bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of an executive function intervention programme in MS: a placebo-controlled and pseudo-randomized trial
Authors: Fink Frauke , Rischkau Eva , Butt Martina , Klein Jan , Eling Paul , Hildebrandt Helmut
Published: July 2010

We evaluated a rehabilitation programme for executive deficits in multiple sclerosis patients by comparing outcome scores of a cognitive intervention group (CIG; n = 11) with those of a placebo group ( n = 14) and an untreated group ( n = 15). Executive functioning and verbal learning improved significantly more in the CIG. The treatment effect on verbal learning was still present at 1-year follow-up. Baseline brain atrophy, quantified by the brain parenchymal fraction, was associated with treatment effects for one aspect of executive functioning. Consequently, cognitive intervention may be beneficial and baseline brain atrophy has some predictive value in determining treatment outcome for executive functioning.
Factors associated with adolescent physical activity during middle school physical education: A one-year case study
Authors: Senne Terry , Rowe David , Boswell Boni , Decker James , Douglas Shaun
Published: July 2010

The purpose of this descriptive component of a larger, exploratory case study was to examine associations among lesson contexts, teacher behaviors, and adolescent physical activity over a year of physical education (PE) at one school. Middle school students ( n = 206) and their PE teachers ( n = 4) were observed twice-weekly across one academic year. Data were collected using the System for Observing Fitness Instruction Time (SOFIT), Behavioral Evaluation Strategy and Taxonomy (BEST) software and Yamax SW-200 pedometers. Students spent 32.5 percent lesson time in at least moderate intensity activity, averaging 1542 steps per lesson. Higher activity levels were associated with lesson contexts of fitness activity, skill activity, and game play; while lowest activity levels occurred during free play. Higher activity levels were associated with teacher behaviors of promoting fitness, demonstrating fitness, and observing; lower activity levels were associated with teacher behaviors of general instruction and management.
Crush injuries and crush syndrome - a review. Part 2: the local injury
Authors: Jagodzinski Nikolas A , Weerasinghe Charitha , Porter Keith
Published: July 2010

Crush injuries can occur in considerable numbers following natural disasters or acts of war and terrorism. They can also occur sporadically after industrial accidents or following periods of unconsciousness from drug intoxication, anaesthesia, trauma or cerebral events. A common pathophysiological pathway has been elucidated over the last century describing traumatic rhabdomyolysis leading to myoglobinuric acute renal failure and a systemic ‘crush syndrome’ affecting many organ systems. If left unrecognised or untreated then mortality rates are high. If treatment is commenced early and the systemic effects are minimised then patients are often faced with significant morbidity from the crushed limbs themselves. We have performed a thorough review of the English language literature from 1940—2009 investigating crush injuries and crush syndrome and present a comprehensive, two-part summary. Part 1: The systemic injury, we concentrate on the systemic crush syndrome. We determine the pathophysiology, clinical and prognostic indicators and treatment options such as forced alkaline diuresis, mannitol therapy, dialysis and haemofiltration. We discuss more controversial treatment options such as allopurinol, potassium binders, calcium therapy and other diuretics. We also discuss the specific management issues of the secondary ‘renal disaster’ that can occur following earthquakes and other mass disasters. Part 2: The local injury, we look in more detail at the pathophysiology of skeletal muscle damage following crush injuries and discuss how to minimise morbidity by salvaging limb function. In particular we discuss the controversies surrounding fasciotomy of crushed limbs and compare surgical management with conservative techniques such as mannitol therapy, hyperbaric oxygen therapy, topical negative pressure therapy and a novel topical treatment called gastric pentadecapeptide BPC 157.
Boundary Spanners Revisited
Authors: Nissen Laura Burney
Published: July 2010

While collaborative change models are gaining momentum in human services, more needs to be known about those leading the changes in a contemporary context. The professional experiences of those who work among diverse, fragmented, even rival factions, often without formal authority, and manage to facilitate cross-system cooperation among multiple partners remain under explored. They represent the evolution of a rich and varied history of models of leadership in social networks and social movements. In this qualitative study, leaders from the Reclaiming Futures initiative reflect on their roles in collaborative efforts to improve substance abuse treatment and community involvement in juvenile justice. Findings revealed the characteristics and strategies of successful boundary spanners — valuable for those engaged in such work and for future workforce development.
Using ‘observations of care’ in nursing research: a discussion of methodological issues
Authors: Harrison Anthony
Published: July 2010

Observations of care were developed as part of a professional development programme by the Royal College of Nursing in 1997 and have since been used in both professional development and research settings, but their use as part of the research process is potentially problematic. This is due to a lack of clarity and discussion regarding their philosophical positioning and the associated methodological issues likely to be encountered by qualitative researchers. Observations of care can be seen as part of a wider ethnographic tradition of participant observation, but because of the lack of clarity regarding their provenance and utility, novice researchers may experience difficulty in locating them within the ethnographic paradigm. The aim of this paper is to consider the issues associated with their transfer from part of a professional development strategy to their use within a qualitative research setting, illustrating key methodological issues with examples from the author’s own research. It is hoped that this paper will be the start of a critical discourse on their use within research.
The classification and treatment of Kienböck’s disease: the state of the art and a look at the future
Authors: Lichtman D. M. , Lesley N. E. , Simmons S. P.
Published: July 2010

