Consumer satisfaction with water, wastewater and waste services in Portugal

While the concept of consumer satisfaction is a central topic in modern marketing theory and practice, citizens' satisfaction with public services, and especially water and waste services, is a eld that still remains empirically rather unexplored. The following study aims to contribute to this area by analysing the determinants of user satisfaction in the water, wastewater and waste sector in Portugal, using a unique survey of 1070 consumers undertaken by the Portuguese Water and Waste Regulator ERSAR. I perform an analysis of the relation between overall service satisfaction and attributespeci c service satisfaction with an ordered logit model. I then explore if subjective consumer satisfaction can be re ected by ERSAR's technical performance indicators. The results suggest that overall consumer satisfaction is driven by consumer's satisfaction with speci c service aspects but unrelated to socioeconomic and demographic characteristics. Furthermore, I show that there is no monotonic association between ERSAR's technical performance indicators and consumers' levels of satisfaction.

Insertion dans les soins après une première hospitalisation dans un secteur pour psychose [Linkage to care after first hospitalisation for psychosis]

BACKGROUND: First hospitalisation for a psychotic episode causes intense distress to patients and families, but offers an opportunity to make a diagnosis and start treatment. However, linkage to outpatient psychiatric care remains a notoriously difficult step for young psychotic patients, who frequently interrupt treatment after hospitalisation. Persistence of symptoms, and untreated psychosis may therefore remain a problem despite hospitalisation and proper diagnosis. With persisting psychotic symptoms, numerous complications may arise: breakdown in relationships, loss of family and social support, loss of employment or study interruption, denial of disease, depression, suicide, substance abuse and violence. Understanding mechanisms that might promote linkage to outpatient psychiatric care is therefore a critical issue, especially in early intervention in psychotic disorders. OBJECTIVE: To study which factors hinder or promote linkage of young psychotic patients to outpatient psychiatric care after a first hospitalisation, in the absence of a vertically integrated program for early psychosis. Method. File audit study of all patients aged 18 to 30 who were admitted for the first time to the psychiatric University Hospital of Lausanne in the year 2000. For statistical analysis, chi2 tests were used for categorical variables and t-test for dimensional variables; p<0.05 was considered as statistically significant. RESULTS: 230 patients aged 18 to 30 were admitted to the Lausanne University psychiatric hospital for the first time during the year 2000, 52 of them with a diagnosis of psychosis (23%). Patients with psychosis were mostly male (83%) when compared with non-psychosis patients (49%). Furthermore, they had (1) 10 days longer mean duration of stay (24 vs 14 days), (2) a higher rate of compulsory admissions (53% vs 22%) and (3) were more often hospitalised by a psychiatrist rather than by a general practitioner (83% vs 53%). Other socio-demographic and clinical features at admission were similar in the two groups. Among the 52 psychotic patients, 10 did not stay in the catchment area for subsequent treatment. Among the 42 psychotic patients who remained in the catchment area after discharge, 20 (48%) did not attend the scheduled or rescheduled outpatient appointment. None of the socio demographic characteristics were associated with attendance to outpatient appointments. On the other hand, voluntary admission and suicidal ideation before admission were significantly related to attending the initial appointment. Moreover, some elements of treatment seemed to be associated with higher likelihood to attend outpatient treatment: (1) provision of information to the patient regarding diagnosis, (2) discussion about the treatment plan between in- and outpatient staff, (3) involvement of outpatient team during hospitalisation, and (4) elaboration of concrete strategies to face basic needs, organise daily activities or education and reach for help in case of need. CONCLUSION: As in other studies, half of the patients admitted for a first psychotic episode failed to link to outpatient psychiatric care. Our study suggests that treatment rather than patient's characteristics play a critical role in this phenomenon. Development of a partnership and involvement of patients in the decision process, provision of good information regarding the illness, clear definition of the treatment plan, development of concrete strategies to cope with the illness and its potential complications, and involvement of the outpatient treating team already during hospitalisation, all came out as critical strategies to facilitate adherence to outpatient care. While the current rate of disengagement after admission is highly concerning, our finding are encouraging since they constitute strategies that can easily be implemented. An open approach to psychosis, the development of partnership with patients and a better coordination between inpatient and outpatient teams should therefore be among the targets of early intervention programs. These observations might help setting up priorities when conceptualising new programs and facilitate the implementation of services that facilitate engagement of patients in treatment during the critical initial phase of psychotic disorders.

