bluuebunny/crossref_metadata_2025 huggingface dataset:
The Self-Efficacy for Managing Chronic Disease Scale – French version: A validation study in primary care
Authors: Hudon Catherine
Published: October 2016

Rationale and objectiveThe evaluation of patient self-efficacy for managing chronic diseases is important in self-management education programs. A valid instrument to evaluate self-efficacy exists: the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEM-CD). The purpose of this study was to assess the psychometric properties of a French version of the instrument (SEM-CD Fv) in a primary health care context.MethodThe French translation of the questionnaire was obtained through a rigorous translation-back-translation process. Cronbach’s alpha, test-retest reliability (intra-class correlation coefficient, ICC), concurrent validity with the Skill and Technique Acquisition domain of the Health Education Impact Questionnaire (Heiq) and exploratory factor analysis were used to assess the psychometric properties of the SEM-CD Fv.ResultsWe analysed data from 326 primary care patients. The Cronbach alpha of the instrument was 0.93 (95% CI: 0.92 – 0.94). The ICC between the two administrations of the questionnaire (two-week interval) was 0.82 (95% CI: 0.69 – 0.90, p < 0.001). Concurrent validity of the SEM-CD Fv with the Skill and Technique Acquisition domain of the HeiQ showed a correlation coefficient of 0.49 (95% CI: 0.40 – 0.58, p < 0.001). Factor analysis for the SEM-CD Fv resulted in a one-factor solution that explained 73.8% of the variance.ConclusionThe SEM-CD Fv is a valid and reliable instrument to measure self-efficacy for managing chronic diseases in primary care patients.
Provider Views of the Feasibility and Utility of Lifestyle Obesity Treatment in Primary Care: Insights from the Think Health! Study
Authors: Phipps Etienne , Chacko Lisa , Fassbender Jennifer , Allison Kelly , Sarwer David , Wallace Samantha , Tan-Torres Susan , Bowman Marjorie , Wadden Thomas , Kumanyika Shiriki
Published: October 2016

Rationale:   Feasible approaches for providing obesity treatment in primary care settings have been difficult to identify. We assessed the views of primary care clinicians and practice staff about a simplified, lifestyle weight loss program after their participation in a randomized trial designed to evaluate the program within their clinical practices.  Methods: Post-hoc interviews were conducted with 13 clinicians and 12 auxiliary staff at the 5 participating practices in the Think Health! Study of weight management in primary care.  A 13-item survey was used to guide semi-structured interviews about the perceived strengths, weakness, and potential long-term utility of the program. Responses were analyzed using descriptive statistics and qualitative methods. Results:  Providers unanimously endorsed the need for weight loss counseling for their patients.  They supported the need for more frequent visits initially to best engage patients in a weight loss program.  Additional training in counseling skills was desired. Conclusion:  Clinicians participating in a practice- based trial valued having weight loss materials available to share with patients.  Offering patient materials that convey key content and structure for behavior change tasks while allowing provider discretion in how materials are integrated into patient care might be a viable option for testing in future practice-based research.
Comorbidity forces physiotherapists to deviate from guideline recommendations resulting in various treatments for the same patient: a Vignette study
Authors: Dorenkamp Sarah , Mesters Ilse , Tejink Joep , De Bie Rob
Published: October 2016

Rational, aims and objectives: The aim of this Vignette study was to assess whether physiotherapists (PTs) make reasoned adaptations to evidence-based treatment recommendations when co-morbidity influences single disease treatment. Method: To study the influence of co-morbidity on treatment recommendations, 3 vignettes were created based on authentic patient data. In the first vignette, a patient with a single-diseased Intermittent Claudication (IC) was described, in the second vignette, co-morbidity Chronic Obstructive Pulmonary Disease (COPD) was added. In the third vignette, Knee Osteoarthritis (OA) was additionally added. Therapists described 3 treatment plans and their decision rationale. A random selection of 100 Dutch Claudication Network members was invited to participate in this qualitative study. Results: The response rate was 61%. Thirty percent of the physical therapists did not adjust treatment despite co-morbidity. Another 30% partly adapted the treatment plan when co-morbidity was added to the vignette. The presence of co-morbidity induced 40% to abandon guideline recommendations and to create an individualised treatment plan based on the health needs of the vignette patient. Conclusion: This study showed that the majority of PTs makes adaptations to otherwise evidence-based recommendations when co-morbidity is present in order to tailor treatment to the specific needs of the individual patient. However, the same patient was treated in various ways by different PTs.
Susan Benedict and Linda Shields (eds) Nurses and Midwives in Nazi Germany; The “Euthanasia programs”, New York: Routledge, 2014. ISBN 978-0-415-89665-8.
Authors: Lindsay Margot
Published: October 2016

No abstract
HOMAGE TO EDMUND PELLEGRINO
Authors: Muela Ricardo Abengozar
Published: October 2016

On the 4th of July 2014, a Sattelite Symposium on Bioethics was held during The First Annual Conference and Awards Ceremony of The European Society For Person Centered Healthcare, including a simple act of homage to Dr. Edmund Pellegrino. The necessity for training in medical ethics and bioethics is increasingly well acknowledged by both medical practitioners, medical students and indeed patients. This observation led to the Spanish CEEM (Consejo Estatal de Estudiantes de Medicina, España), in co-operation with The National Conference of Deans of Faculties of Medicine of Spain (Conferencia Nacional de Decanos de las Facultades de Medicina, España) and the OMC (Organización Médica Colegial) to create a guide entitled “Ethical Recommendations for Clinical Practice.”
Summary statistics for Patient-reported Outcome Measures: the improvement ratio
Authors: Nemes Szilard , Greene Meridith E , Bulow Erik , Rolfson Ola
Published: October 2016

