bluuebunny/crossref_metadata_2025 huggingface dataset:
A Falta de Cadáveres para Ensino e Pesquisa
Authors: Cordeiro Rogério Guimarães , Menezes Ricardo Fernandes
Published: January 2020

ABSTRACT The aim of this study is to address the importance of providing unclaimed corpses and cadavers donated for use in studies, focusing on the training of health professionals, the improvement of professionals already trained in this area and the advance of research, mainly in surgical techniques, in the scope of educational and research institutions, both public and private. It seems unanimous, among the authors who deal with the matter, the view that the use of corpses is irreplaceable in technical training and professional development. There is, however, a lack of the material in question, which in turn is due to a series of difficulties raised here, such as the lack of regulation centers that manage the flow of capture and distribution of cadavers and the decrease in the number of unclaimed corpses. The following problem is thus defined: on the one hand, there is a clear need to obtain human remains for basic education in the health area – fundamentally in the disciplines of Anatomy – for the improvement of professionals in this area and for research – such as the disciplines of surgical techniques –; on the other hand, the lack of cadaveric material is evident, a fact that, by consequence, has been compromising the final quality of health services, especially those of surgical nature. A bibliographic survey was carried out aiming to know the state of the art on the current legislation and on the Bills currently submitted to the National Congress. It was found that, despite the existence of legislation concerning this matter, it is necessary to have legislative-normative improvement to encompass the several demands, including those of the emerging technologies. The legislative process is very slow, taking into account the need indicated here, considering the significant increase in the number of courses in the health area. It is necessary, therefore, that urgent measures be taken to supply the needs in the area, which must necessarily take place through legal and regulatory norms.
An Updated Primer on Entrustable Professional Activities (EPAs)
Authors: Cate Olle ten
Published: January 2020

ABSTRACT Since the turn of the millennium, competency-based medical education (CBME) has become a new standard for medical training in many countries. CBME has been operationalized in detailed frameworks of competencies that every physician should demonstrate at graduation, and similar frameworks have been created for specialties. However, the competencies, describing qualities that physicians should possess, do not directly translate into everyday activities of physicians. For that reason, the Entrustable Professional Activities (EPAs) were introduced. EPAs are units of professional practice that may be entrusted to undergraduate students, once they show the competencies needed to perform them without supervision. EPAs have become a popular topic within CBME programs in many countries and hundreds of publications within only a few years. This paper was written to introduce the strengths and weaknesses of EPAs. After a brief historical overview, the reason why EPAs are a bridge between a competency framework and daily clinical practice is explained. While competencies are qualities of individuals, EPAs are units of work. The two can be seen as two dimensions of a matrix, showing that almost all activities in health care are based on multiple competencies, such as communication skill, collaboration, professional behavior, content knowledge. Next, entrustment decision-making as a form of assessment is created and a framework of levels of supervision is presented. Entrustment decisions focus on the level of supervision a student requires for a specific activity, divided into five levels (1: allowed to observe; 2; allowed to perform under direct supervision; 3: allowed to perform under indirect supervision; 4: allowed to perform the activity unsupervised; 5: allowed to supervise the activity performed by more junior learners). For readers interested in applying the concept to practice, a stepwise approach to the curriculum development is proposed. The paper concludes with an overview of the state-of-the-art of working with EPAs across disciplines, professions and countries.
E o Passado é uma Roupa que Não nos Serve Mais: uma Reflexão sobre Integração Ensino-Saúde-Comunidade em Curso Médico do Nordeste
Authors: Souza Carlos Dornels Freire de , Correia Divanise Suruagy , Araújo Maria Deysiane Porto , Wanderley Roberta Albuquerque , Machado Michael Ferreira
Published: January 2020

RESUMO A formação médica, assim como a sociedade brasileira, tem passado por importantes transformações. Tais mudanças buscam atender as demandas sociais e sanitárias contemporâneas, sobretudo no que diz respeito a uma formação voltada à realidade sociossanitária local. Em razão disso, a formação deve buscar desenvolver competências, habilidades e atitudes em um cenário de integração do ensino com a saúde e a comunidade. O curso de Medicina da Universidade Federal de Alagoas, campus Arapiraca, iniciado no ano de 2015, resulta do processo de expansão das escolas médicas do País e do processo de interiorização das ações dessa universidade. O curso está estruturado em três eixos (tutoria, habilidades médicas e integração ensino-saúde-comunidade). Neste texto, pretende-se apresentar o processo de trabalho do eixo de Integração Ensino-Saúde-Comunidade (Iesc), seus principais avanços e os desafios envolvidos no processo de formação. O Iesc tem como missão promover a aproximação entre o acadêmico e a realidade sociossanitária local a fim de garantir uma formação médica capaz de oferecer uma assistência integral, respeitosa, ética, crítica e humanística, considerando o sujeito e o contexto em que está inserido, sua cultura, crença, hábitos e costumes. Em 2017, para cumprir sua missão, o eixo reestruturou o currículo do curso de modo que a formação ocorra no ciclo básico (primeiro e segundo anos), passando pelo ciclo intermediário (terceiro e quarto anos) e alcançando o internato (quinto e sexto anos). Nossa experiência tem mostrado que o aprendizado significativo deve nascer da prática, isto é, do processo de experimentações com a realidade. É nítido o maior envolvimento dos nossos estudantes quando incluímos atividades com finalidades práticas bem definidas. Nossa sistemática de trabalho envolve reuniões mensais, quando são discutidos os principais problemas e elaboradas estratégias de condução do eixo, padronização de cadernos de curso e estratégias avaliativas, processo de formação continuada dos docentes, como parte do plano bianual de qualificação e inclusão de avaliação por parte dos acadêmicos, com o semestre em curso. A variedade de estratégias pedagógicas, todas ancoradas nas metodologias ativas de ensino-aprendizagem, contribui para o maior envolvimento dos nossos estudantes nas aulas. Os principais desafios são consolidar a inserção na rede de saúde local e qualificar o corpo docente no uso de metodologias ativas em todos os processos de aprendizagem.
BABY-LED WEANING, AN OVERVIEW OF THE NEW APPROACH TO FOOD INTRODUCTION: INTEGRATIVE LITERATURE REVIEW
Authors: Gomez Melisa Sofia , Novaes Ana Paula Toneto , Silva Janaina Paulino da , Guerra Luciane Miranda , Possobon Rosana de Fátima
Published: January 2020

