bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breves apontamentos sobre a relação entre geografia e literatura
Authors: Anjos Melissa 
Published: May 2017

ResumoAs pesquisas que a ciência geográfica vem desenvolvendo tem buscado inovar suas abordagens e dialogar com diferentes campos do conhecimento, entre eles o campo literário. Como resultado, tem produzido experiências que, entre outros enfoques, celebram as possibilidades de interseção entre ciência e arte. Desta maneira, a geografia tem criado possibilidades de leituras do universo vivido sob diferentes vieses, recortes, campos empíricos, metodologias e instrumentos teóricos. Assim, a compreensão do mundo a partir das tramas expostas pelos artistas (literatos) e fomentar uma leitura de mundo repleto de expressões existenciais se configura como um relevante caminho de entendimento a partir da inter-relação entre a linguagem científica e a artística. Dito isto, este artigo inicia uma discussão teórica acerca da relação entre ciência (geografia) e arte (literatura).Palavras-chave: Geografia. Ciência. Arte. Literatura. AbstractThe research that the geographical science has been developing has sought innovate its approaches and dialogue with different fields of knowledge, including the literary field. As a result, experiencesproduced, among other approaches, celebrate the possibilities of intersection between science and art. In this way, geography has created opportunities for readings the lived universe under different meanings, clippings, empirical fields, methodologies and theoretical instruments. Thus, the understanding of the world from plots exposed by artists (writers) and to foster a reading world filled with existential expressions is configured as an important path of understanding from the inter-relationship between the scientific and artistic language. This paper begins a theoretical discussion about the relation between science (geography) and art (literature).Keywords: Geography. Science. Art. Literature. RésuméLes recherches développées par la science géographique ont innové leurs approches et le dialogue avec des différents domaines du savoir, entre eux, le champ littéraire. Comme résultat, il a produit des expériences que, entre autres approches, célèbrent les possibilités d'intersection entre la science et l’art. De cette façon, la géographie a créé des possibilités des lectures de l'univers vécu sous différents sens, découpage, champs empiriques, méthodes et outils théoriques. Ainsi, la compréhension du monde à partir des intrigues exposées par les artistes (écrivains) et de favoriser une lecture du monde plein des expressions existentielles est configuré comme un moyen important de compréhension de la relation entre la langue scientifique et artistique. Cela dit, cet article commence avec une discussion théorique sur la relation entre la science (géographie) et l'art (littérature).Mots-Clés : Géographie. Science. Art. Littérature.
Do physicians who manage head injuries also diagnose and treat benign paroxysmal positional vertigo (BPPV) in patients with head injuries?
Authors: Khalid Muhammad Masood , Bashir Khalid , Zayed Sameh , Farook Saleem 
Published: May 2017

Background: Benign paroxysmal positional vertigo (BPPV) is a common medical condition. According to recent literature, it is prevalent in about 28% of the head injury patients. BPPV can be easily diagnosed in the Emergency Department (ED) by a simple bedside Dix-Hallpike test, in which patients experience vertigo and nystagmus as observed by the physician. It can be treated effectively in the ED by the Epley maneuver. In 2014, over 3,000 patients presented the ED at Hamad General Hospital with a head injury. Hospital guidelines often do not explicitly include BPPV symptoms as a possible complication of head injury. This may result in the physician being unable to manage BPPV, leading to longer sufferings for the patients.

Objectives: The purpose of this study was to evaluate current practice amongst physicians in a tertiary care hospital when managing BPPV in head injury patients.

Methods: Physicians working in Emergency Medicine, neurosurgery, trauma, and orthopaedics were asked to complete a paper based question survey.

Results: A total of 91 physicians completed the survey. 95.5% (n = 85) specified that they manage head injuries in their clinical practice. Only 29.6% (n = 27) indicated that they routinely investigate the possibility of BPPV in head injury patients. 73.6% (n = 67) stated lack of knowledge of BPPV and training in management to be the main reasons for not exploring BPPV. 91.1% (n = 83) stated willingness to receive further training in the management of BPPV.

Conclusion: In this study, physicians, when dealing with head injuries, were found not routinely diagnosing and managing BPPV. Lack of knowledge and training about this condition has been stated as the most common reasons for not exploring possibility of BPPV in head injury patients. The study confirms the need for training of physicians in managing this important condition early to prevent further disability in patients.
Organophosphorus toxicity awareness among Emergency Department healthcare providers in Tertiary Care Hospital, Qatar
Authors: Awad Waleed , Abbasy Mohamed E. , Ebrahim Ahmed Hai , Gaffer Rana , Khan Saad Salahuddin 
Published: May 2017

Background: Organophosphorus poisoning is a global public health problem. Annually, approximately 200,000–300,000 individuals die worldwide from Organophosphorus poisoning with the majority of deaths occurring in developing countries. In many countries in the Middle East, legislation is inflexible and unable to cope with new challenges. Often standards are not consistent with international and national needs. Hamad General Hospital (HGH) is the main tertiary care hospital in Qatar with its Emergency Department (ED) sees in access of 1500 patients in a 24 hour period. Anecdotally, there is a wide variation in practice of Organophosphorus toxicity management at HGH ED. The aim of this study is to check the knowledge and practice of the healthcare workers involved in managing such cases regarding decontamination, use of PPE and management.

