Asylee Access to Refugee Health Screenings: Refugee Health Screenings Should Be Urgently Granted to Asylees in Washington State

Thesis (Master's)--University of Washington, 2016-06

Hand in hand:privatising five star hotels in Egypt through the stock market will enhance the latter's role as well as set an example of the benefits that could be gained from privatisation

This thesis examines the possibility of privatising public owned five star hotels in Egypt through its stock market in order to give a boost to the Egyptian privatisation programme and to help activate its stock market. To explore these aspects, two main technical exercises were executed. First the writer constructed, for the first time in Egypt, a daily price index for Cairo Stock Exchange and an index for the tourism sector, in order to analyze the efficiency of the capital market. This technical analysis showed that Cairo stock exchange is inefficient, stagnant and undergoes minimal fluctuations, especially when compared to other developed and emerging markets. Second, given the importance and complexity of the valuation of SOEs prior to their privatisation, a sample of three five star hotels that could be prime candidates for privatisation via the stock market in Egypt were selected and a detailed financial analysis for the three hotels was concluded. The result was a valuation range for the three hotels using various valuation methods. Nevertheless it was found out that the final value of hotels will be determined by the market itself. Depite the inefficiency of Cairo Stock Exchange, the thesis did not rule out privatisation through the stock market. On the contrary it cited several examples of developing countries that were able to successfully privatise some of their SOEs via their rudimentary capital markets. Finally, the thesis recommended that five star hotels could be pefect candidates for privatisation via the stock market in Egypt. This is because five star hotels are profitable, privately managed, non strategic and not highly capital intensive businesses. In addition, they do not suffer from overstaffing and the industry in which they operate i.e. tourism sector, has high growth prospects and is of an international nature. Therefore it is anticipated that privatisation of five star hotels can attract a lot of investors because of the relatively high returns. This in turn will help activate and popularize the capital market in Egypt. At the same time the benefits of privatisation would be more visible which will give more momentum to the privatisation programme and make it more politically acceptable.

Para não deixar o cerebro na maquina : um estudo sobre os sentidos de "cultura" e "lazer" no discurso da "teoria do lazer" em interrelação com o discurso de trabalhadores organizados no sindicato cutista dos metalurgicos de São Jose dos Campos

Universidade Estadual de Campinas. Faculdade de Educação Física

Development of a more efficient classifying cyclone

A more efficient classifying cyclone (CC) for fine particle classification has been developed in recent years at the JKMRC. The novel CC, known as the JKCC, has modified profiles of the cyclone body, vortex finder, and spigot when compared to conventional hydrocyclones. The novel design increases the centrifugal force inside the cyclone and mitigates the short circuiting flow that exists in all current cyclones. It also decreases the probability of particle contamination in the place near the cyclone spigot. Consequently the cyclone efficiency is improved while the unit maintains a simple structure. An international patent has been granted for this novel cyclone design. In the first development stage-a feasibility study-a 100 mm JKCC was tested and compared with two 100 min commercial units. Very encouraging results were achieved, indicating good potential for the novel design. In the second development stage-a scale-up stage-the JKCC was scaled up to 200 mm in diameter, and its geometry was optimized through numerous tests. The performance of the JKCC was compared with a 150 nun commercial unit and exhibited sharper separation, finer separation size, and lower flow ratios. The JKCC is now being scaled up into a fill-size (480 mm) hydrocyclone in the third development stage-an industrial study. The 480 mm diameter unit will be tested in an Australian coal preparation plant, and directly compared with a commercial CC operating under the same conditions. Classifying cyclone performance for fine coal could be further improved if the unit is installed in an inclined position. The study using the 200 mm JKCC has revealed that sharpness of separation improved and the flow ratio to underflow was decreased by 43% as the cyclone inclination was varied from the vertical position (0degrees) to the horizontal position (90degrees). The separation size was not affected, although the feed rate was slightly decreased. To ensure self-emptying upon shutdown, it is recommended that the JKCC be installed at an inclination of 75-80degrees. At this angle the cyclone performance is very similar to that at a horizontal position. Similar findings have been derived from the testing of a conventional hydrocyclone. This may be of benefit to operations that require improved performance from their classifying cyclones in terms of sharpness of separation and flow ratio, while tolerating slightly reduced feed rate.