ABSTRACT Objective: To analyze the scientific literature on Baby-Led Weaning with an integrative literature review to identify risks and benefits. Data source: The databases used were: National Library of Medicine (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS – Literatura Latino-Americana e do Caribe em Ciências da Saúde), US National Library of Medicine (PubMed), and Virtual Health Library (BVS – Biblioteca Virtual em Saúde) in December 2017. The inclusion criteria established were publications in English with the descriptor “baby-led weaning” in the heading, abstract, or keywords, classified as original articles, of primary nature, and available online and in full. We excluded review articles, editorials, letters to the editor, critical commentaries, and books on the subject, as well as articles not available in full and duplicates. Data summary: We identified 106 articles, of which 17 met the selection criteria. The Baby-Led Weaning method was significantly associated with the baby’s satiety, the start of complementary feeding, and adequacy of weight gain. On the other hand, choking and the intake of micronutrients were negatively associated, however with no statistical differences. Conclusions: Despite the benefits found, the risks still deserve attention and should be investigated with longitudinal randomized controlled studies to ensure the safety of the method when practiced exclusively.
DRUG-RELATED PROBLEMS IN CARDIAC NEONATES UNDER INTENSIVE CARE
Authors: Nascimento Amanda Roseane Farias do , Leopoldino Ramon Weyler Duarte , Santos Marco Edoardo Tavares dos , Costa Tatiana Xavier da , Martins Rand Randall
Published: January 2020

ABSTRACT Objective: To determine the frequency and nature of the Drug Related Problems (DRP) in neonates with cardiac diseases admitted to an Intensive Care Unit. Methods: This prospective cross-sectional study was developed at the Neonatal Intensive Care Unit (NICU) of a teaching maternity hospital in Brazil from January 2014 to December 2016. All neonates diagnosed with any heart disease (congenital heart disease, cardiomyopathy, arrhythmias, etc.) and who were admitted to the NICU for more than 24 hours with at least one prescribed drug were included in the study. Demographic and clinical data were collected from the records of the institution’s clinical pharmacy service. DRP and their respective interventions were independently reviewed and classified by two pharmacists. DRP classification was performed through the Pharmaceutical Care Network Europe v6.2 system. Results: 122 neonates were included in the study. The frequency of neonates exposed to DRP was 76.4% (confidence interval of 95% [95%CI] 65.9–82.0), with a mean of 3.2±3.8 cases/patient. In total, 390 DRP were identified, of which 49.0% were related to “treatment effectiveness”, 46.7% to “adverse reactions” and 1.0% to “treatment costs”. The medicines most involved in DRP were Vancomycin (10.2%; n=46), Meropenem (8.0%; n=36) and Furosemide (7.1%; n=32). Pharmacists performed 331 interventions, of which 92.1% were accepted by physicians and nurses. Conclusions: The study showed that DRP are very frequent in patients with cardiac diseases hospitalized in the NICU, predominating problems related to the effectiveness and safety of the drug treatment.
QUALITY OF LIFE EVALUATION AND ASSOCIATED FACTORSIN ASTHMATIC CHILDREN AND ADOLESCENTS ATTENDED IN A SPECIALIZED OUTPATIENT CLINIC
Authors: Fontan Fernanda Chedid de Souza , Duwe Sérgio Wilson , Santos Karoliny dos , Silva Jane da
Published: January 2020

ABSTRACT Objective: To evaluate the quality of life and its association with disease control, severity, allergic comorbidities and adherence to treatment in children and adolescents with asthma. Methods: A cross-sectional study that included children and adolescents aged seven to 17. The Paediatric Asthma Quality of Life Questionnaire (PAQLQ) was used to assess their quality of life. Sociodemographic and clinical data were obtained from the chart and from a questionnaire. Descriptive statistics were performed and chi-square or Fisher’s exact tests were used to verify the existence of associations between quality of life and disease control, severity, comorbidities and adherence to treatment. The level of statistical significance was set at p<0.05. Results: 101 children/adolescents were evaluated (62.4% boys), with a mean age of 10.1 years. On average, the PAQLQ score was ≤5.9 points, indicating moderate / severe quality of life impairment. Higher levels of control, as well as higher disease severity, were associated with higher quality of life impairment, both in total PAQLQ score and domains (p<0.05). The presence of comorbidities was also associated with higher quality of life impairment (p=0.01), except in the emotional function domain. Adherence to treatment showed no association with quality of life. Conclusions: Children and adolescents with asthma present impairment in their quality of life, and this is related to poorer control and severity of the disease, as well as to the presence of allergic comorbidities.
STATURE ESTIMATE OF CHILDREN WITH CEREBRAL PALSY THROUGH SEGMENTAL MEASURES: A SYSTEMATIC REVIEW
Authors: Lamounier Joel Alves , Marteletto Nathália Macedo , Calixto Cristina Amaral , Andrade Marcia Reimol de , Tibúrcio Jacqueline Domingues
Published: January 2020

