bluuebunny/crossref_metadata_2025 huggingface dataset:
ANALISIS EFEKTIVITAS DAN KONTRIBUSI PAJAK RESTORAN TERHADAP PAJAK DAERAH DAN PENDAPATAN ASLI DAERAH PEMERINTAH KOTA BANJARMASIN
Authors: Rahman Hutama Aqliana , Abidin M. Zainal
Published: November 2022

Abstract : Restaurant Tax is one of the regional taxes that contributes to increasing Regional Taxes in order to carry out regional government development. This study aims to determine the level of effectiveness and contribution of the Restaurant Tax to Original Local Government Revenue (PAD) of the City of Banjarmasin. The data used in the form of secondary data from 2020 to 2021. The data source is obtained from the Banjarmasin City Government. The method used in this research is descriptive quantitative analysis. The results showed that the level of effectiveness of the Banjarmasin City Restaurant Tax was classified as very effective with an average effectiveness level of 107.28%. Meanwhile, the percentage of the restaurant tax contribution to the Banjarmasin Regional Tax shows an average of 24.86% with the category enough to contribute to Regional Tax Revenue and the percentage of the Restaurant Tax contribution to Original Local Government Revenue (PAD) of Banjarmasin City shows an average of 15.09% with the category less contribution to Original Local Government Revenue (PAD)

 Keywords : Effectiveness, Contribution, Restaurant Tax, Local Tax, Original Local Government Revenue (PAD)

 

Abstrak : Pajak Restoran merupakan salah satu pajak daerah yang memberikan kontribusi dalam meningkatkan Pajak Daerah guna menjalankan pembangunan pemerintahan daerah. Penelitian ini bertujuan untuk mengetahui tingkat efektivitas dan kontribusi Pajak Restoran terhadap Pajak Daerah dan Pendapatan Asli Daerah (PAD) Kota Banjarmasin. Data yang digunakan berupa data sekunder dari tahun 2020 sampai dengan tahun 2021. Sumber data diperoleh dari Kantor Badan Pengelolaan Keuangan, Pendapatan dan Aset Daerah (BPKPAD) Banjarmasin. Metode yang digunakan dalam penelitian menggunakan analisis deskriptif kuantitatif. Hasil penelitian menunjukkan bahwa tingkat efektivitas Pajak Restoran Kota Banjarmasin tergolong sangat efektif dengan rata-rata tingkat efektivitasnya sebesar 107.28%. Sedangkan, untuk persentase kontribusi Pajak Restoran terhadap Pajak Daerah Banjarmasin menunjukkan rata-rata sebesar 24.86% dengan kategori cukup berkontribusi terhadap Pendapatan Pajak Daerah dan untuk persentase kontribusi Pajak Restoran terhadap Pendapatan Asli Daerah (PAD) Kota Banjarmasin menunjukkan rata-rata sebesar 15.09% dengan kategori kurang memberikan kontribusi terhadap Pendapatan Asli Daerah

Kata Kunci: Efektivitas, Kontribusi, Pajak Restoran, Pajak Daerah, Pendapatan Asli Daerah (PAD)
GAMBARAN TINGKAT PENGETAHUAN SISWA SEKOLAH DASAR TENTANG ISI PIRINGKU
Authors: Kusumaningsih Tri Puspa , Listia Risky Dwi
Published: November 2022

Gerakan Masyarakat Hidup Sehat berdasarkan Inpres No 1 Tahun 2017 bertujuan meningkatkan kesehatan masyarakat. Hasil Riskesdas (2018) menunjukkan bahwa secara nasional perilaku penduduk umur >10 tahun kurang mengonsumsi sayur dan buah (95,5%),di Kabupaten Purworejo (53,4%). Kementerian Kesehatan membuat slogan isi piringku guna memaksimalkan pola makan gizi seimbang. Hasil survey yang telah dilakukan di Sekolah Dasar pada 6 anak, terdapat 4 anak yang tidak memahami porsi isi piringku dan terdapat 2 anak belum mengerti. Tujuan penelitian ini untuk mengetahui gambaran tingkat pengetahuan siswa di Sekolah Dasar tentang isi piringku. Metode penelitian adalah deskriptif kuantitatif, instrument penelitian menggunakan checklist. Jumlah responden 57 orang. Total sampling. Hasil penelitian sebagian besar responden memiliki tingkat pengetahuan baik (87,72%) tentang isi piringku, tingkat pengetahuan cukup (12,28%), dan tidak ada yang kurang. Nilai rata-rata responden 86,55, Modus 91,67, dan Median 87,50. Dari hasil penelitian menunjukan tingkat pengetahuan responden tentang isi piringku sebagian besar baik.
ASUHAN KEBIDANAN IBU HAMIL, BERSALIN, NIFAS, DAN BAYI BARU LAHIR PADA NY. D DI BPM SRI MULYANI, Amd.Keb KECAMATAN BUTUH
Authors: Zuliyanti Nurma Ika , Priyanto Putri Nuary
Published: November 2022

