Infecção viral respiratória comunitária e hospitalar em pacientes submetidos a transplante de células tronco hematopoiéticas

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

The Charity and the Poverty

At the end of the middle Ages, financial savings institutions developed, largely in response to the increasingly usurious money-lending practices of the Jews and to the adaptation of church authorities to the by then well developed commercial and financial operations. It was the Franciscan Order that took the initiative to develop such institutions, first in Italy and later in other western European Mediterranean towns. These were the so-called Monte di Pieta, which lent money at low rates of interest taking objects in pawn as security. However, as they had to operate with circulating capital and on the principles of savings banks, they may be considered to be the predecessors of modern banks. Although charity was declared in the very names of these institutions, this was no longer in the sense of the medieval mercy towards the virtuous poor, but more a support for impoverished members of higher social strata, as loan applicants had to place valuable movable property in pawn, meaning that they first had to possess such property. In spite of this, the institutions had the character of the primeval accumulation of capital, although not so much for individuals as for a community or, in the latter's name, for a commune, i.e. the local authority, which at least in the cases of Koper and Piran was also the founder. However, the stagnation of trade with the hinterland and the decline in the economic power of the Venetian Republic, particularly in the late 17th and early 18th centuries, pushed pawnshops into a more miserable existence, with ups and downs linked with the irregularities of profit-making on behalf of the institution, particularly by its clerks.

Seniors in Society. Strategies to Retain Individual Autonomy

The research project on "Seniors in Society. Strategies to Retain Individual Autonomy" (2002 - 2004) is supported by the Grant Agency of the Czech Republic. It's importance is empha-sized by the relevance of social and economic aspects of demographic ageing of the popula-tion and that of fundamental changes associated with the transformation of Czech society. The objectives of the research are (1) to find out seniors' material and social resources sup-porting their relative autonomy in everyday life, (2) to record their personal expectations from state, community, or formal and informal support and aid institutions, respectively, and (3) to uncover their engagement in social interaction and individual experiencing of the integration into social groups. The data acquired become the base for (4) identifying the typologies corre-sponding to the levels of seniors' social integration (i.e. groups of relatives, friends, neighbours, special-interest and professional groups). By applying qualitative methods, we explore (5) strategies of everyday life and coping with life cycle events and crisis within par-ticular types. Special attention is paid to the family background of the seniors, including rela-tives in the vertical line. Specifically, we focus on (6) conditions under which family is capa-ble and willing to help or actually is helping it's oldest members, as well as on their interpre-tation within (7) identified types of the relatives supportive systems.

Enemy damage of exotic plant species is similar to that of natives and increases with productivity

1 .In their colonized ranges, exotic plants may be released from some of the herbivores or pathogens of their home ranges but these can be replaced by novel enemies. It is of basic and practical interest to understand which characteristics of invaded communities control accumulation of the new pests. Key questions are whether enemy load on exotic species is smaller than on native competitors as suggested by the enemy release hypothesis (ERH) and whether this difference is most pronounced in resource-rich habitats as predicted by the resource–enemy release hypothesis (R-ERH). 2. In 72 populations of 12 exotic invasive species, we scored all visible above-ground damage morphotypes caused by herbivores and fungal pathogens. In addition, we quantified levels of leaf herbivory and fruit damage. We then assessed whether variation in damage diversity and levels was explained by habitat fertility, by relatedness between exotic species and the native community or rather by native species diversity. 3. In a second part of the study, we also tested the ERH and the R-ERH by comparing damage of plants in 28 pairs of co-occurring native and exotic populations, representing nine congeneric pairs of native and exotic species. 4. In the first part of the study, diversity of damage morphotypes and damage levels of exotic populations were greater in resource-rich habitats. Co-occurrence of closely related, native species in the community significantly increased the probability of fruit damage. Herbivory on exotics was less likely in communities with high phylogenetic diversity. 5. In the second part of the study, exotic and native congeneric populations incurred similar damage diversity and levels, irrespective of whether they co-occurred in nutrient-poor or nutrient-rich habitats. 9. Synthesis. We identified habitat productivity as a major community factor affecting accumulation of enemy damage by exotic populations. Similar damage levels in exotic and native congeneric populations, even in species pairs from fertile habitats, suggest that the enemy release hypothesis or the R-ERH cannot always explain the invasiveness of introduced species.

Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women ('Option B+') in Malawi

OBJECTIVE To explore the levels and determinants of loss to follow-up (LTF) under universal lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') in Malawi. DESIGN, SETTING, AND PARTICIPANTS We examined retention in care, from the date of ART initiation up to 6 months, for women in the Option B+ program. We analysed nationwide facility-level data on women who started ART at 540 facilities (n = 21 939), as well as individual-level data on patients who started ART at 19 large facilities (n = 11 534). RESULTS Of the women who started ART under Option B+ (n = 21 939), 17% appeared to be lost to follow-up 6 months after ART initiation. Most losses occurred in the first 3 months of therapy. Option B+ patients who started therapy during pregnancy were five times more likely than women who started ART in WHO stage 3/4 or with a CD4 cell count 350 cells/μl or less, to never return after their initial clinic visit [odds ratio (OR) 5.0, 95% confidence interval (CI) 4.2-6.1]. Option B+ patients who started therapy while breastfeeding were twice as likely to miss their first follow-up visit (OR 2.2, 95% CI 1.8-2.8). LTF was highest in pregnant Option B+ patients who began ART at large clinics on the day they were diagnosed with HIV. LTF varied considerably between facilities, ranging from 0 to 58%. CONCLUSION Decreasing LTF will improve the effectiveness of the Option B+ approach. Tailored interventions, like community or family-based models of care could improve its effectiveness.

SERIOUS MORBIDITY DUE TO ACUTE RESPIRATORY DISEASE ASSOCIATED WITH EPIDEMIC INFLUENZA

Current measures of the health impact of epidemic influenza are focused on analyses of death certificate data which may underestimate the true health effect. Previous investigations of influenza-related morbidity have either lacked virologic confirmation of influenza activity in the community or were not population-based. Community virologic surveillance in Houston has demonstrated that influenza viruses have produced epidemics each year since 1974. This study examined the relation of hospitalized for Acute Respiratory Disease (ARD) to the occurrence of influenza epidemics. Considering only Harris County residents, a total of 13,297 ARD hospital discharge records from hospitals representing 48.4% of Harris County hospital beds were compiled for the period July 1978 through June 1981. Variables collected from each discharge included: age, sex, race, dates of admission and discharge, length of stay, discharge disposition and a maximum of five diagnoses. This three year period included epidemics caused by Influenza A/Brazil (H1N1), Influenza B/Singapore, Influenza A/England (H1N1) and Influenza A/Bangkok (H3N2).^ Correlations of both ARD and pneumonia or influenza hospitalizations with indices of community morbidity (specifically, the weekly frequency of virologically-confirmed influenza virus infections) are consistently strong and suggest that hospitalization data reflect the pattern of influenza activity derived from virologic surveillance.^ While 65 percent of the epidemic period hospital deaths occurred in patients who were 65 years of age or older, fewer than 25 percent of epidemic period ARD hospitalizations occurred in persons of that age group. Over 97 percent of epidemic period hospital deaths were accompanied by a chronic underlying illness, however, 45 percent of ARD hospitalizations during epidemics had no mention of underlying illness. Over 2500 persons, approximately 35 percent of all persons hospitalized during the three epidemics, would have been excluded in an analysis for high risk candidates for influenza prophylaxis.^ These results suggest that examination of hospitalizations for ARD may better define the population-at-risk for serious morbidity associated with epidemic influenza. ^

Avian species identity and predation success in tropical cacao agroforestry of the Napu Valley in Central Sulawesi, Indonesia

