bluuebunny/crossref_metadata_2025_split huggingface dataset:
La démocratie participative au secours du paternalisme des élus. À propos des usages politiques d’un budget participatif
Authors: Sainty Jessica 
Published: March 2021

En se fondant sur l’étude monographique du budget participatif d’Avignon depuis 2017, cet article entend mettre l’accent sur les rapports usuels des élus à la participation citoyenne. S’intéresser à la façon dont les élus cadrent et pilotent le dispositif de budget participatif, avec l’aide des services technico-administratifs, permet de déceler le maintien d’une lecture paternaliste du fonctionnement de la démocratie au niveau local : celle-ci repose sur une vision hiérarchisée de la démocratie, dans laquelle les mandats représentatifs continuent d’être perçus comme prépondérants par rapport à la participation citoyenne, voire plus légitimes.
Jardins, parcs et paysages dans l’œuvre de Hermann Hesse – ou Par-delà nature et culture
Authors: Fournier Kiss Corinne 
Published: March 2021

La distinction entre jardins et paysages semble relever de l’évidence selon nos critères occidentaux : les premiers relèveraient de la culture (les jardins réclament l’intervention systématique et visible de l’Homme), les seconds de la nature (les paysages donnent l’impression de se développer librement et indépendamment de l’action humaine). Hermann Hesse, à de nombreux moments de son œuvre, s’appuie lui aussi sur cette dialectique, qu’il développe en privilégiant les oppositions entre le clos et l’ouvert, entre l’exotique et le familier. Néanmoins, ce qui semble devoir constituer une différence irréductible finit chez lui toujours par être remis en question, généralement déjà au sein de la même œuvre : les jardins font éclater leur clôture, renoncent à leur ordre et à leur aménagement, s’immiscent dans les paysages, tandis que les paysages sont présentés comme des prolongements des jardins et s’avèrent contenir une bio-diversité parfaitement insoupçonnée au départ, qui n’a rien à envier à celle des jardins. Jardins et paysages sont « en mouvement », et ils deviennent non seulement de véritables palimpsestes surchargés d’écritures de lieux multiples, mais fonctionnent également, pour l’observateur, comme un moyen privilégié d’entrer en confrontation avec son inconscient et d’accéder à une meilleure connaissance de soi.
« Zoocène » technologique dans la science-fiction
Authors: Hillard Anne-Sophie 
Published: March 2021

Cet article tente d’analyser le rôle des figures anthropomorphiques dans deux récits de science-fiction. Ces textes, dépeignant un « zoocène » technologique où l’humanité connaît une fin lente mais certaine, reflètent, tels des miroirs, les préoccupations contemporaines d’une humanité aux prises avec sa propre (r)évolution. Comment se projette cet anthropos en constante métamorphose ? Les deux œuvres étudiées, naviguant dans des mondes de lisières peuplées d’êtres hybrides et d’animaux-tech, soulignent cette projection incertaine. En mettant en scène des univers alternatifs où les animaux sont les détenteurs du discours, de la culture et de la technologie, Simak et Dath ne proposent pas simplement des figures animales anthropomorphiques et des corps humains réduits à leur animalité. Au contraire, l’hybridité technologique des animaux nous force à regarder l’Anthropocène comme un moment de l’histoire révolu et invite à réfléchir sur l’importance de l’évolution ; si le sort de l’humanité est dû à son incapacité à évoluer, les figures animales, elles, s’hybrident sans cesse, s’altérant au point de devenir alien. Dans cette mesure, il s’agit de s’intéresser aux allers-retours, fructueux dans ces textes, entre animal et humain et de ce que permet l’hybridité pour une humanité en reconfiguration.
Gaining Experience Over Time
Authors: Daraie Saied , Hasanvand Shirin , Goudarzi Fateme , Rassouli Maryam 
Published: March 2021

Background:
The transition of tracheostomy patients to the home poses many challenges for both the patient and the family. Identifying and understanding the experiences of family caregivers pave the road for discovering and meeting care needs. This study has been aimed to explain the experiences of family caregivers of patients with a tracheostomy about patient care at home.

