bluuebunny/crossref_metadata_2025 huggingface dataset:
Penyuluhan Pentingnya Akhlakul Karimah Bagi Mahasiswa Dalam Menjalani Kehidupan Perkuliahan
Authors: Zidane Ardiansyah  , Ryan Gunawan  , Ani Nur Aeni
Published: December 2021

Penyuluhan ini bertujuan untuk mengingatkan kepada para mahasiswa perihal pentingnya akhlakul karimah dan bagaimana menerapkan sifat-sifat akhlakul karimah dalam kehidupan perkuliahan pada mahasiswa di Universitas Pendidikan Indonesia di Kampus Sumedang. Metode pengabdian berupa penyuluhan secara virtual dengan memanfaatkan aplikasi Zoom Meeting dan alat bantu yang digunakan adalah Canva sebagai media presentasi . kegiatan penyuluhan ini berupa pemberian pemahaman mengenai pentinya akhlakul karimah dan berupa diskusi tanya jawab dengan peserta. Penyuluhan mengenai pentingnya akhlakul karimah bagi mahasiswa ini dimaksudkan agar mahasiswa di Universitas Pendidikan Indonesia di Kampus Sumedang dapat menerapkan nilai-nilai akhlakul karimah pada masa perkuliahan maupun seterusnya. Kegiatan ini berhasil meningkatkan pemahaman mahasiswa Universitas Pendidikan Indonesia Kampus Sumedang mengenai pentingnya akhlakul karimah bagi mahasiswa dalam menjalani kehidupan perkuliahan.
COVID-19 pandemic and the Philippine real estate property cycle: indications of bubble and burst in the “new normal”?
Authors: Abueg Luisito , Zamora Christian Marvin , Correa Leonard Nevin
Published: December 2021

The Philippines has been one of the countries greatly affected by the COVID-19 pandemic. The country is regarded to be under the world's longest lockdown with an upsurge of cases, and it has also entered into an official recession with record-breaking economic contraction and high unemployment rates, fueling economic uncertainties. These macroeconomic indicators show serious signs of the adversities of the pandemic affecting the real estate development sector. As the real estate sector recalibrates its plans on response, recovery, and resiliency, this paper attempts to provide empirical evidence on the celebrated model in real estate economics proposed by Homer Hoyt and later developed by Glenn R. Mueller: the property cycle. We also provide contextualization on the property cycle empirics under the pandemic, given the sector’s reintroduction of the Real Estate Investment Trust (REIT). We argue that the REIT mainly supports the real estate development industry given the adversities of the pandemic and its accompanying recession, as well as an update to the long-term plans of the industry and its players in compliance with the “new normal”.
Pandemic Threat, Ostrom Threshold and Pre-Emptive Public Goods: why East Asia performed better in the COVID-19 crisis
Authors: Fabella Raul
Published: December 2021

The COVID-19 pandemic is an eminent threat posed by nature to the survival of the whole community. The cost X it imposes upon the community can be mitigated by the community’s pre-emptive public goods: an early warning system, capacity for monitoring, contact tracing and isolating infected persons, the strength of its public health system and the cultivated readiness to cooperate with anti-COVID protocols. The community provides these public goods in a nonstrategic game N (Nature) where the probability of a “bad outcome” (being symptomatically infected) falls with the total spending on pre-emptive public goods. Aside from N, members of the community play an Economic Dilemma Game (EDG), a symmetric Prisoner’s Dilemma Game (PDG) with strategy set (C, D), where the community earns its economic income which in turn provides the financing of the pre-emptive public goods. Games EDG and N are fused into a composite game N+EDG by defining the probability of a good outcome as increasing with the level of public goods financing. N+EDG has the same strategy set (C, D) as EDG but the payoffs of players are composite: the payoff from EDG less the expected share of the pandemic cost to the members. We show that there is a threshold pandemic cost X0 (Ostrom threshold) so that if X ≥ X0, the N+EDG has dominant strategy in C. At the cooperative equilibrium, the community is at its peak strength: economic output from EDG is largest and the contribution to pre-emptive public good is highest. A severe-enough cost of the pandemic threat as perceived by the group (i) causes players to exhibit an altruistic phenotype (choosing C every time) and (ii) leads to the lowest probability of a bad outcome. We argue that previous experience with pandemics in the last two decades on top of a higher tendency to follow authority in East Asia supported both the provision of better pre-emptive public goods and the higher abidance with anti-COVID protocols. These explain better performance.
Fortalecimiento de la escucha activa a través del aula invertida en una institución de educación básica de la ciudad de Barranquilla.
Authors: Tejedor Fuentes Erica Paola
Published: December 2021