Avian ecosystem services such as the suppression of pests are considered being of high ecological and economic importance in a range of ecosystems, especially in tropical agroforestry. But how bird predation success is related to the diversity and composition of the bird community, as well as local and landscape factors, is poorly understood. The author quantified arthropod predation in relation to the identity and diversity of insectivorous birds, using experimental exposure of artificial, caterpillar-like prey on smallholder cacao agroforestry systems, differing in local shade management and distance to primary forest. The bird community was assessed using both mist netting (targeting on active understory insectivores) and point count (higher completeness of species inventories) sampling. The study was conducted in a land use dominated area in Central Sulawesi, Indonesia, adjacent to the Lore Lindu National Park. We selected 15 smallholder cacao plantations as sites for bird and bat exclosure experiments in March 2010. Until July 2011, we recorded several data in this study area, including the bird community data, cacao tree data and bird predation experiments that are presented here. We found that avian predation success can be driven by single and abundant insectivorous species, rather than by overall bird species richness. Forest proximity was important for enhancing the density of this key species, but did also promote bird species richness. The availability of local shade trees had no effects on the local bird community or avian predation success. Our findings are both of economical as well as ecological interest because the conservation of nearby forest remnants will likely benefit human needs and biodiversity conservation alike.

Arquitectura judicial en Aragón en la última centuria

La arquitectura judicial puede considerarse como la manifestación construida de uno de los aspectos fundamentales que definen una cultura, periodo histórico, o ámbito geográfico, que es la administración de justicia en cada sociedad. La Ley y el Derecho requieren unos ámbitos espaciales singulares en los que desarrollar los procesos que culminan con el acto judicial, el contraste de versiones e investigaciones que tienen como objetivo la búsqueda de la verdad por encima de todo. La arquitectura se configura como el escenario en el que tiene lugar el juicio, y ha de contribuir en este noble cometido. El conocimiento de la arquitectura judicial requiere -en primera instancia- un análisis arquitectónico, pero además esta visión se puede y se tiene que enriquecer con los enfoques que la propia práctica jurídica ha de aportar, y que en gran medida condicionan su creación y proyecto, en todo lo relativo a funcionalidad y simbología. Sin olvidar que nuestra formación es fundamentalmente arquitectónica, cabe plantear que el área de conocimiento a la que va dirigida esta investigación también se abre en diversas vías, que parten de la confluencia de aspectos legales, arquitectónicos, urbanos, y simbológicos. Además, todos estos aspectos son planteados en relación con las particularidades de una región concreta, Aragón, donde la ley ha tenido sus propias manifestaciones y códigos, donde la arquitectura y la ciudad se han contextualizado en un lugar concreto, y donde la simbología ha tenido su manera particular de transmitirse. Respecto a los objetivos que esta tesis plantea, podemos plantear en un primer estadio el análisis del carácter de la arquitectura judicial, como concepto y expresión amplia que manifiesta la función del edificio y su traducción en una simbología propia, y que queda vinculado, por lo tanto, a la funcionalidad de los procedimientos que en él tienen lugar y a la solemnidad alegórica de la Justicia. Para llevar a cabo este estudio se pretende establecer una metodología de estudio propia, que surge de considerar como valores formativos del tipo de arquitectura judicial a la tríada de valores urbanos, funcionales, y simbólicos. En primer lugar se evaluará la repercusión urbana de la arquitectura judicial, conforme a su consideración de equipamiento publico representativo de una sociedad. Se analizará, por