bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning to think critically about health using digital technology in Ugandan lower secondary schools: A contextual analysis
Authors: Ssenyonga Ronald , Sewankambo Nelson K. , Mugagga Solomon Kevin , Nakyejwe Esther , Chesire Faith , Mugisha Michael , Nsangi Allen , Semakula Daniel , Oxman Matt , Nyirazinyoye Laetitia , Lewin Simon , Kaseje Margaret , Oxman Andrew D. , Rosenbaum Sarah 
Published: February 2022

Introduction
The world is awash with claims about the effects of health interventions. Many of these claims are untrustworthy because the bases are unreliable. Acting on unreliable claims can lead to waste of resources and poor health outcomes. Yet, most people lack the necessary skills to appraise the reliability of health claims. The Informed Health Choices (IHC) project aims to equip young people in Ugandan lower secondary schools with skills to think critically about health claims and to make good health choices by developing and evaluating digital learning resources. To ensure that we create resources that are suitable for use in Uganda’s secondary schools and can be scaled up if found effective, we conducted a context analysis. We aimed to better understand opportunities and barriers related to demand for the resources, how the learning content overlaps with existing curriculum and conditions in secondary schools for accessing and using digital resources, in order to inform resource development.

Methods
We used a mixed methods approach and collected both qualitative and quantitative data. We conducted document analyses, key informant interviews, focus group discussions, school visits, and a telephone survey regarding information communication and technology (ICT). We used a nominal group technique to obtain consensus on the appropriate number and length of IHC lessons that should be planned in a school term. We developed and used a framework from the objectives to code the transcripts and generated summaries of query reports in Atlas.ti version 7.

Findings
Critical thinking is a key competency in the lower secondary school curriculum. However, the curriculum does not explicitly make provision to teach critical thinking about health, despite a need acknowledged by curriculum developers, teachers and students. Exam oriented teaching and a lack of learning resources are additional important barriers to teaching critical thinking about health. School closures and the subsequent introduction of online learning during the COVID-19 pandemic has accelerated teachers’ use of digital equipment and learning resources for teaching. Although the government is committed to improving access to ICT in schools and teachers are open to using ICT, access to digital equipment, unreliable power and internet connections remain important hinderances to use of digital learning resources.

Conclusions
There is a recognized need for learning resources to teach critical thinking about health in Ugandan lower secondary schools. Digital learning resources should be designed to be usable even in schools with limited access and equipment. Teacher training on use of ICT for teaching is needed.
Face mask fit hacks: Improving the fit of KN95 masks and surgical masks with fit alteration techniques
Authors: O’Kelly Eugenia , Arora Anmol , Pirog Sophia , Pearson Charlotte , Ward James , Clarkson P. John 
Published: February 2022

Introduction
During the course of the COVID-19 pandemic, there have been suggestions that various techniques could be employed to improve the fit and, therefore, the effectiveness of face masks. It is well recognized that improving fit tends to improve mask effectiveness, but whether these fit modifiers are reliable remains unexplored. In this study, we assess a range of common “fit hacks” to determine their ability to improve mask performance.

Methods
Between July and September 2020, qualitative fit testing was performed in an indoor living space. We used quantitative fit testing to assess the fit of both surgical masks and KN95 masks, with and without ‘fit hacks’, on four participants. Seven fit hacks were evaluated to assess impact on fit. Additionally, one participant applied each fit hack multiple times to assess how reliable hacks were when reapplied. A convenience of four participants took part in the study, three females and one male with a head circumference range of 54 to 60 centimetres.

Results and discussion
The use of pantyhose, tape, and rubber bands were effective for most participants. A pantyhose overlayer was observed to be the most effective hack. High degrees of variation were noted between participants. However, little variation was noted within participants, with hacks generally showing similar benefit each time they were applied on a single participant. An inspection of the fit hacks once applied showed that individual facial features may have a significant impact on fit, especially the nose bridge.

Conclusions
Fit hacks can be used to effectively improve the fit of surgical and KN95 masks, enhancing the protection provided to the wearer. However, many of the most effective hacks are very uncomfortable and unlikely to be tolerated for extended periods of time. The development of effective fit-improvement solutions remains a critical issue in need of further development.
Early discontinuation of adjuvant chemotherapy in patients with early-stage pancreatic cancer correlates with inferior survival: A multicenter population-based cohort study
Authors: Muhammadzai Javeria , Haider Kamal , Moser Michael , Chalchal Haji , Shaw John , Gardiner Donald , Dueck Dorie-Anna , Ahmed Osama , Brunet Bryan , Iqbal Mussawar , Luo Yigang , Beck Gavin , Zaidi Adnan , Ahmed Shahid 
Published: February 2022

Background
The current study aimed to determine the association between timing and completion of adjuvant chemotherapy and outcomes in real-world patients with early-stage pancreatic cancer.

