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Whole Family (whole + family)
Selected AbstractsExperience of prophylaxis treatment in children with severe haemophiliaHAEMOPHILIA, Issue 2 2002T. T. YEE The practice of prophylactic treatment of boys with severe haemophilia has been evaluated in our centre. Prophylaxis was started at the median age of 3.7 years (range 0.4,12.7 years) in 38/41 children (93%) under 17 years of age. Median follow-up was 4.1 years (range 0.4,12.7 years). The criteria of primary prophylaxis according to the definition by the European Paediatric Network of Haemophilia Management was fulfilled by 9/38 (24%). Although a majority [76%, 29/38] of the children started prophylaxis after a median number of joint bleeds of 3.5, 70% of the children in this group had clinical joint scores of 0. Intravenous catheter insertion was required at a median age of 15.5 months (range 5,36 months) in 21% of the children, resulting in a catheter infection rate of 1.74 per 1000 catheter days. None developed an inhibitor on prophylaxis and three patients who had low-titre inhibitors (< 5 Bethesda units) prior to prophylaxis had undetectable inhibitors after prophylaxis. The home-treatment training programme required considerable time and cost. As a result, 87% of the children used peripheral venous access and hospital visits declined as prophylaxis became established. Parents' incentives for prophylaxis were that the children undertook many physical activities and sports previously not recommended, there was less parental anxiety and an overall improvement in the quality of life for the whole family. [source] Arriving at a strategic theory of the firmINTERNATIONAL JOURNAL OF MANAGEMENT REVIEWS, Issue 4 2000Steven E. Phelan The theory of the firm seeks to explain the existence and boundaries of the firm in relation to the market. Since the pioneering work of Coase (The nature of the firm. Economica, 4, 386,405, 1937), economics has developed a whole family of theories that focus on the ability of firms to economize on certain costs of using markets. More recently, researchers in strategic management have published several theories of the firm that have tended to emphasize the benefits of incorporation rather than the costs of using the market. Although researchers in the strategy profession have tentatively labeled their work as ,moving towards' a strategic theory of the firm, economists have been very critical of existing approaches. This paper seeks to begin ,arriving' at a strategic theory of the firm by addressing these criticisms and offering an integration of the strategic and economic perspectives within an institutional framework. The paper concludes with future directions for research in the theory of the firm. [source] Determinants of perceived health in families of patients with heart diseaseJOURNAL OF ADVANCED NURSING, Issue 2 2004Päivi Åstedt-Kurki PhD RN Background., Heart disease is a severe long-term illness, which often requires lifestyle changes and self-care and affects the life of the whole family. Perceived family health is highly complex. It combines people's values and everyday experiences, such as knowledge about their own health, what they do to promote their health, how their life progresses, and how they feel physically and emotionally. Aim., The aim of this paper is to report a study to describe the perceived health of families of patients with heart disease and to ascertain factors related to family health. Methods., Data were collected by questionnaire with a convenience sample of 161 family members of patients receiving treatment on two medical wards of a university hospital in southern Finland. Data were analysed using means and medians and tested by parametric and non-parametric tests. A stepwise regression analysis was also used. Results., The most important predictors of family health were family structural factors, effect of illness symptoms on daily life, and family relationships. The strongest predictor was family structural factors. It was found that the better the family structure and relationships, the better the family health. Similarly, the greater the effect of the illness on the patient's daily life, the worse the family health. Conclusion., The findings suggest that supporting family functioning in the families of people with heart disease is an important challenge for family nursing. [source] More than one Wavelength: Identifying, Understanding and Resolving Conflicts of Interest between People with Intellectual Disabilities and their Family CarersJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2001V. Williams The present paper describes conflicts of interest in families which include someone with intellectual disabilities. Data were taken from a study concerned with the 1995 Carers Act. The research examined the experiences and views of 51 families who had some kind of assessment by a social services department. Cases were analysed where it was found that carers, the people for whom they cared and the assessors did not agree about such conflicts. Assessors sometimes stereotyped families and spoke of conflicts of interest when the situation was more complex. In particular, the real conflict was often between the whole family and an inadequate service system that did not offer enough support or choices to the individual. Conflicts which had occurred were related to three major motives driving carers: (1) the need for a break from caring; (2) the need to speak for their disabled relative; and (3) their concern for standards of behaviour. The present authors report on how these situations were handled by assessors and conclude with some recommendations for good carer assessments which will help to resolve conflicts of interest. A greater degree of informed choice for individuals with intellectual disabilities will in itself resolve many potential conflicts of interest. [source] A literature review of the potential effects of having a parent with chronic renal failureJOURNAL OF CLINICAL NURSING, Issue 5a 2008Frances Coldstream MSc, PGCEA Aims and objectives., This review aims to answer the question ,What are the possible effects on children of having a parent with chronic renal failure?' Background., Chronic illness affects the whole family, not just the individual with the illness. It would appear that little research has been undertaken to consider the potential effects on children when a parent has chronic renal failure. Method., Systematic review. Conclusions., There are many potential effects of parental chronic renal failure that have been documented. These are both