bluuebunny/crossref_metadata_2025 huggingface dataset:
Cultura de seguridad del paciente y factores asociados en una red de hospitales públicos españoles
Authors: Gama Zenewton André da Silva , Oliveira Adriana Catarina de Souza , Hernández Pedro Jesus Saturno
Published: March 2013

Este estudio objetivó describir la Cultura de Seguridad del Paciente (CSP) en una red de hospitales públicos, según las percepciones de los profesionales sanitarios, y analizar la asociación de factores sociolaborales. Se realizó una encuesta a 1.113 profesionales de ocho hospitales españoles, a través de un cuestionario con 12 dimensiones de la CSP. Las percepciones se describen mediante los Porcentajes de Respuestas Positivas (PRP) y Negativas (PRN) a cada dimensión, y se analiza la asociación de factores con regresión lineal múltiple. La dimensión "trabajo en equipo en la unidad" se destacó con el mayor PRP (73,5) y "dotación de personal" con el mayor PRN (61). Los factores más asociados a la CSP (p < 0,05) fueron el "servicio" (farmacéutico y quirúrgico) y la "profesión" (enfermería), ambos de forma positiva. Así, la mejora de la CSP debe centrarse en la racionalidad de la dotación del personal y aprovecharse de la buena relación dentro de las unidades, utilizando los servicios farmacéutico y quirúrgico, y los enfermeros, como benchmark para otros servicios y profesionales.
"Stuck in the muck": an eco-idiom of distress from childhood respiratory diseases in an urban mangrove in Northeast Brazil
Authors: Nations Marilyn , Gondim Ana Paula Soares
Published: March 2013

Situated in neo-democratic globalizing Northeast Brazil, this anthropological study probes the role of ecological context in framing, experiencing, and expressing human distress. Ethnographic interviews, narratives, and "contextualized semantic analysis" reveal the lived experience of childhood respiratory diseases among 22 urban mangrove dwellers. Informants speak an "eco-idiom of respiratory distress" based on a popular "eco-logic", reflecting the harsh reality of "living in dampness". "Higher-up" residents legitimize their feelings of superiority by stigmatizing "lowlanders" as taboo, diseased (with porcine cysticercosis, swine flu) "filthy pigs, stuck in the muck" (atolados na lama). Animalizing inhabitants' identities demotes them to nonpersons. Besides infections, children suffer social stigma, ostracism, and barriers for accessing care. Promoting a "favorable environment" requires reducing ecological risk, challenging class-based prejudice, and restoring human dignity.
Insegurança alimentar em domicílios com adolescentes da Amazônia Legal Brasileira: prevalência e fatores associados
Authors: Guerra Lúcia Dias da Silva , Espinosa Mariano Martínez , Bezerra Aída Couto Dinucci , Guimarães Lenir Vaz , Lima-Lopes Maria Aparecida
Published: March 2013

Estudo transversal de base populacional, realizado em 2007, para investigar a prevalência de insegurança alimentar e fatores associados em domicílios com adolescentes da área urbana de quatro municípios da Amazônia Legal Brasileira, abrangência da rodovia BR-163, que liga Cuiabá, Mato Grosso, a Santarém, Pará. Aplicou-se a Escala Brasileira de Insegurança Alimentar a uma amostra de 363 domicílios e se realizou avaliação antropométrica de 534 adolescentes com idade entre 10 e 19 anos. Na análise múltipla, utilizou-se o modelo de regressão de Poisson. Os resultados apresentaram uma prevalência de 23,1% de insegurança alimentar moderada e grave, indicando associação com as seguintes categorias: baixa renda familiar, condições de saneamento precárias, naturalidade do Estado de Mato Grosso e raça/cor (preta) do adolescente. Os resultados apontam a necessidade de ações para a melhoria do acesso ao saneamento básico, a qualificação de recursos humanos visando à geração de emprego e renda e a ações educativas que ampliem a compreensão sobre insegurança alimentar e seus determinantes nos municípios.
Reliability and validity of the Exercise Benefits/Barriers scale in the elderly
Authors: Victor Janaína Fonseca , Ximenes Lorena Barbosa , Almeida Paulo César de
Published: March 2013

OBJECTIVE: Assess the reliability and validity of the Exercise Benefits/Barriers Scale (EBBS) in the elderly. METHODS: The reliability was assessed by internal consistency (Cronbach's alpha) and by the test-retest Kendall's W. To verify the construct validity it was used a correlation between the EBBS results and the personal and clinic variables. RESULTS: The Cronbach's alfa of the EBBS was 0.94. The test-retest value was 0.60. The variables that presented association with the EBBS were: level of education (p = 0.02), practice of physical activity (p = 0.0001), with whom one resides (p= 0.032) and lifestyle (p= 0.0001). CONCLUSION: The statistical analysis revealed that the translated version of the EBBS is valid and reliable however, its use is recommended in different scenarios due to regional differences in Brazil, in order to have the validity of the instrument widely exploited.
Prevalence of fatigue and associated factors in chronic low back pain patients
Authors: Salvetti Marina de Góes , Pimenta Cibele Andrucioli de Mattos , Braga Patrícia Emília , McGillion Michael
Published: March 2013

