bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Survey of Psychiatric Healthcare Workers' Perception of Working Environment and Possibility to Recover Before and After the First Wave of COVID-19 in Sweden
Authors: Alexiou Eirini , Steingrimsson Steinn , Akerstrom Magnus , Jonsdottir Ingibjörg H. , Ahlstrom Linda , Finizia Caterina , Wijk Helle , Degl'Innocenti Alessio 
Published: December 2021

Objective: This study aimed to investigate the impact of the first wave of the COVID-19 pandemic on perceived working environment, including the possibility to recover, among psychiatric healthcare workers (PHCWs) in comparison with pre-pandemic measures.Method: A link to an anonymous, web-based COVID-19 related survey was sent via email to all PHCWs at a university hospital in Sweden (n = 1,618) in September 2020. The response rate was 38% (566 of 1,507 eligible participants). Working environment survey responses collected in 2019 were used as pre-pandemic comparators. Statistical analyses were performed to assess overall impact over time on work demands, support, motivation, and recovery, stratified by professional role, and considering variables such as access to personal protective equipment.Results: The percentage of individuals responding negatively to statements about working environment increased significantly for most items after the first wave. Similarly, the increase of five of the investigated factors indicated a more negative perception of recovery during the pandemic. Registered nurses reported a greater negative impact of the pandemic on perceived working conditions and ability to recover than other professional groups. PHCWs working with patients with COVID-19 (35%) who reported being worried about becoming infected (12%) or infecting others (17%), or lacking adequate personal protective equipment (22%) were more negatively impacted regarding work environment-related items than those who did not.Conclusions: PHCWs' working environment and possibility for recovery were impacted by the first wave of the COVID-19 pandemic, nurses being most affected. Although psychiatric services do not directly care for patients with severe COVID-19 infection, the results from this study suggests that mental health services should also prepare for future pandemics.
Readability and Comprehension of Printed Patient Education Materials
Authors: Szabó Pálma , Bíró Éva , Kósa Karolina 
Published: December 2021

Background: Health literacy, a recently determined construct plays an important role in how individuals are able to manage their health. A useful approach for the assessment of health literacy is to measure the comprehension of available patient education materials (PEMs).Objective: We aimed at assessing the usefulness of PEMS available in Hungarian by testing comprehension of selected PEMs in different groups of users.Methods: Comprehension of patient education materials in the domain of healthcare was tested by selecting PEMs and creating questions based on their text in 3 dimensions of health literacy: understand, process/appraise, apply/use. Twenty questions were created that could be answered without pre-existing knowledge by reading the appropriate text taken from PEMs. Comprehension was examined in four groups: laypersons, non-professional healthcare workers, 1st year healthcare students, and 5th year medical students. Readability indices were calculated for the same texts to which questions were created.Results: Laypersons answered &lt;50% of the PEMs-based questions correctly. Non-professional healthcare workers performed better with 57% of right answers but significantly worse than healthcare students or medical students. Those with at least high school qualification (maturity exam) showed significantly higher comprehension compared to those with lower educational attainment. Persons in good or very good health also had significantly better comprehension than those in less favorable health. All readability indices showed that comprehension of the tested PEMs required at least 10 years of schooling or more. Therefore, these PEMS are difficult to understand for persons with less than high school level of education.Conclusion: Rephrasing of the investigated patient educational materials would be recommended so that they better fit the educational attainment of the Hungarian population. Evaluation of the readability and comprehensibility of other PEMs also seems warranted.
Telehealth to the Rescue During COVID-19: A Convergent Mixed Methods Study Investigating Patients' Perception
Authors: Al-Sharif Ghadah A. , Almulla Alia A. , AlMerashi Eman , Alqutami Reem , Almoosa Mohammad , Hegazi Mona Zakaria , Otaki Farah , Ho Samuel B. 
Published: December 2021

