CREDIBILIDADE EMPRESARIAL: UMA REVISÃO BIBLIOGRÁFICA DOS CONCEITOS E DAS METODOLOGIAS DE PESQUISA

O presente trabalho analisa contribuições científicas sobre o tema credibilidade empresarial, abordando os conceitos, as dimensões e as metodologias privilegiadas nelas. Apesar da crescente importância desse tema, associado a assuntos como o comportamento do consumidor, a responsabilidade socioambiental e o consumo sustentável, ele ainda é pouco discutido e estudado no Brasil. Baseado em uma revisão bibliográfica, o estudo utiliza principalmente fontes da literatura internacional. Verificou-se que as dimensões que compõem a credibilidade baseiam-se em dois modelos: o modelo da atratividade da fonte, referindo-se à atratividade física do comunicador de uma mensagem; e o modelo de credibilidade, evidenciando a credibilidade composta pelas dimensões: competência e confiabilidade. Entre as metodologias encontradas, a abordagem quantitativa é majoritária, enfatizando a influência da credibilidade da empresa nas atitudes envolvendo a marca e a propaganda, bem como na intenção de compra. Destacam-se como variáveis de estudo: gênero, envolvimento com o produto, categoria de produto e nível socioeconômico; contexto no qual cada empresa atua encontra-se inserido; fatores cognitivos e afetivos; a percepção da organização; a percepção das questões que envolvem a organização e a percepção que os consumidores têm de si mesmos

Risk of pre-eclampsia in women taking metformin: a systematic review and meta-analysis

© 2017 Diabetes UK Aims: To perform meta-analyses of studies evaluating the risk of pre-eclampsia in high-risk insulin-resistant women taking metformin prior to, or during pregnancy. Methods: A search was conducted of the Medline, EMBASE, Web of Science and Scopus databases. Both randomized controlled trials and prospective observational cohort studies of metformin treatment vs. placebo/control or insulin either prior to or during pregnancy were selected. The main outcome measure was the incidence of pre-eclampsia in each treatment group. Results: Overall, in five randomized controlled trials comparing metformin treatment (n = 611) with placebo/control (n = 609), no difference in the risk of pre-eclampsia was found [combined/pooled risk ratio (RR), 0.86 (95% CI 0.33–2.26); P = 0.76; I2 = 66%]. Meta-analysis of four cohort studies again showed no significant effect [RR, 1.21 (95% CI 0.56–2.61); P = 0.62; I2 = 30%]. A meta-analysis of eight randomized controlled trials comparing metformin (n = 838) with insulin (n = 836), however, showed a reduced risk of pre-eclampsia with metformin [RR, 0.68 (95% CI 0.48–0.95); P = 0.02; I2 = 0%]. No heterogeneity was present in the metformin vs. insulin analysis of randomized controlled trials, whereas high levels of heterogeneity were present in studies comparing metformin with placebo/control. Pre-eclampsia was a secondary outcome in most of the studies. The mean weight gain from time of enrolment to delivery was lower in the metformin group (P = 0.05, metformin vs. placebo; P = 0.004, metformin vs. insulin). Conclusions: In studies randomizing pregnant women to glucose-lowering therapy, metformin was associated with lower gestational weight gain and a lower risk of pre-eclampsia compared with insulin