Rationale, aims and objective: Patient-reported outcomes measures (PROMs) can facilitate objective comparisons of alternative treatments and can aid clinicians, researchers, decision-makers and members of the general public in gauging different healthcare providers’ performance. However, this assumes an easy to use and understand summary measure. Methods: Using PROMs (EQ-5D index, EQ VAS and VAS Pain) from 1799 patients in 7 Swedish hospitals with at least 200 hip arthroplasty surgeries in 2009, we illustrated the possibility of summarizing pre- and post-treatment PROM values with the help of a simple index. This index expressed the attained improvement as a percentage of the total possible improvement. Change score, Cohen’s effect size and Standardized Response Means served as alternative measures. Results: The Improvement Ratio index proved capable of offering a vivid and easy to understand summary of healthcare providers’ performance. The alternative measures indicated similar patterns as the Improvement Index. The routines of statistical inference made possible null-hypothesis testing of the improvement in different groups or testing for trends. Conclusions: This simple improvement index gives an easy to understand summary measure that appeals not only to researchers, but also to laymen for consulting healthcare provider comparisons or countrywide white papers. We recommend using the Improvement Ratio index to summarize the PROMs outcome of elective surgeries.
Equity and person-centeredness in provision of tinnitus services in UK National Health Service audiology departments
Authors: Hoare Derek James , Broomhead Emily , Stockdale David , Kennedy Veronica
Published: October 2016

Rationale, aim and objective: Chronic tinnitus is a prevalent condition broadly managed using individualised sound-based interventions, individualised or group education, counselling, or cognitive therapies. In the UK, therapy is largely delivered by audiologists or hearing therapists and, where available, clinical psychologists and physicians. Changes in the structure of the health service necessitate ongoing evaluation to monitor equity and person-centeredness of care. The purpose of the current evaluation was to describe provision and explore diversities in the services provided for tinnitus patients across the four countries of the UK and consider these relative to current commissioning and clinical practice guidelines.  Method: A 37 item questionnaire was devised and distributed via email and social media to reach audiology departments in the UK and 147 valid responses were acquired during the 3 month period of the evaluation.  Results: The structure and provision of tinnitus services varies widely across the four countries of the United Kingdom in terms of which clinicians provide the services. Outside of England there was no report of clinical psychology or audiovestibular physician involvement in services. There is also variability in access to psychological therapy or support (little training in CBT in Scotland and none in Northern Ireland), self-help groups (little involvement but interest from clinicians) and devices (e.g., one quarter of departments do not currently offer combination hearing aid devices for tinnitus). Clinicians are increasingly using validated questionnaires to evaluate the effectiveness of tinnitus management in their departments.Conclusions: Training in and the provision of psychological support for tinnitus patients by audiologists is particularly a concern for Scotland and Northern Ireland and has implications for the person-centeredness of audiology services. Capacity and need for research in paediatric tinnitus, combination devices, non-ear level sound devices and audiologist-delivered psychological therapy, are noted.
Multi-morbidity: we need co-produced solutions
Authors: Dowrick Christopher
Published: October 2016

Commentary on: van den Broeke, J.,  van der Aa, M., Busschers,  W., Stronks, K. & Plochg, T. (2015). Renewing the expertise of health and social care professionals to provide integrated care: Evaluation of an intervention in a deprived Dutch neighbourhood. European Journal for Person Centered Healthcare 3 (4) 442-453.
CauseHealth: integrating philosophical perspectives into person centered healthcare
Authors: Anjum Rani , Copeland Samantha , Mumford Stephen , Rocca Elena
Published: October 2016

No abstract
Drug therapy in patients subject to outpatient compulsory mental health care
Authors: Drivenes Karin , Bergan Stein , Saether Oddvar
Published: October 2016

Rationale, aims and objectives: The use of coercion in mental health services is controversial. Little is known about drug therapy in patients subject to ambulant compulsory mental healthcare. The purpose of this study was to describe the drug therapy and follow-up in patients subject to ambulant compulsory mental healthcare at Sorlandet Hospital, Norway and, if possible, to improve drug therapy through specific advice from a consultant pharmacist.Method: Relevant information was obtained from the medical records of the included patients. Drug reviews were processed. Identified drug-related problems (DRPs) were presented to the interdisciplinary treatment teams and initiatives were documented. Results: Of the 101 patients subject to ambulant compulsory mental healthcare, 77 patients met the inclusion criteria. On average each patient used 3.6 drugs overall. All patients were using at least one antipsychotic agent, 83 % used depot injections. We identified 68 DRPs in 51 patients. Of these, 54 DRPs were concurred by the psychiatrist treating the patient. The most common type of concurred DRP was "lack of monitoring". The most common initiative was "discussion in the multidisciplinary team or with the patient". Conclusion: Even though the indication was clear, drugs were not always prescribed. Or they were prescribed in too low doses, according to the request of the patient. Among the presented DRPs a high proportion was concurred on, but few alterations were made immediately. A pharmacist can contribute to improving drug therapy, but pharmacists are not currently regular members of the interdisciplinary treatment team.
Measurement properties of the Illness Perception Questionnaire in practitioners working with patients with co-morbid schizophrenia and learning disability
Authors: Martin Colin , Fleming Mick , McCorkindale Stewart
Published: October 2016

