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1

Education permanente  

Microsoft Academic Search

We have heard a lot, both at this conference and before it, of the needs for Oducation permanente, of the institutional opposition inertia to its introduction, and about ways and means whereby the existing structures of higher and adult education might be modified to enable everybody to take advantage of so much of what is offered as may satisfy his

Derek Buchanan

1973-01-01

2

The Kaiser Permanente Community Health Initiative: Overview and Evaluation Design  

PubMed Central

We provide an overview of the Kaiser Permanente Community Health Initiative—created in 2003 to promote obesity-prevention policy and environmental change in communities served by Kaiser Permanente—and describe the design for evaluating the initiative. The Initiative focuses on 3 ethnically diverse northern California communities that range in size from 37 000 to 52 000 residents. The evaluation assesses impact by measuring intermediate outcomes and conducting pre- and posttracking of population-level measures of physical activity, nutrition, and overweight.

Schwartz, Pamela M.; Rauzon, Suzanne; Beery, William L.; Gee, Scott; Solomon, Loel

2010-01-01

3

Alphabetisation conscientisante comme base d'une education permanente  

NASA Astrophysics Data System (ADS)

D'après la pratique et les enseignements vécus, nous pensons qu'une alphabétisation fonctionnelle et conscientisante est susceptible de constituer la base d'une éducation permanente (life long education), à condition que: Une philosophie et une anthropologie de la libération de l'homme soient le fondement de 1'alphabétisation;

Ndimurukundo, Nicephore

1994-05-01

4

Taking Stock of the Kaiser Permanente Partnership Story  

Microsoft Academic Search

The success of the 2000 interest-based contract negotiation at Kaiser Permanente (KP) does not mean that future challenges to this approach to negotiation have evaporated. Among the factors that con- tributed to the success thus far were: establishing buy-in to what was a new approach for many people; effective coordination in a complex environment; deadline pressure; managing internal negotiations; effec-

Susan C. Eaton; Robert B. McKersie; Nils O. Fonstad

2004-01-01

5

Kaiser Permanente's experience of implementing an electronic medical record: a qualitative study  

Microsoft Academic Search

Objective To examine users' attitudes to implementation of an electronic medical record system in Kaiser Permanente Hawaii. Design Qualitative study based on semistructured interviews. Setting Four primary healthcare teams in four clinics, and four specialty departments in one hospital, on Oahu, Hawaii. Shortly before the interviews, Kaiser Permanente stopped implementation of the initial system in favour of a competing one.

J Tim Scott; Thomas G Rundall; Thomas M Vogt; John Hsu

2005-01-01

6

Kaiser Permanente-Sandia National Health Care Model: Phase 1 prototype final report. Part 2 -- Domain analysis  

Microsoft Academic Search

This report describes the results of a Cooperative Research and Development Agreement between Sandia National Laboratories and Kaiser Permanente Southern California to develop a prototype computer model of Kaiser Permanente`s health care delivery system. As a discrete event simulation, SimHCO models for each of 100,000 patients the progression of disease, individual resource usage, and patient choices in a competitive environment.

D. Edwards; A. Yoshimura; D. Butler; R. Judson; W. Mason; L. Napolitano; R. Mariano; D. Eddy; L. Schlessinger

1996-01-01

7

Interventions to Improve Quality of Care: The Kaiser Permanente-Alzheimer's Association Dementia Care Project  

Microsoft Academic Search

Objective: To improve quality of dementia care in a Kaiser Permanente service area through rigorous dissemination of prac- tice guidelines and social worker support for physicians and patients. Study Design: Pre-post design with practice behavior change assessed by medical record review, and provider and caregiver sat- isfaction with care assessed by surveys. Methods: A diagnostic guideline and later a management

Debra L. Cherry; Barbara G. Vickrey; Lenore Schwankovsky; Elizabeth Heck; Michelle Plauché; Ralph Yep

8

Accretionary history of an oceanic crustal assemblage: The Permanente terrane near Pacifica, California  

NASA Astrophysics Data System (ADS)

Previous studies of the Calera limestone (Permanente terrane, Franciscan complex) of California have shown that deposition occurred at approximately 25°N paleolatitude atop an oceanic plateau or rise, and that it was subsequently transported northeast and accreted to the North American continental margin in the early Tertiary. The Permanente terrane in the study area along the Pacific coast south of San Francisco contains a suite of rock types present in north dipping imbricate thrust slices possibly related to the subduction and accretion of an oceanic crustal sequence. Geochemical studies of greenstones, thought to represent fragments of the dismembered oceanic crust, indicate affinities with mid-ocean ridge basalts and within-plate basalt. These greenstones may represent fragments of the rise upon which the Calera limestone was deposited. Metamorphic minerals in the greenstones indicate both sea-floor metamorphism and locally, high-pressure, low-temperature metamorphism. It is concluded tentatively that the entire Permanente terrane in the study area underwent high-pressure, low-temperature metamorphism but that temporal or geologic conditions prevented widespread recrystallization or development of blueschist facies minerals. Structures in the deformed rocks can be related to underthrusting beneath the continental margin and attachment to the overriding plate. Studies of veins indicate several stages of dewatering. It is likely that dewatering was a major process in the attachment event, as shown by veins associated with this phase of deformation. Structurally interleaved mélanges and broken formation contain sedimentary rock clearly derived from a continental margin; these rocks probably represent trench and trench slope facies that were underthrust with the accreting oceanic crustal sequence.

Larue, D. K.; Barnes, Ivan; Sedlock, R. L.

1989-04-01

9

The Pathways Study: a prospective study of breast cancer survivorship within Kaiser Permanente Northern California  

Microsoft Academic Search

Objective  With 2.3 million breast cancer survivors in the US today, identification of modifiable factors associated with breast cancer\\u000a recurrence and survival is increasingly important. Only recently new studies have been designed to examine the impact of lifestyle\\u000a factors on prognosis, including Pathways, a prospective study of women with breast cancer in Kaiser Permanente Northern California\\u000a (KPNC).\\u000a \\u000a \\u000a \\u000a Methods  Pathways aims to examine the

Marilyn L. Kwan; Christine B. Ambrosone; Marion M. Lee; Janice Barlow; Sarah E. Krathwohl; Isaac Joshua Ergas; Christine H. Ashley; Julie R. Bittner; Jeanne Darbinian; Keren Stronach; Bette J. Caan; Warren Davis; Susan E. Kutner; Charles P. Quesenberry; Carol P. Somkin; Barbara Sternfeld; John K. Wiencke; Shichun Zheng; Lawrence H. Kushi

2008-01-01

10

The Kaiser Permanente Colorado Clinical Pharmacy Anticoagulation Service as a model of modern anticoagulant care.  

PubMed

The Clinical Pharmacy Anticoagulation Service (CPAS) at Kaiser Permanente Colorado grew from a single pharmacist assisting a single physician to a comprehensive service staffed by over 20 employees. CPAS provides care for over 7200 patients with each CPAS pharmacist managing all aspects of anticoagulation therapy for 150 to 500 patients. Unique aspects of CPAS include its centralized organization structure, the use of telepharmacy, collaboration drug therapy management agreement with referring physicians and a robust research agenda. Results of various CPAS research projects have been published in the peer-reviewed medical literature. PMID:18804262

Witt, Daniel M

2008-09-18

11

The Readmission Reduction Program of Kaiser Permanente Southern California--Knowledge Transfer and Performance Improvement  

PubMed Central

In 2011, Kaiser Permanente Northwest Region (KPNW) won the Lawrence Patient Safety Award for its innovative work in reducing hospital readmission rates. In 2012, Kaiser Permanente Southern California (KPSC) won the Transfer Projects Lawrence Safety Award for the successful implementation of the KPNW Region’s “transitional care” bundle to a Region that was almost 8 times the size of KPNW. The KPSC Transition in Care Program consists of 6 KPNW bundle elements and 2 additional bundle elements added by the KPSC team. The 6 KPNW bundle elements were risk stratification, standardized discharge summary, medication reconciliation, a postdischarge phone call, timely follow-up with a primary care physician, and a special transition phone number on discharge instructions. The 2 additional bundle elements added by KPSC were palliative care consult if indicated and a complex-case conference. KPSC has implemented most of the KPNW and KPSC bundle elements during the first quarter of 2012 for our Medicare risk population at all of our 13 medical centers. Each year, KPSC discharges approximately 40,000 Medicare risk patients. After implementation of bundle elements, KPSC Medicare risk all-cause 30-day Healthcare Effectiveness Data and Information Set readmissions observed-over-expected ratio and readmission rates from December 2010 to November 2012 decreased from approximately 1.0 to 0.80 and 12.8% to 11%, respectively.

Tuso, Philip; Huynh, Dan Ngoc; Garofalo, Lynn; Lindsay, Gail; Watson, Heather L; Lenaburg, Douglas L; Lau, Helen; Florence, Brandy; Jones, Jason; Harvey, Patti; Kanter, Michael H

2013-01-01

12

Effect of urban growth on streamflow regimen of Permanente Creek, Santa Clara County, California  

USGS Publications Warehouse

This report presents the results of an investigation of the effect of urban growth on the streamflow regimen of Permanente Creek in Mountain View, Santa Clara County, Calif. The data available did not permit a complete study of all hydrologic aspects, but there is conclusive evidence that the volume of storm runoff produced by rainfall on the valley floor has increased substantially as a result of urbanization. In 1945, storm runoff from the 5.12-square mile project area was insufficient to balance channel losses, and the streamflow entering the project area in the Permanente Creek channel was greater than that leaving the area. If, however, total outflow from the project area is considered to be the sum of the streamflow leaving the area plus channel seepage in the area, the ratio of total outflow to inflow was 1:18. By 1958, storm runoff from the project area was far in excess of channel losses and the ratio of total outflow to inflow was 1:70. This increase in outflow is attributed to the fact that urban development during the period 1945 to 1958 increased the extent of impervious surface in the project area from about 4 percent to 19 percent. The effect of urban growth in other basins in Santa Clara County should be investigated before any attempt is made to project the quantitative results of this study to other areas in the county.

Harris, E. E.; Rantz, S. E.

1964-01-01

13

Kaiser Permanente-Sandia National Health Care Model: Phase 1 prototype final report. Part 2 -- Domain analysis  

SciTech Connect

This report describes the results of a Cooperative Research and Development Agreement between Sandia National Laboratories and Kaiser Permanente Southern California to develop a prototype computer model of Kaiser Permanente`s health care delivery system. As a discrete event simulation, SimHCO models for each of 100,000 patients the progression of disease, individual resource usage, and patient choices in a competitive environment. SimHCO is implemented in the object-oriented programming language C{sup 2}, stressing reusable knowledge and reusable software components. The versioned implementation of SimHCO showed that the object-oriented framework allows the program to grow in complexity in an incremental way. Furthermore, timing calculations showed that SimHCO runs in a reasonable time on typical workstations, and that a second phase model will scale proportionally and run within the system constraints of contemporary computer technology.

Edwards, D.; Yoshimura, A.; Butler, D.; Judson, R.; Mason, W.; Napolitano, L.; Mariano, R. [Sandia National Labs., Livermore, CA (United States); Eddy, D.; Schlessinger, L. [Kaiser Permanente, Pasadena, CA (United States)

1996-11-01

14

Is the Kaiser Permanente model superior in terms of clinical integration?: a comparative study of Kaiser Permanente, Northern California and the Danish healthcare system  

PubMed Central

Background Integration of medical care across clinicians and settings could enhance the quality of care for patients. To date, there is limited data on the levels of integration in practice. Our objective was to compare primary care clinicians' perceptions of clinical integration and three sub-aspects in two healthcare systems: Kaiser Permanente, Northern California (KPNC) and the Danish healthcare system (DHS). Further, we examined the associations between specific organizational factors and clinical integration within each system. Methods Comparable questionnaires were sent to a random sample of primary care clinicians in KPNC (n = 1103) and general practitioners in DHS (n = 700). Data were analysed using multiple logistic regression models. Results More clinicians in KPNC perceived to be part of a clinical integrated environment than did general practitioners in the DHS (OR = 3.06, 95% CI: 2.28, 4.12). Further, more KPNC clinicians reported timeliness of information transfer (OR = 2.25, 95% CI: 1.62, 3.13), agreement on roles and responsibilities (OR = 1.79, 95% CI: 1.30, 2.47) and established coordination mechanisms in place to ensure effective handoffs (OR = 6.80, 95% CI: 4.60, 10.06). None of the considered organizational factors in the sub-country analysis explained a substantial proportion of the variation in clinical integration. Conclusions More primary care clinicians in KPNC reported clinical integration than did general practitioners in the DHS. Focused measures of clinical integration are needed to develop the field of clinical integration and to create the scientific foundation to guide managers searching for evidence based approaches.

2010-01-01

15

Developing Minimally Invasive Surgery Centers Within Kaiser Permanente: The Integrated Multidisciplinary Experience of Los Angeles  

PubMed Central

Minimally invasive surgical therapies are growing in type and volume of interventions. As one of the largest health delivery organizations in the US, Kaiser Permanente staff must be aware that the proliferation of these technologies has occurred in parallel within many surgical specialties, with a large variation in level of implementation between different regions and even within regions. In Los Angeles, we have developed the Minimally Invasive Surgery Center, encompassing a multidisciplinary, integrated approach. It unites the effort and expertise of many outstanding practitioners within the organization and consolidates the achievements of many surgical specialties. It also brings together the elements needed to provide the highest level of care to our patients in a safe, efficient, cost-effective environment, with minimal morbidity and best long-term outcome.

Chien, Gary W; Abbas, Maher A

2009-01-01

16

Acute Uterine Bleeding Unrelated to Pregnancy: A Southern California Permanente Medical Group Practice Guideline  

PubMed Central

Acute uterine bleeding unrelated to pregnancy has been defined as bleeding “sufficient in volume as to, in the opinion of the treating clinician, require urgent or emergent intervention.” The Southern California Permanente Medical Group updated its guidelines for the management of this condition on the basis of the best available evidence, as identified in a systematic review of the available literature. Given the paucity of studies evaluating this condition, the guidelines, by necessity, include recommendations largely based on opinion or other sources such as case series that are, in general, categorized as low-quality evidence. Medical interventions with single or combined gonadal steroidal agents administered parenterally or orally show promise, but more high-quality studies are needed to better define the appropriate drugs, dose, and administrative scheduling. There is also some evidence that intrauterine tamponade may be useful in at least selected cases. Special attention must be paid to both diagnosing and treating inherited disorders of hemostasis, such as von Willebrand disease, that may otherwise be underdiagnosed in both adolescent and adult women.

Munro, Malcolm G

2013-01-01

17

The Kaiser Permanente Implant Registries: Effect on Patient Safety, Quality Improvement, Cost Effectiveness, and Research Opportunities  

PubMed Central

Introduction: Considering the high cost, volume, and patient safety issues associated with medical devices, monitoring of medical device performance is critical to ensure patient safety and quality of care. The purpose of this article is to describe the Kaiser Permanente (KP) implant registries and to highlight the benefits of these implant registries on patient safety, quality, cost effectiveness, and research. Methods: Eight KP implant registries leverage the integrated health care system's administrative databases and electronic health records system. Registry data collected undergo quality control and validation as well as statistical analysis. Results: Patient safety has been enhanced through identification of affected patients during major recalls, identification of risk factors associated with outcomes of interest, development of risk calculators, and surveillance programs for infections and adverse events. Effective quality improvement activities included medical center- and surgeon-specific profiles for use in benchmarking reports, and changes in practice related to registry information output. Among the cost-effectiveness strategies employed were collaborations with sourcing and contracting groups, and assistance in adherence to formulary device guidelines. Research studies using registry data included postoperative complications, resource utilization, infection risk factors, thromboembolic prophylaxis, effects of surgical delay on concurrent injuries, and sports injury patterns. Conclusions: The unique KP implant registries provide important information and affect several areas of our organization, including patient safety, quality improvement, cost-effectiveness, and research.

Paxton, Elizabeth W; Inacio, Maria CS; Kiley, Mary-Lou

2012-01-01

18

The Pathways Study: A Prospective Study of Breast Cancer Survivorship within Kaiser Permanente Northern California  

PubMed Central

Objective With 2.3 million breast cancer survivors in the U.S. today, identification of modifiable factors associated with breast cancer recurrence and survival is increasingly important. Only recently new studies have been designed to examine the impact of lifestyle factors on prognosis, including Pathways, a prospective study of women with breast cancer in Kaiser Permanente Northern California (KPNC). Methods Pathways aims to examine the effect on recurrence and survival of 1) lifestyle factors such as diet, physical activity, quality of life, and use of alternative therapies and 2) molecular factors such as genetic polymorphisms involved in metabolism of chemotherapeutic agents. Eligibility includes any woman diagnosed with invasive breast cancer within KPNC, no previous diagnosis of other invasive cancer, age 21 years or older, and ability to speak English, Spanish, Cantonese, or Mandarin. Newly-diagnosed patients are identified daily from electronic pathology records and are enrolled within two months of diagnosis. An extensive baseline interview is conducted, blood and saliva samples are collected, and body measurements are taken. Women are followed for lifestyle updates, treatment, and outcomes by self-report and query of KPNC databases. Results Recruitment began in January 9, 2006, and as of January 16, 2008, 1,539 women have been enrolled along with collection of 1,323 blood samples (86%) and 1,398 saliva samples (91%). Conclusions The Pathways Study will become a rich resource to examine behavioral and molecular factors and breast cancer prognosis.

Kwan, Marilyn L.; Ambrosone, Christine B.; Lee, Marion M.; Barlow, Janice; Krathwohl, Sarah E.; Ergas, Isaac Joshua; Ashley, Christine H.; Bittner, Julie R.; Darbinian, Jeanne; Stronach, Keren; Caan, Bette J.; Davis, Warren; Kutner, Susan E.; Quesenberry, Charles P.; Somkin, Carol P.; Sternfeld, Barbara; Wiencke, John K.; Zheng, Shichun; Kushi, Lawrence H.

2008-01-01

19

An Evaluation of Approaches to Asthma Self-Management Education for Adults: The AIR\\/Kaiser-Permanente Study  

Microsoft Academic Search

The purpose of the AIR\\/Kaiser-Permanente asthma project is to evaluate various approaches to the education of adults with asthma, identifying those types of patients for whom particular approaches are most cost effective. Critical self-management prac tices for adults with asthma were identified using the critical incident technique. An individualized and a group administered educational program are being developed to teach

Sandra R. Wilson-Pessano; Peter Scamagas; Gary M. Arsham; Luis Chardon; Stamatiki Coss; Donald F. German; Gary W. Hughes

1987-01-01

20

B4-1: An Overview of Kaiser Permanente's Research Program on Genes, Environment, and Health.  

PubMed

Background/Aims The Research Program on Genes, Environment, and Health (RPGEH) is a large, population-based resource for genetic epidemiology developed by scientists at the Kaiser Permanente (KP) Northern California Division of Research. The goal of this program is to link research data for 500,000 broadly consented health plan members, including longitudinal electronic medical records (EMR), genomic data from biospecimens, and environmental exposure data from surveys and geographic information system (GIS) databases in order to support research on many different health conditions. Methods In 2011, the RPGEH established a state-of-the-art biorepository. The KP clinical lab infrastructure is used to collect and transfer blood samples to the biorepository where saliva, serum, plasma, buffy coat and extracted DNA samples are processed and archived. The biorepository includes a facility for separating blood into components for storage, as well as DNA extraction and normalization. Storage capabilities include -80 C and -20 C freezers, an ambient storage unit and LN2 freezers. The biorepository was designed to store blood components for up to 500,000 health plan members. Although initially participant recruitment was by postal mail, electronic methods of recruitment have now been developed. The goal of this effort was to decrease the per person cost of contact and to recruit younger members. By leveraging the KP EMR, blood draw orders are now automatically entered by RPGEH staff for consenting participants. These samples are then stored in the RPGEH biorepository and tracked in a Laboratory Information Management System. Results A survey of adult health plan members has provided data on health-related behaviors and other risk factors for 430,000 RPGEH participants. To date, 190,000 biospecimens from consenting RPGEH participants have been collected. Genome-wide genotyping and telomere length analysis of 100,000 RPGEH participants have been performed. Conclusions At >200,000 participants (with specimens for >100,000 genotyped), the RPGEH is already an extremely unique and valuable resource. PMID:24085930

Schaefer, Cathy; Rowell, Sarah; Henderson, Mary; Walter, Lawrence; Sadler, Marianne; Miles, Sunita; Schaffer, Donna; Croen, Lisa; Jorgenson, Eric; Kushi, Lawrence; Quesenberry, Charles

2013-09-01

21

B4-1: An Overview of Kaiser Permanente's Research Program on Genes, Environment, and Health  

PubMed Central

Background/Aims The Research Program on Genes, Environment, and Health (RPGEH) is a large, population-based resource for genetic epidemiology developed by scientists at the Kaiser Permanente (KP) Northern California Division of Research. The goal of this program is to link research data for 500,000 broadly consented health plan members, including longitudinal electronic medical records (EMR), genomic data from biospecimens, and environmental exposure data from surveys and geographic information system (GIS) databases in order to support research on many different health conditions. Methods In 2011, the RPGEH established a state-of-the-art biorepository. The KP clinical lab infrastructure is used to collect and transfer blood samples to the biorepository where saliva, serum, plasma, buffy coat and extracted DNA samples are processed and archived. The biorepository includes a facility for separating blood into components for storage, as well as DNA extraction and normalization. Storage capabilities include ?80 C and ?20 C freezers, an ambient storage unit and LN2 freezers. The biorepository was designed to store blood components for up to 500,000 health plan members. Although initially participant recruitment was by postal mail, electronic methods of recruitment have now been developed. The goal of this effort was to decrease the per person cost of contact and to recruit younger members. By leveraging the KP EMR, blood draw orders are now automatically entered by RPGEH staff for consenting participants. These samples are then stored in the RPGEH biorepository and tracked in a Laboratory Information Management System. Results A survey of adult health plan members has provided data on health-related behaviors and other risk factors for 430,000 RPGEH participants. To date, 190,000 biospecimens from consenting RPGEH participants have been collected. Genome-wide genotyping and telomere length analysis of 100,000 RPGEH participants have been performed. Conclusions At >200,000 participants (with specimens for >100,000 genotyped), the RPGEH is already an extremely unique and valuable resource.

Schaefer, Cathy; Rowell, Sarah; Henderson, Mary; Walter, Lawrence; Sadler, Marianne; Miles, Sunita; Schaffer, Donna; Croen, Lisa; Jorgenson, Eric; Kushi, Lawrence; Quesenberry, Charles

2013-01-01

22

Community Implementation and Translation of Kaiser Permanente's Cardiovascular Disease Risk-Reduction Strategy  

PubMed Central

Introduction: Since 2003, Kaiser Permanente (KP) has implemented innovative cardiovascular disease (CVD) risk-reduction clinical practices in Northern and Southern California that emphasize the use of cardioprotective medications—aspirin, angiotensin-converting enzyme inhibitors, and statins—in individuals at very high risk of experiencing heart attacks and strokes. Because an internal KP retrospective analysis demonstrated decreased morbidity and mortality among KP patients with diabetes, there is significant value in implementing this strategy in the broader community population, particularly in safety-net clinics serving the uninsured. Methods: To implement this risk-reduction clinical practice in the community, clinical and programmatic sections of KP had to connect with a set of community partners that share a similar approach of evidence-based prevention. Successful implementation required a well-planned and coordinated collaboration between KP and the community entities that allowed for and supported adaptation in local delivery structures. Results: Forty-six ambulatory clinic sites based at community health centers and in public hospital/health systems in California's safety net have initiated KP's CVD risk-reduction program. This resulted in 1125 community-clinic patients in Southern California and 1120 patients in Northern California receiving their first prescription for at least 1 of the 3 cardiovascular medications within the first 18 months of implementation. KP Colorado, KP Georgia, and KP Northwest are also implementing these strategies in their local communities. Discussion: The results of program initiation demonstrate successful translation of the KP CVD risk-reduction strategy to the broader, non-KP member community: uptake of 46 community clinic sites in 2 KP Regions, with a projection of >11,000 patients being prescribed the 3 cardioprotective medications in subsequent years and in multiple Regions. This may be a model for further spread of CVD prevention measures, and prevention programs for other diseases, to all populations throughout the US, notably underserved communities disproportionately affected by chronic conditions.

Wong, Winston; Jaffe, Marc; Wong, Michelle; Dudl, R James

2011-01-01

23

Patterns and predictors of breast cancer chemotherapy use in Kaiser Permanente Northern California, 2004-2007.  

PubMed

Chemotherapy regimens for early stage breast cancer have been tested by randomized clinical trials, and specified by evidence-based practice guidelines. However, little is known about the translation of trial results and guidelines to clinical practice. We extracted individual-level data on chemotherapy administration from the electronic medical records of Kaiser Permanente Northern California (KPNC), a pre-paid integrated healthcare system serving 29 % of the local population. We linked data to the California Cancer Registry, incorporating socio-demographic and tumor factors, and performed multivariable logistic regression analyses on the receipt of specific chemotherapy regimens. We identified 6,004 women diagnosed with Stage I-III breast cancer at KPNC during 2004-2007; 2,669 (44.5 %) received at least one chemotherapy infusion at KPNC within 12 months of diagnosis. Factors associated with receiving chemotherapy included <50 years of age [odds ratio (OR) 2.27, 95 % confidence interval (CI) 1.81-2.86], tumor >2 cm (OR 2.14, 95 % CI 1.75-2.61), involved lymph nodes (OR 11.3, 95 % CI 9.29-13.6), hormone receptor-negative (OR 6.94, 95 % CI 4.89-9.86), Her2/neu-positive (OR 2.71, 95 % CI 2.10-3.51), or high grade (OR 3.53, 95 % CI 2.77-4.49) tumors; comorbidities associated inversely with chemotherapy use [heart disease for anthracyclines (OR 0.24, 95 % CI 0.14-0.41), neuropathy for taxanes (OR 0.45, 95 % CI 0.22-0.89)]. Relative to high-socioeconomic status (SES) non-Hispanic Whites, we observed less anthracycline and taxane use by SES non-Hispanic Whites (OR 0.63, 95 % CI 0.49-0.82) and American Indians (OR 0.23, 95 % CI 0.06-0.93), and more anthracycline use by high-SES Asians/Pacific Islanders (OR 1.72, 95 % CI 1.02-2.90). In this equal-access healthcare system, chemotherapy use followed practice guidelines, but varied by race and socio-demographic factors. These findings may inform efforts to optimize quality in breast cancer care. PMID:23139057

Kurian, Allison W; Lichtensztajn, Daphne Y; Keegan, Theresa H M; Leung, Rita W; Shema, Sarah J; Hershman, Dawn L; Kushi, Lawrence H; Habel, Laurel A; Kolevska, Tatjana; Caan, Bette J; Gomez, Scarlett L

2012-11-09

24

A retrospective analysis of health systems in Denmark and Kaiser Permanente  

PubMed Central

Background To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy. Methods Retrospective analysis of secondary data in the Danish Health Care System (DHS) with 5.3 million citizens and the Kaiser Permanente integrated delivery system (KP) with 6.1 million members in California. We used secondary data to compare population characteristics, professional staff, delivery structure, utilisation and quality measures, and direct costs. We adjusted the cost data to increase comparability. Results A higher percentage of KP patients had chronic conditions than did patients in the DHS: 6.3% vs. 2.8% (diabetes) and 19% vs. 8.5% (hypertension), respectively. KP had fewer total physicians and staff compared to DHS, with134 physicians/100,000 individuals versus 311 physicians/100,000 individuals. KP physicians are salaried employees; in contrast, DHS primary care physicians own and run their practices, remunerated by a mixture of capitation and fee-for-service payments, while most specialists are employed at largely public hospitals. Hospitalisation rates and lengths of stay (LOS) were lower in KP, with mean acute admission LOS of 3.9 days versus 6.0 days in the DHS, and, for stroke admissions, 4.2 days versus 23 days. Screening rates also differed: 93% of KP members with diabetes received retinal screening; only 46% of patients in the DHS with diabetes did. Per capita operating expenditures were PPP$1,951 (KP) and PPP $1,845 (DHS). Conclusion Compared to the DHS, KP had a population with more documented disease and higher operating costs, while employing fewer physicians and resources like hospital beds. Observed quality measures also appear higher in KP. However, simple comparisons between health care systems may have limited value without detailed information on mechanisms underlying differences or identifying translatable care improvement strategies. We suggest items for more in-depth analyses that could improve the interpretability of findings and help identify lessons that can be transferred.

Fr?lich, Anne; Schi?tz, Michaela L; Strandberg-Larsen, Martin; Hsu, John; Krasnik, Allan; Diderichsen, Finn; Bellows, Jim; S?gaard, Jes; White, Karen

2008-01-01

25

The Kaiser Permanente Clinician Cultural and Linguistic Assessment Initiative: Research and Development in Patient-Provider Language Concordance  

PubMed Central

Patient–clinician language concordance is a critical component of the language access equation and is considered the gold standard for communication. As a result of lack of validated testing standards, measures, and tools, Kaiser Permanente developed the Clinician Cultural and Linguistic Assessment Initiative to ensure verifiable linguistic proficiency in clinical encounters and has established a standard level whereby the clinician is deemed to have a qualifying level of proficiency in communicating directly with patients independent of an interpreter. Our benchmarking efforts in language concordance have been rooted with the key aim to identify talented bilingual and bicultural clinician workforce and to establish the systems foundation to coordinate appropriate language services. We share accomplishments, lessons learned, and promising practices to inform future efforts in language concordance.

MSN, Gayle Tang; Lanza, Oscar; Rodriguez, Fatima Marinely; Chang, Annie

2011-01-01

26

Measuring the impact of patient counseling in the outpatient pharmacy setting: development and implementation of the counseling models for the kaiser permanente\\/USC patient consultation study  

Microsoft Academic Search

The Southern California region Kaiser Permanente Medical Care Program, which serves 2.2 million patients, and the University of Southern California School of Pharmacy have designed and implemented a patient consultation study to determine the cost-effectiveness of three different approaches to providing pharmacist consultation to outpatients. This paper describes the development and implementation of these three models. A total of 107

Kathleen A. Johnson; Matt Nye; Kathleen Hill-Besinque; Marisue Cody

1995-01-01

27

La posesión como hecho punible  

Microsoft Academic Search

Este trabajo estudia el delito de posesión, el cual se extiende semánticamente hasta términos como custodia, mantener disponible, almacenar, etc., y como conminada con la pena se halla la posesión de explosivos, de armas de fuego, de drogas, de pornografía infantil, etc. En este mismo trabajo se analizan, bajo la óptica del Código Penal alemán, cómo las acciones graves o

Friedrich Christian Schroeder

28

Lake Como 1991 Reservoir Survey.  

National Technical Information Service (NTIS)

This report presents the results of the first extensive survey of Lake Como by Reclamation since construction of Como Dam. The primary objective of the 1991 survey was to gather necessary data for computing the current total and active capacities of Lake ...

R. L. Ferrari

1992-01-01

29

PS3-16: Access and Collaboration with the Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH)  

PubMed Central

Background/Aims The Kaiser Permanente Northern California (KPNC) Research Program on Genes, Environment, and Health (RPGEH) provides a research resource to support investigations of environmental and genetic factors in the development of a wide variety of conditions. While the resource is still evolving with new data collection, it consists of data from surveys and electronic medical records on over 400,000 adult members of KPNC; biospecimens collected and stored on ~200,000 of these individuals; and data from genome-wide and telomere-length assays on ~110,000 of those who have contributed biospecimens; and linkage of these members to environmental, area-level databases. Methods The RPGEH was developed in part with the understanding that it would be made available to the scientific community for appropriate studies. An Access and Collaborations Core has developed procedures for submission of applications for research studies, their review, and decisions on approval and support. Review of proposals by an Applications Review Committee follows a two-step process, with a pre-application to assess feasibility (e.g., adequate numbers of the phenotype: availability of appropriate data, given inclusion criteria) and a full application to assess appropriateness of the study in the RPGEH context. Scientific merit; alignment with RPGEH guiding principles, including ethical, legal, and social implications; consistency with informed consents; potential overlap with prior approvals; and collaboration with a researcher affiliated with the Division of Research are among the criteria for approval. As an alternative for select analyses, genomic and selected phenotypic data will be available in the NIH database of genotypes and phenotypes (dbGaP) for the substantial subset of RPGEH participants who have consented to dbGaP deposition. Results As of October 31, 2012, the RPGEH has received 74 pre-applications and full applications for the use of its resources; only 6 pre-applications were not approved. In 2011–2012, 13 approved applications were funded by NIH and other agencies. Studies currently underway include genome-wide association studies of prostate cancer, bi-polar disorder, multiple sclerosis, and mammographic density. Conclusions Access to the unique and outstanding research resources of the RPGEH balances the mission of promoting research with the need to shepherd finite resources and safeguard member confidentiality.

Schaffer, Donna; Kushi, Lawrence; Henderson, Mary; Clancy, Heather; Somkin, Carol; Quesenberry, Charles; Jorgenson, Eric; Samelson, Allen; Whitmer, Rachel; Habel, Laurel; Barcellos, Lisa

2013-01-01

30

PS1-8: A Prospective Study of Breast Cancer Survivorship in Kaiser Permanente Northern California: The Pathways Study.  

PubMed

Background/Aims With over 2.5 million breast cancer survivors in the U.S. today, identification of modifiable factors associated with recurrence and survival is imperative. The Pathways Study, a prospective study of breast cancer survivors in Kaiser Permanente Northern California (KPNC) is examining the effects of lifestyle (e.g., diet, physical activity, complementary and alternative medicine [CAM]), contextual (e.g., social and built environment characteristics), medical care, and genetic and molecular factors on breast cancer prognosis. Methods Women who are newly-diagnosed with invasive breast cancer are identified daily from KPNC electronic pathology records. Eligibility criteria include being at least 21 years old at diagnosis, no previous history of invasive cancer, and English, Spanish, or Chinese-speaking. Women are enrolled during an in-person baseline interview with collection of blood and saliva specimens, and followed periodically for lifestyle updates, treatment, and outcomes via mailed questionnaires, telephone interviews, and web surveys. Outcomes are also confirmed using KPNC electronic databases. Results As of October 23, 2012, 4,340 women have been enrolled. The cohort is racially and ethnically diverse: 62% White, 12% Hispanic, 12% Asian, 8% Black, 3% Other. Blood and saliva have been obtained on 89% and 95% of enrollees, respectively. Recruitment is planned to end in March 2013, and follow-up will continue through June 2015 and beyond pending further funding. A total of 230 recurrences and 245 deaths have been confirmed. Conclusions To date, 14 papers have been published on topics ranging from CAM use at diagnosis, quality of life at diagnosis, lymphedema risk factors, physical activity during treatment, employment status and quality of life, adherence to adjuvant hormonal therapy, breast cancer DNA methylation profiles, and correlates of breast cancer subtypes. The Pathways Study has provided a platform for several ancillary studies, investigating lymphedema, racial disparities in treatment, the physiology of aging, and bone health, and also has provided support for several career development awards. The research team has also included Zero Breast Cancer, a nonprofit organization dedicated to breast cancer research through community participation. The Pathways Study has become a rich resource of behavioral, genetic and molecular factors and breast cancer outcomes. PMID:24085867

Roh, Janise; Munneke, Julie; Kwan, Marilyn; Ergas, Isaac; Song, Jun; Yao, Song; Ambrosone, Christine; Wiencke, John; Lee, Marion; Gomez, Scarlett; Barlow, Janice

2013-09-01

31

Internet Infrastructures and Health Care Systems: a Qualitative Comparative Analysis on Networks and Markets in the British National Health Service and Kaiser Permanente  

PubMed Central

Background The Internet and emergent telecommunications infrastructures are transforming the future of health care management. The costs of health care delivery systems, products, and services continue to rise everywhere, but performance of health care delivery is associated with institutional and ideological considerations as well as availability of financial and technological resources. Objective To identify the effects of ideological differences on health care market infrastructures including the Internet and telecommunications technologies by a comparative case analysis of two large health care organizations: the British National Health Service and the California-based Kaiser Permanente health maintenance organization. Methods A qualitative comparative analysis focusing on the British National Health Service and the Kaiser Permanente health maintenance organization to show how system infrastructures vary according to market dynamics dominated by health care institutions ("push") or by consumer demand ("pull"). System control mechanisms may be technologically embedded, institutional, or behavioral. Results The analysis suggests that telecommunications technologies and the Internet may contribute significantly to health care system performance in a context of ideological diversity. Conclusions The study offers evidence to validate alternative models of health care governance: the national constitution model, and the enterprise business contract model. This evidence also suggests important questions for health care policy makers as well as researchers in telecommunications, organizational theory, and health care management.

2002-01-01

32

Storm-runoff generation in the Permanente Creek drainage basin, west central California - An example of flood-wave effects on runoff composition  

USGS Publications Warehouse

Variations in the isotopic and chemical composition of storm runoff in the 10.6-km2 Permanente Creek basin, Santa Clara County, California, indicate that changes in water composition lag behind changes in streamflow. This lag occurs even though field observations and rainfall-runoff modeling indicate that much of the storm runoff must be composed of "new" water running off impervious surfaces. The apparent incompatibility posed by the presence of "old" water and the direct and indirect evidence that surface runoff contributes substantially to storm runoff can be explained if initial rises in streamflow result from effects of flood waves. Flood waves composed of old channel water reach downstream locations ahead of the new water derived from impervious areas. By this mechanism, streamflow can rise rapidly in response to surface runoff and still be composed of large amounts of old water. Data collected in Permanente Creek indicate that flood waves can occur even in small basins, at least when those basins contain impervious surfaces. ?? 1990.

Nolan, K. M.; Hill, B. R.

1990-01-01

33

Health-Plan and Employer-Based Wellness Programs to Reduce Diabetes Risk: The Kaiser Permanente Northern California NEXT-D Study  

PubMed Central

Primary prevention of diabetes is increasingly recognized by both health plans and employers as an important strategy to improve the health of insured populations. As a part of the Natural Experiments in Translation for Diabetes (NEXT-D) network, the Kaiser Permanente Northern California (KPNC) Division of Research is assessing the effectiveness of 2 health plan-initiated programs to prevent the onset of diabetes in patients at high risk. The first study evaluates a telephonic health-coaching program that provides counseling on healthful eating, active living, and weight loss to KPNC members. The second evaluation examines a postpartum glucose screening and educational diabetes prevention program for women with gestational diabetes mellitus that KPNC implemented in 2006. Identifying effective approaches to preventing diabetes will be of value to health care systems, policy makers, and public health officials seeking to understand the roles systems and employers can play in preventing chronic illness.

Brown, Susan D.; Neugebauer, Romain; Adams, Sara R.; Adams, Alyce S.; Wiley, Deanne; Ferrara, Assiamira

2013-01-01

34

The Department of Veterans Affairs, Department of Defense, and Kaiser Permanente Nationwide Health Information Network Exchange in San Diego: Patient Selection, Consent, and Identity Matching  

PubMed Central

The Nationwide Health Information Network allow for the secure exchange of Electronic Health Records over the Internet. The Department of Veterans Affairs, Department of Defense, and Kaiser Permanente, participated in an implementation of the NwHIN specifications in San Diego, California. This paper focuses primarily on patient involvement. Specifically, it describes how the shared patients were identified, were invited to participate and to provide consent for disclosing parts of their medical record, and were matched across organizations. A total 1,144 were identified as shared patients. Invitation letters containing consent forms were mailed and resulted in 42% participation. Invalid consent forms were a significant issue (25%). Initially, the identity matching algorithms yielded low success rate (5%). However, elimination of certain traits and abbreviations and probabilistic algorithms have significantly increased matching rate. Access to information from external sources better informs providers, improves decisions and efficiency, and helps meet the meaningful use criteria.

Bouhaddou, Omar; Bennett, Jamie; Cromwell, Tim; Nixon, Graham; Teal, Jennifer; Davis, Mike; Smith, Robert; Fischetti, Linda; Parker, David; Gillen, Zachary; Mattison, John

2011-01-01

35

Health-plan and employer-based wellness programs to reduce diabetes risk: The Kaiser Permanente Northern California NEXT-D Study.  

PubMed

Primary prevention of diabetes is increasingly recognized by both health plans and employers as an important strategy to improve the health of insured populations. As a part of the Natural Experiments in Translation for Diabetes (NEXT-D) network, the Kaiser Permanente Northern California (KPNC) Division of Research is assessing the effectiveness of 2 health plan-initiated programs to prevent the onset of diabetes in patients at high risk. The first study evaluates a telephonic health-coaching program that provides counseling on healthful eating, active living, and weight loss to KPNC members. The second evaluation examines a postpartum glucose screening and educational diabetes prevention program for women with gestational diabetes mellitus that KPNC implemented in 2006. Identifying effective approaches to preventing diabetes will be of value to health care systems, policy makers, and public health officials seeking to understand the roles systems and employers can play in preventing chronic illness. PMID:23369768

Schmittdiel, Julie A; Brown, Susan D; Neugebauer, Romain; Adams, Sara R; Adams, Alyce S; Wiley, Deanne; Ferrara, Assiamira

2013-01-01

36

Measuring of impact of patient counseling in the outpatient pharmacy setting: development and implementation of the counseling models for the Kaiser Permanente/USC Patient Consultation Study.  

PubMed

The Southern California region Kaiser Permanente Medical Care Program, which serves 2.2 million patients, and the University of Southern California School of Pharmacy have designed and implemented a patient consultation study to determine the cost-effectiveness of three different approaches to providing pharmacist consultation to outpatients. This paper describes the development and implementation of these three models. A total of 107 pharmacies (approximately 600 pharmacists) participated in the study and were assigned to provide one of the models of patient consultation, designated the Kaiser Permanente (KP) model, the state model, and the control model. The KP model (20 pharmacies) provided targeted pharmaceutical care services to high-risk patients based on drug use. The state model (67 pharmacies) provided California-mandated patient consultation to patients with new or changed prescriptions, instructions for use, relevant warnings and precautions, storage requirements, and the importance of compliance. The control model (20 pharmacies) provided consultation when deemed necessary by the pharmacist and provided care similar to that provided before mandatory consultation in California. The KP and state models used the same pharmacist/technician/clerk resources, but the control pharmacies limited personnel resources to those existing before the mandatory consultation law was passed in California. The paper describes the KP model in detail and provides a literature-based rationale for targeting particular high-risk patients for expanded services. The paper also describes the training process, gives an example of a high-risk patient intervention, provides information on documenting pharmacist interventions in all models, and explains the method used for monitoring implementation of the models. PMID:8595650

Johnson, K A; Nye, M; Hill-Besinque, K; Cody, M

37

PS3-15: Genome-Wide Association Study of Anxiety Disorders: Early Results from Kaiser Permanente's Research Program on Genes, Environment, and Health (RPGEH)  

PubMed Central

Background/Aims The Kaiser Permanente/UCSF Genetic Epidemiology Research Study on Adult Health and Aging (GERA) cohort includes 110,266 individuals with comprehensive longitudinal medical records along with genome-wide genotype data. As such, it provides an unprecedented opportunity to conduct a number of genome-wide association studies (GWAS) of psychiatric disorders. Post-traumatic stress disorder (PTSD) and panic disorder (PD) are prevalent, persistent, disabling and heritable anxiety disorders. Numerous candidate gene studies have been published with inconsistent findings. We conducted the GWAS of PTSD and the GWAS of panic disorder among non-Hispanic white GERA cohorts to detect the underlying heterogeneous genetic architecture. Methods We identified a total of 6177 combined ASD and PTSD cases in the GERA cohort, in which cases had two or more psychiatric diagnoses of ASD and/or PTSD; the GERA cohort supplied 63,613 controls. A total of 1483 subjects with two or more diagnoses of panic disorder and 75,379 controls were included in the GWAS of panic disorder. All the cases and controls were genotyped on the custom Affymetrix Axiom EUR arrays with 674,518 SNPs. Results In the GWAS of combined ASD and PTSD or the GWAS of PD, a suggestive association with ASD/PTSD was found with a SNP in an intergenic region on chromosome 10 near the ANKRD20A gene (OR = 1.11, P = 1.42×10?7), as well as neighboring SNPs. In the GWAS of PD, we replicated a SNP association (rs1873727) in intron 3 of TMEM132D which was reported in a recent GWAS of PD. Conclusions Our analysis did not yield conclusive associations with PTSD or PD. We replicated a candidate gene in TMEM132D in the PD analysis. This suggests that we can observe true association signals for these disorders, but additional cases are needed to detect modest effects. GWAS of psychiatric disorders remain challenging.

Shen, Ling; Hoffmann, Thomas; Kvale, Mark; Sakoda, Lori; Banda, Yambazi; Kwok, Pui-Yan; Risch, Neil; Jorgenson, Eric; Schaefer, Cathy

2013-01-01

38

Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System  

PubMed Central

Background Self-management support is considered to be an essential part of diabetes care. However, the implementation of self-management support within healthcare settings has appeared to be challenging and there is increased interest in “real world” best practice examples to guide policy efforts. In order to explore how different approaches to diabetes care and differences in management structure influence the provision of SMS we selected two healthcare systems that have shown to be comparable in terms of budget, benefits and entitlements. We compared the extent of SMS provided and the self-management behaviors of people living with diabetes in Kaiser Permanente (KP) and the Danish Healthcare System (DHS). Methods Self-administered questionnaires were used to collect data from a random sample of 2,536 individuals with DM from KP and the DHS in 2006–2007 to compare the level of SMS provided in the two systems and identify disparities associated with educational attainment. The response rates were 75?% in the DHS and 56?% in KP. After adjusting for gender, age, educational level, and HbA1c level, multiple linear regression analyses determined the level of SMS provided and identified disparities associated with educational attainment. Results Receipt of SMS varied substantially between the two systems. More people with diabetes in KP reported receiving all types of SMS and use of SMS tools compared to the DHS (p?

2012-01-01

39

PS1-09: Public Opinion of Family History and Genetic Testing for Common Diseases: Results from Focus Groups with Kaiser Permanente Colorado Members  

PubMed Central

Background and Aims: With the advent of personalized medicine, consumers are routinely exposed to information about new gene discoveries, family history, and direct-to-consumer (DTC) advertising of genetic tests. Since 2008, the BRACAnalsysis® test for breast cancer risk has been steadily advertised directly to consumers in different markets across the US, and at least 3 companies now offer DTC genetic screening for $300 – $1000, with more companies entering this burgeoning market. The specific aims of this project are to: determine how individuals understand the issue of family history and DTC genetic tests, and to determine how individual perspectives about issue salience and issue frames differ by population group. Methods: As part of a CRN pilot project, focus groups were conducted with Kaiser Permanente Colorado members in 2009 to determine individual perspectives and public opinion about the importance and value of family history, DTC genetic testing, and DTC advertising and other media representations of DTC genetic tests. Focus groups were conducted by concordant population groups: General population KPCO members, members who self-identify as African American, members who self-identify as Hispanic/Latino, women with a recent referral for BRCA1/2 testing, KPCO primary care providers, and KPCO specialty care providers. Results: Results on focus group demographics, media use, trust in information, and most trusted information sources are presented. Additional results include coding focus group transcripts for value and polarity (positive/negative) of opinion on family history and genetic testing. Additional coding for how different population groups frame opinion on the issue (progressive, deterministic, caution) include results on whether frames are similar or different across population groups. Finally, information on the impact of media presentations on member opinion and decision-making were assessed. Conclusions: Individual opinions about the value of family history and genetic testing for disease risk vary greatly. Salience of themes related to genetic testing and DTC genetic tests specifically may vary across concordant population groups.

Rahm, Alanna Kulchak

2010-01-01

40

B4-4: Genome-Wide Association Study of Macular Degeneration: Early Results from the Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH)  

PubMed Central

Background/Aims Age-related macular degeneration (AMD) is the most common cause of vision loss in individuals over the age of 50 in the United States. Genetic factors explain a large portion of the risk of developing AMD, and genetic variants at the CFH, HTRA1/ARMS2, C2/CFB, and C3 gene loci have previously been associated with the disease. Methods We conducted a genome-wide association study (GWAS) of AMD in the Kaiser Permanente Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort. The GERA cohort includes 110,266 subjects with extensive electronic medical record information on eye examinations, diagnoses and treatment of vision disorders, and dense genome-wide genotype information on more than 675,000 genetic markers generated using Affymetrix Axiom arrays. The cohort is ethnically diverse, with 7.5% Asian, 7% Latino, 3.5% African American, and 81% non-Hispanic white subjects. We identified a total of 2,147 AMD cases (46 Asian, 125 Latino, 11 African American, and 1,965 non-Hispanic whites) and 37,521 controls (2,013 Asian, 3,201 Latino, 1,168 African American, and 31,139 non-Hispanic whites) for analysis. Analyses were conducted separately for each race/ethnicity group. Results In the largest group, non-Hispanic whites, we identified highly significant associations with variants in the CFH and HTRA1/ARMS2 gene regions, and genome-wide significant associations in the C2/CFB and C3 gene regions. Conclusions These results confirm those of previous studies and demonstrate the power of the GERA cohort for combining information from electronic medical records with extensive genotype data. This approach can be applied to additional vision disorder phenotypes, including response to treatment and disease progression.

Jorgenson, Eric; Sciortino, Stan; Shen, Ling; Ranatunga, Dilrini; Hoffmann, Thomas; Kvale, Mark; Banda, Yambazi; Kwok, Pui-Yan; Walter, Lawrence; Risch, Neil; Schaefer, Cathy

2013-01-01

41

B4-4: Genome-Wide Association Study of Macular Degeneration: Early Results from the Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH).  

