本研究採用「發展性」、「互動式」、「團體書目療法」的進行方式，選取中介班學生4位，高關懷學生7位，其中5男6女，共11位九年級學生，進行每周兩小時為一次，共十二次書目療法團體課程，並採用「青少年心理健康量表」做為研究工具，蒐集11位成員在書目療法團體前後，關於「憂鬱向度」、「焦慮向度」、「自傷向度」、「衝動向度」、「精神困擾」等心理構念的百分等級變化情形，並輔以訪談資料，分析書目療法團體課程對於中輟高關懷學生之心理層面與行為的改變和影響。 　　研究之結果，中輟高關懷學生經過十二次書目療法團體後，在青少年心理健康量表各向度有明顯的下降，顯示書目療法之「認同」、「淨化」、「領悟」架構有助於調節情緒，並達到改善其心理健康之狀態。 / "Development", "interactive" and "group bibliography" were implemented to this study. 5 male and 6 female students in the ninth grade were selected, including 4 students from midway-resources-class and 7 students with high risk. A total of 12 times bibliographic therapy group courses were conducted on weekdays, and the (MHSA-SA) was used as a research tool to collect 11 members before and after the bibliographic therapy courses , on "depression-tendency", "anxiety-tendency", "suicide-tendency", "impulse behavior", "mental disturbance" and other psychological conception of the percentage of changes in the course situation, and supplemented by interviews with information, analysis of bibliographic therapy group courses for dropout high-risk students psychological level and changes in behavior and influence. 　　The results of the study showed that the items of (MHSA-SA) had decreased significantly after 12 times of bibliographic therapy group courses, and the "identification", "catharsis" and "insight" adjust the mood, and to improve the state of its mental health.

La résistance aux antibiotiques a pris une ampleur considérable du fait de l’utilisation des antibiotiques dans de nombreux domaines. Pour respecter l’approche « OneHealth », il est essentiel d’avoir une image spécifique de chaque situation, afin d’orienter les recommandations et de limiter la dissémination des gènes, des plasmides et des clones. Nos objectifs étaient adaptés à nos populations d’étude (chevaux et porcs) afin d’ajuster les résultats aux besoins des filières. Dans la filière équine, nous avons quantifié les résistances phénotypiques et identifié les gènes de β-lactamases à spectre étendu (BLSE/AmpC) présents dans le microbiome des chevaux sains, et nous avons identifié les facteurs de risque associés à leur portage en France et au Québec. En France, nous avons également caractérisé les mécanismes de dissémination des gènes de BLSE/AmpC. Nous avons mis en évidence qu’en France et au Québec, les E. coli commensaux provenant de fèces de chevaux sains étaient majoritairement non susceptibles à l’ampicilline, l’amoxicilline/acide clavulanique et la streptomycine et que des E. coli multirésistants et porteurs de gènes codant pour des BLSE/AmpC étaient détectés dans respectivement environ 45% et 8% des chevaux. Le blaCTX-M-1 était majoritairement détecté bien qu’en France d’autres BLSE aient été identifiés (blaCTX-M-2 et blaCTX-M-14) ainsi que le gène AmpC blaCMY-2. L’administration d’un traitement médical, le nombre de personnes s’occupant des chevaux, le type d’activité et le fait de participer à un évènement équestre dans les trois derniers mois ont été identifiés comme des facteurs de risque du portage des E. coli multirésistants ou producteurs de gènes BLSE/AmpC, soit en France soit au Québec. En France, le plasmide IncHI1-ST9 était majoritairement associé aux gènes blaCTX-M-1/2 et à l’opéron fos. Pour la filière porcine, nos objectifs étaient de colliger les données de la base de données du laboratoire EcL entre 2008 et 2016, d’évaluer la présence d’un agrégat spatio-temporel pour les isolats ETEC:F4 non susceptibles à l’enrofloxacine et de caractériser ces isolats et les éléments génétiques mobiles qu’ils transportent. En effet, l’enrofloxacine est un antibiotique de haute importance en santé humaine, et doit donc faire l’objet d’une surveillance accrue. Nous avons trouvé que plus de 90% des isolats d’E. coli entérotoxinogènes détectés chez des cas de porcs malades soumis au laboratoire EcL de 2008 à 2016 au Québec, étaient multirésistants. Le virotype LT:STb:F4 prédominait jusqu’en 2014, puis a été dépassé par le virotype LT:STb:STa:F4. Un agrégat spatio-temporel d’isolats LT:STb:STa:F4 non susceptibles