Educar para o regresso a casa após o transplante hepático

RESUMO: Em cuidados de saúde diferenciados, a promoção da saúde e as actividades de educação para a saúde são indispensáveis à capacitação individual, habilitando a pessoa a prevenir complicações da sua patologia e a agir no sentido de exercerem um maior controlo sobre a sua própria saúde para a obtenção de ganhos em saúde. Com esta investigação pretendeu-se analisar a satisfação da pessoa transplantada hepática sobre os cuidados de enfermagem prestados, no âmbito da educação para a saúde e identificar dimensões que influenciaram a percepção e experiência da pessoa, face à preparação do regresso a casa. Foi realizado um estudo descritivo, transversal, de abordagem de investigação mista e exploratório, com orientação quantitativa e qualitativa, num movimento dedutivo-indutivo, baseado numa amostra de conveniência de 75 pessoas transplantadas hepáticas do Hospital de Curry Cabral. Os resultados foram analisados no âmbito da problemática em estudo, baseada na estrutura do movimento metodológico, ao nível das expectativas, experiência e percepção da satisfação da pessoa transplantada hepática. Neste estudo, salienta-se que os factores do domínio sócio-demográfico que influenciaram as expectativas são a idade e o tempo de internamento, assim como as experiências anteriores influenciaram a forma como a pessoa transplantada hepática recebeu as informações nesse internamento. As pessoas submetidas a transplante hepático, inquiridas neste estudo, afirmaram, em termos globais, que os cuidados de enfermagem recebidos durante o internamento, no âmbito da educação para a saúde, para o regresso a casa foram “Bons/Muito Bons” e “Razoáveis”. As expectativas, experiências anteriores, experiência com os cuidados de enfermagem e as percepções sobre os cuidados de enfermagem e a preparação para o regresso a casa são, neste contexto, reconhecidas como influenciadoras da satisfação com os cuidados de enfermagem. É imprescindível, portanto, que as actividades de educação para a saúde desenvolvidas pelos enfermeiros, usando a sua autonomia, contribuam para enfatizar o cuidar profissional em enfermagem, dando visibilidade à sua intervenção com a pessoa e/ou família no regresso a casa. SUMMARY: In differentiated healthcare, the promotion of health and health education activities are indispensable for personal empowerment, preparing the individual to prevent complications of his own disease, exercising a greater control over his own health, resulting in global health gains. This investigation was intended to analyse the satisfaction of liver transplant patients about the nursing care given, concerning health education, as well as to try and identify aspects that influenced the patient’s perception and experience when dealing with the preparation of returning home. The study was descriptive, with a mixed approach of exploratory and mixed inquiry, with qualitative and quantitative orientation, in a deductive-inductive direction. The population integrated a convenience sample of 75 liver transplant patients admitted at the Curry Cabral Hospital. The results were analysed according to the objectives, based on the methodological movement structure, level of expectations, experience and perception of the patient’s satisfaction. This study draws attention to the fact that demographic factors such as age and hospitalisation time influenced expectations, as well as previous experiences influenced the manner in which these patients received information during their hospital stay. The patients submitted to liver transplant, questioned in this study, affirmed, in a global manner, that nursing care given during admission, concerning health education for returning home were "Good/Very Good" and "Reasonable". Expectations, previous experiences, experience with and perceptions about nursing care as well as hospital discharge preparation were in this context, recognized as influences on the satisfaction of nursing care given. It is indispensable, therefore, that activities related to health education autonomously developed by nurses, contribute to emphasize the professional role of nursing care, highlighting the nurse’s intervention with the patient and/or family when returning home.

Quand faut-il opérer une rupture de la coiffe des rotateurs [When to operate a rotator cuff tear?]

Rotator cuff disease is the most common pathology causing shoulder pain with an overall prevalence rate of 30%. There is a significant association between increasing age and the presence of rotator cuff tears. Spontaneous healing of clinically relevant tears has not been observed. Although satisfactory pain relief is possible without rotator cuff tendon healing, functional outcome is better for healed repairs. Operative treatment must be considered in the context of the reasonable expectations for success. Repairability and potential of surgically tendon construct to heal are important considerations in surgical indications. There is no difference of outcomes between the arthroscopic and the open techniques.

Le «recours en oppression» : quelles attentes raisonnables pour les créanciers ?

La gouvernance des sociétés par actions canadiennes accorde une place aux créanciers, qui contribuent considérablement à leur financement. Les créanciers fournissent une prestation en échange d’une promesse d’être payé plus tard, de sorte qu’ils sont en conflit d’agence avec d’autres parties prenantes de la société par actions, particulièrement les dirigeants. Principale voie procédurale des litiges en droit des sociétés, le recours en cas d’abus (ou « recours en oppression ») permet d’endiguer certains aspects de ce conflit d’agence en octroyant aux tribunaux de larges pouvoirs pour pallier les abus. Cette intervention judiciaire s’exprime par la théorie des attentes raisonnables, selon laquelle le tribunal doit protéger non seulement les droits des parties, mais également leurs attentes raisonnables. La jurisprudence permet de conclure à des attentes raisonnables relativement à l’information fournie par la société, au patrimoine social et au processus décisionnel des dirigeants. Elle laisse également entrevoir une attente raisonnable à l’égard des modifications du partage des risques découlant d’un événement imprévisible.

A copyright exception for private copying in the United Kingdom

This paper discusses the proposed copyright exception for private copying in the UK in the aftermath of the Hargreaves Review. It explores the options by which the exception shall retain a realistic scope without significantly impacting on the interests of the rightholders and addresses the concept of possible harm that may arise due to private copying. It concludes that an exception for copying of content legally owned by an individual to another medium or device for private use corresponds to consumers’ reasonable expectations without causing more than minimal harm to the rightholders’ interests and without requiring an accompanying introduction of a fair compensation scheme.

