bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome assessment after hip fracture
Authors: Parsons N. , Griffin X. L. , Achten J. , Costa M. L.
Published: March 2014

Objectives

To study the measurement properties of a joint specific patient reported outcome measure, a measure of capability and a general health-related quality of life (HRQOL) tool in a large cohort of patients with a hip fracture.

Methods

Responsiveness and associations between the Oxford Hip Score (a hip specific measure: OHS), ICEpop CAPability (a measure of capability in older people: ICECAP-O) and EuroQol EQ-5D (general health-related quality of life measure: EQ-5D) were assessed using data available from two large prospective studies. The three outcome measures were assessed concurrently at a number of fixed follow-up time-points in a consecutive sequence of patients, allowing direct assessment of change from baseline, inter-measure associations and validity using a range of statistical methods.

Results

ICECAP-O was not responsive to change. EQ-5D was responsive to change from baseline, with an estimated standardised effect size for the two datasets of 0.676 and 0.644 at six weeks and four weeks respectively; this was almost as responsive to change as OHS (1.14 at four weeks). EQ-5D correlated strongly with OHS; Pearson correlation coefficients were 0.74, 0.77 and 0.70 at baseline, four weeks and four months. EQ-5D is a moderately good predictor of death at 12 months following hip fracture. Furthermore, EQ-5D reported by proxies (relatives and carers) behaves similarly to self-reported scores.

Conclusions

Our findings suggest that a general HRQOL tool such as EQ-5D could be used to measure outcome for patients recovering from hip fracture, including those with cognitive impairment. Cite this article: Bone Joint Res 2014;3:69–75.
The locations of memory: Migration and transnational cultural memory as challenges for art history
Authors: Petersen Anne Ring
Published: March 2014

In the contemporary world, a considerable number of artists are on the move, due to the triple processes of globalization, decolonization and migration. Migrant artists, and also cosmopolitan artists that travel widely, are transnational cultural workers with ties to several places. As ‘bridging persons’, migrant artists have more than one sense of home, and they play a seminal role in the translation between cultures, and in the transformations between the local and the global. However, the multiple cultural references in their works also raise the difficult question of the provenance of their art. This article addresses the issue of how transnational cultural memory is articulated in works by migrant artists, as well as how to access it analytically. After outlining the general issues concerning the impact of migration on contemporary art, the article explores the usefulness of three conceptual frameworks: hybridity (Homi Bhabha, Stuart Hall); migratory aesthetics (Mieke Bal); and the notion of the work of art as a migrant’s event (Syed Manzurul Islam). Taking British Palestinian artist Mona Hatoum as my example, it is my contention that her exhibition ‘Interior Landscape’ (Venice, 2009) constitutes a migrant’s event.
Marketing musicals: Commercializing the avant-garde in Spring Awakening
Authors: Hoskins Vicki L.
Published: March 2014

The creative team of Spring Awakening (2006) never anticipated the musical becoming a commercial success. Librettist Steven Sater, composer Duncan Sheik and director Michael Mayer all hoped that the musical would enjoy a modest off-off-Broadway run, but they never imagined it would find a home on the Great White Way. Rather, the creators sought to eschew musical theatre conventions and incorporate avant-garde theatricality in an effort to present an anti-Broadway (and therefore anti-establishment) mentality. This article examines Spring Awakening’s place within the avant-garde tradition against its success within the commercial sphere of Broadway. Can a commercially successful musical ever truly be thought of as avant-garde?
Making Broadway musicals: An interview with Jess Goldstein
Authors: Dee Das Joanna
Published: March 2014

Jess Goldstein has been the costume designer for a number of Broadway productions, including Love! Valour! Compassion! (1995), Jersey Boys (2005), The Apple Tree (2007) and Newsies (2012). He won a Tony Award for his work on The Rivals (2005). In addition to designing for Broadway, Goldstein has designed for the Woodland Opera, regional theatre, and a number of off-Broadway productions. He also teaches at the Yale School of Drama. Below are excerpts from a conversation among Goldstein (JG), Princeton undergraduate students Marjorie Kroll (MK), Gaku Liu (GL), and Nora Sullivan (NS), and members of a general public audience about the process of designing costumes for Broadway and Goldstein’s work on Newsies in particular. This conversation took place as a part of the Making Broadway Musicals: Artists and Scholars in Conversation symposium at Princeton University on 21 April 2012.
Reviews
Authors: Dinero Dan , Cox-Williams Briony , La Spina Riccardo , Martin George
Published: March 2014

Hard Times: The adult musical in 1970s New York City, Elizabeth L. Wollman (2013) Oxford, New York: Oxford University Press, 271 pp., ISBN: 978-0-19-974748-1, h/bk, $27.95

Richard Wagner’s Women, Eva Rieger, trans. Chris Walton (2009) Woodbridge, NY: The Boydell Press, 239 pp., ISBN: 9781843836858, h/bk, £30.00

Verdi in America: Oberto through Rigoletto, George W. Martin (2011) Rochester, NY: University of Rochester Press (Eastman Studies in Music), 4782 pp., ISBN:10 1580463886, ISBN:13 9781580463881, h/bk, £45

Verdi’s Il Trovatore, the Quintessential Italian Melodrama, Martin Chusid (2012) Rochester, NY: University of Rochester Press, 161 pp., ISBN: 13: 9781580464222, h/bk, £31.00
Spatio temporal and environmental factors influencing macroalgal β diversity in the Red Sea, Egypt
Authors: Issa Ahmed A. , Hifney Awatief F. , Abdel-Gawad Khayria M. , Gomaa Mohamed
Published: March 2014

