967 resultados para quality use of medicines


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Background: The use of complementary and alternative medicines (CAM) is growing in Australia, with women higher users than men. Yet, only a few Australian studies have explored the use of CAM during pregnancy.

Aims
: To explore the use of CAM, the types of CAM practitioners consulted, physical symptoms/complaints for which CAM are used by a sample of pregnant Australian women, and women's perceptions of the efficacy of CAM in treating those complaints.

Methods: Three hundred and twenty-one pregnant women, who volunteered for a study exploring women's well-being during pregnancy, completed a self-report questionnaire in their late second/early third trimester.

Results: Seventy-three per cent of women had used at least one kind of complementary therapy in the prior eight weeks of pregnancy. Over one-third of the women had visited at least one alternative medicine practitioner during pregnancy. Approximately one-third of the women reported taking CAM to alleviate a specific physical symptom, with 95.7% of these women reporting they either got completely better or a little bit better with use of CAM; one quarter reported planning to use an alternative therapy to assist with labour preparation. Age, number of physical symptoms experienced, income level and level of education were not associated with greater use of CAM (P < 0.05); however, women reporting more physical symptoms were more likely to consult a CAM practitioner.

Conclusion
: Findings highlight the substantial use of CAM during pregnancy and the need to have all health professionals adequately informed about such therapies during this life stage.

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As a small island country, Mauritius is relying on its human capital and innovative hi-tech industry to ensure future economic viability in the global market. As such, Mauritian education authorities are seeking ways to raise educational standards. One idea being canvassed is that Total Quality Management (TQM) could provide the framework for Mauritian school leaders to deliver imperatives for change and improvement and to achieve the aim of ‘world- class quality education.’ This paper reports the findings of a research into Mauritian principals’ current practices in line with TQM tenets and their perceptions about the usefulness or otherwise of ideas implicit in TQM. The findings indicate that whilst principals agree with current progressive notions and thinking compatible with the TQM philosophy, they have not fully translated them into their practice. The paper identifies challenges and opportunities worthy of discussion for school improvement in twenty-first century Mauritius with its high-tech, world-class ambitions.

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Background: Behaviour support plan (BSP) quality is known to be an important aspect of the support provided to people with disability who show challenging behaviours and has been found to lead to reductions in challenging behaviour. Preliminary evidence suggests that quality of plans is associated with reductions in the use of restraint
and seclusion.
Method and materials: Quality of a sample of behaviour support plans was assessed using the Behaviour Support Plan – Quality Evaluation II (BSP-QE II) Guide (Browning Wright, Saren & Mayer, 2003). Episodes of restraint and seclusion before and during implementation of plans were examined by comparing restraint and seclusion use between individuals with high quality versus low quality plans.
Results: Compared to individuals with low quality plans, individuals with high quality plans were found to be subjected to less restraint and seclusion over time, while those with low quality plans were subjected to increases. With the exception of one quality component, all components in high quality plans were found to be associated with decreases in restraint and seclusion use.
Conclusions: The results support earlier preliminary findings that quality of behaviour support plans are associated with reductions in restrictive intervention use. The findings are important because they suggest that increasing quality of behaviour support plans may lead to decreases in restraint and seclusion over time.

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Osteoporosis and depression are major public health problems worldwide. Studies have reported an association between antidepressant use, mainly selective serotonin reuptake inhibitors (SSRIs), and bone mineral density (BMD), but the issue remains unclear.

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Mass production of nanofibers from needleless electrospinning shows great potential in research and development of nanofibers. However, how to improve the electrospinning performance so as to achieve high quality nanofibers is still of great challenge. In this study, airflow has been applied to optimize upward needleless electrospinning from ring spinneret. Effects of airflow speed and the position of airflow on the nanofiber quality and production rate have been investigated. It has been found that thinner and more uniform nanofibers were produced when airflow was applied to needleless electrospinning system. It also improved the collected nonwoven membrane, resulting in better nanofibrous structure of the as-spun nanofibers. Application of airflow on needleless electrospinning would further benefit the development of mass production of nanofibers from needleless electrospinning.

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This study was carried out at Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista, Botucatu, SP, Brazil, and evaluated bone quality in broiler breeders. Twenty-three families of Ross broiler breeders were housed in 5.0-m² pens. The families were comprised of 13 females and one male at the onset of the experimental period. The mean number of females per family was 9.34 at the end of the trial. The feeding program and management followed strain guidelines (Agroceres Ross, 2003). Bone analyses were performed in the right tibia and femur using optical radiographic densitometry at 4, 8, 12, 15, 20, 24, 30, 35, 42, 47 and 52 weeks of rearing. Trap nests were used to collect eggs from the breeders two weeks before and after the evaluation weeks. At each evaluation day, five birds were sacrificed after radiographs were taken and the tibias and femurs were collected to perform the following analyses: fatfree dry matter, ash percentage, bone resistance and Seedor index. Therefore, it was possible to establish correlations between bone quality and eggshell quality. Characteristics of bone quality were highly correlated to each other; on the other hand, there were no correlations between bone quality and external egg quality. In conclusion, there was no effect of egg production on egg quality, possibly because there was no reabsorption of bone minerals.

