bluuebunny/crossref_metadata_2025 huggingface dataset:
Cannabis et migration irrégulière chez de jeunes Tunisiens en difficulté : entre besoin d’appartenance sociale et quête du bonheur
Authors: Mathlouthi Sihem , Fares Nizar , Talbi Marwa
Published: July 2019

L’objectif de cette étude est d’identifier les liens existants entre la fréquence de consommation de cannabis et la migration irrégulière chez des jeunes Tunisiens ( n  = 131) et d’expliquer l’émergence de ces pratiques par l’examen du besoin social d’appartenance et des dispositions positives, dont principalement l’optimisme et les croyances en un monde juste. Selon les résultats, ces deux types de conduites paraissent être associées à des processus psychosociaux et positifs se trouvant tantôt convergents, tantôt divergents. En effet, plus les jeunes utilisent le cannabis et plus ils s’engagent dans un projet de migration irrégulière. Renforcer les habiletés positives chez ces jeunes, dans le cadre d’activités groupales offrant un climat d’acceptation et un réseau relationnel stable peut constituer une piste d’intervention prometteuse pour la prévention de la consommation de cannabis et la migration irrégulière.
Ouvrières agricoles et conventions collectives : de la discrimination à la reconnaissance ? (1950-2018)
Authors: Escudier Jean-Louis
Published: July 2019

L’objet de cet article est de présenter l’évolution, sur le long terme, de la prise en compte du travail et de la rémunération des ouvrières agricoles dans les conventions collectives mises en œuvre en France dans le cadre de la loi du 11 février 1950. La première partie, centrée sur la genèse de ce long processus de mise en œuvre des conventions collectives agricoles, est consacrée à l’examen des modalités d’intégration des emplois agricoles considérés comme « traditionnellement féminins » dans les nomenclatures d’emplois, notamment la substitution d’une grille hiérarchique unique à des grilles d’emplois différenciées selon le genre. Y sont évalués l’apport et les limites du corpus législatif en matière d’égalité professionnelle pour l’emploi des ouvrières agricoles. La seconde partie vise à apprécier le degré de prise en compte des compétences féminines, notamment le traitement réservé à la servante de ferme, et à identifier les conventions collectives les moins discriminantes envers les ouvrières agricoles en général. Enfin, la troisième partie, focalisée sur l’évolution constatée ces quinze dernières années, tend à analyser le renouvellement des discriminations selon le genre dont pâtissent encore les ouvrières agricoles dans un contexte de sévère tassement des hiérarchies salariales.
Brazil: from Eliticized- to Mass-Based Financialization.
Authors: Lavinas Lena , Araújo Eliane , Bruno Miguel
Published: July 2019

While research on financialization, considered the latest stage of the development of capitalism, initially focused on industrialized countries, it has now expanded to include emerging markets. This article provides new insights into the current Brazilian case, while arguing also that Brazil was already grappling with a premature, eliticized process of financialization in the 1980s, however embryonic. From the 2000s on, there came a new wave of financialization. This time, however, it was mass-based, using social policy as collateral. The article first establishes a timeline for and taxonomy of how financialization has been deployed in Brazil. It then examines how policies aimed at promoting social inclusion have been diverted to that end. Finally, it presents regression analyses demonstrating a negative correlation between financialization and the provision of public goods and services, which has become increasingly privatized. It also finds a positive relationship between financialization and income and cash transfers, the latter serving as collateral for the former.
Intégrer la division sexuelle du travail au rapport social de travail. Pistes pour l'analyse régulationniste
Authors: Berthonnet Irène , Clos Clémence
Published: July 2019

L’article propose de compléter le rapport social de travail à partir d’une analyse en termes de rapports sociaux de sexe. Nous montrons à partir de l’exemple du déploiement du développement durable dans l’hôtellerie, ici pris comme une innovation organisationnelle, que l’analyse régulationniste du rapport social de travail mériterait d’être enrichie par celle des rapports sociaux de sexe qui s’articulent avec les rapports de domination classiques. C’est en particulier dans l’existence d’une division sexuelle du travail que s’articulent rapport social de travail et rapports sociaux de sexe.
Lin Yifu, l’Afrique et le modèle chinois d’émergence
Authors: Pairault Thierry
Published: July 2019

Cette réflexion résulte d’une conjonction de questions que mes recherches sur les relations entre la Chine et l’Afrique ont suscitées. Que ce soit la promotion d’un modèle chinois de développement tant par la Banque mondiale que par la Chine elle-même, l’engouement des pays africains pour la création de zones économiques spéciales, leur volonté d’être parties prenantes de la stratégie des nouvelles routes de la soie, les ambiguïtés de la notion d’émergence, partant la concurrence idéologique que la Chine instaure à des fins politiques… tout me ramenait vers un personnage, Lin Yifu (Justin Lin), qui, sans être central ni même idéologiquement à l’avant-garde, occupe une place visible – c’est l’élément important – tant en Chine qu’à l’étranger, en particulier en Afrique, où le laboratoire d’idées qu’il dirige propage ses conseils.
The Feminization of Employment through Export-Led Strategies: Evidence from Viet Nam.
Authors: Tran Thi Anh-Dao
Published: July 2019

