878 resultados para expectations gaps


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This article reports the case of a 55-year-old female patient who presented with unsatisfactory temporary crowns in the right mandibular premolars and molars, and a premolar-to-molar fixed partial denture in the left side. The clinical and radiographic examinations revealed a fracture of the left first premolar that was a retainer of the fixed partial denture and required extraction. Initially, the acrylic resin crowns were replaced by new ones, and a provisional RPD was made using acrylic resin and orthodontic wire clasps to resolve the problem arising from the loss of the fixed partial denture. Considering the patient's high esthetic demands, the treatment options for the definitive prosthetic treatment were discussed with her and rehabilitation with implant-supported dentures was proposed because the clinical conditions of the residual alveolar ridge were suitable for implant installation, and the patient's general health was excellent. However, the patient did not agree because she knew of a failed case of implant-retained denture in a diabetic individual and was concerned. The patient was fully informed that implant installation was the best indication for her case, but the arguments were not sufficient to change her decision. The treatment possibilities were presented and the patient opted for a clasp-retained removable partial denture (RPD) associated with the placement of crowns in the pillar teeth. The temporary RPD was replaced by the definitive RPD constructed subsequently. Although RPD was not the first choice, satisfactory esthetic and functional outcomes were achieved, overcaming the patient's expectations. This case report illustrates that the dentist must be prepared to deal with situations where, for reasons that cannot be managed, the patient does not accept the treatment considered as the most indicated for his/her case. Alternatives must be proposed and the functional and esthetic requirements must be fulfilled in the best possible manner.

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As orientações aos pais favorecem a aceitação da deficiência auditiva e esclarecem possibilidades e condutas que viabilizam o desenvolvimento da criança. Devem ser cuidadosas, a fim de evitar insegurança, ansiedade, expectativas irreais ou reações inadequadas dos pais. Essas orientações são oferecidas no diagnóstico e no acompanhamento, mas as restrições de tempo e financeiras são dificuldades dos pais para o comparecimento freqüente a programas que forneçam um suporte contínuo. A proposta deste trabalho foi elaborar e avaliar um programa de orientação não presencial para pais de crianças com deficiência auditiva severa e profunda, de dois a seis anos de idade. O programa, estruturado em quatro unidades, foi aplicado a 30 pais atendidos no Hospital de Reabilitação de Anomalias Craniofaciais da USP, em Bauru/SP. As unidades foram formuladas com base nas orientações que os especialistas de diferentes áreas transmitem durante o diagnóstico da deficiência auditiva e nas dificuldades e interesses dos pais, identificando-se o conhecimento sobre as avaliações e acompanhamentos, opiniões sobre desempenho e necessidades da criança, deles próprios e das famílias. Para avaliação do programa foram analisadas as respostas dos pais aos questionários das unidades e às entrevistas finais. As análises revelaram que o programa forneceu aos pais, como eles desejavam, informações claras e sugestões de atividades que pudessem ser adequadas ao contexto familiar e colaborassem para o desenvolvimento da criança. Alguns pais encontraram dificuldade em se expressar por escrito e realizar algumas atividades, mas nas entrevistas, foi verificado que tal fato não inviabilizou o entendimento e a participação no programa.

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Cefalópodes coleóides (lulas, sépias e polvos) produzem espermatóforos muito complexos que são transferidos à fêmea durante a cópula por meio do hectocótilo, um apêndice modificado nos machos. Durante a transferência à fêmea, ocorre a chamada "reação espermatofórica", complexo processo de evaginação do aparato ejaculatório do espermatóforo, que conduz à exteriorização da massa espermática e corpo cimentante. A presente revisão sintetiza o conhecimento acerca da morfologia e funcionamento desta estrutura exclusiva dos coleóides, identificando lacunas e definindo estratégias que possibilitem avanços na área. Poucos trabalhos abordam com detalhes a morfologia e anatomia funcional dos espermatóforos dos cefalópodes, grande parte do conhecimento acerca da estrutura do espermatóforo tendo sido gerada por trabalhos clássicos do século XIX e início do século XX. Investigações acerca do funcionamento dos espermatóforos são consideravelmente mais raras, estando o conhecimento básico sobre a reação espermatofórica restrito a apenas 19 espécies de coleóides. A revisão da literatura especializada permite sugerir que existem dois tipos básicos de fixação de espermatóforos em Decapodiformes (lulas e sepióides): fixação superficial e implante profundo (ou intra-dérmico). Na fixação superficial, comum em diversas espécies (e.g., Loliginidae, Sepiidae, Ommastrephidae), a base dos espermatângios é aderida ao tecido-alvo aparentemente por meio do corpo cimentante, a partir de substâncias adesivas e, em alguns casos, estruturas de fixação. No implante profundo, comum em alguns grupos de lulas oceânicas e de águas profundas (e.g., Architeuthidae, Cranchiidae, Octopoteuthidae, Sepiolidae), os espermatóforos implantam-se inteiramente no corpo da fêmea, de forma autônoma. Permanece desconhecido o mecanismo responsável pelo implante profundo. Em Octopodiformes (polvos), o espermatóforo é inserido no gonoduto feminino, alcançando a glândula oviducal, onde estão localizadas as espermatecas, ou a cavidade do ovário. Como o funcionamento extracorpóreo dos espermatóforos depende exclusivamente da intrincada estrutura e organização de seus componentes (e.g., membranas e túnicas), somente investigações detalhadas dessas estruturas proverão as bases para a compreensão do funcionamento e da exata função do complexo espermatóforo dos coleóides. Recomenda-se o desenvolvimento de um protocolo simples e eficiente para coloração e preparação total de espermatóforos, de forma que seja possível expandir as descrições morfológicas do espermatóforo em estudos taxonômicos e anatômicos, permitindo, portanto, ampliação do conhecimento acerca desta enigmática estrutura.

