bluuebunny/crossref_metadata_2025 huggingface dataset:
O pós-estruturalismo e os estudos críticos de gestão: da busca pela emancipação à constituição do sujeito
Authors: Souza Eloisio Moulin de , Souza Susane Petinelli , Silva Alfredo Rodrigues Leite da
Published: March 2013

Os Estudos Críticos em Gestão (ECG) são formados por bases epistemológicas distintas. Contudo, haveria algum ponto em comum que fosse capaz de dar um status de campo de estudo aos ECG? Alguns autores afirmam que a busca pela emancipação seria uma característica comum às correntes de pensamento que fazem parte dos ECG. Diante desse panorama, este artigo problematiza se a emancipação realmente é uma característica presente no movimento pós-estruturalista, enfocando principalmente as possíveis diferenças entre o pós-estruturalismo e a Teoria Crítica sobre esse tema, bem como analisando quais as possíveis distinções existentes entre autores pós-estruturalistas relacionadas à emancipação e à subjetividade. Para tanto, realizou-se uma pesquisa bibliográfica em estudos que discutem as principais características dos Estudos Críticos em Gestão. Conforme será descrito, o pós-estruturalismo deixa claro que pretende romper com a dicotomia existente na concepção de sujeito, na qual, em um polo, encontra-se um sujeito completamente autônomo (sujeito individual) e, no outro, um sujeito determinado pelo social (sujeito coletivo), rompendo com a dicotomia agência versus estrutura. Entende-se que emancipação é um ponto-nodal entre os Estudos Críticos em Gestão e não somente uma característica comum. Nesse sentido, o que existem são emancipações no plural, pois há diferenças conceituais entre e dentro das abordagens dos Estudos Críticos em Gestão que têm implicações diretas nos conceitos de universalidade, subjetividade e emancipação, bem como em suas formas de ação política.
Efeitos da internacionalização sobre o desempenho de multinacionais de economias em desenvolvimento
Authors: Andrade Alisson Maxwell Ferreira de , Galina Simone Vasconcelos Ribeiro
Published: March 2013

A relação entre o grau de internacionalização e o desempenho das empresas multinacionais (EMNs) tem sido amplamente estudada na literatura de negócios internacionais. Entretanto, a maior parte dos estudos é realizada com empresas dos países desenvolvidos. De modo a contribuir com o desenvolvimento da teoria de internacionalização-desempenho, este artigo mostra uma análise dessa relação no universo das EMNs de economias em desenvolvimento. O principal objetivo do trabalho é avaliar se a estratégia de expansão internacional dessas EMNs está sendo traduzida em forma de eficiência e eficácia na gestão do negócio da empresa. A amostra do estudo corresponde a 33 das 100 empresas multinacionais (EMNs) mais internacionalizadas de economias em desenvolvimento, sendo que as informações levantadas referem-se a um período de 6 anos (2004-2009). Os dados foram obtidos junto a duas fontes: (a) United Nations Conference on Trade and Development (UNCTAD); e (b) Thomson Reuters Datastream. Após análises de regressão múltipla, método dos mínimos quadrados, bem como análise de dados em painel, verificou-se uma relação linear-negativa entre o grau de internacionalização e o desempenho das EMNs de economias em desenvolvimento, indicando que quanto maior o grau de internacionalização, menor tende a ser o desempenho dessas empresas.
Swap, futuro e opções: impacto do uso de instrumentos derivativos sobre o valor das firmas brasileiras
Authors: Ribeiro Philippe Lemes , Machado Sérgio Jurandyr , Rossi Júnior José Luiz
Published: March 2013

O trabalho analisa o impacto do uso de derivativos e a direção e magnitude do prêmio de cobertura relacionado a cada tipo de instrumento derivativo no valor da firma para uma amostra de empresas brasileiras não financeiras de capital aberto no período de 2004 a 2007. Os resultados indicam que a utilização de derivativos está relacionada a um impacto positivo e significativo sobre o valor de mercado das empresas. As evidências mostram que o uso de derivativos está associado a um "prêmio de cobertura" (hedging premium). Dessa maneira, é possível afirmar que as firmas que fazem uso da gestão de risco com derivativos têm um valor de mercado superior, no mercado brasileiro, quando comparadas a firmas que não utilizam esses instrumentos financeiros (hedging premium). Os resultados também indicam que, quando a análise se concentra no tipo de instrumento utilizado, a gestão de risco com tipos distintos de derivativos gera impacto de magnitude heterogênea no valor da firma. Contratos de swap e futuro/termo apresentam um impacto positivo e estatisticamente significante. Já para as opções, o impacto, embora positivo, não é estatisticamente significativo. Portanto, os resultados obtidos não só confirmam as expectativas de que a utilização de instrumentos derivativos exerce um impacto positivo e estatisticamente significativo sobre o valor da firma, mas também mostram que existe uma diferença relevante no efeito associado a derivativos distintos. Em conjunto, os resultados corroboram o fato de que investidores estão dispostos a pagar um maior valor por firmas que fazem gestão ativa de risco financeiro em ambientes mais voláteis como o Brasil, e essa disposição varia de acordo com o instrumento utilizado e com a eventual combinação de derivativos financeiros. Em pesquisa futura, uma análise das causas do impacto heterogêneo dos distintos instrumentos derivativos deve ser realizada para um melhor entendimento dos mecanismos pelo qual a política de gerenciamento de risco gera valor às firmas.
Histoplasmose simulando neoplasia primária de pulmão ou metástases pulmonares
Authors: Dall Bello Aline Gehlen , Severo Cecilia Bittencourt , Guazzelli Luciana Silva , Oliveira Flavio Mattos , Hochhegger Bruno , Severo Luiz Carlos
Published: March 2013