lo tanto, si se dan posiciones urbanas concretas o arbitrarias, y si éstas se pueden tratar como una constante histórica. En segundo lugar, la especificidad y delicadeza de los usos que alberga llevan consigo planteamientos funcionales absolutamente complejos y específicos. Se considera que merece la pena analizarlos para evaluar si son propios de este tipo de arquitectura, así como su posible origen e implicación en la construcción del espacio judicial. En tercer lugar, se analizarán los edificios judiciales desde su consideración de soporte de una gran cantidad de materializaciones de simbológicas, no sólo desde un punto de vista iconográfico, sino además vinculadas a los procesos y ordenamientos judiciales, que se traducen en la construcción de espacios con una fuerte carga simbólica y escenográfica. En un segundo estadio se analiza la validez de la aplicación de dichos valores en el estudio de una serie de casos concretos de la arquitectura judicial en el territorio de Aragón en el siglo XX. Se buscará con ello la posibilidad de establecer variantes geográficas y temporales al tipo propias de esta comunidad, con unas particularidades forales que pueden dar lugar a ellas, así como posibles líneas evolutivas, o por el contrario, la imposibilidad de establecer pautas y relaciones a partir del análisis de los casos concretos y su valoración global. ABSTRACT Judicial architecture can be seen as the built manifestation of one of the key aspects that define a culture, a historical period, or a geographic scope, which is the administration of justice in every society. Law requires specific spaces to develop its own proceedings, that culminate with the judicial act. It is the contrast of versions and investigations that have an objective, the search for the truth. Architecture is configured as the stage in which the trial takes place, and has to contribute to this noble task. The knowledge of the judicial architecture requires -in the first instance - an architectural analysis, but in addition this vision can be enriched by some questions from the legal practice. They determine project decissions, specially functional and symbologycal aspects. Our main visión of the theme is architectural, but this research is also opened in many ways, that com from the confluence of legal, architectural, urban, and simbologic aspects In addition, all these questios are considered in relation to the peculiarities of a specific region, Aragon, where the law has its own manifestations and codes, where the architecture and the city have been contextualized in a particular way, and where the symbology has its particular way to be transmitted. About the objectives that this thesis purposes, we can suggest in a first stage the analysis of the character of the judicial architecture, as a concept that expresses the function of a building, and its translation into a particular symbology, allegorical to the solemnity of the Justice. To carry out the investigation proccess is neccesary to define a new methodology. It comes form considering the formative values of the judicial architecture, developed on the triad of urban, functional, and symbolic, values. Firstly, we analyse the urban aspects of judicial architecture, according to its consideration as a main public equipment of a society. Therefore we can search for specific or arbitrary urban locations of the courts, and if they can be considered as historic constants. Secondly, we analyse the specificity an complexity of the judicial uses, their possible origin, and involvement in the construction of judicial space. Thirdly, we analyse the court as scenographic stage, that support lots of symbolic elements and aspects linked to legal system. The second stage applies the values methodology on judicial architecture in Aragon in the twentieth century, with the possibility of establishing geographical and temporal variants os the court type in this community, or on the contrary, the inability to establish patterns and relationships from the analysis of specific cases and their overall rating.

Three Dichotomies in Lawyers’ Ethics (With Particular Attention to the Corporation as Client)

