bluuebunny/crossref_metadata_2025_split huggingface dataset:
ESTRUTURA ORGANIZACIONAL: ESTUDO DE UMA OPERADORA DE PLANO DE SAÚDE, MODALIDADE COOPERATIVA MÉDICA
Authors: Do Carmo Eduardo , Loebel Eduardo 
Published: May 2017

Esta pesquisa foi desenvolvida com o objetivo de descrever a estrutura organizacional de uma operadora de saúde suplementar, a luz das configurações estruturais propostas por Mintzberg (2003) e sua influência sobre o desempenho. O método adotado foi o estudo de caso de uma Unimed de pequeno porte (chamada de OPX), com sede em uma cidade do interior de São Paulo. A coleta de dados ocorreu por meio da análise de documentos, observação direta e entrevistas semiestruturadas com seus principais gestores e a análise e interpretação dos dados deu-se a partir da análise de conteúdo, de Bardin (2010). Os resultados evidenciaram que a OPX é uma burocracia profissional marcada pelo alto nível de centralização das decisões nas mãos do presidente em detrimento da participação coletiva; autonomia reduzida e limitada dos gestores e demais funcionários da organização; alto nível de autonomia médica, apesar da existência de controles gerenciais de custos; baixo nível de especialização dos funcionários administrativos combinada com alto nível de especialização dos médicos; ausência de um organograma formal; forte vínculo da singular com a Federação e Confederação do Sistema Unimed.
COMPETÊNCIAS PROFISSIONAIS DE GESTORES DE NÍVEL ESTRATÉGICO DE UMA OPERADORA DE AUTOGESTÃO EM SAÚDE
Authors: Martins Luiza Maria , Ferraz Monaliza Antunes , Vieira Adriane , Oliveira Fernanda Esthefane Garrides , Roquete Fátima Ferreira 
Published: May 2017

Introdução: no cenário do subsistema de saúde suplementar no Brasil, as operadoras da modalidade de autogestão representam o segmento não comercial, sem fins lucrativos. As especificidades dessas operadoras, bem como as demandas contínuas da Agência Nacional de Saúde Suplementar (ANS), caracterizam um ambiente desafiador para os gestores de nível estratégico dessas organizações. Objetivo: conhecer quais competências profissionais são mobilizadas, no exercício da função, pelos gestores de nível estratégico de uma operadora de autogestão em saúde, na visão deles próprios. Métodos: pesquisa de abordagem qualitativa, caráter descritivo, cujo método adotado foi o estudo de caso. Os dados foram coletados por meio de entrevistas com roteiro semi-estruturado e analisados com base no modelo de competências profissionais de Cheetham e Chivers (1996, 1998, 2000). Resultados: os gestores de nível estratégico evidenciaram um conjunto de habilidades relacionadas à competência comportamental, com destaque para aquelas necessárias ao bom relacionamento intraprofissional. Observou-se uma dinâmica entre as dimensões contextuais do trabalho e a expressão e adequação das competências profissionais desses gestores às situações particulares vivenciadas por eles na operadora. Conclusões: os relatos dos participantes da pesquisa revelaram que o exercício da função de gestão de nível estratégico nesse cenário de estudo requer a mobilização e a combinação de diversas habilidades e confirmaram a complexidade que envolve a gestão de uma operadora de autogestão em saúde no ambiente regulamentado pelo Estado.
Post-thyroidectomy permanent hypocalcemia and hypoparathyroidism: frequency and risk factors
Authors: Elsaeiti M , Alsaeiti K 
Published: May 2017

