bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive prediction method of road friction for vehicle dynamics control
Authors: Li L , Song J , Li H-Z , Shan D-S , Kong L , Yang C C
Published: June 2009

The contact friction characteristic between a tyre and the road is a key factor that dominates the dynamics performance of a vehicle under critical conditions. Vehicle dynamics control systems, such as anti-lock braking systems, traction control systems, and electronic stability control systems (e.g. Elektronisches Stabilitäts Programm (ESP)), need an accurate road friction coefficient to adjust the control mode. No time delay in the estimation of road friction should be allowed, thereby avoiding the disappearance of the optimal control point. A comprehensive method to predict the road friction is suggested on the basis of the sensor fusion method, which is suitable for variations in the vehicle dynamics characteristics and the control modes. The multi-sensor signal fusion method is used to predict the road friction coefficient for a steering manoeuvre without braking; if active braking is involved, simplified models of the braking pressure and tyre force are adopted to predict the road friction coefficient and, when high-intensity braking is being considered, the neural network based on the optimal distribution method of the decay power is applied to predict the road friction coefficient. The method is validated through a ground test under complicated manoeuvre conditions. It was verified that the comprehensive method predicts the road friction coefficient promptly and accurately.
Thermal—mechanical coupled simulation of a solid brake disc in repeated braking cycles
Authors: Hwang P , Wu X , Jeon Y B
Published: June 2009

Braking operation is a process that converts kinetic energy and potential energy of a moving automobile into other energies. Most of the mechanical energy is transferred into heat. Frictional heat, which is generated on the interface of the disc and pads, can cause high temperature during the braking process. The objective of the present work is to determine temperature distribution, thermal distortion, and thermal stress in a solid disc by three-dimensional modelling for repeated braking. Braking is applied four times in the present study; the vehicle is decelerated from 100 to 50 kph with 0.6 g, after which the velocity is again accelerated to 100 kph. In order to simulate the friction heat behaviour accurately in repeated braking, the moving heat source, which is defined by time and space variable, is applied on the frictional surface. The temperature field and thermal stress in the disc present a non-uniformity characteristic because of the moving heat source. Temperature and thermal stress of the point on the frictional surface of the brake disc present fluctuation in the braking operation. The coning angle due to the non-uniform radial temperature distribution varies with temperature. Thermal fatigue is also discussed in this article.
Thermomechanical properties and tribological behaviour of CaCO3 whisker-reinforced polyetheretherketone composites
Authors: Lin Y-X , Gao C , Chen M
Published: June 2009

The thermal expansion properties, dynamic mechanical properties, and related tribological properties of polyetheretherketone (PEEK) composites filled with 0–25 wt.% content of calcium carbonate (CaCO3) whisker were investigated. The composite specimens were prepared by compression moulding. Thermomechanical analysis (TMA) was performed to determine linear coefficients of thermal expansion (CTE). Dynamic mechanical thermo-analysis (DMTA) was employed within the temperature range of 25–300 °C. Tribological testing of composites in dry wear mode against a carbon steel ring was carried out on a MM200 block-on-ring apparatus. All specimens show a large change in CTE at glass transition temperature ( Tg), but CTEs of CaCO3/PEEK composites at temperatures below and above Tg are much lower than pure PEEK. For 25 per cent CaCO3/PEEK the average CTE in the temperature range of 25–120 °C is about half lower than PEEK. CaCO3 whisker shows a significant effect on the dynamic stiffness at low and high temperatures. The increase of whisker content contributes to a rise to the storage modulus. CaCO3-whisker-filled PEEK composites exhibit considerably lower friction coefficient and wear rate than pure PEEK. With an increase in CaCO3 whisker contents, coefficient of friction of PEEK composites continuously decreases, while the specific wear rate shows minima for 15 per cent CaCO3 whisker inclusion with an approximate seven times improvement in comparison with PEEK. The improved tribological performance of CaCO3/PEEK composites is ascribable to the reinforcing effectiveness of CaCO3 whisker, which contributes to increase the thermal stability, stiffness, and load-carrying capacity of PEEK composites in terms of counteracting the effects of thermal softening and adhesion during the friction process.
Experimental study of tilting pad journal bearing—rotor system with acoustic emission technique
Authors: Zhang G-H , Liu Z-S , Wang X-W , Xu H-J
Published: June 2009

The performance characteristics including pressure distribution and vibration of four tilting pads bearing—rotor system were experimentally studied. The acoustic emission (AE) technology was used to investigate the impact between the pad and the shaft while the shaft is rotating. The pressure distributions indicated the film shape of different pads. The major finding was to know how the tilting pad bearing—rotor system worked with impact phenomenon and to propose a method for identifying the occurrence and position of the impact by employing the AE technique.
Effect of Support on the Suppression of Hot Spot Formation in the Partial Oxidation of Methane
Authors: Shishido Tetsuya , Morishima Reina , Yoshinaga Yusuke , Hasegawa Sadao , Tanaka Tsunehiro
Published: June 2009

Ni-based catalysts supported on perovskite oxides and α-Al2O3 were prepared to investigate catalytic performance and catalyst bed temperature profile in the partial oxidation of methane. Ni/LaAlO3 showed high activity and remarkably suppressed hot spot formation in the catalyst bed even at high space velocity. The effect of support is discussed on the basis of the state of Ni.
The incidence of selected congenital malformations during a two-year period in Tehran, Iran
Authors: Delshad Salaheddin , Tabar Ahmad Khalegnejad , Samae Hadi , Mollaean Mansour , Nasiri Seyyed Javad , Jazayeri Seyyed Mohammad , Moharamzad Yashar , Amini Arash
Published: June 2009

