bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Disseminated Melioidosis Presenting with Septic Arthritis and Diffuse Pulmonary Consolidation in an Otherwise Healthy Adult: A Case Report
Authors: Sherng Lee Hai , Ahamed Riyaaz Abdul Azeez , Hong Yeoh Seng
Published: November 2019

Background: Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is most prevalent in South-East Asia, northern Australia, and the Indian subcontinent. Septic arthritis is a rare manifestation of melioidosis. Melioidosis is usually found in patients with diabetes, heavy alcohol use, or chronic lung disease. Case: We report a case of melioidosis in an otherwise healthy 44-year-old male, who presented with acute painful left knee swelling, high-grade fever associated with chills, rigors and night sweats, and a productive cough. Examination revealed active synovitis with effusion involving his left knee, ankle and elbow joints and scattered crackles over both lung fields. Chest X-ray showed diffuse pulmonary consolidation. Abdominal ultrasound showed splenic micro-abscesses. The diagnosis was made based on a positive blood culture for Burkholderia pseudomallei. He was started on appropriate antibiotics and responded well, becoming afebrile after 48 hours, while his joint effusions disappeared after one week. Conclusion: Septic arthritis only occurs in 4% of patients with melioidosis. When there is diffuse pulmonary involvement, melioidosis may mimic disseminated tuberculosis, sepsis syndromes, and systemic vasculitis syndromes. This case is relevant for medical literature as melioidosis is emerging and is expanding its territories worldwide. It should be considered early in the differential diagnoses in endemic areas so that treatment can be started early to reduce its high mortality and morbidity.
Creating and Completing Service-Learning within Medical School Curricula: From the Learner’s Perspective
Authors: Makadia Frini , P. Mehta Priya , E. Wisely Clayton , Santiago-Torres Juan E , Hartmann Katherine , J. Welker Mary
Published: November 2019

Background: This article describes a service-learning project implemented at local free clinics by students at the Ohio State University College of Medicine and identifies key factors in their success. Methods: In response to a lack of longitudinal patient-physician relationships at free clinics, the students developed an initiative linking free clinic patients with diabetes to primary care homes for longitudinal care and counseled patients on the benefits of establishing a longitudinal relationship with a primary care physician. Results: All patients counseled were linked, compared to a historical 10% linkage rate, and 78% of patients scheduling initial appointments. Five factors were identified and listed by the students as key to the project’s process, success, and impact. Conclusion: Although all of these listed factors may prove difficult to replicate, this case-study serves as a model for other medical schools incorporating service-learning and exhibits that medical students can become integral portions of healthcare infrastructure.
Ocular Auscultation: A Review
Authors: Fernando Gallego Daniel , Rivas-Grajales Ana Maria , Jose Gallego Carlos
Published: November 2019

Ocular auscultation is a commonly neglected step of routine physical examination. An adequate ocular auscultation can be helpful in discovering an ocular bruit, which is an important diagnostic finding for a broad spectrum of pathologic conditions, some of which are potentially fatal. In this article, we present a literature review on the physical exam maneuver of ocular auscultation, as well as the pathophysiology and differential diagnosis of ocular bruits. We also included a description of the adequate auscultation technique and a discussion about the applicability of ocular auscultation in clinical practice
Down Syndrome and Quality of Life: A Case Report
Authors: L. Schroeder Hilary , Joanes Marianinha , Small Andre , Maramraj, Raghu
Published: November 2019

Background: Quality of life is considered a crucial component to the well-being of patients with Down syndrome. The strength of quality care through stable social and psychological interactions has built a framework for a positive well-being for patients with Down syndrome, improving their quality of life. Case: A 55-year-old African American female with a history of Down syndrome, congenital heart disease, and newly-diagnosed early onset Alzheimer’s disease presented with an arm contusion resulting from regular caretaking. The patient’s history was reviewed, and the complexity of her condition was discovered. While a subset of Down syndrome patients have cardiac complications and others have early-onset Alzheimer’s, our patient had both. We believe this complicated her condition. After the diagnosis of Alzheimer’s was made, the caregivers noticed a significant decline in her ability to communicate and continue day-to-day activities. Despite the decline in functions, a positive mood was apparent. Conclusion: Multiple medical interventions, along with strong family support, positively contributed to the patient’s quality of life. Therapies targeting cognition could result in the maintenance of quality of life and, ultimately, lower health care costs.
Cystoid Macular Edema: Causes, Diagnosis and Treatment
Authors: Bravo-Alcobendas Noelia , Zulueta Joseba , Salobrar-García Elena , J Salazar Juan , M Ramírez José
Published: November 2019

The purpose of this paper is to conduct a review of studies on cystoid macular edema published in the last seven years. Cystoid macular edema is a major cause of loss of visual acuity. It is the final common pathway of many diseases and can be caused by numerous processes including inflammatory, vascular, adverse drug reactions, retinal dystrophy or intraocular tumors. These processes disrupt the blood-retinal barrier, with fluid extravasation to the macular parenchyma. Imaging tests are essential for both detection and monitoring of this pathology. Fluorescein angiography and autofluorescence show the leakage of liquid from perifoveal vessels into the tissue where it forms cystic spaces. Optical coherence tomography is currently the gold standard technique for diagnosis and monitoring. This allows objective measurement of retinal thickness, which correlates with visual acuity and provides more complete morphological information. Based on the underlying etiology, the therapeutic approach can be either surgical or medical with anti-inflammatory drugs. We found that disruption of the blood-retinal barrier for various reasons is the key point in the pathogenesis of cystoid macular edema, therefore we believe that studies on its treatment should proceed on this path.
Clinical Utility and Alterations in Bacterial Flora in Fecal Microbiome Transplantation
Authors: A. Dave Atman , Robson Rachel
Published: November 2019

