Understanding treatment-related symptoms, symptom management techniques, and symptom management self-efficacy in a sample of non-muscle invasive bladder cancer patients

The current literature available on bladder cancer symptom management from the perspective of the patients themselves is limited. There is also limited psychosocial research specific to bladder cancer patients and no previous studies have developed and validated measures for bladder cancer patients’ symptom management self-efficacy. The purpose of this study was to investigate non-muscle invasive bladder cancer patients’ health related quality of life through two main study objectives: (1) to describe the treatment related symptoms, reported effectiveness of symptom-management techniques, and the advice a sample of non-muscle invasive bladder cancer patients would convey to physicians and future patients; and (2) to evaluate Lepore’s symptom management self-efficacy measure on a sample of non-muscle invasive bladder cancer patients. Methods. A total of twelve (n=12) non-muscle invasive bladder cancer patients participated in an in-depth interview and a sample of 46 (n=4) non-muscle invasive bladder cancer patients participated in the symptom-management self-efficacy survey. Results. A total of five symptom categories emerged for the participants’ 59 reported symptoms. Four symptom management categories emerged out of the 71 reported techniques. A total of 62% of the participants’ treatment related symptom-management techniques were reported as effective in managing their treatment-related symptoms. Five advice categories emerged out of the in-depth interviews: service delivery; medical advice; physician-patient communication; encouragement; and no advice. An exploratory factor analysis indicated a single-factor structure for the total population and a multiple factor structure for three subgroups: all males, married males, and all married participants. Conclusion. These findings can inform physicians and patients of effective symptom-management techniques thus improving patients’ health-related quality of life. The advice these patients’ impart can improve service-delivery and patient education.^

A comparison of healthcare access, healthcare utilization and asthma self-management for Hispanic children in border and non-border regions of Texas

The purpose of this culminating experience was to investigate the relationships between healthcare utilization, insurance coverage, and socioeconomic characteristics of children with asthma along the Texas-Mexico Border. A secondary data analysis was conducted on cross-sectional data from the Texas Child Asthma Call-back Survey, a follow-up survey to the random digit dialed Behavior Risk Factor Surveillance Study (BRFSS) conducted between 2006-2009 ( n = 556 adults living in households with a child with asthma).^ The proportion of Hispanic children with asthma in Border areas of Texas was more than twice that of non-Border areas (84.8% vs. 28.8%). Parents in Border areas were less likely to have their own health insurance (OR = 0.251, 95% C.I. = 0.117-0.540) and less likely to complete the survey in English than Spanish (OR = 0.251 95% C.I. = 0.117-0.540) than parents in non-Border areas. No significant socio-economic or health care utilization differences were noted between Hispanic children living in Border areas compared to Hispanic children living in non-Border areas. Children with asthma along the Texas-Mexico Border, regardless of ethnicity and language, have insurance coverage rates, reported cost barriers to care, symptom management, and medication usage patterns similar to those in non-Border areas. When compared to English-speakers, Spanish-speaking parents in Texas as a whole are far less likely to be taught what to do during an asthma attack (50.2% vs. 78.6%).^ Language preference, rather than ethnicity or geographical residence, played a larger role on childhood asthma-related health disparities for children in Texas. Spanish-speaking parents in are less likely to receive adequate asthma self-management education. Investigating the effects of Hispanic acculturation rates and incongruent parent-child health insurance coverage may provide better insight into the health disparities of children along the Texas-Mexico Border.^

Future pandemic influenza control (FPIC) related strategic management plan based on the 2009 H1N1 pandemic influenza review of health policy decisions, their practice and implications