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In this work we report on a comparison of some theoretical models usually used to fit the dependence on temperature of the fundamental energy gap of semiconductor materials. We used in our investigations the theoretical models of Viña, Pässler-p and Pässler-ρ to fit several sets of experimental data, available in the literature for the energy gap of GaAs in the temperature range from 12 to 974 K. Performing several fittings for different values of the upper limit of the analyzed temperature range (Tmax), we were able to follow in a systematic way the evolution of the fitting parameters up to the limit of high temperatures and make a comparison between the zero-point values obtained from the different models by extrapolating the linear dependence of the gaps at high T to T = 0 K and that determined by the dependence of the gap on isotope mass. Using experimental data measured by absorption spectroscopy, we observed the non-linear behavior of Eg(T) of GaAs for T > ΘD.

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Este artigo objetiva apresentar e discutir uma experiência de atendimento em triagem psicológica realizada em uma clínica-escola de psicologia de São Paulo-SP. A proposta triagem estendida, em oposição à tradicional, podia ocorrer em até seis entrevistas, seguindo referencial psicanalítico. Foram atendidos dez participantes que não haviam conseguido vaga para a triagem semanal da clínica. A análise incluiu aspectos tais como adesão, queixa manifesta versus latente, desenvolvimento do processo, expectativas em relação ao atendimento e encaminhamentos. Concluiu-se pela viabilidade e vantagens desta forma de recepção de clientes em uma realidade carente de recursos de atenção à saúde.

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A Organização Mundial de Saúde tem hoje duas classificações de referência para a descrição dos estados de saúde: a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde, que corresponde à décima revisão da Classificação Internacional de Doenças (CID-10) e a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). A utilização da CIF vem sendo aguardada com grande expectativa pelas organizações de pessoas com deficiências e instituições relacionadas. A falta de definição clara de "deficiência" ou "incapacidade" tem sido apontada como um impedimento para a promoção de saúde de pessoas com deficiência. É importante que essas definições, especialmente no âmbito legislativo e regulamentar, sejam consistentes e se fundamentem num modelo coerente sobre o processo que origina as situações de incapacidade. Este artigo tem como objetivo apresentar elementos da CID-10 e da CIF, e o papel que desempenham para definir deficiência e incapacidade. Os componentes da CIF podem contribuir para diferentes campos de aplicabilidade no que diz respeito ao entendimento das definições de deficiência ou incapacidade a partir do conceito de funcionalidade e dos fatores contextuais.

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A Organização Mundial de Saúde tem hoje duas classificações de referência para a descrição dos estados de saúde: a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde, que corresponde à décima revisão da Classificação Internacional de Doenças (CID-10) e a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). A utilização da CIF vem sendo aguardada com grande expectativa pelas organizações de pessoas com deficiências e instituições relacionadas. A falta de definição clara de "deficiência" ou "incapacidade" tem sido apontada como um impedimento para a promoção de saúde de pessoas com deficiência. É importante que essas definições, especialmente no âmbito legislativo e regulamentar, sejam consistentes e se fundamentem num modelo coerente sobre o processo que origina as situações de incapacidade. Este artigo tem como objetivo apresentar elementos da CID-10 e da CIF, e o papel que desempenham para definir deficiência e incapacidade. Os componentes da CIF podem contribuir para diferentes campos de aplicabilidade no que diz respeito ao entendimento das definições de deficiência ou incapacidade a partir do conceito de funcionalidade e dos fatores contextuais