Pada saat ini Angka Kematian Ibu di Indonesia masih sangat tinggi, khususnya Angka kematian ibu melahirkan di provinsi Jawa Tengah tahun 2012 berdasarkan laporan dari kabupaten/kota, mengalami peningkatan bila dibandingkan dengan AKI pada tahun 2011. Untuk menurunkan Angka Kematian Ibu melahirkan perlu dilakukan pengkajian, intervensi data, diagnosa masalah, antisipasi, penatalaksanaan, evaluasi dan membahas kesenjangan antara teori dan praktik. Metode yang digunakan dalam asuhan komprehensif ini adalah pendekatan dengan memberikan asuhan kebidanan secara langsung kepada klien dengan menggunakan teknik wawancara, observasi, pemeriksaan dan studi dokumentasi. Klien memeriksakan kehamilannya saat usia kehamilan 37+6 minggu, kemudian melahirkan pada usia kehamilan 38 minggu secara spontan, melahirkan bayi berjenis kelamin perempuan, masa nifas klien berjalan normal dan tidak ada penyulit. Setelah masa nifas minggu ke-6 akhirnya klien memutuskan untuk menggunakan KB suntik 3 bulan. Setelah penulis melakukan asuhan kebidanan secara komprehensif dari kehamilan umur 37 minggu sampai KB dapat disimpulkan bahwa klien tidak ada komplikasi apapun dan dalam keadaan sehat.
GAMBARAN TINGKAT PENGETAHUAN IBU TENTANG POLA MAKAN BALITA DI POSYANDU DUSUN GENTAN KECAMATAN KALIKAJAR KABUPATEN WONOSOBO
Authors: Sholichah Nur , Sari Intan Permata
Published: November 2022

Berdasarkan studi pendahuluan yang telah dilakukan secara wawancara terhadap 10 ibu balita di desa Gentan. Diberikan pertanyaan tentang apa itu pola makan, dampak pola makan tidak sehat seperti apa,prinsip pola makan seperti apa dan manfaat pola makan apa saja. Tujuan penelitian ini untuk mengetahui gambaran tingkat pengetahuan ibu tentang pola makan balita di Desa Gentan berdasarkan karakteristik responden. Metode Penelitian : Metode penelitian ini deskriptif dengan pendekatan cross sectional. Populasi dalam penelitian ini ibu balita berjumlah 53 responden, sampel diambil menggunakan teknik purposive sampling. Sampel dalam penelitian ini 48 responden. Alat ukur menggunakan kuesioner. Analisis data menggunakan univariat. Hasil Penelitian terdapat 35.8% (19 responden) dengan pengetahuan baik, berpengetahuan cukup 62.3% (33 responden) dan berpengetahuan kurang 1.9% (1 responen). Berdasarkan hasil penelitian diperoleh kesimpulan bahwa tingkat pengetahuan tingkat pengetahuan ibu tentang pola makan balita di desa Gentan berpengetahuan baik. Diharapkan Ibu balita Menambah wawasan informasi dan edukasi tentang pola makan balita.
GAMBARAN PENGETAHUAN IBU TERHADAP PELAKSANAAN IMUNISASI CAMPAK DI PUSKESMAS BAYAN
Authors: Wulandari Fetty Chandra , Susilo Anes Lucsyana
Published: November 2022

Pada tahun 1996 menyimpulkan bahwa campak dimungkinkan untuk diedikasi, karena satusatunya pejamu (host) atau reservoir campak hanya pada manusia dan adanya vaksin denganpotensi yang cukup tinggi dengan effikasi vanksin 85%. Berdasarkan pencatatan danpelaporan di Indonesia pada tahun 2016 cakupan imunisasi campak sebanyak 92,5%. Danditemukan masalah di Puskesmas Bayan 30 (23,43%) orang kurang mengetahui tentangimunsisasi campak. Tujuan penelitian untuk mengetahui gambaran pengetahuan ibu terhadappelaksannan imunisasi campak di Puskesmas Bayan. Jenis penelitian deskriptif, Metodepenelitian menggunakan pendekatan cross sectional, populasi semua ibu yang memiliki bayiusia 0-9 bulan, sampel 20 orang, metode pengambilan sampel accidental sampling, teknikpengambilan data menggunakan kuesioner, Analisa penelitian menggunakan analisa univariat,uji validitas menggunakan pearson product moment dan uji reabilitas menggunakan alphacronbach dan program data menggunakan SPSS 16. Hasil penelitian menunjukkan mayoritasresponden memiliki umur >30 tahun (45%), pendidikan SMA (65%), tidak bekerja (75%),dan mayoritas responden memilki pengetahuan terhadap imunisasi campak kategori cukup(55%).
GAMBARAN TINGKAT PENGETAHUAN LANSIA TENTANG VAKSINASI COVID-19 DI DESA PASAR SENEN KECAMATAN AMBAL KABUPATEN KEBUMEN
Authors: Kusumaningsih Tri Puspa , Elviyani Riska
Published: November 2022

Kelompok usia yang paling rentan terkena dampak penyakit covid 19 yaitu lanjut usia. Daya tahan tubuh yang menurun dan penyakit komorbid pada lansia meningkatkan kerentanan lansia di musim pandemi Covid-19. Berdasarkan hasil studi pendahuluan terhadap 30 lansia yang hadir di posyandu Desa Pasar Senen diberikan pertanyaan mengenai vaksin covid-19 terdapat 10 lansia yang kurang mengetahui tentang vaksin covid-19. Tujuan penelitian ini untuk mengetahui Gambaran Tingkat Pengetahuan Lansia Tentang Vaksinasi COVID-19 di Desa Pasar Senen, Kecamatan Ambal, Kabupaten Kebumen. Metode penelitian ini deskriptif dengan pendekatan cross sectional. Populasi dalam penelitian ini lansia berjumlah 224 responden dan sampel sebanyak 74 responden dengen accidental sampling. Alat ukur menggunakan kuesioner. Analisis data menggunakan univariat. Hasil penelitian Tingkat pengetahuan lansia tentang vaksin covid-19 yaitu baik 40 responden (54,1 %), Cukup 19 responden (25,7%), dan kurang 15 responden (20,3%). Diharapkan tenaga kesehatan meningkatkan konseling tentang vaksin covid 19 di kalangan lansia.
FAKTOR-FAKTOR YANG MEMPENGARUHI RENDAHNYA AKSEPTOR AKDR DI WILAYAH KERJA PUSKESMAS PURWOREJO
Authors: Wulandari Fetty Chandra , Nisa Zarra Fakhirotun
Published: November 2022

