bluuebunny/crossref_metadata_2025 huggingface dataset:
Retention of Urine after radical Hysterectomy for Cervical Cancer
Authors: Rana Jyoti , Rong Shi Hui , Mehata Suresh
Published: February 2014

A total of 90 patients with cervical cancer, who underwent radical hysterectomy were included in this study. 25 patients, i.e. 27.8% were menopausal and 11 patients, i.e. 12.2% had blood loss more than 500ml. The patients with retention of urine after radical hysterectomy were compared in relation with loss of blood volume intra- operatively, parity, and menopause; as the possible causes of retention of urine. The overall frequency of retention of urine among the patients who underwent radical hysterectomy for the cervical cancer was 42.2%. The statistical analysis showed that the relation of urine after radical hysterectomy for cervical cancer with loss of blood volume, parity and menopause was found to be non-significant.DOI: http://dx.doi.org/10.3126/jmmihs.v1i1.9897 Journal of Manmohan Memorial Institute of Health Sciences Vol.1(1) 2011; 24-29
A Community Based Study on Care Practice and Attitudes on male Circumcision in Muslim Community of Arghakanchi District, Nepal
Authors: Paudel Mohan , Mehata Suresh
Published: February 2014

Male circumcision is an obligatory religious or puberty rite among Muslims, Jews, Africans, and some other peoples. When, where, how, and by whom the operation is performed vary from group to group. The study was conducted in Pali VDC of Arghakhanchi district. Pali VDC is situated about 22 kilometers in the east from Sandhikharka, the headquarter of the district. It covers about 125 hectors land and is divided into 9 wards. It has 5500 populations in an average. There is one secondary school, one lower secondary school and two primary schools. The Muslim population resides entirely in ward no-1, 2, 3 & 4 of the VDC.The practices regarding circumcision and health seeking behaviour seems not very satisfactory as the practice so far has not been conducive to health of the children. This has been carried out nearly 100% by Hazam who is not health worker and hospitalization of circumcision is almost absent. Only small proportion of cases of circumcision (22%) during post circumcision period have sought for health institutions. However, looking at the use of modern medicines (injections/ tablets/capsules) during circumcision by about 23% shows the hope for improvement. People?s attitudes regarding circumcision seems far better than the practices that are currently prevalent in the community. The higher share of people in favor of hospitalization (91%) and the opinions of majority (62%) as health workers the appropriate decision maker makes the sign of possible intervention program to be successful.DOI: http://dx.doi.org/10.3126/jmmihs.v1i1.9898 Journal of Manmohan Memorial Institute of Health Sciences Vol.1(1) 2011; 30-35
Problems Faced by Domestic Child Workers in Katmandu Metropolitan City, Nepal, 2006
Authors: Kaphle Maheshor
Published: February 2014

Children working in an employer?s house with or without wages are known as domestic child workers. Domestic child workers (DCWs) are basically employed to perform domestic chores such as washing dishes, cooking, cleaning the house. Objectives: to identify the problems faced by domestic child workers. Study design and sample size: a cross-sectional study was conducted with 200 domestic child workers. Study variables: age sex reason of work, type of work, hours of work per day, monthly wages and health problems. Statistical analysis: chi-square test, z-test, ANOVA etc. result and conclusion: the study found that near about two-third of DCWs was girl. Mean age was 12.32years (SD 0.13). Main cause of migration to city from home town was to study followed by earning money. Most of them do all household work for 12 to 18 hours per day. So they did not get adequate time for rest/sleep. Majority of them did not get weekly leave. More than forty percent of DCWs were working without wages. Most of them who get wages, earn below 500 rupees ($6.66) per month. Most of them had not formal contract and more than two-third of them not was willing to leave current work due to study purpose and not getting formal schooling as current problems. DCWs who work more hours per day get more health problems. Most of them suffered from fever headache and cold/cough. More than two third of DCWs were abused during domestic work. Most of them were scolded by their employers. To go further and want to do vocational training were their future aspiration.DOI: http://dx.doi.org/10.3126/jmmihs.v1i1.9899 Journal of Manmohan Memorial Institute of Health Sciences Vol.1(1) 2011; 36-39
Helping Ingredients (excipient) in Pharmaceutical formulation: Coloring Agents – use and health concern
Authors: Khanal Dharma Prasad
Published: February 2014

DOI: http://dx.doi.org/10.3126/jmmihs.v1i1.9900 Journal of Manmohan Memorial Institute of Health Sciences Vol.1(1) 2011; 40-48
Educating the 21st Century Event Management Graduate: Pedagogy, Practice, Professionalism, and Professionalization
Authors: Bladen Charles , Kennell James
Published: February 2014

This article discusses whether event management can yet be classified as a bona fide profession, how staff working in the industry can be effectively professionalized, and how professional university education programs can be better designed to achieve this end. The article discusses
the findings and limitations of some of the existing literature concerning professionalism within event management, and whether event management can yet be wholly described as “a profession” according to conventional definitions. The event management profession and event management
education are discussed in terms of improving pedagogy in relation to the requirements of event industry practice. Finally the work concludes that the challenges of educating future event professionals require a rethink of events education so as to develop more reflective practice.
Event Management Education and Professionalism: The View from the Trenches
Authors: Jiang Jeff , Schmader Steven Wood
Published: February 2014

