Whole-person care: from rhetoric to reality. Achieving parity between mental and physical health.

The report presents evidence on a range of factors affecting disparity between mental and physical health, and includes case studies and examples of good practice to illustrate some of the key issues and solutions. It should be seen as the first stage of an on-going process over the next 5"10 years that will deliver parity for mental health and make whole-person care a reality. It builds on the Implementation Framework for the Mental Health Strategy in providing further analysis of why parity does not currently exist, and the actions required to bring it about. A parity approach should enable NHS and local authority health and social care services to provide a holistic, whole person response to each individual, whatever their needs, and should ensure that all publicly funded services, including those provided by private organisations, give people's mental health equal status to their physical health needs. Central to this approach is the fact that there is a strong relationship between mental health and physical health, and that this influence works in both directions. Poor mental health is associated with a greater risk of physical health problems, and poor physical health is associated with a greater risk of mental health problems. Mental health affects physical health and vice versa. The report makes a series of key recommendations for the UK government, policy-makers and health professionals. Recommendations include: The government and the NHS Commissioning Board should work together to give people equivalent levels of access to treatment for mental health problems as for physical health problems, agreed standards for waiting times, and agreed standards for emergency/crisis mental healthcare. Action to promote good mental health and to address mental health problems needs to start at the earliest stage of a person's life and continue throughout the life course. Preventing premature mortality " there must be a major focus on improving the physical health of people with mental health problems. Public health programmes must include a focus on the mental health dimension of issues commonly considered as physical health concerns, such as smoking, obesity and substance misuse. Commissioners need to regard liaison doctors (who work across physical and mental healthcare) as an absolute necessity rather than an optional luxury. NHS and social care commissioners should commission liaison psychiatry and liaison physician services to drive a whole-person, integrated approach to healthcare in acute, secure, primary care and community settings, for all ages. Mental health services and mental health research must receive funding that reflects the prevalence of mental health problems and their cost to society. Mental illness is responsible for the largest proportion of the disease burden in the UK (22.8%), larger than that of cardiovascular disease (16.2%) or cancer (15.9%). However, only 11% of the NHS budget was spent on NHS services to treat mental health problems for all ages during 2010/11. Culture, attitudes and stigma " zero-tolerance policies in relation to discriminatory attitudes or behaviours should be introduced in all health settings to help combat the stigma that is still attached to mental illness within medicine. Political and managerial leadership is required at all levels. There should be a mechanism at national level for driving a parity approach to relevant policy areas across government; all local councils should have a lead councillor for mental health; all providers of specialist mental health services should have a board-level lead for physical health and all providers of physical healthcare services should have a board-level lead for mental health. The General Medical Council (GMC) and Nursing and Midwifery Council (NMC) should consider how medical and nursing study and training could give greater emphasis to mental health. Mental and physical health should be integrated within undergraduate medical education.This resource was contributed by The National Documentation Centre on Drug Use.

Triatoma rubrovaria (Blanchard, 1843) (Hemiptera - Reduviidae - Triatominae) IV: bionomic aspects on the vector capacity of nymphs

Triatoma rubrovaria has become the most frequently captured triatomine species since the control of T. infestans in the state of Rio Grande do Sul (RS), Brazil. The aim of this study was to evaluate aspects of the vectorial competence of T. rubrovaria using nymphs raised in laboratory under environmental conditions of temperature and humidity and fed on mice. The average developmental period of T. rubrovaria was 180.1 days. The percentage of defecation shortly after feeding was still higher than previous studies in which samples of T. rubrovaria subjected to a slight starvation period before the blood meal were used. The obtained results support former indication that T. rubrovaria presents bionomic characteristics propitious to be a good vector of Trypanosoma cruzi to man. Therefore its domiciliary invasion process must be continuously monitored.

Preliminary data on the performance of Aedes aegypti and Aedes albopictus immatures developing in water-filled tires in Rio de Janeiro

A monthly survey of Aedes aegypti and Aedes albopictus immatures in discarded tires at a site in metropolitan Rio de Janeiro showed that Ae. albopictus was much more abundant in the rainy season, but Ae. aegypti abundance showed a less clear seasonal pattern. Pupal masses for Ae. albopictus showed a seasonal trend. In contrast, Ae. aegypti pupae did not show any clear trend in weight. Large Ae. albopictus pupae were found in the warmer months, when water volume was higher, pH lower, and larval abundance lower. Further studies should be carried out to assess how seasonal variations in body size may impact vector competence of these species in Brazil.

