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Characterisation of paediatric feeding disorders and the underlying factors implicated in their development and maintenanceAldridge, Victoria January 2013 (has links)
Feeding disorders are psychological conditions that occur during infancy and early childhood, and result in insufficient intake of foods. Existing feeding disorder research identifies a raft of factors associated with predisposition, development and maintenance of feeding disorders, as well as a multitude of potential outcomes for the child and the system around them. However, neither feeding disorders nor their aetiological bases are well defined or uniformly applied in general, academic or clinical domains. Furthermore, the relationships and differences between observable characteristics, diagnostic criteria, and problem perceptions, and the bearing of these on disorder identification and treatment, are under-researched. The numerous definitions and profiles for feeding disorders make comprehension and knowledge gathering very difficult for caregivers and researchers, and thus hinder research and clinical progression in the field. The overarching aim of this thesis was to examine and characterise paediatric feeding disorders. The objective was to characterise and triangulate what feeding disorders are in terms of observable appearance, external perception, and psychometric properties, and better understand what constitutes a feeding disorder from multiple relevant perspectives. A mixed methods approach was taken to the collection and analysis of data, to obtain both depth and breadth of information. The results of the current thesis suggest that feeding disorders are characterised by a variety of behaviours and features within a biopsychosocial model. While physical models of feeding disorders are outdated, the potential for underlying physical contributing factors and resultant physical outcomes was highlighted throughout the current research and should not be ignored. However, overreliance on physicality, under-recognition of psychological processes, and consequent deficits to disorder identification within clinical settings, was also illustrated within the research. Furthermore, significant issues were raised regarding the lack of a consistent and inclusive model of feeding problems and disorders within healthcare systems. Though most clinicians saw feeding on a scale from normal to abnormal and frequently emphasised the value of early identification and treatment, the referral and treatment pathways that were discussed whereby only the most severe or physically affected children were treated, were not consistent with these models. Interviews with mothers highlighted the role of intrinsic child factors within the development of disordered feeding, including challenging behavioural characteristics, sensory sensitivities, difficult temperament, and lack of feeding motivation or avoidance of new foods. The importance of these child factors was supported by psychometric assessment, which identified distinct patterns of child characteristics associated with different types of problematic or disordered feeding, and a strong association between disordered feeding and the parent perception of having a difficult child. Furthermore, video observations of child mealtimes highlighted not only disparity in the amount of food eaten between disordered and non-disordered children, but a considerable deficit in the level of interest, motivation, and engagement with feeding shown by disordered children. Deficits to child feeding motivation pose a problem for parents that is less obvious than extreme emotional reactions, but which can be equally distressing for the parent who views nourishing their child as one of their major responsibilities. This point was reinforced across parent interviews and mealtime observations, and should be a key factor in the identification of families in need of support and intervention. Parent interviews, healthcare professional interviews, and psychometric assessment, all highlighted the considerable presence and role of parent anxiety within feeding disorder development. Parent anxiety was discussed as a potential cause and an outcome of challenging feeding behaviour, exacerbated by the perceived extent of the child s feeding condition and the dearth of support and information about dealing with significant feeding issues. Anxiety was seen by parents and healthcare professionals to influence the feeding strategies used by parents, and without intervention to contribute to a downward spiral of negative feeding interactions. Disordered feeding was also seen to interfere with social interactions, which would otherwise play an important role in the child s feeding and dietary development, and provide social support and guidance for parents. These patterns of problem and disorder perpetuation are liable to persist while general and clinical understanding of feeding disorders is minimal and inconsistent. The findings of the current thesis pose a great variety of potential influences and risk factors for feeding disorder development, supporting an individualistic approach to disorder identification and intervention, and the need for a significant change in the current systems for dealing with feeding disorders. It is essential to take each of the different components into consideration to understand the specific mechanisms underpinning the maintenance of the feeding disorder and aid selection of the most suitable and efficient approach to intervention. The pattern of factors implicated in each individual feeding disorder case will be differentiated according to the child, the parent and the child s general environment. Identification of the full range of children in need of support and intervention is reliant on recognition of the diversity in disorder type, severity and presentation.
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Study on feelings of school avoidance, depression, and character tendencies among general junior high and high school studentsHonjo, Shuji, Sasaki, Yasuko, Kaneko, Hitoshi, Tachibana, Kota, Murase, Satomi, Ishii, Takashi, Nishide, Yumie, Nishide, Takanori 10 1900 (has links)
No description available.
