bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘HINTS’ At The Front Door: An Acute Stroke Service Quality Improvement Project
Authors: Rayner Rebecca , Hmu Chit 
Published: July 2019

Background/Aims Differential diagnosis of acute vertigo syndrome is challenging. In the acute medical setting, it is difficult to ascertain whether a person has definite peripheral vestibular pathology or a posterior circulation stroke. Mismanagement of these groups within our service is costly, with regards to correct medical input, MRI scan use and bed use within acute stroke services and the hospital setting. Research has demonstrated that the Head Impulse, Nystagmus, and Test of Skew (HINTS) test is efficacious, specific and sensitive in non-UK countries in determining if acute vertigo patients have dangerous (stroke) or benign (peripheral vestibular) pathology. It is not widely used in the UK. This may be due to well-known themes in implementation evidence such as cultural and clinician factors, as well as the lengthy time it takes to embed research into clinical settings. Methods We have started exploring, using Plan Do Study Act cycles, if the HINTS test can be successfully used in a large acute stroke service and the quality improvement effects this may have for patients (correct diagnosis, education/management and follow-up), financially to the Trust (efficient use of MRI scanning) and to the Stroke Pathway (effective bed use/acute medical management). Results Early results in round one of the quality improvement plan show that HINTS is a feasible bedside test to complete with 100% accuracy in the patients it was used on within the acute stroke pathway. This involved one stroke consultant and the patients' diagnosis with HINTS was assessed against routine follow-up MRI as appropriate. HINTS training has now been provided to all the stroke consultant and registrar team, A&E registrars and A&E advanced clinical practitioners, to senior physiotherapists in the acute stroke pathway and to the stroke alert nurses. Data gathering has commenced for round two, focusing further on bed use effects, as well as consideration of staff satisfaction with HINTS, and development of a recommended pathway for acute vertigo syndrome patients.
Exploring The Views Of Stroke Survivors Around Post Stroke Fatigue In Saudi Arabia: A Qualitative Interview Study
Authors: Alahmari Wafa , Alhowimel Ahmed , Alotaibi Mazyad , Kontou Eirini , Logan Pip , Coulson Neil 
Published: July 2019

Background/Aims Among stroke survivors, post-stroke fatigue is highly prevalent, ranging from 25% to 85% and has a significant impact on their quality of life. The available literature on post-stroke fatigue is still rudimentary, especially from middle-eastern countries such as Saudi Arabia, which is a country with a complex health care system and diverse population. The aim of this study is to explore the post-stroke survivors' experiences and perceptions of their post-stroke fatigue. To our knowledge, this is the first attempt to understand post-stroke fatigue among stroke survivors living in Saudi Arabia. Methods This was a qualitative study where semi-structured interviews were conducted with stroke survivors who were diagnosed to have fatigue based on the Fatigue Severity Scale. A total of eight participants were recruited using a purposive sampling technique for the study. Interviews with the participants were recorded, transcribed verbatim and analysed using inductive thematic analysis. Validity was ensured through data triangulation with participants. Results The 8 participants (male=4; female=4), aged between 27 and 65 years (mean 52, standard deviation 14), were interviewed. Their scores on the Fatigue Severity Scale ranged from 4.5 to 6 (mean 5.3, standard deviation 0.5). On analysing the interview transcripts, 8 over-arching themes were generated: fatigue after stroke; symptomatology of post-stroke fatigue; pre-stroke fatigue levels and lifestyle; stroke survivors' perspectives of post-stroke fatigue; post-stroke fatigue's impact on daily living; coping with post-stroke fatigue; post-stroke fatigue patients' perception on physiotherapy; type of support from family and health care professional. Conclusions The results from this study highlights the lack of awareness about fatigue after stroke among stroke survivors. Also, the themes indicate that there is a need to educate stroke patients and their caregivers about post-stroke fatigue and how they should manage it. Based on patients ‘experiences’, physiotherapy seems to be helpful in reducing fatigue symptoms after stroke, but sill there is a need to design specific physiotherapy interventions with suitable frequency and intensity to target fatigue after stroke. In summary, post-stroke fatigue has a significant impact on their quality of life concerning social participation and their daily life. Stroke survivors did not receive enough support from health care professionals with respect to post-stroke fatigue, and it is highly essential to train health care practitioners to identify and acknowledge post-stroke fatigue appropriately.
Predictors Of Outcome Following Anterior Cruciate Ligament Reconstruction: A Prospective Cohort Study In Uk Sports Medicine
Authors: Neal Bradley Stephen , Miller Stuart , Small Claire , Lack Simon David 
Published: July 2019

