bluuebunny/crossref_metadata_2025 huggingface dataset:
Can Less Be More? Organ Preservation Strategies in the Management of Rectal Cancer
Authors: Rouleau-Fournier F. , Brown C.J.
Published: November 2019

Background: Total mesorectal excision (tme) is the current standard of care for the treatment of rectal cancer. However, that surgery is associated with significant morbidity and mortality. Clinicians and patients are seeking alternatives to radical resection. Currently, prevalent organ-sparing strategies under investigation include local excision and nonoperative management (nom). Methods: We reviewed the current evidence in the literature to create an overview of the use of transanal endoscopic surgery and watch-and-wait strategies in the modern management of rectal cancer. Results: Compared with radical resection, transanal endoscopic surgery in patients with early rectal cancer (cT1) having favourable histopathologic features is associated with an increased risk of local recurrence, but no difference in 5-year survival. In patients with T2 or early T3 cancer, strategies that use neoadjuvant or adjuvant therapy as adjuncts to local excision are under evaluation. Nonoperative management is a new option for patients who experience a complete clinical response after neoadjuvant chemoradiotherapy (ncrt). The selection criteria that will appropriately identify patients for whom nom will succeed are not established. Conclusions: Local excision is appropriate for early rectal cancer with favourable histopathologic features. Although organ-preserving strategies are promising, the quality of the evidence to date is insufficient to replace the current standard care in most patients. Patients should be offered nom in the safe setting of a clinical trial or registry. Rigorous follow-up, including endoscopy and imaging at frequent intervals is recommended when radical resection is forgone.
As mulheres docentes do IFPR e a questão de gênero: protagonistas ou coadjuvantes no processo formativo dos cursos técnicos?
Authors: Incerti Tânia Gracieli Vega , Carvalho Ana Maria de , Casagrande Lindamir Salete
Published: November 2019

Este artigo tem por finalidade apresentar os resultados de uma pesquisa, a qual objetivouconhecer o lócus das mulheres docentes do Instituto Federal do Paraná (IFPR) - CampusCuritiba. O corpo docente do Campus constitui-se por duzentos e vinte e cincoservidores/as, disto cento e sete são mulheres e cento e dezoito são homens. Aoanalisarmos esses números observamos inicialmente que não há uma prevalência no quese refere às relações de gênero, entretanto cabe investigar em que áreas elas e eles estãoatuando. A pesquisa foi feita a partir da coleta de dados documentais/institucionais, queao se ter em mãos os resultados, para além da disposição em gráficos, necessariamentenos leva a muitas reflexões que denotam uma análise qualitativa. Acreditamos, por fim, queos resultados desta pesquisa podem nos levar a refletir sobre a inserção da mulher naCiência e Tecnologia, visto que o espaço sócio ocupacional pesquisado é um local deeducação formal, com vistas à ciência e ao desenvolvimento de tecnologias.
Tecnologia e gênero repensando relações
Authors: Kominek Andrea Maila Voss , Vanali Ana Crhistina
Published: November 2019

A relação entre tecnologia e gênero deve ser compreendida a partir de seu contextohistórico, cultural e social, assim como qualquer outro tipo de relação. Neste sentido, nopresente trabalho será evidenciado as raízes de gênero na construção e utilização datecnologia e analisar as contradições presentes no discurso de pretensa neutralidade degênero. Busca-se apontar a necessidade de superar o paradigma cartesiano (eurocêntrico,branco e masculino) para assumir um sujeito além do teórico-universal, um sujeitocorporificado1, com especificidades e desafios particulares. A tradição cultural eurocêntricae androcêntrica presente no meio universitário e científico permeia de forma subliminar opensamento e os conceitos dos teóricos da ciência e da tecnologia. Assim, a pretensaneutralidade da tecnologia se orienta para relações monolíticas, herméticas e unilaterais,enquanto as perspectivas feministas desafiam esta racionalidade neutra e instrumental.
Entrevista com Lindamir Salete Casagrande
Authors: Freitas Lucas Bueno de
Published: November 2019

Entrevista com Lindamir Salete Casagrande.
Por uma agenda de cuidado à saúde de refugiados LGBTI: reflexões a partir da bioética e das relações internacionais
Authors: Silveira Matheus
Published: November 2019

O objetivo dessa pesquisa é investigar possibilidades de temas para uma agenda de cuidado à saúde de refugiados LGBTI, através da Bioética e das Relações Internacionais. A preocupação com as motivações do fenômeno do refúgio é fato recente, embora seja recorrente na história. Os refugiados LGBTI, em maioria, deixam seus Estados de origem pelo temor a perseguição embasado em razões como a sua orientação sexual e/ou identidade de gênero. O direito à saúde de qualidade é um dos domínios negados a esta população em diversas regiões no mundo, fazendo com que o tema, seja de suma relevância. Para alcançar tal proposta, preceitos bioéticos como o apreço a dignidade humana e o esclarecimento são pilares para todos os envolvidos no processo. Conclui-se que a necessidade de atentar para as condições ambientais de uma Nação significa visualizar todos os condicionantes que podem interferir na qualidade de vida, no desenvolvimento humano dos indivíduos, sejam esses oriundos ou não do território.
Travestis e transexuais e sua inserção no mercado formal de trabalho
Authors: Silva Antônio Sidney Da , Luna Moisés Saraiva de
Published: November 2019

