845 resultados para Partner Reponses to Sexual Issues


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Environmental shifts and lifestyle changes may result in formerly adaptive traits becoming non-functional or maladaptive. The subsequent decay of such traits highlights the importance of natural selection for adaptations, yet its causes have rarely been investigated. To study the fate of formerly adaptive traits after lifestyle changes, we evaluated sexual traits in five independently derived asexual lineages, including traits that are specific to males and therefore not exposed to selection. At least four of the asexual lineages retained the capacity to produce males that display normal courtship behaviours and are able to fertilize eggs of females from related sexual species. The maintenance of male traits may stem from pleiotropy, or from these traits only regressing via drift, which may require millions of years to generate phenotypic effects. By contrast, we found parallel decay of sexual traits in females. Asexual females produced altered airborne and contact signals, had modified sperm storage organs, and lost the ability to fertilize their eggs, impeding reversals to sexual reproduction. Female sexual traits were decayed even in recently derived asexuals, suggesting that trait changes following the evolution of asexuality, when they occur, proceed rapidly and are driven by selective processes rather than drift.

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Current increases in antifungal drug resistance in Candida spp. and clinical treatment failures are of concern, as invasive candidiasis is a significant cause of mortality in intensive care units (ICUs). This trend reflects the large and expanding use of newer broad-spectrum antifungal agents, such as triazoles and echinocandins. In this review, we firstly present an overview of the mechanisms of action of the drugs and of resistance in pathogenic yeasts, subsequently focusing on recent changes in the epidemiology of antifungal resistance in ICU. Then, we emphasize the clinical impacts of these current trends. The emergence of clinical treatment failures due to resistant isolates is described. We also consider the clinical usefulness of recent advances in the interpretation of antifungal susceptibility testing and in molecular detection of the mutations underlying acquired resistance. We pay particular attention to practical issues relating to ICU patient management, taking into account the growing threat of antifungal drug resistance.

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The interest in sexuality of adolescents in medical practice is often mainly focussed on the onset of sexual intercourse and on the emergence of contraceptive needs, though the beginning of adolescence takes place much earlier with the first signs of puberty followed by the menarche. At the issue of this profound metamorphosis the adolescent needs to adapt herself to a modified, sexual body. Adolescence is also a time of identity development and of changes in relationships, which are influenced by gender role in family and perception related to gender during childhood. This article shows epidemiological data to consider and the main issues of gynaecologic consultation with the adolescent. The different stages of development depend on biological and environmental factors which either favour resilience or weaken the individual due to a lack of affection or to abusive relationships. Medical consultation for a gynaecological problem, questions on puberty and development or on contraception give medical professionals and especially gynaecologists a chance to address sexual issues naturally, to anticipate questions as well as contraceptive needs. The consultation with the adolescent includes also the screening for behaviour related to a lack of information or a personal or relational difficulty.

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On June 9, 2009, the Northeast Iowa Highway 150/52 Coalition met with the Iowa Department of Transportation (Iowa DOT) in Cedar Falls, Iowa to discuss concerns regarding roadway conditions and safety which has become a concern because of the potential economic development in the area. In response to the issues raised by the coalition, the Iowa DOT requested that a road safety audit be conducted on the corridor to identify where low-cost improvements could be beneficially applied to address safety concerns.

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As the American population continues to grow older, aging and sexuality has become a frequent topic of discussion. Specifically, questions have been raised about if and how older adults experience sexual desire; how dementia and other age-related health issues impact an individual’s ability to express desire for and consent to sexual acts; and whether older adults forfeit their right to intimacy once they move into a long-term care facility. By federal law, individuals residing in long-term care are afforded multiple rights, many of which are relevant to sexuality. These rights include but are not limited to: the rights to privacy, confidentiality, dignity and respect; the right to make independent choices; and the right to choose visitors and meet in a private location. The OSLTCO strives to preserve these rights by promoting attitudes of awareness, acceptance, and respect of sexual diversity.

