bluuebunny/crossref_metadata_2025 huggingface dataset:
Estudo avaliativo da predisposição à síndrome de burnout em professores de uma Universidade de Parnaíba-PI
Authors: Fabiana Machado da Silva Luciana Maria , Dos Santos Teles Lauriane Maria , Ximenes Aragão Savanna de Brito , De Lima Santiago da Silva Carla Fernanda
Published: August 2020

Síndrome de burnout é um estresse ocupacional comum, principalmente, em profissionais atuantes em uma relação ininterrupta e emocional com outras pessoas (Tibúrcio & Moreno, 2009). Avaliou-se sua predisposição em docentes de uma Universidade de Parnaíba-PI, utilizando-se do Maslach Burnout Inventory (MBI) e um questionário sociodemográfico. Para análise, empregou-se o software estatístico SPSS, versão 18.0, realizando-se análise de frequência dos dados sociodemográficos, Análise Fatorial (AF), que obteve três fatores: Exaustão, Realização

Profissional, Despersonalização; Alpha de Cronbach 0,87; 0,79; 0,63, respectivamente, e média de cada dimensão para identificar a predisposição. Obtiveram-se baixos níveis de Exaustão e Despersonalização e altos de Realização Profissional; no entanto, em relação à frequência de pessoas, identificou-se um número significativo com índices médios de Exaustão, sugerindo alerta sobre a predisposição ao burnout.

Palavras-chave: Professores universitários; Exaustão; Síndrome de burnout.
Reflexões sobre alienação parental em um projeto de mediação de conflitos
Authors: Da Luz Ariele Faverzani , Gelain Denise , De Lima Luana Rocha
Published: August 2020

A Mediação de Conflitos é um processo de caráter amigável, que visa a resolução de demandas familiares, sobretudo aquelas que envolvem a Síndrome de Alienação Parental, sendo o diálogo a principal ferramenta para sua execução. Assim, este estudo tem por objetivo refletir sobre a importância da Mediação de Conflitos na amenização e/ou eliminação da Alienação Parental nos casos atendidos no projeto Mediação de Conflitos da Faculdade IMED de Passo Fundo-RS, no ano de 2013. Trata-se de uma pesquisa qualitativa de cunho exploratório, no qual foram utilizados como instrumentos o Termo de Mediação de cada caso e entrevistas semi-estruturadas. A exploração e a análise dos dados coletados foram realizadas por meio do método de Análise de Conteúdo de Bardin. Ao final, foi possível verificar que a Mediação de Conflitos obteve resultados positivos nos casos de Síndrome de Alienação Parental, revelando-se como uma técnica eficiente ao garantir o bem-estar dos filhos.

Palavras-chave: Mediação de conflitos; Família; Alienação parental; Psicologia.
Determinación del índice cardíaco vertebral en perros de raza mestiza
Authors: Castillo Edy , Pabaña Javier Pabaña , Rubio Pablo , Alvarado Juan , Maldonado Manuel
Published: August 2020

El objetivo de esta investigación fue determinar el índice cardíaco vertebral (ICV) en perros de raza mestiza, en la ciudad de Cuenca a una altitud de 2560 msnm y comparar el resultado con diferentes estudios realizados en investigaciones anteriores a diferentes altitudes. El tamaño de la de la silueta cardiaca fue evaluado por el método de Buchanan y Bucheler (1995), que relacionan el alto y ancho del corazón con el número de vértebras torácicas en perros Beagle. Para este estudio se empleó una investigación descriptiva de corte transversal, seleccionándose treinta y tres perros de raza mestiza clínicamente sanos, sin discriminación de sexo, y con edades comprendidas entre uno a cinco años. Los animales fueron sometidos a un examen clínico y radiográfico del tórax con una proyección lateral derecha. Los valores del índice cardíaco vertebral obtenidos presentaron una distribución normal, con promedio de 9,38 vértebras y una desviación estándar de ±0,15. El valor mínimo encontrado fue igual a 8,8 vértebras y el máximo fue igual a 9,8 vértebras. Se realizó el análisis de confianza de los datos del ICV de acuerdo al peso, edad y sexo, comprobando que la medida obtenida como rango general del ICV es estandarizada en perros de raza mestiza y no está influenciada por los mismos.
Gestión y vigilancia sanitaria de la fauna silvestre en el Perú
Authors: Elías Roberto , Berenguel Raúl , Beraún Yuri , Enrique Claudia , Vásquez Pedro
Published: August 2020

Las enfermedades infecciosas son una seria amenaza para la conservación de la vida silvestre. En los últimos años, el crecimiento poblacional y los cambios ambientales han incrementado notablemente el acercamiento y el contacto de las personas con la fauna silvestre, lo cual junto al cambio de uso de las tierras han alterado el balance ecológico entre patógenos y sus hospederos humanos y animales, por eso la gestión y vigilancia sanitaria de la fauna silvestre deben implementarse en un sentido más amplio e integral que el que se realiza actualmente en nuestro país, por lo que urge la necesidad de promover las reformas necesarias para reorganizar y fortalecer la institucionalidad vinculada a estas.
THERAPY LOW BACK PAIN WITH SWEDISH MASSAGE, ACUPRESSURE AND TURMERIC
Authors: Putri Dyah Ayu Rhomandhoni , Imandiri Ario , Rakhmawati Rakhmawati
Published: August 2020

