bluuebunny/crossref_metadata_2025 huggingface dataset:
İzlenim Yönetimi ve Yaşam Doyumu İlişkisinde Kişilik Özelliklerinin Rolü
Authors: Acar Eyüp , Karavelioğlu Mihri Barış
Published: May 2023

Kişilik özellikleri ile İzlenim yönetimi taktikleri ve yaşam doyumu ortak paydada buluşan ve bireyin toplumsal yapı içerisinde sergiledikleri davranışlar hakkında ipucu sunan konulardır. Dolayısıyla beden eğitimi ve spor öğretmenlerinin kişilik özellikleri ile izlenim yönetimi taktikleri ve yaşam doyumu arasındaki ilişkinin belirlenmesi önemli görülmektedir. Çalışmanın genel amacı, spor liselerinde görev yapan beden eğitimi ve spor öğretmenlerinin izlenim yönetimi taktikleri ile yaşam doyumu ilişkisinde kişilik özelliklerinin rolünü incelemektir.
Araştırmanın evrenini Türkiye’de 2020-2021 eğitim-öğretim yılında spor lisesi n=79 tematik spor lisesi n=10 olmak üzere toplamda n=89 spor lisesinde çalışan beden eğitim ve spor öğretmeni oluşturmaktadır.
Örneklem grubunu ise araştırmanın evreni içerisinden çalışmaya gönüllülük esası ilkeleri doğrultusunda katılan, evrenin %77 lik kısmını temsil eden toplamda n=373 beden eğitimi ve spor öğretmeni oluşturmaktadır.
Çalışmada veri toplama araçları olarak katılımcıların kişilik özelliklerini belirlemek için Gosling ve arkadaşları (2003) tarafından geliştirilen ve Atak (2013) tarafından Türkçeye uyarlanan “On-Madde Kişilik Ölçeği" kullanılmıştır. Katılımcıların kullanmış olduğu izlenim yönetimlerini belirlemek için Bolino ve Turnley (1999) tarafından geliştirilen ve Türkçe’ye Basım, Tatar ve Şahin (2006) tarafından uyarlanan “İzlenim Yönetimi Ölçeği”  kullanılmıştır. Yaşam doyum düzeylerini belirlemek için Diener, Emmons, Larsen ve Griffin (1985) tarafından geliştirilen Dağlı ve Baysal (2016) tarafından Türkçeye uyarlanan “Yaşam Doyumu Ölçeği” kullanılmıştır.
Verilerin analizinde tanımlayıcı ve betimleyici istatistik yöntemleri, ikili gurupların karşılaştırılmasında bağımsız örneklem t testi, üç ve daha fazla gurupların karşılaştırılmasında tek yönlü varyans analizi ile değişkenler arasındaki ilişki düzeyini belirlemek için korelasyon analizi, bağımsız değişkenlerin bağımlı değişken üzerindeki etkilerini belirlemek için regresyon analizi kullanılmıştır.
Sonuç: Beden eğitimi ve spor öğretmenlerinin ağırlıklı olarak sorumlu kişilik özelliği sergilediği, izlenim yönetimi taktiklerinden niteliklerini tanıtarak kendini sevdirme taktiğini kullandığı tespit edilmiştir. Kişilik özellikleri, izlenim yönetimi taktikleri ve yaşam doyumu bazı demografik değişkenlere göre farklılık göstermektedir. Ayrıca kişilik özellikleri, izlenim yönetimi taktikleri ve yaşam doyumu arasında da anlamlı ilişkiler bulunmuştur.
Pesticide Utilization and Insecticide Residue Levels in Rice from Banaybanay, Davao Oriental
Authors: Sumile Edito , Generalao Lourdes
Published: May 2023

Pesticides for rice production were widely used in Banaybanay, Davao Oriental. These included insecticides, herbicide and molluscide in this order. etofenprox and fipronid were the most utilized insecticide, butachlor and thiobencarb+24D for herbicide. copper oxychloride and benomyl were the most used fungicides by farmers while niclosanide for mulluscide. Farmers used the conventional knapsack sprayer in applying pesticides in the rice field. Farmers usually applied insecticide at a range of one to more than 11 times but most applied it from one to five times. Herbicides and fungicides were applied once or twice per season although few had to apply five times Farmers' frequency of spraying and dosage of applying pesticides were usually based on the recommendation indicated on the product label. Only a few did not follow the manufacturer's instructions. Insecticide and herbicide were applied at a range of one to IOL; one to six L. of fungicide or molusscide; others had used one to 10 sachsets, and five to 50 sacks of fertilizer per cropping season. Twenty-two percent had been using pesticides for six to 10 years, and 4% for more than 31 years. Insesticide residues were detected in Hybrid rice. Cypermethrin residue was detected above the level of Allowable Daily Intake while deltamethrin was below it.
YENİLENEBİLİR ENERJİ KAYNAKLARINDA YAPAY ZEKÂ KULLANIMI
Authors: DİRİK Regaib , TAŞKESEN Edip , DİRİK Ömer
Published: May 2023

