bluuebunny/crossref_metadata_2025 huggingface dataset:
Information Integration and Service Quality: Information Acquisition and Sharing Perspective
Authors: Margaret Dr. Ekeins , Odo Tare L.
Published: September 2023

The paper investigates the empirical link between information integration and service quality. Specifically, to examine the relationship between information acquisition and service quality, to ascertain the relationship between information sharing and service quality. The study adopted the resource-based view theory (RBV). A correlational survey design was employed and a questionnaire was adopted as the primary source for data collection from the top management employees of the studied telecommunication firms, inferential analysis was done using Spearman Rank Correlation Coefficient. The study revealed that there is a significant relationship between information acquisition and service quality, and also there is a significant relationship between information sharing and service quality. This paper concludes that information integration correlates with service quality. It was recommended that business organizations should invest in standard information technologies that support information acquisition and sharing from multiple sources in the business environment.
Analysis of Garri Marketing in Atiba Local Government Area, Oyo State Nigeria
Authors: Ojedokun I.K. , Akinyode A.E
Published: September 2023

The study was conducted in Atiba Local Government Area of Oyo State in the south west zone of Nigeria. The main of the study is to examine the profitability of garri in the study. Specifically, to describe the socio economic characteristics; marketing practices and experience and costs and returns of garri marketers in the study area. Simple random sampling techniques was used to select representative samples with a total of 120 respondents. Budgetary analysis and regression analysis was used to estimate the cost and return and factors that determine the profitability of garri marketers in the study area. The result revealed that majority (90%) of the respondents were female with low literacy level owing to the fact that most of the respondent had primary education has the highest level of education. Majority (53.34%) of the respondent are within the age range of 26-35years.This implies that most people who are engage in this business are in the active age. Majority of the respondent are wholesalers (65.83%) while 27.50% of the respondents are retailer. The result on cost and returns revealed that Total revenue was N43, 200, 000 and Total cost was N 35,130,058 with a Gross margin of N8,674, 300 and Net Profit of N 8,069,942 per Month. The benefit cost ratio is N1.23 since BCR is greater than 1, this implies that garri marketing is very profitable. The result on the constraints showed that fluctuation in price (40.83%) is the most serious problem facing garri marketing in the study area due to season of the year. This could be attributed to dry season when harvesting tends to reduce and supply becomes low as a result of caking of the soil which makes harvesting difficult and costly, other problems that also surface are customer buying on credit and not paying on time, goods not delivered on time due to poor road infrastructure and lack of capital. Based on the result obtained from regression analysis there is significant relationship between reve
Roles of African Cultural Factors in Lotto Patronage
Authors: Chikwendu Chimezie , Omeje Obiageli
Published: September 2023

In an attempt to uncover and address African cultural factors precipitating lotto patronage among youths, this study investigated roles of African cultural factors in lotto patronage. A total of one hundred and twenty-four comprising 119 males and 5 fameless, between the ages of 16-43 years, with a mean age of 26.21 and standard deviation of 1.76, sampled using purposive and available sampling techniques. All residing in Achara layout, Enugu south metropolis of Enugu State. A 13-item questionnaire designed by the researchers was used as the research instrument. Cross sectional survey design was adopted, while Chi-Square was used to analyze the scores obtained from the participants. The findings revealed that there are strong significant influence of people’s views of parental pressure on their children to get rich and appear like others (x 2 = 68.26 P <.001);prestige accorded to the rich by the society (x 2 = 54.22, P < .001), societal expectations to acquire wealth by all means in other to belong to high class (x 2 = 20.16, P<.001), accolades given to the rich by the society while displaying money at functions (x 2 = 11.64, P < .001), the urge amongst the youths to live flamboyant lives (x 2 = 71.26, P <.001), trying to meet up with family and friends needs (x 2 = 14.22, P < .001), the zeal to acquire properties (x 2 = 77.44, P < .001), the urge to appear flashy and rich amongst the family members (x 2 = 9.33, P < .01), and unemployment (x2 = 8.26, P <.001). The zeal to acquire properties had the highest coefficient (x2 = 77.44, P < .001) and as such proven to be strongest African cultural factor that promotes lotto patronage, while unemployment yielded least contributor of lotto patronage. It was therefore recommended that there is need to change views of those African cultural factors especially the zeal African youths have to acquire properties which sometimes
Access and Mobility to Transportation for the Rural Poor: Examining the Role of Intermediate Means of Transportation (IMT) in Kafin Lemo, Burra District Ningi Local Government Area of Bauchi State, Nigeria
Authors: Ningi Nasiru Barau , Ningi AuwalIs’ haq , Duala Tata
Published: September 2023

The research examine the role of Intermediate Means of Transportation (IMT) in addressing the transportation needs of the rural poor of KafinLemo ward of Burra district in Ningi local Government area of Bauchi State, Nigeria. The study was undertaken from a qualitative perspective because of the need to ask more probing questions than just limiting the participants to a set of responses. The data was collected through in-depth interviews and focus group discussions. The responses highlight the fact that in the absence of the conventional vehicle.
Testes moleculares para nódulos tireoidianos indeterminados: Revisão integrativa da literatura
Authors: Mehanna Samya Hamad , Steinmacher Carolina de Oliveira , Soares Gregório Andreassa , Castro Eduardo Morais de , Linhares Julia Costa
Published: September 2023

