bluuebunny/crossref_metadata_2025 huggingface dataset:
Empathy and Burnout During Residency: Which Changes First?
Authors: Crump William J. , Ziegler Craig , Fricker Steve
Published: September 2022

Background and Objectives: The issue of declining empathy and increasing burnout among residents is of concern for most programs. Numerous studies have shown these changes in both medical students and residents. However, the sequence of empathy decline and increasing burnout is unresolved and most studies have been cross sectional. This paper reports an individually-paired longitudinal analysis intended to clarify the sequence of these changes.
Methods: Beginning in 2017, 35 family medicine residents across all 3 years of training at a rural program completed an established empathy survey and a previously-validated single burnout question at the start of each year and at the midpoint. First, the empathy score for each resident was aligned with the next following burnout measure, and then the reverse sequence was followed, with burnout aligned with the following empathy score.
Results: With 125 responses to 133 survey opportunities, we saw a 94% response rate. Empathy scores across residency years decreased slightly and then improved almost to baseline. However, the analysis of variance test for quadratic trend was not significant. The burnout measure increased significantly over the residency years (J-T Statistic=4.89, P<.001). The correlation of the empathy score changing first showed a nonsignificant correlation (Rs=-.150, P=.133). The Spearman’s ρ of the burnout measure changing first was significant (Rs=-.300, P=.006).
Conclusions: In this group of residents, changes in burnout occurred before changes in empathy. If further research supports this finding, residency programs could focus more on efforts to address burnout to mitigate decreases in empathy.
Comfort With Uncertainty in Medical Students and Their Residency Choice: A Residency Research Network of Texas Study
Authors: Young Richard A. , Cruz Inez , Kale Neelima J. , Chang Jennifer G. , Buck Katherine , Ogbeide Stacy A. , Williamson Meredith L.C. , Sarkar Arindam , Preikschat Bailey A.
Published: September 2022

Background and Objectives: Little is known about how comfort with uncertainty (CwU) influences career choice in medical students. The authors of this study examined the correlation between CwU and primary care career choice.
Methods: In academic years 2017-2018 and 2018-2019, the authors distributed surveys to third-year medical students from eight US medical schools, seven in Texas. The survey tool included two CwU scales and one comfort with ambiguity scale. Other questions covered career plans, family and personal background, and student debt. In the subjects’ fourth year of medical school, authors obtained match data from the medical schools and the authors further communicated with the students where indicated. The primary outcome was the composite score of the three scales correlated to career choice, with a focus on primary care and family medicine.
Results: Among 642 participants, there was no difference in CwU scores between students who matched into primary care versus specialty fields (3.39 vs 3.37 average of three scales, P=.65, each individual scale NS) or family medicine (FM) vs all other fields (3.39 vs 3.37 average of three scales, P=.81). Other bivariate predictors of FM choice were more similar than different to previous studies, such as osteopathic more likely than allopathic, lower family income, planning to care for underserved populations, and had a primary care role model. Logistic regression found the two biggest predictors of FM were osteopathic training and the importance of educating patients about health promotion and disease prevention.
Conclusions: We found no correlation between CwU and medical student career choice for primary care or FM. We discuss confounding factors that may impact results, as well as recommendations for medication education and public policy.
A Comparison of Resident-Completed and Preceptor-Completed Formative Workplace-Based Assessments in a Competency-Based Medical Education Program
Authors: Lee Jonathon R. , Ross Shelley
Published: September 2022

Background and Objectives: In competency-based medical education (CBME), should resident self-assessments be included in the array of evidence upon which summative progress decisions are made? We examined the congruence between self-assessments and preceptor assessments of residents using assessment data collected in a 2-year Canadian family medicine residency program that uses programmatic assessment as part of their approach to CBME.
Methods: This was a retrospective observational cohort study using a learning analytics approach. The data source was archived formative workplace-based assessment forms (fieldnotes) stored in an online portfolio by family medicine residents and preceptors. Data came from three academic teaching sites over 3 academic years (2015-2016, 2016-2017, 2017-2018), and were analyzed in aggregate using nonparametric tests to evaluate differences in progress levels selected both within and between groups.
Results: In aggregate, first-year residents’ self-reported progress was consistent with that indicated by preceptors. Progress level rating on fieldnotes improved over training in both groups. Second-year residents tended to assign themselves higher ratings on self-entered assessments compared with those assigned by preceptors; however, the effect sizes associated with these findings were small.
Conclusions: Although we found differences in the progress level selected between preceptor-entered and resident-entered fieldnotes, small effect sizes suggest these differences may have little practical significance. Reasonable consistency between resident self-assessments and preceptor assessments suggests that benefits of guided self-assessment (eg, support of self-regulated learning, program efficacy monitoring) remain appealing despite potential risks.
Pregnancy is a State of Balance Between Opposing and Interactive Inhibitory and Stimulatory Systems Secondary to Exponential Uterine Wall Tension and Laplace’s Law: A Hypothesis II
Authors: Hegazy Ali
Published: September 2022

