bluuebunny/crossref_metadata_2025 huggingface dataset:
The patient's experience of being a human subject
Authors: Kerrison Susan , Laws Sophie , Cane Mary , Thompson Alan
Published: August 2008

Summary

Objective

To explore the patient's experience of clinical research with a view to improving its conduct.

Design

Qualitative analysis of focus groups, semi-structured telephone interviews and questionnaires undertaken with subjects of clinical research.

Subjects

265 patients enrolled in two therapeutic and four non-therapeutic clinical studies were invited to take part. 95 agreed; 32 took part in focus groups, 34 in telephone interviews and 29 returned a questionnaire. Response rate (36%).

Results

Most patients are channeled into research by the health care professionals treating them. Benefits of taking part were seen as: extra care; increased surveillance; obtaining expert information; and being able to help others. Participants also had criticisms which included lack of information about research findings, problems in making sense of adverse events, insufficient attention to their comfort and ‘unscientific’ aspects of particular studies.

Conclusion

Participation in clinical research is not entirely altruistic. Patients expected reciprocity in their on-going relationship with the researcher. Therefore to help ensure that patients continue to support clinical research, we suggest that: time should be allowed for providing information; greater attention should be paid to physical comfort; opportunities should be provided for involvement in research design, in the excitement of research and for giving feedback on the findings; and contact between patients taking part in the same study should be facilitated. By investing in the idea of scientific progress through research, some subjects are able to transform their suffering into hope for the future.
Geriatric surgery is about disease, not age
Authors: Preston Stephen D , Southall Ashley RD , Nel Mark , Das Saroj K
Published: August 2008

Summary

Maintaining life span and quality of life remains a valid aim of surgery in elderly people. Surgery can be an effective way of restoring both length and quality of life to older people. Minimally invasive techniques and surgery under local anaesthesia make fewer demands on geriatric physiology; given that co-morbidity is a stronger predictor of outcome from surgery than age, this is a significant consideration.
Embracing Activism in Apartheid South Africa: The Sisters of Mercy in Bophuthatswana, 1974–94
Authors: Higgs Catherine , Evans Jean N.
Published: August 2008

In South Africa in the latter half of the twentieth century, the Church shifted from a stance of seeming complicity with the government's racist policies to a more active role with the country's peoples. Religious congregations such as the Sisters of Mercy, Johannesburg, moved to increase their activities in areas such as justice and peace, hunger relief, and especially education and skills training. This article examines the Sisters' varied work with displaced peoples in Bophuthatswana from 1974 to 1994.
“Aloha Spirit” and the Cultural Politics of Sentiment as National Belonging
Authors: Ohnuma Keiko
Published: August 2008

From the “Live Aloha” bumper stickers seen throughout Hawai‘i to the state constitution advising lawmakers to “give consideration to the Aloha Spirit,” the panacea of aloha is trotted out to answer every source of conflict in the Islands, from political to spiritual. The trope has been synonymous with Hawai‘i for so long that few people are bothered by its resistance to definition, its tendency to evoke closure where one would expect to see debate and dissent. I propose that this is not only because aloha points toward the things closest to people’s hearts—family, church, and nation—but also and more importantly because it succeeds in obscuring a history of traumatic meanings, all carrying political investments that remain couched beneath the seemingly transparent universality of such private sentiments as love and kindness. As a metonym for the Aloha State, “aloha spirit” serves as both social lubricant and glue, binding a cultural and political entity whose membership is contested. Unresolved historical contests run beneath the surface, however, driving an economy of lack that serves to keep aloha in motion. It is in the interest of divesting the figure of its traumatic power that this genealogy attempts to unpack some of the signifier’s hidden histories.
Access to Appointments Based on Insurance Status in Washington, D.C.
Authors: Blanchard Janice , Ogle Kathleen , Thomas Oluwatoyin , Lung Derrick , Asplin Brent , Lurie Nicole
Published: August 2008

In the U.S., emergency departments see millions of patients requiring timely and adequate outpatient follow-up. Using a hypothetical patient presenting with a scripted presentation of hypertension evaluated in the emergency department and requiring close outpatient follow-up, randomly selected providers in the District of Columbia were queried by phone to evaluate their accessibility based on insurance status. Seventy one percent of calls for privately insured hypothetical patients resulted in a successful appointment. Medicaid fee-for-service was associated with a significantly lower rate of successful appointments (36.6%) than private insurance (p=.002.) Uninsured “patients” had only a 13% success rate when considering out-of-pocket payment limitations of less than $50 (p<.001 compared with private). Access to primary care follow-up is poor in the District of Columbia for all types of insurance; however people with Medicaid fee-for-service and the uninsured face especially strong barriers.
Barriers to Cervical Cancer Screening among Low-Income HIV-Positive African American Women
Authors: Andrasik Michele Peake , Rose Rachel , Pereira Deidre , Antoni Mike
Published: August 2008

