bluuebunny/crossref_metadata_2025 huggingface dataset:
Pengaruh Tax Retention Rate, Deferred Tax, Deferred Tax Assets, Dan Return On Assets Terhadap Earning Management
Authors: Rochaendi Dinny Nuari Nurlita , Ginting Wajib
Published: January 2022

Earning Management is an action usually taken by managers to increase or decrease company profits in the current period following the goals and needs of the company. This study aims to examine the Tax Retention Rate, Deferred Tax, Deferred Tax Assets, and Return on Assets on Earning Management in Trade, Service, and Investment Sector companies listed on the Indonesia Stock Exchange for 2011-2018. The data used is secondary data. This research method is quantitative with a descriptive and verification approach. The population of this research is trading, service, and investment companies as many as 164 companies. The number of samples in this study was 11 companies which were determined using the nonprobability sampling method with purposive sampling technique; data collection was carried out through documentation and literature study. This study was tested using classical assumptions, multiple linear regression analysis, Pearson correlation coefficient test, coefficient of determination test, and hypothesis testing using a partial test (t-test) and simultaneous test (f test). Based on the research results on the t-test, the results obtained that the Tax Retention Rate has a significant negative effect on Earning Management where tcount is -4.945, greater than t-table is -1.992. Deferred Tax has no effect on Earning Management where the count of 0.732 is more minor than the t-table of 1.992. Deferred Tax Assets have no effect on Earning Management where a count of 0.261 is more minor than the t-table of -1.992. Return on Assets has no effect on Earning Management where a count of 1.238 is more significant than t-table of 1.992. Based on the research results on the f test, the results show that the Tax Retention Rate, Deferred Tax, Deferred Tax Assets, and Return on Assets simultaneously (together) affect Earning Management where the count value of 6.470 is more significant than the f-table of 2.46. The coefficient of determination concludes that the Tax Retention Rate, Deferred Tax, Deferred Tax, Deferred Tax Assets, and Return on Assets affect Earning Management by 23.8%. While the remaining 76.2% were influenced by other factors outside this research, such as good governance, free cash flow, leverage, and company size.
Menguji Loyalitas Umat terhadap Fatwa: Studi Kasus Persepsi Masyarakat Muslim Ponorogo terhadap Fatwa Haram Bunga Bank
Authors:   Institut Agama Islam Negeri Ponorogo, Rofiah Khusniati , Achmad Bashori Yudhi , Hasan Wahid Soleh
Published: January 2022

Buku ini mencoba untuk mengungkap kembali catatan penting dalam sejarah perbankan Indonesia pada akhir tahun 2003, yaitu dikeluarkannya fatwa Majelis Ulama Indonesia (MUI) tentang status bunga bank. Berdasarkan hasil Rakernas MUI tangga 14-16 Desember 2003, Komisi Fatwa MUI menerbitkan fatwa bahwa bunga bank adalah riba (haram) yang kemudian disahkan tanggal 22 Desember 2003. Diterbitkannya fatwa bahwa bunga bank adalah riba nasi’ah yang diharamkan oleh MUI menjadi salah satu pendorong pelaksanaan perbankan syariah di Indonesia. Kini, setelah kurang lebih 15 tahun dari dikeluarkannya fatwa MUI tersebut, ternyata fakta di lapangan masih banyak umat muslim yang masih berhubungan dengan lembaga riba tersebut. Dari fakta di atas dapat disimpulkan, bahwa pasca keluarnya fatwa MUI pada tahun 2003 tentang haramnya bunga bank kurang membawa dampak yang signifikan terhadap perkembangan perbankan syariah di Indonesia. Hal ini juga menggambarkan bahwa adanya fatwa tersebut tidak berpengaruh kepada masyarakat muslim khususnya, untuk berhijrah dari bank berbasis riba ke bank syariah. Penduduk Indonesia dengan mayoritas muslim, dengan adanya fatwa tersebut seharusnya mampu berperan banyak dan dapat dijadikan pegangan umat dalam memecahkan persoalan-persoalan yang terjadi yang berkaitan dengan muamalah maupun ibadah.  Berdasarkan kasus tersebut, tulisan dalam buku ini berupaya mengungkapkan bagaimana persepsi umat Islam Ponorogo terhadap fatwa bunga bank yang diterbitkan MUI. Selain persepsi, peneliti juga berupaya mengungkapkan bagaiamana loyalitas umat Islam Ponorogo dalam mengimplementasikan fatwa tersebut dalam kehidupan bermuamalah.
De Genova, Nicholas y Tazzioli, Martina (eds.) (2021). Europa / crisis. Nuevas palabras clave en la ‘crisis’ en y de ‘Europa’
Authors: Ferrer Gallardo Xavier
Published: January 2022

De Genova, Nicholas y Tazzioli, Martina (eds.) (2021)Europa / crisis. Nuevas palabras clave en la ‘crisis’ en y de ‘Europa’Madrid: Catarata, 126 p.ISBN 978-84-1352-155-8
Perspectivas y luchas antirracistas en el Movimiento Loco y los Estudios Locos: una revisión
Authors: Guzmán Martínez Grecia
Published: January 2022