Supporting intra-task parallelism in real-time multiprocessor systems

Os sistemas de tempo real modernos geram, cada vez mais, cargas computacionais pesadas e dinâmicas, começando-se a tornar pouco expectável que sejam implementados em sistemas uniprocessador. Na verdade, a mudança de sistemas com um único processador para sistemas multi- processador pode ser vista, tanto no domínio geral, como no de sistemas embebidos, como uma forma eficiente, em termos energéticos, de melhorar a performance das aplicações. Simultaneamente, a proliferação das plataformas multi-processador transformaram a programação paralela num tópico de elevado interesse, levando o paralelismo dinâmico a ganhar rapidamente popularidade como um modelo de programação. A ideia, por detrás deste modelo, é encorajar os programadores a exporem todas as oportunidades de paralelismo através da simples indicação de potenciais regiões paralelas dentro das aplicações. Todas estas anotações são encaradas pelo sistema unicamente como sugestões, podendo estas serem ignoradas e substituídas, por construtores sequenciais equivalentes, pela própria linguagem. Assim, o modo como a computação é na realidade subdividida, e mapeada nos vários processadores, é da responsabilidade do compilador e do sistema computacional subjacente. Ao retirar este fardo do programador, a complexidade da programação é consideravelmente reduzida, o que normalmente se traduz num aumento de produtividade. Todavia, se o mecanismo de escalonamento subjacente não for simples e rápido, de modo a manter o overhead geral em níveis reduzidos, os benefícios da geração de um paralelismo com uma granularidade tão fina serão meramente hipotéticos. Nesta perspetiva de escalonamento, os algoritmos que empregam uma política de workstealing são cada vez mais populares, com uma eficiência comprovada em termos de tempo, espaço e necessidades de comunicação. Contudo, estes algoritmos não contemplam restrições temporais, nem outra qualquer forma de atribuição de prioridades às tarefas, o que impossibilita que sejam diretamente aplicados a sistemas de tempo real. Além disso, são tradicionalmente implementados no runtime da linguagem, criando assim um sistema de escalonamento com dois níveis, onde a previsibilidade, essencial a um sistema de tempo real, não pode ser assegurada. Nesta tese, é descrita a forma como a abordagem de work-stealing pode ser resenhada para cumprir os requisitos de tempo real, mantendo, ao mesmo tempo, os seus princípios fundamentais que tão bons resultados têm demonstrado. Muito resumidamente, a única fila de gestão de processos convencional (deque) é substituída por uma fila de deques, ordenada de forma crescente por prioridade das tarefas. De seguida, aplicamos por cima o conhecido algoritmo de escalonamento dinâmico G-EDF, misturamos as regras de ambos, e assim nasce a nossa proposta: o algoritmo de escalonamento RTWS. Tirando partido da modularidade oferecida pelo escalonador do Linux, o RTWS é adicionado como uma nova classe de escalonamento, de forma a avaliar na prática se o algoritmo proposto é viável, ou seja, se garante a eficiência e escalonabilidade desejadas. Modificar o núcleo do Linux é uma tarefa complicada, devido à complexidade das suas funções internas e às fortes interdependências entre os vários subsistemas. Não obstante, um dos objetivos desta tese era ter a certeza que o RTWS é mais do que um conceito interessante. Assim, uma parte significativa deste documento é dedicada à discussão sobre a implementação do RTWS e à exposição de situações problemáticas, muitas delas não consideradas em teoria, como é o caso do desfasamento entre vários mecanismo de sincronização. Os resultados experimentais mostram que o RTWS, em comparação com outro trabalho prático de escalonamento dinâmico de tarefas com restrições temporais, reduz significativamente o overhead de escalonamento através de um controlo de migrações, e mudanças de contexto, eficiente e escalável (pelo menos até 8 CPUs), ao mesmo tempo que alcança um bom balanceamento dinâmico da carga do sistema, até mesmo de uma forma não custosa. Contudo, durante a avaliação realizada foi detetada uma falha na implementação do RTWS, pela forma como facilmente desiste de roubar trabalho, o que origina períodos de inatividade, no CPU em questão, quando a utilização geral do sistema é baixa. Embora o trabalho realizado se tenha focado em manter o custo de escalonamento baixo e em alcançar boa localidade dos dados, a escalonabilidade do sistema nunca foi negligenciada. Na verdade, o algoritmo de escalonamento proposto provou ser bastante robusto, não falhando qualquer meta temporal nas experiências realizadas. Portanto, podemos afirmar que alguma inversão de prioridades, causada pela sub-política de roubo BAS, não compromete os objetivos de escalonabilidade, e até ajuda a reduzir a contenção nas estruturas de dados. Mesmo assim, o RTWS também suporta uma sub-política de roubo determinística: PAS. A avaliação experimental, porém, não ajudou a ter uma noção clara do impacto de uma e de outra. No entanto, de uma maneira geral, podemos concluir que o RTWS é uma solução promissora para um escalonamento eficiente de tarefas paralelas com restrições temporais.

