Treatment approaches for clients with a stroke-affected upper limb: Are we following evidence-based practice?

Stroke rehabilitation is an area of practice that many occupational therapists encounter during their career. The literature promotes a wide range of management techniques and support devices for people who have a stroke-affected upper limb, but little is known about the validity of those that occupational therapists actually use in practice. A questionnaire was sent to occupational therapists working in Queensland and northern New South Wales facilities (n = 35), in which adults with a stroke were likely to be treated. Eighteen respondents answered questions about the management techniques and support devices used in their facility, and their perception of the benefit of these devices in the reduction of hemiplegic shoulder pain. Results are discussed with reference to evidence-based practice and indicate an urgent need for the collation and dissemination of the best current evidence available for the management techniques and support devices used in this area, as well as further research to extend this evidence.

The modeling of turbulent reactive flows based on multiple mapping conditioning

A new modeling approach-multiple mapping conditioning (MMC)-is introduced to treat mixing and reaction in turbulent flows. The model combines the advantages of the probability density function and the conditional moment closure methods and is based on a certain generalization of the mapping closure concept. An equivalent stochastic formulation of the MMC model is given. The validity of the closuring hypothesis of the model is demonstrated by a comparison with direct numerical simulation results for the three-stream mixing problem. (C) 2003 American Institute of Physics.

A unit cell waveguide model of a reflectarray formed by microstrip patches and slots

An equivalent unit cell waveguide approach (WGA) is described to obtain reflection coefficient phase curves for designing a microstrip patch reflectarray supported by a ground plane with periodic apertures or slots. Based on the presented theory, a computer algorithm for determining the reflection coefficient of a plane wave normally incident on a multi-layer structure of patches and apertures is developed. The validity of the developed algorithm is verified by comparing the obtained results with those published in the literature and the ones generated by Agilent High Frequency Structure Simulator (HFSS). A good agreement in all the presented examples is obtained, proving that the developed theory and computer algorithm can be an effective tool for designing multi-layer microstrip reflectarrays with a periodically perforated ground plane. (C) 2003 Wiley Periodicals, Inc.

Designing a 161-element Ku-band microstrip reflectarray of variable size patches using an equivalent unit cell waveguide approach

An equivalent unit cell waveguide approach (WGA) to designing 4 multilayer microstrip reflectarray of variable size patches is presented. In this approach, a normal incidence of a plane wave on an infinite periodic array of radiating elements is considered to obtain reflection coefficient phase curves for the reflectarray's elements. It is shown that this problem is equivalent to the problem of reflection of the dominant TEM mode in a waveguide with patches interleaved by layers of dielectric. This waveguide problem is solved using a field matching technique and a method of moments (MoM). Based on this solution, a fast computer algorithm is developed to generate reflection coefficient phase curves for a multilayer microstrip patch reflectarray. The validity of the developed algorithm is tested against alternative approaches and Agilent High Frequency Structure Simulator (HFSS). Having confirmed the validity of the WGA approach, a small offset feed two-layer microstrip patch array is designed and developed. This reflectarray is tested experimentally and shows good performance.

Clinicians' attitudes to clinical practice guidelines

To the Editor: In their systematic review of clinicians' attitudes to clinical practice guidelines, Farquhar et al1 found that, although healthcare providers reported high satisfaction with guidelines, a significant number also expressed concerns about their practicality, their role in cost-cutting and their potential for increasing litigation. The review, however, did not address other potentially significant concerns of clinicians regarding the perceived validity of guidelines and the influence of external agencies (such as the pharmaceutical industry) on treatment recommendations.

Quality of life assessment in the community-dwelling elderly: Validation of the Assessment of Quality of Life (AQoL) Instrument and comparison with the SF-36

Measurement of Health-Related Quality of Life (HRQoL) of the elderly requires instruments with demonstrated sensitivity, reliability, and validity, particularly with the increasing proportion of older people entering the health care system. This article reports the psychometric properties of the 12-item Assessment of Quality of Life (AQoL) instrument in chronically ill community-dwelling elderly people with an 18-month follow-up. Comparator instruments included the SF-36 and the OARS. Construct validity of the AQoL was strong when examined via factor analysis and convergent and divergent validity against other scales. Receiver Operator Characteristic (ROC) curve analyses and relative efficiency estimates indicated the AQoL is sensitive, responsive, and had the strongest predicative validity for nursing home entry. It was also sensitive to economic prediction over the follow-up. Given these robust psychometric properties and the brevity of the scale, AQoL appears to be a suitable instrument for epidemiologic studies where HRQoL and utility data are required from elderly populations. (C) 2003 Elsevier Science Inc. All rights reserved.

