Unlicensed personnel administering medications to older persons living at home : a challenge for social and care services

BACKGROUND: Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge. AIM: The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care. METHODS: Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis. RESULTS: According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality. CONCLUSIONS: Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients. IMPLICATIONS FOR PRACTICE: This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.

The Adequacy of Health Care Services for the Elderly in China

This study examines the adequacy of health care services for the elderly in China, specifically focusing on the influence of location, method of payment, living situation, and financial status. The study finds that rural residents, respondents living alone and respondents unable to meet all of their daily costs have a lower probability of reporting the availability of adequate health care. It also investigates the reasons why elderly respondents do not visit the hospital when it is necessary, concluding that financial and distance constraints are main deterrents. Finally, changes in the reported adequacy of health care over time are taken into consideration, and are found to follow a likely pattern given the history of the health care system in China. This is an important investigation given the historical background of health care in China, the current cost problems facing residents, and, consequently, the policy changes that will need to be implemented by the Chinese government in the near future.

Inclusão da criança com deficiência na estratégia de saúde da família

The objective of analyze the shift of the working process of the ESF team in care of children with disabilities, from awareness-raising actions. It is a qualitative study, with the action-research method. Thirteen health professionals were involved from two teams of ESF unit area of the Unidade de Saúde da Família Dr. Chico Porto (UBSFCP) in Mossoró, from March to August 2011. Data were analyzed following the direction of freirean s thematic analysis. In the situational diagnosis of the current reality of CwD assistance in that UBSFCP, through participant observation and application of semi-structured interviews with professionals, we realize that despite these actions carry some assistance to the CwD, in practice few are used for inclusion and accessibility. The monitoring of the CwD is done through individual consultations by each team professional, home visits when possible, both ruled on the complaints and problems, with little solving in the used actions. Since the need for a change in the treatment model and training requirements as pointed out by professionals in the interview, then we decided to build the proposed of training suggested by the multidisciplinary team and put together collectively the achievement of this moment in all its phases. In the step of implementation (action), aspects related to the current situation in Brazil and Mossoró (Laws, policies and health care) for the CwD and CwD Assistance and their family in the ESF in the first two moments of the first training (action) were contemplate. On the second day we discussed the specialized care to CwD, contribution of the Handicapped Parents and Friends Association of Mossoró and in a second moment a workshop was held in which awareness for inclusion of CwD and actions of ESF were discussed. All these moments were discussed and collectively constructed. In the evaluation, we found that implementation (action) allowed to the professional the comprehension of new understandings about people with disabilities, on ways to include, guiding, caring, watching, and mainly to have a new vision on health assistance of the CwD, expanding assistance beyond clinical aspects and recognizing the educational aspects of the rights and duties of citizens and the inclusion of these children in the social spaces area. As difficulties, we face the need for some professionals to be absent to attend another job, solve personal problems, and little or no participation. Thus, during this action-research, the subjects were able to realize the importance of carrying out their practice to the quality of life for him and to the one they care

Desenvolvimento de um middleware para comunicação via web services e sua aplicação em sistemas de aquisição de dados industriais

The control of industrial processes has become increasingly complex due to variety of factory devices, quality requirement and market competition. Such complexity requires a large amount of data to be treated by the three levels of process control: field devices, control systems and management softwares. To use data effectively in each one of these levels is extremely important to industry. Many of today s industrial computer systems consist of distributed software systems written in a wide variety of programming languages and developed for specific platforms, so, even more companies apply a significant investment to maintain or even re-write their systems for different platforms. Furthermore, it is rare that a software system works in complete isolation. In industrial automation is common that, software had to interact with other systems on different machines and even written in different languages. Thus, interoperability is not just a long-term challenge, but also a current context requirement of industrial software production. This work aims to propose a middleware solution for communication over web service and presents an user case applying the solution developed to an integrated system for industrial data capture , allowing such data to be available simplified and platformindependent across the network

Epidemiologia do transtorno obsessivo-compulsivo: uma revisão

Os inquéritos populacionais são importantes, pois amostras clínicas tendem a apresentar vieses de seleção. Aspectos sociodemográficos e relacionados à própria condição mórbida podem interferir na procura por tratamento. Pela natureza egodistônica do transtorno obsessivo-compulsivo, seus portadores tendem a ocultar o problema, podendo não procurar ou demorar a procurar tratamento. Porém, a maior parte do conhecimento atual sobre o transtorno obsessivo-compulsivo advém de amostras clínicas, que não representam a totalidade dos casos. Foi feita uma revisão convencional da literatura através do Medline, PsicoInfo e Lilacs de inquéritos populacionais sobre o transtorno obsessivo-compulsivo, cobrindo o período de 1980 a 2004, utilizando-se como palavras-chave epidemiologia, transtorno obsessivo-compulsivo, inquéritos populacionais e prevalência. Estudos realizados em diferentes países indicam para o transtorno obsessivo-compulsivo uma prevalência atual em torno de 1,0% e ao longo da vida de 2,0 a 2,5%. Diferentemente de amostras clínicas, em quase todas as amostras populacionais há predomínio de mulheres e portadores que têm apenas obsessões. A freqüente comorbidade com outros transtornos mentais, particularmente depressão e outros transtornos ansiosos, repete-se em casos da população geral, que apresentam ainda uma associação com abuso de substâncias. Muitos portadores não estão em tratamento, particularmente os casos puros. Indicadores de incapacitação funcional demonstram um considerável impacto negativo do transtorno obsessivo-compulsivo. É preciso melhorar o conhecimento da população e dos profissionais de saúde sobre os sintomas do transtorno obsessivo-compulsivo para aumentar a procura de atendimento, assim como a correta identificação e abordagem terapêutica deste grave problema de saúde.

