bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety Culture at Primary Healthcare Level: A Cross-Sectional Study among Employees with a Leadership Role
Authors: Klemenc-Ketiš Zalika , Poplas Susič Antonija 
Published: December 2019

Abstract

Introduction
An effective leadership is critical to the development of a safety culture within an organization. With this study, the authors wanted to assess the self-perceived level of safety culture among the employees with a leadership function in the Ljubljana Community Health Centre.

Methods
This was a cross-sectional study in the largest community health centre in Slovenia. We sent an invitation to all employees with a leadership role (N=211). The Slovenian version of the SAQ – Short Form as a measurement of a safety culture was used. The data on demographic characteristics (gender, age, role, work experience, working hours, and location of work) were also collected. An electronic survey was used.

Results
The final sample consisted of 154 (69.7%) participants, out of which 136 (88.3%) were women. The mean age and standard deviation of the sample was 46.2±10.5 years. The average scores for the safety culture domains on a scale from 1 to 5 were 4.1±0.6 for Teamwork Climate, Safety Climate, and Working Conditions and Satisfaction, 3.7±0.5 for Perception of Management, 3.6±0.4 for Communication, and 3.5±0.6 for Stress Recognition.

Conclusion
The safety culture among leaders in primary healthcare organizations in Slovenia is perceived as positive. There is also a strong organizational culture. Certain improvements are needed, especially in the field of communication and stress recognition with regards to safety culture.
Gender Differences in Predictors of Self-Medication with Tranquillizers and Sleeping Pills: Results of the Population-Based Study in Serbia
Authors: Tripković Katica , Šantrić Milićević Milena , Odalović Marina 
Published: December 2019

AbstractBackgroundPrevious studies among the Serbian population concluded that the trend of self-medication with tranquillizers and sleeping pills requires deeper study. The objective is to identify gender differences in socio-demographic, health, and health service predictors of self-medication with tranquillizers and sleeping pills in a Serbian population of 15 years old and above.MethodsThis was a population-based, cross-sectional study. Data was extracted from the most recently available results of the Serbian National Health Survey of 2013. Multivariate logistic regression was used to determine independent self-medication predictors.ResultsThe study included 14,623 participants, of which 51.77% were female. While 5.6% of the females reported self-medication with tranquillizers and sleeping pills, only 2.2% of males reported such practice (p<0.001). The presence of chronic disease, stress, and physical pain in the last month before the interview was significantly associated with an increased likelihood of self-medication with observed drugs in both genders. Age was the most significant socio-demographic predictor of self-medication in females, while in males it was unemployment. Women of 55–65 years of age showed a greater risk from self-medication with tranquillizers and sleeping pills in comparison to women of 15–24 years of age (aOR=4.75, 95% CI: 1.83–12.33). Unemployed males showed a greater tendency for such practice in comparison to employed (aOR=1.86, 95% CI: 1.19–2.91).ConclusionThe findings highlighted predictors of self-medication with tranquillizers and sleeping pills and important differences between genders, which may contribute to the design of gender-sensitive surveillance, identification, and the prevention of such undesirable practices through evidence-based and appropriately tailored public health actions.
Can 'More Speech' Counter Ignorant Speech?
Authors: Lepoutre Maxime Charles 
Published: December 2019

