bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of serum levels of interleukin-10 and transforming growth factor-β1 among Egyptian children with wheezy asthma phenotype
Authors: Zedan Magdy M.E. , Zedan Mohamed M. , El-Said Afaf M. , Badran Ahmed M.H. , Wahba Yahya
Published: May 2023

Background

Asthma is known to be a heterogeneous disease that forms a problem in asthma management. Symptom-based asthma phenotyping with endotyping of the proposed phenotype is a trial to solve this problem. Asthma phenotypes and endotypes facilitate research, establish genetic associations, identify biomarkers, and test for new lines of treatment.

Aim

To clarify the cytokine profile of wheezy asthma phenotype which could pave the way to personalize asthma medicines according to symptom-based asthma phenotypes.

Patients and methods

A case–control study was conducted in 50 asthmatic patients presented solely with wheezes with a mean±SD of age of 9.54±2.81 years and 50 healthy controls, with a mean±SD of age of 8.98±2.79 years. The studied cases and controls underwent assessment of serum levels of interleukin-10 (IL-10), transforming growth factor-β1 (TGF-β1), total serum immunoglobulin E (IgE), peripheral eosinophilic percent, and pulmonary function tests.

Results

Wheezy asthma phenotype showed significant increase in parental smoking, positive family history, total serum IgE, peripheral eosinophilic percent, and TGF-β1 compared with controls. However, serum IL-10 showed significant decrease in cases versus controls. Asthmatics with allergic rhinitis showed significant increase in total serum IgE and peripheral eosinophilic percent compared with non-allergic rhinitis asthmatics.

Conclusion

Wheezy asthma phenotype showed significant increase of serum TGF-β1 as a promoting effect of airway remodeling, significant decrease in serum IL-10, and significant increase of both total serum IgE and eosinophilic percent. This throws a light on the importance of asthma phenotyping according to symptomatology, as a trial toward tailoring asthma medications.
Drug reaction/rash with eosinophilia and systemic symptoms syndrome caused by antibacillary drugs
Authors: Baina Sofia , Benamor Jouda , Bourkadi Jamal E.
Published: May 2023

Drug reaction/rash with eosinophilia and systemic symptoms (DRESS) stands for serious and potentially life-threatening toxidermia, as it can cause severe visceral manifestations. Antituberculosis drug-related DRESS remains rare and unrecognized. In this paper, we report the case of a 76-year-old patient with DRESS induced by antituberculosis prescribed medicines for a culture-confirmed pulmonary tuberculosis.
Pharmacoprophylactic equivalence of rifapentine compared with isoniazid
Authors: Joob Beuy , Wiwanitkit Viroj
Published: May 2023

Background

Tuberculosis is an important infection and is still the most important problem worldwide. The prevention of infection is an important consideration. Focusing on the risk group, HIV-infected patient group is an important risk population for getting tuberculosis. The use of pharmacoprophylaxis has become a new concept in preventive medicine against tuberculosis for HIV-infected population. The classical regimen is the isoniazid regimen. However, the new introduction of combined rifapentine and isoniazid has become a new alterative preventive measure that can help prevent tuberculosis among HIV-infected cases. The alternative is reported for its efficacy and also mentioned for the shorter period of drug use.

Materials and methods

In the present report, the authors performed a clinical mathematical modeling study to determine the pharmacoprophylactic equivalence of rifapentine compared with isoniazid, with special referencing to the HIV-infected population. First, the comparison of required dosage, period of treatment, as well as prophylactic end point is primarily performed and then appraisal on pharmacoprophylactic equivalence of rifapentine compared with isoniazid is done based on mathematical adjustment for required dosage, period of treatment, and prophylaxis end point.

Results

Based on the appraisal, the final pharmacoprophylaxis equivalence is 1 rifapentine dosage is equal to 4.002748–8.005496 isoniazid dosage or 1 mg rifapentine is equal to 0.00143 week of drug use.

Conclusion

Based on the derived pharmacoprophylactic equivalence, rifapentine can help lower required isoniazid dosage and period of prophylactic drug use in prevention of tuberculosis for HIV-infected case.
Screening for pulmonary mycosis
Authors: Gupta Rajesh , Singla Puneet , Goel Nidhi , Gupta Anupama , Singh Pardeep , Gupta Raghav
Published: May 2023

Introduction

Prevalence of pulmonary mycosis is increasing because of increase in the number of susceptible people, increasing awareness toward these infections, and improved methods of laboratory diagnosis. Inflammation of airway and microbiology of various respiratory infections can be studied using sputum and bronchoalveolar lavage (BAL). The advantage of sputum examination is that it is a noninvasive procedure as compared with BAL.

Objective

To explore the pulmonary mycosis and compare the yield of induced sputum and BAL for detecting pulmonary mycosis.

Patients and methods

The present study was conducted on 98 patients of all age groups and sex who underwent bronchoscopy in the Department of Respiratory Medicine, in association with the Department of Microbiology. Sputum/induced sputum and BAL were collected in sterile vials and sent to the microbiology for examination for fungal species. In microbiology, sputum/BAL samples were subjected to direct microscopy and cultured on Sabouraud dextrose agar. Culture was observed daily until 21 days for any fungal growth.

Discussion

Of 98 patients, 60 were detected with fungal infection via sputum, whereas 64 of 98 patients were detected positive for fungal infection via BAL. Yield of sputum compared with the BAL for diagnosis of fungal infection showed sensitivity of 85.93%, specificity of 85.29%, positive predictive value of 91.66%, negative predictive value of 76.31%, and accuracy of 85.71%.

