bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vulnérabilité des professionnels, vulnérabilité des familles. Éthique et responsabilité en protection de l’enfance
Authors: Boudarse Khalid 
Published: November 2023

En visant une modélisation conceptuelle, cet écrit théorique aborde la vulnérabilité du professionnel de la protection de l’enfance à travers le prisme de son éthique. Dans une dynamique socioculturelle parfois trouble, ce professionnel fait face à la vulnérabilité des familles mais aussi à la sienne propre. Nous soutenons qu’il est fragilisé par un contexte qui altère fortement le déploiement du triptyque qui forme la base de ses actions socio-psycho-éducatives – orientation scolaire spécialisée/soins psychiques/placement. Comment alors s’estimer soi-même comme personne et comme professionnel en évaluant ses actions à l’aune d’une visée éthique pour le moins contrariée par des normes porteuses de nouveaux idéaux ? L’auteur conclut l’article en soulignant le risque de culpabilité que le professionnel peut endosser, à tort. Il plaide enfin pour une éthique à la fois prescriptive, armée de concepts philosophiques, et réflexive, enrichie par les rugosités du terrain, afin d’aborder de front les nouveaux antagonismes qui s’emparent du champ de la protection de l’enfance.
Les jeunes ne vont globalement pas plus mal qu’avant
Authors: Falissard Bruno , Hendriks Karine 
Published: November 2023

Faut-il s’inquiéter de la santé psychique des mineurs ? Attention aux amalgames, prévient Bruno Falissard. Il faut distinguer le sentiment de « mal-être » des troubles qui relèvent de la psychiatrie. Le pédopsychiatre alerte en revanche sur l’état du système de soins, qui ne permet plus la prise en charge efficace de ceux qui en ont besoin.
Il faut recréer les conditions d’une meilleure coopération entre tous les acteurs
Authors: Libert Christophe , Hendriks Karine 
Published: November 2023

Notre modèle de psychiatrie infanto-juvénile, qui a 50 ans, doit être revisité car l’offre de soins est éparpillée et peu lisible pour les familles comme pour les professionnels. Explications.
Citoyen ou soldat, la vision de Franchet d’Espèrey des mutineries de 1917 et 1919
Authors: Refuveille Laurent 
Published: November 2023

Les mutineries de la Grande Guerre restent un événement mémoriel majeur. Les comprendre, à travers le témoignage du général Franchet d’Espèrey, permet de s’interroger à la fois sur leurs causes profondes, et plus globalement sur la place du soldat-citoyen. Le général, pense d’abord à un complot socialiste, en sur interprétant les signes et en restant prisonnier de son propre cadre d’interprétation et de quelques fascicules qui circulent. Pour lui les soldats sont avant tout à « dresser ». En 1919, en Russie, il est capable d’analyser plus finement la lassitude de soldats maintenus sous les drapeaux.
Improvement in Nurses' Knowledge of Subcutaneous Catheter Use for Pain Management
Authors: Daniel Stephanie , Zurmehly Joyce 
Published: November 2023

Background:
Nurses often have insufficient knowledge of subcutaneous catheter use for pain management. This quality improvement project evaluated implementation of an evidence-based subcutaneous catheter nursing policy with education to improve pain management for hospitalized patients.

Method:

A convenience sample of nurses (
N
= 515) completed a posttest after online training on effective subcutaneous pain management. Patient pain ratings were assessed to evaluate whether they changed after nurses' training.

Results:

Posttest scores showed the online learning module effectively contributed to nurses' knowledge of subcutaneous catheter pain management. A statistically significant reduction occurred in patient pain ratings (
p
< .001) postintervention. The number of patients experiencing moderate or severe pain decreased by 58%, for a significant reduction in pain.

Conclusion:

An online learning module was successful in educating nurses on pain medication administration through an indwelling subcutaneous catheter.

[
J Contin Educ Nurs.
2024;55(1):13–20.]
Improving the Use of Subscale-Specific Interventions of the Braden Scale Among Nurses
Authors: Stevens Lindsey , Liu Jianfang , Voigt Natalie 
Published: November 2023

Background:
Pressure injuries (PIs) are costly to hospitals and have a negative impact on patient outcomes. Despite the use of validated tools that describe PI risk, such as the Braden Scale, the incidence of PIs remains high. Studies have shown that Braden Scale subscale scores should be considered when planning care; however, there is a discrepancy between understanding the importance of subscale-specific interventions and implementation. The goal of this study was to test the ability of an educational intervention tailored to specific interventions based on the subscales of the Braden Scale to improve knowledge among nurses.

