bluuebunny/crossref_metadata_2025 huggingface dataset:
Responsabilisation des femmes enceintes et soins différenciés dans le suivi médical du diabète de grossesse
Authors: Racioppi Aurélie
Published: June 2022

Cet article est issu d’une recherche doctorale portant sur la surveillance médicale des femmes enceintes atteintes de diabète gestationnel (DG) dans deux maternités publiques d’Île-de-France. Dans un contexte de médicalisation de la grossesse et d’un dépistage intensif du DG, je compare les modalités de prise en charge de la maladie dans ces deux maternités et j’analyse comment elles peuvent conduire à des soins différenciés. Bien qu’elles varient, ces modalités reposent en grande partie sur « l’observance » des femmes enceintes. Pour les professionnelles de santé, obtenir une bonne observance de la part de leurs patientes prend la forme d’une délégation des soins. Cette délégation leur permet de maîtriser les risques de la maladie mais également de soulager l’organisation des services de diabétologie et de maternité. Elle s’appuie sur l’autonomie des femmes dans leur prise en charge, ce qui pose plus de difficultés aux femmes des classes pauvres et populaires. Ces dernières doivent alors compenser par elles-mêmes les failles institutionnelles telles que l’absence de traducteur·rice ou d’alternative au suivi numérique, ce qui constitue un frein dans leur accès à des soins de qualité.
Des soins différenciés aux violences en salle de naissance : études en Afrique de l’Ouest et du Centre
Authors: Vasseur Patricia , Kane Hélène , Le Grand Fosso Albert
Published: June 2022

Malgré la promotion de référentiels et guides de bonnes pratiques, les soins de l’accouchement en Afrique de l’Ouest et du Centre demeurent très différenciés, exposant certaines femmes à des relations dégradées et à des prises en charge médicales de moindre qualité. L’analyse de données d’enquêtes anthropologiques menées dans cinq pays sur une quinzaine d’années montre l’existence de discriminations fondées sur l’âge, le statut marital, la parité, l’ethnicité et la pauvreté dès les premiers contacts. La différenciation des soins se construit dans les manières de produire du soin. Elle relève de l’ordinaire des rapports sociaux et s’accorde à des formes de personnalisation des soins. Cependant, pour certaines femmes discriminées, elle se traduit parfois par une violence qui s’exacerbe à l’approche de la naissance. Les incertitudes obstétricales ainsi que le sentiment d’impuissance favorisent une irritabilité professionnelle et la survenue de maltraitances, au-delà de l’intention des soignants. Des formes de violences physiques et verbales admises hier le sont de moins en moins aujourd’hui, témoignant d’un changement des sensibilités.
De la réanimation à l’accompagnement de la fin de vie : les répertoires pluriels de la prise en charge en médecine intensive-réanimation
Authors: Denise Thomas
Published: June 2022

Partant d’une enquête ethnographique menée dans trois services hospitaliers français entre 2012 et 2018, cet article vise à rendre compte des parcours de soins et de fin de vie en réanimation. Nous montrons que la trajectoire de la maladie se découpe en trois phases – curative, d’attente, palliative – au cours desquelles les soignant·e·s mobilisent des répertoires d’actions sensiblement différents. Oscillant entre une approche clinique et des savoirs informels, ces répertoires produisent des changements ontologiques qui redéfinissent le statut du malade. Le passage du statut de malade curable à celui de malade incurable conduit à une réorganisation de l’arc de travail autour de la fin de vie, et dans lequel les soignant·e·s œuvrent à une définition de la « bonne mort ». Le travail entrepris auprès du malade et de sa famille montre que la prise en charge de la fin de vie reste soumise à l’appréciation des équipes en même temps qu’elle constitue un espace d’échange et de discussion à travers lequel les proches peuvent se réinvestir.
Accoucher à Melilla. Les pratiques médicales à l’épreuve des « parturientes sans droits » à la frontière hispano-marocaine
Authors: Rico Berrocal Raquel
Published: June 2022

Cet article propose une analyse des soins différenciés en santé périnatale à partir d’une enquête ethnographique réalisée à la frontière hispano-marocaine de Melilla. Le contexte géopolitique rassemble des conditions propices aux processus de catégorisation sociale et des inégalités de soins, notamment des personnes considérées comme non légitimes à bénéficier d’une prise en charge à l’hôpital. Les discours sur les préjudices causés par l’arrivée de Marocaines enceintes sans suivi médical décrivent une institution qui ne disposerait pas des outils nécessaires pour affronter les vicissitudes de sa situation. Un travail de terrain de deux ans dans la maternité de l’enclave a permis de mettre en évidence les tensions entre les instances locales et centrales, qui se traduisent par de pratiques médicales inconcevables dans un autre contexte. L’accouchement des étrangères y est vécu comme une menace, tout comme ceux des Mélilliennes qui partagent une caractéristique commune avec elles : l’ethnicité. La discrimination dans les pratiques médicales est une manière de défendre l’institution et « l’espagnolité » de l’enclave, tout en renforçant la vulnérabilité d’une partie des professionnel·le·s et des usagères.
Santa Elina, Mato Grosso, site ancien au centre de l’Amérique du Sud
Authors: Vialou Denis , Vialou Águeda Vilhena
Published: June 2022

