bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical Access Hospital Nurses’ Perceptions of Obstacles to End-of-Life Care: A Qualitative Study
Authors: Beckstrand Renea L. , Macintosh Janelle L. B. , Drake Jeanette , Newman Con , Rasmussen Ryan , Luthy Karlen E. 
Published: July 2023

Background
Critical care nurses working in urban settings have reported obstacles in caring for dying patients. However, the perceptions of such obstacles by nurses working in critical access hospitals (CAHs), which are located in rural areas, are unknown.

Objective
To study stories and experiences related to obstacles in providing end-of-life care reported by CAH nurses.

Methods
This exploratory, cross-sectional study presents the qualitative stories and experiences of nurses working in CAHs as reported on a questionnaire. Quantitative data have been previously reported.

Results
Sixty-four CAH nurses provided 95 categorizable responses. Two major categories emerged: (1) family, physician, and ancillary staff issues and (2) nursing, environment, protocol, and miscellaneous issues. Issues with family behaviors were families’ insistence on futile care, intrafamily disagreement about do-not-resuscitate and do-not-intubate orders, issues with out-of-town family members, and family members’ desire to hasten the patient’s death. Issues with physician behaviors were providing false hope, dishonest communication, continuation of futile treatments, and not ordering pain medications. Nursing-related issues were not having enough time to provide end-of-life care, already knowing the patient or family, and compassion for the dying patient and the family.

Conclusion
Family issues and physician behaviors are common obstacles in rural nurses’ provision of end-of-life care. Education of family members on end-of-life care is challenging because it is most families’ first experience with intensive care unit terminology and technology. Further research on end-of-life care in CAHs is needed.
Frailty, Acute Brain Dysfunction, and Posthospitalization Disability Outcomes in Critically Ill Older Adults
Authors: Caldwell Corrielle , Verghese Joe , Gong Michelle N. , Kim Mimi , Hope Aluko A. 
Published: July 2023

Background
Identifying potentially modifiable factors that mediate adverse outcomes in frail adults with critical illness may facilitate development of interventions to improve intensive care unit (ICU) survivorship.

Objectives
To estimate the relationship between frailty, acute brain dysfunction (as reflected by delirium or persistent coma), and 6-month disability outcomes.

Methods
Older adults (aged ≥50 years) admitted to the ICU were enrolled prospectively. Frailty was identified with the Clinical Frailty Scale. Delirium and coma were assessed daily with the Confusion Assessment Method for the ICU and the Richmond Agitation-Sedation Scale, respectively. Disability outcomes (death and severe physical disability [defined as new dependence in 5 or more activities of daily living]) were assessed by telephone within 6 months after discharge.

Results
In 302 older adults (mean [SD] age, 67.2 [10.8] y), both frail and vulnerable patients had a higher risk for acute brain dysfunction (adjusted odds ratio [AOR], 2.9 [95% CI, 1.5-5.6], and 2.0 [95% CI, 1.0-4.1], respectively) compared with fit patients. Both frailty and acute brain dysfunction were independently associated with death or severe disability at 6 months (AOR, 3.3 [95% CI, 1.6-6.5] and 2.4 [95% CI, 1.4 -4.0], respectively). The average proportion of the frailty effect mediated by acute brain dysfunction was estimated to be 12.6% (95% CI, 2.1%-23.1%; P = .02).

Conclusion
Frailty and acute brain dysfunction were important independent predictors of disability outcomes in older adults with critical illness. Acute brain dysfunction may be an important mediator of increased risk for physical disability outcomes after critical illness.
Written Communication, Visitation Policies, and Awareness of Medical Issues Among Intensive Care Unit Families
Authors: Thinnes William E. , Harrison Mitchell R. , Basapur Santosh , Weiss Matthew A. , Quinn Thomas V. , Ritz Ethan M. , Shah Raj C. , Greenberg Jared A. 
Published: July 2023

Background
Open intensive care unit (ICU) visitation policies facilitate communication between clinicians and patients’ families. Restrictive visitation policies (eg, during a pandemic) may reduce families’ comprehension of information.

Objectives
To determine whether written communication increased awareness of medical issues among ICU families and whether the effect size depended on the visitation policies in place when participants were enrolled.

Methods
Families of ICU patients were randomly assigned to receive usual care with or without daily written patient care updates from June 2019 to January 2021. Participants were asked whether patients had experienced 6 ICU problems at up to 2 time points during the ICU stay. Responses were compared with the study investigators’ consensus.