PubMed

Background/Aims Age-related macular degeneration (AMD) is the most common cause of vision loss in individuals over the age of 50 in the United States. Genetic factors explain a large portion of the risk of developing AMD, and genetic variants at the CFH, HTRA1/ARMS2, C2/CFB, and C3 gene loci have previously been associated with the disease. Methods We conducted a genome-wide association study (GWAS) of AMD in the Kaiser Permanente Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort. The GERA cohort includes 110,266 subjects with extensive electronic medical record information on eye examinations, diagnoses and treatment of vision disorders, and dense genome-wide genotype information on more than 675,000 genetic markers generated using Affymetrix Axiom arrays. The cohort is ethnically diverse, with 7.5% Asian, 7% Latino, 3.5% African American, and 81% non-Hispanic white subjects. We identified a total of 2,147 AMD cases (46 Asian, 125 Latino, 11 African American, and 1,965 non-Hispanic whites) and 37,521 controls (2,013 Asian, 3,201 Latino, 1,168 African American, and 31,139 non-Hispanic whites) for analysis. Analyses were conducted separately for each race/ethnicity group. Results In the largest group, non-Hispanic whites, we identified highly significant associations with variants in the CFH and HTRA1/ARMS2 gene regions, and genome-wide significant associations in the C2/CFB and C3 gene regions. Conclusions These results confirm those of previous studies and demonstrate the power of the GERA cohort for combining information from electronic medical records with extensive genotype data. This approach can be applied to additional vision disorder phenotypes, including response to treatment and disease progression. PMID:24085932

Jorgenson, Eric; Sciortino, Stan; Shen, Ling; Ranatunga, Dilrini; Hoffmann, Thomas; Kvale, Mark; Banda, Yambazi; Kwok, Pui-Yan; Walter, Lawrence; Risch, Neil; Schaefer, Cathy

2013-09-01

42

PS3-13: Re-Identification Risk Associated with Sharing Linked Genomic and Phenotypic Data from the Kaiser Permanente Research Program on Genes, Environment and Health (RPGEH).  

PubMed

Background/Aims It is now understood that conventional de-identification methods such as the HIPAA Safe Harbor standard do not guarantee anonymity of patient records, which may be vulnerable to a variety of attacks aimed at re-identifying confidential information. We present an analytic framework for evaluating these risks quantitatively in order to be able to explicitly balance privacy and scientific utility. As a concrete example, we examine implications for patient privacy of plans to deposit over 70,000 full-genome genotypes and associated clinical data in the dbGaP federally-managed data repository, as a component of a NIH-funded study conducted by the Research Program on Genes, Environment, and Health (RPGEH) at the Kaiser Permanente Northern California Division of Research (KPNC DOR). Risks are examined from multiple perspectives and risk reduction strategies discussed. Methods Two analytic approaches are described: (1) "k-anonymization", which computes risk based only on the distribution of cell sizes in the disclosed dataset; and (2) "k-map" which takes account of the characteristics of potential reference datasets - e.g., voter rolls, disease registries - which may be available to the attacker. Probabilities of re-identification were computed using a random sample of records from actual study participants, and assumed disclosure of the following phenotypic attributes: 5-year age group, sex, race (5 categories) and a set of 22 ICD9-defined common diseases. For method 2, the KPNC EMR was used as a proxy for a highly informative reference dataset. Results The first method tended to yield very conservative estimates of risk: 9.5% of subjects in the disclosed dataset had unique phenotypic attributes, while 18% were in cells of size <5 and 24% were in cells of size <10. Factoring in characteristics of potential reference datasets, method 2, yielded substantially lower levels of risk: 2% of subjects were distinct, 4% in cells size <5, and 6% in cells of size <10. Conclusions Assessment of re-identification risk of disclosed genomic-phenotypic data is complex, involving differing stakeholders' perspectives, attack types, and characteristics of both the disclosed data and the surrounding information environment. However, reasonable assumptions can be made which allow quantitative estimates of risk, and suggest strategies for risk reduction. PMID:24085938

Walter, Lawrence; Sciortino, Stan; Ranatunga, Dilrini; Kay, Julia; Ludwig, Dana; Somkin, Carol; Henderson, Mary; Schaefer, Cathy

2013-09-01

43

PS3-13: Re-Identification Risk Associated with Sharing Linked Genomic and Phenotypic Data from the Kaiser Permanente Research Program on Genes, Environment and Health (RPGEH)  

PubMed Central

Background/Aims It is now understood that conventional de-identification methods such as the HIPAA Safe Harbor standard do not guarantee anonymity of patient records, which may be vulnerable to a variety of attacks aimed at re-identifying confidential information. We present an analytic framework for evaluating these risks quantitatively in order to be able to explicitly balance privacy and scientific utility. As a concrete example, we examine implications for patient privacy of plans to deposit over 70,000 full-genome genotypes and associated clinical data in the dbGaP federally-managed data repository, as a component of a NIH-funded study conducted by the Research Program on Genes, Environment, and Health (RPGEH) at the Kaiser Permanente Northern California Division of Research (KPNC DOR). Risks are examined from multiple perspectives and risk reduction strategies discussed. Methods Two analytic approaches are described: (1) “k-anonymization”, which computes risk based only on the distribution of cell sizes in the disclosed dataset; and (2) “k-map” which takes account of the characteristics of potential reference datasets – e.g., voter rolls, disease registries - which may be available to the attacker. Probabilities of re-identification were computed using a random sample of records from actual study participants, and assumed disclosure of the following phenotypic attributes: 5-year age group, sex, race (5 categories) and a set of 22 ICD9-defined common diseases. For method 2, the KPNC EMR was used as a proxy for a highly informative reference dataset. Results The first method tended to yield very conservative estimates of risk: 9.5% of subjects in the disclosed dataset had unique phenotypic attributes, while 18% were in cells of size <5 and 24% were in cells of size <10. Factoring in characteristics of potential reference datasets, method 2, yielded substantially lower levels of risk: 2% of subjects were distinct, 4% in cells size <5, and 6% in cells of size <10. Conclusions Assessment of re-identification risk of disclosed genomic-phenotypic data is complex, involving differing stakeholders’ perspectives, attack types, and characteristics of both the disclosed data and the surrounding information environment. However, reasonable assumptions can be made which allow quantitative estimates of risk, and suggest strategies for risk reduction.

Walter, Lawrence; Sciortino, Stan; Ranatunga, Dilrini; Kay, Julia; Ludwig, Dana; Somkin, Carol; Henderson, Mary; Schaefer, Cathy

2013-01-01

44

Rechenverfahren des optischen Korrektionsprogrammms "COMO". Teil 1.  

NASA Astrophysics Data System (ADS)

COMO is a program of an orthogonalization type that was developed in order to achieve that each elementary correction step makes immediate use of the shortest possible step in the system data space even if many rigid boundary conditions are to be taken into account (optimization under constraints). COMO usually does not correct aberrations simultaneously (by minimization), but one after the other. The order is given by the optical designer. For each aberration (paraxial data included) one can either specify a target value or a bandwidth between a lower and an upper limit.

Marx, H.

1989-03-01

45

Reporting on a Talk I Gave Some Months Ago, the Headline in "La Opinion," Los Angeles' Premier Spanish Language Newspaper, Declared the City's School System "en crisis permanente." No One Wrote in to Disagree. The Claremont Letter. Volume 3, Issue 1  

ERIC Educational Resources Information Center

|Reporting on a talk the author gave some months ago, the headline in "La Opinion," Los Angeles' premier Spanish language newspaper, declared the city's school system "en crisis permanente." No one wrote in to disagree. Indeed, at the end of "Learning from L.A.: Institutional Change in American Public Education" (Harvard Education Press) the…

Kerchner, Charles T.

2008-01-01

46

Management of Lake Como: a multiobjective analysis  

SciTech Connect

This paper describes a heuristic approach for improving the performance of multipurpose reservoirs that have already been in operation for a certain number of years. The main characteristic of the method is that the analyst must first learn from the past experience of the manager and synthesize it into a simple operating rule. Then, the analyst must point out, with the help of the manager, what the acceptable modifications of such a rule are. After this has been accomplished, the optimal improvements of the operating rule can be obtained by using standard optimization techniques. Quite satisfactory results have been obtained by applying this approach to Lake Como (Northern Italy), which has been regulated since the end of World War II. In fact, the method shows that both flood protection on the lake shores and water supply to the downstream agricultural areas can be substantially improved, without lowering the mean yearly electricity production of the downstream run-of-river plants. For this reason the operating rule proposed by the method has been programmed on a microcomputer, which is now used every day by the manager as an essential support for his final decision. This and the fact that other actions suggested by this analysis have indeed been undertaken by the local authorities gave to this study the chance to have a positive and direct impact on the lake management.

Guariso, G.; Rinaldi, S.; Soncini-Sessa, R.

1986-02-01

47

PS3-14: CREX: Utility of a Computerized Methodology to Identify Health Conditions Using the EMR for GWAS, in the Kaiser Permanente Research Program on Genes, Environment, and Health  

PubMed Central

Background/Aims The Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort has genotyped data on over 100,000 participants. In order to characterize many health conditions of interest found among respondents for sample-size estimation and GWAS, we sought to extend methodologies that utilized the Electronic Medical Record (EMR) in an automated way to characterize many diseases without the expense and limitation of numerous, complex algorithms specific to individual diseases and conditions. Methods We tested a probabilistic approach that scored clinical decisions recorded in the EMR to capture specific diagnostic and treatment domains. We first considered physician diagnosis alone. We assessed sensitivity and specificity against internal registries at the Kaiser Permanente Northern California Division of Research. We also used the methodology to characterize phenotypes for Types 1 and 2 diabetes for GWAS. We tested a single diagnostic domain in a logistic model based on an ICD-9-CM taxonomy and found high sensitivity and specificity when compared with internal registries for breast, lung, colon and prostate cancers; Barrett’s esophagus; HIV; Crohn’s disease; ulcerative colitis, and diabetes. We then assessed a logistic regression model to distinguish among members with Types 1 and 2 diabetes in the genotyped cohort, utilizing the ICD-9 taxonomy, the earliest age at diagnosis available in the EMR or by self-report, and pharmacy prescription utilization of anti-diabetic drugs. Results The model exhibited a sensitivity of 96.3% and specificity of 99.6% for Type 1 diabetes and a sensitivity of 94.0% and specificity of 98.4% for Type 2 diabetes when compared with the gold standard internal diabetes registry. We identified an additional 60 cases of Type 1 diabetes and conducted comparative GWAS. Conclusions Utilizing diagnostic information in the EMR as independent domains in probabilistic models to accomplish phenotype creation appears to be a reliable approach to facilitate robust characterization for evaluation, analysis and mapping of numerous disease phenotypes. The method is agnostic to input taxonomies as long as the EMR record contains sufficient and reliable atomic detail. It can also be adapted for machine learning given expert user feedback when gold standard databases are not available.

Sciortino, Stan; Walter, Lawrence; Ranatunga, Dilrini; Ludwig, Dana; Schaefer, Cathy; Kay, Julia; Jorgenson, Eric

2013-01-01

48

PS3-14: CREX: Utility of a Computerized Methodology to Identify Health Conditions Using the EMR for GWAS, in the Kaiser Permanente Research Program on Genes, Environment, and Health.  

PubMed

Background/Aims The Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort has genotyped data on over 100,000 participants. In order to characterize many health conditions of interest found among respondents for sample-size estimation and GWAS, we sought to extend methodologies that utilized the Electronic Medical Record (EMR) in an automated way to characterize many diseases without the expense and limitation of numerous, complex algorithms specific to individual diseases and conditions. Methods We tested a probabilistic approach that scored clinical decisions recorded in the EMR to capture specific diagnostic and treatment domains. We first considered physician diagnosis alone. We assessed sensitivity and specificity against internal registries at the Kaiser Permanente Northern California Division of Research. We also used the methodology to characterize phenotypes for Types 1 and 2 diabetes for GWAS. We tested a single diagnostic domain in a logistic model based on an ICD-9-CM taxonomy and found high sensitivity and specificity when compared with internal registries for breast, lung, colon and prostate cancers; Barrett's esophagus; HIV; Crohn's disease; ulcerative colitis, and diabetes. We then assessed a logistic regression model to distinguish among members with Types 1 and 2 diabetes in the genotyped cohort, utilizing the ICD-9 taxonomy, the earliest age at diagnosis available in the EMR or by self-report, and pharmacy prescription utilization of anti-diabetic drugs. Results The model exhibited a sensitivity of 96.3% and specificity of 99.6% for Type 1 diabetes and a sensitivity of 94.0% and specificity of 98.4% for Type 2 diabetes when compared with the gold standard internal diabetes registry. We identified an additional 60 cases of Type 1 diabetes and conducted comparative GWAS. Conclusions Utilizing diagnostic information in the EMR as independent domains in probabilistic models to accomplish phenotype creation appears to be a reliable approach to facilitate robust characterization for evaluation, analysis and mapping of numerous disease phenotypes. The method is agnostic to input taxonomies as long as the EMR record contains sufficient and reliable atomic detail. It can also be adapted for machine learning given expert user feedback when gold standard databases are not available. PMID:24085939

Sciortino, Stan; Walter, Lawrence; Ranatunga, Dilrini; Ludwig, Dana; Schaefer, Cathy; Kay, Julia; Jorgenson, Eric

2013-09-01

49

LA BIO?TICA COMO QUEHACER FILOS?FICO  

PubMed Central

El artículo examina el estatuto epistemológico de la bioética como disciplina académica. El autor sostiene que el estatuto epistemológico de un discurso lo determina la pregunta fundamental que se plantea y la respuesta que se busca, focos integradores del discurso. En el caso de la bioética, la pregunta fundamental es de índole moral. La bioética es pues una disciplina ética que tiene su hogar epistemológico en la filosofía. El autor también defiende el concepto de “éticas aplicadas”. Sugiere finalmente que el método de la bioética, sobre todo la que se hace desde nuestras latitudes, debería adoptar el círculo hermenéutico como metodología para su filosofar.

Ferrer, Jorge Jose

2009-01-01

50

Infância, exclusão social e educação como utopia realizável  

Microsoft Academic Search

RESUMO: A infância, como construção social, tem sofrido, no decurso da 2ª modernidade, processos de reinstitucionalização que, em larga medida, põem em causa as representações e imagens das crianças, dominantes nos últimos 200 anos. A análise da (re)construção das identidades sociais e das subjectividades infantis constitui, desse modo, uma tarefa teórica da mais exigente actualidade. O que, entretanto, aqui se

Manuel Jacinto Sarmento

2002-01-01

51

Adorno, arte e educação: negócio da arte como negação  

Microsoft Academic Search

RESUMO: O eixo temático desta investigação trata de compreender que a obra de arte corporifica na sua forma interna uma autonomia relativa com relação à realidade empírica sobre a qual se torna refle- xão crítica. Ao se caracterizar como mediação com a realidade social que a produziu, a arte é por isso mesmo a sua negação. É esse princí- pio

Luiz Hermenegildo Fabiano

2003-01-01

52

PIER PAOLO PASOLINI E O CINEMA COMO POESIA  

Microsoft Academic Search

Resumo: O artigo visa a tecer algumas considerações acerca da noção de linguagem cinematográfica de Pasolini tomando como referência seu texto Il cinema di poesia. O objetivo é conhecer aspectos da percepção estética e política desse intelectual e refletir sobre o objetivo de Pasolini de mostrar que o cinema é a linguagem expressiva da realidade. A poesia está no modo

Ana Paula Schlesener

53

From Como to Copenhagen: The Beginnings and Ends of Complementarity  

NASA Astrophysics Data System (ADS)

This paper examines the transformation of Bohr's interpretation of quantum phenomena and quantum mechanics, known as complementarity, from the version presented in his famous Como lecture (1927), which introduced complementarity, to a new version that was developed by Bohr shortly thereafter, in part under the impact of his intervening exchanges with Einstein. While the existence of more than one version of Bohr's complementarity (and of still different versions of the Copenhagen interpretation by others) has been noted, Bohr's rethinking itself of complementarity has rarely been adequately addressed. Apart from refining and indeed correcting the Como argument, the transformation in question was, I argue, defined by a shift from a more philosophical to a more experimental argument. My aim is to explore both this shift and the complexity of the relationships between physics and philosophy in Bohr's thinking in order to understand better the beginnings and the ends, also in the sense of aims, of Bohr's complementarity.

Plotnitsky, Arkady

2007-12-01

54

Applicant Services in COMO: Analysis of Data from the U.S. Training and Employment Service Applicant Follow-Up Survey (COMO Data Analysis).  

National Technical Information Service (NTIS)

The study evaluates services provided to job-applicants by the 'COMO' (Comprehensive Model) model Employment Service Offices. One-month follow-up data was collected on samples of ES applicants in 6 COMO cities and 3 non-COMO cities at different points in ...

1973-01-01

55

O trabalho como principio educativo e o trabalho na forma social do capital  

Microsoft Academic Search

RESUMO: O texto tem como finalidade analisar criticamente a concepção do trabalho como princípio educativo no interior da forma social do capital. À luz da contribuição teórica de Marx, sobretudo em O Capital, discute o significado das três categorias fundantes de trabalho ? trabalho concreto, trabalho abstrato e trabalho produtivo ?, bem como a relação de contradição que ocorre entre

Paulo Sergio Tumolo

56

Efetividade da reabilitação pulmonar como tratamento coadjuvante da doença pulmonar obstrutiva crônica  

Microsoft Academic Search

3 Introdução: O paciente portador de DPOC diminui sua atividade física global devido a piora progressiva da função pulmonar como conseqüência de qualquer forma de esforço físico por ele realizado. A reabilitação pulmonar (RP) é utilizada nos EUA e Europa como alternativa terapêutica no tratamento da DPOC. Objetivo: Avaliar a efetividade do programa de RP como tratamento coadjuvante da DPOC.

SÉRGIO LEITE RODRIGUES; CARLOS ALBERTO DE ASSIS VIEGAS; TEREZINHA LIMA

2002-01-01

57

LA ORALIDAD COMO EXPRESIÓN DE LA CULTURA POPULAR TRADICIONAL EN LA COMUNIDAD LA JOSEFA EN CAONAO  

Microsoft Academic Search

El presente artículo tiene como título: “La oralidad como expresión de la cultura popular tradicional en la comunidad La Josefa en Caonao” se centra en analizar la significación de la tradición oral para la comunidad de la Josefa. Sobre la base de los conceptos de cultura, cultura identitaria y tradición se analiza a la tradición oral como expresión de la

Yoanelys Mirabal Pérez; Lahera Alejandre

2011-01-01

58

A TV Digital Interativa como Ferramenta de Apoio à Educação Infantil  

Microsoft Academic Search

A Televisão Digital e Interativa (TVDI) deve revolucionar o mundo das mídias digitais de forma similar à inserção da televisão há cinqüenta anos ou a Web na última década. Na fase atual de discussão do tema, é importante não apenas considerar aspectos técnicos, como também os impactos sociais dessa tecnologia no nosso País. O governo brasileiro coloca a educação como

C. A. S. Santos; Tatiana Aires

2007-01-01

59

DE VIAJES Y MIEDOS: LA AGORAFOBIA COMO UNA FORMA DE CONTROL ECONÓMICO  

Microsoft Academic Search

El objetivo del siguiente trabajo es describir casos análogos de fobia o miedo a los viajes en otras culturas y tiempos diferente a los modernos. En este sentido, consideramos que tanto la cultura aymará como la vida en la antigua roma nos proveen de ejemplos suficientes para considerar a la fobia a los viajes como un problema en extensión. Por

Maximiliano Korstanje

2008-01-01

60

El desarrollo de la escucha como habilidad para comprender, a partir de la asignatura inglés  

Microsoft Academic Search

Este artículo aborda una problemática actual al profundizar en el desarrollo de la habilidad Escuchar como habilidad para comprender, se hace una sistematización de conocimientos teóricos sobre la temática, se intenta mostrar cómo una actividad común de audición encontrada en la mayoría de los libros de texto modernos de la enseñanza del EFL (inglés como idioma extranjero), puede ser explotada

Rafael Lorenzo Hechavarría Pérez

2011-01-01

61

Atomic-Scale Structure of Co–Mo–S Nanoclusters in Hydrotreating Catalysts  

Microsoft Academic Search

By means of scanning tunneling microscopy (STM), it has been possible to obtain the first atomic-scale images of the Co–Mo–S structure present in hydrodesulfurization (HDS) catalysts. Information on the catalytically important edge structures has been obtained by synthesizing single-layer Co–Mo–S nanoclusters using the Au(111) herringbone structure as a template. It is observed that the presence of the Co promoter atoms

J. V Lauritsen; S Helveg; E Lægsgaard; I Stensgaard; B. S Clausen; H Topsøe; F Besenbacher

2001-01-01

62

Die permanente Elektrotherapie des Herzens und ihre verkehrsmedizinische Bedeutung  

Microsoft Academic Search

Two cases of sudden death of individuals with cardiac pacemakers were autopsied within a one year period. Speculations regarding reintegration of such patients into certain professions and particularly their ability to participate in road traffic gave rise to the current report.

H. P. Schmitt; L. Tamaska

1970-01-01

63

Sisyphus in Kambodscha: Der permanente Kampf gegen soziale Schieflagen  

Microsoft Academic Search

In the wake of the economic achievements of 2005 and of early 2006 the mood in Phnom Penh became so optimistic that on August 15 a brand new National Strategic Development Plan (NSDP; for the years 2006-2010) was announced. It emerged as a document of national pride. Is all this great planning, however, in touch with the facts of a

Oskar Weggel

2006-01-01

64

Bimanuelle Membranextraktion bei schwerer proliferativer diabetischer Vitreoretinopathie mit permanenter Endoillumination  

Microsoft Academic Search

\\u000a Zusammenfassung\\u000a Hintergrund  Bei der vitreoretinalen Chirurgie von Augen mit proliferativer diabetischer Vitreoretinopathie und ausgedehnten präretinalen\\u000a Membranen ist es mit der herkömmlichen drei-Port-Vitrektomie schwierig die festen zum Teil vaskularisierten präretinalen Membranen\\u000a von der dünnen atrophen Netzhaut zu präparieren ohne größere Netzhautdefekte zu setzen. Ein bimanuelles Arbeiten mit Pinzette\\u000a und Glaskörperschere kann das präparieren erheblich erleichtern, erfordert bisher jedoch eine Endoillumination über beleuchtete

J. C. Schmidt; C. H. Meyer; S. Hörle

2003-01-01

65

Influencia de los bancos y cajas como accionistas y acreedores en la manipulación contable de las empresas  

Microsoft Academic Search

En este trabajo utilizamos una base de datos formada por 13247 empresas españolas para el periodo 1996-2000 y estudiamos el efecto de la presencia de instituciones financieras –bien sea como accionista o como acreedor- en las practicas de manipulación de beneficios (earnings management) de las empresas. Encontramos que las instituciones financieras como accionistas estimulan las prácticas de manipulación contable en

Jordi Surroca; Josep A. Tribo

2007-01-01

66

Las lenguas como elementos de cohesión social. Del multilingüismo al desarrollo de habilidades para la comunicación intercultural  

Microsoft Academic Search

Resumen La lengua, entendida como factor de cohesión social, ha sido considerada desde diversas perspectivas asimilacionistas como necesaria y prioritaria para la integración en una sociedad receptora de quienes proceden de otras comunidades lingüísticas y culturales. Este artículo propone una reflexión sobre la diversidad como elemento ineludible en la construcción de una nueva ciudadanía multicultural en la que la lengua

Martina Tuts; Colectivo Yedra

67

On the structural differences between alumina-supported CoMoS type I and alumina-, silica, and carbon-supported CoMoS type II phases studied by XAFS, MES, and XPS  

SciTech Connect

In this study the local structure of the Mo and Co promoter atoms in CoMoS type I and II on alumina, and CoMoS type II on various supports is compared using in situ XAFS spectroscopy as the main technique with XPS and MES in a supporting role. In the CoMoS phase the Co atoms are positioned at the edge of the MoS[sub 2] particles, in the same place as the Mo atoms. The CoMoS phase in all catalysts shows a well defined Co-Mo and a Mo-Co coordination. On alumina the CoMoS type II phase is present as a multilayer structure. The silica-supported CoMoS type II closely resembles its alumina-supported counterpart. However, the Mo-S coordination number, the structural ordering and degree of stacking of the carbon-supported type II CoMoS phase is much more similar to the type I CoMoS phase supported on alumina. This contradicts the common opinion that the CoMoS type II phase is fully sulfided and not chemically bonded to the support. Two different types of Co-sites can be distinguished in the suite of catalysts studied in this paper. A Co-site with an approximately fivefold Co-S coordination and possibly a single Co-Mo coordination is predominant in the least active alumina-supported CoMoS type I and CoMoS type II (with Co/Mo = 0.39 at/at) samples. The other Co-site has a sixfold Co-S coordination with possibly a twofold Co-Mo coordination and has the highest activity for HDS. The latter site constitutes a large part of the Co-sites in silica-supported CoMoS phase II and alumina-supported CoMoS type (II) (with Co/Mo = 0.32) and is exclusively present in the carbon-supported CoMoS phase II. 46 refs., 9 figs., 3 tabs.

Bouwens, S.M.A.M.; Zon, F.B.M. van; Veen, J.A.R. van; Koningsberger, D.C. (Eindhoven Univ. of Technology (Netherlands)); Dijk, M.P. van (Koninklijke/Shell Laboratorium Amsterdam (Netherlands)); Kraan, A.M. van der (Delft Univ. of Technology, Mekelweg (Netherlands))

1994-04-01

68

El dolor como terapia. La médula común de los campos de concentración nazis y franquistas  

Microsoft Academic Search

Los campos de concentración franquistas y los nazis evidencian un cuerpo común. En ambos se desarrollaba una terapia para los internos que tenía al cuerpo como vehículo de aprendizaje. El tratamiento político prescribía penalidades físicas — la suciedad, el hambre, la sed— y morales que debían conducir a los prisioneros a comprender la finalidad buscada por el Estado totalitario alemán

Mirta Núñez Díaz-Balart

2005-01-01

69

O papel dos Larídeos como portadores de Salmonella e Listeria spp  

Microsoft Academic Search

Resumo: Tal como noutros países, a população de gaivotas (larídeos) aumentou exponencialmente em Portugal. Para averi- guar as implicações na Saúde Pública deste sobrecrescimento, duzentas e oitenta e cinco amostras de fezes de gaivotas foram analisadas para dois agentes potencialmente patogénicos para o Homem, Salmonella spp. e Listeria sp. Isolou-se Salmonella sp em trinta e sete amostras (13%). Os serotipos

E. L. Duartea; M. M. Guerra; F. M. Bernardo; CIÊNCIAS VETERINÁRIAS

70

La hipnosis como adjunto en el tratamiento del hábito de fumar. Estudio de caso  

Microsoft Academic Search

Se presenta el caso de una paciente de 33 años con dependencia a la nicotina que lle vaba 9 años fu- mando una media de 35 cigarrillos diarios. Intentó dejarlo hace 3 años pero tuvo una recaída a los seis meses por problemas de ansiedad y continuó con su adicción. El tr atamiento tuvo como objetivo que la paciente dejara

María Elena; Mendoza Figueroa

2000-01-01

71

El mobbing como modelo de relaciones laborales en la Banca japonesa en España  

Microsoft Academic Search

Este artículo analiza cómo ciertos modelos empresariales de culturas tradicionales y fuertemente jerarquizadas como la japonesa, junto a factores de globalización, competitividad, fusiones o crisis económica, son el caldo de cultivo para que el acoso psicológico se institucionalice y forme parte de la cultura de empresa y de las relaciones laborales. El análisis se ha realizado en uno de los

Martínez García

72

Frogs and salamanders from the Upper Jurassic Morrison Formation (Quarry Nine, Como Bluff) of North America  

Microsoft Academic Search

Previously undescribed frog and salamander bones from the Morrison Formation, at Quarry Nine, Como Bluff, Wyoming, are reported. One anuran ilium is diagnostically discoglossid and forms the basis of Enneabatrachus hechti, gen. et sp. nov. A second ilium is diagnostically pelobatid and is the earliest record for the family Pelobatidae, although it is indeterminate below family level. Salamander vertebrae appear

Susan E. Evans; Andrew R. Milner

1993-01-01

73

Espessura Endometrial como Fator Orientador do Tratamento Clínico da Gravidez Tubária Íntegra  

Microsoft Academic Search

Objetivos: avaliar a contribuição da medida da espessura endometrial como fator orientador do tratamento clínico da gravidez tubária íntegra. Métodos: estudo observacional longitudinal, no qual se avaliou a maior medida da espessura endometrial em milímetros, no eixo longitudinal uterino, por meio da ultra-sonografia transvaginal, parâmetro que foi correlacionado com a evolução dos casos. Foram incluídas no estudo 181 pacientes que

Roberto da Costa Soares; Júlio Elito Junior; Kyung Koo Han; Luiz Camano

2002-01-01

74

Chromatic weathering of black limestone quarried in Varenna (Lake Como, Italy)  

Microsoft Academic Search

The causes of chromatic weathering in black limestone have been investigated on samples from the main quarry of Varenna (Lake Como, Italy), which provided building stones for Lombard architecture. Our studies have been carried out combing colorimetric, mineralogical, chemical, microstructural and geochemical observations. The results suggest that the chromatic weathering affecting the surfaces of black limestone is not due to

Nicoletta Marinoni; Alessandro Pavese; Angelo Riva; Fiorenza Cella; Tiziano Cerulli

2007-01-01

75

Garcinia cambogia - uma espécie vegetal como recurso terapêutico contra a obesidade?6  

Microsoft Academic Search

Resumo Atualmente, a obesidade é um problema de saúde pública mundial, tanto nos países desenvolvidos como nos em desenvolvimento, apresentando elevação de sua prevalência. A transição nutricional é um processo de modificações seqüenciais no padrão de nutrição e consumo que acompanha mudanças econômicas, sociais e demográficas, e mudanças do perfil de saúde das populações. Este trabalho objetiva abordar a comprovação

Ana C S Santos; Michelle S Alvarez; Priscila B Brandão; Ary G Silva

76

El ejercicio físico como terapia complementaria en el cáncer de próstata  

Microsoft Academic Search

Este artículo presenta como el ejercicio físico es una terapia complementaria en el tratamiento del cáncer próstata. En concreto presentamos el diseño e implementación de un programa de ejercicio físico de fuerza-resistencia adaptado al cáncer de próstata. El modelo base corresponde a la guía de la American College Sports Medicine Position Stand (ACSM 1998). La adaptación y transformación del programa

Bernat Carles Serdà Ferrer; Pilar Monreal Bosch; Arantza Del Valle

2009-01-01

77

Hydrologic flowpaths and biogeochemical cycles in the subalpine Como Creek catchment, Colorado Front Range, USA  

NASA Astrophysics Data System (ADS)

An outstanding question for snowmelt-dominated watersheds of the western US are the responses of biogeochemical processes to two major drivers of environmental change: directional changes in climate and increasing dissolved inorganic nitrogen (DIN) deposition in wetfall. In the Colorado Front Range, atmospheric deposition of DIN has increased several-fold in the last 25 years. In response, nitrate concentrations at the alpine Green Lakes 4 (GL4) catchment have increased from 1985 to 2009 by 0.27 ?eq L-1 yr-1. In contrast, we see no directional change in either nitrate concentrations or fluxes in the subalpine Como Creek catchment. We hypothesize that differences in surface/groundwater interactions result in the differing behavior of stream nitrate between the alpine and subalpine catchments that are receiving similar amounts of DIN from atmospheric deposition. For both basins we sampled precipitation, snowpack, snowmelt, surface water, and subsurface waters. All water samples are analyzed for geochemical, nutrient and isotopic (?18O, ?D) composition. Stream chemistry data from the last ten years at Como Creek show increases in nitrate concentration during baseflow conditions and then a sharp decline during snowmelt. In contrast, in the alpine basin there is sharp increase in surface water nitrate during snowmelt. Hydrograph separation at the alpine GL4 using end member mixing analysis (EMMA) shows that stream flow is a mixture of three components, groundwater, talus, and new snowmelt that each contribute to roughly a third of discharge, with talus flow supplying the majority of nitrate. In contrast, and somewhat surprisingly, EMMA shows that for the subalpine Como Creek basin, annual streamflow is a mixture of only two components, groundwater and new snowmelt. During snowmelt the groundwater and snow contributions are nearly equal and subsurface flows dominate the remainder of the year. Newly installed piezometers at Como Creek provide evidence that the basin is largely a losing reach during snowmelt, with water levels in the piezometers increasing 5-7 m. After peak snowmelt however, Como Creek becomes a gaining stream, with piezometer levels dropping. Thus, both EMMA and piezometers show that surface-groundwater interactions are tightly coupled during snowmelt, with snowmelt at Como first replenishing the subsurface water deficit and increasing groundwater levels before contributing to discharge. Thus, in contrast to the alpine GL4 basin, DIN released in snowmelt is assimilated belowground as snowmelt infiltrates the subsurface in the subalpine basin. Interestingly, at the subalpine Como Creek basin, isotopic and geochemical solute concentrations undergo shifts during periods of winter baseflow prior to snowmelt. In winter much of the stream is frozen and we hypothesize that cryo-concentration of solutes and fractionation of isotopes may influence the concentrations of winter stream samples.

Cowie, R. M.; Williams, M. W.; Zeliff, M. M.; Parman, J.

2011-12-01

78

On the structural differences between alumina-supported CoMoS type I and alumina-, silica-, and carbon-supported CoMoS type II phases studied by XAFS, MES, and XPS  

Microsoft Academic Search

In this study the local structure of the Mo and Co promoter atoms in CoMoS type I and II on alumina, and CoMoS type II on various supports is compared using in situ XAFS spectroscopy as the main technique with XPS and MES in a supporting role. In the CoMoS phase the Co atoms are positioned at the edges of

D. C. Koningsberger; S. M. A. M. Bouwens; F. B. M. van Zon; Kraan van der AM; A. M. van der Kraan; Veen van JAR

1994-01-01

79

DIABETES MELLITUS COMO FACTOR DE RIESGO DE DEMENCIA EN LA POBLACI?N ADULTA MAYOR MEXICANA  

PubMed Central

Introduccion La diabetes mellitus y las demencias constituyen dos problemas crecientes de salud entre la población adulta mayor del mundo y en particular de los paises en desarrollo. Hacen falta estudios longitudinales sobre el papel de la diabetes como factor de riesgo para demencia. Objetivo Determinar el riesgo de demencia en sujetos Mexicanos con diabetes mellitus tipo 2. Materiales y Metodos Los sujetos diabéticos libres de demencia pertenecientes al Estudio Nacional de Salud y Envejecimiento en México fueron evaluados a los dos años de la línea de base. Se estudió el papel de los factores sociodemográficos, de otras comorbilidades y del tipo de tratamiento en la conversión a demencia. Resultados Durante la línea de base 749 sujetos (13.8%) tuvieron diabetes. El riesgo de desarrollar demencia en estos individuos fue el doble (RR, 2.08 IC 95%, 1.59–2.73). Se encontró un riesgo mayor en individuos de 80 años y más (RR 2.44 IC 95%, 1.46–4.08), en los hombres (RR, 2.25 IC 95%, 1.46–3.49) y en sujetos con nivel educativo menor de 7 años. El estar bajo tratamiento con insulina incrementó el riesgo de demencia (RR, 2.83, IC 95%, 1.58–5.06). Las otras comorbilidades que aumentaron el riesgo de demencia en los pacientes diabéticos fueron la hipertensión (RR, 2.75, IC 95%, 1.86–4.06) y la depresión (RR, 3.78, 95% IC 2.37–6.04). Conclusión Los sujetos con diabetes mellitus tienen un riesgo mayor de desarrollar demencia, La baja escolaridad y otras comorbilidades altamente prevalentes en la población Mexicana contribuyen a la asociación diabetes-demencia.

Silvia, Mejia-Arango; Clemente, y Zuniga-Gil

2012-01-01

80

Kinetic modeling of the SWNT growth by CO disproportionation on CoMo catalysts.  

PubMed

A kinetic model has been developed to describe the growth of single-walled carbon nanotubes (SWNT) in the CoMoCAT method, which is based on the disproportionation of CO on supported CoMo catalysts. The model attempts to capture mathematically the different stages involved in this method: (i) catalyst activation or in-situ creation of active sites, i.e., reduced Co clusters by transformation of CoMoOx precursor species, or oxidized sites; (ii) CO decomposition over active sites, which increases the surface fugacity of carbon until reaching a certain threshold; (iii) nucleation of ordered forms of carbon; (iv) C diffusion (both across the surface and into the metal particle); (v) SWNT growth; (vi) termination, by either deactivation of the catalyst active sites or by increase in the carbon concentration at the metal/SWNT interface, approaching that of the metal/gas interface and eliminating the driving force for diffusion. Previous investigations have only explained the growth termination by the former. Here, we emphasize the possible contribution of the later and propose a novel "hindrance factor" to quantify the effect of nanotube interaction with its surroundings on the growth termination. To test the kinetic model and obtain typical values of the physical parameters, experiments have been conducted on a CoMo/SiO2 catalyst in a laboratory flow reactor, in which the rate of carbon deposition was continuously evaluated by the direct measurement of the CO2 evolution as a function of time. The experimental data are fitted very well with model. PMID:19198356

Monzon, A; Lolli, G; Cosma, S; Mohamed, S B; Resasco, D E

2008-11-01

81

UNA “MUY OTRA” FORMA DE HACER POLÍTICA EN MÉXICO, LA RESISTENCIA INDÍGENA EN CHIAPAS COMO HISTORIA DEL HACHA  

Microsoft Academic Search

El argumento central de los zapatistas como práctica de lucha es la apropiación de la exclusión. La exclusión es un proceso histórico de dominio hacia los indígenas. A lo largo de 16 años de existencia pública han hecho evidente tal cuestión. El primero de enero de 1994 le dijeron al mundo que a partir de ese momento la exclusión ha

Juquila Araceli González Nolasco

2010-01-01

82

ASPECTOS NUTRICIONAIS E TOXICOLÓGICOS DAS DROGAS VETERINARIAS USADAS COMO PROMOTORAS DO CRESCIMENTO ANIMAL NO ÜLTIMO DECENIO. PERSPECTIVAS FUTURAS  

Microsoft Academic Search

Referência aos principais grupos de compostos farmacologicamente activos usados como promotores do crescimento dos animais destinados ao consumo humano. São referidas as incertezas quanto à sua segurança, as pressões do consumidor, as decisões políticas e as resultantes restrições legislativas no que respeita ao seu uso. O recurso aos agonistas ß-adrenérgicos na última década, a controvérsia das suas acções no organismo

M. Lourdes A. S. Bastos; Margarida A. Ferreira

1996-01-01

83

Provenance studies of the white marble of the cathedral of Como by neutron activation analysis and data reduction  

Microsoft Academic Search

Marble samples from major Italian quarries and from the Como Cathedral were analyzed for their trace element content, which is indicative of their provenance. Ca, Sc, Cr, Mn, Fe, Co, Rb, Sb, Cs, Ba, La, Ce, Sm, Eu, Gd, Ho, Tm, Yb, Lu, Hf, Th and U elements were determined by neutron activation analysis. Results as well as their precision

M. Oddone; S. Meloni; E. Mello

1985-01-01

84

Development of a Computerized Intravenous Insulin Application (AutoCal) at Kaiser Permanente Northwest, Integrated into Kaiser Permanente HealthConnect: Impact on Safety and Nursing Workload  

PubMed Central

Context: The electronic medical record, HealthConnect, at the Kaiser Sunnyside Medical Center in the Northwest used scanned paper protocols for intravenous insulin administration. A chart review of 15 patients on intravenous insulin therapy using state-of-the-art paper-based column protocols revealed 40% deviation from the protocol. A time study of experienced nurses computing the insulin dose revealed an average of 2 minutes per calculation per hour to complete. Objective: To improve patient safety and to reduce nursing workload burden with a computerized intravenous insulin calculator application connected to HealthConnect. Solution: Using Kaiser iLab developers through innovation funding, a computerized protocol was developed and integrated into HealthConnect, with a computerized tracking system used to store and to analyze intravenous insulin data. Outcome: A review of 35 patient charts using computerized insulin infusion tool indicated 100% accuracy in computations with a reduction of nursing workload from 2 minutes to 30 seconds per calculation. Conclusion: Development and operationalizing an integrated intravenous insulin calculator into HealthConnect was successfully completed at the Kaiser Sunnyside Medical Center, with 97% nursing satisfaction scores and a promise to generate data on intravenous insulin therapy to refine the protocol.

Olinghouse, Christine

2012-01-01

85

Computational tools for pulverized-coal combustion. Seventh quarterly report, October 1982December 1982. [Combustion model COMO  

Microsoft Academic Search

The combustion model (COMO) consists of a number of relatively independent modules that represent the major processes involved in pulverized-coal combustion. These modules will be continually upgraded over the course of the contract. During the first quarter, detailed life-of-the-project task descriptions were prepared, literature searches were conducted, and process models were selected. In the second quarter, formulation and coding of

W. J. Oberjohn; D. K. Cornelius; W. A. Fiveland

1983-01-01

86

A computa»c~ao numerica como ferramenta para o professor de F¶‡sica do Ensino Medio  

Microsoft Academic Search

A proposta deste trabalhoe apresentar ao professor de F¶‡sica do ensino medio uma forma de empregar recur- sos computacionais para esclarecer e aprofundar conceitos de F¶‡sica que s~ao explorados de forma limitada por n~ao se poder recorrer ao Calculo Diferencial e Integral. O p^endulo simplese usado como prototipo para o trata- mento sugerido. Mostramos que apenas com o aux¶‡lio de

Augusto Cesar; Claudio Gon; Marcus Vinicius; Tovar Costa

87

The mixing aspects of NiMo and CoMo hydrotreating catalysts in ebullated-bed reactors  

Microsoft Academic Search

Recently, the Shuaiba Refinery of Kuwait National Petroleum Company (KNPC) conducted a test run using mixed NiMo\\/CoMo catalysts in one of the H–Oil reactors to verify the specifications of a CoMo catalyst. However, reduced unit performance and unstable operation were experienced. This led to the unit shut-down and process time loss. To search the causes for the different reactor behaviours,

Ezra K. T. Kam; Mohammad H. Al-Mashan; Homoud Al-Azmi

1999-01-01

88

Late Glacial to Holocene environmental variabilities: A new multi-proxy paleolimnological study of sedimentary sequences from Como (northern Italy)  

NASA Astrophysics Data System (ADS)

Lake Como (northern Italy) is the deepest Italian lake, reaching a depth of about 425 m. The lambda-shaped lake expands about 45 km in NE-SW direction. Southwards of the hydrologically closed western branch, two sediment cores of 70 m (S1) and 65 m length (S2) were taken in the year 2005 close to the cathedral of Como (Piazza Verdi). The drilling sites are located in the middle of the Southern Alps, some 300 m from the present-day lakeshore. The cores provide the first detailed Late Glacial to Holocene multi-proxy record for the Lake Como basin. Our research is aimed at investigating the environmental and geological evolution of the Insubria Region. The multi-proxy study of the stratigraphic sequences contain geophysical, geotechnical, sedimentological, paleobotanical, and radiocarbon analyses. They have been performed for core S1 and are still in progress on core S2. With this data the working group focuses on two main issues. The first topic is the reconstruction of the natural and anthropogenic processes controlling the ground subsidence in the Como urban area (e.g., Comerci et al., 2007) and another aim is to reconstruct vegetation and land-use dynamics. In particular, 150 samples of vegetal macroremains have been collected in the palustrine deposits along S1 core, down to 31,00 m. Below this depth (dated 14C 12,496 ± 55 yr BP - 15,050 - 14,250 cal yr BP), the amount of plant macroremains in the sediment drops dramatically. The taxonomic determination was carried out on more than 800 macroremains. They are represented by fragments of wood, leaves, needles, seeds, fruits, mosses and tiny charcoals (Motella, 2009, unpublished PhD Thesis). Picea/Larix, Pinus sp., Juniperus with Betula, found in the deeper levels (30.80 - 30.00 m), are the first arboreal taxa that colonized the shores of Lake Como, and show that the reforestation began in this area about 16,000 years ago. During the early Holocene (25.10 m) Abies alba expanded and further upwards the sequence mixed deciduous forests became important. Preliminary results of palynological analyses for a section of the core S2 (35.04 - 18.12 m), show Late Glacial sediments in the depth of 35.04 - 31.16 m, due to vegetation changes related to natural climatic variability, with an alternation of communities typical of cold (Poaceae, Artemisia, Juniperus, Pinus and Betula) and temperate climates (e.g. Quercus). Later, during the Holocene, forests composed by mostly deciduous broadleaves and Abies alba expanded. During the mid and late Holocene human impact increased and modified vegetation. This is shown by the increase of herbs and heliofilous shrubs (26.51 m), typical of deforested spaces for fields and pastures. Human exploitation of wood is represented for example by the dramatic decline of Abies alba (24.97 m). Finally, the increase of Cerealia (19.39 m) is clearly related to intensified agricultural activities. The results of further paleobotanical and geophysical analyses which are in progress will be presented during the conference. Moreover, geochemical measurements (e.g., XRF) will be performed in future for core S2. Researches realized within the project of Italy-Switzerland Cooperation SITINET "Censimento, valorizzazione e messa in rete di siti geologici e archeologici" (Census, increase of value and computerization of geological and archaeological sites). Interreg IV A "Geo-Archeositi dell'Insubria" (Geo-Archaeosites of Insubria).

Höbig, N.; Martinelli, E.; Motella, S.; Michetti, A. M.; Livio, F.; Tinner, W.; Reicherter, K.; Castelletti, L.

2012-04-01

89

Invertebrados Aquáticos como Bioindicadores  

Microsoft Academic Search

Some aquatic invertebrates can indicate the quality of freshwater ecosystem habitats. Their presence or absence can be interpreted as signals of changes in the environment, or help to diagnose the causes of an environmental problem. Anthropogenic impacts are reducing water quality and freshwater biodiversity. Here, we discuss the value of benthic macroinvertebrates as example of potential ecological indicators in Environmental

Marcos Callisto; José Francisco Gonçalves Jr; Pablo Moreno

90

A ESCRITA COMO \\  

Microsoft Academic Search

The writing if configures as a device of formation and autoformation in the formative space of the superior education. In the research that we have carried through with professors in the carried through initial formation in the space of the university we operate with the writing as a tool that places the implied citizens as \\

Valeska Fortes de Oliveira

91

Human Papillomavirus (HPV) Genotypes in Women with Cervical Precancer and Cancer at Kaiser Permanente Northern California†  

PubMed Central

Background The human papillomavirus (HPV) Persistence and Progression Cohort is a natural history study of carcinogenic HPV positive women. Here, we present the HPV genotypes found in first ?500 cases of cervical intraepithelial neoplasia grade 3 (CIN3) or more severe disease (CIN3+) diagnosed at the study baseline. Methods Women aged 30 and older were screened for cervical cancer using Pap smears and tested for carcinogenic HPV using Hybrid Capture 2 (HC2; Qiagen). We randomly selected women who tested HPV positive and were diagnosed with CIN3+ (n = 448) or without CIN3+ (

Castle, Philip E.; Shaber, Ruth; LaMere, Brandon J.; Kinney, Walter; Fetterman, Barbara; Poitras, Nancy; Lorey, Thomas; Schiffman, Mark; Dunne, Anne; Ostolaza, Janae M.; McKinney, Sharod; Burk, Robert D.

2011-01-01

92

Formation des enseignants dans une perspective d'education permanente au benin  

NASA Astrophysics Data System (ADS)

The history of teacher training in Benin, which provides evidence of social and cultural change, suggests that a system of lifelong education should be introduced which unites formal, non-formal and informal education, all of which already exist in embryo. The education originally given to every member of society was a continuing progression from initiate to initiator, a lifelong education that involved, among other things, knowledge of agricultural production. This traditional system was disrupted by the reorganization of teacher training after 1945. Recurrent training of teachers remained inadequate because of limited external funding for in-service training, the lack of teachers, the suspension of recruitment and the closure of teacher training colleges. The 1975 reform, through the initiative known as Operation Education and Development, envisaged links between school and social environment, allying intellectual work with production. This meant a radical change in the role of the teacher, who was confronted with technical advance and was obliged to enter a difficult continuing process of self-training. Furthermore, population growth and the restrictions imposed by the World Bank have brought about developments in both lifelong learning and apprenticeship. These two elements are brought together under an initiative known as Production Scolaire Artisanale, designed for out-of-school learners and artisans. The author concludes that the creation of a coherent system of voluntary education would be possible in a society that was itself favourably disposed to education.

Agboton, Sébastien; Moussa, Yaya Mede

1994-05-01

93

Brief Negotiation Program for Promoting Behavior Change: The Kaiser Permanente Approach to Continuing Professional Development  

Microsoft Academic Search

Background: Behavior change counseling is one of the most difécult and constant challenges faced by health providers. It has a signiécant impact on clinical outcomes as well as patient and provider satisfaction. By encouraging patients to participate in a partnership with health care professionals, Brief Negotiation offers techniques to motivate behavior change successfully. We review the key components of Brief

CECILIA RUNKLE; AMY OSTERHOLM; MA ROBYN HOBAN; ROBERT TULL

2000-01-01

94

PS3-38: The Kaiser Permanente Northern California Member Health Survey Project  

PubMed Central

Background/Aims We will introduce researchers and administrators to the KP Northern California Member Health Survey Project (MHS) and illustrate how it has been used for research and to monitor population sociodemographic and health-related characteristics over time. Methods This is a self-administered survey of independent stratified random samples of adults conducted every 3 years starting in 1993. Seniors and most race-ethnically diverse medical center service populations are oversampled. Survey data can be linked at the individual level to KP clinical, administrative, and utilization data, including kp.org use. Results This Community Benefit-funded survey has been used to monitor KPNC member population characteristics over time, to facilitate research on the membership, and to contribute to community health needs assessment. The MHS captures information about sociodemographic characteristics, health and functional status, behavioral and psychosocial health risks, use of CAM and dietary supplements, IT access (Internet, email, and in 2011, mobile phone and text messaging), and health education modality preferences that is valuable for health research and service planning. Our sample facilitates study of race-ethnic and age group differences in these characteristics. While KPNC’s electronic data capture of member race/ethnicity and health characteristics has grown exponentially since the early 2000s, the Member Health Survey, based on self-reported information obtained from a stratified random sample of adult members, remains the most comparable source of KPNC population statistics to other surveys like the BRFSS, CHIS, and NHIS. We will use MHS data from 1993, 1996, 1999, 2002, 2005, 2008, and 2011 to show changes over time among 25–79 year olds in selected health behavior risk factors (smoking, obesity, exercise, dietary practices, stress, health beliefs), use of selected CAM modalties, and IT access; age and race-ethnic differences in health risk factors and CAM use; and age-related differences in IT access and preferences for IT-based health education. More information about the survey and survey results can be found at www.memberhealthsurvey.kaiser.org. Conclusions Data and statistics from KPNC Member Health Surveys can be useful for researchers and administrators both within and outside KPNC for research and service planning.

Gordon, Nancy; Lin, Teresa

2013-01-01

95

PS3-38: The Kaiser Permanente Northern California Member Health Survey Project.  

