Best practice principles for management of children with developmental coordination disorder (DCD) : results of a scoping review

Background. Developmental coordination disorder (DCD) is a prevalent health condition that is frequently unrecognized despite the substantial evidence that has accumulated regarding how it affects children’s health, education and skills.Most literature focuses on measurement of impairment and description of intervention approaches for individual children; little is known about the principles that should guide best practice and service delivery for children with DCD as a population. The purpose of this study was to identify these principles. Methods. A scoping review was used to ‘map’ the information available to inform intervention and service delivery. Scholarly and grey literature written in English was identified in six databases, using a combination of keywords (e.g. guidelines, management, models and DCD); a ‘snow-balling’ technique was also used in Canada and the UK to access clinical protocols used in publicly funded health care systems. Over 500 documents were screened: 31 met inclusion criteria as they outlined practice principles for children with DCD as a population. Data regarding best practices were independently extracted by two reviewers and then compared with achieve consistency and consensus. Results. Two over-arching themes emerged, with five principles: (1) Organizing services to efficiently meet the comprehensive needs of children (e.g. Increasing awareness of DCD and coordination; Implementing clearly defined pathways; Using a graduated/staged approach); (2) Working collaboratively to offer evidence-based services (e.g. Integration of child and family views; Evidence-based interventions fostering function, participation and prevention). Conclusion Numerous documents support each of the principles, reflecting agreement across studies about recommended organization of services.While these principles may apply to many populations of children with disabilities, this review highlights how essential these principles are in DCD. Researchers, managers, clinicians, community partners and families are encouraged to work together in designing, implementing and evaluating interventions that reflect these principles.

Transportation of Children in Ground Ambulances: Professionals' Knowledge and Safety Measures

Background: The transport of children in ground ambulances is a rarely studied topic worldwide. The ambulance vehicle is a unique and complex environment with particular challenges for the safe, correct and effective transportation of patients. Unlike the well developed and readily available guidelines on the safe transportation of a child in motor vehicles, there is a lack on consistent specifications for transporting children in ambulances. Nurses are called daily to transfer children to hospitals or other care centers, so safe transport practices should be a major concern. Purpose: to know which are the safety precautions and specific measures used in the transport of children in ground ambulances by nurses and firefighters and to identify what knowledge these professionals had about safe modes of children transportation in ground ambulances. Methods: In this context, an exploratory - descriptive study and quantitative analysis was conducted. A questionnaire was completed by 135 nurses and firefighters / ambulance crew based on 4 possible children transport scenarios proposed by the NHTSA (National Highway Traffic Safety Administration) and covered 5 different children´s age groups (new born children, 1 to 12 months; 1 to 3 years old; 4 to 7 years old and 8 to 12 years old). Results: The main results showed a variety of safety measures used by the professionals and a significant difference between their actual mode of transportation and the mode they consider to be the ideal considering security goals. In addition, findings showed that achieved scores related to what ambulance crews do in the considered scenarios reflect mostly satisfactory levels of transportation rather than optimum levels of safety, according to NHTSA recommendations. Variables as gender, educational qualifications, occupational group and local where professionals work seem to influence the transport options. Female professionals and nurses from pediatric units appear to do a safer transportation of children in ground ambulances than other professionals. Conclusion: Several professionals refereed unawareness of the safest transportation options for children in ambulances and did not to know the existence of specific recommendations for this type of transportation. The dispersion of the results suggests the need for investment in professional training and further regulation for this type of transportation.

Transportation of Children In Ground Ambulances: Professionals' Knowledge and Safety Measures.

Summary The transport of children in ground ambulances is a rarely studied topic worldwide. The ambulance vehicle is a unique environment with particular challenges for the safe, correct and effective transportation of patients. Unlike the well developed and available guidelines on the transportation of children in motor vehicles, there is a lack on specifications for transporting children in ambulances. Nurses are called daily to transfer children to hospitals or other care centres, so safe transport practices should be a major concern. Methods An exploratory - descriptive study and quantitative analysis was conducted. The safety measures used by the professionals in the transportation of children in ambulances were analysed based on the NHTSA (National Highway Traffic Safety Administration) recommendations. A questionnaire was applied to 135 nurses and firefighters/crew of Portuguese ambulances using 4 possible transport situations and covering 5 paediatric age groups. Results There are a variety of safety measures used by professionals and a significant difference between actual mode of transportation and the mode they consider to be the ideal. In addition, findings showed that scores related to what ambulance crews do in these scenarios reflect most satisfactory levels of transportation rather than the optimum levels, according to NHTSA recommendations. Variables as gender, educational qualifications, occupational group and local where professionals work seem to influence the transport options. Female professionals and pediatric nurses do a safer transportation of children in ambulances than other professionals. Conclusion The results suggest the need for investment in professional training and further regulation for this type of transportation.

