bluuebunny/crossref_metadata_2025 huggingface dataset:
Expressions of BAFF/BAFF receptors and their correlation with disease activity in Chinese SLE patients
Authors: Zhao LD , Li Y. , Smith MF , Wang JS , Zhang W. , Tang FL , Tian XP , Wang HY , Zhang FC , Ba DN , He W. , Zhang X.
Published: October 2010

B-cell activating factor belonging to tumour necrosis factor family (BAFF) is essential for B-cell survival and function through interaction with its receptors BAFF receptor 3 (BR3), B-cell maturation antigen (BCMA) and/or transmembrane activator and calcium modulator and cyclophilin ligand interactor (TACI), though BCMA and/or TACI can also bind to a proliferation-inducing ligand (APRIL). We evaluate the correlation of the expressions of these ligands/receptors with different clinical manifestations of systemic lupus erythematosus (SLE). Levels of BAFF and APRIL in plasma from 73 SLE patients were determined by enzyme-linked immunosorbent assay. Expressions of BR3, TACI and BCMA on CD19+ B cells were detected by flow cytometry. Clinical data were collected and disease activity was evaluated using SLEDAI-2000. SLE patients had elevated BAFF and APRIL levels in their plasma. BAFF levels correlated positively with SLEDAI while negatively with the BR3 protein expression on CD19+ B cells (p < .05). The detected BR3 protein expression in SLE patients was reduced on CD19+IgD+CD27—, CD19+IgD+CD27+ as well as CD19+IgD—CD27+ B cells compared to the counterparts of healthy controls (p < .001), whereas SLE patients did not differ from healthy controls in BR3 mRNA levels. In untreated new-onset patients, the expression rate of BR3 on CD19+ B cells correlated negatively with SLEDAI (p < .05). Elevation of BAFF and reduction of BR3 on CD19+ B cells were more obvious in those with lupus nephritis (LN, p < .05). TACI expression on CD19+ B cells was up-regulated only in those subjects with LN (p < .05). Elevated plasma BAFF and reduced BR3 protein expression on peripheral B cells could act as biomarkers for active disease in SLE patients. High expression of TACI may indicate the occurrence of LN.
The grammar of institutions: The challenge of distinguishing between strategies, norms, and rules
Authors: Schlüter Achim , Theesfeld Insa
Published: October 2010

The grammar of institutions developed by Crawford and Ostrom presents a common syntax for analysing institutions and dismantles them into their components. This is a promising undertaking given the huge diversity of definitions of institutions, even within a single discipline. Additionally, the grammar opens a long existing black box regarding why individuals do or do not follow an institution. It differentiates between formal sanctions (‘or elses’ in the language of the grammar) which are already well analysed and more moral and emotion based factors (so called delta parameters). This process of differentiation is currently widely observed, particularly in economics. Recognising that it is a necessary step forward in analysing institutions, this paper analyses and develops the grammar: first, in relation to its syntactical clearness; and second, in relation to its particular emphasis on delta parameters as central elements for understanding the efficiency and effectiveness of institutions.
Trust in medical decision-making concerning older people: The views of key professionals in the Dutch health care practice
Authors: Ubachs-Moust Josy , Houtepen Rob , Van der Weijden Trudy , ter Meulen Ruud , Vos Rein
Published: October 2010

This article deals with the issue of public trust in decisions made by individual physicians, concerning older people, as perceived by various key professionals. While trust is a basic element in our health care service, it is at the same time a difficult phenomenon to conceptualize. This article tries to contribute to a better understanding of what trust in medical practice entails and what are the necessary conditions for a society to put trust in the medical profession. The focus is on care for older people under the condition of scarcity in health care resources. Our study has a qualitative design consisting of semi-structured in-depth interviews with 24 key professionals focusing on decision-makers and those in line of professionally organizing or influencing the decision-making process. We found roughly three categories of trust: distrust; trust; and qualified trust. In each category we found different reasons to give or withhold trust and different views on how far the discretionary power of doctors should go. We recommend promoting trust by addressing the criteria or limits brought forward in the qualified trust category. The preconditions as identified in the qualified trust section provide the boundaries and marking points between which physicians have to move regarding the care for older people. The qualifications provide us insight in where and how to invest in trust under these and under different circumstances. An important conclusion is that trust is never finished: trust needs to be gained and negotiated in a continuous process of action and interaction.
‘And where were your brothers in all this?’: A psychosocial approach to texts on ‘brothering’
Authors: Saville Young Lisa , Frosh Stephen
Published: October 2010

This article offers a psychosocial analysis of interview material from a larger study on ‘brothering’, making an empirically grounded contribution to what are frequently abstract debates on the use of psychoanalysis to ‘read’ narratives. Recent psychosocial approaches which employ psychoanalysis alongside discursive psychology are reviewed, including a Lacanian approach which has been described as a less certain and potentially less individualizing and pathologizing gaze to take up in psychosocial studies. The authors put forward the notion of concentric reflexivity to apply Lacanian theoretical concepts to narrative material, ‘troubling’ sense-making, alongside recent calls for psychoanalysis to be employed in psychosocial work as a tool for ‘disintegrating’ and ‘disrupting’ text. The discussion argues for the interruptedness of narrative as an ethical necessity and for acknowledging fragmentation as central to the construction of an ethical subject.
Timing-controlled Decompaction of Polyplexes In Vivo Greatly Enhances Transgene Expression
Authors: Tachibana Yoichi , Hashimoto Tomoko , Nozaki Hisae , Murakami Akira , Yamaoka Tetsuji
Published: October 2010

