bluuebunny/crossref_metadata_2025 huggingface dataset:
THE IMPORTANCE OF COMPLIANCE WITH DISEASE MANAGEMENT IN PATIENTS WITH HEART FAILURE
Authors: YILDIRIM Burak Ogulcan
Published: April 2024

Aim: This research aims to uncover the significance of adhering to the disease management guidelines for individuals suffering from heart failure, given its high prevalence and the consequential morbidity and mortality rates, as supported by the existing literature. Method: The article analyzed recent research studies on heart failure and CAD to determine the importance of patient compliance in disease treatment. The results were presented with statistics. Conclusion: Throughout the world, heart diseases are widely recognized as the primary cause of death and disability. These ailments can result in premature death, significant disability, and a substantial increase in healthcare expenses. Upon examining the factors that lead to the readmission of heart failure patients, it was discovered that non-compliance with physical activity, dietary recommendations, and drug therapy played a significant role. Patients' chances of recovery increase as they become more compliant with their treatment. To initiate the adaptation process, educating patients about their illness, considering their beliefs and values, evaluating their perspective on their health and the factors influencing it, and encouraging their involvement in treatment and care are crucial. It is worth noting that heart disease can be prevented with healthy lifestyle choices and nutrition or treated with a combination of medical intervention, nutritional therapy, and lifestyle changes post-diagnosis. Patients’ ability to afford self-care is crucial in maintaining a high quality of life following a diagnosis. Health professionals play a pivotal role in improving self-care behavior, a non-pharmacological approach that supports treatment, enhances the patient's quality of life and reduces the likelihood of repeated hospitalizations and financial strain. By identifying positive and negative beliefs surrounding patient compliance with treatment and focusing on the patient's attitude towards their treatment, health professionals can effectively enhance self-care behavior.
EVALUATION OF A PATIENT WITH LUNG CANCER IN A PALLIATIVE CARE CENTER IN ACCORDANCE WITH THE ROPER, LOGAN, TIERNEY NURSING MODEL: A CASE REPORT
Authors: TOPÇU Mihraç , PAMUK CEBECİ Sevil
Published: April 2024

Lung cancer creates a significant burden on the health care system in the world, with its high incidence, the need for advanced technology in diagnosis and treatment, and the need for additional health services. Supporting the patient's care and independence and finding solutions to existing problems in the rapidly increasing number of terminal stage patients with lung cancer in the world and in our country require a very comprehensive approach. Care, one of the most important functions of nursing, is a concept that should not be ignored in nursing practices in the rapidly changing and developing field of health. The care plan should be designed with an individualized nursing care philosophy, taking into account individual differences, the course of the disease, and differences between patient types. In this direction, the Nursing Model Based on Daily Living Activities systematizes and groups care for individuals with a holistic approach and allows the individual to diagnose how much he can do these activities on his own and independently. In this way, the individual can be allowed to go through the pre-death process in a manner worthy of human dignity. Aim: In this case report, it is aimed to diagnose, evaluate and manage the nursing process of a lung cancer patient hospitalized in a palliative care center in accordance with the "Roper, Logan, Tierney Nursing Model". Method: A 67-year-old male patient, hospitalized in a city hospital palliative care center in Turkey, is receiving treatment and rehabilitation with the diagnosis of "Pulmonary Disease". During the rehabilitation process, the patient was handled with a holistic approach and diagnosed with the contribution of the nursing model based on daily life activities, the nursing process was managed, the nursing diagnoses identified in the patient and interventions appropriate to these diagnoses were planned and implemented. The case report study was explained and verbal and written informed consent was obtained from the patient's relative. Results: After the analysis of the systematized data, the problems were revealed more clearly and solution-oriented approaches were developed. Conclusion: It has been observed that the application of the nursing model based on daily life activities in the nursing process increases the quality of care.
DETERMINING THE RECREATIONAL POTENTIAL OF THE DAM LAKE AND ITS ENVIRONMENTS: THE CASE OF KIRKLARELİ PROVINCE KAYALIKOY DAM
Authors: KABATAŞ Engin , ATEŞ Oğuz , ÇELİK Fürüzan , YILMAZ Fulya Damla
Published: April 2024

Aim: In this study, it was aimed to determine the recreational potential of Kayalıköy dam and its surroundings, located in the north of Kırklareli University. Method: The research was created by reinterpreting the evaluation methods of similar studies in the literature within the scope of the research. Within the scope of the study, a 3-stage study was carried out. In the first stage, literature review and field study were carried out. In the second stage, the Analytical Hierarchy Process (AHS), which is a multi-criteria decision-making method, was used and the evaluation criteria, whose weights were determined, were applied to the field. In the third stage, the recreational potential of the area was determined through the ArcGIS program and land use suggestions were developed. Results: The 11 main criteria included in the method were scored in the ArcGIS environment with appropriate sub-criteria within their weights and the recreational potential of the area was determined by the overlap method. Within the scope of the evaluation, there are no areas with very low and low recreational potential in the study area. It has been determined by the overlay method that there are 3 classes in the area, as "high recreational potential" 2910 ha, "high recreational potential" 1603 ha and "medium recreational potential" 35 ha. Conclusion: In order to determine the recreation potential of the Kayalıköy dam and its immediate surroundings, which were determined as the study area, the weights of the evaluation criteria in the literature were determined in the ArcGIS environment using the Analytical Hierarchy Process (AHP), one of the Multi-Criteria Decision Making Methods, by taking the opinions of 9 experts. As a result of the evaluation, it was determined that the recreation potential of the area was high and very high.
EFFECTS OF WRAPPING WITH FIBER-REINFORCED POLYMER MATERIALS ON THE PERFORMANCE OF REINFORCED CONCRETE COLUMNS
Authors: SÜMER Yusuf , SHINNO Wallaa
Published: April 2024

