Level Of Consciousness Research Articles

Predictors of Clinically Important Neuroimaging Findings in Children Presenting Pediatric Emergency Department.

The aim of the study is to evaluate predictors of clinically important neuroimaging results, that is, computed tomography and magnetic resonance imaging in children in an academic pediatric emergency department (PED) from 2015 to 2019. This study was conducted in an academic PED. The patient's demographic and clinical characteristics of PED visits and neuroimaging findings requested at the PED were recorded for January 1, 2015, to December 31, 2019. In addition, descriptive statistics and logistic regression analyses were conducted. We described and determined the predictors of clinically important neuroimaging findings in children. Clinically important neuroimaging findings were detected in patients with blurred vision ( P = 0.001), ataxia ( P = 0.003), unilateral weakness ( P = 0.004), and altered level of consciousness ( P = 0.026). Clinically important neuroimaging was found 9.4 times higher in patients with altered level of consciousness, 7.4 times higher in patients with focal weakness, 4.6 times higher in patients with blurred vision, and 3.5 times more in patients presenting with ataxia. Advanced neuroimaging, especially for selected patients in PED, can improve the quality of health care for patients. On the other hand, irrelevant neuroimaging findings can lead physicians away from prompt diagnosis and accurate management. According to our study, advanced neuroimaging can be performed in the early period for both diagnosis and early treatment, especially in selected patients with ataxia, blurred vision, altered consciousness, and unilateral weakness. In other cases, clinicians may find more supporting evidence.

Prognostic models and factors identifying end-of-life in non-cancer chronic diseases: a systematic review

BackgroundPrecise prognostic information, if available, is very helpful for guiding treatment decisions and resource allocation in patients with non-cancer non-communicable chronic diseases (NCDs). This study aimed to systematically review the...

Consumer Behavioural Patterns Towards Milk and Dairy Products: An Analytical Investigation of an Indian Dairy Supply Chain

Background: India has the most significant milk production and consumption level in the world. Fluid milk consumption will rise to 90 million metric tons in FY 2024 (Annual Report 202-23, United States Department of Agriculture). Milk is an essential component of daily diet in every age segment in India. Consumers’ behaviour and consumption patterns are based on their choices and preferences about product quality, price and preferences. This article critically investigates the consumer perception towards indigenous dairy markets and their consumption and behavioural pattern. Methods: Quantitative approach and Multiple Logistic Linear Regression Analysis (MLLRA) technique was used to test the hypothesis to establish a direct and indirect relationship among endogenous and exogenous variables. The sample was drawn from rural and urban regions of India’s top ten milk-producing states. Result: The research findings suggested a significant relationship between the direct and indirect role of consumers buying behaviour characteristics towards milk and dairy products and their satisfaction level. This research is limited to milk processors, dairy companies and dairy scientists in the field of marketing and dairy research. Dairy Farmers, Processors and Producers are vigilant about the quality of food products, especially milk delivered to their end users and their value-addition in the Milk Supply Chain (MSC) and logistics. In the past three years, during the unprecedented COVID-19, consumers’ consciousness level about health and well-being has been argued.

The Role of Smart City in Achieving Sustainable Development: Google Trends Analysis and Exponential Time Series Smoothing Models

The concept of sustainable smart urban development is an important element of the modern discourse on the future development of cities, regions, and the world as a whole, a key component of a strategy aimed at introducing innovations, improving the life quality of citizens, ensuring inclusiveness and sustainability of local development. It integrates the concept of Smart City as the application of advanced innovative technologies to solve urban problems and the concept of Sustainable Development as a balancing of socio-economic and environmental interests to achieve the Sustainable Development Goals. While discussing the problems and prospects introducing any social models or strategies, it is important to understand the level of public interest in this issue, the level of citizens’ awareness, the readiness to receive new information, and the readiness for change. The article is focused on the analysis of retrospective dynamics (from 01.01.2010 to 01.12.2023) and economic and mathematical modelling of forecast trends in changing public interest in the concepts of “Smart City” and “Sustainable Development” (identified using the Google Trends tool). The analysis was carried out for the world as a whole and for Ukraine specifically. The study identifies and describes the evolution of changes in public interest in these topics, identifies the time points of a sharp surge in interest, and conducts a comparative analysis in the content (trends for these two search queries) and spatial context (trends in Ukraine compared to global trends). The countries of the world and regions of Ukraine where user interest in the relevant topics dominates are ranked, and the countries of the world and regions of Ukraine where user interest in the relevant topics dominates are ranked, the TOP-10 are identified. The factors whose influence is relevant to the public interest dynamics are identified (consumer trends, media activity, dynamics of the introduction of relevant concepts, cultural, linguistic, and historical contexts, the general level of education, digital inclusion and consciousness of the population of different countries, etc.) Using the exponential smoothing method, models were built to predict the dynamics of time series – the number of queries from Ukrainian Internet users regarding the concepts of “Smart City” and “Sustainable Development”. Additive forecasting models, which differ in the trend component, are obtained.

