758 resultados para Transition to adult services


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An outline of the state space of planar Couette flow at high Reynolds numbers (Re<105) is investigated via a variety of efficient numerical techniques. It is verified from nonlinear analysis that the lower branch of the hairpin vortex state (HVS) asymptotically approaches the primary (laminar) state with increasing Re. It is also predicted that the lower branch of the HVS at high Re belongs to the stability boundary that initiates a transition to turbulence, and that one of the unstable manifolds of the lower branch of HVS lies on the boundary. These facts suggest HVS may provide a criterion to estimate a minimum perturbation arising transition to turbulent states at the infinite Re limit. © 2013 American Physical Society.

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Background: The prevalence of hearing loss is considerably higher in individuals in residential care than in people within the community-dwelling population, and yet hearing aids and hearing services are relatively underused. Care staff have a key role in supporting access to services. Objectives: This study identifies staff perspectives on hearing loss and their views about potential hearing service improvements. Study design: A four-stage mixed methods study was used, made up of qualitative interviews, observation, a survey and a stakeholder involvement meeting. Results: The qualitative stages indicated that staff were concerned about their levels of interaction with residents. Staff considered maximizing communication as part of their professional role. The quantitative survey indicated that these views were widely held by staff, and the stakeholder stage identified the need for social support and dedicated staff training opportunities. Conclusion: Care home staff regard communication as a shared issue. Future interventions could enhance access to hearing services and provide care home staff with training in hearing loss and hearing aid management. © 2013 Informa Healthcare.

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Periconceptional environment may influence embryo development, ultimately affecting adult health. Here, we review the rodent model of maternal low-protein diet specifically during the preimplantation period (Emb-LPD) with normal nutrition during subsequent gestation and postnatally. This model, studied mainly in the mouse, leads to cardiovascular, metabolic and behavioural disease in adult offspring, with females more susceptible. We evaluate the sequence of events from diet administration that may lead to adult disease. Emb-LPD changes maternal serum and/or uterine fluid metabolite composition, notably with reduced insulin and branched-chain amino acids. This is sensed by blastocysts through reduced mammalian target of rapamycin complex 1 signalling. Embryos respond by permanently changing the pattern of development of their extra-embryonic lineages, trophectoderm and primitive endoderm, to enhance maternal nutrient retrieval during subsequent gestation. These compensatory changes include stimulation in proliferation, endocytosis and cellular motility, and epigenetic mechanisms underlying them are being identified. Collectively, these responses act to protect fetal growth and likely contribute to offspring competitive fitness. However, the resulting growth adversely affects long-term health because perinatal weight positively correlates with adult disease risk. We argue that periconception environmental responses reflect developmental plasticity and 'decisions' made by embryos to optimise their own development, but with lasting consequences.

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Servitization represents a business-model change and organizational transformation from selling goods to selling an integrated combination of goods and services. Competitive advantage is one outcome of this shift. During servitization, companies follow stages to realize services as an opportunity to differentiate from goods and achieve higher customer satisfaction. This study analyzes this transition from base, intermediate, and advanced services by presenting results from 102 senior executives in multinational companies. Our results suggest increasing interest in service-led strategies in manufacturing companies. The results also show that increasing differentiation and high customer satisfaction are fundamental to achieving competitive advantage and superior performance with services. The analysis also indicates the importance of a company’s position in the value chain and the organizational structure it selects to support services in successful servitization.

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We use advanced statistical tools of time-series analysis to characterize the dynamical complexity of the transition to optical wave turbulence in a fiber laser. Ordinal analysis and the horizontal visibility graph applied to the experimentally measured laser output intensity reveal the presence of temporal correlations during the transition from the laminar to the turbulent lasing regimes. Both methods unveil coherent structures with well-defined time scales and strong correlations both, in the timing of the laser pulses and in their peak intensities. Our approach is generic and may be used in other complex systems that undergo similar transitions involving the generation of extreme fluctuations.

