bluuebunny/crossref_metadata_2025 huggingface dataset:
Disparitas Kesejahteraan Masyarakat Terdampak Covid 19 Sebelum dan Sesudah Adanya Program Keluarga Harapan (PKH)
Authors: Jatmiko Udik , Munir Miftahul , Jauhari Ahmad
Published: August 2021

Kesejahteraan masyarakat di dearah pedesaan mulai terabaikan terlebih dengan adanya virus covid 19 yang mengharuskan pemerintah mengambil kebijakan pemberian bantuan baik tunai ataupun non tunai untuk menutup kesenjangan masayarakat khususnya Program Keluarga Harapan (PKH). Responden dalam penelitian ini sebanyak 115 KPM PKH di Desa Boro Kedungwaru Tulungagung. Analisis data menggunakan statistik perbandingan dengan uji paired sample t test. Berdasarkan uji komparatif paired sample t test diperoleh hasil bahwa dengan nilai t hitung sebesar 3,715 > ttabel sebesat 1,658 dengan nilai probabilitas sig. t test sebesar 0,000 < 0,05. maka dapat disimpulkan bahwa Ha diterima dan Ho ditolak yang berarti terdapat perbedaan rata-rata yang signifikan antara kesejahteraan kelompok penerima manfaat (KPM) di masa pandemi covid 19 sebelum dan sesudah menerima bantuan program keluarga harapan (PKH). Disparitas kesejahteraan masyarakat yang terdampak covid 19 dengan adanya PKH tercatat tidak efektif, hal ini terlihat dari aspek sasaran yang menerima bantuan PKH tidak terdata secara tepat dan data masih tumpang tindih dengan penerima bantuan program lainnya.

Kata Kunci: Disparitas, Kesejahteraan Masyarakat, Program Keluarga Harapan

Abstract

The welfare of the community in rural areas is starting to be neglected, especially with the covid 19 virus that attacks all aspects of people's lives, which requires the government from the center to the regions to take policies to provide cash and non-cash assistance to close gaps that exist in the community, one of which is the policy granting the Family Hope Program (PKH). Respondents in this study were 115 KPM PKH in Boro Village, Kedungwaru Tulungagung. Data analysis used comparative statistics with paired sample t test. Based on the comparative test of paired sample t test, the result is that with a t-count value of 3.715 > ttable of 1.658 with a probability value of sig. t test of 0.000
THE CHANGE IN THE BEARING CAPACITY IS CORROSIVE-DAMAGED FLOOR SLABS DEPENDING ON THTHE CHANGE IN THE BEARING CAPACITY IS CORROSIVE-DAMAGED FLOOR SLABS DEPENDING ON THE DEPTH OF DAMAGE TO THE STRETCHED ZONE CONCRETEE DEPTH OF DAMAGE TO THE STRETCHED ZONE CONCRETE
Authors:   JSC «NITS «Stroitelstvo», Minasyan A.A.
Published: August 2021

In this work, the influence of the depth of tensile concrete deterioration on the load-bearing strength and deflections of precast reinforced concrete slabs were determined experimentally. The momenta determination and measurement of deflections was carried out by loading the structure stepwise. Analysis of the results of the study indicated the following: as the plates are damaged, with the increase in the height of tensile concrete deterioration, the stress diagram gets gradually filled in the compressive sectional area and its height decreases, which can lead to the destruction of the structure. At the same time, the shear and bending moment diagram of sectional deformation gets curved. As the slab deflections increase, its load-bearing strength decreases.
OPTIMIZATION OF TRUSS STRUCTURES WITH CHORDS OF STEP-VARIABLE CROSSSECTIONS MADE OF RECTANGULAR PIPES
Authors:   Branch of the North Caucasus Federal University, Marutyan A.S.
Published: August 2021

The article describes the regularity of the optimization calculation of unification zones in relation to beam chords of step-variable cross-sections with the determination of their design coefficients. The rationality of the formation of these chords in truss structures made of rectangular pipes is shown due to the difference not in the heights of the sections, but in their thicknesses with welded joints on the longitudinal slits.The engineering method for calculating such joints, as well as their load-bearing capacity, has been tested by tensile strength tests of the samples.The universality of the technical solution of welded joints with slits ensures their use in structures made of tubular and rolled profiles, and it preserves the accepted layout of standardized trusses with assemblies and flanged connections. The significant reduction in structural material (steel) in standardized trusses made of bent-welded profiles was revealed when chords of uniform cross-sections were replaced with chords of step-variable cross-sections. The article also gives the comparative calculation of the design coefficients and the averaged coefficients of chord elements use when the lengths of the unification zones and the belt panels coincide. Sufficient correctness of the approximate calculation method for solving optimization problems and variant design of load-bearing structures is confirmed.
GLUED WOOD LENTICULAR TRUSSES DESIGN FEATURES, TESTING, STRUCTURAL ANALYSIS AND APPLICATION
Authors:   JSC «Research center «Construction», Pogoreltsev A.A , Turkovskii S.B. ,   JSC «Research center «Construction»
Published: August 2021

