875 resultados para children in need of special support


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"January, 1909."

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AIMS Hyperinsulinism of infancy (HI) is characterized by unregulated insulin secretion in the presence of hypoglycaemia, often resulting in brain damage. Pancreatic resection for control of hypoglycaemia is frequently resisted because of the risk of diabetes mellitus (DM). We investigated retrospectively 62 children with HI from nine Australian treatment centres born between 1972 and 1998, comparing endocrine and neurological outcome in 28 patients receiving medical therapy alone with 34 who required pancreatic resection to control their hypoglycaemia. METHODS History, treatment and clinical course were ascertained from file audit and interview. Risk of DM (hazard ratio) attributable to age at surgery (< vs. greater than or equal to 100 days at last pancreatectomy) and extent of resection (< vs. greater than or equal to 95%) were calculated using Cox proportional hazards regression and categorical variables compared by the chi(2) -test. Neurological outcome (normal, mild deficit or severe deficit) was derived from the most authoritative source. RESULTS Surgically treated patients had a greater birthweight, earlier presentation and higher plasma insulin levels. Of 18 infants < 100 days and 16 greater than or equal to 100 days of age at surgery, four (all greater than or equal to 100 days) became diabetic as an immediate consequence of surgery and five (two < 100 days and three greater than or equal to 100 days) became diabetic 7-18 years later. Surgery greater than or equal to 100 days and pancreatectomy greater than or equal to 95% were associated with development of diabetes (HR = 12.61, CI 1.53-104.07 and HR = 7.03, CI 1.43-34.58, respectively). Neurodevelopmental outcome was no different between the surgical and medical groups with 44% overall with neurological deficits. Patients euglycaemic within 35 days of the first symptom of hypoglycaemia (Group A) had a better neurodevelopmental outcome than those still hypoglycaemic > 35 days from first presentation (Group B) (P = 0.007). Prolonged hypoglycaemia in Group B was due either to delayed diagnosis or to need for repeat surgery because of continued hypoglycaemia. Within Group A, medically treated patients (who presented later with apparently milder disease) had a higher incidence of neurodevelopmental deficit (n = 15, four mild, three severe deficit) compared with surgically treated patients (n = 18, two mild, none severe deficit) (P < 0.025). CONCLUSIONS Poor neurodevelopmental outcome remains a major problem in hyperinsulinism of infancy. Risk of diabetes mellitus with pancreatectomy varies according to age at surgery and extent of resection. Patients presenting early with severe disease have a better neurodevelopmental outcome and lower risk of diabetes if they are treated with early extensive surgery.

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The present study examined the applicability of the double ABCX model of family adjustment in explaining maternal adjustment to caring for a child diagnosed with Asperger syndrome. Forty-seven mothers completed questionnaires at a university clinic while their children were participating in an anxiety intervention. The children were aged between 10 and 12 years. Results of correlations showed that each of the model components was related to one or more domains of maternal adjustment in the direction predicted, with the exception of problem-focused coping. Hierarchical regression analyses demonstrated that, after controlling for the effects of relevant demographics, stressor severity, pile-up of demands and coping were related to adjustment. Findings indicate the utility of the double ABCX model in guiding research into parental adjustment when caring for a child with Asperger syndrome. Limitations of the study and clinical implications are discussed.

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Background. Food allergy is related to poorer quality of life (QoL) and mental health of caregivers. Many parents diagnose food allergy in their child without seeking medical care and there is limited research on this group. This study investigated parental QoL and mental health in parents of children with parent-diagnosed food allergy (PA), medically diagnosed food allergy (MA), and a control group with no allergy (NA). Methods. One hundred and fifty parents from a general population completed validated measures of QoL, anxiety, depression, and stress. Results. Parents of children with food allergy (PA or MA) reported higher stress, anxiety, and depression than the control group (all ). Parents of children with MA reported poorer food allergy related QoL compared to parents of children with PA (); parents of children with PA reported poorer general QoL compared to parents of children with MA (). Conclusion. Parents of children with food allergy have significantly poorer mental health compared to healthy controls, irrespective of whether food allergy is medically diagnosed or not. It is important to encourage parents to have their child medically tested for food allergy and to recognise and refer for psychological support where needed.

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This edition of Polymer Degradation and Stability comprises selected papers presented at the 27th Polymer Degradation Discussion Group (PDDG) Conference, affiliated to the Macromolecular Group of the Royal Society of Chemistry, held at Aston University, Birmingham (UK), September 2007, in honour of Professor Norman Billingham for lifelong career in Polymer Science. Norman Billingham was one of the main founders of the PDDG meetings which have been held annually at different venues in the UK since 1976, and biennially since 1998. The PDDG meetings are forums for scientific developments and open discussion of all aspects of polymer degradation and stabilisation and have always provided younger researchers a platform for presenting and discussing their work in the field. This 27th PDDG meeting, chaired by Sahar Al-Malaika (Aston University), was dedicated to Norman Billingham, the Guest of Honour, in recognition for his distinguished contributions to Polymer Science particularly in the area of polymer degradation and stabilisation. The meeting was attended by 65 delegates from 15 countries in Europe, USA and Australia, many of whom have worked and collaborated with Norman at some points of their career. The guest editors of this issue wish to add their Congratulations to Norman Billingham for his outstanding contributions and achievements in the field of polymer degradation and stabilisation and to wish him very happy years ahead. We wish also to express our gratitude to Elsevier for sponsoring the 27th PDDG event and our appreciation to Professor Norman Billingham in his capacity as the Editor-in-Chief of Polymer Degradation and Stability, for the support and help received during the preparation of this special issue.

