bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing Robotic-Assisted Gait Training in Acute Inpatient Stroke Rehabilitation
Authors: Cao Ning , Packel Andrew , Marcy Elizabeth , Sprik Kelly , Harold Erika , Xiao Rui , Esquenazi Alberto
Published: September 2021

Background:

The recovery of independent walking is one of the major goals of stroke rehabilitation; however, due to the current acute inpatient rehabilitation care paradigm, the intensity of walking practice provided has been far below that recommended for motor recovery to occur. A quality improvement initiative was implemented to encourage the physical therapist (PT) to incorporate various robotic gait training devices as part of the standard allotted PT sessions to improve the intensity of gait training.

Materials and Methods:

After 6 months, a retrospective review was performed to assess the feasibility of the robotic-assisted gait training (RAGT) intervention in limited-ambulatory stroke patients and determine preliminary efficacy of the RAGT program by analyzing Functional Index Measure (FIM) motor gain and accelerometer-based daily step counts in patients who received the RAGT versus a group treated with conventional therapy.

Results:

About 30% of limited-ambulatory patients admitted to the stroke rehabilitation unit received consistent integrated RAGT without safety concerns. Compared to those who received conventional treatment, these patients showed greater mean FIM motor gain (32.30 versus 17.88) at discharge (P < 0.005) and higher number of step counts in PT sessions (P < 0.005). Age, gender, or admission FIM motor were not associated with FIM motor gain.

Conclusions:

Across a 6-month initial implementation period, RAGT was feasible and was associated with higher repetition of walking practice and also with improved FIM motor scores in limited-ambulatory individuals in an acute inpatient stroke rehabilitation program. However, the frequency of RAGT and the percentage of patients participating need to further improve. Some strategies to address these concerns were identified.
Impact of COVID-19 pandemic on bariatric surgery in India
Authors: Bhasker Aparna Govil , Khaitan Manish , Bindal Vivek , Kumar Amardeep , Rajkumar Anirudh , Kaushal Anshuman , Prasad Arun , Parikh Chirag , Sethi Daksh , Goel Deep , Hareendran Deepak Thampi , Bedi Digvijay , Jammu Gurvinder Singh , Leo Jayanth , Kular Kuldeepak , Narwaria Mahendra , Chikkachanappa Mahesh , Motwani Manish , Bharucha Manoj , Ismail Mohamed , Dukkipati Nandkishore , Shah Neha , Tantia Om , Patel Parag , Padmakumar R. , Singh Rahul , Palaniappan Raj , Shrivastava Rajesh , Rajput Ram Raksha Pal , Goel Ramen , Wadhawan Randeep , Garg Rohit , Aggarwal Sandeep , Patolia Sanjay , Baig Sarfaraz J. , Shah Shashank , Shivaram H. V. , Dhorepatil Shrihari , Saggu Sukhvinder Singh , Ugale Surendra , Perungo T. , Soni Vandana
Published: September 2021

Background:

Although safe practice guidelines were issued by the Obesity and Metabolic Surgery Society of India (OSSI) in the end of May 2020, surgeons have been in a dilemma about risk of subjecting patients to hospitalisation and bariatric surgery. This survey was conducted with the objective to evaluate the risk of coronavirus disease-19 (COVID-19) infection in peri- and post-operative period after bariatric and metabolic surgery (BMS).

Methods:

A survey with OSSI members was conducted from 20 July 2020 to 31 August 2020 in accordance with EQUATOR guidelines. Google Form was circulated to all surgeon members through E-mail and WhatsApp™. In the second phase, clinical details were captured from surgeons who reported positive cases.

Results:

One thousand three hundred and seven BMS were reported from 1 January 2020 to 15 July 2020. Seventy-eight per cent were performed prior to 31 March 2020 and 276 were performed after 1 April 2020. Of these, 13 (0.99%) patients were reported positive for COVID-19 in the post-operative period. All suffered from a mild disease and there was no mortality. Eighty-seven positive cases were reported from patients who underwent BMS prior to 31 December 2019. Of these, 82.7% of patients had mild disease, 13.7% of patients had moderate symptoms and four patients succumbed to COVID-19.

Conclusion:

BMS may be considered as a safe treatment option for patients suffering from clinically severe obesity during the COVID-19 pandemic. Due care must be taken to protect patients and healthcare workers and all procedures must be conducted in line with the safe practice guidelines.
О лемме Туэ-Виноградова
Authors: Solymosi Jozsef
Published: September 2021

Доказано обобщение леммы Туэ-Виноградова. Полученные результаты представляют собой еще один пример применения полиномиального метода, многочленов Редеи и метода Степанова.
Ряды Дирихле с периодическими коэффициентами и распределение их значений вблизи критической прямой
Authors: Sourmelidis Athanasios , Steuding Jörn , Suriajaya Ade Irma
Published: September 2021

Класс рядов Дирихле, соответствующих периодическим арифметическим функциям $f$, включает в себя дзета-функцию Римана и $L$-функции характеров Дирихле. В работе изучается распределение значений таких рядов Дирихле $L(s;f)$ и их аналитических продолжений в окрестности критической прямой (которая является осью симметрии соответствующего функционального уравнения типа Римана). В частности, для заданного комплексного числа $a\neq 0$ и четных или нечетных периодических функций $f$ находится количество $a$-значений $\Delta $-множителя функционального уравнения, доказывается существование среднего для значений рядов Дирихле $L(s;f)$ в этих точках, показывается, что ординаты этих $a$-значений равномерно распределены по модулю $1$, и этот результат применяется для доказательства дискретной теоремы универсальности.
О спектральном зазоре и диаметре графов Кэли
Authors: Shkredov Ilya Dmitrievich
Published: September 2021

