bluuebunny/crossref_metadata_2025 huggingface dataset:
Hierbas medicinales utilizadas en la atención de enfermedades del sistema digestivo en la ciudad de Taxco, Guerrero, México
Authors: Flores Adrián Urióstegui
Published: October 2015

Objetivo En el presente trabajo se muestra, a. El uso empírico; b. Las propiedades comprobadas de manera científica, y; c. Las dosis de las principales hierbas medicinales que son empleadas en la atención enfermedades del sistema digestivo (y/o sus signos y síntomas) en la ciudad de Taxco, Guerrero, México.

Métodos El estudio fue cualitativo. Se tomaron en cuenta planteamientos respecto al muestreo en investigación cualitativa. Lo anterior específicamente en lo referente a muestras homogéneas. Se entrevistó a seis médicos tradicionales reconocidos y que tenían conocimiento profundo sobre la temática. Se diseñó y aplicó un cuestionario de entrevista (de preguntas abiertas). El cuestionario incluyó interrogantes relacionadas con las características de las principales hierbas, las enfermedades del sistema digestivo más comunes que se atienden, así como las dosis y partes usadas.

Resultados Los principales hallazgos reflejan aproximadamente 20 plantas que se disponen para sanar dichas afecciones, asimismo, se explican sus usos empíricos, y las propiedades curativas comprobadas científicamente.

Conclusiones Las plantas medicinales continúan formando parte de una compleja estructura médica local; cuyos conocimientos, técnicas terapéuticas y tratamientos especializados se encuentran actualmente vigentes. 
Análisis del desempeño de la batería de evaluación de factores psicosociales en Colombia
Authors: Rubio-Castro Natalia , Luna-García Jairo Ernesto
Published: October 2015

Objetivo Analizar el desempeño de los tres cuestionarios y la ficha de datos generales que conforman la Batería de Instrumentos para la Evaluación de Factores de Riesgo Psicosocial en seis empresas de distintos sectores económicos en Colombia, en lo relacionado con: a. Contenido de los instrumentos; b. Metodología de aplicación, y; c. Recepción por parte de trabajadores y empleadores.

Metodología Estudio de casos múltiples a partir del procesamiento de: 1. Los registros de observación de la aplicación de los cuestionarios; 2. Las anotaciones de los trabajadores sobre los cuestionarios resueltos, y; 3. Las actas de reunión con los representantes de los empleadores. Se observó qué elementos comunes y particulares tenían las empresas para hacer una reclasificación en subcategorías.

Resultados En relación con la categoría “Contenido”, hay limitaciones en los cuestionarios de factores intralaborales y extralaborales, debido a que algunos ítems no aplican para condiciones de trabajo específicas como tercerización o trabajo en campo. En “Metodología”, se observaron prácticas que podrían restar confiabilidad a las evaluaciones, como no disponer de espacios o tiempos adecuados. En la categoría “Recepción” se encontró que, aunque dicha evaluación se considera conveniente para la mayoría de trabajadores y empleadores, algunas acciones de las empresas pueden afectar esta percepción.

Conclusiones Resulta positiva la implementación de la evaluación de las condiciones de trabajo psicosociales en las empresas del país, si bien dicha evaluación, con un instrumento universal, presenta dificultades en un mundo del trabajo cambiante y complejo. Se recomienda complementar estas evaluaciones con métodos cualitativos.
Analysis and Replication of Jianyang Tea Bowls from Song Dynasty China
Authors: Morehead James D. , Vandiver Pamela B.
Published: October 2015

Black-glazed tea bowls from the Jian area of Fujian province, China, were analyzed to understand the physical basis of their visual appearance and the special glaze effects of nucleation, crystal growth, control of glaze flow, and hare’s fur and spotted patterns that have frustrated modern and ancient factories that are unable to produce acceptable replicas. The black-glazed Jian bowls are divided into two distinct groups called “Hare’s Fur” and “Oil Spot”. Black glazes and bodies from the Jian kilns are rich in iron and calcium oxides, made from a plentiful local refractory dark red clay, and fired in hill-climbing dragon kilns. Twenty-six sherds were analyzed from the collection made by James Plumer at the kiln site in 1935 [1]. Analyses were conducted using optical microscopy, Xeroradiography, scanning electron microscopy (SEM-EDS) and electron microprobe analysis (WDS), and petrographic thin section analysis to reverse engineer some of the microstructure, composition and thermal history of Jian ware.
Customization of mechanical properties and porosity of bone tissue scaffold materials via Layer-by-Layer assembly of polymer-nanocomposite coatings
Authors: Ziminska M. , Dunne N. , Hamilton A.
Published: October 2015

The aim of this preliminary study was to adapt Layer-by-Layer (LbL) assembly to fabricate nanocomposite coatings onto open-cell porous structures, enabling customization of mechanical properties and porosity to obtain materials suitable for bone tissue scaffold applications. LbL assembly is a well-established method for fabricating multilayer films with nanometre scale precision over thickness that is based on electrostatic attractions and involves the adsorption of oppositely charged electrolytes onto a substrate. Using LbL assembly, polymer-nanoclay composite coatings were deposited onto open-cell foam substrates. The elastic modulus of coated specimens in compression was improved from 0.078 MPa to 1.736 MPa. The results suggest that polymer-nanoclay coatings deposited via LbL assembly have the potential to improve mechanical properties of porous substrates and fabricate materials with mechanical properties comparable to that of a cancellous bone tissue upon deposition of a sufficient number of multilayers.
Creating Metal Nanoparticle-Reduced Graphene Oxide Sheets by a Simple Desktop Method
Authors: Isseroff Rebecca , Chen Arthur , Blackburn Lee , Lish Justin , Kim Jessica , Chen Andrew , Kim Tae Jin , Gentleman Molly , Rafailovich Miriam
Published: October 2015