A Healthier Future: A Twenty Year Vision for Health and Wellbeing in Northern Ireland 2005-2025

This Regional Strategy, A Healthier Future, aims to provide a vision of how our health and social services will develop and function over the next 20 years. In order to succeed, it must embrace the measures needed to promote health and wellbeing, support, protect and care for the most vulnerable and facilitate the delivery of services.

Predictors of academic achievement and social competence in adolescence : facilitation, inhibition and general cognitive processing /

The relevance of attentional measures to cognitive and social adaptive behaviour was examined in an adolescent sample. Unlike previous research, the influence of both inhibitory and facilitory aspects of attention were studied. In addition, contributions made by these attentional processes were compared with traditional psychometric measures of cognitive functioning. Data were gathered from 36 grade 10 and 1 1 high school students (20 male and 16 female students) with a variety of learning and attentional difficulties. Data collection was conducted in the course of two testing sessions. In the first session, students completed questionnaires regarding their medical history, and everyday behaviours (the Brock Adaptive Functioning Questionnaire), along with non-verbal problem solving tasks and motor speed tasks. In the second session, students performed working memory measures and computer-administered tasks assessing inhibitory and facilitory aspects of attention. Grades and teacher-rated measures of cognitive and social impulsivity were also gathered. Results indicate that attentional control has both cognitive and social/emotional implications. Performance on negative priming and facilitation trials from the Flanker task predicted grades in core courses, social functioning measures, and cognitive and social impulsivity ratings. However, beneficial effects for academic and social functioning associated with inhibition were less prevalent in those demonstrating a greater ability to respond to facilitory cues. There was also some evidence that high levels of facilitation were less beneficial to academic performance, and female students were more likely to exceed optimal levels of facilitory processing. Furthermore, lower negative priming was ''S'K 'i\':y-: -'*' - r " j«v ; ''*.' iij^y Inhibition, Facilitation and Social Competence 3 associated with classroom-rated distraction and hyperactivity, but the relationship between inhibition and social aspects of impulsivity was stronger for adolescents with learning or reading problems, and the relationship between inhibition and cognitive impulsivity was stronger for male students. In most cases, attentional measures were predictive of performance outcomes independent of traditional psychometric measures of cognitive functioning. >,, These findings provide support for neuropsychological models linking inhibition to control of interference and arousal, and emphasize the fundamental role of attention in everyday adolescent activities. The findings also warrant further investigation into the ways which inhibitory and facilitory attentional processes interact, and the contextdependent nature of attentional control.associated with classroom-rated distraction and hyperactivity, but the relationship between inhibition and social aspects of impulsivity was stronger for adolescents with learning or reading problems, and the relationship between inhibition and cognitive impulsivity was stronger for male students. In most cases, attentional measures were predictive of performance outcomes independent of traditional psychometric measures of cognitive functioning. >,, These findings provide support for neuropsychological models linking inhibition to control of interference and arousal, and emphasize the fundamental role of attention in everyday adolescent activities. The findings also warrant further investigation into the ways which inhibitory and facilitory attentional processes interact, and the contextdependent nature of attentional control.

Effects of reflection and social isolation on crayfish behaviour /

Visual stimuli and socialization influence exploratory behaviour in crayfish. The predominant components of spontaneous exploratory behaviour were determined by observing the activity of solitary adult crayfish (Procambarus clarkii) in a glass aquarium containing fresh water and no objects. Five distinct behaviours were observed: rearing up (climbing on the wall), turning around, cornering (facing the comer), backward walking, and crossing (crossing the midline of the aquarium). The frequency of rearing up, cornering and turning around decreased when reflection from the glass wall was blocked with black cardboard, black paint or non-reflective transparent plastic. In a tank containing mirrors on one side and non-reflective plastic on the other, crayfish cornered, reared up, and turned around more in front of the mirrors. Socialization was necessary for crayfish to respond to the reflection. Crayfish that were housed in pairs for two weeks exhibited more rearing up, turning around and cornering in front of the mirrors than in the non-reflective side. Crayfish isolated for two weeks did not show these differences. Socialized crayfish also exhibited more rearing up, turning around and cornering than did isolated crayfish. Thus, crayfish respond to visual stimuli provided by a glass tank, but the responds depends on socialization.

