Cuidado ao paciente idoso hospitalizado: implicações para a equipe de enfermagem

The Brazilian population is ageing rapidly, and chronic diseases have increased. Due to deficient health care services, the diagnosis and treatment of such diseases occur in the tertiary level, which increases costs and reduces the possibilities of early diagnoses. In view of the elderly population‟s increase and of the great demand at hospitalization units, it is important to learn about the difficulties and facilities faced by nursing teams when giving care to hospitalized individuals. In order to reach the objectives, a cross-sectional, prospective, descriptive, analytical and qualitative study was performed with basis on Bardin‟s Content Analysis. Among the difficulties were patients‟ limitations, dependence level, behaviors and habits, interference from companions, feeling of abandonment, perception of needs, dealing with suffering and lack of time for adequate care. As to facilities, acceptance of the disease, adherence to treatment, collaboration, trust in the team, and older patients‟ politeness were reported, which shows that passiveness is an important indicator in caring for the elderly. Older individuals suffer the outcomes of certain physical, psychological and mental deficits. When facing disease conditions, they require special care, including hospitalization and greater attention. The nursing team provides daily care and follows patients‟ development; however, its members are still not knowledgeable enough about the ageing process. This contributes to increase prejudice and erroneous stereotypes about older persons. Therefore, not understanding such process compromises the full care to be provided to older patients. This leads team members to accelerate the care provision process in order to meet the daily work demand, thus compromising older patients‟ autonomy and making them more dependent on the team, whereas the process should follow the opposite path

Fóruns no ambiente Teleduc: reflexões sobre o papel dos mediadores e estratégias de gerenciamento de debates

Online discussion forums have been widely used in internet-mediated courses and blended courses. In these learning contexts, the mediator's (or tutor's) role in supporting successful learning is of considerable importance. Firstly, the present article discusses some studies in which the mediator's role in online learning environments is emphasized. Secondly, we use this discussion to support our qualitative case-study analysis, in which we investigated mediators' debate-management strategies in TelEduc virtual forums. Lastly, we propose a reflective framework about management strategies in forums in virtual learning platforms.

Avaliação da participação e confiabilidade da população em relação à campanha de vacinação anual contra a raiva de cães e gatos no município de Botucatu, São Paulo, Brasil

The annual vaccination campaign against rabies is the most effective prevention procedure for this disease in dogs and cats and hence for human protection also. However, in 2010 and 2011, this activity was interrupted in Brazil due to the occurrence of adverse events associated with vaccination. Even though cases of canine rabies have been decreasing in the last two decades, vigilance must be strengthened in order to maintain pet owners trust in the vaccines provided in public services. This study aimed to determine pet owners participation in the annual vaccination campaign carried out in Botucatu. During March and April 2012, the period before the 42nd campaign, 312 pet owners, dogs and cats, were interviewed. The homes were randomly drawn in blocks from different sectors of the city; all houses on the same block over the 120 km² of urban area participated in the sampling process. Statistical analysis was performed descriptively. The results showed that the owners main motivation to vaccinate their pets during the campaigns is rabies prevention (36%), followed by the proximity of the vaccination station to the house (20.7%), zero cost (10.9%), and the combination of all three factors (16.1%). When asked if they would take their animals back to be vaccinated in another campaign, 60.1% answered yes, 13.5% would go to a private clinic, 2.2% would not take because they do not trust the vaccine and 1.6% had not decided yet. We conclude that the respondents have realized how dangerous Rabies is, because even after the break period, they still utilized the vaccination campaign demonstrating confidence in its effectiveness, while knowing the campaign goals facilitates understanding and participation.

Repensando a metodologia do Índice de Potencial de Consumo (IPC) para estudos sobre consumo nas cidades medias

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Repensando a metodologia do Índice de Potencial de Consumo (IPC) para estudos sobre consumo nas cidades medias

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Entornos colaborativos y ubicuos para el desarrollo de estrategias orientadas al aprendizaje significativo

[EN]This paper aims to provide guidance on how to take advantage existing resources in Internet, for which a study about what is "Collaborative Learning" and conditions for the design of collaborative strategies, is done. The concept of "Ubiquitous Learning" is analyzed as an extension or a natural evolution of E-Learning and M-Learning. At the end, the activities carried out within a presential class supported by technologies in order to generate strategies for meaningful learning will be described. [ES]Este documento tiene por objeto proporcionar orientación sobre cómo aprovechar los recursos que existen en Internet, como parte de un estudio sobre lo que es "aprendizaje colaborativo" y cuáles son las condiciones para el diseño de estrategias de colaboración. El concepto de "aprendizaje ubicuo" se analiza como una extensión o una evolución natural de E-Learning y m- Learning. Al final del documento, se describen las actividades llevadas a cabo, como apoyo a una clase presencial usando herramientas virtuales, con el fin de generar estrategias para el aprendizaje significativo.

