bluuebunny/crossref_metadata_2025 huggingface dataset:
Social protection systems in vulnerable families: their importance for the public health
Authors: Arcos Estela , Sanchez Ximena , Toffoletto Maria Cecilia , Baeza Margarita , Gazmuri Patricia , Muñoz Luz Angélica , Vollrath Antonia
Published: August 2014

OBJECTIVE To analyze the effectiveness of the Chilean System of Childhood Welfare in transferring benefits to socially vulnerable families. METHODS A cross-sectional study with a sample of 132 families from the Metropolitan Region, Chile, stratified according to degree of social vulnerability, between September 2011 and January 2012. Semi-structured interviews were conducted with mothers of the studied families in public health facilities or their households. The variables studied were family structure, psychosocial risk in the family context and integrated benefits from the welfare system in families that fulfill the necessary requirements for transfer of benefits. Descriptive statistics to measure location and dispersion were calculated. A binary logistic regression, which accounts for the sample size of the study, was carried out. RESULTS The groups were homogenous regarding family size, the presence of biological father in the household, the number of relatives living in the same dwelling, income generation capacity and the rate of dependency and psychosocial risk (p ≥ 0.05). The transfer of benefits was low in all three groups of the sample (≤ 23.0%). The benefit with the best coverage in the system was the Single Family Subsidy, whose transfer was associated with the size of the family, the presence of relatives in the dwelling, the absence of the father in the household, a high rate of dependency and a high income generation capacity (p ≤ 0.10). CONCLUSIONS The effectiveness of benefit transfer was poor, especially in families that were extremely socially vulnerable. Further explanatory studies of benefit transfers to the vulnerable population, of differing intensity and duration, are required in order to reduce health disparities and inequalities.
Spatial study of homicide rates in the state of Bahia, Brazil, 1996-2010
Authors: Souza Tiago Oliveira de , Pinto Liana Wernersbach , Souza Edinilsa Ramos de
Published: August 2014

OBJECTIVE To analyze the spatial distribution of homicide mortality in the state of Bahia, Northeastern Brazil. METHODS Ecological study of the 15 to 39-year old male population in the state of Bahia in the period 1996-2010. Data from the Mortality Information System, relating to homicide (X85-Y09) and population estimates from the Brazilian Institute of Geography and Statistics were used. The existence of spatial correlation, the presence of clusters and critical areas of the event studied were analyzed using Moran’s I Global and Local indices. RESULTS A non-random spatial pattern was observed in the distribution of rates, as was the presence of three clusters, the first in the north health district, the second in the eastern region, and the third cluster included townships in the south and the far south of Bahia. CONCLUSIONS The homicide mortality in the three different critical areas requires further studies that consider the socioeconomic, cultural and environmental characteristics in order to guide specific preventive and interventionist practices.
Autonomia no contexto pedagógico: percepção de estudantes de medicina acerca da aprendizagem baseada em problemas
Authors: Smolka Maria Lúcia Rebello Marra , Gomes Andréia Patrícia , Siqueira-Batista Rodrigo
Published: August 2014

Apresentam-se os resultados de uma investigação empírica sobre a percepção de estudantes acerca do processo de construção da autonomia no contexto pedagógico em um curso de Medicina com currículo baseado na Aprendizagem Baseada em Problemas. Trata-se de um estudo de caráter qualitativo e exploratório, em que foram utilizadas entrevistas semiestruturadas. Os resultados apontam boa receptividade/adaptação à ABP, incluindo mudanças nos comportamentos discentes. Porém, questiona-se se essa mudança de postura descrita pelos estudantes representa, efetivamente, uma participação mais ativa na construção do próprio conhecimento - apontando para a autonomia no contexto pedagógico - ou simplesmente uma forma de adaptação ao método.
Avaliando conhecimento em DST de graduandos em medicina segundo a taxonomia de bloom
Authors: Bórnea Eloá Rondi , Gonçalves Aguinaldo , Padovani Carlos Roberto
Published: August 2014

Durante a graduação e o ingresso na especialidade, as avaliações cognitivas são amplamente aplicadas e utilizadas para analisar o aprendizado. Entretanto, nem sempre o instrumento empregado é compatível e suficiente para avaliar os tópicos aprendidos. O objetivo da presente investigação, além de apreender o grau de conhecimento que graduandos de Medicina detêm sobre DST, é investigar a existência de distribuições preferenciais a respeito segundo o gênero. Trata-se de um estudo observacional transversal descritivo de retroanálise. Foi adotada uma bateria de 25 testes de múltipla escolha formulados segundo a tipologia de Bloom, grau de dificuldade, núcleo temático das DST e aplicados a 68 internos do sexto ano. Os resultados registraram distribuição preferencial (p < 0,001) com homogeneidade do alunado em direção à alternativa mais frequente e polarização dos acertos nas categorias Conhecimento e Análise. Esses dados ilustram o modelo de educação médica atual, em que predomina a transmissão de informações ao invés da elaboração e reconstrução do conhecimento, o que tem levado à busca de novas estratégias de ensino e avaliação.
Avaliação do conhecimento da ética médica dos graduandos de medicina
Authors: Godoy Moacir Fernandes de , Ferreira Hanna Rafaela Alves , Pria Otávio Augusto Ferreira Dalla
Published: August 2014