The relation of attentional, emotional, and social regulation to cognitive competence, from infancy to school entry

Recent research on the sources of cognitive competence in infancy and early childhood has highlighted the role of social and emotional factors (for example, Lewis, 1993b). Exploring the roots of competence requires a longitudinal and multivariate approach. To deal with the resulting complexity, potentially integrative theoretical constructs are required. One logical candidate is self-regulation. Three key developmental questions were the focus of this investigation. 1) Does infant self-regulation (attentional, emotional, and social) predict preschool cognitive competence? 2) Does infant self-regulation predict preschool self-regulation? 3) Does preschool self-regulation predict concurrent preschool cognitive competence? One hundred preschoolers (46 females, 54 males; mean age = 5 years, 11 months) who had participated at 9- and/ or 12-months of age in an object permanence task were recruited to participate in this longitudinal investigation. Each subject completed four scales of the WPPSI-R and two social cognitive tasks. Parents completed questionnaires about their preschoolers' regulatory behaviours (Achenbach's Child Behavior Checklist [1991] and selected items from Eisenberg et ale [1993] and Derryberry & Rothbart [1988]). Separate behavioural coding systems were developed to capture regulatory capabilities in infancy (from the object permanence task) and preschool (from the WPPSIR Block Design). Overall, correlational and multiple regression results offered strong affirmative answers to the three key questions (R's = .30 to .38), using the behavioural observations of self-regulation. Behavioural regulation at preschool substantially predicted parental reports of regulation, but the latter variables did not predict preschool competence. Infant selfregulation and preschool regulation made statistically independent contributions to competence, even though regulation at Time 1 and Time 2 ii were substantially related. The results are interpreted as supporting a developmental pathway in which well-regulated infants more readily acquire both expertise and more sophisticated regulatory skills. Future research should address the origins of these skills earlier in infancy, and the social contexts that generate them and support them during the intervening years.

Wellness and balance: perceptions amongst female health care professionals negotiating career, family, and continuing education /

The purpose ofthis study was to explore the perceptions of wellness and bidance amongst female health care professionals negotiating career, family aiul continuing education commitments. Five women who met the criteria of having a family (with children), holding a full-time professional career in health care, and who were presently pursuing continuing education were interviewed. This paper begins with the introduction to the topic of research and the questions to be answered. The review of literature explores the theory and research A^ch precede this study and addresses the surrounding areas of: wellness, balance, multiple roles, stress and continuing education. < This study has assumed a qualitative, phenomenological approach. The data collected through the use of individual interviews were analyzed using a two-part process. Analysis using both (a) methodological interpretation and (b) The Listening Guide method has allowed for the uncovering of major themes, and the portrayal of each participant's unique experience. Some of the major themes which emerged from this research include: wellness as multidimensional and fluctuating, making personal sacrifices, the presence of stress, professional as a vital role, and continuing education as something for me. Perhaps the most significant finding this research has identified is the positive role continuing education can hold in the lives of women already negotiating multiple commitments. The notion that continuing education can act as a means of enhancing perceptions of wellness and balance holds a number of implications in theory, practice, and for future research.

The claim of Amasa Stetson, of Massachusetts, on the United States, for money advanced, in fulfilling the orders of the Government while discharging the duties of Commissary General of Purchases, in time of the late war with Great Britain ; and for services rendered. --

Claim relating to the War of 1812.

Analyzing the learning of the taking personal and social responsibility model within a new physical education undergraduate degree program in El Salvador

EI Salvador presents an unfortunate history that includes a military regime and a civil war that together created a legacy of violence in which the country still struggle nowadays. Salud Escolar Integral (SEI) was created in 2005 as a program to combat youth violence throughout the re-formulation of physical education (PE) classes in public schools, promoting life skills learning that supports the resolution of conflicts with nonviolent ways. In 2007, SEI supported the creation of a physical e~ucation teacher education (PETE) degree at the Universidad Pedag6gica de EI Salvador (UPES), having the goal to assist pre-service teachers with a better understanding of humanistic principles. The present research analyzed if after attending all three years ofUPES PETE program, students presented high self-perception levels of competence and confidence related to attitude, skills and knowledge to teach PE within humanistic principles. Taking Personal and Social Responsibility (TPSR) was the theoretical framework used to analyze the development of humanistic principles. The study had a mixed-method longitudinal design that included questionnaires, reflection templates and interviews. In conclusion, although it is suggested that UPES should provide better support for the development of the teaching principles of empowering students and transfer learning, most of the humanistic principles were highly promoted by the program. At last, it is suggested that future research should track teachers' progress while teaching in schools, in order to analyze if the theory of promoting humanistic principles have also become a daily practice.

