bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamics of changes in population immunity to the SARS-CоV-2 virus in residents the Irkutsk region in the context of the COVID-19 pandemic
Authors: Balakhonov S. V. , Dubrovina V. I. , Pyatidesyatnikova A. B. , Briukhova D. D. , Kiseleva N. O. , Korytov K. M. , Voitkova V. V. , Perezhogin A. N. , Chesnokova M. V. , Gavrilova T. A. , Seledtcov A. A.
Published: May 2021

Background. The ongoing COVID-19 pandemic in the world and in Russia remains the main event in 2020. A comprehensive study of the patterns of development and manifestations of the epidemic process of the new coronavirus infection COVID-19 is an urgent line of research. One of the important aspects of the fight against COVID-19 is the study of population immunity to the SARS-CoV-2 virus in order to assess seroprevalence and the formation process of post-infectious humoral immunity to SARS-CoV-2, forecast the development of the epidemiological situation, identify the features of the epidemic process, as well as planning measures for specific and non-specific disease prevention. The aim of the research is to determine the level and structure of population immunity to SARS-CoV-2 among the humans of the Irkutsk region during the COVID-19 epidemic. Materials and methods. As part of the Rospotrebnadzor project to assess population immunity to SARS-CoV-2 in the population of the Russian Federation, research is being conducted among the population of the Irkutsk region in the periods from 06/23/2020 to 07/19/2020 (stage 1), from 09/16/2020 to 09/25/2020 (Stage 2) and from 12/07/2020 to 12/18/2020 (stage 3), taking into account the reacted one recommended by the WHO. The content of antibodies to SARS-CoV-2 was determined by ELISA using a set of tests for human serum or plasma for specific immunoglobulins of class G to the nucleocapsid of the SARS-CoV-2 virus produced by FBUN GNCPMiB Rospotrebnadzor (Obolensk). The results of a research of the humoral immunity of volunteers show that during the period of an epidemic rise in the incidence of COVID-19 in the Irkutsk region, a low level of seroprevalence was formed (stage 1 – 5.8 ± 0.5%, stage 2 – 12,1 ± 0,7%), and in conditions of a long-term maximum increase in the incidence rate ¬– 25,9±1,0% (stage 3). A significant proportion (stage 1 – 81,2±3,2%, stage 2 – 90.9 ±1,9%) of asymptomatic forms of infection characterize the high intensity of the latently developing epidemic process in the first two stages. High levels of IgG in reconvalescents of COVID-19 persisted for an average of 3 to 4.5 months. Conclusion. The results of assessing the population immunity to the SARS-CoV-2 virus in the population of the Irkutsk region indicate that the seroprevalence level at the 3rd stage of the research was 25.9%. After the disease, on average, 41.6% of persons did not detect antibodies. The results obtained should be taken into account when organizing preventive measures, including vaccination, and predicting morbidity.
Monitoring the quality of domestic measles prevention vaccines
Authors: Binyatova A. S. , Yunasova T. N. , Sarkisyan K. A. , Davydov D. S. , Ilyasova T. N. , Movsesyants A. A.
Published: May 2021

Relevance. The need to increase vaccination coverage in order to eliminate measles in Russia and increase public confidence in vaccination requires constant monitoring of the quality of vaccines used for measles prevention. Aim. Analysis of laboratory quality parameters of commercial series of vaccines for measles prevention produced by JSC NPO Microgen, issued from 2015 to 2020, in comparison with the series issued in the period from 2002 to 2009. Materials and methods. The object of the study was a live measles culture vaccine and a live mumps-measles culture vaccine produced by JSC «NPO «Microgen». The quality analysis of vaccines was carried out according to the consolidated production and control protocols of 422 series of measles vaccine and 855 series of mumps-measles vaccine issued in 2015-2020, and 1043 series of measles vaccine and 902 series of mumpsmeasles vaccine issued in 2002-2009. Results and discussion. It is shown that the quality of the studied vaccines is stable during 16 years of monitoring. The sensitizing properties of both vaccines significantly decreased during the last 6 years of follow-up due to a decrease in the residual content of the antibiotic in the vaccination dose to less than the detection limit, as well as due to the low content of heterogeneous protein (bovine serum albumin). Conclusion. The quality of domestic vaccines for the prevention of measles and mumps meets who requirements; it is characterized by stability over 16 years of follow-up and minimal sensitizing properties. Information about the quality of domestic vaccines for the prevention of measles is an important argument for countering the antivaccination movement, which is a global problem and is recognized by who as one of the most important threats to the health of the world's population.
Multiple Languages and the process of the Teacher Formation in Early Childhood Education
Authors: Carvalho Kézia Costa de Oliveira Rocha , Andrade Maria de Fátima Ramos de , Mizukami Maria da Graça Nicoletti
Published: May 2021

The formation of the Early Childhood Education teacher is a recurring theme in many studies, showing the concern for the quality of the activities carried out with early childhood children. In pedagogy courses, in which future teachers are qualified, there is a concern with training strategies for the appropriation of multiple languages, a theme also studied due to proposals related to Childhood Pedagogy. This research aims to investigate and analyze how teachers of the pedagogy course of a private university in the city of São Paulo, in their educational practices, consider the multiple languages ​​in the formation of teachers of early childhood education. A qualitative approach was chosen. to carry out the research, and as a methodological procedure, we have interviewed ten teachers from the pedagogy course and thirteen students from the sixth semester. The theoretical background adopted is based on the conceptions of children and early childhood education from the perspective of multiple languages. The results showed that teachers use different strategies when working with multiple languages in their disciplines. Nevertheless, such practices or strategies are aimed much more at preschool children than at daycare children.
PERCEPTION INDEX OF ENVIRONMENTAL EDUCATION IN FUNDAMENTAL EDUCATION SCHOOLS IN A CITY ON THE BRAZIL / BOLIVIA FRONTIER
Authors: Paraguassú-Chaves Carlos Alberto , Cavalcante Fábio Robson Casara , Trindade Carla Dolezel , Filho Simão Aznar , Cavalcante Ana Maria Morais da Fonsêca , Góes Sílvia Bezerra de , Costa Vitor Akira Uesugui , Almeida Fabrício Moraes de , Dantas Lenita Rodrigues Moreira
Published: May 2021

