bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficiency measurement in developing countries: application of data envelopment analysis for Iranian hospitals
Authors: Shahhoseini Reza , Tofighi Shahram , Jaafaripooyan Ebrahim , Safiaryan Reza
Published: April 2011

Hospitals have been at the core of health care in most countries during past decades, in view of the importance and criticality of their services and absorbing the highest quota of health care financial resources. Specific problems associated with these organizations in developing countries, such as Iran, have further added to the attention they have received over the course of those years. Efficiency measurement of hospitals based on simple ratios has long been utilized to remedy these problems in Iran. However, application of data envelopment analysis as an advanced method for measuring efficiency of health care organizations is mostly unexplored in this country. The current study has applied this method to investigate technical efficiency of a group of provincial hospitals in Iran. The findings showed that just under 60% of all hospitals at the province were technically efficient, and the remainder faced excess number of inputs (specifically in their non-clinical human resources) that should be attended to by the managers. Implications for practice and research on the efficiency of hospitals in the country and similar settings are provided.
Healthcare complaints handling systems: a comparison between Britain, Australia and Taiwan
Authors: Hsieh Sophie Yahui
Published: April 2011

This paper explores the health care complaints handling reforms enacted in Britain, Australia and Taiwan. A documentary search for policy documents, reports and studies related to the reforms of the health care complaints handling system was conducted. A keyword search was performed within PubMed and ProQuest for the period 1985–2009 to identify relevant articles. The study found that the major difference in health care complaints handling systems between countries, is the mechanism for running a complaints system. Both Britain and Australia have attempted to incorporate patient complaints into their national quality systems. Their intention was to set up mechanisms to create an effective bridge, at a national policy level, between the patient complaints management system and the quality management system.
Ausbildung von „Universalgenies“? Zum Kompetenzbegriff und translatorischen Kompetenzmodellen
Authors: Herold Susann
Published: April 2011

An important element in T&I studies is the problem of teaching translation and interpreting. The following article does not, however, try to answer the question of whether and how we can teach translation to students. The focal point lies instead on the concept of translation/interpreting competence(s) and the question of whether cultivating all the competences identified by T&I studies as essential to translating/interpreting does not in fact entail trying to turn students into universal geniuses. What would this mean for university teachers? And can we integrate the competences defined in T&I studies into a concise model which can be of use in developing realistic teaching methods?
Multimediale Revolution – Multimodaler Text: Eigenschaften multimodaler Texte anhand von Beispielen aus der Anzeigenwerbung
Authors: Hennecke Angelika
Published: April 2011

The present article deals with the question of how - on the one hand - the current “multimedia revolution” changes our conceptions of text, text production and text reception, and which challenges arise from these changes for Applied Linguistics and for Communication Sciences on the other hand. The fact that in the construction of texts other codes are increasingly significant in addition to the verbal-linguistic code needs a wide and interdisciplinary perspective and the cooperation between linguistics and semiotics. From a perspective based on textual semiotics, the author intends to describe the characteristics and specifics of multimodal texts, in order to present a model for their description and characterization. The question which first arises is how the different codes which participate in the construction of the text interact, in what way they are connected and what their constitutive participation in the resulting superior meaning of the whole text is. These theoretical observations are finally illustrated by examples from print advertising, since print advertisements are understood as the epitome of multimodal super-texts, and because of the fact that the above described modifications and changes in our text world appear in a broad manner in texts of mass communication.
Otx2 Promotes the Survival of Damaged Adult Retinal Ganglion Cells and Protects against Excitotoxic Loss of Visual AcuityIn Vivo
Authors: Ibad Raoul Torero , Rheey Jinguen , Mrejen Sarah , Forster Valérie , Picaud Serge , Prochiantz Alain , Moya Kenneth L.
Published: April 2011

Retinal ganglion cells (RGCs) are the projection neurons from the eye to the brain and their loss results in visual impairment in a number of diseases. Transcription factors with a homeodomain can translocate between cells and, in at least one reported case, can stimulate neuronal survival. Otx2 is a homeoprotein transcription factorexpressed in the retina that is taken up by RGCs. We thus hypothesized that Otx2 capture could regulate the survival of adult RGCs. We report that Otx2 stimulates the survival of adult mouse and rat RGCsin vitroand protects RGCs against NMDA-induced toxicityin vivoin mice. In the latter model, Otx2 also preserves visual acuity.
Neural Segregation of Objective and Contextual Aspects of Fairness
Authors: Wright Nicholas D. , Symmonds Mkael , Fleming Stephen M. , Dolan Raymond J.
Published: April 2011

Perception of fairness can influence outcomes in human exchange. However, an inherent subjectivity in attribution renders it difficult to manipulate fairness experimentally. Here using a modified ultimatum game, within a varying social context, we induced a bias in human subjects' acceptance of objectively identical offers. To explain this fairness-related behavior, we use a computational model to specify metrics for the objective and contextual aspects of fairness, testing for correlations between these model parameters and brain activity determined using functional magnetic resonance imaging. We show that objective social inequality, as defined by our model, is tracked in posterior insula cortex. Crucially, this inequality is integrated with social context in posterior and mid-insula, consistent with construction of a fairness motivation that flexibly adapted to the social environment. We suggest that the dual importance of objective and contextual aspects to fairness we highlight might explain seemingly inconsistent societal phenomena, including public attitudes to income disparities.
Medial Temporal Theta/Alpha Power Enhancement Precedes Successful Memory Encoding: Evidence Based on Intracranial EEG
Authors: Fell Juergen , Ludowig Eva , Staresina Bernhard P. , Wagner Tobias , Kranz Thorsten , Elger Christian E. , Axmacher Nikolai
Published: April 2011

