Diabetes care: opinions, needs and proposed solutions of Swiss patients and healthcare professionals: a qualitative study.

AIMS: To explore, both among patients with diabetes and healthcare professionals, opinions on current diabetes care and the development of the "Regional Diabetes Program". METHODS: We employed qualitative methods (focus groups - FG) and used purposive sampling strategy to recruit patients with diabetes and healthcare professionals. We conducted one diabetic and one professional FG in each of the four health regions of the canton of Vaud/Switzerland. The eight FGs were audio-taped and transcribed verbatim. Thematic analysis was then undertaken. RESULTS: Results showed variability in the perception of the quality of diabetes care, pointed to insufficient information regarding diabetes, and lack of collaboration. Participants also evoked patients' difficulties for self-management, as well as professionals' and patients' financial concerns. Proposed solutions included reinforcing existing structures, developing self-management education, and focusing on comprehensive and coordinated care, communication and teamwork. Patients and professionals were in favour of a "Regional Diabetes Program" tailored to the actors' needs, and viewed it as a means to reinforce existing care delivery. CONCLUSIONS: Patients and professionals pointed out similar problems and solutions but explored them differently. Combined with coming quantitative data, these results should help to further develop, adapt and implement the "Regional Diabetes Program".

El paper del joc en el desenvolupament d'infants amb TEA

Jugar no és només un sinònim de diversió, sinó que darrera d’aquesta acció s’amaguen molts elements que són imprescindible per al desenvolupament infantil, ja que l’afavoreix en tots els àmbits de la seva vida. Un nen amb Necessitats Educatives Especial té el mateix dret de gaudir d’una estona de joc, i desenvolupar-­‐se com a persona. De fet, el joc és considerat una eina d’aprenentatge a l’edat infantil. Per això, el present treball de grau té com objectiu principal analitzar la importància del joc com a eina educativa amb infants amb un Trastorn de l’Espectre Autista. S’utilitza una metodologia qualitativa, i a través de l’observació, s’analitza com el joc ajuda a un infant amb Trastorn de l’Espectre Autista a adquirir determinades habilitats i capacitats que li permeten tenir certa autonomia. Els resultats obtinguts, permeten afirmar que la Unitat de Suport a l’Educació Especial utilitza el joc com un recurs didàctic per a treballar amb infants amb Autisme. Per això, es planteja una proposta d’intervenció dins d’aquesta unitat.

Limitations and information needs for engineered nanomaterial-specific exposure estimation and scenarios: recommendations for improved reporting practices

The aim of this paper is to describe the process and challenges in building exposure scenarios for engineered nanomaterials (ENM), using an exposure scenario format similar to that used for the European Chemicals regulation (REACH). Over 60 exposure scenarios were developed based on information from publicly available sources (literature, books, and reports), publicly available exposure estimation models, occupational sampling campaign data from partnering institutions, and industrial partners regarding their own facilities. The primary focus was on carbon-based nanomaterials, nano-silver (nano-Ag) and nano-titanium dioxide (nano-TiO2), and included occupational and consumer uses of these materials with consideration of the associated environmental release. The process of building exposure scenarios illustrated the availability and limitations of existing information and exposure assessment tools for characterizing exposure to ENM, particularly as it relates to risk assessment. This article describes the gaps in the information reviewed, recommends future areas of ENM exposure research, and proposes types of information that should, at a minimum, be included when reporting the results of such research, so that the information is useful in a wider context.

L’Escolarització compartida: el cas de la Laia

Actualment s’està donant molt pes al fet d’incloure dins l’aula a tot aquell alumnat amb necessitats educatives especials per tal de fomentar la inclusió. Aquest fet i com a persona que visc el dia a dia amb persones amb diversitat funcional ha fet que hem plantegi molts dubtes i reptes sobre la inclusió. Així doncs, vaig pensar que seria interessant observar, descriure i analitzar com viu un infant amb diversitat funcional la seva escolarització dins una aula ordinària i dins una aula d’educació especial. La principal participant de la investigació ha estat la Laia, una nena de 10 anys la qual realitza escolarització compartida. La seva família i les tutores dels dos centres han col·laborat en la investigació aportant informació. El mètode utilitzat per a la investigació ha estat una recerca qualitativa a partir de l’anàlisi d’un estudi de cas utilitzant les entrevistes amb la família i els tutors de la Laia, l’observació de Laia dins l’horari escolar i les notes de camp com a instruments de recollida de dades. Com a conclusions pensem que la inclusió d’aquells infants amb diversitat funcional dins l’aula ordinària és molt important ja que els ajuda a viure en un àmbit amb total normalitat i fomenta el respecte de la gent que els envolta. Cal fomentar les situacions d’inclusió amb l’ús d’estratègies com poden ser el treball cooperatiu o establint bones relacions amb la gent que els envolta.

