bluuebunny/crossref_metadata_2025 huggingface dataset:
A unified conceptual model for diagnostic errors: underdiagnosis, overdiagnosis, and misdiagnosis
Authors: Newman-Toker David E.
Published: January 2014

Progress in diagnostic error research has been hampered by a lack of unified terminology and definitions. This article proposes a novel framework for considering diagnostic errors, offering a unified conceptual model for underdiagnosis, overdiagnosis, and misdiagnosis. The model clarifies the critical separation between ‘diagnostic process failures’ (incorrect workups) and ‘diagnosis label failures’ (incorrect diagnoses). By dividing processes into those that are substandard, suboptimal, or optimal, important distinctions are drawn between ‘preventable’, ‘reducible,’ and ‘unavoidable’ diagnostic errors. The new model emphasizes the importance of mitigating diagnosis-related harms, regardless of whether the solutions require traditional safety strategies (preventable errors), more effective evidence dissemination (reducible errors; harms from overtesting and overdiagnosis), or new scientific discovery (currently unavoidable errors). Doing so maximizes our ability to prioritize solving various diagnosis-related problems from a societal value perspective. This model should serve as a foundation for developing consensus terminology and operationalized definitions for relevant diagnostic-error categories.
Assessing clinical reasoning: moving from in vitro to in vivo
Authors: Holmboe Eric S. , Durning Steven J.
Published: January 2014

The last century saw dramatic changes in clinical practice and medical education and the concomitant rise in high-stakes, psychometrically-based examinations of medical knowledge. Higher scores on these high-stakes “in-vitro” examinations are modestly associated with better performance in clinical practice and provide a meaningful degree of assurance to the public about physicians’ competency in medical knowledge. However, results on such examinations explain only a small fraction of the wide variation currently seen in clinical practice and diagnostic errors remain a serious and vexing problem for patients and the healthcare system despite decades of high-stakes examinations. In this commentary we explore some of the limitations of high-stakes examinations in assessing clinical reasoning and propose utilizing situated cognition theory to guide research and development of innovative modes of ”in-vivo” assessments that can be used in longitudinally and continuously in clinical practice.
Laboratory-associated and diagnostic errors: a neglected link
Authors: Plebani Mario
Published: January 2014

Clinical laboratories play a vital role in patient care, but many diagnostic errors are associated with laboratory testing. The past decades have seen sustained improvements in analytical performances but the error rates, particularly in pre- and post-analytical phases is still high. Although the seminal concept of the brain-to-brain laboratory loop has been described more than four decades ago, the awareness about the importance of extra-analytical aspects in laboratory quality is a recent achievement. According to this concept, all phases and activities of the testing cycle should be assessed, monitored and improved in order to decrease the total error rates and thereby improve patient safety. In the interests of patients, any direct or indirect negative consequence related to a laboratory test must be considered, irrespective of which step is involved and whether the error depends on a laboratory professional (e.g., calibration or testing error) or a non-laboratory operator (e.g., inappropriate test request, error in patient identification and/or blood collection). Data collected in various clinical settings demonstrate that many diagnostic errors are associated with laboratory testing. In particular, errors are due to inappropriate test request and/or result interpretation and utilization. Collaborations between laboratory professionals and other care providers, namely clinicians and nurses, are needed to achieve the goal of improved patient safety.
The current and ideal state of anatomic pathology patient safety
Authors: Raab Stephen Spencer
Published: January 2014

An anatomic pathology diagnostic error may be secondary to a number of active and latent technical and/or cognitive components, which may occur anywhere along the total testing process in clinical and/or laboratory domains. For the pathologist interpretive steps of diagnosis, we examine Kahneman’s framework of
Detecting diagnostic error in psychiatry
Authors: Phillips James
Published: January 2014

The question of diagnostic error in psychiatry involves two intertwined issues, diagnosis and error detection. You cannot detect diagnostic error unless you have a reliable, valid method of making diagnoses. Since the diagnostic process is less certain in psychiatry than in general medicine, that will make the detection of error less confidant. Psychiatric diagnostic categories are developed without laboratory tests and other biomarkers. These limitations dramatically weaken the validity of psychiatric diagnoses and render error detection an uncertain undertaking, with go gold standard such as laboratory findings and tissue analysis, as in most of general medicine. With these limitations in mind, I review the methods that are available for error detection in psychiatry.
Synthesis and antimicrobial activities of novel 6-(1,3-thiazol-4-yl)-1,3-benzoxazol-2(3H)-one derivatives
Authors: Łączkowski Krzysztof Z. , Misiura Konrad , Biernasiuk Anna , Malm Anna , Grela Izabela
Published: January 2014

Synthesis, characterization and investigation of antimicrobial activities of seven new 6-(1,3-thiazol-4-yl)-1,3-benzoxazol-2(3H)-ones are presented. Their structures were determined using 1H NMR, 13C NMR and elemental analyses. The compounds possess some biological activity against Gram-positive bacteria, especially against Micrococcus luteus belonging to opportunistic pathogens, with an MIC of 31.25 μg/mL.
Single-Valued Neutrosophic Minimum Spanning Tree and Its Clustering Method
Authors: Ye Jun
Published: January 2014

