bluuebunny/crossref_metadata_2025 huggingface dataset:
Co-use of Tobacco/Nicotine and Cannabis Among Veterans: A Preliminary Investigation of Prevalence and Associations with Mental Health Outcomes
Authors: Fitzke Reagan , Davis Jordan , Pedersen Eric
Published: April 2021

While tobacco and cannabis use rates remain high in the general U.S. population, veterans from the conflicts in Iraq and Afghanistan (i.e., OEF/OIF veterans) are at particularly high risk of high rates of cannabis and tobacco use. Co-use of tobacco/nicotine and cannabis (i.e., using both substances within a specified period of time or combining the drugs within the same device for use) is of growing prevalence in the United States. Tobacco/nicotine and cannabis use is often associated with poor mental health outcomes such as stress, anxiety, and depression. However, little is understood about the prevalence rates of tobacco/nicotine and cannabis co-use among U.S. veterans as well as associations with mental health symptomology. The current study aimed to investigate types of tobacco/nicotine and cannabis co-use among veterans, as well as associations between co-use and mental health outcomes of stress, depression, anxiety, and posttraumatic stress disorder. Participants (N= 1,548) were recruited through social media websites and completed an online survey as part of a larger study. The majority (80%) endorsed tobacco/nicotine and/or cannabis use in the past 30 days. Descriptive analyses were run to assess prevalence of use within the sample. Mean comparisons were conducted to assess differences in past 30-day frequency of use and for mental health outcomes between co-users and single users of either substance. Among the larger sample, 90% endorsed lifetime use of tobacco/nicotine, 23% endorsed lifetime use of cannabis, and 21% endorsed any lifetime co-use of both substances. These participants also endorsed past 30 day use of tobacco/nicotine (77%), cannabis (10%), and co-use (7%). Among the past 30-day cannabis users, 66% reported also using tobacco/nicotine, while 9% of past 30-day tobacco/nicotine users also reported cannabis use. When comparing cannabis-only users to co-users of cannabis and tobacco/nicotine, anxiety symptoms were reported as significantly higher among co-users. Tobacco/nicotine-only users endorsed higher past 30-day frequency of cigarettes and e-cigarettes compared to co-users; however, co-users endorsed significantly higher levels of stress and symptoms of PTSD, depression, and anxiety compared to tobacco/nicotine-only users. Results suggest that the addition of cannabis use in conjunction with tobacco/nicotine use may be associated with greater mental health symptoms among veterans. Findings have implications for future veteran mental health care and substance use treatment among tobacco/nicotine and cannabis co-users.
The Role of Motives in Understanding the Link Between Personality and Cannabis Misuse
Authors: Tang Karen , Otis Elijah , Loverock Alexandra , Wild Cameron , Yakovenko Igor
Published: April 2021

Background and aim: A robust association exists between substance use and personality, with personality risk factors representing phenotypes of vulnerability to substance misuse. As such, personality risk factors may be valuable constructs for understanding specific motivations for substance misuse. Given the loosening of restrictions on cannabis worldwide, research focusing on understanding cannabis use in young adults, a particularly at-risk population, remains a vital area of research. The existing data provides extensive support for the mediating role of coping motives on personality risk factors and problematic cannabis use; however, the role of other types of motives has remained largely unexplored. Our study examined the mediating role of cannabis use motives between personality and cannabis misuse among university students. We also explored the predictive value of personality phenotypes for cannabis use problems. Research question and hypothesis: Do motivations for cannabis use mediate or explain the relationship between personality type and cannabis use problem severity? Hypothesis 1: sensation-seeking (SS) and impulsivity (IMP), but not anxiety sensitivity and hopelessness, will be associated with greater cannabis use problem severity. Hypothesis 2: motives for use (i.e., coping, conformity, social, enhancement, expansion) will mediate the association between personality risk and cannabis use problem severity. Method: A survey was administered to 1073 undergraduate students. We examined whether motivations for use (mediator variable) explained the relationship between personality (predictor variable) and cannabis use disorder severity (outcome variable) using an ordinary least-squares (OLS) based mediation analysis. Results: As hypothesized, SS and IMP predicted greater cannabis use problems. A noteworthy finding was that conformity motives were a significant mediator between SS and IMP and cannabis use, whereby higher levels of SS/IMP led to greater endorsement of conformity motives, which in turn led to lower cannabis misuse. Enhancement motives were also a significant mediator between IMP and cannabis use. Expansion motives were a significant mediator between SS and cannabis use. Conclusion: Understanding reasons for use (i.e., motives) allows us to identify those at greatest risk for cannabis misuse. Findings from this study may help explain the underlying mechanisms by which personality risk factors lead to cannabis use disorder in young adults. A greater understanding of these personality phenotypes may have implications for the development of personality-specific interventions for cannabis use.
Risk and Protective Factors Associated with Cannabis Use in Massachusetts Youth
Authors: Johnson Julie , Doonan Samantha
Published: April 2021