OBJECTIVES: to determine the prevalence and key factors associated with fatigue in chronic low back pain patients. METHODS: cross-sectional study of 215 chronic low back pain patients from three health care centers and two industrial corporations. The crude prevalence of fatigue and its 95% confidence interval (CI) were calculated. Associations between fatigue and the independent variables were measured. RESULTS: the prevalence of fatigue among the participants was 26.0% [95% CI: 20.3 - 32.5]. Fatigue was independently associated with depression and self-efficacy. An increase of one unit in the score of depression increased the risk of fatigue by 9%; an increase of one unit in the score of self-efficacy reduced the risk of fatigue by 2%. CONCLUSIONS: fatigue was prevalent in chronic low back pain patients and associated with depression and self-efficacy. Knowing these factors can direct strategies for prevention and control of fatigue in chronic low back pain patients.
Evaluation of Self-esteem in Nursing Teachers at Public and Private Universities
Authors: Terra Fábio de Souza , Marziale Maria Helena Palucci , Robazzi Maria Lúcia do Carmo Cruz
Published: March 2013

The aim of this study was to evaluate the self-esteem of Nursing faculty in public and private universities and compare the measures presented by two groups of teachers. This descriptive, correlational, cross-sectional quantitative study was conducted with 71 teachers from two universities (public and private) from a municipality in the south of the State of Minas Gerais. After pilot testing and validation, A questionnaire and the Rosenberg Self-Esteem Scale were used. It was found that most teachers had high self-esteem, with no significant difference between the two groups. When the continuous scores on this scale were analyzed, there was a significant difference between universities, showing that the private university teachers had lower self-esteem scores. The Rosenberg Self-Esteem Scale showed high value for coefficient alpha. It was concluded that self-esteem was high predominantly in the studied teachers, but those from the private university had lower scores. These data may help institutions to reflect on the issue and invest in building healthy environments, with the worker/teacher of Nursing as the protagonist, which represents advancement in the knowledge of the subject in the field of Nursing.
Oral Anticoagulation: the impact of the therapy in health-related quality of life at six-month follow-up
Authors: Carvalho Ariana Rodrigues da Silva , Ciol Márcia Aparecida , Tiu Felice , Rossi Lídia Aparecida , Dantas Rosana Aparecida Spadoti
Published: March 2013

OBJECTIVE: to study the changes in health-related quality of life from beginning of anticoagulation therapy to six-month follow-up, and to study associations of sociodemographic and clinical characteristics with measures of quality of life and general health status at six-month follow-up, in individuals using oral anticoagulation due to various medical indications for the therapy. METHOD: prospective study performed at a city in the state of Paraná, Brazil, composed of 78 patients. Measures included the Duke Anticoagulation Satisfaction Scale and the Medical Outcomes Survey Short Form SF-36. RESULTS: mean age was 57 years (S.D.= 16) and 54% were women. Compared to the beginning of therapy, there was a statistically significant improvement in health-related quality of life at six-month follow-up. Linear regression analyses explained 32% and 30%, respectively, of the variance of the Duke Anticoagulation Satisfaction Scale and of the general health status. There was improvement in all components of the SF-36, except Mental Health. CONCLUSION: The use of oral anticoagulation therapy was associated with improvement in health-related quality of life in the first six months of therapy. This study is longitudinal and therefore, has fewer limitations than cross-sectional studies published to date in the Nursing literature in Brazil.
Stress and depression among students of the last semester in two nursing courses
Authors: Moreira Danila Perpétua , Furegato Antonia Regina Ferreira
Published: March 2013

OBJECTIVE: to identify the presence of stress and depression among final year students of two nursing courses, and the association between these variables. METHOD: an exploratory-descriptive study, undertaken with final-year students from the Bachelor's degree and Licenciate's degree courses at the Ribeirão Preto College of Nursing, of the University of São Paulo. The Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI) were applied. RESULTS: of the total of 88 participants in the study, 69.8% have no depression, 18.2% presented dysphoria, 6.8% moderate depression, and 5.7% severe depression, which is a low rate compared to the general population. Medium stress levels were the most frequent (76.9%). There was no significant statistical difference in the stress score between the two groups of students (Student's t-test: p=0.295>0.05). The data showed a relation between the stress and the presence of indicative signs of depression, especially severe depression (Pearson: r-0.755 and p<0.01). Discussion: The majority did not show signs of depression. The depressive states found among the students on the two courses accompanied proportionately those who obtained high stress scores, as recorded by other studies on this issue. CONCLUSION: Students with higher levels of stress are more prone to present depression, deserving educators' attention.
Primary care nurses' approach to cases of violence against children
Authors: Aragão Ailton de Souza , Ferriani Maria das Graças Carvalho , Vendruscollo Telma Sanchez , Souza Sinara de Lima , Gomes Romeu
Published: March 2013

In Primary Care, the field of nursing comes face-to-face with the complexity of violence, leading these professionals to constantly re-evaluate their habitus. OBJECTIVE: to analyze how cases of violence against children and adolescents are approached by primary care nurses, identifying limits and possibilities for dealing with these cases. METHOD: a qualitative study, undertaken in 2011, through semi-structured interviews with 8 out of 48 nurses in the Family Health teams in the city of Uberaba in the state of Minas Gerais, the analysis of which followed the interpretation of meanings, based in dialectical hermeneutics. RESULTS: the following stand out: non-identification of violence as a problem for the nurses; denunciations and notifications as a role of the nurses; and the limits found in the face of violence. CONCLUSION: it is determined that the habitus of nursing directed at health promotion and prevention of violence must be restructured, overcoming the biomedical paradigm and involving intersectorial and multidisciplinary actions.
The "Moving Heart Program": an intervention to improve physical activity among patients with coronary heart disease
Authors: Rodrigues Roberta Cunha Matheus , João Thaís Moreira São , Gallani Maria Cecília Bueno Jayme , Cornélio Marilia Estevam , Alexandre Neusa Maria Costa
Published: March 2013

