bluuebunny/crossref_metadata_2025_split huggingface dataset:
The development of the hypothalamus-pituitary-adrenal axis during infancy may be affected by antenatal glucocorticoid therapy
Authors: Niwa F. , Kawai M. , Kanazawa H. , Okanoya K. , Myowa M. 
Published: October 2019

BACKGROUND: Developmental changes in the hypothalamus-pituitary-adrenal (HPA) axis during infancy have been reported in term infants, but those in preterm infants have yet to be elucidated. If developmental changes in the HPA axis of preterm infants are modulated by any factors, it may affect their future health. Few studies have examined the lasting consequences of antenatal glucocorticoids on the development of the HPA axis. METHODS: We measured pre- and post-palivizumab vaccination salivary cortisol values in two conforming periods of three-months intervals during infancy, and compared cortisol values and the response of cortisol secretion between groups with and without antenatal glucocorticoid (AG) therapy. RESULTS: Although the strength of the response of cortisol secretion to palivizumab fell age-dependently (until late infancy) in the Non-AG group, the opposite pattern was exhibited in the AG group. The changes of the delta cortisol values between the 2 groups were significant. CONCLUSIONS: This study suggests that the HPA axis of preterm infants whose mothers receive AG therapy may be upregulated during infancy, possibly leading to long lasting health problems.
Moderate and severe fetal pyelectasis: Correlation between prenatal aspects and postnatal outcome
Authors: Loardi C. , Signorelli M. , Gregorini M. , Marella D. , Torri F. , Zambelloni C. Mario , Omodei U. , Odicino F. 
Published: October 2019

BACKGROUND: Renal pelvic dilatation (RPD) is a frequent finding in fetal ultrasound. The aim of the study is to correlate the prenatally detected moderate and severe pyelectasis with the postnatal outcome. METHODS: A retrospective analysis involving 90 cases of prenatally detected moderate and severe RPD referred to our prenatal diagnosis centre with 18 months of urological follow-up. Prenatal ultrasound was correlated with postnatal renal function, assessed by plasmatic creatinine and/or renal scintigraphy performed before surgery. RESULTS: Cases were divided between two groups according to postnatal management: group A including 35 newborns (38.9%) that needed surgical treatment and group B with 55 patients (61.1%) who were managed conservatively. The group A presented higher median RPD (18 mm, IQR 12–25 mm) compared to the group B (11 mm, IQR 10–14 mm). The most common anomaly detected within group A was pelvi-ureteric junction (PUI) obstruction (43%). Within group B 32 cases (58%) showed spontaneous resolution of hydronephrosis during postnatal follow up. In case of moderate pyelectasis the risk of postnatal surgery was 25% and raised to 60% for severe RPD. In our study, 29 newborns showed pathologic scintigraphies: 25 required surgery while 4 did not find indication for surgery due to ipsilateral renal function irreversible damage. 6 patients had high creatinine level (>0.6 mg/dl). 35 cases out of 90 (39%) developed monolateral irreversible renal function impairment. CONCLUSION: Moderate and severe RPD are often correlated with postnatal renal damage, therefore a close multidisciplinary follow-up is required. Prenatal scanning is highly predictive of postnatal outcome and can address properly the prenatal counseling.
Use of impregnated catheters to decrease colonization rates in neonates – A randomized controlled pilot trial
Authors: Klemme M. , Staffler A. , De Maio N. , Lauseker M. , Schubert S. , Innocenti P. , Wurster T.M. , Foerster K. , Herber-Jonat S. , Mittal R. , Messner H. , Flemmer A.W. 
Published: October 2019

