758 resultados para Transition to adult services


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Thesis (Master's)--University of Washington, 2016-06

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Despite a century's knowledge that soluble aluminum (Al) is associated with acid soils and poor plant growth, it is still uncertain how Al exerts its deleterious effects. Hypotheses include reactions of Al with components of the cell wall, plasmalemma, or cytoplasm of cells close to the root tip, thereby reducing cell expansion and root growth. Digital microscopy was used to determine the initial injuries of soluble Al to mungbean (Vigna radiata L.) roots. Roots of young seedlings were marked with activated carbon particles and grown in 1 mm CaCl2 solution at pH 6 for ca. 100 min (control period), and AlCl3 solution was added to ensure a final concentration of 50 muM Al (pH 4). Further studies were conducted on the effects of pH 4 with and without 50 muM Al. Four distinct, but possibly related, initial detrimental effects of soluble Al were noted. First, there was a 56-75% reduction in the root elongation rate, first evident 18-52 min after the addition of Al, root elongation continuing at a decreased rate for ca. 20 It. Decreasing solution pH from 6 to 4 increased the root elongation rate 4-fold after 5 min, which decreased to close to the original rate after 130 min. The addition of Al during the period of rapid growth at pH 4 reduced the root elongation rate by 71% 14 min after the addition of Al. The activated carbon marks on the roots showed that, during the control period, the zone of maximum root growth occurred at 2,200-5,100 mum from the root tip (i.e. the cell elongation zone). It was there that Al first exerted its detrimental effect and low pH increased root elongation. Second, soluble Al prevented the progress of cells from the transition to the elongation phase, resulting in a considerable reduction of root growth over the longer term. The third type of soluble Al injury occurred after exposure for ca. 4 h to 50 mum Al when a kink developed at 2,370 mum from the root tip. Fourth, ruptures of the root epidermal and cortical cells at 1,900-2,300 mum from the tip occurred greater than or equal to4.3 h after exposure to soluble Al. The timing and location of Al injuries support the contention that Al initially reduces cell elongation, thus decreasing root growth and causing damage to epidermal and cortical cells.

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A virtual outpatient service has been established in Queensland for the delivery of post-acute burns care to children living in rural and remote areas of the state. The integration of telepaediatrics as a routine service has reduced the need for patient travel to the specialist burns unit situated in Brisbane. We have conducted 293 patient consultations over a period of 3 years. A retrospective review of our experience has shown that post-acute burns care can be delivered using videoconferencing, email and the telephone. Telepaediatric bums services have been valuable in two key areas. The first area involves a programme of routine specialist clinics via videoconference. The second area relates to ad-hoc patient consultations for collaborative management during acute presentations and at times of urgent clinical need. The families of patients have expressed a high degree of satisfaction with the service. Telepaediatric services have helped improve access to specialist services for people living in rural and remote communities throughout Queensland. (C) 2003 Elsevier Ltd and ISBI. All rights reserved.

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An artificial diet incorporating insect cells originally developed for Trichogramma australicum Girault (Hymenoptera: Tricho-grammatidae) was successfully used to rear Trichogramm pretiosum Riley (Hymenoptera: Trichogrammatidae). To refine the diet, individual components were removed. Chicken egg yolk and the insect cells were identified as the most important components for T. pretiosum development. Their removal resulted in few pupae and no adults. Removal of Grace's insect medium, a common component of artificial diets, was found to markedly improve the development of T pretiosum, producing 60% larva to pupa transition and 19% pupa to adult transition. There was no significant difference in T pretiosum development on diets in which milk powder, malt powder or infant formula were interchanged, despite differences in nutrient composition. The use of yeast extract resulted in significantly higher survival to the adult stage when compared with yeast hydrolysate enzymatic and a combination of yeast extract and yeast hydrolysate enzymatic. Comparison of four antimicrobial agents showed the antibacterial agent Gentamycin and the antifungal agent Nystatin had the least detrimental effect on T pretiosum development. The use of insect cell line diets has the potential to simplify artificial diet production and significantly reduce T pretiosum production costs in Australia compared to diets using insect hemolymph or the use of natural or factitious hosts. (c) 2005 Elsevier Inc. All rights reserved.