Surgical management of spontaneous posterior fossa hematoma: predictors of the neurological outcome

ObjectiveTo detect demographic, clinical, and radiological predictors of patient outcomes and prognosis in spontaneous cerebellar hematoma patients that may guide accurate decision making.MethodsThis retrospective study was conducted on 45 patients with spontaneous cerebellar hematoma who underwent surgical treatment. The patient data including demographics (age, gender), preoperative consciousness at the time of admission, medical comorbidities (HTN, DM), radiological findings (location, volume, and diameter of the cerebellar hematoma, hydrocephalus, compression of the fourth ventricle, effacement of the quadrigeminal cistern, intraventricular hematoma, tight posterior fossa, and brain stem compression), and treatment methods were collected and correlated with prognosis. Outcome assessment was done using the Glasgow Outcome Scale (GOS), classified into good outcome (favorable result; GOS > 4) and poor outcome (unfavorable result; GOS < 4).ResultsThere was a statistically significant correlation (p = 0.030) between the time to surgery and GOS, with more favorable outcomes in patients who underwent early surgery compared to late surgery. Unfavorable outcomes were detected in patients with higher Taneda grade and Kirollos grade, and both were statistically significant (p = 0.001). The presence of hydrocephalus and/or brainstem compression had a statistically significant (p < 0.001) negative impact on outcomes. Patients with extensive IVH had an unfavorable outcome compared to other patients (p = 0.016). The mortality rate in our study was 28.9%.ConclusionsSurgical management of spontaneous cerebellar hematoma is challenging. Many factors influence the appropriate decision making and surgical outcome. Predictors of an unfavorable outcome include the level of consciousness at admission, delayed time to surgery, a higher grade of 4th ventricular effacement (Kirollos) and quadrigeminal cistern effacement (Taneda), extensive IVH, hydrocephalus, and brainstem compression (statistically significant). There was no statistical significance regarding gender, age, hematoma volume, or hematoma diameter in relation to an unfavorable outcome.

Ictal kissing: Review of literature and report of 5 cases.

Ictal kissing (IK) is a rare type of automatism observed during epileptic seizures. Despite its uncommon occurrence, understanding the underlying mechanisms, the role of emotions, and the level of consciousness during seizures with IK is essential in providing a comprehensive understanding of epilepsy. We describe five cases (.13%) of IK after performing a retrospective analysis of 3794 long-term, ictal video-EEGs from an epilepsy monitoring unit in Mumbai, India. Our patients with drug-resistant epilepsy showed IK had a wide epileptogenic zone. We discuss the current hypotheses on the mechanisms behind IK, the involvement of temporal lobe structures, and the implications of awareness during seizures. The review concludes by suggesting future directions for research to elucidate the complex phenomenon of IK further.

