The current research emerged in response to recent alerts of increasing organisational safety failures in New Zealand’s high risk industries. It was theorized that safety climate may be largely determined by the quality of safety-centered leadership under which an organisation operates. The study utilized reports of organisational safety prosecutions within New Zealand to develop a quasi-experimental design which compared persecuted and non-prosecuted company’s leaders on measures of ethical values, moral philosophy, social responsibility, corporate psychopathy, and leadership style. Issues of response rate inherent to the study design were encountered during data collection, and no significant between group differences consistent with the study predictions were found. Theoretical and practical interpretations are made in light of the results, suggesting that dynamics within group-decision processes and the top governing structure of companies may be significant factors in affecting leader safety performances within these industries.

In the United States, the rates of unplanned pregnancies and sexually transmitted diseases, including HIV infection, caused by unprotected sex is alarmingly high. Adverse outcomes of unprotected sexual intercourse continue to be a burden, not only for affected adolescents but for the community at large. Using data from the National Longitudinal Study of Adolescent Health, this study applied the PRECEDE model as a means to identify those salient risk factors and risk conditions of sex initiation and engagement in unprotected sex among adolescent students. Results showed that 52.6% of the students have had sexual intercourse and 54.5% of sexually experienced students reported inconsistent condom use during sexual intercourse. Logistic regression analysis showed that risks factors for having had sexual intercourse differ from those for having engaged in unprotected sex in sexually experienced students. Furthermore, these factors also differed between male and female students. Only students’ age and perceived hardships related to pregnancy were found to be common risk factors for both outcomes in both sex groups. Results suggest that the PRECEDE is a practical tool to aid program planners identify the intervention priorities most relevant to their target populations.

No description available.

Background: The effectiveness of paraprofessional home-visitations on improving the circumstances of disadvantaged families is unclear. The purpose of this paper is to systematically review the effectiveness of paraprofessional home-visiting programs on developmental and health outcomes of young children from disadvantaged families. Methods: A comprehensive search of electronic databases (e.g., CINAHL PLUS, Cochrane, EMBASE, MEDLINE) from1990 through May 2012 was supplemented by reference lists to search for relevant studies. Through the use of reliable tools, studies were assessed in duplicate. English language studies of paraprofessional home-visiting programs assessing specific outcomes for children (0-6 years) from disadvantaged families were eligible for inclusion in the review. Data extraction included the characteristics of the participants, intervention, outcomes and quality of the studies. <p>Results: Studies that scored 13 or greater out of a total of 15 on the validity tool (n = 21) are the focus of this review. All studies are randomized controlled trials and most were conducted in the United States. Significant improvements to the development and health of young children as a result of a home-visiting program are noted for particular groups. These include: (a) prevention of child abuse in some cases, particularly when the intervention is initiated prenatally; (b) developmental benefits in relation to cognition and problem behaviours, and less consistently with language skills; and (c) reduced incidence of low birth weights and health problems in older children, and increased incidence of appropriate weight gain in early childhood. However, overall home-visiting programs are limited in improving the lives of socially high-risk children who live in disadvantaged families.</p> <p>Conclusions: Home visitation by paraprofessionals is an intervention that holds promise for socially high-risk families with young children. Initiating the intervention prenatally and increasing the number of visits improves development and health outcomes for particular groups of children. Future studies should consider what dose of the intervention is most beneficial and address retention issues.</p> / http://www.biomedcentral.com/1471-2458/13/17

Prostate cancer is the most common cancer among Canadian men. The standard treatment in high-risk category is radical radiation, with androgen suppression treatment (AST). Significant disease progression is reported despite this approach. Radiation dose escalation has been shown to improve disease-free survival; however, it results in higher toxicities. Hypofractionated radiation schedules (larger dose each fraction in shorter overall treatment time) are expected to deliver higher biological doses. A hypofractionated scheme was used in this study to escalate radiation doses with AST. Treatment was well tolerated acutely. Early results of self-administered quality of life reported by patients shows a decrease in QOL which is comparable to other treatment schedules. Significant positional variation of the prostate was observed during treatment. Therefore, we suggest daily target verification to avoid a target miss. Initial late effects are reasonable and early treatment outcomes are promising. Longer follow-up is required for full outcomes assessments.

Thesis (Ph.D.) -- University of Texas Southwestern Medical Center at Dallas, 2006. / Not embargoed. Vita. Bibliography: 196-222.