Objective: to analyze the Environmental Education Perception Index in the light of national curricular parameters (PCN’s) within the scope of elementary education in state schools in the city of Guajará-Mirim, Rondônia, on the Brazil / Bolivia border. Method: for this study, factor analysis was used as a mechanism for building performance indices for each parameter studied. The Statistical Package for the Social Sciences - SPSS [30] tool was used to determine the proposed indexes that followed the scale advocated by Hair et al [21]. Results: the results presented by the teachers of the 4 schools correspond to the perception index considered “good” with an average index of 0.699. The average perception index of school technicians and managers was 0.591, considered a “regular” index. The students had an average performance of 0.537, considered a “regular” performance index. The general IPEA among all schools surveyed was considered “regular” with a performance index of 0.597. Conclusion: the fact that Guajará-Mirim has 92% of its territory occupied by Conservation Units and Indigenous Lands and a strong environmental policy does not correspond to the level of abstraction applied by formal Environmental Education. Environmental Education given in Guajará-Mirim elementary schools imposes considerable risks on the environmental conscience of future generations, as it presents certain deficiencies in fulfilling its institutional role as a social transformer, configuring itself as a limiter of sustainable development and awareness environmental.
Structured Assessment on Learning Progress
Authors: Fu Shan , Sun Qiong
Published: May 2021

This paper presented a novel technique and practice of the assessment of learning progress of university students in an engineering discipline. Instead of measuring the effectiveness of accumulation of specific knowledge, the newly developed assessment technique evaluates the development of the intelligence of the students. The key components of the proposed technique are a performance-based method for the estimation of the intelligence level and a cognitive mental faculty-oriented decomposition method to determine the intelligence contribution factors for learning subjects and exam questions. The proposed technique was applied to assess the learning progress of a group of university students in the field of automation, and the results from test agreed with the expectation well.
Analysis of the practical reform of engineering thermal physics teaching based on FLUENT
Authors: 赵 逸敏 , Xia Yancheng
Published: May 2021

Engineering thermophysics is a technical science which studies the law of energy transformation in the form of heat and its application.It studies the internal laws of various thermal phenomena and thermal processes, and can be used to guide engineering practice. FLUENT is a tool course that plays a great role in assisting with the simulation of some devices in engineering thermophysics and fluids. However, in the process of learning simulation, students have had difficulty in mastering the FLUENT software and this paper proposes some constructive suggestions for measures to increase students' mastery of this software.
4-year Experience of Nursing Activities Score Use in a Brazilian Cardiac Intensive Care Unit
Authors: Júnior Elias Rodrigues de Almeida , Oliveira Daniel Braga de , Santos Gabriela Rodrigues dos , Felice Rosângela de Oliveira , Gomes Fabiola Alves , Mendes-Rodrigues Clesnan
Published: May 2021

The assessment of nursing workload offers both support for patient care planning and service management. In an Intensive Care Unit (ICU) this workload is measured by the Nursing Activities Scores (NAS), although in specialized areas such as Cardiology, its use is still diminished. Objective: To describe NAS and the prevalence of its sub-items in a Brazilian Cardiac ICU. We also aimed to evaluate NAS oscillation since the opening of the unit, and according to the day of the week. Methods: Daily NAS records collected from November 2014 to October 2018 were assessed, totaling 8600 assessments distributed over 49 months. The data were analyzed according to time, day of the week, number of records per day, and dichotomizing if NAS was higher or lower than 50 points. Results: NAS presented mean value of 52.91 points and a median of 53.40 points. The mean NAS values per month ranged from 45.00 to 59.10 points. The percentage of NAS assessments above 50 points ranged from 20.59 to 92.34% per month and proved to be a better indicator for assessing the variability of the monthly workload. When combined two by two, 66.01% of NAS combinations scored more than 100 points, suggesting the need for more than one nursing professional per day. When the data were stratified by year, 2018 had the lowest means compared to the others. When compared to the mean values in function of the day of the week, it was observed that Monday to Friday (with the highest mean on Wednesday, the predominant day for cardiac surgeries) showed higher values than weekends. Conclusions: Overall, NAS showed low values compared to other general or cardiac ICUs, it also presented temporal variability and our results showed risk of workload overload which can compromise patient care and safety. Such results reinforce the importance of the administrative and assistant aspects of the routine use of NAS in ICUs specially in specialized environments as Cardiac ICU.
Use of Open-Ended Student Worksheet to Improve Mathematics Communication Skills in Algebra
Authors: Kurniawan Heru , Darmono Prasetyo Budi
Published: May 2021

