Consultation for Disordered Puberty: What Do Adolescent Medicine Patients Teach Us?

The period of adolescence is not only marked by important growth and pubertal events, but is also characterized by important psychosocial changes driven by a search for autonomy and the construction of one's identity. It can thus be easily understood that puberty disorders interfere heavily with these process, requiring from the endocrinologist not only medical knowledge, but also a great deal of emotional and psychological skills. They must progressively move from an educational approach that heavily involves the parents to one of shared information and decision making that places the young patient at the center of the therapeutic process. This can be achieved in several ways: respecting the affective and cognitive development of the adolescent; securing his privacy and (if requested by him) confidentiality; exploring his self-image and self-esteem and adapting the therapeutic process to the patient's expectations; reviewing the teenager's lifestyle, including the issue of sexuality and sexual behavior, and involving him in any therapeutic choice that has to be made, even if it does not match with the parents' expectations. The skills required for this respectful and holistic follow-up often exceed the abilities of any physician; it is thus suggested that a team approach involving a clinical nurse and/or a psychologist and/or social worker(s) be set up whenever possible.

Intervals between response choices on a single-item measure of quality of life.

BACKGROUND: A single overall rating of quality of life (QoL) is a sensitive method that is often used in population surveys. However, the exact meaning of response choices is unclear. In particular, uneven spacing may affect the way QoL ratings should be analyzed and interpreted. This study aimed to determine the intervals between response choices to a single-item QoL assessment. METHODS: A secondary analysis was conducted on data from the Lc65+ cohort study and two additional, population-based, stratified random samples of older people (N = 5,300). Overall QoL was rated as excellent, very good, good, fair or poor. A QoL score (range 0-100) was derived from participants' answers to a 28-item QoL assessment tool. A transformed QoL score ranging from 1 (poor) to 5 (excellent) was calculated. The same procedure was repeated to compute seven domain-specific QoL subscores (Feeling of safety; Health and mobility; Autonomy; Close entourage; Material resources; Esteem and recognition; Social and cultural life). RESULTS: Mean (95 % confidence intervals) QoL scores were 96.23 (95.81-96.65) for excellent, 93.09 (92.74-93.45) for very good, 81.45 (80.63-82.27) for good, 65.44 (62.67-68.20) for fair and 54.52 (45.31-63.73) for poor overall QoL, corresponding to transformed QoL scores of respectively 5.00, 4.70, 3.58, 2.05, and 1.00. Ordinality of the categories excellent to poor was preserved in all seven QoL subscores. CONCLUSIONS: The excellent-to-poor rating scale provides an ordinal measure of overall QoL. The intervals between response choices are unequal, but an interval scale can be obtained after adequate recoding of excellent, very good, good, fair and poor.

Au sortir de l'hôpital, comment renforcer la continuité de la prise en charge médicale [Discharge from hospital: how to improve continuity of medical care?].

Early readmission is the major success indicator of the transition between hospital and home. Patients admitted with heart failure reach a 20% rate. Potentially avoidable readmissions, defined as unpredictable and related to a known condition during index hospitalization, represent the improvement margin. For these latter, implementation of specific interventions can be effective. Complex interventions on transition, including several modalities and seeking to encourage patient autonomy seem more effective than others. We describe two models: a pragmatic one developed in a regional hospital, and a more complex one developed in a university hospital during the LEAR-HF study. In both cases, it is imperative to work on "medical liability": should it extend beyond discharge up to the threshold of the private practice?

Self-rule Index for Local Authorities (Release 1.0)

Local autonomy is a highly valued feature of good governance. The continuous attempts of many European countries to strengthen the autonomy of local government show the importance given to decentralisation and far-reaching competences at the lowest units of a state. Measuring and comparing local autonomy, however, has proven to be a difficult task. Not only are there diverging ideas about the core elements of local autonomy, there are also considerable difficulties to apply specific concepts to different countries. This project suggests a comprehensive methodology to measure local autonomy. It analyses 39 European countries and reports changes between 1990 and 2014. A network of experts on local government assessed the autonomy of local government of their respective countries on the basis of a common code book. The eleven variables measured are located on seven imensions and can be combined to a "Local Autonomy Index" (LAI). The data show an increase of local autonomy between 1990 and 2005, especially in the new Central and Eastern European countries. Countries with a particularly high degree of local autonomy are Switzerland, the Nordic countries, Germany and Poland.

