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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

Learning about ICT has all sorts of benefits for young people with SEN but for anyone planning a course, knowing where to start can be difficult. This manual is packed full of practical know-how. It includes: 36 planned sessions ready to deliver Which hardware software to get and how best to use it Time-saving photocopiable and downloadable resources on an accompanying CD

Everything you need to know to educate students with autismEvery 20 minutes, another child is diagnosed with autism. Are you ready to meet this growing educational challenge? This authoritative guide for practitioners—early interventionists, teachers, school counselors and psychologists—provides practical strategies for addressing the unique needs of children on the autism spectrum and their families.Drawing on current research and evidence-based practice, the authors discuss the causes of autism and present methods for educating children and assisting their families in supporting the educational process. Each chapter focuses on a critical issue and offers solutions, including: Improving communication, social, generalization and self-management skills; Designing instruction, intervention, and assessment; Including families in developing goals and interventions; Using students' special interests to deliver instruction; Understanding and preventing challenging behavior; Evaluating practices to promote successful outcomes for students, families and practitionersIncluded are forms, charts, and activities to help practitioners and families fulfill learning programs. Educating Young Children With Autism Spectrum Disorders will give you insight and tools to make a difference in the learning and lives of students with autism spectrum disorders.

The literary potential of trauma is examined in this book, bringing trauma theory and literary texts together for the first time. Trauma Fiction focuses on the ways in which contemporary novelists explore the theme of trauma and incorporate its structures into their writing. It provides innovative readings of texts by Pat Barker, Jackie Kay, Anne Michaels, Toni Morrison, Caryl Phillips, W. G. Sebald and Binjamin Wilkomirski. It also considers the ways in which trauma has affected fictional form, exploring how novelists have responded to the challenge of writing traumatic narratives, and identifying the key stylistic features associated with the genre. In addition, the book introduces the reader to key critics in the field of trauma theory such as Cathy Caruth, Shoshana Felman and Geoffrey Hartman. The linking of trauma theory and literary texts not only sheds light on works of contemporary fiction, it also points to the inherent connections between trauma theory and the literary which have often been overlooked. The distinction between literary theme and style in the book opens up major questions regarding the nature of trauma itself. Trauma, like the novels discussed, is shown to take an uncertain but productive place between content and form.Key Features*Idenitifes and explores a new and evolving genre in contemporary fiction*Thinks through the relation between trauma and literature*Produces innovative readings of key works of contemporary fiction *Provides an introduction to key ideas in trauma theory.

In einer Zeit, in der Aktivität und Leistung alles bedeuten, da power naps und polyphasischer Schlaf die Nachtruhe optimieren sollen, Klartraumtechniken Ressourcen zur Verbesserung körperlicher und geistiger Effizienz kolonisieren, lässt sich – so scheint es – für die Müdigkeit kaum noch argumentieren.

In the post-9/11 world, the European Union has been trying to define its international presence in a way which corresponds to its economic power and enlarged membership. In an effort to assert its identity on the international scene, it has developed a very wide range of economic relations with third countries and international organisations. It has also developed a Common Foreign and Security Policy in the context of which it is gradually shaping its Security and Defence Policy. These policies are carried out on the basis of distinct, albeit interrelated sets of legal rules. This book provides a comprehensive and systematic analysis of these economic, political and security aspects of the relations of the European Union with the rest of the world. It examines their genesis, development and interactions and places them in the specific context of the establishment of the internal market and the broader context of the increasingly interdependent international economic and geopolitical environment. Issues covered include the coexistence of Community and national competence in external relations, the approach of the Court of Justice to international law, the negotiation, conclusion and implementation of international agreements, the relationship between EC and WTO law and the development of the political and security policies of the Union. The book will be of interest to academics, practitioners and students of EU law.

The series features monographs and edited volumes on the topics of lexicography and meta-lexicography. Works from the broader domain of lexicology are also included if they strengthen the theoretical, methodological and empirical basis of lexicography and meta-lexicography. The volumes focus on aspects of lexicography such as micro- and macrostructure, typology, history of the discipline, and application-oriented lexicographical documentation.

