bluuebunny/crossref_metadata_2025 huggingface dataset:
Kajian Tentang Sport Development Index Kota Jambi Tahun 2017
Authors: Indrayana Boy
Published: July 2019

Penelitian ini mengkaji tentang Sport Development Index (SDI) Kota Jambi : Kecamatan Telanai Pura , Kecamatan Jambi Pasar dan Kecamatan Kota Baru dengan empat dimensi , yaitu dimensi Partisipasi Masyarakat Berolahraga , Dimensi Ruang Terbuka ,dimensi Sumber Daya Manusia, dimensi Kebugaran. Tujuan penelitian ini adalah : 1) untuk mendapatkan seberapa besar tingkat partisipasi masyarakat berolahraga di Kota Jambi khususnya Kecamatan Telanai Pura, kecamatan Jambi Pasar dan Kecamatan Kota Baru, 2) untuk mendapatkan informasi tentang berapa luas ruang terbuka yang tersedia  untuk berolahraga di Kota Jambi Khususnya Kecamatan Telanai Pura, Kecamatan Jambi Pasar dan Kecamatan Kota Baru, 3) Untuk mendapatkan informasi tentang tingkat kebugaran masyarakat di Kota Jambi khususnya Kecamatan Telanai Pura, Keamatan Jambi Pasar dan Kecamatan Kota Baru. Penelitian ini dilakukan selama 6 bulan meliputi persiapan sampai pelaporan. Penelitian menggunakan metode yang digunakan dalam penelitian ini adalah metode deskriptif Survey dengan angket dan tes pengukuran. Metode penelitian ini adalah deskriptif survey dengan angket dan tes pengukuran terhadap 270 Orang. Hasil penelitian diperoleh dimensi setiap kecamatan yaitu, Kecamatan Telanaipura, Partisipasi Masyarakat Berolahraga sebesar 0.72, Ruang Terbuka Sebesar 0.254, Kebugaran sebesar 0.39 dan SDM sebesar 0.20. Kecamatan Jambi Pasar Partisipasi Masyarakat Berolahraga sebesar 0.82, Ruang Terbuka sebesar 0.408 , kebugaran sebesar 0.37 dan SDM sebesar 0.24. Sedangkan Kecamatan Kota Baru Partisipasi Masyarakat Berolahraga Sebesar 0.75, Ruang Terbuka sebesar 1.18, Kebugaran sebesar , 0.39 dan SDM sebesar 0.82.
Analisis Yuridis Perjanjian Yang Berklausula Arbitrase Dalam Penyelesaian Sengketa Perdagangan
Authors: Alissa Evalina , Bafadhal Faizah
Published: July 2019

Penelitian ini bertujuan untuk menganalisis  kewenangan absolut dari lembaga Arbitrase dan penyelesaian sengketa alternatif dalam menyelesaikan sengketa perdagangan (bisnis) yang perjanjiannya berklausula arbitrase, serta menganalisis dasar hukum yang berlaku  dalam menyelesaikan  sengketa perdagangan atau bisnis yang berklausula Arbitrase. Dalam  penyelesaian sengketa perdagangan atau bisnis yang di dalam  perjanjian pokoknya mencantumkan perjanjian penyelesaiaan sengketanya berklausula arbitrse, maka itu merupakan kewenangan absolut dari lembaga arbitrase ,hal  ini diatur dalam Undang-Undang Nomor 30 tahun 1999, Undang-Undang tentang Arbitrase dan Penyelesaian Sengketa Alternatif, dalam Pasal  3 dan Pasal 11.
Hele tekster versus utdrag – hvilke tekster velger norsklærerne?
Authors: Skaug Sigrid , Blikstad-Balas Marte
Published: July 2019

Lesing av skjønnlitteratur er en sentral del av norskfaget. Med innføringen av K06 ble listene over verk og forfatterskap fjernet fra norskplanen, og valg av tekster ble med dette opp til den enkelte lærer – et prinsipp som videreføres i fagfornyelsen 2020. Vi vet lite om hvilke tekster lærere velger å bruke i norskundervisningen, og i hvilken grad de leser hele teksten eller et eller flere utdrag fra den, noe vi med denne studien ønsker å undersøke. Datamaterialet bygger på en spørreundersøkelse med 153 norsklærere i vg3, der vi kartlegger hvilke litterære utdrag og hele verk lærerne bruker i undervisningen og deres holdninger til lesing av utdrag og hele verk. Et tydelig funn er at utdrag er en svært utbredt praksis blant lærerne i utvalget. Analysen viser også at visse enkelttekster (hovedsakelig fra 1800-tallet) og utvalgte deler av Henrik Ibsens forfatterskap og tekster er så hyppig brukt i undervisningen på tvers av klasser, at denne litteraturen i praksis er med på å opprettholde en form for skjult litterær kanon. Videre viser analysen at lærerne oppfatter lesing av utdrag og hele verk som to svært forskjellige aktiviteter, som tjener relativt motsetningsfylte mål i norskfaget.
English abstract
Whole Texts Versus Excerpts - Which Texts Do Norwegian Language Teachers Choose?
Reading of literature plays a key role in the language arts subject. In Norway, the curriculum has since 2006 given teachers’ ample room to decide themselves which authors and which literary texts they want to use in their classrooms. To investigate what texts they actually choose to include in their teaching and whether the texts are complete literary works or excerpts, was the main aim of the present study. Drawing on a survey with 153 language arts teachers from the last year of upper secondary school, we have mapped what literary texts and excerpts teachers report reading in class, and teachers’ perceptions of using complete texts versus excerpts. A key finding is that a majority of the teachers report extensive use of literary excerpts, and that some texts (mainly from the 1800s) and parts of Henrik Ibsen’s works predominate across classrooms. The study also suggests that teachers view the reading of excerpts and complete texts as two distinct activities that often serve contradictory purposes.
SAHABAT MUSEUM KONFERENSI ASIA AFRIKA (SMKAA) AKTIVITAS DIPLOMASI PUBLIK KEMENTERIAN LUAR NEGERI RI MELALUI PENGEMBANGAN KOMUNITAS DAN PARTISIPASI PUBLIK
Authors: Lusiana Elnovani , Komala Lukiati , Anwar Rully Khairul
Published: July 2019

