Contribution to the Logistic Evaluation System in the Transportation Process in Santo Domingo, Ecuador

Peer Reviewe

Semantic Integration of Cervical Cancer Data Repositories to Facilitate Multicenter Association Studies: The ASSIST Approach

The current work addresses the unifi cation of Electronic Health Records related to cervical cancer into a single medical knowledge source, in the context of the EU-funded ASSIST research project. The project aims to facilitate the research for cervical precancer and cancer through a system that virtually unifi es multiple patient record repositories, physically located in different medical centers/hospitals, thus, increasing fl exibility by allowing the formation of study groups “on demand” and by recycling patient records in new studies. To this end, ASSIST uses semantic technologies to translate all medical entities (such as patient examination results, history, habits, genetic profi le) and represent them in a common form, encoded in the ASSIST Cervical Cancer Ontology. The current paper presents the knowledge elicitation approach followed, towards the defi nition and representation of the disease’s medical concepts and rules that constitute the basis for the ASSIST Cervical Cancer Ontology. The proposed approach constitutes a paradigm for semantic integration of heterogeneous clinical data that may be applicable to other biomedical application domains

Building new frontiers: An ecosystemic approach to development, culture, education, environment and quality of life

Quality of life, natural and man-made environments, physical, social and mental well-being are currently undermined by all sorts of hazards and injuries; political, economical, social and cultural disarray normalise atrocious behaviours and violence throughout the world. Considering the multiple problems of difficult settlement or solution in our times, current environmental, social, cultural, educational, political and economic policies and practices are examined in view of new paradigms of growth, power, wealth, work and freedom. A multidimensional ecosystemic approach and planning model for the diagnosis and prognosis of quality of life integrate into a dynamic configuration four dimensions of being-in-the- world (intimate, interactive, social and biophysical), as they induce the events (deficits and assets), cope with consequences (desired or undesired) and reorganise for change, enhancing connexions and sealing ruptures. Development and evaluation of teaching programmes, research projects and public policies benefit from a deep understanding of the events, providing a critical comprehensive four-dimensional framework and planning model for effective and responsible action.education; culture; public policies; environment; ecosystems

Allies Not Adversaries: Teaching Collaboration to the Next Generation of Doctors and Lawyers to Address Social Inequality

Recent reports from the Carnegie Foundation for the Advancement of Teaching, as well as from other medical and legal educators, stress that professional training of doctors and lawyers focuses too narrowly on knowledge-based learning, and not enough on context-based problem solving, professionalism, and ethics. Tracing recent calls from both legal and medical educators to increase the teaching of ethics, social responsibility, the lawyer-client and doctor-patient relationship, and holistic problem-solving, this article offers a model of interdisciplinary medical-legal education focused on developing practitioners sensitive to the needs of diverse and disenfranchised clients and patients. It highlights a burgeoning medical-legal partnership model, now in nearly eighty sites across the country, which partners lawyers and doctors to address the underlying social determinants of health for poor children and their families. The medical-legal partnership model, which increasingly includes medical school and law school partners, provides a unique opportunity to engage law and medical students in interdisciplinary problem-solving and ethical reflection, while also expanding their understanding of complex issues of social justice and inequality in our legal and health care systems. An interdisciplinary course offered by Brown Medical School and Roger Williams University School of Law is offered as a model

A Mental Health Checkup for Children at the Doctor’s Office: Lessons from the Medical-Legal Partnership Movement to Fulfill Medicaid’s Promise

Traumatic childhood events and the stress they cause can negatively affect health over a lifetime. For children with Medicaid coverage, visits to the doctor’s office present an opportunity to improve this trajectory. Medicaid’s Early Periodic Screening Diagnostic and Treatment (EPSDT) mandate requires that children receive more than a basic physical when they see a doctor for regular “well-child checks.” As part of a comprehensive look at their development, they should receive mental health check-ups that could identify childhood trauma, its impacts, and the interventions that could help improve health and mental health. Data suggests that many children do not receive these mandatory comprehensive screenings. Significant barriers to screening include lack of transportation for patients, low reimbursement rates for physicians that limit their ability to devote enough attention to screenings, and lack of access to mental health screening tools. Medical-legal partnerships (MLPs) provide a framework for addressing these challenges. MLPs bring together civil legal services lawyers with health providers to address social determinants of health. This article argues that the MLP movement provides a three-tiered paradigm for change for physicians and attorneys to improve the trajectory for children who have suffered trauma and address the gaps in Medicaid EPSDT mental health screening: (1) collaborative advocacy to improve patient health, (2) transformation of health and legal institutions, and (3) policy change

