bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of life in adults with Down syndrome: A mixed methods systematic review
Authors: Ijezie Ogochukwu Ann , Healy Jane , Davies Philip , Balaguer-Ballester Emili , Heaslip Vanessa
Published: May 2023

Background

As the life expectancy of adults (aged ≥ 18 years) with Down syndrome increases for a plethora of reasons including recognition of rights, access, and technological and medical advances, there is a need to collate evidence about their quality of life.

Objective

Using Schalock and Verdugo’s multidimensional quality of life assessment model, this systematic review aimed to identify, synthesise and integrate the quantitative and qualitative evidence on quality of life in adults with Down syndrome via self-and proxy-reporting.

Methods

Five databases were systematically searched: MEDLINE, CINAHL, PsycINFO, Scopus, and Web of Science to identify relevant articles published between 1980 and 2022 along with grey literature and reference lists from relevant studies. A mixed methods systematic review was performed according to the Joanna Briggs Institute methodology using the convergent integrated approach. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results

Thirty-nine studies were included: 20 quantitative, 17 qualitative, and 2 mixed methods studies. The synthesised findings were grouped into the 8 core domains of quality of life: personal development, self-determination, interpersonal relations, social inclusion, rights, emotional, physical and material well-being. Of the 39 studies, 30 (76.92%) reported on emotional well-being and 10 (25.64%) on rights. Only 7 (17.94%) studies reported that adults with Down syndrome have a good quality of life centred around self-determination and interpersonal relations. Most adults with Down syndrome wanted to become more independent, have relationships, participate in the community, and exercise their human rights. Self-reported quality of life from adults with Down syndrome was rated higher than proxy reported quality of life. Discrepancies in quality of life instruments were discovered.

Conclusion

This review highlighted the need for a better systematic approach to improving the quality of life in adults with Down syndrome in targeted areas. Future research is required to evaluate self-and proxy-reporting methods and culture-specific quality of life instruments that are more appropriate for adults with Down syndrome. In addition, further studies should consider including digital assistive technologies to obtain self-reported quality of life data in adults with Down syndrome.

International prospective register of systematic reviews registration number

CRD42019140056.
Identification of diphenylurea derivatives as novel endocytosis inhibitors that demonstrate broad-spectrum activity against SARS-CoV-2 and influenza A virus both in vitro and in vivo
Authors: Kumar Nirmal , Taily Irshad Maajid , Singh Charandeep , Kumar Sahil , Rajmani Raju S. , Chakraborty Debajyoti , Sharma Anshul , Singh Priyanka , Thakur Krishan Gopal , Varadarajan Raghavan , Ringe Rajesh P. , Banerjee Prabal , Banerjee Indranil
Published: May 2023

Rapid evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A virus (IAV) poses enormous challenge in the development of broad-spectrum antivirals that are effective against the existing and emerging viral strains. Virus entry through endocytosis represents an attractive target for drug development, as inhibition of this early infection step should block downstream infection processes, and potentially inhibit viruses sharing the same entry route. In this study, we report the identification of 1,3-diphenylurea (DPU) derivatives (DPUDs) as a new class of endocytosis inhibitors, which broadly restricted entry and replication of several SARS-CoV-2 and IAV strains. Importantly, the DPUDs did not induce any significant cytotoxicity at concentrations effective against the viral infections. Examining the uptake of cargoes specific to different endocytic pathways, we found that DPUDs majorly affected clathrin-mediated endocytosis, which both SARS-CoV-2 and IAV utilize for cellular entry. In the DPUD-treated cells, although virus binding on the cell surface was unaffected, internalization of both the viruses was drastically reduced. Since compounds similar to the DPUDs were previously reported to transport anions including chloride (Cl-) across lipid membrane and since intracellular Cl-concentration plays a critical role in regulating vesicular trafficking, we hypothesized that the observed defect in endocytosis by the DPUDs could be due to altered Cl-gradient across the cell membrane. Usingin vitroassays we demonstrated that the DPUDs transported Cl-into the cell and led to intracellular Cl-accumulation, which possibly affected the endocytic machinery by perturbing intracellular Cl-homeostasis. Finally, we tested the DPUDs in mice challenged with IAV and mouse-adapted SARS-CoV-2 (MA 10). Treatment of the infected mice with the DPUDs led to remarkable body weight recovery, improved survival and significantly reduced lung viral load, highlighting their potential for development as broad-spectrum antivirals.
Efficacy and safety of aceclofenac in musculoskeletal diseases
Authors: Isaikina M. A. , Isaikin A. I. , Akhmedzhanova L. T.
Published: May 2023

Musculoskeletal system pathology is one of the main causes of morbidity and disability worldwide. Inflammation plays the leading role in the genesis of these diseases. Pain is the most important factor leading to a critical decrease in the quality of life and limitation of daily activities. Most current international guidelines for the treatment of acute and chronic low back and neck pain, osteoarthritis, rheumatoid arthritis and other diseases recommend oral non-steroidal anti-inflammatory drugs as first-line therapy. The article presents data from the latest domestic and international studies, including the results of the largest SOS study, which demonstrated the high efficacy and safety of aceclofenac (Aertal) in acute and chronic neck and back pain.
Optimization of migraine attacks relief
Authors: Tabeeva G. R. , Amelin A. V. , Akhmadeeva L. R. , Danilov A. B. , Doronina O. B. , Koreshkina M. I. , Latysheva N. V. , Mendelevich E. G. , Sarvilina I. V. , Sergeev A. V. , Skorobogatykh K. V. , Filatova E. G.
Published: May 2023

