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Public health in practice:the three domains of public healthS.Griffiths a,*,T.Jewell b ,P.Donnelly caSchool of Public Health,Chinese University of Hong Kong,Room 508,5/F School of Public Health,Prince of Wales Hospital Shatin N.T.,Hong Kong bNorfolk,Suffolk and Cambridgeshire Strategic Health Authority Victoria House,Capital Park,Fulbourn,Cambridgeshire,CBI 5XB,UK cSt Andrew’s House,Regent’s Road,Edinburgh,EH13DG,UKReceived 11August 2004;received in revised form 20December 2004;accepted 11January 2005Available online 23June 2005KEYWORDSPublic health practice;Three domains of public health;Health improvement;Health protection;Health service quality;Public health programmes;Teenage pregnancySummary This paper outlines a conceptual model for public health practice by proposing the three domains as a framework to organize and to deliver public health programmes.The model builds on the recognition that public health is everybody’s business and therefore,needs a common definitional base.Different levels of skill and a wide range of contributions are needed if public health programmes are to make the most impact.The different domains of practice help to construct a basis for understanding the necessary elements of the public health system and their interactions.Using teenage pregnancy as a case study of a public health programme highlights the characteristics of the model.It demonstrates not only the importance of the role of directors of public health in taking a population-based overview,but also the need for multisectoral,multidisciplinary working.The relevance of the public health approach not only to primary care but also to the hospital-based sector becomes apparent,as does its relevance to communities,voluntary sector and local government.Integration of the three domains,a common definition and the framework for the public health system will support effective delivery of health improvement.Q 2005The Royal Institute of Public Health.Published by Elsevier Ltd.All rights reserved.IntroductionThe interest in public health amongst politicians,the media and the public has never been greater.The Severe Acute Respiratory Syndrome epidemic and the threat of bioterrorism reinforce the importance of health protection,whilst the obesity epidemic focuses attention on lifestyle factors highlighted in ‘Choosing Health’.1The UK Government’s increasing emphasis on quality stan-dards,outcomes and choice highlights the need for evidence-based knowledge and informed healthPublic Health (2005)119,907–9130033-3506/$-see front matter Q 2005The Royal Institute of Public Health.Published by Elsevier Ltd.All rights reserved.doi:10.1016/j.puhe.2005.01.010*Corresponding author.Tel.:C 441865227174;fax:C 441865227175.E-mail address:sian.griffiths@ (S.Griffiths).service planning.Population approaches to promot-ing health and preventing disease are on many agendas both nationally and locally.In his introduc-tion to the National Health Service(NHS)Improve-ment Plan for England,the Prime Minister says:“A greater emphasis will be given in the NHS to public health,to prevent illnesses and not just treat them”.2This policy shift at the highest political level is welcome,but the greater profile and accompanying higher expectation creates challenges for public health professionals,increasing to unprecedented levels the demand for public health skills not only within the NHS workforce but also across other sectors,particularly local government.The lack of people with specialist skills is particularly proble-matic,because,as Derek Wanless points out:“Difficulties remain in some areas due to capacity problems,the impact of recent organizational changes and the lack of alignment of performance management mechanisms between partners”.3Much of this gap in public health capacity in England is a direct consequence of structural re-organizations following the introduction of‘Shifting the Balance of Power’(StBOP)4and the creation of a new structure for health protection set out in ‘Getting Ahead of the Curve’(GATC).5StBOP created the directors of public health(DPH)in all primary care trusts in England,significantly expand-ing the numbers of specialists needed.Similar moves were made in Wales.However welcome a recog-nition of the need for public health,this‘is spreading resources very thinly’although‘there is a welcome move to broaden the skill base by introducing non-medical specialists’.3GATC has created the new Health Protection Agency(HPA).The HPA has integrated national resources for control of communicable disease and response to chemical and radiological incidents, and provided a focus for response to bioterrorism. The impact has been to fragment the previously integrated public health structures at local level. Consultants in communicable disease are no longer part of local public health departments and,in some instances,there are considerable strains between generalists and health protection special-ists,particularly where capacity is stretched.These problems of capacity,skill shortages and displacement of roles were explored through a series of workshops sponsored by the Minister for Public Health and the Faculty of Public Health6as well as through a survey of the public health workforce.7The White Paper‘Choosing Health’1has more recently recognized the strains on capacity and made recommendations to