Compaction extent of polyplexes was successfully regulated by cold treatment in buffer solution using thermoresponsive gene carriers composed of linear poly(ethyleneimine) (l-PEI) and alkyl side chains. Plasmid DNA (pCMV-Luc) was transfected to COS-1 cells using these carriers with different cold treatments. The luciferase expression was greatly enhanced when cells were treated at 4 °C in well-defined timing. This was a direct observation of how intracellular destabilization in regulated timing is important for nonviral gene transfection.
Low frequency of liver enzyme elevation in HIV-infected patients attending a large urban treatment centre in Uganda
Authors: Ocama P , Castelnuovo B , Kamya M R , Kirk G D , Reynolds S J , Kiragga A , Colebunders R , Thomas D L
Published: October 2010

Liver enzyme elevations among patients on antiretroviral therapy (ART) were determined by prospectively evaluating aspartate aminotransferase (AST) data in a cohort of patients in Kampala over 36 months. A proportion of patients had hepatitis B virus (HBV) status determined. Hepatotoxicity was graded I to IV according to the AIDS Clinical Trial Group criteria. Of 546 patients, 377 (69%) were women; overall median baseline CD4+ T-cell was 97/μL (interquartile range [IQR] 20–164). Hepatitis B surface antigen (HBsAg) was detected in 42 (9%) of 470 persons. ART included lamivudine, with either nevirapine and d4T (74%) or efavirenz and AZT (26%). Median (IQR) AST level at baseline was 35 (27, 53 IU/L). Over 36 months, only eight patients had grade III AST elevation. Neither HBsAg nor ART regimen influenced AST levels. Male gender and CD4+ change from baseline were correlated with AST elevation. Patients with HIV/HBV co-infection were not at an increased risk of AST elevation, which occurred uncommonly in this setting.
Neonatal Trichomonas vaginalis infection: a case report and review of literature
Authors: Trintis J , Epie N , Boss R , Riedel S
Published: October 2010

Neonatal infection with Trichomonas vaginalis is an unusual occurrence. We present a case of T. vaginalis found on routine urinalysis in a five-day-old neonate born at 29 weeks gestational age. The patient was treated with metronidazole and had complete resolution of the infection. This report discusses the significance of diagnosis and treatment of T. vaginalis in the neonate.
Is everyone treated equally? Management of genital Chlamydia trachomatis infection in New Zealand
Authors: Morgan J , Donnell A , Bell A
Published: October 2010

Health disparities often reflect inequitable access to appropriate health care. This study aimed to establish if cases of genital chlamydia infection were managed equitably by age, gender and ethnicity in a region of New Zealand with high rates of chlamydia infection (858 per 100,000 population). Clinical records of 415 genital chlamydia cases from 19 different health-care sites, including general practice and community settings, were reviewed. Data were analysed by demographic variables. For those treated, men were treated more quickly than women (median 3 days versus 6 days, P < 0.001), but there was no difference by ethnicity. Cases without documented treatment were more likely to be women (8.2% versus 2.1%, P = 0.037) and more likely to be Māori than non-Māori (13.6% versus 4.8%, P = 0.036). Overall, the most notable issue was the lack of effective partner notification across all demographic variables. Ongoing efforts are required to ensure equitable access to timely treatment and to ensure that more effective partner notification strategies are implemented.
Special Education Teachers' Perceptions of Benefits, Barriers, and Components of Community-Based Vocational Instruction
Authors: Kim Rah Kyung , Dymond Stacy K.
Published: October 2010

This study investigated special education teachers' perceptions of the benefits, barriers, and components of community-based vocational instruction (CBVI). Participants included special education teachers (N  =  68) from randomly selected high schools in Illinois who had experience delivering vocational curriculum to students with disabilities. Data collection occurred via a survey. Special education teachers perceived CBVI to result in numerous benefits for students with disabilities. Limited resources, requirements of the No Child Left Behind Act, and student issues were identified as barriers to implementation. Incongruence existed between teachers' ratings of the importance and use of the components of CBVI. Years of teaching experience, types of students with disabilities served, size of school, and experience with CBVI affected teachers' perceptions of CBVI.
Medicaid-Covered Alcohol and Drug Treatment Use Among People With Intellectual Disabilities: Evidence of Disparities
Authors: Slayter Elspeth
Published: October 2010

For some, community inclusion facilitates access to alcohol and drugs and, therefore, the potential for developing substance abuse disorders. However, little is known about substance abuse treatment use among people with intellectual disabilities. Using standardized performance measures, substance abuse treatment utilization was examined for Medicaid-covered people with intellectual disabilies and substance abuse (N  =  9,484) versus people without intellectual disabilies (N  =  915,070). The sociobehavioral model of healthcare use guides multivariate logistic regression analyses of substance abuse treatment utilization patterns, revealing disability-related disparities. Factors associated with utilization included being non-White, living in a nonurban area, having a serious mental illness, and living in a state with a generous Medicaid plan for substance abuse treatment. Implications relate to health policy, service delivery patterns, and the need for cross-system collaboration in the use of integrated treatment approaches.
A Multiple Strategy Framework Supporting Vocabulary Development for Students with Reading Comprehension Deficits
Authors: Woolley Gary
Published: October 2010

