bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aktifitas Fisik Menjadi Faktor Dominan Kejadian Hipertensi pada Pasien Rawat Jalan di Puskesmas Kecamatan Cipayung Periode Januari-April Tahun 2023
Authors: Putra Sukma Aditya , Notoatmodjo Soekidjo , Sulistyowati Yeny 
Published: October 2023

Hypertension is an increase in systolic blood pressure exceeding 140 mmHg and diastolic blood pressure exceeding 90 mmHg. The long-term impact of high blood pressure can lead to damage to various organs such as the heart, kidneys, and brain. In 2019, 34 percent of the population in Jakarta experienced the risk of hypertension, both mild and severe. Based on data from the Cipayung District Health Center in 2022, hypertension ranked first among the top 10 most frequently visited diseases on a monthly basis. This research aims to study and explain the relationship between lifestyle and the occurrence of hypertension in outpatients at the Cipayung District Health Center during the period of January-April 2023. The study design of this research is cross-sectional. Data collection is sourced from secondary data obtained from the medical records of the Cipayung District Health Center. The population in this study consists of outpatients who visited the Cipayung District Health Center with data collected from January to April 2023, totaling 1152 individuals, and all of them were analyzed.
Based on the analysis results, it is known that age, gender, education level, physical activity, and salt consumption significantly influence the occurrence of hypertension. Physical activity is the most dominant risk factor influencing the occurrence of hypertension with an odds ratio of 29.714 and a 95% confidence interval of 19.543 - 45.178. Therefore, it is expected that the health center can enhance health promotion efforts and interventions targeting at-risk groups to prevent hypertension in the Cipayung Health Center area. Additionally, establishing sports clubs and healthy Diet Community Kitchens that can be participated in by the community can be beneficial. Increasing community engagement in healthy living can also reduce the risk of hypertension in the population.

Keywords : Hypertension, Physical Activity, Health Center, Cipayung
Hubungan Tinggi Badan Ibu, Riwayat ASI Eksklusif dan Berat Badan Lahir Rendah dengan Kejadian Stunting Pada Balita 24-59 Bulan
Authors: Widiyarti Eka Saputri , Nurzihan Nastitie Cinintya , Muhlishoh Arwin 
Published: October 2023

Stunting atau anak pendek digambarkan sebagai seorang balita yang memiliki tinggi badan lebih rendah dari standar tinggi badan balita seumurannya. Stunting terjadi dari masih dalam kandungan dan baru nampak setelah anak berusia dua tahun. Stunting berkaitan dengan peningkatan risiko kesakitan dan kematian serta terhambatnya pertumbuhan motorik dan mental. Pada anak stunting, cenderung lebih rentan terhadap penyakit infeksi sehingga berisiko mengalami penurunan kualitas belajar di sekolah. Desain penelitian dengan menggunakan metode cohort restropektif. Tujuan dari penelitian ini adalah untuk memperoleh informasi atau gambaran mengenai hubungan antara tinggi badan ibu, riwayat pemberian asi eksklusif dan riwayat BBLR dengan kejadian stunting pada balita usia 24-59 bulan di Kecamatan Wonosamodro, Kabupaten Boyolali. Responden dalam penelitian ini sebanyak 61 balita di Kecamatan Wonosamodro. Pengambilan sampel menggunakan teknik purposive sampling. Variabel yang diteliti adalah tinggi badan ibu, riwayat pemberian ASI eksklusif dan riwayat BBLR. Dianalisis menggunakan uji chi aquare dengan nilai signifikansi <0,05. Penelitian ini menunjukkan bahwa tinggi ibu tidak terdapat hubungan dengan stunting (p=1,000) dan nilai OR = 0,34, riwayat pemberian ASI eksklusif tidak terdapat hubungan dengan stunting (p=0,211) dan nilai OR = 2,444, riwayat BBLR terdapat hubungan dengan stunting (p=0,00) dan nilai OR = 35,858 yang menunjukkan bahwa riwayat BBLR pada balita merupakan faktor yang berhubungan dengan stunting dan merupakan faktor risiko terjadinya stunting sebesar 35,8 kali dibanding dengan balita dengan berat lahir normal.
Schiller crítico de Kant?
Authors: Pires Carlos Eduardo Moreno 
Published: October 2023