Methods
In this multi-center cohort study patients with early-stage pancreatic cancer who were diagnosed from 2007–2017 and underwent complete resection in the province of Saskatchewan were examined. Cox proportional multivariate analyses were performed for correlation with recurrence and survival.

Results
Of 168 patients, 71 eligible patients with median age of 69 years and M:F of 37:34 were identified. Median time to the start of adjuvant therapy from surgery was 73 days. Of all patients, 49 (69%) patients completed adjuvant chemotherapy and 22 (31%) required early treatment discontinuation. Median recurrence-free survival of patients who completed treatment was 22 months (95%CI:15.8–28.2) vs. 9 months (3.3–14.7) if treatment was discontinued early (P<0.001). Median overall survival of those who completed treatment was 33 (17.5–48.5) vs. 16 months (17.5–48.5) with early treatment discontinuation (P<0.001). In the multivariate analysis, treatment discontinuation was significantly correlated with recurrent disease, hazard ratio (HR), 2.57 (1.41–4.68), P = 0.002 and inferior survival, HR, 2.55 (1.39–4.68), P = 0.003. No correlation between treatment timing and survival was noted.

Conclusions
Early discontinuation but not the timing of adjuvant chemotherapy correlates with inferior outcomes.
Prevalence and characterization of asymptomatic thyroid nodules in Assin North District, Ghana
Authors: Morna Martin Tangnaa , Tuoyire Derek Anamaale , Jimah Bashiru Babatunde , Eliason Sebastian , Baffour Appiah Anthony , Rahman Ganiyu Adebisi 
Published: February 2022

BackgroundUltrasound is now the initial imaging modality of choice for detection and characterization of lesions of the thyroid gland. Ultrasound imaging studies of the thyroid gland report varied prevalence of asymptomatic thyroid nodules (ATN), ranging from 20 to 67%. This study estimated the prevalence, characterized and determined factors associated with ATN in selected communities in the Assin North Municipality, Central Region, Ghana.MethodsThe study was a cross-sectional design, involving 320 participants from six (6) communities in the Assin North District of the Central Region of Ghana. Socio-demographic data and data from ultrasound examination of the thyroid gland were analyzed using descriptive and inferential statistical techniques.ResultsThe prevalence of ATN was 11.3% among 320 participants with the mean age of 56.53(±16.5) years. ATNs were common in the left lobe (69%) and predominantly solitary (64%). ATNs increased with age and body mass index (BMI). Those aged 60 years and above had significantly higher odds (OR = 24.40, 95% CI = 2.59–229.86) of having ATNs, likewise overweigh (OR = 5.32, 95% CI = 1.12–25.20) and obese (OR = 12.51, 95% CI = 1.47–106.58) individuals.ConclusionThe prevalence of ATN in our study population was relatively low, and more predictable among those 60 years or older, those in unhealthy BMI categories. There is the need for the reinforcement and intensification of educational campaigns on the consumption of iodized dietary salt as well as the consumption of foods rich in iodine content, particularly among older individuals.
Azithromycin consumption during the COVID-19 pandemic in Croatia, 2020
Authors: Bogdanić Nikolina , Močibob Loris , Vidović Toni , Soldo Ana , Begovać Josip 
Published: February 2022

Background
During the initial phase of the COVID-19 pandemic, there was great enthusiasm for the use of azithromycin with or without hydroxychloroquine.

Objectives
We analyzed azithromycin consumption in Croatia in 2020 and compared this to the period 2017–2019.

Methods
Azithromycin consumption was evaluated using the IQVIA Adriatic d.o.o. database which collects data on azithromycin distribution from wholesale pharmacies to hospital and non-hospital pharmacies in Croatia. We analyzed data for the period from January 2017 to December 2020. Azithromycin distribution was measured as days of therapy (DOT) and reported as per 1000 inhabitants or per 1000 inhabitant-days.