OBJECTIVE: Nosocomial infections increase mortality and morbidity in preterm infants. Central venous line colonization is a major risk factor for the development of such infections. In adults and children, antibiotic and antimycotic impregnated catheters have been demonstrated to reduce colonization. However, recently published data showed no significant difference in bloodstream infection in neonates when an impregnated catheter was used. We investigated the effect of impregnation of percutaneously inserted micro-catheters (PICC) on colonization in preterm and sick term infants in our unit. METHODS: Neonates were randomly assigned to receive either a standard (S-PICC; n = 34) or antibiotic and antimycotic impregnated (IP-PICC; n = 37) PICC. Catheters were placed and removed according to a standard procedure and subsequently examined by roll-out culture. The primary outcome was the rate of colonization defined as >15 colony-forming-units/ml. Additional outcomes were catheter associated or systemic infections. RESULTS: The rate of colonization was lower in neonates who received an IP-PICC as compared to S-PICC (5.6% vs. 12.1% respectively; p = 0.42). However, the difference was not significant. In IP-PICC vs S-PICC, catheter related local infection (CRI) although lower was not statistically significant (2.9% vs. 6.1%; p = 0.60). We observed no difference in catheter related systemic infection (CR-SI) (0% vs. 3.1%, p = 0.48). The neonates whose catheters were colonized were predominantly of a lower gestational age (median 254/7, p = 0.05) and males (100%, p = 0.01). In addition, the median colony count in the colonized IP-PICC catheters was lower as compared to S- PICC group (53 vs 250, p = 0.06). CONCLUSIONS: The use of antibiotic and antimycotic impregnated PICC-lines in neonates tended to decrease colonization rates in neonates in our centers but this difference was not significant. Lower gestational age and male sex are risk factors for catheter colonization.
The evaluation of lymphopenia in infants exposed to opioids in-utero
Authors: Romanos-Sirakis Eleny , Zureikat-Obeid Rudayna , Chein Tova , Demissie Seleshi 
Published: October 2019

BACKGROUND: Chronic use of opioids is associated with hematologic and immunologic effects, including lymphopenia. Despite an increase in opioid use during pregnancy, little is known about the potential immunologic effects on the neonate after exposure to opioids in-utero. We aimed to evaluate the presence of lymphopenia among neonates exposed to opioids in-utero. METHODS: We conducted a retrospective chart review of infants admitted to the neonatal intensive care unit (NICU) of a single institution after exposure to opioids in-utero. We compared the lymphocyte counts of this population to a control NICU population. RESULTS: A higher percentage of neonates exposed to opioids in-utero were lymphopenic compared to our control population (44% vs 24%, p = 0.035). CONCLUSIONS: This is the first study we are aware of, that investigated an association between neonatal lymphopenia and opioid exposure in-utero. Further studies to explore clinical implications of this finding are needed.
Occupational inhalation injury by Hydrogen Sulfide causing multi organ failure –A case study
Authors: Shamarukh Karishma , Faruq - Mohammad Omar , Jahan Nasrin , Sultana Amina , Faruq Ridwan Naim 
Published: October 2019

Hydrogen sulfide is a notorious agent known to cause serious injuries in the occupational field. We are going to discussa case of a 20 years old male working in a effluent treatment plant in Savar, Bangladesh who accidentally entered thefume room and was exposed to the toxic gas. He lost consciousness and was brought to our care from a local hospitalafter endotracheal intubation condition. He was found in state of unconsciousness grade III on admission to our ICU.His brain CT scan revealed diffuse cerebral edema. Chest X-ray revealed finding suggestive of diffuse pneumonitis.Cardiology evaluation suggested Toxic cardiomyopathy as his high sensitive Troponin I was very high on admission (2037ng/L). Supportive care was given in the form of mechanical ventilation, antibiotics, anticonvulsant andanti-ischemic medications. Patient regained consciousness on day 10 after admission and gradually improvedclinically. By the end of the month of stay in hospital he was significantly improved.
Bangladesh Crit Care J September 2019; 7(2): 113-115
PENINGKATAN KREATIVITAS GURU MELALUI PENGEMBANGAN SUPERVISI KEPALA SEKOLAH DAN IKLIM ORGANISASI
Authors: Ghifar Riyadhel , Yusuf Adi E , Sumardi Sumardi , Wulandari Farida 
Published: October 2019

Penelitian ini bertujuan menemukan upaya-upaya meningkatkan kreativitas guru dan gambaran empiris studi tentang hubungan antara supervisi kepala sekolah dan iklim organisasi sekolah dengan kreativitas guru. Metode penelitian yang digunakan dalam penelitian ini adalah metode survei. Metode survei dengan pendekatan korelasional dilakukan terhadap sampel dari suatu populasi, kemudian menganalisa sampel, dan hasil analisa sampel diberlakukan untuk populasi. Populasi dalam penelitian ini adalah seluruh Guru PNS di SDN Se-Gugus 3 wilayah kecamatan Pancoran Mas Kota Depok Provinsi Jawa Barat yang berjumlah 138 orang dari 8 sekolah. Sampel diambil dengan teknik proporsional random sampling, dan dengan rumus Slovin didapat jumlah sampel 103 orang. Penelitian ini menghasilkan kesimpulan sebagai berikut: 1) Terdapat hubungan positif dan signifikan antara Supervisi Kepala Sekolah dengan Kreativitas (ry1 = 0,630, α=0,01); 2) Terdapat hubungan positif, dan kuat, dan signifikan antara Iklim Organisasi dengan Kreativitas (ry2 = 0,730, α=0,01); 3) Terdapat hubungan positif yang sangat kuat, dan signifikan antara Supervisi Kepala Sekolah, dan Iklim Organisasi secara bersama-sama dengan Kreativitas (ry12 = 0,920, α=0,01). Kata Kunci : Supervisi Kepala Sekolah, Iklim Organisasi, Kreativitas
Trends in GP incomes in England, 2008–2017: a retrospective analysis of repeated postal surveys
Authors: Atkins Rose , Gibson Jon , Sutton Matt , Spooner Sharon , Checkland Katherine 
Published: October 2019

