bluuebunny/crossref_metadata_2025_split huggingface dataset:
O viver com a doença falciforme: percepção de adolescentes
Authors: Marques Larissa Nascimento , Cavalcanti Alessandra , Ruzzi-Pereira Andrea 
Published: April 2015

<p>Este estudo transversal descritivo com abordagem quantitativa qualitativa teve como objetivo descrever e analisar a percepção de adolescentes sobre o viver com Doença Falciforme (DF); identificar e analisar quais os principais papéis ocupacionais destes adolescentes e a importância que atribuem aos papéis. Os dados foram obtidos pela Lista de Identificação de<br />Papéis Ocupacionais, por caracterização sociodemográfica dos participantes e por uma entrevista semiestruturada, junto a sete adolescentes com DF, sendo os dados da entrevista submetidos à análise de conteúdo temático categorial e os dados da Lista de Identificação de Papéis Ocupacionais analisados por frequência absoluta e relativa. Conclui-se que o viver com a DF é rodeado de privações que ocorrem em vários espaços do cotidiano do adolescente e podem levá-lo a qualidade de vida insatisfatória, e repercussões negativas no futuro.</p>
Múltiplas avaliações para aquisição de cadeiras de escritório: favorecendo a saúde no trabalho
Authors: Barroso Barbara Iansã de Lima , Galvão Cláudia Regina Cabral 
Published: April 2015

<p>Na busca para defi nir a melhor cadeira de escritório utilizada em terminais informatizados de uma autarquia do município de Manaus/AM, é descrito neste estudo, um processo metodológico de construção para identifi car a melhor cadeira para o trabalho informatizado utilizando múltiplas avaliações: entrevistas estruturadas; mapa de sensação de desconforto e dor proposto por Corlett e Wilson22; e questionários de avaliação por escala sobre a satisfação da cadeira, aplicadas com 71 trabalhadores. Neste estudo caracterizado como exploratório, aplicado, qualitativo e quantitativo, analisou-se estatisticamente dados aferidos em escala, e a opinião espontânea dos participantes na testagem de duas cadeiras. Observou-se que a escolha da cadeira apropriada para o posto de trabalho, na função dos participantes, englobou cadeiras com rodízios e regulagem do assento e encosto, o que pode contribuir para melhoria da produtividade e reduzir o efeito de doenças do trabalho associadas à postura sentada. </p>
Do individual ao coletivo: perfil ocupacional de usuários de um Centro de Atenção Psicossocial
Authors: Salles Mariana Moraes , Matsukura Thelma Simões 
Published: April 2015

<p>As ocupações realizadas pelas pessoas com transtorno mental podem nos informar não apenas sobre a vida cotidiana dos sujeitos, mas também sobre como a sociedade tem lidado com o transtorno mental. Assim, o objetivo do presente artigo é conhecer as ocupações das pessoas com transtornos mentais em relação à singularidade do sujeito, a sua rede social e na sua relação com o contexto social. A metodologia de pesquisa qualitativa foi escolhida para a realização da pesquisa em que foram entrevistados usuários de um Centro de Atenção Psicossocial II, da cidade de São Paulo, e pessoas de sua rede social. As entrevistas semiestruturadas foram utilizadas como um meio de investigação, e para a análise de dados foi utilizada a Análise de Discurso. Verificou-se que as ocupações são centrais para a construção da identidade dos sujeitos e que no processo de engajamento em ocupações os usuários também constroem redes sociais. Também se observou que as pessoas com transtornos mentais podem ter sua vida cotidiana profundamente e negativamente influenciada por um contexto social desfavorável, que não oferece suporte ou condições para que o sujeito se envolva em ocupações significativas. Assim, as ocupações constituem e constroem a trama que tece processos de inclusão e exclusão social desta população.</p>
Atividades na formação do terapeuta ocupacional
Authors: Silva Carla Regina , Von Poellnitz Jéssica Cristina 
Published: April 2015