L’abri rupestre Santa Elina, par son positionnement géographique et son ancienneté pléistocène, renouvelle l’analyse des peuplements préhistoriques sur le continent sud-américain. Dans la Serra où l’abri paraît dissimulé, des hommes du Pléistocène ont chassé un Glossotherium, voici 27 000 ans. Une seconde fois, vers 11 000 ans, à nouveau un paresseux géant fut chassé dans le même milieu protégé. Industries lithiques et ossements constituent des contextes archéologiques assez fournis. Santa Elina participe des premiers peuplements sud-américains, dans un contexte paléontologique devenu ensuite fossile.
Les « rituels » dans la publication de photos sur le réseau social Instagram : une étude appliquée au contexte brésilien
Authors: Eglem Élisabeth
Published: June 2022

Cet article analyse les « rituels » mis en œuvre dans les photos publiées sur le réseau social Instagram. Il en interroge les modalités et significations dans le cas de la société brésilienne imprégnée de spiritualité latente mais aussi marquée par la culture de la consommation. La méthodologie est « netnographique ». La discussion met en relation les informations issues du terrain et les éléments théoriques.
De la Dordogne aux tropiques : les missions archéologiques françaises au Brésil
Authors: Barreto Cristiana
Published: June 2022

Cet article revisite l’histoire des missions archéologiques françaises au Brésil à travers l’examen critique de leurs contextes institutionnels, académiques et scientifiques, et vise à approfondir la compréhension de l’influence française sur l’histoire de l’archéologie brésilienne. Il met en évidence les aspects scientifiques et diplomatiques qui ont donné naissance à de longs programmes de recherche au Brésil et le caractère empirique de l’américanisme français, l’accent mis sur les origines de « l’Homme américain » et la préférence donnée aux études de contextes anciens en amenant aux tropiques une « science préhistorique » issue notamment des fouilles des sites de Dordogne mais aujourd’hui pratiquée dans une perspective globale.
Le Zé Limeira réel et le « poète de l’absurde » : la question raciale dans la construction des espaces de la cantoria nordestine (1940-1970)
Authors: Iumatti Paulo Teixeira
Published: June 2022

Le texte se penche sur la trajectoire du cantador noir Zé Limeira, du point de vue de son insertion dans l’univers de la cantoria de viola, et recourt pour cela à la confrontation entre, d’une part, les indices de son existence réelle, et d’autre part, sa construction dans la fiction, par Orlando Tejo, comme « poète de l’absurde ». Avec cette lecture, je m’efforce de comprendre comment le racisme a imprégné les espaces de la cantoria nordestine tout au long du XXe siècle.
Un « port maudit » : les épidémies de fièvre jaune à Santos (1889-1895)
Authors: Carmo Bruno Bortoloto do
Published: June 2022

À la fin du XIXe siècle, plusieurs villes portuaires des tropiques furent considérées inhospitalières pour l’homme blanc européen. Cet article porte sur l’inscription de la ville brésilienne de Santos (État de São Paulo) dans cette liste des ports surnommés « white man’s grave ». À partir de l’examen de manuscrits et journaux de l’époque, les activités du port paulista sont examinées durant la crise sanitaire qui qui a sévi entre 1889 et 1895, afin de comprendre comment il a pu être assimilé à un « port maudit » et considéré comme une destination à éviter.
Plantes et peuplement : questions et enjeux relatifs à la manipulation et à la domestication de végétaux au Pléistocène final et à l’Holocène initial au Brésil et en Amazonie
Authors: Shock Myrtle P. , Watling Jennifer
Published: June 2022

Dans cet article, nous remettons en question les modèles de peuplement des Amériques se fondant sur la notion d’adaptation à des environnements pauvres en ressources. Des données archéobotaniques provenant de vingt sites archéologiques datés du Pléistocène final et de l’Holocène initial au Brésil et en Amazonie démontrent un usage considérable et persistant d’une grande variété de plantes aujourd’hui domestiquées et/ou hyper-dominantes. En recourant aux concepts de la théorie de construction de niches, nous nous efforçons de discerner les interventions humaines à travers des indices de manipulation et de domestication des plantes et des lieux.
Древнерусские патерики : mетаморфозы жанра ранней монашеской письменности
Authors: Буланин Дмитрий М.
Published: June 2022

Cet article examine les changements qui affectèrent le paterikon en tant que genre spécifique dans les différentes littératures du monde orthodoxe : byzantine, slave du sud (bulgare et serbe) et vieux-russe. Alors que les nouveaux représentants du genre à Byzance et en Bulgarie ne se distinguent en rien des anciens paterika (Evergetis Paterikon, Recueil de paterika), la littérature médiévale russe a produit quelque chose de complètement inédit dans ce domaine. Le Paterikon des Grottes de Kiev et celui de Volokolamsk ne ressemblent qu’en apparence à leurs prédécesseurs. En fait, ils remplissaient une fonction de propagande, les légendes qui y sont assemblées ont pour but de louer les ascètes de ces deux monastères. La tâche principale des compilateurs était à chaque fois de glorifier un monastère en particulier. Les paterika mêlent des récits à des légendes orales sur les abbés les plus célèbres : cette combinaison ne permet pas de dater exactement la collection des Grottes, la plus ancienne parmi les paterika russes. De plus, en l’absence d’intrigue transversale, les blocs narratifs dont le livre est constitué doivent être datés individuellement. Quel que soit le moment où chacun de ces blocs a été écrit, le paterikon en tant que tel semble avoir été constitué peu de temps avant que le premier manuscrit de la collection des Grottes n’ait été copié (1406). Le Paterikon des Grottes, bien qu’il se présente comme une œuvre littéraire remarquable, ne saurait être considéré comme une source historique fiable : il peut s’écouler de nombreuses années, voire des siècles entre la naissance d’une légende sous sa forme orale et le moment de sa fixation écrite. Pour étayer sa thèse, l’auteur s’appuie sur l’histoire d’autres cycles de légendes monastiques tels que le cycle d’Athos Patria et le cycle de Novgorod-Athos la Chronique des temps passés.
Education Quality and Offerings Intersection Post Pandemic for Inclusive Development
Authors: Tubulingane Booysen Sabeho , Angombe Simon T.
Published: June 2022

