bluuebunny/crossref_metadata_2025 huggingface dataset:
PREVALENCE OF HEPATITIS B, HEPATITIS C AND HIV IN MULTIPLY TRANSFUSED SICKLE CELL DISEASE PATIENTS FROM OMAN
Authors: Pathare Anil , Alkindi Salam
Published: November 2019

Background: In Oman, the prevalence of hepatitis B (HBV) infection is 5.8% with 2.8–7.1% HBV carriers. Hepatitis C (HCV) prevalence amongst Omanis is 0.41%. A total of 2917 human immunodeficiency virus (HIV) infections were notified amongst Omanis by 2017. This study was performed as there was no data on the prevalence of HIV, HBV and HCV in sickle cell disease (SCD) patients from Oman.

 

Study Design and Methods: In this retrospective, cross-sectional study, medical records of all SCD patients who attended our hospital between 2011 to 2017 were retrieved from the hospital information system. Following approval by the local medical research and ethics committee, data on HIV, HBV and HCV exposure were recorded to estimate the prevalence.

 

Results: Amongst a total of 1000 SCD patients (491 males and 509 females), twenty-three (2.3%) patients showed positive serology for hepatitis B surface antigen (HbsAg), of whom sixteen (1.6%) were HBV DNA positive.  126 (12.6%) had anti-HCV antibodies (anti-HCV), of whom fifty-two (5.2%) were HCV RNA positive. None of the patients had positive serology for HIV. A normal liver was observed on abdominal ultrasound in 788 (78.8%) patients, whereas, 208 (20.8%) had hepatomegaly and 4 (0.4%) had liver cirrhosis. Thirty-six (3.6%) patients died, but in only two patients, the mortality was due to cirrhosis of the liver.

 

Conclusion: This study provides the first comprehensive data on the prevalence of HBV and HCV infections among Omani SCD patients exposed to blood transfusions. Reassuringly, no case with HIV was observed.

 

Keywords: Prevalence; Hepatitis; HBV; HCV; HIV; infection
IS IT SAFE AND COST SAVING TO DEFER THE CD4+ CELL COUNT MONITORING IN STABLE PATIENTS ON ART WITH MORE THAN 350 OR 500 CELLS/µL?
Authors: Celesia Benedetto Maurizio , Marino Andrea , Fontana del Vecchio Rosa , Bruno Roberto , Palermo Filippo , Gussio Maria , Nunnari Giuseppe , Cacopardo Bruno
Published: November 2019

Background

CD4 lymphocyte cell count represents the main immunological marker used to monitor HIV infection. However, frequent monitoring may be unnecessary, could cause anxiety to the patient as well as burdening healthcare with extra expenses.

 

Objectives and methods

To analyse the probability of maintaining a safe number of CD4 in HIV-positive subjects under treatment with ?350 cells/µl at baseline during a three-year follow up. We conducted a retrospective study performing three analyses with Kaplan-Meyer method considering: 1) all patients independently from their viral load (VL); 2) patients with 500 > CD4 ? 350 cells/µl versus (vs) CD4 ? 500 cells/µl at baseline; 3) patients with VL < 20 copies/ml vs VL > 20 copies/ml.

 

Results

253 subjects were enrolled. The median CD4 count was 623 (489-805) cells/µl. Subjects maintaining ? 350 cells/µl in the first, second and third year were respectively 238 (94.1%), 229 (90.5%) and 226 (89.3%), independently from VL. Within subjects with ? 350 CD4/µl vs ? 500 CD4/µl at baseline, those who maintained ? 350 cells/µl until the third year were respectively 241 (95.3%) and 158 (98.1%). The probability of maintaining these values in the third year was 89.3% for those who had CD4 ? 350/µl at baseline and 98.1% for those who had CD4 ? 500/µl. This probability was around 90% vs 99% for subjects with HIV-RNA above or below 20 copies/ml. Secondly, we tried to estimate the costs of CD4 determinations in a three-year period (from April 1, 2013 to March 31, 2016). We analysed respectively 343 subjects in the first period, 364 in the second and 383 in the third, with a median value of 500 CD4/µl during the research time taken into account. We found a mean value of about two determinations patient/year (2.41 in 2013/2014; 2.32 in 2014/2015; 2.18 in 2015/2016), with a significant decrease between the first and the last period (p<0.001). The mean cost patient/year was €101.51 in the first year, €97.61 in the second, €92.00 in the third (p<0,001). Assuming to extend these procedures to all our patients with stable CD4 cells/µl and monitoring CD4 cell count once in a year, it could be possible to obtain an overall saving of €19,152/year.

 

Conclusions

A very high percentage of subjects maintained a high and safe number of CD4 cells (>350 cells/µl) during a three-year follow up. It could be possible to save up to 66% of the costs by reducing the number of CD4 count determinations in a year, to have other favourable consequences as well, releasing new resources for patient’s management.
Does splenectomy influence the development of Hypothyroidism in Transfusion Dependent Thalassemia Patients? A retrospective study.
Authors: KATTAMIS Christos , Skafida Myrto , Sofocleous Christalena , Kattamis Antonis
Published: November 2019

