bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of the Application of Marketing Mix on the Purchase Decision of Prospective Consumers of Grand Cempaka Housing
Authors: Sudrajad Gesang , Sutanto J.E
Published: February 2020

The purpose of this study was to examine the effect of simultaneous and partial marketing mix on the purchase decision of prospective consumers of Grand Cempaka Housing.This research uses quantitative methods, and is a survey research from the types of explanatory research whose focus is placed on relational research: studying the relationship of variables. The object of research is the residents of Pasuruan City and the sample in this study is the Prospective Consumer of Grand Cempaka Housing. Data analysis uses multiple linear regression analysis methods.The results of the analysis show that Products, Prices, Places and Promotions simultaneously have a significant effect on the Decision of Purchasing Prospective Consumers of Grand Cempaka Housing. This shows that the marketing mix is one of the marketing strategies that should be considered so that the implementation of the marketing strategy can run successfully because the elements in the marketing mix influence each other. Variables in the marketing mix which include Products, Prices, Places and Promotions partially have a significant effect on the Decision of Purchasing Prospective Consumers of Grand Cempaka Housing.
Keywords: marketing mix; purchase decision; property; housing
Effect of Celebrity Endorser Through Social Media on Organic Cosmetic Purchasing Intention Mediated with Attitude
Authors: Murwaningtyas Fransiska , Harisudin Muhamad , Irianto Heru
Published: February 2020

A rapid information and communication technology development results in the change of community’s lifestyle in online shopping. Online marketing strategy should be taken to improve organic cosmetic purchasing intention through Instagram, one of which is to use celebrity endorser in advertisement. Considering Theory of Planned Behavior, this research employed purchase intention, attitude toward advertisement, trustworthiness, expertise, attractiveness variables. The objective of research was to find out the effect of celebrity endorser on attitude toward advertisement and organic cosmetic purchase intention through Instagram. Technique of collecting data used was Google form through social media, Instagram. This research employed Structural Equation Modeling (SEM) with Maximum Likelihood estimation model. The result of analysis on 200 respondents showed that there is a positive effect of celebrity’s trustworthiness, celebrity’s expertise, celebrity’s attractiveness on Attitude toward advertisement and organic cosmetic purchase intention through Instagram. In addition, attitude toward advertisement serves as imperfect mediation of celebrity’s trustworthiness, celebrity’s expertise, celebrity’s attractiveness and purchase intention.
Keywords: Celebrity endorser; Trustworthiness; Attractiveness; Expertise; Theory of Planned Behavior; Attitude Toward Advertisement; Purchasing Intention; Organic Cosmetic; Social Media
THE EFFECTIVENESS OF PLAY THERAPY IN INCREASING THE STUDENTS' SPEECH ABILITY OF PRESCHOOL CHILDREN AT KINDERGARTEN DARUL MUTA’ALLIMIN NGANJUK INDONESIA
Authors: Ali Sodik Muhammad , Nurwijayanti  , Ngibad Khoirul , Perwira Yustika Gaung , Khasanah Uswatun
Published: February 2020

Purpose of the study: The objective of the study to determine the effect of Play Therapy on the Development of Language and Speech Preschool Children In kindergarten DarulMuta’alliminNganjuk Indonesia. Research carried out by observation in kindergarten DarulMuta’alliminNganjuk.

Methodology: Design this study used an experimental research design using pre-test – Post-test control group design. Sampling was done by purposive sampling with a sample of 12 people. Analysis data is performed using a t-test is computerized.

Main Findings: The results showed an average of speech and language development of preschool children before therapy is given play is 7.58 (dubious) and after therapy is given play is 9.04 (normal). Results of testing the hypothesis by using the nonparametric Wilcoxon Signed Ranks Test earned an average difference of language and speech development of preschool children with play therapy with a value of p = 0.002 (<0.005).

Applications of this study: Expected to staff teachers who teach in schools incorporate play therapy in improving language ability and speech to pre-schoolers.

Novelty/Originality of this study: In this study, it can be said that the therapy played an increase in language ability and speech.
Pre-Post Study to Assess EMDR-Based Group Therapy for Traumatized Refugee Preschoolers
Authors: Lempertz Daniela , Wichmann Michelle , Enderle Esther , Stellermann-Strehlow Kerstin , Pawils Silke , Metzner Franka
Published: February 2020

Cross-culturally effective, low-threshold therapies for refugees that can be carried out quickly are urgently required. Worldwide, therapies are lacking, particularly for preschool refugee children, which support coping and prevent chronification of posttraumatic stress. This pilot study examined eye movement desensitization and reprocessing (EMDR)-based group treatment for preschool refugee children in German daycare centers. Ten refugee preschool children aged 4–6 years (n = 5 female) with posttraumatic stress disorder (PTSD) symptoms took part in an EMDR-based group treatment (with 2–4 children per group). PTSD symptoms were rated by parents and preschool teachers using items from the Child Behavior Checklist (CBCL 1½–5), pre- and posttreatment, and at 3-month follow-up. After treatment children tended to display less fear of animals or situations than before treatment. According to preschool teachers' perspective, the total number of PTSD symptoms dropped significantly at posttreatment (d = .93) and at follow-up (d = .81). Before the intervention, preschool teachers rated the children as being more defiant than their parents did (p = .020). After the intervention, the PTSD symptoms of boys were significantly higher than those of girls (p = .036) according to preschool teachers. The results indicate that timely psychotherapeutic interventions can be conducted with refugee children displaying PTSD symptoms in daycare centers. The efficacy of this intervention needs to be studied in a larger sample under controlled randomized conditions.
A Marketing Course And The Liberal Arts: Students’ Perspective Of Interdisciplinary Relevance
Authors: Melchiorre Marilyn Martin
Published: February 2020