<object id="6a59499b-79a9-adae-9bba-c888d9bcb7b7" type="application/gas-events-bb" width="0" height="0"></object><p>As atividades são compreendidas como elementos centrais na construção complexa e contextualizada do processo terapêutico ocupacional, ressalta-se a importância do seu ensino na formação profi ssional. Este trabalho apresenta os resultados de uma pesquisa que objetivou mapear e analisar a formação do terapeuta ocupacional, com enfoque no ensino de atividades e recursos oferecido nos cursos de graduação de Instituições de Ensino Superior públicas do Estado de São Paulo. Para tanto, foram utilizados os Projetos Pedagógicos; realizadas entrevistas com coordenadores e aplicados questionários com os docentes envolvidos com o ensino da temática. Foi possível traçar o perfil das instituições em relação ao ensino de atividades, docentes, laboratórios, processos avaliativos, e integração com a pesquisa e a extensão. Concluí-se que o ensino da temática apresenta um núcleo comum, mas ocorre de forma singular nos cursos a depender dos currículos adotados, assim como, da formação e perspectiva dos docentes. Referenda-se a necessidade das atividades se estruturarem como campo próprio de saber e na formação integrar conteúdos teóricos estruturantes aos relacionados à dimensão prática das experimentações e dos fazeres.</p>
A Hybrid Cloud Regime Methodology Used to Evaluate Southern Ocean Cloud and Shortwave Radiation Errors in ACCESS
Authors: Mason Shannon , Fletcher Jennifer K. , Haynes John M. , Franklin Charmaine , Protat Alain , Jakob Christian 
Published: April 2015

AbstractA deficit of shortwave cloud forcing over the Southern Ocean is persistent in many global climate models. Cloud regimes have been widely used in model evaluation studies to make a process-oriented diagnosis of cloud parameterization errors, but cloud regimes have some limitations in resolving both observed and simulated cloud behavior. A hybrid methodology is developed for identifying cloud regimes from observed and simulated cloud simultaneously.Through this methodology, 11 hybrid cloud regimes are identified in the ACCESS1.3 model for the high-latitude Southern Ocean. The hybrid cloud regimes resolve the features of observed cloud and characterize cloud errors in the model. The simulated properties of the hybrid cloud regimes, and their occurrence over the Southern Ocean and in the context of extratropical cyclones, are evaluated, and their contributions to the shortwave radiation errors are quantified.Three errors are identified: an overall deficit of cloud fraction, a tendency toward optically thin low and midtopped cloud, and an absence of a shallow frontal-type cloud at high latitudes and in the warm fronts of extratropical cyclones.To demonstrate the utility of the hybrid cloud regimes for the evaluation of changes to the model, the effects of selected changes to the model microphysics are investigated.
Quantifying the Added Value of Snow Cover Area Observations in Passive Microwave Snow Depth Data Assimilation
Authors: Kumar Sujay V. , Peters-Lidard Christa D. , Arsenault Kristi R. , Getirana Augusto , Mocko David , Liu Yuqiong 
Published: April 2015

AbstractAccurate determination of snow conditions is important for several water management applications, partly because of the significant influence of snowmelt on seasonal streamflow prediction. This article examines an approach using snow cover area (SCA) observations as snow detection constraints during the assimilation of snow depth retrievals from passive microwave sensors. Two different SCA products [the Interactive Multisensor Snow and Ice Mapping System (IMS) and the Moderate Resolution Imaging Spectroradiometer (MODIS)] are employed jointly with the snow depth retrievals from a variety of sensors for data assimilation in the Noah land surface model. The results indicate that the use of MODIS data is effective in obtaining added improvements (up to 6% improvement in aggregate RMSE) in snow depth fields compared to assimilating passive microwave data alone, whereas the impact of IMS data is small. The improvements in snow depth fields are also found to translate to small yet systematic improvements in streamflow estimates, especially over the western United States, the upper Missouri River, and parts of the Northeast and upper Mississippi River. This study thus demonstrates a simple approach for exploiting the information from SCA observations in data assimilation.
The challenges of coordination in national security management – the case of the terrorist attack in Norway
Authors: Christensen Tom , Lægreid Per , Rykkja Lise H 
Published: April 2015

The article addresses a ‘wicked problem’: Organizing for internal security and societal safety. It examines the central emergency and crisis management under the terrorist attack in Norway in July 2011, with a special focus on the coordinating role of the Ministry of Justice (MJ). Our analysis is based on an in-depth qualitative analysis of relevant official documents and interviews with government officials, using a structural-instrumental and a cultural-institutional perspective to understand outcomes. There is a consensus when it comes to diagnosing the problems, identified as fragmentation, pulverization of accountability and weak coordination arrangements. The organizational changes have been cautious and incremental, however. A gradual upgrading of the MJ as an overarching coordinating ministry does not challenge the existing principles of ministerial responsibility. Suggested solutions are beset with ambiguity and conflicts, and there is a mismatch between problems and available solutions. Points for practitioners Challenges of coordination are evident in modern public administration, related to both vertical and horizontal coordination, and particularly so within the field of internal security and crisis management. New Public Management (NPM)-related reforms have created further coordination problems, especially in policy areas and public services that cross sector boundaries. New arrangements, labeled post-NPM reforms, have tried to counter the alleged increasing fragmentation. The challenges are quite evident when it comes to crisis management, where a combination of organizing for coordination and flexibility is necessary. Major crises do not always lead to radical changes, however. Instrumental and formal changes are often mediated by the existing culture. The result is a rather hybrid and multi-layered modern public administration.
High TPOAb Levels (>1300 IU/mL) Indicate Multifocal PTC in Hashimoto’s Thyroiditis Patients and Support Total Thyroidectomy
Authors: Dong Shuai , Xia Qing , Wu Yi‐Jun 
Published: April 2015

