jishan. Copyright © 2006 by The American Society of Tropical Medicine and Hygiene.

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In this article, we challenge the hegemony of western science fiction, arguing that western science fiction is particular even as it claims universality. Its view remains based on ideas of the future as forward time. In contrast, in non-western science fiction the future is seen outside linear terms: as cyclical or spiral, or in terms of ancestors. In addition, western science fiction has focused on the good society as created by technological progress, while non-western science fiction and futures thinking has focused on the fantastic, on the spiritual, on the realization of eupsychia-the perfect self. However, most theorists assert that the non-west has no science fiction, ignoring Asian and Chinese science fiction history, and western science fiction continues to 'other' the non-west as well as those on the margins of the west (African-American woman, for example). Nonetheless, while most western science fiction remains trapped in binary opposites-alien/non-alien; masculine/feminine; insider/outsider-writers from the west's margins are creating texts that contradict tradition and modernity, seeking new ways to transcend difference. Given that the imagination of the future creates the reality of tomorrow, creating new science fictions is not just an issue of textual critique but of opening up possibilities for all our futures.

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The Integration-Responsiveness framework of Prahalad and Doz (1987) has been used extensively in the international business literature to typify the diverse and often-conflicting environmental pressures confronting firms as they expand worldwide. Although the IR framework has been successfully applied for over a decade, many theoretical and empirical studies have focused on the consequences of these pressures rather than the pressures themselves. Prahalad and Doz identified the economic, technological, political, customer and competitive factors that create the global integration and local responsiveness pressures on the diverse businesses and functions in MNEs. This article explains the methodology, including the procedure for data collection and analysis. The researchers conclude with a discussion of their findings and directions for future research, speculating as to the appropriate definition of the domain of IR pressures and the criteria they might use to validate measures of these.

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The authors have developed an education program for GPs to facilitate informed choice about PSA testing.

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Objectives: To find out the effect of early neurological consultation using a real time video link on the care of patients with neurological symptoms admitted to hospitals without neurologists on site. Methods: A cohort study was performed in two small rural hospitals: Tyrone County Hospital (TCH), Omagh, and Erne Hospital, Enniskillen. All patients over 12 years of age who had been admitted because of neurological symptoms, over a 24 week period, to either hospital were studied. Patients admitted to TCH, in addition to receiving usual care, were offered a neurological consultation with a neurologist 120 km away at the Neurology Department of the Royal Victoria Hospital, Belfast, using a real time video link. The main outcome measure was length of hospital stay; change of diagnosis, mortality at 3 months, inpatient investigation, and transfer rate and use of healthcare resources within 3 months of admission were also studied. Results: Hospital stay was significantly shorter for those admitted to TCH (hazard ratio 1.13; approximate 95% Cl 1.003 to 1.282; p = 0.045). No patients diagnosed by the neurologist using the video link subsequently had their diagnosis changed at follow up. There was no difference in overall mortality between the groups. There were no differences in the use of inpatient hospital resources and medical services in the follow up period between TCH and Erne patients. Conclusions: Early neurological assessment reduces hospital stay for patients with neurological conditions outside of neurological centres. This can be achieved safely at a distance using a real time video link.

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Objectives To find how early experience in clinical and community settings (early experience) affects medical education, and identify strengths and limitations of the available evidence. Design A systematic review rating, by consensus, the strength and importance of outcomes reported in the decade 1992-2001. Data sources Bibliographical databases and journals were searched for publications on the topic, reviewed under the auspices of the recently formed Best Evidence Medical Education (BEME) collaboration. Selection of studies All empirical studies (verifiable, observational data) were included, whatever their design, method, or language of publication. Results Early experience was most commonly provided in community settings, aiming to recruit primary care practitioners for underserved populations. It increased the popularity of primary care residencies, albeit among self selected students. It fostered self awareness and empathic attitudes towards ill people, boosted students' confidence, motivated them, gave them satisfaction, and helped them develop a professional identity. By helping develop interpersonal skills, it made entering clerkships a less stressful experience. Early experience helped students learn about professional roles and responsibilities, healthcare systems, and health needs of a population. It made biomedical, behavioural, and social sciences more relevant and easier to learn. It motivated and rewarded teachers and patients and enriched curriculums. In some countries,junior students provided preventive health care directly to underserved populations. Conclusion Early experience helps medical students learn, helps them develop appropriate attitudes towards their studies and future practice, and orientates medical curriculums towards society's needs. Experimental evidence of its benefit is unlikely to be forthcoming and yet more medical schools are likely to provide it. Effort could usefully be concentrated on evaluating the methods and outcomes of early experience provided within non-experimental research designs, and using that evaluation to improve the quality of curriculums.

