bluuebunny/crossref_metadata_2025 huggingface dataset:
THINKING SEX WITH AN ANDROGYNE
Authors: Meyerowitz Joanne
Published: December 2010

This article puts Gayle Rubin's 1984 article “Thinking Sex” in dialogue with Earl Lind's 1918 book Autobiography of an Androgyne. Rooted in different historical moments, the two works address distinct debates about the nature, politics, and ethics of sexual and gender variance. Taken together, they remind us that our varied attempts to label, describe, and explain gender and sexuality—to define them, knit them together, and tug them apart—have a complex history shaped and stamped by the particular contexts in which they evolved. The two historical texts pry us out of the familiar and thereby position us, in a sense, to anachronize the present, to see our own ways of seeing the world as contingent, curious, and changeable.
SEXUAL HEALING
Authors: Henderson Lisa
Published: December 2010

This article recognizes Gayle Rubin's commitments to intellectual memory, to the study of living sexual populations, and to questions of class as part of the project of studying sex. Together, these commitments acknowledge and welcome interdependence in a harsh world of sexual and academic formation. As the title suggests, they are their own kind of sexual healing.
LOVE AND ANGER
Authors: Duggan Lisa
Published: December 2010

Gayle Rubin's reputation as a star academic and public intellectual has been based on her cool brilliance. But her public and professional reception has also been marked, positively and negatively, by the ambivalence generated by strong feeling. This article describes Rubin's affective surround in an effort to outline the impact of passionate engagement in feminist and queer politics and scholarship.
QUEER MEDIA LOCI IN BANGKOK
Authors: Käng Dredge Byung'chu
Published: December 2010

In the Western popular imagination, Bangkok is a “gay paradise,” a city that affords cheap and easy access to exotic “boys.” This reputation for sex tourism as well as a local cultural tolerance for homosexuality and transgenderism is a common representation of queer Bangkok in English-language media. This article juxtaposes Thai media and lived experience to displace, recontextualize, and expand the prevailing Western view. It argues that Western gazes that depict Thailand as especially tolerant of homosexuality and gender variance may in fact inhibit the free expression of Thai male-bodied effeminacy. Finally, this article argues that the hypersexualization of Thais and new regional alignments are molding local desires and subjectivities away from the West toward East Asia.
Depletion of nuclear actin is a key mediator of quiescence in epithelial cells
Authors: Spencer Virginia A. , Costes Sylvain , Inman Jamie L. , Xu Ren , Chen James , Hendzel Michael J. , Bissell Mina J.
Published: December 2010

Functional differentiation is orchestrated by precise growth-regulatory controls conveyed by the tissue microenvironment. Cues from laminin 111 (LN1) lower transcription and suppress mammary epithelial cell growth in culture, but how LN1 induces quiescence is unknown. Recent literature points to involvement of nuclear β-actin in transcriptional regulation. Here, we show that quiescence induced by growth factor withdrawal, or LN1 addition, rapidly decreases nuclear β-actin. LN1, but not other extracellular matrix (ECM) molecules, decreases the levels of nuclear β-actin and destabilizes RNA polymerase (RNA Pol) II and III binding to transcription sites, leading to a dramatic drop in transcription and DNA synthesis. Constitutive overexpression of globular β-actin in the nucleus reverses the effect of LN1 on transcription and RNA Pol II association and prevents the cells from becoming quiescent in the presence of LN1. The physiological relevance of our findings was verified by identifying a clear spatial separation of LN1 and β-actin in developing mammary end buds. These data indicate a novel role for nuclear β-actin in growth arrest of epithelial cells and underscore the importance of the integrity of the basement membrane in homeostasis.
Electrolyte-balanced heparin in blood gas syringes can introduce a significant bias in the measurement of positively charged electrolytes
Authors: van Berkel Miranda , Scharnhorst Volkher
Published: December 2010

Background: Heparin binds positively charged electrolytes. In blood gas syringes, electrolyte-balanced heparin is used to prevent a negative bias in electrolyte concentrations. The potential pre-analytical errors introduced by blood gas syringes are largely unknown. Here, we evaluate electrolyte concentrations in non-anticoagulated blood compared with concentrations measured in electrolyte-balanced blood gas syringes.

Methods: Venous blood was collected into plain tubes. Ioni-zed calcium, potassium, sodium and hydrogen ions were analyzed directly using a blood gas analyzer and the remaining blood was collected into different blood gas syringes in random order: Preset (Becton Dickinson), Monovette (Sar-stedt) and Pico 50-2 (Radiometer).

Results: Ionized calcium and sodium concentrations were significantly lower in blood collected in Becton Dickinson and Sarstedt syringes compared to non-heparinized (NH) blood. The mean bias exceeded biological variation-based total allowable error, which in most cases leads to clinically misleading individual results. In contrast, ionized calcium concentrations in blood collected in Pico 50-2 syringes were identical to values obtained from NH blood. Sodium showed a minor, yet statistically significant, bias.

Conclusions: Despite the fact that blood gas syringes now contain electrolyte-balanced heparin, one should be aware of the fact that these syringes can introduce pre-analytical bias in electrolyte concentrations. The extent of the bias differs between syringes.
A new tool in the field of in-vitro diagnosis of allergy: preliminary results in the comparison of ImmunoCAP© 250 with the ImmunoCAP© ISAC
Authors: Gadisseur Romy , Chapelle Jean-Paul , Cavalier Etienne
Published: December 2010

Background: The ImmunoCAP© ISAC allows for the determination of specific immunoglobulin E (IgE) against 103 recombinant or purified allergen components in a single analytical step. The aim of our study was to perform a comparison of the specific IgE results measured with the microarray method to those obtained using the traditional method of ImmunoCAP©.

