bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergency Department Length of Stay and Mortality in Critically Injured Patients
Authors: Stey Anne M. , Kanzaria Hemal K. , Dudley R. Adams , Bilimoria Karl Y. , Knudson M. Margaret , Callcut Rachael A.
Published: March 2021

Objective:

Multicenter data from 2 decades ago demonstrated that critically ill and injured patients spending more than 6 hours in the emergency department (ED) before transfer to the intensive care unit (ICU) had higher mortality rates. A contemporary analysis of ED length of stay in critically injured patients at American College of Surgeons’ Trauma Quality Improvement Program (ACS-TQIP) centers was performed to test whether prolonged ED length of stay is still associated with mortality.

Methods:

This was an observational cohort study of critically injured patients admitted directly to ICU from the ED in ACS-TQIP centers from 2010-2015. Spending more than 6 hours in the ED was defined as prolonged ED length of stay. Patients with prolonged ED length of stay were matched to those with non-prolonged ED length of stay and mortality was compared.

Main Results:

A total of 113,097 patients were directly admitted from the ED to the ICU following injury. The median ED length of stay was 167 minutes. Prolonged ED length of stay occurred in 15,279 (13.5%) of patients. Women accounted for 29.4% of patients with prolonged ED length of stay but only 25.8% of patients with non-prolonged ED length of stay, P < 0.0001. Mortality rates were similar after matching—4.5% among patients with prolonged ED length of stay versus 4.2% among matched controls. Multivariable logistic regression of the matched cohorts demonstrated prolonged ED length of stay was not associated with mortality. However, women had higher adjusted mortality compared to men Odds Ratio = 1.41, 95% Confidence Interval 1.28 -1.61, P < 0.0001.

Conclusion:

Prolonged ED length of stay is no longer associated with mortality among critically injured patients. Women are more likely to have prolonged ED length of stay and mortality.
Application of Mobile Call-Based Integrative Body–Mind–Spirit (IBMS) Intervention to Deal With Psychological Issues of COVID-19 Patients: A Case Study in India
Authors: Rentala Sreevani , Ng Siu-Man
Published: March 2021

Aim: The aim of this case study was to assess whether 8 sessions of mobile call based integrated Body-Mind-Spirit (IBMS) intervention could help COVID-19 patient to deal with psychological issues. Methods: This article is based on a practical example of working with COVID-19 patient using the IBMS model. It is a single subject study involving a 50 year old south Indian male living in a Covid Care Center (CCC). Mobile call interviews and brief symptom inventory were used for evaluation. Subject underwent 8 sessions of integrated body-mind-spirit Intervention through video/mobile calls of 45 minutes each time for 8 sessions offered on alternative days over a period of 15 days with pre-post assessments. Results: The results indicate that there was a reduction in somatic symptoms, anxiety and depression on 15th day. Conclusion: Illustrations of real life cases may help psychiatric nurses to gain insight into the application of psycho-social-spiritual interventions through mobile phone during isolation and lockdown.
Environment Education in Indian Schools: The Search for a New Language
Authors: D’Souza Carol , Brahme Milind , Babu M. Suresh
Published: March 2021

This article analyses the National Council of Educational Research and Training textbooks of environmental studies using critical discourse analysis to shed light on questions such as how the environment is dealt with in the text, using what kind of language are environmental concerns framed, how is the current environment crisis contextualized both in terms of ecological and social justice, if at all, and what solutions are suggested in this regard. The article finds that though the content of the textbooks exhibits strong social contextualizing of learners’ surroundings, the thrust is anthropocentric, and the environment figures only as a peripheral concern. Themes such as gender, caste, hygiene, culture, equality and discrimination emerge stronger than those of biodiversity, conservation, pollution, water crisis and global warming. While the in-built thrust on conviviality in the textbooks is necessary and heartening, a better infusion of the current predicament in terms of the environment crisis and how it could be mitigated is recommended.
Applying the Theory of Constraints Principles to Tourism Supply Chain Management
Authors: Zhao Xiaofeng , Hou Jianrong
Published: March 2021

Tourism supply chain management has become an important research topic as individual firms no longer compete as isolated entities but rather as supply chains in the tourism industry. Despite the evidence that benefits can be gained to improve profitability, competitiveness, and customer satisfaction, the research on how to manage the tourism supply chain is very limited. This research contributes to the literature by applying the theory of constraints (TOC) with systems thinking to tourism supply chain management. It proposes that the key issue in tourism supply chain management is the coordination of business activities and the TOC with systems thinking can effectively support tourism supply chain coordination of the various links and processes. The article examines the TOC performance measures and the drum–buffer–rope model in the context of tourism management and applies the focusing process of the TOC as a continuous improvement approach for tourism supply chain management. The research findings suggest that, given modifications to the TOC terminology and the principles, the TOC principles can work as an excellent approach to facilitate the tourism supply chain management.
Indicators and determinants of the years of working life lost: a narrative review
Authors: Shiri Rahman , Hiilamo Aapo , Lallukka Tea
Published: March 2021

Objective:

This narrative review summarizes the available indicators for working life expectancy and years of working life lost (YWLL) and their determinants.

Methods:

We searched PubMed and Embase databases from their inception until August 2020 and screened all studies proposing an indicator for working life expectancy or YWLL. We also reviewed studies focusing on sociodemographic, lifestyle and work-related determinants of working life expectancy and YWLL. The results were synthesized narratively.

