bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, attitudes and habits regarding oral health among nurses of Clinical hospital center Rijeka
Authors: Ivančić Jokić Nataša , Nastić Vendi , Hefler Gordana , Zukanović Amila , Šimunović Erpušina Marija , Cicvarić Odri , Bakarčić Danko
Published: May 2021

Uvod/cilj: Cilj je ovog istraživanja ispitati stupanj znanja i stavove o oralnom
zdravlju medicinskih sestara, prvostupnica/prvostupnika i magistri/magistara
sestrinstva, zaposlenih u KBC-u Rijeka, te vidjeti postoje li razlike u znanju i stavovima
u odnosu na stupanj stručne spreme.
Ispitanici i metode: Istraživanje je provedeno na uzorku od 100 ispitanika
muškog i ženskog spola, u dobi od 22 do 62 godine. Ispitanici su medicinske sestre
sa završenom srednjom školom (49 %) i prvostupnici ili magistri sestrinstva
(51 %). Istraživanje je provedeno putem upitnika Hiroshima University-Dental
Behavioral Inventory (HU-DBI).
Rezultati: Medicinske sestre / medicinski tehničari koji su prvostupnici ili magistri
sestrinstva imaju statistički značajno viši ukupan HU-DBI (p = 0,033). Statistički
značajne razlike nađene su u pitanjima o pažljivom četkanju svakog zuba
(p = 0,026), o odgađanju odlaska stomatologu sve dok ne zaboli zub (p = 0,008)
i o tome da im se dogodilo da im stomatolog kaže da dobro četkaju svoje zube
(p = 0,016).
Zaključak: Dobiveni rezultati pokazuju da medicinske sestre sa završenim studijem
sestrinstva imaju više znanja o oralnom zdravlju i da ta znanja primjenjuju
u svom svakodnevnom održavanju oralne higijene
Priziv savjesti kod zdravstvenih djelatnika – osnovno ljudsko pravo?
Authors: Bošković Sandra , Spevan Marija
Published: May 2021

Uvod: Korištenje prava na priziv savjesti zdravstvenih djelatnika predmet je teorijskih, stručnih i znanstvenih promišljanja koja propituju suprotstavljenost i/ili nesuglasje između prava i obveza pacijenta te prava zdravstvenih djelatnika. Priziv savjesti zdravstvenih djelatnika često se poima kao uskraćivanje pružanja legalne i profesionalno prihvaćene medicinske usluge ili usluga koje spadaju u opseg njihove profesionalne kompetencije. Međutim, priziv savjesti kao apel vlastitoj savjesti koji traži izuzeće od obavljanja ili neobavljanja neke profesionalne aktivnosti mnogo je širi. Cilj ovog rada je pružiti pregled literature kako bi se utvrdio opseg i sadržaj znanstvenih radova o prizivu savjesti zdravstvenih djelatnika. Metode: Pretraživanje literature provedeno je u tri međunarodne baze podataka (Medline, ScienceDirect i Google Scholar) koristeći uključujuće i isključujuće kriterije. Rezultati: Pregledom literature zajednički stav autora je da zdravstveni djelatnici imaju pravo na priziv savjesti. Međutim, jasno je vidljiva podijeljenost autora u razmatranju etičkih pitanja prava pacijenta. Naime, jedni navode da skrb za pacijenta apsolutno nadmašuje pravo sudionika liječenja (zdravstvenog djelatnika) na priziv savjesti, dok s druge strane neki autori razmatraju pravo na priziv savjesti kao dio nepovredivog moralnog integriteta. Također ističu da stručnjaci koji upotrebljavaju pravo na priziv savjesti mogu signalizirati sučelje zagovaranja u situacijama etičkih dilema, moralnih dilema i protivljenje usklađivanju s profesionalnim pritiscima koji mogu biti prisutni u hijerarhijskim strukturama unutar zdravstvenih disciplina i organizacija. Zaključak: S obzirom na dostupnost malog broja istraživanja prema navedenim kriterijima uključivanja, potrebno je provesti dodatna istraživanja na ovu temu kako bi se točno mogli definirati problemi i dobrobiti koji proizlaze iz prava na priziv savjesti. Uz navedeno, potrebno je definirati i etičke aspekte koji omogućuju uvažavanje prava zdravstvenih djelatnika. S druge strane, suprotno stajalište apsolutno cijeni prava pacijenta u skladu sa zdravljem i moralnom dobrobiti za sve.
Detection of Large Vessel Occlusion Stroke in the Prehospital Setting
Authors: van Meenen Laura C.C. , van Stigt Maritta N. , Siegers Arjen , Smeekes Martin D. , van Grondelle Joffry A.F. , Geuzebroek Geertje , Marquering Henk A. , Majoie Charles B.L.M. , Roos Yvo B.W.E.M. , Koelman Johannes H.T.M. , Potters Wouter V. , Coutinho Jonathan M.
Published: May 2021

