Clinical communication and adverse health events: literature review

Abstract Health institutions have an increased risk of occurrence of errors due to their diversity, specificity and volume of services, representing a great concern for health professionals whose main function is to protect the health and lives of their patients. We intend to identify a body of evidence, that shows what the most common adverse events are and what adverse events potentially arise from clinical miscommunications. An integrative literature review using the keywords "Adverse Events", "Patient Safety", "Communication". An inquiry was made on databases PubMed, Web of Science, Scielo and CINAHL, in articles published between January 2010 and March 2016, available in Portuguese and English. Of the 216 articles that emerged were selected eight articles that answered the research questions: what are the most common adverse events that have their origin in communication errors? Analyzing the selected studies, it appears that the most common adverse events arise in the context of obstetrics and pediatrics, in surgical contexts, in the continuity of care and related medication. Patient safety should be seen as a key component of quality in health care, with good management of the risk of fundamental error for the promotion of this security. The knowledge and understanding that communication failures are one of the main factors contributing to the occurrence of errors in the context of health care, allows the subsequent development of strategies to improve this process and thus ensure safer healthcare.

Literature review and update of lower limb neural mobilization

Summarize the available literature descriptions of neural mobilization (NM) techniques and neural provocation tests (NPT) for the Lower Limb (LL). Compilation of data was performed in May 2016 using MEDLINE data base, Google Scholar and the library of the European University of Madrid. After application of inclusion/exclusion criterions 5 books and 14 journal publications where found to be of interest and used during data extraction.Results: a list of 8 different LLNM techniques are applied in a rhythmic alternating oscillatory cycle fashion, starting in the initial position from where the therapist proceeds to move the limb in order to achieve a final position. LL NPTs are useful tools for differential diagnose and selecting the proper LLNM procedure. There is no consensus about the time frame of repetition intervals or amount of tensile strength during NPT never the less it is found to normally be performed at a rate of 2-4 seconds per complete cycle of movement, during 1-5 minutes, 3-5 times a week. LLNM treatment techniques all thou increasingly popular in clinical practice are found to be frugally described and lack proper standardization in regards to therapeutic dosification.

Methodology used in studies reporting chronic kidney disease prevalence : a systematic literature review

BACKGROUND: Many publications report the prevalence of chronic kidney disease (CKD) in the general population. Comparisons across studies are hampered as CKD prevalence estimations are influenced by study population characteristics and laboratory methods. METHODS: For this systematic review, two researchers independently searched PubMed, MEDLINE and EMBASE to identify all original research articles that were published between 1 January 2003 and 1 November 2014 reporting the prevalence of CKD in the European adult general population. Data on study methodology and reporting of CKD prevalence results were independently extracted by two researchers. RESULTS: We identified 82 eligible publications and included 48 publications of individual studies for the data extraction. There was considerable variation in population sample selection. The majority of studies did not report the sampling frame used, and the response ranged from 10 to 87%. With regard to the assessment of kidney function, 67% used a Jaffe assay, whereas 13% used the enzymatic assay for creatinine determination. Isotope dilution mass spectrometry calibration was used in 29%. The CKD-EPI (52%) and MDRD (75%) equations were most often used to estimate glomerular filtration rate (GFR). CKD was defined as estimated GFR (eGFR) <60 mL/min/1.73 m(2) in 92% of studies. Urinary markers of CKD were assessed in 60% of the studies. CKD prevalence was reported by sex and age strata in 54 and 50% of the studies, respectively. In publications with a primary objective of reporting CKD prevalence, 39% reported a 95% confidence interval. CONCLUSIONS: The findings from this systematic review showed considerable variation in methods for sampling the general population and assessment of kidney function across studies reporting CKD prevalence. These results are utilized to provide recommendations to help optimize both the design and the reporting of future CKD prevalence studies, which will enhance comparability of study results.

The long game: five years of simulating the Middle East

Scholarly literature attesting to the benefits of role play in teaching international relations or political science subjects is abundant and universally positive. However, despite many case studies presenting snapshots of single examples, long term data concerning a role play exercise is difficult to find. This study presents student feedback data gathered from 10 iterations of the Middle East politics simulation carried out over 5 years from 2011-15. The data obtained from over 600 respondents establishes very clear trends in terms of satisfaction, engagement, and workload. The findings demonstrate that students can be significantly engaged in the subject matter through role plays and that they value these opportunities and the learning that ensues, even though it may represent more work than they are used to allotting to traditional assignments. The results show that year after year, successive student cohorts have made a clear judgement that extra work is worthwhile when it pays off against their perceived learning. The inference can also be drawn that they do not see this same pay off when completing essay type assignments.

