bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Small House Model to Support Older Adults in Long-Term Care
Authors: Longstaff Whitney , Filkowski Jody , Severn Melissa 
Published: January 2022

The small house model of long-term care (LTC) is identified internationally by several model names. Although some differences exist between the characteristics of these models (e.g., number of residents, degree of resident freedom, facility design), there are 3 recurring components: functional units with a small group of residents, replication of familiar domestic routines, and some form of decentralized staff.
The key philosophic difference between the small house model and the traditional LTC model is the heavy focus on person-centred care. This approach to care in the small house model is firmly rooted in freedom of choice and autonomy for the residents.
Small house models eliminate the strict delineation of roles; staff at all levels are included in the decision-making process. Self-managed and universal work teams are prominent features of the small house model. Frontline staff with strong interpersonal skills are essential for successful implementation.
No strong trend emerges from the literature with respect to the impact of the small house model on resident-centred outcomes compared with more traditional models of LTC. This is likely due to lack of consistency in the outcomes that are measured and variability among the different small house models. This finding is consistent with other reviews on the topic.
Literature exploring the Canadian experience with small house models is limited. The majority of identified studies used data from the US or European jurisdictions, which potentially limits its generalizability to the Canadian context.
Towards ice-thickness inversion: an evaluation of global digital elevation models (DEMs) in the glacierized Tibetan Plateau
Authors: Chen Wenfeng , Yao Tandong , Zhang Guoqing , Li Fei , Zheng Guoxiong , Zhou Yushan , Xu Fenglin 
Published: January 2022

Abstract. Accurate estimates of regional ice thickness, which are generally produced by ice-thickness inversion models, are crucial for assessments of available freshwater resources and sea level rise. A digital elevation model (DEM) derived from surface topography of glaciers is a primary data source for such models. However, the scarce in situ measurements of glacier surface elevation limit the evaluation of DEM uncertainty. Hence the influence of DEM uncertainty on ice-thickness modeling remains unclear over the glacierized area of the Tibetan Plateau (TP). Here, we examine the performance of six widely used and mainly global-scale DEMs: AW3D30 (ALOS – Advanced Land Observing Satellite – World 3D – 30 m; 30 m), SRTM-GL1 (Shuttle Radar Topography Mission Global 1 arc second; 30 m), NASADEM (NASA Digital Elevation Model; 30 m), TanDEM-X (TerraSAR-X add-on for Digital Elevation Measurement, synthetic-aperture radar; 90 m), SRTM v4.1 (Shuttle Radar Topography Mission; 90 m), and MERIT (Multi-Error-Removed Improved-Terrain; 90 m) over the glacierized TP by comparison with ICESat-2 (Ice, Cloud and land Elevation Satellite) laser altimetry data while considering the effects of glacier dynamics, terrain factors, and DEM misregistration. The results reveal NASADEM to be the best performer in vertical accuracy, with a small mean error (ME) of 0.9 m and a root mean squared error (RMSE) of 12.6 m, followed by AW3D30 (2.6 m ME and 11.3 m RMSE). TanDEM-X also performs well (0.1 m ME and 15.1 m RMSE) but suffers from serious errors and outliers on steep slopes. SRTM-based DEMs (SRTM-GL1, SRTM v4.1, and MERIT) (13.5–17.0 m RMSE) had an inferior performance to NASADEM. Errors in the six DEMs increase from the south-facing to the north-facing aspect and become larger with increasing slope. Misregistration of the six DEMs relative to the ICESat-2 footprint in most glacier areas is small (less than one grid spacing). In a next step, the influence of six DEMs on four ice-thickness inversion models – GlabTop2 (Glacier bed Topography), Open Global Glacier Model (OGGM), Huss–Farinotti (HF), and Ice Thickness Inversion Based on Velocity (ITIBOV) – is intercompared. The results show that GlabTop2 is sensitive to the accuracy of both elevation and slope, while OGGM and HF are less sensitive to DEM quality and resolution, and ITIBOV is the most sensitive to slope accuracy. NASADEM is the best choice for ice-thickness estimates over the whole TP.
Stereotyping, Exploitation, and Appropriation of African Traditional Religious Beliefs: The Case of Nyaminyami, Water Spirit, among the Batonga People of Northwestern Zimbabwe, 1860s–1960s
Authors: Matanzima Joshua 
Published: January 2022

