bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-operative functional neurological symptom disorder after anesthesia
Authors: D'Souza Ryan S , Vogt Matthew NP , Rho Edwin
Published: February 2020

A rare manifestation during the post-anesthetic period may include the occurrence of functional neurological symptom disorder (FNSD). FNSD is described as neurological symptoms that are not consistently explained by neurological or medical conditions. We report a case series consisting of six patients who underwent a general anesthetic at a tertiary referral hospital and experienced FNSD in the immediate post-anesthetic period. Life-threatening causes were excluded based on benign physical exam findings and knowledge of past history. Five of six cases manifested with FNSD only in the immediate post-operative setting after exposure to anesthesia, and never otherwise experienced these symptoms during their normal daily lives. MEDLINE and Google Scholar were searched through October 2019 using a highly-sensitive search strategy and identified 38 published cases of post-anesthetic FNSD. Meta-analysis of pooled clinical data revealed that a significant proportion of patients were females (86%), reported a history of psychiatric illness (49%), reported a prior history of FNSD (53%), and underwent general anesthesia as the primary anesthetic (93%). The majority of patients were exposed to diagnostic studies (66% received radiographic tests and 52% received electroencephalogram) as well as pharmacologic therapy (57%). While no deaths occurred, many patients had unanticipated admission to the hospital (53%) or to the intensive care unit (25%). These data may help inform the anesthesia literature on presentation, risk factors, and treatment outcomes of FNSD in the context of anesthetic administration. We contemplate whether anesthetic agents may predispose a vulnerable brain to manifest with involuntary motor and sensory control seen in FNSD.
Testing repetitive tDCS on daily smoking behaviour: A placebo controlled EMA study v1
Authors: Verveer Ilse , Remmerswaal Danielle , Jongerling Joran , M. van der Veen Frederik , H. A. Franken Ingmar
Published: February 2020

The aim of the study was to explore the effects of repetitive tDCS on smoking behaviour by means of ecological momentary assessments (EMA) in a sample of ad libitum smokers Participants recruited for this study were smokers between the age of 18 and 65 years who smoked 10 cigarettes or more a day and who had the ability to speak, read, and write in Dutch. Exclusion criteria were: 1) Current substance use disorder of a substance other than nicotine or caffeine; 2) History of neurological or psychiatric disorders; 3) Any contraindication for electrical brain stimulation procedures (i.e. electronic implants or metal implants); 4) Pregnancy or breast-feeding; 5) Intentions to actively try to quit smoking in the next three months. Participants were recruited via advertisement at Erasmus University Rotterdam from October 2016 until March 2018 and received either course credit or a financial compensation of 20 euro The current study employed a double-blind, randomized, sham-controlled design in which subjects received a total of six tDCS sessions (active or sham) on three days in one week with at least one day in between. Participants were first randomly assigned to either sham or active tDCS. Then, before the tDCS sessions and at three months follow-up, participants completed the Fagerström Test of Nicotine Dependence (FTND; [28]). Breath carbon monoxide concentrations were also measured using a Micro+ Smokerlyzer (Bedfont Scientific Ltd., Rochester, UK) to objectively define smoking. To measure changes in smoking behaviour, participants were asked to keep track of their cigarette consumption, craving and affect in an application on their mobile phones (EMA). Questions in the application were presented at four random times a day for three weeks in total (random assessments; RA’s), starting the week before the first tDCS session. After three months, participants were asked to fill out the same four-time daily random assessments for one more week. In addition, participants were asked to start a session every time they smoked a cigarette (user-initiated smoking assessment; SA) for three months in total. An ‘end of the day’ assessment (EA) was also implemented for three months, which asked participants to fill out the total number of smoked cigarettes of that day.
Transhumanismo: Un giro de tuerca a la pregunta por la técnica de Heidegger
Authors: Muñoz González Diana María
Published: February 2020

El llamado transhumanismo es un proyecto antropotécnico que pretende aumentar las facultades físicas y cognitivas del ser humano mediante el empleo intensivo de las nuevas tecnologías. No obstante, examinado bajo la lente del pensamiento de Heidegger tal proyecto confirma la idea del filósofo alemán de que la técnica moderna es un dispositivo ontológico en el que la totalidad de los entes es emplazada como existencias o recursos explotables. Así pues, en un primer momento el artículo se sirve de la reflexión heideggeriana sobre la técnica para exhibir el peligro de deshumanización que envuelve al proyecto transhumanista. En un segundo momento, en cambio, se pone al descubierto la limitación de su pensamiento para salir al paso de manera aún más eficaz frente al peligro del transhumanismo al rehusarse a afirmar el carácter esencialmente viviente del ser humano.
Análisis de la carga fiscal asociada al impuesto de renta sobre asalariados en Colombia, 1989 a 2018
Authors: Farfán-Rodríguez Juliana Carolina , Duque-Correa Maribel , Orrego-Cárdenas María del-Socorro , Sossa-Uribe Sandra Milena
Published: February 2020