Materials and Methods:
This qualitative study was conducted using a conventional content analysis approach from September 2018 to January 2019. Participants included nine family caregivers and one professional caregiver who were selected through purposive sampling method. The in-depth interviews were conducted at home or in health centers using field notes. Data were recorded manually and analyzed using the five-step method proposed by Granehim and Lundman.

Results:
The data led to the emergence of 1591 initial codes, 23 subcategories, and 6 categories. Categories include the need for training, the need for receiving care support, care challenges, care burden, gaining experience, hope, and inner satisfaction.

Conclusions:
In this study, the family caregivers faced with lots of challenges in caring patients with tracheostomy so that they were in needs of training and support from professionals. Although they got skillful in care and endure burden, they were so hopeful and satisfied with their attempts. Hence, there is a need for official nongovernmental organizations with the aim of maintaining care and protecting their families.
Exploring Facilitators of Regaining Autonomy in People with Spinal Cord Injury
Authors: Farahani Moloud Farmahini , Khankeh Hamid Reza , Hosseini Mohammadali , Dalvandi Asghar , NorouziTabrizi Kian 
Published: March 2021

Background:
One of the most important aims of rehabilitation in Spinal Cord Injuries (SCI) is regaining autonomy, which can affect individuals' Quality of Life (QOL). This study was conducted to understand the experiences of individuals with SCI in terms of regaining autonomy during transition from hospital to community.

Materials and Methods:
The present study was conducted using a qualitative research design. In this study, 15 semi-structured, in-depth interviews were conducted with individuals with SCI in Spinal Cord Injury (SCI) Association of Arak, Iran, from June 2018 to May 2019. The interviews were analyzed using the conventional content analysis method.

Results:
Data analysis emerged four core categories of “self-management” (adaptation to a new life, self-care, responsibility, and seeking information), “social support” (family and friends' support, health care providers' support, and peer support), “access to facilities and resources” (home modification, use of various rehabilitation techniques, and use of mobility equipment), and “spiritual and religious beliefs” (believing in divine destiny and performance of religious rites).

Conclusions:
The present study showed that several factors influenced the regaining of autonomy in individuals with SCI. It is important to consider the impact of these factors during transition from hospital to community. Health service providers can use the findings of this research to help these individuals regain their autonomy.
Designing Virtual Patients for Education of Nursing Students in Cancer Course
Authors: Bahrami Masoud , Hadadgar Arash , Fuladvandi Masoumeh 
Published: March 2021

Background:
One of the best approaches to promote clinical reasoning in nursing education is Virtual Patient (VP). The purpose of this study was to design and implement VPs for nursing student's education in caring for cancer patients.

Materials and Methods:
In the first stage, through a descriptive-exploratory qualitative study using a focus group method, topics with higher priority in cancer nursing were identified. Then, based on the VP Nursing Design Model (VPNDM) for each of these topics, a scenario and then an interactive VP was designed and implemented in the Open Labyrinth application. The content validity of VPs was evaluated by eight experts and then the face validity was examined in the pilot group including 15 nursing students.

Results:
Topics with higher priority in cancer nursing courses were mastectomy, chemotherapy, radiotherapy, hypercalcemia, spinal cord compression, cardiac tamponade, and superior vena cava syndrome. For five scenarios based on the nursing process in three sequences (signs and symptoms, diagnosis and interventions) the VPs were designed. In this process, learning objectives, determining the critical path, adding branches at the decision point, adding feedback, completing the clinical course and related data, and adding multimedia were considered. VPs were revised based on the proposed modifications following face and content validity.

Conclusions:
This article presents VP design steps for use in a nursing student training course. The researchers were able to provide and validate five VPs to care for cancer patients based on the VPNDM.
Awareness of Common Pediatric Surgical Entities among Practicing Indian Pediatricians
Authors: Mahalik Santosh Kumar , Pati Akash Bihari , Das Kanishka 
Published: March 2021

Aim:
Common pediatric surgical entities often get a delayed referral to the pediatric surgeon in the average Indian scenario. This study was conducted to assess the awareness about management of select common pediatric surgical entities among practicing pediatricians.

Materials and Methods:
An online multiple-choice questionnaire consisting of twenty questions related to the diagnosis and management of common pediatric surgical entities encountered by pediatricians in their routine office practice was prepared, and the electronic link was circulated among the practicing pediatricians of India. Each question had one correct response.

