bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatio-temporal analysis of the urban–rural gradient structure: an application in a Mediterranean mountainous landscape (Serra San Bruno, Italy)
Authors: Modica G. , Vizzari M. , Pollino M. , Fichera C. R. , Zoccali P. , Di Fazio S.
Published: December 2012

Abstract. The most recent and significant transformations of European landscapes have occurred as a consequence of a series of diffused, varied and often connected phenomena: urban growth and sprawl, agricultural intensification in the most suitable areas and agricultural abandonment in marginal areas. These phenomena can affect dramatically ecosystems' structure and functioning, since certain modifications cause landscape fragmentation while others tend to increase homogeneity. Thus, a thorough comprehension of the evolution trends of landscapes, in particular those linked to urban-rural relations, is crucial for a sustainable landscape planning. In this framework, the main objectives of the present paper are: (a) to investigate Land Use/Land Cover (LULC) transformations and dynamics that occurred over the period 1955–2006 in the municipality of Serra San Bruno (Calabria, Italy), an area particularly representative of the Mediterranean mountainous landscape; (b) to compare the settlement growth with the urban planning tools in charge in the study area; (c) to examine the relationship between urban–rural gradient, landscape metrics, demographic and physical variables; (d) to investigate the evolution of urban–rural gradient composition and configuration along significant axes of landscape changes. Data with a high level of detail (minimum mapping unit 0.2 ha) were obtained through the digitisation of historical aerial photographs and digital orthophotos identifying LULC classes according to the Corine Land Cover legend. The investigated period was divided into four significant time intervals, which were specifically analysed to detect LULC changes. Differently from previous studies, in the present research the spatio-temporal analysis of urban–rural gradient was performed through three subsequent steps: (1) kernel density analysis of settlements; (2) analysis of landscape structure by means of metrics calculated using a moving window method; (3) analysis of composition and configuration of the urban–rural gradient within three landscape profiles located along significant axes of LULC change. The use of thematic overlays and transition matrices enabled a precise identification of the LULC changes that had taken place over the examined period. As a result, a detailed description and mapping of the landscape dynamics were obtained. Furthermore, landscape profiling technique, using continuous data, allowed an innovative and valuable approach for analysing and interpreting urban–rural gradient structure over space and time.
A novel technique to detect special nuclear material using cosmic rays
Authors: Thomay C. , Baesso P. , Cussans D. , Davies J. , Glaysher P. , Quillin S. , Robertson S. , Steer C. , Vassallo C. , Velthuis J.
Published: December 2012

Abstract. Resistive plate chambers (RPCs) are widely used in high energy physics for both tracking and triggering purposes, due to their excellent time resolution, rate capability, and good spatial resolution. RPCs can be produced cost-effectively on large scales, are of rugged build, and have excellent detection efficiency for charged particles. Our group has successfully built a muon scattering tomography (MST) prototype, using 12 RPCs to obtain tracking information of muons going through a target volume of ∼ 50 cm × 50 cm × 70 cm, reconstructing both the incoming and outgoing muon tracks. The required spatial granularity is achieved by using 330 readout strips per RPC with 1.5 mm pitch. The RPCs have shown an efficiency above 99% and an estimated intrinsic resolution below 1.1 mm. Due to these qualities, RPCs serve as excellent candidates for usage in volcano radiography.
McMaster Mesonet soil moisture dataset: description and spatio-temporal variability analysis
Authors: Kornelsen K. C. , Coulibaly P.
Published: December 2012

Abstract. This paper introduces and describes the hourly high resolution soil moisture dataset continuously recorded by the McMaster Mesonet located in the Hamilton-Halton Watershed in Southern Ontario, Canada. The McMaster Mesonet consists of a network of time domain reflectometer (TDR) probes collecting hourly soil moisture data at six depths between 10 cm and 100 cm at nine locations per site spread across four sites in the 1250 km2 watershed. The sites for the soil moisture arrays are designed to further improve understanding of soil moisture dynamics in a cold and snowy climate and to capture soil moisture transitions in areas that have different topography, soil and land-cover. The McMaster Mesonet soil moisture constitutes a unique database in Canada because of its high spatio-temporal resolution. In order to provide some insight into the dominant processes at the McMaster Mesonet sites a spatio-temporal and temporal stability analysis were conducted to identify spatio-temporal patterns in the data and to suggest some physical interpretation of soil moisture variability. It was found that the seasonal Canadian climate causes a transition in soil moisture patterns at seasonal time scales. During winter and early spring months, and at the meadow sites, soil moisture distribution is governed by topographic redistribution, whereas following efflorescence in the spring and summer, soil moisture spatial distribution at the forested site was equally dominated by vegetation canopy. Analysis of short-term temporal stability revealed that the relative difference between sites was maintained unless there was significant rainfall (> 20 mm) or wet conditions a priori. Following a disturbance in the spatial soil moisture distribution due to wetting, the relative soil moisture pattern re-emerged in 18 to 24 h. Access to the McMaster Mesonet data can be provided by visiting http://www.hydrology.mcmaster.ca.
Simulation of hydrological processes in the Zhalong Wetland within a river basin, Northeast China
Authors: Feng X. Q. , Zhang G. X. , Jun Xu Y.
Published: December 2012