OBJETIVO: Descrever as principais características clínico-radiológicas de pacientes com histoplasmose simulando câncer de pulmão. MÉTODOS: Estudo descritivo e retrospectivo baseado na análise dos prontuários médicos de 294 pacientes diagnosticados com histoplasmose no Laboratório de Micologia da Irmandade Santa Casa de Misericórdia de Porto Alegre, em Porto Alegre (RS), entre 1977 e 2011. O diagnóstico de histoplasmose foi estabelecido por cultura, exame histopatológico ou identificação de bandas M ou H por imunodifusão. Após identificar os pacientes com lesões macroscópicas e com achados compatíveis de malignidade em radiografia ou TC de tórax, os pacientes foram divididos em dois grupos: pacientes com história de câncer e lesões simulando metástases (grupo HC) e pacientes sem história de câncer com lesão simulando neoplasia primária (SHC). RESULTADOS: Dos 294 pacientes com histoplasmose, 15 apresentaram lesões simulando neoplasia primária ou metástases (9 e 6 nos grupos HC e SHC, respectivamente). A idade dos pacientes variou de 13 a 67 anos (mediana, 44 anos) Dos 15 pacientes, 14 (93%) apresentaram lesões pulmonares no momento da internação. CONCLUSÕES: A síndrome clínica e radiológica da doença neoplásica não se limita a malignidade, e, portanto, as doenças infecciosas granulomatosas devem ser consideradas no diagnóstico diferencial.
Impacto da técnica de expiração lenta e prolongada na mecânica respiratória de lactentes sibilantes
Authors: Lanza Fernanda de Cordoba , Wandalsen Gustavo Falbo , Cruz Carolina Lopes da , Solé Dirceu
Published: March 2013

OBJETIVO: Avaliar as alterações da mecânica respiratória e do volume corrente (VC) em lactentes sibilantes em ventilação espontânea após a realização da técnica de expiração lenta e prolongada (ELPr). MÉTODOS: Foram incluídos no estudo lactentes com história de sibilância recorrente e sem exacerbações nos 15 dias anteriores. Para a avaliação da função pulmonar, os lactentes foram sedados e posicionados em decúbito dorsal com máscara facial acoplada a um pneumotacógrafo. As variáveis da respiração corrente - VC e FR - e da mecânica respiratória - complacência do sistema respiratório (Csr), resistência (Rsr) e constante de tempo (psr) - foram mensuradas antes e após a realização de três sequências consecutivas de ELPr. RESULTADOS: Foram avaliados 18 lactentes, com média de idade de 32 ± 11 semanas. Houve um aumento significante no VC após ELPr (79,3 ± 15,6 mL vs. 85,7 ± 17,2 mL; p = 0,009), assim como uma redução na FR (40,6 ± 6,9 ciclos/min vs. 38,8 ± 0,9 ciclos/min; p = 0,042). Entretanto, não houve alterações significantes nos valores da mecânica respiratória (Csr: 11,0 ± 3,1 mL/cmH2O vs. 11,3 ± 2,7 mL/cmH2O; Rsr: 29,9 ± 6,2 cmH2O • mL-1 • s-1 vs. 30,8 ± 7,1 cmH2O • mL-1 • s-1; e psr: 0,32 ± 0,11 s vs. 0,34 ± 0,12 s; p > 0,05 para todos). CONCLUSÕES: Essa técnica de fisioterapia respiratória é capaz de induzir alterações significativas no VC e na FR de lactentes com sibilância recorrente, mesmo na ausência de exacerbações. A manutenção das variáveis da mecânica respiratória indica que a técnica é segura para ser aplicada nesse grupo de pacientes. Estudos com lactentes sintomáticos são necessários para quantificar os efeitos funcionais da técnica.
Análise crítica do discurso: modismo, teoria ou método?
Authors: Rodrigues-Júnior Adail Sebastião
Published: March 2013

A Análise Crítica do Discurso (ACD) tem sido considerada uma teoria potencial para o entendimento das relações de poder e das ideologias frequentemente presentes no discurso. Vários teóricos concordam que a ACD tem contribuído para a compreensão de inúmeros fenômenos linguísticos que, mormente, retratam hegemonias opacas, uma vez que a linguagem é um instrumento poderoso para a disseminação de conceitos preconcebidos, bem como de ideologias. No entanto, por que a ACD recebeu, nos anos noventa, críticas severas de um conjunto significativo de teóricos? Essas críticas apresentaram uma lista ampla de problemas relacionados aos métodos e abordagens utilizados por analistas críticos do discurso. Dentre essas críticas, os problemas de recepção e representatividade são tidos como os mais frequentes no tratamento dos dados feito pelos pesquisadores. Apesar de tudo isso, a determinação dos analistas críticos do discurso em apresentar uma base metodológica à disciplina teve seus resultados positivos - a ACD é hoje um ramo reconhecido da Linguística Aplicada no exterior, dentro da interface entre as Ciências Sociais e as Humanidades. Publicações recentes, principalmente as de Fairclough e seus colegas, levaram em consideração algumas dessas críticas, ao responderem pontualmente às mesmas. Contudo, no Brasil tem havido um "silêncio" em relação a essa questão, sobretudo porque os pesquisadores parecem desconsiderar tais críticas. Neste artigo, pretendo "quebrar esse silêncio" e discutir algumas dessas críticas e seus impactos na ACD e sua aplicação em pesquisas brasileiras. O objetivo principal deste artigo é perceber se algumas pesquisas em ACD no Brasil têm apresentado os mesmos problemas postos por esses críticos, através da análise de quatro artigos que usam a ACD como teoria orientadora, publicados em um número especial sobre a ACD de um reconhecido periódico brasileiro intitulado D.E.L.T.A. Os resultados indicaram que alguns dos problemas mostrados por esses críticos também aparecem nos artigos analisados, o que indica que os analistas críticos do discurso brasileiros precisam atentar para a maneira como abordam e tratam seus dados.
Pergunta-resposta: como o par dialógico constrói uma aula na alfabetização
Authors: Gomes-Santos Sandoval Nonato , Almeida Patrícia Sousa
Published: March 2013

