bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the reproductive health needs of men in the preconception period
Authors: Rabiei Zeinab , Shariati Mohammad , Mogharabian Naser , Tahmasebi Rahim , Ghiasi Ashraf , Motaghi Zahra
Published: February 2023

BACKGROUND:

Male reproductive health is a necessary pillar of childbearing. If a reproductive health assessment is conducted in the preconception period, the chance of a healthy pregnancy can increase. This qualitative study aimed to explore men's reproductive health needs before conception in Iran.

MATERIALS AND METHODS:

This research was a qualitative study conducted in Bushehr city, Iran to explore men's reproductive health needs from April 2021 to November 2021. 30 semistructured interviews were conducted with married men, women, healthcare providers, and specialists individually in the health centers. The sampling method used in this study was purpose-based with maximum variety. All interviews were digitally recorded and transcribed verbatim in Persian and analyzed using directional content analysis. MAXQDA software version 12 was used to facilitate data analysis.

RESULTS:

From the data analysis, 2 themes, 15 categories, and 38 subcategories emerged. The themes included evaluation and health promotion recommendations. It consisted of 10 categories: reproductive life plan evaluation, medical history evaluation, family and genetic history evaluation, social history evaluation, sexual health evaluation, medication evaluation, laboratory evaluation, physical examination, lifestyle evaluation, and mental health evaluation. Health promotion recommendations included five categories: nutritional recommendations, stress management, avoiding harmful behaviors, protective measures against harmful exposure, and need for education.

CONCLUSIONS:

Our results showed that men need a comprehensive evaluation of reproductive health and recommendations to improve their health in the preconception period. Our study findings can inform healthcare providers to increase men's participation in reproductive health.
Effectiveness of a collaborative model in improving maternal and child health outcomes among urban poor in Chandigarh, a North Indian city
Authors: Gupta Madhu , Verma Madhur , Chaudhary Krishna , Bashar MD. Abu , Bhag Chering , Kumar Rajesh
Published: February 2023

BACKGROUND:

To ascertain the effectiveness of a collaborative model between the Department of Community Medicine and state health department to improve MCH outcomes among the urban poor in Chandigarh.

MATERIALS AND METHODS:

A quasi-experimental study was conducted from 2011–12 to 2015–16 in the intervention and control areas. A collaboration was established between the state health department and the Department of Community Medicine of an autonomous institute. The intervention and control areas were mainly inhabited by the poor migrant population. Critical elements of an efficient collaboration such as the early engagement of partners, clearly stated purpose with common goals, effective communication, and no financial conflict were implemented in the intervention area. MCH program's implementation was strengthened through supportive supervision, enhanced community engagement, male partner involvement, tracking of high-risk pregnant women, and identification of problem families. Trend analysis of MCH indicators was done. The difference-in-difference (DID) analysis was done to measure the net effect of the intervention.

RESULTS:

All the MCH indicators improved significantly in the intervention area compared to the control area (P < 0.05). DID analysis depicted a net increase in the early registration of pregnancies by 18%, tetanus toxoid immunization by 9.2%, and fully immunized children by 8.6%. There was also an improvement in the maternal mortality ratio by 121.1 points, infant mortality rate by 2.2 points, and neonatal mortality rate by 2.6 points in the intervention area.

CONCLUSION:

An innovative, collaborative model between the state health department and the Department of Community Medicine effectively improved the MCH outcomes in Chandigarh.
Sexual health promotion interventional program for women undergoing breast cancer treatment
Authors: Zangeneh Sanaz , Savabi-Esfahani Mitra , Taleghani Fariba , Sharbafchi Mohammad Reza , Salehi Mehrdad
Published: February 2023

BACKGROUND:

Women undergoing breast cancer treatment, especially those of reproductive age, experience sexual health challenges. The aim of this study is to design an interventional program for promoting the sexual health of women undergoing breast cancer treatment.

MATERIALS AND METHODS:

This is a mixed qualitative-quantitative exploratory study consisting of four phases. In the first phase, the needs and strategies for promoting sexual health of Iranian women with breast cancer in Isfahan city will be identified through a qualitative study. The patients will be selected using purposive sampling method and the data will be collected through semi-structured interviews. In the second phase of the study, the relevant literature will be reviewed. In the third phase, the initial version of the program will be designed based on the results of qualitative study and review of literature, the appropriate strategies are prioritized by the members of the panel of experts, and then, the final interventional program is prepared. In the fourth phase, the designed interventional program will be conducted as a quasi-experimental study in two groups of intervention and control and the effectiveness of the program on sexual quality of life, sexual satisfaction, and sexual function of women undergoing breast cancer treatment will be evaluated. The type of the intervention will be selected based on the results of the previous phases and the opinion of the expert panel.

CONCLUSIONS:

The results of this study are expected to contribute to the design of an interventional program based on the needs of women undergoing breast cancer treatment and promote health and meet the sexual health needs of breast cancer patients.
To study the knowledge about the handling of biomedical waste among health-care workers in a COVID-19 hospital setting
Authors: Singh Sukhbir , Tom Vrinda , Verma Ramesh , Malik Ishwanti , Vashist Madan Gopal , Dahiya Pushpa
Published: February 2023

BACKGROUND:

The unexpected increase in COVID-19-related waste and its inappropriate disposal had blown up the threat of retransmission of this infection and adversely impacted the environment. The aim of this study was to evaluate the existing knowledge about the handling of biomedical waste (BMW) in the COVID-19 Hospital setting among health-care workers (HCWs).