Contact learning and teaching was suspended in 2020 at many universities globally, including in Namibia, to counter the spread of COVID-19 transmission. The study assessed the impact of the COVID-19 outbreak on student academic performance per respective offering type (online and contact) using quantitative inferential statistical regression analysis. Data from a total of 20770 student population for 2019 and 2020 academic years was applied in the study. The study established that online rather than contact education offering is associated with improved student academic performance at the Namibian university. However, Namibian students do not benefit from online education equally due to socio-economic inequality. A correlation between internet access and online student academic performance was established. The study has also demonstrated the importance of equality in student offering modes in upholding the quality of higher education. An academic research directed at evaluating the level of plagiarism associated with online and contact offering at the Namibian university needs to be conducted.
International Organizations' Aid for Educational Transformation and Inclusive Development
Authors: Rajagopal Kannan , Mahajan Vaishali
Published: June 2022

There has been several research studies and articles on foreign aid for education which predominantly deliberates on the aspects that really works effectively in favor of aid and on the points which indicate the main reasons for the failures of such education aid initiatives. In fact, studies have abundantly shown that these foreign aids for education have made positive contributions to the education aid-recipient nations specifically in terms of enhancing the enrolment percentages under the basic education levels. However, there is also strong evidence on the existence of a wide gap on what the aid does to the nation and what it is intended to possibly achieve specifically in terms of the quality of education anticipated to be achieved. Overall findings of the research studies suggest that interventions are more effective at improving student performance and learning when social norms and intertemporal choices are factored in the design of educational policies and when two or more drivers of change are combined.
Evaluating a School-Based Agricultural Education Program
Authors: Ulmer Jonathan D. , Curry Jr. Kevin W.
Published: June 2022

Systems of education intentionally evaluate students and teachers in the teaching and learning process. For many of the same reasons, the case can be made that programs should undergo systematic evaluation to discover where and how growth can occur. The purpose of this chapter is to provide a practical overview of the SBAE program evaluation process. The authors are careful not to be overly prescriptive in the recommendations for how these should be conducted, in part because effective program evaluation is tailored to the local program. Still, the case is made for why program evaluations should be conducted, what the research indicates good program evaluations look like, and how one should go about conducting one at the local level.
Comparing Agricultural Education Programs Around the World
Authors: Connors James J.
Published: June 2022

Agricultural education programs are offered in many countries around the world. Students are taught hands-on vocational agricultural skills that allow them to enter the agricultural workforce or advance to higher education. Interpersonal communication and leadership skills are offered in some programs but are not a common component of secondary agricultural education curriculum in other countries. Agricultural teachers come to the profession after working in agricultural industry, completing a college degree in technical agriculture or general teacher education, or by completing a formal teacher education program in agriculture. A wide variety of different youth organizations is offered in other countries for students studying agricultural education.
Entrepreneurship Ecosystems and Innovation
Authors: Oba Beyza
Published: June 2022

Entrepreneurial ecosystems have attracted considerable attention from different constituencies. Especially in line with the increasing numbers of start-ups, it is expected that these ecosystems will contribute to entrepreneurial activity and economic growth of a region/nation. However, most of the entrepreneurial ecosystem research and thus developed frameworks focus on advanced economies. On the other hand, ecosystems positioned in emerging economies are exposed different to institutional arrangements that influence resource allocation and entrepreneurial activity. This study argues that context is important in shaping the dynamics of an entrepreneurial ecosystem, the choices of entrepreneurs, and the interactions between the entrepreneurs and other resource providers. To illustrate this, the study focuses on an emerging economy, Turkey, and by utilizing secondary data tries to underpin the institutional voids and resource scarcities that lead to a ‘shallow' entrepreneurial ecosystem.
Sustainable Entrepreneurship
Authors: Sharma Renuka , Mehta Kiran
Published: June 2022

Entrepreneurship has long been acknowledged as a means of generating economic rewards for those involved in it. As the notion of sustainable development has emerged as a critical problem impacting the existing system, it has been suggested that it should not be limited to the generation of money alone. The field of sustainable enterprise (SE) has received a lot of academic interest in the previous 10 years. The SE literature is becoming more difficult to explore because of its fast growth and interdisciplinary nature. Because of the growth of research, there is a lack of a theoretical framework; thus, this area must be investigated, structured, and synthesised to offer clarity. The goal of this study is to give a bibliometric analysis of the field's current state. The study is conducted on a sample of 352 articles published during 2002-2022. This study's results may help both novice and experienced sustainable entrepreneurship scholars by providing a comprehensive overview of the field's development and present state.
Analytical Impact of Digital Marketing on Smart Wearables in India
Authors: Bathla Devesh , Ahuja Raina , Awasthi Shraddha , Santhosh Amrith
Published: June 2022