Not only poststimulus, but also prestimulus neural activity has been shown to be predictive for later successful memory encoding. However, it is still not clear which medial temporal lobe processes precede effective memory formation. Here, our aim was to investigate whether such prestimulus markers for successful memory encoding can be specified based on intracranial recordings directly from the hippocampus and rhinal cortex. For this purpose, we analyzed subsequent memory effects during a continuous word recognition paradigm in 31 presurgical epilepsy patients. We found that rhinal and hippocampal theta and successive alpha power enhancement before word presentation predicted successful memory encoding. Previous studies suggest that stimulus-triggered hippocampal theta activity is particularly related to memory retrieval and activation of a mnemonic context, whereas the alpha rhythm reflects inhibitory top-down control of task processing and executive functioning. In line with these suggestions, we propose that the observed medial temporal theta and alpha power increases before stimulus presentation reflect activation of contextual information and inhibitory top-down control processes preparing for stimulus-triggered memory processing.
Pax6Is Required at the Telencephalic Pallial–Subpallial Boundary for the Generation of Neuronal Diversity in the Postnatal Limbic System
Authors: Cocas Laura A. , Georgala Petrina A. , Mangin Jean-Marie , Clegg James M. , Kessaris Nicoletta , Haydar Tarik F. , Gallo Vittorio , Price David J. , Corbin Joshua G.
Published: April 2011

During embryogenesis, the pallial–subpallial boundary (PSB) divides the two main progenitor domains in the telencephalon: the pallium, the major source of excitatory neurons, and the subpallium, the major source of inhibitory neurons. The PSB is formed at the molecular interface between the pallial (high Pax6+) and subpallial (high Gsx2+) ventricular zone (VZ) compartments. Initially, the PSB contains cells that express both Pax6 and Gsx2, but during later stages of development this boundary is largely refined into two separate compartments. In this study we examined the developmental mechanisms underlying PSB boundary formation and the postnatal consequences of conditional loss ofPax6function at the PSB on neuronal fate in the amygdala and olfactory bulb, two targets of PSB-derived migratory populations. Our cell fate and time-lapse imaging analyses reveal that the sorting of Pax6+ and Gsx2+ progenitors during embryogenesis is the result of a combination of changes in gene expression and cell movements. Interestingly, we find that in addition to giving rise to inhibitory neurons in the amygdala and olfactory bulb, Gsx2+ progenitors generate a subpopulation of amygdala excitatory neurons. Consistent with this finding, targeted conditional ablation ofPax6in Gsx2+ progenitors results in discrete local embryonic patterning defects that are linked to changes in the generation of subsets of postnatal excitatory and inhibitory neurons in the amygdala and inhibitory neurons in the olfactory bulb. Thus, in PSB progenitors,Pax6plays an important role in the generation of multiple subtypes of neurons that contribute to the amygdala and olfactory bulb.
Use-Dependent AMPA Receptor Block Reveals Segregation of Spontaneous and Evoked Glutamatergic Neurotransmission
Authors: Sara Yildirim , Bal Manjot , Adachi Megumi , Monteggia Lisa M. , Kavalali Ege T.
Published: April 2011

Earlier findings had suggested that spontaneous and evoked glutamate release activates non-overlapping populations of NMDA receptors. Here, we evaluated whether AMPA receptor populations activated by spontaneous and evoked release show a similar segregation. To track the receptors involved in spontaneous or evoked neurotransmission, we used a polyamine agent, philanthotoxin, that selectively blocks AMPA receptors lacking GluR2 subunits in a use-dependent manner. In hippocampal neurons obtained from GluR2-deficient mice, philanthotoxin application decreased AMPA-receptor-mediated spontaneous miniature EPSCs (AMPA-mEPSCs) down to 20% of their initial level within 5 min. In contrast, the same philanthotoxin application at rest decreased the subsequent AMPA-receptor-mediated evoked EPSCs (eEPSCs) only down to 80% of their initial value. A 10-min-long perfusion of philanthotoxin further decreased AMPA-eEPSC amplitudes to 60% of their initial magnitude, which remained substantially higher than the level of AMPA-mEPSC block achieved within 5 min. Finally, stimulation after removal of philanthotoxin resulted in reversal of AMPA-eEPSC block, verifying strict use dependence of philanthotoxin. These results support the notion that spontaneous and evoked neurotransmission activate distinct sets of AMPA receptors and bolster the hypothesis that synapses harbor separate microdomains of evoked and spontaneous signaling.
Suppression of Alzheimer's Disease-Related Phenotypes by Expression of Heat Shock Protein 70 in Mice
Authors: Hoshino Tatsuya , Murao Naoya , Namba Takushi , Takehara Masaya , Adachi Hiroaki , Katsuno Masahisa , Sobue Gen , Matsushima Takahide , Suzuki Toshiharu , Mizushima Tohru
Published: April 2011

