725 resultados para Depression, Mental - Case studies


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The external evaluation of non-higher education schools in Portugal has been developed by the General Inspectorate of Education since 2006. A first cycle of evaluation was completed, covering all educational units in continental Portugal up to 2011. The model of evaluation has since been subject to alterations, and a second cycle of evaluation is now coming to an end. The current model of evaluation is based on documental analysis, analysis of students’ results, and panel interviews with a variety of representatives of the school community, and addresses three domains: results, provision of educational service and management. This paper is part of an ongoing research project, developed by 6 universities and supported by the Portuguese Foundation for Science and Technology (PTDC/CPE-CED/116674/2010) which intends to analyse the impacts and effects this process of external evaluation has had on Portuguese schools. This project includes a variety of perspectives and methodologies. In particular, we will focus on two case studies undertaken in two schools from the northern region of Portugal, and more specifically on the perspectives expressed by the teachers of those schools. These particular schools were chosen because they have been evaluated twice and represent different educational levels (basic and secondary), contexts and results. These case studies included the analysis of documental data, interviews to key informants and a questionnaire directed to teachers (n = 141) – the latter will be the main focus of this paper. Teachers are essential elements of the school community when considering the impacts of external evaluation, as any changes directed at teaching practices, student evaluation, among others are only possible through their direct action and implication. Therefore, their perceptions on the process and its impacts are crucial to the understanding of what does and does not change in schools as a consequence of external evaluation. Although teachers’ opinions are not homogenous and each school reveals a number of differences when it comes to teachers’ perceptions of School Evaluation, it was possible to stress some areas as the most and as the least consensual. Teachers in both schools agree External School Evaluation (ESE) is useful for the identification of the schools’ strengths and weaknesses, values students’ external evaluation results, imposes a model for schools internal evaluation (and in fact contributes to the very existence of internal evaluation practices), and contributes to schools improvement. However teachers in both schools do not believe ESE contributes to teachers’ autonomy produces changes in how curriculum is managed, or leads to innovative teaching practices. These results point to a greater emphasis on change at the levels of school management, self-evaluation and particularly internal evaluation, but little impact on the teaching practices. We believe the classroom is at the core of school practices and teaching processes are essential to any measure of school quality and to their impacts on student learning.

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Some organizations end up reimplementing the same class of business process over and over: an "administrative process", which consists of managing a form through several states and involving various roles in the organization. This results in wasted time that could be dedicated to better understanding the process or dealing with the fine details that are specific to the process. Existing virtual office solutions require specific training and infrastructure andmay result in vendor lock-in. In this paper, we propose using a high-level domain-specific language (AdminDSL) to describe the administrative process and a separate code generator targeting a standard web framework. We have implemented the approach using Xtext, EGL and the Django web framework, and we illustrate it through two case studies: a synthetic examination process which illustrates the architecture of the generated code, and a real-world workplace survey process that identified several future avenues for improvement.

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The objective of this research is to identify the factors that influence the migration of free software to proprietary software, or vice-versa. The theoretical framework was developed in light of the Diffusion of Innovations Theory (DIT) proposed by Rogers (1976, 1995), and the Unified Theory of Acceptance and Use of Technology (UTAUT) proposed by Venkatesh, Morris, Davis and Davis (2003). The research was structured in two phases: the first phase was exploratory, characterized by adjustments of the revised theory to fit Brazilian reality and the identification of companies that could be the subject of investigation; and the second phase was qualitative, in which case studies were conducted at ArcelorMittal Tubarão (AMT), a private company that migrated from proprietary software (Unix) to free software (Linux), and the city government of Serra, in Espírito Santo state, a public organization that migrated from free software (OpenOffice) to proprietary (MS Office). The results show that software migration decision takes into account factors that go beyond issues involving technical or cost aspects, such as cultural barriers, user rejection and resistance to change. These results underscore the importance of social aspects, which can play a decisive role in the decision regarding software migration and its successful implementation.

