bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Forecast of the Development of the Eurasian Economic Union
Authors: Pirimbaev Jusup , Kamalov Zalkar
Published: November 2019

The course of economic integration within the framework of the EAEU is proceeding according to a plan outlined in a document on the Union’s development forecast until 2030, when first three countries were members of the EAEU - Russia, Kazakhstan and Belarus. Later, two more countries joined the union - Armenia and Kyrgyzstan. Then based on the real situation, additional adjustments were made. Many problems remain that need to be solved precisely in the field of integration, which, on the one hand, cause the need for an accelerated approach, and on the other, raise doubts about the prospects of this alliance. The article is aimed to study the causes of disputes, identifying factors contributing to the unification of participants, and developing an objective vision of the Union’s development prospects. And also, based on the analysis of today’s relationships among the members of the Eurasian Economic Union, appropriate conclusions and recommendations will be made for further relationship improvement by considering the perspectives of voluntary joining of other countries into the Eurasian Economic Union.
Competitive Strategy Analysis from Entrepreneurship Stories
Authors: Eroğlu Şeyma Gün , İrmiş Ayşe
Published: November 2019

Organizations apply two basic competitive strategies in general. These are the cost leadership strategy and the differentiation strategy. The application of any of the mentioned strategies by focusing on a smaller field in the market is called a focus strategy. Companies gain value in the eyes of customer with the strategy they choose.
The aim of this study is to analyze the competitive strategies applied by the enterprises and the results of these strategies. A semi-configured interview on the entrepreneurs of two firms which open to a wider market from local market in Denizli with their own brands, was conducted. The first enterprise, which has been maintaining its existence for 80 years and has many branches in the different provinces, is a firm producing sugar and sugar products (Firm A). The second, which has been maintaining its existence for 84 years and has branches in close neighbor cities and provinces, is a firm producing soft drinks (Firm B).
The common feature of both firms is that they keep their local characteristics and take their competitive power from the local people. In the research, the competitive strategies of entrepreneurs have been defined and analyzed by benefiting from the entrepreneurship stories that have been brought up to the present day. It was concluded that firm A applied differentiation strategy in the product, production process, and market, while firm B differentiated in the production process without any differentiation in the product and used the focus strategy in the market.
The Long-Run and Short-Run Endogeneity of Money Supply in the Republic of Macedonia: An Empirical Analysis
Authors: Milosheska Gavrovska Milica , Slaveski Trajko
Published: November 2019

The aim of this paper is to assess the endogenous and exogenous approaches on the money creation process on empirical grounds, through analysis in the case of the Republic of Macedonia.
Using the ARDL econometric model, it has been determined that the money supply in the Republic of Macedonia in the period January 2003 - August 2018 is endogenously determined in the long run. The empirical results in the short term show bidirectional causality between deposits and monetary base, as well as between deposits and loans.
However, in the end, the central bank in the Republic of Macedonia has an influence on the money supply. The exogenous monetary policies based on money supply control, can positively influence the amount of liquidity held by commercial banks and, hence, increase the supply of loans, but the demand for loans is still important when stimulating the entry of liquidity in the real economy.
Asset Management Companies and the Place in the Turkish Economy
Authors: Artekin Ayşe Özge , Soydal Haldun
Published: November 2019

With the crisis that started in our country in 2000s, those who owe the bank could not complete their payment obligations, the collection process was damaged and thus the number of problematic loans increased. However, as a result of structural deterioration, bank mergers were experienced, banks' capital was strengthened and many of them were seized by TMSF. This situation has created a distrust of the banking system. In order to change the negative perception, problematic loans which prevent the flow of funds should be solved. At this stage, Asset Management Company has become a need and started to operate in the financial markets of our country. The Asset Management Companies were established in the 1930s to solve the financial problems arising from the global economic crisis. Nowadays, these companies are formed according to the needs and shortcomings and become legal institutions which are effective in eliminating the negative effects of problem loans on banks.
In this study; the effects of problem loans, solutions, the process of emergence of companies in the world and in our country, its importance, aims, types, positive and negative aspects of banks and credit customers are examined. As a method of the study, domestic and foreign literature has been utilized and as a result of the study, it has been concluded that this problem has a positive effect on credit customers and banking system upon the transfer of problem loans to asset management companies.
Panel Estimation for the Relationship between Real Wage, Inflation and Labor Productivity for OECD Countries
Authors: Konya Sevilay , Karaçor Zeynep , Küçüksucu Mücahide
Published: November 2019

There are studies examining the relationship between real wage, inflation and labor productivity in the economic literature. Increase in real wages causes to an increase in labor productivity. On the other hand, productivity increases also induce inflation to fall. Therefore, the aim of this study is to investigate the relationship between real wage, inflation and labor productivity in the 22 OECD countries (Australia, Belgium, Canada, Chile, Czech Republic, France, Greece, Hungary, Japan, Korea, Latvia, Luxembourg, Mexico, Netherlands, New Zealand, Poland, Portugal, Slovak Republic, Slovenia, Spain, Turkey, United States) in the period of 1995-2017 by panel data methods. According to results, the cointegration relationship between real wage, inflation and labor productivity was found. In addition, mutual causality was determined between the variables we discussed.
The Relationship Between Inflation and Nominal Interest Rate: Case of Selected Countries
Authors: Bal Harun , Erdoğan Esma , Palandökenlier Berk
Published: November 2019

