bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of relationship between leadership style and job satisfaction amongst healthcare professionals
Authors: Deshpande Saee , Sahni Shraddha , Karemore Tapasya , Joshi Jayashree , Chahande Jaishree
Published: January 2018

This article was migrated. The article was not marked as recommended. Introduction: Leadership is viewed as a process by which people bring out the best in themselves. Transformational leadership, transactional leadership and laissez faire leadership are the three common leadership styles. Leadership styles are related to job satisfaction to varying degrees. Hence the overall aim of this study is to investigate relationship between the leadership style and job satisfaction amongst medical, dental and physiotherapy professionals working in same institute. Methodology: This is a questionnaire based descriptive study. Leadership style was evaluated using Bass's Multifactor Leadership Questionnaire and job satisfaction was measured by Warr, Cook, and Wall's job satisfaction questionnaire. Result: The results show that both transformational and transactional leadership are positively related to job satisfaction, with correlations of 0.49 and 0.21, respectively. The two attributes negatively related with job satisfaction were transactional leadership (management by exception) lasseiz faire leadership with correlation of -0.120 and -0.160 respectively. Conclusion: The findings supported a strong relationship between various leadership styles and job satisfaction. This study highlights need for creating awareness about leadership style and job satisfaction and also training healthcare workers towards acquiring leadership skills to embrace challenges for high quality equitable health care.
Serious Illness Conversations: Paving the Road with Metaphors
Authors: Hui David , Zhukovsky Donna S. , Bruera Eduardo
Published: January 2018

Serious illness conversations can influence the direction of care by supporting decision-making compatible with the patient's goals. Effective use of core communication techniques, such as active listening and empathic statements, allows for a deeper understanding of the patients’ goals, concerns, communication preferences, and questions. Metaphors can be used to augment end-of-life care planning. Used inappropriately, metaphors can cause misunderstandings and confusion. Applied skillfully, metaphors can personalize challenging discussions, improving patient comprehension and helping patients and their families to plan ahead. The art of communication is to use the right tool for the right person at the right time.

Implications for Practice

Discussions with patients about serious illness concerns are especially challenging for the oncologist. This article provides guidance for preparing for such conversations, including examples of the use of metaphors to personalize and improve communication.
Mutant KRAS Circulating Tumor DNA Is an Accurate Tool for Pancreatic Cancer Monitoring
Authors: Perets Ruth , Greenberg Orli , Shentzer Talia , Semenisty Valeria , Epelbaum Ron , Bick Tova , Sarji Shada , Ben-Izhak Ofer , Sabo Edmond , Hershkovitz Dov
Published: January 2018

Background

Many new pancreatic cancer treatment combinations have been discovered in recent years, yet the prognosis of pancreatic ductal adenocarcinoma (PDAC) remains grim. The advent of new treatments highlights the need for better monitoring tools for treatment response, to allow a timely switch between different therapeutic regimens. Circulating tumor DNA (ctDNA) is a tool for cancer detection and characterization with growing clinical use. However, currently, ctDNA is not used for monitoring treatment response. The high prevalence of KRAS hotspot mutations in PDAC suggests that mutant KRAS can be an efficient ctDNA marker for PDAC monitoring.

Subjects, Materials, and Methods

Seventeen metastatic PDAC patients were recruited and serial plasma samples were collected. CtDNA was extracted from the plasma, and KRAS mutation analysis was performed using next-generation sequencing and correlated with serum CA19-9 levels, imaging, and survival.

Results

Plasma KRAS mutations were detected in 5/17 (29.4%) patients. KRAS ctDNA detection was associated with shorter survival (8 vs. 37.5 months). Our results show that, in ctDNA positive patients, ctDNA is at least comparable to CA19-9 as a marker for monitoring treatment response. Furthermore, the rate of ctDNA change was inversely correlated with survival.

Conclusion

Our results confirm that mutant KRAS ctDNA detection in metastatic PDAC patients is a poor prognostic marker. Additionally, we were able to show that mutant KRAS ctDNA analysis can be used to monitor treatment response in PDAC patients and that ctDNA dynamics is associated with survival. We suggest that ctDNA analysis in metastatic PDAC patients is a readily available tool for disease monitoring.

Implications for Practice

Avoiding futile chemotherapy in metastatic pancreatic ductal adenocarcinoma (PDAC) patients by monitoring response to treatment is of utmost importance. A novel biomarker for monitoring treatment response in PDAC, using mutant KRAS circulating tumor DNA (ctDNA), is proposed. Results, although limited by small sample numbers, suggest that ctDNA can be an effective marker for disease monitoring and that ctDNA level over time is a better predictor of survival than the dynamics of the commonly used biomarker CA19-9. Therefore, ctDNA analysis can be a useful tool for monitoring PDAC treatment response. These results should be further validated in larger sample numbers.
Chemotherapy Toxicity Risk Score for Treatment Decisions in Older Adults with Advanced Solid Tumors
Authors: Nishijima Tomohiro F. , Deal Allison M. , Williams Grant R. , Sanoff Hanna K. , Nyrop Kirsten A. , Muss Hyman B.
Published: January 2018

Background

The decision whether to treat older adults with advanced cancer with standard therapy (ST) or reduced therapy (RT) is complicated by heterogeneity in aging. We assessed the potential utility of the chemotherapy toxicity risk score (CTRS) [J Clin Oncol 2011;29:3457–3465] for treatment decisions in older adults.