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School refusal and depression with school inattendance in children and adolescents: Comparative assessment between the Children's Depression Inventory and somatic complaintsHonjo, Shuji, Nishide, Takanori, Niwa, Sachiko, Sasaki, Yasuko, Kaneko, Hitoshi, Inoko, Kayo, Nishide, Yumie 12 1900 (has links)
No description available.
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"There Is a Limit" : Israel's "Refusenik" movement and its critics / Israel's "Refusenik" movement and its criticsHuizar, Mary Christina 27 February 2012 (has links)
The focus of this report is an examination of the so-called “refusenik” soldiers of Israel. Since Israel’s victory in the 1967 war and the resulting occupation of the West Bank and Gaza Strip, there have been soldiers in the IDF that have refused to serve outside the pre-1967 borders. These soldiers, called “refuseniks,” practice selective refusal. Unlike conscientious objectors, the refusenik soldiers are not pacifists. Their protest is not a condemnation of all war. Rather, it is a calculated protest against the continuing occupation of land outside the Green Line. Although the roots of the refusenik movement can be traced to the 1967 war, the movement did not gain momentum until the 1982 invasion of Lebanon. Initially enjoying broad public support, the war in Lebanon became less popular when it did not end after its initial goals were met. Yesh Gvul, the most famous of the refusenik organizations, was born during this time of waning public support for the war. Other boosts for the refuseniks have come during the first intifada and second intifada. The refuseniks come from varied backgrounds and political affiliations, but the “typical” refusenik is the Ashkenazi male reservist, usually statistically speaking a married, highly educated city-dweller. The military has not followed a coherent strategy for dealing with the refuseniks, alternating between conciliation and accommodation at some time periods and harsh punishment at others. / text
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Depression, volition, and death the effects of depressive disorders on the autonomous choice to forgo medical treatment /Butkus, Matthew Allen. January 2006 (has links)
Thesis (Ph.D.)--Duquesne University, 2006. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 485-518) and index.
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Estimating causal treatment effect in randomized clinical trials with noncompliance and outcome nonresponse /Taylor, Leslie, January 2008 (has links)
Thesis (Ph. D.)--University of Washington, 2008. / Vita. Includes bibliographical references (p. 86-93).
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Agreeing on a way forward management of patient refusal of treatment decisions in Victorian hospitals /Griffiths, Debra. January 2008 (has links)
Thesis (Ph.D.)--Victoria University (Melbourne, Vic.), 2008. / Includes bibliographical references.
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Política, tecnologia e emancipação em O homem unidimensional de Herbert Marcuse / Politics, technology and emancipation in Herbert Marcuse’s One-dimensional manMagalhães, Rogério Silva de [UNIFESP] 08 1900 (has links) (PDF)
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Previous issue date: 2013-08 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Esta dissertação tem dois objetivos. A partir da obra O homem unidimensional: a
ideologia da sociedade industrial (One-dimensional man: studies in the ideology of advanced
industrial society), pretendemos explorar como a alta produtividade de bens nas sociedades
industriais avançadas dos anos de 1960 está intimamente associada à geração de pensamento e
comportamento de servidão. Temos interesse em saber como o sistema de produção dessas
sociedades é responsável pela unidimensionalização da existência humana. Por outro lado, nas
sociedades tecnológicas, é interessante notar que não é só o Estado e as corporações que
produzem homens unidimensionais, mas os homens também produzem a si mesmos como
seres unidimensionais por intermédio da passividade com que aceitam a realidade repressora
estabelecida. Na visão de Marcuse, o modo de vida industrial não existe para libertar os
indivíduos do trabalho alienado, fazendo assim com que tenham tempo livre para desenvolver
suas potencialidades, mas existe para a dominação dos homens e da natureza em nome do
capital. Nosso segundo objetivo é o de examinar as alternativas que Marcuse opõe a esse
controle total das necessidades exercido pelo modo de vida da sociedade unidimensional.
