821 resultados para Factors of professional satisfaction


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In the present study, we evaluated peripheral and central auditory pathways in professional musicians (with and without hearing loss) compared to non-musicians. The goal was to verify if music exposure could affect auditory pathways as a whole. This is a prospective study that compared the results obtained between three groups (musicians with and without hearing loss and non-musicians). Thirty-two male individuals participated and they were assessed by: Immittance measurements, pure-tone air conduction thresholds at all frequencies from 0.25 to 20 kHz, Transient Evoked Otoacoustic Emissions, Auditory Brainstem Response (ABR), and Cognitive Potential. The musicians showed worse hearing thresholds in both conventional and high frequency audiometry when compared to the non-musicians; the mean amplitude of Transient Evoked Otoacoustic Emissions was smaller in the musicians group, but the mean latencies of Auditory Brainstem Response and Cognitive Potential were diminished in the musicians when compared to the non-musicians. Our findings suggest that the population of musicians is at risk for developing music-induced hearing loss. However, the electrophysiological evaluation showed that latency waves of ABR and P300 were diminished in musicians, which may suggest that the auditory training to which these musicians are exposed acts as a facilitator of the acoustic signal transmission to the cortex.

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Abstract Background Neoadjuvant chemotherapy has been considered the standard care in locally advanced breast cancer. However, about 20% of the patients do not benefit from this clinical treatment and, predictive factors of response were not defined yet. This study was designed to evaluate the importance of biological markers to predict response and prognosis in stage II and III breast cancer patients treated with taxane and anthracycline combination as neoadjuvant setting. Methods Sixty patients received preoperative docetaxel (75 mg/m2) in combination with epirubicin (50 mg/m2) in i.v. infusion in D1 every 3 weeks after incisional biopsy. They received adjuvant chemotherapy with CMF or FEC, attaining axillary status following definitive breast surgery. Clinical and pathologic response rates were measured after preoperative therapy. We evaluated the response rate to neoadjuvant chemotherapy and the prognostic significance of clinicopathological and immunohistochemical parameters (ER, PR, p51, p21 and HER-2 protein expression). The median patient age was 50.5 years with a median follow up time 48 months after the time of diagnosis. Results Preoperative treatment achieved clinical response in 76.6% of patients and complete pathologic response in 5%. The clinical, pathological and immunohistochemical parameters were not able to predict response to therapy and, only HER2 protein overexpression was associated with a decrease in disease free and overall survival (P = 0.0007 and P = 0.003) as shown by multivariate analysis. Conclusion Immunohistochemical phenotypes were not able to predict response to neoadjuvant chemotherapy. Clinical response is inversely correlated with a risk of death in patients submitted to neoadjuvant chemotherapy and HER2 overexpression is the major prognostic factor in stage II and III breast cancer patients treated with a neoadjuvant docetaxel and epirubicin combination.

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Abstract Background Hepatitis C chronic liver disease is a major cause of liver transplant in developed countries. This article reports the first nationwide population-based survey conducted to estimate the seroprevalence of HCV antibodies and associated risk factors in the urban population of Brazil. Methods The cross sectional study was conducted in all Brazilian macro-regions from 2005 to 2009, as a stratified multistage cluster sample of 19,503 inhabitants aged between 10 and 69 years, representing individuals living in all 26 State capitals and the Federal District. Hepatitis C antibodies were detected by a third-generation enzyme immunoassay. Seropositive individuals were retested by Polymerase Chain Reaction and genotyped. Adjusted prevalence was estimated by macro-regions. Potential risk factors associated with HCV infection were assessed by calculating the crude and adjusted odds ratios, 95% confidence intervals (95% CI) and p values. Population attributable risk was estimated for multiple factors using a case–control approach. Results The overall weighted prevalence of hepatitis C antibodies was 1.38% (95% CI: 1.12%–1.64%). Prevalence of infection increased in older groups but was similar for both sexes. The multivariate model showed the following to be predictors of HCV infection: age, injected drug use (OR = 6.65), sniffed drug use (OR = 2.59), hospitalization (OR = 1.90), groups socially deprived by the lack of sewage disposal (OR = 2.53), and injection with glass syringe (OR = 1.52, with a borderline p value). The genotypes 1 (subtypes 1a, 1b), 2b and 3a were identified. The estimated population attributable risk for the ensemble of risk factors was 40%. Approximately 1.3 million individuals would be expected to be anti-HCV-positive in the country. Conclusions The large estimated absolute numbers of infected individuals reveals the burden of the disease in the near future, giving rise to costs for the health care system and society at large. The known risk factors explain less than 50% of the infected cases, limiting the prevention strategies. Our findings regarding risk behaviors associated with HCV infection showed that there is still room for improving strategies for reducing transmission among drug users and nosocomial infection, as well as a need for specific prevention and control strategies targeting individuals living in poverty.