β Diversity is an ecological concept used to describe the turnover of species across a wide range of spatial and temporal scales, but such knowledge is lacking for macroalgal assemblages of the Red Sea. β Diversity patterns for Red Sea macroalgae were evaluated from different sites (Hurghada, Safaga, and Al-Quseir) and seasons across different environmental disturbances. β Diversity was studied by partitioning the total number of species (γ diversity) into additive components. Geographical heterogeneity was more important than seasonal heterogeneity in structuring macroalgae both at species and functional group levels. Species replacement as a component of β diversity produced dissimilarity in species composition and taxonomic structure. Replacement of species between sites was responsible for the presence of new functional groups of macroalgae. High β diversity and taxonomic similarity values were characteristic of the macroalgae of the Red Sea. The occurrence of small macroalgal thalli that have short life cycles induced high species replacement and subsequently high β diversity, with spatial heterogeneity and environmental gradient as drivers of β diversity. Anthropogenic disturbance at the Safaga site was suggested to induce variation of macroalgal assemblages and functional groups. Excluding rare species from the data set did not change the high values of b diversity.
Accurate Measurement of the Photon Flux Received Inside Two Continuous Flow Microphotoreactors by Actinometry
Authors: Aillet Tristan , Loubiere Karine , Dechy-Cabaret Odile , Prat Laurent
Published: March 2014

In this study, the photon flux received in two continuous flow microphotoreactors was measured by actinometry (potassium ferrioxalate). The microphotoreactors had two different geometries and were irradiated by either a polychromatic or a monochromatic light source. A model considering the partial absorption of photons through the reactor depth and, if required, the polychromatic character of the light source and the dependence of the actinometer properties on the wavelength were formulated to describe the variation of the actinometer conversion with the irradiation time. The photon flux received in the microphotoreactors could be thus accurately calculated as a function of the emitted wavelength. The same methodology was then applied to measure the photon flux received in a batch immersion well photoreactor. The radiant power received in each photoreactor was compared to that emitted by the lamp and major differences were found, thus confirming the need for this kind of in situ measurement. Finally, some guidelines based on a knowledge of the photon flux were proposed to compare various photoreactors. They revealed in particular that the choice of the most efficient photoreactor depended on the criteria chosen to evaluate the performances (i.e. productivity, Space Time Yield).
A review on Ipomoea carnea: pharmacology, toxicology and phytochemistry
Authors: Fatima Nusrat , Rahman Mohammad Mijanur , Khan Md. Asaduzzaman , Fu Junjiang
Published: March 2014

Phytomedicines are increasingly being established in modern medical science. The shrub Ipomoea carnea has been used traditionally for thousands of years. However, there are few scientific studies on this medicinal plant, and most of the information are scattered. In this review, we have summarized the existing knowledge and recent progress on the medicinal importance of I. carnea. Different extracts of I. carnea plant possess anti-bacterial, anti-fungal, anti-oxidant, anti-cancer, anti-convulsant, immunomodulatory, anti-diabetic, hepatoprotective, anti-inflammatory, anxiolytic, sedative and wound healing activities. However, some toxicological effects have been also reported. Some of the major phytochemicals associated with the bioactivity of I. carnea have been characterized, which have been discussed in this study too. This review article might be beneficial for phytotherapy research, as I. carnea can be a good source for drug development.
Forward and Reverse Mappings in die Casting Process by Neural Network-based Approaches
Authors: Kittur Jayant K. , Parappagoudar M. B.
Published: March 2014

The primary objective of this research is to develop an effective process model to map process parameters on quality characteristics of a commercial die-cast part of aluminium alloy by utilizing Back Propagation and Genetic Neural Networks. In the neural network based forward mapping, die cast component properties have been expressed as the functions of input parameters, whereas attempts are made to determine an appropriate set of input parameters, to ensure a set of desired properties, in reverse mapping. In the present work, the problems related to both the forward as well as reverse mappings are tackled by using a back-propagation neural network (BPNN) and a genetic-neural network (GA-NN). The forward modeling consists of predicting the responses for a set of given process parameters, while reverse model provides the information process parameters for a set of desired responses. Batch mode of training is provided to both the networks with the help of one thousand data, generated artificially from the regression equations obtained earlier by the authors. The performances of both forward and reverse models based on BPNN have been compared with the help of twenty randomly generated test cases. The results show that, BPNN outperforms the GA-NN approach and that both the NN approaches are able to carry out the reverse mappings effectively.
Development and characterization of bronze-Cr-Ni composites produced by powder metallurgy
Authors: Canakci Aykut , Varol Temel , Cuvalci Hamdullah , Erdemir Fatih , Ozkaya Serdar
Published: March 2014

In this study, the bronze-Cr-Ni composites were prepared by means of the powder metallurgical method. The influence of the composition and compact pressure on microstructure, density, hardness and electrical conductivity was examined. Scanning electron microscope (SEM) and energy dispersive X-ray analysis (EDX) were used to analyze the microstructure of the contact materials. The results showed that density of the bronze-Cr-Ni composites decreased with increasing Ni content. Increasing compact pressure led to lower porosity and consequently improved the density of bronze-Cr-Ni composites. The relative green density increased from 78% to 95% with the increase in the compact pressure from 200 MPa to 800 MPa. The hardness values showed a decrease from 95.1 BHN to 71.6 BHN by the addition of Ni from 1 wt% to 5 wt% at 800 MPa. It was found that addition of Ni at 1 wt% was required to achieve increased hardness and sufficient conductivity for bronze-Cr-Ni composites. The electrical conductivities of contact materials containing 3 wt% Ni and 5 wt% Ni was lower than that of 1 wt% Ni.
A case of ectopic ACTH syndrome treated with intermittent administration of dopamine agonists
Authors: Sakihara Satoru , Kageyama Kazunori , Yamagata Satoshi , Terui Ken , Daimon Makoto , Suda Toshihiro
Published: March 2014

