bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sifat Kimia dan Daya Terima Permen Jelly Gandaria (Bouea Macrophylla Griffith) Kombinasi Madu Sebagai Pengganti Gula
Authors: Marda Nurwafiah , Mustafa Irvan , Asmi Nur Fauzia 
Published: October 2023

Permen Jelly merupakan jajanan popular yang dapat dijadikan alternatif dalam meningkatkan asupan senyawa fungsional seperti serat dan senyawa fenolik dengan penambahan buah yang kaya antioksidan dan fitokimia salah satunya gandaria. Gandaria adalah buah endemic Maluku yang pemanfaatanya masih kurang berbandung terbalik dengan manfaatnya yang luar biasa bagi Kesehatan. Tujuan penelitian untuk mengetahui sifat kimia serta daya terima permen jelly gandaria kombinasi madu. Penelitian ini menggunakan true experimental menggunakan RAL dengan penambahan ekstrak gandaria (P1:10%, P2:15%, P3:20% dan P4:25%) dan Uji organoleptik . Analisis sifat kimia (kadar air, kadar abu dan vitamin c) dan organoleptic menggunakan Oneway Annova dan Kruskal Wallis bila data tidak terdistribusi normal. Hasil penelitian menunjukkan kadar air di semua perlakuan >70%, kadar abu masing masing P1: 0,26%, P2: 0,29%, P3: 0,23%, dan P4: 0,29%. Dan vitamin C masing-masing (dalam mg) P1: 61,24 P2:62,65 P3:65,47 dan P4: 66,48. Penambahan gandaria memberikan perbedaan yang signifikan terhadap penerimaan aroma, tekstur dan rasa pada permen jelly (p<0,05). Formula permen jelly gandararia dari segi rasa dan warna adalah P3, dari segi waroma dan tekstur panelis menyukai P2.
Ч.АЙТМАТОВДУН “АК КЕМЕ” ПОВЕСТИНДЕ БАЛАНЫ ЭЛДИК ООЗЕКИ ЧЫГАРМАЧЫЛЫК АРКЫЛУУ ТАРБИЯЛООНУН МААНИСИ
Authors: Алтыкеева Нурзада , Ниясалиева Бактыгул 
Published: October 2023

Макалада “Ак кеме” повестинде колдонулган фольклордук мотивдер жана аладын баланы тарбиялоодогу орду талданат. Тагыраагы Бугу-Эне тууралуу балага таятасы айтып берген жомогунун чыгарма үчүн кандай орунда турары белгиленет. Бугу-Эненин кыргыз элинин эл болуп сакталып калышына себепкер болгону бала үчүн абдан маанилүү эле. Анткени мындан улам бала бугуну ыйык катары тутуп, ал бешик алып келсе деп кыялданат.Мындан тышкары повесттеги элдин өзөгүнөн чыккан ыр тууралуу улама сөздүн мааниси чечмеленет.Улама сөз Ата-Журттун ыйыктыгын, эл-жерге болгон чыныгы сүйүүнү даңазалайт. Повесттеги Чыпалак бала жөнүндөгү жомоктун да өзүнчө орду бар экенине токтолобуз. Ал наадандык, карөзгөйлүк эч убакта адамга жакшылык алып келбесин түшүндүрөт. Ар бир фольклордук чыгарманын повесттеги идеянын ачылышы үчүн табылгыс каражат катары колдонулушун баса көрсөтүүгө болот.
A3‘I have had an epiphany’ student nurses’ reflections on their carbon footprint in simulation
Authors: Ames Hannah , Spowart Lucy 
Published: October 2023

Background and aim:
Healthcare delivery is a major contributor to the climate crisis, producing 4.4% of net carbon global emissions today [1]. The campaign ‘For a Greener NHS’ launched in 2020 set a road map for the National Health Service (NHS) in the UK to reach net-zero emissions for patient care by 2040 [2]. However, to achieve this, staff must be carbon literate and start by understanding the impact of their own professional practice. It follows, therefore, that carbon literacy education must be a priority for healthcare educators. There is to date no research on educating student nurses on carbon literacy or the personal carbon footprints of their practice. Using simulation could provide an innovative solution providing a system-thinking environment that could connect carbon emissions theory to actual practice and develop carbon literacy.
The aim of the study was to explore student nurses’ reflections on their carbon footprint of resources used in simulation and identify the potential role of simulation in developing carbon literacy.
Methods:
This study used qualitative phenomenographic methodology, underpinned by transformational learning theory to explore student nurses’ awareness and attitudes towards their carbon emissions from simulation. Ten participants were asked to log the clinical resources used during a venepuncture and cannulation simulation skills station. Carbon emissions were then calculated for each participant using the Centre for Sustainable Healthcare [3] carbon emissions calculation and were shown to students during one-to-one semi-structured interviews. Data analysis was conducted, discovering the different ways participants conceptualized their carbon footprint.
Results:
Students were unaware and shocked by their carbon emissions from resource use in simulation and wanted to be better educated to enable them to make an informed choice to practise sustainably. Students highlighted the crucial role of simulation educators to educate students using simulation but to role model sustainable practice and design low resource-use simulation. Finally, students were able to connect the impact of their personal clinical practice to the global climate crisis.
Conclusion:
Simulation is a powerful teaching approach to develop carbon literacy, challenging students’ pre-existing knowledge, and enabling them to link their personal practice to the global climate-change crisis.
Ethics statement:
The 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.
A45Developing low carbon care – using simulation to calculate and reduce carbon emissions
Authors: Ames Hannah 
Published: October 2023