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Objective To assess trends in the prevalence and social distribution of child stunting in Brazil to evaluate the effect of income and basic service redistribution policies implemented in that country in the recent past. Methods The prevalence of stunting (height-for-age z score below \22122 using the Child Growth Standards of the World Health Organization) among children aged less than 5 years was estimated from data collected during national household surveys carried out in Brazil in 1974\201375 (n = 34 409), 1989 (n = 7374), 1996 (n = 4149) and 2006\201307 (n = 4414). Absolute and relative socioeconomic inequality in stunting was measured by means of the slope index and the concentration index of inequality, respectively. Findings Over a 33-year period, we documented a steady decline in the national prevalence of stunting from 37.1 per cent to 7.1 per cent. Prevalence dropped from 59.0 per cent to 11.2 per cent in the poorest quintile and from 12.1 per cent to 3.3 per cent among the wealthiest quintile. The decline was particularly steep in the last 10 years of the period (1996 to 2007), when the gaps between poor and wealthy families with children under 5 were also reduced in terms of purchasing power; access to education, health care and water and sanitation services; and reproductive health indicators.Conclusion In Brazil, socioeconomic development coupled with equity-oriented public policies have been accompanied by marked improvements in living conditions and a substantial decline in child undernutrition, as well as a reduction of the gap in nutritional status between children in the highest and lowest socioeconomic quintiles. Future studies will show whether these gains will be maintained under the current global economic crisis

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The purpose of this work was to experimentally investigate the thermal diffusivity of four different gray cast iron alloys, regularly used to produce brake disks for automotive vehicles. Thermal diffusivity measurements were performed at temperatures ranging from room temperature to 600 A degrees C. The influence of the thermal conductivity on the thermomechanical fatigue life is also briefly presented. The measurements were sensitive to the influence of the carbon equivalent and alloying elements, such as molybdenum, copper and chromium. Molybdenum, unlike copper, lowered the thermal diffusivity of the gray cast iron, and alloy E (without molybdenum), besides presenting a relatively low carbon equivalent content and an increase in the values of the thermal diffusivity, presented the best performance during the thermomechanical fatigue. The molybdenum present in alloys B and C did not fulfill the expectations of providing the best thermomechanical fatigue behavior. Consequently, its elimination in the gray cast iron alloy for this application will result in a significant economy.

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The study checked possible theory-methodologic assumptions into Physical Education PCNs by the teachers of the last years of elementary school. The analyses in the publishing allow us to identify the different didactic procedures when compared with those which set up the traditional expectations. From these elements and using the projective method, it was developed an interview with focal group. The data obtained showed us docent perceptions which rearrange the educative practice, and interpretation allows us to realize which of the teachers views approaches the propositions in the official document, even if no reference has been done to it.

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With the advent and development of technology, mainly in the Internet, more and more electronic services are being offered to customers in all areas of business, especially in the offering of information services, as in virtual libraries. This article proposes a new opportunity to provide services to virtual libraries customers, presenting a methodology for the implementation of electronic services oriented by these customers' life situations. Through analytical observations of some national virtual libraries sites, it could be identified that the offer of services considering life situations and relationship interest situations can promote the service to their customers, providing greater satisfaction and, consequently, improving quality in the offer of information services. The visits to those sites and the critical analysis of the data collected during these visits, supported by bibliographic researches results, have enabled the description of this methodology, concluding that the provision of services on an isolated way or in accordance with the user's profile on sites of virtual libraries is not always enough to ensure the attendance to the needs and expectations of its customers, which suggests the offering of these services considering life situations and relationship interest situations as a complement that adds value to the business of virtual library. This becomes relevant when indicates new opportunities to provide virtual libraries services with quality, serving as a guide to the information providers managers, enabling the offering of new means to access information services by such customers, looking for pro - activity and services integration, in order to solve definitely real problems.