Clustering plays an important role in data mining, pattern recognition, and machine learning. Then, single-valued neutrosophic sets (SVNSs) are a useful means to describe and handle indeterminate and inconsistent information, which fuzzy sets and intuitionistic fuzzy sets cannot describe and deal with. To cluster the data represented by single-value neutrosophic information, the article proposes a single-valued neutrosophic minimum spanning tree (SVNMST) clustering algorithm. Firstly, we defined a generalized distance measure between SVNSs. Then, we present an SVNMST clustering algorithm for clustering single-value neutrosophic data based on the generalized distance measure of SVNSs. Finally, two illustrative examples are given to demonstrate the application and effectiveness of the developed approach.
The Hidden Face of Justice: Fairness, Discrimination and Distribution in Transitional Justice Processes
Authors: Cárdenas Juan Camilo , Casas-Casas Andrés , Méndez Nathalie Méndez
Published: January 2014

This article contributes to the literature on the impact of transitional justice measures using behavioral evidence from experiments. We argue that there is a distributional dilemma at the heart of transitional justice programs, given that the State must allocate goods and services both to victims and excombatants. Individual and social preferences over these processes matter, given that they are likely to scale up to undermine or increase public support for transitional justice programs. We offer evidence from the Colombian case, to show what we call the hidden face of justice effect, which occurs when in the transition from war to peace distributional dilemmas arise and generate a social sanction function that creates negative incentives that can affect the achievement of reintegration of ex-combatants and jeopardizes the maintenance of peace. In order to explore the microfoundations that underlie the differences between allocations to victims and ex-combatants, we use data from field experiments and find that ex-combatants expect lower transfers from public officers and citizens and indeed receive lower transfers, if compared to the victims and the control groups included in the study, despite the fact that third-party observers have the power to punish senders when making offers seen by the third-party as unfair.
Doing Public History in Canada’s Truth and Reconciliation Commission
Authors: Milloy John
Published: January 2014

The author discusses his experience with Canada’s Truth and Reconciliation Commission, charged with writing a history of the residential school system for First Nations students in Canada and with producing an archive accessible to both scholarly researchers and the public. Funding and limited governmental support for the project limited its scope and effectiveness, but the TRC has helped educate the Canadian public about residential schools, and has made progress towards reconciliation.
Shared Authority in the Context of Tribal Sovereignty
Authors: Barber Katrine
Published: January 2014

Indigenous and non-Indigenous public history partnerships present unique challenges. Historical colonial practices and their present persistence, divergent historical perspectives, and disciplinary standards that enforce antiquated notions of objectivity and historical truth complicate the spaces of “shared authority.” Moreover, public history institutions and their academic counterparts have historically broadcast colonial success. How can we foster partnerships that do not reinforce “asymmetrical relations of power”? How can educators build capacity in students to partner ethically with Indigenous Nations? This essay draws from a growing body of interdisciplinary scholarship to argue that a triad of concepts–shared authority, contact zones, and survivance–can aid in the development of decolonial public history practices and curricula.
Restoration of fertility by gonadotropin replacement in a man with hypogonadotropic azoospermia and testicular adrenal rest tumors due to untreated simple virilizing congenital adrenal hyperplasia
Authors: Rohayem Julia , Tüttelmann Frank , Mallidis Con , Nieschlag Eberhard , Kliesch Sabine , Zitzmann Michael
Published: January 2014

Context

Classical congenital adrenal hyperplasia (CAH), a genetic disorder characterized by 21-hydroxylase deficiency, impairs male fertility, if insufficiently treated.

Patient

A 30-year-old male was referred to our clinic for endocrine and fertility assessment after undergoing unilateral orchiectomy for a suspected testicular tumor. Histopathological evaluation of the removed testis revealed atrophy and testicular adrenal rest tumors (TARTs) and raised the suspicion of underlying CAH. The remaining testis was also atrophic (5 ml) with minor TARTs. Serum 17-hydroxyprogesterone levels were elevated, cortisol levels were at the lower limit of normal range, and gonadotropins at prepubertal levels, but serum testosterone levels were within the normal adult range. Semen analysis revealed azoospermia. CAH was confirmed by a homozygous mutation g.655A/C>G (IVS2-13A/C>G) inCYP21A2. Hydrocortisone (24 mg/m2) administered to suppress ACTH and adrenal androgen overproduction unmasked deficient testicular testosterone production. As azoospermia persisted due to sustained hypogonadotropic hypogonadism, a combined s.c. gonadotropin replacement with human chorionic gonadotropin (hCG) (1500 IU twice weekly) and FSH (human menopausal gondadotropin (hMG) 150 IU three times weekly) was initiated.

Results

Normalization of testosterone levels and a stable low sperm concentration (0.5 mill/ml) with good sperm motility (85% A+B progressive) were achieved within 21 months of treatment. Despite persisting TARTs, while receiving treatment, the patient successfully impregnated his wife twice, the latter impregnation leading to the birth of a healthy girl.

Conclusions

TARTs in unrecognized (simple virilizing) CAH may lead to unnecessary orchiectomy. In hypogonadotropic, azoospermic CAH, a combined treatment with oral corticosteroids and subcutaneously administered hCG and FSH can successfully restore testicular testosterone production and fertility, even if only one hypoplastic and atrophic testis with adrenal rest tumors is present.
The relationship between endogenous testosterone and lipid profile in middle-aged and elderly Chinese men
Authors: Zhang Nan , Zhang Haiqing , Zhang Xu , Zhang Bingchang , Wang Furong , Wang Chenggang , Zhao Meng , Yu Chunxiao , Gao Ling , Zhao Jiajun , Guan Qingbo
Published: January 2014

Objective

To evaluate the relationship between serum total testosterone (TT) level and lipid profile after adjusting for some traditional confounding factors, free thyroid hormones and TSH in Chinese men.