A reliable and fast instrument for prehospital detection of large vessel occlusion (LVO) stroke would be a game-changer in stroke care, because it would enable direct transportation of LVO stroke patients to the nearest comprehensive stroke center for endovascular treatment. This strategy would substantially improve treatment times and thus clinical outcomes of patients. Here, we outline our view on the requirements of an effective prehospital LVO detection method, namely: high diagnostic accuracy; fast application and interpretation; user-friendliness; compactness; and low costs. We argue that existing methods for prehospital LVO detection, including clinical scales, mobile stroke units and transcranial Doppler, do not fulfill all criteria, hindering broad implementation of these methods. Instead, electroencephalography may be suitable for prehospital LVO detection since in-hospital studies have shown that quantification of hypoxia-induced changes in the electroencephalography signal have good diagnostic accuracy for LVO stroke. Although performing electroencephalography measurements in the prehospital setting comes with challenges, solutions for fast and simple application of this method are available. Currently, the feasibility and diagnostic accuracy of electroencephalography in the prehospital setting are being investigated in clinical trials.
The Ambibaric Brain: Pathophysiological and Clinical Implications
Authors: Hachinski Vladimir , Østergaard Leif
Published: May 2021

We propose a new evolutionary interpretation of the brain’s circulation that has physiological, pathophysiological, and clinical implications. We review the evidence for the concept, discuss clinical implications, and suggest techniques to address outstanding questions. We conclude that the brain circulation contains complementary low-pressure and high-pressure system that must be kept in balance for optimal brain health.
What Is Moroccan Literature? History of an Object in Motion
Authors: Fernández Parrilla Gonzalo , Calderwood Eric
Published: May 2021

What is Moroccan literature, where and when does it happen, and in what languages? In this essay, we tackle these questions by tracing the evolution of the definition of “Moroccan literature” from the first half of the twentieth century until the present. The earliest works of Moroccan literary historiography, such as ʿAbd Allah Kannūn’s al-Nubūgh al-maghribī fī al-adab al-ʿarabī (1937), situated Moroccan literature within the Arabic literary tradition and treated Moroccan literature as an important element in the “Arab-Islamic” identity promoted by the Moroccan nationalist movement. Since Moroccan independence in 1956, this definition of Moroccan literature has come under increasing pressure, as the languages and imaginative geographies of Moroccan literature have expanded to include new voices. In what follows, we consider these debates through a survey of a diverse corpus of literary-historical works that throw into question the linguistic, temporal, and spatial borders of Moroccan literature (and of Morocco itself).
Arabic Poetry in the Twenty-First Century: Translation and Multilingualism
Authors: Fakhreddine Huda J.
Published: May 2021

This paper examines the work of a sample of contemporary Arab prose poets whose poetic investments exceed the linguistic parameters of previous generations. Unlike the pioneers of the prose poem in Arabic in the early 1960s, the poets of this generation are not interested in interrogating Arabic poetic language or reimagining Arabic literary history. Instead, these poets embrace the Arabic literary tradition as an open multi-generic practice exercised in the space between multiple literary and linguistic traditions. This essay shows how their deliberate detachment from the Arabic poetic tradition, as well as from the inheritance of the early modernists, reveals a relationship with the Arabic language that differs from that of their predecessors. Their poetry is thus born translated: it is multilingual and exophonic in its motivations.
Re-membering Syria’s Traumatic Past: Gender, Poetics, and Loss in Manhal al-Sarrāj’s As a River Should
Authors: Istanbulli Linda
Published: May 2021

In a system where the state maintains a monopoly over historical interpretation, aesthetic investigations of denied traumatic memory become a space where the past is confronted, articulated, and deemed usable both for understanding the present and imagining the future. This article focuses on Kamā yanbaghī li-nahr (As a river should) by Manhal al-Sarrāj, one of the first Syrian novels to openly break the silence on the “1982 Hama massacre.” Engaging the politics and poetics of trauma remembrance, al-Sarrāj places the traumatic history of the city of Hama within a longer tradition of loss and nostalgia, most notably the poetic genre of rithāʾ (elegy) and the subgenre of rithāʾ al-mudun (city elegy). In doing so, Kamā yanbaghī li-nahr functions as a literary counter-site to official histories of the events of 1982, where threatened memory can be preserved. By investigating the intricate relationship between armed conflict and gender, the novel mourns Hama’s loss while condemning the violence that engendered it. The novel also makes new historical interpretations possible by reproducing the intricate relationship between mourning, violence, and gender, dislocating the binary lines around which official narratives of armed conflicts are typically constructed.
Autocratization Verity: Insights from Democratic Setbacks in Africa
Authors: Obiagu Uchenna C. , Abada Ifeanyichukwu Michael , Mbah Peter Oluchukwu
Published: May 2021

This study builds on extant literature on autocratization by critically analyzing democratic setbacks, arising from widespread incidents of electoral and political violence in democratic processes in Africa. The study leverages on frustration-aggression propositions to analyze the politico-electoral dynamics in autocratization trends in climes where the incentives to use violence as power acquisition strategy have become a dominant norm either by the ruling elites who seek to remain in power (sometimes by all means – both legal and, mostly, illegal) or by the opposition groups seeking to dislodge the former. As a qualitative research, the study squarely relies on available documented textual materials and rich datasets developed by reputable international research institutes. The analysis of data reveals that autocratization is real, gradual and subtle in Africa, and it is fostered by weak electoral institutions that are helpless in checkmating the use of violent strategies to win an election, which is the most visible element of modern democracy. Based on these findings, deliberate efforts should be made to build and/or strengthen electoral institutions that will rise above group interests and group control and ensure equal playing ground for all political groups in the contestation for state power. This will guarantee stable democratic growth within the context of the democratic principle of equal political opportunity premised on one man, one vote in Africa.
Additions to knowledge of the biodiversity of benthic hydroids (Cnidaria: Hydrozoa) in the Balleny Islands (Antarctica)
Authors: CANTERO ÁLVARO L. PEÑA
Published: May 2021