En este artículo se quiere demostrar que el aula invertida puede ser utilizada como una herramienta para favorecer el fortalecimiento de la escucha activa. Este trabajo parte de una investigación aplicada que se efectuó en una institución educativa de Barranquilla. La muestra fue de diez estudiantes, donde tres de ellos presentan necesidades educativas especiales (NEE). Se aplicó una metodología desde el paradigma sociocrítico, la investigación cualitativa y el enfoque investigación – acción. A su vez, se hizo necesario el despliegue de cinco fases: la observación, el diagnóstico, la planeación, la ejecución y la evaluación. Se obtuvo como resultados, luego de aplicar el último taller de la propuesta pedagógica diseñada, que nueve de los escolares escucha las ideas de los demás y comparten las propias para realizar trabajos de forma colaborativa; ocho de ellos escucha y responde a las ideas del otro sin utilizar un lenguaje o gestos que lo desmerite o ridiculice; nueve utilizan de forma adecuada el lenguaje no verbal como mirar a las personas que hacen parte del auditorio, mantienen una postura correcta al hablar y escuchar, el tono de voz adecuado para ser escuchado y gestos que indiquen que está escuchando activamente, y solo ocho escucha y responde a las preguntas realizadas de forma puntual y sin desviaciones. Así, se concluye que los estudiantes avanzaron significativamente a lo largo del desarrollo de la propuesta. Se demostró que el aula invertida es una gran herramienta para fortalecer la escucha activa, y conlleva a la adquisición de habilidades como el trabajo en equipo.
THE ROLE OF CORPORATE CULTURE IN ECONOMIC DEVELOPMENT OF SMALL AND MEDIUM-SIZED ENTERPRISES
Authors: Lorincová Silvia , Miklošík Andrej , Hitka Miloš
Published: December 2021

Achieving economic development of the enterprise is enabled by the efficient use of resources, efficient processes and, last but not least, a suitable corporate culture. Under the influence of a dynamically changing business environment, corporate culture is gaining in importance and justification. It needs to be monitored and evaluated together with “hard” business indicators. The research explores the key values that should be applied in corporate culture at the strategic level to support the economic development of small and medium-sized enterprises. The differences between small and medium-sized enterprises operating in the industrial sector in Slovakia are defined. As managers have a direct impact on the creation of corporate culture, their preferences regarding corporate culture are examined, using the methodology of Cameron and Quinn. The results of the research prove the preference for applying key values typical for a clan culture. Following the results, it is recommended managers to focus on supporting a clan culture that develops employees. It is the employees who create and build values, bring new, innovative ideas, and with their abilities and skills influence the performance, competitive advantage, economic development, and success of the entire enterprise as well as economic development of small and medium-sized enterprises.
Comparison between results of optical and electrical measurements of free electron concentration in n-InAs specimens
Authors: Yugova Tatyana G. , Belov Aleksandr G. , Kanevskii Vladimir E. , Kladova Evgeniya I. , Knyazev Stanislav N. , Parfent'eva Irina B.
Published: December 2021

A theoretical model has been developed for determining the free electron concentration in n-InAs specimens from characteristic points in far IR reflection spectra. We show that this determination requires plasmon-phonon coupling be taken into account, otherwise the measured electron concentration proves to be overestimated. A correlation between the electron concentration Nopt and the characteristic wavenumber ν+ has been calculated and proves to be well fit by a third order polynomial. The test specimens have been obtained by tin or sulfur doping of indium arsenide. The electron concentration in the specimens has been measured at room temperature using two methods: the optical method developed by the Authors (Nopt) and the conventional four-probe Hall method (the Van der Pau method, NHall). The reflecting surfaces of the specimens have been chemically polished or fine abrasive ground. The condition Nopt > NHall has been shown to hold for all the test specimens. The difference between the optical and the Hall electron concentrations is greater for specimens having polished reflecting surfaces. The experimental data have been compared with earlier data for n-GaAs. A qualitative model explaining the experimental data has been suggested.
Heterologous Vaccination for Preparing COVID-19 Pandemic
Authors: Kim Tae Hyong
Published: December 2021

Infectious disease pandemics are characterized by extreme uncertainty. From the more predictable response to seasonal influenza, which occurs each year, we have learned the importance of effective universal vaccines and therapeutic agents to protect high-risk groups. Heterologous vaccination with different types of vaccines to prevent COVID-19 is already recommended for various reasons: shortages of mass vaccine supply; critical adverse events, and potential superior efficacy as a booster dose. However, very few studies have examined the efficacy and safety of heterologous vaccination with mixed types. This review discusses the efficacy of vaccines currently approved in the Republic of Korea, including heterologous vaccination options.
SGLT2 Inhibition for Diabetic and Non-diabetic Kidney Disease
Authors: Yu Mi-Yeon , Kim Gheun-Ho
Published: December 2021

Chronic kidney disease (CKD) can be progressive, and its prognosis is worse because of increased mortality when it is associated with diabetes and cardiac disease. The outcomes of diabetic kidney disease (DKD) need to be improved, despite multifactorial interventions including glucose and blood pressure (BP) control, and the use of renin-angiotensin system (RAS) inhibitors, statins, and aspirin. Recent clinical trials suggest that sodium-glucose cotransporter-2 (SGLT2) inhibitors offer additional cardiorenal protection in DKD and non-diabetic CKD on top of RAS inhibition. The action of SGLT2 inhibitors is derived from the proximal tubule of the kidney, but their systemic effects beyond glucose-lowering involve hemodynamic and non-hemodynamic mechanisms. First, SGLT2 inhibitors restore tubuloglomerular feedback and relieve glomerular hypertension and albuminuria. Second, natriuresis and renal glycosuria lead to fluid and weight loss, resulting in BP lowering and prevention of heart failure. Third, SGLT2 inhibitors have anti-inflammatory and anti-oxidative actions that can reduce renal and cardiac inflammation and fibrosis, probably via adenosine monophosphate-activated protein kinase and sirtuin-1 activation. Finally, the proximal tubular workload is relieved, accompanied by increased erythropoiesis. Hypoxia-inducible factor 1 may be stimulated by renal outer medullary hypoxia when tubular sodium transport shifts from the proximal convoluted tubule to the proximal straight tubule and thick ascending limb, due to SGLT2 inhibition. These effects may also be beneficial in non-diabetic CKD, and we anticipate that SGLT2 inhibitors will prove effective for albuminuria reduction and preservation of kidney function in primary kidney diseases, including glomerulonephritis.
Differential Diagnosis of Hypoglycemia
Authors: Lyu Young Sang , Kim Jin Hwa , Kim Sang Yong
Published: December 2021