Background: The onset of the pandemic necessitated abrupt transition to telehealth consultations. Although there is a few tools that gauge the patients' perception about their experiences, none of them are contextualized to an emergency in the Middle East and North Africa region. Accordingly, this study aims at developing and validating a tool to address this gap, and deploying it to assess the patients' perception of telehealth services during COVID-19 in Dubai, United Arab Emirates (UAE).Methods: A convergent mixed methods design was adapted. A random selection of 100 patients from Dubai, UAE were invited to participate. Qualitative and quantitative datasets were collected using a tailor-made survey. The qualitative data, collected through open-ended questions, was analyzed using multi-staged thematic analysis. As for the quantitative data, it captured the patients' extent of satisfaction, and was assessed using SPSS (with a series of descriptive and inferential analyses). The qualitative and quantitative findings were then merged via joint display analysis.Results: Out of the 100 patients that were randomly selected, 94 patients participated in this study. The reliability score of Cronbach's Alpha for the instrument was 98.9%. The percentage of the total average of satisfaction was 80.67%. The Principal Component Analysis showed that 88.1% of the variance can be explained by the instrument (p &lt; 0.001). The qualitative data analysis expanded upon the quantitative findings enabling a better understanding of the patients' perception. Three themes, revolving around the quality of the patient telehealth experiences, surfaced: “Factors that worked to the benefit of the patients,” “Factors that the patients were not in favor of,” and “Opportunities for improvements as perceived by the patients.”Discussion: This study introduced a novel patient satisfaction with telehealth consultation survey contextualized to the COVID-19 times in Dubai, UAE. The participants were quite satisfied with the quality of their experience, however they suggested areas for improvement. Regional healthcare decision-makers can leverage the identified advantages and opportunities for improvement of telehealth. This will enable making informed decisions regarding the continuity of telehealth irrespective of how matters unfold in relation to the pandemic. It will also better prepare the healthcare sector for potential resurgence(s) of COVID-19 and/or the occurrence of other similar emergencies.
Diabetes Prevention and Care Capacity at Urban Indian Health Organizations
Authors: Fort Meredith P. , Reid Margaret , Russell Jenn , Santos Cornelia J. , Running Bear Ursula , Begay Rene L. , Smith Savannah L. , Morrato Elaine H. , Manson Spero M. 
Published: December 2021

American Indian and Alaska Native (AI/AN) people suffer a disproportionate burden of diabetes and cardiovascular disease. Urban Indian Health Organizations (UIHOs) are an important source of diabetes services for urban AI/AN people. Two evidence-based interventions—diabetes prevention (DP) and healthy heart (HH)–have been implemented and evaluated primarily in rural, reservation settings. This work examines the capacity, challenges and strengths of UIHOs in implementing diabetes programs.Methods: We applied an original survey, supplemented with publicly-available data, to assess eight organizational capacity domains, strengths and challenges of UIHOs with respect to diabetes prevention and care. We summarized and compared (Fisher's and Kruskal-Wallis exact tests) items in each organizational capacity domain for DP and HH implementers vs. non-implementers and conducted a thematic analysis of strengths and challenges.Results: Of the 33 UIHOs providing services in 2017, individuals from 30 sites (91% of UIHOs) replied to the survey. Eight UIHOs (27%) had participated in either DP (n = 6) or HH (n = 2). Implementers reported having more staff than non-implementers (117.0 vs. 53.5; p = 0.02). Implementers had larger budgets, ~$10 million of total revenue compared to $2.5 million for non-implementers (p = 0.01). UIHO strengths included: physical infrastructure, dedicated leadership and staff, and community relationships. Areas to strengthen included: staff training and retention, ensuring sufficient and consistent funding, and data infrastructure.Conclusions: Strengthening UIHOs across organizational capacity domains will be important for implementing evidence-based diabetes interventions, increasing their uptake, and sustaining these interventions for AI/AN people living in urban areas of the U.S.
The Association Between Cadmium Exposure and Osteoporosis: A Longitudinal Study and Predictive Model in a Chinese Female Population
Authors: Wang Miaomiao , Wang Xinru , Liu Jingjing , Wang Zhongqiu , Jin Taiyi , Zhu Guoying , Chen Xiao 
Published: December 2021

