bluuebunny/crossref_metadata_2025 huggingface dataset:
Representation Matters: A Higher Percentage of Women Orthopaedic Surgery Faculty Is Associated With an Increased Number of Women Residents
Authors: Ranson Rachel , Webber Kassidy , Saker Christopher , Cashin Isabella , Bunstine Josie L. , Patel Aaditya P. , Kirkland Julia , Gianakos Arianna L. , Rumps Mia V. , Mulcahey Mary K.
Published: November 2024

Introduction:

Orthopaedic surgery has been recognized as one of the least diverse surgical specialties. Previous studies have demonstrated that women are heavily underrepresented within orthopaedic surgery. The purpose of this study was to determine whether orthopaedic surgery residency programs with a higher presence of women faculty had a higher proportion of women residents.

Methods:

The Fellowship and Residency Electronic Interactive Database was used to identify all orthopaedic surgery residency programs in the United States. Resident and faculty's sex and degree were recorded in addition to faculty administrative title (eg, program director, chair) and academic rank (clinician, professor, etc). Pearson correlation coefficients were used to compare the number of women residents with the number of women faculty.

Results:

A total of 192 orthopaedic surgery programs were analyzed. Of the 5,747 faculty members and 4,268 residents identified, 13.1% (n = 752) and 22.6% (n = 963) were women, respectively. The number of women residents markedly correlated with the number of women faculty in leadership positions (r = 0.516, P < 0.001), such as chief or chair. The most significant correlations were among women with the academic role of “professor” (r = 0.575, P < 0.001), “assistant professor” (r = 0.555, P < 0.001), and women who held faculty positions but held no higher academic appointment (r = 0.509, P < 0.001). Program directors and assistant program directors were not found to have significant correlations with the number of women residents.

Conclusion:

This study demonstrates a positive correlation between women faculty and residents at orthopaedic surgery residencies. Some academic positions, such as division chief, held more significant associations, whereas other positions, such as professor emeritus, were not held by any women, thereby limiting statistical analysis. Further investigation into minority representation in orthopaedic surgery and initiatives to address the observed disparities is paramount.
A Retrospective Comparison of Headless Versus Standard Interlocking Screw Fixation of Tibia Intramedullary Nails
Authors: Pesante Benjamin D. , Ward Byron A. , Stacey Stephen C. , Parry Joshua A.
Published: November 2024

Introduction:

Symptomatic interlocking screws are common after intramedullary nail fixation of tibia fractures. Low-profile headless interlocking screws recently became available and could potentially reduce the rate of symptomatic screws. The purpose of this study was to compare the rate of symptomatic screws and screw removals between these screw types.

Methods:

A retrospective review identified patients with tibia shaft fractures treated with tibia intramedullary nails between August 1, 2018 to September 1, 2023 by 11 surgeons. Low-profile headless interlocking screws became available on June 28, 2021 and were routinely used thereafter. Patients treated with low-profile headless versus standard headed interlocking screws were compared in terms of symptomatic screws, defined as a patient reporting pain or discomfort at the site of a screw head in clinical documentation, symptomatic screw removals, screw failure (breakage or backout), and procedures to promote bone union.

Results:

Overall, 79 patients were included in the analysis: 33 patients treated with 144 headless screws and 46 patients treated with 187 standard screws. The median patient age was 35 years, and a majority were male (68.4%, n = 54). The median follow-up length was 8.5 months (interquartile range 5.5 to 8.8 months). The headless screw group, compared with standard screw group, did not differ in age, injury mechanism severity, open fracture classification, tobacco use, American Society of Anesthesiologists classification >2, number of interlocking screws used, or follow-up time (P > 0.05). The headless screw group was less likely to have symptomatic screws (0.0% vs. 23.9%; P = 0.002), less likely to have symptomatic screw removal (0.0% vs. 13.0%; P = 0.03), and had no difference in procedures to promote bone union (10.0% vs. 6.8%; P = 0.68) or screw backout (0.0% vs. 4.4%; P = 0.50).

Discussion:

Standard headed interlocking screws were symptomatic in 23.9% of patients and 13.0% underwent symptomatic screw removal. In comparison, no patients treated with low-profile headless interlocking screws had symptomatic screws.

Level of Evidence:

Level 3, diagnostic
Foreword
Authors: Chetter I
Published: November 2024

The JVSGBI has had an incredibly successful first three years. The journal is free, open-access, published online quarterly and represents the whole vascular community. One hundred and seventeen articles have been published and time to on-line publication is ten weeks.
Application of herniostapler versus sutures during Lichtenstein technique. Comparative prospective study.
Authors: Mekhaeel Mekhaeel , Salem Sameh , Protasov Andrey
Published: November 2024