Background: Low back pain is pain that arises below the costal margin and above the inferior gluteal fold. In Traditional Chinese Medicine (TCM) low back pain is referred to as Yao Tong. Low back pain cases experienced by patients are pain that gets worse when exposed to cold air, is too tired and feels stiff and heavy. The patient has low back pain with damp cold pathogenic syndrome. Purpose: To prove the effect of combination therapy for Swedish massage in the back and waist area, acupressure at Shenshu (BL23), Dachangshu (BL25), Taixi (KI3), Taibai (SP3), Fenglong (ST40) and turmeric herbs (Curcuma longa Linn) on low back pain sufferers. Methods: Management of low back pain with Swedish, acupressure and herbal massage methods. Swedish massage therapy is performed on the back and waist area. Acupressure at the points of Shenshu (BL23), Dachangshu (BL25), Taixi (KI3), Taibai (SP3), Fenglong (ST40) with the principle of therapy of kidney and spleen tonification and elimination of cold moist pathogens. The most common herbal therapy for patients is turmeric (Curcuma longa Linn). Results: The curcumin compounds in turmeric can inhibit lipoxygenase, phospholipase A2 and COX-2 so they can reduce low back pain. In the treatment of low back pain, massage and acupressure are performed 2 times a week 12 times. While herbal therapy is given for 42 days taken once a day with a dose of 9 grams of turmeric simplicia. Conlussion: Swedish massage therapy, acupressure and herbs can reduce low back pain.
INCREASING FITNESS WITH ACUPUNCTURE AND HERBS
Authors: Imandiri Ario , Pratama Diarista Salfa , Rahman Abdul
Published: August 2020

Background: Fitness is the state of the body does not experience significant fatigue after doing routine activities. While in Traditional Chinese Medicine (TCM), fitness is defined as the good circulation of Qi-energy and Xue-blood that can cause the function of the organs of Zhang Fu to run well. Physical predisposition is influenced by various factors and assessed in various ways, one of which is by measuring VO2 max calculated by doing cooper test that is running for 12 minutes on the track 400 meters. A person’s VO2 max level indicates the level of physical fitness. Based on the examination that has been done, the patient is exposed to excessive heat pathogens in the Stomach, there are humid pathogens in the body, and Qi and Xue are not sufficient. Purpose: To find out the effect of acupuncture therapy and herbal administration in complementary traditional medicine on improving fitness. Methods: To improve fitness is done acupuncture therapy and herbal therapy. Acupuncture therapy is performed at the Zusanli point (ST 36) and Sanyinjiao point (SP 6). Herbal therapy given during treatment is infusion of leaves Gotu Kola (Centella asiatica (L). Urb) and Liquorice (Glycyrrhiza glabra L.). To improve fitness, acupuncture therapy was performed 12 times in 4 stages of therapy. For herbal therapy infusa leaves Gotu Kola fresh as much as 2.5 grams and 2 grams of Liquorice, taken daily 3 times a day. Results: Acupuncture and herbal therapy that has been done for 26 days showed good results. This is evidenced by the results of copper test VO2 max increased 44.3% and no more complaints felt by patient. Conclution: Acupuncture therapy at the point of Zusanli (ST36), Sanyinjiao (SP6) accompanied by gotu kola herbs (Centella asiatica (L.) Urb) and liquorice (Glycyrrhiza glabra L.) can improve fitness.
Efektifitas Aromaterapi Lavender terhadap Tingkat Kecemasan Menghadapi Osce pada Mahasiswa Keperawatan
Authors: Setyawan Aris , Oktavianto Eka
Published: August 2020

Objective Structured Clinical Examintion (OSCE) merupakan salah satu metode penilaian kompetensi klinis. OSCE menimbulkan tekanan karena harus mengkolaborasikan skill dengan daya ingat yang kuat sehingga meningkatkan kecemasan yang akan berdampak pada perfoma mahasiswa. Salah satu bentuk strategi yang dapat digunakan untuk mengurangi kecemasan adalah dengan aromaterapi jenis lavender yang mempunyai sifat menenangkan, merangsang tidur, efek anxyolitic (anti kecemasan), dan efek psikologis lainya. Tujuan penelitian ini adalah untuk mengetahui efektifitas aromaterapi terhadap tingkat kecemasan menghadapi OSCE pada mahasiswa keperawatan. Penelitian ini merupakan penelitian quasi experiment dengan pendekatan pre-post test with control design. Jumlah sampel sebanyak 32 responden yang terdiri dari 16 responden sebagai kelompok kontrol dan 16 responden sebagai kelompok intervensi (mendapat perlakuan aromaterapi lavender dengan cara inhalasi/menghirup aromaterapi yang telah diteteskan pada cutton bud). Sampel diambil menggunakan teknik simple random sample. Analisis data menggunakan Paired Sample Test. Hasil penelitian didapatkan terjadi penurunan kelompok intervensi sebelum pemberian aroma terapi 57,75 menjadi 51,31 dengan p = 0,001 < 0,05. Aromaterapi lavender efektif dalam menurunkan kecemasan menghadapi OSCE pada mahasiswa keperawatan. Penurunan kecemasan terjadi karena salah satu kandungan lavender yaitu linalool yang mempunyai efek anxyolitic (anti kecemasan).
Espacialização da evapotranspiração na bacia hidrográfica do rio Ipojuca - PE, Brasil
Authors: Araújo Wagner Rodolfo de , De Medeiros Raimundo Mainar , De França Manoel Vieira
Published: August 2020