The proper treatment of Kienböck’s disease, a disorder that displays slow progression with eventual collapse of the lunate and alteration of the surrounding carpal architecture, requires an understanding of its aetiology and natural history. A reproducible classification system assists the surgeon in making appropriate treatment choices. In this discussion, we review the history and rationale for the four-stage step-wise classification system, along with our current treatment algorithm. We also discuss emerging classification systems and speculate on future directions in treatment and research.
Arthroscopically assisted percutaneous fixation for trans-scaphoid perilunate fracture dislocation
Authors: Jeon I.-H. , Kim H.-J. , Min W.-K. , Cho H.-S. , Kim P.-T.
Published: July 2010

Trans-scaphoid perilunate fracture dislocation is a complex carpal dislocation causing marked disruption of the carpal structures. Open treatment has been accepted as standard for this injury. We have used arthroscopically assisted percutaneous screw fixation and bone grafting to treat this injury in four patients. The functional outcome was good. All patients achieved solid union without nonunion or malunion. The complication and morbidity was relatively low; all patients had proper alignment and there was no evidence of instability or avascular necrosis or midcarpal arthritis.
Nerve growth factor promotes breast cancer angiogenesis by activating multiple pathways
Authors: Romon Rodrigue , Adriaenssens Eric , Lagadec Chann , Germain Emmanuelle , Hondermarck Hubert , Le Bourhis Xuefen
Published: July 2010

Background

Although several anti-angiogenic therapies have been approved in the treatment of cancer, the survival benefits of such therapies are relatively modest. Discovering new molecules and/or better understating signaling pathways of angiogenesis is therefore essential for therapeutic improvements. The objective of the present study was to determine the involvement of nerve growth factor (NGF) in breast cancer angiogenesis and the underlying molecular mechanisms.

Results

We showed that both recombinant NGF and NGF produced by breast cancer cells stimulated angiogenesis in Matrigel plugs in immunodeficient mice. NGF strongly increased invasion, cord formation and the monolayer permeability of endothelial cells. Moreover, NGF-stimulated invasion was under the control of its tyrosine kinase receptor (TrkA) and downstream signaling pathways such as PI3K and ERK, leading to the activation of matrix metalloprotease 2 and nitric oxide synthase. Interestingly, NGF increased the secretion of VEGF in both endothelial and breast cancer cells. Inhibition of VEGF, with a neutralizing antibody, reduced about half of NGF-induced endothelial cell invasion and angiogenesis in vivo.

Conclusions

Our findings provided direct evidence that NGF could be an important stimulator for breast cancer angiogenesis. Thus, NGF, as well as the activated signaling pathways, should be regarded as potential new targets for anti-angiogenic therapy against breast cancer.
TLX1 and NOTCH coregulate transcription in T cell acute lymphoblastic leukemia cells
Authors: Riz Irene , Hawley Teresa S , Luu Truong V , Lee Norman H , Hawley Robert G
Published: July 2010

Background

The homeobox gene TLX1 (for T-cell leukemia homeobox 1, previously known as HOX11) is inappropriately expressed in a major subgroup of T cell acute lymphoblastic leukemia (T-ALL) where it is strongly associated with activating NOTCH1 mutations. Despite the recognition that these genetic lesions cooperate in leukemogenesis, there have been no mechanistic studies addressing how TLX1 and NOTCH1 functionally interact to promote the leukemic phenotype.

Results

Global gene expression profiling after downregulation of TLX1 and inhibition of the NOTCH pathway in ALL-SIL cells revealed that TLX1 synergistically regulated more than 60% of the NOTCH-responsive genes. Structure-function analysis demonstrated that TLX1 binding to Groucho-related TLE corepressors was necessary for maximal transcriptional regulation of the NOTCH-responsive genes tested, implicating TLX1 modulation of the NOTCH-TLE regulatory network. Comparison of the dataset to publicly available biological databases indicated that the TLX1/NOTCH-coregulated genes are frequently targeted by MYC. Gain- and loss-of-function experiments confirmed that MYC was an essential mediator of TLX1/NOTCH transcriptional output and growth promotion in ALL-SIL cells, with TLX1 contributing to the NOTCH-MYC regulatory axis by posttranscriptional enhancement of MYC protein levels. Functional classification of the TLX1/NOTCH-coregulated targets also showed enrichment for genes associated with other human cancers as well as those involved in developmental processes. In particular, we found that TLX1, NOTCH and MYC coregulate CD1B and RAG1, characteristic markers of early cortical thymocytes, and that concerted downregulation of the TLX1 and NOTCH pathways resulted in their irreversible repression.

Conclusions

We found that TLX1 and NOTCH synergistically regulate transcription in T-ALL, at least in part via the sharing of a TLE corepressor and by augmenting expression of MYC. We conclude that the TLX1/NOTCH/MYC network is a central determinant promoting the growth and survival of TLX1+ T-ALL cells. In addition, the TLX1/NOTCH/MYC transcriptional network coregulates genes involved in T cell development, such as CD1 and RAG family members, and therefore may prescribe the early cortical stage of differentiation arrest characteristic of the TLX1 subgroup of T-ALL.
The Rites of Statehood: Violence and Sovereignty in Spanish America, 1789–1821
Authors: Adelman Jeremy
Published: July 2010