Lenticular trusses are effective and promising structures that have a number of advantages over trusses of a different shape covering large spans. The main nodes of the trusses are the support ones. At these nodes large shear forces occur. Traditional types of connections did not provide the required reliability of the support nodes. Four variants of support nodes and rigid joints of trusses are proposed. The basis is the connections with glued rods. The test results of the support node fragment of the truss with a span of 30 m in full size are presented. The stress-strain state of the truss support node is analyzed. The strength and effectiveness of the proposed design is proved. For the first time trusses with a span of 24 m were used in 1983 for an industrial building in Volokolamsk. Prefabricated trusses with a span of 48 m are used in the Yantar sports complex in Moscow. During tests, two of them were loaded until complete destruction. The main results are presented. The high rigidity of the trusses and the design assumptions are experimentally confirmed. The algorithm of analysis of rigid joints of the upper and lower belts in the supporting zone of lenticular trusses made of glued wood, designed according to the “TSNIISK” system with glued rods, in accordance with the provisions of SP 64.13330.2011 “Wooden structures”. Two types of nodes are considered. Named objects in Russia, covered with lenticular trusses spans up to 56 m.
Oral contraceptives use reduces ovarian and endometrial cancer risk
Authors:   “Filantropia” Clinical Hospital, Bucharest, Romania, CIOROBA Teodora Gabriela , CIOBANU Anca Marina ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, CIMPOCA-RAPTIS Brînduşa Ana ,   “Filantropia” Clinical Hospital, Bucharest, Romania, GICĂ Corina ,   “Filantropia” Clinical Hospital, Bucharest, Romania, BOTEZATU Radu ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, PELTECU Gheorghe ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, GICĂ Nicolae ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, PANAITESCU Anca Maria ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: August 2021

One of the greatest problems that patients and medical system confront worldwide nowadays is cancer. Even if there is a great focus on treatment improvement, it is equally or even more important to find cancer prevention pathways. If we concentrate on gynecological malignancies, we have as example cervical cancer which can now be prevented through vaccination, but less is known about prevention methods for endometrial and ovarian cancer. In 1992, Alice S. Whittemore first described the protective role of combined oral contraceptives (COC) use against ovarian cancer. After that, many other studies tried to find out how combined oral contraceptive use influence the risk of gynecological cancers. According to all researches, it is now known that COC are associated with risk reduction in ovarian and endometrial cancers. It was observed that their risk reduction depends on different factors such as length of use, the period of life when they were used, or some other associated risk factors. Moreover, it seems that they offer protection only against some histological types of endometrial and ovarian cancer. This review relates the most important findings regarding COC use and their risk reduction effect on ovarian and endometrial cancer in the recent studies. Even if some certain conclusions were made, such as time-dependent effect, more studies need to be conducted in order to have certain future recommendations.
Gastroesophageal reflux disease in pregnancy
Authors:   “Filantropia” Clinical Hospital, Bucharest, Romania, VĂRȘA Ramona Georgiana , CIOBANU Anca Marina ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Farmacy, Bucharest, Romania, CIMPOCA-RAPTIS Brînduşa Ana ,   “Filantropia” Clinical Hospital, Bucharest, Romania, GICĂ Corina ,   “Filantropia” Clinical Hospital, Bucharest, Romania, BOTEZATU Radu ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Farmacy, Bucharest, Romania, GICĂ Nicolae ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Farmacy, Bucharest, Romania, PELTECU Gheorghe ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Farmacy, Bucharest, Romania, PANAITESCU Anca Maria ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Farmacy, Bucharest, Romania
Published: August 2021

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal (GI) disorders and, despite the fact that it is a benign condition, it may seriously affect the quality of life of women during pregnancy. The most commonly symptoms seen of GERD are heartburn and reguritation and the cause is probably an association between the decreased pressure in lower esophageal sphincter (LES), influenced by the high concentrations of estrogen and progesterone, and the increased intra-abdominal pressure. Contrary to non-pregnant patients, the management of GERD during pregnancy is based on a step-up algorithm, beginning with lifestyle modifications and dietary changes. If symptoms persist, or in case of complicated reflux disease, antacids or sucralfate are considered the first-line therapy, followed by the histamine-2-receptor antagonists and proton pump inhibitors. The purpose of this article is to make a review of the medical literature concerning the symptoms, pathophysiology, diagnosis, and management of GERD in pregnancy. For this purpose, a scientific research in databases such as Medline, PubMed, Elsevier, The Lancet was conducted.
Urinary tract infections in pregnancy
Authors:   “Filantropia” Clinical Hospital, Bucharest, Romania, NIȚICĂ Ruxandra-Patricia , GICĂ Nicolae ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, GICĂ Corina ,   “Filantropia” Clinical Hospital, Bucharest, Romania, CIOBANU Anca Marina ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, PELTECU Gheorghe ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, CIMPOCA-RAPTIS Brînduşa Ana ,   “Filantropia” Clinical Hospital, Bucharest, Romania, BOTEZATU Radu ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, PANAITESCU Anca Maria ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: August 2021

