bluuebunny/crossref_metadata_2025_split huggingface dataset:
L’enfant « corps-étranger-familier » en famille d’accueil
Authors: Bernard Alexandra , Sanahuja Maria de la Almudena 
Published: September 2019

Cette réflexion a pour origine les observations cliniques initiales des auteurs, tirées de leurs rencontres avec des enfants placés en famille d’accueil dans le cadre de suivis psychologiques, et avec ces familles qui les accueillent. Leur sensibilité à l’écoute familiale psychanalytique leur a permis de porter une attention sur la souffrance du lien dans une lecture attentive et systématique, au regard de nombreuses situations de ruptures de placement, ou de l’observation de situations de souffrance psychique, que ce soit du côté de l’enfant placé ou de ces familles lors des phases évolutives de l’accueil et de l’accompagnement. En appui sur les conceptualisations psychanalytiques groupales (Bion, 1952, 1982 ; Kaës, 1993) et psychanalytiques familiales (Ruffiot, 1981 ; Aubertel, Ruffiot, 1982) qui indiquent que l’accueil d’un sujet au sein d’un groupe relèverait d’un processus inconscient particulier, les auteurs s’interrogent sur les modalités psychiques présentes lors de l’accueil d’un enfant étranger au cœur de l’intimité de ce groupe familial spécifique, notamment du point de vue fantasmatique. Sous cet angle de lecture, les auteurs apportent des pistes de compréhension des différentes dynamiques de lien repérées dans ces problématiques, pouvant conduire à des ruptures de placement.
Une école en péril de sens
Authors: Suzzoni Cécilia 
Published: September 2019

C’est bien l’aventure du sens qui convainc les élèves : celle d’un savoir unifié, clarifié et réflexif, épousé par eux au terme de la vraie méthode, le chemin après qu’on l’a parcouru. L’universel du sens permet en effet le partage du commun contre la guerre des mémoires et l’atrophie moderne de l’intelligence.
Community Health Center Engagement and Training During Obstetrics and Gynecology Residency
Authors: Cheng Anita Y. , Erlinger Adrienne L. , Modest Anna M. , Chie Lucy , Scott Jennifer , Molina Rose L. 
Published: September 2019

ABSTRACT

Background
Community health centers (CHCs) and federally qualified health centers (FQHCs) are critical health care access points for medically underserved areas in the United States. They also provide opportunities for residents to learn about health system challenges, including workforce shortages, social determinants of health, and health equity.

Objective
We sought to describe current obstetrics and gynecology (OB-GYN) resident engagement and training in community health settings.

Methods
We conducted a website review and survey to identify the prevalence and types of OB-GYN resident exposure to CHCs, including FQHCs. We reviewed 241 program websites to identify community health electives or rotations. We then surveyed program administrators regarding departmental affiliations with CHCs, types of resident involvement, and barriers to resident rotations at CHCs.

Results
The website review revealed that 18% (44 of 241) of programs offered a community health rotation. Of the 241 programs surveyed, 78 program administrators responded (32%). Forty-three programs (55%) had at least 1 affiliated CHC, and 34 programs (44%) allowed residents to rotate at a CHC. The most common barrier to resident rotations at a CHC was inadequate resident coverage of hospital-based clinical responsibilities. Respondents reported that among 782 graduating residents in the 2016–2017 and 2017–2018 academic years, 76 (10%) planned to pursue a position at a CHC.

Conclusions
According to their websites, a small percentage of US OB-GYN residency programs offered a CHC rotation. Of programs responding to a survey on the topic, less than half offered CHC rotations and less than 1 in 10 residents planned to work in CHCs after graduation.
Comparative Analysis of Cost of Biomedical Waste Management in Rural India
Authors: D'souza Bryal , MS Arun , Johnson Bijoy 
Published: September 2019

ABSTRACT

Introduction
The quantum of waste generated from medical care and activities is a global matter of concern. Improper management of biomedical waste (BMW) has a grave health impact on the community, health care professionals, and the environment.1 It is mandatory by law that every medical organization that generates waste should have a system, process, and resources in place for segregating BMW within the organization for proper disposal. The present article deals with the understanding of various costs associated in BMW management process that will help the health care organization to prioritize their spending and focus on areas that require spending to achieve compliance in process of BMW management.