Method:

This study was a prospective, quasi-experimental, single-group design where nurses (
n
= 35) from a neurosurgery stepdown unit in a large teaching hospital completed a preintervention survey (T1), attended an educational presentation, and then completed an immediate postintervention survey (T2) and a 2-month postintervention survey (T3).

Results:

Data analysis compared presurvey scores with postsurvey scores. Nursing comprehension improved from the preintervention survey (T1,
M
= 5.57) to the postintervention surveys (T2,
M
= 6.34; T3,
M
= 6.42) (
p
= .031).

Conclusion:

Nurses showed increased comprehension after the educational intervention from T1 to T3.

[
J Contin Educ Nurs.
2024;55(1):42–48.]
Cutting Edge: CCR8 Signaling Regulates IL-25– and IL-33–Responsive Skin Group 2 Innate Lymphoid Cell Migration and Function
Authors: Sun Zhengwang , Sen Han , Zhu Xueping , Islam Sabina A 
Published: November 2023

Abstract
Group 2 innate lymphoid cells (ILC2s) are sentinels of barrier immunity, and their activation by the epithelial alarmins IL-25 and IL-33 is a defining trait. In this study, we identified a role for the chemokine receptor CCR8 in modulating skin ILC2 abundance and activation. CCR8 signaling facilitated IL-25–induced increases in skin and lung ILC2s, ILC2 activation and systemic IL-13 production, and ligand-directed ILC2 entry into skin and lung. CCR8 controlled ILC2 tissue entry in IL-25–treated naive mice, but only transferred bone marrow ILC2 progenitors were equipped to enter the skin, whereas multiple tissue-sourced ILC2s entered the lung. CCR8 selectively regulated IL-33–induced increases in skin ILC2s, their proliferation, and production of IL-13/IL-5, as well as IL-33–responsive transferred ILC2 trafficking only to the skin. Collectively, we illuminate (to our knowledge) novel aspects of CCR8 signaling-regulated ILC2 motility and function, especially in the skin, in response to two hallmark ILC2-activating alarmins.
Dermatitis Artefacta in the Patients of Obsessive Compulsive Disorder: A Case Series
Authors: Mondal Arijit , Das Ranjan , Chattopadhyay Abhijit , Ghosh Soumi 
Published: November 2023

Abstract
Dermatitis artefacta or factitious dermatitis is a psychodermatological disorder commonly found in dermatology and psychiatric departments. Comorbid psychiatric disorders are frequently seen with this conditions and proper meticulous history and evaluation both from dermatology and psychiatric point of view is needed to make this diagnosis of exclusion. There are no definite diagnostic criteria or treatment protocols for the above conditions and a combination of psychiatric dermatological and psychological approach is needed to manage this. Lack of proper clinical knowledge and awareness regarding the condition may lead to misdiagnosed the cases frequently. Here we have reported the three cases of dermatitis artefacta with comorbid obsessive compulsive disorder.
Homeless Mentally ill in COVID Lockdown: Study from a Tertiary Care Center
Authors: Singh Shipra , Goyal Aparna , Singh Bhupendra , Deshwal Shivani , Gupta Rajiv 
Published: November 2023

Abstract

Objective:
Homeless mentally ill is a vulnerable group and this vulnerability is amplified during the pandemic, especially during the lockdown phase. This study examines the demographic and clinical profile and outcome details of homeless attended in the psychiatry department during the lockdown.

Materials and Methods:
It is a retrospective study. Hospital records of all homeless who attended during the lockdown were examined for demographic, clinical, and rehabilitation details using a semistructured pro forma and descriptive analysis was performed.

Results:
A total of 23 records were found. Most referrals were due to wandering and disorganized behavior increases the risk of COVID transmission. The most common diagnosis was unspecified nonorganic psychosis. Nearly half of them could be rehabilitated.

Conclusion:
Recent pandemic augmented the problems of homeless mentally ill. There is an urgent need for the formulation of well-defined guidelines for this group to improve their well-being and care in such events and otherwise as well.
Evaluation of Knowledge and Attitude toward Substances of Abuse and Reasons for Taking Psychoactive Substances among Patients Abusing Illicit Substances
Authors: Mehta Sumit , Yadav Rashmi , Dhyani Mohan , Avinash Priya Ranjan 
Published: November 2023

Abstract

Background:
Drug abuse is a complex phenomenon, which has various social, cultural, and biological aspects. Knowledge and attitude toward substances of abuse among users are of vital importance for their prevention and treatment, especially in adolescents, as it is the age when the majority of drug users start the use of various substances.

