bluuebunny/crossref_metadata_2025 huggingface dataset:
Sublimations performative et idéative à l’adolescence
Authors: Givre Philippe
Published: October 2023

Destin pulsionnel « le plus rare et le plus parfait », la sublimation réalise un domptage de l’intensité pulsionnelle tout en en préservant la tension psychiquement vivifiante. À défaut que ce don ait pu provenir de l’Autre, les solutions sublimatoires octroient au sujet un « crédit de subjectivation », grâce à l’instauration d’un dialogue imaginaire avec ses doubles. Pour y réussir, deux modalités sublimatoires sont susceptibles de s’exprimer à l’adolescence : la première, dite performative, autorisée par les activités artistiques, donne accès à une forme d’expression qui préserve au maximum le plaisir de faire ; la seconde, dite idéative, impliquée dans l’investigation scientifique et l’activité intellectuelle, repose quant à elle sur le plaisir de pensée. En restant au plus proche du directement pulsionnel, la sublimation artistique conquiert aux yeux de Freud un statut électif et privilégié, puisqu’elle favorise des possibilités d’autoaffectation de soi par soi via la symbolisation primaire.
Traces de bibliothèques
Authors: Marcoux Cécile
Published: October 2023

L’histoire des bibliothèques de psychanalyse peut sembler s’écrire à la marge de l’histoire du mouvement psychanalytique, pourtant ces bibliothèques ont accompagné le mouvement depuis son origine. De la première bibliothèque viennoise à la Bibliothèque Sigmund Freud d’aujourd’hui, un fil de transmission du savoir s’est lentement, et quelquefois douloureusement tissé.
La correspondance Sigmund Freud-Marie Bonaparte : un parcours d’analyse en plusieurs temps
Authors: Chervet Emmanuelle
Published: October 2023

La correspondance de Freud et Marie Bonaparte est le récit d’une véritable analyse, qui commence par l’élucidation de la névrose infantile de Marie. Puis l’élaboration de sa bisexualité alterne avec des mouvements compulsifs qui la poussent à des actes chirurgicaux devant lesquels l’analyse est impuissante. Mais l’élaboration progressive de ses identifications et des deuils afférents lui permet de passer d’une position de victime aux réalisations de l’analyste et de la Princesse, en « dernière des Bonaparte ».
Measurement and spatiotemporal patterns of China's digital economy efficiency
Authors: Xu Yanting , Li Tinghui
Published: October 2023

The digital economy has deeply integrated into various sectors, becoming a significant driving force for economic transformation and development, as new generation information technology continues to advance and mature. This paper builds upon theoretical analysis and employs the global Data Envelopment Analysis (DEA) method, along with relevant data from China's information transmission, software and information services industry spanning the years 2003 to 2020, to dynamically measure the output efficiency of China's digital economy. Based on this, the paper examines the overall characteristics of efficiency changes in the digital economy using distribution dynamics. Additionally, common descriptive statistics and data mapping techniques are utilized to reveal the spatiotemporal patterns of efficiency changes. The findings of the study are as follows: (1) The efficiency of the digital economy in the 31 provincial regions of China remains stable, but the factors influencing this efficiency vary both over time and among specific provinces. (2) From a temporal perspective, the digital economy in China demonstrates an overall positive increase in efficiency, with its volatility and differentiation largely shaped by the shifting factors of technological advancements and technological efficiency. (3) From a spatial perspective, there exists a distinct pattern of spatial disparities in China's digital economy efficiency, with higher efficiency observed in the eastern regions and lower efficiency in the western regions.
Global population surpasses eight billion: Are we ready for the next billion?
Authors: Jain Nityanand , Kourampi Islam , Umar Tungki Pratama , Almansoor Zahra Rose , Anand Ayush , Ur Rehman Mohammad Ebad , Jain Shivani , Reinis Aigars
Published: October 2023

In November 2022, the global population had officially crossed eight billion. It has long been recognized that socioeconomic or health-related problems in the community always accompany an uncontrolled population expansion. International calls have been made regarding lack of universal health coverage, an insufficient supply of healthcare providers, the burden of noncommunicable disease, population aging and the difficulty in obtaining safe drinking water and food. The present health policy paper discusses how to conquer these crowded world issues, including (1) promoting government and international organization participation in providing appropriate infrastructure, funding and distribution to assist people's health and well-being; (2) shifting health program towards a more preventive approach and (3) reducing inequalities, particularly for the marginalized, isolated and underrepresented population. These fundamental principles of health policy delivery as a response to an increasingly crowded world and its challenges are crucial for reducing the burden associated with excessive healthcare costs, decreased productivity and deteriorating environmental quality.
Paris 1900. Le Congrès des religions n’aura pas lieu. La dernière utopie religieuse du xixe siècle ?
Authors: Milbach Sylvain
Published: October 2023