Results:

We identified 13 different indicators for the length of working life or YWLL. The most frequently used indicators were ‘working life expectancy’, ‘healthy working life expectancy’, and YWLL. Working life expectancy and healthy working life expectancy are longer for men than women. Working life expectancy at the age of 50 has been increasing since the mid-90s, and the increase has been larger for women, reducing the sex difference. Working life is shorter for people with a low level of education, in lower occupational classes, for people exposed to high physical work demands, those living in the most socioeconomically deprived areas, people with overweight or obesity, smokers, people who are inactive during leisure time and in people with a chronic health problem.

Conclusions:

Despite increasing interest in understanding the determinants of YWLL, only a few studies have simultaneously considered multiple exit routes from the labour market. We propose a new measure for total YWLL considering all relevant exit routes from employment. This comprehensive measure can be used to assess the effect of given policy changes on prolonging working life.
School Nursing Associations: Restructuring for Contemporary Practice
Authors: Yonkaitis Catherine F. , Madura Karen J. , Vollinger Linda Jeno
Published: March 2021

School nursing associations are the professional organizations that help members collaborate with each other, keep up-to-date with trends and advances within the profession, advocate the positions of the profession, and provide a place of connection with stakeholders and government entities. Participation by members in professional associations is waning across the country affecting the work they can do. The Illinois Association of School Nurses took a proactive approach to reorganize and revitalize their organization and membership.
Product digitalization at Nike: The future is now
Authors: Standaert Willem
Published: March 2021

Nike is well known for the digitalization of its commerce processes, including direct-to-consumer mobile and social commerce, as well as for pushing the envelope in terms of using advanced materials in innovative sportswear. However, leveraging digital technologies to augment products had not taken off yet. Since the turn of the millennium, Nike had launched several product digitalization initiatives, such as product customization, activity tracking and using products as a gateway to exclusive content, yet none of these had seen major success. Against this background, this case focuses on the launch of Nike Adapt, a new product line featuring a self-lacing system, a concept that was 30 years in the making. For Nike, this was the beginning of the era of true personalization based on smart products, so the pressure was high to make the right strategic decisions.
Who and how many can work from home? Evidence from task descriptions
Authors: Holgersen Henning , Jia Zhiyang , Svenkerud Simen
Published: March 2021

The Covid-19 crisis has forced great societal changes, including forcing many to work from home (WFH) in an effort to limit the spread of the disease. The ability to work from home has long been considered a perk, but we have few estimates of how many jobs are actually possible to be performed from home. This paper proposes a method to estimate the share of these jobs. For each occupation, we obtain a WFH friendly measure by asking respondents from Amazon Mechanical Turk (MTurk) to evaluate whether the corresponding tasks can be performed from home based on the descriptions from the International Standard Classification of Occupations 2008 (ISCO-08) standard. The share of WFH friendly jobs in an economy can then be estimated by combining these measures with the labor statistics on occupational employments. Using Norway as an illustrating example, we find that approximately 38% of Norwegian jobs can be performed from home. The Norwegian results also suggest that the pandemic and the government’s attempts to mitigate this crisis may have a quite uneven impact on the working population. Those who are already disadvantaged are often less likely to have jobs that can be performed from home.
The epidemiology of carbapenem resistance in Acinetobacter baumannii complex in Germany (2014–2018): an analysis of data from the national Antimicrobial Resistance Surveillance system
Authors: Said Dunja , Willrich Niklas , Ayobami Olaniyi , Noll Ines , Eckmanns Tim , Markwart Robby
Published: March 2021

Background

Carbapenem-resistant Acinetobacter baumannii complex (CRABC) has globally emerged as a serious public health challenge. This study aimed to describe epidemiological trends and risk factors of carbapenem resistance in A. baumannii complex isolates in Germany between 2014 and 2018.

Methods

We analysed 43,948 clinical A. baumannii complex isolates using 2014 to 2018 data from the German Antimicrobial Resistance Surveillance system. We applied descriptive statistics and uni- and multivariable regression analyses to investigate carbapenem resistance in A. baumannii complex isolates.

Results

The proportion of carbapenem resistance in clinical A. baumannii complex isolates declined from 7.6% (95% confidence interval [95% CI] 4.4–12.7%) in 2014 to 3.5% (95% CI 2.5–4.7%) in 2018 (adjusted OR [aOR] 0.85 [95% CI 0.79–0.93, p ≤ 0.001]). Higher mean CRABC proportions for 2014 to 2018 were observed in secondary care hospitals (4.9% [95% CI 3.2–7.5%], aOR 3.6 [95% CI 2.4–5.3, p ≤ 0.001]) and tertiary care hospitals (5.9% [95% CI 3.0–11.2%], aOR 5.4 [95% CI 2.9–10.0, p ≤ 0.001) compared to outpatient clinics (1.3% [95% CI 1.1–1.6%]). CRABC proportions in hospitals varied between German regions and ranged between 2.4% (95% CI 1.6–3.5%) in the Southeast and 8.8% (95% CI 4.2–17.3%) in the Northwest. Lower CRABC proportions were observed in younger patients (< 1 year: 0.6% [95% CI 0.2–1.3%]; 1–19 years: 1.3% [95% CI 0.7–2.5%]) than adults (20–39 years: 7.7% [95% CI 4.4–13.0%]; 40–59 years: 6.2% [4.2–8.9%]; 60–79 years: 5.8% [95% CI 4.0–8.3%]). In the 20–39 year old patient age group, CRABC proportions were significantly higher for men than for women (14.6% [95% CI 8.6–23.6%] vs. 2.5% [95% CI 1.3–4.5%]). A. baumannii complex isolates from lower respiratory infections were more likely to be carbapenem-resistant than isolates from upper respiratory infections (11.4% [95% CI 7.9–16.2%] vs. 4.0% [95% CI 2.7–6.0%]; adjusted OR: 1.5 [95% CI 1.2–1.9, p ≤ 0.001]).