This study examines students’ reflections on how concepts covered in a marketing course are applied to the broader liberal arts curriculum. The objective was to demonstrate when given a chance with an Interdisciplinary Reflection Assignment, students can articulate interdisciplinary relevance. The study collected sample data from six classes over three years. The assignment embodies the areas of metacognition, reflection, and integration of interdisciplinary knowledge.A content analysis approach was utilized to review both quantitative and qualitative data. Students’ comments are categorized as follows: 32 in “Humanities & Fine Arts”; 31 in “Natural Sciences & Mathematics”; 93 in “Social Sciences & History”; 6 in “Professional Studies” (College, 2019). The assignment results strongly suggest that, when asked, students can articulate the integration of a business marketing course with other liberal arts subject areas. Thus, demonstrating business has a legitimate place in the liberal arts curriculum. This study contributes to education literature by providing a specific pedagogical example that can be easily replicated by other educators at other higher education institutions. The assignment offers added value to enhance student learning and appreciation of how marketing concepts integrate with other academic disciplines.
Reproduction of a scientific knowledge through the eyes of a sociologist. Review of the book by Bruno Latour «Science in action: following scientists and engineers within society»
Authors: Erkina Daria S.
Published: February 2020

The article is dedicated to the consideration of the main ideas of B. Latour’s book “Science in Action: Following Scientists and Engineers Through the Society”. The main topics of the book are identified, as well as its conceptual framework is described. According to Latour, science in modern society exists through overlapping networks of interaction, including not only individuals and groups, but also material objects that serve to acquire knowledge. At the same time, the specificity of science lies in the fact that in it a person becomes both an object and a participant in the process of obtaining, reproducing and disseminating knowledge.
Diffusion Innovations of the Ministry of Social Affairs of the Republic of Indonesia in Disseminating Innovation of the E-Warong Program
Authors: Caesarany Nadya , Karwur Garry Vardy , Rosalina Devia
Published: February 2020

This research aims to find out and to depict the public relations activities in spreading the information of E-Warong program, as well as to discover the obstacles in running the aforementioned public relations activities. A descriptive-qualitative method is used to depict and to describe the examined objects according to the real facts in the field by using interviewees as the source of data. The data is presented using primary and secondary data through in-depth interview, documentation of activities, references related to the research, and data from the internet. The data analysis procedure used is qualitative data with interactive model from Metthew B. Miles and Michael Huberman. The results show that the public relations activities performed by the public relations team of the Ministry of Social Services in spreading the information include the following steps: 1) planning and decision-making in spreading the information of the E-Warong Program; 2) informing and performing the information spreading of E-Warong Program; 3) evaluating the performed information-spreading activity of E-Warong Program. Less appropriate selection of the communication channel for target audiences can be an obstacle faced during the means of information spreading of the E-Warong Program. In the end, the information spreading activity performed by the Ministry of Social Services ran well enough even though there were some flaws in the execution.

Keywords: Public Relations activities, Spreading the Information
OPTIMALISASI BAHAN PEMBELAJARAN IPS BERBASIS TEKNOLOGI INFORMASI DI MGMP IPS JAKARTA TIMUR
Authors: Budiaman  , Rusmono  , Kurniawan Nandi
Published: February 2020

Abstract

This community service program is aimed at empowering teachers to optimize information technology-based social studies learning materials. The partner in this community service activity is the MGMP IPS East Jakarta. The problem faced by partners is the gap in understanding of knowledge about syllabus development, learning materials, and learning media that can be optimized with current developments in information technology. The solution to overcome the problem is by providing assistance from formulating the problem, material orientation, group discussion, and assisting in the preparation of information technology-based social studies material. The method of implementing the activity was begun with a focus group discussion (FGD) between the Chairperson and the Executive Board of the East Jakarta MGMP. The results of the FGDs were implemented in the form of training and mentoring for social studies teachers with material: (1) syllabus development, (2) development of 21st century lesson plans, and (3) information technology-based learning media. The result of this activity was the increase in participants' knowledge and skills in compiling social studies learning materials. The product of the activities in the form of information technology-based learning materials in the form of lesson plans. In addition, workshop participants felt challenged to make information technology-based learning materials more diverse by continuing to realize the idealism of their profession

 

