Dermatology in the immunosuppressed patient

This anniversary book gives an animated description of the first one hundred years of the Swiss Society of Dermatology and Venereology (SSDV – SGDV). The approximately 60 authors write from the subjective perspective of the contemporary witness and thus create a vibrant picture of their field and the times in which we live. “Spirit and Soul of Swiss Dermatology and Venereology 1913 – 2013” is therefore an ideal companion to the medical history book “Dermatologie und Venerologie in der Schweiz – ein historischer Rückblick” (2002 Editions Alphil, ISBN 2-940235-08-2), published in 2003 by the SSDV – SGDV for its 90th anniversary. The anniversary edition for the centennial is written in English in order to make the history of the SSDV – SGDV accessible to a larger international public. The introductory chapter is written in all four national languages (German, French, Italian, and Romansh) and also translated into English. It is followed by chapters about the university and non-university public dermatology and venereology departments, the memoirs of those presidents still living, and the depiction of the numerous sub-disciplines of dermatology. Further important chapters include a large contribution on the beginnings of dermatological research in Switzerland, a series of pieces on medical education and continuing education, and finally an overview of healthcare politics in Switzerland. Our friends in Germany, Austria, France, Italy and the USA have provided the outside perspective on Swiss dermatology and venereology in their essays. All in all an informative and entertaining overview of a very diverse medical specialty has been created, which combines historical facts with dynamic insights into this topical field and the current political healthcare framework.

Awareness of headache and of National Headache Society activities among primary care physicians - a qualitative study

BACKGROUND Headache is one of the most common symptoms in primary care. To improve the quality of headache diagnosis and management with the largest possible benefit for the general population, headache and pain societies around the world have recently been devoting more attention to headache in primary care.The aim of the study was to investigate the potential contribution that national societies can make toward raising the awareness of primary headaches in general practice. FINDINGS In a qualitative telephone survey, targeting primary care practices (PCP), we asked about the frequency of headache patients in their practices and inquired about their treatment and referral strategies.A total of 1000 telephone interviews with PCP have been conducted. Three-hundred and fifty physicians have been directly interviewed, 95% of them see headache patients every week, 23% daily. Direct MRI referral is done by 84%. Sixty-two per cent of the physicians knew the Swiss headache society, 73% were interested in further education about headaches. CONCLUSION The survey yielded information about the physicians' awareness of the Swiss Headache Society and its activities, and about their desire for continuing education in the area of headache. National headache societies should work to improve the cooperation between headache specialists and PCP, aiming for a better care for our patients with headache.

The Perceived Prognosis of Endodontic Treatment and Implant Therapy Among Dental Practitioners

Little data concerning the perceived success of implant therapy in comparison with endodontic treatment exists. While the criteria used to measure the outcome of each modality are not the same, it is not clear if this is appreciated by practicing dentists. The purpose of the study was to evaluate the perceived outcome of implant therapy in comparison to endodontic treatment. A 23 question Web-based survey was distributed to 648 dentists who matriculated from the University of Connecticut School Of Dental Medicine over the past 30 years. The response rate was 47%. Sixty-seven percent of respondents were general dentists. Forty-nine percent of respondents did not know different criteria exist in the literature and are used to evaluate implant and root canal treatment. Fifty-four percent of dentists felt the prognosis of implant therapy was the same as or better than endodontic treatment of teeth with vital pulps. Thirty percent of responders thought root canal treatment of teeth with necrotic pulp was superior to implants and only 16% thought retreatment was preferable. Treatment planning for implant placement vs. retreatment of a restorable tooth was 46% and 32%, respectively. A third of the respondents felt that the role of endodontics will decline in the future. Dentists’ primary source of information regarding implant therapy was continuing education; however, their primary source of information regarding endodontic treatment was their dental program. Dentists felt the prognosis of implant therapy was as good or superior to endodontic treatment of teeth with vital, necrotic or previously treated pulps.

Analysis of a disaster medical track for the Certificate in Emergency Management and Preparedness Program at the University of Texas at Dallas

Since the tragic events of September 11, 2001, the United States has engaged in building the infrastructure and developing the expertise necessary to protect its borders and its citizens from further attacks against its homeland. One approach has been the development of academic courses to educate individuals on the nature and dangers of subversive attacks and to prepare them to respond to attacks and other large-scale emergencies in their roles as working professionals, participating members of their communities, and collaborators with first responders. An initial review of the literature failed to reveal any university-based emergency management courses or programs with a disaster medical component, despite the public health significance and need for such programs. In the Fall of 2003, The School of Management at The University of Texas at Dallas introduced a continuing education Certificate in Emergency Management and Preparedness Program. This thesis will (1) describe the development and implementation of a new Disaster Medical Track as a component of this Certificate in Emergency Management and Preparedness Program, (2) analyze the need for and effectiveness of this Disaster Medical Track, and (3) propose improvements in the track based on this analysis. ^