Design of a doctorate programme on technology assessment: A sabbatical leave project

The work agenda includes the production of a report on different doctoral programmes on “Technology Assessment” in Europe, the US and Japan, in order to analyse collaborative post-graduation activities. Finally, the proposals on collaborative post-graduation programme between FCTUNL and ITAS-FZK will be organised by an ongoing discussion process with colleagues from ITAS.

Dimensionar a logística interna da fábrica Toyota Ovar para a produção de nova viatura

O projeto foi realizado na Toyota (divisão fabril de Ovar), no ano letivo 2014/2015, teve por base um estágio extracurricular que foi realizado para que desta forma tomasse contacto com uma realidade concreta e absoluta no contexto empresarial. O estágio serviu, principalmente, como uma experiência na compreensão do funcionamento de uma indústria de automóveis. Este projeto desenvolve-se no âmbito do 2ºano do Mestrado de Logística e apresenta os contributos desenvolvidos no departamento de logística para a reorganização da mesma para a produção de um novo modelo automóvel. Atualmente, a Toyota, para os modelos de automóveis que produz, recebe os componentes em CKD (Completed Knocked Down) provenientes do Japão em lotes de cinco unidades. Estes lotes são armazenados no armazém, de onde só saem quando for dada ordem para serem produzidos. Cada lote tem várias caixas, que são colocadas à vez numa zona comum de abertura. São retidos os componentes das caixas CKD e colocados nos transportadores próprios dos postos correspondentes (supermercado de linha). Isto significa que sempre que é solicitado uma viatura de um determinado lote, são obrigados a produzir as cinco unidades. Isto significa que as restantes unidades do lote terão que ficar em parque aberto a aguardar venda futura, para além de ter um stock desnecessário, estas unidades ficam vulneráveis e sofrem desgaste, pois estão expostas à intempérie, causando graves problemas de qualidade e respetivos custos associados. Recentemente, foi decidida a produção do modelo Land Cruiser 70 na unidade industrial de Ovar, Portugal, o que obrigou a uma reorganização da produção e processos logísticos para a sua produção. Os objetivos que a empresa pretende com a entrada de um novo projeto Land Cruiser 70, são os seguintes: Alterar o sistema de abastecimento, implementando o abastecimento unitário em toda a fábrica para o novo modelo, garantindo o “one by one production”; Definir o funcionamento do processo logístico desde a chegada dos componentes até ficarem disponíveis no supermercado de linha. Para isso será necessário dimensionar armazém e zona de abertura, definir layouts e quantidade de stocks, bem como definir sistemas de comunicação entre abertura e supermercado; Verificar as peças que vão fazer parte do chassi por posto e contabilizar os dolly´s1 necessários; Fazer o layout de abastecimento da linha do chassi; Calcular o tempo de abertura, de abastecimento e de picking do chassi e de triming. Este projeto tem em conta a política de melhoria contínua de forma a conseguir satisfazer o cliente (ser eficaz) utilizando cada vez menos recursos quer físicos quer humanos (ser eficiente, detetar e eliminar os desperdícios). O presente projeto foi inserido na equipa de melhoria contínua da logística, maioritariamente no chassi. Em termos globais, os objetivos propostos neste estágio foram atingidos com êxito.