The early successful experiences of the East Asian NICs confirmed the role of exports as an engine of growth. Surprisingly, most of the earlier studies omit one important empirical fact, namely that the feminization of work contributed significantly to their rapid industrialization. Feminist trade theories argue that export-oriented development strategies have so far been exploitative of cheap female labour in the South. As globalization gathers pace, an increasing number of women in Developing Countries (DCs) have been absorbed into labour-intensive, export-oriented manufacturing sectors. However, the structural changes that go hand in hand with export promotion, as well as the international environment the South faces today, have dramatically modified the inner drives behind the phenomenon. This paper reviews the salient mechanisms at work through a structuralist approach of gender. By examining women’s labour force participation rate in Viet Nam, we show how patterns of gender relations stemming from structural characteristics, as well as social and institutional practices, is related to export-oriented industrialization.
Vers un nouveau genre de finance ?
Authors: Capelle-Blancard Gunther , Couppey-Soubeyran Jézabel , Rebérioux Antoine
Published: July 2019

Cet article rassemble les principaux résultats des études de genre en finance. À partir d’une présentation des résultats inédits d’une enquête sur les ménages français (enquête Pater), nous examinons d’abord les différences de préférences et de comportements entre hommes et femmes en matière financière, puis leurs incidences à plusieurs niveaux : les choix de placements et l’utilisation de services bancaires et financiers des ménages, les décisions des professionnel·le·s du secteur bancaire et financier, la gestion et la gouvernance des entreprises, pour finir, la conception et la pratique des enseignant·e·s chercheur·e·s en finance. Cinq principaux résultats s’en dégagent : i)  l’enquête Pater tend à confirmer des différences de préférences et d’attitudes financières ; ii) il ne faut pas y voir une simple révélation de préférences, mais plutôt une imprégnation forte des stéréotypes ; iii) quelle(s) qu’en soit la(les) source(s), ces différences sont plutôt préjudiciables aux femmes dans leurs choix de placement et leurs accès au crédit ; iv) les différences observées sont très sensibles au contexte, à l’expérience passée, et à l’éducation, en particulier l’éducation financière ; v) étant donné la représentation encore faible des femmes à des postes à responsabilités et le parcours d’obstacles pour celles qui y accèdent, les études actuelles ne fournissent guère la preuve d’un style de management féminin, d’une gestion nécessairement plus prudente des banques ou d’une attention plus grande à la stabilité financière ou à l’écologie. Nous concluons sur l’idée qu’une plus grande représentation des femmes devrait renforcer les différences en tout genre plutôt que les différences de genre.
Genre et horaires de travail : un nouveau regard à partir de la théorie de la segmentation
Authors: Bustreel Anne , Pernod-Lemattre Martine
Published: July 2019

Cet article s’intéresse à l’influence de la composition genrée de la main-d’œuvre sur les politiques de gestion du temps et des horaires de travail menées par les entreprises. À partir d’une enquête qualitative auprès de responsables d’entreprise, il propose une relecture des trois systèmes de gestion du temps et des horaires analysés dans la théorie de la segmentation : le système de temps fondé sur la performance, le système de temps fragmenté et le système standard, héritier de la norme temporelle fordiste. Il montre que le genre peut être un facteur de dégradation des conditions temporelles d’emploi, comme un facteur d’amélioration en fonction des configurations particulières dans lesquelles se trouve l’employeur.
Socioéconomie de la monnaie mobile et des monnaies locales au Kenya : quelles innovations monétaires pour quel développement ?
Authors: Dissaux Tristan
Published: July 2019

Des innovations monétaires, donnant à la monnaie des formes et des caractéristiques nouvelles, sont aujourd’hui utilisées dans le but de favoriser le processus de développement économique. Au Kenya, elles se concrétisent dans les systèmes de monnaie mobile tels que le M-Pesa, ainsi que dans plusieurs monnaies locales mises en place sur le modèle du Bangla-Pesa. Ces monnaies ont des natures et des logiques divergentes, dont la thèse vise à en montrer les impacts et les implications. Pour cela, nous utilisons notamment des données issues de deux enquêtes de terrain.Les innovations monétaires interpellent les théories du développement, qui ont largement exclu la monnaie de leurs analyses, et qui la considèrent généralement comme étant neutre. L’étude de ces dispositifs nous permet de poser les bases d’une théorie monétaire du développement, en questionnant ce faisant le sens à donner au concept de développement, et les rôles que doivent jouer pour celui-ci la monnaie et la finance.
Effect of sous-vide heat treatment on the phthalic acid esters content in meat
Authors: Jarošová Alžbeta , Jandlová Marcela , Kamení­k Josef
Published: July 2019

