bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hubungan Aktivitas Fisik Terhadap Konstipasi pada Pasien Stroke di RS Islam Siti Rahmah Padang
Authors: Sibarani Maria Valentina , Ulfah Rahmi , Afriyanti Esi 
Published: March 2020

AbstrakKonstipasi merupakan keluhan yang sangat sering pada pasien stroke, jika tidak diatasi akan menyebabkan komplikasi penyakit lainnya. Konstipasi pada pasien stroke bisa disebabkan oleh berbagai faktor, salah satunya diperberat oleh aktivitas fisik yang kurang. Tujuan: Menentukan korelasi aktifitas fisik terhadap konstipasi pada pasien stroke di RS Islam Siti Rahmah Padang. Metode: Subjek penelitian adalah pasien stroke sebanyak 54 orang. Desain penelitian ini adalah cross sectional dengan teknik pengambilan sampel secara simple random sampling. Pengukuran konstipasi menggunakan Constipation Scoring System (CSS) dan untuk menilai aktifitas fisik digunakan International Physical Activity Quosioner (IPAQ). Analisa statisitik dilakukan dengan uji korelasi Spearmen. Hasil: Responden dengan aktifitas rendah dan mengalami konstipasi berjumlah 34 orang (87,18%). Hal ini menunjukan terdapat hubungan yang kuat dan bersifat positif antara aktivitas fisik dan konstipasi pada pasien stroke (p = 0,000, r = 0,608). Simpulan: Terdapat hubungan aktifitas fisik terhadap konstipasi pada pasien stroke di RS Islam Siti Rahmah padang
LIMITE DE GASTOS MUNICIPAIS E RESPONSABILIDADE FISCAL: NOVOS PARÂMETROS ESTABELECIDOS PELA LEI COMPLEMENTAR N. 164/2018
Authors: Martins Urá Lobato 
Published: March 2020

O artigo analisa os limites de gastos municipais de acordo com a Lei de Responsabilidade Fiscal (LRF), dando-se ênfase aos novos parâmetros estabelecidos pela Lei Complementar 164/2018. Nesse sentido, o artigo foi norteado pelas seguintes questões norteadoras: qual o limite constitucional e legal para gastos com pessoal? Quais as sanções que os municípios podem sofrer, caso não cumpram tais limites? Qual o impacto gerado pelas normas introduzidas na LRF pela Lei Complementar n. 164 de 2018? Com o intuito de responder tais questionamentos, foi realizada uma pesquisa bibliográfica e documental. Ao final, serão apresentados argumentos sobre as novas regras estabelecidas com relação ao cumprimento do limite de gastos municipais, analisando as respectivas medidas sancionatórias, avaliando-se, assim, o impacto gerado pelas normas introduzidas na LRF pela Lei Complementar n. 164 de 2018.
PRODUÇÕES DISCURSIVAS DE GÊNERO: uma reflexão crítica sobre a Lei 12.318/2010 e a “Síndrome da Alienação Parental”
Authors: Martins Batalha Glaucia Fernanda Oliveira , De Serra Mendes Maiane Cibele 
Published: March 2020

O artigo visa analisar a “Teoria Gardneriana da Síndrome da Alienação Parental” e a Lei 12.318/2010 numa perspectiva de gênero. Considera-se o discurso jurídico como “tecnologia” que produz o gênero e que naturaliza e difunde “regimes de verdade” sobre a diferença sexualao se embasar nesta pseudo ciência para fundamentar a aprovação da Lei 12.318/2010 e a doutrina nacional, uma vez que instituem a representação da mulher (no âmbito da dissolução da união, seja por separação ou divórcio) como irracional, desequilibrada e alienadora. Para tanto, adota-se uma metodologia que contempla os seguintes procedimentos de pesquisa: pesquisa bibliográfica e pesquisa normativa.
Variación del Puntaje Z Peso-edad en lactantes hospitalizados, características de su alimentación y percepción de los padres
Authors: Morel Zuny Alejandra , Godoy Laura 
Published: March 2020

