bluuebunny/crossref_metadata_2025 huggingface dataset:
Penanggulangan Human Trafficking Di Indonesia
Authors: Syugiarto Syugiarto
Published: June 2022

This study aims to determine the causes of human trafficking by using the hierarchical analysis scheme proposed by Dunn (2003 & 2018) and to find solutions to these problems by mapping the actors involved in the process of formulating policies for overcoming human trafficking. This research itself uses a type of qualitative research with a literature study method.

The results of the study indicate that the causes of human trafficking are economic factors, education of victims of human trafficking and the government. Economic factors are the reason for people to become TKI / TKW abroad, but there are some distribution agents who are not responsible so that the level of human trafficking is getting higher. The low level of education and lack of public knowledge related to human trafficking are the main causes that cause human trafficking in Indonesia to reach 582 people in 2019. The weak implementation of Law Number 21 of 2007 carried out by the government is one of the factors for the high level of human trafficking. in Indonesia. In addition, it is also known that the process of formulating policies to combat Human Trafficking in Indonesia involves several actors, including: Ministry of Women's Empowerment and Child Protection, Legislators / Politicians, Ministry of Education and Culture, Academics, TNI / POLRI, Mass Media, Manpower Distribution Agencies Overseas, NGOs / NGOs and the community as parties who have a high probability of becoming victims of human trafficking.
¿Puede justificar la dirección de tesis doctorales el régimen jurídico de contratación y la remuneración salarial del profesorado universitario?
Authors: Rojo Torrecilla Eduardo
Published: June 2022

La sentencia analiza el impacto de la dirección de tesis doctorales sobre la modalidad de contratación laboral del profesorado, y también sobre la remuneración salarial percibida por su actividad. Concluye, de acuerdo a la consolidada jurisprudencia del Tribunal de Justicia de la Unión Europea, que la normativa comunitaria se opondrá a la nacional aplicada siempre y cuando estemos en presencia de trabajadores fijos que puedan compararse con los temporales, y siempre que no haya una justificación objetiva para la diferencia de trato.

The ruling analyses the impact of the direction of PhD thesis on the mode of employment of professors, and also on the salary received for their activity. It concludes, in accordance with the consolidated case-law of the Court of Justice of the European Union, that Community rules will be opposed to the national rules applied, provided that there are permanent workers who can be compared with temporary workers, and provided that there is no objective justification for the difference in treatment.
Los límites a la reiterada cesión a través de ETT.
Authors: Sempere Navarro Antonio V.
Published: June 2022

Las ambigüedades de la Directiva 2008/14 sobre ETTs explican que esta sentencia deba clarificar aspectos tan relevantes como los referidos al tipo de trabajo que es posible contratar o las garantías formales en favor del trabajador. La evitación de abusos en la materia constituye un mandato legal, pero su concreción queda en manos de la interpretación del caso.

The ambiguities of Directive 2008/14 on temporary employment agencies explain that this ruling must clarify aspects as relevant as those referring to the type of work that can be hired or the formal guarantees in favor of the worker. The avoidance of abuses in the matter constitutes a legal mandate, but its implementation is left to the interpretation of the case.
Acerca de la calificación del despido que vulnera la pretendida "prohibición de despedir
Authors: Viqueira Pérez Carmen
Published: June 2022

La sentencia aborda la debatida cuestión de la calificación que haya de merecer el despido sin causa acaecido durante el Estado de Alarma y vigente la mediáticamente denominada "prohibición de despedir" contenida en el art. 2 RDL 9/2020, cuyo alcance, como se sabe, es un semillero de cuestiones dudosas que han sido objeto de encontradas interpretaciones.

The sentence addresses the debated question of the qualification that the dismissal without cause occurred during the State of Alarm and the media called "prohibition to dismiss" contained in art. 2 RDL 9/2020, which scope, as known, is a hotbed of dubious questions that have been the subject of conflicting interpretations.
Deteksi Dini Masalah Emosi dan Perilaku pada Usia 11 – 18 Tahun di SMK YPPP Wonomulyo
Authors: Susanti Rezky , Akbar K. Fredy
Published: June 2022

Adolescents are individuals aged 11-12 years to 20-21 years. Adolescence is a period of transition where there are many changes in the individual, both physical, and psychological changes. Adolescents who are identical with high curiosity greatly affect their every behavior in everyday life because not everything they want to know is good, sometimes there are some teenagers who fall into negative things due to wrong steps. Especially when viewed from the emotional aspect of teenagers who are still unstable and cannot control themselves well. On the other hand, adolescents are also faced with the challenges of puberty, changes in social and environmental roles in order to achieve independence. These challenges have the potential to cause emotional and behavioral problems for adolescents. These emotional and behavioral problems are very common among teenagers, therefore it is necessary to detect them so that they can be prevented as early as possible. This study aims to identify emotional and behavioral problems at the age of 11-18 years at YPPP Wonomulyo Vocational High School. Research method is a type of quantitative research with data collection techniques were carried out using a strength and weakness questionnaire (SDQ) which will assess emotional and behavioral problems in adolescents. Sampling using total sampling technique and the results obtained by research with 550 respondents, the adolescent emotional and behavioral problems have a normal percentage more than the threshold/borderline percentage and abnormal percentage. So it can be concluded that the level of emotion and behavior of adolescents in YPPP Wonomulyo Vocational High School with normal emotional symptoms is 328 (60%), threshold/borderline 80 (14%), abnormal is 142 (26%) and normal behavior problems are 432 (78%), threshold 75(14%), abnormal 43(8%).
Peran Perawat Sebagai Fasilitator dalam Peningkatan Ekonomi Lansia
Authors: Alif Nurhasbi , Darmiati Darmiati
Published: June 2022