Abstract
Background: Hypoparathyroidism is the most common complication after thyroidectomy and the main reason for frequent outpatients' visits; however, there is a poor understanding of its outcomes, and no clear follow-up strategies are available. We aimed to evaluate the frequency and risk factors of post-thyroidectomy hypocalcemia hypoparathyroidism in Libyan patients.
Methods: A case series study was conducted. The serum calcium and parathyroid hormone level (PTH) were measured at least 8 months post thyroidectomy.
Results: 124 patients were reviewed in this study; 19 (15.3 %) were males and 105 (84.7 %) were females. 30.6 % of males and 13.7% of females developed hypocalcemia and hypoparathyroidism. Total thyroidectomy (TT) was performed in 62.9 % of all patients, while 24.2% of all patients underwent near total thyroidectomy (NTT). 12.1% of all patients underwent bilateral subtotal thyroidectomy (BST) and 1 patient underwent hemi thyroidectomy (0.8%). The risk of hypocalcemia was higher in patients with malignant thyroid disease in comparison to benign thyroids (45.8 % vs. 27% of patients). Papillary thyroid carcinoma (PTC) was the most common cause of both hypocalcemia and hypoparathyroidism (45.5% for both) followed by Graves' disease (22.2% and 14.8% for hypocalcemia and hypoparathyroidism respectively). Hypocalcemia and hypoparathyroidism were more frequent in patients who underwent TT (19.2%), as compared to patients who underwent NTT (6.6 %). Among nine patients who were operated on twice, three patients had hypocalcemia, and two of them were found to be hypoparathyroid; one case is diagnosed with Graves' disease, while the other was diagnosed as PTC.
Conclusion: Total thyroidectomy, and re-operation are associated with increased prevalence of permanent hypocalcemia and hypoparathyroidism when compared to less extensive thyroid resection modes.
Central Retinal Vein Occlusion in Younger Swedish Adults: Case Reports and Review of the Literature
Authors: Wittström Elisabeth 
Published: May 2017

Purpose:
To investigate associated systemic diseases, other conditions, visual outcome, ocular complications and treatment in Swedish patients younger than 50 years with central retinal vein occlusion (CRVO) and reviewing the literature.

Methods:
Twenty-two patients with CRVO, younger than 50 years, were examined with full-field electroretinography (ERG) within 3 months after a thrombotic event, or were periodically examined and were observed for at least 6 months. In 18 of these patients, the initial retinal ischemia was studied using the cone b-wave implicit time in the 30 Hz flicker ERG. Fifteen patients also underwent fluorescein angiography. Optical coherence tomography (OCT) was performed in 14 patients. The patients studied were divided into two groups, non-ischemic and ischemic, which were compared. All patients underwent ocular and systemic examination, as well as complete screening for thrombophilic risk factors.

Results:
Of the 22 patients, 15 had non-ischemic type of CRVO and 7 the ischemic type. Patients with non-ischemic CRVO showed significantly improved visual acuity (VA) at the final examination (p=0.006). Patients with ischemic CRVO showed no significant reduction in VA at the final examination (p=0.225). Systemic hypertension (27% in non-ischemic CRVO and 29% in ischemic CRVO) was the most prevalent systemic risk factor for CRVO. The mean central foveal thickness (CFT) decreased significantly from 402.3±136.2 (µm) at the initial examination to 243.8±48.1 (µm) at the final examination in the non-ischemic group (p=0.005). The mean initial CFT was 444.5±186.1 (µm) in the ischemic CRVO group, which decreased to 211.5±20.2 (µm) at the final visit (p=0.068). Pigment dispersion syndrome (PDS)/pigmentary glaucoma (PG), ocular hypertension and dehydration were equally frequent; four patients each (18%) out of 22. The clinical course of 4 younger patients with PDS/PG are described.

Conclusion:
The patients with non-ischemic CRVO showed significantly improved VA and significantly decreased CFT at the final examination. Systemic hypertension was the most prevalent risk factor for CRVO. Younger adults with CRVO also had a high prevalence of PDS/PG, ocular hypertension and dehydration. This study highlights the importance of careful IOP monitoring, and the need to investigate possible PDS/PG and to obtain an accurate history of the patient including alcohol intake and intense exercise.
Puolesta-asiointi terveydenhuollon sähköisissä asiointipalveluissa Case: PUOLA–hanke
Authors: Hilama Pirjo , Hartonen Virva , Kinnunen Ulla-Mari 
Published: May 2017

Electronic communication is a topical issue in social and health care. Digitalization means of allowing a more customer-oriented services. The purpose of this article is to introduce the ongoing PUOLA project and its connection with the research on its operation and methods. The research is primarily about the evaluation and development of the use of information and communication technologies. Within the project, the transfer of information between My Kanta service and the regional online services will be developed and modelled and solutions on acting on behalf of someone else based on registration and a power of attorney according to national regulations will be functionally piloted. This is a good example of the project, in which the national definitions support regional development. Role in the project development work will brings experience and support to the implementation of national services.
From the organization point of view, the success of the development project requires functioning technology, committed management, motivated superiors and adaptable personnel.
Survey of health informatics education in Finland in 2017
Authors: Tolonen Johanna , Värri Alpo 
Published: May 2017

