bluuebunny/crossref_metadata_2025 huggingface dataset:
Review article: climate change impacts on dam safety
Authors: Fluixá-Sanmartín Javier , Altarejos-García Luis , Morales-Torres Adrián , Escuder-Bueno Ignacio
Published: May 2018

Abstract. Dams as well as protective dikes and levees are critical infrastructures whose associated risk must be properly managed in a continuous and updated process. Usually, dam safety management has been carried out assuming stationary climatic and non-climatic conditions. However, the projected alterations due to climate change are likely to affect different factors driving dam risk. Although some reference institutions develop guidance for including climate change in their decision support strategies, related information is still vast and scattered and its application to specific analyses such as dam safety assessments remains a challenge. This article presents a comprehensive and multidisciplinary review of the impacts of climate change susceptible to affect dam safety. The global effect can be assessed through the integration of the various projected effects acting on each aspect of the risk, from the input hydrology to the calculation of the consequences of the flood wave on population and assets at risk. This will provide useful information for dam owners and dam safety practitioners in their decision-making process.
Stopping the Flood: Could We Use Targeted Geoengineering to Mitigate Sea Level Rise?
Authors: Wolovick Michael J. , Moore John C.
Published: May 2018

Abstract. The Marine Ice Sheet Instability (MISI) is a dynamic feedback that can cause an ice sheet to enter a runaway collapse. Thwaites Glacier, West Antarctica, is the largest individual source of future sea level rise and may have already entered the MISI. Here, we use a suite of coupled ice–ocean flowband simulations to explore whether targeted geoengineering using an artificial sill or artificial ice rises could counter a collapse. Successful interventions occur when the floating ice shelf regrounds on the pinning points, increasing buttressing and reducing ice flux across the grounding line. Regrounding is more likely with a continuous sill that is able to block warm water transport to the grounding line. The smallest design we consider is comparable in scale to existing civil engineering projects but has only a 30 % success rate, while larger designs are more effective. There are multiple possible routes forward to improve upon the designs that we considered, and with decades or more to research designs it is plausible that the scientific community could come up with a plan that was both effective and achievable. While reducing emissions remains the short-term priority for minimizing the effects of climate change, in the long run humanity may need to develop contingency plans to deal with an ice sheet collapse.
Comparison between Brazil and the 30 Most Innovative Countries in the World
Authors: Moser Marisa , Oliveira Mauri Aparecido de , Bueno Ricardo Luiz Pereira
Published: May 2018

Innovation can be defined as the implementation of a new or significantly improved product (good or service), or a process, a new marketing method, a new organizational method in business practices, workplace organization, or external relations. This innovation can be measured by several factors such as investments in research and development, the concentration of high-tech companies traded on the stock exchange, among others. The present study aims to perform a cluster analysis to investigate the behavior of the most innovative countries compared to Brazil. The study contemplates a historical series from the years 2012 to 2015 of the 30 most innovative countries in the world having been added to Brazil. In addition, a series of macroeconomic, political and social variables are considered.
Comparative Studies of the Use of Management Accounting Information
Authors: Zarzycka Ewelina , Dobroszek Justyna , Almasan Alina , Circa Cristina
Published: May 2018

The paper uses the phenomenon of isomorphism to present the similarities and differences in the use of management accounting information by managers in Poland and Romania. In order to analyze the set of data obtained from the conducted survey, cluster analysis and descriptive statistics have been applied. The studied managers use mainly management accounting information for planning and control tasks (budgeting) and less for formulating strategy and decision making. In their work, they rather apply financial data than nonfinancial indicators. The findings confirm that management accounting in both countries is strongly influenced by the mechanisms of coercive, normative and mimetic isomorphism connected with their specific economic and political development.
The effect of light rail transit service on nearby property values: Quasi-experimental evidence from Seattle
Authors: Ransom Michael R
Published: May 2018

This paper examined the effect of the construction of light rail transit stations on surrounding residential property values in Seattle, Washington. It studied sales of homes in the areas around the seven stations that serve primarily residential areas in the Rainier Valley, using a difference-in-differences regression technique to obtain plausibly causal estimates of the effect of new rail service. For these seven stations, the estimated impact of light rail service was positive for only one station and negative for two stations. Estimated impacts for the other stations were small and statistically insignificant. These results suggest that light rail service did not provide value to the neighborhoods in the Rainier Valley of Seattle. I speculate that the transport service provided by light rail was not a significant improvement relative to the bus lines that serviced the area before light rail was built.
Considering Nursing Theory Certification
Authors: Hanna Debra , Buckner Ellen
Published: May 2018

Objetivo: realizou-se uma oficina para discutir o desenvolvimento das certificações teóricas de enfermagem em quatro níveis de conhecimento de enfermagem como parte da conferência anual de 2016 da Roy Adaptation Association International. Materiais e método: discutiram-se oito perguntas em grupos pequenos e grandes. Os pontos de discussão foram escritos num quadro tipo flipchart. Esses pontos foram resumidos neste artigo. Resultados: 35 acadêmicos internacionais de enfermagem participaram. Discutiram os benefícios, limitações e estratégias de um novo tipo de certificação para o conhecimento da teoria da enfermagem em quatro níveis de educação e prática. Conclusão: a certificação da teoria da enfermagem confirmaria o conhecimento de enfermagem sem se tornar uma carga para os enfermeiros. Pode afetar potencialmente como se educam os enfermeiros sobre a teoria em cada um dos quatro níveis de educação, como esses profissionais usam a teoria na prática e a qualidade da atenção de enfermagem oferecida. Há necessidade de dialogar continuamente a respeito do tema.
“Nursing Care with a Human Approach”: A Model for Practice with Service Excellence
Authors: Carvajal Hermida Elsa Yolanda , Sánchez-Herrera Beatriz
Published: May 2018

