Improving hearing aid users' satisfaction through a market survey, instructional video, and booklet

This paper discusses an instructional video and booklet developed to improve hearing aid users’ satisfaction and to educate audiologists on the importance of proper post-fit counseling.

Acceptance of deafness: a study of family strategies and needs

This paper studies the acceptance strategies used by family members of hearing-impaired children. The study looks at how parents view conferences, counseling and meetings with hearing professionals and other parents of deaf children.

La protección constitucional de la familia (Artículos Varios)

La autora enfatiza la necesidad de dotar de ductilidad al Derecho frente a los cambios sociales, refiriéndose particularmente a la familia y sus transformaciones como institución jurídica y como construcción social y cultural. Reflexiona sobre el carácter hegemónico de la familia nuclear burguesa en el derecho, planteando el desafío de que éste responda a la realidad social que muestra diversas formas de familia que no calzan en el modelo dominante. Analiza al matrimonio como el paradigma de la relación de pareja, incluso en la aspiración de aquellos que quieren dotar a su unión de efectos jurídicos, como es el caso de las parejas de homosexuales que se quieren vincular en los mismos términos, o las uniones de hecho, sean éstas heterosexuales u homosexuales, demostrando que, el reconocimiento de otros modelos de familia y la respuesta que se dé a estas demandas, pueden alterar la posición que el matrimonio tiene en la Constitución, y en la garantía institucional que en la misma se consagra.

Recuentos de dos ciudades: Guayaquil en 1899 y Quito en 1906 (Estudios)

Estudio preliminar del desarrollo demográfico de Guayaquil y Quito a fines el siglo XIX e inicios del siglo XX, basado en los censos proto-estadísticos realizados en ambas ciudades en 1899 y 1906, respectivamente. Se estudian las condiciones en las que se realizaron ambos censos, la información cuantitativa que ofrecen y los vacíos que la historia demográfica aún mantiene. El artículo enfatiza en una perspectiva de análisis comparativo entre las dos principales ciudades del Ecuador. Se examina la composición poblacional en términos de grupos de edad, sexo, ocupación, matrimonio, natalidad, mortalidad y educación.

How was patient empowerment portrayed in information leaflets describing the community pharmacy Medicines Use Review service in the UK?

Objective The Medicines Use Review (MUR) community pharmacy service was introduced in 2005 to enhance patient empowerment but the service has not been taken up as widely as expected. We investigated the depiction of the patient–pharmacist power relationship within MUR patient information leaflets. Methods We identified 11 MUR leaflets including the official Department of Health MUR booklet and through discourse analysis examined the way language and imagery had been used to symbolise and give meaning to the MUR service, especially the portrayal of the patient–pharmacist interactions and the implied power relations. Results A variety of terminology was used to describe the MUR, a service that aimed ultimately to produce more informed patients through the information imparted by knowledgeable, skilled pharmacists. Conclusion The educational role of the MUR overshadowed the intended patient empowerment that would take place with a true concordance-centred approach. Although patient empowerment was implied, this was within the boundaries of the biomedical model with the pharmacist as the expert provider of medicines information. Practice implications If patient empowerment is to be conveyed this needs to be communicated to patients through consistent use of language and imagery that portrays the inclusivity intended.

Goal sketching with activity diagrams

Goal orientation is acknowledged as an important paradigm in requirements engineering. The structure of a goal-responsibility model provides opportunities for appraising the intention of a development. Creating a suitable model under agile constraints (time, incompleteness and catching up after an initial burst of creativity) can be challenging. Here we propose a marriage of UML activity diagrams with goal sketching in order to facilitate the production of goal responsibility models under these constraints.