Получена новая оценка, связывающая первое нетривиальное собственное значение оператора Лапласа на графе и диаметр этого графа. Данная оценка эффективна для графов малого диаметра и для графов, количество максимальных путей в которых сравнимо с ожидаемым.
Các nhân tố quyết định năng lực giảng dạy của sinh viên sư phạm: Khảo sát tại trường Đại học Sư phạm Thành phố Hồ Chí Minh
Authors: Long Lê Thái Minh
Published: September 2021

Xác định các nhân tố quyết định năng lực giảng dạy là mục tiêu quan trọng mà các trường Đại học Sư phạm cần đảm bảo để sinh viên khi tốt nghiệp ra trường có thể giảng dạy được ở các trường phổ thông. Bài nghiên cứu sử dụng kiểm định số liệu thống kê, phân tích hồi quy để xác định các thành tố tác động đến năng lực giảng dạy của sinh viên sư phạm tại Trường Đại học Sư phạm Thành phố Hồ Chí Minh. Các nhân tố tác động năng lực giảng dạy trong nghiên cứu bao gồm các thành tố: xây dựng kế hoạch dạy học, sử dụng phương pháp dạy học, kiểm tra, đánh giá kết quả học tập, phát triển chuyên môn bản thân, tư vấn và hỗ trợ học sinh, mỗi thành tố với các mức độ tác động khác nhau tạo thành năng lực giảng dạy đối với sinh viên sư phạm. Các nhân tố này là cơ sở cho các trường đại học sư phạm xây dựng chương trình đào tạo, phân bố thời gian hợp lí để rèn luyện các năng lực giảng dạy cho sinh viên sư phạm.
HUBUNGAN PENGUASAAN KOSAKATA SISWA DENGAN KEMAMPUAN BERBICARA SISWA KELAS XI SMA NEGERI 1 LEDO TAHUN AJARAN 2016/2017
Authors: Tawarik Oxtapianus
Published: September 2021

Penelitian ini bertujuan untuk mengetahui hubungan penguasaan kosakata siswa dengan keterampilan berbicara mereka. Penelitian ini dilakukan melalui desain korelasional. Sampel penelitian ini adalah siswa kelas XI SMAN 1 Ledo tahun pelajaran 2016-2017. Penelitian ini merupakan penelitian korelasi dengan Teknik pengumpulan data kuantitatif deskriptif statistic dan inferensial statistik. alat yang digunakan dalam penelitian ini adalah rubrik score speaking performance untuk mengukur keterampilan berbicara siswa, sedangkan untuk mengukur penguasaan kosakata siswa (vocabulary mastery) menggunakan Multiple choice test (tes pilihan ganda) dimana secara manual (test Item validity and reliability) telah dilakukan validitas dan relibilitas terhadap kedua alat test tersebut. Untuk menganalisis data didalam penelitian ini penulis menggunakan descriptive statistic (nilai individu atau individual score, nilai rata rata atau mean score) dan inferential statistic (pearson product momen correlation) untuk menghitung variable penguasaan kosakata (vocabulary mastery) dan keterampilan berbicara (speaking skill). Hasil penelitian ini menunjukkan bahwa untuk tingkat Kosa Kata dan Prestasi Berbicara Siswa pada kelas XI SMAN 1 Ledo berada pada tingkat yang baik. Peneliti juga menemukan bahwa terdapat korelasi positif antara penguasaan kosakata dengan keterampilan berbicara siswa kelas XI SMAN 1 Ledo tahun pelajaran 2016-2017 dengan signifikansi korelasi sebesar 0,943. Korelasi tersebut tergolong korelasi erat artinya kedua variabel memiliki korelasi yang kuat. Berdasarkan hasil penelitian dapat disimpulkan penguasaan kosakata dan keterampilan berbicara siswa berkorelasi positif, artinya tingkat penguasaan kosakata tertinggi maka tingkat keterampilan berbicara juga tinggi. Oleh karena itu, guru yang berperan dalam mengontrol siswa dalam proses belajar mengajar juga penting untuk mengetahui peningkatan kosa kata dan keterampilan berbicara.
RANCANG BANGUN MEDIA E-BOOK FLIPBOOK INTERAKTIF PADA MATERI INTERAKSI MANUSIA DENGAN LINGKUNGANNYA SEKOLAH DASAR
Authors: Puspita Ervhy Indra , Rustini Tin , Dewi Dinie Anggraeni
Published: September 2021