Este artigo tem como pretensão analisar a unidade dialógica Pergunta-Resposta, fundamental para a organização conversacional, nas interações mantidas em uma aula de alfabetização ocorrida em um contexto escolar singular. O par dialógico é examinado em relação aos gestos profissionais docentes, de modo a observar o movimento da professora e seu estilo de docência na construção da aula em questão. Ao final, justifica-se o foco nas perguntas em detrimento das respostas.
Uma visão pragmática de crenças de alunos sobre o ato de errar
Authors: Vicente Helena da Silva Guerra , Ramalho Fabíula Martins
Published: March 2013

Este trabalho tem por objetivo geral investigar se uma professora universitária e seus alunos partilham crenças a respeito da correção de composições escritas. Como objetivo específico, buscamos caracterizar as relações entre duas crenças desse mesmo grupo de alunos: uma crença antiga de que errar é embaraçoso e deve ser evitado a todo custo, e uma crença em construção de que a correção individualizada de tarefas escritas pode ser benéfica, por permitir-lhes refletir mais demoradamente sobre os seus próprios erros. A primeira crença é inferida a partir de pistas linguísticas que denotam embaraço e distanciamento, presentes em certas estratégias de polidez negativa, como pedidos de desculpas e impessoalização. A segunda, por outro lado, não é facilmente inferida, mas pistas linguísticas conflitantes presentes na fala dos alunos podem ser o indicativo de uma mudança em curso.
Complexity and identity reconstruction in second language acquisition
Authors: Sade Liliane Assis
Published: March 2013

The participation of the individual in different discursive practices contributes to the social formation of identity which is not only constituted, but also, fractalized and emerged via discourse. Taking the concept of polyphony, proposed by Bakhtin (1981, 1986), this work intends to discuss the social formation of the self and the emergence of multiple identities through the perspective of Complexity Theory. Borrowing the concepts of attractors, bifurcation points and fractals from Chaos Theory, and relating them to identity issues, this paper shows how the acknowledgement of identity as a complex/chaotic system can be useful to a deeper understanding of the language acquisition process. Some narratives of AMFALE project are used in order to exemplify the theoretical issues proposed.
Some polemical issues in Applied Linguistics
Authors: Schmitz John Robert
Published: March 2013

In this paper, I look at three polemical issues in Applied Linguistics. I argue, first of all, that the desire for a stable definition of applied linguistics has by no means prevented research in the discipline. Secondly, I contend that the notion or "tradition" of "linguistics applied" (corpus linguistics or lexicography) is broader and more serious than "applicationism" (the use of linguistic formalisms, artificial practices, and terminology) in teaching material that are problematic and motivated by commercial interests. Thirdly, I argue that Educational Linguistics and Applied Linguistics have overlapping research objectives. In the course of the paper, I present some reservations about Educational Linguistics.
Estratégias de comunicação na aprendizagem de português / espanhol por teletandem
Authors: Silva-Oyama Andressa Carvalho
Published: March 2013

O contexto de interação de protótipo teletandem, por meio do aplicativo MSN Messenger, permite o intercâmbio de informação de linguagem em tempo real, pelo uso de voz, texto e imagens (webcam). Foi observado que, por se tratar de um ambiente de troca entre línguas próximas, alguns dos processos de aquisição demonstrados pelos aprendizes se assemelham. No entanto, a língua materna foi o fator de influência para particularidades em relação ao uso de estratégias de comunicação.
Baccharis subgen. Molina (Asteraceae) no estado do Rio de Janeiro, Brasil
Authors: Heiden Gustavo , Baumgratz José Fernando Andrade , Esteves Roberto Lourenço
Published: March 2013

Baccharis compreende ca. 340 espécies distribuídas nas Américas. O indumento em tufos diminutos, formado por tricomas com uma única célula basal, e as flores funcionalmente unissexuais são caracteres diagnósticos do gênero. No estado do Rio de Janeiro ocorrem 55 espécies de Baccharis. O trabalho apresenta os resultados de estudos taxonômicos de Baccharis subgen. Molina (Pers.) Heering para a flora fluminense. No estado, o subgênero está representado por 18 espécies pertencentes a quatro seções - Caulopterae (8 spp.), Molinae (4 spp.), Baccharidastrum (3 spp.) e Trinervatae (3 spp.). É apresentada uma chave para a identificação das seções e espécies e descrições morfológicas, ilustrações, dados de distribuição geográfica e ecologia. Três espécies são novos registros e cinco são excluídas da lista de espécies do Rio de Janeiro.
Desafios atuais da modelagem preditiva de distribuição de espécies
Authors: Giannini Tereza C. , Siqueira Marinez F. , Acosta André L. , Barreto Francisco C.C. , Saraiva Antonio M. , Alves-dos-Santos Isabel
Published: March 2013

