This thesis seeks to examine how funding arrangements for cancer drugs and other treatments, which are not available to everyone within the NHS, are made available to some, on the basis of exceptionality. The escalating costs of cancer treatment and the life threatening nature of cancer make resource allocation decisions for cancer drugs particularly acute, and the recent changes to funding arrangements for cancer drugs within the NHS receive particular scrutiny. In the three papers at the core of this thesis, the concept of exceptionality is explored from legal, ethical and empirical perspectives respectively. The first paper reviews the legal origin of exceptionality as the basis for the allocation of resources for expensive treatments, and explores how the concept has been interpreted by successive judicial reviews concerning access to cancer drugs. Particular attention is paid to the role of social factors in determining exceptionality. Choosing to fund treatment for one patient, and not another, involves a moral choice. In recognition of this, the Department of Health advocates that decision makers use an ethical framework to support decision making regarding exceptionality. The second paper examines the strengths and weakness of Daniels and Sabin’s Accountability for Reasonableness Framework, which is widely used to support resource allocation, focussing on the Relevance Condition, and its applicability to resource allocation within the NHS. The final paper reports the findings of an empirical study examining how PCTs interpret the concept of exceptionality in practice, providing the first comprehensive insight into the factors which are considered in determining whether a patient is exceptional, and exposing some of the external influences on the decision making process. In conclusion, it is argued that whilst the need for discretionary health funding decisions arises in rare circumstances, where this is necessary such decisions should be made on a national, or at least supra-regional basis, to ensure consistency and fairness. If we cannot afford to fund all effective cancer drugs, and other treatments, we should not hide behind the concept of exceptionality, but should have a national debate about how we reach a consensus on which drugs to fund, and about how we pay for those treatments. Whilst acknowledging that cancer is a dreadful disease, it is also argued that, in the absence of any convincing evidence that the management of cancer deserves preferential treatment, the special status of cancer funding within the NHS, which has become increasingly apparent in recent years, should come to an end.

The teaching of the gifted has been a core part of education itself sice it was first formalised, however despite these years of experience the academic community are no closer to understanding or recommending best practice to the thousands of teachers who deal with the challenges associated with gifted and talented education on a daily basis. This study hopes to understand teachers attitudes towards these types of children as well as those children who fall into the doubly exceptional category through qualitative semi structured interviews and focus groups. The resuls showed that while participants held positives attitudes to both types of students under study they were largly unsure as to effectively educate these children and felt that proper government and global guidelines as well as teacher training could overcome these issues.

This thesis focuses on the topic of the experience of talented people with dyslexia. These 'twice exceptional' students are a group of people who deserves more attention than it is nowadays devoted. It is a specific group of people who are rationally talented - traits such as the aim of learning quickly, adopting new information and working with them. They are inquiring, interested in abstract and difficult questions. Their creativity is striking but at the same time they have limitations which is brought by the very specific learning disability in this case mainly dyslexia and some other affiliated disorders. This work's main goal is to describe the experience of this specific group of people, at first by the help of literary survey and then in the empiric part by interview followed by the comparison of the talented people with dyslexia and talented people without dyslexia. This thesis is concluded by suggesting the intervention program for schools in which students are often incorrectly identified and they did not obtain necessary care. key words: twice exceptionality, dyslexia, talent, well-being

No description available.

This is a single-storied building of 1025 square metres space and with an accessible roof through a footbridge designed even for disabled. It is implanted into the entrance zone of green in front of the ecological paper-mill. The presentation and exhibition pavillion should be an extraordinary and reprezentativ object. The building will be placed among green and it aspires to exist in harmony with it. Thus it behaves as its‘ component. Concept is based on an idea of cellulose threads, which is primary structure of an organic stuff. „The threads“ form a supporting structure and determine the platform. The glass facade and even the interior come through three colours, that present the paper making process and even carry an aesthetic benefit. The facade systems utilize energy – they react to the Sun and air movement and even they compose an ornament.

States of emergency haven’t been unconnected to Peruvian history. When the first Constitution was proclaimed, a regime of suspension of constitutional order was declared.  Today,  the normalization of this reality continues being firmly present in the institutional life of the country.In this paper, the author analyzes the paradox that this notion entrails. With this purpose, he goes back to the evolution that this concept has suffered in doctrine. Also, he presents an historical approach to the presence of the institution in our country. / Los estados de excepción no han sido ajenos a la historia peruana. Ni bien se proclamó la primeraConstitución, también se declaró un régimen desuspensión del orden constitucional. Hoy, la normalización de esta realidad integra la vida institu-cional del país.En el presente artículo, el autor analiza la paradoja que entraña esta noción. Con tal propósito, examina la evolución que se ha dado en la doctrina respecto del concepto. Además, nos plantea una aproximación histórica a la presencia de la institución en nuestro país.