We have previously reported on a simple desktop method for producing high quality reduced graphene oxide sheets (RGO) which involved dispersing graphene oxide in an ethanol-water solvent and reducing it with sodium borohydride. Metal salts can also be potent reducing agents. Here we show that when these salts are incorporated into the reduction process, metalized graphene sheets can be formed. Metallic salts were used to form Au, Pt, and AuPt nanoplatelets incorporated into the graphene structure. The nature of these metalized graphene platelets was then examined using FTIR, TEM, and SEM/EDAX. Raman spectroscopy of metalized graphene samples show peak shifts and increased D/G ratios over pure graphene, indicating an increased number of defects in the material and suggesting an attachment of metal atoms to the graphene surface. By using a minimum of metal while maximizing the surface contact area of the graphene sheet, these nanoparticle-RGO composites have potential for use in energy-producing devices and/or as catalysts.
OF WHAT USE ARE PUBLISHED HAWAIIAN SONG BOOKS?
Authors: Stillman Amy Ku'uleialoha
Published: October 2015

This article looks at the role of published songbooks in the preservation and promotion of Hawaiian music.
Application Plugins for Distributed Simulations on the Grid
Authors: Muntean Ioan Lucian , Badiu Alexandra Ioana
Published: October 2015

Computing grids are today still underexploited by scientific computing communities. The main reasons for this are, on the one hand, the complexity and variety of tools and services existent in the grid middleware ecosystem, and, on the other hand, the complexity of the development of applications capable to exploit the grids. We address in this work the challenge of developing grid applications that keep pace with the rapid evolution of grid middleware. For that, we propose an approach based on plugins for grid applications that encapsulate a set of commonly used type of grid operations. We further propose more complex high-level functionalities, such as the plugins for remote exploration of simulation scenarios and for monitoring of the behavior of end-user applications in grids. We provide an example of a grid application constructed with these software components and evaluate based on it the performance of our approach in the context of the simulation of biological neurons. The results obtained on test and production grids demonstrate the usefulness of the proposed plugins, with a small performance overhead compared to traditional grid tools.
Quality of Service Control for WLAN-based Converged Personal Network Service
Authors: Park Eun-Chan , Moon Bongkyo , Kim In-Hwan , Jeong Gu-Min
Published: October 2015

This paper proposes a framework for quality of service (QoS) control in WLAN-based converged personal network service (CPNS). First, we show that the CPNS devices in WLANs occupy the shared wireless channel in an unfair manner; and thus, QoS is degraded. The reasons of such problem are analyzed from two viewpoints of (i) channel access mechanism according to carrier sensing multiple access protocol of WLAN and (ii) TCP congestion control mechanism in response to packet loss. To improve QoS and assure fair channel sharing, we propose an integrated QoS control framework consisting of admission control and rate control. Based on the available capacity, the admission control determines whether or not a specific QoS service can be admitted. The rate control is implemented using congestion window control or token bucket algorithm. The proposed mechanism differentiates QoS service from best-effort (BE) service such that the QoS service is preferentially served to satisfy its QoS requirements and the BE service is served to share the remaining resource in a fair manner. The extensive simulation results confirm that the proposed scheme assures QoS and fair channel sharing for WLAN-based CPNS.
A CONDUÇÃO ELETRÔNICA DAS CONDUTAS: A EDUCAÇÃO COMO ESTRATÉGIA DE DISSEMINAÇÃO DE PRÁTICAS
Authors: Loureiro Carine Bueira , Lopes Maura Corcini
Published: October 2015

RESUMO:O objetivo deste artigo é problematizar, por meio de discursos que propagam o uso das tecnologias digitais (TD) nas escolas públicas, a forma como é disseminado o uso das ferramentas digitais na educação escolarizada. Análises empreendidas nos documentos relativos ao Projeto EDUCOM, ao Programa Nacional de Informática Educativa (PRONINFE), ao Programa Nacional de Informática na Educação (PROINFO) e ao Programa Um Computador por Aluno (PROUCA) constituem o corpus da pesquisa. Pela pesquisa e as discussões aqui empreendidas, demonstra-se que os discursos mobilizados por meio das políticas supracitadas criam as condições de possibilidade para a condução eletrônica das condutas e operam na constituição de sujeitos, cujo comportamento deve afinar-se com as condições de vida próprias da contemporaneidade. A problematização aqui apresentada é de inspiração foucaultiana, e foram utilizadas como ferramentas conceituais as noções de discurso, governamento e governamentalidade.
THE QUALITY OF QUALITATIVE RESEARCH: FROM EVALUATION TO ATTAINMENT
Authors: Benjumea Carmen de la Cuesta
Published: October 2015