An elderly person is someone whose age undergoes biological, physical, psychological and social changes, these changes will have an influence on all aspects of life including their health. The aging process is a life cycle marked by a decrease in the function of various organs in the body which is characterized by the body's vulnerability to various diseases. One of the diseases that are often experienced by the elderly is hypertension. Therefore, the health of the elderly needs special attention, one of which is providing motivation to live by providing activities in the form of economic improvement in the form of small and medium enterprises. Nurses have an idea in realizing elderly activities in helping to optimize health and economic status, especially aimed at underprivileged elderly families and in this case nurses as facilitators introduce various products to facilitate appropriate places, introduce their products online so that the increase in business results for the elderly is seen. of the difference in sales before and after increased to 40 percent.
Effect of Salt and Inhibitoron the Isolation, Purification and Characterization of α -Amylase from Aspergillusniger Produced from Pigeon Pea
Authors: O. R Adegbanke
Published: June 2022

α-Amylase an industrially used enzyme can be obtained from Aspergillusniger and can be produced from food sources such as pigeon pea. α-Amylase was produced from Aspergillusniger isolated from pigeon pea, purified and characterized. This process was achieved using ammonium sulphate, ion exchange DEAE column and gel filtration (Sephadex A-50 and sephadex G-100) chromatography. The effect of salt and inhibitor was determinedAmmonium sulphate precipitation results showed that the highest specific α-amylase activity was (1.01 U/ml. mg) obtained at 11.27% saturation level, with a purity of 1.81-fold of the crude extract and yielding 1.00%. Further purification using gel filtration increased the enzyme purity and yielding 8.94-fold relative to the crude extract 3.01% and yielding Specific activity after purification was 4.99 U/mg. The effect of salts on α-Amylase activity increased to 258.09% when in MgSO4, while decreased to 7.71% and 21.07% when in MnSO4 and CuCl2 respectively and yielded no result when in PbNO3.Its reaction with chemical inhibitors such as Bromosuccinimide was activated to 136.465% and was inhibited at Mercaptoethanol to 0%. All these were determined using a visible spectrophotometer with an absorbance of 540nm, against the control that contains 100µL of the enzyme and 100µL of 1% starch solution.Therefore α -amylase produced from Aspergillusniger can be exploited for potential usage for industrial applications of enzymes in a wide range of production and its application in food processing.
Breast feeding in refugee context: a scoping review
Authors: Vieira Guerra Dr. Juliana Vidal
Published: June 2022

Identification

Author

Year
 

Country which study was conducted

Idiom

Population of the study

A1

Jino e col.(14)

2013

Ghana

English

Refugees from Kigali and Rwanda

A2

Jessri e col.(15)

2013

Canada

English

Migrants e refugees from Middle East

A3

Denis e col.(16)

2014

Canada

English

Refugees and migrants living in Canada

A4

Gallegos e col.(17)

2015

Australia

English

Refugees from Liberia, Sierra Leone, Burundi and Democratic Republic of Congo

A5

Jessri e col.(18)

2015

Canada

English

Migrantes e Refugiadas Árabes e Iranianas

A6

Hufton e col.(19)

2016

England

English

Refugees in Liverpool and Manchester

A7

Hunter-adams e col.(20)

2016

South Africa

English

Migrants And refugees from Democratic Republic of Congo Somalia e Zimbabwe

A8

Woldeghebrie col.(21)

2017

Ghana

English

Liberian Refugees
The attachment opioid antagonist drug of Naltrexone to multi-walled carbon nanotubes by different kinds of reagents carbodiimides
Authors: Gholibeikian Mohammadreza
Published: June 2022

Surface functionalization of multi-walled carbon nanotubes(MWCNTs) by opioid antagonist drug of Naltrexone via chemical modification of carboxyl groups,using of reagents di cyclohexyl carbodiimide(DCC),1-ethyl-3[3-dimethylaminopropyl] carbodiimide hydrochloride(EDC),N-hydroxysuccinimide(NHS),1-hydroxybenzotriazolemonohydrate(HOBT),O-(Benzotriazole-1-yl)-1,1,3,3-tetramethyluraniumtetrafluoroborate(TBTU),were performed. In synthetic organic chemistry,compounds containing the carbodiimide functionality are dehydration agents and are often used to activate carboxylic acids towards amide or ester formation. Carboxylic acids will react with the carbodiimide to produce the key intermediate as O-acylisourea which can be considered as a carboxylic ester with an activated leaving group.We have used of five carbodiimide reagent to synthesis twelve sample in this work.The resulting materials were characterized by different techniques,such as Fourier transform infraredspectroscopy (FT-IR), Thermogravimetricanalysis (TGA),Raman spectroscopy,Scanning Electron Microscopy (SEM),Field Emission Scanning Electron Microscopy(FESEM),Atomic Force Microscopy(AFM),High performance liquid chromatography(HPLC).
The covalent attachment of Naltrexone to multi-walled carbon nanotubes byoxalyl chloride agent
Authors: Gholibeikian Mohammadreza
Published: June 2022

This work presents a novel cascade of chemical functionalization of multi-walled carbon nanotubes(MWCNTs) through chemical modification by an opioid antagonist drug of Naltrexone. Naltrexone-conjugated MWCNTs were synthesized involving the sequential steps of carboxylation, acylation,and finally,Naltrexoneconjugation.The active acyl chlorides in MWCNTs were subsequently mixed with opioid antagonist drug of Naltrexone.The modification of MWCNTs with Naltrexone was investigated by Fourier transform-infrared spectroscopy,Raman spectroscopy,Thermo Gravimetric Analysis,Elemental Analysis,High Performance Liquid Chromatography.Size and surface characteristics of chemically modified MWCNTs were monitored by Transmission Electron Microscopy,Scanning Electron Microscopy,Field Emission Scanning Electron Microscopy,Atomic Force Microscopy.
Isolation, charectirisation chemical and bilogical properties of polybrominated diphenyl ethers from the sponge Dysidea herbacea
Authors: Navath Suryakiran
Published: June 2022

