bluuebunny/crossref_metadata_2025 huggingface dataset:
Corporate Social Responsibility and its Pluralistic Approach during the Covid-19 Pandemic
Authors: Nemani Naga Snigdha , Rudra Medha , Bhalla Manmohit , Abhishek Kumar , Kaushik Muskaan
Published: May 2022

CSR is the model through which the firms contribute towards the social and economic development of the country by engaging in the work of social welfare which impacts the environment around and helps in achieving a greater good of the society. CSR and Corporate Governance are two sides of the same coin. Corporate governance practices encourage a body corporate to perform its activities well internally and also to act responsibly externally. So, a firm having good corporate governance practice acts as a first step toward CSR. This paper will discuss in detail the criteria which needs to be satisfied by the companies to comply with the CSR provisions and also the composition of the CSR Committee. The authors will further discuss the relation between CSR and Corporate Governance and also the association between Globalization and Corporate Social Responsibility. The authors will then focus on the main theme of the paper and will provide a detailed analysis of the CSR activities undertaken during the times of COVID-19 pandemic. The paper will deal with the implications of CSR during the pandemic and also with the contributions made during these times. The authors will provide a detailed framework of the activities undertaken by the Indian companies during these times in a sect-oral differentiation like education, healthcare etc. The paper will also discuss the problems faced by the companies to meet the CSR provisions during these times and the imbalances faced in the supply chain will also be discussed.
CONSERVATION OF OUR GREEN LINEAGE - THE SOIL
Authors: Nemani NagaSnigdha
Published: May 2022

Soil conservation in short can be defined as “preservation of soil from erosion”. This means, protecting the top most layer of the soil from any kind of erosion, or preventing its fertility content due to over usage, salinization or due to any other form of soil contamination. Soil conservation is a set of farming techniques and procedure which are adopted to avoid soil erosion, soil degradation and depletion of fertility of the soil. To avoid these kinds of issues, it is the utmost priority to apply conservation methods to improve production on the same soil, by increasing irrigation facilities, proper fertilization’s to be used in such a way which shall not affect the fertility of the soil, and imparting ourselves to various hybrid means.
Tuning Indian Bio Diversity Laws with Nagoya Protocol: An Analysis
Authors: Chaurpagar Dr. Kapil
Published: May 2022

The conservation of biological diversity is a serious and common concern. The better management of biological resources and biodiversity is essential for the welfare of human beings. As per the international obligation the Government of India, enacted the Biological Diversity Act, 2002. This Act provides conservation of biological diversity, presently there are many lacunas are present in this Act. But the cumbersome process regarding the permission and application of patent is the most impeding provision. New amendment in Biological Diversity Act 2002 endeavors to tune it with the Nagoya Convention. Secondly to remove the lacunas of the present Act and to create a favorable climate for collaborative research and investment. In new amendment Act it is also aimed to simplify the patent application procedure. In new amendment Act Ayush practitioners have been exempted from the Act’s scope. In new amendment Act seeks to bring more foreign investment in biological resources, research, patent and commercial utilization, without compromising the national interest. The major concern with the amendment bill is that the corporate or foreign interest could use the loopholes of permission given to traditional medicine and use it for commercial purposes, without sharing the benefits with the conservers of biodiversity. It is imperative that new laws not only be regulatory, but also be executed with the involvement of local people, particularly village sabhas and panchayats.
The Reference Value Of The Organic Urban Renewal And Smart Urban Governance Mechanism In Extraterritorial Cities For China
Authors: Sun Heyuan , Zuo Jinfeng
Published: May 2022

Urban renewal is regarded as a broad concept involving physical, social, economic and environmental aspects, which is closely related to the goal of sustainable urban development. Traditional urban renewal only focuses on the physical construction including economic input, market operation, infrastructure, land use, organization and implementation, which is far from enough. The community functions as the basic place serving the production and life of urban residents, as well as the basic unit of a city. China’s urbanization has entered a new stage of transformation and development focusing on quality improvement. The concept of emphasizing people-centred, connotative development and urban quality improvement has gradually become the theme of current urban renewal in China. Therefore, in recent years, China has been actively promoting the “Double Urban Repairs” reformation, the two programs of “Ecological Restoration” and “City Betterment”, which have become the focus of public and academic concern. However, in the face of the process of urban community renewal in China, there are still plenty of problems to be solved, such as how to realize the organic combination of urban micro-renewal and community micro-renewal in a more scientific, professional and effective way with social governance as the entry point, how to establish and improve the new mechanism of “Ecological Restoration”, “Reformation of People’s Livelihood” and “Smart Social Governance” while maintaining the overall coordination of community, government and enterprises with the core idea of human-oriented, and how to solve the problems of the unclear practical scope of rules and regulations in the implementation of urban community renewal in China, lack of democratic participation and supervision mechanism and the lagging of community self-government law development behind smart urban governance. The rule of law functions as an important basis for realizing the modernization of the national governance system and governance capacity, and the basic guarantee for social governance. Therefore, through the study of extraterritorial experience and development dilemma of urban community renewal in China, this research is expected to find a development path suitable for urban community renewal in China from the aspects of government policy mechanism, rules and regulations, and public participation.
Pandemic and Prison System: An Exploration of Plight of Prisoners
Authors: Panda Padmaja Priyadarshani , Jena Debesh Kumar , Behera Snehasis , Mohanty Subhankari , Rautray Saurav
Published: May 2022

