15 resultados para epidemiology, measurement, special needs populations

em Consorci de Serveis Universitaris de Catalunya (CSUC), Spain


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The present essay –which is a pilot study conceived to continue the research in depth in the future- is based in a comparative analysis of educational practice between five different primary and pre-school teaching centres in Osona and the educational practice in inclusive educational centres. The essay introduces the objectives of the research and the theoretical and conceptual framework in which it is based (chapter 1) in relation with the main themes and expressions which are the purpose of the study: comprensivity, inclusive school and inclusive practice. The theoretical framework is linked to the principal regulations applied in our context. The study describes the instruments and procedure analysis describes the instruments and procedure analysis which have been designed and used for a qualitative methodological approach, together with the data obtained from the analysis of five teaching centres (chapter 2). The results from the research show that the practice done in the analised schools are not totally comparable to the ones in the inclusive environment. Notwithsanding, there are some similar points, although not totally coincident, like the fact that either the analysed schools or the ones with an inclusive approach show availability and interest in improving integration of all the pupils in the school, also the teachers work together in some aspects like, evaluation of pupils with special needs, objectives and contents and activities fort he specific kind of pupils with special needs parents and the majority of the analyzed schools, like those fallowing inclusive educational approaches, try the pupils with special needs to develop their acquisition within the ordinary class with adapted material. I think, these verifications, some of them close to inclusive educational practice, could constitute a starting point to analyse our model, in order to offer a common curriculum that could respect the different styles and rhythms of acquisition of all the pupils, so that promoting a more flexible and open schooling. In conclusion, the results of this analysis, although dues to its limits, they can not be generalized, they can help to find the necessary changes to bet for a qualitative education in a school for everyone.

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L'existència d'una aula USEE ha de permetre la inclusió dels alumnes amb NEE en un entorn majoritàriament ordinari. El present treball és una aproximació a l'educació inclusiva, les seves dificultats i aplicacions a través d'una experiència pràctica en un institut al voltant de la seva aula USEE. Les tasques pràctiques realitzades estan dividides en dos grans blocs: per una banda la recollida d'informació per a la identificació i l'anàlisi dels grau d'inclusió dels alumnes i del funcionament general del centre i per altra banda, una intervenció a la pròpia aula USEE a través d'un taller de ceràmica, el qual em va permetre valorar el sentiment de pertinença dels alumnes i treballar amb ells temes com l'autoconcepte, l'aprenentatge constructiu, les habilitats socials i les estratègies d'aprenentatge. He pogut constatar com una USEE és un recurs facilitador del model inclusiu si es donen algunes condicions fonamentals com aquelles que afecten a la cultura de centre. Finalment, el treball aporta algunes idees per orientar el centre cap a una millora en la seva cultura inclusiva.

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The exchange of social and economic support between the generationsis one of the main pillars of both family life and welfare systems. Thedebate on how to reform the generational contract is still truncated, however, by focusing on its public dimension only, especially on pensions and health care provisions. For a full account, the transfer of resources between adult generations in the family needs to be included as well. In our previous research we have shown that intergenerationalexchange is more likely to take place but less intense in the Nordicwelfare regime than in the Continental and Southern ones. In thepresent paper we analyze the social mechanisms that create and explain this nexus between patterns of intergenerational transfers and welfare regimes. The notion that Southern European family support networksare stronger and more effective than those of Continental and Northern European countries is only partially confirmed. In Southern (and partly in Continental) countries, children are mostly supported by means of co-residence with their parents till their complete economicindependence. However, once they have left the parental home thereare fewer transfers; support tends to be restricted to children who have special needs (such as for the formation of their own family), and depends more on their parents’ resources. In the Nordic countries, in contrast, transfers are less driven by children’s needs and parentalresources.