Bias in returns to tenure when firm wages and employment comove: A quantitative assessment and solution

It is well known that, unless worker-firm match quality is controlled for, returns to firm tenure (RTT) estimated directly via reduced form wage (Mincer) equations will be biased. In this paper we show that even if match quality is properly controlled for there is a further pervasive source of bias, namely the co-movement of firm employment and firm wages. In a simple mechanical model where human capital is absent and separation is exogenous we show that positively covarying shocks (either aggregate or firm level) to firms employment and wages cause downward bias in OLS regression estimates of RTT. We show that the long established procedures for dealing with "traditional" RTT bias do not circumvent the additional problem we have identified. We argue that if a reduced form estimation of RTT is undertaken, firm-year fixed effects must be added in order to eliminate this bias. Estimates from two large panel datasets from Portugal and Germany show that the bias is empirically important. Adding firm-year fixed effects to the regression increases estimates of RTT in the two respective countries by between 3.5% and 4.5% of wages at 20 years of tenure over 80% (50%) of the estimated RTT level itself. The results extend to tenure correlates used in macroeconomics such as the minimum unemployment rate since joining the firm. Adding firm-year fixed effects changes estimates of these effects also.

Quando ler se torna um prazer: contributo da promoção da leitura literária na infância

Relatório de estágio de mestrado em Educação Pré-Escolar e Ensino do 1º Ciclo do Ensino Básico

Dynamic matching and bargaining: the role of deadlines

We consider a dynamic model where traders in each period are matched randomly into pairs who then bargain about the division of a fixed surplus. When agreement is reached the traders leave the market. Traders who do not come to an agreement return next period in which they will be matched again, as long as their deadline has not expired yet. New traders enter exogenously in each period. We assume that traders within a pair know each other's deadline. We define and characterize the stationary equilibrium configurations. Traders with longer deadlines fare better than traders with short deadlines. It is shown that the heterogeneity of deadlines may cause delay. It is then shown that a centralized mechanism that controls the matching protocol, but does not interfere with the bargaining, eliminates all delay. Even though this efficient centralized mechanism is not as good for traders with long deadlines, it is shown that in a model where all traders can choose which mechanism to

Optimal Climate Change Policies When Governments Cannot Commit

This paper examines the optimal design of climate change policies in the context where governments want to encourage the private sector to undertake significant immediate investment in developing cleaner technologies, but the carbon taxes and other environmental policies that could in principle stimulate such investment will be imposed over a very long future. The conventional claim by environmental economists is that environmental policies alone are sufficient to induce firms to undertake optimal investment. However this argument requires governments to be able to commit to these future taxes, and it is far from clear that governments have this degree of commitment. We assume instead that governments cannot commit, and so both they and the private sector have to contemplate the possibility of there being governments in power in the future that give different (relative) weights to the environment. We show that this lack of commitment has a significant asymmetric effect. Compared to the situation where governments can commit it increases the incentive of the current government to have the investment undertaken, but reduces the incentive of the private sector to invest. Consequently governments may need to use additional policy instruments – such as R&D subsidies – to stimulate the required investment.

Speech by Mr Micheál Martin TD at Launch of Pre-Registration Nursing Degree Programme