This essay explores the varieties of expressions of political violence during the revolutionary conjuncture, 1789 to 1821, across Spanish America from New Spain to Buenos Aires. It challenges some of the familiar ways in which historians have pointed to violence as an inevitable effect of the end of empire, and instead argues that violence became a means to engage in the political process that brought down empire. At the same time, it argues that the role of violence in bringing down the old regime and creating new institutions and habits of rule and protest was at least as important as the role of the public sphere and elections, which historians have recently accented. Indeed, the essay suggests ways in which historians of the public sphere might consider the rituals and languages of violence as part of public conduct, while it was the opening of the public sphere that created a means, or space, to push vindictive patterns of violence into more vindictive directions. Violence was not of a piece, a constant display of carnage. The essay accordingly seeks to illustrate the varieties of uses of political violence and its changes over time, from the first crises of the 1790s to the widespread savagery of the 1810s.
“This England and This Now”: British Cultural and Intellectual Influence in the Spanish American Independence Era
Authors: Racine Karen
Published: July 2010

This essay argues that Great Britain provided the strongest and most relevant contemporary model for the Spanish American independence leaders. Over the course of two eventful decades, 1808 to 1826, over 70 patriot leaders made the long and difficult journey to London to seek political recognition, arms, recruits, and financial backing for their emancipation movements. Countless others remained at home in Spanish America but allied themselves with Britain through their commercial ventures, their ideological affiliation, or their enthusiastic emulation of British institutions, inventions, and practices such as the Lancasterian system of monitorial education, trial by jury, freedom of the press laws, steam engines, and mining technology.

This generation of independence leaders carried on a purposeful correspondence with famous British figures such as abolitionist William Wilberforce, prison reformer Elizabeth Fry, utilitarian philosophers Jeremy Bentham and James Mill, scientist Humphrey Davy, and vaccination proponent Edward Jenner. Their conscious choice to draw closer to Great Britain, rather than Napoleonic France or the early republican United States, reveals much about the kind of cultural model the Spanish American independence leaders admired and their vision of the countries they wanted to create.
Liberal Justice: Judicial Reform in Venezuela’s Courts, 1786–1850
Authors: Zahler Reuben
Published: July 2010

This article addresses two questions regarding the court system in Venezuela, 1780s–1840s, placed within the context of legal reforms throughout Latin America. First, how accurate is the assumption in the historiography that the disruptions of the independence war and the establishment of a republican government prompted Venezuelans to lose confidence in the courts and virtually stop using them? The investigation finds that republican Venezuelans used the courts as much as or more than their colonial counterparts; the number of court cases dropped during periods of intense violence but then quickly rebounded. Second, did the post-independence judicial system effectively integrate liberal legislative reforms into courtroom standards and practices? The study shows that, while republican court reform failed in some measures, it also succeeded in the following four areas: The courts changed the standards of evidence so that they gave clear preference to the empirical observations of the litigants and witnesses rather than their personal reputations; they reorganized court jurisdictions into an unambiguous hierarchy; they increased transparency; and they adopted constitutionally defined civil liberties of defendants in a manner that equates with modern “due process.” The article contextualizes these changes within legal reforms throughout the Atlantic world that, beginning in the eighteenth century, sought to increase state centralization through establishing the dominance of state legislation over other norms of justice (religious law, tradition, and custom) and creating clear bureaucratic hierarchies. Venezuela’s republican government pursued goals previously aspired to by the colonial government, but accelerated them as it promoted legal equality and rational empiricism.
Structure and Photovoltaic Properties of (E)-2-Cyano-3-[4-(diphenylamino)phenyl]acrylic Acid Substituted by tert-Butyl Groups
Authors: Ono Katsuhiko , Yamaguchi Tomoya , Tomura Masaaki
Published: July 2010

(E)-3-{4-[Bis(4-tert-butylphenyl)amino]phenyl}-2-cyanoacrylic acid and its related compounds were synthesized by the Knoevenagel condensation of the corresponding 4-aminobenzaldehydes with cyanoacetic acid. Cyclic voltammetry measurements showed that these organic dyes exhibited reversible oxidation waves. The tert-butyl substituents also decreased molecular stacking in the crystals, thus affecting the photovoltaic properties of the dyes. A solar cell using the tert-butyl-substituted dye exhibited higher performance than that for the analog without tert-butyl group substitution.
Niobium-catalyzed Activation of CF3 Group on Alkene: Synthesis of Substituted Indenes
Authors: Fuchibe Kohei , Atobe Kohei , Fujita Yukari , Mori Keiji , Akiyama Takahiko
Published: July 2010

A CF3 group attached to an alkene functionality was activated by a zero-valent niobium catalyst to generate niobium alkenylcarbenoid species. The niobium carbenoid species then underwent insertion to an internal aromatic C–H σ bond to give indene derivatives in good yields. Isomerization in terms of the alkene geometry was also observed.
Di(hydroxo)porphyrin GeIV Complex/Silica Gel Composite as Visible Light-assisted Radical Generator
Authors: Shiragami Tsutomu , Shiraki Ryuichi , Makise Ryuichi , Matsumoto Jin , Yasuda Masahide
Published: July 2010

A composite of di(hydroxo)germaniumporphyrin with silica gel was used as radical generator which oxidized MeOH to HCHO and hydrocarbons to alcohols in aqueous solution.
Intercontinental hearing assessment – a study in tele-audiology
Authors: Swanepoel De Wet , Koekemoer Dirk , Clark Jackie
Published: July 2010