Background. Urinary tract infections (UTI) are the most common infections during pregnancy. The feto-maternal complications linked to this pathology can be severe if untreated and the treatment has been a subject of interest hence the multiple drugs contraindications in pregnancy, the restraint panel of antibiotics that can be used and the antimicrobial resistance that is constantly increasing. The purpose of this article is to review the latest data from literature and guidelines regarding the best management of the urinary tract infections in pregnancy. Methods. It was undertaken a systematic electronic search for articles, reviews and guidelines using Cochrane Date Base, PubMed and the international protocols in use recommended by the Obstetrics and Gynecology societies (ACOG - American College of Obstetricians and Gynecologists, CNGOF – Collège National des Gynécologues et Obstétriciens Français, RCOG – Royal College of Obstetricians and Gynecologists). Results and conclusions. Special consideration should be given to urinary tract infections developed during pregnancy because they are related to serious fetal and maternal complications. Routine screening is recommended and the antibiotic therapy properly individualized. Emotional impact on the future mothers is particularly important and non-pharmacologic prophylaxis should always be discussed at the begging of pregnancy. Future research should be focused on finding the actual mechanism of pathogenesis that link UTI and the complications they associate.
CARDIAC CHANGES IN ACUTE ISCHEMIC STROKE
Authors:   National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania, Manea Maria Mirabela , Dragos Dorin ,   Emergency University Hospital, Bucharest, Romania,   University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania, Moldoveanu Vladimir ,   National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania, Popa Constantin ,   National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania,   University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania, Tuta Sorin ,   National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania,   University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
Published: August 2021

Purpose: the analysis of the paraclinical features of heart changes in the acute ischemic stroke, especially electrocardiographic (ECG) abnormalities. Material and methods. We performed a prospective study on 23 patients admitted in our stroke unit with large lesions induced by acute ischemic strokes and no history of cardiovascular disease. Results. The average age of patients was 72,87 +/- 11,55 years. On admission NIHSS score was higher in the cardioembolic stroke patients compared to atherothrombotic stroke patients, the difference persisting after the first seven days. Echocardiography demonstrated a larger left atrium area in cardioembolic compared to atherothrombotic stroke patients. The E-wave deceleration time (a diastolic function parameter) was longer in atherothrombotic compared to cardioembolic stroke. The ECG monitoring and repeated 24h Holter monitoring detected atrial fibrillation (AF) in 52, 17% of the patients and it was associated with a higher in-hospital mortality and stroke severity. No significant correlation was found between the increase in troponin T levels and AF, or in-hospital mortality. Discusions. In our study atherothrombotic stroke is associated with a more pronounced tendency to diastolic dysfunction compared to cardioembolic stroke. The percentage of detected AF is higher than expected because of: 1) the higher average age of patients, 2) the inclusion of patients with large strokes, and 3) continuous ECG and Holter monitoring for longer periods of time compared to the usual procedure in stroke patients. Conclusion. The cardiologic monitoring has strong implications for stroke mechanisms and short and long term outcome and prognosis of the patients.
HEREDITARY THROMBOPHILIAS AND THEIR ROLE IN THE ETIOLOGY OF CEREBRAL VENOUS THROMBOSIS
Authors:   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Cociasu Ioana ,   Neurology Clinic, Colentina Clinical Hospital, Bucharest, Davidescu Eugenia Irene ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest,   Neurology Clinic, Colentina Clinical Hospital, Bucharest, Bajenaru Ovidiu Alexandru ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest,   Neurology Clinic, Emergency University Hospital Bucharest
Published: August 2021

Cerebral venous thrombosis (CVT) is a very rare and particular type of stroke. This disease mainly affects young adults and especially women of childbearing age. We performed a retrospective observational study in which we included all consecutive patients admitted with the diagnosis of cerebral venous thrombosis in the Neurology Department of Colentina Clinical Hospital between October 2013 and May 2017. Inclusion criteria were imaging confirmation of cerebral venous thrombosis either by conventional angiography, computed tomography (CT) with contrast or magnetic resonance imaging (MRI) with venography. Exclusion criteria were limited to age under 18 years old. We performed this study in order to show the genetic profile of the Romanian patient with cerebral venous thrombosis. It is the first prospective observational study performed on this disease in Romania. The results of our study concerning hereditary thrombophilia were in agreement with current data in the literature, especially given the fact that all patients presented at least one mutation. The population of patients we enrolled showed clinical and genetic aspects similar to the known epidemiologic profile of the patient with cerebral venous thrombosis, regarding age of onset, prior or concomitant infections, presence of prothrombotic factors and favourable outcome.
HUMAN GUT MICROBIOTA AND ITS EFFECTS ON HUMAN HEALTH IN NORMAL AND PATHOLOGICAL CONDITIONS
Authors:   National Institute of Public Health, Bucharest, Munteanu Anca Magdalena ,   University of Medicine and Pharmacy “Carol Davila”, Bucharest, Cursaru Raluca ,   University of Medicine and Pharmacy “Carol Davila”, Bucharest, Guja Loreta ,   University of Medicine and Pharmacy “Carol Davila”, Bucharest, Carniciu Simona ,   Center of Research in Diabetes and Nutrition Disorders “Corposana”, Bucharest, Borcan Alina Maria ,   University of Medicine and Pharmacy “Carol Davila”, Bucharest,   National Institute of Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, Popescu-Spineni Dana ,   University of Medicine and Pharmacy “Carol Davila”, Bucharest,   Institute of Anthropology “Fr. I. Rainer” of the Romanian Academy, Bucharest
Published: August 2021