ABSTRACT Objective: To review studies that evaluate the correspondence between the estimate height via segmental measures and the actual height of children with cerebral palsy. Data sources: Systematic literature review between 1995–2018, guided by the PRISMA criteria (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), in PubMed, BVS, MEDLINE and Lilacs databases. The descriptors, connected by the AND Boolean Operators, were: anthropometry, cerebral palsy, child and body height. The research comprised papers in Portuguese, English and Spanish, with Qualis-CAPES equal or superior to B3 that addressed the question: “Is there any correlation between estimate height by equations and direct height measures in children with cerebral palsy?” 152 studies were recovered and seven were selected. Their methodological quality was assessed by the scale of the Agency for Healthcare Research and Quality (AHRQ). Data synthesis: Most studies showed no correspondence between estimated and real height. Studies that showed coincidence of the measures contain limitations that could jeopardize the results (sample losses, small samples and exclusion of patients with severe contractures, scoliosis and severe cerebral palsy). Japanese researchers developed an equation which harmoniously aligns the statures; the study comprised only Japanese patients, though. Conclusions: Given the importance of accuracy in height measures to evaluate infant health, it is crucial to carry out more researches in order to safely establish an association between both estimate and real statures. The development of anthropometric protocols, emerged from such researches, would benefit the follow-up of children with severe psychomotor disabilities.
VIRTUAL LEARNING ENVIRONMENT IN PEDIATRIC RHEUMATOLOGY FOR PEDIATRIC RESIDENTS
Authors: Cunha Ana Luiza Garcia , Terreri Maria Teresa , Len Claudio Arnaldo
Published: January 2020

ABSTRACT Objective: To develop, implement and evaluate an online virtual learning environment (VLE) on pediatric rheumatology, aimed at pediatric residents, analyzing its effectiveness and satisfaction rates. Methods: A total of 92 first and second year pediatric residents at two pediatric reference centers were invited to participate in the study. Residents were randomized into a case group (that answered the pre-course test, attended the six virtual pediatric rheumatology modules, and then responded to the post-course test and a satisfaction questionnaire) and a control group (that only answered the pre-course test and, after 4 weeks, the post-course test). Results: Forty-seven residents (51%) completed their participation. In the case group (n=24), the mean percentage of correct answers was 14% higher on the post-course test (p<0.001). The number of correct answers was larger in the case group than in the control one (n=23) in the post-course test (p=0.045). In the assessment of satisfaction with VLE use, residents considered the site easy to navigate (91%), suitable as a learning tool (91%), and attractive in design (79%). They reported poor prior knowledge in pediatric rheumatology (91%) and agreed that there was good learning with the methodology (75%). Conclusions: The virtual learning environment in pediatric rheumatology proved to be an effective teaching tool with high satisfaction rates, providing pediatrician residents with adequate knowledge regarding the initial assessment and management of children with rheumatic diseases.
TRANSLATION AND CULTURAL ADAPTATION OF THE MEDITERRANEAN DIET QUALITY INDEX IN CHILDREN AND ADOLESCENTS
Authors: Simon Miriam Isabel Souza dos Santos , Forte Gabriele Carra , Marostica Paulo Jose Cauduro
Published: January 2020

ABSTRACT Objective: To translate and culturally adapt the Mediterranean Diet Quality Index in Children and Adolescent (KIDMED) for the Brazilian population. Methods: The processes of translation and cultural adaptation followed internationally standardized methodological norms. We used the intraclass correlation coefficient and the Bland-Altman dispersion analysis to assess the reproducibility and calculated the internal consistency with Cronbach’s alpha coefficient. Results: A total of 102 children and adolescents participated in the cross-cultural adaptation, of whom 58 (56.9%) were females, with a mean age of 9.8±4.9 years. The mean overall scores of adherence to the Mediterranean diet in the test and retest were similar (8.00 and 3.80 versus 8.01 and 3.84) for children and adolescents, respectively. The intraclass correlation coefficient for children and adolescents was 0.893 and 0.998, respectively. The internal consistency was 0.72. The Bland-Altman plot analysis showed good agreement between the final scores of the test and retest questionnaires, with no statistically significant difference. Conclusions: The KIDMED questionnaire was translated into Brazilian Portuguese and culturally adapted, presenting high reproducibility. This questionnaire can, therefore, be included and used in Brazilian studies that aim at evaluating the adherence to the Mediterranean diet among children and adolescents.
OUTPATIENT ANALYTIC ASSESSMENT OF ANOREXIA NERVOSA — THE IMPORTANCE OF VENOUS BLOOD GASES
Authors: Pires Sofia Alexandra Pereira , Soares Joana Costa , Luz Alexandra Maria Branco da , Moleiro Pascoal
Published: January 2020

