bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient Experience and Perspective towards Optometry Students during Eye Examination and Consultation in UiTM Vision Care Clinic
Authors: Zainodin Elly Liyana , Mohd Nor Azmi Nur Afiqah
Published: November 2019

Clinical training for optometry students is a gateway for exposure in eye care management. Understanding patient experience and satisfaction of being examined by students is essential to improve clinical competency and education. A survey was done to determine patient experience and perspective among 228 adults who had eye examinations at the UiTM Vision Care clinic. Overall, the majority of the patients rated the care as good (96%) and believed it is vital for students to examine patients (93%). Patients of the fourth-year students were reportedly more happy for future student involvement. Concerns on lengthy examination recommend necessary measures.Keywords: patient experience; optometry; students; clinical educationeISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i12.1932
The Personalization of Conversational Agents in Health Care: Systematic Review (Preprint)
Authors: Kocaballi Ahmet Baki , Berkovsky Shlomo , Quiroz Juan C , Laranjo Liliana , Tong Huong Ly , Rezazadegan Dana , Briatore Agustina , Coiera Enrico
Published: November 2019

BACKGROUND

The personalization of conversational agents with natural language user interfaces is seeing increasing use in health care applications, shaping the content, structure, or purpose of the dialogue between humans and conversational agents.

OBJECTIVE

The goal of this systematic review was to understand the ways in which personalization has been used with conversational agents in health care and characterize the methods of its implementation.

METHODS

We searched on PubMed, Embase, CINAHL, PsycInfo, and ACM Digital Library using a predefined search strategy. The studies were included if they: (1) were primary research studies that focused on consumers, caregivers, or health care professionals; (2) involved a conversational agent with an unconstrained natural language interface; (3) tested the system with human subjects; and (4) implemented personalization features.

RESULTS

The search found 1958 publications. After abstract and full-text screening, 13 studies were included in the review. Common examples of personalized content included feedback, daily health reports, alerts, warnings, and recommendations. The personalization features were implemented without a theoretical framework of customization and with limited evaluation of its impact. While conversational agents with personalization features were reported to improve user satisfaction, user engagement and dialogue quality, the role of personalization in improving health outcomes was not assessed directly.

CONCLUSIONS

Most of the studies in our review implemented the personalization features without theoretical or evidence-based support for them and did not leverage the recent developments in other domains of personalization. Future research could incorporate personalization as a distinct design factor with a more careful consideration of its impact on health outcomes and its implications on patient safety, privacy, and decision-making.
Telecarers in the Co-ordination of Secondary Osteoporosis Prevention in Hip Fracture Patients (Preprint)
Authors: Gani Linsey , Tan Francine , King Thomas Frederick
Published: November 2019

BACKGROUND

There remains a significant treatment gap in osteoporosis patients. Our previous audit found that among all fragility fracture patients, rates of anti-osteoporosis medication initiation were between 10.1 to 31.5% at 1 year.

OBJECTIVE

To reduce over-utilization of hospital visits, we piloted the use of telecarers to follow up patients at specific time intervals post-discharge from hip fracture to monitor osteoporosis treatment and compliance.

METHODS

From January 2017 – January 2018, all hip fracture patients at Changi General Hospital, Singapore were automatically enrolled into the Health Management Unit (HMU) valued care hip fracture program. Upon discharge, telecarers from the HMU follow up patients to remind of attendance at clinic appointments and confirm compliance to anti-osteoporosis medication. Telecarer calls were scheduled at discharge, 3, 6 and 12 months. We assessed the acceptability, completion and treatment rates of patients enrolled in this program

RESULTS

537 patients with hip fracture were enrolled in the telecarer program over 1 year. 341 patients completed 12 months follow up, of which 251 patients (73.6%) were on treatment at 12 months. The most common cause of treatment rejection is patient or family rejection (34.4%), this was followed by 24.4% of physician failure to prescribe and renal impairment in 24.4%, 16.7% of patients were deemed to have advanced dementia with life limiting illness and were thus thought not suitable for treatment.

