[Contraception in adolescence: knowing is not enough].
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Adolescent↗
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Results for “Acceptance Process”
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Estimation of food additive intake: methodology overview.
Any attempt to estimate food additive intake will require some level of screening to reduce the scale of the problem to a manageable level. Even then the process should always begin with crude estimates of food intake and of food additive usage level. The starting point for the latter may be the maximum permitted levels as laid down in the relevant regulations. If at that point the data are deemed acceptable, the process ends. If further requirements are needed they can be for both food intake data and food additive usage levels. Refinement may involve disaggregation of gross categories into more precise categories but research needs to be done to establish the true value of highly refined data. It remains possible that the distribution of the intakes of refined categories is similar to that of the crude categories. Intake data should relate to the population who consume the foods containing the additive in question and even then at some higher level such as the 97.5th percentile. Whether the use of this extreme is acceptable as numbers of subjects diminish in any age and sex breakdown of data remains to be seen. We also need to know something of the dietary habits and sociodemographic characteristics of high consumers and to devise ways of obtaining data for consumers-only from household budget data. Finally we need to know more of how to increase the precision of estimating the percentage of consumers, perhaps combining food frequency questionnaires with 3-day records.
Diet Surveys↗
An efficient method for computer-aided dosage form design.
It is desirable to have slow-release dosage form to be taken once daily, or at most twice daily, as compared to three or four times in a single day. However, the existing computer-aided dosage form design method requires a large amount of computer time when applied to nonlinear disposition drugs. This large commitment of computer time makes it inconvenient to study the feasibility for prolonged-release products containing such drugs. Instead of evaluating all possible combinations of the amount of dose and release rates that produce acceptable steady-state plasma concentrations, only the contour of the dose-release rate domain needs to be determined. An image boundary tracking method has been used to determine such contours. When combined with several modifications of the numerical solution process, the acceptable dose and release rate constants can be determined efficiently. When this modified boundary tracking method was applied to phenytoin, which exhibits nonlinear disposition, the required computer time was reduced to about 5% of the previous method, making the dosage form feasibility assessment practical.
Computer Simulation↗
A time-dependent stopping problem with application to live organ transplants.
We consider a time-dependent stopping problem and its application to the decision-making process associated with transplanting a live organ. "Offers" (e.g., kidneys for transplant) become available from time to time. The values of the offers constitute a sequence of independent identically distributed positive random variables. When an offer arrives, a decision is made whether to accept it. If it is accepted, the process terminates. Otherwise, the offer is lost and the process continues until the next arrival, or until a moment when the process terminates by itself. Self-termination depends on an underlying lifetime distribution (which in the application corresponds to that of the candidate for a transplant). When the underlying process has an increasing failure rate, and the arrivals form a renewal process, we show that the control-limit type policy that maximizes the expected reward is a nonincreasing function of time. For non-homogeneous Poisson arrivals, we derive a first-order differential equation for the control-limit function. This equation is explicitly solved for the case of discrete-valued offers, homogeneous Poisson arrivals, and Gamma distributed lifetime. We use the solution to analyze a detailed numerical example based on actual kidney transplant data.
Decision Making↗
Counseling sexually abused girls: the impact of sex of counselor.
OBJECTIVE: The present study was conducted to assess the impact of sex of counselor on the therapeutic process for sexually abused girls in individual counseling. METHOD: Raters evaluated videotapes of counseling sessions recorded for 35 sexually abused girls who had been systematically assigned to brief-term psychoeducationally oriented treatment with either a male or female counselor. Clients' in-session behavior was rated using accepted therapeutic process measures, while statistically controlling for the effect of girls' pretreatment comfort level with male and female counselors. RESULTS: Overall, MANCOVA results revealed that girls' participation in counseling was not significantly related to session number, the child's age (i.e., preadolescent vs. adolescent), or the sex of counselor who provided treatment services. However, univariate results and graphic representations of girls' behavior suggest that adolescent clients, when compared with their preadolescent counterparts, seemed to be more reluctant to discuss certain child sexual abuse topics. CONCLUSIONS: The findings suggest that caution is warranted regarding categorical recommendations on the assignment of young female survivors to male counselors. Delimitations and limitations of the study and directions for future research are discussed.
Adolescent↗
Anxiety of infertile women undergoing IVF-ET: relation to the grief process.
The psychological state of 102 infertile women undergoing in vitro fertilization and embryo transfer was investigated. The levels of anxiety were measured by the state trait anxiety inventory and the manifest anxiety scale. The process of accepting infertility and attitudes toward treatment were explored by a semistructured interview. The mean score of state anxiety for the subjects was 50.0 which was considerably higher than the standard score of 42 for the general Japanese females. Women undergoing in vitro fertilization and embryo transfer with higher levels of anxiety remain in the introversive stage of the grief process, have a more positive attitude toward treatment, a more pessimistic outlook on the possibility of successful pregnancy, and feel more agitation.