Conclusion

Results were slightly better with BAL, but the difference was not much significant.
Demographic and clinical factors affecting health-related quality of life in patients with pulmonary tuberculosis in Jazan, Saudi Arabia
Authors: Shalabey Heba Mohmmed , Mohammed Hedya Said , Darraj Majid , Hassan Azza Mohammed
Published: May 2023

Introduction

Despite the abundant literature about health-related quality of life (HRQOL) in patients with active pulmonary tuberculosis (PTB) and the scarcity of published literature in KSA, this is the first study to assess the 6-min walk test, sputum examination, and tuberculin test for patients with PTB in correlation with HRQOL domains.

Patients and methods

The study aimed to measure HRQOL among patients with PTB and to identify the demographic and the clinical factors that may affect HRQOL. A cross-sectional study using the WHO-BREF 26-item questionnaire was carried out on 114 patients with PTB at a secondary hospital in Jazan from September 2018 to September 2019.

Results

There was a significant association between the overall perception of health and health status of patients. The social domain had the lowest scores, followed by the environmental, psychological, and lastly, the physical domains. The influence of comorbidities has a significant correlation with the environmental and social domains for HRQOL in patients with PTB. A significant correlation was found between the 6-min walk test and physical and psychological domains. However, sputum smear examination and tuberculin test did not significantly relate to HRQOL domains.

Conclusion

A decrease of the four domains in the assessment of the HRQOL in PTB has been noted in relation to some demographic and clinical factors.
Characteristics and outcome determinants in patients with pulmonary tuberculosis in ICU
Authors: El Assal Gehan M. , AbdelFattah Eman B. , Nabil Mohamed M.
Published: May 2023

Background

Severe tuberculosis requiring intensive care unit care is rare but commonly known to be of bad prognosis. The acute respiratory failure due to pulmonary infections is a common cause for ICU admission. However, despite their high mortality rate, the TB-related critical conditions are rarely reported. Most studies on critical care TB cases were not conducted in high TB burden areas and were retrospective in nature.

Objective

To identify potential prognostic factors and determinants of patient outcome in cases with pulmonary TB admitted to ICU.

Subjects and methods

This was a prospective observational study conducted on 51 patients with active pulmonary TB who required ICU admission for at least 24 h in ICU unit of Abbassia Chest Hospital during the period from January 1, 2018 till December 31, 2018. All patients were subjected to history and clinical examination, radiological and laboratory workup, and APACHI II score. Patients were diagnosed and managed according to National TB Control Guidelines in Egypt. Hospital course, complications and ICU stay period were monitored and were correlated to the outcome.

Results

Mean age of all studied patients was 42.9±16.4 years, 35 male (68.6%) and 16 females. There was Statistically significant correlation between patient outcome, and APACHE II score, arterial blood gases, duration of mechanical ventilation and the total ICU stay in days respectively. ICU complications occurred in 72.5% of patients and they were significantly correlated with patient outcome.

Conclusion

Pulmonary TB requiring ICU is rare but markedly of bad prognosis. Patients commonly admitted to ICU due to respiratory failure, sepsis, multi organ failure, ARDS and massive hemoptysis. Bad prognosis was related to respiratory failure, high APACHE II score, need for mechanical ventilation and its duration, ICU stay and related complications. Mechanical ventilation and APACHE II score were found to be predictors of mortality.
Adding steroids in severe community-acquired pneumonia treatment
Authors: Wafy Safaa , Bayoumi Hassan , El-Naser Shaimaa A.
Published: May 2023

Background

Community-acquired pneumonia (CAP) is the most serious respiratory infection and the leading cause of death from infectious disease around the world.

Objective

The aim of this study was to evaluate the impact of adjuvant systemic steroids on mortality, complications, and duration of hospitalization in severe CAP.

Patients and methods

In a cross-sectional, randomized, controlled clinical trial conducted in the Chest Department at the Respiratory Intensive Care Unit during the period between September 2017 and September 2018. Patients were diagnosed as having severe CAP rapidly assessed by infectious disease society of America/American thoracic society (IDSA/ATS) 2007 were included in this study.

Results

A total of 50 patients were included in this study. These patients were randomly divided into two groups: Group I (steroid group), and group II (control group). The mean age was 55±16.01 and 58.8±20.92 years, respectively. The use of steroids in the treatment of severe CAP is associated with significant improvement in renal, liver, and erythrocyte sedimentation rate parameters with more rapid clinical, radiological, and ultrasonographic resolution. There was a significant reduction in time to clinical stability in group I compared with group II (4.35±1.24 vs 6.54±1.99 days; P=0.02). However, steroid therapy do not affect the duration of ICU stay, need of noninvasive or invasive mechanical ventilation, and duration of hospitalization.

Conclusion

Adding steroids in severe CAP treatment significantly decreases both complications and mortality.
Effect of cigarette smoking on serum testosterone level among male smokers
Authors: El Salam Mohamed A.A. , Zaki Shady , Mousa Mohamed S. , Motawi Ahmed
Published: May 2023

Objective

Smoking is considered as a growing epidemic worldwide, and it was found to have negative influence on health, causing a variety of diseases in both sexes, such as pulmonary fibrosis, chronic obstructive pulmonary disease, cerebrovascular and cardiovascular disorders, pulmonary and extrapulmonary malignancies, infertility, erectile dysfunction, recurrent abortions, and teratogenicity. In addition, several studies have been conducted owing to concerns on its effect on the endocrinal system in males, especially its effects on testosterone levels; however, this concern is still debatable, and all reported results were conflicting.