A evapotranspiração é um dos principais componentes do balanço de água, sendo de utilidade na quantificação das disponibilidades hídricas regionais. Objetiva-se caracterizar as condições climáticas de evapotranspiração na bacia hidrográfica do rio Ipojuca e realizar a sua interpolação, elaborando mapas representativos da distribuição mensal e anual além das variabilidades de altas e baixas evapotranspiração pelo método da krigagem. Utilizou-se de séries de dados mensais e anuais de precipitação e da temperatura média do ar no período de 1962 – 2018. O método da temperatura foi através do software ®Estima_T. Realizaram a classificação climática segundo Köppen e Thornthwaite. Os dados municipais estimados apresentaram boa acurácia de valores evaporativos e sua consistência é de 95% de confiabilidade. O desmatamento, as queimadas e o assoreamento dos rios, lagos, lagoas, riachos, córregos e dos lençóis d’água, vem deixando o solo nu sem cobertura vegetal nos períodos da não produtividade agrícola e reduzindo o nível de evapotranspiração na área estudada.
Plant infesting arthropods sold in supermarkets in the Federal District, Brazil
Authors: Castro Marcelo Tavares de , Montalvão Sandro Coelho Linhares
Published: August 2020

Many Brazilian supermarkets offer ornamental and fruit plants for sale, and many become infested by insects and other arthropods during commercialization. This work reflects the importance of knowing the pests that occur in these plants, to verify possible dissemination of these arthropods to other areas. This study was carried out with monthly visits to five supermarkets chosen at random in the Federal District, Brazil. The plants were identified and visually inspected for the presence of insects and other arthropods. The collected specimens were preserved in jars containing 70% alcohol. Their respective levels of infestation and damage were also observed and noted. Each specimen collected was identified according to specific books and keys for each taxonomic group collected. As a result, 65 plants were found to be infested with insects and mites. Of these, 48 contained sucking insects (Hemiptera) and 17 had spider mites (Tetranychus urticae Koch). Although the insects found are relatively common and have already been reported to be associated with several ornamental plants, this is the first work that records the occurrence of arthropods in ornamentals sold in commercial establishments.
Crescimento em altura de diferentes híbridos de eucalipto em diferentes idades
Authors: Figueiredo Jade Ferreira , Coelho Maria Cristina Bueno , Andrade Dayane Lucena , Aguiar Bruno Aurélio Campos , Ataide Yandro Santa Brigida , Silva Marcos Vinicius Cardoso , Pereira José Fernando , Limeira Mathaus Messias Coimbra
Published: August 2020

O objetivo deste trabalho foi avaliar o crescimento em altura total em metros em dois períodos (25 e 89 meses) de híbridos Eucalyptus urophylla x Eucalyptus camaldulensis (VM 58), Eucalyptus urophylla x Eucalyptus grandis (GG100) e de sementes híbridas de Eucalyptus. urophylla x Eucalyptus grandis.  O estudo foi realizado no sul do estado do Tocantins, em área da empresa PROJECTO no município de Aliança (TO). O dados foram obtidos a partir de inventário estratificado (por híbrido) contínuo, com parcelas retangulares de 27,5 x 28 m (770 m²) cada, distribuídas de forma sistemática em cada estrato. As variáveis dendrométricas avaliadas foram o CAP em cm (após convertido em DAP) e Altura total (Ht) em m. Os resultados obtidos com base no ganho em altura das árvores ao longo das duas idades avaliadas evidenciaram o desempenho superior do clone GG100 em relação aos demais materiais genéticos avaliados, incremento médio de 14,4 m de altura aos 25 meses e 20,7 m aos 89 meses de idade. O incremento médio periódico para as variáveis DAP (cm) e Ht (m) foi de 6,65 cm e 8,06m para híbridos Eucalyptus urophylla x Eucalyptus camaldulensis (VM 58); 9,4 cm  e 6,44m para híbrido de Eucalyptus urophylla x Eucalyptus grandis  (GG100) e de 9,61 cm  e 8,36 m para sementes  híbridas  de  Eucalyptus. urophylla x Eucalyptus grandis . Os híbridos de Eucalyptus urophylla x Eucalyptus grandis (GG100) e sementes de Eucalyptus. urophylla x Eucalyptus grandis obtiveram maior média de crescimento em altura total (m) sendo estes recomendados para plantios na região.
MODEL KONSEPTUAL MEDIA MOTION GRAPHIC INTERAKTIF MATEMATIKA UNTUK SISWA KELAS V SEKOLAH DASAR
Authors: Titik Putri Wardaniasih  , Siti Rohmi Yuliati  , Ika Lestari
Published: August 2020

Abstract: The purpose of this research is to find a conceptual model as a basic in developing a learning media Mathematics of Scale material using motion graphic media. The development model used in this research is Hannapin and Peck's model which is consists of three stages, namely requirements analysis, design, and development or implementation. This research was conducted at SDN Karanggan 01 Gunung Putri, Bogor towards fifth grade students of elementary schools. The results of the product feasibility trial show that interactive motion graphic media is very feasible to use by obtaining an average expert review rating of 95.14% with the category "Very Good". Based on an analysis of previous research findings the conceptual model of interactive motion graphic media that researchers found to be effectively used in schools with problems that researchers found in the field.

Keyword : Motion graphic, Interactive, Mathematic, Scale

Abstrak : Tujuan dari penelitian ini adalah untuk menemukan model konseptual sebagai dasar dalam mengembangkan suatu media pembelajaran Matematika materi Skala menggunakan media motion graphic. Model pengembangan yang digunakan pada penelitian ini adalah model Hannapin dan Peck yang terdiri dari tiga tahapan yaitu analisis kebutuhan, desain, dan pengembangan atau implementasi. Penelitian ini dilaksanakan di SDN Karanggan 01 Gunung Putri, Bogor terhadap siswa kelas V sekolah dasar. Hasil uji coba kelayakan produk menunjukkan bahwa media motion graphic interaktif sangat layak digunakan dengan mendapat penilaian expert review rata-rata sebesar 95,14% dengan kategori “Sangat Baik”. Berdasarkan analisis terhadap temuan penelitian sebelumnya model konseptual media motion graphic interaktif yang peneliti temukan efektif digunakan pada sekolah dengan permasalahan yang peneliti temukan di lapangan.