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BACKGROUND: Porphyria cutanea tarda is the most common form of porphyria, characterized by the decreased activity of the uroporphyrinogen decarboxylase enzyme. Several reports associated HFE gene mutations of hereditary hemochromatosis with porphyria cutanea tarda worldwide, although up to date only one study has been conducted in Brazil. OBJECTIVES: Investigation of porphyria cutanea tarda association with C282Y and H63D mutations in the HFE gene. Identification of precipitating factors (hepatitis C, HIV, alcoholism and estrogen) and their link with HFE mutations. METHODS: An ambispective study of 60 patients with PCT was conducted during the period from 2003 to 2012. Serological tests for hepatitis C and HIV were performed and histories of alcohol abuse and estrogen intake were investigated. HFE mutations were identified with real-time PCR. RESULTS: Porphyria cutanea tarda predominated in males and alcohol abuse was the main precipitating factor. Estrogen intake was the sole precipitating factor present in 25% of female patients. Hepatitis C was present in 41.7%. All HIV-positive patients (15.3%) had a history of alcohol abuse. Allele frequency for HFE mutations, i.e., C282Y (p = 0.0001) and H63D (p = 0.0004), were significantly higher in porphyria cutanea tarda patients, compared to control group. HFE mutations had no association with the other precipitating factors. CONCLUSIONS: Alcohol abuse, hepatitis C and estrogen intake are prevalent precipitating factors in our porphyria cutanea tarda population; however, hemochromatosis in itself can also contribute to the outbreak of porphyria cutanea tarda, which makes the research for HFE mutations necessary in these patients

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[EN]The beneficial or detrimental role of battered piles on the dynamic response of piled foundations has not been yet fully elucidated. In order to shed more light on this aspect, kinematic interaction factors of deep foundations with inclined piles, are provided for single battered piles, as well as for 2X2 and 3X3 groups of piles subjected to vertically incident plane shear S waves.

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Customer satisfaction has been traditionally studied and measured regardless of the time elapsed since the purchase. Some studies have recently reopened the debate about the temporal pattern of satisfaction. This research aims to explain why “how you evaluate a service depends on when you evaluate it” on the basis of the theoretical framework proposed by Construal-Level Theory (CLT). Although an empirical investigation is still lacking, the literature does not deny that CLT can be applied also with regard to past events. Moreover, some studies support the idea that satisfaction is a good predictor of future intentions, while others do not. On the basis of CLT, we argue that these inconsistent results are due to the different construal levels of the information pertaining to retrospective and prospective evaluations. Building on the Two-Factor Theory, we explain the persistence of certain attributes’ representations over time according to their relationship with overall performance. We present and discuss three experiments and one field study that were conducted a) to test the extensibility of CLT to past events, b) to disentangle memory and construal effects, c) to study the effect of different temporal perspective on overall satisfaction judgements, and d) to investigate the temporal shift of the determinants of customer satisfaction as a function of temporal distance.

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In order to assess medical students' knowledge of Basic Life Support (BLS) principles, we defined a minimal knowledge (MK) of three life-threatening medical conditions that should be universally known: cardiac arrest, heart attack and stroke, and compared the results with those of laypersons.

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The aim of this study was to determine risk factors for mortality in different age groups after thoracic endovascular aortic repair (TEVAR).