Dysbiotic states of gut ecology can be altered directly by transplantation of fecal preparation from healthy donors to patients with therapeutic intent. This paper assesses this fecal microbiota transplantation (FMT) in two respects: (1) the bacterial shifts in patient microbiomes with FMT and (2) clinical outcomes and variables of FMT. The PubMed database was searched using the MeSH terms “Feces/microbiology,” “Microbiota,” and “Transplantation.” Thirteen papers found examined clinical outcomes and variables of FMT, and eight assessed metagenomic data and bacterial composition in the peri-FMT period. FMT was reported to have high cure rates in Clostridium difficile infection (CDI), generally increased levels of members of the phyla Bacteriodetes and Firmicutes, and decreased levels of members of Proteobacteria. Therapeutic FMT alters bacterial composition from a dysbiotic state pre-FMT to a healthy commensal state post-FMT in CDI patients, but further studies are necessary to understand its role in the treatment of other diseases
Esterified Anabolic Androgen-Induced Liver Injury in a Hepatitis C Virus-Positive Patient: A CaseReport
Authors: S. Shohdy Kyrillus , M. El Gohary Rasmia
Published: November 2019

Background: Cases of drug induced liver injury still perplex gastroenterologists due to its wide range of presentations that mimic acute and chronic liver conditions. Moreover, matters get complicated when clinicians face the possibility of drug-induced injury in the presence of pre-existing chronic liver disease. Case: A 69 year-old male who was recently discovered to have a hepatitis C viral infection presented with acute manifestations (mixed cholangio-hepatocellular injury) not fully explained by the underlying chronic disease, we suspected an idiosyncratic reaction from an esterified anabolic androgen. His manifestations have appeared acutely after the drug intake and include acute onset of jaundice, abdominal pain, pruritus and choluria. He was improving on drug discontinuity and conservative measures during his brief hospital stay. Conclusion: The underlying chronic disease constitutes a dilemma in diagnosis of superimposed drug-induced liver injury, as the proof of causality is a daunting task. In such cases, it is tempting to link such new emerging manifestations to be a flare-up of the underlying chronic disease rather than to the drug. However, certain clues helped to point this clinical presentation towards a drug-induced liver injury
Response to Medical Students' Attitudes towards Female Sex Workers
Authors: Garnier Hanna , Wisniewski Jakub
Published: November 2019

NA
Tips for Junior Doctors and Medical Students: Writing and Publishing Undergraduate Textbooks
Authors: Bradley Aliso , Mason Katrina A. , Rodrigues Mark A. , Tang Ceen-Ming , Wood Matthew , Lattey Katherine , Byrne Patrick , Ross Michael , Maxwell Simon , Qureshi Zeshan U.
Published: November 2019

NA
A Brave, Unconventional Teacher: A Medical Student's Experience
Authors: Gantxegi Fernández Ibon
Published: November 2019

NA
Experience: A Summer Elective in Germany
Authors: Grazia Grech Maria
Published: November 2019

NA
Association between Muscle Mass and Body Mass Index in Elderly Diabetic Patients Attending Tertiary Care Center in Bangalore, India
Authors: Palanisami Sowbarnika , Kulkarni Vasudha
Published: November 2019

Background: Sarcopenia is a disorder causing age-related loss of muscle mass. Its multifaceted nature has been linked to an increased risk of disability and mortality. Equally, obesity is a well-known risk factor for a host of disorders. A combination of sarcopenia and obesity in elderly diabetics can synergistically lead to increased insulin resistance and risk of metabolic syndrome. This study aimed to identify the association between sarcopenia and obesity in elderly diabetic patients by a cost-effective anthropometric method. Methods: A case-control study was conducted from January 2016 to April 2016 at Dr. B. R. Ambedkar Medical College in Bangalore. Height, weight, mid-arm circumference, and triceps skin fold thickness of 112 diabetic patients and 131 healthy adults were measured. Descriptive statistical analysis and multiple linear regression analysis were carried out. Results: 26.8% of male and 76.8% of female diabetic patients were obese (body mass index ≥25 kg/m2). Incidence of sarcopenia (muscle mass one standard deviation smaller than healthy reference population, cut-off value for diabetic males being <9.79 kg/m2 and for diabetic females <8.53 kg/m2) were 12.5% in male diabetic patients and 5.4% in female diabetic patients. Conclusion: Sarcopenia and obesity are co-morbid illnesses which can cause functional and metabolic impairments in elderly diabetic patients. There exists a moderate association between muscle mass and body mass index. Loss of muscle strength (dynapenia), rather than loss of muscle mass (sarcopenia), is closely associated with disabilities in these patients.
Clinical Audit: Paediatric Medical Team Attendance at Deliveries in an Outer Metropolitan Hospital in Western Australia
Authors: Nadew Gelaye Tadesse
Published: November 2019