Objetivo. Desarrollar un modelo para la práctica de cuidado que permita mejorar de forma continua el cuidado de enfermería en el Hospital Universitario Fundación Santa Fe de Bogotá (FSFB). Materiales y método. Estudio desarrollado por fases secuenciales que incluyó: 1) Identificación de la necesidad de contar con un modelo de cuidado para la práctica, 2) Caracterización del contexto y del escenario deseado; 3) Revisión de literatura; 4) Descripción del modelo; 5) Validación. Resultados. Las tendencias globales en el uso de modelos de enfermería en la práctica clínica reconoce aspectos comunes y enfatiza la pertinencia, metodologías y diversos roles en la implementación. El contexto y proyección de excelencia para enfermería en la FSFB requieren la orientación de un modelo para la práctica que oriente el cuidado y que responda a la vocación de servicio centrado en la experiencia de la salud humana. Conclusión. El modelo de la práctica “Cuidado de enfermería con enfoque humano”, permite comprender y comunicar lo esencial de la práctica enfermería en el ámbito del hospital universitario FSFB, para cualificar dicha práctica de manera permanente.
Instrumento tarjetas de cualidad del dolor: adaptación cultural y evidencias de validez en niños
Authors: Moreno-Ramos Mily Constanza , Mariano-Rossato Lisabelle , Bueno Mariana , Meireles Everson , Guerrero Nidia Sandra , Guedes Danila María
Published: May 2018

Objetivo: evaluar la adaptación cultural y encontrar evidencias de validez del instrumento tarjetas de cualidad del dolor (ITCD). Materiales y método: estudio metodológico y de validación de pruebas, que para la adaptación y validación de contenido realizó la traducción, retrotraducción, panel de expertos, revisión por niños en edad escolar y prueba piloto del ITCD. Además, se evaluó la validez de criterio externo con 90 niños en edad escolar hospitalizados y con heridas. La investigación fue realizada entre enero y febrero del 2015. Resultados: el instrumento fue traducido y retrotraducido a español y a portugués, respectivamente. En la evaluación del panel de expertos fue establecido un índice de validez de contenido de 0,92. En la revisión realizada por los niños se efectuaron cambios a los descriptores de siete tarjetas según sus sugerencias. El estudio piloto, mostró que 17 tarjetas presentaron claridad semántica para más del 90% de los niños. En cuanto a las evidencias basadas en el criterio externo, las variables diagnóstico médico, tipo de herida, infección de la herida e intensidad del dolor mostraron resultados significativos (p<0,05). Conclusiones: el instrumento tarjetas de cualidad del dolor fue adaptado culturalmente y mostró evidencias de validez basadas en el contenido y en el criterio externo.
Diagnósticos de enfermagem segundo a teoria do autocuidado em pacientes com infarto do miocárdio
Authors: Holanda da Cunha Gilmara , Lima Ramalho Ane Kelly , Maia Cruz Alyne Mara , Correia Lima Maria Amanda , Barbosa Franco Katia , Rodrigues de Oliveira Lima Reângela Cintia
Published: May 2018

Objetivo: identificar los diagnósticos de enfermería en personas con infarto de miocardio en emergencia hospitalaria, según la teoría del autocuidado de Orem. Materiales y método: estudio transversal, realizado de febrero a agosto del 2016, con 50 pacientes infartados y que estaban en condiciones de participar en la investigación. La recolección de datos ocurrió a través de entrevista, utilizando cuestionario según la teoría del autocuidado, y se formularon diagnósticos de enfermería con base en la Taxonomía de la NANDA-I. Resultados: la mayoría de los pacientes eran mujeres (54 %), con edades de 60 a 69 años (34 %), ingreso familiar de uno a dos salarios mínimos (88 %), con enseñanza básica (70 %) y jubilados (76 %). Hubo alta frecuencia de hipertensión arterial (62 %), inactividad física (76 %) y tabaquismo (70 %). La prueba rápida para troponina fue positiva en 16 personas (32 %). Muchos infartados presentaban déficits de autocuidado que apuntaron 10 diagnósticos de enfermería, destacándose estilo de vida sedentario (80 %), movilidad física perjudicada (76 %) y riesgo de intolerancia a la actividad (76 %). Los comportamientos de salud propensos al riesgo y la autonegligencia tuvieron relación con tres requisitos de autocuidado. Conclusión: los pacientes necesitaban de asistencia en salud para cambios en el estilo de vida, medidas de confort y realización de actividad y reposo.
Predicting Psychiatric Hospitalizations among Elderly Veterans with a History of Mental Health Disease
Authors: Burningham Zachary , Leng Jianwei , Peters Celena B. , Huynh Tina , Halwani Ahmad , Rupper Randall , Hicken Bret , Sauer Brian C.
Published: May 2018

