1000 resultados para Especial needs


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AIM: To develop and test the Parental PELICAN Questionnaire, an instrument to retrospectively assess parental experiences and needs during their child's end-of-life care. BACKGROUND: To offer appropriate care for dying children, healthcare professionals need to understand the illness experience from the family perspective. A questionnaire specific to the end-of-life experiences and needs of parents losing a child is needed to evaluate the perceived quality of paediatric end-of-life care. DESIGN: This is an instrument development study applying mixed methods based on recommendations for questionnaire design and validation. METHOD: The Parental PELICAN Questionnaire was developed in four phases between August 2012-March 2014: phase 1: item generation; phase 2: validity testing; phase 3: translation; phase 4: pilot testing. Psychometric properties were assessed after applying the Parental PELICAN Questionnaire in a sample of 224 bereaved parents in April 2014. Validity testing covered the evidence based on tests of content, internal structure and relations to other variables. RESULTS: The Parental PELICAN Questionnaire consists of approximately 90 items in four slightly different versions accounting for particularities of the four diagnostic groups. The questionnaire's items were structured according to six quality domains described in the literature. Evidence of initial validity and reliability could be demonstrated with the involvement of healthcare professionals and bereaved parents. CONCLUSION: The Parental PELICAN Questionnaire holds promise as a measure to assess parental experiences and needs and is applicable to a broad range of paediatric specialties and settings. Future validation is needed to evaluate its suitability in different cultures.

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PURPOSE: Needs assessment is recognized to be a key element of mental health care. Patients tend to present heterogeneous profiles of needs. However, there is no consensus in previous research about how patients' needs are organized. This study investigates both general and specific dimensions of patients' needs for care. METHODS: Patients' needs were assessed with ELADEB, an 18-domain self-report scale. The use of a self-assessment scale represents a unique way of obtaining patients' perceptions. A patient-centered psychiatric practice facilitates empowerment as it is based on the patients' personal motivations, needs, and wants. Four seventy-one patients' profiles were analyzed through exploratory factor analysis. RESULTS: A four-factor bifactor model, including one general factor and three specific factors of needs, was most adequate. Specific factors were (a) "finances" and "administrative tasks"; (b) "transports," "public places," "self-care," "housework," and "food"; and (c) "family," "children," "intimate relationships," and "friendship." CONCLUSION: As revealed by the general factor, patients expressing urgent needs in some domains are also more susceptible to report urgent needs in several other domains. This general factor relates to high versus low utilizers of public mental healthcare. Patients also present specific needs in life domains, which are organized in three dimensions: management, functional disabilities, and familial and interpersonal relationships. These dimensions relate to the different types of existing social support described in the literature.

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BACKGROUND: Inflammatory Bowel Disease (IBD) patients are confronted with needs and concerns related to their disease. AIM: To explore information expectations of patients included in a national bilingual IBD cohort in Switzerland (SIBDC). METHODS: This is a mixed-methods study, comprising 1) a semi-narrative survey sent to 1506 patients from the SIBDC and 2) two focus groups conducted with 14 patients to explore and assess the relevance of the survey's findings. Data collected within the framework of the SIBDC was used to characterize survey's responders. RESULTS: 728 patients (48%) replied to the survey: 52.5% females, 56% Crohn's disease (CD), 87% secondary/tertiary level educated, 70% full/part-time employed. On average, 47% of patients sought for information, regardless of the disease stage; 27% of them were dissatisfied with information received at the time of first symptoms. During flares, 43% were concerned about drugs and therapies; in remission, 57% had concerns on research and developments; 27% searched for information linked to daily disease management. Information-seeking increased when active disease, for CD with high levels of perceived stress (OR = 2.47; p = 0.003), and for all with higher posttraumatic stress symptoms. The focus groups confirmed a perceived lack of information about general functioning, disease course, treatments and their risks, extra-intestinal symptoms and manifestations. CONCLUSIONS: Information remains insufficient for IBD patients. Lack of information in specific domains can potentially cause stress and hinder detection of symptoms. Better information should be considered as a potentially important component in improving patients' outcomes in IBD.

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El present treball té com a objectiu l’anàlisi i la conceptualització dels diferents tipus de conflictes empresarials i dels diferents mètodes existents a l’ordenament jurídic per a resoldrel’s. A continuació, s’estudien els Mètodes Alternatius de Resolució de Conflictes (MASC), també coneguts en els països anglosaxons com a Alternative Dispute Resolutions (ADR), com a procediments alterns a la justícia ordinària per a resoldre conflictes i controvèrsies en seu empresarial, aprofundint en les tècniques de la negociació i de la mediació empresarials, i realitzant un estudi especial de la conflictologia empresarial més freqüent susceptible de ser resolta mitjantçant la mediació. Per últim, s’estudien els conflictes societaris, especialment en les societats de capital, així com els mecanismes admesos en Dret per a prevenir-los i evitar-los, amb la finalitat de facilitar una gestió adient del conflicte i simplificar-ne la seva solució. Tenint en compte la rellevància que l’empresa familiar té en la nostra economia, es realitza una anàlisi exahustiva de les seves principals característiques, i del protocol familiar com a instrument idoni per a ajudar a millorar el funcionament de l’empresa familiar i a reduïr-ne el potencial de conflicte.

