Committees for ethics in research involving human subjects

In Brazil since October 1996 there have been guidelines for research involving human subjects. Now human subjects know when their treatment is part of research. Deceit is no longer tolerated. But is not enough to say we offer an explanation to the potential subject and we offer a choice before he or she is confronted with an informed consent form. As in all professional activity, scientific investigation needs social controls. In Brazil, the ultimate responsibility of an investigation lies on the investigator, but in every institution where research is carried out there is a Committee for Ethics in Research. All Committees are subordinated to the National Commission of Ethics in Research, which is submitted to the Brazilian Institute of Health. During 2005 around 17,000 protocols involving 700,000 human subjects were revised by 475 Committees distributed all over the country. Approximately 7,000 people are now working in these Committees.

Live my work : rural nurses and their multiple perspectives of self

Aim. This paper is a report of a study to explore rural nurses' experiences of mentoring. Background. Mentoring has recently been proposed by governments, advocates and academics as a solution to the problem for retaining rural nurses in the Australian workforce. Action in the form of mentor development workshops has changed the way that some rural nurses now construct supportive relationships as mentoring. Method. A grounded theory design was used with nine rural nurses. Eleven semi-structured interviews were conducted in various states of Australia during 2004-2005. Situational analysis mapping techniques and frame analysis were used in combination with concurrent data generation and analysis and theoretical sampling. Findings. Experienced rural nurses cultivate novices through supportive mentoring relationships. The impetus for such relationships comes from their own histories of living and working in the same community, and this was termed 'live my work'. Rural nurses use multiple perspectives of self in order to manage their interactions with others in their roles as community members, consumers of healthcare services and nurses. Personal strategies adapted to local context constitute the skills that experienced rural nurses pass-on to neophyte rural nurses through mentoring, while at the same time protecting them through troubleshooting and translating local cultural norms. Conclusion. Living and working in the same community creates a set of complex challenges for novice rural nurses that are better faced with a mentor in place. Thus, mentoring has become an integral part of experienced rural nurses' practice to promote staff retention. © 2007 The Authors.

[Letter to the Editor] Telemonitoring in Patients with Heart Failure

To the Editor: Chaudhry et al. suggest that enhanced support in the use of a telephone-based interactive voice-response system for patients recently discharged after worsening heart failure does not improve outcomes. This finding is broadly consistent with previous systematic reviews of telephone support1 and contrasts with the substantial effect observed with home telemonitoring of vital signs in similar populations.1 The treatment of patients in the control group was excellent, but unrepresentative of usual clinical care and not inferior to the treatment of patients receiving enhanced support. Monitoring alone is unlikely to improve outcomes but may do so when it improves prescription of or adherence to lifesaving treatments. Given enough resources, traditional methods for delivering care may render an interactive voice-response system or a home telemonitoring system ineffective. Nonetheless, there may be more cost-efficient approaches to ensuring quality care.2 Informal post hoc addition of these data to our recent meta-analysis of telephone support1 does not substantially alter the point estimates for death from any cause or heart-failure−related hospitalizations, but it does nullify the small benefit in hospitalizations for any cause, which may not be reduced by a heart-failure−focused intervention.1 Original article: Telemonitoring in Patients with Heart Failure NEJM. December 9, 2010 | S.I. Chaudhry and Others

Practice uncertainty: Changing perceptions

Practice uncertainty occurs when health care providers feel uncomfortable in response to unfamiliar or challenging patient care situations. Practice uncertainty is inevitable in health care, and there are many contextual factors that can lead to either good or bad outcomes for patients and health care providers. Practice uncertainty is not a well-established concept in the literature, perhaps because of the predominant empirical paradigm and the high value placed on certainty within current health care culture. This study was conducted to explore practice uncertainty and bring this topic into the foreground as a first step toward practice evolution. A shift in the perception of practice uncertainty may change the way in which practitioners experience this phenomenon. This process must start with nursing educators recognizing and acknowledging this phenomenon when it occurs.