In this descriptive cross-sectional study carried out from March 2005 to March 2007, 410 congenital malformations were recorded among 61,112 live births in six general hospitals in different districts of Tehran. The overall incidence was 0.6% (0.69% in males and 0.62% in females) and the most affected system was the digestive system (40%), followed by the musculoskeletal system (20.5%), central nervous system (19.5%), genitourinary system (12.2%) and cardiovascular system (3%). It is essential that government organizations educate the population through scheduled preconceptional primary care visits on interventions like diet supplementation and avoidance of teratogenic agents, in order to decrease the rate of congenital malformations.
Pulmonary nocardiosis from a tertiary care hospital in Southern India
Authors: Chawla Kiran , Mukhopadhyay Chiranjay , Payyanur Prakash , Bairy Indira
Published: June 2009

The present study highlights eight cases of pulmonary nocardiosis diagnosed during the time period of January 2006–March 2008. Nocardia otitidiscaviarum, N. asteroides and N. brasiliensis were isolated from these cases. Whereas six patients were treated successfully, one showed partial response and one case expired before the institution of treatment. Early and correct microbiological diagnosis can help to decrease the disease-related morbidity and mortality.
Serological immunity to diphtheria and tetanus in healthy adults in Delhi, India
Authors: Saxena Sonal , Jais Manoj , Dutta Renu , Dutta A K
Published: June 2009

Widespread childhood immunization with DPT (diphtheria, pertussis and tetanus) has largely eradicated diphtheria and tetanus from many countries. The reduction in the circulation of toxigenic strains has resulted in less natural boosting of adult immunity. As a result, the adult population in countries with high childhood immunization coverage have become susceptible to the disease. The duration of immunity after primary immunization to diphtheria and tetanus is limited and a reduction in immunity is common in adults.  With this perspective, the present study was carried out on a random serum sample of 255 healthy individuals aged 20-50 years.  The serum samples were tested for immunoglobulin G levels against diphtheria and tetanus by enzyme immuno assays. Fifty-three per cent of adults were unprotected; 22 % were seen to have only a basic protection against diphtheria; 25% were protected against both diseases; and 47% were susceptible to tetanus. The susceptibility was seen to increase with age.  To avoid epidemics in the future, immunity must be improved. It is important to treat even the most trivial wound with care and tetanus toxoid immunization. Also, it is necessary to monitor the community for immunity to diphtheria using standard techniques in order to undertake epidemiological surveillances of, and prevention from, these dreadful diseases.
Stroke at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria
Authors: Onwuchewa Arthur , BellGam Hope , Asekomeh God'spower
Published: June 2009

The case records of 202 consecutive adult Nigerian in-patients with stroke at the University of Port Harcourt Teaching Hospital (UPTH) were retrospectively reviewed. The mean age at presentation was 62.62 ± 14.2 years. The male to female ratio was 1:1.2. The commonest risk factors were hypertension, diabetes mellitus, hypercholesterolaemia, older age and a previous history of stroke. Clinically, 67.3% had cerebral infarction (CI), while 27.7% had intracerebral haemorrhage (ICH). The peak age of events for both sub-types was the 7th decade. The case fatality was 55.4% for ICH and 23.5% for CI. Thus, stroke is associated with high mortality at the UPTH. Improved emergency care of stroke patients is needed while the setting up of dedicated stroke centres is advocated. A community-based study is necessary to provide more insight into the problem and also highlight the basis for appropriate intervention and policy.
Clinical neuropathy in HIV/AIDS: an eight-year review of hospitalized patients in Sokoto, northwestern Nigeria
Authors: Isezuo S A , Sani A Z , Ezunu E , Maiyaki S , Njoku C H , Obembe A
Published: June 2009

HIV/AIDS is a multi-systemic disease that targets mainly the immune and nervous systems. Although about 4.4% of Nigerians are infected with HIV, data on the spectrum of HIV-related nervous disease in this population is rare. This study describes the neurological manifestations of HIV/AIDS in northern Nigeria. We undertook retrospective and descriptive analyses of the demographic, clinical, neurologic and laboratory data of all hospitalized HIV/AIDS adults in a referral hospital in northwestern Nigeria. The study period covered 2000 to 2007. We studied 322 HIV/AIDS patients (218 men, 104 women) aged 33.4 ± 11.4 years (range: 18–65 years) who constituted 3.5% of the total medical admissions. HIV transmission was exclusively by heterosexual intercourse involving multiple partners. The majority (70.2%) was married and 78.9% were in stage III/IV HIV/AIDS disease. Fifty-two (16.2%) had CD4+ T-cell count determination, the mean value being 220 ± 147.2 cells/m3, and 58 (18.0%) were on highly active antiretroviral therapy. Fifty-one (15.8%) had neurological complications dominated by central nervous diseases including encephalitis (17.6%), dementia (16.2%) and stroke (14.9%). Peripheral nerve involvements were relatively infrequent. Compared with HIV/AIDS patients without neurological complications, a significantly higher proportion of those with HIV-associated neuropathy had a stage IV disease (30% versus 9.4%, χ2 = 19.5, P < 0.001). Neurological complications, particularly central nervous diseases, are an important cause of morbidity in the HIV/AIDS population.
Prevalence of transfusion transmitted infections in blood donors: an Indian experience
Authors: Chandra Tulika , Kumar Ashutosh , Gupta Ashish
Published: June 2009