ABSTRACT Objective: To evaluate serum biochemical parameters’ evolution, especially venous blood gas (VBG), in anorexia nervosa (AN), correlating with clinical parameters. Methods: Retrospective study including out-patient AN adolescents, between January 2014 and May 2017. Three evaluations were compared: t1) first consultation; t2) consultation with the lowest body mass index (BMI) z-score and t3) with the highest BMI z-score. Results: A total of 24 adolescents (87.5% females) were included, mean age of presentation of 14.9±1.7 years, onset of symptoms 6.4±3.2 months before the first visit. In t1, BMI z-score of -1.91±1.11 kg/m2 and ideal weight % of 84.3±9.2. Amenorrhea was present in 88%. In t2 the analytical alterations were: altered VBG in 100%, altered ferritin (72% elevated), altered thyroid function (53% with thyroxine decrease), dyslipidemia (31% elevation of high density lipoprotein, 25% hypercholesterolemia), elevation of urea (25%), elevation of alanine aminotransferase (14%), hypoglycemia (14%), anemia (9%). Respiratory acidosis was present in 91% in t1, 100% in t2 and 94% in t3. There was a significant decrease between t2 and t3 in mean pCO2 (57.2 versus 53.6 mmHg; p=0.009) and mean HCO3 (30.0 versus 28.8 mEq/L; p=0.023). Conclusions: Respiratory acidosis and increased ferritin were common in this group. Respiratory acidosis was the most frequent abnormality with significant pCO2 and HCO3 variation in the recovery phase. VBG should be considered in AN evaluation, once it seems to be important in assessing the severity of the disease and its subsequent follow-up.
PRE- AND PERINATAL FACTORS ASSOCIATED WITH WEIGHT GAIN AMONG PRESCHOOL CHILDREN ENROLLED AT DAY CARE CENTERS
Authors: Almeida Nykholle Bezerra , Menezes Rísia Cristina Egito de , Sobral Kariny dos Santos , Gomes Jaqueline Fernandes , Longo-Silva Giovana , Silveira Jonas Augusto Cardoso da
Published: January 2020

ABSTRACT Objective: To identify the factors associated with excessive weight gain in preschool children enrolled at daycare centers in a capital of the Northeast region of Brazil. Methods: It was a cross-sectional study conducted at the five daycare centers located in the city’s district of most socioeconomic vulnerability. The study included 326 preschool children (17 to 63 months old) from both genders. The dependent variable was the conditional weight gain (CWG), that represents how much a child, according to their gender, deviated from their peers in relation to the expected weight gain, given sample’s birthweight, gender, and age at the survey. Univariate tests (t-test and analysis of variance) were used to compare CWG means according to environmental and biological factors, considering the independent variables with p<0.20 as electable for the multiple linear regression model. In the final model, variables with p<0.05 or that contributed to the model adjustment were kept. Results: Children’s mean age was 45.4±9.9 months, and 53.4% of the sample consisted of boys. The prevalence of overweight was 7%. In the multivariable linear regression model, it was possible to identify that the following factors were associated with excessive weight gain among preschool children: less than six prenatal care visits (0.36 SD [95%CI 0.13–0.60]), not rooming-in in the postpartum period (0.30 SD [95%CI 0.03–0.58]), and never breastfed (0.44 SD [95%CI 0.06–0.81]). Conclusions: Inadequate prenatal (appointments) and perinatal care (mother-infant rooming-in and absence of breastfeeding) were associated with excessive weight gain among low-income preschool children.
EVENTS ASSOCIATED WITH THE OCCURRENCE OF INTRACRANIAL HYPERTENSION IN PEDIATRIC PATIENTS WITH SEVERE CRANIOENCEPHALIC TRAUMA AND MONITORING OF INTRACRANIAL PRESSURE
Authors: Guerra Sérgio Diniz , Ferreira Alexandre Rodrigues
Published: January 2020

ABSTRACT Objective: To determine the events associated with the occurrence of intracranial hypertension (ICH) in pediatric patients with severe cranioencephalic trauma. Methods: This was a prospective cohort study of patients 18 years old and younger with cranioencephalic trauma, scores below nine on the Glasgow Coma Scale, and intracranial pressure monitoring. They were admitted between September, 2005 and March, 2014 into a Pediatric Intensive Care Unit. ICH was defined as an episode of intracranial pressure above 20 mmHg for more than five minutes that needed treatment. Results: A total of 198 children and adolescents were included in the study, of which 70.2% were males and there was a median age of nine years old. ICH occurred in 135 (68.2%) patients and maximum intracranial pressure was 36.3 mmHg, with a median of 34 mmHg. A total of 133 (97.8%) patients with ICH received sedation and analgesia for treatment of the condition, 108 (79.4%) received neuromuscular blockers, 7 (5.2%) had cerebrospinal fluid drainage, 105 (77.2%) received mannitol, 96 (70.6%) received hyperventilation, 64 (47.1%) received 3% saline solution, 20 (14.7%) received barbiturates, and 43 (31.9%) underwent a decompressive craniectomy. The events associated with the occurrence of ICH were tomographic findings at the time of admission of diffuse or hemispheric swelling (edema plus engorgement). The odds ratio for ICH in patients with Marshall III (diffuse swelling) tomography was 14 (95%CI 2.8–113; p<0.003), and for those with Marshall IV (hemispherical swelling) was 24.9 (95%CI 2.4–676, p<0.018). Mortality was 22.2%. Conclusions: Pediatric patients with severe cranioencephalic trauma and tomographic alterations of Marshall III and IV presented a high chance of developing ICH.
The Impact of Treewidth on Grounding and Solving of Answer Set Programs
Authors: Bliem Bernhard , Morak Michael , Moldovan Marius , Woltran Stefan
Published: January 2020

