Somatisation in primary care: experiences of primary care physicians involved in a training program and in a randomised controlled trial

Background: A new intervention aimed at managing patients with medically unexplained symptoms (MUS) based on a specific set of communication techniques was developed, and tested in a cluster randomised clinical trial. Due to the modest results obtained and in order to improve our intervention we need to know the GPs' attitudes towards patients with MUS, their experience, expectations and the utility of the communication techniques we proposed and the feasibility of implementing them. Physicians who took part in 2 different training programs and in a randomised controlled trial (RCT) for patients with MUS were questioned to ascertain the reasons for the doctors' participation in the trial and the attitudes, experiences and expectations of GPs about the intervention. Methods: A qualitative study based on four focus groups with GPs who took part in a RCT. A content analysis was carried out. Results: Following the RCT patients are perceived as true suffering persons, and the relationship with them has improved in GPs of both groups. GPs mostly valued the fact that it is highly structured, that it made possible a more comfortable relationship and that it could be applied to a broad spectrum of patients with psychosocial problems. Nevertheless, all participants consider that change in patients is necessary; GPs in the intervention group remarked that that is extremely difficult to achieve. Conclusion: GPs positively evaluate the communication techniques and the interventions that help in understanding patient suffering, and express the enormous difficulties in handling change in patients. These findings provide information on the direction in which efforts for improving intervention should be directed.

El mundo de abajo. Aproximaciones a la connotación simbólica de lo subterráneo a través de la exploración artística desde el recorrido, la memoria y la acción

413 p. : il., col.

Intermediate serial cost-sharing rules

In this paper we give a generalization of the serial cost-sharing rule defined by Moulin and Shenker (1992) for cost sharing problems. According to the serial cost sharing rule, agents with low demands of a good pay cost increments associated with low quantities in the production process of that good. This fact might not always be desirable for those agents, since those cost increments might be higher than others, for example with concave cost functions. In this paper we give a family of cost sharing rules which allocates cost increments in all the possible places in the production process. And we characterize axiomatically each of them by means of an axiomatic characterization related to the one given for the serial cost-sharing rule by Moulin and Shenker (1994).

El ácido all trans retinoico reduce in vitro el efecto protumoral de los factores de crecimiento e incrementa la eficacia de la quimioterapia en el rabdomiosarcoma S4MH

257 p.

El caso del colegio "San Martín" de Donostia

Nivel educativo: Grado. Duración (en horas): De 41 a 50 horas

Approaches towards increasing domestic fish production in Nigeria: "Fish for All"

The paper critically examines the factors militating against domestic fish production in artisanal, aquacultural and industrial sectors in Nigeria. Approaches towards increasing fish production from all these sectors were suggested and discussed in line with the National Economic Empowerment Development Strategy (NEEDS) and Poverty Alleviation programmes of the Federal Government to meet the nation's fish protein requirement within the next three years

Design for all: designing for the motion-impaired user

Designing for all requires the adaptation and modification of current design best practices to encompass a broader range of user capabilities. This is particularly the case in the design of the human-product interface. Product interfaces exist everywhere and when designing them, there is a very strong temptation to jump to prescribing a solution with only a cursory attempt to understand the nature of the problem. This is particularly the case when attempting to adapt existing designs, optimised for able-bodied users, for use by disabled users. However, such approaches have led to numerous products that are neither usable nor commercially successful. In order to develop a successful design approach it is necessary consider the fundamental structure of the design process being applied. A three stage design process development strategy which includes problem definition, solution development and solution evaluation, should be adopted. This paper describes the development of a new design approach based on the application of usability heuristics to the design of interfaces. This is illustrated by reference to a particular case study of the re-design of a computer interface for controlling an assistive device.

Familia eredu berriak haur hezkuntzan. Ikastetxe konfesional baten analisia.

[eus] Gradu Amaierako Lan honek Haur Hezkuntzako etapan familia aniztasunari ematen zaion trataera aztertzea du helburu. Horretarako Bilboko Elizbarrutiko ikastetxe zehatz batean kasu ikerketa bat egitea erabaki da. Azterketaren ardatza ikastetxearen izaera konfesionala familia eredu berrien aniztasuna lantzeko zenbateraino traba izan litekeen frogatzea izan da. Ikerketarako erabilitako metodologia kualitatiboa izan da, eztabaida taldea, elkarrizketa sakonak, behaketak eta edukien analisien bidezko teknikak nagusiak izanik. Teknika horien bitartez lortutako informazioaren inguruan zenbait ondorio atera dira eta, azkenik, horiek guztiak kontuan harturik hobekuntzarako proposamena planteatu da.