MATERIALS AND METHODS:

It was a prospective cross-sectional study done for 3 months, i.e., October 2020–December 2020 among nursing professionals across all seniority posted in COVID hospital. A pretested questionnaire comprised 20 questions was used as a study tool.

RESULTS:

The response rate of our study was 94%. The mean age of respondents was 33.97 years, and the mean length of service was 8.32 years. The study revealed that the respondents had a mean knowledge score of 12.21 (Median 12, standard deviation 2.129 and 95% confidence interval of 11.92–12.51).

CONCLUSIONS:

There is consensus among the researchers/scholars that COVID-BMW hazards are much more significant than regular BMW. Therefore, its awareness among the HCWs can be a panacea for safer handling of BMW generated in COVID Hospital.
’Perceptions’ and ‘practices’ to antibiotic usage among diabetic patients receiving care from a rural tertiary care center
Authors: Inchara Manjunath , Reddy Mahendra M. , Ramya Nagesh
Published: February 2023

BACKGROUND:

Contribution to antibiotic resistance can happen at two interfaces – doctor prescribing antibiotics inadvertently or patient's usage of antibiotics inadvertently. This study was conducted among diabetic inpatients in a rural tertiary health center in Kolar, South India, to assess the various practices related to antibiotic use and to explore the possible reasons for these practices with regard to antibiotic use.

MATERIALS AND METHODS:

An exploratory sequential mixed-methods study was conducted with an initial cross-sectional quantitative study followed by qualitative in-depth interviews during August–September 2019. A pretested semi-structured questionnaire was used to capture the sociodemographic, disease-, and treatment-related characteristics and practices related to antibiotic use. An open-ended interview guide was used to conduct in-depth interviews. The practices to antibiotic use were reported using frequency (percentage). Manual descriptive content analyses were done by two investigators separately to identify codes under the broad topic “reasons for adopted practices with regard to antibiotic use.”

RESULTS:

Of the 152 diabetic inpatients interviewed, 20 (13.2%) felt that antibiotics are safe drugs and can be used commonly. Among these inpatients, seven (4.6%) knew that antibiotics can kill bacteria and four (2.6%) perceived ‘antibiotic resistance’ as a big problem in India. The practice of checking the expiry date before using antibiotics was seen in 21 (13.8%) and 44 (29%) of them finished the full course of antibiotics. A total of six codes were identified under the broad theme of “reasons for adopted practices with regard to antibiotic use” among diabetic inpatients.

CONCLUSIONS:

Less than one-third of them completed the antibiotic course given by the doctor, and almost everyone was ready for over-the-counter purchase of antibiotics offered by the pharmacist. The reasons for such practices were mostly attributed to the “partial drug purchases” and “incomplete advice by the doctor.” There is an urgent need to plan and deliver an interventional package to enhance the knowledge and inculcate good antibiotic usage practices among these high-risk populations.
Investigating the effectiveness of psychological interventions in response to stress, anxiety, and depression in coronavirus disease 2019 patients
Authors: Rahmati Fatemeh , Khalili Robabe
Published: February 2023

Coronavirus disease 2019 (COVID-19) has caused different kinds of psychological consequences. Identifying and providing psychological plans and protocols can be effective in promoting patients’ mental health. The study was conducted to investigate the effect of psychological interventions in response to stress, anxiety, and depression in COVID-19 patients. The present study was performed based on a systematic review. The studies were done by using different combinations of keywords in databases such as Science Direct, ProQuest, PubMed, and Google scholar search engines and in Persian databases such as Magiran, SID, Iranmedex from July 25 to September 7, 2020. Out of 4533 articles that were found after extensive search, 9 articles were evaluated and qualitatively analyzed for data extraction with the 2010 consort checklist. The final articles were from different countries of China, the USA, France, Italy, and Iran and were about COVID-19 patients and their health-care providers. Interventions ranged from relaxation, music therapy to mental health and extensive psychological skills including adaptation methods, mindfulness and self-care, and crisis management. Anxiety was the highest and then stress and depression were the next indicators. The results showed a positive effect of these interventions on stress, anxiety, depression, and even the quality of life, sleep and family and child function. The number of studies in this field is increasing. We see a variety of psychological and educational interventions every day. It is hoped that by designing standard protocols for psychological intervention, effective steps can be taken to improve the mental health of patients and health-care providers.
Health protection challenges of slums residents during the COVID-19 pandemic, according to the social determinants of health framework
Authors: Mehrolhassani Mohammad Hossein , Yazdi-Feyzabadi Vahid , Rafiee Noora , Ghasemi Sara
Published: February 2023

BACKGROUND:

Coronavirus disease-2019 (COVID-19) pandemic can aggravate the health problems in slum areas. The present study intends to examine the challenges of health protection of slum's residences during the COVID-19 pandemic with the Social Determinants of Health perspective, in Kerman city in Iran.