Results
In the period 2017–2020, total azithromycin DOT in Croatia increased in 2017, 2018, 2019, and 2020 (1.76, 1.91, 1.91 and 2.01/1000 inhabitant-days, respectively). Non-hospital pharmacies received 2.18 times and hospital pharmacies 4.39 times more DOT units/1000 inhabitants of azithromycin in March 2020 compared to the average distribution rate in March 2017–2019. During the peak of the COVID-19 epidemic (November and December 2020) azithromycin distribution increased considerably in hospital (3.62 and 3.19 times, respectively) and non-hospital pharmacies (1.93 and 1.84 times, respectively) compared to the average consumption in the same months in 2017–2019.

Conclusions
Our data showed increased azithromycin distribution in the period 2017–2020 which indicates azithromycin overuse. Preliminary information on COVID-19 treatments with a desire to offer and try what is available even in the absence of strong scientific evidence may have influenced practices of antimicrobial prescriptions.
أثر جائحة كورونا Covide 19) ) على المسؤولية العقدية للناقل الجوي عن تأخير رحلات النقل أو الغاءها "قراءة في قانون تنظيم الطيران المدني البحريني الصادر بالقانون رقم (14) لسنة 2013 والقانون المدني البحريني
Authors: جناحي د. وفاء يعقوب 
Published: February 2022

إن جائحة كورونا، وما ترتب عليها من إجراءات احترازية لم تشهدها الأجيال الحالية، أثرت بشكل مباشر على كثير من القطاعات، أولها قطاع الطيران، ومن المنطقي أن تمتد تبعاته إلى الالتزامات التعاقدية، مثل عقود النقل والشحن الجوي.

لذلك أثير جدل قانوني بين فقهاء القانون بعد ظهور الفيروس في الصين وانتشاره في أغلب دول العالم، حول مدى احقية شركات الطيران الذين اضطروا إلى توقيف أنشطتهم تنفيذاً للقرارات الوقتية الصادرة من الحكومات في مختلف دول العالم الاستناد إلى هذه القرارات لتبرير فسخ عقودهم أو تأجيل تنفيذ التزاماتهم في المواعيد المتفق عليها؟

في الحقيقة ذهب البعض إلى اعتبار الأوبئة ومنها فيروس كورونا من قبيل القوة القاهرة التي يستحيل معها تنفيذ الالتزامات وبالتالي يجوز لشركات الطيران التمسك بها لإعفائها من المسؤولية ومن ثم فسخ العقد، في حين تمسك البعض الآخر على تكييف الأوبئة التي تصيب البشرية على أنها ظروف استثنائية عامة مؤقتة لا تجعل تنفيذ الالتزام مستحيلا بل تؤدي فقط إلى تأجيله، وبالتالي يرى أصحاب هذا الرأي بإمكانية تطبيق نظرية الظروف الطارئة على عقود النقل متى توافرت شروطها. وهناك اتجاه ثالث يرى بأن الأسباب التي منعت شركات الطيران من تنفيذ التزاماتها في ظل جائحة كورونا هو ليس الفيروس بذاته وإنما الإجراءات الحكومية والتدابير الاحترازية المترتبة على انتشار الفيروس والتي تكيف على أنها من أفعال الغير وتعتبر صورة من صور السبب الأجنبي.
Implementação do serviço de teleconsulta farmacêutica para pessoas com diabetes mellitus: foco no autocuidado apoiado
Authors: QUEIROZ REIJANE MARA PINHEIRO , Pessoa Nívia Tavares , Romero Nirla Rodrigues , Fonteles Marta Maria de França 
Published: February 2022

No atual cenário da pandemia da Covid-19, pessoas com diabetes mellitus (DM) requerem, além dos cuidados médicos contínuos, com estratégias multifatoriais de redução de risco, a aproximação de profissionais de saúde capacitados para o apoio ao autocuidado, mesmo que de forma remota. Objetivou-se Implementar o serviço de teleacompanhamento farmacêutico, no contexto da Telessaúde, para prestação do autocuidado apoiado em pessoas com DM na pandemia da covid-19. A população envolvida foi formada por pessoas com DM tipo 2 que apresentavam hemoglobina glicada ≥ 9,0% e que estavam dispostas a participar do acompanhamento por telefone com um farmacêutico da Central de Medicamentos dos terminais de ônibus (CDMT) do município de Fortaleza. Para iniciar a realização do acompanhamento era lido o Termo de Consentimento Livre e Esclarecido (TCLE). A primeira fase do projeto de implementação do serviço foi a capacitação dos profissionais farmacêuticos, seguida da estruturação de um formulário para acompanhamento de pessoas com DM de forma remota, facilitando a identificação de indicadores de processo e de resultados clínicos no contexto do autocuidado apoiado. Entender e conhecer a realidade e o comportamento, auxiliando no processo do cuidado de pessoas com DM com alto risco, por meio de uma tecnologia de fácil acesso como o telefone, foi de valia, servindo de modelo para estender o atendimento a outras pessoas de forma a envolver mais farmacêuticos e outros profissionais, caracterizando assim um serviço multiprofissional dentro do Sistema Único de Saúde (SUS).
Atuação do farmacêutico técnico de saúde mental durante a pandemia da COVID-19
Authors: Araújo Gilmar da Silva 
Published: February 2022