Methods

This was a retrospective study based on an epidemiological investigation including 11 000 subjects. Bivariate and partial correlation analysis, multiple linear regression analysis, and a general linear model were used to assess the influence of TT on the lipid profile. Additionally, the odds ratios (ORs) (95% CIs) for hypertriglyceridemia and low HDL-C in relation to TT categories were calculated using logistic regression analysis.

Results

A total of 4114 subjects whose mean age was 56.04±8.75 years were finally analyzed. There was a significant linear trend toward lower total cholesterol (TC), lower triglycerides (TG), and higher HDL-C with increasing serum TT, which remained significant after adjusting for age, BMI, fasting blood glucose, systolic blood pressure, free triiodothyronine, free thyroxine, and TSH. Compared with the bottom quartile of TT, the adjusted OR (95% CI) for hypertriglyceridemia and low HDL-C was 0.082 (0.048–0.138,P=0.000) and 0.669 (0.503–0.891,P=0.006) respectively in the top quartile of TT.

Conclusions

TT was correlated negatively and linearly with TC, TG, and LDL-C and positively and linearly with HDL-C. Low TT might have adverse effects on the lipid profile and thus represent a risk factor for hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C, suggesting the importance of maintaining an appropriate TT level in men.
Short oestrous cycles in sheep during anoestrus involve defects in progesterone biosynthesis and luteal neovascularisation
Authors: Brown H M , Fabre Nys C , Cognié J , Scaramuzzi R J
Published: January 2014

Anoestrous ewes can be induced to ovulate by the socio-sexual, ‘ram effect’. However, in some ewes, the induced ovulation is followed by an abnormally short luteal phase causing a so-called ‘short cycle’. The defect responsible for this luteal dysfunction has not been identified. In this study, we investigated ovarian and uterine factors implicated in male-induced short cycles in anoestrous ewes using a combined endocrine and molecular strategy. Before ovulation, we were able to detect a moderate loss of thecal expression of steroid acute regulatory protein (STAR) in ewes that had not received progesterone priming (which prevents short cycles). At and following ovulation, we were able to identify a significant loss of expression of genes coding key proteins involved in the biosynthesis of progesterone (STAR,CYP11A1andHSD3B1(HSD3B)) as well as genes coding proteins critical for vascular development during early luteal development (VEGFAandKDR(VEGFR2)), suggesting dysfunction in at least two pathways critical for normal luteal function. Furthermore, these changes were associated with a significant reduction of progesterone production and luteal weight. Additionally, we cast doubt on the proposed uterus-mediated effect of prostaglandin F2α (PGF2α) as a cause of short cycles by demonstrating the dysregulation of luteal expression of the PGF receptor, which mediates the luteal effects of PGF2α, and by finding no significant changes in the circulating concentrations of PGFM, the principal metabolite of PGF2α in ewes with short cycles. This study is the first of its kind to examine concurrently the endocrine and molecular events in the follicular and early luteal stages of the short cycle.

Free French abstract

A French translation of this abstract is freely available athttp://www.reproduction-online.org/content/147/3/357/suppl/DC1
Cost-effectiveness Analysis of the National Perinatal Hepatitis B Prevention Program
Authors: Barbosa Carolina , Smith Emily A. , Hoerger Thomas J. , Fenlon Nancy , Schillie Sarah F. , Bradley Christina , Murphy Trudy V.
Published: January 2014

OBJECTIVE:

To analyze the cost-effectiveness of the national Perinatal Hepatitis B Prevention Program (PHBPP) over the lifetime of the 2009 US birth cohort and compare the costs and outcomes of the program to a scenario without PHBPP support. PHBPP’s goals are to ensure all infants born to hepatitis B (HepB) surface antigen–positive women receive timely postexposure prophylaxis, complete HepB vaccine series, and obtain serologic testing after series completion.

METHODS:

A decision analytic tree and a long-term Markov model represented the risk of perinatal and childhood infections under different prevention alternatives, and the long-term health and economic consequences of HepB infection. Outcome measures were the number of perinatal infections and childhood infections from infants born to HepB surface antigen–positive women, quality-adjusted life-years (QALYs), lifetime costs, and incremental cost per QALY gained. The health outcomes and total costs of each strategy were compared incrementally. Costs were evaluated from the health care system perspective and expressed in US dollars at a 2010 price base.

RESULTS:

In all analyses, the PHBPP increased QALYs and led to higher reductions in the number of perinatal and childhood infections than no PHBPP, with a cost-effectiveness ratio of $2602 per QALY. In sensitivity analyses, the cost-effectiveness ratio was robust to variations in model inputs, and there were instances where the program was both more effective and cost saving.

CONCLUSIONS:

This study indicated that the current PHBPP represents a cost-effective use of resources, and ensuring the program reaches all pregnant women could present additional public health benefits.
Antidepressants and Suicide Attempts in Children
Authors: Cooper William O. , Callahan S. Todd , Shintani Ayumi , Fuchs D. Catherine , Shelton Richard C. , Dudley Judith A. , Graves Amy J. , Ray Wayne A.
Published: January 2014

OBJECTIVES:

Recent data showing possible increased risk for suicidal behavior among children and adolescents treated with selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) antidepressants have created significant concern among patients, families, and providers, including concerns about the risk of individual antidepressants. This study was designed to compare the risk for medically treated suicide attempts among new users of sertraline, paroxetine, citalopram, escitalopram, and venlafaxine to risk for new users of fluoxetine.