This cross-sectional study is based on the qualitative and quantitative research design to review health policy decisions, their practice and implications during 2009 H1N1 influenza pandemic in the United States and globally. The “Future Pandemic Influenza Control (FPIC) related Strategic Management Plan” was developed based on the incorporation of the “National Strategy for Pandemic Influenza (2005)” for the United States from the U.S. Homeland Security Council and “The Canadian Pandemic Influenza Plan for the Health Sector (2006)” from the Canadian Pandemic Influenza Committee for use by the public health agencies in the United States as well as globally. The “global influenza experts’ survey” was primarily designed and administered via email through the “Survey Monkey” system to the 2009 H1N1 influenza pandemic experts as the study respondents. The effectiveness of this plan was confirmed and the approach of the study questionnaire was validated to be convenient and the excellent quality of the questions provided an efficient opportunity to the study respondents to evaluate the effectiveness of predefined strategies/interventions for future pandemic influenza control.^ The quantitative analysis of the responses to the Likert-scale based questions in the survey about predefined strategies/interventions, addressing five strategic issues to control future pandemic influenza. The effectiveness of strategies defined as pertinent interventions in this plan was evaluated by targeting five strategic issues regarding pandemic influenza control. For the first strategic issue pertaining influenza prevention and pre pandemic planning; the confirmed effectiveness (agreement) for strategy (1a) 87.5%, strategy (1b) 91.7% and strategy (1c) 83.3%. The assessment of the priority level for strategies to address the strategic issue no. (1); (1b (High Priority) > 1a (Medium Priority) > 1c (Low Priority) based on the available resources of the developing and developed countries. For the second Strategic Issue encompassing the preparedness and communication regarding pandemic influenza control; the confirmed effectiveness (agreement) for the strategy (2a) 95.6%, strategy (2b) 82.6%, strategy (2c) 91.3% and Strategy (2d) 87.0%. The assessment of the priority level for these strategies to address the strategic issue no. (2); (2a (highest priority) > 2c (high priority) >2d (medium priority) > 2b (low priority). For the third strategic issue encompassing the surveillance and detection of pandemic influenza; the confirmed effectiveness (agreement) for the strategy (3a) 90.9% and strategy (3b) 77.3%. The assessment of the priority level for theses strategies to address the strategic Issue No. (3) (3a (high priority) > 3b (medium/low priority). For the fourth strategic issue pertaining the response and containment of pandemic influenza; the confirmed effectiveness (agreement) for the strategy (4a) 63.6%, strategy (4b) 81.8%, strategy (4c) 86.3%, and strategy (4d) 86.4%. The assessment of the priority level for these strategies to address the strategic issue no. (4); (4d (highest priority) > 4c (high priority) > 4b (medium priority) > 4a (low priority). The fifth strategic issue about recovery from influenza and post pandemic planning; the confirmed effectiveness (agreement) for the strategy (5a) 68.2%, strategy (5b) 36.3% and strategy (5c) 40.9%. The assessment of the priority level for strategies to address the strategic issue no. (5); (5a (high priority) > 5c (medium priority) > 5b (low priority).^ The qualitative analysis of responses to the open-ended questions in the study questionnaire was performed by means of thematic content analysis. The following recurrent or common “themes” were determined for the future implementation of various predefined strategies to address five strategic issues from the “FPIC related Strategic Management Plan” to control future influenza pandemics. (1) Pre Pandemic Influenza Prevention, (2) Seasonal Influenza Control, (3) Cost Effectiveness of Non Pharmaceutical Interventions (NPI), (4) Raising Global Public Awareness, (5) Global Influenza Vaccination Campaigns, (6)Priority for High Risk Population, (7) Prompt Accessibility and Distribution of Influenza Vaccines and Antiviral Drugs, (8) The Vital Role of Private Sector, (9) School Based Influenza Containment, (10) Efficient Global Risk Communication, (11) Global Research Collaboration, (12) The Critical Role of Global Public Health Organizations, (13) Global Syndromic Surveillance and Surge Capacity and (14) Post Pandemic Recovery and Lessons Learned. The future implementation of these strategies with confirmed effectiveness to primarily “reduce the overall response time’ in the process of ‘early detection’, ‘strategies (interventions) formulation’ and their ‘implementation’ to eventually ensure the following health outcomes: (a) reduced influenza transmission, (b) prompt and effective influenza treatment and control, (c) reduced influenza related morbidity and mortality.^

Trabajo social e intervención profesional : la violencia y su impacto en los adolescentes : aportes al diseño de políticas sociales para la no violencia