Materials and methods
Descriptive cross-sectional study was carried out, to study the compliance of BMW management at three different hospitals with respect to Bio-Medical Waste (Management and Handling) Rules, 2011. A retrospective study was conducted to analyze cost data for a 1-year time period. Cost involved in BMW management was analyzed and classified as capital and recurring costs. The study was undertaken in Udupi taluk, and the taluk comprises 11 hospitals (1 Government and 10 private hospitals). The hospitals were selected using convenient sampling as taking permission to conduct the study was difficult. Only three hospitals were permitted to carry out the study.

Results and discussion
Compliance was found to be better in accredited hospital than in nonaccredited hospital. This could be attributed to strict adherence to standard operating procedures and regular training of staff. Cost involved in BMW management was analyzed as capital and recurring costs. Since most of the hospital outsource final disposal, capital costs are significantly less compared to recurring costs. Among the recurring costs, maximum expenditure is on consumables like color-coded bags. Cost per bed per day for handling BMW was calculated and it was found to be higher in smaller hospitals.

How to cite this article
Bryal D'souza, Arun MS, Johnson B. Comparative Analysis of Cost of Biomedical Waste Management in Rural India. Int J Res Foundation Hosp Healthc Adm 2016;4(1):11-15.
Comparison of the Efficacy and Safety of Intrathecal Fentanyl 20 μg vs Sufentanil 5 μg as Adjuvant to Bupivacaine 0.5% (12.5 mg) using Combined Spinal Epidural Technique for Lower Limb Orthopedic Surgeries
Authors: Umbarkar Sanjeeta R , Gandhi Manju N , Iyer Hemlata R , Thawale Roshan S 
Published: September 2019

ABSTRACTAimTo compare the efficacy and safety of intrathecal fentanyl 20 μg vs sufentanil 5 μg as adjuvant to bupivacaine 0.5% (12.5 mg) using combined spinal epidural (CSE) technique for lower limb orthopedic surgeries.BackgroundUse of local anesthetics along with opioids intrathecally has been widely reported. We aimed to compare two commonly used opioids as adjuvants to local anesthetic agents in combined spinal epidural techniques.Materials and methodsA total of 60 patients were recruited in this prospective, randomized, double-blind study to receive either intrathecal sufentanil 5 μg (Group S) or fentanyl 20 μg (Group F) as adjuvants to 12.5 mg of 0.5% hyperbaric bupivacaine. The onset and duration of sensory and motor block and the pain scores were assessed perioperatively. Duration of analgesia was recorded. The incidence of side effects such as nausea, vomiting, pruritus, shivering. and postdural puncture headache (PDPH) were recorded.ResultsDemographic data and hemodynamic and respiratory parameters were comparable in both the groups. Onset of analgesia—time to reach highest level of analgesia—was faster in the sufentanil group. Sufentanil group patients had higher grade of motor block. Patients in fentanyl group had higher score of sedation than those of sufentanil group. None of the patients in any group had nausea, vomiting, or pruritus.ConclusionAddition of either fentanyl or sufentanil to intrathecal bupivacaine as an adjuvant in CSE technique enhances the quality of analgesia and motor block with minimal side effects. Hence, this is useful in orthopedic patients, especially in the geriatric age group.How to cite this articleUmbarkar SR, Gandhi MN, Iyer HR, Thawale RS. Comparison of the Efficacy and Safety of Intrathecal Fentanyl 20 μgvsSufentanil 5 μg as Adjuvant to Bupivacaine 0.5% (12.5 mg) using Combined Spinal Epidural Technique for Lower Limb Orthopedic Surgeries. Res Inno Anaesth 2016;1(1):1-4.
Cerebral Oxygenation during Pediatric Cardiac Surgery: Identification of Vulnerable Periods using Near-infrared Spectroscopy
Authors: Mange Mehul , Sarkar Manjula 
Published: September 2019

ABSTRACT

Objective
Neurologic sequelae remain a well-recognized complication of pediatric cardiac surgery. The aetiology of neurologic injury is almost certainly multifactorial, imbalance between cerebral oxygen supply and demand is likely to play an important role. We sought to measure regional cerebral oxygenation in children undergoing cardiac surgery using nearinfrared spectroscopy to ascertain such vulnerable periods.

Materials and methods
This study is an observational study of 18 children (median age 1.3 years) undergoing cardiac surgery. Regional cerebral oxygenation was monitored using the INVOS3100 cerebral oximeter and related to hemodynamic parameters at each stage of the procedure.