Methods: This is a cross sectional survey using a pre developed questionnaire collected from a representative sample of 280 physicians of different grades and nurses in HGH ED.

Results: Till date collected data from 156 nurses and 66 emergency physicians showed failure of recognition of correct indication of atropine use in 47% of nurses (73 out of 156) and in (15%) of physicians (10 out of 66). Wearing appropriate respiratory and skin protective equipment while attending to patients with suspected Organophosphorus poisoning was up to the desired standard in 54% of nurses (85 out of 156) and 97 % of physicians (64 out of 66). The more years of experience the more safety awareness.

Conclusion: Junior staff knowledge about anti dote indications and diagnosis is the best. However the seniors are more aware about protective measures. We recommend the introduction of standardized Evidence based clinical algorithm and developing of educational sessions aiming to increase awareness about organophosphorus toxicity management. A secondary audit is necessary following the above intervention to measure the awareness improvement.
Dieting – a very risky business? Simultaneous determination of anti-diabetic and weight-loss agents in herbal and dietary supplements
Authors: Azimi Salman 
Published: May 2017

The presence of undeclared pharmaceuticals, including drugs that have been withdrawn from the market, in anti-diabetic and weight-loss herbal and dietary supplements can pose a serious health risk to consumers; they also undermine confidence in legitimate products. To protect consumers from potentially harmful products that are marketed as dietary supplements, the Drug QC Laboratory, Qatar is involved in the testing of herbal and dietary products. Traditionally this testing has required a combination of several analytical methods which presents a substantial investment of time and resources. To improve laboratory efficiency a single UPLC-MS/MS method was developed for the supplement screening followed by a confirmatory method based on multiple reaction monitoring (MRM) analysis. Screening analysis comprised LC/MS with automated searching against an in-house generated MS spectral library. Confirmation and quantification was performed by MRM analysis. The developed method was applied to 654 supplements submitted to our laboratory in 2014-15. Analysis revealed that 42 herbal anti-diabetic and weight lost products were tainted with undeclared registered or banned drugs, namely sibutramine (n = 30), phenolphthalein (n = 21), glibenclamide (n = 4), metformin (n = 4), phenformin (n = 2), pioglitazone (n = 1), fluoxetine (n = 2), orlistat (n = 1), methylephedrine (n = 1) and methamphetamine (n = 2). Five hot beverages tea and coffee were found to contain a combination of sibutramine and phenolphthalein.
The Syrian civil war: Impact of on-going violence on Syrian children's social, educational and health status
Authors: Elsaeidy Abdallah Mohamed Elsafti , Van Berlaer Gerlant , Al Safadi Mohammad , Pathan Sameer A. , Redrawn Atef 
Published: May 2017

Background: The Syrian civil war since 2011 is one of the most complex humanitarian emergencies in history. This protracted disaster has but negative aspects, especially on living, educational and health care infrastructure and services. The goal of this study is to document the impact of four years of war on Syrian children's social, educational and health status.

Methods: A cross sectional observational study was conducted in May 2015. Health care workers, especially trained for this study, visited home by home in four Syrian governorates with a prospectively designed questionnaire.

Results: Of 1080 filled-out questionnaires, 1001 were complete and included in this study. Most lived in the Aleppo governorate (n = 413; 41%), 359 in Idleb (36%), 147 in Hamah (15%) and 82 in Lattakia (8%). Median age was 6 years (IQR; 0-15), most were male (n = 611; 61%). Almost 20% of all children were Internally Displaced Persons (n = 196), 45 lost their father (5%) and 41 (4%) had their father missing, 19 (2%) lost their mother and of 27 (3%) the mother was missing. Of all, 855 (86%) had access to safe drinking water, and 775 (77%) could access appropriate sanitation. About 16% (n = 156) had interrupted access to nutrition. Almost 27% suffered from diseases related to malnutrition. Access to specific health care providers was disturbed in 64% (n = 646), and only 28% had an updated vaccination status. Of all school-aged children, 450 (51%) had no access to education at the time of the study. Most children suffered from respiratory (29%), neurological (19%) or digestive (17%) diseases, 4% was victim of injury or violence, and 2% suffered from mental problems.

