bluuebunny/crossref_metadata_2025 huggingface dataset:
LA PAURA. RIFLESSIONI INTERDISCIPLINARI PER UN DIBATTITO CONTEMPORANEO SU VIOLENZA, ORDINE, SICUREZZA
Authors: Storti Claudia , Colao Floriana
Published: July 2021

The book Riflessioni interdisciplinari per un dibattito contemporaneo su violenza, ordine, sicurezza offers an interesting interdisciplinary perspective on aspects of the social life that undoubtedly show continuity between past and present and that exert a strong influence on criminal systems. If fear, as an instinct, constitutes a natural defense tool for the individual, ‘collective’ fear is a phenomenon open to different declinations, not all positive, as we will see, for example, in the current hypertrophy of the criminal law. Sometimes collective fear is triggered by objective causes (e.g. by natural catastrophes, epidemics, famines, wars or revolutions); sometimes, instead, collective fear is generated by the so called ‘culture of fear’. Such culture instills and amplifies a sense of insecurity towards true or presumed enemies by using propaganda, rhetoric or violence (just think at the ‘function’ of terrorism). This insecurity, in turn, drives people to search safety and strengthens the power of those who offer protection even with the tools of the criminal law.
Common anti-oxidant vitamin C as an anti-infective agent with remedial role on SARS-CoV-2 infection. An update
Authors: Michailides Christos , Velissaris Dimitrios
Published: July 2021

Coronavirus disease -2019 (COVID-19) has led to a worldwide multifaceted crisis. The medical world agonizes to contend with the problem, but a string of tested medications has been proven unavailing. Vitamin C is well described as a salutary antioxidant and some trials conclude that it may be a potential antiviral drug. In high doses, Vitamin C can alternate crucial steps in the pathogenesis of sepsis and acute respiratory distress syndrome. This dynamic was the driving force behind trials around the world that tried immunonutrition as a weapon against clinical entities. We summarize the mechanisms of action of Vitamin C and its role against infections and the current literature referring to the potential role of Vitamin C in SARS-CoV-2 infection, also as a contingent treatment agent.
Automation of boring machines: chapter 10 - Short Course on Hardrock Boring
Authors: Tervo R
Published: July 2021

During the past twenty years, raise borer manufacturers have continually improved their machines, and users have made advances in their operating techniques. An articulated rod handler relieves the operator of a heavy and onerous task in adding or removing drill
rods. Machine condition monitors can keep a check on oil temperatures and levels, and shut the machine down if limits are exceeded. Reliable economical, carefully programmed controllers (PLC's) or small computers may be used to aid the operators to reduce maintenance costs, and to increase machine
life and availability.
A computer controlled raise borer was successfully used in 1983, with significant improvements in performance. Further progress may be made by applying the techniques of expert systems which will provide the correct response to changing machine conditions, or to variable ground, as effectively as a
highly skilled operator, but perhaps more quickly.
Explanation of trial sequential analysis: using a post-hoc analysis of meta-analyses published in Korean Journal of Anesthesiology
Authors: De Cassai Alessandro , Tassone Martina , Geraldini Federico , Sergi Massimo , Sella Nicolò , Boscolo Annalisa , Munari Marina
Published: July 2021

Background: Trial sequential analysis (TSA) is a recent cumulative meta-analysis method used to weigh type I and II errors and to estimate when the effect is large enough to be unaffected by further studies. The aim of this study was to illustrate possible TSA scenarios and their significance using meta-analyses published in the Korean Journal of Anesthesiology as working material.Methods: We performed a systematic medical literature search for meta-analyses published in the Korean Journal of Anesthesiology. TSA was performed on each main outcome, estimating the required sample size on the calculated effect size for the intervention, considering a type I error of 5% and a power of 90% or 99%.Results: Six meta-analyses with a total of ten main outcomes were included in the analysis. Seven TSAs confirmed the results of the meta-analyses. However, only three of them reached the required sample size. In the two TSAs, the cumulative z-lines were not statistically significant. One TSA boundary for effect was reached with the 90% analysis, but not with the 99% analysis.Conclusions: In TSA, a meta-analysis pooled effect may be established to assess if the cumulative sample size is large enough. TSA can be used to add strength to the conclusions of meta-analyses; however, pre-registration of the TSA protocol is of paramount importance. This study could be useful to better understand the use of TSA as an additional statistical tool to improve meta-analysis quality.
A simple appendicitis? An anatomical pitfall
Authors: Wajman Slawomir , Gewartowska Magdalena , Antoniak Robert , Stanczyk Marek
Published: July 2021

Rationale:

We present a case of appendicitis with an uncommon course due to rare anatomical location of the appendix in the right retroperitoneal space below the diaphragm and above the liver.

Patient's concern:

A 32-year-old, previously healthy male with a history of congenital diaphragmatic hernia repair in childhood, presented with 3 days of mild, colicky, central abdominal pain associated with fever, nausea and vomiting. At presentation, pain was localized to the right lower quadrant.

Diagnosis:

Even though diagnosis of appendicitis was clear, we decided to confirm it with computer tomography (CT). CT revealed elevation of the right dome of the diaphragm and perforated appendix located above the liver.

Intervention:

Appendectomy was performed via right subcostal approach instead of usual incision in the right lower quadrant.

Outcome:

Patient recovered well and was discharged on the 5th day after operation.