Background: The attendance of paediatric medical teams at deliveries has become accepted as an integral part of birth management under current multidisciplinary team arrangements. Under current guidelines, specific clinical indicators have been developed to determine whether paediatric teams need to attend deliveries. High rates of attendance indicate that paediatric medical team resources are being extended beyond the criteria at the expense of essential services being provided elsewhere. Methods: A retrospective clinical audit was used to evaluate the frequency of paediatric team attendance and related clinical indicators. Deliveries were recorded and audited for a randomly selected calendar month. Paediatric team attendance was evaluated against foetal distresses, types of delivery, gestational age and birth weight. Results: A total of 112 deliveries were recorded for the selected calendar month and paediatric medical teams attended 74.1% (n=80) of the deliveries. Participants were comprised of 50.9% (n=57) male and 49.1% (n=55) female babies. Of these deliveries, 66.7% (n=72) were term, 30.6% (n=33) post-term and 2.8% (n=3) pre-term. A total of 69.4% (n=75) of deliveries were spontaneous vaginal deliveries (SVD), while 22.2% (n=24) were caesarean sections and 8.3% (n=9) were instrumental deliveries. Foetal distress was experienced by 16.2% (n=17) of babies. Conclusion: Paediatric medical team attendance at deliveries was higher than the combined rate of caesarean sections, pre-term babies, instrumental deliveries and reported cases of foetal distress.
The Journey of Insulin: Leaving a Legacy as a Medical Student
Authors: Al-Sukaini Ahmad , Qureshi Muhammad Aslam , Suker F
Published: November 2019

N/A
Methylprednisolone-Responsive Leptospiral Acute Pulmonary Syndrome
Authors: Modesto Santos Vitorino
Published: November 2019

NA
Artist Featured in IJMS Volume 4: Yimeng Zhang
Authors: Of IJMS Executive Board
Published: November 2019

N/A
International Journal of Medical Students - Year 2016 - Volume 4 - Supplement 1
Authors: IJMS Executive Committee of
Published: November 2019

International Journal of Medical Students - Year 2016 - Volume 4 - Supplement 1
Dynamics of Antibiotic Prescription in Royal Hampshire County Hospital in November 2016: A Prospective Study
Authors: Lee-A-Ping Kathrine , Saeed Kordo , Dryden Matthew , Sim Gavin
Published: November 2019

Background: Antimicrobial Stewardship and The Start Smart – Then Focus strategy provide guidelines aimed at improving the increasing trend of antibiotic resistance. The aim of this study was to assess whether antibiotics were being prescribed at Royal Hampshire County Hospital (a district general hospital), in accordance with the hospital’s and the NICE guidelines and whether this followed the Start Smart – Then Focus approach.

 

Methods: During November 2016, medical notes of 12 randomly selected in-patients of Royal Hampshire County Hospital on 45 antibiotics, were used to measure the dynamics of their prescriptions.

 

Results: 91% of the 45 prescriptions were in accordance with hospital guidelines, 82% of cases had appropriate samples sent before commencing antibiotics, 5% out of 27% had a planned switch from intravenous administration to oral (the remaining 73% were initially started on oral regimes) and 80% had planned stop dates.

 

Conclusion: Appropriate samples, stop dates, planning and documentation in patient notes must be improved with regards to antibiotic use.
Pathophysiology, Diagnosis and Treatment of Immune Thrombocytopenia
Authors: Găman Mihnea-Alexandru , Maria  Găman Amelia
Published: November 2019

Immune thrombocytopenia (ITP) is an acquired disorder characterized by isolated thrombocytopenia with a peripheral blood count < 100.000/ mm3 in the absence of any obvious initiating or underlying causes, by antibody mediated destruction of platelets and suppression of megakaryocyte and platelet production on the basis of immune deregulation. ITP is idiopathic (primary) in 80% of cases and secondary to several associated disorders in 20% of cases. A diagnosis of exclusion, based on patient history, physical examination, complete blood count and examination of the peripheral blood smear, is used for ITP. The treatment of ITP is indicated in adult patients with platelet counts below 20.000-30.000/ mm3, with bleedings or risk for bleeding. First line therapy is represented by corticosteroids, intravenous immunoglobulins and intravenous anti-RhD. Second-line treatment is represented by: splenectomy, inhibition of the monocytic phagocytic system therapy, immunosupressive therapy, anabolic steroids, anti-CD20 therapy, and thrombopoietin receptor agonists.
A Religious Patient and Her Sleep Problems: Reflections on an Experience in which Sleeping Pills were not Prescribed
Authors: Henrique Roza Thiago
Published: November 2019

The spirituality, cultural beliefs and religion of any patient are likely to have an impact on his/her health, and well-being. Health professionals, mainly young physicians and medical students, often fail to consider this type of background when taking care of their patients. This experience is a report of an interesting encounter, in the field of mental health, in which the spiritual beliefs and socioeconomic needs of a patient were considered during her treatment. Consequently, sleeping pills were not prescribed in her case.
Why Did I Choose Pathology as a Career?
Authors: Ta Robert
Published: November 2019

NA
Student Heart Failure Intervention Pilot (SHIP): A Study of Risk Factor Analytics and Population Outreach
Authors: Reichert William Byron , Hoatam Gerard , Schmidt Emily , Leher Michael , Gorur Arathi , Jones Anna , Kalya Anantharam , Radhakrishnan Priya
Published: November 2019

Background: Heart failure (HF), the leading cause of hospitalization in adults over the age of 65, is a difficult-to-treat syndrome associated with high morbidity and mortality. Home-monitoring programs may help reduce HF-associated morbidity, but can be difficult to establish in smaller clinical settings. In this quality improvement project, we identified local patients at high risk of HF-related morbidity and hospitalizations, then implemented a medical student-based constant-contact program to encourage their follow-through on self-care.