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We investigated family members’ lived experience of Parkinson’s disease (PD) aiming to investigate opportunities for well-being. A lifeworld-led approach to healthcare was adopted. Interpretative phenomenological analysis was used to explore in-depth interviews with people living with PD and their partners. The analysis generated four themes: It’s more than just an illness revealed the existential challenge of diagnosis; Like a bird with a broken wing emphasizing the need to adapt to increasing immobility through embodied agency; Being together with PD exploring the kinship within couples and belonging experienced through support groups; and Carpe diem! illuminated the significance of time and fractured future orientation created by diagnosis. Findings were interpreted using an existential-phenomenological theory of well-being. We highlighted how partners shared the impact of PD in their own ontological challenges. Further research with different types of families and in different situations is required to identify services required to facilitate the process of learning to live with PD. Care and support for the family unit needs to provide emotional support to manage threats to identity and agency alongside problem-solving for bodily changes. Adopting a lifeworld-led healthcare approach would increase opportunities for well-being within the PD illness journey.

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Sokoldalú nemzetközi megállapodások és programok foglalkoznak a hulladékok keletkezésének és az országhatárokon átterjedő hatásainak problémájával, a nemzetközi együttműködést szükségessé tevő megoldásokkal. A leginkább átfogó megközelítést a probléma hajtóerőinek szentelt globális programok tartalmazzák, de a fenntarthatóság alapelveire támaszkodó termelési eljárásokra és fogyasztási szokásokra, a zöld gazdaságra való áttérést szorgalmazó dokumentumok nem tartalmaznak számon kérhető kötelezettségeket. A konkrétabb hulladékkeletkezési és hatásterjedési ügyekben – mindenekelőtt a veszélyes hulladékok és a nemzeti fennhatóság alá nem tartozó területekre eljutó vagy ott keletkező hulladékok esetében – jóval konkrétabb nemzetközi megállapodások és programok léteznek. Ezek szabályozási, szakpolitikai, technológiai célokat, feladatokat határoznak meg az országok és az érintett ágazati szereplők szintjén is. Egyes problémák kapcsán és egyes térségekben a hulladékgazdálkodás jelentős eredményeket tud felmutatni, de általában véve a nemzetközi megállapodások hatékony végrehajtásával komoly gondok vannak. Továbbá a meglévő nemzetközi eszközök összességükben még teljes körű végrehajtásuk esetén sem lennének képesek ellensúlyozni a hulladékprobléma globális szintű növekedését. Következésképpen további erőfeszítésekre van szükség – minden kormány, érintett nem-kormányzati szervezet és az ágazatok részéről – különösen a megelőzés vonatkozásában. ____ Various multilateral agreements and programmes deal with the problems of waste generation and its transboundary impacts, and those solutions, which necessitate international co-operation. Those global programmes include the most comprehensive approach, which are dedicated to the drivers of these problems, however, these documents promoting the transition to sustainable production and consumption, or to the green economy do not consist of binding commitments. In case of more concrete issues of waste generation and transboundary impacts there are much more concrete international agreements and programmes, especially, for the hazardous waste streams and the waste transmitted to and/or generated in areas outside national jurisdiction. These determine regulatory, policy, technological goals and tasks for the participating countries and the relevant sectors. Significant progress is demonstrated for some specific problems and in certain regions, but in general, there are serious concerns about the efficient implementation of the international agreements in their entirety. Moreover, even if those were fully accomplished, the existing set of the international instruments would be unable to counterweigh the global increase of the waste problem. Consequently, further efforts are needed by all countries, the relevant non-governmental organisations and sectors, primarily in order to prevent the further global escalation of the problem.