Abstrak

Kegiatan pengabdian kepada masyarakat terintegrasi KKN ini bertujuan untuk memberdayakan guru-guru dalam mengoptimalisasikan bahan pembelajaran IPS berbasis teknologi informasi. Mitra dalam kegiatan pengabdian kepada masyarakat ini adalah MGMP IPS Jakarta Timur. Permasalahan yang dihadapi mitra adalah adanya kesenjangan pemahaman pengetahuan tentang pengembangan silabus, bahan pembelajaran, dan media pembelajaran yang dapat dioptimalkan dengan perkembangan  teknologi informas saat ini. Solusi untuk mengatasi permasalahan dengan melakukan pendampingan dari merumuskan masalah, orientasi materi, diskusi kelompok, dan pendampingan penyusunan materi IPS berbasis teknologi informasi. Metode pelaksanaan kegiatan dilakukan diawali dengan focus group discussion (FGD) antara Ketua Pelaksana dengan Pengurus MGMP Jakarta Timur. Hasil FGD  diimplementasikan dalam bentuk pelatihan dan pendampingan guru-guru IPS dengan materi: (1) pengembangan silabus, (2) pengembangan RPP abad 21, dan  (3) media pembelajaran berbasis teknologi informasi. Hasil kegiatan ini adalah meningkatnya pengetahuan peserta dan keterampilan dalam menysusun bahan pembelajaran IPS. Produk hasil kegiatan berupa bahan pembelajaran berbasis teknologi informasi dalam bentuk RPP. Selain itu peserta workshop merasa tertantang untuk membuat  bahan pembelajaran berbasis teknologi informasi yang lebih beragam dengan terus mewujudkan idealisme profesinya secara konsisten.
Pengaruh Kepemimpinan Transformasional, Kompensasi Dan Good Corporate Governance Terhadap Kinerja Karyawan
Authors: Elyanto Redi Yuniansyah , Syairudin Bambang
Published: February 2020

Penelitian ini bertujuan untuk menganalisa bagaimana pengaruh kepemimpinan transformasional, kompensasi dan Good Corporate Governance terhadap kinerja karyawan. Populasi dalam sampel ini adalah seluruh karyawan dari beberapa perusahaan yang bergerak di bidang jasa survey kepelabuhanan dan penilai kerugian asuransi. Sebuah kuesioner di desain sebagai metode pengumpulan data dari seluruh populasi atau sampel yang dalam penelitian ini. Kemudian setelah data tersebut diperoleh,akan dianalisa dengan menggunakan metode Partial Least Square (PLS).Penelitian ini menunjukkan bahwa ketiga variabel yaitu kepemimpinan transformasional, kompensasi serta good corporate governance berpengaruh positif terhadap kinerja karyawan, namun hanya variabel good corporate governance yang berpengaruh signifikan terhadap kinerja karyawan.
Peran Akuntan Pendidik dalam Meningkatkan Profesionalisme Calon Akuntan
Authors: Sawitri Aristha Purwanthari , Fauziyah -
Published: February 2020

Persaingan  sumber daya manusia saat ini semakin ketat khususnya di negera Asia Tenggara (ASEAN) hal ini didukung pula dengan ditandatanganinya kesepakatan antar negara-negara ASEAN mengenai persaingan bebas yang disebut ASEAN Economic Community (AEC). Perguruan tinggi merupakan kunci utama dalam mencetak generasi bangsa khususnya calon akuntan karena calon akuntan mempunyai peran yang besar dalam perkembangan perekonomian di suatu negara serta peran akuntan pendidik diperlukan untuk mencetak calon akuntan yang berkualitas dan profesional. Peran akuntan dalam penelitian ini yaitu komitmen dan kompetensi akuntan pendidik untuk menciptakan profesionalisme calon akuntan. Definisi seseorang yang professional antara setiap individu berbeda-beda. Dimana untuk menjadi seseorang yang professional harus menguasai bidang pengetahuan (knowledge), ketrampilan (skill), dan karakteristik (Ethics). Sampel penelitian ini adalah perguruan tinggi swasta di Surabaya. Hasil penelitian ini ditemukan bahwa variabel komitmen dan kompetensi secara bersama-sama berpengaruh terhadap profesionalisme calon akuntan, serta ditemukan bahwa hanya variabel komitmen berpengaruh positif secara signnifikan terhadap profesionalisme, sedangkan 33,9% dipengaruhi oleh variabel lain di luar penelitian.
Analisis Faktor-Faktor Pada Perilaku Pembelian Konsumen Terhadap Produk Makanan dan Minuman Lokal di Kota Surabaya
Authors: Setioningtyas Widhayani Puri , Wisnu Sutama
Published: February 2020

Surabaya merupakan kota terbesar kedua di Indonesia yang memiliki respon serta perkembangan yang baik terhadap industri perdagangan khususnya dalam bidangmakanan dan minuman. Kondisi tersebut ditunjukkan dengan banyaknya produsen atau pengusaha lokal yang memproduksi berbagai macam makanan dan minuman baru sehingga memicu peningkatan persaingan pada industri tersebut.Tak heran jika berbagai cara dilakukan oleh produsen untuk menawarkan produknya agar dapat menarik minat beli konsumen. Namun tingginya persaingan menyebabkan banyak produk tidak dapat berkembang maupun bertahan di pasaran. Selan jutnya terdapat beberapa faktor yang diketahui mampu memberikan pengaruh pada perilaku pembelian konsumen terhadap produk makanan dan minuman lokal antara lain, yaitu : (a) Aktualitas produk, (b) Kualitas dan Masalah Kesehatan, (c) Penampilan Produk, (d) Kesegaran dan Rasa, (e) Rasa Ingin Tahu dan Gengsi. Berikutnya variabel terikat yakni Perilaku Pembelian Konsumen merupakan faktor terpenting yang harus diraih oleh produsen agardapat mempertahankan eksistensi serta mengembangkan produknya dalam pasar di Kota Surabaya.Objek penelitian yang digunakan dalam penelitian ini adalah konsumen yang gemar atau berulangkali membeli produk makanan dan minuman lokal di Kota Surabaya. Tahap berikutnya adalah analisis data dengan menggunakan analisis regresi linier multiple dengan instrumen kuesioner.
ANALISIS PEMILIHAN PORTOFOLIO OPTIMAL PADA KOMBINASI INDEKS BISNIS-27 MENGGUNAKAN SINGLE INDEX MODEL
Authors: Fariana Rina , Adi Bayu
Published: February 2020