Análisis retrospectivo de las hipoglucemias inducidas por venlafaxina en pacientes con sobredosis

IntroductionRecent publications relate the presence of hypoglycemia in venlafaxine (VLX) poisoning depending on the dose. Our aim was to analyze the clinical characteristics of patients who presented hypoglycemia induced by VLF overdose. Patients and methodsRetrospective study carried out in the Balearic Islands (2020–2023). Inclusion criteria: serum concentrations of VLX + O-desmethyl-venlafaxine (O-VLX)>800 ng/mL. The characteristics of patients with and without hypoglycemia were compared. ResultsTwenty-one patients were included, 8 (38.1%) with hypoglycemia. No differences were found in the doses referred to in both groups. Peak concentrations of VLX + O-VLX (ng/mL) were 9,783 [4,459–17,976] in patients with hypoglycemia and 1,413 [930–1,719] in patients without hypoglycemia (p<0.0001). The presence of hypoglycemia was associated with: lower age and level of consciousness; and higher frequency of suicide attempts, seizures, mydriasis, tachycardia and serotonin syndrome, invasive respiratory support, fluid therapy and ICU admission (p<0.05). ConclusionsThe detection of hypoglycemia in a VLX overdose case is a readily available marker to suspect the severity of the patient. In any case, serum concentrations when available allow us to confirm intoxication.

Artery of Percheron Infarction: Clinical Presentation and Outcomes.

Occlusion of the artery of Percheron (AOP) produces bilateral thalamic infarction classically leading to deficits of arousal. This nonspecific presentation complicates the diagnosis of acute ischemic stroke. We sought to describe the spectrum of clinical presentation, diagnostic neuroimaging findings, and outcomes in AOP infarction (AOPi). We conducted a keyword search of our health system's neuroimaging database from 2014 to 2022 to identify patients with AOPi. We abstracted patient demographics, clinical presentation, neuroimaging findings, acute treatment, and modified Rankin Scale (mRS) scores (at baseline, 3 months, and 12 months). We used descriptive statistics to report our findings. Our initial keyword search identified 192 potential AOPi cases. Fifteen cases of AOPi were confirmed and included in our study (8 female [53%], median age 65 years [interquartile range (IQR): 59.5-79.5], median presenting NIHSS 6 [IQR: 2-22]). Common clinical findings on presentation were systolic blood pressure (SBP) > 140: 12 patients (80%); decreased level of consciousness (LOC): 11 patients (73%); diplopia: 8 patients (57%); disorientation: 6 patients (42%); dysarthria: 4 patients (28%); and acute memory/cognitive disturbance: 3 patients (21%). Twelve cases (80%) presented to the emergency department (ED). Median time from symptom onset to ED arrival was 774.5 minutes (IQR: 202.25-3789.0), 4 cases (27%) arrived within 4.5 hours, and one patient (7%) received intravenous thrombolysis. The median time from ED arrival to stroke diagnosis was 519.0 minutes (IQR: 227.5-1307). Head CT was only diagnostic when obtained >570 minutes from time last known well; MRI was diagnostic at all time points. Rates of functional independence (mRS ≤2) at baseline, 3 months, and 12 months were 64%, 21%, and 18%, respectively. The diagnosis of stroke was considerably delayed in patients with AOPi, and only one patient received IV thrombolysis. SBP >140, impaired consciousness, and diplopia were the most common findings at presentation. CT was often nondiagnostic, but MRI demonstrated bilateral thalamic infarct in all cases. AOPi caused considerable long-term morbidity. Clinicians should maintain a high degree of suspicion for AOP stroke and consider thrombolysis in appropriately selected patients.

Evaluation of qCON and qNOX indices in pediatric surgery under general anesthesia.

The objective of the study was to evaluate the performances of qCON and qNOX indices in pediatric populations undergoing surgery under general anesthesia (GA), focusing on the induction and recovery periods. Both the indices are derived from electroencephalogram (EEG) and implemented in the CONOX monitor (Fresenius Kabi, Germany). After approval of the institutional ethics committee, this prospective observational study was conducted in pediatric patients of either sex in the age group of 1-12 years belonging to the American Society of Anesthesiology (ASA) grade I and II undergoing elective surgery under GA. Anesthetic technique was GA with or without regional analgesia (RA). All patients underwent inhalation induction and maintenance using sevoflurane. Patients were monitored with the use of a CONOX monitoring system (Fresenius Kabi, Germany), connected via a set of electrodes placed over the forehead. qCON and qNOX scores were recorded during awake (on operating table premedicated with oral midazolam 0.5 mg/kg), at induction, at loss of eyelash reflex, intubation/laryngeal mask airway (LMA) insertion, before and after regional anesthesia, surgical incision, at cessation of anesthesia, emergence, extubation, and eye-opening. Registered results were also analyzed compared with the minimum alveolar concentration of sevoflurane (MAC). A total of 46 pediatric patients were enrolled in the study with a mean age of 5.6 years. All the patients were either ASA I or II. There was a simultaneous fall and rise of qCON and qNOX upon induction and recovery, respectively. There was a rise in qNOX with surgical incision irrespective of RA. However, there was a greater rise in qNOX following surgical incision in those who did not receive RA (P = 0.33) Also both qCON (P = 0.06) and qNOX (P = 0.41) were poorly correlated with MAC values of sevoflurane during GA in the pediatric population. Both qCON and qNOX values change predictably with changes in the conscious level and with different noxious stimuli. Further studies are required to confirm the findings taking into account the postoperative assessment of delirium and recall of intraoperative events.

