>Magister Scientiae - MSc / Healthcare professionals (HCPs) have a primary role to play in the detection, assessment and spontaneous reporting of adverse drug reactions (ADRs). An improvement of their related knowledge, attitude and practice concerning pharmacovigilance and ADR reporting is vital. The objective of the study was to determine whether or not pharmacovigilance training, provided by a Pharmaceutical Company, would improve HCP’s perceptions and adherence to pharmacovigilance and ADR reporting. A quasi-experimental research design was used. A total of 44 HCPs participated in the study. Participants were divided into two groups: an experimental group that received pharmaceutical training intervention; and a control group that did not receive any training. Using a self-administered questionnaire before and after the training intervention assessed the knowledge, attitudes, and practice of pharmacovigilance and ADR reporting displayed amongst the HCPs.

Burnout in healthcare professionals (HCPs) can negatively affect HCPs’ health and the overall functioning of the healthcare system. Of great concern is the negative effect of HCP burnout on psychological, cognitive, and work-relevant functioning. Mindfulness-based interventions have been shown to decrease burnout in HCPs and preliminary evidence suggests they may improve work-relevant outcomes. However, the literature is limited by methodological issues and generalizability concerns. The current pragmatic trial investigated feasibility, acceptability, and effectiveness of Mindfulness for Interdisciplinary Healthcare Professionals (MIHP) using a partially randomized, waitlist-controlled, crossover design [intention-to-treat sample: 22 in the mindfulness group (MG), 26 in the control group (CG)] on psychological, cognitive, and interprofessional measures. The present study also included an explanatory aim evaluating mindfulness practice time and practice quality as mediators of change. Within-group changes were assessed with the combined crossover data for mediation and three-month follow-up analyses. Finally, the present study explored the perceived effects of MIHP and how MIHP had its effects using a grounded theory approach. Results found mixed evidence for feasibility and acceptability. Small to large effects were found for the MG on outcomes of burnout, perceived stress, and mindfulness. These effects were present with groups combined and remained at the follow-up. No effect of MIHP was found on cognitive or interprofessional outcomes. Practice time and quality were not significant mediators of main effects. A grounded theory model is proposed for how MIHP may exert its positive effects within the context of healthcare.

Abstract Introduction and Background: Euthanasia has expanded significantly around the world over the past years. The debate concerning euthanasia has focused on the legalization, complex issues faced by the medical team, and perspective on assisted dying. Euthanasia known as assisted suicide is a deliberate medical procedure of intentionally withholding treatment or withdrawing life-support measures to end the life of a suffering patient. Purpose Statement: To define euthanasia and its background as well as discuss the psychological and moral effects that surround the subject. Literature Review: Five articles were selected. Quantitative and exploratory qualitative studies were obtained from existing literature, collection of data and statistics from relevant publications, peer-reviewed analysis, and original research papers with a focus on psychological and moral effects on participating, healthcare professionals. Findings: Participation in euthanasia can have significant emotional and psychological impacts on participating healthcare professionals which can lead to long-term personal and professional effects. Some are unsupportive of this practice while some were supportive of it. Conclusion: Despite the importance of this topic to medical practice, there are limited studies on addressing the psychological and moral impacts of euthanasia on participating healthcare professionals. Future research needs to explore how health professionals are negatively emotionally affected by their involvement in assisted suicide

No / Nigerian health professionals are impacted by several global forces bearing down on them, one of which is the positive economic prospects associated with emigrating to work abroad. This emigration is an aspect of increased global mobility which has had an adverse effect on the Nigerian health economy. This is important globally because countries with the smallest healthcare workforce capacities such as Nigeria have the poorest health outcomes. The emigration of health professionals from Nigeria will continue until domestic structures such as improved healthcare infrastructures, job security, and financial rewards change for the better. Thus, it is important that measures aimed at supporting the Nigerian health workforce be implemented with a focus on building and managing for sustainability within the context of international interdependency. Accordingly, this chapter is aimed at creating a theoretical framework for building capacities and managing the challenges of the Nigerian health workforce vis-à-vis the opportunities offered by globalization.