A project to improve the information seeking skills and increase the use of evidence-based research in public health practice

The ability of public health practitioners (PHPs) to work efficiently and effectively is negatively impacted by their lack of knowledge of the broad range of evidence-based practice information resources and tools that can be utilized to guide them in their development of health policies and programs. This project, a three-hour continuing education hands-on workshop with supporting resources, was designed to increase knowledge and skills of these resources. The workshop was presented as a pre-conference continuing education program for the Texas Public Health Association (TPHA) 2008 Annual Conference. Topics included: identification of evidence-based practice resources to aid in the development of policies and programs; identification of sources of publicly available data; utilization of data for community assessments; and accessing and searching the literature through a collection of databases available to all citizens of Texas. Supplemental resources included a blog that served as a gateway to the resources explored during the presentation, a community assessment workbook that incorporates both Healthy People 2010 objectives and links to reliable sources of data, and handouts providing additional instruction on the use of the resources covered during the workshop.^ Before- and after-workshop surveys based on Kirkpatrick's 4-level model of evaluation and the Theory of Planned Behavior were administered. Of the questions related to the trainer, the workshop, and the usefulness of the workshop, participants gave "Good" to "Excellent" responses to all one question. Confidence levels overall increased a statistically significant amount; measurements of attitude, social norms, and control showed no significant differences before and after the workshop. Lastly, participants indicated they were likely to use resources shown during the workshop within a one to three month time period on average. ^ The workshop and creation of supplemental resources served as a pilot for a funded project that will be continued with the development and delivery of four 4-week long webinar-based training sessions to be completed by December 2008. ^

Spirituality of Thai Buddhists with chronic cardiovascular disease

Background. Advances in medical technology contribute to the survival rate of a growing number of persons with chronic illnesses. Individuals with chronic cardiovascular disease (chronic CVD) are among other chronically ill persons who add to the need for healthcare services. They need to cope and live with the chronic conditions and find a new balance to make sense of their lives. Thai Buddhists with chronic CVD may use their religious resources to cope with their illnesses because religious beliefs are reflected in patterns of living. The aims of the study were to: (a) explore how Thai Buddhists with chronic CVD construct the spiritual aspects of the illness experience, (b) explore how Thai Buddhists with chronic CVD may use their spiritual/religious resources as a means of coping with the illness, and (c) explore the impacts of spiritual/religious beliefs and/or practices on the daily lives of Thai Buddhists with chronic CVD. ^ Methods. Ethnography was employed and data were collected from December 1, 2007 to May 31, 2008 using in-depth interviews with 20 participants. Field notes were also recorded. ^ Findings. Three categories emerged from the study data: set of spiritual and biomedical beliefs and practices, integrated meanings, and positive consequences of the integration of spiritual and biomedical beliefs and practices. ^ Conclusions. The findings of the study suggest the importance of understanding and integrating spiritual needs into care of patients with chronic CVD. The findings revealed that the participants constructed ideas of their illness and meanings for living and coping with the illness, and integrated spiritual and biomedical beliefs and practices, resulting in positive outcomes. Further research could test interventions which facilitate such coping; for example, using reflective thinking and group support. Other studies might explore how age affects Buddhist views of the illness. ^

The assessment of standardized training programs in public health preparedness

The Texas Bioterrorism Continuing Education Consortium (BCE) provided National Disaster Life Support (NDLS) training courses throughout the state of Texas in 2005, to help improve knowledge and skills pertaining to bioterrorism and other public health emergencies. The NDLS training courses include curriculum in Basic Disaster Life Support (BDLS) and Core Disaster Life Support (CDLS). A course evaluation which included items assessing ability and willingness of training participants, role of responders, and other variables was mailed to all NDLS participants who provided contact information. An analysis was conducted to determine whether the survey respondents participated in the Hurricanes Katrina and/or Rita relief efforts, as well as to evaluate the impact of the NDLS training courses on the participant's ability and willingness to respond during a disaster. The study population (n = 2150) consisted mostly of nurses (50%) (n=1074). A chi-square test of analysis indicated the following results. Among the survey respondents who took the CDLS course, there was no statically significant difference by occupation pertaining to ability or willingness to respond (x2 [df = 5] = 4.02, p= 0.546); (x2 [df = 5] = 2.45, p = .783). However, there was a statistically significant difference among those respondents who took the BDLS course with respect to ability, and a slightly significant difference with respect to willingness (x2 [df = 5] = 13.35, p = .020 and (x2 = [df = 5] = 10.299, p = .067). These findings are similar to previous studies assessing willingness to respond to a disaster.^ A second analysis was conducted with these survey data to evaluate the implications for disaster response training for the NDLS courses. Results indicated that the majority of disaster responders served in the role for which they were professionally trained (Physicians=68%; Nurses = 50.4%). Nurses, EMT, and Fire professionals served in multiple roles. These results suggest the importance of developing training programs that will prepare professionals to serve in multiple roles. The development of standardized evaluation methods would fill an important gap in assessing impact of national training programs. ^

