Unsatisfied Need Research Articles

Investigation of the supportive care for postoperative patients with colorectal cancer

Objective To get a comprehensive understanding of the supportive care needs of postoperative patients with colorectal cancer , and to provide the basis to carry out health guidance for nursing staff.Methods Totals of 161 patients with colorectal cancer were chosen from March to July , 2012.Based on the Australian Bonevski ’ s supportive care needs survey （ SCNS ） , a self-design questionnaire including six demand dimensions and seventy items was used in the research .Results The mean rate of need of the six dimensions was 79.12%and the unsatisfied need rate was 78.63%.The score of mental need , need of care and support , need of physical and daily life , need of the healthcare information , the need of sexual life and the need of stoma were （2.71 ±0.56）, （2.66 ±0.46）, （2.25 ±0.67）, （1.94 ±0.67）, （1.88 ±1.25） and （0.66 ±1.18）, respectively.The postoperative care need among each dimension was significantly different （F=867.81, P〈0.05）.Conclusions The nursing staff should comprehensively understand the patient ’ s demand and adjust the nursing service timely .Nursing managers should carry out continuing education of nurses based on patients ’ demand, to promote the development of nursing science . Key words: Colorectal cancer Postoperative care Questionnaire survey Health services needs and demand Supportive care

Can't finish what you started? The effect of climactic interruption on behavior

Individuals experience a greater frequency of interruptions than ever before. Interruptions by e-mails, phone calls, text messages and other sources of disruption are ubiquitous. We examine the important unanswered question of whether interruptions can increase the likelihood that individuals will choose closure-associated behaviors. Specifically, we explore the possibility that interruptions that occur during the climactic moments of a task or activity can produce a heightened need for psychological closure. When an interruption prevents individuals from achieving closure in the interrupted domain, we show that the resulting unsatisfied need for psychological closure can cause individuals to seek closure in totally unrelated domains. These findings have important implications for understanding how consumer decisions may be influenced by the dynamic—and often interrupted—course of daily events.

Psychological distress and unsatisfied need for psychosocial support in adolescent and young adult cancer patients during the first year following diagnosis

Identifying at-risk adolescent and young adult (AYA) cancer patients and referring them to age-appropriate psychosocial support services may be instrumental in reducing psychological distress and promoting psychosocial adaptation. The purpose of this study is to identify trajectories of clinically significant levels of distress throughout the first year following diagnosis and to distinguish factors, including supportive care service use, that predict the extent to which AYAs report distress. In this prospective multisite study, 215 AYAs aged 15-39 years were assessed for psychological distress and psychosocial support service use within the first 4 months of diagnosis and again 6 and 12 months later. On the basis of distress scores, respondents were assigned to one of four distress trajectory groups (Resilient, Recovery, Delayed, and Chronic). Multiple logistic regression analyses examined whether demographics, clinical variables, and reports of unsatisfied need for psychosocial support were associated with distress trajectories over 1 year. Twelve percent of AYAs reported clinically significant chronic distress throughout the first 12 months following diagnosis. An additional 15% reported delayed distress. Substantial proportions of AYAs reported that needs for information (57%), counseling (41%), and practical support (39%) remained unsatisfied at 12 months following diagnosis. Not getting counseling needs met, particularly with regard to professional mental health services, was observed to be significantly associated with distress over time. Substantial proportions of AYAs are not utilizing psychosocial support services. Findings suggest the importance of identifying psychologically distressed AYAs and addressing their needs for mental health counseling throughout a continuum of care.

P02-269 A new proposed protocol to evaluate anxiety, depression and the needs of cancer patients

Aims:To examine the perceived needs by patients and radiotherapists using a modified by us version of the Camberwell Assessment of Need (CAN).Methods:We eliminated 4/22 areas of the CAN scale -ideated for psychotic patients- in order to adapt it to oncological subjects (naming it CANo). Each of the scale areas values: the existence of a specific need; the help received from care-givers; the help coming from social services; the completeness of the help received. CANo was administrated to 30 solid cancer subjects consecutively admitted in 2007 to the Radiotherapy Department of Novara Hospital (Italy), and to their respective treating radiotherapists. Patients with cognitive impairment were excluded. Patients were also administrated the following protocol: HADS (Hospital anxiety and depression scale); Paykel's list of stressful events; MBTI (Mayer-Briggs Type Indicator); EORTC QLQ-C30.Results:Anxiety and depression occurred at any level in 15/30 of cases. There was a significant correlation (Spearman coefficient: SC) between the numbers of needs on CANo scale and anxiety (SC:0.4; p=0.002) or depression (SC:0.48; p=0.006) levels. Higher scores in all functional EORTC scales corresponded to lower needs detected by CANo. Patient needs were perceived less important by patients themselves than their physicians (mean satisfied need scores: 1.87 vs. 3; unsatisfied need scores: 0.63 vs. 1.03). The staff overestimated patient physical health needs (7/30 vs 3/30), psychological distress (20/30 vs 5/30), relationship difficulties (9/30 vs 2/30), received information correctness (7/30 vs 2/30).Conclusions:The CANo scale may be useful to detect oncological patient needs and to improve the quality of care.

