bluuebunny/crossref_metadata_2025 huggingface dataset:
Chloride intracellular channel 6 inhibits hepatocellular carcinoma progression by modulating immune cell balance and promoting tumor cell apoptosis
Authors: Zhou He , Xi Yue , Chen Xueyang
Published: February 2025

Objective

Chloride intracellular channel 6 (CLIC6) is essential for the development of cancer, and it is widely studied for the treatment of various cancers. This study aimed to explore the potential mechanisms of CLIC6 in the treatment of hepatocellular carcinoma (HCC).

Material and Methods

Initially, a subcutaneous xenograft model of HCC was established. The model groups were treated with varying levels of CLIC6 recombinant protein. After 21 days, tumor and liver tissues were harvested. Tumor size and weight were measured, and hematoxylin-eosin staining was used to assess histopathological changes in the tumor tissues. Terminal deoxynucleotidyl transferase-mediated 2’-deoxyuridine 5’-triphosphate nick-end labeling staining was employed to evaluate apoptosis in tumor tissue cells. Quantitative real-time polymerase chain reaction and Western blot were utilized to analyze cytokine messenger ribonucleic acid ( mRNA) levels in the liver or tumor tissues, and immunohistochemistry was conducted to assess cytokine expression.

Results

CLIC6 significantly inhibits tumor proliferation and enhances apoptosis in tumor tissue cells. CLIC6 markedly reduces the mRNA levels of interleukin (IL)-6, IL-1β, interferon-γ, tumor necrosis factor-α, and IL-17A in liver tissue when increasing transforming growth factor-β and IL-4 mRNA levels. CLIC6 potentially modulates Th cell balance by regulating forkhead box protein P3, GATA-binding protein 3, T-box expressed in T cell, and retinoic acid receptor-related orphan receptor γt (ROR-γt) expression, thereby restraining HCC progression in mice. Moreover, CLIC6 mitigates hepatic oxidative damage via the Janus tyrosine kinase 1/signal transducer and activator of the transcription pathway, attenuates c-Jun N-terminal kinase (JNK) phosphorylation, and modulates apoptosis-related proteins, effectively hindering HCC development.

Conclusion

CLIC6 demonstrates potent antitumor effects in HCC through inhibition of proliferation, promotion of apoptosis, modulation of cytokine levels, regulation of immune cell balance, and attenuation of oxidative stress pathways.
Exploring miR-3148’s impact on Krüppel-like factor 6-driven mitophagy and apoptosis in myocardial ischemic injury
Authors: Huang Chusheng , Li Lipeng , Deng Hailong , Su Jincheng , Wei Qingjun , He Ying , Xian Lei
Published: February 2025

Objective

Myocardial infarction (MI) is a leading cause of death worldwide, accounting for millions of fatalities annually. The injury and repair of cardiomyocytes are closely associated with the changes in gene expression. MicroRNAs could serve as a potential target for MI treatment. This work aims to investigate the role of miR-3148 in mitochondrial dynamics during acute MI (AMI) with a specific focus on its regulatory mechanisms in mitophagy and apoptosis, which could reveal potential therapeutic targets for AMI treatment.

Material and Methods

MiR-3148 levels in patients with AMI and experimental models were measured to assess the effects of miR-3148 on cardiomyocyte viability under oxygen and glucose deprivation (OGD). The present investigation involved monitoring mitophagy markers, including PTEN-induced kinase 1 (PINK1), parkin RBR E3 ubiquitin-protein ligase (Parkin), Beclin1, and microtubule-associated protein 1A/1B light chain 3 II/I (LC3 II/I) ratio, as well as apoptotic markers such as cysteine-aspartic acid protease (Caspase) 9, Caspase 3, and cytochrome C (Cyt C). In addition, Krüppel-like factor 6 (KLF6) was examined as a target of miR-3148.

Results

MiR-3148 was significantly elevated in patients with AMI and models. MiR-3148 overexpression reduced cardiomyocyte viability, whereas miR-3148 knockdown protected against OGD injury. The inhibition of miR-3148 activated mitophagy, as shown by the increased PINK1, Parkin, Beclin1 levels, and LC3 II/I ratios, and reduced sequestosome 1 (p62), and apoptotic markers levels. MiR-3148 directly targeted KLF6, reducing its expression. The suppression of KLF6 aggravated OGD injury by disrupting PINK1/Parkin-mediated mitophagy and enhancing apoptosis. Attenuating KLF6 expression reversed the protective effects of miR-3148 inhibition, indicating reciprocal regulation.

Conclusion

In myocardial ischemic injury, miR-3148 modulates PINK1/Parkin-mediated mitophagy and apoptosis through KLF6 regulation. This finding highlights miR-3148 as a key factor in the pathogenesis of AMI and as a potential therapeutic target.
Impact of lifestyle modification on type 2 diabetes outcomes
Authors: Mandloi Ashish , Bisani K G , Verma Rani
Published: February 2025

Objectives

Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder with increasing global incidence, contributing to significant healthcare costs. Lifestyle modifications, including dietary changes, physical activity, and behavioral interventions, are critical in managing T2DM. This study evaluates the impact of lifestyle modifications on glycemic control and clinical outcomes in individuals with T2DM.

Material and Methods

A cross-sectional study was conducted with 272 T2DM patients aged 30–70 years recruited from a tertiary care hospital. Participants were divided into two groups: those who adhered to lifestyle modifications (n = 141) and a control group (n = 131). Data on demographic details, medical history, lifestyle practices, clinical parameters, and laboratory tests were collected. Primary outcomes included HbA1c levels and fasting blood glucose, while secondary outcomes involved BMI (body mass index), lipid profiles, and diabetes-related complications.