To test the postulated hypothesis that splenectomy may influence the development of Hypothyroisdism (HT) in Transfused Dependent Thalassemia (TDT) young patients, basic factors known to influence the development of hypothyroidism were evaluated in 52 TDT adult patients (25 splenectomized) with HT. Precise analysis of data not only failed to disclose any statistical differences but revealed similarities, between splenectomized and non- splenectomized patients in respect to: i) the age at diagnosis of HT and ii)the ferritin levels on diagnosis and at the year of study. Interestingly a statistically higher age at diagnosis was recorded in central HT irrespective of splenectomy.
DIAGNOSTIC PERFORMANCE AND SAFETY OF BRONCHOALVEOLAR LAVAGE IN THROMBOCYTOPENIC HAEMATOLOGICAL PATIENTS FOR ASPERGILLOSIS DIAGNOSIS: A MONOCENTRIC, RETROSPECTIVE EXPERIENCE.
Authors: Cefalo Mariagiovanna , Puxeddu Ermanno , Sarmati Loredana , Paterno Giovangiacinto , Fontana Carla , Nassa Daniela , Pane Gloria , De Bellis Eleonora , Palmieri Raffaele , Buzzatti Elisa , Meconi Federico , Laureana Roberta , Casciani Paola , Zizzari Anna Giulia , Rogliani Paola , De Fabritiis Paolo , Maurillo Luca , Buccisano Francesco , Cantonetti Maria , Arcese William , Venditti Adriano , Del Principe Maria Ilaria
Published: November 2019

Background: although bronchoalveolar lavage (BAL) measurements of galactomannan antigen (GM) seems to be more sensitive than serum testing to detect invasive pulmonary aspergillosis (IPA), a consensus on the most appropriate diagnostic threshold of the BAL GM test is still unclear. Moreover, there is uncertainty as to whether BAL is a safe procedure in patients with hematological malignancies (HM) and thrombocytopenia (TC).

Objectives: based on this background, 102 adult patients with HM and associated thrombocytopenia were retrospectively analyzed with the twin aims of 1) determining whether BAL is a safe and feasible procedure; and, 2) identifying the most appropriate threshold for GM positivity  in the diagnosis of IPA.

Patients/Methods: each BAL was considered as one case/patient. One hundred twelve BALs were carried out in 102 HM patients: at the time of the BAL, the median platelets count (PLTs) in all patients was 47x109/L (1-476) and 31 patients (27%) had PLTs< 20x109/L.

Results: complications from the BAL were infrequent (3.5%) and mild. No bleeding was reported. The BAL GM cut off of >0.8 was associated with the best diagnostic accuracy (sensitivity 72.97% and specificity 80%). Antifungal treatment of patients with BAL GM >0.8resulted in  a clinical-radiological improvement in 35/41patients (85%).

Conclusions: BAL was a safe procedure also in thrombocytopenic patients, permitting an IPA diagnosis not otherwise identifiable using  EORTC/MSG criteria. Our data suggest that a BAL GM value of>0.8 represents the most useful cut-off in terms of sensibility and specificity. Further prospective studies on a larger number of patients are needed to confirm these results.
CURING HEMOGLOBINOPATHIES: CHALLENGES AND ADVANCES OF CONVENTIONAL AND NEW GENE THERAPY APPROACHES.
Authors: Motta Irene , Ghiaccio Valentina , Cosentino Andrea , Breda Laura
Published: November 2019

Inherited hemoglobin disorders, including beta-thalassemia (BT) and sickle-cell disease (SCD) are the most common monogenic diseases worldwide, with a global carrier frequency of over 5%. With migration they are becoming more common worldwide, making their management and care an increasing concern for health care systems.

BT is characterized by an imbalance in the α/β-globin chain ratio, ineffective erythropoiesis, chronic hemolytic anemia, and compensatory haemopoietic expansion. Globally, there are over 25,000 births each year with transfusion-dependent thalassemia (TDT). The current available treatment for TDT is lifelong transfusions and iron chelation therapy or allogenic bone marrow as curative option. SCD affects 300 million people worldwide  and severely impacts the quality of life of patients, who experience unpredictable, recurrent acute and chronic severe pain, stroke, infections, pulmonary disease, kidney disease, retinopathy, and other complications. While survival has been dramatically extended, quality of life is markedly reduced by disease- and treatment-associated morbidity.

The development of safe, tissue specific and efficient vectors, and efficient gene editing technologies have led to the development of several gene therapy trials for BT and SCD. Yet, the complexity of the approach presents its hurdles. Fundamental factors at play include the requirement for myeloablation on a patient with a benign disease, the age of the patient and consequent bone marrow microenvironment. A successful path from proof-of-concept studies to commercialization must render gene therapy a sustainable and accessible approach for a large number of patients. Furthermore, the cost of these therapies is a considerable challenge for the health care system. While new promising therapeutic options are emerging and many others are on the pipeline5, gene therapy can potentially cure patients. We herein provide an overview of the most recent potentially curative therapies for hemoglobinopathies and a summary of the challenges that these approaches entail.
Thalidomide-Induced Leukocytoclastic Vasculitis in Leprosy
Authors: Belgaumkar Vasudha Abhijit , Patil Pallavi Prataprao , Chavan Ravindranath Brahmadeo , Suryataley Prernaa R.
Published: November 2019

Thalidomide has become the gold standard for the treatment of erythema nodosum leprosum (ENL) within a few decades of its serendipitous discovery for this condition. It has also demonstrated efficacy in dermatoses such as recalcitrant oral aphthae, prurigo nodularis, and pyoderma gangrenosum. Despite a good safety profile, thalidomide is known to cause side effects such as sedation, constipation, peripheral neuropathy, and thromboembolism. Although rare and anecdotal, adverse cutaneous drug reactions (ACDRs) have been reported. Both thalidomide and its newer analogs have been implicated for maculopapular, urticaria-angioedema, Steven–Johnson-like, toxic epidermal necrolysis, and acneiform eruptions. Only a few cases of leukocytoclastic vasculitis (LCV) occurring in patients of multiple myeloma on this drug have been described till date. However, this unusual presentation of ACDR due to thalidomide in leprosy has not been hitherto documented. Herein, we describe a patient of lepromatous leprosy with ENL who developed thalidomide-induced LCV and discuss myriad aspects such as immunopathogenesis with emphasis on the possible role of various cytokines such as interleukin (IL)-2, IL-6, IL-12, and tumor necrosis factor-alpha.
A Comparative Study between Topical Adapalene (0.1%) versus a Combination of Topical Adapalene (0.1%) and Intense Pulsed Light Therapy in the Treatment of Inflammatory and Noninflammatory Facial Acne Vulgaris
Authors: Karan Shah , Vikrant Jadhav , Anil Gugle
Published: November 2019

Introduction:

Acne vulgaris is a common dermatological disorder encountered in dermatology practice. Various treatment modalities are available for acne. Lasers and light-based therapies are also gaining popularity with good clinical results. The choice of treatment depends on the type and severity of acne.

