bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomized Phase II Adjuvant Trial of Dose-Dense Docetaxel Before or After Doxorubicin Plus Cyclophosphamide in Axillary Node-Positive Breast Cancer
Authors: Puhalla Shannon , Mrozek Ewa , Young Donn , Ottman Susan , McVey Anne , Kendra Kari , Merriman Nancy J. , Knapp Mark , Patel Taral , Thompson Mark E. , Maher James F. , Moore Timothy D. , Shapiro Charles L.
Published: March 2008

Purpose

An anthracycline-based combination followed by, or combined with, a taxane is the sequence used in most adjuvant chemotherapy regimens. We hypothesized that administering the taxane before the anthracycline combination would be associated with fewer dose reductions and delays than the reverse sequence. To test this hypothesis, a randomized phase II multicenter adjuvant chemotherapy trial was performed.

Patients and Methods

Fifty-six patients with axillary node-positive, nonmetastatic breast cancer were randomly assigned either to group A (docetaxel [DOC] 75 mg/m2 intravenously [IV] every 14 days for four cycles followed by doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2 [AC] IV every 14 days for four cycles); or to group B (AC followed by DOC) at the identical doses and schedule. Pegfilgrastim 6 mg subcutaneous injection was administered 1 day after the chemotherapy in all treatment cycles. The primary objective was to administer DOC without dose reductions or delays before or after AC and calculate the relative dose intensity (RDI) of DOC and AC.

Results

The majority of toxicities were grade 0 to 2 irrespective of sequence. The RDI for DOC was 0.96 and 0.82, respectively, in groups A (DOC followed by AC) and B (AC followed by DOC), with more frequent dose reductions occurring in group B (46% v 18%). The RDI for AC was 0.95 and 0.98 in groups A and B, respectively.

Conclusion

The administration of DOC before AC results in fewer DOC dose reductions and a higher RDI than the reverse sequence. Larger trials evaluating the sequence of DOC before anthracyclines are justified.
The relationship of maternal mentalization and executive functioning to maternal recognition of infant cues and bonding
Authors: Turner Jennifer M. , Wittkowski Anja , Hare Dougal Julian
Published: March 2008

The study examined associations between maternal mentalization ability, executive functioning, recognition of infant cues, and bonding in a non‐clinical sample of mothers. It employed a correlational design. Sixty‐four mothers of young infants completed assessments of mentalization ability, executive functioning, and bonding. Photographs of infant facial expressions were utilized to assess ability to recognize infant cues of emotion, but this was not found to correlate with either maternal mentalization or executive functioning ability. Whilst a trend towards a significant positive relationship between mothers' cued ability to attribute mental states and their ability to recognize infant facial expressions was observed, no significant relationships were found between bonding scores and performance on the executive functioning and mentalization measures. The present study contributes to our current understanding of the influence of maternal cognitive factors, specifically mentalization and executive functioning, on the development of the mother–infant relationship. Future research, methodological issues, and clinical and theoretical implications are discussed.
How are employees at different levels affected by privatization? A longitudinal study of two Swedish hospitals
Authors: Falkenberg Helena , Näswall Katharina , Sverke Magnus , Sjöberg Anders
Published: March 2008

Despite the amount of privatizations around the world in recent decades, only limited research attention has been paid to how privatization affects the employees. The effects are likely to vary depending on the individual's position in the organization. The aim of this study was to investigate how employees' work‐related attitudes and strain changed after privatization of a Swedish acute care hospital, and to analyze whether the effects of privatization differed between employees at various hierarchic levels. Questionnaire data collected at a hospital 1 year before and 2 years after privatization, as well as at a hospital which remained a public administration unit, suggest only limited effects of privatization on a general level, but that employees at various hierarchic levels may be affected differently. While employees at a high level (physicians) and low level (assistant nurses) reported only marginal differences over time in work attitudes and strain, also in comparison with their colleagues at the comparison hospital, work attitudes of employees at the intermediate level (registered nurses) decreased after privatization. These results emphasize the importance of taking hierarchic level into account when a privatization is implemented and analyzed.
Is the loss of diagnosticity of the eye region of the face a common aspect of acquired prosopagnosia?
Authors: Rossion Bruno , Kaiser Martha D. , Bub Daniel , Tanaka James W.
Published: March 2008

A recent study published in this journal has shown an abnormal performance at discriminating differences with respect to the eyes of unfamiliar faces in two acquired prosopagnosic patients, but preserved processing of the mouth region. Here we extend these findings by showing a similar lack of sensitivity to the eyes in the very same face matching experiment for the prosopagnosic patient PS, who also showed normal performance for detecting differences in the mouth region. These results complement previously published evidence that the patient PS presents a lack of sensitivity to diagnostic information located on the eyes of familiar faces during individual face recognition tasks. More generally, they indicate that the impaired processing of the eyes of faces is a fundamental aspect of acquired prosopagnosia that can arise following damage to different brain localizations.
Age-Related Changes in the Osteogenic Differentiation Potential of Mouse Bone Marrow Stromal Cells
Authors: Zhang Weixi , Ou Guomin , Hamrick Mark , Hill William , Borke James , Wenger Karl , Chutkan Norman , Yu Jack , Mi Qing-Sheng , Isales Carlos M , Shi Xing-Ming
Published: March 2008