Conclusions

In contrast to many other regions worldwide, carbapenem resistance proportions among clinical A. baumannii complex isolates are relatively low in Germany and have declined in the last few years. Ongoing efforts in antibiotic stewardship and infection prevention and control are needed to prevent the spread of carbapenem-resistant A. baumannii complex in Germany.
Lymphatic filariasis, infection status in Culex quinquefasciatus and Anopheles species after six rounds of mass drug administration in Masasi District, Tanzania
Authors: Lupenza Eliza , Gasarasi Dinah B. , Minzi Omary M.
Published: March 2021

Background

Lymphatic filariasis (LF) elimination program in Tanzania started in 2000 in response to the Global program for the elimination of LF by 2020. Evidence shows a persistent LF transmission despite more than a decade of mass drug administration (MDA). It is advocated that, regular monitoring should be conducted in endemic areas to evaluate the progress towards elimination and detect resurgence of the disease timely. This study was therefore designed to assess the status of Wuchereria bancrofti infection in Culex quinqefasciatus and Anopheles species after six rounds of MDA in Masasi District, South Eastern Tanzania.

Methods

Mosquitoes were collected between June and July 2019 using Center for Diseases Control (CDC) light traps and gravid traps for indoor and outdoor respectively. The collected mosquitoes were morphologically identified into respective species. Dissections and PCR were carried out to detect W. bancrofti infection. Questionnaire survey and checklist were used to assess vector control interventions and household environment respectively. A Poisson regression model was run to determine the effects of household environment on filarial vector density.

Results

Overall, 12 452 mosquitoes were collected of which 10 545 (84.7%) were filarial vectors. Of these, Anopheles gambiae complex, An. funestus group and Cx. quinquefasciatus accounted for 0.1%, 0.7% and 99.2% respectively. A total of 365 pools of Cx. quinquefasciatus (each with 20 mosquitoes) and 46 individual samples of Anopheles species were analyzed by PCR. For Cx. quinquefasciatus pools, 33 were positive for W. bancrofti, giving an infection rate of 0.5%, while the 46 samples of Anopheles species were all negative. All 1859 dissected mosquitoes analyzed by microscopy were also negative. Households with modern latrines had less mosquitoes than those with pit latrines [odds ratio (OR) = 0.407, P < 0.05]. Houses with unscreened windows had more mosquitoes as compared to those with screened windows (OR = 2.125, P < 0.05). More than 80% of the participants own bednets while 16.5% had no protection.

Conclusions

LF low transmission is still ongoing in Masasi District after six rounds of MDA and vector control interventions. The findings also suggest that molecular tools may be essential for xenomonitoring LF transmission during elimination phase.
Associations between the cortisol awakening response and patient-evaluated stress and mood instability in patients with bipolar disorder: an exploratory study
Authors: Faurholt-Jepsen Maria , Frøkjær Vibe Gedsø , Nasser Arafat , Jørgensen Niklas Rye , Kessing Lars Vedel , Vinberg Maj
Published: March 2021

Objective

The Cortisol Awakening Response (CAR) measured as the transient increase in cortisol levels following morning awakening appears to be a distinct feature of the HPA axis. Patients with bipolar disorder (BD) experience daily stress, mood instability (MI) and studies have shown disrupted HPA-axis dynamics. Aims: to evaluate (1) patient-evaluated stress against the CAR, (2) associations between the CAR and mood symptoms, and (3) the effect of smartphone-based treatment on the CAR.

Methods

Patients with BD (n = 67) were randomized to the use of daily smartphone-based monitoring (the intervention group) or to the control group for six months. Clinically rated symptoms according to the Hamilton Depression Rating Scale 17-items (HDRS), the Young Mania Rating Scale (YMRS), patient-evaluated perceived stress using Cohen’s Perceived Stress Scale (PSS) and salivary awakening cortisol samples used for measuring the CAR were collected at baseline, after three and six months. In the intervention group, smartphone-based data on stress and MI were rated daily during the entire study period.

Results

Smartphone-based patient-evaluated stress (B: 134.14, 95% CI: 1.35; 266.92, p = 0.048) and MI (B: 430.23, 95% CI: 52.41; 808.04, p = 0.026) mapped onto increased CAR. No statistically significant associations between the CAR and patient-evaluated PSS or the HDRS and the YMRS, respectively were found. There was no statistically significant effect of smartphone-based treatment on the CAR.

Conclusion

Our data, of preliminary character, found smartphone-based patient-evaluations of stress and mood instability as read outs that reflect CAR dynamics. Smartphone-supported clinical care did not in itself appear to disturb CAR dynamics.
Laterality and region-specific tau phosphorylation correlate with PTSD-related behavioral traits in rats exposed to repetitive low-level blast
Authors: Perez Garcia Georgina , De Gasperi Rita , Gama Sosa Miguel A. , Perez Gissel M. , Otero-Pagan Alena , Pryor Dylan , Abutarboush Rania , Kawoos Usmah , Hof Patrick R. , Dickstein Dara L. , Cook David G. , Gandy Sam , Ahlers Stephen T. , Elder Gregory A.
Published: March 2021

