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Core Problem (core + problem)
Selected AbstractsTelling stories from everyday practice, an opportunity to see a bigger picture: a participatory action research project about developing discharge planningHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2009Pia Petersson RN Abstract In spite of laws, rules and routines, findings from Swedish as well as international research show that discharge planning is not a simple matter. There is considerable knowledge about discharge planning, but the quality of the actual process in practice remains poor. With this in mind, a research and developmental health and social care network decided to use participation action research to explore the discharge planning situation in order to generate new ideas for development. This paper reports on the research process and the findings about our enhanced understanding about the discharge planning situation. Story dialogue method was used. The method is based on stories from everyday practice. The stories are used as ,triggers' to ask probing questions in a dialogical and structured form. Local theory is developed to help the participants to find solutions for action in the practice. Our findings were that the discharge planning situation could be seen as a system including three interconnected areas: patient participation, practitioners' competence and organizational support. To reach good quality in discharge planning, all these three issues need to be developed, but not only as routines and forms. Rather, when developing a discharge planning situation, a system where relational aspects such as confidence and continuity are essential and thus needs to be considered. To achieve a change, the core problem needs to be clarified. When the issue is complex, the solution needs to consider the bigger picture and not just the parts. Telling stories from everyday practice, and to systematically reflect and analyse those in interprofessional groups can create opportunities for enhanced understanding, as well as be a vehicle for future change of practice. [source] Welfare, Work Requirements, and Dependant-CareJOURNAL OF APPLIED PHILOSOPHY, Issue 3 2004Elizabeth Anderson abstract This article considers the justice of requiring employment as a condition of receiving public assistance. While none of the main theories of justice prohibits work requirements, the arguments in their favour are weak. Arguments based on reciprocity fail to explain why only means-tested public benefits should be subject to work requirements, and why unpaid dependant care work should not count as satisfying citizens' obligations to reciprocate. Arguments based on promoting the work ethic misattribute recipients' nonwork to deviant values, when their core problem is finding steady employment consistent with supporting a family and meeting dependant care responsibilities. Rigid work requirements impose unreasonable costs on some of the poor. A welfare system based on a rebuttable presumption that recipients will work for pay, conjoined with more generous work supports, would promote justice better than either unconditional welfare or strict requirements [1]. [source] Implementing molecular connectivity theory, a basic tool in modeling drugsJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 8 2007Lionello Pogliani Abstract The concepts of chain graph, general graph, and complete graph have been used to implement the graph framework of molecular connectivity (MC) theory. Some concepts of this theory have been addressed using "external" theoretical concepts belonging mostly to quantum or structural chemistry, with no direct counterpart in graph theory. Thus, while the concept of chain graph can be used to tackle the cis-trans isomerism problem, the concept of pseudograph, or general graph can be used to tackle the description of the sigma -, pi -, and nonbonding n -electrons. The concept of complete graph can instead be used to tackle the electron core problem of the atoms of a molecule. Graph concepts can also be used to tackle the problem of the hydrogen contribution in hydrogen depleted graphs, which are encoded by the aid of a perturbation parameter, which differentiates between compounds with similar hydrogen-suppressed chemical graphs, like the graphs of CH3F and BH2F. These concepts have allowed redesign of a central parameter of MC theory, the valence delta, giving MC indices with improved model quality as exemplified here with different properties for each treated topic. © 2007 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 96:1856,1871, 2007 [source] Nonprofit versus corporate governance: An economic approachNONPROFIT MANAGEMENT & LEADERSHIP, Issue 3 2008Gerhard Speckbacher This article proposes a new theoretical concept of nonprofit governance using transaction cost economics and the economic theory of contracts. After a short review of economic approaches to corporate governance, I clarify the specific nature of the governance problem in nonprofit organizations. Based on this analysis, I derive criteria for selecting an organization's relevant stakeholders. If stakeholders provide valuable specific resources without the protection of a comprehensive contract that details exactly how the organization is to use these resources, then such stakeholders seek decision and control rights in order to direct the use of the resources they have provided. I argue that the core problem of governance is how to enhance valuable specific contributions of the relevant stakeholders while keeping the costs of bargaining between stakeholders and the costs of collective decision making low. The theory developed is then applied in a discussion of practically relevant governance mechanisms, and the concept of governance is used to contribute to the discussion on the strengths and weaknesses of the nonprofit character of organizations from a governance perspective. [source] A simple solution to the k -core problemRANDOM STRUCTURES AND ALGORITHMS, Issue 1-2 2007Svante Janson Abstract We study the k -core of a random (multi)graph