Contemporary narratives about asymmetries in responsibility in global agri-food value chains: the case of the Ecuadorian stakeholders in the banana value chain.

Global concerns over environmental and social issues in agrifood value chains have increased and are reflected in a number of voluntary sustainability standards and regulatory initiatives. However, these initiatives are often based on poor knowledge of production realities, creating a disconnect between producing and consuming countries. Through narrative analysis, this paper reveals asymmetries in the responsibilities of the various actors participating in Ecuadorian banana value chains, providing clear problem- and solution-framings. Despite the broad range of actors interviewed, our analysis reveals convergence in two main narratives that reflect asymmetries amongst local actors in terms of their ability to participate, ability to maintain participation, and adaptation strategies in view of changing external factors. One narrative relates to sustainability adaptations, the cost of which is not shared among all value chain actors. This is combined with a downward trend in the price of bananas and the lack of a differentiated price to account for losses and costs arising from increasing sustainability standards. Another narrative reflects a value chain structure that threatens small-farm survival. It highlights the urgency of protecting small-farm activity by enforcing national regulation and developing new market segments/models that understand small-scale producer reality. Study results show that the multitude of standards is not seen as beneficial and that downstream actors rather wish for common minimum standards to reduce business costs. Compatibility between standards and local realities should be a priority for global sustainability standards adoption. Building on the problems and solution-framings of local value chain links, we give voice to local actors, and link their perceptions to existing literature and discursive politics while contributing to social transparency and addressing the democratic deficit in agrifood value chains.

Panorama nacional do ensino da psiquiatria nas escolas médicas brasileiras / An overview of the teaching of psychiatry in Brazilian medical schools

OBJETIVO: Determinar o perfil de ensino da psiquiatria nos cursos médicos brasileiros, verificando o número de professores envolvidos e suas titulações, o número de disciplinas e o enfoque predominante, material didático e local de ensino/aprendizagem. MÉTODO: O estudo foi baseado no levantamento de dados obtidos pela aplicação de questionários nas escolas médicas brasileiras que constam no site da Associação Brasileira de Educação Médica. RESULTADOS: Das 119 escolas médicas brasileiras, 85 (71 por cento) responderam à pesquisa. O número de professores psiquiatras envolvidos no ensino variou de 1 a 5 (75,3 por cento); desses, 1 a 2 (43,4 por cento) eram doutores/livres-docentes, 1 a 2 (45,8 por cento) eram mestres, e 1 a 2 (57,3 por cento) eram especialistas. Observou-se que 41,2 por cento das escolas oferecem duas disciplinas de psiquiatria, com enfoque predominantemente psicodinâmico e clínico (61,2 por cento). Em 52,9 por cento dos casos, o conteúdo programático não é desenvolvido apenas em cadeiras específicas de psiquiatria. As disciplinas oferecem, em 64,7 por cento dos casos, aulas práticas em contextos clínicos gerais. A carga horária durante o curso é de 61-90 horas-aula (26,2 por cento), e 88,9 por cento têm livros-textos básicos. Em 83,3 por cento das escolas médicas, essas disciplinas são avaliadas pelos alunos ao final das mesmas. CONCLUSÃO: Foi observada uma grande heterogeneidade nas regiões avaliadas, em pelo menos 71 por cento das escolas. Novos estudos devem aprofundar este primeiro levantamento.

OBJECTIVE: To determine the profile of psychiatric teaching in Brazilian medical schools, with a focus on the number of professors involved and their respective degrees, the number of disciplines devoted to psychiatry and the predominant approach (psychodynamic/clinical/other) adopted, the didactic materials employed and the teaching and learning facilities available. METHODS: The study was based on the collection of data via application of questionnaires at all medical schools registered with the Brazilian Association of Medical Education (Associação Brasileira de Educação Médica). RESULTS: Of the 119 Brazilian schools contacted, 85 (71 percent) returned the questionnaires. The number of professors graduated in psychiatry at each school varied from 1 to 5 (75.3 percent); of these, 1 to 2 (43.4 percent) had a PhD degree, 1 to 2 (45.8 percent) a master's degree, and 1 to 2 (57.3 percent) were specialists. The findings revealed that 41.2 percent of the schools offered two disciplines of psychiatry, with a predominantly psychodynamic/clinical approach (61.2 percent). At 52.9 percent of the schools, teaching of psychiatric topics was not restricted to the specific disciplines; 64.7 percent of the disciplines offered hands-on training in general clinical settings. Mean number of credit hours of psychiatric teaching along the medical program was 61-90 (26.2 percent), and 88.9 percent of the programs used books as the main choice for didactic purposes. At 83.3 percent of the medical schools, psychiatric teaching is graded by students at the end of each discipline. CONCLUSION: The present findings revealed an important heterogeneity in the geographic regions assessed, affecting at least 71 percent of the schools. New studies are warranted to advance the preliminary findings herein reported.

Diabetes Mellitus e perda auditiva neurossensorial / Diabetes Mellitus and sensorineural hearing loss

Esse trabalho tem como objetivo revisar a relação entre a perda auditiva neurossensorial e o Diabete Mellitus, buscando mostrar as principais alterações que acontecem a orelha interna, além de abordar aspectos relacionados a evolução clínica, conduta e tratamento.

Prevalência de vírus respiratórios em lactentes com bronquiolite aguda e sibilância recorrente em uma emergência pediátrica no sul do Brasil / Prevalence of respiratory virus in infants with acute bronchiolitis abd recurrent wheezing in an emergency room in south Brasil

Objetivo: descrever a prevalência de vírus em lactentes hospitalizados, comparando o primeiro episódio de sibilância (bronquiolite aguda) com sibilância recorrente. Métodos: Foram coletadas amostras de secreção nasofaríngea para pesquisa de vírus respiratórios no período de maio a setembro, 2000 e em 2001, de pacientes que internaram na Emergência Pediátrica com quadro de infecção respiratória aguda de vias aéreas inferiores. Resultados: foram selecionados para o estudo 124 pacientes. O número de coletas positivas para vírus foi de 84 (67,7%), sendo a grande maioria (67,8) pelo vírus sincicial respiratório (VSR). Foi diagnosticada bronquiolite aguda em 77 pacientes (62%) e sibilância.