bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factors Linked to Development of Cardiomyopathy in Adults with Beta- Thalassemia Major in a Tertiary Care Hospital
Authors: Rajesh K Meena  , Ramesh Chand Meena  , Sourabh Sharma
Published: September 2023

Beta-thalassemia major is a genetic disorder adversely affecting the life of the patient and the whole family. Repeated blood transfusions are required to maintain the hemoglobin level, which create a state of iron overload in the body leading to ectopic iron deposition in the heart, liver, pancreas and other organs. Thalassemia cardiomyopathy is the most dreaded complication of this resultant iron overload. The present study was a cross-sectional study involving 77 patients with thalassemia major, whose age, body mass index (BMI), blood pressure (BP), hemoglobin, serum ferritin levels were correlated with their twodimensional echocardiographic findings. Out of the total 77 patients, 63 had diastolic dysfunction, 6 had systolic dysfunction and remaining 8 had normal left ventricular function. The mean age of the patients was 22.42 years and their mean BMI was 16.82. Patients with systolic dysfunction had lower hemoglobin and higher serum ferritin levels as compared to other patients. The study concluded that cardiac dysfunction is seen more in younger age, higher BMI, lower BP, low hemoglobin levels and raised serum ferritin levels. Thus, early intensive iron chelation therapy should be provided to all the patients to curb this dreaded complication.
Patient Counseling for Finerenone
Authors: Sanjay Kalra  , Banshi Saboo  , Beatrice Anne  , Mathew John  , Pradip Dalwadi  , Shehla Shaikh
Published: September 2023

Finerenone is a nonsteroidal mineralocorticoid receptor antagonist, which is used to retard the progression of chronic kidney disease in persons with type 2 diabetes. This communication describes the various aspects of patient counseling needed to ensure safe and effective usage of the molecule. It utilizes the 5C checklist: Confirmation of clinical indication; Caveats and contraindications; Concerns and checkpoints; Caution and use with concomitant medication; and Constraints and cost, to create a simple, yet comprehensive tool for clinical use.
Adolescent Obesity and Type 2 Diabetes Mellitus: Synaptics and Heuristics
Authors: Meenakshi Verma  , Davinder Singh Batth  , Mohan T Shenoy  , Suneet K Verma
Published: September 2023

The adolescent population is the foundation for a Nation’s progress. Their shoulders therefore must be emboldened with health and dignity to ensure a developed Nation. However, the multitude of prevailing epidemics have left nostone unturned to enfeeble their strength. Type 2 diabetes mellitus (T2DM) and obesity stand amongst the top shotguns. There is a dire need to execute preventive as well as therapeutic actions to contain the epidemic, for which one must be well versed with the attributable risk factors. In this article, we will understand the synaptics of adolescent obesity and T2DM and what strategies are recommended by the health authorities to prevent and overcome this rising epidemic.
Dual Left Circumflex Artery
Authors: Monika Maheshwari  , Vishwas  , Rakesh Mahla
Published: September 2023

Dual Left Circumflex Artery
Implementasi sistem ERP pada divisi rantai pasok PT. Pindad (Persero)
Authors: Alwan Saddam , Ainul Fahmi Muhammad
Published: September 2023

Kemajuan teknologi masa kini pada sektor bisnis tentunya sangat cepat berkembang dan mudah di adopsi oleh perusahaan - perusahaan besar salah satunya PT. Pindad. Sistem Enterprise Resource Planning (ERP) di PT Pindad, sebuah perusahaan manufaktur terkemuka. Sistem ERP (Enterprise Resource Planning) adalah sebuah perangkat lunak yang mengintegrasikan berbagai fungsi bisnis dalam satu sistem terpusat. Artikel ini menguraikan langkah-langkah yang diambil dalam proses implementasi ERP. Studi ini juga menyoroti tantangan yang dihadapi selama implementasi, seperti adaptasi terhadap perubahan proses bisnis, integrasi dengan sistem yang ada, dan manajemen perubahan organisasi. Melalui analisis mendalam, jurnal ini mengidentifikasi manfaat yang dihasilkan dari implementasi ERP, seperti peningkatan efisiensi operasional, visibilitas yang lebih baik terhadap rantai pasokan, dan pengambilan keputusan yang lebih tepat waktu berdasarkan data yang terintegrasi. Dengan demikian, penelitian ini memberikan wawasan berharga bagi perusahaan manufaktur lain yang berencana untuk mengadopsi sistem ERP dalam upaya meningkatkan kinerja dan daya saing mereka. Penelitian ini juga berisi tentang permasalahan yang terjadi pada implementasi sistem ERP ini yaitu human error dan perbedaan jumlah material pada lembar dokumen dengan jumlah pada sistem. Dari permasalahan tersebut ditemukan beberapa solusi yang memiliki potensi paling banyak untuk di aplikasikan ke perusahaan atau solusi paling optimal berkaitan dengan kondisi dan keadaan perusahaan yaitu Pelatihan atau Sosialisasi, Regenerasi Sumber Daya Manusia, Menghitung stock material (stock opname).
PENGEMBANGAN ASPEK BISNIS PADA KLINIK KESEHATAN
Authors: Iffan Muhammad
Published: September 2023

Artikel ini mendokumentasikan upaya pengabdian masyarakat dalam mengembangkan aspek bisnis di Klinik Kesehatan Diana. Tujuan dari kegiatan ini adalah untuk memberikan pemahaman kepada Klinik Diana mengenai pengembangan aspek bisnis dengan menggunakan Analisis SWOT. Metode yang digunakan dalam pengabdian ini meliputi observasi, wawancara, dan analisis data. Tim pengabdian bekerja sama dengan manajemen dan staf medis Klinik Kesehatan Diana untuk mengidentifikasi masalah dan potensi perbaikan dalam berbagai aspek bisnis. Hasil pengabdian ini menunjukkan beberapa temuan penting antara lain SDM masih belum memahami perngembangan aspek bisnis dengan menggunakan Analisa SWOT, masih kurangnya pengetahuan masyarakat mengenai keberadaan Klinik Diana, dan belum adanya kerjasama dengan lembaga asuransi. Berdasarkan temuan tersebut, tim pengabdi memberikan rekomendasi dengan memberikan pemahaman kepada SDM Klinik Diana mengenai pengembangan aspek bisnis dengan menggunakan Analisis SWOT, melakukan promosi yang berkelanjutan baik secara langsung maupun menggunakan pemasaran digital untuk meningkatkan kesadaran masyarakat terhadap keberadaan Klinik Diana, dan mengakselerasi proses kerjasana Klinik Diana dengan lembaga asuransi. Pengembangan aspek bisnis di Klinik Kesehatan Diana diharapkan dapat memberikan dampak positif yang signifikan bagi masyarakat setempat, memberikan akses yang lebih baik terhadap layanan kesehatan yang berkualitas, dan berkontribusi pada pengembangan sektor kesehatan.
ELEKTRONİK TİCARET PAZAR YERİNDE ARACILIK SÖZLEŞMESİ
Authors: BADUR Emel , HATİPOĞLU Kutluay
Published: September 2023