Neste artigo, buscaremos mostrar que os epigramasas Escrúpulos da Consciência e Decisão não devem ser tomados como uma crítica por parte de Schiller à tese kantiana sobre o valor moral das ações moralmente exigidas, tal como apresentada nos famosos exemplos da primeira seção das Fundamentação; também não devem ser interpretados como uma forma de crítica à psicologia moral de Kant, mais exatamente, à sua teoria sobre a motivação moral. Ao invés disso, veremos que aqueles famigerados epigramas são uma espécie de sátira não da filosofia moral kantiana, mas de uma interpretação equivocada da mesma, muito difundida já à quela época.
A54Co-produced scenario-based simulations: Respect for, and understanding of, those from transgender and gender diverse communities
Authors: Hamilton Carrie , Miller Julie , Spencer Jess , Tomkins Caroline 
Published: October 2023

In July 2018 the government launched the national LGBT action plan to advance the rights of LGBT people to improve the way that public services work for them, regardless of their sexual orientation, gender identity or sex characteristics [1]. Transgender and gender diverse (TGD) [2], individuals continue to experience discrimination and disadvantages in accessing healthcare whilst often having complex health needs, furthermore, there is a gap in undergraduate curriculums on TGD patient care [3].
A workshop was co-produced with members of the TGD community; scenario content was translated from their own experiences of prejudice and disrespect. In order to maximize participation, the scenario is delivered through forum theatre. It centres on an individual from the TGD community (played by a trans-actor) and the assumptions of a health professional (played by an actor). Audience members watch the scenario unfold; at closure of the first run through, the audience have a facilitated discussion. During the second run through, audiences are invited to change the behaviour of the health professional, leading to preferable, respectful and safe care. The actors have been trained to amend their actions as instructed by the audience members via the facilitator. After the simulation, the trans-actor de-roles and then describes the journey of transitioning their gender identity and presentation. The simulation and the lived experience are separated and treated as two separate elements of the training.
The co-produced scenario-based simulation has been successful in promoting respect and understanding of those from the TGD community. Audiences have been a broad range of professional groups: vocational, undergraduate and registrants. This session has been repeated over fifty times, with changes made to suit the audience background. Health professionals have had the opportunity to learn and practice appropriate communication skills. The lived experience component post-simulation was impactful in providing a personal insight into the challenges faced by TGD individuals. Participants reported an increase in knowledge of the needs of, and confidence in communicating with, members of the TGD community.
The co-produced, replicable, scenario-based simulation, featuring forum theatre and lived experience, is an effective method of promoting respect and understanding of those from the TGD community. The simulation provides healthcare professionals with the opportunity to learn and practice appropriate communication skills. Separating the simulation with lived experience is an essential component, due to ethical and safety issues, although linking the two, strengthens the authenticity of the session.
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A32Towards a taxonomy of scale: a sustainable approach
Authors: Rolfe Ursula , Holley Debbie 
Published: October 2023

Background and aim:
Taking simulation from concept through to scalable delivery is complex, contested and an under-theorized process. The traditional approaches to scaling innovations, proposed by Everett Rogers in the 1960s is the notion of diffusion of innovation; we argue that this is of limited use in our context of working with NHS health professionals supporting their learning post-covid. Our approach to scaling draws the upon the well-tested seminal works on taxonomies by Coburn (2003) [1] and her dimensional framework, Dede et al (2007) [2], with their educational scaling model, plus the systematic review of Greenhalgh et al (2004) [3] in health services.
Activity:
By considering the ways in which our eight Health Education England (HEE) simulation projects have been delivered, this work presents an emerging framework, designed to enable the orchestration of team discourse about theory, the production of simulation artefacts as tools for design discourse and the identification of scalable systemic pain points. We pay particular attention to scaling innovations in practice and organizational change, which are in our view enabling factors in the sustainable adoption of learning technologies by end users in the workplace.
Findings:
Successful scaling is more than just being about the number of users we can reach. It requires underpinning by an understanding about the changes in practice an innovation can bring about, and how valuable these changes are to stakeholders. Challenges remain as to whether such changes can be sustained over time, and the extent to which users and stakeholders are involved in co-creating the innovation. Individuals within the organizations – and their attitudes, beliefs, and habits – play an equally important role in exploring new technologies and practices with an open mind and perceiving these as an added value in their work environment and daily routines.
Conclusion:
This work illustrates the need to strategically involve the ‘missing middle’ and starts to identify the key role these people play in that space between where scaling factors reside between top-down strategy and bottom-up initiatives.
Ethics statement:
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A86Using Value Based Simulation to recruit high school students into the more difficult to fill roles within health and social care – contact author (Carla)
Authors: Dickson Jamie , Mardon Julie 
Published: October 2023

