Dual diagnosis in mental health inpatient and day hospital settings.

Many mental health patients also have substance misuse problems, so mental health service staff need to be skilled to provide simple prevention and treatment interventions, assisted by drug and alcohol specialists. This guidance covers the assessment and clinical management of patients with mental illness being cared for in psychiatric inpatient or day care settings who also use or misuse alcohol and/or illicit or other drugs*. It also covers organisational and management issues to help mental health services manage these patients effectively. The key message is that the assessment and management of drug and alcohol use are core competences required by clinical staff in mental health services. The guidance aims to: â?¢ encourage integration of drug and alcohol expertise and related training into mental health service provision; â?¢ provide ideas and guidance to front-line staff and manages to help them provide the most effective therapeutic environments; â?¢ help mental health services plan action on dual diagnosisâ? .This resource was contributed by The National Documentation Centre on Drug Use.

Internationalisation of Irish Education Services Report of Interdepartmental Working Group

Following Government approval of a proposal by the Minister for Education and Science, an interdepartmental group was established with the remit of considering the question of the ‘Internationalisation’ of Irish education services. Issues that arose in the context of the group’s work include quality assurance, immigration and visa issues and abuse of the system, need for better regulation, future marketing and promotion arrangements, academic and institutional supports for international students and scholarships.

Estudio comparativo de la calidad de la información ofrecida sobre los servicios en las webs de las bibliotecas virtuales de universidades a distancia

S'exposa el resultat d'un estudi comparatiu sobre la comunicació web dels serveis de les biblioteques virtuals universitàries d'una selecció d'universitats a distància entre les quals hi ha la UNED, la UOC i l'Open University. Aquest estudi es fa observant les diferències qualitatives de diversos aspectes, com ara l'organització, l'accessibilitat, els formats, el redactat, la utilitat i la presentació de la informació sobre els serveis de la biblioteca oferta en la web als usuaris d'aquelles universitats i/o Biblioteques que han realitzat el procés de gestió de qualitat o han confeccionat la carta de serveis i les que no. Entre diverses recomanacions i exemples de bones pràctiques, l'estudi conclou que les universitats i biblioteques que no mostren cap tipus de procés de qualitat en la seva institució podem veure que són les que obliden alguns elements essencials i molts detalls pel que fa a la descripció de la oferta de serveis es refereix. Conclusió i recomanacions extensibles a qualsevol biblioteca universitària que ofereixi informació en línia sobre els seus serveis. A partir de l'elaboració de fitxes que recullen els diversos aspectes a observar de cadascuna de les biblioteques hem ponderat, d'acord amb la diversa bibliografia consultada, cadascun com desaconsellable, recomanable i excel·lent amb el resultat d'un informe que mostra totes les recomanacions per a cadascun dels elements.

Social inequalities and mortality in Europe-results from a large multi-national cohort

BACKGROUND Socio-economic inequalities in mortality are observed at the country level in both North America and Europe. The purpose of this work is to investigate the contribution of specific risk factors to social inequalities in cause-specific mortality using a large multi-country cohort of Europeans. METHODS A total of 3,456,689 person/years follow-up of the European Prospective Investigation into Cancer and Nutrition (EPIC) was analysed. Educational level of subjects coming from 9 European countries was recorded as proxy for socio-economic status (SES). Cox proportional hazard model's with a step-wise inclusion of explanatory variables were used to explore the association between SES and mortality; a Relative Index of Inequality (RII) was calculated as measure of relative inequality. RESULTS Total mortality among men with the highest education level is reduced by 43% compared to men with the lowest (HR 0.57, 95% C.I. 0.52-0.61); among women by 29% (HR 0.71, 95% C.I. 0.64-0.78). The risk reduction was attenuated by 7% in men and 3% in women by the introduction of smoking and to a lesser extent (2% in men and 3% in women) by introducing body mass index and additional explanatory variables (alcohol consumption, leisure physical activity, fruit and vegetable intake) (3% in men and 5% in women). Social inequalities were highly statistically significant for all causes of death examined in men. In women, social inequalities were less strong, but statistically significant for all causes of death except for cancer-related mortality and injuries. DISCUSSION In this European study, substantial social inequalities in mortality among European men and women which cannot be fully explained away by accounting for known common risk factors for chronic diseases are reported.

El futuro de la sanidad ambiental en Andalucía: oportunidades de mejora.

In the present article is presented a portrait of the situation of the environmental health in the administration of Andalusian Goverment; are analyzed implanted management formulations and we believe a reflection space on the professional exercise and the course begun with the organizational process in the Andalusian public health. The public health system has not undergone reconstruction from the process of transferences from the State towards the autonomous Communities. We identified the extrapolation of the model clinicalassistance management to the public health structures without delving what is sufficient in their organization and objectives. Setting of business process management (BMP) has got worse the administrative bureaucracy and the teamwork has not been preceded of alliances and agreements that generate feeling of ownership the same organization to avoid professional conflicts. We bet on strengthening the paper of the environmental health technicians as referring in the identification of this performances within public health system. For this propose we need the implication of all the professionals in the reform of the organization and management of the health public, to evolve in the professional exercise creating a regulated academic specialty and to define the competences maps in their different capabilites areas.