Aims:

(1) To evaluate the efficacy and safety of topical adapalene (0.1%) gel in facial acne vulgaris. (2) To evaluate the efficacy and safety of topical adapalene (0.1%) gel in combination with intense pulsed light (IPL) in facial acne vulgaris. (3) To compare the above results.

Materials and Methods:

A total of 50 patients with facial acne were included. IPL device equipped with an acne treatment filter emitting light between 430 and 1200 nm was used. Adapalene 0.1% in gel form was used. One side of the face was treated with plain adapalene gel and another side with a combination of daily application of adapalene, with fortnightly exposure of IPL. A total of four sittings of IPL at the interval of 15 days were given. Final evaluation was done 2 weeks after the last session of IPL.

Results:

On adapalene + IPL-treated side, statistically significant reduction in comedones started from the 2nd visit,P < 0.05. On the 6th visit, there was statistically significant difference in mean comedones (P < 0.05) between two sides. After the study (9 weeks), the mean reduction in inflammatory lesion was 69.98% for adapalene-treated side and 79.92% for combination therapy.

Conclusion:

IPL therapy with 430–1200 nm wavelength filter is an effective adjuvant therapy when used with adapalene 0.1 gel. It gives an additional benefit in the treatment of acne. We can avoid systemic antibiotics and retinoids using adapalene and IPL combination in mild-to-moderate acne.
Real-Life Efficacy and Safety of Secukinumab
Authors: Neema Shekhar , Radhakrishnan S , Singh Sehdev , Vasudevan Biju , Chatterjee Manas
Published: November 2019

Background:

Secukinumab is a fully human monoclonal antibody against interleukin-17. Phase III trials have shown encouraging results in chronic plaque psoriasis. The real-life data for safety and efficacy of secukinumab are limited.

Methodology:

This was a retrospective, single-center, observational study conducted in a tertiary care center of East India between January 2016 and December 2017. Patients with chronic plaque psoriasis who were initiated on injection secukinumab during the study period and completed 52 weeks of observation period were included in the study. Analysis was performed using SPSS version 25.

Results:

Twenty patients were recruited in the study. Mean age of the patients was 46 years and mean duration of disease was 11 years. Eleven (55%) patients were biologic experienced and Nine (45%) patients were biologic naïve. Mean Psoriasis Area and Severity Index (PASI) score at baseline was 17.05 (±6.7). Fifteen (75%) patients achieved PASI75 at 4 weeks. Seventeen (85%) patients achieved PASI75, 13 (65%) achieved PASI90, and 10 (50%) patients achieved PASI100 at 12 weeks. Eighteen (90%), 10 (50%), and 7 (35%) patients maintained PASI75, PASI90, and PASI100 response, respectively, at the end of 52 weeks. Adverse effects were seen in 6 (30%) patients over 52 weeks. Drug discontinuation was required because of severe exacerbation of eczema and recalcitrant vulvovaginal candidiasis in one patient each.

Conclusion:

Secukinumab is an effective drug for the management of chronic plaque psoriasis even in patients who have previously been treated with systemic drugs and other biologics; however, adverse effects are more common as compared to what trial data suggest.

Limitations of Study:

Small sample size and retrospective study design are main limitations of the study.

Strength of Study:

This is first real-life data with 52 weeks follow up from India.
Successful Treatment of Pyogenic Granuloma with Sclerotherapy
Authors: Bansal Neelima , Belgaumkar Vasudha A. , Chavan Ravindranth B. , Doshi Bhavana Ravindra
Published: November 2019

Pyogenic granuloma (PG) is a common benign vascular proliferation that usually occurs on the skin and mucosa. Various treatment options exist in literature with no clear consensus. Our objective was to evaluate the efficacy and safety of sclerotherapy (sodium tetradecyl sulfate [STS]) in PG. This case series included 15 patients of PG, treated with intralesional injection of the STS (3%, 30 mg/ml) solution. All patients showed complete resolution of PG, without any major complication or recurrence during a 6-month follow-up period.
“PRIDE” Complex
Authors: Agrawal Shashank Krishna , Supekar Bhagyashree Babanrao , Wankhade Vaishali , Singh Rajesh Pratap
Published: November 2019

Epidermal growth factor receptor inhibitors are currently widely used for the treatment of nonsmall cell lung cancer and head-and-neck malignancy. These are associated with constellation of cutaneous reactions termed as PRIDE complex which comprises papulopustules and/or paronychia, regulatory abnormalities of hair growth, itching, and dryness. We report two cases of PRIDE complex, diagnosed clinically and histopathologically in patients of nonsmall cell carcinoma of the lung being treated with erlotinib and gefitinib.
The Prevalence and Predictive Factors of Internet Addiction and Its Relationship with Emotional Intelligence Among Medical Students
Authors: Yekefallah Leili , Dehghankar Leila , Razaghpoor Ali , Hasannia Elham , Hosseini Narges , Mafi Maryam
Published: November 2019

Introduction:

Abundant applications of the Internet in recent years have resulted in emerging of a phenomenon known as “Internet addiction.” The present study was conducted with the aim of investigating the prevalence of Internet addiction (IA) and its relationship with emotional intelligence (EI) among students of Qazvin University of Medical Sciences.

