Quality Rating and Improvement Systems: Considerations for Children from Immigrant Families

As the percentage of immigrants in the U.S. has steadily increased over the last forty years, it is not surprising to find that many children in the U.S. are now born to at least one foreign-born parent or are immigrants themselves. As the U.S. becomes more minority majority, cultural and linguistic diversity will become a key issue when developing goals, policies, and practices to meet the needs of children and families.However, questions remain about whether Quality Rating and Improvement Systems and other quality initiatives are considering the needs of immigrant families and children. This issue of Making the Link discusses some of these concerns and recommendations that can improve systems for immigrant children

EDUCACIÓN INCLUSIVA E INTERCULTURAL EN ZONAS RURALES Y URBANAS DE DIFÍCIL ACCESO

The fight for equality and the defense of human rights in the current globalized and multicultural context, is a problematic of unusual dimensions in the training of people. Early childhood education is a privileged instance to understand diversity as a factor of cultural enrichment. Family and school are the first settings, where boys and girls get in contact with culture, molding their identity. This study is circumscribed to the non conventional educational modality called "kindergarten on wheels" (jardin sobre ruedas) in Vilches Alto area, Maule Region, which provides the chance to describe and interpret the educational performance, in the light of mothers living in rural remote areas. As research design, the case study was used, incorporating focus group and interviews as data collection instruments. It should be pointed out that, among the most relevant results, mothers consider this educational experience as an inclusive instance which favors the integral development of boys and girls.La lucha por la equidad y la defensa de los derechos humanos en el actual contexto globalizado y multicultural es una problemática de dimensiones inusitadas en la formación de las personas. La formación inicial es una instancia privilegiada para comprender la diversidad como factor de enriquecimiento cultural. Familia y escuela son los primeros entornos en los que, niños y niñas entran en contacto con la cultura moldeando su identidad. El estudio se delimita a la modalidad educativa no convencional, jardín sobre ruedas, en la zona de Vilches Alto región del Maule, que nos brinda la posibilidad de describir e interpretar el desempeño de las actuaciones educativas en la mirada de las madres de sectores rurales apartados. Para ello, se emplea como estrategia de diseño el estudio de caso acompañado de entrevistas y focus groups. Entre los resultados más relevantes destaca que las madres ven en la experiencia educativa una instancia inclusiva que favorece el desarrollo integral de los niños y niñas

Proceso de participación comunitaria en salud en los barrios Porvenir y La Libertad de San Gil

Introducción. Esta investigación estudia el proceso de participación comunitaria en salud de los barrios Porvenir 1, 2 y La Libertad. Metodología. Fue un estudio descriptivo realizado en los barrios Porvenir 1 y 2 y La Libertad durante 18 meses. Se aplicó la ficha sociosanitaria de Alonso y una encuesta estructurada para el diagnóstico comunitario y mediante grupo focal a las familias de estos barrios se establecieron actividades de salud y su posterior evaluación. Resultados. Participativamente se encontró mal manejo de los residuos sólidos, superpoblación de caninos y baja convocatoria de la junta de acción comunal, por tanto, el grupo focal lideró los procesos de participación comunitaria con las familias que permitió establecer los horarios de recolección de basuras, instalar un recipiente para recolección por familia, vacunar al 100% de caninos y felinos y un acercamiento de la comunidad con la junta de acción comunal. Conclusión. El trabajo comunitario resultó más efectivo con la visita domiciliaria y sí la problemática era sentida por todos los barrios

El Boletín de la Asociación Andaluza de Bibliotecarios : análisis de los artículos de investigación (1998-2002)

Se procede al análisis de los artículos de investigación publicados en el Boletín de la Asociación Andaluza de Bibliotecarios durante el periodo comprendido entre 1998-2002, con el objetivo de intentar establecer el perfil medio de sus autores (sexo, procedencia institucional, geográfica, etc.) y de sus artículos (materias, estructura de publicación, etc.) para llegar a conocer a fondo esta publicación que juega un papel esencial entre los profesionales de la Comunidad Autónoma de Andalucía. | An analysis is carried out of the research articles published in the Andalusian Library Association Bulletin during the 1998-2002 period with an aim to establishing the profile of both the authors (gender, institutional affiliation, geographical origin, etc.) and the articles themselves (subject coverage, structure, etc.) in order to gain a deeper understanding of this journal which plays an essential role among the Andalusian Autonomous Region professionals