strengthen it at all levels in both service and academic public health.In this paper,we describe a model to support public health practice which proposes an approach to defining public health,describes a public health system and constructs a framework based on three inter-relating domains of public health practice to address both the shortcomings and the need to modernize intervention methodologies in public health.Supporting specialist public health practiceDefining public healthThe Alma Ata Declaration of Health for All8and the Ottawa Charter9emphasize well being,not just absence of disease,as the basis of public health.It emphasized,that it is not only the impact of individual behaviours which influence health but also of social,economic,political and environmen-tal factors on the health of populations.To be effective,public health needs to:†be population based;†emphasize collective responsibility for health, its protection and disease prevention;†recognize the key role of the state,linked to a concern for the underlying socio-economic and wider determinants of health,as well as disease;†have a multidisciplinary basis,which incorporates quantitative as well as qualitative methods;†emphasize partnerships with all of those who contribute to the health of the population, including individuals,communities,voluntary groups and the business sector.10In the UK,following the Acheson review into public health in England in1988,the most fre-quently employed definition building on that of Winslow11has been that public health is:“The science and art of preventing disease, prolonging life and promoting,protecting and improving health through the organized efforts of society”.12Derek Wanless suggested an adaptation:“the science and art of preventing disease, prolonging life and promoting health throughS.Griffiths et al.908the organized efforts and informed choices of society,organizations,public and private,com-munities and individuals”.3Wanless argued that the earlier definition failed to reflect the importance of supporting individuals in their choice of healthy lifestyle,focussing more on the post-war settlement that improving better health,particularly in poor communities,was better achieved through structural solutions insti-gated by the state.He argues that rather than being ‘done unto’,individuals need to ‘fully engage’in their health choices.13This emphasis on choice reflects current political philosophy,with the debate between individual choice and state inter-vention highlighting the tension within the political arena about how much can be achieved by govern-ment without accusation of ‘nanny–statism’,and how much needs to be left to individual choice.‘Choosing Health’explores this move toward personalization of healthy choices,also reflecting the need to reduce health inequalities by addres-sing access to choices,more information and partnerships within communities.It is our contention that,however the definition of public health is finessed,the health of the population will only be improved through engage-ment not only of individuals but of governments and communities.Thus,public health practice needs to demonstrate not only an understanding of technical skills to support individuals in promoting healthy choices,but an engagement with influencing the broader determinants which impact on the health of populations.Fig.1illustrates the need for thisbroad conceptualization which connects the indi-vidual to the structural determinants of health.A public health systemThe challenge this wide remit poses can confound not only the public who are unclear about what public health means but also the specialists who have to organize what they do in the most effective way.A helpful framework to ensure delivery is to think of a public health system.The characteristics of the public health system within the current institutional frame of reference can be described as:†working within a national policy framework;†working at all population levels:local,regional,national and international;†delivering comprehensive public health pro-grammes for populations,including vulnerable groups,to improve and protect health;†being an integral part of primary care working with all partners particularly local authorities and hospital trusts;†led in each locality/geographic area by a DPH;†working through locally organized multidisciplin-ary public health teams which are made up of specialists,practitioners and interested people in communities including voluntary and commu-nity groups and community advocates;†part of managed multidisciplinary and public health networks working across organizations;†supported by timely,accurate and accessible public healthinformation;Figure 1The main determinants of health.Source:Dahlgren and Whitehead,199217.Public health in practice909†part of the primary care organization having local discretion about priorities and methods of delivery;†being based on strong partnerships with commu-nities,local government and the voluntary sector,and utilizing local strategic partnerships and local area agreements;†framing and monitoring activities through DPH annual reports which provide an independent assessment of the health of the local population, supporting health equity audits and health impact assessments;†ensuring that action on key public health issues is reflected in the plans of partners as well as the NHS local delivery