NURSES' PERCEPTION REGARDING THE IMPLEMENTATION OF COMPUTER-BASED CLINICAL NURSING DOCUMENTATION

This qualitative, exploratory, descriptive study was performed with the objective of understanding the perception of the nurses working in medical-surgical units of a university hospital, regarding the strategies developed to perform a pilot test of the PROCEnf-USP electronic system, with the purpose of computerizing clinical nursing documentation. Eleven nurses of a theoretical-practical training program were interviewed and the obtained data were analyzed using the Content Analysis Technique. The following categories were discussed based on the references of participative management and planned changes: favorable aspects for the implementation; unfavorable aspects for the implementation; and expectations regarding the implementation. According to the nurses' perceptions, the preliminary use of the electronic system allowed them to show their potential and to propose improvements, encouraging them to become partners of the group manager in the dissemination to other nurses of the institution.

Anointing variation across wild capuchin populations: a review of material preferences, bout frequency and anointing sociality in Cebus and Sapajus

The frequency of anointing bouts and the materials used for self- and social anointing vary across capuchin species in captivity, but there is little published data on capuchin anointing in the wild. Here we present previously unpublished data on anointing behaviors from capuchin monkey populations at ten different field sites and incorporate these data into a review of the anointing literature for captive and wild capuchins. Using a comparative phylogenetic framework, we test four hypotheses derived primarily from captive literature for variation in anointing between wild untufted capuchins (Cebus) and tufted capuchins (Sapajus), including that (1) the frequency of anointing is higher in Cebus, (2) Cebus uses a higher proportion of plant species to insect species for anointing compared with Sapajus, (3) anointing material diversity is higher in Cebus, and (4) social indices of anointing are higher in Cebus. We found that wild Cebus anoints more with plant parts, including fruits, whereas wild Sapajus anoints more with ants and other arthropods. Cebus capucinus in particular uses more plant species per site for anointing compared with other capuchins and may specialize in anointing as an activity independent from foraging, whereas most other capuchin species tend to eat the substances they use for anointing. In agreement with captive studies, we found evidence that wild Cebus anoints at a significantly higher frequency than Sapajus. However, contrary to the captive literature, we found no difference in the range of sociality for anointing between Cebus and Sapajus in the wild. We review anointing in the context of other Neotropical primate rubbing behaviors and consider the evidence for anointing as self-medication; as a mechanism for enhanced sociality; and as a behavioral response to chemical stimuli. Am. J. Primatol. 74:299314, 2012. (c) 2011 Wiley Periodicals, Inc.

Petrology and Sr-Nd characteristics of the Nova Lacerda dike swarm, SW Amazonian Craton: new insights regarding its subcontinental mantle source and Mesoproterozoic geodynamics

The NNW-trending Nova Lacerda tholeiitic dike swarm in Mato Grosso State, Central Brazil, intrudes the Nova Lacerda granite (1.46 Ga) and the Jauru granite-greenstone terrain (ca. 1.79-1.77 Ga). The swarm comprises diabases I and II and amphibolites emplaced at ca. 1.38 Ga. Geochemical data indicate that these are evolved tholeiites characterized by high LILE/HSFE and LREE/HSFE ratios. Isotopic modelling yields positive epsilon(Nd)(T) values (+0.86 to +2.65), whereas values for epsilon(Sr)(T) range from positive to negative (+1.96 to -5.56). Crustal contamination did not play a significant petrogenetic role, as indicated by a comparison of isotopic data (Sr-Nd) from both dikes and country rocks, and by the relationship between isotopic and geochemical parameters (SiO2, K2O, Rb/Sr, and La/Yb) of the dikes. We attribute the origin of these tholeiites to fractional crystallization of evolved melts derived from a heterogeneous mantle source. Comparison of the geochemical and isotopic data of the studied swarm and other tholeiitic Mesoproterozoic mafic intrusions of the SWAmazonian Craton the Serra da Providencia, Colorado, and Nova Brasilandia bimodal suites - indicates that parental melts of the Nova Lacerda swarm were derived from the most enriched mantle source. This enrichment was probably caused by the stronger influence of the EMI component on the DMM end-member. These data, coupled with trace element bulk-rock geochemistry of the country rocks, and comparisons with the Colorado Complex of similar age, suggest a continental-margin arc setting for the emplacement of the Nova Lacerda dikes.