Class mobilisation and class consciousness in the British strike wave of 2022–23

For a brief period, the British strike wave of 2022-23, which broke out during the inflationary surge and subsequent ‘cost of living crisis’, both reflected and enabled the articulation of a heightened level of class consciousness, given expression by the left of the trade union movement. The widespread collapse in living standards interacted with the longerterm weakening of consumption-based identities in the wake of the financial crash, and the manifest profiteering of big business, to create a moment where it was possible for union leaderships to describe the strike wave and the plight of working people in terms of a class struggle. The longer-term legacy of this moment is yet to become clear.

Liquor for breakfast, fighting against alcohol consumption

IntroductionThe harmful consumption of alcohol is known for how tortuous its management can be in mental health, encouraging introspection of it as a serious problem is perhaps the main key to starting to battle against its damaging influence on the development of a functional and full life.ObjectivesTo describe a clinical case showing an unpredictible complication in an alcohol detoxification process.Methods54-year-old man, native of Cádiz, widowed for half a decade, without children. He resides with his parents in the family home. Currently unemployed for approximately a year. He has previously worked in the IT sector. As a notable somatic history, we found long-established arterial hypertension and a total hip replacement. He has been under irregular follow-up with a mental health team for anxiety-depressive symptoms in the context of grief. He goes to the emergency service brought by his family to begin the detoxification process in the hospital setting. He acknowledges ethanol consumption since he was widowed, which began when he awakes; quantities that ranged between one or up to three bottles of distilled liquor per day, generally consumption is in the home environment. A little less than a year ago, he began to isolate himself in his room and abandon his self-care, eating increasingly insufficient food intake, refusing to receive professional care to quit the habit, mainly because he did not recognize it as disruptive.The patient was admitted to hospital with symptoms suggestive of withdrawal, making it extremely difficult to control blood pressure levels. On the third day of admission to the acute care unit, fever peaks, blood pressure levels well below normal parameters, and compromised level of consciousness began to be evident.ResultsBlood tests were performed that, together with the clinical picture, suggested imminent septic shock, so critical care was contacted for transfer and stabilization. A germ of probable urinary etiology sensitive to a broad spectrum of antibiotics was isolated in blood cultures, and the medication of the detoxification process was progressively optimized. Once clinical stability was achieved at all levels, an inpatient cessation resource was managed, which the patient accepted and considered suitable for his complete recovery.ConclusionsA holistic approach to the alcoholic patient is important, since serious problems of an organic nature often arise. This is why a multidisciplinary intervention is necessary, as well as a holistic approach to care, involving both classic pharmacology and assiduous long-term psychotherapeutic intervention.Disclosure of InterestNone Declared

Association of Serum Macrophage Migration Inhibitory Factor with 3-Month Poor Outcome and Malignant Cerebral Edema in Patients with Large Hemispheric Infarction.