METHODS:

A retrospective cohort study included 36 842 children aged 6 to 18 years enrolled in Tennessee Medicaid between 1995 and 2006 who were new users of 1 of the antidepressant medications of interest (defined as filling no prescriptions for antidepressants in the preceding 365 days). Medically treated suicide attempts were identified from Medicaid files and vital records and confirmed with medical record review.

RESULTS:

Four hundred nineteen cohort members had a medically treated suicide attempt with explicit or inferred attempt to die confirmed through medical record review, including 4 who completed suicide. The rate of confirmed suicide attempts for the study drugs ranged from 24.0 per 1000 person-years to 29.1 per 1000 person-years. The adjusted rate of suicide attempts did not differ significantly among current users of SSRI and SNRI antidepressants compared with current users of fluoxetine. Users of multiple antidepressants concomitantly had increased risk for suicide attempt.

CONCLUSIONS:

In this population-based study of children recently initiating an antidepressant, there was no evidence that risk of suicide attempts differed for commonly prescribed SSRI and SNRI antidepressants.
Adherence to Label and Device Recommendations for Over-the-Counter Pediatric Liquid Medications
Authors: Budnitz Daniel S. , Lovegrove Maribeth C. , Rose Kathleen O.
Published: January 2014

OBJECTIVE:

To reduce dosing errors when administering orally ingested over-the-counter liquid medications, the US Food and Drug Administration (FDA) and the Consumer Healthcare Products Association released voluntary recommendations for dosing directions and dosing devices. This study assessed recommendation adherence for national brand name orally ingested over-the-counter liquid pediatric analgesics/antipyretics and cough, cold, and allergy medications available after the FDA guidance was finalized in 2011 to identify and prioritize specific improvements to dosing directions and devices.

METHODS:

Recommendations were categorized as top tier or low tier based on potential to directly address ≥3-fold dosing errors. Two independent reviewers assessed dosing directions and accompanying dosing devices for adherence to recommendations.

RESULTS:

Of 68 products, 91% of dosing directions and 62% of dosing devices adhered to all top tier recommendations; 57% of products adhered to every top tier recommendation, and 93% adhered to all or all but one. A dosing device was included with all products. No dosing directions used atypical volumetric units (eg, drams), and no devices used volumetric units that did not appear in dosing directions. Six products used trailing zeros or failed to use leading zeros with decimal doses; eight did not use small font for fractions. Product adherence to low tier recommendations ranged from 26% to 91%.

CONCLUSIONS:

Products adhered to most recommendations in the final FDA guidance and Consumer Healthcare Products Association guideline, suggesting that these voluntary initiatives promote adherence to recommendations. Improving adherence to recommendations should be prioritized based on potential to reduce harm.
Triplet Harvesting in White Organic Light-Emitting Diodes
Authors: Hofmann Simone , Leo Karl , Gather Malte C.
Published: January 2014

In this paper, we review our recent work on triplet harvesting (TH) and its application in white organic light-emitting diodes (OLEDs). This includes the configuration of highly efficient single unit two-color and tandem four-color white OLEDs reaching efficacies of more than 30 lm/W at 1000 cd/m², as well as the development of new blue fluorescent emitters. The new compounds are chemically designed to exhibit a high triplet energy to allow TH by a green phosphorescent emitter. In a first step towards white TH OLEDs, we fabricated blue-green TH OLEDs to prove the validity of our concept.
Conductivity and Microstructure of Inkjet-Printed Silver Tracks Depending on the Digital Pattern, Sintering Process, Substrate and Ink
Authors: Weise Dana , Grimm Andrea , Weiß Uwe , Mitra Kalyan Yoti , Sowade Enrico , Baumann Reinhard R.
Published: January 2014

Silver nanoparticle inks are increasingly applied for the manufacture of inkjet-printed electrically conductive patterns. In order to obtain high conductivity, the printed liquid patterns have to be functionalized by an appropriate post- treatment step. Modern post-treatment methods using e.g. microwaves, intense pulsed light or adopted infrared radiation, are nevertheless the basis of the thermal process. The thermal treatment e.g. in furnaces or on heating plates, is applicable for a great variety of inks and ensures an efficient sintering without major technical efforts. It has been studied intensively wherein the reports mainly focus on reduction of the resistivity by controlling the parameters of the thermal treatment. Our researches exceed these comparative studies by investigating multi-layered patterns, their manufacturing and post-treatment.

Two silver nanoparticle inks were inkjet printed on a rigid and a flexible substrate. The geometry of the patterns was varied. The different drying behaviors of the inks were investigated. In addition, the number of layers which were printed on top of each other was varied. The sintering temperatures and time durations were varied.

The morphology of the patterns is investigated by profilometry and optical microscopy. The microstructure is analyzed by scanning electron microscope and X-ray diffraction. Furthermore, the electrical characteristics were determined by the measurement of the resistance. The results indicate the relation between the manufacture and the resulting microstructure and functionality of the patterns. The knowledge of these parameters enables us to control the industrial manufacturing of similar conductive patterns.
Consumo alimentar e fatores dietéticos envolvidos no processo saúde e doença de Nikkeis: revisão sistemática
Authors: Tanabe Fabiana Hitomi , Drehmer Michele , Neutzling Marilda Borges
Published: January 2014

