Coping is excellent in Swiss Children with inflammatory bowel disease: results from the Swiss IBD cohort study.

BACKGROUND: Inflammatory bowel disease (IBD) starting during childhood has been assumed to impair quality of life (QoL) of affected children. As this aspect is crucial for further personality development, the health-related quality of life (HRQOL) was assessed in a Swiss nationwide cohort to obtain detailed information on the fields of impairment. METHODS: Data were prospectively acquired from pediatric patients included in the Swiss IBD Cohort Study. IBD activity was evaluated by PCDAI and PUCAI. The age adapted KIDSCREEN questionnaire was evaluated for 110 children with IBD (64 with Crohn's disease 46 with ulcerative colitis). Data were analyzed with respect to established reference values of healthy controls. RESULTS: In the KIDSCREEN index a moderate impairment was only found for physical wellbeing due to disease activity. In contrast, mental well-being and social support were even better as compared to control values. A subgroup analysis revealed that this observation was restricted to the children in the German speaking part of Switzerland, whereas there was no difference compared to controls in the French part of Switzerland. Furthermore, autonomy and school variables were significantly higher in the IBD patients as compared to controls. CONCLUSIONS: The social support for children with IBD is excellent in this cohort. Only physical well-being was impaired due to disease activity, whereas all other KIDSCREEN parameters were better as compared to controls. This indicates that effective coping and support strategies may be able to compensate the burden of disease in pediatric IBD patients.

La flexibilité du temps de travail: entre autonomie et contraintes. Une étude de cas en Suisse.

Flexitime : between autonomy and constraints. A case study in SwitzerlandBy looking at how a new regulation is translated into everyday practices, this dissertation explores through a specific case study the degree of autonomy gained by wage-earners with the introduction of flexible working schedules. The guiding hypothesis is that by introducing procedural rules, flexitime opens the space for more daily negotiations, therefore reinforcing the effects of power relations inherent to employment relationships. The goal is to understand, through a sociological approach, how employees experience a form of working time that transfers responsibility for time management to them, and howthey integrate work-related constraints with their life outside the workplace. The first part of the dissertation sets up the context of the case study. It offers a definition of flexibility by situating it in the broader history of work time, as well as in relation to various organizational forms and cultural transformations. An international literature review and a focus on the Swiss case are offered. In the second part, the focus is narrowed to a specificSwiss firm specialized in mail-order, where a system of individualized management of annual work time has been introduced. By combining a quantitative and qualitative approach, it is possible to analyze determinants of the practices internal to the firm anddeterminants related to employees themselves, as well as the way in which employees articulate these two orders of constraints. The results show that the implementation of flexible working time is not affecting daily negotiation practices so much as it is creating a set of informal rules. The autonomy ofwage-earners is expressed first and foremost through their capacity to produce, negotiate, and legitimate these rules. The intraindividual level has proven to be central for the social regulation of flexible working time. It is not so much a question of legitimation, but rather the process of institutionalization nurtured by the energy invested by wage-earners in their personal quest for a compromise between their various roles, identities, and aspirations. It is this individualized regulation that is ensuring the success of the system under study.

Myönteisiä kokemuksia ulkoistamisesta; yksilön työhyvinvoinnin näkökulma

Tutkimuksen tarkoituksena on selvittää, miten yksilö kokee ulkoistetuntyösuhteensa työhyvinvoinnin näkökulmasta. Kirjallisuuskatsauksessa tuodaan esiin ulkoistamisen erityispiirteitä ja työhyvinvoinnin osalta sitä kuormittavia ja sääteleviä tekijöitä. Tutkimus on laadullinen tutkimus, jonka empiirinen osuus on koottu yksilöhaastatteluilla Ruokolahden kunnassa. Kunnanjohdon edustajilta kerättiin tietoa ulkoistamisesta strategisena ratkaisuna. Ulkoistettuja tehtäviä hoitavien pienyrittäjien haastatteluiden fokus oli työhyvinvointikokemuksissa. Ulkoistetuissa suhteissa löytyi paikallisten, perinteisten työolotekijöiden lisäksi hajautetulle organisaatiolle spesifisiä työn kuormitustekijöitä, joilla oli vaikutusta työhyvinvointikokemuksiin. Mm. työntekijöiden autonomisuuden lisääntyminen ja sopimusosapuolten luottamuksen molemminpuolinen kasvu ulkoistamissopimuksen aikana ovat tässä tutkitussa tapauksessa tehneet työhyvinvointikokemukset positiivisemmiksi verrattuna aiempiin palkkatyösuhteisiin, vaikka työhyvinvoinnin pohdinta on ollut sekundaarista pohdintaa niin ulkoistajilla kuin ulkoistetuillakin.