This research work starts with the definition of prison and a brief history of the prison reform. Prison is a place where the offenders are kept due to the wrong they have done to society. The COVID-19 pandemic has aggravated the possibility of contamination of COVID-19 and deteriorated the mental well-being of inmates. Studies directed since the epidemic of COVID-19 have uncovered increased tension, feeling more restless because of stresses connecting with them or a friend or family member contracting coronavirus, and bothered side effects of existing psychological sickness pandemic have somehow or the other affected the prisoners and the prison reforms. Next, the research paper discusses various rights of the prisoners and how are they being violated during the pandemic for example The basic rights which every pre-trial, under trial, and convicted prisoner are guaranteed under various laws are being violated like the mulaqat system, communication with friends and education are being violated. The paper again tries to throw light on the facts of aftercare services, medical facilities and meeting with family provided in jails during Pandemic. Further, some measures of how can these problems be tackled has been in this project.
The Effect of Financial Ratio and Interest Rate of Bank on Working Capital Loan Distribution (Study on Commercial Banks Listed in The Indonesia Stock Exchange for The Period 2017 – 2021)
Authors: Dwi Dewianawati  , Fajar Purwanto  , Erry Setiawan
Published: May 2022

Banking has a major role in the economy to raise funds from the public which is then channeled back to the community in the form of credit. Not optimal lending conducted by the bank into the background of this study. For that we need to be determined how financial ratios, and the bank rate on loans for working capital. The data used in this research is secondary data where the population used in this study is a commercial bank listed on the Indonesia Stock Exchange in the period 2017-2021. Purposive sampling method, so that from 40 companies acquired a total of 14 banks as samples. The analytical method used in this research is multiple linear regression. Partial results of this study show that the LDR and ROA significantly and negatively related to working capital lending. CAR positive and significant impact on working capital lending, while interest rates don’t affect the working capital loan portfolio. And simultaneously shows that LDR, CAR, ROA and interest rates significant positive effect on working capital loans.
Acceso a Recursos Genéticos en México
Authors: Aguilar-Navarro Carlos Omar
Published: May 2022

México en materia legislativa ha enfrentado diversas tensiones en temas de biodiversidad, por lo que es necesario preguntar si ¿México puede proteger su biodiversidad con el marco regulatorio actual? Una respuesta suficiente para cubrir todas las áreas relevantes es difícil; sin embargo, limitar la pregunta a un contexto determinado como el tema de los recursos genéticos, puede ser un criterio o guía para evaluar si existen las condiciones favorables para la protección de la biodiversidad en México.

Actualmente México omite una ley para regular de forma específica el acceso y el uso de los recursos genéticos, así como la protección de los conocimientos tradicionales, siendo la única herramienta aislada el régimen de propiedad intelectual. En el 2018 se hizo un esfuerzo muy importante para que el Senado mexicano aprobara la Ley General de Biodiversidad para incorporar el Protocolo de Nagoya a la legislación; sin embargo, integrar un marco normativo con estas disposiciones de manera transversal para los tres niveles de gobierno no fue posible, y mucho menos fue posible fortalecer y actualizar las disposiciones de la Ley General de Vida Silvestre para conservar la biodiversidad en México.

La estrategia nacional en biodiversidad como instrumento de política pública carece de herramientas para ser utilizada en los programas sectoriales, así como un referente en los programas de planeación a nivel Estatal y Municipal como lo establece la Ley General de Vida Silvestre.
The Centrality of the Actor-Network of the Manpower Bill in Tempo's Weekly Magazine Reporting
Authors: Gora Radita
Published: May 2022

The drafting of the Job Creation Bill (RUU) invites public controversy to the occurrence of a community movement rejecting the Job Creation Bill and also the omnibus law. This has invited Tempo magazine to report on the draft regulation by placing statements of certain actors in the news as well as Tempo's tendency to involve actors in its communication network. So here it is indicated that there is a problem of ambiguity in the involvement of political actors in the news. Through the use of media sovereignty theory to examine the media in utilizing their freedom of authority, as well as analysis of communication networks to identify the presence of the central actor in Tempo's reporting. Here it is found that the network density is low, the relationship between actors and actors needs to go through several steps so that the network distribution is very wide. In addition, Tempo has an imbalance in placing political actors in Tempo's reporting, so political actors are not fully explained in terms of their relationships, including the network relations between these political actors.
Knowledge around back pain and spinal disorders among Aseer patients: A cross sectional study
Authors: Alburaidi Ibrahim , AlQahtani Saleh Saeed , saran Fahad mohammed , Alshehri Zuhair Abshan , Dashnan Rayan Dulaym , Al Mansour Sultan Abdullah , al-Jahami Faisal , Alshehri Shaker , Alasmari Hani Fayez Ahmed , Alqahtani Jamal Saad Saeed , Alshehri Meshari Shar
Published: May 2022