Methods:
One hundred patients of opioid dependence admitted to a psychiatry ward were assessed using a semi-structured pro forma, which assessed the knowledge, reasons for initiating, and attitude toward substances on a Likert scale. The age of the first intake of substances, frequency of drug use, and physical and psychological changes after intake of substances were also evaluated.

Results:
Joy-seeking (91%), lack of knowledge about complications/hazards of drugs (89%), friends offer/peer pressure (87%) followed by low self-confidence (86%), and to eliminate shyness (85%) were found as major reasons for initiating the opioid use. Social factors such as family disputes (23%) and parents’ divorce (20%) were considered the least unlikely excuse for substance abuse. Young respondents (ages of 20–29 years) reported a decrease in shyness and improved self-esteem as reasons for intake.

Conclusions:
Different regions and different age groups seem to have different factors as psychosocial etiologies of substance abuse. Policymakers and other agencies need to look into this before making strategies for controlling this menace.
Parental stress parameter difference after caring for congenital adrenal hyperplasia children with genital ambiguity
Authors: Saktini Fanti , Fitrikasari Alifiati , Asikin Hang Gunawan , Noerhidajati Elly , Utari Agustini 
Published: November 2023

Abstract

Introduction:
Congenital adrenal hyperplasia (CAH) disrupts cortisol biosynthesis, which may cause genital ambiguity in females. Caring for children with genital ambiguity creates parental distress. Common stress parameters include biological (e.g., serotonin cortisol) and psychological (e.g., Depression, Anxiety, and Stress Scale [DASS] scores). This study elaborated parental stress parameter differences among parents of CAH children with and without genital ambiguity.

Methods:
This cross-sectional study included 34 fathers and 44 mothers of children with CAH. All participants agreed to fill in the DASS-42 and socioeconomic questionnaire. Morning serum serotonin and cortisol samples were examined using the enzyme-linked immune-absorbent assay technique.

Results:
The median (minimum–maximum) value of serotonin concentration was lower in fathers compared to mothers (281.18 [78.44–122.91] ng/ml vs. 399.78 [122.91–1050.0] ng/ml, P = 0.11); in parents of children with genital ambiguity (292.22 [78.44–1050.00] ng/ml vs. 426.71 [150.78–1050.00] ng/ml, P = 0.01); and in parents of children with a diagnosis time <1 year (225.00 [93.41–570.33] ng/ml vs. 371.815 [78.44–1050.00] ng/ml, P = 0.046). Higher cortisol concentration was observed in parents of children with diagnosis time <1 year (78.65 [50.89–126.89] ng/ml vs. 63.33 [6.14–283.67] ng/ml, P = 0.046). The proportion of depression was 24.4%, anxiety 45.1%, and stress 21.8%.

Conclusion:
Fathers, parents of children with genital ambiguity, and being recently diagnosed had lower serum serotonin levels. Parents of recently diagnosed children had higher cortisol levels. Anxiety was more common than depression and stress.
Role of detailed information about anaesthesia during PAC to reduce patient’s anxiety during the perioperative period
Authors: Padsala Krishna , Patel Harsha , Nakum Rajesh , Sojitra Nalin P. 
Published: November 2023

ABSTRACT

Background:
Perioperative anxiety may adversely influence anaesthetic induction and patient’s recovery. Pharmacological interventions include the use of narcotics, sedatives and anxiolytics. However, such drug interventions are typically accompanied by adverse reactions. Perioperative anxiety experienced by patients can be significantly diminished through the provision of comprehensive information regarding the anaesthesia procedure, surgical procedure and perioperative events during the pre-anaesthetic assessment conducted in an outpatient consultation clinic.

Aims:
This prospective study was conducted to assess the impact of providing comprehensive information on alleviating patient anxiety throughout the perioperative period.

Materials and Methods:
This prospective observational study was conducted on 60 patients to assess patient’s perioperative anxiety for anaesthesia and surgery. All study participants were asked to mark their pre-operative anxiety on the Visual Analogue Scale-Anxiety (VAS-A) and asked to fill the questionnaire of Amsterdam Pre-operative Anxiety and Information Scale (APAIS).