Abstract. Zhalong National Nature Preserve is a large wetland reserve on the Songnen Plain in Northeast China. Wetlands in the preserve play a key role in maintaining regional ecosystem function and integrity. Global climate change and intensified anthropogenic activities in the region have raised great concerns over the change of natural flow regime, wetland degradation and losses. In this study, two key hydrologic components in the preserve, open water area and storage, as well as their variations during the period 1985–2006 were investigated with a spatially-distributed hydrologic modeling system, SWAT. A wetland module was incorporated into the SWAT model to represent hydrological linkages between the wetland and adjacent upland areas. The modified modeling system was calibrated with streamflow measurements from 1987 to 1989, in a Nash efficiency coefficient (Ens) of 0.86, and was validated for the period 2005–2006, in an Ens of 0.66. In the past 20 yr, open water area in the Zhalong Wetland fluctuated from approximately 200 km2 to 1145 km2 with a rapid decreasing trend through the early 2000s. Consequently, open water storage in the preserve decreased largely, especially in the dry seasons. The situation changed following the implementation of a river diversion in 2001. Overall, the modeling yielded plausible estimates of hydrologic changes in this large wetland reserve, building a foundation for assessing ecological water requirements and developing strategies and plans for water resources management within the river basin.
Seismic capacity evaluation of unreinforced masonry residential buildings in Albania
Authors: Bilgin H. , Korini O.
Published: December 2012

Abstract. This study evaluates seismic capacity of the unreinforced masonry buildings with the selected template designs constructed per pre-modern code in Albania considering nonlinear behaviour of masonry. Three residential buildings with template designs were selected to represent an important percentage of residential buildings in medium-size cities located in seismic regions of Albania. Selection of template designed buildings and material properties were based on archive and site survey in several cities of Albania. Capacity curves of investigated buildings were determined by pushover analyses conducted in two principal directions. The seismic performances of these buildings have been determined for various earthquake levels. Seismic capacity evaluation was carried out in accordance with FEMA (Federal Emergency Management Agency) 440 guidelines. Reasons for building damages in past earthquakes are examined using the results of capacity assessment of investigated buildings. It is concluded that of the residential buildings with the template design, with the exception of one, are far from satisfying required performance criteria. Furthermore, deficiencies and possible solutions to improve the capacity of investigated buildings are discussed.
Net accumulation rates derived from ice core stable isotope records of Pío XI glacier, Southern Patagonia Icefield
Authors: Schwikowski M. , Schläppi M. , Santibañez P. , Rivera A. , Casassa G.
Published: December 2012

Abstract. Pío XI, the largest glacier of the Southern Patagonia Icefield, reached its neoglacial maximum extent in 1994 and is one of the few glaciers in that area which is not retreating. In view of the recent warming it is important to understand glacier responses to climate changes. Due to its remoteness and the harsh conditions in Patagonia, no systematic mass balance studies have been performed. In this study we derived net accumulation rates for the period 2000 to 2006 from a 50 m (33.2 4 m weq) ice core collected in the accumulation area of Pío XI (2600 m a.s.l., 49°16´40´´ S, 73°21´14´´ W). Borehole temperatures indicate near temperate ice, but the average melt percent is only 16% ± 14%. Records of stable isotopes are well preserved and were used for identification of annual layers. Net accumulation rates range from 3.4 to 7.1 water equivalent (m weq) with an average of 5.8 m weq, comparable to precipitation amounts at the Chilean coast, but not as high as expected for the Icefield. Ice core stable isotope data correlate well with upper air temperatures and may be used as temperature proxy.
The Arctic Sea ice in the CMIP3 climate model ensemble – variability and anthropogenic change
Authors: Behrens L. K. , Martin T. , Semenov V. A. , Latif M.
Published: December 2012

Abstract. The strongest manifestation of global warming is observed in the Arctic. The warming in the Arctic during the recent decades is about twice as strong as in the global average and has been accompanied by a summer sea ice decline that is very likely unprecedented during the last millennium. Here, Arctic sea ice variability is analyzed in the ensemble of CMIP3 models. Complementary to several previous studies, we focus on regional aspects, in particular on the Barents Sea. We also investigate the changes in the seasonal cycle and interannual variability. In all regions, the models predict a reduction in sea ice area and sea ice volume during 1900–2100. Toward the end of the 21st century, the models simulate higher sea ice area variability in September than in March, whereas the variability in the preindustrial control runs is higher in March. Furthermore, the amplitude and phase of the sea ice seasonal cycle change in response to enhanced greenhouse warming. The amplitude of the sea ice area seasonal cycle increases due to the very strong sea ice area decline in September. The seasonal cycle amplitude of the sea ice volume decreases due to the stronger reduction of sea ice volume in March. Multi-model mean estimates for the late 20th century are comparable with observational data only for the entire Arctic and the Central Arctic. In the Barents Sea, differences between the multi-model mean and the observational data are more pronounced. Regional sea ice sensitivity to Northern Hemisphere average surface warming has been investigated.
Adjuvant Effect of Microencapsulated NOD Ligands Studied in a Human Phagocytic Cell Line
Authors: Mathew Simi , Toch Toralf , Frentsch Marco , Lendlein Andreas , Wischke Christian
Published: December 2012

Background

Modern subunit vaccines, which are of high purity compared with traditional vaccines, are often incapable of inducing strong immune responses as necessary to build an immunological memory. The desired level of immune response can be achieved only by codelivering immune-modulating agents along with the antigenic epitopes present in these high-purity formulations. This study aimed to explore the adjuvant effect of nucleotide oligomerization domain (nod) receptor agonists as immunomodulators encapsulated in polymeric microparticles as carriers.

