bluuebunny/crossref_metadata_2025 huggingface dataset:
Disfagia sarcopénica
Authors: Patino-Hernandez Daniela , Germán Borda Miguel , Venegas Sanabria Luis Carlos , Chavarro-Carvajal Diego , Cano-Gutiérrez Carlos Alberto
Published: July 2018

La disfagia sarcopénica es la dificultad deglutoria asociada con la pérdida de masa, fuerza y función muscular generalizada. Su prevalencia aumenta en pacientes ancianos, así como en aquellos con malnutrición o con desuso de la musculatura deglutoria. Está relacionada con desenlaces adversos, como lo son la neumonía aspirativa, la acumulación de residuos en la cavidad orofaríngea luego de la deglución, la peor calidad de vida y los tiempos de estancia hospitalaria prolongados. Se realizó una revisión de la literatura disponible sobre el tema con el fin de proveer una guía para la detección temprana y el manejo de esta entidad clínica, necesarios para una adecuada práctica clínica.
Síndrome de Budd Chiari: revisión de tema
Authors: Correa Gaviria Simón , Ramírez Ana Catalina , Espinoza Herrera Yeinis Paola , Restrepo Gutiérrez Juan Carlos
Published: July 2018

El Síndrome de Budd-Chiari (SBC) es una entidad poco usual; su incidencia se calcula de uno en cien mil. Consiste en una obstrucción completa o parcial del flujo venoso localizada en cualquier lugar desde las pe- queñas venas hepáticas hasta la porción suprahepática de la vena cava inferior. De acuerdo con su etiología puede clasificarse en: primario (cuando la obstrucción se debe a una enfermedad venosa), o secundario (cuando se atribuye a una compresión extrínseca o a la invasión por una lesión que se origina fuera de las venas como neoplasias o quistes). En la mayoría de los casos se presenta como un cuadro de inicio súbito de dolor abdominal, ascitis y hepatomegalia, pudiendo ser asintomático. El diagnóstico definitivo se establece por estudios de imagen; si bien deben solicitarse exámenes básicos de laboratorio y estudios de extensión. Las modalidades de imagen incluyen la ultrasonografía Doppler, la tomografía computarizada, la resonancia magnética y la angiografía por sustracción digital, que es considerada el patrón de oro. La primera medida terapéutica que debe emprenderse en estos pacientes es la anticoagulación con heparina de bajo peso molecular, seguida de antagonistas de vitamina K. La mayoría de los pacientes requieren un enfoque multidisciplinario y un tratamiento escalonado que incluye procedimientos radiológicos, como la aplicación de balones y stents y la inserción de shunts portosistémicos transyugulares intrahepáticos (TIPS), procedimien- tos quirúrgicos de descomprensión y, por último, trasplante hepático.
Comparison of Management Practices in Public and Private Universities in Khyber Pakhtunkhwa
Authors: Khan Nasrullah , Aajiz Dr Niaz Muhammad , Ali Akber
Published: July 2018

 This study attempted to compare the management practices in public and private universities in Khyber Pakhtunkhawa, Pakistan. The comparison is based on availability of written rules and regulations, distribution of tasks, availability of managers, access to officers, time management, work load, staff promotion procedure and appraisal system. Additionally, the comparison is also based on transparency, political intervention, use of authorities, nepotism and biasness, human resource availability and functions, academic decisions, existence of different decision making bodies, committees and their role in policy making and implementation and management styles. The population comprised all recognized universities in Khyber Pakhtunkhawa and a convenience sampling of six universities included three from public and three from private sector. The findings showed that both sector universities had the required offices, staff members and managers. The areas where private universities were observed weak as compared to public universities were lack of proper staff vacancy advertisements and induction policies, vague appraisal system, low salary packages and limited freedom to managers. Public universities were found unsatisfactory in areas including staff induction on merit based policies and political intervention, lack of monitoring system and lack of collegiality amongst university offices. The study recommends that universities in both sectors should prepare staff and student manuals for transparency procedures, should improve the skills and knowledge of its staff/managers by conducting seminars/ workshops/ trainings in collaboration with HEC and other regulatory bodies on regular basis, and establish public private partnership to improve university management system in Pakistan.
Implementation of CIPP Model for Quality Evaluation at School Level: A Case Study
Authors: Aziz Shamsa , Mahmood Munazza , Rehman Zahra
Published: July 2018

Evaluation denotes the monitoring of progress towards desired goals and objectives. The purpose of this study was to evaluate educational quality at schools using Stufflebeam’s CIPP evaluation model (1983). The population comprised the principal, heads of each wing and teachers of various branches of a Welfare School System in Rawalpindi. Data were collected through the CIPP evaluation checklist (2002), semi structured interviews, document analysis and observations. Data were analyzed via content and thematic analysis. Findings indicated that this group of welfare schools focused on quality education by using different means, such as advanced technology, effective communication, relevant courses as well as teaching and learning strategies; however, it was found that teachers focused more on theoretical work and rote learning, which put pressure on students and had a negative effect on their intellectual abilities. Moreover, there was lack of proper space, effective environment and the schools were situated in rented buildings.

