897 resultados para Precarious Progress
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This paper will critically consider the implications for Scottish athletes who have publicly stated their personal opinion on the Scottish independence referendum. Developments such as the inclusion of sport within the Scottish Government’s White Paper on Scottish independence, the establishment of the ‘Working Group on Scottish Sport’ and the establishment of the ‘Sport for Yes’ campaign group demonstrate the harnessing of sporting issues as an additional, if somewhat peripheral, debate point in the referendum campaigns (Lafferty, 2014; Scottish Government, 2013; Working Group on Scottish Sport, 2013, 2014). The latter of these developments, the establishment of the ‘Sport for Yes’ campaign group, is of particular interest, offering evidence of the explicit political mobilisation of past and present athletes in support of the ‘Yes Scotland’ pro-independence campaign. Whilst the pro-union ‘Better Together’ campaign does not possess a comparable group to the ‘Sport for Yes’ example, examples of athletes discussing the potential negative impact of Scottish independence on the funding and organisation of Scottish sport have been capitalised upon by pro-union campaigners, as exemplified in the comments of Sir Chris Hoy (BBC, 2013; Daily Record, 2013a). Given the negative reaction to Hoy’s comments from certain pro-independence campaigners (Daily Record, 2013b; Swanson, 2013), other Scottish athletes have understandably attempted to avoid controversy by refusing to align with either side of the referendum debate. This paper will therefore consider the potential pitfalls for athletes who publicly announce their political positions, whilst also scrutinising the extent to which such pronouncements are of political significance, drawing upon past academic analyses of the interrelationship between sport and politics (e.g. Coghlan, 1990; Houlihan, 1994; Jeffreys, 2012; Macfarlane, 1986; Whannel, 2008).
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It is commonly accepted that the educational environment has been undergoing considerable change due to the use of the Information and Communication tools. But learning depends upon actions such as experimenting, visualizing and demonstrating through which the learner succeeds in constructing his own knowledge. Although it is not easy to achieve these actions through current ICT supported learning approaches, Role Playing Games (RPG) may well develop such capacities. The creation of an interactive computer game with RPG characteristics, about the 500th anniversary of the city of Funchal, the capital of Madeira Island, is invested with compelling educational/pedagogical implications, aiming clearly at teaching history and social relations through playing. Players interpret different characters in different settings/scenarios, experiencing adventures, meeting challenges and trying to reach multiple and simultaneous goals in the areas of education, entertainment and social integration along the first 150 years of the history of Funchal. Through this process they will live and understand all the social and historical factors of that epoch.
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RESUMO: O Ministério da Saúde do Governo do Ruanda identifica a saúde mental como uma área de prioridade estratégica para a intervenção em resposta à alta carga dos transtornos mentais no Ruanda. Ao longo dos últimos 20 anos após o genocídio, o sector público reconstruiu sua Resposta Nacional de Saúde Mental com base no acesso equitativo aos cuidados, através do desenvolvimento de uma Política Nacional de Saúde Mental e novas estruturas de saúde mental. A política de Saúde Mental do Ruanda, revista em 2010, prima pela descentralização e integração dos serviços de saúde mental em todas as estruturas nacionais do sistema de saúde e ao nível da comunidade. O presente estudo de caso tem como objetivo avaliar a situação do sistema de saúde mental de um distrito típico de uma área rural no Ruanda, e sugerir melhorias, incluindo algumas estratégias para monitoras as mudanças. Os resultados do estudo permitirão ao Ruanda reforçar a sua capacidade para implementar o Plano Nacional de Saúde Mental ao nível dos distritos. O relatório também será útil para monitorar o progresso da implementação de serviços de saúde mental nos distritos, incluindo a prestação de serviços de base comunitária e a participação dos usuários, suas famílias e outros interessados na promoção, prevenção, assistência e reabilitação em saúde mental. Este estudo também procurou avaliar o progresso da implementação dos cuidados de saúde mental a nível descentralizado, com vista a compreender as implicações em termos de recursos desses processos. Foi realizada uma análise situacional num local do distrito, baseado em entrevistas com as principais partes interessadas responsáveis, usando o Instrumento de Avaliação de Sistemas de Saúde Mental da Organização Mundial da Saúde (WHO-AIMS). Os resultados sugerem que os recursos humanos para a saúde mental e serviços de base comunitária de saúde mental