Satisfaction with pregnancy and delivery services: The quality of maternity care services as experienced by women

Objective: The objective of this study was to investigate the opinions of women regarding the satisfaction about the quality of maternity care received. We hope to establish whether health care technology increases satisfaction or whether it actually interferes with the construction of personal satisfaction in the process of care. Design and setting: Information was gathered using the focus group technique. The area of study comprised the post-natal groups run as part of the Sexual and Reproductive Health Programme of the Catalan Health Authority. (Spain) Participants: Five focus groups were held between May 2006 and July 2007. Findings: Quality of care is a complex concept in which a number of independent core features can be identified. We have grouped these core features into three basic categories. Safety: the hospital and its technological facilities, and the technical expertise of health professionals. The other two main pillars of quality of care are the human dimension of the relationship between the carers and the patient, and finally the structural aspects that determine the context in which the heath care is provided. Key conclusions and implications for practice: The mothers of our study feel satisfied with healthcare technology and view it as a source of security; technology become indispensable features in order to reduce the anxiety provoked by the perceived lack of confidence in their ability as mothers. In this study, women, both during pregnancy and especially when giving birth, believe their feelings and values should be understood by professionals, from whom they seek empathy and a personal commitment, and not just information.

La formulación magistral: adquisición de compètencias mediante ABP y estrategias no presenciales

[cast] La formulación magistral, una de las actividades profesionales más representativas del farmacéutico, consiste en la elaboración, de acuerdo con una prescripción médica, de un medicamento personalizado, adaptado a un paciente concreto, en un compromiso profesional de solucionar un problema de salud específico. La amplia oferta de medicamentos industriales ha reducido considerablemente esta actividad, que a pesar de todo, debe considerarse una herramienta de futuro en sintonía con la tendencia personalizadora actual de la medicina y las necesidades del paciente. Los conocimientos y competencias requeridas para dicha actividad profesional se introducen actualmente en la carrera de Farmacia mediante una asignatura optativa. En el presente trabajo se presenta el planteamiento metodológico diseñado por el Grupo de Innovación Docente de Tecnología Farmacéutica (GIDTF) y el grupo e-Galenica, ambos de la Universidad de Barcelona, para esta asignatura. Dicha metodología esta basada en el Aprendizaje Basado en Problemas (ABP) incluyendo tutorías y prácticas de campo, apoyada en estrategias no presenciales como foro de debate, recursos on-line, cuestionarios y tareas de autoevaluación a través de la plataforma Moodle del Campus Virtual de la UB. Se evalúan asimismo los resultados académicos y las respuestas de los estudiantes a las encuestas realizadas en relación al sistema de impartición de la asignatura. [eng] The pharmaceutical compounding, one of the most representative professional activities of pharmacists, involves the preparation of an individualized medicine tailored to a specific patient in a professional commitment to solve a specific health problem, according to a prescription. The wide range of industrial medicine has significantly reduced this activity, which nevertheless should be considered a tool of the future in line with the current trend of personalizing medicine and patient needs. The knowledge and competences required for this professional activity are introduced to the students of Pharmacy through an optional subject. In this paper we present the ethodological approach developed for this subject by the Teaching Innovation Group of pharmaceutical Technology (GIDTF) and e-Galenica group, both from the University of Barcelona. This methodology is based on Problem-Based Learning (PBL) including tutorials and practices in other centres, supported by out of class strategies as discussion forum, online resources, self-assessment questionnaires and work through the platform Moodle of Virtual Campus UB. The academic performance and student responses to surveys in relation to the didactic methodology are also assessed.

Students’ viewpoint on engineering subjects taught in English

The European Educational Institutions have the challenge and the commitment to enhance multilingual competence and teaching curricular subjects in a foreign language is seen as one of the most promising alternatives. In that context, professors teaching different engineering subjects at the School of Engineering of the UPC at Manresa (EPSEM) have been involved in projects aiming at analyzing the current linguistic situation and developing some on-line open access materials using CLIL as a strategy. They formed the u-Linguatech Research Group on Multilingual Communication in Science and Technology in order to provide such resources in an effective and efficient way. In this paper, we focus on students’ perception of the improvement of their multilingual competence throughout their Engineering degree, by means of subjects taught in English by non-native speakers. Data about the English level of current students are taken into account. We also describe the use of the above resources to improve the quality of subjects learning related to Chemical Engineering curricula.