Isolation, charectirisation of polybrominated diphenyl ethers from the sponge Dysidea herbacea is described. The sponge Dysidea herbacea was collected from the Mandapam Coast, Tamilnadu, India. Isolated gram quantities of hydroxylated polybrominated diphenyl ether (HO-PBDE) and semi-synthesized a series of new PBDEs derivatives and tested them for antibacterial and cytotoxic activities.
Assessment of Effects of Motivation on Production Operatives in The Nigerian Construction Industry
Authors: K.B Fagbemi
Published: June 2022

This study investigates the effect of motivation on operatives’ productivity in the Nigerian construction sector. The purposes of this study are to inform the management of contracting firms in Nigeria construction industry about the critical motivational factors that affects operatives’ productivity. The study was conducted by administering questionnaires to people of allied professionals in the Nigerian construction industry. To satisfy the aim of this study, 70 respondents were administered questionnaire, which were analyzed using ranking and percentile. The results showed there were 24 factors which motivate operatives towards improved productivity in the construction industry of Nigeria. The study also found that intrinsic factors have a stronger effect than extrinsic factors in motivating operatives. The study concludes that work itself is the most critical factor that motivates operatives towards improved productivity and recommends that operatives be encouraged by motivation, to make sure that they identify with the organization.
Will Catalysts Save Our Environment?
Authors: Navath Suryakiran
Published: June 2022

If you own a car, then at some point in your life, you’ll end up having to go to the mechanic to address any emergent car troubles. You may experience engine troubles, slower acceleration, or smoke coming out of your car’s exhaust, only to find out that you have a “bad cat.” What do these cute little furballs have to do with cars?
Выборы строгого режима: Как российские выборы стали невыборами, и что с этим делать? Политико-правовое исследование с элементами математики
Authors:   Free University Moscow, Лукьянова Елена , Порошин Евгений ,   Free University Moscow, Арутюнов Андроник , Шпилькин Сергей , Зворыкина Екатерина
Published: June 2022

Эта книга о роли и значении выборов в демократическом и в антидемократическом процессах. В ней на примере трансформации российского избирательного законодательства двух первых десятилетий XXI века показано, как с помощью манипуляции избирательной системой и электоральными практиками можно нивелировать демократические институты и сменить вектор политического развития на противоположный. Авторы приводят классификацию поправок в избирательное законодательство, которая может быть использована другими странами как маркер при оценке трансформации политических режимов. В книге также проводится анализ зависимости эффективности деятельности парламентов от состояния избирательной системы.
EVALUATING THE USAGE OF DIFFERENT TYPES OF SEARCH ENGINES IN SELECTED COUNTRIES
Authors: Khan N Zafar Ali , Sunil T.Venkata Siva , Kumara T.Charan Ajay
Published: June 2022

A search engine is known as software that is accessed on the internet which aids in searching a database of information accor ding to the users query. The engine provides a list of results that best match what the user is trying to find. Today various types of search engines are available on the internet each with its own abilities and features. Search engines became an important day to day tool for finding the required information without knowing where exactly it is stored. Internet usage has been tremendously increased in recent days with the easy to use search engines like Google, Bing and Yahoo!. There are different types of search engines to get the information that one is looking for. The most used world -wide search engine is Google. There are a number of different international search engines and US search engines. In this study different types of search engines are analyzed. The study tries to find which search engines are mostly used and why they are preferred in particular selected countries. The study is based on collected statistics of usage of top search engines in selected countries. The study also evaluates based on which features the search engines varies and why search engines varies from country to country.
The New Era of College Students' Analysis and the Path to Explore the Issue of Labor Education Research
Authors:   College of Chemistry and Chemical Engineering, Southwest Petroleum University, zhao luomeng , Li Zhi ,   School of Civil Engineering and Geomatics, Southwest Petroleum University, Zhang Yaling ,   College of Chemistry and Chemical Engineering, Southwest Petroleum University, Jiang Shangli ,   College of Chemistry and Chemical Engineering, Southwest Petroleum University, Wu Daqing ,   College of Chemistry and Chemical Engineering, Southwest Petroleum University
Published: June 2022

Based on the time background and the situation of labor education of college students in the new era, we use the thought of socialism with Chinese characteristics in the new era as the theoretical guidance, combined with the practice of deep exploring students' labor education new connotation, to rich the theory of labor education for college students and to improve the effect of college students' labor education. Further study on the labor education of college students in the new era is helpful better to grasp the law of the growth of college students and better realize the fundamental task of moral cultivation.
Saint-Saens Violin: Concerto No. 3
Authors: Wu Yaowan , Chang Yi-Li
Published: June 2022

The present study discusses the Violin Concerto No. 3, in B minor, op. 61, by Camille Saint-Saëns, focusing on the first and second movements. The purpose is to help performers in their understanding of the concerto by providing context and an analysis of the composer’s musical style. Saint-Saëns was a prolific French composer, pianist, organist, and writer with a unique understanding of music. After the Franco-Prussian War in the 1870s, a movement to revive the tradition of national music emerged. In 1871, Saint-Saëns and his friends established the Société Nationale de Musique in Paris with the aim of introducing new French classical work and promoting the revival of the nation through art. One such piece was Saint-Saens’ own Third Violin Concerto. As well as providing the historical and cultural context to his composition, the present study examines the musical structure of the work and appropriate playing styles. The study of the literature and the analysis of the genealogical examples revealed that the structure of the work is classical in style and the tone is romantic.
Lignocellulosic Biomass Waste Adsorbent for Removal of Dye from Aqueous Solution
Authors: Alhogbi Basma G.
Published: June 2022