Communication is the foundation of every learning activity. Mathematical communication is a skill to represent ideas in mathematical language so that it is understood by others who are used in problem-solving activities. This study aims to improve mathematical communication skills by using open-ended student worksheets in algebra. The research sample involved 6 junior high schools in Purworejo Regency, Indonesia which is divided into 2 groups, the experimental group consists of 91 students and the control group consists of 96 students. The study design used a randomized static group comparison design. The research instrument used 5 item essay tests that contained non-routine problems. The data analysis technique used an independent sample T-test. The results showed that the communication skills of students who were subjected to learning using open-ended student worksheets were better than the communication skills of students who were subjected to learning using student worksheets that are commonly used by teachers. These results provide an important impact that teachers should always integrate the presentation of non-routine problems in the form of worksheets as an integral part of mathematics learning.
THEORETICAL AND METHODOLOGICAL CONTRIBUTIONS OF THE KNOWLEDGE ECONOMY
Authors: Cruz Uilmer Rodrigues Xavier da , Garcia Ricardo Alexandrino
Published: May 2021

With the emergence of new paradigms in social and labor relations, before the property or assets of a company are valued. However, today, in addition, it is also considered that knowledge (in innovations, technology, experience, trade secrets, among others) adds value to an institution. Therefore, this research seeks to detail the phenomenon of the knowledge economy, in job prospects, education, environment and innovation, in addition to relating this concept to the collection of recyclable materials. The problem question developed to initiate the reflections was: How is the knowledge economy related and positively influences work activities such as the collection of recyclable materials? The general objective, on the other hand, is to understand how knowledge, experience and innovations are configured as fundamental for the improvement of processes and work in industries and organizations, here, specifically, the recycling industry. The specific objectives are focused on: detailing the emergence of the concept of the “Knowledge Economy”; understand how the knowledge economy relates to aspects of education, labor and the environment; understand the concept of social innovation and how it applies to third sector organizations; and learn about the “Steps of knowledge” applied to the activity of recycling materials. The methodology was an analysis of the recurring literature related to the topic of the knowledge economy and the recycling industry. It is concluded, therefore, that the workers of this branch make up the large group of Brazilians in conditions of informality and social exclusion and rights, and that is why the discussion addressed here is so important. for believing that the condition of these recyclers continues to be highly undervalued, despite being so important, both for society and for the environment.
Optimal Pairs Trading Strategy under Geometric Brownian Motion and its Application to the US stocks
Authors: Shin Dong Hoon
Published: May 2021

This study is a study on pair trading, a representative market-neutral investment strategy. A general pair trading strategy uses econometric techniques to select a pair of stocks and calculates the trading price level depending on a single variable called the variance of stock returns without any theoretical background. This study applies the optimal pair trading strategy proposed by Liu et al. (2020) to the top US market cap stocks and examines its performance. This strategy proposes a mathematical background for optimally calculating the trading price level. Since the statistical method for pair selection can be omitted, a pair can be formed only with good stocks with guaranteed liquidity. In addition, strategic risk management is possible because the stop loss set according to the market situation is performed. As the top 10 market cap stocks traded on the US exchange, daily closing price data for 10 years from 2011 to 2020 were applied to optimal pair trading. It was confirmed that the rate of return may differ depending on the adjustment of various parameters including the level of stop loss. In this study, an applicated strategy that properly managed pairs trading and stocks together earned the minimum annual average return 17.88% and the Sharpe ratio reached 1.81. These numbers can be better with the adjustment of the parameters.
Scar Pregnancy a Diagnostic Conundrum: A Case Report
Authors: Pokhrel Manoj , Acharya Shreedhar Prasad , Sharma Jyotshna , Thapa Meena
Published: May 2021

Cesarean scar pregnancy is a rare form of ectopic pregnancy which may lead to uterine rupture and catastrophic hemorrhage. We report a case of cesarean scar pregnancy in a 35-year-old female with the past history of cesarean section presented with complaints of amenorrhoea for 6 weeks and non-specific  pain. Two Transvaginal sonography was done 48 hours apart which suggested a cesarean scar pregnancy in one and cervical pregnancy on the other. Magnetic Resonace Imaging showed a well-defined cystic lesion of (21x19)mm2 embedded within the previous cesarean scar which confirmed the diagnosis of cesarean scar pregnancy. Laparotomy unveiled uterus around 6 weeks size and a (3x3)cm2 bulge was noted at the site of previous scar in lower uterine segment, where a small incision was given and the gestational sac was removed following which the uterine incision was closed with 2-0 polyglactin suture. High index of suspicion and prompt diagnosis is ofparamount for reducing morbidity and mortality.
Perception towards Online Classes during COVID-19 among MBBS and BDS Students in a Medical College of Nepal: A Descriptive Cross-sectional Study
Authors: Sharma Nitasha , Bhusal Chet Kant , Subedi Sandip , Kasarla Rajeshwar Reddy
Published: May 2021

Introduction: Sudden outbreak of COVID-19 pandemic has affected the educational system worldwide, forced the medical colleges to close due to lock down, and disrupted the classroom face-to-face teaching process. As a result, medical colleges shifted to an online mode of teaching. The aim of this study is to find out the perception towards online classes during COVID-19 lockdown period among MBBS and BDS students at a medical college of Nepal.

Methods: This was a descriptive cross-sectional study carried out at Universal College of Medical Sciences and Teaching Hospital among first and second year Bachelor in Medicine, Bachelor of Surgery and Bachelor in dental surgery students from 1st June 2020 to 30th August 2020. Ethical approval was taken from Institutional Review Committee of Universal College of Medical Sciences and Teaching Hospital (IRC UCMS, Ref: UCMS/IRC/025/20). Convenient sampling method was used. Semi-structured questionnaire was used. Statistical Package for Social Sciences 22 was used for analysis and frequency and percentage was calculated.