Yasa koyucu tarafından 2022 yılında, Elektronik Ticaretin Düzenlenmesi Hakkında Kanun’da (ETDHK), 7416 sayılı Kanun aracılığıyla önemli değişiklikler gerçekleştirilmiş ve bu değişiklikler uyarınca Ticaret Bakanlığı tarafından Elektronik Ticaret Aracı Hizmet Sağlayıcı (ETAHS) ve Elektronik Ticaret Hizmet Sağlayıcılar (ETHS) Hakkında Yönetmelik çıkarılmıştır. Yapılan değişikler sonucunda e-ticaret pazar yeri kavramına, bu ortamda faaliyet gösteren taraflara ve taraflar arasındaki hukuki ilişkiye dair önemli düzenlemeler Türk Hukukuna dahil edilmiştir. Söz konusu değişikliğin önemli sonuçlarından biri de e-ticaret pazar yerinde faaliyet gösteren ETAHS ve ETHS arasında kurulan aracılık sözleşmesine dair bazı belirlemelerin yapılmış olmasıdır. Bu makalenin konusunu oluşturan aracılık sözleşmesi, e-ticaret pazar yerinde ETAHS ve ETHS arasında kurulan, isimsiz bir sözleşmedir. Aracılık sözleşmesinin, e-ticaret pazar yerinde ETAHS tarafından ETHS’ye sunulan aracılık hizmetinin kapsam ve koşullarının Yönetmelik’te belirlenen asgari içerik koşuluna uygun olarak yazılı veya elektronik ortamda düzenlendiği; sunulan hizmet karşılığında ETHS’nin ETAHS’ye bir bedel ödediği; tam iki tarafa borç yükleyen ve sürekli borç ilişkisi doğuran bir sözleşme olarak tanımlanması mümkündür.
İSVİÇRE FEDERAL MAHKEMESİ İÇTİHATLARI ÇERÇEVESİNDE ORTAK VE ALACAKLILARIN YÖNETİCİLERİN MAL VARLIĞINDAN ŞİRKETTEN ÖNCE YARARLANMA İHTİMALİNE KARŞI BİR ÖNLEM
Authors: GÜNER Temel
Published: September 2023

Anonim ve limited şirketlerde ortak ve alacaklılar doğrudan zararlarının tazmini için yönetim/müdürler kurulu üyelerine karşı sorumluluk davası açtıklarında tazminat şirkete değil kendilerine ödenmektedir. Bu durum ortak ve alacaklılarla birlikte şirketin de doğrudan zarara uğradığı ihtimalde şirketin aleyhine sonuç doğurmaktadır. Zira ortak ve alacaklılar şirketten önce harekete geçip zararlarını tazmin ettiklerinde genellikle yöneticilerin malvarlığında başvurabilecek bir meblağ kalmamakta, şirket zararını tazmin edememe riskiyle karşılaşmaktadır. Bu risk şirket iflas ettiğinde daha da belirgin hale gelmektedir. Nitekim iflas gerçekleştiğinde şirket adına sorumluluk davası açılabilmesi için ikinci alacaklılar toplantısında bu yönde bir karar alınması gerektiğinden, bu karar alınana kadar ortak ve alacaklılar önceden harekete geçip yöneticilerin mal varlığından öncelikle faydalanmakta, yöneticilerin mal varlığında şirketin başvurulabileceği bir meblağ kalmamaktadır. Bunun önüne geçmek isteyen İsviçre Federal Mahkemesi ortak ve alacaklılarla birlikte şirketin de doğrudan zarara uğradığı ihtimalde ortak ve alacaklıların sorumluluk davası açabilmeleri için münhasıran kendi menfaatlerini koruma amacı güden bir normun ihlali şartını aramakta, böylece ortak ve alacaklıların dava hakkını önemli ölçüde kısıtlamaktadır. Federal Mahkeme, başlangıçta hem iflas içinde hem de iflas dışında benimsediği bu uygulamasını güncel kararlarında sadece iflas halinde devam ettirmektedir. Çalışmamızda İsviçre Federal Mahkemesi’nin bu konudaki uygulaması incelenmektedir.
Using Whatsapp in Teaching Vocabulary: A Case Study from Palestine
Authors: Ahmed Raba  , Sameer Qadous  , Mahmoud Itmeizeh
Published: September 2023

essaging applications have become well-known among 21st-century students worldwide and in Palestine in particular. These applications are useful in teaching and learning all disciplines and English in particular. This study has sought to find out the effect of using the WhatsApp application in enriching primary school students’ vocabulary. To this end, a 20 sixth-grade students (10 males and 10 females) from Al-Omariya Private Schools, Nablus were selected as a study sample. Since the research adopted one-group design method, a pre-test was administered to assess the student's level in vocabulary knowledge and to ensure their homogeneity. After that, the students in the experimental group received vocabulary instructions and a teacher's pedagogy through WhatsApp messages, which included pictures, texts and videos, three days a week for two months. A post-test was administered to the experimental group to measure the effect of using WhatsApp instructions on their vocabulary knowledge and gender as well. The results revealed that using WhatsApp had a significant effect on the improvement of the student's vocabulary knowledge. They also showed that there were differences in the effect of using WhatsApp in teaching vocabulary between males and females in favor of males. In light of these findings, the researchers suggest using WhatsApp messaging in other private and government schools.

