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Bakgrund Att vara barn och leva med en kronisk sjukdom innefattar återkommande besök inom barnsjukvården. Alla barn med deras familjer hanterar situationen på olika sätt och utifrån deras förutsättningar. Barnsjukvården arbetar utifrån ett förhållningssätt som är familjefokuserat, där trygghet är centralt. De flesta barn med kroniska sjukdomar blir unga vuxna och beräknas återgå till vuxensjukvården vid 18 års ålder. Transitionens utgång kan återspeglas i personernas egna förutsättningar, därför är alla transitioner unika. Syfte Syftet var att belysa patienters upplevelser och erfarenheter i transitionen från barn- till vuxensjukvård vid kronisk sjukdom. Metod Vald metod var en litteraturöversikt. Sökningar genomfördes i CINAHL samt PubMed. Integrerad analys användes och de 15 utvalda artiklarna kvalitetsgranskades utifrån Sophiahemmet Högskolas bedömningsunderlag. Dessa sammanställdes i en Matris. Resultat I resultatet framkom patienters delade uppfattningar och erfarenheter genom sina transitionsprocesser, många hade upplevt sorg och oro över att lämna en trygg barnsjukvård med en tillåtande miljö. Vidare beskrev patienter vikten av att kunna erhålla individanpassad information. I denna litteraturöversikt framträdde kategorierna: patienters intryck under transitionsprocessen, förberedelse, självständighet och egenvårdsförmåga i samband med transition samt vårdpersonalens betydelse i transition. Slutsats Förberedelse och en individuell utformad informationsåtergivelse ansågs vara viktiga aspekter för en lyckad transitionsprocess. Patienter hade delade upplevelser och erfarenheter gällande sin transition från barn- till vuxensjukvård. För att möjliggöra lyckade transitioner för patienten var ett personcentrerat förhållningssätt hos sjuksköterskan viktigt för att stödja patienten i processen.

The research on transition in supersonic and hypersonic boundary layers has been reinvigorated in the last decades because of the increased interest in high-speed flight. The receptivity to environmental disturbances of high-speed boundary layers developing over flat plates or curved surfaces is a very important problem because the transition process is directly impacted by it. The main objective of the research is to determine the effect of small steps on laminar high-speed boundary-layers that are excited by freestream disturbances in the form of vorticity and acoustic waves. Both supesonic and hypersonic regimes are analyzed using a high-order compressible Navier-Stokes numerical algorithm. It is found that both the backward and the forward steps are capable of stabilizing the disturbances that propagate inside the boundary layer. This will potentially delay the formation of three-dimensional disturbances that are precursors to transition into turbulence.

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Background/Purpose: Healthcare transition is the “purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult-oriented health care systems.” The American College of Physicians has partnered with national organizations, including the ACR, to develop guidelines and tools to promote a smooth transition to adult care. We aim to assess current transition practices and beliefs among North American pediatric rheumatology providers and to identify differences from a 2010 provider survey published by Chira et al. Methods: In April 2018, Childhood Arthritis and Rheumatology Research Alliance (CARRA) members received a 25-item online survey about healthcare transition. Got Transition’s Current Assessment of Health Care Transition Activities for Transitioning Youth to Adult Health Care Providers was used to measure clinical transition processes on a scale of 1 (basic) to 4 (comprehensive). Bivariate data analysis was used to compare 2010 and 2018 survey findings. Results: Over half of CARRA members completed the 2018 survey. Participants included pediatric rheumatologists (74%), adult- and pediatric-trained rheumatologists (4%), pediatric rheumatology fellows (18%), and other (4%), including emeritus faculty and mid-level providers. Most belonged to university-affiliated practices (87%) in the U.S. (91%). Providers aim to transfer patients at age 18 (23%) or 21 (33%), but the actual age of transfer is often 21 or older (56%). The most common target age to begin transition planning was 15-17 (49%). Few providers use the ACR transition tools (31%) or have a dedicated transition clinic (23%). Only 17% have a transition policy in place; 63% do not consistently address healthcare transition. Transition outcomes of interest included an adult rheumatology visit within 6 months of the last pediatric visit (80%), adherence to medications and plan of care (78%), continuous insurance coverage (78%), and patient-reported gaps in access to care (76%). When compared to the 2010 survey, improvement was noted in 3 of 12 transition barriers: availability of adult primary care providers, availability of adult rheumatologists, and transition knowledge and skills of pediatric staff (p<0.001). However, more providers cited the close bond among adolescents, parents and pediatric providers as a barrier (Figure 1). Conclusion: This survey of pediatric rheumatology providersdemonstrates some improvement in transition barriers since 2010, though most practices still maintain minimal support for patients and providers around healthcare transition. Further research is needed to understand how to effectively facilitate transition to adult care for young adults with childhood-onset rheumatic diseases.

Motion transitioning is a common task in real-time applications such as games. While most character motions can be created a priori using motion capture or hand animation, transitions between these motions must be created by an animation system at runtime. Because of this requirement, it is often difficult to create a transition that preserves the feel that the actor or animator has put into the motion. An additional difficulty is that transitions must be created in real-time. This paper provides a method of creating motion transitions that is both computationally feasible for interactive speeds, and preserves the feel of the original motions. To do this, we build the transition from both a procedural motion and a motion segment taken from the motions being transitioned between.