This study elucidates the perspective of low-income HIV-positive African American women who have not received cervical cancer screening for five or more years, on the barriers they face in accessing and using reproductive health care. We focused on how women who live in a severely economically depressed and racially segregated neighborhood experience barriers to cervical cancer screening. Andersen’s Behavioral Model of Health Services Use, which allows for the organization of conditions and situations that bar utilization of health services, served as the theoretical framework. Findings from individual semi-structured interviews with 35 participants revealed the importance of psychological and emotional barriers as well as the more commonly reported economic, social, and health care system barriers. We suggest how access to care for this population can be increased by including psychological and emotional components in intervention efforts.
A Taxonomy of Medical Comorbidity for Veterans Who are Homeless
Authors: Goldstein Gerald , Luther James F. , Jacoby Aaron M. , Haas Gretchen L. , Gordon Adam J.
Published: August 2008

Homeless veterans have numerous medical and behavioral health problems. Grouping homeless people based on comorbidity patterns may assist in determining severity of illness and triaging health care more effectively. We sought to determine if a finite number of profiles could be identified related to demographic characteristics, living situation, length of homelessness, and referral areas using interview data from 2,733 veterans who were presently or recently homeless. We considered 12 disorders: eye problems, hypertension, cardiovascular problems, COPD/emphysema, tuberculosis, gastrointestinal problems, hepatic disease, neurologic disorders, orthopedic problems, skin problems, and trauma. Ratings were evaluated using cluster analysis. Comparison statistics were used to compare intercluster differences in demographics, homeless situation, and referral recommendations. A four-cluster solution is proposed: generalized illness, hepatic disease, lung disease, and neurologic disorder. Medical health problems are common and heterogeneous in homeless individuals. Classifications of these problems may be useful in planning treatment and predicting outcome.
Perceptions of Race/Ethnicity-Based Discrimination: A Review of Measures and Evaluation of Their Usefulness for the Health Care Setting
Authors: Kressin Nancy R. , Raymond Kristal L. , Manze Meredith
Published: August 2008

Background . To assess discrimination in health care, reliable, valid, and comprehensive measures of racism/discrimination are needed.
Objective . To review literature on measures of perceived race/ethnicity-based discrimination and evaluate their characteristics and usefulness in assessing discrimination from health care providers.
Methods . Literature review of measures of perceived race/ethnicity-based discrimination (1966–2007), using MEDLINE, PsycINFO, and Social Science Citation Index.
Results . We identified 34 measures of racism/discrimination; 16 specifically assessed dynamics in the health care setting. Few measures were theoretically based; most assessed only general dimensions of racism and focused specifically on the experiences of African American patients. Acceptable psychometric properties were documented for about half of the instruments.
Conclusions . Additional measures are needed for detailed assessments of perceived discrimination in the health care setting; they should be relevant for a wide variety of racial/ethnic groups, and they must assess how racism/discrimination affects health care decision making and treatments offered.
Personal Review and Justice Analysis of Nursing Experiences in Haiti
Authors: Emmott Helen
Published: August 2008

Health care providers frequently struggle to develop wise applications of theoretical knowledge. As a nurse studying traditional approaches in ethics while simultaneously volunteering in Haiti, I wrestled with the notion of justice in the midst of radical material inequities. Paul Farmer, physician and anthropologist, provides an analytic perspective for health care providers who work in poor and underserved countries by expanding the liberation theology of the 1970s to include social applications. Analyzing my past experiences in Haiti using Farmer’s methodology provided insight into my successes and failures and prompted me to search for personal and professional reasons to provide care for the poor in the future. This type of reflection is essential for health care providers who work with the underserved, regardless of their religion or the country in which they work.
Access to Health Care and Voting Behavior in the United States
Authors: Ziegenfuss Jeanette Kane , Davern Micahel , Blewett Lynn A.
Published: August 2008

This study examines the relationship between difficulties accessing health care and voting behavior, in order to assess the possible impact that increasing constraints on access to care will have on future voting behavior. Using data from the American National Election Study we found that the proportion of people with difficulty accessing care increased significantly from 27% in 2000 to 35% in 2004. A larger proportion of those with difficulties in accessing care voted in 2004 than in 2000 and their preferences also changed to more heavily favor the Democratic candidate. If the number of those experiencing difficulties accessing care continues to grow, access to care could become a more salient campaign issue. In 2004, Democratic candidates were favored by this group, which is likely to be a constituency that both parties will try to capture in future elections.
The Role of Health Insurance Coverage in Cancer Screening Utilization
Authors: Robinson JaMuir M. , Shavers Vickie
Published: August 2008

Introduction. Although previous studies have shown a correlation between health insurance coverage and cancer screening, underinsurance and cancer screening among racial/ethnic minorities has not been examined. Methods. Data from the 2000 and 2003 National Health Interview Surveys are used in this analysis. Cross-tabulations, age, and racial/ethnic group stratified regression analyses are used to examine associations between health insurance status and receipt of mammography, Pap testing, prostate specific antigen tests, fecal occult blood test (FOBT) and colorectal endoscopy. Results. In overall models, uninsurance was associated with lower receipt of all tests except FOBT among participants ages 65–85 years. Underinsurance was associated with lower receipt of mammography among women under 65 years only. Conclusion. These findings show age variation in the association between cancer screening and health insurance coverage. In addition, health insurance appears to act similarly across racial/ethnic groups. Further examination of underinsurance in cancer screening utilization and other health behaviors is needed.
Primary Care for Low-Income Populations: Comparing Health Care Delivery Systems
Authors: Grossman Ellie , Legedza Anna T.R. , Wee Christina C.
Published: August 2008