Geochemical evidence of the 8.2 ka event and other Holocene environmental changes recorded in paleolagoon sediments, southeastern Brazil

The paleoclimatic record of Jureia Paleolagoon, coastal southeastem Brazil, includes cyclic and gradual changes with different intensities and frequencies through geological time, and it is controlled by astronomical, geophysical, and geological phenomena. These variations are not due to one single cause, but they result from the interaction of several factors, which act at different temporal and spatial scales. Here, we describe paleoenvironmental evidence regarding climatic and sea level changes from the last 9400 cal yr BP at the Jureia Paleolagoon - one of the main groups of protected South Atlantic ecosystems. Geochemical evidences were used to identify anomalies from multi-proxy analyses of a paleolagoon sediment core. The anomalies of centennial scale were correlated to climate and transgression-regression cycles from the Holocene period. Decadal scale anomalous oscillations in the Quaternary paleolagoon sediments occur between 9400 and 7500 cal yr BP, correlated with long- and short-term natural events, which generated high sedimentation rates, mainly between 8385 and 8375 cal yr BP (10 cm/yr). Our results suggest that a modem-day short-duration North Atlantic climatic event, such as the 82 ka event, could affect the environmental equilibrium in South America and intensify the South American Summer Monsoon. (C) 2011 University of Washington. Published by Elsevier Inc. All rights reserved.

Three-dimensional CT reconstruction: other tool to teach in the veterinary colleges

[ES]The purpose of this paper was to use threedimensional computed tomographic reconstruction as another tool to teach in the veterinary colleges. 2-millimeters thick transverse images of two foals and one dog were obtained. Images provided excellent detail of relevant anatomic structures and detailed information regarding the extent of disease and accurate discrimination of neoplastic versus non-neoplastic diseases. Tridimensional reconstruction can be a valuable diagnostic aid for clinical evaluation of several disturbances and could be used as a tool for teaching anatomy in veterinary schools.

Eco-Management and Audit Scheme (EMAS): An evaluation of success factors in the agricultural sector. The case of Italy's Emilia Romagna region.

Different tools have been used to set up and adopt the model for the fulfillment of the objective of this research. 1. The Model The base model that has been used is the Analytical Hierarchy Process (AHP) adapted with the aim to perform a Benefit Cost Analysis. The AHP developed by Thomas Saaty is a multicriteria decision - making technique which decomposes a complex problem into a hierarchy. It is used to derive ratio scales from both discreet and continuous paired comparisons in multilevel hierarchic structures. These comparisons may be taken from actual measurements or from a fundamental scale that reflects the relative strength of preferences and feelings. 2. Tools and methods 2.1. The Expert Choice Software The software Expert Choice is a tool that allows each operator to easily implement the AHP model in every stage of the problem. 2.2. Personal Interviews to the farms For this research, the farms of the region Emilia Romagna certified EMAS have been detected. Information has been given by EMAS center in Wien. Personal interviews have been carried out to each farm in order to have a complete and realistic judgment of each criteria of the hierarchy. 2.3. Questionnaire A supporting questionnaire has also been delivered and used for the interviews . 3. Elaboration of the data After data collection, the data elaboration has taken place. The software support Expert Choice has been used . 4. Results of the Analysis The result of the figures above (vedere altro documento) gives a series of numbers which are fractions of the unit. This has to be interpreted as the relative contribution of each element to the fulfillment of the relative objective. So calculating the Benefits/costs ratio for each alternative the following will be obtained: Alternative One: Implement EMAS Benefits ratio: 0, 877 Costs ratio: 0, 815 Benfit/Cost ratio: 0,877/0,815=1,08 Alternative Two: Not Implement EMAS Benefits ratio: 0,123 Costs ration: 0,185 Benefit/Cost ratio: 0,123/0,185=0,66 As stated above, the alternative with the highest ratio will be the best solution for the organization. This means that the research carried out and the model implemented suggests that EMAS adoption in the agricultural sector is the best alternative. It has to be noted that the ratio is 1,08 which is a relatively low positive value. This shows the fragility of this conclusion and suggests a careful exam of the benefits and costs for each farm before adopting the scheme. On the other part, the result needs to be taken in consideration by the policy makers in order to enhance their intervention regarding the scheme adoption on the agricultural sector. According to the AHP elaboration of judgments we have the following main considerations on Benefits: - Legal compliance seems to be the most important benefit for the agricultural sector since its rank is 0,471 - The next two most important benefits are Improved internal organization (ranking 0,230) followed by Competitive advantage (ranking 0, 221) mostly due to the sub-element Improved image (ranking 0,743) Finally, even though Incentives are not ranked among the most important elements, the financial ones seem to have been decisive on the decision making process. According to the AHP elaboration of judgments we have the following main considerations on Costs: - External costs seem to be largely more important than the internal ones (ranking 0, 857 over 0,143) suggesting that Emas costs over consultancy and verification remain the biggest obstacle. - The implementation of the EMS is the most challenging element regarding the internal costs (ranking 0,750).