El objetivo de este estudio es describir, a partir de una revisión bibliográfica, tres líneas temáticas desde perspectivas descoloniales sobre algunos debates entre el movimiento loco y los movimientos antirracistas. La primera línea aborda de manera crítica la reproducción del racismo en la definición histórica y hegemónica de la “salud mental” y la “enfermedad mental”. La segunda línea analiza la invisibilización de lógicas racistas y colonial/modernas dentro del propio movimiento loco, en los procesos de construcción de identidades y sujetos de referencia. La tercera presenta debates sobre el uso del término “descolonización” dentro del mismo movimiento. La conclusión del análisis es que, debido a la distancia histórica que ha marcado la articulación entre ambos movimientos, es necesario repensar las posibilidades, identidades y marcos teóricos de resistencias comunes.
Elecciones al Parlamento Europeo y discapacidad
Authors: Muñoz Ruiz Concepció
Published: January 2022

Este comentario analiza, en primer lugar, dos documentos del Comité Económico y Social Europeo (CESE) que plantean la necesidad de buscar soluciones que garanticen el derecho real de voto en las elecciones al Parlamento Europeo de las personas con discapacidades. En segundo lugar, se analiza una iniciativa legislativa del Parlamento Europeo sobre la reforma electoral. Se trata de un documento posterior al del CESE, que tiene muy en cuenta sus propuestas.
El problema del derecho al voto de las personas con discapacidades es poco conocido, pero de gran relevancia, puesto que afecta a derechos fundamentales de un número importante de ciudadanos europeos, que va en aumento, ya que, como reflejan los textos analizados, también se han de tener en cuenta las discapacidades relacionadas con el envejecimiento y las hospitalizaciones.
Future research guidelines on soft power: an oblique approach of the literature on the intertwinement between creative industries and place branding
Authors: De Campos Rodolfo Paião , Galina Simone Vasconcelos Ribeiro , Giraldi Janaina De Moura Engracia
Published: January 2022

Objetivo: O objetivo deste artigo é apresentar diretrizes interdisciplinares para pesquisas futuras sobre soft power, analisando seu entrelaçamento com indústrias criativas e place branding.Metodologia: Trata-se de uma revisão sistemática da literatura utilizando o Methodi Ordinatio na base de dados Scopus. Os artigos são classificados de acordo com sua relevância e revisados por meio de técnicas de análise de conteúdo e abordagem oblíqua.Principais resultados: Embora vários autores não façam uso do termo soft power em si, a maioria deles faz alusões oblíquas ao seu conceito, de onde tiramos inferências para pesquisas futuras.Contribuições: Por meio do Methodi Ordinatio, identificamos os artigos mais relevantes sobre o objeto de estudo. Analisando-os, nossa principal contribuição é um conjunto de diretrizes para futuras pesquisas sobre soft power em seis áreas: Psicossociologia, Mobilidade Laboral, Planejamento Urbano, Diplomacia Artística, Gastrodiplomacia e Indicações Geográficas.Relevância e originalidade: até onde sabemos, o triângulo das indústrias criativas, place branding e soft power foi estudado apenas de forma delimitada, e este parece ser o primeiro artigo a vinculá-lo às áreas mencionadas.Implicações gerenciais e sociais: Este triângulo não apenas contém desafios teóricos inexplorados, mas também apresenta áreas pouco observadas por profissionais e formuladores de políticas, o que pode provocar mais clareza para o planejamento da imagem de cidades, regiões e países. Não obstante a necessidade de mais estudos, as áreas que envolvem artes e gastronomia parecem ser iniciativas viáveis a curto prazo, enquanto as demais podem ser mais demoradas e custosas.
Museu corporativo como ativo cultural estratégico para fortalecer a marca Brasil
Authors: Do Monte Ana Luiza Almeida , Pompeu Randal Martins , Holanda Marcus Mauricius
Published: January 2022

Objetivo: Estender o conhecimento existente sobre museus corporativos como importantes ativos culturais na promoção da marca de lugar.Método: Qualitativo, com abordagem exploratória e aplicação de técnicas de análise temática.Originalidade: Desperta a atenção para o fato de que o museu corporativo não pertence somente à empresa, mas também à cidade, região e país onde está localizado, podendo atrair turistas e investidores, além de alimentar o orgulho de pertencer nos residentes.Resultados: Panorama da localização dos museus corporativos brasileiros, incluindo as principais características e similaridades com os centros de memória. Proposições para futuras pesquisas.Contribuição teórica: Apresenta modelo teórico explicativo de como o lugar pode utilizar o museu corporativo para impulsionar sua marca e como este pode garantir a sua longevidade.
Estimating stakeholder-based place brand equity: one place, multiple perspectives
Authors: Gelain da Cunha Sofia , Bins Luce Fernando , Rovedder de Oliveira Marta Olivia
Published: January 2022