Las bibliotecas para pacientes en los hospitales españoles

Basándonos en la premisa de que la lectura juega un papel muy importante en la recuperación de las personas hospitalizadas, presentamos un análisis sobre la situación actual de las bibliotecas para los pacientes ubicadas en los hospitales públicos de nuestro país, con el fin de obtener una visión de conjunto sobre su estado presente que nos permita conocer cuáles son sus objetivos y cuáles las dificultades con las que se encuentran para el desarrollo de su labor. | Starting from the premise that reading plays an important role in the recovery of hospital patients, an analysis is presented of the present situation of patientsâ libraries in public hospital in Spain. The aim is to give an overview of their present state focusing on both their objectives and difficulties encountered to carry out their mission

El plan de bibliotecas de la Unión Europea

Se describe el Plan de Bibliotecas de la Comunidad Europea: sus orígenes y etapas, analizándose la participación española en el mismo. | The origins and stages of the Library plan of the European Community are described, analysing in particular the participation of Spain

THE EFFECTS OF INTERNATIONAL EMIGRATION ON THE ACAZÓNICA AND HATO DE LA HIGUERA AGROECOSYSTEMS IN VERACRUZ, MEXICO

Mexico has a tradition of migration to the United States. Nevertheless, Veracruz had not experienced a significant exodus of its population up until the nineteen nineties, when emigration from Veracruz began to increase rapidly, especially in the rural sector, thus affecting the region’s agroecosystems. Correspondingly, the main objective of this investigation was to analyze how international emigration has affected the agroecosystems of two rural communities in the state of Veracruz. Special attention was paid to factors such as family income, decision making, labor organization, agricultural diversity, technological management and the purpose of production. Information was gathered by direct observation and from interviews with key informants. A survey was conducted in 60 homes and six case studies were employed. Although there are differences between communities, regarding the type of migration (legal or illegal), generally, the following patterns were identified: 1) Agricultural activity is primarily subsidized by remittances sent by emigrants; 2) The departure of the head of the family leads to a change concerning who makes  the decisions;  woman normally occupy subordinate roles; 3) Migration results in an increase in the number of hired farm workers and a greater work load for those who remain in the community; 4) The departure of the work force tends to diminish agricultural diversity; 5) Remittances have a positive impact on technological management by the family production unit; 6) Illegal emigration favors subsistence farming, whereas legal emigration favors commercial production

Intraperitoneal pressure in peritoneal dialysis

The measure of intraperitoneal pressure in peritoneal dialysis is easy and provides clear therapeutic benefits. However it is measured only rarely in adult peritoneal dialysis units. This review aims to disseminate the usefulness of measuring intraperitoneal pressure. This measurement is performed in supine before initiating the drain of a manual exchange with âYâ system, by raising the drain bag and measuring from the mid-axillary line the height of the liquid column that rises from the patient. With typical values of 10â16 cm H2O, intraperitoneal pressure should never exceed 18 cm H2O. With basal values that depend on body mass index, it increases 1â3 cm H2O/L of intraperitoneal volume, and varies with posture and physical activity. Its increase causes discomfort, sleep and breathing disturbances, and has been linked to the occurrence of leaks, hernias, hydrothorax, gastro-esophageal reflux and enteric peritonitis. Less known and valued is its ability to decrease the effectiveness of dialysis significantly counteracting ultrafiltration and decreasing solute clearance to a smaller degree. Because of its easy measurement and potential utility, should be monitored in case of ultrafiltration failure to rule out its eventual contribution in some patients. Although not yet mentioned in the clinical practice guidelines for PD, its clear benefits justify its inclusion among the periodic measurements to consider for prescribing and monitoring peritoneal dialysis. Resumen: La medida de la presión intraperitoneal en diálisis peritoneal es muy sencilla y aporta claros beneficios terapéuticos. Sin embargo, su monitorización todavía no se ha generalizado en las unidades de diálisis peritoneal de adultos. Esta revisión pretende divulgar su conocimiento y la utilidad de su medida. Se realiza en decúbito antes de iniciar el drenaje de un intercambio manual con bolsa en Y, elevando la bolsa de drenaje y midiendo la altura que alcanza la columna de líquido desde la línea medio-axilar. Los valores habituales son 10 a 16 cmH2O y nunca debe superar los 18 cmH2O. Aumenta de 1 a 3 cmH2O por litro de volumen intraperitoneal sobre valores basales que dependen del índice de masa corporal y varía con la postura y la actividad física. Su aumento provoca malestar, alteraciones del sueño y de la respiración, y se ha relacionado con la aparición de fugas de líquido, hernias, hidrotórax, reflujo gastroesofágico y peritonitis por gérmenes intestinales. Menos conocida y valorada es su capacidad para disminuir la eficacia de la diálisis contrarrestando, sobre todo, la ultrafiltración y, en menor grado, el aclaramiento de solutos. Por su facilidad de medida y potencial utilidad, debería ser uno de los factores que investigar en los fallos de ultrafiltración, pues su elevación podría contribuir a ellos en algunos pacientes. Aunque todavía no se menciona en las guías de actuación en diálisis peritoneal, sus claros beneficios justifican su inclusión entre las mediciones periódicas que considerar para la prescripción y seguimiento de la diálisis peritoneal. Keywords: Intraperitoneal pressure, Hydrostatic pressure, Ultrafiltration, Ultrafiltration failure, Mechanical complications of peritoneal dialysis, Infusion volume, Palabras clave: Presión intraperitoneal, Presión hidrostática, Ultrafiltración, Fallo de ultrafiltración, Problemas mecánicos en diálisis peritoneal, Volumen de infusió