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Objective: To determine the frequency and pattern of methods of outcome assessment used in Australian physical rehabilitation environments. Design: Postal survey. Methods: A questionnaire on service type, staffing, numbers of adults treated and outcome measures used for 7 conditions related to injury and road trauma as well as stroke and neuromuscular disorders was sent to 973 services providing adult physical rehabilitation treatment. Results: Questionnaires were completed by 440 service providers for a response rate of 45%, similar to that reported in a recent European survey reported in this journal. A small number of measures were reported as in use by most respondents, while a large number of measures were used by a few respondents. Measures of physical changes were used more frequently than those of generic well-being or quality of life. Ease of use and reporting to other professionals were cited as the most important reasons in selection of outcome measures. Conclusion: This Australian-wide survey detected considerable heterogeneity in outcome measurement procedures used in rehabilitation environments. While the goal of measurement may vary between providers and differ between conditions, the results highlight opportunities for harmonization, benchmarking and measurement of health-related quality of life.

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Something of a design after-thought, mobile phone SMS (Short-Message Services) have been enthusiastically adopted by consumers worldwide, who have created a new text culture. SMS is now being deployed to provide a range of services and transactions, as well as playing a critical role in offering an interactive path for television broadcasting. In this paper we offer a case study of a lucrative, new industry developing internationally at the intersection of telecommunications, broadcasting, and information services—namely, premium rate SMS/MMS. To explore the issues at stake we focus on an Australian case study of policy responses to the development of premium rate mobile messaging services in the 2002-2005 period. In the first part, we give a brief history of premium rate telecommunications. Secondly, we characterise premium rate mobile message services and examine their emergence. Thirdly, we discuss the responses of Australian policy-makers and industry to these services. Fourthly, we place the Australian experience in international context, and indicate common issues. Finally, we draw some conclusions from the peregrinations of mobile message services for regulators grappling with communications policy frameworks.

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The major changes of the transition to adulthood are argued to be stressful, and health-related behaviors such as smoking and physical activity may be adopted, consolidated, or abandoned at this time. On the other hand, research has suggested that the normative transitions of emerging adulthood, although involving considerable change, may be associated with low stress because they are perceived as both positive and normal at this life stage. This article examines relations between the timing and sequencing of life transitions and stress and health-related behaviors, focusing on the transition to young adulthood among Australian women. A total of 853 women aged 22 to 27 provided information about the timing and sequencing of 6 life transitions: moving out of home, stopping full-time education, starting full-time work, having the first live-in relationship, marriage, and motherhood-and stress, smoking, and physical activity. Most had moved out of home, stopped full-time education, and started full-time work, but only 14% had undertaken all 6 transitions. Overall, 70% of participants had made transitions in order Overall, the findings suggest that the relations between timing and sequencing of transitions, and indicators of health, are moderate for smoking, but small for stress and for physical activity. These effects remained after controlling for socioeconomic status of the participants' families of origin. Matching current social norms for the timing and sequencing of life changes may be of less importance for women's well-being than is commonly believed. Although the significant relations between early or out of order transitions and smoking are of concern, the smaller relations with stress and with sedentariness suggest that such transitions may have limited negative consequences, and support the view that individuals are active in choosing the life path that is appropriate for them and their circumstances.

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The rapid uptake of mobile devices has created the capacity to provide services to consumers while they are on the move, and new mobile services (m-services) are constantly emerging. In past research, personal attributes have been found to be important in the adoption and use of information and communication technology. However, little research has been conducted in the area of m-services. To explore factors influencing the use of these services, this paper examines personal attributes in terms of motivational, attitudinal and demographic characteristics. Specifically, it investigates the influence of innovativeness, self- efficacy, involvement and impulsiveness, as well as age and gender on m-services use. Data were collected from a convenience sample of 250 respondents using an online survey and a modified snowball procedure. Age and gender were quite well balanced in the sample. The multiple regression model was significant and the hypotheses relating to the positive relationship between impulsiveness, involvement and gender and m-services were supported. Findings are discussed, further implications for managers are suggested and directions for future research are proposed.