Methods: We selected 86 clinically relevant patients on the basis of their specific IgE for recombinant allergens (ImmunoCAP© 250, Phadia). Also, we selected two patients with a high total IgE to evaluate the non-specific binding of IgE. All samples were screened with the ImmunoCAP© ISAC. Then, we compared the 555 specific IgE antibodies results provided by ImmunoCAP© ISAC with the specific IgE levels obtained with ImmunoCAP© 250.

Results: We observed that 82 of the 384 results found to be positive with ImmunoCAP© were negative with ISAC© (concordance 78.65%). Of 171 negative results obtained with ImmunoCAP©, 11 were positive with ISAC© (concordance 93.57%). No non-specific binding was observed.

Conclusions: Our results show that the ImmunoCAP© ISAC has good analytical performance when compared with the ImmunoCAP© 250 method. We did not observe any non-specific binding. However, better sensitivity for some clinically relevant allergen components, such as rPru p 3 is needed.
Serum hepcidin-25 in comparison to biochemical markers and hematological indices for the differentiation of iron-restricted erythropoiesis
Authors: Thomas Christian , Kobold Uwe , Thomas Lothar
Published: December 2010

Background: Biochemical markers have problems in distinguishing iron deficiency anemia (IDA) from anemia of chronic disease (ACD), and the combined state of iron-restricted erythropoiesis (IRE) with ACD (ACD/IRE). We investigated the extent to which hepcidin-25, a potential marker for the evaluation of iron metabolism, enables the differentiation of the states above, and to assess its correlation with convential markers of iron deficiency.

Methods: One hundred and fifty-five patients with anemia were classified as having IDA, ACD or ACD/IRE using clinical findings, biochemical markers and hematological indices. The diagnostic performance of hepcidin-25 alone or in combination with the reticulocyte hemoglobin content (CHr) was evaluated using receiver-operating characteristic curve analysis and multivariate analysis. Hepcidin-25 was determined using an isotope-dilution micro-HPLC-tandem mass spectrometry method.

Results: Hepcidin-25 correlated with biochemical markers of iron deficiency but not with hematological indices. Use of a hepcidin-25 cut-off of ≤4 nmol/L allowed the differentiation of IDA from ACD and ACD/IRE, but not the discrimination of ACD from ACD/IRE in patients with severe inflammation. Furthermore, the discrimination of ACD/IRE from ACD required the combination with CHr.

Conclusions: Hepcidin-25 is primarily an indicator for decreased body iron levels, but not for IRE. The combination of hepcidin-25 with CHr in a diagnostic plot (hepcidin-25 plot) might be useful for the differentiation of ACD from ACD/IRE and IDA.
Determination of oxidative and occupational stress in palliative care workers
Authors: Casado Ángela , Castellanos Alberto , López-Fernández Ma Encarnación , Ruiz Rocío , Imedio Eulalia López , Castillo Carmen , Fernández-Nieto Ana María
Published: December 2010

Background: In previous work, we demonstrated that some occupational workers in stressful conditions can have increases in several markers of oxidative stress when compared to other workers. We investigated two antioxidant enzymes, superoxide dismutase (SOD) and catalase (CAT) activities, and malondialdehyde (MDA) concentrations, according to demographics, lifestyle and occupational parameters in palliative care unit workers, and analyzed the relationship with occupational burnout.

Methods: Fifty-two palliative care unit workers and 50 gender- and aged matched healthy individuals as controls were surveyed. Spectrophotometric and high-pressure liquid chromatography methods were used for biochemical determinations.

Results: No significant variation with respect to gender were detected with respect to SOD and CAT activities, MDA concentrations or occupational burnout. MDA concentrations increased with age in controls and palliative care unit workers, and we observed significant differences in MDA between controls and palliative care unit workers for all age groups. Significant variation in MDA concentrations were detected between unmarried (287.22±8.31 nmol/mg hemoglobin) and married individuals (317.18±6.24 nmol/mg hemoglobin), but not with respect to divorced individuals (288.41±5.64 nmol/mg hemoglobin). Significant differences were detected between smokers and non-smokers for SOD, CAT and MDA, but not for alcohol, coffee, tea or cola consumption. Significant differences were seen in MDA concentrations between those who frequently practice some kind of sport (280.59±7.62 nmol/mg hemoglobin) and those who never practice any kind of sport (299.12±8.09 nmol/mg hemoglobin), and between those who frequently ate fruit and greens (291.05±8.11 nmol/mg hemoglobin) and those who never eat fruit and greens (316.31±7.42 nmol/mg hemoglobin). SOD activity and MDA concentrations are higher in palliative care workers who work the evening and night shifts (p<0.01), and these workers also show significantly higher levels of stress.