Introduction: Patient Aligned Care Team (PACT) care managers are tasked with identifying aging Veterans with psychiatric disease in attempt to prevent psychiatric crises. However, few resources exist that use real-time information on patient risk to prioritize coordinating appropriate care amongst a complex aging population.Objective: To develop and validate a model to predict psychiatric hospital admission, during a 90-day risk window, in Veterans ages 65 or older with a history of mental health disease.Methods: This study applied a cohort design to historical data available in the Veterans Affairs (VA) Corporate Data Warehouse (CDW). The Least Absolute Shrinkage and Selection Operator (LASSO) regularization regression technique was used for model development and variable selection. Individual predicted probabilities were estimated using logistic regression. A split-sample approach was used in performing external validation of the fitted model. The concordance statistic (C-statistic) was calculated to assess model performance.Results: Prior to modeling, 61 potential candidate predictors were identified and 27 variables remained after applying the LASSO method. The final model’s predictive accuracy is represented by a C-statistic of 0.903. The model’s predictive accuracy during external validation is represented by a C-statistic of 0.935. Having a previous psychiatric hospitalization, psychosis, bipolar disorder, and the number of mental-health related social work encounters were strong predictors of a geriatric psychiatric hospitalization.Conclusion: This predictive model is capable of quantifying the risk of a geriatric psychiatric hospitalization with acceptable performance and allows for the development of interventions that could potentially reduce such risk.
Diagnóstico del aprendizaje táctico en la selección nacional femenina de balonmano, categoría juvenil
Authors: Banegas Lenigan Jaime , Secades Xabel
Published: May 2018

La presente investigación parte de las insuficiencias que se manifiestan en la inadecuada utilización del diagnóstico como instrumento de medición del aprendizaje de los contenidos tácticos en el balonmano femenino, categoría juvenil de Honduras. Lo cual se orienta el objetivo a elaborar una metodología para contribuir al desarrollo del diagnóstico del aprendizaje táctico en dichas jugadoras. En este sentido se define como objeto de investigación: el proceso de evaluación en las jugadoras del equipo balonmano y como campo de acción: el diagnóstico del aprendizaje táctico. En post de alcanzar su finalidad organizada a partir de las tareas investigativas se utilizaron métodos teóricos y empírico, así como técnicas de investigación, al permitir evidenciar las carencias desde el punto de vista científico que dieron lugar a formular el problema y contribuyeron a constatar no solo los resultados del diagnóstico, sino las valoraciones finales a través del criterio de especialistas. La novedad científica radica en la estructuración de la metodología para el diagnóstico del aprendizaje táctico, desde una perspectiva sistémica, al contextualizar su aplicación en los diferentes momentos de la formación de las jugadoras. Dota al proceso de enseñanza aprendizaje de un conjunto de ejercicios e instrumentos basados en registros de medición, que favorecen el desempeño profesional de los entrenadores para determinar el desarrollo alcanzado por estas en cada etapa de la preparación.
Effect of applying centering pregnancy model versus individual prenatal care on certain prenatal care outcomes
Authors: Marzouk Tyseer , Abd-Allah Inas Mohamed , Shalaby Hend
Published: May 2018

Objective: This study aimed to compare effect of applying centering pregnancy model (CPM) versus individual prenatal care on certain prenatal care outcomes.Methods: A quasi experimental research design was followed. A purposive sample of 216 pregnant women without medical or obstetric problems requiring individualized care, was recruited from the Antenatal Outpatient Clinics of Mansoura University Hospitals, Egypt. Participants were randomly assigned to receive prenatal care under CPM or individual prenatal approach. Data were collected for the healthy behaviors adoption using Pregnancy-relevant Health Behaviors scale, women’s extent of troubling about pregnancy physical discomforts using a Pregnancy Symptoms Distress scale, and women’s satisfaction with prenatal care using Patient Participation & Satisfaction Questionnaire.Results: Post-intervention, CPM group equated to individual care group experienced lower distress about experienced pregnancy physical discomforts (8.06 ± 2.40 vs. 15.42 ± 3.84 respectively; t = 16.89 & p < .001), reported higher engagement to pregnancyrelevant health behaviors (37.71 ± 2.91 vs. 29.78 ± 4.3 respectively; t = 15.59 & p < .001), and higher satisfaction with and participation in care (80.8 ± 10.4 and 63.8 ± 11.1 respectively, t = 11.62 & p < .001).Conclusions: Hypotheses of the current study were accepted where CPM of prenatal care was associated with increased women adoption to the pregnancy-relevant healthy behaviors, reduced women distress about the experienced pregnancy physical discomforts and increased women participation and satisfaction about prenatal care.
Hypercalcemia due to milk alkali syndrome: An emerging cause of hypercalcemia: A case report and review of literature
Authors: Pandey Yadav , Joshi Krishna Prasad , Priyambada Priya , Chaudhary Anmol
Published: May 2018

