bluuebunny/crossref_metadata_2025 huggingface dataset:
320-detector row CT coronary angiography: effects of heart rate and heart rate variability on image quality, diagnostic accuracy and radiation exposure
Authors: Sun G , Li M , Jiang X-S , Li L , Peng Z-H , Li G-Y , Xu L
Published: February 2012

Objectives: To evaluate the effects of heart rate and heart rate variability on image quality, patient dose and diagnostic accuracy of 320-detector row CT.

Methods: 94 patients were prospectively enrolled. Heart rate was defined as the mean value of different intervals elapsing between two consecutive R waves in an electrocardiogram (R–R intervals) and the heart rate variability was calculated as the standard deviation from the average heart rate. The image quality was evaluated by four grades, according to motion artefacts (“step artefacts” and “blurring artefacts”). The diagnostic accuracy was analysed in 43 patients who were scheduled for invasive coronary angiography (ICA). The coeffects of heart rate and heart rate variability on image quality, radiation dose and diagnostic accuracy were evaluated by multivariate regression.

Results: The mean image quality score was 1.2±0.5 and the mean effective dose was 14.8±9.8 mSv. The results showed that heart rate (74.0±11.2 beats per minute) was the single factor influencing image quality (p<0.001) and radiation dose (p<0.001), while heart rate variability (3.7±4.6) had no significant effect on them (p=0.16 and p=0.47, respectively). For 43 patients who underwent ICA, heart rate and heart rate variability showed no influence on the accuracy (p=0.17 and p=0.12, respectively). Overall sensitivity was 97.4% (37/38), specificity was 99.4% (351/353), positive predictive value was 94.9% (37/39) and negative predictive value was 99.7% (351/352).

Conclusion: 320-detector row CT, with improved longitudinal coverage of detector, resolves step artefact and high patient dose caused by irregular heart rate. However, it is still recommended to control heart rate to a lower level to eliminate blurring artefact and radiation dose.
Consumption Externality and Yield Uncertainty in the Influenza Vaccine Supply Chain: Interventions in Demand and Supply Sides
Authors: Arifoğlu Kenan , Deo Sarang , Iravani Seyed M. R.
Published: February 2012

We study the impact of yield uncertainty (supply side) and self-interested consumers (demand side) on the inefficiency in the influenza vaccine supply chain. Previous economic studies, focusing on demand side, find that the equilibrium demand is always less than the socially optimal demand because self-interested individuals do not internalize the social benefit of protecting others via reduced infectiousness (positive externality). In contrast, we show that the equilibrium demand can be greater than the socially optimal demand after accounting for the limited supply due to yield uncertainty and manufacturer's incentives. The main driver for this result is a second (negative) externality: Self-interested individuals ignore that vaccinating people with high infection costs is more beneficial for the society when supply is limited. We show that the extent of the negative externality can be reduced through more efficient and less uncertain allocation mechanisms. To investigate the relative effectiveness of government interventions on supply and demand sides under various demand and supply characteristics, we construct two partially centralized scenarios where the social planner (i.e., government) intervenes either on the demand side or the supply side, but not both. We conduct an extensive numerical analysis.

This paper was accepted by Yossi Aviv, operations management.
Public Opinion and Executive Compensation
Authors: Kuhnen Camelia M. , Niessen Alexandra
Published: February 2012

We investigate whether public opinion influences the level and structure of executive compensation. During 1992–2008, the negativity of press coverage of chief executive officer (CEO) pay varied significantly, with stock options being the most criticized pay component. We find that after more negative press coverage of CEO pay, firms reduce option grants and increase less contentious types of pay such as salary, although overall compensation does not change. The reduction in option pay after increased press negativity is more pronounced when firms, CEOs, and boards have stronger reputation concerns. Our within-firm, within-year identification shows the results cannot be explained by annual changes in accounting rules regarding executive compensation, stock market conditions, or pay mean reversion.

This paper was accepted by Brad Barber, finance.
Optimizing Organic Waste to Energy Operations
Authors: Ata Barış , Lee Deishin , Tongarlak Mustafa H.
Published: February 2012

A waste-to-energy firm that recycles organic waste with energy recovery performs two environmentally beneficial functions: it diverts waste from landfills and it produces renewable energy. At the same time, the waste-to-energy firm serves and collects revenue from two types of customers: waste generators who pay for waste disposal service and electricity consumers who buy energy. Given the process characteristics of the waste-to-energy operation, the market characteristics for waste disposal and energy, and the mechanisms regulators use to encourage production of renewable energy, we determine the profit-maximizing operating strategy of the firm. We also show how regulatory mechanisms affect the operating decisions of the waste-to-energy firm. Our analyses suggest that if the social planner's objective is to maximize landfill diversion, offering a subsidy as a per kilowatt-hour for electricity is more cost effective, whereas if the objective is to maximize renewable energy generation, giving a subsidy as a lump sum to offset capital costs is more effective. This has different regulatory implications for urban and rural settings where the environmental objectives may differ.
Unit-Contingent Power Purchase Agreement and Asymmetric Information About Plant Outage
Authors: Wu Owen Q. , Babich Volodymyr
Published: February 2012