Date Palm Tree Fiber (DPTF) is a renewable raw material which is considered a biomass waste excess of date farms and manufactures. This biomass was successfully utilized as solid phase extractor (SPE) for removal of methylene Blue dye (MB) from polluted water. The chemical composition and the surface morphology of the SPE was critically assigned based on FT-IR, and FE-SEM. In batch separation mode, the impact of several analytical parameters e.g. contact time, weight of biomass, solution pH and initial concentration on the MB dye uptake from aqueous media by DPTF solid adsorbent was critically studied. At the optimized parameters, good adsorption capacity (qe,exp =9.153 mg/g) at pH 6 was achieved. The data of MB uptake were subjected to Langmuir and Freundlich to assign the most probable retention mechanism. The adsorption fitted well with Langmuir isotherm models qm 648 mg/g. The data were fitted well with pseudo- second order model as supported from the qe,cal (9.225 mg/g) value. Excellent extraction (99%) of MB dye was achieved from the environmental water samples. The DPTF solid sorbent is a non-toxic and renewable raw material of lignocellulosic biomass has a potential to uptake MB dye from wastewater.
Penggunaan Media Perendaman dari Daun Kelor (Moringa oleifera L.) dengan Konsentrasi yang Berbeda Terhadap Daya Rekat dan Daya Tetas Ikan Lele Mutiara (Clarias gariepinus)
Authors: Yohanes Erry Angga Andwityo , Jumiati Jumiati , Rahmaningsih Sri
Published: June 2022

Tujuan penelitian ini untuk mengetahui pengaruh ekstrak daun kelor (Moringa oleifera L.) sebagai media perendaman dengan konsentrasi yang berbeda terhadap daya tetas  ikan lele mutiara (Clarias gariepinus). Parameter yang diamati yaitu daya rekat dan daya tetas telur.. Metode yang digunakan dalam penelitian ini adalah eksperimen. Rancangan Acak Lengkap (RAL) dengan 4 perlakuan dan 3 ulangan. Data dianalisis menggunakan uji F. Hasil dari penelitian menunjukkan nilai daya rekat telur pada perlakuan K (kontrol), A (15 ppt), B (20 ppt) dan C (25 ppt) yaitu Fhitung (121,83) > F5% (4,07) dan F1% (7,59) terdapat perbedaan sangat nyata (P<0,01) diantara keempat perlakuan. Nilai rata-rata daya rekat telur pada perlakuan K (kontrol) 2,13%, A (15 ppt) 2%, B (20 ppt) 1,47% dan C (25 ppt) 1%. Dosis terbaik pada perlakuan C (25 ppt). Nilai Nilai daya tetas pada perlakuan (kontrol), A (15 ppt), B (20 ppt) dan C (25 ppt) yaitu Fhitung (40,67) > F5% (4,07) dan F1% (7,59) terdapat perbedaan sangat nyata (P<0,01) diantara keempat perlakuan. Nilai rata-rata daya tetas telur pada perlakuan K (kontrol) 50%, A (15 ppt) 73,3%, B (20 ppt) 80% dan C (25 ppt) 83,3%,. Dosis terbaik pada perlakuan C (25 ppt).
Parrots Need You! The Lacey Act and USDA-APHIS
Authors: Miller Apryl
Published: June 2022

Two new sets of regulations, from different parts of the US Government, are poised to create serious problems for parrot caregivers, avian veterinarians, rescuers, and breeders. This article looks at the legal foundations of the proposed amendments to the Lacey Act, which may prevent parrot caregivers from taking their birds across state lines for medical or behavior help, and the new USDA-APHIS regulations, which will put an undue strain on avian veterinary professionals.
Everybody loves Fido! The Ethics of Including Animals in Mental Health Work
Authors: Moser Tara , Smith Jodi
Published: June 2022

Animals have been used as adjuncts in therapy since the time of Freud, and there are more and more programs that use animals to help patients communicate and heal. Animal Assisted Play Therapy is a combination of play therapy and animal assisted therapy, where play with animals is used to help children. Including an animal in your work, especially in work with children, brings a unique set of responsibilities to the animals as well as your clients. This article discusses the guiding principles of Animal Assisted Play Therapy, and the ethics involved in working with animals in this way.
Who Keeps the Dog? Divorce Advice from a Pet Custody Expert
Authors: Bryen Karis
Published: June 2022

Anyone who works with family pets is likely to end up with clients in the heartbreaking situation of getting a divorce and needing to decide who keeps the dog. This article is designed to give dog professionals insights and tools when faced with this situation so they can best assist their clients to make sound decisions that puts the wellbeing of the dogs first.
Continuing the Virtual Classroom at SPCA Monterey County
Authors: Newman Wendi , Logue Bonnie
Published: June 2022

In November 2020, the IAABC Foundation Journal published our article on switching to online dog training classes due to COVID. Here we present a follow-up article to show the progress of our program and some of our observations. The program has shifted in focus, with some elements proving highly successful and retained, and others being replaced by more traditional in-person offerings.
Case Study: Luna — Reactivity to Other Dogs Part 1
Authors: Gumas Jennifer
Published: June 2022

A case of dog-dog reactivity in an energetic older dog, is made more complicated by the client's specific situation and set of needs, and then turns into human-directed aggression as their living situation becomes more stressful. Working within Luna's adoptive caregiver's capacities requires patience and creative thinking. Recommending the client make some difficult decisions in the short-term for the sake of their health proves challenging but necessary. Part 1 of a 2-part case study.
Sex in the Psittacine
Authors: Csaky Kashmir
Published: June 2022

The dedication most parrot caregivers have to their avian companion’s wellbeing, combined with their air-conditioned, artificially-lighted indoor lifestyles, means they are in perfect shape to want to reproduce. If they’re not careful, caregivers may foster a sexual relationship with their parrot that leads to frustration on both sides. This article discusses the myriad factors that determine a parrot’s natural reproductive cycle, and explains how to make some simple changes to prevent hormone-related problematic behaviors from developing.
Case Study: Bilbo – Aggression and Escape Behaviours in a Horse
Authors: Allen Abigail
Published: June 2022

