Development needs of people with physical disabilities in Lebanon : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Development Studies at Massey University

This thesis is concerned with people who are physically disabled and are living in Lebanon. The discussion focuses on what development has occurred for these people, how their households manage their lives within their local and national environment, what their needs are, and which service providers are attempting to address these needs. The national environment in which these people live and the situation of disabled people in developing countries is also considered. The thesis question asks if the service providers are meeting the development needs of the people with physical disabilities. The needs of the disabled people fall into two broad categories: practical and social. The Lebanese state is not active in addressing these needs and this role falls to the non-governmental organisations. It is shown that the non-governmental organisation services are in some way meeting the development needs of the people with physical disabilities. But both the non-governmental organisations and the people with physical disabilities identify weaknesses in the non-governmental organisation service provision. The physically disabled people experience improvements in their quality of life through their own efforts or with the support of the non-governmental organisations and/or their families

Maternal Diabetes Mellitus as a Risk Factor for High Blood Pressure in Late Childhood

Intrauterine fetal conditions can have lifelong cardiovascular effects. The impact of maternal diabetes mellitus on children’s cardiovascular profile is not well established. The goal of this study was to explore the association between maternal diabetes mellitus and offspring’s blood pressure (BP) ≤10 years of age. Generation XXI is a prospective birth cohort, which enrolled 8301 mother-offspring pairs, including 586 (7.1%) children of diabetic mothers. The associations between maternal diabetes mellitus and BP at 4, 7, and 10 years of age was modeled using linear regression. A mixed-effects model was built to assess differences in BP variation over time. Path analysis was used to quantify effects of potential mediators. Maternal diabetes mellitus was associated with higher BP in offspring at the age of 10 (systolic: β, 1.48; 95% CI, 0.36–2.59; and diastolic: β, 0.86; 95% CI, 0.05–1.71). This association was independent of maternal perinatal characteristics, and it was mediated by child’s body mass index and, to a lesser extent, by gestational age, type of birth, and birth weight (indirect effect proportion, 73%). No significant differences in BP were found at 4 and 7 years of age. Longitudinal analysis showed an accelerated systolic BP increase on maternal diabetes mellitus group (β, 1.16; 95% CI, 0.03–2.28). These finding were especially relevant in males, suggesting sex differences in the mechanisms of BP prenatal programing. Our results provide further evidence that maternal diabetes mellitus is associated with high BP late in childhood, demonstrating a significant role of child’s body mass in the pathway of this association.This work was supported by Programa Operacional de Saúde–Saúde XXI, Quadro Comunitário de Apoio III, and Administração Regional de Saúde Norte (Regional Department of Ministry of Health); FEDER (European Regional Development Fund) through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology–FCT (Portuguese Ministry of Science, Technology and Higher Education) through Unidade de Investigação em Epidemiologia–Instituto de Saúde Pública da Universidade do Porto (EPI Unit; POCI-01-0145-FEDER-006862; Ref UID/DTP/04750/2013); Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund-DOCnet (NORTE-01-0145-FEDER-000003); and from the Calouste Gulbenkian Foundation

Evaluation of the pilot of domestic violence protection orders

In 2011/12, a 15 month pilot took place in three police force areas (Greater Manchester, West Mercia and Wiltshire) to test a new civil provision, Domestic Violence Protection Orders (DVPOs). DVPOs were designed to provide immediate protection for victim-survivors following a domestic violence incident in circumstances where, in the view of the police, there are no other enforceable restrictions that can be placed upon the perpetrator. DVPOs aim to give victim-survivors time, space and support to consider their options by placing conditions on perpetrators, including restricting/removing perpetrators from households, and preventing contact with, or molestation of, victim-survivors. The approach, introduced by the Crime and Security Act 2010, comprises an initial temporary notice (Domestic Violence Protection Notice, DVPN), authorised by a senior police officer and issued to the perpetrator by the police, followed by a DVPO that can last from 14 to 28 days, imposed at the magistrates’ court

