Ansiedad, depresión y calidad de vida en personas adultas con VIH/SIDA y deterioro cognitivo leve

El Virus de la Inmunodeficiencia Humana (VIH) y el Síndrome de Inmunodeficiencia Adquirida (SIDA) han tenido a lo largo de los años un comportamiento epidemiológico que muestra la tendencia al aumento, de tal forma que ha llegado a considerarse como un problema de salud pública a nivel mundial. Sin embargo los tratamientos antiretrovirales han permitido que las personas con esta infección tengan una tasa de supervivencia mayor; pero ligado a esto, se han presentado efectos secundarios tales como problemas con la memoria y el funcionamiento cognitivo de estas personas. Además se ha encontrado que las personas con VIH/SIDA tienen algunas alteraciones en su área afectiva y generalmente ven afectada su calidad de vida. Este es un estudio exploratorio descriptivo que tuvo por objeto describir la ansiedad, depresión y percepción de calidad de vida en 35 pacientes con VIH/SIDA con deterioro cognitivo leve, seleccionados por conveniencia. Se aplicaron tres cuestionarios, el BDI-II para evaluar la sintomatología depresiva; el BAI para evaluar la sintomatología ansiosa y el MOS-SF30 para evaluar la calidad de vida. Además, se realizó una entrevista semiestructurada para profundizar en la evaluación de estas tres variables. Dentro de los resultados se evidenció que todos los paciente presentan algún nivel de ansiedad y de depresión, evalúan su calidad de vida en un punto medio; ni óptima ni baja. Se discuten estos y otros resultados.

Creating a world class business through a merger of two equals: an interview with Paul Walsh, Chief Executive Officer of Diageo Plc

Purpose – The purpose of this paper is to explore, from a practical point-of-view, a number of key strategic issues that critically influence organisations' competitiveness. Design/methodology/approach – The paper is based on a semi-structured interview with Mr Paul Walsh, CEO of Diageo. Diageo is a highly successful company and Mr Walsh has played a central role in making Diageo the number one branded drink company in the world. Findings – The paper discusses the key attributes of successful merger, lessons from a complex cross boarder acquisition, rationale for strategic alliance with competitors, distinctive resources, and the role of corporate social responsibility. Research limitations/implications – It is not too often that management scholars have the opportunity to discuss with the CEOs of large multinationals the rational of key strategic decisions. In this paper these issues are explored from the perspective of a CEO of a large and successful company. The lessons, while not generalisable, offer unique insights to students of management and management researchers. Originality/value – The paper offers a bridge between theory and practice. It demonstrates that from Diageo's perspective the distinctive capabilities are intangible. It also offers insight into how to successfully execute strategic decision. In terms of originality it offers a view from the top, which is often missing from strategy research.

Risking the ire of investors in pursuit of long-term value: an interview with Cynthia Carroll, the CEO of Anglo American plc

Purpose – The purpose of this paper is to demonstrate how key strategic decisions are made in practice at successful FTSE 100 companies. Design/methodology/approach – The paper is based on a semi-structured interview with Ms Cynthia Carroll, Chief Executive of Anglo American plc. Findings – The interview outlines a number of important factors on: the evolution of strategy within Anglo American, strategy execution, leadership at board and executive levels, and capturing synergies within the company. Originality/value – The paper bridges the gap between theory and practice. It provides a practical view and demonstrates how corporate leaders think about key strategic issues

Rescuing a telecom giant from the jaws of bankruptcy: a case study and an interview with Sir Richard Lapthorne, chairman of Cable & Wireless

Purpose – The purpose of this paper is to demonstrate key strategic decisions involved in turning around a large multinational operating in a dynamic market. Design/methodology/approach – The paper is based on analysis of archival documents and a semi-structured interview with the chairman of the company credited with its rescue. Findings – Turnaround is complex and involves both planned and emergent strategies. The progress is non-linear requiring adjustment and change in direction of travel. Top management credibility and vision is critical to success. Rescue is only possible if the company has a strong cash generative business among its businesses. The speed of decision making, decisiveness and the ability to implement strategy are among the key ingredients of success. Originality/value – Turnaround is an under-researched area in strategy. This paper contributes to a better understanding in this important area and bridges the gap between theory and practice. It provides a practical view and demonstrates how a leading executive with significant expertise and successful turnaround track record deals with inherent dilemmas of turnaround

BSkyB transformation from a new loss-making venture to a successful organisation: case study and interview with Jeremy Darroch, Chief Executive of British Sky Broadcasting Group Plc

Purpose – This paper aims to articulate strategic dilemmas faced by a Chief Executive of a highly successful company and how such dilemmas were resolved. Design/methodology/approach – The case is based on a semi-structured interview with Mr Jeremy Darroch – Chief Executive of BSkyB – and analysis of documentary evidence. Findings – It is often difficult to implement strategies that simultaneously yield high organic growth rate, innovation, and a healthy balance-sheet. The paper sheds light on how Sky has met this challenge. Research limitations/implications – The research offers a unique insight into the views of a principal strategist and articulates the background to offer context, however, because of its design the findings are not generalisable. Originality/value – Very few articles offer insight into the thinking of those with principal responsibility for design and delivery of strategy. This paper offers such an insight based on a detailed interview with a highly successful Chief Executive.