Conditional random fields for entity extraction and ontological text coding

Previous research suggests that one field with a strong yet unsatisfied need for automatically extracting instances of various entity classes from texts is the analysis of socio-technical systems (Feldstein in Media in Transition MiT5, 2007; Hampe et al. in Netzwerkanalyse und Netzwerktheorie, 2007; Weil et al. in Proceedings of the 2006 Command and Control Research and Technology Symposium, 2006; Diesner and Carley in XXV Sunbelt Social Network Conference, 2005). Traditional as well as non-traditional and customized sets of entity classes and the relationships between them are often specified in ontologies or taxonomies. We present a Conditional Random Fields (CRF)-based approach to distilling a set of entities that are defined in an ontology originating from organization science. CRF, a supervised sequential machine learning technique, facilitates the derivation of relational data from corpora by locating and classifying instances of various entity classes. The classified entities can be used as nodes for the construction of socio-technical networks. We find the outcome sufficiently accurate (82.7 percent accuracy of locating and classifying entities) for future application in the described problem domain. We propose using the presented methodology as a crucial step in the process of advanced modeling and analysis of complex and dynamic networks.

Minimum welfare levels of farm workers in the San Quintín and Mexicali valleys, Baja California

Farm workers represent one of the poorest sectors of the population in Mexico, including Baja California. This study compares the welfare levels of a mostly immigrant population of indigenous workers from San Quintín Valley with those of mestizo farm workers from Mexicali Valley. Surveys were conducted between 1997 and 2000 by the Instituto de Investigaciones Sociales of the Universidad Autónoma de Baja California and the Instituto Nacional Indigenista, based on the parameters proposed by the Unsatisfied Basic Needs method to measure poverty level. In general, the comparison did not reveal significant differences in welfare levels between both agricultural valleys, even though the populations compared were not homogeneous (one indigenous and the other mestizo). Both groups of families were found to live in poverty, and approximately one in four in extreme poverty. Nutrition proved to be the most unsatisfied need for both groups, followed by education. Most of the farm workers in both valleys earned minimum wage, or twice the amount, despite the region's high cost of living.

Reform or Professional Responsibility as Usual: Whither the Institutions of Regulation and Discipline?

This article predicts five institutional changes that are likely to occur in the professional responsibility area in the twenty-first century. First, the enforcement of professional ethics will likely become more nationalized. Lawyers should expect a more uniform system of professional regulation and a greater degree of negotiation among the states and federal government concerning the types of regulation that are appropriate. Second, the article suggests that disciplinary systems will become more transparent, particularly with respect to policy-making in the disciplinary process and enforcement. Opening the process will enhance respect for the rules and improve enforcement techniques. Third, local bar associations will reevaluate the functions they perform and acknowledge the multiplicity, and occasional inconsistency, of the goals they seek to achieve. As a result, local bars will rely more on other regulators to restrain lawyer misconduct. They will shift their priorities towards functions, including lawyer assistance, that bar associations are uniquely suited to fulfilling. Fourth, the article predicts changes in the licensing and admission of lawyers. A system of specialty examination and licensing will provide official methods of differentiating among lawyers. At the same time, redefinition of the practice of law will result in a decrease in some forms of licensing. Greater recognition of the interrelationship between legal and nonlegal work will open the door to negotiation among the professions regarding who may provide services tangential to law. Sanctioning lay-providers may also be a necessary reaction to the growing, unsatisfied need of the poor and middle classes for law-related services.

Paciente amputado de miembro inferior: Necesidades físicas, emocionales y sociales insatisfechas

El presente trabajo tiene como objetivo analizar las necesidades físicas, sociales y emocionales insatisfechas experimentadas por el paciente adulto joven que sufre la amputación de un miembro inferior, con el propósito de conocer de forma directa y real cuáles son sus experiencias vividas, tomando al individuo como un ser único, integral y autónomo. Cada paciente enfrenta la amputación de distintas formas, pues confluyen aspectos como la manera en que la persona ve la vida, la capacidad de afrontar situaciones difíciles, la personalidad, el apoyo familiar, las expectativas y las esperanzas. Aunque cada necesidad insatisfecha tiene un nombre especifico, el ser humano la manifiesta según el proceso de aceptación y adaptación a la amputación. Para este estudio se realizaron entrevistas en profundidad a seis pacientes que asistían al Centro Integral de Rehabilitación Colombiano (CIREC), a partir de las cuales pudo concluirse que la dimensión emocional es la más afectada y en menor proporción el aspecto físico, puesto que éste es el primero en ser satisfecho.