The aim of the study was to monitor the migration of the phthalic acid esters dibutyl phthalate (DBP) and di-2-ethylhexyl phthalate (DEHP) from packaging to meat wrapped in plastic when heat treated by sous-vide method. A heat treatment temperature of 80 °C was used for 4 and 8 hours with reheating at 80 °C for 1 hour. The average DBP and DEHP concentrations in meat ranged from 2.24 to 4.66 mg.kg-1 and 2.29 to 10.35 mg.kg-1 of the original sample, respectively. The average DBP and DEHP concentrations found in plastic packaging ranged from 3.06 to 6.37 µg.g-1 and 5.70 to 7.83 µg.g-1 of plastic, respectively. The average concentrations of DBP in water bath range from 16.25 to 23.38 µg.l-1, while the average concentrations of DEHP in water bath were determined between 0.24 and 1.82 µg.l-1. The above results were compared with the results measured at sous-vide treatment temperature of 70 °C for 4 hours, 8 hours, and with 1 hour of reheating. The average concentrations of DBP and DEHP in all meat samples exceeded the specific migration limits of both phthalates (0.3 mg.kg-1 for DBP and 1.5 mg.kg-1 for DEHP).
Recombinant metalloprotease as a perspective enzyme for meat tenderization
Authors: Minaev Mikhail , Makhova Anzhelika Aleksandrovna
Published: July 2019

eptidase family M9 (MEROPS database) is true collagenases and contains bacterial collagenases from Vibrio and Clostridium. One of the producers of M9A subfamily peptidase is Aeromonas salmonicida (locus - ASA_3723). The aim of the study was production of recombinant metallopeptidase Aeromonas salmonicida by transformation Pichia pastoris for further meat tenderization. Laboratory amounts of recombinant peptidase were obtained and test evaluation of enzyme activity was performed. Recombinant peptidase broke the peptide bond «Pro-Leu-Gly-Met-Trp-Ser-Arg» (one of the collagen chains, (Mw = 846.06)). The concentration of the substrate (peptide) after 180 min was 2 – fold decrease as compared with control. The maximum shear force of heat-treated samples had a 1.27 – fold decrease as compared with the control. As a result of histological studies of beef shank samples, the specific effect of the supernatant on the structure of connective tissue was established. Muscle fibers have not changed. The recombinant enzyme could be used for the meat tenderization.
Characterization of fruit trees pollen
Authors: Pospiech Matej , Javůrková Zdeňka , Tremlová Bohuslava , Běhalová Hana
Published: July 2019

One of the options to determine botanical origin of trees or honey is the analysis of pollen grains. The characteristics of pollen grains in Czech flora has not been sufficiently described yet. Within this work, fruit trees pollen of Czech origin was characterized on the basis of morphological and spectral description of pollen grains produced by fruit species of M. domestica, P. armenica, P. persica, P. domestica, P. avium and P. cerasus. The morphological characterization results of the studied fruit species are consistent with results by other authors, but certain differences between the pollen grains of some fruit trees were confirmed. Most morphological differences were confirmed among the Malus and Prunus genera. Results of morphological and spectral analyzes further confirmed the differences between some types of fruit trees, but homogeneity remained for individual species even in mixed samples. Morphological and spectral analysis can therefore be used for botanical identification of pollen. If this knowledge is applied to pollen analysis in honey, these methods can also be used to verify the botanical origin of honey.
Potency of Okra flour (Abelmoschus esculentus) in improving adiponectin level and total antioxidant capacity of high fat diet streptozotocin rat model
Authors: Fauza Ahdiyatul , Al-Baarri Ahmad Ni'matullah , Djamiatun Kis
Published: July 2019

T2DM has increase in global-morbidity and mortality. Oxidative stress and adiponectin-levels are important for insulin-resistance and pancreatic-b-cell-dysfunction in T2DM. Okra fruit is rich of quercetin and phytosterol which have positive-effect for T2DM. Research aimed was to study the effect of okra-flour to adiponectin-levels and total-antioxidant-capacity (TAC) in T2DM. Thirty Wistar-rats were divided randomly in five groups. K1 and (X1, X2 and X3)-treated-groups were in T2DM-condition-induced by high-fat-diet-(HFD)-Streptozotochin-(STZ)-nicotinamid-(NA). Healthy-controls-(K2)-group was also used. Okra-flour was given orally for 28 days at doses of 0.1; 0.2 and 0.3 g/Kg-body-weight/d to X1, X2 and X3-groups, respectively. Statistical program was used to analyse the different between pre-post-intervention, and between groups. Correlations between variables were also analysed. The serum-adiponectin and TAC-levels were measured by ELISA and ABTS-methods, respectively. By comparing pre and post-intervention, adiponectin levels of all-intervention-(X1, X2, X3)-group were  increase (p = 0.027 for X1 and X2; p = 0.028 for X3), while in the same period the decrease were found in group K1 (p = 0.026) and K2 (p = 0.028). Increase-TAC-levels pre-post-intervention was observed in group all-intervention-groups (p = 0.027), while no change in K1 (p = 0.66) and the decrease in group K2 (p = 0.039). Reduce-fasting-blood-glucose-levels pre-post-intervention were shown in the all-intervention-groups (p = 0.028), while for the K1 groups was increase (p = 0.028). There were significant differences between the five-groups on fasting-blood-glucose-levels, adiponectin and TAC-levels, and X3-group showed the highest adiponectin and TAC-levels. Very-strong-correlations were found between glucose-adiponectin-TAC-levels-post-intervention. Okra-flour make better glucose-adiponectin and TAC-levels in T2DM-conditions. Okra dose of 0.30 g/Kg-body-weight/day is the best in increasing adiponectin and TAC-levels.
Physical factors relevant for efficient Hawthorn fruit extraction
Authors: Gorlov Ivan Fiodorovich , Drucker Olga Vyacheslavovna , Kryuchkova Vera Vasilievna , Slozhenkina Marina Ivanovna , Mosolova Natalya Ivanovna , Knyazhechenko Olga Andreevna
Published: July 2019