Cannabis policies are continuously evolving, over half of U.S. youth now live in a state with a form of legalized cannabis. Monitoring risk and protective factors is critical to ensure evidence-based youth prevention in this post cannabis-prohibition era. Massachusetts has enacted and implemented three forms of legalization: (1) Decriminalization (2008), (2) medical cannabis (2012), and (3) adult-use cannabis (2016). This study used state Youth Risk Behavior Survey (YRBS) data of participants in grades 9-12 from 2007-2017 (N=17,691). Logistical regression models were run to assess effects of varying cannabis policy and risk or protective behaviors on cannabis use outcomes: (1) Lifetime use; (2) Past 30-day; and (3) Past 30-day heavy use. The enactment of cannabis policies was not associated with greater odds of youth reporting Lifetime and Past 30-day cannabis use behaviors. Any adult-support [heavy use OR=0.43 (95% CI=0.37,0.50), p<.001], better grades [heavy use OR=0.25 (95% CI=0.21,0.29), p<.001], and being heterosexual [heavy use OR=0.42 (95% CI=0.34,0.51), p<.001] were associated with lower odds of all cannabis use outcomes. Multiple risk factors broadly categorized under: risky sexual behaviors, non-heterosexual orientation, weapon carrying/exposure, hopelessness and suicidality behaviors, driving behaviors, and disability were associated with greater odds of cannabis use. Sensitivity analyses showed only one risk behavior was moderate by cannabis policy enactment. Results suggest that cannabis prevention efforts should not occur in a silo, rather evidence-based models for reducing risky behaviors generally may have the largest impact. Building and supporting relationships with trusted adults for youth at higher risk should be emphasized.
Validation of the Spanish Version of the Marijuana Consequences Questionnaire (S-MACQ)
Authors: Pilatti Angelina , Bravo Adrian , Michelini Yanina , Rivarola Montejano Gabriela , Pautassi Ricardo
Published: April 2021

Background: The Marijuana Consequences Questionnaire [MACQ] assesses marijuana-related problems. This 8-factor (50-items) measure covers a broad array of multiple dimensions encompassing 50 negative consequences of gradient severity that are particularly relevant in the context of college. The present study aimed to validate the Spanish version of the 50-item Marijuana Consequences Questionnaire (S-MACQ) by analyzing the psychometric properties of internal, convergent, and concurrent validity and estimating internal consistency. We also examined the correlation between the brief (SB-MACQ) and the full S-MACQ and whether they similarly correlate with marijuana outcomes and marijuana-related variables. Method: College students from the two largest public universities of Cordoba city (Argentina) completed an online survey as part of a broader study focused on marijuana use and risky sexual behaviors. Only data from students that reported last-year marijuana use (n=470; 70.6% women; Mean age 22.67±3.52 years; 45.7% enrolled in psychology) were included in the study. We conducted independent samples t-tests to evaluate differences in the number of negative consequences (for the total scale and for each S-MACQ dimension) as a function of biological sex or frequency of use. Confirmatory factor analyses (CFA) was conducted to examine the factor structure of the S-MACQ. We conducted Pearson correlation analyses to examine the association between the number of marijuana-related consequences as measured by the S-MACQ and scores (a) in the CUDIT, a standardized measure of marijuana-related problems (i.e., convergent validity), (b) frequency and quantity of marijuana use (i.e., concurrent validity), (c) motives for marijuana use (i.e., concurrent validity). We examined the Pearson correlation between the SB-MACQ and the S-MACQ and then we estimated the difference between the Pearson correlation of the SB-MACQ and the S-MACQ with all the marijuana outcomes and marijuana-related variables. Results: Results from the CFA supported an 8-factor structure. The scores of the S-MACQ showed appropriate internal, concurrent and convergent validity, alongside with adequate internal consistency. The S-MACQ was largely correlated with the SB-MACQ and the correlations between these two versions and marijuana outcomes/marijuana-related variables did not significantly differ. Discussion: Findings supported the S-MACQ as a valid measure to assess marijuana-related problems in Spanish-speaking students. The instrument can be used to identify a broad diversity of marijuana problems in this population.
Average Intoxication as a Proxy for Cannabis Use
Authors: Altman Brianna , Mian Maha , Ueno Luna , Earleywine Mitch
Published: April 2021

Assessing cannabis use is challenging due to the lack of standardized doses, differing potencies among products, and the potential for sharing with others. Although legalization of cannabis might give users a better sense of the quantity purchased and THC/CBD composition of products, issues in assessment and measurement can still preclude researchers from understanding use patterns. Given these challenges, the present work examines whether an individual’s average level of intoxication after cannabis consumption might serve as a better proxy for cannabis use than quantity of use. Data was aggregated from several studies related to cannabis use and health behaviors and collapsed across common variables (N = 2,659, Mean age = 34.08, 61.9% Male, 84.8% Caucasian). Our sample reported using cannabis either six or seven days per week, consuming approximately 1.12 ounces of cannabis per month (SD = .35 ounces), attaining an average intoxication of 3.49 on a scale from 0 (“Not at all”) to 6 (“Extremely high;” SD = 1.21), and experiencing a mild amount of cannabis-induced impairment as measured by the Cannabis-Associated Problems Questionnaire (CAPQ; M = 8.21, SD = 9.08). In this sample of frequent users, average intoxication levels were significantly related to cannabis problems (r = .153, p < .001) while quantity per month appeared to be unrelated (r = .005, p = .798). Using Meng’s (1992) procedure for comparing correlated correlation coefficients, these relations were found to significantly differ from each other (Z = - 5.53, p < .001). Our results provide preliminary evidence supporting cannabis-induced intoxication as a better proxy for cannabis use than quantity consumed. Individuals might more accurately remember their experiences of being high as opposed to recalling how much they consumed over a month’s span. Future work should continue to examine relations between intoxication and other indices of cannabis use to confirm and extend our findings.
Cannabis Outcome Expectancies, Cannabis Use Motives, and Cannabis Use among a Small Sample of Frequent Using Adults
Authors: Anthenien Amber , Prince Mark , Wallace Gemma , Jenzer Tiffany , Neighbors Clayton
Published: April 2021

