The effectiveness of splinting as perceived by the parents of children with Juvenile Ideopathic Arthritis

Juvenile idiopathic arthritis (JIA) is an important disease of childhood with farreaching effects on the child and family. Splinting is a major treatment modality used by occupational therapists for children with JIA. Parents play a central role in whether, when and how splints are used with their children on a daily basis. This paper describes a qualitative research project, which was undertaken to evaluate an occupational therapy service for children with JIA whose treatment had involved splinting. Using semi-structured interviews, the study investigated five mothers' perceptions of the effectiveness of splinting for their children. The interviews revealed five major points. First, the informants generally believed the splinting to be effective. Secondly, the children involved generally resisted wearing splints because they were physically uncomfortable and made them feel different to other children. Thirdly, the mothers used a variety of strategies to ensure that their children wore the splints. Fourthly, the perception of having a positive and supportive relationship with the therapist enhanced the mothers' ability to adhere to splinting. Lastly, the mothers' grief at having a child with JIA influenced their ability to understand and attend to information about specific interventions such as splinting. Practical responses to these findings are outlined.

Men's perceived health needs

Cross-sectional survey data describing health priorities and needs perceived by men and women living in Newcastle, Australia are compared and contrasted with national health policies. The highest prevalence of felt needs for men were stress (13 percent), cost of medical care (10 percent) and money problems (9 percent); while stress (16 percent), overweight (16 percent) and money problems (15 percent) were highest for women. These contrast with the 2000 National Health Priorities of cancer. mental health, injury, cardiovascular health, diabetes and asthma. We conclude that men's perceived unmet health needs are similar to those of women; while sharing some commonalities, they also differ from health professional priorities. Incorporating felt needs into health service planning and delivery is a critical unmet challenge for government planners.

Perceived stress as a predictor of the self-reported new diagnosis of symptomatic CHD in older women

This article describes one aspect of a prospective cohort study of 10,432 women aged between 70 and 75 years. After a 3-year period, 503 women self-reported a new diagnosis by a doctor of angina or myocardial infarction (symptomatic coronary heart disease [CHD]). Time one psychosocial variables (Duke Social Support Index, time pressure, Perceived Stress Scale, Mental Health Index, having a partner, educational attainment, and location of residence) were analyzed using univariate binary logistic regression for their ability to predict subsequent symptomatic CHD. Of these variables, the Duke Social Support Index, Perceived Stress Scale and the Mental Health Index were found to be significant predictors of symptomatic CHID diagnosis. Only the Perceived Stress Scale, however, proved to be a significant independent predictor. After controlling for time one nonpsychosocial variables, as well as the frequency of family doctor visits, perceived stress remained a significant predictor of the new diagnosis of symptomatic CHD in this cohort of older women over a 3-year period.

Unraveling the barriers to reconceptualization of the problem in chronic pain: The actual and perceived ability of patients and health professionals to understand the neurophysiology

To identify why reconceptualization of the problem is difficult in chronic pain, this study aimed to evaluate whether (1) health professionals and patients can understand currently accurate information about the neurophysiology of pain and (2) health professionals accurately estimate the ability of patients to understand the neurophysiology of pain. Knowledge tests were completed by 276 patients with chronic pain and 288 professionals either before (untrained) or after (trained) education about the neurophysiology of pain. Professionals estimated typical patient performance on the test. Untrained participants performed poorly (mean +/- standard deviation, 55% +/- 19% and 29% +/- 12% for professionals and patients, respectively), compared to their trained counterparts (78% +/- 21% and 61% +/- 19%, respectively). The estimated patient score (46% +/- 18%) was less than the actual patient score (P < .005). The results suggest that professionals and patients can understand the neurophysiology of pain but professionals underestimate patients' ability to understand. The implications are that (1) a poor knowledge of currently accurate information about pain and (2) the underestimation of patients' ability to understand currently accurate information about pain represent barriers to reconceptualization of the problem in chronic pain within the clinical and lay arenas. (C) 2003 by the American Pain Society.

O sentido de ser professor de Educação Física pelos “modos de ser sendo junto ao outro no mundo” perverso- fascista e democrático: a vivência real & no filme “Má Educação”