Age-dependent bone loss has been well documented in both human and animal models. Although the underlying causal mechanisms are probably multifactorial, it has been hypothesized that alterations in progenitor cell number or function are important. Little is known regarding the properties of bone marrow stromal cells (BMSCs) or bone progenitor cells during the aging process, so the question of whether aging alters BMSC/progenitor osteogenic differentiation remains unanswered. In this study, we examined age-dependent changes in bone marrow progenitor cell number and differentiation potential between mature (3 and 6 mo old), middle-aged (12 and 18 mo old), and aged (24 mo old) C57BL/6 mice. BMSCs or progenitors were isolated from five age groups of C57BL/6 mice using negative immunodepletion and positive immunoselection approaches. The osteogenic differentiation potential of multipotent BMSCs was determined using standard osteogenic differentiation procedures. Our results show that both BMSC/progenitor number and differentiation potential increase between the ages of 3 and 18 mo and decrease rapidly thereafter with advancing age. These results are consistent with the changes of the mRNA levels of osteoblast lineage-associated genes. Our data suggest that the decline in BMSC number and osteogenic differentiation capacity are important factors contributing to age-related bone loss.
The Impact of Programs to Increase Contraceptive Use Among Adult Women: A Review of Experimental and Quasi‐Experimental Studies
Authors: Kirby Douglas
Published: March 2008

CONTEXT:  Because rates of unintended pregnancy, abortion and unintended birth are very high among adult women in the United States, it is important to identify interventions that can increase contraceptive use in this population.

METHODS:  PubMed, PsycINFO and POPLINE were searched for experimental or quasi‐experimental studies published between 1990 and 2005 that evaluated policies or programs designed to increase contraceptive use or reduce pregnancy among adult women in the United States. In addition, relevant journals were searched, experts were asked to provide further citations and several subsequently published articles were included.

RESULTS:  Only 11 studies that assessed programs, and none that assessed policies, were found. The evaluated interventions offered pregnancy and STD prevention counseling (one study); provided contraceptives in settings other than family planning clinics (two studies); had women initiate contraceptive use during the medical visit (two studies); provided advance supplies of emergency contraception (four studies); or implemented systems to remind injectable contraceptive users about their next injection (two studies). The interventions generally had positive, albeit short‐term, effects on contraceptive use; none reduced pregnancy rates. Programs that gave women a contraceptive during the visit were the most effective at increasing method use. Advance provision of emergency contraception increased the likelihood of its use and did not affect regular contraceptive use.

CONCLUSIONS:  Very few studies have evaluated interventions to increase contraceptive use among adult women. A research plan that rigorously assesses the impact of different approaches to increasing contraceptive use among adult women should be an integral part of any long‐term effort to prevent unintended pregnancy in the United States.
Cultural proximity in TV entertainment: An eight-country study on the relationship of nationality and the evaluation of U.S. prime-time fiction
Authors: Trepte Sabine
Published: March 2008

In previous research, cultural proximity has been operationalized by ‘hard facts’ such as geographical distance, the exchange of goods or persons (tourists and immigrants) and the similarity of political systems. This article will try to complement current work in the field by suggesting a new operationalization derived from Hofstede's (1991) cultural dimensions. A survey was conducted in eight countries with a student sample (N = 325) to find out if international audiences which resemble each other in terms of Hofstede's (1991) cultural dimensions have similar attitudes towards U.S. prime-time fictional programming. The results show that Hofstede's four cultural dimensions significantly differentiate between the U.S.A., Asian and European countries in a student population. However, operationalizations based on geographical distance allow a better differentiation between nation-states in terms of how they evaluate U.S. fiction. It will be discussed whether cultural dimensions in general are able to measure cultural proximity.
A case for an integrative view on affect regulation through media usage
Authors: Schramm Holger , Wirth Werner
Published: March 2008

Zillmann's mood-management theory (Zillmann, 1988) has acquired a prominent place in media psychology and makes reliable predictions about people's hedonistically motivated mood regulation via entertainment offerings. However, the full potential for explaining affect regulation through media usage has not been exhausted so far. Therefore, we aim at an integrative view of the field based on empirical findings from communication studies as well as on the background of contemporary theories of mood (regulation) and emotion (regulation). The purpose of this analysis is to argue towards an integrative theoretical perspective which considers both unconscious and conscious/reflected processes of affect regulation through media, supplements the hedonistic motive with other non-hedonistic, instrumental motives of affect regulation, looks at selection behavior as well as at other behavioral and cognitive strategies of affect regulation, and encompasses individual attributes (particularly those with affinity to affects).
Telling what yesterday's news might be tomorrow: Modeling media dynamics
Authors: Hollanders David , Vliegenthart Rens
Published: March 2008

In this article, we discuss the use of time series models in communication research. More specifically, we consider autoregressive and moving-average processes, which together constitute the autoregressive integrated moving average-framework (ARIMA). This approach provides a comprehensive framework to deal with the essential issue of stationarity and to model the dynamics of any time series by estimating the autocorrelation structure. Underlying the models are questions as to what extent news tends to reproduce itself and how news flows adjust after deviations from the normal news stream. The data illustrating the models consist of visibility-scores of the immigration issue in Dutch national newspapers. The empirical analysis demonstrates that the impact of immigration figures on this visibility is not significant when the ARIMA-framework is applied, while an analysis using OLS suggests a positive influence.
ICT performance in processes of knowledge sharing in organizations: A review of literature
Authors: Nelissen Paul , Wenneker Marieke , van Selm Martine
Published: March 2008