Poor comprehenders are generally students who have significant language-learning deficits. A particular problem for students with poor comprehension is that they have difficulty learning new vocabulary because they are inclined to read less, and are unable to apply new meanings to unfamiliar words. This leads to the situation where the gap widens between them and their more successful peers, resulting in more noticeable reading difficulties in later grades. They generally have good word decoding skills but have difficulty connecting meaning to unfamiliar words in context. This is often problematic because they have particular difficulties making inferences and forming a coherent mental model of what they have read. However, effective vocabulary instruction can be achieved by the incorporation of an intervention framework that balances the teaching of word-learning strategies with strategies fostering whole story integration. This article introduces a pedagogical construct based on a modified KWL framework using a combination of evidence-based visual and verbal instructional methods, in conjunction with the development of metacognitive and self-regulating strategies. The implication is that the cognitive load on working memory will be reduced and overall story comprehension will be improved when a well-constructed pedagogical framework is utilised to enhance the acquisition of new vocabulary during reading.
A study of industrial design students' employment preparation and choices in Taiwan
Authors: Yang Ming-Ying , You Manlai , Han Ching-Yi
Published: October 2010

This study surveys industrial design (ID) students' employment preparation in Taiwan, including career awareness, competency required, working attitudes and values and vocational choices. Both qualitative and quantitative approaches were adopted and data were collected in three stages:
literature review, in-depth interviews and questionnaire survey. The findings show that approximately 37 per cent of 904 participants decide not to enter the ID profession after graduation. ID students' career awareness is fairly good in terms of knowledge, values, preferences and self-concepts,
but approximately one-fourth of the surveyed items received low mean ratings. The students' awareness of some of the job tasks and competencies required of industrial designers does not match the reality, and their perception of the lifestyle tends to be unrealistically negative, which is
an observation not previously reported in the literature. The above, perhaps unrealistically negative, perception might be related to the high proportion of students rejecting an industrial design career after graduation. The authors discuss these results in the contexts of the national and
international design employment markets. The findings could help design educators to understand what information needs to be provided to ID students, and help plan career guidance programmes.
Productive passions and everyday pedagogies: Exploring the industry-ready agenda in higher education
Authors: Ashton Daniel
Published: October 2010

This article addresses the increasing emphasis placed on industry collaboration and dialogue for underpinning student employability. Drawing on research with higher education students on digital games development courses, this article examines students' accounts of preparing themselves
as industry-ready in terms of industry needs. On an industry-focused Games Design course, students highlighted their appreciation and engagement with industry needs and what is required on their part to enhance their employment prospects. Criticism in this context was focused on making better
games. Students on a theory and practice mix course, in contrast, drew on theory to offer critical accounts focused on industry norms and production practices. To explore these different critical engagements and how they sit in relation to students becoming industry-ready, this article draws
on everyday pedagogies to highlight students' revealing reflections on the industry-ready agenda in higher education.
The POOL Model: Foregrounding an alternative learning and teaching approach for digital media design in higher education
Authors: Fleischmann Katja
Published: October 2010

Recent studies show that current higher digital media design education generally fails to equip students with the expertise and skills suited to the requirements of the industry. This is a result of design education largely adhering to a curriculum model developed for and applicable
to multimedia design practice in the 1990s. Utilization of this model persists, although it has become increasingly unviable due to rapid technological advances and a resultant shift in the industry away from the individual designer and towards collaborative team design. An alternative learning
and teaching model is currently under development at a regional Australian university, referred to as the POOL Model. This new model is a multidisciplinary system of interdependent collaboration and expertise exchange across university, industry and community sectors, intended for implementation
in undergraduate curriculum to prepare students for collaborative multidisciplinary practice and meaningful careers in the industry. Using data obtained by industry, design educators and students, this article evidences the rationale for the development of the model, which will form the basis
for the ongoing development of the new curriculum through trial and revision.
We kind of try to merge our own experience with the objectivity of the criteria: The role of connoisseurship and tacit practice in undergraduate fine art assessment
Authors: Orr Susan
Published: October 2010

This article explores connoisseurship in the context of fine art undergraduate assessment practice. I interviewed twelve fine art lecturers in order to explore and unpack the concept of connoisseurship in relation to subjectivity, objectivity and tacit practice. Building on the work
of Bourdieu (1973, 1977, 1986) and Shay (2003, 2005), both of whom problematize the view that subjectivity and objectivity are binary opposites, my research illustrates the ways that connoisseurship is underpinned by informed professional judgements located in communities of practice. Within
this particular conception of connoisseurship, the lecturers' expertise is co-constituted in communities of assessors through participation and engagement. Standards reside in communities of practice.
Reviews
Authors: Bull Karen , Cruz Juan , Wade Sally
Published: October 2010

RESEARCHING LEARNING IN HIGHER EDUCATION: AN INTRODUCTION TO CONTEMPORARY METHODS AND APPROACHES' GLYNIS COUSIN (2009) Routeledge: Higher Education (Taylor and Francis), New York and UK, ISBN 978-0-415-99165-0

ART AND THEORY AFTER SOCIALISM, MEL JORDAN AND MALCOLM MILES
(2008) Bristol, UK: Intellect Books, 125 pp, ISBN 978-1-84150-211-3

A HANDBOOK FOR TEACHING AND LEARNING IN HIGHER EDUCATION, ENHANCING ACADEMIC PRACTICE, HEATHER FRY, STEVE KETTERIDGE AND STEPHANIE MARSHALL (2009) 3rd edn., 2 Park Square, Milton Park, Abingdon, Oxon: Routledge,
526 pp., ISBN 978-0-415-43464-5 (pbk) 27.99
Marketing Foods and Beverages in Schools: The Effect of School Food Policy on Students’ Overweight Measures
Authors: Dority Bree L. , McGarvey Mary G. , Kennedy Patricia F.
Published: October 2010