ObjectiveWe aimed to identify whether thyroid peroxidase antibodies (TPOAb) are indicative of multifocal papillary thyroid cancer (PTC) in Hashimoto’s thyroiditis (HT) patients and may help to determine necessity for total thyroidectomy.Study designRetrospective cohort study.SettingTeaching hospital.SubjectsA total of 808 consecutive patients with HT alone or with HT and unifocal or multifocal PTC were included.MethodsPreoperative thyroid function tests, TPOAb determination, preoperative ultrasonography, intraoperative frozen biopsy, and postoperative routine pathologic examination to confirm thyroid nodules were performed for all patients. Patients with nodules or malignancy potential on ultrasound and fine‐needle aspiration cytology were included. Patients with hyperthyroidism, concomitant chronic disease, a history of other malignant tumors, or history of major diseases were excluded. All patients underwent surgery, and HT and PTC were confirmed by postoperative pathologic results.ResultsNo significant differences were found in age and sex between groups (P >. 05). TPOAb ≤1300 IU/mL were more prevalent in the HT + unifocal PTC group than in the other groups (99.57% vs 15.52% and 60.75%, P <. 001). TPOAb >1300 IU/mL were more prevalent in the HT + multifocal PTC group than in the other groups (84.48% vs 0.43% and 39.25%; P <. 001). Compared to the other groups, the HT + multifocal PTC group had higher percentages of patients with elevated thyroid‐stimulating hormone and positive central lymph node (LN) metastasis (elevated thyroid‐stimulating hormone: 8.7% vs 3.2% and 6.5%, P =. 008; positive central LN metastasis: 74.57% vs 67.38% and 0%, P <. 001).ConclusionHigh TPOAb levels (>1300 IU/mL) are definitive indicators of multifocal PTC in HT patients, which may support surgical treatment with total thyroidectomy.
Prevalence and Severity of Dysphonia in Patients with Cystic Fibrosis
Authors: Willis John , Michael Deirdre D. , Boyer Holly , Misono Stephanie 
Published: April 2015

ObjectiveTo assess the prevalence and severity of dysphonia in patients with cystic fibrosis sinusitis. We hypothesized that patients with CF sinusitis, compared with 2 control groups, would have higher self‐reported prevalence of dysphonia and greater severity of dysphonia, according to patient‐reported outcome measures as well as auditory‐perceptual evaluation by expert listeners.Study DesignCross‐sectional comparative pilot study.SettingAcademic tertiary care clinic.Study Participants and MethodsAnalysis included 37 study participants: 17 patients with CF sinusitis, 10 healthy individuals, and 10 patients with non‐CF sinusitis. All participants completed the 10‐item Voice Handicap Index (VHI‐10) questionnaire and provided voice samples. On all samples, 6 blinded speech‐language pathologists independently performed auditory‐perceptual evaluation, using Consensus Auditory‐Perceptual Evaluation of Voice. To assess severity of sinonasal symptoms, we used the 20‐item Sinonasal Outcome Test (SNOT‐20). Standard parametric and nonparametric statistical analysis was performed.ResultsThe differences between the 3 groups in prevalence of abnormal VHI‐10 scores were not statistically significant. SNOT‐20 scores were similar in the 2 sinusitis patient groups. VHI‐10 scores were highest in patients with CF sinusitis, intermediate in patients with non‐CF sinusitis, and lowest in healthy individuals (P =. 005). Auditory‐perceptual evaluation demonstrated greater overall severity of dysphonia in patients with CF sinusitis compared with the 2 control groups (P =. 0005).ConclusionsCystic fibrosis sinusitis appeared to be associated with worse vocal function as measured by patient self‐report as well as auditory‐perceptual evaluation of voice compared with patients with non‐CF sinusitis and healthy controls. Further investigation in this area is warranted.
Conventional and 3‐Dimensional Computerized Tomography in Eagle’s Syndrome, Glossopharyngeal Neuralgia, and Asymptomatic Controls
Authors: Kent David T. , Rath Tanya J. , Snyderman Carl 
Published: April 2015