The findings of this PhD provide a significant contribution to early intervention research. The ability to detect those at ultra-high risk for psychosis (UHR) has been made possible in recent years. It is well known that people with serious mental illness have poor physical health, yet prior to this PhD little was known about the physical health of UHR individuals. This PhD explores the physical health and lifestyle of the UHR group, and makes recommendations for the development of a physical health intervention. A range of methods have been used including quantitative and qualitative methods, systematic reviews and meta-analyses, and a clinical audit. Therefore, a multifaceted approach to investigate the physical health and lifestyle of UHR individuals has been taken. Papers 1-3 suggest UHR individuals are more likely to live an unhealthy lifestyle than their peers. This includes lower levels of physical activity, and higher levels of substance use (generally cannabis, tobacco and alcohol). Paper 4 contains a clinical audit showing physical health and lifestyle factors are not monitored routinely in early detection services, despite the UHR phase being an ideal opportunity to intervene. Living an unhealthy lifestyle can have a detrimental effect on physical and mental health. Papers 1-4 emphasise the need to intervene to promote a healthy lifestyle for the UHR group. In line with the Medical Research Guidelines for the development of complex interventions, a theoretical model is applied in Paper 5. The final paper presents a qualitative study with UHR individuals, their parents and clinicians to explore barriers and facilitators to living a healthy lifestyle and inform the development of a physical health intervention. A final evidence synthesis includes recommendations for future work and the clinical implications of this thesis. The findings of this PhD provide an important and timely contribution to early intervention research. Prior to this work, the physical health of UHR individuals had been largely under researched. For the first time, this PhD presents evidence to suggest individuals at ultra-high risk for psychosis experience cardiovascular risk, and there is an opportunity to intervene to promote physical health. Although not all UHR individuals will develop psychosis, many will continue to experience difficulties with their mental health. Given that this group are also more likely to live an unhealthy lifestyle, it is important to take a holistic approach to treating those at imminent risk for psychosis, considering both mental and physical health.