The Balleny Islands, an isolated archipelago located 240 km off the coast of Victoria Land (East Antarctica), are separated from the Antarctic continental shelf by waters more than 2000 m deep. The benthic hydroid fauna of these islands is little known, with only 25 species reported so far. The present study contributes to a better knowledge of the benthic hydrozoans inhabiting this archipelago by studying a small collection held at the National Institute of Water and Atmospheric Research Invertebrate Collection at Wellington, New Zealand. Sixteen species of benthic hydroids were found in the collection, belonging to nine families and 12 genera of Leptothecata. Kirchenpaueriidae and Oswaldella, with three species each, are the most speciose family and genus. Ten species represent new records for the region. The total number of benthic hydroid species known from the islands is raised to 34.
Aviation Turbulence Forecasting at DWD with ICON: Methodology, Case Studies, and Verification
Authors: Goecke Tobias , Machulskaya Ekaterina
Published: May 2021

We present a detailed evaluation of the turbulence forecast product eddy dissipation parameter (EDP) used at the Deutscher Wetterdienst (DWD). It is based on the turbulence parameterization scheme TURBDIFF, which is operational within the Icosahedral Nonhydrostatic (ICON) numerical weather prediction model used operationally by DWD. For aviation purposes, the procedure provides the cubic root of the eddy dissipation rate ε1/3 as an overall turbulence index. This quantity is a widely used measure for turbulence intensity as experienced by aircraft. The scheme includes additional sources of turbulent kinetic energy with particular relevance to aviation, which are briefly introduced. These sources describe turbulence generation by the subgrid-scale action of wake eddies, mountain waves, and convection, as well as horizontal shear as found close to fronts or the jet stream. Furthermore, we introduce a postprocessing calibration to an empirical EDR distribution, and we demonstrate the potential as well as limitations of the final EDP-based turbulence forecast by considering several case studies of typical turbulence events. Finally, we reveal the forecasting capability of this product by verifying the model results against one year of aircraft in situ EDR measurements from commercial aircraft. We find that the forecasted EDP performs favorably when compared to the Ellrod index. In particular, the turbulence signal from deep convection, which is accounted for in the EDP product, is advantageous when spatial nonlocality is allowed in the verification procedure.
Potential for New Constraints on Tropical Cyclone Surface-Exchange Coefficients through Simultaneous Ensemble-Based State and Parameter Estimation
Authors: Nystrom Robert G. , Greybush Steven J. , Chen Xingchao , Zhang Fuqing
Published: May 2021

The tropical cyclone (TC) surface-exchange coefficients of enthalpy (Ck) and momentum (Cd) at high wind speeds have been notoriously challenging to estimate. This difficulty arises from many factors, including the difficulties in collecting observations within the turbulent TC boundary layer, and the complex coupled physical interactions between the TC boundary layer and ocean surface, which are challenging to accurately model. Motivated by recent studies highlighting the limited practical predictability of TC intensity as a result of uncertainty in the physical representation of the air–sea fluxes of momentum and enthalpy at high wind speeds, we investigate the potential to estimate the surface enthalpy and momentum exchange coefficients through ensemble data assimilation. Significant ensemble correlations between tangential wind, radial wind, and simulated infrared brightness temperatures with parameters controlling the enthalpy and momentum exchange coefficients suggest potential to use all-sky satellite and/or airborne radial velocity observations to estimate these unknown parameters. Using a series of observing system simulation experiments (OSSEs), simulated infrared brightness temperature observations, and a known truth, we demonstrate some potential for simultaneous state and parameter estimation with an ensemble-based data assimilation system to converge toward the correct known parameter values. In all OSSEs with either one or multiple unknown parameters, the initial parameter errors are reduced through simultaneous model state and parameter estimation. However, challenges still exist in converging to the precise true parameter values, as state errors during rapid intensification can project onto the parameter estimates.
Evaluation of the quick-clotting serum separator tube, VQ-Tube™, for clinical chemistry and thyroid hormone assays
Authors: Jo Sung Jin , Chae Hyojin , Lee Yong-Wha , Seo Jong Do , Song Sang Hoon , Lee Jehoon
Published: May 2021

Background

The type of blood collection tube affects specimen quality and laboratory results. Because plasma specimens have a shorter processing time compared with serum specimens, emergency biochemistry tests use plasma. However, serum specimens remain stable after centrifugation and show more accurate results than plasma. Therefore, a quick-clotting serum separator tube is expected to be useful for shorter turnaround times and accurate results. We evaluated a new quick-clotting serum separator tube VQ-Tube™ (AB Medical, Korea) for clinical chemistry and thyroid hormone assays.

Methods

One hundred volunteers from four university hospitals were recruited, and peripheral blood samples were collected in quick-clotting serum separator tube VQ-Tubes™ and the commonly used serum separator tube V-Tubes™. The obtained specimens were used for 16 clinical chemistry assays and three thyroid hormone assays.