Con el Decreto 649 de 1989 se establece el Estatuto Tributario Nacional, desde entonces al 2018 se implementaron quince reformas tributarias, modificando las condiciones de depuración de la base gravable para la determinación del impuesto de renta, esto implica alteraciones en la carga fiscal soportada por los contribuyentes. Este artículo permite evidenciar los resultados del análisis normativo de los cambios en la carga fiscal del impuesto para los Asalariados durante el período de tiempo establecido, en relación a posibles afectaciones sobre decisiones de consumo, ahorro e inversión; así como los principios de equidad horizontal, vertical, progresividad, proporcionalidad o regresividad de los cambios en las tarifas; es decir, los efectos redistributivos que originaron los diversos cambios normativos. La metodología a utilizar será el análisis mixto, sobre las normas tributarias e información reportada por la DIAN para el periodo de estudio sobre las declaraciones de renta de las personas naturales.
El pensamiento narrativo aplicado al conocimiento y a la identidad. Análisis de los resultados de la escala de Educación e Identidad Narrativa en estudiantes de España, Corea del Sur y Ecuador
Authors: Sevilla Vallejo Santiago
Published: February 2020

Este estudio plantea el valor de la narración para la formación educativa e identitaria del alumnado universitario. El objetivo es conocer en qué medida los alumnos perciben esto a través de la escala Educación e Identidad Narrativa. Para ello, se comparan los resultados obtenidos por alumnos de España, Corea del Sur y Ecuador que cursan sus estudios en español. Estos muestran una actitud positiva y señalan la necesidad de seguir trabajando en la aplicación de los textos narrativos y en la competencia escrita.
El cuento en lengua materna como elemento facilitador
Authors: Sánchez Morillas Carmen María , Sevilla Vallejo Santiago
Published: February 2020

En el primer ciclo de Educación Infantil, una de las tareas docentes, en lengua materna, es facilitar el desarrollo de la competencia comunicativa, así como el entrenamiento de la expresión oral. El maestro, en su tarea educativa diaria, acude al diseño de actividades que aúnen, desde el currículo, lo literario, lo cultural y lo emocional. Una de las primeras vías para lograrlo es trabajar por medio del cuento; para ello es necesario que el docente esté lo suficientemente entrenado para llevar a cabo sus objetivos. No solo se trata de leer un cuento, sino saber cómo trabajarlo con niños pequeños. Ante este caso, en nuestra investigación pretendemos exponer los resultados de una experiencia piloto, llevada a cabo con 65 alumnos de Magisterio de Educación Infantil, en la Universidad de Granada, durante el curso académico de 2017-2018, en la asignatura de “Didáctica de la Lengua y la Literatura Infantil”.
Leer y sentir: la educación emocional y literaria en educación infantil
Authors: Montijano Serrano Belén
Published: February 2020

El interés por la adquisición y desarrollo de la educación emocional a través de la lectura literaria se ha incrementado en las últimas décadas. Prueba de ello es la variedad de investigaciones y estudios que reivindican el papel indiscutible de la competencia emocional en el marco de una formación integral de los niños y jóvenes. El objetivo de este trabajo es ofrecer una propuesta metodológica para la adquisición y desarrollo de la educación emocional a través de la lectura literaria en la etapa de educación infantil. Primero, se revisan los principales modelos de inteligencia emocional que sirven de base para la conceptualización de la educación emocional en el contexto educativo; segundo, se explican los agentes emocionales que intervienen en las fases de la propuesta (mediador-profesor, lector-alumno y texto); y, por último, se realiza una reflexión sobre aspectos de interés relacionados con esta temática.
Interest Groups in Multi-Level Contexts: European Integration as Cross-Cutting Issue in Party-Interest Group Contacts
Authors: Berkhout Joost , Hanegraaff Marcel , Statsch Patrick
Published: February 2020

Policy-specific actor-constellations consisting of party- and group-representatives commonly drive the effective establishment of new policy programmes or changes in existing policies. In the EU multi-level system, the creation of such constellations is complicated because it practically requires consensus on two dimensions: the European public policy at stake and the issue of European integration. This means that, for interest groups with interests in particular policy domains, and with limited interest in the actual issue of European integration, non-Eurosceptic parties must be their main ally in their policy battles. We hypothesise that interest groups with relevant European domain-specific interests will ally with non-Eurosceptic parties, whereas interest groups whose interests are hardly affected by the European policy process will have party-political allies across the full range of positions on European integration. We assess this argument on the basis of an elite-survey of interest group leaders and study group-party dyads in several European countries (i.e., Belgium, Lithuania, Italy, Netherlands, Poland, and Slovenia) in a large number of policy domains. Our dependent variable is the group-party dyad and the main independent variables are the European policy interests of the group and the level of Euroscepticism of the party. We broadly find support for our hypotheses. The findings of our study speak to the debate concerning the implications of the politicisation of European integration and, more specifically, the way in which party-political polarisation of Europe may divide domestic interest group systems and potentially drive group and party systems apart.
The EU Multi-Level System and the Europeanization of Domestic Blame Games
Authors: Heinkelmann-Wild Tim , Kriegmair Lisa , Rittberger Berthold
Published: February 2020