Simulation based education (SBE) has been used to help attract school students into healthcare previously but commonly this is in a try it and see format using manikins to gain insight into history taking or physical examination. Also traditionally we tend to focus on more traditional healthcare professions such as nursing medicine and physiotherapy as common examples.
In our region we have been working closely with our national youth academy looking at novel ways to attract and recruit our young people into more difficult to fill roles within health and social care such as home care roles and healthcare support worker roles.
There are many good examples across the general workforce where simulation training can aid successful transition into the work place [1]. We are aware that certain areas of health and social care are more difficult to recruit to and wondered if values-based simulation could aid successful recruitment in this area?
An immersive simulation session was designed based on 2 scenarios with space for reflection on who am I and what matters to me as a human. The first scenario was based on a reablement opportunity and focussed in on mutual goal setting giving space to express needs in the social care environment. The young learner was able to explore what skills they had and whether they were true to their own values. The second scenario was based in a hospital and looked at a health care support worker accompanying a patient to theatre. The school students had a chance to practice active listening and looking after a person who was anxious. It was amazing to see the skill set that the young people brought to both scenarios.
The session has been delivered in schools, colleges and a national event. There are plans to bring the immersive simulation session to recruitment fairs.
The take home messages from the sessions have been in alignment with the individuals and social care core values reflecting compassion, motivational techniques and mutual goal setting. Comments such as ‘I am astonished that I could make a difference to that person’ and ‘I hadn’t thought about a career in social care before but now I know how rewarding it feels I’m considering it’ reflect these findings. We will also look at the effect on recruitment as we roll out and scale up the work.
Immersive simulation respects the young person’s core values when enabling them to make meaningful and lasting choices about careers in health and social care.
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A80Simulation: a tool to improve the confidence of International Medical Graduates transitioning into working in the NHS
Authors: Jones Samuel , Premchandran Divya , Smalley Benjamin 
Published: October 2023

International medical graduates (IMGs) are doctors that have graduated from a medical university outside of the UK and subsequently employed by the NHS. The transition to working within the NHS presents them with many new challenges including communication, cultural differences, healthcare system differences, NHS policies and UK legal frameworks, and the expectations attributed to a doctor practicing in the UK. They often commence work with little training about these practical challenges and as a result encounter a steep learning curve. IMGs are significantly more likely to receive complaints and face fitness to practice investigation [1]. Therefore, developing educational opportunities to help them adapt to working in the NHS is a necessity.
Simulation has been shown to improve the confidence, knowledge and provides an ethically and educationally safe setting for doctors to develop their practice [2,3]. We therefore created an IMG oriented simulation programme that focussed on some of the key challenges they face.
We delivered simulation sessions on four separate days with 6-8 IMG candidates at each. Sessions consisted of two clinical scenarios divided into sections, approximately 20 minutes long, each targeting a key educational outcome. We used a combination of a computerized simulation manikin (SimMan Essential) and live actors. Key educational outcomes included managing an acutely deteriorating patient, escalating to a senior, obtaining a collateral history, breaking bad news and duty of candour. Each candidate had the opportunity to participate in a part of the simulation whilst the others observed. The candidates were then debriefed and learning objectives explored by a trained faculty member. The candidates were asked to complete pre-simulation, immediate post-simulation and 3-month post-simulation feedback forms using a nominal Likert scale. They scored 1-10 (10 being ‘strongly agree’) on their confidence around each component of the educational outcomes.
We had 21 candidates complete the simulation day, with 19 responses to the immediate post simulation survey and 9 responses to the 3-month post simulation survey. The results showed a significant increase in the confidence of the candidates for each educational outcome, with mean scores increasing from 6-7 to >9. We also demonstrated that the candidate’s confidence remained and they were still using the skills they had learned 3 months later.
We have demonstrated that IMG oriented simulation is a valuable educational tool for doctors transitioning into working within the NHS. Confidence around a variety of difficult topics increases and the lessons learned have a lasting impact.
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A100Simulating to manage post thyroidectomy haematoma safely: Improving fidelity whilst reducing cost
Authors: Vale Owen , Hadfield Andrew , Maidment Catrin , Huckle Danielle , Diaz-Navarro Cristina 
Published: October 2023