Introdução: Os nódulos de tireoide são comuns, com prevalência de 40% a 60% e taxa de malignidade de 5% a 15%. A punção aspirativa por agulha fina (PAAF) tem sido usada desde meados dos anos setenta para realizar o diagnóstico citopatológico dessas lesões. Porém, o dilema surge quando o resultado é indeterminado. A incerteza sobre esses espécimes foi impulsionador para o desenvolvimento de métodos moleculares que analisam o material da PAAF além do olhar microscópico. Desenvolvimento: Trata-se de uma revisão integrativa de literatura realizada a partir das bases de dados PubMed e Scielo e guiada pela seguinte questão norteadora: “quais testes moleculares disponíveis atualmente e sua capacidade de diagnosticar nódulos tireoidianos indeterminados na PAAF?”. A amostra final foi composta por 13 artigos. Em relação aos exames genéticos disponíveis atualmente, temos: Afirma (GEC e GSC), Thyroseq (v2 e v3), Rosetta GX Reveal e ThyGenX/ThyraMIR. De modo geral, os achados da pesquisa mostram o impacto positivo dos resultados dos testes no manejo de casos de nódulos categorizados como indeterminados na PAAF. As informações sugerem que o uso em pacientes Bethesda III e IV podem ter predição acurada do risco de malignidade e reduzir o número de tireoidectomias realizadas desnecessariamente. Considerações finais: A American Thyroid Association já inclui recomendações gerais sobre o uso e interpretação de testes moleculares auxiliares levando-se em consideração o contexto clínico, ultrassonográfico e achados citológicos, não havendo algoritmo específico para seleção dos casos duvidosos.
Violência em médicos: uma análise documental
Authors: Tanajura Tarcísio César Assunção , Santos Cinara Dourado Pereira Correia , Silva Júnior Geraldo Lino da , Vasconcelos Pedro Fonseca de
Published: September 2023

A violência é um dos principais desafios ético-políticos em âmbito nacional e local. Possui diversos tipos dentre eles, a violência institucional contra médicos. Tal violência, antes relatada somente nas grandes metrópoles, hoje sofre a interiorização, disseminando em todos os municípios do Brasil. Ao menos em tese, o Conselho Federal de Medicina (CFM) já introduziu medidas de conscientização sobre as agressões vividas pelos médicos, mas ainda há aumento relativo nos casos de hostilidade vivenciada por estes profissionais. O presente estudo teve o objetivo de realizar uma análise documental da violência em médicos no Brasil. Trata-se de uma pesquisa exploratória e documental no site do CFM e após a escolha das publicações e seleção do conteúdo, procedeu-se a fase de análise dos dados, fundamentado na Técnica de Análise de Conteúdo de Bardin. Os resultados apontaram que as principais causas de violência contra os médicos são: a demora no atendimento, falhas na assistência, falta de harmonia, discordância quanto às condutas e a deterioração da relação médico-paciente, insatisfação com o serviço; pobreza e doenças psíquicas. Esse tipo de violência prejudica os trabalhos e tem levado ao adoecimento de médicos e até a decisão de se desligarem do trabalho, deteriorando a qualidade assistencial. Como medidas preventivas se pode destacar a criação de comitês de bioética, registro em forma de boletins de ocorrência por parte dos médicos, medidas de melhorias de infraestrutura e recursos humanos, entre outros. Conclui-se que investimentos em saúde são necessários, facilitando atendimentos, não faltando materiais de trabalho e acelerando exames complementares a cada consulta. Tais medidas, podem minorar os riscos para acontecimento desse agravo à saúde.
Implantação de um repositório digital para projetos integradores apresentados na unidade de ensino SENAC MPR Parintins
Authors: Rocha Cleiliana Cruz , Santos Lorene Batista dos , Santos Emilly da Silva , Bruce Mariana de Souza , Silva Vanessa Coelho da , Costa Max Adilson Lima , Almeida Jean Reis de , Batalha Antonio Lucas Barbosa , Viana Jocemilda da Silva
Published: September 2023

O presente estudo tem como tema Implantação de um Repositório Digital para Projetos Integradores apresentados na Unidade de Ensino Senac MPR Parintins. Buscou implantar um Repositório Digital para Projetos Integradores, com a finalidade de desenvolver e apoiar os alunos e acadêmicos da instituição a levarem seus projetos para o Mercado de Trabalho. O estudo teve como base os estudos desenvolvidos por autores, como Senac (2022), Sebrae (2013), Kotler (2006), Chiavenato (2007), Gil (2007) e Silveira (2020), entre outros. O estudo foi realizado com enfoque quanti-qualitativa, com apoioda pesquisa exploratória. Os sujeitos deste estudo foram 12 (doze) Profissionais da instituição SENAC MPR Parintins entre coordenador, docentes, supervisor e 21 (vinte e um) empresários de diversos segmentos de Parintins. Como resultado, o estudo aponta que a Plataforma Repositório Digital é viável,articula os conhecimentos estudados, apoio a instituição e acadêmico, com um olhar voltado também ao Mercado de Trabalho. Evidenciou-se que o objetivo do estudo foi alcançado porque o trabalho conseguiuanalisar a falta de acesso, armazenamento e organização dos Projetos Integradores e que a instituição Senac MPR Parintins necessita de recursos para o desenvolvimento de Projetos voltados para as novas tecnologias. Como possibilidades, os empresários acreditam que o Repositório Digital pode ajuda-los a melhorar a qualidade de suas empresas com ideias inovadoras e consultoria especializadas. A análise Swot revela que é preciso inserir no planejamento estratégico as atualizações dos profissionais para as novas tecnologias, com cursos e treinamentos específicos para os profissionais.
Contribuições de uma experiência educativa docente com aula prática para ensinar piscicultura no ensino médio integrado em zootecnia
Authors: Paula Daniella Aparecida de Jesus , Cruz Sayonara Ribeiro Marcelino , Mendonça Michele de Oliveira
Published: September 2023

