908 resultados para Involvement
Resumo:
This research explores the policy implications of the approval of three wind energy projects on the Oak Ridges Moraine, and their impact on the Coordinated Land Use Planning Review process. Specifically, it focuses on the involvement of First Nations and environmental non-governmental organizations (ENGOs). This research was conducted through analyzing submissions to the Coordinated Land Use Planning Review, related legislation and policy, Environmental Review Tribunal hearing documents, and interviews with key informants. This research culminates in a number of recommendations to the Coordinated Review informed by the analysis.
Bullying Involvement and Adolescent Substance Use: A Study of Multilevel Risk and Protective Factors
Resumo:
Bullying, frequent drunkenness, and frequent cannabis use are significant health-risk behaviours among youth. While many studies have demonstrated that bullying involvement may initiate a developmental pathway to both types of frequent substance use, there is a limited understanding of the connection between these behaviours. The presence of risk and protective factors within youths’ relationships and within their neighbourhoods may alter the associations between bullying involvement and both types of frequent substance use. A systemic approach is needed to assess the complex, social environments in which youth are embedded. The current thesis consists of two studies that examined the associations between bullying and both types of frequent substance use within the context of youths’ social environments. In Study 1, multilevel modeling was used to examine the associations between bullying and frequent substance use within the context of individual and neighbourhood risk factors. Our results indicated that the risk factors associated with both frequent drunkenness and frequent cannabis use exist at both levels, with neighbourhoods altering the association of individual risk factors. Moreover, bullying was a unique risk factor associated with both types of frequent substance use, whereas indirect associations were observed for victimization. Study 2 used a similar methodology to examine the association between bullying and both types of frequent substance use within the context of individual and neighbourhood protective factors. Once again, our results indicated that the protective factors associated with both types of frequent substance use exist at multiple levels, and that neighbourhoods altered the association of individual protective factors. Additionally, positive relationship characteristics interacted with the link between bullying and both types of frequent substance use. Together, these findings clarify the nature of the bullying-substance use link and emphasize the need to study adolescent development in context.
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In the early years of the current decade, I spearheaded my school's and school board's participation in a research program on parental involvement led by Kenneth Leithwood from the Ontario Institute for Students in Education (OISE) at the University of Toronto. Despite all the extensive work I did as part of this research program and the ongoing professional reading I have done with respect to parental involvement and engagement, I have yet to share fully the knowledge gained with my staff or our parent community. Therefore, this purpose of this master's project is to provide a means for such dissemination. To do so, I have created two parallel presentations/workshops: one for staff during out first professional development day in September and one for parents at their second Parent Council meeting in October. The final chapter moves beyond these workshops to allow me to reflect on the progress made to date with parental engagement in my school and to look forward toward where I as Principal hope to lead my school community in the future.
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The assessment of adolescent drinking behavior is a complex task, complicated by variability in drinking patterns, the transitory and developmental nature of the behavior and the reliance (for large scale studies) on self-report questionnaires. The Adolescent Alcohol Involvement Scale (Mayer & Filstead, 1979) is a 14-item screening tool designed to help to identify alcohol misusers or more problematic drinkers. The present study utilized a large sample (n = 4066) adolescents from Northern Ireland. Results of Confirmatory Factor Analyses and reliability estimates revealed that the 14-items share sufficient common variance that scores can be considered to be reliable and that the 14 items can be scored to provide a composite alcohol use score.
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The current structure of the health and social care system in Northern Ireland has its origins in the Review of Public Administration (RPA) which was initiated by the Northern Ireland Executive in June 2002. The purpose of RPA was to review Northern Ireland’s system of public administration with a view to putting in place a modern, citizen-centred, accountable and high quality system of public administration. The structure was designed to be more streamlined and accountable and aimed at maximising resources for front-line services and ensuring that people have access to high quality health and social care. Another key feature is the placement of public health and wellbeing firmly at the centre of the system, with a greater emphasis on prevention and support for vulnerable people to live independently in the community for as long as possible.