En 1893 s’était tenu à Chicago, en marge de l’exposition universelle, un Parlement des religions qui avait réuni des représentants des principales religions du monde. En 1895, un petit groupe de catholiques, sous l’impulsion de l’abbé Félix Klein, envisagea de renouveler l’expérience à l’occasion de l’Exposition universelle prévue à Paris en 1900. Cette initiative, dont l’abbé Victor Charbonnel devint le principal promoteur, se heurta à une forte hostilité qui fit échouer le projet. L’étude des débats autour de cet échec permet d’éclairer à la fois les tensions et les aspirations religieuses de la France des années 1890, et ce projet d’un congrès des religions à Paris mérite d’être interrogé comme la dernière utopie religieuse du xixe siècle.
L’économie contrariée des Goncourt. Lecture croisée de Charles Demailly et Renée Mauperin
Authors: Péraud Alexandre
Published: October 2023

On sait que les Goncourt aiment à condamner les vulgarités de l’argent-roi. Mais cette antienne réactionnaire, et assez balzacienne, ne saurait occulter la critique profonde de l’économie politique qu’entreprennent le Journal et les romans. Tout en refusant les facilités de l’héroïsme économique et du romanesque de l’argent, les Goncourt composent des drames économiques où ils appréhendent les structures du libéralisme telles qu’elles sont intériorisées par les individus, depuis la mécanique de l’équilibre jusqu’aux jeux de compensation en passant par l’utilitarisme et l’idéal de maîtrise bourgeois.L’article se propose de décrypter cette intériorisation à travers les exemples de Charles Demailly et de Renée Mauperin. On s’arrêtera, avec ce dernier, sur la peinture du mariage comme théâtre de l’économie des passions bourgeoises. Mais loin de rejoindre le cortège des romans de la fille mal mariée, le récit transforme la famille Mauperin en laboratoire où s’opposent des modèles économiques antagonistes… entre lesquels les Goncourt se gardent de trancher.
Peines et bonheurs de l'économie dans Germinie Lacerteux
Authors: Pignol Claire
Published: October 2023

Depuis le XVIIIe siècle, les théories économiques veulent mettre au jour les mécanismes qui régissent le monde social afin d’en améliorer le fonctionnement, c’est-à-dire de vaincre la pauvreté et de repousser la menace de la mort par manque de ressources. Le roman des Goncourt, à travers le récit d’une vie singulière qui s’adresse à l’imagination et suscite l’émotion du lecteur, fait entendre la manière dont l’économie est vécue. À la chute douloureuse de leur personnage, les auteurs n’offrent pas d’explication susceptible de compléter l’analyse économique ou de s’y substituer. Ils font plutôt entendre comment l’anthropologie fondatrice de la pensée classique, celle de la pénurie, du malheur et de la menace de la mort, imprègne la pensée des personnages et fonde, davantage que tout mécanisme, la chute de Germinie.
Identification of Urban Heat Island Effect on Land Use Land Cover Changes
Authors: Thambawita T. K. C. N. , Munasinghe D. S. , Yapa L. K. K.
Published: October 2023

The effect of urban heat island (UHI), characterized by higher temperatures in urban areas compared to surrounding rural areas, is a significant consequence of rapid urbanization. As cities continue to grow and attract more people, the UHI effect intensifies due to increased heat-absorbing surfaces and reduced green spaces. This can lead to various environmental and health issues, specifically affecting vulnerable populations. This study investigates the phenomenon of UHIs in the Kalutara district of Sri Lanka and examines the relationship between Land Use Land Cover (LULC) changes, urbanization, and the intensity of UHIs. Landsat satellite images from 1991, 2001, 2011, and 2021 were analyzed using Remote Sensing and Geographic Information System (GIS) techniques to create land Surface Temperature (LST) maps and LULC maps. The results show a significant expansion of urban areas and a reduction in green areas within the Kalutara district over the study period, accompanied by an increase in the intensity of UHIs. Regression analysis indicates a negative correlation between the percentage of green areas and LST, highlighting the cooling effect of vegetation. Conversely, a positive correlation is found between LST and the percentage of urban areas. The research demonstrates the spread of UHIs from limited urban centers in 1991 to larger urban areas and adjacent regions in 2021. The findings emphasize the need for sustainable land management practices, preservation of green areas, and effective urban planning strategies to mitigate the adverse effects of UHIs.
Frontal lobe circulation in patients of schizophrenia with and without cannabis dependence: A comparative study
Authors: Dash Soumya Ranjan , Pattojoshi Amrit , Sahu Amiya Krushna , Sahoo Surjeet
Published: October 2023

Background:

The symptom profile of schizophrenia is related to the regional cerebral circulations as advocated in various studies. Cannabis dependence in schizophrenia is more common than in the general population. Previous studies comparing the frontal lobe function in schizophrenia with and without comorbid cannabis dependence have shown conflicting results. In this study, we compared the blood flow in the frontal lobes of patients of schizophrenia with and without comorbid cannabis dependence.

Aim of the Study:

The aim was to compare the blood flow in the anterior cerebral artery (ACA) and middle cerebral artery (MCA), in patients of schizophrenia with and without cannabis dependence.

Materials and Methodology:

This was a hospital-based cross-sectional study. After fulfilling the inclusion and exclusion criteria 28 patients of schizophrenia with cannabis dependence and 28 patients of schizophrenia without cannabis dependence were selected for the study. The blood flow was assessed using Trans-cranial Doppler (TCD) in the ACA and MCA of the left and right sides in both the study groups through the temporal window.