BackgroundThere is widespread concern over the recruitment and retention of GPs in England. Income is a fundamental consideration affecting the attractiveness of working in general practice.AimTo report on trends in average incomes earned by GPs in England, adjusted for inflation and contracted time commitment.Design and settingPostal surveys of random samples of GPs working in England in 2008, 2010, 2012, 2015, and 2017.MethodTrends in average reported incomes of partner and salaried GPs were directly standardised for the reported number of sessions worked per week and adjusted for inflation.ResultsData were obtained from between 1000 and 1300 responders each year, representing response rates between 25% and 44%. Almost all responders (96%) reported the income they earned from their job as a GP. Mean nominal annual income decreased by 1.1% from £99 437 in 2008 to £98 373 in 2017 for partner GPs and increased by 4.4% from £49 061 to £51 208 for salaried GPs. Mean sessions worked decreased from 7.7 to 7.0 per week for partner GPs and decreased from 5.6 to 5.3 per week for salaried GPs. Mean income adjusted for sessions worked and inflation decreased by 10.0% for partner GPs and by 7.0% for salaried GPs, between 2008 and 2017.ConclusionThe decrease in GP income adjusted for sessions worked and inflation over the last decade may have contributed to the current problems with recruitment and retention.
A Educação do Campo e o Discurso da Interdisciplinaridade: reverberações nas enunciações discentes
Authors: Mittmann Verônica de Lima , Duarte Claudia Glavam 
Published: October 2019

A interdisciplinaridade vem se constituindo como uma verdade que atravessa o campo educacional brasileiro na contemporaneidade. Neste sentido, este estudo teve como objetivo perceber quais enunciados sobre a interdisciplinaridade circulam no curso Licenciatura em Educação do Campo: Ciências da Natureza – campus Litoral Norte da Universidade Federal do Rio Grande do Sul – UFRGS. De forma específica, este artigo problematiza e apresenta uma análise do discurso na perspectiva foucaultiana de enunciações que emergiram nas falas dos discentes do referido curso ao justificarem a necessidade de um currículo interdisciplinar. Percebemos que a justificativa destes estudantes acaba duplicando enunciados que atravessam a enunciação de autores que são referência da Licenciatura em Educaçãodo Campo. Acreditamos que esta ressonância de enunciados poderá estar fortalecendo de forma concomitante tanto o Discurso da Interdisciplinaridade quanto o Discurso da Educação do Campo. Para este ensaio foram realizadas entrevistas com 32 discentes e as ferramentas teóricas utilizadas advêm da oficina de Michel Foucault.
Participação Popular, Educação e a Cidade para todos: compromisso com a cidadania
Authors: Silveira Gerveson Tramontin 
Published: October 2019

Este artigo analisa a participação popular e a lógica democrática participativa no planejamento urbano na luta pela escola pública. É fruto de pesquisa desenvolvida no período de 1993 a 2000, no município de Ponta Grossa - PR. Tem como conceitos centrais a participação popular, a educação e a gestão pública, concebendo-os como elementos essenciais para a construção da cidadania e para a garantia de políticas públicas na área da educação. A partir da análise da participação popular, foi possível concluir que a conquista e a implementação de políticas públicas passam necessariamente pela mobilização, organização e participação popular na gestão pública.
Educação Ambiental e a Formação de Pedagogos
Authors: Buczenko Gerson Luiz , Rosa Maria Arlete 
Published: October 2019

