bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design Thinking for Creating an Increased Value Proposition to Improve Customer Experience
Authors: Kleber Daniel Marco-Stefan 
Published: August 2018

Purpose of this conceptual study is the identification of design thinking approaches and underlying logic for increasing the value proposition to improve customer experience in today´s dynamic and fast-changing business environment. Method of research based on content analysis of distinctive streams in the literature on design thinking for delivering the increased value proposition. Core elements of design thinking were identified and combined with service-oriented thinking logics aiming at providing superior value proposition and thus to improve customer experience. Furthermore, the article elaborates on the delimitation of Design thinking from Designerly thinking, and a new model for enhancing customer value propositions, the wheel of Design thinking, was developed based on core elements of Design thinking approaches. This approach has a potential to shape and redefine existing markets and to improve adjustment of products and services to dynamic customers´ needs and demands.DOI: 10.15408/etk.v17i2.7311
Influence of Transformational Leadership and Work Engagement On Innovative Behavior
Authors: Ariyani Nafiah , Hidayati Sri 
Published: August 2018

Innovative behavior, employee engagement and transformational leadership are critical variables that should be the focus of every organization’s this era of rapid technological change. This study aims to determine the effect of transformational leadership and work engagement on innovative behavior in the banking industry in Indonesia. The technique sampling is purposive sampling, so the numbers of samples are 378 people. The Data analysis technique is multiple linear regression analysis. The results show that transformational leadership and work engagement have a significant and positive effect on innovative behavior, in which work engagement as a mediating variable will to the positive influence of transformational leadership on innovative behavior. These findings suggest that it is necessary to apply transformational leadership styles and increase employee engagement to improve innovative employee behavior.DOI: 10.15408/etk.v17i2.7427
Prenatal Diet and Child Growth at 18 Months
Authors: Dodd Jodie M. , Louise Jennie , Deussen Andrea R. , McPhee Andrew J. , Owens Julie A. , Robinson Jeffrey S. 
Published: August 2018

OBJECTIVE:
Our objective was to evaluate the effect of an antenatal dietary and lifestyle intervention in pregnant women who are overweight or obese on child outcomes at age 18 months.

METHODS:
We conducted a follow-up study of children at 18 months of age who were born to women who participated in the Limiting Weight Gain in Overweight and Obese Women during Pregnancy to Improve Health Outcomes randomized trial. The primary follow-up study outcome was prevalence of child BMI z scores &gt;85th percentile. Secondary study outcomes included a range of anthropometric measures, neurodevelopment, general health, and child feeding. Intention to treat principles were used in analyses, according to the treatment group allocated at randomization.

RESULTS:
A total of 1602 children were assessed at age 18 months (lifestyle advice, n = 816; standard care, n = 786), representing 75.0% of the eligible sample (n = 2136). There were no statistically significant differences in the prevalence of child BMI z scores &gt;85th percentile for children born to women in the lifestyle advice group, compared with the standard care group (lifestyle advice, 505 [47.11%] versus standard care, 483 [45.36%]; adjusted relative risk: 1.04; 95% confidence interval: 0.94 to 1.16; P = .45). There was no evidence of effects on child growth, adiposity, neurodevelopment, or dietary and physical activity patterns.

CONCLUSIONS:
There is no evidence that providing pregnant women who were overweight or obese with an antenatal dietary and lifestyle intervention altered 18-month child growth and adiposity.
Cryoablation for locally advanced pancreatic cancer
Authors: Ionkin D. A. , Karelskaya N. A. , Stepanova Yu. A. , Zemskov V. M. , Kozlova M. N. , Zhavoronkova O. A. , Chzhao A. V. 
Published: August 2018

