Barriers to interventions aimed at promoting the health of health care workers in Brazil

Objective. To search the literature for circumstances that impede injury and disease prevention and other activities intended to improve the health of the health care worker. Methods. The SciELO database was searched for articles published in 1967-2008. This was supplemented by a PubMed search for the period 1950-2008. The following key words were used to identify articles in English, Portuguese, and Spanish: work, health personnel, occupational, risks, diseases, ergonomics, work ability, quality of life, organization, accidents, work conditions, intervention, and administration. Articles on injury and disease prevention and occupational health in a health care setting in Latin America were selected, along with articles focused on health promotion in the health sector. Results. The following shortcomings were identified: activities lacked a sound theoretical foundation and were not integrated with the health services management; a failure to evaluate the effectiveness of the activity; health surveillance focused solely on a specific disease or injury; management not committed to the proposed activity; miscommunication; inability of workers to participate, or control the work environment; and, programs or efforts that were limited to changing the workers` behaviors. Conclusions. The literature shows that all the barriers identified by this study affect both the health care workers` health as well as their productivity.

The species complex Astyanax fasciatus Cuvier (Teleostei, Characiformes) - a multidisciplinary approach

Cytogenetic data have provided important clues that the Astyanax fasciatus populations from the Upper Parana River basin could be a part of a more diverse fish group, usually included on the same taxa. Samples collected in Cachoeira de Emas, SP, in Mogi-Guacu River basin, show two major cytotypes presenting 2n = 46 and 2n = 48 chromosomes, with distinct karyotypic formula, despite the fact that the molecular data suggested some degree of gene flow between these cytotypes. Cytogenetic and morphometric analyses were performed in this species, aiming to contribute to the understanding of the natural history from such fish group. Two allopatric populations with distinct standard cytotypes were analysed, and the data obtained suggest the separation into two groups. (c) 2008 The Authors Journal compilation (c) 2008 The Fisheries Society of the British Isles.

THE EXTENT OF MULTIDISCIPLINARY AUTHORSHIP OF ARTICLES ON SCIENTOMETRICS AND BIBLIOMETRICS IN BRAZIL

The publications in scientometrics and bibliometrics with Brazilian authorship expanded exponentially in the 1990-2006 period, reaching 13 times in the Web of Science database and 19.5 times in the Google Scholar database. This increase is rather superior to that of the total Brazilian scientific production in the same time period (5.6 times in the Web of Science). Some characteristics to be noticed in this rise are: 1) The total number of articles during this period was 197; in that, 78% were published in 57 Brazilian journals and 22% in 13 international journals. 2) The national and international articles averaged 4.3 and 5.9 citations/article, respectively; two journals stood out among these, the national Ciencia da Informacao (44 articles averaging 6.7 citations/article) and the international Scientometrics (32 articles averaging 6.2 citations/article). 3) The articles encompass an impressive participation of authors from areas other than information science; only one-fourth of the authors are bound to the information science field, the remaining ones being distributed among the areas of humanities/business administration, biology/biomedicine, health and hard sciences. The occurrence of adventitious authors at this level of multidisciplinarity is uncommon in science. However, the possible benefits of such patterns are not clear in view of a fragmented intercommunication among the authors, as noticed through the citations. The advantages of changing this trend and of using other scientometric and bibliometric databases, such as SciELO, to avoid an almost exclusive use of the Web of Science database, are discussed.

NUCEL (Cell and Molecular Therapy Center): A multidisciplinary center for translational research in Brazil

Social and economical development is closely associated with technological innovation and a well-developed biotechnological industry. In the last few years, Brazil`s scientific production has been steadily increasing; however, the number of patents is lagging behind, with technological and translational research requiring governmental incentive and reinforcement. The Cell and Molecular Therapy Center (NUCEL) was created to develop activities in the translational research field, addressing concrete problems found in biomedical and veterinary areas and actively searching for solutions by employing a genetic engineering approach to generate cell lines over-expressing recombinant proteins to be transferred to local biotech companies, aiming at furthering the development of a national competence for local production of biopharmaceuticals of widespread use and of life-saving importance. To this end, mammalian cell engineering technologies were used to generate cell lines over-expressing several different recombinant proteins of biomedical and biotechnological interest, namely, recombinant human Amylin/IAPP for diabetes treatment, human FVIII and FIX clotting factors for hemophilia, human and bovine FSH for fertility and reproduction, and human bone repair proteins (BMPs). Expression of some of these proteins is also being sought with the baculovirus/insect cell system (BEVS) which, in many cases, is able to deliver high-yield production of recombinant proteins with biological activity comparable to that of mammalian systems, but in a much more cost-effective manner. Transfer of some of these recombinant products to local Biotech companies has been pursued by taking advantage of the Sao Paulo State Foundation (FAPESP) and Federal Government (FINEP, CNPq) incentives for joint Research Development and Innovation partnership projects.