Background/Aims Following anterior cruciate ligament reconstruction, patients are reported to be at greater risk of re-rupture if they fail to meet structured discharge criteria. This prospective cohort study aimed to provide objective and subjective measures guiding safe return to play of amateur athletes following anterior cruciate ligament reconstruction. Methods Primary anterior cruciate ligament reconstruction patients presenting to Pure Sports Medicine were invited to participate. Successful return to play was determined using the Patient-Specific Functional Scale at the primary end point (9/12 post-operative), with scores >8 indicating successful outcomes. Secondary data were collected at baseline (Knee Injury and Osteoarthritis Outcome Score, Anterior Cruciate Ligament-Quality of Life), 3/12 (Knee Injury and Osteoarthritis Outcome Score, Anterior Cruciate Ligament-Quality of Life, quadriceps and hamstrings dynamometry), 6/12 (Knee Injury and Osteoarthritis Outcome Score, Anterior Cruciate Ligament-Quality of Life, quadriceps and hamstrings dynamometry, single/triple hop) and 9/12 post-operative (Knee Injury and Osteoarthritis Outcome Score, Anterior Cruciate Ligament-Quality of Life, quadriceps and hamstrings dynamometry, single/triple hop and slalom run). Binary logistic regression was used to determine the association between secondary data and the primary outcome. Results A total of 90 participants with anterior cruciate ligament reconstruction were recruited from March 2017 to June 2018, and 87 participants consented to baseline measures. To date, 29 participants have completed full data collection, with 12 participants determined to have a successful outcome. A lower hamstrings:quadriceps ratio in the contralateral limb at 3/12 post-operative (odds ratio: 0.005, 95% confidence interval: 0.001–0.89, P=0.045) and a higher Anterior Cruciate Ligament-Quality of Life score at 6/12 post-operative (odds ratio: 1.1, 95% confidence interval: 0.02–1.20, P=0.012) are associated with positive 9/12 post-operative outcomes. Conclusions Preliminary data analysis indicates that both hamstrings:quadriceps ratio function and participant psychology are associated with positive outcomes post-anterior cruciate ligament reconstruction.
Qualidade da água: parâmetros e métodos mais utilizados para análise de água de recursos hídricos superficiais
Authors: Ramos Adolfo De Souza , Oliveira Vicente De Paulo Santos de , Araújo Thiago Moreira de Rezende 
Published: July 2019

