Modifications of behavior management strategies pre- and post-covid-19 scenario A survey among pediatric dentists

Background: COVID-19 presented a unique scenario among children, specifically all over the world. The children had decrease outdoors activities and learning times, increased use of electronic gadgets and changes in sleep patterns. These altered behavior patterns of children directly influenced their behavior in the dental operatory. This coupled with the stringent protocols of COVID-19, made the behavior management of children a tedious task. However, as they say that necessity is the mother of all inventions, the pediatric dentist took this time to evaluate newer methods of behavior management and modified old strategies with newer modifications. Aim: The main aim of this study was to observe the modifications in behavior management strategies among pediatric dentists in the post-COVID-19 era while managing the child in dental operatory. Materials and Methods: Four hundred pediatric dentists were mailed a questionnaire consisting of 24 open and closed-ended questions consisting of personal data, professional information, and questions regarding various behavior management techniques used by them in pre- and post-COVID-19 era. Data obtained were subjected to statistical analysis using SPSS version 26.0, IBM, and a comparison of frequencies of categories of variables with groups was made using Chi-Square test and McNemar test. Results: The results showed that there were statistically highly significant changes in behavior management strategies pre- and post-COVID-19 scenario with P < 0.01. Conclusion: Conventional techniques like Tell-Show-Do were popular in both pre- and post-COVID-19 times with minor modifications in approach, but conscious sedation and distraction techniques were evaluated to have gained more popularity in the post-COVID-19 times along with exploration of new novel techniques.

Closed-loop management strategies for patients with severe mental disorder complicated with COVID-19 infection / 四川精神卫生

With the fluctuating condition of the COVID-19 epidemic， the current findings remain unclear about the preventive measures and coping strategies for patients with severe mental disorders at the nodes of the transmission chain. Past experience in prevention and control has shown that establishing an effective system for emerging infectious disease prevention and control and establishing transitional wards in specialist mental healthcare institutions play a significant role in reducing the risk of epidemic transmission. However， there is no formulated strategy for the management of patients with severe mental disorders and COVID-19 infection who have recurrent or worsened mental symptoms during the diagnosis and treatment of COVID-19 and are unable to cooperate with the treatment in Fangcang shelter hospitals or infectious wards. Based on the field research in the front line of the epidemic prevention， this paper discusses the management strategies of patients with severe mental disorders and COVID-19 infection in the context of the practical difficulties in managing patients with severe mental disorders and COVID-19 infection， emergency management strategies， protective conditions for front-line psychiatric medical staff and the legal basis for the management of patients with severe mental disorders and COVID-19 infection in emergency situations.

Benefit Analysis of Grid Connected Photovoltaic Solar System with Energy Storage

Abstract The use of batteries combined with photovoltaic (PV) systems connected to the grid allows the storage of surplus energy from photovoltaic generation for later use. This combination can reduce dependence on the grid, since, for most consumers, peak consumption does not occur simultaneously with peak generation from the PV system. This article describes the initial operation of a PV system with 10.72kWp connected to grid and associated to a storage system with 57.6kWh lead-acid batteries installed at the Federal University of Technology - Paraná, in Curitiba city, Campus Neoville. We present an analysis of the benefits obtained from the combined use of the PV system connected to the grid with energy storage, reducing the total energy consumed from the grid. A brief analysis of the demand showed that, for this UTFPR campus, the peak power consumption occurred between 10:00 and 12:00 AM, which was also the interval of peak photovoltaic generation. We have observed that a scheduled battery discharge of 5.5% of the storage capacity from May to November and 9% discharge in December has resulted in R$ 1,154.44 of saving in the first seven months of operation.