 

Methods: Between June 2012 and September 2014, our clinic treated 197 patients for systolic or diastolic HF. These patients’ baseline characteristics were evaluated for trends that increased their risk for hospitalization. Of the high-risk patients identified (n=80), 12 (15%) were enrolled in the project. An 8-week constant-contact intervention was initiated through weekly calls. Patients’ health statuses were recorded and the importance of self-care was reiterated.

 

Results: High-risk HF patients were identified based on >10 clinic visits during the study period; 3 were lost to follow-up. Each patient completed two questionnaires at the study’s beginning and conclusion, with response rates of 67% (6/9) and 56% (5/9). Most participants reported symptom improvement and increased knowledge about their conditions.

 

Conclusion: Our preliminary population-guided, medical-student initiated intervention in a small clinical setting was designed to increase patient understanding and compliance and to improve HF symptoms. Although the study was limited by its low participation rate, drastic improvements in self-reported outcomes were noted among participants. A larger study with similar positive outcomes could ultimately influence follow-up methods.
Abstracts of the 4th International Academic Medical Congress of Maranhão (IV COIMAMA) (2017)
Authors: IJMS Executive Committee of
Published: November 2019

Abstracts of the 4th International Academic Medical Congress of Maranhão (IV COIMAMA) (2017)
Abstracts of the Malaysian Medics International (MMI) Research Symposium 2017
Authors: Executive Committee of IJMS
Published: November 2019

Abstracts of the MMI Research Symposium 2017
Assessment of Medical Students’ Attitudes Towards Research and Perceived Barriers
Authors: Althubaiti Alaa , Al Muqbil Bashayer , Al Buraikan Doaa
Published: November 2019

Background: Health research has been integrated as part of the curriculum of many health sciences teaching universities. The aim of this study is to measure the attitude of medical students towards research.

Methods: A cross-sectional survey study was conducted from March to May 2016 using the Student Attitude Towards Research (SAR) scale. The survey was distributed amongst undergraduate medical students at the College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia. Main outcome measure was score on attitude scale with 15 Likert-type statements.

Results: A total of 237 responses were collected from the students (55.6% males and 44.3% females). In general, students agreed that ‘research is important for identifying and investing problems in a subject matter’ (N=206, 86.9%). Female students showed significantly more positive attitude towards research (P<0.05). In regards to the degree of involvement of the faculty in the research program, 35% of students agreed that it was acceptable, and 48.1% agreed that the faculty members have adequate skills to handle research methodology.

Conclusion: Most of the surveyed students were aware of the importance of undertaking medical research, but their attitude to the field was not always positive. There is an urgent need to introduce research programs as a part of the curriculum of all medical colleges, and ensure that these programs meet their goals and continue to be improved by providing good infrastructural facilities in order to provide skillful physicians to support research related activities.
Dandy-Walker Malformation in an Asymptomatic 27-Year-Old Woman. A Case Report
Authors: Jiménez Joyce Antonella , Landívar Daniel Francisco , Posligua Fernando Xavier , González Jorge Rigoberto
Published: November 2019

Introduction: Dandy-Walker malformation (DWM) is a rare congenital disorder that involves the cerebellum and fourth ventricle. Incidentally detected asymptomatic DWM is sparsely reported in literature at extremes of age (from 1 to 75 years) in association with different diseases. We aim to report the case of a patient with an incidental finding of a DWM after a road traffic accident, reinforcing the importance of suspicion, investigation, diagnosis of clinical presentations. The Case: This case report describes a 27-year-old female patient who presented to the emergency room after a motor vehicle collision. She suffered a left kidney and spleen injury. The patient’s brain CT scan revealed an enlarged cisterna magna with normal cerebellum, partial hypoplasia of the cerebellar vermis and enlargement of the fourth ventricle compatible with DWM. Neurological examination was unremarkable. An exploratory laparotomy was performed, and the left kidney and spleen showed hemorrhage, so a left nephrectomy and splenectomy was done. Conclusions: This case report aimed to characterize the DWM, which is a congenital malformation of the central nervous system. Asymptomatic patients do not require surgical treatment; however, these patients should be followed up once a year.
Recurrent Painful Ophthalmoplegic Neuropathy Affecting Right Oculomotor Nerve in 10-Year-Old Male. Case Report
Authors: Segar Sharmila , Duphare Chandni , Aburime Osemelu
Published: November 2019

Background: Recurrent painful ophthalmoplegic neuropathy (RPON), formerly known as ophthalmoplegic migraine (OM), is a poorly understood condition that presents with recurrent unilateral headaches and at least one ocular cranial nerve (CN) palsy, generally in childhood. There has been ongoing debate about whether the etiology of this disorder is neuropathic or related to migraines. The Case: We present a case about a 10-year-old male with his third presentation of RPON, repeatedly affecting his right oculomotor nerve. His treatment choices are discussed, along with associated outcomes. The patient was treated with topiramate with resolution of his symptoms occurred within one month. Conclusion: As the annual incidence of RPON is rare at fewer than 1 case per million people, clear documentation of observed cases with treatment failures and successes is key to building evidence for future management.
Awareness among Parents of Beta Thalassemia Major and Intermedia Patients in Three Centers in Baghdad and Al-Nasiriyah, Iraq in 2017
Authors: Mutar Mohammed Tareq , Majid Mustafa , Jaleel Ammar , Saad Ali , Abdulmortafea Ali , Talib Hashim
Published: November 2019