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Global competition requires that the companies adapt themselves to technological changes rapidly, develop new products, reduce the cost, shorten the time to market, and increase the quality. In this context, supplier involvement in New Product Development (NPD) is determinant for a company to respond to the requirements of the increasingly dynamic markets. The main purpose of the paper is to demonstrate the importance of supplier involvement in NPD, buyer-supplier relationships and their effects on buyer’s NPD process, highlighting the benefits of supplier involvement, the barriers, the strategic aspects and industry aspects. These issues are addressed with a case study from the semiconductor industry. Besides helping to understand NPD in the semiconductor industry, the contribution and fi ndings of this work are clear: the results achieved confirm the findings of studies referred in the literature review, and confirm that the semiconductor industry sector requires a closer and more complex relationship structure with suppliers, given the specificities and challenges of the sector, such as rapid technological changes, permanent innovation, global competition, reduction of cost and time-to-market cycle, increased capacity, among other. The main contribution of the paper to the scientific literature and to managers is the better understanding of the buyer-supplier relationships in NPD in the semiconductor industry.
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OBJECTIVE: To investigate the perceived needs for health services by persons with stroke within the first year after rehabilitation, and associations between perceived impact of stroke, involvement in decisions regarding care/treatment, and having health services needs met. METHOD: Data was collected, through a mail survey, from patients with stroke who were admitted to a university hospital in 2012 and had received rehabilitation after discharge from the stroke unit. The rehabilitation lasted an average of 2 to 4.6 months. The Stroke Survivor Needs Survey Questionnaire was used to assess the participants' perceptions of involvement in decisions on care or treatment and needs for health services in 11 problem areas: mobility, falls, incontinence, pain, fatigue, emotion, concentration, memory, speaking, reading, and sight. The perceived impact of stroke in eight areas was assessed using the Stroke Impact Scale (SIS) 3.0. Eleven logistic regression models were created to explore associations between having health services needs met in each problem area respectively (dependent variable) and the independent variables. In all models the independent variables were: age, sex, SIS domain corresponding to the dependent variable, or stroke severity in cases when no corresponding SIS domain was identified, and involvement in decisions on care and treatment. RESULTS: The 63 participants who returned the questionnaires had a mean age of 72 years, 33 were male and 30 were female. Eighty percent had suffered a mild stroke. The number of participants who reported problems varied between 51 (80%, mobility) and 24 (38%, sight). Involvement in decisions on care and treatment was found to be associated with having health services needs met in six problem areas: falls, fatigue, emotion, memory, speaking, and reading. CONCLUSIONS: The results highlight the importance of involving patients in making decisions on stroke rehabilitation, as it appears to be associated with meeting their health services needs.
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Across Europe, citizens are increasingly expected to participate in the implementation of flood risk management (FRM), by engaging in voluntary-based activities to enhance preparedness, implementing property-level measures, and so forth. Although citizen participation in FRM decision making is widely addressed in academic literature, citizens’ involvement in the delivery of FRM measures is comparatively understudied. Drawing from public administration literature, we adopted the notion of “coproduction” as an analytical framework for studying the interaction between citizens and public authorities, from the decision-making process through to the implementation of FRM in practice. We considered to what extent coproduction is evident in selected European Union (EU) member states, drawing from research conducted within the EU project STAR-FLOOD (Strengthening and Redesigning European Flood Risk Practices towards Appropriate and Resilient Flood Risk Governance Arrangements). On the basis of a cross-country comparison between Flanders (Belgium), England (United Kingdom), France, the Netherlands, and Poland, we have highlighted the varied forms of coproduction and reflected on how these have been established within divergent settings. Coproduction is most prominent in discourse and practice in England and is emergent in France and Flanders. By contrast, FRM in the Netherlands and Poland remains almost exclusively reliant on governmental protection measures and thereby consultation-based forms of coproduction. Analysis revealed how these actions are motivated by different underlying rationales, which in turn shape the type of approaches and degree of institutionalization of coproduction. In the Netherlands, coproduction is primarily encouraged to increase societal resilience, whereas public authorities in the other countries also use it to improve cost-efficiency and redistribute responsibilities to its beneficiaries.
