Unmet health needs in patients with coronary heart disease: implications and potential for improvement in caring services

BACKGROUND: Improving the quality of health care services requires tailoring facilities to fulfil patients' needs. Satisfying patients' healthcare needs, listening to patients' opinions and building a closer provider-user partnership are central to the NHS. Few published studies have discussed cardiovascular patients' health needs, but they are not comprehensive and fail to explore the contribution of outcome to needs assessment. METHOD: A comprehensive self-administered health needs assessment (HNA) questionnaire was developed for concomitant use with generic (Short Form-12 and EuroQOL) and specific (Seattle Angina Questionnaire) health-related quality of life (HRQL) instruments on 242 patients admitted to the Acute Cardiac Unit, Nottingham. RESULTS: 38% reported difficulty accessing health facilities, 56% due to transport and 32% required a travelling companion. Mean HRQOL scores were lower in those living alone (P < 0.05) or who reported unsatisfactory accommodation. Dissatisfaction with transport affected patients' ease of access to healthcare facilities (P < 0.001). Younger patients (<65 y) were more likely to be socially isolated (P = 0.01). Women and patients with chronic disease were more likely to be concerned about housework (P < 0.05). Over 65 s (p < 0.05) of higher social classes (p < 0.01) and greater physical needs (p < 0.001) had more social needs, correlating moderately (0.32 < r < 0.63) with all HRQL domains except SAQ-AS. Several HRQL components were highly correlated with the HNA physical score (p < 0.001). CONCLUSIONS: Patients wanted more social (suitable accommodation, companionship, social visits) and physical (help aids, access to healthcare services, house work) support. The construct validity and intra-class reliability of the HNA tool were confirmed. Our results indicate a gap between patients' health needs and available services, highlighting potential areas for improvement in the quality of services

Orienta����o profissional direcionada aos alunos do curso t��cnico de n��vel m��dio em agrimensura

This article is the result of the implementation of a program of professional guidance group, based on behavioral analytic principles - psychological theory that addresses human behavior in its interaction with the environment. The program was developed with the objective to assist participants in their career choice at a time of life when such behavior is required in adolescents that are not always repertoire to make such a choice. Participated in the intervention twenty-four adolescents of both sexes, aged 16 and 18, students from middle-level technical course in surveying the Federal Technological University of Paran�� - Campus Pato Branco. The results were satisfactory, and at the end of the intervention participants reported greater clarity about career choice that they would from then.

Developing smart services by Internet of Things in manufacturing business

Manufacturing companies have passed from selling uniquely tangible products to adopting a service-oriented approach to generate steady and continuous revenue streams. Nowadays, equipment and machine manufacturers possess technologies to track and analyze product-related data for obtaining relevant information from customers��� use towards the product after it is sold. The Internet of Things on Industrial environments will allow manufacturers to leverage lifecycle product traceability for innovating towards an information-driven services approach, commonly referred as ���Smart Services���, for achieving improvements in support, maintenance and usage processes. The aim of this study is to conduct a literature review and empirical analysis to present a framework that describes a customer-oriented approach for developing information-driven services leveraged by the Internet of Things in manufacturing companies. The empirical study employed tools for the assessment of customer needs for analyzing the case company in terms of information requirements and digital needs. The literature review supported the empirical analysis with a deep research on product lifecycle traceability and digitalization of product-related services within manufacturing value chains. As well as the role of simulation-based technologies on supporting the ���Smart Service��� development process. The results obtained from the case company analysis show that the customers mainly demand information that allow them to monitor machine conditions, machine behavior on different geographical conditions, machine-implement interactions, and resource and energy consumption. Put simply, information outputs that allow them to increase machine productivity for maximizing yields, save time and optimize resources in the most sustainable way. Based on customer needs assessment, this study presents a framework to describe the initial phases of a ���Smart Service��� development process, considering the requirements of Smart Engineering methodologies.

A implanta����o de hidrel��tricas na Amaz��nia brasileira, impactos socioambientais e �� sa��de com as transforma����es no territ��rio : o caso da UHE de Belo Monte

Tese (doutorado)���Universidade de Bras��lia, Instituto de Ci��ncias Humanas, Departamento de Geografia, P��s-Gradua����o em Geografia, 2016.