Advancement in innovation and technology has transformed the lifestyle of individuals. Wearable innovation is an old-style case of such insight. Despite the fact that this innovation has been common for quite a while, the furor of wearable development began when the model of Google Glass was concocted. It helped clients to start thinking past this present reality. Preceding the prototype, customers were uninformed about wearable development. In the 21st century, wearable innovation has purchased new advancements which have helped wearables to take off in the mechanical market. While it is intended to study the awareness of smart wearables, it is also synthesized to identify the key perceptions about smart wearables in the study. It is further being analysed to check the influence of digital marketing in purchase decision for smart wearables with specific focus on all digital platforms.
Supporting the Development of Lifelong Learning Skills
Authors: Dattathreya Priyadarshini
Published: June 2022

Constant self-evaluation and lifelong learning skills are some of the key characteristics of competent healthcare professionals. Additionally, the ability to set goals and use feedback to enhance performance has been identified as one of the core competencies for entering medical students. This chapter uses educational theories to describe the lifelong learning skills required for academic success. This chapter also provides recommendations to pre-health programs on strategies that support the development of these skills. The recommendations include general strategies to foster self-regulated learning and specific academic coaching strategies that promote the holistic development of pre-health professional students.
Fostering Resilience and Well-Being Among Pre-Health Students
Authors: Frame Leigh A. , Dyer Kirsti , Powell Cynthia A. , Dawson Donnell , Warren Alison , Corr Patrick G. , Siglin Mandy
Published: June 2022

The well-being (health and wellness) of the pre-health student directly contributes to their short-term academic success and their long-term professional and personal aspirations. The pre-health advisor has a role to play in fostering an environment in which the pre-health student can thrive, including supporting their well-being. This chapter addresses major contributing factors: stress management and mental clarity can be accomplished in many ways, e.g., mindfulness meditation. Cognition is dependent upon immune function, which is generally supported by a diverse, plant-rich diet. Physical activity (exercise and natural movement) supports mental health and cognition and are often limited in the pre-health student as well as healthcare professionals without intentional incorporation. Restorative sleep allows for healing and repair throughout the body (including the brain) as well as memory integration; simple steps can improve sleep quality and quantity. Ultimately, the pre-health advisor should utilize cross-campus partnerships to promote a culture of well-being.
Mentorship of Pre-Health Professional Students
Authors: Powell Baker Dana , Cassar Linda
Published: June 2022

Mentoring is essential to professional development and socialization in many fields, but this relationship is critical to health professions practitioners. These professionals come to their respective disciplines with the requisite learning from their educational programs, but they will also benefit from the guidance of a mentor. Mentoring relationships allow mentees to move their practice along the continuum from novice to expert. This translates to safer, more coordinated care at the bedside and a more holistically developed practitioner. This chapter examines types of mentoring relationships and how professionals can decide which best meets their needs and goals. Review of the characteristics of effective mentors and mentees is an important element of this chapter, as it is crucial for those seeking these roles to know their responsibilities. Discussion of how mentoring diverse groups of health professions students will help to reduce disparities in healthcare is an important focus of this chapter.
Using Pre-Professional Competencies in Advising, Tracking, and Writing Letters of Evaluation
Authors: Chuck Emil , Elam Carol
Published: June 2022

This chapter presents organizational templates for advisors and admissions officers when describing or evaluating competency development among prospective students. Using these templates, stakeholders can articulate the strengths and capabilities of individual applicants based on information provided on their applications and letters of evaluation. Each major characteristic and competency are described with example sources identified to demonstrate the concept of “knows how, shows how, and does” for competency development. These concepts are generally reinforced in holistic review training for admissions staff and faculty evaluators to provide a consistent standard of assessment, especially in reviewing letters of evaluation.
How an Anti-Racist Organizational Change Model Can Build Capacity to Support Historically Excluded Students
Authors: Ward Maranda C. , Corr Patrick G. , Fernes Vivika Aarti , Wang Tammy
Published: June 2022

Increasing diversity among the health workforce is not enough to address healthcare disparities. Advisors and administrators need to understand the role of justice, equity, diversity, and inclusion in the development of anti-racist organizations. This chapter considers the history and impact that the systemic exclusion of Black, Indigenous, People of Color (BIPOC) has on the healthcare system, provides an overview of modern efforts to attempt to resolve this problem through pipeline programs, considers one institution's efforts to make anti-racist change, and discusses how administrators and advisors in pre-health programs and pipeline programs can apply an antiracist organizational change model to build their capacity to support historically excluded students.
Complex Ways in Which Landscape Conditions and Risks Affect Human Attitudes Towards Wildlife
Authors: Muneza Arthur B. , Amakobe Bernard , Kasaine Simon , Kramer Daniel B. , Githiru Mwangi , Roloff Gary J. , Hayward Matt W. , Montgomery Robert A.
Published: June 2022