Methods

Microparticles (MP) prepared from poly[(rac-lactide)-co-glycolide] (PLGA) (Mn = 5 kDa, PD = 3.2) by the water-in-oil-in-water (w/o/w) emulsion/solvent evaporation technique were characterized in terms of size, surface morphology, payload and endotoxin content. As NOD agonists, N-acetylmuramyl–L-alanyl–D-isoglutamine (MDP; NOD 2) and γ-d-glutamyl-meso-diaminopimelic acid (iE-DAP; NOD 1) were encapsulated. The immunomodulatory potential of these ligand-loaded MP was evaluated with a human acute monocytic leukemia cell line (THP-1X Blue-CD14 cells).

Results

The MP prepared had a phagocytosable size (<10 μm) with a unimodal size distribution and low endotoxin content (<0.5 EU/mL). A dose-dependent cell activation could be established for MDP-loaded microparticles.

Conclusions

MP with suitable characteristics for phagocytosis can be prepared and loaded with NOD agonists. The capability of these ligand-loaded microparticles to activate monocytes suggests their broader exploration as vaccine carriers.
Influence of Different Heating Regimes on the Shape-Recovery Behavior of Poly(L-Lactide) in Simulated Thermomechanical Tests
Authors: Ghobadi Ehsan , Heuchel Matthias , Kratz Karl , Lendlein Andreas
Published: December 2012

Aim

Multifunctional polymer-based biomaterials, which combine degradability with a shape-memory capability and in this way enable the design of actively moving implants such as self-anchoring implants or controlled release systems, have been recently introduced. Of particular interest are approved degradable polymers such as poly(L-lactide) (PLLA), which can be easily functionalized with a shape-memory effect. In the case of semicrystalline PLLA, the glass transition can be utilized as shape-memory switching domain.

Methods

In this work we applied a fully atomistic molecular dynamics simulation to study the shape-memory behavior of PLLA. A heating-deformation-cooling programming procedure was applied to atomistic PLLA packing models followed by a recovery module under stress-free conditions allowing the shape recovery. The recovery was simulated by heating the samples from Tlow = 250 K to Thigh = 500 K with different heating rates β of 125, 40 and 4 K·ns−1.

Results

We could demonstrate that the obtained strain recovery rate (Rr) was strongly influenced by the applied simulation time and heating rate, whereby Rr values in the range from 46% to 63% were achieved. On its own the application of a heating rate of 4 K·ns−1 enabled us to determine a characteristic switching temperature of Tsw = 473 K for the modeled samples.

Conclusions

We anticipate that the atomistic modeling approach presented should be capable of enabling further study of Tsw with respect to the molecular structure of the investigated SMP and therefore could be applied in the context of design and development of new shape-memory (bio)materials.
Antiangiogenic Therapy of Colorectal Cancer: State of the Art, Challenges and New Approaches
Authors: Sarmiento Roberta , Longo Raffaele , Gasparini Giampietro
Published: December 2012

Advanced colorectal cancer is the first tumor type for which an antiangiogenic agent, namely bevacizumab, has been approved by the Food and Drug Administration for therapy in humans; it has been in use since February 2004. This review paper summarizes and discusses the results obtained with this agent and highlights the main open or controversial issues on antiangiogenic therapy, taking into account that the clinical results obtained are below the expectations, particularly in the adjuvant setting.
The Influence of Process Conditions on the Chemical Composition of Pine Wood Catalytic Pyrolysis Oils
Authors: Pereira J. , Agblevor F. A. , Beis S. H.
Published: December 2012

Pine wood samples were used as model feedstock to study the properties of catalytic fast pyrolysis oils. The influence of two commercial zeolite catalysts (BASF and SudChem) and pretreatment of the pine wood with sodium hydroxide on pyrolysis products were investigated. The pyrolysis oils were first fractionated using column chromatography and characterized using GC-MS. Long chain aliphatic hydrocarbons, levoglucosan, aldehydes and ketones, guaiacols/syringols, and benzenediols were the major compounds identified in the pyrolysis oils. The catalytic pyrolysis increased the polycyclic hydrocarbons fraction. Significant decreases in phthalate derivatives using SudChem and long chain aliphatics using BASF catalyst were observed. Significant amounts of aromatic heterocyclic hydrocarbons and benzene derivatives were formed, respectively, using BASF and SudChem catalysts. Guaiacyl/syringyl and benzenediols derivatives were partly suppressed by the zeolite catalysts, while the sodium hydroxide treatment enriched phenolic derivatives. Zeolite catalyst and sodium hydroxide were employed together; they showed different results for each catalyst.
Long-Term Multimodal Exercise Program Enhances Mobility of Patients with Parkinson’s Disease
Authors: Pereira Marcelo Pinto , Oliveira Ferreira Maria Dilailça Trigueiro de , Caetano Maria Joana Duarte , Vitório Rodrigo , Lirani-Silva Ellen , Barbieri Fabio Augusto , Stella Florindo , Gobbi Lilian Teresa Bucken
Published: December 2012

Objective. This study aimed to evaluate the effect of a long-period multimodal exercise program on balance, mobility and clinical status of patients with Parkinson’s disease (PD). Methods. Thirty-three PD patients were assigned into two groups: a training group (TG—n=22; aged 67.23±8.39 years) and a control group (CG—n=9; aged 71.56±8.50 years). The TG patients were enrolled in a 6-month multimodal exercise program. This program was designed to improve physical capacity components and to reduce PD impairments. Balance and mobility were assessed immediately before and after the training protocol using the Berg Balance Scale (BBS), the “Timed up and go” (TUG), and the Posture Locomotion Test (PLM). Also, clinical variables were assessed (disease stage and impairments). Results. The TG showed an improvement in the TUG (P=0.006) while CG were not influenced by the 6-months period. Both groups showed no differences for BBS and PLM and for their disease impairments—assessed through the Unified Parkinson’s disease Scale. Conclusions. Long-term multimodal exercise programs are able to improve mobility of patients with Parkinson’s disease and therefore should be used on clinical day life.
Conservation, Compensation, and Evolution of N-Linked Glycans in the HIV-1 Group M Subtypes and Circulating Recombinant Forms
Authors: Travers Simon A.
Published: December 2012