Rationale, aims and objectives: The widely-used Illness Perception Questionnaire (IPQ) adapted for use in patients with major mental health problems and those who care and work with them, was originally developed for evaluating the illness perceptions of patients with physical pathology. There have been concerns expressed regarding the appropriateness of the IPQ and derivative measures of it in axis I disorders such as schizophrenia. The current investigation examined the measurement characteristics of a modified version of the IPQ in mental health practitioners working with patients with schizophrenia co-morbid with learning disability.  Method: Two hundred and ten mental health practitioners working with patients with schizophrenia co-morbid with learning disability participated in the study. Contemporary models of the measurement structure of the IPQ were evaluated using confirmatory factor analysis. The internal reliability of the IPQ was also evaluated.Results: Single factor, 5-factor and 6-factor models were evaluated against data. All models were found to offer a poor fit to the data. The internal reliability of the measure was also found to be unsatisfactory overall.  Conclusions: Consistent with one previous study that has found poor measurement characteristics of the IPQ when used in the context of schizophrenia, the current study found the measure to be a poorly performing index of illness perceptions. Echoing previous observations of the use of this tool in axis I disorder, it is recommended that a new measure of illness perceptions be developed using contemporary research methodology sensitive to the context of psychotic illness in order to provide a more effective tool for the provision of person-centered psychiatry and healthcare.
Impact of an exercise programme on sustaining physical activity for recovering cancer patients: A qualitative study.
Authors: Queen Martyn , Bloxham Saul , Brown Phil , Coyle Melissa , Jane Ben
Published: October 2016

Background Pedometers have been shown to improve adherence to exercise programmes. Evidence suggests that PA can improve physical function, wellbeing and reduce the negative impact of some cancer related side-effects. Yet, there are limited PA guidelines for cancer patients in the UK. The aim was to examine the impact of an 8-week exercise programme on sustaining physical activity (PA) at 3-month follow-up. Method A qualitative study with 12 mixed site cancer patients aged 43-70 (10 women, 2 men), involved in an 8-week exercise programme. The Programme took place at a University in the South West of England, UK. Semi-structured interviews with patients took place 3 times over 6 months. A grounded theory approach was used to analyse the data. Results We found that the number of patients perceived to be physically active prior to take-up of the physical activity programme were low (20%). At completion, most patients reported being physically active (84%), sustained but to a lesser extent (67%) at 3-month follow-up. Explanations for sustained PA at follow-up included application of knowledge gained from the Programme in relation to walking technique and use of pedometers and perceived health and fitness gains. Explanations for those not physically active included new diagnosis, reduced mobility following surgery and lack of clear exit route or progression to another structured opportunity. Conclusion Our study has provided valuable insight into how a supervised multi-modal physical activity programme can enable recovering cancer patients to develop a physically active lifestyle.
Preferences cannot be treated as epidemiological characteristics in person-centred care: a riposte
Authors: Kaltoft Mette Kjer , Nielsen Jesper Bo , Salkeld Glenn , Dowie Jack
Published: October 2016

We are delighted that Pedersen and colleagues have responded [1] to our implicit challenge [2] and welcome the opportunity to clarify our position in this Riposte. Essentially, it will reaffirm our position, but we will also identify important underlying sources of disagreement that surface in this Discrete Choice Experiment (DCE) debate. We will also raise issues concerning person-centred decision support, especially in the coming era of so-called ’precision medicine’, given that the requirements for this support was the prime motivation for the original paper.We remain unconvinced that the quantitative group average results from a DCE have any serious role to play in Person-Centred Care (PCC). In our definition, PCC requires the individual's preferences to be formally and explicitly elicited at or near the point of the clinical decision in the most effective and practical way possible. Doing so is obviously the simple and direct means to address any informational asymmetry between doctor and patient in relation to the latter's preferences. Not doing so and endorsing the use of DCE group average results as ‘a starting point’ in a ‘clinician-guided’ procedure represents a threat to implementing fully Person-Centred Shared Decision-Making (SDM). We repeat our belief, in the light of the commentators’ contrary one, that this will constitute a major deterrent to the development and adoption of practical clinical decision support tools; ones that include the personalised preference elicitation at the point of decision that is an essential aspect of preference-sensitive, multi-criterial decision-making.
Prostate cancer patients' experience of involvement in decision-making. A phenomenological hermeneutic study.
Authors: Netsey-Afedo Mette Loewe , Birkelund Regner
Published: October 2016

Background: Shared decision-making (SDM) is a process increasingly recommended as a mean of involving patients in their care. Research shows, however, that it is infrequently employed in everyday clinical practice. Only limited research has been carried out concerning prostate cancer patients’ experiences of being involved in the course of their disease and whether they experience being informed in a relevant way. In Denmark this area remains under investigated. Patient satisfaction, treatment results and patient safety can be improved if patients are involved in decision-making concerning the course of their disease. Studies have shown that many prostate cancer patients prefer to engage in SDM with their doctor.Aim: We aimed to examine prostate cancer patients' experience of becoming involved in decision-making concerning the course of their disease, as well as to examine whether they felt sufficiently informed.Method: This study is based on qualitative semi-structured life-world interviews of 6 prostate cancer patients. The interviews were carried out in the participants’ homes during March and April 2014. The interpretation of the data is based on Paul Ricoeur’s phenomenological-hermeneutic theory of interpretation.Results: Through analysis and interpretation of the data, two themes were identified: (1) Following the procedure (2) Like being a parcel at the mail distribution centre. The patients experienced being sent through a standard procedure with a one-sided focus on examinations and treatment issues. Recurring themes in the patients’ narratives were insufficient communication, objectification and lack of involvement in decisions concerning their disease and treatment. Conclusion: It is concluded that most patients do not become involved in decision-making and do not feel sufficiently informed. This observation has direct implications for the extent to which care provision is person-centered.
The role of family medicine in improvising efficiency, equity and quality of primary healthcare services. Is it significant?
Authors: Sharifa Ezat Wan Puteh , Pannarunothai Supasit , Nurul Azwa Mohd Ismail , Nurmawati Ahmad
Published: October 2016

