Realidad educativa en Mendoza: violencia y consumo en adolescentes insertos en escuelas y universidades.

La adolescencia implica sujetos en proceso de desarrollo. En dicho proceso, los adultos  son referentes necesarios: cumplen  funciones de protección, amparo,  guía, y orden. Los adultos de hoy tienen dificultades para ejercer la autoridad. Los sujetos que disponen de referentes adecuados tienen mayores posibilidades de resolver las situaciones que se les presentan sin caer en actos de violencia y consumo desubjetivante

How much do health care providers value a community-based asthma care program? – a survey to collect their opinions on the utilities of and barriers to its uptake

<p>Abstract</p> <p>Background</p> <p>A comprehensive asthma care program (ACP) based on Canadian Asthma Consensus Guidelines was implemented in 8 primary care sites in Ontario, Canada. A survey was distributed to health care providers' (HCPs) to collect their opinions on the utilities of and barriers to the uptake of the ACP.</p> <p>Methods</p> <p>A 39-item self-administered survey was mailed to 184 HCPs and support staff involved in delivering the ACP at the end of implementation. The items were presented in mixed formats with most items requiring responses on a five-point Likert scale. Distributions of responses were analyzed and compared across types of HCPs and sites.</p> <p>Results</p> <p>Of the 184 surveys distributed, 108 (59%) were returned, and of that, 83 were completed by HCPs who had clinical contact with the patients. Overall, 95% of the HCPs considered the ACP useful for improving asthma care management. Most HCPs favored using the asthma care map (72%), believed it decreased uncertainties and variations in patient management (91%), and considered it a convenient and reliable source of information (86%). The most commonly reported barrier was time required to complete the asthma care map. Over half of the HCPs reported challenges to using spirometry, while almost 40% identified barriers to using the asthma action plan.</p> <p>Conclusion</p> <p>Contrary to the notion that physicians believe that guidelines foster cookbook medicine, our study showed that HCPs believed that the ACP offered an effective and reliable approach for enhancing asthma care and management in primary care.</p

A cluster randomised controlled trial of the clinical and cost-effectiveness of a 'whole systems' model of self-management support for the management of long- term conditions in primary care: trial protocol

BackgroundPatients with long-term conditions are increasingly the focus of quality improvement activities in health services to reduce the impact of these conditions on quality of life and to reduce the burden on care utilisation. There is significant interest in the potential for self-management support to improve health and reduce utilisation in these patient populations, but little consensus concerning the optimal model that would best provide such support. We describe the implementation and evaluation of self-management support through an evidence-based 'whole systems' model involving patient support, training for primary care teams, and service re-organisation, all integrated into routine delivery within primary care.MethodsThe evaluation involves a large-scale, multi-site study of the implementation, effectiveness, and cost-effectiveness of this model of self-management support using a cluster randomised controlled trial in patients with three long-term conditions of diabetes, chronic obstructive pulmonary disease (COPD), and irritable bowel syndrome (IBS). The outcome measures include healthcare utilisation and quality of life. We describe the methods of the cluster randomised trial.DiscussionIf the 'whole systems' model proves effective and cost-effective, it will provide decision-makers with a model for the delivery of self-management support for populations with long-term conditions that can be implemented widely to maximise 'reach' across the wider patient population.Trial registration numberISRCTN: ISRCTN9094004

Specie esotiche invasive di rilevanza unionale in Italia: aggiornamenti e integrazioni

La Commissione Europea (CE) ha inserito ad oggi 36 taxa esotici vegetali nella lista delle specie esotiche invasive di rilevanza unionale ai sensi del Regolamento (UE) n. 1143/2014 del Parlamento Europeo e del Consiglio, recante disposizioni volte a prevenire e gestire l’introduzione e la diffusione delle specie esotiche invasive. La lista delle specie di rilevanza unionale viene periodicamente aggiornata e include quelle specie che rappresentano una grave minaccia per la biodiversità, ma anche per la salute dei cittadini e le attività economiche nei territori dell’Unione Europea e che necessitano di una gestione concertata a livello comunitario. La CE vigila sullo stato di ogni taxon grazie anche a periodiche rendicontazioni da parte dei paesi dell'Unione. In vista di tali report, tra il 2020 e il 2021 è stata definita e integrata la distribuzione di queste specie in Italia

Perception of asthma as a factor in career choice among young adults with asthma

BACKGROUND/AIM: Asthma is a common chronic condition that can be aggravated by workplace exposures. Young adults with asthma should know how their future occupation might affect their asthma, and potentially, their quality of life. The aim of the present study was to assess the awareness of young adults to occupational risks for asthma and high-risk occupations, as well as their perception of the role of asthma in career choice

Feasibility of a Provincial Voluntary Reporting System for Work-Related Asthma in Ontario

OBJECTIVE The Ontario Work-Related Asthma Surveillance System: Physician Reporting (OWRAS) Network was established in 2007 to estimate the prevalence of work-related asthma (WRA) in Ontario, and to test the feasibility of collecting data for cases of WRA from physicians voluntarily.METHODS: More than 300 respirologists, occupational medicine physicians, allergists and primary care providers in Ontario were invited to participate in monthly reporting of WRA cases by telephone, postal service or e-mail.RESULTS: Since 2007, 49 physicians have registered with the OWRAS Network and, to date, have reported 34 cases of occupational asthma and 49 cases of work-exacerbated asthma. Highly reactive chemicals were the most frequently reported suspected causative agent of the 108 suspected exposures reported.CONCLUSION: Despite the challenge of enlisting a representative sample of physicians in Ontario willing to report, the OWRAS Network has shown that it is feasible to implement a voluntary reporting system for WRA; however, its long-term sustainability is currently unknown.Peer Reviewe

Updating the evidence base for suctioning adult patients: A systematic review

OBJECTIVES: To update a previous clinical practice guideline on suctioning in adult patients, published in the Canadian Respiratory Journal in 2001