Lessons:

Previous congenital diaphragmatic hermia repair may change the location of the appendix. The appendix at rare locations could lead to an uncommon course of appendicitis. On this very note, surgeons should have a high index of suspicion, and CT may help avoid inadvertent complications.
Artificial intelligence for COVID-19 and future pandemics
Authors: Debroy Abhrajit , George Nancy
Published: July 2021

The pandemic of severe acute respiratory syndrome coronavirus 2 has spread very quickly all over the world and has become an unparalleled public health crisis. This unforeseen and exceptional situation has instigated a wave of research to investigate the virus, track its spread, and study the disease it causes. Current methods of diagnosis and monitoring largely rely on polymerase chain reactions and enzyme-linked immunesorbent assay methods. In this hour of crisis, researchers are looking for new technologies to monitor and control such disease outbreaks. Artificial intelligence (AI) is one such technology. Being an evidence-based tool, this technology has the potential to upgrade our disease management strategies and help us to restrict the spread of such diseases. AI can play an effective role in tracking the spread of diseases, screening of the population, identifying patients and developing treatments of diseases. Through this review, we aim to analyze the role of AI in the diagnosis, monitoring and treatment of diseases like coronavirus disease 2019, with most recent updates and assess the prospects of this technology in the management of such diseases.
Dynamics of transmission of COVID-19 cases and household contacts
Authors: Rajmohan Priyanka , Jose Ponnu , Thodi Jubina Bency Anthoora , Thomas Joe , Raphael Lucy , Krishna Swathi , Gopinathan Unnikrishnan Uttumadathil , Kuttichira Praveenlal
Published: July 2021

Objective:

To study the transmission dynamics of coronavirus disease 2019 (COVID-19) among 101 confirmed cases and their 387 household contacts and to determine risk factors associated with secondary attack among the household contacts.

Methods:

A prospective cohort study was conducted from January 1st 2021 to February 28th 2021, among 101 SARS-CoV-2 cases and 387 household contacts who were followed up for 14 days from the last day of contact with the index case of COVID-19. The dynamics of disease transmission was estimated, and factors affecting transmission risk were analyzed. Besides, the association between various factors and household secondary attack rate was determined.

Results:

The median incubation period was found to be 5 days, and the observed reproductive number (R) was found to be 1.63 (95% CI: 1.28-1.98). The mean household secondary attack rate was 40.7%. Contacts with comorbidities like diabetes mellitus, hypertension, dyslipidemia, and hypothyroidism had significantly higher attack rates (P<0.05).

Conclusions:

As new variants of SARS-CoV-2 emerges, it is crucial to know the trasmission dynamics. This study shows a high secondary attack rate of COVID-19 among household contacts that must be closely monitored.
The recommended amount of physical activity, sedentary behavior, and sleep duration for healthy Saudis
Authors: Alfawaz Rasha A. , Aljuraiban Ghadeer S. , AlMarzooqi Mezna A. , Alghannam Abdullah F. , BaHammam Ahmed S. , Dobia Ali M. , Alothman Shaima A. , Aljuhani Osama , Aljaloud Khalid Saad
Published: July 2021

BACKGROUND:

The goal of the 24-h Movement Practice Guidelines for Saudi Arabia is to provide policymakers, health-care providers, researchers, sports professionals, and members of the public with recommendations on the duration of time they should spend engaged in physical activity, sedentary behavior, and sleep throughout all age groups.

METHODS:

A modified RAND appropriateness method and the “GRADE-ADOLOPMENT” approach of guideline recommendations were used by a guideline development panel to develop the present recommendations.

RESULTS:

The recommendations were based on the integrated needs of the following age groups: children (0–2 years), preschoolers (3–5 years), children and adolescents (6–17 years), adults (18–64 years), and older adults (≥65 years). The guidelines also include special considerations for sleep duration in the Saudi culture, such as dawn prayer and Ramadan.

CONCLUSIONS:

Several research gaps in physical activity, sedentary behavior, and sleep were identified and highlighted by the guideline development panel for potential future research.
Point-of-care diagnostic lung ultrasound is highly applicable to the practice of medicine in Saudi Arabia but the current skills gap limits its use
Authors: Rajendram Rajkumar , Souleymane Mamdouh , Mahmood Naveed , Kharal Mubashar , AlQahtani Mohammad
Published: July 2021

CONTEXT:

Coronavirus disease 2019 (COVID-19) has put a spotlight on point-of-care diagnostic lung ultrasound (POCDLUS). However, the spectra of respiratory disease and resources available for investigation vary internationally. The applicability of POCDLUS to internal medicine (IM) practice in Saudi Arabia and the current use by Saudi physicians are unknown.

AIMS:

The aim of the present study was to determine the applicability of POCDLUS to IM practice in Saudi Arabia and quantify the residents' current skills, accreditation, and use of POCDLUS.

METHODS:

A questionnaire was distributed to the IM residents at our institution to assess their knowledge, use of POCDLUS, and their perceptions of its applicability in IM.

STATISTICAL ANALYSIS:

Standard descriptive statistical techniques were used. Categorical data, presented as frequency, were compared using the Chi-squared test. The Likert scale responses, presented as mean ± standard deviation, were compared with a Student's t-test.

RESULTS:

In total, 100 residents participated (response rate 92.6%) and reported that POCDLUS was applicable to their practice. Identifying pleural effusions was most applicable. A small proportion (n = 7) had received training, nine used POCDLUS regularly, none were accredited and the overall self-reported level of knowledge was poor.

CONCLUSIONS:

Whilst POCDLUS is applicable to IM practice in Saudi Arabia, the significant skills gap preclude the provision of a POCDLUS service. As COVID-19 can cause an interstitial syndrome, our pandemic preparation response should include POCDLUS training. The current study is supported by a similar Canadian study and the international standardisation of POCDLUS training may be feasible. The findings of the current study may facilitate the development of POCDLUS training programs for internists throughout Saudi Arabia.
The efficacy of airway pressure release ventilation in acute respiratory distress syndrome adult patients
Authors: Othman Fatmah , Alsagami Noura , Alharbi Reem , Almuammer Yara , Alshahrani Shatha , Ismaeil Taha
Published: July 2021

BACKGROUND:

To recruit poorly ventilated lung areas by providing active and adequate oxygenation is a core aspect of treating patients with acute respiratory distress syndrome (ARDS). The airway pressure release ventilation (APRV) mode is increasingly accepted as a means of supporting patients with ARDS. This study aimed to determine whether the APRV mode is effective in improving oxygenation, compared to conventional ventilation, in adult ARDS patients.