Introduction: Hypercalcemia is relatively common in clinical practice. Primary hyperparathyroidism and malignancy accounts for more than 90 percent of all cases of hypercalcemia. Milk alkali syndrome which is hypercalcemia classically caused by ingestion of large amount of calcium and absorbable alkali which was once virtually disappeared as a cause of hypercalcemia has emerged as a third leading cause of hypercalcemia. We present a case of hypercalcemia secondary to ingestion of calcium carbonate tablets resulting in milk alkali syndrome.Case presentation: Patient is a 45-year-old female with history of gastroesophageal reflux disease came to the emergency department with complaints of dizziness, constipation, fatigue and confusion for 3 weeks. She was hypotensive to 83/53 mmHg at arrival. Significant laboratory results were - Potassium of 2.2 mmol/L (3.5-5.1 mmol/L), chloride 73 mmol/L (98-107 mmol/L), Bicarbonate 50 mmol/L (22-29 mmol/L), Blood urea 22 mg/dl (9.8-20.1 mg/dl), Cr 1.4 mg/dl (0.5-1.0 mg/dl), total calcium of 16.6 mg/dl (9-11 mg/dl), ionized calcium 2.02 mmol/L (1.15-1.33 mmol/L), PTH was low to 8.9 pg/ml (10-65 pg/ml). Arterial blood gas showed metabolic alkalosis. Extensive evaluation to find the cause of hypercalcemia was negative. Detailed history after initial stabilization, revealed that she had been taking 10 tablets of calcium carbonate tablets per day and 1 glass of milk daily for reflux symptoms for the last eight weeks. Based on the history and after ruling out all the other serious causes, diagnosis of milk alkali syndrome was made and patient was discharged with proton pump inhibitor with advice to avoid calcium carbonate. Her hypercalcemia responded well to fluid resuscitation.Conclusions: Milk alkali syndrome once a rare cause of hypercalcemia has emerged as a third leading cause of hypercalcemia in completely different scenario. It is important to evaluate the patient with proper history including the use of over the counter calcium supplements to determine the etiology of hypercalcemia. Our case highlights the importance of proper history taking in the evaluation of hypercalcemia and that not all the cause of severe hypercalcemia is secondary to malignancy.
The effect of a mindfulness based stress reduction intervention on the perceived stress and burnout of RN students completing a doctor of nursing practice degree
Authors: Turkal Melissa , Richardson Luann G. , Cline Thomas , Guimond Mary Elizabeth
Published: May 2018

Background and objective: There is a vast amount of literature documenting the epidemic of stress and burnout within the nursing profession. It is well established that chronic stress contributes to burnout among nursing staff and students.  Research suggests that organizational change, curriculum adjustment, and mindfulness interventions can contribute to decreased stress and better outcomes for nurses. The objective of this study was to investigate the effect of a Mindfulness Based Stress Reduction (MBSR) intervention on the perceived stress and burnout of students in a cohort of Registered Nurses (RNs) completing a Doctor of Nursing Practice (DNP) Degree.Methods: This study utilized pre and post data collection to explore the effect of a MBSR intervention on self-reported perceived stress and burnout using the Perceived Stress Scale (PSS) and Copenhagen Burnout Inventory (CBI). Study participants (n = 24) received a general orientation to the study followed by a brief intervention using the body scan meditation, a component of the MBSR-model. Students registered with the Remind mobile app to supplement the live instruction and to encourage the students to engage in daily mindfulness practice.Results: The repeated measures ANOVAs for all three CBI factors showed that personal, work, and client burnout means were statistically lower at four weeks post-intervention than they were at baseline. Perceived stress measures four weeks post-intervention were also statistically lower than baseline. There were no demographic interactions, and only one main effect for gender, in that males reported lower perceived stress. Conclusions: The MBSR intervention was successful in reducing the self-reported perceived stress and burnout of RN students completing their DNP Degree.
The Internal Audit Effectiveness Evaluated with an Organizational, Process and Relationship Perspective
Authors: Azzali Stefano , Mazza Tatiana
Published: May 2018

Using a unique database of Italian companies, we perform structural equation modeling technique to test the association between organizational, processes and relationship measure of internal audit effectiveness and firm pressures and performances. We find that size, listing and Big4 are significantly and positively associated with the internal audit effectiveness. We contribute to literature showing that organizational (e.g. presence of a charter, chief auditing executive experience), processes (audit plan risk based, quality assurance program, guidelines), and relationship (with auditee, senior management, chief financial officer, audit committee) measures are useful to evaluate the internal audit effectiveness. We provide support for profession, agency and institutional theories. We implement the measure of internal audit effectiveness with a structural equation model to be able to consider the different components of organizational, processes and relationship separately in a single model. Extending previous literature, we show that this measure of internal audit effectiveness is effective in discovering significant determinant of internal audit effectiveness and could be used in future research.
Corporate Social Responsibility Activities that Influence Customer Loyalty of SMEs
Authors: Turyakira Peter K.
Published: May 2018

Businesses are increasingly required to address the demands of key stakeholders, in addition to those of shareholders. There is an increasing role of corporate social responsibility (CSR) to large businesses and small and medium enterprises (SMEs) alike. However, research to support the degree of the application of CSR activities to SMEs with respect to customer loyalty is limited. The purpose of this study was to examine the selected CSR activities that impact the customer loyalty of SMEs. A self-administered questionnaire was distributed to selected SMEs in Kampala District, while Structural Equation Modeling was utilised to determine the influence of independent variables on the dependent variable. The study findings revealed that the selected CSR activities (Society-oriented CSR activities, Market-oriented CSR activities and Environmental-oriented CSR activities) positively influence the Customer loyalty of SMEs.
The Usefulness of Regulatory Capital for Investors’ Judgments in the Basel 3 Framework
Authors: Mechelli Alessandro , Sforza Vincenzo , Stefanoni Alessandra , Cimini Riccardo
Published: May 2018