The “glycan shield” exposed on the surface of the HIV-1 gp120envglycoprotein has been previously proposed as a novel target for anti-HIV treatments. While such targeting of these glycans provides an exciting prospect for HIV treatment, little is known about the conservation and variability of glycosylation patterns within and between the various HIV-1 group M subtypes and circulating recombinant forms. Here, we present evidence of strong strain-specific glycosylation patterns and show that the epitope for the 2G12 neutralising antibody is poorly conserved across HIV-1 group M. The unique glycosylation patterns within the HIV-1 group M subtypes and CRFs appear to explain their varying susceptibility to neutralisation by broadly cross-neutralising (BCN) antibodies. Compensatory glycosylation at linearly distant yet three-dimensionally proximal amino acid positions appears to maintain the integrity of the glycan shield while conveying resistance to neutralisation by BCN antibodies. We find that highly conserved clusters of glycosylated residues do exist on the gp120 trimer surface and suggest that these positions may provide an exciting target for the development of BCN anticarbohydrate therapies.
Hysteresis of Isotherms of Mixed Monolayers of N-Octadecyl-N′-phenylthiourea and Stearic Acid at Air/Water Interface
Authors: Sudheesh Siji , Ahmad Jamil , Singh Girija S.
Published: December 2012

Surface pressure area isotherms of Langmuir monolayers formed by spreading mixed solutions of varying concentrations of N-octadecyl-N′-phenylthiourea (OPT) and octadecanoic acid or stearic acid (SA) over air-water interface are described. Examination of the hysteresis behavior and an analysis of the limiting area per molecule of the isotherms show that when the spread solution has an excess of OPT, the limiting surface area is consistent with a monolayer composed of equimolar amounts of the two components. This indicates that any excess thiourea, which on its own does not form a stable monolayer, is squeezed out and is not part of the monolayer. On the other hand, when the spreading mixture has an excess of SA over OPT, the isotherm indicates that the entire originally spread material is incorporated into the surface film. In this case, the values of area/molecule indicate that the monolayer is composed of SA : OPT complex with a ratio of 1 : 1 together with the excess SA remaining in the monolayer.
Peculiarities of Photoluminescence in Porous Silicon Prepared by Metal-Assisted Chemical Etching
Authors: Iatsunskyi Igor , Smyntyna Valentin , Pavlenko Nykolai , Sviridova Olga
Published: December 2012

Photoluminescent (PL) porous layers were formed on p-type silicon by a metal-assisted chemical etching method using H2O2 as an oxidizing agent. Silver particles were deposited on the (100) Si surface prior to immersion in a solution of HF and H2O2. The morphology of the porous silicon (PS) layer formed by this method was investigated by atomic force microscopy (AFM). Depending on the metal-assisted chemical etching conditions, the macro- or microporous structures could be formed. Luminescence from metal-assisted chemically etched layers was measured. It was found that the PL intensity increases with increasing etching time. This behaviour is attributed to increase of the density of the silicon nanostructure. It was found the shift of PL peak to a green region with increasing of deposition time can be attributed to the change in porous morphology. Finally, the PL spectra of samples formed by high concentrated solution of AgNO3 showed two narrow peaks of emission at 520 and 550 nm. These peaks can be attributed to formation of AgF and AgF2 on a silicon surface.
How to Talk to a Roman Student: The Teacher’s Authority in Dionysius of Halicarnassus’sDe compositione uerborum
Authors: Weaire Gavin
Published: December 2012

Dionysius of Halicarnassus’s De compositione uerborum provides an idealized model of the pedagogical relationship between a Greek teacher and his Roman student. A sociolinguistic investigation of passages addressed to the student Metilius Rufus suggests that Dionysius can assert his professional authority only obliquely, and instead resorts to a strategy of "authority substitution" in which he appeals to alternative sources of authority: classical Greek authors and the world of adult aristocratic Roman speech.
Blinding as a Means of Becoming Invisible: Reflections on the Context ofP.Oxy. LVIII.3931
Authors: Phillips Richard L.
Published: December 2012

This article proposes a new interpretation of P.Oxy. LVIII.3931, a blinding ritual for achieving invisibility. The discussion explores how previous scholars have translated the verb ἐπ̣ιπορεύομαι in line 9 of the text. Although prior editors have read it as either "I shall press hard" or "I travel forth," here the case is made for interpreting it as ἐπ̣(ε)ὶ πορεύομαι, "when I go forth." Such an interpretation is consistent with other invisibility spells whose context for invisibility is open-ended, but which also include phrases or clauses referencing the time or circumstance under which the newly acquired invisibility is said to function.
Homer in the Late Antique Commentary on Statius’sThebaid
Authors: Smith R. Scott
Published: December 2012

This paper seeks to determine the extent to which the commentator of the late antique commentary on Statius’s Thebaid knew Homer and to establish the main sources for that Homeric knowledge. The article identifies three main ways that the commentator had access to the "supreme classical poet": (1) memory (forged by early study of Homer), (2) lexica and encyclopedias, and (3) Vergilian scholarship. Analysis of these three areas indicates that the commentator had only limited familiarity with Homer’s poems and that he likely had not read Homer since schooling.
A AIDS como condição crônica e o papel do Médico de Família e Comunidade e da Estratégia Saúde da Família
Authors: Santos Alessandra Fátima de Mattos , Deveza Michael
Published: December 2012

