Trends and uptake of new formulations of controlled-release oxycodone in Canada

Purpose: This study investigated the impact of changing availability of tamper‐deterrent and non‐tamper‐deterrent oxycodone on prescribing patterns of controlled‐release oxycodone across Canada. Methods: We conducted a population‐based, serial cross‐sectional study of controlled‐release oxycodone dispensing from community pharmacies across Canada between October 2007 and April 2016. We calculated rates of dispensing (tablets per 100 population) and reported the relative market share of generic non‐tamper‐deterrent controlled‐release oxycodone. All analyses were reported nationally and stratified by province. Results: After the introduction of a tamper‐deterrent formulation, the national rate of controlled‐release oxycodone dispensing fell by 44.6% (from 26.4 to 14.6 tablets per 100 population from February 2012 to April 2016). Between December 2012 and July 2013, there was moderate uptake of generic non‐tamper‐deterrent controlled‐release oxycodone (968 452 tablets; 16.0% in July 2013), which appeared to have little impact on the overall rate of controlled‐release oxycodone dispensing in Canada. However, the uptake of generic non‐tamper‐deterrent oxycodone varied considerably by province. By April 2016, 55.0% of all controlled‐release oxycodone tablets dispensed in Quebec were for the generic formulation. […

Fluvial contributions of nutrient salts, dissolved trace elements and organic carbon to the sea by pristine temperate rivers (SW Europe)

12 páginas, 5 figuras, 3 tablasA summary of the water characteristics of the rivers Sor, Mera and Landro that drain into the Northern Galician Rias (NW Iberian Peninsula) is presented. The analysis was based on fortnightly monitoring during 2008, for major and minor chemical elements in the dissolved phase (Al, As, Cd, Co, Cu, Fe, Mn, Mo, Ni, Pb, U, V, Zn), nutrients (nitrate, nitrite, ammonium, phosphate, silicate), suspended particulate matter, chlorophyll-a and tracers of water quality chemistry (dissolved inorganic nitrogen and carbon). The data cover rivers not urban, agriculturally or industrially affected. Continental inputs of the material via rivers into the Northern Galician Rias were measured and annual fluxes of the dissolved chemical elements to the rias were calculated. In spite of the high variability in water flow, this study provides a good estimate of the overall amounts of nutrients and dissolved elements discharged to pristine ria systemsThis work is a contribution to the Spanish LOICZ program and was supported by the ‘Spanish Ministry of Science and Technology’ through the CICYT program (INTERESANTE project, ref. CTM2007-62546-C03/MAR). N. Ospina-Alvarez thanks the Spanish National Research Council (CSIC) for their financial support (JAE-Pre contract).Peer reviewe

Implementation of auditory screening programs at preschool and school age: a way to follow

Introduction: The auditory screening is an evaluation that aims at identifying early any alteration in hearing in order to permit the earliest possible diagnosis. In pre-school and school children, we verify a high pathological prevalence in the middle ear which is asymptomatic in many cases and that can only be detected through the implementation of auditory screening programmes.Objectives: To determine the prevalence of hearing loss in the auditory screening programmes at preschool and school age. Methods: The sample consisted of 420 children, aged between 3 to 11, attending pre-school and primary school in a school group in the centre of the country. All the children have undergone an otoscopy, a tympanogram and a pure tone audiogram screening ("pass / fail") ") at the frequencies of 1000Hz, 2000Hz and 4000Hz. The children with cerumen obliterans, those with hearing threshold superior to 20db in at least, one tested frequency in one ear, those who presented a tympanogram type B, uni or bilateral or type C2 in both ears didn’t undergo the screening. The cases that presented a tympanogram type C2 unilateral were submitted to repetition. Results: Although most children (77,6%) passed the screening, we verified that 19% were sent to the Otorhinolaryngologist (ORL) for not having passed the screening and 3,4% of the children were requested to repeat the tympanogram one month and a half later. The children aged 3 to 5 were the ones who failed the screening the most and were sent to ORL consultation -35,7% children aged 3 and 31,4% aged 5. On the other hand, the 10 year-age range was the one that presented the lowest percentage of cases sent to ORL consultation (6, 5%). Conclusion: The auditory screening is a process that should be compulsory in pre-school and school age in order to obtain early diagnosis and intervention, reducing the impact of hearing loss in the global child development.info:eu-repo/semantics/publishedVersio

Rare earth elements in coastal sediments of the northern Galician shelf: Influence of geological features