Military veterans who experience blast-related traumatic brain injuries often suffer from chronic cognitive and neurobehavioral syndromes. Reports of abnormal tau processing following blast injury have raised concerns that some cases may have a neurodegenerative basis. Rats exposed to repetitive low-level blast exhibit chronic neurobehavioral traits and accumulate tau phosphorylated at threonine 181 (Thr181). Using data previously reported in separate studies we tested the hypothesis that region-specific patterns of Thr181 phosphorylation correlate with behavioral measures also previously determined and reported in the same animals. Elevated p-tau Thr181 in anterior neocortical regions and right hippocampus correlated with anxiety as well as fear learning and novel object localization. There were no correlations with levels in amygdala or posterior neocortical regions. Particularly striking were asymmetrical effects on the right and left hippocampus. No systematic variation in head orientation toward the blast wave seems to explain the laterality. Levels did not correlate with behavioral measures of hyperarousal. Results were specific to Thr181 in that no correlations were observed for three other phospho-acceptor sites (threonine 231, serine 396, and serine 404). No consistent correlations were linked with total tau. These correlations are significant in suggesting that p-tau accumulation in anterior neocortical regions and the hippocampus may lead to disinhibited amygdala function without p-tau elevation in the amygdala itself. They also suggest an association linking blast injury with tauopathy, which has implications for understanding the relationship of chronic blast-related neurobehavioral syndromes in humans to neurodegenerative diseases.
The aspiration test: an arthroscopic sign of lateral meniscus posterior horn instability
Authors: Jacquet Christophe , Magosch Amanda , Mouton Caroline , Seil Romain
Published: March 2021

The suspensory mechanism of the posterior horn of the lateral meniscus (PHLM) is an anatomically complex structure including the popliteomeniscal fascicles, the meniscotibial posterior root attachment and the meniscofemoral ligaments. Damage to one or several of these structures – either through knee trauma or congenital abnormalities—can result in an instability of the PHLM that may lead to lateral knee pain, locking sensations or lack of rotational control of the knee (e.g. after anterior cruciate ligament injuries). The diagnosis of PHLM instability is complex due to the lack of reliable clinical tests and imaging signs. Direct visual dynamic inspection via arthroscopy thus remains the gold standard. However, arthroscopic probing of the PHLM is not always reliable and the precise quantification of the amount of subluxation of the PHLM can be difficult. Therefore, the main objective of this report was to describe a quick and easy arthroscopic screening test called “the aspiration test” in order to help surgeons to detect PHLM instability. During the exploration of the lateral tibiofemoral compartment with the knee kept in the figure of 4 position, the arthroscope is placed in the antero-lateral portal and directed towards the lateral tibiofemoral compartment. The aspiration test is then performed by activating the aspiration of the 4-mm shaver when located in the intercondylar notch. In case of a PHLM instability, an excessive displacement of the PHLM is observed. After repair, a second aspiration test allows to verify that the PHLM has been stabilized.
The Effects of Genetic Mutations and Drugs on the Activity of the Thiamine Transporter, SLC19A2
Authors: Enogieru Osatohanmwen J. , Koleske Megan L. , Vora Bianca , Ngo Huy , Yee Sook Wah , Chatad Derrick , Sirota Marina , Giacomini Kathleen M.
Published: March 2021

A rare cause of megaloblastic anemia (MA) is thiamine-responsive megaloblastic anemia (TRMA), a genetic disorder caused by mutations inSLC19A2(encoding THTR1), a thiamine transporter. The study objectives were to (1) functionally characterize selected TRMA-associated SLC19A2 variants and (2) determine whether current prescription drugs associated with drug-induced MA (DIMA) may act via inhibition of SLC19A2. Functional characterization of selected SLC19A2 variants was performed by confocal microscopy and isotopic uptake studies of [3H]-thiamine in HEK293 cells. Sixty-three drugs associated with DIMA were screened for SLC19A2 inhibition in isotopic uptake studies. Three previously uncharacterized SLC19A2 variants identified in TRMA patients exhibited disrupted localization to the plasma membrane along with near-complete loss-of-function. Ten of 63 drugs inhibited SLC19A2-mediated thiamine transport ≥ 50% at screening concentrations; however, with the exception of erythromycin, none was predicted to inhibit SLC19A2 at clinically relevant unbound plasma concentrations. Data from electronic health records revealed reduced levels of thiamine pyrophosphate (TPP) in patients prescribed erythromycin, consistent with inhibition of SLC19A2-mediated thiamine transport. Here, we confirmed the role of three SLC19A2 variants in TRMA pathology. Additionally, we report that inhibition of SLC19A2 is a potential, but uncommon mechanism for DIMA.
“Democracy’s Unfinished Business”
Authors: Sullivan Patrick
Published: March 2021

The Truman Commission created the modern community college in 1947 to democratize our system of higher education in America. Before this moment, higher education was thoroughly segregated by race, class, and gender. The modern open-admissions two-year college cannot, therefore, be understood simply as a convenient, low-cost alternative to four-year colleges. It is—by mission and mandate—a social justice institution.
Mattilda Bernstein Sycamore
Authors: Gossett Che , Hayward Eva
Published: March 2021

The following is an interview with author and activist Mattilda Bernstein Sycamore conducted by Che Gossett and Eva Hayward. Sycamore discusses how she uses fiction to work through historical traumas, inviting readers to imagine the AIDS pandemic as not simply memory but as continuing crisis that necessitates desiring into the archive so that we might begin to understand AIDS. Trauma cannot be historically rendered—this is the catastrophe of this experience, past and present are affectively collapsed—so we must be creative in how we refuse to forget a pandemic that remains ongoing.
OR Practice–Data Analytics for Optimal Detection of Metastatic Prostate Cancer
Authors: Merdan Selin , Barnett Christine L. , Denton Brian T. , Montie James E. , Miller David C.
Published: March 2021