MARS (Media Asset Retrieval System): Puget Sound���s Digital Archive

The MARS (Media Asset Retrieval System) Project is the collaborative effort of public broadcasters,libraries and schools in the Puget Sound region to create a digital online resource that provides access to content produced by public broadcasters via the public libraries. Convergence ConsortiumThe Convergence Consortium is a model for community collaboration, including organizations such as public broadcasters, libraries, museums, and schools in the Puget Sound region to assess the needs of their constituents and pool resources to develop solutions to meet those needs. Specifically, the archives of public broadcasters have been identified as significant resources for the local communities and nationally. These resources can be accessed on the broadcasters websites, and through libraries and used by schools, and integrated with text and photographic archives from other partners.MARS��� goalCreate an online resource that provides effective access to the content produced locally by KCTS (Seattle PBS affiliate) and KUOW (Seattle NPR affiliate). The broadcasts will be made searchable using the CPB Metadata Element Set (under development) and controlled vocabularies (to be developed). This will ensure a user friendly search and navigation mechanism and user satisfaction.Furthermore, the resource can search the local public library���s catalog concurrently and provide the user with relevant TV material, radio material, and books on a given subject.The ultimate goal is to produce a model that can be used in cities around the country.The current phase of the project assesses the community���s need, analyzes the current operational systems, and makes recommendations for the design of the resource.Deliverables��� Literature review of the issues surrounding the organization, description and representation of media assets��� Needs assessment report of internal and external stakeholders��� Profile of the systems in the area of managing and organizing media assetsfor public broadcasting nationwideActivities��� Analysis of information seeking behavior��� Analysis of collaboration within the respective organizations��� Analysis of the scope and context of the proposed system��� Examining the availability of information resources and exchangeof resources among users

Aproximaciones a mindfulness en la psicolog��a contempor��nea

Este trabajo es una revisi��n de literatura que abarca una selecci��n de art��culos disponibles en bases de datos especializadas y publicados en el periodo comprendido entre los a��os 2006 a 2016 para art��culos cient��ficos y entre los a��os 2000 a 2016 para libros. En total se revisaron: 1 tesis doctoral, 1 tesis magistral, 111 art��culos y 9 libros o cap��tulos de libros. Se presentan diversas definiciones de mindfulness y formas de conceptualizarla, sus mecanismos de acci��n, sus enfoques psicoterap��uticos predominantes, los efectos de su pr��ctica estable, sus principales campos de acci��n y la importancia de la formaci��n de los docentes que imparten la pr��ctica. Finalmente se presentan algunas conclusiones acerca del di��logo entre la literatura psicol��gica sobre mindfulness y algunas de las concepciones de la tradici��n budista en torno a la meditaci��n.

Are health assessments in the community acceptable to those involved? Yes, Yes and maybe

Aim: To test the acceptability of a comprehensive health assessment program (CHAP) in adults with an intellectual disability (ID). Method: We interviewed adults with ID, their general practitioners (GPs) and caregivers (healthcare triad), before and after the intervention period as part of a clustered randomised controlled trial to test the use of the CHAP tool in adults with ID. A content and thematic analysis of these interviews will be presented. Results: We found adults with ID were unable to recall the health assessment consultation or differentiate this consultation from the usual contact with their GP. GPs and residential staff where largely supportive of the process and considered it did improve the care they could provide to AWID. They also considered that the intervention helped other members of the healthcare triad. Conclusions: The CHAP was found to be acceptable to caregivers and GPs however further work is needed to ascertain the views of adults with ID.

Child psychiatry takes to the streets: A developmental partnership between a university institute and children and adolescents from the streets of Sao Paulo, Brazil

Objective: High levels of domestic violence, mental illness, and alienation from authorities are associated with high incidence of children/adolescents living on the streets in low and middle income countries. The Equilibrium Project (Programa Equilibrio) was created to facilitate social reintegration through a virtual partnership between an academic psychiatric institute and highly vulnerable children and adolescents living on the streets, in group shelter with supervision, and in other high risk situations. Methods: Descriptive presentation of qualitative data and analysis of preliminary empirical data collected over a 24-month period. Results: Dialogue between academic professionals, street children, and city officials shaped The Equilibrium Project over the last 2 years. The program has progressively moved from a professional clinic setting to a community-based but protected activity center with recreational and professional services and an emphasis on linkage with social service agencies, city government and law enforcement officials in an academic research context. A total of 351 patients have been served of whom virtually all were neglected by their parents, 58.4% report physical or sexual abuse, 88.89% have been diagnosed with a psychiatric disorder, 40.4% drug use. After 2 years of operation, 63.5% (n = 223) successfully completed or continue in treatment and 34.8% (n = 122) were reunited with their families. Conclusions and Practice implications: Program development guided by consumer input led to a successful program offering professional services in a protected community setting that facilitates social reintegration by providing ""go between"" services integrating relationships between alienated consumers and formal psychiatric, pediatric, social service, and criminal justice systems. (C) 2011 Elsevier Ltd. All rights reserved.

Necessidades de informa????o e compet??ncias informacionais no setor p??blico: um estudo de caso

O texto apresenta parte do referencial te??rico de pesquisa de doutorado, que buscou estabelecer rela????es te??ricas e pr??ticas entre as necessidades de informa????o de uma determinada atividade e as compet??ncias informacionais desenvolvidas para atend??-las. A premissa da pesquisa foi que a atividade estudada, a supervis??o indireta de institui????es financeiras, era intensiva em informa????o e poderia ser estudada como atividade informacional, a partir do uso de par??metros informacionais. Os par??metros utilizados nos modelos te??ricos foram o ciclo e a tecnologia da informa????o e os contextos de comunica????o da informa????o. A pesquisa emp??rica se iniciou com a identifica????o dos fatores cr??ticos de sucesso da atividade, visando a posterior mapeamento das necessidades de informa????o e das compet??ncias dos profissionais supervisores. Os resultados obtidos e sua an??lise permitiram relacionar os fatores cr??ticos de sucesso da atividade ??s necessidades de informa????o dos profissionais de supervis??o indireta e ??s suas compet??ncias informacionais.