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The role of support from teachers on the academic and emotional adjustment of a ethnically and economically diverse sample of adolescents was examined. Analyses were conducted on data from a larger study examining social networks across the transition to junior high school. Participants in the current study included 694 African-American, Hispanic-American and European-American students in grades 6 and 8 from public elementary schools in South Florida. Some of these schools are located in economically distressed areas and some are in middle income areas. Children were interviewed, and information on teacher social support resources, school stressors, risk and academic and emotional adjustment was obtained. Several significant findings emerged from the analyses. First, overall teacher support was a significant predictor of a wide range of academic and emotional adjustment outcomes. Second, teacher support compensated for low peer support on teacher rated behavior problems. Third, teacher support interacted with school stress to predict depressed affect and self esteem. Fourth, teacher support interacted with low ecological risk conditions to predict feelings of loneliness. ^

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The goal of this study was to examine the longitudinal effects of five family factors on alcohol use among adolescent males. The family factors included familism (family pride, loyalty, and cohesion), parent derogation (being put down by parents), parent/child communication, family alcohol problems and family drug problems. The study focused on the effects of the family factors reported by a sample of 451 White-non-Hispanic and African American males during early and mid-adolescence on (1) the intensity of alcohol use in mid-adolescence, and (2) the number of problems associated with alcohol use during the transition to young adulthood. The study also explored racial differences in the effects of the family factors. The data for this study were derived from a two-phase longitudinal epidemiologic cohort study of male and female adolescents enrolled in middle schools in Miami, FL. Data were collected at four points between 1990 and 2001. Linear and logistical regressions were used to analyze the effects of the family variables on the dependent variables. ^ The results of the analyses indicated that all of the family variables except family drug problems were statistically significant predictors of the level of alcohol use and alcohol-related problems. Familism had a moderate influence on both of the dependent variables at all data points, while parent derogation, parent/child communication and family alcohol problems were weak predictors. While the family factors varied by race, their impact on the dependent variables did not vary substantially. ^ This study had methodological shortcomings related to measurement and design that may have contributed to the weak influence of the variables. Future studies should explore possible mediating effects of these variables, and should employ more sensitive measures that are culturally appropriate. The results suggest that, since early family factors have long-term effects on children's substance-using behaviors, the family environment should be addressed in prevention and intervention efforts. ^

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This study aimed to evaluate the effectiveness of the Independent Living (IL) program targeting foster youths to prepare them for effective adulthood. The study employed a pre-post, two-group comparative research design. The IL group was composed of 49 young adults who participated in the IL or SIL (subsidized IL) program prior to their emancipation from foster care (mean age, 20.6 years). The comparison was made up of 18 young adults who experienced foster care but never participated in the IL or SIL programs (mean age, 20.2 years). Data were collected via a mailed survey that included the Daniel Memorial Independent Living Assessment (DMILA) and an additional questionnaire developed by the researcher. The study also examined: (1) why youth in foster care do not participate in IL programs, (2) how participating youth evaluate IL services and what recommendations they make to improve services, and (3) the internal consistency of the DMILA. Results suggest that the DMILA assessment has mediocre reliability. IL program participation is associated with better educational, employment, income, housing, early parenting-prevention, transportation, anger control, criminal-prevention, and self-evaluation outcomes. However, IL participation is not associated with better social support, perceived parenting competence, substance abuse-prevention, sexual risk-prevention outcomes, increased knowledge in money management skills, job seeking and job maintenance skills, interpersonal skills, or lower depression. Results also suggest that the outreach activities of the IL program may be flawed. IL participants reported the IL program was doing best in educational preparation, criminal involvement prevention, and money management preparation and least well in parenting preparation, housing preparation, employment preparation, and substance abuse prevention. To improve services, youths recommended primarily that IL counselors develop closer relationships with youths, that IL training better address organizational skills, and that monthly subsidy be raised and SIL eligibility requirements softened. The study's political context and limitations are also discussed and implications are derived regarding prevention, intervention, outreach, mentorship, empowerment, cross-systems collaboration, and future research. ^