A modelagem preditiva tem sido aplicada para analisar a distribuição geográfica de espécies, a partir de extrapolações das características ambientais dos locais conhecidos de ocorrência. O interesse por esse tipo de modelagem deve-se à necessidade de respostas rápidas e fundamentadas para as ameaças que as espécies têm enfrentado, devido à perda de habitat, invasão de espécies exóticas, mudanças climáticas, entre outros. Este artigo oferece uma visão geral dos avanços recentes no campo da modelagem e visa incentivar a discussão e aplicação desse método, que pode auxiliar tanto na aquisição de conhecimento básico sobre a biologia das espécies, quanto na análise e formulação de políticas para sua conservação.
De bois e outros bichos: nuances do novo Realismo brasileiro
Authors: Pellegrini Tânia
Published: March 2013

O texto interpreta dois contos de Marçal Aquino, "Boi" e "A exata distância da vulva ao coração", publicados em duas coletâneas diferentes, procurando verificar como o Realismo aí representa em profundidade as relações tensionadas entre o social e o ficcional. Revisitando gêneros tradicionais como a tragédia e o melodrama, de modo a acomodá-los às exigências mercantis da indústria da cultura, o autor explora o tema da violência urbana brasileira, nas suas manifestações concretas e simbólicas.
Phylogeographic Diversity of the Winter Moths Operophtera brumata and O. bruceata (Lepidoptera: Geometridae) in Europe and North America
Authors: Gwiazdowski Rodger A , Elkinton Joseph S , Dewaard Jeremy R , Sremac Marinko
Published: March 2013

The European winter moth, Operophtera brumata (L.), an invasive forest defoliator, is undergoing a rapid range expansion in northeastern North America. The source of this invasion, and phylogeographic diversity throughout its native range, has not been explored. To do this, we used samples from a pheromone-baited trap survey of O. brumata collected across its native range in Europe, and invasive range in North America. Traps in North America also attract a congeneric species, the Bruce spanworm O. bruceata (Hulst), and the western Bruce spanworm O. b. occidentalis (Hulst). From this sampling, we sequenced two regions of the cytochrome c oxidase subunit I mitochondrial gene; one region corresponds to the DNA ‘barcode’ region, the other is a nonoverlapping section. We used these sequences, in combination with sequence data from a recent survey of the Geometridae in western North America, for phylogenetic and phylogeographic analyses to characterize genetic divergence and variation for O. brumata in North America and Europe, and O. bruceata and O. b. occidentalis in North America. We found O. brumata mtDNA diversity to be dominated by a single widespread, and common haplotype. In contrast, O. bruceata shows high haplotype diversity that is evenly distributed throughout North America. Phylogeographic patterns indicate an introduction of O. brumata in British Columbia likely originated from Germany, and suggest the invasive population in northeastern North America may have its origins in the United Kingdom, and/or Germany. We found uncorrected pairwise sequence divergence between Operophtera species to be ≈7%. O. b. occidentalis is ≈ 5% divergent from O. bruceata, has a restricted range in the Pacific Northwest, and has unique morphological characters. Together these lines of evidence suggest O. b. occidentalis may be deserving of species status. Additionally, a single morphologically unique Operophtera specimen, similar to O. bruceata, was collected in southern Arizona, far outside the known range of O. bruceata. This suggests that North America may contain further, unsampled, Operophtera diversity.
Performance evaluation of airtightness in concrete tube structures for super-speed train systems
Authors: Park Joonam , Kim Lee-Hyeon , Nam Seong-Won , Yeo Inho
Published: March 2013

A super-speed tube train (SSTT) system is a conceptual alternative transportation system where trains could operate with a practical speed as high as 700 km/h in a vacuum tunnel, which minimises air resistance. This paper presents the results of a preliminary study involving an airtightness performance evaluation of a concrete vacuum tube structure for an SSTT. A formula for determining the flow rate of the air movement caused by the pressure difference inside and outside the tube structure is derived on the basis of Darcy's law. A material test is performed to measure the air permeability of concrete with various compressive strengths. A large-scale experimental study is then conducted for concrete tube structures with various joint configurations to investigate the suitability of concrete tube structures for an SSTT system. The results show that, as expected, a structure with more joints or bonds tends to be less airtight. A sensitivity study shows that the system's airtightness performance level increases with an increase in either the diameter or thickness of the tube. Moreover, an increase in the diameter or thickness of the tube enhances the effectiveness of any approach used for improving the airtightness of the system.
Nutrient‐specific solubility patterns of leaf litter across 41 lowland tropical woody species
Authors: Schreeg Laura A. , Mack Michelle C. , Turner Benjamin L.
Published: March 2013