ACTH-dependent Cushing's syndrome includes Cushing's disease and ectopic ACTH syndrome (EAS). The differential diagnosis of Cushing's disease from EAS in cases of ACTH-dependent Cushing's syndrome is a challenging problem. We report here a case of EAS with an unknown source of ACTH secretion. Extensive imaging procedures, involving computed tomography (neck to pelvis), pituitary magnetic resonance imaging, and whole-body18F-fluorodeoxyglucose-positron emission tomography, failed to reveal the source of ACTH secretion. Intermittent administration of bromocriptine, a short-acting and nonselective dopamine agonist, has afforded adequate suppression of plasma ACTH and cortisol levels over the long term.

Learning points

Tumor excision is the primary treatment for EAS. However, when surgery is impossible, medical therapy is needed to treat hypercortisolism.

In cases where the source of ACTH secretion is unknown, inhibitors of steroidogenesis, such as metyrapone, mitotane, ketoconazole, and etomidate, are mostly used to suppress cortisol secretion.

Medications that suppress ACTH secretion are less effective, therefore less popular, as standard treatments.

In the present case, short-term treatment with dopamine agonists was effective for the long-term suppression of both ACTH and cortisol levels.
Risk Factors Predicting the Postoperative Outcome in 134 Patients with Active Endocarditis
Authors: Neragi-Miandoab Siyamek , Skripochnik Edvard , Michler Robert , D'Alessandro David
Published: March 2014

Background: Surgery remains the cornerstone in management of endocarditis.

Methods: In this retrospective cohort we evaluated the operative outcome of patients with infective endocarditis. The SPSS program was used to analyze the data.

Results: A total of 134 predominantly male patients (60%) with a mean age of 55 � 12.4 years were examined. The procedures included single valve (n = 88; 66%), double/multiple valves (n = 29; 22%), and valve-coronary artery bypass graft (CABG) (n = 16; 12%). Perioperative mortality was 11.9% (n = 16). In the multivariate analysis, dialysis (odds ratio [OR] = 7.88; 95% confidence interval [CI] [1.78-34.77]; P = .006), sepsis (OR = 19.5; 95% CI [2.76-137.9]; P = .002), and perfusion time (95% CI [1.00-1.02]; P = .003) were independent predictors of perioperative mortality. The overall long-term survival at 28 months was 69.2% � 4%. Dialysis (P = .0001) was a predictor of mortality, whereas elevated creatinine in nondialysis patients (P = .0002) was not. In the multivariate analysis, dialysis (hazard ratio [HR] 4.06%; 95% CI [0.936-8.526]; P = .0002), CABG (HR 2.32; 95% CI [1.086-4.978]; P = .0299), chronic obstructive pulmonary disease (HR 2.20; 95% CI [1.027-4.739]; P = .0426), and double/multiple valve procedure (HR 3.0; 95% CI [1.467-6.206]; P = .0027) were risk factors for long-term mortality.

Conclusion: Renal failure but not renal insufficiency is a risk factor for short and long-term mortality.
Does Mild Renal Failure Affect Coronary Flow Reserve after Coronary Artery Bypass Graft Surgery?
Authors: Günday Murat , Çiftçi Özgür , Çalışkan Mustafa , Özülkü Mehmet , Bingöl Hakan , Körez Kazım , Aşlamacı Sait
Published: March 2014

Introduction: There are only a limited number of studies on the link between mild renal failure and coronary artery disease. The purpose of this study is to investigate the effects of mild renal failure on the distal vascular bed by measuring the coronary flow reserve (CFR) in transthoracic echocar-diography after coronary artery bypass grafting (CABG)

Methods: The study included 52 consecutive patients (12 women and 40 men) who had undergone uncomplicated CABG. The patients were divided into 2 groups. Group 1 included patients with a preoperative glomerular filtra-tion rate (GFR) of 60-90 (mild renal failure), and group 2 included those with a GFR >90. The CFR measurements were carried out through a second harmonic transthoracic Doppler echocardiography.

Results: The mean age was 60.08 ± 1.56 years in group 1 and 60.33 ± 1.19 in group 2. The mean preoperative CFR was 1.79 ± 0.06 in group 1 and 2.05 ± 0.09 in group 2. The mean postoperative CFR was 2.09 ± 0.08 in group 1 and 2.37 ± 0.06 in group 2. There was a statistically significant difference between the 2 groups as to preoperative creatinine clearance, preopera-tive estimated GFR, postoperative day 7 creatinine clearance, postoperative month 6 creatinine clearance, postoperative day 7 estimated GFR, postoperative month 6 estimated GFR, pre-operative CFR, and postoperative CFR (P < .05). After bypass surgery, there was a significant increase in the mean postopera-tive CFR, when compared with the mean preoperative CFR (P = .001).

Conclusion: In our study, we detected a decrease in CFR in patients with mild renal failure. We believe that in patients undergoing CABG for coronary artery disease, mild renal failure can produce adverse effects due to deterioration of the microvascular bed.
A Novel Approach: Trans-ascending Aorta Balloon Aortic Valvuloplasty via Sternotomy for Treating Severe Valvular Aortic Stenosis in a Low-Weight Infant
Authors: Gao Lei , Wu Qin , Xu Xinhua , Zhao Tianli , Jin Wancun , Yang Yifeng
Published: March 2014

Background: Severe congenital aortic stenosis in infants is a life-threatening congenital heart anomaly that is typically treated using percutaneous balloon aortic valvuloplasty.

