bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitória, Espírito Santo (ES): experiência exitosa em Práticas Integrativas e Complementares (PICs)
Authors: Sacramento Henriqueta Tereza
Published: July 2019

RESUMO

Neste texto, apresentam-se as Práticas Integrativas e Complementares (PICs) no Município de Vitória, ES, a partir do convite para relato da experiência exitosa. As PICs, no âmbito municipal, iniciaram em 1990 e foram implantadas na atenção básica, tendo como princípio a integralidade como cuidado à saúde e gestão que reconhece a autonomia e a diversidade cultural e social dos cidadãos. Os profissionais de saúde foram contratados numa perspectiva da atenção à saúde dos usuários atendidos na rede municipal, de modo complementar, tendo como eixo estruturante a atenção primária em saúde. Destaca-se a fitoterapia como primeira PIC introduzida com sucesso em 100% dos territórios de saúde, com prescritores capacitados, medicamentos fitoterápicos disponibilizados nas farmácias e projetos de jardins terapêuticos. Com a implantação das hortas urbanas comunitárias orgânicas, construiu-se uma firme parceria com as secretarias municipais de meio ambiente e de educação. Outras PICs ofertadas: arteterapia e musicoterapia no Centro de Atenção Psicossocial; aulas de ioga em parques e serviços, tais como academias da saúde; consultas médicas especializadas em homeopatia e acupuntura no centro municipal de especialidades. Além destas, em alguns serviços, profissionais de saúde com formação específica, mediante apresentação de projetos ofertam: do-in; dança circular; auriculoterapia; meditação e reiki. A institucionalização da política municipal de PICs garante que sejam cumpridas as estratégias e diretrizes, potencializando e ampliando ações de promoção da saúde, prevenção e tratamento de doenças para recuperação da saúde por métodos mais leves e medicamentos naturais, atuando pela valorização da totalidade do sujeito e não somente do corpo.
Assistência de enfermagem no pré-natal de baixo risco na atenção primária
Authors: Muniz Fernanda de Fátima Santos , Rocha Francisca das Chagas Gaspar , Ramos Aline Sharlon Maciel Batista , Nunes Simony Fabiola Lopes
Published: July 2019

O objetivo do estudo foi descrever as ações de enfermagem na atenção ao pré-natal de baixo risco em uma Unidade Básica de Saúde no interior do nordeste brasileiro. Trata-se de um estudo descritivo de natureza quantitativa, desenvolvido com 32 enfermeiros de uma Unidade Básica de Saúde no município de Santa Rita - MA, no período de setembro de 2014 a julho de 2015, sendo os dados coletados por meio de instrumento semiestruturado. Dos 32 enfermeiros, as principais ações realizadas eram: fornecer o cartão da gestante devidamente preenchido (84%), identificar e classificar as gestantes de risco e/ou vulnerabilidade e encaminha gestantes de risco, para serviço especializado, respectivamente e 50% dos profissionais afirmaram que a dificuldade das gestantes é realizar os exames solicitados. Conclui-se que apesar do enfermeiro realizar as ações preconizadas no pré-natal de baixo risco, existem fatores que podem comprometer essas ações, como: a realização dos exames laboratoriais, a inexistência de capacitação e carência de protocolos na unidade.
Autoavaliação da saúde por idosos atendidos em um centro ambulatorial de referência
Authors: Pereira Kéury Guimarães , Da Silva Patrick Leonardo Nogueira , Oliveira Maricy Kariny Soares , Gamba Mônica Antar , Alves Elaine Cristina Santos , E Martins Aurelina Gomes
Published: July 2019

Os brasileiros vivenciam consideráveis mudanças demográficas e etárias em decorrência do aumento da expectativa de vida e acentuado envelhecimento populacional. Objetivou-se identificar a autoavaliação da saúde por idosos atendidos em um centro ambulatorial de referência. Trata-se de um estudo descritivo, exploratório, com abordagem quantitativa. A amostra compreendeu 217 idosos. Utilizou-se como instrumento de coleta de dados um questionário estruturado, adaptado, reduzido e validado. A mesma foi realizada em fevereiro de 2013. Os dados foram tabulados e apresentados em tabelas. O tratamento se deu por meio de análise estatística descritiva simples. Observou prevalência do sexo feminino, insatisfação com a vida atribuída por problemas de saúde na qual a maior parte a considerava ruim ou péssima. Destes problemas, prevaleceu a hipertensão arterial sistêmica e dor no corpo. Foi referida a capacidade de realização das atividades de vida diária sem ajuda. Parte relatou satisfação com as atividades realizadas no tempo livre. Foi relatada carência de companhia. Faz-se necessário a criação de centros e grupos de interação e convívio social da terceira idade, junto às instituições de ensino superior do município de modo a prolongar a expectativa de vida, bem como melhorar a qualidade e satisfação pessoal.
Social Policy in the Early Decentralization Era: Formulation and Politicization to the Local Public Health Insurance in Banyuwangi
Authors: Mitra A. Kusuma Bayu
Published: July 2019