Today, the healthy nutrition market is one of the most promising market niches; modern consumers increasingly claim fortified products for their diets. One of the ways to increase the biological and physiological value of products is their enrichment with extracts of plant origin. The aim of the work was to study the influence of various factors on the process of hawthorn fruit extraction and determine the optimal parameters of the technological process. The study objects were hawthorn fruit extracts produced by the statistical method of maceration (with stirring). In the extracts obtained, there were determined the quantitative content of tannins and pectin substances, dietary fiber and vitamins. Currently, the global health and wellness food market is steadily growing due to changes in consumer behaviour patterns and developing of healthy self-consciousness. The studies conducted by the authors have shown that extracting of plant materials and the efficiency of biologically active substances extraction are influenced by the following factors: the extractant pH, grinding type and size of raw materials and process parameters. The optimal technological regimes have been established. They are the extraction temperature of 60 °C and extraction time of 30 minutes. The appropriate grinding size of dry hawthorn fruit has been determined to be up to 2.8 mm of a particle. In case of milk being an extractant, a high extraction dynamic of pectic substances and dietary fibers was observed. So, the hawthorn milk extract has been revealed to have higher organoleptic characteristics.
Career Path Management between the Theory and Application: Measuring its Relationship with Satisfying Employees’ Needs: A Study on the Jordanian Commercial Banks
Authors: Moh’d Abu Bakir Sahar
Published: July 2019

Based on what has been proved in theory; human resources constitute the inimitable competitive advantage, and retaining them is crucial for sustainability. Hence it is necessary to satisfy employees’ needs to reduce their intention to leave. Many researchers suggested career path management as a tool for satisfying employees’ multi needs; accordingly this study aimed to examine the degree to which Jordanians Commercial banks are engaged in career path management in terms of career path planning, and career development (socialization, coaching and mentoring, and counseling), and if the Banks are able to satisfy employees needs based on Maslow’s five sets of needs.

The study aimed also to assess the relationship between career path management and satisfying employees’ needs.

7 banks participated in the study, 50 employees from each Bank represented the sampling unit, the questionnaire used for collecting the required data and information, 336 questionnaires were valid for statistical analysis using SPSS version 22.

The main results of the study revealed that the surveyed banks are engaged in career path management, except for counseling sessions.

Relied on the respondents’ answers the Banks are able to satisfy three sets of needs “the security, self-esteem, and self-actualization”.

The statistical results show also that there is a statistically significant relationship ranged between moderate to strong between career path management dimensions and the five sets of needs satisfaction  “ physiological, security, social, self- esteem and self-actualization”.

Based on the findings it is recommended to enhance the continuity of career path management process, in addition to search for means that can satisfy the physiological and social needs of employees.
Civil Society Perspectives on the Criminal Chamber of the African Court of Justice and Human Rights
Authors: Olugbuo Benson Chinedu
Published: July 2019

Civil Society Perspectives on the Criminal Chamber of the African Court of Justice and Human Rights

In June 2014, African Heads of States and Governments adopted the Protocol on the Amendments to the Protocol on the Statute of the African Court of Justice and Human Rights in Malabo, Equatorial Guinea. The Malabo Protocol seeks to expand the jurisdiction of the African Court to international and transnational crimes. This development raises fundamental issues of jurisdiction, capacity, political will and regional complementarity in the fight against impunity in the African continent. The paper interrogates the role of Civil Society Organisations in the adoption and possible operationalisation of the Court in support of the efforts of the African Union to end human rights abuses and commission of international and transnational crimes within the continent.
A Proposal for the International Law Commission to Study Universal Criminal Jurisdiction
Authors: Jalloh Charles Chernor
Published: July 2019

A Proposal for the International Law Commission to Study Universal Criminal Jurisdiction

The principle of universal jurisdiction is a unique ground of jurisdiction in international law that may permit a State to exercise national jurisdiction over certain crimes in the interest of the international community. This means that a State may exercise jurisdiction regarding a crime committed by a foreign national against another foreign national outside its territory. Such jurisdiction differs markedly from the traditional bases of jurisdiction under international law, which typically require some type of territorial, nationality or other connection between the State exercising the jurisdiction and the conduct at issue. Due to the definitional and other ambiguities surrounding the universality principle, which has in its past application strained and today continues to strain relations among States at the bilateral, regional and international levels, this paper successfully made the case for the inclusion of “Universal Criminal Jurisdiction” as a topic in the long-term programme of work of the International Law Commission during its Seventieth Session (2018). It was submitted that taking up a study of this timely topic, which has been debated by the Sixth Committee of the UN General Assembly since 2010, could enhance clarity for States and thereby contribute to the rule of law in international affairs. It will also serve to continue the ILC’s seminal contributions to the codification and progressive development of international criminal law.
Effect of Genetic Algorithm–Based Wavelength Selection as a Preprocessing Tool on Multivariate Simultaneous Determination of Paracetamol, Orphenadrine Citrate, and Caffeine in the Presence of p-Aminophenol Impurity
Authors: Boltia Shereen A , Soudi Aya T , Elzanfaly Eman S , Zaazaa Hala E
Published: July 2019

