Cambios en los cuidadores informales en cuanto a estilos de vida, relaciones y alteraciones de salud mental

Changes in the informal caregiver life styles, relations and alterations of mental health. Justification.The increase of the population aged 65 years and older in developed countries is generating a proportional increasing of the dependency caused by chronic pathologies. The care of these persons is being carried out by relatives, informal carers, leading to some alterations in diverse areas, among them mental alterations, as a consequence of taking care. Objectives. To develop a profile of the informal carers and to correlate the caregiver burden with the carers disorders. To detect risk factors to allow carrying out premature nursing interventions to diminish the disorders in the informal carers. Design. An observational and cross-sectional study is made in primary care health services area of the city of Girona. Methodology. Random sample of carer of dependent people at their home , assigned to the program of domiciliary attention (ATDOM) of the educational basic areas of health (ABS). A sample size of 269 persons, with a level of precision of 9% was needed. Questionnaire ICUB 97, the test of Barthel, the Philadelphia Geriatric Center scale, and a questionnaire are used as instruments that includes demographic and social variables, and mental and physical carers disorders.Results. A total of 80 participants were interviewed. The most common problems as consequence of taking care were the backache, to feel more tired, to feel impotent and to have less free time. Correlation between the level of dependence of the patient with the number of problems perceived by the caretaker does not exist. Since they are informal carers they eat frequently outside the habitual schedule, took place an increase or loss of weight, experienced more disorders in sexual life and an increasing lack of interest in surroundings. A 33% of the informal carers are being treated for problems related to the mental health.Conclusion. The fact of being informal carer carries important consequences in their health, the lifestyles and the social relations. These can be attenuated if the nursing interventions are able to consider to the well-taken care of subject, and its surroundings in an holistic way. The professionals of infirmary of mental health must contribute to their knowledge and abilities contributing to make an assessment, a diagnosis and an intervention paying special attention to psycho-social aspects mentioned

Cambios en los cuidadores informales en cuanto a estilos de vida, relaciones y alteraciones de salud mental

Changes in the informal caregiver life styles, relations and alterations of mental health. Justification.The increase of the population aged 65 years and older in developed countries is generating a proportional increasing of the dependency caused by chronic pathologies. The care of these persons is being carried out by relatives, informal carers, leading to some alterations in diverse areas, among them mental alterations, as a consequence of taking care. Objectives. To develop a profile of the informal carers and to correlate the caregiver burden with the carers disorders. To detect risk factors to allow carrying out premature nursing interventions to diminish the disorders in the informal carers. Design. An observational and cross-sectional study is made in primary care health services area of the city of Girona. Methodology. Random sample of carer of dependent people at their home , assigned to the program of domiciliary attention (ATDOM) of the educational basic areas of health (ABS). A sample size of 269 persons, with a level of precision of 9% was needed. Questionnaire ICUB 97, the test of Barthel, the Philadelphia Geriatric Center scale, and a questionnaire are used as instruments that includes demographic and social variables, and mental and physical carers disorders.Results. A total of 80 participants were interviewed. The most common problems as consequence of taking care were the backache, to feel more tired, to feel impotent and to have less free time. Correlation between the level of dependence of the patient with the number of problems perceived by the caretaker does not exist. Since they are informal carers they eat frequently outside the habitual schedule, took place an increase or loss of weight, experienced more disorders in sexual life and an increasing lack of interest in surroundings. A 33% of the informal carers are being treated for problems related to the mental health.Conclusion. The fact of being informal carer carries important consequences in their health, the lifestyles and the social relations. These can be attenuated if the nursing interventions are able to consider to the well-taken care of subject, and its surroundings in an holistic way. The professionals of infirmary of mental health must contribute to their knowledge and abilities contributing to make an assessment, a diagnosis and an intervention paying special attention to psycho-social aspects mentioned

Educational Opportunity through The Advocate

This communication tool comes from the Office of the State Long-Term Care Ombudsman to long-term care facilities administrators and directors. The Office's objective is to share information regarding various topics of long term care.

Learning in the working place: the educational potential of a multihead microscope in pathology postgraduate training.

Training future pathologists is an important mission of many hospital anatomic pathology departments. Apprenticeship-a process in which learning and teaching tightly intertwine with daily work, is one of the main educational methods in use in postgraduate medical training. However, patient care, including pathological diagnosis, often comes first, diagnostic priorities prevailing over educational ones. Recognition of the unique educational opportunities is a prerequisite for enhancing the postgraduate learning experience. The aim of this paper is to draw attention of senior pathologists with a role as supervisor in postgraduate training on the potential educational value of a multihead microscope, a common setting in pathology departments. After reporting on an informal observation of senior and junior pathologists' meetings around the multihead microscope in our department, we review the literature on current theories of learning to provide support to the high potential educational value of these meetings for postgraduate training in pathology. We also draw from the literature on learner-centered teaching some recommendations to better support learning in this particular context. Finally, we propose clues for further studies and effective instruction during meetings around a multihead microscope.