11 páginas, 3 tablas, 4 figurasThe Northern coast of Galicia, NW Iberian Peninsula, exhibits a variety of geological features: Ortegal allochthonous complex, Ollo-de-Sapo autochthonous domain and massifs of Bares, Barqueiro and San-Ciprian. In order to examine the influence of terrestrial lithologies on coastal sediments, 103 samples were collected in the Rias of Ortigueira, Barqueiro and Viveiro, their neighbouring shelf and the estuaries of Mera, Sor and Landro rivers. Aluminium, Fe, Sc, particulate inorganic and organic carbon and rare earth elements (REE) were determined in the 6) near Cape Ortegal and the innermost ria zones. The ratio between light and heavy REE (L/H) showed lower values (4–11) around Cape Ortegal and the shelf while higher ratios (15–23) were detected in west of the Cape Estaca-de-Bares and in the inner Viveiro Ria due to elevated contributions of La and Ce. The L/H values normalised to ES reflects the importance of HREE in the adjacent area to Ortegal Complex (LN/HN1.4) in the inner estuaries and west Cape Estaca-de-Bares. The highest REE individual ES normalised were measured in fine-grained sediments of the Mera and Sor estuaries. Sediments from the eastern shelf of Cape Ortegal presented enhanced ratios only for HREE. These results indicate that distribution of REE in the northern Galician region is highly depending on the neighbouring lithological pattern, contrasting with the situation found in the western Galician shelf and the Bay of Biscay. Lanthanides can, thus, provide a useful tool to follow the sediment pathway in the land–sea boundary zones, denoting continental geochemical imprint or fluvial outputs accordingly to the existing hydrological and geological conditionsCICYT project ‘Influence of meteorological forcing, land geochemistry and estuarine zone in the hydrodynamic, biogeochemical cycle of trace metal and rare earth and plankton transport in the Northern Galician Rias (NW Spain)’, ref. CTM2007-62546-C03/MAR, in cooperation with the Spanish–Portuguese Action ref. 2007PT0021Peer reviewe

Os direitos sociais assistenciais e a dignidade da pessoa humana

No presente trabalho, examinou-se a aplicabilidade dos direitos sociais assistenciais em uma perspectiva de direitos humanos fundamentais, da dignidade da pessoa humana e justiça social. Desde a concepção básica de assistência social e assistencialismo, no Brasil, até o enfrentamento das políticas públicas para a operacionalização dos direitos sociais, passandose pela análise constitucional e de evolução da legislação e das características dos direitos sociais, a fim discutir acerca de sua efetiva proteção e realização, tendo como foco o BPC da LOAS e, se este benefício, atende ao disposto no art. 203, V da CF/88, no tange ao critério de ¼ da renda per capita familiar para sua concessão, tendo em vista a necessidade que assola nossa sociedade de novos conceitos relativos à efetivação desses direitos, pois o Brasil possui uma cultura assistencialista, em que os direitos existem, mas há grandes entraves para que sejam efetivos. Para tanto, utilizou-se, na presente pesquisa, o método histórico e o comparativo com coleta de dados constituída de fontes secundárias, primárias e terciárias que se trata, respectivamente, de pesquisa bibliográfica, pesquisa de campo - mediante observação e pesquisa de dados juntos ao Instituto Nacional do Seguro Social, Ministério Público Federal e a Justiça Federal – subseção de Rio Grande – e de ferramentas de busca na internet, em que se consultaram informações entendidas como relevantes à pesquisa. Dessa forma, o presente trabalho mostra o claro panorama em que os direitos sociais estão inseridos: não se concretizam de forma eficaz, tornando a população cliente das políticas públicas e do sistema

The working process of a neonatal intensive care unit

The objective of this study was to analyze the organization of the working process of a Neonatal Intensive Care Unit through the relationships established between the social actors present in the micropolitical space. This study used an unconventional methodology, adapted to a qualitative study. A case series study was adopted, whose trajectory was referred to as sentinel-trajectory, through which it was possible to detect noises that affected the quality of the care provided. The analysis of the flowchart revealed weaknesses of the contract network, problems regarind the registers and documentations, and errors in the health care process.Este estudio tuvo como objetivo analizar la organización del proceso de trabajo en una Unidad de Terapia Intensiva Neonatal, mediante las relaciones establecidas entre los actores sociales presentes en el espacio micropolítico. Se trata de una metodología no convencional, adaptada al estudio cualitativo. Se adoptó un estudio de serie de casos, cuya trayectoria fue denominada trayectoria-centinela y, a través de ella, se detectaron ruidos que influenciaron en la calidad de la atención. El análisis del flujograma reveló fragilidad en la de de contractualidad, problemas de registro y archivo de documentación, y errores referidos al proceso de atención.Este estudo teve como objetivo analisar a organização do processo de trabalho em uma Unidade de Terapia Intensiva Neonatal através das relações estabelecidas entre os atores sociais presentes no espaço micropolítico. Trata-se de uma metodologia não-convencional, adaptada a estudo qualitativo. Adotou-se um estudo de série de casos cuja trajetória foi denominada trajetória-sentinela e, através desta foram, detectados ruídos que influenciaram na qualidade da assistência. A análise do fluxograma revelou fragilidades na rede de contratualidade, problemas de registros e arquivamento de documentação e, erros relativos ao processo assistência

