bluuebunny/crossref_metadata_2025 huggingface dataset:
GP roles in emergency medical services: a systematic mapping review and narrative synthesis
Authors: Burrell Alexander , Scrimgeour Grace , Booker Matthew
Published: March 2023

Background

A significant proportion of emergency medical services (EMS) work is for problems that may be amenable to timely primary care management and could benefit from GP input. Utilising GPs in EMS may reduce avoidable emergency department (ED) conveyance, releasing emergency ambulances for higher-acuity care, and meeting patient needs earlier in the evolution of an emergency call.

Aim

To collate and summarise evidence on how GPs are utilised in EMS.

Design & setting

Systematic mapping review and narrative synthesis.

Method

A systematic literature search was conducted using search terms for general practice and emergency care. Primary research articles investigating the utilisation of GPs in non-critical EMS were included. An inductive framework was used to structure the results alongside a narrative synthesis.

Results

Twenty-one articles were included. GPs were embedded in EMS for urgent management of high-acuity patients or used as an intervention to avoid unnecessary ED conveyance in selected lower-acuity patients. The importance of interprofessional relationships and training for GPs involved in EMS was highlighted. No studies explored patient-reported outcomes. Outcomes measured were predominantly ED non-conveyance and admission avoidance, with GP services as an intervention reducing the likelihood of these outcomes.

Conclusion

Embedding GPs in EMS might service different purposes depending on context. There is some evidence that GP EMS services may reduce the likelihood of ED conveyance and hospital admission in selected cases; it is unclear whether this is owing to case selection or GP involvement. Future research should incorporate patients’ views and experiences.
COVID-19 Tanılı Klinik ve Yoğun Bakım Hastalarında ABO ve Rh Kan Grup Antijenlerinin Mortalite ile İlişkisi: Bir Pandemi Hastanesi Deneyimi
Authors: TOPAL Serra , ÇALIŞKAN Gülbahar , SAYAN Ayça , KELEBEK GİRGİN Nermin
Published: March 2023

Giriş ve Amaç: Coronovirus 2019 (COVID-19) tüm dünyada pek çok kişiyi etkileyen ve mortalitesi yüksek olan pandemiye neden olmuştur. ABO kan grupları vasküler, koroner kalp hastalıkları gibi birçok kronik hastalık yanında viral enfeksiyonlarla da ilişkilendirilmektedir.Bu çalışmada kan gruplarının COVID-19’a yatkınlık ve mortalite ile ilşkisini araştırmayı amaçladık.

Gereç ve Yöntemler: 17 Mart 2020 ve 30 Kasım 2020 tarihleri arasında PCR pozitif COVID-19 tanısı ile hastanemizde yatırılarak tedavi edilen erişkin hastaların dosyaları retrospektif olarak incelendi. Demografik veriler, ABO ve Rh kan gruplarının dağılım oranları kaydedildi. Kan gruplarının mortaliteye etkisi incelendi. Hastalar serumlarında anti-A bulunması (B ve O kan grubu) ve bulunmamasına (A ve AB kan grubu) göre gruplandırılarak yaş, cinsiyet, yoğun bakıma (YB) yatış ve mortalite açısından karşılaştırıldı.

Bulgular: Çalışmaya 3137 hasta dahil edildi. Hastaların 2231’i kliniğe, 906’sı YB’ye yatırılmıştı. Hastalar 55.17±17.90 yaşında olup, %51.2’si erkek idi. Hastaların A, B, AB ve O kan grubuna sahip olma oranları sırasıyla %47.5, %14.5, %8.3 ve %29.6 idi. Hastaların 530’nun tedavisi eksitus ile sonuçlanmıştı. Yaş, klinik ve YB hastalarında mortaliteyi etkilemişti (ikisi için p=0.000). Tüm hastalarda erkek cinsiyette mortalite (%61.9) anlamlı olarak yüksekti (p=0.000). Rh’ın ve serumda anti-A izohemaglütinin bulunmasının mortalite ile ilişkisi yoktu (p=0.42, p=0.565). Multivariate lojistik regresyon analizi sonucu kan grubu mortalite ile ilişkili tespit edilmedi. Yaş, erkek cinsiyet ve mekanik ventilasyon gereksinimi mortalite için bağımsız risk faktörü olarak saptandı (sırasıyla OR.1.073p=
Tip 2 Diyabetus Mellituslu Hastalara Verilen Video Destekli Eğitimin Subkutan İnsülin Uygulama Becerisi Ve Kan Glikoz Düzeylerine Etkisinin İncelenmesi
Authors: AKSU Özge , AKMAN Özlem
Published: March 2023