O cuidado farmacêutico tem se tornado prática contínua na saúde e o Centro de Atenção Psicossocial (Caps) é um instrumento onde o profissional tem desenvolvido suas atribuições. O presente trabalho tem como objetivoapresentar ações do farmacêutico à população do território de Ermelino Matarazzo, localizado na região da zona leste do município de São Paulo, nas quais foram ofertados cuidados aos que mais sofreram com os impactostrazidos pela pandemia da Covid-19. Sendo assim, a metodologia utilizada foi um relato dessas ações desenvolvidas pelo farmacêutico junto à equipe multiprofissional do Caps-IJ II Ermelino Matarazzo, entre as quais: visitase atendimentos domiciliares aos usuários, oferta de água e sabão para higienização das mãos e orientações à população do bairro. Tais ações e atribuições do profissional tiveram impactos no levantamento da produçãode dois procedimentos: visitas/atendimentos domiciliares e reuniões de matriciamento, ocorrendo um aumento progressivo dos números das ações quando comparados os anos de 2019, 2020 e 2021. Nos dois últimosanos, com a pandemia decretada, as práticas de cuidados foram repensadas. Além dos ganhos quantitativos, apareceram os qualitativos, por meio de relatos dos usuários em suas mudanças de rotinas e acesso e adesão às terapias. Conclui-se que, para que as práticas dos cuidados farmacêuticos em saúde mental se concretizem, faz-se necessário o apoio da gestão com redistribuição das atribuições e agendas, sensibilização da população e outros serviços da rede intersetorial, como forma de estímulo ao profissional.
Dispensação Trimestral de Anastrozol e Tamoxifeno durante a pandemia de COVID-19
Authors: Oliveira Juliana dos Santos de , Valverde Ingrid Ambrosio Pires Morais , Rodolpho Patricia Silva Novaes 
Published: February 2022

No câncer de mama, a hormonioterapia é utilizada para reduzir o risco de recidiva (reaparecimento da doença ou de sintomas), para tratar a recidiva ou casos avançados. O tempo de tratamento varia de 5 a 10 anos. A atual pandemia da Covid-19 trouxe a preocupação de diminuir o risco de infecção em pacientes oncológicos em uso de hormonioterapia. Além disso, o medo por parte dos pacientes de comparecerem ao ambiente hospitalar poderia prejudicar sua adesão ao tratamento. O objetivo deste trabalho foi reduzir a média diária de atendimentos a pacientes em uso de hormonioterapia no serviço de oncologia, diminuindo riscos de exposição à Covid-19. Foi utilizada a dispensação trimestral de Anastrozol e Tamoxifeno para os pacientes, com exceção dos que estavam iniciando o tratamento. A dispensação trimestral foi implantada em março de 2020, gerando uma redução já significativa, em abril de 2020, de quase 30% no número de pacientes que compareceram ao hospital para retirada desses medicamentos, quando comparado ao mês anterior (março n = 226; abril n = 167). Em maio e junho de 2020, houve uma queda de mais de 80% de pacientes que foram ao serviço retirar a hormonioterapia, evitando aglomerações e reduzindo o risco de contágio. Foi possível concluir, com o desenvolvimento desse trabalho, que o papel do farmacêutico, durante situações de pandemia, vai muito além de suas atividades clínicas. A visão de logística e planejamento desse profissional auxiliaram na redução de risco de infecção pelo novo coronavírus dos pacientes oncológicos e possibilitaram a continuidade do tratamento.
Enfrentamento à Covid-19: cuidando do cuidador com PICs
Authors: De Donato Aline Corazza , Heyn Regina Célia de Camargo 
Published: February 2022