Background: The utilization of selection methods such as genetic algorithm (GA) aims to construct better partial least squares (PLS) and principal component regression (PCR) models than those established from the full-spectrum range. Objective: Determination of paracetamol (PAR), orphenadrine citrate (Or.cit), and caffeine (CAF) in the presence of PAR nephrotoxic impurity [p-aminophenol (PAP)]. GA was applied to select the optimum wavelengths used. Methods: A calibration set was prepared in which the three drugs, together with PAP, were modeled by multilevel multifactor design. This calibration set was used to build the PLS and PCR models, either with or without preprocessing the data using GA. Results: Results were compared with and without preprocessing, and this revealed that GA can find an optimized combination of spectral wavelengths, yielding a lower root mean square error of prediction as well as a lower number of latent variables used. The results of the two models show that simultaneous determination of the aforementioned drugs can be performed in the concentration ranges of 20–60, 3–11, and 1–9 μg/mL for PAR, Or.cit, and CAF, respectively. Conclusions: The proposed models were applied for the determination of the three drugs in their pharmaceutical formulations, and the results were verified by the standard addition technique. Highlights: GA can be useful as a wavelength selection tool before applying multivariate PLS and PCR methods. GA gives an improvement in the predictive ability of the models with lower RMSEP and less number of latent variables (LVs). The proposed PLS, PCR, GA-PLS, and GA-PCR spectrophotometric methods were able to determine paracetamol, orphenadrine citrate, and caffeine in the presence of p-aminophenol and severe spectral overlapping.
Demografi og triage af børn med akutte mavesmerter
Authors: Purup Thomas , Ahrensberg Jette Møller , Nikolajsen Lone
Published: July 2019

Formålet med dette studie var primært at beskrive populationen af børn med mavesmerter i de danske akutmodtagelser. Det sekundære formål var at undersøge, om det danske triagesystem viser en tendens til at kunne detektere, hvem der har potentielt livstruende sygdomme (PLS – appendicitis anvendt som indikator), eller omvendt udelukke, hvem der ikke har.

Data for alle børn med ”mave- og flankesmerter” i skadestuen på Aarhus Universitetshospital (AUH) i 2017 er inkluderet i dette retroperspektive kohorte-studie. Børnene kategoriseres efter en række karakteristika (alder, køn mv.), og der er vist grafer over triagefordelingen for hver gruppe.

276 børn er inkluderet. Medianalderen var 12 år, med 46% drenge og 54% piger. De fleste havde stærke smerter (239 patienter; 87%) og 90 børn (33%) havde påvirkede vital-parametre. 148 børn (66%) fik en uspecifik diagnose, mens 94 børn (34%) fik en specifik. Appendicitis blev fundet i alle triagekategorier.

Data viser en tendens til, at en lav triagescore ikke udelukker PLS (som appendicitis). Det kan sammenfattes, at børn med mavesmerter præsenterer sig meget forskelligt, og at vitalparametrene ved ankomst ikke altid afspejler alvorligheden af den tilstand, som barnet indlægges med.

ENGLISH

The main aim of this study was to describe characteristics of children presenting with abdominal pain in a Danish Emergency Department (ED). The secondary aim was to assess if the present triage system in the Danish EDs is indicative of children with potentially life-threatening diseases (PLTD – appendicitis used as indicator).

Data of all children with “abdominal and flank pain” in the ED at Aarhus University Hospital (AUH) during 2017 were included in this retrospective cohort study. Patients were classified according to several characteristics (e.g. age, gender) and graphs of triage distribution were shown and compared.

A total of 276 children were included. Median age was 12 years, with 46% boys and 54% girls. Most patients had severe pain (239 patients, 87%) and 90 patients (33%) had affected vital parameters. A total of 148 patients (66%) got an unspecific diagnosis at discharge, while 94 patients (34%) got a specific diagnosis. Appendicitis was found in all triage categories.

Data show a tendency towards low triage not excluding PLTD (such as appendicitis). Also, data suggest that children with abdominal pain show a great variation in symptoms, and vital parameters at admission does not always reflect the severity of the child’s condition.
Alkohol og abstinenser på akutafdelingen - gør vi det godt nok?
Authors: Knudsen Heidi Hellerup , Svenningsen Louise May , Svenningsen Helle
Published: July 2019

Abstract:

Baggrund: På akutafdelingen møder vi ofte patienter med et skadeligt alkoholforbrug. Behandlingen af deres abstinenser kan være kompliceret, og ikke ufarlig. Med baggrund i flere indberettede utilsigtede hændelser vedr. overdosering med Klopoxid, blev der i førsteforfatterens akutafdeling udarbejdet en instruks, der kunne støtte læger og sygeplejersker i behandling af alkoholabstinenser.

Formål: Formålet med denne artikel er, at føre læseren igennem vores studie og tydeliggøre vigtige resultater. Desuden ønsker vi at inspirere til tværfaglig refleksion i egen klinisk praksis.