Results
Of 219 participants, 131 (60%) were restricted from visiting. Participants in the written communication group were more likely than participants in the control group to correctly identify shock, renal failure, and weakness and were just as likely as participants in the control group to correctly identify respiratory failure, encephalopathy, and liver failure. Participants in the written communication group were more likely than participants in the control group to correctly identify the patient’s ICU problems when all 6 were grouped as a composite outcome, with the adjusted odds ratio of correct identification tending to be higher among participants enrolled during restricted versus open visitation periods: 2.9 (95% CI, 1.9-4.2; P &lt; .001) vs 1.8 (95% CI, 1.1-3.1; P = .02), P = .17 for difference.

Conclusions
Written communication helps families correctly identify ICU issues. The benefit may be enhanced when families cannot visit the hospital. ClinicalTrials.gov Identifier: NCT03969810
Cruzando fronteras, un caso de talento desde la escasez: una experiencia comunicacional con un niño ‘gifted’ (superdotado y talentoso
Authors: Morales Ramírez María Ester , Salas Guzmán Natalia 
Published: July 2023

Junior (*) acaba de terminar su panfleto de presentación para la Feria Científica Escolar, lo pasó en la computadora de su tío, pues en su casa no hay una propia, y lo está imprimiendo. Es un folleto sencillo, blanco y negro, pues su familia hace un gran esfuerzo para poder comprar el papel blanco con el que imprimen. Junior saca su caja de lápices de color (los que le regaló la maestra por sacar un cien en los exámenes pasados) y colorea cuidadosamente algunas partes del folleto, “para que se vea atractivo, quiero ganar” le comenta a su mamá. Su proyecto científico es ambicioso, lo ha denominado “Electri –mon”, nombre sumamente infantil y que hace referencia a su etapa del desarrollo socio emocional. Sin embargo, al leer el objetivo, puesto en la primera página del panfleto, nos damos cuenta de algo singular. El mismo dice “comprobar cómo sustancias naturales combinadas con metales puros, generan energía eléctrica”, bajo el tema “elementos naturales que producen energía eléctrica”. Mientras colorea y dobla las hojas para crear la ilusión de panfleto, piensa acerca de la importancia de proteger el ambiente, y de encontrar una sustancia natural que sirva como electrolito para hacer reaccionar el metal y producir electricidad, sin tener que usar las baterías convencionales que producen contaminación. Este parecería un proyecto científico normal, hasta que nos damos cuenta de que Junior recién cumplió los siete años, y este proyecto se adelanta, de manera significativa a los proyectos de otros niños de su edad.
Debido a que hoy en día esta es la realidad de algunos de nuestros niños, es que en las próximas páginas, vamos a entrelazar un estudio de caso real, de una experiencia comunicacional sobre un niño gifted (Superdotado y Talentoso), contraponiéndolo con lateoría reconocida mundialmente acerca de los niños talentosos, en un afán por aprender de la experiencia para suscitar un conjunto de sentimientos, de ideas, de costumbres, de palabras, en donde la abundancia de los mensajes que despiertan las necesidades o convicciones latentes en este tipo de niños.
En la terminología psicológica, estos mensajes designan el condicionamiento de un conjunto de técnicas comunicacionales que permiten adoptar artificialmente, y sin que el sujeto receptor se de cuenta, modelos de comportamiento o de pensamiento más o menos complejos, que permiten apoyar mucho más las expectativas escondidas que teníamos en este caso; buscaremos, más que un aporte teórico, una aplicación práctica, de que una mente brillante no necesariamente es capaz de comunicar sus capacidades excepcionales descubriendo que el talento y la pobreza no son factores excluyentes.
KAJIAN FILSAFAT KRISTEN TERHADAP PENGEMBANGAN KEMAMPUAN BERPIKIR TINGKAT TINGGI SISWA PADA PRAKTIK PEMBELAJARAN HYBRID
Authors: Lucky Egilia , Bermuli Jessica Elfani 
Published: July 2023