Objetivou-se analisar a contribuição da aula prática sobre parâmetros de qualidade da água para a piscicultura como ferramenta auxiliar no processo ensino e o desempenho dos estudantes do curso técnico em zootecnia integrado ao Ensino Médio do IFSUDESTE MG, Campus Rio Pomba. A atividade constituiu-se da observação de uma situação-problema com a investigação da qualidade da água dos tanques do Setor de Piscicultura pelos parâmetros: transparência, oxigênio dissolvido, temperatura, amônia e nitrato. Os estudantes participaram ativamente, confeccionaram o Disco de Secchi e redigiram dez relatórios com características de aprendizado prático. A atividade revelou-se essencial desenvolvimento do aprendizado sobre os conceitos importantes de qualidade de água.
Mobilização Articular como Recurso Terapêutico Manual Aplicado na Fisioterapia
Authors: Navega Marcelo Tavella , Cipolli Jamilly Radiuc , Roide Leticia Yoko Nakamura de , Severino Luisa Placideli , Spinoso Deborah Hebling
Published: September 2023

As mobilizações articulares, tanto da coluna vertebral quanto das demais articulações são recursos terapêuticos manuais eficazes no processo de reabilitação e prevenção de disfunções musculoesqueléticas que podem levar à diminuição da capacidade funcional. Sendo assim, o domínio da fundamentação teórica e conhecimento prático das técnicas de mobilizações são importantes para Fisioterapeutas que buscam a melhor funcionalidade em indivíduos que querem melhorar sua capacidade funcional. Por meio do raciocínio clínico baseado no Conceito Maitland, que envolve todo processo de avaliação e tratamento, este capítulo trará as mobilizações mais usadas na prática clínica do Fisioterapeuta.
Relato de experiência do projeto Artesanato e extensão: Uma ponte entre a academia e a comunidade
Authors: Linke Paula Piva , Barcelos Silvia Mara Bortoloto Damasceno , Dalberto Anelise Guadagnin , Theodoro Anderson da Silva , Schmidt Maria Eduarda Chaykowski
Published: September 2023

O projeto desenvolvido pretende colaborar com o artesanato rural paranaense por meio de ações extensionistas que foquem em melhorias, valorização e divulgação de seus produtos, focando a geração de renda com a comercialização destes produtos, por meio de oferta de ações de extensão na área da produção e divulgação de imagens do artesanato rural; na área da identidade e criatividade no artesanato rural e na área da produção de produtos de artesanato rural de casulos de seda de segunda qualidade. O projeto utilizou-se da (RBS) Revisão Bibliográfica Sistemática para a construção do referencial teórico dos assuntos específicos de cada módulo. Em cada etapa do projeto foi utilizado técnicas específicas para cada Oficina de acordo com suas especificidades.
Stabilization by chemical preservatives of carboxymethyl cellulase from fungus Aspergillus niger produced by State Solid fermentation in fruit residues using chemical preservatives
Authors: Junqueira Letícia Lima , Costa Floriatan Santos , Franco Marcelo , Assis Sandra Aparecida de
Published: September 2023

The residues of fruticulture as acerola, guava, passion mango can be efficiently used to produce enzymes by Solid state fermentation. In this work we used these residues and filamentous fungus Aspergillus niger ATCC 1004 to obtain carboxymethyl cellulases (CMCase). The preservation of enzyme activity is a fundamental for provide commercial enzymes with good price and high enzyme activity. Three substances (sodium chloride, sodium benzoate and monosodium phosphate) were tested as enzyme activity preservative using a simplex-centroid mixture design was applied to obtain the better concentrations of this substances. The effect of preservatives was tested for 72 hours on the activity of the CMCase enzyme by incubating the enzyme with the salts of sodium chloride, monosodium phosphate and sodium benzoate at various concentrations, in citrate-phosphate buffer pH 5.0 at 50 mM, at a temperature of 50 °C. The results showed that the mixture that favored the optimum condition simultaneous response was composed of 42% sodium chloride, 38% sodium benzoate, and 20% monosodium phosphate. Then, the substances studied shows that are good option to preserve the CMCase enzyme produced fungus Aspergillus niger ATCC 1004.
The importance of games for the therapy of children with ADHD
Authors: Carvalho Aline dos Santos Moreira de , Mesquita Thais Barros , Albuquerque Léia Flauzina da Silva , Amorim Veronica Cristina Pinto de , Anchieta Gabrielle Oliveira dos Santos , Rocha Renata , Silva Lana Cristina de Almeida , Batista Renan da Silva , Trinta Valeska Rogéria Vieira
Published: September 2023