Objective: Labor is viewed as the result of a physiologic release from
an inhibitory effect of pregnancy on the myometrium, rather than an
active process mediated by contractile agonists. The contractile
stimulators and relaxation mechanisms have not yet been well defined.
The objective of the study is to identify the systems that control
uterine function during pregnancy. Design: Research Study Setting:
Portiuncula University Hospital, Ireland Population: N/A Methods: This
study investigated the current evidence-based literature that may
support the hypothesis, accompanied by a 40-second 3D animation. Main
Outcome Measures: N/A Results: Uterine mechanotransduction has
functional and molecular components, wherein the exponential uterine
wall tension (EUWT) is the functional component, and the intrinsic
myometrial cell character (IMCC) is the molecular component. IMCC
enables the uterus to control its functions both autonomically and
intrinsically, secondary to changes in tension. EUWT is measured by
Laplace’s Law and is created and maintained by interaction among the
gestational sac, uterus, and cervix, for which the primary function is
to maintain the EUWT. Directly, EUWT mechanotransduction and
progesterone/estrogen stimulation induce the inhibitory system and
indirectly, they induce the stimulatory system by inducing myometrial
hyperplasia and hypertrophy. The inhibitory system is the main system
that maintains pregnancy through a stretch-dependent mechanism. The
stimulatory system makes the cervix lose its strength through the YVU
pattern formation by transforming it into the lower uterine segment,
thus terminating the pregnancy. Conclusion: There is evidence-based
support for the hypothesis which might be the first step in uncovering
the human parturition’s mystery.
Malfunction in Either the Inhibitory System or Stimulatory System, or Both, Changes the Timing of Birth or Mode of Delivery: A Hypothesis IV
Authors: Hegazy Ali
Published: September 2022

Objective: Spontaneous preterm birth is the leading global cause of
neonatal death, and countless efforts have failed to establish a single
effective treatment for preterm labor. Labor dystocia is the major cause
of primary cesarean delivery; however, its biological mechanisms during
labor are poorly understood. When post-term pregnancy truly exists the
cause is usually unknown. The objective of the study tries to identify
the possible cause of these obstetric complications Design: Research
Study Setting: Portiuncula University Hospital, Ireland Population: N/A
Methods: This study investigated the current evidence-based literature
that may support the hypothesis. Main Outcome Measures: N/A Results:
Obstetric literature is replete with overwhelming evidence that
malfunction of any exponential uterine wall tension (EUWT) component
(stretch-dependent inhibitory system) terminates the pregnancy. Most of
the current therapeutic preterm strategies are focused on preventing
premature EUWT failure e.g. the cervical stitch. Progesterone treatment
for preterm labor may be working by enhancing the stretch-dependent
inhibitory system by modulating uterine wall plasticity and EUWT.
Post-term pregnancy is due to the failure of the stimulatory system to
transform the cervix into the lower uterine segment and to lose its
resistance that terminating the pregnancy at full term. A combined
malfunction of the two systems causes labor dystocia e.g rupture of
fetal membranes with a long cervix. Conclusion: There is growing
evidence to support the hypothesis that malfunction of the inhibitory
system causes preterm labor, malfunction of the stimulatory system
causes post-term pregnancy and labor dystocia is due to a combined
malfunction of the two systems.
Laryngotracheal separation surgery in a patient with severe Angelman syndrome involving a 19.3 Mb deletion on 15q11.2--q14
Authors: Horikawa Yohei , Yatsuga Shuichi , Ohya Takashi , Okamatsu Yuki
Published: September 2022

Previous reports of clinical course of Angelman syndrome (AS) described
typical histories of choking, dysphagia, and severe pneumonia, but there
were few bedridden cases or none requiring laryngotracheal separation
surgery (LTS) were existed. We report a severe bedridden case of AS
requiring LTS involving a 19.3 Mb deletion on 15q11.2–q14.
Acute post-traumatic dermoid peritonitis: a rare entity
Authors: Fendri sami , Rejab Haitham , Trigui Ayman , Abid Bassem , Mejdoub Youssef , Bouzid_ahmed Ahmed , fourati kais , Boujelbene Salah
Published: September 2022

Rupture of ovarian dermoid-cyst is rare case. We report the case of a
woman admitted for acute post-traumatic abdominal pain due to ruptured
ovarian cyst. The patient was operated and we found a very abundant
peritoneal effusion with left ovarian cyst which was broken. we
performed a left adnexectomy.
Chromosome-level assembly of male Opsariichthys bidens genome provides insights into the regulation of the GnRH signaling pathway and genome evolution
Authors: Liu Dong , Gui Lang , Zhu Yefei , Xu Cong , Zhou Wenzong , Li Mingyou
Published: September 2022