Competencias Profesionales

En el entorno del ejercicio profesional, las destrezas, los valores y actitudes personales, tienen un papel relevante y complementario al de los conocimientos. Este es el motivo de que la enseñanza basada en competencias, como una combinación de saber, ser, hacer y estar con otros, esté en la línea deseada. En este sentido, las universidades han estado elaborando nuevos planes de estudio en los que se desarrollan los nuevos Grados de acuerdo al EEES, incluyendo en estos, las competencias genéricas de cada titulación, que en general, se ciñen a las propuestas presentadas en el proyecto Tuning 2003.La investigación llevada a cabo sobre la competencia comunicativa escrita en el Grado de Ingeniería en Informática, se ha centrado en universidades de toda la geografía española. La información se ha analizado en función de dos marcos de clasificación: el marco curricular (planes de estudio y memorias de verificación de Grado) y el marco de evaluación (rúbricas).La investigación ha corroborado, que la competencia comunicativa escrita, una competencia instrumental genérica que está en el grupo de las destrezas lingüísticas, se trabaja de forma natural en una variedad de asignaturas repartidas a lo largo de los planes de estudio del Grado de Ingeniería en Informática, hecho que favorece la consecución de esta competencia. Aunque solo alrededor de un 20% de los planes de estudio analizados presentan una asignatura, la cual, uno de sus objetivos principales sea la de favorecer la competencia comunicativa escrita, se entiende, además de por la transversalidad de la competencia comunicativa escrita en un plan de estudios TIC, porque esta competencia, como se ha señalado, se puede trabajar de forma eficaz dentro de las metodologías de otras asignaturas.La investigación nos ha llevado a la conclusión, de que un futuro Graduado en Ingeniería Informática de una universidad española, presentará suficiencia en la competencia comunicativa escrita, ya que en esa dirección apuntan las referencias analizadas. El uso de rúbricas se hace necesario para evaluar el aprendizaje de dicha competencia, ya que sin evaluación, no hay posibilidad de constatar si realmente se alcanzan los niveles de calidad deseados.El modelo educativo que propone la UOC, permite que se desarrollen de forma preeminente una serie de competencias transversales, que resultan básicas a la hora de enfrentarse a los retos que nos propone la sociedad, preparando a profesionales, además de con los conocimientos técnicos propios de un Ingeniero en Informática, con las habilidades y competencias transversales necesarias que completan su formación técnica.

Anàlisi de models d'ensenyament-aprenentatge de competències no tècniques als estudis d'Enginyeria en informàtica

Actualment a l'Estat espanyol s'està implantant el Pla Bolonya per incorporar-se a l'Espai Europeu d'Estudis Superiors (l'EEES). Com a un dels principals objectius, l'EEES pretén homogeneïtzar els estudis i de manera concreta les competències adquirides per qualsevol estudiant independentment d'on hagi realitzat els seus estudis. Per això, existeixen iniciatives europees (com el projecte Tuning) que treballen per definir competències per a totes les titulacions universitàries.El projecte presenta l'anàlisi realitzat sobre vint Universitats de diferents continents per identificar models d'ensenyament-aprenentatge de competències no tècniques. La recerca es centra addicionalment en la competència comunicativa escrita.La font principal de dades ha estat la informació proporcionada a les pàgines Web de les universitats i molt especialment els seus plans d'estudi.

Análisis de la enseñanza-aprendizaje y evaluación de competencias transversales en general, y de la competencia de la comunicación escrita en particular, en currículos TIC

Este Proyecto Fin de Carrera, pertenece al área de 'Competencias profesionales' y tiene como objetivo el análisis de diversas experiencias de enseñanza-aprendizaje y de evaluación de competencias transversales, haciendo hincapié en la competencia de la comunicación escrita, dentro de la formación de currículos TIC. El análisis se centra en los planes de estudios del Grado en Ingeniería Informática de 10 universidades españolas representativas (públicas, privadas y a distancia) como representación de la "nueva" formación de currículos TIC en nuestra sociedad.