Aim. To improve quality and duration of life in patients with locally advanced pancreatic cancer. Material and methods. Cryosurgery through laparotomy has been performed in 36 patients with locally advanced pancreatic cancer since 2012. There were 14 (38.9%) men and 22 (61.1%) women (mean age 58 ± 6.8 years). Dimensions of pancreatic tumors were from 4 to 10 cm. Domestic devices “CRYO-MT”, “CRYO-01”, “ELAMED” and cryoapplicators with a diameter 2–5 cm were applied. Target temperature was about 186 °С, time of exposure – 3–5 min. There were 1–5 sessions of cryoablation (mean 2.4) and their number depended on tumor dimensions. Local cryodestruction was supplemented by bypass anastomoses in 18 patients (50%). All patients subsequently underwent adjuvant chemotherapy with additional regional chemoembolization in 10 of them. Results. There were no lethal outcomes during cryodestruction and in postoperative period. Early postoperative complications occurred in 14 (38.8%) patients, severe complications – in 13.6%. Cryodestruction was followed by complete regression (39.2%) or significant improvement (41.6%) of pain syndrome. 6-, 12-, 24- and 36-month survival was 92%, 84%, 48% and 14%, respectively. Median survival was 18.2 months. Conclusion. Cryodestruction is able to improve patients’ quality of life due to reduced pain syndrome in case of locally advanced pancreatic cancer. Certain increase of survival was observed in additional chemotherapy.
Tıp Fakültesi 5. ve 6. Sınıf Öğrencilerinde Flört Şiddetinin Değerlendirilmesi
Authors: AÇIKGÖZ Bilgehan , AÇIKGÖZ Banu , KARAKOYUN Ali Rıza , ASLAN YÜKSEL Nehir , AKCA Fatih , Demir Akca Ayşe Semra , Ayoğlu Ferruh Niyazi 
Published: August 2018

Giriş:Şiddet, yaşamımızın gerçeklerinden
biridir ve en önemli sosyal sorunların başında gelmektedir. Şiddet fiziksel,
cinsel veya duygusal özellikte olabilmektedir. Şiddet, flört ilişkisinde
tecavüz, dövme, tehdit etme, cinsel taciz ve duygusal kötüye kullanma gibi
farklı şekillerde gerçekleşebilir. Flört
şiddeti de üzerinde yeterince araştırılma yapılmamış bir alandır. Bu çalışmada
Tıp Fakültesi 5. ve 6. sınıf öğrencileri arasında flört şiddetinin sıklığı ve
türünün belirlenmesi amaçlanmıştır.Gereç: Tanımlayıcı
özellikteki bu araştırmada; Mayıs-Haziran 2014 tarihleri arasında Bülent Ecevit
Üniversitesi Tıp Fakültesi’nde öğrenim gören dönem 5 ve 6 sınıf öğrencisi 105
kişiden çalışmaya katılmayı kabul eden 88(%83,8)’inde yapılmıştır.
Araştırmacılar tarafından hazırlanan anket formuyla öğrencilerin
sosyo-demografik özellikleri, flört içinde şiddet uygulama ve maruz kalma
durumları sorgulanmıştır. Bulgular:Çalışmaya katılan 88 kişinin yaş ortancası 24 yıl ve
33(%37,5)’ü erkektir. Öğrencilerin 69 (%78.4)’unun daha önce veya şimdi flört
ilişkisi olmuştur. İlk flört yaş ortancası 17 (min:10, max:24)’dir. Daha önce
flört yaşayanların 15(%22)’i flört şiddetine maruz kalmamış ve
uygulamamıştır. Fiziksel 10(% 14,7)’u, 51(%75.0)’i duygusal, 9(%13.2)’u cinsel
flört şiddetine maruz kalmıştır. Şiddet uygulayanların ise 16(%20,6)’sı
fiziksel, 45(%66,2)’i duygusal, 5(%7,4)’i cinsel şiddet uygulamıştır. En sık maruz kalınan (%33,0) ve uygulanan (%28,4) şiddet
şekli ise sesini yükselterek konuşmadır. Sonuç:

Bu çalışmada en sık uygulanan ve maruz kalınan şiddet şeklinin
partnerine karşı sesini yükseltmek, en sık görülen şiddet tipinin duygusal
şiddet olduğu belirlenmiştir. Şiddet ve
şiddeti etkileyen faktörlerin ortaya konulabilmesi için daha detaylı, uzun
süreli ve değişik gruplarda yapılan çalışmalara gereksinim vardır ve şiddetin
niteliksel ve niceliksel boyutunun birlikte değerlendirilmesi gerekmektedir.
Meram Tıp Fakültesi Hastanesi Aile Hekimliği Polikliniğine Başvuran Hastaların D Vitamini Düzeylerinin Değerlendirilmesi
Authors: ÖKSÜZ Ahmet , KUTLU Ruhuşen 
Published: August 2018

Amaç:
Bu çalışmada bir yıl süresince aile hekimliği polikliniğine başvuran on sekiz
yaş ve üzeri hastaların D vitamini düzeylerinin cinsiyete, yaşa, aylara ve
mevsimlere göre dağılımının incelenmesi amaçlandı.Gereç
ve Yöntem: Tanımlayıcı tipte olan bu çalışma Necmettin Erbakan
Üniversitesi Meram Tıp Fakültesi Aile Hekimliği polikliniğine
01.01.2015-01.01.2016 tarihleri arasında herhangi bir nedenle başvuran ve D
vitamini düzeyleri ölçülen hastaların dosyaları retrospektif olarak taranarak
yapıldı. Hastalar yaşlarına, örneklerin alındığı aylara ve mevsimlere göre
gruplandırıldı. Verilerin değerlendirilmesinde SPSS 20.00 paket programı
kullanıldı, p&lt;0.05 değeri anlamlı kabul edildi.Bulgular:
Çalışmamızda yer alan 716 kişinin %76.3’ü (n=546) kadın, %23.7’si (n=170)
erkekti. Hastanemize başvuran hastalarda; %76.1 (n=545) sıklıkta vita­min D
eksikliği ve %12.3 (n=88) D vitamini yetersizliği tespit edilirken, sadece
%11.6 (n=83) hastada D vitamini seviyesi normal olarak bulundu. Cinsiyetlere
göre D vitamini düzeylerinin dağılımları incelendiğinde kadınlarda D vitamini
düzeyleri erkeklere göre istatistiksel olarak anlamlı derecede eksik bulundu (p=0.008). Mevsimler ile D vitamini
düzeyleri arasında istatistiksel olarak anlamlı bir farklılık saptandı (p=0.006). Sonbaharda eksiklik %30.1
(n=164) olup en düşük seviyede idi. D vitamini düzeyleri %28.9 (n=24) sıklıkta
en çok yaz mevsiminde normal idi. Aylara göre D vitamini düzeyleri arasında
istatistiksel olarak anlamlı bir fark vardı (p&lt;0.001). En fazla eksiklik %12.7 (n=69) olarak aralık ayında
görülmekte iken, temmuz ayında D vitamini değerleri %15.7 (n=13) sıklıkta
normal aralıktaydı.

Sonuç: Bu çalışmada %88.4 gibi çok yüksek sıklıkta D vitamini eksiklik ve
yetersizliği tespit edilmiştir. Çalışmamızda D vitamini düzeylerinin cinsiyete,
aylara ve mevsimlere bağlı değiştiği görüldü.
Analysis of the Type 2 Diabetic Patients Followed in a University Clinic
Authors: KOCAK Mehmet Zahid , AKTAS Gulali , ERKUS Edip , T. DUMAN Tuba , ATAK Burcin M. , SAVLİ Haluk 
Published: August 2018

Objective: The aim of present study was to determine the effects
of factors to diabetic regulation; such as, awareness of the disease,
compliance with treatment, awareness of HbA1c target, in T2DM patients whom
followed up in our clinic.

Methods: Patients with T2DM were enrolled to this retrospective study. Patient’s
data were obtained and recorded from institutional database. As well as blood
pressure, anthropometric measurements, physical examination signs, and
laboratory parameters were recorded. Study population grouped into two
according to HbA1c level; well-regulated T2DM group with a HbA1c lower than 8%
and poorly-controlled T2DM group with a HbA1c 8% or greater.