Este artigo foi idealizado durante o desenvolvimento de tese de doutoramento em Educação, que teve como objetivo geral analisar a existência de articulação entre a tendência crítica de Educação Ambiental (EA) e a concepção de Educação do Campo (EC) no trabalho do coordenador pedagógico de escola pública localizada em APA de manancial. Nesse cenário, surgiram os contatos com quatro estabelecimentos escolares investigados, num total de quatro escolas rurais municipais (três em Piraquara, localizadas na APA do Piraquara, e uma em São José dos Pinhais, na área da futura APA do Miringuava). Nessas escolas, foram entrevistadas as coordenadoras pedagógicas, em razão do objetivo geral inicialmente traçado. Diante desse contexto, vislumbrou-se a possibilidade de análise da formação da professorapedagoga em relação à EA, como consequência dos resultados da análise de conteúdo (BARDIN, 1977) das entrevistas. Os objetivos específicos foram assim propostos: avaliar a presença da EA na formação das professoras pedagogas; explorar nos resultados das entrevistas as concepções de EA; e buscar uma aproximação das concepções levantadas às macrotendências de EA (LAYRARGUES, 2012). A indagação de pesquisa foi assim definida: na formação das professoras pedagogas, está presente a abordagem de EA? Percebeu-se que há um predomínio das macrotendências conservacionista e pragmática no pensar e desenvolver as atividades de EA nas escolas observadas. Configura-se, assim, um reprodutivismo de ações e projetos que, ano a ano, são reprisados, sem estabelecer uma relação maior com oentorno da escola, a comunidade e os problemas socioambientais aflorados, que podem suscitar uma abordagem crítica que busque, se não a superação, o despertar da reflexão das futuras gerações.
Relações entre Educação Ambiental e Educação Física na Educação Infantil
Authors: Abreu Marise Jeudy Moura de , Carneiro Sônia Maria Marchiorato 
Published: October 2019

O presente artigo, referenciado à Tese “O diálogo da Educação Física com a Educação Ambiental na Educação Infantil: um processo de formação de docentes na Rede Municipal de Ensino de Curitiba”, objetiva a evidenciar a relevância da Educação Ambiental na Educação Física, desde a Educação Infantil. Sob essa perspectiva, enfocam-se as diferentes formas de manifestações corporais, vivenciadas pelas crianças em seus ambientes de vida, com destaque às experiências corporais lúdicas, de observação e exploração, nas relações com o eu e os outros, rumo à formação socioambiental cidadã. Motivadas pela curiosidade das “coisas” que habitam os ambientes naturais e sociaise, a mais, incentivadas pelos professores a apreender o mundo por meio dos sentidos, com experiências lúdicas e colaborativas, as crianças podem entender e vivenciar – dentre outros – conceitos como cuidado, respeito, solidariedade, coexistência e interdependência, deveras significativos na linha da cidadania socioambiental. Para tanto, faz-se necessário o empenho de toda comunidade envolvida – diretores, professores, pais, pedagogos e auxiliares administrativos – como coparticipantes na elaboração de um Projeto Político Pedagógico quecontribua para o avanço qualitativo das instituições de educação infantil.
Aneurismas paraclinoideos: experiencia personal de 1 año en el Hospital Regional de Temuco
Authors: Jiménez Palma Oscar 
Published: October 2019

Se presenta la experiencia personal en el tratamiento de 5 pacientes con 7 aneurismas paraclinoideos tratados quirúrgicamente en el Hospital Regional Temuco durante junio de 2015 y julio de 2016 (13 meses). Todos los pacientes fueron previamente discutidos con neurorradiologo Intervencional local y considerados no favorables para terapia endovascular. En todos ellos se realizó una craneotomía mini pterional con clinoidectomía extradural y exposición de la arteria carótida interna cervical. Cuatro pacientes consultaron con hemorragia subaracnoidea y requirieron cirugía cerebral de urgencia. En 6 aneurismas se realizó clipaje y en 1 trapping. Cuatro pacientes no tuvieron deterioro neurológico y evolucionaron favorablemente mientras que 1 paciente falleció por hipoperfusión secundario al trapping de la carótida supraclinoidea. Se enfatiza el manejo interdisciplinario, el plan preoperatorio y el conocimiento de la neuroanatomía en el tratamiento de esta patología.
Regulatory T Cell Development in the Thymus
Authors: Owen David L. , Sjaastad Louisa E. , Farrar Michael A. 
Published: October 2019

Abstract
Development of a comprehensive regulatory T (Treg) cell compartment in the thymus is required to maintain immune homeostasis and prevent autoimmunity. In this study, we review cellular and molecular determinants of Treg cell development in the thymus. We focus on the evidence for a self-antigen–focused Treg cell repertoire as well as the APCs responsible for presenting self-antigens to developing thymocytes. We also cover the contribution of different cytokines to thymic Treg development and the cellular populations that produce these cytokines. Finally, we update the originally proposed “two-step” model of thymic Treg differentiation by incorporating new evidence demonstrating that Treg cells develop from two Treg progenitor populations and discuss the functional importance of Treg cells generated via either progenitor pathway.
Alternative Educational Approach to Wheelchair Accessibility Awareness
Authors: Pebdani Roxanna N. , Bourgeois Paul J. 
Published: October 2019

