Personalens förväntningar inför sammanslagning av förlossnings-, BB- och neonatalavdelningen och att samtidigt införa samvård : Kvalitativ studie med fokusgruppsintervjuer

Bakgrund: Anknytningen underlättas mellan barn och föräldrar om de kan vara tillsammans redan från förlossningen. Teamarbete förbättrar kvalitén och bidrar till helhetsperspektiv i vården. En god arbetsmiljö och ett gott samarbete mellan personal är viktigt för effektiviteten av samvård. Att undersöka personalens förväntningar inför ett nytt arbetssätt är betydelsefullt eftersom det kan avspegla sig i den vård som senare ges.Syftet med studien var att belysa personalens förväntningar inför sammanslagning av olika vårdavdelningar och att samtidigt införa samvård.Metoden var en kvalitativ metod med totalt 14 deltagare i tre fokusgruppsintervjuer. Datainsamlingen analyserades med en kvalitativ innehållsanalys.Resultatet sammanfattades med temat ”Tryggt och välkänt eller nytt och osäkert – förändringsarbetets balansgång” som beskrev personalens känslor inför sammanslagningen. Kategorierna ”Att få en bra miljö för föräldrar och personal”, ”Att samarbeta med familjen i fokus”, ”Att förena två kliniker och kulturer” och ”Att genomgå en arbetsplatsförändring” beskrev de förväntningar och farhågor personalen uttryckte.Slutsatser: Resultatet visade på förväntningar av att vård- och arbetsmiljö skulle förbättras samt att samarbetet mellan klinikerna skulle bli mer effektivt. Det framkom att det var av betydelse att ha fungerande informationsflöden, uppleva delaktighet samt ha en tydlig ledning i en genomgripande organisationsförändring.

Volatility Triggered Range Forward (VTRF): an instrument for protection against volatility fluctuations in the BRL/USD pair

Este trabalho propõe um instrumento capaz de absorver choques no par BRL/USD, garantindo ao seu detentor a possibilidade de realizar a conversão entre essas moedas a uma taxa observada recentemente. O Volatility Triggered Range Forward assemelha-se a um instrumento forward comum, cujo preço de entrega não é conhecido inicialmente, mas definido no momento em que um nível de volatilidade pré-determinado for atingido na cotação das moedas ao longo da vida do instrumento. Seu cronograma de ajustes pode ser definido para um número qualquer de períodos. Seu apreçamento e controle de riscos é baseado em uma árvore trinomial ponderada entre dois possíveis regimes de volatilidade. Esses regimes são determinados após um estudo na série BRL/USD no período entre 2003 e 2009, basedo em um modelo Switching Autoregressive Conditional Heteroskedasticity (SWARCH).

Soil texture spatial variability of different parent material in pereira barreto, São Paulo state

The variation of soil textural characteristics is a function of the relief and parent materials. The objective of this work was to study soil texture spatial variability from different parent material in Pereira Barreto, SP. An area of 530.67 hectares was mapped through the use of Global Positioning System receivers and obtaining of Digital Elevation Models. A set of 201 soil samples was collected from every seven hectares, at three depths: 0 - 0.25 m; 0.25 - 0.50 m; and 0.80 - 1.00 m. The amounts of sand, silt and clay were obtained by the pipette method and analyzed by both descriptive statistics and geostatistics. Soil textures varied as a function of parent materials and topography.

A medida cautelar na ação direta de inconstitucionalidade: uma abordagem pela perspectiva do princípio do acesso à justiça