A retrospective study was done on blood units collected from replacement and voluntary donors from 2001 to 2007. Seropositivity of transfusion transmitted disease in replacement donors was 1.96% in hepatitis B surface antigen, 0.85% in hepatitis C virus, 0.23% in HIV and 0.01% in syphilis. Voluntary donors had an almost negligible infectivity rate.
Incidence and outcome of peripartum cardiomyopathy from a tertiary hospital in South India
Authors: Pandit Vinay , Shetty Sirish , Kumar Ashwini , Sagir Afrin
Published: June 2009

There is very little literature regarding peripartum cardiomyopathy (PCM) from Asian countries. A study of PCM was conducted at Kasturba Medical College Hospital, Manipal, with special reference to incidence and outcome. The incidence of PCM was 1 case per 1374 live births. Major risk factors for the development of PCM were multiparity and advanced maternal age. Echocardiography is useful in early diagnosis and for follow-up assessment of left ventricular function. Most of the patients noticed good symptomatic improvement at time of discharge and during the follow-up with standard therapy. Clinical improvement was well correlated with improvement of LV function by echocardiography. Significant thrombotic complications were noticed. None of the patients died during the study and follow-up period.
Tuberculosis in systemic lupus erythematosus in Chinese patients
Authors: Wang Jing , Pan Hai-Feng , Su Hong , Li Xiang-Pei , Xu Jian-Hua , Ye Dong-Qing
Published: June 2009

This study investigates the prevalence and clinical and laboratory features of patients with systemic lupus erythematosus (SLE) associated with TB in Chinese patients, as well as its similarities to and differences from patients without TB. Our results show that SLE patients with TB (SLE-TB) might be a subgroup of patients with distinct clinical and laboratory features. Therefore, specific treatment should be given in order to provide a better outcome for SLE-TB patients.
Scurvy-a forgotten disease with an unusual presentation
Authors: Kumar Vishal , Choudhury Panna
Published: June 2009

We report an unusual case of scurvy where a six-year-old female presented with clinical and radiological features suggestive of juvenile idiopathic arthritis. However, follow-up radiological examination, carried out in view of refractory arthritis, was diagnostic for scurvy and the patient later responded well only with vitamin C therapy.
Outcomes of Perioperative β-Blockade in Patients Undergoing Noncardiac Surgery: A Meta-Analysis
Authors: Talati Ripple , Reinhart Kurt M , White C Michael , Phung Olivia J , Sedrakyan Art , Kluger Jeffrey , Coleman Craig I
Published: June 2009

Background:

Several studies have evaluated the impact on myocardial infarction (MI), stroke, and overall mortality of perioperative β-blocker use in patients undergoing noncardiac surgery (NCS). However, most studies did not have adequate sample size and statistical power and were therefore underpowered to adequately evaluate these end points.

Objective:

To conduct a meta-analysis to determine the balance of benefits and harms associated with perioperative β-blocker use in NCS.

Methods:

A systematic literature search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials was conducted from January 1960 through February 2009. Manual reference search was performed to identify additional relevant trials. Randomized, double-blinded, placebo-controlled trials comparing the use of β-blockars with placebo; using β-blockers perioperatively in β-blocker–naïve patients undergoing NCS; and evaluating endpoints of Ml, stroke, or all-cause mortality were included.

Results:

Six trials (N = 10,183) met our inclusion criteria. Perioperative β-blocker use was associated with a significant reduction in patients' odds of developing Ml (OR 0.74, 95% CI 0.61 to 0.89) but a significant increase in odds of developing stroke (OR 1.98, 95% CI 1.23 to 3.20) and also a nonsignificant increase in mortality (OR 1.21, 95% CI 0.98 to 1.49) versus placebo. Control-rate meta-regression determined that patients with highest baseline odds of stroke had decreased relative odds of having a stroke with a β-blocker versus placebo (β coefficient –0.97; 95% credible interval –1.04 to –0.90).

Conclusions:

When perioperative β-blockers are used in NCS patients, there is a trade-off between reduction in MI and increase in stroke, with a troubling trend toward an increase in mortality. Patients with lower baseline odds of developing stroke appear to be at greater risk of β-blockgr–induced stroke.
Delirium in a Patient with Toxic Flecainide Plasma Concentrations: The Role of a Pharmacokinetic Drug Interaction with Paroxetine
Authors: Tsao Yvonne Y , Gugger James J
Published: June 2009

Objective:

To describe a case of flecainide-induced delirium associated with a pharmacokinetic drug interaction with paroxetine.

Case Summary:

A 69-year-old white female presented to the emergency department with a history of confusion and paranoia over the past several days. On admission the patient was taking carvedilol 12 mg twice daily, warfarin 2 mg/day, folic acid 1 mg/day, levothyroxine 100 μg/day, pantoprazole 40 mg/day, paroxetine 40 mg/day, and flecainide 100 mg twice daily. Flecainide had been started 2 weeks prior for atrial fibrillation. Laboratory test findings on admission were notable only for a flecainide plasma concentration of 1360 μg/L (reference range 200–1000). A metabolic drug interaction between flecainide and paroxetine, which the patient had been taking for more than 5 years, was considered. Paroxetine was discontinued and the dose of flecainide was reduced to 50 mg twice daily. Her delirium resolved 3 days later.

Discussion:

Flecainide and pharmacologically similar agents that interact with sodium channels may cause delirium in susceptible patients. A MEDLINE search (1966–January 2009) revealed one in vivo pharmacokinetic study on the interaction between flecainide, a CYP2D6 substrate, and paroxetine, a CYP2D6 inhibitor, as well as 3 case reports of flecainide-induced delirium. According to the Naranjo probability scale, flecainide was the probable cause of the patient's delirium; the Horn Drug Interaction Probability Scale indicates a possible pharmacokinetic drug interaction between flecainide and paroxetine.

