bluuebunny/crossref_metadata_2025_split huggingface dataset:
PENGARUH BEBAN KERJA, DISIPLIN KERJA DAN LINGKUNGAN KERJA (Studi Pada UMKM Pengrajin Sepatu Di Wilayah Gunung Puntang)
Authors: Rahmi Palupi Permata , Riskayani Eneng 
Published: January 2022

Penelitian ini bertujuan untuk mengetahui dan menganalisis pengaruhbeban kerja, disiplin kerja dan lingkungan kerja terhadap produktivitas kerjaKaryawan (Studi Pada UMKM Pengrajin Sepatu Di Wilayah Gunung Puntang).Metode yang digunakan dalam penelitian ini adalah metode kuantitatif denganpendekatan deskriptif dan verifikatif. Teknik pengumpulan data dilakukandengan metode simple random sampling dengan menggunakan rumus Slovinberjumlah 51 orang responden. Analisis data untuk menjawab rumusan masalahmenggunakan analisis deskriptif, uji asumsi klasik, uji regresi berganda, ujikoefisien korelasi, uji korelasi berganda, uji koefisien determinasi, serta pengujianhipotesis dengan uji t dan uji F. Hasil penelitian ini menyatakan bahwa (1) Secara parsial, beban kerjaberpengaruh terhadap produktivitas kerja Karyawan (Studi Pada UMKMPengrajin Sepatu Di Wilayah Gunung Puntang. (2) Secara parsial, disiplin kerjatidak berpengaruh terhadap produktivitas kerja Karyawan (Studi Pada UMKMPengrajin Sepatu Di Wilayah Gunung Puntang. (3) Secara parsial, lingkungankerja berpengaruh terhadap produktivitas kerja Karyawan (Studi Pada UMKMPengrajin Sepatu Di Wilayah Gunung Puntang. (4) Secara simultan, beban kerja,disiplin kerja dan lingkungan kerja berpengaruh terhadap produktivitas kerjaKaryawan (Studi Pada UMKM Pengrajin Sepatu Di Wilayah Gunung Puntang.
Changes in the microcirculatory bed in patients with post-mastectomy syndrome
Authors: Fionik O. V. , Krasnikova V. V. , Pokatilo D. A. , Pospelova M. L. 
Published: January 2022

The purpose of the study: to determine the features of the state of the microcirculatory bed in women with post-mastectomy syndrome as a cause of fibrosis.Material and methods. The study involved 76 women, of whom two groups were formed. The first group consisted of 46 patients aged 25 to 49 years (mean age – (43.8 ± 3.8) years old) with post-mastectomy syndrome (PMES), the average period after radicle treatment of breast cancer was (4.3 ± 2.1) years. All patients underwent mastectomy, radiation and chemotherapy for the treatment of breast cancer, followed by a comprehensive examination to exclude metastasis and continued tumor growth, as well as to exclude hemodynamically significant violations of venous and arterial blood flow of the upper extremities. The second group was formed of 30 healthy female volunteers aged 25 to 43 years, whose average age was (33.75 ± 10.70) years old. Clinical and instrumental methods of examination were used: anthropometric method, lymphoscintigraphy of the upper extremities, laser Doppler flowmetry, determination of the expression level of intercellular adhesion molecules sICAM-1, sPECAM-1.The results. Gross violations of the function of the microcirculatory bed were revealed: endothelial dysfunction, spasm of precapillary sphincters, decrease in the intensity of blood flow in the metabolic capillaries, the predominance of passive mechanisms of blood flow regulation. These changes lead to tissue hypoxia, which may be the trigger for the development of fibrosis and lymphedema. Endothelial dysfunction, which is confirmed by increased expression of specific biomarkers, may be the basis of these disorders. A complex, long-term change in the work of microvessels leads to a breakdown of compensatory mechanisms.Conclusion. The study of the pathogenetic mechanisms of the development of post-mastectomy syndrome will allow forming preventive strategies in patients after treatment of breast cancer, improving the quality of life of these patients. Further search for promising predictors of the development of fibrosis, the study of changes in the microcirculatory bed will provide additional information about the pathogenesis of PMES, to identify changes in the soft tissues of the upper extremities at an early stage of post-mastectomy syndrome, may be important for the development of more effective methods of treatment of PMES.
Utilizing the Maximum Workload Range for Practice Periodization
Authors: Sanders Gabriel J. , Peacock Corey A. 
Published: January 2022