We aimed to investigate the associations of macrophage migration inhibitory factor (MIF), toll-like receptors 2 and 4 (TLR2/4), and matrix metalloproteinase 9 (MMP9) with 3-month poor outcome, death, and malignant cerebral edema (MCE) in patients with large hemispheric infarction (LHI). Patients with LHI within 24h of onset were enrolled consecutively. Serum MIF, TLR2/4, and MMP9 concentrations on admission were measured. Poor outcome was defined as a modified Rankin Scale score of ≥ 3 at 3months. MCE was defined as a decreased level of consciousness, anisocoria and midline shift > 5mm or basal cistern effacement, or indications for decompressive craniectomy during hospitalization. The cutoff values for MIF/MMP9 were obtained from the receiver operating characteristic curve. Of the 130 patients with LHI enrolled, 90 patients (69.2%) had 3-month poor outcome, and MCE occurred in 55 patients (42.3%). Patients with serum MIF concentrations ≤ 7.82ng/mL for predicting 3-month poor outcome [adjusted odds ratio (OR) 2.827, 95% confidence interval (CI) 1.144-6.990, p = 0.024] also distinguished death (adjusted OR 4.329, 95% CI 1.841-10.178, p = 0.001). Similarly, MMP9 concentrations ≤ 46.56ng/mL for predicting 3-month poor outcome (adjusted OR 2.814, 95% CI 1.236-6.406, p = 0.014) also distinguished 3-month death (adjusted OR 3.845, 95% CI 1.534-9.637, p = 0.004). Lower serum MIF and MMP9 concentrations at an early stage were independently associated with 3-month poor outcomes and death in patients with LHI. These findings need further confirmation in larger sample studies.

Alpha anteriorization and theta posteriorization during deep sleep.

Brain states (wake, sleep, general anesthesia, etc.) are profoundly associated with the spatiotemporal dynamics of brain oscillations. Previous studies showed that the EEG alpha power shifted from the occipital cortex to the frontal cortex (alpha anteriorization) after being induced into a state of general anesthesia via propofol. The sleep research literature suggests that slow waves and sleep spindles are generated locally and propagated gradually to different brain regions. Since sleep and general anesthesia are conceptualized under the same framework of consciousness, the present study examines whether alpha anteriorization similarly occurs during sleep and how the EEG power in other frequency bands changes during different sleep stages. The results from the analysis of three polysomnography datasets of 234 participants show consistent alpha anteriorization during the sleep stages N2 and N3, beta anteriorization during stage REM, and theta posteriorization during stages N2 and N3. Although it is known that the neural circuits responsible for sleep are not exactly the same for general anesthesia, the findings of alpha anteriorization in this study suggest that, at macro level, the circuits for alpha oscillations are organized in the similar cortical areas. The spatial shifts of EEG power in different frequency bands during sleep may offer meaningful neurophysiological markers for the level of consciousness.

Trends in reported GHB-related presentations to Sydney emergency departments between 2012 and 2021.

In overdose, gamma-hydroxybutyrate (GHB) and its precursors can cause decreased levels of consciousness, coma and death. Here, we aim to describe reported exposure to GHB at four EDs in Sydney, New South Wales (NSW), Australia. We searched the ED databases of four Sydney metropolitan hospitals for presentations relating to GHB exposure between 2012 and 2021. We calculated annual number of presentations stratified by hospital, age, sex, mode of arrival and triage category. A total of 3510 GHB-related presentations to ED were recorded across the four hospitals. Data for all hospitals were only available from 2015 onwards and between 2015 and 2021; there was a 114% increase in annual presentations (from 228 to 487). Males represented 68.7% of all presentations and the median age was 31 years (range 16-74 years). There was an increase in the proportion of female presentations between 2012 and 2021 (from 27.9% to 37.9%) along with the severity of presentation over the same period, with the proportion of presentations with a triage category 1 increasing from 19.7% to 34.5%. Increases in recorded absolute number and severity of GHB-related presentations to Sydney EDs are a major public health concern. There may also be shifts in the demographics of those with GHB-related presentations. Renewed efforts are required to understand the drivers of these increases to optimally target harm reduction approaches.

