bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of the 12-gene Breast DCIS Score® assay with local recurrence in patients with ductal carcinoma in situ treated on accelerated partial breast radiotherapy protocols
Authors: Leonard Charles , Tole Shannon , Turner Michelle , Bennett John , Howell Kathryn , Carter Dennis
Published: December 2020

Background

The following analysis explores clinicopathologic factors and the 12-gene Breast DCIS Score test result in order to better define an appropriate DCIS (ductal carcinoma in situ) population eligible for APBI (accelerated partial breast radiotherapy).
Methods

This exploratory analysis aimed to retrospectively measure the association between the 12-gene Oncotype DX Breast DCIS Score® assay (Redwood City, CA) and relevant clinicopathologic factors with locoregional recurrence in a pooled cohort of women treated with local excision and APBI on prospective phase II (NCT01185145) and phase III (NCT01185132) clinical trials. Univariable Cox proportional hazards regression was used to determine whether there was an association between local recurrence and DCIS Score result risk group (≥ 39 vs < 39) and clinicopathologic factors.
Results

This analysis included 104 evaluable patients (n = 18 from NCT01185145 and n = 86 from NCT01185132). The median age was 60 years (range: 40–79). Seventy-nine percent of patients were postmenopausal. The median span of DCIS was 10 mm (range 2–45 mm). Two-thirds of the cohort presented with necrosis (71%). The distribution of DCIS Score® results ranged from 0 to 82, with 69% of patients having a DCIS Score result < 39. The median follow-up time was 8.2 years in NCT01185145 versus 3.0 years in NCT01185132. There were 6 local ipsilateral breast recurrences. DCIS Score result was significantly associated with local recurrence in univariable modeling, hazard ratio = 10.3 (95% CI 1.7, 198.4); p = 0.010. None of the clinicopathologic characteristics resulted in any significant association with locoregional recurrence.
Conclusion

The Breast DCIS Score assay demonstrated risk stratification in this cohort of patients treated with local excision and APBI pooled from two clinical trials. These results are consistent with those recently published utilizing whole breast radiotherapy. Due to the small number of local recurrence events and limited follow-up time, further investigations are needed to confirm findings.
Lateral lumbar interbody fusion after reduction using the percutaneous pedicle screw system in the lateral position for Meyerding grade II spondylolisthesis: a preliminary report of a new lumbar reconstruction strategy
Authors: Takami Masanari , Taiji Ryo , Okada Motohiro , Minamide Akihito , Hashizume Hiroshi , Yamada Hiroshi
Published: December 2020

Background: Utilization of a cage with a large footprint in lateral lumbar interbody fusion (LLIF) for the treatment of spondylolisthesis leads to a high fusion rate and neurological improvement owing to the indirect decompression effect and excellent alignment correction. However, if an interbody space is too narrow for insertion of an LLIF cage for cases of spondylolisthesis of Meyerding grade II or higher, LLIF cannot be used. Therefore, we developed a novel strategy, LLIF after reduction by the percutaneous pedicle screw (PPS) insertion system in the lateral position (LIFARL), for surgeons to perform accurate and safe LLIF with PPS in patients with such pathology. This study aimed to introduce the new surgical strategy and to present preliminary clinical and radiological results of patients with spondylolisthesis of Meyerding grade II.Methods: Six consecutive patients (four men and two women; mean age, 72.7 years-old; mean follow-up period, 15.3 months) with L4 spondylolisthesis of Meyerding grade II were included. Regarding the surgical procedure, first, PPSs were inserted into the L4 and L5 vertebrae fluoroscopically, and both rods were placed in the lateral position. The L5 set screws were fixed tightly, and the L4 side of the rod was floated. Second, the L4 vertebra was reduced by fastening the L4 set screws so that they expanded the anteroposterior width of the interbody space. At that time, the L4 set screws were not fully tightened to the rods to prevent the endplate injury. Finally, the LLIF procedure was started. After inserting the cage, a compression force was added to the PPSs, and the L4 set screws were completely fastened. Results: The mean operative time was 183 min, and the mean blood loss was 90.8 mL. All cages were positioned properly. Visual analog scale score and Oswestry disability index improved postoperatively. Bone union was observed using computed tomography 12 months after surgery.Conclusion: For cases with difficulty in LLIF cage insertion for Meyerding grade II spondylolisthesis due to the narrow anteroposterior width of interbody space, LIFARL is an option to achieve LLIF combined with posterior PPS accurately and safely.Trial registration: UMIN-Clinical Trials Registry, UMIN000040268, Registered 29 April 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000045938
Predictive value of live birth rate based on different intrauterine adhesion evaluation systems following TCRA
Authors: Cao Mingzhu , Pan Yingying , Zhang Qingyan , You Danming , Feng Shuying , Liu Zhi
Published: December 2020