The purpose of this paper is to theoretically explore in what ways Information and Communication Technology (ICT) corresponds with knowledge sharing in organizations. We will address the research question: “What notions and relationships have been proposed in the literature regarding ICT use and knowledge sharing?” In order to draw connecting lines between different bodies of literature, we developed two notions of ICT performance as a guiding principle in reviewing the literature. On the one hand, ICT is portrayed as a guide that moulds ways of knowledge sharing, and on the other hand ICT is described as a facilitator that follows existing knowledge sharing processes in organizations. The two types of ICT performance offer a tool with which approaches and perspectives on ICT in processes of knowledge sharing can be interconnected and displayed in one overview. This systematic research overview that connects separate notions and ideas coming from different disciplines results in a synthesis of research questions that are relevant for future research on the role of ICT in knowledge sharing in organizations.
Prediction of the Fatigue Limit of Prestrained Carbon Steel Under Tensile Mean Stress
Authors: Kang Minwoo , Irisa Kentaro , Aono Yuuta , Noguchi Hiroshi
Published: March 2008

The effect of tensile mean stress on the fatigue limit of carbon steel was investigated. Annealed 0.1 % and 0.5 % carbon steel specimens were subjected to monotonic tension to produce prestrain. Fatigue tests were performed using a servohydraulic fatigue test machine. The experimental results showed that tensile mean stress degraded the fatigue limit. However, the tensile mean stress did not affect the decrease in the surface hardness as a result of fatigue loading for the specimen without a defect. In the case of the specimen with a defect, the decrease in the hardness was small and did not depend on the mean stress or stress amplitude. Formulae for predicting the fatigue limit of prestrained carbon steel specimens under tensile mean stress were proposed. The results calculated using the formulae showed good agreement with the experimental results.
Novel Uncertainty-Evaluation Method of Virtual Instrument Small Sample Size
Authors: Leyi Ge , Zhongyu Wang
Published: March 2008

Owing to the complication of virtual instrument measurement process, the authors applied Guide to the expression of uncertainty in measurement to evaluate the final measurement-uncertainty. However there are three essential problems that should be solved first: establishing a measurement model, calculating all error sensitivity coefficients, and correlation-coefficient. In order to analyze all random errors of the virtual instrument (VI) measurement chain, in this paper the main structure of VI measurement systems was discussed first. To establish the model of VI small sample measurement, a radial basis function neural network was used, then, based on this model, all error sensitivity coefficients were calculated by some difference equations; to calculate all correlation-coefficient of these error sources, a special arithmetic based on grey system theory was used. In the end, according to a general measurement example, uncertainty-evaluation results of this new method and Monte Carlo method were consistent, and this new method was proved.
Immune Reconstitution and Recovery of FOXP3 (Forkhead Box P3)-Expressing T Cells After Transplantation for IPEX (Immune Dysregulation, Polyendocrinopathy, Enteropathy, X-linked) Syndrome
Authors: Zhan Hong , Sinclair Jo , Adams Stuart , Cale Catherine M. , Murch Simon , Perroni Lucia , Davies Graham , Amrolia Persis , Qasim Waseem
Published: March 2008

Immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome is a rare X-linked disorder that usually presents in early childhood with immune enteropathy, diabetes mellitus, and other autoimmune complications. The disease is caused by mutations in the forkhead box P3 gene, a transcription factor that is essential for the development and function of regulatory T cells. This population of cells plays an essential role in controlling immune responses and preventing autoimmunity. Immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome is often initially treated with immunosuppressive drugs, but only allogeneic hematopoietic stem cell transplantation has offered the possibility of cure. We recently performed an unrelated donor transplant in a child with immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome by using a reduced-intensity conditioning regimen. This transplant provided a rare opportunity to gain valuable insight into the regeneration of the immune system after transplantation. Clinical recovery was associated with the emergence of regulatory T cell populations, the majority of which expressed memory phenotype markers and raised important questions about the origin and longevity of the FOXP3+ regulatory T cell pool.
Atividade física e estado de saúde mental de idosos
Authors: Benedetti Tânia R Bertoldo , Borges Lucélia Justino , Petroski Edio Luiz , Gonçalves Lúcia Hisako Takase
Published: March 2008