A Organização Mundial de Saúde estima que em 2007 havia 30 a 36 milhões de pessoas vivendo com o vírus HIV e 2 milhões de mortesrelacionadas à AIDS neste mesmo período. É necessário para a estratégia do enfrentamento da epidemia: conhecer áreas adscritas, buscarcuidar de forma integral de uma pessoa, considerando seu contexto familiar e comunitário, suas relações interpessoais e de trabalho. Aestratégia de saúde que preenche todos os requisitos descritos é a medicina de família e comunidade. Esperamos identificar o conceitoda integralidade enquanto ferramenta utilizada pelo médico de família e comunidade na abordagem ao paciente com HIV e AIDS. Para ocontrole da epidemia através da prevenção e adesão ao tratamento medicamentoso é necessária uma abordagem integral aos pacientesvivendo com HIV/AIDS.
Um Melanoma “mascarado”
Authors: Rego Cláudia Sofia , Silva Ana Luísa , Ribeiro Elias
Published: December 2012

O melanoma é um tumor que se desenvolve como resultado da transformação maligna dos melanócitos, estimando-se a sua incidência global em 132.000 casos/ano. Este relato de caso reporta-se a um doente do sexo masculino com 70 anos, história de Diabetes Mellitus tipo 2 há dez anos e psoríase vulgar extensa há seis anos. Em aproximadamente um ano, este desenvolveu lesão ulcerada da região plantar do pé direito, que ao exame histológico revelou melanoma maligno, ulcerado, nível V de Clark, com 5,6 mm de espessura (Breslow). Foi submetido à exérese cirúrgica da lesão e biópsia de gânglio sentinela que foi negativa. O estadiamento inicial revelou evolução avançada do tumor primário (TNM IIC). Exames imagiológicos detetaram metastização gástrica, reclassificando a doença num estádio TNM IV. O melanoma maligno pode ser de difícil diagnóstico como se pode constatar neste caso em que uma ulceração plantar foi avaliada tardiamente, atrasando o diagnóstico de uma neoplasia grave e com elevada taxa de mortalidade.
AMQ e POA: diferenças e semelhanças na avaliação da Estratégia de Saúde da Família
Authors: Franco Camila Ament Giuliani dos Santos , Faoro Nilza Teresinha , Kami Maria Terumi Maruyama , Volpi Ademar Cezar
Published: December 2012

Introdução: Instituída pelo Ministério da Saúde (MS), a Avaliação para Melhoria da Qualidade (AMQ) é um instrumento de avaliação e aperfeiçoamento das equipes da Estratégia de Saúde da Família (ESF). A Secretaria Municipal da Saúde de Curitiba conta, desde 2002, com o Plano Operativo Anual (POA) que é uma estratégia de gestão voltada para resultados, aprimoramento, planejamento e avaliação. Este instrumento é composto por 81 indicadores. Assim, o município do estudo conta com duas formas de avaliação de qualidade em todas as suas Unidades de Saúde da Família. O objetivo deste trabalho foi analisar as concordâncias e discordâncias entre o POA e o AMQ nos programas da saúde da criança, adolescente, mulher, diabéticos, hipertensos e saúde mental. Metodologia: Participaram do estudo 12 equipes de Saúde da Família. Para realizar a comparação foram levantados os indicadores que estavam presentes tanto no AMQ (instrumento cinco) quanto no POA-2010. Após as comparações foram realizadas porcentagens simples e análise das discordâncias. Resultados: Ao total, 28 indicadores estavam presentes tanto na AMQ como no POA. No geral houve concordância de respostas em 53,6%. Na avaliação da AMQ, 82% das respostas foram consideradas totalmente adequadas para o item avaliado, enquanto na avaliação realizada pelo POA este índice caiu para 46,4%. Conclusão: Observou-se discordância entre os itens comparados da AMQ e do POA. Alguns fatores podem ser responsáveis pela discordância entre eles: a utilização de dados recuperados automaticamente através das ações registradas pela equipe no prontuário eletrônico no POA e a obrigatoriedade da sua realização. Além disso, a realização facultativa da AMQ e a não parametrização das respostas (SIM x NÃO) podem contribuir para a divergência das respostas.
Avaliação das ações estratégicas na atenção à saúde do idoso em Unidades Básicas de Saúde de Teresina-PI
Authors: Luz Larissa Almondes da , Futino Marilia Ione , Luz Emanuela Almondes da , Martins Gabriella Miranda , Barbosa Emanuelle Pires Magalhães , Rocha Lamartine de Moura
Published: December 2012