MATERIALS AND METHODS:

The present study was a qualitative content analysis. Data were collected by purposeful sampling in-depth and semi-structured interviews with 16 people. The interviews were conducted (from October to December 2020) with the local representatives of the slum's residents, health-care workers, managers of facilitation offices, and welfare social service centers that are located in slum areas (Interview's guide is attached). The textual material from the interviews was entered into the MAXQDA software and directed content analysis was used to analyze the data.

RESULTS:

Data analysis led to the identification of 4 categories (Sociocultural, Situational, Economical, and Physical environment) and 12 subcategories: Sociocultural: lack of awareness, begging culture, low trust in disease control programs, low bottom-up planning, and increasing violence; Situational: decreasing donors’ activities and canceling important meetings; Economical: unemployment, decreasing in income, and increasing limitations of many institutions in providing resources; and Physical environment: inadequate space and inappropriate conditions in some houses and alleys for people protection against Corona viruses.

CONCLUSIONS:

Slum residents have faced many challenges during the COVID-19 pandemic. These challenges can affect the health of slum and other urban dwellers. Multidisciplinary thinking and actions are needed. Increase awareness and engagement slum residents in control disease programs should be considered.
Assessment of knowledge and awareness regarding intellectual property rights among the health-care professionals in Belagavi city
Authors: Deshpande Apurva Prashant , Ankola Anil V , Sankeshwari Roopali , Jalihal Sagar , Kabra Laxmi , Bhat Deepika V , Choudhury Abhra Roy
Published: February 2023

BACKGROUND:

Intellectual property rights (IPRs) are increasingly becoming significant for sustainable growth of today's knowledge-based society. An inappropriate knowledge regarding IPR can fail to reserve rights for one's intellectual creation. Hence this study was planned with an aim to assess knowledge, awareness, and practices regarding intellectual property rights in India amongst the health-care professionals in Belagavi city.

MATERIALS AND METHODS:

A descriptive cross-sectional study was conducted among the postgraduate students and faculty of six health-care professional institutions in Belagavi, Karnataka. A total of 724 responses were recorded using convenient sampling. Data was collected using self-administered validated questionnaire which included demographic details and total 20 questions pertaining to knowledge, awareness, and practices regarding IPR. Two-point Likert scale was used. Descriptive statistics, Mann–Whitney U-test, and Chi-square test were applied.

RESULTS:

A total of 724 responses were recorded, 411 from postgraduate students and 313 from faculty of 6 health-care professional institutions. It was observed that 24.3% and 39.3% of postgraduate students and faculty participants, respectively, had maximum knowledge while 35.5% of faculty and 27.5% of postgraduate students had maximum awareness regarding IPR in India. Only 17.6% and 10.2% of faculty and postgraduate students had previously attended workshops on IPR.

CONCLUSION:

The present study identified that both faculty and postgraduate students of health-care profession have less knowledge and awareness regarding IPR. However, both knowledge and awareness regarding IPR were better among faculty when compared to postgraduate students. Thus, the academic community requires a higher level of sensitization and exposure to IPR in India.
Microcystic Meningioma – A Diagnostic Dilemma During Intraoperative Squash Smear Study
Authors: Kaur Sukhpreet , Karode Rahul , Gulwani Hanni V.
Published: February 2023

Background:

Meningiomas are generally slow-growing, benign, and non-infiltrating in nature. They are usually easy to diagnose cytologically if they are of the meningothelial type; however, they may cause diagnostic challenges when they manifest as unusual morphological variants, like the microcystic type. Because of the rarity of microcystic meningioma (MM), information on its cytological features is rarely available in the literature.

Objectives:

The goal of this study is to review the cytological features of MM in crush preparations prepared at the time of intra-op consultation and to identify the more common features which are helpful in rendering a correct diagnosis.

Material and Methods:

Cytological features of five cases of MM were reviewed and noted from the records.

Results:

There were five patients of MM with a male: female ratio of 1.5:1 and a mean age of 52 years. All tumors were supratentorial and dura-based. Magnetic resonance imaging (MRI) showed low signal intensity on T1 and high signal intensity on T2 weighted images in four cases. Cytosmears were moderate-to-highly cellular. There were variable-sized cystic spaces within the meningothelial cell clusters. In four cases, nuclear pleomorphism was frequently observed. Nuclear pseudoinclusions, atypical mitoses, vascular proliferation, and necrosis were absent in all cases. Whorling and psammoma bodies were seen in only one case.