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The present study aimed to evaluate the volatiles profile of red mombin (Spondias purpurea) pulp and its powder produced by spray-drying (SD) as an example to show utility of headspace solid-phase microextraction (HS-SPME) in the analysis of parameters such as the quality and stability of fruit products. Volatiles profiles of the pulp were identified by gas chromatography-mass spectrometry (GC-MS), quantified by gas chromatography-flame ionization detector (GC-FID) and compared to the profile of the powder stored at 0, 60 and 120 days in plastic (PP) or laminated packages (LP). The results showed that the technique was able to identify 36 compounds in the red mombin pulp, 17 out of which have been described for the first time in this fruit, showing that red mombin fresh pulp appears to be unique in terms of volatiles composition. However, only 24 compounds were detected in the powder. This decrease is highly correlated (r(2) = 0.99), at least for the majority of compounds, to the degree of volatility of compounds. Furthermore, the powder stored in PP or LP showed no statistical differences in the amounts of its components for a period of 120 days of storage. Finally, this work shows how HS-SPME analysis can be a valuable tool to assess the quality and stability of fruit products.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Certain medicines are considered potentially inappropriate (PIM) for elderly people as they increase the risk of adverse drug events (ADE) and because safer alternative therapies are available on the market. In this context, in order to identify the instruments that assess the quality of medical prescriptions for elderly and to determine which drugs are considered PIM, a bibliographic survey was conducted in PUBMED, LILACS and PAHO databases, in February and March/2010. The search strategy included the use of health descriptors and a manual search in the references cited by selected papers. During the period of data collection, 15 instruments were identified. In 2012, with the publication of the update of Beers criteria, this instrument was included in the study. We identified 163 PIM of 25 therapeutic classes, of which 125 (76.7%) are marketed in Brazil. Of these, 31 (24.8%) are essential medicines (RENAME 2012), of which 13 have safer therapeutic equivalents and 19 (15.2%) are over-the-counter drugs. Data suggest the need for inclusion of safer alternatives for the elderly in the national list of essential medicines and the pharmaceutical care for early detection of ADE in this age group, in order to contribute to the safe use of medicines.

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

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White Rock Lake reservoir in Dallas, Texas contains a 150-cm sediment record of silty clay that documents land-use changes since its construction in 1912. Pollen analysis corroborates historical evidence that between 1912 and 1950 the watershed was primarily agricultural. Land disturbance by plowing coupled with strong and variable spring precipitation caused large amounts of sediment to enter the lake during this period. Diatoms were not preserved at this time probably because of low productivity compared to diatom dissolution by warm, alkaline water prior to burial in the sediments. After 1956, the watershed became progressively urbanized. Erosion decreased, land stabilized, and pollen of riparian trees increased as the lake water became somewhat less turbid. By 1986 the sediment record indicates that diatom productivity had increased beyond rates of diatom destruction. Neither increased nutrients nor reduced pesticides can account for increased diatom productivity, but grain size studies imply that before 1986 diatoms were light limited by high levels of turbidity. This study documents how reservoirs may relate to land-use practices and how watershed management could extend reservoir life and improve water quality.

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Landslide hazard and risk are growing as a consequence of climate change and demographic pressure. Land‐use planning represents a powerful tool to manage this socio‐economic problem and build sustainable and landslide resilient communities. Landslide inventory maps are a cornerstone of land‐use planning and, consequently, their quality assessment represents a burning issue. This work aimed to define the quality parameters of a landslide inventory and assess its spatial and temporal accuracy with regard to its possible applications to land‐use planning. In this sense, I proceeded according to a two‐steps approach. An overall assessment of the accuracy of data geographic positioning was performed on four case study sites located in the Italian Northern Apennines. The quantification of the overall spatial and temporal accuracy, instead, focused on the Dorgola Valley (Province of Reggio Emilia). The assessment of spatial accuracy involved a comparison between remotely sensed and field survey data, as well as an innovative fuzzylike analysis of a multi‐temporal landslide inventory map. Conversely, long‐ and short‐term landslide temporal persistence was appraised over a period of 60 years with the aid of 18 remotely sensed image sets. These results were eventually compared with the current Territorial Plan for Provincial Coordination (PTCP) of the Province of Reggio Emilia. The outcome of this work suggested that geomorphologically detected and mapped landslides are a significant approximation of a more complex reality. In order to convey to the end‐users this intrinsic uncertainty, a new form of cartographic representation is needed. In this sense, a fuzzy raster landslide map may be an option. With regard to land‐use planning, landslide inventory maps, if appropriately updated, confirmed to be essential decision‐support tools. This research, however, proved that their spatial and temporal uncertainty discourages any direct use as zoning maps, especially when zoning itself is associated to statutory or advisory regulations.