We evaluated the validity of remote pure tone audiometric testing conducted from North America on subjects in South Africa. Desktop-sharing computer software was used to control an audiometer in Pretoria from Dallas, and PC-based videoconferencing was employed for clinician and subject communication. Thirty adult subjects were assessed, and the pure tone audiometric thresholds (125–8000 Hz) obtained through conventional face-to-face and remote testing were compared. Face-to-face and remote audiometry thresholds differed by 10 dB in only 4% of cases overall. The limits of agreement between the two techniques were −8 and 7 dB with a 90% confidence interval of −5 to 5 dB. The average reaction times to stimulus presentations were similar, within −108 and 121 ms. The average test duration was 21% longer for remote testing (10.4 vs. 8.2 min). There were no clinically significant differences between the results obtained by remote intercontinental audiometric testing and conventional face-to-face audiometry. It may therefore be possible to expand the reach of audiological services into remote underserved regions of the world.
Need and feasibility of telemedicine in non-urban day care centres
Authors: Setia Monika , DelliFraine Jami L
Published: July 2010

There appear to have been no studies of telemedicine in rural day care centres. We have assessed the feasibility of using telemedicine in eight rural day care centres in Pennsylvania, from the day care centres' perspective. The average number of children in these centres was 76 (range 20–150). The centres sent an average of 4.7 children home each month because of illness. Using telephone and face-to-face interviews, we assessed their perceived need for and familiarity with telemedicine, as well as their openness and preparedness for implementing telemedicine. Most day care centres reported a need for telemedicine and were open to learning how to use it. Some centres were concerned about adequate space for the equipment, but overall, the centres felt that their resources were adequate. Telemedicine in rural day care centres appears to be feasible, and would have the potential to save time and money for parents, as well as perhaps improving health care for children in rural areas.
Feasibility of dynamic cardiac ultrasound transmission via mobile phone for basic emergency teleconsultation
Authors: Lim Tae Ho , Choi Hyuk Joong , Kang Bo Seung
Published: July 2010

We assessed the feasibility of using a camcorder mobile phone for teleconsulting about cardiac echocardiography. The diagnostic performance of evaluating left ventricle (LV) systolic function was measured by three emergency medicine physicians. A total of 138 short echocardiography video sequences (from 70 subjects) was selected from previous emergency room ultrasound examinations. The measurement of LV ejection fraction based on the transmitted video displayed on a mobile phone was compared with the original video displayed on the LCD monitor of the ultrasound machine. The image quality was evaluated using the double stimulation impairment scale (DSIS). All observers showed high sensitivity. There was an improvement in specificity with the observer's increasing experience of cardiac ultrasound. Although the image quality of video on the mobile phone was lower than that of the original, a receiver operating characteristic (ROC) analysis indicated that there was no significant difference in diagnostic performance. Immediate basic teleconsulting of echocardiography movies is possible using current commercially-available mobile phone systems.
Work Participation After Acquired Brain Injury: Experiences of Inhibiting
and Facilitating Factors
Authors: Ellingsen Kjersti L. , Aas Randi W.
Published: July 2010

Aim: The aim of this study was to provide new
insight into the factors that affect work participation by those with
cognitive deficits following an acquired brain injury.
Method: The study had a qualitative
exploratory design, with three focus-group interviews used to collect data.
The first group comprised workers with experience of cognitive deficits
after a traumatic brain injury (TBI), anoxic brain damage and stroke, the
second group professionals from specialist levels of social security service
and the third professionals from specialised health care services.
Transcribed interviews were analysed using a conventional approach to
content analysis. Major findings: A broad range
of factors affected work participation. Personal factors, the psychosocial
adaptation process, injury-related consequences as well as factors in the
working environment were found to inhibit work participation. Acceptance of
a different level of functioning and a new role in working life was an
important but time-consuming process. Significant working-environment
barriers were workplace demands, the attitudes of employers and colleagues,
complicated information, excessive bureaucracy, too little practice before
going back to work and physical barriers. Optimism and being determined were
found to be particularly important facilitating personal factors. Important
resources provided by the working environment were social support,
time-related flexibility, relevant tasks and accommodations.
In Their Own Words: Exploring the Phenomenological Field of a Sample of Employed Persons Who Are Deaf in Barbados
Authors: Blackman Stacey , Maynard Donna-Maria
Published: July 2010

An estimated 14,000 persons who are deaf (PWAD) reside in Barbados, many of whom are believed to live below the poverty line. Data on the employment status of PWAD in Barbados is sparse; this research seeks to fill a gap in the literature and inform social policy. Qualitative methodologies were utilized to understand how participation in the labour market influences the lives of PWAD in Barbados. The current research seeks to inquire into the phenomenological field of five persons who are deaf through a multiple case study strategy using focus group interviews. Data were analysed to derive themes common across participants and ecological systems theory was used to understand how PWAD cope in the world of work. The following research questions are addressed in an attempt to capture the unique perspectives of PWAD: (1) What are the experiences of persons who are deaf and employed? and (2) How does having a disability impact the lives of PWAD? The data revealed a relationship between environmental stressors such as attitudinal barriers and discrimination in the workplace and their psychological and behavioural impact in the form of resignation, frustration, isolation and creative coping among PWAD.
Mind-Set Metrics in Market Response Models: An Integrative Approach
Authors: Srinivasan Shuba , Vanhuele Marc , Pauwels Koen
Published: July 2010