Non state power semakin menunjukkan geliat pergerakan yang perlahan menguat, tapi menuju pasti pada satu orientasi globalisasi politik dunia.  Diplomasi bukan lagi panggung bagi segelintir elit politik dunia, akan tetapi pada perkembangannya, diplomasi publik semakin mengambil bagian dalam bidang kajian hubungan internasional.  Penulisan artikel ini mengacu kepada kondisi latar belakang singkat yang telah dipaparkan diatas.  Menggunakan metode studi kasus dalam penelitian kualitatif, Komunitas Sahabat Museum Konferensi Asia Afrika (SMKAA) dinaungi oleh Direktorat Diplomasi Publik Kementerian Luar Negeri Republik Indonesia (KEMLU RI) dan diimplementasikan melalui pendekatan pengembangan komunitas & partisipasi publik. Artikel  ini berusaha untuk menggambarkan penerapan metode pengembangan komunitas dan partisipasi publik dalam kegiatan serta aktivitas organisasi SMKAA.  Diharapkan melalui kajian ini, secara ilmiah akan membingkai perkembangan terkini dalam kegiatan diplomasi publik KEMLU RI yang dapat menjadi role model bagi pengembangan komunitas serupa di lingkup global.
Proses Pembakaran Pirolisis dengan Jenis Biomassa dan Karakteristik Asap Cair yang Dihasilkan
Authors: Ridhuan Kemas , Irawan Dwi , Inthifawzi Rizki
Published: July 2019

Biomassa merupakan satu-satunya sumber karbon yang dapat diperbaharui dan mampu diproses menjadi bahan bakar yang berupa gas, cair, dan padat yang baik. Biomassa juga dapat diolah menjadi bahan pengawet makanan karena mengandung senyawa-senyawa antibakteri dan antioksidan dalam bentuk cairan atau asap cair. Untuk mendapatkan hasil asap cair yang sesuai dan memadai dengan peruntukannya maka perlu diolah dengan menggunakan berbagai jenis jenis biomassa yang diproses pada pembakaran pirolisis. Dengan pembakaran pirolisis biomassa terdekomposisi termokimia dengan pemanasan menjadi gas kemudian didinginkan dikondensor dan menjadi cairan atau asap cair. Tujuan penelitian ini adalah untuk mengetahui jumlah asap cair yang dihasilkan dari jenis biomassa baku kulit kelapa muda, bambu dan kulit durian dengan karaktristik asap cairnya yang dibakar secara pirolisis. Penelitian ini dilakukan di laboratorim Teknik Mesin Universitas Muhammadiyah Metro, penelitian ini menggunakan reaktor pirolisis, retot dan kondensor dengan bahan bakar dan bahan baku biomassa yang sama yaitu kulit kelapa muda bahan bakar 13 kg dan bahan baku 3 kg, bahan bakar bambu sebesar 13 kg dan bahan baku 3 kg, bahan bakar kulit durian sebesar 8 kg dan bahan baku 1,2 kg. Hasil penelitian yang didapat yaitu kulit kelapa muda menghasilkan asap cair 100 ml dengan karakteristiknya yaitu pH 0.596, viskositas 1.780 CPs dan densitas 0,343 g/cm3 lalu bambu menghasilkan asap cair 120 ml dengan karakteristiknya yaitu pH 0.707, viskositas 2.626 CPs  dan nilai kalori 1983,950 Cal/g, densitas 0,427 g/cm3 dan kulit durian menghasilkan asap cair 74 ml dengan karakteristiknya yaitu pH 0.676, viskositas 1.574 Cps dan nilai kalori 2177,464 Cal/g, densitas 0,271 g/cm3Kata kunci: Pembakaran, Pirolisis, asap cair, biomassa.
Zadovoljstvo roditelja zdravstvenom skrbi djece u Klinici za dječje bolesti Zagreb
Authors: Jurić Marina , Anić Dunja , Begić Nevenka , Hošnjak Ana Marija , Kolačko Štefanija , Luetić Franka
Published: July 2019

Aim. The goal of the research is to assess parent satisfaction with children’s health care in the Children’s Hospital Zagreb and to determine whether there were differences in their assessment with regard
to the clinic at which the child is hospitalized.

Methods. The sample included 160 participans (parents of children hospitalized in the Clinic for Pediatric Surgery and the Pediatric Clinic in the Children’s Hospital Zagreb). As a research method an anonymous modified Picker questionnaire was used. Participation in the research was voluntary.

Results. 36.9% of respondents think that their children’s health care is
excellent, 43.8% think it is very good and 15% think it is good. 58.1% of parents believe that their child was frightened during hospitalization. 53.8% of respondents rated the hospital food as good, 98.8% of them said they have confidence and trust in the doctors and nurses who take care of their child. 4.4% of parents felt they were not sufficiently involved in decision-making about their child. 72.5% of children during hospitalization felt pain. Parents of children hospitalized in surgical departments have a better opinion of alleviating pain.

Conclusions. 81% of respondents assesed the care of their child as very good or excellent and there is no significant difference in satisfaction
with regard to the clinic at which the child is hospitalized. The variables found to have a correlation with the total satisfaction score are: a sense of confidence and trust in doctors, psychological preparation of the child, parents’ perception of participating in their child’s care, quality of the food, perception of parents about safety on
the ward.
Opinions of the final year secondary health care students and the final year students of the undergraduate Nursing study programme sbout organ donation
Authors: Đurić Želimir , Mikšić Štefica , Kurtović Biljana
Published: July 2019

Aim. To examine and compare the opinions of the final year secondary health care students and the final year students of the undergraduate Nursing study programme about the significance of organ donation.

