39 resultados para Interventions in the family system


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Alcohol misuse has been linked to negative organizational outcomes, including reduced productivity and increased absenteeism. Additionally, media reports have focused on alcohol misuse within sporting organizations. Given the paucity of research evaluating alcohol misuse interventions in professional sporting organizations, two systematic literature searches were conducted. Review one examined alcohol interventions in the workplace, and Review two included sport as a search term. Resultant papers demonstrated four categories of workplace alcohol interventions; brief, web based, psychosocial, and random drug and alcohol testing. Brief interventions were prevalent, yielding largely non-significant results. Review two studies evaluated a community sporting intervention, which adopted an ecological, multi-level approach, yielding significant improvements in alcohol consumption, drink-driving, and club profitability. Brief interventions in workplaces were ineffective, and no brief interventions were found in elite sporting organizations. However, community sporting interventions showed promising results. Ongoing evaluation of alcohol interventions in professional sporting organizations are recommended.

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Today’s power system network is more complex with enhanced responsibility to maintain reliable, stable and quality supply of power at transmission and distribution level. Maintaining grid balance is a bigger issue, in case of any unexpected generation shortage or grid disturbance or any participation of an intermittent nature of renewable energy sources like wind and solar power in the energy mix. In order to compensate such imbalance and improve reliability, and stability of power system, an energy storage system (ESS) can be considered as a vital solution. Also ESS can be used to mitigate associated issues of renewable energy sources while integration into the power system network. Thus ESS supports to get a reduction in greenhouse gas (GHG) emissions by means of integrating more renewable energy sources to the grid effectively. There are various types of Energy Storage (ES) technologies which are being used in power systems network for large scale (MW) to small scale (KW) level. Based on the type and characteristics, each storage technology is suitable for a particular role of applications. This paper presents an extensive review study on various types of ES technologies in characteristics and applications point of view. It also demonstrates various applications of ESS in detail. Finally, with the aid of ES-selectTM tool software, a feasibility analysis has been carried out to identify a suitable ES technology for appropriate applications at different grid locations and also helps to develop a smart hybrid storage system for grid applications in future.

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Despite queer readings and interpretations by scholars and fans alike, the official Star Trek universe is devoid of any concrete or obvious representation of LGBTIQ identities. While this appears to be a case of symbolic annihilation, two recent episodes of the Internet series Star Trek New Voyages: Phase II (2004–, webseries), titled ‘Blood and Fire: Part One’ and ‘Blood and Fire: Part Two’, finally go where official Star Trek texts could, or would, not. Taking up the dual perspective of both fan and scholar, in this article I argue that these episodes use the conspicuous absence of representations of sexual diversity in the Star Trek franchise proper as the impetus for a creative intervention, one that embodies the capacity of science fiction texts to explore human sexuality beyond the confines of heteronormative identities.

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COPPER IS INDISPENSABLE for development and function of the central nervous system (CNS). This is dramatically illustrated by the severe neuropathological deficits in Menkes disease, an X-linked copper deficiency disorder resulting from mutation of the gene that encodes an essential copper transporting P1B-type ATPase, ATP7A. Since its discovery over two decades ago, the role of ATP7A in copper transport and homeostasis has been inextricably linked to satisfying systemic and CNS requirements for copper. In a recent issue of American Journal of Physiology-Cell Physiology, Hodgkinson et al. (8) describe an important body of work, which for the first time distinguishes the CNS requirement for ATP7A from the CNS requirement for copper.

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Food allergy has a dramatic impact on a child's (and their family's) quality of life and places a major financial burden on the community. It has been hypothesized that the increase in food allergy may relate to the concordant rise in prevalence of vitamin D insufficiency. More recently a second hypothesis has implicated vitamin A sufficiency in the development of immune tolerance. Together, these hypotheses have prompted investigation into the circulating levels of vitamins A and D in relation to food allergy prevalence. This review aims to examine the relationship between vitamins A and D and food allergy. The first part of this review presents the available epidemiological data which proposes a dramatic increase of food allergy and related anaphylaxis during the last two decades. There is some indirect evidence that variation in food allergy prevalence within countries might be linked with ambient ultra violet radiation exposure and thus potentially with vitamin D levels. Only a few studies to date have directly examined the relationship between measured serum vitamin D levels and either food sensitization or allergy. The significance of vitamin A in food allergy prevalence is only provided through a hypothetical association due to its role in the immune system. The second part of this review discusses the relevant aspects of the analytical methods to assess vitamin A and D levels in children. The primary methods utilized relate to measuring the main circulating forms of vitamins A and D in blood i.e. retinol and 25-hydroxy-vitamin-D3 respectively. Chromatographic separation coupled with mass spectrometric detection is considered the gold standard method for both vitamins. These analytical methods should be fully validated for the use in pediatric populations to ensure they are fit for their clinical purpose.