Metode kontrasepsi yang digunakan akseptor KB didominasi oleh metode kontrasepsi jangka pendek, sehingga tingkat efektifitasnya dalam pengendalian kehamilan lebih rendah dibandingkan jenis kontrasepsi lainnya (AKDR). Tujuan penelitian untuk mengetahui faktorfaktor yang mempengaruhi rendahnya akseptor AKDR di PMB Rosida Himawati dengan menggunakan metode survey analitik dan rancangan cross sectional. Populasi penelitian adalah semua akseptor KB di PMB Rosida Himawati. Pengambilan sampel menggunakan teknik accidental sampling dengan waktu pada bulan maret-april 2022. Analisis data menggunakan analisis univariat dan analisis bivariat. Hasil penelitian berdasarkan nilai asyimp.sig ≤ 0.05 menunjukkan bahwa tidak terdapat hubungan antara status ekonomi dengan kurangnya penggunaan alat kontrasepsi AKDR; terdapat hubungan antara pengetahuan dengan kurangnya penggunaan alat kontrasepsi AKDR; terdapat hubungan antara pendidikan dengan kurangnya penggunaan alat kontrasepsi AKDR; dan tidak terdapat hubungan antara umur dengan kurangnya penggunaan alat kontrasepsi AKDR.
ANALISIS PENGGUNAAN KONTRASEPSI SUNTIK TERHADAP PENINGKATAN TEKANAN DARAH
Authors: Setyorini Catur , Hanifah Lilik , Lieskusumastuti Anita Dewi , Febriani Anggi
Published: November 2022

Akseptor keluarga berencana yang menggunakan kontrasepsi hormonal (pil dan suntik) dalam kurun waktu tertentu sering mengeluhkan masalah kesehatan, salah satunya adalah hipertensi atau tekanan darah tinggi. Tujuan: Mengetahui hubungan penggunaan kontrasepsi suntik terhadap peningkatan tekanan darah. Penelitian analitik dengan pendekatan Cross Sectional. Sampel dalam penelitian ini adalah akseptor KB suntik yang dijumpai saat dilakukan penelitian di Bidan Asih Ngemplak Boyolali pada bulan Januari-Maret 2022 sebanyak 34 responden. Kriteria inklusi akseptor KB suntik, kriteria eksklusi adalah akseptor KB suntik dengan obesitas dan riwayat hipertensi. Metode pengumpulan data dengan menggunakan data primer dan sekunder. Analisis data menggunakan uji Chi Square. Responden yang menggunakan KB suntik 1 bulan sebanyak 18 responden (53%) dan 3 bulan sebanyak 16 responden (47%). 18 responden yang menggunakan KB suntik 1 bulan, mengalami peningkatan tekanan darah 1 responden (5%) dan tidak mengalami peningkatan tekanan darah sebanyak 17 responden (95%), Sedangkan responden KB suntik 3 bulan sebanyak 16 responden yang mengalami kenaikan tekanan darah sebanyak 2 responden (13%) dan 14 responden (87%) tidak mengalami peningkatan tekanan darah. Uji statistik menunjukkan penggunaan kontrasepsi suntik tidak berhubungan dengan terjadinya peningkatan tekanan darah dengan p-value 0,48 (p>0,05). Penggunaan kontrasepsi suntik tidak berhubungan dengan peningkatan tekanan darah.
Development and performance evaluation of cowpea threshing machine
Authors: Olajide OG  , Oladimeji AO
Published: November 2022

A cowpea threshing machine was designed, constructed and evaluated in the Department of Agricultural and Bio-Environmental Engineering Technology, Rufus Giwa Polytechnic, Owo, Ondo State, Nigeria. The machine was constructed using locally available materials with the primary aim of reducing drudgery attached to the traditional method of threshing cowpea. The machine consisted of the hopper, the threshing unit, the cleaning unit, the outlet and a single phase electric motor. The machine was evaluated based on the varied operating speed of 450rpm, 550rpm and 650rpm and moisture content of 13.5%, 14.5% and 15.5% respectively. The results showed that the machine efficiency increases with increase in feed rate and decrease in moisture content. An optimum level of 94.4% efficiency was observed at the speed of 650rpm and moisture content of 13.5%.
Optimal Time Trajectory Planning and Control of Space Cable Robot based on " Brachistochrone " Theory
Authors: Tahere Morowati  , Seyed Kamaleddin Mousavi Mashhadi  , Mohammad Fiuzy
Published: November 2022

This paper presents optimal-time trajectory planning of Samen cable robot using optimal control theory. The optimal-time trajectory planning solution method is based on the calculus of variations method. This issue can be solved by the Pontryagin’s Minimum Principle using the Bang-Bang control. To do so, a time-cost function is considered. By turning optimal-time trajectory planning into a problem-solving procedure with a two-point boundary value problem, the solving stages begin. In addition, the beginning and the end of the path are certain, which can be solved with numerical algorithms. One of the most important and effective methods of minimum time trajectory planning is the brachistochrone method. In this study, the brachistochrone curve is introduced and solved by both brachistochrone method and minimum time trajectory planning using optimal control. First, the path generation for the robot is described using optimization methods; subsequently, with respect to appropriate cost functions, a proportional-integral-derivative controller (PID) and a sliding mode for tracking generated paths are presented. By testing the algorithms in the simulation environment, good and acceptable results are obtained. Simulation results demonstrate proper performance of the proposed method.
Rehabilitation after critical illness (RaCI) enhanced physiotherapy input following critical care discharge: A quality improvement project
Authors:   Physiotherapy Department, University Hospital of Wales, Cardiff, CF14 4XW, UK, Lewis Megan , Twose Paul ,   Physiotherapy Department, University Hospital of Wales, Cardiff, CF14 4XW, UK
Published: November 2022