Negative interactions between humans and wildlife (i.e. those presenting risks to human security or private property) can trigger retaliation and potential human-wildlife conflict (HWC). The nature and strength of these human responses may depend on previous interactions with wildlife and can be shaped by landscape conditions. However, the ways in which previous experiences and landscape conditions interact to shape peoples' attitudes towards wildlife are not well-understood. We conducted our study in Tsavo Conservation Area, Kenya, which experiences some of the highest rates of HWC documented in East Africa. We explored how previous experiences with wildlife and landscape conditions interact to inform the attitudes of people towards wildlife. We conducted semi-structured surveys among 331 households and fit an ordinal mixed-effects regression model to predict human attitudes to wildlife as a function of landscape conditions and previous interactions. Respondents indicated that baboons, elephants, and lions posed the greatest risks to human security and private property. Households experiencing risks from wildlife wanted wildlife populations to decrease, whereas households depending on grazing lands outside the study area wished to see wildlife increase. Our study demonstrates that human-wildlife interactions have important social and spatial contexts, and are not uniform across households in the same area owing to location of private property. Correspondingly, for interventions to be effective, we recommend considerations of local contexts and landscape conditions of communities.
Predictors of Knowledge of Cervical Cancer Screening Among Pregnant Women Attending Antenatal Clinic in Enugu, Nigeria
Authors: Otti Chidiebere J. , Izuka Emmanuel O. , Obiora-Izuka Chinelo E. , Ifebi Okechukwu C. , Ikeako Lawrence C. , Nwagha Uchenna I.
Published: June 2022

Background:

One per cent of women diagnosed with cervical cancer are pregnant or postpartum at the time of diagnosis. Therefore, awareness during pregnancy is of utmost significance.

Objective:

To determine predictors of knowledge of cervical cancer screening among pregnant women who attended antenatal clinics in Enugu, Nigeria.

Materials and Methods:

It was a descriptive cross-sectional study of 419 pregnant women who attended antenatal care at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu (139) and the Mother of Christ Specialist Hospital, Enugu (280). A multistage random sampling method was used to select the study centres and the participants. The questionnaires were administered by the interviewers and the data collected included sociodemographic characteristics, knowledge, and practice of cervical cancer screening. Data were analyzed using SPSS version 23.

Results:

The mean age of the participants was 28.86 ± 5.69, Christians (92.7%), and married (82.5%). Most of the respondents (82.3%) heard about cervical cancer screening methods through their gynecologists and of the 198 respondents who have heard about cervical cancer screening, 151 (76.3%) knew about Pap smear. One hundred thirty-eight (69.7%) of the participants believe that screening for premalignant lesions of the cervix can be performed during pregnancy. Only 37.9% of the participants had ever done Pap’s smear in the past 3 years. Respondents with higher social status (Civil/Public servants) were 10 times more likely to know about cervical cancer screening than those with lower social status (Trader/farmer/artisan) (P = 0.027, OR = 9.957, 95% CI = 1.301 – 76.191).

Conclusion:

Higher social status is more predictive of knowledge of cervical cancer screening amongst pregnant women attending antenatal clinics. Gynaecologist disseminate the information on cervical cancer screening more and Pap’s smear remain the main screening modality known to pregnant women. Efforts should be made by other health workers and the media to disseminate appropriate information on screening modalities for the prevention of cervical cancer
Emergency Preparedness for Management of Suspected Cases of Viral Haemorrhagic Fever Among Healthcare Workers in a Tertiary Referral Center
Authors: Onubogu Chinyere U. , Njoku Jackson G. , Ushie Simon N. , Egeonu Richard O. , Obasikene Godwin , Anyaoku Chinekwu S. , Nwosu Chinekwu , Emelumadu Obiageli F.
Published: June 2022

Background:

Effective viral haemorrhagic fevers (VHFs) control demand adequate emergency preparedness among healthcare workers (HCWs).

Objective:

This study assessed the emergency preparedness for VHF control among HCWs at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra state, Nigeria.

Materials and Methods:

It was a cross-sectional study conducted among 345 HCW at the NAUTH, Nnewi, Nigeria. Data was analysed using statistical package for social sciences (SPSS, IBM, Chicago IL, USA) software version 21. Chi square and student’s t-test were used to test associations between categorical and continuous variables, respectively. A p-value of <0.05 was considered statistically significant.

Results:

Their mean age and length of service were 33.9 ± 8.88 and 6.6 ± 7.08 years, respectively. Two-third were doctors, nurses and lab scientists. A major proportion of the HCWs were aware of VHF (88.4%), and knew it could be acquired at workplace (83.8%) and at least 2 correct features (74.2%) or one preventive measure (79.1%). Only 53.0% and 47.2% knew that the hospital had a VHF control policy and standard operating procedure (SOP), respectively. Different category of HCWs varied significantly in awareness of VHF; and knowledge about the risk of acquiring it at workplace, features or preventive measures, and VHF control policy or SOP. Doctors, nurses and lab scientists performed better than other HCWs in VHF knowledge. Previous training on VHF or encounter with suspected case was highest among the doctors (P < 0.001) while adequate supply (P < 0.001) or regular use (P = 0.008) of PPE was highest among lab scientists. Suspected VHF case was encountered by 21.2% of the HCWs out of which 26% (19/73) notified relevant unit. Only 29.3% of the HCWs agreed that VHF control was adequate in their unit. Commonest reasons cited for disagreeing were lack of training (79.2%), standard precaution materials (63.6%), SOPs (59.7%) and inadequate support by hospital management (58.4%).