Materials and Methods

This was a prospective observational study of patients aged ≥65 years receiving first-line chemotherapy for advanced cancer for which combination chemotherapy is the standard of care. Patients were categorized as high risk (CTRS ≥10), for whom RT (dose-reduced combination or single-agent chemotherapy) is deemed appropriate, or nonhigh risk (CTRS <10), for whom ST is deemed appropriate for toxicity. The primary objective was to estimate the agreement in chemotherapy choice (ST vs. RT) between the treating physician and the CTRS using a κ statistic.

Results

Fifty-eight patients (median age, 71 years) were enrolled. Thirty-eight patients received ST (21 had CTRS <10, and 17 had CTRS ≥10), and 20 patients received RT (12 had CTRS ≥10, and 8 had CTRS <10), with minimal agreement in chemotherapy choice (κ = 0.14; 95% CI, −0.10 to 0.38). Grade 3–4 toxicity and hospitalization occurred in 60% and 27% of 55 patients with follow-up data, respectively. Among patients receiving ST, patients with CTRS ≥10 had a higher incidence of toxicity (88% vs. 40%, p = .006) and hospitalization (50% vs. 15%, p = .03) than those with CTRS <10.

Conclusion

Older patients with cancer with a high CTRS who receive combination chemotherapy have an exceedingly high rate of severe toxicity and hospitalization.

Implications for Practice

The potential utility of the chemotherapy toxicity risk score (CTRS) in old adults with advanced solid tumors receiving first-line chemotherapy was assessed. Little agreement was found between chemotherapy treatment decisions based on the clinical impression versus what was recommended based on the CTRS. Among patients treated with standard-dose combination chemotherapy, patients with CTRS ≥10 had a very high incidence of grade 3–4 toxicities and hospitalization, which was significantly greater than that of patients with a low CTRS (<10). These findings suggest that the addition of CTRS to the clinical impression has a potential to improve treatment decisions.
Plasma Potassium Determines NCC Abundance in Adult Kidney-Specific γENaC Knockout
Authors: Boscardin Emilie , Perrier Romain , Sergi Chloé , Maillard Marc P. , Loffing Johannes , Loffing-Cueni Dominique , Koesters Robert , Rossier Bernard C. , Hummler Edith
Published: January 2018

The amiloride-sensitive epithelial sodium channel (ENaC) and the thiazide-sensitive sodium chloride cotransporter (NCC) are key regulators of sodium and potassium and colocalize in the late distal convoluted tubule of the kidney. Loss of the αENaC subunit leads to a perinatal lethal phenotype characterized by sodium loss and hyperkalemia resembling the human syndrome pseudohypoaldosteronism type 1 (PHA-I). In adulthood, inducible nephron-specific deletion of αENaC in mice mimics the lethal phenotype observed in neonates, and as in humans, this phenotype is prevented by a high sodium (HNa+)/low potassium (LK+) rescue diet. Rescue reflects activation of NCC, which is suppressed at baseline by elevated plasma potassium concentration. In this study, we investigated the role of the γENaC subunit in the PHA-I phenotype. Nephron-specific γENaC knockout mice also presented with salt-wasting syndrome and severe hyperkalemia. Unlike mice lacking αENaC or βΕΝaC, an HNa+/LK+ diet did not normalize plasma potassium (K+) concentration or increase NCC activation. However, when K+ was eliminated from the diet at the time that γENaC was deleted, plasma K+ concentration and NCC activity remained normal, and progressive weight loss was prevented. Loss of the late distal convoluted tubule, as well as overall reduced βENaC subunit expression, may be responsible for the more severe hyperkalemia. We conclude that plasma K+ concentration becomes the determining and limiting factor in regulating NCC activity, regardless of Na+ balance in γENaC-deficient mice.
Exogenous Gene Transmission of Isocitrate Dehydrogenase 2 Mimics Ischemic Preconditioning Protection
Authors: Kolb Alexander L. , Corridon Peter R. , Zhang Shijun , Xu Weimin , Witzmann Frank A. , Collett Jason A. , Rhodes George J. , Winfree Seth , Bready Devin , Pfeffenberger Zechariah J. , Pomerantz Jeremy M. , Hato Takashi , Nagami Glenn T. , Molitoris Bruce A. , Basile David P. , Atkinson Simon J. , Bacallao Robert L.
Published: January 2018

Ischemic preconditioning confers organ-wide protection against subsequent ischemic stress. A substantial body of evidence underscores the importance of mitochondria adaptation as a critical component of cell protection from ischemia. To identify changes in mitochondria protein expression in response to ischemic preconditioning, we isolated mitochondria from ischemic preconditioned kidneys and sham-treated kidneys as a basis for comparison. The proteomic screen identified highly upregulated proteins, including NADP+-dependent isocitrate dehydrogenase 2 (IDH2), and we confirmed the ability of this protein to confer cellular protection from injury in murine S3 proximal tubule cells subjected to hypoxia. To further evaluate the role of IDH2 in cell protection, we performed detailed analysis of the effects of Idh2 gene delivery on kidney susceptibility to ischemia-reperfusion injury. Gene delivery of IDH2 before injury attenuated the injury-induced rise in serum creatinine (P<0.05) observed in controls and increased the mitochondria membrane potential (P<0.05), maximal respiratory capacity (P<0.05), and intracellular ATP levels (P<0.05) above those in controls. This communication shows that gene delivery of Idh2 can confer organ-wide protection against subsequent ischemia-reperfusion injury and mimics ischemic preconditioning.
The development of the child's fine motricity in the children's school. Comparative study of practice factors and evaluation parameters
Authors: Vieira Viviana Silva , Condessa Isabel Cabrita
Published: January 2018