Results:
One hundred and seventy-five responses were obtained, collated, grouped, and analyzed. Overall, 35% of all responses were correct. Individually, 56% of respondents marked 51%–75% of answers correctly; only 7% scored above 75%. Some clinical observations were disparate: 65% were unfamiliar with preputial adhesions and 51% would discharge a preterm neonate with inguinal hernia without a surgical consult. There is a tendency toward unnecessary imaging (60% – localization of undescended testis, 91% – wet umbilicus, and 51% – postanal dimple) and overzealous medical management (propranolol for the involuting hemangioma). However, 82%–88% concurred on the standard conservative or surgical management in index conditions such as hypospadias and umbilical problems.

Conclusion:
There was a concurrence in the principles of management of common pediatric surgical entities between pediatricians and pediatric surgeons in 35%. Misdiagnosis, unwarranted investigations, overzealous medical management, and delayed surgical consults figured in 65%. A systematic professional interaction between the physicians and surgeons would facilitate a coordinated management. A larger study would yield more meaningful data.
Coccygectomy for Chronic Refractory Coccygodynia in Pediatric and Adolescent Patients
Authors: Almetaher Hisham Almohamady , Mansour Mohamed Awad , Shehata Mohamed Ali 
Published: March 2021

Aims:
Coccygodynia (also known as coccydynia and coccyalgia) described for the first time by Simpson in 1859. It is a disabling pain in the coccyx usually provoked by sitting or changing position from a sitting to a standing position. Treatment started with adjustment of ergonomics as specialized cushion for sitting, application of local heat, and oral analgesics. The aim of this study was to assess the results of total or partial coccygectomy for patients suffering from chronic refractory coccygodynia and not improving on conservative treatment in pediatrics and adolescents.

Methods:
The study included 22 patients, 8 of them with chronic refractory coccygodynia not responding to conservative management underwent partial or total coccygectomy using Key's surgical exposure after good preoperative preparation.

Results:
This study included 5 females (62.5%) and 3 males (37.5%), their ages ranged from 7 to 15 years. The results were excellent in 75% of patients and good in the remaining cases. The mean length of hospital stay was 1.43 ± 0.98 days. No significant intraoperative or postoperative complications were reported. The parents were satisfied in almost all cases in the long term follow up.

Conclusions:
Coccygodynia is a disabling problem, especially in pediatric patients. Coccygectomy is a feasible management option and has a favorable outcome when performed for an appropriate indication.
Anephric Neonate and Evolution of our Study on Intestinal Dialysis
Authors: Chatterjee Uday Sankar 
Published: March 2021

Purpose:
Intestinal dialysis for end-stage renal disease (ESRD) is a proposed renal replacement therapy, and studies are going on worldwide to make it practicable. We are also doing the same study in our institution and would like to share our experience in managing an anephric neonate with intestinal dialysis in the perspective of our ongoing study of intestinal dialysis since 2010.

Patients and Methods:
We did double-ended jejunostomy in an isolated loop of the jejunum keeping the main tract intact with jejunojejunal anastomosis in this anephric neonate. Following that, we started irrigation with peritoneal dialysis fluid from the 3rd postoperative day (POD) in that jejunal loop through jejunostomy.

Results:
This patient had no uremic features since re-admission and showed better laboratory and clinical outcomes with combined jejunal loop and colonic dialysis for 7 days. However, the patient died on the 9th POD following severe hypoglycemia.

Conclusions:
From this study, it seems intestinal dialysis, with necessary modifications done in our subsequent patients, which might be recommended for ESRD in children as well as in adults.
Routine use of Circumferential ‘Doughnut’ Biopsy in Pull through Surgery for Hirschsprung's Disease
Authors: Murthi Govind V. S. , Townley Oliver G. , Lindley Richard M , Cohen Marta C. 
Published: March 2021

Aims:
The aim of this study was to review the use of the on-table “doughnut” biopsy for frozen section assessment of bowel in the operative management of Hirschsprung's disease (HD).

Methods:
This was a single-center retrospective review of doughnut histopathology reports, operation notes, and slides from 2010 to 2017. Data were assessed for the presence of transition zone (TZ) features and the subsequent decision as to the level of pull-through.