Typical hospital setups comprise units such as clinics, inpatient wards, outpatient services, casualty services, operating theatres, laboratories, medical schools (for university hospitals) and out-reach medical camps. Healthcare professionals are required to support these different units hence the need to be constantly mobile in undertaking their duties. These duties require that they frequently consult colleagues, receive handover from previous duty staff or share information on previous work undertaken. Successful use and adoption of handheld devices such as PC tablets, PDAs and smartphones integrated to health information systems can minimize the physical mobility. Information sharing using M-health solutions in complex and diverse healthcare settings draw focus beyond the spatiality gains to the coordination of the teams, processes and shared artefacts in healthcare. CSCW research abounds with various concepts that can be useful in characterizing mobility and communication amongst collaborating health workers. Design for mobile health solutions, therefore, provides an opportunity to further ground theoretical frameworks from exemplary studies on health information systems. The overall objective of the study is to propose design suggestions that target successful information sharing in the deployment and use of M-health solutions. To achieve this objective, the thesis investigates and analyses factors influencing the use and adoption of M-health solutions. A qualitative literature review is used in the study to explore significant factors in the acceptance and use of health information systems. A questionnaire developed from these key factors is used to determine the perceptions of healthcare professionals on M-health solutions based on related literature and on a field study. Finally, the findings are discussed using concepts from CSCW literature namely, mobility, common information spaces, temporality and cognitive and coordinative artefacts. As a result, a conceptual model integrating constructs from the Technology acceptance model (TAM) and IS Success model was developed that can be useful in investigating perceptions in the use of M-health solutions. Design suggestions were proposed for the development of future M-health solutions that aim to achieve successful information sharing amongst healthcare professionals.

Class of 2012 Abstract / Specific Aims: To identify and assess cultural competency courses for healthcare professionals that are available to pharmacy students. Methods: A literature review was performed to identify research articles discussing pharmacy courses in health care disparities. Additionally, a systematic review of all curricula for ACPE accredited schools of pharmacy was conducted and these syllabi were subsequently evaluated. Main Results: The search identified XXX articles focusing on specific health disparities curricula in schools of pharmacy and XXX syllabi about specific courses. Out of those articles and syllabi XXX were included in the analysis. Results are pending. Conclusions: Anticipated results will be utilized to design effective health disparities curricula at the University of Arizona College of Pharmacy.

A fragmentação do trabalho em saúde, atualmente, tem sido muito estudada. Os estudos apontam que esta além de esvaziar o trabalho de sentido, gerando conseqüências emocionais para os profissionais, trás repercussões na vida dos pacientes, uma vez que, entre outras coisas, prioriza os aspectos técnicos do atendimento em detrimento dos aspectos psicossocias. Considerando que a infecção ao HIV trás desdobramentos psicossociais na vida da pessoa contaminada, a atuação voltada para estes aspectos torna-se primordial. Assim sendo, este estudo tem como objetivo recuperar a síntese do processo de trabalho em HIV/Aids a partir dos profissionais envolvidos neste processo. Dentro da abordagem de pesquisa qualitativa foram realizadas 10 entrevistas com profissionais da Unidade Especial de Tratamento de Doenças Infecciosas do HC de Ribeirão Preto. Estas foram semi-estruturadas e realizadas segundo procedimentos de evocação-enunciação-verificação. As falas dos profissionais foram agrupadas conforme as semelhanças de seus conteúdos temáticos e analisadas à luz do materialismo histórico. Os dados mostraram que três Elementos constituem a síntese do processo de trabalho em HIV/Aids: Elementos de Competência Psicossocial; Elementos de Controle Sócio-Político e Administrativo; Elementos de Competência Técnica. Embora os profissionais estudados tenham privilegiado em suas reflexões os Elementos de Competência Psicossocial, a dicotomia entre habilidade técnica e competência psicossocial se faz presente na atuação. Todavia com novas configurações, pois não há a negação destes aspectos e estes não pareceram ser relegados a