Gotowe bibliografie tematyczne / High risk families

Gotowa bibliografia na temat „High risk families”

Autor: Grafiati
Data publikacji: 4 czerwca 2021
Data aktualizacji: 31 stycznia 2023

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Artykuły w czasopismach na temat "High risk families"

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Deccio, Gary, William C. Horner i Dee Wilson. "High-Risk Neighborhoods and High-Risk Families". Journal of Social Service Research 18, nr 3-4 (marzec 1994): 123–37. http://dx.doi.org/10.1300/j079v18n03_06.

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Palmer, Emma. "Child Maltreatment and High Risk Families". British Journal of Social Work 45, nr 6 (25.06.2015): 1937–38. http://dx.doi.org/10.1093/bjsw/bcv057.

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Vieira, Viviane Cazetta de Lima, Mayckel da Silva Barreto, Verônica Francisqueti Marquete, Rebeca Rosa de Souza, Mayara Maria Johann Batista Fischer i Sonia Silva Marcon. "Vulnerability of high-risk pregnancy in the perception of pregnant women and their families". Rev Rene 20 (25.04.2019): e40207. http://dx.doi.org/10.15253/2175-6783.20192040207.

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Wu, Xue, Jing Pang, Xumin Wang, Jie Peng, Yan Chen, Shilong Wang, Gerald F. Watts i Jie Lin. "Reverse cascade screening for familial hypercholesterolemia in high-risk Chinese families". Clinical Cardiology 40, nr 11 (listopad 2017): 1169–73. http://dx.doi.org/10.1002/clc.22809.

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Sittner, Barbara J., John DeFrain i Diane Brage Hudson. "Effects of HIGH-RISK PREGNANCIES on Families". MCN, The American Journal of Maternal/Child Nursing 30, nr 2 (marzec 2005): 121–26. http://dx.doi.org/10.1097/00005721-200503000-00010.

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Tomlin, Angela M., i Azar Hadadian. "Early intervention providers and high‐risk families". Early Child Development and Care 177, nr 2 (luty 2007): 187–94. http://dx.doi.org/10.1080/03004430500379234.

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Narod, Steven A. "Screening for cancer in high risk families". Clinical Biochemistry 28, nr 4 (sierpień 1995): 367–72. http://dx.doi.org/10.1016/0009-9120(95)00022-2.

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Coon, Hilary, Todd M. Darlington, Emily DiBlasi, W. Brandon Callor, Elliott Ferris, Alison Fraser, Zhe Yu i in. "Genome-wide significant regions in 43 Utah high-risk families implicate multiple genes involved in risk for completed suicide". Molecular Psychiatry 25, nr 11 (23.10.2018): 3077–90. http://dx.doi.org/10.1038/s41380-018-0282-3.

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Abstract Suicide is the 10th leading cause of death in the United States. Although environment has undeniable impact, evidence suggests that genetic factors play a significant role in completed suicide. We linked a resource of ~ 4500 DNA samples from completed suicides obtained from the Utah Medical Examiner to genealogical records and medical records data available on over eight million individuals. This linking has resulted in the identification of high-risk extended families (7–9 generations) with significant familial risk of completed suicide. Familial aggregation across distant relatives minimizes effects of shared environment, provides more genetically homogeneous risk groups, and magnifies genetic risks through familial repetition. We analyzed Illumina PsychArray genotypes from suicide cases in 43 high-risk families, identifying 30 distinct shared genomic segments with genome-wide evidence (p = 2.02E-07–1.30E-18) of segregation with completed suicide. The 207 genes implicated by the shared regions provide a focused set of genes for further study; 18 have been previously associated with suicide risk. Although PsychArray variants do not represent exhaustive variation within the 207 genes, we investigated these for specific segregation within the high-risk families, and for association of variants with predicted functional impact in ~ 1300 additional Utah suicides unrelated to the discovery families. None of the limited PsychArray variants explained the high-risk family segregation; sequencing of these regions will be needed to discover segregating risk variants, which may be rarer or regulatory. However, additional association tests yielded four significant PsychArray variants (SP110, rs181058279; AGBL2, rs76215382; SUCLA2, rs121908538; APH1B, rs745918508), raising the likelihood that these genes confer risk of completed suicide.
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Rhiem, K., C. Fischer, K. Bosse, B. Wappenschmidt i R. K. Schmutzler. "Increased risk of cervical cancer in high-risk families with and without mutations in the BRCA1 and BRCA2 genes". Journal of Clinical Oncology 25, nr 18_suppl (20.06.2007): 5588. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.5588.

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5588 Background: In BRCA germline mutation carriers increased risks for cancer at other sites than breast and ovary have been reported. Methods: To evaluate the risk of BRCA-associated cancers, we conducted a cross-section analysis in 4405 individuals from 409 families with BRCA1 (n=86) or BRCA2 mutations (n=53) and 270 high risk BRCA1/2 negative families ascertained by the Familial Breast and Ovarian Cancer Center Cologne. We considered proven mutation carriers, individuals affected by breast and ovarian cancer and their first degree relatives and identified 921 individuals from BRCA1 (604 female; 317 male), 571 from BRCA2 (365 female; 206 male) and 2913 from BRCA1/2 negative (1938 female; 975 male) families that suffered from 677 cancers other than breast and ovarian cancers. Relative risks (RR) of the study group compared to the general population were evaluated by the standardized incidence ratio (SIR), using data from two German Cancer Registries. Results: The risk for cervical cancer is significantly increased in women from BRCA1 and BRCA2 positive (RR=4.59, 95% CI=2.20 to 8.44, and RR=3.69, 95% CI=1.20 to 8.61; p=<0.001) and from BRCA1/2 negative families (RR=2.97, 95% CI=1.88 to 4.45). Moreover, the risk for pancreatic cancer in women from BRCA2 positive and BRCA1/2 negative families as well as the risk for prostate cancer in men from BRCA2 positive families is increased (RR=5.10, 95% CI=1.65 to 11.90; RR=1.98, 95% CI=1.02 to 3.46; RR=2.09; 95% CI=1.00 to 3.84). Conclusions: We here report an increased risk of cervical cancer for women from BRCA1 and BRCA2 positive and from BRCA1/2 negative high risk families, respectively. These results are in line with other studies in BRCA1 and 2 positive individuals and should be considered in the clinical risk management of these individuals. No significant financial relationships to disclose.
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Loescher, Lois, Janice Crist, Lee Cranmer, Clara Curiel-Lewandrowski i James Warneke. "Melanoma High-Risk Families' Perceived Health Care Provider Risk Communication". Journal of Cancer Education 24, nr 4 (październik 2009): 301–7. http://dx.doi.org/10.1080/08858190902997290.