Challenges in packaging waste management: A case study in the fast food industry

The main research problem of this thesis is to find out the means of promoting the recovery of packaging waste generated in thefast food industry. The recovery of packaging waste generated in the fast food industry is demanded by the packaging waste legislation and expected by the public. The means are revealed by the general factors influencing the recovery of packaging waste, analysed by a multidisciplinary literature review and a case study focusing on the packaging waste managementof McDonald's Oy operating in Finland. The existing solid waste infrastructure does not promote the recovery ofpackaging waste generated in the fast food industry. The theoretical recovery rate of the packaging waste is high, 93 %, while the actual recovery rate is only 29 % consisting of secondary packaging manufactured from cardboard. The total recovery potential of packaging waste is 64 %, resulting in 1 230 tonnes ofrecoverable packaging waste. The achievable recovery potential of 33 %, equalling 647 tonnes of packaging waste could be recovered, but is not recovered mainly because of non-working waste management practises. The theoretical recovery potential of 31 %, equalling 583 tonnes of packaging waste can not be recovered by the existing solid waste infrastructure because of the obscure status of commecial waste, the improper operation ofproducer organisations, and the municipal autonomy. The sorting experiment indicated that it is possible to reach the achievable recovery potential inthe existing solid waste infrastructure. The achievement is promoted by waste producer -oriented waste management practises. The theoretical recovery potential can be reached by increasing the consistency of the solid waste infrastructure through governmental action.

Asociaciones entre la red social y la discapacidad al comienzo de la vejez en las ciudades de Madrid y Barcelona en 2005

La pérdida de autonomía a edades avanzadas no se asocia únicamente con el envejecimiento sino también con características del entorno físico y social. Investigaciones recientes han demostrado que la red social, la integración social y la participación, actúan como predictores de la discapacidad en la vejez. El objetivo de este trabajo es nalizar el efecto de la red social sobre el nivel de autonomía(en términos de discapacidad instrumental y básica) en etapas iniciales de la vejez.

Un país amb 7 territoris

El nou Estatut d’autonomia de Catalunya (2006) preveu la creació de vegueries, enteses en la doble funció d’ens local en substitució de les diputacions i com a àmbit d’actuació perifèrica de la Generalitat. Resta per aclarir l’encaix de la vegueria amb la província estatal. Hores d’ara la planificació del territori i bona part de l’administració perifèrica de la Generalitat s’organitza en 7 àmbits, en tant que l’Estat manté inalterada la seva organització en 4 províncies. S’estudien els precedents històrics de les vegueries contemporànies i en particular el debat i gestació de 9 regions en temps de la Generalitat republicana (1931-1939). Es posa de relleu la important aportació intel·lectual d’Enric Lluch en la reforma i simplificació del mapa de vegueries (de 9 a 7). Es planteja el feixuc trànsit efectuat des de la idea de “província única” al plantejament d’un increment en el nombre de províncies-vegueries.