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STUDY DESIGN: Retrospective case review. OBJECTIVES: In the present study, the neurological outcome, retirement and prognostic factors of patients with spinal cord injury without radiographic abnormality (SCIWORA) were evaluated. SETTING: Swiss national work accident insurance database. METHODS: The medical histories of 32 patients who were insured by the Swiss Accident Insurance Fund (SUVA) and had SCIWORA between 1995 and 2004 were evaluated thoroughly. Moreover, all available magnetic resonance imaging (MRI) scans were evaluated. RESULTS: At the last follow-up, none of the patients had complete spinal cord injury, only 4 patients had severe deficits and 12 patients had normal motor and sensory function in the neurological examination. However, only 7 out of 32 patients had returned to full-time work and 10 out of 32 patients were fully retired. Both the presence of spinal cord change (ρ=0.51) and higher maximum spinal cord compression (ρ=0.57) in MRI scan correlated with the likelihood for retirement; older age (ρ=0.38) and physical load of work (ρ=0.4) correlated with retirement to a lesser extent. CONCLUSION: Although the neurological outcome of SCIWORA is mostly good, the retirement rate is high. Presence of spinal cord change and severity of cord compression are the best predictors for the degree of retirement.

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Background: Autogenous bone grafts obtained by different harvesting techniques behave differently during the process of graft consolidation; the underlying reasons are however not fully understood. One theory is that harvesting techniques have an impact on the number and activity of the transplanted cells which contribute to the process of graft consolidation. Materials and Methods: To test this assumption, porcine bone grafts were harvested with four different surgical procedures: bone mill, piezosurgery, bone drilling (bone slurry), and bone scraper. After determining cell viability, the release of molecules affecting bone formation and resorption was assessed by reverse transcription polymerase chain reaction and immunoassay. The mitogenic and osteogenic activity of the conditioned media was evaluated in a bioassay with isolated bone cells. Results: Cell viability and the release of molecules affecting bone formation were higher in samples harvested by bone mill and bone scraper when compared with samples prepared by bone drilling and piezosurgery. The harvesting procedure also affected gene expression, for example, bone mill and bone scraper samples revealed significantly higher expression of growth factors such as bone morphogenetic protein-2 and vascular endothelial growth factor compared with the two other modalities. Receptor activator of nuclear factor kappa B ligand expression was lowest in bone scraper samples. Conclusion: These data can provide a scientific basis to better understand the impact of harvesting techniques on the number and activity of transplanted cells, which might contribute to the therapeutic outcome of the augmentation procedure.

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There exists some discrepancy considering the overall health and well-being of young women in sports and performance domains. The current study aimed to examine self-reported levels of perfectionism, body esteem, and social support among college women participating in organized sports and dance. A total of 103 participants completeda series of questionnaires intended to capture these major variables of interest. Results upheld one of three major hypotheses, specifically in regards to between-group differences for lean and non-lean sport athletes. One of the most important findings wasthat among lean sport participants the relationship between body esteem and social support was statistically significant and positive, and among non-lean sport participants this same relationship was nonsignificant and negative. The applied implication of thisfinal finding is discussed, with particular emphasis on potential strategies for upholding the positive relationship between body esteem and social support among lean sport athletes.

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This study of the process of language shift and maintenance in the bilingual community of Romanians living in Hungary was based on 40 tape-recorded Romanian sociolinguistic interviews. These were transcribed into computerised form and provide an excellent source of sociolinguistic, contact linguistic and discourse analysis data, making it possible to show the effect of internal and external factors on the bilingual speech mode. The main topics considered were the choice of Romanian and Hungarian in community interactions, factors of language choice, code-switching: introlanguage and interlanguage, reasons for code-switching, the relationship between age and the frequency of code switching in the interview situation, and the unequal competition of minority and majority languages at school.

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This study of the process of language shift and maintenance in the bilingual community of Romanians living in Hungary was based on 40 tape-recorded Romanian sociolinguistic interviews. These were transcribed into computerised form and provide an excellent source of sociolinguistic, contact linguistic and discourse analysis data, making it possible to show the effect of internal and external factors on the bilingual speech mode. The main topics considered were the choice of Romanian and Hungarian in community interactions, factors of language choice, code-switching: introlanguage and interlanguage, reasons for code-switching, the relationship between age and the frequency of code switching in the interview situation, and the unequal competition of minority and majority languages at school.