The purpose of this study was to examine the perspectives of college students with learning disabilities through their lived experiences. Specifically, as they related to their high school learning experiences, their transition to higher education, and their continued academic and social support in higher education. The researcher gathered qualitative data to gain insight into the world of students with learning disabilities. The study consisted of a survey, focus group, and in-depth interviews. The data were reviewed in order to achieve a holistic picture of what the students* perceptions illustrate and to understand thematic commonalities from their lived experiences. The researcher hoped to shape possible effective instructional strategies and supports for students with learning disabilities in secondary and post-secondary educational experiences.

Academically capable youth with disabilities often have daily functioning challenges that impact adulthood outcomes. The studies in this dissertation address this concern by focusing specifically on a particular area of challenge: the ability to take over the decision making, problem solving, and organization needed to carry out complex daily life tasks in real life contexts. The purpose of the two studies were to: (1) distinguish deficits in discrete skills from challenges organizing skills to self-manage complex tasks associated with adult roles and (2) explore the extent to which challenges in social, cognitive and behavioral factors relate to self-management of daily life tasks. In Study 1, data from the National Longitudinal Transition Study-2 (NLTS2) were analyzed using a structural equation modeling approach to test associations between executive functioning, behavioral health, and social communication skills and self-management of daily life tasks in youth who graduated with a high school diploma. The model findings were compared with an alternate model testing the associations of the underlying factors and discrete functional skills. Study 1 findings indicated that challenges in underlying factors in diploma-track youth with disabilities are more strongly associated with the ability to self-manage life tasks, supporting the conceptual distinction between daily task management and discrete, foundational functional skills. While this study provided a generalizable model of factors associated with management of life tasks for academically capable youth with disabilities, this study was limited in that the variables were not specifically tailored to the constructs of interest, thus providing a broad, yet possibly imprecise picture of the relationships among these variables. Study 2 expanded on Study 1, providing a more detailed investigation of the factors associated with self-management of daily life tasks by using measures that were specifically selected to represent metacognition, internalizing behaviors, and social communication skills within a sample of academically capable autistic youth (N= 46). Study findings suggested that all three factors are associated with the ability to manage complex tasks, with executive functioning partially mediating the association between social communication skills and internalizing behaviors on task management. Together, the study findings confirm self-management of daily life tasks as a distinct area of challenge for academically capable youth with disabilities and provide a more detailed understanding of what is breaking down in the process of learning to manage life tasks and participate in valued adult roles. These findings can ultimately provide guidance on how to design targeted interventions in order to enable participation in independent living and productivity for academically capable youth with disabilities as well as highlight a potential target for outcome measurement in intervention studies that aim to improve daily life functioning and participation in the community. / 2023-09-27T00:00:00Z

<p>Phase change materials (PCMs) has emerged as advanced functional materials for efficient thermal energy storage and release. Compared to other organic and inorganic PCMs, oxide-based PCMs have attracted growing interest because of small volume expansion, minor leakage issue, and moderate latent heat. In this dissertation, two special cases of oxide-based PCMs is discussed, i.e., vanadium dioxide (VO₂), and Bi-based perovskite/supercell structures. Specifically, VO₂ emerges as a focus of research because of its well-known semiconductor-to-metal transition (SMT) upon heating close to 68 °C. The intrinsic coupling of SMT and R-M1 structural change makes VO₂ a favorite material both scientifically interesting and technologically important for potential sensor and memory device applications. On the other hand, BFMO supercell structure originates from the double-perovskites, while the substrate-induced epitaxial strain induces the stacking and commensurate modulations of Fe/Mn double layers. The significantly enhanced multiferroic response is attributed to its non-centrosymmetric structure.</p> <p>In this dissertation, a comprehensive study on the FM integration and novel approaches to achieve broad range transition temperature (<em>T</em>_<em>c</em>) tuning is explored in VO₂ thin films. Specifically, three novel metal/VO₂ nanocomposite designs are discussed, i.e., Pt/VO₂, Ni/VO₂ and Li/VO₂, with different morphology and Tc tuning mechanisms. First, by reconstructing the energy band structure at the metal/VO₂ interface, bidirectional <em>T</em>_<em>c</em> tuning in Pt/VO₂ nanocomposites can be achieved owing to the size dependent work function of Pt NPs. Next, by engineering the morphology by lattice matching, diffusion kinetics, and interfacial mixing, the exploration on Ni/VO₂ nanocomposites achieve the combined goals of Tc tuning and magnetic incorporation/magneto-optical (MO) coupling. Finally, by varying Li concentration during the metal-ion intercalation, <em>T</em>_<em>c</em> of both VO₂(B) and VO₂(M1) thin films can be systematically tailored because of structural deformation and the change in charge carrier density. The demonstration of metal/VO₂ nanocomposite thin films reveals a promising approach to fulfill various working environments for VO₂-based novel electronics, photonics, and spintronics. Furthermore, the microstructure evolution of the ultrathin BFMO supercell structure as well as its physical properties is first studied. The robust ferromagnetic and ferroelectric response is preserved in the ultrathin structure less than 10 nm, making it an attractive candidate for next-generation spintronics based on 2D materials.</p>