Patients and methods

Herein, the cohort study was conducted on a subgroup of smoking males (n=155) to evaluate its effect on serum total testosterone (T), estradiol (E2), as well as T/E2 ratio compared with a non-smoking control group (n=134).

Results

Our results have shown that there was a significant statistical difference between smoker and non-smoker groups concerning serum total testosterone (T), estradiol (E2), and subsequently T/E2 ratio, with P values of 0.002, less than 0.001, and less than 0.001, respectively. In addition, there was a statistically significant negative correlation between the duration of smoking and T. However, there was no correlation between duration of smoking and either E2 or T/E2 ratio.

Conclusion

Thus, the current study added further evidence to the unsettled debate suggesting negative harmful effects of smoking on serum testosterone level.
Evaluation of human allergen-specific immunoglobulin G, total immunoglobulin E, hematological parameters, and lung function in mill workers exposed to grain dust in South-East Nigeria
Authors: Uzoma Ijeoma C. , Ugwu Christian , Ozoamusi Elvira , Okhuevbie Daniel , Okenwa Chinenye
Published: May 2023

Background

The incidence of allergy among mill workers has been a public health concern over the years. The human allergen-specific immunoglobulin G (IgG) and the total immunoglobulin E (IgE) are markers for allergic disorders and are important in health monitoring of individuals exposed to allergens. Nonadherence to health and safety precautions by grain workers has led to an increase in respiratory symptoms and other pathologies.

Aim

The aim is to assess human allergen-specific IgG and total IgE concentrations, hematological parameters, and lung functions in factory workers exposed to grain dust for effective health monitoring.

Patients and methods

A total of 69 patients were enrolled; 29 of them were controls whereas 40 were mill workers. Blood samples collected from the patients were analyzed using Mindray autoanalyzer for full blood count, whereas ELISA method was used for the estimation of human allergen-specific IgG and total IgE. The spirometric lung function test was evaluated using Micro 1 Spirometer.

Results

Lung function was significantly decreased compared with the control (P<0.05) in values of forced vital capacity (%Pred) and forced expiratory volume in 1 s (%Pred). But no significant difference was observed for the forced expiratory volume in 1 s/forced vital capacity ratio (%Pred). Additionally, the hematological parameters showed an increase in red blood cells, hemoglobin, packed cell volume, mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean corpuscular hemoglobin of mill workers compared with the control group (P<0.05). The total IgE in mill workers and the control group showed no significant difference; however, the human allergen-specific IgG was increased in mill workers than in the control group.

Conclusions

Human allergen-specific IgG level may be a better indicator of allergy in mill workers.
Management of human epidermal growth factor receptor 2–negative metastatic breast cancer
Authors: Vaid Ashok Kumar , Deshmukh Chetan , Rohatgi Nitesh , Ghosh Joydeep
Published: May 2023

Human epidermal growth factor receptor 2 (HER2)-negative subset is the most heterogeneous group of metastatic breast cancers (MBCs) as it includes both hormone receptor (HR)-positive and HR-negative breast cancer (or TNBC), which have different therapies and treatment challenges. Though endocrine therapy (ET) remains the treatment backbone in HR-positive HER2-negative cases, about 40% of the patients show intrinsic or acquired resistance to ET due to multiple mechanisms. Combining different therapies such as ET and other targeted therapies with or without chemotherapy fails to give continued benefit, unlike cyclin-dependent kinase (CDK) 4/6 inhibitors that have shown a great benefit. TNBC has conventionally been treated ineffectively with systemic chemotherapy. Recently, poly (ADP-ribose) polymerase inhibitors (PARPi) have emerged for HER2-negative breast cancer (BC) patients, including TNBC. Olaparib and talazoparib have recently been approved in germline BRCA-mutated (gBRCAm) HER2-negative MBC. Additionally, ongoing trials of PARPi in combination with various therapies are expected to provide more and better treatment options for gBRCAm HER2-negative breast cancer.
Role of immunotherapy in metastatic EGFRm NSCLC
Authors: Dhabhar Boman , Sahoo Tarini P. , Akshay J.K.
Published: May 2023

EGFR-TKIs have changed the landscape of metastatic NSCLC treatment with a significant improvement in survival of EGFRm patients compared to wild-type EGFR. Even with the newer third generation EGFR TKIs like, Osimertinib, which has proven efficacy against the resistance mutation of EGFRm T790M, progression eventually occurs. There are limited treatment options for patients with metastatic EGFRm NSCLC with other acquired resistance. Therefore, novel therapeutic combination strategies are being researched to overcome potential resistance to EGFR-TKI-targeted therapy. The ICIs targeting the programmed cell death-1 pathway in patients with EGFRm NSCLC were greatly anticipated based on preclinical studies showing increased PD-L1 expression. In clinical settings, this increased expression did not translate into a survival benefit. Treatment with ICIs failed to positively affect EGFRm patients because of multiple reasons: nonsynonymous tumor mutational burden, lower PD-L1 expression in tumors, and cancer cells utilizing alternate immune escape mechanisms. The NCCN guidelines currently do not recommend immunotherapy in patients with metastatic EGFRm NSCLC. Recently, a subgroup analysis in the IMpower150 study provided a signal for overall survival of atezolizumab with bevacizumab plus chemotherapy in EGFRm-TKI progressed patients. Based on these encouraging findings, several combinations of ICIs and EGFR-TKIs are being evaluated in TKI-failed EGFRm patients. These regimens might provide a favorable therapeutic effect by combining higher response rates of TKIs and durable disease control of ICIs. However, further research is warranted to understand the exact underlying molecular and cellular mechanisms responsible for the clinical benefits. In this article, we explored the TKI failed metastatic EGFRm NSCLC, reviewed the available clinical data of ICI use in metastatic EGFRm NSCLC, and discussed its emerging role as a combination regimen in this patient population.
Ideal sequencing in Stage IV epidermal growth factor receptor mutant Non–Small-Cell Lung Cancer
Authors: Walia Meenu , Singhal Manish K. , Kamle Mangesh S.
Published: May 2023