This study contributed to raising the awareness of students, teachers and curriculum designers of the importance of utilizing    WhatsApp in teaching and learning. It also contributed to introducing students to new strategies and techniques for learning English vocabulary in a new environment that promotes students’ motivation and enhances autonomous learning whenever and wherever they want according to their pace. The study may also participate in introducing foreign researchers to the reality and capacities of the Palestinian educational context that may lead to mutual collaboration in future.
تحليل كفاءة الطلاب في تمييز بين الصحيح والمعتل من الأفعال
Authors: Ilyas Haddat , Karo Tiy Kusmarrabbi , Tumanggor Ilham
Published: September 2023

أسئلة البحث هي كيف كفاءة الطلاب في التمييز بين الصحيح والمعتل من الأفعال في الصف الثالث المتوسط بمعهد منهاج السنة لبوهن باتو أوترا؟ وأغراضه لوصف مستوى كفاءة الطلاب في التمييز بين الصحيح والمعتل من الأفعال في الصف الثالث المتوسط بمعهد منهاج السنة لبوهن باتو أوترا. والمنهج المسخدم في هذا البحث هو البحث الميداني الكمي بالنوع الوصفي، وطريقة تحليل البيانات المستعملة هي طريقة الاختبار. واتخذ الباحث أربعة اختبارات لنيل المعلومات. ونتيجة البحث هي: حصل الطلاب على النتيجة 96% في الاختبار الاختياري، والنتيجة 92% في الاختبار التكملة، والنتيجة 85،71% في الاختبار الاختياري بوضع الجدول، والنتيجة 91،64% في الاختبار المزاوجة. والمعدل الإجمالي من جميع اختبار الطلاب حصل على النتيجة 91.64% وحصل على تقدير "جيد جدًا". وعلى ذلك لقد تمكن طلاب معهد منهاج السنة الصف الثالث تلقائيًا في تمييز بين الفعل الصحيح والمعتل من الأفعال.
ALT Flap Single-Stage Donor Site Closure with Loco-Regional Flaps: A Systematic Review
Authors: Caputo Glenda Giorgia , Tel Alessandro , Scarabosio Anna , Contessi Negrini Filippo , Caputo Glenda Giorgia , Gratteri Marco , Alessandri-Bonetti Mario , Camillo Parodi Pier , Albanese Roberta , Mura Sebastiano
Published: September 2023

The anterolateral thigh (ALT) flap is currently the main choice as a free flap for head and neck reconstruction, including intraoral and facial defects and it is gaining popularity in abdominal, orthopedic and pelvis reconstruction [1]. It can also be used as a pedicled flap in abdominal or perineum reconstruction. One of the most important property of the ALT flap is the low donor site morbidity, both functionally and aesthetically, compared to other workhorse flaps, thanks to the possibility to reach a direct suture in 80% of the cases. Many possibilities are currently available to cover the defect when direct suture is not achievable. A split thickness skin graft has traditionally been used to address the remaining skin defect. Due to the alteration of the thigh skin sensitivity and poor aesthetic outcomes, loco-regional flaps are gaining tremendous momentum in the field. In fact, they allow surgeons to get the donor site closure in one stage surgery, with a good tissue quality, with a like-with-like tissue. A systematic review according to the PRISMA guidelines was performed concerning the issue of donor site closure after ALT harvesting.
Strategi Belajar Siswa Berprestasi
Authors: Syahrizal Hasan , Nurhafizah
Published: September 2023

Strategi belajar merupakan salah satu cara siswa dalam mencapai tujuan belajar .Penelitian ini bertujuan untuk menganalisis dan mendeskripsikan strategi belajar siswa berprestasi. Metode penelitian ini menggunakan pendekatan kualitatif deskriptif, subjek dalam penelitian ini adalah siswa berprestasi yang mendapatkan juara 1 sampai dengan 3 yang berjumlah 30 orang dari 10 kelas. Teknik pengumpulan data dilakukan dengan observasi, wawancara dan dokumentasi, dengan teknik analisis data yakni reduksi data, penyajian data, dan penarikan kesimpulan/verifikasi. Hasil penelitian ini menunjukkan bahwa siswa berprestasi yang mendapatkan juara 1 sampai 3 di kelas memiliki strategi giat dalam belajar, memperhatikan guru saat belajar, menghormati guru, santun, semangat mengerjakan tugas dari guru dan tidak berbicara kasar terhadap guru, selain itu pada saat dirumah dalam keterangan wawancara siswa membaca buku sebelum kesekolah, mengerjakan PR dengan baik, disiplin, dan mayoritas siswa berprestasi tidak membenci. Impikasi dari penelitian ini memberikan gambaran yang dilakukan oleh siswa berprestasi dalam mencapai hasil belajar yang optimal dikelas dengan predikat juara 1 sampai dengan 3 di kelas
Peran Guru Dalam Mengembangkan Nilai Moral Agama Anak Usia Dini
Authors: Siyami Kusnul , Zaharuddin
Published: September 2023

Peran guru dalam mengembangkan nilai moral agama anak usia dini sagatlah penting. Penelitian ini bertujuan untuk menganalisis peran guru dalam mengembangkan nilai moral agama anak usia dini. Penelitian ini merupakan penelitian kualitatif, subjek dalam penelitian ini adalah guru kelas dan guru pendamping kelompok A. Teknik pengumpulan data dilakukan dengan wawancara, observasi dan dokumentasi. Analisi data dilakukan dengan triangulasi data. Hasil penelitian ini menunjukkan bahwa pertama, peranan guru diantaranya sebagai ahli instruksional yaitu guru menyusun satuan kegiatan harian, sebagai motivator, guru sebagai model, guru sebagai pembimbing, dan guru sebagai pengarah kedua, faktor pendukung dalam pelaksanaan peranan guru dalam membimbing moral anak adalah kerjasama yang baik antar guru serta kepiawaian dalam mengatasi anak didik, ketiga, faktor penghambat yaitu karakteristik anak didik dan pola asuh orang tua yang berbeda-beda serta cara mengajar guru yang berbeda-beda meskipun mempunyai tujuan yang sama
Manajemen Peserta Didik Pada Era Pandemi Covid-19
Authors: Faniati Fenny , Sandi Qalka
Published: September 2023