O contexto do desenvolvimento da motricidade motora fina da criança varia com inúmeros fatores. Na escola, todas as crianças terão oportunidade para desenvolver a sua motricidade, e o educador terá de colocar à sua disposição recursos e atividades enriquecedoras para promover essa aquisição, que é importante para a aprendizagem de literacias básicas da vida escolar.Com esta investigação tivemos dois propósitos: a. conhecer os fatores de prática, através da perspetiva de educadoras sobre a importância da motricidade fina para a criança e a potencialidade do trabalho em atividades de expressão – plástica e motora; b. avaliar e comparar a motricidade fina de dois grupos de crianças do pré-escolar. Aplicámos uma entrevista a 5 Educadoras de Infância e uma prova baseadas no Teste Movement ABC a 116 crianças (4 - 6 anos), ambos os grupos de duas escolas.Os nossos resultados permitem-nos concluir que embora no discurso das educadoras a importância do trabalho de motricidade fina e os fatores de prática fossem semelhantes, registámos valores diferenciados em mais de 30% dos parâmetros das provas aplicadas aos dois grupos de crianças Pudemos perceber, que as crianças apresentam resultados variados nos parâmetros de avaliação, em função da escola.
Capacitação, empoderamento e melhoria da qualidade de vida das pessoas idosas
Authors: Veiga Sofía , Santos Ana Catarina , Gonçalvez Ana Filipa
Published: January 2018

O envelhecimento da população traz novos e inúmeros desafios às sociedades atuais. Um dos desafios mais importantes foca-se na necessidade de alterar a visão de incapacidade, de passividade, de vulnerabilidade, de dependência e de isolamento social que a sociedade e os próprios idosos conferem à fase da velhice. Urge então criar condições para que o processo de envelhecimento seja vivido o mais satisfatoriamente possível, proporcionando um maior bem-estar e qualidade de vida às pessoas mais velhas. Assente nestes princípios, o presente trabalho procura dar conta de um projeto de educação social, desenhado e desenvolvido numa Instituição de Apoio à Terceira Idade (IATI). Tendo em conta a análise crítica da realidade, realizada em conjunto com os atores sociais, como defende a metodologia de investigação-ação-participativa privilegiada na educação social, foi destacado um conjunto de problemas e necessidades, assim como de recursos e potencialidades.Foi então pensada a finalidade do projeto – promover a capacitação, o empoderamento e a consequente melhoria da qualidade de vida das pessoas idosas da IATI - e delineados os objetivos gerais e específicos. Duas ações foram equacionadas, tendo em conta os interesses, os gostos e as necessidades dos participantes. A primeira, envolvendo os profissionais, teve como intuito sensibilizá-los para a importância da participação ativa das pessoas idosas nos processos de tomada de decisão.A segunda visou ampliar e aprofundar os laços relacionais entre as pessoas idosas, assim como potenciar a capacitação e a participação das mesmas. Na avaliação final do projeto, baseada no Modelo CIPP, os diferentes atores sociais reconheceram as mudanças ocorridas. Valorizaram sobre-tudo a maior participação, capacitação e empoderamento das pessoas idosas, que se refletiu na melhoria do seu bem-estar quotidiano, pessoal e coletivo, assim como da sua qualidade de vida.
Intervención en la esfera cognitiva, afectiva, y funcional en demencia, desde terapia ocupacional aplicada en sala Snoezelen
Authors: Miguel-García Inmaculada , González-Bernal Jerónimo , González-Santos Josefa , Jiménez-Eguizabal Alfredo
Published: January 2018

Introducción: El envejecimiento es un proceso natural que se acompaña de un declive gradual de las capacidades tanto a nivel funcional como a nivel cognitivo o afectivo que puede dificultar a la persona a llevar su vida diaria con normalidad al influir en el desempeño y verse alteradas las destrezas cognitivas, sensoriales, motoras o emocionales. La intervención no farmacológica está ocupando un importante espacio a la hora de abarcar las diferentes problemáticas que presentan las personas mayores. La terapia Snoezelen o estimulación multisensorial (EMS) tiene gran relevancia en el tratamiento para las personas con demencia y con deterioro cognitivo con la finalidad de crear una interacción entre la persona, la tarea y el ambiente mediante la activación de los diferentes sentidos para experimentar tedistintos tipos de sensaciones.Objetivo: Evidenciar el efecto que una intervención desde Terapia Ocupacional tiene en un entorno Snoezelen como medio para potenciar las destrezas cognitivas, sensoriales, motoras y emocionales en usuarios con deterioro cognitivo leve, moderado y grave, y su repercusión en la calidad de vida.Metodología: Se trata de un estudio cuasiexperimental con evaluación pre y post. Los datos se recogen mediante las herramientas MMSE, Barthel y Cornell.Resultados: Tras realizar los análisis estadísticos correspondientes no se obtuvieron resultados significativos a nivel cognitivo, afectivo y funcional; salvo a nivel afectivo en deterioro grave.Discusión: A pesar de que el presente artículo no muestre de manera significativa la eficacia de la intervención en un entorno Snoezelen, son diferentes estudios los que muestran la efectividad de la misma, especialmente a nivel cognitivo y conductual.Conclusiones: los resultados parecen indicar que una intervención en un entorno Snoezelen, en un corto periodo de tiempo, no muestran ningún tipo de repercusión.
As Tecnologias Digitais e as Apps: contributos e valências para idosos com demências
Authors: Teixeira Gil Henrique
Published: January 2018

