Protocol for the PINCER trial: a cluster randomised trial comparing the effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices

Background: Medication errors are an important cause of morbidity and mortality in primary care. The aims of this study are to determine the effectiveness, cost effectiveness and acceptability of a pharmacist-led information-technology-based complex intervention compared with simple feedback in reducing proportions of patients at risk from potentially hazardous prescribing and medicines management in general (family) practice. Methods: Research subject group: "At-risk" patients registered with computerised general practices in two geographical regions in England. Design: Parallel group pragmatic cluster randomised trial. Interventions: Practices will be randomised to either: (i) Computer-generated feedback; or (ii) Pharmacist-led intervention comprising of computer-generated feedback, educational outreach and dedicated support. Primary outcome measures: The proportion of patients in each practice at six and 12 months post intervention: - with a computer-recorded history of peptic ulcer being prescribed non-selective non-steroidal anti-inflammatory drugs - with a computer-recorded diagnosis of asthma being prescribed beta-blockers - aged 75 years and older receiving long-term prescriptions for angiotensin converting enzyme inhibitors or loop diuretics without a recorded assessment of renal function and electrolytes in the preceding 15 months. Secondary outcome measures; These relate to a number of other examples of potentially hazardous prescribing and medicines management. Economic analysis: An economic evaluation will be done of the cost per error avoided, from the perspective of the UK National Health Service (NHS), comparing the pharmacist-led intervention with simple feedback. Qualitative analysis: A qualitative study will be conducted to explore the views and experiences of health care professionals and NHS managers concerning the interventions, and investigate possible reasons why the interventions prove effective, or conversely prove ineffective. Sample size: 34 practices in each of the two treatment arms would provide at least 80% power (two-tailed alpha of 0.05) to demonstrate a 50% reduction in error rates for each of the three primary outcome measures in the pharmacist-led intervention arm compared with a 11% reduction in the simple feedback arm. Discussion: At the time of submission of this article, 72 general practices have been recruited (36 in each arm of the trial) and the interventions have been delivered. Analysis has not yet been undertaken.

Evolutionary patterns in neotropical Helieae (Gentianaceae): evidence from morphology, chloroplast and nuclear DNA sequences

Parsimony-based phylogenetic analyses of the neotropical tribe Helieae (Gentianaceae) are presented, including 22 of the 23 genera and 60 species. This study is based on data from morphology, palynology, and seed micromorphology (127 structural characters), and DNA sequences (matK, trnL intron, ITS). Phylogenetic reconstructions based on ITS and morphology provided the greatest resolution, morphological data further helping to tentatively place several taxa for which DNA was not available (Celiantha, Lagenanthus, Rogersonanthus, Roraimaea, Senaea, Sipapoantha, Zonanthus). Celiantha, Prepusa and Senaea together appear as the sister clade to the rest of Helieae. The remainder of Helieae is largely divided into two large subclades, the Macrocarpaea subclade and the Symbolanthus subclade. The first subclade includes Macrocarpaea, sister to Chorisepalum, Tochia, and Zonanthus. Irlbachia and Neblinantha are placed as sisters to the Symbolanthus subclade, which includes Aripuana, Calolisianthus, Chelonanthus, Helia, Lagenanthus, Lehmanniella, Purdieanthus, Rogersonanthus, Roraimaea, Sipapoantha, and symbolanthus. Generic-level polyphyly is detected in Chelonanthus and Irlbachia. Evolution of morphological characters is discussed, and new pollen and seed characters are evaluated for the first time in a combined morphological-molecular phylogenetic analysis.