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This paper describes an audit of prevention and management of violence and aggression care plans and incident reporting forms which aimed to: (i) report the compliance rate of completion of care plans; (ii) identify the extent to which patients contribute to and agree with their care plan; (iii) describe de-escalation methods documented in care plans; and (iv) ascertain the extent to which the de-escalation methods described in the care plan are recorded as having been attempted in the event of an incident. Care plans and incident report forms were examined for all patients in men's and women's mental health care pathways who were involved in aggressive incidents between May and October 2012. In total, 539 incidents were examined, involving 147 patients and 121 care plans. There was no care plan in place at the time of 151 incidents giving a compliance rate of 72%. It was documented that 40% of patients had contributed to their care plans. Thematic analysis of de-escalation methods documented in the care plans revealed five de-escalation themes: staff interventions, interactions, space/quiet, activities and patient strategies/skills. A sixth category, coercive strategies, was also documented. Evidence of adherence to de-escalation elements of the care plan was documented in 58% of incidents. The reasons for the low compliance rate and very low documentation of patient involvement need further investigation. The inclusion of coercive strategies within de-escalation documentation suggests that some staff fundamentally misunderstand de-escalation.
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Background. In the treatment of differentiated thyroid cancer (DTC), in absence of enlarged lymph nodes, the role of routine central lymph node dissection (RCLD) remains controversial. The aim of this study is to analyze data resulting from total thyroidectomy (TT) not combined with RCLD in the treatment of DTC. Methods. We retrospectively evaluated the clinical records of 80 patients treated between January 1996 and December 2003 with TT without RCLND, in absence of suspected enlarged lymph nodes at preoperative ultrasonography and intraoperatively during neck exploration. In this series, 75 patients (93.7%) underwent radioiodine (RAI) ablation, followed by Thyroid Stimulating Hormone (TSH) suppression therapy. In case of locoregional lymph nodal recurrence, a central (VI) and ipsilateral (III-IV) selective lymph node dissection was performed. Results. Incidence of permanent hypoparathyroidism (iPTH < 10 pg/ml) and unilateral temporary vocal fold paralysis were respectively 2.55% and 2.55%. Locoregional recurrence, with positive cervical lymph nodes, after a 10.3 ± 4.7 years mean follow-up was observed in 3 patients (3.75%). They were submitted to a central (VI) and ipsilateral (III-IV) selective neck dissection without significant complications. Conclusions. In our series, TT not combined with RCLD was associated to a low locoregional recurrence rate, even if the lack of a control group treated with RCLD does not allow any generalized assumption. RCLD may be indicated in high risk patients, in whom lymph nodal recurrence is more frequent. More prospective randomized studies are needed to better define the role of RCLD and postoperative radioiodine ablation.
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The purposes of the present multistudy were to develop and provide initial construct validity for measures based on the model of parental involvement in sport (Study 1) and examine structural relationships among the constructs of the model (Study 2). In Study 1 (nparents = 342, nathletes = 223), a confirmatory factor analysis was used to verify the psychometric properties of the measures. Content and construct validity were evaluated, as well individual and composite reliability. Multi-group analysis with two independent samples provided evidence of factorial invariance. In Study 2 (nparents = 754, nathletes = 438), structural equation modeling analysis supported the hypothesised model in which athletes’ perceptions of parents’ behaviours mediated the relationship between parents’ reported behaviours and the athletes’ psychological variables conducive to their achievement in sport. The findings provide support for the parental involvement in sport model and demonstrate the role of perceptions of parents’ behaviours on young athletes’ cognitions in sport.
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The importance of considering the differences between the male and female sex in clinical decision-making is crucial. However, it has been acknowledged in recent decades that clinical trials have not always adequately enrolled women or analyzed sex-specific differences in the data. As these deficiencies have hindered the progress of understanding women’s response to medications, agencies in the United States have worked towards the inclusion of women in clinical trials and appropriate analysis of sex-specific data from clinical trials. This review outlines the history and progress of women’s inclusion in clinical trials for prescription drugs and presents considerations for researchers, clinicians, and academicians on this issue.