Unexpected clobetasol propionate profile in human stratum corneum after topical application in vitro

Purpose. The validity of using drug amount-depth profiles in stratum corneum to predict uptake of clobetasol propionate into stratum corneum and its transport into deeper skin layers was investigated. Methods. In vitro diffusion experiments through human epidermis were carried out using Franz-type glass diffusion cells. A saturated solution of clobetasol propionate in 20% (V/V) aqueous propylene glycol was topically applied for 48 h. Steady state flux was calculated from the cumulative amount of drug permeated vs. time profile. Epidermal partitioning was conducted by applying a saturated drug solution to both sides of the epidermis and allowing time to equilibrate. The tape stripping technique was used to define drug concentration-depth profiles in stratum corneum for both the diffusion and equilibrium experiments. Results. The concentration-depth profile of clobetasol propionate in stratum corneum for the diffusion experiment is biphasic. A logarithmic decline of the drug concentration over the first four to five tape strips flattens to a relatively constant low concentration level in deeper layers. The drug concentration-depth profile for the equilibrium studies displays a similar shape. Conclusions. The shape of the concentration-depth profile of clobetasol propionate is mainly because of the variable partitioning coefficient in different stratum corneum layers.

Modified logit life table system: Principles, empirical validation, and application

Despite its widespread use, the Coale-Demeny model life table system does not capture the extensive variation in age-specific mortality patterns observed in contemporary populations, particularly those of the countries of Eastern Europe and populations affected by HIV/AIDS. Although relational mortality models, such as the Brass logit system, can identify these variations, these models show systematic bias in their predictive ability as mortality levels depart from the standard. We propose a modification of the two-parameter Brass relational model. The modified model incorporates two additional age-specific correction factors (gamma(x), and theta(x)) based on mortality levels among children and adults, relative to the standard. Tests of predictive validity show deviations in age-specific mortality rates predicted by the proposed system to be 30-50 per cent lower than those predicted by the Coale-Demeny system and 15-40 per cent lower than those predicted using the original Brass system. The modified logit system is a two-parameter system, parameterized using values of l(5) and l(60).

O t??nel no fim da luz: a privatiza????o do setor el??trico em Mato Grosso

Este artigo tem por objetivo analisar a forma????o de consensos sociais e pol??ticos para a reforma do Estado e de seu aparelho em n??vel estadual, conforme a governabilidade democr??tica. Optou-se por uma pesquisa sobre a privatiza????o das Centrais El??tricas Mato- Grossenses S.A. (Cemat), considerada representativa tanto da reforma empreendida pelo Estado de Mato Grosso quanto das dificuldades do setor el??trico em n??vel nacional. O referencial metodol??gico dessa pesquisa ?? composto de um problema e de quatro hip??teses de trabalho. Trata-se de estudo de caso da esp??cie ???provas de plausibilidade???, em que, por uma aplica????o iterativa, apresenta-se uma proposi????o te??rica inicial e, em seguida, as conclus??es da pesquisa s??o comparadas, o que permite sua revis??o e compara????o. Para tanto, descrevem-se a privatiza????o da Cemat e os problemas da desestatiza????o do setor el??trico brasileiro no seu conjunto. Por fim, na conclus??o, verifica-se a validade das hip??teses e fazem-se algumas considera????es finais sobre a pesquisa.

Burocracia e a revolu????o gerencial: a persist??ncia da dicotomia entre pol??tica e administra????o

Este ensaio trata da integra????o entre pol??tica e administra????o no contexto da chamada revolu????o gerencial. O texto est?? estruturado em cinco segmentos. Os dois primeiros delineiam uma interpreta????o weberiana do problema da burocracia: a dicotomiza????o entre pol??tica e administra????o, tanto no n??vel te??rico da governan??a contempor??nea, onde prop??e-se um quadro de refer??ncia anal??tica ?? integra????o entre pol??tica e administra????o, quanto no contexto da moderniza????o da administra????o p??blica brasileira. O terceiro segmento busca caracterizar os atributos do modelo ideal de administra????o p??blica preconizado pela revolu????o gerencial, a partir da contraposi????o de outros paradigmas reconstitu??dos da literatura: um ortodoxo, um liberal, outro empreendedor. O quarto segmento sustenta que os modelos de administra????o p??blica preconizados pela revolu????o gerencial apresentam o mesmo car??ter dicotomizante entre pol??tica e administra????o t??pica da burocracia. O sexto segmento ensaia algumas reflex??es sobre a validade da revolu????o gerencial, sua contribui????o para a experi??ncia brasileira e sobre o advento de uma revolu????o p??s-gerencial.

The decentralized social networking systems towards mobilizing actions of citizenship and solidarity against cancer

The goal of the present study is mapping the nature of possible contributions of participatory online platforms in citizen actions that may contribute in the fight against cancer and its associated consequences. These platforms are usually associated with entertainment: in that sense, we intent to test their validity in other domains such as health, as well as contribute to an expanded perception of their potential by their users. The research is based on the analysis of online solidarity networks, namely the ones residing on Facebook, Orkut and the blogosphere, that citizens have been gradually resorting to. The research is also based on the development of newer and more efficient solutions that provide the individual (directly or indirectly affected by issues of oncology) with the means to overcome feelings of impotence and fatality. In this article, we aim at summarizing the processes of usage of these decentralized, freer participatory platforms by citizens and institutions, while attempting to unravel existing hype and stigma; we also provide a first survey of the importance and the role of institutions in this kind of endeavor; lastly, we present a prototype, developed in the context of the present study, that is specifically dedicated to addressing oncology through social media. This prototype is already available online at www.talkingaboutcancer.org, however, still under development and testing. The main objective of this platform is to allow every citizen to freely build their network of contacts and information, according to their own individual and/ or collective needs and desires.