METHODS:

We conducted the study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched for clinical trials in PubMed, Embase, Web of Science, and the Cochrane Library until April 2019. We included all studies comparing APRV and other conventional mechanical ventilation modes for adult ARDS patients. Our primary outcome was oxygenation status (defined as the day 3 PaO2/FiO2 ratio). The secondary outcomes were the length of stay (LOS) in the intensive care unit (ICU) and mortality. Sensitivity analyses were performed including studies with conventional low-tidal volume ventilation as a comparator ventilation strategy.

RESULTS:

We included six clinical trials enrolling a total of 375 patients. The day 3 PaO2/FiO2 was reported in all the studies, and it was significantly higher in patients receiving APRV (mean difference [MD] 51.9 mmHg, 95% confidence intervals (CI) 8.2–95.5, P = 0.02, I
2= 92%). There was no significant difference in mortality between APRV and the other conventional ventilator modes (risk difference 0.07, 95% CI: −0.01–0.15, P = 0.08, I
20%). The point estimate for the effect of APRV on the LOS in ICU indicated a significant reduction in the ICU LOS for the APRV group compared to the counter group (MD 3.1 days, 95% CI 0.4–5.9, P = 0.02, I
2= 53%).

CONCLUSION:

In this study, using the APRV mode may improve oxygenation on day 3 and contribute to reducing the LOS in ICU. However, it is difficult to draw a clinical message about APRV, and well-designed clinical trials are required to investigate this issue.
Small-airway disease and its reversibility in human immunodeficiency virus-infected children on highly active antiretroviral therapy
Authors: Ayuk Adaeze C. , Ndukwu Chizalu I. , Uwaezuoke Samuel N.
Published: July 2021

BACKGROUND:

Lung function abnormalities may occur in children with human immunodeficiency virus (HIV) infection. Small-airway disease (SAD) precedes abnormalities in forced expiratory volume in 1 s (FEV 1).

OBJECTIVE:

This study aims to assess the presence and reversibility of SAD in HIV-infected children using the Global Lung Function Initiative standards.

METHODS:

A cross-sectional study was conducted over 6 months at the Paediatric HIV Clinic of the University of Nigeria Teaching Hospital in Enugu, Southeast Nigeria. Eligible consenting children with HIV infection were recruited. Lung function was measured, and the reversibility of FEV1 and forced vital capacity (FVC) was assessed at 12% while that of forced expiratory flow between 25% and 75% (FEF25-75) was assessed at 12%, 15%, and 20%. Predictors of abnormal Z-score values were determined by multivariate linear and logistic regressions. Statistically significant values were set at P < 0.05.

RESULTS:

The mean Z-score for FEV1, FVC, and FEF25-75 was − 2.19, −1.86, and − 1.60, respectively. Most patients (73%) had abnormal FEV1, while 52% had abnormal FEF25-75. Significant changes in FEV1 (P = 0.001) and FEF25-75 (P < 0.001) occurred after the bronchodilator response (BDR) test. Of the children whose FEV1 showed positive BDR, 70.9% had low zFEV1; 50% had low zFEF25-75, while all had low FEV1. Nutritional status (Z-score for body mass index) was significantly associated with low FEV1.

CONCLUSIONS:

Abnormal FEF25-75 as a marker of SAD and FEV1 with a positive BDR are common in HIV-infected children. These lung function abnormalities justify long-term follow-up for these patients.
Clinical profiles associated with SARS-CoV-2 infection and complications from coronavirus disease-2019 in children from a national registry in Saudi Arabia
Authors: Almuzaini Yasir , Alsohime Fahad , Subaie Sarah Al , Temsah Mohamad Hani , Alsofayan Yousef , Alamri Fahad , Alahmari Ahmed , Alahdal Hadil , Sonbol Hana , Almaghrabi Rana , Nahhas Mahmoud , Khan Anas
Published: July 2021

CONTEXT:

Exploring clinical characteristics of coronavirus disease-19 (COVID-19) in children may help in prevention and treatment guidelines.

AIMS:

The aim of the to describe the spectrum of pediatric COVID-19 in Saudi Arabia.

SETTINGS And DESIGN:

A multicenter, retrospective, cross-sectional study involving pediatric COVID-19 patients across all Saudi regions.

METHODS:

All patients aged between 2 months and 18 years with a confirmed diagnosis of COVID-19 were included. The primary end point was the hospitalization.

STATISTICAL ANALYSIS USED:

Descriptive statistics were used to describe the baseline demographic data and clinical characteristics. Numerical data were explored using Kolmogorov–Smirnov test and Shapiro–Wilk test, while Chi-square or Fisher's exact test were used for categorical data.

RESULTS:

Among the 654 pediatric COVID-19 patients, 4.7% (n = 31) were hospitalized, with one patient only needing pediatric intensive care admission. Sex, breastfeeding, birth status, and the patients' living environment showed no significant association with hospitalization. Most children (80.3%, n = 525) were symptomatic, with two symptoms that were significantly associated with admission, namely, vomiting (P = 0.007) and nausea (P = 0.026). History of admission within the last year was identified in 10.4% (n = 68) children but had no association with worse outcome. The median duration of hospitalization for the entire group was 5.5 days, with longest hospital stay for age group 7–12 years (median 6 days).