 
Analysis of the Concept Continuing Education in Nursing Education
Authors: Agyepong Edith Biamah , Okyere Enoch Danso
Published: July 2018

 

 The term continuing education is extensively used throughout nursing education literature. This paper sought to re-examine the concept ‘continuing education’ for its meaning, relevance and appropriateness of application. The authors examined the definitions of continuing education from dictionaries, thesauruses, and current nursing education literature for meanings, usages, attributes, antecedents and consequences in line with Walker and Avant (2005) method of concept analysis. Model, borderline, and contrary cases were also presented. The paper concludes that the development of a theory of continuing education is usually preceded by a logical analysis of the concept which includes distinguishing properties, antecedents and outcomes of further education. The subsequent step in the development of the theory of lifelong education requires establishing theoretical relationships between perceptions, motivation and barriers to continuing education. It recommends that empirical studies of further education, whether qualitative or quantitative can be carried out to find out the effects of lifelong education on the nursing profession to enhance research in nursing and advance professionalism in nursing.
Gender Comparison of Emotional Intelligence of University Students
Authors: Fida Asfandyar , Ghaffar Abdul , Zaman Amir , Satti Asif Niwaz
Published: July 2018

 Emotional intelligence is a contributing construct to learning and other personal and career developments. It is a perplex notion involving many conceptions which resulted in various tools of emotional intelligence. University education is a terminal stage when young people are ready to enter the job arena and are expected to be emotionally sound. Numerous studies have been carried out on the differentiation of emotional intelligence of the learners, particularly at graduate and post-graduate levels. This study is an attempt to investigate emotional intelligence of the university students. Since there are differences in the findings of various studies in terms of gender; therefore, this study also considers to explore the discrepancy of the emotional cognizance of the male and female learners at university level. The target participants of this investigation were the students of all five faculties of a university in Khyber Pukhtunkhwa, a province in Pakistan. The Wong and Law Emotional Intelligence Scale (WLEIS) developed by Wong and Law (2002) was used for data collection. The outcomes of the investigation showed that female learners were ahead of male in emotional intelligence. Further, the learners of business and economics had superior level of emotional intelligence, while students of Arts and Humanities had inferior level of emotional intelligence. The study put forward some valuable suggestions, particularly through curricula enhancement and for further research activities.
The influence of silica nanoparticles on thermal degradation and mechanical properties of nanocomposites based on aliphatic polyurethanes
Authors: Pavlicevic Jelena , Spirková Milena , Bera Oskar , Jovicic Mirjana , Kojic Dejan , Mészáros-Szécsényi Katalin , Budinski-Simendic Jaroslava
Published: July 2018

Nanocomposites based on aliphatic polyurethanes have recently attracted a lot of attention regarding economical and ecological aspects, due to their improved thermal and mechanical properties. The aim of this paper was to investigate the influence of silica nanoparticles, differing in size and specific surface, on thermal stability and degradation, lifetime and mechanical characteristics of the obtained nanocomposites. Two series of nanocomposites based on aliphatic polyurethanes were obtained by using a single-step procedure and by addition of silica nanoparticles of types A380 or N999 at different loadings (0,0 0.15, 0.5, 1,0 and 3.5 wt.%). It was found that the increase in heating rate caused shifting of the onset temperature to higher values (from 283 to 312 ?C). According to the shape of DTG curves, it was observed that the degradation mechanism of prepared nanocomposites consists of two overlapping processes, related to the scission of hard and soft building blocks. Based on DTG results, the addition of larger N999 silica nanoparticles induced lower thermal degradation, shifting the maximum rate temperatures of the first and second degradation stages to lower values, and caused the change in the degradation mechanism. Addition of smaller silica nanoparticles (A380) did not significantly affect the mechanism of the degradation reaction, indicating homogeneity of the obtained nanocomposites. The presence of A380 nanoparticles improved thermal stability of nanocomposites, by increasing the onset temperature from 286 ?C for the pristine elastomer to 303 ?C for the sample containing 3.5 wt.% of silica. Existence of interactions of A380 silica nanoparticles with hard and soft phases was observed, based on the increase in the maximum rates of the first and second degradation steps. The activation energy of thermal degradation of polyurethanes modified with A380 silica nanoparticles was obtained by using the Flyn-Wall and Toop models. Dependence of the activation energy and the lifetime of nanocomposites based on aliphatic polyurethanes on the silica content were estimated. The highest Ea values (determined for 1 and 5 % weight loss) were found for nanocomposites containing 0.5 and 0.15 wt. % of A380 silica nanoparticles (121 and 161.2 kJ/mol). A negative effect of the silica addition on mechanical properties of nanocomposites was observed. The polyurethanes containing smaller SiO2 particles (A380) had a higher tensile strength, elongation at break and hardness as compared to the elastomers filled with larger silica nanoparticles (N999).
The Character and Effects of Sanctions Imposed on Russia in Consequence of Aggression Against Ukraine
Authors: Żukowska Helena
Published: July 2018

The economic sanctions imposed on Russia have adversely affected the development of the Russian economy. Russia’s GDP has decreased, GDP growth rate has slowed down, global demand has declined, prices and interest rates have risen. Inflation has increased, the rouble has become devalued, the amount of foreign exchange reserves has gone down, and life quality of Russian citizens has deteriorated. The sanctions of the Western states against Russia as well as the sanctions reciprocally applied by Russia against the broadly understood foreign countries have negatively influenced the economies of many Western states which have also been affected by worse conditions of economic growth after 2014.
The Economic Crisis of 2008 and the Financial System Supervision: Towards an European Banking Union
Authors: Kolovou Evaggelia , Gikas Grigorios , Kyritsis Kostantinos
Published: July 2018