Beginning with the 2006–2007 academic year, the U.S. government required that all federally funded schools have local wellness policies to promote healthful living and reduce obesity among their students; however, little evidence exists on which school food policies are effective. This article finds evidence that prohibiting à la carte junk food sales during meals reduces the likelihood that students will be overweight or obese by 18 percentage points. The data are merged student–parent–school survey responses collected from a small sample of schools in one Great Plains state. The estimation controls for students’ activity levels, genetics, and socioeconomic factors; parents’ activity levels and attitudes; and the overall mix of school marketing policies that promote healthful eating and drinking habits. The results indicate that banning à la carte junk food sales is a potentially effective policy to reduce the likelihood of students being overweight and obese.
Understanding how Graphic Pictorial Warnings Work on Cigarette Packaging
Authors: Kees Jeremy , Burton Scot , Andrews J. Craig , Kozup John
Published: October 2010

The 2009 Family Smoking Prevention and Tobacco Control Act requires cigarette packages to contain stronger warnings in the form of color, graphic pictures depicting the negative health consequences of smoking. The authors present results from a between-subjects experiment with more than 500 smokers that test (1) the effectiveness of pictorial warnings that vary in their graphic depiction of the warning and (2) an underlying mechanism proposed to drive potential effects of the manipulation of the graphic depiction. The findings indicate that more graphic pictorial warning depictions strengthen smokers’ intentions to quit smoking. Recall of warning message statements is reduced by moderately or highly graphic pictures compared with a no-picture control or less graphic pictures. The results also show that the graphic warnings affect evoked fear, and in turn, fear mediates the effects of the graphic warning depiction on intentions to quit for the sample of smokers. This pattern of results indicates that though highly graphic pictures may reduce specific message recall and limit the direct effect of recall on intentions to quit, highly graphic pictures increase intentions to quit smoking through evoked fear (i.e., fear fully mediates the effect of the graphic depiction level). The authors discuss implications for consumer health and policy decisions.
Nucleic acid reference materials (NARMs): definitions and issues
Authors: Payne Deborah A. , Mamotte Cyril D.S. , Gancberg David , Pazzagli Mario , van Schaik Ron H.N. , Schimmel Heinz , Rousseau Francois
Published: October 2010

Molecular diagnostics is one of the most rapidly growing areas of laboratory medicine. This rapid growth of clinical molecular tests has outpaced the availability and development of reference methods and reference materials. Such methods and materials are important for the development, validation, and interpretation of diagnostic methods and tests. Yet, there is a lack of harmonization between the numerous international organizations currently either certifying or defining reference materials. The objective of this position paper is to review and clarify the definition, attributes and applications for the use of reference materials in the context of molecular diagnostics.

Clin Chem Lab Med 2010;48:1531–5.
Modellbasierte Kalibrierung von Streifenprojektionssystemen mit telezentrischer Kamera
Authors: Haskamp Klaus , Kästner Markus , Reithmeier Eduard
Published: October 2010

Für die Messung von Bauteilgeometrien mittels Streifenprojektionstechnik ist es zunächst notwendig, eine Kalibrierung des Sensors vorzunehmen, um das Sensorverhalten über Blackbox- oder physikalisch-mathematische Modelle zu charakterisieren. In diesem Artikel erfolgt zunächst eine Beschreibung des Modells des Streifenprojektionssystems auf Basis der projektiven Geometrie, wobei die objektseitige Telezentrie des Kameraobjektivs berücksichtigt wird. Anschließend wird eine Kalibrierstrategie zur Ermittlung aller modellierten Systemparameter vorgestellt. Das so ermittelte Sensormodell soll als numerische Simulation im Rechner umgesetzt und in Verbindung mit Monte-Carlo-Methoden zur Unsicherheitsanalyse verwendet werden. Es ist geplant, mit Hilfe dieser Simulation den Einfluss der einzelnen Systemparameter hinsichtlich der Messgenauigkeit näher zu untersuchen.
Detektion von Verschleißbereichen mittels ortsaufgelöster 3D-Rauheitsanalyse
Authors: Leis Alexander , Kästner Markus , Reithmeier Eduard
Published: October 2010

In der Tribologie ist es oft notwendig, die Verschleißbereiche auf der Kontaktoberfläche zu finden und quantitativ zu beschreiben. Innovative optische Messmethoden ermöglichen eine flächenhafte Erfassung der Oberflächentopografie mit hoher Auflösung, jedoch können Bereiche mit niedrigem Verschleißgrad häufig nicht zuverlässig gemessen werden. Im Rahmen dieser Veröffentlichung wird eine neue Methode zur ortsaufgelösten Analyse der 3D-Oberflächenrauheitsparameter vorgestellt, mit der insbesondere auch die Detektion von Bereichen mit sehr niedrigem Verschleißgrad ermöglicht wird.
Ein modifiziertes Bath-Interferometer zur Profilmessung von Mikrostrukturen
Authors: Gerhard Christoph , Vollertsen Frank
Published: October 2010

Im vorliegenden Artikel wird ein robustes Common-Path-Interferometer auf der Basis eines Interferometers nach Bath und Gates vorgestellt. Ein lateral positionierbarer Strahlteilerwürfel erlaubt in diesem Aufbau das Scannen einer Prüflingsoberfläche durch die Variation des Abstandes zwischen Referenz- und Messstrahl. Daher kann auf eine aktive Positionierung des Prüflings bei der Vermessung von Profilschnitten verzichtet werden. Der messbare Tiefenbereich sowie die minimale messbare Mikrostrukturgröße sind durch den Wechsel der verwendeten Fokussieroptik einstellbar.
Kraftmikroskopie durch Einzelpunktantastung an Strukturkanten
Authors: Hüser Dorothee , Häßler-Grohne Wolfgang , Katzer Klaus-Dieter , Hunecken Jens , Fuß Hans-Achim , Bosse Harald
Published: October 2010