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O objetivo desse estudo é descobrir se as cidades de Guarulhos e São Bernardo do Campo têm chances de, ao explorar sua vocação turística para os negócios, obter reais possibilidades de ampliar seu mercado de trabalho na área de hotelaria. Para realizar o que se propôs, utilizou-se dos dados primários advindos das entrevistas pessoais com alguns profissionais ligados ao setor; além dos dados secundários e informações coletadas nos próprios sites das prefeituras, sindicatos, meios de hospedagem e outras associações que integrados à pesquisa bibliográfica verificou-se que as duas cidades possuem potencial turístico para os negócios porque contam com parques industriais que possibilitam a entrada e permanência de pessoas que vem às cidades para realizar diversos tipos de negócios. Para tanto, precisam hospedar-se, geralmente, por um espaço de tempo em que pretendem descansar, alimentar-se, banhar-se como se estivessem em suas casas. Além desse potencial, as cidades apresentam mais algumas características em comum como a localização de aeroportos, Cumbica e Congonhas, bem próximos de seus centros e, ainda, servem de passagem para outras cidades consideradas mais acolhedoras como Santos, Guarujá entre outras localizadas no litoral e São Paulo, na região conhecida como a grande São Paulo. Por isso Guarulhos e São Bernardo acabam sendo pouco aproveitadas no que se refere aos seus potenciais turísticos. A pesquisa aponta que se houver investimentos nesse setor, o turismo poderá crescer tornando-as cidades receptivas àqueles que as visitam por motivo de trabalho e que precisam de uma boa hospedagem e, muitas vezes, de um lugar para utilizar como seu próprio escritório. Com isso, aumenta-se a necessidade de profissionais qualificados para atender às expectativas desses turistas. Conseqüentemente amplia-se o mercado de trabalho nas áreas voltadas ao turismo e hotelaria das cidades. Entre elas, destacam-se Transportes, Comércio, Segurança, Gastronomia, Cultura, Esportes e Lazer, Redes Hoteleiras e até mesmo Escolas Técnicas e Faculdades. Identificou-se que as duas cidades estudadas possuem potencial turístico para os negócios e podem ampliar o mercado de trabalho hoteleiro a partir da conscientização das partes interessadas em investirem na infra-estrutura, na capacitação dos Recursos Humanos, na estrutura dos empreendimentos hoteleiros e na divulgação do local, dos produtos e dos serviços oferecidos.(AU)

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In the UK, low vision rehabilitation is delivered by a wide variety of providers with different strategies being used to integrate services from health, social care and the voluntary sector. In order to capture the current diversity of service provision the Low vision Service Model Evaluation (LOVSME) project aimed to profile selected low vision services using published standards for service delivery as a guide. Seven geographically and organizationally varied low-vision services across England were chosen for their diversity and all agreed to participate. A series of questionnaires and follow-up visits were undertaken to obtain a comprehensive description of each service, including the staff workloads and the cost of providing the service. In this paper the strengths of each model of delivery are discussed, and examples of good practice identified. As a result of the project, an Assessment Framework tool has been developed that aims to help other service providers evaluate different aspects of their own service to identify any gaps in existing service provision, and will act as a benchmark for future service development.

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This report details an evaluation of the My Choice Weight Management Programme undertaken by a research team from the School of Pharmacy at Aston University. The My Choice Weight Management Programme is delivered through community pharmacies and general practitioners (GPs) contracted to provide services by the Heart of Birmingham teaching Primary Care Trust. It is designed to support individuals who are ‘ready to change’ by enabling the individual to work with a trained healthcare worker (for example, a healthcare assistant, practice nurse or pharmacy assistant) to develop a care plan designed to enable the individual to lose 5-10% of their current weight. The Programme aims to reduce adult obesity levels; improve access to overweight and obesity management services in primary care; improve diet and nutrition; promote healthy weight and increased levels of physical activity in overweight or obese patients; and support patients to make lifestyle changes to enable them to lose weight. The Programme is available for obese patients over 18 years old who have a Body Mass Index (BMI) greater than 30 kg/m2 (greater than 25 kg/m2 in Asian patients) or greater than 28 kg/m2 (greater than 23.5 kg/m2 in Asian patients) in patients with co-morbidities (diabetes, high blood pressure, cardiovascular disease). Each participant attends weekly consultations over a twelve session period (the final iteration of these weekly sessions is referred to as ‘session twelve’ in this report). They are then offered up to three follow up appointments for up to six months at two monthly intervals (the final of these follow ups, taking place at approximately nine months post recruitment, is referred to as ‘session fifteen’ in this report). A review of the literature highlights the dearth of published research on the effectiveness of primary care- or community-based weight management interventions. This report may help to address this knowledge deficit. A total of 451 individuals were recruited on to the My Choice Weight Management Programme. More participants were recruited at GP surgeries (n=268) than at community pharmacies (n=183). In total, 204 participants (GP n=102; pharmacy n=102) attended session twelve and 82 participants (GP n=22; pharmacy 60) attended session fifteen. The unique demographic characteristics of My Choice Weight Management Programme participants – participants were recruited from areas with high levels of socioeconomic deprivation and over four-fifths of participants were from Black and Minority Ethnic groups; populations which are traditionally underserved by healthcare interventions – make the achievements of the Programme particularly notable. The mean weight loss at session 12 was 3.8 kg (equivalent to a reduction of 4.0% of initial weight) among GP surgery participants and 2.4 kg (2.8%) among pharmacy participants. At session 15 mean weight loss was 2.3 kg (2.2%) among GP surgery participants and 3.4 kg (4.0%) among pharmacy participants. The My Choice Weight Management Programme improved the general health status of participants between recruitment and session twelve as measured by the validated SF-12 questionnaire. While cost data is presented in this report, it is unclear which provider type delivered the Programme more cost-effectively. Attendance rates on the Programme were consistently better among pharmacy participants than among GP participants. The opinions of programme participants (both those who attended regularly and those who failed to attend as expected) and programme providers were explored via semi-structured interviews and, in the case of the participants, a selfcompletion postal questionnaire. These data suggest that the Programme was almost uniformly popular with both the deliverers of the Programme and participants on the Programme with 83% of questionnaire respondents indicating that they would be happy to recommend the Programme to other people looking to lose weight. Our recommendations, based on the evidence provided in this report, include: a. Any consideration of an extension to the study also giving comparable consideration to an extension of the Programme evaluation. The feasibility of assigning participants to a pharmacy provider or a GP provider via a central allocation system should also be examined. This would address imbalances in participant recruitment levels between provider type and allow for more accurate comparison of the effectiveness in the delivery of the Programme between GP surgeries and community pharmacies by increasing the homogeneity of participants at each type of site and increasing the number of Programme participants overall. b. Widespread dissemination of the findings from this review of the My Choice Weight Management Project should be undertaken through a variety of channels. c. Consideration of the inclusion of the following key aspects of the My Choice Weight Management Project in any extension to the Programme: i. The provision of training to staff in GP surgeries and community pharmacies responsible for delivery of the Programme prior to patient recruitment. ii. Maintaining the level of healthcare staff input to the Programme. iii. The regular schedule of appointments with Programme participants. iv. The provision of an increased variety of printed material. d. A simplification of the data collection method used by the Programme commissioners at the individual Programme delivery sites.