Sustainable bioenergy: a framework for decision makers

Includes bibliography

SMEs in the environmental goods and services market: identifying areas of opportunity, policies and instruments: case studies: Argentina, Chile, Colombia and Mexico

Includes bibliography

Modernization and new services of the Brazilian active control network

The Brazilian Network for Continuous Monitoring of GNSS - RBMC is a national network of continuously operating reference GNSS stations. Since its establishment in December of 1996, it has been playing an essential role for the maintenance and user access of the fundamental geodetic frame in the country. In order to provide better services for RBMC, the Brazilian Institute of Geography and Statistics - IBGE and the National Institute of Colonization and Land Reform - INCRA are both partners involved in the National Geospatial Framework Project - PIGN. This paper provides an overview of the recent modernization phases the RBMC network has undergone highlighting its future steps. These steps involve the installation of new equipment, provide real time data from a group of core stations and compute real-time DGPS corrections, based on CDGPS (The real-time Canada-Wide DGPS Service) (The Real-Time Canada-Wide DGPS Service. http://www.cdgps.com/ 2009a). In addition to this, a post-mission Precise Point Positioning (PPP) service has been established based on the current Geodetic Survey Division of NRCan (CSRS-PPP) service. This service is operational since April 2009 and is in large use in the country. All activities mentioned before are based on a cooperation signed at the end of 2004 with the University of New Brunswick, supported by the Canadian International Development Agency and the Brazilian Cooperation Agency. The Geodetic Survey Division of NRCan is also participating in this modernization effort under the same project. This infrastructure of 66 GNSS stations, the real time, post processing services and the potentiality of providing Wide Area DGPS corrections in the future show that the RBMC system is comparable to those available in USA and Europe. © Springer-Verlag Berlin Heidelberg 2012.

Current status, uncertainty and future needs in soil organic carbon monitoring

Increasing human demands on soil-derived ecosystem services requires reliable data on global soil resources for sustainable development. The soil organic carbon (SOC) pool is a key indicator of soil quality as it affects essential biological, chemical and physical soil functions such as nutrient cycling, pesticide and water retention, and soil structure maintenance. However, information on the SOC pool, and its temporal and spatial dynamics is unbalanced. Even in well-studied regions with a pronounced interest in environmental issues information on soil carbon (C) is inconsistent. Several activities for the compilation of global soil C data are under way. However, different approaches for soil sampling and chemical analyses make even regional comparisons highly uncertain. Often, the procedures used so far have not allowed the reliable estimation of the total SOC pool, partly because the available knowledge is focused on not clearly defined upper soil horizons and the contribution of subsoil to SOC stocks has been less considered. Even more difficult is quantifying SOC pool changes over time. SOC consists of variable amounts of labile and recalcitrant molecules of plant, and microbial and animal origin that are often operationally defined. A comprehensively active soil expert community needs to agree on protocols of soil surveying and lab procedures towards reliable SOC pool estimates. Already established long-term ecological research sites, where SOC changes are quantified and the underlying mechanisms are investigated, are potentially the backbones for regional, national, and international SOC monitoring programs. © 2013 Elsevier B.V.

Current developments in the transport sector and future prospects

Over the past three years, talks conducted at the subregional level have led to the signing of multimodal transport agreements, and these have been implemented by Mercosur and reviewed by the Andean Community; multimodal transport is only now starting to come into its own in South America but is already a common practice in the region covered by NAFTA. These trends continued in 1997, with consolidation being the dominant theme; on the one hand, consolidation occurred in business, with integrated services increasingly on offer, while on the other the authorities became aware of the need to promote linkages between different modes of transport. Highlights of 1998 may well include major plans for investments in intermodal infrastructure and greater interaction between users and service providers in both the public and private sectors, in order to develop regional intermodal transport systems.

Institutional framework, co-modality and sustainable transport services

This issue of the FAL bulletin focuses on the problems which public institutions encounter when formulating transport policies and the challenge of designing and implementing systemic, integrated, sustainable transport policies in the current institutional framework in the countries of Latin America.