Broad-scale mapping of seafloor habitats in the north-east Atlantic using existing environmental data

If marine management policies and actions are to achieve long-term sustainable use and management of the marine environment and its resources, they need to be informed by data giving the spatial distribution of seafloor habitats over large areas. Broad-scale seafloor habitat mapping is an approachwhich has the benefit of producing maps covering large extents at a reasonable cost. This approach was first investigated by Roff et al. (2003), who, acknowledging that benthic communities are strongly influenced by the physical characteristics of the seafloor, proposed overlaying mapped physical variables using a geographic information system (GIS) to produce an integrated map of the physical characteristics of the seafloor. In Europe the method was adapted to the marine section of the EUNIS (European Nature Information System) classification of habitat types under the MESH project, andwas applied at an operational level in 2011 under the EUSeaMap project. The present study compiled GIS layers for fundamental physical parameters in the northeast Atlantic, including (i) bathymetry, (ii) substrate type, (iii) light penetration depth and (iv) exposure to near-seafloor currents andwave action. Based on analyses of biological occurrences, significant thresholds were fine-tuned for each of the abiotic layers and later used in multi-criteria raster algebra for the integration of the layers into a seafloor habitat map. The final result was a harmonised broad-scale seafloor habitat map with a 250 m pixel size covering four extensive areas, i.e. Ireland, the Bay of Biscay, the Iberian Peninsula and the Azores. The map provided the first comprehensive perception of habitat spatial distribution for the Iberian Peninsula and the Azores, and fed into the initiative for a pan- European map initiated by the EUSeaMap project for Baltic, North, Celtic and Mediterranean seas.

Valor diagnóstico del pepsinógeno i/ii como biomarcador de lesiones pre-malignas y malignas gástricas: revisión sistemática

Antecedentes: El cáncer gástrico se diagnostica tardíamente. Sólo en países como Corea y Japón existen políticas de tamizaje, que se justificarían en cualquier país con alta prevalencia de cáncer gástrico como Colombia o Chile. El análisis del pepsinógeno sérico se ha propuesto para el diagnóstico de lesiones premalignas y malignas gástricas, por lo cual se pretende revisar sistemáticamente en la literatura el valor diagnóstico del cociente pepsinógeno I/II como marcador de lesiones premalignas y malignas gástricas. Metodología: Se revisó la literatura hasta septiembre del 2016 con palabras claves lesiones malignas, premalignas gástricas y pepsinógeno en las bases de datos PubMed, OVID, EMBASE, EBSCO, LILACS, OPENGRAY y Dialnet, artículos de prueba diagnóstica que evaluaran el cociente pepsinógeno I/II en relación con los hallazgos histológicos. Resultados: Se incluyeron 21 artículos conun total de 20601 pacientes, que demuestranuna sensibilidad entre13.7% - 91.2%, una especificidad entre 38.5% - 100%, un Valor Predictivo Positivo entre 6.3% - 100% y un Valor Predictivo Negativo entre 33.3% - 98.8%del cociente pepsinógeno I/II en relación con el diagnósticode lesiones premalignas y malignas gástricas. Conclusiones: Los valores del cociente pepsinógeno I/II disminuidos se relacionan con la presencia delesiones premalignas y malignas gástricas.Dado que tiene mejor especificidad que sensibilidad, en cuanto prueba para tamizaje, sería útil para la selección de pacientes que se beneficiaríande la EVDA. Se requieren más estudios de prueba diagnóstica para validar un punto de corte específico que pueda ser utilizado como valor estándar.

Crossing frontiers between tourism and demography. An empirical analysis based on European travellers’ behaviour

This paper aims to establish possible tourism demand scenarios of European travellers to Portugal based on the relationship with changing population structures. A combination of the EuROBAROMETER report 370 (“Attitudes of Europeans towards Tourism in 2013”) and the cohort-component method for population projections will allow the development of different possible tourism demand scenarios. Following the European report, individuals who travelled in 2013 were most likely to live in a household with two or more individuals. Thus, if elderly couples are together till later in their life and in better physiological shape, it is possible that the number of elderly individuals travelling for tourism purposes will increase in the near future. If we can expect tourists from developing countries to be younger due to their demographic dynamics than those from developed countries, where the ageing population is growing fast, we can expect that the percentage of the elderly among tourists will increase. Furthermore, the 2013 European report found that the combination of socio-demographic variables, such as, age, population, gender, household dimension, country of residence and trip purpose explained tourism demand scenarios for Portugal, confirming that seniors and families evidence a paramount sense of importance for the destination. In the literature there is a lack of discussion about the effects of demography in the future and the role of an ageing population in tourism demand choice patterns. We aim to contribute to filling this gap. Consequently, we strongly believe that this paper contributes to the literature by introducing a new field of discussion about the importance of demographic changes in shaping travel trends.