Results

The Lifestyle Modification Group showed significantly improved glycemic control with lower HbA1c (7.2% vs. 8.0%, p < 0.001) and fasting blood glucose (112.4 mg/dL vs. 125.6 mg/dL, p < 0.001) compared to the control group. Additionally, the lifestyle group had significantly better lipid profiles, including lower total cholesterol (185.2 mg/dL vs. 198.5 mg/dL, p = 0.003) and LDL (low-density lipoprotein) cholesterol (102.5 mg/dL vs. 115.2 mg/dL, p = 0.001) and higher HDL (high-density lipoprotein) cholesterol (47.3 mg/dL vs. 42.8 mg/dL, p = 0.010). However, the differences in the prevalence of diabetes-related complications were not found to be statistically significant.

Conclusion

Lifestyle modification positively impacts glycemic control and lipid metabolism in T2DM. Further research with long-term follow-up and larger sample sizes is needed to confirm these findings and explore the long-term effects on diabetes-related complications.
Assessing the impact of the Aarambh nurturing care model on the capacity & support structures for caregiver empowerment: A qualitative study
Authors: Sundar R. Naveen Shyam , Kothekar Pranali , Raut Abhishek V. , Gupta Subodh
Published: February 2025

Background & objectives

The provision of nurturing care during the crucial developing phase from pregnancy to three years is essential for enduring health. The Aarambh project, executed in specific districts of Central India, utilised existing Integrated Child Development Scheme (ICDS) and healthcare facilities to improve nurturing care. This study assessed the influence of loving care interventions on the skills, functionality, and support systems of anganwadi workers (AWWs) to enhance the capabilities of primary carers.

Methods

This qualitative study evaluated the competencies of AWWs by observing house visits and mothers’ meetings in both control (Deoli, Wardha) and intervention blocks (Ralegaon, Yavatmal), Maharashtra. Comprehensive interviews were performed with AWWs, primary carers, ICDS supervisors, CDPOs, ASHAs, and parents.

Results

AWWs in the intervention group exhibited substantial enhancements in providing age-appropriate guidance, play, and communication activities along with effective community-based events.

Interpretation & conclusions

The findings of this study suggest empowerment of beneficiaries and child development through this discussed programme framework. In light of this, it is apparent that the soft skills of service providers hold paramount importance for achieving sustainable outcomes.
Surgical Innovation: Ultrasound gel – A dermal filler training tool for young injectors
Authors: Kanumuru Pooja , Venkataram Aniketh , Singh Sukhbir , Mysore Venkataram Nagaraj
Published: February 2025

Dermal fillers have gained increased popularity as a nonsurgical esthetic procedure over the past few years. The learning curve in injectables is very steep and needs a lot of practice. Young injectors get trained in dermal filler injection techniques at various workshops through observation courses or through cadaveric studies. However, due to the high cost of the filler injections, it has been very difficult for young trainees to afford hands-on injectable training courses. We describe an alternative to the expensive hyaluronic acid fillers as a training tool for young injectors.
Intimate Partner Violence: A Qualitative Exploration of Lived Experiences of Men
Authors: Satapathy Sankalpa , Mukherjee Navonil , Pal Jayita , Mukhopadhyay Bijay Prasad
Published: February 2025

Background

Intimate partner violence (IPV) is a significant public health and human rights issue affecting all genders. IPV is overwhelmingly prevalent among women, but it is being increasingly acknowledged that men, too, are IPV victims.

Objectives

This study draws on the lived experiences of ever-married men to explore the various forms and effects of IPV experienced by them from their female partners within the ambit of heterosexual marriages.

Material and Methods

In-depth interviews were conducted with 15 ever-married men with a history of having experienced domestic violence from their female partners to reveal the different forms of IPV and how it affected their lives.

Results

Findings suggest the prevalence of physical, emotional, and financial abuse affecting men’s health and financial well-being in myriad ways. Social norms inhibit men from seeking support due to fear of being targets of social ridicule. In addition, skewed legislative measures in favor of women work against the provision of justice to men.

Conclusion

The study adds to the growing body of work on IPV being pervasive among men. It highlights delayed help-seeking behavior among men due to misplaced notions of gendered behavior and identifies the acknowledgment of IPV among men as a social problem to being the first step to its effective redressal.
Newer Vaccines Applicable to Public Health Problems in India: A Comprehensive Review
Authors: Datchanamourtty Priyanga , Rajalakshmi M.
Published: February 2025

Vaccines are biological tools that enhance the immune system’s ability to combat infectious diseases, saving millions of lives globally each year. India’s Universal Immunization Programme, one of the largest in the world, targets 12 preventable diseases, including polio, measles, and tetanus, while continually adding new vaccines such as those for Rotavirus and Pneumococcal infections. Launched in 2014, Mission Indradhanush aims to achieve 90% immunization coverage by focusing on under-vaccinated and zero-dose children in high-risk areas. Recent advancements like the Electronic Vaccine Intelligence Network have modernized vaccine logistics, ensuring efficient distribution and real-time monitoring. India’s commitment to eliminating measles and rubella by 2023 exemplifies its sustained efforts to strengthen immunization infrastructure, improve coverage, and address emerging public health challenges.
Anaesthetic management of a rare case of congenital factor VII deficiency – Patient posted for shoulder arthroscopic synovectomy: A case report
Authors: Joseph Nisheed , Banasode Gayathri Subhash
Published: February 2025

Factor VII deficiency (F7D) is a rare coagulation disorder. It poses significant challenges for anaesthetic management due to a heightened risk of bleeding. This case report describes the successful anaesthetic management of a 20-year-old woman with congenital F7D who underwent elective shoulder arthroplasty for ‘Pigmented Villonodular Synovitis.’ A multidisciplinary approach incorporating preoperative recombinant activated factor VII and tranexamic acid, general anaesthesia with an interscalene brachial block, and meticulous surgical technique and close monitoring ensured a favourable outcome. This approach emphasises the importance of early identification and meticulous management of F7D to ensure safe surgical outcomes.
Role of superficial cervical plexus block with lignocaine and dexamethasone following modified radical mastoidectomy: A randomised controlled trial
Authors: Ahuja Vanita , Indumathi K. , Thapa Deepak , Mitra Sukanya , Gupta Nitin , Mahajan Aastika
Published: February 2025

Aims and Objectives

The study aimed to compare the worst pain levels following superficial cervical plexus block (SCPB) with lignocaine and perineural dexamethasone versus no block using the PAIN OUT patient outcome questionnaire.