Results:
During the pre-information evaluation, patient’s mean VAS-A score was 4.73 ± 2.75 which decreased to 3.65 ± 2.53 in post-information evaluation (P = 0.027). The overall APAIS score during pre-information and post-information evaluation was 17.4 ± 8.06 and 13.18 ± 7.06 (P = 0.002). The mean APAIS score for anaesthesia and surgery during the pre-information evaluation was 2.67 ± 1.46 and 3.13 ± 1.54, respectively, which decreased to 2.04 ± 1.18 and 2.35 ± 1.30, respectively, in post-information evaluation. This difference in APAIS score evaluation during pre-information and post-information evaluation for anaesthesia (P = 0.0105) and surgery (P = 0.003) was statistically significant.

Conclusion:
Perioperative anxiety experienced by patients can be effectively mitigated by providing comprehensive information pertaining to anaesthesia procedures, surgical procedures and perioperative events during the pre-anaesthetic assessment conducted within an outpatient consultation clinic.
Simulation-based training in central venous catheterization for first-year postgraduate students: A prospective study
Authors: Kaur Haramritpal , Kaur Sarabjot , Singh Amandeep , Grover Urvashi , Maheshwari Chandni , Chawla Sumitpal Singh 
Published: November 2023

ABSTRACT

Background:
The current model of procedure training involves lectures, seminars, observations and personalised education in small groups or by watching videos on digital platforms. Central venous catheterisation (CVC) is an important skill; however, its training largely remains unstructured. There is a need of protocol-based uniform training policy.

Aims:
The aims and objectives of the study are to prepare and implement simulation-based CVC training module for the 1st year post-graduate students.

Materials and Methods:
After approval from the institutional ethical committee, 1st year post-graduate students of anaesthesia, medicine and surgery were enroled. Training modules and questionnaires were prepared with discussions amongst faculty. Students’ baseline knowledge regarding the CVC was noted on mannequins along with self-reported confidence. After that, they were subjected to training module. Students repeat knowledge and confidence regarding CVC were noted. In the next few months, procedures performed by post-graduate students were directly observed and rated. Students as well as faculty feedback regarding this teaching module was also collected.

Results:
Training module was associated with a statistically significant increase in knowledge and self-reported confidence regarding the knowledge and skill of CVC (P < 0.05). Most of the students and faculty agreed regarding the training module utility.

Conclusions:
A structured simulation module for CVC helped to improve students’ knowledge and confidence about the CVC skill. The module was well accepted by both faculty and students.
A noisy airway: Varying causes for upper airway obstruction in a child
Authors: Srinivasan Ranjini , Krishna Sushma , Dinakar Chitra , Pratibha CB 
Published: November 2023

ABSTRACT
Noisy breathing is a common symptom in infancy and childhood. It can sometimes be intimidating to the parents and a diagnostic challenge to the treating physician. Causes for a noisy airway include congenital and acquired conditions. They can vary in etiology from self-resolving conditions like laryngomalacia to more sinister entities like malignant tumors. We present a 3-year-old girl who presented with noisy breathing since the age of 6months associated with poor weight gain and chest deformity. Due to persistence of her symptoms, she underwent upper airway evaluation at different time points and was found to have varied causes for her noisy respiration that included airway malacia, pharyngeal wall inspiratory collapse and later adenoidal hypertrophy which was complicated by symptoms suggestive of obstructive sleep apnea. The above three conditions are known to co-exist and can manifest at varied points of time. Since it is unusual to encounter varied causes of upper airway obstruction in the same patient, this case is being presented for its rarity and to highlight the importance of evaluating the upper airway repeatedly if symptoms are persistent, variable or progressive.
Point of Care Tests
Authors: Sharma Anuradha , Chourasia Ekta , Goswami Shubham 
Published: November 2023

Background:
Point of care tests provide rapid information about the patient's condition, with a turnaround time of 15 min. During the COVID-19 pandemic, many such point of care tests were developed, to aid in the rapid diagnosis of SARS-Cov-2 infection.

Aim:
To describe and synthesize the available literature on point of care tests for diagnosis of SARS-CoV-2.
Methodology: This narrative review was done through online literature search, using Google Scholar and PubMed.

Result:
There were 51 point of care tests for diagnosis of SARS-CoV-2 which were validated using different samples, such as such as nasopharyngeal swabs(42), oropharyngeal and naso-pharyngealswabs(2), oropharyngeal swab in VTM(1) nasal swabs(5) and throat swab(1).