OBJETIVO: Analisar consumo alimentar e fatores dietéticos envolvidos no processo saúde e doença da população de nikkeis.MÉTODOS: Foi realizada revisão sistemática da literatura, com buscas nas bases de dados do Lilacs, SciELO e PubMed/Medline, referente ao período de 1997 a 2012, de estudos observacionais sobre o consumo alimentar de nikkeis. Inicialmente, foram analisados 137 títulos e resumos, sendo excluídos estudos de intervenção, aqueles que apresentavam somente níveis séricos de vitaminas e metabólitos e estudos que não contemplassem o objetivo da revisão. Desses, foram selecionados 38 estudos avaliados com base no método de Downs & Black (1998), adaptado para estudos observacionais, permanecendo 33 para análise.RESULTADOS: Foram encontrados poucos estudos sobre consumo alimentar de nikkeis fora do Havaí, dos Estados Unidos e do estado de São Paulo (principalmente em Bauru), no Brasil. Houve elevada contribuição dos lipídios no valor calórico total dos nipo-brasileiros, em detrimento dos carboidratos e das proteínas. Nos Estados Unidos, a prevalência de consumo de alimentos de alta densidade energética foi elevada em nipo-americanos. Os nisseis (filhos de imigrantes) apresentaram, em média, maior consumo de produtos da dieta japonesa, enquanto os sanseis (netos de imigrantes) apresentaram um perfil alimentar mais ocidentalizado.CONCLUSÕES: O consumo alimentar de nikkeis, embora ainda conservando alguns hábitos alimentares de japoneses nativos, revela alta prevalência de consumo de alimentos típicos do padrão ocidental (alimentos processados, ricos em gorduras e sódio e pobres em fibras), que pode estar contribuindo para o aumento de doenças crônicas nessa população.
Adesão a modos saudáveis de vida mediante aconselhamento por profissionais de saúde
Authors: Toledo Mariana Tâmara Teixeira de , Abreu Mery Natali , Lopes Aline Cristine Souza
Published: January 2014

OBJETIVO: Estimar a prevalência e fatores associados à adesão a modos saudáveis de vida.MÉTODOS: Estudo transversal conduzido com usuários maiores de 19 anos de uma unidade básica de saúde de Belo Horizonte, MG, entre 2009 e 2010. A amostra foi selecionada para estimar a proporção de pessoas que aderiram a modos saudáveis de vida (alimentação saudável e prática de atividade física) mediante aconselhamento realizado por profissionais de saúde e os fatores sociodemográficos, alimentares e de saúde associados. Adicionalmente, foram analisados os benefícios e dificuldades percebidas para a adesão a modos saudáveis de vida. Realizou-se análise descritiva, univariada (Qui-quadrado de Pearson ou Exato de Fisher) e multivariada mediante Regressão de Poisson.RESULTADOS: Dos 417 participantes, apenas 40,8% recebeu o aconselhamento, dos quais 50,9% apresentaram adesão. Na análise multivariada, a adesão foi associada com a percepção de ser ter uma alimentação era saudável (RP = 1,67; IC95% 1,15;2,43) e a participação em serviço público de promoção da saúde (RP = 1,55; IC95% 1,18;2,03). Maior disposição e redução de peso foram referidas como principais benefícios da adesão, enquanto a dificuldade para mudar hábitos e falta de tempo foram as barreiras mais relatadas.CONCLUSÕES: A adoção de modos de vida mais saudáveis requer a proposição de estratégias que favoreçam a adesão, bem como a participação dos profissionais na realização do aconselhamento como ação de promoção da saúde que gere maior autonomia e qualidade de vida, sustentado por políticas e programas de promoção da saúde.
Adaptação cultural da versão brasileira do Godin-Shephard Leisure-Time Physical Activity Questionnaire
Authors: São-João Thaís Moreira , Rodrigues Roberta Cunha Matheus , Gallani Maria Cecília Bueno Jayme , Miura Cinthya Tamie de Passos , Domingues Gabriela de Barros Leite , Godin Gaston
Published: January 2014

OBJETIVO: Realizar adaptação cultural para versão brasileira do questionário de atividade física no tempo de lazer e avaliar a validade de conteúdo, praticabilidade, aceitabilidade e confiabilidade.MÉTODOS: Foram realizadas as etapas de tradução, síntese, retrotradução, avaliação por comitê de especialistas e pré-teste, seguidos pela avaliação da praticabilidade, aceitabilidade e confiabilidade (teste-reteste). Os juízes avaliaram as equivalências semântico-idiomática, conceitual, cultural e metabólica. A versão adaptada foi submetida ao pré-teste (n = 20) e teste-reteste (n = 80) em indivíduos saudáveis e pacientes com doenças cardiovasculares, em Limeira, SP, entre 2010 e 2011. A proporção de concordância do comitê de juízes foi quantificada por meio do Índice de Validade de Conteúdo. A confiabilidade foi avaliada segundo critério de estabilidade, com intervalo de 15 dias entre as aplicações, a praticabilidade pelo tempo gasto na entrevista e a aceitabilidade pelo percentual de itens não respondidos e proporção de pacientes que responderam a todos os itens.RESULTADOS: A versão traduzida do questionário apresentou equivalências semântico-idiomática, conceitual, cultural e metabólica adequadas, com substituição de algumas atividades físicas mais adequadas para a população brasileira. A análise da praticabilidade evidenciou curto tempo de aplicação do instrumento (média de 3,0 min). Quanto à aceitabilidade, todos os pacientes responderam a 100% dos itens. A análise do teste-reteste sugeriu estabilidade temporal do instrumento (Índice de Correlação Intraclasse = 0,84).CONCLUSÕES: A versão brasileira do questionário apresentou propriedades de medida satisfatórias. Recomenda-se sua aplicação a populações diversas em estudos futuros, a fim de disponibilizar propriedades de medida robustas.
Evolução dos preços relativos de grupos alimentares entre 1939 e 2010, em São Paulo, SP
Authors: Yuba Tania Yuka , Sarti Flávia Mori , Campino Antonio Carlos Coelho , Carmo Heron Carlos Esvael do
Published: January 2014