EFFECT OF FLUOROGESTONE ACETATE ON THE VAGINAL MICROBIOTA FROM EWES PELIBUEY IN THE PAPALOAPAN REGION

Ewes are polyoestrous seasonal animals, however in order to increase their fertility, progesterone derivatives are used by means of impregnated sponges with 20 mg of fluorogestone acetate (FGA). Nevertheless, the use of sponges with FGA generates vaginitis, erythema and interferes with fertility. This paper studies the effect of FGA and sponge over the microbiota vaginal in ewes anestrous. To obtain experimental samples, fifteen ewes anestrous were used. Five ewes were used as control group. Ten ewes anestrous were used and data were collected before, withdrawal and 56 h after withdrawal of sponges with and without FGA, in order to quantify, identify and evaluate changes in the vaginal bacterial microbiota. In the normal microbiota were found Escherichia and Klebsiella strains; however, after removal of the devices, were found enteropathogenic coliform bacterias and some opportunistic as Shigella, Enterobacter, Citrobacter, E. coli, Pseudomonas and Acinetobacter. Also found that the device without FGA, induces a change in the vaginal microbiota, thus, causes vaginitis. In vitro sensitivity tests were performed on the strains identified using twelve different antibiotics; the results showed a higher sensibility to enoxacin, then to the trimethoprim-sulfamethoxazole, ceftriaxone, chloramphenicol and ampicillin. Antibiotics use is necessary to prevent the vaginitis in ewes with dispositive. In conclusion, the intravaginal sponges promote of the vagina inflammation and produce coliform bacteria in vagina

Burden and centralised treatment in Europe of rare tumours: results of RARECAREnet - a population-based study

Background Rare cancers pose challenges for diagnosis, treatments, and clinical decision making. Information about rare cancers is scant. The RARECARE project defined rare cancers as those with an annual incidence of less than six per 100 000 people in European Union (EU). We updated the estimates of the burden of rare cancers in Europe, their time trends in incidence and survival, and provide information about centralisation of treatments in seven European countries. Methods We analysed data from 94 cancer registries for more than 2 million rare cancer diagnoses, to estimate European incidence and survival in 2000–07 and the corresponding time trends during 1995–2007. Incidence was calculated as the number of new cases divided by the corresponding total person-years in the population. 5-year relative survival was calculated by the Ederer-2 method. Seven registries (Belgium, Bulgaria, Finland, Ireland, the Netherlands, Slovenia, and the Navarra region in Spain) provided additional data for hospitals treating about 220 000 cases diagnosed in 2000–07. We also calculated hospital volume admission as the number of treatments provided by each hospital rare cancer group sharing the same referral pattern. Findings Rare cancers accounted for 24% of all cancers diagnosed in the EU during 2000–07. The overall incidence rose annually by 0.5% (99·8% CI 0·3–0·8). 5-year relative survival for all rare cancers was 48·5% (95% CI 48·4 to 48·6), compared with 63·4% (95% CI 63·3 to 63·4) for all common cancers. 5-year relative survival increased (overall 2·9%, 95% CI 2·7 to 3·2), from 1999–2001 to 2007–09, and for most rare cancers, with the largest increases for haematological tumours and sarcomas. The amount of centralisation of rare cancer treatment varied widely between cancers and between countries. The Netherlands and Slovenia had the highest treatment volumes. Interpretation Our study benefits from the largest pool of population-based registries to estimate incidence and survival of about 200 rare cancers. Incidence trends can be explained by changes in known risk factors, improved diagnosis, and registration problems. Survival could be improved by early diagnosis, new treatments, and improved case management. The centralisation of treatment could be improved in the seven European countries we studied. Funding The European Commission (Chafea)