Essas alternativas elaboram-se em diferentes registros e dimensões: nova tecnologia, filosofia,
imaginação, arte e protesto dos excluídos. Cada uma delas será analisada em um subtítulo. / The current dissertation has two goals. Taking One-dimensional man: studies in the
ideology of advanced industrial society as a primary source, we intend to explore how the
massive production of goods in advanced industrial societies in the 1960’s is closely related to
the creation of thinking and behavior directed toward servitude. We have a keen interest in
learning how the production system of these societies is responsible for the emergence of a
one-dimensional human existence. On the other hand, in these technological societies, it is
interesting to realize that not only the State and the corporations that create one-dimensional
men, but men also create themselves as one-dimensional human beings through their passive
behavior toward the established repressive reality. In Marcuse’s point of view, the industrial
way of life does not exist to free the individuals from alienated labor, providing them with
free time to develop their potentialities, but to dominate human beings and nature in order to
make profit on it. Our second goal is to examine the alternatives that Marcuse opposes to the
total control of needs exercised by the way of life in the one-dimensional society. These
alternatives are designed in different levels and dimensions: new technology, philosophy,
imagination, art and the protest of the excluded. Each of them will be analyzed in a single
subheading.
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Tuberculose pulmonar e o uso de drogas ilÃcitas: entre a cura e o abandono / Pulmonary tuberculosis and the use of illicit drugs: between cure and abandonmentJanete GalvÃo Martins Cassiano 30 May 2014 (has links)
A tuberculose à uma doenÃa infecciosa e contagiosa causada por uma bactÃria, o Mycobacterium tuberculosis. O abandono do tratamento da tuberculose pulmonar por pacientes com baciloscopia positiva favorece a manutenÃÃo da cadeia de transmissÃo, assim como o aumento das populaÃÃes bacterianas resistentes à quimioterapia de primeira linha. Iniciar o tratamento, desistir dele, retratar, abandonar novamente... situaÃÃo cada vez mais frequente na populaÃÃo acometida por tuberculose e usuÃria de drogas, lÃcitas ou ilÃcitas. O consumo de substÃncias psicoativas cresceu assustadoramente a partir da segunda metade do sÃculo XX, configurando-se nas Ãltimas dÃcadas como um fenÃmeno de massa e como uma questÃo de saÃde pÃblica. Segundo a OMS, cerca de 10% das populaÃÃes dos centros urbanos de todo o mundo, consomem abusivamente substÃncias psicoativas, independentemente da idade, sexo, nÃvel de instruÃÃo e poder aquisitivo. O presente trabalho tem como objetivo avaliar a influÃncia do uso abusivo de drogas ilÃcitas no abandono do tratamento para tuberculose pulmonar em uma Unidade de AtenÃÃo PrimÃria à SaÃde no municÃpio de Fortaleza. Por meio de estudo epidemiolÃgico observacional, retrospectivo, foram analisamos fatores socio-epidemiolÃgicos e fatores clÃnicos de pacientes em tratamento para tuberculose pulmonar, verificando-se a presenÃa do uso abusivo de drogas nesta populaÃÃo, e a influÃncia destas no abandono do tratamento, utilizando para isso questionÃrios estruturados (questionÃrio geral e ASSIST). Resultados: dos 116 casos de tuberculose investigados, 68,9% sÃo do sexo masculino, com mÃdia de idade de 37,5 anos, de cor parda (72,4%), solteiro (56,9%), com ensino fundamental incompleto (50%). A situaÃÃo de emprego da maioria (37%) era de desemprego. Quanto ao perfil epidemiolÃgico do caso, 84,4% eram de casos novos, 13% de reingresso apÃs abandono e 2,6% de recidiva. O motivo que levou ao encerramento do caso mostrou-nos um dado alarmante: 36% dos pacientes abandonaram o tratamento. Comparando as diferenÃas entre o grupo de cura e o de abandono, nÃo houve diferenÃa significativa entre a mÃdia das idades dos dois grupos (p > 0,75). Em ambos os grupos houve predomÃnio do sexo masculino, porÃm observamos uma diferenÃa significativamente maior no grupo do abandono (p = 0,0001). No grupo abandono o nÃvel de escolaridade foi inferior ao do grupo cura/conclusÃo (p = 0,017). Houve associaÃÃo entre abandono e desemprego (p < 0,0001) e reingresso apÃs abandono. Pelo resultado do questionÃrio ASSIST, a frequÃncia do uso de drogas na vida correspondeu a 95,1% para o Ãlcool, seguido do tabaco.