Amyloid-β peptide (Aβ) plays an important role in the pathogenesis of Alzheimer's disease (AD). Aβ is generated by proteolysis of β-amyloid precursor protein (APP) and is cleared by enzyme-mediated degradation and phagocytosis by microglia and astrocytes. Some cytokines, such as TGF-β1, stimulate this phagocytosis. In contrast, cellular upregulation of HSP70 expression provides cytoprotection against Aβ. HSP70 activity in relation to inhibition of Aβ oligomerization and stimulation of Aβ phagocytosis has also been reported. Although thesein vitroresults suggest that stimulating the expression of HSP70 could prove effective in the treatment of AD, there is a lack ofin vivoevidence supporting this notion. In this study, we address this issue, using transgenic mice expressing HSP70 and/or a mutant form of APP (APPsw). Transgenic mice expressing APPsw showed less of an apparent cognitive deficit when they were crossed with transgenic mice expressing HSP70. Transgenic mice expressing HSP70 also displayed lower levels of Aβ, Aβ plaque deposition, and neuronal and synaptic loss than control mice. Immunoblotting experiments and direct measurement of β- and γ-secretase activity suggested that overexpression of HSP70 does not affect the production Aβ. In contrast, HSP70 overexpression did lead to upregulation of the expression of Aβ-degrading enzyme and TGF-β1 bothin vivoandin vitro. These results suggest that overexpression of HSP70 in mice suppresses not only the pathological but also the functional phenotypes of AD. This study provides the firstin vivoevidence confirming the potential therapeutic benefit of HSP70 for the prevention or treatment of AD.
Estrogen Shapes Dopamine-Dependent Cognitive Processes: Implications for Women's Health
Authors: Jacobs Emily , D'Esposito Mark
Published: April 2011

The prefrontal cortex (PFC) is exquisitely sensitive to its neurochemical environment. Minor fluctuations in cortical dopamine (DA) can profoundly alter working memory, a PFC-dependent cognitive function that supports an array of essential human behaviors. Dopamine's action in the PFC follows an inverted U-shaped curve, where an optimal DA level results in maximal function and insufficient or excessive DA impairs PFC function. In animals, 17β-estradiol (the major estrogen in most mammals, referred to henceforth as estradiol) has been shown to enhance DA activity, yet no human study has adequately addressed whether estradiol's impact on cognition occurs by way of modulating specific neurochemical systems. Here we examined the effects of endogenous fluctuations in estradiol on working memory in healthy young women as a function of baseline PFC DA [indexed by catechol-O-methyltransferase (COMT) Val158Met genotype and, at a finer scale, COMT enzyme activity]. The results demonstrate that estradiol status impacts working memory function and, crucially, the direction of the effect depends on indices of baseline DA. Moreover, consistent with a DA cortical efficiency hypothesis, functional MRI revealed that inferred optimal DA was associated with reduced PFC activity sustained across task blocks and selectively enhanced PFC activity on trials with the greatest demand for cognitive control. The magnitude of PFC activity during high control trials was predictive of an individual's performance. These findings show that although estrogen, considered in isolation, may have unpredictable effects on cognitive performance, its influence is clarified when considered within a larger neuromodulatory framework. Given the clinical prevalence of dopaminergic drugs, understanding the relationship between estrogen and DA is essential for advancing women's health.
Multisensory Processing in Spatial Orientation: An Inverse Probabilistic Approach
Authors: Clemens Ivar A. H. , De Vrijer Maaike , Selen Luc P. J. , Van Gisbergen Jan A. M. , Medendorp W. Pieter
Published: April 2011

Most evidence that the brain uses Bayesian inference to integrate noisy sensory signals optimally has been obtained by showing that the noise levels in each modality separately can predict performance in combined conditions. Such a forward approach is difficult to implement when the various signals cannot be measured in isolation, as in spatial orientation, which involves the processing of visual, somatosensory, and vestibular cues. Instead, we applied an inverse probabilistic approach, based on optimal observer theory. Our goal was to investigate whether the perceptual differences found when probing two different states—body-in-space and head-in-space orientation—can be reconciled by a shared scheme using all available sensory signals. Using a psychometric approach, seven human subjects were tested on two orientation estimates at tilts <120°: perception of body tilt [subjective body tilt (SBT)] and perception of visual vertical [subjective visual vertical (SVV)]. In all subjects, the SBT was more accurate than the SVV, which showed substantial systematic errors for tilt angles beyond 60°. Variability increased with tilt angle in both tasks, but was consistently lower in the SVV. The sensory integration model fitted both datasets very nicely. A further experiment, in which supine subjects judged their head orientation relative to the body, independently confirmed the predicted head-on-body noise by the model. Model predictions based on the derived noise properties from the various modalities were also consistent with previously published deficits in vestibular and somatosensory patients. We conclude that Bayesian computations can account for the typical differences in spatial orientation judgments associated with different task requirements.
Spectroscopic and Molecular Docking Investigations on the Interaction of Rutin with Bovine Serum Albumin
Authors: Jhonsi M. Asha , Selvaraj S. , Paramaguru G. , Venuvanalingam P. , Renganathan R.
Published: April 2011