Metode: Ved hjælp af metodetriangulering blev data fra audit af 10 konsekutive udvalgte journaler og 27 spørgeskemaer udfyldt af afdelingens sygeplejersker sammenholdt og analyseret vha. statistik og indholdsanalyse.

Resultat:Resultaterne viste tydelig diskrepans mellem sygeplejerskernes opfattelser af egen praksis og reel klinisk praksis. Ingen journaler opfyldte alle de målte indikatorer, og opfyldelsen af de enkelte indikatorer var meget svingende. Sygeplejerskerne italesatte instruksen som tvetydig og mangelfuld på flere områder, men også som et vigtigt redskab i deres daglige arbejde.

Konklusion:Behandling af abstinenser hos den alkoholafhængige patient er vanskelig og var særdeles mangelfuld i de 10 analyserede journaler. Sygeplejerskerne opfattede primært instruksen positivt, men dette modsvarede ikke resultaterne fra auditten.

                                    

Abstract:

Background:In the emergency department, we often meet patients with harmful alcohol consumption. The treatment of their withdrawal symptoms can be complicated and harmful to the patients. Based on several reported unintended accidents regarding overdose with Chlordiazepoxid, first writer's emergency department made an instruction to support doctors and nurses in the treatment of alcoholic withdrawal symptoms.

Aim:The aim of this article is to guide the reader through our study and clarify important results. In addition, we want to inspire to interdisciplinary reflection in the readers clinical practice.

Method:We compared data from audit of 10 consecutive selected journals and 27 questionnaires completed by the department's nurses by using method triangulation analyzed statistically and by content analysis.

Result:The results clearly demonstrated discrepancy between nurses' perceptions of their own practice and data from the audit. No records met all the measured indicators, and the performance of the individual indicators was very fluctuating. Nurses described the instruction as ambiguous and inadequate in several areas, but also as an important tool in their daily work.

Conclusion:Treatment of withdrawal symptoms in the alcohol dependent patient is difficult and was particularly inadequate in the 10 analyzed records. Nurses primarily perceived the instruction positively, but this did not match the results of the audit.
Afbrydelser og forstyrrelse på en akutafdeling
Authors: Døssing Kristina Villekjær
Published: July 2019

Baggrund

Sygeplejersker på en akutafdeling får flere og flere funktioner. Patienterne skal plejes og behandles, og behandlingen skal koordineres med patient, læge, pårørende, samt nye patienter skal modtages. De mange kontakter stiller store krav til sygeplejerskens kognitive evner, og det kræver, at sygeplejersken hele tiden skal bevare overblikket, så der ikke opstår fejl.

Formål

Formålet med opgaven var at undersøge omfanget af afbrydelser, og hvordan afbrydelser påvirker sygeplejerskens koncentration, og i hvor høj grad afbrydelser påvirker patientsikkerheden.

Metode

Der blev anvendt en kvalitativ metode med feltobservation i egen afdeling på akutafdelingen på Hospitalsenhed Midt i Viborg. Seks sygeplejersker blev observeret i én vagt på seks forskellige dage. Vagterne var af 8 timers varighed og var delt mellem dagvagter og aftenvagter.

En afbrydelse blev defineret, som en personlig eller telefonisk henvendelse på et tidspunkt, hvor sygeplejersken allerede var i gang med en anden opgave, samt patientklokker fra alle stuer på afsnittet, som alarmerede på telefonen. Afbrydelsen kunne både være af mere hastende karakter end den opgave sygeplejersken stod med i forvejen eller mindre hastende karakter.

Resultater

På de seks observationsdage blev sygeplejersken afbrudt i gennemsnit cirka 11 gange i timen, svarende til cirka hvert 5. minut. Cirka 50% af afbrydelserne var patientklokker og cirka 25 % af afbrydelserne var det en anden sygeplejerske, som afbrød.

Sygeplejersken var, trods stort pres på nogle af observationsdage, gode til at holde alle bolde i luften og vende tilbage til de afbrudte opgaver. Det blev vurderet, at patientsikkerheden ikke var i fare, da de sygeplejersker, der blev observeret udviste rummelighed og overskud. Der blev observeret én enkelt episode, hvor sygeplejersken ikke fik udleveret smertestillende medicin rettidigt. Hun kom dog i tanke om det efter cirka 30 minutter, hvorfor det ikke blev vurderet, som en trussel for patientsikkerheden.

Konklusion

Sygeplejersker i dagvagt og aftenvagt i en akutafdeling oplever mange afbrydelser i løbet af vagten. De afbrydelser, der blev observeret i studieperioden, kompromitterede dog ikke patientsikkerheden. Det vurderes alligevel, det er værd at mindske afbrydelserne, så de, der forekommer, er af mere væsentlig karakter.
An Innovative Model of Culturally Tailored Health Promotion Groups for Cambodian Survivors of Torture
Authors: Berkson Sarah Y. , Mollica Richard , Tor Svang , Lavelle James , Cosenza Carol
Published: July 2019

Cambodians living in the U.S.A. suffer from depression, posttraumatic stress disorder (PTSD), and chronic medical disease at rates far in excess of national averages. The Harvard Program in Refugee Trauma’s Cambodian Health Promotion Program seeks to address this burden of disease by offering them culturally tailored health education in a group setting.