We used data-analytics approaches to develop, calibrate, and validate predictive models, to help urologists in a large statewide collaborative make prostate cancer staging decisions on the basis of individual patient risk factors. The models were validated using statistical methods based on bootstrapping and evaluation on out-of-sample data. These models were used to design guidelines that optimally weigh the benefits and harms of radiological imaging for the detection of metastatic prostate cancer. The Michigan Urological Surgery Improvement Collaborative, a statewide medical collaborative, implemented these guidelines, which were predicted to reduce unnecessary imaging by more than 40% and limit the percentage of patients with missed metastatic disease to be less than 1%. The effects of the guidelines were measured after implementation to confirm their impact on reducing unnecessary imaging across the state of Michigan.
Hockey: a pain in the butt! Isolated superior gluteal artery rupture following blunt pelvic trauma – an unusual case
Authors: Burton H , Mossadegh S , McCarthy R
Published: March 2021

Superior gluteal artery rupture is a rare complication of trauma but a significant one with potential for substantial morbidity and mortality. This case demonstrates the importance of early diagnosis and treatment of this injury pattern. Endovascular embolisation has become the most effective treatment for pelvic haemorrhage. Acknowledgement of this rare injury as a differential diagnosis is vital to facilitate rapid diagnosis and appropriate treatment.
Diffractive saturable loss mechanism in Kerr-lens mode-locked lasers: direct observation and simulation
Authors: Parshani Idan , Bello Leon , Meller Mallachi-Elia , Pe’er Avi
Published: March 2021

Passive mode-locking relies critically on a saturable loss mechanism to form ultrashort pulses. However, in Kerr-lens mode-locking (KLM), no actual absorption takes place, but rather losses appear due to diffraction, and actual light must escape the cavity. The Kerr-lens effect works to generate through diffraction an effective instantaneous saturable absorber that depends delicately on the interplay between the spatial and temporal profiles of the pulse. Despite the importance of KLM as a technique for generating ultrafast pulses and the fundamental role of diffraction losses in its operation, these losses have never been observed directly. Here, we measure the light that leaks out due to diffraction losses in a hard-aperture Kerr-lens mode-locked Ti:sapphire laser, and compare the measured results with a numerical theory that explicitly calculates the spatiotemporal behavior of the pulse.
Interactions of protective behavioral strategies and cannabis use motives: An online survey among past-month users
Authors: Genrich Gregor , Zeller Céline , Znoj Hans Jörg
Published: March 2021

Given the constant high prevalence of cannabis use and cannabis dependence, it is important to determine protective behaviors on the individual level, which buffer the effects of risk factors. Protective Behavioral Strategies for Marijuana (PBSM) have been identified to play an important role for harm reduction in adolescent and young adult users. In the present study, we analyzed if PBSM moderate the effects of use motives (captured by the Marijuana Motives Measure, MMM) on the severity of dependence beyond the effects of age, gender, education and cannabis use frequency. We used confirmatory factor analysis (CFA) to validate the German versions of PBSM and MMM. Data was gathered in an online survey distributed to randomly chosen households in the city of Bern in the German speaking part of Switzerland. The final sample comprised 362 past-month users. Results showed negative correlations between PBSM and cannabis use frequency and severity of dependence. The only motives being correlated with severity of dependence were coping and routine, beyond frequency of use. PBSM significantly moderated the effect only of routine motives on the severity of dependence. However, only a few cases who used PBSM extensively were affected. PBSM appear to be an important factor to reduce harm among past-month users but not among those with dependent use patterns, e.g. coping and routine users. Clinical implications are discussed. The routine factor adds significantly to the MMM and should be implemented and improved in future studies. PBSM as well as the MMM can be used in future studies in German speaking populations.
Plutarco. Vidas Paralelas: Aristides e Catão Censor
Authors: Pinheiro Joaquim
Published: March 2021

Em diferentes contextos, Aristides e Catão Censor são paradigmas de figuras históricas que se dedicaram à causa pública. Enfrentando obstáculos de diversa natureza, souberam, apesar dos oponentes à sua estratégia política, manter os seus valores. Por meio da arete e da dynamis distinguiram-se na politeia e atingir a doxa. No entanto, como é muitas vezes inerente à atividade política, isso contribuiu para o ostracismo de Aristides e também Catão Censor conseguiu suscitar a inimizade em vários sectores da sociedade romana. Plutarco, selecionando um conjunto de ações, evidencia um aspeto que é transversal na história do pensamento político: o coletivo e o privado. Aristides, mais do que Catão Censor, consegue valorizar o sentido coletivo da sua ação política em detrimento do bem-estar individual. O que para alguns pode ser falta de ambição, para Aristides é respeito pela justiça e pelo coletivo. Quanto a Catão Censor, distingue-se pelo sucesso com que gere o privado, o que pode ser um sinal de mesquinhez ou grandeza de espírito. No exercício das suas funções políticas, procuraram ambos manter uma conduta moral exemplar, ainda que condicionados por diferentes circunstâncias pessoais e também sociais
Studying the mechanisms of the Somatic Marker Hypothesis in Spiking Neural Networks (SNN)
Authors: Jiménez-Rodríguez Alejandro , Castillo Luis Fernando , González Manuel
Published: March 2021

In this paper, a mechanism of emotional bias in decision making is studied using Spiking Neural Networks to simulate the associative and recurrent networks involved. The results obtained are along the lines of those proposed by A. Damasio as part of the Somatic Marker Hypothesis, in particular, that, in absence of emotional input, the decision making is driven by the rational input alone. Appropriate representations for the Objective and Emotional Values are also suggested, provided a spike representation (code) of the information.
Aplicabilidade da Lei de Acesso à Informação em Municípios / Applicability of the Access to Information Law in the Municipalities
Authors: Souza Junior Paulo De Tasso de , Ceolin Alessandra Carla , Silva Talita Roberta Vasconcelos da , Celestino Michelle Lima , Almeida Nilson Braga de , Carvalho Rafael Rodrigues
Published: March 2021