Amidst recent policy discussions about the health care safety net there has been relatively little information about whether the actual site of care affects care quality. We therefore used National Health Interview Survey data to describe low-income adults seeking primary care at different types of sites and the quality of access and preventive care at these sites. After adjusting for sociodemographic characteristics and illness burden, hospital-outpatient- department patients were more likely to receive vaccinations for influenza (adjusted odds ratio [AOR] 1.3, 95% confidence interval [CI] 1.0–1.6) and pneumococcus (AOR 1.4, 95% CI 1.1–1.8) than were those at clinics or health centers. Hospital-clinic patients were more likely to report delays in care due to office administrative difficulties (AOR 1.3, 95% CI 1.1–1.7) and more likely to have more than one emergency room visit (AOR 1.9, 95% CI 1.5–2.3). Physicians’ office or HMO patients were less likely to report administrative delays in care than those at clinics or health centers, but there were no other differences in quality between these two site types. Policymakers and health care services analysts and providers must monitor quality as they decide how best to deliver care to vulnerable populations.
Delivering Care Out of the Box: The Evolution of an HIV Harm Reduction Medical Program
Authors: Mund Pamela A. , Heller Daliah , Meissner Paul , Matthews David W. , Hill Michael , Cunningham Chinazo O.
Published: August 2008

Disparities in HIV health care continue to exist among New York City’s marginalized populations. We describe the evolution and development of a unique collaborative program that blends harm reduction and medical care. This program addresses disparities and needs of a particularly marginalized population: unstably housed substance users with HIV infection.
Mexican Immigrant Women’s Perceptions of Health Care Access for Stigmatizing Illnesses: A Focus Group Study in Albuquerque, New Mexico
Authors: Horwitz Russell H. , Roberts Laura Weiss , Warner Teddy D.
Published: August 2008

This study examines attitudes of Mexican female immigrants to Albuquerque, New Mexico, regarding barriers to health care access in the United States and Mexico for stigmatizing and non-stigmatizing illnesses and moderating effects of social support. Native Spanish speakers conducted three focus groups (in Spanish) lasting two hours with seven to eight participants. Focus groups were transcribed, translated, and coded. Frequency data were calculated by number of times concepts or themes were raised. Comparisons of barriers to health care access were made between U.S. and Mexican cultures. The majority (86%) of comments on barriers for non-stigmatizing illnesses implicated U.S. culture; the majority (90%) for stigmatizing illnesses implicated Mexican culture. Social support for stigmatizing illnesses was discussed. Participants discussed important issues of health care access for stigmatizing illnesses that may have implications for this population’s health status. Greater attention should be paid to stigma and social support in future empirical studies.
Who Speaks for the Health Consumer?
Authors: Fox Michael H.
Published: August 2008

Although consumer-directed health care has become a fashionable concept in recent years, stories abound asking whether the so-called free market in health care can provide adequate access to quality health care at an affordable price. In spite of these concerns, consumer-directed health care continues as the face of legitimacy behind an industry-driven campaign to limit regulatory protections of the consumer in the market and encourage the growth of health insurance products that place spending options closer to the consumer, whether or not these options are available, affordable, or easily understood. Understanding whether this empowerment is real begins with first asking what it now means to be a health consumer. This commentary offers perspective on the dilemma faced by millions of Americans in navigating our health care system under the assumption that market-driven choices foster consumer empowerment in health care, and suggests approaches for expanding the true consumer voice.
The Impact of Publicly Funded Family Planning Clinic Services on Unintended Pregnancies and Government Cost Savings
Authors: Frost Jennifer J. , Finer Lawrence B. , Tapales Athena
Published: August 2008

Publicly funded family planning clinics serve millions of low-income women each year, providing a range of critical preventive services and enabling women to avoid unintended pregnancies. It is important to quantify the impact and cost-effectiveness of such services, in addition to these health benefits. Using a methodology similar to prior cost-benefit analyses, we estimated the numbers of unintended pregnancies prevented by all U.S. publicly funded family planning clinics in 2004, nationally (1.4 million pregnancies) and for each state. We also compared the actual costs of providing these services ($1.4 billion) with the anticipated public-sector costs for maternity and infant care among the Medicaid-eligible women whose births were averted ($5.7 billion) to calculate net public-sector savings ($4.3 billion). Thus, public expenditures for family planning care not only help women to achieve their childbearing goals, but they also save public dollars: Our calculations indicate that for every $1 spent, $4.02 is saved.
Breast and Cervical Cancer Screening Among Low-income Women in Nebraska: Findings from the Every Woman Matters Program, 1993–2004
Authors: Feresu Shingairai A. , Zhang Wanqing , Puumala Susan E. , Ullrich Fred , Anderson James R.
Published: August 2008

Objective. To examine the likelihood of enrollees in the Nebraska Every Woman Matters program being screened for breast and cervical cancer. Methods. We explored the relationship between sociodemographic characteristics and receiving cancer screening services. Results. Older and Native American women were more likely than younger and White women to have mammograms ordered [adjusted odds ratio (OR) = 1.41, 95% confidence interval (CI) 1.08, 1.85]. African American [OR = 0.54, 95% CI 0.46, 0.64] and Native American women [OR = 0.47, 95% CI 0.39, 0.55] were less likely than White women to have clinical breast exams performed. Native American [OR = 0.19, 95% CI 0.16, 0.23] and African American women [OR = 0.56, 95% CI 0.46, 0.68] were less likely than White women to have a Pap test performed. Conclusion. Receiving cancer screening services was related to race; thus, understanding barriers for screening for minority women is warranted.
The Russian Empire and Egypt, 1900–1915: A Case of Public Diplomacy
Authors: Quenoy Paul Du
Published: August 2008