Investment is an important thing for everyone as an alternative in the storage of funds and to gain profit. Investors are faced with two things in making investments, namely risk and return. Diversification is one way to minimize risk by forming a portfolio of stocks. This study aims to determine and analyze optimal portfolio selection using single index model.The type of research used in this research is descriptive research with quantitative approach. The object of this research is using the company collected in BISNIS-27 index, with the research period from 2011 to 2015. The data collection method used is purposive sampling, where the company to be analyzed is only companies listed in BISNIS-27 stock index consistently during nine (9) periods from February 1, 2011 to July 31, 2015, and stocks are not suspended during the period February 1, 2011 to July 31, 2015. Data required in the analysis of data is historical price of stocks and IHSG (Indeks Harga Saham Gabungan). Analyzer using microsoft excel.
Pengaruh Kualitas Layanan dan Lokasi Terhadap Kepuasan dan Loyalitas Pelanggan pada Don’s Warnet Cikarang
Authors: Suhendra Asep Dony
Published: February 2020

Competition in the business world, especially the cafe industry shows an increasing trend. For some internet cafe managers, the importance of creating customer satisfaction and customer loyalty is very important and a primary goal. Managers of internet cafe services are now competing to improve optimal services to achieve these goals .Customer satisfaction and customer loyalty are expressions of feelings or impressions of everyone when using a product or service. This research aims to identify and examine the factors that may affect the customer's satisfaction and loyalty in Don 's Warnet Cikarang . With a sample size of 200 people , the research carried out on the visitors who have used the services of Don 's Warnet , and conducted by purposive sampling technique .The results show that customer satisfaction is positively and significantly influenced by the quality of service and location factors . As for the only customer loyalty is positively and significantly influenced by customer satisfaction factors . The moderating variable frequency of visits and customer's place of residence does not give significant results on satisfaction and customer loyalty .Thus , it can be concluded that in order to get satisfaction and customer loyalty , besides place the business location that is close to the customer's environment , Don 's Warnet should further improve the quality of services , especially in the field of reliability of internet access , responsiveness operators , security environment and a sense of empathy towards the customer . So the satisfaction perceived by customers , is expected to make a loyal customer to the products / services used .
Pemanfaatan Pengguna Handpone Pada Masyarakat Desa Keleyan Kecamatan Socah Kabupaten Bangkalan
Authors: Dastiyana Nova
Published: February 2020

Perkembanga teknologi jaman sekarang semakin berkembang dan semakin canggih, masyarakat jaman sekarang banyak yang menggunakan handpone sebagai alat komunikasi. Handpone adalah parangkat telekomunikasi elektronik yang mempunyai kemampuan dasar yang sama dengan handpone konvensional saluran tetap,namun dapat dibawa kemana –mana dan tidak perlu di sambungkan dengan jaringan telepon menggunakan kabel.handpone telah merubah perilaku komunikasi manusia dengan menembus ruang dan waktu. Banyak sekali dampak  positif dan negative dari penggunaan handpone. Saat ini perkembangan tekhnologi handpone sangat berkembang pesat. Hampir semua orang mempunyai handpene sebagai alat komunikasi yang sangat mudah digunakan oleh masyarakat Indonesia, handpone ini tidak hanya sebagai alat komunikasi semata,tetapi saat ini dapat dimanfaatkan sebagai multimedia dan salah satunya dapat dimanfaatkan dalam dunia pendidikan.   handphone memang berdampak positif terhadap masyarakat desa terutama dalam rangka menjaga tetap terjalinnya hubungan komunikasi dengan orang-orang teristimewa kerabat atau famili yang berada jauh di luar daerah. Namun di dalam kapasitas sebagai smartphone dengan berbagai fitur yang dimilikinya   sebagai   sumber   informasi   ternyata   hal   itu   belum   banyak   diketahui pemanfaatannya oleh masyarakat desa.
Analisis Pengaruh Biaya Kompensasi Terhadap Motivasi Dan Kinerja Karyawan
Authors: Hasanah Uswatun
Published: February 2020

Motivasi adalah dorongan yang timbul dalam diri seseorang secara sadar atau tidak sadar untuk melakukan suatu tindakan dengan tujuan tertentu, usaha yang menyebabkan seseorang atau kelompok tertentu tergerak melakukan sesuatu karena ingin mencapai tujuan yang dikehendakinya, kompensasi adalah segala bentuk sesuatu baik berupa uang, maupun barang fisik maupun nonfisik oleh perusahaan diberikan kepada karyawan yang bekerja di suatu perusahaan, sedangkan kinerja karyawan adalah  merupakan  suatu tingkatan pencapaian hasil kerja  yang dicapai dalam melaksanakan tugas dan pekerjaan yang diberikan kepada pegawai dengan memperoleh imbalan prestasi tertentu.
5c Factor Analysis Aspects Of The Designation Of Lending Of Working Capital In Pd. Bpr Bank Regional Lamongan
Authors: Mardhotillah Izzati Choirini
Published: February 2020