In this paper, we aim to study how the performance of modern answer set programming (ASP) solvers is influenced by the treewidth of the input program and to investigate the consequences of this relationship. We first perform an experimental evaluation that shows that the solving performance is heavily influenced by treewidth, given ground input programs that are otherwise uniform, both in size and construction. This observation leads to an important question for ASP, namely, how to design encodings such that the treewidth of the resulting ground program remains small. To this end, we study two classes of disjunctive programs, namely guarded and connection-guarded programs. In order to investigate these classes, we formalize the grounding process using MSO transductions. Our main results show that both classes guarantee that the treewidth of the program after grounding only depends on the treewidth (and the maximum degree, in case of connection-guarded programs) of the input instance. In terms of parameterized complexity, our findings yield corresponding FPT results for answer-set existence for bounded treewidth (and also degree, for connection-guarded programs) of the input instance. We further show that bounding treewidth alone leads to NP-hardness in the data complexity for connection-guarded programs, which indicates that the two classes are fundamentally different. Finally, we show that for both classes, the data complexity remains as hard as in the general case of ASP.
Influence of soil microstructure on air permeability in compacted clay
Authors: Nguyen Viet , Pineda Jubert Andrés , Romero Enrique , Sheng Daichao
Published: January 2020

This paper describes an experimental study aimed at evaluating the influence of soil microstructure on air permeability in compacted clay. Air permeability measurements, estimated using the gas pressure decay method, were carried out for a wide range of compaction states. The evolution of the air permeability during wetting and drying paths was also evaluated. The experimental results show that, for an increase in the as-compacted degree of saturation, air permeability may either increase or decrease depending on the as-compacted dry density. Air permeability increases with increasing the degree of saturation in loose specimens, whereas the opposite trend is observed for dense specimens. Microstructural analysis, carried out using mercury intrusion porosimetry (MIP) tests, shows a strong dependency of the air permeability on the as-compacted soil microstructure. This behaviour is also noticed in specimens that experienced a large variation in the degree of saturation during wetting and drying. Microstructural data indicate that air permeability is mainly controlled by large pores that display high connectivity. The degree of saturation plays a dual role in soil microstructure which, in turn, affects the air permeability. Denser specimens (dry density ≥ 1·5 Mg/m3) show a reduction in keff due to the expansion of the clay aggregates with increasing the as-compacted degree of saturation. The increase in the as-compacted degree of saturation in loose samples (dry density ≤1·3 Mg/m3) produces an enhancement in the proportion of macro pores, thus increasing keff, as a consequence of modifications in the pore size distribution. A threshold value has been identified, above which further increase in degree of saturation causes a reduction in the proportion of macro pores, and therefore in keff. A new proposal for estimating the air permeability is proposed in this paper based on the determination of a pore size parameter obtained from MIP data. The proposed approach seems capable of describing the evolution of air permeability for the whole spectrum of compaction states, including specimens subjected to wetting and drying paths.
Social value for whom, by whom and when? Managing stakeholder dynamics in a UK megaproject
Authors: Mulholland Cara , Chan Paul W , Canning Kate , Ejohwomu Obuks A
Published: January 2020

Studies of project success have generally recognised the role that stakeholder management plays in shaping a collective understanding of value. While these studies have typically focused on new builds, few studies have examined stakeholder management at the end of the life of a built asset. This paper draws on a single megaproject case study into social value in nuclear decommissioning and remediation to examine how ‘success’ or ‘failure’ in projects is framed and the implications of stakeholder management in shaping these notions of performance. By tracing the historical development of Dounreay, UK, an experimental nuclear energy site at an advanced stage of decommissioning, it was found that key stakeholders change over time, as those most affected by the changing dynamics of the megaprojects come and go, with resulting impacts on the ways that conditions for success are framed and social value is defined. The authors’ findings stress the importance of taking a pluralistic and processual view of stakeholders and demonstrate the need for policymakers, practitioners and researchers to pay greater attention to fragmentation and integration of stakeholders’ interests and influences as they change over time. These dynamics of stakeholder management will in turn challenge preconceived ideas of success that are often framed in the early stages of a project.
Short-term Planning, Monetary Policy, and Macroeconomic Persistence
Authors: Gust Christopher , Herbst Edward , López-Salido J. David
Published: January 2020

This paper uses aggregate data to estimate and evaluate a behavioral New Keynesian (NK) model in which households and firms plan over a finite horizon. The finite-horizon (FH) model outperforms rational expectations versions of the NK model commonly used in empirical applications as well as other behavioral NK models. The better fit of the FH model reflects that it can induce slow-moving trends in key endogenous variables which deliver substantial persistence in output and inflation dynamics. In the FH model, households and firms are forward-looking in thinking about events over their planning horizon but are backward looking regarding events beyond that point. This gives rise to persistence without resorting to additional features such as habit persistence and price contracts indexed to lagged inflation. The parameter estimates imply that the planning horizons of most households and firms are less than two years which considerably dampens the effects of expected future changes of monetary policy on the macroeconomy. \
KAJIAN PENAMBAHAN DUMMY ALUMINUM PADA POSISI IRADIASI SENTRAL (CIP) TERHADAP PARAMETER NEUTRONIK REAKTOR RSG-GAS
Authors: Susanto Susanto , Susanti Fitri
Published: January 2020