Objetivo: O objetivo desse estudo é desenvolver e testar uma medida de valor de marca de lugar baseada na perspectiva de múltiplos stakeholders.Metodologia/Abordagem: O valor de marca de lugar baseado no stakeholder é estimado por meio de CB-SEM, usando MANOVA para comparar as diferenças e similaridades entre aqueles que têm diferentes interesses e comportamentos em relação ao lugar. Os resultados são baseados em pesquisa conduzida com stakeholders do Vale dos Vinhedos, região vinícola do sul do Brasil.Resultados: A lealdade teve o maior efeito no valor da marca, seguida pelo valor percebido e pela consciência de marca, a qual apresentou um efeito negativo. Os grupos de stakeholders foram distinguidos baseados em interesse e comportamento (frequência de visita e proximidade). Houve diferenças significativas em todas as dimensões do valor da marca quando comparado o grupo com alta frequência de visita em relação àqueles com baixa frequência. Por outro lado, houve limitações na diferenciação do valor da marca nas outras duas abordagens de agrupamento.Contribuições teóricas / metodológicas: Há uma predominância, na literatura especializada, do uso de critérios subjetivos para agrupar stakeholders, o que limita a realização de estudos comparativos entre diferentes grupos e lugares. Esta limitação é endereçada com o desenvolvimento de uma medida que considera comportamento para formar grupos independentes de stakeholders: comunidade, locais e turistas.Relevância / originalidade: Os resultados embasam a proposição de uma medida para avaliar a perspectiva de múltiplos stakeholders sobre o valor de marca de lugar baseado em dados comportamentais.
Models of alienation in education: selected views and educational recommendations
Authors: Tomaszek Katarzyna
Published: January 2022

The problem of alienation in education is an issue that has been rarely analysed in Poland so far. However, experiencing alienation is related not only to poor indicators of functioning as a pupil/student (i.e., poor school achievements, lack of sense of learning, disengagement in the implementation of the curriculum or educational burnout), but also to a high risk of development disorders, marginalization, and disconnection from the community in the individual's adult life. The aim of the article is to characterize selected theoretical models of alienation in education, which present this phenomenon from various perspectives, including alienation as a specific state of an individual (model by Bradford Barnhardt and Paul Ginns), alienation as an attitude towards school (model by Ella R. Kahu), alienation as a process of losing involvement in educational activities (model by Stephen J. Fyson), alienation in the social and ecological (systemic) approach, which indicates multidimensional and multilevel nature of this phenomenon (Jennifer M. Case and Juanita Bezuidenhout et al.) and in the holistic approach (SAL model by Tina Hascher and Andreas Hadjar). The theoretical analyses carried out in the article are based on a review of Polish and foreign literature. The characterized perspectives of alienation in education allow for a precise determination of activities aimed at minimizing this phenomenon in the school and academic environment.
Online studies and motherhood: possibility or limitation of development opportunities? Analysis of biographies of female students
Authors: Zaworska-Nikoniuk Dorota
Published: January 2022

The aim of this article is to show how young women studying remotely during the first wave of the COVID-19 pandemic combine the roles of mother, student and often also a professional worker. In the study I used the research scheme proposed by K. Konarzewski, distinguishing the method of selecting a research sample (targeted selection), data collection (individual qualitative interview) and data analysis (here: content analysis). I used the biographical approach in the interpretation of D. Jemielniak (2012) using a thematic biography the narrative of which oscillated around the experience of combining the social roles of mother and student. Fourteen full-time and part-time students of first, second and third cycle studies participated in the research. The difference between them was the number of children and their age. The qualitative nature of the conducted research does not allow for generalization of the conclusions. In the case of my interlocutors, it turned out that in a pandemic situation online education relieved the family budget, while often overburdening women. Nevertheless, it was often perceived as beneficial by mothers of infants and young children, who perceived the time spent at university as taken from their children. Mothers of children in preschool and school age (especially raising a few children) preferred stationary education at the university, because the need to simultaneously exercise the care and educational function and participate in classes distracted them. They needed time away from their family, treating it as time for themselves, to pursue their own professional aspirations and social interactions. An important conclusion from the research is the postulate for the creation of online studies at universities, facilitating the improvement of professional qualifications and the implementation of educational aspirations of young women, pregnant or raising young children, as well as the creation of a support system for young parents choosing full-time studies (e.g., in the form of care and educational points at universities).
Carbon monoxide concentrations and carboxyhemoglobin profiles from commercially available portable generators equipped with a CO hazard mitigation system
Authors: Zimmerman Stephen M , Emmerich Steven J , Brookman Matthew J
Published: January 2022

The U.S. Consumer Product Safety Commission (CPSC) is focused on addressing the hazard of acute carbon monoxide (CO) poisoning of consumers from portable generators that can result in serious, long term health effects or death in exposed individuals. Under an interagency agreement with CPSC (CPSC-I-17-0023), the National Institute of Standards and Technology (NIST) conducted a series of tests on four commercially available portable generators advertised as certified to one of two voluntary standards requiring CO hazard mitigation systems for portable generators. These tests characterized the indoor CO concentrations and the associated calculated carboxyhemoglobin (COHb) profiles on simulated occupants when the generators were operated in or near a test house under various operational and environmental conditions. This report presents the measured CO data and calculated COHb levels from those tests. In addition, model validation tests and simulations were performed for 2 Cases (3 tests each) to supplement those already reported in NIST Technical Note 2049.
Virtus Coronata Ex Augustissima Et Serenissima Domo Austriaca et Hispana . El retato ecuestre como símbolo de la Casa de Austria
Authors: Polleross Friedrich
Published: January 2022