Educational and psychosocial programmes for adolescents with diabetes: approaches, outcomes and cost-effectiveness

Diabetes incurs heavy personal and health system costs. Self-management is required if complications are to be avoided. Adolescents face particular challenges as they learn to take responsibility for their diabetes. A systematic review of educational and psychosocial programmes for adolescents with diabetes was undertaken. This aimed to: identify and categorise the types of programmes that have been evaluated; assess the cost-effectiveness of interventions; identify areas where further research is required. Sixty-two papers were identified and Subjected to a narrative review. Generic programmes focus on knowledge/skills, psychosocial issues, and behaviour/self-management. They result in modest improvements across a range of outcomes but improvements are often not sustained, suggesting a need for continuous support, possibly integrated into normal care. In-hospital education at diagnosis confers few advantages over home treatment. The greatest returns may be obtained by targeting poorly controlled individuals. Few studies addressed resourcing issues and robust cost-effectiveness appraisals are required to identify interventions that generate the greatest returns on expenditure. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Expressing medicine side effects: assessing the effectiveness of absolute risk, relative risk, and number needed to harm, and the provision of baseline risk information

Objective: To assess the effectiveness of absolute risk, relative risk, and number needed to harm formats for medicine side effects, with and without the provision of baseline risk information. Methods: A two factor, risk increase format (relative, absolute and NNH) x baseline (present/absent) between participants design was used. A sample of 268 women was given a scenario about increase in side effect risk with third generation oral contraceptives, and were required to answer written questions to assess their understanding, satisfaction, and likelihood of continuing to take the drug. Results: Provision of baseline information significantly improved risk estimates and increased satisfaction, although the estimates were still considerably higher than the actual risk. No differences between presentation formats were observed when baseline information was presented. Without baseline information, absolute risk led to the most accurate performance. Conclusion: The findings support the importance of informing people about baseline level of risk when describing risk increases. In contrast, they offer no support for using number needed to harm. Practice implications: Health professionals should provide baseline risk information when presenting information about risk increases or decreases. More research is needed before numbers needed to harm (or treat) should be given to members of the general populations. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Over the counter medicines and the need for immediate action: a further evaluation of European Commission recommended wordings for communicating risk

A study examined people's interpretation of European Commission (EC) recommended verbal descriptors for risk of medicine side effects, and actions to take if they do occur. Members of the general public were presented with a fictitious (but realistic) scenario about suffering from a stiff neck, visiting the local pharmacy and purchasing an over the counter (OTC) medicine (Ibruprofen). The medicine came with an information leaflet which included information about the medicine's side effects, their risk of occurrence, and recommended actions to take if adverse effects are experienced. Probability of occurrence was presented numerically (6%) or verbally, using the recommended EC descriptor (common). Results showed that, in line with findings of our earlier work with prescribed medicines, participants significantly overestimated side effect risk. Furthermore, the differences in interpretation were reflected in their judgements of satisfaction, side effect severity, risk to health, and intention to take the medicine. Finally, we observed no significant difference between people's interpretation of the recommended action descriptors ('immediately' and 'as soon as possible'). (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.

Can valuation factors be prescribed? The case of collective enfranchisement and leasehold extension of flats in England and Wales

Recent concerns over the valuation process in collective leasehold enfranchisement and lease extension cases have culminated in new legislation. To underpin this, the Government (Department of Environment Transport and the Regions (DETR)) commissioned new research, which examined whether the valuation of the freehold in such cases could be simplified through the prescription of either yield or marriage value/relativity. This paper, which is based on that research, examines whether it is possible or desirable to prescribe such factors in the valuation process. Market, settlement and Local Valuation Tribunal (LVT) decisions are analysed, and the basis of 'relativity charts' used in practice is critically examined. Ultimately the imperfect nature of the market in freehold investment sales and leasehold vacant possession sales means that recommendations must rest on an analysis of LVT data. New relativity curves are developed from this data and used in conjunction with an alternative approach to valuation yields (based on other investment assets). However, the paper concludes that although the prescription of yields and relativity is possible, it is not fully defensible because of problems in determining risk premia; that the evidential basis for relativity consists of LVT decisions; and that a formula approach would tend to 'lead' the market as a whole.