When the empirical studies in the literature on inflation and interest relation are examined, it can be seen that a positive or negative change in one of these two variables has a significant effect on the other variable. This situation reveals the necessity of evaluating the relationship between variables within the framework of cause and effect. In this study, the relationship between inflation, interest rates, showing similar macroeconomic structures Turkey, Indonesia and Brazil the country for the period 1985-2018 using annual data sets separately for each country were explained by the VAR model. The results showed only right way for Turkey to reciprocate the nominal rate of inflation variables for Indonesia and Brazil were found bidirectional causality between countries.
Evaluation of Hotel Websites Using Content Analysis: A Study in Bishkek
Authors: Maksüdünov Azamat
Published: November 2019

With the rapid expansion of the internet corporate websites are becoming an important tool of communication with target markets. The target markets of the hotels go beyond the borders of the country and can be anywhere in the world. Effective use of the corporate web sites is an important factor that affects the success of hotel enterprises in the competitive environment. In this context, the main purpose of this study is to evaluate hotels’ web sites in Bishkek and to reveal the situation in terms of characteristics that should be in their web pages. A total of 30 hotel websites have been reviewed. Data was obtained from hotel web sites using an evaluation form. Percentage and frequency techniques were applied to analyze the data and results are given by hotel types (three or four stars). According to the results, it was found that hotels’ web sites are not sufficient in terms of required features and both three and four star hotels demonstrate same performance. In particular, it can be said that the hotel web sites are very poor in terms of information about the destination. Hotels should benefit from the results of academic studies and, if necessary, to conduct their own researches in order to have an effective web sites.
Testing The Validity of The Phillips Curve for Turkey With Vector Autoregressive and Markov Switching Models on The Basis of Inflation and Unemployment
Authors: Yılmaz Fatih , Şeker Onur , Pektaş Eren
Published: November 2019

In this study, we tested the validity of the Phillips Curve for Turkey. We used Markov Switching Model for examine the relationship between two variables in different regime periods, Engle Granger Causality Test for detect the causality between two variables, Johansen Cointegration Test for observe the long term equilibrium relationship and The Impulse Response Analysis and Variance Decomposition Analysis for investigate the explanatory effect of two variables on each other. As a result of the analysis, it was determined that Inflation and Unemployment act together in the short and long term. Between 2010M01 and 2017M10, it was determined that the Phillips Curve is ineffective for Turkey.
PENGARUH PENYULUHAN PROGRAM PERENCANAAN PERSALINAN DAN PENCEGAHAN KOMPLIKASI (P4K) TERHADAP SIKAP IBU HAMIL DALAM PENCEGAHAN KOMPLIKASI KEHAMILAN DI DESA KENANGA KAB. INDRAMAYU TAHUN 2016
Authors: . Dartiwen
Published: November 2019

Pelaksanaan program P4K dipengaruhi beberapa faktor diantaranya pengetahuan, dukungan keluarga, situasi geografis dan budaya. Kurangnya pengetahuan baik ibu hamil atau masyarakat tentang pencegahan komplikasi kehamilan mempengaruhi rendahnya cakupan P4K. Dengan rendahnya pengetahuan ibu hamil dan masyarakat tentang pentingnya pencegahan komplikasi kehamilan maka kesadaran akan pentingnya manfaat P4K juga rendah. Penelitian ini bertujuan untuk mengetahui pengaruh penyuluhan tentang P4K terhadap upaya pencegahan komplikasi pada ibu hamil di Desa Kenanga Kabupaten Indramayu periode Januari-Mei 2016. Metode penelitian yang digunakan dalam penelitian ini adalah rancangan pre eksperimen one group pretest-posttest design dengan populasi dan sampel seluruh ibu hamil di Desa Kenanga sebanyak 34 orang. Analisis data menggunakan uji Wilcoxon. Instrument penelitian menggunakan kuesioner. Hasil penelitian menunjukkan bahwa sikap ibu hamil dengan kategori baik sebelum diberikan penyuluhan 10 orang (29,41%), setelah diberikan penyuluhan 28 orang (82,35%). Sikap ibu hamil dengan kategori cukup sebelum diberikan penyuluhan 4 orang (11,76%) setelah diberikan penyuluhan 6 orang (17,65). Sikap ibu hamil dengan kategori kurang sebelum diberikan penyuluhan 20 orang (58,83%) setelah diberi penyuluhan tidak ada responden dengan kategori kurang (0%). Ada pengaruh penyuluhan tentang P4K terhadap upaya pencegahan komplikasi pada ibu hamil. Penyuluhan yang diberikan telah mampu memberikan pengetahuan maupun informasi tentang P4K sehingga diharapkan ibu hamil dapat meningkatkan kesadaran dan kewaspadaan dalam melakukan upayaupaya untukmencegah terjadinya komplikasi kehamilan dan persalinan. Kata kunci : Penyuluhan P4K, Sikap, Upaya pencegahan komplikasi
EFEKTIVITAS PEMBERIAN BIJI RAMI TERHADAP NYERI SENDI PADA WANITA MENOPOUSE
Authors: Lusiana Arum , Sumarni Sri , Ayuningtyas Ayuningtyas
Published: November 2019

Menopause merupakan masa yang pasti dihadapi dalam perjalanan hidup seorang perempuan dan suatu proses alamiah sejalan dengan bertambahnya usia. Data laporan Riskesdas 2013 menyebutkan bahwa persentase kejadian lansia yang menderita penyakit sendi di Indonesia adalah 24,7%. Pada wanita lansia prevalensi yang didiagnosis nakes lebih tinggi pada perempuan (13,4%) dibanding laki-laki (10,3%) demikian juga yang didiagnosis nakes atau gejala pada perempuan(27,5%) lebih tinggi dari laki-laki (21,8%). Data tersebut menunjukkan bahwa wanita lansia dominan mengalami nyeri sendi dari pada pria lansia dan persentase lansia yang mengalami penyakit sendi berdasarkan diagnosis dan gejalanya di Jawa Tengah adalah 11,2%.