INTRODUÇÃO: Várias escolas de Medicina do País criaram disciplinas para o ensino de Ética Médica, mas o impacto dessa intervenção não tem sido claramente questionado. OBJETIVO: Mensurar o conhecimento referente ao tema Ética Médica adquirido pelos alunos do curso de Medicina da Faculdade de Medicina de São José do Rio Preto (Famerp). MÉTODOS: Trata-se de estudo transversal descritivo. Os graduandos do ano letivo de 2012 responderam a um questionário autoaplicável com 12 questões objetivas, com três opções (verdadeiro, falso, desconhece), elaboradas com base no Código de Ética Médica (CEM). Os dados foram analisados com auxílio da estatística descritiva e inferencial; consideraram-se significantes valores de p ≤ 0,05. RESULTADOS: Dos 387 alunos, 251 responderam ao questionário (64,9%). Houve nítida evolução de conhecimento da primeira para a quarta série, porém, a partir da quarta série, houve estagnação do conhecimento. Além da estagnação observada, houve baixa taxa de acertos na sexta série (56,2%), apesar de ter sido a mais alta. CONCLUSÃO: Há necessidade do ensino formal da Ética Médica durante todos os anos da graduação, já que o modelo atual, com ensino apenas na terceira série, se mostrou ineficaz.
Conhecimentos em atenção pré-hospitalar e suporte básico de vida por estudantes recém-ingressos de medicina
Authors: Maia Evanira Rodrigues , Gonçalves Júnior Jucier , Lima Estelita Pereira , Campos Warner , Jovino Eduarda Monteiro , Fernandes Fernando França , Lacerda Victor Rocha Cabral de
Published: August 2014

Reconhecer sinais iminentes de morte em vítimas de trauma, acidente vascular encefálico e acidentes domésticos constitui parte do Suporte Básico de Vida (SBV), ação fundamental à prática médica. Objetivou-se investigar o conhecimento em manobras no SBV e urgências domiciliares entre estudantes recém-ingressos de Medicina. Estudo quantitativo, analítico e quase-experimental, realizado com estudantes do primeiro semestre 2012.2 do curso de Medicina de universidade pública do Ceará - Campus Cariri em Barbalha (CE), Brasil. Os dados foram coletados em fases. Na primeira etapa, aplicou-se um questionário com 40 perguntas de múltipla escolha sobre manobras de atendimento pré-hospitalar em SBV como pré-teste de forma presencial. A segunda etapa consistiu num minicurso de 20 horas com profissional treinado. Na terceira fase, utilizou-se pós-teste para comparar as questões acertadas antes e depois do curso. Quanto aos conhecimentos adquiridos, houve acréscimo nos temas traumatismo raquimedular, liberação de vias aéreas e cuidados domiciliares. Há necessidade de realizar cursos com maior carga horária para fundamentar uma prática médica centrada nos temas de menor rendimento dos estudantes.
Aproveitamento teórico-prático da disciplina anatomia humana do curso de fisioterapia
Authors: Arruda Rodrigo Moreira , Sousa Cintia Regina Andrade
Published: August 2014

A Anatomia Humana estuda as estruturas do corpo humano e as relações entre elas. Assim, seu ensino a estudantes da área da saúde, incluindo alunos de Fisioterapia, é de extrema importância. É necessário um bom aproveitamento nesta disciplina para se tornar um bom profissional, porém as estratégias de ensino-aprendizagem nesta disciplina têm sido bastante discutidas. Com base nesta premissa, este estudo teve por objetivos avaliar o aproveitamento teórico-prático dos discentes do curso de Fisioterapia na disciplina Anatomia Humana, bem como descrever as facilidades e dificuldades enfrentadas e suas implicações durante o curso. Para tanto, foi elaborado um questionário específico e utilizada também a avaliação dos professores realizada pelo Colegiado de Fisioterapia. O tratamento estatístico foi composto por análise descritiva e correlação de Pearson, sendo os dados analisados pelos programas Microsoft Excel® 2007 e Graphpad Prism®. Não se observou correlação entre desempenho do aluno e grau de satisfação diante de diferentes parâmetros analisados neste trabalho. O estudo revelou que os alunos apresentam aproveitamento satisfatório, mas há grandes insatisfações quanto à forma como a disciplina é conduzida.
Visão de preceptores sobre o processo de ensino-aprendizagem no internato
Authors: Barreto Vitor Hugo Lima , Marco Mario Alfredo De
Published: August 2014

INTRODUÇÃO: Os cursos de Medicina do Brasil oferecem, nos dois últimos anos, o estágio obrigatório nas cinco áreas médicas essenciais, chamado internato. Atualmente, serviços de saúde das redes municipais e estaduais passaram a compor os estágios do internato. OBJETIVO: O presente estudo dedicou-se a conhecer a realidade do internato do curso de Medicina da Universidade Federal de Pernambuco através da perspectiva do preceptor. METODOLOGIA: Trata-se de um levantamento descritivo, de natureza qualitativa, em um corte transversal, aplicado às cinco áreas básicas do internato. Foram realizadas entrevistas com os preceptores coordenadores dos serviços de saúde envolvidos no internato. RESULTADOS: As categorias temáticas mais relevantes para o estudo foram: expectativa do preceptor sobre a formação médica durante o rodízio; modelos de ensino da preceptoria; gestão do ensino e integração ensino-serviço. CONCLUSÕES: O estudo representa um aprofundamento sobre as atividades de ensino nos cenários de prática do internato. As categorias analisadas representam pontos cruciais para o aperfeiçoamento da integração ensino-serviço. Outros estudos deverão abordar as perspectivas do estudante, do professor e do gestor, importantes para complementar as informações obtidas no presente estudo.
Reflexão discente sobre a futura prática médica através da integração com a equipe de saúde da família na graduação
Authors: Makabe Maria Luisa Faria , Maia José Antonio
Published: August 2014

