bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abordajes de la educación sexual en universidades públicas costarricenses: Un estudio exploratorio
Authors: Preinfalk-Fernández María Luisa 
Published: September 2016

This research paper aims to show the panorama and scope of the current existing sex education practices carried out by the Costa Rican public universities. It analyzes different initiatives, its theoretical approaches that guide the actions, their purposes and other relevant aspects. The analysis includes secondary information as well as the point of view of students and university staff, as inputs for decision-making aimed at improving the overall education of young people. The findings take part of an exploratory research based on qualitative and quantitative methodologies based on gender and constructionism perspective. The information was gathered via the application of a questionnaire to a specific uneven stratified cluster groups, composed by 766 enrolled undergraduate students since first semester 2011 at Universidad Nacional de Costa Rica. The statistical margin of error was 1.5% and the confidence level of 95%. In addition, two focus groups with students and depth interviews with 16 persons were made. Data were tabulated with CSPRO software and analyzed using R software. The findings suggest that Costa Rican universities recognize the importance of sex education as an essential part of overall development of students. Most of the initiatives are institutionalized; however, the lack of guidelines or policies on the subject, in most institutions, affects quality, consolidation and expansion of services. The need to strengthen and expand training activities on sexuality was identified as well. The students have a high opinion about the services offered, but few of them use these services, because they are perceived as less accessible and friendly. This paper concludes that it is a priority to maintain and strengthen existing initiatives on sexual education, so that they can effectively satisfy the needs of youth, with timely interventions and quality to enjoy a healthy and safe sexuality free from violence.
Die Vergabe von Rettungsdienstleistungsaufträgen und -konzessionen nach neuem Vergaberecht
Authors: Jaeger Wolfgang 
Published: September 2016

Zusammenfassung
Keine der Vorschriften des neuen deutschen Vergaberechts ist in ihrer Auslegung und in ihrer Wirksamkeit so umstritten wie § 107 Abs. 1 Nr. 4 GWB. Mit diesem Beitrag soll versucht werden, Klarheit in diesem Streit zu gewinnen.
“Minimum Advertised Price” policies and the dividing line between price and non-price restraints – An analysis under U.S. antitrust and EU competition law in view of recent UK decisions
Authors: Schlimpert Denis 
Published: September 2016

Abstract
“Minimum Advertised Price” (MAP) policies prohibit retailers from advertising prices below a certain amount fixed by their suppliers. Legally, they leave the final decision on resale pricing to the retailers. However, given that, especially in the context of online sales, the communication of discounts through advertising is one of the retailers’ “key incentives” for price competition, MAP policies raise specific issues as to where the dividing line between (unlawful) price and (lawful) non-price restraints in vertical agreements is drawn. In this respect, the following contribution analyses MAP policies both under U.S. antitrust and EU competition law. With regard to the latter, it will particularly focus on two recent UK decisions.
Lietuvių katalikų jaunimo sąjungos „Pavasaris“ ženkleliai: datavimas, gamintojai, tiražai ir simboliai
Authors: Remecas Eduardas 
Published: September 2016

„Pavasario“ sąjunga, o nuo 1933 m. federacija, buvo didžiausia narių skaičiumi organizacija Lietuvoje 1919–1940 m. Per visą savo gyvavimo laiką organizacija triskart keitė savo narių ženklelių išvaizdą – 1920, 1925 ir 1935 m. Trečią kartą buvo išleisti skirtingi ženkleliai vyrams, mergaitėms ir jauniesiems nariams. Be narių ženklelių, organizacija buvo išleidusi ir proginius ženklelius: pirmosios (1924 m.) ir antrosios (1927 m.) pavasarininkų dainų šventės choristams, dirigentams bei chorvedžiams ir 1938 m. surengto jubiliejinio 25 metų pavasarininkų kongreso dalyviams. Taip pat „Pavasario“ federacija 1934 m. pagamino specialius ženklelius uoliausiems žurnalo „Pavasaris“ platintojams. „Pavasario“ sąjunga dalyvavo ir sportinėje veikloje. Ji kartu su kitomis katalikiškomis organizacijomis buvo įkūrusi sporto organizaciją Lietuvos gimnastikos ir sporto federacija (LGSF). Savo ženklelį organizacija įsigijo 1929 m.
Missed Opportunities for Influenza Vaccination Among Hospitalized Children With Influenza at a Tertiary Care Facility
Authors: Rao Suchitra , Williams Joshua T.B. , Torok Michelle R. , Cunningham Maureen A. , Glodè Mary P. , Wilson Karen M 
Published: September 2016

OBJECTIVES:
To identify the extent and characteristics of missed opportunities for influenza vaccination among children hospitalized with influenza at a tertiary children’s hospital.