Aim: Increasing the resistance of reinforced concrete load-supporting components to external loads or restoring their original strength by utilizing fiber-reinforced composite materials has become an increasingly utilized technique in recent years. Because this process provides a wrapping effect on the concrete, it effectively boosts the element's strength and contributes to shear strength and energy absorption capacity. This paper presents the results of a comprehensive FEM investigation on the behavior of axially loaded square reinforced concrete columns with rounder corners that have been strengthened with carbon fiber-reinforced polymer CFRP wraps. First, a finite element model verified by experimental work, which allows laboratory experiments to be carried out in a computer environment, was obtained using ABAQUS software. 27 square reinforced concrete columns measuring 200*200*1100 mm were modelled and analysis was carried out using a non-linear finite element analysis. Three parameters of concrete strength, type of wrapping (full and partial) and the distance between stirrups were considered. According to the analysis results, significant increases were observed in the compressive strength of square reinforced concrete columns wrapped with CFRP compared to the unwrapped columns. It has been determined that full wrapping of the column increases the strength more than 3 times compared to ½ wrapping. It was found that the increase in ductility was relatively limited. Method: First, a numerical model of an experimental study from the literature was generated in the computer environment utilizing the non-linear finite element approach in this study. A parametric analysis was then performed to test the column strengths under various conditions in order to acquire extensive data. ABAQUS finite element software was used to examine all numerical models developed for the parametric study under axial load. Results: According to the parametric study results, fully wrapped columns performed significantly better than strip wrapped columns. It was determined that as the concrete strength increased, the strength of the confined columns increased more than twice. Conclusion: The numerical model implemented using ABAQUS finite element software confirmed the axial loaded column experiment obtained from the literature with an acceptable approximation. Parametric study conducted with the proposed finite element model showed that the percentage of wrapping with FRP composites plays an important role in increasing the axial load-carrying capacity of the column.
La importancia de los cuentos conocidos en el aprendizaje del inglés como lengua extranjera: una propuesta metodológica para el aula de 5 años / The importance of well-known stories to English language learning: a methodological proposal for 5 years old
Authors: González Martín María Mar , Querol Julián Mercedes
Published: April 2024

Las narraciones de cuentos son un recurso ampliamente utilizado en la enseñanza del inglés como lengua extranjera en el aula de educación infantil, pudiéndose introducir de diferentes modos. En el trabajo presentamos el diseño de una propuesta para fomentar la participación de los niños en la narración de cuentos en inglés que son ya conocidos en su lengua madre. Este enfoque, basado en dos métodos, el TPR-Storytelling y el método Artigal, se pone a prueba en una clase con niños de 5 años, en una intervención educativa de 3 sesiones. Los resultados de este estudio piloto muestran la eficacia de la propuesta en relación al grado de participación en la actividad, comprensión general y adquisición de vocabulario. Por otra parte, esta experiencia visibiliza las fortalezas y aspectos a mejorar de la propuesta, permitiendo el rediseño de la misma en este sentido.
Apuntes sobre la revalorización del léxico en la teoría lingüística y en la enseñanza de lenguas / Notes on the changing role of lexis in linguistic theory and language teaching
Authors: Sánchez Rufat Anna
Published: April 2024