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Dysregulations in the brain serotonergic system and exposure to environmental stressors have been implicated in the development of major depressive disorder. Here, we investigate the interactions between the stress and serotonergic systems by characterizing the behavioral and biochemical effects of chronic stress applied during early-life or adulthood in wild type (WT) mice and mice with deficient tryptophan hydroxylase 2 (TPH2) function. We showed that chronic mild stress applied in adulthood did not affect the behaviors and serotonin levels of WT and TPH2 knock-in (KI) mice. Whereas, maternal separation (MS) stress increased anxiety-and depressive-like behaviors of WT mice, with no detectable behavioral changes in TPH2, KI mice. Biochemically, we found that MS WT mice had reduced brain serotonin levels, which was attributed to increased expression of monoamine oxidase A (MAO A). The increased MAO A expression was detected in MS WT mice at 4 weeks old and adulthood. No change in TPH2 expression was detected. To determine whether a pharmacological stressor, dexamethasone (Dex), will result in similar biochemical results obtained from MS, we used an in vitro system, SH-SY5Y cells, and found that Dex treatment resulted in increased MAO A expression levels. We then treated WT mice with Dex for 5 days, either during postnatal days 7-11 or adulthood. Both groups of Dex treated WT mice had reduced basal corticosterone and glucocorticoid receptors expression levels. However, only Dex treatment during PND7-11 resulted in reduced serotonin levels and increased MAO A expression. Just as with MS WT mice, TPH2 expression in PND7-11, Dex-treated WT mice was unaffected. Taken together, our findings suggest that both environmental and pharmacological stressors affect the expression of MAO A, and not TPH2, when applied during the critical postnatal period. This leads to long-lasting perturbations in the serotonergic system, and results in anxiety-and depressive-like behaviors.

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Pressure ulcers are serious problems within hospital and aged care settings and are associated with adverse health outcomes and high treatment costs. Because of a high incidence of pressure ulcers in the health system, attention is now being directed to not just preventing, but also more effectively treating them. Nutrition plays a fundamental part in wound healing, with malnutrition, dehydration and recent weight loss identified as independent risk factors for the development of pressure ulcers. While the optimal nutrient intake to promote wound healing is unknown, increased needs for energy, protein, zinc and vitamins A, C and E have been documented. There is reasonable evidence to show that nutritional support, mostly by high-protein oral nutritional supplements, is effective in significantly reducing the incidence of pressure ulcers in at-risk patients by 25%. Intervention studies using high-protein or specialised disease-specific nutritional supplements support a trend to increased healing of established pressure ulcers. Such specialised supplements are typically based on defined amounts of arginine, vitamin C and zinc. Mechanisms by which nutritional support can aid in pressure ulcer prevention and healing are likely related to addressing macro- and/or micro-nutrient deficiencies arising from either poor oral intake or increased nutrient requirements related to the wound healing process. With much more research still to be done in this area, nutrition support appears an efficacious and costeffective adjunct to current medical and nursing approaches in the prevention and treatment of pressure ulcers.

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The Australian Government's current health reform agenda provides a timely opportunity to highlight the contribution of health psychology interventions in the prevention and management of chronic diseases associated with lifestyle risk factors. The World Health Organisation (2009) has identified the main risk factors responsible for deaths internationally as high blood pressure (responsible for 13% of deaths), tobacco use (9%), high blood sugar (6%), physical inactivity (6%), overweight and obesity (5%), high cholesterol (5%), unsafe sex (4%) and alcohol use (4%). A number of these factors also increase the risk of major chronic diseases - cardiovascular disease, diabetes and cancers. There is now a substantial evidence base for the effectiveness of health improvement interventions based on psychological theory, research and practice and hence they deserve a high level of recognition within systems for funding health. This article presents a summary of a systematic review of the evidence for the effectiveness of health psychology interventions in the prevention and treatment of chronic diseases associated with lifestyle risk factors.

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Introduction. Nonpharmacologic interventions are themselves complex and are often combined with drugs and other interventions in the treatment of rheumatic diseases. Therefore, overall strategies for treatment are complex interventions. These should be evaluated regarding their processes and outcomes.
Methods. The CARE network, an international organization of health professionals (physicians and nonphysicians) and patients conducted a survey in 2008 to identify core outcomes in the ICF perspective, completed with a second survey (2009–2010) with patients in routine practice. These surveys have provided new information about domains to investigate as a basis for evaluating complex interventions.
Results. Outcome Measures in Rheumatology Clinical Trials (OMERACT) participants in this Special Interest Group agreed that current outcomes used in pharmacological research are not sufficient if the nonpharmacologic independent or combined contributions are to be assessed; other domains need to be addressed. This is an area of interest for further development.
Conclusion. Recommendations are proposed to develop research in the area of outcome for evaluation of complex interventions in rheumatic diseases.