Towards a full cosmological exploitation of cosmic voids

A stately fraction of the Universe volume is dominated by almost empty space. Alongside the luminous filamentary structures that make it up, there are vast and smooth regions that have remained outside the Cosmology spotlight during the past decades: cosmic voids. Although essentially devoid of matter, voids enclose fundamental information about the cosmological framework and have gradually become an effective and competitive cosmological probe. In this Thesis work we present fundamental results about the cosmological exploitation of voids. We focused on the number density of voids as a function of their radius, known as void size function, developing an effective pipeline for its cosmological usage. We proposed a new parametrisation of the most used theoretical void size function to model voids identified in the distribution of biased tracers (i.e. dark matter haloes, galaxies and galaxy clusters), a step of fundamental importance to extend the analysis to real data surveys. We then applied our built methodology to study voids in alternative cosmological scenarios. Firstly we exploited voids with the aim of breaking the degeneracies between cosmological scenarios characterised by modified gravity and the inclusion of massive neutrinos. Secondly we analysed voids in the perspective of the Euclid survey, focusing on the void abundance constraining power on dynamical dark energy models with massive neutrinos. Moreover we explored other void statistics like void profiles and clustering (i.e. the void-galaxy and the void-void correlation), providing cosmological forecasts for the Euclid mission. We finally focused on the probe combination, highlighting the incredible potential of the joint analysis of multiple void statistics and of the combination of the void size function with different cosmological probes. Our results show the fundamental role of the void analysis in constraining the fundamental parameters of the cosmological model and pave the way for future studies on this topic.

Sustainable exploitation of offshore renewable energy sources

Energy transition is the response of humankind to the concerning effects of fossil fuels depletion, climate change and energy insecurity, and calls for a deep penetration of renewable energy sources (RESs) in power systems and industrial processes. Despite the high potentials, low impacts and long-term availability, RESs present some limits which need to be overcome, such as the strong variability and difficult predictability, which result in scarce reliability and difficult applicability in steady-state processes. Some technological solutions relate to energy storage systems, equipment electrification and hybrid systems deployment, thus accomplishing distributed generation even in remote sites as offshore. However, all of these actions cannot disregard sustainability, which represents a founding principle for any project, bringing together economics, reliability and environmental protection. To entail sustainability in RESs-based innovative projects, previous knowledge and tools are often not tailored or miss the novel objectives. This research proposes three methodological approaches, bridging the gaps. The first contribute adapts literature-based indicators of inherent safety and energy efficiency to capture the specificities of novel process plants and hybrid systems. Minor case studies dealing with novel P2X processes exemplify the application of these novel indicators. The second method guides the conceptual design of hybrid systems for the valorisation of a RES in a site, by considering the sustainability performances of alternative design options. Its application is demonstrated through the comparison of two offshore sites where wave energy can be valorised. Finally, “OHRES”, a comprehensive tool for the sustainable optimisation of hybrid renewable energy systems is proposed. “OHRES” hinges on the exploitation of multiple RESs, by converting ex-post sustainability indicators into discrimination markers screening a large number of possible system configurations, according to the location features. Five case studies demonstrate “OHRES” versatility in the sustainable valorisation of multiple RESs.

Neo-commodification of persons: exploitation of personal data and impact on the sharing economy

The notion of commodification is a fascinating one. It entails many facets, ranging from subjective debates on desirability of commodification to in depth economic analyses of objects of value and their corresponding markets. Commodity theory is therefore not just defined by a single debate, but spans a plethora of different discussions. This thesis maps and situates those theories and debates and selects one specific strain to investigate further. This thesis argues that commodity theory in its optima forma deals with the investigation into what sets commodities apart from non-commodities. It proceeds to examine the many given answers to this question by scholars ranging from the mid 1800’s to the late 2000’s. Ultimately, commodification is defined as a process in which an object becomes an element of the total wealth of societies in which the capitalist mode of production prevails. In doing so, objects must meet observables, or indicia, of commodification provided by commodity theories. Problems arise when objects are clearly part of the total wealth in societies without meeting established commodity indicia. In such cases, objects are part of the total wealth of a society without counting as a commodity. This thesis examines this phenomenon in relation to the novel commodities of audiences and data. It explains how these non-commodities (according to classical theories) are still essential elements of industry. The thesis then takes a deep dive into commodity theory using the theory on the construction of social reality by John Searle.