Conclusion:

Emergency preparedness for VHF control was poor among studied HCWs. Innovative surveillance/notification system, and best practices for infection control should be enforced. HCWs should be adequately trained on VHF control.
A Comparative Study of Skin to Epidural Distance at Lumbar Region Using Median and Paramedian Techniques
Authors: Achi Joseph O. , Amucheazi Adaobi O. , Ajuzieogu Virginus O. , Onyeka Tonia C.
Published: June 2022

Background:

The median and the paramedian approaches are used to access the epidural space. Median approach is commonly used but can be technically difficult in certain patients. The paramedian approach is the alternative. Success rate during the blind procedure is determined by the skin to epidural distance (SED). SED in turn is affected by patients’ anthropometric characteristics. Prediction of the SED serves to determine the depth of needle advancement in order to improve the success rate.

Objectives:

The study compared the SED using median vs. paramedian approaches, the time required to access the epidural space, place the catheter, and investigate anthropometric factors which may have influenced this distance among the participants.

Materials and Methods:

The study was a blinded randomized controlled study. Following ethical approval and informed consent, 60 women scheduled for elective gynecological procedures were allocated to one of the two groups: Group M (median) (30) and Group PM (paramedian) (30).

Results:

The SED was longer using the PM approach. The mean time it took to gain access was shorter in the PM group. The mean SED increased as the body mass index increased in both groups (P < 0.0001). There was a significant association of anthropometric measurements with the SED using both approaches.

Conclusion:

The study showed that the SED was longer in the PM group. Also as the patient’s anthropometric measurements increased, so did the SED.
Health Risk Behavior of Adolescents with Sickle Cell Disease in Nigeria
Authors: Ajike Patience T. , Adediran Kofoworola , Kotila Taiwo R. , Dairo Magbagbeola D.
Published: June 2022

Background:

The advances in medical practice have increased the average life expectancy of people living with sickle cell disease (SCD) to 54 years. The high prevalence rates of SCD in Nigeria therefore highlights the need for research that will support overall disease management.

Objective:

To determine the health risk behavior (HRB) of adolescents with sickle cell disease in Nigeria.

Materials and methods:

In a cross-sectional descriptive survey using purposive sampling method, 122 adolescents with SCD attending sickle cell clubs in Ogun State, Nigeria were selected for the study. A 58-item questionnaire adapted from the Youth Risk Behavior Survey (YRBS) instrument developed by Centre for Disease Control and Prevention (CDC) was used to collect data from the adolescents.

Results:

The mean age of the respondents was 15.7 ± 2.3 years, there were more females (58.2%) than males (41.2%). Majority were from a monogamous family setting and average to large family size (≥3siblings) (63% and 76% respectively) and only 6% of the parents had no formal education. The mean ages at first sexual intercourse, cigarette smoking and alcohol use were 16 ± 5.7, 15.7 ± 0.7, and 14.9 ± 1.9 years respectively. One-fifth (21.3%) have had sex and half (50%) of them have had sex by the age of 17. Over one-tenth (13.9%) had smoked cigarette while 14.8% had taken alcohol. Adolescents from monogamous family background were more likely to be involved in substance abuse (χ2: 4.99; P=0.008) and exposed to sexual activities (χ2: 10.9; P=0.004) than those from polygamous or single parent family.

Conclusion:

It was concluded that adolescents with SCD are involved in HRB and may be dependent on family characteristics. It is recommended that regular health care of chronically ill adolescents should include screening and counselling for HRBs.
Innovative method for wound debridement in open globe injury
Authors: Shah Mehul , Shah Shreya , Gupta Satyam , Singh Romi
Published: June 2022

Background:

Open globe injury is a serious sight threatening condition. Full-thickness, non-selfsealing corneal lacerations require repair in the operating room. During repair, debridement of the wound is an important step. Incarceration of the intraocular structures in the wound eg. Iris, lens capsule, vitreous leads to improper healing if not removed properly.

Purpose:

To demonstrate the technique of wound debridement in open globe injury.

Synopsis:

Manual removal of incarcerated tissue contents leads to incomplete cleaning & enormous traction on intra ocular contents. In this video, we have tried vitrectomy cutter with higher vacuum for cleaning the edges of the wound especially in the posterior aspect and debri removal, followed by easy suturing. All tissue in the wound edges are removed effectively without any traction on intraocular contents.

Highlights:

Vitrectomy cutter is a very useful and effective tool to clean wound edges and good apposition & suturing of wound.