Approche éducationnelle des patients à risque cardiovasculaire [Educational approach to patients with cardiovascular risk factors]

In the outpatient setting, the long-term management of cardiovascular risk factors is essential to prevent recurrent cardiovascular disease. Recent studies have shown an additional benefit of beginning cardiovascular secondary prevention during the hospital stay. Early, in-hospital initiation of proven beneficial medications, such as aspirin or blood lipid lowering drugs and therapeutic lifestyle change counseling, improves patients' long-term outcome, as long as there is continuity of care in the outpatient setting. A recent hospitalization may be a teachable moment, when patients are more likely to modify their health behaviors. The continuity of care between in-hospital medicine and the outpatient setting helps patients in the long-term management of their cardiovascular disease.

Impact of enhanced compliance initiatives on the efficacy of rosuvastatin in reducing low density lipoprotein cholesterol levels in patients with primary hypercholesterolaemia.

The effectiveness of lipid-lowering medication critically depends on the patients' compliance and the efficacy of the prescribed drug. The primary objective of this multicentre study was to compare the efficacy of rosuvastatin with or without access to compliance initiatives, in bringing patients to the Joint European Task Force's (1998) recommended low-density lipoprotein cholesterol (LDL-C) level goal (LDL-C, <3.0 mmol/L) at week 24. Secondary objectives were comparison of the number and percentage of patients achieving European goals (1998, 2003) for LDL-C and other lipid parameters. Patients with primary hypercholesterolaemia and a 10-year coronary heart disease risk of >20% received open label rosuvastatin treatment for 24 weeks with or without access to compliance enhancement tools. The initial daily dosage of 10 mg could be doubled at week 12. Compliance tools included: a) a starter pack for subjects containing a videotape, an educational leaflet, a passport/goal diary and details of the helpline and/or website; b) regular personalised letters to provide message reinforcement; c) a toll-free helpline and a website. The majority of patients (67%) achieved the 1998 European goal for LDL-C at week 24. 31% required an increase in dosage of rosuvastatin to 20 mg at week 12. Compliance enhancement tools did not increase the number of patients achieving either the 1998 or the 2003 European target for plasma lipids. Rosuvastatin was well tolerated during this study. The safety profile was comparable with other drugs of the same class. 63 patients in the 10 mg group and 58 in the 10 mg Plus group discontinued treatment. The main reasons for discontinuation were adverse events (39 patients in the 10 mg group; 35 patients in the 10 mg Plus group) and loss to follow-up (13 patients in the 10 mg group; 9 patients in the 10 mg Plus group). The two most frequently reported adverse events were myalgia (34 patients, 3% respectively) and back pain (23 patients, 2% respectively). The overall rate of temporary or permanent study discontinuation due to adverse events was 9% (n = 101) in patients receiving 10 mg rosuvastatin and 3% (n = 9) in patients titrated up to 20 mg rosuvastatin. Rosuvastatin was effective in lowering LDL-C values in patients with hypercholesterolaemia to the 1998 European target at week 24. However, compliance enhancement tools did not increase the number of patients achieving any European targets for plasma lipids.

Technology educational affordance: Bridging the gap between patterns of interaction and technology usage

Peer-reviewed

Analyzing hidden semantics in social bookmarking of open educational resources

Web 2.0 services such as social bookmarking allow users to manage and share the links they find interesting, adding their own tags for describingthem. This is especially interesting in the field of open educational resources, asdelicious is a simple way to bridge the institutional point of view (i.e. learningobject repositories) with the individual one (i.e. personal collections), thuspromoting the discovering and sharing of such resources by other users. In this paper we propose a methodology for analyzing such tags in order to discover hidden semantics (i.e. taxonomies and vocabularies) that can be used toimprove descriptions of learning objects and make learning object repositories more visible and discoverable. We propose the use of a simple statistical analysis tool such as principal component analysis to discover which tags createclusters that can be semantically interpreted. We will compare the obtained results with a collection of resources related to open educational resources, in order to better understand the real needs of people searching for open educational resources.

The effects of regional educational policies on school failure in Spain

This paper presents a regional analysis of the effects of educational policies implemented in Spain between 1992 and 2003, focusing specifically on school failure rates. We consider the impact of expenditure per pupil, class size, and pupil-teacher ratio on dropout rates at the end of compulsory education and on the proportion of early school-leavers in the 18-24 year age group. Our results indicate that higher levels of educational expenditure per pupil and lower class sizes and pupil-teacher ratios reduce rates of dropout and early school-leaving (although class-size is not always significant). However, the magnitude of the effects of these variables is small at the average level.