CONCLUSIONS

Telecarer may be a useful adjunct in the monitoring of osteoporosis treatment post hip fractures. However the main limitations of treatment remain with patient and primary care clinician education which remains a challenge. Further studies should look into a combination of telecarer intervention for both patients and primary care clinicians to increase awareness of secondary fracture prevention. Given the significant mortality and morbidity post hip fractures, future efforts should also be aimed at primary prevention of hip fractures.
Evaluation Criteria for Weight Management Apps: Validation Using a Modified Delphi Process (Preprint)
Authors: Robles Noemí , Puigdomènech Puig Elisa , Gómez-Calderón Corpus , Saigí-Rubió Francesc , Cuatrecasas Cambra Guillem , Zamora Alberto , Moharra Montse , Paluzié Guillermo , Balfegó Mariona , Carrion Carme
Published: November 2019

BACKGROUND

The use of apps for weight management has increased over recent years; however, there is a lack of evidence regarding the efficacy and safety of these apps. The EVALAPPS project will develop and validate an assessment instrument to specifically assess the safety and efficacy of weight management apps.

OBJECTIVE

The aim of this study was to reach a consensus among stakeholders on a comprehensive set of criteria to guide development of the EVALAPPS assessment instrument. A modified Delphi process was used in order to verify the robustness of the criteria that had been identified through a literature review and to prioritize a set of the identified criteria.

METHODS

Stakeholders (n=31) were invited to participate in a 2-round Delphi process with 114 initial criteria that had been identified from the literature. In round 1, participants rated criteria according to relevance on a scale from 0 (“I suggest this criterion is excluded”) to 5 (“This criterion is extremely relevant”). A criterion was accepted if the median rating was 4 or higher and if the relative intraquartile range was equal to 0.67 or lower. In round 2, participants were asked about criteria that had been discarded in round 1. A prioritization strategy was used to identify crucial criteria according to (1) the importance attributed by participants (criteria with a mean rating of 4.00 or higher), (2) the level of consensus (criteria with a score of 4 or 5 by at least 80% of the participants).

RESULTS

The response rate was 83.9% (26/31) in round 1 and 90.3% (28/31) in round 2. A total of 107 out of 114 criteria (93.9%) were accepted by consensus—105 criteria in round 1 and 2 criteria in round 2. After prioritization, 53 criteria were deemed crucial. These related mainly to the dimensions of security and privacy (13/53, 24.5%) and usability (9/53, 17.0%), followed by activity data (5/53, 9.4%), clinical effectiveness (5/53, 9.4%), and reliability (5/53, 9.4%).

CONCLUSIONS

Results confirmed the robustness of the criteria that were identified, with those relating to security and privacy being deemed most relevant by stakeholders. Additionally, a specific set of criteria based on health indicators (activity data, physical state data, and personal data) was also prioritized.
5G: The New Opportunities and Challenges in Medical Internet (Preprint)
Authors: Xu Chenjie , Wang Yaogang
Published: November 2019

UNSTRUCTURED

The 6th World Internet Conference took place in Wuzhen, Zhejiang Province from October 19 to 22 in China. The theme of this year's conference is "Intelligent Interconnection for Openness and Cooperation: Building a Community with a Shared Future in Cyberspace". Hot internet-related issues, such as artificial intelligence, internet of things and 5G, had been held in the conference. Under the current trend of the times, we have higher and higher requirements for information transmission and exchange. And with the mobile network technology rapidly developed, there are countless flashing wisdom behind the development of mobile network technology from the generation, transmission to reception of information. Since the introduction of 1G in the early 1980s and 4G in the 2010s, a new wireless mobile communication technology has been released every 10 years or so. The emergence of mobile network technology has illuminated the modern society.
Lupus Miliaris Disseminatus Faciei: Enhanced cosmesis by Combination of Medications, Laser and Fillers (Preprint)
Authors: Sakhiya Sr Jagdish , Kaklotar Jr Jitesh , Gandhi Jr Jashmine , Sakhiya Dhruv , Khambhati Jr Ravi , Purohit Jr Madhav , Daruwala Jr Feral , Dudhatra Jr Nimish
Published: November 2019

UNSTRUCTURED

A rare granulomatous disease of unknown origin is lupus miliaris disseminatus faciei (LMDF). Associated pitted scars are major complication leads to psychological distress resulting in increased demand for dermatological consultation. Histopathologically, epithelioid granulomas with caseation necrosis are the typical presentation. Advanced research is still ongoing, yet its treatment remains challenging. Management should be individually structured and, the appropriate combination may have a beneficial effect. We report an LMDF case with facial and extra facial localization successfully treated with a combination of medications, the fractional CO2 laser and fillers. In conclusion, the attitude of the patient towards the scar has considerably improved after treatment. In the past era, most authors assumed that a relationship existed between tuberculosis, rosacea and sarcoidosis, however, many authors found it to be a distinct entity. Herein, we also discussed the distinction between listed the ambiguous entities.
Adopting Patient Portals in Hospitals: Qualitative Study (Preprint)
Authors: Hulter Pauline , Pluut Bettine , Leenen-Brinkhuis Christine , de Mul Marleen , Ahaus Kees , Weggelaar-Jansen Anne Marie
Published: November 2019

BACKGROUND

Theoretical models help to explain or predict the adoption of electronic health (eHealth) technology and illustrate the complexity of the adoption process. These models provide insights into general factors that influence the use of eHealth technology. However, they do not give hospitals much actionable knowledge on how to facilitate the adoption process.