Identity, image, and sexuality in young adults with cancer

The impact of disease and treatment on a young adult's self-image and sexuality has been largely overlooked. This is surprising given that establishing social and romantic relationships is a normal occurrence in young adulthood. This article describes three female patients' cancer journeys and demonstrates how their experiences have impacted their psychosocial function and self-regard. The themes of body image, self-esteem, and identity formation are explored, in relation to implications for relationship-building and moving beyond a cancer diagnosis. This article has been written by young cancer survivors, Danielle Tindle, Kelly Denver, and Faye Lilley, in an effort to elucidate the ongoing struggle to reconcile cancer into a normal young adult's life.

School integration and the friendships of youth with developmental disabilities

- The present study was an investigation into the effect ofschool integration on the friendships ofyouth with developmental disabilities and their peers without disabilities. The youths, their parents, and their teachers provided insights into the youths' friendships. A qualitative paradigm was used in this research. The researcher guided the collection and analysis ofthe data with the phenomenologicallifeworld existentials of body, space, time, and human relation (Van Manen, 1990). Individual interviews were conducted with each youth, and group interviews were conducted with each triad (a youth, their parent(s), and their teacher) to discuss the youth's friendships and the supports necessary to facilitate the friendships. Through phenomenological analysis of the data, four thematic statements emerged: friendships are far from perfect, to have a friend you have to be a friend, parents as choreographers offriendship, and teachers as reluctant partners in friendship facilitation. Based on the results ofthis study, it was concluded that the development of friendships between youth with developmental disabilities and their peers without disabilities was happening in integrated school settings. However, it was also evident that the support ofteachers and parents alike were required to facilitate the development and maintenance ofsuch friendships. Recommendations for practice are discussed, including the need for active participation by the youth's parents in the facilitation offriendships, and the use ofa "circle offriends" to facilitate friendship development. Also discussed are the recommendations for further research, including the need for the youth's friends to be interviewed regarding their friendships with the youth with disabilities, and the need for researcher observation ofth~ friendships in action. Further research could also explore the role ofthe mother versus the father in facilitating friendships, and the role of recreation and leisure opportunities in the ,development offriendships.

Uppfattningar om en organisationsförändring : En fallstudie av en förändrad ledningsorganisation avseende Barn- och ungdomsförvaltningen i Rättviks kommun

Studien syftar till att undersöka effekter av en genomförd förändring av ledningsorganisationen inom Rättviks kommuns Barn- och ungdomsförvaltning. Mot denna bakgrund formuleras följande frågeställningar: - Hur har de önskade effekterna av den genomförda organisationsförändringen fått genomslag med avseende på hur verksamheten styrs och koordineras i praktiken? - Hur uppfattar de involverade aktörerna den nuvarande organisationsformens funktionalitet? - I vad mån har den nya organisationen löst de problem som var orsak till att omorganisationen genomfördes? Studien är en kvalitativ fallstudie. Bolman och Deal (2005) anlägger fyra olika perspektiv på organisationer, nämligen strukturellt, Human Relation (HR), politiskt och symboliskt, d.v.s. ett tvärvetenskapligt angreppssätt, på hur organisationer och deras verksamhet kan beskrivas, tolkas och förstås. Det är också dessa perspektiv som utgör grundstommen i den analys som görs av resultatet av studien. Har då Barn- och ungdomsförvaltningen blivit mera välfungerande och i så fall på vilka sätt? Den nya organisationsstrukturen uppfattas som ändamålsenlig och i huvudsak välfungerande, d.v.s. den skapar många av de förutsättningar som behövs för att det ska vara möjligt att hantera problem, optimera resurser och koordinera verksamheten trots att det i intervjuerna framkommer kritiska synpunkter, samtidigt som enkätsvaren i övervägande grad är positiva. Bilden skulle kunna uppfattas som motsägelsefull, men som vi argumenterar för så behöver det inte vara fallet. De problem som finns beror inte i de flesta fall på brister i den organisatoriska strukturen, utan snarare på andra faktorer, t.ex. att verksamheten har ett komplext innehåll samt på hur aktörerna spelar sina roller. Den huvudsakliga förbättringspotentialen verkar inte finnas i att den organisatoriska strukturen förändras, men ändå kan ändå en del aspekter av den nuvarande organisationsstrukturen diskuteras i fråga om tänkbara alternativa lösningar.