Results:
Fifty-five patients had a doughnut biopsy taken as part of their intraoperative frozen section histopathology for pull-through for HD during the study period. Forty-eight required a single doughnut, six required a second more proximal doughnut, and one required a third doughnut. Of the 55 first doughnuts, 37 were identified as normal bowel, 17 were TZ, and not defined in the report in one case. Of the 17 TZ doughnuts, 8 were accepted for pull-through and 7 underwent second doughnuts (normal = 4 and TZ = 3). The third doughnut (one case) was normal. TZ was accepted for pull-through in 10/54 (18.5%) patients despite the use of a doughnut. However, TZ was avoided in six (11.1%), where the single-point biopsy was “normal.”

Conclusions:
The doughnut allows the entire circumference of pull-through level to be assessed, enabling TZ identification that can be missed by single seromuscular biopsies. This allows identification and avoidance of TZ pull-through, although sometimes, it is accepted for other reasons.
How three high-fee independent secondary schools in the Western Cape currently conceptualise language support for international students with language barriers
Authors: Clift Mariana 
Published: March 2021

A steadily increasing number of wealthy foreigners, mainly from other African countries, opt to send their teenage children to independent secondary schools in South Africa to give their children what they perceive to be the “best education possible” (Spaull, 2015: 14). As is the case globally, international students entering the South African independent school system at secondary level may face major difficulties in acquiring academic English.International students with language barriers tend to gravitate towards schools without rigorous entrance examinations in place. This article focusses on three high-fee independent secondary schools in the Western Cape, two boarding schools and one day school, whose websites in 2017 did not indicate that they had formal, exclusionary entrance examinations in place. Data subsequently provided by these schools showed that their student bodies did, in fact, include a substantialnumber of international students. For this study, the principal and two other senior members of staff at each of the three schools were interviewed to ascertain how they provided language support for international students with language barriers. After reporting backon these interviews, the discussion section of the article critically analyses current practices, with the conclusion of the article acting as a preamble for a follow-up article, in which aspects of the CLIL (content and language integrated literacy) model will be identified whichcould prove useful to these schools to further support students and staff.
Keywords: international students, language support, independent schooling, challenges, secondary schools
Enfermedades: raras, un verdadero reto
Authors: Vargas Carlos Salazar 
Published: March 2021

En estos días se ha dado a conocer en la prensa nacional el caso de unas pacientes con enfermedad de Pompe y la necesidad que tienen que la CCSS, les provea un medicamento que supuestamente puede paliar dicha patología. El medicamento no solo es caro, sino que su eficacia no está completamente demostrada, según la publicación periodística. Esta situación debe hacernos reflexionar sobre el tema de las enfermedades raras (ER), de pacientes que las padecen y de sus familiares.
Intolerancia a la lactosa
Authors: De Céspedes Montealegre Carlos 
Published: March 2021

La lactasa es una disacaridasa que desdobla específicamente la lactosa de la leche en sus monosacáridos componentes, la glucosa y la galactosa que consecuentemente son absorbidos a nivel del yeyuno. La lactosa que pasa al colon es desdoblada por la ß -galactosidasa, una enzima de la flora bacteriana normal, y al carecer el colon de los sistemas de transporte para la glucosa y la galactosa, estas son metabolizadas por las bacterias de la misma flora a ácidos orgánicos de cadena corta (3-4 carbonos), con la producción concomitante de gas hidrógeno (H2), con la consecuente diarrea osmótica y sus signos acompañantes de dolor abdominal, borborigmos y flatulencia, lo cual conforma el cuadro clínico de la intolerancia a la lactosa. Variaciones en la composición del microbioma intestinal, pueden explicar en parte las diferencias individuales en las manifestaciones clínicas ante ingestas de cantidades similares de lactosa.
La intolerancia a la lactosa se debe en principio a una disminución o ausencia de la actividad de la lactasa. La enzima se encuentra integrada a la membrana del enterocito en el borde en cepillo del epitelio del yeyuno, lo cual dificulta la medición directa de su actividad en la práctica ante la necesidad de obtener una biopsia. De hecho, la medición del H2 en el aire espirado es la forma más práctica hasta ahora, de estimar la actividad de la lactasa en la clínica. La adición de una prueba de tolerancia a la lactosa con medición de la glucosa sanguínea aumenta significativamente la confiabilidad de los resultados.
En medicina, usualmente se clasifica la deficiencia de lactasa en primaria y secundaria. Se considera deficiencia secundaria de la lactasa a la actividad decreciente de la enzima que resulta del daño en el epitelio intestinal provocado por trastornos inflamatorios como la enfermedad de Crohn, por diarreas de origen infeccioso o por desnutrición. En el presente editorial no nos referimos a la deficiencia secundaria de la lactasa.
Barreras y facilitadores relacionados con el diagnóstico de la lepra en Costa Rica
Authors: Rivera Chavarría Ana , Sánchez Hernández Germana , Espinoza Aguirre Azálea 
Published: March 2021