Objective: The association between cadmium exposure and osteoporosis has been rarely reported in longitudinal studies. In this study, we investigated the association between osteoporosis and cadmium exposure and developed predictive models in women in a longitudinal cohort.Materials and Methods: In total, 488 women living in southeastern China were included at baseline (1998). Cadmium in blood (BCd) and urine (UCd) and also renal dysfunction biomarkers and bone mineral density (BMD) were determined both at baseline and follow-up. A total of 307 subjects were finally included after excluding subjects that did not have exposure or effect biomarkers. Osteoporosis was defined based on T score ≤ −2.5. Multiple linear regression and multivariate logistic analysis were used to show the association between baseline data and follow-up osteoporosis. Based on the identified associated factors, nomograms were developed to graphically calculate the individual risk of osteoporosis.Results: The baseline BMD in subjects with osteoporosis was significantly lower than that in subjects without osteoporosis (0.59 vs. 0.71 g/cm2, p &lt; 0.05). The prevalence of low bone mass at baseline was higher in subjects with osteoporosis than in those without osteoporosis (23.5 vs. 7.2%, p = 0.001). Logistic regression analysis demonstrated that age [odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.16–1.27], UCd (OR = 1.03, 95% CI: 1.002–1.06) and the presence of low BMD (OR = 3.84, 95% CI: 1.49–9.89) were independent risk factors for osteoporosis. For those subjects with normal baseline BMD, age, UCd, and baseline BMD were also independent risk factors for osteoporosis. The OR value was 1.16 (95% CI: 1.10–1.22) for age, 2.27 (95% CI: 1.03–4.99) for UCd &gt; 10 μg/g creatinine, and 0.39 (95% CI: 0.21–0.72) for BMDbaseline. We developed two nomograms to predict the risk of osteoporosis. The area under the curve was 0.88 (95% CI: 0.84–0.92) for total population and was 0.88 (95% CI: 0.84–0.92) for subjects with normal baseline BMD, respectively.Conclusion: Baseline age, UCd, and BMD were associated with follow-up osteoporosis in women. Nomograms showed good performance in predicting the risk of osteoporosis.
Effect of a Concise Educational Program on COVID-19 Vaccination Attitudes
Authors: Kaim Arielle , Siman-Tov Maya , Jaffe Eli , Adini Bruria 
Published: December 2021

Background: Vaccination has been recognized as a vital step for containing the COVID-19 outbreak. To ensure the success of immunization efforts as a public health containment measure, a high level of public vaccination compliance is essential. Targeted educational programs can be utilized to improve attitudes toward vaccination and improve the public's uptake of protective measures.Methods: In this cross-sectional study, we aimed to evaluate the impact of a concise educational program on perceived knowledge regarding the COVID-19 vaccine, vaccine importance and trust, protection and fear from COVID-19, trust in authorities, as well as individual resilience.Results: The study evaluated 503 participants that completed the questionnaire before and after viewing a concise video tutorial on vaccination. Following the educational program, scores of five variables increased significantly compared to their pre-viewing level: knowledge, personal resilience, trust in authorities, vaccine importance, as well as perceived protection. Those that were vaccinated and/or intend to be vaccinated (N = 394) report higher levels of knowledge, trust in authorities, vaccine importance, vaccine trust, and fear of being infected as compared to those that are unwilling to get vaccinated. Positive significant correlations were found between resilience and trust in authorities (r = 0.169, p &lt; 0.001), vaccine importance (r = 0.098, p = 0.028), and feeling protected (r = 0.310, p &lt; 0.001). Trust in authorities was positively correlated with vaccine importance (r = 0.589, p &lt; 0.001) and vaccine trust (r = 0.177, p &lt; 0.001). Vaccine importance was positively correlated with vaccine trust (r = 0.149, p = 0.001), but not correlated with knowledge score.Conclusion: The findings of the study demonstrate the benefits of educational programs on improving attitudes toward vaccination acceptability. Incorporation of such concise educational programs by authorities may improve uptake of COVID-19 vaccination and help overcome public vaccine hesitancy. We recommend that such a concise and easily implementable educational program be incorporated as a response component to the current and future outbreaks.
Natural History of Diabetic Retinopathy Through Retrospective Analysis in Type 2 Diabetic Patients—An Exploratory Study
Authors: Gupta Mehak , Singh Amarjeet , Duggal Mona , Singh Ramandeep , Bhadada Sanjay , Khanna Poonam 
Published: December 2021