Conclusions: Our findings suggest that oxidative stress, occupational stress and occupational burnout levels are similar in men and women. Occupational stress increases oxidative stress levels probably as a response to increased generation of reactive oxygen species. Working during the evening and night shifts increases oxidative levels and burnout levels.
„Versprechungen“ der Verwaltung – Zusagen, Zusicherungen und ähnliche behördliche Erklärungen
Authors: Hebeler Timo , Schäfer Björn
Published: December 2010

Im deutschen Verwaltungsrecht gibt es unterschiedliche Arten von behördlichen Erklärungen, die hier unter der – nicht rechtstechnisch, sondern deskriptiv zu verstehenden – Bezeichnung »Versprechungen der Verwaltung« zusammengefasst und im Einzelnen dargestellt werden. Das gemeinsame Moment dieser behördlichen Erklärungen besteht darin, dass die Verwaltung zwar bereits gegenwärtig handelt, dieses Handeln aber – zumindest wenn man es im größeren Kontext betrachtet – noch nicht abschließend ist, sondern auf weiteres Tätigwerden in der Zukunft gerichtet ist und dieses zukünftige Tätigwerden entweder vorbereitet, teilweise bereits regelt oder sonstwie beeinflusst. Rechtlich können diese behördliche Erklärungen sehr unterschiedlich zu bewerten sein.
StR Der strafprozessuale Tatbegriff
Authors: Steinberg Georg , Stam Fabian
Published: December 2010

So wie die materiellrechtliche Konkurrenzlehre (§§ 52 ff. StGB) für das Verständnis des materiellen Strafrechts eine Schlüsselstellung einnimmt – weshalb die insoweit oft festzustellende studentischerseits geübte Vernachlässigung unverzeihlich ist! –, ist der prozessuale Tatbegriff ein wichtiger Schlüssel für das Verständnis des Strafprozessrechts im Ganzen. Deshalb, aber auch als möglicher Gegenstand der »Prozessualen Zusatzfrage« in der Examensklausur, ist der prozessuale Tatbegriff unbedingt »examensrelevant« und sollte daher in seinen Grundzügen beherrscht werden.

Er wird im folgenden in zwei Schritten knapp erläutert. Zunächst wird skizziert, welche konkreten Folgen sich aus dem Vorliegen einer oder mehrerer Taten in den verschiedenen Abschnitten des Strafverfahrens ergeben. Sodann wird der prozessuale Tatbegriff präziser definiert mit Blick auf Grenzfälle, nämlich darauf, dass er vom materiellrechtlichen Tatbegriff (§§ 52 ff. StGB) in einigen wichtigen Konstellationen abweicht. Abschließend wird kurz auf die (wachsende) Bedeutung des Tatbegriffs im europarechtlichen Kontext eingegangen.
Examensklausur Schwerpunktbereich Arbeitsrecht Europarechtswidrige Kündigungsfrist, Verwirkung des Widerspruchsrechts und gegenläufige betriebliche Übung
Authors: Jacobs Matthias , Krois Christopher
Published: December 2010

Der nachstehende Fall wurde im Wintertrimester 2009 als fünfstündige Examensklausur für den Schwerpunktbereich Arbeit, Wirtschaft und Soziales an der Bucerius Law School (Hamburg) gestellt. Der erste Teil problematisiert unter anderem die vom EuGH im Januar 2010 konstatierte Europarechtswidrigkeit von § 622 II 2 BGB sowie aktuelle Fragen des Betriebsübergangs, insbesondere die Verwirkung des Widerspruchsrechts. Der zweite Teil behandelt die Zulässigkeit der gegenläufigen betrieblichen Übung nach der Schuldrechtsreform.
Pictura & Nomenclatura. Zur Wissensvermittlung in Wort und Bild in der Sachgruppenlexikographie des 17. Jahrhundert
Authors: Müller Peter O.
Published: December 2010

Onomasiological dictionaries, in which the vocabulary is arranged primarily according to thematic groups, played a major role within early modern lexicography. They were used in particular as travel vocabularies in order to procure a useful stock of basic terms while abroad and also belonged to prevalent modes of teaching in the humanistic school system, especially in elementary instruction. During the second half of the 17th century a lasting change of knowledge transfer inside this type of dictionary occurred by including illustrations which permeate not only Johann Amos Comenius' Orbis sensualium pictus but also Johann Georg Seybold's Teutsch-Lateinisches Wörterbüchlein. Both works will be conceptually explicated against the background of traditional topical lexicography and it will be shown that in both works, which mark the starting point of the history of the pictorial dictionary in the German-speaking parts, different semantic purposes of illustrations correlates with distinct vocabulary-picture-relations.
Semantik, Pragmatik und Wörterbuchform in einsprachigen Wörterbüchern
Authors: Wiegand Herbert Ernst
Published: December 2010

This paper looks at a question that has up to now not yet been put, namely which textual dictionary structure elements with which features, by the use of which the user can find semantic and pragmatic knowledge within an article can systematically be differentiated. In order to do this the following four dictionary structure elements are introduced: items, item texts, functional item additions and item symbols. Then the dictionary structure elements for enabling knowledge regarding meaning are treated by means of examples, e.g. different types of items giving the meaning, different types of items giving semantically related expressions, different types of pragmatically enriched items giving the paraphrase of meaning, etc. Finally, the dictionary structure elements enabling pragmatic knowledge are discussed, e.g. different types of diasystematic labelling items and pragmatic labelling symbols. In conclusion, a brief perspective is given on the relevant approach to meaning.
A Fiber Optic Sensored Triaxial Testing Device
Authors: Lee Jui-Ting , Tien Kai-Cheng , Te Ho Yen , Huang An-Bin
Published: December 2010