Long term beef production in extensive cow-calf systems in the tropical savannas of eastern Colombia / Producción continua de carne en sistemas extensivos de cría en las sabanas tropicales del oriente de Colombia

ABSTRACT Replacement beef heifers in extensive systems of the neotropical savannas of Colombia are low priority animals and are assigned to native savannas and low-quality pastures, with scarcely researched long-term consequences. The study pooled data from four contemporary grazing experiments to determine the effects of low growth rates of heifers on their lifetime production of liveweight gains (LWGs) per year and per hectare (ha) subject to different management strategies. Three growth rates were imposed on grazing heifers during the growing phase (i.e. nine-36 months of age) on Brachiaria humidicola pastures. Upon the end of the previous phase, animals were allocated to a B. humidicola paddock with a reduced stocking rate or introduced to a B. decumbens sward to allow compensatory LWGs during the breeding phase (i.e. cows plus weaned calves). Severely limited heifers allowed to make compensatory growth did not reach the outputs of better fed animals. Regardless of the strategy followed, high producing years tended to be followed by lower production in the following year. Comparison with reasonably fed breeding cows full-time on well-managed B. decumbens showed important and significant differences in favor of the more intensive system over the lifetime of the animals. Over the nine-year period, the systems' beef output (i.e. weaned calves plus cows' LWGs) ranged between 86 and 206 kg/ha/year and demonstrated that a wide array of low input management alternatives is feasible. Beef output increases if the LW of cull cows is considered, particularly if they are allowed a short period of fattening during the rainy reason on a low input pasture.

RESUMEN Las novillas de reemplazo en los sistemas extensivos de cría de los Llanos Orientales de Colombia son animales de baja prioridad para el productor y generalmente se les asignan sabanas nativas o pasturas de baja calidad. Las consecuencias de dicha estrategia de manejo han sido poco investigadas. Este trabajo reunió datos de cuatro experimentos de pastoreo contemporáneos y de largo plazo para estimar el efecto de las bajas tasas de crecimiento sobre la ganancia de peso por año y por hectárea (ha) de novillas sometidas a diferentes estrategias de manejo. Se usaron tres cargas animales durante la fase de crecimiento para lograr tasas de crecimiento contrastantes entre los nueve y 36 meses de edad, con pasturas de baja calidad de Brachiaria humidicola, caracterizadas por bajo contenido de proteína bruta y baja digestibilidad. Durante la fase de cría y reproducción las novillas pasaron a pasturas de B. humidicola o de B. decumbens con cargas reducidas, para permitir ganancias de peso compensatorias. Los animales de menor ganancia durante el crecimiento no lograron ganancias compensatorias que les permitieran alcanzar a aquellos mejor alimentados. Independientemente de la estrategia de alimentación, años de relativamente alta producción fueron seguidos por años de baja producción en forma cíclica. La comparación con animales mejor alimentados con pastura de B. decumbens bien manejada, mostró diferencias considerables y significativas acumuladas durante su vida útil. A lo largo de nueve años de experimentación, la producción de ganancia de peso de vacas más terneros destetos varió entre 86 y 206 kg/ha/año, demostrando las consecuencias de largo plazo del amplio rango de estrategias de manejo experimentadas. La producción de carne en estos sistemas se puede aumentar si se le suma el peso de vacas de descarte, particularmente, si le les permite un periodo de ceba corto durante la estación lluviosa, incluso usando pasturas de calidad baja.

Urban streams in Latin America: Current conditions and research needs

Introduction: Latin America is a highly urbanized region, with most of its population living in cities and urban centers. While information about urban streams in Latin America is rather limited, streams are expected to experience similar environmental impacts and conservation issues as urban streams in parts of the globe, including habitat loss, channelization, sewage discharge, trash, and loss of riparian habitats. Objective: We surveyed a network of researchers from approximately 80% of the countries in Latin America to obtain information on the condition, state of knowledge, and threats to urban streams in the region. Methods: Most participants were reached via the Macrolatinos@ network (www.macrolatinos.net). Results: We obtained 104 responses from researchers in 18 of the 23 Latin American countries. Most urban streams are impacted or degraded, and inputs of contaminants and wastewater discharges were considered major drivers of stream degradation. Most respondents indicated that stream channelization is common, with some streams completely channelized or buried. Sewage and rainfall runoff management were identified as a major factor degrading streams, with most respondents suggesting that streams are a primary destination for wastewater discharge, much of which is untreated. Major limitations to urban stream conservation in Latin America are the result of limited ecological knowledge, lack of citizen interest or political will to protect them. There are isolated efforts to restore urban streams and riparian zones, but these are initial steps that need further development. Conclusions: Our research network of Latin American scientists proved to be a valuable tool to assess a large number of urban rivers in a relatively understudied region. Urban streams in Latin America face a diversity of stressors and management challenges, and we propose three areas that would benefit from further research to improve our understanding and management of these systems: (1) Studies should focus on the watershed, rather than isolated reaches, (2) researchers should strive to attain a better understanding of ecosystem function and the services provided by urban streams to justify management and restoration efforts, and (3) studies that integrate economic models where downstream users pay for upstream protection and restoration could prove beneficial for many Latin American cities in attempting to address water conservation issues.