CONCLUSIONS:

COVID-19 is usually a milder disease in children. Although having preexisting medical conditions was linked to a longer hospitalization, it was not associated with worse outcome. Continuous surveillance will allow additional characterization of the burden and outcomes of pediatric COVID-19-associated hospitalizations.
Fatal rapidly progressive interstitial lung disease in a patient with amyopathic dermatomyositis
Authors: Mobeireek Abdullah , Conca Walter , Mohammed Shamayel , AlObaid Fahad , AlHajji Mohammed
Published: July 2021

Interstitial lung disease (ILD) is a well-established common manifestation of idiopathic inflammatory myopathies. Yet, till now, the pathogenetic mechanisms are still poorly understood, classification is evolving and prognosis is variable. A refractory and rapidly progressive ILD (RPILD) that is associated with dermatomyositis (DM) with minimal muscle weakness and normal creatine kinase (termed clinically amyopathic DM) is increasingly being recognized, with more incidence in Asians. However, we are not aware of reports of the Arab region. Herein, we present a 38-year-old male with this condition that ended with a fatal outcome despite aggressive therapy, with a review of recent literature.
Prevalence of Undernutrition among Preschool Children (3-6 Years) Attending Anganwadi Centers in Urban Mysuru
Authors: George Preetha Susan , Murthy M. R. Narayana
Published: July 2021

Introduction:

For balanced growth and childhood development, adequate nutrition is very necessary. The health and nutritional status of children is an indicator of the health and nutrition of the community and the nutritional profile of the entire country. Undernutrition is not only a significant cause of childhood morbidity and mortality, but it jeopardizes physical as well as mental development of children. The Public Distribution Scheme's bias toward calories and subsidies continued on rice and wheat and did not include more diverse and nutritious foods.

Aims and Objectives:

This study aims to determine the prevalence of undernutrition among preschool children (3–6 years) attending Anganwadi in Urban Mysuru.

Materials and Methods:

This community-based cross-sectional study was carried out in the field practice area of Bannimantap Urban Primary Health Centre for a period of 1 year. A total of 365 children (3–6 years) were included in the study. Required total sample size of 365 children in the age group of 3–6 years was selected from each Anganwadi as per population proportionate to size sampling technique. A pretested, semi-structured proforma was used to collect data pertaining to sociodemographic variables, maternal-related variables, and child-related variables. Data were coded and entered into MS Excel 2016 and analyzed using SPSS Version 22.

Results:

Among the total 365 children aged 3–6 years, 54.7% were males and 45.3% were females. Majority (60.8%) of the children hailed from nuclear family and 50% belonged to upper lower socioeconomic class. The prevalence of undernutrition which constitutes underweight, stunting, and wasting was 25.4%, 23.5%, and 10.2%, respectively. Prevalence of severe acute malnutrition was 0.3%.

Conclusion:

Lack of socioeconomic development along with ignorance of cost-effective nutritional diet intake contributed to undernutrition in our study area.
Acute Kidney Injury in Intensive Care Unit
Authors: Singh Narinder Pal , Kathuria Danish , Aggarwal Neeru P. , Gupta Anish Kumar , Kaur Gurleen
Published: July 2021

Background:

Acute kidney injury (AKI) has both short term as well as long-term consequences in critically ill patients. The present study is an attempt to study its etiological profile in intensive care units (ICUs) which has been only scarcely done in India.

Methods:

One hundred and twenty patients admitted with or developing AKI during their ICU stay were included in the prospective study and were defined as well as staged according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Patients were followed up at discharge and at 3 months to determine the outcome as either favorable (renal recovery) or adverse (residual renal dysfunction, dialysis dependence, or death). Various known risk factors, as laid down by KDIGO, were identified and analyzed with respect to their association with the outcome.

Results:

Out of total of 120 subjects, almost half of the subjects (47.5%) had Stage I AKI, 27.5% had Stage II AKI and the remaining quarter of subjects had Stage III AKI. One fourth had pre-existing chronic kidney disease and three-fourth subjects had developed de novo AKI of which more than half of patients had community-acquired AKI. Anemia and sepsis were the most prevalent risk factors. The highest rate of renal recovery was demonstrated in Stage I AKI. Overall mortality was 28%, highest in Stage III AKI.

Conclusion:

The study demonstrated increasing prevalence of the adverse outcome in a linear fashion with an increase in the severity of AKI. Sepsis was not only the most prevalent risk factor but was also strongly associated with an adverse outcome. The epidemiology of AKI in critical care in India has started to resemble high-income group countries, in terms of both age distribution as well as etiology.
Perceptions and Beliefs on Vaccination for COVID-19 in Delhi
Authors: Sharma Abha , Srivastava Anshuman
Published: July 2021

Introduction:

It is believed that despite all the measures taken to curb the contagion, a vaccine will be the most effective tool in preventing the spread and complications of coronavirus disease-2019 (COVID-19) and achieving a state of normalcy again. Scientists from worldwide have been successful in developing the vaccine against SARS-CoV-2, but COVID-19 vaccination faces several challenges which may impact its success.

Methodology:

A cross-sectional study was done to determine the beliefs and perceptions of people on COVID-19 vaccination in Delhi in the month of March–April 2021 with the help of a questionnaire which was distributed online. It contained 22 questions and was finalized after the review through a pilot study and content validation. Statistical analysis was performed using Microsoft Excel 2007.

Results:

A total of 286 participants were analyzed, of which 55% were female. The mean age was 33.4 years. Intention of people for taking vaccination was analyzed with relation to different age groups, and positive trend was seen in people with advancing age and it was also statistically significant (P = 0.002). It was seen that people with higher education and of higher socioeconomic status were more inclined to get vaccination; however, in our study, 39.1% of the participants were concerned about the safety of the vaccine.