Background: Little is known about the factors influencing use among frequent cannabis users, defined here as using at least three times per week. Outcome expectancies and motives for cannabis use have been independently examined in relation to cannabis use, but not among frequent users. Further, the associations among distinct expectancies and motives for cannabis use have yet to be explored. The current study examined whether expectancies influence cannabis use through cannabis use motives among frequent users. Additionally, we examined more nuanced relationships among three cannabis outcome expectancies (relaxation/tension reduction, social, perceptual/cognitive) and four motives (enhancement, social, coping, expansion). Method: Bayesian path analysis with informative priors was used to examine associations among expectancies, motives, and outcomes in a sample of 54 (63% male) young adult frequent users (i.e., at least three times per week; 65% used daily). Participants were recruited from the community and completed self-report questionnaires assessing cannabis use, expectancies, and motives. Results: Findings support hypotheses that cannabis use expectancies were associated with unique motives for frequent cannabis users. Perceptual/cognitive enhancement expectancies were the only expectancy to consistently relate to all four cannabis use motives. Social expectancies were related to enhancement, social, and expansion motives for use, and relaxation/tension reduction expectancies were associated with coping motives. Conclusions: Results extend previous work examining direct and indirect effects of expectancies and motives among frequent using young adults. Findings support the potential clinical utility of exploring the perceived functional benefits of cannabis use for individual frequent users as well as potential alternatives that might serve similar functions with fewer risks and consequences.
Референция официального текста
Authors: Фролова Ольга Евгеньевна
Published: April 2021

В статье рассматривается референция официального текста на примере указов мэра Москвы за период март-июнь 2020 г. Были рассмотрены логико-семантический и прагматический аспекты референции. Конкретно-референтные именные группы в текстах называют участников ситуации, организующих помощь населению и отвечающих за это. Конкретно-референтны также именные группы, называющие локусы заражения. Именные группы, называющие адресата помощи, не относятся к конкретным объектам внеязыковой действительности. Анализ текста с помощью программы Istio.com позволяет определить частотность лексики, а это показывает степень значимости участника ситуации для говорящего.

Так в тексте, составленном из указов мэра Москвы за период с марта по июнь 2020 г., в фокусе внимания адресанта оказывается имя существительное гражданин, что свидетельствует о направленности текста и важности для говорящего данного участника ситуации.
Elegia (?) dla kanonu: [Rec.:] Harold Bloom, „Zachodni kanon. Książki i szkoła wieków”. Przeł. Bohdan Baran i Michał Szczubiałka (Warszawa: Wydawnictwo Aletheia, 2019, ss. 643)
Authors: Dąbrowska Magdalena
Published: April 2021

Artykuł zawiera omówienie książki Harolda Blooma Zachodni kanon. Książki i szkoła wieków (1994), wydanej w przekładzie polskim Bohdana Barana i Michała Szczubiałka w 2019 roku (Wydawnictwo Aletheia, 643 ss.). Książka zostaje przedstawiona w kontekście wcześniejszych teorii Blooma z zakresu komparatystyki literackiej, zawiera podstawowe informacje o ich znajomości przez polskich czytelników (Lęk przed wpływem… i in.). W artykule zostaje omówiona struktura książki: część pierwsza i ostatnia mieszczą rozważania teoretyczne na temat kanonu literackiego zatytułowane Elegia dla kanonu i Elegijna konkluzja, część środkową stanowi omówienie 26 pisarzy światowych, uznawanych przez Blooma za reprezentujących ścisły kanon literacki; książka jest zaopatrzona w aneks zawierający spis nazwisk pisarzy z „pełnego” kanonu literackiego z podziałem na epoki i kraje (Epoka teokratyczna, Epoka arystokratyczna, Epoka demokratyczna, Epoka chaotyczna: Proroctwo kanoniczności). W centrum kanonu Bloom umieszcza Williama Szekspira. Literaturę rosyjską w „ścisłym” kanonie reprezentuje Lew Tołstoj. Bloom ocenia pisarzy z punktu widzenia uniwersalności wymowy ich dzieł oraz stopnia oryginalności, której miarą jest inność i nowatorstwo w porównaniu z poprzednikami.
Рецензия на сборник очерков Войцеха Кайтоха „Osiem szkiców o dziełach kultury popopularnej. Dawnych i współczesnych” (Kraków 2019) [Восемь очерков о произведениях популярной культуры прошлого и настоящего (Краков 2019)
Authors: Бабоша Иван
Published: April 2021

В рецензии представлен обзор сборника очерков Войцеха Кайтоха, известного польского филолога, о различных явлениях популярной культуры. На примерах фантастических рассказов С. Лема, А. Стругацкого и А.К. Толстого, детективной литературы, современных киноадаптаций Шекспира, вольтеровского «Кандида», а также российских сериалов автор демонстрирует, что развлекательные произведения в действительности могут затрагивать весьма серьезную проблематику.
Determination of residual dimethylaminopropylamine in aminopropylamides of fatty acid using high-performance liquid chromatography
Authors: Krasnikov D. A. , Demchak I. V. , Khudoleeva E. S.
Published: April 2021

A procedure for determination of the residual content of N,N-dimethyl-1,3-propanediamine (DMAPA) during synthesis of N,N-dimethylaminopropylamides of fatty acids (DMAPA FA) from coconut oil has been developed. The analysis was performed using high performance liquid chromatography on a Shimadzu LC-20 Prominence device equipped with a diode array detector and reversed phase column GL Sciences Inertsil ODS-3. Precolumn derivatization was carried out with a 13% — dansyl chloride (5-(dimethylamino)naphthalene-1-sulfonyl chloride) solution in acetone to increase the analyte response. The selected composition of the mobile phase — acetonitrile and triethylamine phosphate buffer solution (pH 3.0) in a volume ratio of 2:3 and optimized chromatographic conditions provided a clear peak of DMAPA with a retention time of 8.7 – 8.9 min. The proposed method provides determination of 0.02 – 10% DMAPA in DMAPAFA samples. Correctness of the procedure was confirmed in spike tests. The results obtained can be used for assessing the degree of conversion of starting materials in the synthesis of N,N-dimethylaminopropylamides of fatty acids, as well as for forecasting the content of N,N-dimethyl-1,3-propanediamine in the products on their base.
Child poverty in the United States from the perspective of conflict theory
Authors:   1Department of Center for Social Work Education, School of Health and Human Services, Widener University, Chester, PA, USA,2Department of Social Work, University of Tripoli, Tripoli, Libya
Published: April 2021