Hook snout carp Opsariichthys bidens is an important farmed fish in East
Asia that shows sexual dimorphism in growth, with males growing faster
and larger than females. To understand these complex traits and improve
molecular breeding, chromosome-level genome assembly of male O. bidens
was performed using Illumina, Nanopore, and Hi-C sequencing. The 992.9
Mb genome sequences with a contig N50 of 5.2 Mb were anchored to 38
chromosomes corresponding to male karyotypes. Of 30,922 functionally
annotated genes, 97.5% of BUSCO genes were completely detected. Genome
evolution analysis showed that the expanded and contracted gene families
in male o.bedins genome were enriched in 76 KEGG pathways, and 78
expanded genes were involved in the GnRH signaling pathway that
regulates the synthesis and secretion of luteinizing hormone and
glycoprotein hormones, further acting on male growth by inducing growth
hormone. Compared to the released female O. bidens genome, the number of
annotated genes in males was much higher than in females (23,992). The
male chromosome LG06 exhibited over 97% of identity with the female’s
GH14/GH38. Male-specific genes were identified for LG06, where
structural variety, including deletions and insertions, occurred at a
lower rate, suggesting a centric fusion of acrocentric chromosomes GH14
and GH38. The genome-synteny analysis uncovered significant
inter-chromosome conservation between male O. bidens and grass carp, and
the former originating from ancestral chromosome breakage to increase
the chromosome number. Our results provide a valuable genetic resource
for studying the regulation of sexual dimorphism, sex-determining
mechanisms and molecular-guided breeding of O. bidens.
DISSEMINATED LUPUS VULGARIS WITHOUT UNDERLYING ACTIVE PULMONARY TUBERCULOSIS: A CASE REPORT OF AN ATYPICAL PRESENTATION
Authors: Pudasaini Prajwal , Paudel Sushil , G.C Sagar , Adhikari Sadiksha , Pudasaini Prashanta
Published: September 2022

Lupus vulgaris is a paucibacillary form of cutaneous tuberculosis
occurring in those with high immunity. Given the high degree of immunity
that underlies this chronic disease, lesion is usually localized and
disseminated forms are uncommon. our case of disseminated disease
without underlying active pulmonary tubercular foci was an interesting
finding
A comprehensive review of colorectal cancer therapeutic strategies with a glance to the future
Authors: Kumar Anil , Gautam Vipasha , Sandhu Arushi , Rawat Kajal , Sharma Antika , SAHA LEKHA
Published: September 2022

Colorectal cancer (CRC) affects one in every 23 men and 25 women, making
it the third most common cancer. CRC accounts for 8% of all
cancer-related deaths, making it the second most common cause of death
due to cancer. Standard and conventional CRC treatments include surgical
expurgation for resectable CRC and radiotherapy, chemotherapy,
immunotherapy, and their combinational regimen for non-resectable CRC.
Despite these tactics, nearly half of patients develop incurable
recurring CRC. These constraints necessitate the development of new
target-specific therapeutic strategies such as targeted immune boosting
therapies, non-coding RNAs based therapies, natural products, oncolytic
viral therapies, have shown promising results in preclinical and
clinical studies. We have tethered the entire evolutionary trends in the
development of CRC treatments and have gone over the potential of new
therapies and how they might be used in conjunction with conventional
treatments, as well as their advantages and drawbacks as future
medicines
Experimental study on heat transfer characteristics of high-temperature heat pipe
Authors: Xu Bowen , Li Jinwang , Lu Ningxiang , Wang Changji
Published: September 2022

High-temperature heat pipes have broad application prospects in terms of thermal protection of hypersonic aircraft and cooling of space nuclear reactors. In this paper, a high-temperature heat pipe heat transfer performance experimental platform is built to study the heat transfer performance of high-temperature heat pipes at different inclination angles. A heat transfer network model of high-temperature heat pipes containing NCG is established to analyze the influence of NCG. The results show that as the inclination angle of the heat pipe increases, the start-up time of the heat pipe does not change. The heat transfer performance is best when the inclination angle is 30?. High-temperature heat pipes containing NCG will reduce the effective length of the high-temperature heat pipe, increase the thermal resistance, and reduce the heat transfer performance. The high-temperature heat pipe analysis model with NCG established in this paper can be used to predict the heat transfer performance of high-temperature heat pipes containing NCG.
Method for Low-Temperature Vacuum-Thermal Cleaning of Surface Single Crystals Si and GaAs
Authors: IMANOVA Gunel
Published: September 2022

The paper reports on a method of low-temperature vacuum-thermal cleaning of the surface of Si and GaAs single crystals developed by the authors, which consists in implanting Ba+ ions (or alkaline elements) into Si and GaAs crystals preliminarily cleaned by ultra-high vacuum by ion etching and subsequent annealing in two stage at 800 K - 15 minutes and at 1000 K for 30 minutes. The effect of effective cleaning is achieved due to the fact that the introduced ions of Ba+ and alkaline elements, being active, form compounds with impurity atoms (O, C, S, N, etc.) at the first stage and are removed together with impurities after the second stage of heating.
Simulation and prediction of the temperature field of copper alloys fabricated by selective laser melting
Authors: Chen Dongju , Wang Peng , Sun Kun , Tang Yuhang , Kong Shuai , Fan Jinwei
Published: September 2022