Reti socievoli: l’impatto dei social networks nella costruzione dello spazio pubblico

La tesi si è consolidata nell’analisi dell’impatto dei social networks nella costruzione dello spazio pubblico, nella sfera di osservazione che è la rete e il web2.0. Osservando che il paradigma della società civile si sia modificato. Ridefinendo immagini e immaginari e forme di autorappresentazione sui new media (Castells, 2010). Nel presupposto che lo spazio pubblico “non è mai una realtà precostituita” (Innerarity, 2008) ma si muove all’interno di reti che generano e garantiscono socievolezza. Nell’obiettivo di capire cosa è spazio pubblico. Civic engagement che si rafforza in spazi simbolici (Sassen, 2008), nodi d’incontro significativi. Ivi cittadini-consumatori avanzano corresponsabilmente le proprie istanze per la debacle nei governi.. Cultura partecipativa che prende mossa da un nuovo senso civico mediato che si esprime nelle “virtù” del consumo critico. Portando la politica sul mercato. Cultura civica autoattualizzata alla ricerca di soluzioni alle crisi degli ultimi anni. Potere di una comunicazione che riduce il mondo ad un “villaggio globale” e mettono in relazione i pubblici connessi in spazi e tempi differenti, dando origine ad azioni collettive come nel caso degli Indignados, di Occupy Wall Street o di Rai per una notte. Emerge un (ri)pensare la citizenship secondo due paradigmi (Bennett,2008): l’uno orientato al governo attraverso i partiti, modello “Dutiful Citizenship”; l’altro, modello “Self Actualizing Citizenship” per cui i pubblici attivi seguono news ed eventi, percepiscono un minor obbligo nel governo, il voto è meno significativo per (s)fiducia nei media e nei politici. Mercato e società civile si muovono per il bene comune e una nuova “felicità”. La partecipazione si costituisce in consumerismo politico all’interno di reti in cui si sviluppano azioni individuali attraverso il social networking e scelte di consumo responsabile. Partendo dall’etnografia digitale, si è definito il modello “4 C”: Conoscenza > Coadesione > Co-partecipazione > Corresposabilità (azioni collettive) > Cultura-bility.

Il principio di proporzionalità nella disciplina del mandato d'arresto europeo

Il presente lavoro affronta un tema di particolare attualità nella applicazione del mandato d’arresto europeo. Pensate per il contrasto alle forme più gravi di criminalità, le procedure di consegna hanno trovato sempre più spesso applicazione per vicende criminose di scarsa offensività, determinando conseguenze gravi sui diritti fondamentali degli individui coinvolti e mettendo a rischio la reciproca fiducia tra gli Stati membri nello spazio di libertà, sicurezza e giustizia. Ciò ha imposto alle istituzioni europee di richiamare gli Stati membri al rispetto del principio di proporzionalità, quale principio generale del diritto europeo. Il presente studio analizza i presupposti e le modalità di applicazione di tale principio, alla luce del nuovo assetto impresso all’Unione dal Trattato di Lisbona e nella prospettiva dei diritti fondamentali. In particolare, esso si sofferma sul ruolo da attribuire, rispetto allo specifico tema, alla Carta dei diritti fondamentali dell’Unione ed all’art. 52 par. 1 in essa previsto, ove emerge la valenza costituzionale del principio di proporzionalità.

Analisi del protocollo Tor e del simulatore Shadow

L’obiettivo che si pone questa tesi è quello di analizzare alcune soluzioni esistenti riguardo i problemi riguardanti privacy e sicurezza informatica. Nello specifico sarà illustrato il programma Tor, un sistema di comunicazione grazie al quale si garantisce l’anonimato in Internet. Sponsorizzato inizialmente dall’US Naval Research Laboratory, all’origine veniva utilizzato per poter effettuare comunicazioni militari criptate; è stato successivamente un progetto della Electronic Frontier Foundation ed ora è gestito da The Tor Project, un’associazione senza scopo di lucro che si occupa del relativo sviluppo. Le ricerche e gli sviluppi riguardanti questa tecnologia vengono tuttavia resi difficili da problemi di scalabilità e dalla difficoltà di riprodurre risultati affidabili. Nel corso della tesi saranno illustrati gli studi riguardanti il simulatore Shadow, un progetto Open Source gestito da The Tor Project, che permette la simulazione del protocollo Tor. I risultati ottenuti dai test effettuati sul simulatore, possono essere riapplicati in seguito alla rete reale Tor, poiché grazie a Shadow è possibile testare ed ottenere risultati attendibili circa il comportamento e la corretta esecuzione del software Tor.