Günümüzde, enerji üretiminde yenilenebilir enerji kaynaklarına olan ihtiyaç giderek daha önemli hale gelmektedir. Konvansiyonel(alışılagelmiş) enerji kaynaklarının tükenilebilir olması ve çevrede yarattığı olumsuz etkileri göz önüne alındığında yenilenebilir enerji kaynaklarının gerekliliğine her zaman olduğundan daha fazla ihtiyaç duyulduğu görülmektedir. Ancak, yenilenebilir enerji kaynakları verimli bir şekilde kullanılmadığında, enerji üretiminde karşılaşılan sorunlar devam edecektir. Bu nedenle, yapay zekâ gibi sürekli gelişme gösteren ileri teknolojilerin yenilenebilir enerji kaynaklarına entegrasyonu sağlanarak elde edilen enerjinin verimliliği artırılmıştır. Yapay zekâ teknolojisi, yenilenebilir enerji kaynaklarının verimli bir şekilde kullanılmasına yardımcı olmuştur Ayrıca, enerji üretim verilerinin analizi ve tahmini için yapay zekâ kullanımı da enerji üretiminde karşılaşılan sorunları çözmek için etkili ve verimli bir araç olacaktır. Yapay zekâ kullanımı, yenilenebilir enerji kaynaklarının verimli kullanımıyla birlikte, enerji üretiminde sürdürülebilir bir gelecek için önemli bir adımdır. Bu teknolojinin kullanımı, enerji üretimini artırmakla beraber var olan enerjinin sürdürülebilir bir şekilde kullanımını da sağlayacaktır. Bu çalışmada, yenilenebilir enerji kaynakları için yapay zekâ teknolojilerinin kullanımı incelenmiştir. Ayrıca, yapay zekâ teknolojilerinin yenilenebilir enerji kaynaklarındaki kullanımının avantajları ve dezavantajları araştırılmıştır. Sonuç olarak, günümüzde yenilenebilir enerji kaynaklarına olan ihtiyaç hızlı bir şekilde artış göstermektedir ve yapay zekâ teknolojisi, bu kaynakların verimli bir şekilde kullanımına yardımcı olmaktadır. Yapay zekâ teknolojisi, enerji üretim verilerinin analizi ve tahmini için kullanılarak enerji üretiminde karşılaşılan sorunların çözümüne katkıda bulunmaktadır. Bu teknolojinin kullanımı, enerji üretimini artırmanın yanı sıra var olan enerjinin sürdürülebilir bir şekilde kullanımını da sağlayacaktır. Ancak, yapay zekâ teknolojilerinin dezavantajları da dikkate alınarak, yenilenebilir enerji kaynakları için yapay zekâ teknolojilerinin dikkatli bir şekilde kullanılması gerekmektedir.
Rüzgar türbinlerinin farklı rüzgar hızı koşullarında performans karşılaştırması
Authors: Kahraman Hüseyin , Cesur İdris
Published: May 2023

Enerji, bugün dünyanın en önemli sorunlarından biridir. Fosil enerji kaynakları tükeniyor, bu nedenle dünya yeni enerji kaynakları arayışı içindedir. Rüzgar, eski zamanlarda sulama ve un değirmenlerinde kullanılan bir yenilenebilir enerji kaynağıdır. Teknolojinin ilerlemesiyle birlikte rüzgar enerjisinden elektrik üretilmeye başlanmıştır. Bu çalışmada rüzgar enerjisi ve türbinleri tanıtılmış, kanat profilleri ve tasarım faktörleri incelenmiştir. Evrimsel yapı optimizasyonu, boyut, şekil ve topoloji optimizasyonu için basit ve etkili bir yöntem olarak kullanılabilir. Bu yöntem, yapı tasarımını geliştirme ve en uygun hale getirme konusunda oldukça yeni bir araçtır. Kirişlerin en uygun tasarımları araştırıldı ve QBlade programı kullanılarak gerçekleştirildi. Yapıdaki gerilme dağılımı optimize edildi ve kafes benzeri tasarımlar elde edildi. Bu nihai tasarımlarda, başlangıç hacmine göre %30-40'a varan oranlarda azalma görüldü. Topoloji optimizasyonunun önemi ve amacı üzerinde duruldu ve yapılan çalışmaların sonuçları sunuldu. Bu çalışmanın ana amacı, en uygun tasarımları arayarak yenilenebilir enerji kaynaklarının verimliliğini artırmaktır.
Basketbol Hakemi El İşaretlerinin Nesne Tanıma Yöntemleri Kullanılarak Sınıflandırılması
Authors: Biçer Ozan , Zalluhoğlu Cemil
Published: May 2023

Teknolojinin gelişmesiyle birlikte, yapay zekâ ve bilgisayar görüşü teknikleri spor alanında da insan hayatına girmeye başladı. Günümüzde basketbol hakemleri, maç içinde verdikleri kararları masa hakemlerine el işaretleri ile gösterir ve masa hakemleri bu doğrultuda bazı verileri skor tabelasına işler. Bu işlem insan kaynaklı hatalar sebebiyle bazen aksamaktadır ve maçın duraklamasına sebep olmaktadır. Bu çalışmada, bilgisayar görüşü teknolojisi ile bu probleme bir çözüm önerilmektedir. Bu amaçla basketbol hakemlerinin el işaretleri için bir veri seti elde edilmiştir. Bu veri seti üzerinden iki adet derin öğrenme modeli eğitilmiştir ve başarı sonuçları paylaşılmıştır. Gerçekleştirilen çalışma, bahsedilen sürecin yapay zekâ desteği ile geliştirilebileceği ve sadece basketbol değil, tüm spor dallarına sağlayabileceği potansiyel katkıları göstermektedir.
Madra Dağı (Balıkesir) Yöresinin Staphylinidae (Coleoptera) Türlerinin Çukur Tuzak Yöntemiyle Belirlenmesi
Authors: Ateş Kürşat Can , Varlı Sakin Vural
Published: May 2023

– Bu çalışma 2010-2011 yılları arasında çukur tuzak yöntemi kullanılarak Balıkesir il sınırları içerisinde bulunan Madra Dağı Yöresinin Staphylinidae familyasına ait üyelerin belirlenmesine yönelik yürütülmüştür. Arazi çalışması; Mayıs (2010)- Aralık (2011) dönemlerinde kızılçam, kestane, karışık karaçam ve meralık biyotoplarını kapsayan 6 örnekleme sahasında gerçekleştirilmiştir. Çalışma sonunda; Staphylinidae familyasına bağlı 5 tür (Ocypus curtipennis Motschulsky, 1849, Quedius levicollis Brulle, 1832, Ocypus orientis Smetana and Davies, 2000, Ocypus (Pseudocypus) sericeicollis Menetries, 1832, Ocypus (Pseudocypus) mus Brulle, 1832) olmak üzere toplam 5 tür belirlenmiştir. Ayrıca çalışma alanında incelenen türlerin sinonimleri, morfolojileri ve yayılış alanları verilmiştir.
Araba Radyatöründeki Nanoakışkanların Isı Transfer Performansı
Authors: Taşkesen Edip , Dumrul Hakan , Damarseçkin Serdal , Gürbüz Hüseyin , Bilen Elif Nur
Published: May 2023