Introduction: Low Back Pain (LBP) is one of the most common health problems and is considered the second highest reason for seeking medical advice. In most cases, LBP is not an indication of serious disorder, however, it can be considered the leading cause of disability and work absence around the world. In Saudi Arabia, it was found that the prevalence of LBP and pattern of its symptoms ranges from 53.2 % to 79.17 %. Aims: to assess the level of knowledge related to their disease, among patients with LBP.. Methods: A cross-sectional study was conducted in the region of Asser, Saudi Arabia and comprised patients presenting with lower back pain. In this study, we had used the Arabic version of validated questionnaire called (LBP knowledge questionnaire “LKQ”) which was prepared and validated by Maciel et al. The questionnaire was distributed online using social media such as Facebook and WhatsApp between patients with non – specific LBP from both genders. Results: We received 183 responses from patients with LBP. Among this sample, males represented 60.7 % of the sample. Furthermore, almost two thirds of the sample were married (57.9 %) and 39.9 % of them were single. Finally, we found that 49.7 % of the sample had monthly income of less than 5000. Considering level of knowledge about LBP in this sample, we found that almost all of the sample (97.8 %) had partial knowledgeable about their disease. Demographic factors such as gender, age, marital status and monthly income had no effect on this level of knowledge (P-value =0.103, 0.467, 0.661, 0.347 respectively) Conclusion: We found in this study, that the level of knowledge among patients toward LBP was inadequate where most patients had partial level of knowledge about their condition. Age, gender, marital status and monthly income had no effect on this level of knowledge. More investigations should be conducted using another design such as prospective design in order to indicate the exact reasons for this low level of knowledge among patients toward LBP. Key words: back pain, spinal disorders,
Barriers to Compliance of Hypertensive Patients in Abha City, Saudi Arabia
Authors: Almonawar Alhussein Ali , Alasmary Ali Saeed , Mogbel Mohammed Mabkhoot , Almojamad Hassan Mussa
Published: May 2022

Aim of Study: To measure non-compliance and to identify barriers to compliance among hypertensive patients. Patients and Methods: A total of 200 hypertensive patients attending Al-Qabel Primary Health Care (PHC) Center since at least one year were included in this study. A structured data collection interview questionnaire was used. To assess non-compliance of hypertensive patients, the Hill-Bone Non-Compliance to High Blood Pressure Therapy Scale was used. Results: Only 11% of hypertensive patients were highly compliant. The main barriers for full compliance were forgetfulness (39%) and being asymptomatic (30%). Some patients were non-compliant as a result of disliking the manner of medical service provided by the primary health care (PHC) team (16%), or they felt the need to take some rest from the daily antihypertensive medication (15.5%). Controlled blood pressure was achieved among 58% of patients. Saudis were significantly more non-compliant than non-Saudis (p<0.001). Married patients expressed significantly higher non-compliance than single patients (p=0.015). Non-compliance scores were significantly higher among smokers than non-smokers (p<0.001); and significantly higher among patients who were treated with multiple antihypertensive drugs (p=0.019). Patients with uncontrolled systolic or diastolic blood pressure had significantly higher non-compliance mean scores (p<0.001 for both). Conclusions: Non-compliance of hypertensive patients attending PHC settings in Abha is high. Main barriers against full compliance of hypertensive patients are forgetfulness, absence of symptoms, dissatisfaction with provided health care and being tired of treatment side effects. Non-compliance is significantly higher among younger, newly diagnosed, Saudi, married and smoker patients. Non-compliance is also significantly higher among hypertensive patients on multiple antihypertensive medications. Recommendations: Health education of hypertensive patients should cover information on the disease, medication, exercise, diet and follow up visits. Patients should be advised to include self-reminders to avoid missing intake of medication and follow up visits. Hypertensive patients should be advised to avoid smoking. PHC physicians should spend enough time with their hypertensive patients listening to their complaints and to meet patients’ expectations of a consultation and to avoid any unnecessary over-prescription of multiple anti-hypertensive medications. Key words: Hypertension, Barriers to compliance, Primary care, Saudi Arabia.
Risk Factors for Diabetic Ketoacidosis among Type 1 Diabetic Children Registered at “Heraa Diabetes Center” in Makkah Al-Mokarramah City, Saudi Arabia
Authors: Ballaji Waleed K. , Hadadi Hassan M.
Published: May 2022