ResumenEl objetivo de este artículo es poner de relieve aquellos aspectos más relevantes del panorama lingüístico durante las últimas cinco décadas –etapa decisiva en la revalorización del componente léxico– que han contribuido a la fuerte transformación en el valor del léxico, lo cual ha acabado revolucionando el ámbito de la enseñanza de lenguas extranjeras. Para ello, se parte de una sucinta revisión sobre el papel del léxico en relación con la lengua: desde una perspectiva más bien teórica, desde otra “adquisicionista” y, por último, desde una perspectiva pedagógica. A lo largo del breve recorrido historiográfico que presentamos van recogiéndose los rasgos que desde un primer momento integraron el conocimiento léxico, así como algunos de los más destacados que progresivamente –gracias a los desarrollos en semántica léxica, lingüística del texto, análisis del discurso y lingüística de corpus– se han ido incorporando a esta competencia. El artículo concluye con una descripción y explicación fundamentada de los aspectos que caracterizan actualmente la enseñanza de vocabulario en lenguas extranjeras, en general, y del español, en particular. AbstractThe aim of this article is to highlight the most relevant aspects of the linguistic scenario over the last five decades -a decisive stage in the appreciation of the lexical component- which contributed to the enormous changes in the value of the lexicon that has come to revolutionize the field of foreign languages teaching. To do this, we start from a brief review of the role of the lexicon in relation to language: from a more theoretical perspective, from an "aquisitionist" one and, finally, from a pedagogical perspective. Throughout the brief historiographical analysis that it is presented, the aspects which were integrated into the lexical knowledge from the very first moment, as well as the ones which have been incorporated later on into this competence are collected –thanks to the developments in the fields of lexical semantics, text linguistics, discourse analysis and corpus linguistics. The article concludes with a description and reasoned explanation of the aspects that currently characterize the vocabulary teaching in a foreign language, in general, and in Spanish language in particular.
Lectura extensiva y lecturas graduadas en lengua inglesa. Análisis comparativo de los diferentes sistemas de clasificación Extensive reading and English graded readers. Analysis of different systems of classification
Authors: Ángel Pedro Moñino
Published: April 2024

Resumen:Las lecturas intensiva y extensiva siguen siendo dos de las prácticas didácticas orientadas hacia la mejora de la comprensión; esta última, frecuentemente con la ayuda de libros graduados que en principio se consideran como un medio de adaptarse a la competencia lingüística del estudiante y sus necesidades. Sin embargo los criterios utilizados por las grandes editoriales para la clasificación  no siempre son coherentes. Además, la disposición generalizada de internet y los materiales digitales aconsejan al profesor el uso de criterios variados, puesto que materiales auténticos o textos destinados al aprendizaje del inglés como primera lengua (L1) están disponibles para su uso con estudiantes de inglés como segunda lengua (L2) o lengua extranjera (ILE). Una combinación de criterios nos dará una perspectiva más completa para la elección de libros graduados.  Abstract: Intensive and extensive reading remain two of the teaching practices aimed at improving comprehension; the latter, often with the help of graded books initially considered as a means of adapting to the students’ linguistic competence and their needs. However, the criteria used by the big publishers for the classification are not always consistent. Furthermore, the widespread availability of the internet and digital materials advise the teacher to use a variety of criteria, since authentic materials or texts for learning English as a first language (L1) are available to be used with learners of English as a second language (L2) or as a foreign language (EFL). A combination of criteria will give us a more complete picture for choosing graded books.
LEARNING AND IMPROVEMENT OF THE COMMUNICATIVE COMPETENCE IN UNIVERSITY STUDENTS. RESEARCH PROJECT
Authors: Onieva Lopez JUAN LUCAS , Torres Begines Concepción
Published: April 2024

This article is the result of a research project conducted during five months with university students from the degree in Primary Education at the University of Malaga. Due to their deficient command over the oral and gestural expressions and looking for the improvement of their communicative competences, several activities were proposed. For example: topic presentations, expositions, role- playing and workshops; in addition to improvisation playing and development of activities related to diverse didactic contexts. Along this research, we create and validate the test used by the students for their self-evaluation. Through it we could know their level of acquisition and improvement of the oral and gestural abilities.
Biblioteca escolar, lectura y literatura infantil y juvenil:selección de títulos actuales en español y portugués (2005-2015)/School library, reading and Children's and Young’s Literature:selection of current titles in Spanish and Portuguese (2005-2015)
Authors: Selfa Sastre Moisés , Balça Angela , Costa Paulo
Published: April 2024

ResumenLa función del bibliotecario en la Biblioteca Escolar resulta de todo imprescindible para que este realice una buena selección de obras y títulos que sean los adecuados para despertar el interés lector en los jóvenes estudiantes. Partiendo del concepto de canon literario entendido este como una selección subjetiva de textos literarios, en este artículo proponemos un conjunto de obras de literatura infantil y juvenil escritas en español y portugués, publicadas entre 2005 y 2015, que puede formar parte de la Biblioteca Escolar por dos motivos fundamentales: por un lado, se trata de publicaciones actuales; por otro, con cada una de ellas se puede despertar el gusto por la lectura de unos textos escritos explícitamente para el público infantil y juvenil. Las obras seleccionadas las agrupamos, como sostiene la bibliografía actual sobre esta cuestión, en tres géneros: cuento y álbum ilustrado, poesía y teatro. AbstractThe role of the librarian in the School Library is essential for this makes a good selection of titles that are adequate to arouse reader interest in young students. Based on the concept of literary canon understood as a subjective selection of literary texts, in this paper we propose a set of works of children's literature written in Spanish and Portuguese, published between 2005 and 2015, which may be part of the School Library by two fundamental reasons: firstly, it is current publications; on the other, each one can awaken the love of reading of texts written specifically for young audiences. The selected titles are grouped, as claimed by the current literature on this issue, in three genres: story and picture books, poetry and theater.
RESILIENCY PRACTICES IN EDUCATIONAL CRISIS MANAGEMENT AMONG SCHOOL ADMINISTRATORS
Authors: Pastor Mark Joseph Deblois , Acosta Rosabel Lorenzo , Aquino Marlowe U
Published: April 2024