Amaç; Bu araştırmada, Tip 2 diyabetes mellituslu hastalara verilen video destekli eğitimin subkutan enjeksiyon uygulama becerileri, kan glikozu ve Hemoglobin A1c düzeylerine etkisinin incelenmesi amaçlanmıştır.
Yöntem; Araştırma randomize kontrollü deneysel bir çalışmadır. Araştırmaya Eylül 2018Haziran 2019 tarihleri arasında İstanbul’da bir Devlet Hastanesine başvuran ve insülin tedavisine başlanan Tip 2 Diyabetli hastalar alınmıştır. Araştırma örneklemi; anlamlılık düzeyi =0.05, %95 güven aralığında ve %80 güç sağlamak üzere, kontrol grubuna 50, uygulama grubuna 50 hasta olmak üzere toplam 100 hasta alınmıştır. Girişim olarak araştırmacılar tarafından hazırlanan güncel “Subkutan Enjeksiyon Uygulama Videosu” her uygulama öncesi izlemeleri yönergesi ile uygulama grubundaki hastaların mobil telefonlarına gönderilmiştir. Kontrol ve uygulama grubu hastaların eğitim öncesi ve 3 ay sonra kontrollerinde kan glikozu ve hemoglobin A1c düzeyleri laboratuvar verilerinden alınmıştır. Verilerin değerlendirilmesinde, tanımlayıcı istatistikler, ki kare, bağımlı ve bağımsız gruplarda t testi, Mann-Whitney U testi, etki büyüklüğü hesaplamada Cohen’s d istatistiği kullanılmıştır.
Bulgular; Her iki grubun hem kendi içlerinde hem de birbiri ile karşılaştırılmasında; eğitimden hemen sonraki (p=0.024) ve eğitimden 3 ay sonraki (p=0.000) subkutan insülin uygulama beceri gözlem formu puan ortalamalarında anlamlı fark saptanmıştır (p<0.05). Ancak gruplar arasında eğitimden 3 ay sonraki kan glikoz düzeyleri (p=0.917) ve HbA1c düzeyleri (p=0.797) arasında fark yoktur (p>0.05).
Sonuç; Tip 2 Diyabetli hastaların eğitiminde; standart diyabet eğitimi içine subkutan insülin uygulama becerilerini geliştirecek gereksinimi olduğunda sürekli ulaşabileceği video destekli görsel eğitim materyalleri kullanılmalıdır.
РОЗРОБКА WEB-СЕРВІСУ ДЛЯ СТВОРЕННЯ ЕЛЕКТРОННИХ ТРЕНУВАЛЬНИХ ВПРАВ
Authors: Курганський А. Р. , Олефіренко Н. В.
Published: March 2023

Цифрові засоби навчання посідають значне місце в освітньому процесі, вони змінюються й набувають нових ролей у поточній ситуації. Наразі особливо затребуваними є такі електронні ресурси, що здатні забезпечити реальну варіативність завдань, їх неповторюваність, терпеливо перевіряти правильність кожного завдання і надавати різнорівневу допомогу кожному користувачеві. Здійснено аналіз функціональних можливостей наявних онлайн сервісів, зорієнтованих для проєктування й реалізацію електронних тренажерів, який свідчить про необхідність їх розвитку й суттєвого розширення з тим, щоб учитель зміг обрати саме той тренажер, який відповідав би потребам і вимогам конкретного уроку й поставлених методичних завдань. У наукових публікаціях висвітлюються різні аспекти проблем проєктування й ефективного використання дидактичних електронних ресурсів в освітньому процесі, проте залишаються актуальними питання створення таких конструкторів, які будуть зручні для конкретної ситуації на уроці або конкретному учителю. У статті розглянуто технологію проєктування й реалізації вебсервісу, конструктора тренувальних вправ, в яких учневі потрібно вказати фрагмент зображення в якості відповіді на запитання. Розкрито зміст етапів проєктування: цілепокладального, аналітичного, створення моделі тренажера, методичного, вибору інструментальних засобів, апробаційного та рефлексивно-корекційного. Розроблений вебсервіс має дві складові – конструктор тренажерів та тренажер. Всі розробки учителя зберігаються у хмарі, можуть бути доступними у будь-який момент. Перевагами вебсервісу є: підтримка особливого типу вправ, зорієнтованих на пошук фрагмента у загальному зображенні; наявність адаптивного інтерфейсу, зручний і легкий інтерфейс додатка; можливість використовувати векторні й растрові векторні зображення для побудови вправи; доступність додатка користувачам через розміщення даних у хмарі; можливість використання при вивченні різних предметів; доступність банку готових тренажерів, розроблених раніше учительською спільнотою. Сервіс розроблений мовою програмування Visual C# з використанням технології Blazor і може бути застосований у навчанні школярів будь-яких дисциплін.
Physical activities traditional games and javanese culture of particularly Wayang Kulit
Authors: Tri Wibowo Antonius , Sukarmin Yustinus , Purwanto Sugeng , Tri Iwandana Dody
Published: March 2023

Abstract Physical activity has a favorable influence, including teaching students to focus on learning, as well as strengthening emotional control and emotional intelligence. Games that use technology can prevent children from feeling the game's process, from feeling how to cooperate with their peers, from learning to tolerate, understand, and forgive one another, and from inhibiting psychomotor development and cognitive (thinking) and affective (emotional). Purpose This study aims to determine how much interest teenagers have in traditional games and Javanese culture, especially Wayang Kulit in the Special Region of Yogyakarta. Material and methods This research is a survey method, data collection using a questionnaire. The sampling technique used was purposive sampling with the criteria of adolescents aged 13-19 years domiciled in the Province of the Special Region of Yogyakarta totaling 478 consisting of 293 males and 185 females. Results From this study, the results obtained were the variable data of traditional games, the interest factor of teenagers in traditional games with a score of 34,946 in the "high" category, the action factor for playing traditional games with a score of 32,686 in the "medium" category. As for the Javanese culture variable regarding Wayang Kulit, the Javanese cultural interest factor scores 32,686 in the "medium" category and the action factor for Javanese culture scores 22,069 in the "low" category. Conclusions The conclusions in this study are joint effort needed whether parents always introduce Javanese culture and traditional games to their children, teachers introduce them consistently through physical education learning, and the government makes policies that require the introduction of Javanese culture and traditional games to always be carried out regularly. In addition, alternative innovations are needed to develop fun sports games to introduce Javanese culture, especially Wayang Kulit and traditional games so that if they are consistently carried out continuously, Javanese culture and traditional games will remain sustainable.
Strategies for conducting online-based physical education research during COVID-19: investigate the lecturer's perception
Authors: Samsudin Samsudin , Setiawan Edi , Abdul Gani Ruslan , Winarno M.E , Anggara Suganda Mikkey , Kardiyanto Deddy Whinata , Németh Zsolt
Published: March 2023