Quais são os “modos de ser sendo junto ao outro no mundo” professores de Educação Física da Prefeitura Municipal da Serra, ES, situados no que se denomina “real” e do professor de Educação Física padre José no filme “Má Educação” de Pedro Almodóvar situado no que se denomina “ficcional”? Que contribuições reflexivas podem trazer tais dados (analisados hermeneuticamente) para a Formação Continuada de professores de Educação Física [3]? OBJETIVO: Descrever os “modos de ser sendo junto ao outro no mundo” de [1] professores de Educação Física que trabalham em escolas públicas da Prefeitura Municipal da Serra, ES & do [2] padre José, personagem ficcional, professor de Educação Física no filme espanhol de 2004 “Má Educação” fazendo-o primeiramente através de uma pesquisa clássica (descritiva e hermenêutica) e depois uma literaturalizada e artística (hermenêutica). MARCO TEÓRICO: Trata-se de uma proposta discursiva (teórica) fenomenológica existencial de tendência marxista criada por Pinel; METODOLOGIA: Tratou-se de uma pesquisa fenomenológica existencial seguindo recomendações de Forghieri (2001) e Pinel (2006; 2012) - dentre outros. Os 29 professores de Educação Física foram provocados a mostrarem os seus “modos de ser sendo junto ao outro no mundo” do ofício professor de Educação Física. Depois essa mesma provocação foi feita ao personagem do filme. RESULTADOS & DISCUSSÃO: Descreveram-se [1] os “modos de ser sendo junto ao outro no mundo” dos professores de Educação Física na dimensão do real e do ficcional (cinema), e não se objetivou comparação por mais que isso tenha ficado evidente. Esses professores, em 2011/2012, experienciando uma democracia (im)perfeita brasileira [que tem até tendências neofascistas], mais ainda assim democracia - foram compreendidos sempre tomando um norte/ rumo/ direção em subjetivação pelos Guias de Sentido (GS – Pinel) democráticos reconhecimento [demanda do grupo em ser valorizado, reconhecido], em (im) potência [impotência e potencia possível de vir a lume sempre; a força e seu outro lado, a fragilidade de ser], afetando [o que se pratica e pensa/sente afeta a si mesmo, o outro e o mundo; o afetar produz mais subjetivações], sonhando [há demanda sempre de realizar projetos de vida; o projeto de ser sempre devir, em construção sempre; é uma precisão imprecisa], saudavelmente insano [o quão perto pode estar a experienciar a sanidade e a loucura e o quanto uma loucura é sã, pois criativa, inventiva, produtiva, opositora ao estabelecido] – eles mesmos junto ao outro no mundo tornando-se sujeitos. [2] Já o professor de Educação Física padre José da película almodovariana é um professor que de imediato pode ser apreendido como sólido e fixo na sua perversão fascista, ele como parte legitimadora do Estado espanhol de Franco, na década de 60, provavelmente em 1964, que é, na ficção, o espaço-tempo de José e suas ações pedagógicas e psicológicas (e de Educação Física). Mas não é apenas o fascismo que torna o fascista um criador de um cotidiano fascista, pois afinal, paralelamente a ele, no concreto e na ficção, haviam pessoas generosas, resistentes e resilientes que atuavam contra essas pressões quase na maioria das vezes advindas do todo (Estado) – eram pessoas democráticas individualmente e em pequenos e grandes grupos; eram exemplo de resistência contra o estabelecido pela ideologia dominante de então. José numa instituição fascista não conseguiu refletir e agir diferentemente, isto é, com mais saúde mental, escolhendo (na liberdade) ser fascista, ser menor (pouco) – optou não ser-mais. Finalmente os mesmos dados são apresentados em outra estética possível e sempre aberta, inconclusa, devir... As artes e a poesia (bem como a literatura) procuram cuidadosamente desvelar os “modos de ser junto ao outro no mundo” professor de Educação Física do mundo real e do imaginário (fílmico) desvelando muitas vezes indissociados. PÓSCRITO: O autor descreve as possíveis implicações do seu estudo para educação física pautado sempre em uma proposta de criar um discursso insubmisso focando na ideia de que uma pesquisa demanda narrar a vida, e literaturalizar a ciência.

Consumidor de mídias móveis : a influência do perfil do adotante na relação entre valor percebido e intenção de compra

O presente estudo tem por objetivo avaliar se o perfil do adotante de inovações altera a relação entre o Valor Percebido e a Intenção de Compra de mídias móveis (smartphones, tablets, ultrabooks e leitores de e-books). Trata-se de uma pesquisa quantitativa que busca explorar a relação estrutural entre as variáveis por meio de Modelagem de Equações Estruturais (SEM – Strutural Equation Modeling). O modelo de pesquisa proposto foi desenvolvido tendo como base a Teoria da Difusão da Inovação (TDI), a Teoria Unificada de Aceitação e Uso de Tecnologia (UTAUT), o Modelo de Aceitação de Tecnologia (TAM), o Modelo Baseado em Valor (VAM), o Modelo de Aceitação de Tecnologia pelo Consumidor (CAT) e o Modelo de Influência Social (IS). Para coletar os dados foi utilizada a técnica snowball sampling ou amostragem em bola de neve, forma de amostragem não probabilística utilizada em pesquisas sociais. Foi feito um levantamento (survey), distribuindo-se questionário disponibilizado pela rede social Facebook, a partir dos contatos do autorsolicitando-se que os respondentes replicassem em suas páginas pessoais o link da pesquisa, ampliando a amostra. A coleta dos dados foi realizada nos meses de setembro e outubro de 2013, obtendo-se um total de 362 questionários respondidos. O estudo apresentou um efeito significativo da variável Valor Percebido na Intenção de Compra (estatística t = 4,506; nível de significância de 1%), além de sustentar a influência moderadora do Perfil do Adotante sobre essa relação (estatística t = 4,066; nível de significância de 1%), apresentando alto impacto sobre a Intenção de Compra (f 2 = 0,582) e relevância preditiva moderada (q2 = 0,290). Entre as variáveis antecedentes relacionadas à adoção de tecnologia, não apresentaram efeito significativo sobre o Valor Percebido: a Facilidade de Uso Percebida, a Complexidade Percebida e o Risco Percebido. O modelo contribuiu significativamente para explicar a influência dos fatores que impactam o Valor Percebido (R2 = 51,7%) o efeito do Valor Percebido na Intenção de Compra (R2 = 49,1%) de equipamentos eletrônicos portáteis. O suporte da presumidade influência moderadora do Perfil do Adotante sobre a relação Valor Percebido e Intenção de Compra indica que as organizações devem conhecer melhor os consumidores desse tipo de equipamento móveis, segmentando e desenvolvendo ações alinhadas com cada perfil de adotante.