The escalating impact of pandemics on schools, as exemplified by the pandemic crisis, underscores the pressing need for adept crisis management by school administrators. This study explores resiliency practices employed by public school administrators in the province of Ilocos Norte, Philippines, across three schools’ divisions before, during, and after the pandemic. Utilizing a phenomenological and narrative inquiry approach, themes emerged through categorization, analysis, and interpretation of data from documents and interviews. The findings underscore the importance of equipping school administrators with essential management tools such as capability-building initiatives, sustainability and contingency plans, as well as dynamic policies and guidelines. These elements collectively contribute to establishing resilience during pandemics. In response to these needs, the study introduces the Educational Crisis Resiliency Management Framework (ECRMF), a strategic educational management strategy validated for school administrators in Ilocos Norte. This framework serves as a comprehensive response to educational crisis, including pandemics, emphasizing the necessity of preparedness and effective crisis leadership. The ECRMF offers a valuable resource for school administrators navigating crises, emphasizing the importance of proactive measures and strategic procedures. As a conclusion, the study recommends further research to investigate additional practices of school administrators, providing a more in-depth exploration of disaster management in the educational realm.
BASIC PSYCHOLOGICAL NEEDS, MOTIVATION, AND FOREIGN LANGUAGE VOCABULARY LEARNING STRATEGIES AND SKILLS OF INDONESIAN UNIVERSITY STUDENTS
Authors: Susanto Alpino , Oktavia Yunisa , Kumalasari Tety , Silitonga Frangky
Published: April 2024

Foreign language vocabulary learning can be pursued if the students have motivation and interest in which psychological factors play an important role in enacting learning strategies toward increased skills. This study aims to examine the integrated process model of the BasicPsychological Needs (BPN) variable as a behavioural phenomena in relation to autonomous and controlled motivation individually or collectively toward Vocabulary Learning Strategies (VLSs) and Vocabulary Skills (VSs). A total of 186 students of one university participated in this research. The Basic Psychological Needs of Second Language Scale (BPNSLS) was employed to assess the BPN, meanwhile the Self-Determination Theory of Second Language Scale (SDTSLS) was to assess the autonomous and controlled motivation. There are three questionnaires (BPNSLS, SDTSLS, VLSs) were adopted and adapted of the previous study. The fourth research instrument was Vocabulary Level Test (VLT) version b to assess vocabulary skills. A partial least square was used to contest the research model. The structural model of the relationship between the variables of basic psychological needs, self-determination theory, vocabulary learning strategies, and vocabulary mastery, revealed that vocabulary learning strategies play a crucial role in looking at the influence of motivational orientation on vocabulary skills described in the proposed model. This study suggests that further research can explore more on how motivation relates to learning strategies in general and comparing between autonomous versus controlled motivation.
Building Rapport in an Oral Mediation Task: An Analysis of Upper-Intermediate Learners’ Use of Small Talk and Other Positive Politeness Language Formulae
Authors: Guadamillas Gómez María Victoria
Published: April 2024

This article analyses the individual responses of 20 upper-intermediate learners to an oral mediation task. Particularly, it focuses on the initial and closing linguistic resources and strategies that are displayed in each participant’s production in order to address the needs of the recipient included in the task description. With this aim, some categories of analysis are created. These categories have been designed following the descriptors of the Companion Volume of the CEFRL as well as previous literature and studies on small talk’s functionalities. Therefore, to analyse the initiation of the conversation the categories of using greetings, empathy and compassion linguistic markers and readiness to help formulae are explored. On the other hand, to inquire into the ending of the sustained-monologue, comprehension checking formulae, empathetic markers used as well as concluding and summarizing formulae have been studied. The results show that there is a lack of attention to the task’s description and, thus, to the recipient’s needs. Furthermore, additional training is needed in concluding formulae, including unimportant talk.
Competencia oral y libros de texto de Educación Primaria
Authors: Muedra Peris Maria Teresa , Gómez López Ángela , Morón Olivares Eva
Published: April 2024

La competencia oral es esencial para el desarrollo personal y profesional; por tanto, es necesario que se incluya en el proceso de enseñanza y a aprendizaje de todos los niveles educativos. Dado el uso mayoritario del libro de texto en las aulas españolas, el objetivo de este artículo es analizar cómo se desarrolla la competencia oral en los libros de texto de lengua española de Educación Primaria. Se seleccionaros cuatro colecciones de libros de texto (dese 1º a 6º) con un amplio alcance nacional y se clasificaron las actividades orales según una taxonomía creada y validada. Los resultados mostraron una presencia baja de actividades orales, así como una limitación en los tipos de textos orales y una falta de alineación con las recomendaciones de la literatura especializada. Ya que los libros de texto son el instrumento metodológico usado principalmente en clases españolas, generar instrumentos de análisis de los materiales escolares ayuda a los profesores a mejorar sus prácticas y a ser conscientes de las fortalezas y debilidades de los libros de texto.
sentir de los Equipos de Orientación Educativa y Psicopedagógica de la Comunidad de Madrid respecto a su situación y funciones en el marco del derecho a la educación inclusiva
Authors: Palomo Rodríguez Raquel , Echeita Sarrionandia Gerardo , Simón Rueda Cecilia
Published: April 2024