Reasoning with incomplete and imprecise preferences

Preferences are present in many real life situations but it is often difficult to quantify them giving a precise value. Sometimes preference values may be missing because of privacy reasons or because they are expensive to obtain or to produce. In some other situations the user of an automated system may have a vague idea of whats he wants. In this thesis we considered the general formalism of soft constraints, where preferences play a crucial role and we extended such a framework to handle both incomplete and imprecise preferences. In particular we provided new theoretical frameworks to handle such kinds of preferences. By admitting missing or imprecise preferences, solving a soft constraint problem becomes a different task. In fact, the new goal is to find solutions which are the best ones independently of the precise value the each preference may have. With this in mind we defined two notions of optimality: the possibly optimal solutions and the necessary optimal solutions, which are optimal no matter we assign a precise value to a missing or imprecise preference. We provided several algorithms, bases on both systematic and local search approaches, to find such kind of solutions. Moreover, we also studied the impact of our techniques also in a specific class of problems (the stable marriage problems) where imprecision and incompleteness have a specific meaning and up to now have been tackled with different techniques. In the context of the classical stable marriage problem we developed a fair method to randomly generate stable marriages of a given problem instance. Furthermore, we adapted our techniques to solve stable marriage problems with ties and incomplete lists, which are known to be NP-hard, obtaining good results both in terms of size of the returned marriage and in terms of steps need to find a solution.

Do domestic interests matter? – Der Einfluss nationaler Interessengruppen auf die Position von Staaten zur Umweltpolitik auf EU-Ebene