The significant repercussions of the recent crisis in the financial sector and the real economy have led to the development of policies aimed at strengthening the stability of the international banking system. Banking regulatory reforms (Basel III) improve micro-prudential supervision and involve macro-prudential supervision to avoid systemic risk. Capital requirements are tightening up and the quality of core capital is upgraded in order to provide greater coverage of losses and better risk management. In addition, a new framework for liquidity risk is introduced, as well as a complementary tool for limiting leverage. Recently, an agreement was reached in the EU to establish a Banking Union in the Eurozone, based on uniform regulation, supervision, bank clearing and deposit protection mechanisms. This framework includes a common banking capital for bank consolidation, which aims to reduce the impact on savers. This study aims to analyse the banking sector's activities and the constituent elements of the existing regulatory framework, particularly those involved in the causes of the financial crisis. It also aims to present the dimensions of the new regulatory framework for joint supervision leading to the European Banking Union and to analyse the pillars that form it, even though they are still in progress. The analysis will also build on the experiences from the recent crisis, in order to reach clear conclusions about the necessity and role of the Banking Union.
Foreign Currency Loans and Stability of the Banking System in Poland
Authors: Olszewska Grażyna A.
Published: July 2018

The aim of the study was to answer the question whether and to what extent foreign currency loans may pose a threat to the stability of the banking system in Poland. The reason for exploring this problem is the situation in which Swiss franc mortgage loan parties found themselves. The problem concerned not only Poland, but also appeared in Hungary, Spain and Ukraine. The aforementioned countries have adopted various strategies in order to solve this issue. Currently, there is a discussion in Poland over the form of solution to the situation in which the Swiss franc debtors have found themselves. This article presents the following hypotheses: (1) The credit policy of banks, which includes mortgage lending in Swiss francs, was a typical action in terms of risk management which in this case was two-way in nature. In addition, banks did not have the opportunity to significantly impose its policies on customers, as evidenced by the degree of market development and market competition. (2) Conversion of mortgage loans according to the CHF historic exchange rate can affect the stability of the banking system. The article presents the main types and sources of bank risks with particular emphasis on credit risk and foreign exchange risk. In addition, the paper shows the importance of this kind of risk in the context of the systemic stability of the banking sector in a situation of exchange rate stability disturbances. Verification of the research hypothesis was based on literature studies and analysis of statistical data.
La Santa Sede e l’Europa centro-orientale dopo la Grande Guerra. Il Concordato con la Romania
Authors: BUCUR Ioan-Marius
Published: July 2018

Riassunto: La Santa Sede e l’Europa centro-orientale dopo la Grande Guerra. Il Concordato con la Romania. I rapporti diplomatici tra la Romania e la Santa Sede e, in particolar modo, la questione relativa al Concordato sono stati a lungo indagati dalla storiografia romena, soprattutto negli ultimi decenni. Partendo da alcuni contributi storiografici recenti, ci proponiamo di inserire l'evoluzione dei rapporti diplomatici romeno-vaticani e specialmente la questione del Concordato nella dinamica dell'evoluzione internazionale del periodo interbellico, soprattutto dello spazio central-sud-est europeo, da un lato, e di evidenziare la connessione tra il livello politico-istituzionale e quello ecclesiastico nel consolidare il processo di costruzione nazionale (national building) della Romania, dall'altro.
Rezumat: Sfântul Scaun și Europa Central-Răsăriteană după „Marele Război”. Concordatul cu România. Tema relaţiilor diplomatice româno-vaticane şi, în subsidiar, chestiunea Concordatului, a suscitat un interes crescând din partea istoricilor români în deceniile din urmă. Pornind de la unele din contribuțiile istoriografice recente, ne propunem să inserăm evoluția relațiilor diplomatice româno-vaticane și în particular chestiunea Concordatului în dinamica evoluţiei internaţionale din anii interbelici, cu precădere din spațiul central-est european, pe de o parte, și să reliefăm legătura dintre aspectul politico-instituţional şi cel ecleziastic în consolidarea procesului de edificare naţională (national building) în cazul României interbelice, pe de altă parte.
Cuvinte cheie: Sfântul Scaun, România, concordat, Biserica Catolică.
LA MAIN PASSIVE: ABSENCE D’ŒUVRE, RESISTANCE ET DESŒUVREMENT
Authors: APOSTOL Patricia
Published: July 2018

The Passive Hand: Absence d’œuvre, Resistance and Désœuvrement. I question the rapport between the hand as an aesthetic notion and the value of passivity, in order to define the dynamic of the relationship between passivity and creation. I, first, examine the Blanchot’s metaphor regarding the act of creation as being a privative intervention of the left hand, passive, on the right hand, active, under the light of a critical reading of the Nietzschean concepts of active force—reactive force; then, I analyse the passivity of the discourse under three types of rapport: the inspiration and the absence of the œuvre, the resistance and the œuvre, the disobedience and the désœuvrement. From the absence of the œuvre of the inspired artist to the resistance at the œuvre, which creates the œuvre, and lastly, to the reactive force which affirms the refusal of the œuvre and produces the absence of the œuvre, passivity makes a circular movement from the impossibility of the oeuvre towards the désœuvrement, from from its genesis to its heterogenesis.
COLLABORATIVE PHENOMENOLOGICAL PRACTICES
Authors: COSMESCU Alexandru
Published: July 2018