São numerosos a produção de textos e os debates centrados na arrecadação de tributos, mas é extremamente pequeno o interesse demonstrado pela nossa doutrina pela forma como é empregada a altíssima carga tributária exigida dos contribuintes. A questão torna-se incompreensível em razão da extrema miséria em que vive 1/5 da população brasileira e do fato de que os órgãos controladores só exercitam a sua competência saneadora depois do dano consumado. Controle prévio, no entanto, não é só aquela participação formal de concordância em relação a certos atos do Poder Público, é o momento em que ocorre a fiscalização do Tribunal, não a obrigatoriedade mecânica exigida para a eficácia do ato. Esses desacertos ocorrem em razão dos inadequados paradigmas do Direito Administrativo e do Direito Constitucional, que insistem em sobreviver em um Estado moderno, democrático e republicizado. O Direito (material e formal) deveria promover uma ininterrupta interatividade entre o Estado e a sociedade e a formação de uma consciência cívica capaz de impedir a exclusão do cidadão na gestão pública. O controle social proposto encontra seu fundamento último nas imperfeições do sistema democrático representativo e na insegurança jurídica que a judicialização de políticas públicas e uma mais ampla atuação do Tribunal de Contas, capaz de chegar até o trâmite dos tipos orçamentários, poderiam provocar. Assim, o jogo democrático não seria exercido somente na aparência, porquanto democracia e contestabilidade são prismas de uma mesma materialidade. Em síntese, o estado de exceção permanente em que vivemos, produto de um extremo desequilíbrio entre fato, valor e norma, exige uma imediata mudança no inoperante sistema de checks and balances. O alargamento dos meios de controle, entretanto, só serão seguros se o sistema permitir uma efetiva participação popular no amplo debate que deve ser travado entre todos os atores representativos de uma democracia verdadeiramente deliberativa. O controle social não é a panacéia de todos os males, mas é a única forma de tornar eficaz o complexo conjunto de opções empregadas para o controle interno e externo eficaz de políticas públicas. Como adverte Bobbio, citado na conclusão do trabalho, \"já estamos demasiadamente atrasados (...) Não temos muito tempo a perder\". / The production of texts is wide and the discussions are focused on tax collection but the interest demonstrated by our scholars on the way whereby the very high tax burden charged from taxpayers is used is extremely poor. The issue becomes unintelligible in view of the extreme poverty in which one fifth of the Brazilian population lives and of the fact that the controlling authorities exercise their remedying powers only after the damage is consummated. However, prior control is not only that formal participation consisting in the agreement with certain acts performed by Public Authorities, it is the time when the Court exercises its surveillance, not the mechanical obligatoriness required for effectiveness of the act. Such mismatching occurs because of the inadequate paradigms of Adrninistrative Law and Constitutional Law, which insist in surviving in a modern and democratic State, and further, a State conformed to the republican system. In opposition, the Law (both material and formal) must promote an interrupted interactivity between the State and society and the creation of a civic awareness, capable of preventing the citizen\'s exclusion from public management. The social control proposed is ultimately grounded on the imperfections of the representative democratic system and on legal unsafety, which the judicialization of public policies and a wider performance by the Audit Court, capable of reaching the channels of the budget types, could provoke. Thus, the democratic game would not be played only in appearance, since democracy and the exercise of contestation are angles of the same materiality. In short, the state of permanent exceptionality in which we live, which is the product of an extreme unbalance among fact, value and norm, requires an immediate change in the inoperative checks-and-balances system. However, the enlargement of the control means shall only be safe if the system allows the population\' s actual participation in the wide discussion that must be conducted among all actors who represent an actual deliberative democracy. Social control is not a remedy for all diseases, but the only form of rendering effective the complex set of options used for the efficiency of internal and external controls of public policies. As warned by Bobbio, quoted in the conclusion of the work, \"we are already too late (...). We have not much time to waste\".

No description available.

There is an increase in the number of children who are identified as gifted, and exhibit a learning disorder as well. This condition is known as dual exceptionality. However, there are few empirical studies about this topic. Therefore, the purpose of this article is to pres- ent a case study of a gifted child who was in the process of being diagnosed with Asperger Syndrome. Interviews were conducted with the child, the mother and professionals that served him. Psychological, neurological and phonological evaluations carried out with the boy were analyzed. The mother and professionals raised further explanations for the child’s behavior. The difficulties in the diagnostic process and the need for a multidisciplinary approach are explored. / Se observa un aumento en el número de niños identificados como superdotados que también tienen algún trastorno, condición conocida como doble excepcionalidad. Sin embargo, hay escasez de investigaciones sobre el tema. Luego, el objetivo es presentar un estudio de caso de un niño superdotado que se encontraba en proceso de identificación del síndrome de Asperger. Se realizaron entrevistas con el niño, la madre y los profesionales que lo asistían, y se analizaron evaluaciones psicológica, neurológica y fonoaudiológica llevadas a cabo con el chico. Madre y profesionales hacen ponderaciones acerca del diagnóstico y plantean otras explicaciones para la conducta del niño. Así, darse cuenta de las dificultades en el proceso de identificación y la necesidad del enfoque multidisciplinar para el fenómeno. / Observa-se um aumento no número de crianças identificadas como superdotadas que também apresentam algum transtorno, em uma condição que é denominada dupla excepcionalidade. Porém, há escassez de pesquisas sobre o tema. Nesse sentido, o objetivo deste artigo é apresentar um estudo de caso de uma criança superdotada que estava em processo de diagnóstico da Síndrome de Asperger. Foram realizadas entrevistas com a criança, a mãe e os profissionais que a acompanhavam, e foram analisadas as avaliações psicológica, neurológica e fonoaudiológica, realizadas ao menino. A mãe e os profissionais fazem ponderações enquanto ao diagnóstico e levantam outras possibilidades de explicação para os comportamentos da criança. Percebemse as dificuldades no processo de identificação e a necessidadede um olhar multidisciplinar sobre o fenômeno.