Desain penelitian yang digunakan adalah Experiment yaitu Quasi Experiment dengan desain One group pre test-post test design. Jumlah sampel sebanyak 109 orang yang terdiri atas 55 orang menkonsumsi biji rami dan 50 orang tidak mengkonsumsi biji rami. Analisis data dilakukan dalam dua tahapan yaitu analisis univariat, bivariat, dengan bantuan software SPSS.

Hasil penelitian menunjukkan terdapat perbedaan rata-rata nyeri sendi pada wanita menopause yang mengkonsumsi biji rami dan tidak mengkonsumsi biji rami. Nyeri sendi wanita yang mengkonsumsi biji rami lebih rendah dibandingkan yang tidak mengkonsumi biji rami.

Dari hasil penelitian disimpulkan bahwa terdapat pengaruh konsumsi biji rami terhadap nyeri sendi pada wanita menopause.
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN GAGAL GINJAL KRONIK PADA PASIEN USIA < 45 TAHUN DI RUANG HEMODIALISA RSUD INDRAMAYU
Authors: . Wayunah , Puspitasari Neneng Ratnanengsih , Jannah Fatikhatul
Published: November 2019

Gagal ginjal kronik merupakan suatu kondisi dimana ginjal mengalami penurunan fungsi yang terjadi secara progresif dan irreversible. Banyak faktor yang dapat menyebabkan GGK pada pasien usia < 45 tahun. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan kejadian GGK pada pasien usia < 45 tahun. Penelitian ini dilakukan dengan pendekatan case study. Sampel dipilih dengan tekhnik counsecutive sampling, dengan jumlah 98 responden. Alat pengumpul data dalam penelitian ini menggunakan kuesioner. Analisis data bivariat yang digunakan dalam penelitian ini adalah uji chi square. Hasil penelitian diketahui faktor yang berhubungan adalah faktor riwayat penyakit diabetes mellitus (p value = 0,002). Sedangkan faktor yang tidak berhubungan adalah faktor zat kimia (p value = 0,295), faktor kurang asupan cairan (p value = 0,366), faktor riwayat hipertensi (p value = 0,518) dan faktor riwayat obstruksi saluran kemih (p value = 0,312). Simpulan dalam penelitian ini faktor yang berhubungan adalah diabates mellitus dan faktor yang tidak berhubungan adalah konsumsi zat kimia, kurang asupan cairan, riwayat penyakit hipertensi dan riwayat penyakit obstruksi saluran kemih. Saran dalam penelitian ini ditujukan kepada perawat untuk meningkatkan edukasi kepada masyarakat tentang pencegahan terjadinya GGK.

Abstrak

Chronic Renal Failure is a condition that decreasing kidney function, occurning progresive and irreversible. Many factors causes CRF in patiens aged < 45 years. Purpose of this study was to determine the factors associated with the occurrence of CRF in patiens age < 45 years.This research was conducted with case study approach. Samples selected with counsecutive technique sampling with 98 respondents. Data collection, this study using a questionnaire. The bivariae data analysis used in this study is the chi square test. The results is known factors associacted with in a diabetes mellitus of history factor (p value = 0,002) while factor unrelated chemical substances is a factor ( p value = 0,925), less intake of fluids factor (p value = 0,366), hypertension of history factor ( p value = 0,518) and history of obstruction of tract urinary factor (p value = 0,312).

Conclusions in this research that there is a relationship between the factors of history of diabetes mellitus with chronic renal failure event in patients aged < 45 years. Suggestions in this study was shown to the nurse to increase public education about the prevention of the occurance of CRF.
HUBUNGAN MOTIVASI DENGAN KEPATUHAN PERAWAT DALAM PRAKTIK KEBERSIHAN TANGAN DI RUANG BEDAH RSUD KABUPATEN INDRAMAYU
Authors: Saefulloh Muhammad , Sugiarto Heri , Suwanto Suwanto
Published: November 2019

ABSTRAK

Menjaga kebersihan tangan merupakan upaya pencegahan infeksi nosokomial yang ditularkan melalui tangan. Penelitian ini bertujuan untuk mengetahui hubungan antara motivasi dengan kepatuhan perawat dalam praktik kebersihan tangan di ruang Bedah RSUD Indramayu Tahun 2017.

Metode Penelitian ini merupakan penelitian survei analitik dengan pendekatan cross sectional. Sampel penelitian ini sebanyak 30 perawat yang bekerja di ruang Bedah RSUD Kabupaten Indramayu. Alat pengumpulan data menggunakan kuesioner.

Berdasarkan hasil penelitian diketahui motivasi tinggi sebanyak 66,7%. Dan kepatuhan perawat dengan kategori patuh sebesar 90,0%. Hasil analisis bivariat menunjukan p-value sebesar 0,03 dan Î± = 0,05 yang berarti ada hubungan antara motivasi dengan kepatuhan perawat dalam praktik kebersihan tangan di ruang Bedah RSUD Kabupaten Indramayu tahun 2017 (p-value 0,03, Î± = 0,05).

Saran dari penelitian ini adalah perawat dipaparkan untuk menjaga kebersihan tangan dan meningkatkan ketaatan kebersihan tangan untuk mengurangi infeksi nosokomial

Kata Kunci : Kebersihan tangan, motivasi, kepatuhan

ABSTRACT

Keeping hand hygiene will prevent the nosocomial infection that is transmitted by hand. The objective of this study is to find the correlation between motivation towards nurses obedience in implementing hand hygiene at Surgery care room RSUD Kabupaten Indramayu year 2017.