In the present paper, I examine the possibility of doing phenomenology in a collaborative manner. Faced with the fading of the ethos of seeing for oneself and the predominance of meta-phenomenology passing for phenomenological work, Herbert Spiegelberg proposed the organization of phenomenology workshops. After offering an analysis of the method of philosophical workshops exemplified by a contemporary proponent of philosophical practice, Oscar Brenifier, I identify several problems such a workshop can face and several commitments that can help create the co-subjectivity necessary for sym-phenomenologizing.
FATHERHOOD’S SUBJECTIVE EXPERIENCE IN THE FACE OF ADOLESCENT CHILDREN’ DEPRESSIVE SYMPTOMATOLOGY AND SUICIDE ATTEMPT
Authors: SALDAÑA TUMBAY Milagros Rocío
Published: July 2018

Fatherhood’s subjective experience in the face of adolescent children’ depressive symptomatology and suicide attempt. The fatherhood’s experience of living with a teenage son or daughter who presents depressive symptomatology and has tried to commit suicide constitutes a subjective experience in and of itself. For the father, these adverse conditions represent a challenge in his constituted role and cause an emotional impact which must be analysed by considering his subjective constitution. The aim of this research is to explore this experience by using a phenomenological qualitative approach. To do that, semi-structured interviews and the application of a test of incomplete sentences were applied to parents whose adolescent children received ambulatory care after a first suicide attempt in a psychiatric hospital in Peru. The results show that participants experience various emotions that involve impotence, anger, sadness, guilt, and relief around three stages: the onset of symptoms, attendance at a psychiatric hospital and the perception of remission of the symptoms. It was found that although at the beginning the fathers find it difficult to get involved with affection with their younger children, they are able to recover the bond through of the reconstitution and reorganization of their role.
A relação da incontinência urinária feminina de esforço e a atividade física
Authors: Sinésio Deise Maria Moraes , Santos Rose , Escobar Felipe , Sinésio Luís Eduardo Moraes
Published: July 2018

O objetivo desta pesquisa foi analisar se a atividade física contribui ou não para a melhoria da Incontinência Urinária de Esforço (IUE) em mulheres na faixa etária de 35 a 55 anos. O estudo caracteriza-se do tipo transversal, descritivo com enfoque qualitativo. Para compor a amostragem, selecionaram-se 24 mulheres, cuja faixa etária compreendia idades entre 35 e 55 anos. Os dados foram coletados por meio de um questionário com 8 (oito) perguntas objetivas. Destaca-se a intervenção dos profissionais de Educação Física considerados indispensáveis à orientação e prescrição dos exercícios recomendados às mulheres com quadro de IUE, que podem ultrajar todos os conceitos, melhorar os efeitos dessa relação e, consequentemente, a qualidade de vida dessas mulheres.Descritores: Interdisciplinaridade, Aprendizagem, Participação. The relationship between feminine urinary stress incontinence and physical activityAbstract: The objective of this research was to analyze whether or not physical activity contributes to the improvement of Urinary Stress Incontinence (USI) in women aged 35 to 55 years. The study is characterized by a cross-sectional, descriptive type with a qualitative approach. To compose the sample, 24 women were selected, ranging in age from 35 to 55 years. The data was collected through a questionnaire with 8 (eight) objective questions. It is important to highlight the intervention of physical education professionals considered indispensable for the orientation and prescription of the exercises recommended for women with USI, which may outrage all concepts, improve the effects of this relationship and, consequently, the quality of life of these women.Descriptors: Interdisciplinarity, Learning, Participation. La relación entre incontinencia urinaria femenina de esfuerzo y la actividad físicaResumen: El objetivo de esta investigación fue analizar como la actividad física contribuye o no para la mejora de la incontinencia urinaria de esfuerzo (IUE) en mujeres en el grupo de edad de 35 a 55 años. El estudio se caracteriza por el tipo transversal, descriptivito con el foco cualitativo. Para componer el muestreo, se seleccionaron 24 mujeres, cuya franja etaria comprendía edades entre 35 y 55 años. La recolección de datos fue hecha por medio de una encuesta con 8 (ocho) preguntas objetivas. Se destaca la intervención hecha por los profesionales de Educación Física considerados indispensables a la orientación y prescripción de los ejercicios recomendados a las mujeres con cuadro de IUE, que pueden ultrajar todos los conceptos, mejorar los efectos de esta relación y, consecuentemente, la calidad de vida de esas mujeres.Descriptores: Interdisciplinaridad, Aprendizaje, Participación.
Mapping Global Research Output in Big Data during 2007-16
Authors: Dhawan S.M. , Gupta Brij Mohan , Gupta Ritu
Published: July 2018

The paper examines global research in big data, as covered in Scopus database 2007-16, on a series of bibliometric indicators. The study finds that big data registered exceedingly fast growth (135.2%), but averaged low citation impact per paper (3.75) and accounted for very low share of highly cited papers (0.86%) in 10 years. The study reports publication trends in big data research by top countries, top institutions, top authors, top journals, major subject areas, publication modes, and country-level share of international collaborative publications. The study concludes that big data is a subject of recent origin. Given its major potential to impact business, governance, society, healthcare, industry and many other sectors, big data is fast emerging as a major discipline of interest and importance to nations, corporates, and institutions across developed and fast emerging economies.
Manajemen Pemupukan pada Perkebunan Kelapa Sawit (Elaeis guineensis Jacq.) Kabupaten Rokan Hulu, Riau
Authors: Hidayat Wahyu , Yahya Sudirman
Published: July 2018