Methods: The usual route is the femoral artery under radiographic guidance. However, this procedure may be limited by the small size of the femoral artery in low-weight infants. An infant weighing only 7 kg with severe aortic stenosis (peak gradient was 103 mmHg) was successfully treated with a novel approach, that is trans-ascending aorta balloon aortic valvuloplasty guided by transesophageal echocardiography.

Results: The patient tolerated the procedure well, and no major complications developed. After the intervention, transesophageal echocardiography indicated a significant reduction of the aortic valvular peak gradient from 103 mmHg to 22 mmHg, no aortic regurgitation was found. Eighteen months after the intervention, echocardiography revealed that the aortic valvular peak gradient had increased to 38 mmHg and that still no aortic regurgitation had occurred.

Conclusions: In our limited experience, trans-ascending aorta balloon aortic valvuloplasty for severe aortic stenosis under transesophageal echocardiography guidance effectively reduces the aortic peak gradient. As this is a new procedure, long-term follow up and management will need to be established. It may be an alternative technique to treat congenital aortic stenosis in low-weight patients.
Surgical Treatment of Double Valve Endocarditis
Authors: Tas Serpil , Adademir Taylan , Tuncer Eylem Yayla , Donmez Arzu Antal , Polat Ebru Bal , Aksut Mehmet , Songur Murat , Tuncer Altug , Sismanoglu Mesut
Published: March 2014

Background: We have retrospectively analyzed the results of the operations made for aortic infective endocarditis with mitral involvement in a single center in 19 years.

Methods: From May 1992 to January 2011, we have operated on 72 patients with infective endocarditis of the aortic valve with mitral valve involvement. Fifty-two patients (72.2%) were male and the mean age was 40.5 � 15.5 (9-73) years. The blood cultures were positive in 33 patients (45.8%) and the most commonly identified microorganism was Streptococcus. Nine patients (12.5%) had prosthetic valve endocarditis. The mean duration of follow-up was 6.8 � 4.7 (0.1-16.9) years, adding up to a total of 156.1 patient/years.

Results: A total of 155 procedures were performed on these 72 patients. The most commonly performed procedure was aortic valve replacement, in 63 patients (87.5%). Aortic annular involvement was present in 9 cases (12.5%). In-hospital mortality was seen in 13 patients (18.1%). Postoperatively, 13 (18.1%) patients had low cardiac output, 9 (12.5%) had heart block, and only 1 of them required permanent pacemaker implantation. The actuarial survival rates for 1, 5, and 10 years were 96.4% � 2.5%, 84.4% � 5.1%, and 77.4 � 6.7%, respectively.

Conclusions: Double-valve endocarditis is a serious condition and the surgeon must be aware of the high rates of mortality and morbidity in these patients. Although no association was found, heart blocks and septic embolization must be handled with caution. The patients generally do well after surgery, and recurrences and reoperations decrease by the second year after operation.
Diverse Cell Type-Specific Mechanisms Localize G Protein-Coupled Receptors to Caenorhabditis elegans Sensory Cilia
Authors: Brear Andrea G , Yoon Jason , Wojtyniak Martin , Sengupta Piali
Published: March 2014

The localization of signaling molecules such as G protein-coupled receptors (GPCRs) to primary cilia is essential for correct signal transduction. Detailed studies over the past decade have begun to elucidate the diverse sequences and trafficking mechanisms that sort and transport GPCRs to the ciliary compartment. However, a systematic analysis of the pathways required for ciliary targeting of multiple GPCRs in different cell types in vivo has not been reported. Here we describe the sequences and proteins required to localize GPCRs to the cilia of the AWB and ASK sensory neuron types in Caenorhabditis elegans. We find that GPCRs expressed in AWB or ASK utilize conserved and novel sequences for ciliary localization, and that the requirement for a ciliary targeting sequence in a given GPCR is different in different neuron types. Consistent with the presence of multiple ciliary targeting sequences, we identify diverse proteins required for ciliary localization of individual GPCRs in AWB and ASK. In particular, we show that the TUB-1 Tubby protein is required for ciliary localization of a subset of GPCRs, implying that defects in GPCR localization may be causal to the metabolic phenotypes of tub-1 mutants. Together, our results describe a remarkable complexity of mechanisms that act in a protein- and cell-specific manner to localize GPCRs to cilia, and suggest that this diversity allows for precise regulation of GPCR-mediated signaling as a function of external and internal context.
Studies on the possible aetiological role of different Candida species in pathogenesis of dentine caries by monitoring the calcium release from tooth particles
Authors: Szabó Béla , Majoros László , Papp-Falusi Erzsébet , Szabó Zsuzsanna , Szabó Judit , Márton Ildikó , Kelentey Barna
Published: March 2014

An in vitro model has been developed for study of cariogenic potential of different Candida species. Slices were prepared from the root of extracted healthy teeth. These disks were covered with inert material, only the central hole, i.e. the root canal dentin surface remained uncovered. These preparates with free root dentin surfaces were incubated in Sabouraud medium in the presence of six-six Candida albicans, Candida glabrata, Candida tropicalis, Candida krusei, Candida inconspicua and Candida norvegensis strains. The calcium release was detected for 15 days. Two types of release could be distinguished. C. albicans deliberated calcium more aggressively (type “A” curve), while other Candidas were characterized by less expressed calcium releasing capacity (type “B” curve). Curves type “A” and “B” were divided into four steps in order to characterize more precisely the different dynamics of calcium release. Analyses of the different steps also suggested the more aggressive behaviour of C. albicans. Our results indicate that in addition to cariogenic role of different bacteria, fungi may also actively take part in the dentinal caries progress.
Shortening the length of stay and mechanical ventilation time by using positive suggestions via MP3 players for ventilated patients
Authors: Szilágyi Adrienn K. , Diószeghy Csaba , Fritúz Gábor , Gál János , Varga Katalin
Published: March 2014