The European Union and the USA collaborate in developing the skills of the application of information technology in the health care workforce. A part of this activity is a project which studies the gaps in the present education and proposes methods of filling these gaps. The objective of this paper is to identify the existing IT related education to the health care work force in Finland. A secondary objective was to get an impression of the experience and attitudes of the members of this workforce about health IT education.
This paper presents the results of the survey of how information technology is educated to the students of the health care professions in Finland in the year 2017. In addition to literature search including also the study guides of many major health care professional education organizations, 24 telephone interviews of health care professionals in different fields in Finland were made.
The results show that although basic information technology education is often available at every level of education, it is expected that the health care professionals learn to use the health information systems during their training periods or later in working life. The interviews showed that the given education varied considerably and some of the personnel had received no or only a little education on IT during studies. As the amount and quality of on-the-job information technology education varies, many health care professionals are not able to fully benefit from the information systems if their general feeling is that they just “survive” from daily activities with them.
The results lead to suggest that the health professional degrees should contain at least a minimal amount of relevant health IT education which is tested with an exam and that the present health care workforce should receive ear-marked in-service training in the use of health information technology based on the needs of the individual.
Towards business ecosystems for connected health
Authors: Francis Gomes Julius , Pikkarainen Minna , Ahokangas Petri , Niemelä Riikka 
Published: May 2017

Digitalisation is seen as a vehicle for restructuring practices of social and health care in Finland. A conceptual model of connected health has evolved over time focusing on bringing together individuals and health professionals by means of ‘eHealth’, ‘telecare’, ‘telemedicine’ or ‘telehealth’ services and data connected via the Internet of Things. Digital transformation has triggered the emergence of innovative connected health services, as well as novel business models in the health and healthcare sector. Additionally, current literature emphasises growing importance of ecosystems in advancing the connected health business. The main reason for this, the increased understanding of business ecosystems would allow companies to create coherent services that would be easier for patients and health professionals (e.g. doctors and nurses) to use.
This paper aims to develop and present a conceptual model for business ecosystem for connected health by mapping service needs for healthcare in the future. For this research, we conducted 16 meetings/workshops related to business models and business ecosystems. We also involved different end-user groups in our research (seven doctor interviews, four workshops with nurses and digital discussions and workshops with 12 parents with sick children).
This qualitative case study illustrates the construct of the Nordic Central Hospital test lab- an innovation ecosystem for connected health service providers. Alongside the broad service map, we demonstrate the logic of value flow between different layers of services in the ecosystem. From an originality perspective, this multidisciplinary paper focuses on the pediatric day surgery to check the scope of connected health, which has not been done before.
Booking system, video conferencing (VC) solution and online forms for improving child psychiatric services in Pohjois-Savo region
Authors: Bykachev Kirsi , Turunen Outi , Sormunen Marjorita , Karppi Jussi , Kumpulainen Kirsti , Turunen Hannele 
Published: May 2017

Abstract
Purpose Early detection and timely treatment of child psychiatric problems require multi-professional collaboration and interaction between primary and specialized health care. The “eHealth Services for Child and Adolescent Psychiatry (eCAP), 2015-2018” project aims at improving child psychiatric services in peripheral areas by developing eHealth tools facilitating better cooperation between professionals working with children with mental health problems.
Methods The online booking system allows the primary healthcare professionals in Pohjois-Savo region to book a video conference (VC) with experts in child psychiatry for consultation, supervision or follow-up of care. Background information gathered from the parents, teacher and the child by online forms helps the consult to prepare for the meeting, which can be carried out on computer, laptop, table or smartphone. The developed services will be evaluated based on the log data and user experiences from the pilot phase.
Results The services will improve the quality, availability and cost-effectiveness of child psychiatric outpatient services in the region. Increased multi-professional collaboration among professionals will support preventive work, early identification and treatment in natural developmental environments of children. The travel needs for families are expected to decrease.
Conclusions eHealth can help to meet the global challenge of providing sufficient, timely child psychiatric services in remote, sparsely populated areas with limited resources, but information security and compatibility of different technical applications require innovative solutions. Furthermore, the people-related factors are crucial in introducing a sustainable change: the users must understand the benefits and receive training to adopt the new tools and routines for their work.
OS FÓRUNS DE EDUCAÇÃO INFANTIL E AS POLÍTICAS PÚBLICAS PARA A INFÂNCIA NO BRASIL
Authors: Arelaro Lisete Regina Gomes , Maudonnet Janaína Vargas de Moraes 
Published: May 2017