Continuidad De Cuidados y Comunicación interniveles entre equipos de emergencias sanitarias y Atención Primaria.

The gradual incorporation of the nurses to the extrahospital emergency teams give them a holistic aspect in the field of care. And this is not possible without addressing the possibility of continuity of care and communication with other levels of care. All efforts in this regard and made speeches themselves as nursing, "Refer" (Nic 8100) and "Exchange of information on health care" (Nic 7960), is the conceptual framework of this work, which objetives are to quantify and exposing the proceedings in this line taken by the nurses of emergency team.

Recepción, clasificación según escala Manchester y atención sanitaria inicial al paciente que acude a un Dispositivo de Cuidados Críticos y Urgencias (DCCU) con motivo de consulta “Diabetes”: Posibilidad de intervención finalista de la enfermera en la consulta de triage (Triage Avanzado) ante la hipoglucemia. Colaboración multidisciplinar y criterios de derivación

The Andalusian Public Health System (SSPA) is considering the last time an attempt urgent process management through triage consultation, both hospital and primary care environment and tables situations in which the nurse responsible for these consultations can carry out a final statement of which only she is directly responsible through their independent intervention and referral (Triage Advanced). Pose, at once and consistently to the idea of teamwork, where they can be the limits to that intervention finalist and the circuits to follow. This paper proposes a definition line of one of those situations through triage concepts universally tested, and takes full advantage of advanced practice profile offered by nurses Device Critical Care (DCCU) of the SSPA and any the emerging legal and regulatory framework in terms of standardized collaborative prescription, us know legitimate receivers. This work stems from the vision of professionals and our contribution to that line of institutional work that must be consensus.

State Library and Library Service Areas Plan of Service FY05-06

Vision: Each Iowans will have equal access to information and ideas in order to participate knowledgeably and productively in a democratic society and to lead an enriched life through lifelong learning. Mission: Helping libraries provide the best possible service to Iowans.

Government Spending and Re-election

Does additional government spending improve the electoral chances of incumbent political parties? This paper provides the first quasi-experimental evidence on this question. Our research design exploits discontinuities in federal funding to local governments in Brazil around several population cutoffs over the period 1982-1985. We find that extra fiscal transfers resulted in a 20% increase in local government spending per capita, and an increase of about 10 percentage points in the re-election probability of local incumbent parties. We also find positive effects of the government spending on education outcomes and earnings, which we interpret as indirect evidence of public service improvements. Together, our results provide evidence that electoral rewards encourage incumbents to spend part of additional revenues on public services valued by voters, a finding in line with agency models of electoral accountability.

Compétences en santé déficientes: obstacle à une prise en charge optimale [Low health literacy: barrier to optimal care].

Health literacy is defined as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." Low health literacy mainly affects certain populations at risk limiting access to care, interaction with caregivers and self-management. If there are screening tests, their routine use is not advisable and recommended interventions in practice consist rather to reduce barriers to patient-caregiver communication. It is thus important to include not only population's health literacy but also communication skills of a health system wich tend to become more complex.

A Adopção, pela primeira vez – Constrangimentos Encontrados na Adopção n óptica Financeira