Simulation training sessions were designed at the University Hospital of Wales in order to implement the new national guidelines for the management of suspected haematoma following thyroid surgery [1].
Opportunities included on site portable training with a part task trainer and high-fidelity scenarios simulating patient deterioration following thyroid surgery in an immersive environment.
Our initial design for the high-fidelity set-up included a simulated neck haematoma achieved by using a second generation supraglottic airway device (SAD) with an inflatable cuff placed in the manikin’s neck with the laryngeal opening outwards and tubing inside the chest. The opening was filled with red jelly, covered by simulated strap muscles (made from simulated small bowel with interrupted sutures) and simulated neck skin (which presented a sutured incision complete with steri-strips). Ongoing bleeding was simulated by injecting liquid jelly through the SAD’s gastric port via a long connecting tube in the manikin’s thorax.
This simulation training increased confidence and familiarity with the steps required to manage post thyroid surgery haematomas in 100% (15/15) of candidates, with 73% grading the mannikin ≥4/5 for realism. However, it was costly to provide and time-consuming to set up.
It was decided to try to make the set-up cheaper and easier to reproduce without impairing quality.
Equipment costs were reviewed and alternative options identified. Expensive components included the SAD and bowel material, which were replaced with a cheaper SAD and a disposable tourniquet fashioned as shown in
Making the simulation larynx and strap muscles. A step by step guide
The cost of disposable props used in each session was reduced from £133.04 to £8.52 with the new equipment. The designers also felt it was significantly more robust and easier to reproduce. This approach could also be easily adapted for mobile part-task training, improving multi-disciplinary access to training.
Feedback showed 47% of candidates felt the new set-up to be better, and 47% reported non-inferiority.
Changing to new equipment resulted in a design that was significantly cheaper, easier to source and set-up, while being at least as realistic and offering training opportunities outside the high-fidelity environment.
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A24Calculating the cost of simulation based education. What to include?
Authors: Byrne Dara , Fitzgerald Laura , O’Dea Angela 
Published: October 2023

Background and aim:
The cost of developing simulation-based education (SBE) facilities is high. However, the cost of sustaining SBE activities is often not considered in the initial outlay and facilities and centres can find themselves in financial difficulty early on. In addition to the cost of the initial capital and technology costs, there are many other costs incurred when running and sustaining SBE programmes. These are often not apparent or considered by simulationists when establishing new programmes. Research to date has focused on cost effectiveness and a return on investment [1]. However, the sustainability of a SBE programme is related to the ability to meet these costs. The aim of this work is to develop a simulation cost calculator that considered all costs incurred in skills programme development.
Methods:
Following consultation with experienced simulation faculty, the finance office, human resources and buildings office and equipment providers, a cost calculator template was devised to categorize the items required for SBE. The template allows for the calculation of the cost of teaching a procedural skill per person based on the total cost of all of the items in the template plus the number of attempts required for teaching and/or assessment.
Results:
The cost calculator categories for procedural skills teaching in a simulated environment included recurrent costs such as heating, light and cleaning of the simulation space/facility, consumables, single use simulators, fixed equipment/initial outlay, waste disposal, depreciation costs and staff costs. To illustrate, the calculated cost for a bowel anastomosis workshop using biological materials is approx. €235 per person while the equipment cost for a basic skill such as venepuncture is €161.17.
Conclusion:
Adequate resourcing is critical to establish, run and sustain SBE programmes. A cost calculator template will help new facilities to project their budget requirements and to decide what skills education they can support and sustain long term.
Ethics statement:
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
A62Mini in Disruption, Major in Impact: The Use and Sustainability of ‘Mini-Sims’
Authors: Tang Cary , Tarhini Mariam , Wilson Esther , Hester Benjamin , Redwood Vanessa , Duzy Ashley 
Published: October 2023

Simulations can be important for wider learning and patient safety [1]. However, the delivery of traditional simulations is not always feasible [2]. We developed an alternative ‘Mini-Sim’ to deliver high quality teaching with a sustainable approach, aimed to save time and resources.
The simulation team delivered traditional ward-based simulations every Wednesday. Where this was not possible, due to timing or staffing constraints, we delivered ‘Mini-Sims’. This involved participant verbalizing their assessments to a pre-written scenario with a facilitator asking follow-up questions as opposed to physically acting out. Data collected over 5 months included the type and duration of simulation, how many participants were involved, and resources required.
Across the 5 months, between 0 to 16 participants were reached monthly using traditional simulations, whereas ‘Mini-Sims’ reached 4 to 14,
Comparing participant numbers from ‘Traditional Sims’ with ‘Mini-Sims’ delivered between October 2022 to February 2023
Where resources and time are limited, the minimalistic approach of ‘Mini-Sims’ provide consistent teaching opportunities and promotes sustainability in man-power, time, and costs. Whilst humble in appearance, ‘Mini-Sims’ show sizeable potential for sustainable learning.
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.