ABSTRACTThe objective of this paper is to emphasize the importance of quality in the research process instead of its valuation afterwards, an issue the literature has given extensive attention to. In addition, it is a reflection on the debate about the quality of qualitative research and presents the assessment of quality as a situated practice. Reflexivity is presented not as a criterion to assess the research quality but as an instrument to achieve it. There are three characteristics of qualitative research that researchers need to pay reflexive attention to. The first is that qualitative studies deal with human experiences; the second that these experiences are subjective; and the third that qualitative knowledge is ideographic and constructed during the study. Beyond these characteristics, issues are signaled that are constantly repeated in the studies and that unknowingly are a threat to their quality are addressed in this paper.
BRAZILIAN NETWORK FOR NURSING AND PATIENT SAFETY: CHALLENGES AND PERSPECTIVES
Authors: Caldana Graziela , Guirardello Edinêis de Brito , Urbanetto Janete de Souza , Peterlini Maria Angélica Sorgini , Gabriel Carmen Silvia
Published: October 2015

ABSTRACT This study's aim was to describe the experience of implementing the Brazilian Network for Nursing and Patient Safety, as well activities intended to disseminate a culture of patient safety in health and educational institutions. This is an experiment report. The Brazilian Network was completed six years ago and, since its establishment, has promoted actions always in consonance with the objectives of the International Network for Nursing and Patient Safety and the World Alliance for Patient Safety. Networks proposed by the Pan American Health Organization corroborated the actions taken by the Brazilian Network. These actions have been successful, as every year new members are added and new Centers are established, while the Network has participated in academic, scientific and government activities. The challenge lies in increasing the impact of these actions to implement safe practices effectively in healthcare facilities.
IMPACTS OF NEOLIBERALISM ON HOSPITAL NURSING WORK
Authors: Gonçalves Francisco Gleidson de Azevedo , Souza Norma Valéria Dantas de Oliveira , Zeitoune Regina Célia Gollner , Adame Gabriela Fontes Pessanha Leite , Nascimento Sonia Maria Pereira do
Published: October 2015

ABSTRACTThis study aims to describe and analyze the implications of the neoliberal model in the dynamics of hospital work, in the view of the nursing workers. It is a qualitative, descriptive and exploratory research. The scenario is a teaching hospital, and the subjects are 17 nursing workers. The collection took place in July and August 2011, through a semi-structured interview. The data treatment technique was the content analysis. The results show that neoliberalism in hospital nursing work entails several negative impacts, which focus on the inappropriate distribution of material resources, as well as the heavy use of technologies in the process of care. There is also a high turnover of workers contracted due to low wages and precarious employment conditions. We conclude that the neoliberal model has both negative and positive effects. It is considered important to approach this subject in training courses of future nursing staff.
Influence of spirituality, religion and beliefs in the quality of life of people with spinal cord injury
Authors: Magalhães Samira Rocha , Carvalho Zuila Maria de Figueiredo , Andrade Luciene Miranda de , Pinheiro Ana Karina Bezerra , Studart Rita Mônica Borges
Published: October 2015

The objective was to evaluate the influence of spirituality, religion and personal beliefs in the quality of life of people with spinal cord injury. This is a quantitative and exploratory longitudinal cross-sectional study. Data were collected from 49 people with spinal cord injury in two steps, in the hospital and at home, by applying the Quality of Life assessment tool - Spirituality, Religion and Personal Beliefs (WHOQOL-SRPB). Exploratory analyses were performed by using univariate frequency distributions and descriptive measures; validation of internal consistency; and by calculating the dimensions of the scale scores. The results show that the dimensions related to spirituality, religion and personal beliefs patients adopted as strategies to improve their quality of life in this research were confirmed by the high scores in the WHOQOL SRPB areas in both phases; there were differences only in the dimensions Sense of life and Spiritual strength. It is hoped that this study can highlight the importance of spiritual and emotional care.
THE WORK PROCESS IN RADIOLOGICAL NURSING: INVISIBILITY OFIONIZING RADIATION
Authors: Melo Juliana Almeida Coelho de , Gelbcke Francine Lima , Huhn Andrea , Vargas Mara Ambrosina de Oliveira
Published: October 2015

ABSTRACT Qualitative descriptive and exploratory research, performed with 20 nursing professionals working in a general radiology unit and surgery center with the "C-arm" equipment, and the hemodynamics unit of a southern Brazilian teaching hospital. Aim was to analyze the dimensions of the work process for radiological technology nurse professionals. This paper made clear that radiological technologies are outside nursing, which leads to the invisibility of ionizing radiation, leading to inappropriate attitudes about radiological protection, which can be related to harm in professionals, caused by lack of knowledge about this issue. Among radiological nursing work process dimensions, the care dimension emerged. The necessity of implementing a continuous educational program in services which utilize radiological technologies was emphasized, thereby promoting, for patients and for nursing professionals, safer environments and integral care.
Modelo de dinâmica de sistemas para o processo de S&OP ampliado
Authors: Domingos Jean Carlos , Politano Paulo Rogério , Pereira Néocles Alves
Published: October 2015