As designadas «Aplicações Digitais – Apps» têm vindo a tornar-se uma realidade como ‘ferramentas digitais’ associadas aos smartphones e tablets. O incremento desta oferta tem vindo a cobrir diferentes valências e áreas. No presente artigo, pretende-se dar a conhecer um conjunto de Apps, através de uma descrição sumária das mesmas, numa área associada ao treino do domínio cognitivo. São também apresentados alguns resultados de investigações que vieram demonstrar a sua mais-valia junto de cuidadores e de cidadãos mais idosos no sentido de prevenirem problemas associados a demências. Pois, os resultados têm permitido verificar que a utilização regular das Apps, através das atividades/jogos que disponibilizam, se tem tornado vantajosa pelo facto de estimular treino de várias capacidades que podem combater o acréscimo de demências, principalmente, junto dos cidadãos mais idosos.
Promoción y formación del voluntariado con personas mayores en la universidad española
Authors: Sitges Maciá Esther , Lorente Martínez Raquel , Saorín Román Mª Jesús
Published: January 2018

El marco legal del voluntariado en las universidades queda reflejado en la Ley de voluntariado (Ley 45/2015), afirmando, que éstas “proveerán lo necesario para fijar los medios y sistemas de relación que hagan posible la información recíproca, la cooperación técnica y la acción conjunta en el ejercicio de sus competencias, con el fin de integrar sus actuaciones, contribuyendo con ello a mejorar la acción voluntaria y la participación solidaria de la ciudadanía”. En el caso de las personas mayores, los programas de voluntariado universitario pueden suponer una vía para fomentar la participación en la sociedad, promover el envejecimiento activo y saludable. En el presente trabajo nos planteamos analizar cuál es el papel de las universidades españolas en la promoción del voluntariado de personas mayores. Se describen los resultados relativos al número de voluntarios mayores y la oferta de cursos formativos de voluntariado con personas mayores en una muestra de 43 universidades españolas. Los resultados revelan que existe poca oferta de cursos de formación en el ámbito del voluntariado con personas mayores y poca participación de los universitarios mayores y jóvenes en estos programas. Animamos a que las universidades aumenten sus esfuerzos para promover la formación del voluntariado con personas mayores.
Diferencias en calidad de vida en personas mayores físicamente activas de 60 años según el nivel de actividad física practicada
Authors: Parra-Rizo Maria Antonia , Bonete López Beatriz
Published: January 2018

La calidad de vida es una prioridad en el ámbito de estudio del envejecimiento junto con la práctica de actividad física, junto con el estudio de la capacidad funcional y el envejecimiento saludable.El objetivo ha sido explorar las diferencias en la percepción de calidad de vida en función de los diferentes niveles practicados de actividad física (alto, moderado o bajo). Se ha empleado el International Physical Activity (IPAQ) recomendado por la OMS, y el cuestionario de calidad de vida CUBRECAVI en un grupo de 397 personas de 60 a 90 años físicamente activas de la provincia de Alicante. Los resultados indican una mayor calidad de vida en aquellos que realizan actividad física de alta intensidad. Al contrario, los que realizan una actividad moderada o baja, la autovaloración de la calidad de vida no depende de la actividad física. Con ello, la práctica de actividad física de alta intensidad favorece una mayor percepción de calidad de vida en personas mayores. Estos datos se pueden tener en cuenta como estrategia de implementación en los programas de intervención de actividad física en la vejez.
Diversidade Cultural de Psicanálise de Casal e Família - “Viúvas e órfãos de vivos”
Authors: Oliveira Sizalda
Published: January 2018

As conquistas, os descobrimentos marcam a História de Portugal, que se contempla na apropriação intracultural familiar. A guerra, a emigração, inscrevem na população um “estranho desejo”, que se volta para o exterior. Os homens vão-se…ficam as mulheres e os filhos.... Institui-se o legado familiar, promovendo o impasse geracional e constitui-se o fantasma familiar. Aguardam a vinda messiânica, ficando presos e impedidos de aceder à ambivalência afetiva e à mensagem paradoxal.Constroem-se vínculos patológicos, coexistentes com um narcisismo familiar frágil. Vive-se a pseudo- segurança da união com o fantasma do presente-ausente, verifica-se a ausência de desenvolvimento do “self familiar” coeso e coerente, tão característico das “Famílias de Vidro”. As vulnerabilidades emocionais destes agregados familiares inscrevem nas suas memórias traumas, culpas, lutos suspensos e, sofrimentos não mentalizados que culminam em (de)formações narcísicas e falhas identitárias que, interrogamos: não estarão ao serviço dos objetos fantasmáticos transgeracionais, à pró-cura de dinâmicas transformadoras com sentido e significantes?
Competencias transversales en la formación inicial del profesorado: el caso del ocio
Authors: Luis Rico M. Isabel , De La Torre Cruz Tamara , Escolar Llamazares M. Camino , Huelmo García Jonathan , Palmero Cámara Carmen , Jiménez Eguizábal Alfredo
Published: January 2018