Associations of neighbourhood greenness with physical and mental health : do walking, social coherence and local social interaction explain the relationships?

Background: Studies have shown associations between health indices and access to “green” environments but the underlying mechanisms of this association are not clear.

Objectives: To examine associations of perceived neighbourhood “greenness” with perceived physical and mental health and to investigate whether walking and social factors account for the relationships.

Methods: A mailed survey collected the following data from adults (n  =  1895) in Adelaide, Australia: physical and mental health scores (12-item short-form health survey); perceived neighbourhood greenness; walking for recreation and for transport; social coherence; local social interaction and sociodemographic variables.

Results: After adjusting for sociodemographic variables, those who perceived their neighbourhood as highly green had 1.37 and 1.60 times higher odds of better physical and mental health, respectively, compared with those who perceived the lowest greenness. Perceived greenness was also correlated with recreational walking and social factors. When walking for recreation and social factors were added to the regression models, recreational walking was a significant predictor of physical health; however, the association between greenness and physical health became non-significant. Recreational walking and social coherence were associated with mental health and the relationship between greenness and mental health remained significant.

Conclusions: Perceived neighbourhood greenness was more strongly associated with mental health than it was with physical health. Recreational walking seemed to explain the link between greenness and physical health, whereas the relationship between greenness and mental health was only partly accounted for by recreational walking and social coherence. The restorative effects of natural environments may be involved in the residual association of this latter relationship.

Sexual practices and the duration of last heterosexual encounter : findings from the Australian longitudinal study of health and relationships

This study investigated the association between sexual practices and duration of a sexual encounter. Using data from a population-based computer-assisted telephone survey of 8,656 Australians aged 16 to 64 years, four distinct patterns of sexual practices among respondents were found: “basic sexual encounter” (involving mainly kissing, cuddling, stroking one's partner and being stroked, and vaginal intercourse), “basic sexual encounter plus oral sex,” “all assessed sexual practices” (all sexual behaviors included in the survey), and “mainly vaginal intercourse” (characterized by lower levels of kissing, cuddling, and stroking). For both men and women, respondents classified in the basic sexual encounter plus oral sex, and all assessed sexual practices clusters reported significantly longer durations than those in the basic sexual encounter group, whereas respondents in the mainly vaginal intercourse cluster reported shorter durations. These differences were found even after allowing for demographic differences in sexual duration—specifically, age and partner type of the most recent opposite-sex partner. These findings add to the understanding of what typically happens in a sexual encounter. Overall, longer sexual encounters appear to be associated with the inclusion of the least common sexual practices—namely, oral sex and self-stimulation.

O auto da morte e da vida : a escrita barroca de João Cabral de Melo Neto

This dissertation, entitled O Auto da Morte e da Vida: A escrita barroca de João Cabral de Melo Neto, has the aim of analising, interpreting, in a baroque perspective, Cabral s writing in the poem/play Morte e vida severina Auto de Natal Pernambucano, taking as basis the theories of Eugênio D´Ors, Severo Sarduy, Omar Calabrase, Lezama Lima, Afonso Ávila, Affonso Romano de Sant´Anna and others cited in the body of this work. During the analisys we feature confluences, relations, similarities, identification between the Baroque of the counter reformation and the modern Baroque or Neobaroque. We seek to comprehend the baroque which is new in the XX century and Cabral s poetry as an element of the contemporaneity, by updating the concept of the Baroque in the 1600s, when it is detected in its purest characteristic in human relation (the life of the Northwestern brazilian) through an intangible reality (the death). The Baroque as a cultural summary of a period of instability and transformation, with the power of dismantling an already established poetry. The fight between words and things, language and reality