Introducción: Latinoamérica es una región altamente urbanizada, con la mayoría de su población viviendo en ciudades y centros urbanos. Es bastante limitada la información sobre los ríos urbanos en esta región, sin embargo, se reconocen algunas problemáticas ambientales sobre estos ecosistemas urbanos, los cuales suelen ser similares en toda la región. Algunas de estas son la pérdida de hábitat, la canalización, la descarga de aguas residuales, la basura y la pérdida de zonas ribereñas. Objetivo: Nuestro propósito es obtener información sobre la condición, el estado del conocimiento y las amenazas de nuestros ríos urbanos en Latinoamérica. Métodos: Para esto se compartió una encuesta entre investigadores de la región, contactados en su mayoría a través de la red Macrolatinos@ (www.macrolatinos.net). Resultados: Se recibieron 104 respuestas de personas en 18 países, de los 23 que conforman Latinoamérica. La mayoría de los ríos urbanos se encuentran degradados, principalmente por los aportes de contaminantes y la descarga de aguas residuales. Existen ríos que han sido canalizados completamente, sin embargo, otros presentan algunos tramos con estructuras duras y muy pocos muestran una condición natural. El manejo de las aguas residuales y de la escorrentía de lluvias se identificaron como un factor importante en estos ríos. Es común encontrar sistemas combinados de alcantarillado y escorrentía de lluvias, que finalmente se mezclan y llegan a los ríos sin un tratamiento considerable. Las principales limitaciones para la conservación y restauración de los ríos urbanos en Latinoamérica es la falta de conocimiento ecológico, el desinterés del ciudadano y la falta de voluntad política. Aunque existen esfuerzos aislados que viene trabajando por restaurar tanto los ríos como las zonas ribereñas, estos son pasos iniciales que necesitan un mayor desarrollo. Conclusiones: Nuestra red de investigación de científicos latinoamericanos demostró ser una herramienta valiosa para evaluar una cantidad de ríos urbanos de forma rápida y precisa. Nuestros ríos enfrentan una serie de impactos estresantes, por lo que requieren urgente gestión. Se proponen tres áreas o enfoques particulares para mejorar la comprensión y gestión de los ríos urbanos en Latinoamérica: (1) Los estudios deben centrarse desde la visión de cuenca, (2) Es necesario una comprensión de la función del ecosistema acuático y la identificación de los servicios ecosistémicos, para justificar la gestión y restauración, y finalmente, (3) Los modelos de pagos por servicios ambientales pueden ser una buena estrategia para gestionar proyectos de conservación y restauración en las cuencas altas de estos ríos urbanos.

Weathering the storm: COVID-19 infection in patients with hematological malignancies / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.

Weathering the storm: COVID-19 infection in patients with hematological malignancies / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.

Adaptive Responses to Climate Change: Evaluating the Implementation and Effectiveness of Water Resource Management Strategies in Selected Hotels within the Environs of Lake Naivasha