Leaching is a mechanism for the release of nutrients from litter or senesced leaves that can drive interactions among plants, microbes, and soil. Although leaching is well established in conceptual models of litter decomposition, potential nutrient solubility of mineral elements from recently senesced litter has seldom been quantified. Using a standardized extraction (1:50 litter‐to‐water ratio and four‐hour extraction) and recently senesced leaf litter of 41 tropical tree and liana species, we investigated how solubility varies among elements, and whether the solubility of elements could be predicted by litter traits (e.g., lignin, total element concentrations). In addition, we investigated nutrient forms (i.e., inorganic and organic) and ratios in leachate. Water‐soluble elements per unit litter mass were strongly predicted by total initial litter element concentrations for potassium (K; r2 = 0.79), sodium (Na; r2 = 0.51) and phosphorus (P; r2 = 0.66), while a significant but weaker positive relationship was found for nitrogen (N; r2 = 0.36). There was no significant relationship for carbon (C) or calcium (Ca). Element‐specific solubility varied markedly. On average 100% of total K, 35% of total P, 28% of total Na, 5% of total N, 4% of total Ca, and 3% of total C were soluble. For soluble P, 90% was inorganic orthophosphate. The high solubility of K, Na, and P as inorganic orthophosphate suggests that these nutrients can become rapidly available to litter microbes with no metabolic cost. Few common predictors of decomposition rates were correlated with element solubility, although soluble C (milligrams per gram of litter) was negatively related to lignin content (r2 = 0.19; P < 0.004). Solubility of elements was linked within a species: when a species ranked high in the soluble fraction of one element, it also ranked high in the solubility of other elements. Overall nutrient‐specific patterns of solubility from recently senesced litter emphasize that litter elements cannot be treated equally in our conceptual and empirical models of decomposition. The relatively high potential solubility of P as orthophosphate from fresh litter advances our understanding of ecological stoichiometric ratios and nutrient bioavailability in tropical forests.
Competition in benthic marine invertebrates: the unrecognized role of exploitative competition for oxygen
Authors: Ferguson Nick , White Craig R. , Marshall Dustin J.
Published: March 2013

Competition is a ubiquitous structuring force across systems, but different fields emphasize the role of different types of competition. In benthic marine environments, where some of the classic examples of competition were described, there is a strong emphasis on interference competition: marine invertebrates are assumed to compete fiercely for the limiting resource of space. Much of our understanding of the dynamics of this system is based on this assumption, yet empirical studies often find that increases in density can reduce performance despite free space being available. Furthermore, the assumption that space is the exclusively limiting resource raises paradoxes regarding species coexistence in this system. Here, we measure the availability of oxygen in the field and in the laboratory, as well as the tolerance of resident species to low‐oxygen conditions. We show that oxygen can be the primary limiting resource in some instances, and that exploitative competition for this resource is very likely among benthic marine invertebrates. Furthermore, growth form (and the associated risk of oxygen limitation) covaries with the ability to withstand oxygen‐poor conditions across a wide range of taxa. Oxygen availability at very small scales may influence the distribution and abundance of sessile marine invertebrates more than is currently appreciated. Furthermore, competition for multiple resources (space and oxygen) and trade‐offs in competitive ability for each may promote coexistence in this system.
Designing effective reserve networks for nonequilibrium metacommunities
Authors: Gouhier Tarik C. , Guichard Frédéric , Menge Bruce A.
Published: March 2013

The proliferation of efficient fishing practices has promoted the depletion of commercial stocks around the world and caused significant collateral damage to marine habitats. Recent empirical studies have shown that marine reserves can play an important role in reversing these effects. Equilibrium metapopulation models predict that networks of marine reserves can provide similar benefits so long as individual reserves are sufficiently large to achieve self‐sustainability, or spaced based on the extent of dispersal of the target species in order to maintain connectivity between neighboring reserves. However, these guidelines have not been tested in nonequilibrium metacommunity models that exhibit the kinds of complex spatiotemporal dynamics typically seen in natural marine communities.

Here, we used a spatially explicit predator–prey model whose predictions have been validated in a marine system to show that current guidelines are not optimal for metacommunities. In equilibrium metacommunities, there is a community‐level trade‐off for designing effective reserves: Networks whose size and spacing are smaller than the extent of dispersal maximize global predator abundance but minimize global prey abundance because of trophic cascades, whereas the converse is true for reserve networks whose size and spacing are larger than the extent of dispersal. In nonequilibrium metacommunities, reserves whose size and spacing match the extent of spatial autocorrelation in adult abundance (i.e., the extent of patchiness) escape this community‐level trade‐off by maximizing global abundance and persistence of both the prey and the predator. Overall, these results suggest that using the extent of adult patchiness instead of the extent of larval dispersal as the size and spacing of reserve networks is critical for designing community‐based management strategies. By emphasizing patchiness over dispersal distance, our results show how the apparent complexity of nonequilibrium communities can actually simplify management guidelines and reduce uncertainty associated with the assessment of dispersal in marine environments.
Outcomes of Senior Reach Gatekeeper Referrals: Comparison of the Spokane Gatekeeper Program, Colorado Senior Reach, and Mid-Kansas Senior Outreach
Authors: Bartsch David A. , Rodgers Vicki K. , Strong Don
Published: March 2013

Outcomes of older adults referred for care management and mental health services through the senior reach gatekeeper model of case finding were examined in this study and compared with the Spokane gatekeeper model. Colorado Senior Reach and the Mid-Kansas Senior Outreach (MKSO) programs are the two Senior Reach Gatekeeper programs modeled after the Spokane program, employing the same community education and gatekeeper model and with mental health treatment for elderly adults in need of support. The three mature programs were compared on seniors served, isolation, and depression ratings. Nontraditional community gatekeepers were trained and referred seniors in need. Findings indicate that individuals served by the two Senior Reach Gatekeeper programs demonstrated significant improvements. Isolation indicators such as social isolation decreased, and depression symptoms and suicide ideation also decreased. These findings for two Senior Reach Gatekeeper programs demonstrate that the gatekeeper approach to training community partners worked in referring at-risk seniors in need, in meeting their needs, and in having a positive impact on their lives.
Case Management: The Allocation of Hours and Influencing Factors in the Management of Survivors of Traumatic Brain Injury
Authors: Arnold Susan , Elder Meagan
Published: March 2013

Case management is a service frequently provided to clients following a traumatic brain injury (TBI); however, the time required for this service is uncertain. To identify factors that influence case management for clients with TBI, a descriptive analysis of 64 client files were provided with case management services of a rehabilitation provider based in Sydney, Australia. These files were then further examined by using qualitative measures to determine the relationship among case management factors, time required, and the severity of the injury. This information was statistically analyzed to identify what factors predicted the greatest use of case management time. The analysis identified inappropriate behavior, family dynamics, accommodation, and formal relationships as primary affectors on case management time. Other issues identified as less demanding of case management time were sustaining employment and provision of equipment.