Objective: The aim of this study was to assess the predictive value of five different intrauterine adhesion (IUA) evaluation systems for live birth rate following transcervical resection of adhesion (TCRA).Method: This retrospective study included 128 women with IUA who desired for spontaneous conception after TCRA. All the patients were retrospectively scored by the American Fertility Society (AFS) classification, European Society of Gynecological Endoscopy (ESGE) classification, March’s classification (March), Nasr’s classification (Nasr) and Chinese IUA diagnosis classification criteria (Chinese). The predictive value of these evaluation systems was determined by receiver operating characteristic (ROC) curves and area under a ROC curve (AUC).Results: The correlation coefficients of AFS, ESGE, March, Nasr and Chinese classification and the live birth rate were 0.313, 0.313, 0.288, 0.380, and 0.336, respectively. Among women with hypomenorrhea and amenorrhea, as well as women with no infertility, the severities determined by all five evaluation systems were correlated with live birth rate (P < 0.001). All five scoring systems were efficient to predict live birth rate. Among them, Nasr’s classification showed the highest AUC (0.748) with the best predictive value. Multivariate logistic regression analyses showed that Nasr’s classification had the highest OR (OR, 6.523; 95% CI, 2.612, 18.263). And, Nasr’s classification system also showed highest sensitivity (81.8%) and negative predictive value (96.7%) when divide the system into mild IUA vs. moderate and severe IUA Conclusion: AFS, ESGE, March, Nasr and Chinese classification were demonstrated to be capable of predicting live birth following TCRA although the predictive capacities might be limited, and Nasr’s classification showed the highest predictive value of live birth.
Atoms in Gaseous and Solid States and their Energy and Force Relationships under Transitional Behaviors
Authors: Ali Mubarak
Published: December 2020

Recalling the conventional insights of different atomic states, it is possible to discover new insights, which can cope with the existing challenges. Atoms, in fact, form from the electrons and energy knot nets. Suitably intercrossed overt photons construct energy knots in atoms of all elements. In growing atoms of gaseous and solid states, schemes of intercrossing overt photons become different. To construct atomic lattice in any element, overt photons in suitable length and number intercross by keeping the centers of their lengths at a common point. A scheme of intercrossing overt photons frames energy knots simultaneously clamping to positioned electrons. Atoms are differentiated on the basis of their different numbers of energy knots and electrons. A number of unfilled states in an atom represents a valency. Excluding hydrogen, atoms possess the same valency as specified for them. However, two more electrons with two already prescribed ones for the first shell form the zeroth ring of atom. In the hydrogen atom, only two electrons are occupied by two energy knots; two overt photons of the least measured lengths intercross to form the shape like digit eight. In this way, four electrons remain occupied by four energy knots to form helium atom. Thus, a helium atom is related to a zeroth ring in all higher order atoms. In order to validate these aforementioned statements, the concept of studying protons and neutrons is no longer significant. As far as the atoms of gaseous state are concerned, electrons possess minimum required potential energy. In this way, electrons of gaseous atoms remain above the middle of occupied energy knots in more than half the length, and they keep on experiencing maximum required levitational force along the north pole. In atoms of solid state, electrons possess maximum required potential energy. In this way, electrons of solid atoms remain below the middle of occupied energy knots in more than half the length, and they keep on experiencing maximum required gravitational force along the south pole. Each transition state of the atom is under the established relation of energy and force. Under transitional energy of an atom, electrons deal with infinitesimal displacements within their occupied energy knots, where the orientational force keeps on engaging them to introduce the recovery, neutral, re-crystallization and liquid states. Electrons left to the center of atom orientate from north to east clockwise, and electrons right to the centre of atom orientate from north to west anti-clockwise during the conversion of gaseous atom to liquid state. On the other hand, electrons left to the center of atom orientate from south to east anti-clockwise, and electrons right to the center of atom orientate from south to west clockwise during the conversion of solid atom to liquid state. These fundamental revolutions shed new light on the development of sustainable science and engineering.
Approaching the end of post - soviet transition? Trends of youth crime in Klaipėda in 2005-2019
Authors: Kraniauskas Liutauras , Acus Arūnas
Published: December 2020

The article presents a sociological and criminological analysis of data on registered youth criminal offences (young people of 14-29 years old) in Klaipėda. The analysed period covers the years from 2005 to 2019 (late post-Soviet period).  It includes youth crime offences and persons suspected of committing a crime. The period is characterised by a constant downward trend in crime. There were no substantial changes in criminal law during this period, however, Lithuania significantly strengthened the legal and material background for work with juveniles and young adults.  On the basis of the insights of the theories of anomie, social control and ecological criminology, the article analyses the key indicators of youth crime and its dynamics. The changes by age and employment of persons who have allegedly committed criminal offences are analysed.
The social-psychological factors influencing women-prisoners’ feeling of loneliness
Authors: Baranauskienė Ingrida , Kovalenko Alla , Leonova Inna
Published: December 2020

The article presents the study on the factors influencing appearance of loneliness at female prisoners. The results obtained indicate that loneliness is caused not only by subjective factors, such as personal traits, needs, motives, but also by an objective factor - the socially closed structure of detention places and the limited environment there. The main subjective reasons for female prisoners’ feelings of loneliness are despair, fears, depression and aggression, caused by their inability to satisfy their needs for communication, safety, personal development and goal achievement.