METHODS:
We conducted a retrospective cohort study of hospitalized patients with polymerase chain reaction–confirmed influenza admitted to Children’s Hospital Colorado from 2010 to 2014. We reviewed medical records for vaccination status and previous visits. The primary outcome was the proportion of underimmunized patients hospitalized with influenza with at least 1 missed opportunity visit (visit before influenza diagnosis in which an eligible patient did not receive the influenza vaccine). The relationship between sociodemographic characteristics and the primary outcome were examined using χ2 tests and nonparametric tests, and variables with P &lt; .2 were entered into a multivariate logistic regression model.

RESULTS:
Among 322 patients hospitalized with influenza, 199 (61%) were undervaccinated; 83 of 199 (42%) had at least 1 missed opportunity for influenza vaccination. Multivariate analysis demonstrated that high-risk status (adjusted odds ratio 6.9, 95% confidence interval 3.8–12.4) was associated with increased odds of having a missed opportunity visit. Most missed opportunity visits were to subspecialty clinics (42%), and most visits (71%) occurred from September to November.

CONCLUSIONS:
More than 40% of hospitalizations for influenza in children are associated with at least 1 missed opportunity visit at a tertiary center. Our findings highlight the potential role of tertiary care institutions in increasing influenza vaccination rates among children.
Missed Opportunity: Why Parents Refuse Influenza Vaccination for Their Hospitalized Children
Authors: Cameron Melissa A. , Bigos David , Festa Christopher , Topol Howard , Rhee Kyung E. 
Published: September 2016

BACKGROUND AND OBJECTIVES:
Hospitals are required to screen and administer the influenza vaccine to all admitted children unless contraindicated or refused by parents, yet vaccination rates remain low. Our goal was to examine reasons for refusal among pediatric patients admitted during influenza season.

METHODS:
All children age 6 months to 18 years admitted to 2 network community hospitals from October 1, 2013 to March 31, 2014, without contraindications, were offered influenza vaccination prior to discharge. Parents who refused vaccination were asked their reason for refusal. Chi-square tests and logistic regression were used to determine factors associated with refusing the vaccine in the inpatient setting.

RESULTS:
Three hundred twenty-five of 786 unique patients admitted during influenza season were eligible for vaccination. Of these, 49.8% refused. Parents of females, whites, and those with private insurance were more likely to refuse vaccination. Patients whose immunization status was otherwise up to date were more likely to accept (Odds Ratio 2.39, 95% Confidence Interval 1.05-5.41). Commonly cited reasons for refusal were: preference to have vaccination by the primary care provider (24.1%), concern for side effects (16.1%), not wanting vaccination (13%), doubt in efficacy (8%), concern that the child was already sick (6.8%), no prior influenza vaccination (6.7%) and feeling that it was not needed (5.6%).

CONCLUSIONS:
Hospitalization during influenza season provides an opportunity for health-care providers to educate families about influenza and vaccinate patients if appropriate. However, nearly half of parents of eligible children declined vaccination. More study is required to determine strategies that can increase influenza vaccination acceptance.
Pediatric Procedural Sedation Using Dexmedetomidine: A Report From the Pediatric Sedation Research Consortium
Authors: Sulton Carmen , McCracken Courtney , Simon Harold K. , Hebbar Kiran , Reynolds Jason , Cravero Joseph , Mallory Michael , Kamat Pradip 
Published: September 2016

OBJECTIVES:
Dexmedetomidine (DEX) is widely used in pediatric procedural sedation (PPS) by a variety of pediatric subspecialists. The objective of our study was to describe the overall rates of adverse events and serious adverse events (SAEs) when DEX is used by various pediatric subspecialists.

METHODS:
Patients from the Pediatric Sedation Research Consortium (PSRC) database were retrospectively reviewed and children that received DEX as their primary sedation agent for elective PPS were identified. Demographic and clinical data, provider subspecialty, and sedation-related complications were abstracted. SAEs were defined as death, cardiac arrest, upper airway obstruction, laryngospasm, emergent airway intervention, unplanned hospital admission/increased level of care, aspiration, or emergency anesthesia consult. Event rates and 95% confidence intervals (CIs) were calculated.