negative, for example depression and under achievement and positive, for example , enhanced self-esteem. Children, in particular, appear to have a need for information that is not being met. The review has helped to refine a project looking at the information needs of children who have a parent with chronic renal failure, from the perspective of the child. Relevance to clinical practice., There appears to be a lack of information to direct nursing practice in this area. Practitioners need to be aware that chronic parental illness impacts on the whole family. Appropriate referral mechanisms for the child and family are necessary, in addition to an understanding of the needs of these children. [source] Sharing life with a gluten-intolerant person , the perspective of close relativesJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2007A. Sverker Abstract Background, Several studies indicate the importance of social support in the case of chronic disease. Aim, The aim was to explore dilemmas experienced by close relatives living with a person suffering from coeliac disease, and to describe the strategies they used to deal with these dilemmas. Methods, Twenty-three informants were interviewed. A systematic inductive qualitative method, the critical incident technique was used. Results, Disease-related worries included having bad conscience about not being affected by the disease, experiencing anxiety and witnessing the vulnerability of the affected relative in social situations. Dilemmas related to manage daily life were connected with increased domestic work, restricted freedom of action and the diseased person's preferential right of interpretation of health risks associated with the coeliac disease and deviations from the diet restrictions. Dilemmas related to disturbances in social life, concerned lack of information, knowledge and understanding. Different strategies were described to manage daily life. Conclusions, Close relatives experienced a variety of dilemmas that affected the situation of the whole family. The role of relatives in handling the coeliac disease with the diseased person in the everyday life might be underestimated, and to provide relatives with better knowledge regarding the disease might improve the situation also for patients. [source] Conceptualization and sources of costs from breast cancer: Findings from patient and caregiver focus groupsPSYCHO-ONCOLOGY, Issue 5 2005Sophie Lauzier Assessment of economic burden of breast cancer to patient and family has generally been overlooked in assessing the impact of this disease. We explored economic aspects from the perspective of women and their caregivers. Focus groups were conducted in 3 Quebec cities representing urban and semi-urban settings: 3 with 26 women first treated for non-metastatic breast cancer in the past 18 months, and 3 with 24 primary caregivers. We purposefully selected participants with different characteristics likely to affect the nature or extent of costs. Thematic content analysis was conducted on verbatim transcripts. Costs of breast cancer could be substantial, but were not the most worrisome aspect of the illness during treatments. Some costs were considered unavoidable, others depended on ability to pay. Costs occurred over a long period, with long term impact, and were borne by the whole family and not just the woman. Principal cost sources discussed were those associated with accessing health care, wage losses, reorganization of everyday life, and coping with the disease. This study provided deeper understanding of cost dynamics and the experience of costs among Canadian women with non-metastatic breast cancer, whose treatment and medical follow-up costs are borne through a system of universal, publicly funded health care. Copyright © 2004 John Wiley & Sons, Ltd. [source] Revision of pyrrhotite structures within a common superspace modelACTA CRYSTALLOGRAPHICA SECTION B, Issue 5 2007Zunbeltz Izaola The structure of pyrrhotite (Fe1,,,xS with 0.05 ,x, 0.125) has been reinvestigated in the framework of the superspace formalism. A common model with a centrosymmetric superspace group is proposed for the whole family. The atomic domains in the internal space representing the Fe atoms are parametrized as crenel functions that fulfil the closeness condition. The proposed model explains the x -dependent space groups observed and the basic features of the structures reported up to now. Our model yields for any x value a well defined ordered distribution of Fe vacancies in contrast to some of the structural models proposed in the literature. A new (3,+,1)-dimensional refinement of Fe0.91S using the deposited dataset [Yamamoto & Nakazawa (1982). Acta Cryst. A38, 79,86] has been performed as a benchmark of the model. The consistency of the proposed superspace symmetry and its validity for other compositions has been further checked by means of ab initio calculations of both atomic forces and equilibrium atomic positions in non-relaxed and relaxed structures, respectively. [source] Computational Study of the Phosphoryl Transfer Catalyzed by a Cyclin-Dependent KinaseCHEMISTRY - A EUROPEAN JOURNAL, Issue 30 2007Marco De, Vivo Dr. Abstract A cyclin-dependent kinase, Cdk2, catalyzes the transfer of the ,-phosphate from ATP to a threonine or serine residue of its polypeptide substrates. Here, we investigate aspects of the reaction mechanism of Cdk2 by gas-phase density functional calculations, classical molecular dynamics, and Car,Parrinello QM/MM simulations. We focus on the role of the conserved Asp127 and on the nature of the phosphoryl transfer reaction mechanism catalyzed by Cdk2. Our findings suggest that Asp127 is active in its deprotonated form by assisting the formation of the near-attack orientation of the substrate serine or threonine. Therefore, the residue does not act as a general base during the catalysis. The mechanism for the phosphoryl transfer is a single SN2-like concerted step, which shows a phosphorane-like transition state geometry. Although the resulting reaction mechanism is in agreement with a previous density functional study of the same catalytic reaction mechanism (Cavalli et,al., Chem. Comm.2003, 1308,1309), the reaction barrier is considerably lower when QM/MM calculations are performed, as in this study (,42,kcal,mol,1 QM vs. ,24,kcal,mol,1 QM/MM); this indicates that important roles for the catalysis are played by the protein environment and solvent waters. Because of the high amino acid sequence conservation among the whole family of cyclin-dependent kinases (CDKs), these results could be general for the CDK family. [source] |