Rutin is an anticancer herbal drug. The interaction between rutin and bovine serum albumin (BSA) was studied by using absorption, steady-state, time resolved and synchronous fluorescence spectroscopic techniques. The results of fluorescence titration revealed that rutin could strongly quench the intrinsic fluorescence of BSA through a static quenching process. The binding constant and number of binding sites of rutin with BSA were obtained by fluorescence quenching method. The distance between donor and acceptor is calculated according to Förster's non-radiative energy transfer theory. The results of synchronous fluorescence spectra showed that the binding of rutin with BSA can induce conformational changes in BSA and it was further confirmed by docking studies. Molecular docking of rutin with BSA indicated that it docked close to Trp 212, which is present within the hydrophobic subdomain. In addition, the effect of metal ions on the binding constants of BSA⋯rutin complex has also been discussed.
Femtosecond Coherence Spectroscopic Study of the Onset of Chemical Denaturation of Myoglobin upon Addition of Minor Amounts of Urea
Authors: Meyer-Ilse Julia , Akimov Denis , Dietzek Benjamin
Published: April 2011

The interaction of urea with myoglobin, as a benchmark system for heme-containing proteins, is studiedviafemtosecond coherence spectroscopy. The work focuses on the effect of urea on the appearance of low-wavenumber oscillations, which are a measure of the geometrical structure of the heme group and its interaction with the polypeptide chain. Pursuing this approach, structural alterations (i.e.changes in the vibrational dynamics of the heme group) are detected at denaturant concentrations below the full denaturation limit of 6 M urea for myoglobin. In particular, the low-wavenumber oscillation associated with the heme-doming (i.e.the out-off-plane vibration of the propyrin macrocycle) is found to appear spectrally shifted with a concentration of only 3 M urea. These results suggest that the local environment around the heme is already altered despite the fact that macroscopic unfolding as manifested in the thermodynamic properties of the polypeptide chain is not complete at these urea concentrations.
Development and Validation of the Japanese Version of Organization‐Based Self‐Esteem Scale
Authors: Matsuda Yoriko , Pierce Jon L. , Ishikawa Rie
Published: April 2011

Development and Validation of the Japanese Version of Organization‐Based Self‐Esteem Scale: Yoriko Matsuda, et al. Health Psychology and Welfare Research Institute, J. F. Oberlin University—

Objectives

The purpose of this study was to validate a Japanese version of the organization‐based self‐esteem (OBSE) scale, a positive self‐concept that has been proven to play an important role in predicting employees' work attitudes and behaviors primarily in a Western organizational setting.

Methods

Two independent ield studies, Study One and Study Two, involving 1,562 Japanese employees from a variety of organizations were conducted by employing a web‐based questionnaire.

Results

In Study One, initial evidence for the factorial validity of an eight‐item, single factor scale, with high internal consistency (0.93 and 0.88 for Sample 1 and Sample 2, respectively) and test‐retest reliability (r=0.84) was provided. In Study Two, the eight‐factor structure was replicated and multiple‐group conirmatory factor analysis (CFA) demonstrated measurement invariance across two samples. In addition, a series of CFA demonstrated that the Japanese OBSE is a distinct construct from global self‐esteem, job complexity and work engagement. Furthermore, the nomological validity evidence was demonstrated through structural equation modeling.

Conclusions

The Japanese OBSE scale is presented as a psychometrically sound measure that can contribute to furthering substantive OBSE research.
Relationship between Receiving a Workplace Oral Health Examination Including Oral Health Instruction and Oral Health Status in the Japanese Adult Population
Authors: Oshikohji Tadaaki , Shimazaki Yoshihiro , Shinagawa Takashi , Fukui Nao , Akifusa Sumio , Hirata Yukio , Yamashita Yoshihisa
Published: April 2011

Relationship between Receiving a Workplace Oral Health Examination Including Oral Health Instruction and Oral Health Status in the Japanese Adult Population: Tadaaki Oshikohji, et al. Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science—

Objectives

Dental caries and periodontal disease are highly prevalent in the Japanese adult population. Oral examination is an effective method to ind various oral health problems in their early stages. However, workplace oral examination is not common in Japan. The purpose of this study was to examine the relationship between receiving workplace oral health examination, including oral health instruction, and oral health status in the Japanese adult population.

Methods

This study was performed using data from 4,484 Japanese employees aged 35–74 yr. The proportion of teeth with a probing depth (PD) ≥4 mm and the number of decayed teeth were used for periodontal disease and dental caries parameters. The subjects were asked by questionnaire about past experiences with workplace oral health examination.

Results

The subjects who Received a workplace oral health examination every year had better periodontal health status than those receiving an examination for the irst time. The odds ratio for having ≥10% of teeth with PD ≥4 mm in the subjects who Received workplace oral health examination every year was 0.63 (p<0.05) after adjustment for age, sex, smoking habits, tooth brushing habits, routine visits to dental clinics, number of missing teeth, and oral hygiene status, in a multivariate, multinomial logistic regression analysis. On the other hand, no significant relationship was found between workplace oral health examination and number of decayed teeth.