Treatments for gestational diabetes: a systematic review and meta-analysis

Objective To investigate the effectiveness of different treatments for gestational diabetes mellitus (GDM). Design Systematic review, meta-analysis and network meta-analysis. Methods Data sources were searched up to July 2016 and included MEDLINE and Embase. Randomised trials comparing treatments for GDM (packages of care (dietary and lifestyle interventions with pharmacological treatments as required), insulin, metformin, glibenclamide (glyburide)) were selected by two authors and double checked for accuracy. Outcomes included large for gestational age, shoulder dystocia, neonatal hypoglycaemia, caesarean section and pre-eclampsia. We pooled data using random-effects meta-analyses and used Bayesian network meta-analysis to compare pharmacological treatments (ie, including treatments not directly compared within a trial). Results Forty-two trials were included, the reporting of which was generally poor with unclear or high risk of bias. Packages of care varied in their composition and reduced the risk of most adverse perinatal outcomes compared with routine care (eg, large for gestational age: relative risk0.58 (95% CI 0.49 to 0.68; I2=0%; trials 8; participants 3462). Network meta-analyses suggest that metformin had the highest probability of being the most effective treatment in reducing the risk of most outcomes compared with insulin or glibenclamide. Conclusions Evidence shows that packages of care are effective in reducing the risk of most adverse perinatal outcomes. However, trials often include few women, are poorly reported with unclear or high risk of bias and report few outcomes. The contribution of each treatment within the packages of care remains unclear. Large well-designed and well-conducted trials are urgently needed. Trial registration number PROSPERO CRD42013004608

A randomized clinical trial comparing metformin and insulin for the treatment of gestational diabetes

Objetivo: Avaliar o controle glicêmico em pacientes que utilizaram metformina ou insulina para tratamento do diabetes gestacional, identificando fatores preditores da necessidade de insulina complementar nas pacientes que tiveram, como terapêutica inicial, a metformina. Método: pacientes com DG que não obtiveram controle glicêmico com dieta e exercícios físicos foram randomizadas para receber metformina (n=46) ou insulina (n=46). Os critérios de inclusão foram: gestação única, realização de dieta e exercícios físicos por período mínimo de uma semana, sem controle glicêmico satisfatório, ausência de fatores de risco para acidose láctica, ausência de anormalidades anatômicas e/ou cromossômicas do produto conceptual. Foram excluídas as gestantes que apresentaram perda de seguimento pré-natal. Resultado: A comparação das médias glicêmicas pré-tratamento medicamentoso não mostrou diferença estatisticamente significativa entre os grupos (p=0,790). Porém, após a introdução dos medicamentos, foram observados médias glicêmicas menores no grupo metformina, ao longo do dia (p=0,020), principalmente, após o jantar (p=0,042). Pacientes que utilizaram metformina tiveram menor ganho de peso (p=0,002) e, também, menor frequência de hipoglicemia neonatal (p=0,032). Doze pacientes do grupo metformina (26,08%) necessitaram de insulina complementar para controle glicêmico. A idade gestacional precoce (odds ratio 0,71, CI95% 0,52-0,97; p=0,032) e a média glicêmica pré-tratamento medicamentoso (odds ratio 1,061, CI95% 1,001-1,124; p=0,046) foram identificadas como preditoras da necessidade de insulina complementar. Conclusão: A metformina foi eficaz em propiciar controle glicêmico adequado, com menor ganho de peso e menor frequência de hipoglicemia neonatal. Foi identificado grupo de pacientes com maior probabilidade de necessitar de complementação com insulina para atingir controle glicêmicoObjective: To evaluate glycemic control in women receiving metformin or insulin for the treatment of gestational diabetes, and to identify factors predicting the need for supplemental insulin in women initially treated with metformin. Methods: Women with gestational diabetes who did not achieve glycemic control with diet and exercise were randomized to receive either metformin (n=46) or insulin (n=46). Criteria for inclusion were singleton pregnancy, diet and exercise for a minimum period of one week without satisfactory glycemic control, absence of risk factors for lactic acidosis, and absence of anatomic and/or chromosome anomalies of the conceptus. Patients who were lost to prenatal follow-up were excluded. Results: Comparison of mean pretreatment glucose levels showed no significant difference between groups (P=.790). However, lower mean glucose levels across the day were observed in the metformin group after introduction of the drug (P=.020), especially after dinner (P=.042). Women using metformin presented less weight gain (P=.002) and a lower frequency of neonatal hypoglycemia (P=.032). Twelve women in the metformin group (26.08%) required supplemental insulin for glycemic control. Early gestational age (OR=0.71, 95%CI: 0.52-0.97; P=.032) and mean pretreatment glucose level (OR=1.061, 95%CI: 1.001-1.124; P=.046) were identified as predictors of insulin need. Conclusion: Metformin was found to provide adequate glycemic controlwith lower mean glucose levels across the day, less weight gain and a lower frequency of neonatal hypoglycemia. Logistic regression analysis showed that gestational age at diagnosis and mean pretreatment glucose level were predictors of the need for supplemental insulin therapy in women initially treated with metformi