Aims: This study sought to evaluate the adoption of water resource management strategies in hotels in an attempt to attain water sustainability. Specifically, the research sought to assess the current structural and non-structural water resource management strategies adopted by selected hotels in the environs of Lake Naivasha; establish the perceived effectiveness of both the structural and non-structural water resource management strategies adopted to enhance water sustainability; and compare the structural and non-structural water management strategies in terms of their effectiveness in promoting water sustainability in hotels within environs of Lake Naivasha. Study Design: The study adopted a case study design. Place and Duration of Study: This study was conducted in hotels within the environs of Lake Naivasha between May and December 2010. Methodology: A census of 30 Class (A) registered hotels was conducted, and purposive sampling was used to select 120 respondents from the management staff within the selected hotels. Convenience sampling was used to select 8 managers of water management bodies who acted as key informants during personal interviews. Primary data was collected from the hotel management staff using questionnaires and from managers of water management through personal interviews. Data from questionnaires were analysed using the Statistical Package for Social Science (SPSS) to derive descriptive statistics on the implementation of WRM strategies. Results: Findings revealed that a majority of the sampled hotels had embraced water resource management strategies through the development of alternative water resources, use of water saving technology, treatment of recycled water and use of water saving manuals. Further, the structural water resource management strategies were perceived to be more effective as they impacted more on reducing the operating costs, promoted environmental conservation and were more preferred than the non- structural strategies despite being more expensive to implement. Conclusion: It is concluded that water sustainability is however achievable through a combination of a variety of WRM strategies.

Algoritmo de insuficiencia cardíaca aguda Manejo inicial:: etapa prehospitalaria, departamento de emergencias, internación en unidad coronaria

Con la finalidad de "saber qué hacer" en el ámbito de la urgencia de una insuficiencia cardíaca aguda y con el objetivo de optimizar las estrategias de diagnóstico y tratamiento en el primer contacto con un paciente que podría estar cursando esta patología, se presentan en este artículo, conceptos fundamentales sobre definiciones de esta patología, clasificaciones clínicas y hemodinámicas, manejos iniciales en diferentes escenarios (etapa pre hospitalaria, departamento de emergencia, ingreso a unidad coronaria) y finalmente, un algoritmo diagnóstico y terapéutico para la rápida toma de decisiones. Es nuestro objetivo que médicos generalistas, clínicos, internistas y/o cardiólogos, puedan en una forma organizada y eficiente optimizar el diagnóstico y manejo precoz de esta condición clínica que amenaza la calidad de vida y supervivencia.

Algorithm of acute heart failure Initial management: prehospital stage, emergency department, admission to coronary unit In order to "know what to do" in the area of acute heart failure and with the objective of optimizing diagnostic and treatment strategies in the first contact with a patient who might be attending this pathology, article, fundamental concepts on definitions of this pathology, clinical and hemodynamic classifications, initial management in different scenarios (prehospital stage, emergency department, coronary unit admission) and, finally, a diagnostic and therapeutic algorithm for rapid decision making. It is our goal that general practitioners, clinicians, internists and / or cardiologists, in an organized and efficient way, can optimize the diagnosis and early management of this life-threatening clinical condition.

Algoritmo de insuficiência cardíaca aguda Manejo inicial: estágio pré-hospitalar, departamento de emergências, admissão à unidade coronária Para "saber o que fazer" na área de insuficiência cardíaca aguda e com o objetivo de otimizar estratégias de diagnóstico e tratamento no primeiro contato com um paciente que possa estar atendendo a esta patologia, artigo, conceitos fundamentais sobre definições desta patologia, classificações clínicas e hemodinâmicas, gerenciamento inicial em diferentes cenários (estágio pré-hospitalar, departamento de emergência, admissão da unidade coronária) e, finalmente, um algoritmo diagnóstico e terapêutico para a tomada de decisões rápidas. Nosso objetivo é que clínicos gerais, clínicos, internistas e / ou cardiologistas, de forma organizada e eficiente, possam otimizar o diagnóstico e o gerenciamento precoce desta condição clínica que ameaça a vida.

Discussion on the management strategy of patients aged over 70 years with esophageal cancer / 中国胸心血管外科临床杂志

@#Esophageal cancer (EC) is the eighth dangerous cancer in the world. As the global population ages, the management of elderly patients with EC poses a challenge as they have many aging-associated diseases and physiological changes. In addition, the data on the tolerability of cancer treatment and the use of combined therapies in the patients to guide their treatment are limited. In this paper, we reviewed the literatures and discussed the effect of surgical resection and the potential complications of elderly patients. We reviewed the basic principles of combined therapy and the potential benefits of chemotherapy or chemoradiotherapy for patients and focused on the management of elderly patients with EC as well as the role of comprehensive assessment for aging to provide treatment options for elderly patients.