De acuerdo con la Observación General núm. 4 (NU, 2016), el derecho a la educación inclusiva no es compatible con la existencia de dos sistemas paralelos de educación. Sin embargo, muchos países han reinterpretado el significado de la inclusión considerando los entornos separados como una opción adecuada en algunos casos. En el centro de este dilema, en España, se sitúan las y los orientadores quienes, a través de la evaluación psicopedagógica, identifican al alumnado que recorrerá su escolarización por la vía segregada. En este trabajo se analizan las emociones y preocupaciones que experimentan los profesionales de la orientación en la Comunidad de Madrid (España) vinculadas a su situación y el papel que a este respecto juegan en el sistema educativo. Para ello, se llevó a cabo un estudio utilizando el análisis temático reflexivo como método de investigación, en el que se recogieron las voces de 177 profesionales mediante 21 grupos de discusión. Los resultados evidencian emociones de estrés, frustración y soledad vinculadas a la excesiva carga de trabajo que experimentan estos profesionales, el rol que desempeñan en el marco del derecho a una educación inclusiva y la relación que mantienen con los centros escolares y la administración.
Revisión sistemática sobre la relación resiliencia-rendimiento académico del alumnado en educación obligatoria: análisis de evaluaciones a gran escala
Authors: Redondo Blasco Valentín , Martínez Abad Fernando
Published: April 2024

Las investigaciones que competen el estudio del rendimiento académico proliferan en los últimos años, conforme a los trabajos académicos que valoran las diferentes variables inmersas en el contexto educativo. Numerosas variables han sido examinadas con relación al concepto del rendimiento académico: referentes al alumnado, profesorado y comunidad educativa en general. La resiliencia ha demostrado ser una de las variables definitorias en la explicación del rendimiento académico del alumnado. No obstante, en lo que refiere a la relación acaecida entre la resiliencia y el rendimiento académico, las investigaciones desarrolladas no parecen seguir caminos comunes ni encontrar resultados similares y concluyentes. El objetivo del presente trabajo es el de esclarecer las investigaciones relacionadas con el estudio del binomio resiliencia-rendimiento académico en los últimos años, con una muestra de población resultante de los diseños de pruebas a gran escala en el ámbito educativo. En definitiva, y, a modo de resumen, presentamos aquí una revisión sistemática de la literatura (RSL) que compendia una serie de artículos que conciben en su estudio objetivo, la relación entre resiliencia y rendimiento académico del alumnado perteneciente a la educación básica obligatoria.
The Main Factors Controlling Probabilistic Seismic Hazard Variability
Due to Epistemic Uncertainty in Greece: Results from a
One-Factor-at-a-Time Analysis
Authors: Kerkenou Athanasia , Papazachos Costas , Margaris Basil , Papaioannou Christos
Published: April 2024

We present a one-factor-at-a-time (OFAT) sensitivity study for the Probabilistic Seismic Hazard Assessment (PSHA) in Greece. The analysis examines several PSHA controlling factors, such as seismic source model (geometry, etc.), active tectonics (faulting type, etc.), as well as the employed ground-motion prediction equations (GMPEs). We have considered only peak ground acceleration (PGA) and peak ground velocity (PGV) for a typical PSHA scenario (10% probability of exceedance in 50 yr). OFAT results are presented using Tornado diagrams for 42 major urban centers of Greece that cover the study area revealing regions of different PSHA uncertainty. In general, the most critical factors controlling PSHA uncertainties are the Gutenberg–Richter (G-R) parameters (a and b), as well as the employed GMPE. However, significant spatial variability of these factors is observed with large differences between high- and low-seismicity regions, as well as between PGA and PGV. The results not only provide an objective assessment of the variability of PSHA uncertainties but also verify the need for additional work to minimize epistemic PSHA uncertainties, focusing on the most critical factors that control PSHA.
The Most Vulnerable Children Faced Unique Risks During COVID-19: How Agencies Communicated with Communities on Parenting in Low Resource and Humanitarian Settings
Authors: El-Khani Aala , Bertram Kathryn , Stephens Lauren , Romig Laura , Ghalegolabi Huda , Wendt Ulrike , Maalouf Wadih
Published: April 2024