Video link:

https://youtu.be/y_kCxLdwhuQ
Under lock and key: Incorporation of blockchain technology in the field of ophthalmic artificial intelligence for big data management - A perfect match?
Authors: Ramesh Prasanna Venkatesh , Devadas Aji Kunnath , Ray Prajnya , Ramesh Shruthy Vaishali , Joshua Tensingh , Priyan Vinoth , Ramesh Meena Kumari , Rajasekaran Ramesh
Published: June 2022

Big data has been a game changer of machine learning. But, big data is a form of centralized version of data only available and accessible to the technology giants. A way to decentralize this data and make machine learning accessible to the smaller organizations is via the blockchain technology. This peer-to-peer network creates a common database accessible to those in the network. Furthermore, blockchain helps in securing the digital data and prevents data tampering due to human interactions. This technology keeps a constant track of the document in terms of creation, editing, etc., and makes this information accessible to all. It is a chain of data being distributed across many computers, with a database containing details about each transaction. This record helps in data security and prevents data modification. This technology also helps create big data from multiple sources of small data paving way for creating a well serving artificial intelligence model. Here in this manuscript, we discuss about the usage of blockchain, its current role in machine learning and challenges faced by it.
Neurotization of the human cornea – A comprehensive review and an interim report
Authors: Rathi Anubha , Bothra Nandini , Priyadarshini Smruti R , Achanta Divya S R , Fernandes Merle , Murthy Somasheila I , Kapoor Anasua G , Dave Tarjani V , Rath Suryasnata , Yellinedi Rajesh , Nuvvula Rambabu , Dendukuri Gautam , Naik Milind N , Ramappa Muralidhar
Published: June 2022

We present a comprehensive review of existing literature on surgical corneal neurotization (SCN) as a treatment modality for neurotrophic keratopathy (NK) with an interim report of seven cases where SCN was performed using the indirect approach and followed up till 18 months postoperatively to look for improvement in ocular surface, corneal sensations, and nerve regeneration by using in vivo confocal microscopy (IVCM). A literature search was performed for publications with keywords “corneal nerves,” “neurotization,” “esthesiometry,” “corneal anesthesia,” and “neurotrophic keratopathy.” All literature available till December 31, 2020 was reviewed and included to describe NK and its management options, particularly SCN. NK is associated with absent or reduced corneal sensations and is managed using a step-ladder algorithm ranging from medical management for symptomatic relief to surgical corneal neurotization. Both direct and indirect approaches of SCN have a favorable outcome with reduced surgical morbidity in the indirect approach using sural nerve graft. Post neurotization, corneal sensation recovery may take up to 3–6 months, while nerve regeneration on confocal microscopy can take as long as 6 months–1 year.
Association of dry eye disease with smoking: A systematic review and meta-analysis
Authors: Tariq Muhammad Ali , Amin Hamza , Ahmed Bilal , Ali Uzair , Mohiuddin Ashar
Published: June 2022

There is conflicting evidence for the association between smoking and dry eye disease (DED). We conducted a meta-analysis to determine the true relationship between smoking and DED. A systematic literature search was performed using electronic databases, including PubMed, Embase and Cochrane Library, till August 2021 to identify observational studies with data on smoking as risk factor of DED. Quality assessment of the included studies was conducted using Joanna Briggs Institute (JBI) critical appraisal checklists. The random-effects model was used to calculate the pooled odds ratio (OR). Heterogeneity was evaluated by Cochrane Q and I2 index; in addition, subgroup, sensitivity, and meta-regression analyses were performed. Publication bias was assessed using funnel plot and Egger’s regression test. A total of 22 studies (4 cohort and 18 cross-sectional studies) with 160,217 subjects met the inclusion criteria and were included in this meta-analysis. There is no statistically significant relationship between current smokers (ORadjusted = 1.14; 95% CI: 0.95–1.36; P = 0.15; I2 = 84%) and former smokers (ORadjusted = 1.06; 95% CI: 0.93–1.20; P = 0.38; I2 = 26.7%) for the risk of DED. The results remained consistent across various subgroups. No risk of publication bias was detected by funnel plot and Eggers’s test (P > 0.05). No source of heterogeneity was observed in the meta-regression analysis. Our meta-analysis suggest current or former smoking may not be involved in the risk of dry eye disease. Further studies to understand the mechanism of interaction between current smokers and formers smokers with DED are recommended.
Insertion of a Preserflo microshunt inside a non-valved glaucoma shunt to treat late-onset hypotony
Authors: Malick Huzaifa , Zou Di , Stead Richard
Published: June 2022

We present a case of advanced glaucoma with previously failed trabeculectomy who underwent a Baerveldt tube (BVT) insertion, with initial success. However, 9 months post BVT insertion he developed profound clinically significant hypotony. Two attempts at controlling this with suture exchange led to episodes of significant ocular hypertension, followed by hypotony each time. We describe a technique of using a cut segment of the novel, polystyrene-block-isobutylene-block- styrene (SIBs) based Preserflo Microshunt (Santen Inc., Miami, FL) inserted into the tip of a BVT to control late onset hypotony with success. IOP at 6 weeks was 12mmHg on two drops with complete resolution of the choroidal maculopathy.
Sympathetic ophthalmia: A comprehensive update
Authors: Parchand Swapnil , Agrawal Deepshikha , Ayyadurai Nikitha , Agarwal Aniruddha , Gangwe Anil , Behera Shashwat , Bhatia Priyavat , Mulkutkar Samyak , Barwar Gulshan , Singh Ramandeep , Sen Alok , Agarwal Manisha
Published: June 2022

Sympathetic ophthalmia is a rare, bilateral, granulomatous, panuveitis following penetrating trauma or surgery to one eye. Clinical presentation commonly occurs within the first year of trauma occurrence but can be delayed by several years. It manifests as acute/chronic granulomatous uveitis with yellowish-white choroidal lesions or Dalen–Fuchs nodules. Initially, patients respond rapidly to corticosteroid therapy, but a majority require long-term use of corticosteroid-sparing agents to prevent recurrences. The purpose of this review is to elaborate on the current understanding of the pathophysiology, the importance of multimodal imaging in early diagnosis, and the role of newer immunomodulatory and biological agents in recalcitrant cases.
Refractive errors among commercial drivers
Authors: Kumar Mukesh , Mahaseth Aarti , Parveen Shafia , Rafeeq Uzma , Chauhan Lokesh
Published: June 2022

Purpose:

To determine the pattern of refractive error among commercial drivers in north India.