ObjectiveEagle’s syndrome (ES) is an aggregate of symptoms, including recurrent throat pain, foreign body sensation, dysphagia, or facial pain related to an elongated styloid process (SP). It resembles glossopharyngeal neuralgia and has been linked to irritation of the glossopharyngeal nerve. This study was designed to determine whether computerized tomography (CT) imaging of the stylohyoid chain (SHC) differs between asymptomatic controls (ACs), patients with glossopharyngeal neuralgia (GN), and patients with ES.Study DesignCase series with chart review.SettingTertiary otolaryngology practice.Subjects and MethodsConventional and 3‐dimensional CT reconstructions of the SHC were reviewed for 10 ES, 17 GN, and 30 AC patients. Demographic and clinical symptom data were recorded. Anatomic data collected from CT scans included length of the ossified SP, anterior‐posterior and medial‐lateral styloid process angulation, ossification pattern of the SHC, and minimum distances between the SP tip, the internal carotid artery, and the tonsillar fossa.ResultsThe average distance from the SP tip to the tonsillar fossa was significantly shorter in ES (12.7 mm) compared with GN (21.4 mm; P =. 027) or AC (24.8 mm; P <. 0005) patients. No other variables were significantly different between groups, including average SP length (ES: 48.0 vs GN: 40.3 vs AC: 40 mm; P >. 05).ConclusionThe SP was significantly closer to the tonsillar fossa in patients with ES compared with ACs. No significant differences were found in other measures. Distance to the tonsillar fossa may be a more appropriate diagnostic criterion for ES than SP length and may contribute to the pathophysiology of ES.
Lessons Learned in the Surgical Treatment of Neurogenic Thoracic Outlet Syndrome Over 10 Years
Authors: Likes Kendall C. , Orlando Megan S. , Salditch Quinn , Mirza Serene , Cohen Anne , Reifsnyder Thomas , Lum Ying Wei , Freischlag Julie A. 
Published: April 2015

Objective: To evaluate our extensive experience over a decade in the treatment of patients with neurogenic thoracic outlet syndrome (NTOS) who underwent first rib resection and scalenectomy (FRRS). Methods: Patients treated with FRRS for NTOS from 2003 to 2013 were retrospectively reviewed using a prospectively maintained database. Results: Over 10 years, 286 patients underwent 308 FRRS. During the first 5-year period, 127 FRRS were performed (96 F, 31 M), with an average age of 36.9 years. During the second 5-year period, 181 FRRS were performed (143 F, 38 M), with an average age of 33 years. A total of 24 children (age ≤18years) underwent FRRS, 9 during the first 5 years and 15 during the second 5 years. When comparing the second 5-year period to the first 5-year period, patients were younger ( P = .066), reported a significantly shorter length of preoperative symptoms (35.4 vs 52.1 months, P < .01), prior narcotic use decreased from 31.5% to 23.8% ( P < .05), and a history of prior surgical intervention on the ipsilateral side (head, neck, and shoulder) increased from 30.1% to 51.9% ( P < .01). Use of lidocaine blocks as a diagnostic tool (57%-35.4%, P = .06) and Botox blocks as a therapeutic tool (29.1%-12.7%, P < .01) decreased in the second 5 years with similar positive results. Improved or fully resolved symptoms following FRRS increased from 89% in the first 5 years to 92.8% in the second 5 years. Average length of follow-up over the 10-year period was 13.4 months. Conclusion: Excellent results were seen in this surgical series reported for NTOS. Younger patients with shorter duration of symptoms with less narcotic use led to even better FRRS results in the second 5 years of surgical intervention. An established vascular practice for referrals for NTOS resulted in an increased number of appropriate patients for surgical intervention, requiring fewer lidocaine and/or Botox injections preoperatively.
Hypoglycemia in Type 2 Diabetes - More Common Than You Think
Authors: Gehlaut Richa Redhu , Dogbey Godwin Y. , Schwartz Frank L. , Marling Cynthia R. , Shubrook Jay H. 
Published: April 2015