Conclusions

These results suggest that workplace oral health examination accompanied by oral health instruction may be effective for maintenance of periodontal health.
Phase Transformations of Nanocrystalline Martensitic Materials
Authors: Waitz T. , Tsuchiya K. , Antretter T. , Fischer F.D.
Published: April 2011

The physical phenomena and engineering applications of martensitic phase transformations are the focus of intense ongoing research. The martensitic phase transformation and functional properties such as the shape-memory effect and superelasticity are strongly affected by the crystal size at the nanoscale. The current state of research on the impact of crystal size on the phase stability of the martensite is reviewed summarizing experimental results of various nanostructured martensitic materials and discussing the corresponding theoretical approaches. The review outlines the effects of crystal size on the complex morphology of the martensite, leading to interface structures not encountered in coarse-grained bulk materials. The unique shape-memory properties of martensitic materials can persist even at the nanoscale. Nanocrystalline martensitic materials can be processed to obtain tailored functional properties in combination with enhanced strength. Structural changes of metallic nanowires are similar to those arising by martensitic phase transformations and also can lead to shape-memory effects, as predicted by atomistic simulations.
Phase Transitions in Nanoscale Ferroelectric Structures
Authors: Streiffer S.K. , Fong D.D.
Published: April 2011

Over decades of effort, investigations of the intrinsic phase transition behavior of nanoscale ferroelectric structures have been greatly complicated by materials processing variations and by the common and uncontrolled occurrence of spacecharge, which interacts directly with the polarization and can obscure fundamental behavior. These challenges have largely been overcome, and great progress in understanding the details of this class of phase transitions has been made, largely based on advances in the growth of high-quality, epitaxial ferroelectric films and in the theory and simulation of ferroelectricity. Here we will discuss recent progress in understanding the ferroelectric phase transition in a particular class of model systems: nanoscale perovskite thin-film heterostructures. The outlook for ferroelectric technology based on these results is promising, and extensions to laterally confined nanostructures will be described.
Coping with Chronic Illness: Information Use and Treatment Adherence among People with Diabetes
Authors: Goering Elizabeth , Matthias Marianne S.
Published: April 2011

This study's goal is to understand the complex relationship among information usage, medication adherence, and disease management in people with diabetes. Toward this end, we conducted 21 in-depth interviews with Type 2 diabetics. We queried patients on the sources and adequacy of information that they received about their disease, as well as on how closely they adhered to their prescribed medication regimen. Interviewees identified 12 sources of information that they used to varying degrees in managing their diabetes. Of these sources, patients relied most heavily on their doctors, particularly upon initial diagnosis, in spite of delivering mixed assessments of the adequacy of their physicians’ provision of information. Other sources patients most frequently discussed included diabetes education programs, friends/family, the internet, the information leaflet that accompanies prescriptions, and written information. Further, those who reported high adherence to their treatment regimen tended to rely on different sources than those who reported low adherence. Findings are interpreted within the framework of the health belief model, and implications for designing effective interventions are discussed.
Positioning Identity in Clinical Interviews with People who Stutter
Authors: Guendouzi Jackie , Williams Mandy J.
Published: April 2011

Clinicians often rely on ethnographic interviews to make judgments about the effect of stuttering on the lives of people who stutter. This form of interview aids the clinician in assessing specific dimensions of the client's life (e.g. career choice, education etc) that might be impacted by dysfluency. Further, the information gathered from ethnographic interviews is used to make professional judgments relating to the client's personality type and behavioral traits. This study used methods associated with discursive psychology to examine data taken from two ethnographic interviews between a clinician and two people who stuttered. The interviews were semi-structured and used probe questions to elicit the participants’ viewpoints about the effects of stuttering on their lives. Data taken from the interviews were then examined to investigate the subject positions participants discursively aligned to within their accounts. We discuss the implications of making clinical judgments regarding a client's identity from such interviews.
How Care Providers Construct and Frame Problems Related to Violence in Institutional Care for Older People
Authors: Sandvide Åsa , Åström Sture , Saveman Britt-Inger
Published: April 2011

The aim was to describe how care providers discursively constructed and framed problems related to the occurrence of violence in their interactions with older persons in institutional care. The study followed a social constructionist approach where violence was considered a social phenomenon constructed in discursive processes. It was based on the assumption that the way in which a problem is articulated is closely connected to beliefs, which in turn create and maintain a space for the support of certain actions and solutions that are possible and relevant in the given context. The analyzed text comprised narrative interviews with 46 care providers who had been involved in violence that occurred in social interactions with older persons. The analysis was inspired by discourse theory. The interactions were presented as a difficult and unavoidable problem related to the illness, caring for the body, competence and profession as well as the social order. The descriptions of the violence and related problems are manifestations of discourses. The prevailing discourses in the text were the medical and physical. The presentations of problems can be used to challenge dominant ways of thinking as well as the beliefs and common understandings about the subject.
The Role of Active Participation in Interaction for Children Who Use Augmentative and Alternative Communication
Authors: Sundqvist Annette Sophie , Plejert Charlotta , Rönnberg Jerker
Published: April 2011