Conclusion:

Cytological features identified would be helpful in the diagnosis of microcystic meningiomas, especially in unusual radiological findings. Their unusual cytological features might lead to problems in differential diagnosis from other intracranial tumors, including glioblastoma, metastatic tumor, etc.
Pharmacological Evaluation of Scopoletin in the Carbon Tetrachloride- Induced Hepatotoxicity Model in Wistar Rats
Authors: Sharma Swati , Anand Aishwarya , Bhatia Alka , Sharma Vishal , Singh Anupam K. , Banerjee Dibyajyoti , Patil Amol N.
Published: February 2023

Background:

Several phyto-chemicals have been identified and suggested as potential therapeutic options for hepatotoxicity management

Objective:

To assess the hepatoprotective effect of scopoletin, a pure phyto-chemical, in carbon tetrachloride (CCl4)-induced hepatotoxicity model in Wistar rats

Methods:

Thirty-six rats in total, six in each group, were utilized in this study. Animals in group 1 received normal saline; those in group 2 received carbon tetrachloride in olive oil (0.5 ml/kg, i.p. in ratio 1:1); those in groups 3, 4, and 5 received oral scopoletin (1 mg/kg, 5 mg/kg, 10 mg/kg dose-wise groups); and those in group 6 received N-acetyl cysteine (NAC) 150 mg/kg. Blood sampling was performed on day -3, day 1, and day 7 of the CCl4 administration. Rats were sacrificed on day 7 of the experiment for histological examination and oxidative stress measurement of the liver

Results:

The 5 mg/kg scopoletin group showed a maximum reduction in AST levels [727.33 ± 29.15 in medium dose (MD) group vs 1526.66 ± 60.72 in the experimental control (EC) group (P < 0.001) and ALT levels of 532.66 ± 24.23 in MD group vs 894.83 ± 52.47 in EC (P < 0.01)]. The dose-dependent action was not observed with scopoletin doses. The protective effect of scopoletin was confirmed by MDA and GSH levels (P < 0.05) coupled with histo-pathological findings. In the present study, a reversible model of CCl4-induced hepatotoxicity was observed to get normalized in a week’s time

Conclusion:

The study confirms the hepatoprotective action of scopoletin in an acute model of hepatic injury with the putative anti-oxidant mechanism.
E-learning during the COVID-19 Pandemic in Various Healthcare Institutes of India
Authors: Kumar Surender , Singh Bishnupati , Mahuli Amit Vasant , Singh Ankita , Mahadevan Vallabh , Ranjan Madhu
Published: February 2023

Introduction:

A multicentric study on the benefits and outcomes of e-learning was lacking during the pandemic. This study aimed to find out the participation, satisfaction, and insights of dental and medical undergraduate learners toward digital learning during the COVID-19 pandemic in various healthcare institutes of India.

Material and Methods:

A questionnaire-based cross-sectional study was conducted using Google Forms online on e-learning among students from the first to the final year of MBBS and BDS courses in five healthcare institutions

Results:

Most participants (72.7%) reported cellular data as their mode of internet connection. Seventy point eight percent of participants stated online classes did not affect health. Eyestrain (54.6%) was the most common, followed by headache and fatigue, whereas only 21.2% chose obesity and disturbed sleep as a consequence of e-learning

Conclusion:

Most students had experience in digital learning, in which the use of smart phones with cellular data was the most common mode of digital learning during the pandemic.
Investigating the Role of EPA and DHA on Cellular Oxidative Stress; Profiling Antidiabetic and Antihypertensive Potential
Authors: Aldhafiri Fahad K.
Published: February 2023

Background:

Polyunsaturated fatty acids (PUFAs) remain part of the diet and are essential for growth and development. Furthermore, omega − 3 fatty acids boost various cardiovascular disease risk factors as well as lower blood pressure and cholesterol levels. The effects of PUFAs on glycemia in type 2 diabetes patients are unclear. In the present study, the anti-diabetic and anti-hypertensive potential of eicosapentenoic acid (EPA) and docosahexaenoic acid (DHA)—two polyunsaturated fatty acids—were examined.

Material and Methods:

Using 3T3-L1 pre-adipocyte cells fed with PUFAs, the antioxidant capacity of EPA and DHA was assessed using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay/test. The DPPH activity of EPA and DHA was 49.72 and 50.51%, respectively, indicating a reduction in oxidative stress. The number, size, and total lipid content of adipocytes in adipose tissue were used to study the anti-diabetic effect of EPA and DHA. Both PUFAs were revealed to have a much lower capacity for cell lysis of 3T3-L1 pre-adipocytes when compared to propylene glycol monomethyl ether acetate (PMA). In 3T3-L1 pre-adipocyte cells that had been treated with EPA and DHA, the gene expression profiles for ATP synthase 6 were examined

Results:

The results demonstrated a similar trend of reducing total lipid content in 3T3-L1 pre-adipocyte cells treated with EPA and DHA. The amount of cell lysis was then examined for 3T3-L1 pre-adipocyte cells exposed to DHA and EPA, and the results showed 38.45% and 41.26%, respectively. In the 3T3-L1 pre-adipocyte cells, treatment with PUFAs, EPA, and DHA dramatically lowered total lipid content after 48 hours. The study also revealed that exposing 3T3-L1 pre-adipocyte cells to EPA at 90 g/ml for 48 hours reduced the total lipid content by a significant amount

Conclusion:

According to the findings, EPA and DHA therapy reversed oxidative stress in mitochondria and upregulated the ATP synthase 6 gene. This discovery shows how EPA and DHA have anti-diabetic and hypertension properties.
An overview of Early Paleozoic arc systems in New Brunswick, Canada, and eastern Maine, USA
Authors: Fyffe Leslie R. , Van Staal Cees R. , Wilson Reginal A. , Johnson Susan C.
Published: February 2023