Discussion and conclusion: After four years of civil war in Syria, children have lost parents, live in substandard life quality circumstances, and are at risk for outbreaks because of worsening vaccination status and specific healthcare provider attention.
Evaluation of the use of MOODLE-based e-learning for faculty development in Emergency Medicine
Authors: Qotb Mohamed Abdelkader , Farook Saleem 
Published: May 2017

Background: Today, e-learning is of strategic importance to teaching and learning in Emergency Medicine (EM). We adopted an interactive e-learning platform based on the open source software called MOODLEa using a blended learning strategy to assist the implementation of a dedicated faculty development program known as the EM consolidation program. This 12-month program was designed to meet the developmental needs of 20 EM specialists who qualified from different parts of the world. The program is delivered through an innovative blend of workplace and simulation-based assessments, educational portfolio and individualized training in selected clinical areas. The e-learning platform was used by the program participants to share learning resources, communicate, and coordinate various educational activities over the last 6 months.

Methods: We sought feedback from the participants through a MOODLE-based online questionnaire to evaluate their satisfaction, usage patterns and feedback of their e-learning experience.

Results: Out of 20 participants, 90% (n = 18) completed the questionnaire. Two-thirds declared proficiency in computer skills and were enthusiastic about the technology. Their prior experience was related to certified courses rather than interactive forum-based e-learning. About their current experience with MOODLE, 86.7% of participants found it easy to use without any major technical problems. Most of them preferred to access the platform once or twice a week, with 20% accessing on a daily basis. Of the participants, 75% of them accessed MOODLE through their smartphones and 12.5 % through tablet devices. All areas of the e-learning course were found to be useful. The forum-based discussion area was highly rated. The overall learning material was perceived as appropriate and well designed. Among the participants, 62.50% liked the current methodology of blended learning, and 31.25% wished to replace traditional method with e-learning. Also 93.75% of the respondents stated that e-learning was time saving.

Conclusion: Learners involved in this e-learning initiative were overall satisfied by the current implementation of MOODLE and with a third of users preferring e-learning to traditional learning. The use of smartphones and tablet devices was widespread in this small study and hence we recommend support for these devices in implementing similar e-learning initiatives.

Reference: [1] Cook DA, Yvonne S. Online learning for faculty development: A review of the literature. Med Teach. 2013;35(11):930–937.
a MOODLE – Modular Object Orientated Dynamic Learning Environment. http://moodle.org.
How can the practice and documentation of procedural sedation pre-assessment be improved in a high-volume tertiary care emergency department?
Authors: Bashir* Khalid , Alshinnawy Mohamed , Fawzy Mahmoud , Elmaasarawi Ahmad , Badawy Ehab , Abdeldayem Hossam 
Published: May 2017

Background: Procedural sedation (PS) is commonly used in the Emergency Department (ED) to lessen pain, apprehension, and agony for patients during medical procedures. PS encompasses administering of sedative medications with or without the simultaneous delivery of analgesic agents. Safe and effective PS in the ED is a skill that is fundamental to practice of Emergency Medicine. Patients undergoing PS in ED should have a documented evidence of pre-sedation assessment, including prediction of difficulty in airway management, ASA physical status and fasting status.

Aim: The aim of this audit, as a part of a QIP, was to assess the current practice and documentation of PS pre-reassessment among the ED physicians.

Methods and settings: This was an electronic questionnaire survey sent to all ED physicians via their work e-mails. Sixty-seven emergency physicians took part in the survey; however, only 62 completed it. This is a high-volume ED in a large tertiary care hospital where up to 1,600 patients are seen daily and PS is practiced frequently.

Results: Sixty-two ED physicians completed the electronic survey. Only 33.33% (n = 21) stated that they document PS pre-assessment as a usual practice. Among the participants, 69.35% (n = 43) stated the lack of time as the commonest reason for not documenting the PS pre-assessment. And 79.03% (n = 49) admitted that availability of a PS pre-assessment form would improve practice and documentation.

Conclusion and recommendation: Only one-third of the physicians documented PS pre-assessment as a usual practice. The majority of the physicians indicated lack of time as the reason for not documenting the PS pre-assessment. There is a need for a simple assessment form with a checklist and regular training for all ED physicians in PS pre-assessment to practice safely and effectively.
Facial bone fracture with dental injuries from a 4-WD air bag deployment: A case report in Qatar
Authors: Abdul-Aziz Azhar , Javid Sasha , Al Kahlout Baha , Bhat Imran Nazir 
Published: May 2017

Background: Injuries from air bag deployment have long been documented and studied like orbital blowout fractures, auditory injuries, etc. However, we report here a case of an alveolar process fracture associated with dental injuries and clear history of face-to-air bag impact only, which has rarely been documented and hence important to be reported.

