Causes for the underreporting of adverse drug events by health professionals: a systematic review

Objective: Identifying the main causes for underreporting of Adverse Drug Reaction (ADR) by health professionals. Method: A systematic review carried out in the following databases: LILACS, PAHO, SciELO, EMBASE and PubMed in the period between 1992 and 2012. Descriptors were used in the search for articles, and the identified causes of underreporting were analyzed according to the classification of Inman. Results: In total, were identified 149 articles, among which 29 were selected. Most studies were carried out in hospitals (24/29) for physicians (22/29), and pharmacists (10/29). The main causes related to underreporting were ignorance (24/29), insecurity (24/29) and indifference (23/29). Conclusion: The data show the eighth sin in underreporting, which is the lack of training in pharmacovigilance. Therefore, continuing education can increase adherence of professionals to the service and improve knowledge and communication of risks due to drug use.

Qualitative methodogy: revealing a new path for research in dentistry

Currently, it is easy to find health professionals who not only attach importance to qualitative methods, but also recognize their help to better understand their patients' lives. However, its use in dentistry is still incipient, either due to ignorance or because of technical / operational difficulties in identifying possibilities for their use in research. Thus, the purpose of this study was to review the literature on the characteristics and peculiarities of the qualitative methodology, demonstrating their techniques of collecting, recording and analyzing data. For this, we performed a descriptive literature, from a survey in the "LILACS", "BBO" and "PUBMED" databases, by keywords related to the theme, selecting only the papers that mentioned the "importance" of qualitative research, the "characteristics and fundamentals," and the "techniques of collecting, recording and data analysis" involving this methodology. It was found that all studies have highlighted the importance of qualitative research to the construction of new knowledge that cannot be achieved by quantitative data. We found many different techniques to gather, record and analyze qualitative data applied to the dentistry field. It was concluded that qualitative research represents a new path to be followed by dentistry, so that we are able to plan actions in ethical and humane public health dentistry, bringing better results to the population, because of the depth of knowledge that your date can.

Causes for the underreporting of adverse drug events by health professionals: a systematic review

Objective: Identifying the main causes for underreporting of Adverse Drug Reaction (ADR) by health professionals. Method: A systematic review carried out in the following databases: LILACS, PAHO, SciELO, EMBASE and PubMed in the period between 1992 and 2012. Descriptors were used in the search for articles, and the identified causes of underreporting were analyzed according to the classification of Inman. Results: In total, were identified 149 articles, among which 29 were selected. Most studies were carried out in hospitals (24/29) for physicians (22/29), and pharmacists (10/29). The main causes related to underreporting were ignorance (24/29), insecurity (24/29) and indifference (23/29). Conclusion: The data show the eighth sin in underreporting, which is the lack of training in pharmacovigilance. Therefore, continuing education can increase adherence of professionals to the service and improve knowledge and communication of risks due to drug use.

Diretrizes projetuais e o emprego das tendências: o design de móveis residenciais no polo de Arapongas/PR

Constant social, cultural and political changes influence directly people’s life and define their needs and tastes. Trends have the role of signaling through these facts people’s preferences regarding to objects and can, therefore be connected with great design, as it works with project that is a planning activity for future. In this context, this study aimed to characterize trend jobs in Brazilians home designing methodology. For both: theoretical aspects were studied that led to reasoning, a field research in five Furniture industries Pole of Arapongas/PR was done, and a research for possible developmental reference of furniture in Brazil. Results indicated: misused and mistaken concepts of trend and ignorance on how they operate lack of knowledge about industries sector consumer profile, the concern about sales and not with consumer as “furniture user” and finally, the existence of Brazilian referential sources, but the lack of skilled professionals that could decode these sources.