RESULTS:
During the study period, 13 072 children were sedated using DEX, accounting for 5.3% of all sedation cases entered into the PSRC. Of the sedated patients, 73% were American Society of Anesthesiologists Physical Status class 1 or 2. The pediatric providers responsible for patients sedated with DEX were anesthesiologists (35%), intensivists (34%), emergency medicine physicians (12.7%), hospitalists (1.1%), and others (17%). The overall AE rate was 466/13 072 (3.6%, 95% CI 3.3% to 3.9%). The overall SAE rate was 45/13 072 (0.34%, 95% CI 0.19% to 0.037%). Airway obstruction was the most common SAE: 35/13 072 (0.27%, 95% CI 0.19% to 0.37%). Sedations were successful in 99.7% of cases.

CONCLUSIONS:
We report the largest series of PPS using DEX outside the operating room. Within the PSRC, PPS performed using DEX has a very high success rate and is unlikely to yield a high rate of SAEs.
Pain Assessment and Management After a Knowledge Translation Booster Intervention
Authors: Stevens Bonnie J. , Yamada Janet , Promislow Sara , Barwick Melanie , Pinard Marie ,   on behalf of the CIHR Team in Children’s Pain
Published: September 2016

BACKGROUND AND OBJECTIVES:
Inadequate pain treatment leaves hospitalized children vulnerable to immediate and long-term sequelae. A multidimensional knowledge translation intervention (ie, the Evidence-based Practice for Improving Quality [EPIQ]) improved pain assessment, management, and intensity outcomes in 16 units at 8 Canadian pediatric hospitals. The sustained effectiveness of EPIQ over time is unknown, however. The goals of this study were to determine the following: (1) sustainability of the impact of EPIQ on pain assessment, management, and intensity outcomes 12, 24, and 36 months after EPIQ; (2) effectiveness of a pain practice change booster (Booster) intervention to sustain EPIQ outcomes over time; and (3) influence of context on sustainability.

METHODS:
A prospective, repeated measures, cluster randomized controlled trial was undertaken in the 16 EPIQ units, 12 months after EPIQ completion, to determine the effectiveness of a practice change booster (Booster) to sustain EPIQ outcomes. Generalized estimating equation models examined outcomes controlling for child and unit contextual factors.

RESULTS:
Outcomes achieved during EPIQ were sustained in the use of any pain assessment measure (P = .01) and a validated pain assessment measure in the EPIQ units (P = .02) up to 36 months after EPIQ. Statistically significant improvements in pain management practices persisted in EPIQ units; results varied across time. There were no significant differences in outcomes after implementation of the Booster between the Booster and Nonbooster groups.

CONCLUSIONS:
Improved pain assessment and management practices were sustained after EPIQ; however, the Booster did not seem to provide additional impact.
Evaluation of management of tracheal stenosis: our experience of 25 patients
Authors: Swami Himanshu , M. Bharath , G. Chaitra B. 
Published: September 2016

<p class="abstract"><strong>Background:</strong> This study was conducted at a tertiary referral centre. Tracheal stenosis is a relatively rare complication, the chief etiologies being prolonged intubation and trauma. The management is difficult and requires variety of skill based procedures which can be either endoscopic or open technique. Our objective was to determine factors for deciding on the type of surgery required for patients with tracheal stenosis.</p><p class="abstract"><strong>Methods:</strong> 25 consecutive patients of tracheal stenosis referred to our department were selected after confirming the diagnosis by fibre optic examination and CT scan. </p><p class="abstract"><strong>Results:</strong> All the patients were managed using various techniques. Long segment and circumfrential stenosis underwent resection and anastamosis. Other cases were managed by either endoscopic techniques or tracheoplasty.</p><strong>Conclusions:</strong> The main factors for deciding the type of intervention are the length of stenotic segment and presence circumferential stenosis.
A comparative study between i-gel and classical laryngeal mask airway in elective surgery under general anaesthesia
Authors: Engineer Smita R. , Jansari Digant B. , Saxena Saumya , Patel Rahul D. 
Published: September 2016