Perceptions of work engagement of nurses in Taiwan

Purpose. The purpose of this study was to determine the perceptions of work engagement of Taiwanese nurses with 3 specific aims: (1) understand Taiwanese nurses' perceptions of work engagement; (2) explore the factors influencing work engagement, and (3) examine how work engagement impacts nursing care for patients. ^ Design. The study used an ethnographic approach with participant observation and semi-structured interviews with RNs. ^ Setting. The study was conducted in the highest and lowest nurse turnover medical surgical units at a regional teaching hospital in southwestern Taiwan. ^ Sample. Purposive sampling resulted in 28 formal interviews with RNs who provided direct patient care, had at least 3 months experience in nursing, and were full-time employees. ^ Methods. Descriptive data were collected through participant observation in each unit. Observations were made while attending meetings, continuing education sessions, and informal conversations with RNs. Field notes and audio recorded semi-structured interviews were analyzed using qualitative thematic analytic techniques. ^ Findings. Findings revealed perceptions of work engagement spanned four domains: patients ("wholehearted care"), work (positive attitude), self (fulfillment and happiness), and others (relationships with colleagues). Providing "wholehearted care" toward patients was the foundation of work engagement for nurses in Taiwan. Engaged nurses felt fulfilled, happy, and found "meaning" through the process of patient care. The study revealed five factors that influenced work engagement: personal, organizational, social, patient, and professional. The impact of work engagement on nurse and patient outcomes are confirmed. ^ Conclusions. Taiwanese nurses connect work engagement with patients, the job, oneself, and colleagues. "Wholehearted patient care" is the core manifestation of work engagement among these nurses. In contrast, studies in western business only focused on work attitudes. Losing interest and "heart" lead to work routines which can lead to individual unhappiness. Findings from this study validate the multiple factors contributing to work engagement of nurses. Job demands and resources can only partially explain what hinders work engagement. Work disengagement and burnout share some commonality but should be measured differently. An understanding of RNs' perceptions of work engagement may provide direction for strategies that improve work engagement leading to decreased RN turnover. ^

Educación pública universitaria : República Argentina 1998-2008

La educación en la Argentina está articulada bajo criterios sociales establecidos pero que son básicamente arbitrarios y sustentados en supuestos no demostrados que afirman que el conocimiento se construye a partir de ciertos contenidos y no de otros. Dichos criterios no han variado mayormente durante las últimas décadas y siguen utilizándose como plataforma inicial a partir de los cuales se articula la educación posterior del educando. Los sistemas de educación superior en América Latina sufren una crisis a raíz de la creciente internacionalización de las nuevas tecnologías de comunicación e información y de los reclamos de inclusión social de los sectores marginados, entre otras razones. Las tecnologías de compresión digital dan origen a un modelo educativo "en red" caracterizado por un funcionamiento no presencial, mediante el cual se produce la transformación del rol de la Universidad, como centro de descubrimiento y posesión del conocimiento, para convertirse en apenas una intermediaria en la búsqueda del saber y la información. Esta nueva modalidad de educación crece en la medida en que puede cubrir una demanda social de educación superior insatisfecha, conformada básicamente por adultos que trabajan, estudiantes de zonas alejadas de los centros educativos, extranjeros que carecen de opciones educativas y alumnos globalizados. Por ello, la educación virtual nace como una nueva respuesta a viejas demandas. La construcción de una sociedad planetaria y la convivencia del multiculturalismo, además de representar la expresión de sociedades abiertas, que quizás no dispongan de bases comunes de cohesión nacional, debe ser parte de un nuevo proyecto de solidaridad y confraternidad mundial.Resulta sumamente importante que las Universidades de América Latina defiendan su participación como tales en los mercados regionales mediante la adquisición de mayor flexibilidad, actualización y excelencia, para erigirse de esta manera como una opción comparativamente válida. Asimismo, creemos que la educación, entendida como todo el corpus del conocimiento que tiene una persona, no se construye de manera arbitraria sino, por el contrario, de manera selectiva de acuerdo a las posibilidades del educando; y es precisamente sobre la base de esta pormenorizada elección el sustento sobre el cual el alumno llega posteriormente a desarrollos intelectuales superiores. El objetivo del presente trabajo se centra en mostrar la importancia de índole social y política que tienen la flexibilización y la personalización en el currículum de estudios universitarios, al momento de observar el resultado final del ejercicio profesional del graduado. Desde este punto de vista, es fundamental que la elección de los contenidos del plan de estudios de la carrera universitaria estén a cargo del educando, con la dirección de una unidad académica, especialmente en relación con lo que hoy se conoce como "aprendizaje justo a tiempo". Dicho en otras palabras, solamente cuando el educando trasciende ese fundamento institucional e inicial de conocimientos para abrevar en otras fuentes, como las Artes, la Religión, la Filosofía, etc., puede relacionar y comparar conocimientos diferentes entre sí, pero cuya elección obedece fundamentalmente a criterios personales y no meramente institucionales