In the selective laser melting (SLM) process, the experimental approach to determine the optimal process parameters is labor-intensive, material-intensive, and time-consuming. The use of simulation methods also requires more time support and higher hardware requirements. In this paper, a three-dimensional transient heat transfer model and a neural network optimization process parameter model in the process of preparing copper alloys by SLM are developed by combining finite element simulation methods with neural network prediction. The thermal behavior of the multitrack molten pools was investigated by ANSYS APDL, and the effects of different laser powers and scanning speeds on the temperature field and structure dimensions of the molten pools were discussed. The results show that the current single-track has a significant preheating effect on the unmachined single-track and a reheating effect on the machined single-track during the multitrack forming process. The laser power and scanning speed can be controlled to regulate the temperature, 3D size, and heat spread area of the molten pool to avoid over-melting and under-melting. The accuracy of the temperature field model was verified by single-track experiments. A neural network prediction model was constructed to predict the maximum temperature and size of the molten pool by optimizing the backpropagation neural network with a genetic algorithm, providing a methodological guide for the study of SLM process parameters.
Multispot laser welding for increased gap bridgability
Authors: Volpp Joerg
Published: September 2022

Laser beam welding is a promising technology to enable automated high-quality welding procedures at significantly higher processing speeds compared to conventional processes. However, its usability is often limited by gap bridgability. This disadvantage is related to the small laser beam spot sizes that require low gap sizes for joining, which are often practically not available, and the desired welding without additional filler materials to enable high processing speeds without direction restrictions. New possibilities of beam shaping for process control are also available now for high-power laser processing and they show promising results. The resulting complex effects require additional investigation to understand the mechanisms and the use of the technologies for process improvements. Therefore, in this work, advanced beam shaping optics with up to four separate laser beam spots was used to understand the impact of multiple-spot welding on the process dynamics and gap bridgability. Gap bridgability was measured by an opening gap setup, while spatter amounts as indicators of process dynamics were measured by high-speed imaging. It was shown that multiple-spot laser welding can increase the gap bridgability, probably due to the initiated melt flow toward the joining partners. Symmetric separation of the keyholes toward the sheets increased the gap bridgability, while additional low-intensity spots in the center were able to stabilize the melt pool and reduce spattering.
Producción de hongo orellana (Pleurotus ostreatus) sobre residuos agrícolas y pastos generados en la comunidad de Obonuco, Nariño
Authors: Obando Gabriel Andres , Vásquez-Garcia Andrea , Benavides-Palacios Diana Esperanza , Jojoa-Martínez Henry Fabián
Published: September 2022

Fue evaluado el cultivo artesanal de hongo orellana, con cuatro mezclas diferentes de residuos, así: dos agrícolas y dos de pastos, en la comunidad de Obonuco, Nariño, a través de indicadores como número de días de incubación, número de días de aparición de primordios, rendimiento, eficiencia biológica y productividad. Para esta evaluación fueron realizados cuatro experimentos con diferentes tratamientos. Los que se comportaron mejor respecto a días de incubación y aparición de primordios fueron los compuestos por sustratos de cáscara de arveja, rastrojo de cultivo de maíz, pasto kikuyo, aserrín, salvado de trigo y 1 % de carbonato de calcio, con aislamiento térmico y un porcentaje de semilla del 5 y 9 %, con 28 y 30 días de incubación, respectivamente. En cuanto al número de días de aparición de primordios, fue 28 para ambos tratamientos. El rendimiento de los sustratos varió entre 286 a 296 g, con diferencia significativa (p < 0,05) en algunos tratamientos. Se obtuvieron eficiencias biológicas entre 28,4 y 29,6 %, según el porcentaje de semilla empleado. La productividad estuvo entre 0,28 y 0,30 g de hongo por cada 1000 g de sustrato.
Det är inte enbart att gå in i ett klassrum och lära ut något!
Authors: Florin Sädbom Rebecka
Published: September 2022