Resumo Apesar de o processo de S&OP (Sales and Operations Planning) não ser uma prática nova nas empresas, principalmente naquelas de grande porte, ainda é tema de estudos nas suas práticas e ferramentas computacionais de apoio. Modelos e ferramentas computacionais focadas para o auxílio no processo de S&OP são utilizadas e podem contribuir para a melhoria da qualidade da sua execução e dos seus resultados. As ferramentas mais comuns são aquelas baseadas em planilhas eletrônicas, e as mais sofisticadas, em técnicas de pesquisa operacional inseridas em sistemas APS (Advanced Planning Systems). A partir da revisão bibliográfica realizada sobre teoria e técnicas computacionais usadas para o auxílio do processo de S&OP, foi identificada a ausência de estudos relacionados ao uso de Dinâmica de Sistemas (System Dynamics). Adicionalmente, a revisão aponta a necessidade de estudos relacionados à integração de análise econômica e financeira durante a elaboração dos planos agregados e o uso de variáveis probabilísticas no processo que possibilitem a análise estatística no sentido de fornecer planos mais confiáveis. Outra questão relevante observada é que os gestores que participam do processo de S&OP nem sempre têm uma visão global de todas as variáveis e restrições envolvidas neste processo, assim observa-se também que as técnicas e ferramentas utilizadas para execução do processo de S&OP não oferecem uma visão holística das atividades e variáveis envolvidas. Com isso, neste trabalho, é proposto um modelo de Simulação de Dinâmica de Sistemas que proporcione uma visão holística para o processo de S&OP e que permita a integração com os processos da área financeira e o uso de variáveis probabilísticas. A avaliação dos resultados das simulações realizadas com o modelo, apoiada por um projeto de experimentos (DoE), mostra que os planos gerados são compatíveis se comparados com a prática empresarial, com a vantagem de tratar a análise econômica e financeira simultaneamente e ainda possibilitar a geração de inúmeros cenários de planos de S&OP.
A arte do improviso: o processo de trabalho dos gestores de um Hospital Universitário Federal
Authors: Littike Denilda , Sodré Francis
Published: October 2015

ResumoEste artigo tem por objetivo analisar o processo de trabalho dos gestores de um Hospital Universitário Federal. Trata-se de uma pesquisa de abordagem qualitativa realizada mediante entrevista com 12 gestores. Entende-se por processo de trabalho o objeto a ser trabalhado, as ferramentas de trabalho e a atividade humana em si. Reconhece o trabalho como categoria analisadora dos modos de gestão dos profissionais de saúde. O HUF é responsável por duas políticas sociais, a educação e a saúde. O objeto de trabalho dos gestores é a questão organizacional, e as ferramentas de gestão utilizadas são burocráticas e antiquadas para o atual contexto político da gestão hospitalar. A característica mais expressiva na gestão desse hospital é o improviso, que degrada a potência dos gestores de tal modo que, ao invés de realizarem mudanças inovadoras no seu processo de trabalho, preferem deixar a função. O improviso resultou em uma produção de empecilhos sequenciais no aspecto decisório na gestão deste hospital escola. Enfim, analisou-se a transferência da gestão do HUF, da administração pública direta pela Universidade, para a Empresa Brasileira de Serviços Hospitalares, sob a alegação de se instituir um "novo" modelo de gestão.
Entre "feudos" e cogestão: paradoxos da autonomia em uma experiência de democratização da gestão no âmbito hospitalar
Authors: Silva Atila Mendes da , Sá Marilene de Castilho , Miranda Lilian
Published: October 2015

ResumoObjetivou-se analisar a implantação dos Colegiados Gestores (CGs) e Unidades de Produção (UPs) em um hospital do Rio de Janeiro, na perspectiva do discurso dos atores responsáveis por esse processo, focalizando a problemática da autonomia dos sujeitos implicados na produção do cuidado. Trata-se de uma pesquisa qualitativa de abordagem clínica-psicossociológica, realizada através de estudo de caso, apoiado sobretudo em entrevistas semiestruturadas. Estes arranjos de gestão foram valorizados pelos entrevistados, principalmente como um meio de amplificar o comprometimento dos trabalhadores, pois sua inclusão nos colegiados ampliaria sua capacidade decisória, concomitantemente os mobilizaria a se comprometerem mais com o cuidado prestado. Por outro lado, mencionam resistências advindas da luta pela manutenção da concentração de poder nas categorias profissionais, bem como o desafio de lidar com diferentes conflitos de interesses. Como principal conclusão, o estudo indica que os CGs e UPs devem incluir possibilidades de trabalho com os conflitos e os processos intersubjetivos, sob pena de tornarem-se espaços excessivamente idealizados e pouco eficazes.
Saúde Mental: como as equipes de Saúde da Família podem integrar esse cuidado na Atenção Básica?
Authors: Gryschek Guilherme , Pinto Adriana Avanzi Marques
Published: October 2015

ResumoA Saúde Mental é parte das atribuições da Saúde da Família. Esta revisão procurou entender como a Saúde Mental se insere na prática da Estratégia de Saúde da Família. Realizou-se uma revisão de literatura científica, na Base de Dados Biblioteca Virtual de Saúde, com os descritores: "Saúde Mental;" "Saúde da Família;" "Atenção Primária à Saúde". Os critérios de inclusão foram estudos brasileiros de 2009 a 2012 que contribuíssem para a compressão da seguinte pergunta: "Como inserir os cuidados em Saúde Mental na rotina da Estratégia Saúde da Família?". Encontraram-se 11 artigos, que identificam dificuldades e estratégias dos profissionais na Atenção Básica com Saúde Mental. O encaminhamento e a medicalização foram práticas comuns. O Apoio Matricial é a estratégia de capacitação das equipes que permite novas abordagens em Saúde Mental no contexto da Atenção Básica. A Gestão deve ter papel ativo na construção de redes de cuidado em Saúde Mental.
Avaliação de serviços em saúde mental no Brasil: revisão sistemática da literatura
Authors: Costa Pedro Henrique Antunes da , Colugnati Fernando Antonio Basile , Ronzani Telmo Mota
Published: October 2015