Esse artigo tem como objetivo refletir sobre a atuação dos Fóruns de Educação Infantil na incidência e monitoramento de políticas públicas para a infância no país e seus desafios atuais em um cenário de retrocesso das políticas sociais no Brasil. Para tanto, discute-se as origens dessas instâncias, algumas de suas estratégias de incidência e o modo como vem estabelecendo relação com o Estado. Também é objeto de discussão os projetos antagônicos de sociedade em que de um lado se crê na descentralização e na desresponsabilização do Estado e de outro, se defende um projeto democrático popular que compreende descentralização política como possibilidade de articulação de processos decisórios participativos, de controle social e de alargamento do papel do Estado.
POLÍTICAS PÚBLICAS E EDUCAÇÃO INFANTIL
Authors: Santos Maria Walburga dos , Lombardi Lucia Maria Salgado dos Santos 
Published: May 2017

Tendo por tema principal as Políticas Púbicas e a Educação Infantil, o presente dossiê compõe o volume 3, número 1, da Laplage em Revista e propõe diálogo, debate e reflexão em torno de pesquisas recentes que problematizam, na vastidão e complexidade da área, questões que versam a respeito de temáticas caras para a educação das crianças em interface com Políticas Públicas, contando com trabalhos acadêmicos oriundos dos estados de São Paulo, Rio de Janeiro, Ceará e Paraná e contribuições internacionais de Cuba e Portugal.
Are phloem sieve tubes leaky conduits supported by numerous aquaporins?
Authors: Stanfield Ryan C. , Hacke Uwe G. , Laur Joan 
Published: May 2017

PREMISE OF THE STUDY:Aquaporin membrane water channels have been previously identified in the phloem of angiosperms, but currently their cellular characterization is lacking, especially in tree species. Pinpointing the cellular location will help generate new hypotheses of how membrane water exchange facilitates sugar transport in plants.METHODS:We studied histological sections of balsam poplar (Populus balsamifera L.) in leaf, petiole, and stem organs. Immuno‐labeling techniques were used to characterize the distribution of PIP1 and PIP2 subfamilies of aquaporins along the phloem pathway. Confocal and super resolution microscopy (3D‐SIM) was used to identify the localization of aquaporins at the cellular level.KEY RESULTS:Sieve tubes of the leaf lamina, petiole, and stem were labeled with antibodies directed at PIP1s and PIP2s. While PIP2s were mostly observed in the plasma membrane, PIP1s showed both an internal membrane and plasma membrane labeling pattern.CONCLUSIONS:The specificity and consistency of PIP2 labeling in sieve element plasma membranes points to high water exchange rates between sieve tubes and adjacent cells. The PIP1s may relocate between internal membranes and the plasma membrane to facilitate dynamic changes in membrane permeability of sieve elements in response to changing internal or environmental conditions. Aquaporin‐mediated changes in membrane permeability of sieve tubes would also allow for some control of radial exchange of water between xylem and phloem.
Steep Decay of GRB X-Ray Flares: The Results of Anisotropic Synchrotron Radiation
Authors: Geng Jin-Jun , Huang Yong-Feng , Dai Zi-Gao 
Published: May 2017

Abstract
When an emitting spherical shell with a constant Lorentz factor turns off emission abruptly at some radii, its high-latitude emission would obey the relation of

(the temporal index) =

(the spectral index). However, this relation is violated by the X-ray fares in some gamma-ray bursts (GRBs), whose

is much more steeper. We show that the synchrotron radiation should be anisotropic when the angular distribution of accelerated electrons has a preferable orientation, and this anisotropy would naturally lead to a steeper decay for the high-latitude emission if the intrinsic emission is limb-brightened. We use this simple toy model to reproduce the temporal and spectral evolution of X-ray flares. We show that our model can well interpret the steep decay of the X-ray flares in the three GRBs selected as an example. Recent simulations on particle acceleration may support the specific anisotropic distribution of the electrons adopted in our work. Reversely, confirmation of the anisotropy in the radiation would provide meaningful clues to the details of electron acceleration in the emitting region.
Nos enfants terroristes victimes du libéralisme, même
Authors: Liaudet Jean-Claude 
Published: May 2017