Material and Methods

This randomised, placebo-controlled trial included 46 patients, 18–70 years of age, of the American Society of Anesthesiologists (ASA) physical status I/II scheduled for mastoidectomy. The postoperative maximum pain intensity scores using the PAIN OUT patient outcome questionnaire were considered as the primary outcome. The patients received interventions as per group allocation. In group block (n = 23), an ultrasound-guided (USG) SCPB was administered using 5 ml of 2% lignocaine with 4 mg dexamethasone. In group control (n = 23), no block was performed, and only dressing was done. All patients received intravenous (IV) paracetamol 1 g every 6 h. In case any patient-reported pain, IV diclofenac was administered.

Results

During the study period of 24 hours, patients in group block experienced lower worst pain as compared to group control(p-value = 0.001). Similarly, the visual analogue scale score on movement was lower in group block at the following intervals: 15 min (p-value = 0.02), at 1 hour (p-value = 0.007), at 4 hours (p = 0.03), and 12 hours (p-value = 0.04) following surgery. Rescue analgesia was lower in group block versus group control (p-value < 0.01).

Conclusion

Postoperative SCPB with lignocaine and perineural dexamethasone provided a superior worst pain score during 24 hours using the PAIN OUT patient outcome questionnaire following modified radical mastoidectomy.
Comparison of ease of intubation with Airtraq®, Miller, Macintosh laryngoscope blades in children: A prospective randomised trial
Authors: Gangadharan Arunima Kandirithy , Kurdi Madhuri S. , Bhosale Raghavendra , Sarasamma Athira Gopinathan , Mitragotri Milon Vasant , CR Akshay
Published: February 2025

Aims and Objectives

In children, the airway often presents unique anatomical challenges that can make intubation difficult, particularly when attempting to align the line of sight with the laryngeal inlet. However, video laryngoscopes offer several advantages over traditional direct laryngoscopy by eliminating the need for precise alignment, thereby facilitating easier and more successful intubation. The primary objective of the study was to compare the ease of intubation with Airtraq®, Miller, and Macintosh laryngoscope blades. The secondary objectives were to compare the mean intubation time, Cormack-Lehane (CL) grade, percentage of glottis opening (POGO), number of intubation attempts, and haemodynamic response between Airtraq®, Miller, and Macintosh laryngoscope blades of appropriate sizes in children undergoing elective surgeries under general anaesthesia.

Material and Methods

75 paediatric patients of American Society of Anesthesiologists physical status I and between 2 and 10 years of age were consecutively enroled and randomly allocated to one of the three groups: group A (Airtraq®, n = 25), group B (Miller, n = 25), and group C (Macintosh, n = 25). Patients were intubated with one of the three devices, viz. Airtraq®, Miller, and Macintosh laryngoscope blades, and the ease of intubation, mean intubation time, CL grade, POGO score, number of intubation attempts, and haemodynamic responses were noted.

Results

The ease of intubation was better with Airtraq® compared to Miller and Macintosh laryngoscope blades (p-value = 0.001). The mean intubation time [mean ± standard deviation (SD)] for Airtraq® (41.52 ± 6.63 seconds) [95% confidence interval (CI): 38.78, 44.26] was significantly greater than for Miller and Macintosh laryngoscope blades, 33.12 ± 6.77 seconds (95% CI: 24.78, 31.78) and 28.28 ± 8.48 seconds (95% CI: 30.32, 35.92), respectively, p-value <0.05, though the POGO score was more for Airtraq® [mean ± SD (86% ± 10)] (95% CI 81.87, 90.13) compared to Miller blade (72% ± 12.25) (95% CI 66.94, 77.06) p-value <0.05. The POGO score with Airtraq® was more than with Macintosh blade, though statistically insignificant (95% CI 76.52, 85.08) (p-value = 0.290). The modified CL grading was better with Airtraq® compared with Miller and Macintosh (p-value = 0.020), with no significant difference in the haemodynamic response between the three blades. The number of first and second attempts at intubation was 56% and 44% for Airtraq and 88% and 12% for Miller blade, respectively. Intubation was successful in the first attempt for the Macintosh blade group.

Conclusion

Even though the ease of intubation and glottic visualisation was better with the Airtraq® compared to Miller and Macintosh blades in children, the time taken for intubation was more with the Airtraq® when compared to Miller and Macintosh laryngoscope blades.
Pathological Findings of Feline Pansteatitis (Yellow Fat Disease) in a 9-Month-Old Siberian Queen
Authors: Hassan Bashir , Enam Samson James , Nuhu Suleman Muktar , Binhambali Abdulhakeem , Mustapha Rashidah Abimbola , Saleh Ahmadu , Musa Farida , Idris Sheriff Yusuf , Sousa Vanessa Saraiva
Published: February 2025