Protective effects of social networks on disability among older adults in Spain

The loss of autonomy at advanced ages is not only associated with ageing, but also with the characteristics of the physical and social environment. Recent investigations have shown that social networks, social engagement and participation act like predictors of disability among the elderly. The aim of this study is to determine whether social networks are related to the development and progression of disability in the early years of old age. The source of data is the first wave of the survey "Processes of Vulnerability among Spanish Elderly", carried out in 2005 to a sample of 1 244 individuals. The population object of study is the cohort aged 70 to 74 years in metropolitan areas (Madrid and Barcelona) and not institutionalized. Disability is measured by the development of basic activities of daily life (ADL), and instrumental activities of daily life (IADL). The structural aspects of the social relationships are measured through the diversity of social networks and participation. We used the social network index (SNI). For each point over the SNI, the risk of developing any type of disability decreased by 49% (HR = 0.51, 95%CI = 0.31-0.82). The SNI was a decisive factor in all forecasting models constructed with some hazard ratios (HR) that ranged from 0.29 (95%CI = 0.14-0.59) in the first model to 0.43 (95%CI 0.20-0.90) in the full model. The results of the present study showed a strong association between an active social life, emotional support provided by friends and confidents and disability. These findings suggest a protective effect of social networks on disability. Also, these results indicate that some family and emotional ties have a significant effect on both the prevalence and the incidence of disability.

Construcción del Cuestionario de Desarrollo Emocional de Adultos (QDE-A)

El propósito de este trabajo es presentar la construcción y aplicación del Questionari de Desarrollo Emocional para Adultos (QDE-A). Se trata de la versión catalana del Cuestionario de Desarrollo Emocional para Adultos (CDE-A). Los instrumentos disponibles para la medición de la competencia emocional son escasos y todos ellos sujetos a criticas centradas fundamentalmente en la falta de un marco teórico claro y de fundamentos empíricos firmes (Pérez, Petrides y Furnham, 2005). El QDE-A, se enmarca en la línea de investigación sobre educación emocional del GROP (Grupo de Investigación en Orientación Psicopedagógica). Se trata de un cuestionario de autoinforme basado en el marco teórico de la educación emocional desarrollado por el GROP (Bisquerra, 2000 y 2007) según el cual la competencia emocional se compone de cinco dimensiones: conciencia emocional, regulación emocional, autonomía emocional, competencias sociales y competencias para la vida y el bienestar. El QDE-A ofrece una puntuación global y otra para cada una de estas dimensiones. En este artículo se expone el proceso de elaboración para llegar a la versión definitiva que en su forma extensa consiste en una escala que dispone de 48 ítems. Los datos se basan en una muestra de 1537 adultos. La fiabilidad medida por el alfa de Cronbach es de 0,92, para la escala completa y superior a 0.70 para cada una de las dimensiones. La correlación entre cada una de las dimensiones y la puntuación total es significativa en todos los casos con un nivel de p<0.01. El QDE-A responde a la necesidad de disponer de un instrumento riguroso, adaptado a la población catalana, que permite evaluar el nivel de competencia emocional en adultos y fundamentar las intervenciones en educación emocional.

Proyecto de inserción sociolaboral centro penitenciario de Pamplona

Este proyecto de intervención se basa en la elaboración y diseño de un Proyecto de Inserción Sociolaboral, aplicado a un caso real localizado en el Centro Penitenciario de Pamplona; la población diana es un grupo de internas entre 18 y 45 años. El objetivo general de este proyecto es: “capacitar a las internas en técnicas y habilidades encaminadas a lograr un alto grado de autonomía personal para la integración en el mercado laboral y a la sociedad”. El proyecto está dividido en diferentes partes: a) marco teórico como base conceptualizadora para la construcción del proyecto, b) el diagnóstico, a partir de la aplicación de diferentes técnicas cualitativas y cuantitativas, c) formulación del proyecto, d) aplicación y e) evaluación del mismo. El proyecto pretende mostrar y concienciar sobre la situación actual del colectivo penitenciario en relación al ámbito laboral, mostrando cuáles son sus necesidades y las que les dificultan de cara a su integración laboral al salir de prisión, y por lo tanto, de cara a su mejor integración social. Se pretende trasladar a la sociedad a nivel general y en especial, al resto de centros penitenciarios, la importancia que tiene realizar este tipo de intervenciones y proyectos desde prisión.

Treatment of type B periprosthetic femur fractures with curved non-locking plate with eccentric holes: Retrospective study of 43 patients with minimum 1-year follow-up.