Results:

A statistically significant difference (P = 0.049) was found in the pulsatility index of the left ACA where it was lower in schizophrenia patients with cannabis dependence (0.97 ± 0.24) in comparison to schizophrenia patients without co-morbid cannabis dependence (1.11 ± 0.28). However, after using Bonferroni correction for multiple comparisons (P < 0.05/12 i.e., P < 0.004), this comparative statistics too lost its significance. No significant difference was found in the mean flow velocity and resistance index of frontal lobe circulation between the two groups.

Conclusion:

Chronic cannabis use is having some sparing effect on vascular resistance in the frontal circulation of schizophrenia patients. However, this effect is not significant enough to alter the pattern of frontal circulation.
Fibrinous nodular anterior segment membrane as a presentation of chronic postoperative Aspergillus endophthalmitis
Authors: Temkar Shreyas , Agarwal Disha , Natarajan Kaviyapriya , Ganesh Rajesh Nachiappa , Deb Amit Kumar , Ganesan Niruban , Behera Geeta
Published: October 2023

A 63-year-old lady, with over-the-counter steroid use, presented with a gradual progressive diminution of vision 6 months after uncomplicated cataract surgery. On examination, the vision was hand movements and the anterior chamber (AC) showed a thick, irregular fibrinous membrane over the iris and pupil and a fixed hypopyon, and B-scan revealed vitritis. AC membrane and vitreous biopsy was done along with intracameral and intravitreal Amphotericin-B. Owing to the poor response and microbiological tests suggestive of Aspergillus, core vitrectomy with intravitreal Voriconazole injection was done. Significant improvement in vision and inflammation was noted, after 1 month. Fungal etiology must be suspected in the presentation of endophthalmitis as a fibrinous and nodular membrane, and all such patients must be reviewed for systemic immunosuppression.
Retinal detachment following lightning injury mimicking acute retinal necrosis: A case report
Authors: Gaur Sandhya , Vidhu Vidhata , Singh Jayanti , Sen Alok
Published: October 2023

A 16-year-old male presented with a diminution of vision after 1 month of lightning injury. Fundus examination showed inferior retinal detachment with multiple sieve-like breaks. After pars plana vitrectomy, he developed mutton fat keratic precipitates and anterior segment inflammation. Sieve-like breaks and mutton-fat keratic precipitates (MF-KPs) led to the diagnostic dilemma of viral etiology. The patient responded well to treatment with steroids and antivirals, showing good visual recovery after silicone oil removal. Lightning strike injury–related retinal detachment can rarely mimic an acute retinal necrosis (ARN)-related retinal detachment (RD).
Case report: A rare case of Epstein-Barr virus with ocular manifestation
Authors: Corless Danika , Koklanis Konstandina , Malesic Linda A
Published: October 2023

Epstein-Barr virus (EBV), a herpes virus with a global prevalence exceeding 95%, is infrequently associated with ocular manifestations. We present a case of a 57-year-old Caucasian male who experienced acute bilateral vision loss following a preceding viral illness accompanied by fever. Initial corrected visual acuity was measured at 6/90, and imaging revealed bilateral retinal posterior pole and peripheral white spots, and hyper-reflective macular changes. Three weeks later, spontaneous improvement led to a visual acuity of 6/18, with minimal changes observed in the retinal disruption. Serology testing confirmed the presence of EBV antibodies. At the 6-month follow-up, the patient demonstrated further improvement with visual acuity of 6/12 and reduced foveal granularity. Remarkably, at the 19-month follow-up, the patient achieved near-complete resolution of vision to pre-infection levels, measuring 6/6 without receiving specific treatment. This case highlights a rare retinal manifestation of EBV characterized by an atypical presentation and underscores the significance of considering non-ocular causes when encountering unexplained vision loss.
Posterior reverse encephalopathy syndrome with myriad of etiologies and presentations
Authors: Bindu Malini M , Anklesaria Vidhi K , Girish Anita T , Soumya HV , Gulati Shantanu , Mehta Vinaayak
Published: October 2023

We hereby report cases of posterior reverse encephalopathy syndrome (PRES) with varying etiologies, presentations, and treatment outcomes. In this series, amongst four cases of PRES with sudden diminution of vision, two were male patients with high blood pressure, one was a case of pulmonary tuberculosis, and one case of imminent eclampsia. All patients were treated with respect to underlying etiopathology. Although appalling at presentation, the cases showed marked improvement clinically within the first week. There is need for high index of suspicion, and improvement of clinical condition suggests excellent prognosis in PRES cases.
Steroid challenge: Response to dexamethasone implant in persistent, simple central serous chorioretinopathy
Authors: Behera Umesh C , Brar Anand S
Published: October 2023

A male in his 30s was diagnosed with acute central serous chorioretinopathy (CSC) in the left eye for 3 months and after an unsuccessful oral eplerenone therapy presented with persistent disease. Continuing vision blur, worsening subretinal fluid, and absent fluorescein leak on angiography prompted us (based on earlier experience) to use the novel therapy of dexamethasone intravitreal implant. Successful resolution was noted in 2 months with visual improvement. We describe the first use of an intravitreal long-acting corticosteroid implant in a case of persistent, simple CSC with a favorable outcome.
Rho-kinase inhibitors in pseudophakic cystoid macular edema with secondary glaucoma
Authors: Mohapatra Ayushi , Bardoloi Priyadrashana , Lingam Vijaya , Bhende Muna
Published: October 2023