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Peer-reviewed

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In this paper a brief outline of the origin and development of vocational guidance and career development during the 20thcentury is presented We elaborate a summary of the changes society has suffered during the last decades, and which affect career counselling either directly or indirectly, and which imply a need for modifications in the current approach to career counselling. Subsequently, we propose new perspectives that will be needed to face these changes, and which have been suggested by different authors. Also some competencies needed by career counselors while acting at different levels of intervention are suggested

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The aim of this Thesis is to study how to manage the front-end of the offering planning process. This includes actual process development and methods to gather and analyze information to achieve the best outcome in customer oriented product offering. Study is carried out in two parts: theoretical part and company related part. Theoretical framework is created introducing different types of approaches to manage product planning processes. Products are seen as platforms and they are broken down to subsystems to show different parts of the development. With the help of the matrix-based approaches product platform related information is gathered and analyzed. In this kind of analysis business/market drivers and cus-tomer/competitor information are connected with product subsystems. This gives possibilities to study product gaps/needs and possible future ideas/scenarios in different customer segments. Company related part consists of offering planning process development in real company environment. Process formation includes documents and tools that guide planning from the information gathering to the prioritization and decision making.

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[spa] El estudio afronta la regulación de los derechos de participación en los Estatutos de Autonomía de nueva generación. La novedad que representan estas normas respecto a sus predecesoras es la incorporación de una carta de derechos que vinculan de forma más explícita y detallada a los poderes públicos autonómicos. Los estatuyentes han interiorizado el creciente auge del fenómeno participativo regulando, junto a los tradicionales derechos de participación política, nuevos instrumentos y técnicas participativas, que se enmarcan en el concepto de democracia participativa. Significativa es, en este sentido, la voluntad política plasmada en la competencia que asumen algunos de ellos (Cataluña, Andalucía y Aragón)para la regulación de las consultas populares en cualquiera de sus modalidades ("encuestas, audiencias públicas, foros de participación") distintas el referéndum.

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Since we routinely put questions forward for discussion that involve urban planning in Barcelona, let's begin with one that might seem too obvious: What to do about its main street? We solicited the views of 13 professional architects and geographers who have some connection to the Rambla, either because they live or work nearby or once did professionals, in other words, who are intimately familiar with it. The range of their responses surprised us. Issues like making the Rambla car-free or the street's physical design, recurring themes in recent years, here take a back seat. Instead, questions about underlying urban structures and street-level uses come up repeatedly

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A lo largo de la última década, la heterogeneidad identitaria, lingüística, religiosa, cultural y étnica ha crecido de manera significativa en España debido a la llegada de inmigrantes, lo cual está planteando al Sistema Educativo problemas hasta ahora desconocidos. En este artículo se discuten las relaciones entre lengua, escuela e inmigración con un énfasis especial en los factores implicados en la adquisición de la lengua de uso escolar. Se discute tanto el tiempo que el alumnado inmigrante tarda en aprender dicha lengua como el papel de su lengua inicial en dicha adquisición. La discusión se realiza a partir del análisis de datos provenientes de evaluaciones internacionales, así como de trabajos de investigación realizados en situaciones escolares multilingües y se reflexiona sobre su pertinencia para el establecimiento de una política educativa que tenga en cuenta las dificultades de las y los inmigrantes con la adquisición y el dominio de la lengua de la escuela. Finalmente, se abordan las nuevas necesidades de los sistemas educativos en relación con alguno de los retos que plantea la educación intercultural y se enfatiza la importancia de la práctica educativa para encontrar soluciones a los problemas que se derivan de la nueva situación escolar

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Book review.

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The existence of a minimum storage capacity of grains as a condition for the maintenance of regulator physical stocks has been used as a strategic factor in the agribusiness expansion. However, in Brazil the storage infrastructure has not followed the growth of the agricultural sector. This fact is evident in the case of soybeans that currently represent 49% of grain production in the country, whose volume production has been increasing significantly over the years. This study aimed to predict the futureneeds of static storage capacity of soybeans from historical data to estimate the investment needed to install storage units in Brazil for the next five years. A statistic analysis of collected data allowed a forecast and identification of the number of storage units that should be installed to meet the storage needs of soybeans in the next five years. It was concluded that by 2015 the soybean storage capacity should be 87 million tons, and to store 49% of soybeans produced, 1,104 storage units should be installed at a cost of R$ 442 million.

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The principle of patient autonomy is a cornerstone of bioethics. According to this concept, patients should be given the power to make decisions related to their treatment. It is an important component of modern medical ethics, which has received much interest in current literature. However, the rate of participation of patients and their willingness to participate are variable according to the cultural, social and family environments in which they are inserted. The aim of this paper is to promote a brief descriptive review on autonomy, the preferences of patients and the use of informed consent as an instrument for the exercise of autonomy in literature, and to stress the lack of debate, as well as the pressing need for discussion of these current issues nationwide.