Desde que fuera proclamado “Emperador Romano” en Trento en 1508, Maximiliano I venía trayéndose la idea de una estatua ecuestre que tomara como modelo la de Marco Aurelio sobre el Capitolio de Roma. El monumento, diseñado por Hans Burgkmaier “El Viejo”, según la apreciación del humanista Konrad Peutinger, combinaba la antigua representación de la Gloria, con la función de representar al donante y a la memoriae cristiana . El epitaphium fue levantado en un coro que financió Maximiliano para la Basílica de San Ulrico y Santa Afra en Augsburgo. La ejecución se le confió a Gregor Erhart, aunque el monumento quedaría inconcluso . Al habsburgo no solamente se le señala en la inscripción como “Imperator Caesar”, sino que además se le representa tanto con la corona imperial como con el orbe, lo que hace referencia al monumento imperial romano. Por otra parte, la espada en alto hace alusión a la porfía de Maximiliano como Protector de la Cristiandad.
Investigating an Online Course for Player Psychosocial Development in Elite Sport (Professional Football)
Authors: Richardson Lee , Lugo Ricardo , Firth Andrea
Published: January 2022

The scope of this study was to examine the perceived effectiveness of an online course based on an applied psychological model (The Four Pillars ©). The course was developed for the Professional Footballers’ Association (PFA) for young professional players, to assist in the process of transition into the professional game and to promote psychosocial development. We investigated how an online course might assist in the process of professional and psychosocial development by providing contextually relevant and evidence-based sport psychological concepts and principles that are relevant for maintaining a career in elite sport (football) and transitioning into the professional game. A total of n=219 16-18-year-old professional players and n=18 club staff members completed the eight modules of the online course. A post-course online survey was completed by both sets of participants and data was collected online. Both qualitative and quantitative data was collected. Qualitative data was based on thematic analysis of experiences given by the participants while quantitative data explored associations and differences between coaches and players. Findings indicate that both coaches and players found the online course beneficial in raising awareness of the demands that elite professional football can place upon mental health, and providing the potential to develop psychological literacy around relevant psychological coping and performance skills that may promote improved performance and provide a protective mechanism for mental health. Future studies should focus on the real-world efficacy of the online course in the development of psychological skills and the protection of mental health.
Keywords: Psychological literacy, Psycho-social development, Professional football, Elite sport, Academy, Mental health
Depressive Symptoms in Danish Elite Athletes Using the Major Depressive Inventory (MDI) and the Center for Epidemiological Studies Depression Scale (CES-D)
Authors: Kuettel Andreas , Melin Anna , Larsen Carsten H , Lichtenstein Mia Beck
Published: January 2022

Background: The prevalence of depressive symptoms among athletes is an ongoing debate in the scientific literature.

Aims: The aim of the current study was to assess the prevalence of depressive symptoms in Danish elite athletes and to evaluate the psychometric properties of the Major Depressive Inventory (MDI) and the Center for Epidemiological Studies Depression Scale (CES-D) in athletes.

Methods: The total sample comprised 996 athletes from two cross-sectional studies using the MDI (n = 409) and the CES-D (n = 587).

Results: Using the original cut-off points, the MDI found 8.6% and the CES-D found 22.0% at risk of depression. Using alternative cut-off points recommended in the literature, both instruments detected 10-11% of athletes at risk of depression. No statistically significant differences were found related to age, injury, and type of sport between high risk and low risk groups, whereas female gender was identified as a risk factor for higher depressive symptoms. Principal component analyses confirmed a single factor structure in both instruments with sufficient item loadings on the first component and Cronbach α values of .89 and .88.

Discussion: We recommend regular screening of depressive symptoms in elite athletes, with MDI and CES-D as reliable instrument for that purpose.
BØN
Authors: Henkel Heiko , Bandak Andreas
Published: January 2022

Forord
NÄRMRE ALLAH
Authors: Stjernholm Simon
Published: January 2022

I antropologiska studier av islamisk bön har den vädjande, åkallande och relativt informella duʿa-bönen ägnats markant mindre uppmärksamhet än salat och dhikr. Denna artikel bidrar till studiet av muslimsk fromhet genom en analys av hur ideal och praktik rörande privat duʿa kan konstituera ett annorlunda bedjande subjekt jämfört med de ideal och praktiker som kopplas till salat. Artikeln analyserar två föreläsningar av danska muslimska predikanter som bägge fokuserar på att instruera sina lyssnare i att utföra duʿa. Dessa predikanter strävar efter att artikulera islam i överensstämmelse med deras – ofta unga – danska muslimska publiks behov, uppfattningar och kunskapsnivåer. Föreläsningarna framfördes ursprungligen i en sunnitisk respektive en shiʿitisk moské och har därefter distribuerats online. Samtidigt som de två föreläsningarna skiljer sig åt beträffande deras referenser till traditionella auktoritativa källor uppvisar de också likheter. Båda framhäver den processuella effekten av duʿa på den bedjande snarare än dess potentiella materiella resultat, uppmanar sin publik att utföra duʿa i avskildhet för att utveckla en uppriktig intimitet med Gud, och uppmuntrar till att integrera duʿa i vardagslivet för att öka ens tillit till och närhet till Gud. Artikeln visar att danska muslimer instrueras i duʿa-praktiker som passar väl in i en religiös kultur präglad av protestantism. Därutöver indikerar artikeln möjliga frågeställningar för framtida forskning om muslimsk fromhet med fokus på faktiskt utförande av duʿa samt de betydelser som bönen tillskrivs av muslimer i både Danmark och andra jämförbara kontexter.