Considerando que a inclusão no mercado de trabalho torna-se cada vez mais difícil, especialmente quando não se tem aptidão profissional/educacional suficientes, pesquisa-se sobre a inserção de travestis e transexuais neste mercado, a fim de abordar a marginalidade trabalhista vivida por maioria destes. Para tanto, é preciso entendermos os entraves que dificultam seu acesso ao mercado de trabalho. Realiza-se, então, uma pesquisa bibliográfica/documental usando o método dedutivo para estudar a violência, abusos e vida pregressa destes. Diante dessa violência, abusos e de sua vida pregressa, percebe-se a ligação desses fatores com os históricos de exclusão dos laços familiares e do abandono escolar – ambientes fundamentais para a formação do sujeito – em decorrência do preconceito e da discriminação sofrida nesses ambientes constatando-se que tais indivíduos não são responsáveis diretos pela informalidade trabalhista que as assola mas, sim, a sociedade que as exclui de seu seio com pensamentos e atitudes retrógrados de preconceito, discriminação e homicídios.
De la lucha sindical a las políticas públicas de las mujeres en la universidad. El caso de puebla
Authors: Rivera Gómez Elva
Published: November 2019

Neste trabalho me proponho em primeiro lugar a analisar os antecedentes das políticas públicas referentes a educação superior e as políticas de igualdade e eqüidade nas universidades e, em segundo lugar, apresento as origens da luta pela reivindicação dos direitos trabalhistas das mulheres no sindicalismo universitário, no início da década de oitenta na Universidade Autônoma de Puebla. As fontes documentais e as entrevistas nos permitem analisar, por meio do discurso, um marcado sexismo e androcentrismo na vida sindical universitária no início da década de oitenta. Nosso trabalho estará sustentado na análise e interpretação das fontes documentais e qualitativas analisadas a partir da metodologia fem inista. Pretendemos construir uma genealogia das mulheres universitárias. Por ela retomamos a experiência de duas classes de mulheres: as acadêmicas fem inistas e as acadêmicas feministas sindicalista para encontrar os pontos de coincidência no contexto da vida sindical e acadêmica universitária no início dos anos oitenta.
Gênero e diversidade sexual no espaço escolar: temáticas que necessitam ser abordadas
Authors: Gomes de Carvalho Marilia , Salete Casagrande Lindamir
Published: November 2019

O objetivo deste artigo é apresentar os resultados de um curso de capacitação que visou sensibilizar as/os profissionais da educação sobre a equidade de gênero e a diversidade sexual em uma pequena comunidade do litoral do Paraná (Matinhos). Foram realizadas diversas atividades que visavam atingir o objetivo do curso. O método participativo utilizado permitiu que as/os pesquisadoras/es trocassem conhecimentos sobre os temas planejados para o curso, buscando construir concepções de gênero mais igualitárias em suas comunidades locais. Com este método foi possível a produção conjunta de conhecimentos sobre os problemas que as profissionais da educação encontram em sua prática escolar, como consequência de preconceitos e discriminações de gênero. Acredita-se que o objetivo do curso foi alcançado e que os profissionais foram sensibilizados e poderão aplicar e multiplicar estes conhecimentos em seu cotidiano escolar.
As representações de gênero e diversidade sexual na mídia internet: artefato de trabalho no contexto escolar
Authors: Tavares da Costa Rocha Cristina
Published: November 2019

Este artigo apresenta parte de um módulo (de amplo projeto) relativo a representações de gênero e diversidade sexual na Internet, reconhecida esta como a maior de todas as redes que integram as novas tecnologias da informação e da comunicação (TICs) na contemporaneidade, caracterizada pela Sociedade em Rede. O projeto é intitulado “Refletindo gênero na escola: A importância de repensar conceitos e preconceitos”, que visa sensibilizar profissionais da rede municipal de educação de Matinhos-PR sobre as questões de gênero e diversidade sexual no ensino fundamental. O nome fo módulo, que é o quarto e último da série do projeto como um todo, é: Gênero, diversidade sexual e mídia3. No presente artigo o enfoque dado à Internet privilegia sua recente conceituação como mídia. E, a partir desta conceituação, reforça-se a necessidade da Internet ter uma inserção mais significativa no ensino em geral, e no fundamental, em particular, como instrumento de trabalho e pesquisa para alunos/as e profissionais da educação, direcionado às reflexões sobre relações de gênero e diversidade sexual, visto que este instrumento auxilia a ampliar condições de cidadania aos indivíduos e coletividades. Da perspectiva da Internet como mídia e como artefato direcionado à Educação, são ressaltadas: 1) sua dimensão conservadora, visto que reproduz o status quo cultural vigente no sentido de permanências em relação a situações que reforçam concepções de caráter heterossexual e, em decorrência, de atitudes estereotipadas, preconceituosas, homofóbicas e discriminatórias em relação a GLBTs4; e 2) sua dimensão libertária, visto que incorpora concepções além das ainda hegemônicas heteronormativas, a exemplo de sites, matérias, imagens, sobre GLBTs.
Identidades sexuais e de gênero: interfaces dos direitos humanos, educação e cidadania na ágora da diversidade
Authors: Santos Josue Leite dos , Thürler Djalma
Published: November 2019