no distrito continuam a ser extremamente limitados. Os profissionais de saúde mental são adicionalmente limitados na sua capacidade para oferecer intervenções de emergência a pacientes psiquiátricos e garantir a continuidade do tratamento farmacológico a pacientes com condições crônicas. Para planejar efetivamente, de acordo com as necessidades da comunidade, sugerimos que o sistema de saúde mental deve envolver também os representantes das famílias e dos usuários no processo de planificação de modo a melhorar a sua contribuição no processo de implementação das atividades de saúde mental. Este estudo de caso do Distrito de Bugesera oferece a primeira análise de nível distrital dos serviços de saúde mental no Ruanda, e pode servir como uma mais-valia para a melhoria do sistema de saúde mental, incluindo a advocacia para a melhoria da qualidade dos cuidados de saúde mental a este nível, aumentando o financiamento para a implementação de serviços clínicos de saúde mental e os recursos humanos disponíveis para a prestação de cuidados de saúde mental, principalmente a nível dos cuidados primários.--------------------- ABSTRACT: To deal with the high burden of mental health disorders resulting from consequences of the 1994 genocide against Tutsis, the Rwanda Ministry of Health (MoH) considers mental health as a priority intervention. For the last 20 years, Ministry of Health focused on rebuilding a national and equity-oriented mental health program responding to the population needs in mental health. Mental health services are now decentralized and integrated in the national health system, from the community level up to the referral level. This study assessed the situation of mental health services in one rural district in Rwanda. It was aimed at assessing the progress of implementation of mental health care at the decentralized level, focusing on resource implications and processes. This study is based on interviews conducted with key stakeholders, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS). Findings show that human resources for mental health care and community-based mental health services of the assessed district remain extremely limited. Mental health professionals face limitation regarding the ability to provide emergency management of psychiatric patients and to ensure continuity of psychopharmacological treatment of patients with chronic conditions. To improve the implementation process of mental health interventions and activities, a planning process based on community needs and the involvement of representatives of families and users in planning process should be considered. The Bugesera case study on the situation of mental health services can serve as a baseline for improvement of the mental health program in Rwanda, in terms of quality care services, infrastructure and equipment, human and financial resources.
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Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and 2008 are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes.
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Gastrointestinal stromal tumours (GIST), despite being rare, pose a relevant medical problem from the viewpoint of diagnosis and management. GIST are fragile, liable to metastasize and often located in delicate structures. Surgical options, therefore, are limited. In the last decade an improved understanding of the molecular mechanisms of the disease has resulted in novel modes of treatment. The introduction of systemic tyrosine kinase inhibitor therapy with imatinib has significantly improved the outcome of the disease and prolonged the survival of GIST patients. For many patients the acute threat of a deadly cancer has been transformed into a manageable chronic condition. Drug safety, tolerability and compliance, subjects of concern in all long-term therapies, have proven to be acceptable for the tyrosine kinase inhibitor imatinib. The present paper provides a compact overview of the epidemiology, pathophysiology and morphology of GIST, with special reference to the underlying molecular biology. Relevant aspects of diagnosis, therapy and monitoring of the disease are reviewed with particular emphasis on the available clinical evidence and recent guidelines.
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13th Congress, 3d session. House. Doc. no. 13.
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13th Congress, 3d session. House. Doc. no. 13. October 28, 1814. Read, referred to the Committee on Foreign Relations. Printed by A. and G. Way
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A brochure for Ontario Hydro marking the 50 year Jubilee. The brochure also describes the change over from 25 cycle to 60 cycle service. A map details the areas that have made the change to 60 cycle power and those still waiting to transition. There is also a section of eight questions and answers concerning the change to 60 cycle power.
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The article discusses the McDonald's Corporation audit and the ways to improve the handling of livestock on the way to slaughter.