Background: Hypoglycemia is often the limiting factor for intensive glucose control in diabetes management, however its actual prevalence in type 2 diabetes (T2DM) is not well documented. Methodology: A total of 108 patients with T2DM wore a continuous glucose monitoring system (CGMS) for 5 days. Rates and patterns of hypoglycemia and glycemic variability (GV) were calculated. Patient and medication factors were correlated with rates, timing, and severity of hypoglycemia. Results: Of the patients, 49.1% had at least 1 hypoglycemic episode (mean 1.74 episodes/patient/ 5 days of CGMS) and 75% of those patients experienced at least 1 asymptomatic hypoglycemic episode. There was no significant difference in the frequency of daytime versus nocturnal hypoglycemia. Hypoglycemia was more frequent in individuals on insulin (alone or in combination) ( P = .02) and those on oral hypoglycemic agents ( P < .001) compared to noninsulin secretagogues. CGMS analysis resulted in treatment modifications in 64% of the patients. T2DM patients on insulin exhibited higher glycemic variability (GV) scores (2.3 ± 0.6) as compared to those on oral medications (1.8 ± 0.7, P = .017). Conclusions: CGMS can provide rich data that show glucose excursions in diabetes patients throughout the day. Consequently, unwarranted onset of hypo- and hyperglycemic events can be detected, intervened, and prevented by using CGMS. Hypoglycemia was frequently unrecognized by the patients in this study (75%), which increases their potential risk of significant adverse events. Incorporation of CGMS into the routine management of T2DM would increase the detection and self-awareness of hypoglycemia resulting in safer and potentially better overall control.
Idiopathic pneumonia syndrome after hematopoietic cell transplantation: evidence of occult infectious etiologies
Authors: Seo Sachiko , Renaud Christian , Kuypers Jane M. , Chiu Charles Y. , Huang Meei-Li , Samayoa Erik , Xie Hu , Yu Guixia , Fisher Cynthia E. , Gooley Ted A. , Miller Steven , Hackman Robert C. , Myerson David , Sedlak Ruth H. , Kim Yae-Jean , Fukuda Takahiro , Fredricks David N. , Madtes David K. , Jerome Keith R. , Boeckh Michael 
Published: April 2015

Key PointsIn patients with previously diagnosed IPS, more than half (57%) had pathogens detected by currently available diagnostic methods. Detection of a pathogen was significantly associated with high mortality regardless of significance of pathogenicity in lung.
Association between trends in clinical variables and outcome in intensive care patients with faecal peritonitis: analysis of the GenOSept cohort
Authors: Tridente Ascanio , Clarke Geraldine M , Walden Andrew , Gordon Anthony C , Hutton Paula , Chiche Jean-Daniel , Holloway Paul AH , Mills Gary H , Bion Julian , Stüber Frank , Garrard Christopher , Hinds Charles ,   on behalf of the GenOSept Investigators
Published: April 2015

Abstract
Introduction
Patients admitted to intensive care following surgery for faecal peritonitis present particular challenges in terms of clinical management and risk assessment. Collaborating surgical and intensive care teams need shared perspectives on prognosis. We aimed to determine the relationship between dynamic assessment of trends in selected variables and outcomes.

Methods
We analysed trends in physiological and laboratory variables during the first week of intensive care unit (ICU) stay in 977 patients at 102 centres across 16 European countries. The primary outcome was 6-month mortality. Secondary endpoints were ICU, hospital and 28-day mortality. For each trend, Cox proportional hazards (PH) regression analyses, adjusted for age and sex, were performed for each endpoint.

Results
Trends over the first 7 days of the ICU stay independently associated with 6-month mortality were worsening thrombocytopaenia (mortality: hazard ratio (HR) = 1.02; 95% confidence interval (CI), 1.01 to 1.03; P <0.001) and renal function (total daily urine output: HR =1.02; 95% CI, 1.01 to 1.03; P <0.001; Sequential Organ Failure Assessment (SOFA) renal subscore: HR = 0.87; 95% CI, 0.75 to 0.99; P = 0.047), maximum bilirubin level (HR = 0.99; 95% CI, 0.99 to 0.99; P = 0.02) and Glasgow Coma Scale (GCS) SOFA subscore (HR = 0.81; 95% CI, 0.68 to 0.98; P = 0.028). Changes in renal function (total daily urine output and renal component of the SOFA score), GCS component of the SOFA score, total SOFA score and worsening thrombocytopaenia were also independently associated with secondary outcomes (ICU, hospital and 28-day mortality). We detected the same pattern when we analysed trends on days 2, 3 and 5. Dynamic trends in all other measured laboratory and physiological variables, and in radiological findings, changes inrespiratory support, renal replacement therapy and inotrope and/or vasopressor requirements failed to be retained as independently associated with outcome in multivariate analysis.

Conclusions
Only deterioration in renal function, thrombocytopaenia and SOFA score over the first 2, 3, 5 and 7 days of the ICU stay were consistently associated with mortality at all endpoints. These findings may help to inform clinical decision making in patients with this common cause of critical illness.