”När jag blir ledsen skär jag mej!” En kvalitativ studie om vad som ligger i fokus i ungdomars diskussioner, på ett webbaserat community, kring självskadebeteende

Syftet med denna uppsats var att beskriva vad som låg i fokus i ungdomars diskussioner, på ett webbaserat community, kring självskadebeteende. Urvalet blev 114 ungdomar mellan 13 och 25 år på communityt Helgon.net. Frågeställningarna var: ”Vilka huvudteman ligger i fokus i ungdomarnas diskussioner?”, ”Fungerar diskussionerna på forumen som ett socialt stöd?” och ”Vilka erfarenheter har ungdomarna av professionell hjälp?” Den metod som användes var en kvalitativ analys av de fyra huvudtemana ”Självskadetrend”, ”Varför skada sig själv”, ”Sårskador, ärr och skamkänslor” och ”Behandling och stöd”, som skapades utifrån vad som låg i fokus i ungdomarnas diskussioner. Enligt Alderman, Ahmed och Stacey är självskadebeteende ett sätt att hantera känslomässigt svåra situationer och att därigenom återställa den inre balansen, alltså en slags överlevnadsstrategi. Studien visar att diskussionerna på forumen fungerat som ett socialt stöd för ungdomarna, där de har kunnat ta del av varandras erfarenheter, information och tips. De flesta ungdomar hade negativa erfarenheter av professionell hjälp eftersom de bland annat kände sig felaktigt bemötta. Studien har även visat att flera ungdomar tycker att det är lättare att skriva om sin problematik till andra på Internet än att berätta om det till professionella. Uppsatsförfattarnas idé utifrån detta har varit att det vore lämpligt om de professionella använde sig mer av Internet för att kunna nå ut till ungdomarna. Detta skulle i sin tur ge en möjlighet till att arbeta mer förebyggande och fånga upp de ungdomar som ligger i riskzonen.

T cell clones from Schistosoma haematobium infected and exposed individuals lacking distinct cytokine profiles for Th1/Th2 polarisation

T cell clones were derived from peripheral blood mononuclear cells of Schistosoma haematobium infected and uninfected individuals living in an endemic area. The clones were stimulated with S. haematobium worm and egg antigens and purified protein derivative. Attempts were made to classify the T cell clones according to production of the cytokines IL-4, IL-5 and IFN-gamma. All the T cell clones derived were observed to produce cytokines used as markers for the classification of Th1/Th2 subsets. However, the 'signature' cytokines marking each subset were produced at different levels. The classification depended on the dominating cytokine type, which was having either Th0/1 or Th0/2 subsets. The results indicated that no distinct cytokine profiles for polarisation of Th1/Th2 subsets were detected in these S. haematobium infected humans. The balance in the profiles of cytokines marking each subset were related to infection and re-infection status after treatment with praziquantel. In the present study, as judged by the changes in infection status with time, the T cell responses appeared to be less stable and more dynamic, suggesting that small quantitative changes in the balance of the cytokines response could result in either susceptibility or resistant to S. haematobium infection.

Use of lights and siren: is there room for improvement?

OBJECTIVE: The objective of this study was to analyse the use of lights and siren (L&S) during transport to the hospital by the prehospital severity status of the patient and the time saved by the time of day of the mission. METHODS: We searched the Public Health Services data of a Swiss state from 1 January 2010 to 31 December 2010. All primary patient transports within the state were included (24 718). The data collected were on the use of L&S, patient demographics, the time and duration of transport, the type of mission (trauma vs. nontrauma) and the severity of the condition according to the National Advisory Committee for Aeronautics (NACA) score assigned by the paramedics and/or emergency physician. We excluded 212 transports because of missing data. RESULTS: A total of 24 506 ambulance transports met the inclusion criteria. L&S were used 4066 times, or in 16.6% of all missions. Of these, 40% were graded NACA less than 4. Overall, the mean total transport time to return to the hospital was 11.09 min (confidence interval 10.84-11.34) with L&S and 12.84 min (confidence interval 12.72-12.96) without. The difference was 1.75 min (105 s; P<0.001). For night-time runs alone, the mean time saved using L&S was 0.17 min (10.2 s; P=0.27). CONCLUSION: At present, the use of L&S seems questionable given the severity status or NACA score of transported patients. Our results should prompt the implementation of more specific regulations for L&S use during transport to the hospital, taking into consideration certain physiological criteria of the victim as well as time of day of transport.

Accuracy of prehospital triage of trauma patients by emergency physicians: a retrospective study in western Switzerland.