Little research effort has examined the perspective of those who work in the complex and rapidly growing field of event management on whether they perceive their own field as a profession, and what role event management education should play in the professionalization of the field.
The purpose of this article is twofold: 1) it examines whether event management can be indeed considered as a profession based upon existing literature and the attributes of professionalism as defined by those in the events industry; and 2) it provides a unique perspective from the viewpoint
of current industry leaders on whether event management is a profession, what characteristics constitute event management professionalism, and the role of event management education (academic vs. professional) in affecting the professionalization of event management. Seventeen event management
industry leaders, from five continents and seven countries, provided responses to an electronic survey. The results indicate that while noticeable efforts for event management to become a fully recognized profession have been made, additional work is still needed. Namely, a joint effort is
required by both industry and academia to identify commonalities and design the event management education system to better address the industry's rapidly increasing professional development needs.
The Professionalization of Festival Organizations: A Relational Approach to Knowledge Management
Authors: Stadler Raphaela , Fullagar Simone , Reid Sacha
Published: February 2014

In this article we examine the emergence of knowledge management (KM) within the professionalization of festivals and events. The growing complexity of festival management places pressure on organizations to effectively manage “knowledge” in order to succeed. Knowledge is commonly conceptualized as information that can be stored or itemized through checklists. We offer an alternative conceptualization of KM as a relational construction shaped by the organizational culture and structure. We develop this relational approach through a case study of the Queensland Music Festival (QMF) to examine the construction of KM roles and responsibilities. Our ethnographic research and qualitative analysis identifies how QMF implicitly utilizes chief knowledge officer, knowledge broker, and knowledge worker roles. These roles were successfully performed over a short duration and yet they were not defined or explicitly stated. We discuss how the culture and spatial organization of work teams contributed to a collective understanding of the value of sharing and creating knowledge. With growing professionalization we argue that festival organizations will increasingly develop a more self-conscious awareness of the significance of KM language and practice. The findings will enable festival managers to better understand how KM processes are embedded within an organizational culture and contribute to organizational learning.
Business Events and Friendship: Leveraging the Sociable Legacies
Authors: Foley Carmel , Edwards Deborah , Schlenker Katie
Published: February 2014

Business events are celebrated for their contributions to community and industry. They are understood to be shared social contexts in which people meet to advance knowledge, sell products, and network. Less celebrated and, arguably, less understood is that business events provide a
context for the development of friendships. In 2011 an online survey was conducted with the delegates of five international business events held in Sydney, Australia in the period 2009–2011. The survey was designed to investigate business legacies of the events (such as investment
opportunities, research collaborations) rather than sociable legacies. however, a surprising number of references to friendship were made in the “additional comments” sections of the questionnaire. reflecting on this finding, this article argues that friendships forged
at business events contribute to, respectively: the well-being of delegates, association membership levels, conference attendance, retention of personnel in the profession, successful research and professional collaborations, and creativity and innovation in the sector. Business event planners
can maximize opportunities for sociable outcomes among delegates by designing warm and inviting event spaces that facilitate interaction, and by providing social space for the development of relationships, optimal conditions for sociability, and opportunities for play to stimulate creativity
and build community.
The Motives of Ambassadors in Bidding for International Association Meetings and Events
Authors: Lockstone-Binney Leonie , Whitelaw Paul , Robertson Martin , Junek Olga , Michael Ian
Published: February 2014

As destinations contest the rights to host international association-based meetings and events, competitive points of difference in the bidding process can mean the success or loss of a bid. One of these points of difference has been the growth of ambassador programs worldwide. These
programs consist of influential, high-profile individuals, representing their particular industry body or association. Ambassadors work together with destination marketing organizations (DMOs) and meetings/conference professionals in putting forward bids to their association for future events.
To understand the motivations of ambassadors in bidding for international meetings and events, an exploratory study employing an online survey was conducted with ambassadors from three programs, one based in Australia, one based in Southeast Asia, and one in the Middle East. The results provide
a demographic profile of ambassadors and highlight their motives for actively bidding for international meetings and events. The study adds to knowledge on a topic for which limited research has been undertaken—that of the bidding process for business events—and expands understanding
of how ambassador programs, together with DMOs, can contribute to a professional bidding process for globally roaming international association meetings and events.
The Gran Fondo and Sportive Experience: an Exploratory Look at Cyclists' Experiences and Professional Event Staging
Authors: Berridge Graham
Published: February 2014

There has recently been a significant upsurge in popularity in cycling with not only increased participation evident but also new participants taking up cycling, especially in the UK, parts of Europe, US, and Australia. The branch of cycling that has witnessed the largest growth, in
both numbers of events and participants, is the “gran fondo” or “sportive” cycle event. However, very little is known about either the organization of these events or the cultural experiences of cyclists participating in them. The focus of this article is to provide
an exploratory narrative of the characteristics of a gran fondo or sportive, explored via a participant observation approach and interpreted through the use of experience theory. Drawing upon the exploratory stage of a larger “experiential ethnography” of cyclists at these types
of events, the article presents observation findings from 12 event days to identify key characteristics of these events as experienced by participants. These are understood and contextualized within a discussion around the nature and concept of event experiences and related to the need for
professional event organizers to identify experience components by applying models of experience within a management framework.
Through the looking glass: a trip inside the L2 reader’s head
Authors: Taillefer Gail
Published: February 2014