Background and aim:
Climate change is considered one of the most pressing global concerns for the future and the single biggest health threat [1]. Healthcare delivery is a major contributor to the climate crisis, producing 4.4% of net carbon global emissions today [2]. One of the largest contributors to NHS carbon emissions is the use of equipment, consumables and clinical care itself [2]. Therefore, clinical staff have a significant part to play in reducing carbon emissions and achieving national carbon reduction targets. However, they must be carbon literate and understand the impact of personal practice on global carbon emissions and be able to identify ways to deliver low carbon models of care [3]. Simulation could play a significant role in educating and developing sustainable practice in healthcare students through a system thinking approach. Allowing students to examine the environmental impact of healthcare delivery and support innovative solutions to reduce carbon emissions without compromising care.
The aim was to firstly increase nursing students’ awareness of the carbon emissions from the delivery of patient care. Secondly to improve clinical decision-making in the selection and implementation of interventions to enable the delivery of low carbon care.
Activity:
Undergraduate nursing students took part in a specifically designed simulation scenario. Students completed the scenario of a patient presenting to the Emergency Department with exacerbation of Chronic Obstructive Pulmonary Disease (COPD), implementing care and interventions as clinically indicated. After completion of the simulation students then calculated the carbon emissions from the clinical resources they used, using the Centre for Sustainable Healthcare carbon emissions calculation.
Findings:
Debriefing identified that students did not consider sustainability and carbon emissions in their current clinical decision-making. Students were shocked by the amount of carbon emissions generated from interventions. Students identified areas where they could reduce carbon emissions without compromising care such as inappropriate use of gloves, using dry powdered inhalers, and reducing unnecessary cannulation.
Conclusion:
Simulation could play a pivotal role in developing sustainable clinical decision-making skills in healthcare students and staff. Actively calculating carbon emissions allows students to directly see the environmental impact of their practice, increasing carbon literacy and stimulating low carbon care practice. This use of simulation should be explored further by educators across professions to support both national and global climate change policies.
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.
A28Developing and delivering a telephone skills simulation training for non-registered NHS mental health call-handlers
Authors: Thame Anna , Hamilton Carrie 
Published: October 2023

Background and aim:
Registered healthcare professionals undertake a wide range of mental health work, sometimes with little preparation and training [1]. Increasingly non-registered staff take on mental health call-handler roles, having conversations with vulnerable individuals over the phone; these staff often lack the training to effectively communicate with callers. The aim of this initiative was to design and deliver a telephone skills training program for non-registered NHS mental health call-handlers, with the hypothesis that such training would improve their communication skills and overall job performance. Studies have shown that receiving training in having supportive mental health conversations over the phone increases staff confidence and changes their attitudes [2] and has the potential to benefit staff retention.
Methods:
A mixed-methods approach was used in the design, incorporating both qualitative and quantitative data collection and based on the needs and feedback of the call-handlers themselves. Evidence shows that involving simulated patients (SPs) can be effective in telephone studies [3]; leading us to train experienced SPs in their roles as members of the community phoning the help line. All was face to face, although conducted over the phone with the SP hidden. Active participants, the SP and the observing participants all became involved in the debrief. The content covered active listening, empathy, signposting and options in handling the challenging situations. Developed over a month, the programme was delivered as part of an overall training for their roles.
Results:
The evaluation of the session indicated significant self-rated confidence in having calls with members of the public. The scenarios increased in intensity, covering topics ranging from bullying, domestic violence, gambling addiction and intent to take life. Qualitative feedback from the call-handlers showed that they felt more confident and prepared in their roles, and were better equipped to handle challenging situations. The involvement of SPs was also found to be authentic and highly beneficial by the call-handlers. Participants requested frequent practice sessions, face to face or online.
Conclusion:
Investing in providing targeted training and support for non-registered NHS mental health call-handlers, can have a positive impact on their communication skills, overall job performance and likely staff retention. This can ultimately lead to improved quality of care and patient outcomes in the mental health sector. The involvement of SPs can provide a valuable learning experience, both in role and in the debrief, for call-handlers, and help to prepare them for real-life scenarios.
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.
A16‘Not being afraid of saying dying’: sharing key vocabulary for palliative care discussions through simulation debrief
Authors: Huggin Amy , Churm Deepta , Robinson Lucy , Massey Laura , Leng Owain 
Published: October 2023