Patrimonio e patrimoni: Alla ricerca dei confini attuali della responsabilita' patrimoniale

Il presente lavoro di tesi mira a ricostruire lo scenario evolutivo della responsabilità patrimoniale del debitore, a partire dai principi generali sanciti dall'art. 2740 c.c. sino al diffondersi, sempre più dilagante negli anni più recenti, del fenomeno dei patrimoni separati, il quale ha contribuito a quella che è stata definita da autorevole dottrina l’“erosione” del carattere universale della responsabilità patrimoniale. In questa prospettiva, la ricerca condotta dall'autore si propone il duplice obiettivo di dimostrare, da un lato, l’ormai sostanziale ribaltamento del rapporto regola(garanzia generica)–eccezione(separazione patrimoniale) previsto dalla norma succitata, e, dall’altro, il ridimensionamento del valore della riserva di legge imposta dal secondo comma dell’art. 2740 c.c. con riguardo all’individuazione e alla disciplina dei patrimoni separati, dovuto all’affermarsi di forme di segregazione di carattere generale e flessibile ed al conseguente potenziamento del ruolo assunto dall’autonomia privata nel campo della separazione patrimoniale. Al perseguimento di tale obiettivo si aggiunge, inoltre, una valutazione dei nuovi orizzonti del fenomeno della separazione patrimoniale e, in particolare, dei segnali di apertura del nostro ordinamento all’adozione di una regolamentazione interna del trust, i cui vantaggi e la cui compatibilità con il nostro sistema giuridico vengono dimostrati attraverso il confronto con la disciplina dell'istituto in esame nell’ordinamento inglese.

Servizi Sociali Territoriali e Università: Esempi di Sinergie Possibili per un Percorso di Qualità

Although – or because – social work education in Italy has for some 15 years now been exclusively in the domain of the university the relationship between the academic world and that of practice has been highly tenuous. Research is indeed being conducted by universities, but rarely on issues that are of immediate practice relevance. This means that forms of practice develop and become established habitually which are not checked against rigorous standards of research and that the creation of knowledge at academic level pays scant attention to the practice implications of social changes. This situation has been made even worse by the dwindling resources both in social services and at the level of the universities which means that bureaucratic procedures or imports of specialisations from other disciplines frequently dominate the development of practice instead of a theory-based approach to methodology. This development does not do justice to the actual requirements of Italian society faced with ever increasing post-modern complexity which is reflected also in the nature of social problems because it implies a continuation of a faith in modernity with its idea of technical, clear-cut solutions while social relations have decidedly moved beyond that belief. This discrepancy puts even greater strain on the personnel of welfare agencies and does ultimately not satisfy the ever increasing demands for quality and accountability of services on the part of users and the general public. Social workers badly lack fundamental theoretical reference points which could guide them in their difficult work to arrive at autonomous, situation-specific methodological answers not based on procedures but on analytical knowledge. Thirty years ago, in 1977, a Presidential Decree created the legal basis for the establishment of social service departments at the level of municipalities which created opportunities for the direct involvement of the community in the fight against exclusion. For this potential to be fully utilized it would have required the bringing together of three dimensions, the organizational structure, the opportunities for learning and research in the territory and the contribution by the professional community. As this did not occur social services in Italy still often retain the character of charity which does not concern itself with the actual causes of poverty and exclusion. This in turn affects the relationship with citizens in general who cannot develop trust in those services. Through uncritical processes of interaction Edgar Morin’s dictum manifests itself which is that without resorting to critical reflection on complexity interventions can often have an effect that totally the opposite to the original intention. An important element in setting up a dynamic interchange between academia and practice is the placement on professional social work courses. Here the looping of theory to practice and back to theory etc. can actually take place under the right organizational and conceptual conditions, more so than in abstract, and for practitioners often useless debates about the theory-practice connection. Furthermore, research projects at the University of Florence Social Work Department for instance aim at fostering theoretical reflection at the level of and with the involvement of municipal social service agencies. With a general constructive disposition towards research and some financial investment students were facilitated to undertake social service practice related research for their degree theses for instance in the city of Pistoia. In this way it was also possible to strengthen the confidence and professional identity of social workers as they became aware of the contribution their own discipline can make to practice-relevant research instead of having to move over to disciplines like psychology for those purposes. Examples of this fruitful collaboration were presented at a conference in Pistoia on 25 June 2007. One example is a thesis entitled ‘The object of social work’ and examines the difficult development of definitions of social work and comes to the conclusion that ‘nothing is more practical than a theory’. Another is on coping abilities as a necessary precondition for the utilization of resources supplied by social services in exceptional circumstances. Others deal with the actual sequence of interventions in crisis situations, and one very interestingly looks at time and how it is being constructed often differently by professionals and clients. At the same time as this collaboration on research gathers momentum in the Toscana, supervision is also being demanded more forcefully as complementary to research and with the same aim of profiling more strongly the professional identity of social work. Collaboration between university and social service filed is for mutual benefit. At a time when professional practice is under threat of being defined from the outside through bureaucratic prescriptions a sound grounding in theory is a necessary precondition for competent practice.