Credit evaluation is an important element in the provision of credit to the debtor. Lending activities, we need a good and thorough analysis of all aspects of credit to support the credit approval process, in order to prevent a credit risk. With its mission as an agent of development, banks are increasingly playing a role in the economy with increased lending to some sectors of the economy are priorities for improving the economy of the people and support the development of nasional.Tujuan of this study was to determine the creditworthiness conducted by the PD BPR Bank Regional Lamongan. From the analysis of the data using analytical tools 5C character, capacity, capital, collateral, condition states that the majority of borrowers eligible to receive a credit of PD. BPR lamongan Regional Banks. The credit approval process is a credit application by the debtor, research files, bank information search, site visits, analysis of credit research. If approved it will be an agreement or binding of collateral. Once it is done coaching supervision of credit or credit.Credit evaluation is an important element in the provision of credit to the debtor. Lending activities, we need a good and thorough analysis of all aspects of credit to support the credit approval process, in order to prevent a credit risk. With its mission as an agent of development, banks are increasingly playing a role in the economy with increased lending to some sectors of the economy are priorities for improving the economy of the people and support the development of nasional.Tujuan of this study was to determine the creditworthiness conducted by the PD BPR Bank Regional Lamongan. From the analysis of the data using analytical tools 5C character, capacity, capital, collateral, condition states that the majority of borrowers eligible to receive a credit of PD. BPR lamongan Regional Banks. The credit approval process is a credit application by the debtor, research files, bank information search, site visits, analysis of credit research. If approved it will be an agreement or binding of collateral. Once it is done coaching supervision of credit or credit.
Peran Religiusitas Dalam Memoderasi Perilaku Loyal Pasien Terhadap Suatu Rumah Sakit Islam Pku Surakarta
Authors: Haryanto Budhi , Panama Zulfikar Saad Octa , Cahyono Edi , Fenitra RA.
Published: February 2020

Tujuan penelitian ini adalah untuk menerangkan peran religiusitas dalam memoderasi pengaruh kualitas layanan dan citra terhadap kepuasan pasien dan loyalitas.  Sampel diambil secara acak sebanyak 250 orang pasien yang sedang menunggu antrian periksa di Rumah Sakit Islam PKU Muhamadiyah Surakarta. Data yang terkumpul dianalisis menggunakan Multi-Group SEM. Hasil uji menunjukkan bahwa kualitas layanan, citra rumah sakit dan kepuasan pasien mempengaruhi loyalitas, sedangkan kualitas layanan tidak berpengaruh terhadap loyalitas pasien.  Ditemukan juga, bahwa religiusitas memeoderasi pengaruh kualitas layanan, citra rumah sakit dan kepuasan paseien terhadap loyalitas pasien.  Hasil penelitian menunjukkan bahwa pasien dengan tingkat religiusitas yang tinggi dan rendah mempunyai perbedaan tingkat loyalitas di Rumah Sakit Islam PKU Muhamadiyah Surakarta.  Hasil penelitian ini mendukung penelitian terdahulu dengan objek yang berbeda.  Penelitian ini juga mengemukakan penemuan, implikasi teoritis di masa mendatang dan saran untuk penelitian selanjutnya.
Exploring Patient-Reported Barriers to Advance Care Planning in Family Practice
Authors: Author) Carrie Bernard(Former Corresponding , Tan Amy , Slaven Marissa , Elston Dawn , Heyland Daren K. , Author) Michelle Howard(New Corresponding
Published: February 2020

Background Although patient-centred care has become increasingly important across all medical specialties, when it comes to end of life care, research has shown that treatments ordered are not often concordant with people’s expressed preferences. Patient and family engagement in Advance Care Planning (ACP) in the primary care setting could improve the concordance between patients’ wishes and the healthcare received when patients cannot speak for themselves. The aim of this study was to better understand the barriers faced by older patients regarding talking to their family members and family physicians about ACP. Methods In this multi-site cross-sectional study, three free text questions regarding reasons patients found it difficult to discuss ACP with their families or their family physicians were part of a self-administered questionnaire about patients’ knowledge of and engagement in ACP. The questionnaire, which included closed ended questions followed by three probing open ended questions, was distributed in 20 family practices across 3 provinces in Canada. The free text responses were analyzed using thematic analysis and form the basis of this paper. Results 102 participants provided an analyzable response to the survey when asked why they haven’t talked to someone about ACP. 254 answered the question about talking to their physician and 340 answered the question about talking to family members. Eight distinct themes emerged from the free text response analysis: 1. They were too young for ACP; 2. The topic is too emotional; 3. The MD should be responsible for bringing up ACP 4. A fear of negatively impacting the patient-physician relationship; 5. Not enough time in appointments; 6. Concern about family dynamics; 7. It’s not a priority; and 8. A lack of knowledge about ACP. Conclusions Patients in our sample described many barriers to ACP discussions, including concerns about the effect these discussions may have on relationships with both family members and family physicians, and issues relating to patients’ knowledge and interpretation of the importance, responsibility for, or relevance of ACP itself. Family physicians may be uniquely placed to leverage the longitudinal, person- centred relationship they have with patients to mitigate some of these barriers.
A self-administered, artificial intelligence (AI) platform for cognitive assessment in multiple sclerosis (MS)
Authors: Khaligh-Razavi Seyed-Mahdi , Sadeghi Maryam , Khanbagi Mahdiyeh , Kalafatis Chris , Nabavi Seyed Massood
Published: February 2020