Background: Thalassemia is an autosomal recessive disease common in Iraq with a prevalence of 35.7 per 100000. Beta thalassemia major is a life-threatening condition with many complications which if not managed could cause death at an early age. This cross-sectional study aimed to assess the awareness of parents/caregivers of children with beta-thalassemia major and intermedia, as enhancing awareness is the first and the most important step in all prevention programs

Methods: We conducted this study in three thalassemia centers (two in Baghdad and one in Al-Nasiriyah) from July 20th, 2017 to September 20th, 2017. This study involved 193 parents of thalassemic children under the age of 15 who come to the centers frequently for blood transfusion. The study assessed the awareness questionnaire through interviews. Data analysis was performed using the Statistical Package for the Social Sciences program (SPSS) version 24.

Results: We found that awareness was low in many aspects. The highest knowledge was for foods that thalassemic patients shouldn't eat and for the early manifestation signs in thalassemic patients which is 94.8% and 86%, respectively. The lowest knowledge was for the consideration of human immune deficiency virus as a transfusion-transmitted disease and for the chance of having an affected child when both parents are carriers which were 37.3% and 11.9%, respectively.

Conclusion: Parents have low awareness of thalassemia in many aspects. Thalassemia care centers may need to provide more education for the parents of patients with thalassemia.
Aneurysmal Subarachnoid Hemorrhage in a 68-Year-old Hyperglycemic Female Patient: Case Report and Literature Review
Authors: Morgan Paul Marcel
Published: November 2019

Background: While hyperglycemia is intimately associated with uncontrolled diabetes mellitus (DM), recent clinical studies have demonstrated that hyperglycemia is also present in the early acute phase of stroke and is associated with poor prognosis and increased long-term mortality. About half of patients with acute hemorrhagic stroke also present with hyperglycemia upon admission. But more than 50% of patients with acute hemorrhagic stroke develop hyperglycemia even without a previous history of DM. This sheds new light on the relationship between DM, hyperglycemia, and hemorrhagic stroke, with a pathophysiology that is perhaps more profound than is conventionally understood.

The Case: We report a case of a 68-year-old female, with a history of DM Type 2 and stage 3 hypertension who presents to the emergency room (ER) at the Western Regional Hospital in Belmopan City, Belize, with hemorrhagic stroke and hyperglycemia. Diffuse subarachnoid hemorrhage was found in the frontal, temporal, and parietal regions. Mild intraventricular hemorrhage was also observed in the frontal horns and basal cisterns. And small areas of intraparenchymal hemorrhage were present in the frontal lobes. The patient was stabilized and treated conservatively with calcium channel blockers, and diuretics.

Conclusion: Despite a unifying consensus that is still pending, maintaining glucose levels between 110-120 mg/dl by using continuous insulin infusions after traumatic brain injury or aneurysmal subarachnoid hemorrhage may carry some clinical benefit with slightly improved outcome.
The Missing Generation: The Completion of Matthew’s Genealogy
Authors: Bryan Steven M.
Published: November 2019

At the beginning of Matthew’s Gospel, the precisely conceived genealogical scheme of 3 tables of 14 generations falls short by one generation in the third table. This shortfall was intended by Matthew as a puzzle that the conclusion of the narrative resolves with the appearance of Jesus as the resurrected Christ with the 11 disciples, newly designated as his “brothers.” If “Judah and his brothers” in the first table of the genealogy represent Israel in its original constitution and “Jeconiah and his brothers” represent Israel in its experience of national judgment and dissolution, the depiction of the Twelve as the resurrected Christ and his brothers at the end of the narrative represents Israel in its reconstitution. Part of Matthew’s literary genius is evident in the fact that he uses a genealogy to launch an argument that the identity of this people has never simply been a matter of ancestry. The missing generation at the end of the genealogy poses a question explored throughout the narrative but not fully resolved until the end of the Gospel.
Structure and Theology in Proverbs: Its Function as an Educational Program for Novice Leaders in Ancient Israel
Authors: Dunham Kyle C.
Published: November 2019

Proverbs has languished from neglect in biblical scholarship as an allegedly deficient fund for theological formulation. Recent studies have plied to fill this lacuna by focusing on the book’s literary structure as the key to its theological contribution. While some skepticism concerning its purposeful arrangement remains, several studies have adduced evidence from the final form of Proverbs to suggest it served in ancient Israel as an educational curriculum aimed at moving the implied reader from simple ethical decisions to complex social applications. This article argues that this reading strategy finds support in the preamble, which outlines a training regimen designed to advance the inexperienced youth toward the virtues of righteousness, justice, and integrity for the goal of exercising sociopolitical leadership. The literary structure of Proverbs discloses the collocation of key terms from the preamble that the final author/editor has embedded as mnemonic signposts in the opening and closing seams of its seven wisdom collections. A structural-canonical reading highlights this intentional and dynamic movement: by progressing through the seven courses of leadership, the callow initiate matures and matriculates to navigate the intricate demands and dangers of societal leadership in the royal court.
The Newspaper Industry in a Changing Landscape The Shift in News Content of Various Newspapers as a Response to the Rise of Social Media
Authors: Shen Neil
Published: November 2019