Wie kann man Ergebnisse internationaler Umweltpolitik erklären? Wie hilfreich ist dabei die liberale Theorie der Internationalen Beziehungen (IB) von Andrew Moravcsik? Die vorliegende Arbeit versucht diese Fragen anhand eines Fallbeispiels internationaler Umweltpolitik – der Position der Bundesrepublik Deutschland bezüglich der einzelnen Streitfragen der EU-Verordnung 443/2009 über den CO2-Ausstoß von Automobilen – zu beantworten. Es wird eine theoriegeleitete Außenpolitikanalyse durchgeführt, deren Hauptaugenmerk auf der spezifischen nationalen Präferenzbildung in einem bestimmten Fall liegt. Hier weist Moravcsiks Theorie eine „Lücke“ auf. Wessen Interessen sich aus welchen Gründen in einer bestimmten Situation wie durchsetzen und damit Politik beeinflussen bleibt unklar. Deshalb erweitert die Arbeit Moravcsiks liberale Theorie der IB mithilfe von Annahmen und Erkenntnissen aus der Verbändeforschung nach innen. Auf diese Weise werden die situationsspezifischen Interessen und die situationsspezifische Durchsetzungsfähigkeit der betroffenen Akteure – nationale Interessengruppen – erhoben und untersucht, inwiefern man mit ihrer Hilfe die deutsche Position zur EU-Verordnung 443/2009 erklären kann. Empirisch erweist sich dabei, dass die Position der BRD zu acht von neun Streitfragen der EU-Verordnung 443/2009 den Interessen einer Koalition aus Industriegewerkschaft (IG) Metall und Verband der Automobilindustrie (VDA) entsprach, weil diese im vorliegenden Fall mit Abstand die größte Durchsetzungsfähigkeit aufwiesen. Lediglich bezüglich einer Streitfrage wich die Position der BRD von den Interessen von IG Metall und VDA ab. Damit lässt sich festhalten: Die Position der BRD zur EU-Verordnung 443/2009 kann weitgehend mithilfe der nach innen erweiterten liberalen Theorie nach Andrew Moravcsik erklärt werden. Trotz möglicher Schwierigkeiten bei der Übertragung erscheint daher eine Anwendung des nach innen erweiterten Liberalismus auf weitere erklärungsbedürftige Phänomene der internationalen Umweltpolitik und damit eine Überprüfung der Theorie insgesamt eine interessante und sinnvolle Aufgabe zu sein.

Benchmarking in the SWISSspine registry: results of 52 Dynardi lumbar total disc replacements compared with the data pool of 431 other lumbar disc prostheses

The SWISSspine registry is the first mandatory registry of its kind in the history of Swiss orthopaedics and it follows the principle of "coverage with evidence development". Its goal is the generation of evidence for a decision by the Swiss federal office of health about reimbursement of the concerned technologies and treatments by the basic health insurance of Switzerland. Recently, developed and clinically implemented, the Dynardi total disc arthroplasty (TDA) accounted for 10% of the implanted lumbar TDAs in the registry. We compared the outcomes of patients treated with Dynardi to those of the recipients of the other TDAs in the registry. Between March 2005 and October 2009, 483 patients with single-level TDA were documented in the registry. The 52 patients with a single Dynardi lumbar disc prosthesis implanted by two surgeons (CE and OS) were compared to the 431 patients who received one of the other prostheses. Data were collected in a prospective, observational multicenter mode. Surgery, implant, 3-month, 1-year, and 2-year follow-up forms as well as comorbidity, NASS and EQ-5D questionnaires were collected. For statistical analyses, the Wilcoxon signed-rank test and chi-square test were used. Multivariate regression analyses were also performed. Significant and clinically relevant reduction of low back pain and leg pain as well as improvement in quality of life was seen in both groups (P < 0.001 postop vs. preop). There were no inter-group differences regarding postoperative pain levels, intraoperative and follow-up complications or revision procedures with a new hospitalization. However, significantly more Dynardi patients achieved a minimum clinically relevant low back pain alleviation of 18 VAS points and a quality of life improvement of 0.25 EQ-5D points. The patients with Dynardi prosthesis showed a similar outcome to patients receiving the other TDAs in terms of postoperative low back and leg pain, complications, and revision procedures. A higher likelihood for achieving a minimum clinically relevant improvement of low back pain and quality of life in Dynardi patients was observed. This difference might be due to the large number of surgeons using other TDAs compared to only two surgeons using the Dynardi TDA, with corresponding variations in patient selection, patient-physician interaction and other factors, which cannot be assessed in a registry study.