Results
Prior to the onset of bypass, 10 patients had a decrease in regional cerebral oxygenation, reaching a saturation less than 35% in 5 cases. The most common cause was handling and dissection around the heart prior to and during caval cannulation. With institution of bypass, regional cerebral oxygenation increased. Discontinuation of bypass caused a precipitous decrease in regional cerebral oxygenation in three patients, reaching less than 40%.

Conclusions
These observations suggest that the pre- and early post-bypass periods are vulnerable times for provision of adequate cerebral oxygenation. Near-infrared spectroscopy is a promising tool for monitoring O2 supply/demand relationships especially during circulatory arrest.

How to cite this article
Mange M, Sarkar M. Cerebral Oxygenation during Pediatric Cardiac Surgery: Identification of Vulnerable Periods using Near-infrared Spectroscopy. Res Inno Anaesth 2016;1(1):15-18.
Convulsion on Table in an American Society of Anesthesiologists Grade I Pregnant Patient Posted for Emergency Cesarean Section: Anesthesia Management
Authors: Wajekar Anjana , Taware Manisha , Kamat Uma 
Published: September 2019

ABSTRACT
Convulsions occurring on the operating table in any patient, especially a pregnant patient, can be a nightmare. Initial management with regard to airway, breathing, and anticonvulsants remains the same. The differential diagnosis includes eclampsia, hypoglycemia, peripartum cerebrovascular thrombosis, subarachnoid hemorrhage, infection, intracranial tumor, head injury, idiopathic epilepsy, vasculitis, amniotic fluid embolism, etc. Magnetic resonance imaging of the brain of our patient revealed posterior reversible encephalopathy syndrome, a neuroradiological diagnosis. Management is supportive with anticonvulsants, cerebral decongestants, and treating the underlying cause including blood pressure control and early cesarean section. There is a small risk of permanent neurological damage or death.

Abbreviations
Amniotic fluid embolism – AFE; Posterior reversible encephalopathy syndrome – PRES; American Society of Anesthesiologists – ASA; G2P1L1 – Gravida 2, para 1, live birth 1

How to cite this article
Wajekar A, Taware M, Kamat U. Convulsion on Table in an American Society of Anesthesiologists Grade I Pregnant Patient Posted for Emergency Cesarean Section: Anesthesia Management. Res Inno Anaesth 2016;1(1): 25-27.
Dexmedetomidine for Conscious Sedation in Bilateral Inferior Petrosal Sinus Sampling
Authors: Barnwal Neeraj , Dias Raylene , Mamde Rahul 
Published: September 2019

ABSTRACT
Cushing's syndrome in an acromegalic patient is a very rare presentation. To differentiate a Cushing's disease from Cushing's syndrome due to ectopic adrenocorticotropic hormone (ACTH) secreting tumors, inferior petrosal sinus sampling (IPSS) is required. Acromegaly patients have associated airway abnormalities posing a challenge to administration of anesthesia. Traditionally, most IPSS was done under general anesthesia. But now it is being recognized that general anesthesia for this procedure has its own implications and hence conscious sedation is being used for this purpose. We describe our experience with the novel agent dexmedetomidine for conscious sedation in this procedure.

How to cite this article
Barnwal N, Dias R, Mamde R. Dexmedetomidine for Conscious Sedation in Bilateral Inferior Petrosal Sinus Sampling. Res Inno in Anesth 2016;1(2):61-62.
Anesthetic Management of a Sellar Mass Excision in a Patient of Multiple Endocrine Neoplasia Type 1 Syndrome: A Rare Case
Authors: Shetty Anita N , Oak Shrikanta P , Jain Ruchi A 
Published: September 2019

ABSTRACT
Multiple endocrine neoplasia (MEN) type 1 is an autosomal dominant disease, commonly characterized by neoplasms of parathyroid glands, pituitary gland and pancreas islet cells. The anesthesia management in such patients for surgical procedures is challenging due to multiple endocrine gland involvement and its resultant implications, making every case a unique entity. The anesthesia management for MEN type I patients pose unique challenges to the anesthesiologist requiring meticulous preoperative evaluation, intraoperative anticipation, prevention and management of potential complications along with postoperative monitoring. We present a case of successful management of excision of a sellar mass in a patient with MEN type I syndrome with full postoperative recovery with the use of propofol, dexmedetomidine and desflurane anesthesia.