Results

The differences (%) in the test results obtained from the samples in each tube satisfied the allowable difference ranges (19 assays). The differences in the test results between the tubes satisfied the desired specifications for accuracy except for the glucose results (2.75%). The paired t-test revealed significant differences between the results of six assays, but each set of results showed a good correlation. Samples were visually inspected for serum clarity and gel barrier integrity, and incomplete clotting reactions and haemolysed serum were not observed.

Conclusions

The new quick-clotting VQ-Tube™ demonstrated reliable test results compared with the commonly used serum separator tube V-Tube™. This quick-clotting tube will provide fast test results with adequately separated serum specimens, especially for patients who need fast tests.
Enhancing mechanical properties of biaxial E-glass fabric/epoxy composite using cellulose nanocrystals: Impact of mixing medium
Authors: Laghaei Reyhaneh , Fashandi Hossein , Hejazi Seyyed Mahdi , Shaghaghi Samira , Shamaei-Kashani Alireza
Published: May 2021

Epoxy, a thermoset resin with myriad applications, suffers from drawbacks such as brittleness and lack of fracture toughness. A breakthrough in reinforcing epoxy-based composites can be achieved by developing cost-effective and environment-friendly nanoparticles with high elastic modulus and low density such as cellulose nanocrystals (CNCs). In this research work, CNCs were used to reinforce biaxial E-glass fabric/epoxy composite. The impact of CNCs mixing medium, i.e. hardener or a mixture of epoxy and hardener, was highlighted, as also illustrated in the graphical abstract. Biaxial E-glass fabric/CNCs/epoxy (BE2CE) nanocomposite containing optimum content of CNCs exhibited significantly enhanced mechanical properties, i.e. tensile strength and modulus, fracture toughness and Charpy impact strength. This was discussed considering synergistic contribution of CNCs and E-glass fibers to reinforce epoxy-based composite, which was manifested by increased E-glass fiber-epoxy interfacial shear strength (IFSS) at the presence of CNCs. The IFSS was measured using single fiber micro-droplet pull-out test. Additionally, regardless of CNC content, considering hardener as the mixing medium yielded superior results in manufacturing BE2CE nanocomposite.
Quality of Life and Associated Factors Among Male Wheelchair Handball Athletes
Authors: Calheiros David dos Santos , Neto Jorge Lopes Cavalcante , Melo Flávio Anderson Pedrosa de , Pedrosa de Melo Fábio Ítalo , Munster Mey de Abreu van
Published: May 2021

Although scarce, some recent studies have observed good self-reported quality of life (QOL) among wheelchair users who are involved in adapted sports. These findings have encouraged further investigations, particularly investigations of combined sociodemographic and sport factors in the study of QOL. In this study we analyzed the association between sociodemographic and sport factors with QOL in a cross-sectional study of 105 male wheelchair handball (WH) athletes with higher and lower QOL. We used the World Health Organization Quality of Life – BREF (WHOQOL-BREF) scale to evaluate the respondents QOL; and we used a sociodemographic questionnaire to evaluate associated sociodemographic and sport factors. A logistic regression analysis found these athletes’ good QOL to be generally characterized by stable marital status, disability due to cerebral palsy, the use of locomotion/mobility resources, full independence, bi-weekly training, and the use of a custom-made wheelchair for around 70% of their daily living activities. These findings support the role of such sociodemographic and sport factors in determining QOL among these WH respondents. These findings reveal the important issues to be considered in the sport modality when attempting to improve the QOL and functionality of these participants and perhaps WH athletes worldwide.
Incidence and profile of acute intoxication among adult population in Najran, Saudi Arabia: A retrospective study
Authors: Wahba Mohamed A , Alshehri Bandar M , Hefny Mona M , Al Dagrer Rami A , Al-Malki Safar DS
Published: May 2021

Acute poisoning is considered one of the most important medical emergencies, resulting in severe morbidity and mortality, and is an economic burden on governments. This study aimed to determine the extent of acute adult intoxication among the population located in the Najran area, Saudi Arabia, over the last 3 years (from January 2017 to December 2019). The study is a hospital-based retrospective observational study. The data of all acutely intoxicated adult patients were collected from patients’ files of King Khalid Hospital, the main hospital in the Najran area. In this study, the total number of intoxicated patients was 852. Patients were divided into three groups according to their age: 15–25 years, 26–35 years and >35 years. Accidental intoxication was predominant (64.6%), especially with therapeutic drugs (60.2%), predominantly acetaminophen and amphetamine, which intoxicated 24.5% and 23.4% of the patients, respectively. Moreover, this study showed that 10.6% of patients were intoxicated with overdoses of alcohol, mostly among patients aged over 35 years. Furthermore, the present study revealed that 23.9% of patients were intoxicated with household chemicals, especially Clorox bleach or Flash. Patients presented with a wide range of symptoms; some were even asymptomatic. Overall, patients’ outcomes were good; mortalities were few (1.2%), and most fatalities were found in patients aged over 35 years (60%). The present study showed that pharmaceutical drugs constituted the most common causative agents in acute intoxication. Household chemicals, especially Clorox bleach, Flash and pesticides, are highly implicated in the acute toxicity problem. Drug abuse, especially amphetamine and alcohol, still represents a great threat facing people from the Najran region. It is crucial to deliver effective public health education programmes to increase community awareness about the predisposing risk factors of acute toxicity, whether as overdoses or suicide attempts.
Beyond Integration: A Phenomenology of Faith-Informed Clinical Practice
Authors: Tipton Paula J. , Colburn Anita , Parker Stephen , Underwood Lee
Published: May 2021