Manajemen peserta didik merupakan pengelolaan penerimaan peserta didik disekolah. Tujuan dari penelitian ini untuk menganalisis dan mendeskripsikan manajemen peserta didik pada era pandemi covid-19. Metode penelitian ini menggunakan pendekatan kualitatif deskriptif, subjek penelitian yakni guru dan kepala sekolah. Teknik pengumpulan data dilakukan dengan wawancara dan dokumentasi. Teknik analisa data dengan reduksi data, penyajian data dan penarikan kesimpulan. Hasil penelitian dapat diuraikan bahwa pelaksanaan manajemen peserta didik berjalan baik, guru dan orang tua bekerjasama dalam memberikan bimbingan kepada anak yang mana bahan ajar disediakan oleh guru, seperti vidio dan lain-lain, sedangkan orang tua membantu anak dalam mempelajari bahan ajar yang dikirimkan oleh guru. Adapun hambatan-hambatan seperti tidak semua orang tua memiliki andorid, kesibukan orang tua dalam mencari nafkah dan kuota internet yang cukup mahal untuk didapatkan orang tua dalam mengakses internet agar dapat menerima bahan ajar dari guru
Implementasi Kurikulum Pondok Pesantren di MTS Sa’adatuddaraein Suhada Kecamatan Enok Kabupaten Indragiri Hilir
Authors: Oftania Maria , Nurmadiah  , Asmariani
Published: September 2023

Kurikulum pondok pesantren memiliki perbedaan dengan sekolah umum, dan bahkan terdapat perbedaan antara satu pondok pesantren dengan pesantren lain. Tujuan penelitian ini untuk mengetahui implementasi kurikulum pondok pesantren dan untuk mengetahui apa faktor penghambat dan faktor pendukung dalam implementasi kurikulum pondok pesantren. Penelitian ini menggunakan pendekatan kualitatif deskriftif, Informan kunci dalam penelitian ini adalah kepala sekolah, sedangkan guru dan siswa dijadikan sebagai informan tambahan. Teknik pengumpulan data penelitian ini adalah observasi, wawancara, dan dokumentasi. Teknik analisis data menggunakan reduksi data, penyajian data dan penarikan kesimpulan. Hasil penelitian ini ditemukan bahwa: pertama, pola I: materi agama yang diajarkan berasal dari kitab-kitab klasik (kitab kuning) dan metode pembelajarannya menggunakan wetonan dan sorogan. pola II: pendekatan pembelajaran dilaksanakan secara klasikal dan non-klasikal. pola III: kurikulum telah ditambahi dengan mata pelajaran umum dan aneka kegiatan ketrampilan, kesenian, organisasi. pola IV: menitik beratkan pembelajaran ketrampilan disamping agama. pola V: pengajaran kitab klasik menjadi bagian penting dari pembelajaran di MTs Saadatudarein. a)  Pesantren mengadopsi model madrasah. b) Kurikulum pesantren di bagi menjadi dua bagian, yaitu kurikulum pesantren dan kurikulum pemerintah dengan modifikasi materi agama. c) Ada juga pesantren menyelenggarakan sekolah umum dengan kurikulum yang mengikuti kementerian pendidikan dan kebudayaan. d) ada pesantren yang menyusun kurikulum pendidikan agama mereka sendiri. Kedua: faktor pedukungnya adalah dukungan dari pihak masyarakat, terpenuhinya kebutuhan pangan santri, kualitas guru dan staf memadai, komitmen kuat dari pengelola, partisipasi aktif santri. Sedangkan faktor penghambatnya adalah, kurangnya dukungan dari Orang Tua/Wali Murid, perubahan regulasi pendidikan, tantangan teknis, teknis ini dapat mempengaruhi kelancaran pelaksanaan kurikulum. Perbedaan pandangan dan opini, resistensi terhadap perubahan, kurangnya pelatihan dan pembekalan, tantangan pengukuran dan evaluasi
Pengawasan Kepala Madrasah Dalam Peningkatan Kedisiplinan Tenaga Pendidikan di Madrasah Tsanawiyah Nurul Wathan Pusaran
Authors: Mandasari Rati , Maimunah  , Murtopo Ali
Published: September 2023

Kepala sekolah merupakan seorang supervisor yang melakukan pengawasan disekolah. Tujuan penelitian ini untuk mengetahui pengawasan kepala madrasah dalam peningkatan kedisiplinan guru, dan untuk mengetahui faktor-faktor yang mempengaruhi pengawasan kepala madrasah dalam peningkatan kedisiplinan guru. Penelitian ini menggunakan metode kualitatif, dengan jenis penelitian adalah penelitian lapangan (field research). Informan kunci dalam penelitian ini adalah kepala madrasah, sedangkan guru dan siswa dijadikan sebagai informan tambahan. Adapun teknik pengumpulan data dalam penelitian ini adalah wawancara, observasi dan penelitian lapangan, dokumentasi. Teknik analisis data menggunakan reduksi data, display data, dan penarikan kesimpulan. Hasil penelitian ini ditemukan bahwa (1) Pengawasan kepala madrasah dalam peningkatan kedisiplinan guru di MTs Nurul Wathan Pusaran Kecamatan Enok telah efektif yang meliputi pengawasan, bimbingan dan motivasi. Proses pengawasan dilakukan dengan membandingkan standar kedisiplinan guru MTs Nurul Wathan dan melaksanakan perbaikan. (2) Faktor-faktor yang mempengaruhi pengawasan kepala madrasah dalam peningkatan kedisiplinan guru di MTs Nurul Wathan Pusaran Kecamatan Enok. Adapun penerapannya dipengaruhi oleh tiga faktor yaitu Kebijakan pimpinan, kesadaran individu masing-masing dan faktor sarana dan prasarana. Pengawasan yang dilakukan oleh kepala madrasah dapat dikatakan efektif dalam meningkatkan kedisiplinan guru MTs Nurul Wathan, ditinjau dari minimnya ketidak disiplinan guru madrasah dan adanya peningkatan kedisiplinan guru.
Pengaruh Disiplin Kerja Dan Stres Kerja Terhadap Kinerja Pegawai UPTD Puskesmas Sambi Kab. Kediri
Authors: Erika Priya Ningtias  , Ahmad Jauhari  , Nur Hidayati
Published: September 2023