A externalização como estratégia da gestão de serviços públicos locais / La externalización como estrategia de gestión en los servicios públicos locales / Outsourcing as management strategy in local public services

Resumen A modo de contribución al debate académico sobre el uso de la externalización como fórmula de provisión de los servicios públicos locales, el artículo plantea focalizar la atención en los factores político-institucionales. A partir de la revisión de los principales argumentos presentes en la literatura se plantea su contraste empírico a través de un estudio transversal que comprende todos los municipios de más de 5 mil habitantes de Catalunya, una Comunidad Autónoma española. Se construye una tipología de municipios mediante un análisis de componentes principales y un análisis clúster y se contrasta la existencia de diferencias en el porcentaje de externalización entre tipos de municipios. Los resultados muestran la relevancia de los factores político-institucionales en la selección de la fórmula de prestación de servicios y permiten identificar tres estrategias que plantean la externalización como mecanismo de flexibilidad en la gestión pública.

Resumo Como contributo para o debate acadêmico sobre o uso da terceirização como um meio de fornecer serviços públicos locais, o artigo se propõe a chamar a atenção para os fatores políticos e institucionais. A partir da revisão dos principais argumentos presentes na literatura, seu contraste empírico surge por meio de um estudo transversal que compreende todos os municípios com mais de 5 mil habitantes da Comunidade Autônoma da Catalunha, na Espanha. Elabora-se uma tipologia de municípios mediante uma análise de componentes principais e uma análise de clusters em que se contrastam as diferenças de percentagens de externalização entre diferentes tipos de municípios. Os resultados mostram a importância dos fatores políticos e institucionais na escolha da fórmula de prestação de serviços e permitem identificar três estratégias que enfocam a externalização como um mecanismo de flexibilidade na gestão pública.

Abstract As a contribution to the academic debate on the use of outsourcing as a formula for the provision of local public services, the article proposes to focus attention on political-institutional factors. The paper departs from the review of the main arguments highlighted by the literature and it contrasts their expected results in cross-sectional study based on data from all the municipalities with over 5,000 inhabitants in Catalonia, a Spanish Autonomous Community. A typology of municipalities is constructed through principal component analysis and a cluster analysis and the existence of differences in the percentage of outsourcing among types of municipalities is tested. The results show the relevance of political-institutional factors in the selection of the service provision formula and allow us to identify three strategies that propose outsourcing as a mechanism of flexibility of public management.

Diagnosis and management strategies of multiple primary lung cancer / 中国医学影像技术

With the development of MSCT and the widely applications of low-dose CT screening for lung cancer,the incidence of multiple primary lung cancer (MPLC),especially for which is characterized by ground glass opacity (GGO).However,the current clinicopathological criteria,molecular genetic technology and management strategies can not meet the needs of individualized demand.The latest progresses in the diagnostic aspects of MPLC,estrogen concentration in synchronous MPLC,molecular genetic characteristics,and management strategies of MPLC were reviewed in this paper.

Effect of caregiver characteristics on dementia management strategies / Efeito das características dos cuidadores nas diferentes estratégias de gerenciamento da demência

ABSTRACT. Caregiving has an important influence on the prognosis of dementia, particularly regarding the management strategy implemented. Therefore, evaluating which characteristics of caregivers can influence the choice of a particular strategy for managing dementia is needed. Objective: To evaluate the association between characteristics of caregivers and their management strategies as applied to patients with dementia. Methods: A cross-sectional study involving 45 professional caregivers from two nursing homes in Porto Alegre, Brazil, was conducted. Age, gender, education, years as a caregiver, income, burden, depressive and anxiety symptoms and dementia management strategies were evaluated for all participants. Pearson's or Spearman's correlation tests were applied according to the variable distribution (parametric or non-parametric). Bivariate correlation analysis was applied. P<0.05 was considered statistically significant. Results: There was a significant and moderate positive correlation between burden measured by the Zarit Burden Interview and criticism measured by the Dementia Management Strategies Scale (Spearman's rho = 0.555, p < 0.001). No other correlations were observed. Conclusion: Among the caregiver characteristics that directly affect the approach to managing dementia, high caregiver burden was found to be associated with high criticism, an authoritative way of managing dementia. This exploratory study indicated that a possible way of decreasing negative dementia management is to reduce caregiver burden.