Demonstrations of marketing effectiveness currently proceed along two parallel tracks: Quantitative researchers model the direct sales effects of the marketing mix, and advertising and branding experts trace customer mind-set metrics (e.g., awareness, affect). The authors merge the two tracks and analyze the added explanatory value of including customer mind-set metrics in a sales response model that already accounts for short- and long-term effects of advertising, price, distribution, and promotion. Vector autoregressive modeling of the metrics for more than 60 brands of four consumer goods shows that advertising awareness, brand consideration, and brand liking account for almost one-third of explained sales variance. Competitive and own mind-set metrics make a similar contribution. Wear-in times reveal that mind-set metrics can be used as advance warning signals that allow enough time for managerial action before market performance itself is affected. Specific marketing actions affect specific mind-set metrics, with the strongest overall impact for distribution. The findings suggest that modelers should include mind-set metrics in sales response models and branding experts should include competition in their tracking research.
A Comparative Study on Parameter Recovery of Three Approaches to Structural Equation Modeling
Authors: Hwang Heungsun , Malhotra Naresh K. , Kim Youngchan , Tomiuk Marc A. , Hong Sungjin
Published: July 2010

Traditionally, two approaches have been employed for structural equation modeling: covariance structure analysis and partial least squares. A third alternative, generalized structured component analysis, was introduced recently in the psychometric literature. The authors conduct a simulation study to evaluate the relative performance of these three approaches in terms of parameter recovery under different experimental conditions of sample size, data distribution, and model specification. In this study, model specification is the only meaningful condition in differentiating the performance of the three approaches in parameter recovery. Specifically, when the model is correctly specified, covariance structure analysis tends to recover parameters better than the other two approaches. Conversely, when the model is misspecified, generalized structured component analysis tends to recover parameters better. Finally, partial least squares exhibits inferior performance in parameter recovery compared with the other approaches. In particular, this tendency is salient when the model involves cross-loadings. Thus, generalized structured component analysis may be a good alternative to partial least squares for structural equation modeling and is recommended over covariance structure analysis unless correct model specification is ensured.
Teacher Feedback on Writing
Authors: Nurmukhamedov Ulugbek
Published: July 2010

Most writing teachers make use of pens/pencils or computers as a tool to provide their students with written feedback. This article recommends a range of feedback modes for writing teachers, including (1) pen-and-paper, (2) insert comment/track change (giving comments by deleting and adding), and (3) insert audio (recording your voice). Advantages and disadvantages of each feedback mode, based on teacher’s observation as well as students’ preferences, are discussed to help writing teachers consider how different commenting modes might facilitate their feedback process.
Community Literacy and the Rhetoric of Local Publics. Elenore Long (2008)
Authors: Dryer Dylan B
Published: July 2010

Community Literacy and the Rhetoric of Local Publics. Elenore Long (2008) West Lafayette, Indiana: Parlor Press. pp. 316 ISBN: 978–1-60235–056–4
Dever do Estado: metamorfoses da publicização da existência e produção de subjetividades
Authors: Bernardes Anita Guazzelli , Guareschi Neuza Maria de Fátima
Published: July 2010

O objetivo deste artigo é problematizar o público no que tange às transformações que permitem passar de um discurso da saúde pública para um discurso da saúde coletiva. Focalizam-se as rupturas produzidas por um conjunto de práticas que permitem um outro jogo de posições possíveis. Parte-se de uma genealogia do público e do modo como este se transforma quando se articula a novos objetos no campo da saúde formulados pela reforma sanitária: o dever e a cidadania. Para esta análise, utilizam-se os conceitos foucaultianos de verdade, poder e subjetividade. Assim, este artigo discute a forma de configuração do público em termos de experiência de alteridade, experiência de população/pobreza/Estado/epidemias e experiência de saúde/Estado/dever/cidadania.
Oferta e demanda por média complexidade/SUS: relação com atenção básica
Authors: Pires Maria Raquel Gomes Maia , Göttems Leila Bernarda Donato , Martins Cristiano Mundim Ferreira , Guilhem Dirce , Alves Elioenai Dornelles
Published: July 2010

Investiga-se a configuração da oferta e demanda por serviços de média complexidade do Distrito Federal (DF) e municípios de Goiás próximos à Brasília - entorno. Nossa hipótese é de que a organização da oferta dos serviços de atenção básica (AB) do DF e entorno sobrecarrega os serviços de média complexidade (MC), diminuindo a equidade no acesso. Objetivamos analisar a demanda por serviços de MC no DF e sua relação com a AB; quantificar a procedência, problema de saúde, motivo da procura, tempo de deslocamento e procedimentos realizados em pessoas que buscam atendimento nos hospitais do DF; indicar prioridades de mudanças na gestão do SUS para ampliação do acesso. Avaliação por triangulação de métodos, complementaridade das abordagens qualitativa e quantitativa. Estudo da oferta mediante análise dos sistemas de informação do SUS e da demanda por meio de survey com 1.585 usuários de sete hospitais do DF. Ocorre subutilização da oferta de serviços do DF, com duplicidade de ações básicas entre os hospitais e os centros de saúde. Recomenda-se revisão na regionalização e hierarquização dos serviços de saúde do DF e Goiás, bem como investimentos na incorporação de tecnologias para a atenção básica.
Surto de diarréia por rotavírus no município de Bom Jesus (PI)
Authors: Araújo Telma Maria Evangelista de , Dantas Jordânia Miranda , Carvalho Carlos Eduardo Feitosa , Costa Maria Amélia de Oliveira
Published: July 2010