OBJECTIVE: Accurate identification of major trauma patients in the prehospital setting positively affects survival and resource utilization. Triage algorithms using predictive criteria of injury severity have been identified in paramedic-based prehospital systems. Our rescue system is based on prehospital paramedics and emergency physicians. The aim of this study was to evaluate the accuracy of the prehospital triage performed by physicians and to identify the predictive factors leading to errors of triage.METHODS: Retrospective study of trauma patients triaged by physicians. Prehospital triage was analyzed using criteria defining major trauma victims (MTVs, Injury Severity Score >15, admission to ICU, need for immediate surgery and death within 48 h). Adequate triage was defined as MTVs oriented to the trauma centre or non-MTV (NMTV) oriented to regional hospitals.RESULTS: One thousand six hundred and eighti-five patients (blunt trauma 96%) were included (558 MTV and 1127 NMTV). Triage was adequate in 1455 patients (86.4%). Overtriage occurred in 171 cases (10.1%) and undertriage in 59 cases (3.5%). Sensitivity and specificity was 90 and 85%, respectively, whereas positive predictive value and negative predictive value were 75 and 94%, respectively. Using logistic regression analysis, significant (P<0.05) predictors of undertriage were head or thorax injuries (odds ratio >2.5). Predictors of overtriage were paediatric age group, pedestrian or 2 wheel-vehicle road traffic accidents (odds ratio >2.0).CONCLUSION: Physicians using clinical judgement provide effective prehospital triage of trauma patients. Only a few factors predicting errors in triage process were identified in this study.

Spinal epidural hematoma: not always an obvious diagnosis.

Spinal epidural hematoma (SEH) is a rare neurosurgical emergency. SEH is characterized by an archetypal clinical presentation including abrupt spinal pain followed more or less rapidly by various degrees of neurological deficit. The diagnosis of SEH, often based on a clinical presumption, represents a clinical challenge. Several reports have outlined missed or delayed diagnosis due to unusual and confusing onsets or unawareness of this diagnosis by physicians. Therefore, physicians should keep in mind the possibility of SEH in their differential diagnosis when confronted with patients complaining of sudden onset of acute spinal pain with or without neurological sign, because the impact of a delayed diagnosis can be disabling catastrophic neurological sequelae. We suggest that SEH is a dynamic disease, which occurs in patients with an abnormal vasculature structural degenerative change. The bleeding is probably of multifactorial origin incriminating veins as well as arteries. Therefore, we proposed a classification of SEH, according to the most probable etiology whatever the associated factors, in six groups: spontaneous, secondary, iatrogenic, traumatic, recurrent, and idiopathic SEH.

Characteristics of highly frequent users of a Swiss academic emergency department: a retrospective consecutive case series.

OBJECTIVES: The aim of this study was to describe the demographic, social and medical characteristics, and healthcare use of highly frequent users of a university hospital emergency department (ED) in Switzerland. METHODS: A retrospective consecutive case series was performed. We included all highly frequent users, defined as patients attending the ED 12 times or more within a calendar year (1 January 2009 to 31 December 2009). We collected their characteristics and calculated a score of accumulation of risk factors of vulnerability. RESULTS: Highly frequent users comprised 0.1% of ED patients, and they accounted for 0.8% of all ED attendances (23 patients, 425 attendances). Of all highly frequent users, 87% had a primary care practitioner, 82.6% were unemployed, 73.9% were socially isolated, and 60.9% had a mental health or substance use primary diagnosis. One-third had attempted suicide during study period, all of them being women. They were often admitted (24.0% of attendances), and only 8.7% were uninsured. On average, they cumulated 3.3 different risk factors of vulnerability (SD 1.4). CONCLUSION: Highly frequent users of a Swiss academic ED are a highly vulnerable population. They are in poor health and accumulate several risk factors of being even in poorer health. The small number of patients and their high level of insurance coverage make it particularly feasible to design a specific intervention to approach their needs, in close collaboration with their primary care practitioner. Elaboration of the intervention should focus on social reinsertion and risk-reduction strategies with regard to substance use, hospital admissions and suicide.

InserQual: una eina per a la millora de la qualitat en l'acompanyament a la inserció laboral

InserQual és un protocol nascut al tercer sector que garanteix a les entitats la quali tat del procés d'acompanyament a la inserció laboral. Les enlitats ques' hi dediquen acostumen a treballara partir de l' ilinerari lineal class ic,queconsidera la inserciócom un procés lineal i ordenat que va de I' atur a I'ocupació. InserQual reformula aquest itinerari aportant la imatge de la rotonda. Aquesta aporta a I' itinerari un valor afegitde fl ex ibilitat i adequació a les necessitats de cada usuari/aria. LnserQual és, perlant, unaeina útil i propera, específica per a entitats dedicades a la inserció laboral de persones amb dificultats i que aporta un seguit d' actuacions molt concretes, pero flexibles, que permeten als professionals millorar en la seva intervenció del dia a dia.

Uso de las nuevas tecnolog??as como instrumento de atenci??n a la diversidad en el aula

Se pretende elaborar unidades did??cticas en el ??rea de Ciencias de la Naturaleza utilizando las tecnolog??as inform??ticas que permitan atender a la diversidad facilitando que cada alumno pueda trabajar a su ritmo.