OBJETIVO: Avaliar a associação entre nível de atividade física e o estado de saúde mental de pessoas idosas. MÉTODOS: Inquérito de base populacional com amostragem probabilística, incluindo 875 idosos da cidade de Florianópolis, Santa Catarina, em 2002. Foram aplicados os questionários: Internacional de Atividades Físicas e Brazil Old Age Schedule. Os problemas de saúde mental avaliados foram depressão e demência, além da prática de atividade física total (lazer, ocupação, deslocamentos e serviços domésticos). Após análises descritivas e bivariadas, realizou-se análise ajustada por meio de regressão logística, com ajuste para os fatores de atividade física total, atividade de lazer, escores de depressão e demência. RESULTADOS: Verificou-se associação estatisticamente significativa e inversa de demência e depressão com atividade física total e atividade física no lazer. A odds ratio ajustada para demência entre os sujeitos sedentários para atividade física total comparada à dos ativos foi de 2,74 (IC 95%: 1,85; 4,08), enquanto o respectivo valor para depressão foi de 2,38 (IC 95%: 1,70; 3,33). CONCLUSÕES: Os resultados reforçam a importância de estilo de vida ativo para prevenção de problemas de saúde mental de idosos. Infere-se que a atividade física tem conseguido reduzir e/ou atrasar os riscos de demência, embora não se possa afirmar que a atividade física evita a demência.
Agreement between data obtained from repeated interviews with a six-years interval
Authors: Martins Carolina Castro , Ramos-Jorge Maria Letícia , Cury Jaime Aparecido , Pordeus Isabela Almeida , Paiva Saul Martins
Published: March 2008

The objective of the study was to compare information collected through face-to-face interviews at first time and six years later in a city of Southeastern Brazil. In 1998, 32 mothers (N=32) of children aged 20 to 30 months answered a face-to-face interview with structured questions regarding their children's brushing habits. Six years later this same interview was repeated with the same mothers. Both interviews were compared for overall agreement, kappa and weighted kappa. Overall agreement between both interviews varied from 41 to 96%. Kappa values ranged from 0.00 to 0.65 (very bad to good) without any significant differences. The results showed lack of agreement when the same interview is conducted six years later, showing that the recall bias can be a methodological problem of interviews.
Queimadas de cana-de-açúcar no Brasil: efeitos à saúde respiratória
Authors: Ribeiro Helena
Published: March 2008

O artigo objetivou atualizar as informações sobre a produção científica referente aos efeitos da queima da cana-de-açúcar à saúde respiratória, em vista da expansão das plantações de cana no Brasil e no estado de São Paulo. São comentados estudos publicados no período de 1996-2006 que tratam de efeitos à saúde da queima da cana e/ou de poluentes atmosféricos produzidos pela queima. Os estudos sugerem que uma parcela da população - sobretudo de idosos, crianças e asmáticos - tem sua saúde agravada pela queima da cana-de-açúcar, demandando atendimento dos serviços de saúde e assim onerando os serviços de saúde e suas famílias.
Atenção aos tabagistas pela capacitação de profissionais da rede pública
Authors: Azevedo Renata Cruz Soares de , Higa Celina Matiko Hori , Assumpção Isilda Sueli Andreolli Mira de , Fernandes Rejane Firmino , Boscolo Marília Montoya , Frazatto Cecília Regina Gonzaga , Goulart Welson
Published: March 2008

O estudo avaliou desdobramentos de um treinamento para abordagem de tabagistas para 40 profissionais da rede pública, de novembro de 2004 a março de 2007. Os profissionais realizaram abordagem mínima individual (3.419 tabagistas) e grupal (982). Dos pacientes fumantes que participaram dessas atividades, 9,2% conseguiram parar de fumar. As dificuldades relatadas pelos profissionais foram baixa adesão dos pacientes (11%), falta de medicação (38%) e de apoio/estrutura da unidade (29%). O treinamento aumentou a população abordada pelas unidades de saúde nas estratégias de prevenção do tabagismo.
Considerações sobre a atenção domiciliária e suas aproximações com o mundo do trabalho na saúde
Authors: Kerber Nalú Pereira da Costa , Kirchhof Ana Lúcia Cardoso , Cezar-Vaz Marta Regina
Published: March 2008

Este texto apresenta uma reflexão sobre a atenção domiciliária enquanto um trabalho em saúde, que vem se expandindo no sistema público e privado, ao mesmo tempo em que discute a atenção domiciliária e a possibilidade da mesma alavancar um impacto significativo na qualidade de vida e na saúde da população. Apresenta a atenção domiciliária como uma possibilidade estratégica de reorganização do Sistema de Saúde, por meio da integração entre os trabalhadores e as instituições de saúde. Também são consideradas os possíveis impactos políticos, econômicos e técnicos da atenção domiciliária no sistema de saúde, nos trabalhadores e nos usuários desse serviço.
Prevalência de sintomas de anorexia nervosa e insatisfação com a imagem corporal em adolescentes do sexo feminino do Município de Florianópolis, Santa Catarina, Brasil
Authors: Alves Emilaura , Vasconcelos Francisco de Assis Guedes de , Calvo Maria Cristina Marino , Neves Janaina das
Published: March 2008