Aim of Study: To assess risk factors associated with DKA among T1DM children registered at “Heraa Diabetes Center”, Makkah Al-Mokarramah City, Saudi Arabia. Patients and Methods: A retrospective hospital-based, case-control research design was followed and included 375 diabetic patients aged less than 15 years. The “Study Group” included 125 children who had a past history of diabetic ketoacidosis (DKA Group), while the “Control Group” comprised 250 diabetic children who did not have past history of DKA. A data collection sheet was designed by the researchers. Results: There was significantly more positive family history in the DKA group than the control group (78.4% and 68%, respectively, p=0.036). The mothers were the main person who injects the child. Differences between both study groups according to the person who injects the child was statistically significant (p=0.029). DKA occurred more than once in 59.2% of diabetic children, and in 46.4% of children with over-activity. The main presenting symptoms of DKA were polyuria, thirst and vomiting. The main causes and triggering factors were eating too many sweets (65.6%), missing blood sugar monitoring (57.6%), omitting the insulin dose (22.4%), or infection (12.8%). Children in the control group were significantly more compliant than those in the DKA group regarding daily measurement of blood sugar (82.8% and 71.2%, respectively, p=0.009), timely receiving treatment (96% and 82.4%, respectively, p<0.001), following a healthy diet (79.6% and 65.6%, respectively, p=0.003), and receiving health education (95.2% and 88%, respectively, p=0.011). Conclusions: Risk factors for DKA include positive family history of diabetes, and less educated or employed mothers, but its incidence is lower among children of parents with health-related jobs. It can be triggered by over-activity. It is caused by eating too many sweets, missing blood sugar monitoring, omitting the insulin dose, or infection. Noncompliance is associated with higher incidence of DKA. Recommendations: All parents of diabetic children should receive health education and be trained about management of diabetes, compliance to diabetes management, continuous monitoring of glucose levels, and early manifestations of DKA. Key Words: Diabetic ketoacidosis, Type 1 diabetes, Children, Risk factors, Compliance, Saudi Arabia.
Diagnostic approach to eosinophilia in children
Authors: Shasho Raghba
Published: May 2022

Hematopoiesis is the process which maintains lifelong production of haemopoietic (blood) cells from bone marrow. Blood consists of three types of cells (Erythrocyte – Leukocytes - palates), and plasma. Leukocytes are divided into 2 types of granulocytes (including neutrophils, eosinophils and basophils); and agranulocytes (including lymphocytes and monocytes). Eosinophil attack and kill parasites and cancer cells, and help with allergic responses, so their role is to protect the body from bacteria and parasites. They are found in the peripheral blood and also tissue, so they are closer to where the site of infection may occur. The eosinophil is a much-overlooked cell, more usually considered as a curious form of phagocytic leucocyte with functions similar to its more numerous cousins, the neutrophil. However, a dramatic blood and tissue eosinophilia is an important part of adaptive immunity to parasitic helminthic infections, whilst more detrimentally, the eosinophil is thought to make a major contribution to the inflammation underlying the pathogenesis of disorders such as asthma, allergic rhinitis and atopic dermatitis .[1]. Eosinophilia is a common finding in clinical practice and presented in a broad spectrum of diseases, some of them hematologic disorders and others non – hematologic (infection disease – allergic disease – medication reaction, and autoimmune disease). Key words: eosinophilia, children, diagnostic approach
Machine Learning in Otorhinolaryngology, Head and Neck Surgery and its applications in diagnosis and management: Undergraduates Perception toward New Era
Authors: Alomary Saleh Abdulmoneim , Alorainy Belal Abdullah , Albargan Naif Saleh , Alotaibi Fahad Z. , Alkholaiwi Feras
Published: May 2022

Background & aim: Machine learning (ML) is a growing field concerned with predicting novel situations from previous observations. The aim of this study was to determine medical students’ perceptions of ML in otorhinolaryngology, head, and neck surgery and its applications in diagnosis and management. Also, to assess medical students’ awareness of current challenges facing the application of ML in medical practice in the Kingdom of Saudi Arabia (KSA). Methods: A cross-sectional survey was conducted in February–May 2021 among medical students in Saudi Arabia. The participants were provided with questionnaires of the survey using electronic forms. Validation of the questionnaire was done using exploratory factor analysis and confirmatory factor analysis. There were 8 validated items on Attitude and 6 items on Knowledge. Results: A total of 538 students completed the questionnaire. The majority of the students were familiar with machine learning in general 308 (57.3%). However, only a few of the participants were familiar with machine learning applications in the field of otorhinolaryngology, head, and neck surgery 184 (34.2%). There was a significant difference between knowledge and attitude with the current year of study and GPA score, however, gender had no difference, yet there was a significant association between attitude among male and female medical students. Conclusion: Medical students in the KSA demonstrated a good knowledge of ML in general, although many were not familiar with machine learning applications in the field. Key words: Machine learning, Otorhinolaryngology, Medical student, Kingdom of Saudi Arabia
Exploring the Treatment Types and Challenges in Patients with Chronic Obstructive Pulmonary Disease: A Qualitative Study
Authors: Baba Mian Ali Kamran , Khan Shaheer Ellahi , Hasnain Fatima , Sakina Rabab , Talat Afsheen , Irfan Afifa Binte
Published: May 2022