Evidence from several studies has shown improved progression-free survival (PFS) with first- or second-generation epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) compared with chemotherapy for advanced NSCLC patients. But resistance to first or second-generation TKI therapies after 9 to 12 months of treatment initiation is a concern. Osimertinib is a third-generation, irreversible, oral EGFR-TKI that potently and selectively inhibits both EGFRm (epidermal growth factor receptor mutated) and EGFR T790M and has demonstrated efficacy in NSCLC central nervous system (CNS) metastases. Trials have reported significantly longer PFS and higher median duration of response with osimertinib compared with first-generation EGFR-TKIs (erlotinib, gefitinib) and chemotherapy, respectively. And relatively lower rates of discontinuation due to adverse events (AEs). Significant improvement in overall survival was also observed when used as first-line treatment. Because EGFR-mutated tumors are highly dependent on EGFR signaling, optimal sequence of available TKIs – erlotinib, gefitinib, afatinib, dacomitinib, and osimertinib – is necessary. The sequencing of EGFR-TKIs has changed over the past decade and depends on factors such as expected efficacy, CNS activity, tolerability, and options available after progression. Third-generation TKI may be the preferred first-line treatment because patients may not opt for or die before the start of second-line therapy, and it is difficult to predict which patients will eventually develop T790M mutation. The favorable tolerability profile alongside a longer time to disease progression makes osimertinib a preferred first-line treatment. Though clinical practice guidelines do not provide clear consensus on the most preferred EGFR-TKI, recent updates recommend osimertinib as a first-line treatment for advanced NSCLC patients. Also, improved patient selection incorporating clinical and molecular characteristics will help translate to better survival outcomes and improved quality of life. This review aims to determine the optimal sequence of administration of the EGFR-TKIs considering toxicity, quality of life, and survival outcomes among advanced NSCLC patients.
Gonadotropin-releasing hormone agonists in prostate cancer
Authors: Raja T. , Sud Rahul , Addla Sanjai , Sarkar Kalyan K. , Sridhar P.S. , Talreja Vikas , Jain Minish , Patil Ketaki
Published: May 2023

Androgen deprivation therapy (ADT) using gonadotropin-releasing hormone agonist (s) (GnRH-A) remains the backbone of advanced prostate cancer treatment. In this review, we assessed the efficacy, safety, and convenience of administration of various GnRH-A. All GnRH-A (goserelin, triptorelin, buserelin, histrelin, and leuprorelin) have comparable potential to suppress testosterone (T) levels (≤50 ng/dL in a month and ≤20 ng/dL in 3 months). However, goserelin has shown better efficacy in maintaining T levels ≤50 ng/dL compared with leuprolide. The incidences of T escape are lower with goserelin and leuprolide than buserelin. Goserelin also has maximum benefit in prostate-specific antigen suppression. In neoadjuvant setting, when only goserelin was used, the 10-year overall survival (OS) rate was 42.6% to 86%. When either goserelin or leuprolide was used, the 10-year OS rate was 62%. As an adjuvant to radical prostatectomy, goserelin had a 10-year survival rate of 87%, and triptorelin had an 8-year survival rate of 84.6%. Goserelin further showed an absolute survival rate of 49% when used as an adjuvant to radiotherapy. The survival rates further improved when GnRH-A are used as combined androgen blockade compared with monotherapy. The frequency and severity of adverse events (hot flushes, fatigue, sexual dysfunction) are comparable among the GnRH-A. Goserelin appears to be the most convenient of all the GnRH-A for administration. Lack of conclusive comparative evidence makes it imperative to have a holistic approach of considering the patient profile and the disease characteristics to select the appropriate GnRH-A for ADT in prostate cancer.
A Qualitative Study of the Psychological Experiences of Health Care Workers During the COVID 19 Pandemic
Authors: Dang Priyanka , Grover Naveen , Srivastava Prashant , Chahal Savita , Aggarwal Ashish , Dhiman Vishal , Kaloiya Gauri Shanker
Published: May 2023

Background:

Health-care workers (HCWs) are at the forefront of managing the massive responsibility of public health response to COVID-19. The aim of the present study was to explore the psychological experiences of these frontline HCWs.

Methods

: A qualitative study was carried out with 24 frontline HCWs posted in COVID-19 wards, using purposive and snowball sampling methods. Data were collected using focus group discussions and individual interviews, which were transcribed and analyzed using Braun and Clarke's six-phase framework of thematic analysis.

Results:

HCWs were overburdened. It caused them to experience symptoms of depression and anxiety. Most of them showed positive appraisal coping and believed that people would have to learn to live with it.

