905 resultados para Breaking bad-news


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Two of the government’s six media reform bills passed in the House of Representatives with multi-party support on Tuesday 19 March. While most attention and debate has focused on the regulation of the news media and ownership, the changes approved on 19 March are both significant and far-reaching.

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OBJECTIVE: The diagnosis of Alzheimer's disease (AD) remains difficult. Lack of diagnostic certainty or possible distress related to a positive result from diagnostic testing could limit the application of new testing technologies. The objective of this paper is to quantify respondents' preferences for obtaining AD diagnostic tests and to estimate the perceived value of AD test information. METHODS: Discrete-choice experiment and contingent-valuation questions were administered to respondents in Germany and the United Kingdom. Choice data were analyzed by using random-parameters logit. A probit model characterized respondents who were not willing to take a test. RESULTS: Most respondents indicated a positive value for AD diagnostic test information. Respondents who indicated an interest in testing preferred brain imaging without the use of radioactive markers. German respondents had relatively lower money-equivalent values for test features compared with respondents in the United Kingdom. CONCLUSIONS: Respondents preferred less invasive diagnostic procedures and tests with higher accuracy and expressed a willingness to pay up to €700 to receive a less invasive test with the highest accuracy.

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The eye and the brain are prototypical tissues manifesting immune privilege (IP) in which immune responses to foreign antigens, particularly alloantigens are suppressed, and even completely inhibited. Explanations for this phenomenon are numerous and mostly reflect our evolving understanding of the molecular and cellular processes underpinning immunological responses generally. IP is now viewed as a property of many tissues and the level of expression of IP varies not only with the tissue but with the nature of the foreign antigen and changes in the limited conditions under which privilege can operate as a mechanism of immunological tolerance. As a result, IP functions normally as a homeostatic mechanism preserving normal function in tissues, particularly those with highly specialized function and limited capacity for renewal such as the eye and brain. However, IP is relatively easily bypassed in the face of a sufficiently strong immunological response, and the privileged tissues may be at greater risk of collateral damage because its natural defenses are more easily breached than in a fully immunocompetent tissue which rapidly rejects foreign antigen and restores integrity. This two-edged sword cuts its swathe through the eye: under most circumstances, IP mechanisms such as blood-ocular barriers, intraocular immune modulators, induction of T regulatory cells, lack of lymphatics, and other properties maintain tissue integrity; however, when these are breached, various degrees of tissue damage occur from severe tissue destruction in retinal viral infections and other forms of uveoretinal inflammation, to less severe inflammatory responses in conditions such as macular degeneration. Conversely, ocular IP and tumor-related IP can combine to permit extensive tumor growth and increased risk of metastasis thus threatening the survival of the host.

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Tese dout., University of Edinburg, 2008

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As long as the social rented sector - which comprised 6% of the housing stock - housed traditional families and the allocation procedures were rather loose, little commotion came about. A combination of changes in family structures (leading to the in stream of ethnic minorities), economic changes (leading to the in stream of poor people), and the strengthening of allocation procedures towards those most in need, did change perceptions. Marginalisation and ghettoisation became during the 1990s the buzzwords when talking and writing about social rented housing. In this article, we will explain the background of the scapegoat trends and the possible consequences for social tenants in particular and for the social rental housing in general.

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La presente investigación tiene como objetivo reconocer y aprender a utilizar el color en el medio audiovisual, es decir, conocer sus cualidades, técnicas y estrategias para, de esta forma, dar justa dimensión a su gran capacidad expresiva. El mirar y, posteriormente, observar permite saber el tipo de atmósferas que son necesarias para sugerir determinados estados. Estas atmósferas se generan gracias a los elementos que las componen, cada uno de ellos con sus formas, colores, ubicación en el espacio, más la interrelación global entre ellos. La composición visual se da a partir del conjunto de elementos distribuidos en el espacio. Que se ven “envueltos” con la luz planteada. Toda esta suma, es la que consigue expresar una emoción por parte del creador y, si se sabe “leer”, una correcta interpretación por parte del espectador. Esta “alfabetización visual” establece nexos entre el creador y el receptor, lo que lleva a unos y otros a un mayor conocimiento en la utilización de las reglas. Ello permite reforzar el texto narrativo, que “se articula en dos niveles: la historia —lo narrado, el qué— y el discurso —el modo de narrarlo, el cómo—, es decir, el plano del contenido y el plano de la expresión” (García, F., 2011, p.12). El creador de la obra audiovisual guía al espectador por los caminos de la historia que está desarrollando, mientras que el espectador, al saber “leer”, puede conocer el camino por donde tiene que transitar para disfrutarlo y entenderlo en su totalidad. Comprender la información que proporciona el color parecería innato al ser humano del siglo XXI, dominado por un entorno netamente visual. Pero no es así. Por lo tanto, si se aprende a conocer los parámetros sobre los que se desarrolla la información que se presenta visualmente, se conseguirá hacer más eficaz la comunicación, a la vez que se fomentará la creatividad, por un lado, y el disfrute visual, por otro...

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In this paper, we analyse the nature of the relationship between market power and technical efficiency for producers' cooperatives. More specifically we test two hypotheses: first, we evaluate the extent to which increasing market pressure may help producers' cooperatives to improve technical efficiency to guarantee positive profits; second, we test whether higher technical efficiency induces producers' cooperatives to have a larger market share. These hypotheses are tested on a sample of Italian conventional and cooperative firms for the Wine Production and Processing sector, using both frontier analysis and dynamic panel techniques. The results support the hypothesis that increasing market pressure can affect positively the cooperativeś efficiency, while gains in technical efficiency do not seem to have any impact on the cooperatives' market share. © 2008 Springer Science+Business Media, LLC.

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Since the findings of a Fatal Accident Inquiry (FAI) in 2010, clinicians working in Scotland have been advised to discuss the risk of Sudden Unexpected Death in Epilepsy (SUDEP) with patients immediately or soon after a diagnosis of epilepsy is made. A thematic analysis was used to describe the experiences discussing SUDEP of 10 clinicians (six Consultant Neurologists and four Neurology Registrars) working in Scotland. Five themes were found: Clinicians employ a ‘SUDEP protocol’, suggesting there is a standardised way of discussing SUDEP with patients and all clinicians routinely discuss SUDEP with newly diagnosed epilepsy patients; The FAI has diffused into practice through meetings and discussions with colleagues; ‘Breaking Good News’ refers to the ambivalence clinicians feel about discussing SUDEP; ‘Falsely anticipating anxiety’ refers to clinicians anticipating a distressed response from patients despite this very rarely occurring; Clinicians suggest that ‘pressure hinders effective communication’ to patients – suggesting that the pressure to discuss SUDEP early after diagnosis may have an emotional impact on patients and affect the amount of information they can take in. Implications for guideline development are discussed.