Kata Kunci : Motion graphic, Interaktif, Matematika, Skala
Adherence to Combination Antiretroviral Therapy among Pregnant Women Enrolled in a HIV Prevention Program in Rural North-central Nigeria
Authors: Calder Cedrina L. , O Heather , Tabatabai Mohammad , Maxwell Celia J. , Marryshow Salisha , Ahonkhai Aima A. , Audet Carolyn M. , Wester C. William , Aliyu Muktar H.
Published: August 2020

Objective: Adherence to combination antiretroviral therapy (ART) among pregnant women is essential to attaining the goal of eliminating mother-to-child HIV transmission. The objective of this study was to determine which factors affect adherence to ART among HIV-positive women enrolled in a large prevention of mother-to-child HIV transmission (PMTCT) trial in rural north-central Nigeria.

Methods: The parent study included 372 HIV-positive pregnant women enrolled in a cluster-randomized control trial conducted at 12 health facilities in Nigeria between 2013 and 2015. This secondary analysis included HIV-positive women (and their infants) from the original trial with documented adherence data (n=210, 56.5%). The primary outcome was maternal adherence to ART, determined by self-report and based on the visual analogue scale (VAS) of a validated medication adherence tool. Participants with a VAS score of ? 95% were classified as adherent. We employed multivariate logistic regression to evaluate the predictors of maternal ART adherence in the study sample.

Results: Approximately 61.0% of study participants (128/210) were adherent to ART. The majority of adherent participants (62.5%, 80/128) were enrolled in the trial intervention arm. The most common cited response for non-adherence was fear of status disclosure. Adherence to ART was associated with study arm (intervention arm vs. control arm, adjusted Odds Ratio (aOR) [95% CI]: 16.95 [5.30-54.23]), maternal ethnicity (Gwari vs. Other, aOR = 0.13 [0.05-0.38]), and partner HIV status (HIV-positive vs. unknown, aOR = 3.14 [1.22-8.07]).

Conclusion and Global Health Implications: Adherence to ART among a cohort of pregnant women enrolled in a PMTCT trial in rural North-Central Nigeria was associated with trial arm, maternal self- reported ethnicity, and partner
PERIPHERAL PUBLISHING: THE POSSIBILITIES OF MARGINAL MODELS
Authors: Michael Rose
Published: August 2020

There is considerable interest in independent publishing models that operate at or on the periphery of our industry, beyond the ‘centre’ of commercial publishing—from ‘litmags’ (Edmonds 2015) to ‘prosumers’ (Stinson 2016); self-publishers, to digital-first and open access examples. There is less discussion of established ‘literary’ writers producing ‘peripheral’ works, which may be significant in the current context, when publishing faces the challenge of technological developments ‘orders of magnitude greater than the momentous evolution from monkish scriptoria to movable type’ (Epstein 2010). As an author and publisher—working in both roles across distinct categories—I am interested in creative projects that mis/use aspects of generic forms to re/make (a)new literary fiction. In this paper, I consider David Mitchell’s latest novel/la, Slade House (2015), in light of its first appearance as a Twitter ghost story released at midnight on All Hallows’ Eve: a tale-in-instalments that gothic readers and fanfic communities alike would be familiar with, but was and still is more novel for mainstream trade publishers. Mitchell’s avant-garde example may work to illustrate the direction and fluidity of literary fiction at a point in publishing history when traditional practices are being challenged by writers via alternative models of production, which may exhibit a capacity to move between genres that might, in earlier times, have seemed exclusive.
O Estágio Curricular como Fenômeno Extensionista: eficiência numa indústria de autopeças em Santa Catarina através da redução do tempo de setup numa máquina fresadora marca Lorenz®
Authors: ZAAK SARAIVA Illyushin , BUTZEN Eduardo , De PELEGRIN Jessé , BALAN Neimar
Published: August 2020

Este artigo descreve projeto de melhoria cujo objetivo foi a redução do tempo de setup de uma máquina fresadora usada na produção de engrenagens de caixas de câmbio em uma indústria de autopeças na cidade Joaçaba – SC, fruto principal do estágio curricular do curso técnico em mecânica do IFC - Campus Luzerna. Entre 19/01/2015 e 24/04/2015 foi realizado um estudo descritivo e analítico da fábrica pesquisada, em quatro etapas, (1ª) análise pormenorizada dos processos de produção de engrenagens na fábrica; (2ª) estudo do funcionamento da máquina fresadora na produção destas engrenagens; (3ª) análise do processo de fresamento de engrenagens pela máquina estudada; (4ª) elaboração de um estudo completo dos tempos e movimentos do setup da máquina em produção. Obteve-se uma planilha pormenorizada de tempos e movimentos a partir da qual elaborou-se a proposta de redução do tempo de setup conforme Shingo (2000) adaptado por Souza (2009), e que consiste dos itens: (1) adoção de painel móvel (Checktable) para organização das ferramentas de setup; (2) indexação das engrenagens padronizadas utilizadas no cálculo das peças fabricadas; (3) utilização de grampos em “U” para fixação das engrenagens na fresadora; (4) separação de Setup Interno e Setup Externo; e (5) adoção do balanceamento do setup entre dois operadores. Conclui-se, a respeito do objetivo principal, que o mesmo foi atingido, já que foi possível reduzir-se em 38,6% o tempo médio de setup da máquina analisada, podendo o referido processo de melhoria servir de base para futuros estudos sobre o tema em indústrias similares no Brasil.
Research transparency promotion by surgical journals publishing randomised controlled trials: a survey
Authors: Lombard Nicolas , Gasmi Anis , Sulpice Laurent , Boudjema Karim , Naudet Florian , Bergeat Damien
Published: August 2020