à l’enrofloxacine a été détecté entre 04/2015 et 09/2016 au centre de la Montérégie. Nous avons démontré la présence d’un clone ETEC:F4 non susceptible à l’enrofloxacine, à haut risque, qui se dissémine en Amérique du Nord depuis 2013. Les isolats appartenant à ce clone sont ST100, O149:H10. Ils sont multirésistants, et associés à une pathogénicité et une virulence augmentée par rapport aux isolats détectés avant 2000. Ils portent le réplicon IncFII. Les résistances et leur mécanisme de dissémination sont différents selon l’espèce animale. Ces divergences sont fonction de l’usage des antibiotiques, et des échanges possibles avec les différents protagonistes en contact avec les animaux. / Antimicrobial resistance has become an essential issue in the last decades because of the extensive use of antimicrobials in numerous sectors. In order to follow the OneHealth approach, it is critical to have a precise picture of each situation, to adjust recommendations and prevent resistance gene dissemination as well as plasmid and clone spread. Our objectives were adapted to the animal populations under study. Therefore, our results were compatible with each sector. In the equine sector, we quantified phenotypic resistance and identified β-lactamase (ESBL/AmpC) genes present in the intestinal microbiome of healthy horses and we identified risk factors associated with their carriage both in France and in Quebec. Then, in France we characterized ESBL/AmpC gene spread mechanisms. We demonstrated that commensal E. coli originating from the feces of healthy horses were mostly non-susceptible to ampicillin, amoxicillin/clavulanic acid and streptomycin. The presence of multidrug resistant E. coli and of E. coli carrying ESBL/AmpC genes was found in around 45% and 8% of horses respectively. The most frequently detected gene was blaCTX-M-1, although blaCTX-M-2 and blaCTX-M-14 were also identified in France. The AmpC gene blaCMY-2 was identified in both localities. Medical treatment, staff number, activity, and participation in an equestrian event within the last three months were identified as risk factors for MDR or ESBL/AmpC E. coli. In France, commensal E. coli from healthy horses most commonly possessed the IncHI1-ST9 plasmid. This plasmid carries blaCTX-M-1/2 genes and the fos operon. For the swine sector in Quebec, our objectives were to gather data provided by the Animal pathogenic and zoonotic E. coli (APZEC) database between 2008 and 2017, to assess the presence of a spatio-temporal cluster for enrofloxacin non-susceptible ETEC:F4 and to characterize these isolates and the mobile genetic elements they carry. Enrofloxacin is an antibiotic classified as highly important in human medicine and as such needs to come under higher scrutiny. For this sector, we demonstrated that more than 90% of enterotoxigenic E. coli (ETEC) isolates from diseased swine submitted to the EcL between 2008 and 2016, were multidrug resistant. The main virotype in 2014 was LT:STb:F4. It was subsequently replaced by the LT:STb:STa:F4 virotype. A spatio-temporal cluster of LT:STb:STa:F4 isolates non-susceptible to enrofloxacin was detected between 04/2015 and 09/2016 in the centre of the Monteregie region. These isolates constituted an ETEC:F4 high risk enrofloxacin non-susceptible clone, which has been spreading in North America since 2013. Isolates belonging to this clone are ST100, O149H10, phylogroup A, and fimH gene negative. These isolates are multidrug resistant and associated with a higher pathogenicity and virulence than isolates detected before 2000. They all carry the incFII replicon. Resistance and mechanisms of dissemination are different according to the animal species being studied. This is likely due to different patterns of antimicrobial use in each industry and possible interactions with different protagonists in contact with the animals. It is essential to understand the situation for each animal species in order to adapt recommendations for efficiently limiting the spread of resistance genes, plasmids and clones.