The effects of a general excercise program on task self-efficacy and social physique anxiety in older adults

Older adults represent the most sedentary segment of the adult population, and thus it is critical to investigate factors that influence exercise behaviour for this age group. The purpose of this study was to examine the influence of a general exercise program, incorporating cardiovascular, strength, flexibility, and balance components, on task selfefficacy and SPA in older adult men and women. Participants (n=114, Mage = 67 years) were recruited from the Niagara region and randomly assigned to a 12-week supervised exercise program or a wait-list control. Task self-efficacy and SPA measures were taken at baseline and program end. The present study found that task self-efficacy was a significant predictor of leisure time physical activity for older adults. In addition, change in task self-efficacy was a significant predictor of change in SPA. The findings of this study suggest that sources of task self-efficacy should be considered for exercise interventions targeting older adults.

“Weathering a Hidden Storm”: An Application of Andersen’s Behavioral Model of Health, and Health Services Use for Those with Diagnosable Anxiety Disorder

Abstract: Research has primarily focused on depression and mood disorders, but little research has been devoted to an examination of mental health services use amongst those with diagnosable anxiety disorder (Wittchen et al., 2002; Bergeron et al., 2005). This study examined the possible predicting factors for mental health services utilization amongst those with identifiable anxiety disorder in the Canadian population. The methods used for this study was the application of Andersen’s Behavioral Model of Health Services Use, where predisposing, need and enabling characteristics were regressed on the dependent variable of mental health services use. This study used the Canadian Community Health Survey (cycle 1.2: Mental Health and Well-Being) in a secondary data analysis. Several multiple logistics models predicted the likelihood to seek and use mental health services. Predisposing characteristics of gender and age, Enabling characteristics of education and geographical location, and those with co-occurring mood disorders were at the greatest increased likelihood to seek and use mental health services.

"Weathering a hidden storm" : an application of Andersen's behavioral model of health, and health services use for those with diagnosable anxiety disorder

"Weathering a Hidden Storm": An App~ication of Andersen's Behaviora~ Mode~ of Hea~th, and Hea~th Services Use for Those With Diagnosab~e Anxiety Disorder Research has primarily focused on depression and mood disorders, but little research has been devoted to an examination of mental health services use amongst those with diagnosable anxiety disorder (Wittchen et al., 2002; Bergeron et al., 2005). This study examined the possible predicting factors for mental health services utilization amongst those with identifiable anxiety disorder in the Canadian population. The methods used for this study was the application of Andersen's Behavioral Model of Health Services Use, where predisposing, need and enabling 111 characteristics were regressed on the dependent variable of mental health services use. This study used the Canadian Community Health Survey (cycle 1.2: Mental Health and Well- Being) in a secondary data analysis. Several multiple logistics models predicted the likelihood to seek and use mental health services. Predisposing characteristics of gender and age, Enabling characteristics of education and geographical location, and those with co-occurring mood disorders were at the greatest increased likelihood to seek and use mental health services.

Educator Evaluation of Academic and Social Competence in Students with Acquired Brain Injury (ABI) Relative to Assessed Performance and Sense of Belonging

Acquired brain injury (ABI) is the leading cause of death and disability amongst children and adolescents andpresents itself with challenges associated in cognitive, social, emotional, and behavioural domains. These changes may interfere with academic performance and social inclusion, influencing self-esteem and personal success. The current study examined a subset of data to capture the sense of academic and social belonging for students with ABI as a function of the classroom teachers’ subjective perception of ability, their ABI knowledge, and student identification. Overall, a discrepancy was found between educators’ subjective ratings of student performance and students’ neurocognitive capacity. Educator knowledge and identification of ABI influenced student success in academic and social domains independent of teaching approach. This research has implications for the identification of ABI in the classroom and related challenges students experience. Educators are underprepared for the reintegration of students returning to school and lack appropriate knowledge and strategies to accommodate individual needs.

A Quantitative Study of Social Capital Components, Self-Reported Health Status and Social Determinants of Health

This quantitative descriptive co-relational study used telephone survey interviews and stratified random sampling to collect data related to Social Capital (SC) and its components (trust and safety, reciprocity, civic engagement and collective action) and selected determinants of health variables in Niagara Region, Canada. Among the four components of social capital, trust and safety levels were highest among all participants (m=5.42, SD=1.0), with community engagement yielding the lowest mean score for the sample (m=1.93, SD=.8). Reciprocity had the strongest association with all other components of SC (r=0.51). Those most likely to report low levels of SC and health were unattached and low-income females. Males were more likely to report higher trust and safety levels and higher levels of self-rated health. In this study, a linear relationship between self-reported health status and SC was not found. Marital and employment status were associated with differences in mean scores of SC and self-reported health.