A practical framework for the generation and selection of strategic plans of action, The relevance of timeframe considerations and a systems thinking approach

The paper proposes a methodology especially focused on the generation of strategic plans of action, emphasizing the relevance of having a structured timeframe classification for the actions. The methodology explicitly recognizes the relevance of long-term goals as strategic drivers, which must insure that the complex system is capable to effectively respond to changes in the environment. In addition, the methodology employs engineering systems techniques in order to understand the inner working of the system and to build up alternative plans of action. Due to these different aspects, the proposed approach features higher flexibility compared to traditional methods. The validity and effectiveness of the methodology has been demonstrated by analyzing an airline company composed by 5 subsystems with the aim of defining a plan of action for the next 5 years, which can either: improve efficiency, redefine mission or increase revenues.

Anotação sintética, numa perspectiva de Direito Público, ao Acórdão n.º 63/2006, em Plenário, do Tribunal Constitucional (português), de 24 de Janeiro de 2006 - qual proibição constitucional de impostos retroactivos? A tese de Oliveira Salazar.

Resumo: 1 – Sumário do Acórdão do Tribunal Constitucional n.º 63/2006, de 24 de Janeiro de 2006; 2 – Texto completo do Acórdão do Tribunal Constitucional n.º 63/2006, de 24 de Janeiro de 2006: cfr. http://www.tribunalconstitucional.pt/tc/acordaos/20060063.html , 18 de Maio de 2012; 3 – Anotação sintética; 3.1 – Introdução à anotação sintética e suas características neste caso concreto; 4 – A referência, abstracta e concreta, do princípio constitucional da «proibição de impostos retroactivos»; 5 – Alguns aspectos nucleares da eficácia temporal das normas jurídico-tributárias, brevitatis causa, das normas jurídico-fiscais; 6 – A chamada «aplicação das normas fiscais» (e/ou tributárias) no seio da «aplicação no tempo»: algumas breves notas sobre a tradição jurídico-lusitana, v.g. do ponto de vista da doutrina, a partir de 1976, designadamente até 1985; 6.1 – A tese de António de Oliveira Salazar; 7 – Conclusões. § Abstract: 1 - Summary of the Judgment of the Constitutional Court n. 63/2006 of January 24, 2006; 2 - Complete text of the Judgment of the Constitutional Court n. 63/2006 of January 24, 2006: s. http://www.tribunalconstitucional.pt/tc/acordaos/20060063.html , May 18, 2012; 3 - Synthetic Note: 3.1 - Introduction to syntheticannotation and its characteristics in this case; 4 - The reference, abstract and concrete, the constitutional principle of «prohibition of retroactive taxes»; 5 - Some aspects of nuclear the temporal validity of the legal and tax rules, brevitatis causa of legal and tax rules; 6 - the so-called «implementation of tax laws» (and/or tax) within the «Application in time»: some brief notes on the legal tradition -Lusitanian, e.g. from the standpoint of doctrine, from 1976, namely until 1985; 6.1 - The thesis of António de Oliveira Salazar; 7- Conclusions. PS: este "abstract" está tal qual como na publicação.

Anotação sintética, numa perspectiva de Direito Público, ao Acórdão n.º 63/2006, em Plenário, do Tribunal Constitucional (português), de 24 de Janeiro de 2006 - qual proibição constitucional de impostos retroactivos? A tese de Oliveira Salazar.

The present article aims to analyze the Judgment no. º 63/2006 of the Constitutional Court, of January 24, 2006, verifying the characteristics of the case, under reference abstract and concrete, of the constitutional principle of the prohibition of retroactive tax. It also examines the core aspects of the temporal validity of the legal and tax rules, brevitatis causa of legal and fiscal standards. Thus, it scrutinizes the call application of tax rules (and / or tax) within the application in time, consisting brief notes on the legal tradition-Lusitanian, from the standpoint of doctrine, from 1976 to 1985 including, recalling the Thesis Salazar on non-retroactivity of tax law. § O presente artigo pretende analisar o Acórdão do Tribunal Constitucional n.º 63/2006, de 24 de Janeiro de 2006, verificando de forma sintética as características do caso concreto, sob referência abstracta e concreta, do princípio constitucional da proibição de imposto retroativos, analisando ainda os aspectos nucleares da eficácia temporal das normas jurídico-tributárias, brevitatis causa, das normas jurídico-fiscais. Para tanto, se averigua a chamada aplicação das normas fiscais (e/ou tributárias) no seio da aplicação no tempo, constando breves notas sobre a tradição jurídico-lusitana, do ponto de vista da doutrina, a partir de 1976, designadamente até 1985, recordando a Tese de Salzar sobre a não retroatividade da lei fiscal.