Behaviour of general dental practitioners in Germany regarding posterior restorations with flowable composites

Because the recommendation to use flowables for posterior restorations is still a matter of debate, the objective of this study was to determine in a nationwide survey in Germany how frequently, for what indications, and for what reasons, German dentists use flowable composites in posterior teeth. In addition, the acceptance of a simplified filling technique for posterior restorations using a low stress flowable composite was evaluated. Completed questionnaires from all over Germany were returned by 1,449 dentists resulting in a response rate of 48.5%; 78.6% of whom regularly used flowable composites for posterior restorations. The most frequent indications were cavity lining (80.1%) and small Class I fillings (74.2%). Flowables were less frequently used for small Class II fillings (22.7%) or other indications (13.6%). Most frequent reasons given for the use of flowables in posterior teeth were the prevention of voids (71.7%) and superior adaptation to cavity walls (72.9%), whereas saving time was considered less important (13.8%). Based on the subjective opinion of the dentists the simplified filling technique seemed to deliver advantages compared to the methods used to date particularly with regard to good cavity adaptation and ease of use. In conclusion, resin composites are the standard material type used for posterior restorations by general dental practitioners in Germany and most dentists use flowable composites as liners.

Individual differences in first and fourth year college women’s short term mating strategy preferences and perceptions

Using survey methodology, a cross sectional study was undertaken to ascertain whether first and fourth year college women have different perceptions and behavior associated with short term mating preferences. It was hypothesized that after incurring significant negative or costly experiences associated with hooking up, fourth year women would prefer men who had qualities associated with a desired long term partner as opposed to characteristics associated with short term mating partners. The results were partially consistent with the hypothesis. Reported preferences in a desired partner and perspective on hooking up differ between first and fourth year groups. No difference was found between frequency and willingness to hookup between the two groups. The findings are explained in terms of evolutionary theory, social exchange theory, and sexual script concepts.

Format preferences of district attorneys for post-mortem medical imaging reports: understandability, cost effectiveness, and suitability for the courtroom: a questionnaire based study

The objective of this study was to explore the perception of the legal authorities regarding different report types and visualization techniques for post-mortem radiological findings.

[Investigation of abortions and other animal health problems in relation to vaccination against Bluetongue virus in 2009]

By the distribution of a questionnaire between all Swiss cattle practitioners it was possible to investigate abortions and other animal health problems related to Bluetongue vaccination 2009. The questionnaire helped to obtain plausibility and timely relation of the reported disorders. 58 abortions in cattle and different herd health problems could be examined. Because there is no possibility to show that a vaccination itself leads to an abortion the results of proven causes of abortions prior and after Bluetongue vaccination were compared regarding their diagnosis. Due to the fact that diagnosis and solving rate of abortions did not differ before and after vaccination, the vaccination itself cannot be responsible for the abortions. Evaluation of different herd health problems showed that Bluetongue vaccination was not responsible for these disorders which often existed already prior to vaccination. Herd health problems generally have multifactorial causes what makes it difficult to asses the effect of Bluetongue vaccination in some cases.

Government Influence and the Failure of Fannie Mae and Freddie Mac

In 2008 two government-sponsored enterprises, Fannie Mae and Freddie Mac, were placed into conservatorship due to insolvency. The financial bailout of the two publically traded corporations came at the expense of the American tax payer. This study investigates the relationship between direct and indirect government influence and the increasing risk taking of Fannie Mae and Freddie Mac from the late 1990’s through their conservatorship in 2008. As government-sponsored enterprises Fannie Mae and Freddie Mac have many special advantages that other publically traded companies did not possess. These advantages allowed Fannie Mae and Freddie Mac to increase their profitability. Theoretical literature regarding Congress and the bureaucracy suggests that the actions of bureaucrats can be linked to the preferences of Congressional members because bureaucrats are responsive to potential threats or perceived threats from the legislature. This theory is applicable to Fannie Mae and Freddie Mac, and is used to explain why the government was able to directly and indirectly influence the government-sponsored enterprises. Overall this investigation has determined that the United States government pursued a clear mission that determined to increase the availability of housing to all Americans, specifically to low-income and under-served individuals, through the use of the government-sponsored enterprises. Despite this link there is no conclusive data to show that the pursuit of this housing mission led Fannie Mae and Freddie Mac to operate in riskier business segments. This study has also found that motivation regarding profit-seeking and compensation structure provide a more plausible explanation for why the government-sponsored enterprises began to engage in riskier business practices that led to their insolvency.