The medical research of the last 1-2 decades allows us to look at the human gut microbiota and microbiome as to a structure that can promote health and sometimes initiate disease. It works like an endocrine organ: releasing specific metabolites, using environmental inputs, e.g. diet, or acting through its structural compounds, that signal human host receptors, to finally contributing to the pathogenesis of several gastrointestinal and non-gastrointestinal diseases. The same commensal microbes were found as shapers of the human host response to drugs (cardiovascular, oncology etc.). New technologies played an important role in these achievements, facilitating analysis of the genetic and metabolic profile of this microbial community. Once the inputs, the pathways and a lot of human host receptors were highlighted, the scientists were encouraged to go further into research, in order to develop new pathogenic therapies, targeting the human gut flora. Dual therapies, evolving these “friend microbes”, are another actual research subjects. This review gives an update on the current knowledge in the area of microbiota disbalances under environmental factors, the contribution of gut microbiota and microbiome to the pathogenesis of obesity, obesity associated metabolic disorders and cardiovascular disease, as well as new perspectives in preventing and treating these diseases, with high prevalence in contemporary, economically developed societies. It brings the latest and most relevant evidences relating to: probiotics, prebiotics, polyphenols and fecal microbiota transplantation, dietary nutrient manipulation, microbial as well as human host enzyme manipulation, shaping human responses to currently used drugs, manipulating the gut microbiome by horizontal gene transfer.
ASPECTS OF THE RECOVERY PROGRAM IN A PATIENT WITH INCOMPLETE CERVICAL VERTEBRO-MEDULLARY TRAUMATISM DUE TO SECONDARY GENERALIZED CONVULSIVE SEIZURES
Authors:   Spitalul Clinic de Urgenţă „Bagdasar-Arseni“, Bucureşti, Stoica Simona Isabelle , Chipăruş Carmen Elena ,   Spitalul Clinic de Urgenţă „Bagdasar-Arseni“, Bucureşti, Lăpădat Magdalena Vasilica ,   Spitalul Clinic de Urgenţă „Bagdasar-Arseni“, Bucureşti, Onose Gelu ,   Spitalul Clinic de Urgenţă „Bagdasar-Arseni“, Bucureşti,   Universitatea de Medicină şi Farmacie„Carol Davila“, Bucureşti
Published: August 2021

The number of spinal cord injury patients continues to be a challenge for neuromotor recovery. Consequences are sensitivity and motility disorders which leads to different invalidity degrees. At the same time, food excesses/of nutritional toxic products or other aggresive factors (urinary tract infections, ingrown nails, autonomic dysreflexia and so on) can disturb central nervous system functions up to secundar generalized sceizures triggering (which can severely affect the lifestyle of patients). For all these reasons, is very important to study carefully the evolution of spinal cord injury patients and their lifestyle precursor traumatic events. The authors will present the complex and difficult evolution of a case with incomplete posttraumatic tetraplegia (treated neurosurgical conservately).
Çocuklarda Fiziksel Aktivite Seviyesi Motor Beceri ve Dikkat Düzeylerinin İncelenmesine Yönelik Bir Araştırma
Authors: İBİŞ Serkan , AKA Hasan , KURT Songül , AKTUĞ Zait Burak
Published: August 2021

Bu çalışmanın amacı, 11 yaşındaki çocukların motor beceri (MB), fiziksel aktivite seviyesi (FAS) ve dikkat düzeylerinin (DD) belirlenmesi ile bu değişkenler arasındaki ilişkinin incelenmesidir. Çalışmaya 11 yaşında 101 erkek ve 121 kız olmak üzere toplam 222 çocuk gönüllü olarak katılmıştır. Çalışmada çocukların FAS’leri ilköğretim öğrencileri için fiziksel aktivite soru formu (PAQ-C) ile, MB’leri, büyük kas becerilerini ölçme testi (BÜKBÖT) ile DD’leri ise D2 dikkat testi ile belirlenmiştir. Çocukların FAS, MB ve DD’lerine ait verilerin yüzde ve frekans değerleri kullanılmış ve FAS, MB ve DD’leri arasındaki ilişki pearson korelasyon analizi ile belirlenmiştir. Yapılan analiz sonuçlarına göre MB’lerin kategorilendirilmesinde erkeklerin %78,2’sinin; kızların ise %74,4’ünün ortalama altı, kötü ve çok kötü kategorisinde olduğu; DD’lerinin kategorilendirilmesinde ise erkeklerin % 49,5’nin; kızların ise %20,7’nin kötü ve vasat kategorisinde olduğu belirlenmiştir. Katılımcıların FAS’leri ile DD’leri arasında anlamlı bir ilişki bulunmazken, FAS’i ile lokomotor beceri arasında pozitif yönlü anlamlı bir ilişki belirlenmiştir. Ayrıca MB ile DD parametreleri arasında da anlamlı ilişki tespit edilmiştir. Sonuç olarak, çocukların temel MB’lerinin ve DD’lerinin geliştirilmek istendiği durumlarda, içerisinde fiziksel aktiviteler bulunan oyun ve sportif faaliyetlere yönlendirilmesi önerilebilir.
Authority to Decide
Authors: Aitken Lee
Published: August 2021