Alors qu’il existe une « Mission lecture » pour évaluer la performance de lecture des élèves et étudiants dans leur langue maternelle, le besoin se fait sentir d’un outil semblable pour la langue 2. En anglais de spécialité, il convenait de mettre en place des formations destinées à développer la compétence de lecture. L’auteur présente ici une évaluation quantitative et qualitative du travail mené en ce sens à partir de l’ouvrage de J. Billant et P. Fade Compréhension écrite en anglais pour les sciences humaines (1992).
Reading biomedical English: method and materials
Authors: Divasson Lourdes
Published: February 2014

Aujourd’hui, le besoin de dominer l’anglais écrit et oral est devenu indispensable pour les Sciences de la santé. Néanmoins, les Facultés de médecine ne consacrent pas assez de temps à l’enseignement de cette langue et, par conséquent, l’objectif de nombreux cours est encore la compréhension d’un texte écrit. Dans cette communication, on considère la différente organisation des principaux types de textes ainsi que le vocabulaire, la syntaxe, les hedgings et d’autres caractéristiques de cette prose scientifique. La recherche faite ces dernières décennies à propos l’EMP (English for Medical Purposes) a donné naissance à des glossaires, dont nous mentionnons les plus significatifs, pour les avoir trouvés intéressants en ce qui concerne la compréhension par la lecture.
Enquête sur l’évaluation de l’anglais par les Anglophones dans les publications des scientifiques français
Authors: Crosnier Elizabeth
Published: February 2014

Les scientifiques français qui souhaitent publier en pays anglophones sont souvent obligés de revoir la qualité de leur anglais. C’est pourquoi une enquête sous forme de questionnaire a été menée auprès des réviseurs britanniques et américains (referees), qui évaluent les articles scientifiques avant leur publication. L’objectif est d’une part de déterminer les critères linguistiques considérés lors de cette évaluation, d’autre part d’informer sur les processus d’évaluation. Les résultats obtenus peuvent être exploités par les scientifiques afin d’améliorer l’anglais ainsi que par les enseignants pour la formation des futurs chercheurs. Enfin, ils contribuent à une meilleure connaissance de l’anglais scientifique.
Writing scientific articles in English: Solutions for French researchers?
Authors: Birch-Becaas Susan
Published: February 2014

Des recherches ont déjà porté sur les caractéristiques linguistiques et discursives de l anglais scientifique, montrant les choix grammaticaux et le schéma interne des textes. Une enquête auprès d’auteurs nous permet d’étudier leurs stratégies d’apprentissage de la langue et des conventions du discours ainsi que leur façon de rédiger. De plus, une étude d’un corpus d’articles scientifiques devrait révéler les erreurs récurrentes qui forment le noyau d’éléments problématiques. Ces données devraient permettre le développement d’un outil pédagogique. Ce dernier répondrait aux besoins des chercheurs et améliorerait la collaboration entre le correcteur anglophone et le chercheur, pour faciliter le passage de celui-ci à la communication internationale.
Fonction des équivalences dans un dictionnaire bilingue
Authors: Schuwer Martine
Published: February 2014

Dans un dictionnaire bilingue, on conçoit bien l’objectif explicite du lexicographe qui propose, pour un terme, plusieurs équivalences dans la langue cible. Il rend ainsi compte de la non-isomorphie bien établie des champs sémantiques. Mais au-delà de ces informations, quelle fonction ces équivalences jouent-elles pour le lecteur ?
Une pratique active de communication dans un enseignement de spécialité : la vidéo-correspondance
Authors: Hay Josiane
Published: February 2014

La communication porte sur une expérience de réalisation de lettres-vidéo par des étudiants de deuxième année de DEUG scientifique (A et B) de l’Université Joseph-Fourier de Grenoble. La présentation de l’expérience est précédée d’une définition de la pratique. Les activités décrites sont placées dans le contexte d’un enseignement de l’anglais de spécialité.
La notion de scénario comme outil d’évaluation de la compétence en langue
Authors: Isani Shaeda , Hérino Micheline
Published: February 2014

Cet article présente la maquette d’un nouveau diplôme destiné à évaluer les compétences en langue. L’approche choisie pour le type d’épreuve proposé est une approche holistique. Il s’agit d’évaluer les capacités d’un candidat à accomplir une mission complexe proche de la vie réelle. L’épreuve se présente sous la forme d’une simulation de déroulement d’un scénario avec étude de cas et résolution de problèmes. Les situations proposées s’appuient sur la notion de compétences langagières transversales du domaine de la communication professionnelle.
Complexité tarifaire et choix de consommation
Authors: Rebaï Lilia , Flacher David
Published: February 2014