Results: A total of 150 patients with T2DM (72 men and 78 women) enrolled. Waist
circumference, body mass index, duration of diabetes, LDL-cholesterol , total
cholesterol, triglyceride and serum creatinine were significantly lower in
well-controlled compared to poorly-controlled diabetic subjects (all p&lt;0.05).
Rate of well-regulated subjects was higher in patients living in urban compared
to subjects living in rural area (p=0.01). Diabetic regulation rate was
significantly higher in patients acknowledge the diabetic medications, in self-monitoring
blood glucose, in subjects aware of HbA1c target, and free of diabetic
complications; neuropathy, nephropathy, and diabetic foot (all p&lt;0.05).

Conclusion: Striking result of present
study is that most important factors associated with better diabetic control
were self monitoring of blood glucose, awareness of treatment target and
acknowledgement of the diabetic medications; which all could be achieved by
education and participation of the patient to the therapeutic process.
The Histopathological Findings of Adenoid Tissue After Topical Mometasone Furoate Implementation
Authors: AKCAN Fatih Alper , Bayram Akcan Hümeyra , Dundar Yusuf , Uluat Ahmet , Karakuş Esra 
Published: August 2018

Objective: Pediatric sleep disordered breathing
(SDB) is a common childhood disease with a potential risk of several
comorbidities. The most common cause of SDB in childhood is upper
airway obstruction due to adenotonsillar hypertrophy and the classical treatment is
adenotonsillectomy. However, it carries a risk of many complications and
persistent apnea. Topical nasal steroid treatment may be an alternative to
surgery in the treatment of pediatric SDB. However, histopathological effects
of topical nasal steroids are mostly understudied.

Methods: A retrospective controlled clinical
study in an academic tertiary referral center. A total of 110 children were
involved in the study who underwent adenoidectomy for the treatment of SDB. The
study group (51-children) was treated with topical nasal mometasone furoate
monohydrate 100 mcg/day. The control group (59-children) was selected randomly
and all had no history of topical nasal steroid pre-operatively. Post-operative
adenoidectomy specimens were reviewed according to acute/chronic inflammation
findings, follicular hyperplasia, goblet cell hyperplasia, squamous metaplasia,
fibrosis, atrophy, ulcer and hemorrhage. The findings were scored
semiquantitatively for statistical analysis.

Results: Chronic inflammation findings,
follicular hyperplasia and goblet cell hyperplasia were significantly decreased
in the study group in addition fibrosis, atrophy and ulcer findings were
significantly increased in the study group. However, there was no statistical
difference between the groups according to acute inflammation and hemorrhage.

Conclusion:
Topical nasal corticosteroids significantly suppress the nasopharyngeal
inflammatory process in SDB. This treatment may be an alternative to surgery at
least in patients with mild and moderate disease.
Serum Sistatin-C Düzeyleri Diyastolik Kalp Yetmezliğinde Öngördürücü Olabilir
Authors: KAYAPINAR Osman , ÖZDE Cem , KAYA Adnan 
Published: August 2018