Objective: To describe the surgical journal position statement on data-sharing policies (primary objective) and to describe the other features of their research transparency promotion. Methods: Only “SURGICAL” journals with an impact factor superior to 2 (Web of Science) were eligible for the study. They were not included if there were no explicit instructions for clinical trial publication in the official instructions for authors (OIA) and if there were no randomized controlled trial (RCT) published between 1st January 2016 and 31st December 2018. The primary outcome was the existence of a data-sharing policy in the instructions for authors. Data sharing policy was detailed in 3 categories, inclusion of data sharing policy mandatory, optional or not available. Details on research transparency promotion were also collected, namely the existence of a “prospective registration of clinical trials requirement” policy; a conflict of interests (COIs) disclosure requirement and a specific reference to reporting guidelines such as CONSORT for RCT. Results: Among the 87 surgical journals eligible, 82 were included in the study: 67 (82%) had explicit instructions for RCT and of the remaining, 15 (18%) had published at least one RCT. The median impact factor was 2.98 [IQR=2.48-3.77] and in 2016 and 2017, the journals published a median of 11.5 RCT [IQR=5-20.75]. Data-sharing statement instructions (primary outcome) was retrieved in 41 journals (50%); Data-sharing statement instructions were mandatory in four cases (4.9%), optional in 45% (n=37) and not available in 50% (n=41) of the journals. As for data-sharing statements, no association was found between journal characteristics and the existence of data-sharing policies (mandatory or optional). A “prospective registration of clinical trials requirement” was associated with ICMJE allusion or affiliation and higher impact factors. Journals with specific RCT instructions in their OIA and journals referenced on the ICMJE website more frequently mandated the use of CONSORT guidelines. Conclusion: Research transparency promotion is still limited in surgical journals. Standardisation of journal requirements according to ICMJE guidelines could be a first step forward for research transparency promotion in surgery.
The effect of an educational intervention to improve tuberculosis infection control among nurses in Ibadan, south-west Nigeria: a quasi-experimental study
Authors: Akande Patrick Aboh
Published: August 2020

Background: Nurses are particularly vulnerable to acquiring tuberculosis (TB) because they are in the frontline of patient care. There is inadequate implementation of cost-effective TB infection control (TBIC) measures in most health facilities. Training has been shown to be effective in improving the knowledge and work practices of nurses. This study sought to utilize a multi-method educational intervention to improve the TBIC-related knowledge and practices of nurses in two secondary health facilities in Ibadan, South-West Nigeria.Methods: This quasi-experimental study involved 200 nurses (100 each in the intervention and comparison groups). Baseline data were collected in May 2014. This was followed by training of the nurses in the intervention group. After 6 months, the second wave of data was collected and the nurses in the comparison group also received the training thereafter. The final wave of data collection took place 12 months after the commencement of the study. The mean scores of the nurses were determined and comparison was made between both groups at different time points using independent t-test.Results: The nurses in both groups were statistically comparable in their socio-demographic characteristics, and baseline mean knowledge (68.6 and 67.7%) and practice scores (79.1 and 80.6%) respectively. After the intervention group received the intervention, there were appreciable improvements in the scores at 6 months (knowledge – 85.9%, practice – 98.5%), which were significantly different from those of the comparison group (knowledge – 69.5%, practice – 78.8%). A large effect size was demonstrated in the improvement in knowledge score in the intervention group at 6 months compared with the other group (Cohen’s d η 2 {\displaystyle \eta ^{2}} = 1.7). Similarly, there were improvements in the scores of the nurses in the comparison group at 12 months after the group had also received the intervention (knowledge – 88.2%, practice – 93.5%). At this point, the mean scores between both groups were no longer significantly different. Conclusions: The improvement in post-intervention scores implies that the educational intervention adopted for this study was effective in improving TBIC among the nurses. It also underscores the importance of continuous training/retraining of nurses and other healthcare workers in improving and sustaining TBIC at health facilities.
Icarisid I specifically facilitates ATP or nigericin-induced NLRP3 inflammasome activation and causes idiosyncratic hepatotoxicity
Authors: Gao Yuan , Xu Guang , Ma Li , Shi Wei , Wang Zhilei , Zhan Xiaoyan , Qin Nan , He Tingting , Guo Yuming , Niu Ming , Wang Jiabo , Bai Zhaofang , Xiao Xiaohe
Published: August 2020

Background

Epimedii Folium(EF) is commonly used for treating bone fractures and joint diseases, but the potential hepatotoxicity of EF limits its clinical application. Our previous study confirms that EF could lead to idiosyncratic drug-induced liver injury (IDILI) and hepatocyte apoptosis, but the mechanism remains unknown. Studies have shown that NLRP3 inflammasome plays an important role in the development of various inflammatory diseases such as IDILI. Specific stimulus-induced NLRP3 inflammasome activation may has been a key strategy for lead to liver injury. Therefore, main compounds derived from EF were chosen to test whether the ingredients in EF could activate the NLRP3 inflammasome and to induce IDILI.