Conclusions:

Supratherapeutic flecainide plasma concentrations may cause delirium. Because toxicity may occur when flecainide is prescribed with paroxetine and other potent CYP2D6 inhibitors, flecainide plasma concentrations should be monitored closely with commencement of CYP2D6 inhibitors.
An integrative model of safety climate: Linking psychological climate and work attitudes to individual safety outcomes using meta‐analysis
Authors: Clarke Sharon
Published: June 2009

Meta‐analytic path analysis was utilised to test an integrative model linking perceived safety climate to hypothesized organisational antecedents and individual outcomes. Psychological climate, especially the perception of organisational attributes, was found to be significantly associated with safety climate (both constructs measured at the individual level). A partial mediation model was supported. Within this model, the relationship between safety climate and safety behaviour was partially mediated by work‐related attitudes (organisational commitment and job satisfaction), and the relationship between safety climate and occupational accidents was partially mediated by both safety behaviour and general health. Safety climate acted as a partial mediator in the relationship between psychological climate and safety behaviour, with direct effects from climate perceptions relating to the leader and organisational processes. Avenues for further research and practical implications are discussed.
An “Epeleptick” Bondswoman: Fits, Slavery, and Power in the Antebellum South
Authors: Boster Dea H.
Published: June 2009

Epilepsy, as nineteenth-century observers understood the disease construct, was a feared diagnosis associated with insanity and uncontrollability. Cases of epileptic fits in slaves—whether they were considered genuine or feigned— highlighted deep struggles among white masters, physicians, and slaves themselves over the control of African American bodies. Some slaves who experienced fits were subjected to prolonged experimental treatments at the hands of physicians and white masters. Although Southern medical sources largely ignored the connection between epilepsy and trauma in slaves, abolitionists and ex-slave narratives published in the North used epilepsy as a representation of the institution’s cruelty. Some white observers thought that slaves with epilepsy were prone to malingering; epileptic fits were also a tool of slave resistance and had a significant role in slave sale negotiations. I use the case study of a fifteen-year-old bondswoman in Virginia, diagnosed with epilepsy in 1843, to illustrate the significance of the disease in the lives of African American slaves.
Thaumatology at One Remove: Empathy in Miraculous-Cure Narratives in the Later Middle Ages
Authors: Cohen Esther
Published: June 2009

The article deals with records of thaumaturgic cures, especially a series of miracle cures taking place within an enclosed community of Colettine nuns in fifteenth-century Ghent. These miracles, all performed by the local founder and saint, Colette Boëllet, consisted in curing several nuns from acute and chronic illnesses. The pain of these illnesses is described in a superlatively extravagant mode, and the record, made by an external notary, is evidence of a “competition in suffering” among the nuns, with harmony restored through the common written testimony.
Eyewitness vs. Mediated Narratives of Lost Cities at the End of the Middle Ages: Acre, Constantinople, Granada
Authors: Aslanov Cyril
Published: June 2009

The end of the Middle Ages is characterized by significant changes in Mediterranean geopolitics: in Eastern Mediterranean, the Christian powers were driven out by the progression of the Mameluks and the Ottoman Turks. In the Western Mediterranean, however, the Christian powers of the Iberian Peninsula completed the Reconquista. The fall of Acre in 1291, the conquest of Constantinople in 1453, and the capture of Granada in 1492 inspired a whole range of narratives from eyewitness reports to indirect and sometimes exagerated accounts. I would like to investigate the process of amplification that provoked the crystallization of some stereotypes related to the lost of the aforementioned cities: the massive massacre of the Christians in Acre reported in the anonymous Chronicle of the Templar of Tyre , the legend of the miraculous transformation of the last Byzantine emperor Constantine XI Paleologos into marble transmitted by Greek folklore, the story of Boabdil gazing for the last time at the Alhambra from a rocky eminence south of Granada. These stories show an interesting interplay between eyewitnesses, amplification nurtured by a high dose of nostalgia, and reminiscences of older narratives related to the topos of the capture of such antique cities as Troy or Carthago. My approach will analyze the process by virtue of which the intertextual processes obliterated the taste of authenticity contained in the genuine eyewitness report.
Neither (4k 2 + 1) nor (2k(k – 1) + 1) is a Perfect Square
Authors: Fang Jin-Hui
Published: June 2009

In the present paper, by employing Cilleruelo's method, we prove that neither
Maternal serum adiponectin multimers in patients with a small-for-gestational-age newborn
Authors: Mazaki-Tovi Shali , Romero Roberto , Vaisbuch Edi , Erez Offer , Mittal Pooja , Chaiworapongsa Tinnakorn , Kim Sun Kwon , Pacora Percy , Yeo Lami , Gotsch Francesca , Dong Zhong , Yoon Bo Hyun , Hassan Sonia S. , Kusanovic Juan Pedro
Published: June 2009

Objective: Several mechanisms of disease have been implicated in the pathophysiology of small-for-gestational-age (SGA) including an anti-angiogenic state, and an exaggerated intravascular pro-inflammatory response. Adiponectin plays a role in a wide range of biological activities including those that have been implicated in the pathophysiology SGA. Thus, the aim of this study was to determine if third trimester adiponectin concentrations differed between women with normal weight infants and those with an SGA neonate.