Metodologias ativas de ensino-aprendizagem apontam a necessidade de colocar o aluno em contato com o paciente e suas necessidades desde o início do curso médico. A reflexão sobre a realidade por meio da problematização assume papel fundamental, juntamente com uma visão humanística do paciente, conhecendo, entendendo e respeitando a complexidade deste. Assim, este trabalho teve por objetivo investigar como a inserção longitudinal de estudantes de Medicina em cenários comunitários de Atenção Básica à saúde poderia influenciar sua formação. Mediante entrevistas, observou-se que o contato com a comunidade - particularmente em visitas domiciliárias, acompanhando agentes comunitários de saúde - resultou em profundas reflexões sobre a inserção social dos sujeitos como alunos e futuros profissionais.
Qualidade de cebola minimamente processada em diferentes tipos de cortes
Authors: Antunes Andréa M , Manoel Luciana , Evangelista Regina M , Ono Elizabeth O , Vieites Rogério L
Published: August 2014

A alta perecibilidade da cebola tem limitado seu período de conservação e proporcionado altas perdas pós-colheita. A necessidade em se consumir produtos frescos tem levado o mercado de produtos minimamente processados a um grande aumento. Operações de corte durante o processamento mínimo podem não apenas causar importantes reações bioquímicas nos tecidos da cebola como também afetar sua qualidade sensorial, resultando numa redução da vida pós-colheita do produto. O objetivo deste trabalho foi avaliar a influência de diferentes cortes sobre a qualidade de cebolas minimamente processadas. Cebolas cv. Baia Periforme foram transportadas para o laboratório onde foram selecionadas, limpas, classificadas, descascadas, minimamente processadas em rodelas, raladas e picadas, posteriormente, sanitizadas por 10 minutos em hipoclorito de sódio a 100 mg L-1. O produto foi mantido em bandejas de isopor recobertas com filme de PVC em porções de 80 g e conservadas em câmara fria a 5±1ºC e 85±5% de UR, durante 6 dias. Foram realizadas avaliações físicas, químicas e físico-químicas. O delineamento estatístico utilizado foi inteiramente casualizado com 3 tratamentos e 3 repetições (grupo parcela) e 5 repetições para grupo controle. Na análise sensorial (aparência e aroma) utilizaram-se 10 repetições. Para a comparação entre as médias foi utilizado o teste Tukey a 5% de probabilidade. As cebolas fatiadas em rodelas mantiveram mais estáveis os teores de sólidos solúveis, acidez titulável, açúcares totais, açúcares redutores e não redutores durante a conservação refrigerada A cebola ralada, destacou-se em relação às características sensoriais, indicando que os tipos de cortes interferiram nestas características e que a cebola processada ralada foi a mais aceita pelos avaliadores.
Preparados homeopáticos en el crecimiento y en la producción de repollo cultivado en sistema orgânico
Authors: Pulido Edwin E , Boff Pedro , Duarte Tatiana S , Boff Mari IC
Published: August 2014

El repollo es consumido preferencialmente in natura y en muchos casos es producido de manera convencional, dejando trazas de residuos químicos, lo cual puede generar afecciones directas sobre la salud del consumidor y del agricultor. El objetivo del trabajo fue evaluar la influencia de preparados homeopáticos en altas diluciones en el crecimiento de plántulas y en la producción de repollo, en sistema orgánico. El trabajo fue compuesto por cinco experimentos para estudiar nueve tratamientos con cuatro repeticiones siendo la conducción de tres experimentos en invernadero, utilizando el diseño experimental de bloques completos al azar, y de dos experimentos en el campo utilizando el diseño experimental de bloques al azar. Los tratamientos estudiados fueron los preparados de Arnica montana,Silicea terra, Carbo vegetabilisy Sulphur en la 6CH y 30CH (orden de dilución centesimal hahnemanniana); y agua como testigo. Sulphur6CH aumentó en dos de los tres experimentos la altura y la longitud de raíz en relación al testigo, en plántulas de repollo. Silicea terra 30CH y Sulphur6CH aumentaron la producción y la materia seca de cabezas de repollo cultivadas en campo, así como, Arnica montana 6CH y 30CH también incrementaron la materia seca de cabezas. Se concluyó que Sulphur6CH se destacó como promisorio para mejorar la calidad de las plántulas de repollo, así como en la producción y materia seca de cabezas de repollo en condiciones de campo siendo estas últimas características también mejoradas por Silicea terra30CH.
Evaluation of sources, doses and application schedules of nitrogen on drip-irrigated tomato
Authors: Marouelli Waldir A , Souza Ronessa B , Braga Marcos B , Silva Washington LC
Published: August 2014

We aimed to establish strategies for nitrogen (N) fertilization on drip-irrigated determinate-growth-habit tomato, under Cerrado conditions of Central Brazil. Three field experiments were carried out in a randomized block design. In experiment I six N doses (0, 80, 160, 240, 320 and 400 kg ha-1 N) were tested, in experiment II six combinations of the N forms (nitric; ammonium; amide; 2/3 nitric + 1/3 ammonium; 2/3 nitric + 1/3 amide; and 1/3 nitric + 2/3 amide) were evaluated, and in experiment III the combination of three soil pre-plant fertilization fractions (0, 20 and 40%) was evaluated with two splitting schemes of the remaining N via fertigation (linear and adjusted N-uptake curve). SPAD chlorophyll index and N content were measured in the leaves of tomato plants on experiment I. The physical and economic yields of tomato crop were maximized for the doses of 287 kg N ha-1 and 270 kg N ha-1, respectively, with doses of 2.1 g and 2.0 g of N per kg of commercial fruit. The yield was maximized for 52 SPAD units. The combinations of forms and the application schedules of N had no significant effect on the yield components of the tomato crop.
Plant density in production of mini lettuce cultivars in organic system management
Authors: Takahashi Keiko , Cardoso Antonio II
Published: August 2014