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Purpose – The purpose of this paper is to propose a theoretical framework, based on contemporary philosophical aesthetics, from which principled assessments of the aesthetic value of information organization frameworks may be conducted.Design/methodology/approach – This paper identifies appropriate discourses within the field of philosophical aesthetics, constructs from them a framework for assessing aesthetic properties of information organization frameworks. This framework is then applied in two case studies examining the Library of Congress Subject Headings (LCSH), and Sexual Nomenclature: A Thesaurus. Findings – In both information organization frameworks studied, the aesthetic analysis was useful in identifying judgments of the frameworks as aesthetic judgments, in promoting discovery of further areas of aesthetic judgments, and in prompting reflection on the nature of these aesthetic judgments. Research limitations/implications – This study provides proof-of-concept for the aesthetic evaluation of information organization frameworks. Areas of future research are identified as the role of cultural relativism in such aesthetic evaluation and identification of appropriate aesthetic properties of information organization frameworks.Practical implications – By identifying a subset of judgments of information organization frameworks as aesthetic judgments, aesthetic evaluation of such frameworks can be made explicit and principled. Aesthetic judgments can be separated from questions of economic feasibility, functional requirements, and user-orientation. Design and maintenance of information organization frameworks can be based on these principles.Originality/value – This study introduces a new evaluative axis for information organization frameworks based on philosophical aesthetics. By improving the evaluation of such novel frameworks, design and maintenance can be guided by these principles.Keywords Evaluation, Analysis, Bibliographic systems, Indexes, Retrieval languages, Philosophy

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TESLA project (Transfering Energy Save Laid on Agroindustry) financed by the European Commission, had the main goals of evaluating the energy consumption and to identify the best available practices to improve energy efficiency in key agro-food sectors, such as the olive oil mills. A general analysis of energy consumptions allowed identifying the partition between electrical and thermal energy (approximately 50%) and the production processes responsible for the higher energy consumptions, as being the in the mill and paste preparation and the phases separation. Some measures for reducing energy waste and for improving energy efficiency were identified and the impact was evaluated by using the TESLA tool developed by Circe and available at the TESLA website.

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Background Anxiety disorders and major depressive disorder (MDD) are common and disabling mental disorders. This paper aims to test the hypothesis that common mental disorders have become more prevalent over the past two decades. Methods We conducted a systematic review of prevalence, remission, duration, and excess mortality studies for anxiety disorders and MDD and then used a Bayesian meta-regression approach to estimate point prevalence for 1990, 2005, and 2010. We also conducted a post-hoc search for studies that used the General Health Questionnaire (GHQ) as a measure of psychological distress and tested for trends to present a qualitative comparison of study findings. Results This study found no evidence for an increased prevalence of anxiety disorders or MDD. While the crude number of cases increased by 36%, this was explained by population growth and changing age structures. Point prevalence of anxiety disorders was estimated at 3.8% (3.6-4.1%) in 1990 and 4.0% (3.7-4.2%) in 2010. The prevalence of MDD was unchanged at 4.4% in 1990 (4.2-4.7%) and 2010 (4.1-4.7%). However, 8 of the 11 GHQ studies found a significant increase in psychological distress over time. Conclusions The perceived "epidemic" of common mental disorders is most likely explained by the increasing numbers of affected patients driven by increasing population sizes. Additional factors that may explain this perception include the higher rates of psychological distress as measured using symptom checklists, greater public awareness, and the use of terms such as anxiety and depression in a context where they do not represent clinical disorders.

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"A large proportion of people who experience drug problems also experience a range of mental health problems. Similarly, many people who experience mental health problems engage in hazardous drug use. The experience of these co-occurring disorders increases use of treatment services, but is associated with poorer prognosis. The implementation of effective responses has been hindered by the disaggregated systems of care that have been adopted in many countries; many problems are the outcome of poorly organised systems of care that do not reflect the needs of a large proportion of clients who experience various problems. There is a dearth of quality research to guide the development of evidence-based responses to co-occurring drug and mental health problems. This book introduces the reader to the issues, guided by a series of questions. These encourage the reader to consider the evidence about the nature and prevalence of co-occurring disorders and the challenges they create for individuals, the community and service providers. The diverse range of expertise of the contributors provides the opportunity to consider the challenges of navigating the various systems of care from the perspective of consumers, parents and clinicians. Researchers and clinicians examine the available evidence about the links between the various disorders and discuss the implications for treatment through a series of case studies. The reader is guided through evidence-based clinical decision-making. The editor and contributors argue that, while our knowledge and expertise is improving, there is a need to better resource and integrate treatment services to foster the adoption of evidence-based and effective responses. Poor systems of care don’t necessarily cause co-occurring mental health and drug problems, but they can contribute to poor outcomes."--Publisher website