Medindo valor em comunidades de prática: caso multicurso

Communities of Practice are groups of people who share a concern, problem or passion about a topic, and who deepen their knowledge and expertise by interacting regularly. It¿s use as a tool for planning and implementation of programs for continuous training of teachers in Brazil is not widespread, but used occasionally. This dissertation seeks to demonstrate the use of the communities of practice theory in continuous teachers training in the Brazilian reality. It presents some models of continuous formation currently in process in Brazil, points to the principles of knowledge management taken by this work, presents the communities of practice theory and the criticism of this in its theoretical part. For the case study was used the methodology described by Robert Yin (2005) of single case study to examine the Multicurso, program to continuously train math teachers in the state of Goiás, Brazil. The community of practice formed in this program was examined on its form, as to the cultivation of communities of practice, as to the development and about the challenges of geographical distribution. Going beyond, this work has as its main objective to propose a methodology for measuring the value of communities of practice from the case studied, without the intention to make generalizations about the measurement of value in projects of various kinds. The model proposed indicators separated into two categories, the outcome and impact, to facilitate the measurement of value and prevent that communities of practice are to be criticized or super estimated by assignment of value to those without the unequivocal proof of unique causality at the same time it searchs to attest that the contribution of communities of practice in improvements in the systems in which the CoP are in.

Avaliação da interação universidade - empresas - governo no desenvolvimento de projetos inovadores no RN por micro e pequenas empresas

Knowledge and innovation were seen as major forces, both for survival, as the acquisition of competitive advantages in the Brazilian economy, as well as adding value to the product as a market differentiator. The Triple Helix model is directed toward the knowledge-based economy. Over the past six years, the Federal Government through the Financier of Studies and Projects ( FINEP ) invested in technological innovation projects, economic subsidies, about U.S. $ 1 billion supporting more than 800 projects with these resources. According to the MCTI , the Northeast, over the years 2000 to 2010 increased spending on Science and Technology (considering the activities of research and development more scientific and related activities) of the State Government in relation to its total revenue In 2000, 0.51% of total revenues were invested in Science & Technology, while in 2010 this figure increased to 1.31%. Among the nine Northeast states, Paraíba is highlighted. In 2000, 0.33% of its total revenues were directed to innovation, reaching 2.04% in 2010, the largest increase in the region while the RN invested 0.24% in 2000 and in 2010 reached the level of 1.42 %. According to IBGE, in the period 2000-2011, the micro and small enterprises surpassed the barrier of 6 million establishments. In 2000, there were 4.2 million establishments while in 2011 were 6.3 million active establishments. Therefore, throughout the period, there was a creation of approximately 2.1 million new establishments. Between 2000 and 2011, micro and small businesses have created 7.0 million formal jobs, 8.6 million jobs in 2000 to 15.6 million in 2011. This scenario shows the importance of this study in relation to the investment of governments in RD & I in micro and small enterprises. This study aims to analyze the interaction Universities - Business - Government in the development of innovation in micro and small companies in Rio Grande do Norte participants of the edicts of Inova FAPERN. We chose to adopt as a research method case study concerning the procedure of the research, exploratory, descriptive, and on documents with engineers and researchers of innovation projects approved by PAPPE Subsidy (Inova -RN I, II and III). Data collection was done through the report made by FAPERN entitled: " Evaluation of companies financed and supported by the Grant Program for Technological Innovation for Micro and Small Enterprises RN - INOVA -RN " (2010) and a questionnaire with 40 closed questions and 1 opened to 30 affirmative composed based on a 5-point Likert scale. The analysis of data was qualitative and quantitative. The study provided to identify the importance and barriers arising from the relation between Government Enterprise (micro and small) and University as essential to the economic development of the region. It was also identified that, in the innovation projects, 70% of the goods or services originating from research were to market these, 50% resulted in a patent for the company and 80% publications of scientific articles

Avaliação do programa de atenção à saúde do trabalhador: uma abordagem da atenção primária