Søgeord: islam, Danmark, predikan, bön, duʿa, innerlighet
ENQUETE: BØN SOM VINDUE
Authors: Marie Sidsel
Published: January 2022

Enquete
REDAKTIONEN HAR MODTAGET
Authors: Tidsskriftet Antropologi
Published: January 2022

Redaktionen har modtaget
”I imagine that they will probably ask about my lifestyle”
Authors: Braae Sofie , H. Merrild Camilla
Published: January 2022

Encouraged by recent calls for more locally based public health policy and interventions (Blue, Shove, Carmona & Kelly, 2016), the aim of this ar- ticle is to explore some of the factors that influence why so many ‘at risk’ people do not participate in preventive health checks. We do this by focusing on what health promotion and illness prevention means in the lives of people who are sometimes considered hard to reach with health promotion initiatives. The study is based on a concrete targeted preventive health check intervention, offered to residents in selected neighborhoods characterized by high levels of unemployment and low levels of income (Larsen, Sandbæk, Thomsen & Bjerregaard, 2018), with the speci- fic aim of reducing social differences in health and illness.
Qualitative exploration of dental and health care personnel’s awareness of signs displayed in victims of torture with focus on the oral cavity
Authors: Willix Karolina , Ekman Evelina , Klefbom Carin , Karlsson Lena
Published: January 2022

Abstract

Introduction Numerous torture victims have experienced severe physical or phycological trauma to their face, mouth, and teeth. A dental visit carries a risk for torture survivors to relive the trauma, since the situation may trigger a recollection of previous suffering. Although health care personnel at resource center for torture victims are equipped with various tools to help and assist these individuals in their rehabilitation, very few centers have protocols in place to refer out victims to dental professionals with experience and knowledge in the area. The aim of this study was to investigate the extent of dental and health care personnel’s knowledge and awareness to detect various torture signs with focus on the oral cavity. 

Material and Methods Dental (n=16) and health care (n=6) personnel conducted individual interviews, group interviews, and qualitative data from a questionnaire. All interviews were transcribed, and a phenomenological-hermeneutical method was used to analyze the participants' answers.

Results Six health care and 16 dental personnel answered the questionnaire, and 5 health care and 16 dental personnel participated in the interviews. Dental personnel demonstrated a lack of knowledge and experiences regarding signs of torture with focus on the oral cavity, nor a multidisciplinary collaboration on torture victims. Most of the health care personnel had clear suggestions for external signs of torture and showed good knowledge of how to refer a torture victim to dental personnel.

Discussion Through a multidisciplinary approach, potential harmful long-term effects resulting from dental care visits can be prevented and the approach can additionally contribute to better resource utilization in health care. There is a need for increased awareness and knowledge of injuries and signs resulting from torture in the oral cavity among dental and health care personnel.
Nursing students’ perceptions regarding feedback from their educators in a selected higher education institution in KwaZulu-Natal province, South Africa
Authors:   Department of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa, Rathobei L M , Dube M B
Published: January 2022

Background. There is global awareness of investment in higher education to ensure quality learning. Provision of quality feedback is perceived as a key benchmark of effective learning and a vital requirement in meeting students’ expectations. Nevertheless, increased students’ demands and expectations regarding quality feedback compete with increased pressure on academic resources, which may result in student dissatisfaction. Despite the high priority that higher education institutions (HEIs) place on quality of feedback, insufficient research studies have been conducted of student nurses’ perceptions of such feedback. Objectives. To describe nursing students’ perceptions of feedback received from educators in a selected HEI. Method. A non-experimental, exploratory descriptive design was used to guide the research process. The non-probability convenience sampling method was used, with 75 nursing students as respondents. A descriptive statistics procedure was used to present the findings of the study. Results. Most respondents (82.7%) reported that they received understandable, timely, personalised, criteria-referenced, positive clear feedback after assessment. Conversely, 17.3% of respondents indicated that they received delayed, non-understandable feedback, as well as unclear and negatively written feedback. The findings of the study suggest that quality feedback mechanisms in the selected HEI were used for effective learning and to meet nursing students’ requirements and expectations. Conclusion. The findings of the research indicate that nursing students receive quality feedback after assessment. However, there is a need for the HEI to develop a clear organisational structure with an operational guideline to aid the feedback process and ensure that all students receive quality feedback, improving their performance and meeting their needs. The feedback process should be made transparent and communicated to educators and students.
Understanding of clinical reasoning by undergraduate students and clinical educators in health and rehabilitation sciences at a South African University: The implications for teaching practice
Authors:   Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, South Africa, Talberg H , Camroodien-Surve F , Amosun S L
Published: January 2022