A preocupação com mensuração da qualidade da água tem adquirido cada vez mais destaque em âmbito mundial, face à crescente demanda de água para fins de abastecimento e uso agrícola, bem como a progressiva perda de potabilidade dos recursos hídricos disponíveis A definição da qualidade da água é dependente do uso pretendido, pois devem ser considerados parâmetros físico, químicos e biológicos distintos para cada caso. O CONAMA - Conselho Nacional do Meio Ambiente classificou os corpos hídricos em nove classes, conforme o valor máximo permitido de determinados parâmetros e o tipo de uso das águas (denominada com enquadramento), sendo um importante critério no gerenciamento dos recursos hídricos. Foi objetivo do presente trabalho realizar uma revisão bibliográfica de artigos científicos referentes à análise da qualidade de águas superficiais, publicados nos últimos cinco anos (2014 a 2018) em diferentes regiões do Brasil. Enfoque foi dado na verificação dos métodos empregados e os parâmetros mais comumente avaliados na caracterização da qualidade da água. Para pesquisa dos trabalhos consultados foram pesquisadas as seguintes palavras chave: “análise qualidade de água”, “análise parâmetro qualidade de água”, “caracterização qualidade de água”. A tabulação dos dados originou gráficos de percentual de parâmetros analisados conforme a resolução CONAMA nº 357/2005. O cálculo do IQA apareceu em 25,5% dos artigos. O número de parâmetros estabelecidos pelo CONANA nº 357/05, demanda grande investimento. Os indicadores adotados pela ANA – Agência Nacional de Águas demandam poucos parâmetros para análise, porém nem sempre retratam a real condição do recurso hídrico, caso estejam contaminados por metais pesados, porém são ferramentas bastantes utilizadas para tomadas de decisões e gestão.
TÜKETİCİLERİN ALIŞVERİŞ MERKEZİ TERCİH ETME UNSURLARININ İLİŞKİYİ SÜRDÜRME İSTEKLERİNE VE SADAKATE ETKİSİ: CAPACITY VE CAROUSEL ALIŞVERİŞ MERKEZİ ÖRNEKLERİ
Authors: BAKIR N. Ozan 
Published: July 2019

Son zamanlarda tüketicilerin tüketim alışkanlıklarının değişmesi ve gelişmesi nedeniyle, perakende sektörü etkilenmiştir. Tüketicilerin yaşam tarzlarındaki değişiklikler alışveriş merkezine olan talebi arttırmıştır. Ülkemizde alışveriş merkezlerinin sayıca artması, yoğun bir rekabet ortamı getirmiştir. Bu nedenle, tüketicilerin alışveriş merkezlerini tercih etme unsurlarının tespit edilmesi önemli bir durum haline gelmiştir. Bu araştırmanın amacı, tüketicilerin alışveriş merkezlerini tercih etme nedenlerinin, ilişkiyi sürdürme isteğine ve sadakate etkisinin incelenmesidir. Ayrıca, tüketicilerin alışveriş merkezlerini tercih etme nedenlerinin Carousel ve Capacity Alışveriş Merkezleri arasındaki farklılıkların tespit edilmesi araştırmanın yan amacını oluşturmaktadır. Çalışma, İstanbul Avrupa yakasında yer alan Bakırköy ilçesinde olan iki alışveriş merkezinde gerçekleştirilmiştir. Toplam 400 ziyaretçi ile yüz yüze anket yapılmıştır. Araştırmada tüketicilerin alışveriş merkezlerini tercih etme unsurları “çocuklara yönelik hizmetler”, “mağaza ve marka çeşitliliği”, “imaj ve iç mekân”, “çevre düzeni ve tasarım”, “özel günlerdeki aktiviteler”, otopark ve ulaşım” ve “iç mekânda rahatlık ve kolaylık sağlayan hizmetler” olarak ortaya çıkmıştır. Ayrıca ilişkiyi sürdürme isteği ile sadakat arasında kuvvetli ve pozitif yönde bir korelasyon olduğu tespit edilmiştir.
Short- and long-term results of percutaneous full-endoscopic and microsurgical lumbar discectomy: prospective cohort study
Authors: Kravtsov M. N. , Mirzametov S. D. , Malakhovskiy V. N. , Alekseyeva N. P. , Gaidar B. V. , Svistov D. V. 
Published: July 2019