In the development of a country or a region, the quality of citizen’s health is very important. So that’s why, in order to improve the quality of citizen’s health, there needs a social policy action by the government, especially with the right decision making in its formulation process. In the local context, the Banyuwangi Public Health Services Insurance (JPKMB) Program is the answer to these problems, where the program offers free primary health service without charge for whole community levels. The main finding in this research is that in the decision making of the JPKMB Program, the decision-maker claims that they have done in-depth consideration and analysis using the rational approach model. But the facts on the research suggests that decision-makers tend to use an incremental approach model, where they make decisions quickly because it is affected by various limitations. This is due to health issues being politicized in terms of political campaigning purposes by one of the candidates who was competing in the local general elections of Banyuwangi Regency 2005. Consequently, after the candidate has been elected, the candidates should run the free health service program immediately, no matter what way. Its can be said that the decision making of the JPKMB Program is not going through a mature process.Dalam pembangunan suatu negara ataupun daerah, kualitas kesehatan masyarakat sangatlah penting. Oleh karena itu, untuk meningkatkan kualitas kesehatan masyarakat, dibutuhkan kebijakan sosial yang baik dari pemerintah, kususnya melalui pembuatan keputusan yang tepat dalam proses formulasinya. Pada tataran lokal, Program Jaminan Pelayanan Kesehatan Masyarakat Banyuwangi (JPKMB) adalah jawaban dari masalah tersebut, dimana dalam program tersebut disediakan pelayanan kesehatan gratis bagi seluruh lapisan masyarakat. Temuan utama dari penelitian ini adalah bahwa dalam pembuatan keputusan program JPKMB, pembuat keputusan mengklaim telah menggunakan pertimbangan dan analisis mendalam dengan model pendekatan rasional. Tapi pada faktanya peneliti lebih menemukan gejala bahwa pembuat keputusan cenderung menggunakan model inkremental, dimana mereka membuat keputusan dalam proses yang sangat cepat disebabkan berbagai keterbatasan. Dalam hal ini isu kesehatan telah dipolitisasi sebagai alat kampanye politik dari salah satu kandidat yang berkompetisi di Pilkada Banyuwangi 2005. Konsekuensinya setelah kandidat tersebut terpilih, pelayanan kesehatan gratis harus segera dilakukan, tidak peduli bagaimanapun caranya. Sehingga dapat dikatakan bahwa pembuatan keputusan program JPKMB tidaklah melalui proses yang matang.
Factors Widening the Gap between Hypothetical and Actual choices—Empirical Evidence from the Japanese Medical Insurance Market—
Authors: Fujii Yoichiro , Inakura Noriko
Published: July 2019

This study examines the consistency in risk aversion between hypothetical and actual choices in medical insurance. Utilizing a unique survey in which individuals in Japan are asked about their perception of a hypothetical necessary amount for hospitalization benefits and the actual insurance contract amount at the time of hospitalization, the study identifies that the gap between the hypothetical and actual domains is not constant. Even between two similar domains of hospital benefits selection, the gap is found to vary depending on respondents’ anxiety about future medical expenses, their level of financial literacy, and other personal attributes such as age and occupation. The results of this study strongly suggest a need for exercising caution when using the degree of risk aversion obtained by hypothetical questions, questionnaire surveys, and experiments to predict actual behavior.
Candidate reference method for determination of vitamin D from dried blood spot samples
Authors: Zakaria Rosita , Allen Katrina J. , Koplin Jennifer J. , Roche Peter , Greaves Ronda F.
Published: July 2019

Background

The current millennium has seen an explosion in vitamin D testing with the overarching aim of requests to clinically stratify patients as replete or deficient in vitamin D. At a population level, dried blood spot (DBS) sampling offers a less invasive and more practical application for assessment of vitamin D status. We have therefore aimed to develop a sensitive and robust DBS vitamin D method that is traceable to serum for use in population-based studies.

Methods

Blood spots, calibrators and controls were prepared by punching a 3.2 mm DBS from filter paper and placed into a 96-well micro-plate. The DBS disk was eluted with a combination of water-methanol and internal standard (ISTD) solution followed by supported-liquid extraction and derivatisation. The extract was analysed by liquid-chromatography tandem-mass spectrometry in positive electrospray-ionisation mode with 732.5 > 673.4 and 738.4 > 679.4 m/z ion-transitions for derivatised vitamin D and the ISTD, respectively. Vitamin D results were made traceable to the National Institute of Standards and Technology reference material through the inclusion of Chromsystems vitamin D calibrators.

Results

25-Hydroxy-vitamin D3 and its related ISTD were detected at a retention time of 7 min. The seven-point calibration-curve consistently demonstrated a coefficient of determination of 0.99 with an experimentally determined reportable range of 0.5–376 nmol/L. Method validation studies using DBS samples demonstrated 12.9% between-assay imprecision at 45 nmol/L, 84% average recovery and high correlation with plasma vitamin D (correlation coefficient = 0.86).

Conclusions

We have successfully developed an analytical method for vitamin D quantitation from DBSs which will be applied to our population-based vitamin D research study. This approach improves traceability of DBS results and potentially could be used broadly for other DBS measurands that require comparison to serum/plasma for their interpretation.
Data protection in biobanks from a practical point of view: what must be taken into account during set-up and operation?
Authors: Drepper Johannes
Published: July 2019

The European General Data Protection Regulation (GDPR) incorporates many of the principles of data protection that were already in force in the past. Insofar the data protection requirements for German biobanks have not fundamentally changed since the GDPR became applicable in May 2018. In detail, however, new and relevant requirements have been added. Due to many derogation clauses that allow national deviations, federal and state laws must also be taken into account in Germany, depending on the legal form of the biobank or the supporting institution, which increases the complexity in individual cases. Research-oriented biobanks can still rely on informed, voluntary and explicit consent from patients or test persons. Other legal bases are also possible in certain cases. The information and transparency requirements have increased with the DSGVO, which has led to higher administrative costs. However, a major problem existed before and continues to exist in clarifying how biobanks deal with the right to know and the right not to know of their subjects, how this is explained in advance and which policy can be implemented in the long term, also in the context of targeted recruitment for later studies. The complexity of the regulatory framework and the resulting demands on biobanks make the development and implementation of standards unavoidable. In addition, it is recommended that such infrastructures be centralised, professionalised and equipped with the necessary resources.
Antioxidant and cytotoxic activity of three Turkish marine-derived fungi
Authors: Gözcelioğlu Bülent
Published: July 2019

Background

Marine-derived fungi are appraised as a favorable source for discovering new bioactive secondary metabolites. In the last few decades researchers have concentrated on marine-derived fungi to obtain new and pharmaceutically active bioactive secondary metabolites with therapeutic potential.