Adolescencia y comportamiento antisocial

Resumen tomado de la publicaci??n

Effect of arousal increase in predictable and random task switching : Evidence for the involvement of the anterior attentional network in random but not in predictable task switching

Resumen tomado de la publicaci??n

25 anys de formaci?? del professorat al CEP de Menorca. '25 a??os de formaci??n del profesorado en el CEP de Menorca'

Resumen tomado del autor

Pla provincial de formaci?? del professorat : 1991-1992. 'Plan provincial de formaci??n del profesorado : 1991-1992'

Resumen tomado del propio recurso

Dinámicas fronterizas, una aproximación desde las políticas del gobierno colombiano para la frontera norte de Santander-Táchira (2010-2014)

El interés de este estudio de caso, es analizar la situación fronteriza en materia comercial y de seguridad; evaluando las políticas públicas implementadas por el gobierno Santos, para darle solución a los problemas estructurales de la zona de estudio, comprendida por Norte de Santander y el Táchira. Adicionalmente se explican los problemas comerciales y de ilegalidad en la zona, que en la actualidad tienden a expandirse como una red controlada por las Farc, Auc y Bandas Criminales, que han cooptado la institucionalidad de ambos Estados. Y finalmente se determina que las políticas implementadas desde la administración Santos han sido insuficientes para terminar los problemas estructurales en materia comercial y de seguridad en la zona.

El ni??o obeso

Analizar la obesidad infantil, y sus repercusiones en la personalidad del ni??o y en el marco escolar. La primera muestra se realiza sobre 7947 ni??os procedentes de 9 colegios valencianos, en edades comprendidas entre los 6 y 14 a??os. La segunda muestra se compone de 30 ni??os obesos y 30 no obesos para analizar el esquema corporal. La tercera muestra a 30 ni??os obesos y 30 no obesos, con edades comprendidas entre los 9 y 13 a??os para determinar la agresividad reprimida. Se hallan en la primera muestra los porcentajes totales de obesidad infantil, teniendo en cuenta el nivel socioecon??mico y cultural. En la segunda muestra se realiza un an??lisis psicol??gico del cuerpo, y en la tercera se mide la agresividad y la frustraci??n. Escala de Alexandre, completada con las matrices progresivas de Raven para la inteligencia, en los casos individuales; el test de Daurat-Hmeljak para el esquema corporal; el test de Rosezweig-Garc??a Yag??e para medir la frustraci??n-agresividad. An??lisis estad??stico: porcentajes. An??lisis comparativo de los porcentajes totales de la obesidad infantil con los de otros pa??ses. Prueba U de Mann-Whitney entre ambos grupos raz??n cr??tica, desviaci??n t??pica, varianza, niveles de significaci??n. Puede generalizarse, por la amplitud de la muestra, que el 4,65 por ciento de la poblaci??n escolar valenciana es obesa, porcentaje similar con los de otros pa??ses. El ni??o obeso puede padecer importantes trastornos de la corporeidad, encontr??ndose diferencias significativas en los niveles de colocaci??n y elecci??n. Esto es importante ya que el esquema corporal es la clave de toda la organizaci??n de la personalidad. Se confirma que el ni??o obeso tiene una agresividad reprimida, siendo la pasividad una consecuencia l??gica. Se hace necesaria la recuperaci??n del ni??o obeso mediante un tratamiento motor, diet??tico y psicopedag??gico, completado con una educaci??n psicomotriz. Este tratamiento tambi??n debe incidir en la familia. La escuela puede ayudar a la recuperaci??n mediante la educaci??n alimentaria, clases de gimnasia, asistencia al ni??o y formaci??n a los padres.

Mejorar la salud materna : objetivo n 5 de los Objetivos de Desarrollo del Milenio : Infantil

Manos Unidas aborda en sus campa??as los Objetivos del Milenio y con este fin, elabora los materiales educativos en los niveles de infantil, primaria y secundaria, que ofrecen al profesorado para el curso 2007-2008. Con el lema Madres sanas, derecho y esperanza, durante el a??o 2008 se trabaja el Objetivo del Milenio n?? 5: mejorar la salud materna. La meta consiste en reducir la tasa de mortalidad materna para el a??o 2015. Se elige este objetivo ya que se cumplen el 60 aniversario de la Organizaci??n Mundial de la Salud y la Declaraci??n Universal de los Derechos Humanos. Mejorar la salud materna es la base sobre la que se versan los materiales educativos destinados al profesorado, unos materiales que se realizan para los niveles de infantil, primaria y secundaria y que se componen fundamentalmente de actividades din??micas, f??cilmente aplicables en la clase y que ofrecen a los docentes recursos que permitan trabajar en el aula, la educaci??n en valores y la educaci??n para el desarrollo. Los materiales constan de una carpeta-caja para cada uno de los niveles de ense??anza. La carpeta de infantil contiene un cuaderno con documentaci??n y actividades, un cuadernillo en color con cuentos relacionados con valores, y seis carteles tama??o A3 con estos mismos cuentos..