This paper analyzes a unit-contingent power purchase agreement between an electricity distributor and a power plant. Under such a contract the distributor pays the plant a fixed price if the plant is operational and nothing if plant outage occurs. Pricing a unit-contingent contract is complicated by the fact that the plant's true status is its private information. The difference between the electricity spot price and the unit-contingent contract price provides an incentive for the plant to misreport its status and earn profit at the distributor's expense. To prevent misreporting, the distributor may inspect the plant and levy penalties if misreporting is discovered. We find that some type of misreporting under certain circumstances can benefit both the plant and the distributor, because it serves as a risk-allocation mechanism between the two parties. We show that such a risk-allocation mechanism is equivalent to using state-contingent options and prohibiting misreporting.
What Is Interesting in Operations Management?
Authors: Cachon Gérard P.
Published: February 2012

This essay discusses my view of the essential characteristics of interesting research in general and in operations management in particular. It is based on my Manufacturing and Service Operations Management Distinguished Fellows presentation given at the University of Michigan, June 27, 2011.
Crying Without a Cause and Being Easily Upset in Two-Year-Olds: Heritability and Predictive Power of Behavioral Problems
Authors: Groen-Blokhuis Maria M. , Middeldorp Christel M. , M. van Beijsterveldt Catharina E. , Boomsma Dorret I.
Published: February 2012

In order to estimate the influence of genetic and environmental factors on ‘crying without a cause’ and ‘being easily upset’ in 2-year-old children, a large twin study was carried out. Prospective data were available for ~18,000 2-year-old twin pairs from the Netherlands Twin Register. A bivariate genetic analysis was performed using structural equation modeling in the Mx software package. The influence of maternal personality characteristics and demographic and lifestyle factors was tested to identify specific risk factors that may underlie the shared environment of twins. Furthermore, it was tested whether crying without a cause and being easily upset were predictive of later internalizing, externalizing and attention problems. Crying without a cause yielded a heritability estimate of 60% in boys and girls. For easily upset, the heritability was estimated at 43% in boys and 31% in girls. The variance explained by shared environment varied between 35% and 63%. The correlation between crying without a cause and easily upset (r = .36) was explained both by genetic and shared environmental factors. Birth cohort, gestational age, socioeconomic status, parental age, parental smoking behavior and alcohol use during pregnancy did not explain the shared environmental component. Neuroticism of the mother explained a small proportion of the additive genetic, but not of the shared environmental effects for easily upset. Crying without a cause and being easily upset at age 2 were predictive of internalizing, externalizing and attention problems at age 7, with effect sizes of .28–.42. A large influence of shared environmental factors on crying without a cause and easily upset was detected. Although these effects could be specific to these items, we could not explain them by personality characteristics of the mother or by demographic and lifestyle factors, and we recognize that these effects may reflect other maternal characteristics. A substantial influence of genetic factors was found for the two items, which are predictive of later behavioral problems.
Polymorphisms in Nevus-Associated Genes MTAP, PLA2G6, and IRF4 and the Risk of Invasive Cutaneous Melanoma
Authors: Kvaskoff Marina , Whiteman David C. , Zhao Zhen Z. , Montgomery Grant W. , Martin Nicholas G. , Hayward Nicholas K. , Duffy David L.
Published: February 2012

An evolving hypothesis postulates that melanomas may arise through ‘nevus-associated’ and ‘chronic sun exposure’ pathways. We explored this hypothesis by examining associations between nevus-associated loci and melanoma risk across strata of body site and histological subtype. We genotyped 1028 invasive case patients and 1469 controls for variants in methylthioadenosine phosphorylase (MTAP), phospholipase A2, group VI (PLA2G6), and Interferon regulatory factor 4 (IRF4), and compared allelic frequencies globally and by anatomical site and histological subtype of melanoma. Odds-ratios (ORs) and 95% confidence intervals (CIs) were calculated using classical and multinomial logistic regression models. Among controls, MTAP rs10757257, PLA2G6 rs132985 and IRF4 rs12203592 were the variants most significantly associated with number of nevi. In adjusted models, a significant association was found between MTAP rs10757257 and overall melanoma risk (OR = 1.32, 95% CI = 1.14–1.53), with no evidence of heterogeneity across sites (Phomogeneity =.52). In contrast, MTAP rs10757257 was associated with superficial spreading/nodular melanoma (OR = 1.34, 95% CI = 1.15– 1.57), but not with lentigo maligna melanoma (OR = 0.79, 95% CI = 0.46–1.35) (Phomogeneity =.06), the subtype associated with chronic sun exposure. Melanoma was significantly inversely associated with rs12203592 in children (OR = 0.35, 95% CI = 0.16–0.77) and adolescents (OR = 0.61, 95% CI = 0.42–0.91), but not in adults (Phomogeneity =.0008). Our results suggest that the relationship between MTAP and melanoma is subtype-specific, and that the association between IRF4 and melanoma is more evident for cases with a younger age at onset. These findings lend some support to the ‘divergent pathways’ hypothesis and may provide at least one candidate gene underlying this model. Further studies are warranted to confirm these findings and improve our understanding of these relationships.
Perinatal Outcome of Monochorionic Twins With Selective IUGR Compared With Uncomplicated Monochorionic Twins
Authors: Weisz Boaz , Hogen Liat , Yinon Yoav , Gindes Liat , Shrim Alon , Simchen Michal , Schiff Eyal , Lipitz Shlomo
Published: February 2012

Objective: To evaluate the perinatal outcome of MC twins with selective IUGR (sIUGR).

Study design: A prospective study, which included three groups of MC twins: Group A, uncomplicated MC twin pregnancies (n = 91); group B, sIUGR with normal umbilical artery Doppler (n = 19); and group C, sIUGR with abnormal (absence or reversed EDV) umbilical artery Doppler (n = 18). The latter were routinely hospitalized in the high-risk ward under strict surveillance.