Long stay in intensive care unit (ICU) and prolonged ventilation are deleterious for subsequent quality of life and surcharge financial capacity. We have already demonstrated the beneficial effects of using suggestive communication on recovery time during intensive care. The aim of our present study was to prove the same effects with standardized positive suggestive message delivered by an MP3 player. Patients ventilated in ICU were randomized into a control group receiving standard ICU treatment and two groups with a standardized pre-recorded material delivered via headphones: a suggestive message about safety, self-control, and recovery for the study group and a relaxing music for the music group. Groups were similar in terms of age, gender, and mortality, but the SAPS II scores were higher in the study group than that in the controls (57.8 ± 23.6 vs. 30.1 ± 15.5 and 33.7 ± 17.4). Ourpost-hocanalysis results showed that the length of ICU stay (134.2 ± 73.3 vs. 314.2 ± 178.4 h) and the time spent on ventilator (85.2 ± 34.9 vs. 232.0 ± 165.6 h) were significantly shorter in the study group compared to the unified control. The advantage of the structured positive suggestive message was proven against both music and control groups.
Recurrence of primary sclerosing cholangitis after liver transplantation — The Hungarian experience
Authors: Gelley Fanni , Zádori Gergely , Görög Dénes , Kóbori László , Fehérvári Imre , Gámán György , Gerlei Zsuzsanna , Nagy Péter , Sárváry Enikő , Nemes Balázs
Published: March 2014

Introduction

Recurrence of primary sclerosing cholangitis (rPSC) after liver transplantation (OLT) significantly affects longterm graft survival. We aimed to evaluate the incidence of rPSC and clinical data of these patients in Hungary.

Patients and Methods

We retrospectively analyzed data of 511 whole liver transplantations from 1995 to 2011. During the study period, 49 OLTs were performed in 43 adult patients with end-stage PSC (10%).

Results

Out of 49 OLT, 24 cases were excluded, rPSC was diagnosed in six patients (12%). Patients with rPSC had significantly higher mortality (p = 0.009) and graft loss (p = 0.009) in comparison to patients without recurrent disease. Younger recipient age, higher donor BMI was observed in the rPSC group. One patient was diagnosed with de novo IBD, the remaining five patients had worsening IBD activity in the posttransplant period. PreOLT colectomy was performed in 21% of the control and none of the rPSC group. PostOLT colectomy was performed in two rPSC patients due to severe therapy resistant colitis.

Conclusions

Recurrent PSC significantly affects long-term mortality and graft loss. Younger age at OLT, higher donor BMI and severe active IBD may be associated with PSC recurrence. PreOLT total colectomy might have protective effect against rPSC.
Advantages of a workbench reshaped AR1 mod catheter for right coronary angiography by right radial approach
Authors: Baldi Cesare , Mirra Marco , di Maio Marco , Attisano Tiziana , Di Muro Michele Roberto , Vigorito Francesco , Farina Rosario , Polito Maria Vincenza , Giudice Pietro , Piscione Federico
Published: March 2014

Transradial approach in cardiac catheterization is increasing. In daily practice, coronary angiography via radial artery is usually performed by using catheters designed for femoral approach. The aim of this study was to evaluate advantages in the use of a workbench reshaped AR1 mod catheter, in terms of procedural duration time, number of catheters per procedure, fluoroscopy time, contrast agent administered volume, images quality and costs. Two hundred patients, submitted to coronary angiography via right radial artery in our institution, have been retrospectively reviewed. Patients have been divided in two groups, depending on whether a workbench reshaped Cordis Amplatz AR1 mod catheter (rAR1 mod), or catheters in their original shape (OC) have been employed. In the rAR1 mod group (100 patients) a lower number of catheters per procedure (1.07 ± 0.25 vs. 1.47 ± 1.65; p < 0.001), a more frequent right coronary selective engagement (76.76% vs. 53.12%; p < 0.001), a smaller amount of contrast agent (63.02 ± 27.77 vs. 80.85 ± 29.22 ml, p < 0.001), a reduced fluoroscopy and global procedural time (4.19 ± 2.91 vs. 5.69 ± 3.85 min, p = 0.004; and 34.58 ± 17.05 vs. 42.58 ± 17.26 min, p = 0.001, respectively) were observed. According to our experience, when right coronary angiography via right radial approach is performed, the utilization of rAR1 mod catheter correlates with multiple advantages in terms of procedural parameters.
Computed tomography as a problem solving tool in non-radiopaque central venous port systems — A report of three cases
Authors: Gossner Johannes
Published: March 2014

Central venous port systems are now routinely used in oncology. The non-functioning port system is a common issue in radiology departments. Fluoroscopy is a first-line imaging modality. The potential usefulness of computed tomography as a problem-solving tool in three complex cases with non-radiopaque central venous port systems is presented.
On Burglars and Makers of Links
Authors: Hirst Jacqueline Suthren
Published: March 2014

