Design and ergonomics of package inserts of drugs in Brazil: a reality in construction

This research deals with the design of leaflets of medicines, evidencing the problems resulting from the lack of Brazilian normalization to promote the use of the graphical representation of instructional texts warnings. It approaches studies related to the effectiveness and efficiency of information systems, highlighting the semiotics and the cultural and informational ergonomics. The analysis of the context uses as method, an analytical study on selected warnings of thirty leaflets of medicines, followed by interviews lead with the public managers involved with the regulation of the pharmaceutical companies, and two experiments with users performed in city of Recife, in State of Pernambuco: one aiming at to identify how they interact with the leaflets of medicines, and the second one testing their understanding concerning standardized illustrations in the United States and the South Africa. The results show the need for improvements in presentation and graphic representation of leaflets of medicines, powering them to the role of communication, to ensure the consumption of medicine safely by its users. The conclusion congregates parameters and recommendations for the graphic representation of warnings in leaflets of medicines in Brazil.     

Mind‐Mindedness as a Multidimensional Construct: Appropriate and Nonattuned Mind‐Related Comments Independently Predict Infant–Mother Attachment in a Socially Diverse Sample

In a socially diverse sample of 206 infant–mother pairs, we investigated predictors of infants’ attachment security at 15 months, with a particular emphasis on mothers’ tendency to comment appropriately or in a non‐attuned manner on their 8‐month‐olds’ internal states (so‐called mind‐mindedness). Multinomial logistic regression analyses showed that higher scores for appropriate mind‐related comments and lower scores for non‐attuned mind‐related comments distinguished secure‐group mothers from their counterparts in the insecure‐avoidant, insecure‐resistant, and insecure‐disorganized groups. Higher scores for appropriate mind‐related comments and lower scores for non‐attuned mind‐related comments also independently predicted dichotomous organized/disorganized attachment. General maternal sensitivity predicted neither attachment security nor organization, although sensitivity was found to relate to dichotomous secure/insecure attachment specifically in the context of low socioeconomic status. The findings highlight how appropriate and non‐attuned mind‐related comments make independent contributions to attachment and suggest that mind‐mindedness is best characterized as a multidimensional construct.     

In search of the ideal measure of accuracy for subnational demographic forecasts

We examine nonlinear transformations of the forecasterror distribution in hopes of finding a summary errormeasure that is not prone to an upward bias and usesmost of the information about that error. MAPE, thecurrent standard for measuring error, often overstatesthe error represented by most of the values becausethe distribution underlying the MAPE is right skewedand truncated at zero. Using a modification to theBox-Cox family of nonlinear transformations, wetransform these skewed forecast error distributionsinto symmetrical distributions for a wide range ofsize and growth rate conditions. We verify thissymmetry using graphical devices and statisticaltests; examine the transformed errors to determine ifre-expression to the scale of the untransformed errorsis necessary; and develop and implement a procedurefor the re-expression. The MAPE-R developed by ourprocess is lower than the MAPE based on theuntransformed errors and is more consistent with arobust estimator of location.     

Training for efficiency: work, time, and systems-based practice in medical residency

Medical residency is a period of intense socialization with a heavy workload. Previous sociological studies have identified efficiency as a practical skill necessary for success. However, many contextual features of the training environment have undergone dramatic change since these studies were conducted. What are the consequences of these changes for the socialization of residents to time management and the development of a professional identity? Based on observations of and interviews with internal medicine residents at three training programs, we find that efficiency is both a social norm and strategy that residents employ to manage a workload for which the demand for work exceeds the supply of time available to accomplish it. We found that residents struggle to be efficient in the face of seemingly intractable "systems" problems. Residents work around these problems, and in doing so develop a tolerance for organizational vulnerabilities.     

Multisystemic Therapy for Disruptive Behavior Problems in Youths With Autism Spectrum Disorders: A Progress Report

Youths with autism spectrum disorders (ASD) often engage in serious disruptive behaviors that interfere with their ability to successfully manage day‐to‐day responsibilities and contribute to relationship problems with caregivers, peers, and teachers. Effective treatments are needed to address the factors linked with disruptive behavior problems in this population of youths. Multisystemic therapy (MST) is a comprehensive family‐ and community‐based treatment approach that has been effective with other difficult‐to‐treat populations of youths and holds promise for youths with ASD. In this article, we review the broad range of factors associated with disruptive behaviors among youths with ASD and discuss how MST interventions can be adapted to address those factors. We also present a framework for our adaptation of the MST model for youths with ASD. This framework includes a recently completed pilot study as well as an ongoing efficacy trial that together have served to identify key interventions for our adaptation of the MST model.     

The Family Context of Relational Aggression in “Difficult to Treat” Female Juvenile Offenders

Female juvenile offenders often engage in socially aggressive behaviors that make them more difficult to treat than male juvenile offenders. This social (i.e., relational) aggression may be developed or maintained through transactions with family members. To investigate this issue, we measured relational aggression in the family interactions of 140 adolescents divided by gender and offender status into four equal‐sized groups (female juvenile offenders, male juvenile offenders, female nonoffenders, and male nonoffenders). Adolescents and caregivers completed a family discussion task, and raters coded relationally aggressive behaviors at the dyadic level. Results showed that female juvenile offenders and their mothers directed more relational aggression toward each other than did mother–adolescent dyads in the other groups. Implications of these results for treatment and research are discussed.