The provision of clinical counseling within the context of a Christian worldview has profound meaning for those who seek education in Christian institutions. This phenomenology explored the essence of faith-informed clinical practice for experienced licensed professional counselors. The following six overarching themes emerged from interviews with 10 clinicians: Faith-Informed Clinical Practice Emerges from an Eternal Perspective, Distinct Aspirations of Faith-Informed Clinicians, The Clinician’s Inner World, Bi-directional Influences of Faith and Professional Development, Clinical Issues Specific to Faith-informed Practice, and Suggestions for Faith-Based Education. Recommendations include the replacement of integration studies with spiritual formation and a more holistic, practical, experiential, and spiritual approach to counselor training in faith-based institutions.
Bringing Books Back: Enhancing the Understanding of Psychotherapy in Psychology Students Through Book Club Participation
Authors: Khokhlova Olga , Bhatia Aditi
Published: May 2021

Background:

The experiential and reflective nature of psychotherapeutic training is not always captured in undergraduate psychology teaching, therefore, there is a need for educational strategies that provide opportunities for deeper understanding of the therapeutic process.

Objective:

This article evaluates one such strategy—A Book Club, to support the understanding of psychotherapeutic practice and mental health in Psychology undergraduate students at a private university in Dubai, UAE.

Method:

Psychotherapy-related books were assigned as prior reading each month, which were then discussed in the group meetings facilitated by clinically experienced Psychology lecturers. Fifteen semi-structured interviews were carried out with students and analyzed using thematic analysis.

Results:

Four primary themes were generated—(1) Diversity in perspectives, (2) Autonomous learning environment, (3) Reality orientation, and (4) Sparking self-insight. The results highlight that Book Clubs are useful in fostering deeper conceptualizations of the therapeutic relationship, visualizing future careers in psychotherapy, and promoting self-awareness among students.

Conclusion:

Discussions centred around books can provide students with discourse opportunities that enhance students’ interpersonal skills and improve student engagement.

Teaching Implication:

Book clubs can be a useful platform for teachers to help students connect the knowledge that they have previously acquired in the classroom with real-life experiences of psychotherapists described in books.
Effects of 0.5% and 2.0% Sodium Lauryl Sulfate in Male CD-1 Mice From a 3-Month Oral Gavage Toxicity Study
Authors: Irizarry Rovira Armando R. , Hilbish Kim G. , Schroeder Matthew , Boorman Gary A. , Credille Kelly M. , Ballard Darryl , Hanson Jeff C. , Niedenthal Andrea
Published: May 2021

The tolerability of single daily gavage doses of 0.5% or 2.0% (wt/vol) sodium lauryl sulfate (SLS) in 11- to 12-week-old male CD-1 mice was evaluated in a study of 3 months in duration. Live-phase, gross necropsy, and histopathologic parameters were evaluated. Mortality of 14% occurred in mice administered formulations containing SLS. Clinical observations in mice administered SLS included abnormal respiration (audible, irregular, and/or labored), swollen abdomen, rough haircoat, hunched appearance, and hypoactivity. Necropsy findings in mice administered SLS consisted of enlarged intestines containing abnormal contents with gas. There were no instances of mechanical gavage–related injury. Histologic evaluation of the respiratory tract revealed injury to the nasal passages and nasopharynx, including, but not limited to, inflammation, exudate, apoptosis/necrosis of epithelium, and atrophy of epithelium or olfactory nerves. Collectively, the data indicated that under the experimental conditions of our 3-month study in male CD-1 mice, once-daily gavage administration of vehicle formulations containing SLS at 0.5% or 2.0% resulted in nasal injury and 14% mortality supportive of gastroesophageal reflux. Sponsors utilizing formulations containing SLS in toxicity studies in CD-1 mice should exclude gastroesophageal reflux as a confounding factor in studies with morbidity or mortality associated with respiratory distress or evidence of aerophagia.
CANVAS: A New Genetic Entity in the Otorhinolaryngologist’s Differential Diagnosis
Authors: Costales María , Casanueva Rodrigo , Suárez Vanessa , Asensi José María , Cifuentes Guadalupe A. , Diñeiro Marta , Cadiñanos Juan , López Fernando , Álvarez‐Marcos César , Otero Andrea , Gómez Justo , Llorente José Luis , Cabanillas Rubén
Published: May 2021

Objective

The biallelic inheritance of an expanded intronic pentamer (AAGGG)exp in the gene encoding replication factor C subunit 1 (RFC1) has been found to be a cause of cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS). This study describes clinical and genetic features of our patients with clinical suspicion of the syndrome.

Study Design

A retrospective descriptive study from an ataxia database comprising 500 patients.

Setting

The study was performed at the Otorhinolaryngology Department of a hospital in the north of Spain.

Methods

Specific genetic testing for CANVAS was performed in 13 patients with clinical suspicion of complete or incomplete syndrome. The clinical diagnosis was supported by quantitative vestibular hypofunction, cerebellar atrophy, and abnormal sensory nerve conduction testing.

Results

Nine of 13 (69%) patients met clinical diagnostic criteria for definite CANVAS disease. The first manifestation of the syndrome was lower limb dysesthesia in 8 of 13 patients and gait imbalance in 5 of 13. Eleven of 13 (85%) patients were carriers of the biallelic (AAGGG)exp in RFC1.