Nuestra investigación se centra en determinar la preeminencia de la educación para el ocio dentro de la configuración competencial del profesorado en su formación inicial, a través del análisis de documentación de ámbito internacional, europeo y nacional relacionados con las competencias profesionales del profesorado. El interés radica en la necesidad detectada por insertar dentro del desempeño docente aspectos competenciales transversales que satisfagan el objetivo educativo de promover y desarrollar en el individuo las competencias necesarias para desenvolverse con éxito en el mundo global, multicultural y cambiante. El ocio humanista se sitúa como competencia transversal que permite de forma individual y colectiva el desarrollo positivo y sostenible, formando parte de la configuración social contemporánea, lo que plantea la necesidad de ser tenido en cuenta en los planteamientos formativos iniciales de los docentes como agentes de cambio y promotores del cambio educativo.
Conocimiento financiero y su importancia para los usuarios de servicios comerciales y financieros para elegir la mejor opción para pagar deudas
Authors: García-Santillán Arturo , Moreno-García Elena , Silva-Montes Maritza
Published: January 2018

El propósito del estudio se centró en conocer cuál esquema de amortización de deuda genera mayor costo financiero entre los sistemas: Francés, Alemán y Americano  así como la propuesta de García-Santillán, 2014) para el contexto latino. Al final se obtiene evidencia que nos lleva a pensar  que el sistema Americano es el que genera mayor costo financiero a cargo del deudor que los otros esquemas. Además el sistema de amortización de deuda alemán es el que genera el más bajo costo financiero.
An Employer's Recourse to Lock-Out and Replacement Labour: An Evaluation of Recent Case Law
Authors: Botha Monray Marsellus , Lephoto Motsoane
Published: January 2018

South African labour affairs are in a volatile state. Conflicting rights and interests as well as the balancing of these rights and interests are contributing to this state of affairs. In recent years, the contentious issues of workers' right to use their economic power to put pressure on employers and employers' recourse to lock-out and replacement labour have come under the spotlight again. Prolonged, violent and unprotected strikes have raised the question whether our industrial relations framework should be revisited, and have complicated matters even further. The question whether employers may use replacement labour and have recourse to lock-outs when an impasse exists during wage negotiations has come to the fore again and is evaluated in the context of the adversarial collective bargaining framework in South Africa.
Pursuing the Right to an Effective Remedy for Human Rights Violation(s) In Cameroon: The Need for Legislative Reform
Authors: Agbor Avitus A
Published: January 2018

Undoubtedly, global and regional human rights instruments clearly entrench the right to an effective remedy for a human rights violation. The substantive nature of the right to an effective remedy makes it relevant to the realisation of the right to equality as well as the right to equal protection under the law. Cameroon, as a State Party to most of these human rights instruments, is bound to adopt measures aimed at giving effect to the rights contained therein. One of such steps, in my opinion, is the enactment of domestic legislation that defines the content of these rights; stipulates the forums where remedies for human violations could be pursued; specifies what kinds of remedies a victim of a human rights violation would get at the end; and lastly, defines who can access such forums. Unfortunately, the lack of domestic legislation that meets these requirements means the right to an effective remedy for a human rights violation in Cameroon cannot be realised. It is argued in this paper that the critical nature of the right to a remedy, given its bearing on other substantive human rights as well as the protection and promotion of human rights, warrants progressive efforts undertaken by the State in order to give effect to this right. Therefore, the sheer lack of a legislative instrument in this regard makes it very difficult for the pursuit of a right to a remedy when there is a violation of human rights. As evidenced by legislative developments in numerous African States that are States Parties to these international instruments, there is growing consensus that the enactment of domestic legislation that answers the questions of content; forums; outcomes and access is a positive and vital step towards the realisation of the right to an effective remedy for a human rights violation.
Liability to Pay Retirement Benefits when Contributions were not Paid to the Retirement Fund: A Reply to Mr Nkosi
Authors: Marumoagae Motseotsile Clement
Published: January 2018

This paper responds to the fascinating article written by Mr Thulani Nkosi relating to the devastating effects of employers failure to pay over their employees' retirement funds contributions to the relevant retirement funds.  In particular, I respond to Nkosi’s main argument that retirement funds should pay withdrawal benefits notwithstanding the fact that they did not receive members’ retirement fund contributions from contributing employers.  I argue that while such an approach is understandable, it is nonetheless, legally unsound and further demonstrates that it is not supported by the law as it stands today.  I further argue that Nkosi's reliance on the principle of equity as advocated by Professor John Murphy when he was the Pension Funds Adjudicator to a larger extent does not pay attention to how occupational defined contribution funds operates. The basis of my argument is that defined contribution funds rely on members' contribution and it would not be sustainable for these funds to pay retirement benefits to members whose contributions they did not receive.
Cryopreserve cells v1
Authors: Thai Bao
Published: January 2018

Cryofreezing cells for preservation.
Seguir a los difuntos. Una etnografía multisituada de las prácticas funerarias transnacionales
Authors: Solé Arraràs Ariadna
Published: January 2018