Blame games between governing and opposition parties are a characteristic feature of domestic politics. In the EU, policymaking authority is shared among multiple actors across different levels of governance. How does EU integration affect the dynamics of domestic blame games? Drawing on the literatures on EU politicisation and blame attribution in multi-level governance systems, we derive expectations about the direction and frequency of blame attributions in a Europeanized setting. We argue, first, that differences in the direction and frequency of blame attributions by governing and opposition parties are shaped by their diverging baseline preferences as blame avoiders and blame generators; secondly, we posit that differences in blame attributions across Europeanized policies are shaped by variation in political authority structures, which incentivize certain attributions while constraining others. We hypothesize, inter alia, that blame games are “Europeanized” primarily by governing parties and when policy-implementing authority rests with EU-level actors. We test our theoretical expectations by analysing parliamentary debates on EU asylum system policy and EU border control policy in Austria and Germany.
YOUNG UKRAINIANS’ ACCUSATIONS TOWARD THE PARTICIPANTS OF SOCIAL AND POLITICAL LIFE UNDER THE INFLUENCE OF GENERATIONAL IDENTITY
Authors: Vasiutynskyi V. O.
Published: February 2020

The course of political processes in contemporary Ukrainian society is strongly influenced by experiencing and evaluation of historical and actual guilt by different groups of the population. The corresponding problems affect the state and development of the public consciousness, in particular the consciousness of the youth. The purpose of this article is to identify the features of accusation for the problems in Ukrainian society made by Ukrainian students, depending on their subjective identification with different generations of fellow citizens. According to the survey of 120 Kyiv students, they are quite active in accusing the Ukrainian authorities, the oligarchs and the mafia, Russia as an aggressor, pro-Russian forces in Ukraine, communists, and older generations. The psychological structure of accusations includes attention to the Ukrainian-Russian confrontation, intra-Ukrainian political disagreements, the differences between ordinary and elite groups of the population, and work of the authorities. According to estimates, which respondents gave “on behalf” of different generations, they themselves accuse Russia, the Russian authorities and Russians in a less extent that their peers and older generations. In their opinion, the accusations toward the Soviet ideology weaken with age. The same can be said about the assessment of the President Poroshenko’s faults.
There are differences recorded depending on the respondents’ identification with peers or the generation of their parents. “On behalf” of peers, the respondents estimated relatively higher in the guilt of the older generation and lower the faults of the Communists. “On behalf” of their parents, the respondents accused more strongly the law enforcement agencies; and “on behalf of” their grandfathers, they accused the previous government led by Yanukovych and the residents of Crimea and Donbas.
Lecciones de Portugal / Lessons from Portugal
Authors: Fernández García Aladino
Published: February 2020

Este breve trabajo de investigación es un ejercicio de síntesis geográfica concebido como una actividad de extensión universitaria desde el aula Casa de La Buelga, dependiente de la Universidad de Oviedo. Es decir, fue utilizado para la realización de un itinerario cultural por cuatro ciudades del norte de Portugal. Su objetivo principal es el de mostrar los excepcionales paisajes urbanos de Oporto, Guimarães, Braga y Valençado Minho sobre la base de sus nodos componentes: romanos, medievales, modernos y contemporáneos.Ce brief travail de recherche, qui est, d’ailleurs un exemple de géographie de synthèse, a été conçu comme un exerciced’extension universitaire du centre Casa de La Buelga. Ce document a été utilisé pour la mise au point d’un itinéraire culturel a travers quatre villes du nord du Portugal, dont le but principal est de montrer les exceptionnels paysages urbains de Porto, Guimarães, Braga y Valença do Minho basés sur les parties principales de ces villes: romaines, médiévales, modernes et contemporaines.This short research paper, an example of syntheticalGeography, was conceived for the development of a universityextension exercise by the Casa de la Buelga Extension Classroom. Namely, it was used to conduct a four-city cultural itinerary through Northern Portugal. Its main aim is to show the outstanding urban landscapes of Porto, Guimaraes, Braga and Valença do Minho based on the main parts of these cities: roman, medieval, modern and contemporary.
Prácticas de liderazgo de los directores noveles para la inclusión educativa
Authors: Leiva Guerrero María Verónica , Gairin Sallán Joaquín , Guerra San Martín Sebastían
Published: February 2020

Este artículo se enmarca en una investigación mayor, proyecto Fondecyt que refiere a cómo los directores que están ejerciendo el cargopor primera vez dan respuesta a las necesidades derivadas de la inclusión educativa en sus centros escolares. Para ello, se realizó unestudio de Casos Múltiples, de tipo transversal, con aplicación de una entrevista en profundidad a 9 directores nóveles de centrosescolares municipales de la región de Valparaíso. Los resultados indican que las prácticas de liderazgo inclusivo se sitúan en cuatrodimensiones: rediseño de la organización con foco en lo inclusivo, desarrollo profesional inclusivo, atención a los aprendizajes diversose instalación de una cultura inclusiva. Siendo la dimensión rediseño de organización, con foco en lo inclusivo, la que presentó mayorpresencia. Para estos directores nóveles, tiene gran importancia poseer un clima laboral que permita la cohesión de las percepciones delos miembros de la comunidad escolar, respecto de su trabajo y rol social institucional.Palabras Clave: Liderazgo, inclusión, director, novel, prácticas.
El futuro de la Universidad y la Universidad del Futuro. Ecosistemas de formación continua para una sociedad de aprendizaje y enseñanza sostenible y responsable
Authors: Álvarez-Arregui Emilio , Arreguit Xavier
Published: February 2020