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Rozprawy doktorskie na temat "High risk families"

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Hopper, Jennifer. "Communication within Families at-risk for Type 2 Diabetes". University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1367937775.

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Barnes, Christopher. "Cognitive, emotional and environmental mediators of early parenting in high risk families". Thesis, University of Wolverhampton, 2008. http://hdl.handle.net/2436/33753.

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The UK currently has the highest number of premature births (babies born before 37 weeks gestation age and below 2.5kg) in Europe affecting around 70,000 babies and their caregivers each year. Consequently many interventions have been created to support the development of the preterm newborn and minimise the complications of prematurity. Many of the interventions developed have been predominantly tactile and have almost exclusively focused upon their effect upon the baby and not, for example considered the effect that this type of intervention might have upon the parents; specifically the mother, when they are the ones who perform the therapy. In fact there is a severe lack of systematic studies investigating the latter. Hence, the aim of this thesis was to search for research-based evidence on the benefits of environmental support to both babies (e.g. increased weight gain or awake periods) and their mothers (e.g. higher perceptions of themselves as a mother) during hospital confinement and within the context of Neonatal Health Psychology (NNHP). For this reason, the main hypothesis investigated whether mothers’ cognitions and emotions; specifically Maternal Self-Efficacy, Self-Esteem and Attachment, would be affected by environmental mediators in the form of structured or non-structured tactile sensory nurturing interventions. The empirical work reported in this thesis is divided into 3 distinct phases. Firstly, as their was no appropriate measure of maternal Self-Efficacy for mothers of hospitalised preterm neonates the main aim of Phase-1 was to develop and validate an appropriate measure. Using a prospective survey method and a mixed design (between/within and correlational) a total of 160 mother-preterm dyads (pooled from 2 cohorts; cohort 1, N=100; cohort 2, N=60) were recruited. The results demonstrated that the Perceived Maternal Parenting Self-Efficacy (PMPS-E) tool had good initial psychometric properties (including internal/external reliability and construct validity) for its use with mothers of relatively healthy hospitalised preterm neonates. Secondly, in order to investigate mothers’ perceived maternal parenting self-efficacy beliefs further Phase-2 examined whether the type of feeding a mother chose to give to her baby mediated her self-efficacy beliefs. The results suggested that breastfeeding a preterm neonate during hospital confinement may adversely affect mothers’ perceptions of their efficacy in all aspects of parenting. Finally, using an experimental method Phase-3 tested the main hypothesis of this thesis and used a randomised cluster control trial (RCCT) design to allocate 60 mothers and their preterms equally to one of three cluster groups; consisting of either structured (e.g. TAC-TIC therapy or Using a Toy) or non-structured (Placebo/Control) tactile sensory nurturing interventions. The main findings illustrate that tactile sensory nurturing interventions do mediate maternal cognitions and emotions, preterm weight gain and behavioural state. In particular, mothers who performed TAC-TIC demonstrated significantly higher self-reported perceptions in their self-efficacy, self-esteem and attachment, which was attributed to the fact that these babies spent increased amounts of time in an alert and responsive behavioural state, and gained more weight throughout the study period. Thus, the work presented throughout this thesis has implications for Neonatal Health Psychologists and other Health Care professionals’ practice within neonatal units, the use of Neonatal Health Psychology as a framework to study the preterm neonate and their family, and also the way in which both mothers and their hospitalised preterm neonates are supported during hospital confinement.
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Houston, Natasha. "Evaluation of a Family-Centered Parenting Program for Culturally Diverse High-Risk Families". Thesis, NSUWorks, 2008. https://nsuworks.nova.edu/fse_etd/21.

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The purpose of this study was to evaluate the effectiveness of a family-centered parenting program for culturally diverse high-risk families using science-based curricula and evaluation tools. Despite the evidence supporting the effectiveness of parenting education, there are still limitations to the current body of knowledge. Research has been conducted primarily with middle-class European American mothers. Less is known about parenting education with culturally and economically diverse families. In addition, much of the additional research targeted well-functioning families. High-risk families are less likely to participate in parenting programs and research studies. Most programs do not use evidence-based curricula or conduct evaluations using valid reliable measures. Last, most programs work solely with the parent and do not have a family-centered approach. Including children suggests the entire family learns together and has a better opportunity to build family cohesion. This study utilized a science-based curricula parenting program for at-risk families. The sample population included 31% Caucasian, 2% Hispanic, 66% Native American, and 1% of other races combined. Quantitative data reflected that overall parenting scores increased in both target and control groups based on the scores from pretest to posttest with a t score of 0.459 for the target group and 0.346 for the control group. Overall, the program was successful, and the applied dissertation effectively met each of the 6 outcomes. Nonprofit organizations should review the findings of this applied dissertation to develop more programs that incorporate science-based curricula to address the parenting needs of those who are high risk.
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Campbell, Carroll C. "Adolescents’ Perception of Parental Deterrents of High-Risk Behavior and Prediction of Involvement in Risk Behaviors as Measured by the Risky Behavior Scale". The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1306342286.

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Grayton, L. "Minding the baby : the challenges of implementing a reflective functioning programme with high-risk families". Thesis, University College London (University of London), 2014. http://discovery.ucl.ac.uk/1448076/.