El presente artículo presenta una reflexión metodológica sobre el estudio de las prácticas funerarias en contexto trasnacional a las que dediqué mi tesis doctoral (2015) centrada en la repatriación de difuntos entre Catalunya y Kolda (Senegal). Es también el principal objeto del proyecto internacional MECMI con base en la UQAM (Canadà). La repatriación de difuntos es una práctica habitual entre distintos grupos migrantes y su estudio exige investigar en contextos múltiples, diseñar una etnografía que implica buscar constantemente un campo que se mueve, seguir a nuestro objeto de estudio por las cartografías que este mismo dibuja. La investigación de los ritos funerarios transnacionales exige usar elementos de las dos primeras formas o técnicas con las que la etnografía multisituada define sus objetos de estudio según George E. Marcus. El cuerpo difunto no es exactamente una cosa y su ambigüedad simbólica como persona y/o cosa ha sido un elemento de reflexión de la antropología de la muerte. Sin embargo, se trata de una forma de hacer etnografía que nos permite reflexionar como el ritual funerario transnacional es, en sí mismo, una forma de construir esta “comunidad transnacional”.
Age-specific serum prostate-specific antigen references range among healthy men in Port Harcourt, Nigeria: a retrospective hospital-based study
Authors: Amadi Collins , Odum Ehimen P.
Published: January 2018

Background: Total prostate-specific antigen (PSA) levels increase with advancing age. Its age-specific ranges are being advocated to increase its sensitivity and specificity. This study was aimed to examine the relationship between total PSA levels and age, and to determine the age-specific ranges among healthy men without prostatic diseases in our environment.Methods: In this retrospective hospital-based study, records of men without prostatic diseases who had visited University of Port Harcourt Teaching Hospital for routine screening for prostate cancer using serum total PSA between 1st January 2012 and 31st December 2016 were retrieved and analyzed using descriptive statistics and Spearman’s correlation test. A p-value < 0.05 was considered significant.Results: Records of 476 men aged 38 to 86 years were recruited for the study. The age-specific total PSA reference range using the 95th percentile total PSA concentration values in each 10year groups were 0-1.60, 0-4.93, 0-6.93, 0-7.80, 0-9.65, and 0-13.30 for the age groups 30-39, 40-49, 50-59, 60-69, 70-79 and >80years respectively. There was a positive correlation between serum PSA concentration and age (rs = 0.395; p<0.001).Conclusions: Total PSA increases with advancing age and its age-specific reference range in this study are similar to findings in our environment but higher than the values found in other parts of the world. We suggest serum PSA normal reference values should be characterized by age and race in our environment.
The relationship of serum leptin, serum TNF-α, plasma lipids and obesity parameters in patients treated with weight neutral antidepressants
Authors: Gangavaram Naveen Kumar Reddy , Siddapa Adarsh Lakkur , Muthiah Bhanukumar , Ram Dushad
Published: January 2018

Background: Leptin and tumor necrosis factor (TNF­α) are involved in weight regulation1. Elevated lipids are frequently encountered in obese people which are helpful in the formation of atherosclerotic plaques in the coronary arteries. This study helps us to know whether weight neutral antidepressant therapy can be therapeutic option in those with obesity associated with depression.Methods: It is a Longitudinal study of sample size 72 where Patients with obesity attending to JSS hospital who are found to be depressive in both inpatients and out patients fulfilling the inclusion and exclusion criteria.Results: Our study showed mean difference value of weight, BMI and waist circumference, S. leptin, S.TNF-α, S. total cholesterol, S. LDL-C, S. VLDL-C, triglycerides of obese patients treated with lifestyle modifications, psychotherapy and weight neutral antidepressants at baseline and 3rd month was significantly decreased when compared to obese patients treated with lifestyle modifications, psychotherapy alone at baseline and 3rd month is 3.5kgs, 1.2kg/m2, 0.89cm, 9.53pg/ml, 10.86pg/ml, 22.34mg/dl, 17.94mg/dl, 4.42mg/dl, 21.78mg/dl and 1.2kgs, 0.32kg/m2, 0.02cm, 5.22pg/ml, 7.86pg/ml, 11.72mg/dl, 15.37mg/dl, 1.98mg/dl, 9.54mg/dl respectively (p=0.0001).Conclusions: Our study demonstrated a significant weight loss, and significant decrease in S. Leptin, S. TNF- α, TC, LDL-C, VLDL-C, triglycerides, when obese patients treated with lifestyle modifications, psychotherapy and weight neutral antidepressant (Desvenlafaxine).
Duration of analgesia, sensory and motor blockade and intra operative hemodynamic changes caused by intrathecal bupivacaine, bupivacaine plus clonidine and bupivacaine plus dexmedetomidine in spinal anesthesia: prospective, comparative study
Authors: P. Sankaranand , G. V. Krishna Prasad
Published: January 2018