Objective

In this study three marine-derived fungi were isolated and identified from marine invertebrates and investigated with regard to their antioxidant and cytotoxic activities.

Materials and methods

DPPH, SO, NO, and ABTS assays were used for monitoring free radical scavenging activity, and the MTT assay was used for testing cytotoxic activity against HCT-116 colon cancer cells.

Results

According to the obtained results Malassezia restricta extract was shown to have the highest antioxidant and cytotoxic activities compared to the other tested fungi strains.

Conclusion

This study is the first report about the antioxidant and cytotoxicity activity of Acremonium sclerotigenum, Aspergillus flavus, and M. restricta. This serves as a valuable preliminary study for activity-guided isolation of secondary metabolites.
Evaluating serum elastin levels in striae gravidarum
Authors: Gürlek Beril , Ural Ülkü Mete , Tuğcugil Sibel , Arpa Medeni , Önal Özgür
Published: July 2019

Objective

Striae gravidarum (SG) is the most common dermatological defect in pregnancy leading to cosmetic anxiety with unknown etiopathogenesis. The aim of the study was to analyze the relation between serum elastin levels and striae and identify possible independent associated risk factors.

Materials and methods

This was a prospective observational study. In total, 138 primipara pregnant women were examined before delivery. Participants were separated into two groups according to the presence of SG. Striae assessment was performed according to Davey score. Before the active phase of labor patients were physically examined and blood samples were collected. Personal characteristics, features of birth, skin findings and serum elastin levels were compared between groups.

Results

Term pregnant women with SG had significantly higher serum elastin levels than those without SG (99.46 ± 32.92 vs. 88.36 ± 19.12, respectively; p = 0.018).

Conclusions

Serum elastin levels were increased in women with SG. However, the newly synthesized elastin may not be functional as it is thin and disorganized. Therefore, increased elastin production may not prevent the formation of striae. This finding may provide an impetus to explore the pathomechanisms of striae. Further controlled trials are warranted to determine the clinical significance of serum elastin levels in the formation of SG.
Investigating the Relationship Between Perfectionistic Self-Presentation and Social Anxiety Using Daily Diary Methods: A Replication
Authors: Kehayes Ivy-Lee L. , Mackinnon Sean P.
Published: July 2019

Worrying about the negative consequences of appearing imperfect to others (i.e., perfectionistic self-presentation) is conceptually related to social anxiety. Mackinnon, Battista, Sherry and Stewart (2014) tested whether perfectionistic self-presentation could predict social anxiety beyond several important covariates using a 21-day daily measurement approach. We sought to replicate Mackinnon et al.’s (2014) findings using the same daily diary methodology. Participants included 263 young adults (79.9% women;M age = 21.4) who completed a series of questionnaires once per day for 21 days. Participants completed measures of perfectionistic self-presentation, perfectionism cognitions, social anxiety, depressed mood and socially prescribed perfectionism. Intraclass correlations suggested measures had both within-subjects and between-subjects variability. Confirmatory factor analyses supported the a-priori factor structures at both levels. Using multilevel structural equation modeling, we showed that perfectionistic self-presentation predicted social anxiety even when controlling for socially prescribed perfectionism, depressed mood and perfectionism cognitions at both levels, replicating Mackinnon et al (2014). Our replication suggests that perfectionistic self-presentation is an important predictor of daily social anxiety. Intervention efforts may wish to target perfectionistic self-presentation in order to better help treat those with social anxiety. Open data/methods: https://osf.io/ty2aj/.
The Application of Value Clarification Technique (VCT) Learning Model on Students’ Characters of Adiwiyata Program
Authors: Hidayatiningtyas Kumala , Iswari Retno Sri , Sukaesih Sri
Published: July 2019

The concrete success of Adiwiyata program is a self-awareness of the surrounding environment in controlling undisciplined habit and taking action as a shared responsibility. The character building using Value Clarification Technique (VCT) learning model becomes a teacher’ alternative in emphasizing students’ activity. This study aimed at analyzing the effect of VCT learning on students’ characters through population density material and humans’ role in the environmental management. The research used quasi-experimental design with nonequivalent posttest only control group design. The population of this study was a total of 293 students of class VII in SMPN 2 Jati Kudus in the academic year of 2016/2017. The sampling used simple random sampling technique. The data of this research were characters of discipline, responsibility, and environmental care obtained from psychological scales instrument and observation sheets, implementation sheets of VCT models, and responses questionnaires of students and teacher. The data analysis techniques used t-test, simple regression, correlation test, and coefficient of determination. The results showed that the VCT learning model had a strong positive correlation to the responsibility character and a moderate correlation to the discipline and environmental care character that could be generalized. Moreover, the results of the correlation analysis and coefficient of determination of VCT learning on students’ characters of discipline, responsibility, and environmental care were 33.2%, 38.3%, and 22.7% respectively. These results indicated that there was another dominant factor on students’ characters.
The Effectiveness of 5e Inquiry Learning Model by Using Interactive Notebook on The Subject of Cell
Authors: Prabawati Faricha , Pribadi Tyas Agung , Pukan Krispinus Kedati
Published: July 2019