Knowledge and Expectations of Support People in Prenatal Genetic Counseling Sessions

Prenatal genetic counseling patients have the ability to choose from a myriad of screening and diagnostic testing options, each with intricacies and caveats regarding accuracy and timing. Decisions regarding such testing can be difficult and are often made on the same day that testing is performed. Therefore, it is reasonable to consider that the support people brought to an appointment may have a role in the decision-making process. We aimed to better define this potential role by examining the incoming knowledge and expectations of support people who attended prenatal genetic counseling appointments. Support people were asked to complete a survey at one of seven Houston area prenatal clinics. The survey included questions regarding demographics, relationship to patient, incoming knowledge of the appointment, expectations of decision-making and perceived levels of influence over the decisions that would be made during the counseling session. The majority (79.4%) of the 252 participants were spouses/partners. Overall, there was poor knowledge of the referral indications with only 33.5% of participants correctly identifying the patient’s indication. Participants had even poorer knowledge of testing options that would be offered during the session, as only 17.7% were able to correctly identify testing options that would be discussed during the genetic counseling session. Of participants, just 3.6% said that they did not want to be included in discussions about screening/testing options. Only a few participants thought that they had less influence over decisions related to the pregnancy than over non-pregnancy decisions. Participants who reported feeling like they had a higher level of influence were likely to attend more of the pregnancy-related appointments with the patient. Findings from this study have provided insight into the perspective of support persons and have identified gaps in knowledge that may exist between the patients and the people they choose to bring with them into the genetic counseling session. In addition, this study is a starting point to assess how much the support people think that they impact the decision-making process of prenatal genetic counseling patients versus how much the prenatal patients value the input of the support people.

The boundaries of acceptance: Do expectations for the complainant's psychological injury affect legal decisions in a sexual harassment case

Research indicates that people engaged in legal decision-making use a host of biases and preconceptions to guide their decisions about whether the evidence presented to them is reasonable. However, few theories address how such expectations affect legal decision-makers. The present study attempted to determine if social judgment theory (SJT) can explain how and when legal decision-makers rely on expectations for the complainant's psychological injury in a hostile environment sexual harassment case. Two experiments provided undergraduate participants with a written summary of a hostile work environment allegation that first manipulated participants' expectations about reasonable psychological injuries (mild v. severe), and then presented them with actual severity levels of psychological injury (ranging from minimal to extreme). Experiment 1 (N = 295) hypothesized and found that participants who expected severe injuries perceived a greater range of psychological injuries to be reasonable than participants expecting mild injury. Experiment 2 ( N = 202) used similar methodology and investigated whether perceived reasonableness for the injury allegations affected legal decisions. Experiment 2 hypothesized that participants expecting severe psychological injury should render more pro-complainant decisions than participants expecting mild psychological injury. This result should be most pronounced when participants receive a moderate injury allegation, since this allegation was perceived as reasonable by participants expecting severe injury, but unreasonable by participants expecting mild injury. Consistent with SJT, participants who received a moderate injury but expected a severe injury found more liability than participants who received a moderate injury but expected a mild injury. Inconsistent with SJT, participants' expectations did not affect their compensatory damage decisions. In fact, more severe injury allegations increased damage awards regardless of participants' expectations. Although the results provide mixed support for applying SJT to legal decisions in sexual harassment cases, they emphasize the continuing role of oft-unstudied extra-legal factors (juror's expectations and psychological injury severity) on legal decisions.

Matemal Concepts and Expectations regarding a Preterm Infant

The objective of the present study was: (a) to identify the concerns, verbally expressed, of 50 mothers regarding their preterm infants (PT) and then compare their verbal expression with those of 25 mothers of full-term infants (FT): and (b) to correlate the mothers` verbal expressions with maternal and infant variables. The following instruments were used to compose and characterize the sample: Structure Clinical Interview for DSM III-R Non-Patient (SCID/NP), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and medical charts. Results showed that there was no difference between groups in term of mothers` expectations and conceptualizations, both groups exhibited predominantly positive expectations and concepts. In comparison with FT mothers, PT mothers verbally expressed more feelings and reactions predominantly negative or conflicting in relation to infant birth. Higher levels of maternal anxiety and depression in the PT Group were correlated with more verbal expressions about negative or conflicting emotions. In addition, lower birth weight, higher neonatal risk and longer length of stay in intensive care nursery of the infants were related with more negative or conflicting concepts by the mothers.

Interactive expectations

In modeling expectation formation, economic agents are usually viewed as forming expectations adaptively or in accordance with some rationality postulate. We offer an alternative nonlinear model where agents exchange their opinions and information with each other. Such a model yields multiple equilibria, or attracting distributions, that are persistent but subject to sudden large jumps. Using German Federal Statistical Office economic indicators and German IFO Poll expectational data, we show that this kind of model performs well in simulation experiments. Focusing upon producers' expectations in the consumption goods sector, we also discover evidence that structural change in the interactive process occurred over the period of investigation (1970-1998). Specifically, interactions in expectation formation seem to have become less important over time.

International Grassland Congress Outlook: An historical review and future expectations

Features of the history of the International Grassland Congress are mentioned. Aspects of a number of failed themes in grassland science are described with respect to molecular biology, intensive systems of ruminant production, carbohydrate use in plant growth, plant succession and range condition, and stocking method. Future expectations are focused on meeting a balance of objectives, maintaining reductionist science, taking new initiatives in plant improvement and in the development of animal production systems, and reducing barriers to international trade. The adoption of grassland science depends upon the growth of new learning, especially through cyclical interaction between scientists and farmers.