Feline pansteatitis (FP), also known as yellow fat disease, is an inflammatory condition affecting cats’ adipose tissue, often linked to imbalanced diets rich in unsaturated fatty acids and low in vitamin E. This case report describes a 9-month-old Siberian Queen presented with painful subcutaneous nodules, lethargy, and icterus. Clinical findings included neutrophilic leukocytosis (Bands: 0.44 × 109/L, Neutrophils: 17.10 × 109/L) and elevated liver enzymes (Alkaline phosphatase: 44.8 U/L, Alanine transaminase: 93.0 U/L), while ultrasonography revealed hyperechoic masses and subcutaneous fat necrosis on necropsy with ceroid pigment deposition in abdominal organs. The aim of the presented case report was to describe clinical and pathological findings in a case of FP. This is the first report of FP in feline species from Africa.
Integrasi Program Indonesia Sehat dengan Pendekatan Keluarga (PIS-PK) dalam Manajemen Puskesmas di Puskesmas Sidomulyo Kota Pekanbaru Riau Tahun 2023
Authors: Anna Deddy , Harnani Yessi , Marlina Hastuti , Dewi Oktavia , Ennimay Ennimay
Published: February 2025

Program Indonesia sehat dengan Pendekatan Keluarga (PIS-PK) ini mengintegrasikan pelaksanaan program melalui pendekatan 6 komponen utama dalam penguatan sistem kesehatan (Six building blocks), yaitu upaya pelayanan kesehatan, ketersediaan tenaga kesehatan, sistem informasi kesehatan, akses terhadap ketersediaan obat esensial, pembiayaan dan kepemimpinan pemerintah. Program Indonesia Sehat dengan Pendekatan Keluarga (PIS-PK) merupakan program yang berfokus pada penguatan upaya kesehatan dasar berkualitas yang dilakukan melalui pendekatan keluarga. Namun pelaksanaannya tidak cukup mudah sebab memerlukan motivasi yang kuat, sarana prasarana yang memadai. Riset ini bertujuan Mengetahui Integrasi Program Indonesia Sehat dengan Pendekatan Keluarga dalam manajemen puskesmas di puskesmas Sidomulyo Kota Pekanbaru. Metode: Penelitian menggunakan desain kualitatif dengan pendekatan phenomenologi. Partisipan terdiri dari 7 orang dengan dilakukan wawancara yang dilaksanakan pada bulan Agustus 2023. Hasil penelitian menunjukkan belum optimalnya integrasi program PIS PK disebabkan kurangnya tenaga terlatih dan beban kerja tinggi, infrastruktur dan fasiltas seperti teknologi informasi serta kurangnya partisipasi masyarakat koordinasi antar sektor terkait yang kurang efektif serta keterbatasan komunikasi antar petugas dan pendanaan yang tidak konsisten pengelolaan data yang belum terintegrasi serta kualitas data yang rendah maka disarankan puskesmas melakukan pelatihan berkelanjutan untuk tenaga kesehatan seperti penggunaan teknologi informasi peningkatan koordinasi antar sektor dan peningkatan anggaran serta sosialisasi lebih luas kepada masyarakat sehingga program PIS-PK dapat lebih optimal dalam mencapai tujuan peningkatan kualitas kesehatan keluarga.
Perbedaan Efektivitas Edukasi dengan Metode Demonstrasi dan Video Pijat Bayi terhadap Pengetahuan dan Keterampilan Ibu
Authors: Mandalin Bania , Fatimah Yulia Ulfah , Widiawati Ida , Suparman Suparman
Published: February 2025

Di Indonesia, 29,9% kasus stunting tidak terdiagnosis, dan angka ini meningkat hingga 70% di seluruh dunia. Bayi bisa mendapatkan manfaat dari berbagai bentuk rangsangan, termasuk pijat. Tujuan dari penelitian ini adalah untuk mengevaluasi kemanjuran video tutorial pijat bayi dibandingkan metode tradisional dalam mengajarkan perawatan yang tepat kepada ibu baru. Penelitian ini menggunakan desain kuasi eksperimen dengan pendekatan kuantitatif. desain menggunakan dua kelompok perlakuan sebagai pengganti kelompok kontrol. Pada setiap kelompok intervensi, sampel penelitian terdiri dari 33 ibu yang bayinya berusia antara 1 hingga 12 bulan. Proses pengambilan sampel menggunakan probabilitas sampling. Untuk menganalisis data menggunakan metode univariat, kami menggunakan uji Wilcoxon untuk mengetahui perbedaan pengetahuan dan keterampilan, dan untuk mengetahui perbedaan efektivitas intervensi, kami menggunakan uji Mann Whitney. Tingkat pengetahuan ibu sebelum dan sesudah intervensi ditunjukkan dengan hasil uji Wilcoxon. Keterampilan yang diperoleh serta pengetahuan dan keterampilan kelompok video menunjukkan nilai p sebesar 0,000 < 0,05 setelah intervensi video. Oleh karena itu, pada kelompok yang menjalani demonstrasi, nilai p untuk pengetahuan adalah 0,002 < 0,05 dan untuk keterampilan adalah 0,000 < 0,05. Artinya hasil pengetahuan dan keterampilan pada kelompok tersebut berbeda. Baik metode demonstrasi maupun video pijat bayi tidak berbeda secara signifikan efektivitasnya dalam hal pendidikan ibu, menurut uji Mann-Whitney (nilai P = 0,201). Hasil uji keterampilan untuk kedua intervensi signifikan secara statistik (P = 0,000), yang menunjukkan bahwa metode edukasi video mempunyai dampak yang berbeda terhadap keterampilan ibu dibandingkan metode demonstrasi. Dampak yang didapat dari demonstrasi yaitu pengetahuan ibu meningkat dan ibu dapat memberikan pijat bayi dengan benar.
Analysis of the UPTD Strategy for Community Health Centers with BLUD Status in Jember District Using the SPACE Matrix Approach
Authors: Heruddin Heruddin , Suryaningsih Ika Barokah , Dewanto Iwan
Published: February 2025