A health professional and a bicultural health educator co-facilitated a five-session health promotion group for Cambodian survivors of torture from 2007 to 2011. The program covered five major topics from Western and Cambodian worldviews. They included the meaning of health promotion, nutrition, exercise, stress management and sleep hygiene, and health practitioner-patient communication. The bicultural worker administered Pre and Post semi-structured Health Promotion Questionnaires. The data presented here are the results from 126 participants.

Changes between the Pre and Post health promotion groups demonstrated significant improvements in health status, lifestyle activities, sleep, and depression. Participants revealed greater confidence in communicating with their primary health care practitioner.

Culturally tailored Cambodian health promotion education administered in a small group setting may improve health and mental health behaviors.

Culturally tailored health promotion education in a small group setting may promote healing in survivors of torture. It is an intervention worthy of further research and development.
Psychotherapy with traumatised refugees – the design of a randomised clinical trial
Authors: Vindbjerg Erik , Klimpke Christoph , Carlsson Jessica
Published: July 2019

There is little evidence as to which kind of psychotherapy is the most effective in the treatment of traumatised refugees. At the Competence Center for Transcultural Psychiatry, a series of clinical trials have been conducted since 2008. The first results are pending publication. The aim of this paper is to discuss some of the challenges in adapting Cognitive Behavioural Therapy (CBT) to the treatment of traumatised refugees, as well as describe a randomised clinical trial designed to test two such adaptations. In the described trial one group receives CBT with a focus on cognitive restructuring while the other group receives CBT focusing on Stress Management. A main goal of this setup is to test whether some, perhaps even most, of the traumatised refugees referred to treatment, may benefit from a more direct focus on current stress, and its alleviation through simple, repetitive exercises, compared to a focus on analysing and changing thought patterns.
Activity of Daily Living Performance amongst Danish Asylum Seekers: A cross-sectional study
Authors: Morville Anne-Le , Erlandsson Lena-Karin , Eklund Mona , Danneskiold-Samsøe Bente , Christensen Robin , Amris Kirstine
Published: July 2019

Objective: The aim of this study was to evaluate the extent of Activities of Daily Living (ADL) ability impairment in newly arrived Danish asylum seekers. It was hypothesized that exposure to trauma and torture would negatively influence ADL performance and that measures of ADL ability would be lower in individuals exposed to torture as compared to the non-tortured. Subjects: Forty-three newly arrived asylum seekers aged 20-50 years, from Iran, Afghanistan, and Syria, were consecutively included in the study.

Method: ADL ability was assessed with the observation-based test Assessment of Motor and Process Skills (AMPS). Interviews were based on questionnaires about torture exposure, WHO-5 Wellbeing Index, Major Depression Inventory and Pain Detect Questionnaire. All participants were interviewed and tested using a linguistic interpreter. Results: Thirty-three (77%) participants reported exposure to torture. The tortured did not differ significantly from the non-tortured on measures of ADL ability (two-sample t-tests: Motor, p= 0.36; Process, p= 0.82). ADL performance impairment was observed in the overall study sample. Twelve had motor and 15 process ability measures below age norms and 2 below both AMPS motor and process cut-offs for effortless and efficient ADL performance. There were statistically significant - weak to moderate - correlations between self-reported psychological distress, VAS average pain, pain distribution, and the AMPS measures. Conclusion: The study results supported significant ADL ability impairment in tortured as well as non-tortured newly arrived asylum seekers. Implementation of performance-based evaluation of ADL ability as part of the initial medical screening of this particular population should be considered.
Torture and State Violence in the United States: A Short Documentary History
Authors: Huskey Kristine A
Published: July 2019

Given recent revelations confirming the involvement of high-level U.S. government officials in establishing and implementing the torture and abuse of detainees, Robert M. Pallitto’s book on U.S. torture and state violence is a must read.
A New Generation: How refugee trauma affects parenting and child development
Authors: Tham Johanna Hermansson
Published: July 2019

Elisa van Ee’s dissertation A New Generation: How refugee trauma affects parenting and child development is well written, important and interesting to read. The dissertation focuses on the relationship between the traumatization of refugee parents and the impact traumatization has on their non-traumatized children.
Preface
Authors: Den Otter Joost
Published: July 2019

This special issue of TORTURE is meant to coincide with the twentieth anniversary of the 1994 Rwandan genocide. Annemiek Richters, Grace Kagoyire and their colleagues present a sample of stories of torture and ill-treatment, but also of rehabilitation as experienced and shared by a small group of women who survived the atrocities of this dark period of history, in which over 800,000 people were massacred. 

This Supplementum offers us opportunities for gaining insight on the socio-therapy approach, as well as discovering common themes that may require further research using a variety of methods.

The voice of actual victims of torture has its place in a journal such as ours, and we hope this issue serves its intended purposes. 

Joost den Otter, phD, MD, MSc

Wditor-in-Chief
Introduction
Authors: Richters Annemiek
Published: July 2019

It is generally known that during the 100 days of genocide against the Tutsi in Rwanda in 1994, sexual violence was committed on an unprecedented scale. Many women were first raped and then killed. With a certain degree of probability, the majority of Tutsi women who survived had been raped. Limited information is available regarding the experiences of these women. However, there is enough empirical evidence provided in human rights accounts and research reports substantiating that these women were exposed to unimaginable horror, which for the majority of them had a range of devastating short and long term effects.