Background: This is comparative study to differentiate the effects of Dexmedetomidine and clonidine on duration of analgesia, motor and sensory blockade and the intraoperative hemodynamic profile when mixed with Bupivacaine.Methods: Patients aged 15-45 years having ASA 1 and ASA 2 scheduled for elective orthopedic surgeries under spinal anaesthesia were included and divided into 3 groups equally (50 patients each)’ i.e. Group B received only 3.0 ml of 0.5% Bupivacaine (Heavy); Group C received 3.0ml of 0.5% Bupivacaine (Heavy) mixed with Clonidine 30 µg; and Group D administered with 3.0 ml of 0.5% Bupivacaine (Heavy) mixed with 5µg Dexmedetomidine.Results: Majority of the cases enrolled in the study were knee disorders and the rest being fracture femur, tibia. At preoperative interval mean systolic blood pressure and diastolic blood pressure of Group B was slightly higher than Group C and Group D. At the time when spinal anaesthesia was given, a slight fall in DBP of patients was observed in all Group B, Group C and Group D. Mean heart rate of patients at preoperative interval in patients of Group B, Group C and Group D respectively, with Group C and Group D showing slightly lower mean heart rate as compared with that of the mean heart rate of Group B but the values were not statistically significant. There were no any significant changes in the hemodynamic status.Conclusions: Both of used combinations provide prolonged sensory and motor blockade, hemodynamic stability, minimal side effects, and excellent intraoperative and postoperative analgesia.
Perioperative management of patients with acromegaly-a retrospective analysis
Authors: Nanjundaswamy Nethra H. , Sridhara Raghavendra Biligiri
Published: January 2018

Background: Acromegaly poses several challenges to the anesthetists, neurosurgeons, endocrinologists and intensivists, mandating a careful, coordinated multidisciplinary approach for a successful surgical outcome. An emphasis is required on a thorough preoperative evaluation of airway, neurological and endocrine and metabolic status so as to formulate a suitable perioperative management plan.Methods: The rates of various perioperative complications, both surgical and anesthesia related, during pituitary surgeries in acromegaly patients were studied. Data collected included demographics, patient’s medical history and any associated comorbid conditions, diagnosis, procedure performed, anesthetic management, intraoperative and postoperative complications.Results: This is a retrospective analysis of 22 patients of acromegaly who underwent excision of a growth hormone (GH) secreting pituitary adenoma from October 2012 to December 2017. Male: female, 14:8 with a mean age of 32±9.5 years. The common presenting symptoms were somatic dysmorphism, headache, visual field defects and menstrual irregularities. Preoperative associated co-morbidities were hypertension (4), diabetes mellitus (6), Ischemic Heart Disease (1), hypothyroidism (3), situs solitus (1), lumbar and cervical disc prolapse (1), nephropathy (1) and poliomyelitis (1). One patient had difficult tracheal intubation with repeated attempts at direct laryngoscopy and surgery was deferred to a later date where awake fibreoptic bronchoscopic intubation was done. Two more patients with anticipated difficult airway, trachea was intubated using a fibreoptic bronchoscope. Out of 22 Transsphenoidal surgical approach (transnasal or sublabial) and pterional craniotomy in 18 and 4. Inhalational anaesthetic was used in the majority of patients (isoflurane, 18 and sevoflurane, 03) propofol infusion was used in 1 patient. Intraoperative cardiac complications like hypertension, ventricular ectopics was seen. Postoperatively metabolic, water and electrolyte imbalance were common occurance. CSF rhinorrhoea in 4 patients and one developed meningitis.Conclusions: The present data shows that patients undergoing pituitary surgery for acromegaly have many airway issues, cardiac and metabolic risk factors.
Management of acute diarrhea in children: is the treatment guidelines is really implemented?
Authors: Abbas Jaigam , Chandra Pandey Dinesh , Verma Ashish , Kumar Vijay
Published: January 2018

Background: Acute diarrhea is a common problem in children especially in poor and developing nations. It is one of the leading cause of under-five years’ mortality globally. The children used to die each year of dehydration and electrolyte imbalance caused by acute diarrhea. Despite of WHO recommendations on the use of ORS and zinc in the management of acute diarrhea as a simple and effective treatment, the prescribing trend of ORS and zinc in acute diarrhoea is not up to the mark, which further increases the burden of the problems. Objectives: we aimed to assess; (1) prescribing trend of ORS and zinc in acute diarrhoea in children aged 6months to 5years by health care providers, (2) to asses’ proportion of patient education in acute diarrhea by health care providers.Methods: This was a qualitative, cross-sectional, hospital based study carried among children aged 6months to 5yrs.Results: This study was conducted among 313 children of acute diarrhoea who had been treated outside. Mean age (months) was 27.53±15.87. Out of all children who were treated from outside, 180 (57.50%) took treatment from general physician, 113 (36.10%) children took the treatment from pediatrician, and 20 (6.85%) took the treatment from the physician and 25 (7.9%) took treatment as over the counter antidiarrheal by the pharmacists. Out of them dehydration was documented only in 97 (30.99%), while ORS was given in 229 (73.16%) and zinc was given in 121 (38.65%) children. Patients education was done in 39 (12.46%).Conclusions: There was gross under implementation of treatment guidelines in the management of acute diarrhea by health care providers especially by general physicians.
Predictors of poor glycemic control in type 2 diabetic patients in South Indian population
Authors: De Pushpita , Banu Shaheen , Muthukumar Diviya
Published: January 2018