BRAIN AND CREATIVITY

Great ideas seem to come out of nowhere. Now we are one step closer to understanding how they appear. The areas responsible for language and creativity are thought to compete in the brain, which may explain why some people with brain damage suddenly become artists. Originality - or the ability to think of new ideas that do not occur to many people - is the key aspect of creativity. Researchers are trying to determine the mechanism by which originality is established. While creativity is generated by the right hemisphere of the brain, it is suppressed by language-specific processes in the left hemisphere: “Language regions may compete with the right hemisphere's ability to produce creative ideas.” This would explain why when areas responsible for language processing are affected, originality appears to increase. A brilliant idea is not enough to qualify a person as creative. Creativity is among the human characteristics whose mysteries we are still trying to understand. It seems almost impossible to find a clear definition for it, and it is equally difficult to look for its origins in the human brain. Many researchers define creativity as a special performance that is both new and appropriate. If we look at creativity as a concept rather than a trait, a number of factors must be considered. For example, an ingenious idea must be realized in such a way that it is visible and useful to others. Only a person who succeeds in this can truly be called creative. Creativity is a complex process that requires the activation of several areas of the brain. So far it is not clear whether creativity requires a specific neural architecture or not. At the root of all thoughts, emotions and behaviors is communication between neurons. Brain waves are the products of synchronized electrical impulses resulting from the communication of masses of neurons. The speed of brain waves is measured in Hz and are divided into categories that delineate slow, moderate and fast waves. They change according to activities or feelings. The electroencephalograph measures brain waves of different frequencies in the brain by using sensors placed on the scalp, the frequency representing the recurrence of a wave in one second. If any of these frequencies are deficient, excessive or difficult to access, psychic performance can suffer. Learning about brain waves and brain wave frequencies is key to understanding how to navigate and reprogram the mind, and to access deeper levels of consciousness. In neuroscience, there are five distinct brainwave frequencies, namely Beta waves, Alpha waves, Theta waves, Delta waves, and Gamma waves. Each frequency has its own set of characteristics representing a specific level of brain activity and a corresponding unique state of consciousness.

121 The Effectiveness of Deep Brain Stimulation in Patients With Disorders of Consciousness During Short- and Long-Term

INTRODUCTION: Disorders of consciousness (DoCs) impose heavy medical and economic burdens on families and society. Deep brain stimulation (DBS) has been preliminarily applied to treat patients with disorders of consciousness (DoCs). METHODS: Data from 365 patients with DoCs who were consecutively admitted from 15 July 2011 to 31 December 2021 were retrospectively analysed. Multivariate regression and subgroup analysis were performed to adjust for potential confounders. The primary outcome was improvement in consciousness at 1 year. The CRS-R was used to assess the level of consciousness of each patient. Scores on this scale may vary from 0 to 23, and six subscores are used to quantify auditory, visual, motor and verbal functions as well as communication and arousal. During the surgery, an electrode was implanted into the CM-Pf complex. RESULTS: An overall improvement in consciousness at 1 year was achieved in 32.4% (12/37) of the DBS group compared with 4.3% (14/328) of the conservative group. After full adjustment, DBS significantly improved consciousness at 1 year (adjusted OR 11.90, 95% CI 3.65–38.46, p &lt; 0.001). There was a significant treatment × follow-up interaction (H = 14.99, p &lt; 0.001). An priliminary improvement after DBS treatment could also be seen at 6 months. DBS had significantly better effects in patients with minimally conscious state (MCS) compared with patients with vegetative state/unresponsive wakefulness syndrome (p for interaction &lt;0.001). A nomogram based on age, state of consciousness, pathogeny and duration of DoCs indicated excellent predictive performance (c-index = 0.882). CONCLUSIONS: DBS was associated with better outcomes in patients with DoC, and the effect was likely to be significantly greater in patients with MCS. DBS should be cautiously evaluated by nomogram preoperatively, and randomised controlled trials are still needed.