Objetivo: analizar barreras y facilitadores relacionados con el diagnóstico de la lepra en Costa Rica, desde la perspectiva de la persona con la enfermedad y en el contexto de la vida cotidiana.
Métodos: se llevó a cabo un estudio cualitativo de carácter exploratorio a partir de 25 entrevistas semiestructuradas, a personas con lepra o con antecedente de haberla padecido, de entre 23 y 88 años, atendidos en el sistema de salud público costarricense. A partir del análisis de los datos cualitativos, las barreras y facilitadores se agruparon en factores personales, culturales y la oferta de los servicios de salud.
Resultados: en relación con los factores personales, la mayoría de los participantes reportó no poseer conocimiento ni conciencia previa a la enfermedad. El temor a ser estigmatizado, la sintomatología intermitente, sentirse bien, compromisos laborales y familiares, fueron percibidos como barreras. Entre los factores culturales, algunas creencias religiosas fueron percibidas como barreras, y la historia familiar de lepra como facilitador en términos de la búsqueda de atención y diagnóstico. Con respecto a los servicios de salud, el acceso oportuno a citas con personal de salud informado, la telemedicina y médicos de la familia, fueron citados como facilitadores.
Conclusiones: las principales barreras y facilitadores descritos en los resultados del estudio deben ser tomados en cuenta a fin de contribuir a la detección y tratamiento oportuno de la lepra, para curar la enfermedad, evitar la discapacidad y eliminar la transmisión.
Descriptores: lepra, barreras de acceso a los servicios de salud, diagnóstico precoz, análisis cualitativo, Costa Rica.
DETERMINANTS OF THE PERFORMANCE OF DEVELOPMENT PROJECTS IN DEVELOPING COUNTRIES
Authors: Nanéma Dr. Mahamadi , Nassè Dr. Théophile Bindeouè , Ouédraogo Prof .  Alidou 
Published: March 2021

This article aims to analyze the determinants of the performance of development projects in developing countries in general and in particular in the Burkinabé context. This involves identifying the internal and external factors that explain the performance of development projects in the Burkinabé context. The methodology used is essentially based on the hypothetico-deductive approach which led to the definition of a sample of 44 respondents on the quantitative aspect of the study. The results of the study show that two explanatory variables positively and significantly influence the performance of development projects in Burkina Faso. This concerns in particular the technical organization of projects and the environment or the project intervention area. Notwithstanding these results, recommendations are formulated for more efficiency in the implementation of development projects.
Keywords: Performance, Project Management, World Bank, Project Management.
Gravity Drainage Versus Forced Suction Drainage for Patients With Excess Fluid in Pleural or Peritoneal Spaces
Authors: Li Yan , Argáez Charlene 
Published: March 2021

The evidence for chest drainage with gravity compared with forced suction was mixed. Two randomized controlled trials included in 2 systematic reviews with meta-analysis suggested that there is no difference between chest drainage with gravity versus forced suction regarding the risk of prolonged air leak, or post-operative pneumothorax and the duration of chest tube drainage, or hospital stay, following lung cancer surgery. However, 1 randomized controlled trial included in a systematic review with meta-analysis suggested that chest drainage with gravity resulted in a shorter duration of chest tube drainage and hospital stay compared to forced suction following lung cancer surgery.
One guideline suggests that chest drainage with forced suction does not provide additional benefits for patients undergoing lung surgery compared to gravity drainage.
There is a lack of relevant literature and guidelines on the clinical effectiveness or use of abdominal space drainage with gravity or forced suction.