Keterampilan berpikir tingkat tinggi penting bagi siswa. Namun kemampuan berpikir tingkat tinggi siswa di Indonesia semakin menurun, terutama di masa pandemi Covid-19 akibat penerapan pembelajaran daring. Siswa dapat meningkatkan keterampilan berpikir tingkat tinggi melalui pembelajaran hybrid. Tujuan dari proyek ini adalah untuk menguji pentingnya filsafat Kristen pada keterampilan berpikir tingkat tinggi siswa dalam pembelajaran hybrid. Metode penulisan yang digunakan adalah kajian literatur. Filsafat Kristen yang digunakan adalah Antropologi Kristen yang membahas manusia sebagai gambaran Tuhan yang jatuh dalam dosa, sehingga membutuhkan anugerah keselamatan Kristus untuk kembali menjadi manusia sejati. Guru harus memiliki pemahaman yang benar tentang Antropologi Kristen agar kemampuan berpikir siswa berkembang. Siswa harus bertanggung jawab atas kemampuan berpikir yang diberikan oleh Tuhan. Dapat disimpulkan bahwa penting menggunakan filsafat Kristen untuk melihat perkembangan kemampuan berpikir tingkat tinggi siswa dalam pembelajaran hybrid karena kemampuan berpikir tingkat tinggi merupakan salah satu sifat Allah yang terdapat pada manusia yang merupakan gambar Tuhan sehingga harus ditingkatkan. Saran yang diberikan adalah membahas semua filosofi Kristen untuk mendapatkan pemahaman yang lebih luas.

Kata kunci: Antropologi Kristen, keterampilan berpikir tingkat tinggi, pembelajaran hybrid
KAJIAN TERHADAP KISAH PARA RASUL 10:34-36: UNTUK MENJAWAB PANDANGAN PLURALIS MENGENAI YESUS TUHAN SEMUA ORANG
Authors: Sanda Hendrik Yufengkri 
Published: July 2023

Iman Kristen unik dari semua bentuk kepercayaan manapun di dunia, sebab iman Kristen percaya bahwa Yesus adalah Tuhan dan satu-satunya Juruselamat manusia. Klaim eksklusif tersebut menimbulkan berbagai macam pertanyaan: Bagaimana dengan segala bentuk kepercayaan yang lain? Bukankah hal itu merupakan suatu anggapan yang subjektif berdasarkan semangat fanatisme agama dan sikap arogansi yang berlebihan mentuhankan seorang manusia Yesus? Bukankah benar anggapan para teolog pluralis agama-agama bahwa di semua agama juga memiliki kebenaran dan juruselamat lain sehingga dapat memimpin kepada keselamatan tanpa perlu percaya kepada Yesus? Bukankah Yesus yang disembah orang Kristen hanyalah Tuhan bagi mereka saja sebab dalam agama-agma lainpun memiliki tuhan yang lain? Dan masih banyak pertanyan lainnya. Penelitian ini bermaksud memahami makna asli dari ungkapan rasul Petrus bahwa Yesus Kristus Tuhan semua orang. Metode yang dipakai dalam penelitian ini menggunakan pendekatan hermeneutis. Berdasarkan hasil eksegesis terhadap teks Kis.10:34-36 maka Frasa Yesus Kristus Tuhan semua orang berarti Yesus Kristus adalah Tuhan yang berkuasa atas seluruh ciptaan-Nya sehingga Ia layak disembah sebagai Tuhan dan Juruselamat manusia.
ENGLISH-CONFLICTING FOREIGN LANGUAGES AND LANGUAGE MANAGEMENT STRATEGIES IN INTERNATIONAL BUSINESS COMMUNICATION
Authors: Martinaj Fitnete G. 
Published: July 2023

The English language is considered the global business language and a mutual language to provide communication and understanding in business. Learning foreign languages and implementing language management strategies enable cross-cultural communication, business growth and career enhancement. Drawing on this theory of business communication, this study explores the effects of language proficiency in business operations of Kosovan small and medium-sized enterprises (SMEs), which intend to become integrated globally, by using mixed methods and the interpretation of business managers (Sample 1, N = 5), two pilot tests (Sample 2, N = 7 and N = 29) and an online questionnaire (Sample 3, N = 139). The role of English in business communication was interrelated with an analysis of other foreign languages, along with the implementation of language strategies and the effect of language skills on career development. This squares well with the proposition that these three aspects are consistent in their contribution to effective communication in business and convey richness on both an individual and a company level. The findings offer a new perspective on the effects of using foreign languages in business communication, which consequently contributes to internationalization, multilingualism and cross-cultural communication.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0011/a.php" alt="Hit counter" /></p>
A MARXIST STUDY OF DAN BROWN’S INFERNO
Authors: Al-Hameedawi Mustafa Amjed Jasim , Al-Moussaw Sajjad Issa Ajlan 
Published: July 2023