How to cite this article
Wajekar AS, Shetty AN, Oak SP, Jain RA. Anesthetic Management of a Sellar Mass Excision in a Patient of Multiple Endocrine Neoplasia Type 1 Syndrome: A Rare Case. Res Inno in Anesth 2016;1(2):65-68.
Anesthesia Mumps: An Unusual Presentation
Authors: Gautam Reena 
Published: September 2019

ABSTRACT
Anesthesia mumps is an acute transient swelling of parotid gland following general anesthesia. There are several case reports of anesthesia mumps postoperatively in adults, however there are very few reports in children. Increase in secretions along with improper drainage of saliva causes enlargement of parotid gland. This article lists the various causes implicated for this and the methods to prevent its occurrence. The purpose of this article is to highlight the occurrence of anesthesia mumps in pediatric patient even after a short procedure.

How to cite this article
Gautam R. Anesthesia Mumps: An Unusual Presentation. Res Inno in Anesth 2016;1(2):69-70.
A new bizarre dysoneurid species (Insecta, Trichoptera) in Burmese amber
Authors: Wichard Wilfried , Neumann Christian 
Published: September 2019

Abstract. We describe an extinct caddisfly species, Cretapsyche palpinova sp. nov., from
mid-Cretaceous Burmese amber. The species belongs to the extinct family
Dysoneuridae within the superfamily Sericostomatoidea. The family includes
some species with unusual maxillary palps. Cretapsyche palpinova sp. nov. is characterized by
five-segmented maxillary palps, the second segment being the longest, and the third segment bearing an unusual pin-shaped appendage.
FEMALE ENTREPRENEURSHIP IN RURAL AREAS (EXAMPLE OF THE WIELKOPOLSKIE VOIVODSHIP)
Authors: Wojcieszak Monika 
Published: September 2019

The purpose of the study presented in this paper is to indicate the conditions for, determinants of and barriers to female entrepreneurship. To meet the objective defined above, the author relied on the findings from her own survey conducted in 2019 with a sample of 213 women engaged in economic activity in rural areas of the Wielkopolskie Voivodship. In the group surveyed, most people offered trade-related services. Hairdressing and beauty services are another highly popular activity among the women covered by this study. Once collected from the respondents, the information was analyzed and described with the use of descriptive statistics methods. According to the respondents, the group of key conditions that promote entrepreneurship includes the availability of capital (funds for new and developing companies) and thoughtfully prepared educational and developmental programmes encouraging people to start their own business, as well as public policy for taxes etc. Other important conditions include adequate access to entrepreneurial instruments and measures, and adequate access to technical infrastructure. The interviewees believe that the greatest barrier faced when running a business is the complicated administrative procedure and a lack of startup funds.
Plant density and life history traits of Aconitum spicatum in North-central Nepal: effects of elevation and anthropogenic disturbances
Authors: Chapagain Deep J. , Meilby Henrik , Ghimire Suresh K. 
Published: September 2019

Increasing cross-border trade of medicinal and aromatic plants (MAPs) has put heavy pressure on a considerable number of species in the Himalayas. One of the threatened species in Nepal is Aconitum spicatum. Unfortunately for this species and for many others, our knowledge on population ecology and performance across the distribution range is insufficient, hindering the formulation of species-specific management plans. We therefore studied density and population structure of A. spicatum and assessed variation in its life history traits among three populations (subalpine, lower alpine and alpine) along an elevation gradient (3,000–4,200 m a.s.l.) in Annapurna Conservation Area, north-central Nepal. The results show that human disturbances and topographic factors contributed to the variation in density and life history traits. The overall density ranged between 0.56 ± 0.09 (Mean ± SE) and 2.48 ± 0.24 plants/m2 with highest mean density in the lower alpine and lowest in the subalpine population. The subalpine population was also characterized by lower investment in reproductive structures with lowest seed mass and low seed viability and fecundity. Among the environmental variables tested, harvesting, animal droppings and fire appeared to be the most important factors affecting density of different life stages of A. spicatum. The prevailing harvesting pattern is destructive as it involves uprooting of the whole plant and this appears to be a main reason for low recruitment and reduced density of the subalpine population. The level of disturbance decreased with increasing elevation. In terms of reproductive effort, the alpine population performed best. Our results indicate that the viability of A. spicatum populations depends on controlling over-harvesting and pre-mature harvesting of tubers and protecting younger life stages from grazing, trampling and fire. We therefore recommend that when formulating management guidelines, measures aiming to mitigate such anthropogenic disturbances should be considered.
PERCEPÇÃO AMBIENTAL DOS ALUNOS DE UMA ESCOLA PÚBLICA ESTADUAL ACERCA DO RIO SARAPUÍ, MUNICÍPIO DE DUQUE DE CAXIAS, RIO DE JANEIRO.
Authors: Nascimento Juliana Macedo Lacerda , Brandão Lucas De Esquivel Dias , Barros Marcelo Diniz Monteiro de 
Published: September 2019