<p class="abstract"><strong>Background:</strong> Supraglottic airway devices have been widely used as an alternative to tracheal intubation during general anesthesia both in adults and children. This study was carried out to compare classical laryngeal mask airway (LMA) and i-gel, regarding ease of insertion, adequate placement of device, ability to maintain ETCO<sub>2</sub> and SPO<sub>2</sub>, perioperative hemodynamic parameters and intra operative and postoperative complication.</p><p class="abstract"><strong>Methods:</strong> This prospective, randomized clinical study was done on 100 patients of either sex, age between 5 to 60 years, ASA grade I-III who underwent different surgical procedures under general anesthesia in supine position. After giving premedication, induction of anesthesia was done with inj. Propofol 2-3 mg/kg and inj. Succnylcoline 1.5-2 mg/kg. In “sniffing air” position, airway was secured with either LMA or i-gel. An effective placement of device was checked by a square wave capnography, normal chest expansion, SPO<sub>2</sub> &gt;95%, and absence of audible leak. Patients were observed for time and ease of insertion, number of attempts, perioperative hemodynamic changes and complications.</p><p><strong>Results:</strong> No statistically significant difference was reported between both the groups, regarding heart rate, BP, SPO<sub>2</sub> and ETCO<sub>2</sub>. Duration of insertion was more in group LMA. Insertion was easy and was possible in first attempt in 88% of patients without much manipulation in group i-gel.</p><p><strong>Conclusions:</strong> I-gel is a better alternative supraglottic airway device than LMA in view of ease of insertion with minimal manipulations and minimal complications. Hemodynamic parameters, SPO<sub>2</sub> and ETCO<sub>2 </sub>were maintained in both the groups. </p>
Beneficios de la suplementación con L-carnitina en pacientes pediátricos hemodializados. Reporte de casos
Authors: Martínez-Morales JA , Raya Jiménez P , Monroy Torres R , Daza Benítez L 
Published: September 2016

INTRODUCCIÓN: la mayoría de los pacientes pediátricos con insuficiente renal crónica desarrollan desnutrición y anemia. Para tratar esta última se administra eritropoyetina como tratamiento de elección, pero no se logra recuperar la situación nutricional del paciente, por lo que la L-carnitina es una alternativa que mejora el estado nutricional y, al mismo tiempo, disminuye la frecuencia de anemia.OBJETIVO: mejorar los parámetros bioquímicos y antropométricos después de la suplementación con L carnitina en pacientes pediátricos. MATERIAL Y MÉTODOS: se realizó un estudio analítico y longitudinal, de una serie de casos en 25 participantes, ambos sexos, de 3 a 16 años de edad, con insuficiencia renal crónica y en tratamiento de hemodiálisis. Se les suministró L-carnitina por vía intravenosa (50 mg/ kg/sesión) 30 minutos antes de terminar las sesiones de hemodiálisis, durante tres meses (36 sesiones). Antes y después de la maniobra se compararon algunos indicadores bioquímicos (hemoglobina, albumina, colesterol, triglicéridos, creatinina) y antropométricos. Se realizó una comparación con T de Student y por proporciones (casos que mejoraron después de maniobra y la reducción del riesgo absoluto).RESULTADOS: la edad promedio de los casos fue 12.4 años (rango de 3 a 16 años). Al comparar los casos con T de Student se obtuvo una mejora significativa con la suplementación para el peso seco (p=0.004); índice de masa corporal (p=0.04); albúmina (p=0.02) y colesterol (p=0.003). Con el cálculo por proporciones de los casos que mejoraron con la maniobra se observó la reducción del riesgo atribuible en un rango de 12 a 68% de todas las variables de interés (hemoglobina, albúmina, colesterol, triglicéridos, peso seco e índice de masa corporal).CONCLUSIONES: la suplementación con L-carnitina intravenosa (50 mg/kg/sesión) 30 minutos antes de terminar cada sesión de hemodiálisis, durante tres meses, permitió una mejora en el porcentaje de los casos de estudio para peso seco, índice de masa corporal, albúmina, hemoglobina, colesterol y triglicéridos, con una reducción del riesgo atribuible de 12 a 68% de los casos.
Relación cintura/estatura, una herramienta útil para detectar riesgos cardiovascular y metabólico en niños
Authors: Padrón Martínez MM , Perea Martínez A , López-Navarrete GE 
Published: September 2016