Study design: This cross-sectional study included women with: 1) a normal pregnancy (n=234); and 2) an SGA neonate (n=78). SGA was defined as a birth weight below the 10th percentile for gestational age at birth. The study population was further stratified by first trimester body mass index (BMI) (normal weight <25 kg/m2 vs. overweight/obese ≥25 kg/m2). Maternal serum adiponectin multimers [total, high-molecular-weight (HMW), medium-molecular-weight (MMW) and low-molecular-weight (LMW)] concentrations were determined by ELISA. Non-parametric statistics were used for analyses.

Results: 1) The median maternal serum concentrations of total, HMW and MMW adiponectin were significantly lower in patients with an SGA neonate than in those with normal pregnancies; 2) patients with an SGA neonate had a significantly lower median HMW/total adiponectin ratio and higher median MMW/total adiponectin and LMW/total adiponectin ratios than those with a normal pregnancy; 3) among patients with an SGA neonate, neither maternal serum concentrations of adiponectin multimers, nor their relative distribution differ between normal weight and overweight/obese patients.

Conclusion: 1) Pregnancies complicated by an SGA neonate are characterized by a alterations in the maternal serum adiponectin multimers concentrations and their relative abundance; 2) the findings reported herein suggest that maternal adipose tissue may play a role, in the pathogenesis of SGA.
Caregiver Strain and Youth Suicide Attempt: Are They Related?
Authors: Barksdale Crystal L. , Walrath Christine M. , Compton Jill S. , Goldston David B.
Published: June 2009

There are scant data documenting the relationship between caregiver strain and suicidal behavior among youth. This study includes data from the caregivers of 1,854 youth who received services through the Comprehensive Community Mental Health Services for Children and Their Families Program. Caregiver strain, family functioning, and youth functional impairment were assessed with the Caregiver Strain Questionnaire, Family Life Questionnaire, and Columbia Impairment Scale. Caregivers of suicidal and nonsuicidal youth differed in subjective internalizing strain (e.g., worry and guilt) and objective strain (e.g., constraints on activities). Differences in objective strain persisted even after controlling for family life and youth functional impairment.
Definitions of Suicide and Self‐Harm Behavior in an Australian Aboriginal Community
Authors: Farrelly Terri , Francis Karen
Published: June 2009

In this small qualitative grounded theory study (21 interviews and focus groups with a total of 26 participants) investigating the understandings of and attitudes toward suicide and self‐harm of Aboriginal peoples in a coastal region of New South Wales, Australia, we found that cultural factors particular to these communities influence the way such behavior is defined in an Aboriginal context. A continuation of certain “traditional” cultural forms of self‐harm behavior was evident in participant definitions, notably the practice of female hair cutting, also described as a mourning ritual, which appears to serve as a marker both to the individual and others.
Health development program package and its effectiveness on the students in high schools and universities
Authors: Fritz Péter
Published: June 2009

A dolgozat témája az egészségi állapot komplex fejlesztésének hatékonyságvizsgálata.
Célkitűzések:
1. Összeállítani az egyén bio-pszicho-szociális állapotáról reális képet adó vizsgálati csomagot. 2. Meghatározni az általam kifejlesztett és a vizsgálati csomagra épülő egészségterv egészségfejlesztő hatékonyságát. 3. Bizonyítani a komplex egészségfejlesztési programcsomag hatékonyságát. 4. Meghatározni egy többváltozós egészségmodellt.
Módszerek:
A kutatásban önként jelentkezett egyetemisták vettek részt, N=125 (29 férfi, 96 nő). Három csoportba soroltam a hallgatókat, véletlenszerű kiválasztást alkalmazva, majd felmértem az egészségi állapotukat a program előtt és a program végeztével is. Az I-es és II-es csoport egészségtervet kapott, az I-es csoport pedig részt vett a 3 hónapos egészségfejlesztési programban. A III. csoport volt a kontrollcsoport. Az egészségfejlesztési programcsomag egészségtervet, edzéstervet, pszichotréninget, személyi edzést és tanácsadást tartalmazott.
Eredmények:
A hallgatók az egészségük számára értékesebb és hatékonyabb mozgásos tevékenységeket választanak és azt rendszeresebben űzik, valamint csak egészségtervvel rendelkezők csoportjában is megfigyelhető a heti mozgással eltöltött alkalmak számának emelkedése. A fejlesztési csoportok szubjektív egészségi állapotának növekedése szignifikánsnak mutatkozott (p
1
= 0,02; p
2
= 0,004). A vitális kimerültség az I-es csoportnál szignifikánsan javult, a II-es csoportban tendencia. A hangulati állapot 2 felmérése között szignifikáns különbség van (Wilcoxon). A hallgatók a program végére 13,4%-kal közelebb kerültek a maximális teljesítőképességükhöz. A heti mozgásgyakoriság a legjelentősebb tényező az egészségi állapot szempontjából a BMI, BDI-hez képest, másfélszeresre javítja az esélyét annak, hogy az egészségi állapot jó kategóriájába kerül valaki.
Következtetések:
Az egészségterv és/vagy a személyi, kis csoportos rekreációs edzés a kipróbált kiválasztási, felkészítési és alkalmazott módszerekkel hatékony formában tud működni.
Use of mesenchymal stem cells from adult bone marrow for injured tissue repair
Authors: Salamon Antal , Toldy Erzsébet
Published: June 2009