Results: Neonatal outcome of fetuses complicated with sIUGR and normal Doppler was similar to controls. Neonates born to pregnancies complicated by sIUGR and abnormal Doppler had significantly increased incidence of CNS findings, RDS, NEC, sepsis, and neonatal death compared to controls. Adverse outcome in this group was independently associated only with gestational age at birth.

Conclusion: The perinatal outcomes of MC twins complicated with sIUGR and normal Doppler are similar to uncomplicated MC pregnancies. MC twins with sIUGR and abnormal Doppler have reasonable outcomes, yet significantly more neonatal complications compared to non-complicated MC twins.
Estimation of the Contribution of Assisted and Non-Assisted Reproductive Technology Fertility Treatments to Multiple Births During the Past 30 Years in Japan: 1979–2008
Authors: Ooki Syuichi
Published: February 2012

The effect of assisted reproductive technology (ART) and non-ART ovulation stimulation fertility treatment on the number and rate of multiple live births from 1979–2008 in Japan was estimated using two independent data sources, ART statistics and vital statistics. Japanese ART statistics presented by the Japan Society of Obstetrics and Gynecology between 1989 and 2008 were gathered and reanalyzed. The number and rates of ART between 1984 and 1988 were interpolated using an approximation formula, using the values from 1983, when the first ART baby was born in Japan, and the 1989–1992 values. The number of ART multiples between 1979–1982 was set as equal to zero. The minimum (or maximum) number of non-ART iatrogenic multiple births was estimated by subtracting the maximum (or minimum) ART multiples from the total iatrogenic multiples, which was estimated by vital statistics assuming that spontaneous multiple-birth rates according to maternal age class would be constant. There was an overall increase in the non-ART multiple births during the 30-year period, whereas ART multiples tended to increase from 1983 to 2005, and then rapidly decreased thereafter. The number or percentage of ART multiples was almost consistently lower than that of non-ART multiples. The percentage of non-ART multiples (33%) among the total multiples was estimated to be about three times more than the ART multiples (11–12%) in 2008. Given the medical and social impact of multiple births, it is imperative to construct a hospital-based monitoring system for fertility treatments, specially non-ART fertility treatments and multiple births.
Incidence and Costs of Multifetal Pregnancies in Andalusia (2000–2010)
Authors: Mesa Ernesto González , Peral José Alberto Herrera
Published: February 2012

In the past 50 years the incidence of multiple pregnancies has increased dramatically due almost exclusively to two factors: delayed childbearing and assisted reproductive techniques. In this paper we analyze the variations in the incidence of multiple gestations in Andalusia, one of the biggest administrative regions in Spain, over the last decade. Assisted reproduction techniques are very often evaluated only in terms of implantation and pregnancy rates per cycle, ignoring everything related to complications of multiple births, prematurity or economic overload. The rate of twins in Andalusia has increased from 10.9 per thousand in 2000 to 16.2 per thousand in 2009. The rate of triplet births has also increased in recent years. After a decline in 2003, motivated by promulgation of the first Human Assisted Reproduction Law, there was an increase after a second law came into effect in 2006. Health care spending attributable to the excess of multiple pregnancies reported in the decade 2000–2010 may have been much higher than €25 million.
The Participation of Community Members on Medical Institutional Review Boards
Authors: Lidz Charles W. , Simon Lorna J. , Seligowski Antonia V. , Myers Suzanne , Gardner William , Candilis Philip J. , Arnold Robert , Appelbaum Paul S.
Published: February 2012

The goal of this study was to describe the contributions of community members (unaffiliated members) who serve on institutional review boards (IRBs) at large medical research centers and to compare their contributions to those of other IRB members. We observed and audiotaped 17 panel meetings attended by community members and interviewed 15 community members, as well as 152 other members and staff. The authors coded transcripts of the panel meetings and reviewed the interviews of the community members. Community members played a lesser role as designated reviewers than other members. They were infrequently primary reviewers and expressed hesitation about the role. As secondary or tertiary reviewers, they were less active participants than other members in those roles. Community members were more likely to focus on issues related to confidentiality when reviewing an application than other reviewers. When they were not designated reviewers, however, they played a markedly greater role and their discussion focused more on consent disclosures than other reviewers. They did not appear to represent the community so much as to provide a nonscientific view of the protocol and the consent form.
The Potential Influence of Internet-Based Social Networking on the Conduct of Clinical Research Studies
Authors: Glickman Seth W. , Galhenage Sam , McNair Lindsay , Barber Zachry , Patel Keyur , Schulman Kevin A. , McHutchison John G.
Published: February 2012

The rapid growth of internet usage has led to an explosion of social networking sites for discussion of health issues. This provides a forum for subjects to communicate with one another during the course of the studies. Previous studies have raised concerns about the quality of health information on social networking sites, although none have evaluated content related to ongoing clinical trials. We reviewed material posted in virtual communities by self-identified clinical trial participants. We identified material posted in online health forums that could introduce bias into clinical research studies; we believe that this issue warrants further study and discussion. Physicians and others who conduct clinical trials should be aware of this issue. Study investigators and research teams should also talk to their study subjects about where and how they are obtaining information in order to prevent behaviors and correct misinformation that could put a subject's safety or the study objectives at risk. Given the rapid increase in Internet use for health care, a broader evaluation of both the benefits and potential risks of social networking among research participants during the course of a clinical trial appears warranted.
Kinetics and Statistics of Vapor-Liquid-Solid Growth of III-V Nanowires
Authors: Harmand Jean-Christophe , Glas Frank , Patriarche Gilles , Jabeen Fauzia , Ramdani Mohamed Réda
Published: February 2012