A case study of how past trauma and inadequate current environment can interact to create and maintain problematic behaviors. Bilbo, a young mare with a significant history of aggression and causing injury is sold with the advice that she be euthanized for her behavior. Six weeks later, her new owner called Certified Horse Behavior Consultant Abigail Allen for a consultation, because she is no longer able to be handled at her owner’s facility. Through providing outlets for foraging, opportunities to learn with target training, a proper diet, and the right kind of environmental enrichment, Abigail and her client were able to help Bilbo become more relaxed and significantly less aggressive.
Enrichment for Snakes (And Other Reptiles)
Authors: Torrini Lori
Published: June 2022

An enriched environment for reptiles under captive management isn’t just a tank with some extra objects in it. To really enrich the lives of our reptiles, we need to be creative and introduce some novelty into their lives. This article introduces different ways that reptiles’ lives and environments can be enriched. From using food and feeding to provide cognitive enrichment, to making simple changes to the environment to give them new ways to move and new materials to experience, and even providing opportunities for social enrichment, Lori Torrini offers practical, creative, low-cost examples of how to provide for their needs.
Influencia de la pluripatología y comorbilidad en el ingreso hospitalario en una cohorte de pacientes de una unidad de continuidad asistencial Primaria-Interna
Authors: Fernández Bosch Alba , del Campo Giménez María , Hermida Lazcano Ignacio , Rodríguez Marín Yulema , Camarena Navarro Lucía , Párraga Martínez Ignacio
Published: June 2022

Objetivo: estimar la frecuencia de pluripatología y comorbilidad en pacientes seguidos en una unidad de continuidad asistencial Primaria-Interna, así como conocer sus características clínicas y la relación entre pluripatología y comorbilidad con el ingreso hospitalario.

Diseño: estudio observacional retrospectivo de casos y controles.

Emplazamiento: Unidad de Continuidad Asistencial de Atención Primaria y Medicina Interna (UCAPI) del Complejo Hospitalario Universitario de Albacete.

Participantes: Se analizaron 1.591 pacientes atendidos en una unidad de continuidad asistencial Primaria-Interna (292 con algún ingreso hospitalario en el último año y 1.299 sin ingresos).

Mediciones principales: edad, sexo, problemas de salud, índice de Charlson, consumo de medicamentos y utilización de servicios sanitarios los 3 años previos.

Resultados: del total de la muestra, un 18,4% (IC 95%:16,4-20,3) eran casos con algún ingreso. Presentaba pluripatología un 23,3% (IC 95%: 21,1-25,4) y comorbilidad (índice de Charlson ≥ 2) un 32,6% (IC 95%: 30,2-34,9). Fueron variables asociadas de forma independiente a ingreso hospitalario la pluripatología (OR: 2,51; IC 95%: 1,64-3,83; p < 0,001), comorbilidad (índice de Charlson ≥ 2) (OR: 1,81; IC 95%:1,18-2,78; p = 0,006), tener más de tres problemas de salud (OR: 1,49; IC 95%: 1,07-2,07; p = 0,017), contar con mayor número de consultas de Atención Primaria (AP)  (OR: 1,01; IC 95%: 1,00-1,02; p = 0,005), de hospital (1,03; IC 95%: 1,01-1,05), p < 0,001) y realizar más visitas a urgencias hospitalarias (OR: 1,12, IC 95%: 1,07-1,17).

Conclusiones: casi una cuarta parte de los pacientes seguidos en una unidad de continuidad asistencial entre Medicina interna y de Familia presenta pluripatología y un tercio, comorbilidad. La presencia de pluripatología y comorbilidad son características relacionadas con el ingreso hospitalario, junto con la mayor utilización de servicios sanitarios.

Palabras clave: multimorbilidad, comorbilidad, hospitalización, utilización de servicios de salud.
Síndrome de Haglund: «¿Qué tengo en el talón?»
Authors: Ramos Díaz Celia , Sierra Santos Lucía , Chato Vázquez Marina
Published: June 2022

Se presenta un caso de un síndrome de Haglund que cursa con dolor en retropié y se manifiesta con la tríada de tendinitis aquílea, bursitis retrocalcánea y deformidad de Haglund.

Se diagnosticó clínica y radiológicamente (radiografía y ecografía) y la paciente recibió tratamiento conservador, con buena evolución.

Palabras clave: bursitis, exostosis, talón, calcáneo.
Perfil de pacientes con cronicidad avanzada y necesidades paliativas: un cambio que no llega
Authors: Barrena Urieta Iñigo , Rodríguez Rocha José , Wang Gao Yu , Rol Hoyas Carlos Manuel , Aira Ferrer Pilar , Domínguez Lorenzo Carmen
Published: June 2022

Objetivo: estudiar los posibles cambios en el perfil de pacientes con cronicidad avanzada entre dos cohortes en el momento de su inclusión en un equipo de soporte de atención paliativa domiciliaria (ESAPD) en el marco de la implementación de estrategias de cronicidad.

Método: estudio observacional retrospectivo con enfoque analítico de pacientes no oncológicos derivados a un ESAPD de la Comunidad de Madrid, divididos en dos cohortes (2014 y 2019) definidas por el momento de inclusión en programa. Las variables principales fueron: tiempo de permanencia en programa (TPP), carga sintomática (CS) y situación funcional (SF). Se recogieron variables sociodemográficas y clínicas. Se comparó globalmente y por sexo el efecto de la cohorte (bruto y ajustado) sobre las variables principales mediante LogRank y Cox para el TPP, t-Student para la CS y SF y Modelo Lineal Generalizado para la SF.

Resultados: las cohortes 2014 y 2019 constaron, respectivamente, de 98 y 116 pacientes, 63% y 52% de mujeres, 48% y 35% del ámbito rural y 43% y 27% de institucionalizados, con una media de edad y lugar de fallecimiento similares. En el TPP no se evidenciaron diferencias entre ambas cohortes (p=0,098); el análisis de Cox tampoco mostró asociación (HR = 1,01 [0,75; 1,36]). En la CS no se encontraron diferencias clínicamente relevantes. No se observaron diferencias en la SF una vez ajustada por las variables edad, sexo e institucionalización.