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Tässä työssä käsitellään niitä motiiveja, haasteita ja menestystekijöitä, jotka vaikuttavat lisäarvoatuottavassa liiketoimintaverkostossa. Työssä on selvitetty sitä, miten partneriverkostot syntyvät sekä mitkä seikat vaikuttavat siihen jatkuuko yhteistyö vai ei. Motiiveja partneruuteen on tutkittu kirjallisuudesta sekä analysoimalla työssä esitettyä tapausta. Tässä työssä käydään keskustelua myös partneruuden elinkaaresta, jota ei ole käsitellyssä kirjallisuudessa tuotu esille. Työssä esitettyä tapausta arvioitiin lähettämällä siihen liittyneille henkilöille kysely. Kyselyiden lähettämisen jälkeen järjestettiin haastattelu kyselyyn vastanneiden kanssa. Lopputulokset perustuvat pitkälti haastateltujen henkilöiden kanssa käytyihin keskusteluihin. Kävi ilmi, että arvoa tuottavan partneriverkoston yksi tärkeimpiä tavoitteita on saavuttaa jatkuvuutta liiketoiminnallaan. Ainoastaan pitkäaikaisella partneruudella voidaan saavuttaa merkittäviä etuja markkinoilla. Siksi on tärkeätä, jo partnerin valinnassa, kiinnittää huomiota partneruuden jatkuvuuteen pitkällä tähtäimellä. Liiketoimintaverkostossa partneruudesta syntyvät tuotot ja niiden jakaminen on tärkein yksittäinen osaalue. Oleellista partneruuden jatkuvuudelle pitkällä tähtäimellä on jo partneria valittaessa se, että kyetään arvioimaan miten partneruudesta syntyvät tuotot jaetaan tasapuolisesti ja onko partneruudesta syntyvälle liiketoiminnalle jatkuvuutta. Jotta partneriverkostolle asetetut tavoitteet voitaisiin saavuttaa, on tärkeää suunnitella partneriverkoston hallintaa myös operatiivisella tasolla. Lisäksi tärkeää on jakaa verkostolle asetetut yhteiset tavoitteet organisaatioiden sisällä. Jos ylemmänja operatiivisen tason johdon yhteistyö on riittämätöntä, se vaikeuttaa oleellisesti asetettujen tavoitteiden saavuttamista. Tiedon jakaminen aikaisessa vaiheessa sitouttaa eri sidosryhmät paremmin yhteisiin tavoitteisiin.

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Tämän diplomityön tavoitteena on vertailla maailmanlaajuisen sähköalan yhtiön kanavapartneriohjelmaa yhtiön kilpailijoiden vastaaviin ohjelmiin, sekä laatia yhtiön käyttöön konkreettinen työkalu kanavapartneriohjelmien vertailua varten. Tavoitteena on myös tutkimuksessa kerätyn tiedon perusteella selvittää yhtiön kanavapartneriohjelman vahvuudet ja heikkoudet. Tässä diplomityössä tutkimusongelmaa on ensin tarkasteltu kirjallisuuden valossa, keskittyen kirjallisuuteen kilpailijavertailusta sekä jakelukanavista. Kilpailijavertailu, benchmark,on kuvattu tässä yhteydessä osana laadunhallintaa, painottaen yleisesti käytössä olevaa Campin 10 askeleen kilpailijavertailuprosessia. Tässä tutkimuksessa tarkasteltavat jakelukanavateoriat on jaoteltu kahteen osaan; jakelukanavan rakennetta käsitteleviin teorioihin sekä jakelukanavan hallintaa käsitteleviin teorioihin. Ensin mainitussa keskitytään lähinnä jakelukanavamalleihin ja -tyyppeihin, ja toisessa lähemmin partneri -käsitteeseen; kumppanuuteen, kanavapartnereihin ja kanavapartneriohjelmiin. Tavoitteena oli kerätä mahdollisimman tarkkaa ja ajankohtaista tietoa tutkimuksen kohteena olevien kilpailijayritysten kanavapartneriohjelmista. Tämä osoittautui varsin haastavaksi tehtäväksi. Tarpeeksi tietoa saatiin kuitenkin kerättyä sekä kirjallisuudesta että tehdyn kyselyn avulla, mikä mahdollisti alkuperäisenä tavoitteena olleen kilpailijavertailun sekä sen pohjalta tehdyt analyysit.