A plate tectonic model involving northwesterly retreat of an Iapetan subducting slab has been developed over the last three decades to explain the time span of volcanism recorded within the development of Early Paleozoic arc systems preserved in New Brunswick. These arc systems are referred as the Penobscot arc-backarc (514–482 Ma), and Popelogan–Meductic arc (478–460 Ma). Opening of the Tetagouche backarc basin associated with the Popelogan–Meductic arc was diachronous and heterogeneous and involved volcanism associated mainly with the crustal extension and rifting between 472–455 Ma. The complex evolution of the Tetagouche backarc basin is examined in respect to six sub-basins, containing relatively well documented stratigraphic sections in New Brunswick: namely from northeast to southwest the Fournier, California Lake, Bathurst, Sheephouse Brook, Napadogan, and Becaguimec sub-basins. Recently, alternate plate tectonic models have been proposed for the northern Appalachians based on newly acquired geochronological data from northern Maine. We integrate these new data with existing stratigraphic, structural, paleontological, and geochemical evidence to support and refine the previously proposed migrating-arc model for New Brunswick and Maine.
LIMITS OF POST-DEVELOPMENT IN THE CRITIQUE OF DEVELOPMENT
Authors: Sodré Maiara Tavares , Hespanhol Rosangela Aparecida de Medeiros
Published: February 2023

The theoretical current known as post-development emerged in the 1980s. Its proponents were authors with different analytical focuses and diversified themes, firmly committed to a radical critique of the idea of development. In this regard, this article aims to analyze post-development's theoretical and propositional basis, evaluating its arguments' consistency and the coherence between the basis of this argument and its propositional direction. Initially, the main issues raised by post-development are examined, paying particular attention to the two main strands of criticism of the concept of development. Next, there is a counterargument to the criticisms discussed above to demonstrate their inconsistencies and possible contributions to the reflexive and operational development field. Based on this debate, it is concluded that post-development makes valid and necessary criticisms, if these are intended to improve development projects that aim to address the objective reality of a large part of the Brazilian and global population. However, stripped of this crucial practical focus and an awareness of the gravity of different populations' social situations, post-development contributes little to overcome the history of failures of different development proposals. Keywords: Development, Post-Development, Alternative Development, Theoretical-Propositional Critique.
PRODUCTIVE RESTRUTURATIONS IN CORUMBÁ-MS IN THE PANTANAL REGION
Authors: Ramos Elvis Christian
Published: February 2023

A fundamental geographical argument is that the irruption of significant economic or technical groupings impacts the rhythm and content of transformations in a preexisting space. These forces affect these spaces and are identified in a temporal perspective of economic cycles. This line of reasoning is undeniable since, in the case of Corumbá-MS, several changes occurred cyclically. Nevertheless, in contrast to a uni-causal explanation and abrupt changes, we defend a socio-spatial perspective based on the idea of coexisting and juxtaposed economic agents and processes, which provoke productive restructuring, whose impact can be sinuous and realign into new functions and ongoing geoeconomic dynamics. Keywords: Urban Geography, Socio-Spatial Restructuring, Midwest Region, Corumbá-MS
SOCIO-ENVIRONMENTAL CONTEXT OF EXTENSIVE PALM CULTIVATION IN COLOMBIA
Authors: Fernandes Juana Angélica Felipe , Cediel Laura Charry , Pinilla Humberto Rojas , Silva Lígia de Nazaré Aguiar
Published: February 2023

Colombia is a world leader in palm cultivation. The predominance of this monoculture has generated several social and environmental impacts. For this reason, we sought to analyze the relationships between the consolidation of the oil palm agribusiness in the state of Cesar, between 1960 and 2016. To achieve the proposed objective, a qualitative analysis was chosen, based on data collected from sources bibliographic, with analysis focused on the discourse and relationship between the actors. 14 actors were identified, highlighting the power exercised by the Colombian State, Indupalma and the media. Funding associations and programs were created to make the country more competitive, however, the relationship with small farmers was vertical and focused on inserting them as partners. However, they are in a system that offers low-paid jobs and poor working conditions. Keywords: Monoculture, Agroindustry, Actors.
FLOATING TERRITORIAL ARRANGEMENTS OF THE RIVER LAKE OF TEFÉ AND COARI IN THE AMAZONAS
Authors: Queiroz Kristian Oliveira de
Published: February 2023

The largest urban centers of the Middle Solimões River region in Amazonas State, the cities of Tefé and Coari, have hundreds of traditional Amazonian fluvial structures exercising different spatial functions, they are the floating ones. The objective of this article is to understand the role of the floatings in these cities for regional development and territorial integration. At first, a classification is proposed based on the identification of the residential, commercial, institutional and service functions performed by the floatings in both lakes. Then, a characterization and classification of the floating territorial arrangements of these cities is elaborated. This reading provides subsidies for the understanding of social and economic relations in peripheral fluvial spaces in the Amazon useful or not to integrate the territory and develop this complex region of brazilian sociospatial formation. Keywords: : Floating, Floating Territorial Arrangements, Tefé, Coari, Amazon.
URBANISATION AND UNEVEN DEVELOPMENT OF TOURISM ON THE BRAZILIAN COAST
Authors: Fonseca Maria Aparecida Pontes , Costa Wagner Fernandes , Fagerlande Sergio Moraes Rego , Todesco Carolina
Published: February 2023