Im Zuge der immer höheren Integrationsdichte in der Halbleiterindustrie steigt der Bedarf, Strukturen mit Auflösungen im Sub-Nanometerbereich messen zu können. Grundlage für unterschiedliche optische und elektronenmikroskopische Verfahren zur Strukturbreitenmessung ist die Quantifizierung von Geometrieparametern an Kantenübergängen durch sondenmikroskopische Abtastung der Oberfläche. Dieser Artikel beschreibt ein Verfahren, Strukturkanten mittels Einzelpunktantastung mit Kraftmikroskopen abzutasten. Wesen dieser Strategie ist, die Sonde aus zur lokalen Oberflächenneigung passender Richtung antasten zu lassen. Dies liefert die Möglichkeit, Steigung und Verrundung der Kante sowie den Kantenfuß zu ermitteln.
Principles of Health Care Financing
Authors: Libby Russell ,   Committee on Child Health Financing
Published: October 2010

The American Academy of Pediatrics advocates that all children must have health insurance coverage that ensures them access to affordable and comprehensive quality care. Access to care depends on the design and implementation of payment systems that ensure the economic viability of the medical home; support and grow the professional pediatric workforce; promote the adoption and implementation of health information technology; enhance medical education, training, and research; and encourage and reward quality-improvement programs that advance and strengthen the medical home. Health insurance plans must be portable from state to state, with administrative procedures to eliminate breaks and gaps in coverage to ensure continuous coverage from year to year. Plans should ensure free choice of clinicians and foster coordination with public and private community-based programs for infants, children, and adolescents through the age of 26. The scope of services provided by all health plans must include preventive, acute and chronic illness, behavioral, inpatient, emergency, and home health care. These plans must be affordable and have cost-sharing policies that protect patients and families from financial strain and are without risk of loss of benefits because of plan design, current illness, or preexisting condition.
Acessibilidade aos serviços de saúde por pessoas com deficiência
Authors: Castro Shamyr Sulyvan , Lefèvre Fernando , Lefèvre Ana Maria Cavalcanti , Cesar Chester Luiz Galvão
Published: October 2010

OBJETIVO: Analisar as dificuldades de acessibilidade aos serviços de saúde vividas por pessoas com deficiência. PROCEDIMENTOS METODOLÓGICOS: Estudo qualitativo realizado com pessoas que relataram ter algum tipo de deficiência (paralisia ou amputação de membros; baixa visão, cegueira unilateral ou total; baixa audição, surdez unilateral ou total). Foram entrevistados 25 indivíduos (14 mulheres) na cidade de São Paulo, SP, de junho a agosto de 2007, que responderam perguntas referentes a deslocamento e acessibilidade aos serviços de saúde. A metodologia utilizada para análise foi o discurso do sujeito coletivo e as análises foram conduzidas com recurso do programa Qualiquantisoft. ANÁLISE DOS RESULTADOS: A análise dos discursos sobre o deslocamento ao serviço de saúde mostrou diversidade quanto ao usuário ir ao serviço sozinho ou acompanhado, utilizar carro particular, transporte coletivo, ir a pé ou de ambulância e demandar tempo variado para chegar ao serviço. Com relação às dificuldades oferecidas de acessibilidade pelos serviços de saúde, houve relatos de demora no atendimento, problemas com estacionamento, falta de rampas, elevadores, cadeiras de rodas, sanitários adaptados e de médicos. CONCLUSÕES: As pessoas com algum tipo de deficiência fizeram uso de meios de transporte diversificados, necessitando de companhia em alguns casos. Problemas na acessibilidade dos serviços de saúde foram relatados pelos sujeitos com deficiências, contrariando o princípio da eqüidade, preceito do Sistema Único de Saúde.
Exposição ao tabagismo entre escolares no Brasil
Authors: Barreto Sandhi Maria , Giatti Luana , Casado Leticia , Moura Lenildo de , Crespo Claudio , Malta Deborah Carvalho
Published: October 2010

O objetivo deste trabalho é descrever a exposição ao tabagismo de participantes da Pesquisa Nacional de Saúde do Escolar (PeNSE) e identificar fatores associados a ele. Para se apresentar o perfil de tabagismo regular, era preciso ter fumado cigarro pelo menos um dia nos 30 dias anteriores à pesquisa. As características estudadas foram idade, sexo, raça/cor, escolaridade da mãe, índice de bens do domicílio e dependência administrativa da escola. Os comportamentos de risco e proteção incluídos foram experimentar álcool ou drogas, ter relação sexual, consumo de > 1 copo de bebida alcoólica nos últimos 30 dias e realizar/ter interesse em realizar atividade física na maioria dos dias da semana. A prevalência de fumante regular foi 6,3% (IC95%:5,87-6,74), sendo estatisticamente maior nos mais velhos, de cor parda, cujas mães têm menor escolaridade, estudantes em escolas públicas e apresentando os comportamentos estudados. Na análise multivariável, o tabagismo permaneceu associado à idade e a comportamentos de risco. A chance de fumar também foi menor em quem não faz nem gostaria de fazer atividade física. CONCLUSÃO: comportamentos de risco para a saúde coexistem também na adolescência, sugerindo que políticas de promoção da saúde na adolescência provavelmente terão impacto amplo, incluindo o problema do tabagismo.
Vivência de violência entre escolares brasileiros: resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE)
Authors: Malta Deborah Carvalho , Souza Edinilsa Ramos de , Silva Marta Maria Alves da , Silva Carlos dos Santos , Andreazzi Marco Antonio Ratzsch de , Crespo Claudio , Mascarenhas Márcio Dênis Medeiros , Porto Denise Lopes , Figueroa Alba Lucy Giraldo , Morais Neto Otaliba Libânio de , Penna Gerson de Oliveira
Published: October 2010