Production of mini vegetables in organic system is a good alternative to improve profit, but there are no researches about the optimum plant density for these cultivars in Brazilian conditions. Two experiments were conducted to evaluate the production of mini lettuce cultivars in different plant densities. Experiment 1 was conducted from January 1th (sowing) to February 10th(harvesting), 2012. The experimental design was completely randomized blocks, with six treatments in factorial scheme, 3 mini lettuce cultivars (Tudela, Renoir and Sartre) x 2 spacing between plants (16 and 20 cm), with eight replications and plots (2.04 m2) with six rows, spaced 15 cm. Experiment 2 was conducted from June 6th (sowing) to July 18th (harvesting), 2012. The cultivars Sartre and Renoir were evaluated under four plant densities (444,444; 333,333; 266,667 and 200,000 plants ha-1, corresponding to spacing of 15x15, 15x20, 25x15 and 25x20 cm, respectively). Eight treatments were defined by a factorial scheme 2 (cultivars) x 4 (plant densities) and arranged in a completely randomized block design, with nine replications and plots with 2.04 m2. The evaluated characteristics in both experiments were total and marketable fresh weight per plant, plant dry weight, plant diameter and height, marketable yield and discard percentage. In first experiment, during the summer, cultivar Sartre showed the highest marketable fresh weight (72 g plant-1). Heaviest plants (91.6 g plant-1) were obtained with the higher plant spacing, but the highest yield (2.51 kg m-2) was obtained with the smaller spacing. In winter, plants with higher total (190 g plant-1) and marketable (146 g planta-1) fresh weight were obtained with cultivar Sartre, and the same was observed in low plant density. However, the higher plant density, the higher the yield.
Production and resistance of three scallion cultivars to pink root
Authors: Marcuzzo Leandro L , Carvalho Jaqueline
Published: August 2014

The production of scallion has been widely exploited on small farms, since it requires little care and is largely commercialized close to the production sites. Pink root, caused by Phoma terrestris (syn. Pyrenochaeta terrestris),is among the main diseases affecting this crop. However, little information on aspects related to yield and few cultivars resistant to the disease are available. In this study we evaluated these variables on Konatsu, Natsu and Nebuka cultivars. The experiment was carried out in Lontras, Santa Catarina state, Brazil, in a complete randomized blocks design with four replications. After 80 days of transplantation the following parameters were evaluated: plant mass, total and marketable number of leaves, total and marketable mass of leaves, lenght and weight of roots. The total number of bunches was assessed as an evaluation aiming the market. The disease severity, in percentage on the root system, was assessed for the pink root. The average values of the variables were subjected to analysis of variance by F test and mean comparison test by Tukey, 5%. The Konatsu cultivar presented higher average mass per plant (159 g plant-1) compared to Nebuka and Natsu cultivars. The average mass of marketable leaves for 'Konatsu' was 56.17% higher than for 'Nebuka'. The number of bunches produced by 'Konatsu' was 48% higher than for 'Nebuka'. The cultivar Konatsu was, therefore, more productive and resistant to the pink root disease.
Reação de genótipos de Capsicum ao nematoide-das-galhas
Authors: Pinheiro Jadir B , Reifschneider Francisco JB , Pereira Ricardo B , Moita Antonio W
Published: August 2014

O objetivo desta pesquisa foi avaliar a reação de híbridos porta-enxerto experimentais de Capsicum annuum ['Hibrido Experimental (HE)' e seu Recíproco (HER)] e genótipos elite do programa de melhoramento da Embrapa Hortaliças de C. chinense, C. frutescense C. baccatumà Meloidogyne incognita raça 1, M. javanica e M. enterolobii. Como testemunha suscetível a M. incognita raça 1 e resistente a M. javanicafoi utilizado o híbrido de pimentão 'Magali R', e como testemunhas resistentes a M. incognita raça 1 e M. javanicaforam utilizados os porta-enxertos 'Silver' e 'Snooker'. Para confirmar a viabilidade do inóculo foi utilizado o tomateiro 'Rutgers'. Dois experimentos foram conduzidos em casa de vegetação, em delineamento inteiramente casualizado com seis repetições. Plântulas com 30 dias de idade foram transplantadas para vasos de 2,0 L contendo substrato composto de solo, areia, esterco de gado e palha de arroz carbonizada (1:1:1:1). As plantas foram inoculadas após o transplantio com a deposição de 5,0 mL de suspensão, contendo 5.000 ovos e J2 de cada espécie. Setenta dias após foram avaliados o índice de massa de ovos e de galhas, o número de ovos por grama de raiz e o fator de reprodução. Os híbridos de C. annuum apresentaram resistência a M. incognita e M. javanica e suscetibilidade a M. enterolobii, assim como as testemunhas 'Silver' e 'Snooker'. O híbrido 'Magali R' apresentou resistência somente a M. javanica. Os genótipos de C. chinense e C. baccatumapresentaram suscetibilidade às três espécies, enquanto genótipos de C. frutescens apresentaram suscetibilidade somente a M. enterolobii.Os híbridos experimentais de pimentão e a maioria dos genótipos de C. frutescens avaliados poderão ser utilizados em áreas de cultivo protegido infestadas com M. incognitaraça 1 e M. javanica. Entretanto, a busca por genótipos resistentes a M. enterolobii, bem como o desenvolvimento e a adoção de estratégias de controle é de suma importância.
Clinical Benefits of Above-Standard Dose of Octreotide LAR in Patients With Neuroendocrine Tumors for Control of Carcinoid Syndrome Symptoms: A Multicenter Retrospective Chart Review Study
Authors: Strosberg Jonathan R. , Benson Al B. , Huynh Lynn , Duh Mei Sheng , Goldman Jamie , Sahai Vaibhav , Rademaker Alfred W. , Kulke Matthew H.
Published: August 2014

Background.