The use of semiconductor nanowires as new material building blocks for developing original devices is conditioned by the controllability of their growth. An important challenge is to form nanowires which include heterostructures of predictable dimensions. This objective requires a precise knowledge of the growth kinetics which appears much more complex for nanowires than for standard two-dimensional layers. Here, we present a method which provides detailed information on nanowire formation. The method is implemented with InP1-xAsx nanowires grown by Au-catalyzed molecular beam epitaxy. Controlled and periodic modulations of the incident vapor phase are generated. Due to these modulations, the nanowires show small and short oscillations of composition along their growth axis. These oscillations furnish a time scale which is recorded in the nanowire solid phase. The instantaneous growth rate and the total length of individual nanowires at any time of the growth are accessible. Moreover, the distribution of the oscillation lengths contains the nucleation statistics. This statistics is shown to be strongly sub-Poissonian, which indicates that some regulation mechanism operates. The rapid depletion of group V atoms in the catalyst drop which follows the growth of each ML could explain the self-regulation of nucleation events.
Application of the intra-particle diffusion model for activated carbon fibers in an aqueous medium
Authors: Ramírez-Rodríguez Teresa , de Landa Castillo-Alvarado Fray
Published: February 2012

The intra-particle diffusion model (IPD), proposed by Weber and Morris has been applied to the analysis of the kinetics of adsorption on activated carbon fibers with phosphate groups in the removal of cadmium ions in aqueous media. It is evident that the removal of cadmium ion kinetic model of pseudo-second order provides a better fit than the model of pseudo-first order and the intra-particle diffusion model provides the best to the sample compared activating solution: grams fibers of 1:3.
Fabrication of nano-needle arrays on diamond surface by reactive ion etching
Authors: Misu T. , Koh K. , Arai T.
Published: February 2012

CVD polycrystalline diamond surfaces were etched using reactive ion etching system with either a conventional stainless steel electrode or MgO sintered ceramic containing electrode. The micro-needle array of high aspect on diamond substrate surfaces obtained with MgO electrode was fabricated by using back-sputtering from MgO electrode. The RMS roughness of diamond substrate surfaces obtained with MgO electrode is higher than those obtained with stainless steel electrode.
Microstructures in Pb(In1/2Nb1/2)O3 with the Perovskite B-site Randomness
Authors: Mori S. , Kurushima K. , Kobayashi K. , Ohwa H. , Yasuda N. , Ohwada K.
Published: February 2012

We have investigated microstructures in both the antiferroelectric (AFE) and relaxor states of Pb(In1/2Nb1/2)O3 (PIN) with the perovskite structure by a transmission electron microscopy (TEM). Electron diffraction (ED) experiments revealed that the AFE state is characterized as the modulated structure with the modulation vector of q=1/4 1/4 0. High-resolution TEM images clearly show the coexistence of two types of domains consisting of the modulated and the nonmodulated structures with the 100 ∼ 200 nm size. On the other hand, in the relaxor state there appear two types of diffuse scatterings in the ED patterns. One is diffuse spots at the 1/2 1/2 0-type reciprocal positions and the other is diffuse streaks elongating along the <110> direction around the fundamental spots. The real-space TEM images clearly demonstrate the presence of nanodomains with the average size of ∼ 5 nm. These nanodomains in the relaxor state should be responsible for the characteristic dielectric properties.
Influence of Platinum Bottom Electrodes on the Piezoelectric Performance of PZT Thin Films Hot Sputtered in a High Volume Production Tool
Authors: Kaden Dirk , Quenzer Hans-Joachim , Kratzer Martin , Castaldi Lorenzo , Wagner Bernhard , Heinz Bernd , Mamazza Robert
Published: February 2012

In this work high quality ferroelectric PZT films have been prepared in-situ by hot RF magnetron sputtering. 200 mm wafer were coated with PZT films of 1 μm and 2 μm thickness at sputter rates of 45 nm/min in a high volume production sputtering tool. The films were grown on oxidized Si substrates prepared either with sputtered Ti/TiO2/Pt, sputtered Ti/TiO2/Pt/TiO2 or evaporated Ti/Pt bottom electrodes at substrate holder temperatures in the range from 550 °C to 700 °C. At these temperatures, the material nucleates in the requisite piezoelectric perovskite phase without need of an additional post annealing treatment.

The films were investigated with respect to their chemical composition and their crystallographic, piezoelectric and dielectric properties. At an intermediate chuck temperature of 600 °C the PZT thin films were characterized by a minimum volume fraction of secondary nonpiezoelectric phases. A Zr/(Zr+Ti) ratio of 0.53 has been achieved matching the morphotropic phase boundary. By improving the deposition process and poling procedure, a notable high e31,f coefficient of -17.3 C/m2 has been obtained. The corresponding longitudinal piezoelectric constant was determined to have an effective longitudinal piezoelectric coefficient d33,f of 160 pm/V.
Geometries and Electronic Structure of Graphene and Hexagonal BN Superlattices
Authors: Sakai Yuki , Saito Susumu
Published: February 2012