Online social networks: why we disclose

On online social networks such as Facebook, massive self-disclosure by users has attracted the attention of industry players and policymakers worldwide. Despite the impressive scope of this phenomenon, very little is understood about what motivates users to disclose personal information. Integrating focus group results into a theoretical privacy calculus framework, we develop and empirically test a Structural Equation Model of self-disclosure with 259 subjects. We find that users are primarily motivated to disclose information because of the convenience of maintaining and developing relationships and platform enjoyment. Countervailing these benefits, privacy risks represent a critical barrier to information disclosure. However, users’ perception of risk can be mitigated by their trust in the network provider and availability of control options. Based on these findings, we offer recommendations for network providers.

Privacy Calculus on Social Networking Sites: Explorative Evidence from Germany and USA

Worldwide social networks, like Facebook, face fierce competition from local platforms when expanding globally. To remain attractive social network providers need to encourage user self-disclosure. Yet, little research exists on how cultural differences impact selfdisclosure on these platforms. Addressing this gap, this study explores the differences in perceptions of disclosure-relevant determinants between German and US users. Survey of Facebook members indicates that German users expect more damage and attribute higher probability to privacy-related violations. On the other hand, even though American users show higher level of privacy concern, they extract more benefits from their social networking activities, have more trust in the service provider and legal assurances as well as perceive more control. These factors may explain a higher level of self-disclosure indicated by American users. Our results provide relevant insights for the social network providers who can adjust their expansion strategy with regard to cultural differences.

Between anxiety and hope: the experiences of women with vulval intraepithelial neoplasia during their illness trajectory - a qualitative approach

The vulvar intraepithelial neoplasia (VIN) is a rare chronic skin condition that may progress to an invasive carcinoma of the vulva. Major issues affecting women's health were occurring symptoms, negative influences on sexuality, uncertainty concerning the illness progression and changes in the body image. Despite this, there is little known about the lived experiences of the illness trajectory. Therefore, the aim of this study was to describe the experiences of women with VIN during the illness trajectory. In a secondary data analysis of the foregoing qualitative study we analysed eight narrative interviews with women with VIN by using thematic analysis in combination with critical hermeneutics. Central for these women during their course of illness was a sense of "Hope and Fear". This constitutive pattern reflects the fear of recurrence but also the trust in healing. The eight narratives showed women's experiences during their course of illness occurred in five phases: "there is something unknown"; "one knows, what IT is"; "IT is treated and should heal"; "IT has effects on daily life"; "meanwhile it works". Women's experiences were particularly influenced by the feeling of "embarrassment" and by "dealing with professionals". Current care seems to lack adequate support for women with VIN to manage these phases. We suggest, based on our study and the international literature, that new models of counselling and providing information need to be developed and evaluated.

Using technology to enhance decision making

We focus here on decision making in the everyday clinical situation and do not address decision making in politics and administration, although obviously it affects clinical practice and vice versa. For example, decisions against providing sufficient face-to-face psychotherapy is one factor that may increase the demand for Internet therapy, and vice versa—that is, the use of technology for therapy, as in Internet therapy, might influence to what extent face-to-face therapy needs to be provided. It is obvious that the aggregation of information for political and administrative decisions can take advantage of technology. If technology is used professionally, this should contribute to better informed decisions and less dependency on information provided by lobbyists who might not work in the interest of high-quality service for those who need it. An optimistic view is thus that technology works in favor of patients on this level as well. In the interest of keeping the focus of this chapter manageable, we also do not address treatments fully delivered over the Internet or computers, as for the example described in Comer and Barlow (2014), although such treatments, as they unfold, of course also include decision making.