The concentration of tourism on the Brazilian coast is widely recognised, despite the fact that its development does not take place in an even manner along the entirety of the coast. As a result, the goal of this article is to examine the spatial diffusion of tourism-related activities on the Brazilian shore and seek to identify the places where it gains more prominence, along with the factors that contributed to its uneven growth. The procedures adopted included the study of tourism-related data as contained in two sources: the Guia Quatro Rodas [‘Quatro Rodas’ Motoring Guide] of the Abril Publishing House and the Brazilian Tourism Map, as published by the Brazilian Department of Tourism in its 2019 edition. The mapping and the analysis of the data allowed us to conclude that the spatial character of coastal tourism was conditioned by the pre-existing urban structure, and concentrated on the major cities. It should be noted that small and mid-sized cities, following specific interventions from the Government, became relevant destinations in the regional, domestic and foreign markets. Keywords: Tourism; Brazilian coastal line; Urbanisation; Uneven Development; Guia Quatro Rodas.
DEVELOPMENT AND RURAL TOURISM
Authors: Santos Clediane Nascimento , Thomaz Rosângela Custodio Cortez
Published: February 2023

This research studies the rural development public policy and the rural tourism activity in Rosana and Presidente Epitácio municipalities in São Paulo State/Brazil and Santiago de Compostela and Padrón municipalities in Galicia/Spain. Thus, the general objective is to analyze the tourism territorialization process in rural areas and compare public policies for rural development based on case studies in the Pontal do Paranapanema region in the State of São Paulo and the Autonomous Community of Galicia/SP. The methodological procedures used comparative analysis, highlighting the experience of two Spanish municipalities, Santiago de Compostela and Padrón, to draw similarities and differences with the Brazilian cases. The main results obtained in Brazil derived from the actions of the National Program for the Strengthening of Family Agriculture (PRONAF). The research in Santiago de Compostela and Padrón identified the presence of rural tourism houses, which were restored through subsidies from European Union rural development policies. Keywords: Tourism in the Countryside. Local Development Public Policy.
CAN ECONOMIC COSTS BE FACTORED INTO CONSERVATION PLANNING PROCESSES?
Authors: Magdalena Ulises Rodrigo , Messias Cassiano Gustavo , Luoni Juan Pablo Zbrun , Amorim Raul Reis
Published: February 2023

Society has been increasingly demanding of better environmental conservation practices as a solution to the ongoing crisis causing extreme weather events and biodiversity loss. Yet, a key issue for the definition of priority locations for protected areas that meet the intended conservation goals remains: how to factor and spatialize monetary costs in the goal-function of the planning for areas that better reflect the decision-making influences in the territory. We presented, in this study, the monetary acquisition costs for land purchasing and the opportunity costs for the Piracicaba, Capivari and Jundiaí watersheds. We adopt an approach derived from spatial analysis and remote sensing methodological processes to compile and link information tabulated from farmer assistance institutions with information on natural elements obtained through land use and land cover mapping. Subsequently, we merged data from the geospatial monetary matrix with exact-objects data obtained from the Operation Land Imager (OLI) multispectral sensor attached to the Landsat 8 satellite. Finally, we identified that the monetary costs for conservation actions in the study area have inverse values and that including them in the planning goal-function can help prioritize protected areas that will be less prone to conflict over land-use due to clashes with the economic activity of a territory. Keywords: Opportunity Costs, Acquisition Costs, Protected Areas.
APPLICATION OF VEGETATION INDEXES TO ASSESS CARBON STOCK
Authors: Dhakal Richa , Mandal Ram Asheshwar
Published: February 2023

This was objectively conducted to estimate the carbon stock, to show the relation between carbon stock and indices and to assess the factors affecting carbon stock in community forests. Three community forests (CFs) namely Gumalchowki, Mahakalsthan and Mahalaxmi of Chandragiri Municipality in Nepal were selected as research sites. Altogether 135 plots were randomly established to collect data from the field. The biomass was calculated using Chave et al., equation which was converted into carbon stock multiplying by default value 0.47. The values of Normalized Difference Vegetation Index (NDVI), Difference Vegetation Index (DVI) and Infrared Percentage Vegetation Index (IPVI) were calculated and regression equation between the indices and carbon stock was performed. The result showed that total above ground carbon stock was highest in Mahalaxmi CF with 30.42 ton/ha, followed by Mahakalsthan CF with 22.62 ton/ha and comparatively lowest with 21.55 ton/ha in Gumalchowki CF. The regression analysis between carbon stock and indices showed significantly and positive correlation. The R2 value of NDVI of Gumalchowki, Mahakalsthan and Mahalaxmi CF were found to be 0.51, 0.54 and 0.58, also, RMSE value of CFs were 1.41, 1.36 and 1.91 respectively. Principal component analysis showed that road construction, transmission line expansion, soil erosion, encroachment, disease, weeds, recreation, illegal logging are the major factors affecting carbon stock in all three community forests. Keywords: Carbon, Nepal, Community Forests.
Clinical Assessment of Residents: A Survey of Clinician Educators Regarding Resident Assessment Burden and Modifiable Factors
Authors: Tierney Aaron A. , Rosner Benjamin I.
Published: February 2023

Background

A fundamental role of the clinician educator is to provide thoughtful assessments for resident development. A gap in the literature exists about whether the completion of assessments contributes to clinician educator burden.