Ecosystem services and urban vegetation coverage in Belém: the influence on noise pollution, air pollution and climate regulation

A ligação entre as zonas urbanas e as questões ambientais ficam mais próximas na medida em que cresce a conscientização global de conservar, melhorar e valorizar os serviços ambientais prestados pela natureza para a sustentabilidade da vida, dentro e fora da cidade. Cobertura vegetal (ou cobertura verde) está dentre as principais fontes de tais serviços. Uma vez que o processo de urbanização se mostra irreversível e os problemas ambientais urbanos se alastram em tamanho e extensão, a presença do verde está diretamente relacionada aos indicadores de qualidade de vida urbana. Como reflexo do processo de urbanização, a cidade de Belém perdeu uma grande porcentagem de seus ecossistemas naturais, de modo que este trabalho se concentrou em analisar alguns serviços ecossistêmicos—qualidade do ar, poluição do ar e regulação do clima - fornecidos pela qualidade e pela quantidade de cobertura vegetal local, considerando as alterações na distribuição espaço-temporal, em três distritos administrativos. Um marco teórico foi construído e analisado; a cobertura vegetal foi calculada, utilizando-se NDVI e Cobertura Vegetal Fracional em imagens do LANDSAT 5, ao longo de um período de 23 anos. A partir de uma proposta de escala mais detalhada de NDVI, análises quantitativas e qualitativas da cobertura verde evidenciaram perda significativa de cobertura muito densa, densa, moderada e aumento de áreas de pouca ou nenhuma vegetação. Ademais, lesão das áreas verdes sinalizou tendências de aumento da poluição do ar, da poluição sonora e da temperatura. A carência de dados relacionados ao meio ambiente não deixa dúvida sobre a urgência de investimento nos serviços ambientais provenientes da cobertura vegetal, para a sustentabilidade urbana em Belém, cujos cenários previstos são de drásticas perdas de área verde. Mais pesquisas e iniciativas de instituições públicas e privadas são necessárias para a contribuição aos serviços ambientais em Belém e, consequentemente, ao bem-estar público.

Web Services Aplicados à Visualização

With the rapid growth of the use of Web applications in various fields of knowledge, the term Web service enter into evidence in the current scenario, which refers to services from different origins and purpose, offered through local networks and also available in some cases, on the Internet. The architecture of this type of application offers data processing on server side thereby, running applications and complex and slow processes is very interesting, which is the case with most algorithms involving visualization. The VTK is a library intended for visualization, and features a large variety of methods and algorithms for this purpose, but with a graphics engine that requires processing capacity. The union of these two resources can bring interesting results and contribute for performance improvements in the VTK library. This study is discussed in this project, through testing and communication overhead analysis

Modelagem de processos de negócios: uma proposta no serviço de atendimento ao usuário da biblioteca da Unesp Guaratinguetá

This work is a study on the Technical Service Library and Documentation Prof. Carlos Alberto de Buarque Borges , on the Faculdade de Engenharia de Guaratinguetá , regarding to the service user , aiming to detect and analyze the current problems and suggesting improvements that could result in optimization of care and increased quality of services. For this, was chosen the methodology of Business Processes Modeling, which enabled the detailing of the processes implemented in the library and the identification the critical points , as low investment and short number of employees, which made possible suggest ways to improve the quality of service to users, as awareness campaigns and the implementation of an system to input the literature needed for each course

A New Approach for Managing Bovine Tuberculosis: Veterinary Services’ Proposed Action Plan

Bovine tuberculosis (TB) is a serious disease with animal health, public health, and international trade consequences. The cooperative Federal-State-industry effort to eradicate bovine TB from cattle in the United States has made significant progress since the program’s inception in 1917. However, the goal of eradication remains elusive. This proposed action plan presents Veterinary Services’ (VS’) current thinking about changes we are considering for the TB program to address our current challenges. This action plan will: 1. Reduce the introduction of TB into the U.S. national herd from imported animals and wildlife by: o Applying additional requirements to cattle imports from Mexico o Enhancing efforts to mitigate risks from wildlife 2. Enhance TB surveillance by: o Crafting a comprehensive national surveillance plan o Accelerating diagnostic test development to support surveillance 3. Increase options for managing TB-affected herds by: o Conducting epidemiological investigations and assessing individual herd risk o Applying whole-herd depopulation judiciously and developing alternative control strategies o Applying animal identification (ID) standards to meet animal ID needs 4. Modernize the regulatory framework to allow VS to focus resources where the disease exists 5. Transition the TB program from a State classification system to a science-based zoning approach to address disease risk To succeed, this new approach will require VS’ continued partnership with State animal health and wildlife officials, other Federal agencies, industry, international partners, academia, and other stakeholders. Successful partnerships will allow us to use available resources efficiently to achieve program objectives and protect our nation’s herd. Implementation of the VS proposed action plan will benefit Federal and State animal health officials, the regulated industries, and producers by allowing a more rapid response that employs up-to-date science and can adapt rapidly to changing situations.