Evaluation à l'aide d'un livre de bord des compétences cliniques acquises par des stagiaires en médecine. [Evaluation using a logbook of mastering of clinical skills by medical students]

La maîtrise des compétences cliniques est extrêmement importante pour le médecin. Leur enseignement est aujourd'hui facilité grâce à la disponibilité du «Swiss Catalogue of Learning Objectives for Undergraduate Medical Training» où sont décrits les niveaux de compétence à atteindre au terme des études de médecine. Un carnet de bord a été préparé à la Faculté de biologie et de médecine de Lausanne à partir de ce document. Il a permis de mettre en évidence chez les étudiants une très nette amélioration de la maîtrise des compétences cliniques entre le début et la fin des stages en médecine interne, chirurgie/orthopédie, pédiatrie, gynécologie/obstétrique et psychiatrie. Un tel outil devrait permettre dans l'avenir de mieux guider l'apprentissage des étudiants et de suivre leurs progrès à chaque étape du curriculum. [Abstract] The mastering of the clinical skills is of utmost importance for the physician. The teaching of the skills is nowadays made easier with the <<Swiss Catalogue of Learning Objectives for Undergraduate Medical Training>> which lists all the skills and their respective level of expected mastering at graduation. In order to do a survey on how good the students are at those skills, a logbook based on this document has been setup at the Faculty of biology and medicine of the University of Lausanne. This has shown that students went through a clear progression of the mastering of the skills during their elective year in internal medicine, surgery/orthopaedics, paediatric, obstetric and gynaecology as well as psychiatry. Such an instrument should in the future help to better guide the learning process of the clinical skills and to do a better follow-up of their progress.

Abnormal humoral immune response to influenza vaccination in pediatric type-1 human immunodeficiency virus infected patients receiving highly active antiretroviral therapy

Given that highly active antiretroviral therapy (HAART) has been demonstrated useful to restore immune competence in type-1 human immunodeficiency virus (HIV-1)-infected subjects, we evaluated the specific antibody response to influenza vaccine in a cohort of HIV-1-infected children on HAART so as to analyze the quality of this immune response in patients under antiretroviral therapy. Sixteen HIV-1-infected children and 10 HIV-1 seronegative controls were immunized with a commercially available trivalent inactivated influenza vaccine containing the strains A/H1N1, A/H3N2, and B. Serum hemagglutinin inhibition (HI) antibody titers were determined for the three viral strains at the time of vaccination and 1 month later. Immunization induced a significantly increased humoral response against the three influenza virus strains in controls, and only against A/H3N2 in HIV-1-infected children. The comparison of post-vaccination HI titers between HIV-1+ patients and HIV-1 negative controls showed significantly higher HI titers against the three strains in controls. In addition, post vaccination protective HI titers (defined as equal to or higher than 1:40) against the strains A/H3N2 and B were observed in a lower proportion of HIV-1+ children than in controls, while a similar proportion of individuals from each group achieved protective HI titers against the A/H1N1 strain. The CD4+ T cell count, CD4/CD8 T cells ratio, and serum viral load were not affected by influenza virus vaccination when pre- vs post-vaccination values were compared. These findings suggest that despite the fact that HAART is efficient in controlling HIV-1 replication and in increasing CD4+ T cell count in HIV-1-infected children, restoration of immune competence and response to cognate antigens remain incomplete, indicating that additional therapeutic strategies are required to achieve a full reconstitution of immune functions.

PFC - Competencias Profesionales - Memoria

Análisis de experiencias de enseñanza-aprendizaje de la competencia comunicativaescrita a nivel de Ingeniería Informática.

L'ensenyament-aprenentatge de competències transversals a les titulacions d'enginyeria en informàtica concretament de la competència de comunicació escrita en currículums TIC

Per una banda, contextualitza el concepte de competència professional dins del marc de l'EEES, i reconeix i classifica a partir de la revisió de la documentació existent les competències específiques i transversals o genèriques, que han de tenir els nous titulats del Grau d'EI. Per altra banda, s'escomet l'anàlisi dels plans d'estudi i dels plans docents del Grau per identificar la seva adaptació al EEES,, concretament en el que fa referència a la competència de comunicació escrita.