Adult↗
Family caregiving of the elderly in Botswana: boundaries of culturally acceptable options and resources.
Care of the elderly in Botswana is solely a family responsibility. In the absence of formal programs for the elderly it is important to understand the cultural beliefs that guide decision making regarding acceptance of elderly care. The purpose of this study was to explore the experiences of family caregivers to older persons in Botswana. Using grounded theory methodology, 24 caregivers who were caring for an older person were interviewed. The findings indicate that the perceptions that guided the caregivers' decision making process of acceptance or non-acceptance of assistance from both family members and the government fell into three inter-related but distinct categories: Stigma, Appropriate-inappropriate forms of care; and Sense of Place. It is recommended that cultural sensitivity should be considered in designing models of support for families who are looking after their older relatives. Finally, a clear understanding of the perceptions of family members' needs must be emphasized as these differ from health workers' perceptions of family needs.
Journal Article↗
Empowering the women of the Sahel.
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Africa↗
Consideration of media fill tests for evaluation and control of aseptic processes: a statistical approach to quality criteria.
The concept of upper and lower statistical confidence limits has been introduced to the current media fill tests used for the assurance of aseptic operation. Results of media fill tests can be evaluated with rationale and interpreted more clearly by introducing the upper and lower limits for the number of observed positive units. Quality criteria derived by the misuse of statistics should be reconsidered. Media fill tests are one of the most useful methods for the evaluation of aseptic filling processes, and acceptance criteria have been issued in various official compendia. In some official compendia, various combinations of the number of media fills and the number of detected allowable contaminated units have been indicated based on the misuse of statistics. This study has statistically revealed that the larger number of fills allows for the worse average accepted quality. This study has shown that media fill tests can be used for the evaluation of aseptic operation with fully scientific and statistical rationale by evaluating the statistical lower limit for the number of positive units observed. This study proposed that the new criteria should be simply expressed as the process should be in a controlled state and can manufacture product whose sterility can be statistically assured with 95% confidence level.
Asepsis↗
Euthanasia and HIV disease: how can physicians respond?
By accepting the role of caregiver, the physician can do much to decrease the fear surrounding death. By providing an opportunity for a patient to discuss his ideas and feelings about his own death, physicians can better prepare their patients and themselves for the inevitable. None of us can reverse the dying process. By accepting the fact of death and by reframing our goals to provide care that promotes comfort and dignity, the act of watching our patients die becomes not only bearable but also serene.
Advance Care Planning↗
Acceptance of angulation in the non-operative treatment of paediatric forearm fractures.
Forearm fractures are the most common injury in paediatric traumatology. The unique properties of the juvenile skeleton make it possible to cope well with traumatic deformities such as angulation, apposition and displacement. While we make use of these properties, the exact mechanism and degree of healing remains obscure. Different types of forearm fractures require specific treatment options, each with its limitations. A meta-analysis of recent literature was carried out, and together with the opinions of 18 international experts an effort was made to provide insight into the limits of acceptance of angular deformation in the non-operative treatment of paediatric forearm fractures. With this information we constructed graphs (age versus angulation) for each of the eight types of paediatric forearm fractures. In the absence of proper trials, it is our opinion that the presented Isala graphs can provide useful support in the decision-making process of acceptance of angular deformities in paediatric forearm fractures.
Adolescent↗
Battling AIDS through home care in Uganda and Zambia.
Innovative home care programs, providing a variety of services to persons with HIV infection and their families and reflecting different health, political, cultural, social, and philosophical concepts, have been developed in Africa, starting in 1987. In 1989 the World Health Organization (WHO) Global Programme on AIDS conducted a descriptive study of some of these programs. It is hoped that these experiences will assist planners and health care providers in their decision making and thereby benefit persons with HIV infection and their families. The lessons learned about the context, backgrounds, structure, process, and outcome of the six selected home care programs can be used and adapted by policymakers and program planners in their own settings when deciding on "their" model of home care.
Acquired Immunodeficiency Syndrome↗
[Use of a process computer in nuclear medicine].
The picture processing of scintigrammes (scintillation scanner and scintillation camera) has become possible only by use of process calculators. In the processing of individual static pictures by means of mathematical filtration methods, underground subtraction and formation of classes the perceptibility of details is improved. The evaluation of dynamic photographs of the scintillation camera (to 10 pictures/s) presumes the genuine time working of a process calculator. Out of the sequel of pictures the temporary course of activity in marked picture regions (organs, parts of organs) can be calculated as function curve. Using a small computer system KRS 4,200 (Robotron) in the Radiological Clinic of the Leipzig Karl-Marx-University the temporary and logical course of measuring is regulated in nuclear-medical measuring places. Acceptance and processing of the measuring values is performed by 5 working places in genuine time work. Furthermore, organizational tasks of the course of work are treated by computer.