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Dans les services de première ligne, la majorité des personnes atteintes de dépression souffrent également d’autres maladies chroniques comorbides. Offrir des soins de haute qualité à ces patients représente un défi important pour les intervenants en première ligne ainsi que pour le système de santé. Il y a des raisons de croire que les contextes organisationnels dans lesquels les intervenants pratiquent ont une influence importante sur les soins. Cependant, peu d’études ont examiné directement la façon dont les caractéristiques des cliniques facilitent ou entravent les soins offerts aux patients atteints de dépression et de différents types de maladies chroniques comorbides. L’objectif général de ce projet de recherche était donc de mieux comprendre comment différentes caractéristiques des cliniques de première ligne influencent la qualité des soins pour la dépression chez des patients ayant différents profils de comorbidité. La thèse comporte deux études. Tout d'abord, nous avons effectué une revue systématique examinant les relations entre la comorbidité physique chronique et la qualité des soins pour la dépression dans les services de première ligne afin de clarifier la nature de ces relations et d’identifier les facteurs qui pourraient influer sur ces relations. Ensuite, nous avons effectué une étude aux méthodes mixtes ayant deux volets : (a) un volet quantitatif examinant les relations entre la qualité des soins pour la dépression, les profils de comorbidité des patients, et les caractéristiques des cliniques de première ligne par le biais d’analyses de régression multiniveaux de données issues de deux enquêtes, et (b) un volet qualitatif basé sur une étude de cas explorant les perceptions des professionnels des services de première ligne sur les facteurs organisationnels pouvant influencer la qualité des soins offerts aux patients souffrant de dépression et d’autres maladies chroniques comorbides. Les résultats de ces études ont montré que, bien que la qualité des soins de la dépression en soins primaires soit sous-optimale, certains sous-groupes de patients dépressifs sont plus à risque que d’autres de recevoir des soins pour la dépression inadéquats, notamment des patients ayant uniquement des comorbidités chroniques physiques. Cependant, plusieurs caractéristiques des cliniques de première ligne semblent faciliter l’offre de soins de qualité aux patients atteints de dépression et de maladies chroniques comorbides : les normes et les valeurs liées au travail d'équipe et le soutien mutuel, l'accès au soutien des professionnels ayant une expertise en santé mentale, l’utilisation des algorithmes de traitement et d’autres outils d’aide à la décision pour la dépression, et l’absence d’obstacles liés aux modèles de rémunération inadéquats. Une des façons dont ces caractéristiques favorisent la qualité est en facilitant la circulation des connaissances dans les cliniques de première ligne. Nos résultats suggèrent que des interventions organisationnelles ciblées sont nécessaires pour améliorer la qualité des soins pour la dépression que reçoivent les patients ayant des maladies chroniques comorbides. Ces interventions peuvent viser différents domaines organisationnels (ex : caractéristiques structurelles/stratégiques, sociales, technologies et épistémiques) mais doivent aussi prendre en compte comment les éléments de chaque domaine interagissent et comment ils pourraient influencer les soins pour des patients ayant des profils de comorbidité différents.

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Renner AC, da Silva AAM, Rodriguez JDM, Simoes VMF, Barbieri MA, Bettiol H, Thomaz EBAF, Saraiva MC. Are mental health problems and depression associated with bruxism in children? Community Dent Oral Epidemiol 2011. (C) 2011 John Wiley & Sons A/S Abstract Objectives: Previous studies have found an association between bruxism and emotional and behavioral problems in children, but reported data are inconsistent. The objective of this study was to estimate the prevalence of bruxism, and of its components clenching and grinding, and its associations with mental problems and depression. Methods: Data from two Brazilian birth cohorts were analyzed: one from 869 children in Ribeirao Preto RP (Sao Paulo), a more developed city, and the other from 805 children in Sao Luis SL (Maranhao). Current bruxism evaluated by means of a questionnaire applied to the parents/persons responsible for the children was defined when the habit of tooth clenching during daytime and/or tooth grinding at night still persisted until the time of the assessment. Additionally, the lifetime prevalence of clenching during daytime only and grinding at night only was also evaluated. Mental health problems were investigated using the Strength and Difficulties Questionnaire (SDQ) and depression using the Childrens Depression Inventory (CDI). Analyses were carried out for each city: with the SDQ subscales (emotional symptoms, conduct problems, peer problems, attention/hyperactivity disorder), with the total score (sum of the subscales), and with the CDI. These analyses were performed considering different response variables: bruxism, clenching only, and grinding only. The risks were estimated using a Poisson regression model. Statistical inferences were based on 95% confidence intervals (95% CI). Results: There was a high prevalence of current bruxism: 28.7% in RP and 30.0% in SL. The prevalence of clenching was 20.3% in RP and 18.8% in SL, and grinding was found in 35.7% of the children in RP and 39.1% in SL. Multivariable analysis showed a significant association of bruxism with emotional symptoms and total SDQ score in both cities. When analyzed separately, teeth clenching was associated with emotional symptoms, peer problems, and total SDQ score; grinding was significantly associated with emotional symptoms and total SDQ score in RP and SL. Female sex appeared as a protective factor for bruxism, and for clenching and grinding in RP. Furthermore, maternal employment outside the home and white skin color of children were associated with increased prevalence of teeth clenching in SL. Conclusions: Mental health problems were associated with bruxism, with teeth clenching only and grinding at night only. No association was detected between depression and bruxism, neither clenching nor grinding. But it is necessary to be cautious regarding the inferences from some of our results.