ARBETSRELATERADE STRESSFAKTORER FÖR SJUKSKÖTERSKOR INOM AKUTSJUKVÅRDEN Litteraturöversikt

Bakgrund: Arbetsrelaterad stress hos sjuksköterskor bidrar till hög andel sjukskrivningar. Inom akutsjukvården så är arbetstempot ofta högre än inom andra delar av sjukvården och omsättningen av patienter är stor. Sjuksköterskor som arbetar inom akutsjukvården är mer utsatta för stress. För att hantera stress så kan copingstrategier användas. Syfte: Syftet är att ta reda på vilka stressfaktorer som påverkar sjuksköterskans hälsa inom akutsjukvården, samt vilka copingstrategier som kan användas för att hantera dessa. Metod: Litteraturöversikt med tolv kvalitativa samt kvantitativa vetenskapliga artiklar som berör sjuksköterskan inom akutsjukvården, arbetsrelaterade stressfaktorer samt copingstrategier. Resultat: Det finns ett antal arbetsrelaterade stressfaktorer som bidrar till ohälsa och lidande för sjuksköterskan inom akutsjukvården. Copingstrategier som stöttning av kollegor, avlastande samtal, genomgång av verksamheten och mindfulness, bidrar till att den arbetsrelaterade stressen blir hanterbar och att hälsa uppnås Slutsats: Stressfaktorer som brist på sjuksköterskor, dödsfall eller sexuella övergrepp på barn, våld och hot från patienter och anhöriga, samt brister i arbetsmiljön bidrar till arbetsrelaterad stress. Copingstrategier kan hjälpa att motverka den stress som uppstår. Men för att copingstrategier ska fungera så är det viktigt att använda sig av de strategier som finns och att tid samt möjlighet finns på arbetsplatsen att utföra dessa.

Estrutura de organizações sociais: adaptação aos projetos sociais ou às pressões institucionais?

This is a study concerning in the structure of non governmental organizations, based on the institutional theory. It aims to understand the relation among structure, social projects and environmental influences, analyzing if there is coherence with project social or expresses adaptation to the institutional pressures of the environment. It introduces as theoretical support for the themes, studies about institutional theory and social structure. The research is descriptive and exploratory; it also applies to a study of case, based on the technical procedures. From the research universe, that was compound by non governmental organizations from Natal, RN, Brasil, it was chosen the Casa Renascer, a non governmental organization that works with the combat to the violence and sexual exploration of children and teenagers. The data collection process employed includes documental research, observations and semi structured research devices, guided by the organizational process proposed by Serva (1996) and by the institutional theory. The collected data were qualitatively treated. The analysis was divided into three parts, following the research matters. The social project characterization demonstrated that the organization went by three main phases. The first one, characterized by focus in women and girls education and health; the second shows the emphasis on girls in social risk situation, with preventive approach; and the last one, characterized by victims assistance of violence and sexual exploration. From the analysis using the institutional theory mechanisms, the results showed that exists coherence between structure and environmental influences, but a weak coherence between structure and social projects. It indicates as main determinant of the structure, an aspect forgotten by the institutional theory, the power. It was observed the presence from normative, coercive and mimetic mechanisms, highlighting normative influences

Manifestações da sexualidade infantil: percepção de pais e professoras de crianças de 0 a 6 anos

This article presents a descriptive-qualitative study aimed at investigating the perception of seven teachers, 5 parents and 18 mothers about the sexual expression of children until 6 years old, through a questionnaire with semi-open questions for content analysis. The sexual behavior identified by adults at home or school refers mainly to gender issues and the discovery of the body: the children reproduce conceptions of masculine and feminine, they manipulate their own bodies or that of others, and they talk about dating, kissing in the mouth and sex. The teachers have a higher perception of the children’s sexual behaviors than their parents at home, because they are more explicit in school. Teachers report that the observed behaviors cause anxiety and discomfort, while the parents report that they usually talk with their children about the theme. In general, there are reports of little knowledge about how to deal with children’s sexual manifestations: for teachers, who have little academic training in the area of sexuality, and for the family, who show some personal and moral difficulties. It was concluded that participants understand children as having sexuality because they perceive different expressions of infant sexuality that are typical in the development. It is necessary to invest in teachers’ academic and continuing education in early childhood, and in a joint work with family and school, in search of a positive experience of an emancipatory sexual education for children.