A cada ano, cerca de 650 mil novos idosos são incorporados à população surgindo a necessidade de reorganizar os modelos sociais para atender à saúde no envelhecimento como uma prioridade, os quais visam recuperar, manter e promover autonomia e independência, direcionando medidas coletivas e individuais de saúde para esse fim. O objetivo desta pesquisa foi avaliar as ações estratégicas na atenção à saúde do idoso em Unidades Básicas de Saúde (UBS) de Teresina-PI. Realizado estudo observacional transversal, através da aplicação de questionários de Avaliação para Melhoria da Qualidade da Estratégia Saúde da Família Modificado - Cadernos de Autoavaliação 4 e 5 - Equipe Saúde da Família – Parte II – SAÚDE DE IDOSOS, aplicados aos representantes da diretoria colegiada de 20 UBS de Teresina-PI, após assinatura de TCLE, conforme resolução 196/96, observou-se que 70% das UBS desenvolvem ações coletivas; 60% desenvolvem atividades educativas; 100% apresentam registro dos idosos atualizado; 95% apresentam vacinação em dia; 50% apresentam exame da cavidade oral como rotina; 70% negam acompanhamento pela Saúde Bucal; 70% apresentam exame da superfície corporal como rotina; 60% intervém na capacitação de cuidadores domiciliares; 65% intervém na detecção precoce de demências; 80% dos profissionais conhecem a Política Nacional de Saúde da Pessoa Idosa (PNSPI); 80% negam capacitação para desenvolvimento das ações da PNSPI; 65% não atuam na identificação de incapacidades. Concluiu-se através da avaliação das ações estratégicas na atenção à saúde do idoso que há déficits que se correlacionam com a prática profissional no âmbito interno das UBS de Teresina-PI.
A RBMFC de cara nova
Authors: Lermen Junior Nulvio
Published: December 2012

Caros leitores, É com grande satisfação que tenho a honra de escrever o editorial da primeira edição da Revista Brasileira de Medicina de Família e Comunidade a ir para impressão sob a gestão da nova diretoria da Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC) para o período de 2012 a 2014.Esta edição marca o início de grandes mudanças na RBMFC, a começar pela alteração de editor. O Dr. Marcelo Demarzo nos deixa depois de um produtivo período à frente da revista para se dedicar aos seus estudos de Pós-Doutorado no exterior, sendo substituído pelo Dr. Armando Henrique Norman.O Dr. Armando Henrique Norman é médico graduado pela Universidade Federal do Paraná, com residência em Medicina Geral e Comunitária (antigo nome da especialidade Medicina de Família e Comunidade) pela Pontifícia Universidade Católica do Paraná, mestre em Antropologia Médica pela Universidade de Durham (Reino Unido) e assume o desafio de guiar a RBMFC nesse processo de transformação.Nos próximos meses, esperamos que vocês gradualmente passem a ter uma nova experiência na leitura da RBMFC, tanto na questão da modernização do processo editorial (o qual buscaremos que seja cada vez mais voltado para as novas mídias eletrônicas, facilitando assim o acesso a todos os nossos leitores que estejam conectados à rede) quanto no que concerne ao conteúdo que passará a ter um foco mais voltado para a atualização clínica do Médico de Família e Comunidade (MFC). Desse modo, a RBMFC tem como principal objetivo ser uma fonte de busca preferencial para o aperfeiçoamento contínuo dos profissionais atuantes na Atenção Primária à Saúde (APS) e nas equipes da Estratégia Saúde da Família (ESF).Esperamos a contribuição de todos, seja no envio de trabalhos para possível publicação, seja na participação no processo de revisão editorial, ou ainda na simples leitura e envio de comentários visando o aperfeiçoamento do nosso trabalho. Um grande abraço a todos.
Prevalência de Síndrome Metabólica em uma área rural de Santa Rosa
Authors: Haab Roger Silveira , Benvegnú Luís Antônio , Fischer Ediléia Venske
Published: December 2012

Síndrome Metabólica (SM) é uma condição de prevalência elevada e crescente. Este artigo tem como objetivo descrever os determinantes e também a prevalência deste importante fator de risco para doenças cardiovasculares em uma área rural do município de Santa Rosa. Foi realizado um estudo transversal, em uma população de abrangência da Estratégia Saúde da Família, constituída de adultos jovens na faixa etária de 20 a 49 anos. Foi aplicado um questionário pré-codificado com variáveis sociodemográficas, comportamentais, histórico pessoal e familiar de doenças crônicas, bem como obtidas medidas antropométricas e laboratoriais pertinentes. Para a classificação da Síndrome Metabólica, esta pesquisa seguiu os critérios da National Cholesterol Education Program’s Adult Treatment Panel (NCEP/ATP III) e da International Diabetes Federation. Foram descritos componentes isolados da SM, encontrando alta prevalência de obesidade abdominal e HDL - colesterol baixo em mulheres, bem como alta prevalência de níveis pressóricos aumentados em homens. A prevalência global da SM encontrada foi de 8,5% em homens e 22% em mulheres pelos critérios da NCEP/ATP III, e 15,9% em homens e 25,3% em mulheres pelos critérios da IDF.
Cobertura vacinal real do esquema básico para o primeiro ano de vida numa Unidade de Saúde da Família
Authors: Carneiro Sandra Maria Magalhães Villela , Lessa Simone Schwartz , Guimarães João Alfredo Lins , Loepert Marina Moraes , Silva Diego Barbosa da
Published: December 2012

Objetivos: Avaliar a cobertura vacinal real do esquema básico para o primeiro ano de vida numa Unidade de Saúde da Família de Maceió-AL. Métodos: Estudo do tipo transversal com amostragem do tipo não probabilística no qual foi aplicado questionário através do responsável de todas as crianças maiores de 12 e menores de 24 meses. A carteira de vacinação foi utilizada como fonte de informação. Considerou-se completado o esquema básico, a criança que recebeu a dose das vacinas na idade e intervalos corretos. As variáveis categóricas foram dispostas em proporções. Foram calculados média e desvio padrão para as variáveis numéricas. As diferenças nas proporções das variáveis entre os grupos de crianças com CV adequada e não adequada foram medidas através do teste do Quiquadrado de Pearson% (p < 0,05). Resultados: Obteve-se uma amostra de 66 crianças, das quais, 24,2% (n = 16) completaram o esquema básico de vacinação. Foi observado que 63,6% das crianças haviam apresentado algum tipo de morbidade nos três meses que antecederam a entrevista. A média de número de moradores foi de 4,7 ± 1,8, enquanto que o número médio de irmãos foi de 1,0 ± 1,0. Verificou-se que 75,8% (n = 50) das crianças faziam parte das classes C2 ou D. A média de idade do responsável foi de 30,53 ± 11, variando de 16 a 62 anos. Conclusões: A cobertura para cada uma das vacinas foi sempre maior que a cobertura para o esquema completo. Verificou-se que parcela significativa das crianças desta pesquisa não recebeu todas as doses preconizadas, nas idades adequadas e com os intervalos corretos. Portanto, a unidade necessita aprimorar seus procedimentos técnicos e administrativos a fim de garantir a plenitude da cobertura vacinal em data oportuna.
A educação ambiental como estratégia da Atenção Primária à Saúde
Authors: Pereira Carlos Alexandre Rodrigues , Melo Juliana Valéria de , Fernandes André Luis Teixeira
Published: December 2012