Methods:

The present cross-sectional study was carried out on 325 medical students who were studying at five faculties of Qazvin University of Medical Sciences (School of Medical, School of Paramedical Sciences, School of Health, School of Nursing and Midwifery, and School of Dentistry). In order to collect data, three instruments were used including (1) a checklist for demographic characteristics, (2) IA test, and (3) Schutte EI Scale. Descriptive statistics (frequency, mean, and standard deviation), Pearson correlation, and multivariate linear regression were performed to analyze the data.

Results:

The results showed that the prevalence of moderate and severe levels of IA was reported to be 12% and 0.3%, respectively. Moreover, 31.4% of the students were normal users and 56.3% had a mild addiction to the Internet. The results also showed an inverse and significant relationship between IA and EI (r = −0.163, P = 0.003). Regression model showed that Internet usage time (β = 0.34, P < 0.001), total EI (β = −0.2, P = 0.002), and using social media (β = 0.18, P = 0.007) significantly predicted the prevalence of IA at all levels of the severity of IA.

Conclusion:

The results of this study showed an inverse and significant relationship between IA and EI among medical students. Therefore, we can take an effective step to increase students' emotion and improve their coping skills by holding special workshops and classes so as to prevent them from IA.
Comparing quality of life instruments
Authors: Lin Chung-Ying
Published: November 2019

Introduction:

Children with overweight or obesity are very likely to experience health problems including low levels of psychological well-being and impaired quality of life (QoL). Given that the importance of QoL includes policymaking measuring QoL is especially crucial. Therefore, comparing generic (Kid-KINDL and Pediatric QoL Inventory [PedsQL]) and weight-related (Sizing Them Up) measures could provide insights for healthcare providers to decide how and when to use which QoL instrument.

Methods:

I recruited 199 school children studied between 3rd and 6th grades from 11 schools in Southern Taiwan, and all the children completed child depression inventory (for depression) and Rosenberg self-esteem scale (for self-esteem); one of their parents completed Sizing Them Up, PedsQL, and Kid-KINDL.

Results:

I constructed structural equation modeling to investigate the associations between these instruments, and the results indicated that self-esteem had the strongest relationship with Kid-KINDL; weight had the strongest relationship with Sizing Them Up. Moreover, both PedsQL and Kid-KINDL could observe the depression among children.

Conclusion:

Healthcare providers may have insights to select appropriate measure to assess QoL for overweight/obese children according to my findings.
Predictors of Health Literacy in Community-Dwelling Elderly
Authors: Seifollahzadeh Sima , Motalebi Seyedeh Ameneh , Amirzadeh Iranagh Jamileh , Mafi Maryam , Mohammadi Fatemeh
Published: November 2019

Introduction:

Health literacy is an essential factor for self-care of chronic conditions and maintenance of health and wellness. This research examines whether or not sociodemographic factors predict health literacy in community-dwelling elderly adults.

Methods:

The sample of this cross-sectional study consisted of 250 elderly individuals residing in Qazvin, Iran, who were selected by cluster sampling method. Data were collected using the sociodemographic and Health Literacy for Iranian Adults questionnaires. A multivariate regression model was used for analyzing the data.

Results:

The mean age of 250 elderly people participated in the study was 69.42 ± 6.81 years. Based on the findings of the current study, the majority of the elderly participants had insufficient (n = 79, 31.6%) or not enough (n = 69, 27.6%) health literacy. The results also indicated that good economic status (B = 5.75, standard error (SE) = 2.19, P = 0.009) and living with a spouse (B = −8.75, SE = 3.36, P = 0.010) were associated with higher health literacy. However, having no formal education (B = −26.73, SE = 3.42, P < 0.001) or under diploma education (B = −8.03, SE = 2.53, P = 0.002) and being homemaker (B = −10.58, SE = 3.02, P = 0.001) or unemployed (B = −5.22, SE = 3.13, P = 0.036) were associated with lower health literacy.

Conclusion:

The findings of this study highlight the importance of using appropriate strategies for promoting the health literacy of elderly people.
The Effect of Mothers' Group Counseling on the Health-Promoting Behaviors of Adolescent Girls
Authors: Pourshamsian Monireh , Mafi Maryam , Azh Nezal
Published: November 2019

Introduction:

Promoting adolescents' healthy behaviors through different strategies is essential to prevent the risks of adulthood chronic problems. This study aimed to investigate the effect of mothers' group counseling on the health-promoting behaviors of high school adolescent girls in Qazvin city, Iran.

Methods:

This single-blind, randomized controlled trial was conducted in Qazvin, Iran. Participants were 100 guidance school female students and their mothers who were selected through multistage random sampling. The demographic data form and Health Promoting Lifestyle Profile were used for data collection before and 2 months after the intervention. The intervention was conducted in four sessions lasting for 90–60 min.

Results:

There was no improvement in the mean score of health-promoting behaviors before the intervention in the control group (27 ± 20.313) and the intervention group (23.54 ± 138.86), but after the intervention in the intervention group, a significant improvement was observed with a mean difference of 12.90 in the intervention group whereas 5.26 in the control group. The highest increase was in stress and nutrition control with a mean difference of 3.06 and 2.74, respectively. The ANCOVA test also confirmed the effectiveness of education (P = 0.03, F = 4.43).