Abstract
Introduction.
Compassionating the act of impaired collagen metabolism in the pathogenesis of groin hernias has led to a new grasp of the pathology of groin hernias besides the etiology of their surgical failure. These changes lead to weakening of the fibroconnective tissue of the groin and development of inguinal hernias. Therefore, using this already defective tissue, especially under tension, is a violation of the most of surgeries. This type of thinking inspired investigators to develop a host of prosthetic materials as well as tension-free hernioplasty in order to overcome these complications; Lichtenstein technique [1-3].
However, suture fixation during Lichtenstein technique possesses numerous complications; intraoperative complications; injury to inferior epigastric vein and ilioinguinal nerve. Immediate postoperative complications; pain, seroma, surgical site infection, orchitis and mesh shrinkage; Long term complications; chronic pain, foreign body sensation. On the other hand; using herniostapler during Liechtenstein declines operative-time, postoperative pain and complications incomparison to suture fixation. Furthermore, the application of elastic tacks is superior to metallic tacks regarding foreign body sensation during short-term follow-up for 6 months [4-6].
Materials and methods.
The study used a prospective comparative design, where patients were divided into two groups: Group A (50 patients) underwent Lichtenstein hernia repair using a herniostapler to fix the mesh implants, and Group B (50 patients) underwent Lichtenstein hernia repair using sutures to fix the mesh implants. The key methodological details provided were the sample size, surgical technique, mesh fixation method, and patient characteristics (age, gender, hernia side).
Conclusion.
Herniostapler application was superior to thread fixation in terms of shorter operative time and lower incidence of chronic pain. However, herniostapler usage was associated with a higher incidence of foreign body sensation compared to thread fixation. There was no significant difference in hernia recurrence rates between the two methods.
Editorial
Authors: Alabdulwahhab Khalid
Published: November 2024

From Editor’s Desk…

The World Health Organization (WHO) has designated the mpox outbreak in certain parts of Africa a public health emergency of worldwide significance. During an early outbreak in the Democratic Republic of Congo, at least 450 individuals were killed by the highly contagious disease, which was formerly known as monkeypox. It has now expanded over central and eastern Africa, and scientists are concerned about the rapid development of a new version of the disease, as well as its high mortality rate.

Mpox is spread through close contact, which includes intercourse, skin-to-skin contact, and talking or breathing near to another person. It causes flu-like symptoms, skin lesions, and can be devastating, with four in every 100 cases resulting in death. Over 13,700 cases of mpox have been reported in the Democratic Republic of the Congo since the beginning of the year, with at least 450 deaths. It has also been found in Burundi, the Central African Republic, Kenya, and Rwanda and recently in Sweden.

Vaccines can be used to prevent diseases and control outbreaks, but they are often only available to persons who are at risk or have had close contact with an infected person. According to the World Health Organization, certain antivirals and vaccinations developed for smallpox can also be used to treat Mpox.

Dr. Khalid Mohammed Alabdulwahhab
Editor in Chief
Opinion of Healthcare Organization Employees on the Usefulness, Ease of Use, and Effectiveness of Electronic-Learning for Continuous Professional Development
Authors: Mofeez Fahad , Enazi Anwar , Alyousef Mansour , Alzomia Abdurahman , Qarni Aeyd , Alharthi Ahmed , Alkhalf Abdulrhman , amoudi Sahar , Alanazi Nouf , Alenezi Noura , Hassanein Muna
Published: November 2024

Background and Aims:
To be effective, electronic learning requires user acceptance based on perceptions of its usefulness, ease, and effectiveness. The study aimed to assess opinions of healthcare and other professionals on electronic learning for continuous professional development.

Methods:
A descriptive, cross-sectional study was conducted with 210 Riyadh General Directorate of Health Affairs employees in electronic-learning programmes. Data collection was via a self-administered electronic questionnaire covering background, effectiveness, usefulness, and ease of use variables. Opinions were evaluated with average scores and subgroup comparisons with one-way ANOVA and t-tests.

Results:
Respondents viewed electronic learning favorably for usefulness (mean score (standard deviation) = 29 (8.5) out of 40 points), but expressed concerns about interaction and hands-on training suitability. They also had a positive opinion on ease of use (mean score (standard deviation) = 15.9 (4.2) out of 20 points), yet noted concerns about location availability for training. Similarly, they rated effectiveness favorably (mean score (standard deviation) = 14.6 (5.6) out of 16 points). Males had more positive view of usefulness and ease of use compared to females (usefulness: males 30 (8.3) versus females 27 (8.6), p-value = 0.010; ease of use: males 16.7 (3.8) versus females 13.9 (4.6), p-value = 0.000). Those aged 45-49 showed a more positive opinion on effectiveness compared to those under 45 years (15.8 (5.1) versus 13.8 (5.9), p-value = 0.014).

Conclusions:
Opinions regarding usefulness, ease of use, and effectiveness of electronic learning were favorable, making it an option for implementing continuous professional development training, albeit with careful planning to overcome its shortcomings.
Characteristics and Outcomes of Non-accidental Visceral Injuries Among Children: Five Years’ Experience of National Data in Saudi Arabia
Authors: Eissa Majid , Abanmi Jude , Alabdulkareem Deamah , Alkhowaiter Nahlaa , Alhadlq Norah , Dahlawi Maha , Saleheen Hassan , Alhowaish Norah
Published: November 2024

Background and Aims:
Child maltreatment is a major global public health concern. Non-accidental visceral injury (NAVI) is a type of injury that is deliberately inflicted on the human body, resulting in injury to internal organs, which is considered child abuse. This study aimed to identify the prevalence of NAVI and determine the characteristics of non-accidental injuries among children in Saudi Arabia (SA).