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BACKGROUND: Evidence suggests a relationship between exposure to trauma during childhood and functional impairments in psychotic patients. However, the impact of age at the time of exposure has been understudied in early psychosis (EP) patients. METHOD: Two hundred and twenty-five patients aged 18-35 years were assessed at baseline and after 2, 6, 18, 24, 30 and 36 months of treatment. Patients exposed to sexual and/or physical abuse (SPA) were classified according to age at the time of first exposure (Early SPA: before age 11 years; Late SPA: between ages 12 and 15 years) and then compared to patients who were not exposed to such trauma (Non-SPA). The functional level in the premorbid phase was measured with the Premorbid Adjustment Scale (PAS) and with the Global Assessment of Functioning (GAF) scale and the Social and Occupational Functioning Assessment Scale (SOFAS) during follow-up. RESULTS: There were 24.8% of patients with a documented history of SPA. Late SPA patients were more likely to be female (p = 0.010). Comparison with non-SPA patients revealed that: (1) both Early and Late SPA groups showed poorer premorbid social functioning during early adolescence, and (2) while patients with Early SPA had poorer functional level at follow-up with lower GAF (p = 0.025) and lower SOFAS (p = 0.048) scores, Late SPA patients did not. CONCLUSION: Our results suggest a link between exposure to SPA and the later impairment of social functioning before the onset of the disease. EP patients exposed to SPA before age 12 may present long-lasting functional impairment, while patients exposed at a later age may improve in this regard and have a better functional outcome.

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Tutkimuksen tavoitteena on selvittää Lappeenrannan teknillisen korkeakoulun (LTKK:n) koulutuksellista ja taloudellista vaikuttavuutta Etelä-Karjalassa ja kehittää sitä kuvaavia mittareita. Lisäksi selvitetään sidosryhmien näkemystä LTKK:n imagosta sekä osaamisen ja inhimillisen pääoman alueellista merkitystä. Tutkimus on luonteeltaan toiminta-analyyttinen, mutta sisältää myös käsite-analyyttisiä ja nomoteettisia piirteitä. Lähtökohtana vaikuttavuuden tarkastelussa pidetään yliopiston yhteiskunnallisia funktioita. Nämä funktiot ovat: opetus, tutkimus sekä olemassaolo ja toiminta. Tässä tutkimuksessa yliopisto nähdään inhimillisen pääoman kartuttajana, työvoiman tuottajana, työllistäjänä, rahavirtojen lähteenä, yhteistyökumppanina ja innovaatiokeskuksena. Myös yliopiston imagoa pidetään yhtenä vaikuttavuuden osatekijänä. Tutkimus sisältää sekä teoreettisen että empiirisen osan. Teoriaosassa käsitellään yliopiston vaikuttavuuteen liittyviä käsitteitä ja malleja, osaamisen alueellista merkitystä ja yliopiston roolia inhimillisen pääoman tuottajana sekä yliopiston imagon merkitystä. Tutkimukseen liittyi LTKK:sta vuonna 1997 – 2000 valmistuneille tehty kyselytutkimus sekä sidosryhmiin kohdistettu teema-haastattelu. Tutkimuksen empiriaosassa mitataan LTKK:n alueellista vaikuttavuutta opetukseen, tutkimukseen sekä olemassaoloon ja yhteistyöhön liittyvien mittareiden perusteella. Tutkimuksen perusteella voidaan todeta, että LTKK:n merkitys työvoiman tuottajana on voimakkaasti kasvanut, samoin kuin valmistumisen jälkeen Etelä-Karjalaan jäävien osuus. LTKK:sta valmistuneet pitävät koulutuksen antamia valmiuksia pääosin hyvinä, mutta työnantajat näkevät puutteita muun muassa johtamis- ja sosiaalisissa taidoissa. LTKK saa toiminnallaan aikaan huomattavia rahavirtoja ja on tärkeä yhteistyökumppani alueen muiden toimijoiden kannalta, lukuun ottamatta pienyrityksiä. LTKK:n imago on maakunnassa positiivinen, mutta sen valtakunnallinen tunnettuus on huono.