The purpose of this study was to discover and describe the effectiveness of 5E inquiry learning model by using interactive notebook on the subject of cell. It was a quantitative quasi-experimental research with nonequivalent control group design. The population of this study was the whole eleventh grade science students of SMA Negeri 1 Magelang. The researchers used simple random sampling which took the students from  Class Science 1 of eleventh grade as the experimental class and Class Science 3 of eleventh grade as the control class. In collecting the data, the researchers used the result of pre-test, post-test and the grades of students from experimental class (using interactive notebook) then the assessment of control class students’ laboratory work report performance. Normality test, homogeneity test, average difference test, the improvement of learning skill measurement, and classical completeness measurement were used for data analysis. The result shown that 5E Inquiry-Learning Model by Using Interactive Notebook   on the Subject ‘Cell’ was effective. It was proved by the average of both of classes (experimental class and control class) was significantly different (tcount (7.36) > ttable (2.00)). The difference was supported by the fact that the improvement of learning skill of experimental class students was better the control class students. For the experimental class, the improvement of student learning skill was categorized as medium (index gained 0.61) while control class’ was low (index gained 0.29). In addition, the experimental class had reached the classical completeness rate (the percentage was 87.89%) while the control class had not reached it yet (around 27.27%).
The Influence of Contceptual Understanding Procedures (CUPs) Learning Model with Bio-Quartet Cards on Secondary School Students Learning Interest and Outcomes on Energy Material
Authors: Ariesta Putri , Susanti R , Rahayu Enni Suwarsi
Published: July 2019

This study aimed to describe the influence of Conceptual Understanding Procedures (CUPs) learning model with the use of bio-quartet cards on the seventh grade students’ learning interest and outcomes on Energy material at SMP N 17 Tegal. The study employed Quasi Experimental; Nonrandomized Control Group Pretest and Posttest Design. Population of the study was all the seventh grade students from 8 classes in the academic year 2017/2018. The sample was taken by using purposive sampling technique, obtaining two classes as the subject of this study. VII G as the control group was taught using discovery learning model and VII H as the experimental group was given CUPs learning model with the use of bio-quartet cards. The result of this study showed N-gain of students’ learning outcomes of the experimental group was 0.33 and that of the control group was 0.24. Control group learning interest was stagnant, on the other hand, experimental group learning interest improved at 3% on “very interest” category. Students’ learning interest and outcomes of both groups were not significantly different. The correlation test results of the two variables clearly showed that students’ learning interest and outcomes do not relate significantly, both the experimental group and the control group.
The Influence of Learning Cycle Model Against the Motivation of Learning and Critical Thinking Skills of Students
Authors: Hidayah Farida , Alimah Siti , Anggraito Yustinus Ulung
Published: July 2019

This research aims to know the influence of motivation towards Learning Cycle of learning and critical thinking skills of students on the material of the human digestive system in SMP Negeri 03 Jekulo. The sample used is grade VIII VIII C and D taken with the technique of convenience sampling and research design a non-randomized control group pretest-posttes design. Data obtained in the form of motivation and critical thinking skills as well as the response of teachers and students towards learning Learning Cycle model. Data analysis using SPSS 16.0. The research results obtained studying motivations of students after learning Learning Cycle has increased from 76.87 with higher category be the category with very tinngi 84.67. Results the average critical thinking skills has increased from 76.34 with critical categories into classes with 82.11 wants a category of highly critical. The t-test based on posttest showed thitung > 11.628 from ttabel 2.073 which means there is a significant difference. The response of the students towards the Learning Cycle shows interest because of the interesting activities and serves the appropriate issues with everyday life. The teacher gave a positive response, namely students became active in learning, so that students acquire the knowledge of the concept of direct experience of the menjadiikan pengetahuaanya longer remember.  The conclusions of this research are the Learning Cycle model provides a positive influence motivation towards learning and critical thinking skills on the material of the human digestive system in SMP Negeri 3 jekulo.
Interactive Multimedia Effectiveness in Improving Cell Concept Mastery
Authors: Rosamsi Saiman , Miarsyah Mieke , Ristanto Rizhal Hendi
Published: July 2019

The learning process has been carried out in the conventional way, this is caused by the teacher's understanding of using multimedia is still not optimal, so the learning method used is still limited. This phenomenon makes the researchers interested in doing this research. The purpose of the study  to determine the effectiveness of multimedia use in improving mastery of cell concepts. this study uses a quantitative approach with a quasi-experimental method. This study uses a quantitative approach with a quasi-experimental method. Based on the results of the study, it was found that the use of interactive multimedia provides a good value of effectiveness in mastering the concept of students cells, compared with learning using conventional media. This is evidenced by the t test on spss obtained value t = 0.00. Based on these results the average value of the gain  experimental class is greater, which is 41, compared to the average value of the gain control class, which is 32. The results of this study is  indicate there are differences in learning by using interactive multimedia and learning with conventional media. The success of this research can be used by educators in supporting the learning process, especially in biology.