Anàlisi i proposta de millora del bloc de continguts d'activitats en el medi natural de la ESO

En aquet TFG1 és presenta un estudi on el seu objectiu és l’anàlisi de les dificultats que és troben els professors a l’hora d’impartir les activitats al medi natural, per tal de poder entendré com és que és el bloc de continguts menys treballat. Per això, s’ha utilitzat com a instrument un qüestionari que s’ha aplicat a 49 professors d’educació física de 26 comarques de Catalunya. Aquests docents han estat escollit aleatòriament i han respòs el qüestionari per voluntat pròpia. El tractament estadístic del qüestionari s’ha dut a terme amb Google Drive. Entre les conclusions cal destacar la diferència entre el currículum proposat per la LOE (2006) i el proposat per la LOE (2007), i la clara aposta del professorat per realitzar les activitats al medi natural fora del centre, amb el cost afegit que això suposa. Aquest últim fet, a més, sembla comportar, per una banda, la dificultat afegida que suposa pels professors el fet de sortir fora de l’escola i, per altra banda, la responsabilitat que requereix dur a terme aquestes activitats.

Mammalian Target of Rapamycin Complex 2 Controls CD8 T Cell Memory Differentiation in a Foxo1-Dependent Manner.

Upon infection, antigen-specific naive CD8 T cells are activated and differentiate into short-lived effector cells (SLECs) and memory precursor cells (MPECs). The underlying signaling pathways remain largely unresolved. We show that Rictor, the core component of mammalian target of rapamycin complex 2 (mTORC2), regulates SLEC and MPEC commitment. Rictor deficiency favors memory formation and increases IL-2 secretion capacity without dampening effector functions. Moreover, mTORC2-deficient memory T cells mount more potent recall responses. Enhanced memory formation in the absence of mTORC2 was associated with Eomes and Tcf-1 upregulation, repression of T-bet, enhanced mitochondrial spare respiratory capacity, and fatty acid oxidation. This transcriptional and metabolic reprogramming is mainly driven by nuclear stabilization of Foxo1. Silencing of Foxo1 reversed the increased MPEC differentiation and IL-2 production and led to an impaired recall response of Rictor KO memory T cells. Therefore, mTORC2 is a critical regulator of CD8 T cell differentiation and may be an important target for immunotherapy interventions.

The learning about imaging diagnosis technology

Objective To investigate the learning about management of the technology (efficient use, acquisition and maintenance of imaging diagnosis equipment) in the radiology residency program of Escola Paulista de Medicina - Universidade Federal de São Paulo, with a view to improving the education of radiologists. Materials and Methods Exploratory research where residents, faculty staff and tutors of the program were quantitative and qualitatively approached with Likert scale questionnaires (46), and deepening with recorded interviews (18) and categorization based upon meaning units (thematic analysis). Results Among the participants, 66% agreed that they had the opportunity of learning about the use of radiological equipment; for 61% the program should include knowledge on the importance of acquiring equipment; and 72% emphasized the lack of learning about equipment management and maintenance. Conclusion As the major moment in the education of specialists, the medical residency program provides residents with a favorable environment to the learning of the skills required to the future of their professional practice, but with limited emphasis on the management of the technology: efficient use, acquisition and mainly maintenance of equipment, still poorly explored. Both the investigated program and the medical residency in radiology should incorporate, whenever possible, the commitment with the training in supplementary skills related to equipment management, developing the competence of the future radiologists.

Brief report : Academic amotivation in light of the dark side of identity formation

The study intended to determine motivational profiles of first-year undergraduates and aimed their characterization in terms of identity processes. First, a cluster analysis revealed five motivational profiles: combined (i.e., high quantity of motivation, low amotivation); intrinsic (i.e., high intrinsic, low introjected and external regulation, low amotivation); "demotivated" (i.e., very low quantity of motivation and amotivation); extrinsic (i.e., high extrinsic and identified regulation and low intrinsic and amotivation); and "amotivated" (i.e., low intrinsic and identified, very high amotivation). Second, using Lebart's (2000) methodology, the most characteristic identity processes were listed for each motivational cluster. Demotivated and amotivated profiles were refined in terms of adaptive and maladaptive forms of exploration. Notably, exploration in breadth and in depth were underrepresented in demotivated students compared to the total sample; commitment and ruminative exploration were under and overrepresented respectively in amotivated students. Educational and clinical implications are proposedand future research is suggested.