Submitted by DENISE DE TOLEDO RÓS (denise_ddi@hotmail.com) on 2018-10-17T23:26:49Z No. of bitstreams: 1 Dissertação final- Denise Rós.pdf: 2181491 bytes, checksum: 2f8c2f248e464243102048dda1e2bac7 (MD5) / Approved for entry into archive by Ana Paula Rimoli de Oliveira null (anapaula@foa.unesp.br) on 2018-10-18T12:58:12Z (GMT) No. of bitstreams: 1 rós_dt_me_araca_int.pdf: 2181491 bytes, checksum: 2f8c2f248e464243102048dda1e2bac7 (MD5) / Made available in DSpace on 2018-10-18T12:58:12Z (GMT). No. of bitstreams: 1 rós_dt_me_araca_int.pdf: 2181491 bytes, checksum: 2f8c2f248e464243102048dda1e2bac7 (MD5) Previous issue date: 2018-09-27 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A gestação é um período especial na vida de toda mulher, e visando o bem estar da família e melhoria das condições de saúde o acompanhamento de uma equipe multiprofissional é preconizado. Os Objetivos de Desenvolvimento do Milênio proposto pela Organização das Nações Unidas (ONU), devido a relevância da temática, apresentaram metas e ações específicas para a redução da mortalidade materno-infantil. Dentre as ações destacam-se a ampliação do acompanhamento pré-natal e o incentivo ao aleitamento materno. Os objetivos nesta pesquisa foram: investigar a morbidade bucal referida e o uso de serviços odontológicos por gestantes de alto risco e analisar a intenção de aleitamento materno destas gestantes. Foi realizada pesquisa transversal, com 1200 gestantes de alto risco, que realizaram acompanhamento pré-natal no Ambulatório Médico de Especialidades (AME) do município de Araçatuba. Na coleta de dados foram realizadas entrevistas padronizadas, utilizando-se formulário específico previamente testado em estudo piloto, com entrevistadores calibrados e em local apropriado. As variáveis dependentes foram: o uso do serviço odontológico, a condição bucal autorreferida, intenção de amamentação exclusiva e histórico de amamentação anterior. Para processamento dos dados foram empregados os softwares Epi Info 7.4.1, Bioestat 5.3 e IRAMUTEQ 0.7.2.0. O teste qui-quadrado ao nível de significância de 5% foi empregado para análises quantitativas. Do total de entrevistadas, 40,08% realizaram sua última consulta odontológica com mais de 1 ano, 72,17% relataram de “regular” a “muito ruim” seus dentes e gengivas e 75,58% afirmaram terem tido dor de origem dentária. A condição bucal autorreferida esteve associada com a idade (p=0,0156), escolaridade (p<0,0001), renda (p<0,0001), ocupação (p<0,0001), estado civil (p<0,0001) e com o uso do serviço (p<0,0001), e a consulta odontológica mostrou associação com idade (p=0,0194) e ocupação (p=0,0016). Sobre a amamentação, 8,76% das gestantes apresentavam condições que poderiam afetar o aleitamento. A pretensão de amamentação exclusiva foi afirmada por 93,83%, sendo 69,86% até os 6 meses. O histórico de amamentação anterior mostrou associação com pretensão de amamentação exclusiva (p=0,0165), período de amamentação pretendido (p<0,0001), apoio familiar (p=0,0494) e escolaridade (p=0,0472). A análise qualitativa mostrou, por meio de nuvem de palavra e análise de similitude, que os motivos mais relevantes para a recusa de amamentação exclusiva foram: HIV, uso de medicação, trabalho e falta de informação. Conclui-se que, apesar da condição bucal ser relatada de “regular” a “muito ruim” por parte das pacientes, o uso do serviço odontológico por gestantes de alto risco ainda foi baixo. A maioria das gestantes de alto risco pretendiam amamentar exclusivamente no peito por um período de 6 meses, no entanto, algumas condições poderiam interferir na amamentação. O histórico de amamentação de outros filhos influenciou a intenção de amamentar. / Gestation is a special period in the life of every woman , and aiming at the well - being of the f amily and improvement of health conditions, the follow - up of a multiprofessional team is recommended. Th e Millennium Development Goals proposed by the United Nations (UN), due to the relevance of the theme, presented specific goals and actions to reduce maternal an d child mortality . A mong the actions were the expansion of prenatal care and the encouragement to breastfeeding. The objective s of this research w ere: to investigate the mentioned oral morbidity and the use of dental services by high risk pregnant women an d to analyze the intention of breastfeeding of these pregnant women . A cross - sectional study was carried out with 1200 high - risk pregnant women who underwent prenatal care at the Medical Specialist Ambulatory (MSA) in the city of Araçatuba. In the data col lection, standardized interviews were performed using a specific form previously tested in a pilot study, with interviewers calibrated and in an appropriate place. The dependent variables were: the use of the dental service, the self - reported oral conditio n, exclusive breastfeeding intention and previous breastfeeding history. For data processing, the software Epi Info 7.4.1, Bioestat 5.3 and IRAMUTEQ 0.7.2.0 were used. The chi - square test at the significance level of 5% was used for quantitative analysis. From the total respondents, 40.08% had visited the dental office over 1 year ago, 72.17% reported their teeth and gingiva as "fair" or "very poor", and 75.58% reported having had a toothache. The self - reported oral condition was related to age (p=0.0156), level of education (p<0.0001), income (p<0.0001), occupation (p<0.0001), marital status (p<0.0001), and dental care utilization (p<0.0001) , and dental appointments showed association with age (p=0.0194) and occupation (p=0.0 016). Ab out breastfeeding, 8.76% of pregnant women had conditions that could affect breastfeeding. The intention of exclusive breastfeeding was affirmed by 93.83%, being 69.86% up to 6 months. Breastfeeding history showed association with exclusive breastf eeding (p=0.0165), intended breastfeeding period (p<0.0001), family support (p=0.0494) and schooling (p=0.0472). The qualitative analysis showed, through word cloud and similarity analysis, that the most relevant reasons for refusing exclusive breastfeedin g were: HIV, medication use, work and lack of information . It was concluded that, although the oral condition was reported from "regular" to "very poor" by the patients, the use of dental service by high - risk pregnant women still low. Most high - risk pregna nt women intended to exclusively breastfeed for a period of 6 months, however, some conditions could interfere with breastfeeding. The history of breastfeeding of other children influenced the intention to breastfeed.