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Part 1: Literature Review: This section consists of a meta-analytic review examining the efficacy of video-feedback interventions aimed at promoting parental sensitivity and infant attachment. Outcomes from 18 RCTs contributing 20 intervention effects were examined. Results indicated that video-feedback interventions are efficacious in promoting parental sensitivity, infant attachment security and preventing infant attachment disorganisation. These findings suggest that video-feedback interventions may offer exciting potential for clinical practice. Part 2: Empirical Paper: The empirical paper reports on a qualitative study examining the challenges of implementing ‘Minding the Baby’ (MTB), a preventative parenting programme developed explicitly to promote secure parent-child attachment relationships. Semi-structured interviews were conducted with 13 practitioners delivering the programme. Transcripts were analysed thematically and themes were organised into two domains relating to the challenges of implementation and the components of MTB which practitioners identified as being crucial in engaging mothers in reflective work. Results highlight the importance of designing and delivering services which support mentalisation throughout. In addition, a strong therapeutic relationship was identified to be crucial in engaging mothers in reflective work and in responding to the challenges of implementing a mentalisation-based parenting intervention. The study was conducted in collaboration with another UCL Clinical Psychology doctoral student, whose thesis examines parents’ experiences of the therapeutic process in MTB (Burns, 2014).
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Jones, Laura M. "The family check-up for families of high-risk preschoolers : the moderating effect of children's temperament /". view abstract or download file of text, 2003. http://wwwlib.umi.com/cr/uoregon/fullcit?p3102170.

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Thesis (Ph. D.)--University of Oregon, 2003.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 90-101). Also available for download via the World Wide Web; free to University of Oregon users.
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Mortensen, Jennifer A. "The protective role of the caregiving relationship in child care for infants and toddlers from high risk families". Thesis, The University of Arizona, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3703699.

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Infancy and toddlerhood is an important time for the development of emotion regulation, with interactions between parents and children critical to these processes. Negative parenting behaviors can have a deleterious impact on this development; however, for infants and toddlers in child care, the classroom environment, including teacher-child interactions, provides an important setting for emotional development and may serve as a protective factor when parenting risk at home is high. The aim of the three papers presented in this dissertation was to explore the potential for child care to act as a protective factor for infants and toddlers experiencing different dimensions of parenting risk that threaten emotion regulation development: minimal sensitivity and support, harsh and intrusive behaviors, and physical abuse and neglect. Results confirmed the negative impact of unsupportive, harsh, and intrusive parenting behaviors on emotion regulation, but child care was either insignificant in mitigating these effects or operated as a buffer for certain children only. Additionally, a review of the extant literature suggested that understanding the optimal caregiving experiences in child care that meet the unique regulatory needs of maltreated infants and toddlers is limited. Collectively, implications of these findings include the need to ensure measurement validity when assessing children’s experiences within child care, the importance of considering the interactive nature of child, parent, and child care factors, and the pressing need for more research regarding child care teachers’ roles in facilitating emotional experiences in the classroom that meet the unique regulatory needs infants and toddlers facing risk at home.

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Mortensen, Jennifer Ann. "The Protective Role of the Caregiving Relationship in Child Care for Infants and Toddlers from High Risk Families". Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/556822.

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Infancy and toddlerhood is an important time for the development of emotion regulation, with interactions between parents and children critical to these processes. Negative parenting behaviors can have a deleterious impact on this development; however, for infants and toddlers in child care, the classroom environment, including teacher-child interactions, provides an important setting for emotional development and may serve as a protective factor when parenting risk at home is high. The aim of the three papers presented in this dissertation was to explore the potential for child care to act as a protective factor for infants and toddlers experiencing different dimensions of parenting risk that threaten emotion regulation development: minimal sensitivity and support, harsh and intrusive behaviors, and physical abuse and neglect. Results confirmed the negative impact of unsupportive, harsh, and intrusive parenting behaviors on emotion regulation, but child care was either insignificant in mitigating these effects or operated as a buffer for certain children only. Additionally, a review of the extant literature suggested that understanding the optimal caregiving experiences in child care that meet the unique regulatory needs of maltreated infants and toddlers is limited. Collectively, implications of these findings include the need to ensure measurement validity when assessing children’s experiences within child care, the importance of considering the interactive nature of child, parent, and child care factors, and the pressing need for more research regarding child care teachers' roles in facilitating emotional experiences in the classroom that meet the unique regulatory needs infants and toddlers facing risk at home.
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Jackson, L. A. "Cytogenetic and molecular genetic analysis of normal, pre-malignant and malignant breast tissue from patients in high-risk families". Thesis, University of Cambridge, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.604988.

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The data presented in this thesis demonstrates that 60.0% of the morphologically normal samples from women at high risk for breast cancer showed genomic copy number aberrations by CGH. There was an average of 1.45 aberrations per sample analysed. These aberrations seemed to be spread throughout the genome, however, there were some regions of interest. These were gains on 1p, 9p, 16p 16q and 19. The presence of these aberrations suggests that morphologically normal epithelial cells analysed from these cases have a degree of genomic instability. The CGH results for HUT presented a complicated profile of copy number loss and gain spread throughout the genome. Of the 23 lesions successfully analysed by CGH, 96.7% had genomic aberrations, an average of 4.35 aberrations per sample analysed. The most common sites of aberration were loss at 1p, 9q, 17p, 17q, 19 and 22q and again at 1q, 2q, 6q, 9p, 13q, 18p and X. The immunohistochemical staining of the HUT provided an insight into whether the lesion was derived from a single clone or was a proliferation of a number of cells. However the overall staining patterns were highly variable between and within cases and no common observations were identified. Although the numbers in this study are small and there is a lack of BRCA1 and BRACA2 mutation status information in all samples, there does seem to be a trend towards the BRCA mutation positive samples being more likely to have genomic aberrations and for these samples to have an increased number of aberrations over samples with unknown mutation status. The wide variety copy number losses and gains in these samples suggest that premalignant lesions can, and do, acquire an array of aberrations and still present as a similar morphological lesions.
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Pease, Anna Susan. "Factors influencing infant care practices in the sleep environment among families at high risk of sudden infant death syndrome". Thesis, University of Bristol, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.702488.