Three usually unexpressed, and too often unnoticed, conceptual dichotomies underlie our perception and understanding of lawyers’ ethics. First, the existence of a special body of professional ethics and professional regulation presupposes some special need or risk. Criminal and civil law are apparently insufficient. Ordinary day-to-day morality and ordinary ethics, likewise, are not considered to be enough. What is the risk entailed by the notion of a profession that is special; who needs protection, and from what? Two quite different possible answers to this question provide the first of the three dichotomies examined in this article: one can understand the risk as primarily to a vulnerable client from a powerful professional; or, to the contrary, from a powerful client-lawyer combination toward vulnerable others. Second, what is the foundational orientation of lawyers? Are lawyers serving primarily their particular clients, and those clients’ preferences, choices and autonomy? Or is the primary allegiance of lawyers to some community or collective goal or interest distinct from the particular goals or interests of the client? The third dichotomy concerns not the substance of the risk, or the primary orientation, but the appropriate means of responding to that risk or that fundamental obligation. Should professional ethics be implemented primarily through rules? Or, should we rely on character and the discretion of lawyers to make a thought out, all things considered, decision? Each of these three presents a fundamental difference in how we perceive and address issues of lawyers’ ethics. Each affects our understanding and analysis on multiple levels, from (1) determining the appropriate or requisite conduct in a particular situation, to (2) framing a specific rule or approach for a particular category of situations, to (3) more general or abstract theory or policy. A person’s inclinations in regard to the dichotomies affects the conclusions that person will reach on each of those levels of analysis, yet those inclinations and assumptions are frequently unexamined and unarticulated. One’s position on each of the dichotomies tends to structure the approach and outcome without the issues and choice having been explicitly addressed or possibly even noticed. This article is an effort to ameliorate that problem. Part I addresses the question of what is the risk in the work of lawyers, or the function of lawyers, for which professional ethics is the answer. The concluding section focuses on the particular problem of the corporation as client. Part II then asks the related and possibly consequent question of what is the foundational orientation or allegiance of the lawyer? Is it to the individual client? Or is it to some larger community interest? Again, the concluding section focuses on the corporation. Part III turns to the means or method for addressing the obligations and possible problems of the professional ethics of lawyers. Should lawyers’ ethics guide and confine the conduct of lawyers primarily through rules? Or should it function primarily through reliance on the knowledge, judgment and character of lawyers? If the latter were the guide, ethical decisions would be made on a situation by situation basis under the discretion of each lawyer. Toward the end of each discussion possibilities for bridging the dichotomy are considered (and with such bridges each dichotomy may come to look more like a spectrum or continuum.). At several points after its introduction in Parts I and II, the special problem of the corporation as client is revisited and possible solutions suggested. Illustrating the usefulness of keeping the dichotomies in view, Part IV applies them to several exemplary situations of ethical difficulty in actual lawyer practice. For readers finding it difficult to envision the consequences of these distinctions, turning ahead to Part IV may be useful in making the discussion more concrete. Some commonalities across the dichotomies and connections among them are then developed in the concluding section, Part V.

Three Dichotomies in Lawyers’ Ethics (With Particular Attention to the Corporation as Client)

Three usually unexpressed, and too often unnoticed, conceptual dichotomies underlie our perception and understanding of lawyers’ ethics. First, the existence of a special body of professional ethics and professional regulation presupposes some special need or risk. Criminal and civil law are apparently insufficient. Ordinary day-to-day morality and ordinary ethics, likewise, are not considered to be enough. What is the risk entailed by the notion of a profession that is special; who needs protection, and from what? Two quite different possible answers to this question provide the first of the three dichotomies examined in this article: one can understand the risk as primarily to a vulnerable client from a powerful professional; or, to the contrary, from a powerful client-lawyer combination toward vulnerable others. Second, what is the foundational orientation of lawyers? Are lawyers serving primarily their particular clients, and those clients’ preferences, choices and autonomy? Or is the primary allegiance of lawyers to some community or collective goal or interest distinct from the particular goals or interests of the client? The third dichotomy concerns not the substance of therisk, or the primary orientation, but the appropriate means of responding to that risk or that fundamental obligation. Should professional ethics be implemented primarily through rules? Or, should we rely on character and the discretion of lawyers to make a thought out, all things considered, decision? Each of these three presents a fundamental difference in how we perceive and address issues of lawyers’ ethics. Each affects our understanding and analysis on multiple levels, from (1) determining the appropriate or requisite conduct in aparticular situation, to (2) framing a specific rule or approach for a particular category of situations, to (3) more general or abstract theory or policy. A person’s inclinations in regard to the dichotomies affects the conclusions that person will reach on each of those levels of analysis, yet those inclinations and assumptions are frequently unexamined and unarticulated. One’s position on each of the dichotomies tends to structure the approach and outcome without the issues and choice having been explicitly addressed or possibly even noticed. This article is an effort to ameliorate that problem. Part I addresses the question of what is the risk in the work of lawyers, or the function of lawyers, for which professional ethics is the answer. The concluding section focuses on the particular problem of the corporation as client. Part II then asks the related and possibly consequent question of what is the foundational orientation or allegiance of the lawyer? Is it to the individual client? Or is it to some larger community interest? Again, the concluding section focuses on thecorporation. Part III turns to the means or method for addressing the obligations and possible problems of the professional ethics of lawyers. Should lawyers’ ethics guide and confine the conduct of lawyers primarily through rules? Or should it function primarily through reliance on the knowledge, judgment and character of lawyers? If the latter were the guide, ethical decisions would be made on a situation by situation basis under the discretion of each lawyer. Toward the end of each discussion possibilities for bridging the dichotomy are considered (and with such bridges each dichotomy may come to look more like a spectrum or continuum.). At several points after its introduction in Parts I and II, the special problem of the corporation as client is revisited and possible solutions suggested. Illustrating the usefulness of keeping the dichotomies in view, Part IV applies them to several exemplary situations of ethical difficulty in actual lawyer practice. For readers finding it difficult to envision the consequences of these distinctions, turning ahead to Part IV may be useful in making the discussion more concrete. Some commonalities across the dichotomies and connections among them are then developed in the concluding section, Part V.