Nu bli’r der ballade

Nu bli’r der ballade

Chapter 5: Cancer Trends in Sweden Until 2010

AbstractTo arrive at a reasonable estimate of the total need for radiotherapy, the various descriptions of population trends and measures of cancer trends must be studied concurrently. Incidence and mortality are well documented by official statistics. All prognoses are based on these measures, the official population statistics, and the 1989 population prognosis from Statistics Sweden. Incidence, mortality, and prevalence may be considered either individually or together as indirect measures of the need for radiotherapy at different stages for different types of cancer.Incidence, ie, the number of cases of disease onset during a given period, shows the indirect need for curative radiotherapy, eg, for breast cancer, laryngeal cancer, gynecological tumor types, and head and neck cancer. The projected average annual mean increase in total incidence is 1.0%.Mortality may be used as an indirect measure of the need for palliative treatment for recurring cancer, eg, for bone metastases, prostate cancer, lung cancer, or breast cancer. The mean increase is estimated at 0.9% per year.Likewise, prevalence can be an indirect measure of the need for palliative treatment for cancer diseases of a chronic nature, eg, prostate cancer and multiple myeloma. The total mean increase per year has been estimated at 2.0%.The total need for radiotherapy in the future should be viewed against the background of all these descriptive measures. Assessment must also consider numerous other factors that directly influence need. A change in the indications for treatment can quickly increase the need for radiotherapy, eg, the benefits of radiotherapy for noninvasive breast cancer are currently being studied. Even a change in the indications for surgical intervention for small tumors in the breast influence the need for primary curative radiotherapy in this large group of patients. Likewise, a shift in staging the primary diagnosis, eg, in head and neck cancer, and changes in fractionation (hyperfractionation) may substantially influence need. This is addressed further in another section of the report.The largest single group of cancer patients who receive radiotherapy are those with bone metastases (25% of the total). The size of this group, and thereby the potential unsatisfied need, is largely unknown since no statistics show the prevalence of metastases in the population. This group is comprised mainly of patients that were primarily diagnosed with prostate cancer, breast cancer, and lung cancer. Concerning lung cancer, incidence trends probably provide the best measure of changes in the number of bone metastases over time. The annual increase in incidence has been estimated at 1.5%. As for breast cancer and prostate cancer, mortality trends provide more information about trends in the number of bone metastases. Both types of cancer increased by 1.9% per year. Chapter 6 presents the types of cancer for which radiotherapy is usually given. The projected trends show that each of these cancer diagnoses, except lung cancer in men and cervical cancer in women, are expected to increase in number until the year 2010. Prevalence is expected to increase even more, particularly cancer in the rectum, breast, and prostate. Also, the number of cases of non-Hodgkin's lymphoma is expected to nearly double by 2010.

Ethnicity, migration and health: A population‐based study of 338 refugees from Latin America, 396 nonrefugee immigrants from Finland and 161 from southern Europe and 996 age‐, sex‐ and education‐matched controls from Sweden

This article shows the influence of being a refugee from Latin America or a nonrefugee immigrant from southern Europe or Finland on self‐reported illness, controlling for social factors and lifestyle. The study population consisted of 338 Latin American refugees, a random sample of 396 Finnish and 161 southern European immigrants and 996 age‐, sex‐ and education‐matched Swedish controls. The data were analysed unmatched with logistic regression (multivariate analysis) in main effect models. The strongest independent risk indicator for long‐term illness was being a Latin American refugee (estimated odds ratio (OR)=2.96, 95% confidence interval (CI)=2.19–3.82). There was a significant association between being a Latin American refugee and period prevalence, ill health and unsatisfied need for care. Being a southern European or Finnish immigrant was a risk indicator of ill health but was not associated with the other dependent factors. Not feeling secure in daily life was a strong risk indicator for long‐term illness and ill health (estimated OR=1.89, 95% CI=1.26–2.76 and OR=3.04, 95% CI= 1.97–4.48) respectively). Being a Latin American refugee was equal in importance to traditional risk factors such as overweight and not taking regular exercise for long‐term illness and ill health.