Conclusion

A genetic cause of CANVAS has recently been discovered. We propose genetic screening for biallelic expansions of the AAGGG pentamer of RFC1 in all patients with clinical suspicion of CANVAS, since accurate early diagnosis could improve the quality of life of these patients.
Determining the Impact of Thickened Liquids on Swallowing in Patients Undergoing Irradiation for Oropharynx Cancer
Authors: Barbon Carly E. A. , Chepeha Douglas B. , Hope Andrew J. , Peladeau‐Pigeon Melanie , Waito Ashley A. , Steele Catriona M.
Published: May 2021

The current standard for the treatment of oropharynx cancers is radiation therapy. However, patients are frequently left with dysphagia characterized by penetration‐aspiration (impaired safety) and residue (impaired efficiency). Although thickened liquids are commonly used to manage dysphagia, we lack evidence to guide the modification of liquids for clinical benefit in the head and neck cancer population. The objective of this study was to assess the impact of slightly and mildly thick liquids on penetration‐aspiration and residue in 12 patients with oropharyngeal cancer who displayed penetration‐aspiration on thin liquid within 3 to 6 months after completion of radiotherapy. Significantly fewer instances of penetration‐aspiration were seen with slightly and mildly thick liquids as compared with thin (P <. 05). No differences were found across stimuli in the frequency of residue. Patients with oropharyngeal cancers who present with post–radiation therapy dysphagia involving penetration‐aspiration on thin liquids may benefit from slightly and mildly thick liquids without risk of worse residue.
Procedural Sedation in Minor Procedure Rooms for Pediatric Myringotomy and Tympanostomy: A Quality Improvement Initiative
Authors: Roy Catherine F. , Turkdogan Sena , Nguyen Lily H. P. , Yeung Jeffrey
Published: May 2021

Objective

Lengthy wait times for elective surgery is a widespread health care system conundrum that may increase patient distress and jeopardize health outcomes. The primary aim of this quality improvement project was to reduce the surgical wait time in patients undergoing tympanostomy tube insertion.

Methods

As of January 2018, our tertiary care institution implemented a novel protocol whereby healthy children may undergo tympanostomy tube insertion in a minor procedure room under ketamine sedation administered by pediatric emergency physicians to address lack of both physical and anesthesia staffing resources. A retrospective study of all children undergoing elective tympanostomy tube insertion was conducted between September 1, 2017, and May 8, 2019, to assess wait time to surgery, as well as anesthesia‐related and surgical complications.

Results

Procedural sedation in minor procedure rooms effectively decreased surgical wait times by 53 days (from 134 to 81 days, P <. 001) at 16 months postimplementation. This new protocol was found to be safe and effective for healthy children, with no major surgical or anesthesia‐related complications noted in 113 patients having undergone the procedure in the novel setting.

Discussion

Although conscious sedation by emergency physicians has been well studied across a variety of surgical procedures, its novel use in pediatric tympanostomy tube insertion requires careful patient selection to enhance accessibility while maintaining anesthetic safety.

Implications for Practice

This quality improvement project describes a novel combination of processes, using a minor procedure room space and ketamine‐based procedural sedation to address surgical wait times in pediatric patients undergoing tympanostomy tube insertion.
Buttered Nostalgia: Feeding My Parents During #COVID19
Authors: Faulkner Sandra L.
Published: May 2021

The author uses poetic inquiry as CFIC (critical family and interpersonal communication) methodology to tell a story of cooking, cleaning, and caring for her elderly parents in the house she grew up in during the COVID-19 pandemic for 11 days in March 2020 when COVID-19 lockdowns began in the US. The piece is organized as a series of daily menus, lyric reflections, and narrative poems about family stories, family values, and the enactment of supportive behaviors that detail how a family deals with political differences, identity negotiation, and crisis. The author asks: (1) What does it mean to be a good daughter, and how is this complicated by discourses about the meaning of marriage?; (2) How does one reconcile family differences in political views and hold true to family and personal values?; and (3) How does one decide what obligations to focus on during a moment of personal and international crisis? The use of poetic inquiry shows how public cultural discourses influence private experience.
Magnetic resonance imaging characteristics of chronic prostatitis in patients under the age of 50: is it more than the eye can see?
Authors: Lebovici Andrei , Csutak Csaba , Popa Paula , Crișan Nicolae , Suciu Mihai , Feciche Bogdan , Andraș Iulia , Ștefan Paul-Andrei , Feier Diana Sorina
Published: May 2021

Background

The magnetic resonance (MRI) diagnosis of chronic prostatitis (CP) is insufficiently evaluated.

Purpose

To evaluate the MRI appearance of CP in young patients by comparing it to individuals with non-prostatic related pathology.

Material and Methods

The study included 47 patients with prostatitis‐like symptoms evaluated by urologists and referred to pelvic MRI examination (mean age=40.23±7 years; age range=23–49 years) and 93 age-matched individuals with non-prostatic related pathology (mean age=37.5±7 years; age range=21–49 years). All MRI examinations were performed on a 1.5-T machine using a prostate-specific protocol for the prostatitis group and different protocols that included high-resolution small field of view T2-weighted (T2WI) and diffusion-weighted imaging (DWI), for the control group, depending on the clinical indication.