Conclusions:

Our study demonstrated that despite repeated assurance about the safety of vaccine, people still had doubts and misconceptions which were evident from our study. Hence, this study may help the administrators to understand the community concerns, tweaking current policies, and increasing the awareness campaign so that people gather more knowledge about vaccine benefits and community trust is built.
Depression and anxiety in parents of children and adolescents with intellectual disability
Authors: Sharma Rachit , Singh Harpreet , Murti Mangal , Chatterjee Kaushik , Rakkar Jaspreet Singh
Published: July 2021

Background:

Parents of Intellectual Disabled (ID) children and adolescents are subjected to higher caregiver burden which is associated with Depression and Anxiety. There are very few studies which have assessed these morbidities in an industrial population.

Aims and Objectives:

The aim of this study was to explore the prevalence of Depression and Anxiety and its psychosocial correlates among these parents.

Materials and Methods:

The study was a Cross-sectional observational study, conducted at the Psychiatry unit of a tertiary care multi-specialty hospital in Maharashtra. It examined 99 parents (99 fathers and 98 mothers) of 99 children and adolescents (up to 18 yrs of age) with Intellectual Disability for Depression and Anxiety. Assessment was done using Hospital Anxiety and Depression Scale (HADS).

Results:

94% of mothers and 66.7% of fathers were found to have either anxiety or depressive symptoms, or both. Among mothers, 91.8% had scores suggestive of anxiety, 66.3% for depression and 64.3% for both anxiety and depression. Among fathers 57.6% had had scores suggestive of anxiety, 35.4% for depression and 26.3% for both. The association was significant between HADS Depression sub-scores of parents and child's ID severity, diagnosis of Down's syndrome and lack of family support (P-value <0.05). In addition significant association was also found between father's anxiety and depression scores and age of father and medical co-morbidities in the child (P-value <0.05).

Conclusion:

Significantly high proportions of parents were found to have anxiety /depressive symptoms or both. These symptoms appear to be associated with severity of ID and lack of family support and were significantly more in the primary care giver (mothers).
Evaluation of burden felt by caregivers of patients with schizophrenia and bipolar disorder
Authors: Tanna Kajal Jitendrakumar
Published: July 2021

Background:

It can be a difficult task to provide care to the patients living with mental health issues, especially with chronic diseases such as schizophrenia and bipolar disorder where the patient loses touch with reality.

Aim:

The current study was aimed to assess the of burden of care that caregivers feel while giving care to the patients of schizophrenia and bipolar disorder and to compare the difference in burden between these two conditions. The study also evaluated the factors affecting the caregiver's burden.

Settings and Design:

This was a cross-sectional interview-based study conducted at the psychiatry department of a tertiary care hospital in Gujarat among caregivers of schizophrenia and bipolar disorder.

Subjects and Methods:

Each caregiver was given the Zarit-Burden Interview scale in vernacular language and asked to rate each statement from 0 to 4 where 0: never, 1: rarely, 2: sometimes, 3: quite frequently, and 4: nearly always. The final score was calculated and interpreted as: 0–21 – little or no burden, 41–60 – moderate to severe burden, and 61–88 – severe burden.

Statistical Analysis:

Data of the burden score were expressed as mean and standard deviation and compared using unpaired t-test. Pearson's correlation coefficient was used for correlation between burden score and variables such as age, years of education, and duration of illness. The analysis was done using GraphPad version 3.0 and Microsoft Excel 2016.

Results:

A total of 210 caregivers reported the interview scale completely, of which 105 caregivers belonged to schizophrenia group and 105 were related to bipolar disorder. Average of burden score was 64.89 ± 15.7 and 59.11 ± 17.8 (maximum score: 88) in schizophrenia and bipolar group, respectively, and difference between the group was statistically significant. In both the groups, it was found that, with increase in the age of patients, caregiver's burden significantly increased.

Conclusion:

Caregivers of schizophrenia and bipolar disorder patients feel a considerable burden of care with more burden felt by the caregivers of schizophrenia. The more vulnerable to burden are females, elderly, low-income groups, and patients in whom longer duration of care is required. The caregivers should receive an adequate support for maintaining their own mental health. they should be provided support for maintaining their mental health. Particularly, vulnerable are females, elderly, low-income groups, and longer duration of care. They should be provided with adequate support.
First-episode psychosis
Authors: Prakash Jyoti , Chatterjee K. , Srivastava K. , Chauhan V. S.
Published: July 2021

Study of first-episode psychosis (FEP), an episode of psychotic nature which manifests for the first time in an individual in the longitudinal continuum of his/her illness, has been study matter of research interest in recent years. A comprehensive review of the literature will help us understand the evolution and trajectory of this concept better. A literature review of available articles addressing the concept, phenomenology, evolution, identification, course, and outcome of FEP was done; the same was subsequently divided into broad topics for better clarity and analyzed. FEP constituted a clinical psychotic phenomenon with underlying significant heterogeneity in diagnosis, stability, course, and outcome. The study has attempted to view FEP both as horizontal spectrum across various diagnoses and longitudinally ranging from asymptomatic individual with unknown risk status to attenuated psychosis to multiple relapses/unremitting illness. Many risk and protective factors have been brought out with varying certainty ranging bio-psycho-social spectrum. Efforts have been made to calculate polygenic risk score based on genes involvement/sharing between various psychotic spectrum disorders; as well as biomarker panels to identify people at risk. FEP may prove to be an important concept to understand psychosis in general; without putting things into the diagnostic rubric. It may help understand multiple risk and protective factors for the course and outcome of psychotic illness and may clear the cloud to sharpen the evidence toward commonality and distinctiveness between various psychotic diagnoses in vogue for more comprehensive concept.
COVID-19 Pandemic, Challenges, and Opportunities for Neurorehabilitation in Bangladesh
Authors: Uddin Taslim , Khasru Moshiur Rahman , Islam Mohammad Tariqul , Shakoor Md Abdus , Emran Md Ali , Sakel Mohamed
Published: July 2021