Background
Cognitive impairment is common in patients with MS. Accurate and repeatable measures of cognition have the potential to be used as markers of disease activity.
Methods
We developed a 5-minute computerized test to measure cognitive dysfunction in patients with MS. The proposed test – named the Integrated Cognitive Assessment (ICA) – is self-administered and language-independent. 91 MS patients and 83 healthy controls (HC) took part in Substudy 1, in which each participant took the ICA test and the Brief International Cognitive Assessment for MS (BICAMS). We assessed ICA’s test-retest reliability, its correlation with BICAMS, its sensitivity to discriminate patients with MS from the HC group, and its accuracy in detecting cognitive dysfunction. In Substudy 2, we recruited 48 MS patients, 38 of which had received an 8-week physical and cognitive rehabilitation programme and 10 MS patients who did not. We examined the association between the level of serum neurofilament light (NfL) in these patients and their ICA scores and SDMT scores pre- and post-rehabilitation.
Results
The ICA demonstrated excellent test-retest reliability (r=0.94), with no learning bias, and showed a high level of convergent validity with BICAMS. The ICA was sensitive in discriminating the MS patients from the HC group, and demonstrated high accuracy (AUC = 95%) in discriminating cognitively normal from cognitively impaired participants. Additionally, we found a strong association (r=-0.79) between ICA score and the level of NfL in MS patients before and after rehabilitation.
Conclusions
The ICA has the potential to be used as a digital marker of cognitive impairment and to monitor response to therapeutic interventions. In comparison to standard cognitive tools for MS, the ICA is shorter in duration, does not show a learning bias, and is independent of language.
A Cross-Sectional Study of Job Burnout, Psychological Attachment, and the Career Calling of Chinese Doctors
Authors: Zhang Shu'e , Wang Jinghui , Xie Fengzhe , Yin Dong , Shi Yu , Zhang Min , Yin Hongyan , Li Fujun , Yang Libin , Cao Depin , Sun Tao
Published: February 2020

Background: The main objectives of this study were as follows: (1) evaluate the prevalence of burnout syndrome among doctors, (2) establish associations with demographic factors in China, and (3) examine the mediating role of psychological attachment in the relationship between job burnout and career calling.
Methods:This cross-sectional survey was conducted by administering an online questionnaire in May 2016. The survey was performed across Thirty provinces. In total,A total of 3,016 Chinese doctors were selected as participants, of which 2,617 completed valid questionnaires (effective response rate: 86.77%).
Results: The overall prevalence of burnout symptoms among Chinese doctors was 85.79%. Little variance was reported for burnout symptoms according to age (Waldc2 = 6.843, P < 0.05, OR <1 ), professional title (Waldc2 = 13.110, P < 0.05, OR > 1), and daily working hours (Waldc 2= 7.226, P < 0.05, OR > 1). However, the burnout of Chinese doctors was found to be associated with psychological attachment (B = -0.6433, P < 0.0001) and career calling (B = 0.3653, P < 0.0001); furthermore, psychological attachment (B = 0.2350, P < 0.001) mediated the relationship between job burnout and career calling.
Conclusion: Burnout symptoms among Chinese doctors were prevalent and associated with age, professional title, and long working hours. Chinese doctors aged 20-30 experienced a much higher level of burnout symptoms. The longer hours doctors worked, the more likely they were at risk of burnout symptoms, especially among attending physicians. Doctors who endured high-level burnout tended to exhibit decreasing psychological attachment, which threatened their sense of career calling. Finally, this paper proposed related explanations for the function mechanisms based on both theoretical and practical perspectives.
Efficacy of a complex intervention comprising the guideline evidence-based health information and a training programme on the quality of health information: study protocol of a randomised controlled trial
Authors: Lühnen Julia , Berger-Höger Birte , Haastert Burkhard , Hinneburg Jana , Kasper Jürgen , Steckelberg Anke
Published: February 2020

Background Evidence-based health information (EBHI) is a prerequisite for informed and shared decision-making. The criteria for EBHI have been described comprehensively but the implementation in practice is still insufficient. The guideline evidence-based health information addresses providers of health information. Its goal is to improve the quality of health information. The evidence-based guideline emerged from the German Network for Evidence-based Medicine (DNEbM) and was published in February 2017. In addition, the competences of providers of health information were explored and a training programme was developed. Aim of this study is to evaluate the efficacy of a training programme addressing providers of health information to support the application of the guideline evidence-based health information. We expect the intervention to improve the quality of health information in comparison to provision of the guideline only. Methods The trial uses a superiority randomised control group design with ten months follow-up. 26 providers of health information (groups with up to ten members) will be enrolled to compare the intervention (guideline & training programme) with usual care (guideline publicly available). The 5-day training programme comprises an evidence-based medicine training module and a module to prepare the application of the guideline. The primary outcome parameter is the quality of the health information. Quality is operationalised as the extent of adherence to the guideline’s recommendations. Each provider will prepare a single health information informing a health-related decision on a freely chosen topic. The quality of this information will be rated using the Mapping Health Information Quality (MAPPinfo) checklist. An accompanying process evaluation will then be conducted. Discussion The study results will show whether the efficacy of the intervention justifies implementation of the training programme to enhance health information developers’ competences in evidence-based medicine and to ensure high quality EBHI in the long-term. Trial registration ISRCTN registry, registration number: ISRCTN96941060, Date: 7 March 2019, URL: http://www.isrctn.com/ISRCTN96941060
Enabling routine β-Thalassemia Prevention and Patient Management by Scalable, Combined Thalassemia and Hemochromatosis mutation analysis
Authors: Author) Ghazala Hashmi(Former Corresponding , Qidwai Asim , Fernandes Kristopher , Author) Michael Seul(New Corresponding
Published: February 2020