plans;and†being performance managed on programmes for process,output,outcome and targets.This framework provides the basis for delivery, audit and governance for public health pro-grammes.It places the public health effort as an integral part of the health,social care and local authority systems,and relies on creating partnerships across communities.It allows moni-toring of delivery by defining the public health effort in terms of public health programmes such as screening,immunization,reduction of teenage pregnancy,smoking cessation,prevention of domestic violence,promotion of physical activity and cancer prevention.In doing so,it draws on the expertise available from managed public health networks and from public health observa-tories.Whilst drawn from the English experience, the model can be adapted to other national contexts.The three key domains of public health14 The breadth of public health becomes more manageable if conceptualized within the model of three domains of practice.15These domains of practice underpin specialist practice and also clarify the delivery of public health programmes. Their origins lie in the historic importance of the control of communicable disease,health edu-cation and the role of hospital and community services over the last150years.They cover inter-related but also distinct aspects of public health practice,with each underpinned by public health intelligence and information.Taken together,they describe the wide range of expectations of public health to which population science can be applied.The health improvement domain covers key aspects of activity to reduce inequalities,working with partners not only in the NHS but in other sectors such as education and workplaces.It involves engagement with structural determinants such as housing and employment,as well as working with individuals and their families within commu-nities to improve health and prevent disease through adopting healthier lifestyles.Health protection includes the prevention and control of infectious diseases as well as response to emergencies,be they the result of a chemical or radiation disaster or of bioterrorism.It engages with the regulation for clean air,water and food as well as preventing or dealing with environmental health hazards.Health service quality improvement includes engagement in service delivery,promoting clini-cally effective practice particularly through pro-moting evidence-based care,supporting clinical governance,planning and prioritizing services,and engaging in appropriate research,audit and evaluation.The three domains are not separate entities but overlap and are interdependent.They can be used to describe the services to be delivered,the core skills,knowledge and competencies that are needed,and the roles and responsibilities of those delivering them.Most DPHs who are based within primary care agree that their role is to take an overview across the three domains.7Other specialists may have special expertise in one or other domain,although they will be competent across the domains to the level expected by their professional bodies.For example,Consultants in Communicable Disease Control will work mainly within the domain of health protection,whilst health promotion special-ists work within health improvement.This Figure2The three domains of public health practice. DPH,director of public health.Source:Northern Ireland Faculty of Public Health Training Committee,200418.S.Griffiths et al.910particular use of the domains could be argued to be country specific because it applies to the organiz-ational basis of practice.However,we would suggest that the approach is not only specific to England.It could be applied to population pro-grammes such as reducing tobacco-related harm in China or chlamydia screening in Sweden which take account of the need to promote healthier lifestyles,to protect the public through surveillance and reducing exposure risk,as well as ensuring that there are services for prevention as well as treatment (Fig.2).The utility of the three domains is demonstrated in the following example of the public health programme to reduce teenage pregnancy.Case study:Delivering teenage pregnancy as a public health programmeMany young people are successful in adapting to the role of parenthood and have happy,healthy children.For too many,however,unplanned teenage pregnancy and early motherhood is associated with low educational achievement,poor physical and mental health,social isolation and poverty.For the very young with little personal or financial support,pregnancy can cause considerable distress,not only for the young person concerned,but also for their families.The closer one approaches the issue,the more it becomes clear that there is no easy technical ‘fix’that can be applied.Consequently,activities to tackle teenage pregnancy have to be across sectors and to be multifaceted;anything that is done needs to involve and be under-standable to the vulnerable young people them-selves.They need to tackle:†low expectations—it is more common in dis-advantaged groups with poor expectations of education or jobs.In the UK,there were more teenagers who saw no prospect of a job or thought they would end up on benefits anyway.Put simply—they see no reason not to get pregnant:†Ignorance—young people lack accurate knowl-edge about contraception,sexually transmitted diseases,what to expect in