Hypoglycemia is common but can lead to life-threatening consequences. Accurate diagnosis is important to establish the appropriate treatment strategy. Most cases of hypoglycemia are caused by hypoglycemic agents, although it can occur in individuals without diabetes. A systemic and comprehensive diagnostic approach is required to diagnose hypoglycemia in patients without diabetes. It is important to perform appropriate blood testing during an episode of hypoglycemia. This review will focus on the definition, differential diagnosis, causes, and treatment of hypoglycemia, particularly in people without diabetes.
Molecular Risk Stratification using Next-generation Sequencing in Acute Myeloid Leukemia
Authors: Ahn Jae-Sook
Published: December 2021

Chromosomal abnormalities are an important prognostic factor in cases of acute myeloid leukemia (AML). Molecular mutations have been reported to contribute to the pathogenesis and prognosis of AML. Next-generation sequencing (NGS) has revolutionized the speed and cost of genomic sequencing and enables the parallel analysis of many genes for molecular risk stratification. The molecular mutations currently included in risk stratification at AML diagnosis are c-kit, FLT3-ITD, NPM1, CEBPA (biallelic), RUNX1, ASLX1, and TP53. The importance of screening for mutations has been further emphasized by introducing novel therapeutic targets for molecular mutations, such as FLT3-TKD, IDH1, and IDH2. Molecular mutations are also used to evaluate measurable residual disease during treatment and to select the intensity of the treatment during consolidation and follow-up. Pretreatment leukemic marrow and blood should be stored at a biobank to perform NGS analysis in cases of AML at diagnosis. Samples from various time points during and after treatment should be obtained and stored under appropriate conditions.
Primaire 2021. Les écologistes à l’unisson présidentiel
Authors: Jérome Vanessa
Published: December 2021

Depuis la création du parti vert en 1984, les écologistes sélectionnent leurs candidats à l’élection présidentielle au moyen d’une primaire. Convaincus par les plus récentes « vagues vertes » des élections européennes de 2019 et municipales de 2020 que l’heure de l’écologie présidentielle est enfin venue, ils cherchaient cette année celui ou celle qui leur permettrait de faire d’une pierre deux coups : prendre le leadership d’une gauche éparpillée et perturber le duel annoncé entre Emmanuel Macron et Marine Le Pen. Un scénario qui n’existe qu’à condition que Yannick Jadot, vainqueur de justesse de la plus ouverte des primaires de l’histoire de l’écologie politique, passe la barre du premier tour.
La sororité, pour quoi faire ?
Authors: Mannooretonil Agnès
Published: December 2021

La fraternité serait un vain mot, et un mensonge. Mal définie dans le droit, dévitalisée par l’individualisme, elle subit des reproches nombreux. La solidarité de l’avenir serait-elle la « sororité » ? Un parcours littéraire permet de ressaisir la richesse d’un lien remis à l’honneur par le féminisme.
Reconquérir les corps. L’éducation physique au service de la francisation de la jeunesse dans les territoires alsaciens occupés (1915-1918)
Authors: Stumpp Sébastien
Published: December 2021

Entre septembre 1914 et l’Armistice de 1918, l’armée française occupe une portion de territoire de l’Alsace, région annexée à l’Allemagne depuis 1871. Une administration y est installée pour gérer le quotidien des 62 000 habitants et, plus encore, pour tenter de transformer les mentalités locales. Ses responsables s’attachent notamment à réorganiser les systèmes scolaire (écoles primaires et primaires supérieures) et postscolaire selon les modalités françaises. Dans ce cadre, à côté des disciplines « académiques » (français, histoire-géographie, etc.), ils promeuvent, dès 1915, l’enseignement de l’éducation physique. Cette pratique sert à la fois d’instrument d’acculturation, d’hygiénisation, d’encadrement et de pacification des jeunes Alsaciens. Les acteurs de cette francisation par corps doivent néanmoins composer avec la singularité du contexte alsacien, héritée d’un demi-siècle d’appartenance au Reich.
Le mouvement sportif communiste en résistance : la presse sportive clandestine (1940-1944)
Authors: Pécout Christophe , Vincent Joris
Published: December 2021

La question de la Résistance sportive reste peu étudiée dans l’historiographie liée au Régime de Vichy. Cet article vise ainsi à mettre en lumière l’action résistante de militants et sportifs communistes à travers l’étude d’une presse certaine sportive clandestine ( Sport libre , Sport , L’Action sportive , Le Sport enchaîné ). L’analyse de ces journaux, œuvre d’anciens membres de la FSGT, témoigne d’une continuité de leur engagement politique contre le fascisme et le nazisme initié dans les années trente. Aussi, durant ces quatre années, les tenants de cette presse n’auront-ils de cesse que de dénoncer la collaboration avec l’Allemagne et de critiquer la politique sportive menée par Vichy (Charte des Sports, carte sportive) tout en appelant au fil des mois les sportifs à s’engager dans la lutte au nom de la libération du pays.
Le projet Data Life-Cycle Management (DLCM) en Suisse : une gestion des données de la recherche pensée pour ses utilisateurs
Authors: Burgi Pierre Yves , Makhlouf Shabou Basma
Published: December 2021