KAJIAN PENAMBAHAN DUMMY ALUMINIUM PADA POSISI IRADIASI SENTRAL (CIP) TERHADAP PARAMETER NEUTRONIK REAKTOR RSG-GAS. Reaktor RSG-GAS adalah reaktor riset yang dioperasikan untuk keperluan produksi radioisotop, analisis aktivasi neutron, penelitian dan uji material. Reaktor RSG-GAS beroperasi dengan rata-rata energi terbangkitkan sebesar 625 MWd setiap siklus dan manajemen bahan bakar teras menggunakan pola 5/1 untuk pemuatan bahan bakar. Setiap pergantian teras dilakukan perhitungan dan pengukuran parameter reaktor untuk mengetahui pengaruh terhadap keselamatan operasi reaktor. Pada kondisi operasi normal fasilitas iradiasi dalam teras berisi air atau dummy aluminium. Penambahan dummy aluminium pada fasilitas iradiasi perlu diketahui pengaruhnya terhadap parameter neutronik reaktor RSG-GAS. Tujuan penulisan makalah ini yaitu melakukan perhitungan dan pengukuran parameter operasi reaktor dan mengetahui pengaruh penambahan dummy aluminium terhadap reaktivitas dan fluks neutron pada teras 97 reaktor RSG-GAS. Perhitungan parameter operasi dilakukan menggunakan kombinasi program WIMS/D5 untuk generasi tampang lintang sel, Batan-2DIFF untuk menghitung reaktivitas dan faktor puncak daya radial serta Batan-3DIFF untuk menghitung faktor puncak daya aksial dan fluks neutron dalam teras reaktor. Efek reaktivitas akibat penempatan dummy aluminium pada CIP sebesar 0,17 %Δk/k. Jika dummy aluminium diletakkan di CIP dan IP akan menaikkan fluks di posisi tersebut karena aluminium mempunyai daya moderasi yang sangat baik. Nilai faktor puncak daya radial dan aksial masing-masing 1,2200 dan 1,2902. Berdasarkan hasil perhitungan dan pengukuran besaran tersebut masih berada dalam batas yang diizinkan untuk keselamatan operasi reaktor dan menunjukan bahwa teras 97 reaktor RSG-GAS memenuhi batas keselamatan operasi reaktor.Kata kunci: Dummy aluminium, reaktivitas, fasilitas iradiasi, operasi reaktor
Novel Coumarin Derivatives: Synthesis, Characterization and Antimicrobial Activity
Authors: Naik Chirag G , Malik Gulam M. , Parekh Hitesh M.
Published: January 2020

The novel coumarin derivatives (2,3,4,5,6,7) have been synthesized from the reaction of o-acetyloxy benzoic acid with thionyl chloride yielding 2-acetoxy benzoyl chloride, which on further treatment with ethylacetoacetate gave 4-hydroxycoumarin. Substituted pyrazolones and thiazoles reacted with 4-hydroxy coumarin to give pyrazolones and methyl thiazoles related coumarin derivatives. The newly synthesized products were characterized with IR, 1H and 13C NMR, mass spectroscopic techniques and elemental analysis. The synthesized compounds were screened for their antibacterial and antifungal activity. All the compounds were found to have significant activity against the tested microorganisms. Keywords: Coumarin, thiazole, pyrazolone, antibacterial activity, antifungal activity.
Occupational therapy services and perception of integration of these at primary healthcare level in South Africa
Authors: Jejelaye Anthony , Maseko Lebogang , Franzsen Denise
Published: January 2020

BACKGROUND: Literature indicates that access to rehabilitation services in South Africa is limited. Recent policy documents by the National Department of Health related to disability and rehabilitation propose the integration of occupational therapy services in primary healthcare (PHC). However, the implementation strategies concerning integration are not clear as there is inadequate evidence locally on the occupational therapy service provision in PHC even though there is growing evidence internationally PURPOSE: This study sought to determine the services provided by occupational therapists in PHC and to explore the perceptions of the occupational therapists on the integration of occupational therapy services within the PHC reengineering streams of the National Health Insurance (NHI METHOD: A two-phase explanatory sequential mixed method strategy was utilised in this study. A quantitative survey was sent to members of the occupational therapy professional association and an organisation of professionals providing rehabilitation services in rural communities. Qualitative data were then collected using semi-structured interviews with five therapists who completed the survey FINDINGS: Findings from this study showed there is increasing alignment of occupational therapy services in PHC with the community-based rehabilitation (CBR), the Social Model, the International Classification of Functioning, Disability and Health (ICF), and the Medical Model using client self-management and case-management intervention approaches. The majority of occupational therapists are currently based in district hospitals (42%), community health centres (16%), community organisations (8%), and clinics (8%). Those working in the community indicated they work in a multidisciplinary team (MDT). They also use PHC service delivery models to manage people with disabilities (PWDs). Occupational therapists in PHC have a strong perception of their relevance in the PHC reengineering streams, despite the numerous barriers and few facilitators to the integration of occupational therapy services in the PHC reengineering streams of the NHI CONCLUSION: The perception of the study participants is that occupational therapy service integration in the PHC reengineering streams will lead to improved healthcare. However, they are also of the opinion that integration will not happen without advocacy from occupational therapists or occupational therapy being adequately supported in PHC Key words: Occupational therapy, primary health care re-engineering, integration, National Health Insurance, universal health coverage
Laser microdissection for regional transcriptomics and proteomics v1
Authors: Eadon Michael , Barwinska Daria , Cheng Ying-Hua , J. Ferkowicz Michael , V. Parikh Samir , H. Rovin Brad , P. Shapiro John , C. Dagher Pierre , M. El-Achkar Tarek
Published: January 2020