INTRODUCTION: Periprosthetic femur fracture (PFF) is a serious complication after total hip arthroplasty that can be treated using different internal fixation devices. However, the outcomes with curved non-locking plates with eccentric holes in this indication have not been reported previously. The objectives of this study were to determine: (1) the union rate; (2) the complication rate; (3) autonomy in a group of patients with a Vancouver type B PFF who were treated with this plate. HYPOTHESIS: Use of this plate results in a high union rate with minimal mechanical complications. MATERIALS AND METHODS: Forty-three patients with a mean age of 79 years±13 (41-98) who had undergone fixation of Vancouver type B PFF with this plate between 2002 and 2007 were included in the study. The time to union and Parker Mobility Score were evaluated. The revision-free survival (all causes) was calculated using Kaplan-Meier analysis. The average follow-up was 42 months±20 (16-90). RESULTS: Union was obtained in all patients in a mean of 2.4 months±0.6 (2-4). One patient had varus malunion of the femur. The Parker Mobility Score decreased from 5.93±1.94 (2-9) to 4.93±1.8 (1-9) (P=0.01). Two patients required a surgical revision: one for an infection after 4.5 years and one for stem loosening. The survival of the femoral stem 5 years after fracture fixation was 83.3%±12.6%. CONCLUSION: Use of a curved plate with eccentric holes for treating type B PFF led to a high union rate and a low number of fixation-related complications. However, PFF remains a serious complication of hip arthroplasty that is accompanied by high morbidity and mortality rates. LEVEL OF EVIDENCE: Retrospective study, level IV.

Cultures familiars, mitjans digitals i joves. Restriccions explícites i implícites en la reproducció de l'avantatge generalitzat

La irrupció dels mitjans digitals està generant en les famílies amb adolescents noves formes d'estar junts i de relacionar-se amb l'exterior, que són viscuts sovint amb ansietat per part dels pares. Per estudiar les normes que tant els pares com els seus fills estan generant per regular-les, i com aquestes regulacions es relacionen amb la reproducció de l'avantatge i el desavantatge generalitzat, es proposa superar l'orientació restringida dels riscos i oportunitats i fixar-se en canvi en la manera comles cultures i identitats familiars generen equilibris particulars en les tensions normatives del treball, el consum i l'autenticitat. Mitjançant una recerca empírica qualitativa amb 23 famílies de dos centres d'educació secundària de l'àrea metropolitana de Barcelona, es constata que enlloc de buscar com normes o estils parentals concrets es relacionen amb diferents posicions socials, és preferible analitzar com les diferents cultures i identitats familiars regulen l'adquisició d'autonomia per part dels fills. Aspectes com la familiaritat i reflexivitat vers la tecnologia, l'establiment de rutines i horaris familiars o els contextos relacionals esdevenen així claus per entendre la reproducció de l'avantatge generalitzat. Aquests elements permeten contextualitzar dinàmicament la complexa combinació de les regulacions implícites i explícites en el procés de maduració dels fills.

Educational intervention for parents of adolescents with chronic illness: a pre-post test pilot study.

OBJECTIVE: This pilot experimental study tested the feasibility and intended effect of an educational intervention for parents to help them assist their adolescent child with chronic illness (CI) in becoming autonomous. METHODS: A two-phase pre-post pilot intervention study targeting parents of adolescents with CI was conducted. Parents were allocated to group 1 and 2 and received the four-module intervention consecutively. Intended effect was measured through online questionnaires for parents and adolescents before, at 2 months after, and at 4-6 months after the intervention. Feasibility was assessed through an evaluation questionnaire for parents. RESULTS: The most useful considered modules concerned the future of the adolescent and parents and social life. The most valued aspect was to exchange with other parents going through similar problems and receiving a new outlook on their relationship with their child. For parents, improvement trends appeared for shared management, parent protection, and self-efficacy, and worsening trends appeared for coping skills, parental perception of child vulnerability, and parental stress. For adolescents, improvement trends appeared for self-efficacy and parental bonding and worsening trends appeared for shared management and coping skills. CONCLUSION: Parents could benefit from peer-to-peer support and education as they support the needed autonomy development of their child. Future studies should test an online platform for parents to find peer support at all times and places.

Rentas y seguros privados de dependencia: Un complemento a las prestaciones públicas de dependencia.