Este artigo apresenta os principais resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE). Aplicou-se questionário em uma amostra de conglomerados de 60.973 estudantes do 9º ano do ensino fundamental de escolas públicas e privadas das capitais dos estados brasileiros e do Distrito Federal, entre março e junho de 2009. Analisam-se prevalências e intervalos de confiança de 95% (IC95%) das situações de violência envolvendo adolescentes. Foram identificadas as seguintes situações: insegurança no trajeto casa-escola (6,4%; IC95%: 6,1%-6,8%) e na escola (5,5%; IC95%: 5,2%-5,8%); envolvimento em brigas com agressão física (12,9%; IC95%: 12,4%-13,4%), com arma branca (6,1%; IC95%: 5,7%-6,4%) ou arma de fogo (4,0%; IC95%: 3,7%-4,3%); agressão física por familiar (9,5%; IC95%: 9,1%-9,9%). As situações de violência foram mais prevalentes entre estudantes do sexo masculino. Houve grande variação segundo as cidades estudadas. Os adolescentes estão expostos a diferentes manifestações de violência nas instituições que supostamente deveriam garantir sua proteção e desenvolvimento saudável e seguro - a escola e o lar. Esses resultados visam apoiar medidas de promoção à saúde e prevenção desses fatores de risco.
Bullying in Brazilian schools: results from the National School-based Health Survey (PeNSE), 2009
Authors: Malta Deborah Carvalho , Silva Marta Angélica Iossi , Mello Flavia Carvalho Malta de , Monteiro Rosane Aparecida , Sardinha Luciana Monteiro Vasconcelos , Crespo Claudio , Carvalho Mércia Gomes Oliveira de , Silva Marta Maria Alves da , Porto Denise Lopes
Published: October 2010

The aim of this study is to identify and describe the occurrence of bullying among students in the 9th year (8th grade) from public and private schools from 26 Brazilian state capitals and the Federal District. It is a cross-sectional study involving 60,973 students and 1,453 public and private schools. Data analysis indicates that 5.4% (IC95%: 5.1%-5.7%) of students reported having suffered bullying almost always or always in the last 30 days, 25.4% (IC95%: 24.8%-26.0%) were rarely or sometimes the victim of bullying and 69.2% (IC95%: 68.5%-69.8%) of students felt no humiliation or provocation at school. The capital with higher frequency of bullying was Belo Horizonte (6.9%; IC95%: 5,9%-7,9%), Minas Gerais, and the lowest was Palmas (3.5%; IC95%: 2.6%-4.5%), Tocantins. Boys reported more bullying (6,0%; IC95%: 5.5%-6.5%) compared with girls (4,8%; IC95%: 4.4%-5.3%). There was no difference between public schools 5.5% (IC95%: 5.1%-5.8%) and private (5.2%) (IC95%: 4.6%-5.8%), except in Aracaju, Sergipe, that show more bullying in private schools. The findings indicate an urgent need for intersectoral action from educational policies and practices that enforce the reduction and prevention of the occurrence of bullying in schools in Brazil.
Estado nutricional dos adolescentes e sua relação com variáveis sociodemográficas: Pesquisa Nacional de Saúde do Escolar (PeNSE), 2009
Authors: Araújo Cora , Toral Natacha , Silva Ana Carolina Feldenheimer da , Velásquez-Melendez Gustavo , Dias Antonio José Ribeiro
Published: October 2010

Objetivou-se descrever o estado nutricional dos adolescentes da 9ª série de escolas públicas e privadas das capitais brasileiras e sua associação com variáveis sociodemográficas. Por meio de questionário autopreenchido, foram registradas informações sobre sexo, raça/cor, idade, escola pública/privada, macrorregião do país, escolaridade materna e posse de bens familiares. Peso e altura foram aferidos segundo procedimentos padronizados. A altura para idade e o Índice de Massa Corporal para idade foram avaliados segundo critérios da Organização Mundial da Saúde. Obtiveram-se medidas antropométricas de 58.971 adolescentes, sendo que 2,9% apresentaram déficit estatural e 2,9% magreza. O excesso de peso foi de 23,0% e a obesidade de 7,3%, sendo mais altos no Sul e no Sudeste do país. Déficits de altura e peso, excesso de peso e obesidade foram mais prevalentes nos meninos. Os déficits foram superiores nas escolas públicas, e o excesso de peso e a obesidade nas privadas. Adolescentes cujas mães eram de menor escolaridade ou de famílias mais pobres apresentaram maior déficit de altura; o inverso ocorreu com o excesso de peso e a obesidade. Prevalências de déficits, excesso de peso e obesidade ressaltam a necessidade de intervenções nutricionais direcionadas para esta fase da vida.
Imagem corporal, estado nutricional e comportamento com relação ao peso entre adolescentes brasileiros
Authors: Castro Inês Rugani Ribeiro de , Levy Renata Bertazzi , Cardoso Letícia de Oliveira , Passos Michelle Delboni dos , Sardinha Luciana Monteiro Vasconcelos , Tavares Letícia Ferreira , Dutra Sheila Potente , Martins André
Published: October 2010