Value relevance studies assess how well accounting amounts reflect the market information that investors use for their economic decisions. Analysing a sample of 90 banks listed in 24 European stock markets, this study uses a price model (Ohlson, 1995) and provides evidence that a risk-sensitive metric like regulatory capital is more useful for investors’ decisions than book value of equity and that investors price the parts of regulatory capital that are devoted ideally to absorb losses differently due to the different risks taken. In particular, the part devoted to absorb losses due to credit risk is priced higher than the parts devoted to absorb other risks (e.g. market risks, operational risk). According to our evidence, this is due to the business model of the entities analysed, which are mostly retail and wholesale banks with significant credit exposure to clients and other banks. The paper adds to the literature and has implications for regulators and standard setters showing that the assessment and disclosure of regulatory capital not only strengthens the soundness and the stability of the international banking system (Basle Committee on banking supervision, 1988), but provides to investors useful information for their future investment strategies.
Secondary School Students’ Mental Models Regarding the Space
Authors: Can Sendil , Baybars Meryem Gorecek
Published: May 2018

This study was carried out to reveal the mental models of the secondary school students from different grade levels regarding the concept of space. At the same time, within the context of the study, it was aimed to determine the factors playing a role in the construction of their concepts of space. The study employed the special case study design, one of the descriptive methods. The study was conducted in the spring term of the 2016-2017 school year and the sampling of the study is comprised of the students attending a private secondary school in a city located in the western region of Turkey. In the study, a data collection tool including four open-ended questions developed by the researchers to determine the students’ mental models of the “space” was used. The collected data were analyzed by using descriptive statistical techniques. The findings of the study have revealed that the students mostly associate the concept of the space with the concepts of emptiness (53 students), infinity (50 students), planet (48 students) and star (28 students). These findings are also supported by the students’ drawings and the Celestial Bodies Mental Model was found to be the model most frequently used by the students.
Developing Academic Motivation Scale for Learning Information Technology (AMSLIT): A Study of Validity and Reliability
Authors: Schreglmann Sinan
Published: May 2018

This study aimed to develop Academic Motivation Scale for Learning Information Technology for university students. For this purpose, 120 randomly selected university students studying in different classes and faculties at KSU were invited to the study during the 2016-2017 academic year. To define the scale indicators students were asked to answer the question; “What are your motivations for learning information technologies?”. Four different academicians examined the answers in accordance with the self-determination theory and they created the item pool. After expert examinations and pilot studies, the scale was designed in Likert-type with 18 items in 6 categories. To analyze the construct validity of the scale, 824 randomly selected students among the freshmen at KSU were included in the sample of the research. Among those, 276 of the students were included in the exploratory factor analysis in the first step, 269 were involved to repeat the first step with a new sample, and 279 participated in the last step to carry out the confirmatory factor analysis. Although literature suggest three different types of motivation (extrinsic, intrinsic, and amotivation), in this study, it was found that the intrinsic and extrinsic motivation items were gathered together and expressed as a single factor named “Intrinsic-Occupational Motivation”. According to the results, the final state of the scale included 15 items in two sub-dimensions. The sub-dimensions were named as “Intrinsic-Occupational Motivation” and “Amotivation”. It is understood from the analysis that the results derived from the scale have high reliability.
Prospective Primary School Teachers’ Attitudes Towards Teaching Mathematics
Authors: Tabuk Mesut
Published: May 2018

The aim of the study is to determine prospective primary school teachers’ attitudes towards teaching mathematics. The study is designed according to model of survey in the descriptive type. A total of 236 prospective primary school teachers were examined in order to investigate the effect of gender and program differences on their attitudes towards teaching mathematics. In the study, the questionnaire “Teaching Mathematics” was used to collect the data from prospective teachers. The results revealed that the prospective teachers have positive attitude towards teaching mathematics. It was found also that gender and grade level are not significant factor on attitude scores. Finally, various suggestions were presented for future studies in accordance with the findings obtained.
Does abdominal ultrasound is a useful tool in appendicitis diagnosis?
Authors: Kamiński Mateusz
Published: May 2018

Introduction: Acute appendicitis is the most common acute abdominal illness. Despite diagnosis progress there is still 20% negative appendectomy rate. The aim of the study was to determine the usefulness of abdominal sonography in diagnosis of acute appendicitis.
Materials and methods: Data were collected retrospectively from 326 patients who were operated with suspected appendicitis and had abdominal ultrasound before surgery. Appendicitis was confirmed by pathologic reports. There were two variants of positive abdominal sonography. In the first variant, the positive ultrasound was visualized inflamed appendix. In the second variant, the sonographic diagnosis of appendicitis was based on visualized inflamed appendix or one of indirect signs of appendicitis – localized periappendiceal fluid collection, enlarged lymph nodes, thickening of intestinal wall in right iliac fossa. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were defined and compared.
Results: 83,74% patients has appendicitis in pathologic report. In 39,53% cases appendix was visualized in abdominal ultrasound. In 65,95% cases of sonography indirect signs occurred. In the first variant sensitivity, specificity, PPV and NPV was 47,99%, 79,25%, 92,25% and 22,83%. In the second variant 67,77%, 43,40%, 86,05% and 20,72%. In the second variant sensitivity was significantly higher (p<0,001) but specificity was significantly lower (p<0,001).
Conclusion: Limited sensitivity and specificity cannot confirm appendicitis. Typical clinical course with negative ultrasound should not delay the correct diagnosis and early surgical treatment.
Chylous complications of various severity and manifestations within diverse compartments in reconstructive vascular surgery #)
#) The manuscript is dedicated to Prof. Dr. Z. Halloul
Authors: Wasseroth Klaus , Barth Udo , Albrecht Roland , Rahms Volker , Meyer Frank
Published: May 2018