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Logistics management is increasingly being recognised by many companies to be of critical concern. The logistics function includes directly or indirectly many of the new areas for achieving or maintaining competitive advantage that companies have been forced to develop due to increasing competitive pressures. The key to achieving a competitive advantage is to manage the logistics function strategically which involves determining the most cost effective method of providing the necessary customer service levels from the many combinations of operating procedures in the areas of transportation, warehousing, order processing and information systems, production, and inventory management. In this thesis, a comprehensive distribution logistics strategic management process is formed by integrating the periodic strategic planning process with a continuous strategic issues management process. Strategic planning is used for defining the basic objectives for a company and assuring co operation and synergy between the different functions of a company while strategic issues management is used on a continuous basis in order to deal with environmental and internal turbulence. The strategic planning subprocess consists of the following main phases: (1) situational analyses, (2) defining the vision and strategic goals for the logistics function, (3) determining objectives and strategies, (4) drawing up tactical action plans, and (5) evaluating the implementation of the plans and making the needed adjustments. The aim of the strategic issues management subprocess is to continuously scan the environment and the organisation for early identification of the issues having a significant impact on the logistics function using the following steps: (1) the identification of trends, (2) assessing the impact and urgency of the identified trends, (3) assigning priorities to the issues, and (4) planning responses to the, issues. The Analytic Hierarchy Process (AHP) is a systematic procedure for structuring any problem. AHP is based on the following three principles: decomposition, comparative judgements, and synthesis of priorities. AHP starts by decomposing a complex, multicriteria problem into a hierarchy where each level consists of a few manageable elements which are then decomposed into another set of elements. The second step is to use a measurement methodology to establish priorities among the elements within each level of the hierarchy. The third step in using AHP is to synthesise the priorities of the elements to establish the overall priorities for the decision alternatives. In this thesis, decision support systems are developed for different areas of distribution logistics strategic management by applying the Analytic Hierarchy Process. The areas covered are: (1) logistics strategic issues management, (2) planning of logistic structure, (3) warehouse site selection, (4) inventory forecasting, (5) defining logistic action and development plans, (6) choosing a distribution logistics strategy, (7) analysing and selecting transport service providers, (8) defining the logistic vision and strategic goals, (9) benchmarking logistic performance, and (10) logistic service management. The thesis demonstrates the potential of AHP as a systematic and analytic approach to distribution logistics strategic management.

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The objective of this study is to gather information regarding the adaptation of the range of socio educational projects and services aimed at the transition to an adult life of young persons with intellectual disabilities in Spain. The research of the study has been done in three stages. During each stage, a specific tool has been used. One to one in-depth interviews have been undertaken with 45 professionals and 20 individuals with intellectual disabilities. The Delphi method has been applied to two panels consisting of 20 experts each. Firstly, results focus on the approach to different issues related to the devices. Secondly, the training opportunities that these individuals receive to ease the transition period is addressed. And finally, the study refers to the participation of the individuals themselves and their families in the process. The developed analysis allows us to propose strategies to improve the transition to adult life

