Why Do Families Relinquish Care of Children with Intellectual Disability and Severe Challenging Behaviors? Professional’s Perspectives

Relinquishing care of a child with developmental disabilities can be a traumatic experience for parents. The aim of this study was to explore the perception of professionals regarding the relationships within families and service systems that contribute towards the relinquishment of children with Intellectual Disability (ID) and challenging behavior. Fifteen disability professionals were interviewed from a variety of disciplines, each having been involved in supporting a family while they relinquished care. A constructionist grounded theory approach was used for analysis, with data interpreted through a systemic lens. An accumulation of factors led to relinquishment, including the cumulative isolation of mothers within the family and within informal and professional networks of relationships. These findings must be understood in the context of societal discourses that both pathologise and overburden mothers with caregiving roles for children with disabilities. Interventions need to focus assertively on whole family involvement and repair, and on community development, if relinquishment is to be prevented

Acute Changes on Pulmonary Pressure Following Percutaneous Closure of Secundum Atrial Septal Defect

Pulmonary hypertension is a common complication of congenital heart disease due to systemic – pulmonary circulation shunt which if left uncorrected leads to increased pulmonary artery pressure, vascular remodeling and further increase of pulmonary vascular resistance. Percutaneous closure of the defect interrupts this shunt thus reducing right heart and pulmonary circulation load and pulmonary artery pressure. In this paper we present two cases of percutaneous secundum atrial septal defect closure complicated by pulmonary hypertension along with echocardiographic evaluation of cardiopulmonary hemodynamic changes before and shortly after device closure. Forty years old and thirty three years old females presented to our clinics with classical symptoms of atrial septal defects, assessment revealed TVG of 37 mmHg and 30 mmHg,shortly after the procedure patient was re-evaluated and revealed TVG of 39 mmHg and 23 mmHg respectively. From these cases we conclude that changes in pulmonary artery pressure is not constantly found after device closure. However both patients display improvements in functional capabilities

Costs and benefits of goal advancement: organisational sustainability in LGBT NGOs in post-same-sex marriage Canada

What happens when organisations get what they want? How do external shifts which advance organisational goals affect survival? Existing literature on goal advancement tends to conceptualise it as a normatively ‘good’ thing and focuses on how to attain it. What remains undertheorised is how organisations can paradoxically create problems for themselves when they get what they want. This puzzle is particularly important to understand vis-à-vis the third sector and policy change, as states increasingly rely on nongovernmental organisations (NGOs) for social policy provision. Insofar as ‘getting what you want’ via policy change can have unintended consequences for organisational sustainability, it has direct implications for social policy, governance, and the communities these NGOs serve. Despite its growing policy relevance, however, this puzzle remains understudied. This doctoral thesis fills this gap by examining the case of LGBT NGOs in Calgary, Montreal, and Toronto in the context of long-term same-sex marriage legalisation, a policy change widely seen as socially and politically progressive for LGBT equality and one advancing LGBT NGO goals. Drawing upon organisational management, development management, resource dependence, and organisational ecology literatures, this policy-relevant thesis advances scholarly understandings of organisational continuity. Across city cases, I find that structural forces, organisational factors, and policy shift shape resource availability, resource mobilisation, and resource dependencies. But LGBT NGOs are not simply acted upon, instead exercising agency through adaptive behaviour—illustrating this, I introduce a new concept of organisational hibernation, an adaptation to resource scarcity or an evolving policy domain to maintain continuity. But not all adaptations are beneficial: in the post-marriage political economic context, adaptations made for immediate persistence may negatively impact the sustainability of the LGBT NGO sector. Goal advancement via policy change can be costly with broader impacts for continuity of policy provision and LGBT interest representation in policy processes. This thesis contributes to debates in social policy, NGO studies, LGBT politics, and Canadian politics

An Investigation of Load and Resistance Factor Design of Drilled Shafts Using Historical Field Test Data

To achieve engineered designs with consistent levels of reliability, the Federal Highway Administration (FHWA) mandated that all new bridges initiated after October 1, 2007, including those founded upon drilled shafts, be designed according to the Load and Resistance Factor Design (LRFD) approach. As the first step in developing efficient regional LRFD procedures for drilled shafts, the Drilled SHAft Foundation Testing (DSHAFT) database was formulated. DSHAFT was aimed at assimilating high quality, historical drilled shaft test data from Iowa and the surrounding states, and it presently contains data from 41 drilled shaft load tests, 38 of which are O-cell load tests, along with subsurface information and structural details. Following an introduction to DSHAFT, several challenges associated with subsurface investigations, measurement of geomaterial properties, and test methods employed in current practice for drilled shaft capacity estimations are discussed. An improved procedure is then proposed featuring three different cases for establishing the equivalent top load-displacement response of drilled shafts. Using the proposed procedure and LRFD framework, it is shown that robust, more efficient regional LRFD resistance factors can be established for drilled shafts with a target displacement limit