Ignorant speech, which spreads falsehoods about people and policies, is pervasive in public discourse. A popular response to this problem recommends countering ignorant speech with more speech, rather than legal regulations. However, Mary Kate McGowan has influentially argued that this ‘counterspeech’ response is flawed, as it overlooks the asymmetric pliability of conversational norms: the phenomenon whereby some conversational norms are easier to enact than subsequently to reverse.
After demonstrating that this conversational ‘stickiness’ is an even broader concern for counterspeech than McGowan suggests—it applies not just to oppressive or hateful speech, but also to ordinary policy-related misinformation—I argue that a more sophisticated account of counterspeech can nevertheless overcome it.
First, the stickiness objection overlooks the distinction between ‘negative’ and ‘positive’ counterspeech. Instead of directly negating a distorted proposition, positive counterspeech affirms a correct proposition that is inconsistent with the falsehoods at hand. This, I contend, allows it to counter ignorant speech without triggering the properties that render it sticky.
Second, the stickiness objection presupposes an unrefined conception of counterspeech’s temporality. Counterspeech should be understood as a diachronic process, which not only follows, but also pre-empts, ignorant utterances. Drawing on speech-act theories of silencing, I argue that pre-emptive counterspeech can condition the conversational context so as to prevent subsequent ignorant utterances from enacting sticky conversational norms.
Thus, this theoretically-refined conception of counterspeech helps appreciate how verbal responses might overcome the stickiness of conversational norms; and, in doing so, it reveals that this stickiness need not provide reasons to prefer legal remedies to counterspeech.
CUERPO, PODER Y ÉXITO EN LA NOVELA SIN TETAS NO HAY PARAÍSO: INTERPRETACIÓN DE LA PROSTITUCIÓN DESDE EL ANÁLISIS DISCURSIVO Y VISUAL
Authors: Palomeque Marcos Israel , Clavijo Loor María Alexandra , Herrera Unapanta Fanny Elizabeth 
Published: December 2019

Este trabajo tiene como objetivo elaborar un análisis discursivo y visual de la serie Sin tetas no hay paraíso, producción de Caracol Televisión, para ello busca identificar el funcionamiento de la prostitución prepago y su desdoblamiento en casos reales en Quito. El tratamiento teórico conceptual del análisis del discurso se realizó a través de las reflexiones de diferentes escuelas. La metodología utilizada es descriptiva, se trabajaron matrices de enunciados sobre los diálogos, entrevistas y cuestionarios. En los resultados se destaca que la prostitución prepago está inmersa en el ámbito universitario. Como conclusión, el cuerpo idealizado y cosificado marca las identidades de género y sirve como mecanismo para alcanzar poder y éxito.
Application of Clean and Healthy Living Behavior (PHBS) From The Household Knowledge and Attitude Study
Authors: Putri Ronasari Mahaji , Rosdiana Yanti , Nisa Aprilia Choirun 
Published: December 2019

Background: The behavior of clean and healthy life (PHBS) is an obligation to be carried out by everyone. PHBS is an effort to maintain the health of themselves and their families. The PHBS coaching program has been running for approximately 18 years, but its success is far from expected. It is necessary to explore the factors underlying the failure to implement PHBS. Mothers as educators in the family, have an obligation not only to implement PHBS for themselves, but also educate their children to conduct clean and healthy lifestyle.Purpose: The purpose of this study was to determine the application of clean and healthy behavior (PHBS) from the study of knowledge and attitudes of housewives in the household setting.Method: This research is a descriptive study with a cross sectional approach, involving 39 housewives in RT 03 RW 06 Tlogomas Malang. The sample is taken in total side. The independent variable is the knowledge and attitudes of housewives, while the dependent variable is clean and healthy living behavior. Instrument to explore knowledge, attitudes and behavior using a questionnaire. Data analysis using the Spearman rank test.Result: The results showed that as many as 43.6% of housewives were well informed, 76.9% of housewives had good attitudes, and as many as 69.2% of mothers had good PHBS. Statistical tests show there is no relationship between knowledge with PHBS (p value 0.792), and there is a relationship between attitudes and PHBS of housewives (p-value 0.007).Conclusion: The application of clean and healthy lifestyle is not related to knowledge, but is related to the attitude of housewives in RT 03 RW 06 Tlogomas Malang.
Analysis of Knowledge, Attitude, Employee Action in the Use of Personal Protective Equipment (PPE) with Work Accidents
Authors: Fatimah Nur Aini , Nurwijayanti Nurwijayanti , Farida Siti 
Published: December 2019