Penelitian ini didasari dari studi pendahuluan buku tematik yang hanya memaparkan materi Interaksi Manusia dengan Lingkungan Alam secara singkat. Penelitian desain dan pengembangan ini bertujuan: 1) Menghasilkan produk e-book untuk mata pelajaran IPS kelas V; 2) Mengetahui kelayakan hasil uji produk e-book untuk mata pelajaran IPS kelas V; 3) Mengetahui respon guru dan siswa terhadap produk e-book untuk mata pelajaran IPS kelas V. Metode penelitian ini mengacu pada model pengembangan ADDIE yang memiliki 5 tahapan, yakni: 1) Analyze; 2) Design; 3) Development; 4) Implementation; 5) Evaluation. Penelitian ini menghasilkan produk e-book multimedia yang berbasis flipbook interaktif berupa aplikasi sebagai alat bantu siswa dalam memahami materi interaksi manusia dengan lingkungan alam. Hasil skor penilaian validasi produk pada ahli media sebesar 93,75% (sangat layak), pada ahli materi 95,00% (sangat layak), dan pada ahli bahasa 90,00% (sangat layak), ketiga hasil validasi menunjukan bahwa e-book dapat diuji cobakan. Selanjutnya hasil respon guru dan siswa terhadap e-book secara berurutan 87,50% (sangat baik) dan 87,86% (sangat baik). Dari hasil tersebut, dapat dikatakan bahwa e-book berbasis flipbook interaktif “Kegiatanku dalam Menjaga Lingkungan Alamku” layak digunakan dalam pembelajaran IPS.
The Practices and Challenges of Fiscal Decentralization: A Case of Bedelle Woreda, Oromia Region, Ethiopia
Authors: Tesfaye Gudeta  , Dr. Minhaj Alam  , Damena Tolassa
Published: September 2021

The study's main objective was assessing the practices and challenges of fiscal decentralization at Bedelle woreda, with particular reference to basic selected sectors (Education, Agriculture, Health, Water, and Road). According to the nature of this study, a descriptive research design with qualitative and quantitative methods was adopted. The population of the study was government employees working in selected sectors of Bedelle Woreda. The census sampling technique was used in this research because the study population was manageable. To this effect, 128 participants were selected using a census sampling size. Besides this, Woreda (District) Finance and Economic Development and Woreda Revenue Office Authority officials were purposely selected to conduct interviews. The data-gathering instruments were questionnaires, key informant interviews, and document analyses. Descriptive and inferential statistical techniques were used for data analysis. In descriptive using frequencies and percentages and inferential statistics, multiple linear regression was used to assess relationships between the independent variables (legal framework, revenue, expenditure, employee experience, employee training, management commitment, and fiscal transfers) and the dependent variable (fiscal decentralization). The findings show that internal revenue raising and utilization in the selected sectors was very low. Besides, lack of autonomy in expenditure decisions of sectors, insufficient capacity building, the extent of fiscal transfer, and financial resource were the major challenges in the study area. Overall, the regression analysis revealed that, Revenue raising (β = -0.164, p<0.05), Expenditure decision (β = 0.236, p<0.05), Employee experience (β = 0.525, p<0.05), and Commitment of management (β = 0.172, p<0.05), all have statistically significant and positive effect on fiscal decentralization. Based on the study's findings, it is recommended that existing legal frameworks be modified to enable the sectors to use their budget in line with their action plan to generate and utilize sufficient revenues. Special emphasis should be given to an employee's capacity building, independence of planning and budgeting, and clear autonomy of expenditure assignments. Inter-governmental fiscal relations should also be planned to reduce the horizontal imbalances observed at selected sectors of the woreda under study.
Clinical and functional profile of children with autism spectrum disorders
Authors: Galova Elena A. , Chekalova Svetlana A. , Kotelnikova Olesya L. , Vorob'eva Ol’ga V. , Blagonravova Anna S. , Karyakin Nikolay N.
Published: September 2021

Introduction. Currently, the gain in the number of children patients diagnosed with Autism Spectrum Disorders (ASD) has been recorded. The key feature of the given group is the polysystemic expression, with considerable disruption of the central nervous system, gastrointestinal tract and immune processes. The research of their counteraction and development is essential for determining tactics for ASD patients’ combination treatment. Aim of the study is to present a clinical and functional patient profile with Autism Spectrum Disorders based on the clinical, medical and social trial. Materials and methods. We conducted a pilot observational, comparative study within two groups of children (62 ASD patients and 48 healthy children dominated by boys). The examination included receiving complaints, objective assessment by the paediatrician and neurologist, filling in medical records, covering complaints and the results of patients’ objective examination and parents/caretakers surveys. Results. The study revealed the predominance of complaints about mental disruptions over somatic complaints. Notably, parents/ caretakers indicated the presence of sleep disturbances (up to 22.5%) and specific eating habits (up to 27.4%) in their children. Young patients in the group under consideration exposed signs of allergic diseases chronic intoxication syndromes and micronutrient deficiencies. Nearly one-third of children reported the presence of functional disorders/digestive diseases. Conclusion. Young patients with Autism Spectrum Disorder are diagnosed with burdened physical status in the form of functional disruptions and diseases. These findings necessitate the paediatrician’s active early detection of organs’ malformation and require somatic systematic monitoring by the psychiatrist and skilled attendance of other medical specialists.
Human resource Management Practices Aimed at seeking the commitment of employees on Financial and Non-Financial (subjective) Performance in spanish Firms: An empirical contribution
Authors:   Facultad de Ciencias Económicas y Empresariales, Dpto. de Administración de Empresas y Marketing de la Universidad de Sevilla., Triguero Rafael , Peña Vinces Jesús ,   Facultad de Ciencias Económicas y Empresariales, Dpto. de Administración de Empresas y Marketing de la Universidad de Sevilla., González rendon Manuel ,   Facultad de Ciencias Económicas y Empresariales, Dpto. de Administración de Empresas y Marketing de la Universidad de Sevilla., Sánchez Apellaniz Mercedes ,   Facultad de Ciencias Económicas y Empresariales, Dpto. de Administración de Empresas y Marketing de la Universidad de Sevilla.
Published: September 2021