Primary care is a critical component of any healthcare system and a multiplicity of studies has demonstrated that primary care improves individual and population health outcomes. The provision of more effective and equitable healthcare to populations can be provided through an established primary care system, which is delivered and strengthened by the role of the family medicine specialist. The objective of our study is to describe the rationale for considering family medicine as an essential component of primary healthcare, to provide evidence of its efficiency, equitability and quality, with a practical consideration of its implementation by providing examples from various countries. We conclude that family medicine as an important component in any primary healthcare system and that it is vital to increasing the person-centeredness of individual and population care.
Life-balance self-management programme for community-based older adults living with chronic disease: a feasibility study
Authors: Burrell Beverley Ann , Jordan Jennifer , Crowe Marie , Wilkinson Amanda , Williman Jonathan , Jones Virginia , Harris Shirley
Published: October 2016

Rationale, aims and objectives: Health management strategies are aimed at promoting self-management, healthy lifestyle choices to improve health status and quality of life while addressing cost-effectiveness in health services. We aimed to develop a Life-balance Self-management Programme (LBSP) to test whether taking a trans-diagnostic approach to education combined with presenting mindfulness concepts would enhance self-management with older people with at least one long term condition. This study aimed to test the feasibility of the LBSP in terms of its recruitment strategies, suitability of data collection tools and procedures and if it was acceptable to those receiving it via surveys. Methods: The study utilized a descriptive pre/post-test intervention design. Participants sought were community-based older adults (aged 65+) living with at least one long-term condition and resident in Canterbury, New Zealand. The data analysis was descriptive, correlation between baseline and follow-up were determined.Results: Participants (n=10) reported that they had learnt from the intervention, had adjusted approaches for healthier living and improved self-managing skills. Nil attrition supported the feasibility and acceptability of the intervention.A high correlation was found between measures taken at baseline and at 3 month post-intervention, suggesting meaningful change could be detected within a modest sample size. Conclusion The LBSP, based on empirical and theoretical knowledge, is feasible for trans-diagnostic groups of community-based older adults living with chronic disease. A larger intervention study is planned to test quality of life and functioning as the main outcomes of the programme promoting self-management and to adequately assess effectiveness
Updating the descriptive biopsychosocial approach to fit into a formal person-centered dynamic coherence model - Part I: Some few basics.
Authors: Frölich Thomas , Bevier F F , Babakhani A , Chisholm H H , Henningsen P , Miall D S , Sandberg S , Schmitt A
Published: October 2016

The current biopsychosocial model is predominantly descriptive and ontological semantic and formal issues need to be integrated to it in order to update this approach. Covering aspects of both human biology and human personhood requires the level of discretised facts, the level of underlying coherences and their meaning to be taken into account. For the intended and needed update to the biopsychosocial approach, the resulting model must be congruent with both science and humanities. Prevailing models of health/illness and resultant beliefs have considerable power to define which experience of sickness is valid, and who is alleviated from suffering. As a corollary, the responsibility to be as critical, and careful as possible when accepting, using, or developing, a model of human health and the development of illness is imperative. We propose that one way to address this responsibility is to formalise the most insightful and theoretically promising concept of health and the development of illness to date, George Engel’s „biopsychosocial model“ (BPS) [1]. The intention is to inform and influence healthcare research and practice towards more practicable and beneficent treatment of people within the healthcare and allied systems. The groundwork for this is presented in part I and it differentiates this paper from any other so far on the BPS. A new perspective on ancient philosophy helps to avoid separating topics that are indistinguishable, and compounding topics that should be addressed separately. Part II and part III apply this foundation to more specific issues in person-centred healthcare.
Systematic study of surface morphology, photoluminescence efficiency, and spin-detection sensitivity in (110)-oriented GaAs/AlGaAs quantum wells
Authors: Iba Satoshi , Saito Hidekazu , Watanabe Ken , Ohno Yuzo , Yuasa Shinji
Published: October 2016

We prepared (110)-oriented GaAs/AlGaAs multiple-quantum-well (MQW) samples by molecular beam epitaxy (MBE) under different growth conditions, and conducted systematic measurements of surface morphology, photoluminescence (PL), and spin-detection sensitivity at room temperature. Excellent surface flatness and high PL intensity were observed for the samples grown at temperatures ≥450 °C and As4/Ga flux ratios ≥40. It was found that the PL intensity of (110) MQWs was higher than that of the conventional (100) MQWs grown using the same MBE system. At the same time, we confirmed that the spin-detection sensitivity of (110) MQWs we obtained was an order of magnitude higher than that of the (100) MQWs. These results suggest that the newly developed (110) MQWs indeed have greater advantages than the conventional (100) MQWs for use in emerging spin-optical devices such as spin-controlled lasers.
Fatores relacionados ao desenvolvimento de úlceras em pacientes com Diabetes Mellitus Factors related to the development of ulcers in patients with Diabetes Mellitus
Authors: Targino Iluska Godeiro , Souza Julianne Souto Oliveira , Santos Nicelha Maria Guedes dos , Davim Rejane Marie Barbosa , Silva Richardson Augusto Rosendo da
Published: October 2016