PubMed

Background/Aims We will introduce researchers and administrators to the KP Northern California Member Health Survey Project (MHS) and illustrate how it has been used for research and to monitor population sociodemographic and health-related characteristics over time. Methods This is a self-administered survey of independent stratified random samples of adults conducted every 3 years starting in 1993. Seniors and most race-ethnically diverse medical center service populations are oversampled. Survey data can be linked at the individual level to KP clinical, administrative, and utilization data, including kp.org use. Results This Community Benefit-funded survey has been used to monitor KPNC member population characteristics over time, to facilitate research on the membership, and to contribute to community health needs assessment. The MHS captures information about sociodemographic characteristics, health and functional status, behavioral and psychosocial health risks, use of CAM and dietary supplements, IT access (Internet, email, and in 2011, mobile phone and text messaging), and health education modality preferences that is valuable for health research and service planning. Our sample facilitates study of race-ethnic and age group differences in these characteristics. While KPNC's electronic data capture of member race/ethnicity and health characteristics has grown exponentially since the early 2000s, the Member Health Survey, based on self-reported information obtained from a stratified random sample of adult members, remains the most comparable source of KPNC population statistics to other surveys like the BRFSS, CHIS, and NHIS. We will use MHS data from 1993, 1996, 1999, 2002, 2005, 2008, and 2011 to show changes over time among 25-79 year olds in selected health behavior risk factors (smoking, obesity, exercise, dietary practices, stress, health beliefs), use of selected CAM modalties, and IT access; age and race-ethnic differences in health risk factors and CAM use; and age-related differences in IT access and preferences for IT-based health education. More information about the survey and survey results can be found at www.memberhealthsurvey.kaiser.org. Conclusions Data and statistics from KPNC Member Health Surveys can be useful for researchers and administrators both within and outside KPNC for research and service planning. PMID:24086012

Gordon, Nancy; Lin, Teresa

2013-09-01

96

Moving from Tacit Knowledge to Evidence-Based Practice: The Kaiser Permanente Community Partners Study  

Microsoft Academic Search

For several decades both medical and social work practices have failed to consistently include measures to determine the effectiveness of their care and practices. This is especially true of care management practices. With the growth and aging of our population, this is of particular concern when many of our resources for older adults are channeled into services such as geriatric

Susan M. Enguídanos; Paula M. Jamison

2006-01-01

97

Semis direct sur couverture végétale permanente du sol : de la technique au concept  

Microsoft Academic Search

Direct sowing on permanent vegetal soil caver : front thé technique tu thé design. In agricultural intertropical areas, the cropping systems based on direct sowing on permanent vegetal soil caver constitute a new way of sustainable preservation and valorization of natural resources. They consist in implementation of biomass producing plants (Pueraria sp., Sorghum guinea, Mucuna sp.), which make a permanent

M. RAUNET; L. SEGUY; C. FOVET RABOTS

98

L'education Permanente: Principe Revolutionnaire et Pratiques Conservatrices (Lifelong Education: Revolutionary Principles and Conservative Practices).  

ERIC Educational Resources Information Center

|Reviews the historical formation of the concept of lifelong learning, indicating that it preceded the school and can contribute to policies and strategies designed to increase educational access. Reviews the dynamic between politics and educational activities and argues that a global approach to education is necessary to achieve true educational…

Gelpi, Ettore

1994-01-01

99

Drenaje permanente tunelizado de la ascitis maligna: experiencia inicial con el catéter PleurX ®  

Microsoft Academic Search

ObjectiveThe most common treatment in recurrent malignant ascites is generally temporary peritoneal drainage. We present our experience in placing permanent tunneled catheters in a series of patients and analyze the safety and efficacy of the treatment.

R. Saiz-Mendiguren; M. Gómez-Ayechu; J. J. Noguera; A. García-Lallana; C. Marginet; D. Cano; A. Benito

2010-01-01

100

"Education Permanente" of Young Workers in Leisure Time and on the Job  

ERIC Educational Resources Information Center

In centers for young workers, education forms a link between work and leisure; efforts are made to give young workers incentives for personal development, directed at becoming total human beings in a physical as well as a spiritual sense. (JD)

Deraeck, Guido; Bollaert, Livin

1976-01-01

101

In-situ HRTEM study of the reactive carbide phase of Co/MoS2 catalyst.  

PubMed

Hydrotreatment catalytic operations are commonly performed industrially by layered molybdenum sulfide promoted by cobalt or nickel in order to remove heteroelements (S, N, O) from fossil fuels and biofuels. Indeed, these heteroelements are responsible of the emission of pollutants when these fuels are used in vehicles. In this respect, previous studies made by our research group have shown that the active phase under steady state conditions is partially carbided while strong bending effects of MoS2 slabs were also observed. However, up to now, the morphology of the resulting Co/MoSxCy carbided catalyst has not been fully characterized. In the present study, for the first time, a chemical reaction between the carbon content of a TEM Cu/C grid and a freshly sulfide Co/MoS2 catalyst was in situ observed at 300 °C and 450 °C by HRTEM experimental techniques at ~10 nm of resolution. Results indicate that bending of MoS2 layers occurred due to carbon addition on MoS2 edge sites, as observed in stabilized catalysts after HDS reaction. Using a silicon grid, only cracks of MoS2 slabs were observed without bending effect confirming the role of structural-carbon in this change of morphology. PMID:22925737

Ramos, Manuel; Ferrer, Domingo; Martinez-Soto, Eduan; Lopez-Lippmann, Hugo; Torres, Brenda; Berhault, Gilles; Chianelli, Russell R

2012-07-27

102

O 2 Chemisorption, ESR Spectroscopy, and Hydrodesulfurization Activity on Sulfided CoMo/ Gamma -Al 2 O 3 : Progress Report for July Through September 1984.  

National Technical Information Service (NTIS)

Oxygen chemisorption and electron spin resonance spectroscopy (ESR) have been used to characterize sulfided CoMo/ gamma -Al sub 2 O sub 3 catalysts with different atomic Co/(Co + Mo) ratios ( alpha ). Chemisorption of O sub 2 on sulfided Mo/ gamma -Al sub...

M. Boudart X. H. Kang J. S. Arrieta D. G. Loeffler

1984-01-01

103

A combined X-ray photoelectron and Mossbauer emission spectroscopy study of the state of cobalt in sulfided, supported, and unsupported Co-Mo catalysts  

SciTech Connect

Alumina-supported and unsupported Co-Mo catalysts, as well as Co metal, Co/sub 9/S/sub 8/, and CoMo/sub 2/S/sub 4/ samples, have been studied using X-ray photoelectron spectroscopy (XPS) and Mossbauer emission spectroscopy (MES). The main aim of the study was to examine the feasibility of using XPS to characterize the different Co-containing phases which may be present in sulfided Co-Mo catalysts. The Co phase distributions in the catalyst samples studied by XPS were determined by means of MES. The different cobalt phases observed in the catalysts were Co-Mo-S and Co/sub 9/S/sub 8/, and for the supported catalysts cobalt in the alumina lattice was also observed. Although Co metal, Co/sub 9/S/sub 8/, Co-Mo-S, and CoMo/sub 2/S/sub 4/ are structurally and chemically different and give rise to very different MES spectra, the Co 2p spectra of these compounds are similar. It is shown, however, that by a combination of accurate determinations of binding energy differences and comparisons of peak shapes it is possible to distinguish the different Co phases in the catalysts by XPS. The Co 2p binding energies of Co/sub 9/S/sub 8/ are about 0.5eV smaller than those of Co-Mo-S, and also the Co 2p peak shapes are different. Using XPS, Co/sub 9/S/sub 8/ can only be distinguished from Co metal by a detailed comparison of the Co 2p peak shapes. The close similarity between the Co 2p spectra of Co-Mo-S and CoMosigmaS/sub 4/ suggests that the electronic state of Co in Co-Mo-S is similar to that in CoMo/sub 2/S/sub 4/. However, the MES results show that the two phases are structurally different.

Alstrup, I.; Chorkendorff, I.; Candia, R.; Clausen, B.S.; Topsoe, H.

1982-10-01

104

Ab initio DFT study of hydrogen dissociation on MoS 2, NiMoS, and CoMoS: mechanism, kinetics, and vibrational frequencies  

Microsoft Academic Search

The present study provides detailed discussions about the structures, relative stabilities, and vibrational frequencies of hydrogen species on MoS2, NiMoS, and CoMoS catalyst edge surfaces. The transition states and activation energies for molecular hydrogen dissociation and surface migration of atomic hydrogen on catalyst edge surfaces have been calculated by complete linear synchronous transit (LST) and quadratic synchronous transit (QST) search

Mingyong Sun; Alan E. Nelson; John Adjaye

2005-01-01

105

Linfoma não-Hodgkin apresentando-se como massa hepática única* Non-Hodgkin's lymphoma presenting as a single liver mass  

Microsoft Academic Search

OBJETIVO: Descrever as principais características de imagem do linfoma não-Hodgkin apresentando-se como massa hepática única. MATERIAIS E MÉTODOS: Realizamos estudo retrospectivo mediante análise de ca- sos de pacientes com massa hepática única aos exames de ultrassonografia, tomografia computadorizada e ressonância magnética, com diagnóstico histológico de linfoma não-Hodgkin. Esses exames foram analisa- dos por dois examinadores em consenso. RESULTADOS: Identificamos três

Mila Correia; Góis Peixoto; Araújo Alves; Peixoto Filho; Alessandra Caivano; Rodrigues Ribeiro; Giuseppe D'Ippolito

2009-01-01

106

Low-cost and high-performance CoMoS4 and NiMoS4 counter electrodes for dye-sensitized solar cells.  

PubMed

Porous chalcogels CoMoS4 and NiMoS4 made by a facile solution reaction displayed good electrocatalytic activity in the redox reaction of the I(-)/I3(-) shuttle. Dye-sensitized solar cells with these ternary compounds as counter electrodes (CEs) showed photovoltaic performance similar to the devices made with noble metal platinum CE (7.46%). PMID:24022304

Zheng, Xiaojia; Guo, Jiahao; Shi, Yantao; Xiong, Fengqiang; Zhang, Wen-Hua; Ma, Tingli; Li, Can

2013-09-24

107

O pensamento de Antônio Gramsci como referencial teórico na pesquisa em história da Enfermagem The thought of Antonio Gramsci as a theoretical benchmark of study in the history of Nursing El pensamiento de Antonio Gramsci como referencial teórico de estudios en historia de la Enfermería  

Microsoft Academic Search

RESUMO Cada pesquisador em história da enfermagem é livre nas suas interpretações. Todos nós sentimos necessidade de ordenar nosso campo teórico, para não cairmos no niilismo do caminhar desordenado pela história. Este artigo tem por objetivo propor uma reflexão teórica sobre o pensamento de Antônio Gramsci como referencial téorico de estudos em história da enfermagem. Para GRAMSCI, as relações de

Miriam Heidemann; Maria da Luz; Barbosa Gomes; Maritza Consuelo; Ortiz Sanchez

108

XAS Study at Mo and Co K-Edges of the Sulfidation of a CoMo / Al2O3 Hydrotreating Catalyst  

SciTech Connect

Because of its impact on environment, the removal of sulfur is an indispensable step, called hydrotreatment, in the refining of petroleum. One of the most commonly used hydrotreating catalysts is CoMo-type catalyst which is composed of molybdenum disulfide slabs promoted by cobalt atoms (CoMoS phase) and well dispersed on a high specific area alumina. As far as the highest sulfur content allowed in gasoline and diesel is continually decreasing, more and more efficient and active hydrotreating catalysts are required. In order to optimize the reactivity of the CoMo-type catalyst in hydrotreatment, a better understanding of the processes used to produce the active phase (CoMoS slabs) of the catalyst is necessary. The study reported here deals with the sulfiding mechanism of the slabs and the influence of temperature on the phenomenon. Ex situ X-ray absorption spectroscopy (XANES and EXAFS) was used to study the evolution of the structure of CoMo-type catalyst sulfided at various temperatures (from 293 to 873 K). XAS analysis was performed at both molybdenum and cobalt K-edges to obtain a cross-characterization of the sulfidation of the slabs. It evidenced the formation of various compounds, including two molybdenum oxides, MoS3 (or MoS3-like compound) and Co9S8, at specific steps of the sulfiding process. It showed the role of intermediate played by MoS3 (or MoS3-like compound) during the formation of the slabs and the competition between the appearance of promoted slabs (CoMoS phase) and Co9S8. At last, it leaded to the proposal of a mechanism for the sulfidation of the catalyst.

Pichon, C.; Gandubert, A. D.; Legens, C. [IFP-Lyon, Physics and Analysis Division, Materials Characterization Department, BP3, 69390 Vernaison (France); Guillaume, D. [IFP-Lyon, Catalysis and Separation Division, Heterogeneous Catalysis Department, BP3, 69390 Vernaison (France)

2007-02-02

109

Lo multicultural como mitología y como coartada del racismo  

Microsoft Academic Search

La noción de cultura en tanto que conjunto de caracteres de un colectivo nacional, tribal o religioso, ha venido a reemplazar por equivalencia la noción de raza, desprestigiada por la experiencia nazi. Pero su funcionamiento objetivo es el mismo. Raza, nación y cultura son constructos nacidos a la sombra del Romanticismo, de la reacción antiiluminista. El multiculturalismo es la ideología

Horacio Vázquez Rial

2007-01-01

110

Verschillen Tussen Permanente Geconcentreerde en Niet-Permanente Verspreide Grondwaterwinningen in Relatie tot de Winbare Hoeveelheid Grondwater (Hydrological Effects of Groundwater Extraction for Sprinkler Irrigation and for Drinking Water Supply).  

National Technical Information Service (NTIS)

Until recently in the Netherlands groundwater has mainly been extracted for domestic and industrial water supply. In the last ten years, however, there has been an increasing agricultual demand for groundwater. For instance in 1973 about 4 percent of the ...

H. A. J. Van Lanen

1982-01-01

111

El hombre como cazador sexual  

Microsoft Academic Search

In all men there are two realities: a “primitive” side, determined by ancestral genes that have not had sufficient time to adjust to the current situation and a “civilized” side, resulting from education and culture. Understanding this psychobiologic reality helps to understand many aspects of male sexual behavior. Reproductive capacity over the lifespan, as well as a physiology that allows

José M. Pomerol Monseny

2007-01-01

112

Field Trial of the Efficacy of Dodecavalent Pneumococcal Vaccine at the Kaiser-Permanente Medical Center, San Francisco, California.  

National Technical Information Service (NTIS)

A field trial to assess the efficacy of a dodecavalent pneumococcal vaccine is being carried out. The vaccine has been administered to 6850 persons and 6750 volunteers have received placebo in a double blind fashion according to a computer program of rand...

M. A. Freid

1975-01-01

113

Health Instruction Packages: Permanent Teeth, Dental Deposits, and Dental Instruments. Dientes Permanentes, Depositos Dentales y Instrumentos Dentales.  

ERIC Educational Resources Information Center

These five learning modules use text interspersed with illustrations and reinforcement exercises to instruct dental aide and dental hygiene students about jaw bones and gums, dental deposits, and dental instruments. The first four modules were prepared by Patricia Lind in both Spanish and English. "The Gum and Bone of Permanent Teeth" ("La Encia y…

Lind, Patricia; Germano, Catherine

114

Health Instruction Packages: Permanent Teeth, Dental Deposits, and Dental Instruments. Dientes Permanentes, Depositos Dentales y Instrumentos Dentales.  

ERIC Educational Resources Information Center

|These five learning modules use text interspersed with illustrations and reinforcement exercises to instruct dental aide and dental hygiene students about jaw bones and gums, dental deposits, and dental instruments. The first four modules were prepared by Patricia Lind in both Spanish and English. "The Gum and Bone of Permanent Teeth" ("La Encia…

Lind, Patricia; Germano, Catherine

115

PS2-34: Communication Barriers and Preferences of Limited English Proficient Chinese Speaking Members in Kaiser Permanente  

PubMed Central

Background/Aims Our aim was to learn about the literacy and communication difficulties and preferences of Limited English Proficient Chinese speakers. Methods This was a self-administered waiting room survey of KP Bilingual Chinese module patients. The study sample includes 1672 patients aged 35+ (775 aged 35–59, 897 aged 60+) classified from self-report as Very Limited English Proficient (VLEPs, n = 1242, speaks English not at all or not well) or Limited English Proficient (LEPs, n = 430, speaks English well, but not very well). Results We found: 1) Educational attainment was low overall (approximately 36% had not completed the equivalent of high school, 37% were high school graduates, 15% had some college, and 12% were college graduates), and significantly lower among older patients and within age groups, VLEP versus LEP; (2) 97% of VLEPs and 13% of LEPs do not read English well, 13% of both VLEPs and LEPs do not read Chinese well, and 13% of VLEPs do not read either language well, with older VLEPs having the lowest literacy; (3) 88% of VLEPs and 55% of LEPs usually have trouble understanding letters in English and 43% of VLEPs and 35% of LEPs usually have trouble understanding letters in Chinese; (4) Among VLEPs, 43% preferred print instructions in Chinese, 2% in English, and 55% in both languages; among LEPs: 8% preferred Chinese, 28% English, and 64% both languages; (5) 76% of VLEPs and 42% of LEPs usually have trouble interacting with the KP Call Center on their own; Chinese Call Center agents were desired by 96% of VLEPs and 74% of LEPs; (6) VLEPs are more likely than LEPs to have difficulty understanding instructions (VLEPs: 42% sometimes, 15% usually; LEPs: 25% and 2%) and test results (VLEPs: 41% sometimes, 39% usually; LEPs: 49% and 8%), and more frequently require help from others to understand (VLEPs: 30% sometimes, 60% usually; LEPs 43% and 12%); and (7) VLEPs are less likely than LEPs to use email and Internet, and more likely to need help when doing so. Conclusions Limited English Proficient Chinese patients face many difficulties related to language, literacy, and education in ability to receive and understand health-related communications.

Gordon, Nancy; Tang, Anne

2013-01-01

116

PS2-34: Communication Barriers and Preferences of Limited English Proficient Chinese Speaking Members in Kaiser Permanente.  

PubMed

Background/Aims Our aim was to learn about the literacy and communication difficulties and preferences of Limited English Proficient Chinese speakers. Methods This was a self-administered waiting room survey of KP Bilingual Chinese module patients. The study sample includes 1672 patients aged 35+ (775 aged 35-59, 897 aged 60+) classified from self-report as Very Limited English Proficient (VLEPs, n = 1242, speaks English not at all or not well) or Limited English Proficient (LEPs, n = 430, speaks English well, but not very well). Results We found: 1) Educational attainment was low overall (approximately 36% had not completed the equivalent of high school, 37% were high school graduates, 15% had some college, and 12% were college graduates), and significantly lower among older patients and within age groups, VLEP versus LEP; (2) 97% of VLEPs and 13% of LEPs do not read English well, 13% of both VLEPs and LEPs do not read Chinese well, and 13% of VLEPs do not read either language well, with older VLEPs having the lowest literacy; (3) 88% of VLEPs and 55% of LEPs usually have trouble understanding letters in English and 43% of VLEPs and 35% of LEPs usually have trouble understanding letters in Chinese; (4) Among VLEPs, 43% preferred print instructions in Chinese, 2% in English, and 55% in both languages; among LEPs: 8% preferred Chinese, 28% English, and 64% both languages; (5) 76% of VLEPs and 42% of LEPs usually have trouble interacting with the KP Call Center on their own; Chinese Call Center agents were desired by 96% of VLEPs and 74% of LEPs; (6) VLEPs are more likely than LEPs to have difficulty understanding instructions (VLEPs: 42% sometimes, 15% usually; LEPs: 25% and 2%) and test results (VLEPs: 41% sometimes, 39% usually; LEPs: 49% and 8%), and more frequently require help from others to understand (VLEPs: 30% sometimes, 60% usually; LEPs 43% and 12%); and (7) VLEPs are less likely than LEPs to use email and Internet, and more likely to need help when doing so. Conclusions Limited English Proficient Chinese patients face many difficulties related to language, literacy, and education in ability to receive and understand health-related communications. PMID:24085980

Gordon, Nancy; Tang, Anne

2013-09-01

117

La economía social como enfoque metodológico, como objeto de estudio y como disciplina científica  

Microsoft Academic Search

This article continues an article written by the same author and published by CIRIEC-España in 1997 (no. 25). It analyses social economy at three cognitive levels: first, as a social reality (Social Economy); second, as a scientific discipline which studies its previous reality (the science of Social Economy); third, as a methodological approach in social sciences (the approach of Social

Rafael Chaves

1999-01-01

118

Thermal effects on Co/Mo2C multilayer mirrors studied by soft x-ray standing wave enhanced photoemission spectroscopy  

NASA Astrophysics Data System (ADS)

Here is presented the spectroscopic study of the evolution of the first buried interfaces of a B4C capped Co/Mo2C multilayer mirror induced by thermal treatment up to 600°C. This kind of study is typically performed to simulate the response of multilayer optics working in extreme conditions, as for instance when irradiated by new high brilliance sources as Free Electron Lasers. In fact, the efficiency of multilayers is related to the optical contrast between the alternating high and low density layers, and then to the degree of interdiffusion and the creation or evolution of interface compounds. The analysis has been performed at the Co L23 edge with different soft x-ray spectroscopic techniques including diffuse and specular reflectivity, total electron and fluorescent yield at the BEAR beamline at Elettra (Trieste) (http://www.elettra.trieste.it/elettra-beamlines/bear.html). The presentation is focused on the spectroscopic results obtained by soft x-ray standing wave enhanced photoemission (XSW) from the Mo 3d, B 1s, C 1s, O 1s core levels by using a photon energy close to the Co L23 edge and corresponding to the first Bragg peak of the multilayer. The experimental results have been compared with simulations to obtain information both on the chemical state (e.g. oxidation state) and interface morphology in terms of profiles of distribution of elements and interdiffusion of B, oxidized B and C in the interface region. In summary, it is possible to conclude in favour of a good stability of the multilayer in the investigated temperature range, as confirmed by the good performance in terms of reflectivity. These results confirm the usefulness of XSW for this kind analysis of multilayer optics.

Giglia, A.; Mukherjee, S.; Mahne, N.; Nannarone, S.; Jonnard, P.; Le Guen, K.; Yuan, Y.-Y.; André, J.-M.; Wang, Z.-S.; Li, H.-C.; Zhu, J.-T.

2013-05-01

119

ZOONOSES CAUSADAS POR PARASITAS INTESTINAIS DE CÃES E O PROBLEMA DO DIAGNÓSTICO  

Microsoft Academic Search

RESUMO Os últimos 20 anos foram marcados por um intenso progresso tecnológico e por importantes alterações culturais e sociais com reflexos tanto em saúde humana como animal. Entretanto, infelizmente, as zoonoses causadas por parasitas intestinais de cães não deixaram de ser um problema permanente de saúde pública nos países em desenvolvimento, e uma preocupação crescente nos países desenvolvidos. A eficácia

S. Katagiri; T. C. G. Oliveira-Sequeira

2007-01-01

120

A EFICIÊNCIA DOS PROGRAMAS EDUCATIVOS IMPLEMENTADOS POR EMPRESAS E ORGÃOS GOVERNAMENTAIS COMO FORMA DE PREVENÇÃO AO IMPACTO AMBIENTAL CAUSADO PELO DESCARTE INCORRETO DAS EMBALAGENS DE AGROTÓXICOS EM CAMPOS GERAIS NO SUL DO ESTADO DE MINAS GERAIS  

Microsoft Academic Search

Este estudo atua com uma ferramenta de feedback quanto aos resultados obtidos com os programas educacionais em combate ao descarte incorreto de embalagens vazias no município de Campos Gerais no Sul do Estado de Minas Gerais. Os objetivos são mensurar a eficiência dos -programas educativos implementados por empresas e órgãos governamentais como forma de prevenção ao impacto ambiental causado pelo

Jairo Gustavo De Lima; Marcelo Marcio Romaniello; Cristhiane Oliveira Da Graca Amancio

2008-01-01

121

Coaching como herramienta de liderazgo para el desarrollo de equipos de alto desempeño en el área de ventas (Coaching like tool of leadership for the development of teams of high acting in the area of sales)  

Microsoft Academic Search

Resumen. El presente artículo busca vincular el coaching como herramienta de liderazgo para el desarrollo de equipos de alto desempeño en el área de ventas. Para cumplir con este propósito se realizó una revisión de bibliografía y documentos publicados en la web sobre a esta temática, que permitieron definir conceptualmente su relación con el coaching y los distintos estilos de

Fidel Moreno

2009-01-01

122

INVESTIGAÇÕES EM SISTEMAS DE SERVIÇOS DE SAÚDE COMO FERRAMENTA PARA O ALCANCE DE PROGRAMAS DE CONTROLE DA HANSENÍASE MAIS EFETIVOS NO B RASIL* Health systems research training as a tool for more effective Hansen's disease control programmes in Brazil  

Microsoft Academic Search

RESUMO No Brasil, a hanseníase permanece como um importante problema de saúde pública. Embora um grande progresso tenha sido obtido nos Programas de Controle da Hanseníase (PCH), em todos os níveis do governo nos últimos 20 anos, algumas ações não foram potencializadas. O motivo: lacunas de informação relacionadas a áreas específicas da doença, exacerbadas pela ausência de instrumentos apropriados para

Alberto Novaes Ramos Jr; Jorg Heukelbach; Marcia Gomide; Pieter A. M. Schreuder

123

La mosca blanca Bemisia tabaci (Gennadius) como plaga y vectora de virus en fríjol común (Phaseolus vulgaris L.) The whitefly Bemisia tabaci (Gennadius) as pest and vector of plant viruses of common bean (Phaseolus vulgaris L.)  

Microsoft Academic Search

2 Resumen. La mosca blanca Bemisia tabaci es una de las plagas más ampliamente distribuidas en regiones tropicales y subtropicales del mundo donde afecta más de 600 especies de plantas cultiva- das y silvestres. Los daños que causa se deben a diversos efectos del insecto en las plantas atacadas, como el debilitamiento de la planta por la extracción de nutrientes;

MARÍA ELENA CUÉLLAR; FRANCISCO J. MORALES

2006-01-01

124

Difusión de resultados iniciales del Estudio del Tamoxifeno y del Raloxifeno (STAR): el fármaco para el tratamiento de la osteoporosis, raloxifeno, es tan efectivo como el Tamoxifeno en la prevención de cáncer de seno invasor  

Cancer.gov

Los resultados iniciales del Estudio del Tamoxifeno y del Raloxifeno, STAR, demuestran que el fármaco raloxifeno, actualmente utilizado para prevenir y tratar la osteoporosis en mujeres posmenopáusicas, funciona tan bien como el tamoxifeno para reducir el riesgo de cáncer de seno entre las mujeres posmenopáusicas que tienen riesgo elevado de padecer la enfermedad. Preguntas y respuestas

125

Single-molecule magnet based on a C-type polyoxomolybdate with an S = 11 ground state: [Fe5CoMo22As2O85(H2O)]15-.  

PubMed

A C-type polyoxomolybdate containing a mixed-transition metal cluster Fe(5)Co has been prepared as an ammonium salt, (NH(4))(15)[Fe(5)CoMo(22)As(2)O(85)(H(2)O)]·15H(2)O (1). Interestingly, the magnetism measurements show that the compound exhibits not only an overall ferromagnetic cluster with a large spin ground state of S = 11 but also the behavior of single-molecule magnets. PMID:23135131

Zhen, Yanzhong; Liu, Bin; Li, Lili; Wang, Danjun; Ma, Ying; Hu, Huaiming; Gao, Shengli; Xue, Ganglin

2013-01-01

126

The effect of boron addition on the hydrodesulfurization activity of MoS 2\\/Al 2O 3 and Co–MoS 2\\/Al 2O 3 catalysts  

Microsoft Academic Search

The effect of boron addition was studied on the hydrodesulfurization (HDS) of thiophene over MoS2\\/B\\/Al2O3 and Co–MoS2\\/B\\/Al2O3 (CVD-Co\\/MoS2\\/B\\/Al2O3), which was prepared by a CVD technique using Co(CO)3NO as a precursor of Co. The catalysts were characterized by means of NO adsorption and TEM. The HDS activity of MoS2\\/B\\/Al2O3 catalysts kept constant up to a boron content of about 0.6 wt%

Usman; Takeshi Kubota; Yasuhiro Araki; Katsuaki Ishida; Yasuaki Okamoto

2004-01-01

127

CUIDADOS CRÍTICOS: LA COMUNICACIÓN COMO TERAPIA IMPRESCINDIBLE  

Microsoft Academic Search

Good interpersonal communication impro- ves and facilitates human relationships, gran- ting effectiveness, but the practice of modern Medicine does not consider it as a priority. Critical Care Units are not an exception. Although care is taken effi ciently against ill- ness, the patients and their families are not always satisfi ed with communication between them and caregivers and, at the

Clara Llubiá

2008-01-01

128

B4-5: Neighborhood Deprivation and Telomere Length: Preliminary Findings from the Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH)  

PubMed Central

Background/Aims Shortened telomeres have been associated with numerous adverse health outcomes. In addition, a number of environmental or external exposures, including smoking, air pollution and stress, have been reported to be associated with short telomeres. We sought to examine how neighborhood quality of participants in the RPGEH Genetic Epidemiology Research Study on Adult Health and Aging (GERA) cohort affected telomere length. Methods The GERA cohort is a multi-ethnic cohort (average age = 63 years) of over 100,000 individuals with linked electronic medical records and questionnaire data. Telomere length was determined from a saliva sample in the Blackburn Laboratory using the novel Automated Telomere Length Analysis System (ATLAS) to handle the required high throughput processing of samples. Each sample was assayed six times using qPCR. Relative telomere length (T/S) was obtained from the initial concentrations of the sample telomere (T) with the corresponding sample reference gene (S). The distribution of (T/S) was found to be positively skewed and a log transformation was used to normalize the distribution. The final telomere length end point was the difference in adjusted means of telomere length per standard deviation unit by accounting for age and gender. The NDI is a standardized composite score of neighborhood quality derived from eight 2000 US Census data variables related to poverty/income, occupation, family structure, education and unemployment and normalized to a 100-point scale at the block-group level. Results A higher NDI indicates greater neighborhood deprivation. The NDI was linked with residential address at time of sample collection. We observed a pattern of shorter telomere length with increasing level of neighborhood deprivation. The pattern persisted even after accounting for age, gender, race/ethnicity, smoking, BMI, and the presence of cardiovascular disease, diabetes and other comorbidity. Conclusions Our results suggest that neighborhood can adversely impact telomere length. Future plans will be discussed.

Van Den Eeden, Stephen; Kvale, Mark; Shan, Jun; Lapham, Kyle; Ranatunga, Dilrini; Rowell, Sarah; Sadler, Marianne; Ludwig, Dana; Walter, Lawrence; Whitmer, Rachel; Quesenberry, Charles

2013-01-01

129

Formation des Enseignants dans une Perspective d'Education Permanente au Benin (Teacher Education from a Lifelong Learning Perspective in Benin).  

ERIC Educational Resources Information Center

Examines the history of teacher training in Benin, suggesting that a system of lifelong education should be introduced to unite formal and informal education. Discusses radical changes in the role of the teacher and developments in lifelong learning and apprenticeship caused by national and international sociopolitical programs. (11 citations)…

Agboton, Sebastien; Moussa, Yaya Mede

1994-01-01

130

B4-5: Neighborhood Deprivation and Telomere Length: Preliminary Findings from the Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH).  

PubMed

Background/Aims Shortened telomeres have been associated with numerous adverse health outcomes. In addition, a number of environmental or external exposures, including smoking, air pollution and stress, have been reported to be associated with short telomeres. We sought to examine how neighborhood quality of participants in the RPGEH Genetic Epidemiology Research Study on Adult Health and Aging (GERA) cohort affected telomere length. Methods The GERA cohort is a multi-ethnic cohort (average age = 63 years) of over 100,000 individuals with linked electronic medical records and questionnaire data. Telomere length was determined from a saliva sample in the Blackburn Laboratory using the novel Automated Telomere Length Analysis System (ATLAS) to handle the required high throughput processing of samples. Each sample was assayed six times using qPCR. Relative telomere length (T/S) was obtained from the initial concentrations of the sample telomere (T) with the corresponding sample reference gene (S). The distribution of (T/S) was found to be positively skewed and a log transformation was used to normalize the distribution. The final telomere length end point was the difference in adjusted means of telomere length per standard deviation unit by accounting for age and gender. The NDI is a standardized composite score of neighborhood quality derived from eight 2000 US Census data variables related to poverty/income, occupation, family structure, education and unemployment and normalized to a 100-point scale at the block-group level. Results A higher NDI indicates greater neighborhood deprivation. The NDI was linked with residential address at time of sample collection. We observed a pattern of shorter telomere length with increasing level of neighborhood deprivation. The pattern persisted even after accounting for age, gender, race/ethnicity, smoking, BMI, and the presence of cardiovascular disease, diabetes and other comorbidity. Conclusions Our results suggest that neighborhood can adversely impact telomere length. Future plans will be discussed. PMID:24085933

Van Den Eeden, Stephen; Kvale, Mark; Shan, Jun; Lapham, Kyle; Ranatunga, Dilrini; Rowell, Sarah; Sadler, Marianne; Ludwig, Dana; Walter, Lawrence; Whitmer, Rachel; Quesenberry, Charles

2013-09-01

131

Quelques Facteurs Sociaux Agissant sur la Formation Permanente et l'Education Informelle en Algerie (Social Factors Acting upon Lifelong Learning and Informal Education in Algeria).  

ERIC Educational Resources Information Center

|Analyzes conditions that have led to an increase in private and collective educational initiatives in Algeria, highlighting political and socioeconomic changes since 1988. Indicates that after a long period of a public education monopoly, social factors have led to the development of alternative educational opportunities that are more responsive…

Haddab, Mustapha

1994-01-01

132

RELACIÓN SUELO-ÁRBOL Y FACTORES DE SITIO, EN PLANTACIONES JÓVENES DE TECA (Tectona grandis), EN LA ZONA OESTE DE LA CUENCA DEL CANAL DE PANAMÁ  

Microsoft Academic Search

Recibido: 07\\/12\\/04 Aceptado: 01\\/03\\/05 RE SU MEN Mediante la utilización de un muestreo factorial estratificado con 4 repeticiones (3x3x4) se seleccionaron 36 parcelas permanentes de medición en plantaciones de teca en la zona oeste de la cuenca del Canal de Panamá. En la estratifi- cación se emplearon como criterios el incremento medio anual (IMA) en altura total y la pendiente

Manuel Mollinedo; Luis Ugalde; Alfredo Alvarado; Jean Mark Verjans; Luis Carles Rudy

2005-01-01

133

Potencial de los caldos rizósfera y súper cuatro como biofertilizantes para la sostenibilidad del cultivo de cebolla de bulbo (Allium cepa) Potential of the rhizosphere and super four broths as biofertilizers for the sustainability of the onion bulb (Allium cepa) culture  

Microsoft Academic Search

El objetivo de esta investigación fue evaluar el potencial de los caldos rizósfera y súper cuatro como biofertilizantes para la sostenibilidad del cultivo de cebolla de bulbo. Los caldos se analizaron química y microbiológicamente y se aplicaron a materas, en concentración del 10% a los 20, 40 y 60 días del trasplante. El diseño experimental fue completamente al azar con

Silvio E. Viteri; Marcela Granados; Ana Rosa González

2008-01-01

134

Cojera como forma de debut de un linfoma Burkitt  

Microsoft Academic Search

Musculoskeletal pain is a frequent complaint in pediatrics usually related to benign conditions. However, it may also represent the initial symptom of serious diseases such as infections, malignancies or orthopedic emergencies.We present the case of a child diagnosed with Burkitt's lymphoma whose initial presentation was a limp. This is, to the best of our knowledge, the first case reported in

Marta Barrios López; Rocío Casado Picón; Jaime de Inocencio Arocena; José Luis Vivanco Martínez

2011-01-01

135

Crítica literária e sociedade: como representa o texto literário?  

Microsoft Academic Search

This article discusses, from a theoretical point of view, the paradoxical relationship between literature and society. On the one hand, it criticizes a reading of literature with a sociologizing bias disseminated by the culturalist critique, but tries to retrieve positive aspects mentioned by authors such as Mignolo, Moreiras, Polar and Bhabba. On the other hand, it proposes a reading of

Juan Pablo Chiappara

2006-01-01

136

Depósitos de Tsunami como indicadores de riesgo: evidencias sedimentarias1  

Microsoft Academic Search

The article presents the main keys that have been used for the tsunami deposits study, like evidences to determine: i) phenomenon intensity, ii) frequency, and iii) inundation levels reached by the waves. This is crucial information in the risk management for this kind of natural threat. The highly energetic character of tsunami leaves geomorphologics and sedimentary records clearly identifi able

137

Los indicadores de insustentabilidad urbana como indicadores de conflicto social  

Microsoft Academic Search

Las ciudades son ecológicamente insostenibles. Sus «huellas ecológicas» son muchos mayores que sus propios límites administrativos. Las ciudades procesan unas grandes cantidades de materiales y energía y excretan residuos de distintos tipos. Sin embargo, este artículo se pregunta de manera optimista si acaso no son las ciudades los lugares donde se producen las innovaciones tecnológicas ecoeficientes. Se pregunta también si

Joan Martínez Alier

2002-01-01

138

Custo de bombas centrífugas funcionando como turbinas em microcentrais hidrelétricas  

Microsoft Academic Search

RESUMO: A implantação de microcentrais hidrelétricas é uma das alternativas para suprir com energia comunidades pequenas e isoladas, situadas normalmente na área rural. O aproveitamento de potenciais hidráulicos de pequeno porte é uma alternativa cada vez mais viável devido não só à falta de recursos financeiros para os grandes empreendimentos, mas também pelo imenso potencial de geração em centrais de

Carlos R. Balarim; Luiz A. Targa; Jorim S. Virgens Filho; Alceu G. Andrade Filho; Giovana K. Wiecheteck

2004-01-01

139

Como Planear Mi Vida = Make a Life for Yourself.  

ERIC Educational Resources Information Center

This booklet for teenagers about life planning is presented in parallel English and Spanish versions with a special focus on young Hispanics growing up in America. It discusses hopes and dreams that adolescents may have and gives tips for reaching goals. A sentence completion exercise is included to help readers set goals. Four important goals for…

Haffner, Debra; Casey, Sean

140

Make a Life for Yourself = Como Planear Mi Vida.  

ERIC Educational Resources Information Center

This booklet was devised to help Hispanic teenagers develop a life plan. It provides information for making decisions, and is written in both English and Spanish. Tips are provided for setting goals. A sentence-completion task helps the teenager focus on specific issues, and use concrete language when talking about the goals. Specific goals are…

Center for Population Options, Washington, DC.

141

Como Organizar una Cooperativa (How to Organize a Cooperative).  

National Technical Information Service (NTIS)

Four pamphlets explain co-ops in general, co-ops as businesses, how co-ops succeed and how to form a co-op. Co-ops in the American Private Enterprise System compares co-ops with other businesses. The Business Co-op explains how a co-op can function as a p...

1971-01-01

142

GEOIDEA - Geotecnologia como instrumento da inclusão digital e educação ambiental  

Microsoft Academic Search

GEOIDEA1 Project (Geo-technology as Instrument of Digital Inclusion and Environmental Education) aims to develop and apply a methodology focused on students digital inclusion through the use of Geographical Information System, in particular, in Geography classes. This work has generated, in digital environment, the means for teaching and learning subjects related to mapping, space technology, environment, for example, themes like watersheds,

Angelica Carvalho Di Maio

143

B4-3: Demographic and Behavioral Influences on Telomere Length and Relationship with All-Cause Mortality: Early Results from the Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH).  

PubMed

Background/Aims Telomere shortening is a biomarker of aging, but it is still unclear whether it directly influences aging-related health changes and mortality, or largely reflects the accumulating influences of environmental influences and declining health. Prior studies have reported associations between short telomeres and many health conditions. Mendelian syndromes and heritability studies demonstrate the biological underpinnings of telomere length (TL), yet other studies show that environmental and behavioral factors also influence telomere lengths. Methods As part of the RPGEH, the Genetic Epidemiology Research Study on Adult Health and Aging (GERA), a multi-ethnic cohort (average age = 63 years) has measured TL from saliva samples on over 100,000 individuals with linked electronic medical records. A survey of demographic and behavioral factors was conducted 2 years prior to saliva collection. With these data, we examined demographic relationships with TL, behavioral influences, and relationship of TL with all-cause mortality following sample collection. Results As expected, TL is inversely correlated with age, and women have longer telomeres than men except as young adults. All analyses controlled for age and gender. As seen in other studies, we find significantly longer TL among African Americans than other groups. TL is positively correlated with education and body mass index (BMI), and negatively correlated with cigarette smoking and alcohol consumption. We found no relationship with major depression or stress-related disorders, even when limited to recent episodes. We found that short TL was prospectively associated with mortality, although only those with the shortest TL were at increased risk; the association suggested a critical threshold of short TL determines effects on mortality. The association persisted even after adjustment of the demographic and behavioral factors such as age, sex, race, education, BMI, smoking, and alcohol consumption. Conclusions While this could indicate a direct effect of TL on health, it will also be important to examine the extent of pre-existing morbidities in these individuals to understand their possible role in the pathway between TL and longevity. PMID:24085931

Schaefer, Cathy; Sciortino, Stan; Kvale, Mark; Lapham, Kyle; Ranatunga, Dilrini; Rowell, Sarah; Sadler, Marianne; Ludwig, Dana; Walter, Lawrence; Van den Eeden, Stephen; Whitmer, Rachel

2013-09-01

144

Safety of combined oligosaccharide conjugate Haemophilus influenzae type b (HbOC) and whole cell diphtheria-tetanus toxoids-pertussis vaccine in infancy. The Kaiser Permanente Pediatric Vaccine Study Group.  

PubMed

The safety of the combined oligosaccharide conjugate Haemophilus influenzae (Hib) type b (HbOC) and whole cell diphtheria-tetanus toxoids-pertussis (DTP) vaccine (Tetramune, HbOC-DTP; Lederle) in infancy was evaluated in 6644 recipients of this vaccine and compared with 3914 recipients of separate injections of whole cell DTP and HbOC vaccines when given as a three dose regimen to infants at 2, 4 and 6 months of age in each group. Of the total number of infants in the study, a subset of 1435 were enrolled into the study and then randomly assigned to receive either the Hib-DPT combined vaccine or the separate components. This subset was used to assess local and systemic side effects which were evaluated utilizing telephone interviews 48 to 72 hours after vaccine. The remaining children in the study population were enrolled in a nonrandomized manner. For these children parents were offered the experimental Hib-DPT vaccine and refusers were given HbOC and DTP. Both of these groups of children as well as the randomized subset described above were used to assess rates of episodes of hospitalization, emergency room utilization and sudden infant death syndrome in HbOC-DTP recipients and children who received HbOC and DTP separately. Immunogenicity was evaluated in 123 children by collection of a single serum sample 30 days after the third dose of HbOC-DTP. The observed immunogenicity was comparable to that observed in other recent studies for HbOC and DTP component antigens. The profile of local and systemic side effects observed was virtually identical to that observed after DTP plus HbOC given separately.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8108224

Black, S B; Shinefield, H R; Ray, P; Lewis, E M; Fireman, B; Hiatt, R; Madore, D V; Johnson, C L; Hackell, J G

1993-12-01

145

Un nuevo virus A\\/H1N1, una nueva pandemia: Influenza un riesgo permanente para una humanidad globalizada A new virus A\\/H1N1, a new pandemic: A continuing risk to a globalized humanity  

Microsoft Academic Search

Influenza is a highly contagious disease. There are some historical descriptions of this condition by ancient Greek physicians, and the etiological agents have been known only for the last eight decades. The causative agent is the influenza virus, which has three main types: A, B, and C. Type A is capable of circulating within many different biological reservoirs, including humans,

Fernando Osores Plenge; Jorge Gómez Benavides; Luis Suarez Ognio; César Cabezas Sánchez; Jorge Alave Rosas

2009-01-01

146

B4-3: Demographic and Behavioral Influences on Telomere Length and Relationship with All-Cause Mortality: Early Results from the Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH)  

PubMed Central

Background/Aims Telomere shortening is a biomarker of aging, but it is still unclear whether it directly influences aging-related health changes and mortality, or largely reflects the accumulating influences of environmental influences and declining health. Prior studies have reported associations between short telomeres and many health conditions. Mendelian syndromes and heritability studies demonstrate the biological underpinnings of telomere length (TL), yet other studies show that environmental and behavioral factors also influence telomere lengths. Methods As part of the RPGEH, the Genetic Epidemiology Research Study on Adult Health and Aging (GERA), a multi-ethnic cohort (average age = 63 years) has measured TL from saliva samples on over 100,000 individuals with linked electronic medical records. A survey of demographic and behavioral factors was conducted 2 years prior to saliva collection. With these data, we examined demographic relationships with TL, behavioral influences, and relationship of TL with all-cause mortality following sample collection. Results As expected, TL is inversely correlated with age, and women have longer telomeres than men except as young adults. All analyses controlled for age and gender. As seen in other studies, we find significantly longer TL among African Americans than other groups. TL is positively correlated with education and body mass index (BMI), and negatively correlated with cigarette smoking and alcohol consumption. We found no relationship with major depression or stress-related disorders, even when limited to recent episodes. We found that short TL was prospectively associated with mortality, although only those with the shortest TL were at increased risk; the association suggested a critical threshold of short TL determines effects on mortality. The association persisted even after adjustment of the demographic and behavioral factors such as age, sex, race, education, BMI, smoking, and alcohol consumption. Conclusions While this could indicate a direct effect of TL on health, it will also be important to examine the extent of pre-existing morbidities in these individuals to understand their possible role in the pathway between TL and longevity.

Schaefer, Cathy; Sciortino, Stan; Kvale, Mark; Lapham, Kyle; Ranatunga, Dilrini; Rowell, Sarah; Sadler, Marianne; Ludwig, Dana; Walter, Lawrence; Van den Eeden, Stephen; Whitmer, Rachel

2013-01-01

147

Estimativa da Idade em Crianças Baseada nos Estágios de Mineralização dos Dentes Permanentes, com Finalidade Odontolegal Age Estimation in Children Based Upon Permanent Teeth Mineralization Degree, with a Forensic Dentistry Scope  

Microsoft Academic Search

The estimation of age in children is a legal dentistry examination that seeks to offer technical information to civil, criminal and labor courts. Such a procedure is justified due to the great number of Brazilian children without formal register or identification of any kind, and, consequently, without defined age. Such information is extremely important to determine individual responsibility in civil

Andréa Cunha; Santos Gonçalves; José Leopoldo Ferreira Antunes

148

Whooping Cough Risk Higher Among Kids Who Miss Vaccinations  

MedlinePLUS

... the Institute for Health Research at Kaiser Permanente Colorado, in Denver. These undervaccinated children miss their immunizations ... Ph.D., Institute for Health Research, Kaiser Permanente Colorado, Denver; Bruce Hirsch, M.D., attending physician, division ...

149

Pedro Schacht Pereira - Uma Filosofia Buissonnieuse, ou de como o narrador desce as escadas: Como ler a questão da \\  

Microsoft Academic Search

In this article I address a long-standing issue in Machadian studies, that of the relationship between philosophy and literature in the fiction of Machado de Assis. I start by acknowledging my indebtedness to the studies that Abel Barros Baptista has recently dedicated to the Brazilian author. In his article, \\

Pedro Schacht Pereira

2007-01-01

150

Field technique of permeability tests in highly fissured limestone strata  

NASA Astrophysics Data System (ADS)

Résumé.L'étude de dispositifs de dénoyage est nécessaire pour l'amélioration de sites avant la construction de certaines structures. L'étude de dispositifs de dénoyage efficaces exige d'estimer la valeur du coefficient de perméabilité in situ. Les relations disponibles pour estimer le coefficient de perméabilité ont été développées sur la base de mesures et de conditions de terrain limitées, et les prédictions varient de plusieurs ordres de grandeur. C'est pourquoi il est nécessaire de réaliser des mesures de perméabilité sur le terrain et de déterminer la relation qui permet le meilleur ajustement de ces mesures avant l'étude du dispositif de dénoyage pour des conditions locales et géologiques spécifiques. Ce papier présente des mesures de perméabilité sur le terrain dans des niveaux calcaires complexes chaotiques et diagénétisés. Il propose également une analyse comparative de plusieurs relations disponibles dans la littérature destinées à prédire le coefficient de perméabilité in situ. L'analyse est faite en conditions permanentes et non permanentes. Les résultats montrent que la valeur du coefficient de perméabilité dépend du niveau de la nappe, qui est affecté par le régime de marées. On montre que l'équation de l'US Navy donne la meilleure corrélation avec les mesures de terrain. Resumen.El diseño de sistemas de desecado es necesario para mejorar las condiciones de un emplazamiento antes de la construcción de determinadas estructuras. El diseño de un sistema eficiente de desecado requiere de la estimación del valor de la permeabilidad in-situ. Las relaciones disponibles para tal fin han sido desarrolladas bajo condiciones y medidas de campo limitadas; sus predicciones varían en algunos órdenes de magnitud. Por tanto, es necesario tomar medidas de permeabilidad en campo y determinar la relación que reproduce mejor dichas medidas como paso previo al diseño de un sistema de desecado en condiciones geológicas y de emplazamiento específicas. Este artículo presenta medidas de permeabilidad en campo para estratos de calcita caóticos y diagenéticos. También ofrece un análisis comparativo de diversas relaciones disponibles en la bibliografía con el fin de predecir el valor de la permeabilidad in-situ. El análisis se ha hecho tanto en régimen permanente como en estacionario. Los resultados demuestran que la permeabilidad depende del nivel freático, el cual está afectado por las mareas. La ecuación de la Marina estadounidense es la que proporciona una mejor correlación con las medidas de campo.