O objetivo deste artigo é descrever a concordância entre imagem corporal (IC) e estado nutricional (EN) e verificar a associação de IC e de EN com comportamentos relacionados ao peso corporal (CRPC) entre adolescentes brasileiros. Estudou-se, em 2009, amostra representativa de alunos do 9º ano do ensino fundamental de escolas públicas e privadas das 26 capitais brasileiras e do Distrito Federal. Utilizou-se questionário autoaplicável sobre IC, CRPC e dados sociodemográficos e foram aferidos peso e altura. Utilizou-se o teste Kappa ponderado (KP) para exame da concordância entre EN e IC. Análises de regressão logística foram realizadas para exame da associação entre as variáveis. Do total de adolescentes, 24% apresentavam excesso de peso (EP), quase 2/3 deles tinham alguma atitude para controlar o peso e 7% realizavam práticas extremas para redução do peso (PECP). Foi baixa a concordância entre EN e IC (KP=0,33). Quase metade dos alunos com EP considerava-se com peso adequado e 27%, magros. Maior proporção de adolescentes com EP fazia uso de PECP, quando comparados àqueles de peso adequado e baixo peso. O mesmo foi observado em relação à IC. Conclusão: foi baixa a concordância entre EN e IC. Atitudes de controle de peso e PECP foram frequentes mesmo entre indivíduos com EN adequado.
Direito de acesso ao serviço de reprodução humana assistida: discussões bioéticas
Authors: Medeiros Luciana Soares de , Verdi Marta Inez Machado
Published: October 2010

Este artigo resume estudo cujo objetivo era avaliar como se configura o direito de acesso ao serviço de reprodução humana assistida (RHA). A pesquisa documental foi realizada em fontes oficiais do governo federal. A partir dos critérios da análise de conteúdo, analisaram-se seis projetos de lei e uma portaria, separados em três áreas temáticas (Acesso a quê?; Acesso para quem?; e Condições e critérios de acesso) reveladoras dos núcleos de sentido aqui analisados. A pesquisa revelou que o direito de acesso presente nos documentos oficiais é excludente, restritivo e moralmente induzido por uma categoria profissional e suas arbitrariedades. A articulação com os referenciais da bioética cotidiana foi relevante para trabalharmos as visões de família que se fazem legitimadas por essas propostas de regulamentação, assim como as questões éticas intrínsecas à formulação dos próprios textos delas, que nos remetem à noção de família tradicional, nuclear e patriarcal - modelo este já não mais hegemônico em nossa sociedade, e social e juridicamente ultrapassado por novas concepções familiares que também reivindicam visibilidade e legitimidade pelo Estado. O estudo pretende ser mais uma possibilidade de reflexão sobre questões que envolvem o direito de acesso ao serviço de RHA, partindo do olhar bioético.
Qualidade da assistência materno-infantil em diferentes modelos de Atenção Primária
Authors: Caldeira Antônio Prates , Oliveira Rafael Morroni de , Rodrigues Oreston Alves
Published: October 2010

Avaliou-se a qualidade da assistência materno-infantil em dois modelos de Atenção Primária à Saúde através de entrevistas com 1.200 famílias selecionadas aleatoriamente. Foram avaliados indicadores de processo da assistência, comparando a Estratégia de Saúde da Família com centros de saúde tradicionais. Na avaliação da assistência à criança, a realização precoce da primeira consulta, o acompanhamento do crescimento e desenvolvimento, as orientações para prevenção de acidentes e a profilaxia com sulfato ferroso e vitamina A estiveram estatisticamente associados com o modelo da assistência. Na assistência pré-natal, observou-se diferença estatisticamente significante entre os serviços para orientações sobre amamentação e orientações nutricionais, além da realização de exame de prevenção do câncer de colo uterino. Para os cuidados de saúde da mulher fora do período gestacional, os resultados revelaram que orientações para autoexame das mamas, realização de exame preventivo de câncer de colo uterino no último ano e relato de participação em programa de planejamento familiar estavam associados com o modelo de Atenção Primária à Saúde. Todas as diferenças apontadas mostraram melhor desempenho da Estratégia de Saúde da Família.
BabyCare: apoio à decisão na atenção primária materno-infantil com computadores de mão
Authors: Costa Carmen Lúcia de Bartolo , Pinto Vladimir Camelo , Cardoso Orlando Lima , Baba Marcelo Massakazu , Pisa Ivan Torres , Palma Domingos , Sigulem Daniel
Published: October 2010

O objetivo desta pesquisa foi desenvolver um instrumento digital - aqui denominado Sistema BabyCare - para coleta, armazenamento e apoio à decisão dos profissionais de saúde e demais envolvidos na assistência primária infantil em comunidades carentes. Esse sistema baseia-se em tecnologias de dispositivos móveis para utilização local em unidades básicas de saúde em comunidades carentes, assistidos ou não pelo Programa/Estratégia Saúde da Família (PSF), organizações não governamentais, ambulatórios e hospitais. Utilizou-se Java como linguagem de programação. Foram realizadas avaliações sobre o uso do sistema na cidade de São Paulo, envolvendo 62 usuários com diferentes formações, incluindo voluntários da Pastoral da Criança e do PSF. Os questionários aplicados resultam em alto índice de aceitação geral (98,3%); treinamento in loco considerado adequado (91,9%); percepção na melhoria na rotina e na redução de tempo da consulta (100,0%) e na redução no volume de documentos (96,7%). Conclusão: o protótipo apresentou-se robusto e eficiente para uso em comunidades carentes com infraestrutura precária de informática e telecomunicação.
Perfil do cirurgião-dentista inserido na Estratégia de Saúde da Família em municípios do estado de Pernambuco, Brasil
Authors: Martelli Petrônio José de Lima , Macedo Cícera Lissandra Sá Vieira , Medeiros Kátia Rejane de , Silva Shirley Florêncio da , Cabral Amanda Priscila de Santana , Pimentel Fernando Castim , Monteiro Ive da Silva
Published: October 2010