This article analyzes social problems linked to child poverty in the United States from the perspective of social conflict theory. Specifically, this article depicts the poverty meas-urements used to evaluate poverty issues in the United States. It also describes the United States’ efforts to reform social welfare policies to decrease child poverty. This article aims to educate social work students about factors directly connected to child poverty, such as unemployment, low wages, family structure, education, and immigrants. In doing so, this article uses social theories such as social conflict theory to understand what aspects of American culture are linked to the persistence of child poverty. Finally, this article dis-cusses the long-term plans and massive efforts required to reduce the causes of poverty.
JUSTICE: THE DIALECTIC UNITY OF COMEDY AND TRAGEDY
Authors: GÜNSOY Funda
Published: April 2021

﻿Modern culture is organized by the idea of rationalization which extinguishes the feeling of the tragic life that represent not only tragedy as a literary genre or an aesthetical category, but also the insolubility of conflict between the good ones, the contradiction and conflict in regard to the essence of life, the unexplainable arbitrariness of factual circumstances, devastating potential of passions. This very fact shows that tragedy cannot be seen solely as a means of entertainment or a literary genre. If tragedy as an aesthetical category is the artistic expression of tragic experience, it can only be understood in a cultural context that underlies experience. Tragedies are the ethos of human existence. Indeed, ancient tragic dramas are based on the metaphysical suppostion that conflict, contradiction, arbitrariness and uncertainity is implict to both the structue of human beings and to the whole universe
OSMANLI İŞÇİ TARİHİNE BİR BAKIŞ: THE ORIENTAL CARPET MANUFACTURERS LIMITED’İN [ŞARK HALI KUMPANYASI] ÜRETİM ORGANİZASYONU, İŞÇİLERİ VE ÜCRET POLİTİKASI [1908 – 1914]
Authors: YILMAZ Emrah
Published: April 2021

Bu araştırma, 16 Aralık 1907 tarihinde Londra’da kurulup tüzel bir kişilik kazanan The Oriental Carpet Manufacturers Limited [OCM] veya diğer bir ismiyle Şark Halı Kumpanyası’nın 20. yüzyılın başında kuruluşuna giden süreci ve şirketin kuruluşuyla beraber Anadolu coğrafyasında 1908 yılından itibaren uyguladığı eve iş verme sistemini [putting – out ] ne şekilde organize ettiğini açıklamayı amaçlamaktadır. Araştırmamız ayrıca şirketin eve iş verme sistemi dâhilinde yürüttüğü halı üretim faaliyetleri sonucu Anadolu coğrafyasında istihdam ettiği, ettirdiği halı dokuma işçilerinin sayısını tespit edip, uygulanan ücret politikasını ve halı dokuma işçilerinin çalışma koşullarını ele alarak Osmanlı imalat sektörünün önemli üretim alanlarından biri olan halıcılığın Osmanlı işçi tarihindeki önemini incelemektedir. 1908’den 1914 yılına kadar sadece Anadolu coğrafyasında 50 – 60 bin arasında halı dokuma işçisi istihdam edip eve iş verme sistemi sayesinde kayda değer kârlar elde eden OCM, bu yönüyle Osmanlı halıcılığını monopolize etmiş ve I. Dünya Savaşı’nın hemen öncesine kadar halı üretim faaliyetlerini devam ettirerek aynı zamanda Anadolu - Osmanlı halılarının en önemli ihracatçılarından biri olmuştur.
THOMAS HOBBES’DA EŞİTLİK, ÖZGÜRLÜK VE GÜVENLİK SORUNU: DOĞA YASASI TEMELİNDE BİR DEĞERLENDİRME
Authors: GEÇİT Bekir
Published: April 2021

Bu makale Hobbes’un doğa durumunda ve sivil durum insanların eşitlik, özgürlük ve güvenlik problemlerine ilişkin düşünceleri hakkındadır. Yapılan değerlendirmeler, Hobbes’un doğa yasası düşüncesi temelinde yapılmıştır. Doğa yasası, akılla bulunan, insanlar için zararlı şeyleri yasaklayan ve insan hayatını korumayı amaçlayan ilkelerdir. Doğa durumunda herkes eşittir ve herkesin her şey üzerinde eşit hakkı vardır. Bu, insanlar arasında güvensizlik ve dolayısıyla savaşa neden olur. Ayrıca, doğa durumunda insanları doğa yasasına vicdanları dışında uymaya zorlayacak bir güç yoktur. İnsanlar, kendileri için değerli gördükleri hayatlarını, ailelerini ve mülkiyetlerini korumak ve bunlara gerçek anlamda sahip olmak isterler. Dolayısıyla, insanlar doğa durumundaki haklarını bir egemene devrederek devleti kurmuşlardır. Böylece cehalet, barbarlık ve yoksulluğun kol gezdiği doğa durumunun kötülüklerini terk eden insan, devleti kurarak yasaların kendilerine tanıdığı hak ve özgürlükler sayesinde barış ve refaha kavuşmuşlardır.
HÜSEYİN CAHİT YALÇIN’IN 1946 TARİHLİ RAPORU VE BASIN TARİHİMİZDEKİ ÖNEMİ
Authors: KILIÇ Neslihan
Published: April 2021