The physical quantities involved in a triaxial testing device have mostly been monitored with electric sensors. These sensors are currently subject to short circuit when submerged under water and electromagnetic interference (EMI). Waterproofing and EMI noise filtration have often been a challenge to the triaxial test set-up. These drawbacks can be substantially minimized when using optic fiber sensors. The optic fiber Bragg grating (FBG) sensors have the additional advantage of being partially distributive where multiple sensors can share the same signal transmission line. Taking advantage of these unique capabilities, the authors explored the possibility of converting all pressure/force and linear displacement transducers in a triaxial testing device into FBG based sensors. A series of shearing tests on unsaturated and saturated soil specimens were carried out using the new FBG sensored triaxial testing device. In most cases, the measurement of physical quantities was paired with electric sensors so that the results can be compared. This paper describes the principles of the individual FBG sensor designs and demonstrates their applications in triaxial testing.
Improving the Condensation Resistance of Fenestration by Considering Total Building Enclosure and Mechanical System Interaction
Authors: Nelson Peter E. , Totten Paul E.
Published: December 2010

Many condensation problems at fenestration are related to the adjacent building components the system interacts with. This includes adjacent cladding and wall systems, structural systems used for the connection of the fenestration, and interaction with the building’s mechanical system. We will discuss how the condensation resistance of windows and curtain walls can be greatly improved by aligning the thermal elements in the wall with the thermal aspects of the windows (such as thermal breaks), how air leakage at window systems can increase the volume of condensation, and how thermal bridges adjacent to the fenestration can have a significant impact on the overall performance. We will discuss how Winter time cold air flow from adjacent wall cavities can cause elements at window or curtain wall surrounds (sill, jambs, and head) to condense when they would not otherwise. Thermal improvements through the application of carefully applied and designed insulation systems will also be discussed, as over insulating in some cases can exasperate the condensation problems by further isolating the systems from heat sources. We will discuss the relationship between the heating source position and distance from the window or curtain wall system. The discussion in this paper will be mostly related to Winter time condensation. We will use examples to show (1) how thermal breaks, like rubber and plastic shims below the windows, can disassociate the window from heat loss to colder large thermal wall masses and improve performance; (2) how elements like spandrel panels and shadow boxes can have condensation due to air leakage into the shadow box and proposed solutions for these elements to reduce their condensation risk; (3) how interior curtains, furniture, and interior furnishings can block heat flow and cause condensation; (4) how the two-dimensional thermal analysis can be used to evaluate the condensation potential and evaluate possible solutions; (5) the results of infrared thermography used to evaluate both condensation problems and evaluate the solutions; (6) the importance of long-term data logging and monitoring of the results; and (7) the review of options for reducing condensation occurrences through passive (heat fin and insulation) and active (heat trace) means.
Kinetics and Mechanism of Oxidation of Gabapentin (Neurontin) Anion by Alkaline Diperiodatonickelate(IV) — A Free Radical Intervention
Authors: Hiremath Mallikarjuna I. , Nandibewoor Sharanappa T.
Published: December 2010

The kinetics of oxidation of gabapentin (Neurontin) (GP) by diperiodatonickelate(IV) (DPN) in aqueous alkaline medium was studied spectrophotometrically. The reaction is first order with respect to [DPN] and is an apparent less than unit order, each in [GP] and [alkali] under the experimental conditions. Reaction rate increases with increase in ionic strength and in solvent polarity of the medium. Addition of reaction products has no effect on the reaction rate. A mechanism involving the formation of a complex between the oxidant and substrate has been proposed. The products are identified by spot test, IR and NMR studies. The reaction constants involved in the mechanism were evaluated. There is a good agreement between the observed and calculated rate constants under varying experimental conditions. The activation parameters with respect to the slow step of scheme were evaluated and discussed.
Restoring Pushkin: Ideology and Aesthetics in Prokofiev's Queen of Spades
Authors: Bartig Kevin
Published: December 2010

Immediately following his repatriation in 1936, Prokofiev composed a film score for a screen adaptation of Pushkin's The Queen of Spades. Although the film was never finished, Prokofiev's completed score reveals an idiosyncratic approach to film music, one that is strikingly different than that found in his better known scores such as Alexander Nevsky. Reconstruction of the production and its context demonstrates how Prokofiev's aesthetic goals of a "new simplicity," characterized by lyricism, spare textures, and avoidance of dissonance, would successfully intersect with the ideological goals of a Jubilee celebration planned by the Soviet government for the centenary of Pushkin's death.
Sound Source Mechanics and Musical Timbre Perception: Evidence From Previous Studies
Authors: Giordano Bruno L. , McAdams Stephen
Published: December 2010

Timbre has been conceived of as a multidimensional sensory attribute and as a carrier of perceptually useful information about the mechanics of the sound source. To date, research on musical timbre has focused on defining its acoustical correlates, whereas fragmentary evidence is available on the influence of mechanical parameters. We quantified the extent to which mechanical properties of the sound source are associated with structures in the data from published identification and dissimilarity-rating studies. We focus on two macroscopic mechanical properties: the musical instrument family and excitation type. Identification confusions are significantly more frequent for same-family instruments. With dissimilarity ratings, same-family or same-excitation tones are judged more similar and tend to occupy the same region of multidimensional-scaling spaces. As such, significant associations between the perception of musical timbre and the mechanics of the sound source emerge even when not explicitly demanded by the task.
Toxic Work Environments: What Helps and What Hurts
Authors: Chamberlain Lindsey Joyce , Hodson Randy
Published: December 2010

Toxic or harmful working conditions are an important problem for workers and organizations. Fully understanding the consequences of such conditions has been difficult because in-depth information across organizational contexts is scarce. The current article makes use of a new data set based on content coding the full population of organizational ethnographies ( N = 212) to secure in-depth evaluations across a wide range of organizational contexts. The analysis confirms the role of lack of autonomy and lack of skills as toxic working conditions but suggests an equally important role for organizational chaos. Importantly, returning to the narrative accounts allows exploration of the buffering and exacerbating roles of coworker relations and employee involvement and the mechanisms through which these work to moderate other conditions.
Prospective Validation of a Novel Strategy for Assessing Risk of Significant Hyperbilirubinemia
Authors: Gonçalves Américo , Costa Sandra , Lopes Andreia , Rocha Gustavo , Guedes Maria Beatriz , Centeno Maria José , Silva Jorge , Silva Maria Gorett , Severo Milton , Guimarães Hercília
Published: December 2010

OBJECTIVE:

Our aim was to validate a strategy for assessing the risk of significant hyperbilirubinemia in newborns with gestational ages of ≥35 weeks by combining predischarge bilirubin percentile data with gestational age data, for a European, predominantly white population.