Commentary
The maximum workload range (max range) is a concept suggested by Sanders et al.1 regarding a method used to prescribe adequate practice workloads based off wearable technology data. The max range is calculated as follows from game data:
Max Range = (Mean Total Distance + 1 St. Dev.) to (Maximum Total Distance)
While the example provided utilizes total distance, the max range can be applied to key performance indicators such as high-speed distance, training load, jumps, etc. that are tracked throughout the competitive season in team sports. The max range concept was developed from research that found 12-17% of the time, football athletes, depending on position, accumulated game workloads outside their position’s mean + 1SD. Anecdotally, many coaches and practitioners use simple game averages as a control for ideal practice volumes. Based on previous research, using the game average as control training threshold may result in some high performing athletes being under-conditioned. It is reasonable to suggest that potential compound effects may occur throughout an entire season if athletes are not engaging in rigorous training loads that mimic game-like volumes and intensities.
Figure 1. Theoretical football periodization structure for a defensive back using the max range for high intensity training days.
Educación rural en América Latina
Authors: Castrejón Celso Javier 
Published: January 2022

Resumen: El propósito de este trabajo por un lado es dar cuenta de la situación social del campesinado y la realidad rural en América Latina, y por otro lado, es aproximarse a ciertos casos de educación alternativa en la región, de tal forma que podamos analizar la relación de la educación y el desarrollo rural. Para ello, se revisaron diferentes fuentes bibliográficas sobre el tema y nos apoyamos en trabajo de campo etnográfico. Concluimos dando cuenta de los múltiples avances del proyecto educativo del Centro de Estudios para el Desarrollo Rural surgido en la Sierra Norte de Puebla, México.
Comparative effects of Core Stability Exercises and Endurance Training in Patients with Mechanical Low Back Pain
Authors: Khan Javairia , Khan Palwasha , Arshad Muhammad Umer , Javed Ahsan , Zia Wajeeha , Iqbal Ambreen , Jamshaid Ghazal 
Published: January 2022

Low back pain is a major health problem resulting in psychosocial and physical disability. The prevalence of LBP and risk of recurrence is rising due to the sedentary life style, poor postural awareness and short term oriented intervention plans. It is the need of the time to design one or more exercise plans that can improve pain and functional disability and prevent recurrence of symptoms in patients with mechanical low back pain. Objective: The objective of this study is to compare the effects of core stability exercises and endurance training on the pain and functional disability in the population having mechanical low back pain. Materials and Methods: It was a quasi-experimental study with 74 patients with chronic low back pain, divided equally in two groups containing 37 patients each. Both groups were treated with baseline of moist heat pack in combination with interferential. Group A was treated with core stability exercises and group B was treated with endurance training for five times a week. Pre and post treatment scores were compared with NPRS for intensity of pain and Oswestry Disability Index for functional disability scores. Results: Data was analysis by SPSS.25 on 74 patients. In type of pain, about 79% of patients were suffering from moderate and severe type of pain while there were only 21% of patients who came with mild pain in both groups. Independent t-test was applied for changes between the group on NPRS scale, the results shows significant results with p<0.05. In core stability group the difference between pretreatment and post treatment was 6.08 to 1.4 and in stability group the difference was 6.13 to 1.10. Endurance training exercises on ODI, there was no one with severe disability, and 94.6 %were with minimal disability and only 5.4 % were with moderate disability. It shows that endurance training exercises were better than stability exercises. Conclusion: It is concluded that endurance training has more clinical difference on outcome measures of NPRS and ODI as compared to core stability exercises in patients with mechanical low back pain.
22 Game On! Meeting the Mission of Gamification to Teach Human Factor Skills
Authors: Smith Gill , Holland Jonny 
Published: January 2022

Failings in human factors are a significant contributory factor in accidents/incidents in aviation, energy and healthcare. There is no ‘one thing’ that will address human factor failings- it requires multiple interventions; including developing human factor awareness and skills to influence behavioural change. Local research in the Northern Health & Social Care Trust This project deployed the application of Gamification to human factor learning in healthcare. Feedback from face-to-face Human Factor training is positive, but it is challenging in an organization of 13,500 staff to meet the capacity for this training. More recently, response to COVID-19 has challenged us all to think about how we make training more accessible outside of traditional methods.The Gaming Strategy is centred around Dupont’s Dirty Dozen (Figure 1) – the 12 most common human factor elements which degrade a person’s ability for them to perform effectively and safely, which can lead to errors.Dupont’s dirty dozenThrough a series of missions ‘gamers’ follow a patient (Joe) as he journeys through the healthcare system, and experiences a series of human factor errors. The five missions below, each incorporate Dupont’s Dirty Dozen:
communication and team workinglack of knowledge and assertivenesssituational awarenesscomplacency and normspressure and lack of resourcesEach mission introduces characters and is scenario-driven, depending upon gamers’ responses they will either be successful in their mission (in which case they can proceed to the next step), or unsuccessful and have to restart the mission. At the end of each mission ‘gamers’ must complete a quiz, after which they are rewarded with access to the next mission. The gaming App includes additional learning resources, opportunity for reflection and generation of a completion certificate to support professional development. Psychological and behavioural experiences of gamers’ is captured by the App via quizzes at the start and completion of the Game. The project deployed Quality Improvement and Agile development methodologies. All scenarios and characters were developed by the NHSCT project team, with software development commissioned externally.The Game is accessible via mobile phone from the App Store. Project testing completed in June 2021, with the launch of the Game in NHSCT thereafter. The App has potential for scale-up across NI and the UK.
194 Implementing a Simulation Training Programme for Physician Associates
Authors: Cowan Alicia , Oliver Nathan , O’Brien Richard 
Published: January 2022