OBJETIVO: Analisar a evolução dos preços relativos dos grupos de produtos alimentares e sua influência nas políticas públicas para uma alimentação saudável.MÉTODOS: Foram analisados dados do município de São Paulo de 1939 a 2010, a partir da aplicação de métodos de cálculo de números-índices. Foram utilizados dados do banco de preços e estruturas de ponderação da Fundação Instituto de Pesquisas Econômicas (1939 a 1988) e do Instituto Brasileiro de Geografia e Estatística (1989 a 2010). O banco de preços foi organizado, sua consistência foi testada e os preços foram deflacionados pelo Índice de Preços ao Consumidor. Os dados relativos a preços deflacionados foram calculados e agregados por categorias e grupos alimentares da pirâmide alimentar adaptada. Os índices de preços de cada grupo foram construídos aplicando a fórmula de Laspeyres modificada. O índice geral de preços da alimentação foi comparado com índices de cada grupo alimentar e respectiva categoria: alimentos in natura; alimentos industrializados; bebidas; carnes, leguminosas, leite e ovos; cereais e tubérculos; e refeições fora do domicílio.RESULTADOS: Os grupos alimentares de gorduras, óleos, condimentos, açúcares e alimentos processados (alimentos industrializados) apresentaram tendência de redução de preços em termos relativos. O índice dos alimentos in natura,como frutas e verduras, apresentaram tendência de elevação de preços. Outros grupos alimentares, como cereais, farinhas e massas, carnes, leite e ovos, apresentaram estabilidade de preços relativos ao longo do tempo.CONCLUSÕES: A evolução dos preços relativos dos alimentos no município de São Paulo mostra tendência desfavorável à manutenção da alimentação saudável em nível domiciliar em longo prazo.
Instrumentos em Língua Brasileira de Sinais para avaliação da qualidade de vida da população surda
Authors: Chaveiro Neuma , Duarte Soraya Bianca Reis , Freitas Adriana Ribeiro de , Barbosa Maria Alves , Porto Celmo Celeno , Fleck Marcelo Pio de Almeida
Published: January 2014

OBJETIVO: Construir a versão em Língua Brasileira de Sinais dos instrumentos WHOQOL-BREF e WHOQOL-DIS para avaliar a qualidade de vida da população surda brasileira.MÉTODOS: Utilizou-se metodologia proposta pela Organização Mundial da Saúde (WHOQOL-BREF e WHOQOL-DIS) para a construção dos instrumentos adaptados para população surda em Língua Brasileira de Sinais (Libras). A pesquisa para execução do instrumento consistiu de 13 etapas: 1) criação do sinal qualidade de vida; 2) desenvolvimento das escalas de respostas em Libras; 3) tradução por um grupo bilíngue; 4) versão reconciliadora; 5) primeira retrotradução; 6) produção da versão em Libras a ser disponibilizada aos grupos focais; 7) realização dos grupos focais; 8) revisão por um grupo monolíngue; 9) revisão pelo grupo bilíngue; 10) análise sintática/semântica e segunda retrotradução; 11) reavaliação da retrotradução pelo grupo bilíngue; 12) filmagem da versão para o software; 13) desenvolvimento do software WHOQOL-BREF e WHOQOL-DIS em Libras.RESULTADOS: Características peculiares da cultura da população surda apontaram a necessidade de adaptações na metodologia de aplicação de grupos focais quando compostos por pessoas surdas. As convenções ortográficas da escrita das línguas sinalizadas não estão consolidadas, o que trouxe dificuldades em registrar graficamente as etapas de tradução. As estruturas linguísticas que causaram maiores problemas de tradução foram as que incluíram expressões idiomáticas do português, muitas sem conceitos equivalentes entre o português e a Libras. Foi possível construir um software do WHOQOL-BREF e WHOQOL-DIS em Libras.CONCLUSÕES: O WHOQOL-BREF e o WHOQOL-DIS em Libras possibilitarão que os surdos se expressem autonomamente quanto a sua qualidade de vida, o que permitirá investigar com maior precisão essas questões.
Água de abastecimento público de consumo humano e oviposição de Aedes aegypti
Authors: Marques Gisela R A Monteiro , Chaves Leonardo Suveges Moreira , Serpa Lígia Leandro Nunes , Arduíno Marylene de Brito , Chaves Francisco José Moreira
Published: January 2014