Introducción: La desnutrición en pacientes pediátricos hospitalizados continúa siendo un hallazgo común y una causa frecuente de aumento de la morbimortalidad en niños. Objetivo: Describir la Variación del Puntaje Z del peso-edad en lactantes hospitalizados en sala de internados en el periodo de Septiembre a Diciembre del 2018. Materiales y Métodos: Estudio observacional, descriptivo, transversal, prospectivo con componente analítico. Población: pacientes de 0 a 24 meses hospitalizados en el periodo de septiembre a diciembre del 2018. Variables: edad, sexo, procedencia, tiempo de lactancia materna exclusiva, alimentación actual, alimentación complementaria, comorbilidades, ayuno, peso al ingreso Puntaje Z, peso al egreso Puntaje Z, diagnóstico nutricional al ingreso, diagnóstico nutricional al egreso, diagnóstico de egreso, percepción de los padres. Análisis de datos: sistema SSPPv21, estadística descriptiva. El protocolo fue aceptado por el comité de ética de la institución con consentimiento informado. Resultados: la mediana de edad fue de 7 meses, predominó el sexo masculino 52%, la mayoría proceden del área central 87%, la mediana del tiempo de lactancia materna exclusiva fue 5 meses, la mediana del inicio de alimentación complementaria fue 6 meses, siendo la mediana de días de internación 4 (mínimo 3 y máximo de 6), la alimentación actual corresponde a LME en 40%,el diagnostico nutricional del ingreso: eutrófico en 65% y al egreso 66%, el Pz al ingreso fue 0,29±0,94 y al egreso fue 0,42±0,87. Considerando como punto de corte 5 días de hospitalización, y analizando la variación del Pz (P/E) en relación a los mismos no hubo variación. La percepción de los padres sobre la alimentación de sus hijos durante la hospitalización fue que comen en igual proporción que habitualmente en un 74,3%. Conclusión: No hubo variación estadísticamente significativa en el Puntaje Z de los pacientes hospitalizados y no se encontró variación del estado nutricional durante hospitalización de los lactantes. La mayoría de los pacientes tuvieron corta estancia hospitalaria y no fueron sometidos a ayuno durante la misma.
Conflicto de interés: Los autores declaran no poseer conflicto de interés
Recibido: 20/12/2019 Aceptado: 18/02/2020
Contenido de grasas, sodio, azúcares y edulcorantes declarados en etiquetado nutricional de golosinas, snacks salados y en bebidas dulces no alcohólicas seleccionadas
Authors: Hermosilla Soria Romy Beatriz , Sánchez Bernal Susana F. , Burgos Rodrigo 
Published: March 2020

Introducción: La obesidad en niños se asocia también a ingesta de alimentos ricos en grasas, azúcares y sodio, por ello es importante conocer sus niveles en golosinas y las bebidas dulces. Objetivos: Evaluar contenido de nutrientes críticos acorde al Perfil de Nutrientes de OPS en golosinas dulces, snacks salados y bebidas dulces no alcohólicas envasadas, según información del etiquetado nutricional.
Materiales y Métodos: Estudio transversal, descriptivo, exploratorios. Se evaluó contenido por porción de grasas totales(GT), saturadas(GS) y trans(GTr), sodio, azúcares libres(AL) y edulcorantes artificiales(EA) en golosinas dulces, saladas, y bebidas dulces no alcohólicas (BDNA) según etiquetado nutricional. Niveles excesivos fueron considerados según "Perfil de nutrientes de OPS". Muestra fue por conveniencia obtenida en 2 bocas de expendio. Se excluyeron postres envasados y golosinas con información poco visible. Resultados: Fueron evaluados 104 alimentos agrupados en: confitería (alfajor, magdalenas), chocolates, snacks salados (queso, maíz, galletitas saladas, papas fritas), galletitas dulces, bebidas dulces (jugos/gaseosas/bebidadeportistas). En confitería, 8/13 tenían exceso de GT, 10/13 de GS, 4/13 de GTr, 11/13, de AL, ninguno exceso de sodio, 11/13 tenían EA. Entre chocolates, todos tenían exceso de GT y GS, 2/10 en GTr, ninguno sodio, 9/10 altos en AL, 2/10 contenían EA. Snacks:, 14/17 eran altos en GT, 7/17 en GS, 1/17 en GTr, 15/17 en sodio, 4/17 en AL, 6/17 contenían EA. Galletitas dulces tenían exceso de GT 14/20, de GS 17/20, 6/20 de GTr, de sodio 1/20, todos con AL,17/20 contenían EA. En BDH (n=44), todas tenían exceso de sodio, 36/44 exceso de AL, 21/44 tenían EA. Conclusión: Alimentos de confitería son altos en grasas, azúcares libres y edulcorantes.. Los chocolates son altos en grasas y azucares. Los snacks son altos en sodio y grasas. Las galletitas tienen exceso de azúcares y grasas saturadas, 2/3 contienen edulcorantes artificiales. Las bebidas dulces son altas en sodio y azucares, la mitad tiene edulcorantes artificiales.
Conflicto de interés: Los autores declaran no poseer conflicto de interés
Recibido: 08/02/2019 Aceptado: 20/02/2020
Neurosurgical training and global health education: systematic review of challenges and benefits of in-country programs in the care of neural tube defects
Authors: Gandy Kellen , Castillo Heidi , Rocque Brandon G. , Bradko Viachaslau , Whitehead William , Castillo Jonathan 
Published: March 2020