relationships and what it means to be a parent.Only around half of those under 16years of age and two-thirds of those aged 16–19years use contraception when they start to have sex:and†mixed messages—sex is a staple diet of modern media.Sometimes it may appear to teenagers that sex is compulsory,but contraception,which infrequently receives acknowledgement in the media,is illegal.Mixed messages between the media and parental embarrass-ment leads not to less sex but to less protected sex (Fig.3).Figure 3Teenage pregnancy:applying the three domains.HI,health improvement;HP,health protection;HS,health service delivery and quality.Public health in practice911The three domains can help to frame both the actions needed and those who need to be engaged in constructing the public health programme (Table 1).In addition to the framework being used to determine the range of services needed within a public health programme,the three domains can also be used as the basis for understanding the skill mix needed by those delivering services.Whilst some skills will be those of specialists,the model demonstrates why others in the NHS (midwives,general practitioners)and outside (teachers,Table 1Applying the three domains:Teenage pregnancy as a case studyIssueActionHealth improvementAvoiding unwanted teenage pregnancy through appro-priate sex education,including peer education,and counselling services available to young people attending schools and youth clubs Needs links at policy level with education,schools,youth service,connexions.Roles for school nurses,counsellors,teachers and others in primary care Messages re-inforced through mediaLinks made at local and/or national level with journalistsSupport to young parents within communities,for example,through faith-based groups and providing housing opportunitiesCommunity-based initiatives supported through joint working in local strategic partnerships.Members of public health team will be engaged through local links.Support for housing through housing associations Health protectionYoung people who are having unprotected sex are at risk of sexually transmitted diseases such as chlamy-dia/HIVLocal health protection teams have a role insurveillance based on robust system linked to labs.Needs to communicate with primary care trust team.Advice also needs to be available from GUM clinic/PCT/school-based schemeOnce pregnant,screening for disease including HIV/hepatitis B/syphilisHPA advises on screening working with local providers Local PCT needs to know rates of STIs and whether targets are being metRole for observatories,best linked with HPA.Diversi-fication of provision needs information overview to enable DPH to monitor their populationHealth service qualityUnprotected sex:needs emergency contraception Could be available from local pharmacy,practice,family planning clinicFor those who become pregnant and choose toterminate the pregnancy,services providing not only abortion but counselling and advice are neededService planning need to be aware that access is likely to be primary care:voluntary agency.Role for primary care staff caring for pregnant mother with under-standing of risks,needs for information and social contextFor those continuing with the pregnancy,sensitive antenatal care,delivery and postpartum care followed-up into the community are needed with paediatric follow-upCommissioning role of public health specialist import-ant to ensure quality of services,with community linksPrimary care is essential as the setting for much of this care but needs to link effectively with hospital sectorDPH/specialist links within PCT with clinicians as well as with board are important,articulating needs,effective interventions,priorities and service plans,monitoring outcomes.Health visitor engagement Once the baby is born,schemes such as Surestart 16need to be availableTo help young mothers to get back into education and employment as well as providing parenting skills,childcare advice and provisionHIV,human immunodeficiency virus;GUM,genito-urinary medicine;PCT,primary care trust;HPA,Health Protection Agency;STIs,sexually transmitted diseases;DPH,director of public health.S.Griffiths et al.912community workers,parents)will also need public health skills if programmes are to be delivered effectively.SummaryIn this paper,we have proposed a conceptual model for understanding the context of public health practice by proposing a framework to organize complex systems.The model builds on the recog-nition that public health is everybody’s business and therefore,needs a common definitional base. However,different levels of skill and a wide range of contributions are needed if public health programmes are to make the most impact.The different domains of practice help to construct a basis for understanding the necessary elements of the public health system and the still mix needed. They are a dynamic concept not meant to rigidly demarcate territory but to promote greater under-standing of public health practice.Using teenage pregnancy as a case study of a public health programme highlights the character-istics of the model.It demonstrates not only the importance of the role of the DPH in taking a population-based overview,but also the need for a multisectoral,multidisciplinary approach.The relevance of the public health approach not only to primary care but also to the hospital-based sector becomes