Els nens i nenes amb “Dictamen d’escolarització” i amb suport del CDIAP: estudi de les dimensions de l’atenció a les necessitats especials de l’alumnat, entre tres i sis anys, escolaritzat en un centre públic de la comarca d’Osona

La meva recerca ha tingut com a punt de partida “Els nens i nenes amb “Dictamen d’escolarització” i amb suport del CDIAP: estudi de les dimensions de l’atenció a les necessitats especials de l’alumnat, entre tres i sis anys, escolaritzat en un centre públic de la comarca d’Osona”. A partir d’aquí, s’ha elaborat un marc teòric a partir de les lleis d’educació, decrets que regulen els diferents serveis i un seguit de conceptes bàsics. Un cop elaborat aquest marc teòric per tal de recollir les dades dels alumnes, de tres a sis anys, d’una escola en concret s’ha dissenyat un instrument de recollida de dades que li diem full resum de serveis (FRS). El FRS és un instrument que ens ha servit per recollir totes les dades d’alumnes amb necessitats específiques i, sobretot, per saber quin suport reben per part de l’escola i per part d’altres serveis. A més a més, per recollir informació sobre els diferents serveis que atenen aquesta diversitat s’ha elaborat un guió d’entrevistes (GE). Aquest GE serveix per recollir els aspectes més importants de les entrevistes realitzades a l’EAP (Equip d’Assessorament i Orientació Psicopedagògica), CDIAP (Centre de Desenvolupament Infantil i Atenció Precoç) i CSMIJ (Centre de Salut Mental Infantil i Juvenil). A partir de la informació extreta dels dos instruments, s’han elaborat unes conclusions respecte els objectius plantejats en aquest projecte i la pregunta plantejada a l’inici.

Needs, expectations, and concerns of medical students regarding end-of-life issues before the introduction of a mandatory undergraduate palliative care curriculum.

BACKGROUND: In the past, implementation of effective palliative care curricula has emerged as a priority in medical education. In order to gain insight into medical students' needs and expectations, we conducted a survey before mandatory palliative care education was introduced in our faculty. METHODS: Seven hundred nine students answered a questionnaire mainly consisting of numeric rating scales (0-10). RESULTS: Participants attributed a high importance to palliative care for their future professional life (mean, 7.51 ± 2.2). For most students, symptom control was crucial (7.72 ± 2.2). However, even higher importance was assigned to ethical and legal issues (8.16 ± 1.9). "Self-reflection regarding their own role as a physician caring for the terminally ill along with psychological support" was also regarded as highly important (7.25 ± 2.4). Most students were moderately concerned at the prospect of being confronted with suffering and death (5.13 ± 2.4). This emotional distress was rated significantly higher by female students (5.4 ± 2.4 versus 4.6 ± 2.4; p < 0.001). Seventeen percent of all students rated their distress as being 7 of 10 or higher, which indicates a considerable psychological strain in terms of dealing with end-of-life issues in the future. Professional or personal experience with terminally ill persons lowered these anxieties significantly (4.99 ± 2.34 versus 5.47 ± 2.5, p < 0.05). CONCLUSIONS: Medical students stated a remarkably high interest in learning palliative care competencies. Responding to their specific concerns and needs-especially with regard to the acquisition of emotional coping skills-may be key for the development of successful palliative care curricula.

La responsabilidad social de las multinacionales y el respeto de los derechos humanos a propósito de los informes presentados por el representante especial del Secretario General de Naciones Unidas (RESG) sobre derechos humanos y corporaciones transnacionales y otras empresas.