The Permanent Income Hypothesis: A Test on Czech Privatisation

Since the late eighties, economists have been regarding the transition from command to market economies in Central and Eastern Europe with intense interest. In addition to studying the transition per se, they have begun using the region as a testing ground on which to investigate the validity of certain classic economic propositions. In his research, comprising three articles written in English and totalling 40 pages, Mr. Hanousek uses the so-called "Czech national experiment" (voucher privatisation scheme) to test the permanent income hypothesis (PIH). He took as his inspiration Kreinin's recommendation: "Since data concerning the behaviour of windfall income recipients is relatively scanty, and since such data can constitute an important test of the permanent income hypothesis, it is of interest to bring to bear on the hypothesis whatever information is available". Mr. Hanousek argues that, since the transfer of property to Czech citizens from 1992 to 1994 through the voucher scheme was not anticipated, it can be regarded as windfall income. The average size of the windfall was more than three month's salary and over 60 percent of the Czech population received this unexpected income. Furthermore, there are other reasons for conducting such an analysis in the Czech Republic. Firstly, the privatisation process took place quickly. Secondly, both the economy and consumer behaviour have been very stable. Thirdly, out of a total population of 10 million Czech citizens, an astonishing 6 million, that is, virtually every household, participated in the scheme. Thus Czech voucher privatisation provides a sample for testing the PIH almost equivalent to a full population, thus avoiding problems with the distribution of windfalls. Compare this, for instance with the fact that only 4% of the Israeli urban population received personal restitution from Germany, while the number of veterans who received the National Service Life Insurance Dividends amounted to less than 9% of the US population and were concentrated in certain age groups. But to begin with, Mr. Hanousek considers the question of whether the public percieves the transfer from the state to individual as an increase in net wealth. It can be argued that the state is only divesting itself of assets that would otherwise provide a future source of transfers. According to this argument, assigning these assets to individuals creates an offsetting change in the present value of potential future transfers so that individuals are no better off after the transfer. Mr. Hanousek disagrees with this approach. He points out that a change in the ownership of inefficient state-owned enterprises should lead to higher efficiency, which alone increases the value of enterprises and creates a windfall increase in citizens' portfolios. More importantly, the state and individuals had very different preferences during the transition. Despite government propaganda, it is doubtful that citizens of former communist countries viewed government-owned enterprises as being operated in the citizens' best interest. Moreover, it is unlikely that the public fully comprehended the sophisticated links between the state budget, state-owned enterprises, and transfers to individuals. Finally, the transfers were not equal across the population. Mr. Hanousek conducted a survey on 1263 individuals, dividing them into four monthly earnings categories. After determining whether the respondent had participated in the voucher process, he asked those who had how much of what they received from voucher privatisation had been (a) spent on goods and services, (b) invested elsewhere, (c) transferred to newly emerging pension funds, (d) given to a family member, and (e) retained in their original form as an investment. Both the mean and the variance of the windfall rise with income. He obtained similar results with respect to education, where the mean (median) windfall for those with a basic school education was 13,600 Czech Crowns (CZK), a figure that increased to 15,000 CZK for those with a high school education without exams, 19,900 CZK for high school graduates with exams, and 24,600 CZK for university graduates. Mr. Hanousek concludes that it can be argued that higher income (and better educated) groups allocated their vouchers or timed the disposition of their shares better. He turns next to an analysis of how respondents reported using their windfalls. The key result is that only a relatively small number of individuals reported spending on goods. Overall, the results provide strong support for the permanent income hypothesis, the only apparent deviation being the fact that both men and women aged 26 to 35 apparently consume more than they should if the windfall were annuitised. This finding is still fully consistent with the PIH, however, if this group is at a stage in their life-cycle where, without the windfall, they would be borrowing to finance consumption associated with family formation etc. Indeed, the PIH predicts that individuals who would otherwise borrow to finance consumption would consume the windfall up to the level equal to the annuitised fraction of the increase in lifetime income plus the full amount of the previously planned borrowing for consumption. Greater consumption would then be financed, not from investing the windfall, but from avoidance of future repayment obligations for debts that would have been incurred without the windfall.