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Aquesta comunicació sintetitza el treball que hem realitzat durant el Màster d’Educació Inclusiva de la Universitat de Vic en el curs 2010-2011 tant pel que fa a les pràctiques com pel que fa als continguts dels Mòduls. Els objectius són els següents: aprofundir en el coneixement de la inclusió en l’àmbit educatiu; adquirir estratègies per a l’atenció de la diversitat dels alumnes i dissenyar propostes inclusives en l’àmbit educatiu. Per aconseguir els objectius hem seguit el següent procés: Per una banda, realitzar les pràctiques de caire professionalitzador en el centre educatiu on treballo i analitzar el grau d’inclusivitat de 3 grups de 1r d’ESO d’aquest centre. Paral·lelament, anar seguint les classes de les assignatures i realitzar els treballs proposats, ampliant continguts amb les lectures i les síntesis realitzades. Això ens ha permès dissenyar i fonamentar una proposta de millora per augmentar la inclusió de tots els alumnes. Les pràctiques han estat realitzades en un centre educatiu d’ESO, Batxillerat i Cicles Formatius de la comarca d’Osona en el qual el grau d’inclusivitat detectat en els grups de 1r d’ESO és mitjà-baix, sobretot en algunes àrees, ja que hi ha un grup de deu alumnes que passa el 78,2 % del temps escolar en aula separada de la resta dels companys. La proposta de millora es fonamenta en les “nou regles d’or” de la UNESCO (2001), en els criteris de la European Agency for Development in Special Needs Education (2003)(2008), en la LEC (2009) i en la Resolució del Departament d’Educació (2010). Així mateix, es citen autors de referència i es corrobora l’eficàcia del treball cooperatiu amb els resultats de les investigacions del GRAD. Aquest treball ens permet presentar amb solidesa una proposta de millora a l’equip de professorat que ha de facilitar i atendre la diversitat de tots els alumnes en les aules ordinàries el màxim temps possible.

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Actualment s’està donant molt pes al fet d’incloure dins l’aula a tot aquell alumnat amb necessitats educatives especials per tal de fomentar la inclusió. Aquest fet i com a persona que visc el dia a dia amb persones amb diversitat funcional ha fet que hem plantegi molts dubtes i reptes sobre la inclusió. Així doncs, vaig pensar que seria interessant observar, descriure i analitzar com viu un infant amb diversitat funcional la seva escolarització dins una aula ordinària i dins una aula d’educació especial. La principal participant de la investigació ha estat la Laia, una nena de 10 anys la qual realitza escolarització compartida. La seva família i les tutores dels dos centres han col·laborat en la investigació aportant informació. El mètode utilitzat per a la investigació ha estat una recerca qualitativa a partir de l’anàlisi d’un estudi de cas utilitzant les entrevistes amb la família i els tutors de la Laia, l’observació de Laia dins l’horari escolar i les notes de camp com a instruments de recollida de dades. Com a conclusions pensem que la inclusió d’aquells infants amb diversitat funcional dins l’aula ordinària és molt important ja que els ajuda a viure en un àmbit amb total normalitat i fomenta el respecte de la gent que els envolta. Cal fomentar les situacions d’inclusió amb l’ús d’estratègies com poden ser el treball cooperatiu o establint bones relacions amb la gent que els envolta.

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El presente proyecto quiere ofrecer una respuesta a las necesidades que presentanalgunos adolescentes ingresados en el hospital de día, es decir, proporcionarles una herramienta para disminuir su elevado grado de ansiedad. El proyecto se basa en la práctica de un conjunto de actividades físicas y deportivas programadas, ya que el reconocimiento de los efectos beneficiosos de la práctica de actividades físicas y deportivas es un hecho cada vez más evidente, tanto desde el punto de vista físico, social como psicológico. El siguiente proyecto puede ser un excelente complemento de otras medidas terapéuticas.