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Résumé : La variation de la [Ca2+] intracellulaire participe à nombreux de processus biologiques. Les cellules eucaryotes expriment à la membrane plasmique une variété de canaux par lesquelles le calcium peut entrer. Dans les cellules non excitables, deux mécanismes principaux permettent l'entrée calcique; l'entrée capacitative de Ca2+ via Orai1 (SOCE) et l'entrée calcique activé par un récepteur (ROCE). Plusieurs protéines clés sont impliquées dans la régulation de ces voies d'entrée calcique, ainsi que dans l'homéostasie calcique. TRPC6 est un canal calcique impliquée dans l'entrée calcique dans les cellules à la suite d’une stimulation d’un récepteur hormonal. TRPC6 transloque à la membrane cellulaire et il y demeure jusqu'à ce que le stimulus soit retiré. Les mécanismes qui régulent le trafic et l'activation de TRPC6 sont cependant encore peu connus. Des découvertes récentes ont démontré qu'il y a un rôle potentiel de Rho kinase dans l'activité de TRPC6. Rho kinase est activée par la petite protéine G RhoA qui peut être activée par les protéines G hétérotrimériques Gα12 et Gα13. En plus de Gα12 et Gα13, les protéines de désensibilisation des GPCR β -arrestin 1 et / ou β-arrestin 2 peuvent aussi activer RhoA. Le but de notre étude est d'examiner la participation des protéines Gα12/13 et β-arrestin 1/ β-arrestin 2 dans l'activation de TRPC6 et de la protéine Orai1. Nous avons utilisé des ARN interférant (siRNA) spécifiques pour induire une réduction de l'expression de Gα12/13 ou β-arrestin 1/β-arrestin 2. La conséquence sur l’entrée de Ca2+ dans les cellules a été ensuite déterminée par imagerie calcique en temps réel suite à une stimulation par la vasopressine (AVP), thapsigargin ou carbachol. Nous avons donc identifié que dans des cellules A7r5, une lignée cellulaire de musculaires lisses vasculaires où le canal TRPC6 exprimé de manière endogène, la diminution de l’expression des protéines Gα12 ou Gα13 ne semble pas modifier l’entrée Ca2+ induit par l’AVP par rapport aux cellules témoins. D'autre part, la diminution de l’expression β-arrestin 1 ou β-arrestin 2 dans des cellules HEK 293 ainsi que des cellules HEK 293 exprimant de façon stable TRPC6 (cellules T6.11) ont augmenté l’entrée de Ca2+ induite par thapsigargin, un activateur pharmacologique de SOCE. Des études de co-immunoprécipitation démontrent une interaction entre la β-arrestin 1 et STIM1, alors qu'aucune interaction n'a été observée entre les β-arrestin 1 et Orai1. Nous avons de plus montré à l'aide d'analyse en microscopie confocale que la diminution de l’expression β-arrestin 1 ou β-arrestin 2 n’influence pas la quantité d’Orai1 à la périphérie cellulaire. Cependant, des résultats préliminaires indiquent que la diminution de l’expression β-arrestin 1 ou β-arrestin 2 augmente la quantité de STIM1-YFP dans l'espace intracellulaire et diminue sa quantité à la périphérie cellulaire. En conclusion, nous avons montré que les β-arrestin 1 ou β-arrestin 2 sont impliquées dans l'entrée capacitative de Ca2+ (SOCE) et contrôlent la quantité de STIM1 dans le réticulum endoplasmique.
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Kaposi's sarcoma (KS) is one of the most frequent neoplastic diseases in patients infected with human immunodeficiency virus (HIV). The authors report the case of a 40-year-old male with ascites, peripheral edema and peritoneal carcinomatosis secondary to a gastric KS related to human herpes virus type 8 (HHV-8). The patient had severe immunodeficiency, with a TCD4+ count of 86 cells/µl and newly diagnosed acquired immunodeficiency syndrome. His clinical condition rapidly deteriorated, with multiorgan failure, and he died without the possibility of initiating antiretroviral therapy or chemotherapy. To the authors’ knowledge, carcinomatosis is a rare feature in KS.