Análise das práticas de gestão da cadeia de suprimentos em empresas calçadistas da cidade de Jaú - SP

Pós-graduação em Engenharia de Produção - FEB

Diagnóstico de situação epidemiológica da Leishmaniose visceral canina em Rio Verde-GO

Pós-graduação em Medicina Veterinária - FCAV

The History of the German-Russian Colony in Lincoln

Standing at the corner of Tenth and O streets in the city of Lincoln, Nebraska, any week-day morning between 7:30 and 8 o'clock, you may see pass by you from ten to twenty women with little black woolen shawls on their heads. Ask any citizen who they are, and ninety-nine times in one hundred he will tell you they are "Russians" who live down on the bottoms, that they are going out into the offices and homes to wash and scrub and clean house, and that their husbands are street laborers or work for the railroad. He may then grow confidential and tell you that he "has no use for these people", that "they are only half human", and that he "would just as soon see the Chinese come here as those people". As a matter of fact the greater part of his information is incorrect, partly through race prejudice but chiefly through ignorance of their history. These people, of whom there are about 4,000 in the city (Including "beet fielders"), are Germans, not Russians: they are Teutons, not Slavs; they are Lutheran and Reformed, not Greek Catholics. To be sure they and their ancestors lived in Russia for over one hundred years and they came here directly from the realm of the Czar whoso bona fide citizens they were—but they never spoke the Russian language, never embraced the Greek religion, never intermarried with the Russians, and many of their children never saw a Russian until they left their native village for the new home in America. They despise being called "Russians" just as an Italian resents "Dago"; a Jew, "Sheeny"; and a German, "Dutchman". Ask them where they came from and most of the children and not a few of the grown people will say, "Germany". If you pursue your questioning as to what part of Germany, they will tell you "Saratov" or "Samara" - two governments in the eastern part of Russia on the lower course of the Volga river. The misconceptions concerning the desirability of these German-Russians as citizens arise from their unprogressiveness as compared with those Germans who come to us directly from the mother country. During their century's sojourn in Russia they have been out of the main current of civilization, a mere eddy in the stream of progress. They present a concrete example of arrested development, The characteristics which differentiate them from other Germans are not due to an inherent lack of capacity but to different environment. Notwithstanding this, the German- Russians have some admirable qualities. They bring us large stores of physical energy and an almost unlimited capacity for work. The majority of them are literate although the amount of their education is limited. They are thrifty and independent, almost never applying for public aid. They are law abiding, their chief offenses being those which are traceable to their communal life in Russia. They are extremely religious, all their social as well as spiritual life being bound up in the church which they support right royally. To be sure, the saloon gets their vote (the prohibition vote among them is increasing); but "was not the first miracle that Christ performed the turning of water into wine? If they would shut up the shows (theaters), they wouldn't need to shut up the saloons". The object of this paper is to give the historical setting in which the German-Russians have lived as one means to a better understanding and appreciation of them by our own citizens.

THE CURRENT STATUS OF PLAGUE IN CALIFORNIA

At the first Vertebrate Pest Control Conference in 1964, I traced the history of plague control in California and outlined a revised approach, based on newer concepts of plague ecology. In our state of relative ignorance, this required a number of unproved assumptions about plague occurrence in California that verged on crystal ball gazing. These were principally that (1) plague persists in relatively resistant rodent species in certain favorable locations, (2) ground squirrels and chipmunks experience periodic epizootics, but are not permanent reservoirs, (3) plague "foci" of the past were merely sites of conspicuous epizootics, they did not necessarily correspond to permanent foci, and could result from epizootic migrations over considerable distances, and (4) a number of assumptions about areas of greatest epizootic potential can be made by analyzing the pattern of recurrent plague outbreaks in the past. Since then the validity of these assumptions has been tested by the largest outbreak of plague since the early 1940's. We believe that the results have proved the crystal ball largely correct, resulting in much more precise and efficient epizootic surveillance and deployment of control measures than in the past. The outbreak was for us an administrative emergency that exceeded the capacities of the State Health Department. We greatly appreciated the vital help and cooperation of other agencies and individuals. The U.S, Public Health Service accepted a heavy burden of laboratory testing through its San Francisco Field Station, and provided emergency field personnel. The contributions of State Department of Agriculture, Bureau of Weed and Vertebrate Pest Control; U.S. Parks, Forest Service and Bureau of Land Management; local health and agriculture department; and State Division of Parks personnel were essential in accomplishing control work, as well as epizootic surveillance.

Backlash

In order to be successful at creating a welcoming and pluralistic climate, there must be proper attention paid to backlash. Understanding the underlying causes is the root of creating effective coping strategies. This workshop will suggest ways of understanding and dealing with this phenomenon.