La Sociedad actual se caracteriza por su carácter complejo, interdependiente, dinámico e informacional en la que concurren personas físicas y personas jurídicas que se integran en un medio ambiente político, social, económico, ecológico, físico-finito y con recursos limitados. En este contexto se van consolidando temporalmente y de manera interdependiente distintas macrotendencias que aceleran los procesos de manera exponencial en todos los ámbitos lo que hace germinar nuevos modelos económicos, políticos y sociales que obligan a las personas a una adaptación permanente de sus competencias, necesarias para evitar que se generen polarizaciones, exclusiones y brechas de alfabetización insalvables.Las universidades que han sido lugares de generación y de transmisión de conocimiento deben entender, aceptar y adaptarse al contexto emergente y anticipar futuras situaciones ya que de no hacerlo sus misiones quedarán abocadas a la irrelevancia y serán desplazadas como agentes y referentes educativos. En este artículo se hace un recorrido por todas estas cuestiones y se plantea un modelo ecosistémico para la formación contextualizado a las nuevas exigencias del Espacio Europeo de Educación Superior y tiene en cuenta los principios que guían la Agenda 2030 de Desarrollo Sostenible. Estos referentes se están materializando en el Instituto de Investigación e Innovación Educativa (INIE) de la Universidad de Oviedo a través de proyectos de investigación e innovación educativa y de programas transversales de formación.
The Digital Radio Concentrator System
Authors: Moorhead Simon
Published: February 2020

A reprint of a technical paper from 1986 which details the design and development of the Digital Radio Concentrator System deployed by Telstra to provide automatic telephone services throughout outback Australia.
CONTRIBUIÇÃO PARA A CARACTERIZAÇÃO GEOLÓGICA E CLASSIFICAÇÃO GEOMECÂNICA DOS MACIÇOS ROCHOSOS NA CIDADE DE CRATEÚS-CE
Authors: De Souza Sebastião Rodrigo Cortez , Teixeira Paulo Gildânio Ferreira , De Sousa Fábio José Bezerra
Published: February 2020

O conhecimento dos maciços rochosos e terrosos em que serão implantadas obras de engenharia civil é fundamental para a elaboração de projetos coerentes dos pontos de vista técnico e econômico. Identificar a distribuição espacial dos materiais no subsolo, caracterizá-los quantos às suas propriedades e determinar o estado de tensões permite projetar obras civis mais seguras, que otimizem recursos e que gerem menos impactos ambientais. Contudo, principalmente em cidades interioranas do Estado do Ceará, um estudo tecnicamente adequado nem sempre é realizado de forma adequada e profissional. Visando amenizar essa deficiência no município de Crateús-CE, um trabalho de caracterização geomecânica foi realizado com o objetivo de mapear e classificar o contraste de estabilidade na zona urbana do município Crateús-CE. Para tal, foi utilizado o índice de qualidade de maciço (Q), detalhado nos estudos de Barton (1974). O índice Q é calculado a partir de 6 parâmetros, que são definidos através das características obtidas em diversos afloramentos rochosos distribuídos ao longo da cidade. De posse destas informações pontuais, estes dados foram inseridos em um ambiente SIG (Sistemas de Informação Geográfica) com a finalidade de se obter a interpolação das informações e assim apresentar o produto final na forma de mapas temáticos, de grande utilidade para as empresas de construção que planejem construir obras civis na zona urbana de Crateús.
Prevalencia del Streptococcus agalactiae en maternas usuarias del Hospital Militar Central. Bogotá, (Colombia) año 2010
Authors: García Daniel Alejandro , Mojica María Edith , Méndez Iván Alberto , Pachón Diana Patricia , Prieto Andrés Camilo , Santamaría Elisa Victoria , Calixto Omar Javier , Murcia Cristian Camilo , Palmera Harold
Published: February 2020

Objetivo: establecer la prevalencia del Streptococcus agalactiae en gestantes que asisten al servicio de medicina materno fetal del Hospital Militar Central en el periodo comprendido entre enero 15 de 2010 y septiembre 15 de 2010.Materiales y métodos: estudio observacional descriptivo de corte transversal en gestantes con edad gestacional entre 35 y 37,6 semanas, del Hospital Militar Central de Bogotá. Muestreo por conveniencia de 130 gestantes. Previo consentimiento informado, se realizó hisopado para la toma de muestras del introito vaginal y ampolla rectal, las cuales se incubaron durante 24 horas. Se realizó serotipificación y prueba de susceptibilidad antibiótica a los aislamientos de bilis esculina negativo y la prueba de CAMP (Christie, Atkins, Munch y Petersen) positivo. Los datos de las gestantes incluidas en el estudio, junto con los resultados de cultivo, fueron organizados en una base de datos de Excel® y posteriormente se realizó un análisis descriptivo de variables sociodemográficas y positividad para el aislamiento de S. agalactiae.Resultados: la edad materna promedio fue 28±6,76 años. De un total de 260 muestras analizadas correspondientes a las 130 gestantes, solo una muestra resultó positiva paraStreptococcus agalactiae serotipo Ia (0,38%), correspondiente a una gestante de 37 semanas procedente de Bogotá, con un perfil de susceptibilidad que manifestó resistencia a ampicilina y vancomicina, y sensibilidad a cefalotina, ceftriaxona, eritromicina y clindamicina.Conclusiones: la prevalencia reportada es baja para la población de este estudio, por esta razón es cuestionable realizar el tamizaje de rutina para el Streptococcus agalactiae a las maternas que consultan al Hospital Militar Central.
Auscultando la corrupción en la salud: definición y causas.¿Qué está en juego?
Authors: Manrique-Villanueva Lina , Eslava-Schmalbach Javier
Published: February 2020