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The effects of the herbicide diuron on the early life history stages of broadcast spawning and brooding corals were examined in laboratory experiments. Fertilisation of Acropora millepora and Montipora aequituberculata oocytes were not inhibited at diuron concentrations of up to 1000 mu gl(-1). Metamorphosis of symbiont-free A. millepora larvae was only significantly inhibited at 300 mu gl(-1) diuron. Pocillopora damicornis larvae, which contain symbiotic dinoflagellates, were able to undergo metamorphosis after 24h exposure to diuron at 1000 mu gl(-1). Two-week old P. damicornis recruits on the other hand were as susceptible to diuron as adult colonies, with expulsion of symbiotic dinoflagellates (bleaching) evident at 10 mu gl(-1) diuron after 96 h exposure. Reversible metamorphosis was observed at high diuron concentrations, with fully bleached polyps escaping from their skeletons. Pulse amplitude modulation (PAM) chlorophyll fluorescence techniques demonstrated a reduction in photosynthetic efficiency (Delta F/F'(m)) in illuminated P. dami- cornis recruits after a 2h exposure to 1 mu gl(-1) diuron. The dark-adapted quantum yields (F-v/F-m also declined, indicating chronic photoinhibition and damage to photosystem H. Crown Copyright (c) 2004 Published by Elsevier Ltd. All rights reserved.

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Reforestation in tropical areas is usually attempted by planting seedlings but, direct seeding (the artificial addition or sowing of seed) may be an alternative way of accelerating forest recovery and successional processes. This study investigated the effects of various sowing treatments (designed to create different microsite conditions for seed germination) and seed sizes on the early establishment and growth of directly sown rainforest tree species in a variety of experimental plots at three sites in the wet tropical region of north-cast Queensland, Australia. The different sowing treatments were found to have significant effects on seedling establishment. Broadcast sowing treatments were ineffective and resulted in very poor seedling establishment and high seed wastage. Higher establishment rates occurred when seeds were buried. Seed size was found to be an important factor affecting establishment in relation to micro-site condition. In general, larger seeded species had higher establishment rates at all three sites than species of small and intermediate seed size, but only in sowing treatments where seeds were buried. Overall these results suggest that direct sowing of seed can be used as a too] to accelerate recolonisation of certain rainforest tree species on degraded tropical lands, but initial success will be dependent on the choice of sowing method and its suitability for the seed types selected. The results also indicate that the recruitment of naturally dispersed tree species at degraded sites is likely to be severely limited by the availability of suitable microsites for seed germination. Consequently the natural recovery of degraded sites via seed rain can be expected to be slow and unpredictable, particularly in areas where soil compaction has occurred. (c) 2006 Elsevier B.V. All rights reserved.

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Regular and systematic monitoring of drug markets provides the basis for evidence-based policy. In Australia, trends in ecstasy and related drug (ERD) markets have been monitored in selected jurisdictions since 2000 and nationally since 2003, by the Party Drugs Initiative (PDI). The PDI maximises the validity of conclusions by triangulating information from (a) interviews with regular ecstasy users (REU), (b) interviews with key experts and (c) indicator data. There is currently no other system in Australia for monitoring these markets systematically; however, the value of the PDI has been constrained by the quality of available data. Difficulties in recruiting and interviewing appropriate consumers (REU) and key experts have been experienced, but largely overcome. Limitations of available indicator data from both health and law enforcement continue to present challenges and there remains considerable scope for enhancing existing routine data collection systems, to facilitate monitoring of ERD markets. With an expanding market for ecstasy and related drugs in Australia, and in the context of indicator data that continue to be limited in scope and detail, there is a strong argument for the continued collection of annual, comparable data from a sentinel group of REU, such as those recruited for the PDI.

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Across the last four decades, the structure of the Australian labour market has changed profoundly as non-standard forms of employment have become more prevalent. According to many researchers, the growth of non-standard work has been driven by employee preferences, particularly among married women, for greater flexibility to balance paid work with domestic responsibilities and other non-work related pursuits. In contrast, other researchers argue that the increasing prevalence of non-standard employment reflects employer demands for greater staffing flexibility. From this perspective, non-standard forms of employment are considered to have a negative effect on work-family balance. This paper explores whether non-standard employment is associated with improved or poorer work-to-family conflict and tests whether experiences vary by gender. It concentrates on three common forms of non-standard employment: part-time employment, casual and fixed-term work contracts and flexible scheduling practices (such as evening work, weekend work and irregular rostering). Analysis is based on 2299 employed parents from the first wave of the Household, Income and Labour Dynamics on Australia (HILDA) project. Results show that few scheduling measures are significant determinants of work-family balance. However, part-time employment is associated with reduced work-to-family strain for both men and women, even after controlling for various other employment and household related characteristics. Casual employment, in contrast, incurs the cost of poorer work-family balance for men. Surprisingly, HILDA data show that overall men experience greater work-to-family strain than women.

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This study was undertaken to develop and evaluate the efficacy of an early intervention for children who had been injured in an accident. The aim of the intervention was to prevent the development of longterm psychological consequences. Brochures were developed for children, adolescents, and their parents. These brochures detailed common responses to trauma (and normalized such responses), and suggestions for minimizing any post-trauma distress. Participants were children aged 7-15 admitted to hospital for traumatic injury. The intervention was delivered to one of two hospitals, within 72 hours of the trauma. 103 children and parents participated in the study. The parents and children completed structured interviews and questionnaires 2 weeks, 4-6 weeks and 6 months post-trauma. Outcome analyses also indicated that the intervention reduced parental distress at 4-6 weeks post-trauma. The intervention did not impact significantly on child adjustment over this time period. Results of the 6 month follow-up suggested that the intervention resulted in an amelioration of child anxiety from one to six months post-trauma, whereas the controls exhibited an increase in anxiety over this time period. Overall, it was concluded that the early intervention is a simple, practical, and cost-effective method of reducing child and parent distress post-trauma.