Objetivou-se identificar a prevalência de sintomas de anorexia nervosa e de insatisfação com a imagem corporal em adolescentes (sexo feminino) de Florianópolis, Santa Catarina, Brasil. A amostra foi proporcional, estratificada conforme rede escolar (pública/privada) e região sócio-geográfica, posteriormente distribuída no ensino fundamental e médio. Foram analisadas 1.148 adolescentes sorteadas aleatoriamente nos estratos. A presença de sintomas de anorexia nervosa (EAT+) foi identificada pelo Teste de Atitudes Alimentares e a avaliação da imagem corporal pelo Questionário de Imagem Corporal. As prevalências de EAT+ e insatisfação com a imagem corporal foram 15,6% e 18,8%. O EAT+ apresentou-se associado à faixa de 10-13 anos (OR = 1,542; p = 0,046); sobrepeso e obesidade (OR = 2,075; p < 0,001); insatisfação com a imagem corporal (OR = 14,392; p < 0,0001) e rede pública (OR = 1,423; p = 0,041). A regressão logística múltipla apontou a insatisfação com a imagem corporal como a variável independente de maior risco para a manifestação dos sintomas (OR = 16,7; p < 0,001). Pode-se concluir que as adolescentes em Florianópolis apresentam índices de EAT+ semelhantes àqueles observados em outras regiões brasileiras.
O modelo de regressão linear misto para dados longitudinais: uma aplicação na análise de dados antropométricos desbalanceados
Authors: Fausto Maria Arlene , Carneiro Mariângela , Antunes Carlos Mauricio de Figueiredo , Pinto Jorge Andrade , Colosimo Enrico A.
Published: March 2008

Os dados provenientes de estudos longitudinais se caracterizam pela seqüência de duas ou mais observações em cada indivíduo. Nos estudos de coorte, esses dados geralmente apresentam estrutura desbalanceada. Uma casuística que envolve a avaliação longitudinal de crescimento de lactentes nascidos de mães infectadas pelo HIV foi acompanhada no ambulatório de AIDS pediátrica do Hospital das Clínicas da Universidade Federal de Minas Gerais, Minas Gerais, Brasil. O objetivo deste estudo é demonstrar a aplicação do modelo linear misto na análise de dados longitudinais desbalanceados provenientes dessa coorte. Os resultados mostram que, aos seis meses de idade, os meninos eram, em média, 1,8cm maiores que as meninas e as crianças sororrevertoras eram, em média, 2,9cm maiores que as infectadas. Aos 12 meses, a diferença na altura entre meninos e meninas passou a ser, em média, de 2,4cm enquanto a diferença entre infectados e sororrevertores passou a ser, em média, de 3,5cm. Além de descrever o comportamento longitudinal do crescimento, o modelo também permite estimar a velocidade de crescimento das crianças por sexo e grupo.
Consentir incertezas: o consentimento informado e a (des)regulação das tecnologias de reprodução assistida
Authors: Silva Susana Manuela Ribeiro Dias da
Published: March 2008

Este artigo visa a analisar os contornos locais de criação e utilização dos autoconhecimentos de médicos e "leigos" envolvidos em processos de procriação medicamente assistida a partir do confronto das práticas discursivas destes atores sociais em torno das expectativas, das incertezas e das responsabilidades associadas a estas técnicas em Portugal. Os médicos avaliam as (in)certezas das aplicações dessas técnicas com base em categorias de caráter naturalista e essencialista. Mais, esses critérios são instrumentalizados para eclipsar a ausência de explicação "científica" para os (in)sucessos, reproduzindo a crença no caráter "miraculoso" do progresso científico e tecnológico. A compreensão profana dos benefícios e das limitações dessas técnicas reflete uma atitude reverencial face à medicina e ao paradigma racionalista da perspectiva biomédica, ainda que seja possível vislumbrar alguns espaços de autonomia e resistência face às propostas médicas. As eventuais incertezas dessas técnicas são perspectivadas como efeitos excepcionais e intrínsecos à prática da medicina, aos quais têm de se submeter de forma individual. As mulheres, em particular, identificam-se como as principais responsáveis pela maximização da probabilidade de "sucesso" dessas técnicas.
Percepção de saúde e fatores associados em industriários de Santa Catarina, Brasil
Authors: Fonseca Silvio Aparecido , Blank Vera Lúcia Guimarães , Barros Mauro Virgílio Gomes de , Nahas Markus Vinicius
Published: March 2008

O objetivo foi identificar a prevalência e os fatores associados à percepção negativa de saúde em trabalhadores da indústria no Estado de Santa Catarina, Brasil. Para tanto, foi realizado estudo transversal em amostra representativa de 2.574 sujeitos (62,5% - homens). A percepção negativa de saúde foi o desfecho investigado em relação a variáveis demográficas, sócio-econômicas, perceptivas (estresse e sono) e de saúde. Análise de regressão logística multivariável não condicional baseada em modelo hierárquico foi utilizada para explorar associações. A percepção negativa de saúde foi baixa (11,8%) e positivamente associada com a faixa etária, atividade física de lazer, percepção da qualidade do sono, percepção do estresse e sexo. Em contrapartida, a renda familiar bruta e o nível de escolaridade associaram-se inversamente ao desfecho. Industriários que exerciam trabalhos de maior demanda física e aqueles classificados nos extremos das categorias do índice de massa corporal (< 18,5kg/m² ou >30kg/m²) apresentaram maiores prevalências de percepção negativa de saúde. Diferenças significativas de acordo com o estado civil, consumo de bebidas alcoólicas (binge drinking) e tabagismo não foram verificadas. Poucas associações foram reveladas para o sexo feminino.
Práticas de atendimento a DST nas farmácias do Distrito Federal, Brasil: um estudo de intervenção
Authors: Naves Janeth de Oliveira Silva , Castro Lia Lusitana Cardozo de , Melo Gislane Ferreira de , Giavoni Adriana , Merchán-Hamann Edgar
Published: March 2008