Abstract
This article examines the forms of knowledge that existed between Africans and Europeans regarding local indigenous religious beliefs, focusing particularly on the case of Nyaminyami, a water spirit that is part of the belief systems prevalent among some BaTonga people of northwestern Zimbabwe. The article briefly outlines the “traditional” BaTonga beliefs and practices relating to Nyaminyami, which were diametrically opposed to those of the Europeans. It then scrutinizes the ways the beliefs have been exploited and appropriated by different interest groups and races from the 1860s to the 1960s. The BaTonga people, who held strong beliefs in Nyaminyami, and European colonists used the idea of Nyaminyami for different social, political, and environmental agendas prior to, during, and after resettlement. Nyaminyami played changing sociocultural and economic functions for the BaTonga people over time. They revered Nyaminyami as their river god in the nineteenth and twentieth centuries; they also appropriated the beliefs by rallying behind the river god for protection from their displacement in 1958 following the construction of the Kariba Dam on the Zambezi River. Nyaminyami was also appropriated by European interest groups who used the idea of Nyaminyami to cast Africa as the “dark continent” and to stereotype the BaTonga people as primitive. This article relies on data obtained through a reading of European explorers' texts and by gathering oral traditions among the BaTonga and Shangwe.
Immunologic changes after house dust mite modified rush subcutaneous immunotherapy in allergic rhinitis children
Authors: Rattanamanee Tipyapa , Lumjiaktase Putthapoom , Kemawichanura Nanthisa , Kiewnga Potjanee , Jotikasthira Wanlapa , Manuyakorn Wiparat 
Published: January 2022

Background
House dust mites (HDM) are the major causative allergen for allergic rhinitis. The sole disease-modifying therapy for allergic rhinitis is allergen immunotherapy (AIT). Rush immunotherapy is the accelerated build-up schedules to reach the target maintenance dose.

Objective
To evaluate the kinetic changes of peripheral blood CD4+CD25+FOXP3+ regulatory T cells (Treg) and serum cytokines in children undergoing 2-day modified rush HDM AIT.

Methods
Children aged 5-15 years with allergic rhinitis were enrolled for a 2-day modified rush HDM AIT. Peripheral blood CD4+CD25+FOXP3+ Treg, serum interleukin (IL)-4, IL-13, interferon-γ, and IL-10 were measured at baseline, finishing rush, achieving maintenance dose, 6 months, and 12 months after reaching maintenance dose. Specific IgE (sIgE) to HDM was evaluated at baseline and 12 months after getting the maintenance dose. Rhinitis symptoms were assessed daily using a daily card.

Results
A total of 12 children with a mean age of 13 years were enrolled. Rhinitis symptom-free days per month increased significantly after reaching the maintenance dose compared to baseline (from 9.5 days to 19.5 days, p = 0.002), and the maximum improvement was seen at 1 year. The levels of Treg were significantly increased at 6 months after maintenance dose compared to baseline level (6.27%±1.63% vs. 3.83%±1.80%, p < 0.001). After treatment, there were significantly decreased serum IL-13 at 1 year after maintenance but no significant changes in sIgE to HDM. The systemic reaction during AIT occurred 7 episodes from 119 shots (5.9%).

Conclusion
Two-day modified rush HDM AIT provides acceptable systemic reactions and increases the number of CD4+CD25+FOXP3+ Treg in children.
Association Between the Femoral Stem Design Type and the Risk of Aseptic Revision After Hemiarthroplasty
Authors: Okike Kanu , Chan Priscilla H. , Reddy Nithin C. , Burri Robert A. , Paxton Elizabeth W. , Prentice Heather A. 
Published: January 2022

Introduction:
Although noncemented hemiarthroplasty has been associated with a higher risk of revision surgery as compared with cemented fixation, it remains uncertain whether this increased risk applies to all noncemented stem design types or only a subset. The purpose of this study was to assess the risk of aseptic revision associated with three common types of noncemented stem designs as compared with cemented fixation in the hemiarthroplasty treatment of femoral neck fractures in the elderly patients.