AIM: this paper reports the results of a nursing-administered theory-based intervention, the "Moving Heart Program", based on the implementation intention theory and pointed at improving physical activity adherence among coronary heart disease outpatients in Brazil. METHODS: this experimental study applied assessments at baseline, 1 and 2 months after baseline. The Consolidated Standards of Reporting Trials statement was followed. Participants were randomly assigned to intervention, comprising action and coping plans on how to deal with anticipated barriers (n=69), or a standard-care control group (n=67). RESULTS: participants submitted to the intervention showed significant higher levels of physical activity 2 months after baseline and were significantly more active than the control group. CONCLUSIONS: the results indicate that the intervention is feasible for patients with coronary heart disease and can be a useful tool to facilitate intended lifestyle changes. This study brings relevant contributions to the Nursing field and other health-related areas, once the intervention presents low cost to health services and can be applied in cardiac rehabilitation programs, showing significant benefits to participants.
Nursing teamwork and time to respond to call lights: an exploratory study
Authors: Kalisch Beatrice Jean , Labelle Aimee Elizabeth , Boqin Xie
Published: March 2013

AIM: The aim of this exploratory study was to determine whether the level of nursing teamwork is correlated to call light answering time in acute care hospital patient care units. Background: Teamwork has been shown to improve productivity. In this study, we examine the relationship between unit call light response time as a measure of productivity and the level of teamwork on the unit. METHOD: The Nursing Teamwork Survey was administered to nursing staff on 18 inpatient units in 3 hospitals. In addition to the overall teamwork score, the NTS has 5 subscales. Call light response times were collected from electronic systems which measures the time it takes for nursing staff on a given unit to respond to patient call lights. RESULTS: There was no significant relationship between call light response time and teamwork overall or on the five subscales. Shared mental models, which comprise the conceptual understanding of the roles and responsibilities of each team member, however was moderately correlated with call-light answering times. CONCLUSIONS: It is logical that shared mental models would be associated with call light response time since a common problem in patient units is the "it's not my job syndrome" where nursing staff do not answer call lights for patients assigned to someone else. More research with a larger number of patient units is needed to validate these findings.
A disciplinarização do ensino de Música e as contingências do meio escolar
Authors: Sobreira Silvia
Published: February 2013

A partir da promulgação da Lei 11.769/2008, a educação musical busca sua inserção e aceitação no contexto escolar. Neste artigo, são consideradas algumas características inerentes a este processo. É alegado que as teorizações advindas do campo dos estudos curriculares podem contribuir para o aprofundamento do assunto. Conclui-se que a busca por procedimentos e metodologias adequados pode ser improdutiva se não forem levadas em consideração as várias influências que os conhecimentos sofrem ao se tornarem disciplinas escolares.
Avaliação do comportamento reológico de diferentes iogurtes comerciais
Authors: Mathias Thiago Rocha dos Santos , Andrade Kelita Carlos Silva , Rosa Cíntia Letícia da Silva , Silva Bárbara Amorim
Published: March 2013

A consistência e a viscosidade do iogurte são uns dos principais fatores envolvidos na qualidade e aceitação do produto. Dessa forma, este trabalho apresenta um estudo de comparação reológica entre iogurtes comerciais do Rio de Janeiro, Brasil, em cujas formulações constam diferentes espessantes. Foram utilizadas três grandes marcas do mercado e, entre os espessantes utilizados, estão: goma guar, goma xantana, goma carragena, goma alfarroba e carboximetilcelulose. Previamente às análises reológicas, as amostras de iogurtes foram submetidas à determinação do pH, da acidez (expressa em ácido láctico) e da umidade. As curvas de fluxo e de viscosidade foram obtidas em reômetro rotacional Thermo Haake Mars com geometria placa/placa (35 mm de diâmetro), com variação de taxa de cisalhamento entre 0,02 e 100 s-1 (curva ascendente), e 100 e 0,02 s-1 (curva descendente), em um tempo total de 20 minutos. Foi determinada a histerese como a área entre as curvas e ajustados os modelos de Bingham, Casson, Herschel-Bulkley e Ostwald de Waele. Foram realizados também testes de tixotropia, pela medição da viscosidade em função do tempo a uma taxa constante de 100 s-1, por 10 minutos. Estes foram ajustados pelo modelo de Weltman. Além disso, foram verificadas alterações no comportamento reológico em função da variação de temperatura (4 a 24 ºC), cujos resultados foram avaliados pela Equação de Arrhenius. Todas as amostras de iogurte analisadas apresentaram comportamento pseudoplástico e tixotrópico. Todos os modelos foram bem ajustados para as curvas de fluxo, exceto o modelo de Weltman, que não representou bem os testes de tixotropia.
Influência da germinação e do processamento térmico na digestibilidade proteica e atividade de inibição de tripsina de grãos de quinoa
Authors: Amistá Maria Júlia de Miguel , Tavano Olga Luisa
Published: March 2013