OBJECTIVEThe recognition that neurosurgeons harbor great potential to advocate for the care of individuals with neural tube defects (NTDs) globally has sounded as a clear call to action; however, neurosurgical care and training in low- and middle-income countries (LMICs) present unique challenges that must be considered. The objective of this study was to systematically review publications that describe the challenges and benefits of participating in neurosurgery-related training programs in LMICs in the service of individuals with NTDs.METHODSUsing MEDLINE (PubMed), the authors conducted a systematic review of English- and Spanish-language articles published from 1974 to 2019 that describe the experiences of in-country neurosurgery-related training programs in LMICs. The inclusion criteria were as follows—1) population/exposure: US residents, US neurosurgeons, and local in-country medical staff participating in neurosurgical training programs aimed at improving healthcare for individuals with NTDs; 2) comparison: qualitative studies; and 3) outcome: description of the challenges and benefits of neurosurgical training programs. Articles meeting these criteria were assessed within a global health education conceptual framework.RESULTSNine articles met the inclusion criteria, with the majority of the in-country neurosurgical training programs being seen in subregions of Africa (8/9 [89%]) and one in South/Central America. US-based residents and neurosurgeons who participated in global health neurosurgical training had increased exposure to rare diseases not common in the US, were given the opportunity to work with a collaborative team to educate local healthcare professionals, and had increased exposure to neurosurgical procedures involved in treating NTDs. US neurosurgeons agreed that participating in international training improved their own clinical practices but also recognized that identifying international partners, travel expenses, and interference with their current practice are major barriers to participating in global health education. In contrast, the local medical personnel learned surgical techniques from visiting neurosurgeons, had increased exposure to intraoperative decision-making, and were given guidance to improve postoperative care. The most significant challenges identified were difficulties in local long-term retention of trained fellows and staff, deficient infrastructure, and lower compensation offered for pediatric neurosurgery in comparison to adult care.CONCLUSIONSThe challenges and benefits of international neurosurgical training programs need to be considered to effectively promote the development of neurosurgical care for individuals with NTDs in LMICs. In this global health paradigm, future work needs to investigate further the in-country professionals’ perspective, as well as the related outcomes.
Reaching the horizon and looking beyond: neurosurgery education in Kazakhstan
Authors: Akshulakov Serik , Makhambetov Yerbol , Bralov Askhat , Pazylbekov Talgat , Tursynov Nurtas , Menlibayeva Karashash 
Published: March 2020

Neurosurgery education in Kazakhstan has 55 years of history. The first neurosurgery department was established in 1964 in the city of Almaty, South Kazakhstan (the former capital of Kazakhstan). The department was headed by the pioneer of Kazakhstani neurosurgeons, Prof. Yevgeniya Azarova. A new neurosurgery education system was adopted after a while. To date, 4 medical universities and 1 neurosurgical center in Kazakhstan have a neurosurgery department that prepares around 10 neurosurgeons annually. The country’s populations are currently served by more than 300 neurosurgeons. However, isolated regions lack neurosurgical services and a specialized medical workforce. Urbanization results in inequality of receiving medical care among rural and regional inhabitants.To develop and strengthen the neurosurgery services, the National Center for Neurosurgery was opened in the heart of the country. The center has placed great importance on the development of neurosurgery and neurosurgical education in Kazakhstan. The World Federation of Neurosurgical Societies, European Association of Neurosurgical Societies, Asian Congress of Neurosurgeons, and International Society for Pediatric Neurosurgery have held many international meaningful events on neurosurgery at the center. Opened in 2008, the neurosurgery center has prepared 41 neurosurgeons in the residency program. This article seeks to provide readers with an understanding of the state of neurosurgery education in Kazakhstan and its development history.
Current US neurosurgical resident involvement, interest, and barriers in global neurosurgery
Authors: Lundy Paige , Miller Christopher , Woodrow Sarah 
Published: March 2020