OBJETIVO: Analisar o efeito da qualidade da água de reservatórios domésticos de abastecimento público na resposta oviposicional de fêmeas de Aedes aegypti.MÉTODOS: Estudo conduzido em laboratório a partir de imaturos de Ae. aegypti, coletados em caixas d'água do município de Potim, SP, 2009. Foram disponibilizados simultaneamente três tipos de água por gaiola para a deposição dos ovos: ovipositor (A) com água coletada em caixa d'água de Taubaté, SP; ovipositor (B) com água destilada (controle); e ovipositor (C) com água coletada em caixa d'água de Potim. Foram analisados parâmetros fisicoquímicos. O teste de Kruskall-Wallis foi utilizado para analisar a média de ovos nas diferentes amostras de água e nas comparações posteriores, o teste Dwass-Steel-Chritchlow-Flingner. O índice de atividade de oviposição foi adotado para avaliar a resposta oviposicional.RESULTADOS: Foi observada diferença significativa no número de ovos entre as soluções líquidas testadas (H = 45; p < 0,0001). O número de ovos na água de caixas d'água de abastecimento público de captação em poços profundos (C) foi estatisticamente superior a amostras de água de caixas d'água de abastecimento público de superfície (A) (p < 0,0001) e do Controle (B) (p < 0,0001). Não houve diferença significante entre o número de ovos do Controle (B) e água de superfície (A). A primeira postura foi a mais produtiva em todas as soluções testadas nas três gaiolas. A amostra de água (C) produziu índice positivo (0,54), i.e., atrativo para oviposição.CONCLUSÕES: A qualidade da água influiu na oviposição de Ae. aegypti. As elevadas concentrações de nitrogênio amoniacal na água de abastecimento público sugerem que esse componente químico foi o responsável pela atratividade de fêmeas grávidas de Ae. aegypti para a oviposição nesses criadouros.
Aedes aegypti entomological indices in an endemic area for dengue in Sao Paulo State, Brazil
Authors: Favaro Eliane A , Dibo Margareth R , Pereira Mariza , Chierotti Ana P , Rodrigues-Junior Antonio L , Chiaravalloti-Neto Francisco
Published: January 2014

OBJECTIVE: To evaluate the most productive types of properties and containers for Aedes aegypti and the spatial distribution of entomological indices.METHODS: Between December 2006 and February 2007, the vector's immature forms were collected to obtain entomological indices in 9,875 properties in the Jaguare neighborhood of Sao Jose do Rio Preto, SP, Southeastern Brazil. In March and April 2007, a questionnaire about the conditions and characteristics of properties was administered. Logistic regression was used to identify variables associated with the presence of pupae at the properties. Indices calculated per block were combined with a geo-referenced map, and thematic maps of these indices were obtained using statistical interpolation.RESULTS: The properties inspected had the following Ae. aegypti indices: Breteau Index = 18.9, 3.7 larvae and 0.42 pupae per property, 5.2 containers harboring Ae. aegypti per hectare, 100.0 larvae and 11.6 pupae per hectare, and 1.3 larvae and 0.15 pupae per inhabitant. The presence of yards, gardens and animals was associated with the presence of pupae.CONCLUSIONS: Specific types of properties and containers that simultaneously had low frequencies among those positive for the vector and high participation in the productivity of larvae and pupae were not identified. The use of indices including larval and pupal counts does not provide further information beyond that obtained from the traditional Stegomyia indices in locations with characteristics similar to those of São José do Rio Preto. The indices calculated per area were found to be more accurate for the spatial assessment of infestation. The Ae. aegypti infestation levels exhibited extensive spatial variation, indicating that the assessment of infestation in micro areas is needed.
Sexual Health as a Survivorship Issue for Female Cancer Survivors
Authors: Dizon Don S. , Suzin Daphne , McIlvenna Susanne
Published: January 2014

As more and more people are successfully treated for and live longer with cancer, greater attention is being directed toward the survivorship needs of this population. Women treated for cancer often experience issues related to sexual health and intimacy, which are frequently cited as areas of concern, even among long-term survivors. Unfortunately, data suggest that providers infrequently discuss these issues. We reviewed a contemporary understanding of sexual health of women and the impact of treatment on both sexual function and intimacy. We also provide a review of the diagnosis using the newest classification put forth by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, and potential treatments, including both endocrine and nonendocrine treatments that the general oncologist may be asked about when discussing sexual health with his or her patients.
An mHealth Model to Increase Clinic Attendance for Breast Symptoms in Rural Bangladesh: Can Bridging the Digital Divide Help Close the Cancer Divide?
Authors: Ginsburg Ophira M. , Chowdhury Mridul , Wu Wei , Chowdhury Md Touhidul Imran , Pal Bidhan Chandra , Hasan Rifat , Khan Zahid H. , Dutta Dali , Saeem Arif Abu , Al-Mansur Raiyan , Mahmud Sahin , Woods James H. , Story Heather H. , Salim Reza
Published: January 2014

Objective.

To demonstrate proof of concept for a smart phone-empowered community health worker (CHW) model of care for breast health promotion, clinical breast examination (CBE), and patient navigation in rural Bangladesh.

Methods.

This study was a randomized controlled trial; July 1 to October 31, 2012, 30 CHWs conducted door-to-door interviews of women aged 25 and older in Khulna Division. Only women who disclosed a breast symptom were offered CBE. Arm A: smart phone with applications to guide interview, report data, show motivational video, and offer appointment for women with an abnormal CBE. Arm B: smart phone/applications identical to Arm A plus CHW had training in “patient navigation” to address potential barriers to seeking care. Arm C: control arm (no smart phone; same interview recorded on paper). Outcomes are presented as the “adherence” (to advice regarding a clinic appointment) for women with an abnormal CBE. This study was approved by Women's College Hospital Research Ethics Board (Toronto, Ontario, Canada) and district government officials (Khulna, Bangladesh). Funded by Grand Challenges Canada.

Results.

In 4 months, 22,337 women were interviewed; <1% declined participation, and 556 women had an abnormal CBE. Control group CHWs completed fewer interviews, had inferior data quality, and identified significantly fewer women with abnormal breast exams compared with CHWs in arms A and B. Arm B had the highest adherence.

Conclusion.