This research is motivated that in institutions engaged in the health sector, in this organization human resources are very important in achieving the goals and success of the agency. This study aims to determine the influence of work discipline and work stress on employee performance. This study used quantitative methods. The sampling technique uses Nonprobability Sampling with a saturated sampling method of 47 employees. Testing in this study using SPSS software program version 25.0. The analysis techniques used are validity test, reliability test, classical assumption test, multiple linear regression analysis, t test, F test and determination coefficient test. The results of this study show that  partially the variable of work discipline has a positive and significant effect on employee performance with a calculated tvalue of  3.059>ttable 2.01537 with a signification value of 0.004<0.05 and partially the variable of work stress has a positive and significant effect with  a calculated tvalue of  2.468>ttable  2.01537 with a signification value of 0.018<0.05, simultaneously the variables of work discipline and work stress have a positive and significant effect on employee performance  with a calculated Fvalue of  8.265>Ftable 3.21 with a signification value of 0.001<0.05.
Der Sozialpsychiatrische Dienst
Authors: Albers Matthias , Dippel Alexandra , Elgeti Hermann , Fröhmel Annette , Gagel Detlev , Haase Kristin , Lindstedt Lothar , Petzold Klaus , Tinnemann Peter
Published: September 2023

Der Sozialpsychiatrische Dienst ist im Rahmen des psychosozialen Versorgungssystems in Deutschland der bekannteste Baustein. Er ist in der Regel Teil der kommunalen öffentlichen Gesundheitsversorgung. Basierend auf rechtlichen Grundlagen bieten Sozialpsychiatrische Dienste fachärztliche und sozialarbeiterische Hilfen für Menschen mit psychischen Störungen und seelischen Behinderungen sowie Suchterkrankungen an. Die in diesem Lehrbuch erstmals zusammengefassten Inhalte beruhen auf jahrelanger theoretischer Auseinandersetzung und praktischer Erfahrung der Autoren/innen im ÖGD.
Sozialmedizinische Assistenten/innen
Authors: Abt Birgit , Elvermann Kaija , Haas Petra , Haupt Anja , Hausfeld Birgit , Krämer-Stamm Rita , Rehbock Antje , Starke Dagmar , Stelter Karina
Published: September 2023

Sozialmedizinische Assistentinnen und Assistenten (SMA) sind Fachkräften der Gesundheitsämter. Sie arbeiten z.B. in der Gesundheitsförderung, Prävention und Gesundheitshilfe, wirken bei Einschulungsuntersuchungen mit, beraten über gesundheitliche Risiken und Maßnahmen zur Prävention, unterstützen bei der Untersuchung von Infektionskrankheiten und Impfungen oder machen Hausbesuche bei Familien mit Kindern oder Menschen in besonderen Lebenslagen. Damit Ihre Unterstützung von Ärztinnen und Ärzte eine hohe Relevanz erhält, und in Zukunft zu einem noch wichtigeren Tätigkeitsfeld im Öffentlichen Gesundheitsdienstes werden kann, benötigen SMA das notwendige Rüstzeug im Rahmen einer fundierten Ausbildung. Dieses Lehrbuch soll SMA in Gesundheitsämtern, aber auch aus anderen Einrichtungen des ÖGD, Grundlegenden Prinzipien und Methoden, sowie praktische Erfahrungen vermitteln damit diese sich zielgerecht auf die Arbeiten vorbereiten können.
Teacher Guidance And Counseling Strategy In Handling Bullying Behavior At SMP Negeri 1 Balongan
Authors: Siti Aisyah
Published: September 2023

Bullying is the act of using power to hurt a person or group of people verbally, physically or psychologically so that the victim feels pressured, traumatized and helpless. Teenagers who experience acts of bullying are at greater risk than perpetrators, including experiencing mental health problems such as depression, anxiety and abnormal sleep problems that can carry over into adulthood. The purpose of this study was to describe and provide a prevention to overcome bullying behavior in SMP Negeri 1 Balongan. This research uses descriptive qualitative research by collecting data in the field by providing a statement from the results of the class 8A, 8C, 8E sample with a total of 88 students and from relevant sources. The guidance and counseling teacher's strategy for overcoming bullying behavior in SMP Negeri 1 Balongan schools is by providing a service, namely group guidance to students to overcome bullying in the school environment so that students can implement it in everyday life
Evaluación responsable y ciencia abierta: agenda de reformas
Authors: Rovelli Laura
Published: September 2023

Tanto a nivel global como regional, los sistemas de evaluación académica y de la investigación son foco en los últimos años de diversos cuestionamientos, mientras que la transición paulatina pero sostenida hacia la ciencia abierta conlleva una serie de cambios no sólo en los modelos de producción y circulación de conocimiento, sino también en los criterios, metodologías y prácticas de la evaluación. A partir de un abordaje cualitativo y descriptivo, basado en la recolección de fuentes documentales primarias, el escrito sintetiza las principales tendencias en la agenda internacional de políticas sobre la evaluación académica y de la investigación. Por otra parte, se describen diversos diagnósticos sobre los sistemas de evaluación en la región latinoamericana y los desafíos centrales que enfrentan. De manera panorámica, se introducen algunas iniciativas recientes de reforma evaluativa en tres países de la región. El argumento central del trabajo sostiene la existencia de un consenso más o menos amplio en torno a un conjunto de principios de reforma evaluativa, con incidencia en la agenda de políticas científicas y universitarias globales y regionales, los que en el plano local son reconfigurados a partir de una diversidad de racionalidades, metodologías e instrumentos en competencia.
El rol de la Universidad en la ciencia abierta
Authors: Magallanes Udovicich Mariana Loreta , Morero Hernán Alejandro , Moreno López Alejandra , Vélez Juan Gabriel
Published: September 2023

A pesar de que la ciencia abierta ha sido una meta deseable para la docencia e investigación de este último tiempo, el interés por saber cuánto y cómo se avanza a nivel local es bastante reciente. Este trabajo presenta resultados de una investigación exploratoria y descriptiva llevada a cabo entre 2020 y 2021, orientada a relevar y caracterizar experiencias universitarias de producción colaborativa y ciencia abierta en la Provincia de Córdoba, Argentina. En este artículo nos abocamos a avanzar en la problematización del rol de las universidades en los procesos de construcción del conocimiento abierto, centrándonos en el caso de la Universidad Nacional de Córdoba (UNC). Por un lado, revisamos el rol institucional de uno de los casos identificados en el trabajo de campo cualitativo, que es la Primera Oficina de Conocimiento Abierto (OCA) en América Latina, la OCA de la UNC. Por otro lado, buscamos profundizar a partir de un relevamiento vía encuestas los cruces entre prácticas de conocimiento abierto llevadas adelante por docentes, las respectivas áreas disciplinares y las categorías docentes, con la finalidad de indagar sobre posibles tensiones y reflexionar sobre el grado de madurez de la ciencia abierta en las universidades estudiadas
III Congreso de internacionalización de la Educación Superior
Authors: Passarini José
Published: September 2023