Population structure of the malaria vector Anopheles darlingi in Rondônia, Brazilian Amazon, based on mitochondrial DNA

Anopheles darlingi is the most important Brazilian malaria vector, with a widespread distribution in the Amazon forest. Effective strategies for vector control could be better developed through knowledge of its genetic structure and gene flow among populations, to assess the vector diversity and competence in transmitting Plasmodium. The aim of this study was to assess the genetic diversity of An. darlingi collected at four locations in Porto Velho, by sequencing a fragment of the ND4 mitochondrial gene. From 218 individual mosquitoes, we obtained 20 different haplotypes with a diversity index of 0.756, equivalent to that found in other neotropical anophelines. The analysis did not demonstrate significant population structure. However, haplotype diversity within some populations seems to be over-represented, suggesting the presence of sub-populations, but the presence of highly represented haplotypes complicates this analysis. There was no clear correlation among genetic and geographical distance and there were differences in relation to seasonality, which is important for malarial epidemiology.

A mi què m'expliques?

Els alumnes i les alumnes de primer cicle d'ESO s'enfronten amb les dificultats de la nova etapa i la necessitat de demostrar les seves competències lingüístiques, quant al redactat i la correcció en l'elaboració de textos diversos. Les noves tecnologies de la informació i la comunicació poden ajudar (i han de propiciar-ho) a desenvolupar aquestes capacitats, i han de ser un element motivador perquè els nois i les noies sentin la necessitat de crear produccions escrites pròpies, adequades lingüísticament, coherents i amb les idees ben organitzades.És necessari, a més, que l'avaluació d'aquestes tasques els serveixi per millorar l'expressió en llengua catalana, gramaticalment i ortogràficament, tot ajudant-los a establir sistemes d'autocorrecció i rectificació d'errors.L'exposició pública (en un mitjà com el d'internet) de les seves obres hauria de reblar l'aspecte de la motivació en la creació d'escrits, de manera que els aporti noves expectatives de comunicació i els animi a participar de l'espai virtual que els ofereix aquesta finestra oberta al món. El meu treball té la intenció de ser un projecte educatiu per aconseguir una millora en l'expressió escrita dels alumnes del primer curs d'ESO amb l'ajuda de les eines de les Tecnologies de la Informació i la Comunicació.

Characterization of tumor reactive CD8 T cells induced by peptide vaccination in melanoma patients

ABSTRACT¦Naturally acquired tumor-specific T-cells can be detected in most advanced cancer patients.¦Yet, they often fail to control or eliminate the disease, in contrast to many virus-specific CD8¦T lymphocytes. Therapeutic vaccines aim at inducing and boosting specific T-cells mediated¦immunity to reduce tumor burden. The properties of CD8 T-cells required for protection from¦infectious disease and cancer are only partially characterized.¦The objectives of this study were to assess effector functions, stage of differentiation and¦clonotype selection of tumor-reactive T lymphocytes following peptide vaccination in¦melanoma patients over time. Results were compared to protective viral-specific T-cell¦responses found in healthy individuals. We also characterized dominant versus low/non¦dominant T-cell clonotypes with the aim to further understand the in vivo function of each set¦of frequency-based specific T-cells.¦Here we developed and applied a novel approach for molecular and functional analysis of¦single T lymphocytes ex vivo. T-cell receptor (TCR) clonotype mapping revealed rapid¦selection and expansion of co-dominant T-cell clonotypes, which made up the majority of the¦highly differentiated "effector" T-cells, but only 25% of the less differentiated "effectormemory"¦cells, mostly composed of non-dominant clonotypes. Moreover, we show that¦advanced effector cell differentiation was indeed clonotype-dependent. Surprisingly, however,¦the acquisition of effector functions (cytokine production, killing) was clonotype-independent.¦Vaccination of melanoma patients with native peptide induced competent effector function in¦both dominant and non-dominant clonotypes, suggesting that most if not all clonotypes¦participating in a T-cell response have the potential to develop equal functional competence.¦In contrast, many T-cells remained poorly functional after vaccination with analog peptide,¦despite similar clonotype-dependent differentiation. Our findings show that the type of¦peptide vaccine has a critical influence on the selection and functional activation of the¦clonotypic T-cell repertoire. They also show that systematic assessment of individual T-cells¦identifies the cellular basis of immune responses, contributing to the rational development of¦vaccines.

Assessorament a un grup de treball per millora la competència oral en L2 en una escola bilingüe de Berlin

Aquest treball se centra en l'experiència teoricopràctica de l'Escola Europea Bilingüe Espanyol-Alemany Joan Miró Grundschule, en el plantejament de la millora de la competència oral en L2.