Este trabalho busca um diálogo entre educação, cidadania e os direitos humanos na constituição das diversas identidades sexuais e de gênero. Sob a égide dos fundamentos do Estado Democrático de Direito, dos direitos fundamentais com Declaração Universal dos Direitos Humanos buscamos prevenir a violação e negação dos direitos da pessoa no âmbito escolar, no que tange a diversidade sexual e de gênero. Esperase que esse estudo promova reflexões acerca das normas regulatórias do sexo que sejam capazes de operacionalizar gênero, identidade de gênero e orientação sexual sob a égide diversidade e da diferença, bem como uma ação docente que faça cumprir o que estabelece o artigo 5º da Constituição: “Todos são iguais perante a lei, sem distinção de qualquer natureza”.
Participação das mulheres em funções-chave na produção cinematográfica brasileira
Authors: Alves de Almeida Paula , Eustáquio Diniz Alves José , Britz do Nascimento Silva Denise
Published: November 2019

O Cinema tem importante papel na reprodução das imagens de homens e mulheres, na representação das relações familiares e da sexualidade, na criação de rótulos para pessoas e comportamentos. Vários autores apontam como pontos fundamentais na conquista da equidade de gênero uma mudança na representação da mulher na arte e na mídia, e sua inserção igualitária em todos os níveis de hierarquia no mercado de trabalho. Esta pesquisa aborda esses dois pontos na medida em que apresenta a evolução da participação de mulheres no protagonismo, na direção cinematográ ca e em outras funções de destaque nos lmes brasileiros de longa-metragem lançados entre os anos 1961 e 2010 (tais como roteirista, diretor de fotogra a e produtor). Além disso, apresenta uma contextualização que compara a evolução da participação da mulher no Cinema Brasileiro e no cinema de Hollywood.
Educação profissional e mercado de trabalho: uma investigação a partir das/dos jovens do IFS
Authors: Ferreira Santos Elza
Published: November 2019

O presente trabalho trata das expectativas que jovens estudantes brasileiros têm em relação ao mercado de trabalho. Para tanto, muitos jovens procuram as instituições federais de educação pro ssional. A pesquisa situa-se no Instituto Federal de Sergipe. Nela, por meio de grupos focais e de entrevistas colhemos depoimentos de alunos/as dos cursos técnicos Eletrônica, Eletrotécnica e Desenvolvimento de Sistemas. Deles, procuramos perceber, além de suas expectativas, como se dá a formação acadêmico-pro ssional, como se relacionam com os professores e com os colegas, como se veem homens e mulheres trabalhadores da indústria. A pesquisa está direcionada para a educação pro ssional, mercado de trabalho e relações de gênero. Sua base teórica fundamenta-se em Charlot, Demo, Hirata, Butler etc. As entrevistas e grupos focais foram estudados a partir da análise de discurso numa perspectiva foucaultiana. Os resultados apontam para uma necessária re exão acerca das relações entre mercado de trabalho e educação profissional.
“Um mundo [ainda] dividido”: 20 anos depois
Authors: Cachoeira Menezes Leopoldina , Maria Freire de Lima e Souza Ângela
Published: November 2019

Este artigo analisa a evolução da participação das mulheres docentes na UFBA em diferentes áreas de conhecimento quanto à titulação e à jornada de trabalho, dados atualizados para 2014, a partir da pesquisa que abarcou três períodos – 1974, 1984, 1994 – e foi publicada, em 1997, pela Professora Elizete Silva Passos, Coordenadora do Grupo de Trabalho (GT) Mulher e Educação e integrante da equipe de pesquisadoras permanentes do Núcleo de Estudos Interdisciplinares sobre a Mulher (NEIM) da Universidade Federal da Bahia. Os dados daquele estudo foram recolhidos em doze Estados da Federação, nove da Região Nordeste (Bahia, Sergipe. Alagoas, Pernambuco, Paraíba, Rio Grande do Norte, Ceará, Piauí e Maranhão) e três da Região Norte (Pará, Acre, Amazonas) e apontavam as assimetrias de gênero presentes nas universidades públicas analisadas. Esta comunicação apresenta também novos resultados obtidos através de uma metodologia quantitativa, a partir da coleta de dados do sistema de informatização da UFBA e que, portanto, se restringem à Universidade Federal da Bahia. Em algumas áreas de conhecimento, houve um aumento significativo de mulheres docentes, mas, em outras áreas, esse percentual foi pequeno. Entretanto, no que diz respeito à titulação, houve um aumento considerável de mulheres doutoras nestes 20 anos, perfazendo um total de mais de 600%.
O dito e não dito acerca das relações de gênero no cotidiano das aulas de matemática
Authors: Salete Casagrande Lindamir , Gomes de Carvalho Marilia
Published: November 2019