Results: One hundred fifty six (73.93%) students were enjoying online learning only to some extent, 135 (63.98%) felt online class not equally effective as face-to-face teaching. The students had disturbance during online classes as internet disturbance 168 (79.60%), and electricity problem 47 (22.3%). Similarly, many students 155 (73.50%) felt external disturbance, headache 26 (12.3%), and eye strain 26 (12.3%).

Conclusions: Most of the students suffered from disturbances during online classes probably because of internet and electricity problem. When compulsory to conduct online classes, students felt that not more than three online classes per day should be conducted to avoid eye strain and headache.
Knowledge of Vitamin D among First-year Medical Undergraduate Students of a Medical College: A Descriptive Cross-sectional Study
Authors: Manandhar Pratibha , Manandhar Naresh , Joshi Sunil Kumar
Published: May 2021

Introduction: Vitamin D also known as the sunshine vitamin, helps in bone metabolism and calcium homeostasis. It is estimated that one billion people in the world have vitamin D deficiency making it a public health problem. The objective of this study is to find out the knowledge regarding vitamin D among first-year medical undergraduate students of a medical college.

Methods: This is a descriptive cross-sectional study carried out from 2nd February 2020 to 15th February 2020 at Kathmandu Medical College Teaching Hospital, Duwakot among medical undergraduate students of a medical college. Ethical clearance was received from the Institutional Review Committee of Kathmandu Medical College Teaching Hospital (Reference Number: 2812201809). A structured self-designed multiple-choice questionnaire on vitamin D knowledge was used. Convenient sampling method was applied and statistical analysis was done with Statistical Package for the Social Sciences 20 version.

Results: Out of total 157 undergraduate medical students, 21 (13.3%) exhibited good knowledge, 116 (73.9.8%) had average, and 20 (12.8%) had poor knowledge. There were 83 (52.9%) Bachelor of Medicine and Bachelor of Surgery students, 39 (24.8%) were Bachelor of Dental Surgery and 35 (22.3%) were Nursing students.

Conclusions: We found a satisfactory level of knowledge of vitamin D among first-year undergraduate medical students of a medical college when compared to similar studies. The majority of students from all three disciplines had average knowledge of vitamin D.
Perception of Online Lectures among Students of a Medical College in Kathmandu: A Descriptive Cross-sectional Study
Authors: Bhattarai Bhagabat , Gupta Sujaya , Dahal Sirjana , Thapa Aarzu , Bhandari Pooja
Published: May 2021

Introduction: The COVID-19 global pandemic has affected all aspects of human life, with education no exception. Online lectures have been practiced in different academic institutions around the world. The objective was to know the perception towards online lectures by the undergraduate students of a medical college.

Methods: This descriptive cross-sectional study was conducted among the undergraduate students of dentistry, medicine, and nursing at Kathmandu Medical College via self-administered online questionnaire. Data were collected from November to December 2020 after ethical clearance from institutional review committee (Ref. no. 0311202002). Students who had not attended even one hour of online learning per week were excluded. Responses were collected using Google Forms which were analysed in Microsoft Excel.

Results: Out of 318 valid questionnaires, 143 (44.97%) students agreed that online lectures were effective but 138 (43.4%) disagreed that online lectures were more useful than traditional lectures. One hundred and forty five (45.60%) found online classes difficult to concentrate and 175 (55.03%) agreed that they preferred a combination of traditional teaching and online tutorials. Only two (0.63%) students strongly agreed on excellent internet during classes and 104 (32.70%) agreed it caused economic burden. Mean age of participants was 20.75Â±1.538 years; 202 (63.52%) were females; online learning per week was 18.75Â±9.157 hours; and duration of online learning was 20.28Â±9.997 weeks.

Conclusions: Most of the students had a positive attitude towards e-learning when compared tosimilar studies. Further multicentric studies with larger sample size would better demonstratewhether online education partly or fully can be effective adjunct to traditional face to face interaction.
PEMBERDAYAAN PEMBUATAN NATA DECOCO BAHAN LIMBAH AIR KELAPA PADA FATAYAT NU METRO
Authors: Farida Annikmah , Rahmawati Rita , Asnawi Habib Shulton , Saputra Andika Ari
Published: May 2021

ABSTRAKTujuan dari pendanpingan pemberdayaan  masyarakat ini adalah ntuk pemanfaatan dan  mengatasi masalah pencemaran lingkungan limbah air kelapa menjadi olahan yang bermnanfaat dan bernilai ekonomis dalam bentuk nata decoco untuk para anggota Fatayat  NU Kecamatan Metro Utara Kota Metro sehingga air kelapa yang selama ini tidak dimafatkan oleh para pedagang kelapa dipasar-pasar tradisisonal  yang ada di Kecamatan Metro Utara  dan sekitarnya bisa dirmanfaatkan. Metode yang digunakan dalam pemberdayaan masyarakat ini menggunakan pendekatan pendampingan Asset Based Community Development (ABCD). Adapun jumlah peserta yang hadir  20  orang terdiri dari  Pengurus Fatayat NU  Cabang Kota Metro , Pengurus  Fatayat NU  Anak Cabang Kecamatan Metro Utara dan Pengurus  Fatayat NU Ranting  Kecamatan Metro Utara. Hasil dari pemberdayaan ini adalah  memiliki ketrampilan dalam pengolahan limbah air kelapa menjadi suatu olahan yang bermnafaat  dan bernilai ekonomis sehingga penambah pendapatan bagi keluarga.Kata Kunci: Limbah Air Kelapa, Nata Decoco, PelatihanABSTRACTThe purpose of this community empowerment guidance in to utilize overcome the problem of environmental pollution of coconut water waste into useful economical processing in the form of nata decoco for members of Fatayat NU, Metro Utara District, Metro City so that coconut water has not been ignored by coconut traders. In the traditional markets in Metro Utara District and its surroundings, it can be utilized. The method used in community empowerment uses the Asset Based Community Development (ABCD) mentoring approach. The number of participants who attended was 20 people consisting of the Fatayat NU Management Branch of the Metro City, the Executive of the Fatayat NU Branch of the North Metro District and the Fatayat NU Management, the North Metro District. The result of this empowerment is having skills in processing coconut water waste into a useful and economical process so that it can increase family income.Keywords: Coconut Water Waste, Nata Decoco, Training
Episódio hipotónico-hiporresponsivo pós-vacinação: a propósito de um caso clínico
Authors:   Médico de Família, Alves Cátia , Romeira Ana Margarida ,   Médico de Família, Ferreira Raquel ,   Médico de Família, Almeida Teresa ,   Médico de Família, Leiria-Pinto Paula ,   Médico de Família
Published: May 2021