segundo plano. No entanto, as reflexões apontaram a dificuldade da atuação contemplando plenamente estes aspectos. Estas dificuldades embora tenham como fundamento a fragmentação do saber, conseqüentemente associam-se a estruturação do serviço que se liga às formas protocolares de controle do trabalho em todos os seus níveis. Desta forma, o trabalho se dá a partir da complementariedade de abordagens. Esta fragmentação, além de prejudicar a qualidade do atendimento prestado, dificulta o sentimento de apropriação do trabalho por parte do profissional. Assim sendo, consideramos que a sistematização da aprendizagem informal decorrente da atuação seria uma das alternativas para esta questão. Esta tornaria os profissionais mais ativos no processo de trabalho o que favoreceria a apropriação deste e tornaria a equipe de trabalho mais coesa, uma vez que juntos, os profissionais estariam construindo sua práxis. Além disto, este estudo nos deu a visibilidade que, em algumas situações, a relação estabelecida entre profissional e paciente propicia esta aprendizagem. No entanto, sabemos que a implementação de tal proposta não será fácil, haja visto que rompe com o modelo de atuação vigente e com a estruturação do ensino em saúde, no qual o saber é compartimentado não havendo espaço na atuação para os sentimentos dos profissionais nem dos pacientes. No entanto, observamos que estes sentimentos, entre outras coisas, tem que ser o pano de fundo da atuação. Desta forma, consideramos também, que se faz necessária a discussão em grupo dos sentimentos suscitados pela atuação, pois estes seriam socializados e discutidos entre pessoas que passam pelas mesmas vivências. Isto minimizaria os desdobramentos destes na vida dos profissionais e favoreceria a atuação voltada para os aspectos psicossociais. / Nowadays the fragmentation of health work has been studied a lot. Studies point out that besides giving no sense to work, fragmentation brings emotional consequences to healthcare professionals and results in changes into patients life, because it privileges the technical aspects of care in detriment of psychosocial aspects. Considering that HIV infection results in many psychosocial problems to people living with HIV/Aids, it is primordial to give more attention to these aspects. Therefore, this study aims the recuperation of HIV/Aids work process synthesis considering first all professionals who are involved in this process. Qualitative analysis was the methodological strategy and it included 10 healthcare professionals of Special Unit of Infectious Diseases of HC of Ribeirão Preto. The analysis was semi-structured and according to procedures of evocation- enunciation- verification. The discourses of the professionals were grouped according to thematic contents, and analyzed by historical materialism. Data showed that three Elements constitute work process synthesis in HIV/Aids: Elements of Psychosocial Competency; Elements of Administrative and Socio-Political Control; Elements of Technical Competency. Although the healthcare professionals showed emphasis on reflections about Elements of Psychosocial Competency, the dichotomy between technical skill and psychosocial competency is presented in the during work, but it brings different aspects because there is no denial of any of them, and they do not seem to be relegated as a second place. However, the reflections indicate difficulties in fully consider these aspects during patients care. Although these difficulties are based on fragmentation of knowledge, consequently it is associated with service structure which is linked to work control protocols. The fragmentation impairs patient treating quality and raises objections to healthcare professionals feelings of misappropriation of their job. In such case, we consider that the systematization of informal learning according to work practice would be one of the alternatives, which would result into more functional healthcare professionals and cohesive work teams, and they would be building together their praxis. Furthermore, this study shows that, in some situations, the relationship between patient and healthcare professionals favors this learning. Nevertheless, we are aware that such implementation is not an easy task, because it is not according to the model in vigor, nor to health teaching structure that does not take account patients or professionals feelings. These feelings, among other issues, must be considered during healthcare professionals work. So, we consider the necessity of a group discussion about feelings raised by the work practice, because they would be discussed and socialized among people who have experienced the same situations. This would minimize the problems faced by these healthcare professionals and it would favor psychosocial aspects during work practice.