The article argues that, whereas a great deal of exciting scholarly work has been done on the ways in which South Asian narratives are told, retold and ‘recycled’ across different religious, social and regional contexts, to date little has been written on the way in which philosophical and other commentaries make use of earlier material. Indicating how the contributions in this special issue start to redress the balance, it notes the importance of looking at the ways in which such texts are constructed, not least in the light of contemporary issues about what constitutes originality or plagiarism.
Dhammapada and Dhammapada Commentary
Authors: Appleton Naomi
Published: March 2014

The Dhammapada has been translated many times into Western languages and is widely appreciated for its concise presentation of Buddhist teachings. However, the prose commentary that accompanies it, and which explains when, why and to whom the Buddha spoke the verses in the Dhammapada, is less well-known. In this article, I examine the relationship between the verses of the Dhammapada and the narratives of the commentary, and ask what value is added by reading this popular text in its commentarial context.
Knut A. Jacobsen (ed.), Theory and Practice of Yoga: Essays in Honour of Gerald James Larson
Authors: Warrier Maya
Published: March 2014

Knut A. Jacobsen (ed.), Theory and Practice of Yoga: Essays in Honour of Gerald James Larson. Numen Book Series. Leiden and Boston: Brill, 2005. x + 482 pp. €173.00; US$ 258.00. ISBN 90-04-14757-8 (hardback).
Relationship between subjective social status and perceived health among Latin American immigrant women
Authors: Sanchón-Macias Mª Visitación , Prieto-Salceda Dolores , Bover-Bover Andreu , Gastaldo Denise
Published: March 2014

OBJECTIVE: to explore the relationship between socioeconomic status and subjective social status and explain how subjective social status predicts health in immigrant women. METHODS: cross-sectional study based on data from 371 Latin American women (16-65 years old) from a total of 7,056 registered immigrants accesse through community parthers between 2009-2010. Socioeconomic status was measured through education, income and occupation; subjective social status was measured using the MacArthur Scale, and perceived health, using a Likert scale. RESULTS: a weak correlation between socioeconomic and subjective social status was found. In the bivariate analysis, a significantly higher prevalence of negative perceived health in women with no education, low income, undocumented employment was observed. In the multivariate analysis, higher odds of prevalence of negative perceptions of health in the lower levels of the MacArthur scale were observed. No significant differences with the rest of the variables were found. CONCLUSIONS: the study suggests that subjective social status was a better predictor of health status than the socioeconomic status measurements. Therefore, the use of this measurement may be relevant to the study of health inequalities, particularly in socially disadvantaged groups such as immigrants.
Comparison of hand hygiene antimicrobial efficacy: Melaleuca alternifolia essential oil versus triclosan
Authors: Gnatta Juliana Rizzo , Pinto Flávia Morais Gomes , Bruna Camila Quartim de Moraes , Souza Rafael Queiroz de , Graziano Kazuko Uchikawa , Silva Maria Julia Paes da
Published: March 2014

OBJECTIVE: this study aimed to evaluate the efficacy of hand hygiene performed with two different soap formulations: 0.3% Melaleuca alternifolia essential oil versus 0.5% triclosan, and to compare them with two reference hygiene procedures: the official methodology procedure (soft soap) versus the draft version of the procedure (soft soap + propan-2-ol). METHOD: using the European EN 1499 method, logarithmic reduction factors were determined for the number of colony forming units of Escherichia coli K12 before and after hand hygiene of 15 volunteer subjects, and compared using the one-tailed Wilcoxon test. RESULTS: referring to the soft soap, there was no difference between the performance of soap with 0.3% M. alternifolia and soap containing 0.5% triclosan. The soft soap + propan-2-ol proved to be more effective than the other hand hygiene procedures. CONCLUSION: studies to verify the therapeutic efficacy of essential oil in hand hygiene can improve adherence to this practice.
Work ability in nursing: relationship with psychological demands and control over the work
Authors: Prochnow Andrea , Magnago Tânia Solange Bosi de Souza , Urbanetto Janete de Souza , Beck Carmem Lúcia Colomé , Lima Suzinara Beatriz Soares de , Greco Patrícia Bitencourt Toscani
Published: March 2014

OBJECTIVE: to evaluate the association between psychological demands, control over the work and the reduction of work ability of nursing professionals. METHOD: this cross-sectional study involved 498 nursing professionals of a university hospital in the State of Rio Grande do Sul, Brazil. Data collection was carried out in 2009 using the Brazilian versions of the Work Ability Index and Job Stress Scale, with logistic regression models used for the data analysis. RESULTS: the prevalence of 43.3% for reduced work ability and 29.7% for high-strain in the job (high psychological demand and low control) were observed. The chances for professionals presenting reduced work ability under high-strain were higher and significant when compared to those classified as being under low-strain, even after adjusting for potential confounders, except for age and gender. CONCLUSION: a high prevalence of reduced work ability was observed. This evidence indicates the need for investigation and detailed analysis of the psychosocial aspects of the professionals with regard to the health/disease process of nursing professionals.
A circulação do discurso da Amway: do controle à prática discursiva
Authors: Brunelli Anna Flora
Published: March 2014