Keywords: cell, Interactive Multimedia, Mastery of concepts.
Phosphate matters when investigating hypercalcemia: a mutation in SLC34A3 causing HHRH
Authors: Tang Andrew R , Hinz Laura E , Khan Aneal , Kline Gregory A
Published: July 2019

Hereditary hypophosphatemic rickets with hypercalciuria (HHRH) is a rare, autosomal recessive disorder caused by mutations in the SLC34A3 gene that encodes the renal sodium-dependent phosphate cotransporter 2c (NaPi-IIc). It may present as intermittent mild hypercalcemia which may attract initial diagnostic attention but appreciation of concomitant hypophosphatemia is critical for consideration of the necessary diagnostic approach. A 21-year-old woman was assessed by adult endocrinology for low bone mass. She initially presented age two with short stature, nephrocalcinosis and mild intermittent hypercalcemia with hypercalciuria. She had no evidence of medullary sponge kidney or Fanconi syndrome and no bone deformities, pain or fractures. She had recurrent episodes of nephrolithiasis. In childhood, she was treated with hydrochlorothiazide to reduce urinary calcium. Upon review of prior investigations, she had persistent hypophosphatemia with phosphaturia, low PTH and a high-normal calcitriol. A diagnosis of HHRH was suspected and genetic testing confirmed a homozygous c.1483G>A (p.G495R) missense mutation of the SLC34A3 gene. She was started on oral phosphate replacement which normalized her serum phosphate, serum calcium and urine calcium levels over the subsequent 5 years. HHRH is an autosomal recessive condition that causes decreased renal reabsorption of phosphate, leading to hyperphosphaturia, hypophosphatemia and PTH-independent hypercalcemia due to the physiologic increase in calcitriol which also promotes hypercalciuria. Classically, patients present in childhood with bone pain, vitamin D-independent rickets and growth delay. This case of a SLC34A3 mutation illustrates the importance of investigating chronic hypophosphatemia even in the presence of other more common electrolyte abnormalities.

Learning points:

Hypophosphatemia is an important diagnostic clue that should not be ignored, even in the face of more common electrolyte disorders.

HHRH is a cause of PTH-independent hypophosphatemia that may also show hypercalcemia.

HHRH is a cause of hypophosphatemic nephrocalcinosis that should not be treated with calcitriol, unlike other congenital phosphate wasting syndromes.

Some congenital phosphate wasting disorders may not present until adolescence or early adulthood.
Treatment and long-term outcomes in pituitary carcinoma: a cohort study
Authors: Santos-Pinheiro Fernando , Penas-Prado Marta , Kamiya-Matsuoka Carlos , Waguespack Steven G , Mahajan Anita , Brown Paul D , Shah Komal B , Fuller Gregory N , McCutcheon Ian E
Published: July 2019

Background

Pituitary carcinoma (PC) is an aggressive neuroendocrine tumor diagnosed when a pituitary adenoma (PA) becomes metastatic. PCs are typically resistant to therapy and develop multiple recurrences despite surgery, radiotherapy and chemotherapy. Recently, treatment with temozolomide (TMZ) has shown promising results, although the lack of prospective trials limits assessment of benefit.

Methods

We describe a single-center multidisciplinary experience in managing PC patients over a 22-year period and review previously published PC series.

Results

Seventeen patients were identified. Median age at PC diagnosis was 44 years (range 16–82 years), and the median time from PA to PC transformation was 5 years (range 1–29 years). Median follow-up time was 28 months. Most PCs were hormone-positive (n = 12): ACTH (n = 5), PRL (n = 4), LH/FSH (n = 2) and GH (n = 1). All patients underwent at least one resection and at least one course of radiation after PC diagnosis. Immunohistochemistry showed high Ki-67 labeling index (>3%) in 10/15 cases. Eight patients (47%) had only central nervous system (CNS) metastases; six (35%) had combined CNS and systemic metastases. The most commonly used chemotherapy was TMZ, and TMZ-based therapy was associated with the longest PFS in 12 (71%) cases, as well as the longest period from PC diagnosis to first progression (median 30 months). The 2, 3 and 5-year survival rate of the entire cohort was 71, 59 and 35%, respectively. All patients surviving >5 years had been treated with TMZ-based therapy.

Conclusions

PC management benefits from multidisciplinary care and multimodality therapy. TMZ-based regimens were associated with high survival rates and long disease control.
Commentary on article: Adrenal crisis in treated patients with Cushing’s syndrome
Authors: Torpy David J
Published: July 2019

A study has examined the rates of adrenal crises in patients treated with pituitary or adrenal surgery. Rates were substantial (approximately 9 per 100 patient years), perhaps representing suppression of corticotrope ACTH secretion and deprivation of normal corticotrope number postoperatively. Hormone withdrawal syndrome may have contributed to the rates of apparent adrenal crises given the definition used. Higher rates were seen in patients given relatively high dose glucocorticoids postoperatively in one of the two centres where patients were treated – perhaps some of the patients in the high dose centre had longer periods of corticotrope suppression from exogenous glucocorticoids, increasing the risk period for adrenal crises. The question of optimal glucocorticoid dose and weaning rate after cure of Cushing’s syndrome remains a balance between weaning at a rate sufficiently rapid to allow resumption of normal corticotrope function thereby preventing adrenal crises and providing sufficient glucocorticoid support to avoid hormone withdrawal syndrome or even precipitating an adrenal crisis, in the vulnerable 4–6 month period after successful surgery. There is likely to be considerable inter-individual variability in optimum glucocorticoid dose and weaning rate so that close clinical and biochemical monitoring is currently a practical approach.
Estrategia universitaria basada en habilidades
Authors: Miranda Chavarría Ronald , Valerio Hernández Vanessa
Published: July 2019