Conclusion:

Mothers' group counseling can improve adolescent health-promoting behaviors. Considering the importance of the role of mothers in protecting and promoting the health of adolescent girls, it is essential that maternal education and counseling are prioritized to increase the healthy behaviors of adolescent girls.
The Herth Hope Index
Authors: Soleimani Mohammad Ali , Allen Kelly A. , Herth Kaye A. , Sharif Saeed Pahlevan
Published: November 2019

Introduction:

The objective of this study was to examine the psychometric characteristics of the Persian version of the Herth Hope Index (HHI-Persian version) within a sample of Iranian patients with heart disease (HD).

Methods:

The present research used a clinical sample of HD patients hospitalized in a medical institution in Qazvin, Iran. A total of 500 patients were selected via convenience sampling method and were divided into two subsamples to test for exploratory factor analysis (EFA) (n = 250) and confirmatory factor analysis (CFA) (n = 250) separately. Construct validity of the HHI-Persian version was evaluated using EFA and CFA. The reliability of the HHI-Persian version was first assessed using internal consistency (i.e., Cronbach's alpha) and construct reliability.

Results:

Exploratory factor analysis with varimax rotation revealed that the index had a one factor consisting of 11 items (eigenvalue = 4.784) which explained 38.309% of the total variance. The results showed that the single factor consisting of 11 items has a good fit (χ
2 [42, n = 250] = 107.242,P < 0.001; χ
2/df = 2.553, adjusted goodness-of-fit index [GFI] = 0.889, GFI = 0.929, comparative fit index = 0.938, normed fit index = 0.903, Tucker–Lewis Index = 0.918, incremental fit index = 0.918, and root mean square error of approximation = 0.079 [90% confidence interval = 0.079 (0.061–0.098)]). Cronbach's alpha and construct reliability were 0.856 and 0.878, respectively, which indicates the good reliability of the HHI.

Conclusion:

The findings demonstrated that the HHI-Persian version is a valid and reliable instrument that has potential utility in future research.
Impact of Family Psychoeducation on Hospitalization and Relapse of Bipolar Disorder in Patients with Mixed and Manic Episodes
Authors: Zamir Mohsen , Javani Marzieh , Soleimannejad Maryam
Published: November 2019

Introduction:

Bipolar disorder (BD) is a disabling psychiatric disorder with frequent recurrences. Less than half of the patients with BD show good long-term response to treatment. Apart from pharmacotherapy, psychoeducation may be effective in reducing the symptoms and recurrence of BD, leading to improvements in patients' quality of life. In this study, we examined the effect of family psychoeducation on relapse rate and length of hospital stay in patients with BDs.

Methods:

This randomized controlled clinical trial (ethical committee number; IR.QUMS.REC.1394.136) was performed on 64 patients with BD at 22 Bahman Hospital of Qazvin, Iran. The patients were allocated into the following two groups: intervention and control groups. The patients in the control group received standard medical treatment, whereas those in the intervention group received 4 weekly sessions of family group psychoeducation, in addition to medical treatment. The patients were evaluated using the Beck Depression Inventory Rating Scale and the Young Mania Rating Scale. The recurrence rate, disease severity, and quality of life in both groups were evaluated. The intervention and control groups were followed up for 9 months regarding recurrence and hospitalization, and the results were compared between the groups.

Results:

Data analysis showed a reduction in the frequency and duration of hospitalization in the group receiving family psychoeducation and was dependent on the patient's level of education, place of residence (town/village), duration of illness, and frequency of hospitalization before the intervention.

Conclusion:

In addition to pharmacotherapy, family psychoeducation can have an enormous impact on patients with BDs and limit or decrease the risk of recurrence.
Effect of Peer Education on Physical Activity and Nutrition among Iranian Adolescents
Authors: Damghanian Ali , Sharietpanahi Gazal , Khieltash Azita , Barahimi Hamid
Published: November 2019

Introduction:

Due to the high prevalence of sedentary lifestyle and inappropriate nutrition among adolescents, the present study aimed to investigate the effect of peer-based education on physical activity and nutrition among adolescents.

Methods:

In a randomized field trial with control group, a total of 223 students with a mean age of 16.52 (0.9) years participated in the study. Students were randomly selected from four high schools of Tehran's 17th district, Iran, using the multistage clustered sampling method. Two females and two males high schools were randomly assigned as an intervention or a control group. After selecting peer educators, they were educated about nutrition and physical activity at two 90-min sessions. Then, peer educators were asked to educate their classmates. Data were collected using demographic, nutrition, and physical activity subscales of Health Promoting Lifestyle Profile-II before and 3 months after the intervention. Data were analyzed using analysis of covariance in SPSS version 24 (IBM Corp., Armonk, New York). Results: Peer-based education improved girl's physical activity mean scores (16.19 ± 4.07–19.74 ± 4.25, P > 0.001), but no statistically significant effect on their nutrition. No statistically significant effect was observed after intervention on the nutritional status and physical activity of the male students.

Conclusion:

Peer education seemed to be a good method to improve physical activity among female students, but not their nutrition. In addition, physical activity and nutrition of male students were not improved by the peer education. Therefore, the future research using multidisciplinary approach which targets family involvement, and changes in physical activity and school nutrition policies are needed.
The Association between Religious Belief and Drug Adherence Mediated by Religious Coping in Patients with Mental Disorders
Authors: Movahedizadeh Mohadeseh , Sheikhi Mohammad Reza , Shahsavari Saeed , Chen Hui
Published: November 2019

Introduction:

Adherence to drug regimen is an important factor in the treatment of patients with mental disorders. In some studies, religious beliefs have been shown to be effective for treatment adherence. This study aimed to investigate the association between religious beliefs and adherence to the medication regimen mediated by religious coping in patients with mental disorders.

Methods:

In this cross-sectional study, 164 patients with mental disorders were selected through convenient sampling from educational centers in Qazvin city. Data were collected using a demographic questionnaire, March Drug Adherence Questionnaire, Santaklara's Religious Faithfulness questionnaire, and Pargament Religious Coping questionnaire. Data were expressed as mean ± standard deviation and analyzed using descriptive and inferential statistics.