Türkiye’de yaklaşık 200 yıllık bir geçmişi bulunan basının, kurumsal bir yapı kazanması Cumhuriyet sonrası dönemdedir. 25 Temmuz 1931 tarih ve 1881 sayılı Basın Kanunu ile basının kurumsal bir statü kazanmasında ilk önemli adım atılmıştır. 1923’ten 1950’ye kadar süren tek parti iktidarında basın-iktidar ilişkileri mevcut kanun üzerinden yürütülmüş ancak II. Dünya Savaşı sonrası değişen dünya konjonktürü ve Türkiye’nin Batı bloğunda yer alma çabaları, mevcut hükümetin demokratikleşme yolunda adımlar atmasını zorunlu kılmıştır. Bu çerçevede basın sahasında da çeşitli düzenlemelerin yapılması gündeme gelmiş ve dönemin hükümeti Hüseyin Cahit Yalçın’ı incelemeler yapmak üzere Avrupa’ya göndermiştir. Basın Birliği Başkanı Hüseyin Cahit İngiltere, Fransa, Yunanistan, İtalya ve Danimarka’da çeşitli gözlem ve incelemelerde bulunarak bir rapor hazırlamıştır. Bu çalışmada Hüseyin Cahit Yalçın’ın 1946 tarihli raporu merkeze alınarak raporun 1946 ve sonraki yıllarda yapılan basınla ilgili düzenlemelere etkileri üzerinde durulmuştur. Çalışmanın sonunda basın rejimimizin demokratikleşmesi yolunda dikkate değer adımların atıldığı 1946 ve 1950 tarihli düzenlemelerde, Hüseyin Cahit’in 1946 tarihli raporunun da önemli izlerinin bulunduğunu ifade etmek mümkündür.
Alcances del turismo sostenible: un análisis cualitativo de las experiencias de dos comunidades en Ecuador
Authors: Barros Pinto Freddy Alejandro
Published: April 2021

El presente estudio realizó un análisis cualitativo sobre el alcance del turismo sostenible generado por la ayuda técnica y financiera de la cooperación internacional y de organizaciones no gubernamentales (ONG) con sus proyectos en dos comunidades rurales en el Ecuador: la comunidad de Yunguilla y la comunidad de Oyacachi. Se efectuó una recopilación documental y un análisis del contenido sobre los informes técnicos de ejecución, con el fin de presentar las experiencias obtenidas a través de la adopción de la actividad turística sostenible en los territorios beneficiarios de estos proyectos. Se codificaron los datos precisos de los textos estudiados para realizar un análisis sistemático e interpretativo y exponer la narrativa sobre el alcance del turismo sostenible como una guía para el desarrollo en las comunidades objeto de esta investigación. Se concluye que la asistencia técnica y económica pueden ser las dos caras de la moneda del camino a la sostenibilidad.
«Solo cante barbare, eredità dell’altra guerra»
Canti alpini e resistenziali nei Piccoli maestri di Luigi Meneghello
Authors: Demuru Cecilia
Published: April 2021

The aim of this paper is to highlight the quotations and allusions to World War I and Resistance songs in I piccoli maestri, the second novel by Luigi Meneghello published in 1964.
The United States Medical Licensing Examination: Part One
Authors: Johnson David
Published: April 2021

The United States Medical Licensing Examination (USMLE), co-sponsored and co-owned by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), was implemented in 1992–94 as the successor of the NBME certifying examinations (Parts I, II and III) and the Federation Licensing Examination (FLEX). It is a three-step examination for medical licensure in the United States. The USMLE assesses a physician’s ability to apply knowledge, concepts and principles, and to demonstrate fundamental patient-centered skills important in health and disease and constitute the basis of safe and effective patient care. Results of the USMLE are reported to medical licensing authorities in the United States for their use in granting the initial license to practice medicine.

This article is the first in a series focusing on the USMLE program. The following article provides a broad overview of the USMLE program along with a brief description of the USMLE content, characteristics of test administration, and information on the scoring of the exam. Subsequent articles will focus on development of examination content, quality assurance mechanisms, standard setting and such administrative issues as test accommodations and irregular behavior. The intent of this series is to provide the reader with short, topical articles that collectively provide a better understanding of the nature, role and function of the USMLE in assisting medical licensing authorities in the United States.
Digitized Maternal Early Warning and Response Telehealth System
Authors: Kuppuswami Narmadha , Subramanian Suresh , Groff Karenna J. , Ravichandran Radha Rani
Published: April 2021

Introduction: In this article, we describe a pilot telehealth project for identifying women at risk of developing serious complications early and for instituting timely, appropriate, and up-to-date management even in situations with limited resources and skilled obstetric services. Maternal mortality remains unacceptably high, with less than two-thirds of the signatories to the 2015 Millennium Development Goals achieving the outlined 75% reduction in maternal mortality ratio (MMR) from 1990 to 2015. Looking forward to 2030, the Sustainable Development Goals (SDGs) lay out a target of reducing the MMR in every country to below 70 per 100,000 live births. This will require progress in low-and-middle-income countries at a rate much greater than that seen over the past 15 years. Given that 94% of the global maternal deaths occur in low- and-middle-income countries, a solution to meet the unique challenges of these countries will be necessary to achieve the SDG. The Women’s Obstetrical Neonatal Death and Reduction (WONDER) telehealth system described here offers a potential telehealth solution to reduce mortality and morbidity rates in resource-limited environments by early identification of risk indicators and initiation of care.
Materials and methods: The WONDER system consists of a cloud-based electronic health record with a Clinical Decision Support tool and a color-coded alert system. The Clinical Decision Support tool is based upon Maternal Early Warning Signs and provides real-time assistance to caregivers via relevant national treatment guidelines. This system uses inexpensive computing hardware, displays, and cell-phone technology. This system was tested in a 2-year pilot study in India. A total of 15,184 patients were monitored during labor and the postpartum period.
Results: Within limitations of the study, the incidence of in-hospital eclampsia was reduced by 91.7%, and in 95% of cases, timely treatment was started within an hour of identifying the abnormality in vital signs. Maternal mortality was reduced by 50.1% over local benchmark figures.
Conclusions: The WONDER system identified at-risk patients, directed skilled care to those patients at risk for complications, and helped to institute effective, timely treatment, demonstrating a potential solution for women in resource-limited locations.
The Pandemic News Experience: Covid-19, News Consumption, Mental Health, and the Demand for Positive News
Authors: Nguyen An , Smith Amy , Jackson Daniel , Zhao Xin
Published: April 2021