The feeling of loneliness appears because the influence of the following factors: personal traits, insufficient interpersonal relationships, fear of rejection, subjective and objective causes
RELATIONSHIP BETWEEN PNEUMONIA AND SWALLOWING FUNCTION IN ELDERLY
Authors: BULGUROĞLU Merve , SEREL ARSLAN Selen , DEMİR Numan , BULGUROĞLU Halil İbrahim , KARADUMAN Aynur Ayse
Published: December 2020

Purpose: Anatomical and physiological changes due to aging decrease the efficiency of swallowing and increase the risk of aspiration pneumonia. One of the underlying causes of recurrent pneumonia is swallowing dysfunction, with aspiration. This study aimed to compare the swallowing function in elderly patients with and without pneumonia and to investigate its association with malnutrition. Methods: A total of 44 elderly individuals with 22 aspiration pneumonia history (age=73.00±7.93 years) (study group) and 22 without aspiration pneumonia history (age=70.00±6.39 years) (control group) were included in the study. The swallowing function was evaluated using the Swallowing Ability Function Evaluation (SAFE) and water-swallowing test. Nutritional assessment was performed using the Turkish version of the Mini-Nutritional Assessment. Results: Decreased swallowing ability was observed in 59.1% of the study group and 9.1% of the control group (p<0.001). While the study group had severe disorder the 22.7% of the oral phase and 31.8% of the pharyngeal phase, the control group had no severe disorder. However, there was a 9.1% moderate disorder in the oral and pharyngeal phases in the control group (p<0.001). There was a relationship between the nutritional assessment results of the study group and the oral (r=0.498, p=0.018) and pharyngeal phases of SAFE (r=0.622, p=0.002). Conclusion: Our study showed that the swallowing function is affected in the elderly with a history of pneumonia. It was also observed in the elderly without a history of pneumonia. For this reason, a detailed swallowing evaluation must be performed both elderly patients with and without pneumonia, and a protective swallowing rehabilitation program should be developed through an interdisciplinary approach.
FİZYOTERAPİ VE REHABİLİTASYON EĞİTİMİNDE SİMÜLE HASTA KULLANIMININ ÖĞRENME MOTİVASYONU VE ÖĞRENCİ GERİ BİLDİRİMLERİNE ETKİSİ: RANDOMİZE KONTROLLÜ ÇALIŞMA
Authors: ALACA Nuray , SAFRAN Elif Esma , ÇAĞRI Dilek , FEYZİOĞLU Özlem
Published: December 2020

Amaç: Çalışmamızın amacı, fizyoterapi ve rehabilitasyon (FTR) lisans eğitiminde servikal bölge değerlendirmesi için simüle hasta (SH) kullanımının öğrenme motivasyonuna ve öğrenci geribildirimlerine olan etkisini araştırmaktı. Yöntem: Çalışmaya, FTR Ölçme ve Değerlendirme dersini alan 46’sı kadın, 60 gönüllü ikinci sınıf öğrencisi dahil edildi. Öğrenciler, teorik-uygulama (TU) dersi alan, SH oturumuna katılan ve hem TU dersi alıp hem de SH oturumuna katılan (TU-SH) olarak randomize edildi. Tüm öğrencilere eğitim aşamalarının öncesinde ve hemen sonrasında, konu içeriğinden oluşan 10 test sorusu içeren bilgi ön-son testi uygulandı. Eğitim sonrasında bir kez Öğretim Materyaline İlişkin Motivasyon Ölçeği (ÖMMÖ) yapıldı. Eğitim aşamalarının öncesinde, hemen sonrasında ve bir hafta sonrasında öğrenci geribildirim (endişe-stres-motivasyonfayda) skorları kaydedildi. Sonuçlar: TU ve TU-SH gruplarının ön-son test sonuçları, SH grubuna göre anlamlı olarak daha yüksekti (p<0,001). SH ve TU-SH gruplarında ders öncesi endişe düzeyleri, TU grubunun ders öncesi endişe düzeyine göre yüksekti (SH p=0,002 ve TU-SH p=0,004). Eğitimler sona erdikten hemen sonra SH grubunun endişe düzeyi, TU grubuna göre halen yüksekti (p=0,002). TU-SH ve TU gruplarının ders sonrası motivasyon düzeyi SH grubuna göre yüksekti (p<0,001). TU-SH grubunun bir hafta sonraki motivasyon düzeyi ise, TU grubuna göre yüksekti (p=0,004). TU-SH grubunun, ÖMMÖ puanları diğer gruplara göre daha yüksekti (p=0,005). Tartışma: Servikal bölge değerlendirmesinin öğrenim sürecinde TU dersi ile SH oturumunun beraber verilmesinin bu eğitimlerin ayrı ayrı verilmesinden daha uygun olacağını ve SH etkileşiminin FTR lisans eğitiminde kullanılmasının yarar getireceğini öngörmekteyiz.
Energy, drinking water and health nexus in India and its effects on environment and economy
Authors: Katekar Vikrant P. , Deshmukh Sandip S. , Vasan A.
Published: December 2020

This paper examines energy, drinking water and health nexus in India, and its consequences for the environment and economy. To establish this nexus, K-means cluster analysis and Davies–Bouldin validation index are employed to group 32 Indian states and union territories. The classification was performed based on 16 criteria, and the number of optimal clusters arrived at is 8. The nexus between energy, drinking water and health must be cautiously dealt with to ensure the social and economic growth of the nation. The criterion analysis of the states within these clusters indicates that states and union territories facing energy crises are usually deficient in safe drinking water services; consequently, people of those regions suffer from ill-health, which increases the economic burden on people through the loss of work productivity. With a deficient cash reserve, the communities are incapable of fulfilling the demand for energy and safe drinking water. However, while installing desalination plants to fulfil the need for safe drinking water, their environmental impact must be taken into account, as these systems have high energy consumption and significant environmental impact.
Quantitative assessment of water level regime alterations during 1959–2016 caused by Three Gorges Reservoir in the Dongting Lake, China
Authors: Wang Hongxiang , Zhu Yongwei , Zha Hufei , Guo Wenxian
Published: December 2020