Kegiatan penelitian dilaksanakan di Kabupaten Rokan Hulu, Riau dimulai dari tanggal 13 Februari hingga 13 Mei 2012. Kegiatan penelitian menyangkut aspek teknik dan manajerial dan menjadi karyawan harian lepas (KHL), supervisior dan asisten kebun. Kegiatan penelitian bertujuan untuk meningkatkan kemampuan teknik dan pengetahuan manajerial. Pengumpulan data yang penulis lakukan meliputi data primer dan data sekunder. Data primer meliputi segala informasi yang diperoleh di lapang yang meliputi ketepatan pemupukan, tepat dosis, tepat waktu, dan metode aplikasi. Data sekunder diperoleh dari file perusahaan, berupa data curah hujan, produktivitas, rekomendasi pemupukan, struktur organisasi, dan semua yang berkaitan dengan tenaga kerja. Data yang diperoleh dianalisis menggunakan metode deskriptif.
El webcast como estrategia de aprendizaje significativo en la Fisiología Cardiovascular
Authors: Delgado Rico Hernán Darío , González Olaya Hilda Leonor
Published: July 2018

Introducción: En la actualidad, se hace necesario transformar las actividades educativas para incluir a los “nativos digitales” quienes actualmente componen la mayoría de los estudiantes en las aulas. En el presente estudio se aborda el resultado de una investigación educativa en Ciencias de la Salud usando una metodología de innovación basada en la incorporación de Tecnologías de Información y Comunicación, el webcast. Objetivo: Evaluar el impacto en el aprendizaje de temas de Fisiología cardiorrespiratoria mediante un webcast aplicado en estudiantes de Medicina de segundo año de una universidad colombiana Metodología: Se realizó un estudio cuasiexperimental, que incluyó estudiantes matriculados en segundo año de medicina de una universidad del nororiente colombiano. Para evaluar el impacto en el aprendizaje, se utilizó una prueba estandarizada de conocimentos sobre Fisiología respiratoria y cardiovascular. Resultados: Se encontró mejor desempeño en el grupo que se instruyó usando webcast comparado con el de las clases magistrales (  = 3.47 ± 0.04 versus 3.18 ± 0.03, ±EEM, respectivamente; ANOVA, F= 6.56, p= 0.01). Además, se aplicó una encuesta sobre aspectos del uso y opiniones sobre los materiales. Conclusiones: El webcast es una metodología que permite reorganizar las actividades de formación potenciando procesos de pensamiento formal y logra el aprendizaje significativo de tópicos relacionados con la fisiología cardiovascular; adicionalmente, en los estudiantes se encontró buena recepción de la estrategia innovadora empleada y les permitió tener un desempeño satisfactorio en las pruebas de evaluación de conocimientos, considerándolo como un buen complemento de currículos que lo combinen junto a las disertaciones magistrales. [Delgado-Rico HD, Gonzalez-Olaya HL. El webcast como estrategia de aprendizaje significativo en la Fisiología Cardiovascular. MedUNAB 2017; 20(2): 123-130].
Modelo de Enfermería para optimizar sistemas de salud
Authors: Grinspun Doris
Published: July 2018

Introducción: Los gobiernos de todo el mundo buscan diferentes estrategias para ampliar el acceso a los servicios de salud, abaratar costos y optimizar resultados. Objetivo: Presentar el contexto socio-político de salud en el que se sitúan las guías de buenas prácticas basadas en la evidencia de la Asociación de Enfermeras de Ontario. Temas de reflexión: La discusión se centra en los desafíos claves de salud y atención sanitaria que enfrentan diversos países del mundo, y las amenazas y oportunidades que éstos presentan para Enfermería. Se enfatiza la necesidad del uso de evidencia como una herramienta central pero no la única para optimizar los resultados de salud de los ciudadanos. Conclusiones: Los cuatro componentes principales que facilitan un modelo de atención efectivo corresponde a: Recursos humanos adecuados; trabajo interprofesional positivo; expansión del rol de las enfermeras profesionales; y la práctica basada en la evidencia. Todos estos componentes son necesarios para alcanzar una atención de acceso universal, oportuna y centrada en la persona. [Grinspun D. Modelo de Enfermería para optimizar sistemas de salud. MedUNAB 2017; 20(2): 224-234].
Implementación de la guía de valoración y manejo del dolor, de la Registered Nurses' Association of Ontario (RNAO) en el programa de Enfermería de la Universidad Autónoma de Bucaramanga
Authors: Bonilla Marciales Adriana Patricia , Jaimes Valencia Mary Luz , Serrano Gómez Sergio Eduardo , Arenas Luna Gloria Inés , Padilla García Clara Inés , Criado Morales María Lucenith
Published: July 2018