Pseudophakic cystoid macular edema (PCME) is predominantly a self-limiting entity that can occasionally result in long-term visual deterioration. Rho-kinase (ROCK) inhibitors are therapeutic agents that have been successfully used for intraocular pressure (IOP) control in glaucoma patients and in the management of diabetic macular edema. In this report, we describe a case of mild nonproliferative diabetic retinopathy with PCME and secondary glaucoma. The patient presented with persistent PCME following scleral-fixated intraocular lens insertion, which was unresponsive to anti-vascular endothelial growth factor (anti-VEGF) agents and topical nonsteroidal anti-inflammatory therapy. A successful resolution of PCME was noted on 1-month follow-up after starting the patient on Rho-kinase inhibitors for secondary glaucoma.
Primary orbital melanoma - Report of a rare case and review of literature
Authors: Yogeswari A , Usha C , Abrar Mohamed
Published: October 2023

Primary orbital melanoma is a rare scenario with an uninvolved globe and no intra-ocular component. A 44-year-old male had complaints of diplopia in the right eye for 3 months associated with numbness around the right eye and cheek. Superomedial eccentric proptosis was present, the pupil was reacting to light, and depression and abduction were restricted. Magnetic resonance imaging suggested was suggestive of a schwannoma with intra-orbital extension. Inferior orbitotomy with excision biopsy was performed. The biopsy sample was sent for HPE and surprisingly turned out to be melanoma, IHC HMB 45+. A dangerous diagnosis in disguise can be revealed by diligent efforts of orbital dissection.
Serous macular detachment in a case of posterior microphthalmos: A rare manifestation of pachychoroid spectrum
Authors: Sharma Deepa , Sweta Shubra , Ish Somya , Pathak Ashok
Published: October 2023

A 22-year-old male patient presented with sudden severe diminution of vision in the right eye (RE) for 1 day which was associated with flashes and floaters. He was eventually diagnosed to have posterior microphthalmos with serous macular detachment in the right eye. The appropriate investigations and the treatment, along with the possible pathophysiology are hereby discussed.
Autologous Tenon's patch graft for corneal perforation management and review of literature
Authors: Devi Thounaojam S , Yadav Sandhya , Shrestha Sandhya , Pathuri Divya S , Gupta Neeti , Mittal Sanjeev K
Published: October 2023

The COVID-19 pandemic caused restricted eye retrieval, leading to an acute scarcity of donor corneas. Here, we have reported a series of seven cases of corneal perforation of size 2.9 to 3.7 mm in dimension resulting from diverse cause managed by a Tenon's patch graft with a 100% successful anatomical outcome. All the cases healed completely with scar formation and maintained the anatomical integrity of the eyeball without any intraoperative or postoperative complications.
Isolated sixth nerve palsy as an initial manifestation of systemic lupus erythematosus – A rare case report
Authors: Balraj Arumugam , Hinge Shreeya
Published: October 2023

A 35-year-old female presented to our neuro-ophthalmology OPD with chief complaints of binocular double vision for the past 4 days, which increased in right lateral horizontal gaze. On ocular examination, the patient had restriction of abduction in the right eye, suggestive of right sixth nerve palsy. Investigations revealed antinuclear antibodies positive with titer 1:1000 speckled homogenous pattern suggestive of systemic lupus erythematosus (SLE). Neuroimaging revealed no evidence of an aneurysm in the brain, after which the patient was treated with intravenous methylprednisolone 1 gm once daily pulse steroids for 3 days followed by oral steroids 1 mg/kg was given. The patient improved clinically after 1 month. Although most patients demonstrate the classic diagnostic signs of skin rash and arthritis, the case reported here of an isolated sixth cranial nerve palsy suggests that such an uncharacteristic presentation of SLE is possible.
Inadvertent ocular penetration during eyelid anesthesia – Case presentation and review of literature
Authors: Pal Soham S , Venkatakrishnan Jaichandran Vepary , Poonam Nisar Sonam , Subramanian Nirmala
Published: October 2023

We report a case of inadvertent ocular penetration during eyelid block with local anesthesia for blepharoptosis surgery. A 51-year-old female was planned for levator reattachment procedure for aponeurotic ptosis in the left eye. Following eyelid infiltration using a 30-G, 0.5-inch needle, a localized conjunctival chemosis with intraocular air bubble was noted in the anterior chamber. There was no diminution in vision, and whatever was visible in the posterior segment examination was within normal limits. The procedure was abandoned. After observation for 2 weeks, the patient was operated uneventfully under local anesthesia. Local anesthetic injection during eyelid infiltration may be complicated by inadvertent ocular penetration. Knowing thorough anatomy of the eyelid, using the appropriate technique and immediate identification of signs and symptoms of ocular penetration can prevent any further complications from happening.
Scratched cornea: Case report on incidental bilateral posterior polymorphous corneal dystrophy
Authors: Chowdhary Aakash , Sharma Anshu , Bishnoi Marisha , Dubey Priyanka
Published: October 2023