CHWs guided by our smart phone applications were more efficient and effective in breast health promotion compared with the control group. CHW “navigators” were most effective in encouraging women with an abnormal breast examination to adhere to advice regarding clinic attendance.
Sand strength for back-analysis of pull-out tests at large displacement
Authors: ROUSé P.C. , FANNIN R.J. , TAIEBAT M.
Published: January 2014

Pull-out test data are reported for two textured, planar inclusions embedded in sand. Comparison of measured and back-calculated values of pull-out resistance, and also of the lateral stress on the front wall of the box due to pull-out, support the belief that a plane strain condition prevails at large displacement. The study demonstrates that it is important to account for stress dependency of the friction angle in analysis of tests performed at a normal effective stress less than 50 kPa.
Briefing: Two new EU-funded public transport projects in Bulgaria
Authors: Burley Richard , Baev Ivo
Published: January 2014

A consortium of consultants, led by international multidisciplinary consultancy WYG, is providing professional expertise on two new major public transport projects in Bulgaria. The two initiatives, in the municipalities of Burgas and Plovdiv, are expected to be completed towards the end of 2015.
The Effectiveness of Three Vegetation Indices Obtained from a Canopy Sensor in Identifying Sugarcane Response to Nitrogen
Authors: Rios do Amaral Lucas , Molin José Paulo
Published: January 2014

Methods for estimating the N response of sugarcane (Saccharumspp.) while considering a variable rate of N application are required to allow for improved nitrogen use efficiency (NUE) and higher yields. The objectives of this work were to compare the performance of three vegetation indices obtained from canopy sensor data to assess N in sugarcane fields at various crop stalk height as well as to determine the ability of these in‐season sensor readings to predict the response of yield to N. Seven experiments were conducted in Brazil under different site conditions from 2009 to 2011. The treatments comprised five N application rates ranging from 0 to 200 kg N ha–1. A CropCircle canopy sensor (model ACS‐210, Holland Scientific Inc., Lincoln, NE) was used to determine the amber normalized difference vegetation index (aNDVI), chlorophyll index (CI), and inverse of the simple ratio (ISR) at different crop stalk heights. The N application increased the yield in only three fields (p< 0.1). The best results using the canopy sensor readings, chlorophyll and leaf N content were found when the average crop stalk height was between 0.4 and 0.7 m. A weak relationship was observed between the vegetation indices and N from tissue analyses. The best results were obtained with the ISR due to its highr2, low root mean square error (RMSE), and consequently higher SEq with respect to sugarcane yield. The canopy reflectance sensor is a useful tool for identifying the variability within fields and to determine the variable rate of in‐season N fertilizer application in sugarcane fields.
Assessing the Salt Tolerance of Sulla carnosa Genotypes by Agronomic Indicators
Authors: Gandour Mhemmed , Neji Mohamed , Hessini Kamel , Smida Malek , Abdelly Chedly , Taamalli Wael
Published: January 2014

The progressive salinization of arable lands at a rate of 3 ha min–1 worldwide is a major concern for agricultural crop production. The future of crop improvement to resist or tolerate environmental stresses requires selecting halophytes that will produce high yield and profit. A halophyte, Sulla carnosa (Hedysarum carnosum Desf.), collected from southern and central Tunisia is considered a salt‐resistance species. A group of five populations represented by 150 genotypes (30 genotypes per population) were tested under greenhouse conditions with salt treatments 0 mM (control) and 300 mM (stressed). Fifteen agronomic traits related to vegetative and reproductive growth were evaluated for their responses to salinity stress. Analysis of the population effect and genotypes within population’s effect shows that both population and genotype factors have a significant effect for almost all measured traits. The highest diversity in traits was found within progeny originating from Douiret and Kairouan populations (mean and CV across the 15 traits 48.4 and 46.5%, respectively). Level of phenotypic differentiation (Q_ST) varied according to measured traits; it ranged from 0.108 for flowering time to 0.63 for mean crown width with an average of 0.29. Means comparison and principal component analysis showed that six genotypes from different origins were ranked as salt tolerant and three others as salt sensitive. These findings indicate the potential for selecting plants or traits with improved salt tolerance within that species. The method used allows detection plants or traits with enhanced salinity tolerance after 2 mo of growth for the ability to grow at salt concentrations that prevent the growth of other plants.
A Simple Crop Phenology Algorithm in the Land Surface Model CN‐CLASS
Authors: Chang Kuo‐Hsien , Warland Jon S. , Bartlett Paul A. , Arain Altaf M. , Yuan Fengming
Published: January 2014

Land surface models are useful tools for estimating the contribution and response to climate change of C dynamics in various terrestrial ecosystems. In many land surface models, plant phenological algorithms are incorporated based on field studies in forests. However, to simulate adequately the C cycle over a large area, there is a need to include and validate algorithms for other ecosystems. The Carbon and Nitrogen‐coupled Canadian Land Surface Scheme (CN‐CLASS) is a land surface model that has been applied successfully to the study of C stocks in forest ecosystems. The objective of this study is to incorporate a simple crop phenology algorithm into CN‐CLASS and validate its ability to simulate C cycles at an agricultural site in southern Ontario, Canada. The model was validated on a corn crop (Zea maysL.) in 2005 and 2008 based on measurements of aboveground biomass and net ecosystem productivity (NEP), as well as a well‐tested agricultural model, DayCENT (the daily time‐step version of the CENTURY model). The modified CN‐CLASS showed similar dynamics of biomass allocation compared with field measurements and DayCENT simulations. Regression analysis indicated that the modifications improved the NEP simulation for a cornfield, with the coefficient of determination (R2) relating simulated and observed NEP increasing from 0.51 in the original CN‐CLASS to 0.78 in the modified model. Other crop species could be further validated to expand the model application to crop rotation studies and large areas covered by forests and crop fields in consideration of land management practices.