Developing a conceptual framework to analyse professionalisation in sport federations

Existing research on sport organisations is imprecise in the use of the concept 'professionalisation'. Furthermore, we do not know if analytical concepts of professionalisation correspond with the understanding in practice. This study explores the perceptions of practitioners and proposes a framework to analyse professionalisation in national sport federations. Expert interviews were conducted with six key people from Swiss national sport federations and then analysed these for characteristics of professionalisation using a hermeneutic approach. The characteristics were divided into three areas: (1) changed management philosophy, (2) functional differentiation and specialisation, and (3) application of management tools. However, professionalisation is primarily perceived to be a matter of 'professional' attitude that transforms into federation culture. The practitioners disclose an ambivalent view of professionalisation, e.g. business-like culture vs. voluntarism, for-profit vs. non-profit orientation, autonomy vs. control. A framework is developed that synthesises analytical concepts and practitioners' perceptions to support future comprehensive research into causes, forms and consequences of professionalisation in national sport federations.

The state's response to the Catalan question : an emerging ethnic component in contemporary Spanish nationalism?

Peer-reviewed

The state's response to the Catalan question : an emerging ethnic component in contemporary Spanish nationalism?

Peer-reviewed

Building an open social learning community around a Dspace repository on Statistics

LORs, addressing content management and preservation, have the positive collaterals of institutional positioning and dissemination, but their main benefit is the empowerment of interest-centred learning communities, as we recognise that learning is much more than content, which becomes infrastructure: the LOR provides the learner interaction with the LOs, but also with other learners and teachers.

Liderazgo y dirección de empresas en el s. XXI

Peer-reviewed

Cortosionismo: hablar por los cortos: propuesta didáctica para el uso del cortometraje en el aula de ELE

En este estudio se apuesta por utilizar el material audiovisual en el aula de español como segunda lengua, ya que este material actúa como un sustituto de la realidad en la clase y conecta con el mundo conocido por el aprendiente

Profiles of Second Language Learners in Bilingual Education: A Comparative Study of the Characteristics of Finnish and American Students

The purpose of this comparative study is to profile second language learners by exploring the factors which have an impact on their learning. The subjects come from two different countries: one group comes from Milwaukee, US, and the other from Turku, Finland. The subjects have attended bilingual classes from elementary school to senior high school in their respective countries. In the United States, the subjects (N = 57) started in one elementary school from where they moved on to two high schools in the district. The Finnish subjects (N = 39) attended the same school from elementary to high school. The longitudinal study was conducted during 1994-2004 and combines both qualitative and quantitative research methods. A Pilot Study carried out in 1990-1991 preceded the two subsequent studies that form the core material of this research. The theoretical part of the study focuses first on language policies in the United States and Finland: special emphasis is given to the history, development and current state of bilingual education, and the factors that have affected policy-making in the provision of language instruction. Current language learning theories and models form the theoretical foundation of the research, and underpin the empirical studies. Cognitively-labeled theories are at the forefront, but sociocultural theory and the ecological approach are also accounted for. The research methods consist of questionnaires, compositions and interviews. A combination of statistical methods as well as content analysis were used in the analysis. The attitude of the bilingual learners toward L1 and L2 was generally positive: the subjects enjoyed learning through two languages and were motivated to learn both. The knowledge of L1 and parental support, along with early literacy in L1, facilitated the learning of L2. This was particularly evident in the American subject group. The American subjects’ L2 learning was affected by the attitudes of the learners to the L1 culture and its speakers. Furthermore, the negative attitudes taken by L1 speakers toward L2 speakers and the lack of opportunities to engage in activities in the L1 culture affected the American subjects’ learning of L2, English. The research showed that many American L2 learners were isolated from the L1 culture and were even afraid to use English in everyday communication situations. In light of the research results, a politically neutral linguistic environment, which the Finnish subjects inhabited, was seen to be more favorable for learning. The Finnish subjects were learning L2, English, in a neutral zone where their own attitudes and motivation dictated their learning. The role of L2 as a means of international communication in Finland, as opposed to a means of exercising linguistic power, provided a neutral atmosphere for learning English. In both the American and Finnish groups, the learning of other languages was facilitated when the learner had a good foundation in their L1, and the learning of L1 and L2 were in balance. Learning was also fostered when the learners drew positive experiences from their surroundings and were provided with opportunities to engage in activities where L2 was used.