\"Angesichts hoher Belastungen und unzureichender psychosozialer Betreuung von onkologischen Patient/innen im HNO-Bereich sind Logopäd/innen und Sprechwissenschaftler/innen mit speziellen Anforderungen konfrontiert, die über ihr engeres Berufsfeld hinausgehen. Um ihre Problemwahrnehmungen und Fähigkeiten im Umgang damit sowie einen möglichen Weiterbildungsbedarf zu ermitteln, wurden in einem mehrperspektivischen Mixed-Methods-Zugang folgende Aspekte untersucht: 1. Erfahrungen und Problemfelder der Arbeit mit psychisch belasteten onkologischen HNO-Patient/innen aus Sicht von Logopäd/innen; 2. Selbsteinschätzung der Stärken und Schwächen der Logopäd/innen im Umgang mit Patient/innen und deren Angehörigen; 3. Erfahrungen von Supervisor/innen von onkologisch tätigen Logopäd/innen und 4. Kommunikationskompetenz von Logopäd/innen in emotionalen Gesprächssituationen. Es zeigte sich ein hohes Bewusstsein der Therapeut/innen für die psychische Belastung der Patient/innen. Übereinstimmend wurde von einem sehr hohen psychosozialen Beratungsbedarf und großen Gesprächsanteilen in der logopädischen Therapie berichtet. Diese Sondersituation führte zu Abgrenzungsschwierigkeiten, Überforderungsgefühlen und belastenden Situationen. Das psychoonkologische Wissen und die Gesprächsführungskompetenzen waren bei vielen für diese Anforderungen nicht hinreichend; es besteht dringender Weiterbildungsbedarf.\" (Autorenreferat). \"Head-and-neck cancer patients suffer from high levels of psychological co-morbidity and often do not receive adequate psychological assistance. Therefore, speech therapists are frequently confronted with specific psycho-social challenges transgressing the borders of their standard professional education. To explore their perceptions of these challenges and their skills to deal with them, the following aspects were examined in a mixed-methods approach: 1. Experiences and problems of speech therapists in working with head-and-neck cancer patients. 2. Self-assessment of speech therapists' competence in cancer patient care. 3. Experiences and observations of psychologists who supervised case discussions with speech therapists in oncology. 4. Communication skills of speech therapists in oncology with emotionally distressed patients. Results show that among therapists there is a high level of awareness of patient distress. They agree that there is a need for psychosocial counselling for patients and that an immense part of speech therapy sessions is often needed for talking about personal problems. This difficult situation leads to: a) Deficiencies in speech therapists' ability to address patients' demands and, consequently distancing themselves from their patients. b) Speech therapists feeling overwhelmed with excessive demands and experiencing mental distress themselves. The psycho-oncological knowledge and communication skills among speech therapists were often deficient in light of such high demands. There is a need for further training in psychological and social skills for speech therapists working with head-and-neck cancer patients.\" (author's abstract).

From Frankenstein to futuristic feminist utopias, Decoding Gender in Science Fiction examines the ways science fiction writers have incorporated, explored, and revised conventional notions of sexual difference. Attebery traces a fascinating history of men's and women's writing that covertly or overtly investigates conceptions of gender, suggesting new perspectives on the genre.

Unlike their gaudy day-flying cousins, moths seem to reside in the shadows as denizens of the night, circling around street lights or caught momentarily in the glare of car headlights on a country lane. There are, however, many more species of day-flying moths than there are of butterflies, and as for colours and patterns, many moths rival or even exceed butterflies in the dazzling range of their markings. The study of moths formed an integral part of early natural history and many thousands of drawings, paintings and physical specimens remain in museum collections. In recent years there has been a renewed surge of interest in moths facilitated by advances in digital photography, the Web-based dissemination of scientific expertise and new cartographic projects that enable direct collaboration between amateur experts and scientifically framed research projects. The rich history of vernacular names speaks to the significant place of moths in early cultures of nature: names such as the Merveille du Jour, the Green-brindled Crescent and the Clifden Nonpareil evoke a sense of wonder that connects disparate fields such as folklore, the history of place and early scientific texts.