<p>The research paper analyses Dan Brown's novel <em>Inferno</em> and its portrayal of Marxism. In this context, the plot of the novel, along with the events, characters and organizations are examined. The study also emphasizes how the novel depicts the shadowy power structures that govern societies, such as the Catholic Church or the enigmatic Illuminati organization, which is portrayed through different types of faces or organizations while remaining the same. They also operate in the background, attempting to manipulate events and people in order to preserve their own selfish power and wealth. The research paper also focuses on how Sienna Brooks' character highlights the flaws in the capitalist system, where only the wealthy class has access to technology, further dividing society. The concept of hidden power is also discussed, and it is demonstrated how the novel reflects Marxist theory about the power of the ruling class. Eventually, the research paper delves deeply into Marxism's theoretical and ideological aspects, as well as how they relate to issues of class struggle, moral standards, belief systems, and economic states in modern society. Ending the research with a conclusion that discusses how the novel raises important points about the potential consequences of failing to address the issue of overpopulation, such as the possibility of a global catastrophe caused by resource depletion and disease spread.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0002/a.php" alt="Hit counter" /></p>
FROM ROOTS TO REMEDIES: A DEEP DIVE INTO CUSTOMER SATISFACTION WITH HERBAL MEDICINE IN KLANG VALLEY, MALAYSIA
Authors: Boon Tan Keing , Buchari Nur Azizah Binti , Boudville Heather Marie , Balasubramaniam Renuka , Esuthasu Hamshini , Kanapathipillai Kumaran 
Published: July 2023

This study examined the satisfaction level of consumers who use herbal medicine to remedy their illnesses in the Klang Valley, Malaysia. Herbal medicine is usually plant-based and does not comprise preservatives or artificial colouring. The herbal medicine industry has rapidly grown worldwide because of the global movement towards alternative healthcare, and disease prevention has become a significant concern. Recently, pharmaceutical companies have been extensively conducting clinical studies and therapeutic trials on herbal medicine supplements as an alternative to modern medicine. With the aid of various private and public sectors, most developed and developing nations have produced and improved various herbal medicines for various illnesses through clinical research. This study focuses on the perceived safety, service quality, convenience, and pricing factors influencing consumers' satisfaction with herbal medicines. Questionnaires were distributed through social media to gather the data. The researchers collected 384 responses from the residents of the Klang Valley using the convenience sampling method. The findings of this study show that perceived safety, service quality, convenience, and pricing significantly influence consumers' satisfaction with herbal medicine in the Klang Valley, Malaysia. However, these factors may also generate a paradox where cautiousness escalates, decreasing the demand for herbal medicines. However, herbal medicine industries in Malaysia can formulate strategies to exploit opportunities to create demand and consumer satisfaction.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0001/a.php" alt="Hit counter" /></p>
FAMILY PHYSICIANS’ MOTIVATION PROCESS TOWARD THE DIAGNOSIS AND MANAGEMENT OF DEPRESSION
Authors: Atalıç Hilmi , Can Ali 
Published: July 2023

Depression is a widespread disease and remarks a difficult clinical challenge for primary health care providers or physicians. Primary health care providers, namely Family Physicians (FPs), are crucial in recognizing and managing depression process. The study employed a cross-sectional survey of FPs’ attitudes toward diagnosis and management, asking about their perceptions of their patient depression process. Data for the study was gathered from the FPs who were Facebook group members. 229 out of 550 FPs answered the survey questions. Statistical analysis was conducted using SPSS 24th edition. The study examined whether FPs made a significant difference between gender and years of experience in the profession. A questionnaire comprising items on a 9-point Likert scale was used to capture the perceptions and the data was analyzed using descriptive statistics and t-tests. Analysis of variance (ANOVA) was further employed to examine if the critical factors were perceived differently by FPs’ experience years. The study findings presented that gender did not make a statistically significant difference. There was a significant difference between the 6-10 years of experience group of FPs, the 16-20 years of experience group, and the 21+ years group. The study showed that FPs were undecided in diagnosing and treating depressed patients. The study displayed that FPs' getting to know their patients better facilitates the diagnosis and treatment of depression. However, the study indicated that family physicians were indecisive in the depressed patients' diagnosis and treatment. It can be concluded that the success of depression processes requires the cooperation of FPs and psychiatrists. These findings suggest that healthcare policymakers should consider FPs' strategies for managing depression in the improvement of mental health services.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0015/a.php" alt="Hit counter" /></p>
INSECT TRAP LIGHT BERBASIS ANDROID DENGAN TEKNOLOGI SOLAR CELL SEBAGAI SOLUSI PENGENDALIAN HAMA SERANGGA PERTANIAN
Authors: Putra Ramadhani Setio Enwin , Ningsih Harga Sri Rahayu , Rachmanita Risse Entikaria 
Published: July 2023