The present study deals with the caution measure in the direct action of inconstitutionality. The treatment given to the approach is through the principle of access to justice. For this, a construction of the juridical content in the principle of access to justice is proposed, without losing the focus of its characteristic as a metajuridical principle, which is presented in the constitutional field as a fundamental right, generator of a new universality, destined to guarantee the prevalence of an adequate juridical tutelage. Some challenges of the concretizing hermeutics are still shown to give way to principle of access to justice, dealing with certain limitations and proposals. The direct action of inconstitutionality in face of the dissertation, begins to focus on the presentation of the tutelage of urgency, differentiating it from the other brief tutelage and elevating it to the condition of instrument which is indispensable to the principle of access to justice. In the most specific field of the abstract control of constitutionality, the characteristics of the objective process are defined, their sources, amongst which the regimental norms of the Federal Supreme Court and their role in the new constitutional reality. Finally, the caution measure in the direct action of inconstitutionality is presented by the perspective of principle of access to justice, identifying some points: the interpretations of the principle of the natural judge to adapt him to the aspect of continuous and temporarily adequate juridical account, especially when concerned to emergency; the analysis of facts in the direct action; the bonding objective effects and the erga omnes; the effect over the factual and normative plan; the effect of the caution measure over other processes and over the prescriptional course; the polemic of the possibility of caution measure in direct action of inconstitutionality through omission

Uma análise comportamentalista de relatos verbais e práticas educativas parentais: alcance e limites

O presente artigo discute a relevância de algumas estratégias metodológicas da Análise Aplicada do Comportamento para examinar práticas educativas parentais. Um instrumento e um conceito relacionados à coleta e análise de dados são discutidos sob a ótica teórica e aplicada: relatos verbais e análise funcional comportamental descritiva. Conclui-se que, consideradas as limitações dos relatos, as informações obtidas com essa estratégia e com a análise funcional comportamental descritiva permitem inferir algumas hipóteses sobre os comportamentos de pais e de filhos que podem ser utilizadas em ações que procuram investigar e intervir sobre os comportamentos problema e as habilidades sociais.

Fully Relativistic 4-Components DFT Investigation on Bonding and Dissociation Energy of HgO

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Optical and mechanical design of an ophthalmic instrument: Slit lamp

This work has as objective to develop an interesting research line in the Optical Instrumentation area, that is to associate the Optical Design to the Ophthalmology area. The purpose of it is handling the optical design techniques to design a widely used ophthalmologic instrument called slit lamp. The optical and mechanical design of the slit lamp prototype was carefully projected in order to improve the best quality image, the comfort of the patient and the user, the simplicity of handling, the facility of production the availability of optical and mechanical components in the national market and the low cost of production. The main goal of this work was to realize a project using totally national technology, cheapening the cost and forming the optimum image required for the slit lamp optical system.

A new short and simple health-related quality of life measurement for paediatric rheumatic diseases: initial validation in juvenile idiopathic arthritis

Objective. To develop and validate a new short and simple measure of health-related quality of life (HRQL) in children with juvenile idiopathic arthritis (JIA).Methods. The Paediatric Rheumatology Quality of Life Scale (PRQL) is a 10-item questionnaire that explores HRQL in two domains: physical health (PhH) and psychosocial health (PsH). Validation of the parent proxy report and child self-report versions of the instrument was accomplished by evaluating 472 JIA patients and similar to 800 healthy children. Validation analyses included assessment of feasibility, face and content validity; construct and discriminative ability; internal structure and consistency; test-retest reliability; responsiveness to clinical change; and minimal clinically important difference.Results. The PRQL was found to be feasible and to possess both face and content validity. The PRQL score correlated in the predicted range with most of the other JIA outcome measures, thereby demonstrating good construct validity, and discriminated well between different levels of disease severity. Assessment of internal structure (factor analysis) revealed that the PhH and PsH subscales identify two unambiguously separated domains. The internal consistency (Cronbach's alpha) was 0.86. The intraclass correlation coefficient for test-retest reliability was 0.91. The PRQL revealed fair responsiveness, with a standardized response mean of 0.67 in improved patients. Overall, the PRQL appeared to be more able to capture physical HRQL than psychosocial HRQL.Conclusion. The PRQL was found to possess good measurement properties and is, therefore, a valid instrument for the assessment of HRQL in children with JIA. This tool is primarily proposed for use in standard clinical care.