Introduction: World Health Organisation (WHO) indicates Chronic Obstructive Pulmonary Disease (COPD) to be emerging as the third leading cause of mortality by 2030. COPD not only affects the healthcare system of a country, but also the quality of life of patients and their families. Prevalence of COPD among Pakistani adults aged 40+ was found to be 2.1%; however, the research on patient’s perspectives regarding the challenges faced in the diagnosis and management of COPD in Pakistan is still lacking. Therefore, the authors in this study aim to explore and document the barriers affecting the management of COPD by the patients and their families/care takers. Methods: It is a qualitative study conducted within the boundaries of Islamabad capital territory and district Rawalpindi, Pakistan. The data was collected through in-depth and semi-structured interviews conducted with the respondents who included patients of COPD (n=8) as well as their treatment supporter(s) (n=7), recruited from the OPD wards of three hospitals (two public and one private hospital). Conclusion: The study shows that COPD patients not only face challenges in their physical health, but also in socio-economic and psychological domains that are equally harmful. It highlights varying notions of the respondents as to how treatment-seeking of COPD posed challenges in their lifestyles, at both, household and individual levels. Patients with COPD need high levels of input from healthcare facilities; hence, health care professionals should be trained in case management of COPD. Key words: Non-communicable diseases, chronic diseases, chronic obstructive pulmonary disease, patient’s perspective
Prevalence and associated factors of burnout among nurses in a general hospital in Yanbu, Saudi Arabia
Authors: Alhafithi Maher , Al-Dubai Sami A , Alalwan Saleh S , Masarit Ahmad M
Published: May 2022

Background: Burnout is a prevalent psychological state among nurses. Burnout syndrome consists of emotional exhaustion, depersonalization, and reduced personal accomplishment, which results from prolonged stress in the workplace. Aim: This study aimed at assessing the prevalence and associated factors of burnout among nurses in Yanbu General Hospital, Saudi Arabia. Materials and Methods: A cross-sectional study was conducted among 249 nurses at Yanbu General Hospital, Saudi Arabia. The validated Maslach Burnout Inventory Human Services Survey for Medical Personnel was used to measure burnout. Sources of stress were assessed by 17 items. Data obtained were analyzed using the Statistical Package for the Social Sciences, version. 20. Students’ t-test, correlation and analysis of variance were used to assess the relationship between variables. Results: High burnout was found among 168 (67.5%) participants. The EE score was significantly higher among Saudis, (p=0.004), among those who worked >40 hours per week (p<0.001) and among those who had more than 8 shifts per week (p=0.001). The depersonalization (DP) score was significantly higher among Saudis (p=0.014), and among those who worked >40 hours per week (p<0.001). The personal accomplishment (PA) score was higher among those who had higher monthly income (p=0.038). Sources of stress were associated with the three scales of burnout. Conclusion: Burnout was highly prevalent among nurses in this study and was associated significantly with work related factors and sources of stress in the workplace. Working conditions should be improved to minimize the impact and consequences of burnout among nurses. Key words: Burnout, Mental Health, Nurses, Saudi Arabia, Source of Stress, Yanbu
Stress and a sedentary lifestyle are associated with irritable bowel syndrome in medical students from Saudi Arabia
Authors: Fadl Amna Fadl Bashir , Al-Towerqi Asrar Mohammed , Alharbi Arwa Abdullah , kabrah Danah kamal , Almalki Amwaj Abdulmohsen , Algethami Bashayer Nawar , Albogami Amal Mohammed
Published: May 2022

Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal condition presented by abdominal discomfort due to unknown cause. The prevalence of IBS in the world extends between 5.7% to 34%, with different ranges based on the tools used for diagnosis. Evidence has indicated genetic predisposition and psychosocial stress as risk factors. This study aims to assess the prevalence of IBS with its subtypes in undergraduate medical students using Rome III criteria. We also investigated the association of IBS and emotional disorders including stress among undergraduate medical students in Saudi Arabia. Methods: This cross-sectional study was conducted in January and February 2021 among undergraduate medical students in Saudi Arabia. Volunteer participants answered the questions relating to demographics and surveys containing the Rome III criteria and the Self-reported Stress questionnaire. Results: A total of 300 participants were recruited of whom 63.7% were females. The majority of the participants were aged more than 22 years (72.7%). IBS prevalence in undergraduate medical students was 49.3% in Saudi Arabia which was higher than the global prevalence of IBS. There are many associated factors with IBS including female gender, higher academic year, sleeping less than 6 hours and less exercise practicing. Conclusion: Higher prevalence of IBS was detected in undergraduate medical students in Saudi Arabia than worldwide prevalence. Female gender, higher academic grades, less exercise practicing and sleep disturbance were predictors for IBS. More screening and management of stress causes are needed to decrease medical field stressors. Key words: Irritable bowel syndrome, medical students, stress, sedentary lifestyle
Physicians’ Perceptions and Attitudes toward Use of Electronic Medical Record Systems in Riyadh
Authors: AlOtaib Yasser H. , AlSaedi Moteb M.
Published: May 2022