Al-Salihi, Adnan; Asaad, Abdulah

2002-05-01

151

Estudio de la histerectomía obstétrica como morbilidad en el Hospital América Arias en el año 2003  

Microsoft Academic Search

A retrospective, longitudinal study was performed of all patients who underwent obstetric hysterectomy in the America Arias Obstetrics and Gynecology Teaching Hospital in 2003. A thorough review of the medical records of 20 patients who underwent surgery was performed. The total number of births in the hospital during this period was 3583. Personal data, the number of cases in each

J. R. Cutié; A. Laffita; A. Velazco; M. Toledo

2005-01-01

152

Más allá del amo y del esclavo. La lógica del resentimiento como nuevo escenario filosófico  

Microsoft Academic Search

¿Cuáles son los elementos constitutivos, específicos de nuestro tiempo, pero más o menos generales, de ese deseo identitario de reconocimiento que a menudo parece alimentar una política de la recriminación, una tendencia a hacer reproches al poder más a que aspirar a él? Gilles Deleuze —junto a Nietzsche y otros pensadores contemporáneos— trata de atender al hecho de la lógica

Germán Cano

2009-01-01

153

ELABORACÃO DE UMA BARRA DE CEREAIS COMO ALIMENTO COMPENSADOR PARA PRATICANTES DE ATIVIDADE FÍSICA E ATLETAS  

Microsoft Academic Search

This study had as objective the elaboration of a bar of cereals, with characteristics appropriate nutricionais to the apprentice's of physical activity needs and athlete. They were used as ingredients: isolated protein of the serum of milk (Whey Protein), flakes of rice, oat in flakes, maltodextrina, concentrated juice of passion fruit, glucose, glycerin, inulina, canola oil, dehydrated apple, chestnut of

Larissa Grden; Cristina Soltovski de Oliveira; Eliana Queiroz Bortolozo

2008-01-01

154

LA RAZA COMO DETERMINANTE DEL ACCESO A UN EMPLEO DE CALIDAD: UN ESTUDIO PARA CALI  

Microsoft Academic Search

La discriminación laboral por raza ha sido un tema ampliamente analizado en la economía del trabajo a partir de la estimación de ecuaciones de ingreso para determinar diferenciales en el salario, pero la influencia de este factor en el acceso a un empleo de calidad no se ha explorado lo suficiente. Realizar este análisis cobra vital importancia para una ciudad

CHRISTIAN DAVID BUSTAMANTE; SANTIAGO ARROYO

2008-01-01

155

Efectividad de la vacuna anti-varicela-zoster como profilaxis post-exposición  

Microsoft Academic Search

Summary Introduction. Chickenpox is an endemic and highly contagious viral disease affecting mostly pre- school and school children. We evaluated the effectiveness of an Oka strain Varicella Vaccine (VV) in susceptible children who have had direct contact with varicella-zoster virus (VZV) infected

Angela Gentile; José Marcó del Pont; Emilio Martínez Iriart; Gustavo Pueta; Walter Joaquín; Silvia Castrillón; Marcelo Serantes; Patricia Lamy; Ricardo Rüttimann

156

Como Ayudar a sus Hijos a Aprender Ciencia (Helping Your Child Learn Science).  

ERIC Educational Resources Information Center

|Because most parents say they do not or cannot help their children with science, this booklet was designed to help them do so, easily and with pleasure for both parent and child. The introduction presents information on why and how parents should help their children and provides a general orientation to the ideas and activities offered in the…

Paulu, Nancy; Martin, Margery

157

COMO IMPLANTAR UM PROGRAMA DE ATIVIDADE FÍSICA NA EMPRESA: SUGESTÃO SEM IMPOSIÇÃO  

Microsoft Academic Search

This work deals with the practice of sport in the company, an expedient that has existed for a long time in European and Asian countries, later adopted in the United States, and arriving in Brazil in the second half of the past century, particularly in the South West and Southern regions - São Paulo, Paraná and Rio Grande do

José Maurício Capinussú

2005-01-01

158

Statement from the 1987 Como Meeting of the International Commission on Radiological Protection.  

National Technical Information Service (NTIS)

A summary of the 1987 meeting of the ICRP is given. Topics covered include the work on cancer risk assessment, in particular the atomic bomb survivor studies, the risk of mental retardation by exposure of children to radiation in utero, health risks from ...

1987-01-01

159

«BAILANDO COMO NEGRO»: RITMO, RAZA Y NACIÓN EN ESMERALDAS, ECUADOR1  

Microsoft Academic Search

Throughout the African diaspora blackness has long been associated with rhythmic dancing abilities. The association is often naturalised in popular discourses to suggest that black people have an innate sense of rhythm - that rhythm is «in their blood». This charaterisation is at times appropriated by individuals who self identify as black and consider their dancing skills an important part

Emily Walmsley

160

Em Busca de Delimitações do Enquadramento do Franchising como Alianças Estratégicas AUTORES  

Microsoft Academic Search

In the present paper is questioned the service franchises if it can be classified as strategic alliances. Two reasons impel the discussion. First, the relevance that this franchise type wins in terms of number of establishments and participation in the world economy; and second, the existent gap as the discussion regarding the system of franchising of services as a strategic

PEDRO LUCAS DE RESENDE; FELIPE MENDES BORINI

161

"Tanto Necesitamos De Aqui Como Necesitamos De Alla": "Leer Juntas" among Mexican Transnational Mothers and Daughters  

ERIC Educational Resources Information Center

|This paper presents part of the results of a qualitative study about literacy practices of Mexican transnational mothers, who live in and frequently cross the border between two countries (the United States and Mexico). Drawing on sociocultural approaches to literacy and literature on transnationalism, I analyze one practice: "leer juntas"…

de la Piedra, Maria Teresa

2011-01-01

162

Como Mantener los Socios en su Cooperativa (How to Maintain Membership in Your Cooperative).  

National Technical Information Service (NTIS)

Active membership in cooperatives is the major factor that makes co-ops survive. Five short pamphlets discuss issues for maintaining membership. (1) Strengthening Cooperative Member Interest and Support describes priority areas: creating pride in the co-o...

1970-01-01

163

Papel de los receptores tipo toll en las infecciones virales: el VIH-1 como modelo  

Microsoft Academic Search

The toll-like receptors are an essential component of the innate and adaptive immune response. They are responsible for the recognition of different pathogens agents and trigger responses directed at eliminating the pathogens as well as the development of immunological long-term memory. During viral infections, several different toll-like receptors are activated. These generally induce a protective immune response, but at the

Juan Carlos Hernández; Carlos Julio Montoya; Silvio Urcuqui-Inchima

2007-01-01

164

"Las Charlas" como expresion oral diaria ["Chats" as Daily Oral Practice].  

ERIC Educational Resources Information Center

|An oral practice system of "chats" in the classroom functions as an extemporaneous speaking exercise or chat (without notes or prompt sheets), occurring between two students for a minute or so at the beginning of class, following which the presenters respond to other students' questions. (CNP)|

Borden, Matt

2002-01-01

165

Os métodos científicos como possibilidade de construção de conhecimentos no ensino de ciências  

Microsoft Academic Search

This article deals with the scientific method in the area of science teaching. It focuses on its role in the process of building knowledge. It tries to show how the scientific method can be used in the definition and construction of concepts, especially those inherent to science itself. It treats these aspects from an acceptance point of view as a

Marly Aparecida Giraldelli Marsulo; Maria Ghisolfi da Silva

2005-01-01

166

POLÍTICAS CIENTÍFICAS EN MATERIA DE RENOVABLES: EL CASO DEL HIDRÓGENO COMO FUENTE BÁSICA ENERGÉTICA 1  

Microsoft Academic Search

The paper tries to realize a valuation on the implication of the hydrogen economy in the society. The Global Warning has led the governments to designing diffe- rent policies favoring the alternative energies and improve the environment. Though, in most cases performances have spread out with more intention that real. With this paper there are tried to put in scene

Jesús A. Valero Matas; Juan Romay Coca; Grupo Compostela

2009-01-01

167

Spanish Oral Language Guide: Kindergarten Level. Espanol como Segundo Idioma. Teacher's Guide: Level I.  

ERIC Educational Resources Information Center

|This teacher's guide to Spanish language at the kindergarten level includes a recommended subject presentation sequence for the Spanish curriculum, a sample schedule, a grouping of students using three stations, and a classroom layout. The grouping would be effective when at least one-third of the children are Spanish-speaking or bilingual. The…

Corbell, Gloria; And Others

168

LA COMUNICACIÓN DE CRISIS COMO ELEMENTO CLAVE DE LA COMUNICACIÓN EMPRESARIAL  

Microsoft Academic Search

The crisis communication is part of the company communication area. The crisis management of a company or institution includes several topics and among them we must position the crisis communication. When the communication is considered as a whole, the areas which form part of it (including, for example: governmen- tal relations, public relations, or image management) work together in a

Pilar Saura Pérez; Directora de Comunicación

2010-01-01

169

Paleoecology of the Quarry 9 vertebrate assemblage from Como Bluff, Wyoming (Morrison Formation, Late Jurassic)  

Microsoft Academic Search

Quarry 9 is among the richest microvertebrate localities in the Morrison Formation, having thus far produced the remains of dozens of Late Jurassic taxa. Because this lenticular claystone deposit records such a high diversity of contemporaneous species, it provides an exceptionally detailed view of their paleoecology and local paleoenvironment. In this study, we reexamined the entire Quarry 9 collection, totaling

Matthew T. Carrano; Jorge Velez-Juarbe

2006-01-01

170

Investigação da infância e crianças como investigadoras: metodologias participativas dos mundos sociais das crianças  

Microsoft Academic Search

In the second modernity the childhood participation is assumed as a fundamental principle to a large extent of the scientific speeches that are produced concerning childhood. The Sociology of Childhood, when considering the children as social actors and as citizens of rights, assumes the question of children's participation as central in the definition of a social statute of childhood and

Natália Fernandes Soares; Manuel Jacinto Sarmento; Catarina Tomás

171

Como se posicionam os professores perante manifestações culturais com impacto na natureza. Resultados de uma investigação  

Microsoft Academic Search

The present study is part of a wider research, the aim of which was to investigate the extent to which teachers involved in Environmental Education (EE) projects at the various levels of the Portuguese schooling system supported anthropocentric, biocentric or ecocentric perspectives on the environment. To this end, 60 teachers were interviewed on a variety of issues related to the

António Almeida

2009-01-01

172

Como Solicitar la Asistencia Economica Federal para Estudiantes (How To Apply for Federal Student Aid).  

ERIC Educational Resources Information Center

This guide, written in Spanish, discusses reasons for going to college, how to pay for college, and how to apply for federal student aid in a series of brief, clear illustrations. Following outlines of financial benefits of college, college costs, and space to note costs for the student's area, the guide outlines these steps in the application…

Office of Federal Student Aid (ED), Washington, DC.

173

El caduceo como emblema de la medicina: un error de casi cinco siglos  

Microsoft Academic Search

The snake has been associated to healing arts since the ancient times, probably because its skin-change ability and to symbolize that sola dosis facit venenum. The Staff of Aesculapius and the caduceum derivate from worshipping the snake; it is undeniable that both mythological symbols originated from the Life Tree, which represents wisdom and immortality. The inaccuracy of adopting the caduceum

Feliciano Blanco Dávila; Hernán Ramírez Vel

174

Adubação verde como alternativa agroecológica para recuperação da fertilidade do solo  

Microsoft Academic Search

A recuperação da fertilidade do solo, especialmente do nutriente fósforo (P) tem custo bastante elevado, principalmente quando utilizadas fontes de adubos solúveis. Portanto, é necessário encontrar alternativas de menor custo para recuperação da fertilidade-P. O objetivo desse trabalho foi de avaliar o potencial de produtividade de fi tomassa de espécies de adubos verdes de verão e de inverno submetidas a

Cristiano André Pott; Marcelo Marques; Lopes Müller; Patrick Batista Bertelli

175

Evaluación de algunos residuos orgánicos como sustrato para el cultivo de hongos comestibles  

Microsoft Academic Search

Introduction: Edible mushrooms have an excellent nutritional content; they have all of the essential amino acids, unsaturated fat acids, sugar, vitamins and fiber, and a wide variety of compounds that act against some human diseases. Objective: To evaluate garden remains as a substract to pro- duce two types of the Pleotorus fungus, Pleurotus ostreatus and Pleurotus pulmonarius and standarize the

Adelaida María; Garcés Molina; Natalia Velez Cardona; Santiago Ruiz Alzate; Juan Guillermo Serna DLeón; Ernesto Suarez Holguín

176

LAS LEVADURAS MARINAS COMO HERRAMIENTAS CIENTÍFICA Y BIOTECNOLÓGICA Marine yeasts as Scientific and Biotechnology tools  

Microsoft Academic Search

Marine yeasts comprise a group of microorganisms which existence has been questioned. As a result, the knowledge about its physiology and biotechnology use is scarce. The ecological importance of the marine yeasts is due, at least in part, to their contribution in the ocean's organic matter recycling. In addition, they are valuable sources of biological reagents, cell protein, vitamins, pigments,

Mar Bermejo

2004-01-01

177

ANUÁRIO DE LITERATURA UMBRAL O POEMA COMO EXÍLIO — SOUSÂNDRADE-GUESA EM \\  

Microsoft Academic Search

This essay intends to read in O Guesa, of Joaquim de Sousândrade, a sort of exile-poem. A desert where the poet is an eternal errant, a stranger in his own language, where the representation is not possible anymore and what remains is multi-idiomatic fragmentation, roars, babbles, cacophonies, cries, screams and inversions. A between-place of discords, rupture and deflection, of combat

Ana Carolina Cernichiaro

178

Evaluación de técnicas geoestadísticas como apoyo para la validación de productos en teledetección  

Microsoft Academic Search

This paper evaluates the performance of geostatistical methods to estimate leaf area index (LAI) fields from ground based measurements. These fields are necessary for the direct validation of high and medium spatial satellite derived products. Three models variants of the kriging technique the ordinary kriging (OK), the collocated cokriging (CKC) and kriging with an external drift (KED) are used. The

Eduardo Cassiraga; Javier Haro

179

ARTIGO ARTICLE Violence a global public health problem* Violência como um problema global de saúde pública  

Microsoft Academic Search

This article is a version of the Intro- duction to the World Report on Violence and Health, published by the World Health Organiza- tion (WHO). It presents a general description about this phenomenon and points some basic questions: concepts and definitions about the theme; the state of knowledge about it; nature and typology on violence; proposal of a quantita- tive

Linda L. Dahlberg; Etienne G. Krug

180

Inmigración y barbarie. La construcción social y política del inmigrante como amenaza  

Microsoft Academic Search

Immigration and barbarism. The social and political construction of the immigrant as it threatens This text analyzes the topic of the nowadays close relation between the international migra- tion and the resurgence of the racist ideas and behaviors. To explore the density of this topic, it leaves from a dynamic and constructivist perspective that, insisting on the complexity of the

Enrique Santamaría

2002-01-01

181

La participación como elemento constitutivo de las empresas de la Nueva Economía Social  

Microsoft Academic Search

Participation – democratic functioning – is one of the main elements which make up social economy companies. Within this, certain experiences which aim to solve recently appeared social problems (social integration, fair trade companies, etc.), have been denominated New Social Economy. From the company Stakeholder Theory, this article studies the degree and the ways of participation in the business initiatives

Edmundo Pérez Fernández

2002-01-01

182

La psicoeducación como experiencia narrativa: comprensiones posmodernas en el abordaje de la enfermedad mental  

Microsoft Academic Search

Introduction: Psychoeducation has been an intervention for mental illness since the middle of the 19th Century. It derived from psychiatry, bringing together different disciplines such as psychology, education, and social work among others. Objectives: This article takes a look at postmodern understandings in approaching psychoeducation. Results: A number of questions arise regarding psychoeducational work: How to intervene in mental illness?

María Victoria; Builes Correa; Mauricio Hernando; Bedoya Hernández

183

El portafolio como herramienta de formación y evaluación de los residentes de Dermatología (II)  

Microsoft Academic Search

A portfolio is a collection of material documenting reflection about practice. It contains documents (eg, case histories and questionnaires the resident has used), images, and video recordings that reveal that an individual has acquired the competencies needed for professional practice. This assessment tool simultaneously supports learning and provides evidence for certifying competence. The adoption of portfolio use by a dermatology

J. M. Casanova; X. Soria; L. Borrego; D. De Argila; M. Ribera; R. M. Pujol

2011-01-01

184

ERROS DE MEDICAÇÃO: O ENFERMEIRO, O FARMACÊUTICO E AS AÇÕES EDUCATIVAS COMO ESTRATÉGIAS DE PREVENÇÃO  

Microsoft Academic Search

The nurse and the pharmacist are directly related to the process of medication by means of clearly defined research papers that complement themselves. They are professionals, which by their academic formation, possess the necessary knowledge for the correct development of the processes of the system of medication. For this reason, everybody has the legal responsibility of avoiding medication errors as

Marcus Fernando da Silva; Paulo Celso; Prado Telles; Ana Flora; Fogaça Gobbo

185

Contributions of local knowledge to the physical limnology of Lake Como, Italy.  

PubMed

This article shows how local knowledge may be valuably integrated into a scientific approach in the study of large and complex hydrological systems where data collection at high resolution is a challenge. This claim is supported through a study of the hydrodynamics of a large lake where qualitative data collected from professional fishers was combined with theory to develop a hypothesis that was then verified by numerical modeling. First the fishermen's narratives were found to describe with accuracy internal wave motions that were evident in water column temperature records, which revealed their practical knowledge of the lake's hydrodynamics. Second, local knowledge accounts emphasized the recurrent formation of mesoscale gyres and return flows in certain zones of the lake in stratified conditions, which did not appear in the physical data because of limitations of sampling resolution. We hypothesized that these features developed predominantly because of the interaction of wind-driven internal motions with the lake's bathymetry, and the Earth's rotation in the widest areas of the basin. Numerical simulation results corroborated the fishers' descriptions of the flow paths and supported the hypothesis about their formation. We conclude that the collaboration between scientific and local knowledge groups, although an unusual approach for a physical discipline of the geosciences, is worth exploring in the pursuit of a more comprehensive understanding of complex geophysical systems such as large lakes. PMID:22493231

Laborde, Sarah; Imberger, Jörg; Toussaint, Sandy

2012-04-09

186

Malformación del sistema pancreático-biliar como causa de perforación espontánea de la vía biliar extrahepática  

Microsoft Academic Search

SUMMARY Biliary ascitis usually results from a spontaneous or traumatic perforation of the common bile duct, usually at the junction with the cystic duct. Distal duct obstruction, pancreatic fluid reflux up the common bile duct, congenital weakness or a localized mural malformation of the wall of the common duct have been proposed as possible causes. We present an 11-months-old infant

Carlos Baeza-Herrera; Ulises Darío Medellín-Sierra; Héctor Sanjuán-Fabián; Newton Jiménez-González; Luís Manuel; García-Cabello

187

A SEDUÇÃO LIBERTINA COMO ARTE DO EQUÍVOCO EM CRÉBILLON E LACLOS  

Microsoft Academic Search

Considering all literary texts about libertinage, from Ovid to nowadays, Claude Crébillon and Laclos are surely amongst those who treated with more wit the issue of Eros' ambiguous language. Within the closed and policed universe where theirs characters circulate, a vanity fair as refined as cruel, words' double meaning, when not detected in time or when misinterpreted, can lead the

ANA ALEXANDRA SEABRA DE CARVALHO

2010-01-01

188

Uso de gadolinio como contraste en cpre en pacientes con reacciones adversas a contrastes yodados  

Microsoft Academic Search

IntroductionRadiologic contrasts are required during endoscopic retrograde cholangiopancreatography (ERCP). The most frequently used are iodine-based contrast media. Controversy still surrounds the optimal strategy in patients with previous adverse reactions to iodine contrasts that need to undergo an ERCP.

Eduardo Martín Arranz; Rafael Rey Sanz; María Dolores Martín Arranz; Francisco Gea Rodríguez; Pedro Mora Sanz

189

INCUBACION ANAEROBICA DEL SUELO COMO DIAGNOSTICO DE LA RESPUESTA A NITROGENO DEL MAIZ BAJO SIEMBRA DIRECTA  

Microsoft Academic Search

-1 then the yield increment = 72,5 - 1,38 Nan, if Nan > 48.mg kg -1 the yield increment = 6 %). Nan was related with the time (years) since the last pasture (r 2 = 0.39). These results suggest that Nan probably is associated with light carbon fractions and can be used to explain the response of maize to

PA CALVIÑO; HE ECHEVERRÍA

190

CALIDAD DEL SUELO COMO RESPUESTA A LA APLICACIÓN DE PRACTICAS DE IMPLANTACIÓN FORESTAL  

Microsoft Academic Search

SUMMARY The last years increase the interest to know the impact of silvicultural practices on the characteristics and functionality of the red soils under second rotation. In this study changes in soil organic carbon (OC), light fraction organic matter (LF) and weight of the aggregate mean diameter (MWD) were analyzed in relation to the following site preparation practices: a) manual

A. M. Lupi; R. Fernández; M. Conti

191

Síndrome del dolor miofascial como posible causa de parestesias: presentación de un caso  

Microsoft Academic Search

The presence of paresthesias in the cubital edge of the hand, fourth and fifth finger usually is related to the compression of the C8 root or the cubital nerve. In spite of it, there are occasions in which these symptoms may have other origin. A case study shows, a patient who presented both cervical and dorsal shoulder pain, as well

J. C. Zuil Escobar; C. B. Martínez Cepa

2007-01-01

192

Escuelas sin Drogas. Como Actuar. Edicion 1992. (Schools without Drugs. What Works. 1992 Edition).  

ERIC Educational Resources Information Center

Across the United States, schools and communities have found ways to turn the tide in the battle against drugs. This guidebook describes the methods they have used and the actions they have taken. The first section, "Children and Drugs" outlines the nature and extent of the drug problem and summarizes the latest research on the effects of drugs on…

Department of Education, Washington, DC.

193

Guia Practica: Como Manejar Abejas Africanizadas (Practical Guide: How to Manage Africanized Bees).  

National Technical Information Service (NTIS)

The report discusses beekeeping equipment and methods, including beehive construction and dismantling. Covered are characteristics of African bees as compared with European types. Also, addresses various disease symptoms and general management.

R. Bailey D. Anderson

1986-01-01

194

TRANSFERÊNCIA DE MATÉRIA SECA COMO MÉTODO DE AVALIAÇÃO DO VIGOR DE SEMENTES DE SOJA  

Microsoft Academic Search

The transfer of seed storage material from the cotiledons to the embryo axys of soybean seeds (Glycine max (L.) Merrill) was studied. Two lots of cultivar Bragg with germination above 80% and differing in vigor levels, as assessed by the accelerated aging test were used. The initial seed quality was evaluated by moisture content, weight of 1,000 seeds, germination and

ELIANA LOPES DAN; VERA DELFINA; COLVARA MELLO; CLÓVIS TERRA WETZEL; FLAVIO POPINIGIS; PAULO ZONTA

195

La evaluación como proceso de legitimidad: la opinión de los alumnos. Reporte de una experiencia  

Microsoft Academic Search

En este trabajo se presentan diversas consideraciones sobre la importancia de legitimar la operación social y la gestión institucional en las organizaciones educativas, considerando que uno de los elementos estriba en el derecho a opinar de los alumnos sobre el desempeño docente de sus profesores. En el trabajo se reporta el análisis de 26 010 cuestionarios contestados por los alumnos

FELIPE TIRADO SEGURA; ALEJANDRO MIRANDA DÍAZ; Y ANDRÉS SÁNCHEZ MOGUEL

2007-01-01

196

Como Pagar Su Educacion 1999-2000 (Funding Your Education: 1999-2000).  

ERIC Educational Resources Information Center

This guide, in Spanish, is for students seeking financial aid for attending a college or career school. The guide uses a question-and-answer format to provide practical information on student financial aid available from the federal government. Questions and answers are organized into the following categories: choosing a school; paying tuition and…

Office of Student Financial Assistance (ED), Washington, DC.

197

Nutrición basada en la evidencia en el cáncer como enfermedad caquectizante  

Microsoft Academic Search

Cachexia is characterized by progressive and involuntary weight loss. Cancer is considered to be a cachexia-inducing disease because of the prevalence and importance of cachexia in malignant neoplastic disease. It is well known that malnutrition frequently contributes to the death of cancer patients. However, before routinely recommending nutritional therapy, the real therapeutic benefits it confers should be identified. The present

E. Cancér Minchot; G. Cánovas Molina; M. Durán Poveda; J. Álvarez Hernández; J. J. Gorgojo Martínez

2005-01-01

198

Informacion Bibliografica Educativa (Bibliographic Educational Information). No. 12.  

ERIC Educational Resources Information Center

|The document contains six papers in Spanish which focus on the developmental and other aspects of education permanente. The first paper, The Concept of Education Permanente, discusses the concept as a new dimension in the area of education, capable of limiting inequalities in the presentation of education in general. Descriptions of 20…

Ministerio de Educacion Nacional, Bogota (Colombia). Centro Nacional de Documentacion e Informacion Pedagogica.

199

Caracteristicas de la Instruccion Programada como Tecnica de Ensenanza (Characteristics of Programed Instruction as a Teaching Technique).  

ERIC Educational Resources Information Center

|This discussion of programed instruction begins with the fundamental psychological aspects and learning theories behind this teaching method. Negative and positive reinforcement, conditioning, and their relationship to programed instruction are considered. Different types of programs, both linear and branching, are discussed; criticism of the…

Dorrego, Maria Elena

200

Introduccion, establecimiento y potencial de Apion ulicis como antagonista de Ulex europaeus en el sur de Chile  

Microsoft Academic Search

Resumen  El coleópteroApion ulicis Forster, introducido desde Nueva Zelanda se estableció exitosamente enUlex europaeus L. en todas las localidades del Sur de Chile donde fue introducido, entre los paralelos 37 y 43 grados Lat. Sur.\\u000a \\u000a Los niveles de consumo de semilla que muestran las plantas infestadas con este insecto, indican queA. ulicis puede ser un valioso agente de control biológico de

H. Norambuena; R. Carrillo; M. Neira

1986-01-01

201

The Chernobyl accident: the radioactive contamination in the area of Lake Como and in other Northern Italy sites  

Microsoft Academic Search

Summary The radioactive cloud released during the Chernobyl accident reached the Po Plain and Lombardy in the night of April 30, 1986;\\u000a the cloud remained in the northern Italian skies for a few days and then disappeared either dispersed by winds or washed by\\u000a rains. The evidence in the atmosphere of radionuclides as tellurium, iodine, cesium was promply observed by

D. Capra; U. Facchini; V. Gianelle; G. Ravasini; O. Ravera; A. Pizzala; P. Bacci

1987-01-01

202

Como Emplear con Seguridad Equipo Diesel Movil en Lugares Subterraneos (Safety with Mobile Diesel Powered Equipment Underground).  

National Technical Information Service (NTIS)

The manual provides detailed requirements to use combustion engines in mines. Explosions from gases are to be avoided by measures such as ventilation, air conditioning, piping exhaust. The effects of air temperatures and humidity is also covered.

1966-01-01

203

A TRANSMISSÃO DO SABER EM ELEMENTOS DA CULINÁRIA BAIANA COMO DEPOSITÁRIO DA TRADIÇÃO CULTURAL: UMA ANÁLISE À LUZ DA CONTEMPORANEIDADE  

Microsoft Academic Search

This article focuses on addressing issues of interest concerning the transmission of knowledge on matters of Bahian cuisine, its relationship with the parties, the rituals and celebrations. To this end, it was a sketch map of popular culture in Bahia, scoring their knowledge and taste in cultural practices. Next, the study addresses issues involving food, the hybridism cultural tradition and

Mércia Socorro Ribeiro Cruz; Janete Ruiz Macedo

204

Información sobre salud en internet y sellos de confianza como indicadores de calidad: el caso de las vacunas  

Microsoft Academic Search

ObjectivesTo find out the prevalence of quality trust marks present in websites and to analyse the quality of these websites displaying trust marks compared with those that do not display them, in order to put forward these trust marks as a quality indicator.

Miguel Ángel Mayer; Ángela Leis; Ferran Sanz

2009-01-01

205

O LAZER E A RECREAÇÃO EM BUSCA DA INTENCIONALIDADE: A UTILIZAÇÃO DA TEORIA DAS INTELIGÊNCIAS MÚLTIPLAS COMO PROPOSTA DE INTERVENÇÃO  

Microsoft Academic Search

This study it has as objective to argue, through the bibliographic revision, the leisure while sociocultural fact nowadays, over all in our country. As the Recreation while educative practice it comes growing and searching its legitimity in the work field. And still, to point the use of the Theory of M ultiple Intelligences as subsidy sugestion theoretician- metodologic with respect

Jeane Karla; Albuquerque de Oliveira; Maria Amélia Guedes Barros; Ericka Cilene

206

Posibilidades y limitaciones de las políticas fiscales como instrumentos de salud: los impuestos sobre consumos nocivos. Informe SESPAS 2010  

Microsoft Academic Search

This article discusses the possibilities of indirect taxation as a mechanism that alters the relative prices of goods and services and hence encourages citizens to adopt healthy lifestyles. We review the case of smoking and unhealthy diet. These two cases were chosen because these are the two lifestyle factors with the greatest impact on morbidity and mortality in Spain and

Ángel López Nicolás; Arántzazu Viudes de Velasco

207

THE KELP Macrocystis pyrifera AS NUTRITIONAL SUPPLEMENT FOR GOATS El Alga Marina Macrocystis pyrifera como Sumplemento Alimenticio para Cabras  

Microsoft Academic Search

The present study was aimed to evaluate Macrocystis pyrifera (MP) meal as a nutritional supplement for goats. There is an in- creasing interest to look at nutritional alternatives to guarantee a continuous supply of good quality forage for goats, in many communities around the world. Given its abundance and chemi- cal composition, the algae M. pyrifera is an important potential

Nidia Mora Castro; Margarita Casas Valdez; Alejandro Marín Álvarez; Ruth Noemí; Águila Ramírez; Ignacio Sánchez Rodríguez; Hugo Hernández Contreras; Leonor Sanginés García

208

Design, Development and Experimental Evaluation of Solar Collector with Storage Space Heating System for School Building at Civiglio (Como, Italy).  

National Technical Information Service (NTIS)

This report aims at investigating means for space heating using processes suitable for implementation in areas where the conventional energy resources are scarse. Bearing in mind the low cost of capital investment and utilization possibilities, mainly spa...

G. De Giorgi Fumagalli A. Frascone L. Soma L. Esposito

1988-01-01

209

LA UTILIZACIÓN DE MAPAS CONCEPTUALES COMO ESTRATEGIA DIDÁCTICA PARA LA CONSTRUCCIÓN Y ORGANIZACIÓN DEL PENSAMIENTO EN EDAD PREESCOLAR  

Microsoft Academic Search

A continuación se exponen los resultados y conclusiones de una investigación, basada en la implementación de una propuesta metodológica innovadora para la construcción de Mapas Conceptuales en edad preescolar. Esta experiencia tuvo lugar en dos jardines Infantiles estatales de la ciudad de Cartago, Costa Rica. La población infantil la conformó un grupo de niños y niñas con edades entre los

Jenny Brenes; Ana Sofía Coto; Gloria Hurtado

210

O INTERACIONISMO SIMBÓLICO COMO FUNDAMENTAÇÃO PARA PESQUISAS DE ENFERMAGEM PEDIÁTRICA SYMBOLIC INTERACTIONISM AS A FUNDAMENT FOR PEDIATRIC NURSING RESEARCH  

Microsoft Academic Search

Palavras-chave Palavras-chave: Enfermagem; pediatria; interacionismo simbólico; pesquisa. Abstract: Abstract: Abstract: Abstract: Abstract: This article aims at revising theoretical references of Symbolic Interactionism and highlighting their use in qualitative approach on pediatric researches. Literature from 1969 to 2005 was mentioned. According to those studies, it can be demonstrated that Symbolic Interactionism has been used by caretakers for the analysis of human

Lucimeire Santos Carvalho; Cátia Andrade da Silva; Ana Carla; Petersen de Oliveira; Climene Laura de Camargo

211

LA CARGA DE TRABAJO MENTAL COMO FACTOR DE RIESGO DE ESTR…S EN TRABAJADORES DE LA INDUSTRIA ELECTR\\  

Microsoft Academic Search

The purpose of the present study was to determine how some individual, organizational and ergonomic factors influence work stress and mental workload. Participants were 95 workers (male and female) from an electronics organization located in the metropolitan area of the city of Guadalajara, México. Ergonomic conditions were evaluated through the Ergonomics Evaluation List (OIT); Mental work load was analyzed with

RODOLFO E. GUTIÉRREZ MARTÍNEZ

2006-01-01

212

ECOLOGY, BEHAVIOR AND BIONOMICS As Formigas como Indicadores Biológicos do Impacto Humano em Manguezais da Costa Sudeste da Bahia  

Microsoft Academic Search

Mangroves are common in estuaries along the Atlantic coast of Brazil. Although plant diversity is low, this ecosystem supports a range of animals, offering some resources for non-aquatic organisms. Many insects live in mangroves and, between them, many ant species that are exclusively arboreous. Mangroves throughout the world suffer from high levels of human impact, and this is particularly true

JACQUES H. C. DELABIE; VALÉRIA R. L. DE; M. PAIM; IVAN C. DO NASCIMENTO; SOFIA CAMPIOLO; CLÉA DOS S. F. MARIANO

2006-01-01

213

Los pumas ( Puma concolor) como agentes tafonómicos. Análisis actualístico de un sitio de matanza en los Andes de Mendoza, Argentina  

Microsoft Academic Search

A taphonomic study of the carcass of an adult guanaco (Lama guanicoe) recently killed and consumed by one or more pumas (Puma concolor) in the Laguna del Diamante reserve (Mendoza province, Argentina) is exposed, and the case is discussed in the light of the available taphonomic information on this agent in America. The carcass was dispersed along more than 30m

A. Sebastián Muñoz; Mariana Mondini; Víctor Durán; Alejandra Gasco

2008-01-01

214

Traditional plants as source of functional foods: a review Plantas tradicionales como fuente de alimentos funcionales: una revisión  

Microsoft Academic Search

The aim of this work was to assess the following plants as functional foods that can be found in Mexico: white sapote (Casimiroa edulis), jicama (Pachyrhizus spp.), amaranth (Amaranthus hypochondriacus), sweet fennel (Foeniculum vulgare), oregano (Lippia graveolens), pitahaya (Hylocereus sp.), agave (Agave americana), pelitre (Heliopsis longipes), and purslane (Portulaca oleracea L). The main characteristics, components and active substances, forms of

G. Rivera; V. Bocanegra-García; A. Monge

2010-01-01

215

Contextualizacion y "Expresiones Pragmaticas": "Che" como Senal de Marco (Contextualization and "Pragmatic Expressions": "Che" as Deictic Marker).  

ERIC Educational Resources Information Center

The pragmatic expressions of Argentine Spanish (e.g., "bueno, viste, no? mira") are defined as deictic signals. They are deictic because they indicate elements of the communicative situation: transitions between text segments, conversational roles, or the social relationship between participants. They also signal contextual suppositions and help…

Carranza, Isolda

216

How Can We Provide Safe Playgrounds? = Como podemos proveer lugares con juegos infantiles que no sean peligrosos para los ninos?  

ERIC Educational Resources Information Center

|Outdoor playgrounds can be exciting places where children explore their environment and develop motor and social skills; however, they can also pose serious safety hazards. With the exception of California, no mandatory state or federal standards currently exist regarding manufacture or installation of playground equipment or surfaces. The…

ACCESS ERIC, Rockville, MD.

217

Caminar con y como migrantes para transformar la frontera: foundations for the creation of feminist communities on the border  

Microsoft Academic Search

There are different perspectives and experiences with respect to reading and understanding the United States-Mexico Border\\/Frontera. This paper focuses on the Border\\/Frontera as a space where possibilities and encounters take place and which, if lived in openness and reception, can lead to a vivid interchange that can bring a new way of understanding humanity, culture and differences. Since our Border\\/Frontera

Maria Lourdes Arias Trujillo

2006-01-01

218

Conversor boost atuando como carga eletrônica a corrente controlada para fins de teste de uma célula a combustível  

Microsoft Academic Search

This paper presents the study and implementation of an electronic load for fuel cell testing. In a typical fuel cell electrical testing, it is necessary to draw a controllable dc current from it, thus an electronic load based on the boost converter is connected to the cell to control its output current. The design procedure and simulation results are presented.

Julliano H. S. de Faria; Henrique J. Avelar; J. B. Vieira; L. C. G. de Freitas; E. A. A. Coelho

2010-01-01

219

La participación social como referente estratégico para el fortalecimiento de la salud bucal en las políticas nacionales de salud pública  

Microsoft Academic Search

Oral health is an integral part of the general health of the individual, specially considering that the World Health Organization (WHO) has called the attention of the importance of oral health as part of the general health of the individual. This essay focuses on the importance of collective actions as a part of social participation. Said actions are carried out

Andrés Alonso Agudelo; Eliana Martínez

220

A RELAÇÃO ENTRE O IDIOMA E A IDENTIDADE. O USO DO IDIOMA MATERNO COMO DIREITO HUMANO DOS MIGRANTES  

Microsoft Academic Search

Os imigrantes estabelecidos num país cuja língua não é a mesma de sua terra de origem enfrentam singulares problemas quando crianças, enquanto gerações posteriores a assimilam e precisam fazer frente às questões de identidade pessoal e cultural. A situação coloca desafios ainda mais complexos, quando a cultura dominante no país anfitrião subestima a língua materna do imigrante. Este artigo analisa

Lourdes C. Rovira

221

PET de doble fase con 18F-FDOPA como instrumento para la caracterización de tumores cerebrales  

Microsoft Academic Search

18F-FDOPA is an amino acid analogue used to evaluate presynaptic dopaminergic activity, which has aroused great interest in neuro-oncology. We have evaluated five 18F-FDOPA PET studies of patients referred for study of parkinsonian syndrome. Two subjects had previously treated high-grade brain tumors, one nonspecific brain injury, and 2 subjects presented unexpected tumoral lesions. For all lesions SUVmax, time to SUVmax

M. González-Forero; E. Prieto; I. Domínguez; C. Vigil; I. Peñuelas; J. Arbizu

2011-01-01

222

La ciudad como espectáculo. Marketing territorial, internet y atracción turística en Santiago de Compostela. ¿Éxito o fracaso?  

Microsoft Academic Search

The new information and communication technologies (ICTs) allow us to disseminate and revalue local culture in the information society through computer-mediated communication. With the emergence of ICTs and social access to information in web format, audiovisual production is now being developed as a tool for marketing and for attracting the \\

Yolanda García

223

UNIDAD DE MANEJO PARA LA CONSERVACION DE LA VIDA SILVESTRE COMO ALTERNATIVA PARA “LOS NUEVOS AGRONEGOCIOS† 

Microsoft Academic Search

The contamination of the ecosystems, over-exploitation and introduction of invading plants as well as the climatic change are considered causes of the loss of the biodiversity combined to the illegal animal traffic and plants that are exported of clandestine way to other countries which has gotten to represent between the 60 and 70 percent of the illegal commerce of our

Rafael Retes Lopez; Martha Isela Cuevas Gonzalez; Salomon Moreno Medina; Francisco G. Denogean Ballesteros; Fernando A. Ibarra Flores; Martha H. Martin Rivera

2010-01-01

224

How To Start a Family Day Care = Como Iniciar una Guarderia en El Hogar. [Videotape and Viewer's Guide].  

ERIC Educational Resources Information Center

|Being a family day care provider is work that requires professional responsibilities and attention to the physical, emotional, and educational well-being of children; listening and responding to parents; and running a business. This videotape, in English- and Spanish-language versions, explores the elements involved in starting up a family day…

Raphael, Doris; Weisman, Douglas

225

Barcelona como Frontera Lingüística, Sexual, Espacial y Cultural: La Novela Española a Las Puertas del Siglo XXI  

Microsoft Academic Search

The end in 1975 of the Francoist regime in Spain opened the door to new forms of self-expression, many of them suppressed during the 40 years of dictatorship. This change is especially significant around the traditionally peripheral Comunidades Autónomas that are bilingual, bicultural, and are experiencing a revival of their nationalistic feelings.\\u000aThis study focuses on the work of three

Ana Pérez-Manrique

2006-01-01

226

Ficcion de racionalidad: La memoria como operador mitico en las esteticas polares de Jorge Luis Borges y Jose Lezama Lima  

Microsoft Academic Search

The aesthetic placement and period designation of Jorge Luis Borges (1899–1986) and José Lezama Lima (1910–1976) are complicated issues among critics. Borges is considered a predecessor of the Latin American literary “boom,” but despite that taxonomy his work transcends that definition and provides a foundation for new trends, such as the “neobarroco” cultivated by Severo Sarduy. Lezama is considered part

Jose R Vilahomat

2003-01-01

227

Ficción de Racionalidad: La memoria como operador mítico en las estéticas polares de Jorge Luis Borges y José Lezama Lima  

Microsoft Academic Search

The aesthetic placement and period designation of Jorge Luis Borges (1899-1986) and José Lezama Lima (1910-1976) are complicated issues among critics. Borges is obviously considered a predecessor of the Latin American literary “boom,” but despite that taxonomy his work transcends that definition and provides a foundation for new trends and styles, such as the “neobarroco” cultivated by Severo Sarduy. Lezama

José R. Vilahomat

2003-01-01

228

La evolución histórica de los conceptos científicos como prerrequisito para comprender su significado actual: el caso de la \\  

Microsoft Academic Search

In this article we analyse the historic evolution of Stoichiometry, from its origins introducing the concept of 'equivalent' as a necessity to 'mathematise' chemistry in the XVIII century to the introduction of 'amount of substance' as a fundamental quantity in the XX century. This evolution includes the laws of Richter, Proust and Gay-Lussac, the hypotheses of Dalton and Avogadro, and

Carles Furió Mas; Kira Padilla Martínez

229

Conocimiento objetivo y subjetivo sobre el VIH\\/SIDA como predictor del uso de condón en adolescentes  

Microsoft Academic Search

Objective. To evaluate the association between objective and subjective knowledge on HIV\\/AIDS and condom use. Material and Methods. Analysis of a database from an anonymous, self-applied, randomized survey conducted be- tween 1995 and 1996. Study subjects were 1 410 adoles- cents of four socioeconomic strata from Guadalajara, Mexico. Objective knowledge was assessed with 24 ques- tions regarding HIV\\/AIDS, and subjective

Alberto Villaseñor-Sierra; Ramiro Caballero-Hoyos; Alfredo Hidalgo-San Martín; José Ignacio Santos-Preciado

2003-01-01

230

Estadísticas de visitas en portales web institucionales como indicador de respuesta del público a propuestas de divulgación  

NASA Astrophysics Data System (ADS)

The presence of institutions on the internet is nowadays very important to strenghten communication channels, both internal and with the general public. The Córdoba Observatory has several web portals, including the official web page, a blog and presence on several social networks. These are one of the fundamental pillars for outreach activities, and serve as communication channel for events and scientific, academic, and outreach news. They are also a source of information for the staff, as well as data related to the Observatory internal organization and scientific production. Several statistical studies are presented, based on data taken from the visits to the official web pages. I comment on some aspects of the role of web pages as a source of consultation and as a quick response to information needs. FULL TEXT IN SPANISH

Lares, M.

231

TRABAJO SOCIAL INTERCULTURAL: UNA APROXIMACIÓN AL PERFIL DEL TRABAJADOR SOCIAL COMO EDUCADOR Y MEDIADOR EN CONTEXTOS MULTICULTURALES Y MULTIÉTNICOS  

Microsoft Academic Search

RESUMEN La sociedad española se ha transformado en un corto período de tiempo en una sociedad de inmigración, cuando hasta hace pocos años era más bien una sociedad de emigración. Los flujos migratorios internacionales y el hecho de ser nuestro país una sociedad de receptora de los mismos, han modificado sustancialmente el contexto de intervención del trabajador social que, inevitablemente,

MARÍA JOSÉ AGUILAR IDÁÑEZ

232

Triple Screen or Quad Screen  

MedlinePLUS

... Shirley L. Welch, PhD, DABCC, FACB. Director of Chemistry, Kaiser Permanente, NW, Portland, OR. Barkai G, Goldman ... Accessed 2/17/07. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis CA, Ashwood ER, Bruns ...

233

1 Free State Reporting, Inc. 1378 Cape Saint Claire Road ...  

Center for Biologics Evaluation and Research (CBER)

Text Version... Cardiovascular Disease, Northern California Kaiser Permanente, and a ... life, as well as acute and chronic animal studies ... Free State Reporting, Inc. ... More results from www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials

234

Summary Basis for Regulatory - Pediarix  

Center for Biologics Evaluation and Research (CBER)

Text Version... The study was conducted by the University of California, Los Angeles (UCLA) Center for Vaccine Research and the Kaiser Permanente Southern ... More results from www.fda.gov/downloads/biologicsbloodvaccines/vaccines

235

Effect of Speciality on Primary Care Practice in an HMO. Abstract, Executive Summary and Final Report.  

National Technical Information Service (NTIS)

This prospective study examined whether specialty training of primary care physicians (PCPs) affects practice style, resource utilization, quality or costs of care within a large group model HMO (Kaiser Permanente, Northern California), where practice cul...

J. V. Selby

1999-01-01

236

Model Program Boosts Blood-Pressure Control for Patients  

MedlinePLUS

... cardiovascular risk reduction program for Kaiser Permanente Northern California. From 2001 through 2009, the blood-pressure control ... adults to about 652,000 among Kaiser's Northern California facilities. The average age of patients was 63. ...

237

Particulate Air Pollution and Morbidity in the California Central Valley: A High Particulate Pollution Region.  

National Technical Information Service (NTIS)

The purpose of this study was to evaluate the relationship between particulate air pollution and morbidity among the Kaiser Permanente (KP) membership who reside in the Central Valley (CV) of California. Daily augmented particulate matter (PM) monitoring ...

S. K. Van Den Eeden C. P. Quesenberry J. Shan F. Lurmann

2002-01-01

238

Web-based Weight Management Programs in an Integrated Health Care Setting: A Randomized, Controlled Trial  

Microsoft Academic Search

Objective: To assess the efficacy of a Web-based tailored behavioral weight management program compared with Web-based information-only weight management materials.Research Methods and Procedures: Participants, 2862 eligible overweight and obese (BMI = 27 to 40 kg\\/m2) members from four regions of Kaiser Permanente’s integrated health care delivery system, were randomized to receive either a tailored expert system or information-only Web-based weight

Kendra Rothert; Victor J. Strecher; Laurie A. Doyle; William M. Caplan; Jodi S. Joyce; Holly B. Jimison; Lya M. Karm; Adrienne D. Mims; Mark A. Roth

2006-01-01

239

Abordagem do tema hipertensão arterial e suas relações com o tabagismo e a obesidade como forma de avaliação da aquisição e socialização de conhecimentos em Feiras de Ciências  

Microsoft Academic Search

O presente trabalho apresenta a experiência vivenciada por um professor do Ensino Fundamental de Escola Pública do Paraná, na orientação de uma equipe de alunos de 8ª série, em 2008, visando o desenvolvimento de trabalhos em Feiras de Ciências. A temática da equipe enfoca a hipertensão arterial e seus fatores de risco, tabagismo e obesidade, no município de Floresta. Escolheu-se

Eduardo de Almeida Grenier; Celso Ivam Conegero

2008-01-01

240

Efeito de solventes orgânicos usados como veículos de fungicidas no controle in vitro e in vivo da incidência e da transmissão de Bipolaris sorokiniana em sementes de cevada  

Microsoft Academic Search

Effect of organic solvents used as vehicles for fungicides on the in vitro and in vivo control of incidence and transmission of Bipolaris sorokiniana in barley seeds An important pathogenic feature of the fungus Bipolaris sorokiniana is its capacity to be transmitted through barley (Hordeum vulgare) seeds, sometimes in levels up to 100%, which turns fungus eradication very difficult with

Javier Toledo Barba; Erlei M. Reis; Carlos A. Forcelini

2003-01-01

241

Coexistencia de los diferentes discursos patriarcales y efectos desarrollados en la novela de escritoras de la restauracion: La moda como liberacion de la mujer  

Microsoft Academic Search

The role of women in Spanish society, at the end of the nineteenth century and at the beginning of the twentieth century, was shaped by interactions between the legal system, the Catholic Church, customs, and the politics of marriage. The inflexibility of these aforementioned institutions catalyzed the feminist movement in Spain. Specifically, some women writers used the unyielding nature of

Maria Julia Bello-Bravo

2008-01-01

242

La reparación del daño como mecanismo de tutela de la persona. Del daño a la salud a los nuevos daños extrapatrimoniales  

Microsoft Academic Search

En la actualidad, el operador del Derecho se enfrenta a dos de los más importantes problemas del nuevo derecho de daños: por un lado, la clasificación del perjuicio y, por el otro, la reparación correspondiente a cada una de sus categorías, que debe estar informada por el principio de reparación integral, y que impone en consecuencia considerar más que las

Milagros Koteich Khatib

243

La caracterización de la gestión de la calidad como un proceso inherente a la gestión de la eficacia en las organizaciones  

Microsoft Academic Search

La gestión de la calidad cobra una importancia relevante en el logro de la eficacia para cualquier tipo de organización. Su caracterización permite determinar el conjunto de propiedades distintivas, para una vez identificadas y mediante un proceso de toma de decisiones, posibilite que las que se encuentran de manera correcta sigan comportándose de ese modo, y las que están de

Juan Carlos Mayo Alegre; Luis Manuel Pérez Proenza; Saadia Noemí Reyes Benítez; Néstor Alberto Loredo Carballo

2011-01-01

244

Estudo de Filmes Poliméricos contendo os Silanos ?-UPS e VS como Passivantes em Superfícies Galvanizadas e Eletrodepósitos de Ligas Zn\\/Fe e Zn\\/Co  

Microsoft Academic Search

Zinc excellent ability to protect steel make galvanized (HDG) and zinc electroplated (ED) steels very useful materials in the automotive and construction industries. Galvanized and zinc electroplated steels need, however, to be protected against corrosive environments by organic coating (painting). In order to improve the adherence between the systems Zn\\/coating a chromium plating pre-treatment has been used. However, due to

M. C. G. dos Santos; M. E. P Souza; I. V. P. Yoshida; M. Ballester; C. M. A Freire; R. Landers

245

CHERIAN'S BIVARIATE GAMMA DISTRIBUTION AS A MODEL FOR DROUGHT DATA LA DISTRIBUCIÓN GAMA BIVARIADA DE CHERIAN COMO UN MODELO PARA DATOS DE SEQUÍA  

Microsoft Academic Search

Models for drought are of primary importance for the agricultural sciences. In this note, a drought application is described by deriving the exact distribution of W=X\\/(X+Y) and the corresponding moment properties when X and Y follow Cherian's bivariate gamma distribution. Drought data from the State of Nebraska are used.