Background Early rehabilitation within the critical care setting is proven to have significant impact on functional ability, however the optimum model of care following critical care is unknown. Generally, a decrease in intensity of therapy seen on wards is linked with an initial plateau in a patient’s functional ability. Objective The primary objective of this study was to determine whether enhanced rehabilitation after discharge from critical care reduces patients’ hospital length of stay within a tertiary university hospital. The secondary outcomes include the effect on patient’s functional ability, frequency of physiotherapy activity and the need for support on discharge. Methodology Forty-four critical care participants were involved, over a four-month period, to receive daily physiotherapy provided by the critical care physiotherapy team in addition to existing ward-based therapy. Data was compared to a matched sample (based on risk of developing physical morbidity) from the previous year. Results Compared to before the quality improvement project, clinically significant reductions in patients’ hospital length of stay following critical care discharge were observed with a median saving of 11 hospital bed days. Conclusion In this small, local project, this quality improvement work has demonstrated potential reductions in length of stay because of enhanced physiotherapy input following discharge from critical care.
Is there a link between the activity levels of parents and their children with cystic fibrosis? A scoping review
Authors: Lock Kieren , Coleman Sam , Young David
Published: November 2022

Background Increased exercise levels result in decreased pulmonary exacerbations and hospitalisations in people with cystic fibrosis (CF). There is a clear link in the literature between parental activity levels and that of their children, though this not reported in CF. Objective To investigate whether there is a link between activity levels of parents and children with CF. Method A literature search was conducted to identify studies that evaluated the importance of parental activity and other behavioural factors on children’s activity levels. Two investigators screened titles and abstracts to identify suitable studies using inclusion criteria. A third author reviewed discrepancies with eight articles selected for review. Relevant data was extracted from accepted studies using agreed criteria. Discussion A narrative synthesis was used. The data showed multiple outcome measures discussing adherence and treatment levels within children and young people with CF. Questionnaires were the most commonly used tool to establish activity levels. There were multiple psychosocial programmes effectively used in people with CF. There was limited evidence on the impact parents play on a child’s activity levels or their adherence to treatment. Conclusion There is currently no clear link between parental activity levels and activity levels for children with CF, or adherence to physiotherapy treatment in CF. Evidence shows that family-based interventions can increase a child’s adherence to a variety of CF related treatments. Limitations There is limited research currently published in this area meaning that only eight studies were included for review. Selected studies used a range of methodologies making data analysis and synthesis challenging.
Statement and considerations for the remote delivery of pulmonary rehabilitation services during the COVID-19 pandemic
Authors: Gardiner Lucy , Alderslade Anna , Butler Frances , Graham Laura , Harvey-Dunstan Theresa , Ingram Karen , Lewko Agnieszka , Nolan Claire , Owen Helen , Pilsworth Sam , Stewart Helen , Swingwood Ema , Wainwright Kelly , Wright Christine
Published: November 2022

This document has been produced to support providers of pulmonary rehabilitation (PR) services in response to numerous requests for guidance received by the ACPRC during the COVID-19 pandemic to date. The COVID-19 pandemic and associated national measures to reduce transmission have significantly impacted healthcare provision across the UK. Following the outbreak, many ‘non-essential’ services have adapted in order to provide a partially or fully remotely delivered service (telephone or video-conferencing) in order to continue to serve their local population. A survey of PR healthcare professionals was conducted in the development of this document in order to scope current practice in PR services across the UK. The British Thoracic Society (BTS) have recently produced guidance on PR regarding remote assessment and reopening services for ‘business as usual’ participants (Gardiner et al. 2020a; Singh et al. 2020a). This document seeks to provide pragmatic guidance on the practical delivery of remote PR for healthcare professionals working in this field, which should be used alongside local guidance. We are unable to provide universal recommendations due to the extensive variation in factors currently affecting the delivery of PR services across the UK. The recommendations provided are for guidance only and may be updated in response to further government and national guidelines. This guidance document is formed of 2 parts: • Part 1 covers the background and rationale, methods of guidance development, adapted models of service delivery, risk assessment, workforce, and resources for remote delivery. • Part 2 will cover platforms for remote delivery, components of PR (assessment and re-assessment, exercise, and education) via remote delivery, and audit.
Evaluation of a new animal assisted intervention service for an adult intensive care unit
Authors: Johnson Ruth
Published: November 2022

Introduction An animal assisted intervention (AAI) is an intervention between an animal and a patient during a medical, nursing or therapeutic procedure. It humanises patient care, reduces suffering and loneliness and improves mood. It is a developing service within critical care environments. The current research of AAI in critical care is limited. Method The AAI was provided by a registered pets as therapy (PAT) volunteer and their dog collaborating with intensive care unit (ICU) staff. After the AAI the patient, visitor or staff member completed an electronic questionnaire using the Survey Monkey application on an iPad. The questionnaire comprised of 10 questions of mixed methods design. The aim of this service evaluation was to ascertain if the AAI service was feasible and safe. The service evaluation would also measure the impact of the service on patients, visitors and staff. The overall objective of the service evaluation was to determine if the service should continue and to identify areas for development. Results 47 questionnaire responses were obtained from 2 groups of responders: (1) patients and visitors; and (2) staff. There were no concerns in relation to the dog’s presentation, welfare, cleanliness or handling highlighted by responders. A 10-point Likert scale was used with free text options for comments. 83% of patients and visitors rated the level of enjoyment of the AAI as a maximum score; whilst 70% of staff rated a maximum score for level of enjoyment of the AAI for the patient. 75% of patients and visitors rated the AAI as extremely beneficial. Emergent themes were identified from the qualitative data. These were: mood; distraction; dog and handler; AAI; recommendations, impact and infection control. The first 5 themes were shared between the 2 groups of responders. Discussion and conclusion The data collected demonstrated that providing the service was feasible and safe. Overall, there was a positive response to the service from all responders. This evaluation supports similar findings from the limited research base and highlights areas for future service development.
Helping you help yourself (HYHY) for people with mild breathlessness: A service evaluation in Wales
Authors: Gale Nichola , Jones Una , Pierrepoint Sarah , Carter Joseph
Published: November 2022

