985 resultados para Child restraint system


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In the past decades, social-ecological systems (SESs) worldwide have undergone dramatic transformations with often detrimental consequences for livelihoods. Although resilience thinking offers promising conceptual frameworks to understand SES transformations, empirical resilience assessments of real-world SESs are still rare because SES complexity requires integrating knowledge, theories, and approaches from different disciplines. Taking up this challenge, we empirically assess the resilience of a South African pastoral SES to drought using various methods from natural and social sciences. In the ecological subsystem, we analyze rangelands’ ability to buffer drought effects on forage provision, using soil and vegetation indicators. In the social subsystem, we assess households’ and communities’ capacities to mitigate drought effects, applying agronomic and institutional indicators and benchmarking against practices and institutions in traditional pastoral SESs. Our results indicate that a decoupling of livelihoods from livestock-generated income was initiated by government interventions in the 1930s. In the post-apartheid phase, minimum-input strategies of herd management were adopted, leading to a recovery of rangeland vegetation due to unintentionally reduced stocking densities. Because current livelihood security is mainly based on external monetary resources (pensions, child grants, and disability grants), household resilience to drought is higher than in historical phases. Our study is one of the first to use a truly multidisciplinary resilience assessment. Conflicting results from partial assessments underline that measuring narrow indicator sets may impede a deeper understanding of SES transformations. The results also imply that the resilience of contemporary, open SESs cannot be explained by an inward-looking approach because essential connections and drivers at other scales have become relevant in the globalized world. Our study thus has helped to identify pitfalls in empirical resilience assessment and to improve the conceptualization of SES dynamics.

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The objective of this thesis was to better understand how parental factors influence feeding practices, how mothers experience feeding and what factors mothers perceive influencing feeding in different contexts. This study is largely based on STEPS Study (Steps to Healthy Development of Children), which is a longitudinal cohort of 1797 families. In addition, qualitative data was collected among mothers in Finland and Solomon Islands. The results of this study show that different parental determinants associate with infant and young child feeding behavior and practices. Mothers with high cognitive restraint of eating introduced complementary foods earlier and neophobic mothers’ breastfed exclusively for a shorter time than mothers who ranked lower in these behaviors. Fathers’ poor diet quality associated with shorter total breastfeeding duration. Mothers’ postnatal depressive symptoms associated with shorter duration of exclusive breastfeeding, earlier introduction of complementary foods and lower compliance of feeding recommendations. The higher amount of marital distress associated with longer duration of exclusive breastfeeding and better compliance with feeding recommendations. Mothers, who participated in qualitative interviews, described how complex interplay of individual perceptions, significant others and socio-cultural environment influenced feeding practices and behavior. This study showed that several parental factors influence infant and young child feeding practices as well as compliance with the feeding recommendations. Maternal experiences and perceptions on child feeding relate to the context where mother-infant pair lives in. These results highlight the importance of targeting feeding support and, if needed, specific interventions to mothers and families who are in risk of poor feeding practices.

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The concept of equal opportunity for all students is deeply embedded in the Serbian constitution and in education laws. On that level, there is no doubt that everyone is ensured an opportunity to receive quality education. Many measures in education policy have been created specifically to achieve this objective and make the system fair and inclusive. The Coleman Report was linked to a wave of optimism that certain educational measures would help in achieving these noble goals. This aim is a high priority in education in a democratic country, and due to its importance needs to be re-examined. Thus, the present research examines the equity of students in the Serbian education system, detecting areas on all educational levels that could be (or already are) systemic sources of inequity (e.g., criteria for preschool institution enrolment, the system of student awards, rationalisation of the school network, the concept of entrance exams to secondary school or university, etc.). A number of measures have already been taken in the system specifically to deal with inequity (e.g., the Preschool Preparatory Programme, dropout measures, inclusion, scholarships, etc.). The effects of these measures in particular are analysed in the present work. In addition to an analysis of the systemic sources of inequity in the Serbian education system, the article also makes recommendations for their overcoming. (DIPF/Orig.)