RESUMO. A forma de cuidar o paciente tem uma influência importante no prognóstico da demência, principalmente no que diz respeito às estratégias utilizadas por cuidadores para manejar sintomas comportamentais destes pacientes. Assim, faz-se necessário avaliar quais características dos cuidadores poderiam influenciar na escolha de uma estratégia específica para manejo da demência. Objetivo: Avaliar a correlação de variáveis dos cuidadores com as diferentes formas de manejo da demência. Métodos: Estudo transversal, com 45 cuidadores profissionais de duas instituições de longa permanência para idosos de Porto Alegre, Brasil. Idade, gênero, escolaridade, nível socioeconômico, anos de trabalho como cuidador, sobrecarga de cuidado, sintomas ansiosos e depressivos e estratégias de gerenciamento da demência foram avaliados. Foram utilizados os testes de correlação de Pearson ou Spearman, de acordo com a distribuição das variáveis (paramétricas ou não-paramétricas). Foi considerado como estatisticamente significativos valores de p < 0,05. Resultados: Houve correlação positiva moderada e significativa entre sobrecarga de cuidado pela Escala de Zarit e criticismo pela Escala de Estratégia de Gerenciamento da Demência (Spearman rho = 0,555, p < 0,001). Não foram observadas outras correlações. Conclusão: Entre as características dos cuidadores que afetam diretamente a forma de manejo da demência, percebemos que a sobrecarga de cuidado foi associada ao alto criticismo, uma forma autoritária de manejo da demência. Este estudo exploratório aponta que uma possível maneira de reduzir estratégias negativas de gerenciamento da demência é reduzir a sobrecarga do cuidador.

Analysis of laboratory critical value reporting in the department of spine surgery and management strategies / 中国实用护理杂志

Objective To investigate the common critical value (CV) of patients hospitalized in the department of spine surgery and to determine the corresponding management. Methods Medical records of patients between 2013 January and 2014 December were retrospectively reviewed. 47 cases with CV were noted. The following characteristics of CV were recorded and analyzed, including time-point at occurrence, type, reason and management. Results Most of the CVs (43/47, 91.5%) were detected between 8 am to 12 am, and between 17 pm and 21 pm. Overall, there were 24 cases of abnormal blood electrolyte (51.1%), 13 cases of abnormal routine blood test (27.7%), 5 cases of abnormal blood coagulation test (10.6%), and 1 case of abnormal TnT (2.1%). The remaining 4 cases including 2 cases detected in the night (1 case of abnormal blood gas test and 1 case of abnormal TnT) and 2 cases detected in the afternoon (1 case of positive blood bacteria culture and 1 case of low blood glucose level). Conclusions The most common CVs were summarized in the clinical practice. The findings have important clinical implications concerning the management of these CVs. In addition, preventive modality of daily nursing and standardization of medical management should be applied so as to ensure the safety of patients and rapid recovery.

Effects of self-management strategies on the self-efficacy and self-management behavior in female college students with primary dysmenorrhea / 中华行为医学与脑科学杂志

Objective To explore the effects of self-management strategies on self-efficacy and selfmanagement behavior in female college students with primary dysmenorrhea.Methods Implementing the plan that the interventional group (n=195) received self-management strategies,while the control group (n =196) did not received any intervention.Followed up six months,the self-efficacy and self-management behaviors and Visual Analogue Scale/Score (VAS) of dysmenorrhea pain were compared between two groups before and after the intervention.Results At the 6th month of observation period,the scores of self-efficacy in the intervention group (2.61 ±0.48) were significantly improved compared with the baseline (2.37 ± 0.36) and the control group(2.43±0.46) (both P＜0.05).Besides taking medicine to alleviate dysmenorrhea,other items in the self-management behaviors were significantly higher than baseline and control group (both P＜ 0.05).The mean of dysmenorrhea pain VAS of 6th menstrual period in the intervention group was lower than baseline and the control group (P＜0.05).Conclusion The self-management strategies can effectively improve the self-efficacy and self-management behaviors among female college students,and alleviate the degree of dysmenorrhea pain.