O objetivo deste artigo é apresentar uma parcela dos resultados da pesquisa para realização da tese de doutorado cujo objetivo foi analisar as relações de gênero no cotidiano das aulas de matemática de 5ª a 8ª séries do ensino fundamental. A pesquisa foi realizada em um colégio da rede estadual de ensino de Curitiba, capital do Estado do Paraná, Brasil. A pesquisa foi baseada no método etnográfico com observação, entrevista e análise de documentos. A análise foi feita com base na teoria de gênero buscando identificar o dito e não dito acerca das relações de gênero presentes naquele espaço. Os resultados apontam um silenciamento das relações de gênero e das alunas. Elas parecem ter absorvido a ideia de que devem ouvir mais do que falar, de que não devem se expor. Apontam ainda a necessidade que alunos e alunas tem de serem reconhecidos/as como pertencentes ao grupo. Essa necessidade contribuía para seu silenciamento. Professores/as e alunos/as percebiam as meninas como passivas e organizadas e os meninos como ativos e criativos. De modo geral, as percepções eram baseadas em estereótipos do que é ser homem ou mulher na sociedade atual, fato que demonstra que desde muito cedo estes estereótipos são absorvidos por meninas e meninos e passam a fazer parte de suas formas de pensar e ver as relações cotidianas.
Neotropical Monogenoidea 62. Biotodomella mirospinata gen. nov., sp. nov. (Polyonchoinea: Dactylogyridae): a parasite of the gills of Biotodoma cupido (Cichliformes: Cichlidae), from the Peruvian Amazon
Authors: Murrieta Morey Germán Augusto , Vásquez Arimuya Mariana , Boeger Walter A.
Published: November 2019

Biotodomellagen. nov. (Monogenoidea: Dactylogyridae) is proposed to accommodate Biotodomella mirospinatasp. nov., found on the gills of Biotodoma cupido (Heckel, 1840) (“cara bonita” or “green-streaked eartheater”), a freshwater cichlid from the Peruvian Amazon. The new genus and species differ from other Neotropical dactylogyrids in having the hooks of each hook pair well-differentiated from the remaining pairs, shafts varying in robustness, weakly sclerotized expansions at the proximal end of shaft, and a dorsal anchor with grooved shaft, bifid point. This study represents the first record of a monogenoid from a species of Biotodoma Eigenmann & Kennedy, 1903.
Mixité, inégalité, hétéroconjugalité. La formation des couples chez les migrant·e·s d’Afrique subsaharienne en France
Authors: Marsicano Élise
Published: November 2019

L’auteure part du constat qu’en France, l’union entre une personne immigrée et une personne non immigrée est généralement considérée comme un indicateur d’intégration. Elle propose de déplacer ce regard en abordant la mixité conjugale à partir des discriminations que vivent les groupes minoritaires. Tenant compte à la fois du racisme et de la signification genrée de la mixité, l’article repose sur l’analyse d’une enquête quantitative menée auprès de femmes et d’hommes migrants d’Afrique subsaharienne vivant en France. Il en ressort que si la migration favorise la mixité conjugale, le champ des possibles se referme dans les situations de couple plus formalisées, celles où les deux partenaires vivent ensemble. Ces couples sont en effet majoritairement non mixtes (tous deux sont originaires du même pays), alors que la mixité extra-africaine (le ou la partenaire est d’origine européenne, majoritairement française) et la mixité intra-africaine (les deux partenaires sont de deux pays d’Afrique subsaharienne différents) concernent la majorité des couples non cohabitants. Dans l’ensemble de la population étudiée, l’importance de la mixité intra-africaine donne à voir la manière dont se recomposent les frontières d’appartenance selon des lignes raciales, renforcées par l’expérience d’une condition noire et africaine et par la ségrégation des lieux de vie et de travail. Enfin, l’auteure montre que c’est la conjugalité hétérosexuelle, plus que la non-mixité, qui renforce la domination masculine au sein des relations de couple.
Brass’Art in Molenbeek: an urban experiment in community relations
Authors: Fadil Nadia , Kolly Maryam
Published: November 2019

This paper takes the case of the Brass'Art cultural café located on the municipal square of Molenbeek, as a starting point for a study aimed at understanding the construction of a common urban space with a pluralistic purpose. Based on an ethnographic study between May 2017 and January 2018, this article aims to show how the presence of alcohol in this space mobilises and concentrates diverse and even contradictory repertoires – of a discursive, ethical and emotional nature – behind the creation of public space. The Brass'Art case study reflects at the micro and local level the implications of the coexistence of agents with different religious sensitivities and orientations. According to a pragmatic methodology, this paper tries to demonstrate that the fine tuning of the balance of power between the majority and the minority takes place not so much through conscious negotiations or strategies of “civic indifference”, but through practical adjustments in keeping with the principle of community relations.
A Visual Detection Method for Foreign Objects in Power Lines Based on Mask R-CNN
Authors: Chen Wenxiang , Li Yingna , Li Chuan
Published: November 2019