Attention Deficit Hyperactivity Disorder is conceptualized in two distinct aspects: the biomedical concept and the historical-behavioral theory. Many studies are focused on pedagogical strategies and methodologies that help in the therapy of children with ADHD and, consequently, in the improvement of learning, behavior and relationships, since studies on the disorder are closely linked to the school context, as this is where the diagnosis usually takes place as well as the follow-up of treatments and therapies. One of the methodologies used both in behavioral therapy and in the school context is the methodology of games or gamification, which, through play, aims to develop skills and competences as well as behavioral, social and intellectual aspects of children with ADHD. The present study aims to analyse the importance of games in the therapy of children with ADHD, weaving some characteristics in the therapy, conceptualizing gamification in the school context and relating both to the disorder. For this, we used bibliographic research, of a descriptive and exploratory nature, regarding the proposed objectives. The resulting textual production comprises the results obtained by the bibliographic exploration of the theme, as well as by the relationship of importance analyzed. The author's conclusions and impressions are in the final conclusions.
A look at the health of the population deprived of liberty
Authors: Peron Carolina Sena , Silva Sade Germano de Antonio e , Lobo Taynah Junqueira
Published: September 2023

Little is addressed about the health of the population deprived of liberty, and therefore, such helplessness further corroborates the rates of marginalization and neglect of such individuals. The immense Brazilian territory and the poor economic distribution further validate the coexistence of different realities, this fact culminates in an immense difficulty in achieving the equity proposed by our Unified Health System.
A study on Apple and its actions in retail marketing
Authors: Sila Letícia da , Antunes Maria Julia Muniz , Carrino Adauto Luiz
Published: September 2023

The present work aims to study the marketing and retail actions of the Apple brand and its effects on the marketing environment. Thus, the central problematization seeks to understand how Apple's retail marketing occurs and what are the resulting impacts of these actions on the marketing environment. To this end, the research begins with an analysis of the structure and systematization of the company Apple, seeking to understand its internal organization and how this influences its retail marketing strategies. Then, the specific actions and strategies adopted by Apple in the context of retail marketing are analyzed, such as the design of its stores, customer service, product presentation and holding special events. Faced with this look, the methodology is understood in a systematic review of the existing literature on Apple and its retail marketing actions, so it was possible to obtain a solid theoretical basis. In this way, electronic databases were consulted, including books, scientific articles and other relevant sources, which address the subject of marketing and retail, trying to understand how it occurs and what are the stimuli that keep the Apple brand in the market until the current market scenario. . The results of this research bring relevant information about how the Apple brand behaves within retail in relation to marketing, understanding the strategies adopted by Apple and their impacts on the marketing environment is essential for understanding the company's success in the technology market. Furthermore, this study contributes to the marketing area, providing a detailed analysis of Apple's retail marketing actions. With this perspective, the results obtained can serve as a reference for companies in the technology and retail sector that wish to improve their marketing strategies, in addition to offering a starting point for future academic research on the subject. In short, through a systematic literature review and analysis of Apple's retail marketing actions, this study provided a deeper understanding of how the brand positions itself and influences the marketing environment. This acquired knowledge is valuable both for professionals in the sector and for researchers interested in exploring this specific topic.
Considerations for Chew Items for Dogs and Cats
Authors: Lewis John
Published: September 2023

Veterinary practitioners are often asked by pet owners, “What chew items should I give my pet?” Considerations include dental trauma, chewing behavior and bite forces, and periodontal disease. Characteristics of the ideal chew item may include, but not be limited to, the following: (1) It must be of interest to dogs and cats to encourage chewing behavior; (2) it is either long-lasting or, alternatively, it can be administered frequently without adverse consequences; (3) it is of high nutritional quality with minimal calorie increases above the current diet; (4) it is proven to decrease plaque and calculus; (5) it is not excessively hard to avoid harm to the teeth and jaws; (6) it has a broad safety spectrum with minimal risk of toxicity, choking, and GI obstruction. Maintenance of periodontal health may help to minimize systemic inflammation and sequela of chronic inflammation.
La violencia intrafamiliar durante el confinamiento: experiencias de jóvenes de educación media superior
Authors: Márquez González Mónica , Campos Bedolla Mónica Leticia , García Uribe Ma. Isabel
Published: September 2023

Este artículo presenta los resultados de una investigación sobre la violencia intrafamiliar llevada a cabo durante el confinamiento por Covid -19 con estudiantes de educación media de una institución pública y una privada del municipio de Querétaro, México. El objetivo es describir las experiencias de violencia intrafamiliar que vivieron los y las jóvenes de este sector durante el tiempo que duró el confinamiento. La descripción de lo que los y las jóvenes expresaron estará acompañada de la teoría de enfoque ecológico de Bronfenbrenner (1987) dado que la violencia intrafamiliar no sólo es un fenómeno de carácter endógeno, sino que es un entramado de varios contextos interconectados entre sí (laboral, social y educativo) y contextualizados en el momento histórico que se vivió y el impacto que provocó en el entorno familiar y en lo personal. Los hallazgos se sustentan en datos empíricos arrojados por encuestas (estudio cuantitativo) y entrevistas semiestructuradas (cualitativo) realizadas a la población participante del estudio, 211 de la preparatoria privada y 217 de la pública, dando un total de 428 estudiantes. El método fue mixto y descriptivo.  Desde una mirada ecológica las conclusiones muestran que el confinamiento vino a generar un cambio súbito en el sistema macrosocial que exacerbó las prácticas de violencia en el microsistema familiar observándose sobre todo en las relaciones violentas y la resolución violenta de conflictos, y se objetivizan en la violencia verbal, emocional y física. Siendo la escuela pública la que presenta un mayor porcentaje.
Diseño de una turbina eólica espiral de arquímedes mediante software cad - cae
Authors: Porras Jefferson , Navarrete Luis , Ramírez Jorge , Paredes Sebastián
Published: September 2023