La definición de una estrategia global que permita a una universidad alcanzar su misión o su visión de futuro constituye un asunto de importancia trascendental para las autoridades universitarias. En este artículo se propone un modelo denominado estrategia universitaria basada en habilidades como un recurso conceptual y metodológico para el análisis y la definición de estrategias institucionales en universidades. Se plantean los fundamentos, se describen los escenarios estratégicos y se explica el proceso de elaboración de una estrategia, lo cual se ilustra con el caso concreto de la Universidad Nacional, Costa Rica, como parte de un proceso de planificación global.
Un modelo para la gestión de la información y la tecnología en la Universidad Nacional
Authors: Giesberts Arthur , Carranza Carlos Francisco , Miranda Chavarría Ronald
Published: July 2019

La Gestión de la información, la Tecnología y las Comunicaciones (ITC) en una universidad pública no debe ser vista de manera mitificada como un asunto de especialistas, debe estar direccionada por las autoridades académicas y tener una correspondencia con el modelo de gestión: con el grado de desconcentración y con la rendición de cuentas. Debe desarrollar habilidades estratégicas en materia de información y tecnología para los procesos académicos, de gestión y los servicios de apoyo. El proceso de gestión de la ITC comprende la planificación y organización, la adquisición y la puesta en ejecución de sistemas tecnológicos y de información, la entrega y soporte de servicios relacionados y el monitoreo. Se propone un modelo orgánico desconcentrado, con una instancia de asesoría a la Rectoría responsable de la información estratégica y de orientar el modelo de gestión de la información y la tecnología. Las vicerrectorías definen la naturaleza de la información requerida para los procesos académicos, de gestión y para los servicios de apoyo; en tanto que una instancia operativa administra las redes internas, los datos, el funcionamiento y la seguridad de los sistemas de información. El modelo que se presenta a continuación se ha propuesto para ser implementado en la Universidad Nacional, como parte de un proceso de mejora de los sistemas de generación, procesamiento y uso de la información en las actividades académicas y de gestión universitaria.
La perspectiva docente acerca de la noción de familia de niños y niñas preescolares costarricenses y extranjeros centroamericanos
Authors: Arce Villalobos Doris Rocío , Carballo León Alejandra , Castro Castro Karla Alejandra , Pereira Pérez Zulay
Published: July 2019

El presente artículo retoma algunos de los resultados y conclusiones de una investigación realizada en instituciones preescolares costarricenses acerca de la noción de familia, tanto de niños y niñas costarricenses como extranjeros centroamericanos. Importante de resaltar es que los infantes tienen una noción de familia muy ligada a las experiencias y vivencias de su propia realidad. Se logra determinar una diferencia puesto que, según los docentes, para los costarricenses la familia es nuclear, en tanto que para los extranjeros es más extensa por cuanto reconocen como parte de la familia a personas que no conviven con ellos.
Time and History in the Memories of Soviet Generations
Authors: Vinogradnaitė Inga
Published: July 2019

This article aims to reconsider how and where the boundaries within Soviet generations as differentiable memory communities could be established. On the basis of Mannheimian theory of generational units and the theory of narration, as based on the conceptual metaphors of container, a method to identify the boundaries between generations was devised. The method was applied to biographical narratives, collected during the summer of 2017, and revealed the existence of different history-related calendars to structure time in the biographical past.
Pediatric Respiratory Illness Measurement System (PRIMES) Scores and Outcomes
Authors: Mangione-Smith Rita , Zhou Chuan , Williams Derek J. , Johnson David P. , Kenyon Chén C. , Tyler Amy , Quinonez Ricardo , Vachani Joyee , McGalliard Julie , Tieder Joel S. , Simon Tamara D. , Wilson Karen M. ,   for the Pediatric Research in Inpatient Settings (PRIS) Network
Published: July 2019

BACKGROUND AND OBJECTIVES:

The Pediatric Respiratory Illness Measurement System (PRIMES) generates condition-specific composite quality scores for asthma, bronchiolitis, croup, and pneumonia in hospital-based settings. We sought to determine if higher PRIMES composite scores are associated with improved health-related quality of life, decreased length of stay (LOS), and decreased reuse.

METHODS:

We conducted a prospective cohort study of 2334 children in 5 children’s hospitals between July 2014 and June 2016. Surveys administered on admission and 2 to 6 weeks postdischarge assessed the Pediatric Quality of Life Inventory (PedsQL). Using medical records data, 3 PRIMES scores were calculated (0–100 scale; higher scores = improved adherence) for each condition: an overall composite (including all quality indicators for the condition), an overuse composite (including only indicators for care that should not be provided [eg, chest radiographs for bronchiolitis]), and an underuse composite (including only indicators for care that should be provided [eg, dexamethasone for croup]). Multivariable models assessed relationships between PRIMES composite scores and (1) PedsQL improvement, (2) LOS, and (3) 30-day reuse.

RESULTS:

For every 10-point increase in PRIMES overuse composite scores, LOS decreased by 8.8 hours (95% confidence interval [CI] −11.6 to −6.1) for bronchiolitis, 3.1 hours (95% CI −5.5 to −1.0) for asthma, and 2.0 hours (95% CI −3.9 to −0.1) for croup. Bronchiolitis overall composite scores were also associated with shorter LOS. PRIMES composites were not associated with PedsQL improvement or reuse.