I den här studien undersöks hur två årskullar med ämneslärarstudenter får syn på och förstår en vald lärteori inom ramen för en 7,5 hp kurs där de studerade samhällskunskapsdidaktik. Syftet med studien är att bidra med kunskap om hur studenterna utvecklar ämnesdidaktiskt kunnande på teoretisk grund samt hur de beskriver det. Den teoretiska ramen och upplägget i högskolekursen bygger på variationsteori och studenterna genomförde fältuppgifter, lektionssekvenser samt skrev reflektionsuppgifter. I studien analyseras sedermera genom interpretatorisk fenomenologisk analys (IFA) den metareflektion som studenterna slutligen genomfördeinom ramen för kursen. Materialet bestod av 135 sidor skriven text. Resultatet visar att variationsteorin verkar gynna ämneslärarstudenternas utveckling av samhällskunskapsdidaktiskt kunnande på teoretisk grund vilket kan överbrygga gapet mellan teori och praktik inom ämneslärarutbildningen.
English abstractOne can’t just enter the classroom and begin to teach! Pre-service teachers’ descriptions on the development of didactic knowledge in social studies by variation theory as guiding principle
This study explores how pre-service teachers gain insight into a specific learning theory within the framework of a 7.5 credits course in social studies. The theory-practice divide in teacher education is commonly argued for as problematic. The purpose of the study is therefore to contribute knowledge of how pre-service teachers develop didactic knowledge on a theoretical basis. The theoretical framework and structure of the university course is based on variation theory and the students completed field assignments, lesson sequences and wrote reflection assignments. Data in the study consist of the reflection written by the students within the framework of the course. The material consists of 135 pages of written text which is analyzed through interpretive phenomenological analysis (IPA). The results reveal that variation theory seems to promote the pre-service teachers’ development of didactic reasoning on a theoretical basis. The pre-service teachers discover their future pupils experiences and pre-understanding of the subject content as a fundament for planning lessons in social studies.
Mellom politikk og statistikk: Globale fellesgoder i utviklingspolitikken
Authors: Hagen Rune Jansen , Selbervik Hilde
Published: September 2022

Bærekraftsmålene har gitt klassiske spørsmål innenfor utviklingspolitikken ny relevans: Hvem skal betale for globale fellesgoder? Kan man bruke bistand til dette formålet, eller bør den reserveres for innsats i spesifikke fattige land? I denne artikkelen undersøker vi hvordan DAC-landene, som kollektiv og hver for seg, forholder seg til disse temaene. Vi finner at de sliter med å følge en konsistent linje. Vi mener norske myndigheter kan tjene på å konseptualisere internasjonale fellesgoder bedre. Da blir det for det første enklere å ha en prinsipiell holdning til finansieringen av dem. For det andre kan en slik forståelse gi grunnlag for en strategisk tilnærming til nye initiativer. Det er liten grunn til å tro at man vil ha mye større budsjetter til rådighet fremover. Teorien viser dessuten at man må forvente at det er optimalt å bruke skreddersøm for å fremskaffe ulike fellesgoder. Det krever detaljkunnskap. Vi trenger større forståelse av hvordan eksisterende multilaterale organisasjoner og mekanismer som håndterer både bistand og globale fellesgoder virker. Vi trenger dessuten mer innsikt i hvordan dagens multilaterale system fungerer på ulike felt. Norge kan og bør bidra til det globale fellesgodet som denne typen kunnskap utgjør.
Abstract in EnglishBetween Politics and Statistics: Global Collective Goods and Development PolicyThe adoption of the Sustainable Development Goals has revived some classical issues in development policy: Who should pay for global collective goods? Can foreign aid be used for this purpose, or should such financing be reserved for efforts in specific poor countries? In this article we investigate how the members of the Development Assistance Committee of the OECD, collectively as well as individually, approach these questions. We find that they struggle to be consistent. In our opinion, the Norwegian government could gain from developing a better conceptualisation of global collective goods. This will first of all make it easier to have a consistent policy with respect to financing them. Secondly, such a conceptualisation will allow for a more strategic approach to new initiatives. Going forward, aid budgets are unlikely to grow much. Moreover, theory demonstrates that it is in general optimal to tailor the provision of different collective goods to the peculiarities of each case. This implies that expertise is essential. We need a better understanding of the functioning of existing multilateral organisations and mechanisms that manage both aid and global collective goods. In addition, more knowledge about the workings of the current multilateral system in different fields is required. Such knowledge is a global collective good and Norway could and should contribute to its provision.
Pharmacovigilance and Nursing context: “Nothing less than Safety”
Authors: S Pareek
Published: September 2022

Adverse drugs reactions are major public health concern in worldwide. Pharmacovigilance is a complex process of clinical and scientific discipline that ensures the safety of the medication and avoids adverse drug reactions. Poly-pharmacy, poly-physician, co-morbidities, drug administration errors, use of over the counters (OTCs) drugs, lack of awareness about medications are major cause of the reactions. India joined hand with WHO-UPPSALA in 1997 with the aim to improve the safety of drugs and health of the patients. Despite global concern regarding drug safety there is a lack of understanding and knowledge and reporting of Adversed Drug Reactions (ADRs) among health care professionals. Nurses serve as advocates for the health and safety of patients and may play a crucial role in the pharmacovigilance system & avoiding the mitigating the risks to the patient, promoting public health and determining and maintaining the safety of medicines. Nurses need appropriate knowledge and experience in the field of health care setting including early identification, management and reporting of medicine safety issues and should have a combination of pharmacovigilance training and participating in research studies.
Mental Health Nursing Evaluation Form: A Patient Assessment Guide
Authors: RH Salgado
Published: September 2022