COJO for COVID Recovery is a UKRI/AHRC-funded rapid Covid-19 response research project that addresses the role that constructive journalism (COJO), particularly solution-focused journalism, can play in the pandemic recovery. The research set out in this report details the findings of the project’s initial in-depth interviews and survey with UK news audiences. Four key sets of findings regarding Covid-19 news consumption and experience emerge from this analysis. 1.The high interest in Covid-19 news was associated with the need to monitor and navigate the uncertain evolution of the pandemic as it affected audiences. 2.There was a clear fluctuation that followed “an inverse Bell curve” (up-down-up) pattern of Covid-19 news consumption which was in parallel with the severity of the pandemic and its associated lockdown restrictions. 3.Many of our participants reported switching off from the news or avoiding it for reasons linked to mental and emotional health, including negativity, repetitive reporting and information overload. 4.Participants demanded the media provide more positive news that helps to lift the mood of the public and/or offers ways out of the pandemic.
Semantic variables both help and hinder word production: Behavioural evidence from picture naming
Authors: Lampe Leonie F. , Hameau Solene , Nickels Lyndsey
Published: April 2021

This research investigated how word production is influenced by six feature-based semantic variables (number of semantic features, intercorrelational density, number of near semantic neighbours, semantic similarity, typicality, and distinctiveness). We simultaneously investigated effects of the six semantic variables on spoken picture naming in a large group of participants (n = 87), while controlling for other psycholinguistic variables. Across analyses, number of semantic features was the most consistent predictor with a facilitatory effect on naming latency and accuracy. In addition, inhibitory effects were found on naming accuracy for intercorrelational density and on naming latency for distinctiveness. The facilitatory effect of number of semantic features is suggested to stem from stronger semantic activation with an increasing number of semantic features, which results in facilitated selection of the word’s lexical representation. In contrast, the inhibitory effect of intercorrelational density is most easily accounted for by increased competition at the lexical level. The mechanism underlying the inhibitory effect of distinctiveness is unclear. These findings indicate that future research on factors affecting word retrieval should also control for effects of number of semantic features, intercorrelational density, and distinctiveness. They also suggest that effects of the other semantic variables (e.g., semantic neighbours) reported in the literature were potentially overestimated due to insufficient control of other semantic and/or psycholinguistic variables.
Could Brain-Computer Interface be a new therapeutic approach for Body Integrity Dysphoria?
Authors: Chakraborty Stuti , Saetta Gianluca , Simon Colin , Lenggenhager Bigna , ruddy kathy
Published: April 2021

Patients suffering from Body Integrity Dysphoria (BID) desire to become disabled, arising from a mismatch between the desired body and the physical body. We focus here on the most common variant, characterised by the desire for amputation of a healthy limb. In most reported cases amputation of the rejected limb entirely alleviates the distress of the condition and engenders substantial improvement in quality of life. Since BID can lead to life-long suffering, it is essential to identify an effective form of treatment that causes the least amount of alteration to the person’s anatomical structure and functionality. Treatment methods involving medications, psychotherapy and vestibular stimulation have proven largely ineffective. In this hypothesis article, we briefly discuss the characteristics, aetiology, and current treatment options available for BID before highlighting the need for new, theory driven approaches. Drawing on recent findings relating to functional and structural brain correlates of BID, we introduce the idea of Brain Computer Interface (BCI)/neurofeedback approaches to target altered patterns of brain activity, promote re-ownership of the limb and/or attenuate stress and negativity associated with the altered body representation.
Behavioral Contagion on Social Media: Effects of Social Norms, Design Interventions, and Critical Media Literacy on Self-Disclosure
Authors: Masur Philipp K. , DiFranzo Dominic James , Bazarova Natalie
Published: April 2021

Social norms are powerful determinants of human behaviors in offline and online social worlds. While previous research established a correlational link between norm perceptions and self-reported disclosure on social network sites (SNS), questions remain about downstream effects of prevalent behaviors on perceived norms and actual disclosure on SNS. We conducted two preregistered studies using a realistic social media simulation. We further analyzed buffering effects of critical media literacy and privacy nudging. The results demonstrate a disclosure behavior contagion, whereby a critical mass of posts with visual disclosures shifted norm perceptions, which, in turn, affected perceivers’ own visual disclosure behavior. Critical media literacy was negatively related and moderated the effect of norms on visual disclosure behavioral intentions. Neither critical media literacy nor privacy nudge affected actual disclosure behaviors, however. These results provide insights into how behaviors may spread on SNS through triggering changes in perceived social norms and subsequent disclosure behaviors.
The Semantics of Spatial Demonstratives in Spanish: A Demonstrative Choice Task Study
Authors: Todisco Emanuela , Rocca Roberta , Wallentin Mikkel
Published: April 2021