Los derechos de participación política y administrativa en la Constitución y en los Estatutos de Autonomía: especial referencia al Estatuto de Autonomía de Cataluña

[spa] El estudio afronta la regulación de los derechos de participación en los Estatutos de Autonomía de nueva generación. La novedad que representan estas normas respecto a sus predecesoras es la incorporación de una carta de derechos que vinculan de forma más explícita y detallada a los poderes públicos autonómicos. Los estatuyentes han interiorizado el creciente auge del fenómeno participativo regulando, junto a los tradicionales derechos de participación política, nuevos instrumentos y técnicas participativas, que se enmarcan en el concepto de democracia participativa. Significativa es, en este sentido, la voluntad política plasmada en la competencia que asumen algunos de ellos (Cataluña, Andalucía y Aragón)para la regulación de las consultas populares en cualquiera de sus modalidades ("encuestas, audiencias públicas, foros de participación") distintas el referéndum.

Inter organizational learning within and by innovation networks

The thesis deals with the phenomenon of learning between organizations in innovation networks that develop new products, services or processes. Inter organizational learning is studied especially at the level of the network. The role of the network can be seen as twofold: either the network is a context for inter organizational learning, if the learner is something else than the network (organization, group, individual), or the network itself is the learner. Innovations are regarded as a primary source of competitiveness and renewal in organizations. Networking has become increasingly common particularly because of the possibility to extend the resource base of the organization through partnerships and to concentrate on core competencies. Especially in innovation activities, networks provide the possibility to answer the complex needs of the customers faster and to share the costs and risks of the development work. Networked innovation activities are often organized in practice as distributed virtual teams, either within one organization or as cross organizational co operation. The role of technology is considered in the research mainly as an enabling tool for collaboration and learning. Learning has been recognized as one important collaborative process in networks or as a motivation for networking. It is even more important in the innovation context as an enabler of renewal, since the essence of the innovation process is creating new knowledge, processes, products and services. The thesis aims at providing enhanced understanding about the inter organizational learning phenomenon in and by innovation networks, especially concentrating on the network level. The perspectives used in the research are the theoretical viewpoints and concepts, challenges, and solutions for learning. The methods used in the study are literature reviews and empirical research carried out with semi structured interviews analyzed with qualitative content analysis. The empirical research concentrates on two different areas, firstly on the theoretical approaches to learning that are relevant to innovation networks, secondly on learning in virtual innovation teams. As a result, the research identifies insights and implications for learning in innovation networks from several viewpoints on organizational learning. Using multiple perspectives allows drawing a many sided picture of the learning phenomenon that is valuable because of the versatility and complexity of situations and challenges of learning in the context of innovation and networks. The research results also show some of the challenges of learning and possible solutions for supporting especially network level learning.

Fuerza prensil de la mano asociada al grado de autonomía y riesgo de caída en ancianos

Objetivo: Determinación de la fuerza de prensión de la mano como indicador de la capacidad funcional y grado de autonomía para actividades cotidianas en personas de la tercera edad. Diseño: Se realizó un estudio observacional de diseño transversal. Emplazamiento: Medio comunitario. Centros cívicos, centros culturales y residencias de la tercera edad de la comarca del Bages (Barcelona). 2 Participantes: Se estudió a 61 personas, 40 mujeres y 21 hombres, con un rango de edad comprendido entre los 65 y 90 años, quienes no presentaban afecciones invalidantes graves. Se solicitó su colaboración y aceptación voluntaria tras informar del objetivo del estudio. Mediciones principales: El grado de autonomía funcional se valoró mediante el test de Barthel y el test de Lawton-Brody, y el riesgo de caída mediante el test de Tinetti. La fuerza muscular máxima voluntaria (FMMV) se determinó mediante el test de prensión de la mano (handgrip). Resultados: Los hombres mostraron una correlación positiva y estadísticamente significativa (p=0.001) entre la fuerza prensil de la mano y el grado de autonomía funcional y el menor riesgo de caída (p=0.037). Dicha correlación no fue observada en las mujeres respecto al grado de autonomía (p=0.232) y fue escasa para el riesgo de caída (p=0.048). Conclusiones: El test de handgrip es una herramienta potencialmente útil para estimar la autonomía funcional e instrumental y el riesgo de caídas, especialmente en varones que sobrepasan los 65 años.

Um fotômetro multi-led microcontrolado, portátil e de baixo custo

A microcontrolled, portable and inexpensive photometer is described. It uses six light-emitting diodes (LEDs) as radiation sources and a phototransistor as detector, as well as a microcontroller (PIC - Programmable Controller of Interruption). This device provided total autonomy to the proposed photometer, which was successfully applied to determination of Fe2+ in ferrous syrups and of seven clinical biochemical parameters. As the components are cheap (~U$30.00) and easy to find, the proposed photometer is an economical alternative for routine chemical analyses in small laboratories, for research and teaching. Being portable and microcontrolled, it allows doing field chemical analyses.