Measuring the Unmet Need for Contraception to Space and Limit Births

This paper describes how data from Contraceptive Prevalence Surveys (CPS) can be applied to a model for computing the potential total contraceptive demand and unmet demand during 1 year. By asking respondents in 6 countries (Bangladesh Colombia Costa Rica Korea Mexico and Thailand) to specify their preferences for the timing of their next pregnancy the CPS make it possible for the 1st time on a comparative basis to calculate the need for contraception to space births as well as to prevent them. The key feature of the model used is that it incorporates time as a factor and allows for changes in exposure to the risk of unintended pregnancy. Specifically the model recognizes analytically that pregnant and breastfeeding women who are frequently excluded from estimates of contraceptive need rejoin the group of exposed women and require contraceptive protection for at least part of the time period under review. Applying the model during a 1-year period an average of 34% of fecund married women in the 6 countries wish to postpone or prevent another pregnancy but are not using a contraceptive method. This proportion--the unmet need for contraception--ranges from a low of 22% in Costa Rica to a high of 67% in Bangladesh. Although most of the women with unmet need are likely to be those who wish to terminate childbearing birth spacers nevertheless constitute a sizable proportion of the unmet need group (43% on average ranging from 24% in Korea to 55% in Bangladesh and Costa Rica). Similar proportions of older and younger women 32% and 37% are likely to have an unsatisfied need for contraceptive services; but among younger women the unmet need for contraception to space births predominates whereas among older women the major portion of the unsatisfied need stems from the desire to prevent births. On average women who give birth during the 1-year period account for 36% of the unmet need among younger women and for 13% among older women. The range for younger women is from 26% in Bangladesh and Thailand to 46% in Colombia and for older women from 8% in Korea to 15% in Bangladesh and Colombia. The importance of these findings is that women with a live birth during the 1-year interval are women of proven fecundity whose failure to practice contraception to limit or space births is likely to result in an unintended pregnancy. (authors modified) (summaries in ENG SPA FRE)

The Silent Revolution in Europe: Intergenerational Change in Post-Industrial Societies

A transformation of basic political priorities may be taking place in Western Europe. I hypothesize: (1) that people have a variety of needs which are given high or low priority according to their degree of fulfillment: people act on behalf of their most important unsatisfied need, giving relatively little attention to needs already satisfied—except that (2) people tend to retain the value priorities adopted in their formative years throughout adult life. In contemporary Western Europe, needs for physical safety and economic security are relatively well satisfied for an unprecedentedly large share of the population. Younger, more affluent groups have been formed entirely under these conditions, and seem relatively likely to give top priority to fulfillment of needs which remain secondary to the older and less affluent majority of the population. Needs for belonging and intellectual and esthetic self-fulfillment (characterized as “post-bourgeois” values) may take top priorities among the former group. Survey data from six countries indicate that the value priorities of the more affluent postwar group do contrast with those of groups raised under conditions of lesser economic and physical security. National patterns of value priorities correspond to the given nation's economic history, moreover, suggesting that the age-group differences reflect the persistence of preadult experiences, rather than life cycle effects. The distinctive value priorities imply distinctive political behavior—being empirically linked with preferences for specific political issues and political parties in a predictable fashion. If the respective age cohorts retain their present value priorities, we would expect long-term shifts in the political goals and patterns of political partisanship prevailing in these societies.

The treatment of “colic” in infancy by use of the pacifier

Summary<ul><li>1.The "colic" baby has been a problem for all pediatricians.</li><li>2.The various theories as to the etiology of colic are discussed.</li><li>3.Twenty-eight infants with histories typical of colic were placed on pacifiers.</li><li>4.In every instance except two the pacifier was readily accepted.</li><li>5.With the exception of three infants, the pacifier was successful in relieving the irritability and crying of the infant and in causing a cessation of the symptoms of colic.</li><li>6.The favorable results of our studies on the use of the pacifier in the relief of infantile colic seem to indicate that the crying of the infants may be due either to an unsatisfied need for adequate oral gratification, or from abdominal pain caused by the spasm of intestinal muscles resulting from the general hypertonicity of the infant.</li><li>7.The use of the pacifier does not form a habit, the children discardingit spontaneously at an average age of 13.8 months.</li><li>8.In only two of the twenty-eight cases did infants resort to thumb-sucking during or after discontinuing the pacifier, and these two only while going to sleep after the pacifier had been discarded.</li><li>9.The fact that certain crying infants do not respond to the pacifier byrelaxation would lead to the conclusion that their difficultywas probably due to an etiological factor unrelated to the need for sucking.</li></ul>