Building from scratch a marketing services giant by acquisition: case study and interview with Sir Martin Sorrell, Chief Executive of WPP

Purpose – Mergers and acquisitions are among the most intensely used strategic decisions. Yet research by both academics and consulting groups suggests that many mergers and acquisitions fail to add value. On the other hand there are many companies that successfully use mergers and acquisition to grow and add shareholder value. One such company is WPP. The aim of this paper is to explore why WPP has been successful in its acquisition strategy while so many other companies fail. Design/methodology/approach – The paper draws on documentary evidence and a semi-structured interview with Sir Martin Sorrell – Chief Executive and founder of WPP. Research limitations/implications – The case study offers a unique insight into thinking of a successful acquirer and sheds light on how mergers and acquisitions are managed by WPP. However, because of its design the findings are not generalisable. Originality/value – This case study sheds light on how mergers and acquisitions can be used to create a £9 billion company from a standing start. Furthermore, very few case studies offer insight into the thinking of entrepreneurial Chief Executives who established the business, grew it to become the largest and most profitable marketing services company in the world and engineered close to 300 acquisitions.

Successful strategy making in Bupa not-for-profit provident: a case study and interview with Mr Ray King, chief executive of Bupa

Purpose – The focus of extant strategy literature is on for-profit organisations and within these group public organisations. There are other forms of organisations and following the deep recession of 2008 there is greater interest in other forms of organisation. In this case study and interview the aim is to examine strategy, strategic decisions and strategic management of a not-for-profit provident. Design/methodology/approach – The paper draws on documentary evidence and a semi-structured interview with Ray King, chief executive of Bupa. The perspective of CEO is key in strategy and such perspectives are relatively rarer. Findings – Bupa invests its surplus to provide better healthcare. Free from the pressures of quarterly reporting and shareholders it can pursue long-term value creation for members rather than short-term surpluses. Research limitations/implications – The case study and interview offers a unique insight into strategy-making within a successful mutual provident that has grown organically and externally becoming an international leader in health insurance. Originality/value – This case study sheds light on strategy-making within a not-for-profit provident that has diversified and grown significantly over the past six decades. Furthermore, very few case studies offer insight into the thinking of a chief executive who has successfully managed a business in a turbulent environment.

John Lewis Partnership lessons in logical incrementalism and organic growth: a case study and interview with the Chairman, Mr Charlie Mayfield

Purpose – The purpose of this paper is to demonstrate how strategy is developed and implemented in an organisation with an unusual ownership model. Partnerships are not a prevalent form of ownership but as this case demonstrates they can be extremely effective. Furthermore this case demonstrates how logical incrementalism can be used to implement major strategic decisions. Design/methodology/approach – The paper draws on company documentary evidence and a semi-structured interview with Mr Charlie Mayfield, Chairman of John Lewis Partnership. A chairman has a helicopter view of business whose perspectives are rarely captured by strategy researchers. This case study offers an insight into strategic thinking of a chairman and chief executive of a successful company. Research limitations/implications – The case study and interview offer a unique insight into the rationale behind strategic decisions within a successful partnership that has grown organically in a highly competitive retail market without high gearing. Originality/value – This case study sheds light on strategic moves within partnership. Furthermore, very few case studies offer insight into the thinking of a chief executive who has successfully managed a business in a turbulent environment.

Fear causes tears – perineal injuries in home birth settings : a Swedish interview study

Background: Perineal injury is a serious complication of vaginal delivery that has a severe impact on the quality of life of healthy women. The prevalence of perineal injuries among women who give birth in hospital has increased over the last decade, while it is lower among women who give birth at home. The aim of this study was to describe the practice of midwives in home birth settings with the focus on the occurrence of perineal injuries. Methods: Twenty midwives who had assisted home births for between one and 29 years were interviewed using an interview guide. The midwives also had experience of working in a hospital delivery ward. All the interviews were tape-recorded and transcribed. Content analysis was used. Results: The overall theme was "No rushing and tearing about", describing the midwives' focus on the natural process taking its time. The subcategories 1) preparing for the birth; 2) going along with the physiological process; 3) creating a sense of security; 4) the critical moment and 5) midwifery skills illuminate the management of labor as experienced by the midwives when assisting births at home. Conclusions: Midwives who assist women who give birth at home take many things into account in order to minimize the risk of complications during birth. Protection of the woman's perineum is an act of awareness that is not limited to the actual moment of the pushing phase but starts earlier, along with the communication between the midwife and the woman.