OBJETIVO: identificar fatores relacionados ao desenvolvimento de úlceras em membros inferiores de usuários insulinodependentes residentes no município de São José de Mipibu/RN. MÉTODO: pesquisa quantitativa; os dados foram obtidos mediante entrevista seguida da inspeção estática e aplicação dos monofilamento de Semmes-Weinstein para avaliação do limiar da sensibilidade tátil plantar. Pesquisa aprovada pelo Comitê de Ética em Pesquisa da Universidade Potiguar de Natal/RN, CAAE 0037.0.052.000-11. RESULTADOS: a faixa etária foi de 21 a 72 anos, 68,4% do sexo feminino; 63,3% residentes em zona urbana. Fatores relacionados ao desenvolvimento de úlceras em membros inferiores: sedentarismo (71,6%), hipertensão (65%) e antecedentes de doenças cardiovasculares (56,7%). Na avaliação dos pés, 26,7% pele ressecada, 15% descamativa, 38,3% unhas farináceas, 30% espessadas e 35% dermatites. Em relação à sensibilidade tátil 18,3% apresentaram anestesia do membro afetado. CONCLUSÃO: os dados sugerem que a população estudada é susceptível a desenvolver complicações mais severas e incapacitantes do Diabetes Mellitus.
Estadiamento e grau de resiliência do sobrevivente ao câncer de mama Staging and resilience degree in breast cancer survivors
Authors: Genz Niviane , Muniz Rosani Manfrin , Andrade Francine Pereira , Lange Celmira , Pinto Andressa Hoffmann , De Almeida Natália Leal Duarte
Published: October 2016

Objetivo: Investigar o grau de resiliência e de estadiamento frente aos fatores sociodemográficos dos sobreviventes ao câncer de mama em acompanhamento em um serviço de oncologia. Métodos: Estudo quantitativo, amostra de 112 sobreviventes ao câncer de mama. Foram selecionadas variáveis sociodemográficas, estadiamento clínico, tempo de sobrevida e escala de resiliência. Análise no epi-info 6.04 e teste exato de fischer. Aprovação do Comitê de Ética da Faculdade de Enfermagem da UFPel  nº 31/2009. Resultados: média de idade de 46,2 anos, 60,71% estadiamento II, 81,25% eram brancas, 40,18% com escolaridade entre 5-8 anos, 52,68% casados, 73,32% viveu em zona urbana, 41,96% apresentou alta resiliência e 48,21% mantinha-se em acompanhamento entre 1-3 anos. Conclusão: O estadiamento não está associado ao grau de resiliência, mas sim à idade e tempo de sobrevida confirmando os achados em outros estudos.
Planejamento da alta hospitalar no pós-operatório de idosos: estudo de casos múltiplos Discharge planning in post-operative of elderly: multiple cases study
Authors: Pereira Shimmenes Kamacael , Santana Rosimere Ferreira , Morais Valéria Santos Conceição , Soares Thais Silva , Silva Déborah Marinho
Published: October 2016

Objetivo: Analisar os resultados do planejamento do cuidado de enfermagem no pós-operatório de idosos hospitalizados. Método: Trata-se de estudo de casos múltiplos, de abordagem quantitativa. E, utilizou-se das técnicas de pesquisa: entrevista semiestruturada, observação, levantamento documental e acompanhamento pelo telefone. Amostra composta por 12 idosas. Resultados: Após a alta hospitalar houve relato de melhora significativa no controle da infecção, 100% da amostra demonstrou capacidade de identificar no mínimo dois de fatores de risco para infecção. Houve maior aderência ao regime terapêutico com aumento significativo de 83,4% do acompanhamento médico ambulatorial e manutenção da utilização das medicações prescritas. Conclusão: Considera-se que a execução do plano de alta no seguimento pós-operatório, associado a educação demonstram resultados significativos à recuperação cirúrgica.
Caracterização da qualidade de vida de pessoas com hanseníase em tratamento ambulatorial Characteristics of people of quality of life with leprosy in outpatient treatment
Authors: Araújo Daniella Azevedo Lobo , Brito Karen Krystine Gonçalves , Santana Emanuele Malzac Freire , Soares Valéria Leite , Soares Maria Júlia Guimarães Oliveira
Published: October 2016

Objetivo: Caracterizar a qualidade de vida de pessoas com hanseníase em tratamento ambulatorial. Método: Estudo quantitativo exploratório-descritivo com 59 sujeitos. Para obtenção dos dados socioeconômicos e clínicos dos indivíduos utilizou-se formulário próprio e para a qualidade de vida, o questionário Short Medical Outcomes Study 36 – Item Short-Form Health Survey, o SF-36. Para análise dos dados adotou-se o software estatístico IBM SPSS. Resultados: 78% multibacilares; sexo masculino 54,3%; idade média de 45,9 anos; economicamente ativos 67%. O SF-36 aponta escores médios calculados em valores acima ao escore 50, exceto os aspectos físicos e emocionais (escore < 50) A idade esteve correlacionada aos domínios de capacidade funcional e aspectos físicos, enquanto o sexo esteve associado à saúde mental. Conclusão: A população investigada apresenta qualidade de vida adequada, embora, observa-se que esta se encontra afetada pela doença.Descritores: Hanseníase, Qualidade de vida, Enfermagem.
Cair faz parte da vida: Fatores de risco para quedas em idosos Falling is a part of life: Falls risk factors to the elderly
Authors: Possamai Menezes Luana , Stamm Bruna , Tambara Leite Marinês , Hildebrandt Leila Mariza , Kirchner Rosane Maria
Published: October 2016