On December 24, 2022, in Moscow an interdisciplinary Council of Headache Experts, held under the auspice of the interregional public organization “Russian Society for the Study of Headache”, discussed the key problems of effective treatment of a migraine attack and the possibilities of a specific drug Kaporiza® (rizatriptan). Despite the development of strategies for the relief of migraine attacks and the effectiveness of triptans as first-line therapy, the choice of a specific drug in accordance with the individual clinical profile of the patient is difficult due to the existence of drugs in various forms (standard tablets, oral dispersible forms, injections, nasal sprays, rectal suppositories). Rizatriptan in the form of an orally dispersible tablet (ODT) has a number of advantages: high bioavailability, fast onset of action, and ease of use. Therefore, Kaporiza® (rizatriptan ODT) may be recommended as a priority therapy for all migraine patients who prefer the dispersible tablet form and who experience symptoms of nausea and vomiting, as well as for patients who have experience of poor efficacy and/or poor tolerability of other triptans. The Expert Council recommends to include rizatriptan ODT in the next edition of the clinical guidelines for the diagnosis and treatment of migraine as a first-line agent with Level A evidence.
Withdrawal of valproic acid during pregnancy in women with epilepsy
Authors: Navumava H. I. , Vlasov P. N. , Prusakova A. I. , Usoltseva A. A. , Shnayder N. A. , Dmitrenko D. V.
Published: May 2023

Objective: to analyze the course of epilepsy in women after withdrawal of valproic acid (VA) during pregnancy.Material and methods. The study was conducted in the Center of paroxysmal conditions of Vitebsk Regional Clinical Diagnostic Center. The study included 58 women with epilepsy who gave birth in 2018–2020; a prospective analysis was also done using the Russian Register of Pregnancy and Epilepsy (RRPE) data. The study group included 112 women with epilepsy who were taking VA at the time of conception. In 16.1% of cases (n=18 out of 112) VA was discontinued in the first trimester (withdrawal group), in 83.9% of cases (n=94) VA therapy was continued. We analyzed the frequency of epileptic seizures depending on the use of VA during pregnancy for each trimester and for the entire pregnancy as a whole.Results. According to the Vitebsk Regional Clinical Diagnostic Center, 32 out of 58 (55.2%) patients took VA, all of them had generalized tonicclonic seizures in the structure of epileptic seizures. Seven of 32 patients (21.8%) received VA at a dose of <700 mg/day; 10 (31.3%) – 700–1000 mg/day, 15 (46.9%) – 1000–1500 mg/day. VA was canceled in two cases, in one of them a tonic-clonic seizure developed. According to the RRPE data, in 9 out of 65 (13.8%) cases VA was discontinued in the first trimester (withdrawal group), in 55 out of 65 (84.6%) cases the therapy with VA was continued, and in one case - the drug was changed. The number of women with epilepsy taking VA during pregnancy has decreased from 38.9% (275 out of 707) in 2017 to 24.9% (112 out of 450) by January 2023. According to the RRPE, the majority of patients continued VA therapy during gestation if pregnancy occurred while taking this antiepileptic drug. A high fraction of prescribing VA in patients with focal epilepsy was registered – 58.9% (66 out of 112) with continuation of VA therapy during pregnancy in 61.7% of cases. Among patients with generalized form of epilepsy, VA drugs were taken by 36.6% (41 out of 112). The majority of patients (35.1%; 33 of 94) continued to take VA throughout the entire gestation. About half of the patients took VA at a dose of >700 mg/day in the first trimester and throughout gestation. There were no statistically significant differences in the frequency of tonic-clonic and other types of epileptic seizures during pregnancy in patients who canceled VA and continued therapy, according to RRPE.Conclusion. Further prospective and controlled studies with large sample sizes are needed to determine the most effective and safe strategy for VA withdrawal.
Quality of life of patients with rheumatoid arthritis and comorbid fibromyalgia
Authors: Melikova N. A. , Filatova E. S. , Filatova E. G. , Lila A. M.
Published: May 2023

Objective: to evaluate the impact of comorbid fibromyalgia (FM) on the quality of life (QoL) of patients with rheumatoid arthritis (RA). Material and methods. The study involved 90 patients with confirmed RA who complained of chronic pain. All patients underwent general clinical and laboratory examination. FM was diagnosed according to the 2016 ACR criteria. The questionnaires assessed the presence and severity of fatigue (FSS), anxiety and depression (HADS), sleep disorders (PSQI), cognitive impairment (DSST), symptoms of central sensitization (CSI) and the neuropathic component of pain (DN4, PD). The severity of pain syndrome (PS) was assessed by 10-cm VAS at rest. QoL was assessed using the EQ-5D questionnaire. Results. In the main (FM+) and control (FM-) groups, the average severity of PS according to VAS at rest was 7 and 4 cm (p<0.001), the average score on the CSI questionnaire was 50 and 38.5 (p<0.001), and according to the PD questionnaire – 17 and 11 (p<0.001), respectively. Analysis of the severity of comorbid disorders revealed significant differences between the groups in terms of such parameters as fatigue (p=0.003), anxiety (p=0.001), sleep quality (p<0.001) and cognitive impairment (p=0.021). The QoL of patients (according to EQ-5D) in the main group was significantly lower (0.52 vs. 0.59; p=0.003). Significant correlations were found between the QoL index according to EQ-5D and VAS, FSS and PD values in both groups, CSI, DN4, HADS-T parameters and the number of painful joints – only in the main group. Conclusion. Concomitant FM significantly reduces the QoL of patients with RA. The main factors affecting QoL in patients with RA and comorbid FM were the intensity and neuropathic phenotype of PS, increased fatigue and anxiety. Patients with FM are also significantly more likely to have sleep and cognitive impairments.
Readiness potential as a neurophysiological marker of functional movement disorders
Authors: Tolmacheva V. A. , Dudnik E. N. , Shishorin R. M. , Petelin D. S. , Bezrukov V. E. , Gamirova A. N. , Dolgopolova Yu. V. , Volel B. A.
Published: May 2023