Methods. A cross-sectional study was conducted on a sample of 60 participants of whom 30 were undergraduate Nursing study programme students and 30 were secondary health care students. The research instrument was a questionnaire designed for the purpose of this study, which included the following groups of questions: the first group consisted of questions about the participants’ general data, while the second group contained questions about organ donation itself.

Results. From the obtained results, it was determined that there is no statistically significant difference in the decision to donate organs depending on the level of education. Furthermore, the results show that both groups of participants want to donate organs and the main motivation is to rescue someone’s life. In addition, the majority of participants express the view that such behavior is a humane act.

Conclusion. Education level does not affect organ donation decision making. The main motivation for deciding on donating organs is to rescue
someone’s life. Organ donation is an act of humanity. In the survey, several respondents expressed negative opinion about organ donation. Therefore, it is recommended that workshops aimed at future health professionals, be organized in secondary health care schools and other educational institutions for healthcare professionals to emphasize the importance of organ donation.
Evaluation and care of a polytraumatized patient
Authors: Lovrenčić Petra , Rotim Cecilija
Published: July 2019

Polytrauma is a simultaneous severe injury to at least two body regions where at least one injury, or a combination of multiple injuries, endangers life. The spectrum of injuries and posttraumatic disorders is extremely wide. Most commonly they include shock, hypotension due to bleeding or vital organs injury. Injuries are the leading cause of death
in developed countries today, and proportion of people who experience polytrauma in the total number of the injured is 3%, with a high mortality rate of 22%. Reanimation procedures and understanding of pathophysiology have progressed remarkably, and in the last twenty years, mortality has decreased by twenty percent. Time is a very valuable factor in the treatment of a polytraumatized patient and requires initiation of injury treatment within 60 minutes of its occurrence. In the clinical approach to treatment, algorithms for the treatment of polytrauma are used to achieve the best results of treatment and to reduce posttraumatic complications. Triage is a formal process through which the condition of all the patients is evaluated right after their arrival at the Emergency Department. Triage determines
the urgency of the problem and assesses the allowed and expected waiting time for the beginning of the physician’s examination and treatment of the patient. The approach to a polytraumatized patient is multidisciplinary, includes many specialties and requires continuous education and highly educated staff. High-quality skills, good communication and readiness to respond quickly and efficiently are just some of the key determinants of working with patients with life-threatening conditions.
Promesas y realidades: el fracaso del plan de salida de Estados Unidos de Afganistán (2009-2014)
Authors: Baltar Rodríguez Enrique
Published: July 2019

El presente artículo pretende demostrar que el grave deterioro de la seguridad en Afganistán, luego de la retirada de las fuerzas multinacionales comandadas por la Organización del Tratado del Atlántico Norte (OTAN) en diciembre de 2014, ha sido resultado inevitable del fracaso militar de la estrategia de salida de Estados Unidos. A través del análisis de indicadores relacionados con la violencia y la inseguridad en el país durante el periodo 2009-2014, el artículo sostiene que la estrategia militar diseñada por la administración Obama fracasó en el propósito de asegurar las premisas básicas para que el proceso de traspaso de responsabilidades al gobierno afgano se efectuara en un contexto de estabilidad política relativamente consolidado. En consecuencia, los niveles de violencia e inseguridad registrados después de 2014 forman parte de una misma tendencia de continuidad claramente establecida en años anteriores.
Análisis y comparación del concepto de dao en las tres interpretaciones clásicas del Laozi
Authors: Costantini Filippo
Published: July 2019

Se analiza y compara el concepto de dao en los tres comentarios más influyentes del Laozi, y, en particular, cómo las distintas lecturas del dao en los tres textos se relacionan con diferentes épocas históricas, tradiciones, objetivos y autores de los comentarios. Por ejemplo, la tradición de la escuela Huang-Lao, con su interés en teorías cosmológicas y prácticas de autocultivo, impregna el comentario Heshang gong y su visión del dao como principio cósmico accesible y cognoscible. Por otra parte, en el Xiang Er, la institución religiosa de los Maestros Celestiales plasma el Laozi como texto sagrado y el dao como una divinidad con preceptos claros e inteligibles. A su vez, la relativa libertad interpretativa de Wang Bi, desprovista de influencias exegéticas ortodoxas, junto con la búsqueda de una coherencia interna en el texto, genera un comentario totalmente distinto de la tradición interpretativa anterior. El Laozi se convierte en manual de sabiduría que revela el dao como fundamento lógico del mundo.
Desain Pengembangan Kerjasama Kelembagaan dalam Peningkatan Profesionalisme Civitas Akademika di Fakultas Ilmu Tarbiyah Dan Keguruan (FITK) IAIN Surakarta
Authors: Munadi Muhammad , Wahyuningsih Retno , Khuriyah Khuriyah
Published: July 2019