The physician associate (PAs) profession is a relatively new profession to the NHS. As such, there is no official national or regionally agreed further training to support PAs transitioning from PA school into clinical practice once they have graduated. Simulation training has proved to be an effective tool for developing clinical and non-clinical skills in other groups of clinicians We aimed to describe the development and implementation of a novel PA-specific simulation training programme and present the evaluation of our initial work.We designed and implemented a bespoke simulation training programme based on existing training for junior doctors. This model has three separate simulation sessions, spaced over 2 years, each session has three different clinical scenarios. Seventeen PAs have undergone the first two sessions. The first session contained three scenarios that highlighted important local protocols such as the major haemorrhage protocol and the sepsis At this point in time, we have feedback from 16 candidates from session 1 and 11 from session 2. The results are overwhelmingly positive showing improved confidence, better team-working skills and a perceived perception of improved patient safety following the simulation training, as shown in graphs 1 and 2. The majority of candidates partaking in the session found the simulation training beneficial to their practise. The main negative feedback given was the lack of ‘senior support’ (i.e. from a senior doctor) in the scenarios that were unrealistic to actual practice.The introduction of a novel PA simulation training programme has demonstrated improvements in clinical and non-clinical skills. This supports our aim of improving post-graduate PA training. Work continues to further develop our PA simulation programme and further evaluate its effectiveness with the aim of making this as a regional simulation programme that PAs can undertake when joining the healthcare workforce.
201 Genital Examination Education and Instruction: Lowering Anxiety and Raising Competence
Authors: Polonko Isle 
Published: January 2022

Gynaecologic Teaching Associate (GTA) and Male Urogenital Teaching Associate (MUTA) methodology have been utilized for decades in effective breast, pelvic and urogenital examination clinical skill instruction. This methodology is recognized as the gold standard of instruction when educating learners on the sensitive, invasive clinical skills techniques associated with a genital examination. While research shows it is the most effective way to learn these procedures, outside of the USA and Canada, there are few GTA/MUTA programmes at medical learning institutions.This methodology aims to provide hands-on, standardized instruction in an anxiety-free environment where learners safely practice the clinical skills techniques of breast, pelvic and urogenital examinations and have the unique experience of learning these techniques from the patient’s perspective.The GTA/MUTA is both instructor and live simulated patient, using their own bodies as teaching tools, guiding learners through examination techniques and providing instant feedback. With this unique opportunity for skills acquisition, learners receive step-by-step instruction on an actual person in a quality-controlled environment. In addition to correct palpation techniques, this patient-centred form of instruction addresses the emotional reaction patients may have to these examinations. GTA/MUTA instruction also includes patient education and communication and relaxation techniques. The GTA/MUTA patient empowerment methodology is designed to provide an anxiety-free atmosphere for the learner so that the sensitive nature of the genital examination and the embarrassment often accompanying the examination do not become an obstacle to acquiring safe, effective clinical technique.Decades of research prove that this method lowers learner anxiety and provides exceptional outcomes for learners in a multiplicity of learning criteria, including higher overall scores; superior communication skills; better ability to identify pathology; ‘better interpersonal skills than physician trained with lasting effects that can be demonstrated after clinical exposure’ The methodology has far-reaching implications. The specialized skills of these individuals mean that the teaching method can be brought outside of the well-patient experience; sexual assault providers can practice the trauma examination on live simulated patients; remediation can be provided to practitioners who must relearn techniques to maintain licensure; learners are more empathetic to their patients and more inclined to include their patients in the examination process thus improving patient care. This methodology can be utilized in any setting where invasive examination procedures, patient education and communication must be mastered.
92 Improving Knowledge and Human Factors Skills During a Pandemic: A Multimodal Covid-19 Educational Project
Authors: Sowole Luciana , Dunnell Liam , Maule Sophie P , El-Alami Wathik 
Published: January 2022