Perubahan status 50 Puskesmas menjadi BLUD di Kabupaten Jember  dimana setiap Puskesmas mempunyai latar berlakang yang berbeda beda, ada yang secara kekuatan internal kuat dan ada yang lemah tetapi di sisi lain ada standar-standar yang berlaku sama untuk semua Puskesmas yang harus dicapai sebagai konsekunesi perubahan status Puskesmas menjadi BLUD sehingga dibutuhkan strategi dari Puskesmas untuk mencapai tujuan tersebut. tujuan penelitian ini  adalah untuk menganalisis strategi UPTD Puskesmas dengan status BLUD di Kabupaten Jember menggunakan pendekatan matrik SPACE. Penelitian ini merupakan penelitian deskriptif kuantitatif. Pengolahan dan analisis data dilakukan dengan Analisa kuantitatif, pengumpulan data dilakukan secara cross sectional. Besar sampel 4 Puskesmas yang dipilih menggunakan Teknik purposive sampling. Teknik pengambilan data dengan instrument kuesioner dan divalidasi dengan cara fokus group diskusi (FGD) dan sebagian menggunakan data sekunder yang ada di Puskesmas. Hasil analisis matrik SPACE menunjukkan bahwa Puskesmas dengan kekuatan internal yang lemah berada pada kuadran kompetitif sedangkan Puskesmas dengan kekuatan internal yang kuat berada pada kuadran agresif dan efektivitas organisasi yang diukur berdasarkan aspek kinerja keuangan dan aspek kinerja pelayanan menunjukkan indikator yang baik. Hasil capaian ini dipengaruhi oleh strategi masing-masing Puskesmas sehingga perlu penerapan strategi yang jelas, terukur dan dapat dicapai sesuai kemampuan sebuah organisasi
Evaluation of Effectiveness of the Basic Occupational Health Services in Mangunan, a Pine Forest Tourism Site in Yogyakarta
Authors: Agustin Helfi , Ruliyandari Rochana , Ridwan Ansari Muhammad , Kodriati Nurul
Published: February 2025

Puskesmas Dlingo has initiated Basic Occupational Health Services (BOHS) in the Mangunan forest tourism village since 2019. To develop the BOHS, the program manager of the BOHS at the health centre is to carry out mentoring functions during the initiation of formation, coaching tasks after the UKK post is formed, and monitor and evaluate the implementation of the UKK post. Since its establishment, this UKK post has never been assessed for its activity. The purpose of this study was to assess BOHS in Mangunan forest tourism. This study is qualitative research with a case study approach. The informants consisted of nine people: the BOHS program manager and the head of the Puskesmas Dlingo, workers/cadres, the BOHS supervisor from the Bantul Regency Health Office, and the tourism manager.  All informants were selected purposively. Data were collected using in-depth interview methods and analyzed thematically. The components to assess are the number of cadres, integrated health service activities, promotive and preventive activities, BOHS facilities, recording and reporting, and revolving funds. The study found that all components indicate the BOHS is currently less active and tends to be inactive. Puskesmas policies are needed through budgets, necessary training in occupational health empowerment, and networking.
Ethnic and Language Identities among Finland-Swedish Young People
Authors: Banyanga Jean d’Amour , Östman Lilemor , Kurkiala Jacob , Nyman-Kurkiala Pia
Published: February 2025

In youth many significant physiological and psychological changes take place. These identity changes are especially important for an individual’s identity development. However, questions of identity for young people, especially as they shift from childhood to adulthood, have become a central concern in numerous researches. Ethnic and language identities are bonds that hold a common social identification for individuals who view themselves as members of the same group. This study investigates the role and importance of ethnic and language identities for Swedish-speaking young people in Finland presented through an analysis of existing literature and documents on the matter. The data consists of essays written by 1012 (704 boys and 308 girls) ninth-graders from 12 Finland-Swedish high schools on the topic, “Me, a Finland-Swedish youth.” These were analyzed by using a thematic analysis. The results show that ninth-graders feel that the Finland-Swedish culture gives them a stable foundation in life that affects their identity, health and well-being in a positive way. The language and Finland-Swedish culture appear to be important for the youths’ sense of belonging and happiness as well as for a sense of stability in a changing world. Thus, the results illustrate that their language is an important aspect of self-identity and a central part of their lives.
Electronic and Geometric contributors to Hydrogen Binding in Uranium Oxide Grain Boundaries
Authors: Goel Rajat , Goldman Nir , Kulkarni Ambarish
Published: February 2025

Hydrogen induced corrosion of uranium, which leads to the formation of toxic and pyrophoric \ce{UH3}, raises significant safety concerns for long-term storage of nuclear materials. Previous work suggests hydrogen diffuses through the top passivating oxide layer to initiate hydriding reactions within the underlying grain boundaries (GB). However, the atomistic mechanisms underlying this phenomenon and the structural factors that control its initiation are not well understood. To address this knowledge gap, here we use a high-throughput density function theory (DFT) workflow to investigate the adsorption of H and \ce{H2} in the defective bulk \ce{UO2}. Specifically, we exhaustively investigated the adsorption of H (107 sites) and \ce{H2} (26 sites) in three different coincidence site lattice (CSL) GBs: $\Sigma3$, $\Sigma5$, and $\Sigma9$. Compared to the binding energies in pristine \ce{UO2}, we observe significantly stronger hydrogen adsorption at these GB sites. Interestingly, we find that the trends in H and \ce{H2} adsorption vary considerably across the three GB models. In particular, while a small number of sites in $\Sigma5$ and $\Sigma9$ show exothermic adsorption of H and \ce{H2}, respectively, no such sites are found in $\Sigma3$. Further statistical analysis of these trends suggests that H adsorption, which is adsorbed as a hydride anion (i.e., \ce{H-}), is positively correlated with the value of its negative charge and depends on the number of neighboring oxygen and uranium atoms. Together, these results provide fundamental atomistic insights that could guide the development of future corrosion mitigation strategies for the storage of nuclear materials.
When Deception Promotes Dignity: The Ethics of Using Illusion to Create Safe Spaces for Persons Living with Dementia
Authors: Locke Teti Stowe , Deemer David A. , Hercules William J. , Anderson Diana C.
Published: February 2025