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Online sexual solicitation (solicitation) of youth has received widespread media and research attention during the last decade. The prevalence rates of youth who have experienced solicitation or solicitation attempts vary between studies depending on the methodology used (e.g., whether youth or adults are the target study group). In studies focusing on youth victims, the prevalence of solicitation attempts made by adults during the past year is typically reported to be between 5 and 9%. Adults who solicit youth online have been found to use deception and other manipulative behaviors to gain access to sexual activities with youth. However, previous studies have lacked a control group of adults who solicit other adults online. Without this comparison, one could argue that deceiving others online about one’s identity, and engaging in manipulative behaviors, is an inherent part of most online sexual interactions with strangers. Additionally, little is known about the associations between manipulative behaviors and the solicitation outcomes. In research concerning offline sexual behaviors, it has been noted that situational factors, such as sexual arousal, may alter both sexual interest and behavior. The effects of situational factors on online sexual behaviors have been less extensively studied (especially so with a quantitative approach); no studies have to date focused on adults’ solicitation of youth. Investigating the role of a lowered sexual age preference and the role of situational factors in the soliciting adults could be an important step in order to receive deeper knowledge of the role of traits and states in the context of solicitation. Additionally, there is a lack of knowledge of the effect of the age of the youth. Although previous studies on solicitation has found that older youth, compared with younger youth and children, are more often solicited, the possible reasons for this have not been investigated. Are adults who solicit youth affected by legal deterrence (through the legal age of consent), is it because older youth are more available online, or are the adults’ age preferences merely a product of a normally distributed age preference in the population? The purpose of the present thesis was fivefold: 1) to obtain an estimate of the frequency of adults’ solicitation of youth as self-reported and observed in actual behavior; 2) to explore whether the legal age of consent (LAC) affects solicitation frequency, or whether a normally distributed sexual age preference more accurately describe the proportion of solicited youth of different ages; 3) to investigate the associations of both traits (e.g., lower sexual age preference) and states (immediate situational factors, such as alcohol intoxication), and the solicitation target; 4) to explore whether adults who solicit youth and adults who solicit adults are equally deceitful and manipulative online, and whether the different solicitation outcomes are as common in both groups; and 5) to investigate whether the deceitful and manipulative behaviors engaged in had different associations with the solicitation outcomes depending on the age of the solicited. In the survey study, a convenience sample of 1393 adult participants (aged 18 years or older) self-reported any online communication with strangers during the past year. Of these, 56% (776 respondents) reported that they had solicited or attempted to solicit at least one stranger. Of the respondents, 453 (58.4%) were men, and 323 (41.6%) were women. Participants with only adult contacts (18 years or older) constituted the majority (640 respondents). In contrast, 136 individuals reported a youth contact (a 13 year old or younger, or a 14 to 17-year old). Approximately half of the participants were men in the adult contact group, while 75% of the participants were men in the youth contact group. Approximately 60% of the participants with youth contacts were recruited from two websites associated with a pedophilic sexual interest. In an online quasi-experimental study, with researchers impersonating youth of different ages (10–18 year olds) in chat rooms, 251 online conversations with chat room visitors made up the entire sample. All chat room visitors alleged to be men. The self-reported frequency of having solicited youth (0–17-year olds) during the past year was approximately 10% in our sample of adults who reported communicating with any strangers online. When we observed this behavior in chat rooms, we found that approximately 30% of the chat room visitors who believed they interacted with a 10 to 14 year old attempted to solicit the youth. We found that solicitation attempts increased equally much when increasing the age of the impersonated youth from 14 to 16, as from 16 to 18. Thus, we concluded that a normally distributed age preference in the population was a more plausible explanation to the effect of the age of the solicited, rather than the LAC (here; 15 and 16). If the chat room visitors would have been deterred only by the LAC, we would have expected that the change in amount of solicitation attempts from an illegal age group to a legal age group would have been significantly stronger than changes between age groups within illegal-illegal and legal-legal groups. Our subsample of survey participants from the pedophilia-related websites expectedly reported that they had solicited youth more often in comparison to the sample gathered through general (i.e., not associated with any particular sexual preference) websites. We also found that participants with a youth contact reported higher levels of sexual arousal and shame before the sexual interaction with their online contact, compared with participants with an adult contact. Additionally, the participants with youth contacts who reported consumption of child- and adolescent pornography also reported being more sexually aroused before the interaction, compared to the participants with youth contacts who did not report consumption of these kinds of pornography. We also found clear indications that the online sexual interaction had an alleviatory effect on reported levels of sadness, boredom and stress, independent of the age of the contact. Generally, the participants with youth and adult contacts reported deceiving their contacts as often and suggesting keeping the communication a secret from someone as often. Participants with a youth contact, however, reported using more persuasion techniques for online sexual purposes or for the purpose of an offline meeting, compared to those with an adult contact. In the chat rooms, we found that more indirect ways of future sexual communication (e.g., continuing chatting) was suggested by the chat room visitors that were under the assumption of interacting with youth aged 10 to 14, compared with more direct means (e.g., meeting offline). Survey participants with youth contacts who had used deception, suggested keeping the interactions a secret, and/or persuaded their contact by appealing to the contacts feelings of love and attachment for the participant had also more often engaged in cybersex with the contact. No other manipulative behaviors were associated with the other investigated solicitation outcomes (receiving a sexual picture, meeting offline, and engaging in sexual contact offline) within this group of participants. However, using deception, suggesting secrecy and using persuasion was also positively associated with certain solicitation outcomes within participants with an adult contact. In summary, adults’ solicitation of youth is much more frequent when observed in chat rooms than self-reported. Additionally, an underlying lowered sexual age preference seems to be a motivating factor on a group level in adults who solicit youth. We concluded that directed prevention efforts should be made on pedophiliarelated websites. Additionally, the role of situational factors, especially sexual arousal in persons with a pedo- or hebephilic sexual interest should be investigated further in the context of online sexual solicitation.