Em função de sua versatilidade e indicativos de alto valor nutritivo, a quinoa tem despertado crescente interesse dos pesquisadores das áreas de ciências nutricionais e de alimentos, bem como dos consumidores, que visam cada vez mais ao consumo de produtos associados à promoção da saúde ou alternativos para aqueles com necessidades específicas, como os celíacos, que encontram na quinoa uma possibilidade de consumo. Neste trabalho, avaliaram-se alterações relativas à qualidade proteica dos grãos, nos seguintes aspectos: a atividade de inibição de proteases e a digestibilidade proteica in vitro, em função de modificações sofridas por processo de germinação de 2, 4 e 6 dias, além de diferentes tipos de processamentos térmicos, incluindo-se aquecimentos brandos, a 40 ºC e 45 ºC, e cozimento sob fervura. O processo de germinação não proporcionou melhorias na digestibilidade proteica dos grãos de quinoa, embora tenha sido possível verificar uma redução na atividade de inibição de tripsina ao longo da germinação. Diversamente, os processos envolvendo tratamento térmico se mostraram efetivos em melhorar a qualidade proteica dos grãos, ainda quando as temperaturas de 40 ºC e 45 ºC foram utilizadas. Utilizando-se temperatura de apenas 45 ºC para tratamento dos grãos, seus valores de digestibilidade proteica foram aumentados a ponto de serem equivalentes ao observado para o cozimento tradicional dos grãos, realizado sob fervura, o que pode ser uma observação positiva aos que optam por consumo de grãos minimamente processados.
O atual resgate crítico da teoria marxista da dependência
Authors: Carcanholo Marcelo Dias
Published: March 2013

O objetivo central deste artigo é discutir as principais categorias da teoria marxista da dependência. Tal esforço se justifica por causa do resgate que essa perspectiva teórica vem recebendo nos últimos anos. Em primeiro lugar, discute-se o significado original do que a teoria entende por dependência e, a partir disso, a natureza específica da inserção das economias dependentes no capitalismo mundial. Em seguida, além de se reafirmar o caráter central da superexploração da força de trabalho como característica específica dessas economias, argumenta-se que esse caráter só é inteligível quando entendido como a resposta do capitalismo dependente às diferentes formas de transferência de valor para as economias centrais. Em virtude do anterior, o trabalho conclui com apontamentos sobre as direções que podem ser seguidas por um resgate crítico da teoria marxista da dependência.
Comparison and calibration of numerical models from monitoring data of a reinforced concrete highway bridge
Authors: Andrade R. G. M. de , Trautwein L. M. , Bittencourt T. N.
Published: March 2013

The last four decades were important for the Brazilian highway system. Financial investments were made so it could expand and many structural solutions for bridges and viaducts were developed. In parallel, there was a significant raise of pathologies in these structures, due to lack of maintenance procedures. Thus, this paper main purpose is to create a short-term monitoring plan in order to check the structural behavior of a curved highway concrete bridge in current use. A bridge was chosen as a case study. A hierarchy of six numerical models is shown, so it can validate the bridge's structural behaviour. The acquired data from the monitoring was compared with the finest models so a calibration could be made.
Gêneros textuais e ensino de língua materna: entre o caminho e a pedra
Authors: Guimarães Ana Maria de Mattos
Published: March 2013

O objetivo deste artigo é mostrar que a presença do conceito de gênero na sala de aula de língua materna pode transformar a realidade do ensino do texto escrito. A proposta de trabalho com gêneros em foco parte da teoria do Interacionismo Sociodiscursivo e mostra que cada gênero deve ser trabalhado por um determinado período de tempo, com ênfase em seus conteúdos específicos, que o diferenciam dos demais gêneros, sem perder de vista seu propósito comunicativo. Essa proposta concebe gêneros de texto como uma forma de articular as práticas linguageiras, entendendo-os como passíveis de serem aprendidos, mas, sobretudo, como formas de interação. Concretiza ainda a possibilidade de incluir elementos de estruturação linguística nesse trabalho, sem prejuízo da apropriação de um gênero pelos alunos. Dados empíricos serão apresentados e discutidos para a exemplificação da proposta.
Upholding the Principles of Autonomy, Beneficence, and Justice in Phase I Clinical Trials
Authors: Owonikoko Taofeek K.
Published: March 2013

This commentary discusses the importance of maintaining the three core principles of autonomy, beneficence, and justice in phase I clinical trials.
My Thuan – Vietnam's first cable-stayed bridge
Authors: Palmer Peter Michael
Published: February 2013

My Thuan Bridge was built over the Mekong River in southern Vietnam and has made a major contribution to the economic development of the Mekong delta. It was the first cable-stayed bridge to be built in Vietnam and has a navigation span of 350 m and a total length of 1536 m. The bridge was jointly funded by Australia and Vietnam; a joint steering committee was formed to manage the project, ensuring close cooperation at all levels of work. An extensive feasibility study investigated the difficult engineering problems associated with the site and evaluated the social and environmental impacts of the project. Alternative bridge designs were prepared and costed before deciding on the final design of the bridge. A major Vietnamese training programme was integrated into the project to transfer the new technology to Vietnam and the bridge was constructed in 33 months at a cost of A$83 million (1A$ = €0.785, 2012).
Reduction of alkali−silica reaction expansion of mortars by utilisation of pozzolans
Authors: Gökçe H. Süleyman , Şimşek Osman , Korkmaz Serdar
Published: March 2013