The purpose of this paper is to assess the relationship between Human Resource Management (HRM) practices and organizational performance in Spanish firms from a financial and non-financial perspective (subjective). The empirical study was conducted with a sample of 102 firms in the region of Andalucía (Spain). The results of statistical analysis have shown the fundamental role of establishing HRM practices aimed at seeking the employees’ commitment and its positive influence on organizational performance. Results also showed that the subjective measures for organizational performance better explained this phenomenon of study.
Consideraciones para calcular el ratio precio-utilidad de la bolsa de valores de Lima: metodología y aplicaciones
Authors:   Pontificia Universidad Católica del Perú, Perú, Pereda Javier
Published: September 2021

In this paper we construct a methodology to calculate the price-earnings ratio (PER) of the General Index of the Lima Stock Exchange (IGBVL) for the period 1995-2011 following Shiller (2005). Results show that equity prices, in the analyzed period, basically responded to the expected evolution of earnings of the companies, even during the period of the equity prices boom that preceded the financial crisis of 2008. This conclusion is reinforced when we calculate, following Hayford y Malliaris (2004), the implicit equity premia expected for stock investors. We find high values of equity premia during the period of stock prices boom, which would justify the high PER values registered in that period.
Case Discussion Responsabilidad Social Interna en J-V Resguardo
Authors:   Universidad ESAN, Lima, Peru, Jáuregui Kety
Published: September 2021

J&V Resguardo es una empresa peruana dedicada a brindar servicios de vigilancia privada, seguridad personal y guardianía, con 23 años en el mercado nacional. Cuando se inició en 1989, la empresa contaba con cuatro vigilantes y dos clientes. En el año 2006, J&V Resguardo incursionó en el mercado latinoamericano al abrir una oficina en Ecuador. Para el 2010 era una organización con seis mil vigilantes en Perú, y más de mil en Ecuador. Además, contaba con más de cien vehículos de supervisión y un centro de entrenamiento de diez mil metros cuadrados en Lurín (distrito de la Provincia de Lima). En octubre de ese año sus ventas ascendieron a más de treinta y cuatro millones de dólares.
Systemic family counseling with young school-age students during the pandemic and post-pandemic crisis
Authors:   ", Cuznetov Larisa ,   Ion Creanga",   State Pedagogical University, Moldova
Published: September 2021

The article contains a theoretical study with the recommendation of practical implications from the authors' own experience, which elucidates the purpose, objectives, tasks, content and technology of systemic counseling of the family with young school children during the pandemic and post-pandemic crisis. Likewise, the study contains the content and specificity of the counseling process for the family, adults and children.
Self-Confidence and Perceptions of Athletic Training Students Following Simulated Experiences: A Mixed-Methods Pilot Study
Authors: Stedge Hannah , Herzog Valerie
Published: September 2021

Purpose: Athletic training clinical education provides students with a variety of real-life patient encounters under the supervision of a credentialed athletic trainer. However, clinical education experiences may not allow for all students to practice more invasive or less common skills such as rectal thermometry. The purpose of this study was two-fold: 1) determine the effect of a series of low to high-fidelity simulated rectal thermometry experiences on athletic training students’ self-confidence scores; and 2) through a phenomenological qualitative approach, explore athletic training students’ perceptions following the simulated rectal thermometry experiences. Method: This study used a quasi-experimental, mixed methods, one-group repeated measures design. Participants were nine first year professional Master of Athletic Training students who completed four simulated experiences on the skill of rectal thermometry. The outcome measures were The Athletic Trainer’s Self-Confidence Scale (ATSCS) and qualitative semi-structured open-ended interviews. Results: Friedman’s ANOVA revealed a statistically significant improvement from the participant’s baseline ATSCS scores to the last post-test scores. We identified three major themes following qualitative interviews: 1) Perception changes before and after participation; 2) Benefits of a series of four simulations; 3) Explanations for the improvements in confidence and competence. Conclusions: A series of simulated learning activities using high-fidelity and standardized patient interactions can help improve athletic training students’ self-confidence. Though future research is needed, athletic training education programs should consider implementing simulated experiences to equip athletic training students to transition to practice.
An Introduction to Interprofessional Education for First Semester Doctoral Occupational Therapy and Physical Therapy Students
Authors: Trojanowski Suzanne , Woodworth Jillian , Wiencek Anna Rose , Yorke Amy
Published: September 2021

Purpose: Interprofessional education (IPE) engages health care professional students in order to develop the knowledge, skills, and attitudes required of a health care practitioner. IPE can be challenging to execute; however, exposing students early in their professional education in IPE has positive results. Occupational therapy (OT) and physical therapy (PT) are health care professions who commonly work with each other. The purpose of this study is to describe the process and outcomes of implementing an IPE experience with first year doctoral OT (OTD) and PT (DPT) students completed within the first six weeks of the first semester of their respective programs. Methods: Ninety-one (31 OTD, 60 DPT) students were placed in small groups and discussed professional identities and interprofessional collaboration among OT/PT during pre-professional observations. Students completed the Readiness for Interprofessional Learning Scale (RIPLS) pre-post-meeting and a written reflection post-meeting. Results: Ninety-one students completed the Pre-RIPLS survey, while only 58 Post-RIPLS were completed (13 OTD, 45 DPT). The response rate was 63.7% overall (41.9% OT and 75% PT). A statistically significant difference was found between pre- to post-test RIPLS score among the entire group (p = 0.013), and the DPT students (p = 0.020), but not the OTD students (p = 0.414). Written reflections included the following themes: influence of personal experiences leading to choice of profession, observations shaping knowledge of the professions, similarities and differences between the two professions, and future collaboration. Conclusion: An IPE activity can be implemented early in the professional education of OTD/DPT students with positive results.
An Audit of the Use of Simulation in Australian and New Zealand Physiotherapy Curricula
Authors: Ryall Tayne , Preston Elisabeth , Mahendran Niruthikha , Bissett Bernie
Published: September 2021