Nous introduisons la notion de « complexité tarifaire » en tant que structure (ou présentation) tarifaire entraînant une méconnaissance des prix par les consommateurs ou des difficultés particulières à comparer les prix ou à les interpréter. Une enquête originale menée auprès de 1 500 consommateurs représentatifs de la population tunisienne en 2007-2008 permet de montrer l’existence de cette complexité dans le secteur des services de télécommunications : les consommateurs interrogés se révèlent effectivement mal informés sur les prix et leur comportement apparaît plus rationnel (en termes de minimisation des coûts) lorsque les prix sont clairement communiqués. L’ensemble de ces résultats témoignent de la nécessité d’envisager les fondements d’une nouvelle forme de régulation sectorielle : celle de la complexité tarifaire. Des pistes sont proposées pour tenir compte à la fois de la complexité d’origine stratégique et de la complexité liée à l’innovation.
Role of Mouse and Human Autophagy Proteins in IFN-γ–Induced Cell-Autonomous Responses against Toxoplasma gondii
Authors: Ohshima Jun , Lee Youngae , Sasai Miwa , Saitoh Tatsuya , Su Ma Ji , Kamiyama Naganori , Matsuura Yoshiharu , Pann-Ghill Suh , Hayashi Mikako , Ebisu Shigeyuki , Takeda Kiyoshi , Akira Shizuo , Yamamoto Masahiro
Published: February 2014

IFN-γ mediates cellular innate immunity against an intracellular parasite, Toxoplasma gondii, by inducing immunity-related GTPases such as p47 IFN-γ–regulated GTPases (IRGs) and p65 guanylate-binding proteins (GBPs), which also participate in antibacterial responses via autophagy. An essential autophagy protein, Atg5, was previously shown to play a critical role in anti–T. gondii cell-autonomous immunity. However, the involvement of other autophagy proteins remains unknown. In this study, we show that essential autophagy proteins differentially participate in anti–T. gondii cellular immunity by recruiting IFN-γ–inducible GTPases. IFN-γ–induced suppression of T. gondii proliferation and recruitment of an IRG Irgb6 and GBPs are profoundly impaired in Atg7- or Atg16L1-deficient cells. In contrast, cells lacking other essential autophagy proteins, Atg9a and Atg14, are capable of mediating the anti–T. gondii response and recruiting Irgb6 and GBPs to the parasites. Although IFN-γ also stimulates anti–T. gondii cellular immunity in humans, whether this response requires GBPs and human autophagy proteins remains to be seen. To analyze the role of human ATG16L1 and GBPs in IFN-γ–mediated anti–T. gondii responses, human cells lacking ATG16L1 or GBPs were generated by the Cas9/CRISPR genome-editing technique. Although both ATG16L1 and GBPs are dispensable for IFN-γ–induced inhibition of T. gondii proliferation in the human cells, human ATG16L1 is also required for the recruitment of GBPs. Taken together, human ATG16L1 and mouse autophagy components Atg7 and Atg16L1, but not Atg9a and Atg14, participate in the IFN-γ–induced recruitment of the immunity-related GTPases to the intracellular pathogen.
Inhibitory Fcγ Receptor Is Required for the Maintenance of Tolerance through Distinct Mechanisms
Authors: Li Fubin , Smith Patrick , Ravetch Jeffrey V.
Published: February 2014

The inhibitory FcγR FcγRIIB is widely expressed on B cells, dendritic cells (DCs), and myeloid effector cells and modulates a variety of Ab-driven in vivo functions. Although it has been established that FcγRIIB plays an important role in the maintenance of peripheral tolerance, the responsible cell-specific FcγRIIB expression remains to be determined. In this study, we generated mice with selective deletion of FcγRIIB in B cells, DCs, and myeloid effector cells and evaluated these novel strains in models of tolerance and autoimmune diseases. Our results demonstrate that mice with selective deletion of FcγRIIB expression in B cells and DCs have increased Ab and T cell responses, respectively, and display enhanced susceptibility to disease in distinct models, suggesting that FcγRIIB expression in distinct cellular populations contributes to the maintenance of peripheral tolerance through different mechanisms.
Influenza Infection Suppresses NADPH Oxidase–Dependent Phagocytic Bacterial Clearance and Enhances Susceptibility to Secondary Methicillin-Resistant Staphylococcus aureus Infection
Authors: Sun Keer , Metzger Dennis W.
Published: February 2014

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a leading contributor to mortality during recent influenza pandemics. The mechanism for this influenza-induced susceptibility to secondary S. aureus infection is poorly understood. In this study, we show that innate antibacterial immunity was significantly suppressed during the recovery stage of influenza infection, even though MRSA superinfection had no significant effect on viral burdens. Compared with mice infected with bacteria alone, postinfluenza MRSA–infected mice exhibited impaired bacterial clearance, which was not due to defective phagocyte recruitment, but rather coincided with reduced intracellular reactive oxygen species levels in alveolar macrophages and neutrophils. NADPH oxidase is responsible for reactive oxygen species production during phagocytic bacterial killing, a process also known as oxidative burst. We found that gp91phox-containing NADPH oxidase activity in macrophages and neutrophils was essential for optimal bacterial clearance during respiratory MRSA infections. In contrast to wild-type animals, gp91phox−/− mice exhibited similar defects in MRSA clearance before and after influenza infection. Using gp91phox+/− mosaic mice, we further demonstrate that influenza infection inhibits a cell-intrinsic contribution of NADPH oxidase to phagocyte bactericidal activity. Taken together, our results establish that influenza infection suppresses NADPH oxidase–dependent bacterial clearance and leads to susceptibility to secondary MRSA infection.
Effect of type of secondary task on cued gait on people with idiopathic Parkinson′s disease
Authors: Chawla Harsha , Walia Shefali , Behari Madhuri , Noohu Majumi M.
Published: February 2014