Russia’s relationship with Egypt developed as both lands underwent prolonged periods of modernization. Constrained by geopolitical factors in the Middle East, Russia approached Egypt in the late nineteenth century and especially in the first fifteen years of the twentieth century with “soft power.” This approach included mutually beneficial trade relationships, cultural exchanges, and international assistance in the realm of information and technology. A close examination of the Russo-Egyptian relationship reveals that the Russian Empire was furthering its ends in the Middle East by peaceful means intended to impress the region’s societies favorably, a concept sometimes characterized today as “public diplomacy.”
The Countermodern Moment: A World-Historical Perspective on the Thought of Rabindranath Tagore, Muhammad Iqbal, and Liang Shuming
Authors: Webb Adam K.
Published: August 2008

In the early twentieth century, traditionally minded intellectuals in Asia offered strikingly similar responses to modernity. This article examines the countermodern visions of Rabindranath Tagore, Muhammad Iqbal, and Liang Shuming. Inspired by high-culture versions of Hinduism, Islam, and Confucianism, these three thinkers offered parallel critiques of materialism and the decline of self-cultivation. At the same time, they brought issues of civilizational identity and universalism to the fore. While their cosmopolitanism never reached the point of making common cause politically, their intellectual legacy has enduring relevance for the global culture clash between modernity and its critics.
Isopropanol Protein Precipitation for the Analysis of Plasma Free Metanephrines by Liquid Chromatography–Tandem Mass Spectrometry
Authors: Marney Luke C , Laha Thomas J , Baird Geoffrey S , Rainey Petrie M , Hoofnagle Andrew N
Published: August 2008

Background: High-performance liquid chromatography–tandem mass spectrometric (LC-MS/MS)1 analysis of plasma free metanephrines is the most diagnostically sensitive and specific screening test for the diagnosis of pheochromocytoma. We sought to develop an in-house method for this expensive test

Methods: We used off-line isopropanol protein precipitation of plasma to remove interfering substances before LC-MS/MS analysis. We compared the extraction efficiency and limits of quantification of protein precipitation to those of previously reported solid-phase techniques.

Results: The new method had limits of quantification of 0.09 nmol/L and 0.17 nmol/L for metanephrine and normetanephrine, respectively. Method comparison with a previously described solid-phase extraction method revealed Deming regression slopes of 0.904 and 0.994, intercepts of 0.007 and 0.023, and SEs of the residuals (Sy|x) of 0.071 and 0.284 for metanephrine and normetanephrine, respectively. Extraction efficiency of isopropanol protein precipitation was 66% for metanephrine and 35% for normetanephrine, results that were superior to the efficiencies of 4% and 1% for our adapted solid-phase extraction method. No ion suppression was observed at the retention times for metanephrine and normetanephrine.

Conclusions: Isopropanol protein precipitation is a novel and effective off-line sample preparation method for metanephrines that offers a less expensive alternative to on-line solid-phase extraction for low-volume testing and requires a sample volume of only 200 μL. The mass spectrometric analysis time is equivalent to that of solid-phase techniques.
A New Reign of Terroir
Authors: druckman charlotte
Published: August 2008

This article looks at French Michelin favorite Thierry Marx and his unique approach not just to cooking, but also to the notion of terroir itself. From his near-obsession with the Paulliac lamb born and bred in the Medoc region to his nomadic culinary background, he simultaneously embraces and rejects the classic identification with one's own soil and the harvest the latter reaps. This renegade and seemingly oxymoronic stance begs for and inspires a re-defining of that micro-regional concept in an age where globalism and multiculturalism dominate.
““Breaking Bread with a Spread”” in a San Francisco County Jail
Authors: cate sandra
Published: August 2008

In many jails and prisons, inmates devise a cuisine that supplements –– or replaces –– the official meals provided them. Nearly every evening in the San Francisco County jails, inmates make ““spread,”” the generic term for this cuisine, out of dried ramen noodles and ingredients saved from their meal trays or purchased on weekly commissary orders. Based on a series of over thirty interviews, inmate's recipes indicate wide ethnic variations in spread, as well as skills in inventing pies and other desserts. Obtaining ingredients and sharing spread establishes bonds between individuals and groups within the jail setting.