Objective. To analyze immediate and long-term results of percutaneous endoscopic and microsurgical discectomy.Material and Methods. A prospective cohort study in two groups of patients was conducted in 2015–2018. The observation period was 6–42 months. Group 1 included 110 patients who underwent percutaneous endoscopic lumbar discectomy, and Group 2 – 331 patients who underwent microdiscectomy. Efficiency was assessed using NRS-11, ODI, SF-36, and MacNab questionnaires.Results. The operating time, bed day number, and disability period were shorter in Group 1 (p < 0.001). The average effective dose of radiation exposure to the patient was 4.4 mSv in transforaminal endoscopy, and 0.8 mSv in interlaminar and microsurgical discectomy. There were no significant intergroup differences in frequency and types of complications and reoperations. The portion of symptomatic hernia recurrence in Group 1 was 10 %, in Group 2 – 4.8 %. Significant differences in neurological outcomes and quality of life were not revealed. Good and excellent outcomes according to MacNab criteria were noted in 78.2 % and 84.9 %, in Groups 1 and 2, respectively.Conclusion. The percutaneous endoscopic discectomy allows reducing hospital stay length and disability period, while having clinical efficacy equal to that of other disectomy methods. A statistically insignificant increase in the risk of hernia recurrence after percutaneous endoscopic discectomy was noted.
Efficiency of using polyacrylic acid silver salt in decompression and stabilization surgery on the lumbar spine involving 1 to 3 segments
Authors: Kolesov S. V. , Grin A. A. , Slinyakov L. Y. , Morozova N. S. , Gorbatyuk D. S. , Zheltyakov O. E. 
Published: July 2019

Objective. To determine possible effect of the preparation of an incomplete polyacrylic acid silver salt on the volume of intraoperative and postoperative blood loss in open posterior surgery on the spine involving up to three segments.Material and Methods. Study design: randomized prospective multicenter cohort analysis. Level of evidence – IIb. The study was based on 90 patients aged 27 to 65 years who underwent decompression and stabilization surgical interventions on the lumbar spine through posterior median approach using transpedicular fixation system with fixation of up to three vertebrae. A comparison of perioperative blood loss volume in patients with local application of polyacrylic acid silver salt and without it was performed.Results. The volume of inraoperative blood loss (the sample was described using the mean value and standard deviation M ± σ) in the study group was 258.1 ± 164.5 ml (min 90; max 890), in the control group – 405.5 ± 157.9 ml (min 190; max 950). The postoperative blood loss through drainage (M ± σ) was 81.500 ± 77.046 ml (min 20; max 400) in the study group, 151.560 ± 74.745 (min 20; max 600) in the control group. Comparison of both intraoperative and postoperative blood loss according to the Mann-Whitney U-test confirms the high statistical significance of differences (p < 0.01), which suggests the effectiveness of the preparation.Conclusion. The use of incomplete polyacrylic acid silver salt in decompression and stabilization interventions on the lumbar spine involving 1 to 3 segments can effectively reduce the volume of blood loss both during surgery and in the postoperative period.
Defining the Concept of Risk Applied in Entrepreneurship. Conceptual Delimitation Risk - Entrepreneurial Uncertainty
Authors: Alexandru Tărăbîc Andrei 
Published: July 2019

Abstract
Even though in many cases the terms of risk and uncertainty are similar, they have to be delimited to understand the meaning of each, individual, as accurately as possible. The two terms are combined in different situations. No matter how well the risk is managed, uncertainty cannot be removed because all possible situations and interdependencies cannot be taken into account. Thus, a source of risk can be considered uncertainty in itself if it is based on poor quality information about the actual internal or external situation of the company. Also, in my conclusion, traditional financial theory distinguishes between systematic risk and particular risk, which reaches the company’s overall risk. Investors can reduce total risk with the two primary risk management instruments, namely diversification and asset allocation.
Completeness of Written Discharge Guidance for English- and Spanish-Speaking Patient Families
Authors: Platter Erin , Hamline Michelle Y. , Tancredi Daniel J. , Fernandez y Garcia Erik , Rosenthal Jennifer L. 
Published: July 2019

OBJECTIVES:
Written discharge guidance for hospitalized pediatric patients should include language-appropriate key elements to ensure positive discharge outcomes. Our objective in this study was to determine the completeness of written pediatric discharge guidance and to test the hypothesis that Spanish-speaking families with limited English proficiency (LEP) receive less complete written discharge guidance than English-speaking families.