Posterior polymorphous corneal dystrophy (PPCD) is a dominantly inherited corneal endothelial disorder, typically considered bilateral and asymptomatic. We report a case of bilateral PPCD that presented as an incidental finding on routine ophthalmic examination. Related visual prognosis is discussed. A 27-year-old male presented for a routine ophthalmic examination. Visual acuity was recorded for both eyes. A detailed slit-lamp examination and anterior-segment optical coherence tomography (AS-OCT) was done. Best-corrected visual acuity was recorded as 6/6 for both eyes. Slit-lamp examination revealed band-shaped lesions in the inferior quadrant of bilateral corneas, at the junction of Descemet's membrane and corneal endothelium. AS-OCT revealed central corneal thickness as 556 and 544 µm for the right and left cornea, respectively, along with a hyper-reflective lesion at the level of corneal endothelium in the right eye.
A rare generational presentation of Best's vitelliform macular dystrophy
Authors: Narayanam Swetha , Gudapati Ram K
Published: October 2023

A mother and son were referred to our Retina OPD with complaints of decreased vision for 4 months; the mother additionally complains of distorted vision. The best corrected visual acuity at presentation was 6/6 in the right eye and 6/9 in the left eye for the son and 6/9 in both eyes for the mother. Near vision was N6 for both. The posterior segment showed small egg yolk-like lesions at the macula for the son and larger scrambled egg-like lesions for the mother. The presentation typically lines with Best's vitelliform macular dystrophy. We would like to report this case series as it is rare to see two generations present at the same time with this disease however asymmetric it is.
Secondary iris cyst following ocular blunt trauma: A case report
Authors: Mallapragada Lakshmi S. V. , Peram Venkatratnam , Mahendra Superna , Linga Prathima
Published: October 2023

We present an uncommon case of a post-traumatic iris cyst following blunt trauma with secondary glaucoma. A 19-yr-old male presented with hyphaema and redness in the right eye. Slit-lamp examination and ultrasound biomicroscopy were consistent with an inferior iris cyst. Intraocular pressure was raised, and angle recession was present in the nasal quadrant on gonioscopy which made us probe for blunt trauma history, which was present. With no other causative history or signs and ruling out ciliary body tumor using imaging, we made our diagnosis. Pressures were reduced with antiglaucoma medication. Though uncommon, blunt trauma should be considered as a cause after ruling out other causes, especially malignancy.
Bilateral optic neuritis with complete ophthalmoplegia: An extremely rare complication following COVID-19 (Covishield) vaccination
Authors: Kanungo Sanghamitra , Mishra Anurag , Ananta Sidhartha
Published: October 2023

A 35-year-old healthy female presented with decreased vision, headache, painful and restricted ocular movement 5 days following the second dose of coronavirus disease 2019 (COVID-19) (Covishield) vaccination. Her best-corrected visual acuity was 6/36 in both eyes, and color vision was defective. Dilated fundus showed bilateral disc edema. She developed complete ophthalmoplegia 2 days following initial presentation. Imaging studies and systemic investigations were normal. She was treated with systemic corticosteroids. Complete recovery was noted 1 month following presentation. It is critical to raise awareness about the different complication following different COVID vaccinations, but equally important is a timely and justified treatment which would lead to complete recovery.
Legalization of Recreational Cannabis: Is India Ready for it?
Authors: Chithra Nellai K. , Bojappen Nandhini , Vajawat Bhavika , Pai Naveen Manohar , Gowda Guru S. , Moirangthem Sydney , Kumar Channaveerachari Naveen , Math Suresh Bada
Published: October 2023

Cannabis is one of the oldest psychoactive substances in India and worldwide. Many developed countries like Canada, Netherlands and few states of the USA have legalized the use of recreational cannabis. However, In India, the recreational use of cannabis and its various forms such as ganja, charas, hashish, and its combination is legally prohibited. There have been several discussions and public interest litigations in India regarding the legalization of recreational cannabis use and its benefits. With this background, this article addresses the various implications of legalizing recreational use of cannabis, a multibillion dollar market and its impact on mental health, physical health, social, cultural, economic, and legal aspects with the lessons learnt from other countries that have already legalized recreational cannabis use. It also discusses whether India is prepared for the legalization of recreational cannabis, given the current criminal justice and healthcare systems. The authors conclude that, India is perhaps not enough prepared to legalize cannabis for recreational use. India's existing criminal justice and healthcare systems are overburdened, finding it challenging to control medicinal use, which is often the first contact point for cannabis-related concerns.
Resilience, Social Connectedness, Mental Health Status and Quality of Life in Children of Parents with Mental Illness
Authors: Gogoi Rini , Ali Arif
Published: October 2023

Background:

Children of parents with a mental illness (COPMI) are at greater risk of psychological and physical ill-health, increased behavioral and developmental difficulties, educational underachievement and lower competency than their peers compared to children of healthy parents. The aim of this study was to find resilience, Social Connectedness, mental health status and quality of life (QoL) in COPMI.

Materials and Methods:

Cross sectional Analytical study was used in the present study. Thirty COPMI with age group of 11–18 years of age, either of the biological parents was diagnosed with severe mental illness (Schizophrenia and Bipolar affective disorder according to international classification of diseases-10) were selected. Socio-demographic data sheet, Connor-Davidson Resilience Scale, KIDSCREEN-27 (QoL), Social Connectedness Scale, Strength and Difficulties Questionnaire (SDQ) were administered.

