bluuebunny/crossref_metadata_2025 huggingface dataset:
A Validity Study of the Evaluation Tool of Children’s Handwriting–Cursive
Authors: Koziatek Susan M. , Powell Nancy J.
Published: October 2010

OBJECTIVES. This study examined concurrent validity of the Evaluation Tool of Children’s Handwriting–Cursive (ETCH-C) by comparing ETCH-C total legibility percentage scores with handwriting grades from teachers. The study also identified the legibility percentage score discriminating between satisfactory and unsatisfactory handwriting.

METHOD. The participants were 101 fourth graders who completed two handwriting instruments. Three teachers sorted the Cursive Practice and Review work sheets into A, B, C, and unsatisfactory groups to establish handwriting grade. The study compared ETCH-C total legibility percentage scores with teacher grading, using personal judgment of handwriting on the Cursive Practice and Review work sheet.

RESULTS. Mean legibility percentage scores increased significantly as handwriting grade increased. The concurrent validity coefficients were .61 for ETCH-C total words and .65 for ETCH-C total letters and handwriting grade. ETCH-C legibility percentage scores discriminating satisfactory from unsatisfactory handwriting ranged from 73% to 82% on ROC (receiver operating characteristic) curves.

CONCLUSION. Results support the concurrent validity of the ETCH-C with handwriting grades. A 75% word legibility percentage score discriminated satisfactory and unsatisfactory handwriting.
Patients’ Perspectives on the Self-Identified Goals Assessment
Authors: Melville Lisa Link , Baltic Tamara A. , Bettcher Timothy W. , Nelson David L.
Published: October 2010

OBJECTIVE. The purpose of this study was to investigate patients’ perspectives of the validity of the Self-Identified Goals Assessment (SIGA), which is designed for use by occupational therapists working in subacute rehabilitation and skilled nursing facilities. The SIGA has two primary purposes: (a) to help the patient identify personally meaningful occupational goals to be addressed in therapy and (b) to evaluate changing levels of patient-defined success in desired occupations.

METHOD. Participants (20 women, 10 men) were patients with varied diagnosed conditions at a hospital-based subacute facility. Their mean age was 73.4 years (SD = 12.2). The SIGA was administered by the patients’ regular occupational therapy practitioner after admission and before discharge; a graduate student followed up each administration of the SIGA by asking participants fixed-alternative and open-ended questions about the usefulness of the assessment. Fixed-alternative questions were analyzed as simple dichotomies, and open-ended questions were analyzed through categorization into convergent and divergent themes across participants.

RESULTS. Twenty-nine of the 30 participants confirmed the personal meaningfulness of goals identified in the SIGA admissions interview, and 28 reported that they thought the SIGA helped the therapist realize what was personally important to them. On admission, 9 participants reported difficulty quantifying their performance on the 0-to-10 scale; however, 27 reported that their scores were accurate self-assessments. Participants’ perspectives of the SIGA tended to be particularly positive at discharge.

CONCLUSION. Given the lack of efficient, structured approaches to the measurement of self-identified goals in subacute and skilled nursing facilities, the SIGA tentatively is recommended for use in these settings, pending future research.
Family Routines and Rituals: A Context for Occupational Therapy Interventions
Authors: Segal Ruth
Published: October 2010

PURPOSE. This paper explores the importance of family daily routines and rituals for the family’s functioning and sense of identity.

METHODS. The findings of this paper are derived from an analysis of the morning routines of 40 families with children with disabilities in the United States and Canada. The participants lived in urban and rural areas. Forty of the 49 participants were mothers and the majority of the families were of European descent. Between one and four interviews were conducted with each participant. Topics included the family’s story, daily routines, and particular occupations. Data on the morning routines of the families were analyzed for order and affective and symbolic meaning using a narrative approach.

FINDINGS. The findings are presented as narratives of morning activities in five families. These narratives are examples for rituals, routines, and the absence of a routine. Rituals are discussed in terms of their affective and symbolic qualities, routines are discussed in terms of the order they give to family life, whereas the lack of family routine is discussed in terms of lack of order in the family.

CONCLUSIONS. Family routines and rituals are organizational and meaning systems that may affect family’s ability to adapt them.
An Evidence-Based and Occupational Perspective of Interventions for Persons With Substance-Use Disorders
Authors: Stoffel Virginia C. , Moyers Penelope A.
Published: October 2010

An interdisciplinary evidence-based review of interventions among persons with substance-use disorders was completed in 2001 as part of American Occupational Therapy Association’s (AOTA’s) Evidence-Based Literature Review Project (Lieberman & Scheer, 2002). Four effective interventions for adults and adolescents with substance use were identified, including brief interventions, cognitive behavioral therapy, motivational strategies, and 12-step programs. The research studies reviewed reported outcomes primarily related to reduction in alcohol and drug use. Occupational therapy interventions grounded in current evidence-based literature are suggested. Interventions are modified to include an occupational perspective leading to outcomes consistent with the Occupational Therapy Practice Framework (American Occupational Therapy Association [AOTA], 2002). Study findings propose research questions to encourage further investigation of the effectiveness of these best practice interventions.
A Pilot Study To Investigate Shoulder Muscle Fatigue During a Sustained Isometric Wheelchair-Propulsion Effort Using Surface EMG
Authors: Niemeyer Linda O. , Aronow Harriet U. , Kasman Glenn S.
Published: October 2010

OBJECTIVE. The primary aim of this pilot study was to develop a testing protocol for gathering shoulder muscle surface electromyography (EMG) data during a sustained submaximal isometric wheelchair-propulsion effort. Of special interest was analysis of the median frequency of the surface EMG signal power spectrum; a negative median frequency shift during a sustained effort is an indicator of muscle fatigue. The long-term goal is to improve our understanding of how fatigue and muscle imbalance might play a role in the development of a broad array of upper-extremity overuse syndromes.