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Objectives: To explore interactions between audiology patients and volunteers, to describe encounters and define the role of volunteers. Methods: Qualitative ethnographic and interview study of volunteer-patient interactions. Ten volunteer participants from two volunteer schemes in South West England were observed and interviewed. Three patient participants were interviewed. Results: Analysis of observational data showed that volunteers provided support relating to local services and hearing aids, but did not engage in discussions about hearing loss. Interviews with volunteers identified gaps in audiology provision, including accessible services and clear information and highlighted a need for more support from audiology services to enable them to fulfil their role. Volunteer interactions with patients mimicked a clinician-patient encounter and volunteers employed strategies and behaviours used by professional audiologists. Conclusions: Audiology volunteers could provide an accessible bridge between health services and the community but their care is limited to focus on hearing aids. Practice implications: Volunteers enable patients to use hearing aids appropriately and are a core element of current care arrangements. However, volunteers express a need for adequate support from audiology services. Volunteers have the potential to increase service capacity and to bridge the gaps between community and audiology healthcare services.

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Constant increase of human population result in more and more people living in emergency dangerous regions. In order to protect them from possible emergencies we need effective solution for decision taking in case of emergencies, because lack of time for taking decision and possible lack of data. One among possible methods of taking such decisions is shown in this article.

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This dissertation investigated the effects of a peer coaching relationship between a special education teacher and two general education teachers. More specifically, a two-tier multiple baseline design across subjects was used to evaluate the effects of peer coaching on the general education teachers' use of effective instructional practices (EIPs) and subsequent effects on the engagement rate and academic performance of students with and without disabilities. The peer coaching process included modeling, direct support, and feedback on the use of effective instructional practices including getting student attention, giving specific directions, asking specific questions with wait time, contingent positive reinforcement, positive error correction, precorrection, prompting, and proximity control. A 30-second partial interval recording procedure was used to observe the general education teachers' use of effective instructional practices and student engagement rates. Student participants' academic performance was measured using weekly quizzes. ^ Peer coaching resulted in an overall increase in the teachers' use of EIPs. One general education teacher had a 30% increase in average EIP use from 46% during the baseline phase to 76% during intervention. Student engagement for her two student participants with and without disabilities indicated an increase from 54% to 69% and from 47% to 65% respectively. Results for the second general education teacher indicated a 34% increase in average EIP use from 55% during the baseline to 89% during intervention. Student engagement for the two student participants with and without disabilities in her class increased from 48% to 83% and from 29% to 71% respectively. Student academic performance showed a small increase. In follow-up observations, the effects of peer coaching on teacher use of EIPs and student engagement and academic performance were maintained. ^ The results of this study suggest that using peer coaching to support general education teachers can be an effective method to improve the educational outcomes of students with and without disabilities in general education. Further research is needed to investigate the effects of peer coaching with other special and general educator partnerships and other student participants. ^

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Background: Worldwide, it is estimated that there are up to 150 million street children. Street children are an understudied, vulnerable population. While many studies have characterized street children’s physical health, few have addressed the circumstances and barriers to their utilization of health services.

Methods: A systematic literature review was conducted to understand the barriers and facilitators that street children face when accessing healthcare in low and middle income countries. Six databases were used to search for peer review literature and one database and Google Search engine were used to find grey literature (theses, dissertations, reports, etc.). There were no exclusions based on study design. Studies were eligible for inclusion if the study population included street children, the study location was a low and middle income country defined by the World Bank, AND whose subject pertained to healthcare.

In addition, a cross-sectional study was conducted between May 2015 and August 2015 with the goal of understanding knowledge, attitudes, and health seeking practices of street children residing in Battambang, Cambodia. Time location and purposive sampling were used to recruit community (control) and street children. Both boys and girls between the ages of 10 and 18 were recruited. Data was collected through a verbally administered survey. The knowledge, attitudes and health seeking practices of community and street children were compared to determine potential differences in healthcare utilization.

Results: Of the 2933 abstracts screened for inclusion in the systematic literature review, eleven articles met all the inclusion criteria and were found to be relevant. Cost and perceived stigma appeared to be the largest barriers street children faced when attempting to seek care. Street children preferred to receive care from a hospital. However, negative experiences and mistreatment by health providers deterred children from going there. Instead, street children would often self treat and/or purchase medicine from a pharmacy or drug vendor. Family and peer support were found to be important for facilitating treatment.

The survey found similar results to the systematic review. Forty one community and thirty four street children were included in the analysis. Both community and street children reported the hospital as their top choice for care. When asked if someone went with them to seek care, both community and street children reported that family members, usually mothers, accompanied them. Community and street children both reported perceived stigma. All children had good knowledge of preventative care.