Methods:
A cross-sectional study was conducted based on the National Family Safety Registry (NFSR), which consists of 62 child-protection centres among health sector in SA. A total of 30 children with NAVIs were registered in the NFSR from April 2017 to March 2022.

Results:
The children mean age was 6.5±4.7 years.There was a sharp increase in NAVI cases over the five-year period, particularly after 2020, from two cases per year in 2017 to nine cases in 2021. NAVI predominantly affected children aged 5-10 years (40.1%). Lung injury was the most common form of NAVI, accounting for 23.3% of the cases. As a consequence of NAVI, 2 of the victims has died and 7 of them had deteriorated health status.

Conclusions:
NAVI in children in SA is a significant problem. This study provides important information on the socio-demographic characteristics and injury patterns of children with NAVI. This information can help develop prevention and intervention strategies to reduce the incidence of NAVI among children in SA.
Prevalence and Awareness of Anabolic-Androgenic Steroids Usage Among Gym users in Majmaah, Saudi Arabia
Authors: AlMutairi Ahmed
Published: November 2024

Background and Aims:
The use of anabolic-androgenic steroids among athletes and gym users is still prevalent despite the enforcement of regulations and penalties. The hormones are used to enhance muscle mass and performance, but frequent use is associated with various side effects. The objectives of this research were to study the prevalence, use, and level of knowledge of gym users on AAS.

Methods:
The study design was ross-sectional. The sample size was 152, including males who used the gym in the last six months. The data was collected by a pre-tested questionnaire after obtaining ethics approval. The SPSS software was employed for data analysis. The chi-square test was used to compare the qualitative data and a p-value of less than 0.05 was considered significant.

Results:
The age of most (85.5%) gym users was between 20 and 40 years, and the education level of most of them was university (84.2%). The prevalence of AAS use was 13.2%. The level of knowledge of 62.5% of the AAS users was poor. The advice to use was mostly provided by the gym coaches (75%). The occupation showed a significant relationship with the level of knowledge, the students have the highest level (42.9%) of AAS adequate knowledge.

Conclusions:
The prevalence of the use of AAS in Majmaah, Saudi Arabia is moderate. The level of knowledge of AAS among the Gym users is inadequate. The students are the most knowledgeable about AAS. The advice to use AAS is commonly from the Gym coaches.
Improving the Teaching of Patient Safety in Medical School: Perspectives from Medical Students
Authors: Halwani Muhammad
Published: November 2024

Background and Aims:
Patient safety is a critical aspect of healthcare delivery. The inclusion of patient safety education in medical school curricula is, therefore, considered essential in shaping competent healthcare professionals. Al Baha University Faculty of Medicine introduced the patient safety education module into its medical program for fourth-year students. This study aims to assess the impact of the program on the overall experience of fifth and sixth-year students who have studied the module and are currently in their clinical years.

Methods:
An electronic questionnaire comprising 10 questions was distributed to the students, with response options of yes, no, or not sure. In case of a "no" response, students were required to select one of the three available options. The questionnaire, ensuring anonymity, covered topics that are covered in the module such as patient safety discipline, medical errors, communication skills, teamwork, risk assessment, infection prevention and control, patient falls and medication safety.

Results:
Out of 162 students, 143 (88%) responded, revealing varying levels of satisfaction within different sections of the module ranging from 54% to 73% and overall satisfaction exceeded 50%. Other concerns were expressed regarding integration with other modules and the need for more practical sessions. Recommendations were made for the module to be presented as a standalone course and to introduce more hands-on activities for enhanced engagement.

Conclusions:
Feedback from students highlighted the necessity for adjustments, including delivering the module independently and enhancing practical sessions. These findings emphasize the importance of evolving curriculum structures to ensure optimal learning experiences and ultimately improve patient care outcomes.
Outcomes of Out-of-Hospital Cardiac Arrest with Initial Shockable Rhythm: The Role of Bystander and Dispatch-Guided CPR in Sarajevo's Physician-Led Emergency Medical Teams
Authors: Drkic Tatjana , Sljivo Armin , Ljuhar Kenan , Palikuca Amna , Knezevic Arijana , Karamehic Emina , Fetahovic Lamija , Bosnjak Melica
Published: November 2024

