La salut reproductiva de la dona immigrant: una anàlisi des de la influència cultural

El progressiu increment del flux migratori en els darrers anys a Catalunya genera un major percentatge de dones en estat fèrtil que requereixen d’una atenció vinculada a la seva salut reproductiva. D’aquesta manera, els professionals sanitaris es veuen sotmesos a treballar sota una diversitat cultural que moltes vegades genera un “xoc intercultural” dificultant la relació assistencial entre professional i usuari. Per aquest motiu, el següent estudi pretén donar una aproximació de la influència cultural de la dona immigrant (marroquina i subsahariana) en quatre àmbits: embaràs, part, post-part i maternitat.Hipòtesis: S’identifiquen necessitats bàsiques assistencials no resoltes satisfactòriament en el grup de dones immigrants (marroquines i subsaharianes) en el període del part, puerperi immediat i intermedi, a més d’un impacte intercultural associat.Objectiu principal: Conèixer les vivències, percepcions i conductes de les dones marroquines i subsaharianes en l’embaràs, el part, el post-part, la maternitat dins el seu marc cultural i com influeixen en l’atenció sanitària del nostre país.Material i mètodes: S’ha realitzat un estudi de disseny mixt. Per una banda s’ha disposat d’una metodologia qualitativa descriptiva que utilitza la teoria fonamentada “Grounded Theory” com a instrument metodològic, i per l’altra, s’ha optat per una metodologia quantitativa per analitzar les dades clíniques i epidemiològiques de gestants immigrants que havien donat a llum al Servei d’Obstetrícia-Sala de Parts de l’Hospital Sta. Caterina (Girona), durant el període comprès entre el mes de novembre de 2012 i gener de 2013.La recollida de dades s’ha realitzat sota una entrevista semiestructurada i una observació participant com a instruments qualitatius, i el suport del “carnet de l’embaràs” i la “història obstètrica” de cada dona per elaborar l’estudi quantitatiu. Pel que fa a l’anàlisi de les dades en l’estudi qualitatiu s’ha seguit el procés analític plantejat per la Teoria fonamentada i en el cas de l’estudi quantitatiu, s’ha comptatamb el suport d’una tesi doctoral per comparar els resultats amb els de les dones autòctones, dels quals fa referència la tesi.Resultats: En l’estudi qualitatiu, s’han trobat especificitats culturals en relació a la percepció del part, desenvolupament del part ( a nivell conductual), implicació en el post-part, valoració de l’atenció sanitària rebuda i el concepte de maternitat. Pel que fa a l’estudi quantitatiu comparatiu, s’han indentificat diferències entre el col·lectiu de la mostra estudiada i les dones autòctones referent als antecedents obstètrics i paritat, al control gestacional i al desenvolupament del part ( a nivell fisiològic)

Project DAPHNE II: summary of results

This paper sets out the main findings of a comparative research project carried out by research groups in five European countries (Belgium, France, Portugal, Italy and Spain), with the support of the European Union as part of the Daphne II programme. The goal of the project was to analyse violent situations in night-time leisure activities, especially those occurring between young people, together with the efficacy of social and institutional responses to these situations.

El suport familiar en la malaltia mental: influència del suport familiar en el control de la malaltia en una persona que pateix un transtorn mental server

Aquest treball té com a objectiu principal conèixer si hi ha millora en el control de la malaltia d’una persona que pateix un trastorn mental sever quan disposa d’un suport adequat de la família. Els objectius específics marcats són, avaluar la càrrega familiar que suposa tenir la responsabilitat de cuidar un familiar amb malaltia mental, conèixer les actituds dels familiars de persones que pateixen una malaltia mental, involucrar a la família dins de la teràpia del familiar amb malaltia mental severa, i aconseguir un grau de cooperació i comunicació favorable de la família al pacient. Es tracta d’un estudi d’investigació quantitatiu, transversal i de tipus analític, el qual la mostra de la població estudiada estarà composta de 100 pacients entre 20 i 30 anys amb diagnòstic de trastorn mental sever segons el DSM-IV, atesos durant l’últim any en el Centre de Salut Mental d’Adults de Vic i els seus cuidadors principals o persones més properes. Es realitzarà recollida de dades a través de la revisió de les històries clíniques, informació facilitada pel terapeuta que tracta al pacient i entrevistes als familiars cuidadors o persona més propera i als mateixos pacients. Aquesta entrevista la faran professionals entrenats i competents. Amb tot això s’establirà una correlació entre les variables d’estrès, suport als familiars i el desenvolupament dels rols, i s’agruparan les variables de manera que quedin estructurades en subgrups.