Relative stabilities and electronic structure of graphene/h-BN superlattices are discussed in the framework of the density functional theory. Most importantly, relative stabilities between commensurate and incommensurate superlattices are studied. Commensurate graphene/h-BN monolayer superlattices are found to be definitely more stable than incommensurate superlattices. In graphene/h-BN bilayer superlattices, commensurate superlattices are found to be slightly more stable than incommensurate superlattices. Results also imply that a finite pressure can induce transition from an incommensurate superlattice to a commensurate superlattice.
Template Assisted Fabrication and Magnetic Properties of Cobalt Ferrite Nanostructures
Authors: Zhang Jian H. , Chen Liyin , Williams Xylona L.
Published: February 2012

Spinel cobalt ferrite nanotubes and nanowires of about five micrometers in length were fabricated using anodic aluminum oxide (AAO) templates of 20 – 200 nm pore diameters and sol-gel processing. A cobalt ferrite sol was prepared by mixing the acetic acid solution of cobalt (II) acetate and ethanol solution of iron (III) acetylacetonate. The templates filled with precursor were obtained after they were dipped into the sol and dried in air. The template/precursor composites were sintered in air at 500 ºC to form cobalt ferrite phase, which was verified by XRD. The morphology of the nanostructures determined by SEM revealed that the cobalt ferrite nanotubes were formed in the channels of 100 nm and 200 nm diameters in the templates, whereas the nanowires were formed in the 20 nm channels of the templates. The magnetic measurement of cobalt ferrite nanowires by a SQUID magnetometer showed that the nanowires are superparamagnetic at room temperature. The room temperature measurement of magnetization versus the applied field on the nanowire arrays in 20 nm channels of templates showed that the coercivity is 1.57 kOe and 1.47 kOe for the nanowire axis parallel and perpendicular to the applied field, respectively, indicating that the nanowire arrays are nearly magnetically isotropic. However, the coercivity of cobalt ferrite nanowires fabricated in this work is much larger than those in the similar systems reported in the literatures.
O conhecimento intuitivo no cuidado de enfermagem
Authors: Silva Alcione Leiteda da , Baldin Sonciarai Martins , Nascimento Keyla Cristiane do
Published: February 2012

Trata-se de um estudo qualitativo, do tipo exploratório descritivo, que teve por objetivo caracterizar o conhecimento intuitivo no cuidado de enfermagem. Os dados qualitativos foram obtidos através de entrevistas semi-estruturadas com 78 profissionais de enfermagem do sexo feminino. A análise dos dados foi realizada com base no QSR vivo e interpretados através de um referencial teórico construído a partir de estudos da literatura da enfermagem norte-americana. A partir da análise das informações, a intuição emergiu enquanto sentimento, conhecimento e como ambos. Foram identificados três atributos definidores: 1) conhecimento de um fato ou verdade; 2) compreensão imediata do conhecimento; 3) conhecimento independente do processo de raciocínio linear, bem como três tipos de intuição: inferência cognitiva, intuição gestáltica e função pré-cognitiva. Os resultados deste estudo mostram um paralelo com os encontrados na literatura da enfermagem norte-americana.
Mulher e AIDS: rompendo o silêncio de adesão
Authors: Reis Ana Lúcia , Xavier Iara de Moraes
Published: February 2012

Este artigo tem como objetivo discutir a relevância do grupo de adesão em relação à qualidade de vida das mulheres soropositivas ao HIV, que participam dessa atividade no Centro Municipal de Saúde. Pesquisa descritiva com abordagem qualitativa, focalizando oito mulheres infectadas pelos parceiros fixos. Referencial teórico aborda HIV/AIDS, gênero e cuidado de enfermagem. Estudo evidencia como estratégias de enfrentamento à AIDS o incremento do SUS e do PAISM e a utilização de abordagens interdisciplinares e metodologias críticas multiprofissionais na implementação da atenção em saúde. Conclui que o cuidado em enfermagem, no contexto do processo saúde-doença da mulher, deve pautar-se na integralidade da assistência humanizada, observando os princípios éticos e de solidariedade e as relações de gênero.
As potencialidades da enfermeira na gestão do cuidado em saúde
Authors: Bellato Roseney , Pereira Wilza Rocha
Published: February 2012

Neste artigo buscamos fazer um ensaio sobre as questões da subjetividade que estão em jogo no gerenciamento do cuidado em serviços de saúde pela enfermeira. Para tanto, fomos buscar elementos em alguns estudos desenvolvidos sobre planejamento e administração, na Sociologia do Quotidiano e na Teorização Feminista, no que se refere ao gerenciamento do cuidado em saúde. Concluímos haver necessidade de atualizar as potencialidades da enfermeira como gerenciadora, a partir dos olhares teóricos referidos, revalorizando aspectos e sentimentos até então desconsiderados no espaço-tempo da instituição de saúde, tais como a subjetividade, a relacionalidade, o desejo, a criatividade, a responsabilidade, entre outros.
Saúde mental: reconstruindo saberes em enfermagem
Authors: Oliveira Francisca Bezerra de , Fortunato Maria Lucinete
Published: February 2012

O manicômio, apesar de criticado, reformado ou mesmo negado, ainda é uma prática preponderante no cuidado às pessoas com transtornos mentais. Tal prática tem como princípio básico o isolamento do doente mental, contrariando todas as possibilidades de assistência centrada num humanismo ético. Este ensaio procura interpretar a institucionalização do asilo, da psiquiatria, da doença mental e o processo da reforma psiquiátrica, buscando contribuir para as reflexões acerca da desinstitucionalização e dos saberes e práticas de enfermagem em saúde mental.
Enfermagem e serviço de atendimento pré-hospitalar: descaminhos e perspectivas
Authors: Martins Pedro Paulo Scremin , Prado Marta Lenise do
Published: February 2012