Conclusions:

Continued support for professional help is needed for HCWs at present and in the aftermath of the pandemic.
Knowledge and Perceived Ability to Deal with Physical Comorbidities in Substance Use Disorders
Authors: Sharma Nidhi , Ghosh Abhishek , Pillai Renjith R. , Subodh B. N. , Basu Debasish , Mattoo Surender Kumar , Basu Aniruddha , Shah Raghav , Roub Fazle
Published: May 2023

Background:

Despite the magnitude and impact of co-occurring physical and substance use disorders (SUDs) and evidence of effectiveness of integrated care, the training for management of comorbidities has been neglected. Our objective was to examine the effectiveness of 1-day continuing medical education (CME) in this area on participants' perceived and objective knowledge and skills.

Materials and Methods:

It was a cross-sectional study of CMEs conducted in a tertiary care center with a pre-post assessment design. Assessment included rating perceived knowledge and skill on a five-point scale and objective multiple-choice questions. Subjective feedback on qualitative aspects of the CME was taken. Out of total 154 participants, 69 completed pre-post assignments that included interactive lectures through multimodal presentations and problem-based learning. Pre-post comparisons were done by paired t-test and Wilcoxon signed-rank test.

Results:

Pre-CME assessment showed low mean scores (4.04 [1.75]) in objective (assessment to be added) and limited perceived knowledge and ability. However, objective knowledge assessment showed a significant improvement (P < 0.001) after the CME. Perceived knowledge and skills showed a significant positive (P < 0.001, all comparisons) change in all the four (CME-1) and seven (CME-2) domains assessed. CME was perceived to be excellent in terms of the practical value of material (60.3%), able to meet its stated objectives (60.3%), quality of instructions (58.8%), and organization of material (60.3%).

Conclusion:

CME is a viable option for training of psychiatrists to address the unmet need for treating co-occurring physical and SUDs. Future studies with experimental designs should determine the effectiveness of the components of CMEs.
Working Parents and Child Screen Media Use
Authors: Sinha Ankit Kumar , Patra Suravi
Published: May 2023

Screen media use by children has been a subject of constant concern by parents, teachers, pediatricians, psychiatrists, and policymakers. The potential for its misuse often shadows media use in terms of its educational and communication opportunities. Adding to the concerns is that excessive screen media use is associated with poor physical and mental health. COVID-19 lockdowns, school closure, and online classes have increased media exposure to children. The prevailing risky situation has prompted global health agencies and professional societies to issue guidelines for safe media use. Parents in their day-to-day life grapple with the problem of knowing how much media is good are media addicting and how to regulate media use in their children. Whether working from home or on-site, working parents face more complex problems wherein their media use is known to shape the kids' screen media use. This viewpoint discussed the problem statement, and the possible solutions for the already overburdened parents juggling work demands, childcare, and screen media use in their children.
Psychiatric Rehabilitation in Indian General Hospital Psychiatry Unit Settings
Authors: Sivakumar Thanapal , Roy Amrita , Reddy K. Shanivaram , Angothu Hareesh , Jagannathan Aarti , Muliyala Krishna Prasad , Bhola Poornima , Gandhi Sailaxmi , Kumar Devvarta
Published: May 2023

In India, General Hospital Psychiatry Units (GHPUs) are the backbone for mental health care. GHPUs have less stigma, facilitate inter-specialty collaboration, and provide integrated mental and physical healthcare. GHPUs offer a predominantly medical model of care and face multiple challenges in offering psychiatric rehabilitation, including a severe crunch of human resources. This article summarizes the basic concepts of psychiatric rehabilitation, possible rehabilitation interventions in resource-constrained settings, and interventions that can be delivered with the help of caregivers and frontline mental health workers. The article concludes with some of the pragmatic indigenous models of psychiatric rehabilitation at GHPUs.
Home-Based Care in the Community
Authors: Tyagi Shikha , Katoch Akshit , Das Subhash , Gupta Nitin
Published: May 2023

Treatment gap in mental health is vast and continues to remain a grim reality. Amongst community mental health care, one approach available is home based care (HBC). However, HBC services are almost lacking in India. Nevertheless, the limited evidence points towards a successful utility of HBC till date. In this article, the Chandigarh experience of HBC is presented and discussed in detail in order to demonstrate its utility and effectiveness. Lastly, recommendations are provided for the future of HBC.
Felt Needs of the Caregivers for the Home Based Care for their Family Members with Severe Mental Illnesses
Authors: Kartikeyan Deepika , Majhi Gobinda , Kumar Vijay K. G.
Published: May 2023

Background:

Home-based care for persons with severe mental illness is a family-focused approach and addresses the caregiver's responsibility. It is cost-effective compared to the inpatient hospital settings, and it also allows the patients to stay with families in their communities while treatment is going on. In this context, this study aimed to explore the barrier to access mental health services and the caregivers' felt needs for home-based care for their family members with severe mental illness.

Methods:

This study adopted a cross-sectional descriptive design with 60 caregivers of family members with severe mental illnesses. Quantitative data were collected through a semi-structured interview schedule prepared and validated for this study, and the severity of illness was measured using the Clinical Global Impression Scale.

Results:

Caregivers faced difficulty in traveling along with their family members to the hospital for treatment (76.7%), accessibility issues (65%), and problems in mobilizing the patient to the hospital (54%). The majority of the caregivers (75%) preferred home-based care to manage the illness of the patient, with a focus on pharmacotherapy (83.3%), and the patient considered there should be appropriate training at home (63.3%).