Conclusión: no se observaron diferencias en el perfil de pacientes con cronicidad avanzada incluidos en el programa del ESAPD entre los años 2014 y 2019 en el marco de la implementación de estrategias de cronicidad.

Palabras clave: cuidados paliativos, Atención Primaria, enfermedad crónica, diagnóstico precoz, anciano frágil.
Emancipation och evolution. Ellen Key och den villkorade kärleken
Authors: Borgström Eva
Published: June 2022

Ellen Key was one of the most influential writers on gender issues in Sweden at the turn of the century 1800/1900. She was internationally well known, and kept in touch with many distinguished European writers within this field. She introduced the concept "social mother". Ellen Key wrote about feminist issues and women's movements, but she wrote in a way that was controversial to many contemporary feminists. She criticised the institution of marriage, had a sympathetic attitude to extramarital relations and pleaded for better social and legal conditions for unmarried mothers and their children. This, and many other feminist ideas, caused criticism from the conservative parties. But she also attacked the feminist movement for trying to obtain equal opportunities by transforming women's gender roles to be more like those of men. She thought that if women were to study, work, exercise power and live like men did, their femininity would be impaired in the not so far future. She also meant that this imperfection could be handed down from one generation to another. Ellen Key mixed sex and gender in a sometimes very confusing way, which was rather typical of the period. Herthinking wasas heavily influenced by eugenics and social Darwinism as it was by feminist thinking. This article aim to show in what ways, according to Key, feminism threatened femininity and in the long run human race itself. It is shown that heteronormativity and contemporary antifeminist clichés play an important role in this feared process. Another focus in the article is to analyse the paradoxes, inconsistencies and contradictions in "Missbrukad kvinnokraft" ("Misused Women's Power") 1896. It is suggested that by analysing the textual and logical ambivalences in Ellen Keys thinking we may learn more not only about the mechanisms of heteronormativity but also about the breaches against it.
A case of skullbase chondromyxoid fibroma
Authors:   Korea Skull Base Society, Lee Changhee , Hong Sang Duk
Published: June 2022

Chondromyxoid fibroma (CMF) is a rare benign cartilaginous tumor that usually arises from metaphysis of the long bone of the lower extremities. Only 1%-5% of CMF occurs in the head and neck and few cases of sinonasal CMF have been reported. Because sinonasal CMF and chondrosarcoma have common radiologic and pathologic feature, it is difficult to distinguish from chondrosarcoma. However fast and accurate diagnosis is important because mortality of chondrosarcoma is nearly 50%. This report describes one case of skullbase CMF attached to posterior septum and rostrum of sphenoid bone, mimicking chondrosarcoma in radiologic findings. We tried to share diagnostic and therapeutic process of skullbase CMF which occurred in unusual location, and elaborate differentiating points of cartilage neoplasms in the nasal cavity which have completely different prognosis.
Aktywne Rozpoznawanie POChP w Grupach Wysokiego Ryzyka w Polsce w Latach 1999–2011, Co Dalej?
Authors: Zieliński Jan
Published: June 2022

Przewlekła obturacyjna choroba płuc (POChP) jest przewlekłą, postępującą, trwającą kilkadziesiąt lat chorobą kończącą się zgonem z powodu powikłań, którymi najczęściej są: niewydolność oddychania i hipoksyjne nadciśnienie płucne (serce płucne) [...]
Pneumocystozowe Zapalenie Płuc u Chorej na Limfangioleiomiomatozę
Authors: Mydłowski Tomasz , Radzikowska Elżbieta , Oniszh Karina , Szczepulska-Wójcik Ewa , Jaguś Paulina , Wiatr Elżbieta
Published: June 2022

A 47-year-old, non-smoking woman was admitted to the National Tuberculosis and Lung Diseases Research Institute for diagnosis of progressive exertional dyspnoea and numerous small thin-walled, air-filled cysts equally distributed throughout both lungs revealed in HRCT (high resolution computed tomography) examination. Histological assessment of specimens obtained by open lung biopsy revealed proliferation of immature smooth muscle, showing the expression of the antigen HMB45. On this basis, diagnosis of lymphangioleiomyomatosis was established. The disease caused essential ventilation damage of the lungs (FEV1 1.34 L; 39.71% pred, VC 4.02 L; 94.96% pred, FEV1/ /VC 0.33–4 1.81% pred, DLCO 3.65 mmol/min/Kpa 38.35% pred).During the observation, despite the lack of immunological disorders, the patient developed Pneumocystis jiroveci pneumonia (PCP) that was treated with trimethoprimsulfamethoxazole. Lymphangioleiomyomatosis is a rare disease which results from a defect of TSC genes. The disease is not related to immunological defects or disorders. However, the considerable cystic destruction of the lungs can predispose the patient to opportunistic infections such as the one in the presented case.
Chorobliwa Otyłość Jako Przyczyna Niewydolności Oddychania
Authors: Zieliński Jan
Published: June 2022

Światowa epidemia otyłości dotarła do Polski. Otyłość może być powodem całkowitej, hiperkapnicznej niewydolności oddychania. Powikłanie to należy podejrzewać u osób chorobliwie otyłych, o BMI > 35. Rozpoznanie potwierdza się badaniem gazów krwi tętniczej wykazującym PaO₂ < 60 mm Hg i PaCO₂ > 45 mm Hg. Najczęstszą przyczyną niewydolności oddychania jest ciężka postać obturacyjnego bezdechu sennego. U około 10% chorych rozpoznaje się zespół hipowentylacji otyłych. Rozpoznanie ustala się za pomocą badania polisomnograficznego. Leczenie polega na zastosowaniu nieinwazyjnej wentylacji w nocy, stosując aparat CPAP lub BiPAP. Leczenie przyczynowe polega na redukcji masy ciała. Próby stosowania niskokalorycznej diety są nieskuteczne. Skuteczne jest dostępne w Polsce leczenie bariatryczne.
The New Recommendations of the 7th Edition of the TNM Classification for Lung Cancer in Pathologic Assessment (pTNM)
Authors: Langfort Renata
Published: June 2022