Background Pulmonary rehabilitation (PR) is an evidence-based intervention which improves exercise capacity and quality of life (QoL) for patients with chronic obstructive pulmonary disease (COPD). Commonly, outpatient rehabilitation is available for patients with significant breathlessness (Medical Research Council (MRC) >3). This evaluation explored changes in exercise capacity and knowledge of condition and their relationship with the impact of COPD (CAT score) at baseline following a community exercise and education programme delivered by the British Lung Foundation (BLF) in people with mild breathlessness (MRC ≤2). Methods People with mild breathlessness, MRC ≤2, were recruited from GP surgeries, the BLF website and support groups. The 6-week Helping you help yourself (HYHY) programme included weekly exercise, education and social engagement. Participants were assessed at baseline using the COPD Assessment Tool (CAT), 6-minute walk test (6MWT), Bristol COPD Knowledge quiz (BKQ), and questions on self-management was assessed by questionnaire. After 6 weeks 6MWT, BKQ and self-management were assessed and related to CAT at baseline. The usefulness of the programme to participants was also assessed by questionnaire. Results In the 210 patients who completed assessments before and after HYHY, there was an increase in 6MWT distance, median (IQR) 60 (30–80)m and BKQ 3 (1–4) points (p <0.05), and most elements of self-management improved. Almost all participants considered HYHY useful (p <0.05). There was no relationship between baseline CAT score and change in outcome measures (p >0.05). Conclusion The results support the provision of community rehabilitation as an alternative to hospital-based interventions to support and promote self-management in people with mild breathlessness across the severity of disease burden as measured by CAT.
Does the incremental shuttle walk test predict the development of a hospital acquired pneumonia in patients undergoing elective oesophagectomy: A service evaluation
Authors: Weblin Jonathan , Cuell James , McWilliams David
Published: November 2022

Introduction Post-operative morbidity following oesophagectomy is high, with pulmonary complications, including hospital acquired pneumonia (HAP), the most commonly reported. Functional assessment to determine fitness for surgery is important to provide an individualised risk profile, helping to guide collaborative decision making around selection for surgery and post-operative care. The incremental shuttle walk test (ISWT) can be used to objectively measure functional capacity. Previous studies have demonstrated walking <350m on the ISWT is associated with significantly higher 30 day and 3-year mortality. The aim of this service evaluation was to assess if walking <350m on the ISWT correlated with the development of HAP. Methods Consecutive patients with oesophagogastric cancer listed for an elective oesophagectomy at a large U.K. tertiary hospital between December 2017 and February 2020 were included in analysis. All patients completed the ISWT at pre assessment clinic approximately 1 week prior to surgery. Primary outcome was incidence of HAP. Secondary outcomes included re-intubation rates, intensive care unit (ICU) re-admissions, ICU and hospital length of stay, and 30, 90 day and 12 month mortality. Results 121 patients completed the ISWT and were included in analysis of which 25 (21%) walked <350m. Those walking <350m had significantly higher rates of hospital acquired pneumonia (44% v. 11%, p = 0.0003) and spent significantly longer on ICU (5 v. 3 days, p = 0.041). Poor performance on ISWT had no significant effect on either 30, 90 day or 12 month mortality. Conclusion Walking less than 350 metres on the ISWT pre operatively was associated with a significant increase in the likelihood of developing HAP and longer stays in the ICU. The ISWT may therefore be a useful tool to help manage patient and clinician expectations, guide clinical decision making related to post-operative care, for example, high dependency unit vs ICU and direct post-operative resources like physiotherapy to patients most at risk.
Patient experiences of face-to-face and remote clinics in a cystic fibrosis service – what can we learn?
Authors: Shepherd Elizabeth , Davis Laura , Stevens Keeley
Published: November 2022

Clinic flow at the Wessex adult cystic fibrosis service was recognised to be sub-optimal with patients spending on average 36% of their total clinic time waiting to see the next clinician. Changes had been made to improve the clinic experience for patients and clinicians and following these changes an initial questionnaire was completed in 2019 to explore patients’ views of the face-to-face clinic experience. Results were analysed from the first questionnaire but before further changes could be implemented the COVID-19 pandemic began and almost all clinic appointments became remote appointments. A second questionnaire was completed in July 2020 to understand the patients’ perceived advantages and disadvantages of face-to-face and remote clinics. A total of 25 adults with cystic fibrosis completed the 1st questionnaire and 48 completed the 2nd questionnaire. Participants reported advantages and disadvantages to both types of clinic appointment and neither type of appointment offered the perfect solution. A majority of participants (71%) were happy to continue with remote clinic appointments in the future with some participants keen for a hybrid approach of face-to-face and remote appointments. The feedback from both questionnaires has provided clinicians at the Wessex adult cystic fibrosis service with the opportunity to further improve the current clinic experience and to give patients a greater choice of clinic appointment type which also meets their clinical and personal needs.
Influence of age and gender on cardiovascular response to isometric exercise in apparently healthy individuals
Authors: Odebiyi Daniel , Ajepe Titilope , Akingbade Oluwatoyin
Published: November 2022