Özet :Amaç: Önceden diyastolik kalp yetmezliği
sistolik kalp yetmezliğinin gibi değerlendirilirken günümüzde bunların
birbirinden ayrı patofizyolojik mekanizmalarla ilerlediği bilinmektedir. Biz bu
çalışmada serum Sistatin C konsantrasyonu ile kalbin diyastolik fonksiyonları
arasındaki ilişkiyi göstermeyi denedik. Yöntem: Bu çalısmaya Mayıs 2010 ve Eylül
2010 tarihleri arasında Düzce Universitesi Tıp Fakültesi Hastanesi Kardiyoloji polikliniğine başvuran
bireyler dahil edildi. Deneklerin diyastolik parametreleri değerlendirildi ve
Sistatin C düzeyleri çalışıldı.Denekler diyastolik fonksiyonlarına göre normal
,grade 1, grade 2 olarak üç gruba ayrıldı ve serum sistain-c düzeyi ile bu
gruplar arasında ilişki araştırıldı. Bulgular: Bu çalışmada, Grade I ve Grade II
diyastolik disfonksiyonu olan denekler ile diyastolik fonksiyonu olmayan
denekler serum Sistatin C seviyelerine göre karşılaştırıldı. Diyastolik
disfonksiyon olan gruplarda Sistatin C düzeyinde anlamlı düzeyde artmış olduğu
gösterildi (normal -grade 1:p&lt;0,0001,Normal-grade 2: P&lt;0,004). Sistatin C
değeri için cutof değerini 0,997 ng/ml olarak bulduk. Bu noktada sistatin C nin diyastolik disfonsiyonu
göstermede spesifitesi % 80,
sensitivitesi % 78.95 bulundu .

Sonuç: Serum sistain C düzeyi diyastolik
disfonksiyonun erken tespitinde ve takibinde faydalı olabilir.Abstract:Aim: Formerly diastolic heart failure
eveluated as sistolic heart failure but nowadays we know their distinc
patophisyolojical mechanism.In this study we tried to Show the relations
between diastolic dysfunction and serum cyctatin C consantrations. Methods : We included the individuals who admitted to cardiology clinic of Düzce
University Medical Faculty between May 2010 and September 2010. We evaluate the
serum cystatin C consantrations and
diastolic dysfunction among 88 person. we evoluated the diastolic parameters
with 2D echocardiography , TDI and PW doppler mesuraments.The 88 study
participants were categorized according to their diastolic parameters into
three groups normal ,grade 1 and grade 2. We made cystatistical analysis in
each groups and parameters. Results: İn this study the participants
who has grade 1 and grade 2 diastolic disfunction were compaired with normal
participants (who has normal Diastolic function) according to their serum
cycstatin C consentrations.We shown the sytatisticly significant incrise of
serum cycstatin C levels in the group of diastolic disfunction Grade 1 and
Grade 2.(nomal-grade 1:p&lt;0,0001,normal-grade 2:p&lt;0,004). And we find that
the cut off ratio for Cystatin C was 0,997 ng/ml . On this point Cystatin c was
%80 specific and %78.95 sensitive for diastolic disfunction.

Conclusion: Serum Cystatin C levels may be
useful in the early detection and monitoring of diastolic dysfunction.
Commentary: The Invention of Aboriginal Diabetes: The Role of the Thrifty Gene Hypothesis in Canadian Health Care Provision
Authors: Hay Travis 
Published: August 2018

<p class="Default"> </p><p class="Pa7"> The purpose of this study was to analyze the extent to which the ‘thrifty gene hypoth­esis’ remains embedded within regimes of Canadian health care. The thrifty gene hypothesis, formulated by the American geneticist and travelling scientist James V. Neel in 1962, proposed that Indigenous peoples were genetically predisposed to Type 2 diabetes due to the foodways of their ancestors. The hypothesis was func­tionally racist and based on what biologi­cal anthropologists now call ‘the myth of forager food insecurity.’ Importantly, Neel reconsidered his own hypothesis in 1982 before he ultimately rejected it in 1999; nonetheless, in the mid-1990s, a team of Canadian scientists led by the endocrinolo­gist Robert Hegele of Western University conducted a genetic study on the OjiCree community of Sandy Lake First Nation in northern Ontario. Thereafter, Hegele told the academic world and news media that he had discovered a thrifty gene in Sandy Lake. Like Neel, Hegele later came to reject his own study in 2011. Nonetheless, the ‘thrifty gene hypothesis’ and Hegele’s Sandy Lake study continue to be cited, referenced, and reproduced in the current Clinical Guidelines of the Canadian Diabetes Asso­ciation, as well as across state-related health literature more broadly. The purpose of this study, then, will be to apply the PHCRP to the thrifty gene hypothesis in a Canadian context.</p><p class="Pa7"><em>Ethn Dis.</em>2018;28(Suppl 1):247- 252; doi:10.18865/ed.28.S1.247.</p>
The Intersectionality of Racial and Gender Discrimination among Teens Exposed to Dating Violence
Authors: Roberts Lynn , Tamene Mahader , Orta Olivia R. 
Published: August 2018