Lancé en août 2015 dans le cadre du programme national Informations scientifique visant à poser les bases de l’ Open Science en Suisse, et cofinancé par swissuniversities, le projet Data Life-Cycle Management (DLCM) fournit aux chercheurs des accès et des partages aisés aux publications scientifiques et aux données de recherche.
Un miracle social. Du bon usage de l’empathie par le meneur
Authors: Kahn Laurence
Published: December 2021

De la servitude volontaire décrite par le Grand Inquisiteur de Dostoïevski à la soumission au meneur selon Freud, relu par Françoise Coblence, de la fabrication des « grands petits hommes » que sont les leaders selon Adorno à « l’ensorcellement » d’un village autrichien par la prodigieuse empathie d’un Führer, dépeint par Hermann Broch, de la mystique de la guerre examinée par Walter Benjamin à la folie collective repue de magie, l’auteur explore deux ressorts de la psychose des masses : non seulement la perte en rationalité, mais également la perte en irrationalité tout aussi dommageable. Privé des sources étrangement inquiétantes de sa vie psychique et du lien primitif au monde que forge intuitivement l’habitation symbolique du mythe, comment l’homme peut-il lutter contre la réalisation concrète, en acte, du crime ? Où trouverait-il l’élan d’une création collective ? Ce faisant, la part d’irrationalité nécessaire à la vie de l’esprit ne s’oppose-t-elle pas en tous points à la « dictature de la raison » ?
Une tension insoutenable : l’héritage chrétien dans la formation des foules modernes. Une relecture de Psychologie de masse et analyse du moi
Authors: Christ Julia
Published: December 2021

L’analyse de la formation de la foule telle que Freud la mène dans Psychologie de masse et Analyse du moi est communément considérée comme une contribution à une théorie des foules en général. Le présent article tâche de montrer que tel n’est pas le cas. Que Freud, en analysant la formation de la foule depuis l’étude du psychisme individuel et des opérations de « remplacement » qui doivent s’y opérer afin qu’une foule advienne, inscrit en réalité la possibilité même de ce mode de production d’un collectif dans l’héritage chrétien des sociétés européennes.
Common Eider Wintering Trends in Nova Scotia, 1970–2019
Authors: Robertson Gregory J. , Wong Sarah N. P. , Tomlik Molly D. , Milton G. Randy , Parsons Glen J. , Mallory Mark L.
Published: December 2021

Common eiders Somateria mollissima have been a focus of conservation and management efforts in eastern North American for over a century; however, the complex population structure and multiple subspecies make assessing the status of populations challenging. The coastlines of Nova Scotia, Canada, are an important wintering area for common eiders, and significant harvests of common eiders occur in the province. We analyzed trends in the number of wintering common eiders using the coasts of Nova Scotia from dedicated waterfowl surveys flown since 1970, and every year since 1992. We used Generalized Additive Models to assess the apparent non-linear trends in the counts of common eiders over the past 50 y. We found that numbers of common eiders wintering in Nova Scotia increased from 1970 to the early 2010s, with strong growth in the 2000s (peaking at 7% growth/y). Since the early 2010s, the growth has stopped, and the numbers are now declining. Recent declines in the population wintering in Nova Scotia corroborate other evidence that common eiders are declining in the region, and may also indicate distributional shifts of common eiders in eastern North America.
Reply on the comments about Piccione F, Maccarone MC, Cortese AM, Rocca G, Sansubrino U, Piran G, Masiero S. Rehabilitative management of pelvic fractures: a literature-based update. Eur J Transl Myol. 2021 Sep 17;31(3):9933. doi: 10.4081/ejtm.2021.9933
Authors: Maccarone Maria Chiara , Coraci Daniele , Sansubrino Umberto , Piccione Francesco , Masiero Stefano , Zanella Raffaele
Published: December 2021

We thank the authors of the Letter of Zehua Li, et al. (2021)1 and the Editor for the opportunity to discuss our work more thoroughly. The comments on the article written by Piccione et al. (2021)2 are certainly interesting and highlight limitations of the previously published article. However, we need to make some clarifications.
Factors Affecting Nurses’ Ability to Provide Effective Care in a Disaster Response: A Review
Authors: Kimin Amelia , Nurachmah Elly , Lestari Fatma , Gayatri Dewi
Published: December 2021

Disasters cause death, trauma, and psychological distress. Comprising the largest number of healthcare workers, nurses play a crucial role in reducing the impact of a disaster. The objective of this review is to identify the factors that influence nurses’ ability during a disaster emergency response to provide adequate care. This research was conducted by doing a literature search from the Pro-Quest and Science-Direct databases using the PRISMA-ScR to screen the articles. The final results included 13 articles. An analysis was performed to identify themes in line with the purpose of the review. All factors affecting nurses’ ability to respond to a disaster situation were classified into three themes: 1) factors increasing nurses’ ability, 2) barriers to delivering effective nursing care, and 3) support needed to maintain the nurses’ ability. During an emergency situation due to a disaster, adequate knowledge and skill to save lives, treat injuries, manage stress and coordinate between teams are the basic competencies needed for optimal care. Nurses’ clinical experience or previous disaster experience and training could increase nurses’ adaptability in disaster conditions. Support from nurses’ workplace and proper implementation of disaster management policy enhance nurses’ services and prevent barrier under disaster condition. The results emphasize that future training should aim for improving nurses’ knowledge and skills, including the knowledge of nurses’ family to protect themselves and deal with disasters. Such knowledge increased family preparedness, which is an important factor to enhance nurses’ willingness to work following a disaster.
The Effects of Acceptance and Commitment Therapy on Psychosocial Impact and Adherence of Multidrug-Resistant Tuberculosis Patients
Authors: As'hab Priyo Purnomo , Keliat Budi Anna , Wardani Ice Yulia
Published: December 2021