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In the current thesis, the reasons for the differential impact of Holocaust trauma on Holocaust survivors, and the differential intergenerational transmission of this trauma to survivors’ children and grandchildren were explored. A model specifically related to Holocaust trauma and its transmission was developed based on trauma, family systems and attachment theories as well as theoretical and anecdotal conjecture in the Holocaust literature. The Model of the Differential Impact of Holocaust Trauma across Three Generations was tested firstly by extensive meta-analyses of the literature pertaining to the psychological health of Holocaust survivors and their descendants and secondly via analysis of empirical study data. The meta-analyses reported in this thesis represent the first conducted with research pertaining to Holocaust survivors and grandchildren of Holocaust survivors. The meta-analysis of research conducted with children of survivors is the first to include both published and unpublished research. Meta-analytic techniques such as meta-regression and sub-set meta-analyses provided new information regarding the influence of a number of unmeasured demographic variables on the psychological health of Holocaust survivors and descendants. Based on the results of the meta-analyses it was concluded that Holocaust survivors and their children and grandchildren suffer from a statistically significantly higher level or greater severity of psychological symptoms than the general population. However it was also concluded that there is statistically significant variation in psychological health within the Holocaust survivor and descendant populations. Demographic variables which may explain a substantial amount of this variation have been largely under-assessed in the literature and so an empirical study was needed to clarify the role of demographics in determining survivor and descendant mental health. A total of 124 participants took part in the empirical study conducted for this thesis with 27 Holocaust survivors, 69 children of survivors and 28 grandchildren of survivors. A worldwide recruitment process was used to obtain these participants. Among the demographic variables assessed in the empirical study, aspects of the survivors’ Holocaust trauma (namely the exact nature of their Holocaust experiences, the extent of family bereavement and their country of origin) were found to be particularly potent predictors of not only their own psychological health but continue to be strongly influential in determining the psychological health of their descendants. Further highlighting the continuing influence of the Holocaust was the finding that number of Holocaust affected ancestors was the strongest demographic predictor of grandchild of survivor psychological health. Apart from demographic variables, the current thesis considered family environment dimensions which have been hypothesised to play a role in the transmission of the traumatic impact of the Holocaust from survivors to their descendants. Within the empirical study, parent-child attachment was found to be a key determinant in the transmission of Holocaust trauma from survivors to their children and insecure parent-child attachment continues to reverberate through the generations. In addition, survivors’ communication about the Holocaust and their Holocaust experiences to their children was found to be more influential than general communication within the family. Ten case studies (derived from the empirical study data set) are also provided; five Holocaust survivors, three children of survivors and two grandchildren of survivors. These cases add further to the picture of heterogeneity of the survivor and descendant populations in both experiences and adaptations. It is concluded that the legacy of the Holocaust continues to leave its mark on both its direct survivors and their descendants. Even two generations removed, the direct and indirect effects of the Holocaust have yet to be completely nullified. Research with Holocaust survivor families serves to highlight the differential impacts of state-based trauma and the ways in which its effects continue to be felt for generations. The revised and empirically tested Model of the Differential Impact of Holocaust Trauma across Three Generations presented at the conclusion of this thesis represents a further clarification of existing trauma theories as well as the first attempt at determining the relative importance of both cognitive, interpersonal/interfamilial interaction processes and demographic variables in post-trauma psychological health and transmission of traumatic impact.

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There is evidence that contact with the natural environment and green space promotes good health. It is also well known that participation in regular physical activity generates physical and psychological health benefits. The authors have hypothesised that ‘green exercise’ will improve health and psychological well-being, yet few studies have quantified these effects. This study measured the effects of 10 green exercise case studies (including walking, cycling, horse-riding, fishing, canal-boating and conservation activities) in four regions of the UK on 263 participants. Even though these participants were generally an active and healthy group, it was found that green exercise led to a significant improvement in self-esteem and total mood disturbance (with anger-hostility, confusion-bewilderment, depression-dejection and tension-anxiety all improving post-activity). Self-esteem and mood were found not to be affected by the type, intensity or duration of the green exercise, as the results were similar for all 10 case studies. Thus all these activities generated mental health benefits, indicating the potential for a wider health and well-being dividend from green exercise. Green exercise thus has important implications for public and environmental health, and for a wide range of policy sectors.