<p class="Default"> </p><p class="Pa7"> <strong>Objective: </strong>Driven by intersectionality, a central tenet of Critical Race Theory, this study examines the combined associations of racial and gender discrimination, which are interlocking, macro-level social forces, and teen dating violence (TDV).</p><p class="Pa7"><strong>Design: </strong>Self-report surveys were admin­istered via Audio Computer Assisted Self Interview (ACASI) equipment. Logistic regression models were used to estimate associations between racial and gender discrimination and TDV.</p><p class="Pa7"><strong>Setting: </strong>Study participants were recruited during August 2003 to June 2004 from high school health classes and an after-school program located in South Bronx neighbor­hoods of New York City.</p><p class="Pa7"><strong>Participants: </strong>Non-probability sample of 142 Black and Latino teens aged 13-19 years who reported experiences dating someone of a different sex.</p><p class="Pa7"><strong>Main Measures: </strong>Experienced discrimina­tion based on race and gender adapted from the Experiences of Discrimination (EOD) instrument, dating violence items from the Youth Dating Violence Survey.</p><p class="Pa7"><strong>Results: </strong>Of the participants, 40.1% re­ported experiencing both racial and gender discrimination, and nearly all (93%) experi­enced dating violence. Participants reporting both racial and gender discrimination were 2.5 times more likely to report experiencing the highest frequency of dating violence, adjusted for age and sex (95% CI: 1.0- 6.7). A dose-response of EOD observed in unadjusted models (P for trend =.024) was no longer statistically significant after adjust­ment for age and sex (P for trend =.073).</p><p class="Default"><strong>Conclusions: </strong>Strategies to prevent TDV in this population should not ignore the com­pounding negative effects of racial and gen­der discrimination.</p><p class="Default"><em>Ethn Dis. </em>2018;28(Suppl 1):253-260; doi:10.18865/ed.28.S1.253.</p>
Commentary: Critical Race Theory Training to Eliminate Racial and Ethnic Health Disparities: The Public Health Critical Race Praxis Institute
Authors: Butler, III James , Fryer Craig S. , Garza Mary A. , Quinn Sandra C. , Thomas Stephen B. 
Published: August 2018

<p class="Pa6"> Racism is a fundamental cause of racial and ethnic disparities in health outcomes. Researchers have a critical role to play in confronting racism by understanding it and intervening on its impact on the health and well-being of minority populations. This requires new paradigms and theoretical frameworks that are responsive to structural racism’s present-day influence on health, health disparities, and research. To address the complexity with which racism influences both health and the production of knowl­edge about minority populations, the field must accelerate the professional develop­ment of researchers who are committed to eliminating racial and ethnic health disparities and achieving health equity. In this commentary, we describe a unique and vital training experience, the Public Health Critical Race Praxis Institute at the Univer­sity of Maryland’s Center for Health Equity. Through this training institute, we have focused on the experiential knowledge of diverse researchers committed to examining racism and trained them on putting racism at the forefront of their research agendas. The Institute brought together investigators from across the United States, including junior and senior faculty as well as post­doctoral fellows. The public health critical race methodology was purposefully used to structure the Institute’s curriculum, which instructed the scholars on Critical Race Theory as a framework in research. During a 2.5-day training in February 2014, scholars participated in activities, attended presenta­tions, joined in reflections, and interacted with Institute faculty. The scholars indi­cated a strong desire to focus on race and racism and adopt a Public Health Critical Race Praxis framework by utilizing Critical Race Theory in their research. <em></em></p><p class="Pa6"><em>Ethn Dis. </em>2018;28(Suppl 1):279-284; doi:10.18865/ed.28.S1.279.</p>