- Nanoakışkanların üstün termofiziksel, reolojik ve tribolojik özelliklerinden dolayı, otomobillerde ısıtransferi ve yağlama gibi uygulamalarda kullanılabilirler. Otomobillerde nanoakışkanların, radyatörsoğutucu, motor yağlayıcı, klima sistem yağlayıcı, motor yakıtı, fren sıvısı ve şok absorblayıcı gibi olasıuygulamaları bulunmaktadır.Bu çalışmada, araba radyatöründe soğutucu akışkan olarak nanoakışkanların kullanılması ile ısı transferhızındaki değişim incelenmiştir. Nanoakışkanların radyatörlerdeki ısı transferi üzerindeki etkisi, birkaçfaktöre bağlıdır. Bunlar arasında nanoakışkanın konsantrasyonu, boyutu, şekli ve akışkanın viskozitesi gibifaktörler yer almaktadır. Ayrıca, nanoakışkanların radyatörün içinde nasıl dağıldığı da önemlidir.Nanoakışkanların homojen bir şekilde dağılması, daha iyi bir ısı transferi sağlamaktadır.Sonuç olarak, araba radyatörlerinde kullanılan nanoakışkanlar, daha iyi ısı transferi sağlayarak aracınmotorunun daha verimli çalışmasına ve daha uzun ömürlü olmasına yardımcı olduğu görülmüştür.
Çocuklarda Anemi Hastalığının Teşhisinde Topluluk Öğrenme Yöntemlerinin Kullanılması
Authors: Farzaliyev Emin , Saihood Qusay , Sonuç Emrullah
Published: May 2023

Okul öncesi çocukların en yaygın hastalığı, özellikle gelişmekte olan ülkelerde, anemi olarakbilinmektedir. Anemi genellikle kötü beslenme ile ilişkili olup, demografik ve sosyal faktörlerle deyakından ilişkilidir. Önceki çalışmalarda, çocuklardaki anemi hastalığını tahmin etmek ve ilişkili faktörleribelirlemek için istatistiksel yöntemler kullanılmıştır. Ancak, bu yöntemlerin yetersiz olduğu sonucunavarılmıştır. Bu çalışmada, çocuklarda anemi hastalığını tahmin etmek için topluluk öğrenme (ensemblelearning) tekniklerinin kullanımı araştırılmıştır. Anemi hastalığını tahmin etmek için Karar Ağacı, DestekVektör Makineleri, Rastgele Orman, Lojistik Regresyon, En Yakın Komşu gibi çeşitli makine öğrenmesialgoritmaları test edilmiştir. Daha sonra bu sınıflandırıcılar, torbalama (bagging), artırma (boosting),istifleme (stacking) gibi öğrenme teknikleri ile modellenerek daha doğru ve güçlü bir tahmin modelininoluşturulması amaçlanmıştır. Bu çalışmada kullanılan veri seti, Irak'ın Haditha Genel Hastanesi vekliniklerinden toplanan 600 örneği içermektedir. Bu örneklerden 429'u anemi hastası iken, 171'i anemihastası değildir. İlgili veri setinde her bir örneğe ait 31 özellik bulunmaktadır. Veri seti üzerinde farklıtopluluk tekniklerinin performansları değerlendirilmiştir. Sonuçlara göre topluluk öğrenme teknikleribireysel sınıflandırıcılara göre daha az doğrulukla tahminde bulunmuştur. Ayrıca, topluluk öğrenmeteknikleri arasında artırma yönteminin en yüksek doğruluğa (%91) eriştiği görülmüştür. Çalışma, topluluköğrenme tekniklerinin çocuklarda anemi hastalığını tahmin etmek için farklı bir yöntem olabileceğinigöstermektedir. Ancak, gelecekteki araştırmalarda veri önişleme, özellik seçimi gibi yöntemlerinkullanılmasının topluluk öğrenme modellerinin performansını artırmada etkili olabileceği öngörülmektedir.
1.8-sineol (ökaliptol)’ün kronik obstrüktif akciğer hastalığı (KOAH) belirteçleri üzerindeki önemi
Authors: Akbulut Hatice Feyza
Published: May 2023

– 1,8-sineol (ökaliptol), doğada bolca bulunan kafur benzeri bir kokuya sahip renksiz siklik birmonoterpen oksittir. 1.8-sineol, Eucalyptus globulus yapraklarının uçucu yağının ana bileşeni olup, farklıalt türlere göre uçucu yağın yaklaşık %61.0-79.3 kısmını oluşturmaktadır. Ökaliptol gibi monoterpenler,güçlü balgam söktürücü özelliklerinden dolayı KOAH gibi obstrüktif solunum yolu hastalıklarınıntedavisinde yıllardan beri yaygın olarak kullanılmaktadır. Kronik obstrüktif akciğer hastalığı (KOAH)karmaşık ve heterojen bir hastalıktır. KOAH hastalığının teşhisinde ve tedavisinde birçok belirteçler yaygınolarak kullanılmakta ve araştırmalara konu olmaktadır. Bu KOAH biyobelirteçler çok çeşitli moleküllerikapsamaktadır ve kan gazı değerleri (pH, pCO2, pO2); C-reaktif protein (CRP), eritrosit sedimantasyonhızı (ESR) ve fibrinojen gibi akut faz reaktanları; interlökin (IL)-6, IL-8 ve TNF-α gibi sitokinler; beyinnatriüretik peptit (BNP) gibi kardiyak orijinli moleküller; matris metalloproteinaz (MMP)-9 gibi kollajenoluşumunda yer alan moleküller; adiponektin gibi yağ asidi işlemede yer alan moleküller ve sitotoksik T,B ve NK hücreleri gibi lenfositler, çalışılan KOAH belirteçleri arasında yer almaktadır. Birçok araştırmacı1.8-sineol (ökaliptol)’un çoğu KOAH belirteçleri üzerinde olumlu etkiler gösterdiğini rapor etmişlerdir.Yapılan araştırmalara göre 1.8-sineol’ün KOAH belirteçleri üzerine pozitif yöndeki etkisinden dolayıoksidatif strese bağlı KOAH gibi hastalıkların tedavisinde kullanılabilirliğini göstermekte olup konuüzerine daha fazla araştırma yapılmasının hastalığın tedavisine olumlu yönde katkı sağlayacağıkaçınılmazdır.
Electrical and mechanical behaviors of conductor asphalt concrete by the addition of steel fibers
Authors: Messaoud M. , Glaoui B. , Abdelkhalek O.
Published: May 2023