Water transfer from São Francisco river to semiarid northeast of Brazil: technical data, environmental impacts, survey of opinion about the amount to be transferred

The transposition of the São Francisco River is considered one of the greatest engineering works in Brazil of all time since it will cross an extensive agricultural region of continental dimensions, involving environmental impacts, water, soil, irrigation, water payment and other multidisciplinary themes. Taking into account its importance, this subject was incorporated into a discipline of UFSCar (Federal University of São Carlos - Brazil) named "Pollution and Environmental Impacts". It was noted strong reaction against the project, even before the presentation. To allow a critical analysis, the first objective was to compile the main technical data and environmental impacts. The second objective was to detect the three most important aspects that cause reaction, concluding for the following reasons: assumption that the volume of water to be transferred was much greater than it actually is proposed in the project; lack of knowledge about similar project already done in Brazil; the idea that the artificial canal to be built was much broader than that proposed by the project. The participants' opinion about "volume to be transferred" was raised quantitatively four times: 2-undergraduate students; 1-graduate; 1-outside community. The average resulted 14 times larger than that proposed in the project, significant according to t-test. It was concluded that the reaction to water transfer project is due in part to the ignorance combined with a preconceived idea that tend to overestimate the magnitude of environmental impacts.

Development discourse in Romania: from Socialism to EU Membership

With their accession to the European Union, twelve new countries - Romania among them - (re)entered the international community of international donors. In the history of development aid this can be seen as a unique event: it is for the first time in history that such a large number of countries become international donors, with such short notice and in such a particular context that sees some scholars announcing the ‘death’ of development. But in spite of what might be claimed regarding the ‘end’ of the development era, development discourse seems to be rather vigorous and in good health: it is able to extert an undeniable force of attraction over the twelve countries that, in a matter of years, have already convinced themselves of its validity and adhered to its main tenets. This thesis collects evidence for improving our understanding of this process that sees the co-optation of twelve new countries to the dominant theory and practice of development cooperation. The evidence collected seems to show that one of the tools employed by the promoters of this co-optation process is that of constructing the ‘new’ Member States as ‘new’, inexpert donors that need to learn from the ‘old’ ones. By taking a case-study approach, this thesis gathers data that suggests that conceiving of the ‘twelve’ as ‘new’ donors is both historically inaccurate and value-ladden. On one hand, Romania’s case-study illustrates how in the (socialist) past at least one in the group of the twelve was particularly conversant in the discourse of international development. On the other hand, the process of co-optation, while being presented as a knowledgeproducing process, can also be seen as an ignorance-producing procedure: Romania, along with its fellow new Member States, takes the opportunity of ‘building its capacity’ and ‘raising its awareness’ of development cooperation along the line drawn by the European Union, but at the same time it seems to un-learn and ‘lower’ its awareness of development experience in the (socialist) past. This is one possible reading of this thesis. At a different level, this thesis can also be seen as an attempt to account of almost five decades of international development discourse in one specific country – Romania – in three different socio-political contexts: the socialist years (up to the year 1989), the ‘transition years’ (from 1989 to the pre-accession years) and the membership to the European Union. In this second reading, the thesis seeks to illustrate how – contrary to widespread beliefs – before 1989 Romania’s international development discourse was particularly vivid: in the most varied national and international settings President Ceausescu unfolded an extensive discursive activity on issues pertaining to international development; generous media coverage of affairs concerning the developing countries and their fight for development was the rule rather than the exception; the political leadership wanted the Romanians not only to be familiarized with (or ‘aware of’ to use current terminology) matters of underdevelopment, but also to prove a sense of solidarity with these countries, as well as a sense of pride for the relations of ‘mutual help’ that were being built with them; finally, international development was object of academic attention and the Romanian scholars were able not only to reflect on major developments, but could also formulate critical positions towards the practices of development aid. Very little remains of all this during the transition years, while in the present those who are engaged in matters pertaining to international development do so with a view of building Romania as an EU-compliant donor.