La Geografía en la extensión universitaria : Talleres sobre microemprendimientos productivos en áreas rurales y urbanas del municipio de General Pueyrredón

El objetivo del trabajo es difundir actividades de extensión desarrolladas por alumnos y docentes, con la finalidad de mejorar la calidad de vida de la población del área de estudio, brindar la posibilidad de insertarse al mercado laboral y vincular a integrantes del grupo con diferentes actores sociales en espacios propuestos. Diversos diagnósticos detectaron necesidades sociolaborales en barrios de Mar del Plata. Para mitigarlas, integrantes del Voluntariado Universitario diseñan materiales para dictar talleres sobre Microemprendimientos Productivos. La experiencia tiene resultados positivos porque los encuentros son espacios de debate sobre experiencias locales, que incentivan la asociatividad y generan redes sociales.

Desafíos actuales del envejecer

Presentamos hallazgos sobre el envejecer en la actualidad y su entrecruzamiento con la participación en grupos. Señalamos la importancia de la educación permanente en la producción de subjetividad. Se destaca la contribución de las investigaciones referidas a la: docencia, extensión universitaria y formación de investigadores. Partimos del marco teórico de la psicología, se revisan los aportes interdisciplinarios que enriquecen el campo gerontológico. A partir de la longevidad se busca identificar las transformaciones del envejecer, el proceso de revisión identificatoria y el trabajo psíquico de revisar, cuestionar y transformar las significaciones simbólicas, a la par que hacer lugar a lo nuevo en relación con sus funciones: hombre/mujer; esposo/esposa; abuelo/abuela. Se emplea metodología cualitativa: entrevistas en profundidad, historias de vida, crónicas del funcionamiento grupal. Surge la preocupación constante y conciente de los mayores, por preservar su capacidad de desear, crear, producir y gozar, la búsqueda de realización personal y la interrelación con el medio, con los otros y con sus pares. Se observan lógicas propias que promueven la horizontalidad de los vínculos y presentan representaciones, sentidos y conductas que modifican el concepto tradicional del viejo. Se destaca la riqueza del encuentro intersubjetivo entre investigadores y entrevistados, en la elaboración de los cambios.