Case report: A 25-year old female front-seat passenger was involved in a head-on collision between her large four-wheel drive vehicle and another similar-sized vehicle. She was unrestrained and suffered facial and dental pain after the air bag was deployed. She denied hitting the dashboard or losing her consciousness.
On examination, there was mild skin erythema associated with marked tenderness over her left maxilla and left upper jaw. Her upper left medial incisor was missing, while the lateral incisor and adjacent canine seemed to have been pushed upwards and embedded in their respective sockets. No other injury was elicited and she remained vitally stable.
X-ray and CT scan imaging confirmed an alveolar bone fracture with upward displacement of the alveolar margin of the maxilla. Loss of medial upper left incisor, and impaction of the adjacent lateral incisor and canine teeth in the soft tissues at the left naso-labial fold, antero-lateral to the left nasolacrimal bones were also noted.

Discussion: It is important to report these to be included in the potential range of injuries associated with air bag impact MVC. It will help widen the physicians range of possible injuries while evaluating an air bag impact MVC patient, hence aiding diagnosis and management. It will also help in the ongoing research for further modifying the techniques and types of protective devices currently used in vehicles to help prevent such injuries, as well as further highlighting the use of restraint along with use of such devices.
A surprising case of bilateral ureteric stones causing acute renal failure and anuria
Authors: Alkahky Sherif , Qotb Mohmaed , Morley Kostantinos 
Published: May 2017

Introduction: We present a case of bilateral ureteric colic that causes anuric acute renal failure. Bilateral ureteric colic causing acute renal failure is not a new presentation. However, the patient had only 3 mm calculi, making our case unique.

Background: Bilateral renal calculi are an uncommon cause of acute kidney injury (AKI). Obstructing ureteroliths rarely lead to AKI without any underlying renal disease or anatomic abnormalities, such as a solitary kidney or horseshoe kidney. The literature has reported the incidence of a unilateral ureterovesicular junction obstruction secondary to a stone as 20%. However, there are a very few case reports in the literature of urology, nephrology or emergency medicine regarding the incidence of bilateral ureteric calculi. Cases of bilateral ureteric calculi are rare, and cases with AKI and anuria are very rare.

Case presentation: A 30-year-old male presented with bilateral colicky flank pain for 4 days and started to develop macroscopic haematuria. After proper pain management in the Emergency Department, the patient was found to have a raised serum creatinine level (152 μmol/L). A CT scan was performed showing two 3 mm calculi in the left and right proximal ureters. Ultrasound showed moderate left and mild right hydroureteronephrosis. Due to the relatively small size of the stones, and the clinical image of the patient, he was planned for medical expulsive therapy. Surprisingly, the patient developed complete anuria for 2 days and presented to the ED with a serum creatinine level of 843 μmol/L. Bilateral double J stents were placed and urgent ureteroscopy was done. Following treatment, the patient's condition significantly improved and his renal function returned to normal within 4 days.

Conclusion: Even small bilateral stones can result in acute kidney injury.
Raising awareness about driving safety in an ambulance service
Authors: Alinier Guillaume , Meyer John , Hutton David , Farhat Hassan , Bayoumy Ahmed , Gonzales Edwin , Ragbheer Sunjay , Singh Kanhaiya , Aguila Noe , El-Khady Mohmoud , Al Yazidi Khaled , Campbell Craig , Al-Bakri Ahmed 
Published: May 2017

Background: Worldwide ambulances are regularly involved in accidents as staff may not anticipate other drivers' actions, suffer from fatigue, or overestimate their driving privileges. An ambulance driving safety campaign started in June 2015 targeting some 935 registered HMCAS drivers. We aim to determine if our approach is effective in changing behaviours and believes, and reducing the number of accidents involving HMCAS vehicles.

Methods: This study was ethically approved as a quality improvement project and is still ongoing. The campaign made use of ambulance dashboard stickers and posters at ambulance stations' exits with respectively 4 and 6 key messages covering frequent issues resulting in collisions. An official circular also informed staff of the campaign. A month later a survey started to be distributed to staff.

Results: In two month, 189 anonymous online or paper questionnaires were fully completed. 69.2% of respondents had an HMCAS driving qualification (13.7% of qualified HMCAS drivers). On average, they reported having been involved in 0.90 accident requiring vehicle repair. Using a 5-point Likert scale (1 = very unsafe, 5 = very safe) respondents rated themselves as being safe drivers (4.24/5) and underestimated the monthly number of accidents with HMCAS vehicles to be 15.3 (Actual 21.2/month registered in 2014). Other data about self-reported driving behaviour and comparison between their perception about accidents and real data was analysed along with visibility and memorisation of the key messages.

Conclusions: Staff underestimated the number of accidents. Campaign material has been noticed by most staff except for the stickers inside the ambulances driving compartment which is not accessed by 23.2% of the respondents. Staff who saw the posters and stickers remembered nearly half of the information it contained. Although a significant decline accidents occurrences was noticed in September, the impact of the campaign cannot yet be reliably assessed over this relatively short period of time.