Results:

The mean age of the patients was 38.87 ± 14.42 years. The mean duration of the disease was 5.71 ± 5.78 years. The mean of the religious belief score was 30.90 ± 5.96, the mean of the negative religious coping score was 2.17 ± 2.94, and the mean of positive religious coping score was 6.83 ± 4.69. There was a significant positive correlation between religious beliefs, adherence to medication regimen, and positive religious coping. There was a significant negative correlation between religious beliefs, adherence to medication regimen, and negative religious coping.

Conclusion:

There was a significant positive correlation between religious beliefs and adherence to medication regimen in patients with mental disorders. Religious beliefs were directly associated with positive religious coping, and adherence to medication regimen was indirectly associated with negative religious confrontation.
SAE J2450 Supplemental Training Document
Authors:   Vehicle E E System Diagnostic Standards Committee
Published: November 2019

This supplement, which is a living document, is meant to provide both clients and translation suppliers with some suggestions for integrating SAE J2450 into their business practices. It is intended for the use of clients, trainers who wish to develop new evaluators, and those who wish to self-train.
DILEMAS NA TERRITORIALIDADE CAIÇARA: TURISMO, CIDADANIA E CONSUMO
Authors: Huertas Calvente Maria del Carmen Matilde
Published: November 2019

Na contemporaneidade, as rápidas transformações do capitalismo volátil destroem as referências territoriais das populações nativas e constrói multiterritorialidades fragmentadas que podem trazer a exclusão territorial. Com a desterritorialização, os grupos ficam impossibilitados de construir e exercer controle efetivo sobre seus territórios (tanto nas formas de dominação político-econômica quanto de apropriação simbólica-cultural). O texto compara, no aspecto da territorialidade, uma população caiçara, após 20 anos de uma primeira pesquisa científica que observou o primórdio da turistificação do lugar. Constatou-se que, nas mais recentes venda das posses de terras (pelo processo de turistificação) que ocorreram no recorte espacial analisado (Ilhabela, São Paulo, Brasil) o mecanismo sutil do desejo de consumo, consumo mostrado como necessário pelos meios de comunicação, substitui o que antes ocorria via violência explícita. Entender como este processo funciona hoje ajuda a entender mecanismos do processo de desterritorialização e, principalmente, a importância de políticas públicas e outros projetos que apoiem ações coletivas de populações tradicionais.
O USO DA LEGISLAÇÃO AMBIENTAL NA RESTAURAÇÃO DA CONECTIVIDADE ESTRUTURAL DA PAISAGEM: UM ESTUDO DE CASO PARA A BACIA HIDROGRÁFICA DO CORRÉGO DAS POSSES, EXTREMA-MG
Authors: De Azevedo Thiago Salomão
Published: November 2019

No Brasil, a estratégia governamental para garantir o uso sustentado dos recursos naturais em propriedades privadas está baseada na adoção de medidas de comando e controle estabelecidas pelo Código Florestal, sob a forma de Áreas de Preservação Permanente (APP). Considerando esta premissa, o objetivo principal deste trabalho foi verificar se, com o cumprimento da legislação ambiental brasileira estabelecida no Código Florestal, com referência as APP’s, é possível restabelecer a conectividade estrutural da paisagem, tomando como exemplo a bacia do córrego das Posses, localizada no município de Extrema-MG. A metodologia empregada neste trabalho foi embasada no estabelecimento de critérios que fundamentaram a localização das áreas prioritárias de APP’s. Através da utilização de geotecnologias tais critérios foram espacializados, originando cenários que mostram o grau de degradação da paisagem. Os resultados mostraram que, nas Áreas de Preservação Permanente, a legislação ambiental não está sendo cumprida. Entretanto, para a bacia das Posses, a regularização das propriedades com relação ao Código Florestal não é suficiente para manter a conectividade da paisagem, pois ainda assim a área de matas não atinge o limite mínimo exigido para que a mesma percole.
INFLUÊNCIA DO MANEJO AGRÍCOLA NA SUSCETIBILIDADE DOS SOLOS À EROSÃO NA SUB-BACIA HIDROGRÁFICA DO RIO SÃO ROMÃO, NOVA FRIBURGO/RJ.
Authors: Brizzi Raphael Rodrigues , Souza Andrea Paula de , Costa Alexander Josef Sá Tobias da
Published: November 2019

O avanço da pastagem e agricultura sobre a Mata Atlântica, turismo, loteamentos, e o manejo inadequado, cada vez mais colaboram para a degradação dos solos na APA de Macaé de Cima, em Nova Friburgo – RJ. O estudo visa à compreensão de parâmetros erosivos em diferentes usos do solo, tais como floresta-pastagem-cultivo, nas profundidades de 0-10 e 10-20 cm, sendo avaliados a distribuição granulométrica, densidade aparente, densidade das partículas, microporosidade, macroporosidade e porosidade total, carbono orgânico e pH. Os resultados ratificam diversas pesquisas desenvolvidas na relação do uso do solo com a erosão e demostram ser as áreas de pastagem e cultivo as mais degradadas, sendo necessário o fortalecimento do plano de manejo da APA. Assim, destaca-se a importância da floresta na estruturação dos solos frente ao desenvolvimento de processos erosivos, em que as atividades antrópicas na região potencializam a fragilidade inerente ao sistema avaliado, ocasionando a mudança da paisagem.
TERRITÓRIOS RELIGIOSOS: ESTRATÉGIAS ESPACIAIS DAS IGREJAS CATÓLICA, DEUS É AMOR E UNIVERSAL DO REINO DE DEUS EM BELO HORIZONTE
Authors: Palhares Ricardo Henrique , Diniz Alexandre Magno Alves
Published: November 2019