A csontvelőből származó mesenchymalis őssejtek pluripotensek, s képesek porc, csont, valamint adiposus és ínsejtekké differenciálódni. Ezen mesenchymalis progenitor sejteket stromasejteknek vagy mesenchymalis őssejteknek nevezik. A csontvelőben két fő sejttípus van: haematopoeticus sejt és stromasejt. Mesenchymalis őssejtek kis beavatkozással nyerhetők a csontvelőből, majd sejtkultúrában szaporíthatóak. Differenciálódásuk bioaktív molekulákkal, specifikus növekedési faktorokkal segíthető elő. A transforming growth factor beta (TGF-β) család tagjai proteinek, közülük a bone morphogenetic proteinek (BMP) a legfontosabb faktorok, amelyek elősegítik a mesenchymalis őssejtek porc- és csontszövetté történő differenciálódását. Kevésbé ismert még ezen sejteknek a tenogenesisben való szerepe, de már vannak biztató adatok e téren is. A mesenchymalis őssejteknek és növekedési faktoroknak a sérült szövetekbe való juttatásra vivő vázanyagra (carrier, scaffold) van szükség. Mesenchymalis őssejtek használhatók fel génterápiára és a tissue engineering alkalmazására. A szerzők jelen munkájukban áttekintik a mesenchymalis őssejtek, biomolekulák és növekedési faktorok szövetpótlás céljából történő használatával foglalkozó kísérletes vizsgálatok eddigi eredményeit és ismertetik a klinikai alkalmazás lehetőségeit.
Gasto do Ministério da Saúde com medicamentos: tendência dos programas de 2002 a 2007
Authors: Vieira Fabiola Sulpino
Published: June 2009

OBJETIVO: Analisar a evolução do gasto do Ministério da Saúde com medicamentos. MÉTODOS: O gasto total (agregado) do Ministério da Saúde com medicamentos e de seus programas (desagregado) foram analisados para o período de 2002 a 2007. As ações que financiaram a aquisição de medicamentos foram obtidas no sistema Siga Brasil e classificadas segundo os programas de assistência farmacêutica. Os valores liquidados foram identificados para cada programa. Para 2006 e 2007, foram pesquisadas as aquisições de anti-retrovirais. Em relação aos medicamentos do Programa de Dispensação em Caráter Excepcional, confrontaram-se os dados da ação orçamentária com aqueles disponíveis no Sistema Único de Saúde. Os valores obtidos foram deflacionados aplicando-se o Índice de Preços ao Consumidor Amplo. Foi efetuada análise exploratória dos dados. RESULTADOS: O gasto em 2007 foi 3,2 vezes o de 2002 e a participação do gasto com medicamentos no gasto total aumentou de 5,4% em 2002 para 10,7% em 2007. O gasto com os medicamentos da atenção básica teve aumento de 75% e com medicamentos dos programas estratégicos, de 124%. No caso dos anti-retrovirais o aumento foi de aproximadamente 6%, mas com aumento de 77% de 2005 a 2006, seguida de redução de 29% de 2006 a 2007. O aumento mais expressivo do gasto foi observado com os medicamentos de dispensação em caráter excepcional, 252% de 2003 a 2007. CONCLUSÕES: Houve aumento significativo do gasto com medicamentos entre 2002 e 2007, havendo maior participação nesse gasto dos anti-retrovirais e medicamentos de dispensação excepcional, os quais são constituídos por número expressivo de fármacos protegidos por patentes.
Relación del personal de salud con los pacientes en la Ciudad de México
Authors: Herrera-Kiengelher Loredmy , Villamil-Álvarez Mirna , Pelcastre-Villafuerte Blanca , Cano-Valle Fernando , López-Cervantes Malaquias
Published: June 2009

OBJETIVO: Analizar la calidad de la relación del personal de salud con los pacientes hospitalizados. MÉTODOS: Estudio cualitativo realizado de febrero a julio del 2005, en la Ciudad de México. Se aplicaron 40 entrevistas a profundidad a pacientes internados en un hospital de tercer nivel. Las categorías de análisis para explorar la percepción del trato entre los informantes fueron las siguientes: actitudes y acciones del personal médico y de enfermería, comunicación efectiva, grado de conocimiento del paciente y/o familiares sobre el diagnóstico, tratamiento clínico, evolución del agravo. RESULTADOS: En general, se encontró un alto grado de satisfacción con la atención médica. No obstante, los pacientes hospitalizados percibieron como inadecuado el trato cotidiano (no clínico) del personal médico y de enfermería del hospital, relacionado con la falta de confianza para solicitar información acerca de su padecimiento. El uso excesivo de tecnicismos por parte del prestador de servicios reforzó esta percepción de trato inadecuado. CONCLUSIONES: La percepción del trato inadecuado por el personal de salud fuera del ámbito técnico, mostró que la efectividad clínica no significa una plena calidad de la atención y que es necesario incorporar las necesidades y expectativas de trato no clínico de los pacientes a la eficiencia técnica y científica.
A proteção social no Brasil: universalismo e focalização nos governos FHC e Lula
Authors: Costa Nilson do Rosário
Published: June 2009

O artigo analisa a configuração do sistema de proteção social no Brasil após a Constituição Federal de 1988 (CF 1988). Demonstra que a CF 1988 favoreceu a institucionalização de políticas públicas universalistas. Esta institucionalização foi realizada em conflito com os pressupostos da estabilização do Plano Real. O trabalho argumenta que a institucionalização protegeu o gasto público na área social da proposta minimalista da gestão macroeconômica. Identifica também a implementação de programas sociais focalizados nos pobres ao longo da década de 1990. A focalização é uma inovação diretamente associada à agenda do ajuste. Revela que nos governo FHC e Lula ocorreu uma idêntica adesão aos programas sociais focalizados. A focalização da proteção social não teve o poder de vetar as propostas universalistas originadas da democratização dos anos 1980. Demonstra que o Programa Bolsa Família (PBF), principal marca do governo Lula, é uma adaptação, em larga escala, dos programas focalizados de transferência direta de renda do período FHC. A combinação de universalismo e focalização ampliou o escopo da política social. O expressivo crescimento do gasto público social não tem, entretanto, produzido resultados sociais abrangente, ainda que os pobres no Brasil tenham sido beneficiados pela focalização do PBF.
O sistema de saúde brasileiro entre normas e fatos: universalização mitigada e estratificação subsidiada
Authors: Bahia Lígia
Published: June 2009