Neste trabalho, com o intuito de contribuir com as reflexões sobre a circulação dos discursos, analisamos aspectos relativos à circulação do discurso da Amway, uma empresa norte-americana de vendas em rede que tem atuado há um certo tempo no Brasil. Mais exatamente, analisamos as condições dessa circulação no momento em que ocorreu de modo mais intenso, isto é, na década de 90, quando havia milhares de pessoas em diversas partes do país envolvidas com a venda dos produtos da empresa e/ou com o seu consumo. Nosso estudo se baseia na Análise do Discurso de linha francesa, com ênfase nas reflexões de Foucault sobre os mecanismos de controle do discurso e na noção de prática discursiva, tal como reformulada por Maingueneau. A análise revela que o discurso da Amway apresenta aspectos de uma doutrina e que, como uma prática discursiva, não pode ser pensado de modo separado dos sujeitos que veiculam o discurso, do modo como os organiza numa hierarquia específica, nem dos eventos que promove e que são promovidos em nome da empresa. Nesses termos, a análise evidencia como os discursos dizem respeito não só a um conjunto de textos, mas também a uma rede institucional relativa ao grupo social que a enunciação do discurso supõe e torna possível.
As faces de uma polêmica: o episódio do livro didático Por uma vida melhor
Authors: Cavalcanti Jauranice Rodrigues
Published: March 2014

O objetivo deste artigo é analisar discursivamente como as grandes mídias veicularam o episódio envolvendo o livro didático "Por uma vida melhor", de Heloísa Ramos, distribuído pelo Ministério da Educação (MEC). Sabe-se que o caso teve grande repercussão: jornalistas, escritores e estudiosos produziram textos apresentando/discutindo o assunto, o que gerou uma polêmica entre aqueles que defendiam as ideias presentes na obra (distinção entre língua oral e escrita, consideração das variedades linguísticas) e os que a consideravam um incentivo ao "falar e escrever errado". Para analisar o embate, reuniu-se um corpus constituído de textos de diferentes gêneros de discurso, que circularam nas grandes mídias no período de maio a julho de 2011. As categorias de análise mobilizadas provêm dos estudos do discurso, em especial do quadro teórico-metodológico com o qual trabalha o analista de discurso D. Maingueneau. Resultados apontam que a relação polêmica se mostra em diferentes lugares dos textos analisados.
Antecedentes à resistência a sistemas empresariais: a perspectiva de gestores brasileiros
Authors: Macêdo David Gradvohl , Gaete Luciano , Joia Luiz Antonio
Published: March 2014

O objetivo deste estudo é determinar os antecedentes à resistência a sistemas empresariais (ERP). Assim, por meio de levantamento bibliográfico relacionado às causas de resistência a sistemas de informação, elaborou-se um modelo teórico contendo os fatores que influenciam o comportamento de resistência a sistemas ERP. A partir daí, por meio de survey, foram obtidos 169 questionários válidos, preenchidos por gestores de tecnologia da informação brasileiros que já haviam implantado sistemas empresariais. A pesquisa valeu-se, então, de técnicas de análise fatorial e equações estruturais para refinar e testar o modelo proposto. Verificou-se que os fatores, sistemas e inclinação pessoal explicaram cerca de 49% da variância do comportamento de resistência a sistemas empresariais. Assim, conclui-se que sistemas ERP pouco flexíveis, tecnicamente mal projetados, cuja utilização seja de difícil compreensão e que não atendam às necessidades dos profissionais, geram resistência relacionada aos mesmos. Semelhantemente, conclui-se que há uma predisposição intrínseca de alguns usuários a resistir à implantação de sistemas empresariais, indicando que o estudo da resistência a sistemas de informação necessita explorar, cada vez mais, dimensões que contemplem aspectos eminentemente comportamentais dos profissionais.
Relações entre resistência a mudança e comprometimento organizacional em servidores públicos de Minas Gerais
Authors: Marques Antônio Luiz , Borges Renata , Morais Kelly , Silva Mariane Coimbra
Published: March 2014

O objetivo desta pesquisa é identificar as possíveis relações entre resistência à mudança e comprometimento organizacional. Neste estudo, foram avaliados servidores públicos do estado de Minas Gerais submetidos à Avaliação de Desempenho Individual (ADI), ferramenta implantada pelo governo mineiro junto a diversas mudanças que fazem parte do projeto Choque de Gestão. Para testar a hipótese da pesquisa, foi realizado um survey em três Secretarias do Estado de Minas Gerais, cuja amostra obtida foi de 679 respondentes. Utilizou-se a análise fatorial para avaliar o instrumento utilizado, empregou-se a análise de variância para identificar a diferença entre as secretarias de Estado e a regressão linear para testar a hipótese proposta. Os resultados indicam que uma variação positiva da aceitação e da cooperação com a implantação da ADI resulta em aumento do comprometimento percebido, ou seja, o servidor que coopera com as mudanças implantadas tende a apresentar um alto comprometimento com a organização. A principal contribuição da pesquisa é, portanto, relacionar o comprometimento com a percepção que os servidores têm sobre as mudanças organizacionais implantadas pelo governo de Minas Gerais.
Segredo profissional e sua importância na prática de enfermeiros e odontólogos
Authors: Dias Orlene Veloso , Gomes Ludmila Mourão Xavier , Barbosa Thiago Luis de Andrade , Souza Luís Paulo Souza e , Rocha Antônio Lincoln de Freitas , Costa Simone de Melo
Published: March 2014

Este artigo apresenta a definição de segredo e sigilo profissional em saúde, bem como os critérios que os prescrevem, indicando sua importância para enfermeiros e odontólogos. Essas definições basearam-se em extensa pesquisa bibliográfica, incluindo a legislação, artigos eletrônicos em bases acadêmicas e literatura científica impressa. A discussão aponta que o sigilo nos serviços de saúde quanto às informações dos usuários é previsto em lei e pelos conselhos de ética profissional. Este arcabouço legal e normativo define o dever de lealdade do profissional para com o usuário, enfatizando a importância de preservá-lo. A discussão também mostra que o sigilo pode ser quebrado mediante autorização do usuário ou nas situações amparadas legalmente, consideradas como justa causa. Conclui indicando a necessidade de discutir o tema com os trabalhadores de saúde, visando instrumentalizá-los a adotar postura ética e moralmente correta, sendo o próprio texto uma iniciativa no sentido de prover tal informação.
Conflitos éticos na comunicação de más notícias em oncologia
Authors: Geovanini Fátima , Braz Marlene
Published: March 2014