Este artigo aborda a incorporação da saúde bucal à Estratégia de Saúde da Família, o que propiciou a inclusão de novos atores no âmbito da atenção básica: os profissionais de odontologia. Tendo em vista que a odontologia vem norteando o seu trabalho numa prática historicamente curativa com ênfase em atividades restauradoras, questiona-se a implantação desse novo modelo de atenção à saúde em relação aos responsáveis pela execução dessa política - os recursos humanos. O objetivo deste artigo consiste, pois, em caracterizar o perfil dos cirurgiões-dentistas (CD) inseridos na Estratégia de Saúde da Família em municípios do estado de Pernambuco, relacionando-os com as especificidades do programa. Para tal, foi utilizado o banco de dados da pesquisa Modelo de Atenção em Saúde Bucal e Formação do Cirurgião-Dentista Inserido na Estratégia de Saúde da Família no Estado de Pernambuco. Os resultados mostraram que 70,4% dos CD são do sexo feminino, com predominância da faixa etária de 31 a 49 anos de idade, sendo que 65,2% desses são admitidos sob a forma de contrato. Em relação à formação, 67,8% possuem formação com foco na Estratégia de Saúde da Família; 92,3% destes a consideraram pertinente; e 89,6% dos CD relataram realizar atividades educativas.
Percepção de alunos, professores e usuários acerca da dimensão ética na formação de graduandos de odontologia
Authors: Matos Mariângela Silva de , Tenório Robson
Published: October 2010

O presente trabalho buscou analisar a percepção que alunos, professores e usuários dos ambulatórios têm acerca da formação profissional em sua dimensão ética, em dois cursos de odontologia, um público e um privado da Bahia. Buscou, ainda, confrontar essas percepções com a prática observada nos ambulatórios. Com essa finalidade, foram empregadas as seguintes técnicas: questionários para 283 alunos, entrevistas não diretivas para 32 professores e para 36 usuários, além de observação participante em duas disciplinas com práticas ambulatoriais. Os resultados revelam que alunos e professores percebem que essa dimensão da formação tem sido altamente estimulada no curso, de modo que os alunos revelam conhecimento teórico dos princípios da bioética e os usuários, em sua maioria, se sentem respeitados dentro desses princípios. Entretanto, o discurso de alguns desses sujeitos, bem como a observação do cotidiano dos ambulatórios, evidenciaram muitos exemplos e atitudes que revelam certo distanciamento entre o discurso e a prática.
Prevalência de mordida aberta anterior e protrusão dentária em pré-escolares da cidade do Recife (PE, Brasil)
Authors: Granville-Garcia Ana Flávia , Ferreira Jainara Maria Soares , Menezes Valdenice Aparecida de
Published: October 2010

O objetivo deste trabalho foi verificar a prevalência de maloclusões (mordida aberta anterior, protrusão dentária) e sua associação com idade, gênero e tipo de escola em 2.651 pré-escolares da cidade do Recife, PE, Brasil. As crianças foram sentadas em cadeiras escolares na sala da própria creche/escola para a execução do exame clínico; os menores de dois anos foram atendidos no sistema perna-perna ou joelho-joelho, por meio de iluminação natural e artificial. A protrusão dentária foi considerada quando sobressaliência maior que 3 mm, mensurada por meio de sonda periodontal milimetrada. A mordida aberta anterior foi registrada quando não houve contato com os dentes anteriores e os posteriores se mantiveram em oclusão. Foi registrada em ficha clínica a combinação dos dois tipos de maloclusão, ou seja, de mordida aberta e de protrusão dentária. Os dados foram avaliados estatisticamente pelo teste Qui-quadrado e a medida para avaliar a associação entre os eventos foi o odds ratio. A prevalência de protrusão dentária foi 66,1% e mordida aberta anterior, 19,8%; houve associação entre as maloclusões, idade e tipo de escola, porém não houve associação estatisticamente significante entre maloclusão e gênero. Conclui-se que a prevalência de maloclusões em pré-escolares foi elevada e esteve associada à idade e tipo de escola.
Práticas e significados de saúde bucal: um estudo qualitativo com mães de crianças atendidas na Universidade Federal de Santa Catarina
Authors: Robles Ana Carolina Couto , Grosseman Suely , Bosco Vera Lúcia
Published: October 2010

Este estudo objetivou conhecer práticas e significados de saúde bucal de mães de crianças atendidas em clínicas de odontopediatria da Universidade Federal de Santa Catarina. O método qualitativo tipo estudo de caso foi utilizado e os dados foram coletados por meio de entrevista semiestruturada. A população estudada constituiu-se por sete mães que levavam seus filhos para atendimento odontológico na universidade. Observou-se que experiências negativas vivenciadas em tratamentos odontológicos anteriores, dificuldades financeiras e gravidez influenciaram-nas na busca e adesão a tratamentos. A procura pelo dentista ocorreu, principalmente, para realização de procedimentos curativos. As mães cuidam dos dentes de seus filhos por considerarem tais cuidados responsabilidade materna, para prevenir cárie e suas consequências, evitar gastos com tratamentos onerosos e que as crianças passem por experiências desagradáveis com dentistas. As fontes de informação citadas sobre os cuidados com a boca foram dentistas, médicos, enfermeiras, escolas, veículos de comunicação em massa e acadêmicos de odontologia. Apesar de desejarem cuidar da saúde de seus filhos de maneira adequada, nem sempre elas têm condições econômicas e sociais favoráveis para colocar os ensinamentos em prática.