Espiritualidad líquida. Secularización y transformación de la religiosidad juvenil

El objeto de este artículo es investigar las creencias religiosas juveniles en un nuevo contexto de tardo-posmodernidad y tras determinados procesos secularizadores, para determinar en qué creen nuestros jóvenes, cómo viven y construyen sus creencias y qué características tiene el objeto de su fe. Nos interesa saber cuáles son los principales posicionamientos de los jóvenes ante la Trascendencia, así como conocer qué imagen o representación de Dios tienen estos jóvenes. Por último, es preciso saber si estos grupos de creyentes son homogéneos en sus cualidades o bien presentan cierta pluralidad en relación a la moral, los ritos, los dogmas/creencias, cuestiones comunitarias/eclesiales, etc.

The Dangers and Inanity of (Euro-) Nationalism: From Communitarianism to Cosmopolitanism. Egmont Paper No. 77, April 2015

INTRODUCTION In the current times of multifaceted crisis, nationalism looks, more than ever, like a positive and necessary feeling. It seems both natural and indispensable if we are to have viable political and social institutions that meet the needs and preferences of all citizens. The following paper contests this vision. Its criticism of nationalism is directed not only at its national forms, but also at any defence of collective identity based on the same model, such as the various forms of European nationalism. Furthermore, the same overriding criticism can be made of different kinds of nationalism, regardless of their more or less open and progressive political content. In order to ground our argument theoretically and practically, we will try to show that nationalism is always potentially harmful to individual rights, and unnecessary for the maintenance of a just social and political system. We will thus oppose any acritical defence of the intrinsic value of a specific community and the belief in its artificial homogeneity. The historical construction of a supposedly homogeneous community, and the insistence on its values, which are perceived as superior and binding, facilitate the absorption of the individual into the collective. As we will explain further in more details, this holistic approach is typical of communitarian approaches. In that respect, it does not really matter whether they appeal to passion or to reason, to some irrational binding features of the community or to more rational political aspects of a common identity. The main problem in nationalism is not the emotion it can trigger, it is not even its reliance on particular values. What makes nationalism problematic is, firstly, that it tends to overlook the intrinsically divisive and contradictory nature of individual and collective interests in unjust societies; secondly, that it attributes an intrinsic superiority to a particular community over others; and thirdly, that it sees politics as a means to promote the interests, values or identity of that community. As an alternative, we will very briefly advocate a cosmopolitan approach that grounds political legitimacy in a demanding approach to individual freedom, rather than in a shared collective identity. However, even if only briefly, we will also carefully distinguish our own vision of cosmopolitanism from those commonly put forward. Frequently, cosmopolitan perspectives entangle their identity frameworks with concrete political projects, without clearly explaining how the latter derive from the former. Our approach to cosmopolitanism, on the other hand, is, first and foremost, a critical vision of all communitarian postulates according to which politics should be based on some form of collective identity. Thus, we insist on the conceptual distinction between a general stance on identity issues and the more practical political ideology one stands for. In a subsequent step, we link this cosmopolitan framework with a progressive approach to individual rights. Because of our demanding approach to individual freedom, our cosmopolitanism goes hand in hand with a revival of identity-free sovereignty. It is therefore distinct from the severe condemnation of sovereignty often found in most mainstream cosmopolitan positions. Finally, instead of the frequent confusion found in public discourses and in the literature between ideals and reality, our position acknowledges the deep gulf separating these two dimensions. It therefore sketches out very general strategic principles to bring normative ideals closer to political reality.