Introduction: The purpose of this study was to find out the effect of the secondary cognitive and motor task on cued gait in people with Idiopathic Parkinson′s disease (PD). Design and Setting: A repeated measure same subject design carried out at All India Institute of Medical Sciences, Neurology Department, New Delhi. Materials and Methods: The subjects were made to walk in random order on a paper walkway under three conditions: Free walking with cues at preferred walking speed, coin transference while walking with cues at preferred walking speed and digit subtraction while walking with cues at preferred walking speed. Outcome: The stride length, cadence, walking speed and stops were recorded. Results: There was a significant reduction in their walking speed and stride length, but increase in the cadence and the number of stops was seen, when they had to perform dual tasks along with the cued gait, but the changes were more pronounced when secondary cognitive task was added to the cued gait in people with idiopathic PD. Conclusion: The results of this study demonstrated that there is a significant difference in the effect of secondary motor task when compared with secondary cognitive task on cued gait parameters in people with Idiopathic PD.
Perfil das patologias prevalentes na gestação de alto risco em uma maternidade escola de Maceió, Alagoas, Brasil
Authors: Santos Dialla Tâmara Alves dos , Campos Carla Santana Mariano , Duarte Maria Luisa
Published: February 2014

Objetivos: Descrever o perfil epidemiológico das patologias prevalentes na gestação de alto risco na Maternidade Escola Santa Mônica, município de Maceió, Alagoas. Métodos: Estudo epidemiológico, transversal e retrospectivo, realizado por meio da análise descritiva dos dados de prontuários de gestantes atendidas por ocasião do parto no período de janeiro de 2006 a novembro de 2010. Foram incluídos prontuários das gestantes de alto risco atendidas na maternidade no período estudado e excluídos da pesquisa os prontuários não preenchidos corretamente ou incompletos quanto às patologias prevalentes na gestação de alto risco. O cálculo amostral foi realizado a partir do teste de hipótese para uma proporção, segundo Lwanga e Lemeshow. A coleta de dados foi realizada por meio de preenchimento de formulário contendo informações dos prontuários, desenvolvido para esta pesquisa. As variáveis foram: patologias prevalentes na gestação de alto risco, idade materna, paridade, tipo de parto e tempo de gestação. Resultados: Foram analisados 316 prontuários. O trabalho de parto prematuro foi a patologia mais prevalente, representando 31,4% (98/312; IC95% 26,5 a 36,8) das patologias de alto risco. Em relação à idade materna, 72,7% (227/312; IC95% 67,5 a 77,4) das gestantes eram jovens (<30 anos). Quanto ao número de gestações, as multíparas corresponderam a 52,9% (165/312; IC95% 47,3 a 58,3). Considerando o tipo de parto, 59,0% (184/312; IC95% 53,4 a 64,3) foram cesáreos. Quanto ao tempo de gestação, 47,4% (148/312; IC95% 42,0 a 53,0) foram prematuros. Conclusões: O perfil epidemiológico encontrado foi o trabalho de parto prematuro em gestantes jovens e multíparas que evoluíram para um parto cesariano e pré-termo.
Prevalência e controle de hanseníase: pesquisa em uma ocupação urbana de São Luís, Maranhão, Brasil
Authors: Pacheco Marcos Antonio Barbosa , Aires Monica Lice Leite , Seixas Emanuelle Samary
Published: February 2014

Objetivo: Investigar a prevalência de incapacidades em pacientes com Hanseníase em três Unidades Básicas de Saúde (UBS) de São Luís no Maranhão e discutir preliminarmente possíveis modos de controle da doença. Métodos: Foi realizado estudo retrospectivo descritivo por meio dos prontuários de todos os pacientes hansenianos (n=57) cadastrados nas UBS, no período correspondente aos anos de 2008 a 2009. As variáveis coletadas foram: idade, sexo, aspectos e situação clínica dos pacientes (GIF- Grau de incapacidade física, classificação operacional e forma clínica). Resultados: Foram encontrados 57 prontuários de pacientes hansenianos, dos quais 24 continham alguma alteração quanto ao grau de incapacidade dos pacientes. Entre aqueles que tinham algum grau de incapacidade física, 8 (33,3%) encontravam-se entre 21 e 30 anos, 2 (8,3%) tinham menos de 10 anos, 1 paciente (4,1%) tinha mais de 60 anos. Com relação ao sexo, 15 eram homens (62,5%) e 9 eram mulheres (37,5%). Quanto à classificação operacional da doença, três casos eram paucibacilares e 21 multibacilares. Dos 57 casos estudados, 33 usuários apresentaram GIF 0; 17 pacientes, GIF I; e 7 pacientes, GIF II. A prevalência de incapacidades físicas em pacientes com hanseníase neste estudo foi de 42,1%, correspondendo a 24 pacientes. Conclusão: O percentual de 12,28% para GIF II sugere que são necessárias medidas de tratamento e reabilitação com uma abordagem mais específica e foco nos serviços de atenção primária, para se evitar o agravamento da enfermidade e permitir o controle das incapacidades.
Revisão de prontuário como estratégia de ensino-aprendizagem da medicina centrada na pessoa em um ambulatório universitário no município do Rio de Janeiro
Authors: Chazan Ana Cláudia Santos , Silveira Lia Márcia Cruz da , Favoreto Cesar Augusto Orazem
Published: February 2014