Background

The Worldwide resistance prevalence of the first-line tuberculosis drug, rifampicin, in 2017 was 7.4 per 100,000 population, and 82% of them experienced multidrugresistant tuberculosis (MDR-TB). Indonesia is the top 20 country with an MDR-TB burden, and its prevalence is 8.8 per 100,000 population. MDR-TB requires a long-time treatment and has accompanying side effects: biological and psychosocial effects. However, efforts to overcome the psychosocial impacts have not been conducted. This study aims to determine the effect of acceptance and commitment therapy (ACT) on anxiety, depression, suicidal ideation, and treatment adherence in MDR-TB patients.

Design and methods

This research employed a quasi-experimental design with a pre-test three post-tests using total sampling. The pre-test was conducted before the standard nursing intervention, post-test 1 was after the standard nursing intervention, posttest 2 was after ACT session 1, and post-test 3 was after ACT session 2. Data were collected by the Hamilton Rating Scale for Anxiety, Beck Hopelessness Scale, a Scale for Suicide Ideation, and Morisky Medication Adherence Scale.

Results

The standard nursing action and ACT reduce anxiety (p=0.002), reduced depression (p=0.0001), reduced suicidal ideation (p=0.008), and increased treatment adherence (p=0.0001).

Conclusions

The standard nursing action and ACT reduce anxiety, depression, and suicidal ideation. They increase treatment adherence recommended for use in MDR-TB patients.
Thunderstorm allergy and asthma: state of the art
Authors: D'Amato Gennaro , Annesi-Maesano Isabella , Urrutia-Pereira Marilyn , Del Giacco Stefano , Rosario Filho Nelson A. , Chong-Neto Herberto J. , Solé Dirceu , Ansotegui Ignacio , Cecchi Lorenzo , Sanduzzi Zamparelli Alessandro , Tedeschini Emma , Biagioni Benedetta , Murrieta-Aguttes Margarita , D'Amato Maria
Published: December 2021

Thunderstorm-triggered asthma (TA) can be defined as the occurrence of acute asthma attacks immediately following a thunderstorm during pollen seasons. Outbreaks have occurred across the world during pollen season with the capacity to rapidly inundate a health care service, resulting in potentially catastrophic outcomes for allergicpatients. TA occurs when specific meteorological and aerobiological factors combine to affect predisposed atopic patients with IgE-mediated sentitization to pollen allergens. Thunderstorm outflows can concentrate aeroallergens, most commonly grass pollen but also other pollens such as Parietaria and moulds in TA, at ground level to release respirable allergenic particles after rupture by osmotic shock related to humidity and rainfall. Inhalation of high concentrations of these aeroallergens by sensitized individuals can induce early asthmatic responses which can be followed by a late inflammatory phase. There is evidence that, during pollen season, thunderstorms can induce allergic asthma outbreaks, sometimes also severe asthma crisis and sometimes deaths in patients suffering from pollen allergy. It has been observed that changes in the weather such as rain or humidity may induce hydratation of pollen grains during pollen seasons and sometimes also their fragmentation which generates atmospheric biological aerosols carrying allergens. Asthma attacks are induced for the high concentration at ground level of pollen grains which may release allergenic particles of respirable size after rupture by osmotic shock. In other words, it is a global health problem observed in several cities and areas of the world that can strike without sufficient warning, inducing sometimes severe clinical consequences also with deaths of asthma patients. Due to constant climate change, future TA events are likely to become more common, more disastrous and more unpredictable, as a consequence it is important to have deep knowledge on this topic to prevent asthma attacks. Other environmental factors, such as rapid changes in temperature and agricultural practices, also contribute to causing TA.
Deontology vs. Utilitarianism
Authors: Chukwuneke Felix N. , Ezenwugo Anthony C.
Published: December 2021

We live in a society that functions with a system of morals that seeks to determine what is right or wrong. Each society is ruled by moral codes that guide people's action to minimize the risk of sliding into structural dysfunction. To understand the importance of human values within which the society can live and operate in a harmonious state, many great philosophers such as Immanuel Kant and Bentham Jeremy have presented moral theories based on the principles of deontology and utilitarianism, respectively. These two ethical major streams of thought influence ethical decision-making. In utilitarian principles, outcomes justify the means or ways to achieve it and as such the focus is on the consequences of an action, whereas in deontological ethics, obligation to duty is what matters irrespective of the outcome. In medicine, deontology is patient centered, whereas utilitarianism is society centered. Practically, these two moral thoughts seem contradictory but each has its own advantages and disadvantages, which may occasionally intertwine to reach a midpoint level in a critical situation. In a well-resourced setting, the deontology approach to healthcare issues seems more practicable than the utilitarian approach because the duty of care is more focused on the individual and not necessarily on the society. As every rational being thinks of him- or herself as an end, doctors must act in such a way that they treat humanity and their patients always as an end and never simply as a means. The moral worth of a clinician's action in patients’ management therefore depends exclusively on the moral acceptability of the rule of obligation to duty, that is, “cause no harm” irrespective of the consequences. This article highlights the fundamentals of deontology and utilitarian principles as moral theories in medicine with basic examples.
Antibiotic Use and Resistance
Authors: Nwafia Ifeyinwa , Ohanu Martin , Ebede Samuel , Okoil Chukwudi , Nwachukwu Paul , Umenzekwe Chukwudi , Ndubueze Chidiebere , Aroh Adaora , Oraebueze Ibuchukwu , Ezomike Chidiogo , Okeke Princess , Izundu Dominic
Published: December 2021

Background:

Multidrug resistant bacteria have become a major public health concern worldwide. Inappropriate and overuse of antibiotics are known promoters of antibiotic resistance. This study was therefore carried out to assess healthcare workers’ knowledge, attitude, and practice on antibiotic use and resistance.