A partir del proyecto “Movilidad de estudiantes y graduados: Reconocimiento de títulos y el ejercicio profesional en el MERCOSUR”, financiado por el Núcleo de Estudios e Investigaciones en Educación Superior (NEIES) del MERCOSUR, surgió la propuesta de realizar un evento científico y periódico que aborde desde una perspectiva amplia la internacionalización como objeto de estudio. Este proyecto fue llevado adelante por equipos de investigadores de cuatro Universidades: Universidad de la República (Udelar-Uruguay), la Universidad Federal de Integración Latinoamericana (UNILA-Brasil), la Universidad Nacional del Litoral (UNL-Argentina) y la Universidad Nacional de Asunción (UNA-Paraguay). Con este marco, surge el Primer Congreso de Internacionalización de la Educación Superior (CIES 2019), realizado los días 4, 5 y 6 de septiembre de 2019, en Foz de Iguazú, organizado principalmente por la UNILA con el apoyo de las otras tres universidades que eran parte del Proyecto NEIES.
HZ. ALİ İÇİN GÜNEŞİN GERİ DÖNDÜRÜLMESİ RİVAYETİ BAĞLAMINDA SENED TENKİDİNİN İCTİHÂDÎLİĞİ
Authors: UYSAL Şule Yüksel
Published: September 2023

Sosyal bilimlerin hemen her alanında olduğu gibi İslâmî İlimlerde ve hadis tenkidinde ilk aranan özellik, tenkidin objektif olması gerektiğidir. Ancak belli oranda bir öznellikten kurtulmak mümkün olamamaktadır. Hadis tenkidinin gerek râvi değerlendirmesi anlamına gelen sened tenkidi gerekse hadis metninin içeriğinin diğer veriler ışığında değerlendirilmesi münekkidin bakışına göre farklılık gösterir. Bu çalışmada sıhhat değeri bakımından çokça tartışılmış olan bir rivayet üzerinden sened tenkidinin ictihâdîliğinin ortaya konması amaçlanmıştır. Söz konusu rivayet, Hz. Ali’nin ikindi namazını vaktinde kılamaması sonrasında Hz. Peygamber'in dua etmesi ve ardından güneşin döndürülmesini anlatır. Rivayet bazı âlimlerce uydurma olarak değerlendirilirken bazılarınca büyük bir mucize olarak görülmektedir. Otoritelerin râviler hakkındaki tespitleri tavsîfî bir metodla taranmış, elde edilen veriler analiz ve tümevarım yöntemiyle işlenmiştir. Çalışma sonunda ilk dönemde farklı hükümler veren rical âlimlerinin sözlerinin sonraki dönemlerde, nakledilen metnin içeriğine bağlı olarak tercih konusu yapıldığı görülmüştür. Bu yolla müteahhir dönem münekkidi, kendi görüşünü destekleyen hükümleri kullanarak hadisin sıhhati ile ilgili muhtelif sonuçlara ulaşabilmiştir.
Sociological Surveillance of the Pandemic: Exploring Interconnectedness, Panic, and Waves of Crisis
Authors: Lepskiy Maxim
Published: September 2023

The relevance of the sociological study of the COVID-19 pandemic is determined not only by medical problems (zero-patient, the speed of vaccine creation against the virus, the speed of disease spread, etc.), but also by social problems concerning the interaction of people, the impact of the pandemic on social, political, economic, and cultural fields, the processes of transforming social institutions and structures, and the dynamics of the social process both in management and organization, as well as self-organization. The author suggests employing an arsenal of sociological methods and approaches for analysis. The main subject of the article is the problem of studying the impact of a pandemic on modern society with its informational, cognitive-innovative, and hyper-realistic certainty. The author explores the phenomenon of the pandemic, its impact as a global threat and danger on micro, meso, and macro-social structures and organizations, on the main institutions of society, and on international institutions. The pandemic becomes a process of social "freezing" in the broad sense, meaning any relationships among people, but also entails social, political, economic, and cultural constraints; both public and international constraints of states and international institutions. At the same time, the pandemic produces panic as a social phenomenon in various dimensions of masses (socio-behavioral), socio-organizational and institutional, and on a global scale through prompt replication, repetition, modification, rumor, gossip, and information warfare. The theory of social fractality serves as a study of the processes of mimesis, replication, and scaling in masses, socially organizational and global dynamics. The author differentiates various phases of the impact of the pandemic on international processes as certain phases and waves of interaction between countries in the struggle and solidarity. All these define new trends for governments and the world community.
Trender i pasientlogistikk i akuttmottakene ved et norsk universitetssykehus etter innføring av akuttleger
Authors: Bjørnsen Lars Petter , Næss-Pleym Lars Eide , Skaar Torkild , Laugsand Lars Erik
Published: September 2023

Bakgrunn

Økning av pasienter til akuttmottak er en global utfordring. I norske akuttmottakene innførte man en ny spesialitet i akutt- og mottaksmedisin som tiltak for å håndtere økt press på logistikk og ressursutnyttelse. Denne studien så på trender i pasientlogistikken i akuttmottakene ved St. Olavs hospital i lys av innføring av akuttleger. 

 

Materiale og metode

Data fra alle pasienter i akuttmottakene ved St. Olavs hospital i perioden fra 1. januar 2012 til 31. desember 2021 ble inkludert. Rådata ble eksportert og logistiske data om blant annet pasientantall, oppholdstider og behandlingsnivå ble bearbeidet og analysert.

 

Resultater

Akutten i Trondheim har hatt en økt pasienttilstrømming tilsvarende 51% fra 2012 til 2021. Andelen pasienter som hjemsendes etter ferdighåndtering akuttmottaket økte i samme periode fra 11% til 35%, mens antallet innleggelser var relativt stabilt. Oppholdstidene i akuttmottaket i Trondheim økte med 57% til 3 timer 38 minutter.