Water level is considered as the key factor affecting the structure and function of lake ecosystems. The Mann-Kendall technique and range of variability approach (RVA) were used to quantitatively evaluate the hydrologic alteration due to Three Gorges Reservoir (TGR) in Dongting Lake. Results indicate the following. (1) The average annual water levels at Chenglingji station showed increasing trends (p < 0.05), while that at Nanzui station showed a decreasing trend (p < 0.05). The turning year occurred in 2003, which reflects the significant effects of the TGR on the water level regime. (2) The highly altered parameters were 1-, 3-, and 7-day minimum water levels both at Chenglingji and Yangliutan, and in October both at Nanzui and Yangliutan, with the degree of hydrologic alteration being larger than 80%. However, 1-, 3-, 7-, and 30-day maximum water levels at three stations had relatively small alteration, with the degree of hydrologic alteration being smaller than 41%. (3) The hydrologic alteration degrees at Chenglingji, Nanzui and Yangliutan station were all moderate, with changes of 50, 46 and 49%, respectively. (4) Water level regimes at Dongting Lake were mainly jointly affected by reservoir operation, land utilization change and river channelization. These changes in water level regimes have a negative impact on aquatic and terrestrial ecosystems. This study provides a scientific reference for the protection of lake ecosystems under hydrologic alteration.
Influence of pretreatment on the properties of α-Fe2O3 and the effect on photocatalytic degradation of methylene blue under visible light
Authors: Mokhtari S. , Dokhan N. , Omeiri S. , Berkane B. , Trari M.
Published: December 2020

The hematite (α-Fe2O3) nanostructures were synthesized by thermal oxidation of metal at 500 °C under atmospheric pressure. We studied the effect of the electrochemical pretreatment of the substrate before calcinations and its impact on the morphology, crystalline structure, lattice microstructural, and optical properties of α-Fe2O3. Uniform nanosheets were observed on the sample surface after calcination; their dimension and morphology were accentuated by the pretreatment, as confirmed by the SEM images. The characteristics of the nanostructures, analyzed by X-ray diffraction (XRD), revealed a rhombohedral symmetry with the space group R-3c and lattice constants: a = 0.5034 nm and c = 1.375 nm. The average crystallite size and strain, determined from the Williamson-Hall (W-H) plot, showed substantial variations after the substrate pretreatment. The Raman spectroscopy confirmed the changes in the crystal properties of the hematite submitted to pretreatment. The diffuse reflectance allowed to evaluate the optical gap which lies between 1.2 and 1.97 eV, induced by the electrochemical processing. The photocatalytic activity of α-Fe2O3 films was assessed by the degradation of methylene blue (MB) under LED light; 15% enhancement of the degradation for the pretreated specimens was noticed.
Reforma Trabalhista
Authors: Loureiro Fábio
Published: December 2020

Resumo: A Reforma Trabalhista, instituída pela Lei nº 13.467/2017, promoveu consideráveis modificações na legislação brasileira que impactam no cotidiano de inúmeros trabalhadores. No campo do Direito Processual do Trabalho, há uma inovação de destaque: a limitação ao Tribunal Superior do Trabalho na edição de súmulas e orientações jurisprudenciais que criem obrigações e restrições de direitos não previstos em lei. O objetivo deste artigo é analisar como as novas regras afetam a atividade de interpretação legal e consolidação da jurisprudência por parte do tribunal.

Palavras-chave: Legislação Brasileira; Limitações; Enfraquecimento Legal.
O ergue-se [?] do império português após o reconhecimento da independência do Brasil (1825-1835)
Authors: Souza Alan de Carvalho
Published: December 2020

Após o reconhecimento de Portugal da independência do Brasil, a relação das possessões atlânticas com a metrópole intensificou-se? A seguir a recognição, a ex-colônia assinou e ratificou o Tratado antitráfico com a Inglaterra no qual comprometeu-se a abolir o comércio de escravizados. Qual a reação do império português para amenizar o impacto em seus domínios? O objetivo é evidenciar a fragilidade da relação comercial do império com seus domínios e a estrutura na qual a economia se apoiava. Utilizando-se da legislação régia, debates parlamentares e das correspondências dos governadores com o reino, o texto demonstra o aumento da importância econômica da cultura do café e o valor econômico do comércio de escravizados para a receita dos domínios de um império que tinha na arrecadação alfandegária seu principal rendimento.
A medicação antirretroviral como expressão do cuidado com a vida: adesão, esperança e de longevidade
Authors: Gomes Marcia Pereira , Jacintho Barbosa. Diogo , Souza Fabiana  Barbosa Assumpção de , Tosoli Gomes. Antônio Marcos , Silva André Luís Brugger e , Silva Girlene Alves da
Published: December 2020

Objetivos: descrever e discutir o papel da medicação antirretroviral no cotidiano das pessoas vivendo com HIV. Método: qualitativo, descritivo. Entrevistas com 49 pessoas que vivem com HIV. Técnica de análise de conteúdo lexical, com auxílio do software Iramuteq 0.7 alpha 2 .  Resultados: a medicação antirretroviral é vista pelos participantes do estudo como uma segunda chance para a vida, onde a adesão a terapia medicamentosa oferece possibilidades de uma vida boa, com qualidade e longevidade. Ancorados na esperança que ressignifica o olhar sobre a síndrome, para além das limitações da mesma percebendo a oportunização de novos caminhos principalmente pela medicalização. Conclusão: Os resultados mostram que os indivíduos entendem o tratamento como uma segunda chance para a vida, não é a cura mas permite uma maior expectativa de vida e melhor qualidade de vida, mas que para tal precisam participar ativamente da gestão do seu autocuidado, aderindo a terapia medicamentosa.