METHOD. Participants were a convenience sample of seven male manual-wheelchair users with spinal cord injury and 14 able-bodied males. Surface EMG in six right-side shoulder muscles was recorded while subjects resisted a static force equal to 60% of their maximum wheelchair-propulsion strength until fatigued. Percent of maximum voluntary contraction and the median frequency shift for each muscle were analyzed.

RESULTS. The able-bodied group used a higher percent of maximum than the manual-wheelchair group (p < .05), and a more pronounced negative median frequency shift was evident in the able-bodied group (p < .10).

CONCLUSION. Patterns that emerged suggest that spectral analysis of the surface electromyographhic signal has promise as a clinically useful tool to authenticate muscle fatigue in the upper extremities during occupational performance. Such data in the future could be used to justify the need for and benefits of adapted performance techniques and assistive technology.
Time, Space, and the Kaleidoscopes of Occupation
Authors: Zemke Ruth
Published: October 2010

Our daily round of occupations occurs within time and space. Our understanding of occupation has traditionally viewed time and space as part of the external environment. Patterns of the “when?” and “where?” of occupations can be described. But relating time and space to the internal experience of occupation reflects more of the meaning to individuals and more complex patterns arise. Like the varied bits of glass in the object case of an art kaleidoscope, the multiple elements of occupation interact. Reflected in mirrors of our choice, we find always-changing, complex patterns of daily occupation. The elements of occupation most important for maintaining or regaining health and the mirrors and lens through which we view occupation historically have formed shifting patterns in occupational therapy, patterns of how we view ourselves, our practice, and those to whom we provide our services. We must combine the science and the art of occupational therapy as the metaphor of the kaleidoscope combines both, producing awe and wonder at the result.
Improving Dyspnea Management in Three Adults With Chronic Obstructive Pulmonary Disease
Authors: Migliore Anna
Published: October 2010

This case report describes occupational therapy intervention for three adult outpatients with chronic obstructive pulmonary disease (COPD) at one large urban hospital. The occupational therapy intervention was based on the Management of Dyspnea Guidelines for Practice (Migliore, in press). The learning and practice of controlled breathing were promoted in the context of physical activity exertion in a domiciliary environment. In addition to promoting dyspnea management, the controlled-breathing strategies aimed to facilitate energy conservation and to increase perceived breathing control. Although no causality can be determined in a case study design, the patients’ dyspnea with activity exertion decreased and their functional status and quality of life increased following goal-directed, individualized occupational therapy intervention combined with exercise training.
Role of dust alkalinity in acid mobilization of iron
Authors: Ito A. , Feng Y.
Published: October 2010

Abstract. Atmospheric processing of mineral aerosols by acid gases (e.g., SO2, HNO3, N2O5, and HCl) may play a key role in the transformation of insoluble iron (Fe in the oxidized or ferric (III) form) to soluble forms (e.g., Fe(II), inorganic soluble species of Fe(III), and organic complexes of iron). On the other hand, mineral dust particles have a potential of neutralizing the acidic species due to the alkaline buffer ability of carbonate minerals (e.g., CaCO3 and MgCO3). Here we demonstrate the impact of dust alkalinity on the acid mobilization of iron in a three-dimensional aerosol chemistry transport model that includes a mineral dissolution scheme. In our model simulations, most of the alkaline dust minerals cannot be entirely consumed by inorganic acids during the transport across the North Pacific Ocean. As a result, the inclusion of alkaline compounds in aqueous chemistry substantially limits the iron dissolution during the long-range transport to the North Pacific Ocean: only a small fraction of iron (<0.2%) dissolves from hematite in the coarse-mode dust aerosols with 0.45% soluble iron initially. On the other hand, a significant fraction of iron (1–2%) dissolves in the fine-mode dust aerosols due to the acid mobilization of the iron-containing minerals externally mixed with carbonate minerals. Consequently, the model quantitatively reproduces higher iron solubility in smaller particles as suggested by measurements over the Pacific Ocean. It implies that the buffering effect of alkaline content in dust aerosols might help to explain the inverse relationship between aerosol iron solubility and particle size. We also demonstrate that the iron solubility is sensitive to the chemical specification of iron-containing minerals in dust. Compared with the dust sources, soluble iron from combustion sources contributes to a relatively marginal effect for deposition of soluble iron over the North Pacific Ocean during springtime. Our results suggest that more comprehensive data for chemical specificity of iron-rich dust is needed to improve the predictive capability for size-segregated soluble iron particles.
Geomagnetic activity effects on plasma sheet energy conversion
Authors: Hamrin M. , Norqvist P. , Marghitu O. , Buchert S. , Klecker B. , Kistler L. M. , Dandouras I.
Published: October 2010