Background: The Out-of-hospital cardiac arrest (OHCA) remains a major public health challenge worldwide, with survival outcomes heavily influenced by early intervention. The presence of an initial shockable rhythm significantly increases the likelihood of survival when combined with timely cardiopulmonary resuscitation (CPR) and defibrillation. Objective: To analyze patient outcomes and the incidence of bystander and dispatch-guided CPR in cases of OHCA with an initial shockable rhythm treated by physician-led emergency medical teams in Bosnia and Herzegovina. Methods: Data for this study were collected over a 5-year period, from January 2019 to September 2023, using the Utstein protocol. Hospital records were analyzed to determine patient outcomes, with a focus on the 30-day survival rate and favorable neurological outcomes. Instances of dispatch-guided and bystander CPR were recorded for each case based on available patient records. Results: In this study, 1,020 patients were included, with 151 cases (14.8%) having an initial shockable rhythm, of which 14.3% of males and 4.4% of females achieved return of spontaneous circulation (ROSC). ROSC rates varied by year, with the highest in 2019 (20.4%) and 2022 (17.9%). Thirty-day survival with a good neurological outcome was observed in a small percentage of cases. The initial shockable rhythm was found to be statistically significant (p<0.001) for achieving a good neurological outcome after 30 days. Dispatch-guided CPR was attempted in 12.9% of cases, with success in 1.9%. Bystander CPR was performed in 1.4% of cases, and only one case involved the use of an automated external defibrillator (AED). The median response time for successful resuscitations was 2 minutes, while for unsuccessful resuscitations, it was 6 minutes. The findings emphasize the role of age, initial rhythm, and response time in determining outcomes for OHCA patients. Conclusion: The promising survival rate of OHCA patients, despite limited bystander CPR, highlights the impact of short response times and skilled physician-led teams, underscoring the need for public education and a unified registry to address gaps and better understand OHCA epidemiology in Bosnia and Herzegovina.
Knowledge, Attitudes, and Practices Regarding COVID-19 Vaccination Among Internally Displaced People in the Kurdistan Region of Iraq (KRG)
Authors: Abdulkhaliq Arian , Reiter Leopold , Zeglis Ioannis , Natour Wisam , Nassiri Ialda , Rahouande Ines
Published: November 2024

Background: Iraq has yet to establish and initiate any vaccination initiatives to address the ongoing COVID-19 outbreak and mitigate its spread and mortality. Objective: This study aimed to evaluate the existing knowledge, attitudes, and behaviors surrounding COVID-19 vaccination amid the third wave of the outbreak. Methods: This cross-sectional study utilized an anonymous online questionnaire, modeled after a study conducted in Bosnia and Herzegovina, to investigate COVID-19 vaccination attitudes and practices during the third wave of the outbreak in the country. Results: In total, 2744 subjects from 27 camp for Internally Displaced People (IDP camps) in the Kurdistan region of Iraq, mostly male 1642 (61.4%), either with no previous education 701 (26.2%) or with a primary school degree 973 (36.4%), married 1610 (60.2%) and since 2014 1540 (57.6%) stationaed in the IDP Camps were included in the study. Mean age of our sample was 35.2±12.9 ranging 18- 94 years. The mean knowledge test score for our sample was 6.9±3.7 with correct answer rates ranging 27.7-78.2%. Only 31 (1.2%) of subjects scored maximum points on the knowledge test score. In total 1170 (42.7%) subjects agreed that COVID-19 vaccination programs will prevail in a battle versus COVID-19, while 1592 (58.0%) agreed that everyone should be vaccinated against COVID-19. Regarding the vaccination rates, only 421 (15.3%) have already been vaccinated against COVID-19, while 1658 (62.7%) expressed interest to get vaccinated in the future. Conclusion: Our study sheds light on vaccination attitudes among IDP camps in the Kurdistan region of Iraq. Despite lower knowledge scores, willingness to vaccinate against COVID-19 is relatively high, likely due to limited access to vaccines, perceived risk of the disease, and trust in healthcare providers.
Health Professionals' Perception of the Importance of Teamwork and Factors Influencing Teamwork - a Quantitative Cross-sectional Study
Authors: Luckin Amina , Mizdrak Alma , Mujanovic Nedim , Kaknjasevic Benjamin , Gacanin Mirza , Tursum Mirza , Sahinovic Aldin
Published: November 2024

Background: Considering the highly sophisticated activities and the environment in which the work is carried out. It is extremely important to establish a well-organized and efficient team that will contribute to raising the quality of professional activity through its work, and in this way influence the greater satisfaction of patients and their families, but at the same time also reduce stress levels among health professionals. The efficiency of the work is primarily correlated with the exceptional communication of the members within the team. Objective: The aim of the study was to analyze the perception of health professionals about teamwork in relation to professional qualification, workplace, level of health care, length of service, weekly working hours. Methods: A quantitative cross-sectional study included health professionals from the territory of the Federation of Bosnia and Herzegovina. A sociodemographic questionnaire was used and the teamwork domain of the patient safety perception questionnaire (Safety Attitudes Questionnaire -SAQ). Results: The survey included 791 nurses employed in the public health sector at the primary, secondary and tertiary level of health care in the Federation of Bosnia and Herzegovina who are in direct contact or interaction with patients, with at least one year of work experience. Conclusion: Effective teams are characterized by specific knowledge, communication skills and the ability to solve problems. Good cooperation with colleagues, patients and their families, as well as all participants in the health care process, can help to accomplish the task and goal as well as possible and to achieve the desired and expected goal. The results show a positive correlation between the different examined groups, as well as great similarities in attitudes between different levels of health care.
Knowledge, attitudes, and practices regarding Rift Valley fever and West Nile fever among livestock owners and health professionals in selected districts of the Afar Region, Northeast Ethiopia
Authors: Megenas Jemberu , Dadi Mengistu , Mekonnen Tesfu , Larrick James , Kassa Gezahegne
Published: November 2024