In terms of case management hours, the mean was 2.5 hr/month. Where there was a combination of three factors, the time for case management increased to a mean of 3.97 hr, and up to 4.34 hr/month (range: 1.5–14.0 hr) of case management time where 4 factors were identified. A positive relationship between severity of posttraumatic amnesia (PTA) and care and needs score was also noted to impact on amount of case management time and duration of service.
Continuity of Care: Supporting New Graduates to Grow Into Confident Practitioners
Authors: Clements Vanessa , Davis Deborah , Fenwick Jennifer
Published: March 2013

AIM:This article describes how newly qualified midwives experienced their rotation into birth suite and a continuity of midwifery care model. The findings are part of a larger study that aimed to describe graduate midwives’ expectations and experiences of their transition to practice.

BACKGROUND:Knowledge and understanding of how midwives make the transition from student to registered midwife remain limited. However, the literature suggests that this time is a critical period for a new graduate. Although transition support programs for midwives exist in New South Wales, Australia, there appears to be an ad hoc approach to their design, implementation, and effectiveness.

METHOD:A descriptive qualitative approach to elicit the experiences of 38 newly qualified Australian midwives. Telephone interviews and focus groups were used to collect the data. Content analysis was used to analyze the data set.

FINDINGS:The birthing environment was identified as the clinical area, which elicited the greatest level of apprehension for the midwives, whereas those with the opportunity to rotate into a midwifery continuity of care model rated the experience positively.

CONCLUSION:The findings of the study suggest that the newly graduated midwives felt a sense of social and professional belonging to the midwifery continuity of care models in which they worked.

KEYWORDS:newly graduated midwife; transition support programs; birth suite; models of care; continuity of care; hierarchy
Oral Contact Allergy to Suture Material Resulting in Connective Tissue Graft Failure: A Case Report
Authors: Mawardi Hani
Published: March 2013

Introduction: Sutures are used on a daily basis for many dental surgical procedures. However, the risk of oral allergic reaction triggered by suture material cannot be excluded. This case describes possible oral allergic reaction to suture material following periodontal surgery.

Case Presentation: The patient presented with gingival recession of the mandibular anterior sextant requiring root coverage procedure. The patient had a significant allergy history to multiple medications and materials. After harvesting the graft, tissue was sutured using poliglecaprone 25 sutures. The patient developed an allergic reaction to the suture material presenting as severe intraoral swelling and itching. The graft was devitalized and eventually failed.

Conclusions: To the best of the author's knowledge, this is the first case of possible allergic reaction to suture material in dental surgery reported in the literature. It is important to evaluate patients for any allergy history, in addition to medical and medication history, before any dental surgery. Patients with a significant allergy history, as in this case, are at higher risk of developing allergic reaction to any of the dental materials used in periodontal surgical procedures. Awareness of allergic reactions and the necessary management and intervention are critical for patient safety.
Pedicle Connective Tissue Graft With Novel Palatal Tunneling
Authors: Romanos Alain H. , Geurs Nicolaas C. , Abou‐Arraj Ramzi V.
Published: March 2013

Introduction: Implant esthetics can be compromised with a lack of hard and/or soft tissue in the anterior maxilla. Soft‐tissue augmentation is often a crucial step in optimizing esthetic outcomes. Palatal pedicle soft‐tissue grafts present a versatile option and have a high survival potential. This case series presents a pedicle connective tissue graft technique with novel palatal tunneling as an additional tool for implant site development. It has multiple indications, including complete socket closure, augmentation of soft‐tissue volume, enhancement of gingival papillae, and treatment of peri‐implant defects.

Case Series: In the first case, the pedicle graft was performed to achieve soft‐tissue closure over a socket preservation site that was fully dehisced on the facial aspect. This procedure allowed for protecting the bone graft and developing the soft tissue for implant placement 4 months later. The second case was more challenging because of an ankylosed maxillary central incisor presenting with a severe gingival discrepancy. After tooth extraction and hard‐tissue reconstruction, a pedicle graft was used at the time of implant placement to augment the soft tissue over the facial dehiscence of the implant in combination with a bone graft.

Conclusions: The novel palatal tunneling in this technique improved the positioning of the pedicle graft at the recipient site. It also preserved the integrity of the mucosa palatal to the defect site by minimizing the protuberance that resulted at the site of pedicle rotation. Soft‐tissue height and volume were found to be increased.
Autogenous Options for Soft‐Tissue Management of Extraction Sockets in the Anterior Maxilla
Authors: Abou‐Arraj Ramzi V. , Geurs Nicolaas C. , Romanos Alain H.
Published: March 2013

Focused Clinical Question: How can the soft tissue be managed with autogenous options after tooth extraction in the anterior maxilla?