Este estudo analisa a relação entre a Lei de Acesso à Informação e o nível de transparência nos municípios da Região Metropolitana do Recife (RMR). Com a criação da Lei 12.527/2011, determinou-se que os entes federativos teriam de prestar contas à população, ou seja, dar mais publicidade aos seus atos. Sendo assim, a transparência ganhou mais espaço perante a sociedade, que pode e deve participar da gestão pública atuando no planejamento, fiscalização e no controle. A coleta de dados foi realizada por meio de questionários aplicados nas controladorias de cada um dos 14 municípios da RMR. Os resultados demonstram que alguns municípios não cumprem o mínimo estabelecido pela legislação. Outros, a maior parte deles, cumprem a determinação da lei de maneira parcial e/ou incompleta, visto que obedecem a alguns dos requisitos estabelecidos, em detrimento de outros, como os relacionados à divulgação das informações e incentivo à participação popular.
Uso Abusivo de Psicotrópicos e Fatores Associados com a Má Utilização na Atenção Primária à Saúde / Abuse of Psychotropics and Factors Associated with Misuse in Primary Health Care
Authors: Lima Tyssia Nogueira , Sousa Milena Nunes Alves de
Published: March 2021

Na contemporaneidade, o uso excessivo de medicamentos parece ser um dos traços expressivos da civilização ocidental, na qual prevalece a persuasão de que o mal-estar, bem como o sofrimento de todo gênero, deve ser eliminado a qualquer custo. O uso de psicotrópicos é imprescindível no tratamento de alguns formatos de transtornos mentais ou distúrbios psiquiátricos, tais como: ansiedade, insônia, depressão, agitação, convulsão e a psicose. O objetivo desse trabalho, portanto, foi examinar os verdadeiros motivos da utilização de psicotrópicos e quais as características dos pacientes que o empregam. Este trabalho aborda-se sobre uma revisão integrativa da literatura e, para a elaboração do mesmo, algumas fases precisaram ser cursadas. Inicialmente foi feita a escolha do tema e posteriormente formada a questão de pesquisa; após esta etapa foram estabelecidos os critérios de inclusão e exclusão de artigos (seleção da amostra); identificação das informações a serem destacadas dos artigos selecionados; realização da análise dos resultados; findando com a discussão.  O sexo feminino é mais perceptivo em relação à sintomatologia das doenças, por isso, procuram mais cedo por ajuda e apresentam menor resistência ao uso de medicamentos prescritos do que os homens. Pacientes sem uma ocupação profissional apresentam maior prevalência de transtornos mentais. A terapia alternativa não medicamentosa poderia ser abordada, para pacientes que proporcionaram transtornos de depressão, ansiedade e insônia. Os tratamentos medicamentosos para esses distúrbios envolvem fármacos que causam dependência química e efeitos colaterais, e isso leva, na maioria das vezes, as pessoas a se tratarem por longos períodos.
O Uso da Lei da Responsabilidade Fiscal e o Cumprimento no Município de Petrolina/PE: Um Estudo Voltado ao Nível de Conhecimento da Lei e sua Efetividade no Período 2014 a 2017 / The use of the Fiscal Responsibility Law and its Compliance in the City of Petrolina / PE: A Study focused on the level of knowledge of the Law and its Effectiveness in the Period from 2014 to 2017
Authors: Rodrigues Caitiane Pereira , Silva Samuel Modesto Modesto , Goes Claudemar Pimenta , Caffé Hesler Piedade
Published: March 2021

Este Artigo teve o objetivo de analisar o impacto da Lei nº 101/2000 no que se refere à importância da prestação de contas de recursos públicos na Prefeitura Municipal de Petrolina/PE. Foram levantas informações conclusivas sobre esse assunto enfatizando o papel do gestor e contador público em planejar, controlar e apresentar possíveis determinantes na LRF, onde são traçados as metas e objetivos com vistas a resultados e o controle fiscal por parte da gestão.A adequação no cumprimento das informações por meio de publicações no Portal da Transferência, pode se perceber que se faz necessário construir um referencial futuro, por meio das informações contidas e apresentadas ao cidadão, onde estão estruturadas o trâmite adequado e assim podendo reavaliar todo oprocesso a que o planejamento se destina, podendo assim mensurar os riscos de endividamento. Sabemos que sem a avaliação da responsabilidade e eficiência fiscal, não há dados para redução de gastos e o controle da aplicabilidade da lei no município estudado.A Lei de Responsabilidade Fiscal a qual impõe metas, limites e estabelece critérios a ser seguida pela gestão pública, cujo o objetivo é a prevenção de riscos, como também evitar desvios financeiros, que possam desequilibrar as contas públicas, garantindo assim o cumprimento das atividades elaboradas com legitimidade. Através da formulação da LRF a Administração Pública tem por obrigação o planejamento e a realização das atividades de forma transparente, sabendo o limite dos gastos e mantendo o equilíbrio das mesmas.A Transparência na gestão é fundamental para combater a corrupção e proporcionar à sociedade a participação continua e assim fornecendo conhecimento ao cidadão sobre como está sendo aplicados os recursos públicos e desta forma cobrar a gestão pública o que estiver fora do controle estabelecido por lei.Finalizando, conclui-se que o controle é a efetividade e a realização das atividades na Administração Pública, em que a responsabilidade cabe a todos, onde a sociedade está acompanhando e verificando se o que está planejado está sendo executado.
Polimedicação em Pacientes Idosos: Práticas para Minimizar os Malefícios na População Idosa / Polymedication in Elderly Patients: Practices to Minimize Maleficients in the Elderly Population
Authors: Freitas Amanda Medeiros , Freitas Aline Medeiros , Toledo Miguel Aguila , Anacleto Verônica Gomes , Sousa Milena Nunes Alves de
Published: March 2021