This research aims to understand the reality of cooperation management, the reality of cooperation development and development design of institutional cooperation on the improvement of civitas academic professionalism in IAIN Surakarta. This research is categorized as non-positivistic research in which in its analysis, it emphasizes more on the words of the object under study. This study was located in Faculty of Education and Teacher Training since it has a lot of spaces for profession development, especially a space for Field Experience Practice (Praktek Pengalaman Lapangan / PPL) program that nearly covers madrasah/schools in eks-Karesidenan Surakarta, a space for Fieldwork Study (Kuliah Kerja Lapangan), and madrasah/schools empowerment activity. The subject of this research is 4 heads of department, 3 heads of deanship and 3 rectorate officials. Data collection technique is using interview, observation, and documentation. Data validity technique is using source and method triangulation. Data analysis is using interactive analysis model. The result of this research shows that: The reality of cooperation management is still “top down” when it is related to the draft planning of collaboration paper. The reality of cooperation development which was started from cooperation without legal protection develops into the one with legal protection. Cooperation development design is developed through user mapping, strengthen the cooperation with school partners which focuses not only on PPL implementation but also on “give and take” activity which has yet happened between madrasah/schools and faculties in IAIN Surakarta.
Evaluasi Implementasi Kurikulum 2013 pada Mata Pelajaran Matematika Di SMP Negeri
Authors: Mowendu Apriyani Lisnawati , Slameto Slameto , Dwikurnaningsih Yari
Published: July 2019

Curriculum 2013 is one of government’s strategic to decrease the quality of education. SMP Negeri 7 Salatiga is one of school that has implemendted the curriculum since 2014. This evaluation research departs from the problem that found on implementation of curriculum 2013 at SMP Negeri 7 Salatiga, especially on math. The purpose of this study is to describes the implementation of curriculum 2013, especially on math subject at SMP Negeri 7 Salatiga. The subjects of this research are the student and math teachers in SMP Negeri 7 Salatiga. Data collection techniques used in this research were interviews, observation, questionnaires and documentation. Data analysis technique used in this research is descriptive qualitative. This study describes how the implementation of curriculum 2013 in schools is based on model of countenance stake evaluation and is guided by the standards that used. The results showed that: 1) at the antecedents stage, 100% meet the standards of the kurikulum 2013 tools and lesson planning; 2) at the transaction stage, 40% have not met the standards for learning implementation and 40% have not met the standards for the authentic assessment; 3) at the outcomes stage of 83.3% not meeting the standards for authentic assessment results.
Kepemimpinan Guru Pendidikan Agama Kristen
Authors: Lumban Gaol Nasib Tua , Nababan Andrianus
Published: July 2019

Christian religious teacher leadership contributes to improving the learning process quality in school and national education contexts. Ironically, Christian religious teachers are still lacking knowledge in leadership, and not applying adequate leadership in the learning process. Thus, this paper was aimed to describe some characteristics of Christian religious teacher leadership that should be implemented. Based on the result of reviewing, these were found some of Christian religious teacher leadership characteristics: (1) serving students with the heart; (2) acting fair according to the truth of God's word; (3) having optimistic to educate; (4) able to manage time well; (5) loving students; (6) making decision objectively and firmly. In an effort to develop the Christian religious teacher leadership, further research and studies are needed to conduct in order to build the Christian religious teacher leadership concept.
Coexistence of Fabry Disease and immune complex glomerulonephritis: report of two cases in a single family
Authors: Neto José Tibúrcio do Monte , Aldeman Nayze Lucena Sangreman , Chaves Roosevelt Valente , Silva Adalberto Socorro da , Pereira Ester Miranda , Brandão Rafael Melo Santos de Serpa , Lima Antonio Vanildo de Sousa , Filho Daniel Santos Rocha Sobral , Monte Semiramis Jamil Hadad do
Published: July 2019

Objective: To describe two cases of Fabry disease (FD) from the same family nucleus associated with Membranous Nephropathy (MN) and Systemic Lupus Erythematosus (SLE). Case report: We present an index case of a 61-year-old man with nephrotic syndrome and FD (c.1046G>C p.W349S) and his daughter with systemic lupus erythematosus. Appropriate diagnosis based on renal biopsy allowed to conclude that it was, in fact, a primary membranous glomerulopathy caused by the formation of autoantibody against phospholipase A2 receptor and a class V nephritis, respectively, in the index case and his daughter, associated to glycosphingolipid inclusions in renal cells with areas of podocyte effacement. Final considerations: Although FD diagnosis be performed by biochemical and molecular tests, a detailed analysis of the kidney biopsy is essential to diagnose the coexistence of FD and autoimmune diseases, thus allowing a more adequate treatment.
Avaliação das alterações do sono em crianças com síndrome do respirador oral
Authors: Silva Caroline Feliz Fonseca Sepeda da , Gomes Vanessa Coutinho Aguiar , Vilas Boas Louise Silva e Silva , Pezzin Angélica Cristina
Published: July 2019

Metodologia: trata-se de um estudo descritivo transversal e observacional, realizado no Hospital Universitário Bettina Ferro de Souza (HUBFS). Os dados foram colhidos através de um questionário. Resultados: Dentre os pacientes avaliados 57,9% eram do sexo masculino, na faixa etária de 5 a 10 anos (57,4%), seguido de 3 a 4 anos (21,5%). Em relação às manifestações verificadas, ronco (84,6%), sono agitado (75,4%), irritabilidade (65,1%) e apneia (60,5%) se mostraram os mais prevalentes, além da presença em praticamente metade dos pacientes (46,7%) de comorbidades como rinite alérgica e asma. Conclusão: O sexo masculino e a faixa etária entre 5 a 10 anos são fatores importantes na suspeição de sintomas relacionados à SRO. O ronco como sintoma mais frequente durante o sono, demonstrando a ocorrência da respiração oral nestes pacientes, serve de alerta para os responsáveis e profissional de saúde na investigação e, consequente diagnóstico precoce da SRO.
Colecistectomia videolaparoscópica em vesícula biliar duplicada: relato de caso
Authors: Pimenta Eduardo Augusto Pinheiro , Printes Thais Regina Moreira , Bendaham Nayandra Sales , Rodriguez Juan Eduardo Rios , Bendaham Nastassja Sales , Matos Elizeu Rodrigues , Meirelis Suany Serudo , Barbosa Danielle Alcântara
Published: July 2019