Objectives: East Africa is a hotspot for newly emerging arboviral diseases. In nations with limited resources like Ethiopia, outbreaks of vector-borne diseases can overwhelm healthcare systems. This study aimed to evaluate the knowledge, attitudes, and practices of health professionals, and livestock owners in selected areas of the Afar region. A cross-sectional study was employed between June 2021 and April 2022, using questionnaires, key informant interviews, and focus group discussions as data collection tools.
Materials and Methods: A total of 150 (60 livestock owners, 40 animal health workers and para-veterinarians, and 50 public health professionals) participated in the study.
Results: Of the participants, 29.3% (44/150) perceived zoonotic diseases to be transmitted through the consumption of food of animal origin or mosquito bites. More than half (63.3%, 95/150) of the participants had any feeling of insecurity regarding infection by Rift Valley fever (RVF), West Nile fever, or other zoonotic diseases. Animal health workers had higher (27.3±10.9) mean scores of knowledge of RVF, West Nile fever, and another zoonotic disease than public health professionals and livestock farmers/owners at p < 0.01. A statistically significant difference in mean scores was also observed among the educational status groups: illiterate, primary education (grades 1–8), and secondary and above (grades 9+). The mean practice scores were higher in the Amibara district (16.9 ± 6.4) compared to the Haruka district, with a p-value of 0.000.
Conclusion: The present study found substantial knowledge gaps, a low level of risk concern, and high behavioral practices regarding zoonotic diseases. Community education and awareness programs need to be developed, and further investigations into the prevalence and risk factors for zoonosis in such settings should be conducted to identify intervention targets.
The Mosses of Barro Colorado Island
Authors: Salazar Allen Noris , Arrocha Clotilde , Gudiño L. José , Chung Clementina
Published: November 2024

Ninety-two species of mosses in 23 families are reported for Barro Colorado Island (BCI), Panama. Most species grow in the understory with some reaching the upper trunks and tree crowns. Mosses grow on the bark of trees, shrubs, and lianas as well as on palm roots, rocks, and less often soil. Most BCI moss species have creeping stems and branches, whereas some have upright stems and form tight or loose turfs and a few have a dendroid habit growing perpendicular to or pendent from trunks. A majority (56) of BCI species have Neotropical distribution, 14 have ranges that span the Americas and Africa, 19 are pantropical, 2 are cosmopolitan, and 1 is widely distributed in the Neotropics, Africa, and Europe. The BCI moss flora can be compared with inventories at five other lowland and mid-elevation forests in Panama: it shares 33–52 moss species with each of these sites.
Dinamics of the course of tuberculosis in patients with HIN/Tuberculosis co-infection in the background of the new coronavirus infection
Authors: Gololobova T. V. , Kondakova M. N. , Kovaleva R. G. , Elkin A. V.
Published: November 2024

In order to assess the dynamics of the course of tuberculosis in patients in the late stages HIV infection studied clinical, radiological and laboratory data of 36 patients, taking into account the presence or absence of COVID-19, divided into 2 groups. Tuberculosis in patients with HIV infection, in most cases is generalized character; patients are bacterial excretors with multidrug resistant pathogen. COVID-19 more than half of the patients (55.6%) proceed against the background of intoxication without pathognomonic symptoms; pronounced intoxication syndrome largely due to the severity of the tuberculosis process. Negative dynamics tuberculosis is 2.5 times more likely to occur against the background of COVID-19.
Spatial Analysis of Sustainable and Agricultural Development in Southern Brazil
Authors: Lisbinski Fernanda Cigainski , Freitas Felipe André Oliveira , Burnquist Heloisa Lee
Published: November 2024

This study aimed to develop and analyze a Sustainable and Agricultural Development Index (SADI) for the municipalities of the Southern Region of Brazil. The methodology employed included factor analysis through principal component analysis, followed by exploratory spatial data analysis (ESDA) to examine the spatial distribution of the index. The results indicate a generally medium-low level of sustainable agricultural development, with the highest index value being 0.5885 and most others falling below 0.5. The ESDA revealed strong evidence of significant positive spatial correlation among the municipalities, as well as considerable disparities in sustainable and agricultural development across the region. These disparities highlight the need for targeted public policies and coordinated initiatives to improve infrastructure, promote technological innovation, and implement sustainable agricultural practices, aiming for balanced and inclusive growth in the region.
VESTIR-SE DE SI, DESPIR-SE DO OUTRO
Authors: Silva Frederico de Lima , Rodrigues Hermano de França
Published: November 2024