To realise that there is no Court in Australia with unlimited jurisdiction is at one stroke to recognise the continuing importance of Justice Leeming’s standard work, and the relevance of this second edition. The ‘autochthonous expedient’, as Sir Owen Dixon named it, has much to answer for: it leads inexorably to a bifurcated system of state and federal courts, which has many toils and snares for the unwary. To compound the problem, the state courts enjoy a large amount of ‘invested’ federal jurisdiction, which means that on many occasions they exercise it without appreciating the fact that they have done so.
Structural diversity and conservation implications of Parrotia subaequalis (Hamamelidaceae), a rare and endangered tree species in China
Authors: Liu Jie , Zhang Guang-Fu , Li Xue
Published: August 2021

Parrotia subaequalis(H. T. Chang) R.M. Hao & H.T. Wei is a rare and endangered Tertiary relict tree that is endemic to subtropical China. However, little is known about its growth condition and relationship with associated tree species. Here, for the first time we measured the structural diversity ofP. subaequaliscommunities at three representative sites in eastern China using four structural indices, including mingling, tree-tree distance, and diameter and tree height differences. The results showed that: 1) Collectively, mostP. subaequalisand associated tree species were small and mid-sized classes in tree height, and small-sized class in diameter; 2) There were two or more other tree species around most ofP. subaequalisindividuals across the three sites; 3) Overall, the mean distance between reference trees and their neighbors was mainly 1–2 m. Our results indicated that a strong interspecific competition existed betweenP. subaequalisand its associated tree species. Meanwhile, although the reference treeP. subaequalishad slight advantages in both horizontal and vertical planes, we think that it is necessary to take some effective measures to reduce the interspecific competition and thereby keep it at a proper successive stage. In addition, we also discuss the protection level ofP. subaequalisin China, and propose to keep this species at the First-Grade State Protection.
Enhancing Nurse Moral Agency: The Leadership Promise of Doctor of Nursing Practice Preparation
Authors: Grace Pamela
Published: August 2021

An expansive and growing body of literature documents the problem of nurses’ moral distress when they are unable to carry out actions that they perceive to be in the best interests of patients. Further, nurse leaders and educators are not always well prepared to help nurses to develop moral agency. Moral agency is the ability to provide good care and overcome obstacles to good practice. One reason for the lack of preparation is that ethics education in academia, and in ongoing nurse education, has been inconsistent or has focused more on dilemmas than the ubiquitous everyday practice issues. The purpose of this article is to discuss goals of the nursing profession, contemporary challenges to good nursing practice, and leadership from those educated as Doctors of Nursing Practice (DNP). The author argues that the proliferation of (DNP) programs, focused as they are on leadership in practice settings, presents a unique opportunity to prepare nurse leaders who are, first and foremost, skilled and knowledgeable about the ethical content of everyday nursing practice. An ‘ethics matrix’ is described and proposed as an essential base for DNP education upon which all other knowledge is built, with specific discussion of types of leadership and the relationship of transformational learning to transformational leadership.
Identifying and Addressing Ethical Issues with Use of Electronic Health Records
Authors: McBride Susan , Tietze Mari , Robichaux Catherine , Stokes Liz , Weber Eileen
Published: August 2021

With the passage of the Health Information Technology for Economic and Clinical Health Act in 2009, the United States, as of 2017, has achieved 95% saturation with electronic health records as a means to document healthcare delivery in acute care hospitals and guide clinical decision making. Evidence is mounting that EHRs are resulting in unintended consequences with patient safety implications. Clinical teams confront usability challenges that can present ethical issues requiring ethical decision-making models to support clinicians in appropriate action on behalf of safe, effective clinical care. The purpose of this article is to identify and address ethical issues raised by nurses in use of electronic health records. We provide a case scenario with application of the Four Component Model and describe a study of nurse experiences with the EHR. The nursing Code of Ethics, Nursing Scope and Standards, and Legal Implications are reviewed, and we conclude with recommendations and a call to action.
De l’identité dans un monde globalisé : pour une communauté ouverte
Authors: Mesure Sylvie
Published: August 2021

Nous vivons désormais dans un monde à la fois globalisé et culturellement différencié où les questions identitaires revêtent une importance singulière. C’est sur les différentes manières dont nous pouvons conceptualiser notre identité et nos communautés d’appartenance que sera mis l’accent dans cet article. Après avoir souligné les dangers d’une interprétation « communautarienne » de la communauté qui naturalise l’identité en la pensant comme une essence, ainsi que les apories d’une conception universaliste qui l’ouvre à l’ensemble de l’humanité sans tenir compte des identités concrètes et situées, nous plaiderons ici en faveur d’une appréhension « cosmopolite » de la communauté permettant de concevoir l’identité comme plurielle et ouverte à la différence.
Sleep Challenges and Interventions in Children With Visual Impairment
Authors: Ingram David G. , Cruz Jose M. , Stahl Erin D. , Carr Nicole M. , Lind Lisa J. , Keirns Carla C.
Published: August 2021

Purpose:

To examine sleep patterns in a large and heterogeneous group of children with visual impairment.

Methods:

A cross-sectional survey of parents of children with visual impairment was offered via the National Federation of the Blind and the National Organization for Albinism and Hypopigmentation.