Results:

The finding shows that 33.3% of COMPI had low level of resilience and a stronger sense of social connectedness (M = 78.63, standard deviation [SD] = 6.83). Psychological wellbeing (M = 20.77, SD = 2.68) was higher than other domains of QoL, followed by autonomy and parents (M = 18.46, SD = 3.43), school environment (M = 14.56, SD = 2.87), physical wellbeing (M = 14.43, SD = 1.88), and peer and social support (M = 10.87, SD = 2.08). The finding shows that in the total difficulty score (SDQ), 26.7% falls under normal category while 73.3% have abnormal scores. Total Difficulties score (SDQ) has a significant negative correlation with QoL [r=-0.520, P = 0.01] and Social Connectedness (r = ‒0.478, P = 0.01).

Conclusion:

The study highlighted the risk of developing emotional and behavioral problems among COPMI. Resilience based intervention is required at school and community level for mental health promotion among children.
A deep insight on psychological aspect in patients with Sturge-Weber syndrome
Authors: Patokar Arya , Lohe Vidya , Reche Amit , Sune Ravikant , Datkar Dushyant
Published: October 2023

Studies on Sturge-Weber syndrome (SWS) have already focused on various medical aspects of this syndrome. This review is focusing on the psychological aspects of Sturge-Weber syndrome patients, the behaviors of patients, and the effects of the disease on the children. This disorder is characterized by angiomas, glaucoma, and seizures with a birthmark. Patients with this syndrome have behavioral problems, a lack of social skills, and a lack of intellectual or academic skills. These patients are usually introverted because of a lack of warmth and limited communication. Friends or classmates tease them by calling them “ugly.” All this leads to a lack of social skills, and they mostly keep their feelings to themselves and prefer to be alone. Because of all this mocking by classmates, they keep isolating themselves. All this causes psychological problems in children. They start behaving differently, have suicidal tendencies, and fight with their friends who bully them. Psychological problems are mostly seen in children who are lacking in intelligence and functioning and who have seizure disorders, mostly in those who have frequent seizures. Problems like anxiety, depression, mood changes, anger, and violence are also observed in these patients. All this is always ignored by the parents as well as the doctors. This review aims to focus on the psychological aspect of the patients with SWS, to inform the parents about the behavior of their children with SWS, and to pay more attention to the psychological problems. This review is focusing on the importance of the psychological behavior of patients with SWS, how to diagnose it at an early stage, and how to treat and take care of children with SWS.
Effect of lifestyle interventions to reduce depression, anxiety and stress among married women of reproductive age group: A non-randomised controlled trial in urban slums of Bhubaneswar
Authors: Sharma Sumita , Patnaik Lipilekha , Sahu Trilochan
Published: October 2023

BACKGROUND:

Women are more prone to develop mental disorders as compared to men and the role of physical activities to reduce its burden by improving self-esteem is appreciable. This study aimed to evaluate the effect of lifestyle interventions to reduce depression, anxiety and stress among women in urban slums.

MATERIALS AND METHODS:

This study was a non-randomized controlled trial carried out in two slums of Bhubaneswar in married women of reproductive age group (15 years-49 years) from June 2019 to September 2021 after approval from the institutional ethics committee. A total of 128 married women were recruited, 64 women in each arm. DASS-21 was used for assessing depression, anxiety, and stress of all participants. The lifestyle intervention program was provided to 64 women in the intervention group and educational materials were provided to the control arm. DASS score was assessed again and compared with follow-up scores in both groups. Descriptive statistics were expressed as frequency, mean, median, and standard deviations. Independent t-test and paired t-tests were done where applicable.

RESULTS:

There was no significant difference in socio-demographic factors and DASS-21 scores in both groups during baseline. Depression, Anxiety, and stress score were significantly lower in the intervention arm than control arm in the follow-up (P < 0.05). There was a significant difference between the pre-intervention and post-intervention levels of depression, anxiety, and stress among the intervention group (P = 0.05).

CONCLUSIONS:

Simple community-based physical activities as in our intervention program focusing on the reduction of depression, anxiety, and stress levels in women may prevent the rising problems of common mental disorders.
Assessing and predicting the trend of cardiovascular risk factors in 40–80-year population based on the Ira-PEN program as an integrated service in primary health care
Authors: Ezzati Farahnaz , Jafarzadeh Mohammad , Darabi Fatemeh
Published: October 2023

BACKGROUND:

In Iran, half of all mortalities and 79% of those induced by noncommunicable diseases are attributed to cardiovascular diseases. In Iran, due to the high rate of noncommunicable diseases, a modified program (PEN) called Ira-PEN was integrated into the primary care program in health centers. The Ira-PEN program is adapted from the comprehensive WHO-PEN program to estimate the 10-year risk of cardiovascular diseases to control the main risk factors of noncommunicable diseases nationally. This study was conducted to investigate the process of service provision to determine the information needs and the necessary interventions in the comprehensive health service centers of Ardabil Province.