Para modelar y simular una turbina eólica con éxito, hay que seguir un proceso de diseño detallado esto incluye determinar el tamaño y la forma de las palas del rotor, calcular el par requerido por el generador, seleccionar los materiales adecuados para la construcción el funcionamiento de un aerogenerador de espiral de Arquímedes que ha sido expuesto a fenómenos meteorológicos existentes en el casco urbano. en el cantón Latacunga provincia de Cotopaxi. Utilizando la estación meteorológica se logró determinar la velocidad media del viento en la zona, que es de 3,89 m/s, y la velocidad máxima medida, que es de 9,6 metros por segundo. Se planteó en una primera hipótesis de generar 1 kW de potencia eléctrica con los recursos en el sitio, sin embargo, debido a que la velocidad del viento en el lugar de recolección de datos fue insuficiente para alcanzar dicha potencia. Otra opción era aumentar el diámetro del rotor, pero esto no resultó práctico porque el proyecto estaba enfocado al área urbana. En cambio, se especificaron parámetros de diseño mediante cálculos de generación de energía que permitan aprovechar al máximo la energía cinética. Con la ayuda de estas mediciones, se puede generar una potencia de 33,25 W y 485,73 W, respectivamente, a las velocidades media y máxima medidas, respectivamente. Se requiere una velocidad del viento de al menos 15 m/s para generar la potencia máxima de 1 kW bajo las mismas restricciones de diseño.
Depresión, ansiedad y estrés en estudiantes universitarios
Authors: Jiménez Hurtado William , Cusme Torres Nadihezka , Cantuñi Carpio Verónica , Chasillacta Amores Fabiola , Egas Medina Fanny Paola
Published: September 2023

Los problemas de salud mental han ido en aumento en los últimos años, los diferentes cambios sociales han hecho que las exigencias que sufren los jóvenes de hoy no sean las mismas que sufrieron sus padres con su misma edad, no es de sorprenderse que desarrollen trastornos a partir de estas. El principal trastorno del estado de ánimo es la depresión, mientras que el estrés y la ansiedad ocupan un lugar muy importante cuando se habla de las preocupaciones de la vida diaria. Se pudo concluir que existe la presencia de las tres patologías y que estas se encontraban relacionadas entre sí, por lo cual la presencia de una puede estar acompañada de otra. La investigación tiene un enfoque cuantitativo, de diseño transversal con un estudio cuyo propósito fue el de identificar la presencia de estrés, ansiedad y depresión en estudiantes universitarios.
El ejercicio físico mejora la calidad de vida de los pacientes con la enfermedad de Parkinson. Revisión Sistemática
Authors: Llerena Karen , Carrasco Jesenia , Pilco Cynthia , Ribes Diana
Published: September 2023

La enfermedad de Parkinson (EP) es un trastorno progresivo y neurodegenerativo que afecta al estado físico, psicológico, social y funcional de las personas. El ejercicio físico deviene en una alternativa en el control de los síntomas y mejora de la calidad de vida de los pacientes, se utiliza para el tratamiento de algunos de los síntomas motores y no motores. Este estudio se enfoca en delimitar el efecto que tienen en la calidad de vida de los pacientes con la enfermedad de Parkinson las diversas técnicas de rehabilitación con ejercicios físicos, reportadas en la literatura científica seleccionada, mediante la revisión sistemática. Se escogen 20 estudios sobre el tema, constatando en los artículos revisados el empleo y efecto de los ejercicios aeróbicos, los entrenamientos de fuerza y flexibilidad, postura, coordinación y equilibrio; también ejercicios multifacéticos como taichí, yoga y danza, todos en diversas variantes.  Las diferentes formas de ejercicio producen disímiles mejoras en la capacidad aeróbica, fuerza, equilibrio, marcha, calidad de vida y mejora funcional en general. Se evidencia que el ejercicio físico revierte síntomas y atenúa la evolución de la EP. Los programas de rehabilitación deben iniciarse precozmente, ser multifacéticos, seguros y divertidos para mantener la adherencia y las estrategias personalizadas deben ser consideradas. Hay cuestiones sin una respuesta aun avalada científicamente por las limitaciones en las investigaciones, entre estas: el tipo de ejercicio más eficaz, frecuencia de realización, intensidad y series de entrenamiento.
Editor’s Welcome
Authors: Guo Joyce , Ju William
Published: September 2023

Tēnā koutou katoa and welcome to Issue 36 of Te Hautaka o ngā Akongā Rongoā, the New Zealand Medical Student Journal (NZMSJ). The theme of this issue is “Advocacy in Health,” which is crucial in the betterment of the healthcare system for both patients and health professionals. It is our privilege to share with our readers a wide range of insightful and high-quality articles by health care professional students, clinicians, and academics from Aotearoa.