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Introduction. Advice for reducing the risk of Sudden Infant Death Syndrome (SIDS) by modifying the infant sleep environment has led to significant reductions in the number of babies who die. The highest burden of SIDS now lies with the most deprived families in society, where rates remain higher than in the general population. This thesis employed a mixed methods approach to examine knowledge and attitudes to SIDS risk reduction advice and explore the factors that influence decision making for the infant sleep environment among families most at risk. Methods. The four parts to this programme of work included: 1) A systematic review of the literature to reveal how mothers' knowledge of SIDS risk reduction has been measured and provide a suitable tool for use in a quantitative survey. 2) An analysis of longitudinal postal questionnaires from birth to late infancy to assess whether a high risk scoring system for SIDS based on routine demographics identifies risky infant care practices. 3) A quantitative survey of mothers recruited from health visitor-led clinics in deprived areas of Bristol, UK to measure mothers' knowledge and attitudes to SIDS advice. 4) A qualitative survey using home interviews with mothers of infants at higher risk of SIDS to determine decision making processes for the infant sleep environment. Results. The systematic review screened over 3000 papers and uncovered a useful tool for measuring knowledge of SIDS risks. The analysis of 591 postal questionnaires found that a scoring system of demographic characteristics can pick up on differences in infant care for a higher risk group, especially sleeping position and breastfeeding. The face-to-face survey with 400 mothers found poorer knowledge of SIDS risks in a higher risk group using the same scoring system and home interviews with 20 mothers most at risk gave insights into the complex challenges of night time infant care for this group. The interviews suggested that mothers are influenced by family and friends, their own self-efficacy, beliefs they hold about infant safety and care and their perceived barriers to following the recommended advice. Conclusions. This work confirms that families at higher risk for SIDS have poorer knowledge of the risk factors and are more likely to engage in sleep practices that may put their infants at further risk of SIDS. It also confirms that decision-making for infant care is interconnected with social contexts and psychological constructs that can help or hinder when it comes to safe sleep. Where good reasons for following advice were lacking, mothers would fill in the blanks with their own interpretations that risk supporting unsafe sleep decisions. Interventions that target groups of parents where the risks of SIDS are higher, need to consider social influences, beliefs and understanding behind the safer sleep messages if they are to be effective and engage this group in change.
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Książki na temat "High risk families"

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Kaplan, Lisa. Strengthening high-risk families: A handbook for practitioners. New York: Lexington Books, 1994.

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Whittaker, James K. Reaching high-risk families: Intensive family preservation in human services. New York: Aldine de Gruyter, 1990.

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R, Borker Susan, red. Regionalization: Issues in intensive care for high risk newborns and their families. New York: Praeger, 1987.

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Cooperative agreement for establishing a mentoring/advocacy program for high risk youth and their families. [Rockville, Md.?]: Dept. of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, 1998.

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Nếp sống gia đình ở khu đô thị mới: Nghiên cứu trường hợp khu chung cư Trung Hòa-Nhân Chính. Hà Nội: Nhà xuất bản Khoa học xã hội, 2012.

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Aflalo & Gasperini: Edifícios corporativos : família Atrium. Granja Viana, Cotia, SP: Ateliê Editorial, 2004.

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Tracy, Elizabeth. Reaching High-Risk Families. Redaktorzy James K. Whittaker, Jill Kinney, Elizabeth M. Tracy i Charlotte Booth. Routledge, 2017. http://dx.doi.org/10.4324/9781315128047.

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Child Maltreatment and High Risk Families. Dunedin Academic Press, 2014.

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Lazenbatt, Anne, i Julie Taylor. Child Maltreatment and High Risk Families. Dunedin Academic Press, 2014.

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Dempsey, Allison G., Joanna C. M. Cole i Sage N. Saxton. Behavioral Health Services with High-Risk Infants and Families. Oxford University PressNew York, 2022. http://dx.doi.org/10.1093/med-psych/9780197545027.001.0001.

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Abstract There is a growing need for integration of behavioral health providers within medical settings to address mental health concerns of expectant parents, high-risk infants and families, and the frontline medical staff who care for them. This book is designed to be a comprehensive, practical resource for providers working in perinatal and neonatal intensive care settings inclusive of fetal care centers, neonatal intensive care settings, and neonatal follow-up clinics. Contributors are leading experts in various aspects of care for expectant parents, infants, and their families, with backgrounds in medicine, psychology, social work, nursing, and parenting high-risk infants. The book is divided into five sections. Each section provides setting-specific information critical to behavioral health care practice, including an overview of common medical conditions and treatments, roles and activities of integrated health providers, and specific behavioral health issues pertaining to the setting. Case examples are presented throughout to highlight important concepts and application of clinical practice. Section I provides a broad overview of roles and practice issues, including the history of psychological services for high-risk infants, operational considerations, and systems-level approaches to improving care. Section II explores symptom presentation, risk assessment and treatment approaches for perinatal and infant mental health concerns, as well as strategies to support families (e.g., breastfeeding, decision-making, and peer support programs). Sections III–V address key components for clinicians within fetal care settings, neonatal intensive care settings, and neonatal follow-up settings, including an overview of common medical conditions and treatments, activities of integrated health providers, and multidisciplinary collaboration strategies to care for the unique needs of high-risk infants and families.
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Części książek na temat "High risk families"

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Cleophas, Ton J., i Aeilko H. Zwinderman. "Predicting High-Risk-Bin Memberships (1,445 Families)". W Machine Learning in Medicine - a Complete Overview, 25–29. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-15195-3_5.

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Williams, R. R., S. C. Hunt, P. N. Hopkins, S. J. Hasstedt, L. L. Wu, B. M. Stults, M. C. Schumacher, H. Kuida i J. M. Lalouel. "Hypertension and Dyslipidemia in High Risk Families". W Medical Science Symposia Series, 111–15. Dordrecht: Springer Netherlands, 1992. http://dx.doi.org/10.1007/978-94-011-2700-4_13.

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Cleophas, Ton J., i Aeilko H. Zwinderman. "Predicting High-Risk-Bin Memberships (1,445 Families)". W Machine Learning in Medicine - Cookbook Two, 11–15. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-07413-9_2.

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Foulkes, William D., i Steven A. Narod. "Screening for cancer in high-risk families". W Advances in Cancer Screening, 165–82. Boston, MA: Springer US, 1996. http://dx.doi.org/10.1007/978-1-4613-1265-9_12.

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Cleophas, Ton J., i Aeilko H. Zwinderman. "Predicting High-Risk-Bin Memberships (1445 Families)". W Machine Learning in Medicine – A Complete Overview, 29–34. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-33970-8_5.