The paper entitled “Nowa klasyfikacja TNMw raku pluca” (The new TNM classification for lungcancer) by Anna Wrona and Jacek Jassem [...]
Development of Respiratory Function Investigation in Poland—Historical Review
Authors: Kowalski Janusz , Radwan Leszek
Published: June 2022

Spirometria jest uważana za podstawowe ba-danie sprawności wentylacyjnej płuc [...]
The Influence of Sensitivity to Fungal Allergens on the Development and Course of Allergic Diseases of the Respiratory Tract
Authors: Semik-Orzech Aleksandra , Barczyk Adam , Pierzchała Władysław
Published: June 2022

Several epidemiological and diagnostic studies reported increasing prevalence of allergic reactivity to fungi assessed with the use of skin testing or IgE detection. The role of sensitization to fungi in relation to the prevalence and clinical importance in atopic patients remains largely unknown. Although an allergic reaction to fungal allergens is suggested as an important contributing factor in the development of respiratory symptoms, other mechanisms, such as increased exposure to fungal metabolites, mycotoxins and other compounds of immuno-supressant or irritant properties, may also be important. Sensitivity to fungal allergens has been recognized as a risk factor for the development and persistence of asthma, asthma severity and potentially fatal asthma exacerbations, the increased number of episodes of respiratory arrest and admissions to intensive care unit. Thus far, the role of fungi as the dominant exogenous trigger of asthma has not been completely explored. Some authors suggest, that sensitization to fungal allergens is related with specific phenotype of severe asthma. It remains to be clarified, whether this association is caused by colonization of the airways with fungi or an extreme response to exogenous spores.This review critically discusses the present state of knowledge on the prevalence of IgE-mediated allergy to fungi, as well as the contribution of sensitization to fungi to the allergic manifestations, on the basis of the recent literature. We also try to assess the importance of these connections for the future treatment of allergic disorders of the respiratory tract.
Stan Emocjonalny, Funkcje Poznawcze i Jakość życia u Chorych na OBPS
Authors: Farnik Małgorzata , Pierzchała Władysław
Published: June 2022

Zaburzenia struktury snu spowodowane powtarzającymi się bezdechami u chorych na OBPS prowadzą do utrudnienia jego codziennego funkcjonowania [...]
POChP, rak płuca—Wspólna molekularna ścieżka?
Authors: Jassem Ewa
Published: June 2022

U 30–40% chorych na raka płuca stwierdza się przewlekłą obturacyjną chorobę płuc (POChP) [...]
Wiara czyni cuda—Środkowo-Wschodnioeuropejska Sieć Alfa-1 Antytrypsyny
Authors: Chorostowska-Wynimko Joanna
Published: June 2022

Wrodzony niedobór alfa-1 antytrypsyny (AAT) zaliczany jest, obok mukowiscydozy i zespołu Downa, do trzech najczęstszych zaburzeń genetycznych występujących w populacji rasy kaukaskiej [...]
Związek Pomiędzy Obturacyjnym Bezdechem Sennym a Zespołem Metabolicznym
Authors: Januszewicz Andrzej , Prejbisz Aleksander , Florczak Elżbieta
Published: June 2022

Na przestrzeni ostatniej dekady przedmiotem rosnącego zainteresowania i badań klinicznych pozostaje związek pomiędzy obturacyjnym bez-dechem sennym (OBS) a zespołem metabolicz-nym (ZM) [...]
Diagnostic Potential of Contrast-Enhanced Ultrasound (CEUS) In the Assessment of Spleen and Liver Granulomas in the Course of Sarcoidosis
Authors: Grzelak Piotr , Augsburg Łukasz , Majos Agata , Stefańczyk Ludomir , Górski Paweł , Piotrowski Wojciech , Antczak Adam
Published: June 2022

Introduction: The aim of this study was to analyze the diagnostic potential of contrast enhanced ultrasound (CEUS) for the recognition of focal lesions of the spleen and liver in patients suffering from sarcoidosis. Material and methods: We analyzed the outcome of diagnostic imaging in a group of 21 patients treated for pulmonary sarcoidosis, searching for the systemic infiltration of the liver and/or spleen. All the participants are patients with inactive disease, who are monitored every 6 months at the Pulmonology Clinic. Apart from the check-up high-resolution computed tomography (HR-CT)—every 2 years, patients underwent an initial ultrasound examination (US) and if there was a suspicion of systemic infiltration, abdominal CT and/or magnetic resonance imaging (MRI) and CEUS were performed. Results: In 18 patients suffering from pulmonary sarcoidosis diagnostic imaging revealed no systemic infiltration. In three patients, the use of CEUS exposed the presence of lesions in the parenchymal organs. In all cases, the images from CEUS were consistent with those from CT/MRI. Conclusions: CEUS has the potential to become a reliable and safe screening tool for systemic infiltration in patients with sarcoidosis. It may also be an important method of monitoring the effects of therapy.
Lipoid Pneumonia—A Case of Refractory Pneumonia in a Child Treated with Ketogenic Diet
Authors: Buda Piotr , Wieteska-Klimczak Anna , Własienko Anna , Mazur Agnieszka , Ziołkowski Jerzy , Jaworska Joanna , Kościesza Andrzej , Dunin-Wąsowicz Dorota , Książyk Janusz
Published: June 2022