Abstract. In this article we use three years (2001, 2002, and 2004) of Cluster plasma sheet data to investigate what happens to localized energy conversion regions (ECRs) in the plasma sheet during times of high magnetospheric activity. By examining variations in the power density, E·J, where E is the electric field and J is the current density obtained by Cluster, we have studied the influence on Concentrated Load Regions (CLRs) and Concentrated Generator Regions (CGRs) from variations in the geomagnetic disturbance level as expressed by the Kp, the AE, and the Dst indices. We find that the ECR occurrence frequency increases during higher magnetospheric activities, and that the ECRs become stronger. This is true both for CLRs and for CGRs, and the localized energy conversion therefore concerns energy conversion in both directions between the particles and the fields in the plasma sheet. A higher geomagnetic activity hence increases the general level of energy conversion in the plasma sheet. Moreover, we have shown that CLRs live longer during magnetically disturbed times, hence converting more electromagnetic energy. The CGR lifetime, on the other hand, seems to be unaffected by the geomagnetic activity level. The evidence for increased energy conversion during geomagnetically disturbed times is most clear for Kp and for AE, but there are also some indications that energy conversion increases during large negative Dst. This is consistent with the plasma sheet magnetically mapping to the auroral zone, and therefore being more tightly coupled to auroral activities and variations in the AE and Kp indices, than to variations in the ring current region as described by the Dst index.
Signal processing for plane wave actuators
Authors: Corbach T. , Holters M. , Zölzer U.
Published: October 2010

Abstract. Plane wave actuators without an enclosure per se have a forward and backward radiation. The backward radiation is unwanted in many applications when a single direction radiation is desired. To avoid the disadvantages of an enclosure a system is proposed, which provides a high suppression of the unwanted backward radiation using a pair of plane wave actuators. This is achieved by adapted input signal filters. The influences of the second plane wave actuator to the forward radiated signal are suppressed as well. Additionally, the system also provides for- and backward radiation of different signals with a high suppression of the radiation directions crosstalk. The required power for the signal suppression depends on the physical damping of the plane wave actuators and the space in between. The first realized prototype is designed for flat panel dipole loudspeakers to deal with the mentioned problems in the acoustic domain. The filter design and a calibration algorithm for any given pairs of dipole loudspeaker are explained. The good performance of the developed system is proven by measurement results with the prototype system.
An accelerated hybrid TLM-IE method for the investigation of shielding effectiveness
Authors: Fichtner N. , Russer P.
Published: October 2010

Abstract. A hybrid numerical technique combining time-domain integral equations (TD-IE) with the transmission line matrix (TLM) method is presented for the efficient modeling of transient wave phenomena. This hybrid method allows the full-wave modeling of circuits in the time-domain as well as the electromagnetic coupling of remote TLM subdomains using integral equations (IE). By using the integral equations the space between the TLM subdomains is not discretized and consequently doesn't contribute to the computational effort. The cost for the evaluation of the time-domain integral equations (TD-IE) is further reduced using a suitable plane-wave representation of the source terms. The hybrid TD-IE/TLM method is applied in the computation of the shielding effectiveness (SE) of metallic enclosures.
Non-linear behaviour of charge-pump phase-locked loops
Authors: Wiegand C. , Hedayat C. , Hilleringmann U.
Published: October 2010

Abstract. The analysis of the mixed analogue and digital structure of charge-pump phase-locked loops (CP-PLL) is a challenge in modelling and simulation. In most cases the system is designed and characterized using its continuous linear model or its discrete linear model neglecting its non-linear switching behaviour. I.e., the time-varying model is approximated by a time-invariant representation using its average dynamics. Depending on what kind of phase detector is used, the scopes of validity of these approximations are different. Here, a preeminent characterization and simulation technique based on the systems event-driven feature is presented, merging the logical and analogue inherent characteristics of the system. In particular, the high-grade non-linear locking process and the dead-zone are analyzed.
Design and realization of a broadband single-side-band mixer with a very short settling time
Authors: Haßler S. , Reichthalhammer T. , Biebl E.
Published: October 2010

Abstract. To achieve high range resolution in synthetic aperture radar imaging a frequency synthesizer with high bandwidth is a possible solution. To operate in the required frequency band an LF-signal usually has to be upconverted. In this paper we describe the design and realization of a broadband Single-Side-Band Mixer with a very short settling time between frequency steps of arbitrary length inside a high bandwidth. Compared to already existing SSB-Mixers, our novel concept has three major advantages: At first, the mixer could be used in combination with an arbitrary signal source. Due to a modular circuit concept it is possible to use the system for different input frequency ranges. Moreover, just by changing single modules, the output frequency-range can be adapted to individual requirements. Thirdly, as a main advantage, the system is able to generate a high frequency output span with a very fast settling time between frequency steps. Even with applied steps up to 400 MHz, the settling time remains below 3 μs, which is more than 5 times faster than the settling time of similar synthesizers.
Untersuchung von Schutzelementen für IT-Systeme gegen HPEM-Bedrohungen
Authors: Brauer F. , ter Haseborg J. L.
Published: October 2010

Abstract. Die Entwicklung von Schutzschaltungen gegen elektromagnetische Störungen ist unverzichtbar, um die Immunität von komplexen elektronischen Systemen zu gewährleisten. In diesem Beitrag wird das Verhalten von nichtlinearen Schutzelementen für IT-Systeme untersucht. Hierzu finden spezielle Testverfahren im passiven und aktiven Zustand des IT-Testsystems Anwendung.
Sporadic E signatures revealed from multi-satellite radio occultation measurements
Authors: Arras C. , Jacobi C. , Wickert J. , Heise S. , Schmidt T.
Published: October 2010