Introdução: O episódio hipotónico-hiporresponsivo (EHH) pós-vacinação caracteriza-se pela súbita diminuição do tónus muscular, hiporresponsividade e alteração da coloração cutânea (palidez ou cianose), com início imediato ou até 48 horas pós-imunização e em que não é identificável outra causa. Descrição do caso: Descreve-se o caso clínico de uma lactente referenciada à consulta por suspeita de anafilaxia após vacinação e em que a investigação imunoalergológica permitiu excluir o diagnóstico, demonstrar a tolerância à vacina pentavalente e confirmar o EHH. Comentário: Este caso reforça a importância da referenciação destas crianças para a consulta de imunoalergologia para exclusão/confirmação de alergia às vacinas. O EHH é uma entidade rara, pouco descrita na literatura e que pode acometer qualquer criança que seja vacinada. Não deve ser contraindicação para futuras imunizações, sendo, no entanto, recomendável que a dose de vacina pós-episódio seja feita em ambiente hospitalar.
Combater as alterações climáticas na medicina geral e familiar em Portugal
Authors:   Médico de Família, Coelho Inês Laplanche
Published: May 2021

O impacto das alterações climáticas já se faz sentir na saúde dos nossos doentes e esta emergência de saúde pública pode vir a pôr em causa a estabilidade do nosso sistema de saúde. As mudanças no clima afetam praticamente todos os órgãos e sistemas, contribuindo para o aumento da incidência e prevalência de diversas patologias. Como médicos de família podemos assumir um papel ativo na mitigação e adaptação às consequências das alterações climáticas na saúde dos nossos doentes, no nosso sistema de saúde e na saúde do nosso planeta através da alteração dos nossos hábitos nas unidades de saúde, da promoção de mudanças de comportamentos e da consciencialização da comunidade em geral para este problema. Somos provavelmente a última geração a poder travar as alterações climáticas e, por isso, temos o dever de agir.
Morrer no domicílio: fatores associados à satisfação da preferência do doente
Authors:   Médico de Família, Ferreira ita Carvalho Cunha , Capelas Manuel Luís ,   Médico de Família
Published: May 2021

Introdução: A importância do local de morte tem sido estudada e valorizada em cuidados paliativos. Em Portugal parece que a maioria dos doentes prefere morrer no domicílio, embora a sua preferência não seja satisfeita. Objetivos: Identificar fatores associados à satisfação da preferência de morte no domicílio entre doentes acompanhados em cuidados paliativos em Portugal. Métodos: Estudo epidemiológico, observacional, transversal e analítico, em doentes acompanhados durante 2017 nas equipas de cuidados paliativos que responderam a um estudo de maiores dimensões do Observatório Português de Cuidados Paliativos. Foram selecionadas variáveis independentes de caracterização demográfica, social, clínica e de cuidados de saúde. Para análise bivariada foram utilizados os testes χ2, Mann-Whitney e modelo de regressão logística binária. Para análise multivariada foi utilizado o modelo de regressão logística com base no método Forward, baseado no teste de Wald. Resultados: Obtivemos uma taxa de resposta das instituições de 9,8%, com inclusão de 68 doentes, dos quais 52,9% do género masculino e com mediana de 78,5 anos (ampIIQ=19). A satisfação da preferência de morte no domicílio verificou-se em 32,3% (k=0,26) e associou-se de forma estatisticamente significativa a alguns fatores, nomeadamente à residência nos Açores (OR=3,79), à residência numa área rural (OR=10,00), à duração do seguimento desde a admissão numa equipa até à morte (≤ 30 dias, OR=0,15) e ao facto de o doente ser acompanhado por uma equipa comunitária de suporte em cuidados paliativos (OR=9,00). Conclusões: O valor de satisfação da preferência de morte no domicílio obtido foi apenas razoável, encontrando-se entre os valores mais baixos da literatura. Foi identificada uma relação com o local de residência, o tempo de seguimento em cuidados paliativos e o acompanhamento por equipas comunitárias especializadas. Estes fatores facilitadores vão ao encontro dos achados em estudos internacionais e poderão orientar a definição de estratégias adequadas à realidade da população portuguesa.
Síndroma de QT Longo: relato de caso de uma causa rara de síncope em idade pediátrica
Authors:   Médico de Família, Rebelo Alícia Raquel , Lopes Andreia ,   Médico de Família, Magalhães Catarina ,   Médico de Família, Sarmento João ,   Médico de Família, Salgado Miguel ,   Médico de Família
Published: May 2021