Summary: Esthetic concerns are of unique importance in the anterior maxilla. Tooth loss usually leads to significant alterations of the soft‐ and hard‐tissue components of the ridge. These alterations may be prevented or minimized by a variety of tissue augmentation methods at different time points, ranging from tooth extraction to the placement of a restoration. Autogenous soft‐tissue options are available to achieve complete closure of socket grafting and immediate implant sites. They comprise free gingival grafts, free connective tissue grafts, pedicle palatal tissue grafts, and coronally advanced flaps. A decision tree is presented for the different hard‐ and soft‐tissue management options after tooth extraction in the anterior maxilla.

Conclusions: The literature lacks comparative studies among the different soft‐tissue grafting techniques designed for soft‐tissue closure of extraction sockets. Nonetheless, full closure is recognized as an important hallmark for improved healing outcomes. Soft‐tissue augmentation and volume increase were clinically evident with the various techniques. The minimal adverse healing events and improved survival reported with the pedicle grafts tend to favor these options in socket preservation cases, whereas coronally advanced flaps are preferred in severe cases involving multiple sockets.
Assessment of Interleukin‐6 Receptor Inhibition Therapy on Periodontal Condition in Patients With Rheumatoid Arthritis and Chronic Periodontitis
Authors: Kobayashi Tetsuo , Okada Moe , Ito Satoshi , Kobayashi Daisuke , Ishida Kohei , Kojima Anri , Narita Ichiei , Murasawa Akira , Yoshie Hiromasa
Published: March 2013

Background: Overproduction of interleukin (IL)‐6 may play a pathologic role in rheumatoid arthritis (RA) and chronic periodontitis (CP). The present study assesses IL‐6 receptor (IL‐6R) inhibition therapy on the periodontal condition of patients with RA and CP.

Methods: The study participants were 28 patients with RA and CP during treatment with IL‐6R inhibitor, and 27 patients with RA and CP during treatment without IL‐6R inhibitor. Periodontal and rheumatologic parameters and serum levels of cytokine and inflammatory markers and immunoglobulin G against periodontopathic bacteria were examined after medication with IL‐6R inhibitor for 20.3 months on average (T1) and again 8 weeks later (T2).

Results: No differences were observed between the groups in any parameter values at T1, except for serum IL‐6 levels. The anti–IL‐6R group showed a significantly greater decrease in gingival index, bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and serum levels of IL‐6 and matrix metalloproteinase (MMP)‐3 from T1 to T2 than the control group (P <0.05). A significant correlation was found between changes in serum anticyclic citrullinated peptide levels and those in PD and CAL in the anti–IL‐6R group (P <0.05), whereas both groups exhibited a significant association between changes in serum MMP‐3 levels and those in BOP (P <0.05).

Conclusion: Changes in periodontal and serum parameter values were different between the patients with RA and CP during treatment with and without IL‐6R inhibitor.
A 3‐Day Randomized Clinical Trial to Investigate the Desensitizing Properties of Three Dentifrices
Authors: Orsini Giovanna , Procaccini Maurizio , Manzoli Lamberto , Sparabombe Scilla , Tiriduzzi Paolo , Bambini Fabrizio , Putignano Angelo
Published: March 2013

Background: The aim of the present study is to evaluate the relative abilities of three desensitizing dentifrices to provide rapid relief of dentin hypersensitivity (DH).

Methods: Using a double‐mask, randomized design, three dentifrices: 1) containing 8% arginine and 1,450 ppm sodium monofluorophosphate; 2) containing 8% strontium acetate and 1,040 ppm sodium fluoride; and 3) containing 30% microaggregation of zinc‐carbonate hydroxyapatite nanocrystals were compared after 3‐day treatment. Participant's DH was evaluated at baseline and after 3 days using air‐blast, tactile, cold water, and subjective tests.

Results: The final sample consisted of 85 individuals: 29 received the arginine‐based dentifrice (group 1), 27 the strontium acetate–based dentifrice (group 2), and 29 the dentifrice based on zinc‐carbonate hydroxyapatite (group 3). All dentifrices were mostly effective to reduce DH: the percentage of score reduction from baseline to 3 days was >30% for all tests (except for subjective test of group 2). The comparison among the three dentifrices showed that, after 3 days, there was an improvement in air‐blast (mean percentage of reduction, 39.2% in group 1, 42.0% in group 2, and 39.2% in group 3), cold water (41.5%, 51.8%, and 50%), tactile (50.3%, 40.1%, and 33.8%), and subjective (33.1%, 17.4%, and 31.4%) test scores, with differences being significant for cold water and subjective tests. For air‐blast and tactile tests, there were no significant differences across groups at 3 days. Moreover, no significant differences at any test were observed in a subset of patients that were followed up to 8 weeks: all dentifrices were all highly efficacious.

Conclusions: This study documents that the three tested dentifrices significantly reduced DH after 3‐day treatment, supporting their use in clinical practice. To the best of the authors’ knowledge, this is the first report documenting the rapid relief from DH of a zinc‐carbonate hydroxyapatite dentifrice.
Social Impact Analysis of the Effects of a Telemedicine Intervention to Improve Diabetes Outcomes in an Ethnically Diverse, Medically Underserved Population: Findings From the IDEATel Study
Authors: Shea Steven , Kothari Dhruva , Teresi Jeanne A. , Kong Jian , Eimicke Joseph P. , Lantigua Rafael A. , Palmas Walter , Weinstock Ruth S.
Published: March 2013

Objectives. We examined the social impact of the telemedicine intervention effects in lower– and higher–socioeconomic status (SES) participants in the Informatics for Diabetes Education and Telemedicine (IDEATel) study.