Abstract. Radio occultation measurements performed by the satellites CHAMP, GRACE and FORMOSAT-3/COSMIC provide a huge data set for atmospheric and ionospheric investigations on a global scale. The data sets are used to extract information on sporadic E layers appearing in the lower ionospheric E region. This is done by analyzing signal amplitude variations of the GPS L1 signal. Sporadic E altitudes in northern midlatitudes found from radio occultation measurements are compared with ground-based ionosonde soundings. A large correlation of sporadic E altitudes from these two techniques is found.
Automotive radar – investigation of mutual interference mechanisms
Authors: Goppelt M. , Blöcher H.-L. , Menzel W.
Published: October 2010

Abstract. In the past mutual interference between automotive radar sensors has not been regarded as a major problem. With an increasing number of such systems, however, this topic is receiving more and more attention. The investigation of mutual interference and countermeasures is therefore one topic of the joint project "Radar on Chip for Cars" (RoCC) funded by the German Federal Ministry of Education and Research (BMBF). RoCC's goal is to pave the way for the development of high-performance, low-cost 79 GHz radar sensors based on Silicon-Germanium (SiGe) Monolithic Microwave Integrated Circuits (MMICs). This paper will present some generic interference scenarios and report on the current status of the analysis of interference mechanisms.
A reconfigurable software defined ultra-wideband impulse radio transceiver
Authors: Blech M. D. , Ott A. T. , Neumeier P. , Möller M. , Eibert T. F.
Published: October 2010

Abstract. An ultra-wideband (UWB) software defined radio (SDR) implementation is presented. The developed impulse radio (IR) transceiver employs first order bandpass (BP) sampling at a conversion frequency which is four times the channel bandwidth. The subsampling architecture directly provides the RF signal avoiding any non-ideal mixer stages and reduces the requirements of digital signal processing implemented in a field programmable gate array (FPGA). The transmitter consists basically of a multi-Nyquist digital to analog converter (DAC), whereas the implemented matched filter (MF) receiver prototype employs a standard digitizing oscilloscope. This design can be adaptively reconfigured in terms of modulation, data rate, and channel equalization. The reconfigurable design is used for an extensive performance analysis of the quadrature phase shift keying (QPSK) modulation scheme investigating the influence of different antennas, amplifiers, narrowband interferers as well as different equalizer lengths. Even for distances up to 7 m in a multipath environment robust communication was achieved.
A comparision of Hodgkin-Huxley and soliton neural theories
Authors: Appali R. , Petersen S. , van Rienen U.
Published: October 2010

Abstract. Hodgkin and Huxley were the pioneers to abstract biological neuron as an electric circuit and nerve signal as the voltage impulse. The Hodgkin-Huxley theory (Hodgkin and Huxley, 1952) has set the direction and defined the goals for much of the ensuing research in biophysics. However, in 2005, T. Heimburg and A. D. Jackson, biophysicists from Copenhagen proposed a new neural theory called Soliton theory (Heimburg and Jackson, 2005). In this theory, the nerve conduction is proposed as a density wave. In this paper, Hodgkin-Huxley and Soliton theories are described and a theoretical comparison has been carried out throughout the analysis of the theories and models.
A multi-model ensemble method that combines imperfect models through learning
Authors: van den Berge L. A. , Selten F. M. , Wiegerinck W. , Duane G. S.
Published: October 2010

Abstract. In the current multi-model ensemble approach climate model simulations are combined a posteriori. In the method of this study the models in the ensemble exchange information during simulations and learn from historical observations to combine their strengths into a best representation of the observed climate. The method is developed and tested in the context of small chaotic dynamical systems, like the Lorenz 63 system. Imperfect models are created by perturbing the standard parameter values. Three imperfect models are combined into one super-model, through the introduction of connections between the model equations. The connection coefficients are learned from data from the unperturbed model, that is regarded as the truth. The main result of this study is that after learning the super-model is a very good approximation to the truth, much better than each imperfect model separately. These illustrative examples suggest that the super-modeling approach is a promising strategy to improve climate simulations.
Analysis of the impact of climate change on groundwater related hydrological fluxes: a multi-model approach including different downscaling methods
Authors: Stoll S. , Hendricks Franssen H. J. , Butts M. , Kinzelbach W.
Published: October 2010

Abstract. Climate change related modifications in the spatio-temporal distribution of precipitation and evapotranspiration will have an impact on groundwater resources. This study presents a modelling approach exploiting the advantages of integrated hydrological modelling and a broad climate model basis. We applied the integrated MIKE SHE model on a perialpine, small catchment in northern Switzerland near Zurich. To examine the impact of climate change we forced the hydrological model with data from eight GCM-RCM combinations showing systematic biases which are corrected by three different statistical downscaling methods, not only for precipitation but also for the variables that govern potential evapotranspiration. The downscaling methods are evaluated in a split sample test and the sensitivity of the downscaling procedure on the hydrological fluxes is analyzed. The RCMs resulted in very different projections of potential evapotranspiration and, especially, precipitation. All three downscaling methods reduced the differences between the predictions of the RCMs and all corrected predictions showed no future groundwater stress which can be related to an expected increase in precipitation during winter. It turned out that especially the timing of the precipitation and thus recharge is very important for the future development of the groundwater levels. However, the simulation experiments revealed the weaknesses of the downscaling methods which directly influence the predicted hydrological fluxes, and thus also the predicted groundwater levels. The downscaling process is identified as an important source of uncertainty in hydrological impact studies, which has to be accounted for. Therefore it is strongly recommended to test different downscaling methods by using verification data before applying them to climate model data.
Upper layer current variability in the Central Ligurian Sea
Authors: Picco P. , Cappelletti A. , Sparnocchia S. , Schiano M. E. , Pensieri S. , Bozzano R.
Published: October 2010