O objetivo do presente estudo é relatar a experiência do uso de um roteiro elaborado para orientar a revisão de prontuários em um ambulatório de um hospital universitário no município do Rio de Janeiro. O roteiro constava de questões fechadas e abertas abordando os seguintes itens: identificação do paciente, motivo e data da primeira consulta, informações subjetivas, informações objetivas, avaliação das necessidades de saúde do paciente, do plano terapêutico, dos registros, da longitudinalidade do cuidado e conclusões (resumo diagnóstico e terapêutico, proposições para a melhoria dos cuidados e necessidades de aprendizagem). Um prontuário foi escolhido aleatoriamente, copiado e distribuído a seis preceptores voluntários, juntamente com o roteiro. Percebeu-se que, na análise do prontuário, informações importantes de identificação dos usuários e da anamnese estavam ausentes ou desatualizadas. Observou-se concordância em 60% das respostas às perguntas fechadas. A heterogeneidade foi maior para perguntas abertas referentes à compreensão sobre risco, proteção, vulnerabilidade e necessidades não percebidas pelo usuário. Todos os preceptores consideraram o prontuário incompleto e observaram que os registros, centrados na doença, não eram assinados pelo preceptor. Além disso, foram identificados, como necessidades de aprendizagem, o conhecimento biomédico atualizado sobre as doenças de base do paciente e as habilidades sobre abordagem centrada na pessoa. A revisão do prontuário orientada pelo roteiro permitiu aos preceptores perceberem a necessidade de lerem os registros feitos pelos internos nos prontuários após a discussão dos casos, apontou temas para a educação permanente e os levou a refletir sobre o seu papel na formação profissional dos internos do curso de medicina.
O papel do profissional da Atenção Primária à Saúde em cuidados paliativos
Authors: Silva Mariana Lobato dos Santos Ribeiro
Published: February 2014

Introdução: O cuidado a pacientes em fase final da vida é cada vez mais frequente nos serviços de saúde devido ao progressivo envelhecimento da população e o consequente aumento de pacientes com doenças graves. No Brasil, os poucos serviços de cuidados paliativos geralmente estão ligados a hospitais especializados, mas, em vários países, a Atenção Primária à Saúde (APS) é considerada o melhor nível de assistência para a prestação e coordenação dos cuidados paliativos de seus usuários. Métodos: Neste estudo realizou-se uma revisão integrativa de literatura, objetivando compreender quais os papéis dos profissionais da APS em cuidados paliativos. Resultados: Os textos selecionados foram submetidos à análise temática, emergindo oito categorias que descrevem o papel dos profissionais de APS em cuidados paliativos e evidenciam que sua participação é essencial: 1) Possibilitar o cuidado domiciliar; 2) Garantir assistência com integralidade; 3) Utilizar a longitudinalidade como ferramenta de cuidado; 4) Responsabilizar-se pelo cuidado paliativo com a família; 5) Buscar aprimoramento profissional em cuidados paliativos; 6) Viabilizar a coordenação do cuidado; 7) Facilitar o acesso do paciente a cuidados paliativos e sua família; 8) Trabalhar em parcerias dentro e fora da APS. Conclusão: O acesso facilitado a cuidados paliativos, próximo ao lar, associado ao manejo constante dos sintomas e à sensibilidade para com a realidade das famílias, faz toda a diferença para os pacientes em fase final da vida.
Acne vulgar: diagnóstico e manejo pelo médico de família e comunidade
Authors: Silva Ana Margarida Ferreira da , Costa Francisco Pinto da , Moreira Margarida
Published: February 2014

A acne vulgar é a doença cutânea mais frequente, afetando 85 a 100% da população em algum momento da vida; constituindo, por isso, um motivo frequente de consulta na atenção primária à saúde. Geralmente, tem início na puberdade, situando-se o pico de incidência entre os 14 e 17 anos nas adolescentes, e entre os 16 e 19 anos nos rapazes, sendo mais grave e prevalente no sexo masculino. Apesar de extensamente debatida, a acne vulgar requer uma atualização constante. Foi feita uma revisão das diretrizes clínicas, meta-análises e revisões sistemáticas publicadas nos últimos 15 anos, relacionadas à acne vulgar e seu tratamento. Esta patologia é normalmente dividida em três tipos clínicos: comedônica, pápulo-pustulosa e nódulo-cística. O diagnóstico é clínico, contudo outros diagnósticos diferenciais devem ser considerados. Das várias opções terapêuticas farmacológicas disponíveis, destacam-se os retinoides, os antimicrobianos e a terapêutica hormonal, cuja utilização deve ser ponderada, tendo-se em conta as suas indicações – tipo de acne e sua gravidade – e os seus efeitos colaterais. Assim, o médico de família e comunidade desempenha um papel de primeira linha na abordagem da acne vulgar, desde o diagnóstico à gestão das opções terapêuticas.
The UK Foundation Programme for newly qualified doctors: a SWOT analysis
Authors: Lawrence David Stephen , Williams Christopher Gareth
Published: February 2014