Purpose
The many obstacles and difficulties to carry out research in the field of physical education are the gaps and urgency in this research. This study aims to investigate perceptions from lecturers regarding the conveniences and difficulties when carrying out research in physical education during COVID-19.
Material and Methods
This study uses a qualitative approach with phenomenological methods through online-based in-depth interviews. Five lecturers from two universities in Indonesia and one lecturers from universities in Hungary were willing to participate in this research. The way to select them was by sending an email to their respective universities and only 10 people participated in this study. However, 4 people did not qualify because they did not have 10 years of research experience.  All participants signed a consent letter to participate in this study. The interview started with explanation from participants regarding their research experiences, the conveniences and the difficulties faced when carrying out research during pandemic. After the activity was completed, the results of the interviews were collected and then a qualitative statistical analysis was carried out In this study, statistical analysis used thematic method in the form of interviews transcribed word for word.The transcripts were read repeatedly by researchers and three experts, coding and a collection of phrases were arranged into themes.
Results
The findings of this study indicate that there were several conveniences in carrying out research physical education during the COVID-19 period, including the implementation can be done anywhere and anytime, cost-effective and saving time, data collection is easier and faster. Meanwhile, the difficulties were in obtaining research subjects, subjects who have inadequate technological literacy, poor internet network and inaccurate data.
Conclusions
Thus, the conveniences and difficulties of carrying out research were important and must be continuously evaluated, in order to ensure the study able to conduct optimally even during the COVID-19 pandemic crisis.
Vegetative regulation of vascular tone and features of the nervous system of pedagogical universities students. Is there a relationship with professional specialization?
Authors: Kozin Oleksii , Kozina Zhanneta , Cretu Marian , Boychuk Yurii , Pavlović Ratko , Garmash Iryna , Berezhna Yaroslava
Published: March 2023

Purpose. To select recommendations on the use of physical culture means for students of future teachers, it is necessary to identify their functional features and genetically determined properties of the nervous system. Purpose: to reveal the relationship between the performance of the nervous system, orthostatic test and professional specialization of students of pedagogical universities.
Material and methods. Students from 9 different faculties of Ukraine's leading pedagogical institute took part in the study. The total number of subjects was 841 people. Soon the reactions were determined by the program "Psychodiagnostics". Orthostatic reactions were determined by the results of heart rate in the supine position and in the standing position. An analysis of variance (ANOVA) was performed using Duncan's method to determine the influence of teaching faculty on test performance. A correlation analysis of testing indicators and ranks of faculties was carried out using the Tau-b Kendall method.
Results. Students of all experimental faculties were divided into 4 groups according to the number of errors in the choice reaction test based on the results of variance analysis (Duncan method). Faculties were divided into ranks from the first to the fourth. A significant negative correlation of the rank of the faculty according to the indicator of the strength and speed of nervous processes with the heart rate in the standing position (p<0.05) and the difference between the heart rate in the standing and lying positions (p<0.01) was revealed.
Conclusions. Physical exercises should be applied according to the professional characteristics and personal inclinations of the students, who were divided into 4 groups according to the indicators of reaction speed and orthostatic test. For students of the faculties of primary education and preschool education (1st group), we recommend using mobile and sports games. For students of humanities and natural sciences faculties (2nd group), any physical exercises that require an average manifestation of all physical qualities are suitable: dances, gymnastics, sports games, martial arts. Students of the Faculty of Arts (3rd group) are suitable for physical exercises that require high concentration of attention for a long time, for example, cyclical exercises. We recommend that students of the Faculty of Physical Education and Sports (4th group) continue to improve in their chosen sport, while also studying other sports.
Factor’s indicating the performance in men’s artistic gymnastics based on extracted variables at the initial stage of training
Authors: Rathore Prakhar , Chandel Sudhira
Published: March 2023

Purpose

To develop the regression equation with the help of step wise method in linear regression.

Material and methods

In this study, 150 boy's gymnasts from National Sports Academy in Allahabad (India) (age 6+4 years; height 102+46; body weight 22+8) had participated and they provided informed consent before the testing procedure. Over Grip Hang on Horizontal Bar, Bridge up test, Leg Raise Forward, Front Split, Shuttle Run on Floor Exercise, Beam Walk Test, and Flexed Arm Hang on Horizontal Bar were selected as the testing variables and after using the liner regression analysis

Results

The equation was formed which estimates that Beam walk test, Shuttle run on Floor Exercise, Over grip hang on Horizontal, and Flexed arm hang on Horizontal bar account for 41% of the variation in the relation of dependent variables (Gymnastics Performance).

Conclusion

A thorough study of the factors that foster gymnast growth is essential since it is crucial in gymnastics to identify potential early in a player's career [16, 17, 22], for that extracted factors and gymnastics performance were selected to form the regression equation. The four variables selected to create the regression equation which explains 41 % of the total variability which is quite good and valid for estimating the Gymnastics Performance.