Octreotide LAR is used in patients for control of carcinoid syndrome (CS) and other symptoms of hormone hypersecretion. The aim of this study was to examine reasons for octreotide LAR dose escalation and observe CS symptom improvement in patients with neuroendocrine tumors (NETs) who underwent octreotide LAR dose escalation at three cancer referral centers.

Methods.

Medical records for patients with diagnosis of carcinoid or pancreatic NET who had received one dose or more of octreotide LAR above 30 mg every 4 weeks from 2000 to 2012 were reviewed. Reasons for dose escalation and symptomatic outcomes were abstracted for each patient 3 months prior to and up to 12 months following the dose escalation.

Results.

Of the evaluated 239 NET patients, 53% were male, mean age at first dose escalation was 60 years (standard deviation [SD]: 11 years), and mean time from octreotide LAR initiation to first dose escalation was 1.7 years (SD: 2.0 years). The primary reasons reported for dose escalation were carcinoid or hormonal syndrome (62%) or radiographic progression (28%). The most common dose changes at the first dose escalation were 40 mg every 4 weeks (71%) and 60 mg every 4 weeks (18%). Of 90 patients in whom flushing was reported prior to first dose escalation, 73 (81%) were reported to have experienced improvement or resolution of their symptoms following the dose escalation. Of 107 patients who were reported to have experienced diarrhea before the first dose escalation, 85 (79%) were reported to have experienced improvement or resolution after first dose escalation.

Conclusion.

The goal of improved symptom control is a common reason for dose escalation of octreotide LAR. This study suggests that escalation to above the standard dose of octreotide LAR of 30 mg every 4 weeks may result in improved CS symptom control.
Prevalence of Suicidality Among Hispanic and African American Veterans Following Surgery
Authors: Copeland Laurel A. , McIntyre Raphael T. , Stock Eileen M. , Zeber John E. , MacCarthy Daniel J. , Pugh Mary Jo
Published: August 2014

Objectives. We evaluated factors associated with suicidal behavior and ideation (SBI) during 3 years of follow-up among 89 995 Veterans Health Administration (VHA) patients who underwent major surgery from October 2005 to September 2006.

Methods. We analyzed administrative data using Cox proportional hazards models. SBI was ascertained by International Classification of Disease, 9th Revision codes.

Results. African Americans (18% of sample; 16 252) were at an increased risk for SBI (hazard ratio [HR] = 1.21; 95% confidence interval [CI]  = 1.10, 1.32), whereas Hispanics were not (HR = 1.10; 95% CI = 0.95, 1.28). Other risk factors included schizophrenia, bipolar disorder, depression, posttraumatic stress disorder, pain disorders, postoperative new-onset depression, and postoperative complications; female gender and married status were protective against SBI.

Conclusions. The postoperative period might be a time of heightened risk for SBI among minority patients in the VHA. Tailored monitoring and postoperative management by minority status might be required to achieve care equity.
Smoking Cessation Among African American and White Smokers in the Veterans Affairs Health Care System
Authors: Burgess Diana J. , van Ryn Michelle , Noorbaloochi Siamak , Clothier Barbara , Taylor Brent C. , Sherman Scott , Joseph Anne M. , Fu Steven S.
Published: August 2014

Objectives. We examined whether a proactive care smoking cessation intervention designed to overcome barriers to treatment would be especially effective at increasing cessation among African Americans receiving care in the Veterans Health Administration.

Methods. We analyzed data from a randomized controlled trial, the Veterans Victory over Tobacco study, involving a population-based electronic registry of current smokers (702 African Americans, 1569 Whites) and assessed 6-month prolonged smoking abstinence at 1 year via a follow-up survey of all current smokers. We also examined candidate risk adjustors for the race effect on smoking abstinence.

Results. The interaction between patient race and intervention condition (proactive care vs usual care) was not significant. Overall, African Americans had higher quit rates than Whites (13% vs 9%; P < .006) regardless of condition.

Conclusions. African Americans quit at higher rates than Whites. These findings may be a result of the large number of veterans receiving smoking cessation services and the lack of racial differences in receipt of these services as well as racial differences in smoking history, self-efficacy, and motivation to quit that favor African Americans.
Addressing Population Health and Health Inequalities: The Role of Fundamental Causes
Authors: Cerdá Magdalena , Tracy Melissa , Ahern Jennifer , Galea Sandro
Published: August 2014

Objectives. As a case study of the impact of universal versus targeted interventions on population health and health inequalities, we used simulations to examine (1) whether universal or targeted manipulations of collective efficacy better reduced population-level rates and racial/ethnic inequalities in violent victimization; and (2) whether experiments reduced disparities without addressing fundamental causes.

Methods. We applied agent-based simulation techniques to the specific example of an intervention on neighborhood collective efficacy to reduce population-level rates and racial/ethnic inequalities in violent victimization. The agent population consisted of 4000 individuals aged 18 years and older with sociodemographic characteristics assigned to match distributions of the adult population in New York City according to the 2000 US Census.