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El objetivo del proceso de investigación de mi Trabajo de Fin de Grado recae en los beneficios que tienen la naturaleza y los animales sobre las personas con diversidad funcional y más precisamente sobre las personas con trastorno mental. Lo que me motivó en esta investigación fue en primer lugar mi pasión por estos ámbitos y en segundo lugar porque conocía la existencia de dos proyectos magníficos. Uno en el Zoo de Barcelona (Proyecto de voluntariado de personas con Trastorno Mental grave con el Zoo de Barcelona) y otro en la protectora de perros y gatos (CCAAS : Centro Comarcal de Atención a animales de compañía). Para eso me he sumergido en estos proyectos para poder comprender el impacto que tenía la naturaleza y los animales sobre los usuarios. Han participado directamente cinco usuarios. He usado varias metodologías como la observación, el diario de campo, la fotografía y la entrevista semi-estructurada. Los resultados extraídos de la investigación muestran como existen beneficios y tienen un impacto positivo hacia las dimensiones bio-psico-social de las personas con trastorno mental. Las limitaciones del proyecto dependen de la voluntad de participación de cada usuario y a la naturaleza del estudio.

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El tema central d'aquest Treball Final de Grau és el joc i les seves potencialitats com a eina inclusiva. El objectiu de la recerca és conèixer la importància que té el joc en l'educació infantil i indagar sobre las possibilitats que aporta a la inclusió de nens i nenes amb necessitats educatives especials. El treball es divideix en diferents apartats. Inicialment, es fa una recerca teòrica sobre com el joc col·labora en l’educació dels infants a nivell acadèmic i transversal i sobre els beneficis de l’activitat lúdica en els alumnes amb necessitats educatives especials. A continuació, es realitza un estudi de cas d’un infant amb certes necessitats dins d’un context escolar i s’analitza la funció el joc com el mecanisme d’ajuda per incloure’l dins d’un grup. L’estudi es porta a terme mitjançant l’observació de l’infant a l’escola i de entrevistes realitzades amb diferents persones del seu entorn. Per últim, es presenta una anàlisi de les dades recollides amb l’objectiu d’extreure conclusions sobre com el joc pot ser una eina per incloure els infants amb necessitats educatives especials dins d’un grup-classe.

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Aquesta comunicació sintetitza el treball que hem realitzat durant el Màster d’Educació Inclusiva de la Universitat de Vic en el curs 2010-2011 tant pel que fa a les pràctiques com pel que fa als continguts dels Mòduls. Els objectius són els següents: aprofundir en el coneixement de la inclusió en l’àmbit educatiu; adquirir estratègies per a l’atenció de la diversitat dels alumnes i dissenyar propostes inclusives en l’àmbit educatiu. Per aconseguir els objectius hem seguit el següent procés: Per una banda, realitzar les pràctiques de caire professionalitzador en el centre educatiu on treballo i analitzar el grau d’inclusivitat de 3 grups de 1r d’ESO d’aquest centre. Paral·lelament, anar seguint les classes de les assignatures i realitzar els treballs proposats, ampliant continguts amb les lectures i les síntesis realitzades. Això ens ha permès dissenyar i fonamentar una proposta de millora per augmentar la inclusió de tots els alumnes. Les pràctiques han estat realitzades en un centre educatiu d’ESO, Batxillerat i Cicles Formatius de la comarca d’Osona en el qual el grau d’inclusivitat detectat en els grups de 1r d’ESO és mitjà-baix, sobretot en algunes àrees, ja que hi ha un grup de deu alumnes que passa el 78,2 % del temps escolar en aula separada de la resta dels companys. La proposta de millora es fonamenta en les “nou regles d’or” de la UNESCO (2001), en els criteris de la European Agency for Development in Special Needs Education (2003)(2008), en la LEC (2009) i en la Resolució del Departament d’Educació (2010). Així mateix, es citen autors de referència i es corrobora l’eficàcia del treball cooperatiu amb els resultats de les investigacions del GRAD. Aquest treball ens permet presentar amb solidesa una proposta de millora a l’equip de professorat que ha de facilitar i atendre la diversitat de tots els alumnes en les aules ordinàries el màxim temps possible

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Some analysts use sequential dominance criteria, and others use equivalence scales in combination with non-sequential dominance tests, to make welfare comparisons of oint distributions of income and needs. In this paper we present a new sequential procedure hich copes with situations in which sequential dominance fails. We also demonstrate that there commendations deriving from the sequential approach are valid for distributions of equivalent income whatever equivalence scale the analyst might adopt. Thus the paper marries together the sequential and equivalizing approaches, seen as alternatives in much previous literature. All results are specified in forms which allow for demographic differences in the populations being compared.