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If electricity users adjusted their consumption patterns according to time-variable electricity prices or other signals about the state of the power system, generation and network assets could be used more efficiently, and matching intermittent renewable power generation with electricity demand would be facilitated. This kind of adjustment of electricity consumption, or demand response, may be based on consumers’ decisions to shift or reduce electricity use in response to time-variable electricity prices or on the remote control of consumers’ electric appliances. However, while demand response is suggested as a solution to many issues in power systems, actual experiences from demand response programs with residential customers are mainly limited to short pilots with a small number of voluntary participants, and information about what kinds of changes consumers are willing and able to make and what motivates these changes is scarce. This doctoral dissertation contributes to the knowledge about what kinds of factors impact on residential consumers’ willingness and ability to take part in demand response. Saving opportunities calculated with actual price data from the Finnish retail electricity market are compared with the occurred supplier switching to generate a first estimate about how large savings could trigger action also in the case of demand response. Residential consumers’ motives to participate in demand response are also studied by a web-based survey with 2103 responses. Further, experiences of households with electricity consumption monitoring systems are discussed to increase knowledge about consumers’ interest in getting more information on their electricity use and adjusting their behavior based on it. Impacts of information on willingness to participate in demand response programs are also approached by a survey for experts of their willingness to engage in demand response activities. Residential customers seem ready to allow remote control of electric appliances that does not require changes in their everyday routines. Based on residents’ own activity, the electricity consuming activities that are considered shiftable are very limited. In both cases, the savings in electricity costs required to allow remote control or to engage in demand response activities are relatively high. Nonmonetary incentives appeal to fewer households.

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The purpose of this study was to examine the perceived preparedness of college students for the transition from college to full-time employment. The study was concerned with the interest and rationale behind developing a required Exit Course for college students in order to improve the college to work transition. As well, possible content of an Exit Course was evaluated. The importance of addressing college to work transitions is highlighted by two phenomena. First, there are specific employability skills that employers in Canada are seeking in newly hired employees. Second, the provincial government in Ontario is determining college funding based on graduate employment statistics which are measured by graduate satisfaction, graduate employment, and employer satisfaction. The research concentrated on the following stakeholders involved in the transition from college to work: (a) current students, (b) recent graduates, (c) support staff who assist students in college to work transition (Career Educators), and (d) employers. Through qualitative research, including focus groups and interviews, these stakeholder groups participated in the research to determine if the Exit Course was a viable solution to facilitate the transition from college to work. Focus groups were conducted with current students, while one-on-one, semi-structured interviews were conducted with recent graduates, Career Educators, and employers. Common themes elicited from the participants included the following: (a) although students were perceived by the participants of this study to be technically prepared for employment, they were perceived to have weak job search skills and unrealistic expectations of the world of work unless they had received the benefits of a Co-operative Education experience; (b) an Exit Course was seen as a viable solution to the issues involved in college to work transition; (c) an Exit Course should be comprised of skills necessary to obtain and succeed in a job and the course should be taught by individuals with extensive qualifications in this area; and (d) there is a need to develop college and business partnerships to ensure that students are connected to employers. Educators within post secondary institutions, specifically colleges, can benefit from the information provided within this study to gain a better understanding of the perceived level of preparedness of students for the transition from college to work. Suggestions with regard to how to improve this transition were made, with specific reference to the addition of an Exit Course as one possible solution.

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This qualitative study was designed to inquire about the barriers to participation within the fitness industry for people living with mobility challenges. i\n examination of the insights, stolies~ and experiences with barriers through interviews gi ven by 4 people living with mobility challenges (PMC) formed the core of the research. An analysis of the interviews from the 4 PMC informants was performed at t\\/O levels. First, a content analysis served to identify general and specific categories related to barrier issues within various fitness environments. Secondly, in-depth thematic analyses of the entries related to the insights and stories from the 4 informants which emerged from the content analysis of the data gave rise to fi ve thematic statements. From the thematic statements a fitness industry awareness protocol was created in the fonn of a statement response questionnaire. The protocol, which was given to 4 fitness assessors/trainers, \vas used to provide a snapshot of the fitness industry's readiness to work vvith disability. Throughout the process, the four PNIC informants formed a collaborati vely involved group of coresearchers, adding their voices to the narrative of the fitness-barrier experience. The result of the study suggests that barriers to participation within the fitness industry for PMC exist in various forms and levels of severity. The results also suggest that the fitness industry needs to better prepare their people and environment for working with people with physical disabilities, such as PMC, and provide a more open and positi ve environment for participation. Within the context of any fitness-related environment, recognizing that barriers to participation do exist, and acknowledging and accepting people with disabilities for who they are as indi viduals, will serve to develop a relationship where fitness practitioners and people with disabilities can work towards creating an inviting, inclusive, accessible, and barrier-free fitness environment for all.