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.

How Millennials are changing the way of learning: the state of the art of ICT integration in education

Millennials generation is changing the way of learning, prompting educational institutions to attempt to better adapt to young needs by incorporating technologies into education. Based on this premise, we have reviewed the prominent reports of the integration of ICT into education with the aim of evidencing how education is changing, and will change, to meet the needs ofMillennials with ICT support. We conclude that most of the investments have simply resulted in an increase of computers and access to the Internet, with teachers reproducing traditional approaches to education and e-learning being seen as complementary to face-to-face education. While it would seem that the use of ICT is not revolutionizing learning, it is facilitating the personalization, collaboration and ubiquity of learning.

Technology-enhanced education for Millennials: how the Information Society is changing the way of learning

The Information Society has provided the context for the development of a new generation, known as the Millennials, who are characterized by their intensive use of technologies in everyday life. These features are changing the way of learning, prompting educational institutions to attempt to better adapt to youngneeds by incorporating technologies into education. Based on this premise, wehave reviewed the prominent reports of the integration of ICT into education atdifferent levels with the aim of evidencing how education is changing, and willchange, to meet the needs of Millennials with ICT support. The results show thatmost of the investments have simply resulted in an increase of computers andaccess to the Internet, with teachers reproducing traditional approaches to education and e-learning being seen as complementary to face-to-face education.While it would seem that the use of ICT is not revolutionizing learning, it isfacilitating the personalization, collaboration and ubiquity of learning.

Preoperative hyperfractionated accelerated radiotherapy (HART) and concomitant CPT-11 in locally advanced rectal carcinoma: a phase I study.

PURPOSE: Patients with locally advanced rectal carcinoma are at risk for both local recurrence and distant metastases. We demonstrated the efficacy of preoperative hyperfractionated accelerated radiotherapy (HART). In this Phase I trial, we aimed at introducing chemotherapy early in the treatment course with both intrinsic antitumor activity and a radiosensitizer effect. METHODS AND MATERIALS: Twenty-eight patients (19 males; median age 63, range 28-75) with advanced rectal carcinoma (cT3: 24; cT4: 4; cN+: 12; M1: 5) were enrolled, including 8 patients treated at the maximally tolerated dose. Escalating doses of CPT-11 (30-105 mg/m(2)/week) were given on Days 1, 8, and 15, and concomitant HART (41.6 Gy, 1.6 Gy bid x 13 days) started on Day 8. Surgery was to be performed within 1 week after the end of radiochemotherapy. RESULTS: Twenty-six patients completed all preoperative radiochemotherapy as scheduled; all patients underwent surgery. Dose-limiting toxicity was diarrhea Grade 3 occurring at dose level 6 (105 mg/m(2)). Hematotoxicity was mild, with only 1 patient experiencing Grade 3 neutropenia. Postoperative complications (30 days) occurred in 7 patients, with an anastomotic leak rate of 22%. CONCLUSIONS: The recommended Phase II dose of CPT-11 in this setting is 90 mg/m(2)/week. Further Phase II exploration at this dose is warranted.

Self Instructional Math, HR-324, 1995

The Self Instructional Math course book is designed to provide a basic math knowledge for those involved in the planning, design, and construction of highways. It was developed in a manner to allow the student to take the course with minimal supervision and at times that the work schedule allows. The first version of the course was developed in the early 1970's and due to its popularity was revised in the early 1990's to reflect changes in the highway construction math needs. The anticipated move to metric (System International) measurements by the highway industry has necessitated the need to change the math course problem values to metric units. The course includes the latest in Iowa DOT policy information relative to the selection and use of metric values for highway design, and construction. Each unit of the book contains instructional information, section quizzes and a comprehensive examination. All problem values are expressed in metric rather than dual (english and SI) units. The appendix contains useful conversion factors to assist the reader in making the change to metric.