O presente estudo trata de um surto de diarréia, por rotavírus, em um município piauiense, objetivando identificar a etiologia, protocolo para atendimento aos casos. Realizou-se um estudo do tipo série de casos, com 22 crianças atendidas com diarréia aguda em 2006, nas Unidades de Saúde do município de Bom Jesus. Os dados foram coletados mediante realização de entrevistas com formulário aplicado aos responsáveis pelas crianças e observações das fichas de atendimento. A maioria das famílias (59,1%) tinha renda inferior a um salário mínimo, 59,1% utilizavam fossa séptica, 77,3% consumiam água da rede de abastecimento pública e 54,5% não bebiam água filtrada. Com relação à idade, 54,5%, tinham entre um a quatro anos e maioria apresentava estado nutricional adequado. Dentre as 22 amostras de swab retal coletadas para coprocultura, isolaram-se E. coli (69,6%), Klebsiella sp. (95,6%), Proteus Mirabilis (47,8%). Em relação às dezesseis amostras de fezes in natura para pesquisa de rotavírus, 100% foram positivas para o genótipo G2; 93,7%, para o sorotipo P4 e 7,2% não foram tipadas. Conclui-se que o monitoramento contínuo dos genótipos circulantes na população é fundamental, o que implica a necessidade de capacitação dos profissionais da área da saúde para o enfrentamento das diarréias.
Papilomavírus humano e saúde pública: prevenção ao carcinoma de cérvice uterina
Authors: Reis Angela Adamski da Silva , Monteiro Caroline Dias , Paula Leonardo Barcelos de , Santos Rodrigo da Silva , Saddi Vera Aparecida , Cruz Aparecido Divino da
Published: July 2010

O objetivo do presente estudo foi avaliar a aplicabilidade de uma cartilha educativa, que abordou informações de interesse da população para a promoção e prevenção de infecções e neoplasias ocasionadas pelo papilomavírus humano (HPV). O estudo foi realizado em duas etapas. Na primeira, a cartilha educativa foi aplicada a duzentos voluntários, na cidade de Goiânia (GO), de ambos os sexos, com nível de escolaridade variando do ensino médio ao superior. A aplicabilidade da cartilha foi avaliada sem a necessidade de conhecimento prévio dos participantes sobre o HPV. Os participantes responderam a um questionário para a avaliação da cartilha. Na segunda etapa, foi feita uma análise detalhada dos dados, e a cartilha mostrou-se aplicável. Posteriormente, o material didático foi publicado e 2.000 exemplares foram distribuídos gratuitamente em um evento de ação social realizado pela Pontifícia Universidade Católica de Goiás, na cidade de Goiânia. No evento, a cartilha despertou o interesse dos participantes por informações adicionais e propiciou aos voluntários a oportunidade de participar de um estudo para a investigação da presença de HPV como microbiota genital. A cartilha demonstrou-se aplicável e atingiu o seu objetivo de informação e prevenção. É necessário promover campanhas de conscientização da população sobre o HPV e sua relação com as neoplasias malignas.
Doenças infecciosas emergentes e a emergência das doenças: uma revisão conceitual e novas questões
Authors: Grisotti Márcia
Published: July 2010

Contrariamente às expectativas de erradicação das doenças infecciosas, constata-se a emergência, mundial, de doenças desconhecidas para a ciência ou consideradas erradicadas ou sob o controle dos serviços de vigilância epidemiológica. Neste artigo, pretende-se caracterizar o debate sobre as doenças infecciosas emergentes e analisar o conceito difundido pelas publicações dos Centros de Controle e Prevenção de Doenças (CDC) dos Estados Unidos e pelas contribuições das ciências humanas. A revisão da literatura nacional e internacional sobre a temática aponta as ambiguidades na definição das categorias "doença nova" e "doença emergente" e as diferenças entre o conceito de doenças infecciosas emergentes e o estudo da emergência das doenças. Enquanto o primeiro inclui o estudo de infecções específicas e foca a análise no organismo, no paciente e na população humana, o segundo, menos trabalhado, envolve as dimensões epistemológicas do conhecimento médico e da ecologia das doenças infecciosas emergentes, no nível sistêmico (no ecossistema e populações de parasitos e hospedeiros, quaisquer que sejam as espécies, e no comportamento sociocultural), e demanda a integração de várias disciplinas acadêmicas.
As bases filosóficas e históricas do cuidado e a convocação de parceiros sexuais em HIV/aids como forma de cuidar
Authors: Luz Priscilla Mesquita , Miranda Karla Correa Lima
Published: July 2010

Trata-se de um artigo no qual discutimos o conceito do cuidado na perspectiva da filosofia, articulando-o com a prática do enfermeiro, que se apropria desse conceito para fundamentar sua prática profissional. Defendemos que uma maneira de cuidar com ética pode ser realizada na convocação dos parceiros de portadores do HIV/aids. Acreditamos que esse momento é de grande delicadeza e merece ser discutido e institucionalizado pela equipe interdisciplinar que realiza atendimento especializado em HIV/aids.
HIV/aids e meia idade: avaliação do conhecimento de indivíduos da região do Vale do Sinos (RS), Brasil
Authors: Lazzarotto Alexandre , Reichert Marina Tonin , Venker Carolina , Kramer Andréa Sebben , Sprinz Eduardo
Published: July 2010