Introduction: Chylous complications, which occur also in the profile of vascularsurgical interventions with considerable frequency, are challenging with regard to their adequate management.
Aim & method: Compact short overview on epidemiological, classifying, symptomatic, diagnostic and therapeutic aspects of chylous complications in vascular surgery, based on i) own clinical experiences, ii) a current selection of relevant scientific references and iii) representative case reports from clinical practice.
Results (complex patient- & clinical finding-associated aspects): - Basic treatment of lymphedema / postreconstructive edema comprises the complex physical therapy to improve edematous swelling, which need to be usually performed over years.
- In case of lymphocele, wait-and-see strategy can be initially pursued to observe spontaneous clinical course. If the lymphocele and its clinical complaints persist, puncture, placement of a drainage or temporary instillation of doxycyclin or ethanol can be attempted.
- In case of lymphatic fistula, vacuum-assisted closure dressing, radiation and selective ligation of lymphatic vessels after previous application of methylen blue dye can be used.
- Chylascites and chylothorax should be primarily treated – as have been widely established in the mean time – with a consequently conservative approach comprising initially paracentesis / thoracocentesis, protein-enriched and low-fat diet containing middle chain triglycerides (MCT) or total parenteral nutrition combined with the application of a somatostatin analogue (surgical approach as ultima ratio only aiming at ligation of the lesioned lymphatic vessel – if necessary, including preoperative consumption of cream).
Summary: Chylous complications can be primarily treated with conservatice measures, which should be exploited using a step-wise approach prior to surgical intervention as ultima ratio.
Conclusion: The experienced vascular surgeon should be aquainted with a sufficient, finding-adapted management of chylous complications. This requires a well-experienced clinician and surgeon with great expertise regarding the interdisciplinary setting comprising of interventional radiology, vascular (abdominal) surgery and partially surgical intensive care.
Surgical teaching at the Medical School Otto-von-Guericke University of Magdeburg – basic conceptual description
Authors: Udelnow Andrej , Meyer Frank , Kraus Armin , Infanger Manfred , Chiapponi Costanza , Piatek Stefan , Zardo Patrick , Haß Hans-Jürgen
Published: May 2018

Teaching in surgery, one of the classical big clinical and main disciplines beside internal medicine, needs to be also associated with great attention in regard to a valuable final result at the end of the study of human medicine. In particular, surgery is not only the subject to a large number of lectures it also represents one third (four months) of the compulsory internship (practical year – in German, “Praktisches Jahr”) at the end of the study of medicine. Therefore, medical teaching of students should be always part of serious and steady attempts to optimize course und contents as a component of guiding activities focussing onto the substantial improvement of the study of medicine. In detail, the classical and traditionally established type of teaching, the (oral) lecture, has to be further developed and reasonably completed by numerous interactive and practice-oriented teaching, learning and examining modalities (obligatory or facultative seminars / courses, training in [very] small groups of students, bed-side teaching, individual practical exercises within the SkillsLab, groups of young researchers, research projects in teaching, scientific publications on topics and recommendable experiences ot teaching including students, ”Teach-the-teacher“ projects etc.). Although many novel concepts have been inaugurated and considerable advances have been achieved, there is a steady need for further improvement. In the presented representative but medical school-specific overview, the current complex surgical teaching concept, which has been continuously optimized over the last couple of years, at the Otto-von-Guericke University Medical School with University Hospital of Magdeburg (Germany) is described as a scientific and systematizing document as well as a manuscript associated with the ongoing preparation of an institutional “Teaching Manual” on surgical teaching and training for medical students. It should – last but not least – provide the basis for a public discussion, which vice versa might hopefully and possibly result in further structural reforms of (surgical) teaching in the near future.
Analysis of diagnostic-therapeutic results after the first year of life in children of hearing disturbance risk groups
Authors: Wiatr Agnieszka , Kocoń Sebastian , Hartwich Patryk , Stręk Paweł , Składzień Jacek , Ziarno Remigiusz , Wiatr Maciej
Published: May 2018