Conductive asphalt has the potential to satisfy different multifunctional applications. Thebehavior and the electrical and mechanical properties of this asphalt concrete have been modified usingconductive additives, which can improve the durability of the asphalt mix and the service life of thepavement system. Among these additives are steel fibers. The results obtained indicate that the direct tensilestrength of bituminous mix, the resistance to cracking, the energy, and the ductility modulus are increasedwith an increase in the percentage of steel fibers. Electrical resistivity decreased with the addition of steelfibers. So it is concluded that tensile strength increases reversibly with increasing electrical resistivity.
Pesquisa Multidisciplinar em Saúde - Edição III
Authors:   Guilherme Barroso L. De Freitas,   Ariádine Reder Custodio de Souza,   Mayumi Brito
Published: May 2023

O atendimento, abordagem e pesquisa de equipes multidisciplinares é o modelo recomendado pela Organização Mundial de Saúde. Os cuidados são prestados por profissionais de habilidades diversas, os quais se complementam para elevar o conhecimento dos casos e aumentar a chance de resolução e prevenção de problemas. Essa união é conhecida como cuidados multidisciplinares, ou seja, profissionais de uma série de disciplinas trabalham juntos para oferecer cuidados abrangentes que atendam ao maior número possível de necessidades do paciente. Isso pode ser entregue por uma série de profissionais funcionando como uma equipe sob um guarda-chuva organizacional ou por profissionais de várias organizações. À medida que a condição de um paciente muda ao longo do tempo, a composição da equipe pode mudar para refletir as mudanças nas necessidades clínicas e psicossociais do paciente. Para acadêmicos e docentes, manter o elo da multidisciplinaridade abra a visão do conhecimento e permite que os indivíduos envolvidos saiam das suas zonas de conforto e atinjam graus de conhecimento não adquiridos apenas nas emendas tradicionais de cada curso. Desta forma, a Editora Pasteur organizou este livro com trabalhos selecionados, com objetivo de proporcionar ao leitor um material de qualidade, com leitura agradável e que possa elevar o conteúdo dos amantes da inter-transmultidisciplinaridade .
La pandilla TDAH
Authors: Garnica-Gasca Ricardo , Fontes-Zepeda Ariadna
Published: May 2023

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Desarrollo de habilidades de autocontrol en estudiantes. Una revisión sistemática
Authors: Martínez Capristán Alexa Del Rosario
Published: May 2023

La presente investigación tuvo como principal objetivo analizar las conceptualizaciones más empleadas en el contexto académico sobre las habilidades de autocontrol en estudiantes en los últimos 5 años. Se utilizó una metodología con enfoque cualitativo y diseño revisión sistemática, por medio de los buscadores académicos Scielo, Ebsco Host, Google Académico y ProQuest, en el cual se seleccionaron 40 artículos correspondientes al período 2019-2023. Los resultados demostraron que el mayor número de investigaciones se encontró en España, sin embargo se hallaron muchos estudios en distintos países de latinoamérica también. Se concluyó que el autocontrol, debe ser considerado como una habilidad y capacidad elemental para el adecuado funcionamiento profesional, por ello, el sistema educativo debe enfatizar en reajustar el perfil docente y articular estrategias socioemocionales para reducir acciones impulsivas, frustración, desequilibrio emocional y pérdida de la paciencia del maestro, que a su vez, posibiliten la permanencia, continuidad y cumplimiento del proceso enseñanza-aprendizaje en el estudiante. Por lo que es recomendable fortalecer las habilidades emocionales innatas de los estudiantes, porque el autocontrol, neutraliza determinados factores que limitan los procesos educativos, ante lo expresado, es necesario poner en práctica la automotivación y adecuar los comportamientos que podrían desencadenar aquella pérdida de la tranquilidad anímica.
ԵՎՐՈՊԱԿԱՆ ԻՐԱՎՈՒՆՔ (ՄԱՍ II) – ԻՐԱՎՈՒՆՔԻ ԱՂԲՅՈՒՐՆԵՐՆ ՈՒ ԻՐԱՎԱՍՏԵՂԾՈՒՄԸ ՄԻՈՒԹԵՆԱԿԱՆ ԻՐԱՎՈՒՆՔՈՒՄ
Authors: HOVHANNISYAN GOR
Published: May 2023

The first part of the four-part series of articles on European law starts with basic questions and the foundations of organisational law.
The second part explains the legal sources of the European Union law and also deals with the legislative procedures. In addition, the structural principles applicable in the European law are outlined.
The third part focuses on the fundamental rights of the European Union, which - in addition to the fundamental freedoms - are the essential individual rights of European primary law. The structural peculiarities from the perspective of the European and constitutional law are described, with a particular focus on the binding effect of the Charter of Fundamental Rights for the Member States.
The fourth part explains the fundamental freedoms as the central means for establishing the internal market.
ՄՈՐ ԵՎ ՄԱՆԿԱՆ ՇԱՀԵՐԻ ՊԱՇՏՊԱՆՈՒԹՅԱՆ ՄԻՋԱԶԳԱՅԻՆ ԵՎ ՆԵՐՊԵՏԱԿԱՆ ԻՐԱՎԱԿԱՆ ՆՈՐՄԵՐԻ ՎԵՐԼՈՒԾՈՒԹՅՈՒՆ
Authors: ASLANYAN TIRUHI
Published: May 2023