Trata o presente de uma reflexão acerca do surgimento do Atendimento Pré-Hospitalar no Brasil e os respectivos modelos assistenciais, nas últimas décadas. Ao traçarmos a trajetória histórica apontamos os caminhos e os descaminhos desta modalidade de assistência à saúde, em nosso país. São analisadas as tentativas mais recentes de normatização em nível nacional desse serviço, especialmente a Portaria do Ministério da Saúde nº 2048/02, a qual se constitui num ponto de partida, oferecendo subsídios para as instituições e àqueles envolvidos neste campo específico de conhecimento em saúde, a fim de refazer o caminho numa outra perspectiva.
Violência denunciada: ocorrências de maus tratos contra crianças e adolescentes registradas em uma unidade policial
Authors: Garbin Cléa Adas Saliba , Rovida Tânia Adas Saliba , Joaquim Renata Colturato , Paula Adrielle Mendes de , Queiroz Ana Paula Dossi de Guimarães e
Published: February 2012

Esse estudo objetiva verificar o perfil da ocorrência de maus-tratos contra crianças e adolescentes. Foram analisados os dados registrados nas ocorrências policiais da Delegacia de Defesa da Mulher de Araçatuba-SP, no ano de 2008, relativos à agressão; relação vítima-agressor; características sociodemográficas de agressores e vítimas e procura das vítimas por serviço de saúde. Dentre as denúncias feitas, houve uma maior prevalência de maus tratos físicos, sendo a residência o local de maior incidência de agressões. Na maioria das vezes, o agressor era a mãe da criança, sendo o motivo não relatado, na maior parte dos casos. Desse modo, podemos delinear o perfil das ocorrências violentas contra criança, contribuindo para a visualização, conhecimento e enfrentamento do problema.
Diagnósticos de enfermagem para pacientes em risco de desenvolver úlcera por pressão
Authors: Araújo Thiago Moura de , Araújo Márcio Flávio Moura de , Caetano Joselany Áfio , Galvão Marli Teresinha Gimenez , Damasceno Marta Maria Coelho
Published: February 2012

Estudo do tipo transversal, que objetivou identificar diagnósticos de enfermagem em pacientes críticos com risco para desenvolver úlcera por pressão. Foi realizado numa Unidade de Terapia Intensiva de Fortaleza-CE, com uma amostra intencional de treze sujeitos que apresentavam risco para úlcera por pressão, segundo a escala de Waterlow. Foi evidenciado um total de 45 diagnósticos de enfermagem, dos quais dezessete tinham significância clínica para o desenvolvimento de úlcera por pressão. Dentre estes, nove apresentaram frequência ≥ 80%, destacando-se: Integridade da pele prejudicada (100%), Deambulação prejudicada (87%), Deglutição prejudicada (80%), Mobilidade no leito prejudicada (80%) e Troca de gazes prejudicada (80%). O conhecimento destes diagnósticos de enfermagem é importante na detecção das repercussões e base clínica dessas lesões dermatológicas.
Competência interpessoal no cuidado de pessoas com diabetes: percepção de enfermeiros
Authors: Soares Daniela Arruda , Sadigursky Dora , Soares Isabela
Published: February 2012

Pesquisa de natureza qualitativa e exploratória que objetivou apreender a percepção de enfermeiros que cuidam de pessoas com Diabetes sobre a competência interpessoal. Os sujeitos foram onze enfermeiros que exerciam suas atividades em Unidades de Saúde da Família da zona urbana e que preencheram um termo de consentimento. Os dados, obtidos por entrevista semiestruturada, foram analisados e categorizados por meio de análise temática. Os resultados apontaram que os enfermeiros percebem a competência interpessoal como uma habilidade de interação com o paciente, como estabelecimento de um relacionamento interpessoal efetivo e como forma de relacionamento interpessoal. Depreende-se que o exercício desta competência não é passível de padronização, o que enfatiza a singularidade dos processos de interação e do cuidado à saúde.
Comunicação terapêutica na Enfermagem: dificuldades para o cuidar de idosos com câncer
Authors: Peterson Aline Azevedo , Carvalho Emília Campos de
Published: February 2012

O objetivo deste trabalho foi avaliar as dificuldades e suas respectivas causas, na percepção do enfermeiro, ao se prestar assistência ao paciente idoso, com patologia oncológica. O estudo, descritivo, utilizou a Técnica dos Incidentes Críticos para obtenção e análise de dados, respeitados os aspectos éticos. Os sujeitos foram enfermeiros, convidados, funcionários de Unidades de assistência oncológica às pessoas com idade superior a 60 anos e que atuam nas áreas de oncologia há mais de um ano. Foram citados pelos sujeitos 25 incidentes críticos, sendo nove sentimentos negativos, três positivos e 13 com ambos. Concluiu-se que os enfermeiros que relataram intervenções de caráter humano, demonstraram sentimentos positivos, reconhecendo a importância das respectivas ações de enfermagem para oferecer uma assistência humana.
Cuidados de enfermagem no pré-operatório e reabilitação de mastectomia: revisão narrativa da literatura
Authors: Alves Pricilla Cândido , Barbosa Izabel Cristina Falcão Juvenal , Caetano Joselany Áfio , Fernandes Ana Fátima Carvalho
Published: February 2012