MATERIALS AND METHODS:

The present descriptive and analytical study was conducted in the Ardabil University of Medical Sciences. It used the data available in the registration system of the Health Network. The research population consisted of all people aged between 40 and 80 who visited the comprehensive health service centers to perform risk assessment of cardiovascular strokes in the province from 2018 to the end of 2021. The collected data were added to Excel. FORCAST function was used to predict the future through a linear regression analysis. To compare the final results, which is actually a reduction in mortality due to cardiovascular diseases, the difference test of two mortality rates due to cardiovascular diseases was used in 2018 and 2021. Test of two death proportions was performed through z test and Minitab21 Software.

RESULTS:

The prevalence of cardiovascular disease risk factors was as follows: history of heart attack (0.59%), history of stroke (0.51%), history of diabetes (7.9%), history of high blood pressure (15.7%), and history of prediabetics (12.8%). The probability of suffering from lipid disorder was 26.4% and BMI > 30 was 32.4%. The risk factors of hypertension, abdominal obesity, and smoking showed a decrease in the measurement of disease risk factors during 4 years.

CONCLUSIONS:

Identification of the common risk factors in the region helps to focus interventions on effective prevention and treatment measures and adopt evidence-based policies in order to reduce these risk factors. Since the investigated risk factors are rooted in inappropriate behaviors and lifestyles, by modifying these behaviors and changing lifestyles, their prevalence can be reduced and reducing these risk factors will lead to a reduction in the prevalence of cardiovascular diseases.
Development of an exclusive breastfeeding intervention based on the theory of planned behavior for mothers with preterm infants: Study protocol for a mixed methods study
Authors: Okhovat Shirin , Janighorban Mojgan , Kazemi Ashraf
Published: October 2023

BACKGROUND:

Despite the significance and benefits of exclusive breastfeeding, its rate among infants, especially preterm infants, is not optimal. Based on evidence, the mother's attitude toward breastfeeding, the subjective norm, and the mother's perceived behavioral control play a role in initiation and continuation of breastfeeding; so the interventions that consider these factors may be useful for breastfeeding premature infants. The aim of this study is to design and develop an exclusive breastfeeding intervention based on the theory of planned behavior for mothers with preterm infants.

MATERIALS AND METHODS:

This exploratory, sequential, mixed methods study will be conducted in three phases. In the first phase, a qualitative study will be conducted based on the theory of planed behavior, to describe the exclusive breastfeeding beliefs of the mothers with preterm infants, the barriers to breastfeeding, and to explain the ways to overcome them. Moreover, the items of the Predictors Of Exclusive Breastfeeding Questionnaire are prepared based on the theory of planned behavior. In the second phase, the intervention plan is designed based on the literature review and the findings of the qualitative study, and it is approved by a panel of experts. Additionally, the psychometric properties of the questionnaire are evaluated and confirmed qualitatively and quantitatively. In the third phase, the developed intervention is implemented and evaluated.

CONCLUSION:

Implementation of supportive educational interventions based on scientific theories can be a step toward improving the rate of onset and continuation of breastfeeding in mothers with preterm infants. Development of interventions based on evidence, identified beliefs, and perceived barriers of the mothers with preterm infants can provide the foundation for more effective interventions according to cultural, social, and religious contexts.
Attitude, perception, and feedback of graduate medical students on teaching–learning methodology in pathology courses: A call for curricular modernization in Morocco
Authors: Oqbani Kenza , Birouk Mounsif , Abbaoui Sanae , Chaouir Souad , Al Idrissi Najib , Ahid Samir
Published: October 2023

BACKGROUND:

The difficulty of understanding the pathology courses and the student's dissatisfaction with the pathology modules is a universal problem. The principal aim of our survey was to assess the perception and satisfaction of teaching pathology by graduate medical students from nine Moroccan faculties of medicine.

MATERIALS AND METHODS:

This study was conducted among graduate medical students regarding their preferences in pathology teaching modalities, their satisfaction with the current lecture-based courses, their perception of pathology as a specialty, and their thoughts on whether and how such curricula should be modernized. A qualitative and comparative analysis was performed. The differences in modalities of teaching used were investigated.

RESULTS:

We received 274 completed surveys from graduate Moroccan medical students. Seventy-five (27.9 %) students were dissatisfied with the actual lecture-based courses. A total of 131 students (48.5%) considered that the methodology of teaching and learning used in their faculty is insufficient for learning, understanding, and memorizing pathology courses. Additionally, 233 students (86.3 %) considered that the curriculum should be modernized. The majority supported the implementation of case reports (74%), hospital-based rotation in the pathology department (68.7%), and virtual slides (60%) as the most preferred didactic methods.

CONCLUSIONS:

This survey based-study highlighted the limits of the current pathology teaching curriculum in Morocco, insufficiently in line with the aspirations of students. Furthermore, students' responses regarding their knowledge of the pathology laboratory functioning as well as their opinions toward considering pathology as a future career were very surprising, converging toward a huge lack of attractiveness of this discipline.
The challenges of the Iranian nursing system in addressing community care needs
Authors: Ezzati Ebrahim , Molavynejad Shahram , Jalali Amir , Cheraghi Mohammad-Ali , Jahani Simin , Rokhafroz Dariush
Published: October 2023

BACKGROUND:

The nursing system is one of the major and important fields of health and medicine in every country, responsible for providing nursing care and addressing medical and health-related community care needs. The aim of this study was to explain the challenges of the Iranian nursing system in addressing community care needs.