Introducción: el deseo de recibir tratos favorables o preferenciales transgrediendo las normas y la ley origina comportamientos corruptos. El hecho de sobreponer el interés particular sobre el general incide en la sociedad, excluyendo a un porcentaje significativo de la población, que ve afectados sus derechos constitucionales. Este artículo reflexiona sobre el concepto de corrupción y revisa los actores del sistema de salud en Colombia, invitando a una mirada interdisciplinaria, capaz de una lectura crítica de la información que presentan los medios de comunicación.

Objetivo: hacer una reflexión sobre: 1) qué es la corrupción, 2) cuáles son sus causas, 3) cómo incide en el sistema de salud colombiano y 4) discutir la necesidad de una reforma profunda en la formación de los valores culturales que orienten hacia la valoración de la honradez y la transparencia.

Materiales y métodos: a partir de una revisión de fuentes secundarias, el artículo de reflexión señala cómo la corrupción afecta la salud pública. Se busca una aproximación conceptual a la noción de corrupción desde el punto de vista económico, político y cultural. Concluye, desde la perspectiva de la salud pública, con la necesidad de reformas profundas al sistema y de la formación de los profesionales de la salud como ciudadanos participativos con competencias para una lectura crítica de medios.

Resultados: se postulan tres premisas que, desde nuestro punto de vista, deben ser documentadas desde la academia: primera, la corrupción es universal; segunda, la corrupción ha penetrado en el sistema de salud, y, tercera, ha permeado de una manera más marcada debido al sistema de mercado sin regulación.

Conclusiones: la reforma al sistema de salud debe garantizar cero corrupción en el sector, acceso real a la provisión de servicios de buena calidad, con una mirada intersectorial que entienda el papel de los determinantes en salud en la perpetuación de la enfermedad y de la pobreza, y que tenga como meta de control los resultados bajo condiciones de equidad a corto plazo.
Pronóstico perinatal de los fetos con circular de cordón en relación con la vía del parto. Revisión de la literatura
Authors: Bustamante-Zuluaga Carlos , Parra-Anaya Guido , Vergara-Quintero Felipe , Díaz-Yunez Israel , De Nubbila-Lizcano Eduardo
Published: February 2020

Introducción: un supuesto incremento en el riesgo de resultados perinatales negativos en fetos expuestos a circular de cordón a cuello lleva con frecuencia a la realización de la operación cesárea, sin embargo, no es claro que la circular de cordón esté realmente asociada con la frecuencia de malos resultados fetales o neonatales. El objetivo del artículo es hacer una revisión de las publicaciones sobre el resultado perinatal asociado con la circular de cordón a cuello y la vía del parto que reviste mayor seguridad.Materiales y métodos: se realizó una búsqueda bibliográfica en las bases de datos electrónicas PubMed, Ovid, SciELO y LILACS, así como de revistas indexadas y sociedades médicas reconocidas:The American College of Obstetricians and Gynecologists, The Royal Australian and New Zealand College of Obstetricians and Gynaecologists, The American Journal of Obstetrics and Gynecology y the Medical Journal Armed Forces India.Resultados: se revisaron 520 títulos, de los cuales cumplían con nuestros criterios de selección 40 revisiones, correspondientes a diseños de tipo transversal, de cohorte, casos y controles, y revisiones sistemáticas. Los estudios muestran que no se presentan diferencias significativas entre pacientes con y sin circular única de cordón respecto al retardo de crecimiento intrauterino (RCIU), disminución en el valor de Apgar al nacer o mortalidad perinatal como parámetros de evidencia de resultados adversos perinatales. Además, las tasas de cesáreas en pacientes con circular de cordón única están alrededor de un 9% frente a un 13% en pacientes sin circular.Conclusión: la evidencia disponible en la actualidad no soporta de manera consistente la asociación entre la presencia de circular de cordón fetal y resultados perinatales adversos mayores, al compararlos con fetos sin circular de cordón. Existe algún riesgo en situaciones especiales como las múltiples vueltas de cordón y la circular ajustada al cuello. No hay evidencia que soporte la realización de cesárea ante la presencia de circular única en nuca fetal.
Terminal cancer in Northeast India: an analytical study on its rapid growth, causes, and solutions
Authors: VAİPHEİ Suantak D , SİSODİA Devendra Singh
Published: February 2020