Solidarity and human nature

The concept of solidarity inhabits the collective unconscious and is usually related to something consensual, linked to the most basic values of mankind, but to expand that understanding leads to more complex views. Human solidarity would be conditioned by biological, or cultural issue that goes beyond any possible biological determinism. This study seeks to analyze the phenomenon of solidarity and its correlation with life in society from the perspective of complexity, through a cross-sectional analysis in order to cover the phenomenon in question from different perspectives. For that, we appealed to sociobiology, and the social sciences interpretation. We tried to thereby renounce the sole idea and permanent solution, by approaching to the assumptions of complex thinking, which rely precisely to overcome a single organizing principle or a single cause to explain the same phenomenon. It noticed the need of new societal experiences, which would block the advance of competitive individualist paradigm as the sole alternative, highlighting the experiences of the solidarity economy and third sector organizations that have a new business logic, a third social force among the state and the market.</p

Oral Cancer Knowledge Assessment: Newly Graduated versus Senior Dental Clinicians

The present study assessed the level of dentists’ knowledge regarding oral cancer in the city of São Paulo, Brazil. A questionnaire was used to compare the level of knowledge among newly graduated and senior clinicians. A total of 20,154 e-mails were correctly delivered to the dentists registered in the database of the Regional Dentistry Council of São Paulo, and 477 (2.36%) responses were received. This sample consisted of 84 newly graduated clinicians and 105 senior clinicians. For the statistical analysis, the chi-square test and the logistic regression analysis were performed with α = 0.05, and the results were described herein. According to their knowledge level, the results were statistically different between the groups, since 19% of the newly graduated clinicians were evaluated with knowledge grade A (excellent) in comparison to 6.7% of the senior clinicians. In spite of the results indicated that newly graduated clinicians’ knowledge regarding oral cancer was 2.1 times higher, 34.5% of the professionals in this group had regular or poor knowledge on the subject, and several questions relating to clinical characteristics and risk factors indicated that there still exist some knowledge gaps, demonstrating that there is a need for further studies and information activities addressing oral cancer

Teoria da Complexidade e as múltiplas abordagens para compreender a realidade social

Este ensaio é produto de uma reflexão sobre as múltiplas abordagens, que se contrapõe ao reducionismo e ao determinismo positivista hegemônico. Propõe-se a auxiliar na compreensão de como a Teoria da Complexidade apresenta-se como um modelo epistêmico mais frutífero para as ciências sociais à medida que apresenta uma visão mais complexa e ampliada da realidade. Parte-se, no entanto, num primeiro momento, da premissa de que a teoria geral dos sistemas, antes mesmo que o pensamento complexo, propõe-se a romper com o reducionismo, o mecanicismo e o determinismo clássico, mas falha justamente onde o primeiro é mais avassalador para a prática sócia l– na capacidade que este demonstrou durante longos anos de manter a regulação e a ordem vigente. Contudo, sem intencionar apresentar a Teoria da Complexidade como uma alternativa definitiva ao pensamento ortodoxo, faz-se um paralelo entre esta e a dialética marxista, com a qual, ao mesmo tempo em que parece dialogar, diverge num aspecto fundamental – a forma de conceber a mudança social – e a partir disto adentra-se na discussão sobre seu possível relativismo.</p