Methods:
This was a retrospective cohort study of patients aged 60 years and older who sustained a hip fracture and underwent hemiarthroplasty between 2009 and 2018 at one of 35 hospitals owned by a large US health maintenance organization. Hemiarthroplasty fixation was categorized as cemented or noncemented, with the noncemented stems further classified as single wedge without collar, fit and fill without collar, or fit and fill with collar. The primary outcome was aseptic revision, and the median follow-up time was 4.8 years.

Results:
Of 12,071 patients who underwent hemiarthroplasty during the study period (average age 82.0 ± 8.4 years, 67.9% women), 807 (6.7%) received a single-wedge stem without collar, 2,124 (17.6%) received a fit-and-fill stem without collar, 2,453 (20.3%) received a fit-and-fill stem with collar, and 6,687 (55.4%) received a cemented stem. Compared with cemented fixation, all the noncemented stem design types were associated with a markedly higher risk of aseptic revision in the multivariable analysis, including single wedge without collar (hazard ratio [HR] 2.00, 95% confidence interval [CI], 1.38 to 2.89, P < 0.001), fit and fill without collar (HR 1.52, 95% CI, 1.14 to 2.04, P = 0.005), and fit and fill with collar (HR 2.11, 95% CI, 1.63 to 2.72, P < 0.001).

Conclusion:
In the hemiarthroplasty treatment of elderly patients with hip fracture, all routinely used noncemented stem design types were associated with a higher risk of aseptic revision as compared with cemented fixation.
Empowerment of Productive Economic Business for The Poor in Serang City
Authors: Ismawati Iis , Yazid Helmi 
Published: January 2022

Community service is how to empower the poor in urban areas through productive economic efforts, problem identification The number of poor people tends to increase, the existing business opportunities are relatively limited, productive economic businesses are not optimal and market access is limited for business groups.
The purpose of the activity is to foster an entrepreneurial spirit for the poor through the formation of joint business groups, to empower the potential of the poor in increasing family income through increasing productive economic enterprises.
The process of community empowerment in the village begins with the formation stage, then implementation and the last is the stage of handing over assistance. problems related to the factors that influence the dynamics of joint business groups in Banjar Village, increasing productive economic efforts of joint business groups, more directed to chess efforts to improve product quality, production cost efficiency, marketing expansion and business scale improvement.
2 Play to Prepare with Technology-Enhanced Simulation
Authors: Paramsothy Remi , George Michael 
Published: January 2022

Traditional simulation training within medical education has been well established for several decades and involves playing out emergency situations in a role-play format. This type of simulation training is typically located at hospitals and medical centres and requires considerable organization, costs, in-person attendance and allocated time away from clinical commitments. Technological transformation within healthcare education is growing and, in particular, there has been an increase in mobile applications (apps) to aid medical education. Coupling the two together has allowed ‘gamification’ to emerge and grow in popularity as a powerful tool to enhance learning retention.The aim of this innovation project was to create a technology-enhanced simulation app for mobile devices to train in Advanced Life Support (ALS) for cardiopulmonary arrest, using game mechanics.A technology-enhanced simulation mobile app called ‘SimPL’ has been created to facilitate technology-enhanced learning on mobile devices. It allows the user to run physiological observations on a simulated patient. This has gained popularity on the Apple and Google Play Store amongst healthcare professionals. We now want to build on this and start by simulating ALS for cardiopulmonary arrest. A minimum viable demo that healthcare professionals can use to run an ALS scenario is being developed. The aim is to allow healthcare professionals to run through an interactive ALS scenario and give the user flexibility to make any decision they want regarding intervention and see how the patient responds to it. It provides real-time, haptic and constructive performance feedback to the intervention being carried out.The use of technology-enhanced simulation for healthcare education is a novel area and with the fast acceleration of game mechanics development, there is scope for medical education to be delivered in this way. The technology-enhanced simulation app will be launched on the Apple and Google Play Store to all healthcare professionals around the world. Feedback will be gathered from users to allow further developments of the product. The overall outcome is to produce a network of mobile apps to deliver medical education in an interactive, engaging and easily accessible way to help clinicians prepare for emergency medical situations anytime, anywhere.
111 Using Video Teleconferencing for an Effective Remote Simulation Course in Transfer Medicine
Authors: O’dwyer Anthony , Melzer Arndt 
Published: January 2022