Conclusion:

The majority of the caregivers felt the need for home-based care with a preference for both pharmacotherapy and self-care for their family members with severe mental illnesses.
A Qualitative Study to Explore Various Meanings of Mental Distress and Help-Seeking in the Yamuna Valley, North India
Authors: Rawat Meenal , Jadhav Sushrut , Bayetti Clement , Mathias Kaaren
Published: May 2023

Context:

In rural India, mental healthcare remains limited due to scant state services and incongruency between provider- and patient-framing distress. Help-seeking by people with mental health problems is related to how meanings of distress are understood differently by individuals, based on their interaction with various actors in the community and the available cultural explanation within their local ecologies.

Methodology:

This study examines the mutually constituted relationship between meanings of mental distress and help-seeking among people residing in the Upper Yamuna Valley, Uttarakhand, North India. This qualitative study builds on six in-depth interviews with people with severe mental health issues and one person with epilepsy, referred as people with psychosocial disability (PPSD) in the study. The data analysis was iterative and followed thematic approach.

Results:

The study found that personal belief based on one's experience, such as negative self-judgment and wider cultural explanations, such as supernatural beliefs, as well as gender roles, impacted the way people address their mental health problems, in turn shaping their help-seeking behavior. Participants lost hope for a cure after years of trying to find an effective solution. Moreover, lack of access to care and remoteness of the mountainous area made help-seeking and recovery feel impossible.

Conclusions:

This study underscores the need for researchers and policy professionals to explore the local context and culture to improve care and treatment quality. The study also explains that personal explanation of psychosocial problems and help seeking are not unidirectional. It is a complex phenomenon layered with the local contexts which should be addressed in clinical practice, as well as future research. Finally, clinicians' training should address the local cultural language of distress to identify the problem and suggest an effective solution.
Factor Structure of the Bengali Version of the Fagerstrom Test for Nicotine Dependence Questionnaire
Authors: Dutta Abhijit , Bhakta Puja , Mir Anaitulah Ahmed , Singh Suman , Saprunamei Athia Sylvia , Prajapati Ramkripal , Pandey Deepak Kumar , Anal Ch. Lily , Saklani Nitin , Goenka Rachna , Singh Subhas , Chattopadhyay Abhijit , Sharma Pralay , Sadhukhan Satarupa , Ali Sk Swaif , Koley Munmun , Saha Subhranil
Published: May 2023

Context:

The Fagerstrom test for nicotine dependence (FTND) is a self-administered ordinal measure of nicotine dependence containing six items that evaluate the quantity of tobacco smoking, the compulsion to use, and dependence.

Aims:

To date, no Bengali version of the questionnaire is available. We aimed to develop its Bengali version and examine its cross-cultural adaptability considering linguistic equivalence.

Settings and Design:

A cross-sectional study was conducted through consecutive sampling at the outpatients of the National Institute of Homoeopathy, Kolkata.

Subjects and Methods:

The FTND-Bengali version (FTND-B) was produced by standardized forward-backward translations. The psychometric analysis was run to examine its factor structure, validity, and reliability. Reliability was examined using internal consistency (n = 263). Construct validity was examined by exploratory factor analysis (n = 132) using principal component analysis (varimax rotation). Subsequently, confirmatory factor analysis (CFA; n = 131) was performed to verify the model fit.

Results:

The internal consistency was acceptable (Cronbach's α = 0.701; 95% confidence interval [CI] 0.641–0.753). The Kaiser–Meyer-Olkin (=0.712) and Bartlett's test of sphericity (Chi-square 109.593, P < 0.001) both suggested adequacy of the sample. In factor analysis using varimax, all the items loaded above the pre-specified value of 0.3 and identified two components – “restraint” (question no. 1, 2, and 6) and “compulsion” (question no. 3, 4, and 5); explaining 56.1% of the variation. The goodness-of-fit in the CFA model was mediocre, but acceptable (Comparative Fit Index = 0.871, Tucker Lewis Index = 0.759, Root Mean Square Error of Approximation = 0.142, Standardized Root Mean Square Residual = 0.026).

Conclusions:

FTND-B, consisting of 6 items and framed within two components, appeared to be a valid and reliable questionnaire.
Assessment of mandibular asymmetry in different skeletal malocclusions and vertical patterns in adult individuals: A cone-beam computed tomography study
Authors: Alhazmi Nora
Published: May 2023

OBJECTIVES:

The study aims to measure the mandibular condylar height (CH), ramus height (RH), total height (CH+RH), asymmetry index, and condylar volume (Cvol) in individuals with different anteroposterior and vertical skeletal discrepancies.

MATERIALS AND METHODS:

The study sample consisted of 131 subjects (60 females and 71 males) with a mean age of 35.06 ± 12.79 years. Pre-existing CBCT images were divided into groups according to the anteroposterior and vertical skeletal discrepancies. The investigator analyzed the data using t-tests to assess the mandibular bilateral sides of the individuals and gender differences. The mean difference between groups was determined using a one-way analysis of variance (ANOVA). The Chi-square test was used to study the association between the asymmetry index and groups.

RESULTS:

Each individual's bilateral sides exhibited statistically significant differences in CH, RH, and Cvol (P = 0.033, P = 0.039, P = 0.005, respectively), but not in CH+RH (P = 0.458). There were, however, statistically significant gender differences in CH+RH (P < 0.001). Skeletal Class III and hypodivergent groups revealed the highest linear and volumetric values compared to other groups. The asymmetry index was increased in CH (P = 0.006) and Cvol (P = 0.002) in skeletal Class II subjects.