La ley de Promoción de la Autonomía Personal y Atención a las Personas en Situación de Dependencia del 14 de diciembre del 2006 permitirá desarrollar en España un modelo de atención a la dependencia de carácter mixto, en el que el sector público garantizará, mediante el copago, unas coberturas básicas y el sector privado podrá mejorar y complementar las prestaciones ofrecidas por el sector público. En este trabajo nos centraremos en el tratamiento actuarial de la prestación privada de dependencia, la cual se puede percibir en forma de renta o de seguro. El objetivo de una renta de dependencia podría ser ayudar a financiar, periódicamente, el coste que supone para el asegurado la situación de dependencia, mientras que el seguro de dependencia estaría más enfocado a financiar la adquisición, o adecuación, de una determinada infraestructura como consecuencia de la falta de autonomía. Calcularemos la prima única y la provisión matemática de una renta y de un seguro de dependencia contratado por una persona autónoma, basándonos en un modelo de dependencia con los tres grados de dependencia, que son los que se contemplan en la Ley, y supondremos que la cuantía de la renta y del seguro es variable según el grado de dependencia que alcance el asegurado. Para realizar las aplicaciones numéricas utilizaremos distribuciones de mortalidad y tasas de prevalencia que pueden ser adecuadas para la población española y que han surgido de un análisis preliminar.

Assessing positive mental health in people with chronic physical health problems: correlations with socio-demographic variables and physical health status

Background: A holistic perspective on health implies giving careful consideration to the relationship between physical and mental health. In this regard the present study sought to determine the level of Positive Mental Health (PMH) among people with chronic physical health problems, and to examine the relationship between the observed levels of PMH and both physical health status and socio-demographic variables. Methods: The study was based on the Multifactor Model of Positive Mental Health (Lluch, 1999), which comprises six factors: Personal Satisfaction (F1), Prosocial Attitude (F2), Self-control (F3), Autonomy (F4), Problem-solving and Self-actualization (F5), and Interpersonal Relationship Skills (F6). The sample comprised 259 adults with chronic physical health problems who were recruited through a primary care center in the province of Barcelona (Spain). Positive mental health was assessed by means of the Positive Mental Health Questionnaire (Lluch, 1999). Results: Levels of PMH differed, either on the global scale or on specific factors, in relation to the following variables: age: global PMH scores decreased with age (r=-0.129; p=0.038); b) gender: men scored higher on F1 (t=2.203; p=0.028) and F4 (t=3.182; p=0.002), while women scored higher on F2 (t -3.086; p=0.002) and F6 (t=-2.744; p=0.007); c) number of health conditions: the fewer the number of health problems the higher the PMH score on F5 (r=-0.146; p=0.019); d) daily medication: polymedication patients had lower PMH scores, both globally and on various factors; e) use of analgesics: occasional use of painkillers was associated with higher PMH scores on F1 (t=-2.811; p=0.006). There were no significant differences in global PMH scores according to the type of chronic health condition. The only significant difference in the analysis by factors was that patients with hypertension obtained lower PMH scores on the factor Autonomy (t=2.165; p=0.032). Conclusions: Most people with chronic physical health problems have medium or high levels of PMH. The variables that adversely affect PMH are old age, polypharmacy and frequent consumption of analgesics. The type of health problem does not influence the levels of PMH. Much more extensive studies with samples without chronic pathology are now required in order to be able to draw more robust conclusions.

TRANSITION IN ENDOCRINOLOGY: Hypogonadism in adolescence.

Puberty is a remarkable developmental process with the activation of the hypothalamic-pituitary-gonadal axis culminating in reproductive capacity. It is accompanied by cognitive, psychological, emotional, and sociocultural changes. There is wide variation in the timing of pubertal onset, and this process is affected by genetic and environmental influences. Disrupted puberty (delayed or absent) leading to hypogonadism may be caused by congenital or acquired etiologies and can have significant impact on both physical and psychosocial well-being. While adolescence is a time of growing autonomy and independence, it is also a time of vulnerability and thus, the impact of hypogonadism can have lasting effects. This review highlights the various forms of hypogonadism in adolescence and the clinical challenges in differentiating normal variants of puberty from pathological states. In addition, hormonal treatment, concerns regarding fertility, emotional support, and effective transition to adult care are discussed.