Introducción: El programa de enfermería de la Universidad Autónoma de Bucaramanga busca innovar con un currículo globalizado que responda a las necesidades tanto del país como del mundo, para ello se ha vinculado con el proyecto internacional  International Best Practice Spotlight Organization, para la implementación a nivel curricular de la guía de buenas prácticas clínicas de valoración y manejo del dolor basadas en la evidencia científica de la Registered Nurses' Association of Ontario. Objetivo: Reflexionar sobre la experiencia de la implementación de la guía de buenas prácticas clínicas para la valoración y manejo del dolor de la Registered Nurses' Association of Ontario en el programa de Enfermería de la Universidad Autónoma de Bucaramanga. Discusión: Para la metodología de la implementación se consideró como marco de referencia el Proyecto Educativo Institucional, proyecto educativo del programa de la Universidad Autónoma de Bucaramanga, la herramienta de Implementación de buenas prácticas propuesta por la Registered Nurses' Association of Ontario y el levantamiento de información que permitiera identificar los vacíos y las acciones de implementación en los contenidos curriculares respecto al uso de recomendaciones de práctica clínica, para la valoración y manejo del dolor en el currículo del programa de enfermería. Conclusiones: Realizar el levantamiento de información de los contenidos curriculares según las recomendaciones permitió identificar los mínimos curriculares a garantizar tales como: mecanismos del dolor, clasificación, intervenciones farmacológicas, no farmacológicas, implicaciones éticas, gestión y fortalecimiento de la actitud profesional que permita brindar un plan de atención integral del ser humano en cada una de las etapas del ciclo vital. La implementación de la guía de buenas prácticas clínicas de valoración y manejo del dolor permitirá tener un impacto académico en la formación de los futuros profesionales del programa de enfermería, una vez se incluyan transversalmente los contenidos relacionados con las buenas prácticas en las diferentes asignaturas del componente básico, profesional y específico del nuevo plan curricular. [Bonilla-Marciales AP, Jaimes-Valencia ML, Serrano-Gomez SE, Arenas-Luna GI, Padilla-García CI, Criado-Morales ML. Implementación de la guía de valoración y manejo del dolor, de la Registered Nurses' Association of Ontario (RNAO) en el programa de Enfermería de la Universidad Autónoma de Bucaramanga. MedUNAB 2017; 20(2): 148-164].
Prevención de caídas y lesiones derivadas en adultos mayores hospitalizados: Experiencia de cuidado de enfermería de la aplicación de una guía de buenas prácticas en la Fundación Oftalmológica de Santander (FOSCAL)
Authors: Esparza Bohórquez Maribel , Granados Oliveros Lina María , Serrano Sanmiguel Emerson , Peñaloza Jaimes Senieth
Published: July 2018

Introducción: Las caídas representan un indicador de la calidad de cuidado de las instituciones hospitalarias a nivel mundial y generan un problema de salud pública debido al gran impacto que ocasionan en el individuo, familia e institución. Para enfermería es imprescindible contar con estrategias basadas en la mejor evidencia disponible que orienten el cuidado y ayuden a la enfermera en la toma de decisiones que favorezcan la salud de los pacientes más susceptibles de sufrir este tipo de eventos. Objetivo: Disminuir las caídas en personas mayores en los servicios de hospitalización, a través de la implementación de la guía de buenas prácticas en enfermería de la asociación de enfermeras registradas de Ontario. Metodología: Estudio descriptivo, prospectivo de implementación de la guía de Prevención de Caídas y Lesiones Derivadas de las Caídas en Personas Mayores, entre el II semestre de 2012 y II semestre de 2014, en 2 servicios de medicina interna de hospitalización en los cuales se implementó la guía asociación de enfermeras registradas de Ontario: Prevención de Caídas y Lesiones derivadas de las caídas en personas mayores. Fase I: Capacitación-definición de población objeto. Fase II: Implementación-auditoria y seguimiento. Resultados: Se valoró un total de 2,387 (88.3%) pacientes hospitalizados, se identificó el riesgo de caída en 1,960 pacientes (82.1%) y se implementó un plan multifactorial de prevención de caídas en 1,831 (93.4%). 19 usuarios con riesgo presentaron caída con grado de lesión leve y se disminuyó en un 20% la incidencia total de caídas con relación al año 2012. Conclusiones: La implementación de guías de enfermería basadas en la evidencia genera un efecto positivo en la calidad de los cuidados, logrando resultados que impactan en la salud y bienestar de los pacientes. Prevención de caídas y lesiones derivadas en adultos mayores hospitalizados. [Esparza-Bohórquez M, Granado-Oliveros LM, Serrano-Sanmiguel E, Peñaloza-Jaimes S. Prevención de caídas y lesiones derivadas en adultos mayores hospitalizados: Experiencia de cuidado de enfermería de la aplicación de una guía de buenas prácticas en la Fundación Oftalmológica de Santander (FOSCAL). MedUNAB 2017; 20(2): 174-181].
Spor Alışkanlığı Olan ve Olmayan Üniversite Öğrencilerinde Uyku ve Yaşam Kalitesinin İncelenmesi
Authors: YARAN Mahmut
Published: July 2018

Amaç: Bu araştırmanın amacı, spor yapan ve yapmayan üniversite öğrencilerinin uyku ve yaşam kalitesi düzeylerinin
incelenmesidir. Gereç ve Yöntem: Ondokuz Mayıs Üniversitesi’nde farklı fakülte ve yüksekokullarda
okuyan 378 öğrenciye yüz yüze görüşme tekniği ile anket uygulandı. Öğrencilerden haftada en az 3 gün ve en
az 1 saat süreyle sportif bir aktivite yaptıklarını beyan edenler spor yapanlar olarak kabul edildi. Veriler IBM
SPSS Statistics 20 programı kullanılarak analiz edildi. Öğrencilerin fiziksel ve sosyolojik özelliklerine ilişkin
bilgilerini sorgulayan araştırmacı tarafından geliştirmiş kişisel bilgi formu, uyku kalitesini değerlendirmek için
Pittsburgh Uyku Kalitesi İndeksi (PUKİ), yaşam kalitesinin değerlendirilmesinde ise Nottingham Sağlık Profili
(NSP) kullanıldı. Sonuçlar: Öğrencilerin 100’ü (% 26.5) spor yapıyorken, 278’i (% 73.5) düzenli olarak spor
yapmıyordu. Spor yapanlar ile spor yapmayanlar arasında PUKİ değerine göre anlamlı bir farklılık bulunmadı.
Spor yapanların NSP toplam değerleri ile NSP alt parametrelerinden enerji seviyesi, emosyonel reaksiyon ve
fiziksel aktivite değerlerinin spor yapmayanlara göre anlamlı derecede düşük olduğu bulundu (p<0.05). Spor
yapan üniversite öğrencilerinin spor yapmayanlara göre uyku kaliteleri arasında bir fark olmadığı ancak yaşam
kalitelerinin daha yüksek olduğu bulundu. Tartışma: Spor yapan öğrencilerin yaşam kalitesinin daha iyi bulunması,
üniversite öğrencilerinde sporun teşvik edilmesinin gelecekte oluşturacakları yaşam tarzı için önemli
olduğunu göstermektedir. Öğrencilerin uyku kaliteleri arasında bir fark bulunmaması yapılan spor türünün,
spor yapma zamanın da daha detaylı incelenmesi gerektiğini düşündürmektedir.
Inguinal hernias recurrence: causes and surgical treatment
Authors: Ya. P. Feleshtynskyi  , A. А.  Shtaier
Published: July 2018