CONCLUSIONS:

Better performance on some PRIMES condition-specific composite measures is associated with decreased LOS, with scores on overuse quality indicators being a primary driver of this relationship.
Grandes proyectos urbanos alternativos o alternativas a los grandes proyectos urbanos: una revisión a partir del concepto de just city
Authors: Jajamovich Guillermo
Published: July 2019

El artículo reordena la discusión latinoamericana sobre grandes proyectos urbanos a partir del concepto de just city. Mientras parte de la literatura asocia los primeros con el neoliberalismo urbano, dada su orientación hacia la ganancia económica, otra discute cómo las articulaciones entre justicia y espacio apuntan en una dirección política y urbana contraria. A partir del análisis de fuentes secundarias y de abordajes previos sobre grandes proyectos, se postula que, lejos de tratarse de universos contradictorios, las concepciones sobre just city pueden reforzar posicionamientos críticos, pero también reformistas sobre los grandes proyectos urbanos. Esto ocurre en la medida en que se trata de conceptos amplios factibles de ser movilizados desde diversos posicionamientos ideológicos y políticos frente a grandes proyectos urbanos heterogéneos. El artículo postula la existencia de posicionamientos “críticos”, “reformistas” y “entusiastas” a partir de asuntos como: criterios de evaluación promovidos, posicionamientos sobre la cuestión de la participación y posturas sobre el vínculo entre grandes proyectos y recuperación de plusvalías. El cruce entre grandes proyectos urbanos y just city propuesto a propósito de la experiencia latinoamericana permite profundizar el abordaje y evaluación de los primeros desde perspectivas renovadas, así como expandir conceptualmente el análisis de políticas urbanas más amplias.Ideas destacadas: artículo de reflexión en el que se hace un recorrido en la discusión latinoamericana sobre grandes proyectos urbanos a partir del concepto de just city e identifica usos variados de dicho concepto, movilizados desde diversos posicionamientos ideológicos y políticos.
A TEORIA JURÍTICA DE JÜRGEN HABERMASENTRE FUNCIONALISMO E NORMATIVISMO
Authors: Pinzani Alessandro
Published: July 2019

A teoria habermasiana do direito reivindica uma terceira via entre a normatividade das teorias “abstratas” da justiça e o funcionalismo de teorias como a de Luhmann. Na verdade, a posição de Habermas é normativa num sentido forte e, apesar do funcionalismo de sua reivindicação, enfoca apenas o direito positivo moderno, na medida em que não distingue claramente entre direito e moralidade. Outrossim, termina por incorrer nesta aporia, culminando numa espécie de legalização da moralidade.
DISKURSETHIK – AKT – ODER NORMENETHIK?
Authors: Kuhlmann Wolfgang
Published: July 2019

Neste artigo o autor procura mostrar por que o princípio de universalização de Habermas (princípio U) não pode ser fundamentado reflexivamente, como o autor da Teoria do agir comunicativo sugere, bem pode ser considerado como um princípio central de uma filosofia moral.
MARX ET LA PENSÉE CRITIQUE
Authors: Howard Dick
Published: July 2019

Este artigo propõe-se evidenciar o Caráter sistemático, de inspiração hegeliana, da obra de Karl Marx, na sua contribuição crítica para a filosofia moderna. A crítica mariana, segundo o autor, não pode ser em última análise separada de sua filosofia sistemática, mesmo quando se leva em consideração a problemática realização efetiva da filosofia. O papel revolucionário da utopia é, outrossim, 0 que dá conta da atualidade e relevância da filosofia marxiana para O pensamento político contemporâneo.
JUSTIÇA E POLÍTICA
Authors: De Souza Draiton Gonzaga
Published: July 2019

Crônica
RESPONSABILIDADE E JUSTIÇA EM LEVINAS
Authors: Pivatto P. S.
Published: July 2019

O artigo investiga a possibilidade de pensar a questão da justiça sociopolítica a partir da ideia de alteridade.
ACERCA DO (DES)ENCONTRO: HUSSERL, HEIDEGGER E LEVINAS
Authors: Pelizzoli Marcelo Luiz
Published: July 2019

Este trabalho retoma as conclusões de minha tese acerca do sentido da subjetividade & da alteridade em Husserl, Heidegger é Levinas, Trata-se de uma síntese de cunho afirmativo, relativa ao confronto frutífero na linha que vai de Husserl passando por Heidegger em direção ao pensamento de Levinas, onde obras mestras estão como pano de fundo (Meditações cartesianas, Ser e tempo, Totalidade e infinito e Autrement quête...)
CIÊNCIA, RELIGIÃO E UTOPIA – A SOCIEDADE IDEAL NA NOVA ATLÂNTIDA DE FRANCIS BACON
Authors: Spang Michael
Published: July 2019

Este artigo examina a sociedade utópica esboçada na Nova Atlântida de Francis Bacon. As interpretações modernas costumam afirmar que ela é, de modo geral, caracterizada por influências cristãs. Essa compreensão é questionada e uma interpretação alternativa é discutida. Bacon emprega um sistema complexo de indicações veladas, símbolos e alusões com "ambigiidades. Isso sugere que não há um único pano de fundo filosófico, religioso ou cultural para sua sociedade utópica. Portanto, eu sustento que a identidade social da Nova Atlântida é baseada num sincretismo intercultural (e, não, numa ideologia predominantemente cristã).
A ÉTICA COMO DESSACRALIZAÇÃO
Authors: Fabri Marcelo
Published: July 2019

O artigo apresenta à ética levinasiana como uma forma de dessacralização. O ponto de partida é a reação de Levinas a dois tipos de violência: a violência ativa do processo coqnoscitivo é à violência música proveniente da experiência Com o numinoso. Tenta-se demonstrar que a ética levinasiana é uma inteligibilidade que se mantém na fronteira destas duas formas de violência. Daí seu caráter dessacralizante.
ESTUDOS DE FILOSOFIA MEDIEVAL EH PORTUGAL E NO BRASIL - Tendências e desiderata
Authors: Merinhos José Francisco
Published: July 2019