Pesquisa para investigar práticas, características dos trabalhadores e avaliar efetividade de intervenção educativa foi desenvolvida em setenta farmácias de Brasília e Taguatinga, Brasil, distribuídas em dois grupos; metade das farmácias participou de treinamento sobre DST. Realizou-se 411 visitas de pesquisadores simulando sintomas de DST, que resultaram em: encaminhamento ao médico em cerca de 30% dos atendimentos; indicação de medicamentos em mais de 70% dos atendimentos, embora nas entrevistas apenas 16,4% afirmaram fazê-lo; nenhum tratamento indicado era adequado segundo abordagem sindrômica; recomendações preventivas e tratamento de parceiros foram pouco freqüentes; farmacêuticos recomendaram ida ao médico mais do que balconistas e estes indicaram medicamentos mais do que farmacêuticos. O conhecimento dos trabalhadores sobre DST foi considerado superficial. Após intervenção educativa nenhum dos indicadores apresentou melhora significativa em ambos os grupos. As constatações apontam a necessidade de regulamentação e de intervenção para divulgação de práticas educativas para controle de doenças como as DST e para o uso racional de medicamentos nas farmácias.
Preditores sócio-demográficos, de estilo de vida e gineco-obstétricos das concentrações séricas ou plasmáticas de homocisteína, ácido fólico e vitaminas B12 e B6 em mulheres de baixa renda de São Paulo, Brasil
Authors: Almeida Lana Carneiro , Tomita Luciana Yuki , D'Almeida Vânia , Cardoso Marly Augusto
Published: March 2008

O presente estudo investigou fatores sócio-demográficos, de estilo de vida e gineco-obstétricos associados às concentrações séricas ou plasmáticas de homocisteína, ácido fólico, vitaminas B12 e B6 em mulheres de baixa renda de São Paulo, Brasil. Concentrações séricas de ácido fólico e vitamina B12 foram analisadas por fluoroimunoensaio; concentrações plasmáticas de homocisteína e vitamina B6, por cromatografia líquida de alta performance em fase reversa. Variáveis independentes foram inicialmente selecionadas segundo pressupostos teóricos, correlação de Pearson ou teste Kruskal-Wallis (p < 0,20). Concentrações alteradas segundo pontos de corte para homocisteína, ácido fólico, vitaminas B12 e B6 foram observadas em 20%, 6%, 11% e 67% das participantes, respectivamente. Idade foi positivamente correlacionada à vitamina B6 e homocisteína plasmáticas (p < 0,001). Índice de massa corporal foi positivamente correlacionado à vitamina B6 plasmática (p < 0,001). Modelos de regressão linear múltiplos explicaram 10,2%, 5,8%, 14,4% e 9,4% das concentrações de ácido fólico, vitamina B12, vitamina B6 e homocisteína, respectivamente. No presente estudo, variáveis sócio-demográficas, de estilo de vida e gineco-obstétricas apresentaram contribuição importante na variação das concentrações dos indicadores bioquímicos avaliados.
A transição da estrutura etária da população brasileira na primeira metade do século XXI
Authors: Carvalho José Alberto Magno de , Rodríguez-Wong Laura L.
Published: March 2008

A trajetória da população brasileira, na primeira metade deste século, tanto em termos de seu volume, quanto de sua estrutura etária, já está praticamente definida, pois, tanto a transição de mortalidade quanto a da fecundidade já se encontram muito avançadas. Enquanto a população idosa (65 e mais anos de idade) aumentará a taxas altas (entre 2% e 4% ao ano), a população jovem tenderá a decrescer. Segundo projeções das Nações Unidas, de 3,1% da população total, em 1970, a população idosa brasileira deverá passar a aproximadamente 19%, em 2050. Paralelamente, conviverão dentro das populações jovem e adulta subgrupos etários com crescimento negativo e positivo. A transição etária brasileira gera oportunidades e desafios que, se não aproveitados e enfrentados, no momento devido, levará o país a seriíssimos problemas, nas próximas décadas.
Caracterização dos usuários e dos serviços prestados por Centros de Atenção Psicossocial Infanto-Juvenil
Authors: Hoffmann Maria Cristina Corrêa Lopes , Santos Darci Neves , Mota Eduardo Luiz Andrade
Published: March 2008

Este estudo permitiu conhecer características diagnósticas, demográficas e procedimentos terapêuticos relativos à clientela dos Centros de Atenção Psicossocial Infanto-Juvenil (CAPSI), no Brasil, em 2003. Estudo descritivo, de corte transversal, com dados secundários. A análise considerou três conjuntos de variáveis: (a) relacionadas à natureza dos serviços; (b) clientela atendida; e (c) modalidades de cuidado oferecido. Participaram do estudo sete CAPSI que registraram atendimento nos 12 meses do ano de 2003. Esses serviços atenderam 1.456 pessoas, a maioria (62,8%) do sexo masculino e tinham em média 11,1 anos. A modalidade de atendimento predominante foi o não intensivo (49,3%). Os diagnósticos mais freqüentes foram dos transtornos do comportamento e transtornos emocionais (44,5%). Não houve registro de atendimento decorrente do uso de substâncias psicoativas. O percentual de transtornos graves foi de 19,4%. Os CAPSI apresentaram funcionamento semelhante aos serviços ambulatoriais, porém demonstraram atender uma demanda variada, cumprindo, em um curto espaço de tempo, as normas relacionadas ao registro das informações, conforme as modalidades de atendimento preconizadas pelo Ministério da Saúde, ocupando um vazio histórico na atenção pública em saúde mental infanto-juvenil.
Reflexão bioética sobre a priorização e o racionamento de cuidados de saúde: entre a utilidade social e a eqüidade
Authors: Fortes Paulo Antonio de Carvalho
Published: March 2008