Purpose: The aim of this exploratory research was to investigate the use of simulation in physiotherapy curricula across Australia and New Zealand. The key areas of focus were whether simulation was being used, the forms of simulation used for training and assessment, evidence for educational simulation practices, and the enablers and barriers to implementing simulation into the curricula. Method: All Australian and New Zealand Universities offering a physiotherapy degree were invited to participate in an electronic survey. As no pre-existing tool was available to answer the aims of the study, a custom designed survey was developed. The survey was pilot tested on three physiotherapy academics to limit ambiguity and ensure the questions directly related to the purpose of the study. An introductory invitation was circulated via the Council of Physiotherapy Deans Australia and New Zealand. Open and closed ended questions were analyzed following a sequential explanatory strategy. Results: Fourteen (14) of the possible 22 universities (64%) responded, with all indicating that they use simulation for training or assessment and many using it for both. All core areas of clinical practice were represented, as were low to high-fidelity forms of simulation. Role play (77%), low/medium fidelity manikins (77%), and standardized patients (62%) were the most frequently used for training. Role play (73%), standardized patients (45%), objective structured clinical examinations (45%), and low/medium fidelity manikins (37%) were the most frequently used modalities for assessment. The key enablers appear to be availability of equipment, academic support, growing evidence for its use, safety, and positive student experiences. The key barriers appear to be time, cost, and access to trained staff and equipment. Conclusions: Academics across Australia and New Zealand described simulation practices for both training and assessing physiotherapy students. Academics were able to identify a limited but expanding evidence-base for simulation, more strongly focused on training than simulation-based assessments. Recommendations: Further research may justify increased investment of time, money, resources, and training in different simulation modalities.
KAJIAN FRASA PADA NOVEL TRAUMA KARYA BOY CANDRA
Authors: Rosyidah Ulfa , Hasanudin Cahyo , Amin Ahmad Kholiqul Amin
Published: September 2021

Frasa merupakan objek kajian sintaksis yang bersifat nonpredikatif. Penelitian ini bertujuan untuk: 1) mengetahui bentuk frasa pada novel Trauma karya Boy Candra, dan 2) mengetahui relevansi hasil penelitian dengan pembelajaran bahasa di SMA. Penelitian ini merupakan penelitian deskriptif kualitatif. Data penelitian ini berupa bentuk frasa dengan sumber data didapat langsung dari novel Trauma karya Boy Candra. Prosedur penelitian ini menggunakan teknik simak bebas libat cakap, teknik catat, dan teknik wawancara. Teknik analisis data melalui 3 tahapan yaitu, reduksi data, penyajian data  penarikan kesimpulan atau verifikasi. Validasi data yang digunakan dengan teknik triangulasi sumber. Hasil penelitian ini yaitu 1) novel Trauma karya Boy Candra mengandung bentuk frasa endosentris, frasa eksosentris, frasa verba, frasa nomina, frasa numeralia, frasa idiomatik dan frasa ambigu, dan 2) kandungan frasa pada novel Trauma relevan dengan pembelajaran bahasa di SMA, khususnya sebagai sumber belajar pada materi jenis-jenis frasa dan kontruksi frasa dalam kalimat.
Atualização em farmacologia da dor: quais são as opções atuais para o tratamento da dor crônica?
Authors: Scherer Daniele , Feldman Daniel
Published: September 2021

A dor é uma experiência multifatorial considerada hoje como o quinto sinal vital. Quando persiste por mais de 3 meses passa a ser considerada crônica, trazendo morbidade, perda de qualidade de vida e aumentando o risco de outras doenças, como transtornos de humor. Quando falamos de dor crônica, várias classes de medicamentos podem estar indicadas para o seu tratamento, sendo importante entender a farmacologia e características de cada uma para poder individualizar o tratamento e minimizar os efeitos adversos. Os antidepressivos atualmente são considerados peças fundamentais para o tratamento da dor crônica, já que são capazes de modular as vias de dor e reduzir a amplificação dolorosa. Os principais exemplos são os tricíclicos, que aumentam a capacidade da via descendente inibitória da dor, e os duais (inibidores da recaptação da serotonina e noradrenalina), hoje aprovados para o tratamento da fibromialgia e da dor neuropática. Os relaxantes musculares podem ser considerados como adjuvantes no tratamento da dor crônica, sendo boas opções terapêuticas em doenças que causam dor associada à contratura ou espasmos musculares. Já os opioides são uma das principais escolhas no tratamento da dor moderada a intensa, principalmente para a dor de caráter nociceptivo e para a dor oncológica. O conhecimento dos fármacos destas classes é especialmente importante no que tange à escolha da dose, intervalo de administração e efeitos colaterais.