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We discuss the dynamics of the Universe within the framework of the massive graviton cold dark matter scenario (MGCDM) in which gravitons are geometrically treated as massive particles. In this modified gravity theory, the main effect of the gravitons is to alter the density evolution of the cold dark matter component in such a way that the Universe evolves to an accelerating expanding regime, as presently observed. Tight constraints on the main cosmological parameters of the MGCDM model are derived by performing a joint likelihood analysis involving the recent supernovae type Ia data, the cosmic microwave background shift parameter, and the baryonic acoustic oscillations as traced by the Sloan Digital Sky Survey red luminous galaxies. The linear evolution of small density fluctuations is also analyzed in detail. It is found that the growth factor of the MGCDM model is slightly different (similar to 1-4%) from the one provided by the conventional flat Lambda CDM cosmology. The growth rate of clustering predicted by MGCDM and Lambda CDM models are confronted to the observations and the corresponding best fit values of the growth index (gamma) are also determined. By using the expectations of realistic future x-ray and Sunyaev-Zeldovich cluster surveys we derive the dark matter halo mass function and the corresponding redshift distribution of cluster-size halos for the MGCDM model. Finally, we also show that the Hubble flow differences between the MGCDM and the Lambda CDM models provide a halo redshift distribution departing significantly from the those predicted by other dark energy models. These results suggest that the MGCDM model can observationally be distinguished from Lambda CDM and also from a large number of dark energy models recently proposed in the literature.

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The mass function of cluster-size halos and their redshift distribution are computed for 12 distinct accelerating cosmological scenarios and confronted to the predictions of the conventional flat Lambda CDM model. The comparison with Lambda CDM is performed by a two-step process. First, we determine the free parameters of all models through a joint analysis involving the latest cosmological data, using supernovae type Ia, the cosmic microwave background shift parameter, and baryon acoustic oscillations. Apart from a braneworld inspired cosmology, it is found that the derived Hubble relation of the remaining models reproduces the Lambda CDM results approximately with the same degree of statistical confidence. Second, in order to attempt to distinguish the different dark energy models from the expectations of Lambda CDM, we analyze the predicted cluster-size halo redshift distribution on the basis of two future cluster surveys: (i) an X-ray survey based on the eROSITA satellite, and (ii) a Sunayev-Zeldovich survey based on the South Pole Telescope. As a result, we find that the predictions of 8 out of 12 dark energy models can be clearly distinguished from the Lambda CDM cosmology, while the predictions of 4 models are statistically equivalent to those of the Lambda CDM model, as far as the expected cluster mass function and redshift distribution are concerned. The present analysis suggests that such a technique appears to be very competitive to independent tests probing the late time evolution of the Universe and the associated dark energy effects.

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Context. We study galaxy evolution and spatial patterns in the surroundings of a sample of 2dF groups. Aims. Our aim is to find evidence of galaxy evolution and clustering out to 10 times the virial radius of the groups and so redefine their properties according to the spatial patterns in the fields and relate them to galaxy evolution. Methods. Group members and interlopers were redefined after the identification of gaps in the redshift distribution. We then used exploratory spatial statistics based on the the second moment of the Ripley function to probe the anisotropy in the galaxy distribution around the groups. Results. We found an important anticorrelation between anisotropy around groups and the fraction of early-type galaxies in these fields. Our results illustrate how the dynamical state of galaxy groups can be ascertained by the systematic study of their neighborhoods. This is an important achievement, since the correct estimate of the extent to which galaxies are affected by the group environment and follow large-scale filamentary structure is relevant to understanding the process of galaxy clustering and evolution in the Universe.

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Over the last decade, X-ray observations have revealed the existence of several classes of isolated neutron stars (INSs) which are radio-quiet or exhibit radio emission with properties much at variance with those of ordinary radio pulsars. The identification of new sources is crucial in order to understand the relations among the different classes and to compare observational constraints with theoretical expectations. A recent analysis of the 2XMMp catalogue provided fewer than 30 new thermally emitting INS candidates. Among these, the source 2XMM J104608.7-594306 appears particularly interesting because of the softness of its X-ray spectrum, kT = 117 +/- 14 eV and N(H) = (3.5 +/- 1.1) x 10(21) cm(-2) (3 sigma), and of the present upper limits in the optical, m(B) greater than or similar to 26, m(V) greater than or similar to 25.5 and m(R) greater than or similar to 25 (98.76% confidence level), which imply a logarithmic X-ray-to-optical flux ratio log(F(X)/F(V)) greater than or similar to 3.1, corrected for absorption. We present the X-ray and optical properties of 2XMM J104608.7-594306 and discuss its nature in the light of two possible scenarios invoked to explain the X-ray thermal emission from INSs: the release of residual heat in a cooling neutron star, as in the seven radio-quiet ROSAT-discovered INSs, and accretion from the interstellar medium. We find that the present observational picture of 2XMM J104608.7-594306 is consistent with a distant cooling INS with properties in agreement with the most up-to-date expectations of population synthesis models: it is fainter, hotter and more absorbed than the seven ROSAT sources and possibly located in the Carina Nebula, a region likely to harbour unidentified cooling neutron stars. The accretion scenario, although not entirely ruled out by observations, would require a very slow (similar to 10 km s(-1)) INS accreting at the Bondi-Hoyle rate.