El presente trabajo nace como proyección de la tesis de Maestría presentada para obtener el título de Magister en Políticas Sociales y Gestión Local de la Universidad de Artes y Ciencias Sociales (ARCIS) de Chile. Se basa en una investigación de carácter cualitativo en el que el Trabajo Social centra su mirada en la problemática de la violencia como parte de la conflictividad actual y como emergente de la cuestión social, consecuencia manifiesta de la aplicación del modelo neoliberal en nuestro país. En este escenario, los adolescentes ven violentados sus derechos por lo que resulta fundamental analizar el impacto de la violencia en ellos, en sus relaciones interpersonales y con su contexto. Nuestro interés profesional es aportar elementos teórico-conceptuales y prácticos tendientes a favorecer la transformación de las relaciones del tejido social dirigida hacia un contexto de no violencia.

Lo que la escuela no mira, la AUH 'non presta' : Experiencia escolar de jóvenes en condición de vulnerabilidad social

El trabajo analiza las condiciones de construcción de la experiencia escolar de jóvenes de sectores vulnerables a partir de la implementación en el 2009 de la política de Asignación Universal por Hijo para la Protección Social (AUH) en escuelas secundarias de la provincia de Buenos Aires, Argentina. La AUH se diferencia de las intervenciones sectoriales de los '90 al proponer una estrategia más integral y de responsabilidad estatal frente al cumplimiento de las condicionalidades de salud y educación que la medida establece. Pero esta política llega a la escuela secundaria en el marco de dos importantes y contradictorias transformaciones: la extensión de la obligatoriedad escolar y la segregación educativa, producto de las políticas focalizadas compensatorias de los '90 y de las estrategias de distinción de las familias. Frente a estas condiciones, nos interrogamos por los procesos de resignificación de lapolítica a nivel de las instituciones y los actores ya que allí se juega el aporte de la medida a la democratización de la educación. Los procesos de inclusión escolar dependen no sólo de normas formalmente establecidas, sino de cómo éstas son mediadas por las interpretaciones de los agentes,mejorando u obturando la capacidad de la escuela secundaria de aportar a la configuración de experiencias educativas subjetivantes

Information Management and Mediation in a Digital Reference Service Focused in Social Sciences

This paper investigates the current relationship between information management and information mediation along with the digital reference service through a case study which took place in an academic library. The concept of information mediation is herein analyzed, since a conceptual examination provides elements that will help people to comprehend and evaluate the concerned service. The information professional plays a very important role in the mediation aforementioned, which may be directly or indirectly; consciously or unconsciously; by himself/herself or plurally; individually or inserted into a group ? in all such manners that mediator facilitates the acquisition of information, fully or partially satisfying a user?s need of all sorts of knowledge. Meanwhile, we here approach information management from a scope that points out a description over performed activities concerned to policies and procedures put into effect until the service evaluation by proposing a criterion for such point. Finally, we outline a few actions to be implemented in long-term perspective, which goal is to continually ameliorate such assistance, taking in account the human factor

Information Management and Mediation in a Digital Reference Service Focused in Social Sciences

This paper investigates the current relationship between information management and information mediation along with the digital reference service through a case study which took place in an academic library. The concept of information mediation is herein analyzed, since a conceptual examination provides elements that will help people to comprehend and evaluate the concerned service. The information professional plays a very important role in the mediation aforementioned, which may be directly or indirectly; consciously or unconsciously; by himself/herself or plurally; individually or inserted into a group ? in all such manners that mediator facilitates the acquisition of information, fully or partially satisfying a user?s need of all sorts of knowledge. Meanwhile, we here approach information management from a scope that points out a description over performed activities concerned to policies and procedures put into effect until the service evaluation by proposing a criterion for such point. Finally, we outline a few actions to be implemented in long-term perspective, which goal is to continually ameliorate such assistance, taking in account the human factor

Lo que la escuela no mira, la AUH 'non presta' : Experiencia escolar de jóvenes en condición de vulnerabilidad social