Background. Clinical reasoning (CR) is a skill acquired by students under supervision of clinical educators (CEs) when transitioning from classroom to clinical practice to optimise patient care. However, intra- and inter-professional differences in the definition and facilitation of CR have been reported. At the University of Cape Town, a teaching development grant was obtained and used for a staff development initiative aimed at improving the CR skills of undergraduate health and rehabilitation students. Objectives. To gain insight into the understanding of CR among CEs and a cohort of third-year students across 4 professional programmes, using an interpretive approach. Methods. The CEs responsible for third-year supervision (n=45) were invited to take part in a self-developed electronic survey and an initial workshop that explored their understanding of CR. The qualitative survey data, as well as workshop feedback and discussion, were analysed. Students’ understanding was explored during focus group discussions. Results. There were areas of commonality and differences among CEs. They agreed on a cyclical step-like process to CR and the need to cue students to develop this expertise in clinical settings. The approach of CEs in occupational therapy was client focused; physiotherapy CEs described a higher- order thinking; and audiology and speech and language pathology CEs described a structured procedure informed by evidence. Students were unable to conceptualise a complete picture to reasoning and decision-making. Conclusion. The difference between students’ understanding of CR and their poor awareness of strategies employed by CEs to facilitate reasoning could account for difficulties in transitioning from classroom to practice. This scenario suggests that divisions need to look at creating more purposeful strategies to teach students about the CR process and how the facilitation may occur within the clinical setting.
Medical students’ perceptions of global health at the University of Cape Town, South Africa: The gap between interest and education
Authors:   Livingstone Hospital, Gqeberha, South Africa, Potter M , Naidoo P , Pohl L , Chu K
Published: January 2022

Background. Global health competencies are an increasingly important part of medical training; however, there is currently no integrated formal global health curriculum at South African (SA) medical schools, and perceptions of medical students towards global health have not been reported. Objectives. To describe SA medical students’: (i) perceptions of global health; (ii) access to global health education (GHE); (iii) awareness of global surgery as a global health priority; and (iv) perceived relevance of select medical specialties to global health. Methods. Medical students at the University of Cape Town (UCT), SA, were invited to complete a 35-item survey over 2 months in 2018. The survey was designed on REDCap (Research Electronic Data Capture) and distributed by email. All responses were anonymised and self-reported. Results. Of 1 640 medical students, 245 (18%) completed the survey. Only 66 (27%) reported GHE in medical school, whereas 213 (87%) reported a career interest in global health. Childhood in a rural setting was a positive predictor of a career interest in global health, while lack of medical resources and infrastructure in resource-limited communities was the most commonly cited barrier to a career in global health. Most students identified family medicine and infectious diseases as the two most important specialties in global health delivery. The majority of students had limited insight into global surgery, which ranked low as a past and future global health priority. Conclusion. UCT medical students are interested in global health careers, but lack formalised GHE or global surgery education during their medical studies to support and encourage integrating global health into their future careers.
Evaluation of assessment marks in the clinical years of an undergraduate medical training programme: Where are we and how can we improve?
Authors:   Department of Family Medicine, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa, Brits H , Joubert G , Bezuidenhout J , van der Merwe L
Published: January 2022

Background. In high-stakes assessments, the accuracy and consistency of the decision to pass or fail a student is as important as the reliability of the assessment. Objective. To evaluate the reliability of results of high-stakes assessments in the clinical phase of the undergraduate medical programme at the University of the Free State, as a step to make recommendations for improving quality assessment. Methods. A cohort analytical study design was used. The final, end-of-block marks and the end-of-year assessment marks of both fourth-year and final-year medical students over 3 years were compared for decision reliability, test-retest reliability, stability and reproducibility. Results. 1 380 marks in 26 assessments were evaluated. The G-index of agreement for decision reliability ranged from 0.86 to 0.98. In 88.9% of assessments, the test-retest correlation coefficient was <0.7. Mean marks for end-of-block and end-of-year assessments were similar. However, the standard deviations of differences between end-of-block and end-of-year assessment marks were high. Multiple-choice questions (MCQs) and objective structured clinical examinations (OSCEs) yielded good reliability results. Conclusion. The reliability of pass/fail outcome decisions was good. The test reliability, as well as stability and reproducibility of individual student marks, could not be accurately replicated. The use of MCQs and OSCEs are practical examples of where the number of assessments can be increased to improve reliability. In order to increase the number of assessments and to reduce the stress of high-stake assessments, more workplace-based assessment with observed clinical cases is recommended.
Corruption in the public health sector in South Africa: A global bioethical perspective
Authors:   Department of Moral Development of Society, Faculty of Theology, North-West University, Potchefstroom, South Africa, Rheeder R
Published: January 2022