One of the causes of workplace accidents is the lack of awareness of the use of personal protective equipment for workers in the workplace. One of the ways to prevent workplace accidents is to require personal protective equipment (PPE) that meets the requirements, namely: comfort in use, does not hinder the work process, and provides effective protection against types of hazards. The objective of this research was to analyze the knowledge, attitudes, actions of employees in the use of personal protective equipment with work accidents at PT. Bisi International, Tbk., Tulungrejo Pare Kediri. The design of this research was quantitative method of correlation(correlation study) and approach cross sectional. The sampling technique was use Proportionate Stratified Random Sampling with a sample of 96 respondents, the processing unit and engineering unit at PT. Bisi International, Tbk., Tulungrejo Pare Kediri. The results of the research data were analyzed by ordinal regression test. The results of statistical analysis with ordinal regression showed that there was no relationship between knowledge, attitudes, actions of employees in the use of personal protective equipment (PPE) with the occurrence of work accidents at PT. Bisi International, Tbk., Tulungrejo Pare Kediri. The company must play an active role in giving awareness to employees about the importance of adhering to procedures and complying with the regulations in the use of personal protective equipment while working
Effect of Heat Compresses Hydrotherapy to Reduction of Pain Labor Stage 1st
Authors: Susiloningtyas Luluk , Novitasari Fransisika , Wulandari Ratna Feti 
Published: December 2019

Labor pain is an unpleasant stimulus that causes fear and worry. This situation will be stimulate an increase in catecholamineswhich can be cause interference with the strength of uterine contractions so that uterine insertion occurs if not corrected, which will be cause prolonged labor, so that’s necessary to prevent maternal care in the form of methods of pain transfer The One non-pharmacological method is heat compresshydrotherapy. The type of research was used Quasi Experimental withcross sectional approach one group pretest-posttest design. The results of data analysis stated that sig (p) = 0,000 where α = 0.05, p <α, means that therewas an effect of giving heat compress hydrotherapy to the reduction of labor pain in the active phase. Correlation or influence using Wilcoxon Correlation =-0.382.
Relationship between Parenting Pattern with Development Autism Children
Authors: Azizah Eva Nur , Amperiana Sukma 
Published: December 2019

The family role to child development is very necessary. Parentshave an autistic child will experience more complex problemsforming personality, behavior and their fulfillmentis needing. The approach was cross sectional. The samples were 30 parents and 30 autistic. The instrument wasused a parenting questionnaire and observation for development. The analysis used contingency coefficient correlation, p-value was 0.017, smaller than α = 0.05 (p <0.05). There was a relationship the association parenting family with development autistic. Parents provide parenting appropriatetheir children without curbing and still paying attention to the child's freedom will be good for the child. Parenting provided to children must be in accordance with the development to needtheir children. The right parenting can provide opportunities for children that they are part of the people in their environment so that children can develop optimally.
Nasopharyngeal muscle patch for the management of internal carotid artery injury in endoscopic endonasal surgery
Authors: Wang Wei-Hsin , Lieber Stefan , Lan Ming-Ying , Wang Eric W. , Fernandez-Miranda Juan C. , Snyderman Carl H. , Gardner Paul A. 
Published: December 2019

OBJECTIVEInjury to the internal carotid artery (ICA) is the most critical complication of endoscopic endonasal skull base surgery. Packing with a crushed muscle graft at the injury site has been an effective management technique to control bleeding without ICA sacrifice. Obtaining the muscle graft has typically required access to another surgical site, however. To address this concern, the authors investigated the application of an endonasally harvested longus capitis muscle patch for the management of ICA injury.METHODSOne colored silicone-injected anatomical specimen was dissected to replicate the surgical access to the nasopharynx and the stepwise dissection of the longus capitis muscle in the nasopharynx. Two representative cases were selected to illustrate the application of the longus capitis muscle patch and the relevance of clinical considerations.RESULTSA suitable muscle graft from the longus capitis muscle could be easily and quickly harvested during endoscopic endonasal skull base surgery. In the illustrative cases, the longus capitis muscle patch was successfully used for secondary prevention of pseudoaneurysm formation following primary bleeding control on the site of ICA injury.CONCLUSIONSNasopharyngeal harvest of a longus capitis muscle graft is a safe and practical method to manage ICA injury during endoscopic endonasal surgery.
Intratumoral spatial heterogeneity of BTK kinomic activity dictates distinct therapeutic response within a single glioblastoma tumor
Authors: Ibrahim Ahmed N. , Yamashita Daisuke , Anderson Joshua C. , Abdelrashid Moaaz , Alwakeal Amr , Estevez-Ordonez Dagoberto , Komarova Svetlana , Markert James M. , Goidts Violaine , Willey Christopher D. , Nakano Ichiro 
Published: December 2019