Hipertensión arterial secundaria en el adulto: evaluación diagnóstica y manejo / Secondary arterial hypertension in adults: diagnostic assesment and management

La Hipertensión arterial (HTA) es un grave problema de salud pública mundial. En efecto, sus complicaciones causan anualmente 9,4 millones de muertes. La HTA también es un problema de salud de alto impacto en Chile. De hecho, la Encuesta Nacional de Salud (ENS) 2009-2010 del Ministerio de Salud, reportó una prevalencia del 26,9%. La HTA se define como una Presión arterial sistólica (PAS) 140mmHg y/o una Presión arterial diastólica (PAD) 90mmHg. Tradicionalmente, se ha clasificado la HTA en primaria o esencial, que agrupa a más del 90% de los hipertensos adultos; y en secundaria, que reúne a menos del 10% de los hipertensos. En la evaluación inicial de un paciente con HTA, se debe: Confirmar el diagnóstico; 2) Detectar causas de HTA secundaria, y 3) Evaluar riesgo cardiovascular (CV), daño orgánico y comorbilidades. Para ello, se necesita determinar la Presión Arterial (PA) y la historia clínica, que incluya antecedentes familiares, examen físico, pruebas de laboratorio y pruebas diagnósticas adicionales. En un pequeño porcentaje de adultos con HTA, se puede identificar una causa específica y potencialmente reversible; no obstante, debido a su elevada prevalencia, las formas secundarias pueden afectar a millones de pacientes en todo el mundo. Se puede sospechar una forma secundaria de HTA por un alza marcada de la PA, la aparición o empeoramiento repentinos de una HTA, una mala respuesta de la PA al tratamiento farmacológico y por un daño orgánico desproporcionado para la duración de la HTA. Si la evaluación inicial hace pensar que el paciente tiene una HTA secundaria, entonces se debe tener en consideración las causas más relevantes, que se describen en este artículo.

Arterial hypertension is a serious public health problem worldwide. Indeed, its complications cause 9.4 million deaths annually. Hypertension is also a health problem with high impact in Chile. In fact, the National Health Survey 2009-2010, conducted by the Ministry of Health, showed a prevalence of 26.9%. Arterial hypertension is defined as systolic blood pressure (SBP) 140mmHg and/or diastolic blood pressure (DBP) 90mmHg. Traditionally, hypertension has been classified into primary or essential, which represents over 90% of adults with hypertension; and secondary, which includes less than 10% of hypertensive patients. The initial evaluation of a patient with hypertension should: 1) Confirm the diagnosis of hypertension; 2) Detect causes of secondary hypertension; and 3) Assess cardiovascular risk, organ damage (OD) and concomitant clinical conditions. This calls for blood pressure (BP) measurement, medical history including family history, physical examination, laboratory investigations and further diagnostic tests. A specific, potentially reversible cause of BP elevation can be identified in a relatively small proportion of adult patients with hypertension. However, because of the overall high prevalence of hypertension, secondary forms can affect millions of patients worldwide. A secondary form of hypertension can be indicated by a severe elevation in BP, sudden onset or worsening of hypertension, poor BP response to drug therapy and OD disproportionate to the duration of hypertension. If the initial assessment suggests that the patient has a secondary hypertension, then you should take into consideration the relevant causes, which are described in this article.

Antepartum Bleeding of Unknown Origin and Sequlae.

Antepartum bleeding of unknown origin (ABUO) seems to be one of the most common causes of bleeding in third trimester of pregnancy, but has not been studied well. Objective : The present study was aimed to study the incidence, management strategies and the perinatal outcome in cases of ABUO. Methods : Cases diagnosed as ABUO and managed at the rural referral hospital over last 5 years were analyzed. The diagnosis of ABUO was by exclusion of placental abruption, placenta previa and possible causes of bleeding in the lower genital tract by clinical and ultrasonographic examination. Results : The incidence of ABUO was 0.60 % of births. Of all cases of antepartum haemorrage 18.1% were of teenage and of ABUO10.3% cases were of teenage cases compared to overall 5% cases teenage. Perinatal Mortality Rate (PMR) in cases of ABUO was 237, significantly higher than overall PMR of 66 (p value <0.001) during the study period. Preterm births were the most common cause of perinatal mortality in ABUO. Conclusion : Women with ABUO may not need special interventions, but when ABUO occurs preterm births and perinatal loss increase ,so deaths due to prematurity need to be prevented.