Objective

We sought to understand the degree to which completing resident assessments contributes to clinician educator burden, the drivers behind such perception, and whether modifiable factors exist.

Methods

In October 2020, we conducted a cross-sectional study of adult hospital medicine clinician educators to explore burden associated with resident assessment. The authors developed a 10-item electronic survey (Likert type and sliding scale responses), asking about demographics, context, frequency and degree of burden, burdensome aspects of assessments, estimated time for assessments, and percentage of assessments turned in late or never. We conducted subgroup analyses for differences in responses based on sex and number of years practicing, and regression analyses for predictors of burden degree.

Results

Fifty of 81 (62%) surveyed faculty responded. Two percent (1 of 50) reported no burden, while 42% (21 of 50) reported infrequent (“never,” “rarely,” “sometimes”) and 56% (28 of 50) reported frequent (“often,” “always”) burden. Of those experiencing burden, 67% (33 of 49) reported slight or moderate, and 33% (16 of 49) reported significant or extreme burden. Potentially modifiable causes included assessment request boluses, lag time between resident service and assessment requests, and technology involved. Female clinician educators estimated submitting a higher percentage of late assessments than males (65% vs 41%, P=.02). Number of years practicing was inversely associated with assessment time (β=-0.28, P=.01).

Conclusions

Our findings suggest that resident assessments are a source of burden among adult hospital medicine clinician educators and that several potentially modifiable factors may underlie this burden.
When Global Becomes Virtual: A Survey of Virtual Global Health Education Activities During the COVID-19 Pandemic Among Pediatric Educators
Authors: Lam Suet Kam , Winter Jameel , Van Genderen Kristin , Lauden Stephanie M. , Windsor William , Umphrey Lisa
Published: February 2023

Background

During the COVID-19 pandemic, global health education activities were disrupted. Transitioning to virtual options has allowed educators and trainees to continue global health education and partnerships, though the acceptability and implementation of this transition is unknown.

Objective

To evaluate current and planned virtual global health education activities (VGHEAs) of a group of US global health educators during the COVID-19 pandemic and to assess perceived benefits and challenges of VGHEAs.

Methods

A cross-sectional study of pediatric faculty and trainees involved in global health education from 8 institutions in the United States were surveyed anonymously about their global health education activities in 2021. Authors used representative convenience sampling and invited at least 1 faculty member and 2 trainees from each institution in the Midwest Consortium of Global Child Health Educators.

Results

All 8 institutions responded to the survey, with 38 faculty and trainee participants. Institutional implementation of virtual education activities was variable. Respondents reported that VGHEAs allowed them to maintain partnerships with low-middle income countries, though they noted that unreliable internet connections presented challenges. One program reported funding cuts to its global health program during the pandemic.

Conclusions

The COVID-19 pandemic created challenges for global health education programs. Educators and trainees are interested in using potentially cost-saving VGHEAs to maintain international collaborations, continue global health education efforts, and even increase access to equitable educational activities despite pandemic disruptions.
Faculty Perceptions of Frame of Reference Training to Improve Workplace-Based Assessment
Authors: Kogan Jennifer R. , Conforti Lisa N. , Holmboe Eric S.
Published: February 2023

Background

Workplace-based assessment (WBA) is a key assessment strategy in competency-based medical education. However, its full potential has not been actualized secondary to concerns with reliability, validity, and accuracy. Frame of reference training (FORT), a rater training technique that helps assessors distinguish between learner performance levels, can improve the accuracy and reliability of WBA, but the effect size is variable. Understanding FORT benefits and challenges help improve this rater training technique.

Objective

To explore faculty's perceptions of the benefits and challenges associated with FORT.

Methods

Subjects were internal medicine and family medicine physicians (n=41) who participated in a rater training intervention in 2018 consisting of in-person FORT followed by asynchronous online spaced learning. We assessed participants' perceptions of FORT in post-workshop focus groups and an end-of-study survey. Focus groups and survey free text responses were coded using thematic analysis.

Results

All subjects participated in 1 of 4 focus groups and completed the survey. Four benefits of FORT were identified: (1) opportunity to apply skills frameworks via deliberate practice; (2) demonstration of the importance of certain evidence-based clinical skills; (3) practice that improved the ability to discriminate between resident skill levels; and (4) highlighting the importance of direct observation and the dangers using proxy information in assessment. Challenges included time constraints and task repetitiveness.