Methods

Mouse were treated with Icariside I, and then stimulated with inflammasome stimuli and assayed for the production of caspase-1 and interleukin 1β (IL-1β) and the release of lactate dehydrogenase (LDH). Determination of intracellular potassium, ASC oligomerization as well as reactive oxygen species (ROS) production were used to evaluate the stimulative mechanism of Icariside I on inflammasome activation. Mouse models of NLRP3 diseases were used to test whether Icariside I has hepatocyte apoptosis effects and promoted NLRP3 inflammasome activation in vivo.

Results

Icariside I specifically enhances NLRP3 inflammasome activation triggered by ATP or nigericin but not SiO2, poly(I:C) or cytosolic LPS. Additionally, Icariside I does not alter the activation of NLRC4 and AIM2 inflammasomes. Mechanically, Icariside I alone does not induce mitochondrial reactive oxygen species (mtROS), which is one of the critical upstream events of NLRP3 inflammasome activation; however, Icariside I increases mtROS production induced by ATP or nigericin but not SiO2. Importantly, Icariside I leads to liver injury and NLRP3 inflammasome activation in an LPS-mediated susceptibility mouse model of IDILI, but the effect of Icariside I is absent in the LPS-mediated mice model pretreated with MCC950, which is used to mimic knockdown of NLRP3 inflammasome activation.

Conclusions

Our study reveals that Icariside I specifically facilitates ATP or nigericin-induced NLRP3 inflammasome activation and causes idiosyncratic hepatotoxicity. The findings suggest that Icariside I or EF should be avoided in patients with diseases related to ATP or nigericin-induced NLRP3 inflammasome activation, which may be risk factors for IDILI.
Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature
Authors: Goethals Luc , Barth Nathalie , Hupin David , Mulvey Michael S. , Roche Frederic , Gallopel-Morvan Karine , Bongue Bienvenu
Published: August 2020

Background: Falls are a significant source of morbidity in people aged 65 and over, affecting one in three people in this age group. The scientific evidence indicates that physical activity is the most effective method for preventing falls among seniors. Although public health professionals often use social marketing to design and plan successful interventions, its use to promote physical activity and prevent falls among older people remains low. This article aims to provide a new systematic literature review of social marketing interventions promoting physical activity and targeting people aged 60 and over.Methods: Following CRD’s guidance and PRISMA guidelines, we searched between January 2008 and July 2019 for relevant articles in five primary databases using predefined search and inclusion criteria. Two independent reviewers analysed the selected articles to identify evidence of the seven social marketing benchmark criteria, defined by experts in the field as the common elements that contribute to social marketing success.Results: The final review included nine studies. Of the studies selected, three specifically targeted over 60-year-olds, whereas the others segmented the population into several age-based subcategories, including over 60-year-olds. Eight studies highlighted positive results for the participants with an increase in participation or an increase in physical activity level. None of the nine studies selected for this systematic review implemented the entire social marketing approach.Conclusion: Few published interventions use the seven social marketing criteria. Further research is required to encourage uptake and inclusion in successful social marketing interventions to increase program effectiveness in this target population.
Social participation is an important health behaviour for health and quality of life among chronically ill older Chinese people
Authors: Feng Zeyun , Cramm Jane Murray , Nieboer Anna Petra
Published: August 2020

Background: Health behaviours (physical activity, maintenance of a healthy diet and not smoking) are known to be beneficial to the health and well-being of chronically ill people. With China's ageing population and increased prevalence of people with chronic diseases, the improvement of unhealthy behaviours in this population has become crucial. Although recent studies have highlighted the importance of social participation for health and quality of life (QoL) among older people, no study to date has included social participation along with more traditional health behaviours. Therefore, this study aimed to identify associations of multiple health behaviours (social participation, physical activity, maintenance of a healthy diet and not smoking) with health and QoL outcomes (including cognitive and physical function) among chronically ill older adults in China.Methods: For this nationally representative cross-sectional study, wave 1 data from the World Health Organization’s Study on global AGEing and adult health (China) were examined. In total, 6,629 community-dwelling older adults (mean age, 64.9 years) with at least one chronic disease were included. Multivariate linear regression analyses were used to evaluate associations of health behaviours with health and QoL outcomes while controlling for background characteristics.Results: Greater social participation was associated with better QoL [β = 0.127, standard error (SE) = 0.002, p < 0.001], cognitive function (β = 0.154, SE = 0.033, p < 0.001) and physical function (β = –0.102, SE = 0.008, p < 0.001). Physical activity was associated with better QoL (β = 0.091, SE = 0.015, p < 0.001) and physical function (β = –0.155, SE = 0.062, p < 0.001). Sufficient fruit and vegetable consumption was associated with better QoL (β = 0.087, SE = 0.015, p < 0.001).Conclusions: Our findings suggest that social participation is an important health behaviour for quality of life and cognitive function among chronically ill older people in China. Health promotion programmes should expand their focus to include social participation as a health behaviour, in addition to physical activity, maintenance of a healthy diet and not smoking.
The relationship between preoperative T helper cytokines in the ileal mucosa and the pathogenesis of pouchitis
Authors: Kitajima Takahito , Okita Yoshiki , Kawamura Mikio , Kondo Satoru , Toiyama Yuji , Uchida Keiichi , Kusunoki Masato
Published: August 2020