A religiosidade, sua organização e apropriação do espaço de Belo Horizonte e as estratégias locacionais por detrás da distribuição espacial dos templos são as inquietações que norteiam esta pesquisa. Ao nos aproximarmos pragmaticamente do objeto escolhido, percebemos no espaço da capital mineira uma tendência da hegemonia católica. Por outro lado, é cada vez maior o número das comunidades evangélicas, configurando uma disputa do território religioso, principalmente da vertente pentecostal, como as Igrejas Deus é Amor e Universal do Reino de Deus. Essas denominações religiosas apresentam lógicas espaciais diferentes no contexto da metrópole, adotando estratégias locacionais distintas na distribuição espacial dos templos, evidenciando uma forte disputa pelo controle do território.
REFLEXÕES E ANÁLISE SOBRE O PROCESSO DE PRECARIZAÇÃO DO TRABALHO NA CONTEMPORANEIDADE
Authors: Salvador Diego Salomão Candido de Oliveira
Published: November 2019

Tendo em vista o fato de a urbanização do Rio Grande do Norte, especificamente do eixo rodoviário Natal-Caicó, estar sendo alicerçada na expansão da pobreza e na precarização do trabalho, refletimos sobre o processo de precarização do trabalho na contemporaneidade, analisando a existência desse processo no território potiguar e no eixo Natal-Caicó. A análise que realizamos evidencia que vem ocorrendo geração de empregos, mas falta qualidade a esses empregos, tendo-se em vista que eles nem sempre garantem direitos sociais aos trabalhadores empregados, remuneram mal a maioria deles, são efêmeros quanto ao tempo em que os trabalhadores permanecem empregados e determinam dedicação quase exclusiva no decorrer da semana. Além disso, a quantidade de empregos gerados não atende à demanda total por trabalho da população economicamente ativa. Destarte, há muitos trabalhadores desempregados, sendo que alguns nunca estiveram empregados, já ingressando no mercado de trabalho por meio de ocupações da economia não hegemônica.

Palavras-chave: Precarização do Trabalho. Rio Grande do Norte. Eixo rodoviário Natal-Caicó.
CIRCUITO DE PRODUÇÃO DA LARANJA NO BRASIL: DO CULTIVO AOS PRODUTOS INDUSTRIAIS DESTINADOS PRINCIPALMENTE AO MERCADO INTERNACIONAL
Authors: Mergulhão Amanda Duarte
Published: November 2019

Alguns produtos agropecuários como carnes, soja e café estão entre os principais exportados pelo Brasil. Parte do circuito de produção destes produtos acontece em território brasileiro uma vez que a industrialização normalmente é feita em outros países. O Brasil também tem papel de destaque no comércio mundial de suco de laranja o que estimula este estudo com o objetivo destacar as peculiaridades do circuito de produção da laranja. A maior parte da produção do fruto é destinada a industrialização no estado de São Paulo e o suco vai para venda no mercado internacional. Além disso, as laranjas provêm de produtores comprometidos em direcionar a colheita a grandes grupos industriais específicos que acompanham todas as etapas do cultivo, industrialização e comercialização. As decisões de produção são influenciadas pela variação dos estoques dos sucos, capacidade de processamento da indústria e quantidade de frutos a qual é determinada pelas condições climáticas mundiais.
SUSCETIBILIDADE A ESCORREGAMENTOS E RISCO DE QUEDA DE BLOCOS NO GEOSSÍTIO COLINA DO HORTO, JUAZEIRO DO NORTE/CE
Authors: Sousa Sinara Gomes de , Silva Maria Luísa Gomes da , Pereira Thaís Mara Souza , Barbosa Manuella Pontes , Listo Fabrizio de Luiz Rosito
Published: November 2019

Neste trabalho buscou-se identificar áreas suscetíveis a ocorrência de movimentos de massa, enfatizando as tipologias de escorregamentos translacionais e queda de blocos no perímetro de abrangência do Geossítio Colina do Horto, município de Juazeiro do Norte, estado do Ceará. Para tal proposta, foi gerado um mapa de suscetibilidade a partir do modelo matemático SHALSTAB, tido como o modelo de previsão determinístico, além de atividades em campo para identificar e registrar pontos de ocorrência de quedas de blocos. O modelo previu suscetibilidade média a baixa para a ocorrência de escorregamentos translacionais devido a incipiência do manto de intemperismo. Quanto as quedas de blocos, constatou-se que a sua ocorrência se dá através de fatores como: declividade em torno de 75%; predominância do intemperismo físico e biológico na abertura de fraturas no pacote rochoso; ação antrópica por meio de cortes no talude para construções de prédios residenciais, comerciais, e vias de acesso.
PUBLICIZAÇÃO DOS PLANOS MUNICIPAIS E INTERMUNICIPAIS DE RESÍDUOS SÓLIDOS DO ESTADO DE SÃO PAULO
Authors: Borges Ana Claudia Giannini , Pupin Patricia Lopes Freire , Britto Marcel
Published: November 2019