Processos e significados da experiência de pais, mães ou cuidador primário de crianças abusadas sexualmente

Introdução - O abuso sexual de crianças constitui um problema de saúde pública, com aproximadamente 73 milhões de casos de meninos e 150 milhões de meninas registrados anualmente no mundo. O abuso sexual gera consequências negativas e condutas de risco que contribuem com algumas das principais causas de morte, doença e deficiência nas vítimas do abuso. Pais ou cuidadores primários são fundamentais no processo de orientação e de cuidado das crianças abusadas, no sentido de prevenir as consequências cognitivas, comportamentais e emocionais evidenciadas no futuro dessas crianças. Entretanto, as habilidades das famílias de cuidadores para lidar com a problemática ainda são insuficientes. Objetivo - Descrever os processos e significados da experiência vivida pelos pais ou cuidadores primários de crianças abusadas sexualmente. Método - Os dados empíricos foram tratados utilizando-se o Discurso do Sujeito Coletivo (DSC), fundamentado na Teoria das Representações Sociais, que viabiliza a emergência das representações sociais por meio da construção dos discursos coletivos obtidos de depoimentos de um grupo específico. Foram avaliados 60 pais ou cuidadores primários não estupradores, que responderam à cinco situações-problema, cada uma com questões correspondentes, residentes nos municípios de Cajicá e Tabio de Bogotá, Colômbia. O processamento e a análise dos dados foram realizados no sofware Qualiquantisoft, associado à metodologia do DSC. Resultados - Na primeira situação-problema, que aborda o porquê do silêncio do filho sobre o abuso, os entrevistados enfatizaram que é fundamental o relacionamento pais e filhos (45,7 por cento , n = 43), bem como melhorar o papel de pais por meio da escuta, do diálogo e do confiar, dedicando mais tempo às crianças; também acham que o silêncio se deve ao medo por parte das crianças e a ameaças e intimidação por parte do abusador, Na situação-problema 2, relativa à identificação do abuso sexual como problema real, o significado atribuído configura cadeias que se repetem por transmissão intergeracional (26,9 por cento , n = 21). Na situação-problema 3, o que fazer no futuro, 53,3 por cento dos entrevistados (n = 32) acham que a criança está comprometida comportamentalmente e enfatizam a homossexualidade com perda da identidade como consequência da violência sexual. Na situação-problema 4, que enfatiza o papel da rede social quanto ao cuidado da criança, os entrevistados acreditam que a solução é dar proteção (29,1 por cento ; n = 32), com ações que visem a afastar a criança do ambiente agressor, dar orientação, apoio e segurança à criança e à família. A quinta situação-problema que diz respeito ao cuidado das crianças abusadas; 34,26 por cento dos entrevistados (n = 37) enfatizam o apoio e a ajuda com a interveniência da rede de apoio social e afetivo. Conclusão - Para os pais ou cuidadores primários de crianças abusadas sexualmente, os significados se expressam como afetivo, coragem, superação, não ter medo e saber reconhecer as falhas dos pais. Em função dos resultados, que identificam posturas tradicionais dos respondentes, recomenda-se programas inovadores com um alto componente educativo, onde se contextualize o abuso sexual por meio de situações reais em escolas, delegacias, nas famílias e na comunidade, com interveniência das redes de apoio social; enfatiza-se igualmente a necessidade de formação mais humanizada dos profissionais de apoio social.

Estrutura de organizações sociais: adaptação aos projetos sociais ou às pressões institucionais?

This is a study concerning in the structure of non governmental organizations, based on the institutional theory. It aims to understand the relation among structure, social projects and environmental influences, analyzing if there is coherence with project social or expresses adaptation to the institutional pressures of the environment. It introduces as theoretical support for the themes, studies about institutional theory and social structure. The research is descriptive and exploratory; it also applies to a study of case, based on the technical procedures. From the research universe, that was compound by non governmental organizations from Natal, RN, Brasil, it was chosen the Casa Renascer, a non governmental organization that works with the combat to the violence and sexual exploration of children and teenagers. The data collection process employed includes documental research, observations and semi structured research devices, guided by the organizational process proposed by Serva (1996) and by the institutional theory. The collected data were qualitatively treated. The analysis was divided into three parts, following the research matters. The social project characterization demonstrated that the organization went by three main phases. The first one, characterized by focus in women and girls education and health; the second shows the emphasis on girls in social risk situation, with preventive approach; and the last one, characterized by victims assistance of violence and sexual exploration. From the analysis using the institutional theory mechanisms, the results showed that exists coherence between structure and environmental influences, but a weak coherence between structure and social projects. It indicates as main determinant of the structure, an aspect forgotten by the institutional theory, the power. It was observed the presence from normative, coercive and mimetic mechanisms, highlighting normative influences

Estrutura de organizações sociais: adaptação aos projetos sociais ou às pressões institucionais?