Advocacy plays a core role in the realm of healthcare, serving as a powerful catalyst for positive change and improved outcomes on both individual and systemic levels. Healthcare advocacy for the individual involves standing up for the rights, needs, and well-being of patients, ensuring that their voices are heard and their concerns addressed. On a broader scale, advocacy in healthcare contributes to the refinement of healthcare policies, regulations, and services. As providers working on the front lines, health professionals often better identify areas of necessary improvement than policy-makers. Advocacy campaigns and initiatives can shed light on systemic issues, drive policy changes, and influence healthcare regulations that ultimately shape the healthcare experience for everyone.

We believe that by holding stakeholders accountable and pushing for transparency, advocacy serves as a counterbalance to potential shortcomings in the healthcare sector. Overall, the significance of ad- vocacy in healthcare extends beyond individual cases, contributing to a more inclusive, patient-centric, and effective healthcare system for entire communities and populations.
Prescribing a Healthy Planet
Authors: Coffey Dermot , Wright Summer , S. Chauhan Angad
Published: September 2023

Human wellbeing is inexorably linked with planetary health. This relationship has long been understood in Indigenous worldviews and is receiving increasing attention in academic literature and public health movements. Yet education on planetary health and the health implications of climate change has thus far failed to reach across health student curricula. Students of health disciplines, whether they be doctors, nurses, or dietitians, are not receiving adequate education about planetary health. Failure to deliver this information to the next generation of health professionals stymies the protection and restoration of human and planetary health, which is desperately needed for a viable and equitable future.
The JAK/STAT signalling pathway: Tiny molecules transforming therapeutics
Authors: Men Velia
Published: September 2023

Why is an understanding of the JAK/STAT signalling pathway important in common skin diseases and how will that knowledge transform therapeutics?

From genomes to vaccines, organ transplants to biotechnology, it is fair to say that modern medicine has seen magnificent breakthroughs in the last century. Fundamentally, what has enabled these advancements is an understanding of basic cellular and molecular biology. Among the pivotal discoveries in this field, the Janus kinase/ signal transducer and activator of transcription (JAK/STAT) pathway has emerged as a critical player in some of today’s most debilitating and deadly human diseases, including various cancers, autoimmune disorders, and chronic inflammatory diseases. Now, an understanding of the JAK/STAT pathway has become important in common skin diseases, from predictive biomarkers and disease prognosis to tiny molecules transforming therapeutics.
“What’s the damage? Give it to me!”: Type 2 diabetes mellitus and obesity management in primary care with implications for biomedical science, clinical practice and population health
Authors: Swinburn Thomas
Published: September 2023

Type 2 diabetes mellitus (T2DM) is a condition that defines medicine in the 21st century. Multifactorial individual and environmental causes have given rise to a non-communicable disease that challenges traditional prevention and treatment paradigms. In this report, the author explores the case of one patient with T2DM he met during his general practice placement in South Auckland. He argued that in the face of such interwoven challenges, an understanding spanning from the pathophysiology to the pathological environment—and an ability to bridge these understandings in the clinical context—is essential in supporting patients with this complex condition.
How to collaborate with a Biostatistician
Authors: Turner Robin M , Cameron Claire , Samaranayaka Ari
Published: September 2023

Health researchers in various disciplines often seek advice from, or collaboration with, biostatisticians. This advice and collaboration can vary from guidance on a specific point through to extensive collabo- ration over many years across all aspects of the research process. Anecdotally, the level of support that health researchers request is often driven by the researchers’ own beliefs about what biostatisticians do and what they can contribute. This does not always align with what biostatisticians actually do. In this article we summarise, from our own experience, the benefits of collaborating with academic biostatisti- cians by explaining what our jobs involve and how we collaborate best.
Do Swiss urologists and Swiss internists screen themselves and their relatives for prostate cancer? A questionnaire study
Authors: Scherer Thomas P. , Saba Karim , Wettstein Marian S. , Lucca Ilaria , Mortezavi Ashkan , Waisbrod Sharon , Aujesky Drahomir , Capaul Regula , Strebel Raeto T.
Published: September 2023

PURPOSE: Prostate-specific antigen (PSA) screening for men at risk of prostate cancer is controversial. The current recommendation is to raise awareness of prostate cancer and offer PSA screening in accordance with shared decision- making. Whether the possibility of a PSA screen is discussed with the patient depends on the treating physician, but data on physicians’ attitudes towards PSA screening are scarce. This study aimed to examine internists’ and urologists’ personal PSA screening activity as an indicator of their attitude towards PSA screening.
MATERIALS AND METHODS: Members of the Swiss Society of Urology and the Swiss Society of General Internal Medicine were asked in 08/2020 to anonymously complete an online survey about personal PSA screening behaviour for themselves, their fathers, brothers and partners. Categorical and continuous variables were compared by chi-squared tests and t-tests, respectively.
RESULTS: In total, 190/295 (response rate: 64%) urologists and 893/7400 (response rate: 12%) internists participated in the survey. Of the participants, 297/1083 (27.4%) were female. Male urologists >50 years of age screened themselves more often than male internists >50 years of age (89% vs 70%, p <0.05). Furthermore, urologists reported recommending screening statistically significantly more often than internists to their brother, father or partner regardless of their sex (men: 38.1% vs 18.5%; p <0.05; women: 81.8% vs 32.2%; p <0.05).  
CONCLUSIONS: Most participating male physicians >50 years of age have screened themselves for prostate cancer. Furthermore, PSA screening of relatives was significantly associated with the urology specialty. The reasons physicians screen themselves substantially more often than the public and why male and female urologists as well as male internists perform PSA screening more frequently in their private environment than female internists should be further examined.
Medication Non-adherence Among Pediatric Liver Transplant Recipients
Authors: Shamsaeefar Alireza , Motazedian Nasrin , Sayadi Mehrab , Mashhadiagha Amirali , Kazemi Azar , Dehghani Seyed Mohsen , Afshinnia Farsad , Kazemi Kourosh , Malekhosseini Seyed Ali
Published: September 2023