Avalia����o de um programa para a estimula����o da consci��ncia fonol��gica em contexto escolar

Neste trabalho apresentamos um estudo sobre o desenvolvimento da consci��ncia fonol��gica em contexto escolar, pois sabe-se que a consci��ncia fonol��gica pode ser estimulada com ensino expl��cito e que, ao faz��-lo, se facilita a posterior aquisi����o da leitura e da escrita por parte da crian��a (Blachman et al., 2006; Adams et al., 2007), o que, em ��ltima an��lise, consiste no objetivo da estimula����o da consci��ncia fonol��gica. V��rios autores referem que existe uma forte rela����o entre o n��vel de consci��ncia fonol��gica e a inicia����o �� leitura e �� escrita (Bradley e Bryant, 1995, Gillon, 2004) e de que algumas dificuldades na aprendizagem da leitura e da escrita est��o associadas ao fraco desempenho em tarefas de consci��ncia fonol��gica (Freitas et al., 2007). Assim, em contexto escolar, assume-se que a estimula����o precoce e generalizada a todas as crian��as, da consci��ncia fonol��gica, funcionar�� como medida de preven����o do insucesso na aprendizagem da leitura e da escrita (Freitas et al., 2007). Para o estudo aqui proposto �� desenvolvido um programa devidamente ajustado ��s propriedades lingu��sticas do portugu��s europeu e aos requisitos da aprendizagem da leitura e da escrita no referido sistema alvo. Assim, o nosso estudo tem como objetivo central a avalia����o da efic��cia desse programa de desenvolvimento da consci��ncia fonol��gica. Para isso, s��o selecionados quatro grupos de crian��as em idade pr��-escolar e escolar, constituindo assim dois grupos de controlo e dois grupos experimentais. Numa primeira fase, antes de qualquer instru����o formal, �� avaliado o desempenho da consci��ncia fonol��gica das crian��as testadas. Posteriormente, �� aplicado o programa por n��s elaborado para depois se reavaliarem as crian��as, a fim de se aferirem os efeitos dessa interven����o. Os indicadores num��ricos mostram que, em todos os grupos, o desempenho da consci��ncia fonol��gica melhora da primeira para a segunda avalia����o. S��o ent��o comparados os resultados da avalia����o entre os grupos estimulados e n��o estimulados e conclu��mos que o desempenho da consci��ncia fonol��gica melhora significativamente nos grupos estimulados com o referido programa, descartando assim a possibilidade de considerar esse aumento apenas como resultado de um poss��vel efeito de escolaridade (Alves et al., 2010). Com isto �� demonstrada a efic��cia do programa desenvolvido no ��mbito deste estudo, podendo este tornar-se uma mais-valia no trabalho de prepara����o para a inicia����o da leitura e da escrita.

Flu��ncia e precis��o da leitura: avalia����o e desenvolvimento

Projeto de Interven����o apresentado �� Escola Superior de Educa����o de Lisboa para obten����o do grau de Mestre em Did��tica da L��ngua Portuguesa no 1.�� e 2.�� Ciclo do Ensino B��sico

A T��cnica de Dan��a Cl��ssica na Performance Contempor��nea : desenvolvimento de compet��ncias t��cnicas e art��sticas, nos alunos dos ��ltimos anos da Academia de Dan��a Contempor��nea de Set��bal, visando a sua entrada no meio art��stico profissional

Relat��rio Final de Est��gio apresentado �� Escola Superior de Dan��a com vista �� obten����o do grau de Mestre em Ensino de Dan��a.

O desenvolvimento da leitura em crian��as com dificuldades graves de aprendizagem

Projeto de Interven����o apresentado �� Escola Superior de Educa����o de Lisboa para obten����o de grau de mestre em Educa����o Especial, especialidade em Multidefici��ncia

Benchmark exact solutions for the static analysis of multi-layered piezoelectric composite using PVDF

The three-dimensional (3D) exact solutions developed in the early 1970s by Pagano for simply supported multilayered orthotropic composite plates and later in the 1990s extended to piezoelectric plates by Heyliger have been extremely useful in the assessment and development of advanced laminated plate theories and related finite element models. In fact, the well-known test cases provided by Pagano and by Heyliger in those earlier works are still used today as benchmark solutions. However, the limited number of test cases whose 3D exact solutions have been published has somewhat restricted the assessment of recent advanced models to the same few test cases. This work aims to provide additional test cases to serve as benchmark exact solutions for the static analysis of multilayered piezoelectric composite plates. The method introduced by Heyliger to derive the 3D exact solutions has been successfully implemented using symbolic computing and a number of new test cases are here presented thoroughly. Specifically, two multilayered plates using PVDF piezoelectric material are selected as test cases under two different loading conditions and considering three plate aspect ratios for thick, moderately thick and thin plate, in a total of 12 distinct test cases. (C) 2013 Elsevier Ltd. All rights reserved.