apparent,as does its relevance to com-munities,the voluntary sector and local govern-ment.Integration of the three domains,a common definition and the framework for the public health system will support effective delivery of health improvement.AcknowledgementsThe authors would like to acknowledge the helpful comments of colleagues from the Faculty of Public Health,and particularly Dr Fiona Adshead and Dr Selena Gray.They would also like to acknowledge the support of Liz Richards and Allison Thorpe in preparing this article.References1.Department of Health.Choosing health:making healthychoices easier.London:Department of Health;2004.2.Department of Health.NHS improvement plan.London:Department of Health;2004.3.HM Treasury.Securing good health for the whole popu-lation.HM Treasury;2004.4.Department of Health.Shifting the balance of power inEngland.London:Department of Health;2001.5.Department of Health.Getting ahead of the curve.London:Department of Health;2002.6.Faculty of Public Health,Public Health Resource Unit,Department of Health.Joint workshop report on capacity seminars.London:Faculty of Public Health;2004.7.Griffiths S,Wright J,Thorpe A.Choosing health:results of asurvey of the specialist workforce;2004(in preparation).8.World Health Organization.Alma Ata declaration primaryhealth care.Geneva:World Health Organization;1978.9.World Health Organization.Ottawa charter forhealth promotion.Geneva:World Health Organization;1986.10.Griffiths S.In:Beaglehole R,editor.Public health in the UK.In:Global public health.Oxford:Oxford University Press;2002.11.Winslow CEA.The Evolution and significance of the modernpublic health.New York:Yale University Press;1923.12.Department of Health.Public health in England.Report ofthe committee of inquiry into the future development of the public health function.London:Department of Health;1988.13.HM Treasury.Securing our future health:taking a long termview.:HM Treasury;2002.14.Faculty of Public Health—15.Association of Directors of Public Health.The Role of thedirector of public health.London:Faculty of Public Health;2004.16.Surestart./17.Dahlgren and Whitehead diagramme:Whitehead M.&Dahlgren G.Policies and strategies to promote equity in health,WHO,Copenhagen;1992.18.Department of Health,Social Services and Public Safety.Review of the Public Health Function in Northern Ireland, Executive Summary,December2004.Webreferences: /publications/2004/Health-function-exec-summary.pdf,accessed13June2005. Public health in practice913。

03 性侵害实施者分析 04 实施性侵害的伎俩
02 哪些人容易被性侵害
05 如何防止性侵害
0
什么是性侵害
safety education on prevention of sexual assault safety assault safety education on prevention
1
什么是性侵害
参加社交活动与男性单独交往时， 要理智、有节制地把握好自己，尤 其应注意不能过量饮酒。
尽量避免去人群拥挤或偏 僻的处所
如何防止性侵害
不要惧怕，学会保护自己
乘坐交通工具时，遭遇故意抚摸或擦蹭，要大声斥责或狠打其手，引起公众注意，不要隐 忍不说。 遭遇骚扰，要直接提出警告，及时避开。 对于那些失去理智、纠缠不清的无赖或违法犯罪分子，要及时向老师和保卫部门报告，学 会依靠组织和运用法律武器保护自己。
演示完毕感谢您的观看
在家长陪同下去正规医院检查伤害程度
尽量记住罪犯的声音、容貌等特征
因为罪犯是熟悉的人，逆来顺受
立即换下身上所有衣物，并将衣物洗干净
预防性侵害 安全教育
保护好自己 · 远离性侵害
safety education on prevention of sexual assault safety assault safety education on prevention
强暴
强暴是指在对方不 同意或没有理会对 方是否同意的情况 下﹙一般是利用暴 力或武力手段强迫 或威胁﹚，与对方 发生性交行为。
媒介卖淫
所谓媒介，在传播学 意义上是指利用媒质 存储和传播信息的物 质工具。按美国著名 传播学家施拉姆的见 解，“媒介就是传播 过程中，用以扩大并 延伸信息传送的工 具”

AdultsSokol, J. T. (2009) "Identity Development Throughout the Lifetime: An Examination of Eriksonian Theory," Graduate Journal of Counseling Psychology 1(2), Article 14. Retrieved from this article, Sokol reviews the Eriksonian theory through a person’s lifespan. Erikson proposed a life span model of human development that was composed of eight psychosocial stages. A person has to deal with inherent crisis throughout each stage so as to continue with development. He also added the influence that cultur e and society in general has on people’s development. In this article, the author closely examines the various stages of life span in regard to identity formation as proposed under the Eriksonian theory.The author discusses identity development in adulthood in regard to the Eriksonian theory. He criticizes the Erikson on his failure to provide details on identity formation beyond adolescence and mainly provision of contradicting ideas. Erikson states that final identity is fixed at the close of adolescence while still maintaining that identity development goes beyond adolescence into adulthood. As per the author, identity development especially in terms of religion, politics, vocations and sexual choices occur during young adulthood. It continues through middle adulthood through change of circumstances where people reorganize goals and ambitions as well as careers. Women take up masculine characters and vice versa to experience perspective shifts. There is continuous examination and evaluation to revise choices and draw up new beginnings hence identity development.This article is important since it evaluates one of the development theories in regard to human development. Identity formulation even if it mainly occurs in childhood and adolescence, it continues further into adulthood especially since they are more likely to reorganize their lives and take up newBrent, W. R., & Daniel, M. (2009). Personality Trait Change in Adulthood. National Institute of Health. Retrieved from authors define personality traits as enduring patterns of feelings, thoughts, and behaviors among people that distinguish them from others. Recent cross sectional and also longitudinal research