Saralees Nadarajah; Arjun K. Gupta

246

Una Vez en un Millón de Años: Como Enseñar el Tiempo Geológico  

NSDL National Science Digital Library

Helping students understand the magnitude of geologic time strengthens student understanding of biological concepts; illustrates not just when things happened but also how they are interconnected; and identifies and addresses common misperceptions.

Susan Lewis (Carroll University;); Kristen Lampe (Carroll University;); Andrew Lloyd (Carroll University;)

2009-10-05

247

La utilización de la borra del café como substrato de base para el cultivo de Pleurotus ostreatus (Jacq.:Fr.) Kummer  

Microsoft Academic Search

Studies were carried out to screen the industrial strain HK35 of Pleurotus ostreatus for its ability to develop fruiting bodies in solid state cultivation using several substrates containing 17.8 to 55% of coffee spent ground. Our results showed that only 55% of coffee spent ground was used in the substrate without detecting changes in fruiting body or on its biological

Daniel Job

248

Baja Incidencia de Taquicardia Auricular por Macro-Reentrada luego de la Ablación de Fibrilación Auricular Usando como Guía Potenciales Auriculares Fraccionados en Ritmo Sinusal  

Microsoft Academic Search

Resumen La ablación de fibrilación auricular puede resultar pro-arrítmica. Las taquicardias auriculares por macro-reentrada han sido reportadas hasta en 1\\/3 de los pacientes que son sometidos a ablación de fibrilación auricular. Métodos y Resultados: En el presente trabajo se utilizo un abordaje electrofisiológico para eliminar potenciales auriculares izquierdos fraccionados durante ritmo sinusal, sin la intención de crear líneas de bloqueo.

Javier E. Banchs; Erica Penny-Peterson; Soraya Samii; Deborah L. Wolbrette; Gerald V. Naccarelli; Mario D. Gonzalez

2009-01-01

249

Proteinas Foliares de Cultivos Perennes, Como Alternativa para Incrementar la Productividad Agricola (Foliar Proteines of Perennial Crops as an Alternative to Increase Agricultural Productivity).  

National Technical Information Service (NTIS)

This paper projects a new farming technology, related to the utilization and cultivation of lavatera assurgentiflora. This is a perennial plant, resistent to droughts, freezing, adequate to temperate areas, with a good output in the production of leaves. ...

R. A. Munoz

1980-01-01

250

Simulacion de Temblores como Procesos Estocasticos No Estacionarios (Simulation of Accelerograms as Sample Functions of a Non-Stationary Stochastic Process).  

National Technical Information Service (NTIS)

A procedure for the simulation of accelerograms as sample functions of a non-stationary stochastic process is presented. The frequency content and the amplitude of motion are both considered as evolutionary. The spectral density of the acceleration is rep...

S. Ruiz A. Arias H. Sandoval

1981-01-01

251

Un acercamiento a la aplicación de la teoría de las inteligencias múltiples (IM) en la clase de inglés como idioma extranjero en el contexto universitario cubano  

Microsoft Academic Search

El desarrollo de habilidades relacionadas con el discurso oral es una de las prioridades de los estudiantes de lenguas extranjeras. La mayoría de las veces, la destreza en la comunicación verbal es lo que mide el conocimiento del alumno de la lengua extranjera (LE) o la segunda lengua (L2) que se está aprendiendo. Hay muchas razones por lo que las

Daniel Cima de Mesa; Adrian Abreus González

2011-01-01

252

El manejo de la fibra en el confinamiento de terneros como alternativa de alimentación invernal Feedlot as an alternative for calf winter feeding: fibre management  

Microsoft Academic Search

This experiment evaluated, under feedlot management the effect of two strategies of concentrate feeding (daily vs. self-feeder), two ways of feeding the roughage (in a total mixed ration or separately), and two levels of roughage (restricted or ad libitum). Forty eight Hereford male calves (149.9?20.2 kg, 8 month old) were randomly allotted to each treatment (78 days), receiving a diet

O Bentancur; M Lagreca

253

Video game as a preoperative warm-up for laparoscopic surgery Jogo de video game como aquecimento pré-operatório para cirurgia laparoscópica  

Microsoft Academic Search

Objective: The aim of the present study was to assess the influence of video game as warm-up before dry-lab laparoscopic activities. Methods: Eleven medical students participated in this prospective randomized crossover study. Students were divided into two groups. Students in Group 1 had to execute an interrupted suture with the dominant hand using a standardized technique (non-video game group). Students

Fernando Korkes; Marcelo Langer Wroclawski; Alessandro Tavares; Oseas de Castro-Neves Neto; Marcos Tobias-Machado; Antonio Carlos; Lima Pompeo; Eric Roger Wroclawski

2009-01-01

254

Building Your Baby's Brain: A Parent's Guide to the First Five Years = Como estimular el cerebro infantil: Una guia para padres de familia.  

ERIC Educational Resources Information Center

|Noting that all parents can help their baby's brain to grow, this guide, in English- and Spanish-language versions, explores what science has learned about infant brain development and how parents and caregivers can influence cognitive development. Topics covered include: prenatal care, touching your baby, teaching about feelings and…

Dodge, Diane Trister; Heroman, Cate

255

Como evalvar la actuacion del profesor en una clase de segundo idioma (How to Evaluate a Teacher in a Second Language Classroom).  

ERIC Educational Resources Information Center

|This guide in Spanish provides performance criteria for evaluating the foreign language teacher. It provides an outline for analyzing the teacher's actions and teaching methods in the classroom. Through the evaluation by an outsider, the teacher can learn his or her faults in the views of others and can improve on them. The aspects to be analyzed…

Galvez de Bracamonte, Teresa

256

Avaliacao do uso da radiacao ionizante como tratamento quarentenario em Tefritideos (Diptera). (Evaluation of ionizing radiation as quarantine treatment in Tephritidae (Diptera)).  

National Technical Information Service (NTIS)

Gamma irradiation was used to treat: eggs at different ages of C. capitata, third instar larvae of C. capitata, A. fraterculus and A. obliqua, papayas infested with a known number of C. capitata eggs; papayas and mangoes with C. capitata and A. fraterculu...

A. L. Anjos Duarte

1991-01-01

257

RE-TARGETING EXPRESSIVE MUSICAL STYLE USING A MACHINE LEARNING METHOD TEMPLATES FOR DAFX-09, COMO, ITALY TEMPLATES FOR DAFX04, NAPLES, ITALY  

Microsoft Academic Search

Expressive musical performing style involves more than what is simply represented on the score. Performers imprint their per- sonal style on each performances based on their musical under- standing. Expressive musical performing style makes the music come alive by shaping the music through continuous variation. It is observed that the musical style can be represented by appropri- ate numerical parameters,

Simon Lui; Andrew Horner

258

"Como que No Puedo!" Strategies for the Recruitment and Retention of Hispanic Females into Mathematics and Science Post-Secondary Programs and Careers.  

ERIC Educational Resources Information Center

The economic growth of the nation is dependent upon the inclusion of minority and underrepresented groups in science, engineering, mathematics, and technology-related careers. This report especially addresses those barriers encountered by Latina students preparing to enter scientific and technical careers. The paper summarizes the research…

Ramirez, Reynaldo, Jr.; Laurel, Elva G.; Rodriguez-Aguilar, Celvia

259

Cobaias como modelo para teste de vacinas inativadas contra o herpesvírus bovino tipo 1 e o vírus da diarréia viral bovina  

Microsoft Academic Search

The present study reports the use of guinea pigs as a model to study the immunogenicity of bovine herpesvirus type 1 (BoHV-1) and bovine viral diarrhea virus (BVDV) inactivated vaccines. To this purpose, guinea pigs (60) and calves (10) were immunized twice with a 28 day interval with an experimental vaccine containing antigens of both viruses and tested for virus

Letícia Frizzo da Silva; Diego Gustavo Diel; Maria do Carmo Cilento; Rudi Weiblen; Eduardo Furtado Flores

2007-01-01

260

Análisis de dos poblaciones de gallinas criollas (Gallus domesticus) utilizando RAPDs como marcadores moleculares An analysis of two native poultry populations (Gallus domesticus) using RAPD's as molecular markers  

Microsoft Academic Search

México has a great variety of native poultry but knowledge about its diversity is minimal. In this study, twenty individuals belonging to two populations of native hens (Gallus domesticus) were analyzed. They were chosen by egg production, through polymorphism identification generated by DNA random amplification (RAPD's). Amplification generated products show different sizes between 0.2 to 1.1 kb. Polymorphism was detected

Irma Morelia Soto Huipe; Guadalupe Zavala Páramoa; Horacio Cano Camacho; Joel E. López Meza

261

ESTUDO COMPARATIVO DE RETALHOS TUBULARES DE PELE DE RATOS COM DOIS TIPOS DE CATETER COMO MOLDE COMPARATIVE STUDY OF TUBULARIZED SKIN FLAPS OF RATS WITH TWO CATHETER TYPES  

Microsoft Academic Search

RESUMO: Objetivo: A tubulização de retalhos de pele é um artifício técnico muito empregado na correção de hipospádias. Existem controvérsias quanto aos riscos e benefícios do uso de sondas para moldar a neo-uretra e promover a derivação urinária. O objet ivo deste trabalho é avaliar o processo inflamatório, a fibrose e a circunferência interna de retalhos tubulares, em pele de

Fernando Costa; Lúcio Tedesco Marchese

262

How To Talk to Your Teens and Children about AIDS = Como hablar con sus adolescentes y sus ninos sobre el SIDA.  

ERIC Educational Resources Information Center

|Two brochures, one in English and one in Spanish, provide parents with basic information that will enable them to educate their children about Acquired Immune Deficiency Syndrome (AIDS). Contents address 11 questions: (1) What is AIDS? (2) How do you get AIDS? (3) How is AIDS not spread? (4) Who can get AIDS? (5) How can you tell if someone has…

National PTA, Chicago, IL.

263

Alumina supported Co-Mo oxides as a catalyst for hydrodesulphurisation of organic sulfides and disulphides using stopped flow gas chromatography  

SciTech Connect

The authors present a model study on the hydrodesulphurization of dimethyl sulphide, di n-prophyl sulphide, di n-butyl sulphide and dimethyl disulphide on Co-Mo-Al/sub 2/O/sub 3/ surface conducted using stopped-flow chromatographic technique. The plots for the rates of hydrocarbon formation agree well with the first order reaction at the surface of the catalyst.

Ali, L.H.; Sulaiman, S.T.; AlTamer, M.Y. (Chemistry Dept. College of Science, Univ. of Mosul (IQ))

1989-01-01

264

Me escuchas? Como conversar con ninos de cuatro a doce anos (Are You Listening to Me? Communicating with Children from Four to Twelve Years Old).  

ERIC Educational Resources Information Center

Although talking to children is a daily activity for almost everyone at some stage in one's life and an essential activity for professionals who work with children, there is little research on activity. This Spanish-language book describes communication with children between the ages of 4 and 12 years, focusing on open question-and-answer sessions…

Delfos, Martine F.

265

Cidadania Negada: A Educacao como Instrumento de Combate a Pobreza no Brasil (Denial of Citizenship: Education as a Way to Fight Poverty in Brazil).  

ERIC Educational Resources Information Center

|Compares two compensatory social/educational programs developed by the Brazilian government in the last 15 years. States that although one was formulated during the military regime and one during the present government, they both combat poverty and encourage privatization. Concludes that this promotes a process that sees education as social…

Germano, Jose Willington

1995-01-01

266

Gallinaza: un residual avícola como fuente alternativa de nutrientes para producción de biomasa microalgal Chicken manure: poultry waste as an alternative nutrient source for microalgal biomass production  

Microsoft Academic Search

Chicken manure can be used as an alternative nutrient source for microalgal cultures, providing usable algal biomass as an end-product. This study was aimed at assessing the effect of chicken manure soluble fraction (CMSF) at three different concentrations (6, 18 and 36%) on Chroomonas sp. marine microalgae and Chlorella sorokiniana freshwater microalgae growth, pigment and protein production. Non-biode- graded CMSF

Néstor Rosales Loaiza; José Bermúdez; Reyna Moronta; Ever Morales

267

Sound in ecclesiastical spaces in Cordoba. Architectural projects incorporating acoustic methodology (El sonido del espacio eclesial en Cordoba. El proyecto arquitectonico como procedimiento acustico)  

NASA Astrophysics Data System (ADS)

This thesis is concerned with the acoustic analysis of ecclesiastical spaces, and the subsequent implementation of acoustic design methodology in architectural renovations. One begins with an adequate architectural design of specific elements (shape, materials, and textures), with the intention of elimination of acoustic deficiencies that are common in such spaces. These are those deficiencies that impair good speech intelligibility and good musical audibility. The investigation is limited to churches in the province of Cordoba and to churches built after the reconquest of Spain (1236) and up until the 18th century. Selected churches are those that have undergone architectural renovations to adapt them to new uses or to make them more suitable for liturgical use. The thesis attempts to summarize the acoustic analyses and the acoustical solutions that have been implemented. The results are presented in a manner that should be useful for the adoption of a model for the functional renovation of ecclesiastical spaces. Such would allow those involved in architectural projects to specify the nature of the sound, even though somewhat intangible, within the ecclesiastical space. Thesis advisors: Jaime Navarro and Juan J. Sendra Copies of this thesis written in Spanish may be obtained by contacting the advisor, Jaime Navarro, E.T.S. de Arquitectura de Sevilla, Dpto. de Construcciones Arquitectonicas I, Av. Reina Mercedes, 2, 41012 Sevilla, Spain. E-mail address: jnavarro@us.es

Suarez, Rafael

2003-11-01

268

A comparison between diversity, similarity and biotic indices applied to the macroinvertebrate community of a small stream: the Ravella river (Como Province, Northern Italy)  

Microsoft Academic Search

This study aimed at comparing the results obtained by processing a series of data according to several diversity indices (Simpson, Berger-Parker, Margalef, Menhinick, McIntosh, Shannon) and one similarity index (Jaccard) with those obtained from two biotic indices (Trent River Biotic Index, Extended Biotic Index). In addition, Cody's index was adopted to measure the species turnover along the stream gradient. The

Oscar Ravera

2001-01-01

269

DISOLUCIÓN DE SÍLICE BIOGÉNICA EN SEDIMENTOS DE LAGOS UTILIZADOS COMO BIOINDICADORES DE CALIDAD DEL AGUA SILICA BIOGENIC DISSOLUTION IN SEDIMENT OF LAKES, LIKE OF WATER QUALITY BIOINDICATORS  

Microsoft Academic Search

The objective of this work is to show that the amorphous silica dissolution of biogenic origin (diatoms and phytolithes) is a bioindicator of quality of the water of lakes, validating itself with the determination of parameters physical- chemical. The determination of diatoms and phytolithes was made on sediment cores of the Chapala Lake, Mexico. The diatoms and phytolithes separated were

Isabel Israde

2007-01-01

270

De las capacidades dinámicas como enfoque de la estrategia a la integración de competencias para la construcción de un entorno colaborativo Univ - Emp  

Microsoft Academic Search

Este artículo intenta mostrar la importancia de avanzar de un enfoque de capacidades dinámicas a uno de competencias, para construir una estrategia de entornos colaborativos que permita aprovechar los esfuerzos y las oportunidades de la relación universidad- empresa. Para tal fin, el documento está organizado en tres partes: la primera, es una revisión amplia de las perspectivas desde las cuales

Patricia Roncancio R

2011-01-01

271

Mapeamento da cobertura natural e uso da terra como subsidio ao estudo da dinâmica e ocupação do Estado do Tocantins entre 1990 e 2007  

Microsoft Academic Search

In the Amazon Region large areas of savannas and forests have been changing in pasture and agriculture that modify the environment resulting in environmental and economic problems. The Tocantins state has climatics and physicals features common with Amazon and the Brazil Central Region and it is a transiction zone. On the purpose of study the dynamic of coverage and land

Marco Aurélio Barros

272

UTILIZAÇÃO DA FARINHA DE BABAÇU COMO EXTENSOR ALTERNATIVO NA PRODUÇÃO DE PAINÉIS COMPENSADOS USE OF BABAÇU FLOUR WITH ALTERNATIVE EXTENDER FOR P LYWOOD MANUFACTURING  

Microsoft Academic Search

This work aims at evaluating the potentiality of ba baçu flour under differents percents (0%, 50%, 75%, and 100%) as alternative extensers to wheatmeal for plywood manufacturing. Third three panels wit h five veneers were produced using Araucaria angustifolia (Bert.) Ktze, with urea-formaldehyde - UF and phenol-formaldehyde - FF resins and being three panels per treatment. The following formulations (in

Érika da Silva Ferreira; Edvá Oliveira Brito; Setsuo Iwakiri; Silviana Rosso; Cesar Batista

2009-01-01

273

Tips for Parents on Keeping Children Drug Free = Consejos para Los Padres Sobre Como Mantener a Los Hijos Libres de La Droga.  

ERIC Educational Resources Information Center

|Research shows that recent trends in youth drug use have stabilized; however, the rates of use remain at high levels. It has been shown that the earlier drug use is initiated, the more likely a person is to develop drug problems later in life. Youth substance abuse may lead to many other problems that affect not only the child, but also the…

Department of Education, Washington, DC. Office of Intergovernmental and Interagency Affairs.

274

Tips for Parents on Keeping Children Drug Free = Consejos para Los Padres Sobre Como Mantener a Los Hijos Libres de La Droga.  

ERIC Educational Resources Information Center

Research shows that recent trends in youth drug use have stabilized; however, the rates of use remain at high levels. It has been shown that the earlier drug use is initiated, the more likely a person is to develop drug problems later in life. Youth substance abuse may lead to many other problems that affect not only the child, but also the…

Department of Education, Washington, DC. Office of Intergovernmental and Interagency Affairs.

275

How do experts recognize schizophrenia: the role of the disorganization symptom Como os especialistas reconhecem a esquizofrenia: o papel do sintoma desorganização  

Microsoft Academic Search

Objective: Research on clinical reasoning has been useful in developing expert systems. These tools are based on Artificial Intelligence techniques which assist the physician in the diagnosis of complex diseases. The development of these systems is based on a cognitive model extracted through the identification of the clinical reasoning patterns applied by experts within the clinical decision-making context. This study

Denise Razzouk; Jair de Jesus Mari; Itiro Shirakawa; Jacques Wainer; Daniel Sigulem

2006-01-01

276

Procedure-related miscarriages and down syndrome–affected births: implications for prenatal testing based on women’s preferences 1 1 We thank Virginia Gildengorin, PhD, for statistical support. We also thank Bryna Harwood, MD, James Lewis, MD, Ruth Schaber MD, and David Walton, MD, at Kaiser Permanente, and the following physicians for their participation in this study: Albert L. Brooks, MD, Carol Eades, MD, Chris Grover, MD, Susan Sykes, MD (La Clinica de la Raza); Curtis E. Montgomery, MD, Alex Moy, MD, Lawrence Newman, MD, Laura Norell, MD, M. Ming Quan, MD, Kimberly Sorem, MD, and Jonathan Wong, MD (North East Medical Services)  

Microsoft Academic Search

Objective: To determine how pregnant women of varying ages, races, ethnicities, and socioeconomic backgrounds value procedure-related miscarriage and Down–syndrome-affected birth.Methods: We studied cross-sectionally 534 sociodemographically diverse pregnant women who sought care at obstetric clinics and practices throughout the San Francisco Bay area. Preferences for procedure-related miscarriage and the birth of an infant affected by Down syndrome were assessed using the

Miriam Kuppermann; Robert F Nease; Lee A Learman; Elena Gates; Bruce Blumberg; A. Eugene Washington

2000-01-01

277

Comunicação como instrumento de humanização do cuidado de enfermagem: experiências em unidade de terapia intensiva Communication as a tool of humanization of nursing care: experiences in intensive care unit Comunicación como instrumento de humanización de la atención de enfermería: experiencias en la unidad de cuidados intensivos  

Microsoft Academic Search

The present study appears up to the questioning involving the relevance of the communication as instrument to humanizing the nursing care at the Intensive Therapy Unit (ITU). The objective is to know how the patients noticed the communication process implemented by the nursing staff into that ambient and identifying which are their perceptions about the received cares done by the

Edison Luiz Devos Barlem; Valéria Lerch Lunardi; Wilson Danilo; Lunardi Filho

278

MONOCLONAL ANTIBODIES AS A TOOL FOR STUDYING THE PROTEIN-STRUCTURE RELATIONSHIP IN FISH MYOSIN ANTICUERPOS MONOCLONALES COMO HERRAMIENTA PARA EL ESTUDIO DE LA RELACIÓN PROTEÍNA-ESTRUCTURA EN MIOSINA DE PEZ ANTICORPOS MONOCLONAIS COMO FERRAMENTA PARA O ESTUDO DA RELACIÓN PROTEÍNA-ESTRUCTURA EN MIOSINA DE PEIXE  

Microsoft Academic Search

Fish muscle protein presents unique properties such as reduced frozen storage stability and setting phenomena. Both two are associated with myosin interactions and are highly dependent on fish specie. Although protein functional properties are highly correlated with amino acid sequence and with distinct structural domains, it is very difficult to determine this relationship for fish myosin, due to its high

J. A. Ramírez; E. Bandman; M. Wick; M. O. Martín-Polo

1998-01-01

279

EL CUIDADO DE SÍ DE LA EMBARAZADA DIABÉTICA COMO UNA VIA PARA ASEGURAR UN HIJO SANO SELF-CARE OF DIABETIC PREGNANT WOMEN, A WAY OF ENSURING A HEALTHY BABY O CUIDADO DE SI DE GESTANTES DIABÉTICAS COMO UM CAMINHO PARA ASSEGURAR UM FILHO SAUDÁVEL  

Microsoft Academic Search

This focused ethnography explored the beliefs, values, habits and behavioral patterns of diabetic pregnant women who were treated in Hospital Doutor Enrique Tejera, residents of three poor, urban communities in the city of Valencia, Venezuela. The purpose of this study was to find the meaning of self-care for these pregnant women. The Health Analysis, the Theory of Diversity, and the

Carmen Amarilis; Guerra de Castillo; Marta Lucía Vásquez

2006-01-01

280

Pseudomonas aeruginosa COMO CAUSA DE OTITE EXTERNA EM CÃES E VERIFICAÇÃO DO PADRÃO DE SENSIBILIDADE DAS AMOSTRAS ISOLADAS Pseudomonas aeruginosa AS A CAUSE OF EXTERNAL OTITIS IN DOGS AND VERIFICATION OF ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF THE ISOLATES Pseudomonas aeruginosa COMO CAUSA DE OTITIS EXTERNA EN PERROS Y VERIFICACIÓN DEL PATRÓN DE SENSIBILIDAD DE LAS CEPAS A ANTIMICROBIANOS  

Microsoft Academic Search

Samples from 374 cases of external otitis in dogs were analysed by bacteriology, showing Pseudomonas aeruginosa as the main Gram negative aetiological agent, in 39 clinical diseases. Results of antimicrobial susceptibility tests revealed predominantly resistance to betalactamic antibiotics.

Marília SCARTEZZINI; SILVA JÚNIOR

281

Estudio de los intercambios de calor y masa entre un invernadero considerado como colector de aire humedo y un lecho de rocas como sistema de control ambiental. (Study on heat and mass transfer between a greenhouse considered as a solar air heater and a rock packed bed as ambient control system).  

National Technical Information Service (NTIS)

A general study on heat transfer in dry packed beds is made, with special emphasis in comparing different transient models and in identifying the required conditions by which the attained results are equivalent. The differences in thermal behaviour on pac...

J. I. Ajona Maeztu

1990-01-01

282

Estudio de los intercambios de calor y masa entre un invernadero considerado como colector solar de aire humedo y un lecho de rocas como sistema de control ambiental. (Study on heat and mass transfer between a greenhouse considered as a solar air heater and a rock packed bed as ambient control system).  

National Technical Information Service (NTIS)

A general study on heat transfer in dry packed beds is made, with special emphasis in comparing different transient models and in identifying the required conditions by which the attained results are equivalent. The differences in thermal behaviour on pac...

J. I. Ajona Maeztu

1990-01-01

283

Molten carbonate fuel cell product development test  

SciTech Connect

M-C Power Corp. will design, fabricate, install, test, and evaluate a 250 kW Proof-of-Concept MCFC Power Plant. The plant will be located at Kaiser Permanente`s San Diego Medical Center; it will be designed and built by Bechtel Corp. Two 250 keV MCFC stacks will be assembled and tested at M-C Power; one stack will be used to support the San Diego field demonstration. This report outlines 6 tasks: project management/permitting, demonstration design, stack manufacturing, BOP fabrication, site work, and testing.

Scroppo, J.A.; Camara, E.H.; Figueroa, R.A.

1993-11-01

284

Measurement and evaluation of national family planning programs.  

PubMed

RESUMEN: En los últimos quince años diez paises han inaugurado programas nacionales de planeamiento familiar: India, Pakistán, Corea del Sur, Taiwan, Turquía, Malasia, Ceilán, Túez, la República Arabe Unida, y Marruecos. Otros paises, incluyendo Tailandia, Hong Kong, Singapur, Kenya, Barbados, Trinidad y los Estados Unidos, apoyan y/o estimulan actividades de planeamiento familiar. En la mayor parte de los casos la razón fundamental del programa ha sido que si la tasa de crecimiento poblacional disminuyera, aumentaría la tasa de crecimiento económico.Las metas de largo alcance, expresadas típicamente en términos de reducir las tasa.de de natalidad o de crecimiento, tienen su ejemplo en el propósito de Pakistán de reducir su tasa de crecimiento a 26 para 1970; el de Corea de reducir su tasa de natalidad a 20 para 1971; y el de India de reducir su tasa de natalidad a 25 para 1973.Los objectivos intermedios, que cubren diversos aspectos del pro grama, incluyen metas específicas para un determinado mes a año, considerando personal, la adquisición de anticonceptivos, y el número de usarios por método. Las metas específicas anuales de aceptantes de dispositivos intrauterinos (IUD), para Taiwán, Corea, Túnez, Pakistán e India, son comunes, tanto por la naturaleza del artefacto, como por la facilidad de medición de los que continúan utilizándolos. El programa de evaluación en Taiwán, que trata de medir por diversos medios los efectos inmediatos, mediatos y de largo plazo del programa de planeamiento familiar sirve de modelo. El propósito de la evaiuación de un programa de planeamiento familiar es contribuir a la efectividad y eficiencia del programa, midiendo y analizando su progreso. Las áreas a medir pueden ser clasificadas como- (1) conocimiento acerca de; (2) actitudes hacia; (3) práctica de control de natalidad; y (4) nivel de fecundidad.Un buen sistema de evaluación debería incluir: A. Un buen conjunto de estadísticas de servicio presentadas en formularios estandarizados, en las siguienies formas: 1. Informes nensuales por áreas administrativas, sobre los actuales servicios de planeamiento familiar proporcionados en la actualidad, de carácter permanente o de larga duración (al presente, esterilización y IUD de acuerdo a las siguientes características del receptor: residencia, edad, paridad (número de hijos vivos por sexo), y donde se enteró del programa, si es posible "clase";(probablemente educación de la madre, pero posiblemente ocupación del esposo, ingreso, o equivalente); prácticas anticonceptivas anteriores; intervalo; y deseo de tener más hijos. En un programa grande estos datos pueden obtenerse en base a una muestra. 2. Informes mensuales sobre la distribución de suministros anticonceptivos (condones, píldoras, sustancias efervescentes, etc.), los primeros suministros deben ir acompañados de un registro de las características del recipiente, como anteriormente; los suministros subsecuentes se regietrarán sólo en volumen bruto. Esto también se aplicará al ritmo, donde éste método se enseñe a un número considerable de mujeres. 3. Informes regulares sobre las actividades de planeamiento familiar de médicos privados, como una estimación del efecto catalítico del programa del gobierno sobre ci sector privado. 4. Datos generates mensuales, ppr áreas admirtistrativas importantes, sabre: visitas domiciliarias, reuniones, cuñas radiates y televisadas, avisos en los periódicos y personal que trabaja. 5. Para propósitos de seguimiento una entrevi eta de campo cada 6 a 12 meses a cada N mujer de las listas para (1) y (2) arriba, en un total de 300 o 400, para conocer las tasas de continuación y las razones de abandono (ej: desea otro hijo, insatisfecha can ci método, otras). Las mue.stras podrían ser de 300 cada una, con una supuesta experiencia de 6, 12, 18 y 24 meses. B. Un buen conjunto de datos sobre costa (datos sobre cotos actulaes atribuíbles directamente al programa de planeamiento familiar) fraccionados par áreas principales y cinco a seis

Mauldin, W P

1967-03-01

285

Empleo y desempleo entre los adultos mayores argentinos  

Microsoft Academic Search

This paper provides an analysis of the work participation of people aged 60 and above residing in urban areas in Argentina, from data specially processed from the Encuesta Permanente de Hogares for the third quarter of 2009. With this purpose, emphasis is made on the main occupation among those who work and the last occupation among those who are unemployed.

Gabriela Adriana Sala

2011-01-01

286

Development and Evaluation of Self-Management Systems for Children with Asthma: Self-MANAGE and Co-MANAGE.  

National Technical Information Service (NTIS)

This report describes a four-year collaborative research effort by the American Institutes for Research and the Kaiser-Permanente Medical Groups in Santa Clara and San Jose, California, to (a) identify behaviors actually practiced by children in the effec...

S. R. Wilson M. H. Bagshaw P. Scamagas G. W. Hughes B. Rodabaugh

1981-01-01

287

The Calaveras Fault, Northern California: A Geophysical Perspective on Offset and 3-D Geometry  

Microsoft Academic Search

Gravity and magnetic investigations of the Calaveras Fault (CF) present an image of a San Andreas system strike-slip fault that is highly variable along strike, both in offset accommodation and geometry. Geologic correlation of rocks of the Permanente terrane (Franciscan Complex) west of the CF near Gilroy (km 120) with similar rocks east of the San Andreas Fault near Parkfield

R. C. Jachens; C. M. Wentworth; R. W. Graymer; J. P. Walker; F. C. Chuang; R. W. Simpson; R. J. McLaughlin

2002-01-01

288

Meet your senior's online needs to compete in Medicare marketplace.  

PubMed

As more seniors turn to the Internet for health care information and services, is your organization prepared to meet their needs? Kaiser Permanente is reaching the cyber-senior market on the World Wide Web with interactive online services, including discussion groups with providers. PMID:10176065

1997-12-01

289

Mesiodens: presentación de tres casos  

Microsoft Academic Search

Resumen El mesiodens es el diente supernumerario que aparece con mayor frecuencia en la denti- ción definitiva. En la mayoría de ocasiones se trata de un hallazgo casual. El diagnóstico pre- coz permite realizar la extracción de forma temprana, favoreciendo la erupción espontánea de los incisivos permanentes, y evita tener que efectuar otros tratamientos más complejos, quirúrgicos u ortodóncicos. Presentamos

Díaz Ortiz; M. Vicente Rodríguez

2010-01-01

290

Restorative Integral Support (RIS) for Older Adults Experiencing Co-Occurring Disorders  

ERIC Educational Resources Information Center

|The Restorative Integral Support (RIS) model is a whole person response that assists people to overcome adversity. The Adverse Childhood Experiences (ACE) Study conducted by Kaiser Permanente and the Centers for Disease Control and Prevention shows the association between stressors in childhood and multiple later-life health and social problems.…

Larkin, Heather; MacFarland, Nicole S.

2012-01-01

291

Comparison of the Premier Toxin A and B Assay and the TOX A\\/B II Assay for Diagnosis of Clostridium difficile Infection  

Microsoft Academic Search

Clostridium difficile causes nosocomial diarrhea and is responsible for complications such as pseudomem- branous colitis, megacolon, and perforation. Using 442 stool specimens, we compared the sensitivities and specificities of the Premier toxin A and B (Meridian Bioscience, Inc.) and C. difficile TOX A\\/B II (TechLab, Inc., Blacksburg, VA) immunoassays in the Virology Department of the Kaiser Permanente Regional Reference Laboratories.

Susan M. Novak-Weekley; Michele H. Hollingsworth

2008-01-01

292

Alcohol consumption patterns and health care costs in an HMO  

Microsoft Academic Search

We examined the relationship between patterns of alcohol consumption and health care costs among adult members of the Kaiser Permanente Medical Care Program (KPMCP) in Northern California. A telephone survey of a random sample of the KPMCP membership aged 18 and over was conducted between June 1994 and February 1996 (n=10,175). The survey included questions on sociodemographic characteristics, general and

Enid M Hunkeler; Yun-Yi Hung; Dorothy P Rice; Constance Weisner; Teh-wei Hu

2001-01-01

293

Antenatal Ultrasound and Risk of Autism Spectrum Disorders  

ERIC Educational Resources Information Center

We evaluated antenatal ultrasound (U/S) exposure as a risk factor for autism spectrum disorders (ASD), comparing affected singleton children and control children born 1995-1999 and enrolled in the Kaiser Permanente health care system. Among children with ASD (n = 362) and controls (n = 393), 13% had no antenatal exposure to U/S examinations;…

Grether, Judith K.; Li, Sherian Xu; Yoshida, Cathleen K.; Croen, Lisa A.

2010-01-01

294

Identification of Target Bioallergens: Frequency of Specific Aeroallergen Sensitization in an Atopic Population in the Sacramento Region.  

National Technical Information Service (NTIS)

Charts from individuals who filled out a questionnaire and underwent skin testing at Kaiser Permanente clinics in the greater Sacramento area in the year 2000 were pulled for review. 566 subjects had a physician diagnosis of allergic rhinitis or asthma an...

S. Teuber

2004-01-01

295

Community Resources for Promoting Youth Nutrition and Physical Activity  

ERIC Educational Resources Information Center

|Childhood obesity is a national public health crisis. The National Diabetes Education Program (NDEP), the National Institutes of Health and Kaiser Permanente have developed community tools and resources for children and families to lower their risk for obesity through healthier, active lifestyles. The authors describe innovative practices and…

Moore, Kelly R.; McGowan, Melissa K.; Donato, Karen A.; Kollipara, Sobha; Roubideaux, Yvette

2009-01-01

296

Dietary Patterns and the Risk of Barrett's Esophagus  

Microsoft Academic Search

The objective of this study was to examine the associations between dietary patterns and the risk of Barrett's esophagus, a precursor to esophageal adenocarcinoma. The authors conducted a case-control study within the Kaiser Permanente Northern California population between 2002 and 2005. Patients with a new diagnosis of Barrett's esophagus (n ¼ 296 cases) were matched to persons with gastroesophageal reflux

Ai Kubo; T. R. Levin; Gladys Block; Gregory J. Rumore; Charles P. Quesenberry; Patricia Buffler; Douglas A. Corley

2008-01-01

297

Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care  

Microsoft Academic Search

BACKGROUND: Integrated personal health records (PHRs) offer significant potential to stimulate transformational changes in health care delivery and self-care by patients. In 2006, an invitational roundtable sponsored by Kaiser Permanente Institute, the American Medical Informatics Association, and the Agency for Healthcare Research and Quality was held to identify the transformative potential of PHRs, as well as barriers to realizing this

Don E. Detmer; Meryl Bloomrosen; Brian Raymond; Paul Tang

2008-01-01

298

Racial Differences in Bone Density between Young Adult Black and White Subjects Persist after Adjustment for Anthropometric, Lifestyle, and Biochemical Differences  

Microsoft Academic Search

This study tested whether racial differences in bone density can be explained by differences in bone metabolism and lifestyle. A cohort of 402 black and white men and women, ages 25-36 yr, was studied at the Kaiser Permanente Medical Care Program in Northern Califor- nia, a prepaid health plan. Body composition (fat, lean, and bone mineral density) was measured using

BRUCE ETTINGER; STEPHEN SIDNEY; STEVEN R. CUMMINGS; CESAR LIBANATI; DANIEL D. BIKLE; IRENE S. TEKAWA; KIMBERLY TOLAN; PETER STEIGER

299

Intense immunosuppression in chronic progressive multiple sclerosis: the Kaiser study  

Microsoft Academic Search

The value of a short course of intensive immunosuppression with cyclophosphamide in stabilising chronic progressive multiple sclerosis (MS) was examined in a randomised single-blinded, placebo-controlled clinical trial. Forty two patients, from the Kaiser Permanente Medical Care Program, Northern California, were studied. Twenty two patients received a short course of cyclophosphamide in an outpatient neurology clinic until their leucocyte counts fell

W H Likosky; B Fireman; R Elmore; G Eno; K Gale; G B Goode; K Ikeda; J Laster; C Mosher; J Rozance

1991-01-01

300

Comorbid Depression, Chronic Pain, and Disability in Primary Care  

Microsoft Academic Search

Objectives: The objectives of this study were to provide estimates of the prevalence and strength of association between major depression and chronic pain in a primary care population and to examine the clinical burden associated with the two conditions, singly and together. Methods: A random sample of Kaiser Permanente patients who visited a primary care clinic was mailed a questionnaire

BRUCE A. ARNOW; ENID M. HUNKELER; CHRISTINE M. BLASEY; JANELLE LEE; MICHAEL J. CONSTANTINO; BRUCE FIREMAN; HELENA C. KRAEMER; ROBIN DEA; REBECCA ROBINSON; CHRIS HAYWARD

2006-01-01

301

ESTUDIO COMPARATIVO DE LA FORMACIÓN CONTINUA EN ESPAÑA EN RELACIÓN CON LA UNIÓN EUROPEA  

Microsoft Academic Search

La formación continua de los trabajadores ocupados contribuye al reciclaje permanente y a la adquisición de nuevos conocimientos que les permite adaptarse a un entorno laboral y tecnológico en continuo cambio. Todo ello constituye un elemento fundamental para mejorar la competitividad de las empresas. El objetivo de este trabajo es realizar un estudio comparativo de la situación de España

González Flores; Ana Saiz Santos; Euskal Herriko Unibertsitatea

302

Characteristics of Fallers Who Fracture at the Foot, Distal Forearm, Proximal Humerus, Pelvis, and Shaft of the Tibia\\/Fibula Compared with Fallers Who Do Not Fracture  

Microsoft Academic Search

This case-control study examined the relation of circumstances of falls and characteristics of fallers with risk of fractures at five sites among persons 45 years of age or older from five Kaiser Permanente Medical Centers in Northern California from 1996 to 2001. Included were distal forearm (n = 1,016), foot (n = 574), proximal humerus (n = 467), pelvis (n

Theresa H. M. Keegan; Jennifer L. Kelsey; Abby C. King; Charles P. Quesenberry; Stephen Sidney

303

Matrix Theory.  

National Technical Information Service (NTIS)

Two areas of matrix theory are discussed: the theory of permanents, and the theory of nonnegative matrices. Paper (1) deals with permanental compounds and their use in recurrence formulas for permanents of (0,1)-circulants and in related asymptotic formul...

H. Minc

1987-01-01

304

Critical Care Transport: Outcome Evaluation After Interfacility Transfer and Hospitalization  

Microsoft Academic Search

Study objective: To test the hypothesis that interfacility transfer is not associated with increased mortality, duration of stay, or readmission within 7 days. Methods: We matched 3,298 patients who were hospitalized for chest pain or related complaints in Kaiser Permanente medical centers after transfer from the emergency department of a nonplan hospital (transported patients) with 3,298 patients of the same

Jeffrey S Selevan; William Wesley Fields; Wansu Chen; Diana B Petitti; Girma Wolde-Tsadik

1999-01-01

305

Influence du peuplement forestier sur la faune et la microflore du sol et des humus. II. Microbologie et expériences au laboratoire  

Microsoft Academic Search

Cet article suit un article précédemment paru dans le dernier fascicule de cette revue, qui concernait la description des sites et la présentation des principaux résultats relatifs à la faune du sol. Cette étude a été accomplie dans le cadre du projet PIREN-CNRS «Influence des monocultures de résineux et alternatives possibles». Trois stations permanentes ont été étudiées: un peuplement de

P. Arpin; J. F. David; G. G. Guittonneau; G. Kilbertus; J. F. Ponge; G. Vannier

1986-01-01

306

Leukemia, lymphoma, and multiple myeloma following selected medical conditions  

Microsoft Academic Search

The role of selected prior medical conditions in the etiology of hematopoietic malignancies was examined in a case-control study of members of two regional branches of the Kaiser Permanente Medical Care Program (USA). Past history of chronic infectious, autoimmune, allergic, and musculoskeletal disorders was abstracted from medical records for leukemia (n = 299), non-Hodgkin's lymphoma (NHL, n = 100), and

Michele Morin Doody; Martha S. Linet; Andrew G. Glass; Gary D. Friedman; Linda M. Pottern; John D. Boice; Joseph F. Fraumeni

1992-01-01

307

Low documentation of chronic kidney disease among high-risk patients in a managed care population: a retrospective cohort study  

Microsoft Academic Search

BACKGROUND: Early detection of chronic kidney disease (CKD) is sub-optimal among the general population and among high risk patients. The prevalence and impact of major CKD risk factors, diabetes (DM) and hypertension (HTN), on CKD documentation among managed care populations have not been previously reported. We examined this issue in a Kaiser Permanente Georgia (KPG) CKD cohort. METHODS: KPG enrollees

Idris Guessous; William McClellan; Suma Vupputuri; Haimanot Wasse

2009-01-01

308

Body Mass Index and Future Healthcare Costs: A Retrospective Cohort Study  

Microsoft Academic Search

Objective: To assess the relationship between body mass index (BMI) and future healthcare costs.Research Methods and Procedures: We undertook a retrospective cohort study of the relationship between obesity and future healthcare costs at Kaiser Permanente Northwest Division, a large health maintenance organization in Portland, Oregon. Study subjects (n = 1286) consisted of persons who responded to a 1990 health survey

David Thompson; Jonathan B. Brown; Gregory A. Nichols; Patricia J. Elmer; Gerry Oster

2001-01-01

309

Vom Armen- und Arbeitshaus zu Hartz-IV Eine kurze Geschichte der staatlichen Armen- und Arbeitslosenverwaltung zwischen Repression und Almosentransfer  

Microsoft Academic Search

feudalistischen Ständegesellschaft war ‚arbeitslos' maximal der leibeigene Bauer, der nach der Fronarbeit oder nach der Einbringung der Ernte zeitlich eng befristet ‚ohne Arbeit' war - sozusagen nach Feierabend. Das Charak- teristikum des Feudalismus waren nicht fehlende Arbeitsplätze, sondern im Gegenteil der permanente Mangel an menschlicher Arbeitskraft für Fron- und Kriegsdienste im Interesse der herrschenden Adelsklasse. Die Ausbeu- tung der Fronarbeit

Egbert Scheunemann

310

First Report of Candidatus Liberibacter solanacearum in Tomato Plants in Mexico  

Technology Transfer Automated Retrieval System (TEKTRAN)

Tomato (Lycopersicon esculentum Mill.) plants exhibiting symptoms that resemble those of permanent yellowing disease (locally known as “permanente del tomate”) that is associated with phytoplasmas and/or ‘Candidatus Liberibacter solanacearum’ infection were observed in the state of Sinaloa, México i...

311

The risk of acute renal failure in patients with chronic kidney disease  

Microsoft Academic Search

Few studies have defined how the risk of hospital-acquired acute renal failure varies with the level of estimated glomerular filtration rate (GFR). It is also not clear whether common factors such as diabetes mellitus, hypertension and proteinuria increase the risk of nosocomial acute renal failure independent of GFR. To determine this we compared 1,746 hospitalized adult members of Kaiser Permanente

C Y Hsu; J D Ordoñez; G M Chertow; D Fan; C E McCulloch; A S Go

2008-01-01

312

Wet deposition of mercury within the vicinity of a cement plant before and during cement plant maintenance  

Microsoft Academic Search

Hg species (total mercury, methylmercury, reactive mercury) in precipitation were investigated in the vicinity of the Lehigh Hanson Permanente Cement Plant in the San Francisco Bay Area, CA., USA. Precipitation was collected weekly between November 29, 2007 and March 20, 2008, which included the period in February and March 2008 when cement production was minimized during annual plant maintenance. When

Sarah E. Rothenberg; Lester McKee; Alicia Gilbreath; Donald Yee; Mike Connor; Xuewu Fu

2010-01-01

313

EROTISMO E PREVENÇÃO DE DST\\/AIDS ENTRE OS ADOLESCENTES. COMO ATUAM OS MEIOS DE COMUNICAÇÃO? EROTICISM AND PREVENTION OF SEXUAL TRANSMITTED DISEASE AMONG TEENAGERS. HOW MEDIA IS ACTING?  

Microsoft Academic Search

Introduction: the participation of the media in people lives, especially the young, is increasing in frequency and intensity but we have no knowledge about what type of information in eroticism and prevention of sexually transmitted disease (STD) is been transmitted to our adolescents. Objective: evaluate the real load of information about eroticism and prevention of STD\\/Aids. Methods: in an epidemiologic

Glauco R Mello; Gustavo Castro; Claudete Reggiani; Newton S Carvalho

314

LA FAMILIA COMO CONTEXTO DE DESARROLLO INFANTIL. DIMENSIONES DE ANÁLISIS RELEVANTES PARA LA INTERVENCIÓN EDUCATIVA Y SOCIAL FAMILY AS CONTEXT OF CHILD DEVELOPMENT. MAIN COMPONENTS TO EDUCATIONAL AND SOCIAL INTERVENTION  

Microsoft Academic Search

This essay proposes lines of action for professionals in the field of educational and social intervention with families. Firstly, we discuss the importance of the role of families for child development. We also analyse the main dimensions of family context and its relevance for child development: parentsideas about the development and upbringing of their children, affective relations, family socialization, settings

ALICIA MUÑOZ SILVA

315

Learning & Growing Together: Understanding and Supporting Your Child's Development = Aprender y crecer juntos: Como comprender y fomentar el desarrollo de sus hijos [with] Tip Sheets: Ideas for Professionals in Programs That Serve Young Children and Their Families.  

ERIC Educational Resources Information Center

Based on the view that the primary caregivers for infants and toddlers are their own best resource for understanding and caring for their child and that parenting is a lifelong learning process, this book provides information and tools to help caregivers build a strong foundation for their child's development. The book, both in English and…

Lerner, Claire; Dombro, Amy Laura; Powers, Stefanie

316

Como ayudar a su hijo durante los primeros anos de la adolescencia: Para los padres con ninos entre las edades de 10 a 14 anos (Helping Your Child through Early Adolescence: For Parents of Children from 10 through 14).  

ERIC Educational Resources Information Center

|Recognizing that parents and families can greatly influence the development of their 10- through 14-year-olds, this Spanish-language booklet is part of a national effort to provide parents with the latest research and practical information to help them support their children both at home and in school. The booklet is organized in 13 sections…

Paulu, Nancy

317

DESENVOLVIMENTO DE UMA NOVA LINHA DE AÇOS INOXIDÁVEIS DUPLEX OU COMO O NITROGÊNIO PODE REDUZIR O TEOR DE NÍQUEL, MELHORANDO SIMULTANEAMENTE A RESISTÊNCIA À CORROSÃO E PROPRIEDADES MECÂNICAS DOS AÇOS INOXIDÁVEIS  

Microsoft Academic Search

Austenitic stainless steels are widely used for a large number of applications. However when a high corrosion resistance is required the increase in the level of Ni and Mo has a strong impact in the final price of the material. Ferritic stainless steels are normally nickel free and represent a good alternative for applications when the corrosion environment is moderate

Marc Mantel; Eric Chauveau; Antonio S. Viana; Jerome Peultier; Sophie Jacques

318

EL CHILE JALAPEÑO EN QUINTANA ROO MÉXICO: COMO SE CULTIVA Y OPORTUNIDADES DE INVESTIGACIÓN THE CHILI JALAPEÑO IN QUINTANA ROO MEXICO: AS IT IS CULTIVATED AND OPPORTUNITIES OF INVESTIGATION  

Microsoft Academic Search

SUMMARY After 25 years of cultivation jalapeño pepper has had to face a variable and complex problem to stay in the pleasure of the producers and market. This situation bears to diagnosis of the crop in order to recognize the agronomic handling which is practiced by the producers. These finding largely explain the low yield of the jalapeño pepper and

Ángel García Sandoval; Raymundo Nava Padilla

319

AVALIAÇÃO DA PRODUÇÃO DE Pleurotus sajor-caju (FR.) SINGER UTILIZANDO RESÍDUO DO BENEFICIAMENT O TÊXTIL DO ALGODÃO COMO SUBSTRA TO* Evaluation of the production of Pleurotus sajor-caju in cotton textille mill waste  

Microsoft Academic Search

The experiment was conducted to investigate the viability of the production of the edible fungus Pleurotus sajor-caju (Fr.) Singer in substrates in which main source of carbon was the cotton textille mill waste. Two substrates compositions were tested: C1 (cotton textille mill waste, wheat bran, plaster and limestone) and C2 (cotton textille mill waste, wheat bran, bean straw, plaster and

Ana Luisa; Aguiar de Castro; Paulo César; Aguiar Paiva; Vera Lúcia Banys

320

Learning & Growing Together: Understanding and Supporting Your Child's Development = Aprender y crecer juntos: Como comprender y fomentar el desarrollo de sus hijos [with] Tip Sheets: Ideas for Professionals in Programs That Serve Young Children and Their Families.  

ERIC Educational Resources Information Center

|Based on the view that the primary caregivers for infants and toddlers are their own best resource for understanding and caring for their child and that parenting is a lifelong learning process, this book provides information and tools to help caregivers build a strong foundation for their child's development. The book, both in English and…

Lerner, Claire; Dombro, Amy Laura; Powers, Stefanie

321

Determinacao de uranilo utilizando como reagente complexante piridilazoresorcinol pela tecnica voltametrica adsortiva com redissolucao catodica. (Uranyl determination using pyridylazoresorcinol as complexing active by adsorptive voltametry technique with cathodic redissolution).  

National Technical Information Service (NTIS)

The development method for uranyl ion determination by the optimization of chemical reaction and instrumental parameters is shown. This method is based on preconcentration stage, where in adsorptive accumulation of metallic complex in a static electrode i...