Methods:

Descriptive study with convenient sampling conducted among commercial drivers of north India.

Results:

A total of 213 (75.8%) heavy-vehicle and 68 (24.2%) light-vehicle drivers were screened for eye diseases. Refractive error for distance was reported in 44 (15.7%; 95% CI: 11.6–20.4) drivers. Hyperopia was reported in 23 (8.2%; 95% CI: 5.2–12) drivers, followed by myopia in 15 (5.3%; 95% CI: 3–8.6) drivers and astigmatism in six (2.1%; 95% CI: 0.7–4.5) drivers. Presbyopia was reported in 157 (55.8%) drivers. Dry eye was reported in 70 (24.9%), stereo deficiency in 77 (27.4%), and color vision deficiency in 11 (3.9%) drivers. Three drivers were diagnosed with cataract, and two were referred for retina evaluation.

Conclusion:

Hyperopia in both eyes was the most common refractive error. Dry eye disease and color vision deficiency were also reported. Most of the drivers were not using spectacles for refractive error correction. Due to their mobile nature, drivers with cataract and retina diseases did not turn up for follow-up.
Visual impairment and refractive errors in school children in Andhra Pradesh, India
Authors: Prakash Winston D , Marmamula Srinivas , Mettla Asha Latha , Keeffe Jill , Khanna Rohit C
Published: June 2022

Purpose:

Addressing childhood vision impairment (VI) is one of the main goals of the World Health Organization’s (WHO) combating blindness strategies. The primary aim of this study was to estimate the prevalence of VI, causes, and its risk factors in school children in Krishna district, Andhra Pradesh, India.

Methods:

Children aged 4–15 years were screened in schools using the 6/12 Snellen optotype by trained community eye health workers, and those who failed the test and those reported or found to have obvious eye conditions were referred to primary (VC), secondary (SC), or tertiary (TC) care centre appropriately, where they underwent a complete eye examination including cycloplegic refraction and fundus examination.

Results:

A total of 56,988 children were screened, of whom 51.18% were boys. The mean age was 9.69 ± 3.26 years (4–15 years). Overall, 2,802/56,988 (4.92%) children were referred to a VC, of which 632/56,988 (1.11%) required referral to SC/TC. PVA of <6/12 was found in 1.72% (95% confidence interval [CI]: 1.61–1.83). The prevalence of refractive error (corrected and uncorrected) was 2.38% (95% CI: 2.26–2.51) and myopia was 2.17% (95% CI: 2.05–2.29). In multivariable analysis, older children, those in urban schools, private schools, and children with a disability had an increased risk of VI and myopia. Additionally, the risk of myopia was higher among girls than boys. Of those referred and reached SC/TC, 73.64% were due to avoidable causes.

Conclusion:

Childhood VI prevalence was 1.72% in this region. Uncorrected refractive error (URE) was the major cause of VI in children. Older age, schools in urban locations, private schools, and the presence of disability were associated with the risk of VI among children.
Patterns of treatment discontinuation in patients receiving anti-vascular endothelial growth factor for neovascular age-related macular degeneration
Authors: Dhingra Narendra , Upasani Deepa , Ghanchi Faruque D
Published: June 2022

Purpose:

To report the reasons for treatment discontinuation within 5 years in patients receiving intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD).

Methods:

A retrospective case-notes review of patients commenced on anti-VEGF for nAMD who failed to complete 5 years of follow-up was undertaken. The reasons for treatment discontinuation, baseline age, baseline visual acuity (VA) in Early Treatment Diabetic Retinopathy Study (ETDRS) letters, and the VA change at the last follow-up were recorded. Age-specific all-cause mortality was calculated for deceased patients.

Results:

Of the 1177 patients, 551 patients (46.8%) failed to complete the 5-year follow-up. The reasons for treatment discontinuation were death (251), early discharge due to stable disease (110), further treatment deemed futile (100), failure to attend (15), ill health (14), patient choice (7), and transfer of care (1). In 53 patients, no reason was documented. The mean baseline age of those who completed the 5-year follow-up (77.4 ± 7.8 years, 95% confidence interval (CI): 76.8–77.9) was significantly lower than those who discontinued the treatment for any reason (82 ± 7.7 years, 95% CI: 81.4–82.6) (P < 0.0001). Survival analysis showed that baseline VA was not a factor in treatment discontinuation; however, visual stability (±5 letters from baseline) was associated with treatment continuation. The age-specific all-cause mortality in deceased patients was lower than that in the general population.

Conclusion:

At 5 years, only 53% of patients remained in active care, and death was the most common reason for treatment discontinuation. Lower baseline age and VA stability during therapy were associated with treatment continuation.