Este artículo se plantea como una revisión del proceso que se inició a partir de las“Normas sobre las responsabilidades de las transnacionales y otras empresascomerciales respecto a los derechos humanos” que aunque fueron aprobadas en el 55ºperíodo de sesiones de Naciones Unidas de agosto de 2003, finalmente no fueronadoptadas quedando de momento sin entrar en vigor. Se realiza una presentación del papel jugado por el profesor John Ruggie en el proceso posterior a la emisión de las normas, y del informe “Protect, respect and remedy” junto con el informe sobre líneas estratégicas de abril de 2009. Las normas finalmente fueron aprobadas el 16 de junio de 2011 siguiendo la pauta establecida en el informe anteriormente citado.

Besoins, prescriptions et sécurité des produits sanguins labiles ; autosuffisance en produits sanguins labiles [Roundtables of SFTS Congress 2013: Needs, indications and safety of blood products; self-sufficiency in blood products].

The current issues debate brings together experts around the themes of self-sufficiency (in its national and European aspects) and of needs in cellular blood products. The point of view of the manufacturer and prescribers of blood products are confronted.

Financial Needs of Iowa's County Roads, TR-608, 2012

The TR-608 project developed methods and processes for determining current and future Iowa secondary (county) road needs. These tools will be permanently maintained and operated by the Iowa County Engineers Association Service Bureau to provide ongoing need determination services for the state’s ninety-nine county road departments. The systems established via this project will annually tally and report a) how much funding is needed to sustain the county roads long term, b) the adequacy of the secondary roads for the traffic they carry and c) what upgrade needs exist. A “Trend Projection Engine” will also be available to project from current circumstance, with continuation of known revenue and cost trends, to estimate potential outcomes occurring in the next fifteen years. Now that it has been developed, the TR-608 system will continue as an ongoing resource of county road and bridge numbers, condition, trends and issue information for use by counties, either individually or collectively.

Reporting a program evaluation: Needs, program plan, intervention, and decisions

The approach to intervention programs varies depending on the methodological perspective adopted. This means that health professionals lack clear guidelines regarding how best to proceed, and it hinders the accumulation of knowledge. The aim of this paper is to set out the essential and common aspects that should be included in any program evaluation report, thereby providing a useful guide for the professional regardless of the procedural approach used. Furthermore, the paper seeks to integrate the different methodologies and illustrate their complementarity, this being a key aspect in terms of real intervention contexts, which are constantly changing. The aspects to be included are presented in relation to the main stages of the evaluation process: needs, objectives and design (prior to the intervention), implementation (during the intervention), and outcomes (after the intervention). For each of these stages the paper describes the elements on which decisions should be based, highlighting the role of empirical evidence gathered through the application of instruments to defined samples and according to a given procedure.

A comparison of the dental status and treatment needs of older adults with and without chronic mental illness in Sevilla, Spain

Objectives: To study the dental status and treatment needs of institutionalized older adults with chronic mental illness compared to a non-psychiatric control sample. Study Design: The sample size was 100, in which 50 were psychogeriatric patients (study group; SG) classified according to DSM-IV, with a mean age of 69.6 ± 6.7 years, and 50 non-psychiatric patients (control group; CG), with a mean age of 68.3 ± 6.9 years. Clinical oral health examinations were conducted and caries were recorded clinically using the Decayed, Missing and Filled Teeth Index (DMFT). Results were analyzed statistically using the Student"s t-test or analysis of variance. Results: Caries prevalence was 58% and 62% in SG and CG, respectively. DMFT index was 28.3 ± 6.6 in SG and 21.4 ± 6.07 in CG (p < 0.01). Mean number of decayed teeth was higher in SG (3.1) compared to CG (1.8) (p=0.047). Mean number of missing teeth were 25.2 and 16.4 in SG and CG respectively (p<0.05). DMFT scores were higher in SG in all the age groups (p < 0.01). Mean number of teeth per person needing treatment was 3.4 in SG and 1.9 in CG (p= 0.037). The need for restorative dental care was significantly lower in the SG (0.8 teeth per person) than in the CG (1.7 teeth per person) (p = 0.043). Conclusions: Institutionalized psychiatric patients have significantly worse dental status and more dental treatment needs than non-psychiatric patients.