Conclusion

A thorough study of the factors that foster gymnast growth is essential since it is crucial in gymnastics to identify potential early in a player's career [16, 17, 22], for that extracted factors and gymnastics performance were selected to form the regression equation. The four variables selected to create the regression equation which explains 41 % of the total variability which is quite good and valid for estimating the Gymnastics Performance.
Effect of a physical therapeutic intervention on locomotive syndrome in the elderly patients with Parkinson’s disease and sarcopenia
Authors: Didoha Ivanna V. , Aravitska Mariia G. , Yatsiv Yaroslav M. , Hrecheskyi Oleh V.
Published: March 2023

Purpose: to evaluate the effectiveness of the effect of physical therapy on the indicators and severity of locomotive syndrome in elderly patients with Parkinson’s disease and sarcopenia.

Material and methods: 57 elderly people with Parkinson’s disease in combination with sarcopenia were examined. They were divided into two groups: group 1 (followed the principles of standard protocols of outpatient rehabilitation) and group 2 (followed the physical therapy program, which was developed in terms of patient-centered model of rehabilitation taking into account the specifics of each comorbid condition with the use of functional training on the «Prosedos» platform, therapeutic exercises, massage, occupational therapy, nutrition correction, and patient education). The control group consisted of 24 elderly people without signs of sarcopenia and Parkinson’s disease. The effectiveness of the program was evaluated by the dynamics of 25-question Geriatric Locomotive Function Scale, Dynamic Gait Index, Functional Gait Assessment, Activities Balance Confidence Scale, Modified Parkinson Activity Scale.

Results: Elderly patients with Parkinson’s disease and sarcopenia were diagnosed with locomotive syndrome stage 2 (according to the 25-question Geriatric Locomotive Function Scale), which manifested itself as a high risk of falling and deteriorating dynamic balance (according to Dynamic Gait Index, Functional Gait Assessment), decreased confidence in maintaining balance during activities (according to Activities Balance Confidence Scale), violation of activities of daily living (according to Modified Parkinson Activity Scale); it was statistically significantly worse than in their peers (p<0.05). The developed program of physical therapy led to a statistically significant (p<0.05) improvement of all studied parameters of locomotive syndrome in comparison with baseline and the condition of patients who received standard restorative correction.

Conclusions: Elderly patients with comorbid pathology (Parkinson’s disease and sarcopenia) need new physical therapy programs considering the specifics of each disease and its correcting, the presence of locomotive syndrome to improve social and domestic activity of patients and reduce health risks associated with geriatric syndromes – falls and frailty.
Comparing the effect of rhythmic stabilization and combination of isotonic technique on grip strength, pinch strength and dexterity of hand among middle aged healthy individuals - a randomized clinical trial
Authors: Kumar Sanjiv , Nale Apoorva Dattatray
Published: March 2023

Purpose: The aim of the study was to evaluate and compare the effects of Rhythmic Stabilization and a combination of isotonic technique on grip  strength, pinch strength, and dexterity of hand among middle aged healthy individuals. Methods
Forty middle aged healthy individuals were selected on the basis of inclusion and exclusion criteria. Participants were randomly allocated to two groups, with 20 in group A (Rhythmic Stabilization) and 20 in group B (Combination of Isotonic Technique). Treatment was given for 4 weeks, thrice a week.
Outcome measures: grip strength, pinch strength, and dexterity were assessed by the Jamar hand dynamometer, the Pinch gauge, and the Perdue peg board, respectively. Outcome measures were assessed at baseline and after 4 weeks of treatment.
Results
Notably, Group A participants showed a significant improvement in all outcome measures compared to Group B (p<0.05) when compared. Both the interventions were effective for dexterity outcome in both groups (p<0.05).  Conclusion: This study provides evidence that application of Rhythmic Stabilization improves grip strength and pinch strength.  This suggests that static Proprioceptive Neuromuscular Facilitation (PNF) exercises performed on the fingers can improve dexterity, grip strength, and pinch strength in the middle-aged population.
Highlights
As age increases, there is decrease in grip strength and dexterity of a person.
The grip strength, finger strength and dexterity are inter-related.
The Proprioceptive Neuromuscular Facilitation increases strength of muscles.
The static PNF exercises are more effective than the dynamic PNF exercises to improve strength of grip strength, finger strength and dexterity.
Kinesiological models of the neuromuscular system readaptation in mature women after prolonged hypokinesia
Authors: Chernozub Andrii , Manolachi Veaceslav , Potop Vladimir , Khudyi Oleksii , Kozin Serhii , Bokatuieva Viktoriia , Stanescu Marius , Timnea Olivia Carmen
Published: March 2023