Os efeitos da globalização da economia, a graduação de Cabo Verde à categoria de país de desenvolvimento médio, a entrada para a OMC, a parceria especial com a União Europeia, são acontecimentos verificados num passado próximo que vieram trazer novas exigências ao país em diversos domínios. A preparação das contas e o relato da informação pode ser considerada uma delas. De facto, o normativo contabilístico existente até então, assente num Plano Oficial de Contabilidade (PNC) aprovado por diploma legislativo datada de 1984 já não respondia a todas as necessidades de informação nos domínios da contabilidade, fiscalidade e financeira. O trabalho assenta sobretudo na adopção do SNCRF – Sistema de Normalização Contabilística e de Relato Financeiro. O objectivo é analisar o processo de adopção pela primeira vez deste sistema e os impactos que esta adopção teve na posição financeira nas empresas. Foi feito um estudo de caso para ilustrar este processo. Descrevemos como foi adoptado o SNCRF, fizemos uma apreciação a essa adopção e sugerimos melhoria que deveria ser introduzidas para que os resultados do processo incorporassem a quase totalidade dos procedimentos instituídos nos diversos documentos normativos e legais. Ao trabalho foi dado uma dimensão prática consubstanciada num estudo de caso que serviu para ilustrar o processo de transição. O estudo foi abordado numa perspectiva apreciativa tendo sido inventariadas as situações que deveriam ser salvaguardas (de acordo com o novo normativo e imperativos legais) no processo de transição / conversão e que não foram feitas. Demonstrou-se ainda (através da análise da posição financeira da entidade), que o processo de adopção implicou algumas alterações na estrutura financeira e no valor do capital próprio. A conclusão que se chegou indica que o processo não terá sido tão linear como se desejaria apesar de em, substancia, os principais requisitos terem sido cumpridos. The effects of globalization of its economy, the upgrading of Cape Verde to the category of medium development country, the entry to WTO, the special partnership with European Union, are recent events that brought new demands to the country in several areas. . Preparation of the accounts and information report are included in these new requirements. In fact, the accounting standards till then in force, based on an Official Chart of Accounts (PNC) in force after a law of 1984, didn’t meet the requirements on accounting, fiscal and financial information. This work is basically on the adoption of the new SNCRF – System of Accounting Standardization and Financial Reporting. Our aim is to review the initial adoption process of such system and the impacts this adoption has caused to the financial position of enterprises. A case study is included to illustrate this process. We describe how the SNCRF was adopted; we made an analysis of this adoption and suggested improvements to be introduced in such way that the results of the process include most of the procedures established by law. A practical dimension was attached to this work, through a case study illustrating the transition process. The study adopted an analytical approach, listing the situations that should have been (according to the new standards and legal prescriptions) but were not prevented during the transition / conversion process. The study shows (by the analysis of the financial statements of the studied entity) that the adoption process implied some changes to the financial structure and to the owners’ equity value). One arrives to the conclusion that the process was not as linear as one would expect, although essentially the main requirements were accomplished.

Importância da Gestão de Créditos na gestão da Tesouraria das Empresas

A gestão de Crédito é um tema que vem chamando a atenção dos administradores, já que é considerado um instrumento de gestão muito importante no processo competitivo e para o equilíbrio das empresas. O estudo em causa tem como objectivo principal analisar a importância e os impactos da Gestão de Crédito na Tesouraria das empresas, através de um estudo de caso da empresa Electra, SA. Os resultados do estudo mostram que os problemas de tesouraria podem ser de natureza estrutural e conjuntural. A gestão de tesouraria de curto prazo é o mais importante instrumento de gestão financeira que avalia e controla a actividade corrente das empresas, permitindo em tempo oportuno a tomada de decisões, perspectivando uma gestão eficiente, o equilíbrio financeiro e a eficácia organizacional. O tema em estudo pretende realçar a importância que a gestão de créditos tem na gestão da tesouraria de curto prazo, já que este tem como principal função para além da gestão do realizável (créditos), a gestão do disponível, do stock, das dívidas a terceiros a curto prazo. Uma boa gestão de crédito (realizável) permite de uma forma directa ganhos de eficiência a nível da gestão do disponível, na gestão dos stocks e de forma indirecta influencia as decisões a nível da gestão das dívidas a terceiros de curto prazo. Credit management is a subject that has been growing in the administrator’s attention, as it’s considered to be a somewhat important management tool on the competitive process as well as on the company’s balance. The present case study on Electra S.A, aims for the importance and impact analysis of Credit Management on the company’s cashier. The study results demonstrate that the cashier issues can be structure and conjuncture related. The short term cashier management is the most important financial management tool, which assesses and controls the company’s current activity, enabling timely decision making process, foreseeing an efficient management, the financial equilibrium and the organization efficiency. This paper’s main goal is to enhance the credit management importance on the short term cashier management, as the latter’s main goal, apart from the credit management is to administer the availability, the stock and short term third party debts. A good credit management enables a direct efficiency improvement at the availability management level, on the stock management and indirectly influences the decisions taken at the short term third party debt management level.

Summary Report for the Iowa Alzheimer's Task Force 2007 from the Iowa Alzheimer's Disease Demonstration Projects

The Iowa Department of Elder Affairs, in collaboration with the University of Iowa College of Nursing, has been engaged in developing and evaluating community based services for persons with dementia in the state of Iowa over the past 7 years under a grant form the Administration on Aging. This grant tested out several models of care (dementia nurse care manager, memory loss nurse specialist, “People Living Alone Need Support” (PLANS), varying models of respite care), surveyed agencies and service providers in regard to how they provide services for persons with dementia, and provided training to case management, community college instructors, adult day service providers and other related services providers including assisted living and nursing home facilities.

Human Resource Management Succession Planning Guide, 2007

The Iowa Department of Administrative Services - Human Resources Enterprise (DAS-HRE) has developed a variety of tools and resources to address those concerns. Loss of institutional knowledge, or knowledge transfer as it is more frequently referred to, is one of the main topics of the Workforce Planning Guide. Potential difficulties finding new workers was one of the major reasons for adding a chapter on recruitment in the Applicant Screening Manual.