Conclusions

Participants believe that FORT training serves multiple purposes, including helping them distinguish between learner skill levels while demonstrating the impact of evidence-based clinical skills and the importance of direct observation.
Urinary Symptoms Are Unrelated to Leukocyte Esterase and Nitrite Among Indwelling Catheter Users
Authors: Rounds Amanda K. , Tractenberg Rochelle E. , Groah Suzanne L. , Frost Jamie K. , Ljungberg Inger H. , Navia Herminio , Pham Cynthia T.
Published: February 2023

Objectives

To explore the association between dipstick results and urinary symptoms.

Method

This was a prospective 12-month observational study of real-time self-administered urine dipstick results and symptoms in a community setting that included 52 spinal cord injury/disease (SCI/D) participants with neurogenic lower urinary tract dysfunction (NLUTD) who use an indwelling catheter. Symptoms were collected using the Urinary Symptom Questionnaire for Neurogenic Bladder–Indwelling Catheter (USQNB-IDC). The USQNB-IDC includes actionable (A), bladder (B1), urine quality (B2), and other (C) symptoms; analyses focused on A, B1, and B2 symptoms. Dipstick results include nitrite (NIT +/−), and leukocyte esterase (LE; negative, trace, small, moderate, or large). Dipstick outcomes were defined as strong positive (LE = moderate/large and NIT+), inflammation positive (LE = moderate/large and NIT−), negative (LE = negative/trace and NIT−), and indeterminate (all others).

Results

Nitrite positive dipsticks and moderate or large LE positive dipsticks were each observed in over 50% of the sample in every week. Strong positive dipstick results were observed in 35% to 60% of participants in every week. A, B1, or B2 symptoms co-occurred less than 50% of the time with strong positive dipsticks, but they also co-occurred with negative dipsticks. Participants were asymptomatic with a strong positive dipstick an average of 30.2% of the weeks. On average, 73% of the time a person had a negative dipstick, they also had no key symptoms (95% CI, .597-.865).

Conclusion

No association was observed between A, B1, and B2 symptoms and positive dipstick. A negative dipstick with the absence of key symptoms may better support clinical decision-making.
Yaşlı Kullanıcı Gözüyle Konut İç Mekan Güvenliği
Authors: BÜKER Makbule Berfin , ŞAVKIN Raziye , BÜKER Nihal
Published: February 2023

Amaç: Sağlıklı yaşamın temel öğelerinden biri olan konutun niteliği ve kullanıcısına yönelik olarak düzenlenmesi, ev kazaları açısından risk altında olan yaşlı popülasyonda oldukça önemlidir. Bu çalışmada yaşlılarda konutta iç mekânın güvenlik durumu incelenerek, ev güvenliği açısından gerekli iç mekân kriterlerini içeren bir tablo ortaya konması amaçlandı.
Metod: Çalışmaya yaş ortalaması 71.80±6,28 yıl olan 287 yaşlı dahil edildi. Katılımcıların demografik ve tanımlayıcı bilgileri kaydedildi. Ev güvenlik düzeyi araştırmacılar tarafından hazırlanan Konut İç Mekanlarında Yaşlı Ev Güvenliği Kontrol Listesi ile değerlendirildi. Çalışma sonunda her bir katılımcıya iç mekân düzenlemeleri ve düşmelerin önlenmesi için iç mimar ve fizyoterapistlerce bilgilendirme eğitimleri yapıldı.
Bulgular: Yaşlı bireylerin çoğunluğu doğal ve yapay aydınlatmanın yeterli (%90,2), aydınlatma anahtarlarının erişilebilir (%94,8), mobilyaların kendileri için uygun ölçülerde (%88,9) olduğunu, genel olarak yaşadıkları konutun iç mekanındaki yerleşimin rahat ve güvenli hareket etmeye izin verdiğini (%94,1) bildirdi. Bununla birlikte katılımcıların %54,4’ü mobilyaların bulunduğu konuma sabitlenmediğini, %52,3’ü kaza anında yaralanmayı önlemek amacıyla mobilya ve yüzeylerdeki sivri kenar/köşelerde uygun önlemlerin alınmadığını, %76’sı yaşadıkları konutun iç mekânında kaygan zeminlerin, %72,8’i eşiklerin varlığını belirtti.
Sonuç: Yaşlıların yaşadıkları evlerin profesyonel kişilerce değerlendirilip gerekli düzenlemelerin ve önlemlerin alınması ve ev kazaları, ev güvenliği ve düşmeler hakkında bilgilendirme eğitimlerinin yaygınlaşması ile ev kazaları ve yaralanmaların büyük oranda önlenebileceği düşünülmektedir.
Internal and External Determinants of Risk Based Capital
Authors: Sinaga Jhonni , Manurung Adler Haymans , Machdar Nera Marinda , Harly Jacob FoEh John Edward
Published: February 2023

Abstract

This research aims to investigate the determinants of Risk Based Capital (RBC) of Indonesia’s general insurance public listed companies. Panel data regression model was used to analyze the internal and external variables influencing the RBC. This research finds that ratios of sales to total asset, gross profit to total asset, premium claim to total asset, investment to total asset, and interest have a significant impact on the RBC of Indonesia's publicly traded general insurance companies.

JEL classification numbers: C650, G22, G32.
Keywords: Sales to total asset, Policy rate, investment performance, Gross profit to total asset, Premium claim, Panel data regression model, Risk based capital (RBC).