The current paper reveals the definition and classification of recurrent inguinal hernia, the main causes of relapses are highlighted. According to modern data, the relapse causes are divided into three groups: factors caused by the general condition of the patient, morphological features of the primary hernia, and factors that depend on the attending physician. The dependence of the relapses occurrence on the technical errors of the surgeon has been analyzed. Particular attention is paid at the correctness of the certain hernioplasty technique implementation, the surgeon’s experience, the effective treatment method choice of the primary inguinal hernia. The attention is focused on the recurrence mechanisms after endoscopic methods for primary inguinal hernias, which have been increasingly used in general surgical practice. It presents the evolution of improvement laparoscopic plasty techniques to reduce the complications number and relapse rate: using a larger mesh, reducing the taker amount during fixation or the use of methods without fixation with fibrin glue, the entire mesh plastic without cutting it, which prevents relapses at the site of the mesh section. Approaches to the selection of a reliable hernioplasty technique for reducing the number of relapses have been presented. The data are based on the national Swedish and the Danish registers, recommendations of the EHS, according to which it is required to select an alternative mesh placement method to the previous alloplasty for the treatment of relapsing inguinal hernia, the latter allows to use less modified muscle‑aponeurotic structures in the treatment of recurrent inguinal hernias. In this case, special attention should be paid at the sufficient mesh overlapping of scar and atrophied tissues in the inguinal area. The matter of surgical treatment of recurrent inguinal hernias remains up‑to‑date and addresses further improvement.
Comparative effectiveness evaluation of the improved and conventional perioperative antithrombotic therapy in patients with acute calculous cholecystitis and concomitant ischemic heart disease
Authors: V. G. Mishalov  , S. O. Kondratenko  , L. Yu. Markulan
Published: July 2018

The aim — to evaluate the efficacy of improved perioperative antithrombotic therapy in patients who underwent laparoscopic cholecystectomy for acute calculous cholecystitis (ACH) with concomitant ischemic heart disease (IHD).Materials and methods. 168 patients with ACH and IHD who received anticoagulant (ACT) or antiplatelet therapy (APT) before admission to the surgical department of the hospital in Kyiv took part in the study. The comparison group included 95 patients who underwent conventional perioperative antithrombotic therapy, the main group included 73 patients who had bridging therapy according to the developed algorithms. Groups of patients were representative by the functional class of heart failure, angina class, severity and histological form of ACH, the frequency of ACT and APT variants. The target points of the study were the frequency of International Normalized Ratio (INR) therapeutic value achieving or bleeding time (BT) by Lee‑White in the preoperative and early postoperative period and the frequency of hemorrhagic complications.Results and discussion. Immediately before the operation in patients assigned to the main group, the mean INR values were greater than in the comparison group: 2.93 ± 0.18 versus 1.96 ± 0.18. The target values of INR > 2 in the main group were in 18 (90 %) of 20 patients who received warfarin prior to admission, and 11 (52.4 %) of 21 in the comparison group (p = 0.008). Target values of BT > 12 min in the main group were in 48 (90.6 %) of 53 patients who received APT before admission, in the comparison group — in 46 (62.2 %) of 74 (p = 0.001). Statistically significant differences between groups relative to the proportion of patients with therapeutic values of INR and BT were found on the first 3 and 4 days of the postoperative period, respectively. Increased bleeding of the tissues (the bed of the gallbladder), in which stable haemostasis required more than 10 minutes, was observed in 19 (26.0 %) patients in the main group and 20 (21.1 %) in the comparison group (p = 0.449). The need for a tamponade of the gallbladder bed arose respectively in 13 (17.8 %) and 11 (11.6 %) patients (p = 0.253). A decrease in haemoglobin level below 100 g/l, but not lower than 86 g/L, was noted in 4 and 6 patients (all p < 0.05).Conclusions. The improved algorithm of bridging therapy in patients with ACH and concomitant IHD demonstrated a statistically significant increase in the proportion of patients with the target values of the prophylaxis of thromboembolism in the perioperative period (in comparison with the conventional approach) without significant haemorrhagic complications, as in the case of taking anticoagulant or antiplatelet drugs in anamnesis.
One year results of surgical prophylaxis for mammary gland rotation after submuscular augmentative mammoplasty
Authors: V. G. Mishalov  , O. I. Zakhartseva  , V. V. Khrapach  , L. Yu. Markulan
Published: July 2018