Palavras chave ADESÃO; PVHIV; TARV;
Neoplasia maligna e mastectomia
Authors: Almeida Stefania Duarte de
Published: December 2020

De implacável evolução natural à morte em geral, a progressão do câncer de mama é acompanhada de diversos graus de sofrimento físico e emocional para a mulher. Diante disso, este estudo objetiva explorar a necessidade de avaliação e reflexão da práxis em Enfermagem no campo da mastectomia, fazendo uma breve análise do problema e também no que diz respeito à promoção, à proteção e à recuperação da saúde da mulher mastectomizada. Trata-se de um estudo reflexivo sobre neoplasia e mastectomia, numa análise crítica de suas implicações. Necessidade de discutir limites e possibilidades dos enfermeiros na realização dos cuidados específicos a estas mulheres, identificando os fatores que favorecem e/ou dificultam a assistência prestada. Por fim, necessidade de sistematizar o trabalho da equipe de saúde e do aprimoramento constante do saber técnico-científico, para que se possa refletir sobre a práxis em Enfermagem.
A visita domiciliar como prática de ensino em odontologia: revisão de literatura.
Authors: Maluf Fabiano , Thomazini Cordeiro Aline , Paiva Freitas Ana Paula , Aires Saraiva de Oliveira Jéssica , Lima Sousa Neta Marina , Mesquita de Aguiar Souza Maynardma Joade
Published: December 2020

A visita domiciliar (VD), utilizada como prática de ensino, pode contribuir para a formação de um profissional de acordo com o preconizado pelas Diretrizes Curriculares Nacionais (DCN) para o curso de graduação de odontologia. O presente estudo tem o objetivo de realizar uma revisão integrativa da literatura com o intuito de reunir e analisar evidências científicas que abordem a experiência e a importância da VD como proposta pedagógica na formação do acadêmico de odontologia. Foi observado que as VD, como metodologia ativa de aprendizagem, contribuem para a formação de um profissional mais humanizado, crítico, criativo e reflexivo, garantindo a integração ensino-serviço-comunidade com a finalidade de aproximar acadêmicos e comunidade, além de assegurar a vivência com outros profissionais da Estratégia Saúde da Família.  Entretanto, a literatura ainda aponta algumas limitações, sobretudo a necessidade de uma preparação prévia para o bom desempenho acadêmico da atividade.
Educação Permanente em Saúde uma ferramenta na Estratégia Saúde da Família: Encontro guiado pela Socioclínica Institucional
Authors: Ferreira Adicéa Souza , Silva Ana Lúcia Abrahão da
Published: December 2020

Objetivo: analisar e discutir a Educação Permanente em Saúde como ferramenta do processo de trabalho da gerência de cuidados dos enfermeiros atuantes na Estratégia Saúde da Família nos encontros guiados pela Socioclínica Institucional. Método: Estudo de abordagem qualitativa com emprego do desenho Socioclínica Institucional, que opera na lógica de transformar a realidade investigada para compreender a pesquisa. Utiliza-se da produção coletiva do conhecimento e troca de saberes e aprenderes entre participantes e pesquisadores. Os encontros ocorreram no segundo semestre do ano de 2019 o universo do estudo foi composto por 13 enfermeiros, sendo 11 atuantes na ESF e 02 enfermeiros pesquisadores. Resultados: Com os encontros construímos três polos de conhecimento sobre a Educação Permanente como ferramenta do processo de trabalho da gerência de cuidados de enfermeiros atuantes na Estratégia Saúde da Família: 1) A importância da Educação Permanente em Saúde como ferramenta no processo de trabalho; 2) A Educação Permanente em Saúde como ferramenta de comunicação; 3) A Educação Permanente em Saúde como indicador do processo de trabalho. Considerações finais: A Educação Permanente em Saúde configura-se como uma ferramenta de mobilização para o processo de trabalho da gerência de cuidados ao se discutir as ações de saúde no âmbito da Estratégia Saúde da Família.
Saúde emocional dos estudantes do ensino médio em distanciamento social decorrente da pandemia por COVID-19
Authors: Gomes Aline Dias , Tavares Claudia Mara de Melo
Published: December 2020

Objetivos: Averiguar a percepção dos estudantes de ensino médio acerca das suas necessidades emocionais em face da pandemia por COVID 19; propor uma ação educativa que integre serviço de saúde-escola para promoção da saúde emocional dos adolescentes/escolares. Método: Estudo descritivo-exploratório com estudantes do ensino médio de uma escola pública da região metropolitana do Rio de Janeiro. Resultados esperados: Acredita-se que esse estudo contribua para a aproximação ou criação de redes de apoio para auxiliar os adolescentes, caso haja necessidade de apoio emocional. Produto: Esta pesquisa visa propor uma estratégia de aproximação entre estudantes, escola e atenção básica de saúde para apoio as necessidades emocionais dos adolescentes.
Comunicação em Saúde
Authors: De la Torre Bianca Andrade Paz , Caravana de Castro Moraes Ricci Maria Fernanda , Cerqueira Linhares Ulisses
Published: December 2020