OBJECTIVEDespite significant recent efforts applied toward the development of efficacious therapies for glioblastoma (GBM) through exploration of GBM’s genome and transcriptome, curative therapeutic strategies remain highly elusive. As such, novel and effective therapeutics are urgently required. In this study, the authors sought to explore the kinomic landscape of GBM from a previously underutilized approach (i.e., spatial heterogeneity), followed by validation of Bruton’s tyrosine kinase (BTK) targeting according to this stepwise kinomic-based novel approach.METHODSTwelve GBM tumor samples were obtained and characterized histopathologically from 2 patients with GBM. PamStation peptide-array analysis of these tissues was performed to measure the kinomic activity of each sample. The Ivy GBM database was then utilized to determine the intratumoral spatial localization of BTK activity by investigating the expression of BTK-related transcription factors (TFs) within tumors. Genetic inhibition of BTK family members through lentiviral short hairpin RNA (shRNA) knockdown was performed to determine their function in the core-like and edge-like GBM neurosphere models. Finally, the small-molecule inhibitor of BTK, ONO/GS-4059, which is currently under clinical investigation in nonbrain cancers, was applied for pharmacological inhibition of regionally specified newly established GBM edge and core neurosphere models.RESULTSKinomic investigation identified two major subclusters of GBM tissues from both patients exhibiting distinct profiles of kinase activity. Comparatively, in these spatially defined subgroups, BTK was the centric kinase differentially expressed. According to the Ivy GBM database, BTK-related TFs were highly expressed in the tumor core, but not in edge counterparts. Short hairpin RNA–mediated gene silencing of BTK in previously established edge- and core-like GBM neurospheres demonstrated increased apoptotic activity with predominance of the sub-G1 phase of core-like neurospheres compared to edge-like neurospheres. Lastly, pharmacological inhibition of BTK by ONO/GS-4059 resulted in growth inhibition of regionally derived GBM core cells and, to a lesser extent, their edge counterparts.CONCLUSIONSThis study identifies significant heterogeneity in kinase activity both within and across distinct GBM tumors. The study findings indicate that BTK activity is elevated in the classically therapy-resistant GBM tumor core. Given these findings, targeting GBM’s resistant core through BTK may potentially provide therapeutic benefit for patients with GBM.
Giant intracranial aneurysms: natural history and 1-year case fatality after endovascular or surgical treatment
Authors: Dengler Julius , Rüfenacht Daniel , Meyer Bernhard , Rohde Veit , Endres Matthias , Lenga Pavlina , Uttinger Konstantin , Rücker Viktoria , Wostrack Maria , Kursumovic Adisa , Hong Bujung , Mielke Dorothee , Schmidt Nils Ole , Burkhardt Jan-Karl , Bijlenga Philippe , Boccardi Edoardo , Cognard Christophe , Heuschmann Peter U. , Vajkoczy Peter , _ _ 
Published: December 2019