Objetivos: Apresentar um paciente com variação anatômica na vesícula biliar do tipo vesica fellea divisa, que, apesar de congênita, só foi evidenciada na quarta década de vida após um fator desencadeante sintomático. Relato de caso: Paciente masculino, 41 anos, relatava dor difusa de leve intensidade em hipocôndrio direito aliviada com uso de sintomáticos. Negava qualquer manifestação colestática. Referiu início do sintoma há dois anos, quando apresentou episódio álgico de maior intensidade e com irradiação para tórax, necessitando de internação por quatro dias. À exceção da dor em hipocôndrio direito na palpação profunda, o exame físico não mostrou alterações. A ultrassonografia realizada sugeriu presença de vesícula biliar bilobulada com presença de múltiplos cálculos em seu interior. Considerações finais: A importância clínica do caso está associada com o desenvolvimento de colelitíase, uma vez que a condição anatômica promove uma drenagem inadequada da bile e também com um maior risco de complicações perioperatórias, sendo esta condição considerada uma das mais associadas à lesão iatrogênica do ducto biliar durante realização de colecistectomias. Conclui-se que a conduta mais efetiva após a sua identificação é a retirada total do órgão, de modo a evitar reoperações, tendo em vista o mau prognóstico advindo da anomalia.
Acidentes ocupacionais com materiais biológicos notificados em um hospital público de Teresina-PI
Authors: Marques Jaciane Santos , Santana Rosane da Silva , Gomes Cecilia Natielly da Silva , Damacena Denize Evanne Lima , Neves Vivian Lara Silva Neves , Gomes Aline Tavares , Meneses Marilyse de Oliveira , Marques Naiana Maria Diogo da Silva , Santana Edvan
Published: July 2019

Objetivo: Identificar os acidentes ocupacionais com material biológico notificados em um hospital público em Teresina/PI. Métodos: Trata- se de estudo descritivo e exploratório com abordagem quantitativa. A amostra constituiu-se de 88 fichas notificadas. O instrumento de coleta foi elaborado segundo a ficha de notificação do SINAN. O estudo foi aprovado por Comitê de Ética em Pesquisa. Resultados: Dentre os acidentados, 72 (81,82%) ocorreu em mulheres, 40 (45,45%) com idade variando entre 21 a 30 anos, e 50 (56,82%) correspondem aos profissionais da enfermagem. Quanto à exposição, 77 (87,5%) dos acidentes foram pela via percutânea e 81 (92,04%) dos casos o material orgânico presente foi o sangue. Sobre a circunstância do acidente, 26 (29,55%) foram registrados no campo “outros”, porém, sem especificação do acidente, e em 67 (76,14%) a agulha com lúmen foi o principal objeto causador dos acidentes. No tocante a situação vacinal, 62 (70,45%) referiu possuir esquema completo da vacina contra a Hepatite B e 67 (76,14%) que iniciaram o acompanhamento sorológico, abandonaram o tratamento. Conclusão: Há a necessidade de educação permanente quanto aos riscos e prevenção dos acidentes laborais, além da importância da notificação imediata e do acompanhamento sorológico completo.
Os efeitos dos Exercícios de Kegel em idosas com Incontinência Urinária: uma Revisão Sistemática
Authors: Silveira Celiane da Mota , Cavalcante Albério Ambrósio , Ribeiro Edna Graziele de Conceição
Published: July 2019

Objetivo: Analisar os efeitos dos Exercícios de Kegel (EK) em idosas com Incontinência Urinária (IU) realizado pelo fisioterapeuta. Métodos: Revisão sistemática, nela realizou-se pesquisas em várias bases de dados, como: Lilacs, Medline e Scielo. Dessa forma, foram encontrados uma amostra de 11 artigos que estavam de acordo com os critérios de inclusão. Vale ressaltar que foram selecionados artigos publicados em inglês, português e espanhol no período entre 2010 e 2019. Resultados: Após a captação dos artigos foi realizada uma análise dos resultados desses estudos tendo como resultado a confirmação da satisfação das pacientes em perceber que houve uma diminuição dos seus sintomas com um tempo pequeno através do tratamento utilizando EK. Pode-se perceber também que os trabalhos no Brasil realizados sobre esse assunto ainda se encontram limitados e de amostras reduzidas. Conclusão: Assim, verifica-se a necessidade de programas que possibilite a difusão e implementação do tratamento da IU pelo fisioterapeuta, para que quando implementados possam oferecer um tratamento convencional menos oneroso, sem custo e com principal foco: a atenção à saúde da mulher, para garantir sua melhor qualidade de vida.
Prevalência do não uso de preservativo entre universitários e pós-graduandos de uma universidade pública do Norte do Brasil
Authors: Freitas Jeanne Lúcia Gadelha , Pereira Priscilla Perez da Silva , Moreira Kátia Fernanda Alves , Silva Adriana Dias
Published: July 2019

Objetivo: Identificar a prevalência do não uso do preservativo nas últimas cinco relações sexuais entre universitários de uma instituição pública do Norte do Brasil. Métodos: Estudo transversal, com 772 estudantes do ensino superior e pós-graduandos. Foi utilizando um questionário fechado com respostas autorreferidas. A razão de prevalência das variáveis foi analisada pela regressão de Poisson. Resultados: A maioria dos participantes são adultos jovens, sexualmente ativos, com parceiro único e utilizaram o preservativo em pelo menos uma vez das últimas cinco relações sexuais. O não uso do preservativo teve maior prevalência entre estudantes com parceiro único, acima de 40 anos e cursando os últimos períodos dos cursos. Conclusões: Os universitários com um único parceiro sexual em períodos finais de curso estão mais vulneráveis às Infecções Sexualmente transmissíveis pelo uso inconsistente do preservativo. A universidade pode ser um ambiente propicio para ações de promoção à saúde sexual e reprodutiva que visem alcançar, sobretudo os estudantes com parceiro único e em vias de conclusão do curso.
Situação epidemiológica da malária em uma região de Garimpo, na região da Amazônia brasileira, no período de 2011 a 2015
Authors: Lopes Thalyta Mariany Rêgo , Ventura Ana Maria Revorêdo da Silva , Guimarães Ricardo José de Paula Souza e , Guimarães Luis Henrique Rocha
Published: July 2019