Results:

Complete survey results were available for 72 participants, aged 1 to 16 years. Parents of 52 (72%) children reported that their child had cycles of good sleep and bad sleep, and 50 (69%) reported that their child's sleep patterns caused significant stress for them or their family. Scores on the Childhood Sleep Habits Questionnaire (CSHQ) increased (> 41) in 64 (89%) children, indicating a likely clinically significant sleep problem. When compared to normative data from children aged 4 to 10 years, children in the current sample scored higher (more sleep problems) on all eight subscales on the CSHQ. The presence of comorbid developmental delay was most strongly associated with sleep problems. Supplemental melatonin and improving daytime and nighttime schedules or routines were reported as the most helpful for sleep. Many families reported a need for further information regarding melatonin use as a supplement.

Conclusions:

A high proportion of children with visual impairment experience clinically meaningful sleep problems, regardless of degree of light perception or visual acuity. There is a strong need for increased awareness and screening for sleep problems in this population. Potential treatment modalities, including supplemental melatonin, should be discussed with families.

[
J Pediatr Ophthalmol & Strabismus
. 2022;59(2):77–86.]
New Hermite-Hadamard inequalities in fuzzy-interval fractional calculus via exponentially convex fuzzy interval-valued function
Authors: Yang Yanping ,   Yellow River Conservancy Technical Institute, KaiFeng 475004, China, Saleem Muhammad Shoaib , Nazeer Waqas , Shah Ahsan Fareed ,   Department of Mathematics, University of Okara, Okara, Pakistan,   Department of Mathematics, GC University, Lahore Pakistan
Published: August 2021

In the present note, we develop Hermite-Hadamard type inequality and He's inequality for exponential type convex fuzzy interval-valued functions via fuzzy Riemann-Liouville fractional integral and fuzzy He's fractional integral. Moreover, we establish Hermite-Fejér inequality via fuzzy Riemann-Liouville fractional integral.
Recent developments and future perspectives in aging and macrophage immunometabolism
Authors: Pence Brandt D. ,   College of Health Sciences, University of Memphis, Memphis, TN, USA,   Center for Nutraceutical and Dietary Supplement Research, University of Memphis, Memphis, TN, USA
Published: August 2021

Aging is the strongest contributor to the development and severity of many chronic and infectious diseases, primarily through age-related increases in low-grade inflammation (inflammaging) and decreases in immune function (immunosenescence). Metabolic reprogramming in immune cells is a significant contributor to functional and phenotypic changes in these cells, but little is known about the direct effect of aging on immunometabolism. This review highlights several recent advances in this field, focusing on mitochondrial dysfunction, NAD+ metabolism, and therapeutic reprogramming in aged monocytes and macrophages. Perspectives on opportunities for future research in this area are also provided. Targeting immunometabolism is a promising strategy for designing therapeutics for a wide variety of age-related diseases.
Ethos
Authors: Rodolfi Valentina
Published: August 2021

Non disponibile.
‘Progetto Sum’: per la presenza sociale e la cura con il soggetto
Authors: Buffagni Federico , Durante Francesca , Mistrali Maurizio , Polito Laura , Santi Sara , Vanni Fabio , Zorzi Giovanni
Published: August 2021

Non disponibile.
Rapid survey to determine the predictive factors of vaccination coverage in children aged 0 to 59 months in Guinea
Authors: Touré Abdoulaye , Camara Ibrahima , Camara Alioune , Sylla Mariama , Sow Mamadou S. , Keita Alpha K.
Published: August 2021

Background: The Expanded Program on Immunisation has made it possible to prevent more than 3 million deaths in children under 5 years. The objectives of this study were to estimate the vaccination coverage of children from 0 to 59 months and identify factors associated with incomplete vaccination coverage.Methods: A cross-sectional study was carried out in a dispensary in Conakry, Guinea between January and February 2020. Sociodemographic and vaccination information was collected from mothers of 380 randomly select children aged 0 to 59 months. Information on immunisation coverage was gathered from records vaccination cards and maternal reports. Logistic regression was used to identify factors independently associated with incomplete immunisation coverage.Results: Most (66.5%) children aged 12 months were up-to-date with their vaccinations. Factors associated with incomplete vaccination in this age group included: unavailability of vaccination cards (adjusted odds ratio [aOR] 7.58; 95% confidence interval [CI]: 2.56–22.44) and lack of prenatal consultation attendance (aOR 2.93; 95% CI: 1.15–7.48). In contrast only 19.8% (95% CI: 13.9–26.7) of children aged 12–59 months were fully immunised. Factors associated with incomplete vaccination coverage in children aged 12–59 months included high birth order (aOR 10.23; 95% CI: 2.06–19.43), and lack of prenatal consultation attendance (aOR 5.34; 95% CI: 1.48–19.23).Conclusion: Child immunisation coverage is low in Guinea. These results highlight the need to develop strategies based on an integrated approach to overcome obstacles to childhood immunisation in Guinea.
Outcomes of Venus P-valve for dysfunctional right ventricular outflow tracts from Indian Venus P-valve database
Authors: Sivakumar Kothandam , Sagar Pramod , Qureshi Shakeel , Promphan Worakan , Sasidharan Bijulal , Awasthy Neeraj , Kappanayil Mahesh , Suresh Pujar Venkatesh , Koneti Nageswara Rao
Published: August 2021

Background :

Balloon-expandable pulmonary valves are usually not suitable for dilated native outflow tracts.