The article discusses international and domestic legal norms for the protection of the interests and rights of mother and child. Protecting the interests of the family, mother and child is one of the constitutional principles. Article 16 of the Constitution of the Republic of Armenia defines: the family as the natural and basic unit of society, the basis for the preservation and reproduction of the population, as well as motherhood and childhood are under special protection and patronage of the State.
ԺԱՄԱՆԱԿԱԿԻՑ ԿԵՆՍԱԲԺՇԿԱԿԱՆ ՏԵԽՆՈԼՈԳԻԱՆԵՐԻ ՔՐԵԱԻՐԱՎԱԿԱՆ ԿԱՐԳԱՎՈՐՄԱՆ ԱՆՀՐԱԺԵՇՏՈՒԹՅԱՆ ՈՐՈՇ ՀԻՄՆԱՀԱՐՑԵՐ
Authors: SARGSYAN ADELINA
Published: May 2023

. Scientific and technological breakthrough, improvement of medical care technologies, processes of genetic engineering and other biomedical technologies require proper legal, including criminal law regulation. Of course, many potentially socially dangerous acts in these areas have not found their actual manifestation to date, but this does not mean that they do not require criminal legal regulation. After all, several decades ago, with the same success, the world community did not even assume about such negative phenomena as cybercrime, in particular, cyberterrorism, cyberterrorism, phishing, etc., while today the efforts of many states are aimed precisely at criminal legal counteraction to the noted illegal encroachments. In the absence of a definition of the concept of “iatrogeny” and “iatrogenic crimes” at the legislative level, the issues of classification of iatrogenic crimes are widely discussed in scientific circles. Most authors refer to them only traditional iatrogenic crimes, at the same time, we defend the position regarding the attribution of non-traditional iatrogenic crimes to them, which have no less degree of public danger. The issues of genomic research are relevant primarily due to the fact that they are at the intersection of ethics and law. To date, such issues as editing, modification of the human genome, the legal status of the human embryo and its criminal protection, new reproductive technologies are on the agenda. The development of biomedical technologies actualizes the issue of their proper legislative regulation, criminalization of potential socially dangerous acts in the areas under consideration and identification of criminal law problems in the application of modern biomedical technologies.
What Can Student-Run Free Clinics Do for Rural Ethnic Villages in China?
Authors: Zha Mengyi , Huang Yunyi , Ren Xueying , Chen Dan
Published: May 2023

The Sunshine and Love Free Clinic is Chinaâ€™s first and only student-run free clinic. Two successful outreach projects to a rural ethnic village, Dimen, by the volunteers of the clinic took place in 2015: a pilot project focusing on womenâ€™s health, and a larger medical service trip focusing on record building and clinical visits. While the indigenous healing is a great recourse, four major health-related issues were identified through these projects: womenâ€™s health and reproductive health; chronic illness care; a lack of formal medical training among the village clinic staff; and a lack of patient record system. This article proposes that a summer service trip model can be utilized by student-run free clinics in China to tackle these issues, and provide sustainable intermittent long term health care for the rural ethnic China in a culturally sensitive manner.
How Well Does a Student-Run Free Clinic Care for Diabetic Patients?
Authors: Laitman Benjamin M , Mosley Grace , Thomas David C , Meah Yasmin S
Published: May 2023

Background: Student-run free clinics are an integral safety net for the uninsured, particularly for managing chronic conditions such as diabetes. A previous study of diabetes care at the East Harlem Health Outreach Partnership (EHHOP) demonstrated that patients receive comparable care to insured patients. In this study we explore the clinicâ€™s achievement and maintenance of glycemic targets in adult type II diabetes patients.Methods: This was a retrospective study examining hemoglobin A1c (A1c) values from 2009-2012. Patients with baseline A1c â‰¥7.0% and â‰¥2 A1c values recorded were included in this study. Data was analyzed at baseline, 6 months, 1 and 2 years from diagnosis, and at final recorded visit. Prescribed medications were also assessed. Results were compared with other published diabetes quality-of-care metrics.Results: Forty-four patients met entry criteria. Mean baseline A1c was 10.1%Â±2.3% and decreased to 8.3Â±2.3% by 6 months of treatment. By their final visit, 40.9% (n=18) of patients achieved an American Diabetes Association A1c goal of â‰¤7.0%. Of those patients with A1c values above target, 15 reduced their A1c to â‰¤8.0%. Patients whose A1c values reached â‰¤7.0% maintained stable low A1c levels for the remainder of follow-up. Over 90% of patients achieved targets with â‰¥1 hypoglycemic medication. Patients least able to achieve goal A1c were more likely to take a greater number of medications. These results are comparable to other published metrics.Conclusions: Despite resource limitations, uninsured patients at student-run free clinics are able to reach and maintain target A1c at comparable rates to their insured counterparts.
RIME and Reason
Authors: Gururangan Kapil , Lin Steven
Published: May 2023

Student-run free clinics (SRFCs) are unique clinical settings that combine service to underserved populations and medical student education. SRFCs empower students to take charge of real patientsâ€™ care prior to entering clerkship rotations. This real-world education, by fostering an early experience of clinical responsibility, helps students prepare for the role transitions described by the RIME (Reporter-Interpreter-Manager-Educator) framework that defines the training and development of physicians â€“ from reporters and interpreters of clinical data, to patient care managers, to educators of the next generation. We present a narrative of one medical studentâ€™s formative experiences at SRFCs during his preclinical and early clinical years to highlight their value in preparing students for their future careers.
Evaluating HIV and STI Attitudes and Knowledge in First-Year Medical Students
Authors: Mani Sriniwasan B , Bral Daniel O , Soltanianzadeh Yasamin , Choxi Shivali , Ware Deanna , Weissinger Peg , Michaelsen Veronica E , Plankey Michael W
Published: May 2023