Esta é uma cartilha produzida para auxiliar os profissionais de saúde a se atualizarem e desenvolverem estratégias para a Comunicação de Notícias Difíceis (CND), mais especificamente a comunicação de Morte Encefálica (ME). No mesma, iremos abordar o tema Comunicação em Saúde e como as boas práticas comunicacionais podem fazer a diferença na Comunicação de Notícias Difíceis no contexto de Morte Encefálica (ME).Este material foi elaborado como um dos produtos técnicos finais do mestrado em Ciências Aplicadas a Saúde, realizado pela autora na Universidade de Vassouras. Contou, também, com a parceria do Programa Estadual de Transplante (PET) do Estado do Rio de Janeiro.
A imagética motora no desempenho funcional de pacientes com Esclerose Múltipla: revisão de literatura
Authors: Tassiane Maria Alves Pereira  , Letícia de Sousa Vidal  , Marco Orsini  , Silva Janaina
Published: December 2020

A Esclerose Múltipla é uma doença neurodegenerativa incapacitante oriundas de danos ao Sistema Nervoso Central. Entre os sinais e sintomas destacam-se os comprometimentos motores, sensoriais e emocionais que interferem negativamente na qualidade de vida desses pacientes. A Imagética Motora é uma terapia usada através da simulação mental do ato motor capaz de promover alterações neurofisiológicas e melhorar o desempenho funcional. O objetivo desta revisão é verificar o efeito da imagética motora no desempenho funcional de pacientes com esclerose múltipla. Dessa forma, realizou-se uma busca nas bases e banco de dados Pubmed, PEDro, Scopus e Web of Science utilizando os descritores “motor imagery” AND “multiple sclerosis” AND “ functionality”. estipulando critérios de inclusão e de qualidades metodológicas.  No total 5 artigos foram incluídos e compuseram a análise da revisão. Os resultados evidenciaram melhoras significativas na marcha, equilíbrio, qualidade da caminhada, fadiga e qualidade de vida desses pacientes. Conclui-se então que a imagética motora é uma intervenção eficaz na reabilitação funcional de pacientes acometidos pela Esclerose Múltipla.
A simbologia do câncer de mama
Authors: Mendes Nunes Marcela , Fernandes de Amorim Sandra
Published: December 2020

Este artigo teve como objetivos compreender, por meio de uma leitura simbólica, os processos psíquicos que ocorrem com as mulheres acometidas pelo câncer de mama, assim como analisar as tendências de comportamento que se evidenciam na maneira como elas lidam com a questão do corpo diante desse tipo de câncer, que afeta diretamente a relação com a autoimagem. Foram realizadas nove entrevistas semiestruturadas com mulheres que ou estavam em fase de tratamento ou já haviam terminado o processo. Para ampliação dos dados obtidos, posteriormente à entrevista, foi aplicado um questionário likert chamado “Roda das deusas”. Os resultados analisados à luz da psicologia analítica mostraram que muitas mulheres relacionam o seu câncer com algum tipo de fator emocional. No que se refere à simbologia, uma leitura da análise comparada com a mitoanálise mostrou a maior pontuação das deusas Ártemis e Deméter, ambas ligadas a características de doação e de proteção do outro, deixando o cuidado com elas mesmas em segundo plano. Para futuras pesquisas na área, é importante destacar que a mitoanálise foi a vertente arquetípica utilizada, mas que esta não exclui, por exemplo, a compreensão da psicodinâmica ou questões de ordem psicossocial. Como aqui o entendimento da psique feminina foi utilizado dessa forma, o profissional que trabalhar com esse público tem um campo significativo de atuação, sendo esse conhecimento uma contribuição para uma maior compreensão sobre a dinâmica psicológica que cada mulher apresenta.
Physicochemical characterization of the pulp oil of bacuri Attalea phalerata Mart. ex Spreng. (Arecaceae)
Authors: Cardoso Coimbra Michelle , Moreno Luzia Débora Maria , Jorge Neuza
Published: December 2020

The aim of the study was to characterize the pulp oil of bacuri Attalea phalerata Mart. ex Spreng. (Arecaceae) according to official analytical methods. Total phenolic and carotenoids contents were evaluated by spectrophotometry, and tocopherols composition by high-performance liquid chromatography. The fatty acid profile was obtained through gas chromatography from samples transesterified with potassium hydroxide in methanol and n-hexane. According to the proximate composition, bacuri pulp contained 41.5 % carbohydrates and 39.2 % lipids. Regarding its physicochemical properties, the oil showed a free fatty acids content of 0.7 %, a peroxide value of 1.4 meq/kg, a refractive index of 1.463, an iodine number of 84.3 g I2/100 g, a saponification number of 193.5 mg KOH/g, an unsaponifiable matter of 0.5 %, and 48.7 h of oxidative stability. Total phenolic, carotenoids, and tocopherols contents recorded values of 2.4 mg GAE/g, 243.0 µg/g, and 86.8 mg/kg, respectively. The bacuri oil showed a fatty acid composition similar to olive oil and a high percentage of unsaturation, finding 67.3 % of monounsaturated acids, and 11.3 % of polyunsaturated acids. The main fatty acids were oleic (67.3 %), palmitic (13.3 %), and linoleic (10.5 %). Due to its physicochemical characteristics, bacuri oil has a great potential to be used in food preparations, such as salad oil or in margarine formulation.
Attitudes and Perceptions Toward COVID-19 Digital Surveillance: Survey of Young Adults in the United States
Authors: Maytin Lauren , Maytin Jason , Agarwal Priya , Krenitsky Anna , Krenitsky JoAnn , Epstein Robert S
Published: December 2020

Background

COVID-19 is an international health crisis of particular concern in the United States, which saw surges of infections with the lifting of lockdowns and relaxed social distancing. Young adults have proven to be a critical factor for COVID-19 transmission and are an important target of the efforts to contain the pandemic. Scalable digital public health technologies could be deployed to reduce COVID-19 transmission, but their use depends on the willingness of young adults to participate in surveillance.