Abstract. Long-time series of surface currents and meteorological parameters were analysed to estimate the variability of the upper layer circulation and the response to the local winds. Current meter data were collected by an upward-looking RDI Sentinel 300 kHz ADCP deployed in the Central Ligurian Sea (43°47.77' N; 9°02.85' E) near the meteo-oceanographic buoy ODAS Italia 1 for more than eight months, from 13th of September 2003 to 24th of May 2004. The ADCP sampled the upper 50 m of water column at 8 m vertical resolution and 1 h time interval; surface marine and atmospheric hourly averaged data were provided by the buoy. Currents in the sampled layer were mainly barotropic, directed North-West in accordance with the general circulation of the area, and had a mean velocity of about 18 cm/s and hourly mean peaks up to 80 cm/s. Most of the observed variability in the upper thermocline was determined by inertial currents and mesoscale activity due to the presence of the Ligurian Front. Local wind had a minor role in the near-surface circulation but induced internal waves propagating downward in the water column.
Cuidador de cliente com acidente vascular encefálico: associação com diagnósticos de enfermagem
Authors: Moreira Rafaella Pessoa , Araujo Thelma Leite de , Cavalcante Tahissa Frota , Oliveira Ana Railka De Sousa , Holanda Gabrielle Fávaro , Morais Huana Carolina Cândido , Vasconcelos João Dennys Pinheiro , Ximenes Camila Monique Bezerra , Alves Filipe Emmanuel Coelho
Published: October 2010

doi: 10.5216/ree.v12i3.6391O objetivo do estudo foi analisar a associação entre a presença do cuidador de clientes com acidente vascular encefálico e os diagnósticos de enfermagem da classe atividade/exercício da North American Nursing Diagnosis Association (NANDA). Estudo transversal, desenvolvido com 121 clientes que frequentavam uma das oito unidades da Associação Beneficente Cearense de Reabilitação na cidade de Fortaleza-Ceará, cuja coleta de dados ocorreu no período de novembro de 2007 a março de 2008. Para a coleta de dados utilizou-se um formulário e as informações foram coletadas por meio de entrevista e exame físico. Para nomeação dos diagnósticos de enfermagem seguiu-se como referência a Taxonomia II da NANDA. O nível de significância adotado no estudo foi 5%. Quanto aos dados sociodemográficos, a maioria dos participantes era do sexo masculino, idosos, sem companheiros, aposentados ou pensionistas com baixa escolaridade e baixa renda per capita. A maioria dos clientes tinha um cuidador (88%). A presença do cuidador teve associação estatística com os diagnósticos de enfermagem Estilo de vida sedentário (p=0,002), Risco de síndrome do desuso (p=0,02) e Capacidade de transferência prejudicada (p=0,01). Diante desta circunstância, o enfermeiro deve orientar os cuidadores sobre a assistência domiciliar adequada do cliente que sobreviveu ao acidente vascular encefálico. Descritores: Acidente cerebral vascular; Diagnóstico de enfermagem; Assistência ao paciente.
Reflexões de profissionais de saúde acerca do seu processo de trabalho
Authors: Souza Sabrina Silva de , Costa Roberta , Shiroma Lícia Mara Brito , Maliska Isabel Cristina Alves , Amadigi Felipa Rafaela , Pires Denise Elvira Pires de , Ramos Flávia Regina de Souza
Published: October 2010

doi: 10.5216/ree.v12i3.6855Pesquisa qualitativa, descritiva exploratória realizada em uma unidade de emergência com objetivo de identificar a percepção dos profissionais da equipe de saúde sobre os elementos de seu processo de trabalho (objeto, instrumentos, finalidade e produto). Os dados foram obtidos por meio de questionário aberto aplicado a 28 profissionais e analisados com base na análise de conteúdo, que permitiu a construção de cinco categorias que articularam a percepção dos diversos profissionais sobre o objeto do trabalho em saúde; os instrumentos de trabalho; a finalidade do trabalho na emergência, o produto final do trabalho e as especificidades dos diversos profissionais no serviço estudado. Os resultados mostraram diferentes entendimentos acerca destes elementos do processo de trabalho, o que contribui para explicar a dificuldade de realização de um trabalho mais colaborativo e integrador da especificidade das diferentes profissões. Conclui-se que reflexões sobre o processo de trabalho em equipes de saúde podem contribuir para mudanças em direção à integralidade e à humanização da assistência em saúde. Descritores: Trabalho; Serviço Hospitalar de Emergência; Equipe Interdisciplinar de Saúde.
Perfil de internações de pessoas idosas em um hospital público
Authors: Motta Claudia Carvalho Respeita da , Hansel Cristina Gonçalves , Silva Jaqueline Da
Published: October 2010