An e-marketplace of healthcare and social care services: the perceived interest

Purpose – The health and social care sector is receiving growing attention due to the increased life expectancy and to the public demand for a better quality of life and better health services. New cost-efficient approaches are required, and the paper aims to present and discuss the main results of a study undertaken in a Portuguese municipality on the perceived relevance of an e-marketplace of social and healthcare services for the inhabitants in general, and for people with special needs in particular, and the identification of the most relevant services to be offered through this platform. Design/methodology/approach – A wide survey was undertaken to identify the needs of potential users and their expectancies with relation to the proposed platform. The results of the study are a support for the project promoters to understand the viability of the solution and the requirements to the deployment of the pilot experiment, as well as to drive the selection of domains of activities/classes of services to be offered by the platform. Findings – Services such as information about healthcare services, home monitoring/accompanying services 24 hours per day, and personal hygiene services provided at home are the ones recognized by the inquired citizens as the most important, which indicates that the potential users will be mostly people with special needs or their family or caregivers. Originality/value – While still at a preliminary development phase, the project represents a good opportunity to develop a totally innovative service with high potential impact for the senior population and for individuals with special needs.

An e-marketplace of healthcare and social care services: the perceived interest

The health and social care sector is receiving growing attention for the last years, due to the increased life expectancy, the public demand for a better quality of life and for better health services. These requirements can be met with more cost-efficient approaches and using new technology-based solutions for providing services. The paper presents and discusses some of the main results of a study undertaken in Guimarães, a Municipality at the North of Portugal, on the perceived relevance of an e-Marketplace of social and healthcare services for the inhabitants in general, and in particular for people with special needs; the study also included the identification of the most relevant services to be offered by this platform and allowed concluding that such an e-Marketplace is of recognized relevance and that it is expected a good adhesion from the population.

Stress affects theta activity in limbic networks and impairs novelty-induced exploration and familiarization

Exposure to a novel environment triggers the response of several brain areas that regulate emotional behaviors. Here, we studied theta oscillations within the hippocampus (HPC)-amygdala (AMY)-medial prefrontal cortex (mPFC) network in exploration of a novel environment and subsequent familiarization through repeated exposures to that same environment; in addition, we assessed how concomitant stress exposure could disrupt this activity and impair both behavioral processes. Local field potentials were simultaneously recorded from dorsal and ventral hippocampus (dHPC and vHPC respectively), basolateral amygdala (BLA) and mPFC in freely behaving rats while they were exposed to a novel environment, then repeatedly re-exposed over the course of 3 weeks to that same environment and, finally, on re-exposure to a novel unfamiliar environment. A longitudinal analysis of theta activity within this circuit revealed a reduction of vHPC and BLA theta power and vHPC-BLA theta coherence through familiarization which was correlated with a return to normal exploratory behavior in control rats. In contrast, a persistent over-activation of the same brain regions was observed in stressed rats that displayed impairments in novel exploration and familiarization processes. Importantly, we show that stress also affected intra-hippocampal synchrony and heightened the coherence between vHPC and BLA. In summary, we demonstrate that modulatory theta activity in the aforementioned circuit, namely in the vHPC and BLA, is correlated with the expression of anxiety in novelty-induced exploration and familiarization in both normal and pathological conditions.

Offshore outsourcing in large companies: motivations and risks perceived

When companies opt for information systems (IS) outsourcing, within the set of contracted services, they can contract their entire service needs to onshore suppliers or to offshore companies, or part of these services can be contracted to onshore suppliers and the other part to offshore suppliers. The offshore outsourcing reveals itself nowadays as an important strategic option to IS management optimization. This paper presents and discusses the main results of a survey that was carried out in Portugal to determine several aspects of offshore practice in large companies. It allowed the identification of the services more frequently contracted, the most common motivations for choosing offshore suppliers and the main risks perceived by companies. This research contributes to a better understanding of the IS offshore market, enabling client companies and vendors to improve their strategic business action.