The present study investigates active participation of three children with complex communication needs who use augmentative and alternative communication (AAC). Active participation in social interaction is an important factor for children's cognitive development and the advancement of linguistic and social skills. The aim of the study was to identify components in interaction in everyday school settings that manifested themselves as active participation for the children. Three different settings were analyzed for each child: interaction with a peer, a lecture situation with an adult, and a formalized role-play situation. The study identified a number of practices which induce active participation of the child who uses AAC. Practices that are conducive for active participation include relinquishing time and space for the child who uses AAC to be in control of the interaction. It entails to actively invite the child who uses AAC, or other children to be involved in the interaction. Another important practice is to ensure that the communicative parties share common communicative goals. Communication partners’ abilities to balance and counterbalance the necessity to follow, share or sometimes inhibit a need to shape communicative projects initiated by the child, are crucial to achieve participation and engagement of the child in interaction.
Use of Metaphors in Motivational Interviewing Sessions in the Probation Service
Authors: Sarpavaara Harri
Published: April 2011

This paper examines the use of metaphors in client-counsellor interaction in Motivational Interviewing counselling sessions in the context of probation service. Clients who participated in these counselling sessions and in this study had either an alcohol or drug abuse problem. My aim is to show how the interaction between the client and counsellor is shaped by reciprocal use of metaphors, and how the client's change talk finds expression in metaphorical utterances. In these counselling sessions, the use of metaphors appeared in five types of interactions: 1) participants work with and develop together shared metaphors, 2) the client accepts the counsellor's metaphorical description but does not use it him or herself, 3) either the client or the counsellor suggests an alternative metaphor, 4) the counsellor systematically ignores the client's metaphor, and 5) the counsellor does not understand the meaning of the client's metaphor. The analysis suggests that metaphorical utterances play a major part in the interaction between the client and the counsellor and in the client's change talk. These findings support the notion that metaphor and the change are closely linked, and a metaphor may act as a vehicle of change.
When Trustworthiness Matters: How Trust Influences Knowledge-Production and Knowledge-Sharing in a Surgical Department
Authors: Underland Gro
Published: April 2011

Transferring clinical knowledge and bringing various representations of clinical knowledge together is crucial as support for clinical decision-making. While previous scholarship has elaborated patients’ trust of healthcare providers as well as the healthcare system, this article emphasizes trust as a catalyst for clinical knowledge production. Using an observational study of a surgical department at a large Norwegian hospital, the article focuses on knowledge transfer between surgeons in a surgical department. The surgeons’ confidence to initiate knowledge requests and the perceived trustworthiness of knowledge by colleagues is significant. There is a distinct underuse of medical patient records, both paper-based and electronic, which results in an oral transferring and sharing of clinical knowledge. Significantly this oral knowledge-transfer is dynamic and effective, meeting demands for timely patient information. By studying knowledge-intensive work very closely from a perspective that suggests that knowledge is local and developed through trust and dependence, this study identifies how work practices have developed to work well with little support of formal information systems.
Doença de Machado-Joseph descrição de cinco membros de uma família
Authors: Teive Hélio A. Ghizoni , Arruda Walter O. , Trevisol-Bittencourt Paulo C.
Published: April 2011

Os autores apresentam o estudo realizado em 5 membros afetados de uma família portadora da doença de Machado-Joseph. São abordados os diferentes tipos clínicos da doença encontrados, bem como os exames complementares realizados, em particular os estudos de tomografia craniana, exames neurofisiológicos (eletromiografia, estudo de condução nervosa, estudo de potencial evocado auditivo), biópsias de nervo periférico e de músculo estriado esquelético, com estudo histoquímico.
Paracoccidioidomicose de localização intramedular e cerebral
Authors: Morato-Fernandez R. N. , Beraldo P. S. S. , Masini M. , Costa P. H. C.
Published: April 2011

O presente relato de caso, descreve nossa experiência diagnóstica e terapêutica com um paciente que apresentou manifestações clínicas, radiológicas e tomográficas de paracoccidioidomicose comprometendo os pulmões, cérebro e, particularmente, a medula espinhal. Além da raridade do caso, chama-se a atenção para a extrema dificuldade na elucidação diagnóstica definitiva, obtida somente após laminectomia e biópsia cirúrgica de tumoração intramedular ao nível de C5. O paciente recebeu duas séries de tratamento com, ketoconazol (400 a 600 mg/dia). No início de ambas apresentou crise convulsiva tônico-clônica. Especula-se sobre uma possível resposta inflamatória perigranulomatosa intracerebral, relacionada à intervenção terapêutica, ainda sem relato na literatura.
Potenciais evocados na esclerose múltipla experiência recente do HDAL- SARAH
Authors: Brasil-Neto Joaquim P.
Published: April 2011

Descrição dos principais achados anormais em 8 pacientes com suspeita diagnóstica de esclerose múltipla, submetidos a exames de potenciais evocados multimodais no Hospital das Doenças do Aparelho Locomtor - HDAL-SARAH, em Brasília - durante três anos (1987-1989). Quatro desses pacientes foram também examinados posteriormente com a técnica de ressonância nuclear magnética e, em todos eles, este exame também se revelou compatível ao diagnóstico de doença desmielinizante do sistema nervoso central. As modalidades de exame mais úteis para a corroborarão da hipótese diagnostica foram aquelas que evocam respostas visuais e sômato-sensitivas. Este aspecto está de acordo com os resultados descritos na literatura. Conclui-se que os potenciais evocados multimodais representam recurso propedêutico acessível e bastante valioso para o diagnóstico da esclerose múltipla, devendo ser sua utilização incentivada em nosso meio.
Ketoconazole in the treatment of cryptococcosis of the central nervous system
Authors: Trevisol-Bittencourt P. C. , Sander J. W. A. S. , Silvado C. S. , Wittig E. O.
Published: April 2011