Background: More and more children are undergoing liver transplantation and reaching adolescence, even though they must take immunosuppressant drugs for their entire lives. Objectives: This study aimed to determine the non-adherence rate in liver transplant recipients and identify its potential etiologies. Methods: A cross-sectional survey was performed to assay medication adherence among pediatric liver transplant recipients in Shiraz, Iran. The patients' demographic, socioeconomic, and clinical characteristics were collected via interviews. Medication adherence was assessed using a validated Morisky 8-item Medication Adherence Questionnaire (MMAS-8). Results: A total of 157 patients with a mean age of 12.73 ± 4.02 participated in this study. Based on the Morisky adherence scores, 12.1% (n = 19), 25.5% (n = 40), and 62.4% (n = 98) were categorized as low, moderate, and high adherence groups, respectively. Among all studied variables, and follow-up time after transplant were significantly associated with adherence among children after liver transplantation in Iran. Conclusions: The rate and reported causes of non-adherence are similar to those found in previous studies, which is quite remarkable. Proper instruction, financial aid, and recruitment of new technologies are among the strategies to overcome non-adherence.
Fair Allocation of Network Resources for Internet Users
Authors:   , Banchs Roca Albert
Published: September 2023

In a commercial Internet, the traffic behavior is determined by the contracts between the ISPs and the users, where a user can be a dial-up user, or one corporate network or a group of individual customers or networks. Since the user is the entity with whom the contract is signed, it should also be the unit to which network resources are allocated. However, while much research in the past has been directed to fair resource allocations for flows (e.g. maxmin fairness and proportional fairness), much less effort has been invested on fair allocation of resources for users. The work done in this thesis tries to fill this gap: we study how to share fairly the network resources among users, when a user can possibly send several flows through different paths.

The first part of the thesis focuses on the definition of a fairness criterion for the above problem: user maxmin fairness. The proposed criterion is based on the concepts of utility and welfare developed in the field of political science and political economics. We subdivide the problem of fairly allocating the network resources among users in two subproblems: 1) achieve fairness with respect to the utility experienced by the different users (inter-user fairness) and 2) achieve fairness with respect to the utility experienced by the different flows of a user (intra-user fairness). User maxmin fairness is the result of combining the two welfare functions that solve these two subproblems.

Along with the user maxmin fairness criterion, in this thesis we propose a mechanism to implement it: the User Fair Queuing (UFQ) mechanism. In UFQ, a user is allowed to assign any label values to his packets to indicate their relative priority. At the ingress, an algorithm is used to control these labels assigned by the user. We have shown mathematically that: (a) the proposed label control does not allow the asymptotic throughput of a user to exceed its fair rate, and (b) if users label their packets in order to maximize their level of satisfaction or utility, then the resulting bandwidth allocation is user maxmin fair.

In the last part of the thesis, we propose a network architecture for the Internet: the User Fair Differentiation (UFD) architecture. The UFD architecture extends the UFQ mechanism in such a way that its good features for resource sharing are preserved. In addition, UFD provides service differentiation, inter-domain communication, real-time traffic support and extensions for multicast and wireless. The fact that neither admission control nor signaling are required strongly contributes to the simplicity of UFD. The fact that no per-user state is kept at core nodes makes the proposed architecture scalable.

The performance of the UFD architecture has been extensively evaluated via simulations and a prototype implementation. Both simulation and experimental results have validated the architecture proposed in this thesis.
Contribución a la seguridad en servicios multimedia. Aplicación a entornos multicast
Authors:   , Pegueroles Vallés Josep R.
Published: September 2023

Usually multimedia services can be divided into two different phases: access to the service and content distribution. The first phase usually takes place over reliable transport protocols and unicast connections. The second one is often performed over unreliable transport protocols and multicast communications.

Adding security to the first phase only needs a straight application of well known unicast security techniques. On the contrary, adding security to IP multicast requires the study of a new problem because traditional unicast solutions do not fit the new environment.

This Doctoral Thesis deals with the arising problems when security is added to multicast environments and proposes different practical solutions.

Among all the attacks to the distribution phase, eavesdropping is probably the most significant. Ciphering is the security service against eavesdropping. Multicast encryption introduces the Key Management problem in multicast.

If Perfect Forward and Backward secrecy is required the session key must be updated every time a member joins or leaves the multicast group. In huge and highly dynamic groups the unicast distribution of the session key is completely unfeasible

The contributions of this Thesis consist in different logical key tree based updating algorithms for multicast. Our proposals take advantage of pseudo-random functions and modular reduction in order to reduce required bandwidth for updating and total amount of bytes stored in the Key Server.