Purpose To study the peculiarities of adaptive and compensatory reactions in mature women after prolonged hypokinesia using various kinesiological models of the neuromuscular system readaptation. Material and methods 52 women of mature age (39-46 years) after long-term (6-7 years) hypokinesia took part in the study. Group A used a kinesiological model based on free weight exercises with changes in kinematic and dynamic characteristics. Group B used a model based on machine exercises. The following methods were used to monitor adaptation processes: bioelectrical impedance analysis, anthropometry, testing of strength capabilities, biochemical blood analysis (cortisol and creatinine concentration). Results The dynamics of the studied indicators differed significantly between the groups using the proposed kinesiological models for 12 weeks. Thus, the fat-free and body cell mass indicators were 5 times higher in group A women compared to group B participants. The body fat mass decreased by 5 times in group A participants. The circumference measurements reduced in all participants, but in group A the rate of change was 1.8 times faster. The level of strength growth was almost the same in all study participants; it fluctuated within 10-25% compared to the initial data. The cortisol concentration in the blood serum increased only in group B during all stages of control. At the end of the research, the cortisol level did not change in response to stress in the women of group A, which indicates increasing of their resistance level. The basal level of creatinine grew by 4% in group A women after 12 weeks of training, but it did not change in group B participants. These changes indicate an accelerated growth of muscle mass in group A women. Conclusions Pronounced adaptive changes occurred in women of mature age after prolonged hypokinesia in case of using the kinesiological model of the neuromuscular system readaptation with free weight exercises. Applying this model helps to increase the functional capabilities of the body, to strengthen the level of resistance to a stress stimulus, and to improve the morphometric parameters of the body.
Use of elements of basketball as a means of psychomotor development of students
Authors: Lakhno O. G. , Shyyan O. V. , Shyyan V.M. , Solohubova S.V. , Sherman O.A.
Published: March 2023

The aim of the study: to develop and substantiate the methodology of using basketball to develop psychomotor abilities in the process of physical education of students.

Material and methods. The study involved first-year students (boys) who do not play sports but only attend physical education classes. The experimental group consisted of students who used basketball (n = 20), the control group consisted of students who used other means (fitness, aerobics, etc.) (n = 20). Prior to the experiment, the groups did not differ significantly. Duration of implementation of the method from January 2019 to December 2019 Test results were compared before and after the experiment.

Results: The results of the following tests of the experimental group showed statistically significant difference after the experiment: Long jump (sm) (p<0.01), Running 100 m (s) (p<0.001) (number of times) (p<0.001, Ball and face forward 14x2m (s) (p<0.001), Static balancing (s) (p<0.001), Simple reaction time (s) (p<0.001). There was a decrease in the number of students with latent circulatory insufficiency after the experiment in the experimental group.

Conclusion: Experimental verification of the developed methodology for the development of psychomotor abilities by basketball revealed positive changes in the indicators of physical fitness, speed of reaction and special preparedness in basketball. Positive changes in the indicator of the functional status of the cardio-respiratory system of students were also observed.
Determination of the functional state of the body using non-traditional research methods when performing the static exercise: "Prone press ups, static top position" (Cobra)
Authors: Musiyenko O.V. , Mykhats L.V. , Budynkevych S.N. , Popovych S.I.
Published: March 2023

Material and methods. Investigation of the effect of the selected static exercise was performed using the method of determining the electrical conductivity of representative points of the human body. Ten female students of 18-20 years who perfectly mastered the technique of performing the exercise were surveyed. The measurements were performed during, after and after 6 minutes.

Results. Significant changes in indicators of electrical activity in representative points of the human body were revealed. Selected static exercise has a significant impact on the functional state of the person: according to Chinese folk medicine, stimulates the body points corresponding to the acupuncture meridians according to the classification of Chinese medicine cardiovascular, lymphatic and immune systems, colon and submucosa, mucosa spleen, small intestine.

Conclusions. During the study of the effect of static exercise, it was found that the increase of electrical activity of the human body points, which, according to the literature, are responsible for the functions of the respiratory, cardiovascular, lymphatic and immune systems, the large intestine. This exercise also causes a decrease in electrical activity at representative points of the liver, stomach, and inhibits the activity of the small intestine, spleen, and pancreas. It is possible to propose the use of methods for determining the activity of human body points for the study of the influence of static exercises on the human body, along with other generally accepted scientific methods.
Institutional Variance in Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction in Korea, Japan, and Taiwan
Authors: Yamana Hayato , Lee Seyune , Lin Yi-Chieh , Yoon Nan-He , Fushimi Kiyohide , Yasunaga Hideo , Cheng Shou-Hsia , Kim Hongsoo
Published: March 2023

Background: Although there have been studies that compared outcomes of patients with acute myocardial infarction across countries, little focus has been placed on institutional variance of outcomes. The aim of the present study was to compare institutional variance in mortality following percutaneous coronary intervention for acute myocardial infarction and factors explaining this variance across different health systems. Methods: Data on inpatients who underwent percutaneous coronary intervention for acute myocardial infarction in 2016 were obtained from the National Health Insurance Data Sharing Service in Korea, the Diagnosis Procedure Combination Study Group Database in Japan, and the National Health Insurance Research Database in Taiwan. Multilevel analyses with inpatient mortality as the outcome and the hierarchical structure of patients nested within hospitals were conducted, adjusting for common patient-level and hospital-level variables. We compared the intraclass correlation coefficient and the proportion of variance explained by hospital-level characteristics across the three health systems. Results: There were 17,351 patients from 160 Korean hospitals, 29,804 patients from 660 Japanese hospitals, and 10,863 patients from 104 Taiwanese hospitals included in the analysis. Inpatient mortality rates were 6.3%, 7.3%, and 6.0% in Korea, Japan, and Taiwan, respectively. After adjusting for patient and hospital characteristics, Taiwan had the lowest variation in mortality (intraclass correlation coefficient, 1.8%), followed by Korea (2.2%) and then Japan (4.5%). The measured hospital characteristics explained 38%, 19%, and 9% of the institutional variance in Korea, Taiwan, and Japan, respectively. Conclusion: Korea, Japan, and Taiwan had similarly uniform outcomes across hospitals for patients undergoing percutaneous coronary intervention for acute myocardial infarction. However, Japan had a relatively large institutional variance in mortality and a lower proportion of variation explainable by hospital characteristics, compared with Korea and Taiwan.
Experiences and Implications of the First Wave of the COVID-19 Emergency in Italy: A Social Science Perspective
Authors: Masino Serena , Enria Luisa
Published: March 2023