Background and aim:
Simulation as a learning platform is recognized internationally as beneficial in terms of education, training and assessment of doctors [1,2]. This study aimed to introduce and evaluate a novel Palliative Medicine simulation session as a tool for Foundation Year 2 (FY2) doctors to gain competency and confidence in the assessment and management of life-limiting illness.
Methods:
We designed the palliative care (PC) simulation session based on the FY2 curriculum. The three scenarios involved management of opioid toxicity, breaking bad news and shared decision-making with a role-play patient with a gastrointestinal bleed. Session faculty included a mix of healthcare professionals, but always included a PC specialist.
We evaluated the session using a pre- and post-session questionnaire collecting data using 5-point Likert scales and free-text comments. We analysed qualitative data using content analysis. Researcher and methodological triangulation increased the credibility of the findings.
Results:
The three prevalent themes noted from the pre-content analysis were Communication, Prognostication and the Process of complex decision-making. Comments such as ‘Senior colleagues hesitant to have escalation discussions’ and ‘I find it difficult when the patient has a very different idea of how poorly they are’ were examples of quotes given by candidates as pre-session challenges. 95.6% of our candidates felt that the session addressed these challenges, mainly through the debrief process. The main learning points articulated were in relation to prescribing and communication skills. Candidates expressed the importance of ‘picking up communication techniques and phrases’. The debrief was the most highly valued, and frequently mentioned positive element of the content analysis. ‘Open discussions’ was mentioned on numerous occasions, ‘I felt comfortable asking questions’ and ‘Discussion after SIM was very useful’, all support the importance of skilled debrief.
Conclusion:
FY2 doctors identified communication as their biggest concern when managing Palliative Care patients. Our session addressed this through open and frank debrief discussion. This allowed reflection on previous experience and peer-to-peer learning of key vocabulary when talking to patients with a limited prognosis. Further qualitative evaluation of the impact of this session on clinical practice and how peer learning could be incorporated into day-to-day skills development on the wards would be of value.
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.
A113A pilot course amalgamating the benefits of psychological safety, civility, and human factors in a structured debriefing model in simulation-based education
Authors: Brown Radha , Lall Rajesh , Askins Laura 
Published: October 2023

Background and aim:
Simulation-based education (SBE) is one of the leading teaching methods in healthcare. Debriefing is the cornerstone of effective simulation-based medical education. Debriefing is considered vital part to learning from simulation, and for the transfer of learning so that it can be applied to other situations [1]. Feedback from four simulation faculty development days identified that debriefers lacked the confidence to address conflict or use the principles of civility to enhance their debriefs. Teaching which has structured debrief covering civility and human factors are the cornerstone to deliver sessions that instil confidence and patient safety within the organization [2]. Human factor principles that employ psychological safety were introduced in the debriefing course with the purpose of upskilling the debriefers.
Activity:
There are various models of debriefing however, the focus was to provide the three-phase conversation structure. The course covered human factor principles alongside debriefing techniques using the three-phase conversation structure and interactive workshops. We enlisted the services of a specialist human factor/civility lecturer, simulation lead and a simulation lecturer to deliver the course. At the end of the course, the participants had to undertake a debrief to consolidate their learning in a supportive environment and immediate evaluation was obtained using a structured questionnaire (see Table 1-A113).
Evaluation themed responses
Additionally, a pilot study of five participants who had attended the course were randomly selected for a face-to-face interview twenty-four hours after the course. Three open-ended questions were asked. These focussed on whether the application of psychological safety and human factors enhanced their debriefing skills and suggestions for further course development.
Findings:
The results highlighted the value of the inclusion of human factor principles. Both evaluation methods were positive. Attendees commented on the value-added to their simulation training and wanted these principles to be adapted as a structured course. Acknowledging the fact that the sample recruited was small and may not be statistically significant, a future study will include a bigger sample size.
Conclusion:
Currently, this is the only organization within the North-East of England that offers standalone debriefing course. There was an overwhelming demand for a course aimed at educators who are engaged in SBE with emphasis on debriefing to consolidate learners’ experience. This course is intended to be delivered to all educators across the North-East region and beyond.
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.
A10Pilot study looking at the benefits of Virtual Reality (VR) simulation for Physician Associates (PA)
Authors: Heffernan Carl , Rolfe Ursula 
Published: October 2023