METHODS:
We conducted a retrospective review of written discharge guidance provided to 100 English- and 100 Spanish-speaking families at an urban nonfreestanding children’s hospital to assess the inclusion of key elements: follow-up plan, contingency plan, telephone contact, discharge medications, discharge diagnosis, and hospital course. We compared the completeness of discharge guidance (number of elements provided among number of applicable elements) between English- versus Spanish-speaking families.

RESULTS:
When evaluating discharge guidance for the presence of key elements in any language, there was no significant difference between English- and Spanish-speaking families. However, the mean completeness of language-appropriate discharge guidance for English- and Spanish-speaking families was 87.8% (95% confidence interval [CI] 84.4%–91.1%) and 16.0% (95% CI 11.5%–20.4%), respectively. The ordinal logistic regression examining the association between the number of key element deficits and English- (reference group) versus Spanish-speaking families demonstrated an adjusted odds ratio of 339.8 (95% CI 112.4–1027.5).

CONCLUSIONS:
Few Spanish-speaking families with LEP receive written discharge guidance in their preferred language. Complete, language-appropriate discharge guidance was identified as an area for improvement efforts to work toward improving care provided to families with LEP.
MANAJEMEN PENDIDIKAN DAN PELATIHAN TEKNIS FUNGSIONAL PENINGKATAN KOMPETENSI GURU DI BALAI DIKLAT KEAGAMAAN
Authors: Padilah Ipah Parihah , Suryana Yaya 
Published: July 2019

Tujuan penelitian ini adalah untuk mengetahui manajemen diklat di Balai Diklat Keagamaan Bandung yang mencakup profil, perencanaan, pelaksanaan, evaluasi, faktor pendukung dan penghambat penyelenggaraan diklat, serta hasil menejemen penyelenggaraan diklat teknis fungsional peningkatan kompetensi guru di Balai Diklat Keagamaan Bandung. Metode penelitian yang digunakan adalah metode deskriptif-kualitatif. Teknik pengumpulan data dilakukan dengan teknik wawancara, observasi dan menyalin dokumen. Analisis data yang digunakan adalah analisis dengan penafsiran deskriftif semata-mata. Hasil penelitian ini menunjukan bahwa Manajemen Pendidikan dan Pelatihan Teknis Fungsional Peningkatan Kompetensi Guru di Balai Diklat Keagamaan Bandung terdiri dari perencanaan yang meliputi: (1) analisis kebutuhan diklat, (2) rapat kerja, (3) rapat koordinasi, (4) startegi pendekatan, dan (5) penyusunan bahan. Pelaksanaan diklat dilakukan melalui: (1) tahap persiapan, (2) tahap pelaksanaan dan (3) tahap pelaporan. Evaluasi yang terdiri dari: (1) evaluasi terhadap peserta, (2) evaluasi terhadap Widyaiswara, dan (3) evaluasi terhadap penyelenggara.
İslamiyet ve Kudüs
Authors: HARAMAN Ömer Faruk 
Published: July 2019

Bu makalede Kudüs’ün İslam
dinindeki yeri, önemi ve Müslümanlar açısından ne anlam ifade ettiği üzerinde
durulmaktadır. Bilindiği üzere Kudüs, tarih boyunca çeşitli zamanlarda
Yahudilerin, Hıristiyanların ve Müslümanların hakimiyetinde kalmış ve önemli mücadelelere
sahne olmuştur. Her dinin önemli ve kutsal kabul edilen bazı mekanları
bulunmaktadır. Kur’an’da Mescid-i Aksa’ya atıfta bulunulması, konuya ilişkin
hadisler, Müslümanların ilk kıblesi olması gibi hususlar Kudüs’ü Müslümanlar
açısından önemli kılmaktadır. Bu çalışmada öncelikle İslam’ın kutsallık
anlayışı ve Müslümanlar açısından Kudüs’ün kutsiyetinin kaynağı hakkında bilgi
verilecek, ardından ayet ve hadislerden hareketle Mescid-i Aksa’nın neresi
olduğu ve Mescid-i Aksa etrafındaki tartışmalara işaret edilecektir
İsrail’in Kudüs Politikasının Dini Nedenleri Üzerine Bir Analiz
Authors: AYDIN Mahmut 
Published: July 2019