Background: Although the etiology of pouchitis remains unknown, inflammatory cytokines are significantly associated with the pathogenesis of pouchitis. The cytokine responses that characterize inflammatory bowel diseases (IBD) are key pathogenic components of the disease. Although cytokine profiles in the colonic mucosa have been investigated in experimental colitis models or IBD patients, cytokine profiles in the ileal mucosa at colectomy have been rarely assessed. Aim: To assess the relationship between pouchitis and T helper (Th) cytokines in the ileal mucosa collected at the time of colectomy and pouch construction. Methods: This retrospective study involved 68 consecutive patients from January 2004 to May 2011 who underwent ileal pouch–anal anastomosis for ulcerative colitis. Samples were obtained from the terminal ileum of resected specimens at time of total colectomy or subtotal colectomy. mRNA expression levels of Th cytokines (IFN-γ, IL-23A, IL-5, IL-13 and IL‐17A) were determined.Results: Forty of 68 patients (58.8%) developed pouchitis. There was no association between IL-23A expression levels and incidence of pouchitis (p=0.301). Patients with elevated IFN-γ had a significantly higher incidence of pouchitis compared with low IFN-γ patients (p=0.043). Univariate analysis demonstrated a total dose of prednisolone >7000 mg administered before colectomy (p=0.04) and high IFN-γ expression (p=0.02) were significant risk factors for pouchitis onset. In multivariate analysis, elevated IFN-γ messenger(m)RNA levels were significantly associated with pouchitis onset (p=0.03).Conclusion: IFN-γ expression in the normal ileal mucosa at the time of colectomy may be an important factor in the pathophysiology of pouchitis.
Active constituents of Zanthoxylum nitidum from Yunnan Province against leukemia
Authors: Deng Ying , Ding Tongtong , Deng Lulu , Hao Xiaojiang , Mu Shu Zhen
Published: August 2020

Zanthoxylum nitidium (Roxb.) DC (Rutaceae) is well known for inhibiting the proliferation of human gastric, liver, kidney and lung cancer cells, though research on its potential use in treating leukaemia is relatively rare. Twenty-six compounds were isolated from the chloroform and petroleum ether extracts of the roots and leaves of Z. nitidium. They were (+)-9′-O-transferuloyl-5, 5′-dimethoxylaricriresinol (1), 8-(3′-oxobut-1′-en-1′-yl)-5, 7-trimethoxy-coumarin (2), 5, 7, 8-trimethoxy-coumarin (3), 5-(3′, 3′-dimethyl-2′-butenyloxy)-7, 8-dimethoxy-coumarin (4), 2-(5-methoxy-2-methyl-1H-indol-3-yl) methyl acetate (5), 2′-(5,6-dihydrochleletrythrine-6-yl) ethyl acetate (6), 6-acetonyldi-hydrochelerythrine (7), 6β-hydroxymethyldihydronitidine (8), bocconoline (9), zanthoxyline (10), O-methylzanthoxyline (11), rhoifoline B (12), N-nornitidine (13), nitidine (14), chelerythrine (15), 4-hydroxyl-7,8-dimethoxy-furoquinoline (16), dictamnine (17), γ-fagarine (18), skimmianine (19), robustine (20), R-(+)-platydesmine (21), 4-O-methyl-1-methyl-quinoline-2-one (22), 4-methoxy-2-quinolone (23), liriodenine (24), aurantiamide acetate (25), 10-O-demethyl-12-O-methylarnottianamide (26). Four among them, compounds 4-6 and 16, were first confirmed in this study by UV, IR, 1D, 2D NMR and HR-ESI-MS spectra. Compounds 1-2 and 11 were isolated from Z. nitidium for the first time. Of the assayed compounds, 1, 2, 9, 10, 14, 15 and 24, exhibited good inhibitory activities in the leukaemia cell line HEL, whereas compound 14 (IC50: 3.59 µM) and compound 24 (IC50: 15.95 µM) exhibited potent inhibitory activities. So, to further investigate the possible mechanisms, cell cycle and apoptosis assays were performed, which indicated that compound 14 causes obvious S-phase arrest in HEL cells and induced apoptosis, whereas compound 24 only induced apoptosis. The present results suggested both compounds 14 and 24 are promising potential anti-leukaemia drug candidates.
A comparison of medical student competency, attitudes and knowledge of abortion care after a structured clinical curriculum
Authors: Gardner Hallie , Zimmerman Marguerite , Flanigan Moira , Baldwin Maureen K
Published: August 2020

Background: Abortion care is a core educational objective according to the Association of Professors of Gynecology and Obstetrics (APGO), but clinical exposure is variable in medical education. The authors sought to compare professional competency, attitudes, and knowledge regarding abortion between students who attended a structured clinical experience in abortion care to those who chose a less-structured family planning clinical environment.Methods: All medical students participating in the Obstetrics & Gynecology clerkship from 2014-2015 were invited to complete a pre- and post-clerkship survey and grouped based on their attendance to a structured clinical abortion experience at Planned Parenthood (PPCW) versus an alternative Family Planning Clinic (FPC) experience. Self-assessed competency and attitudes about abortion were measured using a 100-mm visual analog scale (VAS). Authors assessed knowledge about abortion with multiple-choice questions.Results: A total of 89 students completed the surveys (PPCW: 74; FPC: 15). Students attending PPCW were more likely to observe counseling about abortion and ultrasound prior to abortion (PPCW: 67/74, 91%; FPC: 4/15, 27%, p=<0.01). More PPWC students observed a surgical abortion (91% versus 7% of FPC students). Self-assessed competency scores improved with composite mean difference in VAS for PPCW of 42.2 mm and FPC of 27.3 mm (p=0.02). Attitude scores were unchanged in those with initial VAS <80 mm. Knowledge improved overall, with greater changes among the PPCW group.Conclusions: A structured clinical abortion experience met APGO educational objectives more than an alternative experience. Future physicians should universally be exposed to clinical abortion care in order to ensure evidence-based education about abortion.
Socioeconomic status, social capital, health risk behaviors, and health-related quality of life among Chinese older adults
Authors: Yang Ying , Wang Shizhen , Chen Lei , Luo Mi , Xue Lina , Cui Dan , Mao Zongfu
Published: August 2020