Results. Universal experiments reduced rates of victimization more than targeted experiments. However, neither experiment reduced inequalities. To reduce inequalities, it was necessary to eliminate racial/ethnic residential segregation.

Conclusions. These simulations support the use of universal intervention but suggest that it is not possible to address inequalities in health without first addressing fundamental causes.
Retaining Homeless Veterans in Outpatient Care: A Pilot Study of Mobile Phone Text Message Appointment Reminders
Authors: McInnes D. Keith , Petrakis Beth Ann , Gifford Allen L. , Rao Sowmya R. , Houston Thomas K. , Asch Steven M. , O’Toole Thomas P.
Published: August 2014

Objectives. We examined the feasibility of using mobile phone text messaging with homeless veterans to increase their engagement in care and reduce appointment no-shows.

Methods. We sent 2 text message reminders to participants (n = 20) before each of their outpatient appointments at an urban Veterans Affairs medical center. Evaluation included pre- and postsurvey questionnaires, open-ended questions, and review of medical records. We estimated costs and savings of large-scale implementation.

Results. Participants were satisfied with the text-messaging intervention, had very few technical difficulties, and were interested in continuing. Patient-cancelled visits and no-shows trended downward from 53 to 37 and from 31 to 25, respectively. Participants also experienced a statistically significant reduction in emergency department visits, from 15 to 5 (difference of 10; 95% confidence interval [CI]  = 2.2, 17.8; P = .01), and a borderline significant reduction in hospitalizations, from 3 to 0 (difference of 3; 95% CI = −0.4, 6.4; P = .08).

Conclusions. Text message reminders are a feasible means of reaching homeless veterans, and users consider it acceptable and useful. Implementation may reduce missed visits and emergency department use, and thus produce substantial cost savings.
Racial Disparities in Cancer Care in the Veterans Affairs Health Care System and the Role of Site of Care
Authors: Samuel Cleo A. , Landrum Mary Beth , McNeil Barbara J. , Bozeman Samuel R. , Williams Christina D. , Keating Nancy L.
Published: August 2014

Objectives. We assessed cancer care disparities within the Veterans Affairs (VA) health care system and whether between-hospital differences explained disparities.

Methods. We linked VA cancer registry data with VA and Medicare administrative data and examined 20 cancer-related quality measures among Black and White veterans diagnosed with colorectal (n = 12 897), lung (n = 25 608), or prostate (n = 38 202) cancer from 2001 to 2004. We used logistic regression to assess racial disparities for each measure and hospital fixed-effects models to determine whether disparities were attributable to between- or within-hospital differences.

Results. Compared with Whites, Blacks had lower rates of early-stage colon cancer diagnosis (adjusted odds ratio [AOR] = 0.80; 95% confidence interval [CI] = 0.72, 0.90), curative surgery for stage I, II, or III rectal cancer (AOR = 0.57; 95% CI = 0.41, 0.78), 3-year survival for colon cancer (AOR = 0.75; 95% CI = 0.62, 0.89) and rectal cancer (AOR = 0.61; 95% CI = 0.42, 0.87), curative surgery for early-stage lung cancer (AOR = 0.50; 95% CI = 0.41, 0.60), 3-dimensional conformal or intensity-modulated radiation (3-D CRT/IMRT; AOR = 0.53; 95% CI = 0.47, 0.59), and potent antiemetics for highly emetogenic chemotherapy (AOR = 0.87; 95% CI = 0.78, 0.98). Adjustment for hospital fixed-effects minimally influenced racial gaps except for 3-D CRT/IMRT (AOR = 0.75; 95% CI = 0.65, 0.87) and potent antiemetics (AOR = 0.95; 95% CI = 0.82, 1.10).

Conclusions. Disparities in VA cancer care were observed for 7 of 20 measures and were primarily attributable to within-hospital differences.
Quasiglobal Multiphase Upscaling of Reservoir Models With Nonlocal Stratigraphic Heterogeneities
Authors: Alpak Faruk O.
Published: August 2014

Representing the complete spectrum of fine-scale stratigraphic details in full-field dynamic models of geologically complex clastic reservoirs is beyond the limits of existing computational capabilities. A quasiglobal multiphase upscaling method—the regional-scale multiphase upscaling (RMU) method—is developed, in which the dynamic effects of subgrid-scale (typically subseismic) nonlocal stratigraphic reservoir elements (e.g., channels, lobes, sand bars, and shale drapes) are captured by means of pseudofunctions for flow simulation. Unlike conventional dynamic multiphase upscaling methods, the RMU method does not require fine-resolution reservoir-scale simulations. Rather, it relies on intermediate-scale sector-model simulations for pseudoization. The intermediate scale, also referred to as the regional scale, is defined as the spatial scale at which the global multiphase flow effects of nonlocal stratigraphic elements can be approximated by fine-resolution flow simulations with reasonable accuracy. During the pseudoization process, dynamic multiphase flow responses of coarse regional-scale sector models are calibrated against those stemming from their corresponding fine-resolution parent models. Each regional-scale sector model is simulated only once at the fine geologic resolution. The process involves automatic determination and subsequent modification of the parameters that describe rock relative permeability and capillary pressure functions. Coarse regional-scale models are simulated a few times until a reasonable match between their coarse- and fine-resolution dynamic responses can be attained. The parameter-estimation step of the pseudoization process is performed by use of a very efficient constrained nonlinear optimization algorithm.