BACKGROUND: The most numerous group from children due to perinatal burden is a group of prematurely born children and whose number continues to increase constantly. The children have higher probability of health problems and they are at risk of a complex threat to their successful development. Premature childbirth is a complicated difficult life situation for parents. Strongly reduced mental well- being is often developed at these parents and sometimes even some clinical symptoms (especially depression, anxiety, posttraumatic stress disorder). Such parenting (as well as other factors) greatly diminishes the overall interaction and communication with the child (especially their sensitivity and responsiveness) which can also be reflected in the parental style. AIM: The aim of the empirical part was to describe the occurrence of individual educational styles in healthy preterm infants 8-12 years old. METHODS: A Questionnaire of parental styles for children between the ages of 8 and 12 was used for this purpose (Čáp, Čechová & Boschek, 2000). RESULTS: A sample of 35 children showed that the most perceived parental style was a style characterized by a negative emotional relationship combined with a strong direction. CONCLUSION: The importance of the results can be seen in the practical application for...

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Newborn hearing screening has become an increasingly important element of neonatal care in developed countries whilst only a few fragmented screening programmes are evident in developing countries. The numerous socio-economic, cultural and healthcare barriers in developing contexts do not, however, negate or diminish the need to ensure optimal outcomes for infants with hearing loss through early identification and intervention programmes. South Africa has taken a first step toward addressing this need by publishing a Year 2002 Hearing Screening Position Statement that was produced by the Professional Board for Speech, Language and Hearing Professions of the Health Professions Council of South Africa. Interim recommendations are made toward universal newborn hearing screening programmes in three contexts: well-baby nurseries,; neonatal intensive care units (NICU) and Maternal and Child Health (MCH) clinics through their 6-week immunisation programmes. Although these clinics constitute an unfamiliar hearing screening context, they are essential platforms toward widespread screening of the majority of infants in South Africa. An urgent need therefore exists to ascertain the feasibility of hearing screening programmes at MCH 6-week immunisation clinics in order to guide the future implementation of widespread hearing screening services in South Africa. To attend to this need, an exploratory descriptive design that jointly implements quantitative and qualitative methods in a dominant-less-dominant model of triangulation was utilised to critically describe a screening programme conducted at two MCH clinics in Hammanskraal (a developing, peri-urban South African community). The quantitative methods included a structured interview to compile biographical and risk information; high frequency immittance measurements; hearing screening with OAE and AABR according to specified protocols, and diagnostic assessment of referred infants. The qualitative methods included field notes and critical reflections describing clinics as screening contexts and elucidating interactional processes involved in sustaining programmes. A total number of 510 infant-caregiver pairs were enrolled as subjects during the five-month research period. Results indicate that clinics not only provide a suitable context, but also the possibility of effective collaborations toward facilitating effective initial infant hearing screening programmes. The caregivers and infants who attended the clinics demonstrated significant degrees of socio-economic deprivation. They also reported an increased incidence of risk indicators exacerbating the population’s risk for congenital hearing loss, poor participation in the hearing screening/follow-up process, and subsequent poor involvement in a family-centred early intervention process for infants identified with hearing loss. The screening protocol effectively classified infants into risk categories for hearing loss and established useful norms for high frequency immittance in infants. The efficiency of the programme was acceptable considering the short period of implementation, but inefficient coverage with the AABR and poor follow-up return rates were obtained at the clinics. Despite prevailing barriers, the MCH 6-week immunisation clinics showed promise as platforms for widespread hearing screening programmes for infants in South Africa. The clinical implications and recommendations that emerged from the research conducted in this study were compiled and presented in the form of a preliminary service delivery model for infant hearing screening at MCH clinics. / Thesis (DPhil (Communication Pathology))--University of Pretoria, 2004. / Speech-Language Pathology and Audiology / unrestricted