Methods :

Indian Venus P-valve registry was retrospectively analyzed for efficacy, complications, and midterm outcomes. Straight valve was used in prestented conduits in patients with right ventricular pressure above two-thirds systemic pressure and/or right ventricular dysfunction. Flared valve 1–4 mm larger than balloon waist was used in native outflow in symptomatic patients, large ventricular volumes, and ventricular dysfunction.

Objectives :

A self-expanding porcine pericardial Venus P-valve is available in straight and flared designs..

Results :

Twenty-nine patients were included. Straight valve was successful in all seven conduits, reducing gradients significantly, including one patient with left pulmonary artery (LPA) stent. Flared valve was successfully implanted in 20 out of 22 native outflow tracts. Sharp edges of the older design contributed to two failures. Complications included two migrations with one needing surgery, endocarditis in one, insignificant wire-frame fractures in three, and groin vascular complication in one patient. There were no deaths or valve-related reinterventions at a mean follow-up of 47.8 ± 24.5 months (1–85 months). Modifications of technique succeeded in three patients with narrow LPA. There was significant improvement in symptoms, right ventricular volume, and pulmonary regurgitant fraction.

Conclusion :

Straight and flared Venus P-valves are safe and effective in appropriate outflow tracts. Straight valve is an alternative to balloon-expandable valves in stenosed conduits. Flared valve is suitable for large outflows up to 34 mm, including patients with LPA stenosis. Recent design modifications may correct previous technical failures. Studies should focus on durability and late complications.
Vertebral artery dissection and associated ruptured intracranial pseudoaneurysm successfully treated with coil assisted flow diversion
Authors: Scullen Tyler , Mathkour Mansour , Werner Cassidy , Zeoli Tyler , Amenta Peter S.
Published: August 2021

Dissecting intracranial pseudoaneurysms (IPs) are associated with a high incidence of rupture and poor neurologic outcomes. Lesions in the posterior circulation are particularly malignant and pose even greater management challenges. Traditional management consists of microsurgical vessel sacrifice with or without bypass. Flow diversion (FD) in the setting of subarachnoid hemorrhage (SAH) represents a reconstructive treatment option and can be paired with coil embolization to promote more rapid thrombosis of the lesion. We report a case of a ruptured dissecting vertebral artery (VA) IP successfully acutely treated with coil-assisted FD. A 53-year-old male presented with a right V4 dissection spanning the origin of the posterior inferior cerebellar artery and associated ruptured V4 IP. The patient was treated with coil-assisted FD. Oral dual-antiplatelet therapy (DAPT) was initiated during the procedure, and intravenous tirofiban was used as a bridging agent. Immediate obliteration of the IP was achieved, with near-complete resolution of the dissection within 48 h. The patient made a complete recovery, and angiography at 6 weeks confirmed total IP obliteration, reconstruction of the VA, and a patent stent. The use of FD and DAPT in the setting of acute SAH remains controversial. We believe that coil-assisted FD in carefully selected patients offers significant advantages over traditional microsurgical and endovascular options. The risks posed by DAPT and potential for delayed thrombosis with FD can be effectively mitigated with planning and the development of protocols. We discuss the current literature in the context of our case and review the challenges associated with treating these often devastating lesions.
Micro-catheter assisted coiling (MAC)
Authors: Muralidharan Vetrivel , Travali Mario , Cavallaro Tiziana Liliana , Tomarchio Letizia , Corsale Gabriele , Cosentino Federica , Politi Marco Angelo , Cristaudo Concetto
Published: August 2021

Background:

Aneurysms with neck diameter >4 mm or dome to neck ratio <2 are wide-neck aneurysms. Balloons and stents are used to assist in coiling the wide-neck aneurysms, but these are associated with increased intra-procedure and peri-procedure risk in ruptured aneurysms. Microcatheter-assisted coiling (MAC) is an alternative salvage technique in these situations which is under reported.

Materials and Methods:

We describe our experience in a cohort of 16 patients with ruptured wide neck aneurysm treated with MAC technique. Our primary objective of intervention in acute setting was to secure the aneurysm to prevent rebleed.

Results:

Anterior communicating artery aneurysm was the most common (56.3%) followed by middle cerebral artery bifurcation aneurysm (18.8%), paraclinoid aneurysm (12.5%), posterior communicating artery aneurysm (6.3%) and basilar tip aneurysm (6.3%). Mean greatest dimension of dome and neck were 8.9 mm and 4.6 mm, respectively. Mean neck to dome ratio was 1.8. Fisher grade 3 and grade 4 subarachnoid haemorrhage (SAH) were observed in 56.3% and 43.7% patients, respectively. Immediate post-procedure digital subtraction angiography (DSA) showed Raymond Roy grade 1, grade 2 and grade 3 embolisation in 62.5%, 33.3% and 6.7% patients, respectively. No distal embolus, vessel occlusion, vessel perforation or aneurysm rupture was observed. Immediate post-procedure DSA showed good distal flow in all patients. Infarct was observed at 24 and 48 hours respectively, in two patients with Fisher Grade 3 SAH.