Patienters upplevelser av livskvalitet vid nydiagnostiserad typ 2 Diabetes Mellitus : En intervjustudie

Syfte: Att undersöka patienters upplevelser av livskvalitet vid nydiagnostiserad typ 2 Diabetes Mellitus. Metod: En empirisk studie med en kvalitativ ansats som innefattade tio deltagare med nydiagnostiserad typ 2 Diabetes Mellitus. Semistrukturerade intervjuer genomfördes utifrån en intervjuguide där insamlad data analyserades med kvalitativ manifest innehållsanalys. Resultat: Studien resulterade i fyra huvudkategorier och tio subkategorier. Upplevelsen av att få ett diagnosbesked varierade mellan deltagarna, för vissa deltagarna var beskedet inte förvånande medan andra upplevde känslor av chock och förnekelse. Deltagarna upplevde positiva förändringar, exempelvis viktnedgång och förbättrad hälsa men även negativa förändringar, exempelvis att vara beroende av läkemedel. Vissa upplevde ingen förändring alls. Typ 2 Diabetes Mellitus påverkade inte deltagarnas fysiska eller psykiska hälsa i de flesta fall. Deltagarna ansåg det som viktig att få stöd från både omgivningen och hälso- och sjukvården. Konklusion: Känslorna över ett diagnosbesked kunde variera men upplevelsen av livskvalitet påverkades inte av Typ 2 Diabetes Mellitus i de flesta fall i studien. Patientens inställning till att leva med Typ 2 Diabetes Mellitus inverkade på förmågan till att utföra egenvård, och distriktsköterskans stöd och engagemang ansågs vara betydelsefullt i sjukdomsprocessen.

Knowledge translation in Uganda : a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.

O Projeto político-pedagógico na perspectiva de consolidação da cultura organizacional e da autonomia da escola

In this research, we have found that, besides the literature in educational area presents the politic-pedagogical project as a pedagogical component that is able to promote changes in educational practices and to consolidate the school autonomy, some researches point to an opposite view-point, mainly due to the fact that these researches verify that several schools have elaborated their project just to comply with a formal exigency of the Brazilian educational reform implemented from the 1990 decade. Despite of the neoliberal and neoconservative forces (that guide this reform) understand the politic-pedagogical project as a way of stimulating scholar organizations, in order to put in practice the educational politics of this decade, we understand that this project can, in fact, promote changes in the scholar practices in the sense of overcoming the bureaucratic scholar culture historically developed in this environment. This research presumes that the process of planning, implementation and evaluation of school actions that is excited by the politic-pedagogical project can stimulate the subjects to develop practices, values, and senses, bypassing in some aspects the culture that is traditionally instituted in school, what will certainly favor the construction of its autonomy. The research that we have done in Professor Ascendino de Almeida Municipal School situated in the South Zone of Natal, RN, Brazil, was developed according to the following methodological procedures: document analysis, semi-structured interview, and participative observation. In the focused school we evidence that the politic-pedagogical project is a product of interpersonal and professional relations that are marked by shared powers, by dialogical action, by participation, and by equality, that (all of them) mediate decisional processes, what makes it possible the construction of common senses in order to guide the educative action. We yet evidence the existence, between the professionals that integrate this institution, of a culture for valuation of planning, of collective reflection, and of theoretical support, besides a commitment with the formation of the student with who they work, this making possible that the politic-pedagogical project constitutes in an orientation for the process of reflection, action, and evaluation of the school work. In these conditions, this project propitiates the consolidation of the school autonomy, what, in its turn, prints higher quality to the educative work developed in the institution

Os currículos praticados no cotidiano da EJA: regulações e emancipações na Escola Centro Educacional Dr. Pedro Amorim

This research has as its object of study practiced in the daily curriculum of Youth and Adults in their midst and considered discussion of the concepts of knowledge as regulation and emancipation. The camp of our research relates to the knowing / doing the teachers of this modality of education, in the Escola Centro Educacional Dr. Amorim-CEPA, the city of Assú/RN and is articulated to the emerging desire to understand how cooperating teachers have thought, organized and practiced the curriculum in order to consider the many complex situations that are present in everyday school life. Our tour was guided by the need to study the relationship between the regulated curriculum and practiced in everyday adult education, as well as to understand, from the knowing / doing of the teachers, the conceptions that guide their teaching practices and, therefore, reflect on this Reality curriculum in order to better signify then. In this sense, we turn to the fundamentals of qualitative research, adopting the procedures of documentary research, participant observation and semi-structured interview, which allowed us to enter a universe of complex dimensions, senses, and that add significant difference, because the forms of use of various practitioners are and unique, in that enroll in school life and define their brand identities. The predominance of a traditional teaching practice nature by a process of training and teaching experience, the lines of flight, volatilities and inventiveness promoted by the circumstances of everyday life are some of the conclusions we draw from the data collected. This reality, we infer that the practice of teachers varies between regulation and emancipation, being this time, many challenges to be faced, namely the process of continuing education, the conceptual understanding of the subject curriculum and the existence of relational different knowing / doing produced, used and created in/from the school routine of Youth and Adults