This paper examines the association between the rise of social media and the types of news content produced by newspaper outlets. Over the past two decades, the rise of social media has precipitated a decline in the role of traditional newspaper outlets. I present two hypotheses and their ensuing rationale – hypothesis one describes how newspapers may increase hard news content to further consolidate their reader base, while hypothesis two postulates that hard news content will decrease as papers try to regain the readers they lost to social media. Data was collected from two reputable and two less-reputable newspaper outlets to see how they reacted to increases in social media usage and whether their responses varied. For each newspaper outlet, the author identified the number of articles that included keywords drawn from hard news and soft news word banks. Using a ratio of hard to soft news, regression analysis was then performed. After running regression analysis with trend data from the Pew Research Center on the number of US adults with social media accounts, results indicate a moderate negative correlation amongst the two more reputable newspapers and no correlation amongst less reputable newspapers, meaning that the more reputable newspapers tended to decrease hard news content as social media became more popular.
Französische Außenpolitik in Zeiten der Polykrise
Authors: Stark Hans
Published: November 2019

Under the presidency of Emmanuel Macron, France has set itself the goal of strengthening its international presence, being more proactive and defining the European reform agenda. However, the French room for manoeuver is limited. The increasingly confrontational nature of the clashes between the United States, China and Russia as well as the US’s challenge to the rules of multilateralism reduce the influence of a regional power such as France. Furthermore, French domestic issues - for example high unemployment and the lack of competitiveness as well as social tensions - contradict its claim to equality on the international stage. Last but not least, France’s capacity to respond to global challenges such as climate change or demographic change in Africa is very limited.
Von Bahr lernen? Anregungen für eine neue Russlandpolitik
Authors: Dembinski Matthias , Rogova Vera
Published: November 2019

Egon Bahr’s 1963 speech outlined ways to achieve rapprochement with the Soviet Union through mutual recognition. The article asks in how far this approach can be useful for the current crisis in Russian-Western relations. It demonstrates that the policy-of-strength-approach has not reached the desired results so far, so that a change in strategy is needed. Along Bahr’s line of argument, it shows that functional separation can help to reduce tensions. If this strategy succeeds, cooperation in fields of mutual interests - that has been low in the past years - should be revived. However, unlike the 1960s, there is a lack of international support for rapprochement with significant divides both within the transatlantic relations and within the European Union.
Deconstructing Peace and Security Dynamics in the Gulf Region
Authors: Wählisch Martin
Published: November 2019

This article focuses on current peace and security dynamics in the Gulf region. It applies system theory aspects to better understand the underlying patterns of evolving political alliances and fault lines. The article points out that power imbalances, frames of a common enemy and interconnected proxy conflicts keep frictions going. The author argues that dialogue efforts in this context need to address those structural impediments to peace in the region. The article concludes with general observations and conditions for a potential security architecture of the region.
Europäische Friedens- und Sicherheitsordnung im Umbruch. Ein Essay
Authors: Giessmann Hans-Joachim
Published: November 2019

The European peace and security order is facing an existential crisis. Its value anchors - democracy, collaboration and integration - are at stake and may seriously weaken due to increasing tendencies of fragmentation and re-nationalization. Such risks are high, because of the weakening of the European Union, an emerging new Cold War, and the erosion of the European arms control regime. However, the current crisis may also result in renewed awareness that more preserving and building of regimes are needed, as well as attainable if collaborative patterns prevail.
Perfil epidemiológico do atendimento antirrábico humano em uma área de planejamento do município do rio de janeiro
Authors: Nascimento Adriana Oliveira do , Matos Rodrigo Aguilar Constantino , Carvalho Simone Mendes , Corrêa Vanessa de Almeida Ferreira , Freire Mary Ann Menezes
Published: November 2019

La rabia se considera un problema de salud pública en Brasil y en todo el mundo. La atención antirrábica se encuentra entre los tres problemas de salud más notificados en el país. Objetivos: describir y caracterizar el perfil epidemiológico de la atención antirrábica en el municipio de Río de Janeiro, en el área del programa 2.1, de 2010 a 2015. Metodología: estudio descriptivo retrospectivo de los registros relacionados con la atención antirrábica humana insertados en el Sistema de Enfermedades de Declaración Obligatoria del municipio de Río de Janeiro. Para la selección de datos utilizamos el programa TabWin 32; La organización y el análisis se desarrollaron en Excel©. Resultados: se encontraron 8.681 registros. De éstos, 8.235 (94,9%) fueron casos de probable exposición posterior al virus de la rabia. De las 8.235 notificaciones, el 70% eran de personas blancas, el 56% mujeres, con énfasis en el grupo de edad de 20 a 59 años (54,7%). La principal forma de agresión fue la mordedura (83,1%) en las manos / pies (41%), y el agresor principal fue el perro (74,4%), en el 72,3% de los casos se indicaron observación y vacunación. Conclusión: se encontró que el perfil epidemiológico de la atención antirrábica en el área del programa 2.1 se produjo en mujeres blancas con el tipo de exposición mordedura en manos y pies, provocadas por perros. Estos datos ayudan a pensar en estrategias de prevención. Es importante ampliar los servicios que brindan atención antirrábica, especialmente vinculados a la Estrategia de salud familiar. La capilarización de este servicio es al menos un reductor de riesgo de la enfermedad, ya que permite la atención básica inmediata.
Percepção dos cônjuges de pessoas com estomia intestinal sobre a sexualidade do casal
Authors: Santos Fernanda Silva , Vicente Natália Gomes , Bracarense Carolina Feliciana , Dal-Poggeto Márcia Tasso , Goulart Bethania Ferreira , Rodrigues Leiner Resende
Published: November 2019