The high-voltage power lines and transmission towers are large in volume, large in number, and wide in coverage, so they are easily attached to foreign objects, which may cause failure of the transmission line. The existing object detection methods are susceptible to weather and environmental factors, and the use of neural networks for target detection can achieve good results. Therefore, this article uses MASK R-CNN as the basic network detection method for detecting foreign objects in the transmission network. The experimental results show that compared with the traditional target detection method, the method adopted in this article has achieved good results in the speed, efficiency, and recognition precision of foreign object detection. In the future, image processing operations can be performed for complex backgrounds of transmission lines to improve recognition effect.
A Study of the Influence of Cross-Channel Integration in Customer Retention
Authors: Choi Youngkeun
Published: November 2019

The focus of this study is how cross-channel integration increases trust and customer retention. By proposing the concepts of channel integration quality as different ways to perceive cross-channel integration, this study develops a model that explores the sub-factors of channel integration quality and the role of trust for consumer retention in omnichannel service. For this, this study surveys 352 consumers using omnichannel service in Korea and analyzes the data using AMOS 24. In the results, first, content consistency and process consistency as the sub-factors of channel integration quality increase trust. Second, trust increases customer retention. Finally, content consistency and process consistency increase consumer retention through trust. The findings contribute to research on customer retention by paying scholarly attention to cross-channel integration characterized by channel integration quality.
Strategic Transformational Transition of Green Economy, Green Growth and Sustainable Development
Authors: Vargas-Hernández José G.
Published: November 2019

This article analyzes a strategic transformational transition of the green economy, green growth, and sustainable development from the institutional perspective. The analysis begins by questioning the implications of the concepts and principles of green economy, green growth and sustainable development from different perspectives in the transformational transition considering the investment, trade, and capacity building though the design and implementation of strategies and policies as well as measures from an institutional analysis. The methodology followed was the analytical review of the literature to derive inferences, challenges, proposals and conclusions. It is concluded that the green economy concept addresses current challenges delivering economic development opportunities and multiple benefits for the welfare of all human beings.
Secure Image Watermarking in a Compressed SPIHT Domain Using Paillier Cryptosystem
Authors: Gupta Ritu , Mishra Anurag , Jain Sarika
Published: November 2019

A secure solution to the problem of copyright infringement and content authentication is to carry out image watermarking in secure signal processing (SSP) domain. Homomorphic encryption is considered one such solution for image watermarking in this domain. The Paillier encryption is found to be suitable for image processing applications in general and for watermarking in particular. In this article, a detailed investigation is carried out by using Paillier cryptosystem for twelve different color images in a compressed domain. The compression of the host images is carried out by SPIHT (Set Partitioning in Hierarchical Trees) coding. The visual quality of the images post embedding and image processing attacks is assessed by using two full reference metrics, Peak Signal to Noise Ratio (PSNR) and Structural Similarity Index (SSIM). The performance evaluation of the Paillier cryptosystem vis-à-vis watermark application development is carried out by computing three benchmark metrics: number of pixels change rate (NPCR), unified average changing intensity (UACI) and encryption speed.
RDF Model Generation for Unstructured Dengue Patients' Clinical and Pathological Data
Authors: Devi Runumi , Mehrotra Deepti , Baazaoui-Zghal Hajer
Published: November 2019

The automatic extraction of triplets from unstructured patient records and transforming them into resource description framework (RDF) models has remained a huge challenge so far, and would provide significant benefit to potential applications like knowledge discovery, machine interoperability, and ontology design in the health care domain. This article describes an approach that extracts semantics (triplets) from dengue patient case-sheets and clinical reports and transforms them into an RDF model. A Text2Ontology framework is used for extracting relations from text and was found to have limited capability. The TypedDependency parsing-based algorithm is designed for extracting RDF facts from patients' case-sheets and subsequent conversion into RDF models. A mapping-driven semantifying approach is also designed for mapping clinical details extracted from patients' reports to its corresponding triplet components and subsequent RDF model generations. The exhaustiveness of the RDF models generated are measured based on the number of axioms generated with respect to the facts available.
The Impact of Social Media Platforms “Instagram” and “Snapchat” on the Purchasing Decision - Structural Equation Modelling Approach
Authors: Alghamdi Eman Ali , Bogari Naima
Published: November 2019

Social media (SM) tools have an immense potential in e-marketing and online shopping. However, there is a lack of researches on the use of social media platform as effective marketing tools. This study has aimed to investigate the revolution of social media in Saudi Arabia through understanding the impact of two popular SM platforms (Instagram and Snapchat) on the purchasing decision of Saudi customers through advertisements and blogger recommendations. Structural equation modeling (SEM) was used to develop a model, which was tested using Confirmatory factor analysis (CFA). The results indicated a positive impact of social media platforms on the purchasing decision of young female users. Moreover, the effectiveness of these platforms in generating electronic-word of mouth (eWOM) among consumers was highlighted. However, further research is needed to promote marketeers and consumers' awareness in the digital marketplace.
Contribution of Men in Safe Motherhood
Authors: Pande Vincent Sebastian
Published: November 2019