Background: There is limited knowledge on the mediating role of different health risk behavior on the relationship between social capital, socioeconomic status (SES), and health-related quality of life (HRQoL) in Chinese older adults. We conducted this study to (a) investigate the condition of health risk behaviors of the Chinese elderly, and (b) assess the relationship between SES, social capital, health risk behaviors, and HRQoL.Methods: A sample of 4,868 adults aged 60 years and older were included in this study, from the China’s Health-related Quality of Life Survey for Older Adults 2018. Participants’ demographic characteristics, SES (education level, family income), health risk behaviors (smoking, alcohol consumption, physical inactivity, unhealthy dietary behavior, unhealthy weight, and sleep disorder) were collected. Social capital and HRQoL were assessed by the 16-item Personal Social Capital Scale (PSCS-16) and WHOQOL-Old, respectively. Structural equation modeling (SEM) was applied to examine the associations between variables.Results: The proportion of smoking, alcohol consumption, physical inactivity, unhealthy dietary behavior, unhealthy weight, and sleep disorder were 32.1%, 36.3%, 62.5%, 45.7%, 31.8%, and 45.5%, respectively. Significant differences were observed in education level, family income, and social capital between elderly individuals with and without each of the six health risk behavior (all p-values < 0.05). Elderly individuals who reported smoking, physical inactivity, unhealthy dietary behavior, and sleep disorder had significantly lower HRQoL than those without these unhealthy behaviors (all p-values < 0.05). SEM analysis showed that SES and social capital positively associated with alcohol consumption. Social capital negatively associated with smoking, physical inactivity, unhealthy dietary behavior, and sleep disorder. SES negatively associated with smoking, physical inactivity, unhealthy dietary behavior, unhealthy weight, and sleep disorder. Smoking, physical inactivity, unhealthy dietary behavior, and sleep disorder correlated with poorer HRQoL.Conclusions: Chinese older adults demonstrated a high incidence of health risk behaviors, especially for physical inactivity (62.5%) and unhealthy dietary behavior (45.7%). Social capital and SES were correlated with the elderly’s HRQoL, as well as with the health risk behaviors. Health risk behaviors played potential mediating role on the relationship between social capital, SES, and HRQoL in Chinese older adults.
Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports
Authors: Yamada Tomoko , Fukuoka Hidenori , Hosokawa Yusei , Odake Yukiko , Yoshida Kenichi , Matsumoto Ryusaku , Bando Hironori , Okada Yuko , Hirota Yushi , Iguchi Genzo , Ogawa Wataru , Takahashi Yutaka
Published: August 2020

Background

Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA).

Methods

In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled.

Results

PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA.

Conclusions

ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC.
The Combination of an Inflammatory Peripheral Blood Gene Expression and Imaging Biomarkers Enhance Prediction of Radiographic Progression in Knee Osteoarthritis.
Authors: Attur Mukundan , Krasnokutsky Svetlana , Zhou Hua , Samuels Jonathan , Chang Gregory , Bencardino Jenny T. , Rosenthal Pamela , Rybak Leon , Huebner Janet L. , Kraus Virginia B. , Abramson Steven B.
Published: August 2020

Objective. Predictive biomarkers of progression in knee osteoarthritis are sought to enable clinical trials of structure modifying drugs. A peripheral blood leukocyte (PBL) inflammatory gene signature, MRI-based bone marrow lesions (BML) and meniscus extrusion scores), meniscal lesions, and osteophytes on x-ray each have been shown separately to predict radiographic joint space narrowing (JSN) in subjects with symptomatic knee osteoarthritis (SKOA). In these studies, we determined whether the combination of the PBL inflammatory gene expression and these imaging findings at baseline enhanced the prognostic value of either alone.Methods. PBL inflammatory gene expression (increased mRNA for IL-1β, TNFα, and COX-2), routine radiographs, and 3T knee MRI were assessed in two independent populations with SKOA: an NYU cohort, and the Osteoarthritis Initiative (OAI). At baseline and 24 months, subjects underwent standardized fixed-flexion knee radiographs and knee MRI. Medial JSN (mJSN) was determined as the change in medial JSW. Progressors were defined by an mJSN cut-point (≥0.5 mm/24 months). Models were evaluated by odds ratios (OR) and area under the receiver operating characteristic curve (AUC).Results. We validated our prior finding in these two independent (NYU and OAI) cohorts, individually and combined, that an inflammatory PBL inflammatory gene expression predicted radiographic progression of SKOA after adjustment for age, sex, and BMI. Similarly, the presence of baseline BML and meniscal lesions by MRI or semi-quantitative osteophyte score on x-ray each predicted radiographic medial JSN at 24 months. The combination of the PBL inflammatory gene expression and medial BML increased the AUC from 0.66 (p=0.004) to 0.75 (p<0.0001) and the odds ratio from 6.31 to 19.10 (p<0.0001) in the combined cohort of 473 subjects. The addition of osteophyte score to BML and PBL inflammatory gene expression further increased the predictive value of any single biomarker. A causal analysis demonstrated that the PBL inflammatory gene expression and BML independently influenced mJSN.Conclusion. The use of the PBL inflammatory gene expression together with imaging biomarkers as combinatorial predictive biomarkers, markedly enhances the identification of radiographic progressors. The identification of the SKOA population at risk for progression will help in the future design of disease-modifying OA drug trials and personalized medicine strategies.