doi: 10.5216/ree.v12i3.6865O aumento do número de pessoas idosas com 60 anos e mais de vida ocasionaram mudanças no perfil epidemiológico da população brasileira, gerando demandas específicas em termos de cuidados e atenção por sua potencialidade para fragilidade biológica, psicológica e social. Para dar conta de tais demandas, faz-se necessário trabalho interdisciplinar qualificado e disponibilidade de complexo aparato hospitalar e ambulatorial. O estudo é exploratório, quantitativo e corte-temporal. Tem como objetivos, identificar e discutir o perfil de pessoas com 60 anos e mais, internadas em um hospital geral público de ensino de Petrópolis - Rio de Janeiro, durante o ano de 2007. Da descrição dos dados, identificamos 767 internações de idosos. O tempo predominante de internação da população do estudo foi de 85% (n=651) por até 30 dias seguidos de 45,3% (n=347) por até 10 dias. Os problemas de saúde descritos como motivo para internação mais prevalentes foram, 23% (n=177) doenças do aparelho digestivo, 18% (n=138) doenças do aparelho circulatório e 11,9% (n=91) neoplasias. Concluímos, de acordo com o percentual significativo de internações, o tempo de permanência hospitalar prolongado e prevalência de morbidades do aparelho digestivo, haver necessidade urgente de sistematização para a promoção de cuidados integrais e específicos para a clientela idosa. Descritores: Hospitalização; Enfermagem Geriátrica; Idoso; Serviços de Saúde para Idosos.
Aleitamento materno: orientações, conhecimento e participação do pai nesse processo
Authors: Paula Angélica Oliveira , Sartori Ana Lucia , Martins Cleusa Alves
Published: October 2010

doi: 10.5216/ree.v12i3.6929A participação do pai durante o aleitamento materno pode encorajar a parceira a amamentar e evitar o desmame precoce. O estudo objetivou investigar o conhecimento do pai acerca do aleitamento materno, orientações oferecidas a ele durante o pré-natal e analisar a sua participação nesse processo. Estudo descritivo de abordagem qualitativa, realizado em Goiânia/Goiás. A coleta de dados foi realizada entre abril e junho de 2009, com nove pais que acompanhavam seus filhos, com idade de até 24 meses, em serviços da rede pública de saúde, por meio de entrevista utilizando-se roteiro semi-estruturado. Após análise temática dos dados foram criadas as três categorias que revelam que, de modo geral o pai não está envolvido no processo de amamentação, apenas dois foram orientados na assistência pré-natal. A maioria dos entrevistados desejava ser pai e que seus filhos fossem amamentados, reconhecem os benefícios do aleitamento para a criança, mas desconhecem os benefícios da amamentação para a mãe. Os dados mostram que não há uma participação ativa desses na amamentação. Concluímos que os serviços de saúde devem estabelecer metas claras, devendo, instituir uma política de capacitação da equipe de saúde como padrão de qualidade da assistência prestada à mulher, a criança e ao pai. Descritores: Aleitamento Materno; Pai; Promoção da Saúde.
A compreensão do fenômeno condição crônica por diabetes mellitus a partir da experiência de adoecimento
Authors: Faria Ana Paula Silva de , Bellato Roseney
Published: October 2010

doi: 10.5216/ree.v12i3.6953 Em nossa experiência profissional temos identificado que abordagem às pessoas com diabetes mellitus (DM) tem sido centrado nas ações de controle e monitoramento da doença, sendo que desconsideram as repercussões e enfretamentos que essas pessoas vivenciam no seu cotidiano. Trata-se de um estudo qualitativo, descritivo, tipo Estudo de Caso que teve como objetivo compreender as repercussões e enfrentamentos que as pessoas em condição crônica por DM vivenciam em seu cotidiano. A apreensão dos dados foi fundamentada na estratégia metodológica da História de Vida Focal que foi operacionalizada pela Entrevista em Profundidade. O estudo foi realizado em Cuiabá/MT, em 2007, com uma pessoa com DM que esteve internado em hospital público por complicações secundárias. A análise dos dados possibilitou compreender que a vida cotidiana que é marcada por enfrentamentos e repercussões como aumento das fases de agudizações e complicações da doença, (re) arranjos cotidianos somados ao medo da dependência do outro para o cuidado e medo da morte. Este estudo possibilita e nos convida e (re) pensarmos as práticas de atenção e de gestão centrada nas pessoas e famílias em condição crônica por DM. Descritores: Diabetes mellitus; Doenças crônicas; Atividades cotidianas.
Práticas cuidadoras que favorecem a integralidade do cuidado ao recém-nascido de alto risco: revisão sistemática
Authors: Duarte Elysangela Dittz , Sena Roseni Rosângela de , Tavares Tatiana Silva
Published: October 2010

doi: 10.5216/ree.v12i3.7509A busca de um cuidado que contemple as dimensões biopsicossociais do recém-nascido, não limitadas às que garantem a sua sobrevida, tem sido promovida através de diferentes práticas que consideramos serem favorecedoras da integralidade. Neste estudo realizou-se uma revisão bibliográfica sistemática com o objetivo de identificar práticas cuidadoras que favorecem a integralidade do cuidado ao recém-nascido de alto risco. A busca foi realizada nas bases de dados BDENF, LILACS, MEDLINE, PAHO, WHOLIS e BVS INTEGRALIDADE, utilizando-se os indexadores Cuidados Integrais de Saúde, Neonatologia, Recém-nascido e Unidades de terapia intensiva neonatal, no período de 1988 a 2009. Foram selecionadas 17 publicações, em inglês, português e espanhol. Os resultados foram agrupados nas categorias: cuidado centrado no recém-nascido e na família, trabalho em equipe multiprofissional, participação da mãe e dos familiares no cuidado ao recém-nascido e continuidade da assistência. Concluiu-se que iniciativas são tomadas para possibilitar um cuidado integral mas que, para construção da integralidade da assistência ao neonato de risco, ainda existem dificuldades a serem superadas, principalmente em relação à ampliação do foco do cuidado e à reorganização do processo de trabalho em Unidade de Terapia Intensiva Neonatal.Descritores: Cuidados Integrais de Saúde; Neonatologia; Recém-nascido; Unidades de terapia intensiva neonatal.
Transfection by Electroporation
Authors: Potter Huntington , Heller Richard
Published: October 2010