This study sought to ascertain the different ways in which men contribute to safe motherhood, particularly during pregnancy care. The main question was to what extent men play their roles during pregnancy care? In order to solve this question, the study employed simple random and purposive techniques to select a sample size of 165 respondents among the four selected wards in Dodoma Municipality. Questionnaires and interview methods were used to collect data from the selected respondents. Data analysis was done using statistical package for social sciences version 20 and the results were presented in tables. From the analysis, it was found that majority of men are beginning to take care of their wives during their pregnancy, supporting them on aspects of finance, emotional, and with advice. The findings further reveal that men still have little contribution on issues related to antenatal care visits. This implies that reproductive health education should be promoted to the community and to men in specific in order to raise their awareness and involvement in pregnancy care.
“You Want Me to Lead?”
Authors: Jones Meredith , Catapano Susan
Published: November 2019

This case study explores the experiences of three American pre-service teachers participating in an international applied learning context in Belize. The pre-service teachers worked in San Pedro Town, Belize for a month with local teachers and children in primary grades. The applied learning context was a demonstration classroom located in the center of the city where local teachers and children would visit each day. The pre-service teachers were responsible for creating lessons and activities, then teaching the children in the demonstration classroom while the Belizean teachers observed. The pre-service teachers also provided professional development for the teachers in the teacher's classroom. Through this international applied learning experience, the pre-service teachers strengthened their teaching and leadership skills while exploring their cultural sensitivity living in a new culture and country. The lessons through international applied learning contexts can greatly influence pre-service teachers' teaching practices when they have their own classroom.
Inclusive Approach to Education for Children With Disabilities
Authors: Farid Shekh , Mostari Mamata
Published: November 2019

BRAC, a leading international development organization, has been working to ensure the rights of persons with disabilities to education through its inclusive education program. This article discusses the BRAC approach in Bangladesh and aims to identify its strategies that are effective in facilitating inclusion. It employed a qualitative research approach where data were collected from students with disabilities, their parents, and BRAC's teachers and staffs using qualitative data collection techniques. The results show that the disability-inclusive policy and all other activities are strongly monitored by a separate unit under BRAC Education Program (BEP). It mainly focuses on sensitizing its teachers and staff to the issue through training, discussing the issue in all meetings and ensuring effective use of a working manual developed by the unit. Group-based learning and involving them in income generating activities were also effective. The findings of the study would be useful for policy makers and other national and international organizations that are working on the issue.
Myocardial contusion: new concepts in diagnosis and management
Authors: Christensen MA , Sutton KR
Published: November 2019

Myocardial contusion is diagnosed with one or a combination of four diagnostic procedures: electrocardiography, echocardiography, creatine kinase MB fractions and/or radionuclide procedures. This article presents a critical review of 18 recent studies addressing the utility, sensitivity and specificity of these tests. Careful review suggests that clinically significant myocardial contusions as a result of blunt trauma are rare and may be detected simply and inexpensively using electrocardiography and careful physical examination. Serum myocardial enzymes and radionuclide studies are nonspecific and are not predictive of cardiac complications. Echocardiography is useful in the management of myocardial decompensation but not as a primary screening tool in blunt cardiac injury. Cost comparisons, resource allocation and implications for critical care practice are discussed.
Age differences in patient recovery patterns following coronary artery bypass surgery
Authors: Artinian NT , Duggan C , Miller P
Published: November 2019

OBJECTIVE: The purpose of this study was to determine whether physical, psychological and social recovery within the first 6 weeks following coronary artery bypass surgery varied by age. METHODS: A repeated measures design was used for this study. Data were collected from a convenience sample of three age groups of patients at the following times: prior to hospital discharge and at 1, 3 and 6 weeks after discharge. The three age groups studied were less than 60 years, 60 to 70 years and more than 70 years. Data were collected by interview and mail questionnaires. The initial sample consisted of 258 patients, of whom 184 completed the study. Eleven instruments were used to measure recovery including the Sickness Impact Profile, Beck Depression Inventory, Rosenberg Self-Esteem scale and the Symptom Inventory. RESULTS: No significant differences were found among the age groups for any of the physical, psychological or social recovery measures. Within each age group physical, psychological and social recovery improved significantly over time. Although patients more than 70 years of age remained in the hospital significantly longer, once discharged, they did not have more difficulty with recovery than the other age groups. DISCUSSION: As expected, all age groups experienced significant improvement in recovery over time. CONCLUSIONS: Contrary to what past research about cardiac surgery and the elderly might lead one to expect, in this study, the oldest patients did not have the poorest recovery patterns. Persons more than 70 years had recovery patterns similar to those of younger age groups.
Weaning from mechanical ventilation: concept development
Authors: Knebel AR , Shekleton ME , Burns S , Clochesy JM , Hanneman SK , Ingersoll GL
Published: November 2019