Aim: This study explores the perceptions of physicians and their attitudes toward the implementation of the electronic medical record (EMR) in general hospitals in Riyadh to identify the perceived difficulties, burdens, and usefulness of implementing electronic medical records. It also aims to identify key demographic factors and training determinant predictors that may help explain physicians’ perceptions of EMRs. Methods: This cross-sectional survey was conducted in three general hospitals in Riyadh using a self-administered questionnaire. A pilot study was conducted to test the questionnaire’s reliability, and random cluster sampling was used to build the sample. Responses were rated using a Likert-type scale. Results: A total of 160 physicians filled out the questionnaire. The majority of physicians (91.3%) stated that they had heard of the EMR. Physicians rated their agreement on the usefulness of implementing the EMR positively (mean score, 3.8/5). Similar, most physicians generally agreed that the EMR could enhance their productivity (mean score, 3.6/5), prevent documentation error (mean score, 3.8/5), improve the quality of services (mean score, 3.8/5), improve the ease of finding patient records (mean score, 4.1/5), improve communication (mean score, 3.8/5), and save their patients’ time (mean score, 3.5/5). However, physicians perceived lack of technical support and reliability of the information from other hospitals as potential burdens. Pearson’s correlation test showed that greater belief in the effectiveness of the EMR was significantly associated with greater belief in its usefulness (r = 0.81, p<0.01). Likewise, greater physician perception of expected technical support was significantly associated with greater physician perception of effectiveness (r = 0.61, p<0.01). Conclusion: There is a necessity for formal educational programs to improve physicians’ overall attitude toward the EMR. Key words: Electronic medical record, Medical records, Riyadh City, Saudi Arabia
Job Related Burnout among Emergency Physicians and Nurses in Dammam City, Saudi Arabia
Authors: Alshahrani Abdulaziz F. , Alhotheyfa Abdullah M. , Alkhiraisy Salman Z. , Abugad Hassan A. , Alshahrani Bander F.
Published: May 2022

Background: Burnout has been related with physical assault especially among health care experts and unit staff who are more in danger of encountering distressing occasions. Objectives: To assess prevalence of burnout among Emergency Department (ED) staff in Dammam City, Saudi Arabia, and to assess the potential associated factors. Methods: A cross-sectional study was conducted in EDs in 3 public hospitals in Dammam during the period from April to July 2019. Results: Most participants suffered from high level burnout for depersonalization and low personal achievement. Burnout was found among 76% of them. Male gender, being married or divorced, poor relationships with colleagues, suffering from psychiatric disorders and having less rest days were significantly associated with higher levels of burnout among the study subjects. Conclusions: Most physicians and nurses working at emergency hospitals in Dammam City, Saudi Arabia, had burnout disorder, especially high compassion fatigue and low personal achievement. Key words: Burnout, Emergency rooms, Physicians, Nurses, work execution, conflict
Insulin Resistance Related to Metabolic Syndrome
Authors: AlShamery Hanan Taha , Sait Neelufur Sulaiman
Published: May 2022

Insulin resistance and metabolic syndrome are one of the major factors associated with higher risks of developing cardiovascular diseases and Type II Diabetes (T2D). Insulin resistance is believed to be one of the underlying causes of the development of T2D. There are numerous environmental and genetic factors influencing the development of these conditions, and while there have been many studies conducted on the topic, there are still many gaps in the scholarly literature on the topic. The interplay between genetic and environmental factors is quite complex, considering that there are many genes involved in the regulation of energy consumption as well as in the protective functions of an organism. Currently, the prevalence of insulin resistance among different populations ranges from 20% to 40%. Still, while the studies conducted before 2016 have found 88 loci associated with the development of T2D most of them are associated with secretion of insulin and function of -cell, and far fewer studies have identified loci associated with insulin resistance. This means that the vast majority of studies are either focused on the insulin response pathway or on the immune response to inflammatory processes caused by metabolic disorders. It can be concluded that biological and genetic mechanisms underlying the development of insulin resistance in metabolic syndrome are complex. For now, it is known that insulin resistance in metabolic syndrome develops due to malfunctioning insulin response pathway, or malfunctioning chronic inflammation response system, and other problems associated with energy and fatty acid metabolism. Considering that the rates of obesity and T2D indeveloping countries are alarming, it is highly important to develop effective evidence-based interventions targeting this problem. Key words; Insulin resistance, genetic factors, Metabolic Syndrome, environmental factors, fatty acid metabolism.
Fake Covid vaccine found in Iran – and beyond?
Authors: Pocock Lesley
Published: May 2022