MATERIALS AND METHODS:

A conventional content analysis method was performed in this exploratory qualitative study, and 27 participants were selected through a purposive sampling method based on the inclusion criteria. In-depth semi-structured interviews were conducted with the subjects, and data saturation was achieved in the 27th interview. The main interviews with the participants were individual, in person, and face-to-face, conducted at different times (morning and evening) in a peaceful environment and at the convenience of the participants. The interviews were recorded by the researcher with the participants' consent. The duration of the interviews ranged from 50 to 70 minutes, given the participants' energy and time. Data analyses were done using Graneheim and Lundman approach.

RESULTS:

After conducting the interviews and the simultaneous analysis, three themes were extracted, including the challenging structure in the internal environment, the operating environment, and the social environment, with seven main categories and 26 subcategories. An inadequate number of nurses given the real needs of society, the unbalanced proportion of employed clinical nurses to the real needs of society, poor presence of nurses in community-based nursing services, insufficient attention to the optimization of the work environment, the gap between education and clinical practice in the nursing system, poor mutual accountability of the community, and policies in the health system were seven main categories in this study.

CONCLUSION:

In general, the results showed that the Iranian nursing system faces many micro, meso, and macroscale challenges. It is necessary to plan properly to enhance the accountability of the nursing system to the current community care needs by improving the situation.
Identifying and prioritizing the stressors of obstetrics and gynecology residents
Authors: Mirzaei Alireza , Jamshidian Sepide , Movahedi Minoo , Haghani Fariba
Published: October 2023

BACKGROUND:

Studies have shown that the obstetrics and gynecology residents face severe burnout and a large number of stressors, and excessive stress could adversely affect performance and quality of patient care. Thus, the current study attempts to identify and prioritize the stressors of obstetrics and gynecology residents at Isfahan University of Medical Sciences.

MATERIALS AND METHODS:

A cross-sectional descriptive-analytical study was conducted on 62 residents and faculty members in the department of obstetrics and gynecology at Isfahan University of Medical Sciences in 2022. Respondents were selected by census method. The stressors of obstetrics and gynecology residents were investigated using a researcher-made, 37-item questionnaire. The questionnaire was prepared based on a literature review and respondents' opinions, then its validity and reliability were confirmed. Collected data were analyzed using the SPSS 20, non-parametric Friedman's test, and descriptive statistics methods.

RESULT:

This study included 46 respondents (74%), 16 faculty members, and 30 residents, who were asked to rate each stressor of the given questionnaire. The residents and their teachers believed that the main stressors were heavy workloads, lack of personal time, long shifts, financial problems, sleep deprivation, and compassion fatigue. Insufficient study time, study workload, and inappropriate assessment systems for residents were among the high-priority stressors, according to the residents. However, the faculty members reported medical errors, unreasonable expectations from residents, and residents' multiple responsibilities as high-priority stressors. According to the Friedman's test, there was a significant difference in rates received from both the faculty members and medical residents (P value <0/001).

CONCLUSION:

The stressors due to the nature of obstetrics and gynecology, medical care, residency training, and medical resident assessment are the highest priority. The findings of this study could be beneficial to the officials in residency training programs to take the necessary corrective actions.
The effectiveness of mindful hypnotherapy on difficulties in emotion regulation, mindfulness, and mental health in patients with major depressive disorder
Authors: Khazraee Hassan , Bakhtiari Maryam , Kianimoghadam Amir Sam , Ghorbanikhah Elaheh
Published: October 2023

BACKGROUND:

More than 300 million people are affected by major depressive disorder, and despite advances in treatments over the past 50 years, this number is increasing worldwide. Due to the high prevalence and increasing numbers, along with problems in various aspects of the patient's life, new effective treatments are essential in this field.

MATERIALS AND METHODS:

This study was a single-blinded randomized clinical trial. Thirty-four patients with major depressive disorder who were referred by clinical psychologists in the clinical psychology clinic of the Taleghani Hospital, Tehran, Iran, were selected by purposive sampling method and randomly assigned to the intervention and wait-list control groups. The Difficulties in Emotion Regulation Scale, the Five Facet Mindfulness Questionnaire, and the Mental Health Continuum Short Form were administered during the baseline and post treatment. Analyses of covariance and the repeated measures analysis of variance (ANOVA) procedure were performed to determine the difference between study groups.

RESULTS:

The results of the analysis of covariance and repeated measures ANOVA showed a clinically significant decrease in difficulties in emotion regulation and a significant increase in mindfulness and mental health in the intervention group (P < 0.001). The mean score (standard deviation) of the difficulties in emotion regulation scores was 123.75 (21.10) in the experimental group at baseline and significantly decreased to 76.19 (26.45) and 68.00 (22.83) after the intervention and two-month follow-up, respectively (P < 0.001). Additionally, the mean scores (standard deviation) for mindfulness and mental health were 93.06 (8.23) and 19.63 (7.92), respectively, at baseline and significantly increased to 149.43 (16.99) and 51.62 (9.78), respectively, after the intervention and to 144.18 (20.55) and 48.50 (13.52) after a two-month follow-up (P < 0.001).

CONCLUSION:

The results show that mindful hypnotherapy is an effective treatment for improving difficulties in emotion regulation, mindfulness, and mental health in patients with major depressive disorder.