METHODS:

We conducted a prospective cohort study with 463 newborns with gestational ages of ≥35 weeks who were admitted to the well-infant nursery. Total bilirubin levels were measured daily until discharge and once after discharge, between the third and eighth days of life, by using a Bilicheck device (Respironics, Murrysville, PA). The values obtained (<52 hours) were plotted on an hour-specific bilirubin nomogram to determine the infant's bilirubin percentile, expressed as a risk zone. Patients were assigned to 1 of 3 risk groups (very low, low, or high) on the basis of a combination of risk zone and gestational age data and were monitored prospectively for the development of significant hyperbilirubinemia. The 95% confidence interval (CI) for the prevalence of significant hyperbilirubinemia was estimated with the binomial distribution method.

RESULTS:

Forty-four infants (11%) developed significant neonatal hyperbilirubinemia. The risks of developing significant hyperbilirubinemia were 1.3% (95% CI: 0.2%–3.7%) for the very low risk group (n = 230 [58.1%]), 3.4% (95% CI: 0.7%–9.8%) for the low risk group (n = 86 [21.7%]), and 47.50% (95% CI: 36.2%–59.0%) for the high risk group (n = 80 [20.20%]).

CONCLUSIONS:

The proposed strategy, based on predischarge bilirubin level and gestational age data, was a valid method for significant hyperbilirubinemia risk assessment in our population.
Predictors of Participant Dropout at Various Stages of a Pediatric Lifestyle Program
Authors: de Niet Judith , Timman Reinier , Jongejan Mieke , Passchier Jan , van den Akker Erica
Published: December 2010

OBJECTIVE:

To evaluate baseline predictors of drop out at various stages in a lifestyle intervention for overweight and obese children.

PATIENTS AND METHODS:

Children and their families (N = 248) (aged 8–14 years) attended a lifestyle intervention. At baseline, we assessed anthropometric and demographic data, measured competence and behavioral problems, and family functioning. Dropout rates were analyzed at various stages in treatment with logistic regression analyses.

RESULTS:

Children who had mothers of non-white descent, who had higher BMI SDS, who participated in fewer activities, who did not have breakfast regularly, and who did not live in families with a static adaptability structure were more likely to drop out between 0 and 12 months. Different characteristics predicted dropout at various stages of treatment: (1) having an ethnic minority status and being older predicted dropping out between 0 and 3 months; (2) having a nonwhite mother, participating in fewer activities, having higher delinquency scores, and not presenting the family as extremely positive predicted dropping out between 3 and 9 months; and (3) having a higher BMI SDS, having fewer social problems, and not living in families with a static adaptability structure predicted dropping out between 9 and 12 months of treatment.

CONCLUSIONS:

The results indicate diffrerent characteristics predict dropping out from a pediatric lifestyle program at various stages in treatment. These findings highlight the need for tailored interventions that target different characteristics at various stages of treatment to reduce drop out rates.
Use of Quality-Improvement Methods to Improve Timeliness of Analgesic Delivery
Authors: Iyer Srikant B. , Schubert Charles J. , Schoettker Pamela J. , Reeves Scott D.
Published: December 2010

OBJECTIVES:

Despite its high prevalence, pain often is poorly managed in the emergency department. We used improvement science and quality-improvement methods to reduce delays associated with opioid delivery for children presenting to the emergency department with clinically apparent extremity fractures.

METHODS:

On the basis of a review of the literature, interviews with key stakeholders, expert consensus, and reviews of isolated examples of patients receiving timely analgesics, a multidisciplinary improvement team identified a set of operational factors, or key drivers, believed to be critical to the performance of appropriate initial pain management for children presenting to the emergency department with acute extremity injury. These key drivers focused the development of an intervention.

RESULTS:

The intervention, termed the orthopedic evaluation process, addressed all 4 identified key drivers simultaneously by standardizing triage decisions, activating necessary health care providers, aligning the care delivery need with necessary resources, and allowing parallel-task completion between physicians and nursing staff. After implementation of this process, 95% of the patients with long-bone extremity fractures treated with intravenous opioids received a first dose within 45 minutes of arrival, compared with a preintervention baseline average of 20%.