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Background: Choosing an adequate measurement instrument depends on the proposed use of the instrument, the concept to be measured, the measurement properties (e.g. internal consistency, reproducibility, content and construct validity, responsiveness, and interpretability), the requirements, the burden for subjects, and costs of the available instruments. As far as measurement properties are concerned, there are no sufficiently specific standards for the evaluation of measurement properties of instruments to measure health status, and also no explicit criteria for what constitutes good measurement properties. In this paper we describe the protocol for the COSMIN study, the objective of which is to develop a checklist that contains COnsensus-based Standards for the selection of health Measurement INstruments, including explicit criteria for satisfying these standards. We will focus on evaluative health related patient-reported outcomes (HR-PROs), i.e. patient-reported health measurement instruments used in a longitudinal design as an outcome measure, excluding health care related PROs, such as satisfaction with care or adherence. The COSMIN standards will be made available in the form of an easily applicable checklist.Method: An international Delphi study will be performed to reach consensus on which and how measurement properties should be assessed, and on criteria for good measurement properties. Two sources of input will be used for the Delphi study: (1) a systematic review of properties, standards and criteria of measurement properties found in systematic reviews of measurement instruments, and (2) an additional literature search of methodological articles presenting a comprehensive checklist of standards and criteria. The Delphi study will consist of four (written) Delphi rounds, with approximately 30 expert panel members with different backgrounds in clinical medicine, biostatistics, psychology, and epidemiology. The final checklist will subsequently be field-tested by assessing the inter-rater reproducibility of the checklist.Discussion: Since the study will mainly be anonymous, problems that are commonly encountered in face-to-face group meetings, such as the dominance of certain persons in the communication process, will be avoided. By performing a Delphi study and involving many experts, the likelihood that the checklist will have sufficient credibility to be accepted and implemented will increase.

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Background: The use of emergency hospital services (EHS) has increased steadily in Spain in the last decade while the number of immigrants has increased dramatically. Studies show that immigrants use EHS differently than native-born individuals, and this work investigates demographics, diagnoses and utilization rates of EHS in Lleida (Spain). Methods: Cross-sectional study of all the 96,916 EHS visits by patients 15 to 64 years old, attended during the years 2004 and 2005 in a public teaching hospital. Demographic data, diagnoses of the EHS visits, frequency of hospital admissions, mortality and diagnoses at hospital discharge were obtained. Utilization rates were estimated by group of origin. Poisson regression was used to estimate the rate ratios of being visited in the EHS with respect to the Spanish-born population. Results: Immigrants from low-income countries use EHS services more than the Spanish-born population. Differences in utilization patterns are particularly marked for Maghrebi men and women and sub-Saharan women. Immigrant males are at lower risk of being admitted to the hospital, as compared with Spanish-born males. On the other hand, immigrant women are at higher risk of being admitted. After excluding the visits with gynecologic and obstetric diagnoses, women from sub-Saharan Africa and the Maghreb are still at a higher risk of being admitted than their Spanish-born counterparts. Conclusion: In Lleida (Spain), immigrants use more EHS than the Spanish born population. Future research should indicate whether the same pattern is found in other areas of Spain and whether EHS use is attributable to health needs, barriers to access to the primary care services or similarities in the way immigrants access health care in their countries of origin.