São numerosos a produção de textos e os debates centrados na arrecadação de tributos, mas é extremamente pequeno o interesse demonstrado pela nossa doutrina pela forma como é empregada a altíssima carga tributária exigida dos contribuintes. A questão torna-se incompreensível em razão da extrema miséria em que vive 1/5 da população brasileira e do fato de que os órgãos controladores só exercitam a sua competência saneadora depois do dano consumado. Controle prévio, no entanto, não é só aquela participação formal de concordância em relação a certos atos do Poder Público, é o momento em que ocorre a fiscalização do Tribunal, não a obrigatoriedade mecânica exigida para a eficácia do ato. Esses desacertos ocorrem em razão dos inadequados paradigmas do Direito Administrativo e do Direito Constitucional, que insistem em sobreviver em um Estado moderno, democrático e republicizado. O Direito (material e formal) deveria promover uma ininterrupta interatividade entre o Estado e a sociedade e a formação de uma consciência cívica capaz de impedir a exclusão do cidadão na gestão pública. O controle social proposto encontra seu fundamento último nas imperfeições do sistema democrático representativo e na insegurança jurídica que a judicialização de políticas públicas e uma mais ampla atuação do Tribunal de Contas, capaz de chegar até o trâmite dos tipos orçamentários, poderiam provocar. Assim, o jogo democrático não seria exercido somente na aparência, porquanto democracia e contestabilidade são prismas de uma mesma materialidade. Em síntese, o estado de exceção permanente em que vivemos, produto de um extremo desequilíbrio entre fato, valor e norma, exige uma imediata mudança no inoperante sistema de checks and balances. O alargamento dos meios de controle, entretanto, só serão seguros se o sistema permitir uma efetiva participação popular no amplo debate que deve ser travado entre todos os atores representativos de uma democracia verdadeiramente deliberativa. O controle social não é a panacéia de todos os males, mas é a única forma de tornar eficaz o complexo conjunto de opções empregadas para o controle interno e externo eficaz de políticas públicas. Como adverte Bobbio, citado na conclusão do trabalho, \"já estamos demasiadamente atrasados (...) Não temos muito tempo a perder\". / The production of texts is wide and the discussions are focused on tax collection but the interest demonstrated by our scholars on the way whereby the very high tax burden charged from taxpayers is used is extremely poor. The issue becomes unintelligible in view of the extreme poverty in which one fifth of the Brazilian population lives and of the fact that the controlling authorities exercise their remedying powers only after the damage is consummated. However, prior control is not only that formal participation consisting in the agreement with certain acts performed by Public Authorities, it is the time when the Court exercises its surveillance, not the mechanical obligatoriness required for effectiveness of the act. Such mismatching occurs because of the inadequate paradigms of Adrninistrative Law and Constitutional Law, which insist in surviving in a modern and democratic State, and further, a State conformed to the republican system. In opposition, the Law (both material and formal) must promote an interrupted interactivity between the State and society and the creation of a civic awareness, capable of preventing the citizen\'s exclusion from public management. The social control proposed is ultimately grounded on the imperfections of the representative democratic system and on legal unsafety, which the judicialization of public policies and a wider performance by the Audit Court, capable of reaching the channels of the budget types, could provoke. Thus, the democratic game would not be played only in appearance, since democracy and the exercise of contestation are angles of the same materiality. In short, the state of permanent exceptionality in which we live, which is the product of an extreme unbalance among fact, value and norm, requires an immediate change in the inoperative checks-and-balances system. However, the enlargement of the control means shall only be safe if the system allows the population\' s actual participation in the wide discussion that must be conducted among all actors who represent an actual deliberative democracy. Social control is not a remedy for all diseases, but the only form of rendering effective the complex set of options used for the efficiency of internal and external controls of public policies. As warned by Bobbio, quoted in the conclusion of the work, \"we are already too late (...). We have not much time to waste\".