Sendo as necessidades de saúde mais amplas que os recursos disponíveis, escolhas têm de ser feitas. Disto resulta ser preciso que se estabeleçam limites, critérios e parâmetros para priorizar o que vai ser ofertado e a quem os serviços e os cuidados de saúde serão oferecidos. Discute-se alternativas éticas para a priorização e racionamento de cuidados de saúde, enfocando os princípios da eqüidade e da utilidade social.
Geomechanics Enables the Success of Horizontal Well Drilling in Libya: A Case Study
Authors: Qiu Kaibin , Felgueroso Julio Gonzalez , Lalinde Gabino , Naas Abdulmagid , Coste Bernard , Fuller John
Published: March 2008

Drilling highly deviated or horizontal wells can be prone to instability problems. This paper describes a case in Libya on which significant difficulties were encountered during drilling the first horizontal development well in a field in Murzuq basin. The first two branches of the well were lost due to severe instability problems.

A comprehensive geomechanics study was carried out to understand the causes of the wellbore failure and to improve drilling design and drilling performance on further development wells in the field. The study specifically included: ■Performing a systematic data audit and integration to identify specific uncertainties in the input data and identify data gaps.■Performing a comprehensive drilling event review to investigate what happened during drilling and what were the major instability problems. All drilling events were organized, categorized and input into a database. A graphical presentation of the drilling events review was generated.■Applying a fit-for-purpose stability model. This simple model is driven by easily accessible input parameters and provides a rapid answer.■Validating a Mechanical Earth Model through history matching. This procedure reduced the uncertainty of the model and the resulting wellbore stability predictions.■Applying innovative visualization and presentation of wellbore stability analysis. This improves understanding and awareness of the various drilling hazards and enables effective utilization of the wellbore stability information during drilling.

The analysis identified the cause of wellbore instability, as being inadequate mud weight while drilling the overlying shale formation in the deviation build-up section. The design of the second horizontal well was optimized based on this study. The well was drilled successfully without problems and, in fact, ahead of drilling schedule. This case demonstrated that a comprehensive geomechanics analysis can greatly improve drilling performance and reduce drilling costs.
Effects of Boundary Conditions and Friction on Static Buckling of Pipe in a Horizontal Well
Authors: Gao Guohua , Miska Stefan
Published: March 2008

A comprehensive buckling model, a group of fourth order non-linear ordinary differential equations, was derived by applying the principle of virtual work. Lateral friction force is included in this model. The equations were normalized to make the solutions independent of the wellbore size, type of pipe and mud. The critical sinusoidal buckling load of tubing with different boundary conditions typically seen in drilling and well completion applications was analyzed based on the analytical solution of the linearized buckling equation. The results show that the effect of the boundary conditions can be neglected when the dimensionless length of tubing is greater than 5π. The authors further investigated the effects of friction on sinusoidal buckling by applying the principle of virtual work. The critical conditions for initiating sinusoidal buckling were determined by a group of three non-linear equations. A perturbation solution of these non-linear equations was obtained. It was found that the critical loads for sinusoidal buckling will increase by 30% to 70% for friction coefficients between 0.1 to 0.3. The authors also conducted an experimental study. The experimental results, including both data obtained by the authors and results published by other researchers, support the proposed model.
Development and Testing of a Rig-Based Quick Event Detection System to Mitigate Drilling Risks
Authors: Aldred Walt , Hutin Remi , Luppens John C.(Chris) , Ritchie Graham
Published: March 2008

High accuracy, speed, and a low false alarm rate are critical to the success of event detection systems and the reduction of non-productive time (NPT) due to unplanned events. The balance between them has been difficult to achieve; however, the application of a probabilistic approach with the use of Bayesian methods has shown significant promise. The results of a research prototype for kick detection using such methods were described in a previous paper (Hargeaves, Jardine, Jeffryes, 2001). The improvements in automated signal processing technology and increased computer power have meant that these new approaches to large scale data analysis in real time are now more widely possible. This paper describes the extension of this work to develop a rig-based quick event detection (QED) system for mitigating a number of common drilling risks, including kicks, circulation loss, and drillstring washout detection.

The QED software application runs on a standard standalone PC at the wellsite and continuously calculates the probability that an event is occurring. The probability changes as an event occurs, which may trigger an alarm. The system continues to evaluate the event as the real-time data is updated and this evaluation provides the drilling team with a continuously evolving probability that the event is occurring. This system helps the team make timely, informed decisions. The system requires minimal hands-on interaction to set up and uses data input via WITS for flow-in and flow-out measurements from typical rig sensors.