With the growing number of children who receive a diagnosis of Autism Spectrum Disorder (ASD), there is an increasing need to identify risk markers that will allow for earlier diagnosis of this disorder. Since no single atypical behavior has been found that is shared by all 12-month-old infants who are later diagnosed with ASD, it is likely that a constellation of markers combine in a way that is more predictive of outcome at this age. Establishing a Cumulative Risk Index (CRI) is one way to investigate which combination of early risk markers is most predictive of later ASD diagnostic outcome. Temperament is one construct of behavior that could act as an early risk marker for ASD and therefore, could add predictive power to a CRI for this disorder. Temperament is defined as a "behavioral style" that includes individual differences in reactivity and self-regulation and emphasizes emotional, attentional and activity related characteristics. Another important aspect of temperament is that it exerts bidirectional influences upon the social environment. Therefore, the study of temperament could provide a method for understanding how children with ASD influence and are influenced by the environment of a testing session. Though important information has been collected about early temperament in children with ASD, much of the data is limited due to its dependence on retrospective and parent-report measures. One measure that allows for direct assessment of temperament during a controlled testing session is the Infant Behavior Record (IBR). The purpose of this study is to investigate early temperament in ASD by using the IBR as an assessment of temperament behaviors in high-risk 12-month old infants. Through this, we hope to reveal group differences in IBR scores, establish a relationship between temperament scores and cognitive test performance, and increase predictive value of the CRI when IBR scores are included. For this study, a revised version of the IBR was filled out while watching video record of the administration of the Mullen Scales of Early Learning (MSEL) at an infant's 12-month lab visit. Scores for the IBR reflected the examiner's impressions of the infant's orientation to objects and people and emotional state. Through using the IBR to study task orientation (TO), affect/extraversion (AE) and activity level (AL) in high-risk infants, this study found that only decreased AE behaviors distinguished high-risk infants who went on to develop ASD (HRA+ASD) from high-risk infants who did not receive an ASD diagnosis (HRA-ASD) (p=.08). To determine the relationship of temperament and cognitive assessment performance, IBR scores were compared to MSEL scores. This study found that across all participants, TO and AE behaviors were positively correlated with MSEL scores (AE rs=.27, p<.001; TO rs=.37, p<.001). This relationship remained true for both the high-risk (AE rs=.20, p<.001; TO rs=.23, p<.001) and the low risk groups (AE rs=.32, p<.001; TO rs=.54, p<.001), as well as for the HRA-ASD infants (AE, trend, p=.057; rs=.24, p<.001; TO rs=.459, p<.001), and the low-risk infants who did not go on to receive a diagnosis of ASD (AE rs=.35, p<.001; TO rs=.47, p<.001). The only group in this study that was found to have no correlations between temperament scores and MSEL scores was HRA+ASD. Since only AE behaviors distinguished HRA+ASD infants, this was the only IBR factor added to a pilot model of the CRI. This study found that the inclusion of AE to a pilot model of the CRI did not add significant predictive value to the model (p=.15). Through using the IBR to investigate temperament in HRA infants, the findings of this study suggest that there are some important differences in temperament behaviors for HRA+ASD infants. Specifically, reduced AE behaviors seem to distinguish the HRA+ASD infants from the other outcome groups. Also, this study found that increased TO and AE behaviors were associated with better performance on a cognitive assessment for all groups except HRA+ASD. These two findings are important, as they differentiate this outcome group from all others, suggesting that there may be a different set of mechanisms employed during a testing session for HRA+ASD infants. This study also found that AE risk did not contribute predictive value to a CRI for this disorder. Taken together these findings suggest that though temperament profiles appear to differ in HRA+ASD infants during the first year of life, this construct of behavior is not a valuable early behavioral risk marker for identifying ASD.

Neonatology is a field of medicine in which immense progress has been seen during the past two decades. As the frontiers of this area are shifting forwards, ethical problems and issues regarding the quality of life of the rescued infants and children grow in importance. Now it is clear that the development and health of children that were endangered in the perinatal period should continue to be followed up by healthcare professionals, sometimes for many years. Ideally, this care should seamlessly follow hospital care. It was the aim of this work to examine how this continuity of care of high-risk newborns is implemented in practice. This Thesis consists of 2 parts: theoretical and practical. The theoretical part analyses the differentiation of newborn care as outlined in the Bulletin of the Czech Ministry of Health; defines the categories of newborns; and explains the basic terms used in the specific domain of high-risk newborns. Foreign experience in the provision of medical care at hospitals as well as in the continuing care after discharging from the hospital for home care is outlined. The empirical part of the Thesis was compiled based on qualitative research survey, accomplished with 3 aims in mind. The first aim was to map what type of care is provided to high-risk newborns at the Intensive Care & Resuscitation Unit of the Plzeň Teaching Hospital and who provides it. The second aim was to ascertain how the parents perceived their role during in-patient care of their babies and how they were educated and engaged in providing the care. And the last aim was to ascertain how the parents appreciated and liked the follow-up system at the Developmental Care Centre. It was found by the survey that the responders (mothers) appreciated most the comprehensiveness of the care provided by the Centre. They found the care adequate, beneficial and motivating. In their view, the desired care continuity had been achieved. The results attained within the empirical part will be presented at a workshop of the perinatology centre.