O objetivo deste estudo é avaliar o nível de conhecimento sobre HIV/aids nos indivíduos de meia idade, participantes de grupos de convivência do Vale do Sinos (RS). O estudo caracterizou-se como transversal, obtendo-se uma amostra de 168 indivíduos, sendo 9,5% homens e 90,5% mulheres, na faixa etária entre 40 e 59 anos. Utilizou-se como instrumento um questionário composto pelos domínios "conceito", "transmissão", "vulnerabilidade", "prevenção" e "tratamento". O ensino fundamental caracterizou 61,3% da escolaridade dos participantes e a renda mensal situou-se entre um e três salários mínimos para 45,2%. No domínio "conceito", 65,2% desconheciam a fase assintomática da infecção e 34,5% apontaram o mosquito como transmissor da aids, no domínio "transmissão". Nos domínios "prevenção" e "vulnerabilidade", 19,5% desconheciam a existência do preservativo feminino e 29,2% acreditaram que a doença é característica de grupos específicos. Quanto ao "tratamento", 12,5% ignoraram a sua existência. De acordo com os achados, os indivíduos da meia idade participantes de grupos de convivência do Vale do Sinos tinham conceitos errôneos sobre HIV/aids que poderiam aumentar o risco à infecção. Sendo assim, é necessário proporcionar programas de saúde pública direcionados para esta população para prevenir ou diminuir o risco de transmissão do HIV.
Perfil da utilização de antimicrobianos em um hospital privado
Authors: Rodrigues Fernanda d'Athayde , Bertoldi Andréa Dâmaso
Published: July 2010

Os antimicrobianos são um dos grupos de medicamentos mais prescritos nos hospitais e que causam uma grande preocupação quanto à adequação do seu uso. Descreveu-se o perfil dos antimicrobianos utilizados num hospital privado do interior do Rio Grande do Sul, analisando a quantidade consumida de cada antimicrobiano. Foram analisadas todas as prescrições de pacientes que utilizaram antimicrobianos enquanto internados no período de março a junho de 2006. O consumo dos antimicrobianos foi expresso em dose diária definida (DDD) por 100 leitos-dia. As análises de utilização de antimicrobianos foram feitas em geral e estratificadas por grupos de idade e por clínicas médicas. Durante o período em estudo, a prevalência do uso de antimicrobianos foi de 52,4% (IC95% 49,2-55,7). As cefalosporinas foram as mais utilizadas (43,4%), seguidas das penicilinas (16,3%), fluorquinolonas (13,0%) e aminoglicosídeos (9,7%). O alto consumo de antimicrobianos durante o período em estudo é resultado da ausência de uma política de controle dos medicamentos prescritos no hospital e da falta de protocolos de uso de antimicrobianos. Para que haja um controle do consumo de antimicrobianos, os hospitais devem assumir uma política de vigilância sobre as prescrições deste grupo de medicamentos.
Comida de hospital: percepções de pacientes em um hospital público com proposta de atendimento humanizado
Authors: Demário Renata Léia , Sousa Anete Araújo de , Salles Raquel Kuerten de
Published: July 2010

O objetivo do estudo foi conhecer a percepção de pacientes sobre a alimentação em um hospital de referência para a Política Nacional de Humanização. Trata-se de uma pesquisa qualitativa para a qual foram realizadas 26 entrevistas em profundidade, semiestruturadas, aplicadas a pacientes adultos e idosos internados há quatro ou mais dias em clínicas médicas. O estudo revelou que os pacientes aprovam o bom atendimento e consideram o cuidado humanizado da equipe de saúde; percebem a alimentação como parte das regras da instituição e a relacionam com a doença e com a recuperação da saúde; consideram que a presença de acompanhante, o ambiente hospitalar, medicamentos e aspectos sensoriais influenciam a aceitação da alimentação. O horário das refeições foi considerado modelo a ser seguido. Os pacientes demonstraram dificuldade em opinar sobre mudanças na alimentação ou sobre suas rotinas. A refeição é um momento de interação entre os próprios pacientes, acompanhantes e equipe de saúde. O estudo concluiu que comer bem no hospital depende do que os pacientes podem ou não comer devido a sua doença, revelando que, possivelmente, não haja identificação da alimentação hospitalar com a sua história alimentar, preferências ou hábitos adquiridos ao longo de sua vida.
Estimativa da ingestão de ferro e vitamina C em adolescentes no ciclo menstrual
Authors: Azevedo Luciana , Martino Hércia Stampini Duarte , Carvalho Flávia Giolo , Rezende Marcelo Lacerda
Published: July 2010