A fragmentação do trabalho em saúde, atualmente, tem sido muito estudada. Os estudos apontam que esta além de esvaziar o trabalho de sentido, gerando conseqüências emocionais para os profissionais, trás repercussões na vida dos pacientes, uma vez que, entre outras coisas, prioriza os aspectos técnicos do atendimento em detrimento dos aspectos psicossocias. Considerando que a infecção ao HIV trás desdobramentos psicossociais na vida da pessoa contaminada, a atuação voltada para estes aspectos torna-se primordial. Assim sendo, este estudo tem como objetivo recuperar a síntese do processo de trabalho em HIV/Aids a partir dos profissionais envolvidos neste processo. Dentro da abordagem de pesquisa qualitativa foram realizadas 10 entrevistas com profissionais da Unidade Especial de Tratamento de Doenças Infecciosas do HC de Ribeirão Preto. Estas foram semi-estruturadas e realizadas segundo procedimentos de evocação-enunciação-verificação. As falas dos profissionais foram agrupadas conforme as semelhanças de seus conteúdos temáticos e analisadas à luz do materialismo histórico. Os dados mostraram que três Elementos constituem a síntese do processo de trabalho em HIV/Aids: Elementos de Competência Psicossocial; Elementos de Controle Sócio-Político e Administrativo; Elementos de Competência Técnica. Embora os profissionais estudados tenham privilegiado em suas reflexões os Elementos de Competência Psicossocial, a dicotomia entre habilidade técnica e competência psicossocial se faz presente na atuação. Todavia com novas configurações, pois não há a negação destes aspectos e estes não pareceram ser relegados a segundo plano. No entanto, as reflexões apontaram a dificuldade da atuação contemplando plenamente estes aspectos. Estas dificuldades embora tenham como fundamento a fragmentação do saber, conseqüentemente associam-se a estruturação do serviço que se liga às formas protocolares de controle do trabalho em todos os seus níveis. Desta forma, o trabalho se dá a partir da complementariedade de abordagens. Esta fragmentação, além de prejudicar a qualidade do atendimento prestado, dificulta o sentimento de apropriação do trabalho por parte do profissional. Assim sendo, consideramos que a sistematização da aprendizagem informal decorrente da atuação seria uma das alternativas para esta questão. Esta tornaria os profissionais mais ativos no processo de trabalho o que favoreceria a apropriação deste e tornaria a equipe de trabalho mais coesa, uma vez que juntos, os profissionais estariam construindo sua práxis. Além disto, este estudo nos deu a visibilidade que, em algumas situações, a relação estabelecida entre profissional e paciente propicia esta aprendizagem. No entanto, sabemos que a implementação de tal proposta não será fácil, haja visto que rompe com o modelo de atuação vigente e com a estruturação do ensino em saúde, no qual o saber é compartimentado não havendo espaço na atuação para os sentimentos dos profissionais nem dos pacientes. No entanto, observamos que estes sentimentos, entre outras coisas, tem que ser o pano de fundo da atuação. Desta forma, consideramos também, que se faz necessária a discussão em grupo dos sentimentos suscitados pela atuação, pois estes seriam socializados e discutidos entre pessoas que passam pelas mesmas vivências. Isto minimizaria os desdobramentos destes na vida dos profissionais e favoreceria a atuação voltada para os aspectos psicossociais. / Nowadays the fragmentation of health work has been studied a lot. Studies point out that besides giving no sense to work, fragmentation brings emotional consequences to healthcare professionals and results in changes into patients life, because it privileges the technical aspects of care in detriment of psychosocial aspects. Considering that HIV infection results in many psychosocial problems to people living with HIV/Aids, it is primordial to give more attention to these aspects. Therefore, this study aims the recuperation of HIV/Aids work process synthesis considering first all professionals who are involved in this process. Qualitative analysis was the methodological strategy and it included 10 healthcare professionals of Special Unit of Infectious Diseases of HC of Ribeirão Preto. The analysis was semi-structured and according to procedures of evocation- enunciation- verification. The discourses of the professionals were grouped according to thematic contents, and analyzed by historical materialism. Data showed that three Elements constitute work process synthesis in HIV/Aids: Elements of Psychosocial Competency; Elements of Administrative and Socio-Political Control; Elements of Technical Competency. Although the healthcare professionals showed emphasis on reflections about Elements of Psychosocial Competency, the dichotomy between technical skill and psychosocial competency is presented in the during work, but it brings different aspects because there is no denial of any of them, and they do not seem to be relegated as a second place. However, the reflections indicate difficulties in fully consider these aspects during patients care. Although these difficulties are based on fragmentation of knowledge, consequently it is associated with service structure which is linked to work control protocols. The fragmentation impairs patient treating quality and raises objections to healthcare professionals feelings of misappropriation of their job. In such case, we consider that the systematization of informal learning according to work practice would be one of the alternatives, which would result into more functional healthcare professionals and cohesive work teams, and they would be building together their praxis. Furthermore, this study shows that, in some situations, the relationship between patient and healthcare professionals favors this learning. Nevertheless, we are aware that such implementation is not an easy task, because it is not according to the model in vigor, nor to health teaching structure that does not take account patients or professionals feelings. These feelings, among other issues, must be considered during healthcare professionals work. So, we consider the necessity of a group discussion about feelings raised by the work practice, because they would be discussed and socialized among people who have experienced the same situations. This would minimize the problems faced by these healthcare professionals and it would favor psychosocial aspects during work practice.