Materials and Methods:

A descriptive cross-sectional study was conducted among healthcare workers from University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. A self-administered questionnaire was used to assess the knowledge, attitude, and practice of antibiotic use and resistance. Descriptive and inferential analyses were subjected on the data.

Results:

A total of 600 healthcare workers were surveyed with male: female ratio of 1:2.2. The mean age of the participants was 39.6±25.6 years. The level of knowledge was 58.8%, followed by attitude (49.1%) and practice (24.3%). The knowledge on super bugs (40.3%) and carbapenem-resistant Enterobacteriaceae (37.3%) was the least on resistant organisms surveyed. The main source of information was internet with the least being television/newspaper. Slightly less than half, (287/600, 47.8%) always do laboratory investigations before commencing antibiotics and (373/600, 62.2%) will stop taking antibiotics when their symptoms improve without completing the dosage. Majority of the participants (91.2%) indicated that healthcare workers are at risk of acquiring the antimicrobial-resistant organisms; however, only 67.7% believed that UNTH has the same problem.

Conclusion:

The knowledge, attitude, and practice of healthcare workers on antibiotic use and resistance were not encouraging. Greater educational interventions are, therefore, necessary to improve public awareness and develop behavioral measures to curb the spread of the resistant organisms.
Global Hunger Index does not really measure hunger - An Indian perspective
Authors: Singh Padam , Kurpad Anura V. , Verma Davendra , Nigam Arun K. , Sachdev Harshpal S. , Pandey Arvind , Hemalatha Rajkumar , Deb Sila , Khanna Kumud , Awasthi Shally , Toteja Gurudayal Singh , Bansal Priyanka G. , Gonmei Zaozianlungliu , Bhargava Balram
Published: December 2021

The Global Hunger Index (GHI) is calculated and disseminated annually. India, which is the 5th largest economy in the world and has a good ranking in many other indicators, has a poor ranking based on this index. After a critical review of the appropriateness of the indicators used in GHI, the Indian Council of Medical Research has the viewpoint that the indicators of undernourishment, stunting, wasting and child mortality do not measure hunger per se. Referring to this index as a Hunger Index, and thereby ranking countries is not appropriate, since many of the measures that are used to evolve an index that measures hunger are probably contextual. Countries should therefore evolve their own measures that are suitable for their own context.
Screening for breast cancer
Authors: Mishra Gauravi A. , Pimple Sharmila A. , Mittra Indraneel , Badwe Rajendra A.
Published: December 2021

Low- and middle-income countries (LMICs) have limited financial resources and proportionately smaller portions allocated for health budget. With competing health priorities, treatment of the diagnosed cases and establishment of treatment facilities are the main concerns in LMICs. Infectious diseases, reducing infant, child and maternal mortality may seem crucial as compared to early cancer detection. LMICs that are committed to providing comprehensive cancer care, will need to judiciously choose the screening tool depending on specifics of how the tool is expected to perform in the population and the cost-effectiveness with respect to the number of lives expected to be saved. Increasing awareness about breast health in general and common cancers and non-communicable diseases (NCDs), in particular, may lead to symptomatic women approaching the healthcare facilities at an earlier stage. When the limited available resources are mobilized towards cancer screening, increasing awareness would lead to greater acceptability of the programme. The reach of the programme to achieve good population coverage, the establishment of the diagnostic referral linkages and the availability and accessibility of treatment facilities, will all decide the outcome of the screening programme.
Assessment of awareness and barriers to clubfoot treatment in the Indian scenario
Authors: Iqbal Mohammed Schezan , Dubey Rajiv , Thakur Kamparsh , Katiyar Sarthak , Prasad Manish
Published: December 2021

Background:

We undertook this study to evaluate the awareness of the Primary Caregivers of children with clubfoot aka Congenital Talipes Equino Varus (CTEV) and their familiarity with the disease, their beliefs, knowledge and compliance to treatment, and barriers encountered during the treatment process.

Settings and design:

Cross-sectional, analytical study.

Materials and methods:

A standard questionnaire in the local vernacular language was prepared, on which 108 respondents were interviewed. Data were analyzed by using Statistical Package for the Social Sciences (SPSS) software program, version 21.0. Chi-square test was applied wherever suitable as a parametric test.

Results:

Approximately 57.40% of participants had no prior knowledge of clubfoot at all, till they had a child born of the deformity in the family. Superstitions like lunar eclipse (37.96%), punishment from God (37.03%), solar eclipse (34.26%) and black magic (26.85%) were widely prevalent as the perceived cause of the deformity. Only 25% of the participants believed that any kind of treatment should be started immediately after birth and 20.37% of the study population felt the first line of treatment should be a visit to a spiritual healer or to a shrine of a saint. Approximately 68.52% of the study participants were satisfied with the explanation of the disease process and treatment plan offered by the treating doctor. Approximately 52.77% perceived social stigma as an obstacle to treatment, whereas 58.33% had difficulties adjusting to change of home or workplace routines.