Bilindiği üzere Müslümanlar peygamberler şehri ve Tevhit inancının iki
önemli merkezinden biri olması dolayısıyla Kudüs’ü kutsal bir kent olarak kabul
etmektedir. Yahudiler ise Kudüs’ü ilk kurucu ata olarak kabul ettikleri İbrahim
peygamber ve oğullarıyla ilişkilendirerek Babil sürgünü sonrası oluşturmaya
başladıkları kutsal tarihlerinin olmazsa olmaz parçası yapmışlardır. Bu yazıda
Yahudi kutsal metinleri ışığında Kudüs’ün Yahudiler için dini ve politik/siyasi
önemi öncelikle ortaya konmaya çalışılmıştır. Daha sonra ise ortaya konan bu
önem üzerinden gerek Yahudiler gerekse farkına varılmadan Yahudi olmayanlar
tarafından dillendirilen ve Yahudileri kutsal metinlerinde ifade edilen Kudüs
algısıyla paralellik arz eden Kudüs söylemlerinin öne çıkarılmaya devam
edilmesi durumunda Kudüs’te Yahudiler dışında başka etnik ve dini grupların
bulunmasının mümkün olmadığı tezi ileri sürülmüştür. Son olarak ise Kudüs’ün
“gökte inşa edildiği”, “arzın kapısı olduğu” ve “ölümden dirilme mekanı” olduğu
gibi söylemlerin Yahudilerin özelde Kudüs’e genelde ise tüm Filistin yurduna
sahip olma ve bunun için de Yahudi olmayanları bölgeden temizlemeye yönelik
terör politikalarına destek olmaktan başka bir işe yaramayacağı örneklerle
ortaya konmaya çalışılmıştır
Kudüs Katliamı Bağlamında Haçlı Seferlerinin Sebepleri
Authors: POLAT Ziya 
Published: July 2019

Haçlı seferleri
Kutsal toprakların kurtarılması veya haçlıların maddi menfaat peşinde koşma
iddialarıyla gündeme gelmektedir. Oysa bu iki sebep tartışılırken seferler
boyunca yapılan katliamlar bazı tarihçiler tarafından bilinçli bir şekilde
gözden ırak tutulmuştur. Batı merkezli tarih anlayışı olayları veya olguları
istediği gibi inşa etmiş, kendileri açısından değerli gördükleri konuları ön
plana çıkarmış, aleyhlerine olacağını düşündükleri yaşanmışlıkları da tarihin
tozlu sayfaları arasına terk etmiştir. Bu yönüyle düşünüldüğünde haçlı
seferleri sebepleri ne olursa olsun katliamcı tabiatı gözler önüne seren önemli
olaylar zincirinden oluşmaktadır. Bu makalenin amacı haçlı seferlerinin
sebeplerini Kudüs katliamı üzerinden irdelemektir. Çalışmanın ana kaynaklarını
haçlı vakayinameleri oluşturacağından hem seferin başlangıç noktasındaki
amaçları kolayca tespit edilebilecek hem de vardığı yerde yapılanlar üzerinden
amaçlarının gerçekliği test edilmiş olacaktır. Böylece haçlıların Kudüs’te
yaptığı katliam gözler önüne serileceği gibi haçlı seferlerinin sebepleri veya
amaçları da daha görünür hale gelmiş olacaktır.