General practitioner, specialist providers case conferences in palliative care: Lessons learned from 56 case conferences

OBJECTIVE: To describe the utility and acceptability to general practitioners and palliative care staff of case conferences in palliative care. METHOD: Research focussed on case conferences conducted between GPs and staff of three specialist palliative care units (in an inner urban, outer metropolitan and regional setting), at the time of referral of patients to the service. Telephone interviews were conducted with all GPs who participated in a case conference, and focus groups were conducted with palliative care staff. RESULTS: For most GPs, case conferences by teleconference were a time effective and immediate means of information transfer. The best instances for a conference were at time of patient referral, time of discharge to the community, or where the case was complex. General practitioners appreciated access to multiple professionals simultaneously. Workload pressures were a drawback of participation for both GPs and specialists. Palliative care team members thought case conferences gave GPs an appreciation of a team approach, and reduced professional isolation. The usefulness of the case conferences depended on the willingness of the GP to participate. General practitioners would participate again provided they did not have to organise the case conference. Specialist staff were concerned by the financial cost of organising case conferences. DISCUSSION: Case conferences provide useful information exchange between GPs and specialist staff, and are acceptable to both parties. Much depends on the individual GPs attitude toward participation, as well as the timing of the conferences in the course of the patient's illness. Organisation needs to be a task of the specialist units, who would need administrative support to organise them. (author abstract)

Conceiving of Europe:diversity in unity

At the end of the 20th century, the development towards a united European Community or European Union and the movement towards a post-bloc Europe are having to be combined. This study explores such subjects as the agendas of European integration and linguistic aspects of the European debate. At the end of the 20th century, the development towards a united European Community or European Union and the movement towards a post-bloc Europe are having to be combined. This study explores such subjects as the agendas of European integration and linguistic aspects of the European debate.

Medication errors in mental healthcare:a systematic review

Methods: It has been estimated that medication error harms 1-2% of patients admitted to general hospitals. There has been no previous systematic review of the incidence, cause or type of medication error in mental healthcare services. Methods: A systematic literature search for studies that examined the incidence or cause of medication error in one or more stage(s) of the medication-management process in the setting of a community or hospital-based mental healthcare service was undertaken. The results in the context of the design of the study and the denominator used were examined. Results: All studies examined medication management processes, as opposed to outcomes. The reported rate of error was highest in studies that retrospectively examined drug charts, intermediate in those that relied on reporting by pharmacists to identify error and lowest in those that relied on organisational incident reporting systems. Only a few of the errors identified by the studies caused actual harm, mostly because they were detected and remedial action was taken before the patient received the drug. The focus of the research was on inpatients and prescriptions dispensed by mental health pharmacists. Conclusion: Research about medication error in mental healthcare is limited. In particular, very little is known about the incidence of error in non-hospital settings or about the harm caused by it. Evidence is available from other sources that a substantial number of adverse drug events are caused by psychotropic drugs. Some of these are preventable and might probably, therefore, be due to medication error. On the basis of this and features of the organisation of mental healthcare that might predispose to medication error, priorities for future research are suggested.