Educación pública universitaria : República Argentina 1998-2008

La educación en la Argentina está articulada bajo criterios sociales establecidos pero que son básicamente arbitrarios y sustentados en supuestos no demostrados que afirman que el conocimiento se construye a partir de ciertos contenidos y no de otros. Dichos criterios no han variado mayormente durante las últimas décadas y siguen utilizándose como plataforma inicial a partir de los cuales se articula la educación posterior del educando. Los sistemas de educación superior en América Latina sufren una crisis a raíz de la creciente internacionalización de las nuevas tecnologías de comunicación e información y de los reclamos de inclusión social de los sectores marginados, entre otras razones. Las tecnologías de compresión digital dan origen a un modelo educativo "en red" caracterizado por un funcionamiento no presencial, mediante el cual se produce la transformación del rol de la Universidad, como centro de descubrimiento y posesión del conocimiento, para convertirse en apenas una intermediaria en la búsqueda del saber y la información. Esta nueva modalidad de educación crece en la medida en que puede cubrir una demanda social de educación superior insatisfecha, conformada básicamente por adultos que trabajan, estudiantes de zonas alejadas de los centros educativos, extranjeros que carecen de opciones educativas y alumnos globalizados. Por ello, la educación virtual nace como una nueva respuesta a viejas demandas. La construcción de una sociedad planetaria y la convivencia del multiculturalismo, además de representar la expresión de sociedades abiertas, que quizás no dispongan de bases comunes de cohesión nacional, debe ser parte de un nuevo proyecto de solidaridad y confraternidad mundial.Resulta sumamente importante que las Universidades de América Latina defiendan su participación como tales en los mercados regionales mediante la adquisición de mayor flexibilidad, actualización y excelencia, para erigirse de esta manera como una opción comparativamente válida. Asimismo, creemos que la educación, entendida como todo el corpus del conocimiento que tiene una persona, no se construye de manera arbitraria sino, por el contrario, de manera selectiva de acuerdo a las posibilidades del educando; y es precisamente sobre la base de esta pormenorizada elección el sustento sobre el cual el alumno llega posteriormente a desarrollos intelectuales superiores. El objetivo del presente trabajo se centra en mostrar la importancia de índole social y política que tienen la flexibilización y la personalización en el currículum de estudios universitarios, al momento de observar el resultado final del ejercicio profesional del graduado. Desde este punto de vista, es fundamental que la elección de los contenidos del plan de estudios de la carrera universitaria estén a cargo del educando, con la dirección de una unidad académica, especialmente en relación con lo que hoy se conoce como "aprendizaje justo a tiempo". Dicho en otras palabras, solamente cuando el educando trasciende ese fundamento institucional e inicial de conocimientos para abrevar en otras fuentes, como las Artes, la Religión, la Filosofía, etc., puede relacionar y comparar conocimientos diferentes entre sí, pero cuya elección obedece fundamentalmente a criterios personales y no meramente institucionales

La Geografía en la extensión universitaria : Talleres sobre microemprendimientos productivos en áreas rurales y urbanas del municipio de General Pueyrredón

El objetivo del trabajo es difundir actividades de extensión desarrolladas por alumnos y docentes, con la finalidad de mejorar la calidad de vida de la población del área de estudio, brindar la posibilidad de insertarse al mercado laboral y vincular a integrantes del grupo con diferentes actores sociales en espacios propuestos. Diversos diagnósticos detectaron necesidades sociolaborales en barrios de Mar del Plata. Para mitigarlas, integrantes del Voluntariado Universitario diseñan materiales para dictar talleres sobre Microemprendimientos Productivos. La experiencia tiene resultados positivos porque los encuentros son espacios de debate sobre experiencias locales, que incentivan la asociatividad y generan redes sociales.

Desafíos actuales del envejecer

Presentamos hallazgos sobre el envejecer en la actualidad y su entrecruzamiento con la participación en grupos. Señalamos la importancia de la educación permanente en la producción de subjetividad. Se destaca la contribución de las investigaciones referidas a la: docencia, extensión universitaria y formación de investigadores. Partimos del marco teórico de la psicología, se revisan los aportes interdisciplinarios que enriquecen el campo gerontológico. A partir de la longevidad se busca identificar las transformaciones del envejecer, el proceso de revisión identificatoria y el trabajo psíquico de revisar, cuestionar y transformar las significaciones simbólicas, a la par que hacer lugar a lo nuevo en relación con sus funciones: hombre/mujer; esposo/esposa; abuelo/abuela. Se emplea metodología cualitativa: entrevistas en profundidad, historias de vida, crónicas del funcionamiento grupal. Surge la preocupación constante y conciente de los mayores, por preservar su capacidad de desear, crear, producir y gozar, la búsqueda de realización personal y la interrelación con el medio, con los otros y con sus pares. Se observan lógicas propias que promueven la horizontalidad de los vínculos y presentan representaciones, sentidos y conductas que modifican el concepto tradicional del viejo. Se destaca la riqueza del encuentro intersubjetivo entre investigadores y entrevistados, en la elaboración de los cambios.

La Geografía en la extensión universitaria : Talleres sobre microemprendimientos productivos en áreas rurales y urbanas del municipio de General Pueyrredón

El objetivo del trabajo es difundir actividades de extensión desarrolladas por alumnos y docentes, con la finalidad de mejorar la calidad de vida de la población del área de estudio, brindar la posibilidad de insertarse al mercado laboral y vincular a integrantes del grupo con diferentes actores sociales en espacios propuestos. Diversos diagnósticos detectaron necesidades sociolaborales en barrios de Mar del Plata. Para mitigarlas, integrantes del Voluntariado Universitario diseñan materiales para dictar talleres sobre Microemprendimientos Productivos. La experiencia tiene resultados positivos porque los encuentros son espacios de debate sobre experiencias locales, que incentivan la asociatividad y generan redes sociales.