Background: The aim of this study is to shed light on the patients ‘knowledge, expectations and attitudes with regards to glucose control, and to understand the barriers to achieving good glucose control among south Indian patients with type 2 diabetes.Methods: A cross-sectional study was conducted among 76 type 2 diabetic patients in this study. Patients’ information such as sociodemographic characteristics, family history of diabetes, diabetes duration, medication adherence, dietary pattern, physical activity was obtained through interview. Anthropometric details were noted during the interview. All available last readings for fasting blood sugar, post prandial blood sugar and glycosylated hemoglobin were abstracted from patients’ records.Results: A total of 76 patients were enrolled in the study. The overall mean (SD) duration of the disease was 9±7.02 years. 63% had HbA1c ≥7%, which is categorized as a poor glycemic control. 43% of the subjects had poor glucose control who did not follow healthy eating plans. 84% of the patients did participate in physical exercise but did not follow as recommended. 67% of the patients have poor knowledge about glucose control.Conclusions: The main results indicate that glycemic control in type 2 diabetes is generally poor. Longer duration of diabetes and not adherent to diabetes self-care management behaviors were associated with poor glycemic control. Therefore, a balanced approach to improve awareness about diabetes and its control both among patients and the medical fraternity is urgent need of the hour in India.
Association between symptom profile of schizophrenia and the perceived wellbeing in their caregivers
Authors: K. Pugazhendhi , M. Kathir , J. Ravishankar
Published: January 2018

Background: The chronic nature of Schizophrenia has a devastating impact not only on the patients but also in their caregivers. The burden experienced by the caregivers can seriously affect the psychological wellbeing and caregivers take up multiple coping strategies to tackle the burden. This study was undertaken to find the association between symptom profile of Schizophrenia patients and the perceived wellbeing of their caregivers.Methods: 30 patients with schizophrenia and their caregivers (parents or spouses), who were actively involved in care of the patient for at least 6 months prior to assessment, were included in the study. Patients were evaluated by socio demographic data sheet and Positive and negative syndrome scale (PANSS) while their caregivers were evaluated using Caregiver socio demographic data sheet, Burden Assessment Schedule (BAS), Coping Checklist (CCL) and Psychological Well Being Questionnaire (PWBQ). Statistical analysis was done using Chi square test and Fischer exact test for categorical variables, Pearson correlation to find correlation between data and Analysis of variance (ANOVA) to find significance of study parameters between groups. p < 0.05 was considered significant.Results: Burden experienced by caregivers was more with a severe symptom profile. Moderate correlation is found between patient’s positive symptom profile, negative symptom profile and burden. There was a weak correlation between patient`s symptom profile and care givers coping strategies. The total PANSS scores did not influence the pattern of coping. There was no statistically significant difference in coping strategies in positive and negative symptom of schizophrenia. There was a moderate negative correlation between patient`s symptom profile (positive and total PANSS score) and psychological wellbeing in caregivers. However, there was a weak correlation between patient negative symptom profile and psychological wellbeing in caregivers.Conclusions: Burden and wellbeing of the care givers of schizophrenic patients are closely inter related. These parameters are in turn related to patient’s symptoms profile namely, the overall psychopathology and more with the positive symptoms of schizophrenia. Though all care givers used different coping strategies, there did not appear to be any interrelation between strategies and the perceived burden, well-being and patient’s psychopathology.
Correlation of sleep quality with anthropometric parameters in young healthy individuals
Authors: Babu Rose , Bahuleyan Biju
Published: January 2018

Background: Obesity, which is the harbinger of various diseases, is considered as the epidemic of this era. Various lifestyle changes have resulted in a younger generation being prone to obesity. On investigating the etiology of obesity in young individuals, besides the change in food habits, sleep has also found a place. Various investigators have come up with conflicting results regarding the correlation between sleep and anthropometric parameters. In this backdrop, the present study was planned to analyze the correlation of sleep quality with anthropometric parameters.Methods: 100 first year MBBS students were given the Pittsburgh sleep questionnaire which gives a self-reported assessment of their sleep quality. Anthropometric parameters of the students were recorded along with body fat analysis using Omron body fat analyzer. The results obtained were tabulated and analyzed.Results: Out of the 100 students 45 were found to be poor sleepers. On analyzing the anthropometric parameters, no significant difference was noted between good sleepers and poor sleepers. The body fat content also did not show any significant difference between the two groups.Conclusions: The findings of the present study show a nonmonotonic relationship between sleep quality and anthropometric parameters. This shows that the response of the adolescent population may differ in comparison with other groups. Hence it is recommended that the poor sleepers in the adolescent group need to be followed up in future.
Cross sectional study for contraceptive practices in antenatal women at tertiary rural institute
Authors: Divedi Pragati , Rawat Rajani , Vishwakarma Soniya , Mittal Nupur , Dwivedi Deepti
Published: January 2018

Background: Objective of the study was to assess the awareness and acceptance for contraceptive practices amongst the women attending the routine antenatal outpatient services at our tertiary rural institute.Methods: It was a cross sectional study done in UP University of Medical Sciences (UPUMS) Saifai. Three hundred fifty (350) patients aged between 18 -40 years were enrolled in the study after written informed consent. A self structured pre formed questionnaire was provided regarding demographic profile, obstetric profile, contraceptive practices and reasons for not using any contraception. Then data were analysed statistically.Results: Majority of the women were between the age group of 30-35 years and had basic level of education. In our study 90% women were aware of one or more methods of contraception. 86.5% accepted the contraceptive practices and 81.43% followed the contraception. 81.43% used temporary methods of which OCPs, IUCDs, and Condoms were common.Conclusions: Majority of the women were between 30-35 years of age. 90% women knew about some method of contraception. 81.4% women followed the temporary method of contraception. Among non users the main reason for not using contraceptive method were mainly lack of knowledge and they wanted more children.