COVID-19 pandemic challenged the health-care system globally. It intensified the existing burden of rehabilitation of neurological patients. That adverse impact has been more profound in developing countries. This is an exploratory narrative review conducted during May 1 to July 31, 2020 to reflect on the COVID-19 impacts and how to address the challenges of rehabilitation services in Bangladesh. Nonsystematic review methods were used, and to some-extent, the Preferred reporting items for systematic review and meta-analysis statements were followed for this review. Bangladesh is a Lower–Middle-Income Country currently facing multiple challenges with more than 16 million people with disability. The country has world's sixth highest density of population and currently further burdened with the largest refugee camp of the world. It has serious shortage of health-care workers at different levels making COVID-19 preparedness and mitigation difficult. The neurorehabilitation services faced serious challenges. There is no database or registry for stroke, spinal cord injury, or traumatic brain injury. The rehabilitation teamwork is facing daunting challenge at the height of COVID-19. Despite shortage of work force, funding, infrastructures, poor awareness, and difficult professional relationship within the rehabilitation team, neurorehabilitation services are gradually developing in Bangladesh.
Knowledge, Attitude, and Practice Regarding COVID-19 Among General Population
Authors: Poddar Aastha , Gogate Abhishek , Kumbar Anusha Sydney Francis , Francis Cordeiro Kurt Sydney , Appajigol Jayaprakash , Javali Shivalingappa B.
Published: July 2021

Context:

The war against coronavirus disease-2019 (COVID-19) continuing. Prevention is the best method to deal with the disease. The success of preventive measures is influenced by behavior of the population which in turn depends on knowledge, attitude, and practices (KAP) of the community.

Aims:

The aim is to evaluate knowledge, attitude, and practices toward COVID-19 of general population who are using internet.

Settings and Design:

Cross-sectional study in general population using Google Forms.

Methods:

The KAP questionnaire previously used in Chinese study adopted here after modifying for content and cultural appropriateness. The questionnaire included the following domains: (i) demographic information, (ii) knowledge about COVID-19, (iii) attitude toward COVID-19, and (iv) preventive practices. The questionnaire was circulated through social media to general population through Google forms.

Statistical Analysis Used:

Chi-square test for association, independent t-test for comparison of two groups, one-way ANOVA for comparison of more than two groups. The statistical significance was set at 5%.

Results:

A total of 2193 participants took part in the study. Most of our participants were well educated and were either postgraduates or graduates 1913 (87.23%). The mean knowledge score of the participants was 10.36 (standard deviation: 1.27, median: 11.00). Most of the participants avoided crowded places, washed hands repeatedly, did not shake hands with any one. Majority of the participants were not taking any prophylaxis medications.

Conclusions:

The population has very good KAP about the disease which is helpful for preventive measures. This may be the reason for better control of the disease till now.
Socializem in socialna empatija v Cankarjevem romanu Na klancu
Authors: Zupan Sosič Alojzija
Published: July 2021

Ivan Cankar je socialno empatijo – zmožnost za globlje razumevanje ljudi, predvsem njihovih razlik in (ne)enakovrednosti – v svojem drugem romanu Na klancu (1902) izrazil s pomočjo socialističnih stališč in prepričanj. Na klancu je prvi simbolistični roman na Slovenskem, v katerem je izvirna poetika, tj. mešanica realizma, naturalizma in simbolizma, izrazila socialne, politične in filozofske ideje s »silnimi sredstvi lepote«. Čeprav glavni liki, to so Francka, Tone in Lojze, le redko razmišljajo socialistično, je treba za celotno sporočilno vrednost romana upoštevati tudi ostale like, na primer pisarja in čevljarja ter nadute vrhniške meščane, predvsem pa simbole. Izvrstna struktura romana nas napelje na dve možnosti izbire za ponižane in razžaljene: prva je individualna rešitev socialnih krivic z dobrodelnostjo, druga pa sistemska sprememba krivične družbe v pravičnejšo. Prva je z marijanskim kultom matere Francke in njenim otroškim upanjem v dobrodelnost bogatih skozi celoten roman izpeljana parabolično, da se potrdi deterministična teza, kako zgolj dobrodelnost za dostojno življenje reveža ni dovolj. Ker je tovrstna individualna rešitev le rezultat sreče – ponazarjata jo simbola klanca kot univerzalnega prostora kapitalističnega izkoriščanja ljudi in tek za vozom –, je v romanu ponujena še druga možnost, ki je simbolistična socialistična vizija (delavske) prihodnosti: sistemska rešitev, torej kolektivna sprememba kapitalizma, nakazana s simbolom odrešilne rdeče iskre, razplamtene v belo svetlobo. Bolj kot natančno določanje meja med različnimi vrstami Cankarjevega socializma se mi zdi v obravnavanem romanu pomembno opozoriti na eklektičnost umetnikovega socializma, torej na prepletenost različnih vrst socializma s socialno demokracijo, drugimi gibanji in lastnimi idejami. Na to opozarjata že sama fragmentarnost Cankarjevega miselnega sistema in znano dejstvo, da je bil avtor izredno kompleksna osebnost, pri kateri je vsakršno shematično poenostavljanje nedopustno.
Koronakriza, njene etične razsežnosti in dileme
Authors: Ošlaj Borut
Published: July 2021

V prispevku bodo predstavljene nekatere etične razsežnosti trenutne pandemije na eni in izstopajoče etične dileme ter izzivi, pred katerimi stoji človeštvo, na drugi strani. Ker v primeru pandemije narava (virus) primarno spodkopava ustaljene kulturne vzorce, to od nas terja ponoven kritični premislek fenomena kulture v njegovem razmerju do narave in življenja. Zato bo posebne pozornosti deležen klasični antropološki binom narava – kultura in tisti pojmi, ki opisujejo njegov etični značaj (kriza, telo, vrednote, pravice in svoboščine, morala, etika, svoboda, posameznik, družba).
Time trends in general practitioners’ home visits for older patients: a retrospective cross-sectional study from Switzerland
Authors: Neuner-Jehle Stefan , Graber Sereina M. , Keizer Ellen , Huber Carola A. , Blozik Eva , Rosemann Thomas , Senn Oliver
Published: July 2021

WHAT IS KNOWN ON THE SUBJECT, AND WHAT THE STUDY ADDS: The number of home visits by general practitioners (GPs) has decreased in recent years, in contrast to the increasing number of frail and older patients in western countries. Current data on GP home visit numbers and rates are lacking for Switzerland. Our study provides new data on GP home visit numbers and rates, and their associations with patient characteristics.