Functional movement disorders (FMD) are widespread and have a significant negative impact on the quality of life of patients. The pathogenesis is not completely clear, but currently there is ongoing research on searching for biological markers using methods such as functional magnetic resonance imaging and electroencephalography (EEG). Objective: detection of the features of the amplitude-frequency characteristics of the readiness potential (RP) formed during FMD. Material and methods. We examined 22 patients with a clinically diagnosed FMD and 22 healthy volunteers (all participants were right-handed). Both patients and the control group underwent an EEG in Erickson's Flanker paradigm with registration of the RP. RP was recorded in the projection area of the precentral gyrus (electrodes C3/C4/C5/C6 in the standard 10–20 overlay scheme). Results. Comparative analysis of RP parameters showed the presence of significant frequency-amplitude differences between the main group and the control group in the right hemisphere in the absence of significant differences in the left hemisphere. At the same time, significant differences were demonstrated between the FMR group and the control group both in terms of the latent period (time to the onset of RP): 33.66±23.69 ms versus 276.28±176.1 ms (p<0.05), and its amplitude: -0.85±0.294 μV versus -0.35±0.26 μV (p<0.05). Conclusion. The results of the present study suggest that neurophysiological parameters such as RP can be considered as a potential diagnostic marker to improve the diagnosis of FMR.
Management of patients with chronic cerebrovascular disease
Authors: Starchina Yu. A. , Kosivtsova O. V. , Sokolov E. A.
Published: May 2023

Cerebrovascular disease is one of the most common pathologies in the practice of a neurologist. Vascular cognitive impairment is the earliest and most objective sign of cerebrovascular pathology. The correction of vascular risk factors – antihypertensive, antiplatelet, lipid-lowering therapy, have the leading role in the treatment of patients with cerebrovascular diseases. It is necessary to pay special attention to non-drug methods of therapy, such as quitting smoking and alcohol abuse, regular physical activity. The possibilities of using dipyridamole for symptomatic and pathogenetic therapy are discussed.
Spiritual Marketing in Increasing Sales Turnover of Micro, Small, and Medium Enterprises in Indonesia
Authors: Triatmo Agus Wahyu , Nugroho Arif , Supandi Supandi , Yuliar Ade
Published: May 2023

The increasing diversity of modern humans has implications for changes in consumer behavior. Previously, consumers solely relied on logical considerations when selecting products or services, but now this framework has been shifted to encompass broader considerations. This trend forces a shift in the marketing paradigm; from rational marketing to emotional marketing, even continuing to spiritual marketing. This article seeks to examine the implementation of spiritual marketing to increase the sales turnover of Micro, Small, and Medium Enterprises (MSMEs) in Indonesia, with a case study of “Komunitas Bubur Sedekah” in Setabelan Banjarsari, Surakarta. This case study applied Hermawan Kertajaya's spiritual marketing theory as a theoretical framework. Data were obtained through in-depth interviews, observation, and documentation. In-depth interviews were held with advisors, porridge sellers, almsgivers, and customers. Observations were conducted to capture data from the porridge business activities. Meanwhile, documentation was utilized to collect data from various social media platforms belonging to the community. The findings of the study indicate that “Bubur Sedekah” is a manifestation of spiritual marketing because it is grounded in ethical spiritual principles, such as theistic, humanistic, and contextual values that bring satisfaction to customers, thus resulting in regular donations. Consequently, the sales turnover of “Bubur Sedekah” has considerably increased, and the sustainability of their business is now assured.
A gamificação com a plataforma wordwall como estratégia de aprendizagem para o ensino de matemática
Authors: Teófilo de Sousa Renata , Ferreira de Azevedo Italândia , Régis Vieira Alves Francisco
Published: May 2023

Este trabalho traz os resultados de uma oficina realizada com os bolsistas do Programa Institucional de Bolsas de Iniciação à Docência, do curso de Licenciatura em Matemática da Universidade Estadual do Ceará, tratando sobre a gamificação no ensino de Matemática e apontando a relevância de sua incorporação à metodologia docente. O objetivo deste trabalho foi construir um conjunto de jogos didáticos direcionados à gamificação de componentes curriculares da disciplina de Matemática utilizando a plataforma Wordwall, com base em um planejamento de aula realizado pelos bolsistas, visando agregar o uso de tecnologias no ensino à sua formação acadêmica. A metodologia tem como natureza uma pesquisa exploratória, do tipo pesquisa-ação, ali os sujeitos participaram de forma ativa de uma oficina, onde foi apresentada a plataforma, sua dinâmica, materiais e formatos disponíveis como recurso ao professor. A partir do primeiro contato com o Wordwall, os bolsistas realizaram como atividade um planejamento de aula com uso da gamificação com o Wordwall, utilizando como temas componentes curriculares da disciplina de Matemática. Como resultados, traz-se um conjunto de planejamentos com possibilidades de aplicação em sala de aula, bem como as impressões dos bolsistas sobre a experiência vivenciada.  Por fim, constata-se que existem poucas pesquisas sobre o tema gamificação com uso da plataforma Wordwall, sendo um campo vasto a ser explorado por pesquisadores da área, dado o potencial que esta estratégia de aprendizagem ativa pode desenvolver nos alunos.
Desenvolvendo conceitos e atitudes sobre a interdisciplinaridade: estratégia didática pelo uso do jogo tangram para a formação inicial de professores de ciências
Authors: Goldschmidt Andréa Inês , Oestreich Laura , Breunig Eduarda , Gutler Paim Mathes
Published: May 2023