Introdução. O tabagismo é considerado atualmente um problema mundial de saúde pública, que extrapola a dimensão fisiológica e psicológica. Assim, é compreendido como um fenômeno social a ser explorado por diferentes áreas do conhecimento. Para a Organização Mundial da Saúde (OMS) faz-se necessário mudar o curso da exposição mundial ao tabagismo, considerando os profissionais da saúde como importantes personagens nas ações antitabagistas. Segundo a OMS, esses profissionais são vistos como igualmente intervenientes no processo de educação em saúde e combate ao tabagismo junto à sociedade, sendo então importante priorizar estudos e ações também com estudantes de cursos da área da saúde, que estarão, em um futuro próximo, trabalhando junto à população. Portanto, torna-se importante a aproximação de suas representações, crenças e visões do processo saúde/doença aos programas de combate ao fumo. Objetivo. Analisar as representações sociais sobre o tabagismo em estudantes de cursos da área da saúde no Brasil e na Espanha. Método. Trata-se de um estudo qualiquantitativo realizado com 163 estudantes em fase de conclusão de cursos da área da saúde. Os dados foram obtidos através de triangulação metodológica com uso dos instrumentos Desenho Temático e Discurso do Sujeito Coletivo em universidades particulares no Brasil e universidades públicas na Espanha, coletados entre agosto de 2013 e maio de 2014. Utilizando a teoria das Representações Sociais, foram criadas categorias a partir dos resultados obtidos em cada um dos instrumentos, e posteriormente analisadas e discutidas com outros estudos na mesma temática. Resultados e Discussão. A identificação das representações sociais permitiu reconhecer uma importante mudança: fumar já não é mais visto como um comportamento positivo elegante e charmoso -, os participantes apresentaram diversas críticas ao comportamento de fumar, especialmente no que se refere ao comportamento de profissionais da saúde, vistos por eles como modelos para a população, principalmente no que se refere à comportamentos saudáveis. Embora se tratando de grupos de culturas diferentes, não foram encontradas diferenças significativas entre as representações dos estudantes do Brasil e da Espanha. Considerações Finais. As informações resultantes do estudo permitem contribuir para o planejamento de programas de educação em saúde principalmente para grupos universitários e de estudantes da área da saúde, bem como auxiliar os programas de cessação do tabagismo. / Introduction. Currently, smoking is considered a worldwide public health problem, which extrapolates the physiological and psychological dimension. Therefore, smoking is understood as a social phenomenon to be explored by different areas of knowledge. The World Health Organization (WHO) considers that a change in the trend of global exposition towards smoking is needed, aiming and considering the healthcare professional as important key roles for antismoking actions. According to WHO, these professionals are viewed as equally capable in meddling the promotion of health education and in combating smoking altogether with the society. Consequently, it is important to prioritize actions and studies engaging students of healthcare related areas, who will be working with people in the society in the near future. Therefore, it becomes important, to make closer their representations, beliefs and thinking from healthy/illness process into antismoking programs. Objective. Analyze the social representations about smoking habits within students of healthcare areas, in Brazil and Spain. Methodology. This research was qualitative-quantitative study with 163 students in its final stages of the undergraduate health care program. Data were collected between August 2013 and May 2014, at private universities in Brazil and public universities in Spain, through triangulation methodology using the following instruments: Thematic Drawing with story and Discourse of Collective Subject. Using the Social Representation Theory, categories were created through the results of each instrument and then, analyzed and discussed with studies within similar thematic. Results and discussion. The identification of social representations allowed recognizing an important change: smoking is no longer seen as a positive behavior - elegant and charming. Participants presented several critiques to smoking habits, especially when the smoking habits are related to healthcare professionals, who are viewed as models of healthy habits. Although there are differences in the cultural background of those two groups, there were not found any significant divergences in the representations of Brazilian and Spanish students. Final Considerations. The information resulting from this study allows us to contribute to the healthcare education programs planning, mainly to university students groups and healthcare areas students as well as assisting in antismoking and smoking cessation programs.