Demonstratives (this/that in English) are pivotal in communication. In this study, we show that semantic features of referents systematically influence speakers’ choices of demonstrative forms for Spanish nouns in the absence of a guiding context. We used the Demonstrative Choice Task (DCT), previously applied to two-term demonstrative languages (Danish, English and Italian), and applied it to Spanish, a three-term demonstrative system (este/ese/aquel), to test if the semantic dimensions driving demonstrative choice overlap with those found for English. 1639 native Spanish speakers were presented with 480 nouns rated along 76 semantic features and were asked to match each noun with a demonstrative. We found that demonstratives are influenced by the same semantic factors as two-term languages, such as manipulability, valence and the self. In Spanish, these semantic factors predict the demonstrative choice between the proximal este/a and a combination of medial and distal forms ese/a and aquel/la. Additional semantic factors affect speakers’ preferences for ese/a versus aquel/a (e.g., visuality and time). We conclude that many of the semantic attractors influencing the choice of demonstratives are constant across languages, independent of the number of terms characterizing the demonstrative system, and provide a window into the landscape of meaning subserving linguistic reference.
Factores de riesgo para morbilidad materna extrema por rotura hepática espontánea en preeclampsia severa
Authors: Valladares Gutiérrez Elías Alexis
Published: April 2021

Introducción. La rotura hepática espontánea es una de las complicaciones más temidas del embarazo, que causa morbilidad materna extrema y muerte y se asocia principalmente con la preeclampsia severa. Objetivo. Determinar los factores de riesgo para rotura hepática espontánea en gestantes con preeclampsia severa. Método. Se realizó un estudio retrospectivo transversal, observacional analítico, de tipo casos y controles, durante el período comprendido entre el 1º de enero de 2006 y el 31 de diciembre de 2018. Treinta y una mujeres con preeclampsia severa que presentaron rotura hepática (casos) fueron comparadas con un grupo de sesenta y dos controles (mujeres con preeclampsia severa que no presentaron rotura hepática), correspondiendo dos controles por caso. Resultados. Los factores estadísticamente significativos para rotura hepática en mujeres con preeclampsia severa fueron el síndrome HELLP (OR = 3,52; IC 95%: 1,58 a 6,39), la eclampsia (OR = 2,23; IC 95%: 1,16 a 5,11) y la edad materna avanzada (OR = 1,96; IC 95%: 1,09 a 4,38) tuvieron asociación estadísticamente significativa para rotura hepática espontánea. Conclusiones. En el presente estudio de gestantes con preeclampsia severa, la edad materna avanzada constituyó factor de riesgo para la rotura hepática espontánea, y el síndrome HELLP y la eclampsia fueron factores asociados.
Fisiopatología de la anemia durante el embarazo: ¿anemia o hemodilución?
Authors: Gonzales Gustavo F. , Olavegoya Paola
Published: April 2021

El hierro es un micronutriente fundamental para la salud; su deficiencia o su exceso son dañinos. Por ello, el organismo regula el requerimiento de hierro en base a su alta capacidad para almacenar y reciclar el hierro corporal de tal manera que su requerimiento es mínimo (1 a 2 mg absorbido/día). Esto se regula a través de la hepcidina, una hormona hepática que inhibe a la proteína transportadora de hierro (ferroportina) y con ello disminuye la absorción de hierro, o su liberación en los tejidos donde se almacenan. Durante la gestación hay una mayor necesidad de hierro para la placenta y el feto, y ello se evidencia en un aumento de la eritropoyesis; sin embargo, la concentración de la hemoglobina disminuye por efecto de una mayor expansión vascular. Esto determina una hemodilución que se evidencia a partir del segundo trimestre, y luego se va normalizando al final del tercer trimestre. La anemia materna por deficiencia de hierro se constituye en un problema de salud pública cuando es de magnitud moderada (7 a 14,5 g/dL) en la gestante afecta a la madre y al neonato. Por ello es importante determinar si una gestante con hemoglobina baja es realmente anémica o tiene una hemodilución, que es un proceso fisiológico que no requiere de tratamiento. Esta revisión presenta las evidencias para poder discriminar entre una anemia verdadera gestacional de una hemodilución fisiológica.
Qué hacer frente a la anemia materna y perinatal
Authors: Urquizo Aréstegui Raúl
Published: April 2021

La Organización Mundial de la Salud señala que la anemia afecta a 1 620 millones de personas en el mundo(1), siendo los más afectados los niños en edad escolar y las mujeres embarazadas. Nuestro país no es ajeno a esta realidad. La anemia sigue siendo un problema de salud pública, sobre todo en los niños menores de 3 años y en las mujeres de edad fértil. Según ENDES 2018, los indicadores de anemia en los niños menores de 36 meses fue 43,5% a nivel nacional, y en ciudades como Puno llegó a 66,7%, en Arequipa, Moquegua a 33,9% y en Lima a 35,5%; 21,1% de las mujeres en edad fértil tienen anemia(2)
Correlación entre el diagnóstico ecográfico prenatal y posnatal en casos de hidronefrosis fetal
Authors: Vilà Famada Anna , Pina Pérez Silvia , Costa Pueyo Jordi , Serra Azuara Laura
Published: April 2021