We are bringing this matter to our readers and regional doctors attention as sadly there is always someone prepared to prey on others misfortune. The original article is on the WHO website and they provide detail on how to identify fake vaccines and those vials that have been tampered with. It was Astra Zeneca fake vaccine discovered in the original report. https://www.who.int/news/item/04-11-2021-medical-product-alert-n-7-2021-falsified-covid-19-vaccine-astrazeneca It is not clear if fake vaccine is still circulating or has been fully removed from circulation but all patients, doctors, health systems and governments should remain vigilant. We stress that all vaccine should be acquired from a reliable and long trusted source. There are implications on various levels, i.e. a systemic flaw where not all vaccines in the system can be trusted and from the population health viewpoint where not all people will necessarily have the immunity they assumed they had. We also need to be aware that whatever was injected was also not necessarily harmless. Ideally the Iranian government should pay for re-vaccination as it is the national system that was flawed and ordinary Iranian people can ill afford the cost of vaccination. We have also found that immunity decreases after vaccination and after infection with COVID-19, and with new variants arising in the community, free (re)vaccination of all citizens will cover any shortfalls caused by fake vaccines and will be a positive population health approach on many levels. It has also been suggested that there may be further corruption within the system whereby casting doubt on A-Z, which is a reputable vaccine, allows some other vaccine vendors to push their own brand and after this reported subterfug,e can providers of competing vaccines/sources all be trusted? It is a systemic failure that a fake vaccine could be introduced in the first place and proper precautions need to be taken to prevent fake vaccines entering the system in all countries. POSTSCRIPT WAR: Once again we have innocent people being slaughtered by the armies of, let us be frank, evil and insane men. The dangerously mentally ill rule most of the planet. How on earth does this happen? How on earth does it still happen in 2022? Family medicine deals with the physical, mental and psychological health of all people and as Publisher of World Family Medicine Journal I feel obliged to speak up about the endless slaughter, the endlessly brutalisation, and the endless dispossession. Today it is Ukraine, yesterday it was Myanmar and who knows who it will be tomorrow. It must stop now and we have to find a way to make it stop forever as it is the biggest family medicine issue on the planet and always has been.
Surgical treatment and Survival of Gallbladder Cancer Patients: A Systematic Review
Authors: Alshehri Ali Ibrahim A.
Published: May 2022

Objective: To assess the outcome and overall survival of surgery for gallbladder cancer. Methods: A systematic literature search was performed in PubMed. The review question was structured in PICO format. Then, the search was conducted according to a certain research strategy and certain limitations. The titles and abstracts of all retrieved citations were assessed by two medical consultants, who decided which articles to read in full text. The selected full text articles were independently screened by the researcher and the two colleagues. In a consensus meeting, it was determined which articles fulfilled the pre-defined inclusion criteria and eligibility. Results: A total of four citations were identified as fulfilling the predetermined eligibility criteria (two prospective cohort studies and two retrospective studies), while 630 studies which did not fulfill the inclusion criteria were excluded. Conclusions: Optimal treatment of gallbladder cancer is still evolving. Radical surgery in combination with standardized lymph node dissection constitutes the cornerstone of the surgical treatment. Patients’ overall survival depends upon their tumor stage, levels of CA199, and tumor location in gallbladder. Key Words: Gallbladder cancer, Surgery, Survival, Systematic Review.
Acute chest syndrome and pulmonary hypertension in sickle cell diseases
Authors: Helvaci Mehmet Rami , Altintas Engin , Yalcin Atilla , Muftuoglu Orhan Ekrem , Abyad Abdulrazak , Pocock Lesley
Published: May 2022

Background: Sickle cell diseases (SCD) are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of hardened red blood cells (RBC) into tissues. Methods: All patients with the SCD were included. Results: The study included 222 males and 212 females with similar mean ages (30.8 versus 30.3 years, p>0.05, respectively). Smoking (23.8% versus 6.1%, p<0.001), alcohol (4.9% versus 0.4%, p<0.001), disseminated teeth losses (5.4% versus 1.4%, p<0.001), ileus (7.2% versus 1.4%, p<0.001), cirrhosis (8.1% versus 1.8%, p<0.001), leg ulcers (19.8% versus 7.0%, p<0.001), digital clubbing (14.8% versus 6.6%, p<0.001), coronary heart disease (CHD) (18.0% versus 13.2%, p<0.05), chronic renal disease (CRD) (9.9% versus 6.1%, p<0.05), chronic obstructive pulmonary disease (COPD) (25.2% versus 7.0%, p<0.001), and stroke (12.1% versus 7.5%, p<0.05) were higher in males but not acute chest syndrome (ACS) (2.7% versus 3.7%), pulmonary hypertension (PHT) (12.6% versus 11.7), and deep venous thrombosis and/or varices and/or telangiectasias (9.0% versus 6.6%), significantly (p>0.05 for all). Mean ages of ACS and PHT were 30.3 and 34.0 years (p<0.05), respectively. Conclusion: Although smoking, alcohol, disseminated teeth losses, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, COPD, and stroke-like atherosclerotic events were higher in males, and the male sex alone is a risk factor for atherosclerosis, ACS and PHT were similar in both genders, and mean age of PHT is much higher than ACS, significantly. In other words, PHT may have a hardened RBC-induced chronic, whereas ACS an acute thromboembolic background, in the SCD. Key words: Sickle cell diseases, acute chest syndrome, pulmonary hypertension, thromboembolism, chronic endothelial damage, atherosclerosis, metabolic syndrome
Multiple myeloma presenting as a pathological rib fracture in a primary health care center and its diagnostic challenges during the COVID 19 pandemic
Authors: Mathew Koshy , Mohideen Fathima Shezoon , Honest Prince Christopher Rajkumar
Published: May 2022