Conclusion:

The awareness level regarding clubfoot in the primary caregivers in the Indian scenario is low and has an implication on successful treatment and compliance.
Socioeconomic status scales
Authors: Majumder Suranjan
Published: December 2021

Socioeconomic status (SES) is a critical measure that helps to correlate well-being and social status. SES plays a significant role in determining an individual’s quality of life, health, social position, and class. The widely accepted SES scales are the Kuppuswamy scale, BG Prasad scale, and Udai Pareekh scale. The income range is revised by using an online dedicated tool for this purpose. The scale is based on the income domain to decide the SES, which needs to be revised regularly based on the Consumer Price Index for Industrial Workers (CPI-IW). The study is the revised income range of the Kuppuswamy scale and BG Prasad scale as per the CPI-IW January 2021. However, all three scales have a few limitations and are not applicable to both the rural and urban areas at the same time.
Adherence to antihypertensive therapy and its determinants among patients attending primary care hospitals of Kashmir, India
Authors: Raja Waseem , Ayub Taha , Jeelani Asif , Khan S. Muhammad Salim
Published: December 2021

Background:

Adherence to antihypertensive therapy is an important factor in determining the clinical course of hypertension. This study was planned to estimate adherence to antihypertensive therapy and its determinants among OPD patients attending two primary care hospitals in Kashmir valley.

Methods:

This study employed a cross-sectional study design. All subjects who reported to OPD between October and December 2020 and had been prescribed antihypertensive medications for at least 1 year were included. Sociodemographic information was collected on a pretested schedule and adherence to medications was assessed by using the-14 item Hill-Bone HBP Compliance to High Blood Pressure Therapy Scale (HB-HBP). Mann–Whitney test and Spearman’s rank correlation coefficient were used.

Results:

A total of 406 subjects were included in the final analysis with a mean age of 58 years for women and 56 years for men. The sample comprised 54% women. More than 60% of subjects were currently married, urban area residents, and belonged to middle strata of social class. The mean score obtained in the HB-MAS (maximum score 56) was 19.26 (SD ± 4.3). Subjects aged 60 years and above, those belonging to lower socioeconomic class, and subjects prescribed three or more drugs with more than once-daily dosing regimen had higher odds of having poor adherence.

Conclusion:

There is suboptimal adherence among OPD patients at primary care level. There is a need for enhanced counselling regarding medication adherence particularly for elderly, poor, illiterate persons and those prescribed multiple medicines with more than once-daily dosing.
Comparison of standard dose with high dose of methylprednisolone in the management of COVID-19 patients admitted in ICU
Authors: Singhai Abhishek , Bhagtana Parneet Kaur , Pawar Neeraj , Pavan G. Sai
Published: December 2021

Context:

The pathological progression in severe Coronavirus Disease 2019 (COVID-19) includes an excessive and unregulated pro-inflammatory cytokine storm. Though the efficacy of corticosteroids like methylprednisolone (MPS) in severe COVID-19 is proven now, its dose and duration are not precise.

Aims:

Our study aimed to compare the effect of a standard dose (SD) of MPS (60–120 mg/day) to a high dose (HD) of MPS (>120 mg/day) on the outcome of hospitalized COVID-19 patients.

Settings and Design:

This study was a cross-sectional study. Patients admitted to AIIMS, Bhopal’s intensive care unit (ICU) from July 2020 to March 2021 were enrolled in the study.

Methods and Material:

The patient’s medical records were extracted from the medical record section of the hospital. The primary endpoint was the all-cause mortality during the hospital stay. The secondary endpoints were the need for mechanical ventilation, the use of vasopressors, the occurrence of acute kidney injury (AKI), and secondary infections.

Statistical Analysis Used:

Data were entered in the MS Excel spreadsheet and coded appropriately.

Results:

Our data showed that survival, the need for mechanical ventilation, the occurrence of AKI, and secondary bacterial infection are comparable among the two groups with no significant difference. The logistic regression analysis showed that there is a slightly higher risk of death for patients with an acute respiratory distress syndrome (ARDS) receiving HD of corticosteroids compared to SD, though these results were found to be statistically non-significant.

Conclusions:

In hospitalized patients suffering from severe COVID-19 pneumonia, an SD of MPS is as effective as an HD of MPS in terms of reduction in mortality and need for mechanical ventilation.
The community health impasse
Authors: Warnky David , Balachandra Swathi S. , Prasad Ramakrishna , Sykes Kevin J. , Lall Dorothy , Bhojani Upendra M.
Published: December 2021

Context:

As social position rises, health improves. Alma Ata set the stage for community-oriented primary care (COPC), and family medicine is perfectly positioned to integrate Social Determinants of Health. India presents a unique environment for innovations in family medicine.

Aims:

This study aimed to (1) assess the ability of different primary care practices to address the social determinants of health (SDoH); (2) identify key obstacles and supports; and (3) provide practical insights to family physicians and other primary care providers (PCPs) for the integration of SDoH and clinical primary care.

Settings and Design:

A diverse sample of primary healthcare practices were selected in southern India for investigation. Data collection involved observation and informal interviews.

Methods and Material:

The researchers used general observation and informal interviews to collect data. Investigators used a basic interview guide to structure conversations and formal journal entries were recorded immediately following each visit.