Resumo: Indivíduos idosos se encontram mais propensos a serem polimedicados, fazendo-se necessária precaução quanto à prescrição sem indicação benéfica definida diante da interação que os fármacos realizam no organismo, o que pode ocasionar em prejuízos ao sujeito. Além da interação medicamentosa, alguns fármacos ainda podem gerar efeitos maléficos superiores aos benéficos, especialmente entre aqueles com maior fragilidade orgânica e com maior necessidade de atenção na prática médica. Com isso, esse trabalho objetiva avaliar a polimedicação em pacientes idosos e expor práticas para minimizar seus malefícios ao grupo. Para tanto, foi realizada uma revisão integrativa da literatura, realizada a partir de dez artigos selecionados em plataforma online nacionais e internacionais. Observou-se que, na biblioteca e bases de dados utilizadas, há poucos estudos realizados abordando o tema na última década. A maioria das publicações foi redigida na língua inglesa, com metodologia de revisão sistemática. Na tentativa de diminuir os efeitos danosos da polifarmácia em pacientes idosos, estudos têm sido propostos a fim de fornecer evidências científicas capazes de validar a prática clínica geriátrica. Todavia, muitas das intervenções/estratégias desenvolvidas se mostraram incertas e pouco confiáveis. Ao tratar a terceira idade, no entanto, o profissional da medicina deve lembrar-se de suas peculiaridades e avaliar a importância real daquela prescrição, seu risco e benefício, interação medicamentosa e possíveis complicações no idoso frágil. Após esta avaliação completa e complexa, é que a prescrição deverá ser realizada, de modo realmente necessário evitando, assim, a polimedicação do idoso.
Gestão Financeira Através do Fluxo de Caixa: Estudo de Geração de Dados para Tomada de Decisões em Propriedades Rurais / Financial Management Through Cash Flow: Data Generation Study for Decision-Making in Rural Properties
Authors: Friske Hadassa Landherr , Soares Ana Cristina Beck Serra
Published: March 2021

O presente estudo se propõe a explorar a aplicação da gestão financeira através da utilização do fluxo de caixa com a finalidade de geração de dados e informações para a tomada de decisões para pequenos horticultores orgânicos em Alta Floresta – MT. A pesquisa se deu através de uma abordagem quantitativa, de natureza aplicada, com objetivo exploratório e utilizou como procedimentos a revisão bibliográfica e o estudo-ação, com coleta e análise de dados. Conclui-se que os objetivos do trabalho foram alcançados e que as hipóteses foram confirmadas parcialmente. Verificou-se que após o acompanhamento de seis meses, as propriedades evoluíram nas suas respectivas estratégias de gestão. Ainda foi possível identificar o produto mais vendido, aprimorar o controle orçamentário e o controle de caixa, acompanhar a evolução dos resultados, bem como, da estrutura do caixa.
Puerpério de Alto Risco: Orientações Recebidas na Alta Hospitalar / High-risk puerperium: Guidelines received at hospital discharge
Authors: Gobbo Catharino Anna Luísa , Santos Izabel Dayana de Lemos , Fontana Medeiros Fabiana , Capello Thais Da Silva , Rodrigues Colombo Gomes Natalia Carolina , Pimenta Ferrari Rosângela Aparecida , Maciel Cardelli Alexandrina Aparecida
Published: March 2021

Esse estudo teve como objetivo identificar as orientações recebidas pelas puérperas de alto risco no momento da alta no puerpério precoce. Estudo quantitativo, realizado em uma maternidade de alto risco, com 296 puérperas, no período de outubro de 2016 a agosto de 2017. Os dados foram analisados no software SPSS 20.0 e o estudo foi aprovado pelo Comitê de Ética em Pesquisa com o parecer 1.757.596. O perfil predominante foi de jovens-adultas, brancas com companheiro fixo, primíparas. Quanto às orientações recebidas na alta hospitalar, houve predomínio do retorno puerperal (80,4%), infecção puerperal (62,2%). Os profissionais que forneceram orientações às puérperas destacaram-se o enfermeiro (65,7%). Evidenciou-se a importância de educação continuada aos profissionais, direcionada para a alta hospitalar, assim como a implementação de protocolo puerperal às gestantes de alto risco.
Aplicação das Práticas Integrativas e Complementares na Atenção Primária à Saúde / Application of Integrative and Complementary Practices in Primary Health Care
Authors: Vidal Mariana Dos Santos Araujo , Sousa Milena Nunes Alves de , Toledo Miguel Aguila
Published: March 2021

Objetivo: Avaliar quais os problemas de saúde abordados pelas Práticas Integrativas e Complementares na Atenção Primária à Saúde. Métodos: Consiste em uma revisão integrativa de literatura, a qual possibilita a construção de um panorama da produção científica disponível acerca do tema, com análise dos artigos publicados nos últimos cinco anos em idioma português, nas bases de dados da Biblioteca Virtual em Saúde e da Biblioteca Nacional de Medicina dos Estados Unidos, com seleção final de 14 artigos para avaliação integral. Resultados: Foram observadas cinco categorias de agravos à saúde nas quais houve aplicação das Práticas Integrativas e Complementares, sendo elas a saúde mental, manejo da dor, doenças crônicas, doenças neurológicas e menopausa. Conclusão: Apesar dessas práticas apresentarem seu uso disseminado em algumas patologias, ainda há uma carência de estudos com foco nas suas aplicações e respectivos resultados na situação de saúde dos indivíduos.
Perfil dos Casos Notificados de Intoxicação Exógena por Medicamentos no Estado do Ceará / Profile of notified cases of exogenous drug poisoning in the State of Ceará
Authors: Alves Pereira Maria Juliana , Alves Pereira Ana Júlia , De Oliveira Dário Rodrigues , Nicácio Beatriz Da Silva , De Sá João Cláudio Leite , Gomes Coelho José Leonardo , Linard Carneiro Ângela Patrícia , Vieira Gadelha Maria Do Socorro
Published: March 2021