Analysis in vitro of direct bonding system with cyanoacrylate ester and orthodontic wires

The aim of this study was to evaluate the tensile strength of orthodontic wires bonded onto the enamel with cyanoacrylate ester. To obtain the specimens, 120 human premolars (extracted for orthodontic or periodontal reasons) were included in acrylic blocks of rapid polymerization with three teeth each. Four groups were formed with ten specimens each. In the specimens, a dental splint model was made with cyanoacrylate ester and round stainless steel wire. In groups I, II and III, cyanoacrylate ester was used with round steel wires, with variation in diameter: 0.014 inches; 0.016 inches and 0.018 inches, respectively. In group IV, round steel wire 0.018 inches was used with photo polymerizing resin composite with previous acid etching. The adhesive force of the materials was measured in two points under the action of the tensiometer (ETM-USA). The number of loose wires was counted along with those that remained fixed according to the different levels of force applied because of the direction of the tensile force (vertical or horizontal) and the diameter of the wire used. The data obtained were first submitted to a descriptive analysis and then submitted to a statistical analysis (Friedman's Test and Dunn's Test of Multiple Comparison - Epi-info 3.2). Within the limitations of the experimental conditions presented, the cyanoacrylate ester or 'Super Bonder (R)' maintained bonded to enamel and steel wires (0.016 and 0.018 inches) during the tensile strength tests under different levels of applied forces.

Cementation of Prosthetic Restorations: From Conventional Cementation to Dental Bonding Concept

The cementation procedure of metal-free fixed partial dentures exhibits special characteristics about the porcelains and cementation agents, which turns the correct association between these materials necessary. Our purpose in this literature review was to point the main groups of cements associated to metal-free restoration and discuss about the advantages, disadvantages, and recommendations of each one. Our search was confined to the electronic databases PubMed and SciELO and to books about this matter. There are essentially 3 types of hard cement: conventional, resin, or a hybrid of the two. The metal-free restorations can be fixed with conventional or resin cements. The right choice of luting material is of vital importance to the longevity of dental restorative materials. Conventional cements are advantageous when good compressive straight, good film thickness, and water dissolution resistance are necessary. However, they need an ideal preparation, and they are not acid dissolution resistant. Conventional cements are indicated to porcelains that cannot be acid etched. Resin cements represent the choice to metal-free restoration cementation because they present better physical properties and aesthetic than conventional agents.

The influence of time interval between bleaching and enamel bonding

Objectives: the purpose of this study was to investigate the penetration of a conventional adhesive material into enamel bleached with 16% carbamide peroxide and 38% hydrogen peroxide using optical light microscopy.Methods: Extracted human teeth were randomly divided into eight experimental groups with six specimens each, according to the bleaching material and time interval after bleaching and before the bonding procedure. Groups were designated as follows: control group, restorations in unbleached teeth; restorations performed immediately after bleaching; restorations performed 7 days after bleaching; restorations performed 14 days after bleaching; and restorations performed 30 days after bleaching. The length of resin tags was measured with an Axiophot photomicroscope at 400x magnification for the calculation of the proportion of tags of study groups compared to the respective control groups. Analysis of variance was applied for comparison between groups; data were transformed into arcsine (p < 0.05).Results: the specimens of experimental groups, in which restorations were performed 7, 14, and 30 days after bleaching, showed better penetration of adhesive material into enamel than specimens restored immediately after bleaching. There was no statistically significant difference between the bleaching materials employed or in the interaction between bleaching agent and time interval.Conclusions: This suggests that a time interval of at least 7 days should be allowed between enamel bleaching and placement of adhesive bonding agents for accomplishment of composite resin restorations.

The influence of temperature of three adhesive systems on bonding to ground enamel