Introduction: After completing a five year undergraduate degree, all newly qualified doctors in the United Kingdom undertake a two-year Foundation Programme which aims to provide them with the necessary experience, supervision and guidance to prepare them for a career in clinical medicine. Foundation Doctors are paid members of the team and undertake a variety of clinical rotations with supervision from senior colleagues, a process that is regulated by a UK Foundation Programme Office. Objective: This paper aims to provide a reflective analysis of this programme to greater inform the international audience. Methods: A critical reflective analysis utilising the SWOT format (Strength, Weaknesses, Opportunities and Threats), conducted by two Foundation Doctors working in the UK. Results and Discussion: We identified a well-established programme which enabled graduates to gain a broad range of clinical experience as a paid doctor but one with considerable variation at both individual and group level. Long-standing shortcomings of being a junior-doctor including long hours and excessive paperwork were still prevalent. We highlighted potential opportunities and threats within the current system, some of which were dependent upon larger political systems governing the NHS in the UK. Conclusion: The Foundation Programme is a robust approach to the training and development of early career doctors. Further research and a deeper international dialogue on the best-practice in this field is needed.
The seasonal variation of the CO2 flux over Tropical Asia estimated from GOSAT, CONTRAIL, and IASI
Authors: Basu S. , Krol M. , Butz A. , Clerbaux C. , Sawa Y. , Machida T. , Matsueda H. , Frankenberg C. , Hasekamp O. P. , Aben I.
Published: February 2014

We estimate the CO2 flux over Tropical Asia in 2009, 2010, and 2011 using Greenhouse Gases Observing Satellite (GOSAT) total column CO2(XCO2) and in situ measurements of CO2. Compared to flux estimates from assimilating surface measurements of CO2, GOSAT XCO2 estimates a more dynamic seasonal cycle and a large source in March–May 2010. The more dynamic seasonal cycle is consistent with earlier work by Patra et al. (2011), and the enhanced 2010 source is supported by independent upper air CO2 measurements from the Comprehensive Observation Network for Trace gases by Airliner (CONTRAIL) project. Using Infrared Atmospheric Sounding Interferometer (IASI) measurements of total column CO (XCO), we show that biomass burning CO2 can explain neither the dynamic seasonal cycle nor the 2010 source. We conclude that both features must come from the terrestrial biosphere. In particular, the 2010 source points to biosphere response to above‐average temperatures that year.
A climatology of medium‐scale gravity wave activity in the midlatitude/low‐latitude daytime upper thermosphere as observed by CHAMP
Authors: Park J. , Lühr H. , Lee C. , Kim Y. H. , Jee G. , Kim J.‐H.
Published: February 2014

We report on a detailed global climatology of medium‐scale (150–600 km) thermospheric gravity wave (GW) activity using mass density observations onboard the CHAMP satellite from 2001 to 2010. Our study focuses mainly on daytime (09–18 h in local time) and midlatitude/low‐latitude upper thermosphere between 300 km and 400 km altitudes. Midlatitude GW activity is strongest in the winter hemisphere. GW activity during June solstice adjacent to the Andes and Antarctic Peninsula is stronger than in any other season or location. GW activity in the low‐latitude summer hemisphere is stronger above continents than above oceans: especially during December solstice and equinoxes. In terms of relative density variation, GW activity is stronger during solar minimum than solar maximum. These results agree well with the characteristics of stratospheric GWs, implying that the CHAMP GWs are mainly caused by GWs from tropospheric/stratospheric processes. Using mesosphere/lower thermosphere wind observations at a Korean Antarctic station, we investigated at which altitudes the upper thermospheric GW climatology becomes visible. While the correlation is insignificant at z=82–88 km, it becomes significant for most cases at z=90–98 km, suggesting that the upper thermospheric GW climatology may start to emerge at z≥90 km.
Dynamic streambed fluxes during rainfall‐runoff events
Authors: Karan Sachin , Engesgaard Peter , Rasmussen Jørn
Published: February 2014

Observed 3‐D temperature distributions within a streambed were used to analyze the effects on exchange fluxes between groundwater and the stream during rainfall‐runoff events. By combining a dense vertical and lateral monitoring network of streambed temperatures with coupled surface/subsurface 3‐D flow and heat transport modeling, we demonstrate how temperature can be used directly as a calibration target. Three model setups with different hydraulic conductivity distributions were evaluated in an optimization approach using temperature and hydraulic head data. The hydraulic conductivity distributions were based on slug test surveys within the streambed and aquifer. A detailed characterization of the hydraulic conductivity of the streambed and aquifer is needed to accurately simulate observed temperatures. Hence, the most sensitive parameters, the vertical hydraulic conductivity and the thermal conductivity, were calibrated within different conductivity zones of the heterogeneous model. Simulated exchange fluxes across the streambed showed variations up to a factor of four within just a meter. Such differences may not have been correctly predicted using 1‐D heat transport models due to lateral conduction amongst the different flow paths. During the rainfall‐runoff event, fluxes decreased substantially (−50%) due to a decrease in the hydraulic gradient with increased stream stage. Although no flow reversals were observed during the studied conditions, it is possible that these can occur during larger rainfall‐runoff events. We show that with the current sampling and modeling techniques, 3‐D temperature data can be used to estimate dynamic exchange in heterogeneous flow fields encountered in the field.
Accurate vertical profiles of turbulent flow in z‐layer models
Authors: Platzek F. W. , Stelling G. S. , Jankowski J. A. , Pietrzak J. D.
Published: February 2014