Multiple Myeloma commonly presents with a myriad of symptoms, signs and abnormal laboratory findings namely bone pains, pathological fractures, lytic bone lesions, anaemia, high ESR, hypercalcemia, raised globulin and presence of monoclonal band in serum/urine. Here, we present a 54-year-old gentleman whose initial presentation was a pathological rib fracture. However, review of his past medical history revealed gout (now asymptomatic) and abnormal laboratory findings that helped us to subsequently diagnose as Multiple Myeloma. The importance of simple investigations like ESR when managing patients with nonspecific symptoms in primary care, listening and looking for signals that suggest an alarming aetiology, following up of investigations and the continuity of care assured by the electronic medical record is highlighted by this case report. Keywords: Multiple myeloma, pathological rib fracture, telemedicine, early diagnosis, primary care
Evaluation and assessment of male infertility in Primary care; A review
Authors: Mohamad Russal Waseem , Alobaidi Ban , Jabbar Sinan
Published: May 2022

Infertility is a common condition seen in primary care practices. The World Health Organization estimates that 9% of couples worldwide struggle with fertility issues and that the male factor contributes to 20-30% of all infertility cases. The diagnosis of infertility in men is primarily based on semen analysis. The main parameters of semen include concentration, appearance, and motility of sperm. Recently, the demand for infertility services has increased, and infertile couples are seen frequently by primary care physicians. A flexible, patient-centred approach is indicated. This article outlines the Family Physician`s evaluation of male infertility and indications for referral to a male infertility specialist. Key words: Male infertility, primary care, spermatogenesis, azoospermia.
Women’s Expectations and Satisfaction with the Quality of Antenatal Care at the Primary Health Care Centers in Unaizah City
Authors: Alrobiaee Sadeem , Jahan Saulat
Published: May 2022

Background: Antenatal care (ANC) is an aspect of preventive medicine that aims to promote maternal and fetal health. The quality of ANC has a great impact on the pregnancy experience and outcome. Aim: The aim of this study is to assess women’s expectations and satisfaction with the quality of ANC provided at primary health care centers (PHCCs) in Unaizah city, Qassim region, Saudi Arabia. Methods: A cross-sectional survey was conducted among women seeking ANC at PHCCs in Unaizah city, during 2021. Two-stage cluster sampling method was used for selection of participants from 5 randomly selected PHCCs. Data were collected by self-administered questionnaire and SPSS software was used for analyzing data. Results: A total of 204 women participated in the survey; 54.5% were 30 years or less in age and 50.5% had university or higher degree. The majority of women were satisfied regarding overall information received (n=189, 92.7%), care received from physicians (n=201, 98.5%) and general quality of the health care provided (n=189, 92.7%). However, 22.5% of the participants were dissatisfied with waiting time at the clinic and 32.3% either did not receive any instructions or thought that the instructions were insufficient regarding danger signs and seeking emergency care during pregnancy. Out of a total 15 score for adequacy of information, the mean score for 31-50 years women was 12.37±3.24 while it was10.63±4.02 for 18-30 years age group (p=0.001). The pregnancy number (p=0.015) and the number of children (p=0.001) were also statistically significantly associated with perceived adequacy of information received during ANC visit. Conclusions: The overall satisfaction with the quality of ANC was high. However, a few aspects of services need improvement including waiting time and the instructions about danger signs and seeking emergency care. Regular satisfaction surveys should be carried out to identify problem areas and to improve the quality of services. Key words: antenatal care, expectations, satisfaction, primary health care centers, Unaizah, Saudi Arabia
Precarização do trabalho na extensão terceirizada: uma análise das chamadas públicas de Assistência Técnica e Extensão Rural (ATER) no estado de São Paulo - Brasil
Authors: Thomson Carolina Rios , Borsatto Ricardo Serra , Bergamasco Sonia Maria Pessoa Pereira
Published: May 2022

A partir de 2003, com a implementação da Política Nacional de Assistência Técnica e Extensão Rural (Pnater), efetiva-se no Brasil um novo formato de governança para a prestação de serviços públicos de Assistência Técnica e Extensão Rural (Ater) que agrega agentes públicos e privados. Dentro desse novo formato, o financiamento, coordenação e regulação do sistema de Ater fica a cargo do Estado, enquanto a execução dos serviços é responsabilidade tanto de instituições públicas como de entidades privadas terceirizadas. A pesquisa ora apresentada explorou as condições laborais de extensionistas contratados por agentes privados executores da Pnater, partindo da hipótese de que o modelo de governança instituído precariza as condições do trabalho extensionista. Para tanto, foram realizadas entrevistas semiestruturadas com extensionistas de campo que atuaram dentro deste modelo no estado de São Paulo. Nossos resultados apontam para uma situação mais complexa do que havíamos imaginado a princípio, porém indicam que o denominado Pluralismo Institucional contribui para que a precariedade se torne condição imperativa nas condições laborais dos profissionais de Ater contratados por agentes privados.