Good afternoon ladies and gentlemen. I am very pleased that you were all able to accept my invitation to join me here today on this landmark occasion for nursing education. It is fitting that all of the key stakeholders from the health and education sectors should be so well represented at the launch of an historic new development. Rapid and unpredictable change throughout society has been the hallmark of the twenty-first century, and healthcare is no exception. Regardless of what change occurs, no one doubts that nursing is intrinsic to the health of this nation. However, significant changes in nurse education are now needed if the profession is to deliver on its social mandate to promote people´s health by providing excellent and sensitive care. As science, technology and the demands of the public for sophisticated and responsive health care become increasingly complex, it is essential that the foundation of nursing education is redesigned. Pre-registration nursing education has already undergone radical change over the past eight years, during which time it has moved from an apprenticeship model of education and training to a diploma based programme firmly rooted in higher education. The Secretary General of my Department, Michael Kelly, played a leading role in bringing about this transformation, which has greatly enhanced the way students are prepared for entry to the nursing profession. The benefits of the revised model of education are clearly evident from the quality of the nurses graduating from the diploma programme. The Commission on Nursing examined the whole area of nursing education, and set out a very convincing case for educating nursing students to degree level. It argued that nurses of the future would be required to possess increased flexibility and the ability to work autonomously. A degree programme would provide nurses with a theoretical underpinning that would enable them to develop their clinical skills to a greater extent and to respond to future challenges in health care, for the benefit of patients and clients of the health services. The Commission has provided a solid framework for the professional development of nurses and midwives, including a process that is already underway for the creation of clinical nurse specialist and advanced nurse practitioner posts. This process will facilitate the transfer of skills across divisions of nursing. In this scenario, it is clearly desirable that the future benchmark qualification for registration as a nurse should be a degree in nursing studies. A Nursing Education Forum was established in early 1999 to prepare a strategic framework for the implementation of a nursing degree programme. When launching the Forum´s report last January, I indicated that the Government had agreed in principle to the introduction of the proposed degree programme next year. At the time two substantial outstanding issues had yet to be resolved, namely the basis on which nurse teachers would transfer from the health sector to the education sector and the amount of capital and revenue funding required to operate the degree programme. My Department has brokered agreements between the Nursing Alliance and the Higher Education Institutions for the assimilation of nurse teachers as lecturers into their affiliated institutions. The terms of these agreements have been accepted by all four nursing unions following a ballot of their nurse teacher members. I would like to pay particular tribute to all nurse teachers who have contributed to shaping the position, relevance and visibility of nursing through leadership, which embodies scholarship and excellence in the profession of nursing itself. In response to a recommendation of the Nursing Education Forum, I established an Inter-Departmental Steering Committee, chaired by Bernard Carey of my Department, to consider all the funding and policy issues. This Steering Committee includes representatives of the Department of Finance and the Department of Education and Science as well as the Higher Education Authority. The Steering Committee has been engaged in intensive negotiations with representatives of the Conference of Heads of Irish Universities and the Institutes of Technology in relation to their capital and revenue funding requirements. These negotiations were successfully concluded within the past few weeks. The satisfactory resolution of the industrial relations and funding issues cleared the way for me to go to the Government with concrete proposals for the implementation of degree level education for nursing students. I am delighted to announce here today that the Government has approved all of my proposals, and that a four-year undergraduate pre-registration nursing degree programme will be implemented on a nation-wide basis at the start of the next academic year, 2002/2003. The Government has approved the provision of capital funding totalling £176 million pounds for a major building and equipment programme to facilitate the full integration of nursing students into the higher education sector. This programme is due to be completed by September 2004, and will ensure that nursing students are accommodated in purpose built schools of nursing studies with state of the art clinical skills and human science laboratories at thirteen higher education sites throughout the country. The Government has also agreed to make available the substantial additional revenue funding required to support the nursing degree programme. By 2006, the full year cost of operating the programme will rise to some £43 million pounds. The scale of this investment in pre-registration nursing education is enormous by any yardstick. It demonstrates the firm commitment of myself and my Government colleagues to the full implementation of the recommendations of the Commission on Nursing, of which the introduction of pre-registration degree level education is arguably the most important. This historic decision, and it is truly historic, will finally put the education of nurses on a par with the education of other health care professionals. The nursing profession has long been striving for parity, and my own involvement in the achievement of it is a matter of deep personal satisfaction to me. I am also pleased to announce that the Government has approved my plans for increasing the number of nursing training places to coincide with