ResumoA avaliação em saúde mental é um mecanismo capaz de produzir informações que contribuam positivamente para a tomada de decisão na área. Logo, é preciso apropriar-se das discussões existentes, refletindo sobre desafios e possibilidades na produção de conhecimento neste campo. Realizou-se uma revisão sistemática da produção científica brasileira sobre avaliação de serviços em saúde mental, identificando e discutindo métodos, perspectivas avaliativas e resultados. A busca de artigos ocorreu nas bases de dados IBECS, Lilacs e Scielo, com recorte temporal da publicação da lei 10.216. Foram encontrados 35 artigos por meio dos descritores e critérios de inclusão e exclusão utilizados. A produção da área concentrou-se nas regiões Sul e Sudeste, com diversos âmbitos e participantes, visando contribuir para o aprimoramento de serviços e decisões na área. Destacam-se os avanços no cuidado, com tratamento humanizado, participativo e comunitário, mas carecendo de maiores investimentos, qualificação profissional e melhorias organizacionais. Postula-se maior integração entre pesquisas, com as avaliações ultrapassando aspectos estruturais e a comparação com modelos hospitalocêntricos.
Longitudinal assessment of the lung mechanics of very low birth weight preterm infants with and without bronchopulmonary dysplasia
Authors: Mello Rosane Reis de , Silva Kátia Silveira da , Costa Anniele Medeiros , Ramos José Roberto de Moraes
Published: October 2015

ABSTRACT CONTEXT AND OBJECTIVE: Prematurity has been correlated with altered lung mechanics. Some infants develop lung injury as a consequence of lung immaturity, invasive mechanical ventilation and exposure to oxygen, thus resulting in bronchopulmonary dysplasia. The aim here was to compare the lung mechanics of preterm infants with and without bronchopulmonary dysplasia during the first year of life. DESIGN AND SETTING: Prospective cohort study in a tertiary-level hospital. METHODS: This study included premature infants at a public hospital who underwent two pulmonary function tests: one at discharge and the other at the corrected age of 4 to 8 months. Tidal volume, lung compliance and lung resistance were measured. Statistical tests were used for comparisons between infants with and without bronchopulmonary dysplasia. RESULTS: 102 children with mean gestational age of 29 ± 2.0 weeks were studied; 17 with bronchopulmonary dysplasia. Lung compliance (0.84 ± 0.29 versus 1.28 ± 0.46; P < 0.001) and tidal volume (6.1 ± 0.94 versus 7.2 ± 1.43; P < 0.01) at discharge were significant lower in children with bronchopulmonary dysplasia than in those without the disease, but no differences were observed at the second test (compliance: 1.53 ± 0.77 versus 1.94 ± 1.01; P = 0.12; and tidal volume: 6.9 ± 1.4 versus 7.3 ± 1.6; P = 0.42). CONCLUSION: Differences in lung mechanics were observed between infants with and without bronchopulmonary dysplasia at hospital discharge but these differences were no longer detected at the final follow-up. The lung mechanics of all the infants improved over this period of time.
Bacterial vaginosis in pregnant adolescents: proinflammatory cytokine and bacterial sialidase profile. Cross-sectional study
Authors: Ferreira Carolina Sanitá Tafner , Marconi Camila , Parada Cristina Maria de Lima Garcia , Duarte Marli Teresinha Cassamassimo , Gonçalves Ana Paula Oliveira , Rudge Marilza Vieira Cunha , Silva Márcia Guimarães da
Published: October 2015

ABSTRACT CONTEXT AND OBJECTIVE: Bacterial vaginosis occurs frequently in pregnancy and increases susceptibility to sexually transmitted infections (STI). Considering that adolescents are disproportionally affected by STI, the aim of this study was to evaluate the cervicovaginal levels of interleukin (IL)-1 beta, IL-6, IL-8 and bacterial sialidase in pregnant adolescents with bacterial vaginosis. DESIGN AND SETTING: Cross-sectional study at mother and child referral units in Belém, Pará, Brazil. METHODS: Vaginal samples from 168 pregnant adolescents enrolled were tested for trichomoniasis and candidiasis. Their vaginal microbiota was classified according to the Nugent criteria (1991) as normal, intermediate or bacterial vaginosis. Cervical infection due to Chlamydia trachomatisand Neisseria gonorrhoeae was also assessed. Cytokine and sialidase levels were measured, respectively, using enzyme-linked immunosorbent assays and MUAN conversion in cervicovaginal lavages. Forty-eight adolescents (28.6%) were excluded because they tested positive for some of the infections investigated. The remaining 120 adolescents were grouped according to vaginal flora type: normal (n = 68) or bacterial vaginosis (n = 52). Their cytokine and sialidase levels were compared between the groups using the Mann-Whitney test (P < 0.05). RESULTS: The pregnant adolescents with bacterial vaginosis had higher levels of IL-1 beta, IL-6 and IL-8 (P < 0.05). Sialidase was solely detected in 35 adolescents (67.2%) with bacterial vaginosis. CONCLUSIONS: Not only IL-1 beta and sialidase levels, but also IL-6 and IL-8 levels are higher in pregnant adolescents with bacterial vaginosis, thus indicating that this condition elicits a more pronounced inflammatory response in this population, which potentially increases vulnerability to STI acquisition.
Más allá del “modelo” chileno: una aproximación multi-sectorial a las relaciones Estado-mercado
Authors: Maillet Antoine
Published: October 2015