The RMU method is evaluated in two proof-of-concept numerical examples involving a plethora of turbidite stratigraphic architectures. The method yields simulation results that are always more accurate than conventionally upscaled coarse-resolution model predictions. Incorporating geologically based pseudofunctions into otherwise simple coarse-resolution full-field reservoir models reduces the simulation cycle time significantly and improves the accuracy of production forecasts. The RMU method typically delivers two to three orders of magnitude in speed up of flow simulations.
Synthesis, crystal structure and properties of [Co(L)2](ClO4)2 (L=1,3-bis(1H-benzimidazol-2-yl)-2-oxapropane)
Authors: Tavman Aydin , Sayil Cigdem
Published: August 2014

The reaction of 1,3-bis(1H-benzimidazol-2-yl)-2-oxapropane (L) with
Co(ClO4)2?6H2O in absolute ethanol produces
di[1,3-bis(1H-benzimidazol-2-yl)-2-oxapropane-k2N,N?]cobalt(II)diperchlorate
chelate complex ([Co(L)2](ClO4)2, 1). The complex 1 was characterized by
elemental analysis, magnetic moment, molar conductivity, thermogravimetric
analysis, FT-IR, UV-visible, mass spectrometry, and its solid state structure
was determined by single crystal X-ray diffraction. According to the
thermogravimetric analysis data, there is no any water coordinated or
uncoordinated in 1 as well as elemental analysis. The complex 1 has 1:2 M:L
ionic characteristic according to the molar conductivity. In the complex, the
distances between the cobalt and the ethereal oxygen atoms (Co1-O2: 2.805(3);
Co2-O1: 2.752(2) ?) show the semi-coordination bonding and the Co(II) ion is
six-coordinated with a N4O2 ligand set, resulting in a distorted octahedron.
Relationship between the maxillary transverse dimension and palatally displaced canines: A cone-beam computed tomographic study
Authors: Hong Wei-Hsin , Radfar Rebecca , Chung Chun-Hsi
Published: August 2014

Objectives: 

To examine the relationship between palatally displaced maxillary canines (PDC) and the maxillary transverse dimension using cone-beam computed tomography (CBCT).

Materials and Methods: 

Thirty-three patients (11 males and 22 females, mean age 18.2 years) with PDC were matched to 66 patients (22 males and 44 females, mean age 18.1 years) without PDC (control) by gender, age, and posterior occlusion. A CBCT image was taken on all the patients prior to any orthodontic treatment. For each patient the maxillary basal bone widths and interdental widths at the maxillary first molars and first and second premolars were measured on axial and coronal sections of CBCT images. In addition, the presence of permanent tooth agenesis and the widths of maxillary incisors were recorded.

Results: 

Similar maxillary transverse dimensions, both skeletally and dentally, were found between the PDC and control groups. In the PDC group, the number of patients with permanent tooth agenesis was six times higher than in the control group. In addition, the maxillary lateral incisors on PDC-affected sides were smaller than those of control group (P < .05).

Conclusions: 

The maxillary transverse dimension, both skeletally and dentally, had no effect on the occurrence of PDC. The higher prevalence of permanent tooth agenesis was found in the PDC group. Moreover, the mean mesiodistal width of maxillary lateral incisors in the PDC group was significantly smaller than in the control group (P < .05).
Variation of orthodontic treatment decision-making based on dental model type: A systematic review
Authors: Pachêco-Pereira Camila , De Luca Canto Graziela , Major Paul W. , Flores-Mir Carlos
Published: August 2014

Objective: 

To determine in which clinical scenarios digital models are valid as replacements for plaster models during orthodontic treatment decision-making process and treatment planning.

Materials and Methods: 

An attempt to identify all pertinent published information was made. Retained articles were those where a decision-making process leading to differential orthodontic treatment plans based on either method were compared. The search was tailored for PubMed and adapted for EMBASE, MEDLINE, the Cochrane Library, LILACS, and Web of Science. A partial grey literature search was conducted through Google Scholar. References lists of the included articles were screened for potential relevant studies. The methodology of selected studies was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS).

Results: 

Only two studies were finally selected for the qualitative and quantitative synthesis. QUADAS results scores from selected studies ranged from 61% to 83% of 11 items evaluated. In one, the overall treatment plan regarding orthognathic surgery for Class II malocclusion changed in 13% to 22% of the cases. In the other one, 6% of the orthodontic treatment plans changed.

Conclusion: 

Digital models could be used to replace plaster models in Class II malocclusion treatment planning.
A Restorative Approach for Class II Resin Composite Restorations: A Two-Year Follow-up
Authors: Santos MJMC
Published: August 2014

This clinical report describes a restorative technique used to replace two Class II resin composite restorations on the upper premolars. A sectional matrix band was used in conjunction with an elastic ring (Composi-Tight) to obtain tight proximal contact. A nanofilled resin composite (Filtek Supreme Ultra) was incrementally applied using oblique layers to reduce the C-factor, each layer being no more than 2 mm thick, and then light cured for 20 seconds with a light-emitting diode lamp (EliparFreeLight 2 LED Curing Light) with a power density of 660 mW/cm2. A centripetal technique was used to restore the lost tooth structure from the periphery toward the center of the cavity in order to achieve a better contour and anatomy with less excess, thereby minimizing the use of rotary instruments during the finishing procedures. Finally, the resin composite restorations were finished and polished, and a surface sealer (Perma Seal) was applied to fill small gaps and defects that may have been present on the surfaces and margins of the restorations after the finishing and polishing procedures.
Longitudinal Results of a 10-year Clinical Trial of Repair of Amalgam Restorations
Authors: Moncada G , Vildósola P , Fernández E , Estay J , de Oliveira Júnior OB , de Andrade MF , Martin J , Mjör IA , Gordan VV
Published: August 2014