Results

Four different T2WI intensity patterns were observed: hyperintense homogenous; slightly to moderate homogenous hypointense; inhomogeneous; and marked hypointense. We found statistically significant differences between the two analyzed groups regarding mean ADC values ( P<0.001), distribution of T2WI intensity patterns ( P<0.0001), and the presence of dilated venous plexus ( P=0.0007). No differences were found regarding prostate volume ( P=0.15). In multivariate analysis, all four analyzed imaging parameters were independent predictors of chronic prostatitis (R2=0.67; P<0.0001). Considered together, an age >28 years, an inhomogeneous or marked hypointense T2WI intensity pattern (types 3 and 4), an ADC value ≤1250, and the presence of dilated venous plexus are able to predict CP with an AUC of 93% (sensitivity=85.1%, specificity=88.4%).

Conclusion

MR parameters like T2WI intensity patterns, ADC values, and venous plexus appearance are promising non-invasive tools in the challenging environment of CP diagnosis.
Impact of corrected sinus node recovery time in predicting recurrence in patients with paroxysmal atrial fibrillation
Authors: Chen Zhi-Song , Tan Hong-Wei , Song Hao-Ming , Xu Wen-Jun , Liu Xue-Bo
Published: May 2021

Objective

Atrial fibrillation (AF) and sinus node dysfunction (SND) have common underlying pathophysiological mechanisms. As an index of SND, corrected sinus node recovery time (CSNRT) may also reflect atrial function. The aim of the present study was to determine whether CSNRT predicts AF recurrence in patients undergoing AF ablation.

Methods

Consecutive patients with paroxysmal atrial fibrillation (PAF) who underwent radiofrequency catheter ablation between January 2017 and December 2018 were enrolled. Clinical data, CSNRT, and other electrophysiology indices were collected and analysed between patients with or without AF recurrence.

Results

A total of 159 patients with PAF who underwent the same radiofrequency catheter ablation procedure were enrolled, including 25 patients with SND. During the one-year follow-up period, 22 patients experienced AF recurrence. Patients with recurrence had a significantly longer CSNRT and a larger left atrial volume index (LAVI) than patients without AF recurrence. SND (CSNRT > 550 ms) and a larger LAVI were independently associated with AF recurrence after ablation. A statistically significant CSNRT cut-off value of 550 ms predicted AF recurrence with 73% sensitivity and 85% specificity.

Conclusion

CSNRT and LAVI are independent predictors of PAF recurrence following ablation.
End-of-life care in children and adolescents with cancer: perspectives from a French pediatric oncology care network
Authors: Blais Sophie , Cohen-Gogo Sarah , Gouache Elodie , Guerrini-Rousseau Lea , Brethon Benoit , Rahal Ilhem , Petit Arnaud , Raimondo Graziella , Pellegrino Beatrice , Orbach Daniel
Published: May 2021

Background:

In developed countries, cancer remains the leading cause of pediatric death from illness after the neonatal period.

Objective:

To describe the end-of-life care characteristics of children and adolescents with solid tumors (ST) or hematologic malignancies (HM) who died from tumor progression in the Île-de-France area.

Methods:

This is a regional, multicentric, retrospective review of medical files of all children and adolescents with cancer who died over a 1-year period. Extensive data from the last 3 months of life were collected.

Results:

A total of 99 eligible patients died at a median age of 9.8 years (range, 0.3–24 years). The most frequent terminal symptoms were pain (n = 86), fatigue (n = 84), dyspnea (n = 49), and anorexia (n = 41). Median number of medications per patient was 8 (range, 3–18). Patients required administration of opioids (n = 91), oxygen (n = 36), and/or sedation (n = 61). Decision for palliative care was present in all medical records and do-not-resuscitate orders in 90/99 cases. Symptom prevalence was comparable between children and adolescents with ST and HM. A wish regarding the place of death had been expressed for 64 patients and could be respected in 42 cases. Death occurred in hospital for 75 patients.

Conclusions:

This study represents a large and informative cohort illustrating current pediatric palliative care approaches in pediatric oncology. End-of-life remains an active period of care requiring coordination of multiple care teams.
Prison Visitation and Concerns about Reentry: Variations in Frequency and Quality of Visits are Associated with Reentry Concerns among People Incarcerated in Prison
Authors: Baker Thomas , Mitchell Meghan M. , Gordon Jill A.
Published: May 2021

Prior studies suggest that visitation may have an impact on successful reentry. At the same time, the impact of visitation on incarcerated people’s concerns about reentry has received little empirical attention. Understanding how factors such as visitation affect concerns about reentry can provide correctional officials with policy directions on how to reduce strains and enhance successful reintegration. Further, while some studies have evaluated frequency of visitation far fewer have examined the impact of quality of visitation. Using a sample of males and females incarcerated in five correctional facilities ( n = 3,084), this study examines how frequency and quality of visitation impact incarcerated people’s concerns about employment, housing, debt, and recidivism upon reentry. Findings suggest that more visits reduce concerns, while negative visits increase concerns about reentry.
Patterns of occupational engagement among community-dwelling older adults in Singapore: An exploratory mixed method study
Authors: Koh Wei Qi , Chia Yuan Lin , Ng Wen Xu , Lim Fiona Y Q , Cheung Therma W C
Published: May 2021

Introduction

The aim of this study is to understand the patterns of occupations among community-dwelling older adults in Singapore. The objectives are to describe their occupational engagement using the Activity Card Sort Singapore, understand their occupational preferences and perceived barriers and facilitators to engagement.