Evidence suggests that children in low resource and humanitarian settings experienced added mental health burdens and violence in the home during the SARS-CoV-2 (COVID-19) pandemic, which may have affected their health and development. For humanitarian response agencies, conducting child protection services during this pandemic had been constrained by safety concerns related to the risk of COVID-19 transmission, and logistical issues aligned with social and public health measures. This paper describes how agencies responded to the identified risks children face, integrating remote risk communication and community engagement approaches and safe in-person dialogues with parents and caregivers into child protection interventions to educate about the disease and prevention, encourage a positive parenting environment and mitigate negative effects on children. United Nations (UN) agencies and non-government organizations (NGOs) must reflect on these different approaches and share lessons learned and best practices internally and at an inter-agency level to support evidence-based responses for future epidemics and pandemics.
Classroom well-being through virtual learning environments in higher education from 2021 to 2023
Authors: Ugalde Eugenia , Díaz-Rojas André
Published: April 2024

The present research deals with the conditions associated with well-being in the classroom through virtual environments of the student population that attends lessons at a private university located in the Central Headquarters in San José, Costa Rica (Central America). The objective is to analyse the conditions associated with well-being in the classroom through virtual learning environments during the years 2021 to 2023. The research uses a quantitative approach, and the type of study is descriptive and cross- sectional. The study was conducted with 731 active students during the period from 2021 to 2023 who used virtual environments to continue their studies. The sample corresponds to 46.5% of the total population (1570 students). The variables associated with well-being conditions in the classroom were environmental and technological conditions; emotional conditions; social conditions; methodological conditions; and student conditions. The Classroom Well-being Scale in virtual environments was used to collect the information. This instrument has a reliability of 95% and a very high correlation between variables (99%). The results show that, in general, there is well-being in the classroom through virtual environments; specifically, that there is a high level of well-being in the classroom in the following aspects: availability of the virtual platform; respect for all people in the classroom environment; assertive communication in the course activities; and free expression of ideas in a respectful environment. The aspects that reflect well-being in the classroom are: quality of audiovisual resources; availability of learning resources; structure of the virtual environment; student participation; and feeling at ease with the course. The aspects to be reinforced to improve well-being are: activities proposed by the teacher in the course; and peer support in carrying out the course activities.
A Comprehensive Analysis of Clinical and Laboratory Characteristics of Thyroid Abnormalities in a Two-Year Outpatient Cross-Sectional Study
Authors: Damdindorj Davaasuren , Bavuu Oyunbileg , Ganbaatar Bolormaa , Sonomtseren Sainbileg , Tumenbayar Bayasgalan
Published: April 2024

Background: The prevalence of thyroid disorders, particularly disseminated Graves’ disease and thyroid nodules, is escalating within the general population. Irregular activation of the immune system is a key factor in causing autoimmune thyroid diseases such as Graves’ disease and Hashimoto thyroiditis. However, the development of autoimmune disorders is influenced by a combination of environmental factors such as urbanization, pollution, and iodine intake. Methods and Results: The study involved 204 patients with thyroid disorders at the department of endocrinology in the outpatient clinic over the past 2 years. The data collection of demographical and clinical information included age, gender, clinical features, laboratory tests, and instrumental analysis. The mean age of participants was 44.35±14.29 years, and females comprised 91.2% of the cases. Among them, 46.1% had thyroid nodules, 36.8% presented with Grave’s disease, 13.2% with Hashimoto’s thyroiditis, and 3.9% with thyroid hyperplasia. The patients with Grave’s disease, the average levels of thyroid antibodies were as follows: anti-thyroid stimulating hormone receptor (Anti-TSHR ) at 21.91±14.02 IU/L, anti-thyroglobulin (Anti-TG) at 265.91±406.03 IU/ml, and anti-thyroid peroxidase (Anti-TPO) at 319.3±327.1 IU/ml, respectively. Additionally, the mean thyroid enlargement was 29.60±16.08 ml. The participants were categorized based on their geographical region, with the distribution as follows: central region 59.3%, northern region 20.1% western region 10.8%, and eastern region 9.8%. Conclusion: Thyroid disorders are prevalent in our population, with greater incidence in females than males. The majority of cases (46.1%) involved thyroid nodules, with a peak age of above 30 years among participants. The central region, particularly the capital city (Ulaanbaatar), exhibited the highest prevalence at 59.3%, as highlighted by the distribution of thyroid abnormalities.
Durum Wheat Production and Soil Chemical Properties in Response to Three Biannual Rotation Cycles with Residue Incorporation
Authors: Hirzel Juan , Undurraga Pablo , Vera Carola , Matus Iván
Published: April 2024

Crop rotations incorporating residues generates benefits in productivity and a better efficiency of resources. However, the incorporation of residues in high quantities is not a common practice, given the lack of comprehension of farmers of the effects on the following crop. This experiment was carried out in an Andisol soil in south-central of Chile. Three biannual rotation cycles (canola-durum wheat and bean-durum wheat) with four levels of residue incorporation (0%, 50%, 100% and 200%) were evaluated on the evolution of grain yield and production of durum wheat residues, and on chemical properties of the soil at the end of the three cycles. The results indicated that pre-cultivation affected the grain yield and residue production of durum wheat, highlighting the positive effect of the bean. In soil, a higher concentration of available N and exchangeable Ca, Mg and K was obtained in the bean-durum wheat rotation, and a higher concentration of available S in the canola- durum wheat rotation. By increasing the dose of waste, an increase in the concentrations of exchangeable Ca, Mg and K was achieved. Finally, the chemical properties of the soil presented positive and negative correlations associated with the management of liming, fertilization and nutrients mostly present in the incorporated waste. This study helped to validate that the continuous incorporation of the residues produced within the rotations in this volcanic soil contributes to the improvement of some of its chemical properties with no effect of yield of the durum wheat crop.
Design and Validation of an integrated Objective Structured Clinical Examination (i-OSCE) for a non-surgical aesthetics postgraduate program.
Authors: Kumar Narendra , Parsa Ali
Published: April 2024