Evaluating an Online Family Assessment Activity: A Focus on Diversity and Health Promotion

This article describes the development, implementation and evaluation of a family assessment activity that was designed for a transition course in an RN-BSN program. The family assessment activity emphasized diversity and health promotion as key curricular concepts highlighted through the use of constructivist teaching strategies in the online classroom. The activity was developed and implemented by utilizing the Family Health Systems (FHS) approach to family assessment and Healthy People 2020 as a framework for family health promotion. The activity was evaluated through faculty observation and student feedback which is discussed in the article

Project THANKS: A Socio-Ecological Framework For An Intervention Involving HIV Positive African American Women With Comorbidities

HIV-positive individuals are living longer today as a result of continuing advances in treatment but are also facing an increased risk for chronic diseases such as diabetes, and hypertension. These conditions result in a larger burden of hospitalization, outpatient, and emergency room visits. Impoverished African American women may represent an especially high-risk group due to disparities in health care, racial discrimination, and limited resources. This article describes an intervention that is based on the conceptual framework of the socio-ecological model. Project THANKS uses a community-based participatory, and empowerment building approach to target the unique personal, social, and environmental needs of African American women faced with the dual diagnosis of HIV and one or more chronic diseases. The long-term goal of this project is to identify features in the social and cultural milieu of these women that if integrated into existing harm reduction services can reduce poor health outcomes among them

Building a Better World: An Ecosystemic Approach to Education, Culture, Health, Environment and Quality of Life

Quality of life, natural and man-made environments, physical, social and mental well-being are currently undermined by all sorts of hazards and injuries; political, economical, social and cultural disarray normalise atrocious behaviours and violence throughout the world. Considering the multiple problems of difficult settlement or solution in our times, current environmental, social, cultural, educational, political and economic policies and practices are examined in view of new paradigms of growth, power, wealth, work and freedom. A multidimensional ecosystemic approach and planning model integrate into a dynamic configuration four dimensions of being-in-the- world (intimate, interactive, social and biophysical), as they induce the events (deficits and assets), cope with consequences (desired or undesired) and reorganise for change.education; culture; public policies; environment; ecosystems

Blaming the victim, all over again: Waddell and Aylward's biopsychosocial (BPS) model of disability

The biopsychosocial (BPS) model of mental distress, originally conceived by the American psychiatrist George Engel in the 1970s and commonly used in psychiatry and psychology, has been adapted by Gordon Waddell and Mansell Aylward to form the theoretical basis for current UK Government thinking on disability. Most importantly, the Waddell and Aylward version of the BPS has played a key role as the Government has sought to reform spending on out-of- work disability benefits. This paper presents a critique of Waddell and Aylward’s model, examining its origins, its claims and the evidence it employs. We will argue that its potential for genuine inter-disciplinary cooperation and the holistic and humanistic benefits for disabled people as envisaged by Engel are not now, if they ever have been, fully realized. Any potential benefit it may have offered has been eclipsed by its role in Coalition/Conservative government social welfare policies that have blamed the victim and justified restriction of entitlements

Working with parents to support their disabled children’s social and school inclusion. An exploratory counseling study

This article synthesizes the long-lasting counseling process of a family with a child suffering from a chronic illness. The provided intervention model draws on a series of principles from various theoretical approaches, namely systemic, psychodynamic, and resiliency. Family functioning and support is considered a catalytic parameter in assisting children with disabilities to fully develop their potential. This project is based on a family and child-centered integrative counseling model adopting the nonmedical conception of disability. Through the presentation of a case study of a couple who faced a critical situation in the life of their child, this article briefly describes the way the family dynamics were readdressed through this intervention counseling model. In addition, this work attempts to give a picture of the complex and confusing emotional states parents may go through when dealing with physical and psychological health-threatening situations and present guidelines for integrated counseling models. © 2015 Taylor & Francis Group, LL