Background: Italy was among the first countries in the world to experience the devastating consequences of the COVID-19 emergency and suffered its consequences to a devastating scale. Understanding how the country got there in spite of a relatively well-resourced public and private health system in at least part of the country, is imperative to be able to operationalise any lessons learnt for future epidemics in Italy and beyond. Methods: The paper reports the findings from a research scoping exercise conducted in Italy in 2020. We conducted extensive archival research and collected 29 testimonies either in writing or as semi-structured interviews. We sampled purposively with a stratification strategy in mind, specifically aiming to gain testimonies from different social groups, classes, ages, and nature of employment. Our sample also reflects the different experiences between the Northern and Southern regions, a divide that has long been economically and politically salient in the country. Results: Evidence and considerations of epidemiological nature normally guide public health responses to crises. This study supports the idea that socio-economic, cultural and political factors also affect transmission outcomes. We highlight specifically the role that socio-economic and health inequalities play in this respect, through factors such as overcrowded dwellings, lack of alternatives to in-person work, informal work set-ups, pervasive organised crime presence, poorly planned social support and communication strategies. Conclusions: A socio-economic and political lens is needed in addition to an epidemiological one to fully understand the social experiences and implications of public health crises such as the COVID-19 pandemic and to devise effective response measures that are locally relevant and acceptable. Thus insights provided by multi-disciplinary task forces can render policy-making and social support interventions as well as communication strategies more effective.
Biopharmaceutical Financialization and Public Funding of Medical Countermeasures (MCMs) in Canada During the COVID-19 Pandemic
Authors: Eren Vural Ipek , Herder Matthew , Doll Agnieszka , Graham Janice E.
Published: March 2023

Background: Analysing the Canadian government’s efforts to support the development of COVID-19 "medical countermeasures" (MCMs), this article seeks insights into political economy as a driver of pandemic response. We explore whether Canadian public funding policy during the pandemic involved departures from established practices of financialisation in biopharmaceutical research and development (R&D), including the dominance of private sector involvement in an intellectual property (IP) intensive approach to innovation underscoring profit, and governance opacity. Methods: We interrogate public funding for MCMs by analyzing how much the Government of Canada (GoC) spent, how those funds were allocated, on what terms, and to whom. We identify the funding institutions, and the funds awarded between February 10, 2020, and March 31, 2021, to support the research, development, and manufacturing of MCMs, including diagnostics, vaccines, therapeutics, and information about clinical management and virus transmission. To collect these data, we conducted searches on the Internet, public data repositories, and filed several requests under the Access to Information Act (1985). Subsequently, we carried out a document-based analysis of electronically accessible research contracts, proposals, grant calls, and policy announcements. Results: The GoC announced CAD$ 1.4 billion for research, development and manufacturing of COVID-19 MCMs. Fully 68% (CAD$ 959 million) of the announced public funding was channelled to investment in private sector firms. Canadian public funding showed a consistent focus on early and late stage development of COVID-19 MCMs and the expansion of biopharmaceutical manufacturing capacity. Assessing whether Canada’s investments into developing COVID-19 MCMs safeguard affordable and transparent access to the products of publicly funded research, we found that access policies on IP management, sharing of clinical data, affordability and availability were not systematic, consistent, or transparent, and few, if any, mechanisms ensured long-term sustainability. Conclusion: Beyond incremental change in policy goals, such as public investment in domestic biomanufacturing, the features of Canadian public policies endorsing financialization in the biopharmaceutical sector remained largely unchanged during the pandemic.
Routinizing the Use of Evidence in Policy – What is Needed?; Comment on "Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis"
Authors: Kuchenmüller Tanja , Boeira Laura dos Santos
Published: March 2023

In their study of sustaining knowledge translation (KT) practices, Borst et al found that this process is an interplay of: (i) constructing and extending networks, (ii) creating contexts that support KT practices, and (iii) understanding how actors create, maintain, and disrupt institutions. Their article is an important contribution to the body of research promoting KT. In this commentary we reflect on the convergences and differences between the concepts of ‘sustaining’ and ‘institutionalizing’ KT, highlighting domains and processes related to the institutionalization, providing an analysis of KT landscape in Brazil and making a case for the need to increase countries’ routine use of evidence.
A Gateway Framework to Guide Major Health System Changes; Comment on ""Attending to History" in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration"
Authors: Eljiz Kathy , Greenfield David , Derrett Alison
Published: March 2023

Recent events – on both a global scale and within individual countries - including the lockdowns associated with COVID-19 pandemic, inflation concerns and political tensions, have increased pressure to reconfigure social services for ongoing sustainability. Healthcare services across the world are undergoing major system change (MSC). Given the complexity and different contextual drivers across healthcare systems, there is a need to use a variety of perspectives to improve our understanding of the processes for MSC. To expand the knowledge base and develop strategies for MSC requires analysing change projects from different perspectives to distil the elements that drove the success. We offer the Gateway Framework as a collaborative transformational system tool to assess and reorganise operations, services, and systems of healthcare organisations. This framework and guiding questions, accounts for past events whilst being proactive, future orientated, and derived from externally defined and a standardised requirements to promote safe, high-quality care.
How to Account for Asymmetries in Deliberative Dialogues Comment on "Evaluating Public Participation in a Deliberative Dialogue: A Single Case Study"
Authors: Jiménez-Pernett Jaime
Published: March 2023