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This research investigates the general user interface problems in using networked services. Some of the problems are: users have to recall machine names and procedures to. invoke networked services; interactions with some of the services are by means of menu-based interfaces which are quite cumbersome to use; inconsistencies exist between the interfaces for different services because they were developed independently. These problems have to be removed so that users can use the services effectively. A prototype system has been developed to help users interact with networked services. This consists of software which gives the user an easy and consistent interface with the various services. The prototype is based on a graphical user interface and it includes the following appJications: Bath Information & Data Services; electronic mail; file editor. The prototype incorporates an online help facility to assist users using the system. The prototype can be divided into two parts: the user interface part that manages interactlon with the user; the communicatIon part that enables the communication with networked services to take place. The implementation is carried out using an object-oriented approach where both the user interface part and communication part are objects. The essential characteristics of object-orientation, - abstraction, encapsulation, inheritance and polymorphism - can all contribute to the better design and implementation of the prototype. The Smalltalk Model-View-Controller (MVC) methodology has been the framework for the construction of the prototype user interface. The purpose of the development was to study the effectiveness of users interaction to networked services. Having completed the prototype, tests users were requested to use the system to evaluate its effectiveness. The evaluation of the prototype is based on observation, i.e. observing the way users use the system and the opinion rating given by the users. Recommendations to improve further the prototype are given based on the results of the evaluation. based on the results of the evah:1ation. . .'. " "', ':::' ,n,<~;'.'

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In 2007, the English Department of Health (DH) issued advice stating 'pregnant woman' and 'those trying to conceive' should abstain from drinking alcohol. As others have noted, this advice was issued despite their being no new evidence about the deleterious effects of low levels of alcohol consumption. In this paper, we argue this development is significant for the social construction of 'risk', since in advocating abstinence without an evidence base for this advice, policy makers formalise a connection between uncertainty and danger. We suggest this development has important implications, most obviously for pregnant women, certainly impacting on the nature of the advice they will now receive and likely more generally on their experience of the transition to motherhood. We suggest it has wider implications for individuals' experience also, as policy makers appear to be advocating the same approach to risk to non-pregnant people. Further, it suggests a noteworthy formalisation of a new definition of risk, which should be debated far more extensively, as it matters for the future development of health policy.

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Across the literature researchers agree that the concept of mentoring results in positive outcomes for both mentors and mentees alike (Enrich et al, 2004). From a pedagogical perspective, student focused mentoring activities in Higher Education are generally perceived to comprise dyadic or triadic relationships that encapsulate a diverse range of learning strategies and/or support mechanisms. Whilst there exists a significant amount of literature regarding the wider value of Peer Mentoring in Higher Education, there remains a notable gap in knowledge about the value of such programmes in enhancing the first year undergraduate experience and thus promoting a smooth transition to University. Using the emergent study findings of a large international project, a multidimensional conceptual framework bringing together the theoretical, conceptual and contextual determinants of Peer Mentoring is proposed. This framework makes a distinctive contribution to current pedagogical theory and practice – particularly in relation to the first year experience.