Objective

The aim of this study is to determine the attitudes of young adults regarding COVID-19 digital surveillance, including which aspects they would accept and which they would not, as well as to determine factors that may be associated with their willingness to participate in digital surveillance.

Methods

We conducted an anonymous online survey of young adults aged 18-24 years throughout the United States in June 2020. The questionnaire contained predominantly closed-ended response options with one open-ended question. Descriptive statistics were applied to the data.

Results

Of 513 young adult respondents, 383 (74.7%) agreed that COVID-19 represents a public health crisis. However, only 231 (45.1%) agreed to actively share their COVID-19 status or symptoms for monitoring and only 171 (33.4%) reported a willingness to allow access to their cell phone for passive location tracking or contact tracing.

Conclusions

Despite largely agreeing that COVID-19 represents a serious public health risk, the majority of young adults sampled were reluctant to participate in digital monitoring to manage the pandemic. This was true for both commonly used methods of public health surveillance (such as contact tracing) and novel methods designed to facilitate a return to normal (such as frequent symptom checking through digital apps). This is a potential obstacle to ongoing containment measures (many of which rely on widespread surveillance) and may reflect a need for greater education on the benefits of public health digital surveillance for young adults.
Digitalizing a Brief Intervention to Reduce Intrusive Memories of Psychological Trauma: Qualitative Interview Study
Authors: Gamble Beau , Depa Katherine , Holmes Emily A , Kanstrup Marie
Published: December 2020

Background

The COVID-19 pandemic has escalated the global need for remotely delivered and scalable interventions after psychological trauma. A brief intervention involving a computer game as an imagery-competing task has shown promising results for reducing the number of intrusive memories of trauma—one of the core clinical symptoms of posttraumatic stress disorder. To date, the intervention has only been delivered face-to-face. To be tested and implemented on a wider scale, digital adaptation for remote delivery is crucial. An important first step is to develop digitalized intervention materials in a systematic way based on feedback from clinicians, researchers, and students in preparation for pilot testing with target users.

Objective

The first aim of this study is to obtain and analyze qualitative feedback on digital intervention materials, namely two animated videos and two quizzes that explain the target clinical symptoms and provide intervention instructions. The second aim is to refine the digitalized materials based on this feedback.

Methods

We conducted semistructured interviews with 12 participants who had delivered or had knowledge of the intervention when delivered face-to-face. We obtained in-depth feedback on the perceived feasibility of using the digitalized materials and suggestions for improvements. Interviews were assessed using qualitative content analysis, and suggested improvements were evaluated for implementation using a systematic method of prioritization.

Results

A total of three overarching themes were identified from the data. First, participants were highly positive about the potential benefits of using these digital materials for remote delivery, reporting that the videos effectively conveyed key concepts of the symptom and its treatment. Second, some modifications to the materials were suggested for improving clarity. On the basis of this feedback, we made nine specific changes. Finally, participants raised some key challenges for remote delivery, mainly in overcoming the lack of real-time communication during the intervention.

Conclusions

Clinicians, researchers, and clinical psychology students were overall confident in the use of digitalized materials to remotely deliver a brief intervention to reduce intrusive memories of trauma. Guided by participant feedback, we identified and implemented changes to refine the intervention materials. This study lays the groundwork for the next step: pilot testing remote delivery of the full intervention to trauma survivors.
Understanding the Islamic principles of milk kinship to enable equitable access for vulnerable infants to donor human milk: Protocol for a qualitative study (Preprint)
Authors: Nguyen Tuan , Hajeebhoy Nemat , Zambrano Paul , Widhiantara Putu , Omer-Salim Amal , Mathisen Roger
Published: December 2020

BACKGROUND

Since 1979, the World Health Organization (WHO) and UNICEF have recommended the use of pasteurized human milk from a human milk bank (HMB) to feed low birthweight and preterm infants as the first alternative when mothers are unable to provide their own milk. Globally, there are about 700 HMBs, and the number is increasing. Concerns relating to milk kinship, insufficient guidance, and inconsistent application of available guidance around HMB might alter the scale up of HMB network in Islamic countries and among children born by Islamic parents in other countries.

OBJECTIVE

This research protocol describes a study that aims to examine Islamic religious concerns relating to milk kinship and HMB in three Southeast Asian countries with a majority or significant Muslim population. Specific objectives are: 1) to examine perceptions of key stakeholders relating to the Islamic principle of milk kinship and their proposed solutions to address potential barriers thereby enabling equitable access of vulnerable babies' to safe donor human milk and 2) to examine current technical guidelines and religious decrees from the perspective of the Islamic principle of milk kinship and HMB services.