Critically ill patients require transfer within and between hospitals – a necessity amplified by ITU capacity pressures during the COVID-19 pandemic. This rising demand highlighted the need for dedicated transfer teams. Alongside establishing and expanding a cross-sector transfer team, we necessarily needed to meet growing training requirements. Transfer medicine is a core competency for intensivists, anaesthetists, ITU nurses and pre-hospital staff, with simulation recommended in the respective curricula. However, COVID-related restrictions alongside demands on staff’s time, limited opportunities for face-to-face training. We overcame these challenges by developing an online simulation-based course. Teleconferencing has previously been received favourably and rated highly for educational benefit The aim of the study was to test the efficacy of and response to remote simulation-based training in transfer medicine.Before attending the online simulation, multi-disciplinary participants completed 3 hours of interactive e-learning hosted online via the platform Rise. This incorporated case-based discussions, practical assignments and filmed presentations. Simulation utilized Zoom teleconferencing to immerse participants in clinical transfers. We used high-fidelity, pre-recorded scenarios made with a mannequin simulator and high-definition video. The participants observed the simulated transfer of critically ill patients (Example screenshot of online simulated scenario with participants observingA total of 21 multi-disciplinary participants completed training: 43% doctors and 57% nurses. 100% of respondents (18) rated the course 5/5 on the Likert scale when asked ‘how much did you enjoy the course’ and 100% would recommend the course to colleagues. All rated the course extremely relevant to their practice. Average assessment scores pre- versus post-course improved by approximately 20% (74.3% to 94.4%) (Results of pre- and post-course knowledge assessmentsWe developed an effective and well-received remote simulation transfer course to deliver training to a wide-reaching audience. Participants were enthusiastic about the innovative and interactive approach, finding the online course enjoyable and relevant to their clinical practice. Results suggest the course effectively increased learning. The flexible nature of online remote provision allows for delivery at scale, to meet a rising demand. Further evaluation will establish the extent at which this training translates to performance, such as a reduction in adverse events in transfer practice.
38 Using Simulation to Improve and Test a Novel Enhanced Care Drug Trolley
Authors: Williamson Jodie , Grundy Sarah , Rowson Mark 
Published: January 2022

The Royal College of Physicians Acute Medicine Taskforce The aim of the study was to optimize the management of life-threatening medical conditions, requiring enhanced care, whilst minimizing the time taken for commencement of drug interventions and staff using a novel Enhanced Care drug trolley.A drawer on a sealable procedure trolley was designated for each emergency and the following items were included:
Treatment algorithmPrescription chartsMonitoring charts (where applicable)Medications and their diluentsSundries (needles, flushes, sanicloths etc.)Blood forms, bottles and blood gas kits (where applicable)Cannulation kitsAirways (where applicable)Oxygen mask (where applicable)A Standard Operating Procedure (SOP) was produced detailing the responsibilities of the ward manager, pharmacy team and nursing staff. Weekly and daily checklists were produced, along with a ‘seal broken’ table. The process, procedures and innovation were discussed and approved by the Drugs and Therapeutics group.Each emergency scenario was tested Results from testing the enhanced care drug trolleySimulation testing led to modifications of the contents of the trolley after feedback from the users. To embed practice, education of the nursing staff and clinicians was commenced to ensure familiarity and confidence to use the trolley, and to ensure governance adhered to.
98 ‘AOSim’: A Decision-Making Simulation Course for Acute Oncology Nurses
Authors: Bains Amarpal , Mann Karishma , Wheeler Joseph 
Published: January 2022