La nuit dans les romans des Lumières Du roman libertin au roman gothique

Cette thèse se propose d’analyser les images de la nuit et ses significations dans les romans du XVIII siècle, à partir des années 1730-1740, dans le cadre de trois littératures: la littérature anglaise, française et italienne. Deux conceptions opposées sont mises en comparaison: la première, d’exorcisation de la nuit, est typique de la première partie du siècle; elle est représentée principalement par le genre des romans libertins. La deuxième conception montre une valorisation de la nuit qu’on trouve en particulier dans les romans gothiques, qui se sont développés à partir de la seconde partie du siècle. Le but final de la présente recherche est de trouver une explication au refus de la nuit de la part de certains auteurs et ensuite de repérer les causes du bouleversement de cette vision. Puisque la nuit empêche le sens de la vue, elle a été considérée une forme de négation de l’espace physique; selon le profil psychologique et anthropologique la nuit constituerait alors la cause principale de la perte d’orientation. Selon une interprétation intellectuelle et philosophique, elle serait un symbole d’ignorance et d’irrationalité. La situation change vers la moitié du siècle des Lumières, car la nuit commence à assumer un rôle actif et nécessaire dans le processus d’apprentissage. Au niveau social, les rencontres les plus importantes adviennent pendant la nuit. Dans le revival des cathédrales gothiques et des châteaux médiévaux, on voit que la nuit s’empare désormais de l’espace, qui s’enrichit de lumières et d’ombres.

Representaciones Sociales de la Medicina Popular en el paciente oncológico adulto, la familia del paciente y los miembros del equipo de salud

Esta investigación tuvo como objetivo general develar las representaciones sociales sobre la Medicina Popular en tres grupos poblacionales, pacientes oncológicos (n=100), familiares de los pacientes (n=25) y miembros del equipo de salud (n=26). Para ello, se realizaron tres estudios cualitativos con cada grupo poblacional y un cuarto en el que se describen las similitudes y las diferencias entre ellos en relación con el objeto de representación. En general, se utilizaron entrevistas en profundidad, ejercicios de asociaciones libres y grupos focales (7 con 62 pacientes). Resultados: paciente oncológico: Medicina Popular representada como una salida optimista a la angustiante situación que está viviendo frente al cáncer; una apuesta a la vida. Para la familia: una contra capaz de mantener con vida y fortaleza al paciente y para el equipo de salud, una realidad incombatible de los pacientes y de la familia, que tiene efecto placebo sobre ellos y que está relacionada con el pensamiento mágico religioso, la fé y la ignorancia de quienes la realizan. En cuanto a las diferencias, el paciente y la familia consideran que la Medicina Popular es una alternativa en la que depositan su fé y confianza; el personal de salud no cree en sus efectos sobre el cáncer y la considera como estafa y engaño para el paciente. En las similitudes, todos coinciden en que es una alternativa, generadora de esperanza, basada en compuestos naturales que le permiten al paciente contribuir a la curación del cáncer y a sobrellevar el malestar provocado por la quimioterapia. Finalmente, se presentan conclusiones generales, se discuten algunos de los hallazgos y la importancia de las RS de la Medicina Popular y su impacto sobre la atención y la calidad de vida del paciente y se plantean algunos interrogantes que podrían favorecer el desarrollo de una línea de investigación en el tema.

