This research represents phase C in the development of Toddler NutriSTEP® (Nutrition Screening Tool for Every Preschooler). NutriSTEP® is a valid and reliable screening tool designed to assess nutritional risk in preschoolers (3-5 years). A draft toddler (18-35 months) version of NutriSTEP® has recently been developed because of an expressed need. Convenience samples of caregivers were recruited across Ontario to assess the test-retest reliability and construct validity of the tool. Test-retest reliability was assessed based on total score and attribute scores using paired sample t-tests and intraclass correlation coefficients; individual questions were assessed using Wilcoxcon signed rank tests and kappa statistics. Construct validity was assessed through comparison of high-risk groups to Toddler NutriSTEP® scores, as well as through exploratory and confirmatory factor analyses. Toddler NutriSTEP® was found to be test-retest reliable and construct valid, and therefore may be used to assess nutritional risk in Canadian toddlers. / Funded by the Canadian Institutes of Health Research

Child abuse and neglect occur in epidemic numbers in the United States and around the world, resulting in major physical and mental health consequences for abused children in the present and future. A vast amount of information is available on the signs and symptoms and short- and long-term consequences of abuse. A limited number of instruments have been empirically developed to screen for child abuse, with most focused on physical abuse in the context of the emergency department, which have been found to be minimally effective and lacking rigor. This literature review focuses on physical, sexual, and psychological abuse and neglect, occurring in one or multiple forms (polyabuse). A systematic, in-depth analysis of the literature was conducted. This literature review provides information for identifying children who have been abused and neglected but exposes the need for a comprehensive screening instrument or protocol that will capture all forms of child abuse and neglect. Screening needs to be succinct, user-friendly, and amenable for use with children at every point of care in the healthcare system.

This thesis investigates factors behind the implementation of ideas within organizations, particularly examining the conditions under which employees are willing to advocate for and invest in the implementation of ideas. This study is addressing the need to understand how organizations can continuously evolve through implementing ideas to maintain their competitive advantage. The study was conducted at a paper and pulp mill operated by Stora Enso, employing a survey-based method to assess how various factors influence employees' willingness to embrace and execute new ideas. Furthermore, it examined the impact of generative screening, an interactive process intended to refine ideas through collaboration and employee involvement. Findings reveal that while generative screening significantly improves how implementable ideas are perceived, it does not consistently impact their appeal or the emotional commitment of employees towards these ideas. This suggests that employing generative screening significantly enhances the practical aspects of the implementation process. Further, the research identifies elements such as perceived idea quality and emotional investment as significant drivers of idea implementation. It demonstrates that practical enhancements through generative screening and emotional factors such as engagement and ownership, must be balanced to effectively foster innovation adoption. This study contributes to the field of innovation management by highlighting the need for organizations to create environments that not only generate but also support the practical and psychological aspects of implementing ideas. Additionally, it empirically tests the implications of generative screening. The insights also provide practical implications for enhancing innovation practices, suggesting strategies to ensure ideas are appealing, sustainable, and viable in practice. / Denna uppsats undersöker underliggande faktorer bakom implementeringen av idéer inom organisationer, med särskilt fokus på de förutsättningar under vilka anställda är villiga att förespråka och investera i att genomföra idéer. Studien behandlar behovet av att förstå hur organisationer kontinuerligt kan utvecklas genom att implementera idéer för att behålla sina konkurrensfördelar. Studien genomfördes vid en massa- och pappersfabrik som drivs av Stora Enso genom en enkätbaserad metod för att bedöma hur olika faktorer påverkar de anställdas vilja att genomföra och implementera idéer. Vidare undersöktes påverkan av så kallad generativ screening, en interaktiv process avsedd att förfina idéer genom samarbete samt anställdas delaktighet. Resultaten visar att medan generativ screening avsevärt förbättrar hur genomförbara idéer uppfattas påverkas inte deras kvalitet eller de anställdas engagemang för dessa idéer. Detta tyder på att användningen av generativ screening signifikant förbättrar den praktiska implementeringsprocessen. Vidare identifierar studien element så som upplevd idékvalitet och emotionell investering som betydande drivkrafter för att implementera idéer. Detta visar att praktiska förbättringar genom generativ screening och emotionella faktorer som engagemang och ägarskap måste balanseras för att effektivt främja innovationer. Denna studie bidrar till området innovationsledning genom att lyfta fram behovet för organisationer att skapa miljöer som inte bara genererar utan också stödjer de praktiska och psykologiska aspekterna av att implementera idéer, samt testar konsekvenserna av generativ screening empiriskt. Insikterna ger också praktiska implikationer för att förbättra innovationspraxis och föreslår strategier för att säkerställa att idéer är attraktiva, hållbara och genomförbara i praktiken.