The study used correlation methode with Crossectional approach. The sample were 30 nurses in Surgery care room RSUD Kabupaten Indramayu. The instrument used questioner. The data was analized by Chi square.

The correlation showed that high motivation is 66,7%. Nurse compliance in hand hygiene practice as much as 90,0%. Bivariate analize showed that there is a correlation between motivation towards nurse obedience in implementing hand hygiene at Surgery care room RSUD Kabupaten Indramayu should be 2017 (p-value 0.03, Î± = 0.05)

Suggestion from this study are nurses exposed to maintain hand hygiene and improve hand hygiene compliance to reduce nosocomial infections.

Keywords : Hand Hygiene, Motivation, Obedience.
IMPACT OF WORKPLACE ENVIRONMENT ON EMPLOYEE PERFORMANCE: MEDIATING ROLE OF EMPLOYEE HEALTH
Authors: Hafee Iqra , Yingjun Zhu , Hafeez Saba , Mansoor Rafiq , Rehman Khaliq Ur
Published: November 2019

Purpose – Purpose of current study is to explore, impact of workplace environment i.e Physical Environmental Factors and Behavioral Environmental Factors on employee productivity (EP) through mediating role of employee health (EH).

Research methodology – This study adopted questionnaire survey method and data was collected from 250 employees working in software houses in Pakistan. Data has been analysed using SPSS and AMOS software. Reliability and correlation analysis was performed by using SPSS while; path analysis was performed using AMOS.

Findings – Results revealed that one unit variance in PEF incorporates 35% change in EH, 33% change in EH is caused by one unit increase in BEF and one unit increase in EH leads to 80% increase in EP. Physical and Behavioural Environmental Factors are positively affecting EH and EH is positivity affecting EP. Results of the study revealed that: employee health is mediating the relationship between workplace environment factors and employee performance.

Research limitations – We used working Environment factors to determine employee health; future studies can consider compensation practices, insurance plans and health benefits by the organisation, a large sample or increased number of mediating variables can be used. The current study has adopted cross-sectional design while future studies can consider longitudinal design.

Practical implications – Organisations must maintain a better environment in order to enhance employee productivity as, employee performance and workplace environment have direct and positive relationship, employees productivity and physical as well as behavioural environment are linked through employee health.
WAVE-INDUCED LOADS ON CROSS-DECK OF A WAVE-PIERCING TRIMARAN WITH DIFFERENT HULL FORMS OF OUTRIGGERS
Authors: Askarian Khoob Abolfath , Ketabdari Mohammad Javad
Published: November 2019

Trimaran has unique hull form with a rapidly growth in recent years due to its application as a mode of transports and naval vessels. Designing trimaran faces many technical challenges because of its complex structural outlines and high-speeds operation. This article investigates the influence of side hulls configuration (symmetric, inboard and outboard types) for wave loads on cross-deck of a trimaran ship when advancing at sea in regular waves. The computation of these hydrodynamic forces is carried out using MAESTRO-Wave 3D panel method code. This code is based on potential flow theory that uses Green’s function with the forward speed correction in the frequency domain. The results demonstrate that the outboard side hull form has the best performance on wave-induced load among three kinds of side hull forms. Furthermore, the results of this study offer more information for selecting the side hull form of the trimaran.
Prevalence of Depression and Its Associated Risk Factors among Young Adult Patients Attending the Primary Health Centers in Tabuk, Saudi Arabia
Authors: Mohsen Al Balawi Maram , Faraj Fatma , Al Anazi Bashayer D. , Al Balawi Dana Mohsen
Published: November 2019

BACKGROUND: The number of young depressive patients approaching the primary health care centres in Saudi Arabia for supportive care and treatment has enormously increased, but more cases of depression are not being diagnosed properly at the primary health care level.
AIM: To assess the prevalence and associated factors of depression among young adult patients attending the primary health centres in Tabuk, Kingdom of Saudi Arabia.
METHODS: A cross-sectional study was done in selected primary health care centres in Tabuk city from March 2018 to June 2018. Patient Health Questionnaire- PHQ-2 and PHQ-9 and a modified questionnaire were used to collect the necessary information and data were analysed by using SPSS (Version 25.0, SPSS Inc. Chicago, IL, USA).
RESULTS: The study included 384 patients aged between 20 and 40 years. Most of them (76.6%) were females. The prevalence of depression was 74%; mild among 37.8%, moderate among 20.8% whereas moderately severe to severe among 15.4% of them. Multivariate logistic regression analysis revealed that married patients were at lower risk for depression (Adjusted odds ratio “AOR” was 0.36, 95% confidence interval “CI” was 0.20-0.93), p < 0.001. Patients who reported a lack of social support were more likely to be depressed than those with social support (AOR = 2.05, 95% CI = 1.03-4.07), p = 0.041. Patients who reported disturbed marriage were at almost four-folded risk of depression compared to those without disturbed marriage (AOR = 3.50, 95% CI = 1.23-9.98), p = 0.019. Patients with financial problems were at almost double risk for developing depression compared to those without financial problems (AOR = 2.37, 95% CI = 1.16-4.85), p = 0.019. Those with stressful experience were significantly more likely to have depression compared to those without stressful experience (AOR = 4.75, 95% CI = 2.58-8.71), p < 0.001. Opposed to patients without a family history of depression, those with such history were at higher significant risk for depression (AOR = 2.75, 95% CI = 1.23-6.14), p = 0.014. Also, patients who reported sleep disorders were at nearly double folds of having depression compared to those without such disorders (AOR = 2.24, 95% CI = 1.16-4.30), p = 0.016.
CONCLUSION: Depression among young adult patients (20-40 years) attending primary healthcare centres in Tabuk is very high. However, it is mostly mild to moderate in its severity. Suicidal thoughts were reported by one-tenth of the participants. Some predictors for depression among them were identified.
L’anxiété, la détresse et la douleur ressentie lors de l’examen anogénital chez les enfants présumés victimes d’agression sexuelle
Authors: Guertin Valérie , Cyr Mireille , Hébert Martine
Published: November 2019