Options for the recovery of mental activity in children after acute brain damage

IntroductionChildren with acute brain damage make up a large group of patients who require multi-stage rehabilitation. Rehabilitation requires the creation of special conditions for psychiatric care and psychological and pedagogical correction of the consequences of severe damage to the nervous system. A differentiated approach to rehabilitation will help restore mental activity with greater efficiency, and subsequently adapt the child to the familiar environment.ObjectivesThe aim of the study is to identify the options for mental activity during the restoration of the level of consciousness in children after acute severe brain damage.Methods210 children under the age of 18 with severe brain damage (traumatic brain injury, hypoxia, hydrocephalus), admitted for treatment and rehabilitation. Clinical-psychopathological, pedagogical methods were used; additionally - diagnostic scales, questionnaires.ResultsDepending on the level of consciousness, mental activity, 4 groups were formed:1st group - 37 (18%) patients had manifestations of mental activity with physical, cognitive and social capabilities in the minimal consciousness “+” (a- / hyperkinetic mutism with emotional reactions, understanding of addressed speech);2nd - 67 (32%) patients had manifestations of physical and cognitive abilities with minimal consciousness “-” (a- / hyperkinetic mutism without emotional manifestations and understanding of addressed speech);3rd - 95 (40%) patients had only the manifestation of physical capabilities at the exit from the vegetative status.4th - 11 (10%) patients had a low manifestation of mental activity in the form of physical capabilities with a vegetative status.Conclusions4 variants of mental activity in children after acute severe brain damage have been identified: from minimal involuntary reactions or their absence in vegetative status to voluntary actions according to the instructions of an adult in minimal consciousness “+”. Taking into account the variability of mental activity helps to differentiate the methods of psychiatric and psychological-pedagogical assistance in the recovery of children already in the early stages of rehabilitation.Disclosure of InterestNone Declared

Investigation of consciousness levels of Çanakkale farmers on environmental and toxicological risks of pesticides

Pesticides are increasingly being used against pests in agricultural fields. However, unconscious use of pesticides results in health risks for humans and the environment. Efforts should therefore be spent to reduce the negative impacts of pesticides. The objective of this study was to measure farmers’ awareness of pesticide use in the agricultural fields of Çanakkale. The sample size was calculated using the “Simple Random Sampling Based on Means” method. The present survey was conducted with 270 farmers. Of the farmers who participated, 25.55% had 31-40 years of farming experience, 47.78% were primary school graduates, and 35.56% were 55-65 years old. Farmers’ knowledge of pesticide use was assessed through Likert scale. Chi-Square test was used to investigate the relationship of farmers’ knowledge level with education, age, farming experience, land size and farming type. Only education was significant. As the education level increased, the knowledge level increased. In terms of farmers’ attitudes, 78.89% of the farmers indicated that they changed their clothes after spraying, 46.67% cared about the information on pesticide labels, 45.18% used protective equipment during spraying, 69.63% cared about PHI (pre-harvest intervals), and 15.92% had knowledge about MRL (Maximum Residue Limit). 41.85% disposed of remaining pesticide solutions to the edge of agricultural fields, 40.74% to garbage and 6.3% to environment. It was concluded based on the present findings that farmers need serious training on pesticide use and the potential effects of pesticides on human health and the environment.

Application of early warning system (EWS) in patients with cardiovascular disorders : a descriptive study

Incidents of clients experiencing sudden cardiac arrest in the inpatient setting or unexpected and unavoidable deaths in the inpatient setting are common. One of the efforts to improve quality related to patient safety in hospitals is the application of the Early Warning System (EWS) to clinical changes in patients in hospital inpatient installations. The purpose of this study was to describe the application of EWS in clients with cardiovascular system disorders, including the risk of seriousness, respiratory rate, oxygen saturation, use of oxygen supplements, systolic blood pressure, pulse frequency, level of consciousness, and body temperature. This study is an observational descriptive study with a cross-sectional approach. The number of respondents was 48 people, namely clients who were treated with diseases of the cardiovascular system. Data analysis using descriptive analysis. The characteristics of respondents obtained in this study showed that the majority of respondents were female (54.2%), the majority of medical diagnoses were congestive heart failure, which was 43.75%, and the average length of stay was 4.63 days. Most of the patient's risk of seriousness was in the moderate category, namely 22 respondents (45.8%). Assessment of clients with cardiovascular system disorders with EWS in this study can predict the level of patient care so that preventive measures can be taken. Recommendations for future research are research on predicting patient mortality using EWS.

Некоторые аспекты взаимосвязи правового сознания сотрудников ФСИН России и обеспечения законности в деятельности уголовно-исполнительной системы

The article examines the issues of formation of professional legal consciousness of employees of the Federal Penitentiary Service of Russia, taking into account the specifics of penal enforcement activities. The author draws attention to the existence of a direct relationship between the level of professional consciousness of employees of the Federal Penitentiary Service of Russia and the state of legality in the process of implementing penal enforcement activities. Special attention is paid in the article to the issue of determining the range of subjects of legality in the penal enforcement system.