 

Fortolkning

Det blir økende press på akuttmottakene i framtiden på grunn av økt pasienttilstrømming. Innføring av akuttleger har en rolle for optimalisering av pasientlogistikken og bidrar til økt andel ferdighåndterte pasienter, og følgelig muligheter for mer utredende og behandlende akuttmottak.
Fluid administration in adult emergency department patients with sepsis
Authors: Jessen Marie
Published: September 2023

Baggrund

Væskebehandling betragtes som en vigtig del af behandlingen af sepsis (akut infektion, i folkemunde kaldet blodforgiftning). Guidelines giver anbefalinger til behandling af septisk shock men ikke til patienter med sepsis uden shock. Vores formål var at undersøge den nuværende væskebehandling af patienter med mistænkt infektion, at undersøge klinikernes beslutningstagning omkring væskebehandling, og slutteligt undersøge om en væskeprotokol, som begrænsede væskebehandlingen til sepsis-patienter, var gennemførlig.

 

Metode

Vi gennemførte et prospektivt, deskriptivt studie, hvor patienter med mistænkt infektion fik registreret intravenøse væsker og drikke i 24 timer. Vi undersøgte væske-voluminer og kliniske variables indflydelse på disse voluminer.

                      Vi udviklede og gennemførte en spørgeskemaundersøgelse om faktorer, der udløser væskebehandling, samt udfordringer til vurdering af dette. Vi inkluderede fire kliniske scenarier.

                      Vi gennemførte et klinisk, multicenter, pilotforsøg, hvor vi randomiserede patienter til enten 24 timers restriktiv eller standard væskebehandling. Det primære effektmål var forskel i 24 timers intravenøs væske imellem de to grupper. 

 

Resultater

Vi inkluderede 734 patienter som havde 24-t væske registreret. Væske-voluminer varierede mellem 200-15870 ml. Patienter med simpel infektion fik i gennemsnit 3656 ml (standard deviation (SD): 1675), og patienter med sepsis 3762 ml (SD: 1839), samlet intravenøst og peroral væske. Sepsis-patienter fik mindre peroral men mere intravenøs væske end patienter med simpel infektion. Kliniske variable forklarede 37% af variansen i væskemængder.

                      I spørgeskemastudiet fandt vi, at væskebehandling er udfordrende, og de fleste beslutninger bygger på klinisk vurdering. Blodtryk var den hyppigst brugte trigger til at starte intravenøs væskebehandling.

                      Vi randomiserede 124 sepsis-patienter. På 24 timer fik patienter i den restriktive gruppe 562 ml (SD: 1076) intravenøst krystalloid vs. 1370 ml (SD: 1438) i standard-gruppen (forskel: -801 ml (95% CI: -1257 to -345), p = 0.001). Der var ingen forskelle i bivirkninger eller andre kliniske endemål.

 

Konklusion

Nuværende væskebehandling varierer meget. Væskebehandling er udfordrende og ofte guidet af blodtryk. Vi opnåede separation i væskevoluminer uden tegn til flere bivirkninger ved 24-t restriktiv vs. standard væskebehandling af sepsispatienter i akutafdelingen. Et fremtidigt studie synes gennemførligt.
Nobelprisen i økonomi 2013: Efficiente eller inefficiente finansielle markeder?
Authors: Plesner Søren
Published: September 2023

Debatten om, hvorvidt de finansielle markeder er efficiente eller ej, har raset i snart 40 år. Nobelprisen i økonomi i 2013 gjorde os ikke klogere på, hvem der har ret, for prisen blev delt mellem de to sider i debatten. I artiklen ses på hypotesen om de efficiente markederog på kritik heraf.
Velfærdsstaten i en foranderlig verden
Authors: Fink Nanna , Pedersen Lisbeth
Published: September 2023

I denne artikel præsenteres en forståelse af den nordiske velfærdsmodel som en samfundsmodel, der grundlæggende hviler på tre interagerende søjler: En solid makroøkonomisk politik, et velreguleret arbejdsmarked og universelle offentlige velfærdsordninger. Artiklen giver et kort historisk overblik over politiske udviklingstræk inden for inden for de tre søjler og – med reference til de tre søjler - et bud på de velfærdsstatens udfordringer.
L’action communautaire, l’État et la collaboration partenariale au Québec
Authors: González Castillo Eduardo
Published: September 2023

Dans cet article, nous abordons les conséquences de la transformation néolibérale de l’État-providence pour les pratiques de collaboration dans l’action et l’intervention communautaire au Québec. Plus particulièrement, nous nous attardons aux obstacles qui se dégagent de l’approche néolibérale de la collaboration pour les pratiques d’organismes communautaires qui s’intéressent aux jeunes qui ont des difficultés de nature judiciaire. L’étude de cette question est réalisée à partir de l’approche gramscienne de l’hégémonie. Trois types d’obstacles sont décelés dans cet article : les obstacles concernent l’efficacité des pratiques d’intervention, ceux reliés au soutien économique de l’action communautaire et ceux relevant de la dimension déontologique. Dans les conclusions, nous soulignons l’importance de situer cette problématique dans le cadre du rapport Société civile-État.
Soutenir une personne aînée composant avec une problématique d’accumulation compulsive : regard sur les réalités vécues par les personnes proches aidantes
Authors: Moreau Annik , Dallaire Bernadette
Published: September 2023

La prévalence de la syllogomanie (ou trouble d’accumulation compulsive) est plus importante chez les personnes âgées de 55 ans et plus. Les proches qui soutiennent ces aînés exercent l’aidance dans un contexte où le vieillissement et le trouble mental sont en interaction. Peu d’études se sont intéressées à ce contexte spécifique de la proche aidance. Cette recherche visait à connaître les enjeux personnels et sociaux rencontrés par les personnes proches aidantes (PPA) des personnes accumulatrices. Nous avons fait appel à un devis qualitatif et recueilli les témoignages de 11 PPA de personnes aînées composant avec une problématique d’accumulation et de 8 intervenantes sociales au cours d’entretiens individuels. Les résultats indiquent que l’interaction du vieillissement et de ce trouble mental amène une charge importante pour les PPA et des inquiétudes spécifiques, ainsi que le développement de stratégies visant à préserver le « soi » dans leur cheminement et à travers l’aidance. Les travailleurs sociaux peuvent jouer un rôle clé pour favoriser le bien-être des PPA. Plus largement, il importe d’instaurer concrètement une « culture de la bientraitance » à l’égard des PPA dans nos sociétés.
Evolution of a functionally intact but antigenically distinct DENV fusion loop
Authors: Meganck Rita M , Zhu Deanna , Dong Stephanie , Snoderly-Foster Lisa J , Dalben Yago R , Thiono Devina , White Laura J , DeSilva Arivianda M , Baric Ralph S , Tse Longping V
Published: September 2023