Nursing notes are essential for mental health nursing, and thus they should be included in mental health education for undergraduate nursing students. In clinical settings, It has been observed that fourth-year nursing students commonly omitted critical information from the assessment of mentally ill patients, neglecting their requirements as well as losing valuable learning opportunities. For this reason, an evaluation form has been created and implemented in order to optimise the student’s learning opportunities. The main objectives that motivated the design of this instrument were to support the nursing student’s learning process, promote a systematic record of the mental examination, and apply specific descriptors in the assessment of the patient’s mental state. This evaluation form was designed according to a systematic and standardized registration system, including the main areas that compose mental health assessment. This cost-effective tool has significantly facilitated the student’s learning and training in mental health nursing. During the five-year period in which this instrument has been applied, student records improved in quality, precision, as well as a positive opinion about it from students. Besides, this document has been recently used in the context of distance education and clinical simulation in mental health by assessing patients in simulated situations, with positive outcomes
Proposed Plan of Home Based New Born Care in Kamis Mushayt, Saudi Arabia -Dr. Krishnavellie Chetty & Mary Johnson
Authors: M Johnson
Published: September 2022

The global burden of neonatal deaths is estimated to be 2.6 million, of which 0.76 million—more than a quarter—occur in India. With a neonatal mortality rate (NMR) of 26 per 1000 live births and infant mortality rate of 39 per 1000 live births,2 deaths in the neonatal period alone contribute to two-thirds of infant deaths in India. Even among postneonatal infant deaths (1–12 months), a major proportion of deaths occur in the second month of life. Any further reduction in infant mortality is therefore intricately linked to a major reduction of neonatal and young infant (0–59 days) deaths. Various attempts have been made to implement innovative approaches for newborn care at community/home level. The Cochrane review on community- based interventions found a significant reduction—by about 25%—in neonatal mortality with community mobilisation and antenatal and postnatal home visits by health workers. The Lancet Every Newborn Study Group estimated that immediate scaling up of various community-based and primary care interventions can avert almost a third of all neonatal deaths by 2017 and one-fifth by 2025. Khamis Mushayt or Khamis Mushait city in south-west Saudi Arabia, located east of Abha, the provincial seat of the Asir province, It is the capital of the Shahran tribe. 8th largest in Saudi Arabia with an estimated population of 1,300,000. The infant mortality rate is a significant indicator of the quality of the health care provided to the population and gives insight into the factors that influence health. According to Millennium Development Goal 4, minimizing the infant mortality rate is a major challenge. Substantial efforts and resources are necessary to overcome these challenges, especially during the neonatal period, which is the main contributor to mortality figures for children under age five.The nursing team is striving to take initiative in promoting the new born care to the best possible so that the morbidity and mortality rates can come down even further and the new born wellbeing will be promoted in the areas of Khamis Mushait where the proposed plan of care is not available.
A Descriptive Survey Regarding Impact of Lockdown on School Going Children
Authors: UR Adhikari
Published: September 2022

Introduction: In India, lockdown for COVID-19 prevention started from March 25th 2020, causing severe disruption to the normal life. All nations’ scientists are still trying to find a solution for it. Beating the virus completely seems to be difficult because of the nature of the virus. In West Bengal, India, schools reopened from February 12th 20218 for class IX-XII only. So school children up to class VIII are still confined at home. In this context, it is important to understand the effects of lockdown on children. Methods: Hundred school students were selected for online (Google form) survey during Oct-Nov 2020 through purposive sampling. After ethics committee approval school children between 6-18 years who were willing to participate were enrolled for the survey. Informed consent was taken from the parents and their children. Descriptive statistics were used for analysis of data. Results: 36% children had increased appetite whereas 12% reported a decrease in appetite during COVID-19 lockdown. Few (9%) students reported long sleeping hours (12-14 hours / day) and majority (61%) of the participants expressed spending their leisure time by watching TV. Most of them (89%) missed the school; 53% participants felt loneliness and 74% missed outdoor games. 60% children also reported the concepts to be unclear in online classes. 46% parents reported behavioral changes of their children like irritability (31%), getting angriness (36%) and temper tantrum (13%) during COVID-19 lockdown. Most (98%) of the school children are maintaining their personal hygiene but 82% children are not doing it in time. 99% had basic knowledge on COVID-19 and its preventive behaviors but 37% didn’t want to wear mask, 30% were not maintaining social (physical) distancing and 10% were not washing their hands regularly. Many participants expressed that their quality of life, quality of study, health and mental health condition deteriorated during the lockdown than the pre COVID situation. Conclusion: Parent’s counselling about the developmental needs of the children in various phase of childhood is required so that parent will put their maximum effort to make and follow a consistent routine for study, play, rest and physical activities of the children.
The Effects of a Health Education Intervention Program on Infantile Colic
Authors: PY Lee
Published: September 2022