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Since 2001 several outbreaks of a new disease associated with Border disease virus (BDV) infection have caused important declines in Pyrenean chamois (Rupicapra pyrenaica) populations in the Pyrenees. The goal of this study was to analyze the post-outbreak BDV epidemiology in the first two areas affected by disease with the aim to establish if the infection has become endemic. We also investigated if BDV infected wild and domestic ruminants sharing habitat with chamois. Unexpectedly, we found different epidemiological scenarios in each population. Since the disease outbreaks, some chamois populations recuperated quickly, while others did not recover as expected. In chamois from the first areas, prevalence was high (73.47%) and constant throughout the whole study period and did not differ between chamois born before and after the BDV outbreak; in all, BDV was detected by RT-PCR in six chamois. In the other areas, prevalence was lower (52.79%) and decreased during the study period; as well, prevalence was significantly lower in chamois born after the disease outbreak. No BDV were detected in this population. A comparative virus neutralisation test performed with four BDV strains and one Bovine viral diarrhoea virus (BVDV) strain showed that all the chamois had BDV-specific antibodies. Pestivirus antibodies were detected in all the rest of analyzed species, with low prevalence values in wild ruminants and moderate values in domestic ruminants. No viruses were detected in these species. These results confirm the hypothesis that outbreaks of BDV infection only affect the Pyrenean chamois, although other wild ruminants can occasionally be infected. In conclusion, two different scenarios have appeared since the first border disease outbreaks in Pyrenean chamois: on the one hand frequent BDV circulation with possible negative impact on population dynamics in some areas and on the other, lack of virus circulation and quick recovery of the chamois population.

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Background In an agreement assay, it is of interest to evaluate the degree of agreement between the different methods (devices, instruments or observers) used to measure the same characteristic. We propose in this study a technical simplification for inference about the total deviation index (TDI) estimate to assess agreement between two devices of normally-distributed measurements and describe its utility to evaluate inter- and intra-rater agreement if more than one reading per subject is available for each device. Methods We propose to estimate the TDI by constructing a probability interval of the difference in paired measurements between devices, and thereafter, we derive a tolerance interval (TI) procedure as a natural way to make inferences about probability limit estimates. We also describe how the proposed method can be used to compute bounds of the coverage probability. Results The approach is illustrated in a real case example where the agreement between two instruments, a handle mercury sphygmomanometer device and an OMRON 711 automatic device, is assessed in a sample of 384 subjects where measures of systolic blood pressure were taken twice by each device. A simulation study procedure is implemented to evaluate and compare the accuracy of the approach to two already established methods, showing that the TI approximation produces accurate empirical confidence levels which are reasonably close to the nominal confidence level. Conclusions The method proposed is straightforward since the TDI estimate is derived directly from a probability interval of a normally-distributed variable in its original scale, without further transformations. Thereafter, a natural way of making inferences about this estimate is to derive the appropriate TI. Constructions of TI based on normal populations are implemented in most standard statistical packages, thus making it simpler for any practitioner to implement our proposal to assess agreement.

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The most suitable method for estimation of size diversity is investigated. Size diversity is computed on the basis of the Shannon diversity expression adapted for continuous variables, such as size. It takes the form of an integral involving the probability density function (pdf) of the size of the individuals. Different approaches for the estimation of pdf are compared: parametric methods, assuming that data come from a determinate family of pdfs, and nonparametric methods, where pdf is estimated using some kind of local evaluation. Exponential, generalized Pareto, normal, and log-normal distributions have been used to generate simulated samples using estimated parameters from real samples. Nonparametric methods include discrete computation of data histograms based on size intervals and continuous kernel estimation of pdf. Kernel approach gives accurate estimation of size diversity, whilst parametric methods are only useful when the reference distribution have similar shape to the real one. Special attention is given for data standardization. The division of data by the sample geometric mean is proposedas the most suitable standardization method, which shows additional advantages: the same size diversity value is obtained when using original size or log-transformed data, and size measurements with different dimensionality (longitudes, areas, volumes or biomasses) may be immediately compared with the simple addition of ln k where kis the dimensionality (1, 2, or 3, respectively). Thus, the kernel estimation, after data standardization by division of sample geometric mean, arises as the most reliable and generalizable method of size diversity evaluation