Background and Aims: Diabetic retinopathy is the most common diabetes-associated microvascular complication and is among the leading causes of vision loss or blindness in the adult population. The present study is a retrospective study that reported the natural history of diabetic retinopathy.Methods: Retrospective medical records of 170 patients aged &gt; 20 years with a confirmed complication of diabetic retinopathy were recruited into the present study. A questionnaire was also sent to each subject for gathering their experiences, and verification was done by the attending medical physicians. The questionnaire was answered by all recruited patients.Results: The results showed that 23 (13.5%) subjects have a family history of diabetic retinopathy with 10 (5.9%) having mild NPDR, 63 (37.1%) with moderate NPDR, 60 (25.3%) have severe NPDR while 37 (21.8%) have PDR complications. The presence of co-morbidities was found in 139 (81.8%) subjects. Patients with PDR reported a significantly longer duration of diabetes mellitus with worse glycemic control.Conclusions: The study revealed and concluded that adherence to the prescribed management regimen is important, for which patient education was the key which was lacking.
Comparison of C2-3 Pedicle Screw Fixation With C2 Spinous Muscle Complex and Iliac Bone Graft for Instable Hangman Fracture
Authors: Xu Dingli , Gan Kaifeng , Wang Yang , Wang Yulong , Ma Weihu 
Published: December 2021

Purpose: To compare the effect between C2 spinous muscle complex graft and iliac bone graft in C2-3 pedicle screw fixation for instable Hangman fracture. Using axial spinous muscle complex instead of iliac bone for instable Hangman fracture can decrease neck pain, bone donor site complication, and operation time.Method: The outcomes of C2-3 pedicle screw fixation with C2 spinous muscle complex were compared with iliac bone graft in 18 and 21 patients with instable Hangman fracture. The mean age was 49.1 ± 15.8 years in the complex group and 55.3 ± 12.2 years in the Iliac group, and the mean time to surgery of the patients was 3.3 ± 0.6 days in the complex group and 3.6 ± 0.9 days in the iliac group. Outcome measures including operation time, blood loss, visual analog scale (VAS) for pain, Japanese orthopedic association score (JOA), American spine injure association classification (ASIA), and bone fusion time were collected from medical records. In addition, the postoperative complications were also recorded.Results: There were significant differences in operation time and interoperative blood loss between the two groups (P &lt; 0.01). Also a significant difference was found in VAS score and JOA score between the two groups (P = 0.0012 and P &lt; 0.001, respectively) at 1-month follow-up, whereas, no significant difference was found at other visit time. In the final visit, all patients showed good bone fusion, and two patients shows incision edema and exudation in the iliac group.Conclusion: C2-3 pedicle screw fixation with C2 spinous muscle complex graft maybe a feasible and safe procedure for instable Hangman fracture.
Dos espacios discursivos de La Guerra de Tres Años
Authors: Martínez Carrizales Leonardo , Martínez Luna Esther 
Published: December 2021

El presente artículo aborda la novela La Guerra de Tres Años de Emilio Rabasa, quien no solo fue un novelista destacado sino un servidor público y un jurista que participó en la confección de documentos del derecho constitucional en México. La obra corresponde al discurso letrado de los liberales y fue publicada por vez primera en el periódico El Universal en 1891, bajo la dirección de Rafael Reyes Spíndola, personaje muy ligado al régimen de Porfirio Díaz.
El artículo tiene como propósito contrastar el espacio discursivo original de la novela (propio de un periódico liberal comprometido en las luchas ideológicas del Porfiriato tardío) con el espacio correspondiente a la segunda edición realizada en 1931 por la editorial Cvltura, cuyo prólogo estuvo a cargo de Victoriano Salado Álvarez. Esta segunda edición se ha convertido en el testimonio textual de referencia para la historiografía literaria mexicana. La consagración editorial de este testimonio, sin embargo, ha pasado por alto las operaciones de sentido que se implican en la incorporación de la obra de un escritor liberal decimonónico en pleno auge del giro populista del México revolucionario, transformando hacia los años treinta las convicciones más preciadas del liberalismo. En este último aspecto estriba el foco de nuestro estudio.
KONVERTER DC-DC PENURUN TEGANGAN DUA FASA
Authors: Mudawari Ahmad 
Published: December 2021

DC-DC Konverter adalah converter yang mengubah tegangan DC konstan menjadi tegangan DC keluaran variable. Pada paper ini dibahas DC-DC konverter dua fasa menggunakan teknik modulasi PWM. Sinyal pulsa kotak tersebut diperoleh dari keluaran rangkaian sinyal pembangkit segitiga yang dibandingkan dengan sinyal tegangan DC yang dapat diatur besarnya sehingga didapatkan pulsa PWM dengan metoda frekuensi konstan yang digunakan untuk mendrive dua buah MOSFET yang berfungsi sebagai saklar elektronik yang masing-masing berbeda fasa sebesar 180 derajat. Dari hasil pengujian menunjukkan bahwa konverter DC-DC dua fasa frekuensi keluaranya dua kali frekuensi switchingnya.
RANCANG BANGUN TURBIN PELTON MIKROHIDRO
Authors: Maridjo  , Bambang Puguh  , Slameto  , Budi Suharto  , Abdulrahman  
Published: December 2021