Les données empiriques concernant les effets de l’examen anogénital à la suite du dévoilement d’une agression sexuelle chez les enfants sont peu nombreuses et contradictoires. L’objectif de cette étude est de documenter l’état émotionnel de l’enfant présumé victime et celui de son parent lors de la visite médicale, ainsi que les facteurs qui pourraient être liés aux niveaux d’anxiété, de détresse et de douleur ressentis par l’enfant. L’échantillon, composé de 55 enfants âgés entre 6 et 12 ans et leurs parents, est réparti en deux groupes, soit 37 enfants présumés victimes et 18 enfants non-victimes ayant consulté pour des infections urinaires. Les résultats des tests statistiques chi-carré et test-t indiquent, contrairement à ce qui était attendu, qu’il n’y a aucune différence significative du niveau d’anxiété ressenti entre les enfants présumés victimes et non-victimes et entre les enfants en général et leur parent. De plus, le niveau de connaissance par rapport à l’examen anogénital n’influence pas le niveau d’anxiété ressenti par l’enfant et le parent, ainsi que le niveau de détresse de l’enfant. Finalement, aucun lien n’a été trouvé entre l’anxiété ressentie par l’enfant avant l’examen et le niveau de douleur rapporté durant celui-ci. Afin d’obtenir un portrait des participants quant aux antécédents médicaux, ainsi qu’aux caractéristiques de l’examen médical, diverses analyses statistiques exploratoires ont été effectuées. Les résultats confirment ceux d’autres études indiquant que les enfants présumés victimes d’agression sexuelle ne ressentent pas plus d’anxiété, de détresse (score total) et de douleur que les enfants non-victimes lors de l’examen.
Outpatient Versus Rapid Recovery Inpatient Knee Arthroplasty: Comparison of Matched Cohorts
Authors: Kimball Chloe C. , Nichols Christine I. , Vose Joshua G.
Published: November 2019

Increased focus on reducing the cost of total knee arthroplasty (TKA) has driven greater interest in performing the procedure in an outpatient setting. This study used exact matching to compare clinical and economic outcomes following TKA in an outpatient vs rapid recovery inpatient setting. This study used a nationally representative commercial database. Patients were grouped into 2 cohorts: same-day outpatient TKA (surgery center or hospital outpatient) or short-stay inpatient TKA (“rapid recovery”; length of stay 1 day or less). Only patients discharged home under self-care or with health care were included. Exact 1:1 matching was performed on clinical and demographic characteristics to control for potential case-selection bias by choice of care setting. Prior to matching, 969 outpatients and 8101 rapid recovery inpatients met selection criteria. The outpatient cohort was younger (median age, 58 vs 61 years), predominantly female (56% vs 51%), and less comorbid (Charlson Comorbidity Index score of 0: 84.2% vs 74.0%) vs the rapid recovery cohort. Post-match, 863 patients were available in each cohort. The outpatient cohort exhibited a significantly lower incidence of opiate use (80.4% vs 90.7%;
P
<.001) and minor complications (2.8% vs 5.8%;
P
=.002). Incidence of major complications (5.2% vs 6.7%,
P
=.173) and 90-day readmissions (5.1% vs 7.3%,
P
=.064) were equivalent. The outpatient median 90-day episode payment was $6824 lower (22%) per patient ($24,749 vs $31,573, respectively;
P
<.001). This study suggests that among carefully selected patients undergoing outpatient TKA, outcomes are equivalent, if not improved, at a lower payor cost compared with a rapid recovery inpatient setting. [
Orthopedics
. 2020; 43(1):36–41.]
The Influence of Mentors in Orthopedic Surgery
Authors: Brook Emily M. , Hu Caroline H. , Li Xinning , Smith Eric L. , Matzkin Elizabeth G.
Published: November 2019

The importance of mentorship in medicine has been established. However, little is known regarding the influence of mentors in orthopedic surgery. This study sought to (1) determine the prevalence of mentoring relationships in orthopedic surgery, (2) assess the influence of mentors in specialty and subspecialty selection, and (3) evaluate the importance of gender in orthopedic mentoring relationships. An electronic survey was distributed to 358 orthopedic surgeons at academic residency programs. Participants were asked to report mentoring relationships and their attitudes toward mentors, including gender preferences. A total of 117 (95 males and 22 females) surveys were returned. The majority of respondents (66.7%, n=78) had at least one mentor in their career, and the majority of respondents (66.7%, n=52) were satisfied with their mentoring experience. Residency was the most common time to have a mentor, and 73.3% (n=44) of respondents indicated their mentor was influential in determining their subspecialty. Although only 50% of respondents indicated they had a mentor in medical school, 84.2% (n=32) believed their mentor was influential in selecting an orthopedic surgery residency. The majority (79.4%, n=62) of respondents did not have a preference on the gender of their mentor. Many orthopedic surgeons have a mentor at some point in their career who influenced their specialty or subspecialty decision. Mentoring experiences are less prevalent in medical school, and female medical students may lack accessibility to mentoring opportunities. Future efforts should focus on opportunities that connect medical students to orthopedic surgery faculty to further diversify the field and close the gender gap. [
Orthopedics
. 2020; 43(1):e37–e42.]
Reproducing the Native Posterior Tibial Slope in Cruciate-Retaining Total Knee Arthroplasty: Technique and Clinical Implications
Authors: Howard James L. , Morcos Mina W. , Lanting Brent A. , Somerville Lyndsay E. , McAuley James P.
Published: November 2019