A travestilidade, assim como a transexualidade, ainda se encontra, com predominância, situada nas ruelas sexuais da sociedade, vista não como manifestação própria e válida da sexualidade humana, e sim sob o manto da disforia higienista que ainda está aderida aos corpos desses sujeitos, resistindo, infelizmente, à prova do tempo. Em A grande atração, conto de Raimundo Magalhães Jr., considerada a primeira obra literária brasileira a trazer uma personagem transgênero como protagonista, vemos problematizados os dilemas da protagonista Luigi Bianchi, que, a despeito do nome masculino, performava para além dessa marcação biológica. Tomando como esteio teórico os subsídios oferecidos pela psicanálise, buscaremos apresentar algumas contribuições em torno da violência que precariza a vivência da sexualidade travesti, a qual perpassa o conto e notabiliza as trágicas implicações para a subjetividade da protagonista.
Highly Efficient Energy Integration: Thermodynamic Analysis of Heat Recovered from SOFC Through S-CO2 And Kalina Cycles
Authors: Elbir Ahmet
Published: November 2024

This study focuses on the implementation of a highly efficient energy integration using solid oxide fuel cell (SOFC) technology. A detailed thermodynamic analysis of the integration of heat energy obtained from SOFC into the Supercritical Carbon Dioxide (S-CO2) cycle and the Kalina cycle aims to assess its effectiveness, sustainability, and economic performance in energy systems. The study presents a thermodynamic analysis encompassing the integration of SOFC technology into an energy system, as well as the integration of the heat energy obtained into the S-CO2 cycle, Kalina cycle, and hot water production. The high energy efficiencies, low carbon emissions, and economic advantages individually achieved by SOFC, S-CO2 cycle, and Kalina cycle are significantly enhanced when integrated into a cohesive system. The integrated system analysis results show an energy efficiency of 89.1%, an exergy efficiency of 64.6%, and an exergetic sustainability index of 0.83, demonstrating that this integration provides an energy solution with high efficiency, sustainability, and a low carbon footprint. Thermodynamic analyses were performed using the EES (Engineering Equation Solver) software. The main contribution of this study is the introduction of innovative approaches to energy efficiency and exergy analysis. The system achieves high energy efficiency through the integration of SOFC and the Kalina cycle. Particularly, optimizing the thermal management of the SOFC and utilizing the ammonia-water mixture more efficiently in the Kalina cycle brings significant improvements in the system's energy and exergy efficiency. These analyses demonstrate higher efficiency and sustainability compared to existing systems, emphasizing the originality of this approach.
Menselijke maat en maatwerk in toezicht en handhaving?
Authors: Raaphorst Nadine
Published: November 2024

Customisation in regulation and enforcement: Navigating professional conduct amidst political and social pressure

In Dutch public policy, attention to customisation and the human factor in public service delivery has increased. Existing research on this topic focuses mainly on service-producing tasks. Little is yet known about how civil servants with a regulatory core task implement customisation and the human factor. By means of semi-structured interviews, I investigated how tax inspectors and managers of the tax administration, small and medium-sized enterprises (SMEs), give meaning to these policy notions. In this study, customisation and the human factor appear as characteristics of professional conduct and as politically driven concepts that come with societal expectations. Tax inspectors consider circumstances of taxpayers in the context of increasing their compliance, and they offer them more space in the process to cater to individual circumstances. The human factor has come on top of this as a political concept, without further definition. Tax inspectors struggle with the question to what extent they can take into account individual circumstances, especially when it comes to breaking laws and rules. Tax inspectors have different views on this. In concert with this, tax inspectors also experience increased pressure from taxpayers.
Spanningen in street-level leiderschap
Authors: Visser E. Lianne , van Gelder Jason
Published: November 2024

Tensions in street-level leadership: How managers navigate customisation and accountability

The government seeks to restore public trust by prioritising customised services and a citizen-centred approach in its public service delivery. While frontline workers are granted greater discretionary authority, they face dilemmas in justifying tailor-made decisions that sometimes deviate from formal rules. This study, based on twelve interviews with managers and frontline workers at the Dutch Employee Insurance Agency (UWV), examines the critical role of frontline managers in balancing customisation with accountability. Managers encourage collective discretion, critically examine decisions, and justify them to higher management. These practices ensure that customisation and accountability are not viewed as conflicting but as mutually reinforcing. Theoretically, this paper adds an accountability perspective to the literature on managing frontline workers. Practically, it highlights the importance of actively fostering learning communities and promoting reflection within teams. This enables managers to not only support customised service delivery but also reshape the relationship between management and the frontline.
Signaleren, handelen, leren
Authors: Kuiper Marlot , Schiffelers Marie-Jeanne , Noordegraaf Mirko
Published: November 2024

Detect, act, learn: How municipalities can identify and tackle pressing situations in policy implementation

The relationship between policy and implementation is under heightened scrutiny due to various issues within Dutch executive organisations, such as the Tax Administration/Benefits and the Employee Insurance Agency (UWV). Recent reports have highlighted the Dutch national government as a significant cause of ‘unprecedented injustice,’ yet local governments struggle to support their constituents effectively. Municipalities for instance have witnessed citizens being disadvantaged by governmental policies and actions, and consequently seeking debt assistance or applying for benefits. This article explores how municipalities identify the signs of these problematic situations, organise responses to these situations, and learn from these experiences. We argue that effective public services revolve around the ability to detect signs, organise responses to them, and systematically learn from them. We provide empirical examples of how this occurs in three Dutch municipalities and discuss the conditions that promote or hinder effective service delivery at the frontline. We conclude with recommendations for both practice and research.
Arrangeren van kennis voor de regio
Authors: van den Berg Arlette , Kunseler Eva , Evenhuis Emil , Verwest Femke
Published: November 2024