Este artigo teve por objetivo desenvolver uma estratégia de ensino que contribuísse para o ensino e a aprendizagem de conceitos sobre a interdisciplinaridade e para o reconhecimento de atitudes e habilidades necessárias nas ações a serem refletidas já na formação docente inicial. Para tanto, utilizou-se o jogo milenar Tangram como base, no intuito de desafiar a melhor compreensão dos conceitos relacionados ao conteúdo abordado, aplicado com trinta alunos em formação inicial docente, em ciências, em uma disciplina da área de Educação. Diversas analogias foram construídas a partir do jogo e relacionadas à conceituação dos termos interdisciplinaridade, multidisciplinaridade, pluridisciplinaridade e transdisciplinaridade. Igualmente, foram discutidos os comportamentos evidenciados durante a atividade, os desafios, as dificuldades e as atitudes necessárias para se pensar em práticas interdisciplinares no ambiente escolar.  A validação da proposta se deu a partir e um questionário semiestruturado, respondido individualmente e analisado por Análise de Conteúdo. Conforme os resultados obtidos, a estratégia proposta se mostrou adequada para trabalhar questões relacionadas à interdisciplinaridade, tanto conceitos, quanto atitudes e habilidades, itens necessários para a consolidação de práticas interdisciplinares dentro da realidade escolar.
Epistemologia de Paulo Freire e Edgar Morin como suporte para construção de uma proposta CTSA
Authors: Coelho da Silva Cantanhede Severina , Rizzatti Ivanise Maria , Cantanhede Leonardo Baltazar
Published: May 2023

O desenvolvimento cognitivo dos estudantes e a maneira de refletir sobre o ambiente escolar vivenciado por estudantes e professores representam aspectos importantes das concepções educacionais de Paulo Freire e Edgar Morin. Tais concepções convergem com as orientações Ciência, Tecnologia, Sociedade e Ambiente (CTSA), pois configuram o entendimento de mundo como espaço da existência humana, oportunizando a aproximação entre temas pertencentes ao cotidiano dos estudantes e o entorno das escolas, uma vez que o mundo problematizado no ambiente da sala de aula é o mesmo do seu contexto mais imediato. Considerando os pressupostos epistemológicos de Freire e Morin, este trabalho discute os indicadores socioeconômicos e da estrutura escolar que podem servir como suporte para a construção de uma proposta com orientação CTSA. A pesquisa é do tipo quati-qualitativa, e a coleta dos dados foi realizada na turma de Licenciatura em Química do Instituto Federal de Educação, Ciência e Tecnologia do Maranhão – IFMA/Campus Codó, utilizando questionários no formato da escala Likert, partindo do reconhecimento dos aspectos da instituição, passando pelo professor e pela conjuntura familiar até alcançar o estudante. Os resultados demonstram que o gerenciamento da instituição já sinaliza para a superação de um paradigma estagnado, típico do cenário escolar brasileiro do século XX e que os fatores relativos ao desempenho dos estudantes na escola estão relacionados com o que acontece fora dela, como a sua situação socioeconômica. Assim, o conhecimento dos indicadores socioeconômicos e da estrutura escolar são fatores que justificam a implementação de uma proposta de ensino com o viés CTSA, tanto para a melhoria do processo de ensino e aprendizagem, quanto para formação de um cidadão capaz de se posicionar de forma crítica, reflexiva e argumentativa diante das situações vivenciadas no dia a dia da sociedade.
Testing and Profiling Athletes: Recommendations for Test Selection, Implementation, and Maximizing Information
Authors: Weakley Jonathon , Black Georgia , McLaren Shaun , Scantlebury Sean , Suchomel Timothy J. , McMahon Eric , Watts David , Read Dale B.
Published: May 2023

Understanding the physical qualities of athletes can lead to improved training prescription, monitoring, and ranking. Consequently, testing and profiling athletes is an important aspect of strength and conditioning. However, results can often be difficult to interpret because of the wide range of available tests and outcome variables, the diverse forms of technology used, and the varying levels of standardization implemented. Furthermore, physical qualities can easily be misrepresented without careful consideration if fundamental scientific principles are not followed. This review discusses how to develop impactful testing batteries so that practitioners can maximize their understanding of athletic development while helping to monitor changes in performance to better individualize and support training. It also provides recommendations on the selection of tests and their outcome measures; considerations for the proper interpretation, setup, and standardization of testing protocols; methods to maximize testing information; and techniques to enhance visualization and interpretation.
Effect of acid media on seed germination performance of Swiss-chard (Beta vulgarise L.)
Authors: Tsegaye Sisay Birhanu , Fentaye Habtam
Published: May 2023