Recent advances in multi-scale interrogation of human tissue, including advanced imaging techniques and the powerful application of large dataset “omics”, have displayed significant promise toward identifying new and specific therapeutic targets, predicting disease progression, and individualizing treatment in participants with acute and chronic kidney disease. Our site, formed by the alliance of Indiana University and Ohio State University, will implement an unbiased tissue interrogation workflow for KPMP human kidney biopsies that integrates largescale 3D tissue imaging for quantitative supervised and unsupervised analysis/cytometry with sub-segmental “omics” data on the same kidney biopsy specimen. The sub-segmental “omics” pipeline will use fluorescence based Laser MicroDissection (LMD) to isolate specific nephron segments and interstitial/other targeted areas, for downstream analysis with transcriptomics and proteomics. The omics analysis will be eventually expanded to include bulk epigenetics. Acting harmoniously with other KPMP sites, our interrogation techniques are expected to facilitate back-mapping of key molecular pathways to the biopsy, which can subsequently identify foci of injury and/or regeneration that can undergo targeted sampling to generate further enriched omics. Therefore, in addition to a significant contribution to the human kidney atlas, our approach will complement other interrogation techniques within KPMP by providing tissue context and increasing spatial resolution for molecular signatures that arise in heterogeneous areas during kidney disease.
High-quality RNA purification with on-column DNase treatment from tissue specimens v1
Authors: Bletsa Magda , Fikatas Antonios , Li Yiqiao , Gryseels Sophie , Felix Drexler Jan , Lemey Philippe
Published: January 2020

This protocol can be used for total RNA purification from tissue samples. It includes an intermediate on-column DNase treatment, which results in higher RNA yield and purity. This method is mainly optimised to obtain hepacivirus RNA extracts for whole-genome sequencing, but it can also be used for any viral RNA purification from samples with lower viral loads.
The Effect of L2 Listening Texts Adapted to the Digital Story on the Listening Lesson
Authors: TANRIKULU Fatih
Published: January 2020

The study conducted as the action research model aimed to identify the effect of use of new story form, digital storytelling (DST) as a product input in listening lessons on listening lessons. Working group of the research consists of higher education undergraduate foreign students mostly financed by UN (N:49). The two-step procedure covers a twelve-week-process of six weeks each. The first step was applied on students studying at C1 level and the second step was applied on students studying at B1 level. During the procedure, 40 texts in DST format were used for listening lesson. Researcher diary, student diary and focus group discussions were used as data collection tools. The data obtained were analyzed with Nvivo 11 qualitative data analysis program. Themes were created by coding and categorizing the data. As a result of the research, it is seen that digital storytelling has a positive effect on the development of listening skills, positively affects learning and is more effective compared to listening lessons taught with voice recordings and increases student motivation.
The Online Learning Self-Efficacy Scale: Its Adaptation into Turkish and Interpretation According to Various Variables
Authors: YAVUZALP Nuh , BAHÇİVAN Eralp
Published: January 2020

The aim of this study was to adapt the Online Learning Self-Efficacy Scale (OLSES), developed by Zimmerman and Kulikowich (2016) to determine university students’ self-efficacy perceptions in online learning environments, into Turkish, and to analyse the validity and reliability of the results of the scale. The original form of the scale, which is in English, consists of three factors (learning in the online environment, time management and technology use) and of 22 items. In this process, first of all the Turkish language equivalence of the scale was ensured, and then, in the light of the recommendations of experts in the field, the content validity of the scale was established. Next, to ascertain its construct validity, the scale was applied to 2,087 university students who were taking at least one of the campus-based common compulsory courses via distance learning. According to the results of the analysis performed in adherence with the exploratory factor analysis used in the original scale, one item was removed from the scale since it had a factor loading below 0.40, and a single-dimension scale consisting of 21 items was obtained. The factor loadings of the items in the scale were observed to range between 0.85 and 0.92. The Cronbach’s alpha coefficient of internal consistency calculated for reliability of the scale was determined as 0.987. Consequently, it is considered that inferences and interpretations to be made based on the Online Learning Self-Efficacy Scale consisting of 21 items and a single dimension will be valid and reliable. In the interpretations made of the research data, the variables of gender and school type were examined. No statistically significant difference was found between groups regarding either gender or type of school.
Childhood Sexual Abuse Survivors Undergoing Cancer Treatment: A Case for Trauma-Informed Integrated Care
Authors: Regal Rachel A. , Wheeler Naomi J. , Daire Andrew P. , Spears Nickolas
Published: January 2020

Patients in medical settings with more adverse childhood experiences (ACEs), such as sexual abuse, demonstrate reduced treatment adherence and greater relational difficulties with providers, potentially contributing to negative health outcomes. Integrated care addresses holistic patient healthcare needs within an interdisciplinary treatment team. Trauma-informed care serves as a potential approach to address patient and provider difficulty, yet practical guidance as to how to implement this approach within integrated care settings is lacking. This article makes the case for trauma-informed integrated care and provides a case example in an oncology setting to illustrate the utility of trauma-informed integrated care with the use of an embedded mental health counselor. Resulting training and practice recommendations include (a) universal screening for ACE in medical settings, (b) enhanced interprofessional education, and (c) provision of embedded counseling and supervision services within integrated care settings. Future research directions are explored.
Current trends in epileptology: priorities, challenges, tasks and solutions
Authors: Avakyan G. N. , Belousova E. D. , Burd S. G. , Vlasov P. N. , Ermolenko N. A. , Kissin M. Ya. , Lebedeva A. V. , Lipatova L. V. , Kiteva-Trenchevska G.
Published: January 2020