has shown that the development of personality traits does occur in all age groups across the life span. It specifically occurs mainly in middle aged people who also tend to score highly on conscientiousness and agreeableness and much lower in traits like neuroticism, openness and extraversion.The authors conclude that the development of personality traits in ongoing from childhood through to late adulthood. In adulthood, it is mainly positively although that does not mean the final trait in the person. It is influenced by certain factors such as growing responsibility and changing circumstances. Most personality changes occur in adults between 20-40 years. As people grow older, they realize that high neuroticism over time resulted in high mortality, depression, physical health and age control.In conclusion, this article touches on the development of humans even through adulthood. It supports the theory that other factors such as social factors affect the human development, and are essential in shaping a person’s life. The article brings out some of the developments that occur in human life especially in terms of character traits thataffect his life thereafter. If one has negative traits they are bound to live for a shorter period.Older AdultsAndrea, M., Weinstein,., Akl, K. E., & Destiny, M. (2012). Physical activity and brain plasticity in late adulthood: a conceptual review. Department of Psychology, University of Pittsburgh; Center for the Neural Basis of Cognition, Pittsburgh, USA. Retrieved from authors in this article link physical exercise and brain plasticity. They cite evidence from neuroscience, kinesiology and epidemiology that shows that physical activity in all stages of development is effective in preventing and in treating of cognitive problems. In late childhood, physical exercise provides a good avenue of ensuring a reduction in the medical burden that comes with various health problems in this stage. The authors show that moderate physical activity even in very sedentary individuals have shown to improve brain and cognitive function. Many of the cognitive functions such as memory, domain of executive control and attention are influenced by physical exercise. Since cognitive decline is a major characteristic of late adulthood, the need for physical activity is crucial.People in the late adulthood stage suffer from brain plasticity where the brain becomes brittle and unconformable. They also suffer from diseases and disorders such as Parkinson’s disease and Alzheimer’s. Physical exercise that is moderate for six months shows significant effect on the brain in this stage. It also delays the onset of Parkinson’s and Alzheimer’s and helps people in this stage to better their motor skills and memory.This article is important in that it tackles some of the challenges that people face during the late adulthood stage. It provides a way of dealing with cognitive decline in an inexpensive way and preventing many diseases. Physical activity is also important during other stages of development in improving cognitive functions.Del, B. E., Sala, E., Hancock, R., Gunnell, C., & Parisi, L. (2007). “Gender, older people and social exclusion. A gendered review and secondary analysis of the data.” ISER Working Paper 2007-13. Colchester: University of Essex. Retrieved from this article, the authors present study findings of older people’s cond itions in the UK. It highlights the gender differences in regard to social inclusion such as provision of care, service use and involvement in social networking. It also includes various imbalances in gender as per the age structure and marital status. The study found out that more men than women are likely to be kept in communal homes and institutions rather than in private homes. Being kept in an institution or home was higher in those who never married although age and illness also contributed. However, blacks and Asians were unlikely to be institutionalized as compared to white people. The article states that most of the people who live alone are mainly widowed but this is true especially for women. Older men tend to remarry after the wife’s death or div orce.The article concludes that gender differences are not large in significant to health conditions among older people. However, older women tend to spend a high percentage of their later lives in poor health as compared to men. Older women make use of health services than men although more men have access to cars for transportation. Rating of the quality of local services and amenities does not differ with gender. In addition, the article concluded that older women interact socially more than women although the men havewider social networks. However, in case of ill health, older people in general call a partner or relative.This article examines the gender differences in older people with regard to health and social networking. This article is relevant in that it discusses on social and gender factors that affect development in older adults. It shows the impacts of the discussed factors as well as what attributes to them and their influence in the lifestyle and lifespan of older adults.SummaryCurrent research focuses much on cognitive development in early childhood and adolescence including the various factors that affect the overall development of infants, children and adolescents. Most research on adolescence and young