Computers↗
Retraining: can do, will do? A practical guide to process and pitfalls.
This article reports the lessons learnt from a period of retraining and from discussion with others who have been involved in a similar process. The conclusions are that retraining should only be undertaken once there is full agreement between all parties involved that it is necessary and feasible. There must also be agreement in advance of the criteria which will constitute successful retraining, and the actions which will be taken to ensure the rapid return of the retrainee to the type of practice which is being offered and has been accepted. The process of retraining requires especially close supervision and is very stressful for the retrainee. It is likely that this should only be undertaken in units specially staffed and funded to accommodate this type of work.
Clinical Competence↗
Provision of induced abortion in Wessex Health Region: unmet need and feasibility of compensatory day care.
A study of routinely collected data showed that in 1975 only 42% of Wessex abortion patients obtained a National Health Service operation in their own region. Within this average the range for own district National Health Service operations was from 8.7% (Central Hampshire) to 68% (South West Hampshire) when known paybed operations had been excluded. Most of the remaining patients obtained private operations outside the region and of these about 50% obtained an operation at the British Pregnancy Advisory Service Clinic (BPAS) at Brighton.A survey of Wessex women obtaining induced abortions at BPAS, Brighton, found that 85% of a sample of patients interviewed would have been willing to have a National Health Service operation locally but it had not been available. Only 24% of these women had been referred by way of a formal and accepted path, and had obtained their operation before ten weeks gestation, a suggested maximum for day-care provision.It this proportion is representative of Wessex patients obtaining operations outside the region, the numbers of patients involved in 1975 would have been 643 and the feasibility of a day surgical unit specially providing for this number would be questionable.It is suggested that by reducing delays in the referral process and accepting patients by nontraditional referral paths at least a further 21% of the patients would have qualified for day care. On the basis of this estimate a Regional Day Abortion Unit is probably a practicable proposition.
Abortion, Legal↗
[Acquired educational deficiency syndrome--AEDS].
In this description of AEDS I would like to present different explanations and diagnostical approaches, preventative measures and therapies for the majority of behavioral disturbances in children and adolescents. In essence, most of these behavioral disturbances in children such as learning disabilities, violence, adolescence problems, appearances of ticks, anorexia, drug abuse and drug addiction are mostly not due to organic reasons, but, in the majority of cases are due to psychological behavioral problems. The roots of these problems are the continuous failure of relationships between the child and the adult who is closest to him/her such as their parents and teachers. Failure stems from the incorrect educational conception of the adults role towards the child and the inability to carry out correct educational theories. Another problem is the inability of the adult to see the interaction between the child and himself through the eyes of the child, and therefore, the adult cannot know and understand what is accepted and processed in the mind of the child. Most adults cannot prevent a natural ingrained reflex to continue supervising over the child even through there is no reasons to do so. Another point to be considered is that over the last few decades children spend more years in their parents home as adults which bring about acute conflicts, creating situations in which one adult is dependent on the other, and has to accept and give in to his ways. Behavioral disturbances do not necessarily come about from extreme oppression such as abuse etc., but from what we call "normal discipline". Oppression may appear on different levels, the extreme being "erasure of ones personality", and of course behavioral disturbances will evolve. Therefore, taking into account the above, it is worthwhile to consider new thoughts and approaches regarding interactions within child-adult relationships.
Adolescent↗
Investigating acceptance in adjustment to chronic pain: is acceptance broader than we thought?
Research on the role of acceptance in adjustment to persisting pain has been facilitated by the development of the Chronic Pain Acceptance Questionnaire (CPAQ). However, to date the CPAQ has been used to explore acceptance of pain without taking into account the likely contribution of other cognitive variables that have been shown to influence adjustment to persisting pain. This study examined the role of pain acceptance, as measured by the CPAQ, in accounting for adjustment to pain when controlling for the effects of other cognitive variables. The results indicated that while the Activity engagement subscale of the CPAQ was predictive of depression severity, neither of the CPAQ's two subscales was predictive of pain severity or physical disability. These findings differ from some reported previously and they suggest that the CPAQ, by itself, may not be sufficient to explain the processes of acceptance of pain and, hence, adjustment to pain. The findings also indicate that the Pain willingness subscale of the CPAQ is not robust and should be discarded. A broader approach to investigating acceptance of pain is proposed.
Adaptation, Psychological↗
Growing confidence. Villagers in Ghana's IP pilot areas learn the power of self-help.
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Africa↗