The underlying aim of the study is to investigate the reasons behinds the rapid growths of cancer populations and the cancer mortality rates in the Northeastern States of the country. The current study is an analytical study on the collected data and reports of the following reliable sources: The Population-Based Cancer Registries’ Data of the Central and State Governments, the data from National Cancer Registry and Regional Cancer Centers, National Family Health Survey of India (NFHS-3), National Institute of Cancer Prevention and Research, and Indian Council of Medical Research. The study will be specific to the reasons behind the rapid growths, causes, and solutions in the Northeastern regions of the country. The study also utilized the available journals database, along with World Health Organization database. The researcher also access to the government’s data and hospitals documents on cancer statistics and their reports. By eliminating the usages of tobacco, cigarettes, chewing, and bitternuts with hygenic environment, the rates of oral lip, breast, mouth, cervical, head and neck, and the nasopharyngeal cancer can successfully be reduces into at least 40-50% in Northeast region, as per the researcher findings. The urgent need of the regions is to develop social awareness on the causes of cancer. Gearing up for health awareness and strengthening the health care team at the community level by addressing the cancer preventive measures in the Northeast region will effectively decreases the growing cancerpopulations of cancer/terminal illness.
The role and assesment of mental and emotional state in patients with arrhythmias
Authors: Neznanov N. G. , Lebedeva U. V. , Rida O. , Petrova V. B. , Palchikova E. I. , Yusifzade A. E.K.
Published: February 2020

The aim is to study the influence and assessment of mental and emotional states in patients with arrhythmias.

Materials and methods. Literature search was performed using the following resources: PubMed, Web of Science, Scopus, as well as in the search system Google Scholar by the key words “psychoarrhythmology”, “neural-cardiac axis”, “psychocardiology”, “arrhythmogenesis”, and “stress-induced arrhythmia”. Articles should be freely available and should represent the most relevant information on the topic. Studies were selected by the largest sample and citation index.

Results. In this review of studies on the correlation of psychosocial factors and constitutional features of personality in patients with arrhythmias, the available data on the pathogenesis of cardiac pathology, including the main arrhythmological disorders in nervous excitation caused by negative emotions and stress are presented. The article also reflects the importance of a multidisciplinary approach to risk prediction, potential risk modifiers and approaches to the treatment of cardiac pathology, taking into account the psycho-emotional state of the patient.

Conclusion. Reducing the severity of the disease requires a comprehensive approach, in particular, psychodiagnostics, psychocorrection, psychotherapy and psychopharmacotherapy. Further development of this approach to this problem will lead to the creation of new programs for early diagnosis, prevention and treatment of cardiac pathology.
Islamic Marketing and Muslim Consumers’ Behavior
Authors: Abuznaid Samir Ahmad
Published: February 2020

Religion is a system of beliefs and practices that dictates individual response and interpretations regarding what is supernatural and sacred (Mukhtar, and Butt,2011). Religion is one of the most universal and influential social institutions that has strong influence on people’s belief, personal identity and value systems (Nooshin Ghodsimaab, 2016).The impact of religion on culture is exerted from the Quran and Sunnah (Abuznaid, 2006; Delener,1994).Religion has received little attention from consumer researchers mainly because they believe that the influence of religion on consumption processes are indirect and the topic of religion has no place in consumer behavior theories and literature.As a result of the widening gap and cultural conflict between the West and Muslim countries, many international companies have become negatively affected by the changes in the international environment, which is reflected in changes in consumer behavior (Al-Hayari et al., 2012).This research aims to discuss the impact of Islam on marketing practices and Muslim consumers’ behavior. A descriptive analytical approach using the interview method was used as a research tool for data collection.Conference papers in the field of Islamic marketing knowledge were consulted. Qur’anic quotes and Ahadiths (sayings and practices of Prophet Muhammad) are heavily used to best describe and explain Muslim consumers behavior. In addition, Muslim scholars and Imams (preachers) have been consulted on some issues for better definitions of Islamic terms and concepts.The findings of the study show that Islam has a major impact on Muslims’ buying behavior. Consumer behavior issues have become more heterogeneous because of cultural differences. This phenomenon makes it progressively important to understand factors impacting it (Abdellatif, Abu Auf, Meddour, Saoula, 2018).This paper will help marketers better address Muslim markets and Muslim consumer’s behavior taking into account that Halal food industry is growing in a number of markets in East Asia countries, North Africa , North America ,South America, Western Europe and the Middle East as the largest market.
ATENDIMENTOS INDIVIDUAIS ORIENTADOS PARA O SOFRIMENTO NO TRABALHO:
Authors: Lima Suzana Canez da Cruz
Published: February 2020

O objetivo proposto no presente artigo é de apresentar e analisar os princípios teórico-metodológicos adotados pela prática de escuta clínica voltada para trabalhadores, na modalidade de atendimento individual, desenvolvida como uma atividade de estágio supervisionado no Serviço de Psicologia Aplicada (SPA) do Curso de Psicologia da Universidade Federal Fluminense de Rio das Ostras sob a responsabilidade da autora. Esta prática teve início no ano de 2014 e ainda está em andamento. Neste período de realização contou com a participação de 22 alunos estagiários envolvidos nos atendimentos e atendeu em torno de 38 servidores municipais readaptados e 21 trabalhadores da região interessados. Consideramos que um dos principais desafios do clínico na proposta que desenvolvemos é de trabalhar o setting terapêutico para torná-lo um espaço de acolhimento para falar sobre si, para entrar em contato com a sua experiência, que favoreça a expressão do sofrimento existente a fim de ampliar sua potência de agir. Os princípios desta prática têm sido construídos a partir da Psicodinâmica do Trabalho e da Psicoterapia Breve proposta por Héctor Fiorini e acreditamos que o diálogo entre tais referenciais têm contribuído para o exercício da escuta clínica.
Intraoperative Intravenous and Intra-Articular Plus Postoperative Intravenous Tranexamic Acid in Total Knee Arthroplasty
Authors: Tsukada Sachiyuki , Kurosaka Kenji , Nishino Masahiro , Maeda Tetsuyuki , Hirasawa Naoyuki , Matsue Yuya
Published: February 2020