Objetivo: Identificar a prevalência de quedas em idosos residentes em área urbana e analisar os fatores de risco associados a quedas. Métodos: Pesquisa quantitativa, transversal e descritiva, da qual participaram 368 idosos. Os dados foram coletados com auxílio de um instrumento com questões sócias demográficas e o Mini Exame do Estado Mental. Para análise foi utilizada a estatística descritiva e teste qui-quadrado. Resultados: Verificou-se que 53% dos idosos apresentaram queda nos últimos seis meses, cuja principal causa tem relação com ambiente doméstico inadequado. 46,7% dos idosos que caíram faziam uso de medicamentos. Dentre os idosos que não estudaram 67,64% apresentaram déficit cognitivo e, destes, 47,8% caíram; 35,54% dos idosos que possuem escolaridade e apresentam déficit cognitivo, 44,1% deles tiveram quedas. Conclusão: O conhecimento dos fatores de risco para quedas em idosos favorece a implantação de ações com o objetivo de maximizar a qualidade de vida e prevenir quedas em idosos.
Integrins and heparan sulfate proteoglycans on hepatic stellate cells (HSC) are novel receptors for HSC‐derived exosomes
Authors: Chen Li , Brigstock David R.
Published: October 2016

Exosomes mediate intercellular microRNA delivery between hepatic stellate cells (HSC), the principal fibrosis‐producing cells in the liver. The purpose of this study was to identify receptors on HSC for HSC‐derived exosomes, which bind to HSC rather than to hepatocytes. Our findings indicate that exosome binding to HSC is blocked by treating HSC with RGD, EDTA, integrin αv or β1 siRNAs, integrin αvβ3 or α5β1 neutralizing antibodies, heparin, or sodium chlorate. Furthermore, exosome cargo delivery and exosome‐regulated functions in HSC, including expression of fibrosis‐ or activation‐associated genes and/or miR‐214 target gene regulation, are dependent on cellular integrin αvβ3, integrin α5β1, or heparan sulfate proteolgycans (HSPG). Thus, integrins and HSPG mediate the binding of HSC‐derived exosomes to HSC as well as the delivery and intracellular action of the exosomal payload.
NMR study of the antifreeze activities of active and inactive isoforms of a type III antifreeze protein
Authors: Choi Seo‐Ree , Seo Yeo‐Jin , Kim Minjae , Eo Yumi , Ahn Hee‐Chul , Lee Ae‐Ree , Park Chin‐Ju , Ryu Kyoung‐Seok , Cheong Hae‐Kap , Lee Shim Sung , Jin EonSeon , Lee Joon‐Hwa
Published: October 2016

The quaternary‐amino‐ethyl 1 (QAE1) isoforms of type III antifreeze proteins (AFPs) prevent the growth of ice crystals within organisms living in polar regions. We determined the antifreeze activity of wild‐type and mutant constructs of the Japanese notched‐fin eelpout (Zoarces elongates Kner) AFP8 (nfeAFP8) and characterized the structural and dynamics properties of their ice‐binding surface using NMR. We found that the three constructs containing the V20G mutation were incapable of stopping the growth of ice crystals and exhibited structural changes, as well as increased conformational flexibility, in the first 310 helix (residues 18–22) of the sequence. Our results suggest that the inactive nfeAFP8s are incapable of anchoring water molecules due to the unusual and flexible backbone conformation of their primary prism plane‐binding surface.
Model studies of short‐term variations induced in trace gases by particle precipitation in the mesosphere and lower thermosphere
Authors: Fytterer T. , Bender S. , Berger U. , Nieder H. , Sinnhuber M. , Wissing J. M.
Published: October 2016

The 3‐D global chemistry and transport model (3dCTM) was used to investigate NO, OH, and O3 from January 2002 to May 2010 between 60 km and 133 km. Their daytime and nighttime mean zonal means (55°–75° geomagnetic latitude) were analyzed with respect to short‐term variations associated with particle precipitation. The corresponding ionization rates were derived from the 3‐D atmospheric ionization module Osnabrück (AIMOS), which is based on particle flux measurements. The trace gas variations with respect to their background were investigated by using a superposed epoch analysis. The 27 day signature associated with particle precipitation is found in NO, while it is only indicated in OH and O3 during winter. A varying solar spectrum associated with the 11 year solar cycle causes modifications of this signal up to 10%, while the main patterns are conserved. Published observations show a clear 27 day signal, qualitatively agreeing with the model results at altitudes >70 km except for O3 in Northern Hemisphere winter. Further differences occur with respect to the magnitude of the trace gas variations, primarily attributed to the different trace gas background and dynamical variations of the background atmosphere. Absolute OH variations are overestimated by the 3dCTM during winter, while the opposite is true for O3. These differences might originate from an unknown offset in AIMOS, incorrect chemical reaction rates, a different background of H2O and O3, and the model dynamics. However, their nonlinear relationship and their altitude of largest response are qualitatively captured in Southern Hemisphere winter.
A diagnostic study on heavy rainfall induced by landfalling Typhoon Utor (2013) in South China: 2. Postlandfall rainfall
Authors: Meng Weiguang , Wang Yuqing
Published: October 2016