Pembangkit listrik tenaga air skala kecil, saat ini banyak dikembangkan di Negara berkembang, baik skala minihidro, mikro maupun picohidro. Saat ini pembangunan tenaga air skala kecil yang termasuk kelompok energi terbarukan lagi gencar dikembangkan di lndonesia. Pembangunan pusat tenaga air skala kecil ini dibuat untuk memenuhi kebutuhan energi listrik di pedesaan yang belum ada jaringan listrik dari PLN. Penelitian ini ditujukan untuk mengkaji pembuatan dari desain, pembuatan, pemasangan, pengoperasian dan pengujian pembangkit tenaga listrik skala kecil jenis picohidro Pelton. Jenis turbin yang di buat dan diuji jenis turbin pelton sudu mangkok, turbin ini dirancang dengan kapasitas debit 4 liter/detik dan head 5 meter yang menghasilkan turbin pelton dengan sudu 17 buah, diameter runner 27 cm, dan dianeter nosel 20 mm. Turbin pelton, diuji dengan variasi beban untuk bukaan katup tertentu untuk mengetahui kinerja turbin. Adapun hasil pengujian turbin pelton untuk bukaan katup penuh adalah 41,38 watt pada putaran 458 rpm dan menghasilkan efisiensi turbin sebesar 24,81%.
Prancangan sistem grounding generator untuk skema proteksi belitan stator generator 100% menggunakan NGT
Authors: Ali Mashar, Kholiq Hernawan, Maula Zahara Firdausi  
Published: December 2021

Untuk menerapkan sistem proteksi stator generator 100% seperti skema neutral overvoltage fundamental (59Gn), undervoltage third harmonics (27N3) perlu perancangan sistem pembumian impedansi tinggi menggunakan Neutral Grounding Transformer (NGT). NGT harus bisa mereduksi arus gangguan tanah. Paper ini akan mengkaji bagaimana merancang NGT untuk keperluan seperti di atas. Dalam perangan ini dimulai dari spesifikasi generator, trafo-trafo dan perlengkapan jaringan lainnya. Dalam paper ini akan dikaji penentuan kapasitas trafo NGT dan resitansi sekundernya. Untuk dapat mendemonstrasikan metode perancangan ini dengan baik, paper ini menggunakan pokok kajian generator dari salah satu PLTU di Indonesia dengan kapasitas 802 MVA, 22,8 kV. Dari hasil studi diperoleh bahwa NGT hasil rancangan memiliki kapasitas hanya 37 kVA, 15000 V/240 V dengan resistor sekunder sebesar 0,38 Ω, 150 kW.
Kata kunci: proteksi stator generator 100%, NGT, kapasitas, resistansi sekunder
Hubungan Perhatian Orang Tua terhadap Hasil Belajar Peserta Didik pada Pembelajaran Geografi
Authors: Khalijah Siti , Suprapta Suprapta , Abbas Ibrahim 
Published: December 2021

This study aims to determine: 1). Knowing how the level of parental attention to the learning outcomes of students in the Social Studies class of SMA Negeri 3 Makassar. 2) Knowing whether there is a significant relationship between parental attention and geography learning outcomes of class X IPS SMA Negeri 3 Makassar. This research is an ex post facto research with a correlational approach. The independent variable in this study is the attention of parents while the dependent variable is learning outcomes. The sampling technique used was random sampling, the number of samples was 52. The data collection was obtained using a questionnaire containing questions about students' attention to learning and learning outcomes, namely the first semester scores with school documentation. The data analysis technique used is descriptive statistics and product moment correlation analysis. The results shssowed that the level of people's attention was categorized as moderate, namely 78 with a percentage of 65%, while the results of learning geography for class X IPS students at SMA Negeri 3 Makassar were categorized as moderate, namely 80 with a percentage of 80%. The results of the product moment correlation analysis obtained = 0.567 and = 0.230 with an error rate of 5% (0.05). It can be concluded that parental attention has a significant effect on student outcomes in geography learning.