CONCLUSIONS:

Significant differences in CH, RH, and Cvol were found on the right and left sides of the same individual. This study found increased linear and volumetric values in males, skeletal Class III, and hypodivergent subjects. Class II individuals had an increased CH and Cvol asymmetry index. This study highlights in-depth knowledge of mandibular asymmetry, which is extremely important to achieve an accurate diagnosis and provide the best treatment outcome.
Isometries of lattices and Hasse principles
Authors: Bayer-Fluckiger Eva
Published: May 2023

We give necessary and sufficient conditions for an integral polynomial without linear factors to be the characteristic polynomial of an isometry of some even, unimodular lattice of given signature. This gives rise to Hasse principle questions, which we answer in a more general setting. As an application, we prove a Hasse principle for signatures of knots.
Cutoff for non-negatively curved Markov chains
Authors: Salez Justin
Published: May 2023

Discovered by Aldous, Diaconis and Shahshahani in the context of card shuffling, the cutoff phenomenon has since then been established for a variety of Markov chains. However, proving cutoff remains a delicate affair, which requires a very detailed knowledge of the chain. Identifying the general mechanisms underlying this phase transition, without having to pinpoint its precise location, remains one of the most fundamental open problems in the area of mixing times. In the present paper, we make a step in this direction by establishing cutoff for all Markov chains with non-negative curvature, under a suitably refined product condition. The result applies, in particular, to the random walk on abelian Cayley expanders satisfying a mild degree assumption, hence to the random walk on
almost all
abelian Cayley graphs. Our proof relies on a quantitative
entropic concentration principle
, which we believe to lie behind all cutoff phenomena.
On Gaussian decay rates of harmonic oscillators and equivalences of related Fourier uncertainty principles
Authors: Kulikov Aleksei , Oliveira Lucas , Ramos João P. G.
Published: May 2023

We make progress on a question posed by Vemuri on the optimal Gaussian decay of harmonic oscillators, proving the original conjecture up to an arithmetic progression of times. The techniques used are a suitable translation of the problem at hand in terms of the free Schrödinger equation, the machinery developed in the work of Cowling, Escauriaza, Kenig, Ponce and Vega (2010), and a lemma which relates decay on average to pointwise decay.

Such a lemma produces many more consequences in terms of equivalences of uncertainty principles. Complementing such results, we provide endpoint results in particular classes induced by certain Laplace transforms, both to the decay lemma and to the remaining cases of Vemuri’s conjecture, shedding light on the full endpoint question.
Steel, Bars, and Forgings and Forging Stock 0.90Si - 1.0Cr - 2.0Ni - 3.2Mo - 2.0Cu - 0.10V (0.07 - 0.13C) Vacuum Arc or Electroslag Remelted
Authors:   AMS E Carbon and Low Alloy Steels Committee
Published: May 2023

This specification covers a premium aircraft-quality, low-alloy steel in the form of bars, forgings, and forging stock.
Recommended Practice for Landing Gear Integrity Programs
Authors:   A-5B Gears, Struts and Couplings Committee
Published: May 2023

This SAE Aerospace Recommended Practice (ARP) provides guidance on the definition, development, and establishing a LGIP.
Turbofan and Turbojet Gas Turbine Engine Test Cell Correlation
Authors:   EG-1E Gas Turbine Test Facilities and Equipment
Published: May 2023

This SAE Aerospace Recommended Practice (ARP) describes a recommended practice and procedure for the correlation of test cells that are used for the performance testing of turbofan and turbojet engines. Test cell correlation is performed to determine the effect of any given test cell enclosure and equipment on the performance of an engine relative to the baseline performance of that engine. When baseline testing is performed in an indoor test cell, the baseline performance data are adjusted to open air conditions. Although no original equipment manufacturer (OEM) documents are actually referenced, the experience and knowledge of several OEM’s contributed to the development of this document. Each engine Manufacturer has their own practices relating to correlation and they will be used by those OEMs for the purpose of establishing certified test facilities.
Reflections on Talent Development: Roles, Philosophies and Conflicts.
Authors:   , Borrie Andrew
Published: May 2023

This study explored the philosophies have underpinned UK sporting talent development programmes using an autoethnographic approach to critique the researcher’s professional career, as it related to the talent development domain. An analytical, rather than evocative, approach was taken to conducting and reporting the autoethnography. The initial stage of the autoethnography used the systematic review of a large pool of the researcher’s documents and work files to stimulate intensive reflection on the researcher’s experiences in the worlds of high-performance sport and education. These reflections were subsequently critiqued in relation to literature relating to philosophy, culture and practice relating to talented athletes. This critique identified a number of problems in the talent domain stemming from the unquestioned primacy of instrumental rationality as a guiding philosophy. Instrumental rationality places the end outcome of a process as being more important than the means to achieve that outcome. Consequently, the growth of a young athlete as a person has become secondary to sports’ desire to create elite sport performers. In looking for solutions to the challenge of instrumental rationality two alternate philosophical perspectives were explored: craftsmanship and elite Bildung. Both these perspectives are based on existential approaches to learning and prioritise the personal growth of the learner above specific performance outcomes. Using these as a base a ‘excellence literacy was proposed as a new paradigm for talent development. Excellence literacy proposes that the focus in talent development should be twofold. Firstly, the creation of young athletes who value the process of pursuing excellence above the outcome of that pursuit. Secondly, the development of young athletes who are able to exercise agency in creating their own identity and life narrative.
Geschichtsstundenplanung
Authors: Buchsteiner Martin , Scheller Jan , Nitsche Martin
Published: May 2023