Este relato procura expor o desenvolvimento das pesquisas em filosofia medieval em Portugal e no Brasil. O autor oferece uma visão das principais instituições que promovem os estudos em filosofia medieval em ambos os países, bem como das oportunidades e expectativas para o futuro que os estudos do pensamento medieval têm naqueles contextos. Ele nos dá informação, em perspectiva histórica, de alguns dos principais eventos nos últimos anos e dos diferentes grupos em Portugal e no Brasil que investigam aquele período da história da filosofia.
FRANCESCO PATRIZI E SEI ERRORI DI ARISTOTELE NELLA DEFINIZIONE DEL TEMPO
Authors: Bottin Francesco
Published: July 2019

Este artigo apresenta as críticas de Francesco Patrizi à concepção aristotélica de tempo na sua Física, isto é, a crítica de Patrizi ao princípio de que o tempo é infinito em termos de infinidade matemática. A principal tese de Patrizi é a de que a “infinidade possível" da matemática acarreta contradições quando aplicada a substâncias naturais e à ciência natural em geral.
L’ERMENEUTICA DEL TESTO ARISTOTELICO: DALLA “VIA ANTIQUA”ALLA “VIA MODERNA”
Authors: Guisalberti Alessandro
Published: July 2019

Este artigo procura compreender o modo como a via antiqua e a via moderna devem ser entendidas no processo de interpretação das obras de Aristóteles da Idade Média até o Humanismo. O autor expõe o sentido etimológico da " palavra modernus e mostra os diferentes significados dela - tanto em discussões filosóficas quanto teológicas - nos séculos 13, 14 e 15.
LUIS ALBERTO DE BONI. Filosofia medieval. Textos. Porto Alegre, Edipucrs, 2000, 418p. (Coleção Filosofia)
Authors: E Silva Paula Oliveira
Published: July 2019

Resenha da obra.
QUANTO A FALTA DE UMA FUNDAMENTAÇÃO ÚLTIMA - Observações sobre uma premissa implícita da justiça comunicativa e da ética do discurso
Authors: Merle Jean-Christophe
Published: July 2019

A teoria da justiça política de Hóffe, fundamentada na justiça comutativa, sustenta que a fundamentação de normas de sociedade, na comunidade discursiva, pela Ética do Discurso de Apel e Habermas, é apenas uma fundamentação derivada, posto que a comunidade discursiva — necessariamente pressupõe direitos humanos A Ética do Discurso afirma, por sua vez, que direitos humanos podem: ser legitimados somente através de discursos. Este artigo sustenta que a pressuposição normativa para ambas - a comunidade discursiva e o princípio de justiça comutativa — é que todos cos seres humanos têm o direito de partilhar o mundo. Somente sob essa premissa da justiça distributiva, pode haver parceiros que exercem reciprocidade e participantes de discurso, que também têm algo sobre o que têm de decidir conjuntamente.
AUTONOMIA, SENTIMENTO DE RESPEITO E DIREITO
Authors: Heck José N.
Published: July 2019

O trabalho apresenta o encaminhamento dado ao fato kantiano da razão em dois artigos recentes e retoma, a seguir, a discussão em torno do sentimento do respeito pela lei moral para concluir que a concepção fichteana de razão prática configura o primeiro mal-entendido do Faktum.
VERDADE E INDICAÇÃO FORMAL: A HERMENÊUTICA DIALÓGICA DO PRIMEIRO HEIDEGGER
Authors: Dos Reis Róbson Ramos
Published: July 2019

No presente artigo, é apresentado um aspecto central da concepção heideggeriana da fenomenologia nos escritos posteriores a 1919, que, à luz dos textos disponíveis na Gesamtausgabe de Martin Heidegger, revela um componente dialógico específico do método filosófico. A tese de que os conceitos e enunciados próprios da filosofia têm um caráter indicativo-formal (formal anzeigend) conduz a uma noção de verdade filosófica, que tem na recepção produtiva e conversacional das sinalizações formais o seu traço definitório. Associada com a noção especulativa de jogo, apresentada por Heidegger no livro Introdução à Filosofia (1928/29), a doutrina das indicações formais permite reconhecer um traço dialógico já na hermenêutica da facticidade do primeiro Heidegger.
A Pesquisa Baseada em Design (PBD): um levantamento de trabalhos realizados no ensino de Matemática
Authors: Soares Gabriel De Oliveira , Pigatto Aline Grohe Schirmer , Bisognin Eleni
Published: July 2019

Com o objetivo de caracterizar os estudos brasileiros que utilizam a Pesquisa Baseada em Design no âmbito do Ensino de/Educação Matemática, esse trabalho apresenta uma Revisão Sistemática de Literatura realizada em três bases de dados, a saber, Scielo, Periódicos CAPES e o Catálogo de Teses e Dissertações da CAPES. Foram encontrados dezesseis trabalhos que atenderam aos critérios estabelecidos para a busca e a seguir, estes foram lidos e tiveram seus dados organizados em quatro categorias definidas a priori: conteúdos matemáticos trabalhados, perspectivas teórico-metodológicas evidenciadas no trabalho, sujeitos e níveis de ensino e, ainda, principais resultados e avaliação. Constatou-se que a maioria dos estudos se desenvolvem com diferentes objetivos de pesquisa e evidenciam uma diversidade de contextos de aplicações. Destacaram-se, principalmente, no que tange às perspectivas teóricas, as teorias Socioculturais e as aplicações com alunos de cursos superiores. Por fim, ressalta-se que essa revisão é proposta como sugestão de novas leituras aos pesquisadores que se dispõem a trabalhar com a Pesquisa Baseada em Design.