In health policy-making, various deliberative mechanisms can be used to engage the members of the public in exploring what might be a reasonable course of action. Scurr et al take power dynamics into consideration to analyse a deliberative dialogue involving stakeholders with diverse points of view. Given such asymmetries at play, the conclusions of deliberations could be biased. Scholars would benefit from guidance on designing and evaluating deliberative processes. This commentary aims to broadly reflect on the possible sources of power and information asymmetries in deliberative dialogues, and to bring the biographical resources approach to deal with such asymmetries.
Sustaining a New Model of Acute Stroke Care: A Mixed-Method Process Evaluation of the Melbourne Mobile Stroke Unit
Authors: Bagot Kathleen L. , Purvis Tara , Hancock Shaun , Zhao Henry , Coote Skye , Easton Damien , Campbell Bruce CV , Davis Stephen M. , Donnan Geoff A. , Foster Shane , Langenberg Francesca , Smith Karen , Stephenson Michael , Bernard Stephen , McGowan Sharon , Yan Bernard , Mitchell Peter , Middleton Sandy , Cadilhac Dominique A.
Published: March 2023

Background: Internationally, Mobile Stroke Unit ambulances (MSUs) have changed prehospital acute stroke care delivery. MSU clinical and cost-effectiveness studies are emerging, but little is known about important factors for achieving sustainability of this innovative model of care. Method: Mixed-methods study from the Melbourne MSU (operational since November 2017) process evaluation. Participant purposive sampling included clinical, operational and executive/management representatives from Ambulance Victoria (emergency medical service provider), the MSU clinical team, and receiving hospitals. Sustainability was defined as ongoing MSU operations, including MSU workforce and future model considerations. Theoretically-based on-line survey with Unified Theory of Acceptance and Use of Technology, Self Determination Theory (Intrinsic Motivation) and open-text questions targeting barriers and benefits was administered (June-September 2019). Individual/group interviews were conducted, eliciting improvement suggestions and requirements for ongoing use. Descriptive and regression analyses (quantitative data) and directed content and thematic analysis (open text and interview data) were conducted. Results: There were 135 surveys completed. Identifying that the MSU was beneficial to daily work (β=0.61), not experiencing pressure/tension about working on the MSU (β=0.17) and thinking they did well working within the team model (β=0.17) were significantly associated with wanting to continue working within the MSU model [R 2=0.76; F(15,60)=12.76 p<.001]. Experiences varied between those on the MSU team and those working with the MSU. Advantages were identified for patients (better, faster care) and clinicians (interdisciplinary learning). Disadvantages included challenges integrating into established systems, and establishing working relationships. Themes identified from 35 interviews were MSU team composition, MSU vehicle design and layout, personnel recruitment and rostering, communication improvements between organisations, telemedicine options, MSU operations and dispatch specificity. Conclusion: Important factors affecting the sustainability of the MSU model of stroke care emerged. A cohesive team approach, with identifiable benefits and good communication between participating organisations is important for clinical and operational sustainability.
The Effects of Blade Coatings on Corce Demand When Pruning Grape
Authors: SELVİ Çağatay
Published: March 2023

The effects of different blade coating materials on force demands were examined in the present study. The force demands when cutting grape branches with St-52 steel, polytetrafluoroethylene (PTFE)-coated and Soft Teflon (STP)-coated lopper blades were measured. A universal testing machine was used as the simulated cutting task together with a force cell in the laboratory. Grape branches were the testing material. The differences between the force demands of blades were significant (P
Fındık Üretimi için Öğrenme Tabanlı Verim Tahmini
Authors: YILDIZ Doğan , YILDIZ Gülcan , DEMİRCİ Sercan
Published: March 2023

Artan nüfus yoğunluğunun ve küresel ısınmadan kaynaklanan iklim değişikliklerinin tarımsal üretimin miktarı ve kalitesi üzerinde önemli etkileri bulunmaktadır. Bu nedenle dünya, gıda kıtlığı gibi ciddi problemlerle karşı karşıyadır. Dolayısıyla tarım, ülkelerin ekonomik ve sosyal kalkınma programlarında bulunan hayati bir faaliyettir. Sert kabuklu meyveler kategorisinde dünyada bademden sonra üretimi en fazla yapılan ürün fındıktır. Üretimi Türkiye, İtalya, İspanya, ABD gibi ülkelerde yoğunlaşmış olan fındığın dünyadaki talebinin yaklaşık %70'ini Türkiye karşılamaktadır. Bu nedenle, fındık üretiminde verime etki eden parametrelerin tespit edilmesi ve bu parametrelere bağlı olarak verimin tahmin edilmesi çok büyük önem arz etmektedir. Bu çalışmada, Sakarya, Düzce, Samsun, Giresun, Trabzon illerindeki ve bu illerin fındık üretimi yapılan ilçelerindeki, fındık üretimine etki eden parametreler incelenerek bir sonraki adımda elde edilecek verim tahmini yapılmıştır. Tahmin işlemi için gereken özniteliklerin eldesi için ham veri setine bazı ön işleme adımları uygulanmış, temel bileşenler analizi (Principal Component Analysis, PCA) ile öznitelik sayısı azaltılmıştır. Ön işlemeden geçen bu veriler girdi olarak, XGBoost algoritması, Yalın Uzun-Kısa Süreli Bellek (Long Short-Term Memory, LSTM) modeli, Yığılmış LSTM modeli, Konvolüsyonel Sinir Ağı (Convolutional Neural Network, CNN) modeli ve CNN-LSTM hibrit modeline verilerek tahmin işlemi gerçekleştirilmiştir. Son olarak bu yöntemlerin her biri için Ortalama Hataların Karekökü (Root Mean Square Error, RMSE) ile tahmin hatası elde edilmiş ve yöntem kıyaslamaları için kullanılmıştır. Bu sonuçlara göre, en düşük RMSE=1,32 değeriyle en iyi performans CNN-LSTM hibrit modeli ile elde edilmiştir.
Çinko-Triflat Katalizörü Kullanılarak Farklı Sübstitüe Izokumarin Türevlerinin Sentezi
Authors: ULUDAĞ Nesimi
Published: March 2023