Obwohl fetale Mißbildungen seit langem bekannt sind, wird eine intensive Prüfung von Arzneimitteln und anderen Substanzen erst seit den 1960er Jahren durchgeführt. Dem Tierschutzbericht von 2001 ist zu entnehmen, daß im Jahr 1999 insgesamt etwa 1,6 Millionen Wirbeltiere zu Versuchszwecken benötigt wurden. Als mögliche Alternative zu Untersuchungen mit Säugetieren wurde ein Testmodell mit Embryonen des Zebrabärblings (D. rerio) entwickelt. Ziel der vorliegenden Arbeit ist es zu klären, ob sich mit den Embryonen von Danio rerio ein teratogenes Potential von Substanzen erkennen und quantifizieren läßt. Dazu wurde DarT (?Danio rerio Teratogenicity Assay?) als Teratogenitäts-Screening Test entwickelt. Es können anhand von toxikologischen Endpunkten sowohl die letalen als auch die subletalen Wirkungen von Substanzen bestimmt werden. Darüber hinaus werden anhand von teratogenen Endpunkten speziell Malformationen erfaßt. Der Vergleich der beobachteten Effekte und der daraus berechneten Wirkkonzentrationen gestattet eine Einschätzung des teratogenen Potentials von Substanzen. Die im DarT erzielten Ergebnisse werden mit der bekannten Zuordnungen des ?säugerteratogenen? Potentials verglichen. Für 88 % der getesteten Substanzen gibt DarT die aus säugertoxikologischen Untersuchungen bekannten Einordnungen hinsichtlich des teratogenen Potentials wieder. Für 10 % der Testsubstanzen wurde das teratogene Potential zu hoch, für 2 % zu niedrig eingeschätzt. Mit dem Testsystem ?Danio rerio Teratogenicity Assay ? DarT? ist ein Vergleich von Substanzen hinsichtlich ihres teratogenen und allgemein toxischen Potentials möglich. In einem Modell können Wirkkonzentrationen und Konzentrations-Wirkungs-Beziehung ermittelt und direkt verglichen werden. Mit DarT kann eine große Anzahl von Substanzen zeit- und kostengünstig untersucht werden. Die aus Untersuchungen mit Säugetieren bekannten Zuordnungen der teratogenen Potentiale von Substanzen wird gut wiedergegeben.

No description available.

The aim of this study was to adapt the Kessler Psychological Distress Scale (K10) for Argentinean population. We conducted a linguistic adaptation of the instrument and an analysis of its psychometric properties. To assess the reliability of the scale, analysis of internal consis- tency was made through Cronbach’s alpha and temporal stability of the items was examined in two different subsamples. In addition, the scale’s validity was assessed, taking into account convergent validity, criterion validity by contrasting groups and factorial composition of the K10. Receiver Operating Characteristic (ROC) analysis was carried out to assess sensitivity, specificity and the area under the curve (AUC). The results of the present study indicate that the K10 is an adequate instrument presenting strong psychometric properties for screeningpsychological distress in our environment. / El objetivo del presente trabajo fue realizar la adaptación argentina de la Escala de Malestar Psicológico de Kessler (Kessler Psychological Distress Scale-K10). Para esto, se llevó a cabo una adaptación lingüística del instrumento y un análisis de sus propiedades psicométricas. Para evaluar la confiabilidad de la escala, se efectuó un análisis de la consistencia interna y se examinó la estabilidad temporal de los ítems. La validez del instrumento fue evaluada teniendoen consideración diferentes indicadores de la misma. Se calcularon, a través de las curvas ROC, los niveles de sensibilidad, especificidad y el área bajo la curva (ABC) de la prueba. Los resultados indican que se puede contar con la K10 como un instrumento de despistaje de malestar psicológico que reúne los requisitos psicométricos necesarios para ser utilizado en población argentina.