Objetivo: identificar la percepción de los cónyuges de personas con ostomía intestinal sobre la sexualidad de la pareja. Método: investigación descriptiva con enfoque cualitativo, basada en la historia de vida focal, utilizando la entrevista en profundidad. Fueron entrevistados trece cónyuges de personas ostomizadas de agosto a noviembre de 2014. Las entrevistas fueron sometidas a la técnica de análisis de contenido en la modalidad temática. Resultados: del proceso de análisis surgieron cuatro categorías temáticas: a) conceptualizar la sexualidad basada en la opinión de los participantes sobre la sexualidad; b) intimidad sexual, con la exposición de varios matices en el ejercicio de la sexualidad, específicamente durante el sexo; c) sentimientos generados por la ostomía en los cónyuges, que trató de las sensaciones después de la cirugía de estoma; d) y estrategias utilizadas para favorecer el ejercicio de la sexualidad y se habló de las tácticas de la pareja en esta área. Consideraciones finales: se descubrió que, desde la perspectiva de los cónyuges de las personas con estoma intestinal, la sexualidad está estrechamente vinculada al sexo, y los cambios en el ejercicio de la sexualidad de la pareja iban desde cero cambio hasta cambios radicales, incluyendo referencias a la abdicación de esta dimensión de la vida humana, dándoles prioridad a otras actividades.
Caracterização dos casos de óbito acidental de crianças por aspiração de corpos estranhos em minas gerais
Authors: Amaral Jesislei Bonolo do , Felix Márcia Marques , Ferreira Maria Beatriz Guimarães , Ribeiro Samira , Barbosa Maria Helena
Published: November 2019

Objetivo: caracterizar los casos de muerte por asfixia accidental en niños. Método: estudio descriptivo y retrospectivo de datos secundarios en el que se analizaron datos de la muerte de niños menores de un año y de uno a cuatro años en el estado de Minas Gerais informados en la base de datos del Sistema Único de Salud de 2005 a 2015. Se identificaron 233 casos de muerte por asfixia. Entre las víctimas había más varones (131; 56,2%), de tez blanca (118; 50,6%), y en una proporción mayor entre los niños menores de un año (175; 75,1%). Los diagnósticos más frecuentes fueron inhalación e ingesta de alimentos, causando obstrucción del tracto respiratorio (155; 66.5%) en niños menores de un año y de uno a cuatro años. Resultados: en promedio, se informaron 14,6 casos por año con gran oscilación durante el período de estudio; en 2002 hubo más cantidad de muertes (21; 9,0%) y en 2006 menos muertes (7; 3%). Conclusión: se realza la importancia de la implementación de medidas preventivas y educativas para reducir los eventos, lesiones y secuelas.
Educação permanente em cateterismo vesical para prevenção de infecção do trato urinário
Authors: Silva Myria Ribeiro da , Cazorla Irene Maurício , Silva João Luís Almeida da , Almeida Talita Hevilyn Ramos da Cruz , Oliveira Patrícia Peres de , Barbosa Dulce Aparecida
Published: November 2019

Objetivo: analizar el impacto de la educación continua en prevención y control de infecciones del tracto urinario en pacientes sometidos a procedimiento de cateterismo vesical intermitente. Método: estudio cuasi-experimental realizadas antes y después del procedimiento, con intervención educativa sobre cuidados con la inserción, mantenimiento y extracción de la sonda vesical intermitente. Se utilizó una escala de 20 preguntas con 124 enfermeros y técnicos de enfermería para medir el conocimiento. Se analizó el análisis del cambio en el patrón de comportamiento de la prueba previa y de la prueba posterior, mediante una escala global, y análisis de covarianza, que ajustó la línea de regresión por categoría profesional. Para analizar el conocimiento y las conductas del procedimiento de cateterismo vesical intermitente, se emplearon las pruebas de Levene para igualdad de varianzas, prueba t para muestras independientes, pruebas inferenciales no paramétricas y chi-cuadrado. Resultados: en el análisis general del estudio, basado en las 20 preguntas consideradas, se observó que, en promedio, los técnicos de enfermería en comparación con los enfermeros obtuvieron siete puntos más de la prueba previa a la posterior (≅12,00 para ≅19,00), mientras que los enfermeros obtuvieron 4,0 puntos (≅16 para ≅20,00). Conclusión: la intervención educativa aumentó significativamente el conocimiento de los profesionales de la salud sobre el procedimiento de cateterismo vesical intermitente y contribuyó a la reducción de la tasa de infección entre las infecciones del tracto urinario en la institución, así como a aumentar el nivel de conocimiento, especialmente de los técnicos de Enfermería después de las intervenciones educativas.
Gravidez na adolescência
Authors: Silva Marielle Jeani Prasnievski da , Nakagawa Janete Tamami Tomiyoshi , Silva Ana Luiza Rabello da , Espinosa Mariano Martinez
Published: November 2019