Do comunismo à União Europeia: 20 anos que mudaram a história política e económica da Bulgária: Uma abordagem pela teoria e prática da condicionalidade

O mecanismo da condicionalidade pode ser considerado como um dos sucessos da UE na avaliação da forma como este afectou os processos de transição nos países pós-comunistas, em particular no caso dos países envolvidos no Quinto Alargamento. Este trabalho avalia a importância do mecanismo da condicionalidade na região da Europa de Leste, buscando analisar as políticas da UE em relação à Bulgária no período de 20 anos de difícil transição de um sistema comunista planificado para uma economia de mercado. Avaliamos também as políticas europeias de pré-adesão e as condições de adesão. Além disso, prestamos ainda atenção ao fenómeno do mecanismo da condicionalidade específico da UE, como tal, comparamos o seu impacto com os mecanismos do FMI e do Banco Mundial. Concluímos com a tentativa de fornecer alguns elementos sobre a utilidade prática do mecanismo de condicionalidade no Sudeste da Europa, definindo as suas principais realizações, bem como os problemas enfrentados. Através de uma revisão da literatura disponível, e adoptando uma perspectiva histórica, procuramos avaliar também as novas responsabilidades que a Bulgária assumiu ao alargar a fronteira exterior da UE e as consequências que daí decorreram para as relações políticas e económicas com os países vizinhos. /ABSTRACT: The conditionality mechanism can be considered one of the successes of the EU when estimated its influence over the transition process in the post-communist countries, especially for the countries involved in the Fifth Enlargement. This study evaluates the significance of the mechanism of conditionality in the region of Eastern Europe, analyzing the policies of the EU for Bulgaria during the 20 years of difficult transition from a planned communist system to a market economy. The European policies of pre-accession and the accession conditions are evaluated. Also, it pays attention to the phenomenon of the conditionality mechanism specific for EU, comparing its impact with the mechanisms of the IMF and World Bank. And concludes with an attempt to provide some elements about how useful has been the conditionality mechanism in South East Europe, defining the main achievements and difficulties that it faces. Having a look at the available literature and also reviewing it from historical point of view, it's evaluated the new responsibilities that Bulgaria assumed after extending the external frontiers of EU and the consequences for the political and economic relations with neighbor countries.

Crossing frontiers between tourism and demography. An empirical analysis based on European travellers’ behaviour

This paper aims to establish possible tourism demand scenarios of European travellers to Portugal based on the relationship with changing population structures. A combination of the EUROBAROMETER report 370 (“Attitudes of Europeans towards Tourism in 2013”) and the cohort-component method for population projections will allow the development of different possible tourism demand scenarios. Following the European report, individuals who travelled in 2013 were most likely to live in a household with two or more individuals. Thus, if elderly couples are together till later in their life and in better physiological shape, it is possible that the number of elderly individuals travelling for tourism purposes will increase in the near future. If we can expect tourists from developing countries to be younger due to their demographic dynamics than those from developed countries, where the ageing population is growing fast, we can expect that the percentage of the elderly among tourists will increase. Furthermore, the 2013 European report found that the combination of socio-demographic variables, such as, age, population, gender, household dimension, country of residence and trip purpose explained tourism demand scenarios for Portugal, confirming that seniors and families evidence a paramount sense of importance for the destination. In the literature there is a lack of discussion about the effects of demography in the future and the role of an ageing population in tourism demand choice patterns. We aim to contribute to filling this gap. Consequently, we strongly believe that this paper contributes to the literature by introducing a new field of discussion about the importance of demographic changes in shaping travel trends.

Exploring the effectiveness of virtual product placement on recall and recognition of new brands

This paper investigates the effectiveness of virtual product placement as a marketing tool by examining the relationship between brand recall and recognition and virtual product placement. It also aims to address a gap in the existing academic literature by focusing on the impact of product placement on recall and recognition of new brands. The growing importance of product placement is discussed and a review of previous research on product placement and virtual product placement is provided. The research methodology used to study the recall and recognition effects of virtual product placement are described and key findings presented. Finally, implications are discussed and recommendations for future research provided.