Caring for organ donors: The intensive care unit nurses' view

The nursing care for patients who are pronounced brain-dead but kept alive to serve as organ donors demands technical-scientific skills and the ability to handle situations that are often in conflict with the traditional concepts of nursing care. Based on the phenomenological approach in this article, essential themes of the lived experience of caring for these patients, including the technical and specific nursing care, the relationship with organ donors and their families, and the nurses' perception of themselves in this professional situation are described. The results point to the contradictions and ambiguities of this type of nursing, especially in regards to the affective and philosophical aspects.

Construction and validation of the brazilian questionário de respostas socialmente habilidosas segundo relato de professores (QRSH-PR)

Behavioral problems in preschool children are one of the most frequent motives for seeking psychological care by parents and caregivers. Instruments are considered necessary, created from a Social Skills Training theoretical-practical perspective, which may systematically assist the identification of social skills and behavioral deficits, helping professionals in the prevention and/or reduction of behavioral problems. The purpose of this study was to test the psychometric validity and reliability of an instrument for evaluation of Socially Skilled Responses, from a teacher's perspective (QRSH-PR For this purpose, 260 preschool children were evaluated, differentiated in subgroups without and without behavioral difficulties, based on the Child Behavior Scale (Escala de Comportamento Infantil/ECI-Professor Studies were conducted for construct, discrimination, concurrent and predictive validity. The Cronbach Alpha was calculated to evaluate internal consistency. The obtained results pointed to positive indicators in reference to construct, discrimination, and predictive validity, and even for good internal consistency, indicating that the items consistently measure the construct of social skills, and differentiated children with and without behavioral problems. The questionnaire is considered to be gauged for evaluation of socially skilled responses from preschool children, and applicable in educational and clinical environments. Copyright 2009 by The Spanish Journal of Psychology.

Senso crítico em estudantes de administração de empresas com habilitação em marketing

Pós-graduação em Ciências Sociais - FFC

Comunidade e eticidade: uma contribuição à aventura sociológica no pensamento de Martin Buber

Nossa investigação deve fazer uma reflexão sobre o conceito de Comunidade em M. Buber, tentando aproximá-lo de uma perspectiva a qual podemos denominar Eticidade, considerando sua respectiva contribuição: a Dialogia, como fonte central de qualquer relação humana. Trataremos aqui especificamente a forma como autor aborda o tema da Comunidade em confronto com o mundo moderno e suas forças despersonalizante e anônimas, sobre as quais, temos um indivíduo sem morada. Para isso, nos valeremos das contribuições dos clássicos da sociologia, tais como: Tönnies, Durkheim e Weber. Desta forma, tentaremos avançar num segundo momento, analisando a Comunidade na Modernidade líquida, a partir das orientações teóricas de Zigmunt Bauman. Neste vislumbraremos a inviabilidade da comunidade numa sociedade onde a individualidade e a identidade são fluidas, e as únicas formas de comunidades existentes não passam de comunidades de solitários. Contudo, partiremos para o momento que consideramos decisivo em nossa análise, faremos uma reflexão sobre a perspectiva dialógica de comunidade, no intuito de abrirmos caminhos para uma reflexão mais antropológica e fenomenológica do conceito, e, principalmente, trazendo à sociologia, a importante contribuição do pensamento de Martin Buber. Sua perspectiva aponta para a Comunidade como um caminho de diálogo, de reconhecimento do outro, bem como, de realização da pessoa no espaço público. Nisto consiste nossa a contribuição à aventura sociológica no que concerne ao tema da comunidade.