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This quantitative study investigated the predictive relationships and interaction between factors such as work-related social behaviors (WRSB), self-determination (SD), person-job congruency (PJC), job performance (JP), job satisfaction (JS), and job retention (JR). A convenience sample of 100 working adults with MR were selected from supported employment agencies. Data were collected using a survey test battery of standardized instruments. The hypotheses were analyzed using three multiple regression analyses to identify significant relationships. Beta weights and hierarchical regression analysis determined the percentage of the predictor variables contribution to the total variance of the criterion variables, JR, JP, and JS. ^ The findings highlight the importance of self-determination skills in predicting job retention, satisfaction, and performance for employees with MR. Consistent with the literature and hypothesized model, there was a predictive relationship between SD, JS and JR. Furthermore, SD and PJC were predictors of JP. SD and JR were predictors of JS. Interestingly, the results indicated no significant relationship between JR and JP, or between JP and JS, or between PJC and JS. This suggests that there is a limited fit between the hypothesized model and the study's findings. However, the theoretical contribution made by this study is that self-determination is a particularly relevant predictor of important work outcomes including JR, JP, and JS. This finding is consistent with Deci's (1992) Self-Determination Theory and Wehmeyer's (1996) argument that SD skills in individuals with disabilities have important consequences for the success in transitioning from school to adult and work life. This study provides job retention strategies that offer rehabilitation and HR professionals a useful structure for understanding and implementing job retention interventions for people with MR. ^ The study concluded that workers with mental retardation who had more self-determination skills were employed longer, more satisfied, and better performers on the job. Also, individuals whose jobs were matched to their interests and abilities (person-job congruency) were better at self-determination skills. ^

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The purpose of this study is two-fold: (1) to investigate the common factors positively influencing academically successful, highly motivated African-American high school students in their educational pursuits; and (2) to determine ways in which educators can facilitate an increased positive impact on minority students' achievement motivation and transition to higher education. ^ Three sources of data inform the qualitative study. Short autobiographical essays address the topic of antecedent factors influencing the students' selection of an academic program of study. Individual interviews using a semi-structured format elicit discussion of prior experiences and influences related to the research sub-questions. Focus group interviews elicit discussion of emergent patterns perceived by the researcher from the autobiographical essays and individual interviews. ^ Results indicate a generic model for success for high achieving African-American students. Students prioritize education as a means to success in life. They receive strong support for educational aspirations from at least one adult within the home. The students are focused on a professional career in the future. The students realize and desire the financial benefits of academic success. The students desire academic challenge. Students have feelings of control over their academic choices; however, they frequently seek the counsel of family members. Prior experience in honors, gifted, or magnet programs did not meet needs. ^ Recommendations for improved educational experiences include: Increase teacher and counselor responsiveness to students. Provide classroom activities which afford more interaction among the students and teacher and relate curriculum to topics of interest. Increase involvement of parents and Black community members in establishing goals and visions of opportunity. Recognize and revere diversity among students within the classroom environment. Set a climate that assumes more individual student responsibility and sets higher academic expectations. ^ The factors influencing academically successful, highly motivated African-American high school students echo the patterns of experiences of many groups. Pride in achievement, emotional support for efforts, expectations of success, independence in thought, and consternation with mediocrity and malaise drive the students to excel academically just like all others who succeed. ^

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We consider experimentally and theoretically a refined parameter space in a mode-locked fiber laser near the transition to multi-pulsing. Increasing cavity energy drives the dynamics through a periodic instability to chaotic dynamics. © 2010 Optical Society of America.

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We consider experimentally and theoretically a refined parameter space near the transition to multi-pulse modelocking. Near the transition, the onset of instability is initiated by a Hopf (periodic) bifurcation. As cavity energy is increased, the band of unstable, oscillatory modes generates a chaotic behavior between single- and multi-pulse operation. Both theory and experiment are in good qualitative agreement and they suggest that the phenomenon is of a universal nature in mode-locked lasers at the onset of multi-pulsing from N to N + 1 pulses per round trip. This is the first theoretical and experimental characterization of the transition behavior, made possible by a highly refined tuning of the gain pump level. © 2010 Copyright SPIE - The International Society for Optical Engineering.