Introducción: el inicio de la actividad sexual durante la adolescencia puede exponer a esta población a algunos riesgos, como el embarazo no planificado. Los estudios muestran que, a pesar del aumento en el uso de métodos anticonceptivos (MAC), el embarazo sigue siendo alto entre las adolescentes. Objetivo: analizar el uso de MAC en adolescentes que quedaron embarazadas durante este período de la vida. Método: estudio de caso- control, realizado con 86 adolescentes embarazadas (casos) y 86 mujeres jóvenes sin antecedentes de embarazo en la adolescencia (controles) en las unidades de Estrategia de Salud Familiar de la ciudad de Cuiabá-MT, de agosto a noviembre de 2016. Resultado: los datos revelaron que las adolescentes usaron MAC en la primera relación sexual (67,4%); sin embargo, al investigar específicamente el uso en el mes en que quedaron embarazadas, se constató que habian disminuido considerablemente dicho uso (37, 2%). Se observó que el uso de MAC es menor entre las adolescentes en comparación con las mujeres jóvenes sin antecedentes de embarazo en la adolescencia. También se observó discontinuidad en el uso de anticonceptivos entre las participantes del estudio. Conclusión: los hallazgos revelaron que las adolescentes emplean menos métodos anticonceptivos en comparación con las jóvenes, desde el inicio de su vida sexual. Además, hay mucha dicontinuidad en el uso de MAC, lo cual pone en evidencia sus fallas. Este hecho indica la necesidad de aumentar la atención y las opciones anticonceptivas para esta población.
Religiosidade e espiritualidade relacionadas às variáveis sociodemográficas, econômicas e de saúde entre idosos
Authors: Silva Ana Teresa de Melo e , Tavares Darlene Mara dos Santos , Molina Nayara Paula Fernandes Martins , Assunção Luiza Maria de , Rodrigues Leiner Resende
Published: November 2019

Introducción: la población de Brasil vive un proceso acelerado de envejecimiento. Las angustias derivadas de dicho por este proceso permiten que la religiosidad / espiritualidad (R/E) ocupen un lugar destacado en la vida de las personas mayores. Objetivo: verificar la asociación de variables sociodemográficas, económicas y de salud con las dimensiones de religiosidad y espiritualidad. Metodología: estudio transversal realizado por encuesta domiciliaria con 643 personas mayores de la comunidad. Los instrumentos utilizados fueron: mini examen del estado mental; caracterización de los datos sociodemográficos, económicos y de salud; medida multidimensional breve de religiosidad y espiritualidad. Se realizó análisis descriptivo y regresión lineal múltiple con siete predictores: género, edad, educación, estado conjugal, ingresos, número de enfermedades y percepción de salud. Resultados: predominantemente mujeres, 60 - 69 años, casados, 1├4 años de escolaridad e ingresos mensuales de un salario mínimo. En cuanto a la percepción de la salud, el 39,8% mencionó regular, el 81,5% informó dos o más enfermedades. En todas las dimensiones de religiosidad / espiritualidad (experiencias espirituales diarias; valores / creencias; perdón; prácticas religiosas particulares; superación religiosa; apoyo religioso; religiosidad organizacional; autoevaluación global), el predictor sexo era estadísticamente significativo. En ninguna de las dos dimensiones el ingreso era estadísticamente significativo. En cuatro dimensiones estaba presente el estado conjugal. En dos dimensiones influía la edad. En tres dimensiones, la educación estaba inversamente asociada. En una sola dimensión influía el número de enfermedades y en dos dimensiones influía la percepción de la salud. Conclusión: se percibió que todas las dimensiones de religiosidad / espiritualidad estaban influenciadas por el sexo. Además, todos los predictores, excepto ingresos, estaban asociados con al menos una dimensión de religiosidad / espiritualidad.
Fatores que acarretam insatisfação no trabalho do enfermeiro no contexto hospitalar privado
Authors: Scussiato Louise Aracema , Peres Aida Maris , Tominaga Louise Bueno Lelli , Galvão Keity Daiany dos Santos , Lima Dayane Cristina de
Published: November 2019

Objetivo: verificar el grado de satisfacción de los enfermeros e identificar los factores que causan insatisfacción laboral dentro del servicio hospitalario. Métodos: estudio exploratorio de métodos mixtos, realizado en un hospital particular de una capital del sur de Brasil. La recogida de datos tuvo lugar entre agosto y septiembre de 2017 con enfermeros asistenciales. Primero se aplicó una escala de satisfacción laboral dividida en cinco dimensiones: satisfacción con los colegas, con el sueldo, con el jefe, con el tipo de trabajo y con las promociones. Después, se invitaron a aquellos enfermeros cuyo resultado en la escala había dado "insatisfecho" a que respondieran una entrevista semiestructurada. Los datos cualitativos de las entrevistas se analizaron de acuerdo con el análisis de contenido temático-categórico, respaldado por el software MAXQDA© para la organización de datos. Resultados: en la investigación participaron 40 enfermeros, 10 de ellos expresaron insatisfacción con la remuneración inadecuada; con la falta de promoción y crecimiento profesional; con el régimen laboral; con la falta de reconocimiento y valoración profesional; con la desviación de la función; con la competitividad y la desunión entre los profesionales y el equipo multiprofesional y con la falta de liderazgo. Sin embargo, trabajar en lo que les gusta y las amistades que se crean con los colegas en el trabajo eran factores de satisfacción para los enfermeros insatisfechos. Conclusión: el reconocimiento de los factores de insatisfacción de los enfermeros puede respaldar la implementación de un plan institucional para cambiar la situación identificada. Los trabajadores satisfechos están más motivados y producen mejor.