La Organización Mundial de Salud reporta que las enfermedades cardiovasculares son las principales causas de muerte en todo el mundo; cada año mueren más personas por ellas que por cualquier otra causa y más de tres cuartas partes de esas defunciones ocurren en los países de ingresos bajos y medios; sin embargo, la mayoría de dichas enfermedades puede prevenirse actuando sobre factores de riesgo como: consumo de tabaco, dietas no saludables, obesidad, inactividad física o el consumo aumentado de alcohol; esto idealmente con estrategias que abarquen a toda la población. En personas con enfermedades cardiovasculares o con alto riesgo cardiovascular debido a presencia de uno o más factores como hipertensión arterial, diabetes, hiperlipidemia o enfermedad cardiovascular confirmada, son fundamentales la detección precoz y el tratamiento temprano, por medio de servicios de orientación o administración de fármacos, según corresponda.
Territorialidade e Reexistência indígena na Fronteira Amazônica:
Authors: Almeida Juliana , Athayde Simone , Castorino Adriano , Seluchinesk Rosane , Albernaz Rosane 
Published: September 2016

Neste artigo são apresentados os resultados obtidos pelo projeto “Nós somos os outros: Identidade e Território Rikbaktsa”, no âmbito do Curso de Especialização “Gestão Colaborativa de Sistemas Socioecológicos na Amazônia Brasileira”, cujo objetivo foi realizar um exercício de avaliação da resiliência socioecológica do povo indígena Rikbaktsa, da Terra Indígena Escondido (Cotriguaçu, Mato Grosso). A metodologia utilizada consiste em uma adaptação da ferramenta elaborada pelo grupo “Resilience Alliance” e orientou o trabalho exploratório de pesquisa colaborativa sobre os temas: reconfiguração territorial pós-contato; formas de uso e ocupação da TI Escondido; e desenvolvimento de metodologias colaborativas junto a grupos indígenas. Foram identificados atributos importantes para resiliência do “Sistema Rikbaktsa” e fatores que ameaçam os processos de reterritorialização e resistência nos quais os Rikbaktsa estão historicamente engajados. São também apresentadas reflexões e recomendações acerca da aplicação dos conceitos e métodos relacionados Ã avaliação de resiliência e princípios de gestão colaborativa.
DIMENSÃO ECONÔMICA DOS INDICADORES DE SUSTENTABILIDADE PARA CAMPOS PETROLÍFEROS EM TERRA:
Authors: Nicodemo Leonardo Pivotto , Turíbio e Silva Nicodemo Sinara Cybelle , Ibrahim Aloufa Magdi Ahmed 
Published: September 2016

Partindo da constatação de que a sustentabilidade pode ser mensurada através de indicadores pautados em bases científicas que lhes confere metodologia segura de avaliação e que, todavia, os critérios para seleção destes indicadores são, em linhas gerais baseadas na subjetividade daquele que os seleciona, este artigo tem por objetivo propor uma metodologia baseada na percepção socioambiental de atores sociais integrada Ã metodologia Delphi para a seleção de indicadores de sustentabilidade. Para tanto, realizou-se a coleta e cruzamento dos dados oriundos da população com os posicionamentos dos especialistas a fim de partir da compreensão do espaço investigado e dirimir opiniões conflitantes. Considerou-se que a percepção socioambiental isoladamente apresentou fragilidades para selecionar indicadores que demandaram compreensão técnica; entretanto, o uso da percepção integrada Ã metodologia Delphi foi eficaz para identificar os indicadores fundamentais para avaliação do estado da sustentabilidade de campos petrolíferos.
Construção da Governança Ambiental na RDS Igapó-Açu (Amazonas, Brasil):
Authors: Rezende Marília Gabriela , Fraxe Therezinha de Jesus Pinto , Witkoski Antonio Carlos 
Published: September 2016

O objetivo principal desta pesquisa foi analisar a governança ambiental na Reserva de Desenvolvimento Sustentável Igapó-Açu, localizada nos municípios de Manicoré, Borba e Beruri. A escolha da área de estudo deve-se ao fato de a RDS Igapó-Açu ser a única Unidade de Conservação (UC) do Amazonas atravessada por uma rodovia federal, o que lhe confere um ordenamento territorial específico e reconfigura os elementos constituintes da governança nesse território. Para atingir os objetivos foram utilizados diferentes instrumentos metodológicos como formulários e entrevistas abertas. Os dados foram sistematizados no Programa Excel e posteriormente representados em forma de organogramas, produzidos por meio do Programa Websphere Analysis. Os resultados da pesquisa indicam que a tessitura da governança ambiental da RDS Igapó-Açu envolve múltiplos fatores, entretanto, a centralidade da rede de articulação política é ocupada pelo Conselho Gestor, que conduz Ã materialização da governabilidade da UC e de seus desdobramentos.