Background and aim:
Simulation is a vital part of medical education [1]. It requires many resources to run successfully [2]. Recently, following the COVID-19 pandemic, Virtual Reality (VR) simulation use has increased. There are advantages to using VR now that costs are more reasonable, saving floorspace and facilitators’ time. However, there are concerns about how useful the software is for Physician Associates (PA), the adverse effects of the headset and whether self-directed debriefing is valuable [3]. This study aims to pilot the questionnaire using VR simulation.
Methods:
As part of teaching during September 2022 and January 2023, VR simulation was incorporated into appropriate seminars. At the end of the session, Year 1 PA students were invited to complete an online questionnaire based on the Simulation Effectiveness Tool, which was modified for VR. Before the session, all students were on-boarded to use the Oculus Quest 2 and Oxford Medical Simulation software.
Results:
Twenty-one out of 25 students completed the questionnaire. 71.4% strongly agreed that VR simulation helped prepare them to respond to a change in the patient’s condition and felt empowered to make clinical decisions. 85.7% felt more confident in providing interventions that foster patient safety. 66.7% felt more confident using evidence-based practice to provide care. When focusing on the self-directed debriefing, 66.7% strongly agreed that it contributed to their learning, and 71.4% strongly agreed that it provided opportunities for self-reflection on their performance. Concerning the headset and software use, 28.6% found it was not easy to log into the headset, but 65% found it easy to load the scenario. 57.1% were confident in navigating the virtual environment. This was after a briefing stage to orientate students to the environment. 70.6% felt safe in the virtual world, and 11.1% felt nauseous while in the scenario. The scenarios were also run via a desktop computer. 85.7% found it easier to navigate the virtual world, with 81% strongly agreeing that they felt immersed in the environment. Surprisingly, 52% of students preferred the desktop version, while 14% favoured it via the Oculus.
Conclusion:
VR simulation is an impactful method of providing simulation-based medical education without needing a simulation suite or facilitators. Interestingly, the desktop version can provide an experience that students prefer, but this requires further investigation.
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.
Factors Related to Gastritis in Kendari City
Authors: Ahmad Ahmad , Sunarsih Sunarsih , Amraeni Yunita 
Published: October 2023

Introduction: Based on an initial survey conducted at 15 Public Health in Kendari City, it was found that gastritis increased by 11798 (29.4%). Kendari City population data as many as 401,719 people spread over 15 sub-districts, seen from the annual report of the Kendari City Office. Thus, researchers feel the need to conduct research on factors related to the incidence of gastritis in Kendari City.
Methods: This type of quantitative research with a cross sectional design has a population of all patients who come for treatment at 15 Kendari City Health Centers totaling 11798 and a sample of 385 patients.
Result: The results of the study stated that of the 385 respondents who declared gastritis there were 201 (52.2%) and 185 (47.8%) respondents stated that they did not have gastritis. Based on statistical tests, it showed that there was a significant relationship between stress and gastritis (p value = 0.000) and smoking on the incidence of gastritis (p value = 0.024) while the variable of diet (p value = 0.000) which means that there is a relationship between diet and the incidence of gastritis in the city of Kendari
Conclusion: There is a relationship between stress and gastritis, there is no relationship between smoking and gastritis, and there is a relationship between diet and gastritis.
Factors Relating to The Performance of Health Officers in Emergency Installations (Study at Bahteramas Hospital, Southeast Sulawesi Province)
Authors: Yuni Sucitra Artha , Sunarsih Sunarsih , Kamalia La Ode 
Published: October 2023

Introduction: Hospital is part of a social and health organization with the function of providing complete services (comprehensive), disease healing (curative) and disease prevention (preventive) to the community. The performance of health workers is a problem that must be overcome, it is because health services determine the quality of hospital services. The performance of health workers can be influenced by workload, work stress, work environment, work fatigue, and the application of SOP.
Methods: This type of research uses a quantitative research design with a cross-sectional study design. The total population is 49 people, with a large sample of 44 people. The sampling technique in this study used the Cluster Random Sampling technique, using the Chi-Square Statistical test.
Results: The results showed that there was a relationship between workload and the results of the X2count = 7.079, the X2table value = 3.841, and the Phi value = 0.449, work stress with the X2count value = 8.838, the X2table value = 3.841, and the Phi value = 0.494.
Conclusion: The performance of health officers influenced by workload, work stress, work environment, work fatigue, and the application of SOPs. It is recommended that the hospital management can pay more attention to their health workers in order to improve the performance of health workers in the ER Bahteramas Hospital, Southeast Sulawesi Province.