Geniş bir doğal bileşik sınıfı oluşturan kumarinler, 19. yüzyıldan günümüze değin oldukça ilgi çeken ve çok sayıda pratik uygulamaya sahip olan organik bileşiklerdir. Kumarin bileşikleri, endüstride ve birçok ticari ilacın yapısında bulunan heterosiklik bileşikler olup, bu çalışmada izokumarinlerin sentezleri için farklı bir yöntem izlenerek metil 2-(feniletil) benzoat (1a-g) ve but-3-en-2-one (2)’nin çinko-triflat-katalizli tandem reaksiyonları gerçekleştirilmiştir. Söz konusu yöntemde, yüksek verimli ve çevre dostu bir reaksiyon oksijensiz ortamda gerçekleştirilmiş ve yeni bir katalizör kullanılarak hedeflenen izokumarin türevleri tek basamakta sentezlenmiştir. Diğer taraftan, elektron çekici ve elektron verici yan grupların reaksiyon oluşumuna ve verimine olan etkileri de araştırılmıştır. Özet olarak bu çalışmada, paladyum(II)-katalizli yüksek oranda regioselektif but-3-en-2-one ile cascada reaksiyonu ile geliştirilmiştir.
Afet ve Acil Durumlara Müdahale Kapsamında Destek Personelin Hazır Oluşluğunun Artırılması
Authors: GERCEK OTER Emine , YILMAZ Gürkan , ÇİNAR Halise , ÖTER Nadir Savaş , ABACIGİL Filiz , ÇEVİK Evrim
Published: March 2023

Bu çalışmada Aydın Adnan Menderes Üniversitesi’nin tüm kampüslerinde afet ve acil durumlara müdahale kapsamında destek personelin hazır oluşluğunun arttırılmasına yönelik online teorik eğitim ile yüzyüze uygulamalı eğitim verilmesi amaçlanmıştır. Ön test-son test deseninin uygulandığı müdahale tipinde bir çalışmadır. Araştırmanın örneklemini Mayıs 2020 – Ağustos 2021 arasında üniversitenin her biriminde (Rektörlük, enstitü, fakülte, yüksekokul, uygulama ve araştırma merkezi, hastane vb.) destek elemanı olarak görevlendirilen toplam 679 personel oluşturdu. Araştırma verileri Birey Tanıtım Formu ve Destek Elemanlarının Afet ve Acil Durumlara Hazır Oluşluğuna Yönelik (Tahliye ve Arama Kurtarma, Yangın) Bilgi Testleri ile toplanmıştır. Verilerin değerlendirilmesinde bağımlı gruplarda t test, Student t testi kullanılmıştır. Katılımcıların Tahliye Arama ve Kurtarma Bilgi Testi Ön-test skor ortalaması 11,5±2,2 iken, Son-test skor ortalaması 13,4±2,7 olarak saptanmıştır. Katılımcıların Tahliye Arama ve Kurtarma Bilgi Testi Ön-test ve Son-test skor ortalamaları arasındaki fark anlamlı olarak bulunmuştur (z =-16,537, p <0,001). Personellerin Yangın Bilgi Testi Ön-test skor ortalaması 11,5 ± 2,2 iken, Son-test skor ortalaması 13,3 ± 2,7 olarak saptanmıştır. Katılımcıların Yangın Bilgi Testi Ön-test ve Son-test skor ortalamaları arasındaki fark anlamlı olarak belirlenmiştir (z = -15,017, p < 0,001). Verilen eğitimin katılımcıların bilgi düzeylerinde artış sağladığı sonucuna ulaşılmıştır. Üniversitelerin bünyelerinde çalışan akademik ve idari personelden oluşan destek elemanlarına yönelik olarak verilen bu eğitimlerin ülkemiz genelinde yaygınlaştırılması önerilmektedir.
Knowledge Level of Coaches of Al-Manaseer League Football Clubs in Jordan Its Relationship to Sport Achievement
Authors: Asri Alsoud Hassan , Awad Al-Soud Mohamoud
Published: March 2023

The study aims to know about the Knowledge level of coaches of al-manaseer league football clubs in Jordan it is relation to sport achievement. The researchers used the descriptive approach to the suitability of the nature and objectives of the study, and the sample of the study consisted of (36) coaches in the intentional way, and The search used two samples measure the knowledge for the coaches , and used "spss" to find the statistical processors find the answers. The result shown the knowledge for personal features for the coaches is good and variable (training class) has the biggest effect for the coaches. And also The results showed the existence of a correlation between the knowledge and the sport achievement for the coaches. The researchers recommended the attention and focus on the Knowledge level of coaches through Knowledge courses in the Knowledge to be as scientific basis when they choose the coaches for professional clubs for football in Jordan.