Electroporation—the use of high‐voltage electric shocks to introduce DNA into cells—can be used with most cell types, yields a high frequency of both stable transformation and transient gene expression, and, because it requires fewer steps, can be easier than alternate techniques. This unit describes electroporation of mammalian cells, including ES cells for the preparation of knock‐out, knock‐in, and transgenic mice. Protocols are described for the use of electroporation in vivo to perform gene therapy for cancer therapy and DNA vaccination. Also described are modifications for preparation and transfection of plant protoplasts. Curr. Protoc. Mol. Biol. 92:9.3.1‐9.3.10. © 2010 by John Wiley & Sons, Inc.
Drug‐Induced Permeabilization of S. cerevisiae
Authors: Mayan Maria D.
Published: October 2010

Budding yeast are not permeable to many drugs. This unit provides a protocol in which polygodial is used to permeabilize the cell membrane, thereby allowing budding yeast cells to be treated with drugs that otherwise would be ineffective. Curr. Protoc. Mol. Biol. 92:13.2B.1‐13.2B.4. © 2010 by John Wiley & Sons, Inc.
Diagnosis of Cryptic Chromosomal Syndromes by Fluorescence In Situ Hybridization (FISH)
Authors: Kashork Catherine D. , Theisen Aaron , Shaffer Lisa G.
Published: October 2010

This unit describes the various methods by which cytogeneticists detect chromosome abnormalities. The unit offers guidance for detecting such abnormalities with fluorescence in situ hybridization (FISH), as well as the benefits, limitations, and other applications of FISH.Curr. Protoc. Hum. Genet. 67:8.10.1‐8.10.20 © 2010 by John Wiley & Sons, Inc.
“It's there and I'm stuck with it”: Patients' experiences of chronic pain following total knee replacement surgery
Authors: Jeffery Alison E. , Wylde Vikki , Blom Ashley W. , Horwood Jeremy P.
Published: October 2010

Objective

To gain insight into patients' experiences of adjustment to chronic pain following recovery from total knee replacement (TKR) surgery.

Methods

Participants were purposively sampled and comprised 28 individuals, 18 women and 10 men, ages 57–87 years, who had undergone a TKR between 2 and 5 years previously. Semistructured interviews explored participants' perceptions of their condition and its impact, including its causes and consequences. Thematic analysis, using the constant comparison technique, was used to identify and analyze patterns and themes from the transcripts.

Results

Although some individuals expressed acceptance of their continuing pain, others reported that it caused them considerable distress. Variation in expressed acceptance and distress was not related to self‐reported pain severity. Various factors relating to adjustment emerged, including perceived improvement or deterioration in circumstances since TKR, surgeon input pre‐ and postsurgery, and beliefs about pain in the context of an individual's life. Participants described a sense of abandonment following TKR and discussed the support they felt they should have received.

Conclusion

The data suggest that adjustment to chronic pain following recovery from TKR surgery is influenced by biomedical and psychosocial factors, including an individual's pain‐related illness cognitions, beliefs, and their perceptions of their condition in a social context. Patient care could be improved by clinicians utilizing a biopsychosocial framework to acknowledge the impact of osteoarthritis of the knee as a multidimensional health condition.
Relative urgency for referral from primary care to rheumatologists: The Priority Referral Score
Authors: Fitzgerald Avril , de Coster Carolyn , McMillan Stewart , Naden Ray , Armstrong Fraser , Barber Alison , Cunning Les , Conner‐Spady Barbara , Hawker Gillian , Lacaille Diane , Lane Carolyn , Mosher Dianne , Rankin Jim , Sholter Dalton , Noseworthy Tom
Published: October 2010

Objective

Timely access to rheumatology consultation is fundamental to appropriate and effective management of patients with musculoskeletal and autoimmune diseases. Yet, for a variety of reasons, limited and delayed access is commonplace. Moreover, information exchange for referral is often inadequate or poorly communicated. The objective of this work was to improve referral from primary care to rheumatology by formulating and testing a clinically coherent, reliable, and non–diagnosis‐dependent Priority Referral Score (PRS).

Methods

Using a deliberative process, a clinical panel of 10 primary care providers (PCPs) and rheumatology specialists reviewed clinical case scenarios and engaged in a highly iterative process to develop criteria, definitions, and weights for the PRS, a linear 100‐point scale to rate the relative urgency of referral. Following tool formulation, clinicians uninvolved with the process tested the PRS against their clinical judgment.

Results

The PRS comprises 8 criteria, with 2–4 levels for each criterion, and each having a weight generated through conjoint analysis, which forced choices around the comparative urgency of all of the criteria and levels. The PRS showed a strong correlation between clinical rankings of rheumatologists and PCPs in both the deliberative panel, and the physicians subsequently involved in the testing of the PRS.

Conclusion

No standardized priority‐setting criteria are available for the full range of primary care referrals to rheumatologists. The PRS had face value with panelists and provided acceptable interrater and intrarater reliability when tested with other rheumatologists and PCPs. Pilot testing with other clinicians and in other settings is justified and prerequisite to use in clinical practice.
Risk factors for squamous intraepithelial lesions in systemic lupus erythematosus: A prospective cohort study
Authors: Tam Lai‐Shan , Chan Paul K. S. , Ho Suzanne C. , Yu Mei‐Yung , Yim So‐Fan , Cheung Tak‐Hong , Wong Martin C. S. , Cheung Jo L. K. , Li Edmund K.
Published: October 2010

Objective

We undertook a prospective cohort study to ascertain the risk factors for the development of squamous intraepithelial lesions (SIL) in patients with systemic lupus erythematosus (SLE).