Breeding objectives for a Nellore cattle rearing system

Abstract:The objective of this work was to define the traits that should be included as breeding objectives for Nellore cattle, according to simulations with a bio-economic model for rearing systems. The economic values (EVs) of the traits were calculated as the differences between the profits due to an increased performance of 1% in each trait, with the others traits remaining constant. To determine the impact of each selection on the revenue system, two scenarios were simulated based on the traits being selected. In the first scenario, the adopted selection criteria were: weaning weight (WW), weaning rate (WR), yearling weight (YW), and mature cow weight (MCW). In the second scenario, the cumulative productivity (CP) of dams was used as an indirect evaluation of the performance of calves, with all the other traits included, except WW. In the first scenario, an EV of R$ 1.44 kg-1 was obtained for WW. In the second scenario, an EV of R$ 2.91 kg-1 was obtained for CP. The trait with the highest EV in both scenarios was WR, which enhanced the profits by R$ 3.21 for each 1% increased performance. The meat price paid to the producer is the factor with the greatest impact on the EVs of all examined traits.

Suorituskyvyn mittaaminen ja johtaminen henkilöstön näkökulmasta

Tämän tutkimuksen tavoitteena oli selvittää niitä tekijöitä, joihin yrityksen johdon tulisi kiinnittää huomiota suorituskykyä mitattaessa. Työssä tarkasteltiin tietämystä yrityksen suorituskyvystä, tavoitteista ja niiden mittaamisesta. Lisäksi tutkittiin yritysten sisäistä viestintää, päätöksentekoon vaikuttamista ja palkitsemista. Asioita tarkasteltiin eri ammattiasemissa olevien näkökulmista sekä esimiesaseman ja koulutustason suhteen. Tutkimuksen empiirinen aineisto kerättiin kyselylomakkeella kahdeksasta yrityksestä, vastauksia saatiin 210 kappaletta. Aineiston analysoinnissa käytettiin ristiintaulukointia ja -2- riippumattomuustestiä. Tutkimuksen tuloksena selvisi, että tieto omasta työstä ja sen tavoitteista on hyvällä tasolla. Henkilökohtaiseen kanssakäymiseen perustuvaa viestintää pidettiin parhaimpana. Omaan työhön ja tiimiin liittyvät päätökset olivat niitä, joihin haluttaisiin tulevaisuudessa vaikuttaa eniten. Palkitsemiskeinoista rahaa pidettiin parhaana, myös vapaa-aika ja kiitokset esimieheltä sekä työkaverilta miellyttivät vastaajia.

Strategiaan sitoutuminen - Case: Lappeenrannan kaupungin kasvatus- ja opetustoimi

Tutkimuksen tavoitteena oli saada kokonaiskuva siitä, kuinka sitoutunut Lappeenrannan kaupungin kasvatus- ja opetustoimen henkilöstö on kaupungin strategiaan ja etenkin siihen sisältyvään toimialan omaan strategiaan. Tutkimuksessa selvitettiin strategian toimeenpanoa hankaloittavat asiat ja esitettiin näihin konkreettisia kehittämisehdotuksia. Tutkimusmenetelminäkäytettiin johtotasolle suunnattua teemahaastattelua ja muulle henkilöstölle suunnattua kyselylomaketta. Tutkimuksen perusteella Lappeenrannan kaupungin johto ja kasvatus- ja opetustoimen johto ovat hyvin sitoutuneita strategiatyöhön, mutta etenkin ei-esimiesasemassa olevan henkilöstön strategiatietämyksessä on puutteita. Henkilöstö on halukas vaikuttamaan strategisiin asioihin, mutta monet kokevat, ettei heillä ole tarpeeksi vaikutusmahdollisuuksia. Kuitenkin toimipisteiden tavoitteet ovat hyvin sopusoinnussa toimialan strategisten tavoitteiden kanssa ja ne ohjaavat henkilöstön työntekoa, joten kasvatus- ja opetustoimessa toimitaan strategian mukaisesti. Päivittäinen työnteko koetaan siltiraskaaksi muun muassa siksi, ettei omalla työllä ja strategialla nähdä aina riittävästi yhteyttä. Erityisesti määräaikaiset työntekijät kokevat vaikeaksi sitoutua strategiaan.

Osaamisen ja yhteistyön kehittäminen oppilaitosten yhteenliittymässä. Case: Espoon seudun koulutuskuntayhtymä

Tutkimuksen tavoitteena on selvittää miten osaamista on hyödynnetty ja yhteistyötä kehitetty ammattioppilaitosten fuusiossa? Tutkielma toteutettiin laadullisenacase-tutkimuksena. Empiirinen osa koostuu seitsemästä haastattelusta ja muusta kirjallisesta aineistosta. Haastatellut henkilöt toimivat Espoon seudun koulutuskuntayhtymän johdossa ja rehtoreina. Osaamisen hyödyntäminen oppilaitosten välillä on vielä vähäistä. Yhteistyötä tehdään lähinnä projekteissa. Monialaisia yhteistyöryhmiä on vielä vähän. Oppilaitokset toimivat edelleen koulutusaloittain itsenäisinä yksikköinä. Näkemykset fuusion syistä ja tavoitteista poikkesivat virallisista fuusiotavoitteista. Yhdistymisen hyötyinä pidettiin ensisijaisesti taloudellisia etuja ja koulutusalan sisäisen kilpailun vähenemistä. Yhteistyöhalukkuudella näyttäisi olevan yhteys sekä osaamisen hyödyntämiseen että integroitumisasteeseen.