Objective Static exercises are an integral aspect of patient rehabilitation and are employed in advanced strength and endurance training programmes. Exercise is a form of self-induced stress leading to circulatory and respiratory changes, therefore, this study sought to determine the influence of age and gender on the cardiovascular responses of apparently healthy individuals to isometric/static exercises. Methodology Sixty apparently healthy individuals (30 males and 30 females) participated in this study. Their ages ranged between 21–50 years and were grouped into 21–30 years, 31–40 years and 41–50 years. Each participant carried out and maintained 30% of maximal isometric voluntary contraction (MIVC) using hand grip for 1, 2 and 3 minutes respectively, with 30-minutes rest period. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured and recorded, at rest, and during each of the sustained contractions. Results There was a statistically significant increase (p <0.05) in the mean SBP, DBP and HR at rest and with every increase in duration (that is, from 1 minute to 3 minutes) of static handgrip contraction, maintained at 30% MIVC in the 3 groups; except for HR for group one (that is, 21–30 years). There was no gender difference (p >0.05) in SBP and DBP of the participants within the 3 groups, although male participants, particularly in group 2 had higher SBP. There was also a statistically significant increase in the HR of female participants compared to the males in group 2. Isometric contraction for 3 minutes produced the greatest change (increase) in cardiovascular parameter across all the groups but more marked among participants in group 2 (that is, 31–40 years). Conclusion The study concluded that submaximal (30% MIVC) isometric upper limb exercise increase blood pressure and heart rate in both sexes, with greatest values when the exercise was sustained for 3 minutes. Hence, efforts should be made to monitor cardiovascular parameters prior to prescribing safe level of isometric exercise. Also, 3 minutes of static/isometric exercises may be avoided, particularly during the rehabilitation of patient with cardiovascular disease.
Referral of patients with chronic obstructive pulmonary disease to pulmonary rehabilitation from primary care: A local survey of GPs and practice nurses
Authors: George Leslie , Kerr Daniel
Published: November 2022

Aim To gain an understanding of the referral practices of local general practitioners (GPs) and practice nurses (PNs) to a local pulmonary rehabilitation (PR) programme in order to improve referral rates of patients with chronic obstructive pulmonary disease (COPD). Methods The study involved a cross-sectional survey of local GP and PNs from 16 GP practices within a local health and social care trust. The survey was distributed electronically and in hard copy form to GP practices and a 1-month period was provided to complete the survey. Inclusion/exclusion criteria GPs and PNs who review patients with COPD were eligible to complete the survey. Outcome measures The study reports on descriptive statistics for perceived referral rates to PR, knowledge of PR referral process within the local area, service user barriers, referral barriers and strategies to improve referral. Inferential statistics were used to determine if differences existed between GPs and PNs with regards MRC questioning and PR education. Results The survey was distributed to a total of 70 people, with responses received from 13 general practitioners (GPs) and 11 practice nurses. The overall response rate for the survey was 34%, with a GP response rate of 23% versus a PN response rate of 79%. 83% percent (n = 20) of respondents estimated they referred <50% and 17% (n = 4) did not refer any COPD patients to PR. The number of PNs who reported that they question service-users around exertional breathlessness and educate around the benefits of PR was significantly higher than participating GPs (p <0.05). 63% (n = 15) of respondents felt that the principal barrier to PR referral was patient unwillingness/refusal to attend. 29% (n = 7) of respondents felt that information leaflets/posters would improve referral rates to PR. Conclusions In this local survey referral from primary care to PR in the COPD population was underutilised by clinicians. PNs reported that they were more likely than GPs to explore patient’s exertional breathlessness and to educate patients regarding the benefits of PR. Respondents perceived that patient unwillingness to attend PR was the primary barrier however practitioner referral barriers in the form of time constraints were also cited. Respondents also cited a perceived lack of patient understanding of the benefits of PR as a factor affecting PR attendance.
A physiotherapy-led early mobilisation protocol for neurosurgical patients with external ventricular drains in intensive care: A service evaluation
Authors: Tan Yi Fang , Pereira Charlotte , Shannon Harriet
Published: November 2022

Background An external ventricular drain (EVD) is used to relieve elevated intracranial pressure in neurosurgical patients, and remains in place for an average of 8 days post-surgery. The presence of an EVD poses a major barrier to early mobilisation due to safety concerns. Eligibility criteria published in EVD mobilisation protocols only consisted of parameters related to the neurological system (Moyer et al., 2017; Young et al., 2019). Parameters pertaining to cardiovascular, respiratory and musculoskeletal systems deemed safe for mobilisation were not stated. Aims To determine the safety, feasibility and effectiveness of implementing an early mobilisation protocol, which included physiological parameters, in patients with EVDs. Methods A retrospective service evaluation was conducted in a neurological intensive care unit. Medical records were reviewed for 2 periods from October 2017 to March 2018 (pre-protocol period) and October 2019 to March 2020 (protocol period). Eligible patients for out-of-bed mobilisation were screened and identified by physiotherapists. Results After protocol implementation, there was a 64.8% increase in the proportion of patients with EVDs mobilised (95% CI, 35.9–82.1%, p <0.0001). Median time from EVD placement to 1st mobilisation decreased from 14 to 3.5 days (p <0.0001). Moreover, the median intensive care and hospital length of stays were significantly reduced from 8 to 3.5 days (p = 0.037) and 38 to 22.5 days (p = 0.030) respectively. No adverse events were recorded in the protocol period. Conclusion The early mobilisation protocol for patients with EVDs enabled safe, feasible and effective mobilisation. Future prospective, controlled research studies are warranted.
An evaluation of the experiences of an ECMO clinical support team implemented during the COVID-19 pandemic
Authors:   Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Southmoor Road, M23 9LT, UK, Driver Kimberley ,   Major Trauma & Orthoplastics, Manchester Royal Infirmary, Oxford Road, M13 9WL, UK, Shaw Nunez Emma ,   Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Southmoor Road, M23 9LT, UK, Shaffi Danielle ,   Nightingale Centre, Wythenshawe Hospital, Southmoor Road, M23 9LT, UK
Published: November 2022