the implementation of the degree programme next year. Ninety-three additional places in mental handicap and psychiatric nursing will be created at Athlone, Letterkenny, Tralee and Waterford Institutes of Technology. This will yield 392 extra places over the four years of the degree programme. A total of 1,640 places annually on the new degree programme will thus be available. This is an all-time record, and maintaining the annual student intake at this level for the foreseeable future is a key element of my overall strategy for ensuring that we produce sufficient “home-grown” nurses for our health services. I am aware that the Nursing Alliance were anxious that some funding would be provided for the further academic career development of nurse teachers who transfer to one of the six Universities that will be involved in the delivery of the degree programme. I am happy to confirm that up to £300,000 in total per year will be available for this purpose over the first four years of the degree programme. In line with a recommendation of the Commission on Nursing, my Department will have responsibility for the administration of the nursing degree budget until the programme has been bedded down in the higher education sector. A primary concern will be to ensure that the substantial capital and revenue funding involved is ring-fenced for nursing studies. It is intended that responsibility for the budget will be transferred to the Department of Education and Science after the first cohort of nursing degree students have graduated in 2006. In the context of today´s launch, it is relevant to refer to a special initiative that I introduced last year to assist registered nurses wishing to undertake part-time nursing degree courses. Under this initiative, nurses are entitled to have their course fees paid by their employers in return for a commitment to continue working in the public health service for a period following completion of the course. This initiative has proved extremely popular with large numbers of nurses availing of it. I want to confirm here today that the free fees initiative will continue in operation until 2005, at a total cost of at least £15 million pounds. I am giving this commitment in order to assure this year´s intake of nursing students to the final diploma programmes that fee support for a part-time nursing degree course will be available to them when they graduate in three years time. The focus of today´s celebration is rightly on the landmark Government decision to implement the nursing degree programme next year. As Minister for Health and Children, and as a former Minister for Education, I also have a particular interest in the educational opportunities available to other health service workers to upgrade their skills. I am pleased to announce that the Government has approved my proposals for the introduction of a sponsorship scheme for suitable, experienced health care assistants who wish to become nurses. This new scheme will commence next year and will be administered by the health boards. Successful applicants will be allowed to retain their existing salaries throughout the four years of the degree programme in return for a commitment to work as nurses for their health service employer for a period of five years following registration. Up to forty sponsorships will be available annually. The new scheme will enable suitable applicants to undertake nursing education and training without suffering financial hardship. The greatest advantage of the scheme will be the retention by the public health service of staff who are supported under it, since they will have had practical experience of working in the service and their own personal commitment to upgrading their skills will be informed by that experience. I am confident that the sponsorship scheme will be warmly welcomed by health service unions representing care assistants as providing an exciting new career development path for their members. Education and health are now the two pillars upon which the profession of nursing rests. We must continue to build bridges, even tunnels where needed to strengthen this partnership. We must all understand partnerships donâ?Tt just happen they are designed and must be worked at. The changes outlined here today are powerful incentives for those in healthcare agencies, academic institutions and regulatory bodies to design revolutionary programmes capable of shaping a critical mass of excellent practitioners. You have an opportunity, greater perhaps than has been granted to any other generation in history to make certain those changes are for the good. Ultimately changes that will make the country a healthier and more equitable place to live. The challenge relates to building a seamless preparatory programme which equally respects both education and practise as an indivisible duo whilst ensuring that high tech does not replace the human touch. This is a special day in the history of the development of the Irish nursing profession, and I would like to thank everybody for their contribution. I want to express my particular appreciation of two people who by this stage are well known to all of you – Bernard Carey of my Department and Siobhán O´Halloran of the National Implementation Committee. Bernard and Siobhán have devoted considerable time and energy to the project on my behalf over the past fourteen months or so. That we are here today celebrating the launch of degree level education is due in no small part to their successful execution of the mandate that I gave them. We live in a rapidly changing world, one in which nursing can no longer rely on systems of the past to guide it through the new millennium. In terms of contemporary healthcare, nursing is no longer just a reciprocal kindness but rather a highly complex set of professional behaviours, which require serious educational investment. Pre-registration nurse education will always need development and redesign to ensure our health care system meets the demands of modern society. Nothing is finite. Today more than ever the health system is dependent on the resourcefulness of nursing. I have no doubt that the new educational landscape painted will ensure that nurses of the future will be increasingly innovative, independent and in demand. The unmistakable message from my Department is that nursing really matters. Thank you.