In this study the effects of natural and artificial pozzolans on alkali–silica reaction expansion of mortars were investigated by using the accelerated mortar bar test method in accordance with the ASTM C 1260. For this purpose, four natural pozzolans – ignimbrite powder (IG), perlite powder (PE), pumice powder (PU) and zeolite powder (ZE) – were used as cement at replacement levels of 0, 5, 10, 15, 20, 25, 30, 35 and 40% by weight of ordinary Portland cement. Four artificial pozzolans – fly ash (FA), brick powder (BP), silica fume (SF) and aerated concrete powder (AP) – were used at replacement levels of 0, 5, 10, 15, 20 and 25% by weight. The expansions of mortar bars were reduced as the replacement ratios of each natural and artificial pozzolans were increased, with the exception of specimens with a replacement level of 15, 20 and 25% AP. It is determined that at comparable replacement ratios SF is the most effective among the pozzolans used and is followed by PU, ZE, IG, PE, FA, BP and AP respectively.
Should We Use Preoperative Epoetin-α in the Mildly Anemic Patient Undergoing Simultaneous Total Knee Arthroplasty?
Authors: Delasotta Lawrence A , Orozco Fabio , Jafari S. Mehdi , Blair Jamie L , Ong Alvin
Published: February 2013

Simultaneous knee arthroplasty is associated with significant blood loss. To prevent transfusion, three preoperative doses of epoetin-α were offered to mildly anemic simultaneous knee arthroplasty patients. A retrospective review, using ICD-9 codes, identified twenty patients from 2007-2009. Epoetin-α increased hemoglobin levels preoperatively (12.6 to 13.9, p<0.01). Twenty patients who did not receive epoetin-α were matched to study patients. Study patients were transfused less (55% vs 95%, p=0.012) and had similar inpatient length of stay. The average blood loss without transfusion was 4.6g/dL. The mildly anemic patient is at high-risk for packed red cell transfusion during simultaneous knee arthroplasty. Three preoperative doses of epoetin-α in the mildly anemic patient decreased total transfusions; however, it did not affect inpatient length of stay.
“A Room Full of Chairs around His Bed”: Being Present at the Death of a Loved One in Veterans Affairs Medical Centers
Authors: Williams Beverly Rosa , Bailey F. Amos , Woodby Lesa L. , Wittich Angelina R. , Burgio Kathryn L.
Published: March 2013

Historically, death took place at home where family held vigil around the dying patient. Today, family presence is an important feature of death and dying in hospital settings. We used hermeneutic phenomenology to explore experiences of being present at the hospital death of a loved one. We conducted in-depth, face-to-face interviews with 78 recently bereaved next-of-kin of veterans who died in 6 Veterans Affairs (VA) Medical Centers in the Southeast United States. Two major themes emerged: 1) “ settling in,” characteristic of the experiences of wives and daughters in the initial phase of the patient's hospitalization; and 2) “ gathering around,” characteristic of the experiences of a wider array of family members as the patient neared death. An in-depth understanding of experiences of next-of-kin present at the hospital death of a loved one can increase staff awareness of family's needs and empower staff to develop policies and procedures for supporting family members.
Stakeholder engagement for comparative effectiveness research in cancer care: experience of the DEcIDE Cancer Consortium
Authors: Greenberg Caprice C , Wind Jennifer K , Chang George J , Chen Ronald C , Schrag Deborah
Published: February 2013

Stakeholder input is a critical component of comparative effectiveness research. To ensure that the research activities of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Network, supported by the Agency for Healthcare Research and Quality, translate into the greatest impact for everyday practice and policy-making in cancer, we were tasked with soliciting stakeholder input regarding priority areas in cancer-related comparative effectiveness research for the DEcIDE Cancer Consortium. Given the increasing emphasis on stakeholder engagement in research, many investigators are facing a similar task, yet there is limited literature to guide such efforts, particularly in cancer care. To help fill this gap, we present our approach to operationalizing stakeholder engagement and discuss it in the context of other recent developments in the area. We describe challenges encountered in convening stakeholders from multiple vantage points to prioritize topics and strategies used to mitigate these barriers. We offer several recommendations regarding how to best solicit stakeholder input to inform comparative effectiveness research in cancer care. These recommendations can inform other initiatives currently facing the challenges of engaging stakeholders in priority setting for cancer.
Mechanisms Underlying the Onset of Oral Lipid–Induced Skeletal Muscle Insulin Resistance in Humans
Authors: Nowotny Bettina , Zahiragic Lejla , Krog Dorothea , Nowotny Peter J. , Herder Christian , Carstensen Maren , Yoshimura Toru , Szendroedi Julia , Phielix Esther , Schadewaldt Peter , Schloot Nanette C. , Shulman Gerald I. , Roden Michael
Published: March 2013

Several mechanisms, such as innate immune responses via Toll-like receptor-4, accumulation of diacylglycerols (DAG)/ceramides, and activation of protein kinase C (PKC), are considered to underlie skeletal muscle insulin resistance. In this study, we examined initial events occurring during the onset of insulin resistance upon oral high-fat loading compared with lipid and low-dose endotoxin infusion. Sixteen lean insulin-sensitive volunteers received intravenous fat (iv fat), oral fat (po fat), intravenous endotoxin (lipopolysaccharide [LPS]), and intravenous glycerol as control. After 6 h, whole-body insulin sensitivity was reduced by iv fat, po fat, and LPS to 60, 67, and 48%, respectively (all P < 0.01), which was due to decreased nonoxidative glucose utilization, while hepatic insulin sensitivity was unaffected. Muscle PKCθ activation increased by 50% after iv and po fat, membrane Di-C18:2 DAG species doubled after iv fat and correlated with PKCθ activation after po fat, whereas ceramides were unchanged. Only after LPS, circulating inflammatory markers (tumor necrosis factor-α, interleukin-6, and interleukin-1 receptor antagonist), their mRNA expression in subcutaneous adipose tissue, and circulating cortisol were elevated. Po fat ingestion rapidly induces insulin resistance by reducing nonoxidative glucose disposal, which associates with PKCθ activation and a rise in distinct myocellular membrane DAG, while endotoxin-induced insulin resistance is exclusively associated with stimulation of inflammatory pathways.
Modular Platforms for Optofluidic Systems
Authors: Brammer Marko , Mappes Timo
Published: February 2013