Evaluation of Recycled Rubber in Asphalt Concrete - Black Hawk County, HR-330B, Construction Report, 1992

The disposal of discarded tires has become a major problem. Different methods of recycling have been researched. Currently, Iowa is researching the use of ground recycled crumb rubber from discarded tires in asphalt rubber cement. Six projects have been completed in Iowa using asphalt rubber cement. This project is located on IA 947 (University Avenue) in Cedar Falls/Waterloo. The project contains one section with asphalt rubber cement used in both the binder and surface courses and one section using asphalt rubber cement in the surface course with a conventional binder. There are two control sections where conventional asphalt pavement was placed.

Transitoriness in cancer patients: a cross-sectional survey of lung and gastrointestinal cancer patients.

Despite earlier diagnosis and advancements in treatment, cancer remains a leading cause of death in the world (13% of all deaths according to the World Health Organization) among men and women. Cancer accounts for approximately 20% of the deaths in the USA every year. Here, we report the findings from a cross-sectional survey of psychosocial factors in lung and gastrointestinal cancer patients. The aim of the study was to explore the associations among transitoriness, uncertainty, and locus of control (LOC) with quality of life. Transitoriness is defined as a person's confrontation with life's finitude due to a cancer diagnosis. A total of 126 patients with lung or gastrointestinal cancer completed eight self-reporting questionnaires addressing demographics, spiritual perspective, symptom burden, transitoriness, uncertainty, LOC, and quality of life. Transitoriness, uncertainty, and LOC were significantly associated with one another (r = 0.3267, p = 0.0002/r = 0.1994, p = 0.0252, respectively). LOC/belief in chance has a significant inverse relationship with patients' quality of life (r = -0.2505, p = 0.0047). Transitoriness, uncertainty, and LOC were found to have a significant inverse relationship with patients' quality of life (transitoriness state: r = -0.5363, p = 0.0000/trait: r = -0.4629, p = 0.0000/uncertainty: r = -0.4929, p = 0.0000/internal LOC: r = 0.1759, p = 0.0489/chance LOC: r = -0.2505, p = 0.0047). Transitoriness, uncertainty, and LOC are important concepts as they adversely influence patients' quality of life. Incorporating this finding into the care of cancer patients may provide them with the support they need to cope with treatment and maintenance of a positive quality of life.

Factores relacionados con la percepción de la calidad docente del profesorado universitario

Se usaron los resultados cuantitativos de las encuestas de valoración cumplimentadas por los estudiantes sobre su opinión respecto a la docencia del profesorado, según el modelo utilizado anualmente por la propia universidad, para determinar cuáles son las variables que se asocian significativamente con la percepción de calidad de la docencia por parte del estudiantado. Mediante técnicas cualitativas (entrevistas y grupos de discusión), se elucidó el discurso sobre la docencia característico del profesorado mejor valorado por los alumnos. Los resultados sugieren posibles intervenciones a realizar por la universidad para mejorar la percepción de la calidad docente, así como la necesidad de sistematizar la información de la que disponen las universidades desde diversos ámbitos de gestión para facilitar un seguimiento continuado y estudiar las posibles acciones.

"Sobre tenir lo Studi de Lleyda en Tortosa"

The lower medieval Catalan model of the estudi general (university) exemplified by the case of Lleida emphasises the weight achieved by the students as a body, the jurisdictional conflicts and, especially, the serious economic difficulties, that poisoned the relations with the poorly paid teaching staff and made the centre impossible to run. In that sense, the monarchy’s incapacity to provide the jurisdictional and financial bases, pushed higher education under a growing ecclesiastical weight snd municipal dependence. The local government, for its part, would have to increase the means of taxation needed to produce the necessary financing. All together, this generated difficulties that would burden the estudis generals throughout the lower Middle ages and into modern centuries, until their closure in the 18th century.