This study evaluated the microtensile bond strength test (mu T), micromorphology of resin-enamel interface (RET) and etching patterns (EP) promoted by the etch-and-rinse adhesive, Prime&Bond NT (PB), and two self-etching adhesives, Clearfil SE Bond (SE) and Adper Prompt L-Pop (APR), to ground bovine enamel surfaces' when applied at temperatures of 5 degrees C (C), 40 degrees C (H) and 20 degrees C (R). Materials and Methods. Sixty-three bovine incisors were randomly divided into nine experimental groups (n=7) according to adhesive systems and temperatures. The buccal enamel surfaces were flattened with 600-grit SiC paper and abraded with a diamond bur under water-cooling. The adhesive systems were applied according to the manufacturer's instructions. After the restorative procedures, the specimens were sectioned into five slabs. Four slabs were prepared for mu T and one for interface analysis. For etching pattern analysis, the remaining 16 bovine enamel fragments were used (n=2). The adhesives were applied and the surfaces were rinsed with organic solvents after application. The specimens for RET and EP analysis were prepared for SEM analysis. Results. No significant differences among the adhesives were found at R temperature. However, at 5 degrees C, PB and APR presented lower bond strength than SE. At H temperature, higher bond strength was observed for PB than for APR and SE. At C and H temperature, formation of the interdiffusion zone was impaired and the treated enamel surfaces presented an undefined EP.

Short-term evaluation of the pulpo-dentin complex response to a resin-modified glass-ionomer cement and a bonding agent applied in deep cavities

Objectives. To evaluate the response of the pulpo-dentin complex following application of a resin-modified glass-ionomer cement or an adhesive system in deep cavities performed in human teeth.Methods. Deep class V cavities were prepared on the buccal surface of 26 premolars. In Group I the cavity walls (dentin) and enamel were conditioned with 32% phosphoric acid and the dentin adhesive system One Step (Bisco, Inc., Itasca, IL, USA) was applied. In Groups 2 and 3, before total etching and application of bonding agent, the cavity floor was lined with the resin-modified glass-ionomer cement-Vitrebond (3M ESPE Dental Products Division, St. Paul, MN, USA) or the calcium hydroxide cement-Dycal (control group, Dentsply, Mildford, DE, USA), respectively. The cavities were restored using light-cured Z-100 composite resin (3M ESPE). The teeth were extracted between 5 and 30 days and prepared for microscopic assessment. Serial sections were stained with H/E, Masson's trichrome, and Brown and Brenn techniques.Results. In Group 1, the inflammatory response was more evident than in Groups 2 and 3. Diffusion of dental material components across dentinal tubules was observed only in Group 1, in which the intensity of the pulp response increased as the remaining dentin thickness decreased. Bacteria were evidenced in the lateral walls of two samples (Group 2) which exhibited no inflammatory response or tissue disorganization.Conclusions. Based on the experimental conditions, it was concluded total acid etching followed by application of One Step bonding agent cannot be recommended as adequate procedures. In this clinical condition the cavity walls should be lined with a biocompatible dental material, such as Vitrebond or Dycal. 2003 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

In vivo evaluation of the biocompatibility of three current bonding agents

The aim of this in vivo study was to evaluate the biocompatibility of three current bonding agents and calcium hydroxide cement. Sixty polyethylene tubes filled with the following materials: Group 1: Prime & Bond NT (PB - Dentsply, US; Group 2: Bond 1 (BO - Jeneric/Pentron, US); Group 3: Optibond Solo (OP - Kerr, US); and Group 4 (control): calcium hydroxide cement - Dycal (CH - Dentsply, US) were implanted into the connective tissue of 30 rats. After 15, 30 and 60 days, the implants were excised and the animals sacrificed. The biopsies were immersed in Karnovsky (pH, 7.2) fixative solution for 48 hours, and processed using routine histological technique. Six-micron-thick sections were cut and stained with hematoxilin and eosin and Masson's trichome technique. Microscopic evaluation was used to compare the connective tissue reactions caused by the experimental and control materials adjacent to the tube opening. At 15 days, the experimental and control materials triggered a moderate to intense inflammatory response which gave rise to a thick capsule adjacent to the tube opening. With time, the inflammatory reaction decreased. At 60 days, the connective tissue adjacent to the bonding agents exhibited a persistent inflammatory response mediated by macrophages and giant cells which were engulfing displaced resin components. on the other hand, for the control group (calcium hydroxide) no inflammatory response associated with a thin capsule adjacent to the material was observed even at the 30-day period. The hard-setting calcium hydroxide cement allowed complete healing and was considered more biocompatible than the bonding agents.