ResumenChile ha sido muchas veces caracterizado como un “modelo” desde los años 1990. Sin embargo, esta clasificación opaca la diversidad existente en las relaciones Estado-mercado. En cambio, una aproximación mediante la comparación multisectorial permite dar cuenta de la heterogeneidad de las políticas públicas en relación a los mercados, y no confundirlas bajo un supuesto “modelo” uniforme. La demonstración se fundamenta en el análisis de las trayectorias sectoriales en materias de energía eléctrica, transporte público en Santiago y pensiones desde las reformas de los Chicago Boys durante la dictadura de Pinochet hasta hoy. Basado en análisis de prensa, entrevistas con actores claves, y una extensiva revisión de bibliografía especializada, se evidencia cómo las políticas, a partir de un mismo punto de origen al final de la dictadura, tomaron caminos distintos durante los gobiernos democráticos. El caso chileno aparece entonces más fragmentado que lo generalmente considerado. Más allá del caso, esta diversidad señala la necesidad de una mayor atención a los procesos de diferenciación y autonomización de las políticas públicas sectoriales.
The importance of breast elastography added to the BI-RADS® (5th edition) lexicon classification
Authors: Fleury Eduardo de Faria Castro
Published: October 2015

SummaryObjective:the aim of this study was to investigate the addition of elastography to the BI-RADS® lexicon for the classification of breast lesions.Methods:a total of 955 consecutive patients who were subjected to breast percutaneous biopsy from January 2010 to December 2012 were retrospectively assessed. Overall, 26 patients who did not present with masses on conventional ultrasound were excluded. The patients were classified according to the fifth edition of the breast imaging and reporting data system (BI-RADS®) lexicon, which includes elastographic findings. The BI-RADS®classification is based on the same classification principles that have been suggested by the author, which classify lesions as soft, intermediate, or hard.Results:the addition of elastographic findings to the BI-RADS® lexicon improved the sensitivity (S), specificity (SP), and diagnostic accuracy (DA) of ultrasound in the assessment of breast lesions, which increased from 93.85, 72.07, and 76.64 to 95.90, 80.65, and 91.39%, respectively.Conclusion:these findings suggest that the addition of elastography to the BIRADS ® lexicon will improve the SP and DA of ultrasound in the screening of breast lesions.
A TELENOVELA DAS 23H: UMA DESCRIÇÃO DO GÊNERO A PARTIR DA TEORIA SEMIOLINGUÍSTICA
Authors: Corrêa-Rosado Leonardo Coelho , Melo Mônica Santos de Souza
Published: October 2015

ResumoDesde 2011, a Rede Globo exibe, geralmente no segundo semestre e na faixa de horário das 23 horas, umremake de uma novela de grande repercussão de décadas anteriores. Além de ser um horário diferenciado para o padrão da emissora, as referidas telenovelas possuem outras características, como uma menor extensão. O presente trabalho objetiva descrever o gênero situacional telenovela a partir de um de seus formatos: a telenovela das 23h. Para essa descrição, consideramos os exemplares exibidos até então:O Astro, exibida em 2011;Gabriela, exibida em 2012; eSaramandaia, exibida em 2013. A perspectiva teórico-metodológica deste trabalho é baseada nos postulados da Teoria Semiolinguística de Patrick Charaudeau (1983, 1992, 2004) e no conceito deformato, delimitado por Aronchi de Souza (2004).
LA CONSTRUCCIÓN KIRCHNERISTA DE LA MEMORIA
Authors: Bermúdez Nicolás
Published: October 2015

Resumen Los efectos sobre la construcción de la memoria colectiva que produjo la irrupción del kirchnerismo en el campo político han sido ampliamente estudiados. Menos investigadas han sido las transformaciones que sufrió esa construcción con el cambio de presidente. Así pues, el objetivo del presente trabajo es exponer un análisis de las operaciones discursivas de construcción de la memoria puestas en obra por Cristina Fernández de Kirchner durante su primer gobierno. La investigación se inscribe en el marco de los estudios del discurso, más precisamente, de la teoría de los discursos sociales. Para el análisis, se ha constituido un corpus de mensajes producidos en eventos de conmemoración. Se ha seguido un procedimiento contrastivo, cotejando los discursos de Cristina Fernández con los de su antecesor, a fin de detectar la especificidad de sus operaciones de rememoración.
Humor, humoristas e problemas de topia discursiva
Authors: Vale Rony Petterson Gomes do
Published: October 2015

ResumoPartindo do conceito de campo discursivo e da história do humorismo, traçamos, em linhas gerais, o caminho do humor das entrelinhas da literatura para sua institucionalização enquanto campo do humor. Procuramos evidenciar, primeiramente, como o humor passa de característica estilística de alguns escritores e poetas para certa regulamentação da profissão de humorista junto aos campos do jornalismo e da publicidade. Em um segundo momento, verificamos que o conceito de VRBANITAS, que regulamenta os usos do riso no discurso, pode ser percebido a partir das disputas de posicionamento entre os sujeitos dentro do campo do humor, que se diferenciam de acordo com a concepção adotada sobre o que é fazer humor e fazer rir, e com os modos de adaptação às constantes mudanças sociais, às novas formas de mídias e ao movimento politicamente correto.
Interação e aprendizagem em Sites de Redes Sociais: uma análise a partir das concepções sócio-históricas de Vygotsky e Bakhtin
Authors: Rabello Cíntia Regina Lacerda
Published: October 2015