Conclusion:
There was global developement of point of care tests on a war footing. The Indian states of Delhi, Maharashtra, Gujarat, Uttar Pradesh, Tamil Nadu, Karnataka, Haryana, Rajasthan, Kerala, Himachal Pradesh, Goa and Uttarakhand, were in the forefront of these developments, as also the USA, Belgium, Taiwan, Korea and South Korea.
The Overall Prevalence and Main Determinants of Prolonged Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting
Authors: Shahsanaei Farzad , Behrooj Soudabeh , Petrudi Nima Rahimi , Khajehbahrami Fahim 
Published: November 2023

Background:
Although respiratory support is necessary to maintain hemodynamic stability in patients undergoing major surgeries, prolonging the time of mechanical ventilation is considered a major complication following these procedures. The identification of potential factors related to this phenomenon should be identified. In the present systematic review, we first assess the pooled prevalence of prolonged mechanical ventilation (PMV) in patients undergoing coronary artery bypass grafting (CABG) surgery and also determine the main predictors for PMV by deeply reviewing the literature.

Materials and Methods:
The manuscript databases including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane were deeply searched by the two blinded investigators for all eligible studies based on the relevant keywords. Based on the titles and abstracts, 88 records were initially included and of those, 15 articles were eligible for the final analysis.

Results:
The pooled prevalence of PMV in the studies that defined PMV as ventilation >24 h was 6.5% (95% confidence interval [CI]: 4.1%–10.2%) and in the studies, PMV as ventilation >48 h was 2.8% (95% CI: 1.7%–4.7%). Demographics (gender and advanced age), obesity, underlying comorbidities (hypertension, chronic kidney disease, cerebrovascular accident, high New York Heart Association class, history of chronic obstructive pulmonary disease, and history of acute coronary syndrome), emergency surgery, intraoperative characteristics (needing intra-aortic balloon pump, increased peak airway pressure, using cardiopulmonary bypass, the type of dose of anesthetics, cross-clamp time, increased units of blood transfusion, occurring cardiac ischemic events within an operation, fluid imbalance, and some anastomoses), and some postoperative outcome such as lowering O2 saturation, sequential organ failure assessment score, inotrope use, pleural effusion, delirium, and prolonged intensive care unit stay were found to be the main determinants for PMV.

Conclusion:
Depending on the definition of PMV, the prevalence of PMV varied from 1.7% to 10.2%. Various factors before, during, and after surgery are the predictors of PMV in these patients, which can be used to design new scoring systems to predict it.
Quality of life assessment in children and their caregivers suffering from allergic rhinitis and/or asthma
Authors: Wadhawan Pallavi , Gupta Neeraj , Srivastava Prakriti , Sachdev Anil 
Published: November 2023

INTRODUCTION:
Asthma and allergic rhinitis (AR) are among the most prevalent diseases worldwide and they frequently persist throughout the life. These have significant effect on physical, financial, and mental wellbeing of patients and caregivers. There have been few attempts previously, assessing the quality of life (QOL) in affected families suffering from these diseases. However, the data from developing countries are scarce. QOL assessment in children and caregivers of patients suffering can help in symptomatic management and provide inputs for the better utilization of resources to achieve optimal treatment.

MATERIALS AND METHODS:
Patient and caregiver QOLs were ascertained using Mini Pediatric Asthma QOL Questionnaire and Pediatric Asthma Caregiver's QOL Questionnaire, respectively, in the study and correlated with disease severity and chronicity using the parametric and nonparametric statistical tools.

RESULTS:
There were 246 pairs of children diagnosed with asthma and/or AR and their caregivers attending the pediatric allergy and asthma clinic. Symptom score, emotional domain, and activity limitation in children did not validate a statistically significant difference in QOL in the various grades of AR/asthma/AR with asthma (P = 0.632) (P = 0.772) (P = 0.496) (P = 0.918) (P = 0.384) and (P = 0.561), respectively. In addition, there was no significant correlation between the severity of asthma and caregiver emotional disturbance (P = 0.594) or caregiver activity limitation (P = 0.446).

CONCLUSIONS:
QOL in children and caregivers where children are suffering from either AR or asthma, or both has not shown any significant difference as per the disease severity or chronicity in various domains. There was no significant difference in QOL noted as per the change in age group, gender of patients, or education status of caregivers.