Introduction: The Objective Structured Clinical Examination (OSCE) is a popular and practical method for evaluating future clinicians’ competence and suitability for independent clinical practice. The present study aimed to develop and validate an integrated objective structured clinical examination to assess aesthetic physicians’ critical thinking and clinical competency. Methods: Initially, an expert panel consisting of five Aesthetic Practitioners with over 15 years of experience and a senior clinical academic were invited to develop a blueprint for the integrated objective structured clinical examination. Through this blueprint, the essential qualities and skills were identified for assessment. In addition, training workshops for examiners and simulated patients were organized to ensure process standardization. The final integrated objective structured clinical examination consisted of 12 stations (four clinical, four critical thinking, and four rest stations lasting 180 min). Results: The Interclass correlation coefficient between the station checklist items was 0.946 (average upper bound 0.916, lower bound 0.968; p<0.00), which was considered significant. The Inter-Item Correlation Matrix among the clinical station and critical thinking checklist items also showed statistical significance. The Pearson correlation coefficient (PCC) was used to ascertain the correlation between the checklist and global ratings, yielding a high correlation (0.80 0.934). Conclusion: The integrated objective structured clinical examination is a valuable and reliable tool for assessing trainees’ aesthetic physicians’ clinical competence and critical thinking.
Promoting eCo-responsibility, eCo-literacy, and eCo-centricity in emergency triAge Regarding climate changE consequences (I-CARE THE 3 Cs): study protocol
Authors: Dos Santos Omar Portela , Verlo Henk , Pereira Alves Paulo Jorge
Published: April 2024

Background: Climate change, ambient air pollution, and non-optimal temperatures are recognized as a global health emergency. Many studies have highlighted increases in the number of emergency hospital admissions and hospitalizations for respiratory and cardiovascular diseases associated with non-optimal temperatures, unconventional gas reserves, particulate matter, grounded level O3, sulphur dioxide, or nitrogen dioxide exposure. Problem statement: According to the Swiss Health Observatory, 14% of the Swiss population used a hospital emergency department (ED) at least once in 2016, representing 1,7 million admissions or 4,718 admissions per day. In the face of evolving climate-associated reasons for presenting at the ED, the scales used for emergency triage are now proving insufficient for their task. It is becoming critical to introduce and implement more appropriate ED triage tools that incorporate risk factors such as ambient temperature and air pollution. It will also require raising nurses’ eco-literacy, eco-responsibility, and eco-centricity, which are currently rated as moderate to low, to ensure adaptation and/or mitigation in the face of this global threat. Future directions and perspectives for the nursing discipline: The nursing discipline must develop its eco-literacy, eco-responsibility, and eco-centricity to take social and professional responsibility for addressing the health-related impacts of climate change. To do so, the research project’s overall aim, which will be achieved in five stages, is to develop, pilot-test, and evaluate the feasibility of a complex nursing intervention named “Education Intervention promoting eCo-literacy, eCo-responsibility, and eCo-centricity in emergency triAge Regarding climate changE consequences (I-CARE the 3 Cs). The I-CARE the 3 Cs intervention aims to provide an adequate, effective, efficient, fair, safe, and patient-centered response to patients’ and nurses’ needs and to develop guidelines for dealing with the health consequences of climate change.
Effects of aconitine on membrane currents and action potentials in neonatal rat ventricular myocytes and its impact on electrocardiographic changes
Authors: Chou Chih-Ju , Cheung So Edmund
Published: April 2024

This study presents an analysis of the electrophysiological effects of aconitine, a toxic diterpenoid alkaloid derived from Aconitum plants, on neonatal rat ventricular myocytes (NRVMs). The research investigates the potential impact of aconitine on various ion currents and cardiac action potentials, shedding light on its arrhythmogenic properties. Whole-cell patch-clamp experiments were conducted to assess the effects of aconitine on delayed-rectifier K+ currents (IK(DR)) and inwardly rectifying K+ currents (IK(IR) in NRVMs. The findings indicate that aconitine exposure led to the inhibition of (IK(DR)) and (IK(IR)), suggesting its potential influence on cardiac repolarization and excitability. Notably, aconitine induced transient inward current (ITI) and early after-depolarizations (EADs) in a concentration- dependent manner, both of which have implications for cardiac arrhythmias. Moreover, the study examined the electrocardiogram changes in Sprague-Dawley rats upon aconitine injection, revealing a prolonged QT interval and the emergence of polymorphic ventricular tachycardia (VTs), indicative of arrhythmic effects. The study emphasizes the importance of understanding the electrophysiological impact of aconitine and similar compounds, considering their potential therapeutic applications and associated toxicities.
Assessment of Progression Markers for Cirrhosis in Cystic Fibrosis Patients
Authors: Matos Gabriela , Kühl Franciane , Cecchetti Guilherme , Hahnemann Carolina , Marques Gustavo , Tafarel Jean
Published: April 2024