Partindo de abordagem qualitativa, com entrevistas semiestruturadas, analisadas pelo método hermenêutico-dialético, busca-se identificar os conflitos éticos vividos por oncologistas na comunicação de diagnósticos de câncer, analisando os problemas desencadeados pelas más notícias. Da pesquisa participaram quinze oncologistas clínicos e cirurgiões, que relataram que a comunicação do diagnóstico de câncer é considerada difícil tarefa devido à ausência de investimentos para o desenvolvimento das habilidades de comunicação na graduação médica; ao simbolismo do câncer; à presença de fantasias relacionadas ao conhecimento do diagnóstico e a dificuldades na abordagem da morte. Os principais conflitos éticos citados estão relacionados à justa adequação moral do emprego da verdade na comunicação, se esta é uma ação beneficente para o paciente, e ao manejo com a família na relação médico-paciente. A conclusão observou que os problemas éticos desencadeaÂdos decorrem, predominantemente, em relações paternalistas com interferência na autonomia do paciente.
Ética e cuidados paliativos: o que os médicos sabem sobre o assunto?
Authors: Brugugnolli Izabela Dias , Gonsaga Ricardo Alessandro Teixeira , Silva Eduardo Marques da
Published: March 2014

A partir do novo Código de Ética Médica brasileiro ficou estabelecido que o médico deve empregar cuidados paliativos na impossibilidade de cura. O objetivo do estudo foi conhecer o estado atual dessa prática. Para tal, conduzimos um estudo epidemiológico transversal quantitativo com os médicos do corpo clínico de um complexo de hospitais-escola quanto aos preceitos éticos implicados no exercício dos cuidados paliativos. Ao se questionar o médico sobre os seus objetivos no cuidado de um paciente, segundo os preceitos da ética médica, a maioria constrói respostas incompletas, apenas 28,9% responderam diretamente que empregariam os cuidados paliativos. A maioria dos médicos (59,2%) ligam os cuidados paliativos somente ao alívio do sofrimento e qualidade de vida e para 38,2% deles a idade ainda é fator de influência importante na indicação. Logo, o conhecimento dos médicos em atividade sobre o tema é precário e medidas de educação médica se fazem necessárias.
Sistema suplementar de saúde e internação domiciliar de idosos na perspectiva da bioética crítica
Authors: Andraos Cláudio , Lorenzo Cláudio
Published: March 2014

No Brasil, atualmente, a internação domiciliar (ID) é a principal opção para a desospitalização de idosos, sobretudo no sistema suplementar. Variados conflitos éticos surgem no contexto da assistência em meio a contextos familiares diversos. Neste trabalho, realizamos um estudo exploratório de dois casos de ID em operadora de planos de saúde, na qual os conflitos éticos identificados foram delimitados a dois campos principais de atuação da bioética: o da bioética clínica, no tocante às relações interpessoais e tomadas de decisão em torno da assistência, e o da bioética aplicada à saúde pública, no pertinente aos desafios para a organização e oferta de serviços. Os conflitos foram discutidos com base no modelo de bioética crítica. O estudo gerou proposições para a redução de alguns conflitos éticos envolvidos na ID e demonstrou a necessidade de pesquisas mais amplas para conhecer em maior extensão e profundidade este problema.
Representação social acerca dos animais e bioética de proteção: subsídios à construção da educação humanitária
Authors: Souza Joseth Filomena de Jesus , Shimizu Helena Eri
Published: March 2014

O presente estudo visa identificar as representações sociais que crianças do ensino fundamental de uma escola pública de Brasília/DF fazem sobre os animais. Quatro grupos focais foram realizados e os dados, interpretados a partir da bioética de proteção, que defende que pacientes morais suscetíveis ou vulnerados a danos devem ser protegidos. O estudo considera ser relevante conhecer as representações sociais de estudantes sobre os animais, com vistas a subsidiar medidas educativas eficazes que contribuam para evitar que se continue a atribuir valor instrumental aos animais. Os dados mostram que a representação dos participantes fundamenta-se no afeto e na empatia por cães e gatos, e no especismo eletivo referente a algumas espécies. A partir dos resultados, foi possível constatar que as crianças tendem a seguir a forma socialmente conotada de classificação, indicando a necessidade de adotar medidas educativas para futuramente romper o padrão antropocêntrico que pauta as relações humanas com as outras espécies.
Municipal status in accordance with declaration criteria
Authors: Hossain Rakibul , Rahman Saifur
Published: March 2014

Rapid population growth throughout Bangladesh has resulted in a steady shift of population from rural to urban areas. In Bangladesh, municipalities are defined based on criteria laid out in the Municipal Ordinance 1977. However, some municipalities have very poor infrastructure and service levels, which raises the question of the validity of the municipal definition criteria contained in the Ordinance. In this work, 18 municipalities in different parts of the Rajshahi region were selected for study, with data collection mainly reliant on secondary sources. It was found that most municipalities in the study area are dominated by rural characteristics. Agricultural activities still play a vital role in occupation patterns and the major share of land use is agrarian, which is clear evidence of a diversion from the municipal declaration criteria stated in the Ordinance. The aims of this study were to explore the formulation of municipalities in accordance with Municipal Ordinance 1977 and to determine existing anomalies in municipal declaration practices.