Learning on human resources management in the radiology residency program

Objective To investigate the process of learning on human resource management in the radiology residency program at Escola Paulista de Medicina – Universidade Federal de São Paulo, aiming at improving radiologists' education. Materials and Methods Exploratory study with a quantitative and qualitative approach developed with the faculty staff, preceptors and residents of the program, utilizing a Likert questionnaire (46), taped interviews (18), and categorization based on thematic analysis. Results According to 71% of the participants, residents have clarity about their role in the development of their activities, and 48% said that residents have no opportunity to learn how to manage their work in a multidisciplinary team. Conclusion Isolation at medical records room, little interactivity between sectors with diversified and fixed activities, absence of a previous culture and lack of a training program on human resources management may interfere in the development of skills for the residents' practice. There is a need to review objectives of the medical residency in the field of radiology, incorporating, whenever possible, the commitment to the training of skills related to human resources management thus widening the scope of abilities of the future radiologists.

Individual Perception of Organizational Values

The objective of this master’s thesis was to examine how corporate values come true among the white-collar employees in the case organization. It was also studied if values were perceived similarly in the different departments. Impact of organizational position and education on value orientation was tested through hypotheses based on earlier values research. There are only few value scales available for measuring organizational values. The empirical study results indicate that personnel’s perception of organizational values can be measured statistically. When defining the scale it is utmost important to link the questions and claims close to the employees’ daily working environment. In this study, Work ethic appeared as the strongest organizational value reflecting respondents’ commitment to their duties. Related to corporate values, Performance was perceived as the strongest value and Emphasis on people the weakest. Value consensus between the departments varied. According to the previous research organizational position and educational level has an impact on value perceptions. In this study, employees in superior position or with higher education perceived organizational values to come true better than subordinates or employees with lower education. Empirical data (N=229) was collected by a web-based survey questionnaire among white-collar employees in the case organization in April 2008. Statistical analyses were performed by SPSS programme.

IEA Bioenergy Task 40 “Sustainable International Bioenergy Trade: Securing supply and demand” Country report of Finland 2008

This study considered the current situation of biofuels markets in Finland. The fact that industry consumes more than half of the total primary energy, widely applied combined heat and power production and a high share of solid biomass fuels in the total energy consumption are specific to the Finnish energy system. Wood is the most important source of bioenergy in Finland, representing 21% of the total energy consumption in 2006. Almost 80% of the wood-based energy is recovered from industrial by-products and residues. Finland has commitment itself to maintaining its greenhouse gas emissions at the 1990 level, at the highest, during the period 2008–2012. The energy and climate policy carried out in recent years has been based on the National Energy and Climate introduced in 2005. The Finnish energy policy aims to achieve the target, and a variety of measures are taken to promote the use of renewable energy sources and especially wood fuels. In 2007, the government started to prepare a new long-term (up to the year 2050) climate and energy strategy that will meet EU’s new targets for the reduction of green house gas emissions and the promotion of renewable energy sources. The new strategy will be introduced during 2008. The international biofuels trade has a substantial importance for the utilisation of bioenergy in Finland. In 2006, the total international trading of solid and liquid biofuels was approximately 64 PJ of which import was 61 PJ. Most of the import is indirect and takes place within the forest industry’s raw wood imports. In 2006, as much as 24% of wood energy was based on foreignorigin wood. Wood pellets and tall oil form the majority of export streams of biofuels. The indirect import of wood fuels increased almost 10% in 2004–2006, while the direct trade of solid and liquid biofuels has been almost constant.

Tuotealustapohjaisen suunnittelun vaikutukset risteilijän suunnitteluaikatauluihin