Optofluidics is increasingly gaining impact in a number of different fields of research, namely biology and medicine, environmental monitoring and green energy. However, the market for optofluidic products is still in the early development phase. In this manuscript, we discuss modular platforms as a potential concept to facilitate the transfer of optofluidic sensing systems to an industrial implementation. We present microfluidic and optical networks as a basis for the interconnection of optofluidic sensor modules. Finally, we show the potential for entire optofluidic networks
Influence of trace elements supplementation on the production of recombinant frutalin by Pichia pastoris KM71H in fed-batch process
Authors: Wanderley Marcela , Oliveira Carla , Bruneska Danyelly , Domingues Lucília , Lima Filho José , Teixeira José , Mussatto Solange
Published: March 2013

Frutalin, a galactose-specific lectin used to detect specific tumour markers, is a protein with low expression level in breadfruit. In the present study, fed-batch fermentation in a stirred tank bioreactor was used as a strategy to enhance protein production by a recombinant Pichia pastoris KM71H. By using this process, the production of recombinant frutalin was 4-fold higher than the value obtained in shaker flasks batch assays. Supplementation of the fermentation medium with trace elements (Pichia trace minerals, PTM) was also evaluated in order to stimulate production of the recombinant protein. The addition of PTM to the minimum medium afforded a recombinant protein production of 13.4 mg L−1, which was 2.5-fold higher than that achieved from the culture medium without PTM supplementation. These results are significant as the development of strategies to improve the production of recombinant frutalin may broaden its application in cancer diagnosis.
Evaluation of temperature effect on growth rate of Lactobacillus rhamnosus GG in milk using secondary models
Authors: Valík Ľubomír , Medveďová Alžbeta , Čižniar Michal , Liptáková Denisa
Published: March 2013

The application of secondary temperature models on growth rates of Lactobacillus rhamnosus GG, the much studied probiotic bacterium, is investigated. Growth parameters resulting from a primary fitting were modelled against temperature using the following models: Hinshelwood model (H), Ratkowsky extended model (RTK2), Zwietering model (ZWT), and cardinal temperature model with inflection (CTMI). As experienced by other authors, the RTK2, ZWT, and CTMI models provided the best statistical indices related to fitting the experimental data. Moreover, with the biological background, the following cardinal temperatures of L. rhamnosus GG resulted from the study by the model application: t min = 2.7°C, t opt = 44.4°C, t max = 52.0°C. The growth rate of the strain under study at optimal temperature was 0.88 log10(CFU mL−1 h−1).
RELATIONAL AUTONOMY AND INDIVIDUALITY
Authors: Friedman Marilyn
Published: March 2013

This review explores some of the important issues raised in Jennifer Nedelsky’s book, Law’s Relations: A Relational Theory of Self, Autonomy, and Law. First, it introduces Nedelsky’s relational approach and her rejection of liberal individualism. Second, it delves more deeply into Nedelsky’s relational account of autonomy. Then, it details Nedelsky’s relational approach to rights and law and argues, among other things, that Nedelsky’s approach has a consequentialist cast to it. Finally, it provides a critical assessment of Nedelsky’s rejection of independence and individualism.
Integrating Observational and Traffic Simulation Models for Priority Ranking of Unsafe Intersections
Authors: Shahdah Usama Elrawy , Saccomanno Frank F. , Persaud Bhagwant
Published: February 2013

Observational models based on reported crash history are the most common measures for identifying unsafe sites for priority intervention. Observational models are good for predicting higher-severity crashes but ignore higher-risk vehicle interactions (e.g., near misses) that failed to result in crashes that are reported in historical data. Proponents of microscopic simulation models argue that failure to recognize these higher-risk interactions can significantly understate the safety problem at a given site and lead to misallocation of scarce treatment funds. This paper takes the position that a complete understanding of the safety problem at a given site can emerge only if both crash potential and traffic conflicts are taken into account. A priority-ranking model that integrates estimates from observational crash prediction models into an analysis of traffic conflicts is presented. Traffic conflicts were based on simulated vehicle interactions and deceleration requirements for different traffic scenarios. The suitability of the approach for priority ranking of sites was assessed with six ranking approaches: crash frequency, empirical Bayes, potential for safety improvement, conflict frequency, conflict rate (sum and cross product of traffic volume), and integrated model. Priority ranking was evaluated with five test criteria: site consistency, method consistency, rank difference, total rank score, and sensitivity and specificity. These models were applied to a sample of 58 signalized intersections from Toronto, Ontario, Canada, for the period from 1999 to 2006. The integrated model was found to yield better results for the five evaluation criteria; this result suggests that the proposed approach has promise.
Granulocyte Colony-Stimulating Factor Promotes Atherosclerosis in High-Fat Diet Rabbits
Authors: Hu Zhaohui , Zhang Jie , Guan Aili , Gong Hui , Yang Ming , Zhang Guoping , Jia Jianguo , Ma Hong , Yang Chunjie , Ge Junbo , Zou Yunzeng
Published: February 2013