This is a study concerning in the structure of non governmental organizations, based on the institutional theory. It aims to understand the relation among structure, social projects and environmental influences, analyzing if there is coherence with project social or expresses adaptation to the institutional pressures of the environment. It introduces as theoretical support for the themes, studies about institutional theory and social structure. The research is descriptive and exploratory; it also applies to a study of case, based on the technical procedures. From the research universe, that was compound by non governmental organizations from Natal, RN, Brasil, it was chosen the Casa Renascer, a non governmental organization that works with the combat to the violence and sexual exploration of children and teenagers. The data collection process employed includes documental research, observations and semi structured research devices, guided by the organizational process proposed by Serva (1996) and by the institutional theory. The collected data were qualitatively treated. The analysis was divided into three parts, following the research matters. The social project characterization demonstrated that the organization went by three main phases. The first one, characterized by focus in women and girls education and health; the second shows the emphasis on girls in social risk situation, with preventive approach; and the last one, characterized by victims assistance of violence and sexual exploration. From the analysis using the institutional theory mechanisms, the results showed that exists coherence between structure and environmental influences, but a weak coherence between structure and social projects. It indicates as main determinant of the structure, an aspect forgotten by the institutional theory, the power. It was observed the presence from normative, coercive and mimetic mechanisms, highlighting normative influences

Median ages at stages of sexual maturity and excess weight in school children

Background: We aimed to estimate the median ages at specific stages of sexual maturity stratified by excess weight in boys and girls.Materials and method: This was a cross-sectional study made in 2007 in Florianopolis, Brazil, with 2,339 schoolchildren between 8 to 14 years of age (1,107 boys) selected at random in two steps (by region and type of school). The schoolchildren were divided into: i) those with excess weight and ii) those without excess weight, according to the WHO 2007 cut-off points for gender and age. Sexual maturity was self-evaluated by the subjects according to the Tanner sexual development stages, and utilizing median ages for the genitalia, breasts, and pubic hair stages.Results: In the boys with excess weight, precocity was observed in the stages 4 for genitals and pubic hair and 2 for pubic hair, with the values for excess and normal weight. The median ages at the beginning of puberty (stage 2-sexual development) for boys and girls in Florianopolis were 10.8 and 10.3 years, respectively.Conclusion: Excess weight is associated with lower median ages in the sexual maturity stages in boys and girls and that it should be taken into account when evaluating sexual maturity in children and adolescents.

Median ages at stages of sexual maturity and excess weight in school children

Abstract: Background: We aimed to estimate the median ages at specific stages of sexual maturity stratified by excess weight in boys and girls. Materials and method. This was a cross-sectional study made in 2007 in Florianopolis, Brazil, with 2,339 schoolchildren between 8 to 14 years of age (1,107 boys) selected at random in two steps (by region and type of school). The schoolchildren were divided into: i) those with excess weight and ii) those without excess weight, according to the WHO 2007 cut-off points for gender and age. Sexual maturity was self-evaluated by the subjects according to the Tanner sexual development stages, and utilizing median ages for the genitalia, breasts, and pubic hair stages. Results: In the boys with excess weight, precocity was observed in the stages 4 for genitals and pubic hair and 2 for pubic hair, with the values for excess and normal weight. The median ages at the beginning of puberty (stage 2–sexual development) for boys and girls in Florianopolis were 10.8 and 10.3 years, respectively. Conclusion: Excess weight is associated with lower median ages in the sexual maturity stages in boys and girls and that it should be taken into account when evaluating sexual maturity in children and adolescents.

Social determinants of sexual satisfaction in Spain considered from the gender perspective

Aims: To describe gender- and social class-related inequalities in sexual satisfaction and analyze their relationship with self-perceived health status. Methods: This population-based, cross-sectional study included 7384 sexually active people aged 16 years and over residing in Spain in 2009 (3951 men and 3433 women). The explanatory variables were gender, age, social class, share in performing domestic tasks, spend time looking after oneself, collaborate economically in supporting the family, caring for children, self-perceived health status, and the desire to increase or decrease frequency of having sexual relations. Bivariate and multivariate logistic regression models were fitted. Results: Among women, sexual satisfaction declines progressively after age 45. Sexual satisfaction is 1.7 times higher among women who look after themselves and who feel good compared with those who do not. The odds of wanting to increase sex is 3.3 times higher for women who are satisfied compared with women who desire a lower frequency of sexual intercourses; and good perceived health was associated with sexual satisfaction. In satisfied men, the corresponding odds is 1.9 times that of men desiring to reduce their frequency of sex. Conclusions: Gender and social class inequalities are found in sexual satisfaction. This is associated with perceived health status, adding evidence in support of the World Health Organization definition of sexual health.