The detection of drilling problems in real time using the QED software on several Integrated Project Management well construction projects is presented, including the lessons learned from deploying the technology in field operations.

The significance of this development is to mitigate drilling risks during well construction projects, where minimizing NPT due to unplanned events is critical to success.
Successful Application of Casing-While-Drilling Technology in a Canadian Arctic Permafrost Application
Authors: Vrielink H. , Bradford J. S. , Basarab L. , Ubaru C. C.
Published: March 2008

The JV operator was looking for a combination of technologies to optimize drilling in Canada's Mackenzie Delta region. The area is characterized by a permafrost section up to 2,000 ft (609 m) thick. This shallow permafrost section is dominated by unconsolidated silt with freshwater ice ranging from 60% volume to pure ice layers. Historically, mechanical heat input has melted the frozen layer, resulting in increased hydrates/shallow gas risks, extreme hole enlargement/cleaning problems, rig support issues, wellbore instability, stuck pipe, hydraulic isolation, and environmental impact issues.

Optimizing drilling operations through the shallow section is critical to maximize the number of wells that can be drilled with the available rigs in this limited-access area. To move the rig requires approximately 3 ft (1 m) of ice cover, which significantly limits the operating season, increasing the need for rig efficiency and reduction of non-productive time (NPT). The industry has endorsed the importance of mud cooling through the shallow permafrost and the underlying hydrate-bearing formations to avoid borehole instability and to control hydrate dissolution. However, the industry has struggled to maintain sufficiently cold mud at the high pump/power rates required to effectively drill/clean the larger surface holes.

To solve the challenges, the operator utilized a casing-while-drilling (CwD) and casing bit system with a unique-to-the-industry mud-chilling technology and a variety of controlled drilling parameters. The CwD and casing bit system allowed the operator to drill and set casing through the problematic zones in one operation with relatively low flow rates to avoid hole enlargement. The lower flow rates also enabled the use of smaller, lighter rig equipment that reduced the required ice thickness to move the rig and therefore increase the winter season operating period. Following the successful implementation of the CwD and casing bit system on the first well of a winter program, the second well was drilled safer with the elimination of a casing string, which further reduced drilling time and cost.
Managing the Retrieval of Triple-Zone Intelligent Completions in Extended-Reach Wells Offshore California
Authors: Izquierdo L. , Ceccarelli T. U. , Hertfelder G. P. , Koerner K. , Pace S.
Published: March 2008

An independent operator in offshore California has successfully achieved triple-zone intelligent well completions in an extended-reach drilling (ERD) campaign in its Rocky Point field. To date, two workover interventions have been performed in a total of five deployments in the field, of which three are currently fully operational.

The Rocky Point reservoir is a highly fractured carbonate and can rapidly initiate water production. Achieving zonal isolation in the wellbore and at the reservoir level is critical.

During the production stage it was recognized that two of the wells did not achieve the required zonal isolation evident by increasing water cut. Thus, the operator made the decision to retrieve these completions to conduct liner cement repairs.

These triple-zone completions are controlled by 3½-in. tubing-retrievable flow-control valves, open/close and multiple-position, that work with dedicated gauges for monitoring of pressure and temperature. Each of the productive zones was isolated by three multiple-port retrievable production packers. The main challenges in retrieving these completions were: –Conveyance of the cutting tools to depth (due to ERD profile);–Accurate location of the cutting targets (+/- 6 inches at 18,000 ft MD);–Severing all control/electric lines and pulling all 3 packers in the same trip;–Redressing and re-running the completions within 2 weeks of retrieval.

This paper describes the feasibility of deploying explosive jet cutters by pumping wireline conveyed assemblies to locator profiles above each packer, which allowed for simple, cost effective intervention, avoiding costly mobiliziation of tractors or coiled tubing. Lessons learned are shown on how completions components were affected by the cutting operation and the extent of their refurbishment before re-completion. The paper also identifies some modifications to intelligent completion design parameters (eg minimum distance of control valves from packers) that will be implemented in future installations.
Intelligent Well Completions System Integration Test Mitigates Risk
Authors: Coludrovich Earl , Pace Shawn , Brady Sam , Campo Craig
Published: March 2008

Completions in deepwater sub sea applications are becoming increasingly more expensive and complex. This complexity is compounded by the challenges of installing intelligent completion equipment in deepwater environments. Reliable completions are a direct result of how well the pre-planning and procedures are implemented. The Industry is challenged to integrate multiple service provider equipment and procedures into a single intelligent completion system. Intelligent Well Completion System Integrity Tests (IWC SIT) are being utilized as a proactive means to mitigate risk. This is especially true in international operations where the logistics and planning have a greater degree of complication for completions. This paper is an overview of an IWC SIT conducted in March 2007 for a West Africa deep water field. The write up is a discussion of the planning, implementation, and learning captured for the operation. Highlighted in the paper is a series of subassemblies as run and retrieved from a land rig location. Actual down hole equipment was utilized. Service provider personnel employed for the operation were also the technicians expected to run the equipment on the deepwater rig. A formal report and video were developed to share lessons learned and best practices with the Project Team. The operation was considered successful due to the efforts of a number of service providers, partners, and operator company personnel. A strong commitment to safety, learning, and improving the operations was demonstrated by all involved.