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Aim: To verify the knowledge of pregnant women on mother-to-child transmission (MTCT) of HIV, the availability of HIV tests in the public health system and counseling on the disease in two cities, Birigui and Piacatu, São Paulo State, Brazil. Methods: This is a descriptive and exploratory research using as samples, the files of 141 pregnant women attending the Basic Health Unit. Data were collected by survey, followed by a semi-structured questionnaire with open and closedend questions. Data were analyzed on Epi Info™ 7.1.4, by the Chi-square and Exact Fisher tests. Results: From all the 141 pregnant women, 119 were interviewed and 92.4% reported to have been informed about the need of taking the HIV test during prenatal exams. However, only 5.9% were counseled and 20.2% reported to be aware of how to prevent MTCT of HIV, usually mentioning lactation suppression and prescribed medication. The association between the knowledge about how to prevent MTCT of HIV and some social, demographic and economic variables like ethnics, educational level, home location, occupation, age and parenting was not verified. Conclusions: It is necessary to advise pregnant women on the importance of taking the HIV test regardless of the examination outcome, which was not observed in the cities where the research was conducted.

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BACKGROUND: Obesity is a significant public health issue and is socially patterned, with greater prevalence of obesity observed in the most socioeconomically disadvantaged groups. Recent evidence suggests that the prevalence of childhood obesity is levelling off in some countries. However, this may not be the case across all socioeconomic strata. The aim of this review is to examine whether trends in child and adolescent obesity prevalence since 1990 differ according to socioeconomic position in developed countries.

METHODS: An electronic search will be conducted via Ovid Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus and Cochrane Collaboration to identify articles that report trends in obesity prevalence in children and adolescents according to socioeconomic position. We will also search grey literature databases including the Virtual Library for Public Health and the System for Information on Grey Literature, as well as websites from relevant organisations. Articles that report on a series of cross sectional studies; describe one or more measure of obesity with data recorded at two or more time points since 1990; and report trends by at least one indicator of socioeconomic position will be included. Quality of included studies will be evaluated according to criteria that consider both internal and external validity. Descriptive analysis will be performed to examine trends since 1990 in childhood obesity prevalence according to socioeconomic position.

DISCUSSION: The review will provide a picture of change over time in developed countries of childhood obesity prevalence across socioeconomic strata and identify whether changes in childhood obesity prevalence are experienced equally across socioeconomic groups.

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Judicial decisions about whether or not to publicly name child homicide offenders have long ani- mated debate in the United Kingdom and internationally. This article draws on case law and in- depth interviews conducted with members of the English criminal justice system to critically analyse the viability of current domestic legislation in the context of the UK’s international human rights obligations. The article identifies ambiguities surrounding the definition of ‘public interest’ in law; the merits of equating the naming of child offenders with open justice, accountability and transpar- ency; and the increasing sabotage of the principle of rehabilitation. By identifying the complexities of this contentious area of judicial discretion, this article highlights the need for a rights-based approach to decisions about publicly naming children in conflict with the law.

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 Ms Benson's thesis focused on evaluating a new, innovative, interactive online training program for investigative interviewer's of child victims. The results were overwhelmingly positive, showing that online training can be implemented in large organisations, and improve trainees' practical interviewing skills and knowledge.

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Most child sexual abuse cases do not result in a full trial or guilty plea; rather, case attrition occurs at earlier stages of the criminal justice system. One reason for the attrition of these cases is the withdrawal of complaints, by children or their caregivers. The aim of the current study was to determine the case characteristics associated with complaint withdrawal in child sexual abuse cases by the child or his or her parents once a report has been made to authorities. All child sexual abuse incidents reported to authorities in one jurisdiction of Australia in 2011 were analyzed (N=659). A multinomial logistic regression was used to predict the following case outcomes: (1) withdrawn by the child or his or her parents, (2) exited for other reasons (e.g., the alleged offender was not identified, the child refused to be interviewed), and (3) resulted in a charge. Five predictors significantly added to the prediction of case outcome: child age, suspect gender, suspect age, child-suspect relationship, and abuse frequency. These results should contribute to the design of interventions in order to reduce complaint withdrawals if these withdrawals are not in the child's best interests.