A systematic review of triage-related interventions to improve patient flow in emergency departments

Background Overcrowding in emergency departments is a worldwide problem. A systematic literature review was undertaken to scientifically explore which interventions improve patient flow in emergency departments. Methods A systematic literature search for flow processes in emergency departments was followed by assessment of relevance and methodological quality of each individual study fulfilling the inclusion criteria. Studies were excluded if they did not present data on waiting time, length of stay, patients leaving the emergency department without being seen or other flow parameters based on a nonselected material of patients. Only studies with a control group, either in a randomized controlled trial or in an observational study with historical controls, were included. For each intervention, the level of scientific evidence was rated according to the GRADE system, launched by a WHO-supported working group. Results The interventions were grouped into streaming, fast track, team triage, point-of-care testing (performing laboratory analysis in the emergency department), and nurse-requested x-ray. Thirty-three studies, including over 800,000 patients in total, were included. Scientific evidence on the effect of fast track on waiting time, length of stay, and left without being seen was moderately strong. The effect of team triage on left without being seen was relatively strong, but the evidence for all other interventions was limited or insufficient. Conclusions Introducing fast track for patients with less severe symptoms results in shorter waiting time, shorter length of stay, and fewer patients leaving without being seen. Team triage, with a physician in the team, will probably result in shorter waiting time and shorter length of stay and most likely in fewer patients leaving without being seen. There is only limited scientific evidence that streaming of patients into different tracks, performing laboratory analysis in the emergency department or having nurses to request certain x-rays results in shorter waiting time and length of stay.

How single is ‘single’ : some pragmatic reflections on single versus multifaceted interventions to facilitate implementation

An earlier overview of systematic reviews and a subsequent editorial on single-component versus multifaceted interventions to promote knowledge translation (KT) highlight complex issues in implementation science. In this supplemented commentary, further aspects are in focus; we propose examples from (KT) studies probing the issue of single interventions. A main point is that defining what is a single and what is a multifaceted intervention can be ambiguous, depending on how the intervention is conceived. Further, we suggest additional perspectives in terms of strategies to facilitate implementation. More specifically, we argue for a need to depict not only what activities are done in implementation interventions, but to unpack functions in particular contexts, in order to support the progress of implementation science.

Making Energy Interventions more Effective : Situation, Interaction, and Precondition

A main purpose of this paper is to propose to policy makers, building professionals, and other non-social scientists a way to make energy interventions more culturally informed and, thereby, more effective. The case study on house purchasers gives an ample illustration of the richer results that can be achieved by paying attention to three aspects of energy efficiency initiatives: the contexts and situations of choice in each particular case, the interaction among relevant social actors, and the culture-specific preconditions for choice. Research on how purchasers of new pre-fabricated houses in Sweden choose their heating system show how such decisions tend to fall between two stools. Furthermore, the organizational structure of housing companies frames house purchasers' decision making. An important result is that energy saving or conversion measures must be promoted at an early stage amongst those who plan and construct buildings (rather than later amongst dwellers and energy end users).

Identification and estimation of interventions using changes in inequality measures

This paper presents semiparametric estimators of changes in inequality measures of a dependent variable distribution taking into account the possible changes on the distributions of covariates. When we do not impose parametric assumptions on the conditional distribution of the dependent variable given covariates, this problem becomes equivalent to estimation of distributional impacts of interventions (treatment) when selection to the program is based on observable characteristics. The distributional impacts of a treatment will be calculated as differences in inequality measures of the potential outcomes of receiving and not receiving the treatment. These differences are called here Inequality Treatment Effects (ITE). The estimation procedure involves a first non-parametric step in which the probability of receiving treatment given covariates, the propensity-score, is estimated. Using the inverse probability weighting method to estimate parameters of the marginal distribution of potential outcomes, in the second step weighted sample versions of inequality measures are computed. Root-N consistency, asymptotic normality and semiparametric efficiency are shown for the semiparametric estimators proposed. A Monte Carlo exercise is performed to investigate the behavior in finite samples of the estimator derived in the paper. We also apply our method to the evaluation of a job training program.

Domestic violence in Brazil: social problems and legislative interventions

Recent statistical data confirms that domestic violence is a structural problem of exceptional gravity. We analyze the frequent legislative changes in Brazil since 2000 as a result of social pressure for protection of abused women. Only the Law 11.340 of 2006 was well received by lawyers, judges and the public opinion. We present the innovations and peculiarities of this statute and the allegations on unconstitutionality. We discuss cases of judicial review of this law and reject the arguments of unconstitutionality. That notwithstanding, we argue that penalization decisions is the wrong way from a criminological point of view because they do not take into consideration the desires and needs of the victims.

The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil

EMOND, Alan et al. The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Pública/ Pan American Journal of Public Health , v.12, n.2, p.101-110, 2002

Assessment of the ergonomic design of diagnostic ultrasound transducers through wrist movements and subjective evaluation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Product functions: interfaces with ergonomic design

In addition to technical quality, increasing emphasis is being placed on the importance of elements such as the appearance and meaning of products. To be successful, therefore, attention must be paid to the aesthetic and symbolic functions of objects as well as to reliability and physical quality. Study of the interfaces of these functions may provide a theoretical basis for the ergonomic design of products. The objective of this review is to attempt to establish the nature of these interfaces.

Análise de aspectos ergonômicos do colete tático - um estudo de caso na ROCAM-RN

This thesis aims to analyze the ergonomic and functional aspects of the motorcycle patrolmen tactical vest and make a contribution to improve their technical and tactical characteristics reconciling pleasantness function, improving working conditions of policeman. The start point of this case study was the following hypothesis : The start point of this case study was the following hypothesis: once the policemen prepare their own tactical vests with layouts created by them. So, if someone observes these layouts, s/he will have an understanding of use of those devices and artifacts questions both positive, and negative. This hypothesis was confirmed by the results, considering that it was possible to understand the use of the tactic vests by means of the Policemen s opinion on issues recognized by themselves. It was also possible to understand that users perform interventions, based on their own inventive or learned from the experience of other policemen