As both product and practice, spread's significance emerges out of its oppositions –– in appearance, taste, and origins –– to jail food. According to the inmates, despite its adherence to nutritional standards, the jailhouse diet represents monotony, insufficiency, and a lack of autonomy; spreading thus provides a creative and social outlet that counters the constraints of incarceration.
Chasing Angels: The Sweet Wine Angelica
Authors: shaw hank
Published: August 2008

Portugal has port, Spain has sherry, Sicily has Marsala –– and California has angelica. Angelica is California's original wine: The intensely sweet, fortified dessert cordial has been made in the state for more than two centuries –– primarily made from Mission grapes, first brought to California by the Spanish friars. Angelica was once drunk in vast quantities, but now fewer than a dozen vintners make angelica today. These holdouts from an earlier age are each following a personal quest for the real. For unlike port and sherry, which have strict rules about their production, angelica never gelled into something so distinct that connoisseurs can say, ““This is angelica. This is not.”” This piece looks at the history of the drink, its foggy origins in the Mission period and on through angelica's heyday and down to its degeneration into a staple of the back-alley wino set. Several current vintners are profiled, and they suggest an uncertain future for this cordial.
Brain Food
Authors: agranoff bernard
Published: August 2008

The lore and the science that recommend the eating of fish as brain food can be traced to the discovery in 1719 of a high content of phosphorus in our brains, which eventually led to the proposal of Jacob Moleschott in 1852 that there could be ““no thought without phosphorus.”” Louis Agassiz added to this the knowledge that fish, like brains, were also rich in phosphorus, and speculated that the eating of fish might improve intelligence. Mark Twain ridiculed the assertion in 1871 in a widely published humorous letter to an aspiring author that nevertheless favorably popularized the notion. We now know that the large amount phosphorus in brain is due to a high concentration of phospholipids, structural molecules of cell membranes and interconnections, such as the axons and dendrites of nerves. A dietary requirement for phosphorus was, however, not substantiated. Nutritionist's and biochemist's attention are now drawn to certain fatty acids present in phospholipids that are termed ““essential,”” meaning they cannot be biosynthesized and must therefore be derived from the diet. Eating fish and other ocean and fresh water food products is recommended based on their content of EPA and DHA, members of the omega-3 family of essential fatty acids. The omega-3 fatty acids interact with the omega-6 family of essential fatty acids, which predominate in land-based food oils. The complex interplay of the two fatty acid families relates not only to their critical presence in our cell membranes, but also in body regulatory processes via chemical messengers derivatives, the eicosanoids. An optimal ratio of our dietary intake of omega-3 to omega-6 fatty acids is deemed important for normal development of the nervous system as well as for optimizing many health-related cardiovascular and immune system functions.
Banqueting at the Lord's Table in Sixteenth-Century Venice
Authors: mciver katherine a.
Published: August 2008

Paolo Veronese's Marriage Feast at Cana (1562––62; Muséée du Louvre, Paris) reflects the dining experience of the Benedictine monks whose tables continued along the walls of the monastery's refectory as an extension of the painting. In effect, the monks shared the meal, becoming part of the miracle portrayed in Veronese's grand banquet. Moreover, the sumptuousness and decadence of late-sixteenth-century Venice, reflects the dining practices and sociability of the time. Feasting scenes, like the one depicted here, often did not emphasize food; rather, the focus was on the conspicuous display of material goods for which the Venetians were famous. The opulence of the environment, the table settings, and service rival the sumptuous dress of the wedding guests.
The effect of weight loss after gastric banding on the molecular distribution of serum adiponectin
Authors: Leth Henrik , Kroustrup Jens Peter , Larsen Jens Fromholt , Andersen Kristian Kjær , Flyvbjerg Allan , Frystyke Jan
Published: August 2008

The above article has been retracted by the authors, as they have withdrawn the data upon which it was based.

The retraction was made before the article reached its final form in the publication process. However, the authors' manuscript, prior to copy editing, page layout and proofing, was initially made available online upon acceptance as an Accepted Preprint.
An Epidemiological Study of Work‐related Violence Experienced by Physicians who Graduated from a Medical School in Japan
Authors: Arimatsu Mayuri , Wada Koji , Yoshikawa Toru , Oda Susumu , Taniguchi Hatsumi , Aizawa Yoshiharu , Higashi Toshiaki
Published: August 2008

An Epidemiological Study of Work‐related Violence Experienced by Physicians who Graduated from a Medical School in Japan: Mayuri Arimatsu, et al. Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan—Healthcare workers are at high risk of being victim of verbal and physical violence perpetrated by patients. There are only a few studies on work related violence among physicians. The aim of this study was to determine how prevalent work‐related violence against physicians is and whether gender, age, specializations and workplaces are associated with verbal and physical violence against physicians in Japan. A questionnaire was mailed to all the 1,705 physicians who had graduated from one medical school in Japan and had practiced for a minimum of 3 yr by the time of this study. The verbal and physical violence experienced by physicians at the hands of their patients and/or clients in the last 6 months preceding this study were collected. We defined ‘verbal violence’ as ‘any threatening statement or complaint’ while ‘physical violence’ referred to ‘the attempted or actual exercise by persons of any physical force so as to cause injury to a physician’. Multiple logistic regression analysis was used to determine the independent contribution of each factor with violence. A total of 540 men and 158 women responded. The adjusted response rate was 41.8%. Among the participants, 168 (24.1%) physicians had experienced verbal violence and 15 (2.1%) physicians had experienced physical violence in the prior 6 months. Verbal violence was positively associated with physicians who were under 30 yr old (odds ratio [OR] = 2.1; 95% confidence interval [CI], 1.0–4.1 for 27–29 yr old) and, psychiatry (OR, 2.4; 95% CI, 1.1–5.4). Physical violence was significantly associated with women (OR, 3.8; 95% CI, 1.1–13.5), specializations such as emergency and anesthesiology (OR, 18.9; 95% CI, 2.8–126.1), and psychiatry (OR, 7.6; 95% CI, 1.6–35.4). There was a considerable number of physicians exposed to violence. Younger physicians and psychiatrists are likely to be exposed to verbal violence. Female physicians, psychiatrists, and emergency physicians are likely to be exposed to physical violence. Education on avoiding from violence should be provided for physicians early in their career.
The Stability of the Oxidative Stress Marker, Urinary 8‐hydroxy‐2'‐ deoxyguanosine (8‐OHdG), when Stored at Room Temperature
Authors: Matsumoto Yuki , Ogawa Yasutaka , Yoshida Rie , Shimamori Ayako , Kasai Hiroshi , Ohta Hisayoshi
Published: August 2008