Die Einheit des Bewusstseins und das Phänomen der Synästhesie

Synästhetiker schmecken Berührungen, sehen Farben und Formen, wenn sie Musik hören oder einen Duft riechen. Es wurden auch so außergewöhnliche Formen wie Wochentage-Farben-, Berührung-Geruch- oder Schmerz-Farben-Synästhesien gefunden. Die von Neuro- wissenschaftlern und Philosophen als „Bindung“ genannte Fähigkeit mehrere Reize, die in verschiedenen Hirnarealen verarbeitet werden, miteinander zu koppeln und zu einer einheitlichen Repräsentation bzw. erfahrenen Einheit des Bewusstseins zusammenzufassen, betrifft jeden gesunden Mensch. Synästhetiker sind aber Menschen, deren Gehirne zur „Hyperbindung“ oder zum hyperkohärentem Erleben befähigt sind, da bei ihnen wesentlich mehr solcher Kopplungen entstehen. Das Phänomen der Synästhesie ist schon seit mehreren Jahrhunderten bekannt, aber immer noch ein Rätsel. Bisher glaubten Forscher, solche Phänomene beruhten bloß auf überdurchschnittlich dichten neuronalen Verdrahtungen zwischen sensorischen Hirnregionen. Aus der aktuellen Forschung kann man jedoch schließen, dass die Ursache der Synästhesie nicht allein eine verstärkte Verbindung zwischen zwei Sinneskanälen ist. Laut eigener Studien ist der Sinnesreiz selbst sowie seine fest verdrahteten sensorischen Pfade nicht notwendig für die Auslösung des synästhetischen Erlebens. Eine grundlegende Rolle spielt dabei dessen Bedeutung für einen Synästhetiker. Für die Annahme, dass die Semantik für die synästhetische Wahrnehmung das Entscheidende ist, müssten synästhetische Assoziationen ziemlich flexibel sein. Und genau das wurde herausgefunden, nämlich, dass normalerweise sehr stabile synästhetische Assoziationen unter bestimmten Bedingungen sich auf neue Auslöser übertragen lassen. Weitere Untersuchung betraf die neu entdeckte Schwimmstil-Farbe-Synästhesie, die tritt hervor nicht nur wenn Synästhetiker schwimmen, aber auch wenn sie über das Schwimmen denken. Sogar die Namen dieser charakteristischen Bewegungen können ihre Farbempfindungen auslösen, sobald sie im stimmigen Kontext auftauchen. Wie man von anderen Beispielen in der Hirnforschung weiß, werden häufig benutzte neuronale Pfade im Laufe der Zeit immer stärker ausgebaut. Wenn also ein Synästhetiker auf bestimmte Stimuli häufig stoßt und dabei eine entsprechende Mitempfindung bekommt, kann das mit der Zeit auch seine Hirnanatomie verändern, so dass die angemessenen strukturellen Verknüpfungen entstehen. Die angebotene Erklärung steht also im Einklang mit den bisherigen Ergebnissen. Die vorliegende Dissertation veranschaulicht, wie einheitlich und kohärent Wahrnehmung, Motorik, Emotionen und Denken (sensorische und kognitive Prozesse) im Phänomen der Synästhesie miteinander zusammenhängen. Das synästhetische nicht-konzeptuelle Begleiterlebnis geht mit dem konzeptuellen Inhalt des Auslösers einher. Ähnlich schreiben wir übliche, nicht-synästhetische phänomenale Eigenschaften den bestimmten Begriffen zu. Die Synästhesie bringt solche Verschaltungen einfach auf beeindruckende Weise zum Ausdruck und lässt das mannigfaltige Erleben stärker integrieren.

Negotiating conservation: the construction of meaningful spaces in a world heritage debate

According to one’s personal biography, social background and the resultant degree of affectedness, a person has certain ideas about the meaning of, in our example, a World Heritage Site (WHS), what he or she can expect from it and what his or her relation to it can and should be. The handling of potentially different meaningful spaces is decisive, when it comes to the negotiation of pathways towards the sustainable development of a WHS region. Due to the fact that – in a pluralistic world – multiple realities exist, they have to be taken seriously and adequately addressed. In this article we identified the ways the Jungfrau-Aletsch- WHS was constructed by exploring the visual and verbal representations of the WHS during the decision-making process (1998-2001). The results demonstrate that in the visual representations (images), the WHS was to a large extent presented as an unspoiled natural environment similar to a touristy promotion brochure. Such a ‘picture-book’-like portrait has no direct link to the population’s daily needs, their questions and anxieties about the consequences of a WHS label. By contrast, the verbal representations (articles, letters-to-the-editor, comments) were dominated by issues concerning the economic development of the region, fears of disappropriation, and different views on nature. Whereas visual and verbal representations to a large extent differ significantly, their combination might have contributed to the final decision of the majority of people concerned to support the application for inscription of the Jungfrau-Aletsch-Bietschhorn region into the World Heritage list. The prominence of economic arguments and narratives about intergenerational responsibility in the verbal representations and their combination with the aesthetic appeal of the natural environment in the visual representations might have built a common meaningful space for one part of the population.