Este trabalho tem como objetivo refletir sobre como as contribuições das concepções sócio-históricas de Vygotsky e de Bakhtin relativas à atitude responsiva, dialogismo, zona de desenvolvimento proximal e conceitos espontâneos e científicos podem trazer luz aos processos de interação, colaboração e aprendizagem em Sites de Redes Sociais (SRSs) de forma a contribuir para a realização de processos educacionais em contextos digitais que conduzam a uma maior participação e construção colaborativa do conhecimento. O artigo relata um estudo exploratório acerca da utilização do SRS Facebook no ensino de língua inglesa no ensino superior com o objetivo de expandir as interações realizadas na sala de aula.
Vocal warm-up and breathing training for teachers: randomized clinical trial
Authors: Pereira Lílian Paternostro de Pina , Masson Maria Lúcia Vaz , Carvalho Fernando Martins
Published: October 2015

OBJECTIVE To compare the effectiveness of two speech therapy interventions, vocal warm-up and breathing training, focusing on teachers’ voice quality.METHODS A single-blind, randomized, parallel clinical trial was conducted. The research included 31 20 to 60-year old teachers from a public school in Salvador, BA, Northeasatern Brazil, with minimum workloads of 20 hours a week, who have or have not reported having vocal alterations. The exclusion criteria were the following: being a smoker, excessive alcohol consumption, receiving additional speech therapy assistance while taking part in the study, being affected by upper respiratory tract infections, professional use of the voice in another activity, neurological disorders, and history of cardiopulmonary pathologies. The subjects were distributed through simple randomization in groups vocal warm-up (n = 14) and breathing training (n = 17). The teachers’ voice quality was subjectively evaluated through the Voice Handicap Index (Índice de Desvantagem Vocal, in the Brazilian version) and computerized voice analysis (average fundamental frequency, jitter, shimmer, noise, and glottal-to-noise excitation ratio) by speech therapists.RESULTS Before the interventions, the groups were similar regarding sociodemographic characteristics, teaching activities, and vocal quality. The variations before and after the intervention in self-assessment and acoustic voice indicators have not significantly differed between the groups. In the comparison between groups before and after the six-week interventions, significant reductions in the Voice Handicap Index of subjects in both groups were observed, as wells as reduced average fundamental frequencies in the vocal warm-up group and increased shimmer in the breathing training group. Subjects from the vocal warm-up group reported speaking more easily and having their voices more improved in a general way as compared to the breathing training group.CONCLUSIONS Both interventions were similar regarding their effects on the teachers’ voice quality. However, each contribution has individually contributed to improve the teachers’ voice quality, especially the vocal warm-up.TRIAL RECORD NCT02102399, “Vocal Warm-up and Respiratory Muscle Training in Teachers”.
Cobertura do Sistema de Informações sobre Nascidos Vivos e potenciais fontes de informação em municípios de pequeno porte em Minas Gerais, Brasil
Authors: Girodo Anne Marielle , Campos Deise , Bittencourt Sonia Duarte de Azevedo , Szwarcwald Célia Landmann , França Elisabeth Barboza
Published: October 2015

Objetivos:estimar a cobertura do Sistema de Informações sobre Nascidos Vivos (SINASC) e a contribuição de potenciais fontes de informação de amostra de municípios da mesorregião do Jequitinhonha, Minas Gerais, em 2008.Métodos:a lista de nascidos vivos (NV) informados ao SINASC foi complementada por NV localizados por busca ativa em cartórios, unidades de saúde, secretarias de assistência social, informanteschave das comunidades, parteiras tradicionais, igrejas, farmácias e arquivos das secretarias municipais de saúde. A cobertura foi calculada a partir da relação de NV informados ao SINASC e total de NV após busca ativa.Resultados:os resultados indicaram uma cobertura precária do SINASC, sendo inferior a 60% em três dos cinco municípios estudados. Quase um quarto dos NV subenumerados não teve Declaração de Nascido Vivo (DN) emitida. As principais fontes de informação foram os cartórios, hospitais e Unidades Básicas de Saúde (UBS), correspondendo juntas ao total de 60% dos NV localizados pela busca ativa.Conclusões:o produto da busca ativa de NV indicou problemas na qualidade da informação dos registros vitais em municípios de pequeno porte, relacionados principalmente a problemas na coleta e no fluxo das informações do SINASC nesses municípios.
A National Survey to Systematically Identify Factors Associated With Oncologists’ Attitudes Toward End-of-Life Discussions: What Determines Timing of End-of-Life Discussions?
Authors: Mori Masanori , Shimizu Chikako , Ogawa Asao , Okusaka Takuji , Yoshida Saran , Morita Tatsuya
Published: October 2015

Background.

End-of-life discussions (EOLds) occur infrequently until cancer patients become terminally ill.

Methods.

To identify factors associated with the timing of EOLds, we conducted a nationwide survey of 864 medical oncologists. We surveyed the timing of EOLds held with advanced cancer patients regarding prognosis, hospice, site of death, and do-not-resuscitate (DNR) status; and we surveyed physicians’ experience of EOLds, perceptions of a good death, and beliefs regarding these issues. Multivariate analyses identified determinants of early discussions.

Results.