Objectives: An experiment was designed with the objectives of studying the effect of acidity (pH) on the seed germination performance of Swiss-chard, and to determine the optimal pH level for the highest seed germination. Methods: The study was carried out in the laboratory of the Department of Horticulture of the University of Wolkite. The treatments were different pH levels (2, 4, 6 and 7) obtained from solutions of citric acid and distilled water in different concentration mixtures. The CRD design was used with three replicates. Findings: Analysis of variance (ANOVA) showed that all recorded germination parameters (germination rate, mean germination time, germination speed and germination index) were all most significantly different (p<0.001) for different pH levels. The highest seed germination rates (85.33% and 81.33%) were recorded at pH 7 and pH 6 respectively. Similarly the highest mean germination time (13 days and 11 days) and the highest germination speed (3.88/day and 3.7/day) were recorded at pH 6 and pH 7, respectively. However, the lowest seed germination rate (4%), the lowest mean germination time (0.5 days) and the lowest seed germination speed (0.18/day) at pH 2. The highest germination index (100 and 95.42) was recorded at pH 7 and pH 6 respectively while the lowest seed germination index (4.61) was recorded at pH 2. In general pH 7 and pH 6 can give the best results to the highest germination yield of Swiss chard.
Associated territorial management, the way to transform the periurban area into a green belt
Authors: Opel Rubén
Published: May 2023

La Plata, like all cities, based its territorial organization -and landscape- on the construction of an inhabited area surrounded by productive green rings. Subsequently, like all other urbanizations, growth by extension generated a fragmented and degraded periphery. Currently, the periurban area presents a growing demand, dispute and conflict between different social groups that is beginning to be included in the political and management agenda. The purpose of this paper is to contribute to the construction of a new management model to transform the periurban area into a green belt, as an environmental, economic and social asset for the whole society.
ChatGPT as Expertless Test Generator
Authors:   G.E. Pukhov Institute for Modelling in Energy Engineering  National Academy of Sciences of Ukraine, Taranowski A.O., , Samoylov V.D. ,   G.E. Pukhov Institute for Modelling in Energy Engineering  National Academy of Sciences of Ukraine
Published: May 2023

Since its launch there has been a plethora of publications about what ChatGPT can and can’t be used for. While OpenAI remained silent about the exact place of ChatGPT in its framework of language models. Just ‘Try ChatGPT’ appeared to be not the best way to consider its applica-tions for less evident purposes that just composing an essay. The author has strong belief that knowing what something really is adds a lot to one’s understanding of what that something is capable of. This article therefore first considers what ChatGPT really is following its missing manual. That allows than overcoming some crucial limitations of ChatGPT in order to propose, substantiate, and experimentally support its applicability to multiple-choice test items construc-tion on the way to increase automation and optimisation in knowledge assessment systems in order to reach the level of that being expertless. The approach proposed is heavily based upon GUI client for ChatGPT while benefits of being used through API are also explained in the light of integration into existing knowledge assessment systems, additional effects, and future transi-tion to GPT-4.
Functional Organization of the User Interface of the Hardware and Software Computer System Equant Cloud
Authors:   G.E. Pukhov Institute for Modelling in Energy Engineering  National Academy of Sciences of Ukraine, Evdokimov V.A.
Published: May 2023

The question of the functional organization of the interfaces of end-user interaction with the «Equant Cloud» computer system is considered. On the basis of the analysis of the technologi-cal process of its functioning in order to ensure the performance of the functions of preparation, carrying out calculations of activity options on the electric energy market and processing data of calculation results, the main typical operations were formulated, which include: making changes to calculation algorithms; collection and preparation of raw data; conducting calcula-tions of electricity market performance indicators; formation of reporting data with the results of calculations and their presentation in visual form; performance of visual data analysis and mon-itoring of calculation results. Examples of user interfaces are provided.
Resident Communication With Patients and Families Preferring Languages Other Than English
Authors: Rojas Christina R. , Coffin Alyssa , Taylor April , Ortiz Priscilla , Jenicek Gabriela , Hart Jessica , Callahan James M. , Shaw Kathy N.
Published: May 2023

OBJECTIVES

Patients and families preferring languages other than English (LOE) often experience inequitable communication with their health care providers, including the underutilization of professional interpretation. This study had 2 aims: to characterize resident-perceived communication with families preferring LOE and to evaluate the impact of language preference on frequency of resident interactions with hospitalized patients and families.

METHODS

This was a cross-sectional study at a quaternary care children’s hospital. We developed a questionnaire for residents regarding their interactions with patients preferring LOE. We concurrently developed a communication tracking tool to measure the frequency of resident communication events with hospitalized patients. Data were analyzed with logistic and Poisson regression models.

RESULTS

Questionnaire results demonstrated a high level of resident comfort with interpretation, though more than 30% of residents reported “sometimes” or “usually” communicating with families preferring LOE without appropriate interpretation (response rate, 47%). The communication tracking tool was completed by 36 unique residents regarding 151 patients, with a 95% completion rate. Results demonstrated that patients and families preferring LOE were less likely to be present on rounds compared with their counterparts preferring English (adjusted odds ratio, 0.17; 95% confidence interval [CI], 0.07–0.39). Similarly, patients and families preferring LOE were less likely to receive a resident update after rounds (adjusted odds ratio, 0.29; 95% CI, 0.13–0.62) and received fewer resident updates overall (incidence rate ratio, 0.45; 95% CI, 0.30–0.69).