Granulocyte-colony stimulating factor (G-CSF) has been reported to improve the function of infarcted heart, but its effects on atherosclerosis are unclear. Here we examined the effects and the potential mechanisms in the high-fat diet rabbit model. Six-month-old male New Zealand white rabbits, fed a high-cholesterol diet or a normal diet for 10 weeks, were treated with vehicle or G-CSF. G-CSF increased lesion area in the thoracic aorta and the plasma levels of total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) at the early phase in the high-fat diet group. High-fat diet-induced arterial endothelium damage and apoptosis were greatly aggravated by G-CSF treatment. In vivo, G-CSF impaired apoptosis induced by oxidized low density lipoprotein (OX-LDL) but it had little effect on cultured endothelial cells (ECs) with vehicle treatment. Further research revealed that G-CSF promoted the upregulation of endothelin-1 (ET-1) and the downregulation of endothelial nitric oxide synthase (eNOS) of thoracic aortae induced by a high-fat diet. In vitro, the effects of G-CSF on expression of ET-1 and eNOS in cultured ECs were consistent with those in vivo. Our results suggested that G-CSF exacerbates lipid abnormity and endothelium damage in hyperlipidemia rabbits, thereby resulting in the deterioration of atherosclerosis and that the ET-1/eNOS system may regulate the progression.
Singlet Oxygen in Antimicrobial Photodynamic Therapy: Photosensitizer-Dependent Production and Decay in E. coli
Authors: Ragàs Xavier , He Xin , Agut Montserrat , Roxo-Rosa Mónica , Gonsalves António , Serra Arménio , Nonell Santi
Published: February 2013

Several families of photosensitizers are currently being scrutinized for antimicrobial photodynamic therapy applications. Differences in physical and photochemical properties can lead to different localization patterns as well as differences in singlet oxygen production and decay when the photosensitizers are taken up by bacterial cells. We have examined the production and fate of singlet oxygen in Escherichia coli upon photosensitization with three structurally-different cationic photosensitizers, namely New Methylene Blue N (NMB), a member of the phenothiazine family, ACS268, a hydrophobic porphyrin with a single cationic alkyl chain, and zinc(II)-tetramethyltetrapyridinoporphyrazinium salt, a phthalocyanine-like photosensitizer with four positive charges on the macrocycle core. The kinetics of singlet oxygen production and decay indicate different localization for the three photosensitizers, whereby NMB appears to localize in an aqueous-like microenvironment, whereas ACS268 localizes in an oxygen-shielded site, highly reactive towards singlet oxygen. The tetracationic zinc(II) tetrapyridinoporphyrazine is extensively aggregated in the bacteria and fails to produce any detectable singlet oxygen.
Land plant evolutionary timeline: Gene effects are secondary to fossil constraints in relaxed clock estimation of age and substitution rates
Authors: Magallón Susana , Hilu Khidir W. , Quandt Dietmar
Published: February 2013

•Premise of the study:Land plants play an essential role in the evolution of terrestrial life. Their time of origin and diversification is fundamental to understanding the evolution of life on land. We investigated the timing and the rate of molecular evolution of land plants, evaluating the effects of different types of molecular data, including temporal information from fossils, and using different molecular clock methods.

•Methods:Ages and absolute rates were estimated independently with two substitutionally different data sets: a highly conserved 4‐gene data set andmatK, a fast‐evolving gene. The vascular plant backbone and the crown nodes of all major lineages were calibrated with fossil‐derived ages. Dates and absolute rates were estimated while including or excluding the calibrations and using two relaxed clocks that differ in their implementation of temporal autocorrelation.

•Key results:Land plants diverged from streptophyte alga 912 (870–962) million years ago (Mya) but diversified into living lineages 475 (471–480) Mya. Ages estimated for all major land‐plant lineages agree with their fossil record, except for angiosperms. Different genes estimated very similar ages and correlated absolute rates across the tree. Excluding calibrations resulted in the greatest age differences. Different relaxed clocks provided similar ages, but different and uncorrelated absolute rates.

•Conclusions:Whole‐genome rate accelerations or decelerations may underlie the similar ages and correlated absolute rates estimated with different genes. We suggest that pronounced substitution rate changes around the angiosperm crown node may represent a challenge for relaxed clocks to model adequately.
Palms do not undergo secondary stem lengthening: A response to Renninger and Phillips (American Journal of Botany99: 607–613)
Authors: Tomlinson P. Barry , Quinn Christopher J.
Published: March 2013

Woody stems that have completed some maturation of metaxylem elements should not be capable of further axial extension (“secondary stem lengthening”). However, this mechanism has been claimed by Renninger and Phillips (American Journal of Botany99: 607–613) to be a feature of the palmIriartea deltoidea. In response, we describe structural features of palm stems based on extensive known features of their anatomy and development. In addition to the inability of metaxylem vessels to extend after they are mature, fully differentiated fibers of the vascular bundle sheath, which would exist at the time of proposed stem elongation would not be capable of belated extension. “Vessel spirals” claimed by these authors to be capable of stretching to accommodate secondary stem lengthening does not refer to well‐established features of the course of vascular bundles. The approach adopted by Renninger and Phillips simply measures stems of different sizes as an implied developmental series. Consequently, results do not take into account changes in the development of the palm stem as it ages. The existence of secondary stem lengthening in the palmIriartea deltoidea, something never before observed in any tree, cannot occur because it would indeed disrupt mature metaxylem vessels and would also require the secondary extension of mature lignified fibers.
Modified leaves with disk‐shaped nectaries of Macaranga sinensis (Euphorbiaceae) provide reward for pollinators
Authors: Yamasaki Eri , Kawakita Atsushi , Sakai Shoko
Published: February 2013