A hallmark of dengue virus (DENV) pathogenesis is the potential for antibody-dependent enhancement, which is associated with deadly DENV secondary infection, complicates the identification of correlates of protection, and negatively impacts the safety and efficacy of DENV vaccines. Antibody-dependent enhancement is linked to antibodies targeting the fusion loop (FL) motif of the envelope protein, which is completely conserved in mosquito-borne flaviviruses and required for viral entry and fusion. In the current study, we utilized saturation mutagenesis and directed evolution to engineer a functional variant with a mutated FL (D2-FL), which is not neutralized by FL-targeting monoclonal antibodies. The FL mutations were combined with our previously evolved prM cleavage site to create a mature version of D2-FL (D2-FLM), which evades both prM- and FL-Abs but retains sensitivity to other type-specific and quaternary cross-reactive (CR) Abs. CR serum from heterotypic (DENV4)-infected non-human primates (NHP) showed lower neutralization titers against D2-FL and D2-FLM than isogenic wildtype DENV2 while similar neutralization titers were observed in serum from homotypic (DENV2)-infected NHP. We propose D2-FL and D2-FLM as valuable tools to delineate CR Ab subtypes in serum as well as an exciting platform for safer live-attenuated DENV vaccines suitable for naïve individuals and children.
Atypical peripheral actin band formation via overactivation of RhoA and nonmuscle myosin II in mitofusin 2-deficient cells
Authors: Wang Yueyang , Troughton Lee D , Xu Fan , Chatterjee Aritra , Ding Chang , Zhao Han , Cifuentes Laura P , Wagner Ryan B , Wang Tianqi , Tan Shelly , Chen Jingjuan , Li Linlin , Umulis David , Kuang Shihuan , Suter Daniel M , Yuan Chongli , Chan Deva , Huang Fang , Oakes Patrick W , Deng Qing
Published: September 2023

Cell spreading and migration play central roles in many physiological and pathophysiological processes. We have previously shown that MFN2 regulates the migration of human neutrophil-like cells via suppressing Rac activation. Here, we show that in mouse embryonic fibroblasts, MFN2 suppresses RhoA activation and supports cell polarization. After initial spreading, the wild-type cells polarize and migrate, whereas the Mfn2-/- cells maintain a circular shape. Increased cytosolic Ca2+ resulting from the loss of Mfn2 is directly responsible for this phenotype, which can be rescued by expressing an artificial tether to bring mitochondria and endoplasmic reticulum to close vicinity. Elevated cytosolic Ca2+ activates Ca2+/calmodulin-dependent protein kinase II, RhoA, and myosin light-chain kinase, causing an overactivation of nonmuscle myosin II, leading to a formation of a prominent F-actin ring at the cell periphery and increased cell contractility. The peripheral actin band alters cell physics and is dependent on substrate rigidity. Our results provide a novel molecular basis to understand how MFN2 regulates distinct signaling pathways in different cells and tissue environments, which is instrumental in understanding and treating MFN2-related diseases.
Distinctive whole-brain cell types predict tissue damage patterns in thirteen neurodegenerative conditions
Authors: Pak Veronika , Adewale Quadri , Bzdok Danilo , Dadar Mahsa , Zeighami Yashar , Iturria-Medina Yasser
Published: September 2023

For over a century, brain research narrative has mainly centered on neuron cells. Accordingly, most neurodegenerative studies focus on neuronal dysfunction and their selective vulnerability, while we lack comprehensive analyses of other major cell types’ contribution. By unifying spatial gene expression, structural MRI, and cell deconvolution, here we describe how the human brain distribution of canonical cell types extensively predicts tissue damage in 13 neurodegenerative conditions, including early- and late-onset Alzheimer’s disease, Parkinson’s disease, dementia with Lewy bodies, amyotrophic lateral sclerosis, mutations in presenilin-1, and 3 clinical variants of frontotemporal lobar degeneration (behavioral variant, semantic and non-fluent primary progressive aphasia) along with associated three-repeat and four-repeat tauopathies and TDP43 proteinopathies types A and C. We reconstructed comprehensive whole-brain reference maps of cellular abundance for six major cell types and identified characteristic axes of spatial overlapping with atrophy. Our results support the strong mediating role of non-neuronal cells, primarily microglia and astrocytes, in spatial vulnerability to tissue loss in neurodegeneration, with distinct and shared across-disorder pathomechanisms. These observations provide critical insights into the multicellular pathophysiology underlying spatiotemporal advance in neurodegeneration. Notably, they also emphasize the need to exceed the current neuro-centric view of brain diseases, supporting the imperative for cell-specific therapeutic targets in neurodegeneration.
avidaR: an R library to perform complex queries on an ontology-based database of digital organisms
Authors: Ortega Raúl , Fortuna Miguel Angel
Published: September 2023

Digital evolution is a branch of artificial life in which self-replicating computer programs—digital organisms—mutate and evolve within a user-defined computational environment. In spite of its value in biology, we still lack an up-to-date and comprehensive database on digital organisms resulting from evolution experiments. Therefore, we have developed an ontology-based semantic database—avidaDB—and an R package—avidaR—that provides users of the R programming language with an easy-to-use tool for performing complex queries without specific knowledge of SPARQL or RDF. avidaR can be used to do research on robustness, evolvability, complexity, phenotypic plasticity, gene regulatory networks, and genomic architecture by retrieving the genomes, phenotypes, and transcriptomes of more than a million digital organisms available on avidaDB. avidaR is already accepted on CRAN (i.e., a comprehensive collection of R packages contributed by the R community) and will make biologists better equipped to embrace the field of digital evolution.