adulthood is based on emerging factors such as education and careers and social technology. Research on adults is mainly on personal development in regard to personality and identity while older adults research is on disease prevention and treatment due to cognitive decline. The main similarity across all groups is physical and cognitive development either positive or negative and emerging issues especially technology. The difference is on issues that affect each age group like growth in children and decline in late adulthood.The most ap plicable theory was Erikson’s theory of psychological development that states that life progresses in a series of stages that are influenced by social factors. Most research articles made reference to the concept of this theory and even discussed on the various factors that affect development. Other applicable theories include attachment theory especially for children and also Piaget’s theory of cognitive development.The lifespan perspective plays a crucial role in understanding of the current research. It gives background information that helps one to understand why a research would be interested in undertaking research on a certain topic. In addition, one is able to relate the situation in a certain stage by looking back and understanding the previous stage as well as the subsequent one. By understanding the holistic perspective on lifespan one can the relate research issues into various stages.ReferencesAndrea, M., Weinstein,., Akl, K. E., & Destiny, M. (2012). Physical activity and brain plasticity in late adulthood: a conceptual review. Department of Psychology, University of Pittsburgh; Center for the Neural Basis of Cognition, Pittsburgh, USA. Retrieved from W. R., & Daniel, M. (2009). Personality Trait Change in Adulthood. National Institute of Health. Retrieved from Del B. E., Sala, E., Hancock, R., Gunnell, C., & Parisi, L. (2007). “Gender, older people and social exclusion. A gendered review and secondary analysis of the data.” ISER Working Paper 2007-13. Colchester: University of Essex. Retrieved from J. T. (2009) "Identity Development Throughout the Lifetime: An Examination of Eriksonian Theory," Graduate Journal of Counseling Psychology1(2), Article 14. Retrieved from。

9410 - 20 Ave N.W.Edmonton, Alberta, Canada T6N 0A4Tel: (780) 437-9100 / Fax: (780) 437-7787June 10, 2021SERIES FFTM3/FFTM3C VALVESTORONTO, ON M9W 6N9345 CARLINGVIEW DRIVE CRN :Drawing No. :Accepted on:0C23177.52Reg Type:NEW DESIGNApril 13, 2031June 10, 2021Design registered in the name of : A-T CONTROLS INCExpiry Date:SCOPE OF REGISTRATION Fitting type:Attention:The design submission, tracking number 2021-02872, originally received on May 26, 2021 was surveyed and accepted for registration as follows:Sincerely,DICK, ASHLING, P. Eng.TECHNICAL STANDARDS & SAFETY AUTHORITY Tanya FrancisIf you have any question don't hesitate to contact me by phone at (780) 433-0281 ext 3337 or fax (780)****************************.The registration is conditional on your compliance with the following notes:** This registration covers only those valves that are in strict compliance with ASME B16.34, with respect to dimensions, pressure and temperature ratings, materials, markings etc ** See attached Scope of Registration, and a List of Plant SitesAs indicated on AB-41 Statutory Declaration form and submitted documentation, the code of construction is B16.34.- It is our understanding that the fitting(s), included as the scope of this submission, that is(are) subject to the Safety Codes Act shall comply with the requirements of the indicated Standard or Code of Construction on the AB-41 Statutory Declaration as supported by the attached data which identifies the dimensions, materials of construction, press./temp. ratings and the basis for such ratings, and the identification marking of the fittings.- This registration is valid only for fittings fabricated at the location(s) covered by the QC certificate attached to the accepted AB-41 Statutory Declaration form.- This registration is valid only until the indicated expiry date and only if the Manufacturer maintains a valid quality management system approved by an acceptable third-party agency until that date.- Should the approval of the quality management system lapse before the expiry date indicated above, this registration shall become void.DOP Cert. No. D0*******An invoice covering survey and registration fees will be forwarded from our Revenue Accounts.Page 1 of 12021-02872**** Ball Valves Series FFTM3/FFTM3C Class 150, 300 & 600** See attached Scope of Registration and List of Plant SitesABSASAFETY CODES ACT - PROVINCE OF ALBERTASee acceptance letter for conditions of registration.ASHLING DICK, P . Eng.2021-06-10Date:By:This stamp and signature have been affixed electronically to this registered design as required by Section 20(1) of the Pressure Equipment Safety Regulation, in accordance with the Electronic Transactions Act.2021-02872ACCEPTED:0C23177.520C23177.5Technical Standards and Safety Authority Boilers and Pressure Vessels SafetyProgramTHIS IS PART OF CRNABSASAFETY CODES ACT - PROVINCE OF ALBERTASee acceptance letter for conditions of registration.ASHLING DICK, P . Eng.2021-06-10Date:By:This stamp and signature have been affixed electronically to this registered design as required by Section 20(1) of the Pressure Equipment Safety Regulation, in accordance with