A formação acadêmica do enfermeiro para o SUS na percepção de docentes e discentes da faculdade de enfermagem/UERN

The model of attention to health in Single Health System (Sistema Único de Saúde SUS) presupposes a human-resources policy which prepares professionals of health to guide the services and sanitary practices. The nurse, a member of health staff, takes over an important role in implementation of principles and standards of SUS, being its professional formation necessary to labor organization in this purpose. In this way this study objectifies to analyse the process of formation of the male nurse in the Politic-Pedagogical Project (Projeto Político-Pedagógico PPP) in the perception of learning and teaching of the Faculty of nursing FAEN of the University of The Rio Grande do Norte State UERN. It treats about a descriptive-exploratory study with qualitative and quantitative approach carried out with learning and teaching of the graduation nursing course. In the field research carried out between the months of november, 2006 and february, 2007, were used like instruments the documental research below PPP´s, structured interview directed to the learning and the closed questionnaire applied to the students of eighth and ninth semesters of graduation course. The results of data about the questionnaires elaborated according to National Curricular Patters (Diretrizes Curriculares Nacionais DCN) and the Instrument of Evaluation Course of Graduation MEC were organized according to six lists about the profile of the learning and teaching that participate of the research; of the didactical-pedagogical organization and PPP´s objectives to the just-graduates person to the didactical-pedagogical curriculum organization. For considering the interviews it was adopted thematic analysis of content discribed in lexical analysis by informatical program ALCESTE which provided the organization of the material in five categories: daily problems of SUS consolidation versus nurse formation, dichotomies about FAEN´s nursing course of curriculum versus principles of integralization of graduating process, the just-graduated one from FAEN and its professional insertion united to SUS politic-pedagogical project and the concern about the overcoming of dichotomies of graduation process abilities and necessary competences to the SUS performing nurse. The analysis of informations deriving from documental performance and field research resulted on the verification that, in spite of good intentions, the implementation strategies showed themselves fragile to cope with the rendering of expressed ideal on PPP. There is still a great gap between what´s thought as innovating graduating process and what´s being really implemented

Estudo representacional da participação familiar nas atividades dos centros de atenção psicossocial no município de Natal-RN

Comprehending social representations of users relatives of Psychosocial Care Centers (CAPS) from Natal-RN, about their participation in the activities of these services, was the purpose of this study. The research instrument used was a semi-structured interview, led to 28 relatives of users of East and West CAPS II, East and North CAPS-ad, involved in the Relative Therapeutic Group, in Relative Meeting, in the Assembly of Users, Technicians and Relatives, according to the therapeutic schedule of each health services, between August to November 2007. Data obtained in family and users identification were characterized with the aid of charts and boards in absolute and/or percentage values. The discursive material from the guide from interviews was submitted to the informational resource ALCESTE (Analyse Lexicale par Contexte d'un Ensemble of Segments of Texte), and analyzed on the basis of the Theory of Social Representations and Central Nucleus Theory. Most of the relatives were women, married, aged over 50 years, who participated for more than two years in CAPS activities, and a coexistence of more than 11 years with the user. From the classification system of ALCESTE were selected categories, identified by: Category 1, Treatment Improvements and Expectations; Category 2, Living User Before and After; Category 3, Activities Relevance, Contradictions and Suggestions; Category 4, Guidelines -- Psychopharmacology and Medicalization; Category 5, Family Participation and Activities; and Category 6, Therapeutic Conditions Thanks, Tips and Vulnerability. The social representation of the family exists in the desire for change, identifying that we need to promote change by the continuity of therapeutic activities and overcome the detected inconsistencies, targeted by strengthening and by the stability of improvements in living and health conditions of users, experienced in CAPS treatment. The central nucleus had corresponded to positive changes in health and living conditions of users, and the peripheral elements were constituted by family conducts before and during treatment, and the expectations of changes in activities, especially in workshops. Despite this family participation be considered important, it still does not meet conditions to promote the inclusion of family, under an emancipating point of view, capable of causing in subject the hope for autonomy, initiative, individual and collective growths, a closer and active involvement in therapeutic activities, in workshops and discussions