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Cleophas, Ton J., i Aeilko H. Zwinderman. "Optimal Binning for Finding High Risk Cut-offs (1,445 Families)". W Machine Learning in Medicine - a Complete Overview, 353–57. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-15195-3_56.

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Cleophas, Ton J., i Aeilko H. Zwinderman. "Optimal Binning for Finding High Risk Cut-offs (1445 Families)". W Machine Learning in Medicine - Cookbook, 123–27. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-04181-0_19.

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Cleophas, Ton J., i Aeilko H. Zwinderman. "Optimal Binning for Finding High Risk Cut-offs (1445 Families)". W Machine Learning in Medicine – A Complete Overview, 473–79. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-33970-8_61.

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Bradshaw, Jessica, i Lynn Koegel. "Adapting Pivotal Response Treatment to Support the Families of High-Risk Infants". W Handbook of Parent-Implemented Interventions for Very Young Children with Autism, 59–76. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-90994-3_4.

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Dunlap, Eloise, Bruce D. Johnson i Doris Randolph. "Ethical and legal dilemmas in ethnographic field research: Three case studies of distressed inner-city families." W Research with high-risk populations: Balancing science, ethics, and law., 207–29. Washington: American Psychological Association, 2009. http://dx.doi.org/10.1037/11878-010.

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Streszczenia konferencji na temat "High risk families"

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Harris, Nathan Scott. "Abstract 802: Multi-cancer profiles in high-risk CLL families". W Proceedings: AACR Annual Meeting 2021; April 10-15, 2021 and May 17-21, 2021; Philadelphia, PA. American Association for Cancer Research, 2021. http://dx.doi.org/10.1158/1538-7445.am2021-802.

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Arason, Adalgeir, Haukur Gunnarsson, Gudrun Johannesdottir, Kristjan Jonasson, Pär-Ola Bendahl, Elizabeth Gillanders, Bjarni A. Agnarsson i in. "Abstract 1855: Genome-wide search for linkage in Icelandic high-risk breast cancer families". W Proceedings: AACR 101st Annual Meeting 2010‐‐ Apr 17‐21, 2010; Washington, DC. American Association for Cancer Research, 2010. http://dx.doi.org/10.1158/1538-7445.am10-1855.

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Clague, Jessica N., Greg Wilhoite, Aaron Adamson, Jeffrey N. Weitzel i Susan L. Neuhausen. "Abstract 908A: RAD51C germline mutations in breast and ovarian cancer cases from high-risk families". W Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL. American Association for Cancer Research, 2011. http://dx.doi.org/10.1158/1538-7445.am2011-908a.

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Kuusisto, Kirsi M., Tommi Rantapero, Minna Kankuri-Tammilehto, Matti Nykter, Satu-Leena Laasanen i Johanna Schleutker. "Abstract LB-284: Exome sequencing of high-risk Finnish hereditary breast and breast-ovarian cancer families". W Proceedings: AACR 106th Annual Meeting 2015; April 18-22, 2015; Philadelphia, PA. American Association for Cancer Research, 2015. http://dx.doi.org/10.1158/1538-7445.am2015-lb-284.

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Seewaldt, Victoria L., Bercedis Peterson i Gloria Broadwater. "Abstract LB-191: Cytological atypia predicts short-term breast cancer risk in women from high-risk families that lack a BRCA mutation." W Proceedings: AACR 104th Annual Meeting 2013; Apr 6-10, 2013; Washington, DC. American Association for Cancer Research, 2013. http://dx.doi.org/10.1158/1538-7445.am2013-lb-191.

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Van Marcke, Cedric, Raphaël Helaers, Céline A. Schoonjans, Martine Berlière, Anne De Leener, Jean-Luc Canon, Peter Vuylsteke i in. "Abstract P5-03-03: Tumor sequencing is useful to reclassify germline variants in unexplained high-risk breast cancer families". W Abstracts: 2019 San Antonio Breast Cancer Symposium; December 10-14, 2019; San Antonio, Texas. American Association for Cancer Research, 2020. http://dx.doi.org/10.1158/1538-7445.sabcs19-p5-03-03.

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Maxwell, Kara N., Lucia Guidugli, Kasmintan Schrader, Steven Hart, Vijai Joseph, Tinu Thomas, Xianshu Wang i in. "Abstract 1291: High and moderate penetrance germline mutations in a number of genes are responsible for a small proportion of familial breast cancer risk in BRCAx families". W Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA. American Association for Cancer Research, 2014. http://dx.doi.org/10.1158/1538-7445.am2014-1291.

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Elhag, Saba, Ibrahem Abdalhakam i Manar Abel-Rahman. "Prevalence of Consanguinity among ASD Individuals: Systematic Review & Meta-analysis". W Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0163.

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Aim: We aim to estimate the global prevalence of consanguinity among the ASD families and compare that among different populations. Methods: Meta-analysis of observational studies reporting prevalence of consanguinity among ASD families was searched systematically in important databases including EMBASE, PubMed and Academic Search Complete. Individual studies were screened by two reviewers independently, extracted data and assessed the risk of bias using a risk of bias tool (Hoy’s tool). Random Effect model was used to calculate pooled weighted estimates due to considerable heterogeneity. Subgroups analysis was also calculated. Results: 10 publications were identified based on our inclusion criteria from 8 different countries, 4 of them were from the Gulf Cooperation Council (GCC) and the rest were from: Lebanon (2 studies), Egypt, Jordan, Iran, and Israel). Studies varied in ASD cases numbers as it ranged between 49 -500, and the total ASD individuals in all studies were 1581. All studies address consanguinity among the ASD families despite the variation in the methods. The pooled estimate of consanguinity among ASD families was 24% Subgroup analysis by the study country led to a higher pooled estimate of consanguinity of 38% in the GCC countries compared to other than GCC countries with a pooled estimate of 16%. In addition, the overall odd ratio calculated from the case-control studies included in our meta-analysis was 1.5. Discussion: To our knowledge, this is the first meta-analysis that studied the prevalence of consanguinity among ASD families worldwide. Children born to consanguineous parents have been reported to have lower social behavior and cognitive ability, which are the main problems with ASD children. Our study qualitatively reviewed the prevalence of consanguinity among ASD families throughout the world and 10 eligible studies from eight countries were identified. We quantitatively synthesized the results and the key findings of this study showed a 24% overall pooled estimate of consanguinity among ASD families. GCC countries showed a high estimated pooled prevalence of consanguinity among ASD families as 38% compared to countries other than GCC 16%, which was higher than our overall pooled prevalence. This high estimate among GCC countries can be related to the high rates of consanguineous marriage in the GCC countries compared to the worldwide rates (20%). In Qatar, the rate of consanguineous marriage reported as 54%. This high rates among GCC countries may be due to factors like rooted cultural beliefs, social life and customs in addition to, economic benefits of keeping wealth within the families. Conclusion: The globally estimated pooled consanguinity prevalence among ASD patients was 24%, GCC countries showed a higher pooled prevalence (38%)
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Esteves, VF, LS Thuler, L. Amendola, PP Frankel, RJ Vieira, RJ Koifman i S. Koifman. "Prevalence of BRCA1 and BRCA2 genes mutations in a sample of families with high risk of breast and ovarian cancer in Brazil." W CTRC-AACR San Antonio Breast Cancer Symposium: 2008 Abstracts. American Association for Cancer Research, 2009. http://dx.doi.org/10.1158/0008-5472.sabcs-6020.