Caring for persons living with dementia (PLWD) is challenging. Some of the most challenging aspects include managing behavioral and psychologic symptoms of dementia (BPSD). Many patients and families will consider dementia care facilities to better manage BPSD, which can contain design elements that use the physical environment to decrease BPSD by deceiving residents and controlling their behavior—all for their own benefit and safety. This immersive approach to behavior management represents a more holistic way to manage BPSD. Considering the especially vulnerable status of PLWD, these design elements should be thoughtfully implemented, researched post-implementation, and discussed with patients and their loved ones. The design-based approach to managing BPSD demonstrates the obligation healthcare providers and facility designers have to be more holistic in designing care environments for PLWD, especially for those living in dementia care facilities.
Three Patients, Two Approaches to Illness, and a Question: the DNA of Clinical Wisdom
Authors: Davis Dave
Published: February 2025

The topic of wisdom raises questions of its meaning in the clinical setting, examined here by describing three patient experiences over a long career, illustrating the need to weigh equally the biomedical and psychosocial aspects of a patient and his or her illness. The patient stories urge the reader to examine the relationship between the two aspects, the role that patient error can play in evoking wisdom, and the bifold, instructive nature of the doctor-patient relationship, a kind of DNA. Finally, the patient stories raise (but do not answer) a question: can clinical wisdom be taught?
Processo de construção das diretrizes da Política de Assistência Farmacêutica do Rio Grande do Sul
Authors: Klimkowski Argoud Vanessa , Gouvea Diego da Silva , Fonseca Raphaela Soares , Da Costa Rodrigo Prado
Published: February 2025

As diretrizes da Política Estadual de Assistência Farmacêutica do Rio Grande do Sul (PEAF-RS) foram elaboradas através de trabalho colaborativo com os segmentos dos usuários, trabalhadores da saúde, gestores e prestadores de serviço do Sistema Único de Saúde (SUS). Este relato descreve o processo participativo de construção das diretrizes da PEAF-RS. Trata-se de um estudo de caso sobre a construção da política a partir do relato da vivência e de documentos públicos relacionados a esse processo. A consulta pública à sociedade civil recebeu 791 contribuições de 102 participantes de todas as regiões do estado e de todos os segmentos da participação social. As contribuições foram sistematizadas em 11 eixos temáticos, discutidas em oficina participativa na cidade de Porto Alegre, com a presença de 84 participantes de todos os segmentos, e foram deliberadas 94 diretrizes. A construção participativa de diretrizes da PEAF-RS contribuiu para a qualificação da gestão do SUS, pois orienta as escolhas estratégicas e prioritárias das gestões estadual e municipais no estado para promoção de ações e serviços da Assistência Farmacêutica, e contribui para futuras experiências de participação social na construção de políticas no SUS.
Gestão de serviços especializados em odontologia por Consórcio Público no interior do Ceará
Authors: Carvalho Felipe Freire de , Albuquerque Izabelle Mont’Alverne Napoelão , Aguiar Ribeiro Marcos , Maciel Jacques Antônio Cavalcante
Published: February 2025

O objetivo do estudo foi avaliar a qualidade da gestão de serviços especializados em odontologia por Consórcio Público no Ceará, Brasil. Trata-se de um estudo avaliativo, sob abordagem quantitativa e qualitativa, conduzido por meio do referencial de Donabedian. O estudo foi realizado no Centro de Especialidades Odontológicas Regional (CEO-R), gerido por um Consórcio Público entre 24 municípios do interior do Ceará. Participaram do estudo 22 cirurgiões-dentistas e 555 usuários. Para a coleta de dados, foram realizadas entrevistas semiestruturadas, aplicação de questionário e análise de fontes documentais. Os dados foram analisados por meio de análise de conteúdo e análise descritiva com medidas de frequências. Verificou-se que a adequada estrutura do Consórcio Público, com decisões colegiadas e normatizações que regulamentam a dinâmica decisória e o rateio financeiro, é fundamental para a garantia do acesso e qualidade da estrutura do CEO-R. Os processos de trabalho enfatizam a potencialidade da compreensão da centralidade do usuário e da Educação Permanente. Os resultados refletem a satisfação dos usuários com a experiência de atendimentos dos profissionais, conforto, higiene e acomodações do CEO-R, bem como da resolutividade das ações. Assim, esse processo avaliativo enfatiza a potência da governança regional para saúde bucal no SUS.
Expansão da Formação para a Atenção Básica
Authors: Siqueira Santos Juliana , Miguel dos Santos Neto Pedro
Published: February 2025

Este artigo tem como objetivo analisar a Política de Residência em Área Profissional da Saúde como estratégia de formação de profissionais para o Sistema Único de Saúde para a qualificação da atenção básica. Trata-se de uma pesquisa social, do tipo estudo de caso, que utilizou como referencial teórico-analítico a Abordagem do Ciclo de Políticas de Stephen Ball, no contexto da prática e dos resultados da política para investigar o Estado de Pernambuco, Brasil. Utilizou-se abordagem de métodos mistos, com pesquisa documental e coleta de dados governamentais (2010-2021), entrevistas semiestruturadas com atores-chave, e análises descritiva e de conteúdo temática. Verificou-se, na série histórica, expressiva expansão dos programas de residência relacionados à organização da atenção básica (saúde da família e comunidade, saúde mental, saúde coletiva), bem como uma melhoria na distribuição de programas para o interior do estado. Embora persistam desafios e problemas estruturais que limitam a implementação da política, os atores sociais compreendem a importância da residência em área profissional da saúde na organização das redes de atenção à saúde, e demonstram, ainda, capacidade de articulação local para qualificação da governança.
Anos de Vida Ajustados por Qualidade e Nível de Atividade Física do Contexto da Atenção Primária
Authors: Queiroz Correia Dayane Cristina , Rodrigues Junior Charles , Teixeira Guiça Juziane , Sanches Codogno Jamile
Published: February 2025