Conclusion:

Ruptured wide neck aneurysms can be embolised with complete preservation of branching vessel and distal flow. Total occlusion can be achieved in 2/3rd of patients.
Differences in Pain Characteristics and Functional Associations between Nursing Home Residents and Community-Dwelling Older Adults: A Cross-Sectional Study
Authors: Tansuğ Melis , Kahraman Turhan , Genç Arzu
Published: August 2021

Background: Pain is one of the most critical issues in older adults, and the place of residence may play an important role in pain characteristics and related factors. However, it is an understudied subject. This study investigated differences in pain characteristics and functional associations between nursing home residents and community-dwelling older adults.Methods: Older adult participants were recruited from nursing homes (n=73) and the community (n=73). Pain characteristics, including type, intensity, and number of pain sites, were evaluated. Other outcome measures were functional mobility, walking speed, functional independence, physical activity, anxiety, depression, and health-related quality of life.Results: Nursing home residents experienced musculoskeletal pain more frequently and had a greater number of pain sites than community-dwelling older adults (p<0.05). Walking speed and mobility were significantly lower and anxiety and depression were significantly higher in nursing home residents (p<0.05). While higher pain intensity was significantly correlated with low scores on physical measures, low health-related quality of life, and higher depression and anxiety symptoms in both groups (p<0.05), the magnitudes of the correlations were much higher in nursing home residents. The number of pain sites was significantly correlated with low scores on physical measures, low health-related quality of life, and higher depression and anxiety symptoms mainly in nursing home residents (p<0.05).Conclusion: Compared to community-dwelling older adults, nursing home residents experienced musculoskeletal pain more frequently and at more sites in the body. Higher pain intensity and number of pain sites were associated with worse clinical variables, mainly in nursing home residents. This study highlights the importance of regular pain assessment, especially in nursing home care settings.
Perception and Determinants of Uptake of Preventive Health Services among the Staff of Obafemi Awolowo University, Ile-Ife, Osun State
Authors: Akinyemi P.A. , Afolabi O.T. , Adeomi A.A. , Olugbade O.T.
Published: August 2021

Background: The rising burden of chronic non-communicable diseases in Nigeria makes the need for preventive health services (PHS) imperative. Thus, this study assessed the perception and determinants of uptake of preventive health services among the staff of Obafemi Awolowo University, Ile-Ife, Osun State.Methods: A cross-sectional analytical study was employed. Two hundred and ninety academic and non-academic staff of the university were enrolled in the study, using a stratified random sampling technique. The sample size was proportionally allocated to various subunits in the institution. Data were collected using a self-administered questionnaire. Determinants of uptake of PHS were assessed using binary logistic regression. A p-value of < 0.05 was considered to be statistically significant.Results: The majority of the respondents, 280 (96.6%) had good perceptions of PHS, and 176 (60.7%) reported barriers in access to PHS. Although a majority of the respondents, 268 (92.4%) had positive attitudes towards PHS, most of the respondents 196 (67.6%) had poor uptake. Common barriers to uptake of PHS were availability and affordability of the services, time constraints, and interference with other activities. Being an academic staff (p = 0.001) and presence of chronic illness (p = 0.043) were significant determinants of PHS uptake.Conclusion: Uptake of PHS was poor among majority of the respondents despite their good perception of the services. This may be linked to the perceived barriers to access. Thus, there is a need for policy formulation and provision of an enabling environment by the University’s authority for ease of access to PHS.
Inclusion of rapeseed and pumpkin seed cakes in diets for Murciano-Granadina goats alters the fatty acid profile of milk
Authors: Boldea I.M. , Dragomir C. , Gras M.A. , Ropotă M.
Published: August 2021

The objective of this research was to assess the effects of including oil-rich feedstuffs in diets for lactating goats on the fatty acid (FA) profile of their milk. Thirty-six Murciano-Granadina goats were randomly assigned to three treatment groups, namely a control diet (CTRL), a diet based on whole rapeseed (RS), and a diet based on pumpkin seed cake (PSC). The diets were composed of 1 kg hay (70 % Italian ryegrass, 30% alfalfa) and 1.24 kg concentrate, and were formulated to be isoenergetic and isonitrogenous. Milk yield and its contents of protein, fat and lactose did not differ significantly among the groups. However, including oil-rich feeds in the diet altered the fatty acid profile of the milk significantly, decreasing its saturated fatty acid (SFA) content and increasing its content of unsaturated fatty acids (UFAs). Effects on polyunsaturated fatty acids (PUFAs), conjugated linoleic acid (CLA), and the n-6 to n-3 ratio depended on the source of dietary lipids. The PSC augmented diet increased the relative amount of PUFAs and fatty acid methyl esters (FAME) in milk (+25 %) significantly In comparison with CTRL, whereas the RS diet produced a limited and statistically insignificant increase (+7.5%). The concentration of CLA was higher in milk from does fed the PSC diet, whereas the n-6 to n-3 ratio was lower in milk from does fed RS. These preliminary results form the basis for developing premium dairy products that are enriched in fatty acids that are more favourable for human health.