Risco para lesões por posicionamento cirúrgico decorrentes da posição supina

Objective: to relate the risk score for injuries due to surgical positioning resulting from the supine position with sociodemographic, clinical, surgical aspects and the occurrence of complications. Method: longitudinal observational study carried out with 89 patients in the supine position. Sociodemographic and clinical variables and the Risk Scale for the Development of Surgical Positioning Injuries were applied. Descriptive, bivariate and logistic regression analyzes were adopted, considering a significance level of α=0.05. Results: age increased by 1.11 times (p<0.001) and obesity by 13.77 times (p=0.01) the chance of increased risk of injury. The proportion of pain (34.1%) and pressure injury in the sacrococcygeal region (91.7%) stood out in patients at higher risk (p=0.05). Conclusion: obese and elderly people had a higher risk of injury. Pain and occurrence of pressure injury in the sacrococcygeal region were the predominant complications in patients at higher risk.Objetivo: relacionar o escore de risco de lesões por posicionamento cirúrgico decorrentes da posição supina com aspectos sociodemográficos, clínicos, cirúrgicos e ocorrência de complicações. Método: estudo observacional longitudinal realizado com 89 pacientes em decúbito dorsal. Aplicadas variáveis ​​sociodemográficas e clínicas e a Escala de Risco para Desenvolvimento de Lesões por Posicionamento Cirúrgico. Adotadas análises descritivas, bivariadas e de regressão logística, considerando-se um nível de significância de α=0,05. Resultados: a idade aumentou em 1,11 vezes (p<0,001) e a obesidade em 13,77 vezes (p=0,01) a chance de aumento do risco de lesões. A proporção de dor (34,1%) e lesão por pressão na região sacrococcígea (91,7%) destacou-se nos pacientes de maior risco (p=0,05). Conclusão: obesos e idosos apresentaram maior risco de lesões. Dor e ocorrência de lesão por pressão na região sacrococcígea foram as complicações predominantes nos pacientes de maior risco

Governança do Conhecimento (GovC): o estado da arte sobre o termo

Objective. In the contemporary organizational context sharing and knowledge transfer play a significant role and it is therefore important to overcome the internal and external barriers for processing. This can be facilitated by the implementation of Knowledge Governance (GovC), an emerging interdisciplinary approach that goes through the fields of knowledge management, organizational studies, strategy and human resources management. The problem is that, besides being a new construct and still little studied in Brazil, conceptual differences are fed by the breadth of possible dimensions of analysis. In this context, the objective of this study is to identify the conceptualization of the Knowledge Governance construct proposed in the scientific literature to support its better understanding and to base future research in the area of knowledge managementMethod. For this, a theoretical research was carried out through a systematic review of the literature, followed by bibliometric and descriptive analysis of the most relevant publications on the subject.Results. The objective was achieved and it is possible to identify the conceptualization, besides the principles and mechanisms of GovC proposed in the literature.Conclusions. It is considered the discussion about the relevant GovC construct in the context of contemporary organizations, however, it indicates the importance of future empirical and theoretical studies in order to foment the discussions on the subject nowadays.Objetivo. En el contexto organizacional contemporáneo el reparto y la transferencia del conocimiento tienen un papel significativo y, por eso, es importante superar las barreras internas y externas para que estos sean procesados. Lo que puede ser facilitado con la implantación de la gobernanza del conocimiento (GovC), un abordaje interdisciplinar emergente, que atraviesa los campos de la gestión del conocimiento, los estudios de organización, estrategia y gestión de recursos humanos. El problema es que, además de ser un construto nuevo y aún poco estudiado en Brasil, se alimentan divergencias conceptuales por la amplitud de dimensiones de análisis posibles. En este contexto, surge el objetivo de este estudio, que es, identificar la concepción del construto gobernanza del conocimiento propuesta en la literatura científica para apoyar su mejor comprensión y fundamentar futuras investigaciones en el área de gestión del conocimiento.Método. Para ello, fue realizada una investigación teórica por medio de una revisión sistemática de la literatura, seguida de un análisis bibliométrico y descriptivo de las publicaciones más relevantes sobre el tema.Resultados. El objetivo fue alcanzado siendo posible identificar la concepción, además de los principios y de los mecanismos de GovC propuestos por la literatura.Conclusiones. Se considera la discusión sobre el constructo GovC pertinente en el contexto de las organizaciones contemporáneas, sin embargo, se señala la importancia de estudios futuros de orden empírica y teórica de modo que fomente las discusiones sobre el tema en la actualidad.Objetivo. No contexto organizacional contemporâneo o compartilhamento e a transferência do conhecimento têm um papel significativo e, por isso, é importante superar as barreiras internas e externas para que estes sejam processados. O que pode ser facilitado com a implantação da Governança do Conhecimento (GovC), uma abordagem interdisciplinar emergente, que atravessa os campos da gestão do conhecimento, os estudos de organização, estratégia e gestão de recursos humanos. O problema é que, além de ser um construto novo e ainda pouco estudado no Brasil, alimentam-se divergências conceituais pela amplitude de dimensões de análise possíveis. Neste contexto, surge o objetivo deste estudo, que seja, identificar a conceituação do construto Governança do Conhecimento proposta na literatura científica para apoiar sua melhor compreensão e embasar futuras pesquisas na área de gestão do conhecimento.Método. Para tal, foi realizada uma pesquisa teórica por meio de uma sistemática revisão da literatura, seguida de análise bibliométrica e descritiva das publicações mais relevantes sobre o tema.Resultados.  O objetivo foi alcançado sendo possível identificar a conceituação, além dos princípios e dos mecanismos de GovC propostos pela literatura.Conclusões. Considera-se a discussão sobre o constructo GovC pertinente no contexto das organizações contemporâneas, no entanto, sinaliza-se a importância de estudos futuros de ordem empírica e teórica de modo a fomentar as discussões sobre o assunto na atualidad