Background: Medical students have been shown to have knowledge deficiencies and stigmatizing attitudes that may compromise their care of patients with human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Many medical schools now offer early exposure to patient care and encourage students to volunteer in free clinics where sexual health care is a common patient concern. In light of increased student involvement in patient care, we sought to characterize knowledge gaps and stigmatizing attitudes in first-year medical students in a major United States city.Methods: We developed a survey instrument by integrating previously validated HIV and STI knowledge questionnaires. These multiple-choice questions tested concepts such as disease transmission, clinical testing modalities, and sexual health care practice standards. In addition, we created a 4-item Likert-type scale to determine student attitudes toward patients with HIV and STIs.Results: A total of 459 medical students completed the questionnaire. The students were predominantly female (254; 55.3%), white (294; 64.1%), and Christian (241; 52.5%), with a mean age of 23.7 (standard deviation 2.45) years. The survey instrument demonstrated significant knowledge gaps in certain areas of HIV/STI testing and counseling, as well as a consistent minority of students who expressed discomfort examining or treating patients with HIV. Overall, 57.8% of the knowledge questions were answered correctly, and 14.3% of students (n=65) were not comfortable touching a patient with HIV.Conclusions: These findings suggest that medical students possess knowledge gaps and stigmatizing attitudes, which could potentially impact patient care in the practice settings in which medical students provide sexual health care. Future research should focus on 3 approaches to overcoming deficiencies in knowledge and attitudes: (1) cultural sensitivity training, (2) targeted education modules, and (3) practical testing training.
Description and Correlation of Blood Pressure Measures to Health Behaviors among Uninsured Individuals Receiving Physical Therapy Services at a Student-Run Clinic
Authors: Arena Sara , Schiller Martha , Mhaid Dalia , Al-Qattan Hussain , Pysh Jill
Published: May 2023

Background: The purpose of this observational study is 1) to describe the prevalence of pre-hypertension (P-HTN) and hypertension (HTN) blood pressure (BP) measures and associated self-reported health behaviors among uninsured women at a student-run clinic (SRC) for physical therapy and 2) to analyze correlations between BP measures and the self-reported health behaviors of this population. Self-reported health behaviors included physical activity, fruit and vegetable consumption, weight management, and smoking behaviors.Methods: Demographic information, BP measurements, and behavioral assessments were collected on patients referred to the Wayne State University-Super All Year Detroit Physical Therapy Clinic between May 2014 and April 2015.Results: Thirty-six females (34 African-American) with a mean age of 52 (SD=9.0) years were included. Pre-hypertension and HTN BPs were identified in 55.6% and 19.4% of the women, respectively. Among women with no prior HTN diagnosis, the prevalence of P-HTN and HTN BPs was 40.0% and 10.0%, whereas the prevalence of P-HTN and HTN BPs was 61.5% and 23.1% in women with a prior HTN diagnosis. Among study participants, 50% engaged in recommended physical activity levels, 50% consumed at least five fruits and vegetable servings per day, 27.8% maintained a healthy weight, and 64.7% abstained from smoking. A significant Spearmanâ€™s rank correlation was identified between a higher frequency of reported positive health behaviors and a lower systolic BP (r=-0.369, p=0.027).Conclusions: Identification of elevated BPs or reduced adherence to recommended healthy behaviors may guide physical therapists or other health care providers to choose health-promoting interventions that enhance patientsâ€™ health and wellness.
Providing Womenâ€™s Cancer Screening and Education in an Underserved Border Population
Authors: Mootz Allison , Belmont De Santiago Andres , Gutierrez Jesus , Steffen Kelcy , Swinney Ira , Francis Maureen
Published: May 2023

Health disparities related to breast and cervical cancer screening and mortality exist for Hispanic women living near the United States (US)-Mexico border. The Medical Student Run Clinic (MSRC) at Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine provides free health care to a primarily Hispanic, Spanish-speaking border community and has focused on expanding its womenâ€™s cancer screening services. The MSRC held mammogram drives, clinical breast exam (CBE) nights, and cervical cancer screenings with the help of student and physician volunteers alongside community health workers. Also, a Womenâ€™s Health Day Clinic was held, providing CBEs, Pap smears, and womenâ€™s health education. Clinic volunteers provided 163 women with CBEs, out of which 154 women then received screening mammograms, nine women were referred directly for diagnostic testing, and one patient was diagnosed with breast cancer. For cervical cancer screening, 55 Pap smears were performed. Through its mammogram drives, cervical cancer screenings, and Womenâ€™s Health Day Clinic initiatives, the MSRC demonstrated a method to increase access to womenâ€™s preventative health care services in a medically underserved community. The MSRCâ€™s womenâ€™s health initiatives serve as examples for other student-run free clinics on how to implement preventative health screenings and education for their patient populations.
Integrating Oral Health at a Free Medical Program
Authors: Bannon Annika , Silk Hugh
Published: May 2023

Free medical clinics offer crucial access to primary care services for underinsured and uninsured patients. Most patients served by these clinics lack dental coverage. Oral health is an important part of overall health, but few free clinics currently offer basic preventive oral health care like fluoride varnish and dental hygiene education. The purpose of this article is to describe the process of integrating oral health services into an existing free medical clinic, discuss challenges and elements of success, and convey hopes for the clinicâ€™s future.
Meeting Patients Where They Are: Evaluating a Student-Run, Shelter-Based Model for Connecting Homeless Patients with a Medical Home
Authors: Brug Aaron Matthew , Green Georgiana , Mayer Scott I. , Gregersen Maren , Kanter Joseph , Jones Catherine E.
Published: May 2023

Background: Substantial barriers exist between persons experiencing homelessness and the health care system, which contributes to significant health disparities. Innovations to connect patients to long-term primary care via the â€˜medical homeâ€™ model have had mixed results. This study evaluates the effectiveness of an innovative, student-run, shelter-based clinic model that leverages its onsite location to link patients to a medical home.

Methods: A retrospective chart review of patient visits at two shelter-based, student-run clinics between October 1, 2016 and October 1, 2017 was performed. Data collected included demographics, health risk factors, medical histories, and visit chief concerns. Patients referred to a medical home were assessed for successful follow-up at that location within 90 days. Successful medical home follow-up attendance was modeled using multivariable logistic regression with backwards elimination and a significance threshold of p<0.05.