Le système d’idéaux du libéralisme ne permet pas aux adolescents de se structurer psychiquement. Ces derniers se trouvent fixés dans une logique pré-adolescente de révolte contre un père imaginaire et de recherche déréelle d’un idéal auquel s’identifier. C’est pourquoi ils sont sensibles à la « solution du djihad ». Il faut en rechercher la cause dans le défaut de transmission entre cette génération historique, celle de la précarité, et la génération historique précédente, celle d’un libéralisme triomphant. Ce dernier est caractérisé par les « non-idéaux » suivants : liberté conçue comme exercice d’une toute puissance dans un contexte de laisser faire, et donc refus de subir comme d’exercer une autorité symbolique. D’où la faillite de la transmission parentale.
Penser la théopathologie au carrefour des idéologies de l’extrême et de l’errance religieuse
Authors: Mecheri Keira , Bibeau Gilles 
Published: May 2017

S’appuyant sur une psychiatrie d’inspiration anthropologique, les auteurs esquissent les contours d’une clinique transdisciplinaire pour la prise en charge des cas de théopathologie. Celle-ci est définie comme un état psychique douloureux caractérisé par un fléchissement de la capacité de discernement, la certitude d’être détenteur de la vérité et d’être porteur d’une mission. La dynamique intrapsychique à l’œuvre dans les théopathologies est discutée en relation à une « théorie du moi » qui distingue dans le sujet trois épaisseurs – le protocolaire, l’essentiel et le transcendantal –, se contaminant mutuellement lorsqu’une personne bascule dans un recours erratique à la religion. Les idéologies de la haine et la pensée de l’extrême font alors apparaître des fanatismes constituant un piège insécurisant pour les sociétés et un danger de dérive pathologique pour les personnes. Ils font appel à une étude de cas clinique pour illustrer la porosité des frontières psychiques et ses dérives potentielles.
Emprise de l’idéal, pacte dénégatif et répétition : l’islamisme comme matrice idéologique du terrorisme djihadiste
Authors: Laoukili Abdelaâli 
Published: May 2017

Le présent article veut examiner comment l’islam depuis ses origines était porteur d’un double message : rétablir le Bien dans l’humanité et combattre le Mal en restaurant la Loi de Dieu sur terre. Les musulmans se sont rassemblés et différenciés dans l’interprétation de ce double message. L’entente fraternelle et la discorde guerrière et destructrice ont jalonné l’histoire des musulmans et des pouvoirs politiques qui se sont succédé, depuis le temps prophétique jusqu’à aujourd’hui. L’idéalisation de la Oumma (communauté des musulmans : matrice fantasmée de l’identité collective) et de la fraternité musulmane a passé sous silence ses aspects violents et mortifères. Au nom de ce même Idéal, constitutif de l’idéologie islamiste, des crimes ont été commis et continuent de l’être dans le monde arabo-musulman et en dehors. Le déni de cette histoire, des mécanismes à l’œuvre et la poursuite de l’idéalisation des origines empêchent une partie des musulmans, et ceux qui épousent l’idéologie islamiste notamment, de construire un rapport apaisé à leur identité et tolérant à l’égard des différences entre eux et avec les autres.
« … Naître de peur »
Authors: Corcos Maurice , Rojas-Urrego Alejandro 
Published: May 2017

Au début, au commencement, pour certains est La peur. Cette sensation brutale de se sentir « seul au monde » qui témoigne qu’à un moment il y a eu désinvestissement, décrochage… qu’un mouvement tendre n’est pas venu, n’a pas été donné, n’a pas pu être reçu… et n’a pas pansé et pensé la forme étrange que le corps en attente de l’enfant prenait. L’enfant souffrira-t-il définitivement de cette « informité »? Encore faudrait-il distinguer une gradation importante (problématique de perte contre problématique du non advenu) : l’attente non de celui qui n’a plus rien à attendre, mais de celui qui n’a rien à attendre… ; l’attente désespérée de celui qui a connu une expérience accordante avec l’objet (et en a acquis une certaine consistance, conscience et connaissance) et l’attente désespécée de celui qui ne l’a pas connue, l’attente dans un monde intérieur vide ou plein d’un objet interne.