Following a rise in COVID-19 cases and hospitalizations in autumn 2020, the resultant pressures on general medical wards galvanized the simulation education team at a London teaching hospital to create a multi-disciplinary educational programme aimed at ward staff caring for the surge in COVID-19 patients. This was especially important in the context of rapidly evolving clinical guidance and recognition of the importance of human factors in re-deployment of staff, thus a multimodal educational project was initiated to develop ward staff knowledge and human factors skills.The aim of the study was to ascertain the effectiveness of the multimodal COVID-19 educational project in improving ward staff knowledge and human factors skills.In October 2020, the team began creating the project – comprising e-learning to improve staff knowledge, e-Learning surveys were completed by 108 learners with a significant difference (p < 0.01) in self-reported pre- and post-survey scores across the six domains. Learners demonstrated mean improvements across all areas of the HuFSHI for the In a limited time frame, the simulation education team implemented a multimodal educational project that improved both ward staff knowledge and human factors skills amidst the second wave of the COVID-19 pandemic. Moreover, following restriction of face-to-face delivery, the project was successfully converted into a purely online format. This ability to be flexible and adapt accordingly is one that needs to be widely adopted going forwards, especially during these unpredictable times. Further challenges included staff release for training, time pressures, managing emotive discussions using the online modality and COVID-19 safety measures. A 6-month follow-up survey is planned to evaluate the benefit to staff’s clinical work and will be included at the presentation.
5 Core Care Skills Simulation Training for Undergraduate Medical Students
Authors: Ellis Laura , Joseph Jemma-Laura 
Published: January 2022

Throughout the coronavirus pandemic, healthcare professionals have needed to rapidly adapt to changing demands. For some, this has involved adapting a ‘task-sharing’ approach which means that professionals undertake tasks that are not usually considered part of their job role, for example, Junior doctors giving medications and many were ‘redeployed’ completely to areas of greater need. In the same vein, the role of the medical student was expanded and explored and some medical students were given the opportunity to undertake paid work as healthcare support workers (HCSWs). It can be argued that the education and training of medical students are heavily focussed on a medical model of healthcare and often lacks depth insight into the caring aspects of patient care.The aim of the study was to create an interactive practical care skills simulation training aimed at medical students.We designed a practical simulation training programme based around the ‘fundamentals of care’ as defined by the nursing and midwifery council Early versions of this course were used as part of a comprehensive induction programme that included testimony from HCSWs working within the site hospital, who were able to share real-life experiences and offer peer support. This helped influence the development of this course to shape it into an innovative multi-disciplinary training. The training course was developed reactively to meet the developing need of students to prepare for redeployment by April of 2020 and since then has grown and developed into the half-day simulation training that is outlined above. It has now been incorporated into the in-hospital clinical skills curriculum for third-year medical students passing through the trust on the understanding that, this course has helped medical students to better understand the role of other professionals and will enable closer multi-disciplinary working in future. Anecdotally, it is obvious from interacting with students that there is a need to incorporate training in basic care into the medical curriculum to prepare students for task-sharing in the future as well as to better understand the caring professions and improve multi-disciplinary working. However, there is not enough post-course data to establish a true effect from this course at present. We continue to run this training course as part of the year 3 undergraduate clinical skills programme and aim to collect more survey data to evaluate and adapt it.
175 Embracing a System-Based Approach to Simulation – The Experience of a Paediatric Hospital During a Global Pandemic
Authors: Broughton Emma , Ross Alasdair , Chigaru Linda , Nambyiah Pratheeban , Williams Sam , Ingram Chris 
Published: January 2022

The GOSH Clinical Simulation Centre (CSC) delivers an established paediatric The aim of the study was to expand the applications of our pan-trust Over the course of 18 months, simulation exercises were designed to focus on rehearsal and refinement of processes and systems, towards uncovering latent safety threats or gaps in practice. A reporting tool was developed; to capture risks and identify mitigating actions. In addition to this, an established reporting structure enabled faculty to share findings and escalate risks to the local patient safety team. The COVID-19 pandemic presented healthcare workers with many new or unfamiliar working practices. This context further shifted our focus towards systems safety simulations (SSS) with the aim of enabling teams to focus on rehearsing and preparing for new ways of working.Ten different exercises were delivered with clinical teams across the trust: successfully informing the development of five new clinical guidelines relating to COVID-19-specific practices. In one exercise alone, 11 latent safety threats (LSTs) were captured and managed with the appropriate teams (Themes from LSTs captured during COVID-19 CT transfer simulationSSS fire evacuation exercise in the IMRI suiteSSS fire evacuation exercise in the new sight and sound buildingThese exercises demonstrate the potential applications of simulation to support process and system improvement. Beyond the pandemic, we aim to continue to deliver SSS exercises to help make clinical systems and spaces safer for patients and teams. Following in the footsteps of successful simulation teams in the USA, we aim to advance this work to deliver SSS at the preconstruction level in future to inform the design of new clinical spaces.