OBJECTIVEIt is estimated that nearly 47 million preventable deaths occur annually due the current worldwide deficit in surgical care; subsequently, the World Health Organization resolved unanimously to endorse a decree to address this deficit. Neurosurgeons from industrialized nations can help address the needs of underserved regions. Exposure during training is critical for young neurosurgeons to gain experience in international work and to cultivate career-long interest. Here, the authors explore the opinions of current residents and interest in global neurosurgery as well as the current state of international involvement, opportunities, and barriers in North American residency training.METHODSAn internet-based questionnaire was developed using the authors’ university’s REDCap database and distributed to neurosurgical residents from US ACGME (Accreditation Council for Graduate Medical Education)–approved programs. Questions focused on the resident’s program’s involvement and logistics regarding international rotations and the resident’s interest level in pursuing these opportunities.RESULTSA 15% response rate was obtained from a broad range of training locations. Twenty-nine percent of respondents reported that their residency program offered elective training opportunities in developing countries, and 7.6% reported having participated in these programs. This cohort unanimously felt that the international rotation was a beneficial experience and agreed that they would do it again. Of those who had not participated, 81.3% reported interest or strong interest in international rotations.CONCLUSIONSThe authors’ results indicate that, despite a high level of desire for involvement in international rotations, there is limited opportunity for residents to become involved. Barriers such as funding and rotation approval were recognized. It is the authors’ hope that governing organizations and residency programs will work to break down these barriers and help establish rotations for trainees to learn abroad and begin to join the cause of meeting global surgical needs. To meet overarching international neurosurgical needs, neurosurgeons of the future must be trained in global neurosurgery.
The state of neurosurgical training and education in East Asia: analysis and strategy development for this frontier of the world
Authors: Ferraris Kevin Paul , Matsumura Hideaki , Wardhana Dewa Putu Wisnu , Vesagas Theodor , Seng Kenny , Mohd Ali Mohd Raffiz , Ishikawa Eiichi , Matsumura Akira , Rosyidi Rohadi Muhammad , Mahadewa Tjokorda , Kuo Meng-Fai 
Published: March 2020

OBJECTIVEThe authors, who are from Indonesia, Japan, Malaysia, the Philippines, and Taiwan, sought to illustrate the processes of training neurosurgeons in their respective settings by presenting data and analyses of the current state of neurosurgical education across the East Asian region.METHODSThe authors obtained quantitative data as key indicators of the neurosurgical workforce from each country. Qualitative data analysis was also done to provide a description of the current state of neurosurgical training and education in the region. A strengths, weaknesses, opportunities, and threats (SWOT) analysis was also done to identify strategies for improvement.RESULTSThe number of neurosurgeons in each country is as follows: 370 in Indonesia, 10,014 in Japan, 152 in Malaysia, 134 in the Philippines, and 639 in Taiwan. With a large neurosurgical workforce, the high-income countries Japan and Taiwan have relatively high neurosurgeon to population ratios of 1 per 13,000 and 1 per 37,000, respectively. In contrast, the low- to middle-income countries Indonesia, Malaysia, and the Philippines have low neurosurgeon to population ratios of 1 per 731,000, 1 per 210,000, and 1 per 807,000, respectively. In terms of the number of training centers, Japan has 857, Taiwan 30, Indonesia 7, Malaysia 5, and the Philippines 10. In terms of the number of neurosurgical residents, Japan has 1000, Taiwan 170, Indonesia 199, Malaysia 53, and the Philippines 51. The average number of yearly additions to the neurosurgical workforce is as follows: Japan 180, Taiwan 27, Indonesia 10, Malaysia 4, and the Philippines 3. The different countries included in this report have many similarities and differences in their models and systems of neurosurgical education. Certain important strategies have been formulated in order for the system to be responsive to the needs of the catchment population: 1) establishment of a robust network of international collaboration for reciprocal certification, skills sharing, and subspecialty training; 2) incorporation of in-service residency and fellowship training within the framework of improving access to neurosurgical care; and 3) strengthening health systems, increasing funding, and developing related policies for infrastructure development.CONCLUSIONSThe varied situations of neurosurgical education in the East Asian region require strategies that take into account the different contexts in which programs are structured. Improving the education of current and future neurosurgeons becomes an important consideration in addressing the health inequalities in terms of access and quality of care afflicting the growing population in this region of the world.
Academic performance after neurosurgery residency training in Turkey: a national survey
Authors: Yakar Fatih , Hanalioglu Sahin , Sahin Balkan , Egemen Emrah , Dere Umit A. , Kiraz İlker , Coskun M. Erdal , Kahilogullari Gokmen 
Published: March 2020