A presente pesquisa transversal teve o objetivo de analisar o índice de QALY e o nível de atividade física de hipertensos cadastrados na atenção primária à saúde. A prática de atividade física foi avaliada pelo questionário de Baecke, Burema e Frijters, em que o escore foi dividido em percentis, classificando os participantes nos grupos P≥75 (mais ativos fisicamente) e P<75 (menos ativos fisicamente). O cálculo do QALY foi analisado pelo tempo despendido com hipertensão (através do inquérito de morbidades autorreferidas) multiplicado pelo valor de utilidade (analisado pelo questionário de qualidade de vida EQ-5D, do grupo EuroQoL). O QALY perdido foi analisado subtraindo o QALY pelos anos com hipertensão. Foram utilizados os testes t de Student e qui-quadrado para comparação e ANCOVA para comparações ajustadas entre os grupos. A significância estatística foi pré-fixada em valores inferiores a 5%. Foram avaliados 659 hipertensos, sendo 472 (71,6%) mulheres e 187 (28,4%) homens. Observaram-se no grupo P<75 indivíduos mais velhos (p=0,012) e maior percentual da amostra nas classes econômicas alta e baixa (p=0,011). O QALY perdido foi menor no grupo com P≥75 (p=0,011), mesmo após ajuste por fatores de confusão (p=0,009). Conclui-se que indivíduos mais ativos apresentaram melhores índices de QALY.
Sala de Situação em Saúde
Authors: Da Silva de Souza Sabrina , Da Cunha Ana Cláudia , Regina Landt Simioni Sinara , Martins Fabricia
Published: February 2025

O objetivo do artigo é descrever como uma ferramenta digital de gestão pública, a Sala de Situação, pode contribuir para a tomada de decisão municipal de saúde pública. Trata-se de um estudo descritivo, realizado no município de São José, Santa Catarina, Brasil. A sala, construída em 2017, desde então é atualizada anualmente e passou pelas seguintes etapas: surgimento da necessidade; construção conceitual, matriz lógica  e metodológica; escolha dos eixos e indicadores; implantação e operação nos diversos níveis da gestão; criação do grupo de diretores com reuniões mensais; validação dos indicadores; aprimoramento da metodologia de análise com modelagem, desempenho e previsão; e, construção do novo aplicativo melhorando a interface, facilitando acesso e automatizando a análise. Dentre os resultados encontrados, a Sala de Situação é considerada extremamente importante, pois oportuniza ao gestor conhecer os vários “segmentos” do setor saúde, retroalimentando o processo de planejamento, tornando-se um importante instrumento de gestão e planejamento. Conclui-se que a sala contribui para decisões que agilizam e qualificam o atendimento da população no espaço e tempo adequados, instrumentalizando um salto de qualidade na articulação integrada com os demais setores da instituição, subsidiando a reorganização do sistema de saúde, articulado em rede regionalizada e hierarquizada.
Características e tendências das modalidades de gestão e prestação de serviços contratualizados no SUS
Authors: Marques Silva João Felipe , Mendonça Fernanda de Freitas , Mendes Pereira Adelyne Maria , Gimenez Carvalho Brigida
Published: February 2025

A multiplicidade de modalidades de gestão e prestação de serviços públicos de saúde e suas distintas formas de contratualização é um dos desafios centrais para a gestão do Sistema Único de Saúde (SUS). Com base em uma matriz de análise da contratualização de serviços de saúde, o artigo analisa, em uma macrorregião, características e tendências das seguintes modalidades: administração pública, privado sem fins lucrativos (filantrópicos e organização social) e com fins lucrativos, fundação estatal de direito privado e consórcio público de saúde. Trata-se de uma pesquisa qualitativa, do tipo estudo de casos múltiplos, utilizando-se de dados secundários e entrevistas, apoiada no referencial institucionalista histórico. Os resultados são apresentados a partir de três dimensões (histórico-estrutural, político-institucional e conjuntural) e variáveis, características e tendências das modalidades pesquisadas. Entre eles, destacam-se: tendência à mercantilização e terceirização dos serviços e da força de trabalho no SUS, aspecto reforçado por modalidades e atores vinculados à esfera pública, além da desarticulação das modalidades com a rede de atenção. A modalidade importa e, para efetivar a atenção aos usuários, deve ser garantida por meio de regulação efetiva, governança pelos gestores públicos e participação social.
Análise do Comportamento dos Gastos Públicos em Saúde
Authors: Gomes Helen Maria da Silva , Engelage Emanuele , Borgert Altair , Fey Vladimir Arthur
Published: February 2025

Este estudo analisa o comportamento dos gastos públicos em saúde e sua relação com os demais gastos por classificação funcional programática no período de 2002 a 2020, o que gera reflexões importantes, inclusive como facilitador para análises futuras de eficiência dos serviços. Utiliza-se as técnicas de análise descritiva, correlação de Pearson e regressão para dados em painel. Constata-se que os gastos em saúde representam 7,9% dos gastos totais do governo, 4,1% dos gastos da União, 11,6% dos estaduais e 23,8% dos municipais. Os gastos em Assistência e Previdência Social, Educação, Urbanismo, Legislativo, Judiciário e Organização Agrária elevam a demanda por recursos aplicados em saúde, enquanto, maiores gastos em Defesa Nacional, Segurança Pública, Saneamento, Desporto e Lazer e Ciência e Tecnologia reduzem esse valor. Isso porque, ações governamentais realizadas a partir desses investimentos podem impactar de diferentes maneiras na qualidade de vida e no bem-estar da população, o que expande o conceito de saúde para além da ausência de doença. Esses resultados ressaltam a importância dessa particularização nas análises, a fim de embasar a gestão e as escolhas públicas.
Fortalecimento da Implementação de Políticas de Educação em Saúde no Brasil Por Meio de Plataformas de Monitoramento e Avaliação
Authors: De Oliveira Lemos Novato Valéria , Simões Lilian Ribeiro de Oliveira , Catussi Paschoalotto Marco Antonio , da Rocha Soares Ferreira Vicente
Published: February 2025