The programme of community-based sociotherapy was implemented in 2005 in the north of Rwanda in what was previously known as Byumba province, and subsequently in 2008 in Bugesera district in the south-east, one of the epicentres of the genocide.
Women, we need to be courageous
Authors: Munyabugingo Illuminée
Published: July 2019

My name is Illuminée Munyabugingo.

The 1994 genocide against Tutsis happened when I was thirty-four years old. I was born in Kigali in a camp for internally displaced persons. My family had moved there from Eastern Province because of the 1959 massacres of Tutsis. We were a family with sixteen children. During the 1959 massacres, the house of my family was not destroyed as it was during the 1994 genocide.

People still had kindness when I was younger.
I died and was resurrected
Authors: Nyampinga Hildegarde
Published: July 2019

I was born in 1974 in the Southern Province of Rwanda, where I grew up with my ten siblings. I moved after the genocide. Today, I live in Bugesera District, in the Eastern Province. My parents were killed during the 1994 genocide. Before they died, I had a very good life. The affection I was given by my aunt is the most pleasant thing I can remember from my life before the genocide. Since my aunt was also killed during the genocide, I cannot enjoy getting her affection anymore.
I found a family through sociotherapy
Authors: Nyiramana Mameritha
Published: July 2019

I was born in the Southern Province of Rwanda. My parents were cattle keepers. We were ten children. We are now four because the other six died during the genocide. Before the genocide, I never experienced any violence.

The first time I encountered violence was during the genocide, when I was nineteen years old. I was raped and I gave birth to a child of the Interahamwe. I have good memories of my life before the genocide, especially of meeting up with my friends. It hurts that I no longer see them, because the genocide separated us. I now live with my three children and a husband. The oldest child is seventeen years old, the second one is three years old, and the last one is one year old.
I now take care of myself and am no longer a drug user
Authors: Muhorakeye Germaine
Published: July 2019

My name is Germaine Muhorakeye. I was born in 1971, in the Western Province. I now live in Bugesera District, where I moved shortly after the genocide. My mother was a housewife and my father an agriculturalist. My father died when I was still young, but his pension allowance continued to help my mother to raise us. We were seven children in my family; three sisters and four brothers. We lived among cows and coffee and banana plantations. Our grandfather also supported our mother. My good memories from before the genocide, when I was still young, are of family meetings and sharing New Year parties at our house. We used to share good meals, cook, and prepare the drinks for New Year parties together. These were my happiest moments, which I will never have back.
Sociotherapy took me out of my solitude
Authors: Foyibi Mutegwamaso
Published: July 2019

I am fifty-eight years old. I have been a widow since 1995. Because of the ethnic conflicts that reigned in Rwanda over a period of many years, I grew up and lived in different neighbouring countries. I returned to Rwanda in 1992, at the age of thirty-eight. I was born into a family of six children, four of whom died during the genocide. Only one sister and I are still alive. I married my husband in 1968 when I was fourteen years old. We had seven children together. Four are alive, the three others died during the genocide.
I wouldn’t still be alive if it wasn’t for sociotherapy
Authors: Kazeneza Therese
Published: July 2019

I was born 1961 in Kayonza District, Eastern Province. We were ten children, three girls and seven boys. My family was rich and we had a good life when I was young. What I liked about my childhood was conversing with my parents and siblings while we were together at home. My mother loved me and I loved her.

The first violence I experienced was in 1973
Coming out of a deep hole after a life of trials
Authors: Uwera Charlotte
Published: July 2019

My name is Charlotte Uwera. I was born in 1969. I studied until primary six. My father was a mason and my mother a cultivator. I am one of six siblings. Three of my siblings died during the genocide and the fourth one faced a normal death. Only my big sister and I survived the genocide.
Conclusion
Authors: Richters Annemiek
Published: July 2019

By way of conclusion I will extract a few themes from the stories I regard as relevant to take into consideration for the purpose of supporting the women who told their stories and advancing their case.
Follow-up study of the treatment outcomes at a psychiatric trauma clinic for refugees
Authors: Buhmann Cæcilie , Mortensen Erik Lykke , Nordentoft Merete , Ryberg Jasmina , Ekstrøm Morten
Published: July 2019

Purpose: To describe change in mental health after treatment with antidepressants and trauma-focused cognitive behavioral therapy.

Methods: Patients receiving treatment at the Psychiatric Trauma Clinic for Refugees in Copenhagen completed self-ratings of level of functioning, quality of life, and symptoms of PTSD, depression, and anxiety before and after treatment. Changes in mental state and predictors of change were evaluated in a sample that all received well-described and comparable treatment.

Results: 85 patients with PTSD or depression were included in the analysis. Significant improvement and effect size were observed on all rating scales (p-value <0.01 and Cohen’s d 45-0.68). Correlation analysis showed no association between severity of symptoms at baseline and the observed change.

Conclusion: Despite methodological limitations, the finding of a significant improvement on all rating scales is important considering that previous follow-up studies of comparable patient populations have not found significant change in the patients’ condition after treatment.