The Stability of the Oxidative Stress Marker, Urinary 8‐hydroxy‐2'‐ deoxyguanosine (8‐OHdG), when Stored at Room Temperature: Yuki Matsumoto, et al. National Institute of Occupational Safety and Health—We examined the stabilities of urinary 8‐hydroxy‐2'‐deoxyguanosine (8‐OHdG) stored at room temperature (25°C) for 24 h or at −80°C for 800 days. Subjects were 19 males and 17 females aged 23–58 yr for the 24‐h study, and 9 males and 4 females aged 24–54 yr for the 800‐day study. We obtained information on the subjects by questionnaires and interviews. The level of urinary 8‐OHdG was measured by HPLC using two‐step separations. There were no significant changes of amount of urinary 8‐OHdG under either storage conditions. We conclude that urine samples can be stored at 25°C and below for 24 h, when the research purpose includes the determination of urinary 8‐OHdG. Urinary 8‐OHdG was also stable for over two years when stored at −80°C.
Effects of Benzo[a]pyrene on Autonomic Nervous System of Coke Oven Workers
Authors: Zhang Hong‐Mei , Nie Ji‐Sheng , Wang Fang , Shi Ying‐Tao , Zhang Ling , Antonucci Andrea , Liu Hui‐Jun , Wang Jing , Zhao Jie , Zhang Qin‐Li , Wang Lin‐Ping , Song Jing , Xue Cui‐E , Di Gioacchino Mario , Niu Qiao
Published: August 2008

Effects of Benzo[a]pyrene on Autonomic Nervous System of Coke Oven Workers: Hong‐Mei Zhang, et al. Department of Occupational Health, School of Public Health, Shanxi Medical University, China—Objectives are to investigate the effects of benzo[a]pyrene (B[a]P) on the autonomic nervous system of coke oven workers. One hundred eightyfour coke oven workers were divided into 3 groups according to their working sites (coke oven bottom group, coke oven side group and coke oven top group), and 93 referents were recruited. B[a]P monitored by air sampling pumps as well as urinary 1‐hydroxypyrene (1‐OH‐Py) was determined by high performance liquid chromatograph with a fluorescence detector (HPLCFD). The autonomic nervous system (ANS) function was determined by 4 tests: Valsalva Manoeuvre heart rate variation (HR‐V), variation of heart rate when breathing deeply (HR‐DB), variation of heart rate when instantly standing up (HR‐IS, including RR30:15 and RRmax:min) and variation of blood pressure when instantly standing up (BP‐IS). The B[a]P mean concentrations in coke oven bottom, coke oven side and coke oven top were 19, 185 and 1,623 ng/m3, respectively. The levels of urinary 1‐OH‐Py were markedly higher in the 3 exposed groups than that in the referent group (p<0.01). No significant difference was found in each group between smokers and nonsmokers (p>0.05). Compared with referents, HR‐V decreased significantly in coke oven workers (p<0.01), representing modulation of parasympathetic nervous function. However, no statistical differences were found in HR‐DB, RR30:15, RRmax:min and BP‐IS between the exposed groups and the control group (p>0.05). HR‐V decreased with the increment of 1‐OH‐Py (p<0.05), and results of multiple linear stepwise regression demonstrated that external exposure level and duration of education entered the HR‐V model; age was a significant factor of HR‐DB and RRmax:min, but no variable was involved in RR30:15 and BP‐IS regression. Benzo[a]pyrene affects the autonomic nervous function of coke oven workers mainly by down‐regulating the parasympathetic nervous function.
Marital Status and Cardiovascular Risk Factors among Middle‐aged Japanese Male Workers: The High‐risk and Population Strategy for Occupational Health Promotion (HIPOP‐OHP) Study
Authors: Kamon Yuko , Okamura Tomonori , Tanaka Taichiro , Hozawa Atsushi , Yamagata Zentaro , Takebayashi Toru , Kusaka Yukinori , Urano Sumio , Nakagawa Hideaki , Kadowaki Takashi , Miyoshi Yuji , Yamato Hiroshi , Okayama Akira , Ueshima Hirotsugu ,   HIPOP‐OHP Research Group
Published: August 2008