Designing knowledge arrangements for multi-level policy issues: An explorative study at PBL Netherlands Environmental Assessment Agency

Notwithstanding a rising demand for strategic knowledge in the environmental domain at the regional level in the Netherlands, its production is mainly organised at the Dutch national level. Various parties have called for the establishment of regional knowledge institutions. Experiences of PBL Netherlands Environmental Assessment Agency however show that focusing on implementing these institutional fixes fails to recognise the multi-level character of the policy context in which the demand for strategic knowledge arises. Based on three PBL projects, this article shows how knowledge production arrangements are designed in continuous interaction between knowledge demand, method and positioning of PBL. This leads to a variety of outcomes. This article concludes with a typology of multi-level knowledge production arrangements, based on these experiences. The typology is intended to advance the debate on the organisation of such arrangements within a multi-level policy context in a reflexive and problem-specific way.
Inleiding bij het themanummer ‘Democratische innovatie en burgerparticipatie’
Authors: Verschuere Bram , Hendriks Frank , Meijer Albert
Published: November 2024

Introduction to the special issue ‘Democratic innovation and citizen participation’

To say that democracy is under pressure is like kicking in a door that is wide open. Many (local) governments are therefore working to innovate that democracy. A frequently used way to escape the democratic malaise is to give citizens more direct input into government and policy. In practice, citizen participation comes in many different forms, from referendums and citizen surveys to citizen panels and consultation meetings, to citizen budgets and experiments with co-creation in which citizens and government join forces to develop and deliver public services. The many experiments with citizen participation have not escaped the attention of researchers in Public Administration and Political Science: there is a growing range of insights into this form of democratic innovation. In this special issue the guest editors, Albert Meijer, Frank Hendriks & Bram Verschuere, present the state-of-the-art contributions of Dutch and Flemish researchers from various universities.
Lessen uit internationaal onderzoek naar de invloed van democratische innovaties
Authors: Michels Ank
Published: November 2024

Lessons from international research on the impact of democratic innovations

Democratic innovations aim to give citizens more say in policy and political decisions. But what is the influence of democratic innovations on policy, citizens, politicians and democratic legitimacy? This article presents international research into the influence of various forms of democratic innovations. It shows that this influence is often limited. Expectations are often high, especially when it comes to the influence on policy. But the results of democratic innovations rarely lead to substantial changes in policy. In a critical reflection on the research findings, the article then discusses some theoretical and methodological challenges in research into the influence of democratic innovations; the risk of manipulation and instrumentalisation of democratic innovations; and the problem of selective policy influence. The contribution concludes with a number of lessons for practice.
De Participatieve Waarde Evaluatie: ervaringen met een nieuwe vorm van grootschalige burgerparticipatie
Authors: Mouter Niek , Beumer Mark
Published: November 2024

The Participatory Value Evaluation: experiences with a new form of large-scale citizen participation

The Participatory Value Evaluation (the Dutch abbreviation is PWE for ‘Participatieve Waarde Evaluatie’) is a democratic innovation that has been applied more than 80 times in the Netherlands. The essence of a PWE is that residents take the place of a policymaker and give advice on policy dilemmas. This article determines the distinguishing elements of a PWE by comparing PWE with other methods such as the referendum and the citizens’ council. In addition, this article describes experiences with the PWE of policymakers and participants in nine cases. Policymakers appreciate that the PWEs provide concrete, usable insights. Because participants in the PWE experience the same dilemma as policymakers, their advice can be translated into policy more easily. Policymakers appreciate that a large and representative group participates in the PWE. This also includes constituents that they normally do not see at offline participation moments such as residents’ evenings. For example, people with a nuanced opinion (‘the silent middle’). Policymakers consider PWE to be an efficient citizen participation method and appreciate the focus that the design process of a PWE provides. Participants are generally very positive about their participation in the PWE. However, there is a group of participants who have a greater need to provide advice outside the policy options offered.
Gluren bij de buren: hoe waarderen Nederlandse en Vlaamse gemeenteraadsleden diverse vormen van burgerparticipatie?
Authors: Goutry Willem , De Smedt Nina , Wagenaar Charlotte
Published: November 2024

Spying on the neighbours: how do Dutch and Flemish municipal councillors value various forms of citizen participation