Objetivo: Analisar os aspectos epidemiológicos e ambientais da maláriaem uma região de mineração na Amazônia brasileira. Métodos: Estudo ecológico, retrospectivo, realizado em Itaituba - Pará. Os dados epidemiológicos foram coletados dos bancos do Sistema de Informação de Vigilância Epidemiológica – malária e do Instituto Brasileiro de Geografia e Estatística, do período de 2011 a 2015, e de 28 localidades do munícipio (dados de campo). Os dados ambientais foram coletados do Sistema de Informação Meteorológica Automática de Superfície, do Instituto Nacional de Meteorologia e Sistema de Monitoramento do Desmatamento na Amazônia Legal do Projeto e dados do Sistema de Mapeamento da Degradação Florestal da Amazônia Brasileira, do Instituto Nacional de Pesquisas Espaciais. Resultados: A malária predominou no gênero masculino (71,9%), na faixa etária de 20 a 39 anos (56,5%). A incidência de malária teve uma relação inversa com os níveis de precipitação. Conclusão: Oconhecimento sobre a epidemiologia da malária pode auxiliar na implementação de políticas públicas para diminuir a prevalência da malária e ajudar a comunidade a aprender como usar a floresta de maneira sustentável.
Efeitos do Treinamento Resistido em Obesos: uma revisão integrativa
Authors: Dutra Priscila Taciana Barbosa , Silva Nayra Suze Souza e , Carvalho Priscilla Durães de , Santos Bruna Nathália , Filho Walter de Freitas , Gomes Nayara Teixeira , Pereira Isabel Cristina Alves , Arcanjo Izabella Nascimento , Cruz Vitória Paula Dias , Pereira Sabrina Gonçalves Silva
Published: July 2019

Objetivo: Revisar na literatura científica a respeito dos efeitos do treinamento resistido em obesos de qualquer faixa etária. Material e métodos: Trata-se de uma revisão integrativa, de caráter teórico e descritivo. Foram incluídos no estudo artigos originais (quantitativos e qualitativos) publicados até dezembro de 2018. Os artigos foram selecionados nas bases de dados PUBMED, PERIÓDICOS CAPES e LILACS. Foram utilizados os descritores musculação, treinamento e obesidade. Resultados e discussão: Obteve-se inicialmente 596 publicações, sendo 11 artigos selecionados no final para construção da revisão. A maioria dos artigos selecionados apresentaram diversos benefícios da prática do treinamento resistido em praticantes obesos, como ganho de massa magra, perda de peso e melhorias na qualidade de vida. Conclusão: Diante dos dados apresentados é possível observar os diversos benefícios para a saúde dos praticantes obesos. Esses resultados revelam a necessidade de programas de promoção e prevenção da saúde que alcancem toda população, inclusive pessoas com sobrepeso e obesidade.
Dermatopathology: An Exciting, Innovative, and Compelling Dermatology Subspecialty Worthy of Continued Consideration among Dermatology Residents
Authors: Brodell MD Robert Thomas , Ferringer Tammie
Published: July 2019

Perhaps because of reimbursement concerns, there has been a decrease in interest in dermatopathology among dermatology residents.  A case is made for the compelling aspects of a career in dermatopathology for clinical dermatologists.
Establishing an evidence-based decision point for clinical use of the 31-gene expression profile test in cutaneous melanoma
Authors: Marks Etan , Caruso Hillary G. , Kurley Sarah J , Ibad Sidra , Plasseraud Kristen M , Monzon Federico A , Cockerell Clay J
Published: July 2019

Treatment plans for cutaneous melanoma are based upon individual risk of recurrence. Decisions made post-diagnosis include recommendation for a sentinel lymph node biopsy (SLNB), followed by management decisions such as surveillance, frequency of follow-up, and interdisciplinary consultations including possible adjuvant therapy use. These have traditionally been guided by clinicopathologic factors, but discordance exists, as a substantial number of melanoma deaths occur in patients diagnosed with disease considered to be early stage by such factors, including a negative SLNB.  Molecular testing can be used to apply an objective approach that optimizes individualized patient care.  The 31-gene expression profile (31-GEP) test has been validated in nearly 1600 patients as an independent predictor of risk of recurrence, distant metastasis and death in Stage I-III melanoma and can guide SLNB decisions in patient subgroups, as demonstrated in 1421 patients.  While clinical use of the 31-GEP test has been adopted into routine practice, an evidence-based analysis of a decision point for use in thin, T1 tumors would be clinically useful.  To help define an appropriate population for 31-GEP testing, we evaluated changes in patient management, cumulative differential risk across Breslow thicknesses based on a large dataset, and 31-GEP subclass distribution in a clinically tested cohort. Based on this, appropriate use of the 31-GEP test for management decisions was found to be in cutaneous melanoma tumors ≥0.3 mm thick.
Identifying changes in trends in the age standardized incidence of melanoma in Australia
Authors: Hille David M
Published: July 2019