CONCLUSIONS:

By applying quality-improvement and process improvement methodology, we identified key drivers for the rapid delivery of systemic opioids to patients with clinically apparent extremity fractures and significantly improved the timeliness of analgesic delivery for this subgroup of patients.
Biotechnological advances in monoclonal antibody therapy: the RANK ligand inhibitor antibody
Authors: Kiss Emese , Kuluncsics Zénó , Kiss Zoltán , Poór Gyula
Published: December 2010

Biológiai gyógyszereket a múlt század közepe óta használ az orvostudomány. Napjainkban szemtanúi lehetünk intenzív fejlődésüknek és elterjedésüknek a klinikai gyakorlatban. Eddig 350 millió beteg részesült a forgalomban lévő körülbelül 250 biológiai terápia valamelyikében. Biológiai készítmények közé sorolandóak a fehérjetermészetű makromolekulák, amelyeknek tömeges gyártását a biotechnológia tette lehetővé. E gyártási modell fogalmát, amely során élő szervezeteket használnak fel a termelésben, magyar mérnök, Ereky Károly vezette be. A szerzők jelen összefoglalóban elsősorban a biotechnológiai úton előállított monoklonálisantitest-kutatás és -fejlesztés történetét, valamint annak gyártását részletezik. Ezek a kutatások – amelyek eredményét két alkalommal is Nobel-díjjal jutalmazták – alapvetően megváltoztatták az immunológiai ismereteket és számos megbetegedés kezelésének lehetőségeit. A szerzők áttekintik az immunglobulinok szerkezetét és alapvető funkcióit, valamint a monoklonális antitestek fejlesztésének eredményeit. A monoklonális antitestek legmodernebb csoportjába tartozik a teljesen humán antitest tulajdonságú RANK-ligand-gátló denosumab, amely először ad lehetőséget a csontanyagcserével foglalkozó szakembereknek, hogy teljesen humán, monoklonális IgG2-alcsoportba tartozó antitestkezelést alkalmazzanak jól körülhatárolt indikációkban. Ehhez kapcsolódva a szerzők vázolják a csontanyagcsere alapvető folyamatait, valamint a RANK-ligand-gátlás nyújtotta előnyöket is. Orv. Hetil., 2010, 151, 2137–2144.
A culinária como objeto de estudo e de intervenção no campo da Alimentação e Nutrição
Authors: Diez-Garcia Rosa Wanda , Castro Inês Rugani Ribeiro de
Published: December 2010

A culinária é aqui abordada como objeto de estudos alimentares e nutricionais e de intervenções que visem a mudanças alimentares. Para explorar este potencial da culinária, dois estudos são apresentados: um qualitativo, voltado para a análise do consumo alimentar, com sujeitos de dois segmentos socioeconômicos, submetidos à restrição de sal; e outro que recorre à culinária como eixo estruturante de um método educativo para a promoção da alimentação saudável. Em ambos os estudos pôde-se constatar o potencial da culinária: no primeiro, como um meio que permite acessar informações sobre procedimentos com alimentos que podem melhorar a qualidade da informação sobre o consumo e as práticas alimentares; e no segundo, como um espaço eficaz para intervenções que visem a mudanças alimentares por abordar suas dimensões sensoriais, cognitivas, simbólicas e práticas.
Simbolismo sobre "natural" na alimentação
Authors: Carvalho Maria Claudia da Veiga Soares , Luz Madel Therezinha
Published: December 2010

Os sentidos incorporados representam um acervo de possibilidades para a vida futura capaz de construir identidades individuais e coletivas. Este trabalho aprofunda os habitus, nos termos de Bourdieu, associados aos estilos "natural" e fast-food, fazendo uma análise interpretativa das trocas simbólicas de elementos reproduzidos nas práticas de alimentação. Consideramos que o arranjo "bricolista" desses elementos possibilita permutas e hibridismos, marcado por uma tensão que reflete a insegurança das inovações tecnológicas. O "natural" é o representante do ideal de autossustentabilidade, da produção não poluidora, que aponta para um enfrentamento da crise sanitária e ecológica do planeta, resistindo à industrialização em larga escala e à urbanização acelerada, entendidos como fatores de depredação das condições básicas de vida. As trocas se dão em um jogo simbólico articulado com o econômico global, em que os atores sociais fazem apostas, illusio, de acordo com intenções particulares na ação concreta. Há chance para reformulação das regras do jogo "no jogo", pois ainda que com um equilíbrio precário de forças, com perdas para o lado mais fraco, um agente pode ter em seu acervo a possibilidade de não reproduzir as pressões da globalização alimentar, o que está distante do que possa aparecer como sobrenatural.
Comer, alimentar e nutrir: categorias analíticas instrumentais no campo da pesquisa científica
Authors: Carvalho Maria Cláudia da Veiga Soares , Luz Madel Therezinha , Prado Shirley Donizete
Published: December 2010

Comer, alimentar ou nutrir circulam na nossa cultura, aproximadamente, como sinônimos e desse modo não dão conta das transformações que vêm ocorrendo na alimentação, que desejadas ou indesejadas contam com um hibridismo de padrões que representa uma mudança tanto de regras como de preferências alimentares. O objetivo do artigo é tornar essas concepções de senso comum categorias de análise e interpretação para pesquisas das Ciências Humanas e da Saúde, numa perspectiva teórica, através da conceituação. Neste espaço interdisciplinar da Nutrição e das Ciências Sociais, o alimento aparece associado a uma função natural (biológica), numa concepção em que natureza se contrapõe à cultura, e a comida assume sentidos e significados culturais (simbólicos). A alimentação expressa divisão do trabalho, da riqueza, é criação histórico-cultural através da qual se pode estudar uma sociedade. Atribui-se à Nutrição um sentido de ação racional, oriundo da constituição dessa ciência na modernidade, inserida num processo histórico de racionalização científica do comer e do alimentar-se. Consideramos que através da conceituação na prática interdisciplinar de pesquisa, que envolve um espaço compartilhado de saberes, podemos ser menos limitados por um modelo teórico uniformizado de saber e mais livres para pensar questões sobre a vida.
O tratamento cartográfico da informação em saúde do trabalhador
Authors: Guimarães Raul Borges , Ribeiro Helena
Published: December 2010