Background: Infantile colic (IC) is defined as uncontrollable irritability or crying in a healthy infant. It usually appears under 12-month after birth and about 10-20% infants have suffered it. The parents of infants with IC suffered from physical and mental anxiety and stressful family relationship. Objective: To examine the effects of an Infantile Colic Health Education Program (ICHEP) on parents’ knowledge, attitudes, and behavioral management with IC. Design: Two-group randomised controlled trail. Settings and Participants: A total of 140 infants from birth to 12-month of age that diagnosed with IC were recruited from a hospital in South Taiwan. Methods: The participants were randomly assigned to either attend the ICHEP (n=70) or the control group (n=70). The questionnaires included the knowledge, attitudes, behavioral management on infantile colic for parents, and the Cronbach’s α value was between 0.58 and 0.63. Pre-post-test, follow-up test and the re-tracing test were conducted. An independent t-test and the generalized estimating equation (GEE) model were used to compare the differences in the study outcomes. The statistical tests were two-sided and a p-value below 0.05 was considered statistically significant. Results: No difference was detected in the baseline characteristics between two-groups. The ICHEP group scores on knowledge, attitudes and behavioural management in the post-test were significantly higher than the pre-test. The average score of ICHEP in re-tracing test (p ＜ 0.001) was significantly higher than the scores of the pre-test (p = 0.08), the post-test (p = 0.001), and follow-up test (p = 0.32). Result was evident that the ICHEP significantly improved parent’ implementation of caring behaviour on IC and reduced the incidence of IC. Conclusions: The ICHEP can not only improve the parent’ knowledge, attitudes and management behaviour on IC but also significantly reduce the incidence of infants with IC. ICHEP can be used as a reference for healthcare workers to immediately provide to parents in the early stages of diagnosis at outpatient clinics in the future. We recommend that ICHEP can include into healthcare workers continues training courses in order to assist in understanding IC, help reduce anxiety and fear of parents, thereby enhancing a harmonious parent-child relationship.
Adjustment to Chronic Diabetes: A Review and Analytical Study
Authors: R Pourhosein
Published: September 2022

Diabetes is a chronic disease that disrupts human biological and psychological interaction; so that the person’s adaptation to the disease is necessary. The present study aimed to review the psychological methods related to adaptation to diabetes. This research is a narrative review study that has been done using the keywords diabetes, self-care, adaptation and, adjustment in specific databases of Medline, Sid, Magiran, PubMed, Scopus, and Science Direct. After reviewing the entry and exit criteria, articles that were not directly related to the topic, as well as articles with duplicate findings were removed. The findings showed that self-care is a spectrum of behaviors of a person that includes diet, medication, exercise, etc., and is influenced by individual and social factors and indicates the degree of adjustment to chronic diseases such as diabetes. Psychological factors not only affect different aspects of the life of people with diabetes, but also affect self-care and management behaviors and achieving proper control in people with diabetes.
Knowledge and Obstacles Perceived by Critical Care Nurses in Endo-tracheal and Tracheostomy Suctioning
Authors: N Jose
Published: September 2022

Tracheostomy and Endo-tracheal suctioning is one of the most common procedure performed in patients with artificial airways. It is a component of airway management and mechanical ventilation that involves the evacuation of the pulmonary secretions from the patient’s airway to prevent complications. Performance obstacle are those inhibiting factors perceived by critical care nurses in terms of knowledge and skill, tool and technology, and work setting which tend to affect their performance. Objectives: i) to assess the knowledge and performance obstacles perceived by critical care nurses while performing Endo- tracheal and Tracheostomy suctioning. ii) To find out the suggestions of critical care nurses on overcoming the performance obstacles identified in Endo-tracheal and Tracheostomy suctioning. Methodology: A cross sectional descriptive survey was designed among 80 and a questionnaire survey conducted among critical care nurses. Results: The performance obstacles during suction as perceived by nurses were 63% reported minimum obstacle, 27% reported medium obstacles, were as only 10% reported many obstacles while performing the suctioning. All of them suggested the need for training at the beginning of clinical posting in the unit, clear cut guidelines/protocol on ET suctioning and updating of guidelines/equipment. Conclusion: The performance obstacles were categorized into knowledge, skill, technology, tool and organization. The performance obstacles perceived by nurses were mostly related to the skill in doing the procedure. The major knowledge related performance obstacles perceived by nurses were inadequate training on ET suctioning in a real patient as s student (70%). Training on ET suctioning should be given during the induction program on the time of joining to the organization.
Raising Children in an Technologically Advanced World
Authors: SN Chauhan
Published: September 2022