This article, the first in a series, is written to clarify the process of weaning from mechanical ventilation and to promote the development of a common language for understanding the complex weaning process. The Third National Study Group on Weaning From Mechanical Ventilation proposes a conceptual model and definitions that will provide a framework for future research on this important topic. This conceptual framework describes the preweaning phase, the weaning process, and the outcome phase of mechanical ventilation. Potential outcomes are completion of weaning, lack of completion, and terminal weaning. The weaning decision continuum incorporates: (1) when and how to begin the weaning process, (2) how to select therapies to assist with difficult weaning and chart progress during weaning, and (3) when to stop weaning if progress is no longer being made. An inherent assumption of this model is that each patient will display unique responses to the weaning process. The proposed conceptual framework and definitions provide a foundation for developing clinical practice guidelines and for guiding future ventilator weaning research.
Effects of continuous lateral rotation therapy on pulmonary complications in liver transplant patients
Authors: Whiteman K , Nachtmann L , Kramer D , Sereika S , Bierman M
Published: November 2019

BACKGROUND: When liver transplant candidates and recipients suffer from pulmonary complications of immobility, the results can be life-threatening. Continuous lateral rotation therapy has been reported to decrease complications of immobility. OBJECTIVES: To determine whether continuous lateral rotation therapy decreases the duration of mechanical ventilation, intensive care unit length of stay, incidence or resolution of atelectasis, incidence or onset time of lower respiratory tract infection and pneumonia. METHODS: Sixty-nine subjects admitted to a liver transplant intensive care unit at a university teaching hospital were randomly assigned to continuous lateral rotation therapy or a stationary bed. All subjects were mechanically ventilated for 24 hours and had a Glasgow Coma Scale score of 11 or less upon admission to the study. Subjects were followed until out of bed, unable to rotate for 3 consecutive days, or transferred from the intensive care unit. Data and chest roentgenogram results were collected on admission and daily during the study. Sputum culture results were obtained if available as part of normal patient care. RESULTS: Incidence of lower respiratory tract infection was significantly lower and length of time to occurrence of lower respiratory tract infection was significantly longer in the continuous lateral rotation therapy group than in the stationary bed group. CONCLUSIONS: Although continuous lateral rotation therapy did not affect duration of mechanical ventilation, length of stay, or incidence of atelectasis, it was effective in decreasing the incidence of, and increasing onset time to, lower respiratory tract infection in the liver transplantation population.
A guideline for competency of the critical care nurse
Authors: Scribante J , Muller ME , Lipman J
Published: November 2019

BACKGROUND: To maintain a high standard of quality nursing care the individual critical care nurse s competencies should be determined objectively. Few international guidelines describe the qualities required by critical care nurses to function effectively in a critical care unit. These guidelines often focus only on the education and training of critical care nurses. OBJECTIVE: To formulate and describe guidelines for the competency requirements of registered critical care nurses. METHOD: A focus group interview, a qualitative research method, was conducted as an open conversation in which each participant could ask questions, comment, or respond to comments. Interaction among the respondents was encouraged to stimulate in-depth discussion. The study was conducted within the framework of South African critical care nursing. RESULTS: The four main categories that were identified are as follows: professional competence, cognitive competence, interpersonal skills, and critical care patterns of interaction. These are described in detail along with a formulated guideline for critical care nurse competency requirements. CONCLUSION: This study describes an attempt to formulate objective guidelines for critical care nurses competency requirements.
Patients' experiences of being in an intensive care unit: a select literature review
Authors: Stein-Parbury J , McKinley S
Published: November 2019

A total of 26 research studies on patients' experiences of being in an intensive care unit were reviewed. The studies were selected because they focused on experiences typical in intensive care units. Many patients recalled their time in the intensive care unit, sometimes in vivid detail. Patients recalled not only experiences that were negative but also ones that were neutral and even positive. Positive experiences included a sense of safety and security promoted especially by nurses. Negative experiences included impaired cognitive functioning and discomforts such as problems with sleeping, pain, and anxiety. The review indicates steps critical care staff can take to develop better ways to understand patients' experiences. Meeting such challenges can improve the quality of patients' experiences and reduce anxiety and may offset potential adverse effects of being a patient in an intensive care unit.
Peripartum cardiomyopathy: an ominous complication of pregnancy
Authors: Futterman LG , Lemberg L
Published: November 2019

PPCM is a relatively rare and lethal disease, poorly characterized and about which little is known. A diagnosis is made within a confined narrow period, the ninth month of pregnancy to the fifth month postpartum. The signs and symptoms of heart failure are classic, and failure is confirmed by an echocardiogram primarily showing either hypertrophy or dilatation and a low ejection fraction. Other causes of heart failure should be ruled out before the diagnosis of PPCM is made. Treatment is supportive and similar to standard therapy for heart failure. Probabilities of atrial or ventricular emboli are similar to the other dilated cardiomyopathies in heart failure and are treated accordingly, i.e., with coumadin or enoxaparin. Since mortality rates are high and can be between 18% and 56%, heart transplantation has been performed and prognosis improved. Finally, immunosuppressant therapy has been used successfully in only a small number of patients who were unimproved after 2 weeks of standard therapy.
The mysteries of the human genome uncovered--medicine is changed forever
Authors: Futterman LG , Lemberg L
Published: November 2019