In many scenarios it is not worth to update the key every time a change in the membership occurs. Services as Web-TV permit a decrease in security in order to reduce bandwidth requirements for key management. In such case batch rekeying algorithms are used. This kind of algorithm process periodically all joining and leaving requests produced since the last rekeying process at once. Batch rekeying algorithms are efficient if and only if the logical tree is maintained balanced. This Thesis also proposes a batch-rekeying algorithm that leads to completely balanced trees for the whole group lifetime.
Batch processing techniques are also combined with the former contributions in order to increase efficiency.

The proposals of this Thesis are not supported by the IETF standard on Key Management for multicast secure communications (GDOI). This is mainly because this standard does not allow members to change their position in the tree while they are members of the group. Finally, an adaptation of GDOI allowing the performance of our contributions is proposed.
Contribución a la protección de agentes móviles frente a hosts maliciosos. Detección de ataques y políticas de castigo
Authors:   , Esparza Martín Óscar
Published: September 2023

Este trabajo presenta tanto el estado del arte como el análisis de las principales propuestas de protección de agentes móviles frente a los ataques de la plataforma de ejecución. La comprensión del problema de los hosts maliciosos y la dificultad que presenta su resolución es importante para entender que todavía no exista una propuesta que dé solución global a dicho problema. Esto sin duda está limitando el uso de los agentes móviles en sistemas abiertos como Internet.
Esta carencia en el ámbito de la seguridad nos ha motivado a desarrollar nuevas propuestas de protección de agentes. Dado que consideramos que las propuestas que tratan de evitar los ataques son demasiado costosas computacionalmente o imposibles de implementar en un sistema real, centraremos nuestros esfuerzos en propuestas que traten de detectar ataques. En ese sentido, se introducen tres nuevas aportaciones que pretenden contribuir a solucionar el problema de los hosts maliciosos. Como primera contribución de la Tesis se introduce un Protocolo de Detección de Sospechosos (SDP) para mejorar algunos aspectos de la propuesta de detección de ataques más conocida, la de las trazas criptográficas de Vigna. No sólo se ha realizado el estudio teórico de SDP, sino que se dispone de una implementación con la cual se han podido realizar pruebas del coste que supone, con resultados positivos. Sin embargo, consideramos que el anterior mecanismo conjunto todavía es demasiado costoso computacionalmente. Por esa razón y como segunda contribución se presenta un mecanismo propio de detección de ataques alternativo al anterior y más ligero computacionalmente. Dicho mecanismo está basado en el empotrado de marcas de agua en el agente, esto es, Watermarking de Agentes Móviles (MAW). Dado que los mecanismos de detección son poco útiles si no hay posibilidad de castigar a los hosts maliciosos, como tercera contribución se presenta una nueva entidad sancionadora, la Autoridad de Revocación de Hosts (HoRA).La implementación de la HoRA está todavía en desarrollo, con lo cual no se han podido realizar las pruebas de evaluación del rendimiento.
Contribución a la validación de certificados en arquitecturas de autenticación y autorización
Authors:   , Satizábal Echevarria Isabel Cristina
Published: September 2023

Authentication and authorisation architectures based on certificates have not been widely accepted due to their cost, inflexibility and difficult management.
The complexity of the Public Key Infrastructure (PKI) is increased by the certification path validation process that involves: discovering the path, retrieving the certificates, verifying their digital signature and checking that none of the certificates have expired or have been revoked. This process demands certain processing and storage capacity from the verifier that can exceed the features of some devices, such as mobile phones and smart cards.
In this thesis, we evaluate the computational cost and the storage capacity required by a verifier to carry out the path validation process and determine that they are critical factors for constrained devices. In addition, we introduce two proposals that contribute to simplify the path validation process from the verifier's point of view: TRUTHC and PROSEARCH.
TRUTHC uses two hash chains to establish an alternative trust relationship among the different entities of a hierarchical PKI. Thus, the signature verification operations are replaced by hash operations, what contributes to decrease the computational cost of the verifier. The path verification is carried out by a Verification Authority (VA). TRUTHC is compatible with the X.509 certificates and its security depends on a large extent of the seeds' confidentiality. TRUTHC can be used in environments where devices have limited processing capacity and it is necessary to delegate the validation process in other entity, such as mobile networks with validation servers.
On the other hand, PROSEARCH establishes a virtual hierarchy in a mesh PKI, based on the trustworthiness level of the participant entities. This protocol facilitates the certification path discovery since in a hierarchical model the trust relationships are unidirectional and there is a single path between each pair of entities.
PROSEARCH does not establish new trust relationships among the entities but it takes the existing relationships to establish the hierarchy. Thus, it is not necessary to issue new certificates or adjust the trust points.
In addition, PROSEARCH is adaptable to entities with limited processing and storage capacities, since hierarchy is established considering a maximum certification path length.
The fast execution of PROSEARCH makes possible its use in different environments such as critical scenarios and ad-hoc networks.
Although the hierarchy found by our protocol is not always the best solution, in our opinion this is not an important drawback since simulation results show that in most cases an acceptable hierarchy is found, especially considering that the simplicity of the protocol makes it easy-to-implement even for constrained devices.