No description available.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Background: One out of every three cancer diagnoses is a skin cancer, and the incidence of both melanoma and non‐melanoma type skin cancers is increasing. Skin cancers, including melanoma, are typically treatable if detected early. However, there is insufficient evidence to support recommendations to establish population based skin cancer screening programs. The specific aims of this study are 1) to evaluate characteristics of participants who attend a community skin cancer screening event and who are referred for follow up due to suspicious lesions, 2) to determine the proportion of participants with suspicious lesions identified at a community skin cancer screening event who complied with a request to visit a dermatologist or primary care physician, and 3) to evaluate attitudes toward sun protection practices, and perceived risk of developing skin cancer among participants who attend a community skin cancer screening and have a suspicious skin lesion. Methods: The Skin Cancer Institute sponsored a series of community skin cancer screening events in Tucson, Arizona from 2006 to 2013. Participants completed an American Academy of Dermatology screening form prior to a skin examination by a dermatologist. Participants with suspicious lesions identified at the examination who agreed to be contacted again received questionnaires 4 months after the initial screening to assess compliance with follow‐up recommendations, and their sun protection practices and risk perceptions. Results: 1979 community members attended the skin cancer screenings. The majority of the participants were Caucasian, females, had blue eyes and brown hair, were college educated, had no prior personal or family history of skin cancer, had health insurance but did not have a regular dermatologist, reported that they had never been to a skin cancer screening before, and stated that without this screening that they would not have their skin examined. 748 (37.8%) of community members were referred and instructed to see a dermatologist for further evaluation of a skin lesion. Of the 441 participants with a suspicious lesion who consented to participate in the follow‐up study, 120 returned a questionnaire; 90 (75%) reported that they followed up with a dermatologist or physician, and 30 (25%) did not. Of the 90 participants who followed up, 53% received a skin biopsy. The self reported diagnoses from the biopsies of the suspicious skin lesions were the following: 1% atypical or dysplastic nevus, 21% actinic keratosis, 16% basal cell carcinoma, 8% squamous cell carcinoma, 2% melanoma, and 38% did not have skin cancer. Conclusions/Impact: This study demonstrated that 38% of community skin cancer screening participants were referred for follow up due to a suspicious skin lesion being identified during a skin cancer screening event. It also appeared that 75% of those who responded to the follow‐up questionnaire complied with the request within four months, although the response rate for the follow‐up questionnaire was low. Therefore, implementing a formal reminder system following the skin cancer screenings may increase the percentage of participants who follow up with a primary care physician or dermatologist after the screening for further evaluation of their suspicious skin lesion.

The health service provides a Child Health Programme (CHP) to all children to help them attain their health and development potential. Core elements include screening, immunisations, growth and development surveillance, health promotion advice, and parenting support. The surveillance/advice/support components (known as Child Health Surveillance CHS) are delivered through a series of universally offered child health reviews mainly provided by Health Visitors (HVs) supplemented by additional support as required. Scottish policy issued in 2005 led to considerable changes to the CHP. The number of CHS reviews was substantially reduced to enable more intensive support of children who required it. A three category indicator of need was introduced at the same time to facilitate the identification of children requiring enhanced support. This thesis aims to explore the shift to more targeted provision of CHS that occurred from 2005 onwards, and to examine the impact of this on the preventive health care provided to pre-school children. The specific objectives are: · To describe the development of professional guidance on the CHP and how this has been adopted into Scottish policy. · To compare the CHP provided in Scotland to that offered in other high income countries. · To examine the impact of the changes to CHS on the coverage of universally offered child health reviews. · To explore, following the changes to CHS, which factors are associated with children being identified as in need of enhanced CHP support. · To assess the impact of the changes to CHS on the totality of preventive care provided to pre-school children by HVs and General Practitioners (GPs). The key methods used are literature review, policy analysis, and analysis of routine health data. Selected findings include the following: · All the high income countries studied provide the same basic elements as the Scottish CHP but the detail of the different programmes varies considerably. Some of the variation may reflect the different needs of different populations, but much seems to reflect different approaches to evidence interpretation and policy making in different settings. · Not all children offered ‘universal’ child health reviews actually receive them. Children from deprived areas are less likely to receive their reviews. Inequalities in review coverage have remained unchanged after the changes to CHS. · Many factors, including those reflecting infant and maternal health and family social risk, are associated with being identified by HVs as needing enhanced CHP support. The threshold at which children are identified as needing enhanced support varies between areas across Scotland. · GP provision of child health reviews has reduced after the changes to CHS as would be expected. Recorded GP provision of other preventive care consultations is uncommon and has not changed. Currently available routine data do not allow trends in the totality of HV provided care to be examined. In summary, the Child Health Programme makes an important contribution to supporting young children and their families but it is a complex service and considerable uncertainty about aspects of its content and delivery remain.

published_or_final_version / Nursing Studies / Master / Master of Nursing