Within a field meeting of experts from the Russian branch of the League Against Epilepsy (RLAE), diagnostic and treatment aspects of epilepsy were discussed with the emphasis on the female population (girls, women of childbearing and older ages). All experts underscored the special features and unique needs of female patients with epilepsy. Experimental and clinical studies on efficacy and safety of traditional and novel antiepileptic drugs (AEDs) applied to women with epilepsy were discussed. It was commonly agreed that the new generation of AEDs did not yet find an appropriate place in the clinical practice, and that they were mainly used as add-on therapy in order to overcome drug resistance. The current use of AEDs in the treatment of epilepsy is, by large, not gender-specific and is not related enough to age, sociodemographic characteristics, and comorbid disorders. It should be noted that the new AEDs are addressed specifically to individual, socio-demographic, gender and clinical features of the patient. The potential of some AEDs (lamotrigine), in fact, remains underestimated by practitioners. Due to the current restrictions in using valproic acid, lamotrigine is the alternative medication for women with epilepsy. Having a balanced profile of efficacy and safety, lamotrigine is recommended as the first choice drug for initial therapy, as well as an alternative monotherapy for epilepsy in women.

These data were presented at the Russian League Against Epilepsy (RLAE) on-site meeting “Epilepsy and Woman” 18 September 2019 (Ohrid, Makedonia).
Prevalência e caracterização das lesões orais na Clínica de Estomatologia da Policlínica Piquet Carneiro – Estudo Retrospectivo de 12 anos
Authors: Soares Álvaro Cavalheiro , Pires Carina Almeida , Rangel Tuanny Lima , Benevides Marcus Vinicius Rego , Machado Monalisa Cristiane Aguillera Matias de Albuquerque , Pêssoa Thiago Moreira , Ramos Ruth Tramontani , Faria Marcelo Daniel Brito , Bastos Luciana Freitas , Cantisano Marilia Heffer
Published: January 2020

Objetivo: avaliar a prevalência dos principais tipos de lesões submetidas à biópsia e identificar o perfil dos pacientes atendidos no ambulatório de Estomatologia da Policlínica Piquet Carneiro (PPC/UERJ, Rio de Janeiro) no período compreendido entre 2000 e 2012. Material e Métodos: estudo transversal e retrospectivo em que prontuários de 2078 pacientes foram avaliados e dados referentes às doenças, idade, gênero, cor da pele e localização anatômica das lesões foram coletados e analisados de forma descritiva. Resultados: 69% dos pacientes (1441 casos) obtiveram o diagnóstico conclusivo através de exame histopatológico, ao passo que 31% (637 casos) obtiveram um laudo histopatológico descritivo. Dos casos com diagnóstico histopatológico conclusivo, 58% eram mulheres, 31% homens e em 11% o sexo não foi informado. A média de idade da população estudada foi de 50,63 anos e em 58% dos casos os pacientes eram leucodermas. O maior número de lesões foram as do grupo dos processos proliferativos não-neoplásicos, sendo a hiperplasia fibrosa inflamatória (30,1%) a mais prevalente. Conclusão: o perfil epidemiológico do paciente atendido no período estudado foi composto predominantemente por mulheres com mais de 50 anos de idade e a lesão oral mais prevalente foi a hiperplasia fibrosa inflamatória. Este estudo reforça a importância do papel da análise histopatológica como método auxiliar de diagnóstico e que possibilita a elaboração de estratégias específicas para prevenção e detecção precoce das doenças orais mais frequentes na população.
Estomatite de contato a creme dental: importância do diagnóstico diferencial
Authors: Amaral Simone Macedo , Miranda Águida Maria Menezes Aguiar , Santos Netto Juliana De Noronha , Pires Fabio Ramôa
Published: January 2020

Objetivo: o objetivo do presente trabalho é relatar 4 casos de estomatite de contato relacionada a cremes dentais com foco em sua apresentação clínica e a importância do diagnóstico diferencial com outras condições reativas, inflamatórias e potencialmente malignas da cavidade oral. Relato de caso: os 4 casos envolveram mulheres adultas e apresentaram-se clinicamente como manchas e placas brancas e vermelhas multifocais acometendo a língua, o assoalho de boca e a mucosa labial, associadas a discreta sensação de queimação e com evolução de 7 a 15 dias. Todas as pacientes relataram terem iniciado o uso de um novo creme dental poucos dias antes do surgimento dos sintomas e todas as lesões desapareceram em um intervalo de 5 a 7 dias após a suspensão do seu uso. Conclusão: estomatite de contato relacionada a cremes dentais deve ser considerada no diagnóstico diferencial das manchas e placas brancas e vermelhas da cavidade oral, e a história clínica detalhada é essencial para o diagnóstico final correto e precoce. Como o uso de novos enxaguatórios e cremes dentais, assim como de outros produtos de higiene oral, vem aumentando, dentistas clínicos devem estar atentos a possibilidade de reações locais orais associadas ao seu uso.