CONCLUSIONS

Hospitalized patients and families preferring LOE experience significant communication-related inequities. Ongoing efforts are needed to promote equitable communication with this population and should consider the unique role of residents.
Does Preterm Status Hinder the Timely Diagnosis of Intestinal Atresia?
Authors: Tolaymat Youness , Irons Raechel , Taylor Janice A. , Rajderkar Dhanashree , Cacho Nicole
Published: May 2023

Intestinal atresia is one of the most common causes of bowel obstruction in newborns. Unfortunately, this diagnosis is often missed or delayed in extremely preterm infants because of complications of prematurity including feeding intolerance and necrotizing enterocolitis. Here we report 2 cases of jejunoileal atresia in extremely preterm infants who were diagnosed beyond 30 days of age. Case 1 had jejunoileal atresia type IIIa, whereas case 2 had type IV jejunoileal atresia complicated by short bowel syndrome. Ideally, intestinal atresia should be diagnosed as early as possible in a patient’s hospital course to attain full enteral feedings earlier and avoid prolonged hospitalization. Planned surgical intervention prior to the development of sepsis or bowel perforation is associated with better outcomes. Ultimately, this report serves as a reminder to physicians that intestinal atresia remains an important differential for infants, including preterm infants, with feeding intolerance in the first days to weeks of age.
Six-Year Follow-up of Childhood Stimulation on Development of Children With and Without Anemia
Authors: Hossain Sheikh Jamal , Tofail Fahmida , Mehrin Syeda Fardina , Hamadani Jena D.
Published: May 2023

BACKGROUND AND OBJECTIVES

Previously, in 30 Bangladeshi villages, 2 groups of children with iron-deficiency anemia (IDA) and nonanemic (NA) iron sufficiency aged 6 to 24 months participated in 2 parallel cluster randomized controlled trials of the effect of psychosocial stimulation on neurodevelopment. The intervention was composed of weekly play sessions at home for 9 months. All children with anemia received iron treatment of 6 months. The intervention improved the mental development of NA but not IDA groups. Six years after end line when the children were aged 8 to 9 years, we aimed to determine if benefits were sustained in the NA group or late-onset benefits emerged in the IDA group.

METHODS

We relocated 372 (90%) of the initial 412 children from all the clusters (villages), and assessed their IQ with the Wechsler Abbreviated Scale of Intelligence-II, motor development, and school achievement including math, spelling, and reading. Analyses were by intention-to-treat, adjusting for clustering.

RESULTS

There was a significant interaction between anemia groups (IDA/NA) and intervention on IQ. The intervention benefitted the NA group’s Full-Scale IQ (effect size, 0.43 [95% confidence interval, 0.08–0.79]) and Perceptual Reasoning Index (effect size, 0.48 [95% confidence interval, 0.08–0.89]) but did not affect the IDA group’s outcomes. No other outcomes were significant.

CONCLUSIONS

The benefits from early childhood psychosocial stimulation on the NA group’s IQ, 6 years after intervention ended, adds to the limited evidence on the sustainability of benefits in low- and middle-income countries. Reasons for lack of effect in children with anemia are unknown.
A Remote Parenting Program and Parent and Staff Perspectives: A Randomized Trial
Authors: Smith Joanne A. , Chang Susan M. , Brentani Alexandra , Fink Günther , Lopez-Boo Florencia , Torino Belen Michel , Codina Marta Rubio , Walker Susan P.
Published: May 2023

OBJECTIVES

To assess impact and implementation of remote delivery of a parenting program following suspension of in-person visits during the coronavirus disease 2019 pandemic.

METHODS

Impact of remote delivery of the Reach Up parenting program on parenting practices was evaluated by randomized trial in Jamaica. Mothers with children aged 5 to 24 months who met 1 of 7 at-risk criteria were enrolled at health centers. Participants were randomly assigned to intervention or control using random number tables generated by a statistician. Intervention comprised a manual for parents with illustrated play activities, phone calls, and short message service messages. The control group received usual care. Parent practices were measured using an adapted Family Care Indicators telephone-administered questionnaire by interviewers unaware of group assignment. Qualitative interviews were conducted with staff and parents in Jamaica and Brazil and staff in Ecuador to identify facilitators and barriers to remote delivery of Reach Up.

RESULTS

Two hundred forty-seven participants were assessed at endline (control n = 130; intervention n = 117). Intervention increased parent activities that support child development, effect size 0.34 SD (95% confidence interval 0.03–0.53), and use of praise, odds 2 times higher with intervention. There were no benefits to interactive language or play materials. Qualitative results showed parents appreciated program continuation and felt motivated to help their child, and methods were acceptable to staff. Barriers included poor mobile phone access, difficulty contacting parents, and feedback limitations without in-person contact.

CONCLUSIONS

Remote delivery methods have potential to contribute to scaling of parenting programs.
Adapting Reach Up and Learn in Crisis and Conflict Settings: An Exploratory Multiple Case Study
Authors: Wilton Katelin Swing , Murphy Katie Maeve , Mahmud Ahsan , Azam Syful , Habib Anika , Ibrahim Iman , Della Neve Eloisa , Pena Gabriela , Mehrin Syeda Fardina , Shiraji Shamima , Hamadani Jena Derakhshani
Published: May 2023

OBJECTIVES

In 2019, >71 million children aged <5 had spent their entire lives in conflict-affected settings. Compounding adversities including violence, poverty, and displacement have immediate and long-term effects on early childhood development, health, behavior, and well-being. In response, adaptations of Reach Up have been implemented in conflict and crisis settings.