Introdução: A síncope é um motivo frequente de preocupação em idade pediátrica. Apesar da sua etiologia ser maioritariamente benigna, é essencial excluir causas graves e potencialmente fatais que, embora raras, devem fazer parte do diagnóstico diferencial destas situações. Para isso, é necessário existir um elevado índice de suspeição. Descrição de caso: Adolescente de 12 anos, previamente saudável, observado no serviço de urgência (SU) por primeiro episódio de perda de consciência (PC) com cinco minutos de duração e hipertonia generalizada. Mãe com episódios de PC classificada como epilepsia, sem outros antecedentes familiares relevantes, nomeadamente sem história familiar de patologia cardíaca em idade jovem ou morte súbita. Exame objetivo e eletrocardiograma (ECG) sem alterações, referenciado à consulta de neuropediatria onde realizou eletroencefalograma normal. Apresentou novo episódio de PC 18 meses depois, com recuperação espontânea em segundos, recorrendo ao SU. Repetiu ECG – ritmo sinusal e intervalo QT corrigido de 511 ms, tendo-se diagnosticado síndroma de QT Longo. Foi referenciado a consulta de cardiologia pediátrica e genética, tendo sido identificada mutação genética e medicado com beta-bloqueador. Após revisão da história clínica materna foi pedida avaliação por cardiologia, com confirmação do mesmo diagnóstico na mãe e na irmã. Comentário: A síndroma de QT Longo caracteriza-se por um defeito da repolarização do miocárdio, associado a risco aumentado de morte súbita. As manifestações clínicas variam, desde ausência de sintomas até palpitações, síncope ou paragem cardíaca. Apesar da raridade, o diagnóstico é acessível através do ECG. No estudo de uma PC, a existência de um traçado de ECG prévio normal não invalida a sua repetição, uma vez que a alteração do intervalo QT pode ser inconstante. A existência de problemas cardíacos na família favorece a hipótese de síncope de causa cardíaca. Em caso de diagnóstico primário na criança deve ser efetuado um rastreio familiar de modo a despistar outros casos eventuais.
Eficácia dos corticoides orais no alívio dos sintomas da síndroma do canal cárpico: qual a evidência atual?
Authors:   Médico de Família, Pinto Nuno Teles , Teles João Soares ,   Médico de Família, Fernandes Vânia Ferreira ,   Médico de Família, Serra Maria João ,   Médico de Família
Published: May 2021

Introdução: A síndroma do túnel cárpico (STC) é causada pela compressão do nervo mediano no seu trajeto através do túnel cárpico e é a neuropatia mais frequente do membro superior. Objetivo: Rever e analisar a evidência atual sobre a eficácia dos corticoides orais no alívio dos sintomas em pacientes com síndroma do túnel cárpico. Material e métodos: Pesquisa de guidelines (GL), ensaios clínicos aleatorizados e controlados (ECA), revisões sistemáticas (RS) e meta-análises (MA), publicadas entre 2009 e 2019, nas bases de dados e sítios de medicina baseada na evidência da PubMed, da Cochrane Library, DARE, Bandolier, TRIP Database, BMJ Evidence-Based Medicine, National Guideline Clearinghouse, NICE, Canadian Medical Association Practice Guidelines Infobase e Primary Care Clinical Practice Guidelines, utilizando-se os descritores MeSH: ‘carpal tunnel syndrome’ e ‘corticosteroids’. Foi aplicada a escala Strength of Recommendation Taxonomy (SORT), da American Academy of Family Physicians, para atribuição dos níveis de evidência (NE) e das forças de recomendação (FR). Resultados: Dos 172 artigos devolvidos da pesquisa efetuada foram selecionados seis: um ECA, quatro RS e uma norma de orientação clínica (NOC). A eficácia dos corticoides orais a curto-médio prazo no alívio sintomático da STC é evidenciada por vários ECA e RS metodologicamente bem concebidos. Na maioria dos estudos a administração oral de 20mg de prednisolona por duas semanas conduz ao alívio temporário dos sintomas. Conclusões: A corticoterapia oral pode ser usada no alívio temporário dos sintomas do STC a curto prazo, num regime de 20mg diários de prednisolona durante duas semanas (SORT A). O seu uso no tratamento a médio e a longo prazo apresenta um nível de evidência mais baixo (SORT B).
Mal de Pott: um diagnóstico improvável
Authors:   Médico de Família, Silva Maria Inês , Pinto Joana ,   Médico de Família, Viana Manuel ,   Médico de Família
Published: May 2021