A. K. Ohara P. A. M. Farias

1990-01-01

322

The role of two acidophilic algae as ecological indicators of acid mine drainage sites El papel de dos algas acidófi las como indicadores ecológicos de zonas de drenajes ácidos de minas  

Microsoft Academic Search

Acidic effl uents, emerging from four abandoned mines (Valdarcas, Carris, Adoria and Cerquido) in Northern Portugal were ana- lyzed regarding physical-chemical, mineralogical and ecological characteristics. Such effl uents present distinct properties since they were mobilized from wastes of different primary ores and mining procedures. Results show that acidophilic algal colonization is dominated by Euglena mutabilis and Klebsormidium sp.. Abundance and

T. M. Valente; C. L. Gomes

323

Limitações na Prática de Exercício Físico como Fator Desencadeante da Obesidade na População de Baixa Renda Limitations in Exertion as a Starting Factor for Obesity in Low Income Population  

Microsoft Academic Search

Obesity is nowadays considered a world epidemic which assaults mainly low income populations, and one of its main causes is sedentarism. However, those individuals have limitations for exertion, which favors obesity development and makes its treatment more difficult. This work aims to comprehend limitations of low income population access to physical exercises practice as part of an obesity treatment. The

Nívea Veiga Almeida; População de Baixa Rend

324

ALTERAÇÕES LIGNO-ANATÔMICAS EM Solanum gilo Raddi POR APLICAÇÃO DE CÁLCIO E BORO COMO ESTRATÉGIA DE DEFESA Ligno-anatomical alteration in Solanum gilo Raddi for the calcium and boron application as defense strategy  

Microsoft Academic Search

Normally woody plants present high lignin content, even overcoming 35% from dry weight. Such values are almost found in arboreal plants. However, young plants or plants with lower growth form than tree show low lignin content. In this term, current levels of lignification could be increased by exogenous factor of stimulation. There are complex enzymatic systems responsible for the lignin

Adriana Firmino; Heber dos Santos Abreu; Ana Cristina; P. Portugal; Alexandre Miguel; Evandro Lima de Souza; Regina Paula; Willemen Pereira; Maria Beatriz de Oliveira Monteiro

325

Como ayudar a su hijo durante la edad preescolar, con actividades para los ninos desde el nacimiento hasta los 5 anos (Helping Your Preschool Child, with Activities for Children from Infancy through Age 5).  

ERIC Educational Resources Information Center

|The first 5 yeas of a child's life are a time of tremendous physical, emotional, social, and cognitive growth. Noting that research shows that children are more likely to succeed in learning when their families actively support them, this Spanish-language booklet is intended for families and caregivers who want to help their preschool children…

Department of Education, Washington, DC. Office of Intergovernmental and Interagency Affairs.

326

Aplicacion de tecnicas de fosfatacion sobre acero al carbon y aluminio, utilizando como agente oxidante la nitroguanidina. (Application of phosphating techniques to aluminium and carbon steel surfaces using nitro guanidine as oxidizing agent.).  

National Technical Information Service (NTIS)

Phosphate coatings are inorganic crystalline deposits laid down uniformly on properly prepared surfaces by a chemical reaction with the treated base metal. The reaction consists in dissolving some surface metal by acid attack and then causing surface neut...

S. A. Briseno

1995-01-01

327

EVALUACIÓN DE LA CALIDAD NUTRICIONAL DE LA HARINA DE PLUMAS FERMENTADAS POR Kocuria rosea COMO FUENTE ALTERNATIVA DE PROTEÍNAS EN LA ALIMENTACIÓN DE AVES Nutritional Evaluation of Kocuria rosea Fermented Feather Meal as an Alternative Protein Source in Poultry Feed  

Microsoft Academic Search

In this research project the nutritional value of fermented feath- ers meal using Kocuria rosea was compared with commercial feathers meal. Experiments were carried out to determine the physical-chemical composition, amino-acids, protein digestibil- ity and metabolic energy value in each of the feeds. The re- sults showed that the fermented product beyond the fat (4.6%) and mineral (15.6%) content, mainly

Annalisse Bertsch; Ramón Álvarez; Nereida Coello

2003-01-01

328

Como ayudar a su hijo durante la edad preescolar, con actividades para los ninos desde el nacimiento hasta los 5 anos (Helping Your Preschool Child, with Activities for Children from Infancy through Age 5).  

ERIC Educational Resources Information Center

The first 5 yeas of a child's life are a time of tremendous physical, emotional, social, and cognitive growth. Noting that research shows that children are more likely to succeed in learning when their families actively support them, this Spanish-language booklet is intended for families and caregivers who want to help their preschool children…

Department of Education, Washington, DC. Office of Intergovernmental and Interagency Affairs.

329

Coping with Social Change: Programs That Work. Proceedings of a Conference (Acapulco, Mexico, June 1989) = Como enfrentarse al cambio social: programas eficaces. Actas de uno Conferencia (Acapulco, Mexico, Junio de 1989).  

ERIC Educational Resources Information Center

|Written in English and Spanish, this document contains the proceedings of the 14th International Congress of Gerontology on concerns about the impact of rapid social change on the well-being of older women and families in Latin American and the Caribbean and about effective programs that address the needs of the older populations. The first…

Hoskins, Irene, Ed.

330

BACTÉRIAS ENDOFÍTICAS COMO AGENTES PROMOT ORES DO CRESCIMENT O DE PLANT AS DE TOMATEIRO E DE INIBIÇÃO IN VITRO DE Ralstonia solanacearum 1 Endophytic bacteria as agents of plant growth promotion in tomato and inhibition in vitro of Ralstonia solanacearum  

Microsoft Academic Search

Out of one hundred and fifty isolates of endophytic bacteria from leaves, stems and roots of healthy tomatoes (Solanum lycopersicum L.), fifty three showed ability to promote tomato plant growth, among these, ten isolates UFV-E17, UFV-E22, UFV- E25, UFV-E26, UFV-E27, Bacillus cereus (UFV-E29), UFV-E49, UFLA 06-LS, UFLA 08-LS and UFLA 11-LS, provided the largest plant growth promotion. Weekly assessment of

Patrícia Baston Barretti; Ricardo Magela de Souza; Edson Ampélio Pozza

331

Un estudio de evaluacion educativa manipulativos en el aprendizaje de las matematicas con estudiantes hispanos adquiriendo ingles academico como segunda lengua (A Study of the Use of Manipulatives in the Assessment of Mathematics Instruction with ESL Hispanic Students).  

ERIC Educational Resources Information Center

|As an alternative form of mathematics assessment for use with limited-English-proficient students, 14 mathematics tasks using manipulatives were administered to 45 Hispanic students in grades 1-3 and readministered 2-3 weeks later. Test reliability and validity, task difficulty, and the relationship among test subscales across grades were…

Lara-Alecio, Rafael; Parker, Richard; Aviles, Claudia; Mason, Samantha; Irby, Beverly J.

1998-01-01

332

Como Promover el Exito de las Ninas y las Minorias en las Ciencias y en las Matematicas. Para Padres/sobre Padres (How To Promote the Science and Mathematics Achievement of Females and Minorities. For Parents/about Parents).  

ERIC Educational Resources Information Center

|Some minority and female students traditionally have not been given the help they need to enroll and succeed in mathematics and science classes. Now, however, various approaches are available to give these students the extra attention they need. Parents can help children develop an interest in science and mathematics by: (1) identifying role…

Schwartz, Wendy

333

Credit versus Money as an Instrument of Control (Avantages du crédit sur la monnaie en tant qu'instrument de contrôle) (Crédito vs. dinero como instrumento de control)  

Microsoft Academic Search

The purpose of the paper is to determine the appropriate considerations for the choice of a monetary control variable when the balance of payments is a key policy objective. These considerations naturally vary with the frame of reference of the analysis. Postwar monetary theory, however, generally has been based on the assumption of a closed economy; the policy conclusions that

Manuel Guitian

1973-01-01

334

Análisis de la utilidad del Clinical Risk Index for Babies por estratos de peso como predictor de muerte hospitalaria y de hemorragia intraventricular grave en la Red Neonatal Española SEN 1500  

Microsoft Academic Search

ObjectiveTo evaluate the usefulness of the Clinical Risk Index for Babies (CRIB) in predicting hospital mortality and severe intraventricular hemorrhage (IVH) in very low birth weight infants stratified by weight groups, in the Spanish neonatal network SEN 1500.

J. M. Guzmán Cabañas; M. J. Párraga Quiles; N. del Prado; M. D. Ruíz; M. García del Río; F. Benito Zaballo; C. Fernández; J. Figueras Aloy

2009-01-01

335

Correlation between thiophene hydrodesulfurization activity and the number of first sulfur neighbors as determined by EXAFS in sulfided CoMo/. gamma. -Al/sub 2/O/sub 3/ samples  

SciTech Connect

Two sets of samples were prepared. The first series involved wetness impregnation of AL/sub 2/O/sub 3/ powder with ammonium heptamolybdate solution, resulting in 7.7% Mo loading after drying. Subsequent impregnations with varying concentrations of Co(NO/sub 3/)/sub 2/ solutions produced a series with varying Co but Ca constant Mo level. The second series was prepared by bulk impregnation of Al/sub 2/O/sub 3/ pellets, using the same impregnating substances. The samples were sulfided and reduced in 2% H/sub 2/S/H/sub 2/ for various periods of time at 500-500 K. The catalysts were then tested for thiophene hydrodesulfurization (HDS) in a fixed bed reactor at 573 K and atmospheric pressure. The nominal turnover rate increased with additions of Co up to ..cap alpha.. = .33 (..cap alpha.. is the atomic ratio Co/Co + Mo) and further increase in Co concentration decreased the rate of HDS. X-ray absorption spectroscopy was performed at ambient temperature with these samples and confirmed these results.

Boudart, M.; Arrieta, J.S.; Betta, R.D.

1983-10-19

336

Como ayudar a su hijo a tener exito en la escuela, con actividades para ninos entre las edades de 5 a 11 anos (Helping Your Child Succeed in School, with Activities for Children Ages 5 through 11).  

ERIC Educational Resources Information Center

|At the heart of the No Child Left Behind Act of 2001 is a promise to raise standards for all children and to help all children meet those standards. This Spanish-language booklet provides information that parents can use to help their child succeed in school. Following an introduction, the second section of the booklet, "The Basics," offers…

Paulu, Nancy

337

What Makes a Good Teacher? Children Speak Their Minds=Qu'est-ce qu'un bon maitre? Les enfants ouvrent leur coeur=Como debe ser un buen maestro? Los ninos opinan.  

ERIC Educational Resources Information Center

This booklet is a product of the UNESCO Associated Schools Project, a network of some 3,800 schools in 131 countries, which conducts pilot projects to promote education for peace, international understanding, and cooperation. Schools taking part in the project participated in an international contest asking for spontaneous reactions to the…

Khawajkie, Elizabeth, Ed.; And Others

338

El compostaje como tecnologia para el tratamiento de residuos: compostaje de bagazo de sorgo dulce con diferentes fuentes nitrogenadas. (Composting as a waste treatment technology: composting of sweet sorghum bagasse with different nitrogen sources).  

National Technical Information Service (NTIS)

The purpose of this work is to study aerobic solid fermentation of sweet sorghum bagasse in mixture with other additives as nitrogen sources to evaluate the utilization of this material as a substrate for composting. The characteristics of sweet sorghum b...

J. Vicente J. E. Carrasco M. J. Negro

1996-01-01

339

Valor nutritivo de la harina de lombriz ( Eisenia foetida) como fuente de aminoácidos y su estimación cuantitativa mediante cromatografía en fase reversa (HPLC) y derivatización precolumna con o-ftalaldehído (OPA)  

Microsoft Academic Search

Earthworms (Eisenia foetida) are of nutritional interest since they are a rich source of protein (> 60% w\\/w). The aim of this work was to determine amino acid content in proteins from samples of earthworm flour. The amino acids were separated by reversed phase high performance liquid chromatography and detected through molecular fluorescence subsequent to derivatization with o-phthalaldehyde. The accuracy

VIELMA-RONDÓN R; OVALLES-DURÁN JF

340

COMO O COMPORTAMENTO DAS ABELHAS NA FLOR DO MORANGUEIRO (Fragaria ananassa Duchesne) INFLUENCIA A FORMAÇÃO DOS FRUTOS? HOW BEE BEHAVIOR ON STRAWBERRY FLOWER (Fragaria ananassa Duchesne) CAN INFLUENCE FRUIT DEVELOPMENT?  

Microsoft Academic Search

RESUMO: Para avaliar o efeito do comportamento de três espécies de abelhas na polinização e produção de morangos, flores primárias dos cultivares Oso Grande (OS) e Sweet Charlie (SC) foram expostas a diferentes tratamentos de polinização: OS - uma e quatro visitas por Trigona spinipes (Apidae), uma visita por Dialictus sp (Halictidae) e quatro visitas mistas (Apis mellifera e T.

Kátia Sampaio MALAGODI-BRAGA

341

EVALUACIÓN DE CINCO DOSIS DE APLICACIÓN DE CENIZA DE CASCARILLA DE ARROZ COMO FUENTE DE SILICIO Y COMPLEMENTO A LA FERTILIZACIÓN CON FÓSFORO Y POTASIO EN EL CULTIVO DE ARROZ (Oryza sativa L.) VARIEDAD F-50  

Microsoft Academic Search

In Ecuador, the rice's crop is barely considered the contribution of silicon (Si) in the fertilization in spite that this nutrient is absorbed in big quantities by the gramineous. This work was made with the objective of studying different dose of silicon using as source the ash of husk of rice besides different levels of phosphorate (P) and potassium (K)

Livinsgthone Andrade Barragán; Arturo Alvarez

342

INFORMAÇÃO TÉCNICA COMO SUBSÍDIO À P&D: CASO DA TECNOLOGIA DE LIGAS COM MEMÓRIA DE FORMA 1 TECHNICAL INFORMATION AS SUBSIDE TO P&D: CASE OF SHAPE MEMORY ALLOYS TECHNOLOGY  

Microsoft Academic Search

The objective of this paper is to present a group of technical information obtained in in Internet accessible databases survey. These information can be used by researches and managers to identify the state-of- the-art in a specific technological field in order to be aware of the latest development; what are being researched and in which areas; by which countries, instituitions

Cristina Gomes de Souza; Juliana Hoyer Insaurrauld

343

Os Esportes Coletivos e Individuais como Meios de Desenvolvimento das Inteligências Múltiplas: Um Estudo com Escolares (Group and Individuals Sports as a Way Developing Multiple Intelligence a Study with Students)  

Microsoft Academic Search

This project involves Bachelors degree in Languages, in Physical Education. We sought to develop a Group of the Studies and Search in Leisure - GEPEL. Had as objective the different intelligences termed Multipl e Intelligence by Gardner (1994), which manifest in people differently and can be wel l developed benefiting their human and social development. In this project, the most

José Carlos de Almeida; Luciene F. Silva; Jorge Luiz Justino; Andrade Cotrim; Claudia B. Ferreira Lima; Pedro A. B. de Oliveira; Vanessa Rocha Mathias; Tiago Agostinho Leal

344

Evaluacion de la radiacion ionizante como tratamiento de control cuarentenario de la falsa aranita de la vid (Brevipalpus chilensis Baker). (Evaluation of ionizing radiation applied to quarantine control of the false grape mite).  

National Technical Information Service (NTIS)

The objectives of this study were to evaluate effect of three dosages of ionizing radiation in combination with cold storage (0-2(sup 0) C), and the effect of cold storage without irradiation, establishing time curves for eclosion of eggs and mortality of...

Y. Jadue C. A. Vargas

1994-01-01

345

Induction of metallothioneins in Mullus barbatus as specific biomarker of metal contamination: A field study in the western Mediterranean Inducción de metalotioneínas en Mullus barbatus como biomarcador específico de contaminación metálica: Estudio de campo en el Mediterráneo occidental  

Microsoft Academic Search

Red mullet (Mullus barbatus, Linnaeus, 1758) is one of the fish species used as bioindicator in the Mediterranean Pollution Monitoring Programme (MEDPOL). This paper presents the results of a field study on the induction of hepatic metallothioneins (MT) in red mullet as specific biomarker of metal contamination. Specimens of M. barbatus were collected in six areas with different degrees of

J. Benedicto; J. Campillo

2005-01-01

346

Nível de Atividade Física como Estimador da Aptidão Física de Estudantes Universitários: Explorando a Adoção de Questionário Através de Modelagem Linear Physical Activity and Fitness in College Studients: Exploring Adoption of a Questionnaire by Linear Modeling  

Microsoft Academic Search

Classification of Physical Activity Level (PAL) is currently considered as a controversial issue inside Sport Science. The aim of study was verify the uses of an adapted questionnaire to classify PAL. The cross-serial essay was developed, taking PAL as independent variable and physical fitness as dependent. A population of 290 medical college freshmen was studied during three consecutive years by

Marcelo Conte; Aguinaldo Gonçalves; Liciana Vaz de Arruda

347

Como ayudar a su hijo a tener exito en la escuela, con actividades para ninos entre las edades de 5 a 11 anos (Helping Your Child Succeed in School, with Activities for Children Ages 5 through 11).  

ERIC Educational Resources Information Center

At the heart of the No Child Left Behind Act of 2001 is a promise to raise standards for all children and to help all children meet those standards. This Spanish-language booklet provides information that parents can use to help their child succeed in school. Following an introduction, the second section of the booklet, "The Basics," offers…

Paulu, Nancy

348

A Guide for Reading: How Parents Can Help Their Children Be Ready To Read and Ready To Learn = Guia Para Leer: Como los padres pueden preparar a sus hijos a leer y aprender desde la infancia.  

ERIC Educational Resources Information Center

|As part of the White House Initiative on Educational Excellence for Hispanic Americans, this brochure (in English and Spanish) provides a guide to assist parents in helping their children become ready to read and to learn. The suggestions include: (1) talking to infants/toddlers to help them learn to speak and understand the meaning of words; (2)…

White House Initiative on Educational Excellence for Hispanic Americans, Washington, DC.

349

Uso da prótese vertical expansível de titânio para costela (VEPTR) como opção na instrumentação sem fusão para tratamento da escoliose neuromuscular The vertical expandable prosthetic titanium rib device (VEPTR) as option in spine instrumentation without arthrodesis in the treatment of neuromuscular scoliosis Uso de la prótesis vertical expansible de titanio para costilla (VEPTR como opción en la instrumentación sin fusión para tratamiento de la escoliosis neuromuscular  

Microsoft Academic Search

Objective: report results of vertical expandable prosthetic titanium ribs (VEPTR) surgery in the treatment of neuromuscular scoliosis without spinal fusion. Methods: a total of 17 patients (mean age 8 years; 3 to 13 years) with neuromuscular scoliosis exceeding 40° of scoliosis measured using the Cobb method and presenting a Risser grade of 1 and 2 before VEPTR surgery. The degree

Élcio Landim; Paulo Tadeu; Maia Cavali; Marcus Alexandre; Mello Santos; Wagner Pasqualini; Rodrigo Castello; Branco Manhães

350

Package deals. Despite increased scrutiny, executive pay at not-for-profit hospitals still on the rise.  

PubMed

Scrutiny of the compensation of executives at not-for-profit healthcare organizations may be growing, but the highest-paid such executives saw their median total pay grow 12% annually, a review of 2011 and 2010 data shows. Leading the pack for actively employed executives was George Halvorson, left, of Kaiser Permanente. "Compensation paid to senior management is substantially less than that of many for-profit health" insurers, a Kaiser spokesman said. PMID:24006688

Evans, Melanie

2013-08-12

351

The Cooperative Healthcare Clinic Model: Following the Same Group of Multi-Morbid Geriatric Patients over Time  

Microsoft Academic Search

The Cooperative Health Care Clinic (CHCC) model was originated by Dr. John C. Scott at Kaiser Permanente in Colorado in 1991\\u000a and was the first of today's three major group visit models to be developed. The CHCC model instills deep social bonds as\\u000a it offers exceptional continuity of care for the 15–20 patients fortunate enough to receive it, because, in

Christian Seiler

352

The Risk for Malignant Primary Adult-Onset Glioma in a Large, Multiethnic, Managed-Care Cohort: Cigarette Smoking and Other Lifestyle Behaviors  

Microsoft Academic Search

Purpose: To determine the risk for malignant primary adult-onset glioma (MPAG) associated with cigarette smoking and other lifestyle behaviors in a large, multiethnic, managed-care cohort.\\u000aMethods: The study population included a cohort of 133,811 subscribers to the Kaiser Permanente Medical Care Program of Northern California who had received a multiphasic health checkup and questionnaire between 1977 and 1985, were at

Jimmy T. Efird; Gary D. Friedman; Stephen Sidney; Arthur Klatsky; Laurel A. Habel; Natalia V. Udaltsova; Stephen Van Den Eeden; Lorene M. Nelson

2004-01-01

353

Imbedding Research in Practice to Improve Medication Safety  

Microsoft Academic Search

Objective: The objective of this project was to improve medication safety at Kaiser Permanente Colorado (KPCO). Methods: Six projects that included over 400,000 members were conducted at medical offices and pharmacies. They focused on drug-drug interactions, warfarin-drug interactions, dosing in patients with impaired kidney function, prescribing among elderly patients, prescribing during pregnancy, and laboratory monitoring of therapy. Physicians and pharmacists

Marsha A. Raebel; Elizabeth A. Chester; David W. Brand; David J. Magid

354

A domesticação das singularidades. Reflexões sobre o paradigma da prevenção - o caso da epidemia de HIV\\/AIDS The domestication of singularity. Reflections on the HIV\\/AIDS prevention speech paradigm  

Microsoft Academic Search

Resumo Refletindo sobre as estratégias de combate à epidemia de HIV\\/Aids, analisa-se o discurso da prevenção num quadro de subjetivação marcado pela constituição de permanente estado de alerta às situações de risco. Temos observado uma medicalização da vida com a importação para o campo da saúde da idéia de administrar riscos. Configura-se o surgimento de um projeto de vida saudável

Camila Miranda de Amorim

355

Incidence and clinical characteristics of interstitial cystitis in the community  

Microsoft Academic Search

We utilized physician-coded diagnoses and chart reviews to estimate the incidence of interstitial cystitis (IC) in women.\\u000a A computer search of the Kaiser Permanente database was performed to identify newly coded diagnoses of IC (ICD-9 code 595.1)\\u000a between May 2002 and May 2005. Chart reviews were performed and patient demographics, diagnosing physicians, and symptom characteristics\\u000a were recorded. The IC incidence

Ronak Patel; Elizabeth A. Calhoun; Richard T. Meenan; Maureen C. O’Keeffe Rosetti; Terry Kimes; J. Quentin Clemens

2008-01-01

356

Validity of Outpatient Medical Records in Identifying Prostate-Specific Antigen (PSA) Tests Administered for Screening Purposes  

Microsoft Academic Search

A case-control study of cancer screening efficacy seeks to compare cases and controls for the receipt of only those tests\\u000a done when there were no symptoms or signs of the cancer that is the target of the screening. We conducted a study to determine\\u000a the accuracy of Kaiser Permanente Northwest (KPNW) medical records in identifying the reason(s) underlying testing for

Sheila Weinmann; Noel S. Weiss; Kathryn Richert-Boe; Andrew G. Glass

2004-01-01

357

Prostate cancer screening and mortality: A case-control study (United States)  

Microsoft Academic Search

Objective: We performed a case–control study at Kaiser Permanente Northwest to assess the association between digital rectal examination (DRE) and prostate-specific antigen (PSA) testing, separately and together, and prostate cancer mortality. Methods: We identified 171 KPNW members who died as a result of prostate cancer from 1992 to 1999 and 342 randomly-selected KPNW members matched to the cases on age,

Sheila Weinmann; Kathryn Richert-Boe; Andrew G. Glass; Noel S. Weiss

2004-01-01

358

An Immediate and Long-Term Study of a Temperament and Parent-Child Interaction Therapy Based Community Program for Preschoolers with Behavior Problems  

Microsoft Academic Search

The immediate and long-term effects of a Parent Child Interaction Therapy (PCIT) derived program offered at a Kaiser Permanente facility were evaluated. There were 73 participants in the initial sample and 23 in the 5–6 year follow-up sample. Child behaviors improved significantly immediately following treatment and some improvements were maintained at follow-up. Over 75% of the follow-up participants utilized additional

Hadas Pade; Daniel O. Taube; Annette E. Aalborg; Paul J. Reiser

2006-01-01

359

Marijuana Use and Medically Attended Injury Events  

Microsoft Academic Search

Study objective: This study evaluated the relation between self-reported marijuana use and 3-year incidence of injury. Methods: We conducted a retrospective cohort study of adult Kaiser Permanente Medical Care Program members who underwent multiphasic health examinations between 1979 and 1986 (n=4,462). Injury-related outpatient visits, hospitalizations, and fatalities within 3 years of examination were determined. Results: Outpatient injury events totaled 2,524;

Barbara L Braun; Irene S Tekawa; Susan G Gerberich; Stephen Sidney

1998-01-01

360

A systematic review of wound cleansing for pressure ulcers (clinical review)1)  

Microsoft Academic Search

Samenvatting  Decubituswonden en\\/of -zweren zijn gelokaliseerde gebieden van weefselschade veroorzaakt door permanente druk op en verminderde\\u000a bloedvoorziening in een bepaald huidgebied. Decubitus is een veelvoorkomende complicatie bij mensen die om een andere reden\\u000a in het ziekenhuis of verpleegtehuis zijn opgenomen en die niet in staat zijn zichzelf te verplaatsen om die druk te vermijden.\\u000a Dit laatste komt vaak voor bij zeer

Berry Middel; Moore Z; Cowman S

2009-01-01

361

Midlife Serum Cholesterol and Increased Risk of Alzheimer’s and Vascular Dementia Three Decades Later  

Microsoft Academic Search

Aims: To investigate midlife cholesterol in relation to Alzheimer’s disease (AD) and vascular dementia (VaD) in a large multiethnic cohort of women and men. Methods: The Kaiser Permanente Northern California Medical Group (healthcare delivery organization) formed the database for this study. The 9,844 participants underwent detailed health evaluations during 1964–1973 at ages 40–45 years; they were still members of the

Alina Solomon; Miia Kivipelto; Benjamin Wolozin; Jufen Zhou; Rachel A. Whitmer

2009-01-01

362

Risk of invasive squamous carcinoma of the cervix associated with screening intervals of 1, 2, and 3 years: a case–control study  

Microsoft Academic Search

Objective: To compare the risks of developing invasive squamous carcinoma of the cervix (ISCC) associated with different lengths of time following a negative Pap test result.Methods: We conducted a matched case–control study using subjects who were members of Kaiser Permanente Medical Care Plan–Northern California Region. Women with an initial diagnosis of ISCC between 1983 and 1995 who had been members

Walter K. Kinney; M. Miller; H-Y Sung; G. F. Sawaya; K. A. Kearney; R. A. Hiatt

2001-01-01

363

Screening Prescription Drugs for Possible Carcinogenicity: Eleven to Fifteen Years of Follow-up1  

Microsoft Academic Search

Using computerized pharmacy records from 1969 to 1973 for a cohort of 143,574 members of the Kaiser Permanente Medical Care Program, we have been testing associations of 215 drugs or drug groups with subsequent incidence of cancer at 56 sites. This paper presents findings with follow-up through 1984. There were 227 statistically significant (P < 0.05, two-tailed) associations: 170 positive,

Joseph V. Selby; Gary D. Friedman; Bruce H. Fireman

364

Simple Rules That Reduce Hospital Readmission  

PubMed Central

To overcome system failures, health care organizations must implement a few simple rules of complex adaptive systems. I describe Transition in Care, Kaiser Permanente Southern California’s program to reduce hospital readmissions, as an example of a program design that meets the principles of complex adaptive systems and enumerate five rules, which must be followed if a health system is to create value for their stakeholders.

Kottke, Thomas E

2013-01-01

365

Marijuana use and cancer incidence (California, United States)  

Microsoft Academic Search

The purpose of this retrospective cohort study was to examine therelationship of marijuana use to cancer incidence. The study populationconsisted of 64,855 examinees in the Kaiser Permanente multiphasic healthcheckup in San Francisco and Oakland (California, United States), between1979-85, aged 15 to 49 years, who completed self-ad-ministered questionnairesabout smoking habits, including marijuana use. Follow-up for cancer incidencewas conducted through 1993 (mean

Stephen Sidney; C. P. Quesenberry; G. D. Friedman; I. S. Tekawa

1997-01-01

366

Multivitamin use and breast cancer outcomes in women with early-stage breast cancer: the Life After Cancer Epidemiology study  

Microsoft Academic Search

Little is known about the relation of multivitamin use to breast cancer outcomes. 2,236 women diagnosed from 1997 to 2000\\u000a with early-stage breast cancer (Stage I ? 1 cm, II, or IIIA) were enrolled about 2 years post-diagnosis, primarily from the\\u000a Kaiser Permanente Northern California Cancer Registry (83%). Multivitamin use pre-diagnosis and post-diagnosis was assessed\\u000a via mailed questionnaire. Outcomes were ascertained yearly by

Marilyn L. Kwan; Heather Greenlee; Valerie S. Lee; Adrienne Castillo; Erica P. Gunderson; Laurel A. Habel; Lawrence H. Kushi; Carol Sweeney; Emily K. Tam; Bette J. Caan

367

Trends and Correlates of HIV Testing During Pregnancy in Racially\\/Ethnically Diverse Insured Population, 1997–2006  

Microsoft Academic Search

Objectives To describe the trends in human immunodeficiency virus (HIV) testing during pregnancy from 1997 through 2006, and the demographic,\\u000a clinical, and health system correlates of being tested in a diverse insured population. Methods Health plan members who had one or more births at ?20 weeks gestation from January 1, 1997 through December 31, 2006 in Kaiser\\u000a Permanente Southern California

Jean M. Lawrence; In-Lu A. Liu; William J. Towner

2009-01-01

368

Complementary and alternative therapy use before and after breast cancer diagnosis: the Pathways Study  

Microsoft Academic Search

Many women use complementary and alternative medicine (CAM) to maintain or improve their health. We describe CAM use among\\u000a the first 1,000 participants enrolled in the Pathways Study, an ongoing prospective cohort study of women diagnosed with breast\\u000a cancer (BC). Participants, identified by rapid case ascertainment in Kaiser Permanente Northern California, are women ? 21 years\\u000a diagnosed with first invasive BC. Comprehensive baseline

Heather Greenlee; Marilyn L. Kwan; Isaac Joshua Ergas; Karen J. Sherman; Sarah E. Krathwohl; Christine Bonnell; Marion M. Lee; Lawrence H. Kushi

2009-01-01

369

What strategic planning can do for you.  

PubMed

Whether it's playing chess or planning for retirement, we all have strategies for different situations in our lives. So why not apply, strategies in our practice ? Companies such as Dell, Wal-Mart, and Home Depot have depended on strategic plans to generatel millions of dollars and guide their organizations into the future. Although most of our practices are not nearly as large as these companies (except maybe Kaiser Permanente), formulating strategies for our practice is vital for future growth. PMID:17494484

Valenzuela, Peter

370

Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy  

Microsoft Academic Search

BackgroundMorgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies.MethodsA descriptive study was conducted among persons at least 13 years of age and enrolled in Kaiser Permanente Northern California (KPNC) during 2006–2008. A case was defined

Michele L. Pearson; Joseph V. Selby; Kenneth A. Katz; Virginia Cantrell; Christopher R. Braden; Monica E. Parise; Christopher D. Paddock; Michael R. Lewin-Smith; Victor F. Kalasinsky; Felicia C. Goldstein; Allen W. Hightower; Arthur Papier; Brian Lewis; Sarita Motipara; Mark L. Eberhard

2012-01-01

371

L’effetto volta e la teoria elettronica della pila  

Microsoft Academic Search

8. Conclusione. — Accertata 1’ esistenza dell’ effetto Volta anche nel vuoto, e perció indipendentemente da ogni azione chimica,\\u000a la coppia bimetallica, ad esempio rame-zinco, costituisce un mezzo naturale e perpetuo atto a produrre in uno spazio anche\\u000a di grandi dimensioni un campo elettrostatico; cosí come un magnete permanente (peró con minore stabilitá) crea intorno a sé\\u000a un campo magnetico.

O. M. Corbino

1927-01-01

372

Menu Labeling Responsive to Consumer Concerns and Shows Promise for Changing Patron Purchases  

Microsoft Academic Search

This study evaluated a calorie labeling intervention in Kaiser Permanente Hospital cafeterias. Three cafeteria conditions were no labeling; calorie and nutrient labeling on posters only; posters plus point-of-purchase menu board calorie labeling. More respondents noticed calorie information at poster plus menu board sites than at poster-only sites (P < 0.05). Over 80% of patrons supported provision of calorie information. There

Karen L. Webb; Loel S. Solomon; Jan Sanders; Carol Akiyama; Patricia B. Crawford

2011-01-01

373

Earthquakes, Segments, Bends, and Fault-Face Geology: Correlations Within the San Andreas System, California  

NASA Astrophysics Data System (ADS)

Three-dimensional geologic maps of regions surrounding parts of the San Andreas Fault system reveal correlations between fault face geology and both short- and long-term behavior of the faults. The Loma Prieta fault segment that ruptured during the 1989 M6.9 earthquake, as defined by its aftershocks, closely corresponds to the subsurface reach (80 km long) where a large body of Logan gabbro is truncated at the fault, as defined by its magnetic anomaly. This Jurassic ophiolitic gabbro and its related rocks occupy an unusual fault-bounded basement block within Salinaa, a largely Cretaceous granitic terrane SW of the San Andreas Fault. The along-fault reach of the Logan gabbro also coincides with essentially the entire Santa Cruz Mountains left-bend in the San Andreas Fault. Rejecting a chance coincidence, the position of the Logan gabbro with respect to the left bend implies that the bend is fixed relative to Salinia and that the block NE of the San Andreas Fault has been forced to negotiate around the bend as the blocks moved past each other. Thus the basement rocks of the Logan block appear to define (control?) the Loma Prieta segment in terms both of short-term behavior (earthquakes) and long-term behavior (restraining bend fault geometry). The Parkfield segment of the San Andreas Fault also closely corresponds to a characteristic geologic unit in the NE face of the fault, the greenstone-rich Permanente terrane of the Franciscan Complex. The along-fault subsurface extent of the Permanente terrane at the fault face, as inferred from a recent 3D tomographic wavespeed model, corresponds to the reach filled by the aftershocks of the 2004 Parkfield earthquake. Furthermore, the 2004 co-seismic slip inferred from geodetic observations also coincides with the Permanente terrane at the fault face. To test whether these observations are directly related to the presence of the Permanente terrane along the fault face, we looked at fault behavior at the location of its offset counterpart, which truncates at the Calaveras Fault near Hollister 175 km to the NW. Here, the along-fault subsurface extent of the Permanente terrane, as defined by its gravity and magnetic anomalies, corresponds to the aftershock distribution of the 1979 Coyote Lake earthquake, giving support to the idea that fault-face geology can influence fault behavior and control fault segmentation.

Jachens, R. C.; Simpson, R. W.; Thurber, C. H.; Murray, J. R.

2006-12-01

374

EVALUACIÓN DE LOS FORRAJES DE MORERA Morus alba Y TULIPÁN Hibiscus rosa-sinensis A DIFERENTES EDADES DE CORTE COMO SUPLEMENTO PARA CORDEROS EN PASTOREO Evaluation of white mulberry Morus alba and chinese hibiscus Hibiscus rosa-sinensis forage harvested at dierent ages as supplements for grazing lambs  

Microsoft Academic Search

The performance and metabolic behaviour of grazing lambs supplemented with Morus alba (M) and Hibiscus rosa-sinensis (T) were evaluated. A total of 32 male crossbreeding lambs (Pelibuey x Dorper or Black Belly) with an average body weight of 18.33±1.56 k were studied during 90 days. The animals were allowed to graze continuously and were supplemented (300 g animal 1 d

PV Obrador-Olán; D Hernández-Sánchez; A Gómez-Vázquez; W Camacho-Chiu

2007-01-01

375

...And That's How It All Began: Putting Information about Your Child's Growth, Health and Safety All within Your Reach...Because the First Years Last Forever! = ...Y asi es como empezo todo: Ponemos a su alcance en forma conjunta la informacion sobre el crecimiento, la salud y la seguridad de su hijo...Porque los primeros anos duran para siempre!  

ERIC Educational Resources Information Center

|Smart Start is North Carolina's model early childhood initiative to help all North Carolina children enter school healthy and prepared for success. This resource guide, in Spanish and English versions, is designed to provide parents with information on infant and child development, health care, and resources for further assistance. Presented in…

North Carolina Partnership for Children, Raleigh.

376

EVALUACIÓN DEL TAMAÑO DE COPA COMO ESTIMADOR DEL CRECIMIENTO DE ÁRBOLES JUVENILES DE Austrocedrus chilensis (D.Don)Pic. Serm. Et Bizzarri. ASSESMENT OF CROWN SIZE AS GROWTH ESTIMATOR IN YOUNG Austrocedrus chilensis (D.Don)Pic. Serm. Et Bizzarri TREES  

Microsoft Academic Search

SUMMARY We assessed four crown variables as stem growth estimators in young Austrocedrus chilensis (D.Don)Pic. Serm. Et Bizzarri trees (4 - 30 years old, and 0.05 - 4 meters tall), growing associated to shrubs. The variables were crown length; gross and net crown volume and leaves dry weight. Net crown volume and crown density (dry weight of leaves per unit

Federico Jorge Letourneau; Ernesto Andenmatten; Tomás Schlichter

377

How To Talk to Your Doctor (and Get Your Doctor To Talk to You!). An Educational Workshop on Doctor Patient Communication = Como Hablarle a su Doctor (iY que su doctor le hable a usted!). Un seminario educativo sobre la comunicacion entre el doctor y el paciente.  

ERIC Educational Resources Information Center

|This workshop, written in both English and Spanish, focuses on improving communication between physician and patient. In the workshop, the trainers will talk about "building bridges" between patient and doctor by understanding the doctor's role and his/her duty to the patient. According to the workshop, a person's doctor should communicate…

Baylor Coll. of Medicine, Houston, TX.

378

Efectos Especiales de Anclaje (Estudio sobre Regresiones de Juicios Condicionales). Parte 2: Invariancia del Juicio No-Condicional Como Valor Estandar Para el Juicio Condicional (Special Effects of Anchoring (Study of Regression of Conditional Judgements) Part 2: Invariance of Unconditional Judgments as Standard Value for the Conditional Judgment). Publication No. 31.  

ERIC Educational Resources Information Center

From the best-fit lines corresponding to sets of families of conditional judgements, the constant stimulus family and the constant condition family, both defined for a same scale object, the coordinate values of the point of intersection of both lines (indifference point) are obtained. These values are studied in relation to the mean values of the…

Lopez Alonso, A. O.

380

Efectos Especiales de Anclaje (Estudio sobre Regresiones de Juicios Condicionales). Parte 2: Invariancia del Juicio No-Condicional Como Valor Estandar Para el Juicio Condicional (Special Effects of Anchoring (Study of Regression of Conditional Judgements) Part 2: Invariance of Unconditional Judgments as Standard Value for the Conditional Judgment). Publication No. 31.  

ERIC Educational Resources Information Center

|From the best-fit lines corresponding to sets of families of conditional judgements, the constant stimulus family and the constant condition family, both defined for a same scale object, the coordinate values of the point of intersection of both lines (indifference point) are obtained. These values are studied in relation to the mean values of…

Lopez Alonso, A. O.

381

Validating growth and development of a seabird as an indicator of food availability: Captive-reared Caspian Tern chicks fed ad libitum and restricted diets [La validaci??n del crecimiento y desarrollo de un ave marina como un indicador de la disponibilidad de comida: pichones de Hydrogprogne caspia criados en cautiverio y alimentados ad libitum y dietas restringidas  

USGS Publications Warehouse

For seabirds raising young under conditions of limited food availability, reducing chick provisioning and chick growth rates are the primary means available to avoid abandonment of a breeding effort. For most seabirds, however, baseline data characterizing chick growth and development under known feeding conditions are unavailable, so it is difficult to evaluate chick nutritional status as it relates to foraging conditions near breeding colonies. To address this need, we examined the growth and development of young Caspian Terns (Hydroprogne caspia), a cosmopolitan, generalist piscivore, reared in captivity and fed ad libitum and restricted (ca. one-third lower caloric intake) diets. Ad libitum-fed chicks grew at similar rates and achieved a similar size at fledging as previously documented for chicks in the wild and had energetic demands that closely matched allometric predictions. We identified three general characteristics of food-restricted Caspian Tern chicks compared to ad libitum chicks: (1) lower age-specific body mass, (2) lower age-specific skeletal and feather size, such as wing chord length, and (3) heightened levels of corticosterone in blood, both for baseline levels and in response to acute stress. Effects of diet restriction on feather growth (10-11% slower growth in diet-restricted chicks) were less pronounced than effects on structural growth (37-52% slower growth) and body mass (24% lower at fledging age), apparently due to preferential allocation of food resources to maintain plumage growth. Our results suggest that measurements of chick body mass and feather development (e.g., wing chord or primary length) or measurement of corticosterone levels in the blood would allow useful evaluation of the nutritional status of chicks reared in the wild and of food availability in the foraging range of adults. Such evaluations could also inform demography studies (e.g., predict future recruitment) and assist in evaluating designated piscivorous waterbird conservation (colony) sites. ?? 2011 The Authors. Journal of Field Ornithology ?? 2011 Association of Field Ornithologists.

Lyons, D. E.; Roby, D. D.

2011-01-01

382

Aglomeração de pequenas e médias empresas como ambiente propício à melhoria de desempenho - caracterização do arranjo produtivo local do setor de confecção de bordados de Ibitinga Gathering small and median enterprises clustering as favorable environment for performance improvement - characterization of the local industrial cluster of embroideries at Ibitinga  

Microsoft Academic Search

Resumo Estudos destacam que a concentração geográfica de Pequenas e Médias Empresas (PME's) de uma determinada atividade econômica pode trazer vantagens competitivas para o setor e as empresas, desenvolvendo a economia industrial e social do local. Entretanto, uma dificuldade nesse novo sistema de produção é definir as ações conjuntas que consigam melhorar o desempenho das PME's do cluster. Assim, o

Mateus C. Gerolamo; Edwin Cardoza; Flávio Vicari; Luiz C. Ribeiro; Luiz C. Ribeiro Carpinetti

383

ADUBAÇÃO COM SILÍCIO COMO F ATOR DE RESISTÊNCIA A INSETOS-PRAGA E PROMOTOR DE PRODUTIVIDADE EM CULTURA DE BA TATA INGLESA EM SISTEMA ORGÂNICO Fertilization with silicon as resistance factor to pest insects and promoter of productivity in the potato crop in an organic system  

Microsoft Academic Search

-1 ; 3- adubação via foliar com solução de ácido silícico a 0,35%; 4- adubação via solo com pó de rocha, na dose correspondente a 2t.ha -1 ; 5-adubação via foliar com solução de pó de rocha a 2%. Os tratamentos foram aplicados 20 dias após o plantio da batata-semente. Foi monitorada a incidência de insetos-praga por meio da determinação

Flávia Batista Gomes; Jair Campos Moraes; Danila Kelly; Pereira Neri

2009-01-01

384

LÓGICA DIFUSA COMO HERRAMIENTA PARA LA BIOINDICACIÓN DE LA CALIDAD DEL AGUA CON MACROINVERTEBRADOS ACUÁTICOS EN LA SABANA DE BOGOTÁ - COLOMBIA Application of fuzzy logic as bioindication tool for the water quality with aquatic macroinvertebrates in the Sabana de Bogotá - Colombia  

Microsoft Academic Search

An application of fuzzy logic (LD) is present in order to calculate the biologic water quality in the Plain of Bogotá, Colombia. Due to the interactions between aquatic organisms and physical and chemiscal variables are a non-linear mathematic prob- lem of great complexity, powerful methods for the analysis of such models are needed. Fuzzy logic offers a possibility due to

JUAN DAVID GUTIÉRREZ; WOLFGANG RISS; RODULFO OSPINA

385

Analysis of chicken fat as adulterant in cod liver oil using Fourier transform infrared (FTIR) spectroscopy and chemometrics Análisis de grasa de pollo como adulterante en aceite de hígado de bacalao usando espectroscopía infrarroja con transformada de Fourier (FTIR) y quimometría  

Microsoft Academic Search

Among three animal fats evaluated, chicken fat (CF) has close similarity in fatty acid profiles with cod liver oil (CLO), compared with mutton fat and beef fat; therefore, CF can be one of the potential adulterants in CLO. Fourier transform infrared (FTIR) spectra of CLO, CF, and their mixtures were measured on direct contact with horizontal attenuated total reflectance (HATR)

A. Rohman; Y. B. Che Man

2011-01-01

386

Surveillance géodésique par GPS: une approche régionale  

Microsoft Academic Search

Depuis quelques années les réseaux géodésiques nationaux\\u000a sont équipés d'un certain nombre de stations GPS\\u000a permanentes. Les systèmes et cadres de coordonnées sont\\u000a ainsi disponibles aisément et permettent un rattachement\\u000a efficace et cohérent d'autres réseaux géodésiques. C'est\\u000a dans ce contexte que s'inscrit cet article qui présente\\u000a une approche régionale de la surveillance géodésique avec\\u000a l'étude d'un réseau pilote couvrant une

Ludovic Rey; Pierre-Yves Gilliéron; Adrian Waegli

2006-01-01

387

Wide local excision for Buschke-Löwenstein tumor or circumferential carcinoma in situ  

Microsoft Academic Search

Purpose  This study aimed to evaluate the outcome of patients with Buschke-Löwenstein tumor or circumferential anal carcinoma in situ\\u000a who underwent wide local excision with flap or skin graft coverage of the wound.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective review was conducted of all patients operated at Kaiser Permanente Los Angeles Medical Center during a 6-year\\u000a period. Outcome measures included postoperative complications, functional results, recurrence

Maher A. Abbas

388

The Northern California Perinatal Research Unit: A Hybrid Model Bridging Research, Quality Improvement and Clinical Practice  

PubMed Central

Kaiser Permanente (KP) has a long-standing commitment to conduct research and report publicly. Simultaneously, it faces a different imperative: harnessing information systems to leverage internal improvements in outcomes, efficiency, and costs. Now that KP HealthConnect, the KP electronic health record, is fully implemented, research challenges at KP are moving away from issues of data access and toward the mechanisms through which raw data create meaningful clinical knowledge that is based on rigorous research. In this report we describe a model for research—the Northern California Division of Research Perinatal Research Unit—that leverages internal and external resources to fulfill these twin missions.

Garrido, Terhilda; Barbeau, Rosemarie

2010-01-01

389

Randomized trial of case-finding for depression in elderly primary care patients  

Microsoft Academic Search

OBJECTIVE: To determine the effect of case-finding for depression on frequency of depression diagnoses, prescriptions for antidepressant\\u000a medications, prevalence of depression, and health care utilization during 2 years of follow-up in elderly primary care patients.\\u000a \\u000a \\u000a DESIGN: Randomized controlled trial.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: Thirteen primary care medical clinics at the Kaiser Permanente Medical Center, an HMO in Oakland, Calif, were randomly assigned\\u000a to

Mary A. Whooley; Barry Stone; Krikor Soghikian

2000-01-01

390

Achieving performance breakthroughs in an HMO business process through quality planning.  

PubMed

Kaiser Permanente's Georgia Region commissioned a quality planning team to design a new process to improve payments to its suppliers and vendors. The result of the team's effort was a 73 percent reduction in cycle time. This team's experiences point to the advantages of process redesign as a quality planning model, as well as some general guidelines for its most effective use in teams. If quality planning project teams are carefully configured, sufficiently expert in the existing process, and properly supported by management, organizations can achieve potentially dramatic improvements in process performance using this approach. PMID:10130708

Hanan, K B

1993-01-01

391

Marijuana use and mortality.  

PubMed Central

OBJECTIVES: The purpose of this study was to examine the relationship of marijuana use to mortality. METHODS: The study population comprised 65171 Kaiser Permanente Medical Care Program enrollees, aged 15 through 49 years, who completed questionnaires about smoking habits, including marijuana use, between 1979 and 1985. Mortality follow-up was conducted through 1991. RESULTS: Compared with nonuse or experimentation (lifetime use six or fewer times), current marijuana use was not associated with a significantly increased risk of non-acquired immunodeficiency syndrome (AIDS) mortality in men (relative risk [RR] = 1.12, 95% confidence interval [CI] = 0.89, 1.39) or of total mortality in women (RR = 1.09, 95% CI = 0.80, 1.48). Current marijuana use was associated with increased risk of AIDS mortality in men (RR = 1.90, 95% CI = 1.33, 2.73), an association that probably was not causal but most likely represented uncontrolled confounding by male homosexual behavior. This interpretation was supported by the lack of association of marijuana use with AIDS mortality in men from a Kaiser Permanente AIDS database. Relative risks for ever use of marijuana were similar. CONCLUSIONS: Marijuana use in a prepaid health care-based study cohort had little effect on non-AIDS mortality in men and on total mortality in women.

Sidney, S; Beck, J E; Tekawa, I S; Quesenberry, C P; Friedman, G D

1997-01-01

392

The effects of an Electronic Medical Record on patient care: clinician attitudes in a large HMO.  

PubMed Central

OBJECTIVE: The purpose of this study is to examine the attitudes of clinicians in a large HMO toward the effect of an outpatient Electronic Medical Record system on the quality of patient care. Attitudes toward a Results Reporting system and an online charting and ordering system are also compared. DESIGN: A cross-sectional study was performed using a survey of Kaiser Permanente Northwest clinicians. In addition, interviews were conducted with the physician leaders of the clinical departments at Kaiser Permanente Northwest. MEASUREMENTS: Clinician attitudes are measured regarding the effects of a Results Reporting system and an online charting and ordering system on the overall quality of patient care and other care-related indices. RESULTS: Most clinicians feel that the outpatient Electronic Medical Record has improved the overall quality of patient care, with 72% reporting an improvement with the use of the Results Reporting system, and 60% reporting an improvement with the use of the online charting and ordering system. On average, clinicians feel that the EMR has also improved the quality of the patient-clinician interaction, the ability to coordinate the care of patients with other departments, the ability to detect medication errors, the timeliness of referrals, and the ability to act on test results in a timely fashion. CONCLUSION: Clinicians perceive an improvement in patient care as a result of using an outpatient Electronic Medical Record system. Clinicians have higher opinions, however, of the effects of a Results Reporting system compared to an online charting and ordering system.

Marshall, P. D.; Chin, H. L.