ObjectiveTo identify changes in the linear trend of the age-standardized incidence of melanoma in Australia for all persons, males, and females. MethodsA two-piece piecewise linear regression was fitted to the data. The piecewise breakpoint varied through an iterative process to determine the model that best fits the data.ResultsStatistically significant changes in the trendof the age-standardized incidence of melanoma in Australia were found for all persons, males, and females. The optimal breakpoint for all persons and males was at 1998. For females, the optimal breakpoint was at 2005. The trend after these breakpoints was flatter than prior to the breakpoints, but still positive.ConclusionMelanoma is a significant public health issue in Australia. Overall incidence continues to increase. However, the rate at which the incidence is increasing appears to be decreasing.
CVID-associated Granulomatous Dermatosis Resembling Sarcoidosis
Authors: Zambito Jeanette R , Shah Pooja R , Scott Glynis A , Evans Andrew , Beck Lisa A
Published: July 2019

Common variable immunodeficiency (CVID) is a disorder of the adaptive immune system predominantly characterized by hypogammaglobulinemia and variable T-cell abnormalities. Patients classically present with recurrent sinopulmonary infections, but interstitial lung disease, autoimmunity, and lymphoproliferative disorders are also common. Approximately 10% of CVID patients are reported to have noncaseating granulomatous disease that is indistinguishable from sarcoidosis on pathology; it most commonly affects the lungs, lymph nodes, and liver.We present the case of a 75-year-old male with known CVID who presented with granulomatous dermatosis on the trunk and extremities in the setting of progressive cognitive impairment, new-onset cough with ground glass opacities on chest computed tomography in the setting of stable mediastinal lymphadenopathy, and the presence of granulomas on prior bone marrow biopsy, initially suggesting the diagnosis of sarcoidosis. Though clinically and histologically similar, it is important to make the distinction between CVID-associated granulomatous disease and sarcoidosis in order to select appropriate treatment.
Lepromatous leprosy: an elusive mimicker mistaken for polyarteritis nodosa and disseminated tuberculosis
Authors: Fasciano Danielle , Innes Matthew , Dorn David , Ullman David , Reddy Vishnu , Ergen Elizabeth , Pavlidakey Peter
Published: July 2019

Leprosy is a chronic infectious disease caused by the obligate intracellular microorganism, Mycobacterium leprae and presents as skin lesions and peripheral neuropathies with upper respiratory mucosa involvement. We present a case of a 36-year-old immunocompromised female whom was recently diagnosed polyarteritis nodosa vasculitis (PAN) in Trinidad and returned back to the US with a two week history of pleuritic chest pain, fever, chills, fatigue, nausea, vomiting, epistaxis and cough.  Physical examination revealed a diffuse rash. Pancytopenia prompted a bone marrow biopsy, which revealed acid-fast bacteria, suspicious for disseminated tuberculosis. Histologic examination of the skin lesions revealed disseminated acid-fast, Fite-positive microorganisms within the dermis and nerves. She developed anuric renal failure and purpura fulminans with disseminated intravascular coagulation (DIC). PCR results from the skin sample shortly thereafter revealed the presence of M. leprae DNA. Mycobacterium tuberculosis complex DNA was not identified.This case demonstrates an unusual presentation of leprosy with bone marrow involvement and highlights the importance of utilizing histologic examination together with molecular diagnostic techniques to aid in establishing the correct diagnosis and treatment. This case also cautions that leprosy can be misdiagnosed as a vasculitis, specifically PAN, as there is overlap in the clinical presentation of each disease and that clinicopathologic correlation is essential.
A case of cutaneous metastatic adenosquamous carcinoma of the cervix
Authors: Novice Taylor Shea , Oberlin David , McHargue Chauncey
Published: July 2019

Introduction:Cutaneous metastasis of cervical carcinoma is very rare, with a reported incidence of .1 to 2%. The adenosquamous carcinoma subtype has been reported the least.3-5 We present a case report of ulceronodular cutaneous metastasis of adenosquamous carcinoma of the cervix.Case Description:A 50-year-old African American female with an eleven-year history of metastatic adenosquamous carcinoma of the cervix presented to the emergency department with an asymptomatic rash in her groin for one-month duration. On physical exam, there were hyperpigmented to violaceous papulonodules across the mons pubis and three ulcerated plaques of the left mons pubis. Punch biopsy was consistent with metastases of cervical adenosquamous carcinoma. No disease specific interventions were taken, and the patient passed away five weeks later.Discussion:Cervical cancer rarely metastasizes to the skin, with a reported incidence of .1 to 2%. Among the subtypes, cutaneous metastasis of cervical adenosquamous carcinoma has been reported the least. In a review of 1185 cases of cervical cancer, Imachi et al found that only 15 cases spread cutaneously, none of which were adenosquamous carcinoma.5 Cutaneous metastases of cervical carcinoma predict a poor prognosis, with an average length of survival of three months.6Our patient developed cutaneous metastases eleven years after diagnosis, which is to our knowledge the longest reported interval from initial diagnosis to development of cutaneous metastases. Although rare, it is important to recognize cutaneous metastases of adenosquamous carcinoma of the cervix as it predicts a poor prognosis and treatment has not been shown to improve outcomes.
Estrategia para la gobernanza de datos abiertos de salud: un cambio de paradigma en los sistemas de información
Authors: D’Agostino Marcelo , Marti Myrna , Mejía Felipe , de Cosio Gerardo , Faba Gladys
Published: July 2019