Abstract
Importance: Despite criticisms of disability simulation and the limited research on the topic, disability simulation activities are often used to increase understanding of the challenges faced by people with disabilities.
Objective: To compare two disability awareness activities (disability simulation and an accessibility audit).
Design: A matched pretest–posttest design with two disability awareness activities to study attitudes, affect, cognitions, and behaviors toward disability.
Setting: A small college in New England.
Participants: Eighty-eight undergraduate students.
Intervention: Participants took baseline tests online, after which they participated in a 1-hr on-campus activity. Participants were randomly assigned to either the disability simulation activity or the accessibility audit activity. Participants took posttest surveys online within 1 wk of completing the intervention.
Results: Results demonstrated that both activities lowered negative emotional responses toward people with disabilities, but participants who completed the tape measure activity had a larger decrease in scores. No significant differences were found between the scores of people who completed the different disability awareness activities.
Conclusions: Given the many criticisms of disability simulation practices and marginal differences between activities, it is time for disability simulation activities to be retired from use.
What This Article Adds: The results of this study demonstrate that disability simulation is no better than an accessibility audit in improving attitudes toward people with disabilities. Therefore, educators should cease use of these activities.
Patient Satisfaction with Physicians and Nurse Practitioners in Multiple Sclerosis Centers
Authors: Thotam Smitha Mary , Buhse Marijean 
Published: October 2019

AbstractBackground:With the predicted shortage of neurologists, care of patients with multiple sclerosis (MS) may be affected. Nurse practitioners (NPs) have successfully filled the provider gaps in a variety of care settings, with positive effects on care outcomes, including patient satisfaction. The purpose of this study was to determine patient satisfaction with physicians (MDs) and NPs in MS centers.Methods:This is a cross-sectional pilot study wherein a convenience sample was recruited from two MS centers. Demographic data were collected previsit, and satisfaction surveys were completed postvisit using the Patient Satisfaction Questionnaire Short Form (PSQ-18) and the Visit-Specific Satisfaction Instrument (VSQ-9). Different attributes of satisfaction and visit times were analyzed.Results:Patient satisfaction with both types of providers was high. All attributes of satisfaction were comparable for NPs and MDs, and they spent similar amounts of time with their patients, often exceeding the scheduled office visit duration. Encounter length was a strong determinant of patient satisfaction: VSQ-9 scores were significantly lower (P = .01) when duration was less than 20 minutes. Satisfaction was higher (P = .011) in patients who were diagnosed as having MS for 10 years or longer or had progressive MS, irrespective of provider type.Conclusions:This pilot study showed that use of standardized questionnaires to determine patient satisfaction with NPs and MDs was feasible. With the impending neurologist shortage and the increased MS prevalence, a collaborative team approach between NPs and MDs may improve access to care in MS centers without compromising patient satisfaction.
Social Participation in Health and the Nursing Role: Using the Ecological Model / Participação Social Na Saúde e o Papel da Enfermagem: Aplicação do Modelo Ecológico
Authors: Ferreira Amanda Guimarães , De Carvalho Deciane Pintanela , Barlem Edison Luiz Devos , Rocha Laurelize Pereira , Da Silva Mara Regina Santos , Vaz Marta Regina Cezar 
Published: October 2019

Objetivo: identificar os elementos do modelo ecológico na análise da produção científica acerca da participação social na saúde e o papel da enfermagem. Método: revisão integrativa, tendo como questão norteadora quais elementos do modelo ecológico são identificados na produção científica acerca da participação social na saúde e o papel da enfermagem? Os artigos foram selecionados por meio de critérios de inclusão e exclusão pré-estabelecidos, obtendo-se 19 estudos para síntese. Resultados: evidenciaram-se elementos individuais, organizacionais e ambientais do Modelo Ecológico, possibilitando a identificação da participação social na saúde e o papel da enfermagem, por meio do pensamento ecológico, conscientização ambiental e de saúde, mudanças de comportamentos e estilos de vida, além do envolvimento da comunidade, instituições de saúde, universidades e profissionais de saúde nessa promoção. Conclusão: a Enfermagem deve incentivar a participação social, tomada de decisões de cuidados e implementação de políticas públicas, promovendo a conscientização.