Methods

One hundred thirty‐seven SLE patients with a normal Papanicolaou (Pap) smear at baseline were evaluated at 6‐month intervals for up to 3 years. At each visit, a Pap smear, human papillomavirus (HPV) DNA test, and clinical assessment were performed.

Results

Among the 137 patients, there were 12 incident cases (8.8%) of SIL over a median followup duration of 30.7 months (interquartile range 25.5–31.7). Among the 30 patients with HPV infection detectable by DNA testing at baseline, 9 (30%) developed SIL. The independent risk factors for the incident SIL in this group of SLE patients included the use of cyclophosphamide (CYC) ever (odds ratio [OR] 5.6, 95% confidence interval [95% CI] 1.1–29.3; P = 0.041) and persistent high‐risk HPV infection (OR 26.9, 95% CI 3.2–222.3; P = 0.002). The use of baseline HPV testing has a higher sensitivity than abnormal cytology (defined as atypical squamous cells of undetermined significance; 47.7% versus 33.3%) in predicting the development of SIL.

Conclusion

Independent risk factors associated with the development of SIL in SLE patients included persistent high‐risk HPV infection and the use of CYC. Low‐risk patients who receive negative test results on both cervical cytology screening and HPV DNA testing may not need to be rescreened within 3 years.
Data‐driven model reference control with asymptotically guaranteed stability
Authors: van Heusden Klaske , Karimi Alireza , Bonvin Dominique
Published: October 2010

This paper presents a data‐driven controller tuning method that includes a set of constraints for ensuring closed‐loop stability. The approach requires a single experiment and can also be applied to nonminimum‐phase and unstable systems. The tuning scheme generates an estimate of the closed‐loop output error that is used to minimize an approximation of the model reference control problem. The correlation approach is used to deal with the influence of measurement noise. For linearly parameterized controllers, this leads to a convex optimization problem. A sufficient condition for closed‐loop stability is introduced, which can be included in the optimization problem for control design. As the data length tends to infinity, closed‐loop stability is guaranteed. The quality of the estimated controller is analyzed for finite data length. The effectiveness of the proposed method is demonstrated in simulation as well as experimentally on a laboratory‐scale mechanical setup. Copyright © 2010 John Wiley & Sons, Ltd.
An Electrochemical Approach to PtAg Alloy Nanostructures Rich in Pt at the Surface
Authors: Peng Zhenmeng , You Hongjun , Yang Hong
Published: October 2010

This paper describes a new approach to the synthesis of PtAg alloy nanostructures rich in Pt at the surface through a selective electrochemical dissolution of Ag from PtAg alloy nanoparticles that are made from platinum acetylacetonate, Pt(acac)2, and silver stearate, Ag(St). The surface and bulk compositions, size, and architecture of these heterogeneous nanostructures are controlled synergistically by changing the upper limits of cycling potentials in perchloric acid (HClO4) aqueous solution to dissolve Ag deterministically. The structures and elemental distributions of Ag and Pt in the resulting heterogeneous nanoparticles are characterized by high‐resolution transmission electron microscopy (HR‐TEM), high‐angle annular dark‐field scanning transmission electron microscopy (HAADF‐STEM) and energy‐dispersive X‐ray (EDX). These Pt‐surface rich PtAg nanostructures exhibit much higher activity than Pt nanoparticles as electrocatalysts in formic acid oxidation reaction (FAOR).
Controlled Synthesis and Functionalization of Ordered Large‐Pore Mesoporous Carbons
Authors: Deng Yonghui , Cai Yue , Sun Zhenkun , Gu Dong , Wei Jing , Li Wei , Guo Xiaohui , Yang Jianping , Zhao Dongyuan
Published: October 2010

Ordered mesoporous carbon C‐FDU‐18s with tunable pore sizes of 12−33 nm and pore wall thicknesses of 5−11 nm were synthesized by using poly(ethylene oxide)‐block‐poly(styrene) (PEO‐b‐PS) diblock copolymers with various PS chain lengths as templates and through the evaporation induced self‐assembly process. The obtained C‐FDU‐18 carbons possess face‐centered cubic mesostructure with Fm3m symmetry, large cell parameters varying from 32 to 54 nm, high Brunauer–Emmett–Teller surface area up to 1000 m2 g−1 and large pore volume of about 0.7 cm3 g−1. By oxidative treatment of HNO3 and H2O2 mixed solution, numerous hydrophilic groups were created in the mesopore channels without destroying the ordered mesostructure of the C‐FDU‐18. Through the in situ reduction of Ag+, Ag nanoparticles (9.7 nm) were successfully introduced into the large mesopores, resulting in functional mesoporous carbons Ag–C‐FDU‐18 with stably trapped Ag nanoparticles. Similarly, by reduction of Fe3+ ions in the large mesopores, superparamagnetic Fe–C‐FDU‐18 with incorporated magnetic nanoparticles (6.2 nm) and fast magnetic response was synthesized. These functional large‐pore mesoporous carbons have high potential for application in various fields such as catalysis, chemical sensing, and magnetic separation and enrichment.