Introdução: As manifestações osteoarticulares da tuberculose são a terceira apresentação mais frequente da tuberculose extrapulmonar, sendo o esqueleto axial o local mais afetado, o que se designa por espondilodiscite tuberculosa ou Mal de Pott. Apresenta-se um caso clínico que pretende alertar para este diagnóstico, pouco frequente nos cuidados de saúde primários, cuja clínica inespecífica e insidiosa pode dificultar e atrasar o diagnóstico e o tratamento. Descrição do caso: Homem, 82 anos, nacionalidade portuguesa, com antecedentes pessoais de hipertensão arterial medicada e controlada. Sem outros antecedentes pessoais de relevo, nomeadamente infeção pelo vírus da imunodeficiência humana (VIH) ou imunossupressão. Desconhece antecedentes pessoais de tuberculose ou contactos de risco. Recorre à consulta aberta da sua Unidade de Saúde Familiar por dor na região dorsal e no hemitórax esquerdo com cerca de quatro meses de evolução, com uma intensidade de 6 em 10, sem irradiação, com alívio parcial com medicação analgésica e anti-inflamatória e agravamento com os movimentos. Sem história de traumatismo. Nega sintomatologia respiratória, neurológica e outros sintomas constitucionais gerais. O exame objetivo não evidenciou alterações à observação da coluna dorsal, nomeadamente sinais inflamatórios locais ou deformação visível da coluna, nem dor à palpação e nem alterações da sensibilidade ou força muscular. Realizou radiografia da coluna dorsal e radiografia do tórax que não revelaram alterações significativas. Dada a evolução temporal optou-se por realizar tomografia computorizada da coluna dorsal que revelou alterações fortemente sugestivas de um processo de espondilodiscite. O doente foi referenciado para o serviço de urgência hospitalar, onde foi proposto internamento para estudo e orientação, do qual se realça biópsia óssea positiva para polymerase chain reaction (PCR) de bacilo de Koch. Foi assumido o diagnóstico de Mal de Pott, tendo o doente iniciado tratamento com anti-bacilares. Comentário: O Mal de Pott tem como sintoma mais comum a dor localizada, com agravamento progressivo ao longo de semanas ou meses, ou seja, uma clínica pouco específica e insidiosa, o que contribui para o atraso no diagnóstico. Podem existir sintomas constitucionais, como perda de peso ou febre, embora estes estejam presentes em menos de metade dos casos. Os métodos de imagem são importantes para o diagnóstico, nomeadamente a tomografia computorizada e a ressonância magnética, sendo a radiografia da coluna pouco sensível, particularmente na fase inicial. Após o diagnóstico, o tratamento deve ser instituído de forma célere com o fim de melhorar o prognóstico. O médico de família tem um papel importante quer na suspeita diagnóstica desta patologia, permitindo o diagnóstico e tratamento atempados, quer no seu seguimento, apoiando a adesão ao tratamento e a gestão das complicações da doença.
Expectativas dos utentes na consulta nos cuidados de saúde primários
Authors:   Médico de Família, Aroso Margarida , Seabra Pedro ,   Médico de Família
Published: May 2021

Objetivos: Caracterizar as expectativas dos utentes face à consulta de medicina geral e familiar (MGF) e analisar se existe relação entre o cumprimento das expectativas do utente e as características sociodemográficas, com a satisfação no final da consulta. Métodos: Consistiu num estudo observacional transversal, realizado numa Unidade de Saúde Familiar (USF) durante quatro semanas. Os utentes que se dirigiam a uma consulta programada eram questionados sobre o interesse em responder a um inquérito anónimo. A primeira página, lida e preenchida antes da consulta, consistiu em dados sociodemográficos (idade, género, escolaridade), número de consultas que teve na USF no último ano e expectativas presentes antes da consulta. A segunda página, respondida após a consulta, consistiu num questionário para analisar as expectativas cumpridas na consulta e outro para avaliar a satisfação com os cuidados médicos. Resultados: Obtiveram-se 65 inquéritos válidos. Verificou-se que a expectativa mais frequente antes da consulta consistia em receber informação sobre os resultados dos exames auxiliares de diagnóstico e a expectativa mais cumprida foi a explicação sobre o tratamento. Quanto ao grau de satisfação no final da consulta, a média de satisfação foi de 4,2 em 5 pontos. Verificou-se que os utentes estavam mais satisfeitos com o grau de confidencialidade e a forma como o médico o/a ouviu. Observou-se maior grau de satisfação em utentes com grau de escolaridade superior, com maior número de expectativas cumpridas e com maior número de ações realizadas e que não eram expectativas que o doente levava para a consulta. Conclusões: É importante identificar as expectativas que os doentes levam para a consulta, pois os utentes que reportam elevado número de expectativas cumpridas têm um elevado nível de satisfação, o qual pode ser atualmente considerado como um importante indicador da qualidade de saúde.
Pengaruh Kepemimpinan, Kompensasi Dan Motivasi Kerja Terhadap Kinerja Karyawan PT. JAK
Authors: Kirana Kusuma Candra , Pradipta Abraham Sukma
Published: May 2021

Penelitian ini bertujuan untuk mengetahui besarnya pengaruh kepemimpinan, kompensasi, dan motivasi kerja terhadap kinerja karyawan pada PT. JAK.  Penelitrian ini merupakan penelitian kuantitatif. Populasi dalam penelitian ini adalah karyawan di Kantor Pusat PT. JAK sebanyak 700 orang, sedangkan sampel penelitian sebanyak 175 responden yang ditentukan dengan simple random sampling. Instrumen penelitian menggunakan kuesioner tertutup dengan lima pilihan jawaban. Uji asumsi klasik terdiri dari uji normalitas, heteroskedastisitas, autokorelasi, dan uji multikolinieritas. Uji statistik terdiri dari uji regresi sederhana dan regresi linier berganda. Hasil penelitian menunjukkan bahwa: 1) kepemimpinan secara parsial berpengaruh positif dan signifikan terhadap kinerja karyawan (thitung= 8,156 > ttabel= 1,974); 2) kompensasi secara parsial berpengaruh positif dan signifikan terhadap kinerja karyawan (thitung= 10,226 > ttabel= 1,974); 3) motivasi kerja secara parsial berpengaruh positif dan signifikan terhadap kinerja karyawan (thitung= 13,982 > ttabel= 1,974); 4) kepemimpinan, kompensasi dan motivasi kerja secara simultan (bersama-sama) berpengaruh positif dan signifikan terhadap kinerja karyawan pada PT. JAK (Fthitung= 78,393 > Fttabel= 2,66). Ketiga variabel bebas secara bersama-sama mempengaruhi kinerja karyawan sebesar 57,9%.
Peningkatan Produktivitas Kerja Melalui Hubungan Kepemimpinan dan Disiplin Kerja Karyawan PT. Pelindo IV (Persero) Makassar
Authors: Hamiddin Muhammad Irwan Nur , Taaha Yulian Rinawaty
Published: May 2021