OBJECTIVEClinical evidence on giant intracranial aneurysms (GIAs), intracranial aneurysms with a diameter of at least 25 mm, is limited. The authors aimed to investigate the natural history, case fatality, and treatment outcomes of ruptured and unruptured GIAs.METHODSIn this international observational registry study, patients with a ruptured or unruptured GIA received conservative management (CM), surgical management (SM), or endovascular management (EM). The authors investigated rupture rates and case fatality.RESULTSThe retrospective cohort comprised 219 patients with GIAs (21.9% ruptured GIAs and 78.1% unruptured GIAs) whose index hospitalization occurred between January 2006 and November 2016. The index hospitalization in the prospective cohort (362 patients with GIAs [17.1% ruptured and 82.9% unruptured]) occurred between December 2008 and February 2017. In the retrospective cohort, the risk ratio for death at a mean follow-up of 4.8 years (SD 2.2 years) after CM, compared with EM and SM, was 1.63 (95% CI 1.23–2.16) in ruptured GIAs and 3.96 (95% CI 2.57–6.11) in unruptured GIAs. In the prospective cohort, the 1-year case fatality in ruptured GIAs/unruptured GIAs was 100%/22.0% during CM, 36.0%/3.0% after SM, and 39.0%/12.0% after EM. Corresponding 1-year rupture rates in unruptured GIAs were 25.0% during CM, 1.2% after SM, and 2.5% after EM. In unruptured GIAs, the HR for death within the 1st year in patients with posterior circulation GIAs was 6.7 (95% CI 1.5–30.4, p < 0.01), with patients with a GIA at the supraclinoid internal carotid artery as reference. Different sizes of unruptured GIAs were not associated with 1-year case fatality.CONCLUSIONSRupture rates for unruptured GIAs were high, and the natural history and treatment outcomes for ruptured GIAs were poor. Patients undergoing SM or EM showed lower case fatality and rupture rates than those undergoing CM. This difference in outcome may in part be influenced by patients in the CM group having been found poor candidates for SM or EM.Clinical trial registration no.: NCT02066493 (clinicaltrials.gov)
Gender disparities in academic rank achievement in neurosurgery: a critical assessment
Authors: Dossani Rimal H. , Terrell Danielle , Kosty Jennifer A. , Ross Robert C. , Demand Audrey , Wild Elizabeth , Peterson Racheal , Ngwenya Laura B. , Benzil Deborah L. , Notarianni Christina 
Published: December 2019

OBJECTIVEThe objective of this study was to evaluate whether there are disparities in academic rank and promotion between men and women neurosurgeons.METHODSThe profiles of faculty members from 50 academic neurosurgery programs were reviewed to identify years in practice, number of PubMed-indexed publications, Doctor of Philosophy (PhD) attainment, and academic rank. The number of publications at each academic rank was compared between men and women after controlling for years in practice by using a negative binomial regression model. The relationship between gender and each academic rank was also determined after controlling for clustering at the institutional level, years in practice, and number of publications.RESULTSOf 841 faculty members identified, 761 (90%) were men (p = 0.0001). Women represented 12% of the assistant and associate professors but only 4% of the full professors. Men and women did not differ in terms of the percentage holding a PhD, years in practice, or number of publications at any academic rank. After controlling for years in practice and clustering at the facility level, the authors found that men were twice as likely as women to be named full professor (OR 2.2, 95% CI 1.09–4.44, p = 0.03). However, when institution, years in practice, PhD attainment, h-index, and number of publications were considered, men and women were equally likely to attain full professorship (OR 0.9, 95% CI 0.42–1.93).CONCLUSIONSData analysis of the top neurosurgery programs suggests that although there are fewer women than men holding positions in academic neurosurgery, faculty rank attainment does not seem to be influenced by gender.
Comparison between optical coherence tomography imaging and histological sections of peripheral nerves
Authors: Carolus Anne E. , Möller Jens , Hofmann Martin R. , van de Nes Johannes A. P. , Welp Hubert , Schmieder Kirsten , Brenke Christopher 
Published: December 2019

OBJECTIVEOptical coherence tomography (OCT) is an imaging technique that uses the light-backscattering properties of different tissue types to generate an image. In an earlier feasibility study the authors showed that it can be applied to visualize human peripheral nerves. As a follow-up, this paper focuses on the interpretation of the images obtained.METHODSTen different short peripheral nerve specimens were retained following surgery. In a first step they were examined by OCT during, or directly after, surgery. In a second step the nerve specimens were subjected to histological examination. Various steps of image processing were applied to the OCT raw data acquired. The improved OCT images were compared with the sections stained by H & E. The authors assigned the structures in the images to the various nerve components including perineurium, fascicles, and intrafascicular microstructures.RESULTSThe results show that OCT is able to resolve the myelinated axons. A weighted averaging filter helps in identifying the borders of structural features and reduces artifacts at the same time. Tissue-remodeling processes due to injury (perineural fibrosis or neuroma) led to more homogeneous light backscattering. Anterograde axonal degeneration due to sharp injury led to a loss of visible axons and to an increase of light-backscattering tissue as well. However, the depth of light penetration is too small to allow generation of a complete picture of the nerve.CONCLUSIONSOCT is the first in vivo imaging technique that is able to resolve a nerve’s structures down to the level of myelinated axons. It can yield information about focal and segmental pathologies.