As recentes mudanças nas relações entre o público e o privado na rede assistencial são enfocadas com base na análise de informações selecionadas sobre serviços de saúde e normas legais relacionadas com o suporte ao subsistema assistencial privado. Essa abordagem retoma as análises que articulam o exame simultâneo das bases materiais e políticas que redefinem permanentemente o âmbito de atuação do SUS. Considerando os limites de abrangência das bases empíricas analisadas, questiona-se os pressupostos subjacentes as acepções de autonomia dos componentes público e privado, a partir das hipóteses sobre o delineamento de tendências interdependentes de expansão de coberturas universais e reestratificação da oferta e demanda.
Desenvolvimento do sus e racionamento de serviços hospitalares
Authors: Ribeiro José Mendes
Published: June 2009

Analisamos o sistema de saúde brasileiro em perspectiva comparada. A migração de clientelas de renda média para operadoras pré-pagas privadas aproxima o caso brasileiro do norte-americano. A produção de serviços hospitalares no SUS demonstra importante redução da oferta agravada pelo crescimento demográfico e por expectativas definidas por disposições constitucionais. A redução é seletiva e concentrada em serviços obstétricos e de clínica médica e nos serviços privados lucrativos. Para se garantir acesso equitativo é necessário: ampliação de gastos públicos; redução dos gastos por desembolso direto; reformas organizacionais; ampliação da capacidade de governo.
O SUS necessário e o SUS possível: gestão. Uma reflexão a partir de uma experiência concreta
Authors: Souza Luis Eugenio Portela Fernandes de
Published: June 2009

O presente texto constitui uma reflexão sobre a experiência do autor como gestor de uma secretaria de saúde de um município de grande porte, durante dois anos e meio. Apresenta uma sistematização dos projetos estratégicos, das atividades políticas e técnicas e da rotina gerencial em que se envolveu enquanto gestor. Parte da identificação de três níveis (macro, meso e micro) e de quatro dimensões da gestão (sociopolítica, institucional, técnico-sanitária e administrativa senso estrito). Em cada dimensão, nos três níveis, são discutidas estratégias de gestão, propostas para contribuir com a construção de um SUS efetivamente universal e eqüitativo. Ainda que seja prematuro avaliar o grau de implantação e os efeitos das estratégias propostas, a sua discussão pode ser útil na medida em que adota um quadro de análise das práticas de gestão fortemente baseado em elementos empíricos. Conclui-se que, embora a consolidação do SUS seja uma luta política que extrapola o espaço da gestão, os gestores são agentes importantes que precisam saber desenvolver estratégias consistentes com os princípios da universalidade e da equidade.
Análise de custos com pessoal e produtividade de equipes do programa de saúde da família em Fortaleza, Ceará
Authors: Rocha Filho Fernando dos Santos , Silva Marcelo Gurgel Carlos da
Published: June 2009

Foram verificados a produtividade e os custos com pessoal das atividades de oito equipes de duas unidades do PSF de Fortaleza, Ceará, através da metodologia de custeio por absorção, em 2004. Os maiores gastos foram com pessoal (75%), principalmente com os membros das equipes do PSF, e com medicamentos (18%). As verbas federais repassadas, em setembro de 2004, por equipe do PSF, foram de R$ 9.543,33. O custo global da atuação da equipe foi de R$ 15.719,00. Alguns profissionais de várias equipes do PSF apresentaram produtividade acima das metas planejadas, porém a média geral das atividades por médico e enfermeiro nas equipes ficou abaixo da metade daquelas metas, com alta capacidade ociosa e tornando as atividades muito onerosas. Verificou-se o custo unitário da visita domiciliar por médico e da consulta de pré-natal por enfermeiro, que seriam menos onerosos se a capacidade ociosa fosse menor. Ha várias alternativas de minimização de custos, incluindo economia de escala relativa a alguns recursos e serviços e renegociação de contratos com empresas e cooperativas. As informações possibilitam o planejamento mais preciso, para manutenção e instalação de equipes, além de alternativas de menores custos com maior produtividade e qualidade.
Adolescentes: conhecimentos sobre sexualidade antes e após a participação em oficinas de prevenção
Authors: Camargo Elisana Ágatha Iakmiu , Ferrari Rosângela Aparecida Pimenta
Published: June 2009