Para la formulación o revisión de políticas, planificación, innovación, investigación, medición del progreso, barreras u oportunidades, se requiere de acceso abierto a datos confiables, información y conocimiento calificado. Esto forma parte de los principios del Código Sanitario Panamericano y de la Constitución de la Organización Panamericana de la Salud. Entre 1950 y 1978, el tema de recolección de datos de salud, en particular sobre estadísticas vitales, se manifestó de manera expresa en cada una de las primeras siete ediciones de la publicación conocida como “Salud en las Américas”. Sin embargo, y a pesar de reconocerse una mejora considerable en la calidad de los datos, se reconoce desde el inicio de los 80 que los sistemas de información en salud de los países requieren de una modernización constante para proporcionar datos de salud con mejor calidad, cobertura y oportunidad para la toma de decisiones informadas. A partir del auge de Internet, el creciente acceso a tecnologías de información y comunicación, y hoy en día con las redes sociales, el aumento de contenidos disponibles se ha masificado y crece de manera exponencial, no estructurada, no clasificada y, muchas veces, sin control. Esta situación obliga a las instituciones de salud a adoptar estrategias y estándares para la gestión de datos abiertos que permitan fortalecer calidad, confidencialidad y seguridad de los mismos. Se propone una estrategia de gobernanza de datos de salud con herramientas, conceptos y recomendaciones que permitirán a los países generar datos abiertos y de mayor calidad, así como confiables y seguros.
Stature is inversely associated with self-reported diabetes in middle-aged Mexican women
Authors: Lopez-Ridaura Ruy , Puchner Karl P , Ortiz-Panozo Eduardo , Vieitez Isabel , Lajous Martín
Published: July 2019

Objective. To investigate whether stature is associated with two highly prevalent cardiom- etabolic disorders—diabetes mellitus (DM) and high blood pressure (HBP) —in middle-aged Mexican women.

Methods. We conducted a cross-sectional analysis of a sample of 93 481 middle-aged Mexican female teachers, all participating in the Mexican Teachers Cohort (MTC, or ESMaestras) study. We used a multivariable regression model to investigate the association of stature quintiles with the self-reported outcomes of DM and HBP.

Results. After adjusting for birth cohort, ethnicity, family history, birthweight, occupation of household’s head during participant’s childhood, menopausal status, and geographical region of birthplace, stature was inversely associated with DM, with the odds for DM being 9% higher in the lowest stature quintile when compared to the highest stature quintile. Stratification for location of residence resulted in confirmation of the above-mentioned findings only in partici- pants living in urban environments.

Conclusions. We found an inverse association of stature with DM but not with HBP. Our data suggest that urban setting might be an important effect modifier of this association, which merits further investigation since it might provide valuable insights into the epidemiological transition occurring in developing countries.
La evaluación de tecnologías sanitarias en el Ministerio de Salud Pública de Ecuador como herramienta para la compra de medicamentos entre 2012 y 2015
Authors: Armijos Luciana , Villacrés Tatiana , Escalante Santiago
Published: July 2019

Objetivo.Conocer el uso de la evaluación de tecnologías sanitarias (ETS) en la toma de decisiones del Ministerio de Salud Pública (MSP) del Ecuador para la compra de medicamentos que no se encuentran en el Cuadro Nacional de Medicamentos Básicos (CNMB).

Métodos.Con la información de las bases de datos de la Dirección de Inteligencia de la Salud (DIS) y la Dirección Nacional de Medicamentos y Dispositivos Médicos (DNMDM), se compararon las decisiones tomadas por ambas instancias, para conocer el uso y la congruencia de los informes de ETS en las decisiones de compra de los medicamentos no incluidos en el CNMB.

ResultadosEntre 2012 y 2015, se han elaborado 227 informes, de los cuales 87 corresponden a medicamentos, 36 a dispositivos, 29 a procedimientos médicos, 34 a programas sanitarios, y 41 a otras tecnologías médicas. De los informes de medicamentos, 59 fueron solicitados por la DNM. La concordancia entre las decisiones tomadas por las dos direcciones que participan en el proceso alcanzó 80%.

Conclusiones.La ETS se inició en el MSP en 2012 a través de la DIS. Considerando que la mayoría de informes evalúan medicamentos, es indispensable que se desarrollen informes para otros tipos de tecnologías médicas y que se difunda al máximo su desarrollo y uso. A pesar de que el nivel de concordancia entre las decisiones es elevado, es importante seguir mejorando el alcance y la calidad de los informes, así como monitorizar la incorporación y difusión de las tecnologías autorizadas y financiadas para conocer la efectividad y el impacto de la ETS en Ecuador.
First detection of dengue and chikungunya viruses in natural populations of Aedes aegypti in Martinique during the 2013 – 2015 concomitant outbreak
Authors: Farraudière Laurence , Sonor Fabrice , Crico Said , Étienne Manuel , Mousson Laurence , Hamel Rodolphe , Missé Dorothée , Failloux Anna-Bella , Simard Frédéric , Yébakima André
Published: July 2019

Dengue and chikungunya viruses are transmitted by Aedes mosquitoes. In Martinique, an island of the French West Indies, Aedes aegypti is the suspected vector of both arboviruses; there is no Aedes albopictus on the island. During the concomitant outbreak of 2013 – 2015, the authors collected wild A. aegypti populations, and for the first time, detected dengue and chikungunya viruses in field-collected females. This paper demonstrates the mosquito’s role in transmission of both dengue and chikungunya on the island, and also highlights a tool that public health authorities can use for preventing outbreaks.
Minimum infectious dose for chikungunya virus in Aedes aegypti and Ae. albopictus mosquitoes
Authors: Powers Ann M , Ledermann Jeremy P , Borland Erin M
Published: July 2019

Understanding the ability of the chikungunya virus (CHIKV) to be transmitted by Aedes vectors in the Americas is critical for assessing epidemiological risk. One element that must be considered is the minimum infectious dose of virus that can lead to transmission following the extrinsic incubation period. This study aimed to determine the minimum infection rate for the two Aedes species studied. The results revealed that doses as low as 3.9 log10 plaque-forming units per mL (pfu/mL) of an Asian genotype CHIKV strain can lead to transmission by Ae. albopictus, and doses of at least 5.3 log10 pfu/mL from the same strain are needed for transmission from Ae. aegypti. These low infecting doses suggest that infected individuals may be infectious for almost the entire period of their viremia, and therefore, to prevent further cases, measures should be taken to prevent them from getting bitten by mosquitoes during this period.