Introdução. O tabagismo é considerado atualmente um problema mundial de saúde pública, que extrapola a dimensão fisiológica e psicológica. Assim, é compreendido como um fenômeno social a ser explorado por diferentes áreas do conhecimento. Para a Organização Mundial da Saúde (OMS) faz-se necessário mudar o curso da exposição mundial ao tabagismo, considerando os profissionais da saúde como importantes personagens nas ações antitabagistas. Segundo a OMS, esses profissionais são vistos como igualmente intervenientes no processo de educação em saúde e combate ao tabagismo junto à sociedade, sendo então importante priorizar estudos e ações também com estudantes de cursos da área da saúde, que estarão, em um futuro próximo, trabalhando junto à população. Portanto, torna-se importante a aproximação de suas representações, crenças e visões do processo saúde/doença aos programas de combate ao fumo. Objetivo. Analisar as representações sociais sobre o tabagismo em estudantes de cursos da área da saúde no Brasil e na Espanha. Método. Trata-se de um estudo qualiquantitativo realizado com 163 estudantes em fase de conclusão de cursos da área da saúde. Os dados foram obtidos através de triangulação metodológica com uso dos instrumentos Desenho Temático e Discurso do Sujeito Coletivo em universidades particulares no Brasil e universidades públicas na Espanha, coletados entre agosto de 2013 e maio de 2014. Utilizando a teoria das Representações Sociais, foram criadas categorias a partir dos resultados obtidos em cada um dos instrumentos, e posteriormente analisadas e discutidas com outros estudos na mesma temática. Resultados e Discussão. A identificação das representações sociais permitiu reconhecer uma importante mudança: fumar já não é mais visto como um comportamento positivo elegante e charmoso -, os participantes apresentaram diversas críticas ao comportamento de fumar, especialmente no que se refere ao comportamento de profissionais da saúde, vistos por eles como modelos para a população, principalmente no que se refere à comportamentos saudáveis. Embora se tratando de grupos de culturas diferentes, não foram encontradas diferenças significativas entre as representações dos estudantes do Brasil e da Espanha. Considerações Finais. As informações resultantes do estudo permitem contribuir para o planejamento de programas de educação em saúde principalmente para grupos universitários e de estudantes da área da saúde, bem como auxiliar os programas de cessação do tabagismo. / Introduction. Currently, smoking is considered a worldwide public health problem, which extrapolates the physiological and psychological dimension. Therefore, smoking is understood as a social phenomenon to be explored by different areas of knowledge. The World Health Organization (WHO) considers that a change in the trend of global exposition towards smoking is needed, aiming and considering the healthcare professional as important key roles for antismoking actions. According to WHO, these professionals are viewed as equally capable in meddling the promotion of health education and in combating smoking altogether with the society. Consequently, it is important to prioritize actions and studies engaging students of healthcare related areas, who will be working with people in the society in the near future. Therefore, it becomes important, to make closer their representations, beliefs and thinking from healthy/illness process into antismoking programs. Objective. Analyze the social representations about smoking habits within students of healthcare areas, in Brazil and Spain. Methodology. This research was qualitative-quantitative study with 163 students in its final stages of the undergraduate health care program. Data were collected between August 2013 and May 2014, at private universities in Brazil and public universities in Spain, through triangulation methodology using the following instruments: Thematic Drawing with story and Discourse of Collective Subject. Using the Social Representation Theory, categories were created through the results of each instrument and then, analyzed and discussed with studies within similar thematic. Results and discussion. The identification of social representations allowed recognizing an important change: smoking is no longer seen as a positive behavior - elegant and charming. Participants presented several critiques to smoking habits, especially when the smoking habits are related to healthcare professionals, who are viewed as models of healthy habits. Although there are differences in the cultural background of those two groups, there were not found any significant divergences in the representations of Brazilian and Spanish students. Final Considerations. The information resulting from this study allows us to contribute to the healthcare education programs planning, mainly to university students groups and healthcare areas students as well as assisting in antismoking and smoking cessation programs.