It is impossible to overemphasize the significance of the recent announcement that 85% of the DNA of the human genome has been decoded. Physicians can now begin teasing out the secrets of human health and disease. Within the next 10 years, it may be possible to determine who may be vulnerable to illnesses like Alzheimer's disease, cancer, and diabetes. The world of medicine will be utterly transformed in a few decades. Even before decoding of the human genome is completed, scientists have begun a new and more challenging research in explaining the molecular basis of life. "Proteonomics," the cataloging and analysis of every protein in the human body looms as the next major scientific medical effort. Proteins are more varied and complex than DNA. Fifty years from now, our understanding of the human organism and its various ills will be transformed beyond recognition through genomics and proteonomics. Stay tuned!
Reliability of nurses' neurological assessments in the cardiothoracic surgical intensive care unit
Authors: Beauchamp K , Baker S , McDaniel C , Moser W , Zalman DC , Balinghoff J , Cheung AT , Stecker M
Published: November 2019

BACKGROUND: Alterations in mental status are common among patients in the cardiothoracic surgical intensive care unit. Changes in mental status can be caused by metabolic factors, medications, or brain injury. In this setting, reliable, serial neurological evaluations are critical for assessing the effectiveness of treatment and the need for additional studies. OBJECTIVES: To estimate the reliability of the Rancho Los Amigos Cognitive Scale and the newly developed Neurologic Intensive Care Evaluation as measures of cognitive function in the cardiothoracic surgical intensive care unit. METHODS: Nurses used 1 of the 2 scales as part of routine neurological assessments of patients in the cardiothoracic surgical intensive care unit. For each test, scores of different observers were correlated and a reliability estimate formed. RESULTS: Interrater reliability was high for both evaluations (Rancho scale, 0.91; Neurologic Intensive Care Evaluation, 0.94). Correlations between the scores of different pairs of observers were also high (mean rho values, 0.84 for the Rancho scale and 0.77 for the Neurologic Intensive Care Evaluation). CONCLUSIONS: Both scales are reliable indicators of the neurological state of patients in the cardiothoracic surgical intensive care unit. These scales measure different, although limited, aspects of cognitive function. Each test was simple to administer and did not take more time than the standard nursing neurological examination. Most of the variability in scoring was related to the different degrees of stimulation used by examiners when assessing patients, not to differences in the interpretation of patients' responses.
How nurses shift from care of a brain-injured patient to maintenance of a brain-dead organ donor
Authors: Day L
Published: November 2019

BACKGROUND: The responsibility of obtaining organs for transplantation rests partly on critical care nurses. How nurses balance care of critically ill, brain-injured patients with the professional responsibility to procure organs is a question of ethical and clinical importance. OBJECTIVES: To describe the experiences of critical care nurses in making the shift from caring for a brain-injured patient identified as a potential organ donor to maintaining a brain-dead body. METHODS: An interpretive, phenomenological design was used. In 2 trauma centers, 9 critical care nurses were interviewed, and 2 of the 9 nurses were observed. RESULTS: Identification of potential organ donors is made under conditions of prognostic ambiguity. The transition from brain injury to brain death is a period of instability in which the critical care team must decide quickly whether to resuscitate a patient in order to procure organs. After a patient is brain dead, critical care nurses' relationship with and responsibility toward the patient change. CONCLUSIONS: The process of identifying potential organ donors and holding open the tentative possibility of organ procurement illustrates the practical difficulties of early referral of potential donors to organ procurement organizations. Early referral to an organ procurement organization implies a commitment to organ procurement that some nurses may hesitate to make because such a commitment changes their relationship with a brain-injured patient.
Perceived Self-Efficacy in Performing and Willingness to Learn Cardiopulmonary Resuscitation in an Elderly Population in a Suburban Community
Authors: Swor Robert , Compton Scott , Farr Lynn , Kokko Sue , Vining Fern , Pascual Rebecca , Jackson Raymond E.
Published: November 2019

• Background Older persons are the group most likely to respond to cardiac arrests in private residences.

• Objective To characterize the knowledge about, attitudes toward, and perceived self-efficacy of older persons in learning and providing cardiopulmonary resuscitation.

• Methods A total of 2743 surveys were mailed to adults 55 years and older who resided in a single Michigan suburb. Data were collected on demographics, medical history, training in and willingness to provide cardiopulmonary resuscitation, and concerns about providing this intervention.

• Results The 631 persons (24.6%) who responded were elderly (mean age, 73.5 years) and had a mean of 1.7 occupants per household. More than one third lived alone. Of all respondents, 275 (43.6%) had received training in cardiopulmonary resuscitation, 370 (58.6%) indicated a willingness to learn cardiopulmonary resuscitation, and 412 (65.3%) thought that they had the ability to perform this intervention. Respondents 80 years or younger were significantly more likely than respondents more than 80 years old to be willing to learn cardiopulmonary resuscitation (65.7% vs 19.0%, P < .001) and perceived themselves as able to perform it (73.0% vs 34.0%, P < .001). The absence of mouth-to-mouth ventilation as part of training had minimal impact on the willingness of either age group to receive training (61.2% vs 58.6%, P = .19). Perceived ability to learn and perform cardiopulmonary resuscitation did not vary with the medical history of the respondent or the respondent’s spouse.

• Conclusion Adults 56 to 80 years old perceive themselves as able to perform cardiopulmonary resuscitation and are interested in receiving training.