Methods

A convergent parallel mixed-method study was conducted over a 5-month period in 2018. Purposive and snowball sampling were used to recruit the participants. Individual 1-h interviews were conducted at participants’ homes. Quantitative data collected include demographic information, Modified Barthel Index scores and activity engagement based on the Activity Card Sort Singapore. Qualitative data was collected using semi-structured interviews.

Results

105 participants were enrolled in the study. Overall, older adults engaged mostly in instrumental and social activities. However, leisure and social activities were most preferred. Gender, educational level and age were found to influence occupational engagement. Overall, six main themes relating to perceived barriers and facilitators to occupational engagement were identified: cognition and physical status, self-efficacy, resources, affect and meaningfulness, social influence and environmental factors.

Conclusion

The findings from this study provided insights into the occupational patterns of community-dwelling older adults in Singapore and their perceived barriers and facilitators to engagement. Recommendations for practice were identified.
Impacts of therapeutic horticulture on happiness and loneliness in institutionalized clients with mental health conditions
Authors: Mourão Isabel , Mouro Cláudia V , Brito Luís Miguel , Costa Sofia R , Almeida Telma C
Published: May 2021

Introduction

Therapeutic horticulture (TH) can be considered a non-pharmacological approach to support psychiatric treatments for the improvement of physical and mental health, but information is lacking on whether it has advantages as compared to more conventional occupational therapies (OTs).

Method

The study focused on institutionalized 25 clients attending TH among other OTs and 15 clients attending OT other than TH. The measures used were the ‘Subjective Happiness Scale’ (SHS) and the ‘Social and Emotional Loneliness Scale for Adults’ (SELSA-S), along with sociodemographic and clinical data. The study design was descriptive, observational and cross-sectional.

Results

Scores obtained from the SHS and SELSA-S were generally similar for both groups, although 40% of clients in the TH group perceived relaxation. These are in agreement with previous studies performed with chronic schizophrenia clients reporting that TH might effectively decrease depression/anxiety symptoms, but the feeling of hopelessness and quality of life did not change, probably due to long-term institutionalization and required medication that may limit other effects. Within the TH group, clients preferred specific horticultural tasks and more days/week attending activities decreased loneliness and increased happiness.

Conclusion

TH interventions as an integrative treatment option merits further study on both process and outcome evaluation, to maximize its effectiveness.
Food as Love: Ethical and Moral Dilemmas in Withdrawal of Artificial Nutrition and Hydration in the Minimally Conscious State
Authors: Newcomer Kelley Finch , Fine Robert L. , Newman Antoinette Fidelia
Published: May 2021

Supportive Palliative Care and Hospice professionals frequently attend to Minimally Conscious State (MCS) patients near the end of life and in so doing, face decisions over maintenance or withdrawal of artificial nutrition and hydration. Although both withholding and withdrawal of artificial nutrition and hydration (ANH) in such circumstances are considered by experts in ethics and law to be acceptable, not all families nor health care professionals agree. This paper will explore basic aspects of serious brain injuries, especially MCS, the psychological role of food in interpersonal relationships, and lessons from clinical ethics that can help in goals of care discussions about withdrawal of ANH.
Psychometric origins of depression
Authors: McPherson Susan , Armstrong David
Published: May 2021

This article examines the historical construction of depression over about a hundred years, employing the social life of methods as an explanatory framework. Specifically, it considers how emerging methodologies in the measurement of psychological constructs contributed to changes in epistemological approaches to mental illness and created the conditions of possibility for major shifts in the construction of depression. While depression was once seen as a feature of psychotic personality, measurement technologies made it possible for it to be reconstructed as changeable and treatable. Different types of scaling techniques (Likert versus dichotomous scales) enabled the separation of depressive personality from reactive depression, paving the way for measuring the severity and intensity of emotions. Techniques to test sensitivity to change provided a means of demonstrating the efficacy of new psychoactive drug treatments. Later, more advanced techniques of precision scaling enabled the management of a new measurement problem, clinician unreliability, associated with the growing number of professionals involved in mental health care. Through statistical management of unreliability, the construct of depression has dramatically reduced over this period from hundreds of questionnaire items to potentially just two. Exploring the history of depression through this lens produces an alternative narrative to those that have emerged as a result of medicalisation and the actions of individuals and pressure groups.
A shear stress model of water-based magnetorheological polishing fluids
Authors: Ma Zongqiao , Cao Jianguo , Xu Xianghua , Xu Jinhuan
Published: May 2021

Magnetorheological polishing fluid (MRPF) with excellent rheological characteristics are efficient in material removal of workpiece. Shear stress is an important evaluation index of rheological characteristics, and is also an important research field of MRPF. In this study, a new shear stress model of MRPF is proposed, which is based on the application of Coulomb’s law in magnetic field. The interaction between magnetic particles on different magnetic chains and the effects of abrasive particles are considered in this model. The proposed model assumes that magnetic particles of MRPF slide in horizontal direction with shear behavior, and the exponential function is introduced to explain the relationship between the number of particles sliding and shear rate. Furthermore, the relationship between shear stress and shear rate is obtained by mathematical method. Compared with experimental data, theoretical model can effectively explain the variation of shear stress with shear rate. The correctness of the particle slip hypothesis has been verified by finite element method.