METHODS

This proposed study will include desk reviews and in-depth interviews (IDIs). Desk reviews will examine and compare the contents of fatwa, regional or national technical guidelines and standards. Qualitative data collection and analysis will be conducted to examine relevant stakeholders' perceptions about the Islamic principle of milk kinship, and proposed solutions to address barriers to equitable access for vulnerable infants to safe donor human milk. A total of 12-18 key stakeholders, including representatives of Muslim Councils, experts on Islamic studies, decision makers from Government Offices, or members of HMB Networks, across Southeast Asia with focus on Indonesia, Malaysia, and Singapore.

RESULTS

This study, funded in June 2020, was approved by the Institutional Review Board (FHI 360) on September 14, 2020. Date(s) of data collection will be September 23 to January 15, 2020. As of December 12, 2020, nine IDIs have been completed. Results are expected to be published in June 2021. We will present a comparison of Fatwa across countries and compared with other major Muslim countries in the world. Findings from in-dept interviews will highlight relevant stakeholders' perceptions grouped by relevant theme such as the principle of milk-kinship and barriers, solutions and recommendations, actors and process, and timelines of establishing HMB services.

CONCLUSIONS

Findings from this study will help to increase the understanding of the evidence-informed process leading to the issuance of a fatwa and development of national technical and operational guidelines.

CLINICALTRIAL

NA
Examining Transnational Student Mental Health Responses to COVID-19 During the Transition to Remote Learning: A Longitudinal Study (Preprint)
Authors: Salazar Preciado Laura Leticia , Haack Sally , González Lucano Luis Renee , Díaz Domínguez Ricardo Javier , Mazar Inbal
Published: December 2020

BACKGROUND

COVID-19 represents a major global health crisis and has resulted in drastic changes to daily life. While even prior to the start of the pandemic college students had a high prevalence of mental health conditions, this group is even more at risk during the pandemic.

OBJECTIVE

To investigate the emotional impact of quarantine and transition to remote learning on health science students from two countries, regarding anxiety prevalence, mental wellbeing and coping behaviors during the first month of the COVID-19 outbreak.

METHODS

A total of 28 students from Tecnologico de Monterrey (TEC) in Guadalajara, Mexico and 19 students from Drake University (Drake) in Iowa, United States participated in the study. All students were studying health sciences, including degree programs such as medicine, pharmacy, and nutrition and wellness. This longitudinal study assessed students’ immediate psychological response during the COVID-19 pandemic by using an anonymous online questionnaire administered in April and again in May 2020. The survey was created to assess anxiety levels, coping mechanisms, and changes in daily habits. Demographics such as gender, age, non-academic working, living arrangements, household size, and number of roommates/co-habitants were also collected.

RESULTS

The April survey sample included 47 students and the May survey sample included 41 students. At least 50% of respondents were females, 20 to 21 years of age. The April survey results showed that more TEC students rated their food intake as higher than before the pandemic when compared to Drake students (p=0.032). Alcohol consumption reportedly stayed the same for Drake students and was lower for TEC students (p=0.004). The May survey results showed a statistically significant difference only for the alcohol consumption (p<0.001). Sleep time between April and May in TEC students showed a significant statistical difference, with students reporting less sleep time in May (p=0.016). The analysis for the level of anxiety according to the Beck Anxiety Inventory showed no statistically significant differences, neither when comparing between intra (TEC p=0.189 and Drake p=0.879) and inter group survey times (TEC vs Drake in April p=0.919 and TEC vs Drake in May p=0.305). The most common physical symptoms reported by students during both study periods were: feeling hot, nervous, fear of losing control, inability to relax, and fear of the worst happening.

CONCLUSIONS

There is growing concern surrounding the mental health status and needs of health science students during the pandemic. It is important to monitor changes in students’ mental health in response to the pandemic and to create interventions that target students appropriately.
La resistencia antimicrobiana en Escherichia coli aislada de canales y heces bovinas de rastros en el centro de México
Authors: Vega Sánchez Vicente , Talavera Rojas Martín , Barba León Jeannette , Zepeda Velázquez Andrea Paloma , Reyes Rodríguez Nydia Edith
Published: December 2020

Escherichia coli is an important microorganism as an intestinal microbiota of animals and humans, so its presence in food serves as an indicator of possible fecal contamination; some strains can cause disease, mainly due to the consumption of water and animal food contaminated. The objective of this study was to detemine the resistance to antimicrobials and the genetic character of E. coli present in the carcasses and feces of bovines killed in slaugtherhouses, and to know the epidemiological panorama in Mexico. The study was carried out in 32 strains in three municipal slaugtherhouses (A, B and C) obtained from bovines in Central Mexico; their resistance profile and their genetic relationship between the different isolates were analyzed by genotyping with the enzyme XbaI-PFGE; The dendrogram was constructed using the coefficient of similarity of Dice with a tolerance of 1.5 %. It is observed that 75 % (24/32) of the isolates show resistance to some antibiotic, 84.3 % (27/32) have an intermediate profile and 12.5 % (4/32) are sensitive to all antibiotics, the 28.1 % (9/32), were MDR; 27 PFGE and pulsetypes will be identified; 7 clusters were formed with 2 or more isolates (A-F and I) and two integrated with a strain (G and H). This study shows a diversity antimicrobial resistance present in cattle carcasses and feces in Mexico, which is a risk factor and a public health problem.