Total knee arthroplasty (TKA) profoundly influences knee biomechanics. Using an arbitrary (often 3° to 5°) posterior tibial slope (PTS) in all cases seldom will restore native slope. This study examined whether the native PTS could be reproduced in cruciate-retaining TKA and how this would influence clinical outcome. Radiographic and clinical outcomes of 215 consecutive TKAs using the PFC sigma cruciate-retaining implant were evaluated. The tibial bone cut was planned to be made parallel to the native anatomical slope in the sagittal plane. The PTS was measured with reference to the proximal tibial medullary canal (PTS-M) and the proximal tibial anterior cortex (PTS-C) on true lateral radiographs using a picture achieving and communication system. Knee range of motion (ROM), Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form Health Survey (SF-12) were evaluated. Mean preoperative PTS-M was 6.9°±3.3°, and mean postoperative PTS-M was 7.0°±2.4°. Mean preoperative PTS-C was 12.2°±4.2°, and mean postoperative PTS-C was 12.6°±3.4°. Preoperative and postoperative PTS were not significantly different for both techniques (
P
>.05). An arbitrary 3° as an acceptable range for PTS-M was achieved in 144 knees (67%) (group 1), and 71 knees (33%) had a difference of more than 3° (group 2). Group 1 had a significantly larger gain in ROM (
P
=.04) as well as improved Knee Society, WOMAC, and SF-12 physical scores compared with group 2 (
P
<.01). The modified surgical technique reproduced the native tibial slope in cruciate-retaining TKA. Reproduction of the native PTS within 3° resulted in better clinical outcomes manifested by gain in ROM and knee functional outcome scores. [
Orthopedics
. 2020; 43(1):e21–e26.]
Puig Castellar de Biosca (Lleida). Una fortificación romana del siglo II a. C. En el noreste de la Hispania Citerior
Authors: Pera Isern Joaquim , Rodrigo Requena Esther , Romaní Sala Núria , Carreras Monfort César
Published: November 2019

Las recientes excavaciones arqueológicas efectuadas en el cerro de Puig Castellar de Biosca (Lleida) han dejado al descubierto los vestigios de un establecimiento militar romano, tipo castellum, singular por sus características tipológicas y su temprana cronología en el marco hispánico. El asentamiento muestra un amplio dominio visual sobre el territorio inmediato; está delimitado por una muralla defensiva con torres. En su interior destaca un gran edificio, erigido en el punto más elevado del recinto, que muestra varias dependencias distribuidas en torno a un patio central que a su vez dispone de una gran cisterna excavada en la roca. También se han localizado algunas dependencias auxiliares cerca del edificio principal y otras adosadas a la cara interna de la muralla, así como una zona con gran actividad metalúrgica de hierro. La gran cantidad de material cerámico recuperado, sobre todo de importación, con un horizonte cronológico bien definido entre el 180 y el 120 a. C., así como las técnicas constructivas y decorativas identificadas en los edificios, nos permiten afirmar que se trata de un complejo militar y administrativo de los primeros decenios de la conquista romana de Hispania.
Nuevas e ignoradas noticias sobre la Kâhina y la conquista árabe del África bizantina: de reina de los bereberes a reina de los romanos
Authors: Soto Chica José , García Amorós Maila
Published: November 2019

El sometimiento del África bizantina por los ejércitos omeyas tiene su eje central en los relatos, cargados de leyenda y a menudo contradictorios, de la llamada «Guerra de la Kâhina». Esta misteriosa mujer, supuesta reina de una tribu bereber del monte Aurés, ha condicionado los intentos de la historiografía contemporánea por establecer un relato coherente desde el punto de vista cronológico, militar y cultural, de la definitiva conquista árabe del África bizantina. El objetivo de este trabajo es poner en valor el texto más antiguo sobre la Kâhina, la Crónica de los árabes, recogido en la obra de Elías de Nísibe. Esto nos permitirá contextualizar adecuadamente a la mítica Kâhina y enmarcar su resistencia a la expansión islámica en un plano plenamente histórico, determinado por la resistencia bizantina ante la expansión árabe por el control del norte de África.
Une frontière n’est pas une frontière est une frontière
Authors: Olivier Florence
Published: November 2019

L’imaginaire littéraire lié à la frontière nord du Mexique s’est vu amplifié et métamorphosé dans la création littéraire récente, tout particulièrement depuis la signature initiale de l’Accord de libre-échange nord-américain, de l’essor du narcotrafic, de l’accélération des processus migratoires. Depuis le début des années 1990, la rapidité des changements économiques, sociaux, démographiques, l’hybridité culturelle des régions frontalières ont suscité, aux côtés d’études de sciences sociales, l’écriture de récits eux-mêmes hybrides qui tentent de répondre aux défis d’une réalité contemporaine dynamique, complexe et violente : nouvelles sous forme de scénarii télévisuels (Luis Humberto Crosthwaite), nouvelles composant un roman kaléidoscopique (Carlos Fuentes), chronique élégiaque du crime (Sergio González Rodríguez), roman rythmique de l’horreur (Roberto Bolaño), fable initiatique (Yuri Herrera). La frontière, terra incognita et carte du futur, condense les traits d’un nouvel espace littéraire, mythique et poétique quoique non dépourvu de réalisme. Elle devient la métaphore du territoire de l’exploration littéraire.
La côte Atlantique dans le roman nicaraguayen ou les enjeux d’une frontière
Authors: Besse Nathalie
Published: November 2019

