The client-oriented model of cultural competence in healthcare organizations

The paper aims to propose a new model of cultural competence in health organizations based on the paradigm of client orientation. Starting from a literature review, this study takes inspiration from dimensions that characterize the cultural competence of health organizations, and re-articulates them in more detail by applying a client orientation view. The resulting framework is articulated into six dimensions (formal references; procedures and practices; cultural competences of human resources; cultural orientation toward client; partnership with community; and self-assessment) that define the ability of a health organization to achieve its mission, acknowledging, understanding, and valorizing cultural differences of internal clients (staff) and external clients (consumers). This study makes an effort to address the paucity of studies linking approaches to managing cultural diversity in health organizations with cultural competence within the framework of client orientation

Influence of a specific aquatic program on social and gross motor skills in adolescents with Autism Spectrum Disorders: Three case reports

Swimming pool activities revealed to be efficacious to train psychomotor skills and increase adaptive behaviors in children with Autism Spectrum Disorders (ASD). Therefore, the purpose of this study was to investigate the efficacy of a specific multi-systemic aquatic therapy (CI-MAT) on gross motor and social skills in three adolescents with Autism Spectrum Disorders (ASD). Methods: three adolescents with ASD of which two boys (M1 with a chronological age of 10.3 years and a mental age of 4.7 years; M2 with a chronological age of 14.6 and a mental age inferior to 4 years) and one girl (chronological age of 14.0 and a mental age inferior to 4 years). The study was divided into three phases: baseline, 12-week CI-MAT program and Post-Test. Participants were administered a battery of tests incorporating anthropometric measurements, gross motor development test and a social skills questionnaire before and after a 12-week MAT-CI program. Results: Subjects improved locomotors and object control skills following the CI-MAT program in a different way. Concerning social behaviors, the higher proportion of gains was observed in the sensitivity of other's presence and eye contact, for the contact domain, and in the comply turn for the relationship domain. Conclusions: The results of this study showed that the CI-MAT program was effective for the development of gross-motor skills and social behaviors in subjects with ASD. Moreover there is an urge to carry out a whole psychological assessment targeting both motor and adaptive development suitable to provide educational and vocational plans of exercises for people with ASD

The detector control system for the HMPID in the ALICE experiment at LHC

The DCS (Detector Control System) of the ALICE experiment at LHC aims to integrate, configure, and monitor all the participating sub-detectors. The HMPID (High Momentum Particle Identification Detector), based on a Ring Imaging Cherenkov, is one of the ALICE sub-detectors. Its control system (CS) has to ensure the detector configuration, standalone running mode for test and maintenance, and integration in the ALICE DCS. In order to design the HMPID CS, we present in this paper an approach based on the GRAFCET Model. First results from the application of the GRAFCET to the liquid circulation apparatus, an HMPID subsystem, are reported. The impact of the solutions for the HV-LV sub-systems on the CS is also presented

An electric vehicle propulsion system's impact on battery performance: An overview

The performance of two types of batteries, lead-acid and nickel-zinc, was measured as a function of the charging and discharging demands anticipated from electric vehicle propulsion systems. The benefits of rapid high current charging were mixed: although it allowed quick charges, the energy efficiency was reduced. For low power (overnight) charging the current wave shapes delivered by the charger to the battery tended to have no effect on the battery cycle life. The use of chopper speed controllers with series traction motors resulted in a significant reduction in the energy available from a battery whenever the motor operates at part load. The demand placed on a battery by an electric vehicle propulsion system containing electrical regenerative braking confirmed significant improvment in short term performance of the battery

Association of total serum cholesterol with functional outcome following home care rehabilitation in Italian patients with stroke.

BACKGROUND: Stroke is a disabling disease. In elderly populations, stroke is the third leading cause of death and the primary cause of reduction in or loss of functional ability and personal autonomy. Possible associations between levels of total serum cholesterol (TC) and both incidence of stroke and functional outcomes after rehabilitation are still under study. OBJECTIVE: To detect positive and negative prognostic factors associated with functional outcomes in first-time stroke patients admitted to an integrated home care rehabilitative program. METHODS: This study enrolled 141 patients with a first-time stroke who were admitted to a home care rehabilitation program. Primary outcome measures were the Barthel activities of daily living (ADL) and mobility indices at the beginning and end of the rehabilitative treatment. The impact of TC and other demographic and clinical variables was analyzed using bivariate and multivariate logistic regression analyses. RESULTS: Age and Short Portable Mental Status Questionnaire (SPMSQ) score were negatively associated with functional outcome. In contrast, elevated TC was positively associated with a better home rehabilitative treatment outcome. Barthel index score at admission was negatively associated with outcomes assessed by the Barthel ADL index and age with outcomes assessed by the Barthel mobility index. In a multivariate logistic regression analysis, SPMSQ score and elevated TC were significantly associated with outcome. Specifically, higher SPMSQ scores were negatively associated with better rehabilitative treatment outcomes, whereas elevated TC was positively associated. CONCLUSIONS: Elevated TC seems to be associated with better functional outcomes in patients with first-time stroke

Interacting Kasner-type cosmologies

It is well known that Kasner-type cosmologies provide a useful framework for analyzing the three-dimensional anisotropic expansion because of the simplification of the anisotropic dynamics. In this paper relativistic multi-fluid Kasner-type scenarios are studied. We first consider the general case of a superposition of two ideal cosmic fluids, as well as the particular cases of non-interacting and interacting ones, by introducing a phenomenological coupling function $q(t)$. For two-fluid cosmological scenarios there exist only cosmological scaling solutions, while for three-fluid configurations there exist not only cosmological scaling ones, but also more general solutions. In the case of triply interacting cosmic fluids we can have energy transfer from two fluids to a third one, or energy transfer from one cosmic fluid to the other two. It is shown that by requiring the positivity of energy densities there always is a matter component which violates the dominant energy condition in this kind of anisotropic cosmological scenarios.Comment: Accepted for publication in Astrophysics &Space Science, 8 page

The current progress of the ALICE Ring Imaging Cherenkov Detector

Recently, the last two modules (out of seven) of the ALICE High Momentum Particle Identification detector (HMPID) were assembled and tested. The full detector, after a pre-commissioning phase, has been installed in the experimental area, inside the ALICE solenoid, at the end of September 2006. In this paper we review the status of the ALICE/HMPID project and we present a summary of the series production of the CsI photo-cathodes. We describe the key features of the production procedure which ensures high quality photo-cathodes as well as the results of the quality assessment performed by means of a specially developed 2D scanner system able to produce a detailed map of the CsI photo-current over the entire photo-cathode surface. Finally we present our recent R&D efforts toward the development of a novel generation of imaging Cherenkov detectors with the aim to identify, in heavy ions collisions, hadrons up to 30 GeV/c.Comment: Presented at the Imaging-2006 Conference, Stockholm, Sweden, June 200

All Static Circularly Symmetric Perfect Fluid Solutions of 2+1 Gravity

Via a straightforward integration of the Einstein equations with cosmological constant, all static circularly symmetric perfect fluid 2+1 solutions are derived. The structural functions of the metric depend on the energy density, which remains in general arbitrary. Spacetimes for fluids fulfilling linear and polytropic state equations are explicitly derived; they describe, among others, stiff matter, monatomic and diatomic ideal gases, nonrelativistic degenerate fermions, incoherent and pure radiation. As a by--product, we demonstrate the uniqueness of the constant energy density perfect fluid within the studied class of metrics. A full similarity of the perfect fluid solutions with constant energy density of the 2+1 and 3+1 gravities is established.Comment: revtex4, 8 page