Introduction:
It is assumed that the critical period for diagnosis of hearing disorders is the baby's first three months of life and that appropriate course and implementation of treatment and/or rehabilitation should begin before a child is six months old. However various kinds of problems may occur during auditory screening of a child may exceed this interval.
Aim:
The aim of this study was an evaluation of auditory screening results for children over 12 months old with congenital hearing loss.
Material and methods:
Results from 250 children were analyzed retrospectively. The study group consisted of children between one and three months old observed between 2015-2016. For the purpose of this analysis we divided the patients into four groups: children with Down Syndrome, children with nervous system disorders , children with cleft palate or both cleft palate and lip and children with congenital CMV.
To discuss performed diagnostics and treatment two groups of children were esteblished:
• with implementation of appropriate course of treatment
• without instituted treatment
Results:
250 children were examined in Level III NICUs in the years 2015 – 2016. The highest proportion of children with the implemented course of proceedings, was in groups with children with congenital CMV (71.1%). The highest proportion of children substituted with a hearing prosthesis was observed in the group of children with Down Syndrome. The lowest proportion of children with the implemented course of proceedings, was in groups with children with cleft palate or both cleft palate and lip (41.6%).
Conclusions:
• Early implementation of treatment and/or rehabilitation in children with hearing disorders is crucial to prevent depression of speech and psychological development. I t is important in children with cleft palate or both cleft palate and lip even if surgical correction is discussed.
• The highest proportion of children with the implemented course of proceedings, was in groups with children with congenital CMV. This children should be observed despite of right results of hearing tests.
• In children with nervous system disorders 1 year period of observation is too short to exclude problems with hearing.
Bacteriotherapy for preventing recurrent upper respiratory infections in children: a real-world experience
Authors: Ciprandi Giorgio
Published: May 2018

Background Recurrent upper respiratory infections (RURI) constitute a social problem for both their pharmaco-economic impact and the burden for the family. Bacteriotherapy could be an interesting preventive option.
Objective The aim of this study was to evaluate the preventive effects of RURI in children.
Design The study was designed as spontaneous, and was conducted in real-life seting. Globally, 80 children (40 males, mean age 5.26 (2.52) years) with RURI were enrolled. Children were treated with Streptococcus salivarius 24SMB and Streptococcus oralis 89a: nasal spray 2 puffs per nostril twice/day for a week for 3 monthly courses. Number of URI, and school and work absences were evaluated and compared with the past year.
Results Bacteriotherapy significantly halved the mean number of URI episodes being 5.98 (2.30) in the past year and 2.75 (2.43) after the treatment (p<0.0001). Bacteriotherapy also induced an over 35% reduction both in the number of school days and in the number of working days missed per month from 4.50 (2.81) to 2.80 (3.42) and from 2.33 (2.36) to 1.48 (2.16) respectively (p<0.0001).
Conclusions This and real-life study provides the first evidence that Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray could be effective in preventing RURI in children.
OS AVANÇOS DOS DIREITOS SOCIAIS E DA EDUCAÇÃO NA CONSTITUIÇÃO FEDERAL DE 1988 E A JUDICIALIZAÇÃO COMO REMÉDIO PARA A MÁ GERÊNCIA DO ESTADO
Authors: Lana Zilda Maria de Oliveira
Published: May 2018

O presente artigo tem por objetivo discutir os impactos que a inserção dos direitos sociais no rol de normas que tratam sobre os Direitos e Garantias Fundamentais na Constituição da República Federativa do Brasil de 1988 causaram aos cidadãos brasileiros. Reflete sobre o papel assumido pelo Estado Democrático Social na elaboração e implementação de políticas públicas, que sejam capazes de garantir maior efetividade aos direitos prestacionais positivos; e discute sobre o fenômeno da intensificação da judicialização associando o mesmo às más gerências do Estado relacionadas ao direito social à educação.
DA INCLUSÃO DOS ALUNOS COM NECESSIDADES ESPECIAIS NA ESCOLA REGULAR
Authors: Araújo Ana Paula Valentim
Published: May 2018

O objetivo deste artigo é demonstrar que é direito de a pessoa com necessidade especial frequentar a escola comum, bem como que o atendimento educacional especial não substitui a escolarização, somente suplementa e/ ou complementa a formação dos alunos, objetivando a independência e autonomia dos mesmos. Neste aspecto, a atual tendência do nosso ordenamento jurídico, e especialmente do Direito à Educação das pessoas com necessidades especiais, é de buscar uma vida digna, visando o pleno desenvolvimento, seu preparo para o exercício da cidadania e sua qualificação para o trabalho. A grande polêmica gerada em torno do tema é o motivo pelo qual é necessário um estudo sobre o caso para que se tenha a melhor solução para o conflito. Conclui-se que cabe às escolas da rede de ensino, inclusive as privadas, receberem os alunos com deficiência, fornecendo o atendimento necessário para sua permanência em sala de aula e alcance do seu desenvolvimento.
Saraus contemporâneos: a importância dos saraus como espaço político de socialização
Authors: Silva Fransuelen Geremias , Radic Leila Maria Ribeiro , Silva Mateus Gomes da , Fonseca Paulo Marcus Oliveira
Published: May 2018

s saraus podem ser definidos como reuniões de pessoas que têm algum vínculo com a arte e com a cultura, sendo essas reuniões, muitas vezes, de caráter informal. O objetivo deste estudo é entender qual a importância dos saraus como espaços políticos de socialização e como podem influenciar na construção do pensamento político do indivíduo. Para isso, tomou-se como campo de investigação o “Sarau Luiz Estrela”, na cidade de Belo Horizonte, em outubro de 2015. Os resultados mostram que nos saraus ocorrem trocas de ideias entre os participantes, e, assim, esses eventos podem exercer uma forte influência no pensamento político, inclusive através dos diálogos que podem ser estabelecidos entre a literatura e os problemas vivenciados pela sociedade. Ainda nessa perspectiva, os indivíduos alimentados pelos saraus acabam rompendo com o automatismo da vivência política, construindo assim um pensamento mais crítico sobre assuntos da sociedade.Palavras-chave: Cidadania. Democracia. Literatura. Saraus. Socialização.
Mecanismos enunciativos: o jogo das vozes e das modalizações em artigos de divulgação científica publicados no âmbito jornalístico
Authors: Almeida Ana Carolina Correia , Souza e Oliveira Pâmela Danielle
Published: May 2018