Conclusions: While most current services lack the proper accommodations for street children, there is a great potential to adapt them to better address street children’s needs. Street children need health services that are sensitive to their situation. Subsidies in health service costs or provision of credit may be ways to reduce constraints street children face when deciding to seek healthcare. Health worker education and interventions to reduce stigma are needed to create a positive environment in which street children are admitted and treated for health concerns.

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Background A developing body of evidence has provided valuable insight into the experiences of caregivers of people with motor neuron disease; however, understandings of how best to support caregivers remain limited.

Aim This study sought to understand concepts related to the motor neuron disease caregiver experience which could inform the development of supportive interventions.

Design A qualitative thematic analysis of a one-off semistructured interview with caregivers was undertaken.

Setting/participants Caregivers of people with motor neuron disease were recruited from a progressive neurological diseases clinic in Melbourne, Australia.

Results 15 caregivers participated. Three key themes were identified: (1) The Thief: the experience of loss and grief across varied facets of life; (2) The Labyrinth: finding ways to address ever changing challenges as the disease progressed; (3) Defying fate: being resilient and hopeful as caregivers tried to make the most of the time remaining.

Conclusions Caregivers are in need of more guidance and support to cope with experiences of loss and to adapt to changeable care giving duties associated with disease progression. Therapeutic interventions which target these experiences of loss and change are worth investigation.

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Abstract : The use of social media tools to support small and medium-sized enterprises (SME) to support their business activities throughout the product life cycle (PLC) phases represents an interesting opportunity. SMEs operate in very competitive environments, and face significant challenges primarily caused by their size disadvantage. By nature, social media tools and platforms can enable them to overcome some of these challenges, as they are often very inexpensive, familiar and easy to use, allowing them to reach large audiences they would not be able to reach with traditional and expensive marketing initiatives. To provide solutions to this problem, this research identified three main objectives. The first objective was to draw a picture of the existing academic literature on the use of social media tools in the PLC context to better understand how these tools were studied and used in businesses, and for what purpose. Second, this research aimed at understanding how SMEs actually use social media tools to support their different business activities to identify the gap between academic research and actual business practices. Finally, based on the findings highlighted from the previous objectives, this research aimed at developing theory on this topic by proposing a conceptual framework of customer engagement enabled by social media. The conceptual framework aimed at answering general questions that emerged from the initial two objectives: Why do some SMEs use social media to support customer engagement, while others do not? Why do firms use different social media tools to support their customer engagement initiatives? Why does the scope of customer engagement initiatives (i.e., across different PLC phases) vary between SMEs? What are the potential outcomes of conducting customer engagement initiatives for the organizing firms? In order to achieve these research objectives, the methodology employed for this research is threefold. First, a systematic literature review was performed in order to properly understand how the use of social media tools in the PLC context had been studied. The final results consisted of 78 academic articles which were analyzed based on their bibliometric information and their content. Second, in order to draw the contrast between the academic publications and managerial reality of SMEs, six semi-structured interviews were conducted to understand how these firms actually use social media to support different activities in each of the PLC phases. Third, five additional semi-structured interviews were performed to gather a deeper understanding of this phenomenon and generate theory to support the proposed conceptual framework. The conceptual framework focuses on the degree of customer engagement, which is comprised of the scope (PLC phases) of customer engagement and the technology (social media tools) employed to support these initiatives. Two sets of antecedents were examined, firm motivators and firm impediments, as they could both potentially affect the scope and the social media tools used to support customer engagement initiatives. Finally, potential customer engagement outcomes for SMEs developing these initiatives were also examined. The semi-structured interviews lasted approximately 25-35 minutes, and were performed using an interview grid consisting of 24 open-ended questions. The interview grid was developed based on the findings of the systematic literature review, and this qualitative approach allowed for a rich understanding of the interviewed SMEs’ use of social media tools to support and engage customers in their different PLC activities. The main results highlighted by this project demonstrate that this field is relatively recent and sees constant increase in research interest since 2008. However, most of the academic research focuses on the use of social media tools to support innovation activities during the new product development process, while the interviewed firms almost exclusively used the tools to engage customers in the later phases of the PLC, primarily for promotion, customer service support, and business development activities. Interestingly, the interviewed firms highlighted several benefits of using social media tools to engage customers, some of which could help them overcome certain size disadvantages previously mentioned. These firms are in need of further guidelines to properly implement such initiatives and reap the expected benefits. Results suggest that SMEs are far behind both large companies and academic research in their use of social media to engage customers in different business activities. The proposed conceptual framework serves as a great tool to better understand their reality and eventually better support them in their social media and customer engagement efforts. However, this framework needs to be further developed and improved. This research project provides a 360-degree view of the phenomenon of the use of social media to support customer engagement for SMEs, by providing both a thorough systematic review of the academic research and an understanding of the managerial reality of SMEs behind this phenomenon. From this analysis, a conceptual framework is then proposed and serves as a stepping stone for future researchers who are interested in developing theory in this field.