the Electronic Transactions Act.2021-02872ACCEPTED:0C23177.520C23177.5Technical Standards and Safety Authority Boilers and Pressure Vessels SafetyProgramTHIS IS PART OF CRNBody Materials: ASTM A216 WCB & A351 CF8MABSASAFETY CODES ACT - PROVINCE OF ALBERTASee acceptance letter for conditions of registration.ASHLING DICK, P . Eng.2021-06-10Date:By:This stamp and signature have been affixed electronically to this registered design as required by Section 20(1) of the Pressure Equipment Safety Regulation, in accordance with the Electronic Transactions Act.2021-02872ACCEPTED:0C23177.520C23177.5Technical Standards and Safety Authority Boilers and Pressure Vessels SafetyProgramTHIS IS PART OF CRNABSASAFETY CODES ACT - PROVINCE OF ALBERTASee acceptance letter for conditions of registration.ASHLING DICK, P . Eng.2021-06-10Date:By:This stamp and signature have been affixed electronically to this registered design as required by Section 20(1) of the Pressure Equipment Safety Regulation, in accordance with the Electronic Transactions Act.2021-02872ACCEPTED:0C23177.52April 13, 2021A-T CONTROLS INC9955 INTERNATIONAL BLVDCINCINNATI OH 45246USWorkorder Type: Registration - Fitting(Conventional)Workorder No: 8005180Your Reference No.:Registered to: A-T CONTROLS INCDear PETE VEZEY,Technical Standards and Safety Authority (TSSA) is pleased to inform you that your submission has been reviewed and registered as follows:CRN : 0C23177.5Main Design No.: Ball Valves Series FFTM3/FFTM3C Class 150, 300 & 600 - See Scope of Registration & List of Plant SitesExpiry Date: Apr 13, 2031Please be advised that a valid quality control system must be maintained for the fitting registration to remain valid until the expiry date.The stamped copy of the approved registration and the invoice are mailed separately (There will be no hard copies for electronic submissions). Should you have any questions or require further assistance, please contact a CustomerServiceAdvisorat1.877.682.TSSA(8772)*********************************.Wewillbehappyto assist you. When contacting TSSA regarding this file, please refer to the Service Request number provided above.Yours truly,Wendy DuEngineer, BPVTel. : +1 416-734-3566Email:************Date:C.R.N.:April 13, 2021.0C23177.5Technical Standards and Safety AuthorityBoilers andPressure Vessels Safety ProgramREGISTEREDSigned:- See stamped Scope of Registration & List of Plant SitesApril 13, 20310C23177.5Technical Standards and Safety Authority Boilers and Pressure Vessels SafetyProgramTHIS IS PART OF CRNBody Materials: ASTM A216 WCB & A351 CF8MTHIS IS PART OF CRN 0C23177.5Technical Standards and Safety Authority Boilers and Pressure Vessels SafetyProgramDate:Account #:Journal #:35231June 18, 202178138TECHNICAL STANDARDS & SAFETY AUTHORITY 345 CARLINGVIEW DRIVE TORONTO ON M9W 6N9TSSAApplication for Design RegistrationThe design, as detailed in your, 0C23177.5 - A-T CONTROLS INC, for a Fitting is accepted for registration as follows:A-T CONTROLS, INC.CRN:0C23177.51Registered To:Drawing #:Scope of Registration Drawing Revision:N/ARe:Attn:Reviewer's Notes:Scope of Registration: Ball Valves Series FFTM3/FFTM3C Class 150, 300 & 600 - See Scope of Registration &List of Plant SitesAs required by CSA B51 4.2.1, this registration expires on 13-Apr-2031. This CRN is valid until the expiry date as long as the Manufacturer maintains a valid quality control program verified by an acceptable third-party agency until that date. Should the certification of the quality control program lapse before the expiry date, this registration shall become void. Any additional conditions of registration stated in TSSA CRN# 0C23177.5 registration shall apply to BC registration.This design was registered based on a technical review performed by the province of initial registration in accordance with the Association of Chief Inspectors policy on reciprocal recognition of design review.Contact me if you have any questions. The invoice for registration will be forwarded under separate :Emilia Tam*******************************Design AdministrationInspection and Technical ServicesMunicipal Relations508-401York AveWinnipeg, Manitoba Canada R3C 0P8T 204-945-3373 F 204-948-2089.mb.ca/itsm_main14 June 2021TSSA345 Carlingview DriveToronto, ON M9W 6N9Dear Tanya FrancisRe: Reciprocal CRN Registration in ManitobaYour application indicates that a CRN has been received in another Canadian Jurisdiction, and therefore your CRN has been registered in Manitoba as follows:File Number: 74-R1571CRN: 0C23177.54Scope: SOR: Ball Valve Series FFTM3 / FFTM3C Class 150, 300 & 600 and List of Plant Sites Manufacturer: A-T Controls IncExpiry Date: 13 April 2031Please find attached invoice for registration.As indicated by the Regulatory Reconciliation and Cooperation Table and the Reconciliation Agreement for the Canadian Registration Number (CRN) for Pressure Equipment, a CRN issued in any Canadian Jurisdiction will be accepted for use in Manitoba.In accordance with Steam and Pressure Plants Regulation and CSA B51, it is the manufacturer’s responsibility to file a Manufacturers Data Report, including partial data reports, with our office, prior to shipping pressure equipment to Manitoba.Please contact ****************.ca for any questions or concerns.Inspection and Technical ServicesMunicipal Relations508 - 401 York Avenue, Winnipeg Manitoba R3C 0P8T (204) 945-3373 | F (204) 948-2089。