The aim — to determine the effectiveness of the upper pole reinforcement of «neo pocket» with prolene thread for the mammary gland prothesis rotation (MGPR) prevention after primary augmentative mammoplasty in the remote postoperative period.Materials and methods. A prospective independent comparison of annual results after primary augmentation mammoplasty in two groups of patients was carried out. The comparison group included 94 patients, the main group — 76 women, whose operation was accompanied by fixing the upper pole of the «neopocket» with the prolene mesh. Any statistical differences were not found between the two groups in age, body mass index, mass of breast prostheses, the proportion of patients who were pregnant and breast‑fed. In all cases, the implanted textured prosthesis was with a high and medium profile. Most patients had prostheses in the volume of 325 — 335 and 375 ml. The evaluation of the MGPR was carried out following the developed procedure with the ESAOTE ultrasound device, the Technos Partner model, by a linear sensor with a frequency of 12.5 MHz.Results and discussion. The comparison group, showed 143 (76.1 %) prostheses being rotated, whereas the main group — 46 (30.3 %) (p = 0.001). In the comparison group, only 4 (1.6 %) women did not have RP of both glands, in the main group — in 39 (51.3 %) (p = 0.001). Significant differences in the degree of MGRP (p = 0.001) were noted due to the absence of angles 120°, 150° and 180° in the main group of the LLP. The main group did not demonstrate even a single case of clinically significant MGPR, while in the comparison group 11 (11.7 %) (p = 0.002). In the main group, the ratio of 30°/60 ° rotation (10.9 and 89.1 %) statistically significantly differed from that in the comparison group (31.5 and 68.5 %) due to a smaller proportion of MGPR at 60° (p = 0.006).Conclusions. A method of fixation of the submuscular «neo pocket» upper pole with prolene mesh a year after the augmentative mammoplasty, avoids clinically significant MGPR (more than 900) in contrast to the traditional method (11.7 %) (p = 0.002), and in cases of clinically insignificant rotation to decrease in 1.3 times the proportion of prostheses rotation at 600 (p = 0.006).
Laparoscopic large hiatal hernia plasty with self-fixating ProGripmesh. Improved efficiency
Authors: V. V. Grubnik  , V. V. Ilyashenko  , Vikt. V.  Grubnik
Published: July 2018

The aim — to study the possibility of ProGrip self‑fixating mesh for laparoscopic plasty for large hiatal hernia (HH).Materials and methods. The present work is based on a retrospective analysis of the operative results of 122 patients with large HH. The age of the operated patients was 39 to 82 years. The patient age ranged from 39 to 82 years, the average age was 64.8 ± 11.2 years. 48 (39.3 %) patients had signs of obesity (BMI > 30 kg/m2). Long‑term results were studied after 6, 12 and 24 months after surgery. All patients were studied with 24h pH‑metry of the esophagus with the DeMeester index calculation at 6th and 12th months.Results and discussion. ProGrip mesh germinated quickly by own tissues and reliably strengthen the performed cruroraphia. There was only 1 recurrence in the group of patients with ProGrip mesh during all supervision term. Functional operative results were positive in the majority of cases. Mean Quality of Life Index before the operation was 35, after the operation — 9 (p < 0.05). 24hr pH‑metry showed a decrease in DeMeester index from 78.0 ± 15.0 before the operation to 13.6 ± 4.0 after surgery (p < 0.01). Comparison of the operative results with the ProGrip mesh and results of 128 operations performed with conventional polypropylene meshes, showed the advantage of ProGrip mesh use.Conclusions. The first experience with self‑fixating ProGrip mesh to strengthen cruroraphia demonstrated safety and high efficiency of the new method. The use of ProGrip mesh allows 1.5 times to reduce the operation time and 5 times to reduce the recurrence rate after laparoscopic fundoplication.
TNM classification of colorectal cancer, 8th edition (2017): clinical application
Authors: I. Y. Galaychuk  , L. S. Bilyansky
Published: July 2018

The article presents the 8th edition of the TNM classification of colorectal cancer (UICC, AJCC, 2017), which introduces changes to T, N, and M categories reflecting contemporary clinical (cTNM) and pathological (pTNM) prognostic grouping of patients with colorectal cancer. Major changes in the classification are commented from the clinical point of view.
Ciprofloxacin in therapy and prevention of purulent infections in patients with the hepatobiliary deseasre
Authors: M. Yu. Nychytailo  , I. I. Bulyk
Published: July 2018

The aim — to study the ciprofloxacin effectiveness in the treatment and prevention of purulent complications in patients with acute surgical pathology of the digestive system.Materials and methods. 85 patients with the pathology of the hepatopancreatobiliary system, which was administered сiprofloxacin (Ciprolet) were observed in the department of laparoscopic surgery and cholelithiasis for the period from 2012 to 2017.Results and discussion. The use of ciprofloxacin in patients with hepatopancreatoduodenal disease was effective in the prevention and treatment of purulent‑septic complications. Only 3 (3.8 %) patients who had undergone surgery on the biliary tract had suppuration of the postoperative wound. There were no cases of peritonitis progression. Intestinal peristalsis was restored on average 4.10 ± 0.08 day after the operation, body temperature and leukocyte count were normalized at 5.10 ± 0.09 day.Conclusions. The use of ciprofloxacin in patients with acute surgical pathology of the hepatopancreatobiliary system and the obstruction of the bile ducts of non‑tumorous genesis complicated by purulent cholangitis and mechanical jaundice is characterized by high clinical efficacy.