AIM
Our study aimed at investigating the time trend of GP home visits to older patients from 2014 to 2018 in Switzerland, and associations between GP home visits and patient characteristics including healthcare utilisation and living situation.

METHODS
Retrospective cross-sectional study of insurance claims data from 2014 to 2018 among patients aged ≥65 years (Nextrapolated = 2,095,102; Nraw = 339,301). We compared patient characteristics between patients with and without GP home visits using descriptive statistics. We performed logistic regression analyses to detect associations between patient characteristics and GP home visits, including subgroups of patients aged ≥80 and patients living in a nursing home. Regression models were adjusted for age and sex.

RESULTS
The yearly GP home visit rate declined from 10.7% to 9.3% from 2014 to 2018 (p <0.0001). Among patients aged ≥80, the rate declined from 26.1% to 23.1% (p <0.0001), and among patients living in a nursing home from 68.7% to 65.8% (p <0.0001). Regression analyses revealed increased health care utilisation and a higher burden of morbidity and mortality in patients receiving GP home visits.

CONCLUSION
There is an ongoing decline of GP home visits over the past years, with a potentially negative impact on the quality of care for older and frail patients.
An Intrusion Intention Analysis Algorithm Based on Attack Graph
Authors: Zhu Zhen , Chai Guofei
Published: July 2021

The discovery of intrusion intention is one of the challenging tasks faced by network security managers. To detect intrusion detections, this paper presents a domain-device attack graph, and collects and analyzes the underlying data of the network topology. On this basis, the attack graph Map was quantified by the Bayesian theory. The minimum weight spanning tree (Min-WFS) algorithm was adopted to automatically recognize the calculation cost of key devices in the network topology, providing an important basis for network maintenance. Experimental results show that the intrusion intentions can be effectively identified with the aid of the quantified domain-device attack graph Map, and this identification method is easy to implement.
Education Quality of Best Public High Schools in South and Central Somalia
Authors: Nur Abdi Hashi , Farah Ali Abdi , Warsame Omar Mohamed
Published: July 2021

The purpose of this study was to explore what nine high school principals did to outperform other schools in the South and Central regions of Somalia. The study highlighted the high school principals’ perception of maintaining education quality concerning curriculum, instruction, and assessment. The study focused on the admission process, teaching, and learning performances of the top nine high schools in South and central Somalia. The methodology of this Qualitative study was descriptive phenomenology. The research design and approach were semi-structured open-ended interview protocol that comprised eight interview questions. Purposeful sampling was the sampling method. Nine principals participated in the study and provided the research data regarding the education quality of nine high schools in Somalia. All nine principals in this study maintained their high schools' education quality using a rigorous admission process. They utilized a government-developed official curriculum. Five principals reported that they employed specialist instructors, while six stated that their students actively participated in the learning process during class time. However, all the participants reported that smartphones hindered student learning. A slight majority of five principals (56%) stated that parental interventions were vital to schools' overall learning achievements. Somalia's public schools are far behind in utilizing effective educational technology. The technological literacy of the teachers is vital to effectively employ the accessible educational technology, which encouraged students to incorporate modern technologies in their learning activities successfully. Rigorous admission process, efficient curriculum, instruction, effective instructional materials, employing professional instructors, and active learning are all important components to maintain education quality.
Influence and Influenced Between Self-Efficacy and Principal Leadership: A Systematic Review
Authors: Puja Kesuma Tubagus Ali Rachman , Sudjarwo Sudjarwo , Pargito Pargito , Ridwan Ridwan , Tusianah Rias , Isnainy Usastiawaty C.A.S , Zainaro M. Arifki , Maydiantoro Albet , Irawan Edy
Published: July 2021

This literature review article aims to look at the variables that influence, are influenced, and mediated by the leadership practices of principals in schools. The authors reviewed 16 research articles from European countries and a small part of Asia and America. The researchers concluded that: 1) Self-efficacy can affect variables such as emotional exhaustion, job satisfaction, normative commitment, and including motivation not to resign. 2) Self-efficacy can fluctuate, influenced by experience, which at that time can also be influenced by the opinions of others. Therefore, a leader is responsible for the development and growth of job satisfaction and teacher self-efficacy. 3) Self-efficacy can be a mediator for the growth and development of other variables. The psychological atmosphere you feel at that moment also adds another variable. The self-efficacy variable can also determine the improvement and achievement of other variables. This study provides new insights into how to manage people for maximum results.
DOCÊNCIA NO ENSINO DE ZOOLOGIA: VIVÊNCIAS DE PROFESSORAS NO PIBID/BIOLOGIA
Authors: SILVA DOS SANTOS GISELLE , NAZARÉ DIAS BASTOS SANDRA
Published: July 2021