ste artigo tem como objetivo analisar as incidências dos mecanismos enunciativos observados em artigos de divulgação científica, publicados no âmbito jornalístico, especificamente, no que se refere ao gerenciamento das vozes enunciativas e das modalizações que permitem explicar as posições do enunciador em relação ao seu interlocutor e ao conteúdo temático veiculado ao seu propósito comunicativo. A análise orientou-se a partir dos pressupostos teórico-metodológicos do Interacionismo Sociodiscursivo, tendo como suporte o conceito de Folhado Textual de Bronckart (1999). A pesquisa, de natureza essencialmente qualitativa, mas em alguns momentos quantitativa, conceitua e descreve os tipos de vozes e as modalizações encontradas no corpus, que se compõe de três artigos extraídos das versões online dos jornais BBC Brasil e Folha de São Paulo. Para análise, fez-se a divisão do texto por parágrafos, com o intuito de localizar, em cada passagem, marcas linguísticas implícitas e explícitas, a fim de verificar como as vozes e as modalizações são distribuídas e orquestradas, qual a predominância existente nesse gênero textual e quais as implicações desses mecanismos para a construção e configuração da enunciação. Observou-se que as incidências dos mecanismos enunciativos, como o uso de modalizadores e vozes textuais, contribuem para construir e explicitar o todo enunciativo, como questões de responsabilidade sobre a enunciação de acordo com posicionamentos enunciativos e podem colaborar para construir sentidos e influenciar modos de pensar e de agir sobre o texto. Palavras-chave: Mecanismos enunciativos. Vozes. Modalizações. Gênero texto de divulgação científica.
Clasificación de los valores de rango de movimiento de la extremidad inferior en jugadores de fútbol sala
Authors: Cejudo A. , Sainz de Baranda P. , Ayala F. , Santonja F.
Published: May 2018

Objetivo: Clasificar los valores de flexibilidad de la extremidad inferior en jugadores de la 2ª División de la Liga Nacional de fútbol sala. Método: 60 jugadores fueron valorados mediante la versión básica del protocolo ROM-SPORT. Se realizó un análisis descriptivo y por percentiles para clasificarlos valores de los siete movimientos evaluados. Resultados y conclusión: El presente estudio define el perfil normal de flexibilidad de la extremidad inferior en un rango de valores entre 8-17º para la extensión de cadera, 39-45º para la flexión de tobillo con rodilla extendida, 40-47º para la flexión de tobillo con rodilla flexionada, 42-47º para la abducción de cadera, 76-96º para la flexión de cadera con rodilla extendida, 116-139º para la flexión de rodilla y 141-147º para la flexión de cadera. Valores superiores a este rango se pueden considerar dentro del perfil óptimo mientras que valores inferiores se pueden considerar dentro del perfil limitado. 
Efectos de un entrenamiento con cargas excéntricas sobre el rendimiento en jugadores de fútbol sala.
Authors: Sánchez-Sánchez J. , Guillen Rodríguez J. , Martín García D. , Romo Martín D. , Barrueco García J. , Bores Cerezal A.J.
Published: May 2018

El objetivo del estudio ha sido analizar los efectos de un programa de entrenamiento específico de 8 semanas, que incluye ejercicios de fuerza excéntrica con dispositivos isoinerciales y con autocargas, sobre la condición física de jugadores de fútbol-sala semi-profesionales. Los 10 jugadores de fútbol-sala (23.73±5.5 años de edad;69.91±8.47 kg de peso; 172.27±6.62 cm de altura) fueron divididos al azar en dos grupos: Grupo Autocarga (GAUT; n=5) y Grupo Máquinas (GMAQ; n=5). Ambos grupos realizaron una sesión de entrenamiento con carga excéntrica a la semana, durante 8 microciclos de competición.  El futbolista fue evaluado antes (pre-test), nada más finaliar (post-test) y 2 semanas después (re-test) de acabar el programa de intervención. Los test empleados fueron: test de flexibilidad sit-and-reach; test salto “squatjump” (SJ) y “countermovementjump” (CMJ); test de velocidad lineal 30-m; test de velocidad con cambio de dirección. El análisis a través de la prueba estadística Wilcoxon, reflejó mejoras significativas en el CMJ en el GAUT (p≤0.05),  la velocidad lineal y en la prueba con cambio de dirección en el GAUT (p≤0.05) y GMAQ (p≤0.01), pero no  se han encontrado diferencias intergrupo en ninguna de las variables estudiadas. Los resultados indican que los ejercicios de carga excéntrica pueden ser un complemento eficaz en los programas de entrenamiento específicos de jugadores de fútbol-sala, debido a su incidencia positiva sobre variables de rendimiento importantes como la velocidad no lineal. 