Este estudo discute o uso de plataformas de monitoramento e avaliação (M&A) para fortalecer a implementação de políticas públicas de educação em saúde, apresentando o Sistema de Mapeamento em Educação na Saúde (SIMAPES) do Brasil como um estudo de caso. A implementação de políticas públicas requer ferramentas adequadas que permitam decisões baseadas em dados. O SIMAPES é uma plataforma de M&A que fornece informações acionáveis para apoiar a política de educação em saúde do Brasil. Este estudo qualitativo utilizou revisão bibliográfica e análise de documentos para examinar o projeto, os recursos, a implementação e os resultados do SIMAPES. Os resultados demonstram que a arquitetura inovadora de dados integrados do SIMAPES apresenta indicadores que permitem avaliações de políticas, assim como identifica lacunas nos serviços, monitora a alocação de recursos e informa o planejamento estratégico adotado. Os benefícios da implementação incluem o fortalecimento das parcerias entre o governo e a academia para a pesquisa em políticas de saúde. Os desafios envolvem a garantia de fluxos de dados confiáveis e padronizados. Conclui-se que o SIMAPES oferece uma arquitetura robusta para dados de políticas de educação em saúde no Brasil, mas sua aplicação efetiva ainda exige esforços coordenados entre as partes interessadas.
Diretrizes para modelo de gestão de riscos para coordenação-geral de gestão de pessoas do Ministério da Saúde
Authors: Vieira de Moraes Lima Waldênia , Richartz Fernando , Fedatto-Pereira Rômulo
Published: February 2025

O modelo de gestão de riscos desenvolvido neste trabalho é aplicável à Coordenação-Geral de Gestão de Pessoas (COGEP) do Ministério da Saúde. Para a construção do modelo, foram analisados o modelo de gestão de riscos proposto pelo Committee of Sponsoring Organizations of the Treadway Commission (COSO), os princípios e as diretrizes de gestão de riscos da ISO 31000 e as medidas para a sistematização de práticas relacionadas à gestão de riscos, aos controles internos e à governança da Instrução Normativa Conjunta nº 1, de 10 de maio de 2016. Além disso, foram realizados o reconhecimento da extensão de toda a cadeia de valor da COGEP, o levantamento de sua missão, visão e valores e a identificação de seus objetivos estratégicos, táticos e operacionais. Por fim, foram definidas etapas necessárias para a construção do modelo de gestão de riscos. Conclui-se, em face do exposto, ter sido acertada a construção de um modelo de gestão de riscos para a COGEP, para uso imediato, tendo em vista os inúmeros benefícios que pode proporcionar.
Gestão da qualidade total no contexto da enfermagem oncológica: Revisão Integrativa
Authors: Dos Santos Juliano , Gomes da Silva Lívia
Published: February 2025

A gestão de qualidade total aplicada a enfermagem oncológica contribui para a melhoria dos cuidados ao paciente com câncer, integrando inovações tecnológicas e considerando as percepções dos pacientes. O objetivo desta revisão foi mapear e descrever estudos sobre a Gestão de Qualidade Total no contexto da enfermagem oncológica, no período de 2013 a 2023, identificando características/aspectos da qualidade e aplicação na gestão de enfermagem. Revisão integrativa da literatura realizada em dezembro de 2023, utilizando os descritores Gestão da Qualidade Total e Enfermagem Oncológica nas bases de dados MEDLINE®, LILACS®, IBECS® E BDENF®. Foram identificados 12 estudos, agrupados em três categorias: Tecnologia e inovação em cuidados de enfermagem (n=5); Percepção e satisfação do paciente (n=4) e (n=3); e Cuidados paliativos e intervenções de enfermagem. Destaca-se a eficácia da tecnologia na otimização de processos, enquanto a percepção do paciente ressalta a importância da qualidade do cuidado. Nos cuidados paliativos, enfatiza-se o papel das intervenções de enfermagem na melhoria da qualidade de vida. Este estudo identifica oportunidades, mostrando a relevância da Gestão de Qualidade Total e das ferramentas quantitativas na melhoria integrada dos cuidados oncológicos, combinando inovação tecnológica com as perspectivas individuais dos pacientes.
Avaliação das parcerias para o desenvolvimento produtivo no setor de saúde: impactos e insights obtidos
Authors: Barreto Kamilla Alves , Nunes Andre
Published: February 2025

Este trabalho tem como objetivo analisar as Parcerias para o Desenvolvimento Produtivo (PDPs) com foco na incorporação de produtos para saúde. Trata-se de um ensaio teórico que buscou refletir sobre o sucesso e o insucesso das PDPs. As PDPs são instrumentos de políticas públicas que celebram acordos entre o setor público e o setor privado com o objetivo de promover a transferência de tecnologia e conhecimento na área da saúde. Na análise efetuada, foi possível observar que as PDPs são uma estratégia importante para ampliar o acesso da população a produtos de saúde, principalmente com a produção local, o que reduz os custos de importação. No entanto, também foi evidenciado que as PDPs enfrentaram desafios e insucessos em muitos casos, o que reforça a importância de avaliações criteriosas e sistemáticas para aprimorar as políticas públicas e para tomar decisões fundamentadas em evidências concretas que permitam a análise da viabilidade econômica dessas parcerias. Nesse contexto, é necessário avaliar se os investimentos realizados estão de fato proporcionando os resultados almejados em termos de benefícios para a saúde pública.