Na adolescência, a vivência da sexualidade torna-se mais evidente. Muitas vezes, manifesta-se através de práticas sexuais inseguras, podendo se tornar um problema devido à falta de informação, tabus ou mesmo pelo medo de assumi-la. O objetivo da pesquisa foi analisar o conhecimento dos adolescentes sobre sexualidade, métodos contraceptivos, gravidez, DST e aids, antes e após oficinas de prevenção. Participaram 117 adolescentes da 8ª série de uma escola estadual de Londrina, Paraná. Foi utilizado um questionário (pré e pós-teste) para identificar a diferença do conhecimento dos adolescentes. Para a análise dos dados, usaram-se os testes quiquadrado e exato de Fischer. A faixa etária concentrou-se entre 14 e 16 anos. Os meninos iniciaram mais cedo suas atividades sexuais. Apenas 28,2% dos adolescentes no pré-teste sabiam do período fértil da menina; após as oficinas de prevenção, o conhecimento superou 55,8%. A aids foi a DST mais citada no pré-teste; no pós-teste, houve referência a outras doenças (41,1%). Os métodos contraceptivos mais conhecidos são o preservativo e a pílula. Não houve relevância estatística entre as respostas sobre atitudes de risco para transmissão de DST/aids. Conclui-se que há necessidade de trabalho sistemático, a médio e longo prazo, sobre sexualidade na escola para os adolescentes.
Universidade, contexto ansiogênico? Avaliação de traço e estado de ansiedade em estudantes do ciclo básico
Authors: Ferreira Camomila Lira , Almondes Katie Moraes de , Braga Liliane Pereira , Mata Ádala Nayana de Sousa , Lemos Caroline Araújo , Maia Eulália Maria Chaves
Published: June 2009

O presente artigo objetiva avaliar a ansiedade-traço e a ansiedade-estado de estudantes universitários do ciclo básico da Universidade Federal do Rio Grande do Norte, verificando diferenças entre três grandes áreas de conhecimento, biomédica, humanística e tecnológica, tendo em vista que a entrada na universidade pode se configurar como uma situação ameaçadora que parece sofrer influência das diferentes características de cada uma dessas áreas. Participaram do estudo 158 estudantes, sendo 71 mulheres e 87 homens, com idade média de 20,04 ± 3,37 anos, respondendo uma ficha de identificação e o Inventário de Ansiedade Traço-Estado (IDATE). Resultados demonstram que as médias de ansiedade-traço e ansiedade-estado desses estudantes encontram-se dentro do esperado para essa população, embora a área biomédica seja percebida como a mais ansiogênica, uma vez que apresenta uma densa grade curricular com intensas demandas acadêmicas, o que parece elevar os escores dos estudantes dessa área, em especial os dos homens.
Nitrogen fertilizer effects on soil carbon balances in Midwestern U.S. agricultural systems
Authors: Russell Ann E. , Cambardella Cynthia A. , Laird David A. , Jaynes Dan B. , Meek David W.
Published: June 2009

A single ecosystem dominates the Midwestern United States, occupying 26 million hectares in five states alone: the corn–soybean agroecosystem [Zea mays L.–Glycine max (L.) Merr.]. Nitrogen (N) fertilization could influence the soil carbon (C) balance in this system because the corn phase is fertilized in 97–100% of farms, at an average rate of 135 kg N·ha−1·yr−1. We evaluated the impacts on two major processes that determine the soil C balance, the rates of organic‐carbon (OC) inputs and decay, at four levels of N fertilization, 0, 90, 180, and 270 kg/ha, in two long‐term experimental sites in Mollisols in Iowa, USA. We compared the corn–soybean system with other experimental cropping systems fertilized with N in the corn phases only: continuous corn for grain; corn–corn‐oats (Avena sativa L.)–alfalfa (Medicago sativa L.; corn–oats–alfalfa–alfalfa; and continuous soybean. In all systems, we estimated long‐term OC inputs and decay rates over all phases of the rotations, based on long‐term yield data, harvest indices (HI), and root : shoot data. For corn, we measured these two ratios in the four N treatments in a single year in each site; for other crops we used published ratios. Total OC inputs were calculated as aboveground plus belowground net primary production (NPP) minus harvested yield. For corn, measured total OC inputs increased with N fertilization (P < 0.05, both sites). Belowground NPP, comprising only 6–22% of total corn NPP, was not significantly influenced by N fertilization. When all phases of the crop rotations were evaluated over the long term, OC decay rates increased concomitantly with OC input rates in several systems. Increases in decay rates with N fertilization apparently offset gains in carbon inputs to the soil in such a way that soil C sequestration was virtually nil in 78% of the systems studied, despite up to 48 years of N additions. The quantity of belowground OC inputs was the best predictor of long‐term soil C storage. This indicates that, in these systems, in comparison with increased N‐fertilizer additions, selection of crops with high belowground NPP is a more effective management practice for increasing soil C sequestration.
Nitrogen stable isotopes in streams: effects of agricultural sources and transformations
Authors: Diebel Matthew W. , Zanden M. Jake Vander
Published: June 2009

The nitrogen stable isotope ratio of biological tissue has been proposed as an indicator of anthropogenic N inputs to aquatic ecosystems, but overlap in the isotopic signatures of various N sources and transformations make definitive attribution of processes difficult. We collected primary consumer invertebrates from streams in agricultural settings in Wisconsin, USA, to evaluate the relative influence of animal manure, inorganic fertilizer, and denitrification on biotic δ15N. Variance in biotic δ15N was explained by inorganic fertilizer inputs and the percentage of wetland land cover in the watershed, but not by animal manure inputs. These results suggest that denitrification of inorganic fertilizer is the primary driver of δ15N variability among the study sites. Comparison with previously collected stream water NO3‐N concentrations at the same sites supports the role of denitrification; for a given N application rate, streams with high biotic δ15N had low NO3‐N concentrations. The lack of a manure signal in biotic δ15N may be due its high ammonia content, which can be dispersed outside the range of its application by volatilization. Based on our findings and on agricultural census data for the entire United States, inorganic fertilizer is more likely than manure to drive variability in biotic δ15N and to cause excessive nitrogen concentrations in streams.