METHODS

This article uses exploratory multiple case study methodology, drawing from implementation and qualitative data from 3 interventions: a mobile phone-based intervention promoting nurturing care among Rohingya and crisis-affected host communities in Bangladesh; Reach Up amid acute violence and displacement in Northeast Syria; and Reach Up group sessions and home visits integrated with health services for an indigenous population in Venezuela.

RESULTS

In Bangladesh, tailoring interactive voice response messages improved responsiveness to the developmental needs of young children, yet complementary in-person services were identified as a key program enhancement. In Syria, rapid adaptations of Reach Up addressed the needs of families in acute crisis, including social–emotional learning games for school-aged children. In Venezuela, Reach Up, coupled with complementary lactation counseling, yielded high rates of uptake and satisfaction, and children’s language development was highlighted as a key area of growth.

CONCLUSIONS

Recommendations to promote early childhood development in crisis and conflict settings include: (1) cultural adaptation based on a holistic understanding of children and caregivers’ needs; (2) the integration of child and family safety and linkages with complementary services on the basis of community needs and priorities, and (3) the importance of designing for scale through blended models and costing analyses.
Integrated Early Childhood Development in Cambodia: Protocol of a Cluster Stepped-Wedge Trial
Authors: King Katherine Merseth , Yeng Seng , Brennan Claire , Creel Darryl , Ames John W. , Cotes Gwyneth , Bann Carla M. , Black Maureen M.
Published: May 2023

OBJECTIVES

Limited evidence is available on mechanisms linking integrated, multisector interventions with early childhood development. The Integrated Early Childhood Development program aims to improve children’s development by promoting targeted caregiving behaviors beginning prenatally through age 5 years, in partnership with the Royal Government of Cambodia.

METHODS

This cluster stepped-wedge trial is being conducted in Cambodia among 3 cohorts, encompassing 339 villages and 1790 caregivers who are pregnant or caring for a child aged <5 years. The 12- to 15-month intervention is delivered to each cohort using a staggered stepped-wedge design. Among all cohorts, enrollment evaluations will be followed by 3 data collection waves. Targeted caregiving interventions are provided through community, group, and home-visiting platforms. Child development is measured using the Caregiver Reported Early Development Instrument and the Early Childhood Development Index 2030. The evaluation assesses mediation through targeted caregiving behaviors: responsive caregiving, nutrition, health and hygiene, and household stability and support; moderation by household wealth, caregiver education, and child birth weight; and sustainability after the intervention concludes.

CONCLUSIONS

This protocol article describes the plans for a cluster randomized controlled trial to measure the impact of an integrated, multisector intervention on children’s development. By partnering with the Royal Government of Cambodia and addressing intervention pathways and moderators, this trial will provide guidance for policies and programs to promote early childhood development using principles of implementation science and equity, including increased investment for vulnerable families.
ADVANCING AND SETTING BACK THE GUARANTEE OF THE RIGHT TO BASIC EDUCATION IN BRAZIL
Authors: ANDRADE EDSON FRANCISCO DE
Published: May 2023

ABSTRACT: This article analyzes the effects of the changes led by the Law of Guidelines and Bases of National Education (LDBEN/1996) during its effectiveness. Initially, we address the relationship between the formal requirement of schooling and the idea of promoting educational equality in the country. Then, with methodological support of Content Analysis, we specifically focus on the devices that modified Title V of LDBEN/1996, related to the levels and modalities of education and teaching, seeking to capture possible repercussions from the perspective of coping or reproducing children’s educational inequalities. In the conclusions, we highlight the LDBEN provisions favorable to the march for the guarantee of the right to basic education, as well as those that represent an evident setback to this claim. Faced with this reality, we defend the discernment about what is effectively inferred from the law, in order to mobilize its progressive contributions in the fight for public education in the current context of the country.
PLANEJAMENTO DE PRÁTICAS PEDAGÓGICAS INTEGRADORAS PARA A EDUCAÇÃO PROFISSIONAL E TECNOLÓGICA
Authors: SOUSA JAILTON RODRIGUES DE , MACIEL EMANOELA MOREIRA
Published: May 2023

RESUMO: Pensar a educação e seus processos não é tarefa simples, frente à grande quantidade de recursos envolvidos e, sobretudo, à complexidade do ser humano. Do universo de variáveis que compõem o processo educativo, o presente texto tem como objetivo discutir aspectos pertinentes ao planejamento e à organização das práticas pedagógicas na Educação Profissional e Tecnológica (EPT), tomando como referência a perspectiva integradora e a formação omnilateral dos sujeitos. O percurso metodológico foi composto de um levantamento bibliográfico sobre o tema, uma pesquisa de campo, com docentes que atuam na EPT, e pela análise e discussão dos dados coletados, à luz da teoria previamente levantada, seguindo a técnica de análise de conteúdo de Bardin (1977). Em tese, no planejamento de práticas pedagógicas integradoras, é essencial que sejam contemplados os seguintes elementos: atuação docente de forma colaborativa e participativa, envolvendo os demais atores do processo educativo; vinculação das práticas pedagógicas, preferencialmente de modo contextualizado, à realidade de vida dos sujeitos aprendentes; superação da disciplinaridade; consideração dos aspectos conjunturais e materiais da escola e dos estudantes. Os resultados da análise dos dados indicam que as práticas pedagógicas planejadas pelos docentes entrevistados contemplam a contextualização e a conjuntura de onde são executadas, os recursos didáticos necessários, a relação entre a disciplina e a proposta formativa do curso. Porém, constatou-se que é preciso ampliar a percepção docente sobre o processo formativo, descentralizar o planejamento das práticas pedagógicas, avançar na superação da disciplinaridade e ampliar a finalidade da formação dos sujeitos para além da preparação profissional.
As epistemes políticas da Covid-19: construções e referentes
Authors: Penaforte Thais
Published: May 2023