In this part, mechanisms responsible for the maintenance of Typhoon Utor (2013) after landfall and its associated heavy rainfall in South China were investigated with methods including piecewise potential vorticity (PV) inversion. The focus was on the monsoonal influence and the interaction between Utor and the mesoscale convective systems (MCSs) embedded in the southwesterly monsoon flow. The results show that after landfall Utor underwent coalescence with the cyclonic monsoon gyres, related to the quasi‐biweekly oscillation (QBWO) and the Madden‐Julian oscillation (MJO). The QBWO cyclonic gyre, which better developed and coalesced with the tropical cyclone (TC) vortex, enhanced the large‐scale southwesterly monsoon flow southeast of the TC, providing favorable condition for initiation of convection and organization of MCSs in the eastern outer rainband of the TC. Latent heat release in the MCSs provided a positive feedback to enhance the TC circulation and the southwesterly monsoon flow, slowing down the decay of Utor and sustaining heavy rainfall. Piecewise PV inversion confirmed that the nonlinear balanced flow inverted from the PV anomaly associated with latent heating in MCSs led to an increase of the low‐level southwesterly flow south of the TC by over 4 m s−1, which contributed notably to the formation of the low‐level jet and moisture convergence in the eastern outer rainband. It is suggested that the positive feedback between the outer rainband MCSs and the southwesterly monsoon flow is a major mechanism responsible for the maintenance of Typhoon Utor after its landfall and the associated postlandfall heavy rainfall over South China.
An introduction to the special issue on Geoscience Papers of the Future
Authors: David Cédric H. , Gil Yolanda , Duffy Christopher J. , Peckham Scott D. , Venayagamoorthy S. Karan
Published: October 2016

Advocates of enhanced quality for published scientific results are increasingly voicing the need for further transparency of data and software for scientific reproducibility. However, such advanced digital scholarship can appear perplexing to geoscientists that are seduced by the concept of open science yet wonder about the exact mechanics and implications of the associated efforts. This special issue of Earth and Space Science entitled “Geoscience Papers of the Future” includes a review of existing best practices for digital scholarship and bundles a set of example articles that share their digital research products and reflect on the process of opening their scientific approach in a common quest for reproducible science.
Subsea ice‐bearing permafrost on the U.S. Beaufort Margin: 1. Minimum seaward extent defined from multichannel seismic reflection data
Authors: Brothers Laura L. , Herman Bruce M. , Hart Patrick E. , Ruppel Carolyn D.
Published: October 2016

Subsea ice‐bearing permafrost (IBPF) and associated gas hydrate in the Arctic have been subject to a warming climate and saline intrusion since the last transgression at the end of the Pleistocene. The consequent degradation of IBPF is potentially associated with significant degassing of dissociating gas hydrate deposits. Previous studies interpreted the distribution of subsea permafrost on the U.S. Beaufort continental shelf based on geographically sparse data sets and modeling of expected thermal history. The most cited work projects subsea permafrost to the shelf edge (∼100 m isobath). This study uses a compilation of stacking velocity analyses from ∼100,000 line‐km of industry‐collected multichannel seismic reflection data acquired over 57,000 km2 of the U.S. Beaufort shelf to delineate continuous subsea IBPF. Gridded average velocities of the uppermost 750 ms two‐way travel time range from 1475 to 3110 m s−1. The monotonic, cross‐shore pattern in velocity distribution suggests that the seaward extent of continuous IBPF is within 37 km of the modern shoreline at water depths < 25 m. These interpretations corroborate recent Beaufort seismic refraction studies and provide the best, margin‐scale evidence that continuous subsea IBPF does not currently extend to the northern limits of the continental shelf.
Perspectives on the causes of exceptionally low 2015 snowpack in the western United States
Authors: Mote Philip W. , Rupp David E. , Li Sihan , Sharp Darrin J. , Otto Friederike , Uhe Peter F. , Xiao Mu , Lettenmaier Dennis P. , Cullen Heidi , Allen Myles R.
Published: October 2016

Augmenting previous papers about the exceptional 2011–2015 California drought, we offer new perspectives on the “snow drought” that extended into Oregon in 2014 and Washington in 2015. Over 80% of measurement sites west of 115°W experienced record low snowpack in 2015, and we estimate a return period of 400–1000 years for California's snowpack under the questionable assumption of stationarity. Hydrologic modeling supports the conclusion that 2015 was the most severe on record by a wide margin. Using a crowd‐sourced superensemble of regional climate model simulations, we show that both human influence and sea surface temperature (SST) anomalies contributed strongly to the risk of snow drought in Oregon and Washington: the contribution of SST anomalies was about twice that of human influence. By contrast, SSTs and humans appear to have played a smaller role in creating California's snow drought. In all three states, the anthropogenic effect on temperature exacerbated the snow drought.
Sensitivity of Pine Island Glacier to observed ocean forcing
Authors: Christianson Knut , Bushuk Mitchell , Dutrieux Pierre , Parizek Byron R. , Joughin Ian R. , Alley Richard B. , Shean David E. , Abrahamsen E. Povl , Anandakrishnan Sridhar , Heywood Karen J. , Kim Tae‐Wan , Lee Sang Hoon , Nicholls Keith , Stanton Tim , Truffer Martin , Webber Benjamin G. M. , Jenkins Adrian , Jacobs Stan , Bindschadler Robert , Holland David M.
Published: October 2016