Au Nicaragua, la côte Caraïbe ou côte Atlantique trace une frontière saturée de questions identitaires ainsi qu’en témoignent les quelques romans qui s’intéressent à l’histoire de cette région. «El Reino Moskito» (La novela de la Costa Atlántica) (1991) de Bayardo Tijerino Molina remémore l’intégration forcée des ethnies locales sous l’ère sandiniste au nom de l’unité nationale et, en réaction à l’autoritarisme du pouvoir central, la contestation de différents groupes indigènes revendiquant leur autonomie. Columpio al aire (1999) de Lizandro Chávez Alfaro dénonce lui aussi un pouvoir arbitraire face auquel l’autre pose une limite en termes de légitimité ou de droit, lorsqu’il relate le moment historique qui a vu la région de la Miskitia être incorporée à l’État nicaraguayen en 1894.Il s’agira de montrer comment la frontière qui sépare la côte Atlantique et la côte Pacifique s’avère d’abord une frontière géographique et culturelle, cause et effet d’une profonde conflictualité, puis comment elle se constitue en frontière politique opposant à l’altérité une unité nationale. C’est également une frontière historique et mémorielle qui se dessine lorsqu’elle pose la question de la légitimité de l’espace autre, et dans le même temps discursive, indissociable de la confrontation des points de vue.
Une tragédie frontalière : La Frontera de David Cureses ou l’inversion du topique de la captive
Authors: Larrue Christophe
Published: November 2019

Le dramaturge argentin David Cureses crée en 1960 la pièce La frontera, adaptation de la Médée d’Euripide qu’il situe sur la frontière (intérieure) au xixe siècle. Le mythe grec y est utilisé pour structurer des motifs argentins du XIXe siècle bien connus comme l’opposition entre civilisation et barbarie, le personnage de la captive, les relations entre Indiens et créoles ou la conquête du désert. Cette dernière provoque sous nos yeux l’éclatement brutal d’une famille mixte (indienne et créole) jusqu’à la catastrophe finale faite de sang et d’exil et c’est paradoxalement la perspective de l’abolition de la frontière qui signe la séparation des communautés. Nous nous interrogerons sur ce qu’apporte cette réécriture quant à la représentation de l’imaginaire de la frontière et sur la résonance qu’elle peut avoir en plein xxe et xxie siècles.
El Taller de Lectura y Escritura y Ciudad Juárez
Authors: Estrada Guevara Ángela
Published: November 2019

El Taller de Lectura y Escritura (TLE) se ofrece desde enero de 2001 en la Biblioteca Carlos Montemayor de la Universidad Autónoma de Ciudad Juárez, Chihuahua, México y otros espacios de la ciudad como alternativa a la frustración y deserción escolar de quienes, por distintas razones experimentan situaciones (Sartre, 1973) y fronteras múltiples en su vida cotidiana (Heller, 1977): étnicas y lingüísticas; de clase social, género y edad; enfermedad y discapacidad, entre otras. Planteamos los propósitos y principios pedagógicos con los que trabajamos, poniendo en el centro la escucha activa y el respeto a la dignidad de las personas para ejercitar el pensamiento, la autonomía y la comunicación para el diálogo (Freire, 2010). Experimentamos la voz propia y colectiva a través de la lectura, escritura y visionado de fotografía, cine y video en español, y en otras lenguas de los participantes. Intentamos reconocer la diferencia como posibilidad de descubrimiento de otros mundos que enriquecen la dinámica comunicativa, la solidaridad y las relaciones humanas.
Un art de la mémoire traumatisée à la frontière
Authors: Dragon Geneviève
Published: November 2019

L’actualité terrible de la frontière entre le Mexique et les États-Unis trouve une résonance particulière dans la confrontation entre le discours brutal de Donald Trump (« Build a Wall! ») et l’invisibilité anonyme des migrants disparaissant sans laisser de traces au cours de leur traversée. C’est précisément cette invisibilité de la condition migrante que nous entendons mettre en lumière dans cet article. À première vue, l’espace du désert est vide et anéantit toute trace des migrants qui y trouvent la mort. L’invisibilité va de pair avec un anonymat qui rime avec le peu d’importance que les autorités accordent à ces migrants, quantités négligeables et innombrables. Des chercheurs, des écrivains, des artistes tentent de combattre cette indifférence en construisant une figure visible de ces migrants, dont parfois il ne reste qu’un nom ou quelques effets personnels abandonnés dans le désert. Au moyen des traces, des empreintes, des bribes de récits familiaux et personnels, il s’agit de reconstruire une histoire, une narration dont l’enjeu est de leur donner droit de cité. De façon plus intime et personnelle, cela permet dans le même mouvement de reconstituer l’intégrité, sinon physique, du moins symbolique, de ces corps meurtris : les familles pourront ainsi faire le deuil de l’être cher et disparu. L’enjeu de notre article porte, dans une dimension interdisciplinaire (au croisement de la littérature, des arts plastiques et de l’anthropologie politique), sur la constitution d’une forme d’artivisme (Richard Lou) de la mémoire qui redonne nom et narration à des exilés. C’est toute la question, en définitive, de la responsabilité éthique et politique des États face à la condition migrante, d’autant plus cruciale aujourd’hui que l’Europe se trouve prise dans l’urgence d’une crise migratoire sans précédent.
Pre-trial Detention in Belgium. An Empirical Study of Explanatory Factors in the Use of the Arrest Warrant and its Duration
Authors: Tange Carrol , Burssens Dieter , Maes Eric
Published: November 2019