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Brandhurst, Grace L., Angelle Bencaz, Sarah North, Ellen Jaeger, Diptasri Mandal i Joan Bailey-Wilson. "Abstract PO-190: Health disparities in high-risk lung cancer families and their association with smoking, environmental exposures, and other etiological factors". W Abstracts: AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; October 6-8, 2021. American Association for Cancer Research, 2022. http://dx.doi.org/10.1158/1538-7755.disp21-po-190.

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Raporty organizacyjne na temat "High risk families"

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Aikins, Julie W. Identifying Military and Combat-Specific Risk Factors for Child Adjustment: Comparing High and Low Risk Military Families and Civilian Families. Fort Belvoir, VA: Defense Technical Information Center, czerwiec 2013. http://dx.doi.org/10.21236/ada586176.

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Walsh, Tomas, i Mary-Claire King. WholeGenome Sequencing of High-Risk Families to Identify New Mutational Mechanisms of Breast Cancer Predisposition. Fort Belvoir, VA: Defense Technical Information Center, październik 2014. http://dx.doi.org/10.21236/ada613308.

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Walsh, Tom, i Mary-Claire King. Whole Genome Sequencing of High-Risk Families to Identify New Mutational Mechanisms of Breast Cancer Predisposition. Fort Belvoir, VA: Defense Technical Information Center, październik 2014. http://dx.doi.org/10.21236/ada613072.

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Busso, Matías, Juanita Camacho, Julián Messina i Guadalupe Montenegro. Social Protection and Informality in Latin America during the COVID-19 Pandemic. Inter-American Development Bank, listopad 2020. http://dx.doi.org/10.18235/0002865.

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Latin American governments swiftly implemented income assistance programs to sustain families' livelihoods during COVID-19 stay-at-home orders. This paper analyzes the potential coverage and generosity of these measures and assesses the suitability of current safety nets to deal with unexpected negative income shocks in 10 Latin American countries. The expansion of pre-existing programs (most notably conditional cash transfers and non-contributory pensions) during the COVID-19 crisis was generally insufficient to compensate for the inability to work among the poorest segments of the population. When COVID-19 ad hoc programs are analyzed, the coverage and replacement rates of regular labor income among households in the first quintile of the country's labor income distribution increase substantially. Yet, these programs present substantial coverage challenges among families composed of fundamentally informal workers who are non-poor, but are at a high risk of poverty. These results highlight the limitations of the fragmented nature of social protection systems in the region.
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Parsons, Helen M., Hamdi I. Abdi, Victoria A. Nelson, Amy M. Claussen, Brittin L. Wagner, Karim T. Sadak, Peter B. Scal, Timothy J. Wilt i Mary Butler. Transitions of Care From Pediatric to Adult Services for Children With Special Healthcare Needs. Agency for Healthcare Research and Quality (AHRQ), maj 2022. http://dx.doi.org/10.23970/ahrqepccer255.

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Objective. To understand the evidence base for care interventions, implementation strategies, and between-provider communication tools among children with special healthcare needs (CSHCN) transitioning from pediatric to adult medical care services. Data sources. We searched Ovid MEDLINE, Ovid Embase, the Cochrane Central trials (CENTRAL) registry, and CINAHL to identify studies through September 10, 2021. We conducted grey literature searches to identify additional resources relevant to contextual questions. Review methods. Using a mixed-studies review approach, we searched for interventions or implementation strategies for transitioning CSHCN from pediatric to adult services. Two investigators screened abstracts and full-text articles of identified references for eligibility. Eligible studies included randomized controlled trials, quasi-experimental observational studies, and mixed-method studies of CSHCN, their families, caregivers, or healthcare providers. We extracted basic study information from all eligible studies and grouped interventions into categories based on disease conditions. We summarized basic study characteristics for included studies and outcomes for studies assessed as low to medium risk of bias using RoB-2. Results. We identified 9,549 unique references, 440 of which represented empirical research; of these, 154 (16 major disease categories) described or examined a care transition intervention with enough detail to potentially be eligible for inclusion in any of the Key Questions. Of these, 96 studies met comparator criteria to undergo risk of bias assessment; however only 9 studies were assessed as low or medium risk of bias and included in our analytic set. Low-strength evidence shows transition clinics may not improve hemoglobin A1C levels either at 12 or 24 months in youth with type 1 diabetes mellitus compared with youth who received usual care. For all other interventions and outcomes, the evidence was insufficient to draw meaningful conclusions because the uncertainty of evidence was too high. Some approaches to addressing barriers include dedicating time and resources to support transition planning, developing a workforce trained to care for the needs of this population, and creating structured processes and tools to facilitate the transition process. No globally accepted definition for effective transition of care from pediatric to adult services for CSHCN exists; definitions are often drawn from principles for transitions, encompassing a broad set of clinical aspects and other factors that influence care outcomes or promote continuity of care. There is also no single measure or set of measures consistently used to evaluate effectiveness of transitions of care. The literature identifies a limited number of available training and other implementation strategies focused on specific clinical specialties in targeted settings. No eligible studies measured the effectiveness of providing linguistically and culturally competent healthcare for CSHCN. Identified transition care training, and care interventions to
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Nolan, Brian, Brenda Gannon, Richard Layte, Dorothy Watson, Christopher T. Whelan i James Williams. Monitoring Poverty Trends in Ireland: Results from the 2000 Living in Ireland survey. ESRI, lipiec 2002. http://dx.doi.org/10.26504/prs45.