Simulation-based education (SBE) as a learning tool is becoming more prevalent, as is the recognition of the importance of non-technical skills. With this insight comes a desire to improve clinical practice using these techniques. ‘AOSim’ has arisen from an intrinsic desire to achieve this from within an Acute Oncology Service (AOS). Wishes to improve confidence, decision-making and teamwork have guided the design and implementation of a novel simulation course in this field.The purpose of the course has been guided by the candidates. The hope is to be able to provide a safe learning environment to explore decision-making, improve confidence in clinical practice and strengthen teamwork.The course design was informed by direct stakeholder analysis. Pre-course surveys aided in planning the course and scenario design. The course would run over half a day and comprise three scenarios, each followed by a debrief. The candidates invited were nurses working in the local AOS and the AOS coordinator. Each scenario was designed with a particular focus in mind; ‘Respectful Challenging’, ‘Clinical Prioritisation’ and ‘Treatment Escalation’. The clinical context of the scenarios was based on oncology to provide a familiar environment for the candidates. This would also enable the focus to be paid to the non-technical skills related to the aims of the course. The scenarios were to be run in a high-fidelity setting using a mixture of role players, mannikins and plants. Faculty roles had been assigned prior to the course date.A course overview was sent to the candidates including the planned date for running the course to allow the candidates to plan for handover of their clinical duties; this allowed protected time for the course to run. ‘AOSim’ was run in a simulation suite in the high-fidelity setting with an experienced faculty. The candidates were introduced to the simulated environment and the importance of psychological safety was explained. The three scenarios ran as planned to include subsequent informative debriefs. Immediate and post-course feedback were positive, particularly with increased confidence levels and team-working ability. This has led to aspirations to run the course again for a different candidate group in the future.
138 Student Perspectives of a Novel Remote Simulation Course
Authors: Freer Hannah , Jones Simon , Lewandowski John , Randles Derek , Dores Craig 
Published: January 2022

This study was designed in response to the pandemic. This was to increase the accessibility of Simulation Training whilst under lockdown restrictions and limited departmental capacity due to social distancing.The aim of the study was to assess final-year medical students’ perspectives on a new method of delivering a simulation course remotely.The technique utilized in the intervention group was a guided experience via ‘Avatars’ – Faculty members who were physically present in the simulation room. Course participants joined via a live video stream and directed the ‘Avatar’ in real time. The scenarios were driven by a script that directed focus to the learning objectives. The debrief followed a ‘pause and perfect’ approach to enhance participation. During these pauses, the students, with guidance from a facilitator, reflected on developments so far and then gave their ‘Avatar’ instructions for the next stage of the scenario. The study took the form of a pragmatic cross-over trial, splitting the cohort into two groups. Group 1 received a face-to-face medicine simulation course and a remote surgery simulation course. Of this group, approximately half had the remote course first and the face-to-face second, the other half in the reverse order. Group 2 had a similar format, however with a face-to-face surgery simulation course and a remote medicine simulation course. The intention was to minimize the influence of pre-course perceptions based on what has already been experienced (i.e. a group might have a different perspective on a face-to-face course if they have had a remote course first and vice versa). Feedback was collected and compared for each.A total of 44 final-year medical students took part in the trial. 40 feedback responses were collected for the face-to-face sessions and 37 for the remote. Overall, the face-to-face simulation sessions were received more positively with 100% of participants scoring face-to-face sessions overall as ‘Excellent’ or ‘Very Good’ compared with 70.2% for the remote simulation. Participants were asked to score out of 10 how much these sessions would change their future practice; the mean score for the face-to-face was 9.29 compared with 8.5 for the remote. Remote simulation produced lower student satisfaction scores compared with face-to-face teaching. Further research is needed to determine the differential impact on knowledge and skills transfer. If there is limited impact, remote simulation could be a viable and valuable alternative to face-to-face simulation, not only during a pandemic but also in diverse environments.