Apesar do reconhecimento da importância dos conhecimentos geográficos e do uso das ferramentas de análise espacial nos estudos da saúde coletiva, esse é um campo ainda pouco explorado pelos pesquisadores brasileiros. Em levantamento realizado nas principais revistas científicas que veiculam os resultados de pesquisa em saúde do trabalhador, verificou-se o grande predomínio do uso de tabelas e gráficos como meio de organizar e apresentar os resultados obtidos, e o número reduzido de mapas. Para isso foram examinados todos os artigos publicados em quatro periódicos (Revista de Saúde Pública, Cadernos de Saúde Pública, Revista Saúde e Sociedade e Revista Brasileira de Epidemiologia) no período de 1967 a 2009. Uma vez analisado o conjunto de artigos selecionados no estudo, aqueles que utilizaram representações cartográficas receberam atenção especial. Verificou-se que, embora ainda pouco utilizadas, as ferramentas do geoprocessamento e da geoestatística com suporte em SIG abrem um campo de novas possibilidades no uso da cartografia temática em saúde do trabalhador no Brasil. Contudo, recomenda-se para os editores das revistas científicas o detalhamento de normas técnicas para publicação de figuras cartográficas, assim como a elaboração de pareceres específicos que possam auxiliar os autores em vista das modificações necessárias para a melhoria da qualidade da comunicação visual de mapas e da correlação espacial por meio do tratamento cartográfico.
Perfil de idosos com internação por quedas nos hospitais públicos de Niterói (RJ)
Authors: Paula Fátima de Lima , Fonseca Maria de Jesus Mendes da , Oliveira Raquel de Vasconcellos Carvalhaes de , Rozenfeld Suely
Published: December 2010

OBJETIVO: Descrever as características comuns de idosos internados, por quedas, em hospitais públicos do município de Niterói - RJ. MÉTODOS: Estudo seccional com 110 pacientes com 60 anos ou mais, nos hospitais públicos de Niterói, internados devido a fraturas pós-queda. Os dados foram coletados com um questionário multidimensional aplicado por meio de entrevista. Foram utilizadas a análise de correspondência múltipla e a análise de conglomerados para descrever as características dos entrevistados. RESULTADOS: Os resultados apontaram quatro grupos. O primeiro grupo era composto de idosos com melhores condições físicas: não fraturaram o fêmur, eram mais independentes, saíam mais de casa antes da queda, tinham boa visão, permaneceram menos tempo internados e saíram do hospital com alta para casa. Outro grupo apresentou indivíduos em piores condições físicas: os menos independentes, os que ficaram mais tempo internados e os que saíram do hospital por óbito. Ainda foi apontado um grupo dos que fraturaram o fêmur, não tinham boa visão e dos que saíam de casa menos de uma vez por semana. O quarto grupo apontou os que saíam de casa uma a duas vezes por semana e os que ficaram internados de 11 a 30 dias. CONCLUSÕES: A análise de correspondência múltipla foi uma técnica útil para identificar subgrupos de pacientes com características comuns, o que fornece indícios para a criação de estratégias nos programas de prevenção de quedas.
Anemia, hipovitaminose A e insegurança alimentar em crianças de municípios de Baixo Índice de Desenvolvimento Humano do Nordeste do Brasil
Authors: Oliveira Juliana Souza , Lira Pedro Israel Cabral de , Osório Mônica Maria , Sequeira Leopoldina Augusta de Sousa , Costa Emília Chagas , Gonçalves Fabiana Cristina Lima da Silva Pastich , Batista Filho Malaquias
Published: December 2010

Determinar a prevalência de anemia e hipovitaminose A e analisar a associação da (in)segurança alimentar com os níveis de hemoglobina e retinol sérico de menores de 5 anos. Estudo transversal, realizado com 501 e 458 famílias em Gameleira e São João do Tigre, respectivamente. A avaliação da (in)segurança alimentar foi realizada através da Escala Brasileira de Insegurança Alimentar. Os níveis de hemoglobina e retinol sérico foram classificados de acordo com a OMS. Foram analisadas as associações com os indicadores socioeconômicos, habitação e biológicos sobre os níveis de hemoglobina e retinol sérico. As prevalências de anemia e hipovitaminose A foram mais elevadas em Gameleira quando comparadas com São João do Tigre. A (in)segurança alimentar moderada e grave das famílias foi de 75% em Gameleira e 64% em São João do Tigre. Na análise de regressão para os níveis de hemoglobina em Gameleira foram identificadas como significantes: escolaridade materna, renda familiar per capita, não possuir TV colorida, água de consumo sem tratamento, piso de barro e idade abaixo de 24 meses, enquanto para São João do Tigre o modelo final ficou resumido à falta de motocicleta e idade da criança. Quanto aos teores de retinol sérico, o modelo final de variáveis associadas ficou sendo renda per capita e sexo para Gameleira, e ausência de telefone celular e de esgotamento sanitário para São João do Tigre. A situação nutricional dessas populações, com prevalências semelhantes de insegurança alimentar, pode apresentar grandes diferenciações, sobretudo na prevalência de carências nutricionais específicas, especialmente, em relação aos fatores determinantes.
Estado nutricional, clínico e padrão alimentar de pessoas vivendo com HIV/Aids em assistência ambulatorial no município de São Paulo
Authors: Silva Erika Ferrari Rafael , Lewi David Salomão , Vedovato Gabriela Milhassi , Garcia Vânia Regina Salles , Tenore Simone Barros , Bassichetto Katia Cristina
Published: December 2010