Marital Status and Cardiovascular Risk Factors among Middle‐aged Japanese Male Workers: The High‐risk and Population Strategy for Occupational Health Promotion (HIPOP‐OHP) Study: Yuko Kamon, et al. Department of Health Science, Shiga University of Medical Science—Marital status is related to cardiovascular disease (CVD) risk factors in Western countries. However, few studies have addressed the relationship between marital status and CVD risk factors in other populations. We investigated lifestyle and CVD risk factors relative to marital status among middle‐aged Japanese men. We analyzed baseline data of 40–59‐yr‐old male workers who participated in the high‐risk and population strategy for occupational health promotion (HIPOPOHP) study. We compared lifestyle and CVD risk factors between men who were married (Group M; n=1,419, mean age 47.9 ± 5.1 yr) and those who had never married (Group N; n=163, mean age 46.7 ± 4.3 yr). Men in Group N were more likely to skip breakfast, work more shifts and exercise less. Current smoking rates, as well as average values of diastolic blood pressure (DBP), serum total cholesterol and fasting plasma glucose were also higher in Group N than in Group M. The proportion of participants with three or more CVD risk factors, namely smoking, hypertension, hypercholesterolemia and hyperglycemia was higher in Group N, than in Group M (12.9% vs. 5.0%, p<0.01). The difference between Groups M and N was more evident in the subgroup of living with others, than in the subgroup of living alone. Since men who have never married might be at higher risk for CVD, effort should be made to educate this population about decreasing lifestyle‐related risk factors.
Trichloroethylene Causes Generalized Hypersensitivity Skin Disorders Complicated by Hepatitis
Authors: Kamijima Michihiro , Wang Hailan , Huang Hanlin , Li Laiyu , Shibata Eiji , Lin Bingjie , Sakai Kiyoshi , Liu Huifang , Tsuchiyama Fumi , Chen Jiabin , Okamura Ai , Huang Xianqing , Hisanaga Naomi , Huang Zhenlie , Ito Yuki , Takeuchi Yasuhiro , Nakajima Tamie
Published: August 2008

Trichloroethylene Causes Generalized Hypersensitivity Skin Disorders Complicated by Hepatitis: Michihiro Kamijima, et al. Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine—Idiosyncratic generalized skin disorders complicated by hepatitis, which resemble severe drug hypersensitivities, occur sporadically in workers exposed to trichloroethylene (TCE) in China. However, it has been a matter of controversy whether the solvent itself, not its impurities or stabilizers, can cause hypersensitivity reactions or not. This study aimed to characterize the exposure of hospitalized patients and their healthy colleagues. TCE metabolites were measured in urine of 19 hospitalized patients suffering from the disorders. To assess the exposure of patients' healthy colleagues, on‐site surveys were conducted in 6 factories where the disorders occurred and in 2 control factories without such occurrences despite TCE use. Urinalysis of the patients detected trichloroacetic acid (TCA) in all of them. Its average concentration in the end‐of‐shift urine was estimated to be 206 mg/l. On‐site survey of healthy exposed workers revealed that the maximum urinary TCA concentrations and the maximum time‐weighted average concentrations of personal TCE exposure were 318–1,617 mg/l and 164–2,330 mg/m3, respectively. There was no common impurity in TCE used in the factories. These results suggested that TCE itself caused the skin hypersensitivity disorders, and that the disorders occurred in factories where TCE metabolites could be extensively accumulated, possibly due to long working hours. Since the lowest TCA concentration in the end‐of‐shift urine of the patients was estimated to be 72–80 mg/l, it is recommended to control TCE exposure to keep the urinary TCA concentration below 50 mg/l to reduce the disease risk.
Potential for Dissemination of the Nonnative Salmonid Parasite Myxobolus cerebralis in Alaska
Authors: Arsan E. Leyla , Bartholomew Jerri L.
Published: August 2008

Myxobolus cerebralis, the myxozoan parasite responsible for whirling disease in salmonids, was first introduced into the United States in 1958 and has since spread across the country, causing severe declines in wild trout populations in the intermountain western United States. The recent detection of the parasite in Alaska is further evidence of the species' capability to invade and colonize new habitat. This study qualitatively assesses the risk of further spread and establishment of M. cerebralis in Alaska. We examine four potential routes of dissemination: human movement of fish, natural dispersal by salmonid predators and straying salmon, recreational activities, and commercial seafood processing. Potential for establishment was evaluated by examining water temperatures, spatial and temporal overlap of hosts, and the distribution and genetic composition of the oligochaete host, Tubifex tubifex. The most likely pathway of M. cerebralis transport in Alaska is human movement of fish by stocking. The extent of M. cerebralis infection in Alaskan salmonid populations is unknown, but if the parasite becomes dispersed, conditions are appropriate for establishment and propagation of the parasite life cycle in areas of south-central Alaska. The probability of further establishment is greatest in Ship Creek, where the abundance of susceptible T. tubifex, the presence of susceptible rainbow trout Oncorhynchus mykiss, and the proximity of this system to the known area of infection make conditions particularly suitable for spread of the parasite.
Incidência de infecção em pacientes com cateter peridural tunelizado
Authors: Iksilara Maria Cecilia , Diccini Solange , Barbosa Dulce Aparecida
Published: August 2008

O cateter peridural tunelizado como via de administração de opiáceos vem sendo utilizado desde o início de 1980. Pacientes com dor crônica, que não obtêm alívio com medicamentos por outras vias, são muito beneficiados com infusão de opiáceo associado a um anestésico local por via peridural. Entretanto, ainda existem dúvidas sobre a eficácia do método, no manuseio e, conseqüentemente, quanto ao risco de infecção e outras complicações. Sendo a equipe de enfermagem fundamental para efetivar o tratamento para o alívio da dor, esse estudo propõe demonstrar como manter a técnica segura. Foram acompanhados 27 pacientes com dor crônica entre 2002 e 2004, que utilizaram o cateter peridural por 18 dias em média, implantados em nível torácico ou lombar. Não houve complicações como abcesso peridural, meningite ou hematoma peridural. A satisfação dos pacientes quanto a analgesia foi evidente.
Vivência de violência familiar: homens que violentam suas companheiras
Authors: Gomes Nadirlene Pereira , Freire Normélia Maria
Published: August 2008