Cystic Fibrosis is an autosomal dominant disease that affects the CFTR gene, which is responsible for producing a protein that regulates the transport of chloride ions across the cell membrane. This alteration results in obstruction in the body's ducts and channels, primarily affecting the pulmonary system. Additionally, other systems can be affected. Cystic Fibrosis-related liver disease is a common complication that can lead to steatosis, fibrosis, and multifocal biliary cirrhosis; however, there are no well-established diagnostic criteria yet. The present study was conducted at the Cystic Fibrosis Outpatient Clinic of the Hospital de Clínicas, Federal University of Paraná, examining 98 medical records of patients with cystic fibrosis for at least 10 years. Patients with hepatitis B, hepatitis C, alcohol consumption, or pregnancy were excluded. The objective was to determine the best predictor for the outcome of cirrhosis, and for this purpose, demographic parameters, laboratory tests, and imaging were collected. The statistical analysis was performed using SPSS® software, with quantitative variables described as mean ± standard deviation and categorical variables presented as the number of observations and percentage. ROC curves were adjusted to determine the best predictor, using the Youden index to establish the optimal cutoff point and the corresponding area under the curve to determine the model's efficacy. The study included 80 patients, and 10 of them (12.5%) were diagnosed with Cystic Fibrosis-related cirrhosis. The average age of the cirrhosis group was 21.6 years, with a predominance of males. The most accurate parameter for predisposition to cirrhosis was the APRI score, with a cutoff value of 0.27. Univariate analysis showed that gender, hepatic changes on ultrasound, splenomegaly, increased portal vein diameter, presence of vomiting, levels of alanine transaminase, aspartate transaminase, platelet count, and FIB-4 score were significantly associated with an APRI score value greater than 0.27. This study suggests the hypothesis that the APRI score is the most sensitive and specific tool for defining cirrhosis in patients with cystic fibrosis.
Navigating Strategic Change Process in Healthcare Organizations During Unexpected Crisis Change Process in Healthcare Organizations During Crisis
Authors: Paul Jijo
Published: April 2024

The Radiation Oncology (RO) clinical department is a significant healthcare facility in university hospitals dedicated to treating cancer patients using radiation. Radiation oncology has undergone significant workflow changes, patient appointments, patient scheduling, treatment flow, medical care, and many more to continuously treat cancer patients safely in healthcare facilities during the pandemic crisis. The present study examined the decision-making, change initiatives, implementation process, and post-transition review of these changes in the department of a major university hospital. In contrast to the usual change initiatives, the executive level made all the crucial decisions with the support of a network of teams and then passed them on to the lower-level employees for quick implementation in the crisis. formulated quickly implemented the formulated decisions, sending the essential communications through various electronic methods. The department performed well in this change initiative/ process, allowing patients to continue radiation treatments by taking the necessary steps to tackle the crisis effectively. The department revenue was reduced over the period, and no employee lost their job due to the effective involvement of the management from the beginning of the crisis. Many employees were allowed to work from home, implemented telehealth programs for patient consultations, and provided patients with specific appointment times for radiation treatments. These steps considerably reduced department traffic to control viral spread issues successfully.
A qualitative study of motivation to self-management in pediatric diabetes health care consultations with adolescents with type 1 diabetes.
Authors: Teyken Rose , Lomholt Johanne , Schou Anders
Published: April 2024

Background. The impact of health care professionals on the motivation for self-management in adolescents with type 1 diabetes has been highlighted as important. It is, however, not well understood how health care practitioners can help increasing motivation to self-management. The aim of the study was to investigate how practitioners can motivate their patients to self-management in consultation and how adolescents with type 1 diabetes experienced that consultation could facilitate motivation to self-management. Methods. The study triangulated participant observations of 11 consultations at a pediatric health care clinic and 10 interviews of the adolescents (age 15-17) about their experiences of consultations. The analysis showed five categories: 1. Consultation dialogue, 2. Roles in treatment, 3. Assuming consultation-facilitated responsibility for self-management, 4. Relationship in treatment, and 5. Consultation context. Results. Overall findings showed that the adolescent’s developmental process of becoming autonomous in relation to self-management was influenced by consultations, and that the need of feeling related was experienced as valued by the adolescents. Conclusions. The feeling of relatedness and development of autonomy were experienced as important for how consultations could facilitate motivation to self-management in 15-17-year-olds and may be fundamental to adolescents’ experience of competence in relation to self-management.