Comparison of visual and auditory modalities for Upper-Alpha EEG-Neurofeedback

Electroencephalography (EEG) neurofeedback (NF) training has been shown to produce long-lasting effects on the improvement of cognitive function as well as the normalization of aberrant brain activity in disease. However, the impact of the sensory modality used as the NF reinforcement signal on training effectiveness has not been systematically investigated. In this work, an EEG-based NF training system was developed targeting the individual upper alpha (UA) band and using either a visual or an auditory reinforcement signal, so as to compare the effects of the two sensory modalities. Sixteen healthy volunteers were randomly assigned to the Visual or Auditory group, where a radius varying sphere or a volume-varying sound, respectively, reflected the relative amplitude of UA measured at EEG electrode Cz. Each participant underwent a total of four NF sessions, of approximately 40 min each, on consecutive days. Both groups showed significant increases in UA at Cz within sessions, and also across sessions. Effects subsequent to NF training were also found beyond the target frequency UA and scalp location Cz, namely in the lower-alpha and theta bands and in posterior brain regions, respectively. Only small differences were found on the EEG between the Visual and Auditory groups, suggesting that auditory reinforcement signals may be as effective as the more commonly used visual signals. The use of auditory NF may potentiate training protocols conducted under mobile conditions, which are now possible due to the increasing availability of wireless EEG systems.info:eu-repo/semantics/publishedVersio

Education, Adult Skills and Social Outcomes: Empirical evidence from the Survey on Adult Skills (PIAAC 2013)

It has widely been acknowledged that education is a major source of economic prosperity and social well-being. Education is not only an important factor in the productivity and innovative capacity of an economy, but is also a prerequisite for social and cultural changes in patterns of consumption and leisure behaviour to achieve a sustainable lifestyle. It puts people in a position to take well-informed decisions about the future, to assume responsibility for these decisions and to judge how their personal behaviour will affect future generations. Thus, we are then well aware that education gives access to knowledge that helps individuals and society to be more stable and resilient in times of change. These social returns can take the form of “market outcomes” such as productivity or earnings and “non-market outcomes” such as health, civic participation and more generally social capital. Deeper understanding of the contribution of education to the provision of these social outcomes is a desirable goal. While the educational system is the primary agent for the acquisition of such knowledge, learning may also take place in the family, the workplace and among our social acquaintances all throughout our live. Nowadays, constant changes taking place in society encourage individuals that besides grasping occupation-specific skills they must also stock some other various information processing skills to help them cope with this rapid changing environment, especially in the labor market. The Survey of Adult Skills (PIAAC) was designed to provide information on some these key skills in society. It directly measures proficiency in several information-processing skills –namely literacy, numeracy and problem solving in technology-rich environment. Simultaneously, it provides insights on key social outcomes such as the level of trust in others, participation in associative, religious, political or charity activities (volunteering), political efficacy or the sense of influence on the political process, and self-assessed health status. The main findings on the relationship between education in its different forms (years of attainment, skills and adult lifelong learning) and the different social outcomes are presented in this report.JRC.DDG.01-Econometrics and applied statistic