Evaluation of the pilot of domestic violence protection orders

In 2011/12, a 15 month pilot took place in three police force areas (Greater Manchester, West Mercia and Wiltshire) to test a new civil provision, Domestic Violence Protection Orders (DVPOs). DVPOs were designed to provide immediate protection for victim-survivors following a domestic violence incident in circumstances where, in the view of the police, there are no other enforceable restrictions that can be placed upon the perpetrator. DVPOs aim to give victim-survivors time, space and support to consider their options by placing conditions on perpetrators, including restricting/removing perpetrators from households, and preventing contact with, or molestation of, victim-survivors. The approach, introduced by the Crime and Security Act 2010, comprises an initial temporary notice (Domestic Violence Protection Notice, DVPN), authorised by a senior police officer and issued to the perpetrator by the police, followed by a DVPO that can last from 14 to 28 days, imposed at the magistrates’ court

Comunicação e saúde: um olhar e uma prática de pesquisa

Pode-se pensar, pesquisar, ensinar, fazer e falar da comunicação e saúde a partir de muitos campos. Os principais são, como se poderia esperar, os que nomeiam essa interface, ambos com ampla gama de temas e perspectivas teóricas. E falar a partir da comunicação é diferente de falar a partir da saúde, cada campo e suas instituições produzindo modos diferentes de apropriação das teorias, das metodologias e também do grau em que participam das políticas, dos processos e práticas e lutas da comunicação e saúde. Neste texto falamos a partir da saúde e de uma inserção específica nesse campo. E o que, mais precisamente, isto quer dizer? Quer dizer que falamos (e atribuímos prioridades) a partir de um contexto demarcado por um sistema público de saúde, o Sistema Único de Saúde (SUS), com seus dinamismos, contradições, saberes, lutas, movimentos sociais e políticos, estruturas, instituições, agendas

Intervenciones en cognición social para personas con esquizofrenia: evidencias y recomendaciones para la práctica clínica

Aunque la mayoría de la investigación llevada a cabo hasta el momento ha mostrado que las intervenciones en cognición social son eficaces para la rehabilitación de las personas con esquizofrenia, todavía no se han establecido recomendaciones de práctica clínica. Su desarrollo podría facilitar el trabajo clínico, la gestión de recursos y la atención que reciben las personas con este trastorno. El presente trabajo aborda esta necesidad; se hace una revisión sistemática de las evidencias científicas de alta calidad identificadas y se formulan recomendaciones de práctica clínica a partir de estas evidencias. Se han seleccionado para el presente estudio un total de 40 ensayos clínicos y 1 metanálisis que tratan sobre los efectos de las intervenciones en cognición social en personas con esquizofrenia. Teniendo en cuenta la evidencia disponible, y su calidad, se desarrollan tres recomendaciones de práctica clínica relacionadas con los efectos positivos de este tipo de intervenciones. El análisis de las evidencias de calidad de los estudios ha puesto de manifiesto que son necesarios más ensayos controlados y aleatorizados, con mayores muestras y seguimientos más largos, para establecer, de manera más precisa, la eficacia y efectividad de las intervenciones en cognición social y, por tanto, favorecer la generalización de resultados

Funcionamiento neuropsicológico de un paciente con trastorno orgánico de la personalidad

El trastorno orgánico de la personalidad (TOP) se caracteriza por la presencia de desinhibición producida por una alteración orgánica que afecta a la conducta, y al funcionamiento del dominio cognitivo, en especial las funciones ejecutivas. Este trabajo analiza los déficits neuropsicológicos de un paciente con TOP y su posible relación con los altos niveles de discapacidad que presenta. La evaluación realizada al paciente muestra una capacidad intelectual global evaluada con la WAIS-III muy por debajo de la media; además, se observan déficits atencionales, en la memoria a corto y largo plazo, y en funciones ejecutivas. Los hallazgos podrían ser consistentes con una alteración general de las funciones ejecutivas que, a su vez, podrían estar comprometiendo la capacidad del paciente para autoregular sus acciones y respuestas. Partiendo de datos anteriores disponibles del paciente se observa un posible deterioro en el funcionamiento intelectual general. Los actuales déficits del paciente, su evolución, así como una consideración de las alteraciones neuropsicológicas, como predictoras de la funcionalidad, podrían explicar sus dificultades. Se propone una intervención rehabilitadora basada en el aprendizaje de estrategias metacognitivas en un contexto que permita la transferencia de lo aprendido a situaciones cuotidianas. Se recomienda que la intervención se haga en el marco de una intervención integral y que la exploración neuropsicológica sea una pieza clave del proceso de rehabilitación del paciente con TOP