Two patients with cryptococcosis of the CNS were treated with ketoconazole (KTZ), an imidazole derivative with fungistatic properties; they had either failed standard therapy (Amphotericin-B + 5-Flurocytosine) or suffred intolerable side-effects to it. Both patients were administered KTZ 800 mg/day as monotherapy for six months without interruption and both responded. One month after KTZ therapy was withdrawn, however, a relapse of the infection was seen in one case. Side-effects were minimal during the trial of treatment. KTZ could be a useful drug in some cases of neurocryptococcosis.
Creutzfeldt-Jakob disease in Venezuela a case report
Authors: Caraballo H. Alejandro J.
Published: April 2011

A case of Creutzfeldt-Jakob disease (CJD) in a 32 year old man is presented. The clinical picture included a rapid progressive dementia associated with ataxia, global aphasia, myoclonus and pyramidal signs, death ocurred after 13 months. The diagnosis of CJD was confirmed by CT and neuropathological studies. This is the first report of CJD occurring in Venezuela.
Non tumoral intracranial expansive processes: clinical-tomographic correlation
Authors: Campos Patricia , Herrera Genaro , Valencia F. , Cabrera A. Fuentes-Dávila Juan , Gotuzzo E. , Chaparro E. , Vizcarra D. , Arbaiza D. , Sánchez J.
Published: April 2011

Presentation of clinical-tomographic correlation in 111 cases of non tumoral intracranial expansive processes seen between 1984-1988 in the Hospital Cayetano Heredia (Lima, Peru). Emphasis is given fundamentally to: (1) the importance of stablishing the or-ganicity of partial and late epilepsy; (2) the high incidence rate of inflammatory infectious processes with CNS compromise in underdeveloping countries; (3) the necessity of making public the importance of two parisitic diseases in the differential diagnosis of non tumoral intracranial expansive processes: free living amebiasis, and toxoplasmosis (especially in association with AIDS).
Secondary bilateral synchrony associated to a parasagittal tumor case report
Authors: Cukiert A. , Gronich G. , Marino Jr. R.
Published: April 2011

A 32 years old woman who had postural limbic and primarily generalized tonic-clonic seizures since the age of 11 presented to us with a CT image strongly suggestive of a mesial meningeoma near the right cingulum. Her ictal EEG pattern was characterized by regular 1.5-2.0 Hz sharp and slow wave complexes. A right craniotomy was performed under general anesthesia and intraoperative electroencephalographic and electrocorticographic recordings were obtained by means of scalp steel electrodes and modified cerebellar stimulation electrodes, respectively. These recordings demonstrated that surface spikes were often independent from the electrocorticographically recorded ones. Before tumor excision, electrical stimulation of the peritumoral mesial cortex resulted in an increase in the epileptic activity. The stimulation of the cavity left after tumor excision led to a prolonged electrographic seizure and neurophysiological procedures were stopped. Post-operatively, the patient has remained seizure free for 6 months and her EEG was normal. The pre-, intra- and post-operative findings in this case suggest that the gliotic peritumoral mesial cortex was at least involved in the epileptogenic process.
Adverse prognostic influence of diabetes mellitus and hyperglycemia on the clinical course of brain infarct: a review of its causes with special reference to the pathogenesis of hyperglycemia in the acute phase of stroke
Authors: André Charles , Novis Sérgio Augusto Pereira
Published: April 2011

In non-diabetic patients, the appearance of hyperglycemia in the acute phase of stroke is related to the extension of cellular injury, and hence to the physiologic stress response. In animal models of ischemic insult, the deleterious effects of hyperglycemia depend heavily on the production of lactic acid «via» activation of the glycolitic anaerobic pathway. The abnormal production of lactic acid and consequent tissular acidosis appear mainly in the early post-reperfusion period, or in states of marked but partial reduction of blood flow. A direct reduction of cerebral blood flow and, perhaps, the production of a hyperosmolar state may contribute to worsening of the ischemic injury. In diabetic patients, previous hemoreologic and microcirculatory changes, and a greater susceptibility to infections may additionally reduce the chances of complete recovery after stroke.
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Authors: Marques Júnior Wilson , Herrera Ronaldo Francisco , Barreira Amilton Antunes
Published: April 2011

Em 35 dentre os 209 pacientes (acometidos por neuropatias periféricas não se conseguiu estabelecer o diagnóstico etiológico. A média de idade foi 37,7 anos e a faixa etária preferencialmente acometida, entre 20 e 50 anos. A investigação laboratorial desses pacientes foi mais extensa que a dos com diagnóstico definido. A proporção entre exames laboratoriais normais e anormais foi 11:1. Os diagnósticos topográficos principais foram: poli-neuropatias axonais, 5 casos; multineuropatias e radiculopatias, 3 casos cada. Nossos adiados são discutidos e confrontados aos da literatura em relação às neuropatias de diagnóstico indefinido.
Cysticercosis of the central nervous system and cerebrospinal fluid immunodiagnosis of 1573 patients in 63 years (1929-1992)
Authors: Spina-França A. , Livramento J.A. , Machado L.R.
Published: April 2011