The accelerated industrialization, coming with the Industrial Revolution, caused profound changes in the working world. These changes led to the households risks from work environment. Trying to assist comprehensively the health of workers, Brazil has a program of Health Care Workers in the Primary Care, and the Family Health Strategy is the main entrance for this system. The study sought to determine if the actions of the health care worker have been developed in primary care through the Family Health Strategy. This is a quantitative study with a methodological evaluation, focusing on normative assessment. The sample was formed by professionals from Team Family Health Strategy, in the municipalities of Pau dos Ferros, Caicó and Natal in Rio Grande do Norte state. The sample consists of 202 professionals (Doctors, Nurses, Assistant / Technician Nursing and Community Health Workers) in 52 Health Family Units from the 3 municipalities cited. The instrument used consists of a checklist, from Manual of Primary Care 5 - Family Health - Occupational Health, Ministry of Health. The data were analyzed describing the variables by its frequency and doing a classification of cities from the scores obtained by each. It was observed that the Family Health professionals know the program of health care worker, however do not know the Manual of Primary Care 5, which is a guidance tool. As a result of non-appropriation of the FHT professionals with worker health, these activities are not performed, mainly surveillance in occupational health and health education labor

Programa de Avaliação de Desempenho: elementos constitutivos e pressupostos na prática avaliativa

This study analyzes the perceptions of technical and administrative UFPA, in relation to the insertion of the components and assumptions of DBP in evaluation practice. Addresses the history, concepts, meanings, about AD methods, skills, evaluation skills, the APF and AD UFPA and Programme itself. The research is characterized as a hypothetical-deductive, descriptive and applied, using the case study. Data were analyzed using a quantitative approach, using the descriptive and inferential statistics. Data were collected through the application of questionnaires to 222 technical and administrative searched IFES, not occupants of FG and CD. The results indicate that the factors perceived in relation to the constituent elements such as: evaluation practice, measurement of competence, program management, timing, individual skills and fundamentals of the program and those related to assumptions such as: democratic process, integrative perspective, character development and pedagogical continuous evaluation practices are perceived in the evaluation process. The study concludes that comparing the results of the constituent elements and assumptions of the PAD of thechnical-administrative UFPA, it can be said about a tendency to change, though subtle, compared to the traditional model of AD, directed only to the granting of career progression for a new logic based on the results, showing an early effectiveness of the program evaluation practice by law and by the Institution. The results are confirmatory of advance evaluation practice in the institution, more so than has previously been expected, which demonstrates the value of scientific criteria of scientific research

Avaliação do estudante: no exercício de avaliação da prática profissional

Este estudo aborda a avaliação do exercício da prática profissional (EAPP) no curso de enfermagem da Faculdade de Medicina de Marília (Famema); tem como objetivo analisar a concepção de avaliação do professor que realizou o EAPP com estudantes de primeira a quarta séries do curso. Trata-se de um estudo qualitativo, modalidade análise de conteúdo e identificação da seguinte temática: as ambigüidades do processo de avaliação. Constata-se que a concepção do professor na avaliação no EAPP aproxima-se muito da abordagem de competência dialógica, que articula e integra resultados, atributos e contexto em situações distintas, com diferentes formas de realizar tarefas essenciais para a formação do enfermeiro. Contradições no processo avaliativo entre os professores, porém, estão presentes e necessitam ser constantemente trabalhadas.

Saúde da Família: O desafio de uma atenção coletiva

The Family Health Strategies, incorporated by the Ministry of Health in 1994, has consolidated the national policy of health care that has as its main care focus the family. In this model, this institution constitutes the first object of attention, understood from its environment and interaction. In recent decades, the Brazilian family structure is suffering profound changes that directly affect the practices of health care. This study redeem the family concepts and ideas and their social representations and still prove and present the importance and the necessity of the use of these ample instruments of collective boarding in health area: the APGAR, the genogram and eco-map, using the environment observation and family history - crucial factors to the reality of the nuclear family diagnosis - for further planning of health action strategies. It was concluded that the current structure of the family require training from the health teams, for physical, cultural, biological and social points of the family context for the correct use of the instruments cited, important tools for collective approach in the public health area.

O Programa Escola da Família Enquanto Política Pública: Políticas Compensatórias e Avaliação de Rendimento

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estresse, depressão e percepção de suporte familiar em estudantes de educação profissionalizante

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

Avaliação de competências profissionais de aprendizes com deficiência: um estudo de caso

Pós-graduação em Educação - FFC