It is clear that corruption as the abuse of power is an enormous bioethical issue in the public health sector in SA, but as a challenge, it has not elicited much discussion from a global bioethical perspective. The Universal Declaration of Bioethics and Human Rights (UDBHR) on corruption considers three matters. First, the existence of corruption as a problem of power is recognised in the health environment and condemned (article 18). Second, corruption is indicated as an immoral phenomenon that harms the interests of the patient (article 4), ignores vulnerable people (article 8) and neglects social responsibility (article 14). Third, it can be concluded that the UDBHR expresses the opinion that corruption has to be combated by a process of ethical decision-making (article 18.2-3), the use of ethics committees (article 19) and ethics education (article 23.1).
Public health emergency preparedness and response in South Africa: A review of recommendations for legal reform relating to data and biological sample sharing
Authors:   School of Law, College of Law and Management Studies, University of KwaZulu-Natal, Durban, South Africa, Steytler M , Thaldar D W
Published: January 2022

COVID-19 exposed flaws in the law regulating the sharing of data and human biological material (HBM). This poses obstacles to the epidemic response, which needs accelerated public health research and, in turn, efficient and legitimate HBM and data sharing. Legal reform and development are needed to ensure that HBM and data are shared efficiently and lawfully. Academics have suggested important legal reforms. The first is the clarification of the susceptibility of HBM and HBM derivatives to ownership, including, inter alia, the promulgation of a revised version of the South African Material Transfer Agreement (SA MTA) by the Minister of Health. This would remove uncertainty regarding the current SA MTA’s perpetual donor ownership clause. The second is the development of data trusts, the adoption of open access to research data, and the creation of an African ‘data corridor’. This would ensure that data are protected while allowing for the efficient transfer of data between researchers for the collective good and in the interest of the public. The third is the amendment of the Space Affairs Act to extend the powers of the Council of Space Affairs to include the management of data collected through the utilisation of Earth observation and geographical information systems. This would ensure the protection of outer space data, legislating its use and sharing once it lands on Earth. The implementation of these legal reforms and developments will better prepare SA to face future epidemics from a health research perspective.
Experiences of emergency care providers conducting critical care transfers in Gauteng Province, South Africa
Authors:   Department of Emergency Medical Care, Faculty of Health Sciences, University of Johannesburg, South Africa, Senekal A C G , Vincent-Lambert C
Published: January 2022

Background. Critical care transfer (CCT) involves the movement of high-acuity patients between facilities. Internationally, CCTs are commonly performed by a dedicated team using specialised vehicles and equipment. These transfers comprise a significant portion of the work of local ambulance services; however, there is a dearth of literature on current approaches and practices. Objectives. To investigate and describe the experiences of a sample of Gauteng Province-based emergency care (EC) providers conducting CCTs. Methods. A qualitative descriptive design used thematic analysis to gather data from 14 purposely selected participants during semi-structured focus group discussions, which were recorded and transcribed verbatim. Data were coded and analysed using ATLAS.ti to generate themes and sub-themes. Results. The two dominant themes that emerged from the study were that there is no common understanding or clear definition of a CCT in the local context, and that systemic challenges are experienced. Participants indicated that their undergraduate training did not sufficiently prepare them to conduct CCTs. Local ambulance services appear to lack a common definition and understanding of exactly what constitutes a CCT and how this differs from ‘normal’ ambulance operations. Participants felt undervalued and poorly supported, with several systemic challenges being highlighted. Conclusions. The absence of a contextually relevant definition of what constitutes a CCT, coupled with potential curriculum deficits in undergraduate EC programmes, negatively impacts on the experiences of EC providers conducting CCTs. Acknowledging CCT as an area of specialisation is an important step in addressing some of the frustrations and challenges experienced by EC providers tasked with conducting such transfers. Further research into formal postgraduate programmes in CCT is recommended.
Association between pre-intensive care unit (ICU) hospital length of stay and ICU outcomes in a resource- limited setting
Authors:   Discipline of Anaesthesia and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa, Khan S , Wise R , Savarimuthu S M , Anesi G L
Published: January 2022

Background. Previous studies demonstrated higher mortality for patients with a longer pre-intensive care unit (ICU) hospital length of stay (LOS), in well-resourced settings. Objectives. The study aimed to determine the association between pre-ICU hospital LOS and ICU outcomes in a resource-limited setting. We hypothesised that longer pre-ICU hospital LOS would be associated with higher ICU mortality. Methods. This was a retrospective cohort study measuring the association between pre-ICU hospital LOS and ICU outcomes using data extracted from a regional hospital ICU in KwaZulu-Natal, South Africa. Consecutive ICU admissions of all patients (medical and surgical) older than 18 years were included during the study period September 2014 to August 2018. A corrected sample size of 2 040 patients was identified. Multivariable logistic regression was used to assess the primary outcome of ICU mortality, and multivariable Cox proportional hazard regression was used for the secondary outcome of ICU LOS. Results. The median pre-ICU hospital LOS was 1 day (interquartile range (IQR) 0 - 2 days). The median length of ICU stay was 2.4 days (IQR 1.1 - 4.8 days) and the observed ICU mortality was 16% (n=327/2 040). Pre-ICU hospital LOS was not associated with ICU mortality in the unadjusted (odds ratio (OR) 1.00; 95% confidence interval (CI) 0.98 - 1.02; p=0.68; n=2 040) and fully adjusted logistic regression models (OR 1.00; 95% CI 0.98 - 1.03; p=0.90; n=1 981) using a complete case analysis for missing patient-level covariates. In Cox proportional hazard models, there was no association between pre-ICU hospital LOS and ICU LOS (hazard ratio 1.00; 95% CI 0.98 - 1.03; p=0.72; n=1 967), including when stratified by admission source. Conclusions. Pre-ICU hospital LOS was not associated with either ICU mortality or ICU LOS in a resource-limited setting. Future studies should aim to include multicentre data and evaluate long-term outcomes.
Critical care research in the resource-limited setting: Leveraging the power of the database
Authors:   Department of Critical Care, King Edward VIII Hospital, Durban, South Africa and Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa, de Vasconcellos K
Published: January 2022