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Mother-child mealtime interactions during preschool years is an important but overlooked factor when evaluating the influence of parent-child relationships on child eating and weight. This paper describes the validation of the Mutually Responsive Orientation (MRO) coding system adapted for assessing parent-child interactions during food preparation and consumption situations. Home-based mealtimes of 94 mothers and their children (3.03 ± 0.75 years) were filmed at two time points, 12-months apart. Filmed dimensions of mutual mother-child responsiveness, shared positive affect, maternal control relating to food and child compliance were assessed. Objective BMI and maternal reports of parenting, feeding, child eating, diet and child temperament were also collected. Correlations, repeated measures ANOVAs and regressions were performed to examine the validity of MRO variables and their stability across both time points. Validation analysis showed the MRO coding system performed as expected: dyads with higher MRO scores expressed lower control/power assertion, lower child non-compliance, and greater committed compliance. The measure demonstrated sensitivity to specific contexts: maternal responsiveness, mother and child positive affect were higher during food consumption compared to food preparation. Coded dimensions were stable across time points, with the exception of decreases in maternal responsiveness in food consumption and child non-compliance in food preparation. MRO and maternal dimensions were correlated with maternally reported parenting and feeding measures. Maternal responsiveness (inversely) and child responsiveness (positively) were concurrently associated with child fussy eating, and child refusal was prospectively and inversely associated with child fussy eating. Findings suggest the adapted MRO coding system is a useful measure for examining observed parent-child mealtime interactions potentially implicated in preschoolers' eating and weight development.

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The Irish health care system is based on a complex and costly mix of private, statutory, and voluntary provisions. The majority of health care expenditure comes from the state, with a significant proportion of acute hospital care funded from private insurance, but there are relatively high out-of-pocket costs for most service users. There is free access to acute hospital care, but not for primary care, for all children. About 40% of the population have free access to primary care. Universal preventive public health services, including vaccination and immunization, newborn blood spot screening, and universal neonatal hearing screening are free. Major health challenges include poverty, obesity, drug and alcohol use, and mental health. The health care system has been dominated for the last 5 years by the impact of the current recession, which has led to very sharp cuts in health care expenditure. It is unclear if the necessary substantial reform of the system will happen. Government policy calls for a move toward a patient-centered, primary care-led system, but without very substantial transfers of resources and investment in Information and Communication Technology, this is unlikely to occur. The paper has been published as part of an overall report of Child Health in Europe: Diversity of Child Health Care in Europe: A Study of the European Paediatric Association/Union of National European Paediatric Societies and Associations http://www.jpeds.com/issue/S0022-3476(16)X0010-8 . (J Pediatr 2016;177S:S87-106).  

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Introduction: There has been a continuous development of new technologies in healthcare that are derived from national quality registries. However, this innovation needs to be translated into the workflow of healthcare delivery, to enable children with long-term conditions to get the best support possible to manage their health during everyday life. Since children living with long-term conditions experience different interference levels in their lives, healthcare professionals need to assess the impact of care on children’s day-to-day lives, as a complement to biomedical assessments. Aim: The overall aim of this thesis was to explore and describe the use of instruments about health-related quality of life (HRQOL) in outpatient care for children with long-term conditions on the basis of a national quality registry system. Methods: The research was conducted by using comparative, cross-sectional and explorative designs and data collection was performed by using different methods. The questionnaire DISABKIDS Chronic Generic Measure -37 was used as well as semi-structured interviews and video-recordings from consultations. Altogether, 156 children (8–18 years) and nine healthcare professionals participated in the studies. Children with Type 1 Diabetes (T1D) (n 131) answered the questionnaire DISABKIDS and children with rheumatic diseases, kidney diseases and T1D (n 25) were interviewed after their consultation at the outpatient clinic after the web-DISABKIDS had been used. In total, nine healthcare professionals used the HRQOL instrument as an assessment tool during the encounters which was video-recorded (n 21). Quantitative deductive content analysis was used to describe content in different HRQOL instruments. Statistical inference was used to analyse results from DISABKIDS and qualitative content analysis was used to analyse the interviews and video-recordings. Results: The findings showed that based on a biopsychosocial perspective, both generic and disease-specific instruments should be used to gain a comprehensive evaluation of the child’s HRQOL. The DISABKIDS instrument is applicable when describing different aspects of health concerning children with T1D. When DISABKIDS was used in the encounters, children expressed positive experiences about sharing their results with the healthcare professional. It was discovered that different approaches led to different outcomes for the child when the healthcare professionals were using DISABKIDS during the encounter. When an instructing approach is used, the child’s ability to learn more about their health and how to improve their health is limited. When an inviting or engaging approach is used by the professional, the child may become more involved during the conversations. Conclusions: It could be argued that instruments of HRQOL could be used as a complement to biomedical variables, to promote a biopsychosocial perspective on the child’s health. According to the children in this thesis, feedback on their results after answering to web-DISABKIDS is important, which implies that healthcare professionals need to prioritize time for discussions about results from HRQOL instruments in the encounters. If healthcare professionals involve the child in the discussion of the results of the HRQOL, misinterpreted answers could be corrected during the conversation. Concurrently, this claims that healthcare professionals invite and engage the child.