Background:

Combined intraoperative intravenous and intra-articular tranexamic acid (TXA) is 1 of the most effective administration routes to decrease the amount of perioperative blood loss during total knee arthroplasty (TKA). However, the additive effect of postoperative intravenous TXA administration remains unclear. We hypothesized that the postoperative repeated-dose intravenous administration of TXA would provide lower perioperative blood loss.

Methods:

We performed a double-blinded, placebo-controlled trial involving patients undergoing primary TKA. A total of 100 patients who were managed with combined intraoperative intravenous and intra-articular TXA were randomly assigned to receive 3 postoperative 1,000-mg doses of intravenous TXA (TXA group) or 3 postoperative doses of intravenous normal saline solution (placebo group) in a 1:1 ratio. The prespecified primary outcome was perioperative blood loss calculated from patient blood volume and the difference in hemoglobin from preoperatively to postoperative day 3. A post hoc power analysis showed that the number of patients allocated to either the TXA group (n = 46) or the placebo group (n = 54) possessed >80% power to detect a 200-mL difference in perioperative blood loss.

Results:

In the intention-to-treat analysis, we found no significant differences in perioperative blood loss between the TXA group and the placebo group through postoperative day 3 (578 ± 229 compared with 640 ± 276 mL, respectively; 95% confidence interval for the difference, −40 to 163 mL; p = 0.23). The prevalence of postoperative thrombotic events did not differ between the 2 groups (4.3% compared with 3.7%, respectively; p > 0.99).

Conclusions:

Postoperative intravenous TXA had no additive effect in reducing perioperative blood loss in patients receiving intraoperative combined intravenous and intra-articular TXA.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
A randomized controlled trial study of the acceptability, feasibility, and preliminary impact of SITA (SMS as an Incentive To Adhere): A mobile technology-based intervention informed by behavioral economics to improve ART adherence among youth in Uganda
Authors: MacCarthy Sarah , Wagner Zachary , Mendoza-Graf Alexandra , Gutierrez Carlos Ignacio , Samba Clare , Birungi Josephine , Okoboi Stephen , Linnemayr Sebastian
Published: February 2020

Background: Studies report serious adherence problems among youth (individuals age 15-24 years of age) in Uganda. Recent growth in mobile phone ownership has highlighted the potential of using text-based interventions to improve antiretroviral treatment (ART) adherence among Ugandan youth. We piloted a randomized controlled trial of a text-based intervention providing weekly real-time antiretroviral adherence feedback, based on information from a smart pill box, to HIV-positive Ugandan youth. In this paper, we report the acceptability, feasibility, and preliminary impact of the intervention. Methods: We randomized participants to a control group, or to receive messages with information on either their own adherence levels (Treatment 1 - T1), or their own adherence and peer adherence levels (Treatment 2 – T2). We conducted six focus groups from December 2016 to March 2017 with providers and youth ages 15-24, double coded 130 excerpts, and achieved a pooled Cohen’s Kappa of 0.79 and 0.80 based on 34 randomly selected excerpts. Results: The quantitative and qualitative data show that the intervention was deemed acceptable and feasible. After controlling for baseline adherence, the T1 group had 3.8 percentage point lower adherence than the control group (95% CI -9.9, 2.3) and the T2 group had 2.4 percentage points higher adherence than the control group (95% CI -3.0, 7.9). However, there was an increasing treatment effect over time for the T2 group with the largest effect towards the end of the study; a 2.5 percentage point increase in the initial 9-weeks that grows steadily to 9.0 percentage points by the last 9-weeks of the study. We find negative treatment effects for T1 in 3 of the 4 9-week intervals. This pilot study was not designed to detect statistically significant differences. Conclusions: Improving youth’s adherence by supplementing information about their adherence with information about the adherence of peers is a promising new strategy that should be further evaluated in a fully-powered study. Providing one’s own adherence information alone appears to have less potential.
Challenges with Scale-up of GeneXpert MTB/RIF® inUganda: a Health Systems Perspective
Authors: Nalugwa Talemwa , Shete Priya B. , Nantale Mariam , Farr Katherine , Ojok Christopher , Ochom Emma , Mugabe Frank , Joloba Moses , Dowdy David W. , Moore David A.J. , Davis J. Lucian , Cattamanchi Adithya , Katamba Achilles
Published: February 2020