1998-01-01

393

Patient-Physician Language Concordance: A Strategy for Meeting the Needs of Spanish-Speaking Patients in Primary Care  

PubMed Central

The Hispanic/Latino community increased by 58% in the last decade (1990–2000) and it is estimated that Hispanics/Latinos will be 30% of the population by 2050. Many of the Hispanic/Latino households (40%) surveyed by the census bureau in 2000 spoke Spanish. Because of its location, the Southern California Permanente Medical Group, which provides the medical services for Kaiser Permanente Southern California (KPSC) serves a large and growing Hispanic/Latino community. It is estimated that by 2010, the KPSC region will be between 30–50% Hispanic/Latino. A Spanish language task force (the task force) was created in 2006 to address the needs of the KPSC Spanish-speaking membership using primary care services. This task force examined data from a variety of sources including electronic medical databases and focus group reports from Spanish-speaking members. Using the task force findings and the literature in this area, we make recommendations to increase patient-physician language concordance in other health care settings so that organizations can effectively serve a growing Hispanic/Latino, Spanish-speaking patient population.

Kanter, Michael H; Abrams, Karyn M; Carrasco, Maria R; Spiegel, Nancy H; Vogel, Ralph S; Coleman, Karen J

2009-01-01

394

What Does Professionalism Mean to the Physician?  

PubMed Central

Professionalism, which is a core competency for physicians, can be described as a spectrum of behaviors and may have a significant impact on the problems in today’s changing health care climate. In this article, we discuss the meaning of professionalism and its role in the Southern California Permanente Medical Group (SCPMG) and consider how it may be applied to integrated care delivery systems such as Kaiser Permanente. To understand professionalism, one must consider Stern’s definition, which consists of four principles: excellence, humanism, accountability, and altruism. SCPMG has taken three of these principles—excellence, accountability, and altruism—and divided the fourth, humanism, into another three principles similar to those identified by the University of California Los Angeles Task Force on Professionalism: humanitarianism, respect for others, and honor and integrity. SCPMG has a rich history and culture of promoting clinical excellence and professionalism, as evidenced by the programs and initiatives described throughout this article. Indeed, the SCPMG experience validates professionalism as a core physician competency comprising a set of behaviors that are continually refined.

Kanter, Michael H; Nguyen, Miki; Klau, Marc H; Spiegel, Nancy H; Ambrosini, Virginia L

2013-01-01

395
396

n´ õas transnacionales como CANON, KODAK y NYKON, entre otras, las cuales mencionan una gran cantidad de proyectos en los que planean construir y evaluar c´ amaras digitales, proyectores de cristal l´ õquido y otros equipos formadores de imagen, todo ello mediante el empleo de EOD. Bajo el contexto anterior se plantea en este art´ õculo hacer una revision de los fundamentos en los que se basa la ´ optica difractiva, los metodos que se utilizan para disenar los sistemasopticos empleando  

Microsoft Academic Search

Nowadays diffractive optics in the fabrication of imaging optical systems is having a boom due to many advantages over the image quality and the use of less optical elements. Diffractive Optical Elements (DOE's) are showing a huge growth in the optical industry and it goes in increasing day to day. Transnational companies like CANON, KODAK and NYON refer to great

J. Castro-Ramos; S. Vazquez-Montiel; J. Hern; O. Garc ´ õa-Lievanos; W. Calleja-Arriaga

397

Análisis de las políticas públicas de comunicación o en las estrategias de comunicación de las instituciones públicas. Así como de los partidos políticos, que aunque formaciones privadas poseen un rol esencial en la formación de la opinión pública, en la manifestación de las demandas ciudadanas y en el reclutamiento de las élites políticas. * El papel de los medios de comunicación y sus consecuencias en la dinámica política. Siendo éste el principal motor de las investigaciones en comunicación política  

Microsoft Academic Search

The role of political communication in the formation and expression of public opinion has been expounded upon by numerous researchers. In the context of political communication, there are three entities involved: the authorities, the media, and society itself. The classic studies of political communication deal with diverse aspects: * Analysis of public political communication or of the communication strategy of

Antonio Castillo Esparcia

398

Artigo Original Determinação da eficiência do VEF 6 como substituto da CVF na triagem diagnóstica da doença pulmonar obstrutiva crônica através da comparação entre as relações VEF 1 \\/CVF e VEF 1 \\/VEF 6 * Determination of the efficacy of FEV 6 as a surrogate for FVC in the diagnostic screening for chronic obstructive pulmonary disease through the comparison of FEV 1 \\/FVC and FEV 1 \\/FEV 6 ratios  

Microsoft Academic Search

Objective: To determine the efficacy of using forced expiratory volume in six seconds (FEV 6 ) as a surrogate for forced vital capacity (FVC) in the diagnostic screening for chronic obstructive pulmonary disease (COPD) by comparing FEV 1 \\/FVC ratios with FEV 1 \\/FEV 6 ratios. Methods: In November of 2003, on World COPD Day, we conducted a campaign of

Marília Montenegro Cabral; Danielle Cristina; Silva Clímaco; Liana Gonçalves de Macedo; Marta de Andrade; Lima Coelho; Ana Lúcia; Pereira Lima; Alves Dias

2007-01-01

399

Sensory Awareness as a Method of Mindfulness Training within the Perspective of Person-Centered Psychotherapy \\/ Sensory Awareness als Methode des Achtsamkeitstrainings innerhalb der Perspektive der Personzentrierten Psychotherapie \\/ La capacidad de conciencia sensorial (‘sensory awareness’) como un método de formación en ‘mindfulness’ dentro de la perspectiva de la psicoterapia centrada en la persona \\/ Sensory Awareness als een methode van opmerkzaamheids training in het perspectief van cliëntgerichte psychotherapie  

Microsoft Academic Search

This article starts with a description of Sensory Awareness as a training method in mindfulness. Subsequently, the influence of Eastern doctrines, i.e., Daoism and Chan Buddhism, on Rogers' thinking is examined. Concepts from person-centered psychotherapies are traced to their Eastern roots. Their function within Sensory Awareness is discussed. Finally, the paper addresses the issue of whether Sensory Awareness can be

Michael M. Tophoff

2006-01-01

400

Effects of bismuth vandate and anthraquinone dye on the photodegradation of polycarbonate  

Microsoft Academic Search

Compostos orgânicos e inorgânicos, tais como óxidos, sais de metais, compostos policíclicos e azo, são freqüentemente usados como colorantes para polímeros. O pigmento vanadato de bismuto vem sendo usado como uma alternativa a pigmentos baseados em cádmio. Corantes baseados na antraquinona pertencem a classe de colorantes policíclicos amplamente usados em polímeros. Além de suas características como colorantes, o vanadato de

Clodoaldo Saron; Maria Isabel Felisberti; Fabio Zulli; Marco Giordano

2007-01-01

401

Large-scale right-slip displacement on the East San Francisco Bay Region fault system, California: Implications for location of late Miocene to Pliocene Pacific plate boundary  

NASA Astrophysics Data System (ADS)

A belt of northwardly younging Neogene and Quaternary volcanic rocks and hydrothermal vein systems, together with a distinctive Cretaceous terrane of the Franciscan Complex (the Permanente terrane), exhibits about 160 to 170 km of cumulative dextral offset across faults of the East San Francisco Bay Region (ESFBR) fault system. The offset hydrothermal veins and volcanic rocks range in age from .01 Ma at the northwest end to about 17.6 Ma at the southeast end. In the fault block between the San Andreas and ESFBR fault systems, where volcanic rocks are scarce, hydrothermal vein system ages clearly indicate that the northward younging thermal overprint affected these rocks beginning about 18 Ma. The age progression of these volcanic rocks and hydrothermal vein systems is consistent with previously proposed models that relate northward propagation of the San Andreas transform to the opening of an asthenospheric window beneath the North American plate margin in the wake of subducting lithosphere. The similarity in the amount of offset of the Permanente terrane across the ESFBR fault system to that derived by restoring continuity in the northward younging age progression of volcanic rocks and hydrothermal veins suggests a model in which 80-110 km of offset are taken up 8 to 6 Ma on a fault aligned with the Bloomfield-Tolay-Franklin-Concord-Sunol-Calaveras faults. An additional 50-70 km of cumulative slip are taken up ? 6 Ma by the Rogers Creek-Hayward and Concord-Franklin-Sunol-Calaveras faults. An alternative model in which the Permanente terrane is offset about 80 km by pre-Miocene faults does not adequately restore the distribution of 8-12 Ma volcanic rocks and hydrothermal veins to a single northwardly younging age trend. If 80-110 km of slip was taken up by the ESFBR fault system between 8 and 6 Ma, dextral slip rates were 40-55 mm/yr. Such high rates might occur if the ESFBR fault system rather than the San Andreas fault acted as the transform margin at this time. Major transpression across the boundary between the Pacific and North American plates at about 3 to 5 Ma would have resulted in the transfer of significant slip back to the San Francisco Peninsula segment of the San Andreas fault. Since that time, the ESFBR fault system has continued to slip at rates of 11-14 mm/yr. If this interpretation is valid, the ESFBR fault system was the Pacific-North American plate boundary between 8 and 6 Ma, and this boundary has migrated both eastward and westward with time, in response to changing plate margin geometry and plate motions.

McLaughlin, R. J.; Sliter, W. V.; Sorg, D. H.; Russell, P. C.; Sarna-Wojcicki, A. M.

1996-02-01

402

PS1-61: Race and Receipt of Radiation Therapy with Curative Intent after Radical Prostatectomy for Prostate Cancer  

PubMed Central

Background/Aims We determined if differences existed in prostate cancer treatment received by Caucasian and African-American men who had local or biochemical recurrence following radical prostatectomy (RP) for prostate cancer at an HMO where access to medical care is theoretically equal for all members. We used data collected for a population-based case-control study designed to evaluate the role of specific molecular markers in prostate cancer survival. The subjects were diagnosed with prostate cancer from 1971 through 2001. Methods Study subjects were members of one of three health plans: Kaiser Permanente Northwest (KPNW), Kaiser Permanente Southern California (KPSC), or Kaiser Permanente Northern California (KPNC). The study population included 90 African-American and 233 Caucasian men with prostate cancer who had either local or biochemical recurrence following RP. We compared the likelihood, according to race, of treatment with salvage radiation therapy with curative intent (SRT) among these subjects. We reviewed medical records of all subjects to determine all treatment received in addition to RP and to assess potential confounding factors and effect modifiers. Results After adjusting for case/control status, institution, age at diagnosis, year of diagnosis, Gleason grade (all matching criteria in the original study), tumor stage, comorbid conditions, presence of positive margins, seminal vesicle involvement or perineural invasion at RP, age at recurrence, year of recurrence, time to recurrence, and intensity of follow-up, Caucasian men were more likely than African-American men to receive SRT in this study population (OR 1.5; 95% CI 0.7–3.1). However, this difference did not reach statistical significance. The factors that did predict for receipt of SRT were the absence of comorbid conditions (OR 2.1; 95% CI 1.1–4.2), recurrence prior to 1994 (OR 2.8; 95% CI 1.4–5.6), and local (rather than biochemical) recurrence (OR 6.9; 95% CI 2.6–18.6). Conclusions Although the difference in receipt of SRT between Caucasian and African-American men was not statistically significant, the point estimate suggests that Caucasian men were about 50% more likely to receive it. It is possible that this is a real difference, and that a study with a larger sample size would show that.

Richert-Boe, Kathryn; Haque, Reina; Van Den Eeden, Stephen; Weinmann, Sheila; Kallakury, Bhaskar

2013-01-01

403

PS1-61: Race and Receipt of Radiation Therapy with Curative Intent after Radical Prostatectomy for Prostate Cancer.  

PubMed

Background/Aims We determined if differences existed in prostate cancer treatment received by Caucasian and African-American men who had local or biochemical recurrence following radical prostatectomy (RP) for prostate cancer at an HMO where access to medical care is theoretically equal for all members. We used data collected for a population-based case-control study designed to evaluate the role of specific molecular markers in prostate cancer survival. The subjects were diagnosed with prostate cancer from 1971 through 2001. Methods Study subjects were members of one of three health plans: Kaiser Permanente Northwest (KPNW), Kaiser Permanente Southern California (KPSC), or Kaiser Permanente Northern California (KPNC). The study population included 90 African-American and 233 Caucasian men with prostate cancer who had either local or biochemical recurrence following RP. We compared the likelihood, according to race, of treatment with salvage radiation therapy with curative intent (SRT) among these subjects. We reviewed medical records of all subjects to determine all treatment received in addition to RP and to assess potential confounding factors and effect modifiers. Results After adjusting for case/control status, institution, age at diagnosis, year of diagnosis, Gleason grade (all matching criteria in the original study), tumor stage, comorbid conditions, presence of positive margins, seminal vesicle involvement or perineural invasion at RP, age at recurrence, year of recurrence, time to recurrence, and intensity of follow-up, Caucasian men were more likely than African-American men to receive SRT in this study population (OR 1.5; 95% CI 0.7-3.1). However, this difference did not reach statistical significance. The factors that did predict for receipt of SRT were the absence of comorbid conditions (OR 2.1; 95% CI 1.1-4.2), recurrence prior to 1994 (OR 2.8; 95% CI 1.4-5.6), and local (rather than biochemical) recurrence (OR 6.9; 95% CI 2.6-18.6). Conclusions Although the difference in receipt of SRT between Caucasian and African-American men was not statistically significant, the point estimate suggests that Caucasian men were about 50% more likely to receive it. It is possible that this is a real difference, and that a study with a larger sample size would show that. PMID:24085890

Richert-Boe, Kathryn; Haque, Reina; Van Den Eeden, Stephen; Weinmann, Sheila; Kallakury, Bhaskar

2013-09-01

404

How Dentists Diagnose and Treat Defective Restorations: Evidence from The Dental PBRN  

PubMed Central

Objectives to (1) identify and quantify the types of treatment that dentists in general dental practice use to manage defective dental restorations; and (2) identify characteristics that are associated with these dentists’ decisions to replace existing restorations. The Dental Practice-Based Research Network (DPBRN) comprises dentists in outpatient practices from five regions: AL/MS: Alabama/Mississippi, FL/GA: Florida/Georgia, MN: dentists employed by HealthPartners and private practitioners in Minnesota, PDA: Permanente Dental Associates in cooperation with Kaiser Permanente’s Center for Health Research, and SK: Denmark, Norway, and Sweden. Methods A questionnaire was sent to all DPBRN practitioner-investigators who reported doing at least some restorative dentistry (n=901). Questions included clinical case scenarios that used text and clinical photographs of defective restorations. Dentists were asked what type of treatment, if any, they would do in each scenario. Treatment options ranged from no treatment to full replacement of the restoration, with or without different preventive treatment options. We used logistic regression to analyze associations between the decision to intervene surgically (repair or replace) and specific dentist, practice, and patient characteristics. Results 512 (57%) DPBRN practitioner-investigators completed the survey. A total of 65% of dentists would replace a composite restoration when the defective margin is located on dentin; 49% would repair it when the defective margin is located on enamel. Most (52%) would not intervene surgically when the restoration in the scenario was amalgam. Dentists participating in solo or small private practice (SPP) chose surgical intervention more often than dentists who participate in large group practices (LGP) or in public health practices (PHP) (p<.0001). Dentists who do not routinely assess caries risk during treatment planning were more likely to intervene surgically and less likely to choose prevention treatment (p<.05). Dentists from the SK region chose the “no treatment” option more often than dentists in the other regions. Conclusions Dentists were more likely to intervene surgically when the restoration was an existing composite, compared to an amalgam restoration. Treatment options chosen by dentists varied significantly by specific clinical case scenario, whether the dentist routinely does caries risk assessment, type of practice, and DPBRN region.

Gordan, Valeria V; Garvan, Cynthia W; Richman, Joshua S; Fellows, Jeffrey L; Rindal, D. Brad; Qvist, Vibeke; Heft, Marc W.; Williams, O Dale; Gilbert, Gregg H

2010-01-01

405

Single-specialty versus multispecialty vascular surgery group model.  

PubMed

The shift in employment options for vascular surgeons in the current era of major health care reform is being widely debated. After the decision to seek hospital employment or independent practice, the choice of then practicing in a single-specialty or a multispecialty practice remains a difficult decision. Although the trend is toward medium-sized to large-sized groups, only 1.2% of medical practices currently have >11 physicians. Barring the large multispecialty groups, such as Kaiser Permanente, Cleveland Clinic, or Mayo Clinic, most vascular practices are constituted as small groups. Which format prospers will depend on adroit management of financial and intellectual capital and nimbleness in adapting to rapidly changing market conditions. In this report, two practicing vascular surgeons debate the merits of single or multispecialty practice, with a commentary to follow. PMID:23473931

Wixon, Christopher L; Jain, Krishna M; Satiani, Bhagwan

2013-03-06

406

A Physician Prescription for the Nursing Shortage  

PubMed Central

In 2003, the Colorado Permanente Medical Group (CPMG), a 780-member, multispecialty physician group that provides ambulatory and hospital care principally in metropolitan Denver and Boulder, embarked upon a multifaceted program to leverage physician leadership to address the nursing shortage. Designated as the “Preferred Clinical Partner Program” (the PCP Program), CPMG sought to participate in solving the nursing shortage by engaging in a number of initiatives. Through an initial fund of $1 million, over $350,000 was used to fund nursing scholarships, over $150,000 was used to provide advanced training to a select group of health care professionals in a program that may be the first physician-partnered MA-to-LPN and RN-to-BSN initiative, and over $500,000 was devoted to building and expanding nursing simulation laboratories. Currently, the accelerated nursing program graduates approximately 32–35 nurses each year and has admitted its seventh cohort of students. Student retention has been excellent.

Cochran, John H

2010-01-01

407

Use of electronic health records can improve the health care industry's environmental footprint.  

PubMed

Electronic health records have the potential to improve the environmental footprint of the health care industry. We estimate that Kaiser Permanente's electronic health record system, which covers 8.7 million beneficiaries, eliminated 1,000 tons of paper records and 68 tons of x-ray film, and that it has lowered gasoline consumption among patients who otherwise would have made trips to the doctor by at least three million gallons per year. However, the use of personal computers resulted in higher energy consumption and generated an additional 250 tons of waste. We conclude that electronic health records have a positive net effect on the environment, and that our model for evaluating their impact can be used to determine whether their use can improve communities' health. PMID:21555478

Turley, Marianne; Porter, Catherine; Garrido, Terhilda; Gerwig, Kathy; Young, Scott; Radler, Linda; Shaber, Ruth

2011-05-01

408

Neural sheath tumors of the brachial plexus: a multidisciplinary team-based approach.  

PubMed

Peripheral tumors of the brachial plexus, although rare, provide an opportunity for the plastic surgeon to coordinate a multidisciplinary team and achieve excellent outcomes. Most of the case series are reported from the neurosurgical literature. We report on the experience of the Kaiser Permanente Brachial Plexus Clinic over a recent 2-year period. A retrospective review was conducted to examine the medical records, radiographic images, operative reports, and pathologic findings of 13 consecutive patients with peripheral nerve sheath tumors of brachial plexus origin. Of the 10 patients requiring surgical exploration, 90% had significant improvement or resolution of pain, with sensory and motor recovery showing mixed results. Average follow-up consisted of 2 years with occupational therapy beginning shortly after operative intervention. Our results are similar to or better than those published in the literature. The plastic surgeon with subspecialty training can safely and successfully treat tumors of the brachial plexus by implementing a multidisciplinary approach. PMID:23392262

Soltani, Ali M; Francis, Cameron S; Kane, Justin T; Kazimiroff, Paul B; Edgerton, Bradford W

2013-07-01

409

G??lapagos: computer-based support for evolution of a convergent medical terminology.  

PubMed Central

Current controlled medical terminologies fall short of the needs of informatics application developers. To overcome the limitations of current medical terminologies, many groups are independently enhancing existing terminologies to meet their local needs. With proper computer-based support, local enhancements can be used as evolutionary stepping stones toward a convergent medical terminology. Gálapagos is a collection of applications that can take local enhancements from multiple sites, identify conflicting design decisions, allow developers to reconcile the conflicting designs, and efficiently disseminate updates tailored specifically for compatibility with locally enhanced terminologies. This paper describes an initial proof-of-concept of the Gálapagos programs using data generated during concurrent SNOMED enhancement by Kaiser Permanente and the Mayo Clinic.

Campbell, K. E.; Cohn, S. P.; Chute, C. G.; Rennels, G.; Shortliffe, E. H.

1996-01-01

410

Outcomes in Treatment for Intradural Spinal Cord Ependymomas  

SciTech Connect

Purpose: Spinal cord ependymomas are rare tumors, accounting for <2% of all primary central nervous system tumors. This study assessed the treatment outcomes for patients diagnosed with spinal cord ependymomas within the Southern California Kaiser Permanente system. Methods and Materials: We studied 23 patients treated with surgery with or without external beam radiotherapy (EBRT). The local and distant control rates and overall survival rates were determined. Results: The overall local control, overall recurrence, and 9-year overall survival rate was 96%, 17.4%, and 63.9%, respectively. Conclusions: The results of our study indicate that en bloc gross total resection should be the initial treatment, with radiotherapy reserved primarily for postoperative cases with unfavorable characteristics such as residual tumor, anaplastic histologic features, or piecemeal resection. Excellent local control and overall survival rates can be achieved using modern microsurgical techniques, with or without local radiotherapy.

Volpp, P. Brian [Department of Radiation Oncology, Kaiser Permanente, Los Angeles, CA (United States)], E-mail: pvolpp@yahoo.com; Han, Khanh [Huntington Memorial Medical Center, Pasadena, CA (United States); Kagan, A. Robert; Tome, Michael [Department of Radiation Oncology, Kaiser Permanente, Los Angeles, CA (United States)

2007-11-15

411

Trimble Vrs Concept  

NASA Astrophysics Data System (ADS)

Presenting the Trimble Virtual Reference Station (VRS) concept. High accuracy Real-Time Kinematic Positioning with GPS is one of todaySs most widely used surveying techniques. But, its use is restricted by the effects of the iono- sphere and troposphere which create systematic errors in the raw data. In practice, these mean that the distance between a rover (mobile) receiver and its reference sta- tion has to be quite short in order to work efficiently. The concept of Virtual Reference Stations offers a new opportunity. When used, the systematic errors in the reference station data are either reduced, or eliminated. This not only allows a user to increase the distance at which the rover receiver is located from the reference, it also increases the reliability of the system and reduces the OTF initialization time. The presentation describes the setup of a VRS system, as well the used model to reduce the error influence in such a permanente reference station network.

Luttenberger, C.

412

Ranked Levels of Influence Model: Selecting Influence Techniques to Minimize IT Resistance  

PubMed Central

Implementation of electronic health records (EHR), particularly computerized physician/provider order entry systems (CPOE), is often met with resistance. Influence presented at the right time, in the right manner, may minimize resistance or at least limit the risk of complete system failure. Combining established theories on power, influence tactics, and resistance, we developed the Ranked Levels of Influence model. Applying it to documented examples of EHR/CPOE failures at Cedars-Sinai and Kaiser Permanente in Hawaii, we evaluated the influence applied, the resistance encountered, and the resulting risk to the system implementation. Using the Ranked Levels of Influence model as a guideline, we demonstrate that these system failures were associated with the use of hard influence tactics that resulted in higher levels of resistance. We suggest that when influence tactics remain at the soft tactics level, the level of resistance stabilizes or de-escalates and the system can be saved.

Bartos, Christa E.; Butler, Brian S.; Crowley, Rebecca S.

2010-01-01

413

Career ladder program for registered nurses in ambulatory care.  

PubMed

RN ladder programs are designed to inspire and reward clinical excellence. Kaiser Permanente Colorado's (KPCO) career ladder program emerged as a result of a labor-management partnership. Career ladder point assignments are reflective of the organization's priorities and values. KPCO's career ladder point tool awards RNs for formal and continuing education, professional presentations, organizational experience and experience as an RN, certifications and active professional memberships, leadership activities, research and publications, and nursing-related volunteer work. Participation in the RN career ladder requires that the nurse achieve a self-determined, manager-approved, measurable goal that will improve patient care. Career ladder nurses at KPCO were significantly more involved in leadership and interdisciplinary activities, quality improvement projects, and preceptorship. PMID:19330975

Nelson, Joan; Sassaman, Becky; Phillips, Alison

414

Sustaining engagement and partnership: model of enhancing cultural capital among nonaffiliated IRB members.  

PubMed

Although federal regulations require the presence of at least one nonaffiliated member on the roster of an institutional review board (IRB), little research exists about how to foster their participation and satisfaction. Guided by principles of justice and diversity, the Kaiser Permanente Southern California IRB adapted the sociological concept of "cultural capital" to develop training and support with its nonaffiliated IRB members. Using in-depth qualitative interviews with four past and current nonaffiliated IRB members, we describe how our initial and ongoing activities enhanced their ability to analyze, communicate, and complete the ethical review of research. This case study is situated in the gaps of existing research about nonaffiliated IRB members by providing insights into how to sustain their engagement while protecting the rights of research volunteers, particularly from vulnerable communities. PMID:23933774

Hung, Yvonne; Ayala, Armida; Morales, Francisco; Frierman-Hunt, Gina; Moreno, Alva; Nwachuku, Ijeoma

2013-07-01

415

The New York Academy of Medicine: Current Grey Literature Report  

NSDL National Science Digital Library

The New York Academy of Medicine has been around since 1847, and they have had a distinctly urban mission since their founding. Their online library contains a number of resources for medical doctors and other health care professionals, and the Grey Literature Report is one of the most compelling offerings on their site. The Report was started in 1999, and it was initially intended for internal research purposes. Currently, the Report is now published bimonthly by the Academy Library, and it contains "unindexed materials that are not produced by commercial publishers and are unavailable through normal, commercial distribution channels." The documents include case studies, conference proceedings, fact sheets, government documents, research reports, and white papers. Recent editions of the Report have included timely works from the AARP, the Commonwealth Fund, the John A. Hartford Foundation, and the Kaiser Permanente Institute for Health Policy.

416

Experience using radio frequency laptops to access the electronic medical record in exam rooms.  

PubMed Central

Kaiser Permanente, Northwest, evaluated the use of laptop computers to access our existing comprehensive Electronic Medical Record in exam rooms via a wireless radiofrequency (RF) network. Eleven of 22 clinicians who were offered the laptops successfully adopted their use in the exam room. These clinicians were able to increase their exam room time with the patient by almost 4 minutes (25%), apparently without lengthening their overall work day. Patient response to exam room computing was overwhelmingly positive. The RF network response time was similar to the hardwired network. Problems cited by some laptop users and many of the eleven non-adopters included battery issues, different equipment layout and function, and inadequate training. IT support needs for the RF laptops were two to four times greater than for hardwired desktops. Addressing the reliability and training issues should increase clinician acceptance, making a successful general roll-out for exam room computing more likely.

Dworkin, L. A.; Krall, M.; Chin, H.; Robertson, N.; Harris, J.; Hughes, J.

1999-01-01

417

An HMO-Based Prospective Pilot Study of Energy Medicine for Chronic Headaches: Whole-Person Outcomes Point to the Need for New Instrumentation  

PubMed Central

Abstract Objectives The purpose of this study was to evaluate an energy healing treatment for possible inclusion as a Kaiser Permanente Northwest (KPNW) Pain Clinic provided therapy, and to identify the appropriate number of treatment sessions for a Pain Clinic protocol, should the intervention prove successful. In addition, our intent was to document the full range of outcomes experienced by patients undergoing energy healing, including whole-person and transformative outcomes should they occur. Setting The setting for this study was Kaiser Permanente Northwest Pain Clinic. Participants Thirteen (13) patients with chronic headache who were members of the KPNW Health Plan were recruited through flyers or mailings. Methods Thirteen (13) participants received at least three energy healing sessions at approximately weekly intervals. Assessments were based on pre- and post-treatment qualitative interviews. Intervention The treatment consisted of three Healing Touch sessions provided by a Certified Healing Touch Practitioner. Treatments contained elements common to all sessions, and elements that were tailored to the individual subject. Results Twelve (12) of 13 participants experienced improvement in frequency, intensity, or duration of pain after three treatments. In addition, 11 of 13 participants experienced profound shifts in their view of themselves, their lives, and their potential for healing and transformation. These changes lasted from 24 hours to more than 6 months at follow-up. Conclusions Energy healing can be an important addition to pain management services. More in-depth qualitative research is needed to explore the diversity of outcomes facilitated by energy healing treatments. Furthermore, the development of new instrumentation is warranted to capture outcomes that reflect transformative change and changes at the level of the whole person.

Ritenbaugh, Cheryl; Kiley, Susan J.; Vuckovic, Nancy; Elder, Charles

2009-01-01

418

Effect of Direct Physician Involvement on Tobacco Abstinence Rates and Other Variables Affecting Participants of a Freedom from Tobacco Class  

PubMed Central

Context Kaiser Permanente measures how often tobacco users are offered strategies to quit but not the success of such strategies. Objective: To compare tobacco abstinence rates for participants of the Kaiser Permanente Riverside (California) Medical Center’s Freedom from Tobacco Class in 2008, before direct physician involvement, and in 2009, after direct physician involvement, and to compare other variables affecting these rates. Design: In a retrospective study, participants were divided into two groups based on year of participation. Data were collected using electronic medical records and phone interviews. Main Outcome Measures: Tobacco use status between both groups at 1, 3, 6, and 12 months after the classes started and within groups by sex, number of classes attended, medication received, and class teacher. Results: The 12-month abstinence rates were 27% in 2008 and 33% in 2009 (p = 0.3). The abstinence rate for men improved from 23% to 38% (2008 vs 2009; p = 0.05), whereas for women it was 30% vs 27% (p = 0.7). Abstinence rates decreased over time for the group as a whole (p < 0.001). Attendance of 6 or more classes was associated with higher abstinence rates. There was no significant impact on abstinence rates due to age, body mass index, class teacher, or medications used. Conclusion: Direct physician involvement improved men’s but not women’s abstinence rates among class participants. The relapse rate was significant over the first year after the class. Further research is needed to study the difference between sexes and the factors affecting relapse.

Ismail, Mohamed H; Ho, Ngoc J; Lara, Nancy Irazu

2013-01-01

419

Qualitative Factors in Patients who Die Shortly After Emergency Department Discharge  

PubMed Central

Objective Early death after ED discharge may signal opportunities to improve care. Prior studies are limited by incomplete mortality ascertainment and lack of clinically important information in administrative data. Our goal in this hypothesis-generating study was to identify patient and process of care-level themes that may provide possible explanations for early post-discharge mortality. Methods We conducted a qualitative analysis of medical records of adult patients who visited any of six hospitals in an integrated health system (Kaiser Permanente Southern California – KPSC) ED and died within 7 days of discharge in 2007 and 2008. We excluded non-members, visits to non-health plan hospitals, patients receiving or referred to hospice care, and patient with Do Not Resuscitate or Do Not Intubate orders. Under the guidance of two qualitative research scientists, a team of three emergency physicians utilized grounded theory techniques to identify patient clinical presentations and processes of care that serve as potential explanations for poor outcome after discharge. Results The source population consisted of a total of 290,092 members with 446,120 discharges from 6 Kaiser Permanente Southern California EDs in 2007 and 2008. A total of 203 deaths occurred within 7 days of ED discharge (0.05%). Sixty-one randomly chosen cases were reviewed. Patient level themes that emerged included an unexplained persistent acute change in mental status, recent fall, abnormal vital signs, ill appearing presentation, malfunctioning indwelling device, and presenting symptoms remaining at discharge. Process of care factors included a discrepancy in history of present illness, incomplete physical exam, and change of discharge plan by a third party, such as a consulting or admitting physician. Conclusions In this hypothesis-generating study, we used qualitative research techniques to identify clinical and process of care factors in patients who die within 7-days after discharge from an ED. These potential predictors will be formally tested in a future quantitative study.

Gabayan, Gelareh Z.; Sun, Benjamin C.; Asch, Steven M.; Timmermans, Stefan; Sarkisian, Catherine; Yiu, Sau; Lancaster, Elizabeth M.; Poon, K. Trudy; Kellermann, Arthur L.; Ryan, Gery; Miniel, Nicholas J.; Flansbaum, Drew; Hoffman, Jerome R.; Derose, Stephen F.

2013-01-01

420

Recent trends in childhood attention-deficit/hyperactivity disorder.  

PubMed

OBJECTIVE To examine trends in attention-deficit/hyperactivity disorder (ADHD) by race/ethnicity, age, sex, and median household income. DESIGN An ecologic study of trends in the diagnosis of ADHD using the Kaiser Permanente Southern California (KPSC) health plan medical records. Rates of ADHD diagnosis were derived using Poisson regression analyses after adjustments for potential confounders. SETTING Kaiser Permanente Southern California, Pasadena. PARTICIPANTS All children who received care at the KPSC from January 1, 2001, through December 31, 2010 (n = 842 830). MAIN EXPOSURE Period of ADHD diagnosis (in years). MAIN OUTCOME MEASURES Incidence of physician-diagnosed ADHD in children aged 5 to 11 years. RESULTS Rates of ADHD diagnosis were 2.5% in 2001 and 3.1% in 2010, a relative increase of 24%. From 2001 to 2010, the rate increased among whites (4.7%-5.6%; relative risk [RR] = 1.3; 95% CI, 1.2-1.4), blacks (2.6%- 4.1%; RR = 1.7; 95% CI, 1.5-1.9), and Hispanics (1.7%-2.5%; RR = 1.6; 95% CI, 1.5-1.7). Rates for Asian/Pacific Islander and other racial groups remained unchanged over time. The increase in ADHD diagnosis among blacks was largely driven by an increase in females (RR = 1.9; 95% CI, 1.5-2.3). Although boys were more likely to be diagnosed as having ADHD than girls, results suggest the sex gap for blacks may be closing over time. Children living in high-income households were at increased risk of diagnosis. CONCLUSIONS The findings suggest that the rate of ADHD diagnosis among children in the health plan notably has increased over time. We observed disproportionately high ADHD diagnosis rates among white children and notable increases among black girls. PMID:23338799

Getahun, Darios; Jacobsen, Steven J; Fassett, Michael J; Chen, Wansu; Demissie, Kitaw; Rhoads, George G

2013-03-01

421

PS3-29: Impact of BMI and Change in BMI on Progression from Normotension to Prehypertension or Hypertension in Patients Ages 3-17  

PubMed Central

Background/Aims Overweight and obesity among US children and adolescents is an important public health problem. Conditions associated with obesity, such as type 2 diabetes, hypertension, and hypercholesterolemia, are becoming more common in children. This study examined the relationship between changes in BMI percentile and incident prehypertension and hypertension in a cohort of children and adolescents. Methods Study subjects were 23,578 patients, ages 3–17, with three or more outpatient primary care visits between 2007 and 2010 at HealthPartners Medical Group, Kaiser Permanente Colorado, or Kaiser Permanente Northern California. Data were extracted from electronic health records (EHR). Change in BMI was defined as: increase, decrease, stayed obese, stayed overweight, and stayed healthy weight using established BMI percentile cut-points. Incident prehypertension and hypertension were defined using blood pressures and diagnosis codes from the EHR. We used time-dependent Cox proportional hazards models to estimate the hazard of change in BMI percentile with incident prehypertension and hypertension. Results Over a median 2.6 years follow-up, there were 7,232 cases of incident prehypertension, 148 diagnoses of incident hypertension, and 107 additional cases of incident hypertension based on blood pressure data from the EHR. Seventy-one prehypertensives went on to develop hypertension. Those who stayed obese, stayed overweight, and increased BMI had increased hazard of incident prehypertension (1.96, 1.39, and 1.49, respectively) and increased hazard of incident hypertension (3.61, 1.21, and 1.83, respectively) compared with those who stayed healthy weight. Conclusions Persistently high BMI or increasing BMI over time was associated with pronounced increase in risk of both incident prehypertension and hypertension. Future research should examine factors associated with the development and recognition of hypertension.

Parker, Emily; O'Connor, Patrick; Kharbanda, Elyse; Adams, Kenneth; Sinaiko, Alan; Margolis, Karen; Greenspan, Louise; Magid, David; Daley, Matthew; Sherwood, Nancy

2013-01-01

422

Spanish brochure WR for web.pmd  

Center for Drug Evaluation (CDER)

Text Version... Algunos pueden evitar enfermedades como las caries dentales, curar enfermedades como el pie de atleta y, con la guía de un médico, ayudan a ... More results from www.fda.gov/downloads/drugs/emergencypreparedness

423

Spanish brochure WR for web.pmd  

Center for Drug Evaluation (CDER)

Text Version... medicamentos pueden también interaccionar con alimentos y bebidas, así como con condiciones médicas como la diabetes, las enfermedades de ... More results from www.fda.gov/downloads/drugs/resourcesforyou

424

ANÁLISIS DE LA EFICACIA PUBLICITARIA EN INTERNET  

Microsoft Academic Search

Internet ha surgido como un nuevo medio que se establece desde una doble perspectiva, como nuevo canal de distribución y como canal de comunicación. Desde este enfoque, permite que los consumidores tengan acceso ilimitado a cualquier información y tener un mayor control sobre la exposición a la publicidad, porque existe la posibilidad de seleccionar la cantidad de contenido comercial que

J. J. Blázquez Resino; A. Molina Collado; A. Esteban Talaya; D. Martín-Consuegra Navarro

2008-01-01

425

Educación y equidad. Algunos aportes desde la noción de educabilidad 1  

Microsoft Academic Search

La gran mayoría de los estudios orientados a esclarecer la relación entre educación y equidad social coinciden en centrar la atención en la educación como una condición indispensable para el logro de una sociedad más equitativa. Los argumentos que permiten pensar a la educación como una instancia previa a la equidad, como su condición de posibilidad, son muy diversos, y

Néstor López

426

Caracterização anatômica, química e antibacteriana de folhas de Brunfelsia uniflora (manacá) presentes na Mata Atlântica  

Microsoft Academic Search

RESUMO: Brunfelsiauniflora é uma espécie pertencente à família Solanaceae conhecida popularmente como manacá e empregada em medicina popular, suas folhas são empregadas contra artrite, reumatismo, sífilis, picadas de cobra, febre amarela, e ainda como diurética e antitérmica. Objetivou-se realizar um estudo anatômico foliar, através de microscopia de luz e de eletrônica de varredura, bem como análises químicas do extrato foliar

Maria Bernadete Gonçalves Martins; Rebeca de René Graf; Alberto J. Cavalheiro; Selma D. Rodrigues

2009-01-01

427

LA GERENCIA DE PROYECTOS DE RESPONSABILIDAD SOCIAL: UN PROBLEMA ÉTICO PRIORITARIO EN LA AGENDA UNIVERSITARIA THE MANAGEMENT OF SOCIAL RESPONSIBILITY PROJECTS: A HIGH-PRIORITY ETHICAL PROBLEM IN THE UNIVERSITY AGENDA  

Microsoft Academic Search

RESUMEN Este trabajo destaca que la gerencia de proyecto de Responsabilidad Social es una urgencia ética en la agenda de las organizaciones universitarias. Se razona sobre la Responsabilidad Social como macro proyecto ético universitario; como se han manejado los proyectos en el ámbito universitario y sobre como el Modelo Intellectus es una opción exitosa. Mediante una Investigación documental, se concluyó

Revista ORBIS; Ciencias Humanas; Jorge Palencia; Isis Bracho; Lesbia Vargas

428

Diferencias por sexo en los criterios y estándares de productividad científica y docente en profesores funcionarios en España  

Microsoft Academic Search

El objetivo del presente trabajo es analizar las diferencias en la opinión que tienen los profesores y pro- fesoras universitarios españoles sobre los criterios y estándares de productividad científica, así como el número mínimo en éstos para ser acreditado como Profesor Titular de Universidad (PTU) o como Catedrático de Universidad (CU). Para ello se encuestó a una muestra de 960

Juan Carlos Sierra; Gualberto Buela-Casal; María Paz Bermúdez; Pablo Santos-Iglesias

2009-01-01

429

GESTÃO DA INFORMAÇÃO E MONITORAMENTO TECNOLÓGICO: O MERCADO DOS FUTUROS GENÉRICOS INFORMATION MANAGEMENT AND TECHNOLOGICAL MONITORING: THE MARKET FOR FUTURE GENERIC DRUGS  

Microsoft Academic Search

Resumo: O presente estudo sobre o mercado dos medicamentos genéricos visa demonstrar, dentre outras, a gestão da informação como mecanismo de apoio ao monitoramento tecnológico e tomada de decisão, tendo como vetor principal análise de patentes. Este estudo aplica a metodologia de inteligência competitiva no sentido de viabilizar a monitoração de drogas genéricas (ind. farmoquímica), bem como formulações (ind. farmacêutica),

Claudia CANONGIA; Adelaide ANTUNES; Maria de Nazaré PEREIRA

430

¿Y PARA QUÉ ME VALE A MÍ LA HISTORIA?  

Microsoft Academic Search

La historia se sitúa como un instrumento idóneo para el desarrollo, no ya sólo de los conocidos como países poco desarrollados, sino también para los denominados desarrollados. Aparece como una herramienta de integración de conocimientos y que arma al ciudadano con destrezas propias y necesarias para su desarrollo personal, pero también para el desarrollo colectivo de la sociedad. Podemos usarla

Antonio Manuel Luna González

2009-01-01

431

El desarrollo humano integral, la teoría de sistemas y el concepto de competencias en el ámbito académico universitario Integral human development and the concept of competitions in the university academic environment  

Microsoft Academic Search

RESUMEN: la Educación puede ser considerada como un proceso social, en el cual cada actividad y cada actor del proceso, deben tender hacia un desarrollo humano integral. En este sentido, el desarrollo humano podría ser visto como un promo - tor y conductor de mejora tanto personal como social. Hoy en día, sin embargo, la economía de libre mercado, es

Comunicación Técnica; Hilda L. Cárdenas

432

Familias Multiproblemáticas y en Riesgo Social: Características e Intervención Multiproblem Families at Social Risk: Characteristics and Intervention  

Microsoft Academic Search

El artículo comprende la familia multiproblemática como un sistema vulnerable de alto riesgo, tanto por la acción de sus mecanismos internos, como de fuerzas sociales que potencian su disfuncionalidad. Tras una extensa revisión bibliográfi ca, los autores proponen como sus características centrales la polisintomatología y crisis recurrentes, la desorganización, el abandono de las funciones parentales y el aislamiento, focalizando específi

Esteban Gómez; María Magdalena Muñoz; Ana María Ha

433

A general binomial regression model to estimate standardized risk differences from binary response data.  

PubMed

Estimates of absolute risks and risk differences are necessary for evaluating the clinical and population impact of biomedical research findings. We have developed a linear-expit regression model (LEXPIT) to incorporate linear and nonlinear risk effects to estimate absolute risk from studies of a binary outcome. The LEXPIT is a generalization of both the binomial linear and logistic regression models. The coefficients of the LEXPIT linear terms estimate adjusted risk differences, whereas the exponentiated nonlinear terms estimate residual odds ratios. The LEXPIT could be particularly useful for epidemiological studies of risk association, where adjustment for multiple confounding variables is common. We present a constrained maximum likelihood estimation algorithm that ensures the feasibility of risk estimates of the LEXPIT model and describe procedures for defining the feasible region of the parameter space, judging convergence, and evaluating boundary cases. Simulations demonstrate that the methodology is computationally robust and yields feasible, consistent estimators. We applied the LEXPIT model to estimate the absolute 5-year risk of cervical precancer or cancer associated with different Pap and human papillomavirus test results in 167,171 women undergoing screening at Kaiser Permanente Northern California. The LEXPIT model found an increased risk due to abnormal Pap test in human papillomavirus-negative that was not detected with logistic regression. Our R package blm provides free and easy-to-use software for fitting the LEXPIT model. PMID:22865328

Kovalchik, Stephanie A; Varadhan, Ravi; Fetterman, Barbara; Poitras, Nancy E; Wacholder, Sholom; Katki, Hormuzd A

2012-08-02

434

Human papillomavirus genotyping after denaturation of specimens for Hybrid Capture 2 testing: feasibility study for the HPV persistence and progression cohort.  

PubMed

Human papillomavirus (HPV) genotyping could be clinically useful, depending on the results of large, prospective studies like the HPV persistence and progression (PaP) cohort. The cohort is based on genotyping and follow-up of Hybrid Capture-positive women at Kaiser Permanente, Northern California. HPV DNA testing by Hybrid Capture 2 requires denaturation with alkali, possibly damaging the DNA for optimal PCR-based genotyping. A feasibility study was conducted on paired aliquots of anonymized specimens from 100 women with low-grade intraepithelial lesion cytology. Test aliquots were left in denaturant for 10 or 18h at 4 degrees C and then neutralized; comparison aliquots were not denatured but diluted to match the timing, temperature, concentration and salt conditions of the treated specimens. The masked aliquots were tested using a commercialized PCR-based assay that detects of 37 HPV genotypes. There was no overall effect of treatment on test positivity or number of types. HPV16 was marginally more likely to be detected in untreated versus treated aliquots (P=0.09) but HPV45 was marginally more likely to be detected in treated than untreated aliquots (P=0.07), suggesting that these differences represented chance (intra-test variability). It can be concluded that residual Hybrid Capture-positive specimens can be genotyped by PCR after Hybrid Capture 2 processing. PMID:17673302

LaMere, Brandon J; Kornegay, Janet; Fetterman, Barbara; Sadorra, Mark; Shieh, Jen; Castle, Philip E

2007-07-27

435

Five-Year Experience of Human Papillomavirus DNA and Papanicolaou Test Cotesting  

PubMed Central

Objective To estimate the 5-year age group-specific test positives for Papanicolaou (Pap) tests and human papillomavirus (HPV) testing in a large, general screening population of women 30 and older. Methods Using data from Kaiser Permanente Northern California, a large health maintenance organization that introduced cotesting in 2003, we evaluated the cotesting results overall and by 5-year age groups. Women (n=580,289) who opted for and underwent cotesting (n cotests=812,598) between January, 2003 and April, 2008 were included in the analysis. Pap tests interpreted as atypical squamous cells of undetermined significance (ASC-US) or more severe were considered to be positive. Women were tested for carcinogenic HPV using an assay approved by the U.S. Food and Drug Administration. Binomial exact 95% confidence intervals (CI) were calculated. Results Overall, 6.27% (CI = 6.21%–6.32%) of cotests were assay positive, and only 3.99% (CI = 3.94%–4.03%) cotests had normal cytology and were assay-positive. By comparison, 5.18% (CI = 5.13%–5.23%) of cotests had ASC-US or more severe cytology, and 2.87% (CI = 2.84%–2.91%) of cotests had ASC-US or more severe cytology and were assay-negative. Conclusions In a general screening population, concerns about excessive HPV test positives among women 30 and older are not borne out.

Castle, Philip E.; Fetterman, Barbara; (ASCP), SCT; Poitras, Nancy; Lorey, Thomas; Shaber, Ruth; Kinney, Walter

2009-01-01

436

Human Papillomavirus Genotyping After Denaturation of Specimens for Hybrid Capture 2 Testing: Feasibility Study for the HPV Persistence and Progression Cohort†  

PubMed Central

Human papillomavirus (HPV) genotyping could be clinically useful, depending on the results of large, prospective studies like the HPV Persistence and Progression cohort. The cohort is based on genotyping and follow-up of Hybrid Capture-positive women at Kaiser Permanente, Northern California. HPV DNA testing by Hybrid Capture 2 requires denaturation with alkali, possibly damaging the DNA for optimal PCR-based genotyping. A feasibility study was conducted on paired aliquots of anonymized specimens from 100 women with low-grade intraepithelial lesion cytology. Test aliquots were left in denaturant for 10 or 18 hours at 4°C and then neutralized; comparison aliquots were not denatured but diluted to match the timing, temperature, concentration and salt conditions of the treated specimens. The masked aliquots were tested using a commercialized PCR-based assay that detects of 37 HPV genotypes. There was no overall effect of treatment on test positivity or number of types. HPV16 was marginally more likely to be detected in untreated versus treated aliquots (P = 0.09) but HPV45 was marginally more likely to be detected in treated than untreated aliquots (P = 0.07), suggesting that these differences represented chance (intra-test variability). It can be concluded that residual Hybrid Capture-positive specimens can be accurately genotyped by PCR after Hybrid Capture 2 processing.

LaMere, Brandon J.; Kornegay, Janet; Fetterman, Barbara; Sadorra, Mark; Shieh, Jen; Castle, Philip E.

2009-01-01

437

Parental Decline of Pneumococcal Vaccination and Risk of Pneumococcal Related Disease in Children  

PubMed Central

Background An increasing number of parents are choosing to decline immunizations for their children. This study examined the association between the parental decision to decline pneumococcal conjugate (PCV7) vaccinations and the risk of hospitalization due to pneumococcal disease or lobar pneumonia in children. Methods We conducted a case-control study nested within a cohort of children enrolled in the Kaiser Permanente Colorado (KPCO) health plan between 2004 and 2009. Each child hospitalized with pneumococcal disease or lobar pneumonia (n=106) was matched to 4 randomly selected controls (n=401). Cases were matched to controls by age, sex, high-risk status, calendar time, and length of enrollment in KPCO. Disease status and parental vaccination decisions were validated with medical record review. Cases and controls were classified as vaccine decliners or vaccine acceptors. Results Among 106 cases, there were 6 (6%) PCV7 vaccine decliners; among 401 controls, there were 4 (1%) vaccine decliners. Children of parents who declined PCV7 immunization were 6.5 times (OR=6.5; 95% CI=1.7, 24.5) more likely to be hospitalized for invasive pneumococcal disease or lobar pneumonia than vaccinated children. Conclusions Parental decline of pneumococcal vaccination apparently increases the risk for hospitalization due to pneumococcal disease or lobar pneumonia in children. Providers can use this information when helping parents weigh the benefits and risks of immunizing their children.

Glanz, Jason M.; McClure, David L.; O'Leary, Sean T.; Narwaney, Komal J.; Magid, David J.; Daley, Matthew F.; Hambidge, Simon J.

2010-01-01

438

Clinician's use of automated reports of estimated glomerular filtration rate: A qualitative study  

PubMed Central

Background There is a growing awareness in primary care of the importance of identifying patients with chronic kidney disease (CKD) so that they can receive appropriate clinical care; one method that has been widely embraced is the use of automated reporting of estimated glomerular filtration rate (eGFR) by clinical laboratories. We undertook a qualitative study to examine how clinicians use eGFR in clinical decision making, patient communication issues, barriers to use of eGFR, and suggestions to improve the clinical usefulness of eGFR reports. Methods Our study used qualitative methods with structured interviews among primary care clinicians including both physicians and allied health providers, recruited from Kaiser Permanente Northwest, a non-profit health maintenance organization. Results We found that clinicians generally held favorable views toward eGFR reporting but did not use eGFR to replace serum creatinine in their clinical decision-making. Clinicians used eGFR as a tool to help identify CKD, educate patients about their kidney function and make treatment decisions. Barriers noted by several clinicians included a desire for greater education regarding care for patients with CKD and tools to facilitate discussion of eGFR findings with patients. Conclusions The manner in which clinicians use eGFRs appears to be more complex than previously understood, and our study illustrates some of the efforts that might be usefully undertaken (e.g. specific clinician education) when encouraging further promulgation of eGFR reporting and usage.