Este estudo objetiva compreender os elementos presentes na construção da identidade dos homens que violentam suas companheiras. De abordagem qualitativa, tem como referencial teórico as Representações Sociais. Foi realizado na comunidade do Calafate, localizada no bairro de San Martin/Salvador-BA. Os sujeitos foram compreendidos por 07 homens que violentavam suas companheiras. Como técnica de coleta de dados, utilizou-se a entrevista semi-estruturada. Os dados foram organizados a partir da Análise de Conteúdo de Bardin, especificamente a Análise Temática, no tema eixo: Relação familiar. O estudo permitiu identificar elementos que interferem na construção da identidade de homens que violentam suas companheiras. Estes têm origem no relacionamento familiar marcado por diversos fatores, dentre os quais: ausência de diálogo e agressões físicas.
Dimensionamento de pessoal de enfermagem em um hospital universitário
Authors: Nicola Anair Lazzari , Anselmi Maria Luiza
Published: August 2008

A investigação desenvolvida na modalidade de estudo de caso, teve como objetivo dimensionar o quadro de pessoal de enfermagem em um hospital universitário. A metodologia adotada contempla a identificação de determinadas variáveis entre elas a classificação de pacientes segundo categoria de cuidado de enfermagem e índice de ausências previstas e não previstas. Foram estudadas as unidades de internação de clinica médica e cirúrgica. Os resultados apontam: o quadro existente de enfermeiros corresponde a 50% daquele projetado, enquanto que para os auxiliares de enfermagem há um excedente de 29,2%. A redefinição do quantitativo de enfermeiros no hospital criará possibilidades para reorganização do trabalho com minimização da carga de trabalho de modo a assegurar qualidade à assistência de enfermagem prestada.
Explorando a "fotovoz" em um estudo etnográfico: uma estratégia de coleta de dados
Authors: Melleiro Marta Maria , Gualda Dulce Maria Rosa
Published: August 2008

Este artigo descreve o emprego do recurso fotográfico na coleta de dados em um estudo etnográfico. O objetivo foi compreender a percepção de gestantes usuárias de um serviço de saúde. Para tanto, essas mulheres foram convidadas, durante o período pré-natal, a fotografar a instituição, onde nasceriam seus filhos. Após a revelação das fotografias, foram agendadas entrevistas, onde as gestantes puderam explicitar seus sentimentos e inquietações, detectados por meio do recurso fotográfico. As fotografias deram "voz" às participantes do estudo, permitindo que aspectos positivos e negativos do âmbito hospitalar fossem desmistificados, minimizando a ansiedade no período que antecedeu o parto.
Intervenções terapêuticas em Unidade de Terapia Intensiva: análise segundo o Therapeutic Intervention Scoring System-28 (TISS-28)
Authors: Garcia Paulo Carlos , Gonçalves Leilane Andrade , Ducci Adriana Janzantte , Toffoleto Maria Cecília , Ribeiro Sandra Cristina , Padilha Kátia Grillo
Published: August 2008

O presente estudo teve como objetivos descrever a prevalência diária das categorias de intervenções terapêuticas e identificar a prevalência dos itens componentes de cada categoria de intervenções terapêuticas, segundo o TISS-28. A amostra incluiu 89 admissões consecutivas na UTI geral de um Hospital Universitário do município de São Paulo. Das 7 categorias do TISS-28, houve prevalência na pontuação das categorias Atividades Básicas e Suportes Ventilatório, Cardiovascular e Renal, com freqüência entre 73,0% e 100,0%. A freqüência dos itens componentes da categoria Atividades Básicas foi maior do que 90,0%. O sub-iten medida quantitativa do débito urinário foi pontuado em 98,2% na categoria Suporte Renal. Os resultados obtidos podem imprimir qualidade a assistência prestada aos clientes, na medida em que contribuem para a previsão de recursos humanos e materiais na UTI.
Tratamento de feridas: análise da produção científica publicada na Revista Brasileira de Enfermagem de 1970-2003
Authors: Pereira Ângela Lima , Bachion Maria Márcia
Published: August 2008

Esta revisão bibliográfica sistematizada teve como objetivo analisar a produção científica acerca da utilização de produtos no tratamento de feridas, publicada na REBEn de 1970 a 2003. Consultamos todos os números da revista publicados no período, identificando 41 artigos de interesse. Após leitura dos mesmos, incluímos na amostra 11 textos. Identificamos maior publicação na década de 1990, predominando autores da área assistencial, delineamento quase-experimental e de relato de experiência. Os produtos estudados foram papaína, própolis, açúcar, bota de Unna, carvão ativado, filme transparente, membrana amniótica, clara de ovo, colagenase, hidrocolóide, alginato de cálcio, pomadas antimicrobianas, ácidos graxos essenciais, fibras de viscose e poliéster. Os resultados encontrados denotam efeitos positivos da utilização dos produtos.