POR SER CONSIDERADA COMO ÁREA DE GRANDE RELEVÂNCIA PARA AS CIÊNCIAS DA VIDA, A ZOOLOGIA LIDA COM UMA ENORME DIVERSIDADE DE FORMAS, DE RELAÇÕES FILOGENÉTICAS E DE DEFINIÇÕES E CONCEITOS SIGNIFICATIVOS QUE CONDUZEM AO ENTENDIMENTO DA HISTÓRIA EVOLUTIVA DOS ANIMAIS. ISSO NOS ABRE UM LEQUE DE POSSIBILIDADES PARA O ENSINO DE ZOOLOGIA, UMA VEZ QUE NA EDUCAÇÃO BÁSICA OS GRUPOS DOS ANIMAIS VERTEBRADOS GANHAM DESTAQUE, POIS COMPORTAM GRANDE PARTE DOS ANIMAIS QUE COMPÕEM O DIA A DIA DOS ALUNOS. SENDO ASSIM, O OBJETIVO DESSE TRABALHO É RELATAR O DESENVOLVIMENTO DE UMA ATIVIDADE ELABORADA NO ÂMBITO DO PROGRAMA INSTITUCIONAL DE INICIAÇÃO À DOCÊNCIA (PIBID) COM O CONTEÚDO DE ZOOLOGIA POR MEIO DA MONTAGEM DE UM MURAL FOTOGRÁFICO ELABORADO A PARTIR DA ÁRVORE EVOLUTIVA (SIMPLIFICADA) DOS VERTEBRADOS. PARALELO A ISSO, DESTACAMOS TAMBÉM A ELABORAÇÃO DE UMA CARTILHA PARA SER UTILIZADA COMO MATERIAL DE APOIO PARA REVISÃO DOS CONTEÚDOS TRABALHADOS EM SALA DE AULA.
EDUCAÇÃO AMBIENTAL: ANÁLISE DO CONHECIMENTO TEÓRICO DE ESTUDANTES DO ENSINO FUNDAMENTAL.
Authors: LORRAYNNE CORREIA ARAÚJO LICA , RODRIGUES DA CONCEIÇÃO ALEXANDRE , DANIELLE ARAÚJO MOTA MARIA
Published: July 2021

A EDUCAÇÃO AMBIENTAL ESTÁ RELACIONADA A CONSTRUÇÃO DE UMA CIDADANIA RESPONSÁVEL, COM INTERAÇÕES ENTRE OS SERES HUMANOS E O MEIO AMBIENTE, ONDE SEJA POSSÍVEL O DESENVOLVIMENTO SOCIAL E ECONÔMICO SUSTENTÁVEL. É IMPORTANTE QUE SEJA TRABALHADA TRANSVERSALMENTE EM TODOS OS ANOS ESCOLARES, NO ENSINO FORMAL E NÃO FORMAL. O OBJETIVO DESSE TRABALHO FOI INVESTIGAR O CONHECIMENTO DE ESTUDANTES DOS ANOS FINAIS DO ENSINO FUNDAMENTAL EM TRÊS ESCOLAS PÚBLICAS NO MUNICÍPIO DE ARAPIRACA-ALAGOAS. PARA REALIZAÇÃO DESSA PESQUISA, FOI UTILIZADO UM QUESTIONÁRIO COM 5 PERGUNTAS DE MÚLTIPLAS ESCOLHAS, ABORDANDO TEMAS MAIS UTILIZADOS EM SALA DE AULA OU PROJETOS JÁ DESENVOLVIDOS NA ESCOLA, BEM COMO AQUELES COM MAIOR VISIBILIDADE NOS MEIOS DE COMUNICAÇÃO E REDE SOCIAIS. ASSIM OPTOU-SE POR UMA ABORDAGEM QUANTITATIVA. DIANTE DOS RESULTADOS OBTIDOS É POSSÍVEL IDENTIFICAR A REALIDADE DOS CONHECIMENTOS A RESPEITO DOS PRINCIPAIS CONCEITOS RELACIONADOS À EDUCAÇÃO AMBIENTAL.
ELABORAÇÃO DE MAPAS CONCEITUAIS PARA APRENDIZAGEM E DIVULGAÇÃO DA BIODIVERSIDADE
Authors: ARAÚJO DE ALMEIDA ELINEÍ , LIMA SANTOS ROBERTO
Published: July 2021

PARA VIABILIZAR AÇÕES DE SUPERAÇÃO NO ESTUDO DOS ANIMAIS, O TRABALHO TEVE COMO OBJETIVOS ENFATIZAR VIVÊNCIAS DE APRENDIZAGEM EFETIVADAS POR MEIO DA CONSTRUÇÃO DE PROJETO ENVOLVENDO MAPAS CONCEITUAIS, PARA EXPLORAÇÃO E DIVULGAÇÃO SOBRE A DIVERSIDADE ANIMAL. CONSIDERANDO O GRANDE POTENCIAL DOS MAPAS CONCEITUAIS NO PROCESSO DE APRENDIZAGEM E DA IMPORTÂNCIA DA SISTEMATIZAÇÃO DOS CONTEÚDOS DE ESTUDO, POR MEIO DE PROJETO, FORAM ESTABELECIDAS ETAPAS PARA CONCRETIZAR AS ATIVIDADES PRETENDIDAS. O PERCURSO FOI DESCRITO, SEGUINDO UMA ORDEM LÓGICA DE EXPOSIÇÃO DA VIVÊNCIA, TAIS COMO, DESCRIÇÃO SOBRE O TEMA DE ESTUDO, CONSTRUÇÃO DE MAPA(S) CONCEITUAL(CONCEITUAIS) INÉDITO(S) E DISCUSSÕES COMPARATIVAS EM TORNO DA BIBLIOGRAFIA PESQUISADA COM AS PROPOSIÇÕES INDICADAS. O TEXTO FINAL, MODIFICADO A PARTIR DO PROJETO CONTEXTUALIZADO, ENQUANTO RELATO DE EXPERIÊNCIA, TRAZEM CONTRIBUIÇÕES PARA APRENDIZAGEM AO POTENCIALIZAR ELEMENTOS PARA O EXERCÍCIO DA ESCRITA CIENTÍFICA DIRECIONADA À DIVULGAÇÃO SOBRE A BIODIVERSIDADE ANIMAL.