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This study is the latest in a series monitoring the evolution of poverty, based on data gathered by The ESRI in the Living in Ireland Surveys since 1994. These have allowed progress towards achieving the targets set out in the National Anti Poverty Strategy since 1997 to be assessed. The present study provides an updated picture using results from the 2000 round of the Living in Ireland survey. The numbers interviewed in the 2000 Living in Ireland survey were enhanced substantially, to compensate for attrition in the panel survey since it commenced in 1994. Individual interviews were conducted with 8,056 respondents. Relative income poverty lines do not on their own provide a satisfactory measure of exclusion due to lack of resources, but do nonetheless produce important key indicators of medium to long-term background trends. The numbers falling below relative income poverty lines were most often higher in 2000 than in 1997 or 1994. The income gap for those falling below these thresholds also increased. By contrast, the percentage of persons falling below income lines indexed only to prices (rather than average income) since 1994 or 1997 fell sharply, reflecting the pronounced real income growth throughout the distribution between then and 2000. This contrast points to the fundamental factors at work over this highly unusual period: unemployment fell very sharply and substantial real income growth was seen throughout the distribution, including social welfare payments, but these lagged behind income from work and property so social welfare recipients were more likely to fall below thresholds linked to average income. The study shows an increasing probability of falling below key relative income thresholds for single person households, those affected by illness or disability, and for those who are aged 65 or over - many of whom rely on social welfare support. Those in households where the reference person is unemployed still face a relatively high risk of falling below the income thresholds but continue to decline as a proportion of all those below the lines. Women face a higher risk of falling below those lines than men, but this gap was marked among the elderly. The study shows a marked decline in deprivation levels across different household types. As a result consistent poverty, that is the numbers both below relative income poverty lines and experiencing basic deprivation, also declined sharply. Those living in households comprising one adult with children continue to face a particularly high risk of consistent poverty, followed by those in families with two adults and four or more children. The percentage of adults in households below 70 per cent of median income and experiencing basic deprivation was seen to have fallen from 9 per cent in 1997 to about 4 per cent, while the percentage of children in such households fell from 15 per cent to 8 per cent. Women aged 65 or over faced a significantly higher risk of consistent poverty than men of that age. Up to 2000, the set of eight basic deprivation items included in the measure of consistent poverty were unchanged, so it was important to assess whether they were still capturing what would be widely seen as generalised deprivation. Factor analysis suggested that the structuring of deprivation items into the different dimensions has remained remarkably stable over time. Combining low income with the original set of basic deprivation indicators did still appear to identify a set of households experiencing generalised deprivation as a result of prolonged constraints in terms of command over resources, and distinguished from those experiencing other types of deprivation. However, on its own this does not tell the whole story - like purely relative income measures - nor does it necessarily remain the most appropriate set of indicators looking forward. Finally, it is argued that it would now be appropriate to expand the range of monitoring tools to include alternative poverty measures incorporating income and deprivation. Levels of deprivation for some of the items included in the original basic set were so low by 2000 that further progress will be difficult to capture empirically. This represents a remarkable achievement in a short space of time, but poverty is invariably reconstituted in terms of new and emerging social needs in a context of higher societal living standards and expectations. An alternative set of basic deprivation indicators and measure of consistent poverty is presented, which would be more likely to capture key trends over the next number of years. This has implications for the approach adopted in monitoring the National Anti-Poverty Strategy. Monitoring over the period to 2007 should take a broader focus than the consistent poverty measure as constructed to date, with attention also paid to both relative income and to consistent poverty with the amended set of indicators identified here.
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Roberts, Tony, i Becky Faith. Digital Aid: Understanding the Digital Challenges Facing Humanitarian Assistance. Institute of Development Studies, marzec 2021. http://dx.doi.org/10.19088/ids.2021.030.

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The UKRI Digital Aid workshop on 9 September 2019 brought together expert practitioners and researchers to focus on the use of digital technologies in humanitarian aid. Participants brought wide experience of digital applications to monitor conflict, refugees, food security, and to reunite families, enable communication and increase donor value for money. The event identified key areas where the rapid pace of technological change is outstripping our current understanding of emerging risks, digital inequalities and ethical dilemmas associated with the use of digital technologies in humanitarian response. The International Committee of the Red Cross (ICRC) in their contribution to the UN Secretary-General’s High-Level Panel on Digital Cooperation warned that it is of critical importance to ‘keep humanitarian purpose, and the people humanitarian organizations are there to protect and assist, firmly at the centre of any developments in order to ensure the humanitarian response do no harm in their application’ (ICRC 2019). Yet workshop discussions showed how humanitarian practitioners are struggling to operationalise the “do no harm” principle in the context of a rapidly changing technological landscape. Workshop participants felt that research has a vital role to play in protecting the interests of vulnerable communities in the digital age.
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Rosero-Bixby, Luis, i Tim Miller. The mathematics of the reproduction number R for Covid-19: A primer for demographers. Verlag der Österreichischen Akademie der Wissenschaften, grudzień 2021. http://dx.doi.org/10.1553/populationyearbook2022.res1.3.

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The reproduction number R is a key indicator used to monitor the dynamics of Covid-19 and to assess the effects of infection control strategies that frequently have high social and economic costs. Despite having an analog in demography’s “net reproduction rate” that has been routinely computed for a century, demographers may not be familiar with the concept and measurement of R in the context of Covid-19. This article is intended to be a primer for understanding and estimating R in demography. We show that R can be estimated as a ratio between the numbers of new cases today divided by the weighted average of cases in previous days. We present two alternative derivations for these weights based on how risks have changed over time: constant vs. exponential decay. We then provide estimates of these weights, and demonstrate their use in calculating R to trace the course of the first pandemic year in 53 countries.
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McKenna, Patrick, i Mark Evans. Emergency Relief and complex service delivery: Towards better outcomes. Queensland University of Technology, czerwiec 2021. http://dx.doi.org/10.5204/rep.eprints.211133.