A Política Nacional de Resíduos Sólidos – PNRS (Lei nº 12.305/2010) estabelece a responsabilidade dos municípios quanto à elaboração, execução e publicização do Plano Municipal de Gestão Integrada de Resíduos Sólidos e/ou Plano Intermunicipal de Resíduos Sólidos. Assim, o objetivo é identificar e analisar o acesso aos referidos Planos Municipais do estado de São Paulo. Importa considerar que a Lei nº 12.527/2011 estabelece o acesso à informação pública como regra, bem como o Estatuto da Cidade (Lei nº 10.257/2001) traz como diretriz a gestão democrática e participação da população na política urbana (incluindo os planos municipais). Após revisão bibliográfica e coleta de dados (sites, e-mail e ligação telefônica), identificou-se que há municípios que não apresentam as informações dos Planos nos órgãos competentes. Isto dificulta a publicização das informações em bancos de dados do governo, assim como o controle social estabelecido pela PNRS, logo, em franca violação das leis de regência.
COMPORTAMENTO HIDROSSEDIMENTOLÓGICO DE BACIA HIDROGRÁFICA COM RESERVATÓRIO
Authors: ZANIN Paulo Rodrigo , BONUMÁ Nadia Bernardi , FRANCO Davide
Published: November 2019

O represamento hídrico altera a hidrodinâmica do escoamento fluvial e dos processos de transporte e deposição de sedimentos. O presente trabalho tem por objetivo amostrar e analisar o comportamento de sedimentos suspensos em uma bacia hidrográfica de 5ª ordem fluvial, que possui um reservatório d'água em seu exutório. Foram realizadas 20 campanhas de amostragem de sedimentos em suspensão, de 2 a 3 metros a montante da barragem, em quatro profundidades da coluna d´água. Para amostrar a mistura água-sedimentos da descarga do reservatório foi utilizado um novo amostrador de sedimentos em suspensão, assim como um novo método de amostragem, dimensionalisados para esta represa. Os resultados do monitoramento mostraram que a concentração de sedimentos suspensos perto do fundo do reservatório é maior do que na superfície do mesmo, sendo que a amostragem do dia 05/09/14 indicou a ocorrência de correntes de turbidez de fundo. A análise estatística dos dados mostra que o sedimento em suspensão não responde rápidamente aos eventos de precipitação, havendo um retardo entre o pico da vazão e os valores máximos da descarga de sedimentos do reservatório. Com esta análise foram identificados dois processos hidrossedimentológicos reponsáveis pela descarga sólida desta represa. No entanto, somente um destes processos foi totalmente caracterizado, o qual é desencadeado pela chuva diária ocorrida entre o atraso temporal de 1 a 2 dias, gerando incremento de água e sedimentos na vazão com atraso de 1 dia, determinando parte da concentração de sedimentos na vazão do dia da amostragem. Já o outro processo, referente a vazão com atraso de 2 dias, que possui maior determinação nos sedimentos suspensos do dia da amostragem, ainda carece de uma maior amostragem espaço/temporal de precipitação e sedimentos suspensos para caracterização de sua gênese, podendo ser devido ao fenômeno de histerese.
A AVALIAÇÃO DA GERAÇÃO DE SEDIMENTOS AO LONGO DA BACIA HIDROGRÁFICA DO RIBEIRÃO DO CARMO. POTENCIAL NATURAL DE EROSÃO, FEIÇÕES MORFOLÓGICAS E CICATRIZES DE MOVIMENTOS DE MASSA.
Authors: Souza Leonardo Andrade de , Sobreira Frederico Garcia
Published: November 2019

A dinâmica da geração e transporte de sedimentos superficiais em uma área urbanizada difere significativamente da mesma dinâmica para áreas rurais, o que torna a sua análise uma tarefa complexa por envolver necessariamente inúmeros fatores de ordem física, meteorológica e antrópica. A Bacia Hidrográfica do Ribeirão do Carmo (BHRC) está localizada nos municípios de Ouro Preto e Mariana, tendo uma área é de 351,60 km2 e um perímetro de 139,22 km. A abordagem realizada teve como pressuposto a elaboração da carta de suscetibilidade a erosão natural, a partir da aplicação da Equação Universal de Perda do Solo (EUPS), para a predição da média anual de perda de solo causada pela erosão laminar, somado à identificação do maior número possível de fontes geradoras de sedimentos (feições morfológicas e cicatrizes de movimentos de massa) ao longo de toda a bacia. Os estudos

relacionados ao entendimento da transformação do meio físico ganham importância à medida que podem auxiliar em uma gestão

ambiental sustentável, sendo para tal necessário correlacionar o diagnóstico do meio físico, com o modelo de desenvolvimento

vigente, apontando tanto os aspectos falhos no planejamento e gestão dos recursos, quanto diretrizes para uma adequada ocupação do solo urbano e rural.

Palavras-chave: Suscetibilidade, Erosão, Ordenamento Territorial.
VARIABILIDADE ESPACIAL DE ATRIBUTOS FÍSICOS DO SOLO EM UMA SUB-BACIA ÀS MARGENS DO RIO MOGI GUAÇU (SP)
Authors: Klinke Neto Gustavo , Oliveira Anna Hoffmann , Pereira Sueli Yoshinaga
Published: November 2019

A espacialização dos atributos do solo é de grande importância na interpretação geográfica da paisagem especialmente quando o foco desejado são as questões hidrogeológicas acerca da capacidade de infiltração da água no solo, sendo a condutividade hidráulica seu indicador direto. Assim, este trabalho buscou verificar a existência de dependência espacial para as variáveis areia, argila, silte, densidade, micro e macro porosidade, volume total de poros e condutividade hidráulica, bem como analisar sua variabilidade e sua espacialização através da Krigagem Ordinária. O estudo foi conduzido em área de planície aluvial, adjacente ao Rio Mogi Guaçu. Os resultados encontrados confirmaram a relação de dependência espacial de todos os atributos analisados na escala pesquisada e revelaram a anisotropia dos atributos condutividade hidráulica, macroporosidade e volume total de poros. Todos os atributos obtiveram seus melhores ajustes no modelo esférico. A relação direta entre macroprorosidade e condutividade hidráulica também foi verificada nas amostras coletadas, colocando a macroporosidade como um bom indicador da capacidade de infiltração em campo.