A Educação Ambiental não deve discutir somente o meio ambiente físico, mas também deve contextualizar a saúde local, destacando os cuidados com a prevenção de doenças e gestão dos fatores ambientais deletérios a saúde. Objetivo: Este trabalho teve como objetivo avaliar a eficácia da Educação Ambiental como estratégia da Atenção Primária à Saúde (APS) num pequeno núcleo urbano isolado no Município de Uberaba. Método: Foi realizado um diagnóstico socioambiental no período de agosto/2009 a janeiro/2010 por meio da aplicação de questionário semiestruturado de pesquisa quantitativa e qualitativa sobre saúde, meio ambiente e desenvolvimento social. Com base nos resultados do diagnóstico, foram elaboradas atividades que envolveram reuniões, palestras e eventos culturais que discutiam os problemas verificados no diagnóstico. A avaliação da eficácia das intervenções foi realizada por meio da verificação de ações comunitárias que surgiram após as atividades. Resultados: Obteve-se a mobilização da Secretaria Municipal de Saúde quanto à qualidade da água de consumo humano e a mobilização comunitária na organização e enfrentamento dos problemas vivenciados, relacionados à educação, assistência médica e representação comunitária. Essas ações não se devem exclusivamente ao trabalho de educação realizado, mas foram motivadas e incentivadas por ele. Conclusão: Verifica-se que a Educação Ambiental é uma estratégia viável para a Atenção Primária à Saúde que pode ter alcance comunitário e trabalhar questões socioambientais que interferem na condição de saúde das pessoas.
Qualidade em serviços públicos: os desafios da Atenção Primária
Authors: Savassi Leonardo Cançado Monteiro
Published: December 2012

O Ministério da Saúde brasileiro sinalizou uma política de avaliação da qualidade da Atenção Primária através da portaria 1.654, de 19/07/2011. Toda mudança organizacional interfere na cultura de qualquer instituição, especialmente quando esta mudança está direcionada para o tema da qualidade. Ela envolve processos, meios internos e pessoas, e não pode ser artificialmente produzida pela força da caneta. No setor saúde, a gestão baseada na qualidade envolve mudanças de foco de atuação e de tecnologias, apoiadas no resgate da relação profissional-paciente, na forma de remuneração de médicos e equipes, na qualificação e capacitação dos profissionais, na qualificação da própria gestão e na participação ativa dos profissionais da saúde na pactuação destas metas e parâmetros de qualidade. Outros instrumentos de avaliação da qualidade já foram implantados no âmbito da Atenção Primária no subsistema público de saúde, e seu seguimento foi interrompido. Qualificar a Atenção Primária passa não apenas pela avaliação, mas pela seleção de profissionais capacitados, qualificação da prestação de serviços, monitorização de resultados e  valorização dos profissionais de saúde envolvidos com a nova cultura.
Ser médico de (sua) família...
Authors: Santos José Agostinho
Published: December 2012

Poderá a relação médico-paciente somar-se a uma relação familiar, com benefício para a pessoa, em determinadas situações clínicas? Luís tem 59 anos e um filho, Abel, médico de família. Perante um quadro de perda de peso e adenomegalias, Abel percebe estar diante de um cenário clínico com elevado grau de suspeição. Relembra as mudanças comportamentais anteriores assumidas por Luís. Todas elas foram iniciadas após o aconselhamento médico pelo filho. Abel identifica o medo de Luís em iniciar qualquer investigação na sua saúde e reconhece a solidez e a confiança fornecidas pela afetividade entre pai e filho numa relação que começara de forma casual e imprevista. Ao contrário do que sempre pensara fazer, Abel assumiu-se como médico do seu próprio pai. O diagnóstico viria a revelar um adenocarcinoma gástrico. O impacto da transmissão das más noticias e do sofrimento na pessoa pôde ser atenuado por  ter sido realizado pelo filho médico.
Avaliação genética itinerante de crianças e adolescentes com deficiência vinculadas à Estratégia Saúde da Família
Authors: Vieira Daniela Koeller Rodrigues , Horovitz Dafne Dain Gandelman , Llerena Júnior Juan Clinton
Published: December 2012