A intoxicação exógena por medicamentos configura-se como um problema de saúde pública. O trabalho de pesquisa teve como finalidade identificar o perfil dos pacientes que contenham ocorrência de intoxicações medicamentosas, notificadas no estado do Ceará, no período de 2015 a 2019. Realizou uma revisão de literatura, com uma abordagem quantitativa e qualitativa, nas bases de dados Pubmed, Lilacs e Scielo, utilizando os descritores drug intoxication e epidemiology. Para a complementação das informações procedeu-se uma busca de informações através do Sistema de Informação de Agravos de Notificação. Entre os 5 anos foram notificados 6.811 casos de intoxicação exógena por medicamentos no estado do Ceará. O perfil das intoxicações, representou-se pelo sexo feminino, entre 20 a 39 anos, da zona urbana, identificando-se como parda, decorrente de uma tentativa de suicido. Se faz necessário, portanto, a participação multiprofissional, com intuito de subsidiar informações necessárias à população e comunidade científica, enfatizando as principais medidas de prevenção em relação as intoxicações medicamentosas.
O Marketing Digital como Ferramenta de Suporte para as Empresas de Confecção do Município de Iguatu – CE / Digital Marketing as a Support Tool for Clothing Companies in the Municipality of Iguatu/CE
Authors: Bezerra Bruno Assuncion , Macêdo Maria Erilúcia Cruz , Silva Samuel Modesto , Góes Claudemar Pimenta , Caffé Filho Hesler Piedade
Published: March 2021

Resumo: Considerando que, visivelmente, a sociedade tem vivenciado uma evolução tecnológica e que tem sido necessário a introdução das empresas no campo digital, nota-se também que se tornou indispensável conhecer algumas técnicas para que se tenha sucesso nos resultados de sua comunicação com os clientes através dos meios digitais. O estudo teve a finalidade de diagnosticar quais os benefícios do marketing digital para as empresas do ramo de confecção da cidade de Iguatu-Ce, tendo como resultado o crescimento geral da empresa, e os seus resultados obtidos. Foi aplicada uma entrevista com questões abertas, buscando obter dados para a análise. O estudo exposto é de natureza básica, fazendo uso de objetivos exploratórios e suas fontes são bibliográficas e documentais. A análise foi cuidadosamente feita a fim de evitar interpretações equivocadas dos dados por meio do Discurso do Sujeito Coletivo, a fim de buscar uma ampla compreensão das informações obtidas. Por meio do estudo exposto, pode-se identificar que o marketing digital é de suma importância para as empresas por trazer para as mesmas diversos benefícios descritos durante a pesquisa, como a aproximação entre as empresas e seus clientes, expansão do mercado onde a empresa atua, fidelização de clientes, aumento da lucratividade, entre outros.
Neues Denken für die Wirtschaft von morgen
Authors: Hochmann Lars , Graupe Silja
Published: March 2021

Die globalen Klimastreiks und die Corona-Pandemie erzeugenDruck zur Transformation der Wirtschaft. Economists4future können ihn in neue Dialogformen, kreative Vorstellungskräfte und friedlichen Gestaltungswillen wandeln.
Rebound-Effekte und Prosumer
Authors: Weiß Julika , Gährs Swantje , Galvin Ray
Published: March 2021

Am Beispiel von Prosumern mit Solarenergie wird dargestellt, wieso es beim Umstieg auf erneuerbare Energien zu Rebound-Effekten kommen kann. Die Gründe hierfür sowie die Rolle politischer Rahmenbedingungen werden basierend auf Interviewergebnissen genauer beleuchtet.
Steigerung des Nachhaltigkeitsbewusstseins von Konsument/innen
Authors: Wolf Isabel , Kaiser Verena
Published: March 2021

Konsument/innen lassen sich nicht gleichermaßen für nachhaltiges Handeln begeistern. Ist es Unternehmen daher möglich, auf das Nachhaltigkeitsbewusstsein von Konsumierenden positiven Einfluss zu nehmen? Das Konzept zeigt auf, welche Maßnahmen aus Unternehmenssicht bezüglich der Steigerung des Nachhaltigkeitsbewusstseins getroffen werden können und wie sich diese umsetzen lassen.
Halaman Belakang
Authors: Editor Editor
Published: March 2021

Petunjuk Penulisan, Cover Belakang
Acute Appendicitis in a Diabetic Child with Salmonella Infection
Authors: Roupakias Stylianos , Apostolou Maria-Ioanna , Anastasiou Anastasia
Published: March 2021

Acute appendicitis is the most frequent and challenging condition requiring emergent intrabdominal surgery in children. The diagnosis of appendicitis becomes more difficult and challenging in children, especially with other medical problems. Computed tomography is the primary tool for diagnosing or excluding appendicitis in cases with atypical presentation. Salmonella infections may present as acute abdominal problems in children. We present a clinical combination that has never been previously reported, of a diabetic girl with non-typhoid Salmonella infection, diagnosed with acute appendicitis. We wonder about the causal correlation of these diseases, versus their simple coexistence.