The "help" question doesn't help when screening for major depression: external validation of the three-question screening test for primary care patients managed for physical complaints.

BACKGROUND: Major depression, although frequent in primary care, is commonly hidden behind multiple physical complaints that are often the first and only reason for patient consultation. Major depression can be screened by two validated questions that are easier to use in primary care than the full DSM-IV criteria. A third question, called the "help" question, improves the specificity without apparently decreasing the sensitivity of this screening procedure. We validated the abbreviated screening procedure for major depression with and without the "help" question in primary care patients managed for a physical complaint. METHODS: This diagnostic accuracy study used data from a cohort study called SODA (for SOmatisation Depression Anxiety ) conducted by 24 general practitioners (GPs) in western Switzerland that included patients over 18 years of age with at least one physical complaint at index consultation. Major depression was identified with the full Patient Health Questionnaire. GPs were asked to screen patients for major depression with the three screening questions one year after inclusion. RESULTS: Out of 937 patients with at least one physical complaint, 751 were eligible one year after index consultation. Major depression was diagnosed in 69/724 (9.5%) patients. The sensitivity and specificity of the two-question method alone were 91.3% (95% confidence interval 81.4-96.4%) and 65.0% (95% confidence interval 61.2-68.6%), respectively. Adding the "help" question decreased the sensitivity (59.4% ; 95% confidence interval 47.0-70.9%) but improved the specificity (88.2% ; 95% confidence interval 85.4-90.5%) of the three-question method. CONCLUSIONS: The use of two screening questions for major depression was associated with high sensitivity and low specificity in primary care patients presenting a physical complaint. Adding the "help" question improved the specificity but clearly decreased the sensitivity; when using the "help" question; four out of ten patients with depression will be missed, compared to only one out of ten with the two-question method. Therefore, the "help" question is not useful as a screening question, but may help discussing management strategies.

Measurements of three-dimensional glenoid erosion when planning the prosthetic replacement of osteoarthritic shoulders.

The three-dimensional (3D) correction of glenoid erosion is critical to the long-term success of total shoulder replacement (TSR). In order to characterise the 3D morphology of eroded glenoid surfaces, we looked for a set of morphological parameters useful for TSR planning. We defined a scapular coordinates system based on non-eroded bony landmarks. The maximum glenoid version was measured and specified in 3D by its orientation angle. Medialisation was considered relative to the spino-glenoid notch. We analysed regular CT scans of 19 normal (N) and 86 osteoarthritic (OA) scapulae. When the maximum version of OA shoulders was higher than 10°, the orientation was not only posterior, but extended in postero-superior (35%), postero-inferior (6%) and anterior sectors (4%). The medialisation of the glenoid was higher in OA than normal shoulders. The orientation angle of maximum version appeared as a critical parameter to specify the glenoid shape in 3D. It will be very useful in planning the best position for the glenoid in TSR.

Control dolor post quirúrgic pacients intervinguts hèrnia inguinal per CMA

El dolor post-operatori és un dels problemes més importants que segons la OMS afecta als pacients intervinguts quirúrgicament i el que més els preocupa. Any rere any hi ha un increment del nombre de pacients intervinguts per Cirurgia Major ambulatòria al nostre país de manera que ha de ser el mateix usuari i la família els que facilitin les cures als pacients al propi domicili. Aquest estudi planteja si introduir intervencions educatives al servei disminueix el dolor post-operatori dels usuaris Objectiu general: Dissenyar un programa d’informació que realitzarà infermeria dirigit als cuidadors i pacients del servei de CMA i que han de ser intervinguts de hèrnia engonal. Avaluar l’eficiència del mateix programa educatiu. Metodologia: l’àmbit d’estudi d’aquest treball serà les unitats de Cirurgia Major ambulatòria de qualsevol centre de Catalunya. Es realitzarà un estudi comparatiu quantitatiu entre dos grups independents integrants per 30 participants en cadascun d’ells (total de 60 participants). Grupo A: protocol habitual de la unitat Grup B: intervenció educativa dissenyada Els participants seran pacients majors d’edat, que compleixen els requisits per ser intervinguts per Cirurgia Major Ambulatòria de Hèrnia inguinal. El participant ha de fer-ho amb un familiar responsable de les seves cures. Es realitzaran 3 enquestes al pacient i 3 al familiar responsable de les cures, la primera a les 24 hores després de la intervenció, la segona a la setmana i l’última a les 2 setmanes. Limitacions de l’estudi: en cas de que el pacient que ha de formar part de l’estudi requereixi ingrés hospitalari per alguna complicació durant la cirurgia el pacient deixa de participar en l’estudi automàticament. En cas que el pacient o familiar no contestin al telèfon el dia i l’hora pactada prèviament també deixarà de formar part de la investigació. Per aquest motiu es tindran 10 pacients de reserva per si calgués reemplaçar el subjecte d’estudi.