on n vertices with a given degree sequence. We let n ,,. Then, under some regularity conditions on the degree sequences, we give conditions on the asymptotic shape of the degree sequence that imply that with high probability the k -core is empty and other conditions that imply that with high probability the k -core is non-empty and the sizes of its vertex and edge sets satisfy a law of large numbers; under suitable assumptions these are the only two possibilities. In particular, we recover the result by Pittel, Spencer, and Wormald (J Combinator Theory 67 (1996), 111,151) on the existence and size of a k -core in G(n,p) and G(n,m), see also Molloy (Random Struct Algor 27 (2005), 124,135) and Cooper (Random Struct Algor 25 (2004), 353,375). Our method is based on the properties of empirical distributions of independent random variables and leads to simple proofs. © 2006 Wiley Periodicals, Inc. Random Struct. Alg.,, 2007 [source] Between memory and destiny: Repetition,THE INTERNATIONAL JOURNAL OF PSYCHOANALYSIS, Issue 2 2007NORBERTO CARLOS MARUCCO This essay focuses mainly on the topic of repetition (agieren),on its metapsychological, clinical, and technical conceptions. It contains a core problem, that is, the question of the represented, the nonrepresented, and the unrepresentable in the psyche. This problem, in turn, brings to light the dialectical relation between drive and object and its specific articulation with the traumatic. The author attributes special significance to its clinical expression as ,destiny'. He points out a shift in the theory of the cure from recollection and the unveiling of unconscious desire, to the possibility of understanding ,pure' repetition, which would constitute the very essence of the drive. The author highlights three types of repetition, namely, ,representative' (oedipal) repetition, the repetition of the ,nonrepresented' (narcissistic), which may gain representation, and that of the ,unrepresentable' (sensory impressions, ,lived experiences from primal times,',prelinguistic signifiers,',ungovernable mnemic traces'). The concept-the metaphor-drive embryo brings the author close to the question of the archaic in psychoanalysis, where the repetition in the act would express itself. ,Another unconscious' would zealously conceal the entombed (verschüttet) that we are not yet able to describe-the ,innermost' rather than the ,buried' (untergegangen) or the ,annihilated' (zugrunde gegangen)-through a mechanism whose way of expression is repetition in the act. With ,Constructions in analysis' as its starting point, this paper suggests a different technical implementation from that of the Freudian construction; its main material is what emerges in the present of the transference as the repetition of ,something' lacking as history. The memory of the analytic process offers a historical diachrony whereby a temporality freed from repetition and utterly unique might unfold in the analysis. This diachrony would no longer be the historical reconstruction of material truth, but the construction of something new. The author briefly introduces some aspects of his conception of the psyche and of therapeutic work in terms of what he has designated as psychic zones. These zones are associated with various modes of becoming unconscious, and they coexist with different degrees of prevalence according to the psychopathology. Yet each of them will emerge with unique features in different moments of every analysis, determining both the analyst's positions and the very conditions of the analytic field. The zone of the death drive and of repetition is at the center of this essay. ,Pure' repetition expresses a time halted by the constant reiteration of an atemporal present. In this case, the ,royal road' for the expression of ,that' unconscious will be the act. The analyst's presence and his own drive wager will be pivotal to provide a last attempt at binding that will allow the creation of the lost ,psychic fabric' and the construction, in a conjectural way, of some sort of ,history' that may unravel the entombed (verschüttet) elements that, in these patients' case, come to the surface in the act. The analysand's ,pure' repetition touches, resonates with something of the new unconscious of the analyst. All of this leads the author to underline once again the value of the analyst's self-analysis and reanalysis in searching for connections and especially in differentiating between what belongs to the analyst and what belongs to the analysand. A certain degree of unbinding ensures the preservation of something ungraspable that protects one from the other's appropriation. [source] The Role of Intellectual Property in the Global Challenge for ImmunizationTHE JOURNAL OF WORLD INTELLECTUAL PROPERTY, Issue 4 2006Tarcísio Hardman Reis The contemporary scenario of international immunization is focused on the implementation of vaccination programs in developing countries, which demonstrates obvious similarities with the policy "access to medicines" under the Agreement on Trade-Related Aspects of Intellectual Property Rights. However, the debate on immunization involves distinct elements and presents different concerns and obstacles, which will be presented throughout this study. Three introductory remarks need to be made in order to place intellectual property (IP) as a core problem of global immunization. The first is that immunization is a world priority. The second is that the global immunization challenge faces the hurdle of the poverty gap. Finally, IP plays a controversial role in the implementation of immunization programs in less developed countries. [source] Diagnosing comorbidity: concepts, criteria, and methodsACTA NEUROPSYCHIATRICA, Issue 1 2004S. Samet Background:, The clinical and etiologic implications of comorbid psychiatric and substance-use disorders are relevant across countries and cultures. The DSM-IV now places greater emphasis on the clinical and research utility of the substance-induced disorders classification, and clarifies several important diagnostic issues specific to primary and