Statistical Analysis Used:

Thematic analysis was conducted with NVIVO software to categorize major themes.

Results:

Seventeen primary healthcare practices were observed; eleven were formally enrolled for interviews. Four inputs and three outputs of socially oriented primary care practices were identified. The inputs include leadership style, appropriate staffing, funding structures, and patient panels. Social interventions, community contact, and treasuring community empowerment were the major outputs.

Conclusions:

Community health lies at the heart of strengthening primary healthcare. Establishing practices that bridge the gap between clinical primary care and SDoH initiatives need to be prioritized. This study fosters agency for family physicians and PCPs to engage with local communities and lead the path toward this integration.
Role of Strain Imaging for Guiding Management of Valvular Heart Disease
Authors: Karande Atul
Published: December 2021

Echocardiographic strain imaging allows more precise evaluation of cardiac function and provides new insights into the complex cardiac mechanics. Global longitudinal strain is found to be clinically useful in various valvular heart diseases. It provides additional diagnostic and prognostic information besides standard echocardiographic and clinical parameters. In this review, a summary of current clinical applications, limitations, and future of strain echocardiography in patients with valvular heart diseases is discussed.
Prevalence and socioeconomic correlates of growth impairment among Saudi children and adolescents
Authors: Al-Hussaini Abdulrahman , Bashir Muhammad Salman , Khormi Musa , Alkhamis Wahid , Alrajhi Mona , Halal Thana
Published: December 2021

Background:

Saudi Arabia has witnessed economic prosperity leading to changes in diet and lifestyle. Concurrent with these changes, the prevalence rates of overweight and obesity are rising. No recent data exist on the trends and pattern of growth impairment among Saudi children. We aimed to provide the most recent estimate of the prevalence of thinness and short stature among healthy school-aged children in Riyadh, Saudi Arabia, and to investigate the effect of parental socioeconomic status (SES) on growth impairment.

Methods:

A cross-sectional study was conducted in 2015 among schoolchildren in Riyadh. A sample of 7931 children (67% girls) aged 6–16 years was randomly selected. Body mass index (BMI) z-score <−2 SD and height z-score <−2 SD, for age and sex, using the WHO reference 2007, defined thinness and short stature, respectively. To assess the impact of SES on growth, we categorized SES into 4 levels by incorporating 4 main indicators: parents’ educational level, family income, type of residence, and parents’ jobs.

Results:

The prevalence of short stature was 15%, and the prevalence of thinness was 3.5%. Stratification of the thinness prevalence rate according to gender indicated that boys were significantly thinner than girls (4.7% versus 2.8%, P = 0.048). Short stature was significantly higher among children in the lower SES classes than among their counterparts in the higher SES classes. Parents of thin children were more likely to be less educated, have less income, live in apartments, and have a lower SES than parents of overweight and obese children.

Conclusions:

The rate of thinness among Saudi children is low, similar to that in developed countries, and is significantly correlated with SES.
Age, chemistry, and tectonic setting of Miramichi terrane (Early Paleozoic) volcanic rocks, eastern and east-central Maine, USA
Authors: Ludman Allan , McFarlane Christopher , Whittaker Amber T.H.
Published: December 2021

Volcanic rocks in the Miramichi inlier in Maine occur in two areas separated by the Bottle Lake plutonic complex: the Danforth segment (Stetson Mountain Formation) north of the complex and Greenfield segment to the south (Olamon Stream Formation). Both suites are dominantly pyroclastic, with abundant andesite, dacite, and rhyolite tuffs and subordinate lavas, breccias, and agglomerates. Rare basaltic tuffs and a small area of basaltic tuffs, agglomerates, and lavas are restricted to the Greenfield segment. U–Pb zircon geochronology dates Greenfield segment volcanism at ca. 469 Ma, the Floian–Dapingian boundary between the Lower and Middle Ordovician. Chemical analyses reveal a calc-alkaline suite erupted in a continental volcanic arc, either the Meductic or earliest Balmoral phase of Popelogan arc activity. The Maine Miramichi volcanic rocks are most likely correlative with the Meductic Group volcanic suite in west-central New Brunswick. Orogen-parallel lithologic and chemical variations from New Brunswick to east-central Maine may result from eruptions at different volcanic centers. The bimodal Poplar Mountain volcanic suite at the Maine–New Brunswick border is 10–20 myr younger than the Miramichi volcanic rocks and more likely an early phase of back-arc basin rifting than a late-stage Meductic phase event. Coeval calc-alkaline arc volcanism in the Miramichi, Weeksboro–Lunksoos Lake, and Munsungun Cambrian–Ordovician inliers in Maine is not consistent with tectonic models involving northwestward migration of arc volcanism. This >150 km span cannot be explained by a single east-facing subduction zone, suggesting more than one subduction zone/arc complex in the region.
Ship Systems and Equipment - Fasteners - Selection and Identification Guidance
Authors:   Ship Systems - Fasteners Committee
Published: December 2021

This SAE Standard provides a comprehensive list of guidelines for the selection, identification, and control of metric- and inch-sized fasteners for use in shipboard applications for both shipbuilder installed joints and for use in shipboard components. This guidance includes the following:

a

Fastener material selection.

b

Fastener thread form and fit selection.

c

Selection of fastener finish, when needed.

d

Selection of locking devices and elements, when needed.

e

Selection of screw thread fastener inserts, when needed.

f

Use of fastener part or identifying numbers.

g

Identification marking requirements.