(51,6%). A Cannabis sativa, a cocaÃna e o crack foram citados por 41,9% dos questionados. Inalantes como lolà e cola de sapateiro jà haviam sido provados por 19,3%. O uso de crack necessita de intervenÃÃo com indicaÃÃo para tratamento intensivo na maioria dos usuÃrios (61,9%), o que demonstra a forÃa de dependÃncia quÃmica que essa substÃncia causa. ConclusÃo: O abandono do tratamento da tuberculose se mostra um risco significativo nos pacientes usuÃrios de drogas, em especial as ilÃcitas onde observa-se um consumo abusivo, necessitando-se de intervenÃÃo, seja uma intervenÃÃo breve ou tratamento mais intensivo. / Tuberculosis is an infectious and contagious disease caused by a bacterium, Mycobacterium tuberculosis. Treatment Refusal for pulmonary tuberculosis in patients with smear-positive favors the maintenance of the transmission chain, as well as increased resistance to first-line chemotherapy. Starting treatment, give it up, portray, leave againâ situation increasingly common in the population affected by tuberculosis and uses drugs, licit or illicit. The consumption of psychoactive substances has increased since the second half of the twentieth century, becoming a mass phenomenon in recent decades and a public health problem. According to WHO, about 10% of the populations of urban centers world consume abusively psychoactive substances, regardless of age, sex, education level and purchasing power. This study aims to evaluate the influence of the abusive use of illegal drugs in the abandonment of treatment for pulmonary tuberculosis in a Unit of Primary Health Care in Fortaleza. Through a epidemiologic, observational and retrospective study, socio-demographic factors and clinical factors were analyzed in patients treated for pulmonary tuberculosis, verifying the presence of substance abuse in this population, and the influence of these in abandonment of treatment, using structured questionnaires (general questionnaire and ASSIST). Results: of the 116 TB cases investigated, 68.9% are male, with a mean age of 37.5 years, mulatto (72.4%), single (56.9%), with incomplete primary education (50%). The employment status of the majority (37%) were unemployed. As to the epidemiological profile of the case, 84.4% were new cases, 13% of return after default and 2.6% of recurrence. The cause of the closure of the case was by treatment refusal in 36% of patients. Comparing the differences between the group cure and abandonment, there was no significant difference between the mean ages of the two groups (p> 0.75). In both groups there was a predominance of males, but had a significantly greater difference in the dropout (p = 0.0001). In the group abandoned, the education level was lower than the cure group (p = 0.017). There was an association between dropout and unemployment (p <0.0001) and return after default. The ASSIST questionnaire showed that the frequency of drug use in life corresponded to 95.1% for alcohol, followed by tobacco. (51.6%). Cannabis sativa, cocaine and crack were cited by 41.9% of respondents. Inhalants like lolo and glue had already been tried by 19.3%. The use of crack needs intensive treatment in the majority of users (61.9%), demonstrating the chemical addiction to this substance. Conclusion: The abandonment of tuberculosis treatment shows a significant risk in patients using drugs, especially illicit substances with abuse use, necessitating the intervention, whether a brief intervention or more intensive treatment.
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SCHOOL REFUSAL BEHAVIOR: EXAMINING TEACHERS’ PERCEPTIONS OF SCHOOL REFUSAL BEHAVIOR OF SECONDARY STUDENTSNicole Jeanne Block (12450528) 25 April 2022 (has links)
<p>Students need to be in attendance at school in order to learn. One concern for schools is when students refuse to attend school on a regular basis. School refusal behavior encompasses all subsets of problematic absenteeism, such as truancy, school phobia, and anxiety. Students dealing with school refusal is a behavior that is multi-faceted. Often times, these students are experiencing psychological matters that are presenting as the symptom of school refusal. The purpose of this study was to survey general education and special education secondary teachers on their perceptions of student absences and to ascertain how they motivate students to attend their classes. The study was centered on two research questions: (1) ‘What are the perceptions of secondary teachers on student absences?’and (2) ‘Are students who exhibit school refusal behavior more likely to be identified as students with special education needs?’ The sample size for this study was 78 certified teachers at an urban high school in the Midwest. The high school had 1,834 students enrolled for the 2020/2021 school year in 9th through 12th grade, with 238 students designated as having special education services. An online survey was created using Google Forms. The survey was designed to not collect respondents’ email addresses to ensure anonymity and was limited to one response per unique email address. The survey did not ask any identifying information such as number of years teaching, subjects taught, etc. Twenty-six completed surveys were returned, for a return rate of 33%.</p>
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