substance-induced disorders. However, no research consensus exists over the core problem of identifying and differentiating the drug and alcohol intoxication and withdrawal symptoms that can mimic psychiatric symptoms in heavy drinkers and drug users. Objective:, To investigate how various diagnostic instruments have measured comorbid psychiatric and substance-use disorders and how each instrument operationalizes the DSM-IV classification. Method:, We review the evolution of the concept of comorbidity beginning with its formalization as the ,primary,secondary' distinction in the Feighner Criteria. We address the ,organic,non-organic' distinction found in the RDC, DSM-III, and DSM-III-R; and finally, review the ,primary' and ,substance-induced' categories of DSM-IV, DSM-IV-TR and ICD-10. We describe how these distinctions have been operationalized in widely used diagnostic instruments. Conclusion:, Further understanding of these classifications and the rela-tionship of co-occurring psychiatric and substance disorders can be accom-plished with the range of available measures, particularly the Psychiatric Research Interview for Substance and Mental Disorders (PRISM), which reliably utilizes and refines DSM-IV classification distinctions. [source] Impact of Human Genome Project on treatment of frail and edentulous patients,GERODONTOLOGY, Issue 1 2004Ichiro Nishimura Objective:, Because of ongoing increases in life expectancy and deferment of edentulousness to older age, dentists are facing a different challenge to satisfy elderly denture wearers with a higher prevalence of chronic diseases. This discussion introduces the Human Genome databases as novel and powerful resources to re-examine the core problems experienced by frail and edentulous patients. Background:, Recent studies demonstrated that mandibular implant overdentures do not necessarily increase masticatory function, perception and satisfaction in denture wearers with adequate edentulous residual ridges. It has been demonstrated that the rate of edentulous residual ridge resorption significantly varies among individuals. The prognosis and cost-effectiveness of denture treatment, with or without implants, may largely depend on how the edentulous ridge is maintained. However, reliable clinical methods permitting dentists to predict the long-term health of the edentulous residual ridge are lacking. Materials and methods:, With the completion of the Human Genome Project, the genomic sequence database from this multinational consortium will provide a unique resource to determine the genetic basis of similarity and diversity of humans. Results:, One base pair in every 100 to 300 base pairs of the genome sequence varies among humans, suggesting that genetic diagnosis using the single nucleotide polymorphisms (SNPs) may provide a novel opportunity to differentiate our edentulous patients. Conclusions:, Future dental service for the elderly will require a personalized care paradigm, using highly sensitive diagnostic technology such as SNP genomic analysis, for recommending the treatment with greatest potential benefit. [source] From need to choice, welfarism to advanced liberalism?LEGAL STUDIES, Issue 1 2005Problematics of social housing allocation Drawing on studies in governmentality, this paper considers the ways in which the selection and allocatioii of households for social housing have been conceptualised and treated as problematic. The paper urgues that the notion of ,need' emerged relatively slowly over the course of the twentieth century as the organising criterion of social housing. Yet ,need' became established as a powerful tool used to place those seeking social housing in hierarchies, and around which considerable expertise developed. While the principle of allocation on the basis of need has come to occupy a hegemonic position, it has operated it continual tension with competing criteria based on notions of suitability. As a consequence, this paper identifies risk management as a recurrent theme of housing management practices. By the 1960s need-based allocation was proving problematic in terms of who was being prioritised; it was also unuble to resist the challenge ofdeviant behaviour by tenunts and the apparent unpopularity of the social rented sector. We argue that the tramition to advanced liberalism prefaced a shift to new forms of letting accommodation bused on household choice, which have been portrayed as addressing core problems with the bureaucratically-driven system. We conclude by reflecting on the tensions inherent in seeking to foster choice, while continuing to adhere to the notion of need. [source] Motor function and methylphenidate effect in children with attention deficit hyperactivity disorderACTA PAEDIATRICA, Issue 8 2010Liv Larsen Stray Abstract Aim:, Hyperactivity, impulsivity and poor attention are the core problems of ADHD and central stimulant medication is the preferred treatment. Many children with ADHD also display motor problems. The present study investigated the presence of motor problems in subjects who showed positive response to central stimulants on ADHD symptoms, compared with non-responders. Method:, This is a retrospective study of 73 children diagnosed ADHD, aged 5,17 years, who had been assessed with parts of the ,Motor Function Neurological Assessment' (MFNU) and evaluated with regard to effect of central stimulant medication. The sample was divided into two subgroups based on the responses to methylphenidate: Medicine responders and Non medicine responders. Results:, Stimulant responders showed significantly more motor problems than the non-responders on all sub-tests and on the total problem score of the MFNU. Motor problems were present both in younger (age 5,10 years) and older (11,17 years) stimulant responders. There were no gender differences in motor performance. Conclusion:, Our findings indicate that the probability of positive effect of central stimulants on core problems of ADHD is higher when motor problems are present in addition to ADHD symptoms, than when motor problems are absent. [source] | |||||||||||||