RESUMO No Brasil, a realidade da Covid-19 foi construída de maneira diversa e multiperspectiva. Dados, princípios científicos, experiências individuais e coletivas buscaram forjar ‘a verdade’ dessa doença. No parlamento brasileiro, as propostas legislativas para enfrentamento da Covid-19 foram dirigidas pela Comissão Externa de Enfrentamento à Covid-19. Assim, este artigo busca analisar a arena narrativa que compôs a realidade política da Covid-19, identificando quais as condições que fizeram com que ideias e argumentações se tornassem deliberações políticas. Empiricamente delineado pelo Narrative Policy Framework, adotaram-se como unidade de análise os discursos e as tramas que compuseram a construção de uma ‘certeza’ ante o risco e a letalidade da Covid-19. A arquitetura dessa doença revelou ascensões políticas e manobras que transformaram a Comissão em uma plataforma de exposição de realidades, com base em cenários e expectativas particulares. Uma engenharia narrativa que resultou no aumento da opacidade dos procedimentos para enfrentamento da pandemia e embaraçamento das linhas de responsabilidade. Assim, as disputas narrativas implicadas na definição da Covid-19, no âmbito parlamentar, indicaram que a estabilização de seu estatuto foi fomentada por uma relação dialética entre determinado conjunto de ideias e sua modelagem da realidade.
Pandemia da Covid-19: variação no uso de internações hospitalares nos municípios g100
Authors: Carvalho Carolina de Campos , Martins Mônica , Viacava Francisco , Peixoto Caio de Paula , Romão Anselmo Rocha , Oliveira Ricardo Antunes Dantas de
Published: May 2023

RESUMO Este estudo objetivou analisar comparativamente o volume e os fluxos para internações hospitalares antes e durante o primeiro ano da pandemia da Covid-19 nos 112 municípios g100. Esses municípios caracterizam-se por ter mais de 80 mil habitantes, baixa renda e alta vulnerabilidade socioeconômica. Foram utilizados dados do Sistema de Informações Hospitalares do Sistema Único de Saúde referentes ao período 2017-2020. Selecionaram-se as internações de adultos (idade ≥ 18 anos), que foram classificadas segundo tipo de admissão ou especialidade do tratamento nas seguintes categorias: eletivas ou urgência/ emergência; tratamento clínico, cirúrgico, obstétrico e oncológico. As internações eletivas apresentaram maior redução no volume em 2020 em relação ao ano anterior devido às medidas adotadas para minimizar os riscos de contágio e priorização do cuidado aos pacientes grave por Covid-19. Não foram observadas alterações significativas em relação ao local de realização das internações de residentes de municípios g100. Contudo, no g100, observou-se diferenciação entre localidades nas quais a regionalização em saúde funciona de forma mais adequada, e em outras onde há escassez de recursos ou necessidade de planejamento e gestão mais efetivos.
Resiliência em saúde pública: preceitos, conceitos, desafios e perspectivas
Authors: Jatobá Alessandro , Carvalho Paulo Victor Rodrigues de
Published: May 2023

RESUMO Em sistemas de saúde, a resiliência se manifesta na capacidade de se adaptar às demandas ou aos eventos adversos e disruptivos, como epidemias e/ou desastres, ajustando o seu funcionamento a situações de estresse, antes, durante ou depois dessas perturbações excepcionais, enquanto mantém o funcionamento e a qualidade da assistência, preservando, assim, as suas atividades e propriedades regulares. Neste ensaio, apresentam-se alguns conceitos sobre a resiliência em sistemas complexos e exemplos de suas aplicações em sistemas e organizações de saúde, envolvendo a resiliência dos indivíduos, equipes e organizações. Destacam-se também desafios e perspectivas para o desempenho resiliente do Sistema Único de Saúde (SUS), que ganhou enorme atenção na pandemia da Covid-19. Conclui-se ressaltando a necessidade de mais pesquisas sobre diversos temas envolvendo a resiliência em saúde para fortalecer a capacidade do SUS para enfrentar os desafios cotidianos e futuras crises sanitárias.
Resilience in public health: precepts, concepts, challenges, and perspectives
Authors: Jatobá Alessandro , Carvalho Paulo Victor Rodrigues de
Published: May 2023

ABSTRACT In a health system, resilience is manifested in the ability to adapt to demands or to adverse and disruptive events, such as epidemics and/or disasters, adjusting its functioning to stressful situations, before, during or after these exceptional disturbances, while maintaining the functioning and quality of assistance, thus preserving its regular activities and properties. In this essay, we present some concepts about resilience in complex systems and their applications in health systems and organizations, involving the resilience of individuals, teams, and organizations. Challenges and perspectives for improving the resilient behavior of the Brazilian Unified Health System (SUS) are also highlighted, a topic that has gained enormous attention in the COVID-19 pandemic. We conclude by emphasizing the need for more research on the various topics involving resilience in healthcare to strengthen the capacity of the SUS to cope with both daily challenges and future health crises.