Unitermos: Dor crônica. Fibromialgia. Opioides. Antidepressivos. Relaxantes musculares.
EARLY SUMMER ZOOPLANKTON OF LAKE VOZHE AND LACHA (VOLOGDA REGION)
Authors: Lazareva V. , Sabitova R.
Published: September 2021

In June 2015, zooplankton (Cladocera, Copepoda, Rotifera) of lakes Vozhe and Lacha, Svid’ River and the headwaters of the Onega River (catchment of the Onega River, White Sea basin) was examined. It was found that crustaceans (mainly the copepods Mesocyclops leuckarti and Eudiaptomus gracilis) dominated the community. The biomass of zooplankton (<1 g / m3) indicated a low food supply for fish (poorly fed water bodies), compared with the beginning of the 1970s, it decreased by 4–10 times. The composition and structure of the community characterized the ecosystem status of the Lake Vozhe as eutrophic, and Lake Lacha as mesotrophic. Changes in the structure of zooplankton over 40 years testified to the eutrophication of the ecosystem of Lake Vozhe and stabilization at the level of mesotrophy of Lake Lacha. In the lakes, the dispersal and relatively high abundance of some thermophilic species (Polyarthra luminosa, Thermocyclops crassus), indicators of eutrophic conditions that were previously absent in the community, were revealed. The productivity (14–34 cal / m2 × day) and the respiration rate of zooplankton (61–122 cal / m2 × day) of the lakes corresponded to the level of northern oligotrophic water bodies. It was shown that at the beginning of summer a significant part of the zooplankton production was consumed by planktonic predators (mainly copepods). Fishes had access to about 15% of the daily production of zooplankton in Lake Vozhe and up to 43% in Lake Lacha. A small proportion of filter feeders (30–60% of the total biomass) was recorded in the modern zooplankton of lakes. By 2015, the filtration capacity of plankton from lakes Vozhe and Lacha decreased by an order of magnitude compared to that in the 1980s. The low self-cleaning ability of lake waters is discussed as the main reason for the growing organic pollution and increased silt accumulation in their ecosystems.
MACROBENTOS OF VOZHE AND LACHA LAKES
Authors: Pryanichnikova Ekaterina
Published: September 2021

The taxonomic composition of macrozoobenthos in lakes Vozhe and Lacha and in some sections in the Svid and Onega rivers is presented. The dominant complex in the lakes was formed by representatives of chironomids. Two species of oligochaetes and a gastropod were dominant in the rivers. The index of faunal similarity of macrobenthos between the lakes was rather high and amounted to 70%, while the similarity between the river and lake benthos was less than 30%. In the lakes, only two taxonomic groups were recorded, oligochaetes and chironomids that formed the basis of the benthos abundance: 87–93% of the average abundance and 92–95% of the average biomass in the lake. Oligochaetes and mollusks played a significant role in the river communities; in total, they formed 76% of the total abundance and 98% of the biomass. The trophic structure of macrobenthos in the lakes was almost similar, except the appearance of the group of phytodetritophages- filter-feeders in Lake Lacha. Detritophages-swallowers dominated in the river communities. In the previous studies of the lakes, the species richness of benthos both in Lake Vozhe and Lake Lacha was much higher. A decrease in the number of taxonomic groups and decrease in their abundance were observed in Lake Vozhe. At the same time, the role of chironomids in the formation of benthos in the lake was still significant. In general, changes in the taxonomic structure and abundance of benthos in lakes Vozhe and Lacha may be caused by a complex effect of environmental factors and long-term and intra-annual dynamics of dominant (cenose-forming) representatives of the main groups of macrobenthos. The simplification of the structure of the bottom communities, the inclusion of species with wide ecological spectra, the predominance of eurybionts among the dominants, may indicate pollution, eutrophication, and contamination of water bodies. According to the indicator species both lakes may be regarded as mesosaprobic water bodies.
Importance of Toy Play in Special Education for young Children: Perspectives and Approaches
Authors: Deshpande Aditi , Ranavaade Vaibhhavi
Published: September 2021

Special needs children have different needs compared to typically growing children in various aspects of life. Their learning is hampered due to the difficulties they face in the normal way of learning. Special education practices have been adopting various play-based methods to address special needs children's difficulties and needs. This research reviews toy play as a learning method and its importance in young special needs children's education. The paper takes different perspectives on play and how it is characterized. A study of Toy Play taxonomies is also presented from the perspective of the learning needs of special needs children. Three prominent special education approaches are studied, and a synthesis of how to play fits into these approaches is presented. The future of toy play and further research areas is discussed. Early childhood play is a normal phenomenon that has much use in early intervention, early childhood special education, and early childhood education. Among these areas, there are still many disagreements about how to characterize and use play. These tensions jeopardize evaluation, action, and curriculum planning practices, as well as their links to science and practice. This essay examines play in early learning, early childhood special education, early childhood education, and how play is viewed and used in these settings.
Arogyavardhini Vati - A Boon for Liver Disorders from Ayurveda (Fatty Liver)
Authors: Dasi Padmaja  , T Maheshwar  , D Anuradha  , Ch VS Koteswara Rao
Published: September 2021

(NAFLD) or the Non-alcoholic Fatty Liver Disease is a global problem affecting a wide range of population associated with co-morbidities. Management of NAFLD is aimed both at managing the liver disease and also its co-morbidities. This is followed with an umbrella of therapeutic modules including lifestyle modifications, diet and the medications. Though both the modern medicine and Ayurvedic medicine follow the comprehensive approach in managing the disease, physicians will be very cautious with medications prescribed as those are associated with adverse effects. In this particular situation, Ayurvedic medicine such as Arogyavardhini vati plays a vital role in relieving the liver disorder, maintaining its health and also the health of digestive system thereby improving the overall health and the quality of life of the patient that is greatly disturbed with the liver disorders. Arogyavardhini vati that is considered one of the best for the liver disorders is critically reviewed in this study.
Historical aspects of the medical education system transformation
Authors: Kagramanyan I. N. , Tarasenko A. I. , Kupeeva I. A. , Yanushevich O. O. , Pashkov K. A. , Efimov A. O.
Published: September 2021

The history of medical and pharmaceutical education development is part of the social history. The quality of medical personnel training determines the efficiency of the entire health care system and has been a priority area of development throughout the history of the Russian state. The paper reflects the main stages of the medical education system development in the period from the 17th century to the present. The training of medical personnel in Russia began in the second half of the 17th century, when, under the Pharmaceutical Order, a medical school was established in 1654to train doctors for the needs of the army.