Background : Beta (β)-thalassemia is one of the most common inherited disorders worldwide, with high prevalence in the Mediterranean, the Middle East and South Asia. Over the past 40 years, many countries have implemented awareness and prevention campaigns that have greatly reduced the incidence of affected child births. In contrast, much remains to be done in South-Asia. Thus, for Pakistan, current estimates of the number of children born with thalassemia are at ~7,000 per annum, with no sign of improvement. Although there is good agreement that intermarriage of carriers is a principal source of the high prevalence of the disorder, effective tools for screening and diagnosis on which to base prevention programs are not readily available. Methods : Here, we present results for a novel “LeanSequencing” process to identify 18 β-thalassemia and related sickle cell anemia, and simultaneously a set of 3 hemochromatosis mutations in a multi-ethnic population of 274 pediatric and adolescent patients treated at Afzaal Memorial Thalassemia Foundation hospital in Karachi, Pakistan. Results : We found substantial differences in the abundance of disease-causing mutations among the principal ethnic groups in our cohort. We also found the hemochromatosis mutation H63D C > G in 61 (or 22.1%) of our patients including 7 (or 2.6%) homozygotes. Conclusions : To our knowledge, this is the first screen combining β-thalassemia and hemochromatosis mutations in a single test, so as to facilitate the early identification of patients who may be at increased potential risk for complications from iron overload and thereby to improve the prospective management of thalassemia patients.
Co-infection with Campylobacter and rotavirus in less than 5 year old children with acute gastroenteritis in Nepal during 2017-2018
Authors: Bhattarai Vishnu , Sharma Saroj , Rijal Komal Raj , Banjara Megha Raj
Published: February 2020

Background: Diarrhoea, although easily curable, is a global cause of death for a half million children every year. Rotavirus and Campylobacter are the most common etiological agents of diarrhoea in children less than 5 years of age. However, in Nepal, these causative agents are not routinely examined for the diagnosis and treatment. The main objective of this study was to determine Campylobacter co-infection associated with rotavirus diarrhoea in children less than 5 years of age. Methods: A cross-sectional study was conducted at Kanti Children's Hospital (KCH), Kathmandu, Nepal from November 2017 to April 2018. A total of 303 stool specimens from children affected with diarrhoea were processed to detect rotavirus using a rapid rotavirus antigen detection test kit, and Campylobacter by microscopy, culture and biochemical tests. Antibiotic susceptibility tests of Campylobacter isolates were performed according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines 2015. Results: Of 303 samples, 91 (30.0%) were positive for co-infection with rotavirus and Campylobacter . Rotavirus mono-infection was detected in 61 (20.1%), and Campylobacter mono-infection was detected in 81 (26.7%) samples. Patient’s age, month of infection, untreated water and frequent soil contact were the major risk factors for infections. Clinical features such as >9 loose motions per day, fever, vomiting, mild to moderate dehydration, diarrhea persisting 6-9 days and presence of mucus in stool were significant (p<0.05) clinical features, and were more severe in coinfection compared to mono-infections in multivariate analysis. Conclusion: The study shows a high rate of rotavirus and Campylobacter coinfection in children with diarrhoea. Diagnosis based management of diarrhoeal cases can guide the specific treatment. Keywords : Campylobacter , rotavirus, co-infection, diarrhoea, children
The Association between Parental Migration and Early Childhood Nutrition of Left-behind Children in Rural China
Authors: Shi Huifeng , Zhang Jingxu , Du Yufeng , Zhao Chunxia , Huang Xiaona , Wang Xiaoli
Published: February 2020