INTRODUÇÃO: Atualmente, a abordagem nutricional desempenha papel essencial no tratamento de pessoas que vivem com HIV/aids, particularmente no caso de alterações metabólicas pelo uso da terapia antirretroviral (TARV) que podem estar associadas ao maior risco de doenças cardiovasculares (DCV). OBJETIVO: Caracterizar o estado nutricional, clínico e a qualidade da dieta de pessoas que vivem com HIV/aids. METODOLOGIA: Trata-se de um estudo transversal envolvendo pessoas que vivem com HIV/aids em atendimento na rede de serviços especializados no município de São Paulo. Os usuários desta rede, em uso ou não de TARV, foram recrutados no período de dezembro de 2004 a maio de 2006, durante consultas de rotina. Foram coletados dados sociodemográficos, clínicos, bioquímicos, antropométricos e dietéticos. A qualidade da dieta foi avaliada segundo escores de padrão de consumo predominantemente "não protetor" e "protetor" para DCV. RESULTADOS: A amostra foi constituída por 238 pacientes em TARV e 76 sem TARV. A média dos níveis de colesterol total, triglicérides e glicemia foram maiores no grupo TARV (p < 0,001). A maior parte dos participantes do estudo, com e sem TARV, apresentava-se eutrófica, com média de índice de massa corporal 24,4 (± 4,3) e 24,3 (± 3,5) kg/m², respectivamente. A relação cintura-quadril foi maior entre homens em TARV que entre aqueles sem TARV (0,90 ± 0,06 versus 0,87 ± 0,05) (p < 0,001). O grupo em TARV apresentou média de escores indicativa de maior consumo de alimentos "não protetores" para DCV (p = 0,001). CONCLUSÃO: Foram evidenciadas condições nutricionais e metabólicas indesejáveis entre aqueles em TARV, predisponentes ao risco de DCV. É apontada a necessidade de direcionamento das intervenções em saúde a pessoas que vivem com HIV/aids, para o controle dos fatores associados a essas doenças antes do desfecho final.
Gene Expression Dynamics During Bone Healing and Osseointegration
Authors: Lin Zhao , Rios Hector F. , Volk Sarah L. , Sugai James V. , Jin Qiming , Giannobile William V.
Published: December 2010

Background:Understanding the molecular features of bone repair and osseointegration may aid in the development of therapeutics to improve implant outcomes. The purpose of this investigation is to determine the gene expression dynamics during alveolar bone repair and implant osseointegration.

Methods:An implant osseointegration preclinical animal model was used whereby maxillary defects were created at the time of oral implant placement, while a tooth extraction socket healing model was established on the contralateral side of each animal. The surrounding tissues in the zone of the healing defects were harvested during regeneration for temporal evaluation using histology, immunohistochemistry, laser capture microdissection, and quantitative reverse transcription–polymerase chain reaction for the identification of a panel of 17 putative genes associated with wound repair.

Results:In both models, three distinct expression patterns were displayed: 1) genes that are slowly increased during the healing process, such as bone morphogenetic protein 4, runt‐related transcription factor 2, and osteocalcin; 2) genes that are upregulated at the early stage of healing and then downregulated at later stages, such as interleukin and chemokine (C‐X‐C motif) ligands 2 and 5; and 3) genes that are constitutively expressed over time, such as scleraxis. Although some similarities between osseointegration and tooth extraction socket were seen, distinct features developed and triggered a characteristic coordinated expression and orchestration of transcription factors, growth factors, extracellular matrix molecules, and chemokines.

Conclusions:Characterization of these events contributes to a better understanding of cooperative molecular dynamics in alveolar bone healing, and highlights potential pathways that could be further explored for the enhancement of osseous regenerative strategies.
A control chart for severity index to detect drought compares favourably to logistic regression
Authors: Townsley Jared , Chimka Justin R
Published: December 2010

We describe the discovery of how a traditional control chart for the Palmer Drought Severity Index (PDSI) to detect drought compares favourably to a theoretically appropriate statistical (logistic regression) model of drought as a function of PDSI. Our empirical results are based on monthly observations of PDSI, precipitation and temperature made in Kansas since 1895. Results from the study suggest that a relatively simple statistical approach based on Shewhart control charts may provide a more accessible method for relevant government agencies to predict droughts, improving resource management and preparation. Moreover, utilizing such an approach over more sophisticated methods may come at little expense regarding prediction errors.
An integrated neural network stochastic dynamic programming model for optimizing the operation policy of Aswan High Dam
Authors: El-Shafie A. H. , El-Manadely M. S.
Published: December 2010

Developing optimal release policies of multipurpose reservoirs is very complex, especially for reservoirs within a stochastic environment. Existing techniques are limited in their ability to represent risks associated with deciding a release policy. The risk aspect of the decisions affects the design and operation of reservoirs. A decision-making model is presented that is capable of replicating the manner in which risks associated with reservoir release decisions are perceived, interpreted and compared by a decision-maker. The model is based on Neural Network (NN) theory. This decision-making model can be used with a Stochastic Dynamic Programming (SDP) approach to produce a NN-SDP model. The resulting integrated model allows the attitudes towards risk of a decision-maker to be considered explicitly in defining the optimal release policy. Clear differences in the policies generated from the basic SDP and the NN-SDP models are observed when examining the operation of Aswan High Dam (AHD). The NN-SDP model yields policies that are more reliable and resilient and less vulnerable than those obtained using the SDP model.