Trata-se de uma pesquisa bibliográfica realizada nas bases de dados Lilacs e Scielo, que objetivou revisar a produção científica referente aos cuidados de enfermagem no período pré-operatório e de reabilitação de mastectomia. Foram analisados dezoito artigos focalizados nas seguintes categorias: Cuidados de enfermagem no pré-operatório da mastectomia e O papel da Enfermagem na reabilitação da mulher mastectomizada. Observou-se que os cuidados de enfermagem nos dois períodos são fundamentais para um tratamento mais humanizado. No entanto, estes se encontram escassos e com orientações pouco esclarecedoras, sendo necessário um maior enfoque por parte da equipe com relação ao seu papel e cuidados prestados à mulher nessa condição.
Advocacia em saúde na atenção à criança: revisão da literatura
Authors: Andrade Raquel Dully , Mello Débora Falleiros , Silva Marta Angélica Iossi , Ventura Carla Aparecida Arena
Published: February 2012

Revisão narrativa da literatura, a partir das bases de dados LILACS e MEDLINE, entre 2004 e 2009, com a qual se objetivou identificar as publicações relativas à temática da advocacia em saúde no âmbito da atenção à saúde da criança. Foram analisados treze artigos e identificados três temas: Ênfase em conhecimentos, habilidades e atitudes para desenvolvimento de competências; Parcerias como um imperativo; Saúde e Direito: relação intersetorial. Os estudos sobre o exercício da advocacia em saúde são relevantes para nossa realidade, especialmente na atenção primária à saúde, chamando a atenção para as possibilidades de sua aplicabilidade no papel do enfermeiro atuante na estratégia saúde da família, junto a famílias e crianças.
Eventos adversos na terapia farmacológica pediátrica: revisão integrativa da literatura
Authors: Martins Tathiana Silva de Souza , Silvino Zenith Rosa , Silva Luciana Rodrigues da
Published: February 2012

Trata-se de uma revisão integrativa da literatura realizada em bases de dados online, no período entre 2003-2009, com o objetivo de identificar as evidências disponíveis sobre os principais eventos adversos relacionados a medicamentos na clientela pediátrica e propor estratégias para a redução dos mesmos. Evidenciou-se a inadequação da apresentação dos fármacos direcionada ao atendimento das necessidades terapêuticas específicas das crianças. Entende-se que a tomada de decisão do enfermeiro sobre o aprazamento seguro, o preparo e a administração de fármacos, deve estar baseada em avaliação criteriosa e individualiza de cada cliente. Assim, é necessário que o profissional esteja embasado cientificamente, para implementar intervenções eficazes que sejam capazes de reduzir e, até mesmo, evitar os eventos adversos oriundos da uni ou polifarmácia.
Investigando a produção do conhecimento sobre a pessoa idosa longeva
Authors: Lima Talita Aquira dos Santos , Menezes Tânia Maria de Oliva
Published: February 2012

Pesquisa bibliográfica, com abordagem quantitativa, que objetivou investigar a produção do conhecimento sobre a pessoa idosa longeva, nas bases de dados SCIELO e LILACS. Foram analisados oitenta e oito artigos científicos, dos quais 69,3% foram produzidos no Brasil, concentrados na região Sudeste (67,2%), com prevalência da abordagem qualitativa (77,3%). Quanto à área de conhecimento, todas as pesquisas fazem parte da grande área Ciências da Saúde, com predomínio de Medicina (76,1%). A enfermagem representou 4,5% das produções. Os objetos mais estudados (72,7%) foram casos clínicos ou relato de experiências. Conclui-se que a produção científica sobre o idoso longevo ainda é singela, mas relevante. Nesta ótica, torna-se essencial ampliar e qualificar as produções e os campos de conhecimentos direcionados a este universo temático.
Transdisciplinaridade na educação à distância: um novo paradigma no ensino de Enfermagem
Authors: Martins Thaís Yamasaki de Campos , Ribeiro Rita de Cássia , Prado Cláudia
Published: February 2012

Este artigo teve como objetivo refletir sobre a necessidade da transdisciplinaridade na educação à distância, pois a mesma pressupõe um modelo novo, transição, mudança, transformação. O objetivo da educação à distância é a utilização de suporte em ambientes virtuais e interativos de aprendizagem, permitindo assim integrar múltiplas mídias de maneira organizada para elaboração de produções, interação e socialização do conhecimento. No Brasil, o ensino de Enfermagem já conta com diversas experiências na utilização da educação à distância, com resultados positivos e promissores, demonstrando boa aceitação por parte dos estudantes e melhora no processo ensino-aprendizagem.
Experimental canine model for sentinel lymph node biopsy in the vulva using technetium and patent blue dye
Authors: Aquino José Ulcijara , Pinheiro Luiz Gonzaga Porto , Vasques Paulo Henrique Diógenes , Rocha João Ivo Xavier , Cruz Diego Alves , Beserra Hugo Enrique Orsini , Cavalcante Raissa Vasconcelos
Published: February 2012