Background: More than one-third of children under 3 years old are left behind at home due to parental migration in rural China, and we know very little about early childhood nutrition of left-behind children (LBC) because of the dearth of research. This study examined the association between parental migration and early childhood nutrition of LBC in rural China.Methods: We used repeated cross-sectional data of rural children aged 6–35 months who participated in two surveys in six counties of northern and southern China in 2013 and 2016 respectively. The length, weight, and hemoglobin concentration were measured by trained health‑care workers blinded to parental migration status. Stunting, underweight, wasting, and anemia were identified with the standards recommended by WHO. Generalized linear regressions and multivariate logistic regressions were employed to explore the association between parental migration and these nutritional outcomes at each time point.Results: 2,336 and 2,210 children aged 6–35 months were enrolled in 2013 and 2016, respectively. The results show a reduction of the risks of stunting, underweight, and wasting from 2013 (16.4%, 8.5%, and 3.5%, respectively) to 2016 (12.1%, 4.0%, and 1.5%, respectively) but highlight a constantly and alarmingly high risk of anemia among these children (44.8% in 2013 and 43.8% in 2016). Children with migrant fathers performed as well as or better than those with non-migrants on these indicators. Children with migrant parents performed slightly worse in 2013, but equal or slightly superior in 2016 on these indicators compared with children with non-migrants and migrant fathers. Children aged 6–17 months with migrant parents had a significantly lower risk of anemia than those living with their mothers or with both parents (43.1% vs. 63.6% and 61.5 in 2013, and 42.5 vs. 60.1% and 66.2% in 2016), even after controlling for children’s sociodemographic characteristics.Conclusions: Parental migration may be not detrimental and even beneficial to early childhood nutrition of LBC in rural China. Continued nutritional support is needed for all rural children, especially interventions for preventing micronutrient deficiency. Programs for LBC are recommended to continue to focus on nutrition but pay more attention to other important health issues.
A multicenter randomized trial of personalized acupuncture, fixed acupuncture, letrozole, and placebo letrozole on live birth in infertile women with polycystic ovary syndrome
Authors: Huang Shiya , Hu Min , Ng Ernest Hung Yu , Stener-Victorin Elisabet , Zheng Yanhua , Wen Qidan , Wang Cong , Lai Maohua , Li Juan , Gao Xingcheng , Wang Xinhua , Hu Zhenxing , Xia Tian , Hu Rongkui , Liu Jianping , Wen Xiaohui , Li Shuna , Quan Kewei , Liang Xingyan , Shang Hongcai , Ma Hongxia , Qiao Jie
Published: February 2020

BACKGROUND Traditional Chinese medicine (TCM) usually involves syndrome differentiation and treatment. Acupuncture, one form of TCM, requires the selection of appropriate acupoints points and needling techniques, but many clinical trials on acupuncture have used fixed acupuncture protocols without accounting for individual differences among patients. We have designed a multicenter randomized controlled trial (RCT) to evaluate whether personalized or fixed acupuncture increases the likelihood of live births in infertile women with polycystic ovary syndrome (PCOS) compared with letrozole or placebo letrozole. We hypothesize that letrozole is more effective than personalized acupuncture, which in turn is more effective than fixed acupuncture, and that placebo letrozole is the least effective intervention. Moreover, we hypothesize that personalized acupuncture is more likely to reduce the miscarriage rate and the risk of pregnancy complications compared to letrozole. METHODS / DESIGN The study is designed as a randomized assessor-blinded controlled trial. A total of 1,100 infertile women with PCOS will be recruited from 28 hospitals and randomly allocated into four groups: A) personalized acupuncture, B) fixed acupuncture, C) letrozole, or D) placebo letrozole. They will receive treatment for 16 weeks, and the primary outcome is live birth. Secondary outcomes include ovulation rate, conception rate, pregnancy rate, pregnancy loss rate, changes in hormonal and metabolic parameters, and changes in quality of life scores. The adverse events will be recorded throughout the trial. All statistical analyses will be performed using the SPSS program V.21.0 (SPSS, Chicago, Illinois, USA), and a p-value <0.05 will be considered statistically significant. DISCUSSION This study will be the first multicenter RCT to compare personalized or fixed acupuncture with letrozole or placebo letrozole on live birth in infertile women with PCOS. The findings will inform whether personalized acupuncture therapy can be considered an alternative treatment to improve the live birth rate in infertile women with PCOS.
Computational MHC-I epitope predictor identifies 95% of experimentally mapped HIV-1 clade A and D epitopes in a Ugandan cohort.
Authors: Lule Daniel Bugembe , Ekii Andrew Obuku , Ndembi Nicaise , Serwanga Jennifer , Kaleebu Pontiano , Pala Pietro
Published: February 2020

Background: Identifying immunogens that induce HIV-1-specific immune responses is a lengthy process that can benefit from computational methods, which predict T-cell epitopes for various HLA types.
Methods: We tested the performance of the NetMHCpan4.0 computational neural network in re-identifying 93 T-cell epitopes that had been previously independently mapped using the whole proteome IFN-g ELISPOT assays in 6 HLA class I typed Ugandan individuals infected with HIV-1 subtypes A1 and D. To provide a benchmark we compared the predictions for NetMHCpan4.0 to MHCflurry1.2.0 and NetCTL1.2.
Results: NetMHCpan4.0 performed best correctly predicting 88 of the 93 experimentally mapped epitopes for a set length of 9-mer and matched HLA class I alleles. Receiver Operator Characteristic (ROC) analysis gave an area under the curve (AUC) of 0.928. Setting NetMHCpan4.0 to predict 11-14mer length did not improve the prediction (37-79 of 93 peptides) with an inverse correlation between the number of predictions and length set. Late time point peptides were significantly stronger binders than early peptides (Wilcoxon signed rank test: p =0.0000005). MHCflurry1.2.0 similarly predicted all but 2 of the peptides that NetMHCpan4.0 predicted and NetCTL1.2 predicted only 14 of the 93 experimental peptides.
Conclusion: NetMHCpan4.0 class I epitope predictions covered 95% of the epitope responses identified in six HIV-1 infected individuals, and would have reduced the number of experimental confirmatory tests by >80%. Algorithmic epitope prediction in conjunction with HLA allele frequency information can cost-effectively assist immunogen design through minimizing the experimental effort.
Keywords: HIV-1, epitope mapping, T-cell, artificial neural network, in-silico , NetMHCpan4.0., MHCflurry1.2.0 and NetCTL1.2.