Introducción. La ecografía prenatal permite detectar una anomalía significativa en 1% de los embarazos; de ellos, 20 a 30% son genitourinarias y 50% de estas son hidronefrosis fetales (HNF). Objetivo. Establecer una correlación entre el grado de hidronefrosis prenatal y posnatal, así como analizar las implicaciones pronósticas. Diseño, pacientes, intervenciones y variables principales. Estudio observacional retrospectivo realizado por la Unidad de Diagnóstico Prenatal del hospital Parc Taulí de Sabadell, que incluyó un total de 177 gestantes con diagnóstico ecográfico de HNF entre enero de 2011 y diciembre de 2016. Se realizó un análisis descriptivo de las variables ecográficas y perinatales más importantes. La principal variable de estudio fue el grado de dilatación de la HNF. Resultados. La prevalencia de HNF fue 1,17%. El 82,8% de los casos fue diagnosticado en la ecografía del 2º trimestre. En 42,9%, la afectación fue bilateral, y en 95,6% la malformación renal fue aislada. La cardiopatía fue la anomalía congénita asociada con más frecuencia (3,3%). De las 93 hidronefrosis de riesgo bajo diagnosticadas en el 2º trimestre, 53,8% se normalizaron en el 3er trimestre, 30,1% permanecieron estables y 16,1% progresaron. De los 32 casos de HNF moderadas-severas diagnosticadas en el 2º trimestre, solo 9,4% se normalizaron en el 3er trimestre. El 46,9% de los neonatos precisó exploraciones complementarias y 14,1% intervención quirúrgica. Conclusiones. Existe buena correlación de la HNF prenatal y posnatal. La HNF leve presenta buen pronóstico, mientras que la moderada-severa suele persistir posnatalmente.
Eficacia del esquema FIGO para el manejo médico del aborto en el primer trimestre
Authors: Sepúlveda Rivera Cintia María , Miranda Araujo Osvaldo , Mora Galván Jessica Aideé , Ruiz Beltrán Arturo Maximiliano , González Vásquez Diego Arturo , León Domínguez Jefsi Argelia
Published: April 2021

Objetivo. Evaluar la eficacia del manejo con misoprostol al emplear el esquema de la Federación Internacional de Ginecología y Obstetricia (FIGO) 2017 para el abordaje de abortos de primer trimestre. Métodos. Estudio transversal realizado entre marzo y septiembre 2018, que incluyó 76 pacientes con diagnóstico de aborto espontáneo en el primer trimestre de gestación y que tuvieron manejo de acuerdo al esquema recomendado por FIGO 2017. Resultados. Las principales indicaciones para la inclusión de las 76 pacientes fueron aborto diferido 57,9%, aborto incompleto 25% y embarazo anembrionado 17,1%. La inducción con misoprostol siguió las indicaciones de FIGO 2017 para el manejo del aborto del primer trimestre. El efecto adverso más frecuente fue el sangrado vaginal asociado a dolor pélvico en 72,3% de las pacientes. Se logró la evacuación uterina completa en 98,6% de los casos. Conclusión. El manejo médico del aborto del primer trimestre de gestación con el uso del misoprostol de acuerdo al esquema FIGO 2017 ofreció una opción terapéutica altamente segura y costo-efectiva.
Criterios sonográficos de evaluación de malignidad del tumor de ovario - Metodología IOTA (International Ovarian Tumor Analysis Group)
Authors: Huerta Igor
Published: April 2021

La detección de una masa anexial durante una sonografía es el punto de partida de un largo camino de ansiedad para las pacientes en ginecología. El cáncer de ovario es una de las neoplasias ginecológicas más frecuentes en el mundo. El 75% de los cánceres de ovario es diagnosticado en estadios avanzados (III o IV), cuya sobrevida a los 5 años no sobrepasa el 10% en promedio. Se han realizado múltiples intentos para unificar el cribado clínico del cáncer ovárico, sin haberse logrado consenso para la pesquisa de esta enfermedad. Los métodos combinados incluyen la ecografía en escala de grises y la flujometría Doppler, que consideran puntuaciones cuantitativas para evaluar el riesgo de cáncer en los tumores ováricos. A pesar de su creciente valor predictivo, este método no es usado frecuentemente por las unidades de diagnóstico de ginecología en el país. El International Tumor Analysis Group (IOTA) ha desarrollado y validado modelos predictivos basados en series de datos multicéntricos con mediciones y recolección de información estandarizada que han logrado un nivel de predicción de patología maligna bastante aceptable. Considerando la alta tasa de falsos positivos de los actuales métodos, es importante mejorar la tasa de detección sonográfica de esta patología para una correcta derivación y abordaje quirúrgico con enfoque oncológico, cuando el caso lo requiera.
Manejo del endometrioma ovárico
Authors: Negrón Rodríguez José
Published: April 2021

afecta aproximadamente a 55% de las pacientes con endometriosis. Es el marcador de severidad de la enfermedad e, independiente de su tamaño, está asociado con lesiones profundas, siendo habitualmente el compromiso multifocal. Comúnmente diagnosticado en mujeres en edad reproductiva, también puede desarrollarse en niñas adolescentes y aún antes de la menarquia. El tratamiento del endometrioma ovárico puede ser médico o quirúrgico. El tratamiento médico está orientado básicamente a aliviar el dolor, pero sobre todo al tratamiento coadyuvante posquirúrgico, con la finalidad de disminuir la recurrencia. El tratamiento quirúrgico tiene rol fundamental, a pesar de sus efectos sobre la reserva ovárica; los beneficios en términos de alivio del dolor y tasas de embarazo espontáneo favorecen este enfoque. Cuatro técnicas quirúrgicas conservadoras son utilizadas en la actualidad, con sus ventajas y desventajas y todas perfectamente realizables por vía laparoscópica: escisión de la pseudocápsula (quistectomía), ablación, la técnica en dos etapas y la técnica combinada. Más importante que la cirugía en sí misma, es la calidad de la cirugía y el uso juicioso de la energía con la que se trabaja. La mejor visión del manejo es la individualización de cada caso, teniendo en consideración las necesidades de la paciente y los factores asociados.