PURPOSE: This paper aims to study and define the experimental model of sentinel lymph node biopsy of the vulva in bitches. METHODS: 0.2 ml of 99mTc phytate was injected intradermally, using a fine gauge insulin needle in the anterior commissure of the vulva. Thirty minutes after 99mTc injection, the inguinal mapping was performed using a gamma probe. After this, 0.5 ml of blue dye (bleu patenté V Guerbet 2.5%) was injected in the same place. After 15 minutes, a 3 cm long inguinal incision was made at point maximum uptake followed by careful dissection, guided by visualization of a bluish afferent lymphatic system that points to the sentinel lymph node (SLN). RESULTS: It was observed that 88% of SLN were identified. It wasn´t found a significant difference among the presence or not of sentinel lymph node in the sides, which is an indication of a good consistency. It was observed a high (88%) and significant (χ2=12.89 and p=0.0003) intercession between both methods (blue dye and radiation). CONCLUSION: The experimental model adopted is feasible, becoming advantageous in applying the association of Patent blue and 99mTc.
Clinical and nutritional status in the late postoperative of pancreaticoduodenectomy: influence of pylorus preservation procedure
Authors: Muniz Cinara Knychala , Braga Camila Bitu Moreno , Kemp Rafael , Santos José Sebastião dos , Cunha Selma Freire de Carvalho da
Published: February 2012

PURPOSE: To evaluate the nutritional status of patients in the late postoperative period of pancreaticoduodenectomy (PD) and compare the long-term outcome according to pylorus-preserving (PPPD) or the standard technique (SPD) in which the pylorus is resected. METHODS: This prospective study was conducted twelve months prior or more in patients who had underwent PD (PD Group, n=15) and health volunteers (Control Group, n=15). At a post hoc analysis, the PD Group was divided in PPPD Subgroup (n=9) and SPD Subgroup (n=6), according to the PD techniques. Gastrointestinal complaints and nutritional status were evaluated, apart from a biochemical assessment; Student t-test or Mann-Whitney test were used. RESULTS: The patients recovered their body weight and the gastrointestinal complaints were uncommon. The PD Group showed higher energy and protein intake even though BMI was lower than in Control Group. There were no differences in laboratorial data, except for higher glycemia, serum alkaline phosfatase and C-reactive protein in PD Group. There was no difference in the various parameters evaluated when the Subgroups (PPPD and SPD) were compared. CONCLUSION: For long-term pancreaticoduodenectomy, the gastrointestinal symptoms are minimal and the patients had the clinical and nutritional status preserved, regardless of pylorus preservation.
Lumbosacral epidural magnesium prolongs ketamine analgesia in conscious sheep
Authors: DeRossi Rafael , Pompermeyer Cassio Tadeu Dias , Silva-Neto Amadeu Batista , Barros Andrea Lantieri Correa de , Jardim Paulo Henrique de Affonseca , Frazílio Fabrício Oliveira
Published: February 2012

PURPOSE: To determine the analgesic, motor, sedation and systemic effects of lumbosacral epidural magnesium sulphate added to ketamine in the sheep. METHODS: Six healthy adult male mixed-breed sheep; weighing 43 ± 5 kg and aged 20-36 months. Each sheep underwent three treatments, at least 2 weeks apart, via epidural injection: (1) ketamine (KE; 2.5 mg/kg), (2) magnesium sulphate (MG; 100 mg), and (3) KE + MG (KEMG; 2.5 mg/kg + 100 mg, respectively). Epidural injections were administered through the lumbosacral space. Analgesia, motor block, sedation, cardiovascular effects, respiratory rate, skin temperature, and rectal temperature were evaluated before (baseline) and after drug administration as needed. RESULTS: The duration of analgesia with the lumbosacral epidural KEMG combination was 115 ± 17 min (mean ± SD), that is, more than twice that obtained with KE (41 ± 7 min) or MG (29 ± 5 min) alone. KE and KEMG used in this experiment induced severe ataxia. The heart rate and arterial blood pressures changes were no statistical difference in these clinically health sheep. CONCLUSION: The dose of magnesium sulphate to lumbosacral epidural ketamine in sheep is feasible, and can be used in procedures analgesics in sheep.
Histology of the rectus abdominis muscle in rats subjected to cranial and caudal devascularization
Authors: Costa Walder , Silva Alcino Lázaro da , Costa Gustavo Rocha , Nunes Tarcizo Afonso
Published: February 2012

PURPOSE: To investigate the microscopic changes in the rectus abdominis muscle in rats subjected to five delay procedure. METHODS: 30 male holtzmann rats, weighting between 250 and 350 grams, were used. The animals were divided into five groups (n=6): A - cranial section of the right muscle; B - caudal section of the right muscle; C - craniocaudal section of the right muscle; D - cranial section reflecting the right muscle in the craniocaudal direction; E - caudal section reflecting the right muscle in the caudocranial direction. On the seventh day after surgery, a resection of the cranial and caudal fragments of the right and left muscles, respectively, was performed for microscopic analysis. Histological alterations were quantified and the right and left (control) muscle fragments compared. Fisher's exact test was used for statistical purposes with a significance level of 5%. RESULTS: The comparison between right and left muscles showed statistically significant differences in group A - inflammatory infiltrate in the cranial fragment (p=0.015); in group C - inflammatory infiltrate (p=0.000) and necrosis (p=0.015) in the caudal fragment; and in group E - edema in the caudal fragment (p=0.000). No significant alterations were noted in groups B and D. CONCLUSIONS: Irrigation exclusively through the perforating muscle vessels is inappropriate; irrigation exclusively through the cranial pedicle causes milder, insignificant histological alterations, when compared with irrigation exclusively through the caudal pedicle; irrigation exclusively through the caudal pedicle causes more pronounced, but still insignificant, histological alterations when compared with other forms of devascularization.