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The attrition of child sexual abuse cases from the criminal justice process was explored. Recommendations to prevent attrition included: more effective communication between stakeholders; enabling connections between children and adults to facilitate disclosures; introduction of peer support programs to prevent withdrawal; and educating children about sexual victimisation to reduce withdrawal.

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The investigation of maternal and child factors influencing the socialization of children’s eating and weight, including the validation of an observational coding system for assessing dyadic mother-child feeding interactions, revealed a range of shared maternal and child mealtime behaviors potentially associated with preschoolers’ willingness to accept parent’s healthful feeding guidance.

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Background: Impairments in social communication are the hallmark feature of autism spectrum disorder (ASD). Operationalizing ‘severity’ in ASD has been challenging; thus stratifying by functioning has not been possible. Purpose: To describe the development of the Autism Classification System of Functioning: Social Communication (ACSF:SC) and evaluate its consistency within and between parent and professional ratings. Methodology: (1)ACSF:SC development based on focus groups and surveys involving parents, educators and clinicians familiar with preschoolers with ASD; and (2)Evaluation of the intra- and inter-rater agreement of the ACSF:SC using weighted kappa(кw). Results: Seventy-six participants were involved in the development process. Core characteristics of social communication were ascertained: communicative intent; communicative skills and reciprocity; and impact of environment. Five ACSF:SC levels were created and content-validated across participants. Best capacity and typical performance agreement ratings varied as follows: intra-rater on 41 children was кw=0.61-0.69 for parents and кw=0.71-0.95 for professionals; inter-rater between professionals were кw=0.47-0.61 and between parents and professionals кw=0.33-0.53. Conclusions: Perspectives from parents, and professionals informed ACSF:SC development, providing common descriptions of the levels of everyday communicative abilities of children with ASD to complement DSM-5. Rater agreement demonstrates the ACSF:SC can be utilized with acceptable consistency in comparison to other functional classification systems.

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The Earth we know today was not always so. Over millions of years have undergone significant ch an g e s brought about by numerous geological phenomena aimed at your balance, some internal order, creating new geological formations and other external order smoothing formations previously created. From t h e tectonic standpoint, Angola is located in a relatively stable area which gives it a certain p ri v i l e g e w h e n compared with some Asian countries or even Americans where quite often occur earthquakes and volcanic eruptions. However, the same cannot be said in relation to the occurrence of an external geodynamics phenomena, such as the ravines, which in recent years has taken shape in many provinces, especially due to anthropogenic activity, giving rise to geological hazards, increasing the risk of damage in buildings and others infrastructures, losses direct or indirect in economic activities and loss of human lives. We understand that the reducing of these risks starts, in particular, by their identification, for later take preventive measures. This work is the result of some research work carried out by the authors through erosion courses of s o i l and stabilization of soils subject to erosion phenomena, carried out by Engineering Laboratory of Angola (LEA). For the realization of this work, we resorted to cartographic data query, literature, listening to s o m e o f the provincial representatives and local residents, as well as the observation in lo co o f s o m e af f e ct ed areas. The results allow us to infer that the main provinces affected by ravine phenomenon are located in Central and Northern highlands, as well as in the eastern region, and more recently in Cuando-Cub an go province. Not ruling out, however, other regions, such as in Luanda and Cabinda [1]. Relatively the causes, we can say that the ravines in Angola are primarily due to the combination of three natural factors: climate, topography and type of soil [2]. When we add the anthropogenic activit y , namely the execution of construction works, the drainage system obstructio n, exploration of m i n e ral s, agriculture and fires, it is verified an increasing of the phenomenon, often requiring immedi at e act i o n . These interventions can be done through structural or engineering measures and by the stabilization measures on the degraded soil cover [3]. We present an example of stabilization measures throu g h t h e deployment of a local vegetation called Pennisetum purpureum. It is expected that the results may contribute to a better understanding of the causes of the ravine phenomenon in Angola and that the adopted stabilization method can be adapted in other affected provinces in order to prevent and making the contention of the ravines.