Lipoid pneumonia (LP) is a chronic inflammation of the lung parenchyma with interstitial involvement due to the accumulation of endoge- nous or exogenous lipids. Exogenous LP (ELP) is associated with the aspiration or inhalation of oil present in food, oil-based medications or radiographic contrast media. The clinical manifestations of LP range from asymptomatic cases to severe pulmonary involvement, with respiratory failure and death, according to the quantity and duration of the aspiration. The diagnosis of exogenous lipoid pneumonia is based on a history of exposure to oil and the presence of lipid-laden macrophages on sputum or bronchoalveolar lavage (BAL) analysis. High-resolution computed tomography (HRCT) is the imaging technique of choice for evaluation of patients with suspected LP. The best therapeutic strategy is to remove the oil as early as possible through bronchoscopy with multiple BALs and interruption in the use of mineral oil. Steroid therapy remains controversial, and should be reserved for severe cases. We describe a case of LP due to oil aspiration in 3-year-old girl with intractable epilepsy on ketogenic diet. Diagnostic problems were due to non-specific symptoms that were mimicing serious infectious pneumonia. A high index of suspicion and precise medical history is required in cases of refractory pneumonia and fever unresponsive to conventional therapy. Gastroesophageal reflux and a risk of aspiration may be regarded as relative contraindications to the ketogenic diet. Conservative treatment, based on the use of oral steroids, proved to be an efficient therapeutic approach in this case.
Zmiany śródmiąższowe w Płucach u Chorych na Zapalenie Wielomięśniowe i Skórno-Mięśniowe—Prezentacja Trzech Przypadków
Authors: Bartosiewicz Małgorzata , Siemion-Szcześniak Izabela , Sobiecka Małgorzata , Wyrostkiewicz Dorota , Radwan-Röhrenschef Piotr , Lewandowska Katarzyna , Langfort Renata , Oniszh Karina , Franczuk Monika , Kuś Jan
Published: June 2022

Zapalenia wielomięśniowe (PM) i skórno-mięśniowe (DM) należą do układowych chorób tkanki łącznej charakteryzujących się osłabieniem siły mięśni proksymalnych oraz zajęciem różnych narządów wewnętrznych, w tym często płuc. Do zmian płucnych w przebiegu PM/DM należą: zapalenia naczyń z rozlanym krwawieniem pęcherzykowym oraz choroba śródmiąższowa płuc (ILD), która jest najczęstszą płucną manifestacją PM/DM, a jej występowanie znacznie pogarsza przebieg choroby i rokowanie. Patogeneza zmian śródmiąższowych w płucach nie jest dokładnie znana, wiadomo że dużą rolę w jej etiologii odgrywają mechanizmy autoimmunologiczne. Nie zaobserwowano związku między ciężkością choroby układowej tkanki łącznej a wystąpieniem zmian w płucach. Choroba śródmiąższowa płuc może się ujawnić w każdym momencie trwania choroby zapalnej mięśni, czasami wyprzedza jej objawy i rozpoznanie. Częstość wykrywania zmian śródmiąższowych w płucach zwiększa się wraz z czułością zastosowanych metod diagnostycznych — “złotym standardem” jest tomografia komputerowa płuc o wysokiej rozdzielczości. Lekiem pierwszego wyboru w leczeniu choroby śródmiąższowej płuc w przebiegu PM/DM są glikokortykosteroidy. W niniejszym artykule przedstawiono przypadki 3 mężczyzn w średnim wieku, chorych na PM/DM, z towarzyszącymi zmianami śródmiąższowymi w płucach, każdy o innym przebiegu klinicznym i obrazie zmian radiologicznych. U wszystkich chorych wykonano badania obrazowe (radiogram i tomografię komputerową klatki piersiowej) oraz czynnościowe układu oddechowego. U wszystkich pacjentów charakter zmian płucnych potwierdzono badaniem histologicznym. U dwóch chorych rozpoznano niespecyficzne śródmiąższowe zapalenie płuc, u jednego — organizujące się zapalenie płuc z odczynem sarkoidalnym w okolicznych węzłach chłonnych. Z powodu zaburzeń w badaniach czynnościowych płuc, wszyscy pacjenci leczeni byli prednizonem, u dwóch chorych dodatkowo wdrożono leczenie azatiopryną lub cyclofosfamidem z dobrym efektem.
منظومة النفس والروح في الكيان الإنساني وعلاقتها بالتزكية
Authors: Al Kahwahjı Bayan
Published: June 2022

على الرغم من كل التطور التقني والتقدم المادي الذي تعيشه البشرية، ومع تقدم الأبحاث في الطب وعلوم الإنسان، لا تزال المنظومة التي تحكم الإنسان بتصرفاته وإدراكه مجهولة إلى الآن، ولم يستطع العلم الحديث بتقنياته المتقدمة أن يضع يده على مكمن القيادة التي تتحكم بالعقل البشري وإدراكه وتصرفاته، ومن ثم التحكم بتصرفاتها وتوجيهها نحو الخير.
ولقد تباينت آراء العلماء والمفسرين والفلاسفة والمفكرين قديماً وحديثاً في تفسيرهم ونظرياتهم وافتراضاتهم للجهة التي تحكم الإنسان: أهي الروح؟ أم النفس؟ أم هي منظومة معقدة ومتراكبة؟ واختلفت تبعاً لذلك تعريفاتهم لكل من النفس والروح؛ لذلك برزت الحاجة الملحة للحديث عن التفسير المنطقي لتلك المنظومة أو الجهة التي تحكم تصرفات الإنسان من وجهة نظر علوم الدين والشريعة بما يشفي غليل ما عجزت عن تفسيره العلوم الطبيعية والتجريبية.
فقام الباحث بتسليط الضوء في هذا البحث على عدد من العناصر المهمة التي يتألف منها الكيان البشري وهي: النفس والروح والبدن، وقام بتعريفها معتمداً على المنهج الوصفي الاستقرائي لما كتبه مشاهير العلماء وكبار الفلاسفة الأقدمون والمحدثون. وكذلك قام باستنباط بعض الآراء ذات الصلة المقتبسة من نصوص الكتاب والسنة معتمداً على المنهج الاستنباطي للوصول إلى صياغة مستخلصة لتلك المنظومة الاعتبارية التي تقود الإنسان وتفسر العلاقة بين الروح والنفس وتكون مسؤولة عن سلوكه وتصرفاته وقادرة على تزكيته وتعديل سلوكه وتقويم مساره.