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Buscando tiempo y espacio para dar voz al alumnado en la comunidad educativa
Authors: Burriel Manzanares Francisca
Published: January 2022

Durante la reciente pandemia, las escuelas se han adaptado construyendo una comunidad digital emergente, pero en general no han pedido a los estudiantes información sobre cómo desarrollarla.  Las redes virtuales que reflejan la sociedad humana (Castells, 2013), se han convertido en espacios de comunicación y convivencia sincrónica y asincrónica entre diferentes sectores educativos. Las habilidades digitales se han convertido en estrategias que las comunidades educativas necesitan para hallar tiempo y espacio que permita al alumnado de la próxima generación desarrollarse con responsabilidad y ciudadanía participativa (NSRP, 2006). Este artículo muestra cómo la interacción participativa entre las familias y la escuela puede tener un impacto significativo en el éxito educativo de los estudiantes. La autora examina los componentes, las mecánicas y las dinámicas que definen la comunicación entre familia y escuela en ocho centros diferentes de educación primaria en Cataluña (España). Compara la información que los estudiantes pueden producir sobre su propia escuela con la información proporcionada por sus padres, maestros y directores de escuela. Utiliza un proceso de recopilación de datos multimodal para analizar documentos escolares, cuestionarios digitales de diferentes sectores educativos y entrevistas en línea de grupos mixtos, para crear una triangulación de datos. El resultado proporciona información tanto global como detallada sobre cómo los estudiantes se han quedado fuera de la toma de decisiones y la transformación educativa, y cómo incluirlos puede ser crucial para involucrarlos en su propio proceso educativo.
Association of Oral Melanosis with Soft Tissue Pathologies: A Hospital- based Observational Study
Authors: Garg Aarushi , Maheswari R , Urs Aadithya B
Published: January 2022

Introduction: Oral pigmentation can be physiological/pathological, exogenous/endogenous. Melanin is the most important pigment responsible for normal pigmentation. Recent increasing evidence shows that melanosis occurs in many oral soft tissue pathologies. Aim: To assess the pigmentation in various oral soft tissue lesions with that of normal oral mucosa. Materials and Methods: An observational study was conducted at Maulana Azad Institute of Dental Sciences, New Delhi, India, for a period of six months. A total of 805 study participants were included in the study population. Among these, 605 study participants with soft tissue pathologies with or without tobacco habits were selected and 200 study participants without any pathology and habit comprised were taken as controls. Assessment of oral melanosis was done at various sites within the oral cavity. Prevalence of melanosis with oral lesions and habits was estimated using Statistical Package for the Social Sciences (SPSS) statistical software (version 16.0). Results: Out of 605, 280 cases (46.28%), and out of 200, 54 controls (27%) showed melanosis which was statistically significant. Melanosis was most prevalent in men, in the age group of 21-40 years predominantly involving the buccal mucosa. Maximum cases presenting melanosis were amongst smoked tobacco users and with both tobacco habits were found in leukoplakia (37.7% and 28.3%, respectively). However, 74.2% smokeless tobacco users with melanosis showed Oral Submucous Fibrosis (OSMF) which was statistically significant. Conclusion: Various forms of tobacco consumption commonly induce intra mucosal pigmentation which could be due to high chemical and mechanical irritation by tobacco. The study attempts to assess the overall prevalence of melanosis in study participants with pathologies and habits to understand the implications of melanosis in pathologies in the general population.
A Rare Presentation of Extraskeletal Osteosarcoma in the Arm
Authors: Thivya Rajeswari , Kannan Aarthi , Ganesh K Priyadharshini
Published: January 2022

Extraskeletal Osteosarcoma (ESOS) is a rare mesenchymal malignancy that commonly manifests in the fifth to seventh decade of life. It occurs frequently in the deep soft tissues of the lower extremities, in particular the thigh. These are aggressive tumours, showing local recurrence, and almost 90% show a distant metastasis in particular to the lung at the time of diagnosis, so it becomes crucial to diagnose these lesions at an early stage. Here, authors report a case of 56-year-old female, who presented with painless swelling of size 2×2 cm in the lateral aspect of the right arm. There was no history of prior trauma. On imaging studies, it was found to be a subcutaneous swelling with calcification and not attached to the nearby bone. Excision biopsy showed a malignant neoplastic lesion with osteoid surrounded by atypical cells with frequent mitosis, and with heterologous bone and cartilage formation. The diagnosis of ESOS was confirmed using special AT-rich sequence-Binding protein 2 (SAT-B2) immunohistochemistry. The case is presented here because of its rarity of occurrence in the arm, size and utilisation of SAT-B2 in confirming the diagnosis.