This article presents the main results of an empirical research aiming to explain the evolution in recourse to and the duration of pre-trial detention in Belgium. A set of hypotheses was tested by analysing case files processed from 1993 to 2008 by investigating judges in three judicial districts (Brussels, Liege and Antwerp). Statistical models for factors associated with the decisions and durations observed were then established.
Cocaine abuse: an expanding healthcare problem for the 1990s
Authors: Paul S , York D
Published: November 2019

Cocaine, the most addictive recreational drug available, has increased in popularity and widespread use in the past decade. Crack, a new form of cocaine that is smoked, is purer and more rapidly absorbed into the vascular system, greatly increasing the risk of overdose. Cocaine produces many physiologic effects on the body systems. This case report focuses on two cardiovascular responses related to cocaine use: cardiomyopathy and coronary vasospasm. Cocaine abusers may present with complaints of chest pain or other nonspecific symptoms that require diligent assessment skills to be recognized as cocaine-related. Therefore, it is essential that nurses be knowledgeable about the effects of cocaine and the symptoms of cocaine abuse.
The effects of ocean sounds on sleep after coronary artery bypass graft surgery
Authors: Williamson JW
Published: November 2019

OBJECTIVE: To investigate the influence of ocean sounds (white noise) on the night sleep pattern of postoperative coronary artery bypass graft (CABG) patients after transfer from an intensive care unit. DESIGN: A before and after trial with an experimental and a control group was used in this intervention study. SETTING: A large public hospital with primary, secondary, and tertiary care facilities. PATIENTS: A consecutive sample of 60 first-time CABG patients was systematically assigned to the experimental or the control group. INTERVENTION: For the experimental group, the sounds were played on the Marsona Sound Conditioner (Marpac Corporation, Wilmington, NC) for three consecutive nights posttransfer from the ICU. No control of environment, except for the elimination of white noise, was done for the control group. MAIN OUTCOME MEASURES: The Richards-Campbell Sleep Questionnaire, a visual analog scale, provided self-reported sleep scores on six variables. Analysis of covariance was used to test the difference between the posttest scores of the groups, with the pretest used as the covariate. RESULTS: There were significant differences in sleep depth, awakening, return to sleep, quality of sleep, and total sleep scores; the group receiving ocean sounds reported higher scores, indicating better sleep. There was no difference in the falling asleep scores. CONCLUSION: The use of ocean sounds is a viable intervention to foster optimal sleep patterns in postoperative CABG patients after transfer from the ICU.
Sodium nitroprusside-induced cyanide intoxication and prevention with sodium thiosulfate prophylaxis
Authors: Hall VA , Guest JM
Published: November 2019

Sodium nitroprusside is an antihypertensive agent used frequently in the critical care setting. Recently, the Food and Drug Administration (FDA) published a report that led to a labeling change emphasizing the pharmacokinetics of nitroprusside with metabolism to highly toxic cyanide. Although evidence validates that cyanogenesis occurs with nitroprusside administration, prevention and treatment of cyanide poisoning is rarely instituted in clinical practice. Simultaneous infusion of thiosulfate with nitroprusside provides the sulfur donor necessary to prevent cyanide accumulation. Cyanide combines with thiosulfate to form the less toxic sodium thiocyanate, which is then excreted. A 10:1 ratio of nitroprusside to thiosulfate in the infusion eliminates the possibility of cyanide intoxication without altering the efficacy of nitroprusside.
Spouse adaptation to mate's CABG surgery: 1-year follow-up
Authors: Artinian NT
Published: November 2019

OBJECTIVE: The purpose of this study was to describe spouses' life stressors, supports, perceptions of illness severity, role strain, physical and mental symptoms of stress, and marital quality 1 year after the mate's coronary artery bypass graft surgery. METHODS: This descriptive study was the third component of a longitudinal panel investigation. (The first component was a period within 48 hours of surgery, and the second was 6 weeks after discharge.) One year after the mate's surgery, spouses received the following instruments in the mail: the Family Inventory of Life Events and Changes, the Norbeck Social Support Questionnaire, the Cantril Ladder Scale, the Strain Questionnaire, the Role Strain Scale and the Dyadic Adjustment Scale. Subjects were a convenience sample of 49 women whose husbands were alive 1 year after their first bypass surgery. Of the women in the sample (n = 49), 98% were white, and the mean age was 56 years. RESULTS: Social support was moderate and significantly less 1 year after surgery than during the first two components (48 hours and 6 weeks after surgery). Women still perceived their husbands to have some illness severity 1 year after surgery. They continued to have physical and mental symptoms of stress and had significantly greater role strain than during the first two periods. Marital quality was average. Spouses reported making several life-style changes. DISCUSSION: During the first year after the patient's bypass surgery, spouses experienced many changes. Although physical and mental symptoms of stress remained the same, role strain increased and social support decreased. The findings suggest testing of such interventions as stress management and time management techniques, support groups, and other psychoeducational interventions. CONCLUSIONS: Although the situation remains difficult for the spouse 1 year after the patient's surgery, nurses and physicians can foster and support spouses through many adjustments and changes.