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Background
Multi attribute utility (MAU) instruments are used to include the health related quality of life (HRQoL) in economic evaluations of health programs. Comparative studies suggest different MAU instruments measure related but different constructs. The objective of this paper is to describe the methods employed to achieve content validity in the descriptive system of the Assessment of Quality of Life (AQoL)-6D, MAU instrument.

Methods
The AQoL program introduced the use of psychometric methods in the construction of health related MAU instruments. To develop the AQoL-6D we selected 112 items from previous research, focus groups and expert judgment and administered them to 316 members of the public and 302 hospital patients. The search for content validity across a broad spectrum of health states required both formative and reflective modelling. We employed Exploratory Factor Analysis and Structural Equation Modelling (SEM) to meet these dual requirements.

Results and Discussion
The resulting instrument employs 20 items in a multi-tier descriptive system. Latent dimension variables achieve sensitive descriptions of 6 dimensions which, in turn, combine to form a single latent QoL variable. Diagnostic statistics from the SEM analysis are exceptionally good and confirm the hypothesised structure of the model.

Conclusions
The AQoL-6D descriptive system has good psychometric properties. They imply that the instrument has achieved construct validity and provides a sensitive description of HRQoL. This means that it may be used with confidence for measuring health related quality of life and that it is a suitable basis for modelling utilities for inclusion in the economic evaluation of health programs.

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Background
There is broad consensus that diets high in salt are bad for health and that reducing salt intake is a cost-effective strategy for preventing chronic diseases. The World Health Organization has been supporting the development of salt reduction strategies in the Pacific Islands where salt intakes are thought to be high. However, there are no accurate measures of salt intake in these countries. The aims of this project are to establish baseline levels of salt intake in two Pacific Island countries, implement multi-pronged, cross-sectoral salt reduction programs in both, and determine the effects and cost-effectiveness of the intervention strategies.

Methods/Design
Intervention effectiveness will be assessed from cross-sectional surveys before and after population-based salt reduction interventions in Fiji and Samoa. Baseline surveys began in July 2012 and follow-up surveys will be completed by July 2015 after a 2-year intervention period.

A three-stage stratified cluster random sampling strategy will be used for the population surveys, building on existing government surveys in each country. Data on salt intake, salt levels in foods and sources of dietary salt measured at baseline will be combined with an in-depth qualitative analysis of stakeholder views to develop and implement targeted interventions to reduce salt intake.

Discussion
Salt reduction is a global priority and all Member States of the World Health Organization have agreed on a target to reduce salt intake by 30% by 2025, as part of the global action plan to reduce the burden of non-communicable diseases. The study described by this protocol will be the first to provide a robust assessment of salt intake and the impact of salt reduction interventions in the Pacific Islands. As such, it will inform the development of strategies for other Pacific Island countries and comparable low and middle-income settings around the world.

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Abstract: The increasing significance of ethics in the accounting profession is evidenced by the seminal events that witnessed the collapse of major corporations (eg. Enron and WorldCom); regulatory interventions (eg. Sarbanes-Oxley Act in the USA and the CLERP 9 Act in Australia); and calls for increased ethics interventions in the accounting curriculum. This project has two objectives: to investigate the nature of ethics education in the Australian accounting curriculum and how it has changed from 2000 to 2012; and to analyse the barriers to enhancing ethics education by soliciting the opinions of Heads of Department/Schools of Australian universities. Compared with early empirical evidence, universities responded to the call for ethics education with increased levels of ethics intervention, but had failed to enhance the extent of ethics education coverage in the intervening period in which the data were collected. He lack of qualified staff and research opportunities represent major obstacles to the enhancement of ethics education.

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This study presents an analysis of the application of underwater video data collected for training and validating benthic habitat distribution models. Specifically, we quantify the two major sources of error pertaining to collection of this type of reference data. A theoretical spatial error budget is developed for a positioning system used to co-register video frames to their corresponding locations at the seafloor. Second, we compare interpretation variability among trained operators assessing the same video frames between times over three hierarchical levels of a benthic classification scheme. Propagated error in the positioning system described was found to be highly correlated with depth of operation and varies from 1.5m near the surface to 5.7m in 100m of water. In order of decreasing classification hierarchy, mean overall observer agreement was found to be 98% (range 6%), 82% (range 12%) and 75% (range 17%) for the 2, 4, and 6 class levels of the scheme, respectively. Patterns in between-observer variation are related to the level of detail imposed by each hierarchical level of the classification scheme, the feature of interest, and to the amount of observer experience. © 2014 Copyright © Taylor & Francis Group, LLC.