Factors contributing to paediatric tube feeding dependence in New Zealand : the speech-language therapy perspective : a thesis presented in partial fulfilment of the requirements for the degree of Master of Speech and Language Therapy at Massey University, Albany, New Zealand

Tube feeding dependency can have serious repercussions for children and their families. Most research relates to intervention programmes for tube withdrawal/weaning onto oral feeding. However, there is limited research into factors contributing to tube feeding dependency. Researchers have found failed or slow weaning/transitioning from tube to oral feeding is more likely after the age of five. In New Zealand the highest number of children who remain tube dependent but could transition to oral feeding are over five years of age. Speech–language therapists (SLTs) are one of the main professions involved in managing these children. This two-phase study aimed to determine the SLTs’ perspective of factors contributing to feeding tube dependency in children. This study used a mixed method approach. Forty-three SLTs participated in an online survey and ten of these participants were interviewed. Two interlinking themes were found as contributing factors to tube feeding dependency in children. They were: (1) Medicalisation of tube fed children in infancy as a root cause of tube feeding dependency. Sub themes included the following: Medical emphasis on weight gain; parents and caregivers influence whether a child remains tube dependent; parents giving misleading information to maintain tube feeding and prolonged NGT feeding. (2) Fragmentation of the tube fed child’s continuity of care. Sub-themes include the following: The need for planning tube withdrawal at the time of insertion, insufficient clinical time, funding issues, the need for intensive service at the time of tube weaning, clinician confidence in the education setting and the normalisation of tube feeding by school age. These themes and sub-themes influence tube feeding dependency in New Zealand, according to the perspective of SLTs. This research highlights the need for further exploration of these factors when the tube is first inserted to prevent dependency and allow the transitioning of children to oral foods as early as possible

Human Rights in the Heartland: An Assessment of Social, Economic, Civil, and Political Rights in the Midwest

This report measures human rights progress in the heart of the United States. In this compilation, eight Midwestern states are evaluated on a freedom index, providing a comparative snapshot of local commitments to civil, political, social, and economic rights

MS-153: The Fritz Draper Hurd ’16 Papers

This collection consists primarily of materials produced by F.D. Hurd himself. The collection includes a memoir draft, photographs of his college experiences, diaries from his college and war time, and various artifacts and memorabilia from Hurd’s time in the military. The collection focuses heavily on Hurd’s college activities and his war service. While the collection does not provide much official information on Hurd’s military service and Gettysburg College experience, it does contain extensive anecdotal information from Hurd’s diaries and remembrances, dictated to his son in the 1970s. There is also a significant amount of information about his time in medical school. Special Collections and College Archives Finding Aids are discovery tools used to describe and provide access to our holdings. Finding aids include historical and biographical information about each collection in addition to inventories of their content. More information about our collections can be found on our website http://www.gettysburg.edu/special_collections/collections/https://cupola.gettysburg.edu/findingaidsall/1172/thumbnail.jp

Study of Supportive Housing in Illinois: First Interim Report

In particular, the study focuses on the change in service use and the cost of services used by Illinois supportive housing residents 2 years before entering supportive housing and 2 years after. This study will inform policymakers, funders, and others about the importance and cost effectiveness of supportive housing in Illinois

Are U.S. states equally prepared for a carbon-constrained world?

Climate concerns linked to greenhouse gas emissions, particularly carbon dioxide (CO2), have taken center stage in the national energy policy debate. Domestic energy use and carbon emissions continue to rise, and forecasts suggest further increases under the existing regulatory structure. However, heightened international and domestic pressure to reduce U.S. carbon emissions suggests that additional changes to the regulatory framework are probable in coming years. ; Reducing U.S. carbon emissions will likely require a comprehensive national framework that will alter the pattern of energy use and production in all 50 states. At issue for state-level policymakers is that carbon restrictions are unlikely to affect the states equally. Energy use and emission patterns vary widely across states, and there is no accepted framework for allocating shares of a national carbon reduction goal. As a result, states that emit the most carbon or have the most energy- and carbon-intensive economies may shoulder the greatest burden. ; Snead and Jones evaluate the current energy posture of the states and thus how prepared they are to cope with ongoing trends in energy use, especially restrictions on carbon emissions. Their findings suggest that the New England, Mid-Atlantic and West Coast states are generally best prepared. These states have the least energy-intensive economies and use fuel mixes with low average carbon intensity; hence, they already release proportionately less CO2. The states expected to be hardest hit by carbon constraints are the traditional energy-producing and agricultural states. These states have energy-intensive economies, by both domestic and international standards, and will face a considerable challenge in altering their energy use and emissions patterns.

Sudan and South Sudan: Colonialism, Conflict, and the Growing Pains of a New Nation

Students will understand the concept of colonialism by comparing and contrasting America with Africa\u27s colonial rule. Students will discover how this often contributes to contemporary conflict by igniting cultural differences. Sudan and South Sudan are used to illustrate contemporary conflict that is in part based upon the effects of a history of colonialism

Walking Wales: Exploring the experiences of people who walk the Wales Coast Path

At the heart of the thesis is the issue of mobility and how the Wales Coast Path has enabled mobility along the entirety of the Welsh coastline. The creation of the Wales Coast Path has afforded an opportunity unlike any other; to explore what it means for walkers to be able to walk the coastline of an entire nation. This thesis focuses on the physical act of walking the Wales Coast Path. Investigating ways in which experiences of the Wales Coast Path are understood, felt and sensed through the bodily actions and performances of walking. The thesis draws upon the data collected whilst walking with, interviewing and experiencing 41 walks along the Wales Coast Path. It shows that using a ‘walking and talking’ method has accessed data which would otherwise have been left untapped, and that this choice of methodology enables the researcher to access the knowledge of people-in-places where meaning is accessed and produced. The thesis acknowledges that knowledge is born through immediate experience and people gain understanding from their lived everyday involvement in the world, through activities such as walking. It shows that sometimes, it is necessary to see, hear, smell, experience or feel a place in order to communicate it to others and to make sense of it. The thesis considers what it means for walkers to be able to walk the entire coast of Wales and what this accomplishment means to their identities, as walkers, and how it influenced their Welsh identities. The research explores how being able to walk the coast of Wales facilitates a sense of cultural attachment and belonging to Wales; to others who walk the Wales Coast Path; and to Welsh identity. The thesis discusses the more-than-human aspects of walking the Wales Coast Path, focusing on an overriding theme which has affected the experiences of the walkers on the Wales Coast Path arguably more than any other. That is, the influence held over the walkers by the Wales Coast Path sign and the range of emotions and sensations generated through its encounter or lack of encounter. The sign is discussed as relational. It is shown how it has been imperative to people’s experiences and how it doesn’t have a fixed influence but changes in accordance with a particular moment in time on the Wales Coast Path