In the Netherlands and Flanders (Belgium), the municipal council plays an important role in promoting various forms of citizen participation. It is therefore important to know how council members view different forms of participation. In this contribution, we mainly focus on two forms. On the one hand, we will look at deliberative forms, such as citizen panels and citizen summits, in which citizens discuss a specific theme and ultimately provide advice. On the other hand, we study aggregative forms, such as referendums, in which citizens can individually make their voices heard on a policy proposal through a vote. Both forms have the potential to strengthen democratic processes and increase citizen involvement, but the way in which they are deployed and followed up depends on political support. Our findings show that council members in the Netherlands and Flanders seem to have more support for deliberative forms of participation than for aggregative forms. This support translates into various advantages and disadvantages that municipal council members identify for both forms and which we link to democratic values: inclusion, citizenship, influence on policy, deliberation and legitimacy.
Strategi Inovasi Marketing Lembaga Pendidikan Islam Menghadapi Revolusi Industri 5.0 dengan Menggunakan SWOT Analysis (Studi Kasus KB-TK-SD IT AL Mubarokah, Rancaekek, Bandung)
Authors: Fauziah Isma , Djatmiko Budi
Published: November 2024

The research employs a qualitative method with a descriptive approach, analyzing data inductively without hypotheses. Data were obtained through in-depth observations of marketing strategies, and analysis was conducted to illustrate how these strategies can be improved. The findings suggest that to maintain and enhance quality, KB-TK-SD IT Al-Mubarokah needs to strengthen its marketing strategies and adapt to digital transformation and societal needs. KB-TK-SD IT Al-Mubarokah, a privately accredited primary school located in Bandung, West Java, uses SWOT analysis to evaluate its marketing strategies. The analysis reveals that the school’s key strengths lie in product quality and optimal digital marketing, while weaknesses include inconsistent digital services and conventional sales methods. Opportunities for growth involve leveraging digital technology and e-commerce platforms, while threats include intense competition and the need for effective communication. The proposed strategies involve leveraging strengths to exploit opportunities, addressing weaknesses through digitalization, and optimizing responses to competitive threats. By implementing these strategies, KB-TK-SD IT Al-Mubarokah aims to strengthen its competitive position and attract more students.
Understanding Education for Sustainable Development: Prospective Teachers' Perspectives, Pedagogical Approaches, and Implementation Challenges
Authors: Jamil Muhammad , Kamran Farrukh , Taj Saira
Published: November 2024

The present qualitative phenomenological study focuses on exploring the prospective teachers' perspectives and strategies regarding Educational for Sustainable Development (ESD) in a district of Punjab. In the present study, six prospective teachers teaching in private educational institutions were selected purposively. Self-developed semi-structured interviews were used to obtain data, which was analyzed employing thematic analysis, supported by NVivo 15, to detect patterns and themes from the data. The findings revealed five key thematic areas: understanding of sustainability, important aspects/topics in ESD, essential skills for students, implementation strategies, challenges, and solutions. Moreover, the educators demonstrated a comprehensive insight into sustainability, focusing on resource preservation, intergenerational obligation, and systems thinking. The study identified active learning methodologies, project-based approaches, and real-world integration as preferred pedagogical strategies. However, the participants faced different challenges, like conceptual complexity, resource constraints, and student engagement issues. The current study highlights the need for structured support systems, enhanced professional development, and institutional backing for effective ESD implementation.
YEREL SEÇİMDE SEÇMEN DAVRANIŞLARINI ETKİLEYEN FAKTÖRLER: “ŞEHİTKAMİL ÖRNEĞİ”
Authors: Omuş Sevil
Published: November 2024

Siyasal davranış sürecinde siyasal katılımın gerçekleşmesi bakımından seçmen davranışlarının etkisi büyüktür. Bu bağlamda, seçmen davranışlarının siyasal katılım sürecini doğrudan ya da dolaylı olarak etkilemesi üzerine sosyolojik, psikolojik, rasyonel tercih, sezgisel oy verme ve siyasal pazarlama modelleri üzerinden incelenmektedir. Siyasal karar sürecindeki seçmen tercihlerinin belirlenmesinde coğrafik yerleşim, protesto oyu, etnik ve din temelli oy verme, parti bağlılığı, geçmişe yönelik oy verme, eğitim, aday, kişisel tutum ve değerler, ekonomik faktörlerin etkisi Şehitkamil örneği üzerinden yerel seçim öncesi anket araştırması sonuçlarına göre incelenecektir. Bu çalışmanın temel amacı, aslında bir seçim sonrası seçmen davranışlarını değerlendirmekten ziyade henüz seçim gelmemiş seçim öncesi seçmen davranışlarını analiz etmeye yöneliktir.
Analysis of key factors for better results during continuous improvement events within engineering environment
Authors: Fiebig Grazielle de Oliveira Netto , Correia Anderson Ribeiro , Schreiner Fernando
Published: November 2024

There are few in-depth studies in the Management literature related to the development of activities implemented during the Kaizen week. This work contains a theoretical basis related to the engineering and product development environments as well as to the Kaizen tool and the Lean tool, which seek to reduce waste and implement continuous improvement. Through a case study in an aviation transportation industry, some Kaizens are analyzed in the engineering environment. With the analysis of data collected in Kaizen Weeks, a dissertative study uses three sources of data collection, between them, structured interview, and demonstrates the theory presented, proving the existence of impacting factors that influence the Kaizen week. Using percentages and multivariate analysis, it highlights the factors that have the biggest impact and the necessary attention to be given to them.