Matematiikan perusopetuksen internet-aineiston tuottaminen

Tämän diplomityön tarkoituksena on kuvata Lappeenrannan teknillisessä yliopistossa matematiikan perusopetuksen virtuaaliympäristöä pedagogisesti toimivana oppimisympäristönä. Matematiikan virtuaalimateriaali on luotu tukemaan lähiopetusta matematiikan perusopetuksessa. Virtuaalimateriaalin kehittämisessä tähdätään pedagogiseen osaamiseen ja järjestelmän toimintalogiikan kehittämiseen sisällönhallintatyökalujen avulla. Opiskelun ja opetuksen kansainvälistymisen myötä on kehitetty perusmatematiikan virtuaaliympäristöä niin, että järjestelmä tarjoaa yliopiston opettajille ja suomalaisille sekä ulkomaalasille opiskelijoille yhteisen perusmatematiikan virtuaaliympäristön. Kehityksen tuloksena on saatu järjestelmä, joka hyödyntää tietoverkkoja kuten Wikipediaa verkko-opetuksen aputyökaluna.

Tietojärjestelmien tukipalveluprosessien kehittäminen - case Helsoft

Tässä diplomityössä on käsitelty tietojärjestelmien tukipalveluun liittyviä prosesseja ja toimintoja. Tukipalvelutoiminnot ovat tietojärjestelmäteollisuuden merkittävä osa-alue ja siihen nähden aiheen tutkimus on ollut hyvin vähäistä. Viimeaikoina aihe on herättänyt kiinnostusta varsinkin asiakaskohtaisia ohjelmistoja toimittavien ohjelmistoyritysten keskuudessa. Diplomityön tarkoituksena oli suunnitella ja kehittää Helsoft Oy:n asiakaskohtaisten ohjelmistojen tukipalvelutoimintoja. Tämän työn näkökulmasta tukipalveluun kuuluu tietojärjestelmän toimituksen jälkeinen asiakkaiden neuvontapalvelu sekä ohjelmiston muutos- ja ylläpitopalvelu. Tukipalvelun sisältö vaihtelee usein asiakaskohtaisesti. Tämän vuoksi tukipalvelusta on syytä tehdä asianmukainen toimittajan ja asiakkaan välinen sopimus. Sopimuksen lisäksi tässä työssä on käsitelty myös muita tukipalvelun työkaluja kuten esimerkiksi tukipalveluohjetta, joka muodostetaan tukipalveluun ottamisvaiheessa. Työn teoriaosassa on käsitelty tietojärjestelmien tukipalvelun perusasioita sekä edellytyksiä tukipalveluprosessin onnistuneen kuvauksen muodostamiselle. Prosessin kuvauskieleksi on valittu UML. Työn soveltavan osuuden sisältö koostuu Helsoftin tukipalvelun nykytilanteen kartoituksesta, uuden yhtenäisemmän prosessimallin suunnittelusta (vaihe 1) sekä tukipalveluprosessin jatkokehityksen ja tehostamisen (vaihe 2) suunnittelusta. Uusi yhtenäinen prosessimalli on suhteellisen helposti käyttöönotettavissa ja standardinmukaisen kuvaustavan johdosta sitä voidaan kehittää jatkossa jatkuvan parantamisen periaatteella.

Tutkimusprojektien hallinnan kehittäminen

Työn tavoitteena oli kuvata projektihallintaa tutkimusympäristössä ja kartoittaa siihen liittyviä erityisominaisuuksia, ongelmia ja kehittämistarpeita. Projektihallinnan kehittämistarpeita tarkasteltiin erityisesti projektipäällikön näkökulmasta. Yliopiston yksikköjä varten kehitettiin projektien hallintaa systematisoiva toimintamalli, joka perustuu projektin elinkaaren vaiheiden tunnistamiseen. Mallissa esitettiin projektin eri vaiheisiin kuuluvat johtamistehtävät. Tehtävien määrittelemiseksi tutustuttiin kirjallisuudessa esiteltävään projektihallinnan teoriaan, ja tehtävien määrittelyä täydennettiin yliopiston tutkimustoiminnan omilla erityisvaatimuksilla.Projektin tehtävien suorittamisen helpottamiseksi selvitettiin projektihallinnan menetelmiä, jotka soveltuvat parhaiten tutkimusprojektien hallintaan. Tärkeimmiksi koetut menetelmät kuvattiin tarkemmin. Esiteltyjen menetelmien avulla sekä projektin operatiivista että strategista johtamista voidaan parantaa. Menetelmien avulla myös projektin sisäistä tiedonvaihtoa voidaan tehostaa ja tiedottamista ulkopuolisille sidosryhmille yhdenmukaistaa.