Three‐dimensional hydrodynamic z‐layer models, which are used for simulating the flow in rivers, estuaries, and oceans, suffer from an inaccurate and often discontinuous bottom shear stress representation, due to the staircase bottom. We analyze the governing equations and clearly show the cause of the inaccuracies. Based on the analysis, we present a new method that significantly reduces the errors and the grid dependency of the results. The method consists of a near‐bed layer‐remapping and a modified near‐bed discretization of the k − ε turbulence model. We demonstrate the applicability of the approach for uniform channel flow, using a schematized two‐dimensional vertical model and for the flow over a bottom sill using the Delft3D modeling system.
Health and Culture
Authors: Quah Stella R.
Published: February 2014

practically all social science research on health and illness in the twenty‐first century acknowledges the influence of culture on health‐related behavior and attitudes. We have advanced from the early assumption that culture was one of several predictors of health behavior. Today we know that culture is not just one of many factors associated with health, but is the context within which health‐related behavior unfolds. This entry discusses in three sections why culture is significant in health‐related behavior: the definition of culture, the link between culture and health behavior, and the link between culture and healing systems.
Professions, Organized
Authors: Martin Graham P.
Published: February 2014

Traditional conceptualizations of “profession” have emphasized, among other things, their autonomy and independence from organizational bureaucracies as one of the defining features of professions. However, empirical study has emphasized the variety of ways in which professions coexist with wider organizational structures, sometimes in conflict, and sometimes in reconciliation. Beyond the “professional bureaucracy,” recent developments in the health care context have given rise to novel ways in which professions and organizations interact, some of which are considered in this entry.
Health Care Delivery System: Mexico
Authors: Castro Roberto
Published: February 2014

Mexico's health care delivery system is described, beginning with a brief historical account of its foundation in 1943 and its evolution since then to date. Two major sectors compose this system: the public sector and the private sector. Institutions from the public sector are described, the main ones being the Mexican Social Security Institute, the Institute of Security and Social Services for State Workers, and the Popular Health Insurance. The private sector is composed of private entrepreneurs and private health insurance companies. A description is given of the funding, benefits, expenditure, population coverage, and infrastructure of the public sector. Some of the main achievements of Mexico's health care delivery system are described, as well as some of its main unsolved problems and contradictions. For instance, a large sector of the Mexican population remains completely unprotected by any kind of public cover, whereas other sectors enjoy more than one type. Moreover, according to some critics, the Popular Health Insurance is largely demagogic.
Voluntary Care
Authors: Power Andrew
Published: February 2014

This entry examines the various meanings given to voluntary care. It traces how these meanings have evolved, including assumptions of community altruism, women's duty of care, and durable charitable efforts to provide support. It critically appraises these assumptions and unpicks the complex relationships involved. It considers how the meaning of voluntary care is also shaped by the portrayal of the person for whom voluntary care is provided. Central to these debates is the issue of proximity – a key theme in understanding the multifaceted dynamics in the provision of voluntary care.
Family Caregivers: Dementia
Authors: Weng Suzie S. , Nguyen Peter V.
Published: February 2014

Family members play an important role in the lives of those who experience dementia. Culture is an important factor in the discussions of family dementia caregiving in Asian American families. Unfortunately, little attention has been placed on understating dementia among Asian Americans partly due to the fact that dementia is still hidden in many communities. The purpose of this paper is to explore the issues related to dementia care in the Asian American community.
Race, Ethnicity, Culture, and Health in the United States
Authors: Egede Leonard E. , Hernandez‐Tejada Melba A. , Strom Joni L.
Published: February 2014

Health outcomes in the United States are influenced by multifactorial components. The impact of factors such as race, racism, ethnicity, and culture has been debated throughout history as possible contributors to health outcomes within specific communities. In concordance with this ongoing discussion, these concepts remain urgent and frequently revisited topics among organizations created to serve the general population; however, evidence is still lacking in support of these factors as direct contributors to poor health. In some instances, race, aspects of culture, and ethnicity continue to drive and direct care, treatment, costs, and health care decision‐making. Perceptions of these concepts solely or collectively continue to create and foster health inequities and disparities within different population groups in the United States. Until America is able to acknowledge, understand, and correct the inequalities that persist racially, culturally, and socially, the divide between care provided to minorities and to whites will continue to persist.
Mental Illness and Labeling Theory
Authors: Markowitz Fred E.
Published: February 2014

The stigma associated with mental illness results in discrimination, loss of socioeconomic status, lowered sense of self‐worth, and increased symptoms. Labeling theory is an explanatory framework that accounts for these effects. In light of developments in the understanding of the causes and treatment of mental illness, the theory has undergone modification from its original version to show how internalized stigma affects well‐being. Recent research integrates modified labeling theory with the reflected appraisals process of identity formation to understand how attitudes toward mental illness affect recovery through their effects on the self‐concept.
Health, Women's
Authors: Shinberg Diane S.
Published: February 2014

Women's health comprises more than popular, everyday notions of beauty, sex appeal, fitness, fashion, and dieting as practiced by women. In a biomedical framework women's health is centered first on reproductive organ systems and secondarily on those diseases that affect disproportionately more women than men. Within a biopsychosocial perspective, women's health addresses physical, emotional, and social dimensions of health and well‐being. Sociological definitions of women's health address health topics that frame gender as a social institution, including gendered patterns within medicine, medical training, doctor–patient interactions, self‐care, prevention, illness behavior, health care utilization, and health‐related politics.