With the advent of the internet, the opportunity to gamble for money is no longer limited by opening hours or that gambling is only available in specific places, which has meant that more and more people have developed an unhealthy relationship with gambling. Having an unhealthy relationship with gambling can have several negative consequences. To address this problem, relatively new legislation has been introduced in Sweden. According to the new legislation, all companies with a Swedish gambling license must implement responsible gambling tools. The purpose of these tools is to encourage users to play in a healthy manner. The results in existing research and literature on responsible gambling tools are contradictory, but in general it has emerged that responsible gambling tools have a low impact, especially among the players who have the greatest need for them, as they do not use the tools in a proper way. This study aims to investigate why responsible gambling tools have low impact among players with gambling problems. The study has a qualitative research approach with semi-structured interviews as a method for data collection. With this as a starting point, eight semi-structured interviews were conducted in which the informant was asked to explain opinions and perceptions about gambling responsible tools. The interviews were analyzed through a thematic analysis, which resulted in seven themes that individually and together can explain the study's purpose. The themes the study found were interpretable legislation, unlicensed gambling, lack of standardization, lack of centralization, lack in user knowledge, lack in provided information and a lack in self-exclusion tools. This study also develops the general knowledge of what the view of responsible gambling tools looks like from the various actors. The themes presented will also be a contribution, that can be used in future research and continued development of responsible gambling tools. / I och med internets framväxt är möjligheten att spela om pengar inte längre begränsad av öppettider eller av specifika platser, vilket medfört att allt fler har utvecklat ett osunt förhållande till spel. Att ha ett osunt förhållande till spel om pengar kan få negativa konsekvenser. För att bemöta detta problem har en relativt ny lagstiftning införts. Alla bolag med svensk spellicens måste enligt den nya lagstiftningen implementera så kallade spelansvarsverktyg. Syftet med dessa verktyg är att uppmuntra användarna att spela på ett sunt sätt. Tidigare forskningsstudier och litteratur om spelansvarsverktyg är motsägelsefulla, men generellt har det framkommit att spelansvarsverktyg har en liten effekt speciellt på de individer som har störst behov av dem, då dessa inte använder spelansvarsverktygen.  Denna studie avser att undersöka varför spelansvarsverktyg har liten effekt på spelare med spelproblem. Studien har en kvalitativ forskningsansats med semistrukturerade intervjuer som metod för datainsamling. Med detta som utgångspunkt genomfördes åtta semistrukturerade intervjuer där informanterna ombads redogöra för åsikter och uppfattningar om spelansvarsverktyg. Resultatet har analyserats genom en tematisk analys som resulterat i sju teman som var för sig och tillsammans förklarar studiens syfte och frågeställning. De sju teman var: icke licensierade spel, bristande lagstiftning, avsaknad av centralisering, avsaknad av standardisering, brister i användarkunskapen, avsaknad av information och brist i självuteslutning. Denna studie bidrar också med kunskap om hur de olika aktörerna ser på spelansvarsverktyg. De presenterade temana blir således ett bidrag som kan användas i framtida forskning och fortsatt utveckling av spelansvarsverktyg

Programs providing interventions for early psychosis are becoming commonplace in the United States (US); however the terrain of existing services within programs remains undocumented. Unlike other countries, the US does not have a systematic approach to defining and treating this population. We examined program characteristics, clinical services, and treatment population parameters for early intervention programs across the US. A semi-structured telephone interview was conducted with program directors between July 2013 and April 2014. Content analysis was used to identify the presence or absence of 32 evidenced based practices recently recommended for early intervention programs (Addington, et al., 2013). Frequent client requests were identified and functional definitions of the population served were assessed. A total of 34 eligible programs were identified; 31 (91.2%) program representatives agreed to be interviewed. Of the 32 essential components, the most prevalent were individual psychoeducation and outcomes tracking; the least prevalent were outreach services and communication with inpatient units. The population was most frequently defined by age restrictions, and restrictions on the duration of psychosis. Emergent themes of client requests included functional and social recovery as well as help meeting practical needs. Findings have the ability to assist researchers and policy-makers in determining best practice models and creating measures of fidelity. This study provides critical feedback on services for the early psychosis population and identifies research to practice gaps and areas for improvement moving forward.