Penelitian ini bertujuan untuk menganalisis: (1) pengaruh kepemimpinan terhadap produktivitas kerja, (2) pengaruh disiplin kerja terhadap produktivitas kerja, (3) pengaruh kepemimpinan dan disiplin kerja secara simultan terhadap produktivitas kerja PT. Pelindo IV (persero) Makassar. Penelitian ini merupakan penelitian asosiatif kausal dengan menggunakan pendekatan kuantitatif. Populasi penelitian ini adalah seluruh karyawan tetap PT. Pelindo IV (persero) Makassar. sebanyak 162 karyawan dengan sampel sebanyak 64 responden. Pengumpulan data menggunakan kuesioner dan wawancara, sedangkan analisis data dilakukan dengan menggunakan analisis regresi linier berganda. Hasil penelitian pada taraf signifikansi 5% menunjukkan bahwa: 1) kepemimpinan berpengaruh positif signifikan terhadap produktivitas kerja, yang ditunjukkan dengan koefisien beta (β) 0,677, signifikansi 0,000. 2) disiplin kerja berpengaruh positif dan tidak signifikan terhadap produktivitas kerja, hal ini ditunjukkan dengan hasil koefisen beta (β) 0,105, nilai signifikansi 0,379. 3) kepemimpinan dan disiplin kerja berpengaruh positif dan signifikan terhadap produktivitas kerja.
Sociological research methodology in the media sphere
Authors:   Akhmet Yassawi International Kazakh-Turkish University, Altynbek D.N. , Serdali B.K. ,   Akhmet Yassawi International Kazakh-Turkish University, Nuskabaev O.N. ,   Akhmet Yassawi International Kazakh-Turkish University
Published: May 2021

The article summarizes the views on the current socio-political, cultural and economic situation in the context of sociological research in journalism. The study is aimed at analyzing the views of young people on what traditional religions they follow, the level of their religious knowledge and what they should do against the activities of non-traditional religious movements and religious extremist organizations and their destructive activities. The article, written using research methods such as pilot studies, rapid surveys, focus group interviews, uses the method of multistage random sampling of sociology in journalism. Quantitative and qualitative approaches to data collection have been implemented. The methods were used to organize and use focus groups, store, process, compare statistics, use the results in media research, select new methods and queries. The effectiveness of sociological research, the choice of respondents, open and closed types, survey methods (questionnaires, content analysis, expert interviews, in-depth interviews, telephone interviews, etc.) are considered. The goals and objectives of content analysis in the media are also clearly formulated. Methods used were social media polls, selective placement by industry, and random polls. The problems of sociological research (organization, planning, recognition of social reality) in the work of the editorial board were not left aside.
A Review - Signature Verification System Using Deep Learning: A Challenging Problem
Authors: Patil Punam R. , Patil Bhushan V.
Published: May 2021

One of the challenging and effective way of identifying person through biometric techniques is Signature verification as compared to traditional handcrafted system, where a forger has access and also attempt to imitate it which is used in commercial scenarios, like bank check payment, business organizations, educational institutions, government sectors, health care industry etc. so the signature verification process is used for human examination of a single known sample. There are mainly two types of signature verification: static and dynamic. i) Static or off-line verification is the process of verifying an electronic or document signature after it has been made, ii) Dynamic or on-line verification takes place as a person creates his/her signature on a digital tablet or a similar device. As compared, Offline signature verification is not efficient and slow for a large number of documents. Therefore although vast and extensive research on signature verification there is need to more focus and review on the online signature verification method to increase efficiency using deep learning.
Interest Rate Spread as the 'Power of Growth' on Financial Profitability of Banks in Africa
Authors: Manu Emmanuel Kwaku , Xuezhou Wen , Somuah Mary Akosuah
Published: May 2021

The high-interest rate has postured solemn distresses to the administration, managers, firms, and the masses. Commercial banks in Africa, principally, are exasperated to use the policy rate to bring down loaning charges. Interest rate charges though have sustained to persist gluey downwards. This study considered the impact of interest rate as the power of growth on financial profitability and examine the causal link amid the measurement variables (bank credit, savings, non-performing loans, and interest rate) between 2000 and 2016. The countries used in this study were investigated as a whole panel and individually per country. First, considering the results from homogeneity assessment and Pesaran CD's checks, we detect the presence of heterogeneity and cross-sectional correlations for the explored data. Second, the CADF and CIPS panel unit root tests report that the variables are non-stationary at their stages but become stationary at their first transformations. Third, the Westerlund-Edgerton panel bootstrap cointegration test shows that the variables are cointegrated and hence possess a structural long-run relationship. Forth, results from the PMG estimator through the panel ARDL model show that; (1) A two-way connectedness is verge by bank credit and FP in the long-period and short-run; (2) A positive and significant one-way cause running from NPLs to BC, a one-way cause amid interest rate and bank credit and lastly one-way causality only in the long-period for NPLs and SAV are evidenced; (3) The PMG estimator through the panel ARDL framework is evidenced to be very significantly effective to the application of Granger causatives test. Though different parameter estimates are evidenced, the results are generally consistent with that of the PMG in terms of connections.