Stundenplanung ist eine Kernaufgabe von Geschichtslehr*innen. Dieses Buch unterstützt Berufsanfänger*innen bei der Planung von Geschichtsstunden und lädt erfahrene Lehrer*innen dazu ein, erneut über das Thema nachzudenken.
Stundenplanung wird als Zusammenhang von Planungstätigkeiten begriffen. Für diese werden im Buch wissenschaftlich begründbare Handlungsoptionen aufgezeigt und Kriterien vorgestellt, die bei der Entscheidung für eine Vorgehensweise helfen. Zahlreiche Praxisbeispiele erleichtern die Anwendung. Eine exemplarische Stunde verdeutlicht am Schluss die vielfältigen Verschränkungen des Planungsprozesses.
Vielfalt in der Elementarpädagogik 2
Authors: Lehner Barbara , Fürstaller Maria
Published: May 2023

Das Praxishandbuch regt an, sich auf pädagogische Praxis verstehend einzulassen und Theorie- und Fachwissen für die Reflexion des eigenen pädagogischen Handelns zu nutzen. Im Buch werden Fallbeispiele und Theorie zu den Themen Trauma, Kultur, Religion, Behinderung, Gender und Sprache miteinander verknüpft. Aufgabe der Fachkräfte ist es, sich im pädagogischen Alltag mit den emotionalen Aspekten des Umgangs mit Vielfalt auseinanderzusetzen, um ihr pädagogische Handeln zu professionalisieren.
Demokratie trotz(t) Antiextremismus?
Authors: Feldmann Dominik
Published: May 2023

Sollte Extremismusprävention ein Teil politischer Bildung sein? Diese Frage tangiert grundlegende Vorstellungen von Demokratie und politischer Bildung.
Extremismusprävention basiert auf der Gegenüberstellung von Demokratie und Extremismus. Dabei gerät oft aus dem Blick, dass gerade das Verhältnis von Demokratie und Antiextremismus durch Widersprüche gekennzeichnet ist und kritischer Prüfung bedarf.
Dieser Band nimmt aktuelle Extremismustheorien mitsamt ihren Schwachpunkten in den Blick und bietet eine kritische Auseinandersetzung mit dem daraus resultierenden Sicherheitskonzept, das zum Schutz der Demokratie politischen Diskurs und damit Demokratie selbst beschränkt.
Deutsche Revolution 1848/49
Authors: Brabänder Michael
Published: May 2023

Die Revolution von 1848/49 hat einen zentralen curricularen Stellenwert und ist in Zeiten wachsender Demokratiegefährdung ein wichtiger bildungspolitischer Erinnerungsort. Auf Basis zahlreicher Primärquellen orientieren sich die Arbeitsblätter des Heftes an den didaktischen Kategorien der Problemorientierung und Kontroversität. Unter Verwendung abwechslungsreicher Methoden und Sozialformen bietet das Basismodul Themenkomplexe wie Vormärz, Ausbruch der Revolution, Nationalversammlung,
Paulskirchenverfassung, Kaiserfrage und Gründe für das Scheitern sowie bleibende Errungenschaften der Revolution. Das Erweiterungsmodul für die Oberstufe umfasst auch Rezeptionsgeschichte und Erinnerungspolitik.
Dekolonisation 1945–1975
Authors: Argast Regula , Metzger Thomas , Sidler Daniel , Ferri Marino
Published: May 2023

Nach 1945 lösten sich innerhalb dreier Jahrzehnte die europäischen Kolonialreiche auf. Der Band behandelt Voraussetzungen, Phasen und Folgen dieses fundamentalen Umbruchs. Die gesammelten Quellen erlauben es, den Unterricht zur Geschichte der Dekolonisation nach 1945 exemplarisch, multiperspektivisch, in Längsschnitten und anhand von Fallbeispielen zu gestalten und dabei die ganz unterschiedlichen Akteur*innen aus lokaler, nationaler und internationaler Perspektive zu Wort kommen zu lassen. Der Blick auf die Geschichte der Dekolonisation zeigt die Kontinuität diskriminierender Ideologien und Praktiken, nicht zuletzt, um ihnen entschieden entgegenzutreten.
QUALIDADE DE VIDA RELACIONADA À SAÚDE EM PACIENTES SUBMETIDOS À PROSTATECTOMIA
Authors: Barichello Elizabeth , Massa Danielle Campos , Nicolussi Adriana Cristina , Mendes Lorena Campos , Barbosa Maria Helena
Published: May 2023

Objetivo: avaliar a qualidade de vida relacionada à saúde (QVRS) de pacientes em pós-operatório tardio de prostatectomia e os fatores associados a possíveis alterações nos padrões urinários, intestinal, sexual e hormonal.
Método: trata-se de estudo observacional transversal com abordagem quantitativa. Utilizou-se um instrumento para caracterização sociodemográfica e clínica e o questionário Expanded Prostate Cancer Index Composite (EPIC). Empregou o teste para postos de Mann-Whitney e correlações de Pearson e Spearman. Foi considerado um nível de significância de α=0,05.
Resultados: participaram do estudo 70 pacientes, com idade média de 67 anos, sem antecedentes familiares com câncer de próstata, casados, brancos, aposentados. 11,4% relataram muito problemático para a função urinária; 4,3% moderadamente problemático para hábito intestinal e 47,1% muito problemático para a função sexual.
Conclusão: o maior impacto na QVRS do paciente prostatectomizado foi a função sexual. Avaliar a QVRS é importante para verificar os resultados obtidos a partir dos tratamentos disponíveis.
DESCRITORES: Qualidade de vida. Prostatectomia. Disfunção erétil. Incontinência urinária. Reabilitação.