We present subannual observations (2009–2014) of a major West Antarctic glacier (Pine Island Glacier) and the neighboring ocean. Ongoing glacier retreat and accelerated ice flow were likely triggered a few decades ago by increased ocean‐induced thinning, which may have initiated marine ice sheet instability. Following a subsequent 60% drop in ocean heat content from early 2012 to late 2013, ice flow slowed, but by < 4%, with flow recovering as the ocean warmed to prior temperatures. During this cold‐ocean period, the evolving glacier‐bed/ice shelf system was also in a geometry favorable to stabilization. However, despite a minor, temporary decrease in ice discharge, the basin‐wide thinning signal did not change. Thus, as predicted by theory, once marine ice sheet instability is underway, a single transient high‐amplitude ocean cooling has only a relatively minor effect on ice flow. The long‐term effects of ocean temperature variability on ice flow, however, are not yet known.
Analysis of the warmest Arctic winter, 2015–2016
Authors: Cullather Richard I. , Lim Young‐Kwon , Boisvert Linette N. , Brucker Ludovic , Lee Jae N. , Nowicki Sophie M. J.
Published: October 2016

December through February 2015–2016 defines the warmest winter season over the Arctic in the observational record. Positive 2 m temperature anomalies were focused over regions of reduced sea ice cover in the Kara and Barents Seas and southwestern Alaska. A third region is found over the ice‐covered central Arctic Ocean. The period is marked by a strong synoptic pattern which produced melting temperatures in close proximity to the North Pole in late December and anomalous high pressure near the Taymyr Peninsula. Atmospheric teleconnections from the Atlantic contributed to warming over Eurasian high‐latitude land surfaces, and El Niño‐related teleconnections explain warming over southwestern Alaska and British Columbia, while warm anomalies over the central Arctic are associated with physical processes including the presence of enhanced atmospheric water vapor and an increased downwelling longwave radiative flux. Preconditioning of sea ice conditions by warm temperatures affected the ensuing spring extent.
Dayside magnetospheric and ionospheric responses to solar wind pressure increase: Multispacecraft and ground observations
Authors: Tian A. M. , Shen X. C. , Shi Q. Q. , Tang B. B. , Nowada M. , Zong Q. G. , Fu S. Y.
Published: October 2016

We provide in situ observations of the transient phenomena in the dayside magnetosphere during the preliminary impulse (PI) and main impulse (MI) event on 30 September 2008. The PI and MI geomagnetic signals are induced by twin traveling convection vortices with opposite polarities in the equivalent ionospheric currents due to a sudden increase of the solar wind dynamic pressure. The two PI‐associated ionospheric current vortices centered at ~07 magnetic local time (MLT), 67° magnetic latitude (MLAT) in the dawnside and ~14 MLT, 73°MLAT in the duskside, respectively. The dawnside MI current vortex centered at ~68° MLAT and 6 MLT, while the duskside vortex center was traveling poleward from ~67° MLAT to ~75° MLAT at a speed of ~5.6–7.4 km/s around 14 MLT. It is found that both dawnside PI‐ and MI‐related current vortices were azimuthally seen up to 4 MLT. Following the magnetosphere sudden impulse, a clockwise flow vortex with a radial scale larger than 3 RE, associated with positive field‐aligned current (FAC), was observed by Time History of Events and Macroscale Interactions during Substorms (THEMIS) spacecraft in the outer dayside magnetosphere. The flow vortex expanded and traveled tailward in the magnetosphere, also being reproduced with global MHD simulations. Based on both observation and simulation technique, we show that the MI‐related FACs are correlated with the large‐scale flow vortex. The PI FACs are partially provided by the mode conversion of fast mode waves into the Alfvén waves near the equatorial plane, while most of it may be generated at a higher‐latitude region in the magnetosphere.
Contrasting behavior of the F2 peak and the topside ionosphere in response to the 2 October 2013 geomagnetic storm
Authors: Lei Jiuhou , Zhong Jiahao , Mao Tian , Hu Lianhuan , Yu Tao , Luan Xiaoli , Dou Xiankang , Sutton Eric , Yue Xinan , Lin Jian , Batista Inez S.
Published: October 2016

In this study, the ionospheric observations from ionosondes, ground‐based GPS receivers, Gravity Recovery and Climate Experiment (GRACE) and MetOp‐A satellites, and Fabry‐Perot interferometer over the Asian‐Australian sector have been used to investigate the responses of the F2 peak and the topside ionosphere to the 2 October 2013 geomagnetic storm, particularly during the recovery phase. The comparison between the multiple simultaneous observations revealed a contrasting behavior of the topside ionosphere and the F2 peak in East Asia during the recovery phase. The upward looking total electron content from low‐Earth orbit (LEO) satellites did not undergo such depletions as seen in the region near the F2 peak, and they even showed increases. Furthermore, the simulation results of the Thermosphere Ionosphere Electrodynamics General Circulation Model are used to explore the possible mechanisms responsible for the observed features. The model results and observations suggested that the contrasting behavior of the F2 peak and the topside ionosphere is mainly associated with the enhancement of the equatorward winds, albeit the disturbed electric fields could play an important role in producing it.