“The greatest legacy one can pass on to one’s children and a grandchild is not money or other material things accumulated in one’s life, but rather a legacy of character and faith”. Evangelist Billy Graham dining together each night my father-in-law converses with us on how he was born and brought up by his parents long back. Having his mother alive all hail and hearty, an old lady of 100 makes him recall his childhood each time he sees her. He flips back on how his father gave him valuable advices on lessons of life, and continues to walks on the principals that his father has imbibed on him as a young boy and he carries a strong impression of his father’s teachings, he expects that the coming generation should live a life as they then lived. Childhood in itself is a sweet memory for each one of us; we all have our own bunch of memories to share. Childhood is even the most correct time to mould a raw person into a fine personality. Living in the 21 st century world, things have seemed to be changing a lot. Parenting, raising children has become a far more different aspect. Since parenting is also an ethical and moral issue, perspective may vary according to the culture and civilization for different people belonging to different set ups. As health personals we too come across many cases that arise merely due to maladjustments or psychological impairments that many a times lead to serious psychiatric problems. The third important thing is that parenting as a complete process and according to the changing time parenting is not the same as it used to be in the past. In the previous years we have been undergoing tremendous technological advancement which in terms is a boon for us. Our lifestyles have heavily changed, we no more live in a joined family, we all are working parents and our outlook for a settled life has changed the world around us. We all live in the world that is modern civilized. Leaving our civilization far behind. Raising kids in this advanced world is a challenge indeed. Since technology has brought curses as well as boons to our lives. We need to balance them both. Things may be difficult but not impossible.
The Situation of Refugee Women and Their Children in a Camp During COVID-19
Authors: MY Celik
Published: September 2022

Objectives: This study was carried out to determine the situation of refugee women and their children during the COVID-19 period. Methodology: This study is a descriptive cross-sectional study. The sample of the study consisted of married women with children aged 0-12 in a refugee camp. Data were collected between 01.06.2021 and 01.08.2021. In the collection of data in the research; Information form has been used. The data were determined by using frequency acquisition and chi-square from descriptive analyzes in SPSS program. Results: It is determined to that 48.8% live with 2 people in a room, 32.6% have a chronic disease, 27.9% are COVID-19 positive, 7% of their children are COVID-19 positive, 47.7% have covid-19 positive in their relatives, 29.1% lost a relative due to COVID-19 and 72.1% wanted to be vaccinated against COVID-19 of participants. In addition, the average age of the participants was 36.98±12.20, the average number of people living in a room was 3.0±1.41 and the average number of children was 4.58±2.01. Conclusions: As a result, refugee women and children are more vulnerable to diseases and epidemics due to their living conditions. Therefore, the inclusion of migrants and refugees in all aspects of the response to COVID-19 is crucial for women’s and children’s health and public health.
Overview of Early Postpartum Perineal Wound Repair Management During Home Care with Hydrotherapy Cold Sitz Bath and Infra Red Therapy
Authors: BM Girsang
Published: September 2022

Background & Aim: The delivery process can be a problem in post partum mothers who find it difficult to adapt to various measures of trauma care for the perineum salama in the postnatal period, this results in a risk of infection in the perineal wound. The appearance of perineal infection can spread to the bladder or in the birth canal which can cause complications. This study aims to assess the effectiveness of sitz bath hydrotherapy interventions and infrared therapy in repairing perineal wounds. Methods & Materials: This study is a comparative study that compares two perineal wound care therapies, namely sitz bath hydrotherapy interventions with infrared therapy Perineal wound repair assessment is performed using the southampton wound rating scale. Assessment and intervention in perineal wounds is carried out twice a day for three consecutive days. The purposive sampling technique was carried out on 20 people with sitz bath hydrotherapy interventions, and 20 people with infrared therapy using Mann-Whitney statistics. Results: Statistically proven that group 1 interventions (cold sitz bath hydrotherapy) (p = 1.00) and group 2 (infra red therapy) (p = 1.00) on the first and second day did not have a significant effect on perineal wound healing . However, cold water sitz bath hydrotherapy intervention was significantly effective in improving the perineal injury process on the third day (p value = 0.037). Conclusion: The method of treating perineal wounds with cold sitz hydrotherapy can be used as a procedure for postpartum maternal perineal repair in health care and at home.
Breast Care and Acupuncture Points GB 21: Boost Up Breast Milk Production
Authors: I Kusumawaty
Published: September 2022

Breast feeding is recognized and highly recommended by the World Health Organization (WHO) as optimal feeding for all infants. However, some of the obstacles experienced by postpartum mothers at the beginning of breastfeeding can cause ineffective breastfeeding. One of the causes of the lack of fulfillment of breast milk in infants is less milk production on the first day after birth. The lack of milk production can cause is that it is difficult for the baby to gain weight. Some alternative efforts that can be done are to stimulate prolactin and oxytocin hormones in postpartum mothers by providing Breast Care and GB21 point acupuncture. This study aimed to determine the effectiveness of breast care and GB 21 acupuncture in postpartum mothers in the first ten days of producing breast milk. The research design used was a quasi-experimental design with Pretest-Posttest with Control Group. The number of samples studied was 90 respondents. Each group was breast care and 30 respondents. The intervention group was treated with acupuncture point GB 21 and 30 control patients. This research was conducted in February 2021 in Muara Enim Regency. The data were analyzed using the T-test and Anova test to see the effect of Breast Care and GB21 point acupuncture on breast milk production in postpartum mothers. The Breast Care action study results significantly increased the baby’s weight compared to the control group, as much as six times, while the administration of GB 21 acupuncture was twice that of the control group. This study concludes that Breast Care is one of the therapies that can increase breast milk production.