• Premise of the study: Nectar is the most common reward provided by animal‐pollinated flowers. Diversity in position and structure of floral nectaries suggests that floral nectar production evolved repeatedly, but the evolutionary origins are not well known. Flowers of the genus Macaranga (Euphorbiaceae) are apetalous and lack floral nectar. Nevertheless, many Macaranga species possess disk‐shaped nectaries on their leaves, sought by ants that defend plants from herbivory. In some Macaranga species, similar glands also occur on the bracteoles—modified leaves subtending the flowers. We investigated whether these glands on the bracteoles of M. sinensis are involved in pollination.

• Methods: Flower visitors were captured, and body pollen was examined. The behavior of flower visitors on inflorescences was also observed. Sugar composition of the nectar from bracteoles and leaves was collected and analyzed using high‐performance liquid chromatography.

• Key results: Various bees and flies with body pollen visited both male and female inflorescences, feeding on nectar from the bracteoles and touching anthers and stigmas in the process. Sugar composition of nectar from the bracteoles and the leaves did not differ.

• Conclusions: Macaranga sinensis was pollinated by insects foraging on the disk‐shaped nectaries on bracteoles. The similar appearance, position, and sugar composition of nectar suggest that disk‐shaped nectaries on bracteoles and leaves are homologous and that nectaries on leaves were recruited to inflorescences to serve floral function in M. sinensis. Having protective mutualism with ants has likely opened an unusual route for the evolution of floral nectar in otherwise non‐nectar‐producing flowers of M. sinensis.
Secondary stem lengthening in palms: Response to commentary by Tomlinson and Quinn1
Authors: Renninger Heidi J. , Phillips Nathan
Published: March 2013

In this response, we address the criticisms put forth by Tomlinson and Quinn (American Journal of Botany 100: 461–464) about our original publication on secondary stem lengthening in Iriartea deltoidea palms (American Journal of Botany 99: 607–613) and find areas on which we may agree. We address our figure of a typical palm vascular bundle; the location, timing, and species where secondary lengthening would likely occur; and our measurement of internodes in various palms as well as our choice of individuals. Our original observations were a novel finding in the field of palm biology, and we invite more research and investigation on this subject.
Agreement Between the DAS28-CRP Assessed with 3 and 4 Variables in Patients with Rheumatoid Arthritis Treated with Biological Agents in the Daily Clinic
Authors: Madsen Ole Rintek
Published: March 2013

Objective.

The Disease Activity Score-28-C-reactive Protein 4 [DAS28-CRP(4)] composite measure for rheumatoid arthritis (RA) is based on 4 variables: tender and swollen joint counts, CRP, and patient global assessment. DAS28-CRP(3) includes only 3 variables, because patient global assessment has been omitted. Thresholds for low and high disease activity are the same for the 2 scores. The objective of our study was to compare the 2 DAS scores and their responses on the individual patient level.

Methods.

Baseline and 12-week disease activity data from 239 patients with RA treated with a biological agent were extracted from the Danish registry for biological treatment (DANBIO). Cohen's effect sizes (ES) and disease activity levels according to the DAS thresholds were assessed. The Bland-Altman method was used to examine the bias between the DAS scores and the 95% limits of agreement (LoA).

Results.

Baseline values for DAS28-CRP(4) and DAS28-CRP(3) were 4.8 ± 1.2 and 4.6 ± 1.1, respectively. At 12 weeks, DAS28-CRP(4) had improved by −1.39 ± 1.34 (p < 0.0001). At that timepoint the bias of DAS28-CRP(3) was −0.07 (LoA −0.69, 0.55) (p < 0.0001). The bias of the DAS28-CRP(3) response was +0.21 (LoA −0.49, 0.91) (p < 0.0001). ES for DAS28-CRP(4) was 1.2 ± 1.1 versus 1.1 ± 1.1 for DAS28-CRP(3) (p < 0.0001). Compared to DAS28-CRP(4), DAS28-CRP(3) categorized 33% fewer patients as having a high level of disease activity, 8% fewer patients as good responders, and 12% more patients as nonresponders.

Conclusion.

Mean values of DAS28-CRP(4) and DAS28-CRP(3) agreed well, but in the individual patient the difference between the scores and their responses may be substantial.
Diagnostic and Statistical Manual of Mental Disorders-5
: Implications for Older Adults and Their Families
Authors: Sorrell Jeanne M.
Published: March 2013

The fifth edition of the
Diagnostic and Statistical Manual of Mental Disorders
(
DSM-5
) is targeted for publication in May 2013. Older adults and their families should be aware of the potential impact that changes in this important document may have on diagnosis and treatment of mental health concerns. Two specific changes related to a new category of Neurocognitive Disorders and a new interpretation of criteria for depression after bereavement are discussed in this article. Nurses can help older adults and their families understand the new
DSM-5
terminology and encourage them to discuss risks, benefits, and likely outcomes of diagnoses, procedures, and treatments that may seem unfamiliar.