The need to provide qualified medical personnel remains relevant, both in wartime and in peacetime. The reforms of medical education that have been taking place over the centuries make it possible to diversify educational programs, as well as the to introduce new educational technologies, considering modern requirements and global trends. The study of the historical aspects of domestic medicine determines a more competent approach to the development of the health care system and medical education.
Causes of death in patients with tuberculosis and human immunodeficiency virus co-infection
Authors: Frolova O. P. , Butylchenko O. V. , Stakhanov V. A. , Enilenis I. I. , Romenko M. A. , Martel I. I.
Published: September 2021

Objectives. The aim of the study was to investigate the cause of death of tuberculosis patients infected with the human immunodeficiency virus (HIV). Many researchers and experts note the urgency of the problem of tuberculosis combined with HIV infection in the world and in Russia. One of the main criteria for assessing the effectiveness of medical care for tuberculosis patients infected with the human immunodeficiency virus is the mortality rate.

Materials and methods. For a detailed study of the causes of death of patients with tuberculosis in combination with HIV infection, we analyzed the causes of death of this contingent of patients in 5 regions of the Russian Federation.

Results. The social characteristics of patients, the forms and course of the disease, the main and immediate causes of death of 223 patients with co-infection with HIV and tuberculosis were studied.

Conclusion. Half of the deaths of tuberculosis patients infected with human im­munodeficiency virus were not associated with tuberculosis. Among these cases, there was either the presence of several infections at the same time, equally leading to death, or separate opportunistic infections (candidiasis, Pneumocystis pneumonia, toxoplasmosis), or cancer. In addition, the lifestyle of patients often became the cause of deaths, namely: drug poisoning and accidents, or cirrhosis of the liver, which develops as a result of alcoholism or hepatitis C infection which occurred during intravenous administration of drugs.
Features of hospitalization of patients in the trauma and orthopedic center in the context of the second wave of the COVID-19 pandemic
Authors: Nikolaev N. S. , Belova N. V. , Preobrazhenskaya E. V. , Malyuchenko Yu. A. , Dobrovol’skaya N. Yu. , Andronnikov E. A.
Published: September 2021

The algorithm for examining patients for SARS-CoV-2 during admission to non-infectious hospitals, a unified route scheme for patients taking into account the potential infectious hazard is not regulated.

The aim of the study is to identify the features of the diagnosis of SARS-CoV-2 during planned hospitalization in the field of “traumatology and orthopedics”; to present schemes for examining patients for SARS-CoV-2 during hospitalization and patient routing in the clinic.

Materials and methods. The route and procedure of examination to exclude the nosocomial spread of COVID-19 in patients hospitalized for three months is described. 3366 survey results were analyzed.

Results. Positive PCR tests for COVID-19 before hospitalization were obtained in 4.5 % of patients. High titers of IgM are found in 7.8 % of cases. At the level of the Pass Office, 10.5 % of arrivals were denied hospitalization. The CT scan of the chest organs, which was then carried out, revealed among the examined 9.1 % of asymptomatic pneumonia, of which 93.5 % – with radiological signs of COVID-19, 2/3 of “covid” pneumonia – with a CT-0 degree. Another part of hospitalizations was postponed due to somatic contraindications during clinical examination. After all the selection stages, 73.2 % of planned hospitalizations ended up. In the hospital, 12 cases of COVID-19 were detected in the postoperative period, more often on the 4th day after the operation. A total of 2,328 patients were discharged during the study period – 69.2 % of planned hospitalizations, a third of patients received a medical withdrawal from hospitalization due to COVID-19.

Conclusions. The peculiarities of admitting patients to planned hospitalization in the traumatology and orthopedics profile is the difficulty of reliably detecting COVID-19 in a limited time. In some cases of asymptomatic course, the disease is detected only with the help of CT diagnostics. In 0.5 % of cases, COVID-19 is detected in the postoperative period. The described patient routing scheme, multistage diagnostics to exclude COVID-19 are able to ensure maximum infectious safety of patients and staff in the clinic.
Prevalence and Outcome of Obstructed Labour at a Tertiary Institution
Authors:   Mulago Specialized Women and Neonatal Hospital, P. O Box 22081, Kampala, Uganda, Nionzima Elizabeth
Published: September 2021