Introduction The COVID-19 pandemic led to an increased demand for critical care provision, with healthcare services and staff having to adopt novel ways of working to meet patient needs. Aims This service evaluation explores the experience and implementation of a team of healthcare staff voluntarily redeployed to a newly created role supporting staff and patients on an intensive care unit (ICU) providing extracorporeal membrane oxygenation (ECMO) to patients with COVID-19 during the first wave of the pandemic. Method This service evaluation presents a qualitative analysis of the team members’ responses to a questionnaire. Results Respondents found participation in the team to be a positive experience. This was attributable to effective training, support and positive feedback from the existing staff, as well as feelings of being valued, contributing to patient care and developing new skills. Learning points were highlighted, including the need for a timely implementation of such a team, with extended training to enhance the team’s collaboration with the existing staff. Comprehensive communication of the role of the team to the existing staff and an agreed list of tasks could enable the team to be utilised more effectively. Conclusions Staff can be successfully redeployed into a support role on ICU without prior experience of the environment. These findings can inform workforce planning and the implementation of similar support teams in the event of future crises.
Research quality; a collective endeavor
Authors: Shifflett Bethany
Published: November 2022

An allegory published nearly 60 years ago titled ‘Chaos in the Brickyard’ (Forscher, 1963) spoke to the decline in the quality of research. In the intervening time, greater awareness of the issues and actions to improve research have emerged. Still, problems persist. This paper is intended to clarify some of the challenges, particularly with respect to quantitative research, then suggest ways the academe can contribute, in concrete ways, to the improvement of the quality of published research. The paper highlights where feasible refinements in research design and analytical techniques can be made and provides a guide to fundamental principles related to data analysis in research.
Avaliação da dor e seus fatores associados durante a inserção do dispositivo intrauterino na Atenção Primária à Saúde
Authors: Barreto Danyella da Silva , Rêgo Maria Eduarda de Melo Pereira do , Melo Neto Alexandre José de , Gonçalves Rafael Dias , Morais Ianna Gil de Farias , Costa Gilka Paiva Oliveira
Published: November 2022

Introdução: A inserção do dispositivo intrauterino é uma competência esperada para o médico generalista. No entanto, esse método encontra muitas barreiras ao ser inserido nas unidades básica de saúde, como a falta de treinamento dos profissionais e o medo que as mulheres têm de sentir dor. Objetivo: Avaliar a intensidade da dor durante o procedimento de inserção do dispositivo intrauterino realizado por médicos generalistas em unidades básicas de saúde na região metropolitana de João Pessoa e sua associação com fatores sociodemográficos, aspectos clínicos da mulher e formação médica. Métodos: Estudo transversal e descritivo, com dados coletados em 16 unidades básicas de saúde nos municípios de Conde, Caaporã, João Pessoa e Sapé, no intervalo de março a outubro de 2019. A coleta de dados foi realizada por entrevista individual com questionário estruturado, e a dor foi graduada pela escala visual analógica. Os dados foram analisados utilizando-se os testes de Mann-Whitney e χ². Resultados: Participaram do estudo 139 mulheres com idade mínima de 14 e máxima de 47 anos, cuja média de dor foi de 5,5 para aquelas que estavam menstruadas e de 4,6 para as que não estavam. A dor leve esteve presente em 20,1%, a dor moderada em 38% e dor intensa em 31,7%. Histerometria acima de 7 cm, histórico de uso de anti-inflamatórios na menstruação e de dismenorreia estiveram mais presentes em quem referiu dor intensa (p<0,001). Quanto à qualificação do médico que insere o dispositivo intrauterino, não houve significância estatística na correlação de dor intensa com o fato de ele ser residente (p=0,268), com o tempo de formatura (p=0,080) nem com a dificuldade técnica encontrada (p=0,065). Conclusões: A dor foi considerada pela maioria das mulheres como moderada, sendo uma oferta e um procedimento viável de ser ensinado e inserido na Atenção Primária à Saúde.
Avaliação de adequabilidade de um serviço de telespirometria
Authors: Faria Amanda Gomes , Molina-Bastos Cynthia Goulart , Gonçalves Marcelo Rodrigues , Schmitz Carlos André Aita
Published: November 2022

Introdução: As doenças respiratórias crônicas estão entre os principais problemas de saúde pública no mundo. Mesmo sendo sensíveis ao tratamento na Atenção Primária à Saúde, são a terceira principal causa de morte no Brasil. Os serviços de telemedicina apresentam-se como aliados importantes dos profissionais de saúde no que tange ao manejo de doenças respiratórias como a asma e a doença pulmonar obstrutiva crônica.  Objetivo: Avaliar a adequabilidade de um serviço de telemedicina diagnóstica em espirometria considerando os indicadores de oferta, utilização e cobertura populacional no estado do Rio Grande do Sul. Resultados: No período estudado, o serviço ofertou 27.672 exames de telespirometria aos usuários do Sistema Único de Saúde do Rio Grande do Sul encaminhados por médicos da Atenção Primária à Saúde. A utilização esteve abaixo de 50% da oferta em todas as macrorregiões de saúde do estado.  Conclusões: O estudo demonstrou que a capacidade instalada pelo serviço esteve adequada para atender à demanda populacional do Rio Grande do Sul, no entanto a baixa utilização do serviço pode estar associada ao desconhecimento sobre ele e à dificuldade em reconhecer essas doenças por parte dos profissionais de saúde da Atenção Primária à Saúde.
Physicochemical and histopathological parameters of broilers with dorsal cranial myopathy
Authors: Pavanello Ana Clara Longhi , Mendonça Fernanda Jéssica , Oliveira Thalita Evani Silva , Torezan Guilherme Baú , Di Santis Giovana Wingeter , Soares Adriana Lourenço
Published: November 2022