OBJECTIVENeurosurgery training programs aim to train specialists. In addition, they are expected to equip the residents with necessary knowledge and skills for academic development. This study aims to gain insights into academic productivity after neurosurgeons graduated from residency training in Turkey.METHODSAn electronic survey was sent to all Turkish Neurosurgical Society members (n = 1662 neurosurgeons) between September and November 2019. The number of participants was 289 (17.4%). Participants were divided into subgroups based on three main factors: training institution type (university hospital [UH] vs training and research hospital [TRH]), training institution annual case volume (low [< 1000 or inadequate cranial/spinal case numbers] vs high [> 1000 and adequate cranial/spinal case numbers]), and training program accreditation status (accredited vs nonaccredited).RESULTSThe majority of the participants (64.7%) graduated from the UHs. Those trained at UHs (vs TRHs) and high- (vs low-) volume centers had their dissertations more frequently published in Science Citation Index/Science Citation Index–Expanded journals, gave more oral presentations after residency, had higher h-indices, had higher rates of reviewership for academic journals, and had greater participation in projects with grant support. In addition, graduates of accredited programs reported more PhD degrees than those of nonaccredited programs.CONCLUSIONSNeurosurgeons trained in higher-case-volume, accredited programs, mostly in the UHs, performed better in terms of scientific activities and productivity in Turkey. Strong research emphasis and supportive measures should be instituted to increase academic performance during and after residency training.
Job satisfaction, engagement, and burnout in the population of orthopedic surgeon and neurosurgeon trainees in mainland China
Authors: Yu Jinli , Zou Fei , Sun Yirui 
Published: March 2020

OBJECTIVEIn China, orthopedics and neurosurgery are among the most desired majors for medical students. However, little is known about the working and living status of specialists in these two fields. This study was aimed at evaluating job satisfaction, engagement, and burnout in the population of Chinese orthopedist and neurosurgeon trainees.METHODSA nationwide online survey was administered in mainland China. Questionnaires were answered anonymously. Job satisfaction, engagement, and burnout were assessed using the Job Descriptive Index, the Utrecht Work Engagement Scale, and the Maslach Burnout Inventory, respectively.RESULTSData were collected from 643 orthopedist trainees and 690 neurosurgeon trainees. Orthopedists and neurosurgeons showed no statistical difference in terms of age, sex, job titles, and preference for working in tertiary hospitals. Orthopedists had a higher marriage rate (p < 0.01), a lower divorce rate (p = 0.017), relatively shorter working hours (p < 0.01), and a higher annual income (p = 0.023) than neurosurgeons. Approximately 40% of respondents experienced workplace violence in the last 5 years. Less than 10% of respondents were satisfied with their pay, and over 70% would not encourage their offspring to become a doctor. Orthopedists were more satisfied with their careers than neurosurgeons (p < 0.01) and had a higher level of work engagement (p < 0.01). In addition, a higher proportion of orthopedists were burnt out (p < 0.01) than neurosurgeons, though the difference between the two groups was not significant (p = 0.088). Multivariate regressions suggested that younger age (≤ 25 years old), being a senior trainee, getting divorced, working in a regional hospital, long working hours (≥ 71 hrs/wk), a low annual income (<¥100,000), sleeping < 6 hrs/day, and experience with workplace violence were significantly related to burnout for both groups.CONCLUSIONSChinese orthopedic surgical and neurosurgical trainees are under significant stress. Orthopedic surgeons showed relatively optimistic data in their assessments of job satisfaction, engagement, and burnout. This study may provide valuable information for orthopedic and neurosurgical candidates considering either specialty as a career.