El trabajo analiza las condiciones de construcción de la experiencia escolar de jóvenes de sectores vulnerables a partir de la implementación en el 2009 de la política de Asignación Universal por Hijo para la Protección Social (AUH) en escuelas secundarias de la provincia de Buenos Aires, Argentina. La AUH se diferencia de las intervenciones sectoriales de los '90 al proponer una estrategia más integral y de responsabilidad estatal frente al cumplimiento de las condicionalidades de salud y educación que la medida establece. Pero esta política llega a la escuela secundaria en el marco de dos importantes y contradictorias transformaciones: la extensión de la obligatoriedad escolar y la segregación educativa, producto de las políticas focalizadas compensatorias de los '90 y de las estrategias de distinción de las familias. Frente a estas condiciones, nos interrogamos por los procesos de resignificación de lapolítica a nivel de las instituciones y los actores ya que allí se juega el aporte de la medida a la democratización de la educación. Los procesos de inclusión escolar dependen no sólo de normas formalmente establecidas, sino de cómo éstas son mediadas por las interpretaciones de los agentes,mejorando u obturando la capacidad de la escuela secundaria de aportar a la configuración de experiencias educativas subjetivantes

Lo que la escuela no mira, la AUH 'non presta' : Experiencia escolar de jóvenes en condición de vulnerabilidad social

El trabajo analiza las condiciones de construcción de la experiencia escolar de jóvenes de sectores vulnerables a partir de la implementación en el 2009 de la política de Asignación Universal por Hijo para la Protección Social (AUH) en escuelas secundarias de la provincia de Buenos Aires, Argentina. La AUH se diferencia de las intervenciones sectoriales de los '90 al proponer una estrategia más integral y de responsabilidad estatal frente al cumplimiento de las condicionalidades de salud y educación que la medida establece. Pero esta política llega a la escuela secundaria en el marco de dos importantes y contradictorias transformaciones: la extensión de la obligatoriedad escolar y la segregación educativa, producto de las políticas focalizadas compensatorias de los '90 y de las estrategias de distinción de las familias. Frente a estas condiciones, nos interrogamos por los procesos de resignificación de lapolítica a nivel de las instituciones y los actores ya que allí se juega el aporte de la medida a la democratización de la educación. Los procesos de inclusión escolar dependen no sólo de normas formalmente establecidas, sino de cómo éstas son mediadas por las interpretaciones de los agentes,mejorando u obturando la capacidad de la escuela secundaria de aportar a la configuración de experiencias educativas subjetivantes

Information Management and Mediation in a Digital Reference Service Focused in Social Sciences

This paper investigates the current relationship between information management and information mediation along with the digital reference service through a case study which took place in an academic library. The concept of information mediation is herein analyzed, since a conceptual examination provides elements that will help people to comprehend and evaluate the concerned service. The information professional plays a very important role in the mediation aforementioned, which may be directly or indirectly; consciously or unconsciously; by himself/herself or plurally; individually or inserted into a group ? in all such manners that mediator facilitates the acquisition of information, fully or partially satisfying a user?s need of all sorts of knowledge. Meanwhile, we here approach information management from a scope that points out a description over performed activities concerned to policies and procedures put into effect until the service evaluation by proposing a criterion for such point. Finally, we outline a few actions to be implemented in long-term perspective, which goal is to continually ameliorate such assistance, taking in account the human factor

An example of integration between en economic and an hydrologic model in the framework of water resource management problems

Growing scarcity, increasing demand and bad management of water resources are causing weighty competition for water and consequently managers are facing more and more pressure in an attempt to satisfy users? requirement. In many regions agriculture is one of the most important users at river basin scale since it concentrates high volumes of water consumption during relatively short periods (irrigation season), with a significant economic, social and environmental impact. The interdisciplinary characteristics of related water resources problems require, as established in the Water Framework Directive 2000/60/EC, an integrated and participative approach to water management and assigns an essential role to economic analysis as a decision support tool. For this reason, a methodology is developed to analyse the economic and environmental implications of water resource management under different scenarios, with a focus on the agricultural sector. This research integrates both economic and hydrologic components in modelling, defining scenarios of water resource management with the goal of preventing critical situations, such as droughts. The model follows the Positive Mathematical Programming (PMP) approach, an innovative methodology successfully used for agricultural policy analysis in the last decade and also applied in several analyses regarding water use in agriculture. This approach has, among others, the very important capability of perfectly calibrating the baseline scenario using a very limited database. However one important disadvantage is its limited capacity to simulate activities non-observed during the reference period but which could be adopted if the scenario changed. To overcome this problem the classical methodology is extended in order to simulate a more realistic farmers? response to new agricultural policies or modified water availability. In this way an economic model has been developed to reproduce the farmers? behaviour within two irrigation districts in the Tiber High Valley. This economic model is then integrated with SIMBAT, an hydrologic model developed for the Tiber basin which allows to simulate the balance between the water volumes available at the Montedoglio dam and the water volumes required by the various irrigation users.