RESUMO Em 2012 foi feita uma investigação com três turmas de 7º Ano do Ensino Fundamental em uma escola pública Estadual no Rio de Janeiro, localizada no município de Duque de Caxias. A faixa etária variou de 11 a 15 anos, sendo 32 alunos do sexo feminino e 14 do sexo masculino. Através de um questionário semiestruturado, almejou-se identificar que conhecimentos esses alunos tinham sobre o rio, como por exemplo, os conhecimentos geográficos, e a relação entre a presença do rio, as aulas de Ciências e a saúde da população ribeirinha. Espera-se que esta pesquisa subsidie a elaboração de campanhas educativas e projetos de intervenção ambiental, principalmente nas 21 favelas que estão presentes ao longo do percurso do rio Sarapuí.Palavras-chave: Educação Ambiental. Educação Básica. Rio Sarapuí.
Preliminary Biological Study of Two Medicinal Plants used in the Mouhoun Region (Burkina Faso): Boscia angustifolia A. Rich (Caparaceae) and Gardenia erubescens Stapf & Hutch (Rubiaceae)
Authors: N’do Jotham Yhi-Pênê , Pare Dramane , Nikiema Mahamadi , Hilou Adama 
Published: September 2019

Aims: Boscia agustifolia and Gardenia erubescens are two medicinal plants widely used in the Mouhoun region. The strong use of these two plants in traditional medicine would be linked to their therapeutic virtues.
Study Design: The purpose of this work was to carry out a preliminary biological study on two plants widely used by the population of the Mouhoun region (Burkina Faso) against certain diseases.
Place and Duration of Study: The harvest of plant material was made in the Mouhoun region in March 2019. The phytochemistry and the antioxidant tests were carried out at LABIOCA in June 2019. The microorganism tests were carried out at CRSBAN.
Methodology: The extracts were obtained by ethanolic maceration. The FRAP method and DPPH were used to evaluate the antioxidant properties of the extracts. The antibiomicrobial activity of the extracts was determined using five microbial strains.
Results: The ethanolic extract of Gardenia erubescens bark had antioxidant activity through the iron ion reduction capacity (6.71 ± 1.16 mMol EAA/100 g extract. Boscia angustifolia showed inhibitory activity on the five microbial strains.
Conclusion: The biological activities obtained with these extracts could be justified by the presence of active phytochemicals such as flavonoids. These biological properties to constitute a reason based on the strong use of these two plants in traditional medicine.
Vulnerability of Local Communities to Oil Installation in Isoko Local Government Area of Delta State, Nigeria
Authors: Tammy Cookey A. , Bodo Tombari , Ukusowa M. M. P. , Igbogho Jude 
Published: September 2019

Background of Study: Petroleum exploration has generated over 90 percent revenues to the Nigerian government, and as such the nation pays all her liabilities from the sales of petroleum products. Nigerian’s mono economy mostly based petroleum exploration, has brought a lot of sufferings to the people in the region where the oils are being drilled from. The people of Isoko Local Government Area (LGA) has suffered from the environmental pollution and devastation of their lands as a result of oil exploration activities for many years now, especially from numerous oil installations of the operating oil companies. This study examines the vulnerability of the local communities to these oil installations.
Materials and Methods: The study employed the use of questionnaire to acquire data relating to the vulnerability of communities to oil installation in Isoko LGA in Delta State. 600 copies of questionnaires were administered to the residents of the chosen communities using a simple random sampling technique which gives room for equal chance of any of the resident to be chosen in the study area. Descriptive statistics was used to explain the frequencies of the variables in terms of their percentage. Results of the analysis were presented using tables, bar charts, hazard maps, among others.
Results: it was revealed that the vulnerability to oil installation is high in the Isoko LGA, thereby leading to a high rate of environmental degradation in these communities.
Conclusion: it is concluded that end the suffering of the people to oil installations, the operating oil companies should pay special attention to needs of their host communities and proactive to any possible hazard that might have results from oil installation. The government should enforce the environmental laws that protect the environment and ensure that the multinational oil companies adhere strictly to them.