Trends in added sugars from packaged beverages available and purchased by US households, 2007–2012

Background: The US Food and Drug Administration's updated nutrition labeling requirements will include added sugars starting in July 2018, but no measure currently exists to identify the added sugar content of products and what it represents among purchases. Beverages are one of the first targets for reducing added sugar consumption, and hence are the focus here. Objective: Our goal was to estimate trends in added sugars in nonalcoholic packaged beverage products available in the United States and to estimate amounts of added sugars obtained from these beverages given the purchases of US households overall and by subpopulations. Design: On the basis of nutrition label data from multiple sources, we used a stepwise approach to derive the added sugar content of 160,713 beverage products recorded as purchased by US households in 2007-2012 (345,193 observations from 110,539 unique households). We estimated the amounts of added sugars obtained from packaged beverages US households reported buying in 2007-2008, 2009-2010, and 2011-2012, overall and by subpopulations based on household composition, race/ethnicity, and income. The key outcomes are added sugars in terms of per capita grams per day and the percentage of calories from packaged beverages. Results: Packaged beverages alone account for per capita consumption of 12 g/d of added sugars purchased by US households in 2007-2012, representing 32-48% of calories from packaged beverages. Whereas the absolute amount of added sugars from beverages has not changed meaningfully over time, the relative contribution of added sugars to calories from beverages has increased. Non-Hispanic black households and low-income households obtain both higher absolute and relative amounts of added sugars from beverages than non-Hispanic white households and high-income households (all P < 0.01). Conclusions: These results provide measures of added sugars from packaged beverages at both the product level and the population level in the United States and can be used for comparisons after the revised nutrition labels are implemented and for future monitoring

Mammalian RAD23 homologs: multifunctional. proteins in DNA repair and development

Preservation of an intact genome is of utmost importance to all living organisms. However. the integrity of DNA. the carrier of genetic information required for proper functioning of cellular processes. is continuously challenged. Cells must overcome endogenous (metabolic) and exogenous (environmental) threats, as well as the intrinsic instability of chemical bonds in DNA itself (e.g. deamination and depurination). Oxidative stress. ultraviolet (UV) light. ionizing radiation (X-rays). and numerous chemicals induce a wide variety of lesions in the DNA. DNA damage can affect cellular processes and can have severe consequences for human health. Its direct effect at the cellular level is inhibition of vital processes like transcription and replication resulting in cell cycle arrest. Accumulation of lesions in DNA above certain thresholds can lead either to (programmed) cell death by apoptosis or to permanent alterations in the genetic code (mutations). These mutations can in turn c

Development of a Database for Drilled SHAft Foundation Testing (DSHAFT)

Drilled shafts have been used in the US for more than 100 years in bridges and buildings as a deep foundation alternative. For many of these applications, the drilled shafts were designed using the Working Stress Design (WSD) approach. Even though WSD has been used successfully in the past, a move toward Load Resistance Factor Design (LRFD) for foundation applications began when the Federal Highway Administration (FHWA) issued a policy memorandum on June 28, 2000.The policy memorandum requires all new bridges initiated after October 1, 2007, to be designed according to the LRFD approach. This ensures compatibility between the superstructure and substructure designs, and provides a means of consistently incorporating sources of uncertainty into each load and resistance component. Regionally-calibrated LRFD resistance factors are permitted by the American Association of State Highway and Transportation Officials (AASHTO) to improve the economy and competitiveness of drilled shafts. To achieve this goal, a database for Drilled SHAft Foundation Testing (DSHAFT) has been developed. DSHAFT is aimed at assimilating high quality drilled shaft test data from Iowa and the surrounding regions, and identifying the need for further tests in suitable soil profiles. This report introduces DSHAFT and demonstrates its features and capabilities, such as an easy-to-use storage and sharing tool for providing access to key information (e.g., soil classification details and cross-hole sonic logging reports). DSHAFT embodies a model for effective, regional LRFD calibration procedures consistent with PIle LOad Test (PILOT) database, which contains driven pile load tests accumulated from the state of Iowa. PILOT is now available for broader use at the project website: http://srg.cce.iastate.edu/lrfd/. DSHAFT, available in electronic form at http://srg.cce.iastate.edu/dshaft/, is currently comprised of 32 separate load tests provided by Illinois, Iowa, Minnesota, Missouri and Nebraska state departments of transportation and/or department of roads. In addition to serving as a manual for DSHAFT and providing a summary of the available data, this report provides a preliminary analysis of the load test data from Iowa, and will open up opportunities for others to share their data through this quality–assured process, thereby providing a platform to improve LRFD approach to drilled shafts, especially in the Midwest region