2012-01-01

439

2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors.  

PubMed

A group of 47 experts representing 23 professional societies, national and international health organizations, and federal agencies met in Bethesda, MD, September 14-15, 2012, to revise the 2006 American Society for Colposcopy and Cervical Pathology Consensus Guidelines. The group's goal was to provide revised evidence-based consensus guidelines for managing women with abnormal cervical cancer screening tests, cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS) following adoption of cervical cancer screening guidelines incorporating longer screening intervals and co-testing. In addition to literature review, data from almost 1.4 million women in the Kaiser Permanente Northern California Medical Care Plan provided evidence on risk after abnormal tests. Where data were available, guidelines prescribed similar management for women with similar risks for CIN 3, AIS, and cancer. Most prior guidelines were reaffirmed. Examples of updates include: Human papillomavirus-negative atypical squamous cells of undetermined significance results are followed with co-testing at 3 years before return to routine screening and are not sufficient for exiting women from screening at age 65 years; women aged 21-24 years need less invasive management, especially for minor abnormalities; postcolposcopy management strategies incorporate co-testing; endocervical sampling reported as CIN 1 should be managed as CIN 1; unsatisfactory cytology should be repeated in most circumstances, even when HPV results from co-testing are known, while most cases of negative cytology with absent or insufficient endocervical cells or transformation zone component can be managed without intensive follow-up. PMID:23519301

Massad, L Stewart; Einstein, Mark H; Huh, Warner K; Katki, Hormuzd A; Kinney, Walter K; Schiffman, Mark; Solomon, Diane; Wentzensen, Nicolas; Lawson, Herschel W

2013-04-01

440

Making the hospital safer for older adult patients: a focus on the indwelling urinary catheter.  

PubMed

The needs of hospitalized geriatric patients differ from the needs of hospitalized younger adults. In an attempt to improve systems of care for the older adult, the Centers for Medicare and Medicaid Services classified urinary tract infections related to the use of indwelling urinary catheters (IUC) as one of eight "never events." The insertion of an IUC is a commonly performed procedure that can cause an array of iatrogenic complications. In addition, the placement of an IUC without medical indication is a risk factor for prolonged hospitalization and inpatient mortality. Foley catheterization has been documented as a culprit in urosepsis and as being associated with geriatric syndromes such as delirium and functional impairment. This article will discuss the indications for the IUC, the complications that can occur because of the IUC, and comment on the Kaiser Permanente Southern California Region's efforts to minimize the unnecessary use of the IUC. Thoughtful and judicious use of the IUC, such as minimizing the use of urinary catheterization, either by not inserting an IUC or by removing it as soon as it is no longer needed, will most likely reduce inpatient morbidity and improve the health of the hospitalized older adult. PMID:21505618

Lee, Eric A; Malatt, Camille

2011-01-01

441

Up and comers: Lt. Cmdr. Robert J. Burg, Maura Loughlin Carley, Pete Delgado, John P. Glaser, Glen Nessel, Kevin Potter, Laura J. Redoutey, Vicki Romero, Nancy Schlichting, Paul Viviano, Greg Wozniak, Lorraine Zippiroli.  

PubMed

Modern Healthcare's 1991 Up and Comers, the fifth annual group, are scattered all over the map, from Boston to the Bay Area, from Flint, Mich., to El Paso, Texas. They work in managed care, associations and specialty hospitals; one even administers the office that cares for members of Congress. At least two are "healthcare brats" whose fathers managed hospitals. One spent time working in a salmon cannery; another was a Peace Corps volunteer in Swaziland. Despite their differences, they share many common traits. They are bright, committed and know how to motivate and involve others. Maura Loughlin Carley, an area administrator for Kaiser Permanente Foundation Health Plans, put it best when she said her goal is to "hire the best people, develop them and keep them happy." They're also committed to seeking new ways to improve healthcare delivery. As Kevin Potter said, "What keeps me humble is that there's so much that I'm learning every day." Each of these emerging leaders is making a mark on the healthcare industry. They were chosen from a field of almost 50 candidates, all 40 or younger, compiled by the editorial staff of Modern Healthcare and readers. PMID:10160762

Pallarito, K; Kenkel, P J; Lutz, S; Gardner, E; Taravella, S; Packer, J; Nemes, J; Greene, J; Berg, E; Wagner, M

1991-08-12

442

Ingestion of Magnetic Toys: Report of Serious Complications Requiring Surgical Intervention and a Proposed Management Algorithm  

PubMed Central

Context: Increasing popularity of strong magnets as toys has led to their ingestion by children, putting them at risk of potentially harmful gastrointestinal tract injuries. Objectives: To heighten physician awareness of the potential complications of magnetic foreign body ingestion, and to provide an updated algorithm for management of a patient who is suspected to have ingested magnets. Design: A retrospective review of magnet ingestions treated over a two-year period at our institutions in the Southern California Permanente Medical Group. Data including patient demographics, clinical information, radiologic images, and surgical records were used to propose a management strategy. Results: Five patients, aged 15 months to 18 years, presented with abdominal symptoms after magnet ingestion. Four of the 5 patients suffered serious complications, including bowel necrosis, perforation, fistula formation, and obstruction. All patients were successfully treated with laparoscopic-assisted exploration with or without endoscopy. Total days in the hospital averaged 5.2 days (range = 3 to 9 days). Average time to discharge following surgery was 4 days (range = 2 to 7 days). Ex vivo experimentation with toy magnetic beads were performed to reveal characteristics of the magnetic toys. Conclusions: Physicians should have a heightened sense of caution when treating a patient in whom magnetic foreign body ingestion is suspected, because of the potential gastrointestinal complications. An updated management strategy is proposed that both prevents delays in surgical care and avoids unnecessary surgical exploration.

Tsai, Jerry; Shaul, Donald B; Sydorak, Roman M; Lau, Stanley T; Akmal, Yasir; Rodriguez, Karen

2013-01-01

443

Candidate Genes and Risk for Cerebral Palsy: a Population-Based Study  

PubMed Central

Studies suggest genetic polymorphisms may increase an individual’s susceptibility to CP. Most findings have yet to be corroborated in an independent cohort. This case-control study is nested within all 334,333 infants ? 36 weeks gestation born at Kaiser Permanente Medical Care Program, 1991–2002. We included only non-Hispanic whites who had a neonatal blood sample available. Case patients (N=138) were identified from medical records to have spastic or dyskinetic CP. Controls (N=165) were randomly selected from the population. We genotyped polymorphisms previously associated with CP: inducible nitric oxide synthase (iNOS) -231, apolipoprotein E (apoE) ?2 and ?4 alleles, tumor necrosis factor-? -308, interleukin-8 -251, lymphotoxin 60, endothelial nitric oxide synthase -922, endothelial protein C receptor 219, mannose binding lectin 54 and 52, factor V Leiden, methyltetrahydrofolate reductase 1298 and 667, prothrombin 20210, and platelet activator inhibitor 11053. Similar to previous reports, the iNOS -231 T allele (25.7% vs. 18.9%, P=0.04) and the apoE ?4 allele (19.3% vs. 13.2%, P=0.04) were more common in patients with CP than in controls. However, there was no statistically significant association between any genetic polymorphism and CP after correction for multiple comparisons.

Wu, Yvonne W; Croen, Lisa A; Vanderwerf, Andrew; Gelfand, Amy A; Torres, Anthony R

2011-01-01

444

Association of beverage consumption with obesity in Mexican American children.  

PubMed

OBJECTIVE: To determine the association of beverage consumption with obesity in Mexican American school-aged children. DESIGN: Cross-sectional study using the baseline data from a cohort study. Mothers and children answered questions about the frequency and quantity of the child's consumption of soda, diet soda, other sugar-sweetened beverages, 100 % fruit juice, milk and water. The questions were adapted from the Youth/Adolescent FFQ. Children were weighed and measured. Data were collected on the following potential confounders: maternal BMI, household income, maternal education, maternal occupational status, maternal acculturation, child physical activity, child screen time and child fast-food consumption. Logistic regression was used to examine the association between servings (240 ml) of each beverage per week and obesity (BMI ? 95th percentile). SETTING: Participants were recruited from among enrolees of the Kaiser Permanente Health Plan of Northern California. Data were collected via an in-home assessment. SUBJECTS: Mexican American children (n 319) aged 8-10 years. RESULTS: Among participants, 20 % were overweight and 31 % were obese. After controlling for potential confounders, consuming more servings of soda was associated with increased odds of obesity (OR = 1·29; P < 0·001). Consuming more servings of flavoured milk per week was associated with lower odds of obesity (OR = 0·88; P = 0·004). Consumption of other beverages was not associated with obesity in the multivariate model. CONCLUSIONS: Discouraging soda consumption among Mexican American children may help reduce the high obesity rates in this population. PMID:23308395

Beck, Amy L; Tschann, Jeanne; Butte, Nancy F; Penilla, Carlos; Greenspan, Louise C

2013-01-11

445

GENDER DIFFERENCES IN QUALITY OF LIFE AMONG LONG-TERM COLORECTAL CANCER SURVIVORS WITH OSTOMIES  

PubMed Central

Objective To describe how gender shapes the concerns and adaptations of long-term (> 5 years) colorectal cancer (CRC) survivors with ostomies. Design Qualitative study using content analysis of focus group content. Setting Member of Kaiser Permanente, residing in either Oregon, Southwest Washington State, or Northern California. Sample Four female and four male focus groups selected from quantitative survey participants with health-related quality of life (HRQOL) scores in the highest or lowest quartile. Methods Eight focus groups, discussed challenges of living with an ostomy. Content was recorded, transcribed, and analyzed using directive and summative content analysis. Main Research Variables HRQOL domains of physical, psychological, social and spiritual well being. Findings All groups reported avoiding foods that cause gas or rapid transit, and discussed how limiting the amount of food eaten controlled the output. All groups discussed physical activities, getting support from friends and family, and the importance of being resilient. Both genders identified challenges with sexuality/intimacy. Coping and adjustment difficulties were discussed by women with men only discussing these issues to a small extent. Difficulties with sleep were primarily identified by Low HRQOL women. Problems with body image and depression were discussed only by Low HRQOL women. Conclusions Common issues included diet management, physical activity, social support and sexuality. Women with low HRQOL discussed problems with depression, body image, and sleep. Implications for Nursing Application of these gender-based differences can inform educational interventions for CRC survivors with ostomies.

Grant, Marcia; McMullen, Carmit K.; Altschuler, Andrea; Mohler, M. Jane; Hornbrook, Mark C.; Herrinton, Lisa J.; Wendel, Christopher S.; Baldwin, Carol M.; Krouse, Robert S.

2011-01-01

446

Health care report cards: will they make the grade?  

PubMed

"Outcomes data are meaningless or misleading unless they are adjusted for severity of illness, presence of comorbidities, documentation of advance directives, and other factors not under the control of providers," observes Ohio State University Professor Timothy Jost, JD. Health care analysts also contend that the time that is required to analyze, complete, and report data can lessen the value of those data. Currently, health care report cards often require several years to produce. Hence, the data that are reported may not accurately reflect a health plan's or other provider's current performance, which can be affected by changes implemented since the data were collected. Also, some experts question the value and wisdom of giving report cards to consumers, who may not understand what the reports are measuring. As UHC official Sheila Leatherman summarizes: "There is no agreement about who should receive the data, in what format, and with what kinds of interpretative materials." "Physicians and others who utilize health care report cards need to be aware of their limitations," summarizes Don Nielsen, MD, associate medical director and quality consultant with Kaiser Permanente. However, the burgeoning efforts at national, state, and community levels to develop report cards should not be ignored, he says. Dr. Nielsen recommends that surgeons and other physicians work with health plans and other entities that are developing report cards to identify limitations in health care measures and data systems and to create better measures of provider performance. PMID:10135910

Politser, P

1994-08-01

447

FIVE YEAR NEURODEVELOPMENTAL OUTCOME OF NEONATAL DEHYDRATION  

PubMed Central

Objective To determine the long-term outcome of neonatal dehydration. Study design We identified 182 newborns rehospitalized with dehydration (weight loss ?12% of birth weight and/or serum sodium ?150 mEq/L) and 419 randomly selected controls from a cohort of 106,627 term and near-term infants ?2000 g born from 1995 through 1998 in Northern California Kaiser Permanente hospitals. Outcomes data were obtained from electronic records, interviews, questionnaire responses, and neurodevelopmental evaluations performed in a masked fashion. Results Follow-up data to the age of at least two years were available for 173/182 children with a history of dehydration (95%) and 372/419 controls (89%) and included formal evaluation at a mean (±SD) age of 5.1±0.12 years for 106 children (58%) and 168 children (40%) respectively. None of the cases developed shock, gangrene, or respiratory failure. Neither crude nor adjusted scores on cognitive tests differed significantly between groups. There was no significant difference between groups in the proportion of children with abnormal neurologic examinations or neurologic diagnoses. Frequencies of parental concerns and reported behavior problems also were not significantly different in the two groups. Conclusions Neonatal dehydration in this managed care setting was not associated with adverse neurodevelopmental outcomes in infants born at or near term.

Escobar, Gabriel J.; Liljestrand, Petra; Hudes, Esther S.; Ferriero, Donna M.; Wu, Yvonne W.; Jeremy, Rita J.; Newman, Thomas B.

2007-01-01

448

Kaiser captures spirit of games.  

PubMed

With a multi-media campaign, Kaiser Permanente blitzed its market area by becoming a sponsor of the Nike World Masters Games. The advertising campaign promoted Kaiser as the exclusive health care sponsor. Company officials are counting on this campaign to leverage the health care institution's commitment to the community. In addition to the advertising, Kaiser searched for local athletes to represent its "play the sports for life" theme. As part of a promotion to award 200 athlete sponsorships to the Games, Kaiser's own master athletes were invited to tell their stories. Some of the members shared stories about such topics as experiencing an accident, receiving assistance from a Kaiser physician and incorporating a lifestyle of sport for rehabilitation. From the hundreds of letters received, two members and one employee were selected for the television spots. The sporting event reinforces Kaiser's philosophy of fitness-oriented lifestyles among its members. The Nike World Masters Games are the largest participatory multi-sport competition in the world, gathering together more than 25,000 men and women from more than 100 countries. PMID:10186402

Herreria, J

449

Translating efficacious behavioral principles for diabetes prevention into practice.  

PubMed

This case study describes the process of translating efficacy-based Diabetes Prevention Program principles into a practical format for delivery within a managed care organization. Using Rogers' innovation-decision process model, the authors tracked the adoption, implementation, and short-term effectiveness of a clinical program. Effectiveness was documented using a pre-post design to detect changes in physical activity and dietary habits. Participants (N = 298) were Kaiser Permanente of Colorado patients enrolled in diabetes-prevention classes. Changes were analyzed using paired-samples t tests and one-way analysis of variance. Participants significantly increased reported minutes of moderate (p < .001, mu = 84.52, CI: 58.44-110.61) and vigorous (t = 2.220, p = .028, mu = 19.05, CI: 2.10-36.00) physical activity and their daily servings of fruits and vegetables (p < .001, mu = 0.20, CI: 0.13-0.27). By identifying the underlying strategies that led to efficacy, professionals can implement sound diabetes-prevention programs that fit within their context. PMID:17494949

Smith-Ray, Renae L; Almeida, Fabio A; Bajaj, Jennifer; Foland, Sally; Gilson, Michele; Heikkinen, Susan; Seagle, Helen; Estabrooks, Paul A

2007-05-09

450

Social organization of self-management support of persons with diabetes: A health systems comparison  

PubMed Central

Objective Identify important organizational elements for providing self-management support (SMS). Design Semi-structured qualitative interviews conducted in two healthcare systems. Setting Kaiser Permanente Northern California and the Danish Health Care System. Subjects 36 managers and healthcare professionals in the two healthcare systems. Main outcome measures Elements important to providing self-management support to persons with diabetes. Results Healthcare professionals’ provision of SMS was influenced by healthcare system organization and their perceptions of SMS, the capability and responsibility of healthcare systems, and their roles in the healthcare organization. Enabling factors for providing SMS included: strong leadership; aligned incentives; use of an integrated health information technology (HIT) system; multidisciplinary healthcare provider teams; ongoing training for healthcare professionals; outreach; and quality goals. Barriers to providing SMS included lack of collaboration between providers and skeptical attitudes towards prevention and outreach. Conclusions and implications Implementation of SMS can be improved by an understanding of the elements that enhance its provision: (1) initiatives seeking to improve collaboration and integration between providers; (2) implementation of an integrated HIT system; and (3) ongoing training of healthcare professionals.

Schi?tz, Michaela; Fr?lich, Anne; Krasnik, Allan; Taylor, Warren; Hsu, John

2012-01-01

451

[Primary malignant bone tumors].  

PubMed

Among human neoplasms, primary malignant bone tumors are fairly rare. They present an incidence rate of roughly 10 cases per 1 million inhabitants per year. During childhood (<15 years), the percentage of malignant bone tumors amounts to 6% of all infantile malignancies. Only leukemia and lymphoma show a higher incidence in adolescence. Of all primary malignant bone tumors, 60% affect patients younger than 45 years and the peak incidence of all bone tumors occurs between 15 and 19 years. The most common primary malignant bone tumors are osteosarcoma (35%), chondrosarcoma (25%), and Ewing's sarcoma (16%). Less frequently (??5%) occurring tumors are chordoma, malignant fibrous histiocytoma of bone, and fibrosarcoma of bone. Vascular primary malignant tumors of bone and adamantinoma are very rare. Staging of the lesion is essential for systemic therapeutic decision-making and includes complete imaging and histo-pathological confirmation of the suspected entity. In most cases, this is established by open- or image-guided biopsy. Based on this information, an interdisciplinary tumor board will determine the individual therapeutic approach. Endoprosthetic or biological reconstruction following wide tumor resection is the most common surgical therapy for primary malignant bone tumors. There is vital importance in a thorough postoperative follow-up and continous after-care by a competent tumor center which is permanentely in charge of therapy. PMID:22130624

von Eisenhart-Rothe, R; Toepfer, A; Salzmann, M; Schauwecker, J; Gollwitzer, H; Rechl, H

2011-12-01

452

Integrating Herbs and Supplements in Managed Care: A Pharmacy Perspective  

PubMed Central

Herbal and other dietary supplements are popular among patients. Whether and how to establish and manage an herbal formulary remains a challenge for conventional managed-care organizations. Pharmacists and clinicians depend on evidence-based guidelines to help determine which products (whether pharmaceutical or herbal) to make available to patients. Evidence from randomized controlled trials that supports the use of most herbal supplements is scarce, yet for some supplements, credible evidence supports the possibility of efficacy. Quality control remains of concern for the supplement industry and for patients and clinicians considering the use of supplements. Clinicians may improve care by both disseminating educational materials and making available to patients popular quality-controlled herbal supplements deemed safe and effective. Kaiser Permanente Northwest (KPNW) has adopted a comprehensive and systematic approach to managing and stocking herbal supplements that can serve as a model for other conventional and managed care organizations. KPNW's dedicated Natural Products Advisory Committee (NPAC) has made considerable progress toward developing a constructive response to KPNW patients' herbal supplement use. Making supplements available at pharmacies can improve clinical outcomes, patient convenience, and quality control. NPAC currently limits its reviews to randomized, controlled trials and data from meta-analyses and systematic reviews for single-ingredient supplements. As interest in this area maintains steady growth, NPAC will continue to study how best to meet patients' needs.

Elder, Charles; Mossbrucker, Pat; Davino-Ramaya, Carrie M; Bez, Ileana; Lin, Margaret M; Terry, Theresa A; Thomas, Emily A; Jones, Sean

2008-01-01

453

Strategies, Programs and Projects 2008 of the Astrophysical Group "SPACE-Universidad Nacional Mayor De San Marcos, Peru" - Preparing for the IYA2009  

NASA Astrophysics Data System (ADS)

We present a review of our efforts to introduce astronomy as scientific career in Peru, showing how our astronomy outreach programs have been one of the most important keys to reach our national astronomical scientific goals, remarking the crucial role that the celebration of the IYA2009 must play, in order to promote PhD programmes in astronomy in developing countries. We show the importance of the creation of the Seminario Permanente de Astronomía y Ciencias Espaciales (SPACE) in the Universidad Nacional Mayor de San Marcos, as an academic scientific and cultural center in Peru, to support our 26 years-old "Astronomical Fridays” which are addressed to wide range of public, from schoolchildren to scientists. We also show how important was to rediscover our ancient astronomical cultural past of Incas in order to promote the construction of a Astronomical Center located near Cusco city over 4000 meters above sea level, which includes a tourist-educational observatory, a scientific optical observatory and a solar radio observatory.

Vera, Victor; Aguilar, M.; Huisacayna, J.

2008-05-01

454

NFP Investor Conference. Growth is back in sight.  

PubMed

In a whirlwind of high-stakes meetings in New York City in mid-May, two dozen of the nation's largest hospitals and health systems strutted their stuff with a single goal: securing their future. Their message was clear: back-to-basics works, and now it's time to grow the business. Executives from 23 providers outlined their work on increasing revenue, boosting margins and shoring up balance sheets. They presented their market positions, strategic initiatives and financial results for investment analysts, credit raters and bond traders. The third annual Non-Profit Healthcare Investor Conference was co-sponsored by the American Hospital Association, Health Forum, the Healthcare Financial Management Association and Salomon Smith Barney. The focus on growth doesn't come without challenges Several common themes emerged from the presentations, among them pressure on reimbursement, workforce shortages, liability insurance issues and capacity constraints. Yet executives agree: it all comes down to the basics, and building the strength to keep their missions alive. As Thomas Meier, vice president and treasurer of Oakland, Calif.-based Kaiser Permanente, put it: "No margin, no mission, no más." PMID:12080922

Haugh, Richard

2002-06-01

455

Potential influence of seasonal influenza vaccination requirement versus traditional vaccine promotion strategies on unvaccinated healthcare personnel.  

PubMed

In a prospective cohort study of 1670 healthcare personnel (HCP) providing direct patient care at Scott & White Healthcare in Texas and Kaiser Permanente Northwest in Oregon and Washington, we examined the potential impact of twelve vaccine promotion strategies on the likelihood of being vaccinated. Internet-based surveys were conducted at enrollment (Fall, 2010) and at post-season (Spring, 2011), which asked HCP whether twelve vaccination promotion strategies would make them "much less" to "much more" likely to be vaccinated next season (on a 5-point Likert scale). Overall, 366 of 1670 HCP (22%) were unvaccinated. Half (50%) of unvaccinated HCP self-reported that a vaccination requirement would make them more likely to be vaccinated and most (62%) identified at least one strategy other than a vaccination requirement that would make them more likely to be vaccinated. In sub-groups of unvaccinated HCPs with specific barriers to vaccination, about one in three (range=27-35%) indicated that interventions targeting specific vaccination barrier would increase the likelihood they would be vaccinated. However, in all cases, significantly more unvaccinated HCP reported that a vaccination requirement would increase the likelihood of vaccination than reported a targeted intervention would have this effect (range in difference scores=+11-23%). PMID:23845807

Thompson, Mark G; McIntyre, Anne F; Naleway, Allison L; Black, Carla; Kennedy, Erin D; Ball, Sarah; Walker, Deborah Klein; Henkle, Emily M; Gaglani, Manjusha J

2013-07-08

456

Overview of the consortium of hospitals advancing research on tobacco (chart)  

PubMed Central

Background The Consortium of Hospitals Advancing Research on Tobacco (CHART) is a network of six projects and a research coordinating unit funded by the National Heart, Lung, and Blood Institute, the National Cancer Institute, the National Institute on Drug Abuse, and the National Institutes of Health (NIH) Office of Behavioral and Social Science Research. The CHART projects will assess the effectiveness and cost-effectiveness of smoking cessation interventions initiated during hospitalization and continued post-discharge. Methods/design Along with a seventh project funded previously under the NIH Challenge grants, the CHART projects will assess smoking cessation strategies delivered to approximately 10,000 hospitalized smokers across a geographically diverse group of nearly 20 private, public, academic, and community hospitals. The CHART research coordinating unit at Kaiser Permanente Center for Health Research provides organizational and data coordination support, facilitating the development of common measures for combining data from multiple CHART projects. Discussion The targeted enrollment in CHART, if achieved, will represent the largest, most diverse pooled dataset of hospitalized smokers receiving smoking cessation assistance, and is designed to contribute to the dissemination and implementation of smoking cessation interventions provided by hospital systems.

2012-01-01

457

Quality and Cost Evaluation of a Medical Financial Assistance Program  

PubMed Central

Background: Kaiser Permanente Colorado has been responding to the financial challenges of its members by providing a medical financial assistance (MFA) program since 1992. However, there have been no evaluations of the effect of this program on members’ use of health services or their health outcomes. Methods: A prospective cohort study of 308 MFA program members who were enrolled between May 16, 2008, and May 16, 2009, examined changes in their use of health services, costs, and self-reported physical and mental health after enrollment in the MFA program. Use of services was analyzed with multiple regression, and costs of services with generalized linear models. Results: MFA increased members’ access to health services. There were no changes in physical or mental health status. For each health care visit before the MFA award, patients used the health care system 0.23 visits less. The MFA amount was not associated with an increase or decrease in use. There was no significant difference in total overall cost. Hospital costs were lower, but costs for clinic visits, pharmacy services, phone calls, and radiology services were significantly higher, resulting in service cost neutrality, possibly because financial barriers before MFA award led to accumulated demand for services. Conclusions: Use of services decreased after MFA was received. There was no significant change in total service cost. MFA improved members’ ability to pay for medical services and increased their satisfaction with health services.

Conner, Douglas A; Beck, Arne; Clarke, Christina; Wright, Leslie; Narwaney, Komal; Bermingham, Neysa W

2013-01-01

458

Study Design for a Comprehensive Assessment of Biologic Safety Using Multiple Healthcare Data Systems  

PubMed Central

Background Although biologic treatments have excellent efficacy for many autoimmune diseases, safety concerns persist. Understanding the absolute and comparative risks of adverse events in patient and disease subpopulations is critical for optimal prescribing of biologics. Purpose The Safety Assessment of Biologic Therapy collaborative was federally funded to provide robust estimates of rates and relative risks of adverse events among biologics users using data from national Medicaid and Medicare plus Medicaid dual-eligible programs, Tennessee Medicaid, Kaiser Permanente, and state pharmaceutical assistance programs supplementing New Jersey and Pennsylvania Medicare programs. This report describes the organizational structure of the collaborative, and the study population and methods. Methods This retrospective cohort study (1998–2007) examined risks of 7 classes of adverse events in relation to biologic treatments prescribed for 7 autoimmune diseases. Propensity scores were used to control for confounding and enabled pooling of individual level data across data systems while concealing personal health information. Cox proportional hazard modeling was used to analyze study hypotheses. Results The cohort comprised 159,000 subjects with rheumatic diseases, 33,000 with psoriasis, and 46,000 with inflammatory bowel disease. This reports summarizes demographic characteristics and drug exposures. Separate reports will provide outcome definitions and estimated hazard ratios for adverse events. Conclusion This comprehensive research will improve understanding of the safety of these treatments. The methods described may be useful to others planning similar evaluations.

Herrinton, Lisa J.; Curtis, Jeffrey R.; Chen, Lang; Liu, Liyan; Delzell, Elizabeth; Lewis, James D.; Solomon, Daniel H.; Griffin, Marie R.; Quellet-Hellstom, Rita; Beukelman, Timothy; Grijalva, Carlos G.; Haynes, Kevin; Kuriya, Bindee; Lii, Joyce; Mitchel, Ed; Patkar, Nivedita; Rassen, Jeremy; Winthrop, Kevin L.; Haynes, Kevin; Nourjah, Parivash; Saag, Kenneth G.

2012-01-01

459

The Case for Unit-Based Teams: A Model for Front-line Engagement and Performance Improvement  

PubMed Central

Unit-based teams (UBTs)—defined as natural work groups of physicians, managers, and frontline staff who work collaboratively to solve problems, improve performance, and enhance quality—were established by the 2005 national agreement between Kaiser Permanente (KP) and the Coalition of KP Unions. They use established performance-improvement techniques and employee-engagement principles (including social-movement theory) to achieve clinical and operational goals. UBT members identify performance gaps and opportunities within their purview—issues they can address in the course of the day-to-day work, such as workflow or process improvement. By focusing on clear, agreed-on goals, UBTs encourage greater accountability and allow members to perform their full scope of work. UBTs are designed to deliver measurable benefits in clinical outcomes and operations, patient-experience enhancements, and physician-team performance or work life. For many physicians, UBTs will require new ways of engaging with their teams. However, evidence suggests that with organizational and physician support, these teams can achieve their goals. This article presents case examples of successful UBTs' outcomes; physicians' comments on their experience working with teams; an overview of UBTs' employee-engagement principles; and advice on how physicians can support and participate in the work of such teams.

Cohen, Paul M; Ptaskiewicz, Mark; Mipos, Debra

2010-01-01

460

Captura de satélites durante a formação de Júpiter  

NASA Astrophysics Data System (ADS)

O planeta Jupiter apresenta um grande número de satélites irregulares. As características das órbitas destes objetos indicam que os mesmos não teriam se formado ao redor do planeta que se encontram. As teorias existentes são de que estes objetos teriam se formado em uma região distante do planeta e sua evolução dinâmica os teria levado a uma captura gravitacional pelo planeta. Tendo em vista que o processo de captura gravitacional sem efeitos dissipativos não produz uma captura permanente, estudamos o processo de captura durante o estágio de formação do planeta. Realizamos simulações numéricas para os casos de satélites prógrados e retrógrados que inicialmente se encontram ao redor de Jupiter com sua massa atual e então, evoluimos a integração voltando no tempo de modo que o planeta sofra uma redução em sua massa (de 100% para 10% de sua massa atual) e verificamos o instante em que o satélites escapa do planeta (quando sua energia do problema de dois corpos se torna positiva). Assim, analisando o problema inverso no tempo, obtivemos em qual estágio de formação de Jupiter aquele hipotético satélite teria sido capturado. Os resultados mostram que os satélites retrógrados são capturados assim que entram na região delimitada pela esfera de Hill do planeta, enquanto que os satélites prógrados só são capturados quando entram numa região bem mais próxima ao planeta, uma fração da esfera de Hill.

Winter, O. C.; Vieira Neto, E.; Yokoyama, T.

2003-08-01

461

Provider Factors and Patient-Reported Healthcare Discrimination in the Diabetes Study of California (DISTANCE)  

PubMed Central

Objective We examined provider-level factors and reported discrimination in the healthcare setting. Methods With data from the Diabetes Study of Northern California (DISTANCE)—a race-stratified survey of diabetes patients in Kaiser Permanente Northern California—we analyzed patient-reported racial/ethnic discrimination from providers. Primary exposures were characteristics of the primary care provider (PCP, who coordinates care in this system), including specialty/type, and patient-provider relationship variables including racial concordance. Results Subjects (n=12,151) included 20% black, 20% Latino, 23% Asian, 30% white, and 6% other patients, with 2% to 8% reporting discrimination by racial/ethnic group. Patients seeing nurse practitioners as their PCP (OR=0.09; 95% CI: 0.01–0.67), those rating their provider higher on communication (OR=0.70; 95% CI: 0.66–0.74) were less likely to report discrimination, while those with more visits (OR=1.10; 95% CI: 1.03–1.18) were more likely to report discrimination. Racial concordance was not significant once adjusting for patient race/ethnicity. Conclusions Among diverse diabetes patients in managed care, provider type and communication were significantly related to patient-reported discrimination. Practice Implications Given potential negative impacts on patient satisfaction and treatment decisions, future studies should investigate which interpersonal aspects of the provider-patient relationship reduce patient perceptions of unfair treatment.

Lyles, Courtney R.; Karter, Andrew J.; Young, Bessie A.; Spigner, Clarence; Grembowski, David; Schillinger, Dean; Adler, Nancy

2011-01-01

462

A Model for Continuing Pharmacy Education  

PubMed Central

Objective To develop and implement a continuing pharmacy education (CPE) program at Kaiser Permanente Colorado (KPCO) Design To address the continuing education needs of its diverse pharmacy staff, an internal continuing pharmacy education (CPE) program was developed. The pharmacy department became an accredited provider by the Accreditation Council for Pharmacy Education (ACPE). Live, interactive, and evidence-based CPE programs, presented by highly qualified internal staff members, utilized videoconferencing and a Web-based learning management system. Cross-accreditation of medical and pharmacy educational programs was offered to KPCO staff members. Assessment Annual needs assessments were conducted to ensure the provision of relevant educational topics and to assess learning needs. To demonstrate outcomes of the CPE programs, 2 methods were utilized: objective effectiveness assessment and knowledge acquisition assessment. This program met the objectives for CPE activities a large majority of the time (usually over 90%), demonstrated statistically significant (p < 0.05) improvement in knowledge from before to after the CPE activity in 11 of 13 questions asked, and minimized the cost to acquire CPE credit for both the pharmacy department and its staff members. Conclusion The KPCO continuing pharmacy education program has developed a high quality and cost-favorable system that has resulted in significant improvements in attendee knowledge.

Newlon, Carey; Dickerhofe, Jeannine

2009-01-01

463

A comparison of maternal outcomes from an alcohol, tobacco, and other drug prevention program for mothers choosing an intervention versus being randomized.  

PubMed

Self-determination theory and substantial research findings suggest that more desirable outcomes may occur when participants are able to choose their prevention or treatment interventions, as having a choice may lead to greater motivation and feelings of self-efficacy. The present study examined the influence of having a choice of family-based prevention programs for youth alcohol, tobacco, and other drug use on mothers' communication outcomes. Families (N = 496) were those with an 11- to 12-year-old enrolled in Kaiser Permanente medical centers at one of four locations. Results from multivariate repeated measures analyses supported the importance of having a choice for improved communication outcomes. As compared with families who were randomly assigned to a program, those allowed to choose showed improved tobacco-specific and peer pressure communication, with marginally improved alcohol communication. No differences were found between the groups for general communication. Results suggest that allowing mothers to participate in decisions about health-related interventions for their teens may lead to better outcomes. PMID:22505572

Byrnes, Hilary F; Miller, Brenda A; Laborde, Nicole

2012-04-13

464

Malignant melanoma slide review project: Patients from non-Kaiser hospitals in the San Francisco Bay Area. Final report  

SciTech Connect

This project was initiated, in response to concerns that the observed excess of malignant melanoma among employees of Lawrence Livermore National Laboratory (LLNL) might reflect the incidence of disease diagnostically different than that observed in the general population. LLNL sponsored a slide review project, inviting leading dermatopathology experts to independently evaluate pathology slides from LLNL employees diagnosed with melanoma and those from a matched sample of Bay Area melanoma patients who did not work at the LLNL. The study objectives were to: Identify all 1969--1984 newly diagnosed cases of malignant melanoma among LLNL employees resident in the San Francisco-Oakland Metropolitan Statistical Area, and diagnosed at facilities other than Kaiser Permanente; identify a comparison series of melanoma cases also diagnosed between 1969--1984 in non-Kaiser facilities, and matched as closely as possible to the LLNL case series by gender, race, age at diagnosis, year of diagnosis, and hospital of diagnosis; obtain pathology slides for the identified (LLNL) case and (non-LLNL) comparison patients for review by the LLNL-invited panel of dermatopathology experts; and to compare the pathologic characteristics of the case and comparison melanoma patients, as recorded by the dermatopathology panel.

Reynolds, P. [California Dept. of Health Services, Berkeley, CA (United States)

1993-01-05

465

Serum cholesterol and the incidence of cancer in a large cohort.  

PubMed

The relation of serum cholesterol to the development of cancer remains unclear. We have examined the incidence of cancer in 160,135 men and women who were health plan members of the Northern California Kaiser Permanente Medical Care Program (KPMCP) and who had a multiphasic health examination in the period 1964 through 1972. In addition to all cancer, we examined individually the nine most common cancers in men and the 12 most common in women. Cancer diagnoses (N = 7477) recorded by the State of California Resource for Cancer Epidemiology Section and the health plan hospital discharge file were used to calculate incidence by quintile of serum cholesterol. Multivariate analysis adjusted for race, education, smoking status, alcohol consumption, body mass index and, in women, for age at menarche, parity, and menopausal status. No strong or consistent relation of low cholesterol to cancer incidence was found. Of the 21 cancers examined, only lymphoma in men and cervical cancer had significantly elevated risks at the lowest quintile of serum cholesterol compared with risks in the highest quintile. Cancer incidence in the first 2 years after the cholesterol measurement was consistently higher among persons whose cholesterol levels were in the lowest quintile. This prospective study did not find evidence that low cholesterol increased the risk of cancer but supports the idea that preclinical cancer in some way lowers serum cholesterol. PMID:3793838

Hiatt, R A; Fireman, B H

1986-01-01

466

Efficacy of contemporary medical management for asymptomatic carotid artery stenosis.  

PubMed

In the Asymptomatic Carotid Artery Stenosis trial (1995), medical management was defined as aspirin in addition to adequate control of comorbidities. Since then, medical management of asymptomatic carotid artery stenosis (CAS) has progressed to include broader use of statins. Our purpose was to review the effect of contemporary medical management on stroke prevention. A retrospective review of the Kaiser Permanente, Southern California medical group database was performed. All patients with a diagnosis of asymptomatic CAS by International Classification of Diseases, 9th Revision codes from 2007 to 2011 were identified. Intervention for stroke prevention was the criteria for exclusion. Medications used were evaluated as was the rate of stroke. Asymptomatic CAS was noted in 7255 patients. Of these, 158 (2.2%) sustained a stroke within a mean follow-up of 37 months. Patients who were taking a statin had a statistically significant lower risk of stroke (1.6 vs 3.9%). The data support that contemporary medical management of asymptomatic CAS has decreased the incidence of stroke in comparison to previously published data. The use of statins was protective against the development of stroke. Future prospective randomized trials are needed to evaluate the efficacy of carotid intervention versus current medical management. PMID:24160784

Chang, Jason; Ahn, Joseph E; Landsman, Nicholas; Rhee, Katherine; Chun, Linda; Patel, Kaushal Kevin

2013-10-01

467

O PROCESSO HISTÓRICO DO ARQUÉTIPO FAMILIAR CONTEMPORÂNEO E A INVENÇÃO DO INCESTO THE HISTORICAL PROCESS OF THE FAMILY ARCHETYPE COMTEMPORARY AND THE INCEST INVENTION EL PROCESO HISTÓRICO DEL ARQUÉTIPO FAMILIAR CONTEMPORÁNEO Y LA INVENCIÓN DEL INCESTO  

Microsoft Academic Search

RESUMO: RESUMO: RESUMO: RESUMO: RESUMO: O incesto emerge na atualidade como problema de saúde, já que é definido como situação de violência sexual. O objetivo deste artigo é refletir acerca do caráter natural da gênese do incesto, contextualizando-o nas narrativas históricas familiares. Trata-se de pesquisa bibliográfica buscando aportes de autores com discussão sobre família. Como resultados, expõem-se as inter-relações entre

Solano LC; Queiroz JC; Carvalho FPV; Timóteo RPS; Monteiro AI

2009-01-01

468

Investigation of sulfur behavior on CoMo-based HDS catalysts supported on high surface area TiO 2 by 35S radioisotope tracer method  

Microsoft Academic Search

Three series of CoMo catalysts (MoO3: 6, 11, 16wt.%) with various Co\\/Mo molar ratios were prepared by successive incipient wetness impregnations of a titania sample previously prepared by the pH swing method, which provides a TiO2 carrier with a high SSA (134m2g?1) and excellent mechanical properties. DBT HDS activity of the catalysts increased with addition of cobalt up to Co\\/Mo=0.4

Atsushi Ishihara; Franck Dumeignil; Danhong Wang; Xiangguo Li; Hisashi Arakawa; Eika W. Qian; Shinichi Inoue; Akinori Muto; Toshiaki Kabe

2005-01-01

469

Catalyst, Coion and the media effect on the oscillatory behavior of resorcinol in the BZ reaction  

Microsoft Academic Search

O estudo diz respeito ao comportamento oscilatório de resorcinol como substrato orgânico na reação de Belousov-Zhabotinsky (BZ) em presença de diferentes íons metálicos como catalisadores no meio aquoso ácido. Verifica-se que íons Mn 2+ como catalisador são mais reativos que íons Fe 2+ . Variando o meio aquoso ácido observa-se que as espécies protonadas são mais facilmente formadas em ácido

Nadeem B. Ganaie; G. M. Peerzada

2009-01-01

470

Frutas y verduras crudas: Cómo seleccionarlas y servirlas de ...  

Center for Food Safety and Applied Nutrition (CFSAN)

... frescos? R Algunas frutas y verduras - como los plátanos - producen gas etileno en forma natural cuando maduran. En ... More results from www.fda.gov/food/foodborneillnesscontaminants/buystoreservesafefood

471

Sistema Solar: de la observación de La Tierra a los planetas gigantes y sus lunas  

NASA Astrophysics Data System (ADS)

La fotoquímica tiene un papel principal en la composición de las atmósferas planetarias. Se examinan diferentes procesos fotoquímicos tanto para atmósferas oxidadas como reductoras, poniendo un especial énfasis en los ciclos químicos más importantes. En este sentido, se presentan diferentes ciclos químicos capaces de producir hidrocarbonos y nitrilos en atmósferas reductoras, así como aquellos capaces de mantener las proporciones de mezcla de las moléculas que contienen oxígeno, tales como CO2, O2 y H2O. También se analizan otros procesos importantes tales como la condensación y procesos de sputtering y de sublimación que han de tenerse en cuenta cuando se realizan modelos sobre la composición atmosférica.

Rodrigo, R.

472

Un caos perfecto: El cine de Emir Kusturica  

Microsoft Academic Search

Desentrañar la vida de este cineasta, capaz de conv ertir el caos en perfección, es una tortura exquisita sólo para quien tenga en el c uerpo una sobredosis de él suficiente como para soportarla. Aunque su nombre ya está inserto en la historia del séptimo arte como el director que más premios ha ganado en el Festival de Cannes, el

Evelyn ERLIJ

473

Casos Empresariales No. 2. II Serie  

Microsoft Academic Search

En el ámbito de la disciplina administrativa se utilizan los casos empresariales como estrategia de aprendizaje. El presente texto desarrolla una casuística que surge de la realidad empresarial colombiana al estudiar los casos de prácticas gerenciales innovadoras de SQL Software, Impsat y Davivienda, como una medio para comprender el fenómeno organizacional latinoamericano y así fortalecer y renovar las pedagogías y

Facultad de Administración de Empresas

474

Las Fuerzas Armadas y el Estado  

Microsoft Academic Search

La Argentina, como Nación, en el nuevo contexto internacional, de libre comercio y de interdependencia económica, no tiene aún una visión homogénea de su pasado. Cada corriente ideológica como así también cada grupo de interés, se inclina, inevitablemente, por aquellas personas o sucesos que sean afines con sus pensamientos, haciendo un análisis subjetivo del pasado para dar validez a su

Claudio Cuello

475

Índice de Comportamiento Objetivo. Una medida para valorar la respuesta al tratamiento de pacientes con trastornos de personalidad graves  

Microsoft Academic Search

Una medida que capta la frecuencia e intensidad de comportamientos disfuncionales experimentados, así como el uso de los servicios de salud mental, se desarrollaron y probaron como parte de un ensayo de tratamiento controlado de pacientes con trastorno de personalidad borderline. El índice de comportamiento objetivo (ICO) se realizó con 136 individuos diagnosti- cados de trastorno de personalidad borderline antes

Heather Munroe-Blum; Lynn McClearly

476

Transformações sociais - Mudanças psíquicas: uma possível relação. Estudo qualitativo sobre a condição feminina. * Social Transformations - Psychical changes: a possi ble relation. A qualitative study on the feminine condition  

Microsoft Academic Search

Resumo: Este estudo têm como objetivo analisar a relação da s possíveis mudanças psíquicas na mulher, a partir das inúmeras transformações sociais ocorridas nos últimos anos n a condição feminina. A pesquisa foi realizada com metodologia qualitativa. Como técnica de investigação, foi adotada a entrevis ta psicológica em sua forma aberta. Foram analisado s três casos. A compreensão das entrevistas

Bianca S. RODRIGUES; Maria Emília; L. SILVA

477

Gestión por competencias: importante para las pymes maquila de pantalón en índigo en la ciudad de Bogotá  

Microsoft Academic Search

Este artículo presenta una revisión de literatura internacional y nacional, sobre temas como el de competencias, los tipos de competencias, competencias laborales y proceso de implementación de la gestión por competencias. Adicionalmente, se muestra la reseña sobre la gestión por competencias en Colombia, así como la metodología utilizada para el trabajo de campo con relación al tema del artículo y

Nathalia Andrea Martínez Valero; Juan Carlos Rincón Gaviria

2010-01-01

478

IMPORTANCIA DE LA RESTRICCIÓN PRESUPUESTRIA INTERTEMPORAL EN UNA ECONOMÍA ABIERTA: CASO COLOMBIANO  

Microsoft Academic Search

Este documento analizó la importancia de la restricción presupuestaria intertemporal y la relevancia que cobra en medio de una coyuntura de incertidumbre y volatilidad como herramienta de diagnostico de la sostenibilidad internacional de los países; fue elaborado como una reflexión de investigación sobre los patrones de endeudamiento aplicando al caso de nuestro país. Para el análisis de los conceptos sobre

RAÚL QUEJADA PÉREZ; RONNY SIBAJA MORALES; SANDRA PATRICIA MOLINA PALENCIA

2010-01-01

479

El valor de uso recreativo del Parque Natural de L'Albufera a través del método indirecto del coste de viaje  

Microsoft Academic Search

La valoración económica de bienes que carecen de mercado, como son los espacios naturales protegidos, proporcionan una valiosa información que puede ser utilizada en el análisis coste-beneficio como fundamento de las decisiones públicas que afectan a la calidad del medio ambiente. En este trabajo se aplica el método indirecto del coste de viaje individual para obtener el valor de uso

S. DEL SAZ SALAZAR; L. PÉREZ Y PÉREZ

1999-01-01

480

DEPRESIÓN EN NIÑOS Y ADOLESCENTES: INFORMACIÓN PARA PADRES Y EDUCADORES DEPRESSION IN CHILDREN AND ADOLESCENTS: A PRIMER FOR PARENTS AND EDUCATORS  

Microsoft Academic Search

La depresión es un problema serio de salud que puede afectar a personas de todas las edades, incluyendo a niños y adolescentes. Generalmente se define como una experiencia en la que persiste una disposición de ánimo triste o irritable, así como también anhedonia, una pérdida de la habilidad de experimentar placer en casi todas las actividades. Incluye también una gama

481

POLÍTICA CRIMINAL DE LAS SANCIONES ALTERNATIVAS A LA PRISIÓN: CRITICAS AL DISCURSO OFICIAL  

Microsoft Academic Search

La pena privativa de libertad a través de la reclusión en el establecimiento carcelario, presentada como una opción alternativa y humanizante para el sistema punitivo vigente hasta el siglo XVII, que tenía como base las penas de muerte y corporales, desde su nacimiento se ha demostrado ineficiente para cumplir sus finalidades formalizadas por el ordenamiento, principalmente los que se refieren

Marcelo Nunes Apolinário

2008-01-01

482

ASPECTOS TEÓRICOS E PRÁTICOS ASSOCIADOS À DECISÃO DE USO DE AGROTÓXICOS: UMA ABORDAGEM INTEGRADA ENTRE A AGRICULTURA, MEIO AMBIENTE E SAÚDE PÚBLICA  

Microsoft Academic Search

O objetivo desse artigo é discutir o que leva o agricultor a aplicar ou não os agrotóxicos, bem como ressaltar quais são os elementos que estão por traz dessa decisão. O presente trabalho abordará o problema a partir de uma análise integrada entre agricultura, meio ambiente e saúde pública, estabelecendo elementos que dão legitimidade à agricultura sustentável como geradora de

Wagner Lopes Soares; Firpo De Souza Porto

2008-01-01

483

EL CASO POMAR: ENSAYO SOBRE LA DEMONIZACIÓN DE LO NO-COMPRENSIBLE  

Microsoft Academic Search

Hasta aquí, hemos descrito los hechos lo más objetivamente como sucedieron. No obstante, el presente trabajo tiene como objetivo estudiar los discursos acaecidos durante el lapso que la familia estuvo desparecida. Por regla general, la sociedad pone a disposición de sus ciudadanos todas las facilidades posibles en materia de seguridad para que éstos puedan desplazarse y circular (Foucault, 2006).

Korstanje Maximiliano E

2010-01-01

484

LA CLASE OCIOSA EN THORSTEIN VEBLEN (reseña)  

Microsoft Academic Search

El objeto de la siguiente reseña es interpretar minuciosamente el sentido que Veblen quiso darle a su teoría sobre “la clase ociosa” como así también su relación con el mundo académico universitario. En la actualidad, la bibliografía especializada en turismo apunta a la construcción de la clase ociosa, sólo como una forma de consumo de bienes y servicios de naturaleza

Korstanje Maximiliano

2008-01-01

485

COMENTARIOS SOBRE LA SATURACIÓN VISUAL: la paradoja de la mayoría  

Microsoft Academic Search

O turismo, diferente de outras áreas, constitui-se de um ramo de atividades executadas por pessoas que, em determinadas situações, tornam-se turistas. Como a área de estudo, o turismo é recente e vem sendo matéria de pesquisa em diversos campos com mais tradição como a sociologia, a economia, a geografia, a psicologia, dentre outras. Principalmente pelo fato de ser um campo

Maximiliano Korstanje

2008-01-01

486

CIENCIA Y NOCIENCIA EN EL TURISMO: RESPUESTA AL ANTROPÓLOGO DEL TURISMO MAXIMILIANO KORSTANJE  

Microsoft Academic Search

He leído con suma atención el trabajo de Korstanje pero tengo que decir, de entrada, que, desafortunadamente, ese trabajo no responde, como su autor cree, al mío. Mi trabajo versa sobre un hecho constatable, no sobre una opinión o sobre una teoría: la ausencia o ignorancia en la literatura del turismo de la función de producción. Como vengo de