Avaliou-se o nível de ingestão de ferro e vitamina C, em adolescente nas três fases do ciclo menstrual. O consumo alimentar de trinta adolescentes foi analisado pela técnica de registro, durante as fases pré-menstrual, menstrual e pós-menstrual, com a análise de dois registros por indivíduo, em cada fase. A prevalência da ingestão foi feita considerando seis registros alimentares de cada adolescente. Os padrões utilizados como referência foram as Dietary Reference Intakes (DRI)- Estimated Average Requirement (EAR) do Institute of Medicine (IOM), utilizando as abordagens probabilística e ponto de corte, para o ferro e vitamina C, respectivamente, além dos valores do Recommended Dietary Allowances (National Research Council). As adolescentes tinham 15,5 ± 1,7 anos, com idade da menarca de 11,8 ± 1,1 anos e ginecológica de 3,6 ± 1,9 anos. O consumo mediano de ferro foi 10,6 mg/dia e de vitamina C, 77,6 mg/dia. Observou-se pelas DRI-EAR uma prevalência de inadequação para ferro de 22,6% e de vitamina C 34% e pelo National Research Council, de 63,3% e 20%, respectivamente. Apesar da divergência entre os padrões, os resultados apontam risco nutricional para a população estudada. Sugere-se a realização de mais estudos dietéticos, utilizando as DRI-EAR, favorecendo diagnósticos nutricionais com subsequente medidas de intervenção.
O consumo de sal e alimentos ricos em sódio pode influenciar na pressão arterial das crianças?
Authors: Costa Fabiana Pires , Machado Sandra Helena
Published: July 2010

O objetivo do estudo foi verificar o consumo de sal e alimentos ricos em sódio e a pressão arterial de escolares de uma escola da rede privada e de outra da rede pública, em Barra do Ribeiro, no Estado do Rio Grande do Sul. Trata-se de um estudo transversal. Foram realizadas medidas antropométricas e de pressão arterial, seguindo métodos padronizados. Os responsáveis pelos escolares responderam questionário com questões referentes às condições socioeconômicas, fatores de risco familiares para hipertensão e hábitos alimentares do escolar (questionário de frequência). Foram avaliados 81 escolares, 42 (51,90%) com idade média 8,3 ± 3,2 anos. Dentre os escolares, 45 (55,60%) eram da rede privada e 36 (44,40%), da rede pública. Foram encontrados dois escolares com hipertensão arterial sistólica e ambos eram da escola da rede pública (p= 0,194); no entanto, o achado pode ter sido casual. Fato seme-lhante pode ter ocorrido com os quatro escolares com hipertensão arterial diastólica; desses, três eram da rede privada. Porém, não houve diferença significativa entre os grupos (p= 0,625). O consumo médio de sal foi de 7,66g (3098,81 mg da Na ou 133,86 mEq). O alimento rico em sódio correlacionado a níveis elevados de pressão arterial sistólica foi o enlatado. Constatamos que, quanto maior o consumo de sal, maior a pressão arterial sistólica. Nessa população, o consumo médio de sal encontra-se acima do recomendado pela literatura atualmente.
Assistência ao parto em São Leopoldo (RS): um estudo de base populacional
Authors: Schreiner Margareth , Costa Juvenal Soares Dias da , Olinto Maria Teresa Anselmo , Meneghel Stela Nazareth
Published: July 2010

O objetivo foi descrever as condições estruturais de assistência ao parto, estabelecer o percentual de cesarianas, as características de atenção ao parto e verificar a associação do tipo e presença de pediatra no parto com variáveis socioeconômicas. Foi realizado um estudo transversal de base populacional, incluindo 840 mulheres de 20 a 49 anos residentes na zona urbana de São Leopoldo (RS). Entre as 840 mulheres entrevistadas na pesquisa, 36 (4,3%) tiveram filho nos doze meses anteriores à realização da pesquisa. O percentual de mulheres que tiveram parto cesáreo foi de 52,8%. Quanto à realização do parto, 97,2% foram feitos por médico e 72,2% das mulheres referiram a presença de pediatra no momento do parto. O financiamento do parto ocorreu em 68,6% dos casos pelo SUS, 20% foram financiados pelos planos privados de saúde e 11,4% foram pagos de forma particular. O parto cesáreo foi menos frequente entre as mulheres de nível socioeconômico mais baixo (RP 0,42; IC95% 0,20-0,86). Verificou-se que 30,4% das mulheres que receberam cuidados pelo SUS não manifestaram presença de pediatra no momento do parto. Foram encontradas evidências mostrando a associação de tipo de parto e variáveis que expressam classe econômica, sendo possível afirmar que a remuneração interfere no tipo de parto.
Análise das diferentes manifestações de cultura quanto aos cuidados em saúde bucal em moradores de região rural ribeirinha em Rondônia, Brasil
Authors: Silva Ricardo Henrique Alves da , Castro Roberta Francisca Martins de , Bastos José Roberto de Magalhães , Camargo Luis Marcelo de Aranha
Published: July 2010

Esse estudo avaliou as práticas populares nos cuidados com a saúde bucal decorrentes de patologias como a cárie dentária, doença periodontal, entre outras, no distrito de Tabajara, Estado de Rondônia, Brasil, tendo em vista que o folclore é muito presente na cultura popular, sendo considerado um fato social e cultural, ao mesmo tempo atingindo e influenciando os cuidados quanto à saúde bucal. Realizou-se um estudo quanti-qualitativo, sendo a amostra composta por catorze mulheres e seis homens. O instrumento de pesquisa compreendeu um questionário, com questões objetivas e subjetivas, sendo os dados analisados sob a forma descritiva. Observou-se um baixo nível de conhecimento em aspectos relacionados à saúde bucal nas pessoas analisadas, bem como uma variedade de métodos alternativos para "tratamento" e "prevenção" de afecções bucais. Concluiu-se que há necessidade de um conhecimento mais aprofundado da população-alvo dos programas em saúde, haja vista que introduzem, quase sempre, mudanças culturais, e para que sejam construtivos e não desintegradores, devem levar em conta a estrutura sociocultural da comunidade onde serão executados.