The aim of this prospective, blind, and randomized clinical trial was to assess the effectiveness of repair of localized clinical defects in amalgam restorations that were initially scheduled for replacement. A cohort of 20 patients with 40 (Class I and Class II) amalgam restorations that presented one or more clinical features that deviated from the ideal (Bravo or Charlie) according to US Public Health Service criteria, were randomly assigned to either the repair or the replacement group—A: repair, n = 19; and B: replacement, n = 21. Two examiners who had calibration expertise evaluated the restorations at baseline and 10 years after according to seven parameters: marginal occlusal adaptation, anatomic form, surface roughness, marginal staining, contact, secondary caries, and luster. After 10 years, 30 restorations (75%) were evaluated (Group A: n = 17; Group B: n = 13). Repaired and replaced amalgam restorations showed similar survival outcomes regarding marginal defects and secondary caries in patients with low and medium caries risk, and most of the restorations were considered clinically acceptable after 10 years. Repair treatment increased the potential for tooth longevity, using a minimally interventional procedure. All restorations trend to downgrade over time.
Hybrid Model Representation of a TLP Including Flexible Topsides in Non-Linear Regular Waves
Authors: Wehmeyer Christof , Ferri Francesco , Andersen Morten , Pedersen Ronnie
Published: August 2014

The rising demand for renewable energy solutions is forcing the established industries to expand and continue evolving. For the wind energy sector, the vast resources in deep sea locations have encouraged research towards the installation of turbines in deeper waters. One of the most promising technologies able to solve this challenge is the floating wind turbine foundation. For the ultimate limit state, where higher order wave loads have a significant influence, a design tool that couples non-linear excitations with structural dynamics is required. To properly describe the behavior of such a structure, a numerical model is proposed and validated by physical test results. The model is applied to a case study of a tension leg platform with a flexible topside mimicking the tower and a lumped mass mimicking the rotor-nacelle assembly. The model is additionally compared to current commercial software, where the need for the coupled higher order dynamics proposed in this paper becomes evident.
TNF-α Blocker Effect of Naringenin-Loaded Sericin Microparticles that Are Potentially Useful in the Treatment of Psoriasis
Authors: Chlapanidas Theodora , Perteghella Sara , Leoni Flavio , Faragò Silvio , Marazzi Mario , Rossi Daniela , Martino Emanuela , Gaggeri Raffaella , Collina Simona
Published: August 2014

This study aims to evaluate the effect of combined use of the racemic flavanone Naringenin (NRG) and the protein sericin as TNF-α blockers. Sericin (SMs) and (R/S) NRG-loaded Sericin (SNRGMs) microparticles were prepared by spray-drying, characterized in terms of morphology and particle size distribution, and encapsulation efficiency was determined. Concerning morphology and particle size distribution of microparticles, results indicated that they were not affected by the presence of NRG. The encapsulation efficiency was almost quantitative (93%), thus proving that sericin can be advantageously loaded with (R/S) NRG. Biological evaluation of (R/S) NRG, SMs and SNRGMs was then performed in lipopolysaccharide (LPS)-stimulated human peripheral blood mononuclear cells (hPBMC). SNRGMs resulted cytotoxic at the higher dose used (200 μg/mL) and the effect was greater than (R/S) NRG alone. Moreover, even if sericin alone was not effective in suppressing LPS-induced serum TNF-α levels, SNRGMs loaded with 9.3% of (R/S) NRG were significantly more potent than (R/S) NRG alone. In summary, this study provides the proof of concept that sericin-based microspheres loaded with TNF-α-blockers could contribute to the down regulation of the cytokine and represents the starting point for the development of new topical formulations for the treatment of middle-stage psoriasis.
Reduction of Photoluminescence Quenching by Deuteration of Ytterbium-Doped Amorphous Carbon-Based Photonic Materials
Authors: Hsu Hui-Lin , Leong Keith , Teng I-Ju , Halamicek Michael , Juang Jenh-Yih , Jian Sheng-Rui , Qian Li , Kherani Nazir
Published: August 2014

In situ Yb-doped amorphous carbon thin films were grown on Si substrates at low temperatures (<200 °C) by a simple one-step RF-PEMOCVD system as a potential photonic material for direct integration with Si CMOS back end-of-line processing. Room temperature photoluminescence around 1 µm was observed via direct incorporation of optically active Yb3+ ions from the selected Yb(fod)3 metal-organic compound. The partially fluorinated Yb(fod)3 compound assists the suppression of photoluminescence quenching by substitution of C–H with C–F bonds. A four-fold enhancement of Yb photoluminescence was demonstrated via deuteration of the a-C host. The substrate temperature greatly influences the relative deposition rate of the plasma dissociated metal-organic species, and hence the concentration of the various elements. Yb and F incorporation are promoted at lower substrate temperatures, and suppressed at higher substrate temperatures. O concentration is slightly elevated at higher substrate temperatures. Photoluminescence was limited by the concentration of Yb within the film, the concentration of Yb ions in the +3 state, and the relative amount of quenching due to the various de-excitation pathways associated with the vibrational modes of the host a-C network. The observed wide full-width-at-half-maximum photoluminescence signal is a result of the variety of local bonding environments due to the a-C matrix, and the bonding of the Yb3+ ions to O and/or F ions as observed in the X-ray photoelectron spectroscopy analyses.