Analysis of heavy metals in dying wetland Pallikaranai, Tamil Nadu, India.

Pallikaranai wetland has high ecological significance as it has been a home for other associated biodiversities. This wetland is highly polluted due to the rapid industrialization, urbanization and dumping of solid waste. The water quality of the Pallikaranai wetland has been studied with reference to toxic metals. The metals analyzed include lead, chromium, iron, copper, nickel, zinc and cadmium. The heavy metal analysis in surface waters were in the following range ; Cd : BDL – 0.019 mg l-1, Fe : BDL – 1.52 mg l-1, Cu : BDL – 0.02 mg l-1, Ni : BDL- 0.60 mg l-1, Pb : 0.03 – 1.13 mg l-1, Zn : 0.002 – 0.14 mg l-1 and Cr : 0.10 – 1.52 mg l-1 respectively. The dominance of various heavy metals in the surface water of the Pallikaranai wetland followed the sequence: Pb> Cr > Fe > Ni > Zn > Cd > Cu. The quality of water has deterioted due to the various anthropogenic activities. Most of the metal ions were in higher concentration compared to the standards. It has been observed that the quality of the surface water is not safe for aquatic and domestic life, hence necessary management actions should be taken to control the quality of the surface water.

Causes of salinity and plant manifestations to salt stress: A review.

Salinity in agricultutal terms is the excess of salts above the level plant require. Most often it poses constrains in the growth hence productivity of the category of plants called glycophytes, wherein falls major crops, therefore is a serious concern. It is often recognized as excess of sodium ions (sodicity) that imparts life threatening consequences in plant due to mal-textured soil hindered porosity and aeration leads to physiological water deficit. Mingling with other edaphic/environmental factors viz. precipitation, temperature, flooding, soil profile, water table exaggerates the catastrophe synergistically. Improper irrigations system, leaching fraction added with land clearing and deforestation have been marked as the major cause. The present review underlines the different sources of salinity stress and their physiological manifestations, toxicity responses alongwith tolerance in plants and management strategies in affected landscapes.

Dermatitis atópica / Atopic dermatitis

La dermatitis atópica (DA) es una dermatosis pruriginosa crónica caracterizada por múltiples exacerbaciones y remisiones que se manifiestan de distintas formas según la edad del paciente. La DA es una de las patologías dermatológicas más comunes en los niños, con una prevalencia que varía entre el 5 y 20 por ciento en la primera década de la vida. En los pacientes con DA hay una tendencia a desarrollar otras condiciones alérgicas como eczema, asma y rinitis alérgica, lo que se denomina diátesis atópica, sin embargo, el fundamento fisiopatológico de esta asociación aún no ha sido aclarado y/o incluso es controversial. La DA es el resultado de interacciones genéticas, metabólicas, infecciosas, inmunes, neuroendocrinas y ambientales, por este motivo el manejo es complejo, multifactorial y las estrategias son hacia los distintos focos patológicos de cada caso en particular.

The atopic dermatitis (AD) is a chronic pruritic dermatitis, typified by multiple flare ups and remissions, which can vary according to the patients age. The AD is one of the most common childhood pathologies affecting between 5 to 20 per cent of the children before they reach the age of 10. Patients suffering from AD are prone to developing other allergic reactions such us eczema, asthma and allergic rhinitis. This condition is known as atopic diathesis; however, the physio-pathological basis of this association has not yet been clarified and is rather controversial.AD is the end result of a number of genetic, metabolic, infectious, immune, endocrine and environmental interactions, which makes it hard to treat because of the various aspects involved and the management strategies needed to deal with each particular case.