Methods. We conducted a randomized controlled trial comparing telemedicine case management with usual care, with blinded outcome evaluation, in 1665 Medicare recipients with diabetes, aged 55 years or older, residing in federally designated medically underserved areas of New York State. The primary trial endpoints were hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol, and systolic blood pressure levels.

Results. HbA1c was higher in lower-income participants at the baseline examination. However, we found no evidence that the intervention increased disparities. A significant moderator effect was seen for HbA1c (P = .004) and systolic blood pressure (P = .023), with the lowest-income group showing greater intervention effects.

Conclusions. Lower-SES participants in the IDEATel study benefited at least as much as higher-SES participants from telemedicine nurse case management for diabetes. Tailoring the intensity of the intervention based on clinical need may have led to greater improvements among those not at goal for diabetes control, a group that also had lower income, thereby avoiding the potential for an innovative intervention to widen socioeconomic disparities.
Association of Discrimination-Related Trauma With Sexual Risk Among HIV-Positive African American Men Who Have Sex With Men
Authors: Fields Errol L. , Bogart Laura M. , Galvan Frank H. , Wagner Glenn J. , Klein David J. , Schuster Mark A.
Published: March 2013

Objectives. We investigated whether 1 form of traumatic stress, discrimination-related trauma (e.g., physical assault because of race), was associated with unprotected anal intercourse, especially when compared with non–discrimination-related trauma, among African American men who have sex with men.

Methods. A convenience sample of 131 HIV-positive African American men who have sex with men receiving antiretroviral treatment completed audio computer-assisted self-interviews that covered unprotected anal intercourse, interpersonal trauma, and whether trauma was because of discrimination on the basis of race/ethnicity, HIV serostatus, or sexual orientation.

Results. Sixty percent reported at least 1 interpersonal trauma; they attributed at least 1 trauma to being gay (47%), African American (17%), or HIV positive (9%). In a multivariate regression, experiencing discrimination-related trauma was significantly associated with unprotected anal intercourse (adjusted odds ratio [AOR] = 2.4; 95% confidence interval [CI] = 1.0, 5.7; P = .04), whereas experiencing non–discrimination-related trauma was not (AOR = 1.3; 95% CI = 0.6, 3.1; P = .53).

Conclusions. HIV-positive African American men who have sex with men experience high levels of discrimination-related trauma, a stressor associated with greater risk taking. HIV prevention interventions should consider the potential damaging effects of discrimination in the context of trauma.
Individual, Psychosocial, and Social Correlates of Unprotected Anal Intercourse in a New Generation of Young Men Who Have Sex With Men in New York City
Authors: Halkitis Perry N. , Kapadia Farzana , Siconolfi Daniel E. , Moeller Robert W. , Figueroa Rafael Perez , Barton Staci C. , Blachman-Forshay Jaclyn
Published: March 2013

Objectives. We examined associations of individual, psychosocial, and social factors with unprotected anal intercourse (UAI) among young men who have sex with men in New York City.

Methods. Using baseline assessment data from 592 young men who have sex with men participating in an ongoing prospective cohort study, we conducted multivariable logistic regression analyses to examine the associations between covariates and likelihood of recently engaging in UAI with same-sex partners.

Results. Nineteen percent reported recent UAI with a same-sex partner. In multivariable models, being in a current relationship with another man (adjusted odds ratio [AOR] = 4.87), an arrest history (AOR = 2.01), greater residential instability (AOR = 1.75), and unstable housing or homelessness (AOR = 3.10) was associated with recent UAI. Although high levels of gay community affinity and low internalized homophobia were associated with engaging in UAI in bivariate analyses, these associations did not persist in multivariable analyses.

Conclusions. Associations of psychosocial and socially produced conditions with UAI among a new generation of young men who have sex with men warrant that HIV prevention programs and policies address structural factors that predispose sexual risk behaviors.
Immigrant Generation and Diabetes Risk Among Mexican Americans: The Sacramento Area Latino Study on Aging
Authors: Afable-Munsuz Aimee , Mayeda Elizabeth Rose , Pérez-Stable Eliseo J. , Haan Mary N.
Published: March 2013

Objectives. We examined whether acculturation and immigrant generation, a marker for assimilation, are associated with diabetes risk in an aging Mexican-origin population.

Methods. We analyzed data on 1789 adults aged 60 to 101 years from the Sacramento Area Latino Study on Aging. We ascertained type 2 diabetes on the basis of diabetic medication use, self-report of physician diagnosis, or a fasting glucose of 126 milligrams/deciliter or greater. Logistic regression modeled prevalent diabetes.

Results. Adjusting for age and gender, we observed significant but divergent associations between immigrant generation, acculturation, and diabetes risk. Relative to first-generation adults, second-generation adults had an odds ratio (OR) of 1.8 (95% confidence interval [CI] = 1.4, 2.4) and third-generation adults had an OR of 2.1 (95% CI = 1.4, 3.1) of having diabetes. Greater US acculturation, however, was associated with a slightly decreased diabetes rate. In the full model adjusting for socioeconomic and lifestyle factors, the association between generation (but not acculturation) and diabetes remained significant.

Conclusions. Our study lends support to the previously contested notion that assimilation is associated with an increased diabetes risk in Mexican immigrants. Researchers should examine the presence of a causal link between assimilation and health more closely.