Tuotealustapohjaisella suunnittelulla pyritään hyödyntämään jo kertaalleen hyväksi todettuja kokonaisuuksia ja moduuleja, joiden avulla voidaan nopeasti suunnitella uusia tuotteita. Tarkoituksena on suunnitella asiakkaan näkökulmasta monia erilaisia tuotteita jopa sarjatuotannon kustannustehokkuudella. Tutkimuksessa esitetään risteilijän tuotealustapohjainen suunnitteluprosessi. Lisäksi työn tavoitteena on tutkia uuden suunnitteluprosessin vaikutukset risteilijän suunnitteluaikatauluihin. Tutkimuksessa haastateltiin Turun telakan suunnitteluosaston ja kehitysosaston johtajia. Haastatteluilla selvitettiin nykyisen suunnitteluprosessin haasteita, joiden nähtiin erityisesti viivästyttävät suunnitteluaikatauluja. Keskeisiä haasteita ovat suunnitteluresurssien ylikuormitus ja suunnittelulaadun huonontuminen. Lisäksi kartoitettiin tavoitteet risteilijän tuotealustaratkaisulle ja suunnitteluaikataululle. Haastattelukierroksen pohjalta ja teoriaa soveltaen analysoitiin risteilijän modulaariseen tuotealustaan perustuva suunnitteluprosessi. Tätä suunnitteluprosessia tutkittiin edelleen case-tutkimuksessa jääasemien osalta, jossa haastateltiin kyseisten alueiden suunnittelijoita. Lisäksi case-tutkimuksessa verrattiin jääaseman ja baaripentterin perussuunnittelun vaiheita toisiinsa. Näistä saatuja tutkimustuloksia verrattiin hyttialueen vakioidun perussuunnitteluohjeen vaikutuksiin suunnitteluprosessissa. Onnistunut tuotealustapohjainen suunnittelu vaatii sitoutumista jokaisella organisaation tasolla, jotta tuotealustassa olevien vakioituja moduuleja myös käytettäisiin. Modulaarisesta toiminnasta siirtyminen tuotealustapohjaiseen suunnitteluun vaatii vakioituja moduuleja ja vakioituja rajapintoja risteilijässä. Case-tutkimuksessa ja johtopäätöksissä on todettu uuden suunnitteluprosessin lyhentävän ja tuovan kustannussäästöjä tuotteen valmistusprosessissa.

Urapolut ja niihin vaikuttavat tekijät S-ryhmässä

Urateoriat ovat murroksessa, kun urat ovat muuttumassa perinteisistä urapoluista rajattomiin, monisuuntaisiin uriin. Samaan aikaan erilaisten trainee-ohjelmien määrä lisääntyy vauhdilla. Urapolkujen tutkiminen on tästä syystä erittäin ajankohtaista. Tämän tutkielman tarkoituksena on tutkia, miten S-ryhmässä työskentelevien kaupallisen kenttäkoulutuksen käyneiden ja sen käymättömien urapolut eroavat toisistaan. Viimeaikaisten teorioiden mukaan urat voidaan jakaa objektiivisiin ja subjektiivisiin uriin sekä perinteisiin ja rajattomiin uriin. Aikaisempien tutkimustulosten pohjalta tarkastellaan yksilöiden uravalintoja ja käsityksiä hyvästä urasta. Myös yksilön sosiaalistuminen organisaatioon vaikuttaa sitoutumiseen ja tätä kautta uraan. Tutkimuksessa on käytetty kvalitatiivisia menetelmiä ja havaintoaineisto on kerätty sähköpostikyselyiden avulla S-ryhmässä työskenteleviltä henkilöiltä. Tutkimustulokset osoittavat, että urapolut ovat erilaisia. Kaikki tutkimukseen osallistuneet kenttäkoulutetut ovat johtaja-asemassa, vertailuryhmän henkilöt asiantuntija- tai päällikköasemassa. Tulosten mukaan ei kuitenkaan voida todeta, että näiden kahden ryhmän urakäsitykset olisivat huomattavasti erilaisia. Onnistunut ura nähdään useimmin subjektiivisesti haastavana, omien tavoitteiden ja kehittymisen saavuttamisena.

Liderazgo y dirección de empresas en el s. XXI

Peer-reviewed

Entre la discapacitat i la diversitat funcional: El professional davant dels canvis de paradigmes i no només de paraules

En qualsevol disciplina els canvis en el vocabulari són importants pel fet que hi ha una evolució en la disciplina mateixa. Pel que fa a la discapacitat i la diversitat funcional no només hi ha un canvi de paraules sinó un canvi conceptual que genera substitucions de vocabulari però no com a sinònims. Els canvis de paradigma als quals fem referència en la darrera dècada comencen a prendre rellevància a molts nivells, com l’acadèmic, el social i el polític, com si fossin un engranatge en què, quan hi ha canvis en una peça, convé també plantejar-los en les altres. Des d’aquest punt de vista alteracions de la concepció de discapacitat i diversitat funcional generen canvis significatius en la manera de generar serveis si calgués. Però a més adquireixen molta importància les novetats a nivell actitudinal i de relació que estableixen els professionals de l’educació social o del treball social sobre les persones amb diversitat funcional.