Attention given to prophylaxis of neurocysiticercosis (NC) is far beyond minimal needs among several regions of the in-development world, and for this reason incidence of the disease persists high among them. This investigation was carried out to show the extent of the problem by analysing the incidence of NC in a region of Brazil (São Paulo). CSF immunodiagnosis of NC by detecting antibodies to Cysticercus cellulosae in a neurodiag-nostics laboratory is evaluated for this purpose. Cases studied in a 63-year period (1929-1992) are reviewed. Total cases in this period is 139,000, and for 1,573 (1.13%) diagnosis is NC. Special characteristics were not detected for colour and sex prevalence. Age bracket prevalence is from 21 to 40 years old (55.3%) high rates occurring for women between 21 to 30 years old, and for men between 31 to 40. Cases distribution in five consecutive decades (1942-1991) shows no decreasing tendency: average incidence is 1% for the 50 years, and it is over this average for the last three decades. Data confirm that incidence continues expressively high throughout the 50 years covered by this study.
Neurocisticercosis en un hospital de la ciudad de Buenos Aires: estudio de once casos
Authors: Villa A. M. , Monteverde D. A. , Rodriguez W. , Boero A. , Sica R. E. P.
Published: April 2011

Fueron examinados 11 pacientes adultos con el diagnostico presuntivo de neuro-cisticercosis, 8 de ellos provenientes de Bolivia y los restantes del interior de la Argentina. Como manifestacion clinica inicial el 82% de ellos mostro convulsiones y el 73% cefaleas. Ambas alteraciones podían estar combinadas en el mismo paciente o presentarse en forma independiente. La tomografia computada de cerebro evidencio calcificaciones y quistes en 5 enfermos, solo calcificaciones en 3, hidrocefalia en 2 y un unico quiste en 1. En 7 casos se efectuo ELISA en el LCR, de ellos 6 resultaron positivos. El tratamiento medico se hizo en base a la administración de praziquantel o albendazol con buena evolución de los pacientes en todos los casos. El tratamiento quirúrgico fue indicado solo en el caso en que una lesion actuase como masa ocupante con aumento de la presión endocraneana (1 caso) o produjera obstruccion de la circulacon del LCR llevando a una hidrocefalia (2 casos). El estudio presente pretende alertar sobre la posibilidad que nuevas regiones, como la Ciudad de Buenos Aires, puedan ingresar dentro del area endemica latinoamericana a consecuencia de los movimientos migratorios internos y externos y el asentamiento de portadores de la parasitosis en el perimetro urbano.
Tendência da mortalidade por doença cerebrovascular no Estado de São Paulo: 1970 a 1989
Authors: Lotufo Paulo Andrade , Lolio Cecília Amaro de
Published: April 2011

OBJETIVO: estudo descritivo da mortalidade proporcional e por coeficientes da doença cerebrovascular (DCbV) na população adulta (20 anos e mais) do Estado de São Paulo. CASUÍSTICA E MÉTODO: a fonte dos dados foi representada pelas tabulações de óbito codificadas pela Fundação Sistema Estadual de Análise de Dados (FSEADE); os dadoa de população foram obtidos dos Censos Demográficos do Brasil de 1970, 1980 e 1991; em todas as séries foi calculada a redução anual dos coeficientes de óbito obtidos nas curvas de regressão. RESULTADOS: a proporção de óbitos por DCbV na mortalidade geral apresentou queda no sexo masculino (M) (- 11,40%) e aumento no sexo feminino (F) (+7,58%); no conjunto das doenças cardiovasculares, apresentou aumento em ambos os sexos, +8,65% (M) e +3,12% (F); os coeficientes de mortalidade ajustados por idade para DCbV apresentaram declínio anual de 1,19% (M) e 1,76% (F) entre 1970 e 1989; as faixas etárias que mais se beneficiaram com o declínio foram as com 60 anos e mais entre os homens e 40 anos e mais entre as mulheres; a Razão de Sobre-mortalidade Masculina apresentou aumento significativo durante o período estudado (22% em 1970 para 45% em 1989), principalmente devido à faixa dos 50-59 anos (36% em 1970 para 69% em 1989). CONCLUSÃO: a queda dos coeficientes por DCbV poderia ser motivada pela maior detecção e controle da hipertensão arterial; outros fatores, como os decorrentes da notificação de óbitos, prevalência da miocardiopatia chagásica, introdução de novos exames diagnósticos e assistência médica, apresentariam papel secundário.
Arachnoid granulation affected by subarachnoid hemorrhage
Authors: Chopard R.P. , Brancalhão R.C. , Miranda-Neto M.H. , Biazotto W.
Published: April 2011

The purpose of this study was to investigate using light microscopy the fibro-cellular components of arachnoid granulations affected by mild and severe subarachnoid hemorrage. The erythrocytes were in the channels delimitated by collagenous and elastic bundles and arachnoid cells, showing their tortuous and intercommunicating row from the pedicle to the fibrous capsule. The core portion of the pedicle and the center represented a principal route to the bulk outflow of cerebrospinal fluid and erythrocytes. In the severe hemorrhage, the fibrocellular components are desorganized, increasing the extracellular channels. We could see arachnoid granulations without erythrocytes, which cells showed big round nucleous suggesting their transformation into phagocytic cells.