Obstructed labour is a common preventable causes of both maternal and perinatal morbidity and mortality in developing countries affecting 3-6% labouring women globally and accounts for an estimated 8% of maternal deaths in Sub-Saharan Africa and South Asia. Objective: To determine the prevalence and outcome of obstructed labour in the Gynaecology and Obstetrics Department at a tertiary hospital in Northern Uganda. Method: This was a retrospective chart review of pregnant women admitted in labour and delivered by caesarean section from 1st January 2016 to 31st December 2017 at a Lira Regional Referral Hospital, a tertiary institution in Lango Sub region. Data was analysed using Statistical Package for Social Sciences version 16.0. Results: A total of 808 medical charts of mothers with obstructed labour were retrieved, evaluated and included in this review out of 12,189 deliveries during the study period, giving a prevalence of 6.6%. Majority (77%; 622/808) mothers admitted with diagnosis of obstructed were referred in from peripheral facilities. Over half (53.4%) of the women were in the age group of 20 to 29 years. Over 53%, were prime gravidae and were twice more likely to undergo C/S due to obstructed labour than multigravidas (OR 1.8; 95% CI 1.5-2.2). Only 49.2% had documented cause of obstructed labour, with Cephalo-pelvic disproportion being most common (17.5%), malposition/mal-presentation (14.6%), and macrosomia (3.6%). Partograph was used in only 46.6% (374) women who had obstructed labour. The commonest maternal complication observed were Sepsis (11%), PPH (5.2%), uterine rupture (4%) and burst abdomen (3%) which led to prolonged hospital stay and loss of fertility to some. Mode of delivery in the 808 reviewed charts was caesarean section, 90.3% of babies were born alive, while 8.5% (69) were born dead, (1.2%) had early neonatal, and 40.2% were referred Paediatric Neonatal Intensive Care Unit (NICU) because of low APGAR score. Conclusion: The prevalence of obstructed labour among women delivered by Caesarean section was high compared to the global average. Majority of the women were referrals from the peripheral health centres and associated with life threatening complications and even death. Young age and prime gravida is associated with obstructed labour and high caesarean section rates. The obstruction in multigravida could be due to secondary cephalo-pelvic disproportion as majority of the babies were in normal range weight. Low use of Partograph to monitor labour was evident among women who had obstructed.
Analysis of Cutback Management Strategy in Financial Sustainability in the Public Sector in Indonesia
Authors:   Universitas Sumatera Utara, Medan, Indonesia, Humaira Rafiqah
Published: September 2021

There are many literature reviews that write about the causes and expected consequences of an environmental, social, and economic crisis. It should be remembered that the role of the public sector is critical to overcoming crises, to promoting sustainable development and to managing the balance between supply and demand for public services. This qualitative research takes a case study approach to public agencies under the Ministry of Finance, namely the Directorate General of Customs and Excise. This study aims to explain financial sustainability in public bodies during the COVID-19 pandemic, and explain cutback management strategies indicated through refocusing carried out by government agencies during the COVID-19 pandemic, as well as explain the relationship between cutback management and financial sustainability which is significantly directly related to the COVID-19 pandemic. The results of the analysis show that there are differences in the financial sustainability of Customs and Excise during the pandemic, namely in terms of state revenues, it certainly changes (decreases) in terms of tax revenues, import duties, and excise. Then identified indicators of cutback strategies at Customs and Excise, and there is a conceptual link between financial sustainability, the COVID-19 pandemic and cutback management strategies.
War, refugees and regional implications: The impact of Afghan refugees on local society of Khyber Pakhtunkhwa, Pakistan
Authors: Khan Asghar , Khan Irfan , Khan Noor Ullah
Published: September 2021

The migration of Afghan refugees into Pakistan started in the wake of Saur (Red) Revolution in 1978, as a result of reforms introduced by the communist regime in Kabul, Afghanistan. However the large influx of refugees to Pakistan took place soon after the invasion of Soviet Union in 1979. Pakistan provided asylum for the approximately 4.2 million refugees. They were settled in 386 camps mostly in rural as well as in urban areas of the country. But the most populous province that has large number of Afghan refugees was Khyber Pakhtunkhwa (KP) (that time N.W.F.P), which has long border (Durand line) with Afghanistan, and also has cultural, religious, and linguistics ties. This large number of immigrants generated grave consequences for Pakistan, especially for Khyber Pakhtunkhwa. They have affected the socio-economic and political life of the province. The main objective of the study was to find out the socio-economic impact of Afghan Refugees living for more than three decades in the host society of KP.  An empirical and analytical methodological approach was adopted for this study. To conclude the findings, the research reveals that that Afghan Refugees have not only affected the social set-up but also the economy of the local host society by introducing various type of social evils like begging, drugs culture, Kalashnikov culture (AK-47), Galemjum culture (prostitution) and corruption.
Traumatic Diaphragmatic Hernia: Management and Review
Authors:   Department of General Surgery, Institute of Medical Sciences, BHU, Varanasi, UttarPradesh,India, kumari Sweety
Published: September 2021

Traumatic diaphragmatic injury (TDI) is a fairly uncommon with incidence of 0.8 and 1.6 %, commonest fallowing blunt trauma abdomen. Right-side have higher mortality rate compared to left side and penetrating injuries. It present as occult to obvious. Laparoscopy offers diagnostic and therapeutic tool of care. Lack of awareness of the condition may delay in diagnosis, results life threatening complications. Missed hernia is a known complication of blunt trauma as acute diagnosis can be difficult to ascertain. An early diagnosis and treatment lead to better outcome. In present study CECT revealed acute diaphragmatic hernia, bilateral pleural effusion and hair line fracture of right tibia on skiagram limb. Because of uncertainty in diagnosis of acute diaphragmatic hernia or rupture surgeons faces challenges for the management, high suspicion index required to diagnose the cases. An early diagnosis and treatment lead to better outcome