Thesis (M. (Nursing)) -- University of Limpopo, 2022 / Background: The referral system is an essential component of the health system. The system meant to complement the Primary Health Care (PHC) principle of treating patients close to their homes at the lowest level of care with the needed expertise. Aim of the study: The aim of the study is to develop the strategies that will facilitate the referral system of high-risk pregnant women in between public sectors in the Bojanala district, North West Province, South Africa. Objectives of the study: To explore the referral system of high-risk pregnant women between public sectors within the Bojanala District, North West Province, South Africa. To develop strategies that will facilitate the referral system of high risk pregnant women in the Bojanala District, North West Province, South Africa. Methods: The researcher first obtained permission from the University of Limpopo Turfloop Research Ethics Committee (TREC), and further requested permission from the North West Department of Health, Bojanala District to conduct the study and was granted the permission. Qualitative, exploratory and descriptive designs were used to explore the referral system of high-risk pregnant women and to describe the strategies to facilitate the referral system of high-risk pregnant women in between public sectors in the Bojanala District, North West, South Africa. Non-Probability Purposive sampling method was used to select the midwives and obstetricians to participate in the study until data saturation was reached. Data were collected through one-on-one interviews using semi structured Interview Guide. The data were analysed using Tesch‘s eight steps of data analysis. Results: The results of this study revealed that the participants are knowledgeable about the referral system though they are many challenges that they encounter when managing high-risk women and having to refer them. They are aware of the current state of referral system and made their own suggestions on how to improve the referral system. Recommendations: Recommendations were made to facilitate the referral system of high-risk pregnant women in the North West Province, Bojanala District. The Department of Health must prioritise the provision of human and material resources to the district in order to achieve a better referral system and reducing the maternal and neonatal mortality as one of the millennium developmental goals. Conclusion: The referral system of high-risk pregnant women in the Bojanala District still has some challenges that need the intervention of the North West Department of Health to provide enough material and human resources to the Maternity Section in order to improve current status and to have an effective referral system

Bakgrund: I samband med en av de värsta industriolyckorna genom historien, dog 1100 textilarbetare som arbetade i en textilfabrik. Textilarbetares farliga arbetsförhållanden blev då en världsangelägenhet och idag förväntas företagen arbeta aktivt med hållbarhet och att möta samhällets nya behov som ändras i takt med den föränderliga värld vi lever i. Som en åtgärd för att möta detta behov har ett direktiv införts år 2016 som omfattar alla större bolag i Sverige. Därav har intresse väckts för vad gäller att vidare studera om det skett en förändring i företags hållbarhetsredovisning genom åren och om regleringen av EU-direktivet 2016 haft någon inverkan på detta. Syfte: Denna studie kommer att ägnas åt att analysera olika företags hållbarhetsredovisningar och beskriva förändringen av hållbarhetsredovisningen för att bidra med en ökad förståelse kring om/hur EU-direktivet 2016 har påverkat svenska företag inom samma bransch hållbarhetsredovisning. Metod: För att besvara studiens syfte har en kvalitativ innehållsanalys tillämpats för attanalysera informationen som de till studien valda företagen har presenterat. En upprättad kodningsmall, som är skapad utifrån studiens syfte med utgångspunkt i 6 kap. 12 § årsredovisningslag (1995:1554), har använts för att ta fram studiens empiriska data. Analysen av den empiriska datan har sedan ställts mot teorier, begrepp och tidigare forskning. Slutsats: Baserat på studiens resultat, som visar att EU-direktivet 2016 inte haft någon märkbar inverkan på företagens innehåll i hållbarhetsredovisningen, har vi funnit att det delvis skett en förändring i vad gäller utformning av företagens hållbarhetsredovisning. Studiens resultat visar även att företagen och deras hållbarhetsredovisning förändrats mycket redan året innan de första lagstadgade hållbarhetsredovisningarna publicerades och detta kan förklaras med utgångspunkt i två andra dimensioner, omgivning som i studien omfattar tre företagsekonomiska teorier (Institutionella teorin, legitimitetsteorin och intressentteorin) och media. / Background: In connection with one of the worst industrial accidents in history, 1100 textile workers working in a textile factory died. Textile workers' dangerous working conditions then became a global concern and today companies are expected to work actively with sustainability and to meet society's new needs that change in line with the changing world we live in. To meet this need, a directive was introduced in 2016 that covers all major companiesin Sweden. Therefore, we then found interest in further studying whether there has been a change in companies' sustainability reporting over the years and whether the regulation of the Accounting Directive in 2016 had any impact on this. Purpose: This study will be devoted to analyzing different companies' sustainability reports and describe the change of the sustainability report to contribute with an increased understanding of if/how the EU directive 2016 has affected Swedish companies in the same industry sustainability reporting. Method: To answer the purpose of the study, a qualitative content analysis has been applied to analyze the information presented by the selected companies for the study. An established coding template, which is created based on the purpose of the study based on Chapter 6, Section 12 of the Annual Accounts Act (1995:1554), has been used to produce the study's empirical data. The analysis of the empirical data was then set against theories, concepts and previous research. Conclusion: Based on the study's results, which show that the 2016 EU Directive has not hada noticeable impact on companies' content in the sustainability reporting, we have found that companies' sustainability reporting has many similarities with each other, which can be explained from the point of view of two other dimensions, environment which in the study includes three theories of business administration (Institutional theory, Legitimacy theory and stakeholder theory) and media.

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