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Emergency Relief (ER) is a Department of Social Services (DSS) funded program, delivered by 197 community organisations (ER Providers) across Australia, to assist people facing a financial crisis with financial/material aid and referrals to other support programs. ER has been playing this important role in Australian communities since 1979. Without ER, more people living in Australia who experience a financial crisis might face further harm such as crippling debt or homelessness. The Emergency Relief National Coordination Group (NCG) was established in April 2020 at the start of the COVID-19 pandemic to advise the Minister for Families and Social Services on the implementation of ER. To inform its advice to the Minister, the NCG partnered with the Institute for Governance at the University of Canberra to conduct research to understand the issues and challenges faced by ER Providers and Service Users in local contexts across Australia. The research involved a desktop review of the existing literature on ER service provision, a large survey which all Commonwealth ER Providers were invited to participate in (and 122 responses were received), interviews with a purposive sample of 18 ER Providers, and the development of a program logic and theory of change for the Commonwealth ER program to assess progress. The surveys and interviews focussed on ER Provider perceptions of the strengths, weaknesses, future challenges, and areas of improvement for current ER provision. The trend of increasing case complexity, the effectiveness of ER service delivery models in achieving outcomes for Service Users, and the significance of volunteering in the sector were investigated. Separately, an evaluation of the performance of the NCG was conducted and a summary of the evaluation is provided as an appendix to this report. Several themes emerged from the review of the existing literature such as service delivery shortcomings in dealing with case complexity, the effectiveness of case management, and repeat requests for service. Interviews with ER workers and Service Users found that an uplift in workforce capability was required to deal with increasing case complexity, leading to recommendations for more training and service standards. Several service evaluations found that ER delivered with case management led to high Service User satisfaction, played an integral role in transforming the lives of people with complex needs, and lowered repeat requests for service. A large longitudinal quantitative study revealed that more time spent with participants substantially decreased the number of repeat requests for service; and, given that repeat requests for service can be an indicator of entrenched poverty, not accessing further services is likely to suggest improvement. The interviews identified the main strengths of ER to be the rapid response and flexible use of funds to stabilise crisis situations and connect people to other supports through strong local networks. Service Users trusted the system because of these strengths, and ER was often an access point to holistic support. There were three main weaknesses identified. First, funding contracts were too short and did not cover the full costs of the program—in particular, case management for complex cases. Second, many Service Users were dependent on ER which was inconsistent with the definition and intent of the program. Third, there was inconsistency in the level of service received by Service Users in different geographic locations. These weaknesses can be improved upon with a joined-up approach featuring co-design and collaborative governance, leading to the successful commissioning of social services. The survey confirmed that volunteers were significant for ER, making up 92% of all workers and 51% of all hours worked in respondent ER programs. Of the 122 respondents, volunteers amounted to 554 full-time equivalents, a contribution valued at $39.4 million. In total there were 8,316 volunteers working in the 122 respondent ER programs. The sector can support and upskill these volunteers (and employees in addition) by developing scalable training solutions such as online training modules, updating ER service standards, and engaging in collaborative learning arrangements where large and small ER Providers share resources. More engagement with peak bodies such as Volunteering Australia might also assist the sector to improve the focus on volunteer engagement. Integrated services achieve better outcomes for complex ER cases—97% of survey respondents either agreed or strongly agreed this was the case. The research identified the dimensions of service integration most relevant to ER Providers to be case management, referrals, the breadth of services offered internally, co-location with interrelated service providers, an established network of support, workforce capability, and Service User engagement. Providers can individually focus on increasing the level of service integration for their ER program to improve their ability to deal with complex cases, which are clearly on the rise. At the system level, a more joined-up approach can also improve service integration across Australia. The key dimensions of this finding are discussed next in more detail. Case management is key for achieving Service User outcomes for complex cases—89% of survey respondents either agreed or strongly agreed this was the case. Interviewees most frequently said they would provide more case management if they could change their service model. Case management allows for more time spent with the Service User, follow up with referral partners, and a higher level of expertise in service delivery to support complex cases. Of course, it is a costly model and not currently funded for all Service Users through ER. Where case management is not available as part of ER, it might be available through a related service that is part of a network of support. Where possible, ER Providers should facilitate access to case management for Service Users who would benefit. At a system level, ER models with a greater component of case management could be implemented as test cases. Referral systems are also key for achieving Service User outcomes, which is reflected in the ER Program Logic presented on page 31. The survey and interview data show that referrals within an integrated service (internal) or in a service hub (co-located) are most effective. Where this is not possible, warm referrals within a trusted network of support are more effective than cold referrals leading to higher take-up and beneficial Service User outcomes. However, cold referrals are most common, pointing to a weakness in ER referral systems. This is because ER Providers do not operate or co-locate with interrelated services in many cases, nor do they have the case management capacity to provide warm referrals in many other cases. For mental illness support, which interviewees identified as one of the most difficult issues to deal with, ER Providers offer an integrated service only 23% of the time, warm referrals 34% of the time, and cold referrals 43% of the time. A focus on referral systems at the individual ER Provider level, and system level through a joined-up approach, might lead to better outcomes for Service Users. The program logic and theory of change for ER have been documented with input from the research findings and included in Section 4.3 on page 31. These show that ER helps people facing a financial crisis to meet their immediate needs, avoid further harm, and access a path to recovery. The research demonstrates that ER is fundamental to supporting vulnerable people in Australia and should therefore continue to be funded by government.
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Progressive cortical thinning might identify children at risk of developing psychotic spectrum symptoms. ACAMH, marzec 2021. http://dx.doi.org/10.13056/acamh.15013.

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Offspring of patients with schizophrenia or bipolar disorder have an increased risk of developing these conditions. However, our capacity to predict the long-term outcomes of these at-risk individuals is limited. Now, researchers have investigated whether longitudinal changes in brain structure differ in individuals at high familial risk who develop psychotic spectrum symptoms, compared to those who do not and to low-risk controls.
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