Results: Within 90 days of referral, 30% of all patients referred to the medical home successfully attended a follow-up appointment, with 57% of new patients attending more than one appointment in the same time interval. Among patients who received referrals, those with a mental health related chief complaint were significantly more likely to follow-up at a medical home than those with other chief complaints (p=0.024). Medicaid insurance status negatively predicted successful follow-up (p=0.041).

Conclusions: Student-run free clinics in locations that access vulnerable populations can be effectively used to link patients to medical homes. A better understanding of these factors may provide insight into how to help patients access a medical home and establish longitudinal care.
Establishing Dermatologic Care for the Homeless and Underserved at a Student-Run Clinic
Authors: Teal Lindsey , Spitz Katherine , Diven Dayna
Published: May 2023

Skin problems are the reason one-third of people experiencing homelessness seek medical care. These conditions are exacerbated by increased exposure to the sun and hazardous environments, malnutrition, physical injuries, and limited access to health care. This is a medically vulnerable population that does not have regular access to specialty care, such as dermatologic care. The objective of this pilot project was to increase access to dermatologic care in the homeless and underserved populations by integrating dermatologic specialists into a student-run clinic. Dermatologic screenings were held at a local student-run clinic monthly. Medical students and dermatologists screened patients for any dermatologic findings and educated patients on skin care and self-screening methods. Afterward, social work students referred patients to local dermatologists that best fit their needs. Patient demographics, skin findings, and qualitative patient responses were recorded. The majority of patients were interested in being screened, as many had never been evaluated by a dermatologist. Many felt the timing and location of the clinic was helpful in obtaining care. All patients successfully taught back skin cancer prevention methods. All skin findings were benign. This experience demonstrates that integrating dermatology specialists into an interprofessional, student-run clinic to provide dermatologic screenings and skin care education can be accomplished. Further studies will evaluate integrating monthly dermatology care at clinic as well as piloting the integration of other medical specialties into the clinic, such as ophthalmology.
Development and Evaluation of Electronic Social Needs Assessment and Resource Connection Tool in Facilitating Utilization of Community Services That Address Upstream Health
Authors: Farthing Heather , Simko Sarah , Eckembrecher Francelia J , Eckembrecher Daphne G , Penabad Isabel , Fernandez Yanelys , Nunez Veronica , Pines Sophia , Cruz Nicole , Tanenbaum Rebecca , Cabrera Berta , Gallardo Luz , Kobetz Erin
Published: May 2023

Background: Social determinants of health (SDOH) put some groups who access care at student-run free clinics (SRFCs) at higher risk for adverse medical outcomes. Free or low-cost community services supplement clinic-based interventions, but access is limited by knowledge, transportation, language, and/or trust. Social needs assessments may be electronically paired with resource connection tools to connect patients to local, validated resources. The objective of this pilot study was to evaluate the SDOH screen and resource connection tool developed at a SRFC.

Methods: The tool was piloted with a convenience sample of 40 patients with scheduled outpatient appointments at a SRFC in Miami, Florida. Participants were given information about a variety of services and screened for high-risk situations such as human trafficking. Follow-up survey via telephone at 2-4 weeks identified survey acceptability, successful connections, and barriers to access.

Results: Forty participants completed the assessment. All participants were counseled regarding exercise and nutrition and requested information about more than one resource. Sixty percent (n=24) were successfully contacted for follow-up. Of these, 29% (n=7) were able to connect with one or more recommended resources. Reasons given for failure to access resources included lack of time or transportation, health issues, and lack of response from contacted organizations.

Conclusions: Social needs assessments may be implemented in SRFCs to identify high-risk needs, facilitate linkage to local organizations that meet these needs, gather data to guide future programming, and provide education and counseling. Stronger connections with local organizations and closed loop referrals may be needed to facilitate connection to community resources.
PODEMOS: A Student-Led International Medical Brigade
Authors: Mason Thomas , Challa Nayanika , Baek Jae , Pollauf Arthur , Veach Emily , Regalado Luis , Leon Jacy
Published: May 2023

PODEMOS, Spanish for â€œWe Canâ€, is an interdisciplinary healthcare organization based in Columbus, Ohio, that is designed to meet the healthcare needs of communities around the city of El Progreso, Honduras. Honduras is a developing country in Central America that scores low in most indicators of healthcare quality and access. Most notably, there is a tremendous need for expanded access in rural communities. Established in 2008 by students from the Ohio State University College of Medicine, PODEMOS conducts biannual medical brigades that run primary care clinics in three rural communities around El Progreso through the volunteer service of United States (US)-based medical, pharmacy, and dental professionals. Additionally, the organization works with local leaders to provide healthcare services for patients with chronic conditions, fill gaps in US-based provider coverage, and recruit patients. PODEMOS bases its care on two models, the acute care model for common adult complaints and all children under the age of 18, and the chronic care model for a subset of adult patients who need more complex care for chronic conditions such as diabetes mellitus and hypertension. Providers then have access to select laboratory and pharmacy services for their patientâ€™s needs. PODEMOS has had a large impact on local communities since its inception, as evidenced by the numerous acute patient visits in its 11 years of existence and the 136 patients currently enrolled in chronic care program. Nevertheless, the organization continues to face challenges in areas such as interprofessional collaboration, security, and maintaining patient turnout. This piece is a descriptive report on PODEMOS, a student-run international medical organization based out of the Ohio State University Wexner Medical Center, that seeks to inform other student-run organizations about the organizationâ€™s structure and operation.
Cost Savings of HPV Testing Alone Versus Co-Testing for Cervical Cancer Screening at a Student-Run Free Clinic
Authors: Wells Ali , Zwygart Kira , Roetzheim Richard , Gonzalez Eduardo
Published: May 2023

Background: Primary high-risk human papillomavirus (hrHPV) testing is an approved alternative method of cervical cancer screening by the United States Preventative Services Task Force. The University of South Florida BRIDGE (Building Relationships and Initiatives Dedicated to Gaining Equality) Clinic is a student-run free clinic with limited screening resources, serving patients below the poverty line. This study aimed to determine the potential cost benefit of primary hrHPV testing in this population.