Background: Many high burden countries are scaling-up GeneXpert MTB/RIF (Xpert) testing for tuberculosis (TB) using a hub-and-spoke model. However, the effect of scale up on reducing TB has been limited. We sought to characterize variation in implementation of referral-based Xpert TB testing across Uganda, and to identify health system factors that may enhance or prevent high-quality implementation of Xpert testing services. Methods: We conducted a cross-sectional study triangulating quantitative and qualitative data sources at 23 community health centers linked to one of 15 Xpert testing sites between November 2016 and May 2017 to assess health systems infrastructure for hub-and-spoke Xpert testing. Data sources included a standardized site assessment survey, routine TB notification data, and field notes from site visits. Results: Challenges with Xpert implementation occurred at every step of the diagnostic evaluation process, leading to low overall uptake of testing. Of 2,192 patients eligible for TB testing, only 574 (26%) who initiated testing were referred for Xpert testing. Of those, 54 (9.4%)were Xpert confirmed positive just under half initiated treatment within 14 days (n=25, 46%). Gaps in required infrastructure at 23 community health centers to support the hub-and-spoke system included lack of refrigeration (n=14, 61%) for sputum testing and lack of telephone/mobile communication (n=21, 91%). Motorcycle riders responsible for transporting sputum to Xpert sites operated variable with trips once, twice, or three times a week at 10 (43%), nine (39%) and four (17%) health centers, respectively. Staff recorded Xpert results in the TB laboratory register at only one health center and called patients with positive results at only two health centers. Of the 15 Xpert testing sites, five (33%) had at least one non-functioning module. The median number of tests per day was 3.57 (IQR 2.06-4.54), and 10 (67%) sites had error/invalid rates >5%. Conclusions: Although Xpert devices are now widely distributed throughout Uganda, health system factors across the continuum from test referral to results reporting and treatment initiation preclude effective implementation of Xpert testing for patients presenting to peripheral health centers. Support for scale up of innovative technologies should include support for communication, coordination and health systems integration.
Disabled and immigrant, a double minority challenge: A qualitative study about the experiences of immigrant parents of children with disabilities navigating health and rehabilitation services in Norway.
Authors: Arfa Shahrzad , Solvang Per Koren , Berg Berit , Jahnsen Reidun
Published: February 2020

• Background: Immigrants and their Norwegian-born children make up approximately 18% of the total population in Norway. While several studies have been conducted on immigrants’ utilization of healthcare services, immigrant families are systematically underrepresented in international studies of children with disabilities. By focusing on experiences of immigrant parents of children with disabilities navigating health and rehabilitation services in Norway, this study generated knowledge of how accessible and tailored the services were from their point of view.
Methods: This study took a qualitative approach, using semi-structured interviews to explore the experiences of immigrant parents of children with disabilities from non-Western countries. The interviews were transcribed, coded, and analyzed via an inductive thematic analytic approach.

Results: The findings show how the “immigrant experience” influenced the way the parents looked at, experienced, and even praised the services. The parents appreciated the follow-up services provided by the pediatric rehabilitation centers, which they experienced as predictable and well-organized. While navigating the services, they experienced several challenges, including the need for information, support, and timely help. They felt exhausted because of years of struggle in the healthcare system to access the help and services they needed. They expressed how this struggle had affected their own health. The feeling of being treated differently from the majority was another challenge they experienced while navigating the services. The findings also show how parents’ experiences of communication with healthcare providers were influenced not only by their own language and communication skills but also by the healthcare providers’ intercultural communication skills and dominant organizational culture.

Conclusions: The parents’ experiences show that there is still a gap between the public ideal of equal healthcare services and the reality of the everyday lives of immigrant families of children with disabilities. By exploring immigrant parents’ experiences, this study highlights the importance of mobilization at both the individual and systemic levels to fill the current gap and provide tailored and accessible services to the entire population.
The disease stage-associated imbalance of Th1/Th2 and Th17/Treg in uterine cervical cancer patients and their recovery with the reduction of tumor burden
Authors: Lin Wei , Zhang Hua-ling , Niu Zhao-yuan , Wang Zhen , Kong Yan , Yang Xing-sheng , Yuan Fang
Published: February 2020

Background

Nearly all uterine cervical cancer (UCC) cases result from human papillomavirus (HPV) infection. After high-risk HPV infection, most HPV infections are naturally cleared by humoral and cell-mediated immune responses. Thus, cervical lesions of only few patients progress into cervical cancer via cervical intraepithelial neoplasia (CIN) and lead to persistent oncogenic HPV infection. This suggests that immunoregulation plays an instrumental role in the carcinogenesis. However, there was a few study on the relation between the immunologic dissonance and clinical characteristics of UCC patients.

Method

We examined the related immune cells (Th1, Th2, Th17, and Treg cells) by flow cytometric analysis and analyzed their relations with UCC stages, tumor size, differentiation, histology type, lymph node metastases, and vasoinvasion. Next, we quantified the Th1, Th2, Th17, and Treg cells before and after the operation both in UCC and CIN patients.

Results

When compared with stage I patients, decreased levels of circulating Th1 cells and elevated levels of Th2, Th17, and Treg cells were detected in stage II patients. In addition, the imbalance of Th1/Th2 and Th17/Treg cells was related to the tumor size, lymph node metastases, and vasoinvasion. We found that immunological cell levels normalized after the operations. In general, immunological cell levels in CIN patients normalized sooner than in UCC patients.

Conclusions

Our findings suggested that peripheral immunological cell levels reflect the patient’s condition.