Objective: This study aimed to investigate the effect of dorsal cranial myopathy (DCM) on chicken meat quality.Methods: Sixty-six Ross 308 AP broilers, 47 days old, of both sexes, weighing about 3.51 kg, were slaughtered according to standard industrial practices, and evaluated for meat color, pH, chemical composition, collagen content, fatty acid profile, and histopathological parameters. Comparisons between normal and DCM-affected meat were performed using Student's t-test at the 5% significance level.Results: Histological analysis of muscle tissues affected by DCM showed myofiber degeneration, proliferation of inflammatory cells, fibroplasia, and necrosis with fibrosis. DCM samples had lower protein content and higher moisture, ash, insoluble collagen, total collagen, and pH. DCM-affected meat was redder and more yellowish. There were no differences in lipid or soluble collagen contents between groups. DCM-affected meat had higher percentages of arachidonic acid (C20:4n−6) and eicosapentaenoic acid (C20:5n−3).Conclusion: This study revealed that DCM-affected meat exhibits considerable changes in quality parameters.
Comprehensive analysis of miRNAs, lncRNAs and mRNAs profiles in backfat tissue between Daweizi and Yorkshire pigs
Authors: Chen Chen , Chang Yitong , Deng Yuan , Cui Qingming , Liu Yingying , Li Huali , Ren Huibo , Zhu Ji , Liu Qi , Peng Yinglin
Published: November 2022

Objective: Daweizi (DWZ) is a famous indigenous pig breed in China and characterized by tender meat and high fat percentage. However, the expression profiles and functions of transcripts in DWZ pigs is still in infancy. The object of this study was to depict the transcript profiles in DWZ pigs and screen the potential pathway influence adipogenesis and fat deposition,Methods: Histological analysis of backfat tissue was firstly performed between DWZ and lean-type Yorkshire pigs, and then RNA sequencing technology was utilized to explore miRNAs, lncRNAs and mRNAs profiles in backfat tissue. 18 differentially expressed (DE) transcripts were randomly selected for quantitative real-time polymerase chain reaction (QPCR) to validate the reliability of the sequencing results. Finally, gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis were conducted to investigate the potential pathways influence adipocyte differentiation, adipogenesis and lipid metabolism, and a schematic model was further proposed.Results: A total of 1,625 differentially expressed transcripts were identified in DWZ pigs, including 27 upregulated and 45 downregulated miRNAs, 64 upregulated and 119 downregulated lncRNA, 814 upregulated and 556 downregulated mRNAs. QPCR analysis exhibited strong consistency with the sequencing data. GO and KEGG analysis elucidated that the differentially expressed transcripts were mainly associated with cell growth and death, signal transduction, peroxisome proliferator-activated receptors (PPAR), AMP-activated protein kinase (AMPK), PI3K-Akt, adipocytokine and foxo signaling pathways, all of which are strongly involved in cell development, lipid metabolism and adipogenesis. Further analysis indicated that the BGIR9823_87926/miR-194a-5p/AQP7 network may be effective in the process of adipocyte differentiation or adipogenesis.Conclusion: Our study provides comprehensive insights into the regulatory network of backfat deposition and lipid metabolism in pigs from the point of view of miRNAs, lncRNAs and mRNAs.
Evaluation of light-emitting diode colors and intensities on slaughter performance, meat quality and serum antioxidant capacity in caged broilers
Authors: Tan Zichao , Zhou Chuanfeng , Shi Xueping , Wang Lihua , Wang Shubai
Published: November 2022

Objective: This study was to evaluate the interaction of three different light-emitting diode (LED) light colors (white, green, and blue) and three intensities (5, 10, and 15 lx) on slaughter performance, meat quality and serum antioxidant capacity of broilers raised in three-layer cages.Methods: A total of 648 (8-days-old) male broiler chicks (Cobb-500) were randomly assigned in 3×3 factorially arranged treatments: three light colors (specifically, white, blue, and green) and three light intensities (namely, 5, 10, and 15 lx) for 35 days. Each treatment consisted of 6 replicates of 12 chicks. The test lasted for 35 days.Results: The semi-eviscerated weight percentage (SEWP) in 5 lx white was higher than that in 15 lx (p<0.01). The eviscerated weight percentage (EWP) (p<0.05) and water-loss percentage (WLP) (p<0.01) decreased in 10 lx white light than those in green light. Under blue light, the content of hypoxanthine (Hx) in muscle was lower than that under white and green light (p<0.01). The content of malondialdehyde (MDA) in 15 lx blue light was higher than that in 10 lx green light (p<0.05). Light color had an extremely significant effect on thigh muscle percentage, WLP, Hx, and crude protein content (p<0.01). Light intensity had a significant effect on SEWP (p<0.05), EWP (p<0.05), lightness (L*) value (p<0.05), WLP (p<0.01), and the contents of superoxide dismutase (p<0.05), MDA (p<0.01), glutathione peroxidase (p<0.01).Conclusion: Using white LED light with 10 lx light intensity can significantly improve the chicken quality of caged Cobb broilers, improve the content of inosine acid in chicken breast and enhance the antioxidant capacity of the body. We suggest that the broiler farm can use 10 lx white LED light source for lighting in 8 to 42 days.