Methods: A retrospective observational study of clinic invoices and patient charts from January 2014 to December 2018 of women receiving cervical cancer screening by co-testing was performed.  

Results: BRIDGE spent $29,122.37 on screening over the five-year period for 128 patients. By elimi-nating cervical cytology, the clinic would have saved $11,594.34. Fifteen patients had abnormal results, ten of which were hrHPV-positive.

Conclusions: The $11,594 saved would allow BRIDGE to screen 110 more patients by primary hrHPV testing and another three by eliminating follow-up for atypical squamous cells of undetermined significance, hrHPV-negative results. One patient with low-grade squamous intraepithelial lesion and negative hrHPV represents a 0.8% risk of missing precancerous lesions the clinic would assume by adopting primary hrHPV testing.
Screening for Torture, Asylum, and Trauma among Patients Seeking Care in an Urban Student-Run Free Clinic
Authors: Pan Jonathan , Leader Andrew , Wang Eileen , Ratnapala Nicole , Garvey Katherine L , Gowda Ramita , Moser Joe-Ann , Mell AJ , Pak Theodore , Singer Elizabeth , Thomas David , Meah Yasmin
Published: May 2023

Introduction: Many immigrants have histories of violence and persecution in their countries of origin that may make them eligible for asylum in the United States. East Harlem Health Outreach Partnership (EHHOP) is a physician-supervised, student-run free clinic (SRFC) of the Icahn School of Medicine at Mount Sinai that serves exclusively uninsured persons, nearly all of whom are immigrants. This study aimed to provide a screening tool to measure the prevalence of self-reported histories of persecution which may be grounds for asylum and connect these patients to appropriate resources such as legal aid and forensic medical services.

Methods: The Screening for Torture, Asylum, and Trauma (STAT) questionnaire was developed to screen patients for potential asylum-eligible histories. The questionnaire probed if participants were ever victims of violence or abuse in their countries of origin and the contexts of such violence. Patients screening positive for trauma which may constitute grounds for an asylum claim (“STAT-positive”) were assigned a case manager to oversee referrals to appropriate resources. Changes in demographics between STAT-positive and STAT-negative patients were determined using Fisher Exact Tests and binomial exact calculations to generate P-values and 95% Confidence Intervals (CI), respectively.

Results: Of the 86 patients screened, 27 (31%; 95% CI [0.22-0.42]) were STAT-positive. Nineteen (70%) were interested in applying for asylum and 15 (79%) of these patients were successfully referred to legal assistance programs. Seventeen (63%) were already receiving care at EHHOP’s mental health clinic. 

Conclusion: There is a high prevalence of patients (31%) within the EHHOP SRFC with histories of violence, abuse, persecution, or discrimination which may be grounds for asylum in the United States. Identifying these patients for targeted interventions may have a significant positive impact for these patients.
The Case for the Safe Re-Opening of Student-Run Clinics during COVID-19
Authors: Hopfer Sarah , Miller Reese , Neese Olivia , Swiezy Sarah
Published: May 2023

Coronavirus disease 2019 (COVID-19) has presented a unique challenge to student-run free clinics (SRFCs), with many closing for several months and all needing to find ways to adapt to the new “normal” of the pandemic. While the prospect of new variants and higher surges continues to threaten our ability to keep SRFC doors open to serve the neediest patients among our community, we present here arguments from need, practicality, safety, and ethics that COVID-19 is the ideal time to maintain—and, even expand—the services SRFCs provide. With so many patients relying on SRFCs for their primary care and with the ability to use precautionary measures to safely see and treat patients, SRFCs should play a vital role in helping the overburdened healthcare system continue to function and provide needed care, despite the devastating impacts of COVID-19.
Impact of COVID-19 on the Delivery of Eye Care to Uninsured Diabetic Patients at a Student-Run Free Clinic: A Comprehensive Evaluation of Eye Clinic Performance
Authors: Chuter Benton , Lieu Alexander , Dayao John Kevin , Bu Jennifer , Chen Kevin , Nishihara Taiki , Baxter Sally
Published: May 2023

Background: Diabetic retinopathy is the leading cause of blindness among working-age adults in the United States and requires timely screening and management. This study evaluates the impact of the coronavirus disease 2019 (COVID-19) pandemic on diabetic retinopathy screening (DRS) for uninsured, predominantly Latino patients at the University of California San Diego Student-Run Free Clinic Project (SRFCP).

Methods: A retrospective chart review was conducted of all living diabetic patients at SRFCP who were seen in 2019 (n=196), 2020 (n=183), and 2021 (n=178). Ophthalmology clinic referrals, scheduled patient visits, and visit outcomes were analyzed longitudinally to determine the impact of the pandemic on screening patterns.

Results: The study population was 92.1% Latino, 69.5% female, with a mean age of 58.7 years. The distribution of patients seen (p<0.001), referred (p=0.012), and scheduled (p<0.001) in 2020 and 2021 significantly differed from 2019. In 2019, 50.5% of 196 patients eligible for DRS were referred, 49.5% were scheduled, and 45.4% were seen. In 2020, 41.5% of 183 eligible patients were referred, but only 20.2% were scheduled and 11.4% were seen. In 2021, there was a rebound: 63.5% of 178 patients were referred, 56.2% scheduled and 46.1% seen. No shows and cancellations represented 12.4% and 6.2% of the 97 encounters scheduled in 2019, but were markedly higher (10.8% and 40.5% respectively) for the 37 encounters scheduled in 2020.

Conclusions: The COVID-19 pandemic significantly impacted the delivery of eye care at SRFCP. The need for annual DRS exceeded the capacity of the ophthalmology clinic in all years studied, but the difference was especially pronounced with more stringent COVID-19 restrictions in 2020. SRFCP patients could benefit from telemedicine DRS programs to improve screening capacity.