As doenças genéticas atingem cerca de 3% a 10% da população e podem levar a problemas de saúde crônicos e deficiências. O objetivo deste trabalho foi descrever uma experiência nacional inédita de assistência na área da genética clínica por meio de uma equipe itinerante de especialistas que avaliou pacientes selecionados pela atenção primária a partir da ficha complementar de cadastro de pessoas com deficiências. Foi realizado estudo descritivo e transversal dos pacientes identificados a partir da ficha complementar de cadastro de pessoas com deficiências, avaliados pela equipe em 2005, 2008 e 2009, num total de 324 famílias. A etiologia da deficiência foi definida como genética em 38% dos casos e ambiental em 32,7%. A prevalência de malformações congênitas foi de 31,8%. A utilização da ESF como porta de entrada ampliou o acesso a serviços de alta complexidade para pessoas com doenças de origem genética, defeitos congênitos e deficiências. Os resultados expõem a necessidade de interiorização da genética médica e suas interfaces com a atenção primária, reforçando a importância da implementação de políticas de saúde nesta área.
Crying patients in General/Family Practice: incidence, reasons for encounter and health problems
Authors: Gérvas Juan , Pastor-Sánchez Raimundo , Pérez-Fernández Mercedes
Published: December 2012

Context: Despite evidence demonstrating the benefits of understanding patients, there is a paucity of information about how physicians address psychological and social concerns of patients. No one study has been published about the incidence of crying in General/Family Practice. Objective: To know the incidence of crying in primary care/general practice, and the patients’ characteristics, their reasons for encounter and their health problems. Design: A descriptive, prospective study, of one year, of three general practitioners/family physicians in Madrid, Spain. Setting: primary care (doctors’ office and patients’ home). Subjects: Face to face encounters with crying patients. Main outcome measure: At least one rolling tear. Results: Patients cried in 157 encounters out of a total of 18,627 giving an incidence rate of 8.4 per thousand. More frequent reasons for encounters were: feeling depressed (12.7%), social handicap (mainly social isolation/living alone) (6.4%), relationship problem with partner (5.1%) and feeling anxious (3.2%). More frequent health problems were: depressive disorder (23.6%), anxiety disorder (8.3%), cerebrovascular disease (5.1%) and loss/death of partner (3.8%). Conclusions: Crying in primary care is not uncommon. Reasons for crying cover the whole range of human problems, mainly social and psychological problems.
Revision of the South African endemic bee genus Redivivoides Michener, 1981 (Hymenoptera: Apoidea: Melittidae)
Authors: Kuhlmann Michael
Published: December 2012

The South African endemic bee genus Redivivoides Michener, 1981 is revised and redefined. The genus comprises seven species, six of which are described here as new: Redivivoides capensis sp. nov. ♀♂, R. eardleyi sp. nov. ♀, R. kamieskroonensis sp. nov. ♀, R. karooensis sp. nov. ♀♂, R. namaquaensis sp. nov. ♀♂ and R. variabilis sp. nov. ♀♂. A key to species is provided.
Estimating the Complier Average Causal Effect for Exponential Survival in the Presence of Mid-Trial Switching
Authors: Yang Zihua , Brentnall Adam R. , Cuzick Jack , Sasieni Peter
Published: December 2012

The intention-to-treat (ITT) rate ratio estimator is conservatively biased for the treatment effect among compliers (who stick with their assigned arm) when individuals switch treatment in two-arm randomised trials. In this article we propose simple ways to estimate the complier average causal effect (CACE) with mid-trial switching. The estimators use aggregate data of events and times rather than individualised data. The motivating model considers survival times as exponentially distributed conditional on whether the individual would comply with randomisation. To estimate the CACE the ante-switch treatment effect and the post-switch treatment effect amongst the compliers are combined. Furthermore, we discuss ways of estimating the counterfactual intent-to-treat (ITT) effect, which is defined as the rate ratio if switching was not permitted. This approach might be a useful alternative to CACE estimation, and so a time and event adjustment of the non-compliers data is developed. Finally, simulated switching scenarios are used to illustrate the importance of correcting for informative switching.
Regressions to Monitor Health Care Quality: A User’s Guide and a New Index
Authors: Butler Richard J. , Johnson William G.
Published: December 2012

: While there is a rich literature regarding hospital quality in general, research examining trends in hospital quality using regression analysis of trends are relatively rare. In the presence of the increasing digitalization of hospital data, the wide accessibility of regression software, and the need for real time feedback on ongoing quality of medical care outcomes, this paper presents simple-to-implement techniques for analyzing the quality of health care outcomes. We present graphical illustrations of the techniques discussed, and we also include a SAS appendix with the code to estimate all the models discussed, including a proposed new regression index: the Exchange index. We employ data from Arizona’s acute care hospitals to illustrate uses of our new index.
Two-Part Pattern-Mixture Model for Longitudinal Incomplete Semi-Continuous Toenail Data
Authors: Mian Rajibul Islam , Hasan M. Tariqul
Published: December 2012

Longitudinal data with true zero values, known as longitudinal semi-continuous data, frequently occur in medical, environmental and biological studies. To model longitudinal semi-continuous data, two-part modelling approaches have been widely used in literature. In the first part of the two-part model, binary logistic regression is commonly used after converting the semi-continuous responses to binary responses. In the second part, the semi-continuous data are converted to positive continuous data after removing the true zero values from the responses. Although positive continuous or non-zero values tend to show a positively skewed distribution pattern, in the literature the normal distribution is commonly used to model them. Also, in longitudinal studies, data often suffer individual dropouts as they are collected overtime. In this paper, we propose a two-part pattern-mixture model to analyze longitudinal semi-continuous data with dropouts. In the proposed approach, we use pattern-mixture binary mixed models for the first part and positively continuous pattern-mixture gamma mixed models for the second part. Our approach can accommodate both subject- and time-specific correlation as well as dropout pattern. We also incorporate a computationally efficient estimation method for our models using a penalize quasi-likelihood approach. The proposed method is illustrated with an application to the longitudinal incomplete toenail data