A proposal for a flexible scheduling and memory management scheme for non-deterministic, andparallel execution of logic programs

In this paper, we examine the issue of memory management in the parallel execution of logic programs. We concentrate on non-deterministic and-parallel schemes which we believe present a relatively general set of problems to be solved, including most of those encountered in the memory management of or-parallel systems. We present a distributed stack memory management model which allows flexible scheduling of goals. Previously proposed models (based on the "Marker model") are lacking in that they impose restrictions on the selection of goals to be executed or they may require consume a large amount of virtual memory. This paper first presents results which imply that the above mentioned shortcomings can have significant performance impacts. An extension of the Marker Model is then proposed which allows flexible scheduling of goals while keeping (virtual) memory consumption down. Measurements are presented which show the advantage of this solution. Methods for handling forward and backward execution, cut and roll back are discussed in the context of the proposed scheme. In addition, the paper shows how the same mechanism for flexible scheduling can be applied to allow the efficient handling of the very general form of suspension that can occur in systems which combine several types of and-parallelism and more sophisticated methods of executing logic programs. We believe that the results are applicable to many and- and or-parallel systems.

The facility manager architect : the social responsability as an added value.

From the very first steps to execute a building, it is essential to analyze its life cycle. Similarly, we should consider the life cycle when projecting an urban intervention. Professionals of the Facility Management take part in construction projects, developing and managing DBFMO projects (Design, Build, Finance, Maintenance & Operate). Whatever the nature of the promoter is – private or public – promoters are leaders in projects of responsible management of spaces, whether these are work spaces, leisure spaces or residential spaces. They know and identify with the company and its performance, its values and its needs. These professionals give sustainable solutions in the life cycle of buildings (offices and housing), new ways to work and initiatives of innovations linked to current social changes: technology, social networks, and new habits. Concepts where innovation is essential should consider responsible values. Social, economic and sustainable aspects have to associate with the management performed by a Facilities Manager when considering the three groups of stakeholders with which it is linked: economic (shareholders), contractual (users), non-contractual (neighborhoods, organizations, etc.). Marcus Vitruvius Pollio, at the beginning of his book "The Ten Books on Architecture" describes and argues how the distribution in buildings must always adapt to their inhabitants. Let us build cities and buildings with responsible criteria, bearing in mind all its users and the needs of each one of them. Not to mention the need to adapt to future requirements with minimum cost and maximum profitability. These needs, under responsible management, are competencies developed by a Facilities Manager in his day to day. He cares and takes over the entire life cycle of buildings and their surroundings. This work is part of the PhD project whose main aim is to study the added value to the architectural profession when social responsibility criteria are applied in his/her role as Facility Manager.

Efficiency analysis of information technology and online social networks management : an integrated DEA-Model assessment

This paper analyses the relationship between productive efficiency and online-social-networks (OSN) in Spanish telecommunications firms. A data-envelopment-analysis (DEA) is used and several indicators of business ?social Media? activities are incorporated. A super-efficiency analysis and bootstrapping techniques are performed to increase the model?s robustness and accuracy. Then, a logistic regression model is applied to characterise factors and drivers of good performance in OSN. Results reveal the company?s ability to absorb and utilise OSNs as a key factor in improving the productive efficiency. This paper presents a model for assessing the strategic performance of the presence and activity in OSN.

People, management and social responsability. The team: the main asset of any management

People, management and social responsability. The team: the main asset of any management. En colaboración con Dña. Montserrat Castellanos Moreno. Profesora Asociada de la Universidad Europea. Journal of Management and Marketing. Thomson Reuters. Zilina. Slovakia