Pada sektor pertanian, ada berbagai tantangan yang hampir tidak lepas dari petani. Salah satunya yaitu tantangan hama tanaman. Hama dapat memberikan pengaruh kurang baik terhadap hasil panen. Pengendalian hama tanaman yang kurang baik dan maksimal akan memberikan dampak yang kurang baik pula terhadap hasil pertanian. Penelitian ini bertujuan untuk membuat dan menerapkan teknologi Insect Trap Light pada pertanian sebagai solusi untuk mengatasi masalah hama tanaman dengan melakukan pengendalian hama guna meningkatkan kualitas dan kuantitas hasil produksi pertanian. Insect Trap Light efektif menurunkan populasi hama serangga yang aktif pada malam hari. Teknologi ini memanfaatkan panel surya untuk mengubah energi matahari menjadi energi listrik sehingga dapat ditempatkan pada lahan yang jauh dari rumah maupun sumber listrik PLN. Dari hasil penelitian yang dilakukan, lampu dapat menyala selama 11 jam dengan menggunakan solar cell 50 Wp dan baterai dengan kapasitas 12 V 35 Ah. Sistem monitoring menggunakan smartphone juga menunjukkan hasil tegangan dan kondisi lampu pada alat perangkap serangga, aplikasi tersebut juga dapat mengontrol lampu dengan baik. Implementasi alat dilakukan pada komoditas terong yang kemudian menghasilkan pengaruh terhadap tanaman dengan tidak adanya penambahan buah yang rusak. Hal tersebut juga menunjukkan bahwa terjadi pengurangan terhadap populasi hama serangga pertanian di lahan tersebut.

Kata-kata kunci: Insect Trap Light, Pengendalian Hama, Solar Cell
Makna “Ayah Jangan Menyakiti Hati Anak” dalam Pendidikan Anak Generasi Z: Sebuah Refleksi Kolose 3:21
Authors: Yemima Kezia , Murwantiningtyas Ika 
Published: July 2023

Fathers are required to pay great attention to their duties and obligations in the spiritual education of children because children learn to know God through the father figure. So the Bible teaches fathers to educate their children properly according to the truth in God's word. Science and technology are always developing and undergoing major changes in accordance with the times. This development certainly affects the spiritual education of fathers, especially in Generation Z. The research aims to explain the implementation of the meaning of the father not to offend the child in Colossians 3:21 in the spiritual education of Generation Z's children. This research uses a qualitative approach with descriptive methods in achieving the objectives. This research uses a literature study and interview method for data collection purpose. The result is that Christian values form the basis of good relationships between Generation Z fathers and children. ABSTRAKAyah diharuskan memberi perhatian yang besar terhadap tugas dan kewajibannya dalam pendidikan kerohanian anak, karena anak belajar mengenal Allah melalui figur ayah. Maka Alkitab mengajar para ayah untuk mendidik anak dengan baik sesuai dengan kebenaran dalam firman Tuhan. Ilmu pengetahuan dan teknologi selalu berkembang dan mengalami perubahan besar sesuai dengan perkembangan zaman. Perkembangan tersebut tentu mempengaruhi pendidikan kerohanian ayah kepada anak khususnya Generasi Z. Penelitian bertujuan untuk menjelaskan implementasi makna ayah jangan menyakiti hati anak dalam Kolose 3:21 dalam pendidikan kerohanian anak Generasi Z. Dalam mencapai tujuan tersebut, penelitian ini menggunakan pendekatan kualitatif metode dekriptif. Penelitian ini menggunakan metode study literatur dan wawancara dengan narasumber untuk pengumpulan data. Penelitian ini berhasil menemukan nilai-nilai kekristenan menjadi dasar dalam relasi yang baik antara ayah dan anak Generasi Z.