As Práticas Integrativas e Complementares em Saúde (PICS) atuam na prevenção e tratamento de saúde, trazendo ganhos significativos para a saúde pública. Importante que o profissional da saúde conheça suas atribuições, mas conheça a si próprio para que desenvolva um bom trabalho e não seja prejudicado por desgastes físicos ou emocionais, impactando na qualidade do cuidado prestado ao usuário do serviço de saúde. Os trabalhadores vinham demonstrando a necessidade de um espaço de escuta para expressarem o que sentiam em relação a si e ao trabalho, tornando-se mais evidente pelo aumento da ansiedade e preocupação entre eles, durante a pandemia da Covid-19. O projeto piloto foi realizado no período de 12/08/2020 à 16/12/2020, no Caps III Rudge Ramos, em São Bernardo do Campo, São Paulo. Neste projeto, intitulado Cuidando do Cuidador com PICS nas Residências Terapêuticas, a farmacêutica e a monitora de oficina terapêutica II ofereceram tratamento complementar de caráter integral aos 23 participantes, em seis encontros quinzenais, utilizando a aromaterapia,arteterapia, cromoterapia, dança circular, musicoterapia e práticas meditativas. Os objetivos foram oferecer aos cuidadores um espaço de apoio, expressão, escuta e troca de experiências; proporcionar reflexão e possibilidade de mudança na maneira de enfrentar as dificuldades do dia a dia, visando restabelecer o equilíbrio e o bem-estar físico, mental, emocional com oportunidade de diminuição dos sintomas ansiosos e de melhoria nas funções laborais. Dos 23 envolvidos no projeto, apenas cinco participaram do último encontro e outros cinco não conseguiram comparecer, mas preencheram a ficha de avaliação final. Importante pontuar que apenas 4% dos participantes do projeto tinham conhecimento sobre as práticas integrativas e complementares. Assim, um dos benefícios evidenciados foi informar e divulgar as PICS. Os participantes compartilharam percepções relacionadas à mudança na rotina de trabalho e a experiência positiva ao final do projeto Cuidando do Cuidador com as PICS.
Multi-Scale Paraxial Models to Approximate Vlasov–Maxwell Equations
Authors: Assous Franck , Furman Yevgeni 
Published: February 2022

Abstract
Even today, solving numerically the time-dependent Vlasov–Maxwell equations is a challenging issue, and developing simpler but accurate approximate models is still worthwhile.
Here, we propose a new family of paraxial asymptotic models that approximates the Vlasov–Maxwell system of equations.
We introduce parameters in our models that allow us to handle relativistic cases, much slower beams or even non-relativistic cases.
These models are derived by introducing a small parameter and provide static or quasi-static approximate equations that are 𝑛-th order accurate; 𝑛 may be chosen as required.
Practically, one can select a model by determining the regime one is interested in and choosing the degree of accuracy needed.
Challenges in decolonizing linguistics: the politics of enregisterment and the divergent uptakes of translingualism
Authors: Canagarajah Suresh 
Published: February 2022

AbstractThis article traces the roots of translingualism in the Global South, with particular relevance to the author’s South Asian heritage. After narrating his attempts to practice this orientation in his research and scholarship, the author analyzes the problematic ways in which translingualism is appropriated in the academic, economic, and political contexts in Global North. Employing the conceptual orientation of enregisterment, the article theorizes the challenges for decolonizing discourses in negotiating a critical and transformative uptake. It concludes by outlining some strategies that can help in entextualizing translingualism to preserve its decolonizing potential. It identifies areas of research that will expand the communities, contexts, and communication that will facilitate more pluriversal epistemologies and practices.
Translanguaging and flows: towards an alternative conceptual model
Authors: Lemke Jay L. , Lin Angel M. Y. 
Published: February 2022

Abstract
While much scholarly work has contributed to the theorizing of translanguaging, in this article, we sketch an alternative model based on materiality and information theory (Bateson, Gregory. 1951. Information and codification; and Conventions of Communication. In Jurgen Ruesch & Gregory Bateson (eds.), Communication: The social matrix of psychiatry, 168–227. New York: Routledge; Lemke, Jay L. 2015. Feeling and meaning: A unitary bio-semiotic account. In Peter Pericles Trifonas (ed.), International handbook of semiotics, 589–616. Dordrecht, the Netherlands: Springer) to theorize translanguaging together with flows, through reconsidering issues of speech events in which features normally associated with different language systems co-occur. And in doing so, we hope to contribute to the ongoing theorizing work in the field of translanguaging.