Among 490 physicians (response rate: 57%), 165 (34%), 65 (14%), 47 (9.8%), and 20 (4.2%) would discuss prognosis, hospice, site of death, and DNR status, respectively, “now” (i.e., at diagnosis) with a hypothetical patient with newly diagnosed metastatic cancer. In multivariate analyses, determinants of discussing prognosis “now” included the physician perceiving greater importance of autonomy in experiencing a good death (odds ratio [OR]: 1.34; p = .014), less perceived difficulty estimating the prognosis (OR: 0.77; p = .012), and being a hematologist (OR: 1.68; p = .016). Determinants of discussing hospice “now” included the physician perceiving greater importance of life completion in experiencing a good death (OR: 1.58; p = .018), less discomfort talking about death (OR: 0.67; p = .002), and no responsibility as treating physician at end of life (OR: 1.94; p = .031). Determinants of discussing site of death “now” included the physician perceiving greater importance of life completion in experiencing a good death (OR: 1.83; p = .008) and less discomfort talking about death (OR: 0.74; p = .034). The determinant of discussing DNR status “now” was less discomfort talking about death (OR: 0.49; p = .003).

Conclusion.

Reflection by oncologists on their own values regarding a good death, knowledge about validated prognostic measures, and learning skills to manage discomfort talking about death is helpful for oncologists to perform appropriate EOLds.

Implications for Practice:

Oncologists’ own perceptions about what is important for a “good death,” perceived difficulty in estimating the prognosis, and discomfort in talking about death influence their attitudes toward end-of-life discussions. Reflection on their own values regarding a good death, knowledge about validated prognostic measures, and learning skills to manage discomfort talking about death are important for improving oncologists’ skills in facilitating end-of-life discussions.
Sorafenib With and Without Transarterial Chemoembolization for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombosis: A Retrospective Analysis
Authors: Zhang Yingqiang , Fan Wenzhe , Wang Yu , Lu Ligong , Fu Sirui , Yang Jianyong , Huang Yonghui , Yao Wang , Li Jiaping
Published: October 2015

Background.

The survival benefit of combining sorafenib and transarterial chemoembolization (TACE) therapy compared with sorafenib monotherapy for patients with advanced hepatocellular carcinoma (HCC) and main portal vein tumor thrombosis (MPVTT) is unclear.

Methods.

Between January 2009 and June 2013, 183 consecutive patients with advanced HCC (Barcelona Clinic Liver Cancer stage C) and MPVTT were retrospectively reviewed. Of these, 89 patients with advanced HCC and MPVTT were enrolled in this study: 45 were treated with combination therapy (sorafenib-TACE group), and the other 44 treated with sorafenib monotherapy (sorafenib group).

Results.

The mean number of TACE sessions per patient was 2.6 (range: 1–5). The median duration of sorafenib in the sorafenib-TACE group and sorafenib group was 5.6 months and 5.4 months, respectively. The disease control rate was similar between the two groups. Median time to progression was 3.0 months (95% confidence interval [CI]: 2.2, 3.7) in the sorafenib-TACE group, and 3.0 months (95% CI: 2.1, 3.8) in the sorafenib group (p = .924). Median overall survival was 7.0 months (95% CI: 6.1, 7.8) and 6.0 months (95% CI: 4.7, 7.3) in the sorafenib-TACE group and the sorafenib group, respectively (p = .544). The adverse events related to sorafenib were comparable between the two groups. Twenty-one adverse events of grade 3–4 related to TACE occurred in 12 patients (26.7%), and 2 of them died (4.4%).

Conclusion.

This study demonstrated no advantage of combination therapy over sorafenib monotherapy. Considering the patients’ morbidity after TACE, sorafenib monotherapy is appropriate for managing patients with advanced HCC and MPVTT.
Prognostic Importance of Pretransplant Functional Capacity After Allogeneic Hematopoietic Cell Transplantation
Authors: Jones Lee W. , Devlin Sean M. , Maloy Molly A. , Wood William A. , Tuohy Sharlynn , Espiritu Noel , Aquino Jennifer , Kendig Tiffany , Michalski Meghan G. , Gyurkocza Boglarka , Schaffer Wendy L. , Ali Benzar , Giralt Sergio , Jakubowski Ann A.
Published: October 2015

Background.

The purpose of this study was to investigate the prognostic importance of functional capacity in patients undergoing allogeneic hematopoietic cell transplantation (HCT) for hematological malignancies.

Patients and Methods.

Using a retrospective design, 407 patients completed a 6-minute walk distance (6MWD) test to assess functional capacity before HCT; 193 (47%) completed a 6MWD test after hospital discharge. Cox proportional hazards regression was used to estimate the risk of nonrelapse mortality (NRM) and overall survival (OS) according to the 6MWD category (<400 m vs. ≥400 m) and the change in 6MWD (before HCT to discharge) with or without adjustment for Karnofsky performance status (KPS), age, and other prognostic markers.

Results.

Compared with <400 m, the unadjusted hazard ratio for NRM was 0.65 (95% confidence interval, 0.44–0.96) for a 6MWD ≥400 m. A 6MWD of ≥400 m provided incremental information on the prediction of NRM with adjustment for age (p = .032) but not KPS alone (p = .062) or adjustment for other prognostic markers (p = .099). A significant association was found between the 6MWD and OS (p = .027). A 6MWD of ≥400 m provided incremental information on the prediction of OS with adjustment for age (p = .032) but not for other prognostic markers (p > .05 for all). Patients presenting with a pre-HCT 6MWD of <400 m and experiencing a decline in 6MWD had the highest risk of NRM.

Conclusion.

The 6MWD is a significant univariate predictor of clinical outcomes but did not provide prognostic information beyond that of traditional prognostic markers in HCT.

Implications for Practice:

The pretransplant 6-minute walk test is a significant univariate predictor of clinical outcomes in hematological patients beyond age but not beyond that of performance status. On this basis, 6-minute walk distance testing should not be considered part of the standard battery of assessments for risk stratification before hematopoietic cell transplantation.