OBJECTIVE

Our study aims to provide insights into patient portal adoption processes among patients and hospital staff, including health care professionals (HCPs), managers, and administrative clerks. Studying the experiences and views of stakeholders answers the following question: How can hospitals encourage patients and HCPs to adopt a patient portal?

METHODS

We conducted 22 semistructured individual and group interviews (n=69) in 12 hospitals and four focus groups with members of national and seminational organizations and patient portal suppliers (n=53).

RESULTS

The effort hospitals put into adopting patient portals can be split into three themes. First, inform patients and HCPs about the portal. This communication strategy has four objectives: users should (1) know about the portal, (2) know how the portal works, (3) know that action on the portal is required, and (4) know where to find help with the portal. Second, embed the patient portal in the daily routine of HCPs and management. This involves three forms of support: (1) hospital policy, (2) management by monitoring the numbers, and (3) a structured implementation strategy that includes all staff of one department. Third, try to adjust the portal to meet patients’ needs to optimize user-friendliness in two ways: (1) use patients’ feedback and (2) focus on optimizing for patients with special needs (eg, low literacy and low digital skills).

CONCLUSIONS

Asking stakeholders what they have learned from their efforts to stimulate patient portal use in hospitals elicited rich insights into the adoption process. These insights are missing in the theoretical models. Therefore, our findings help to translate the relatively abstract factors one finds in theoretical models to the everyday pragmatics of eHealth projects in hospitals.
Artificial Intelligence and Big Data in Diabetes Care: A Position Statement of the Italian Association of Medical Diabetologists (Preprint)
Authors: Musacchio Nicoletta , Giancaterini Annalisa , Guaita Giacomo , Ozzello Alessandro , Pellegrini Maria A , Ponzani Paola , Russo Giuseppina T , Zilich Rita , de Micheli Alberto
Published: November 2019

UNSTRUCTURED

Since the last decade, most of our daily activities have become digital. Digital health takes into account the ever-increasing synergy between advanced medical technologies, innovation, and digital communication. Thanks to machine learning, we are not limited anymore to a descriptive analysis of the data, as we can obtain greater value by identifying and predicting patterns resulting from inductive reasoning. Machine learning software programs that disclose the reasoning behind a prediction allow for “what-if” models by which it is possible to understand if and how, by changing certain factors, one may improve the outcomes, thereby identifying the optimal behavior. Currently, diabetes care is facing several challenges: the decreasing number of diabetologists, the increasing number of patients, the reduced time allowed for medical visits, the growing complexity of the disease both from the standpoints of clinical and patient care, the difficulty of achieving the relevant clinical targets, the growing burden of disease management for both the health care professional and the patient, and the health care accessibility and sustainability. In this context, new digital technologies and the use of artificial intelligence are certainly a great opportunity. Herein, we report the results of a careful analysis of the current literature and represent the vision of the Italian Association of Medical Diabetologists (AMD) on this controversial topic that, if well used, may be the key for a great scientific innovation. AMD believes that the use of artificial intelligence will enable the conversion of data (descriptive) into knowledge of the factors that “affect” the behavior and correlations (predictive), thereby identifying the key aspects that may establish an improvement of the expected results (prescriptive). Artificial intelligence can therefore become a tool of great technical support to help diabetologists become fully responsible of the individual patient, thereby assuring customized and precise medicine. This, in turn, will allow for comprehensive therapies to be built in accordance with the evidence criteria that should always be the ground for any therapeutic choice.
The Arabic Version of the Mobile App Rating Scale: Development and Validation Study (Preprint)
Authors: Bardus Marco , Awada Nathalie , Ghandour Lilian A , Fares Elie-Jacques , Gherbal Tarek , Al-Zanati Tasnim , Stoyanov Stoyan R
Published: November 2019

BACKGROUND

With thousands of health apps in app stores globally, it is crucial to systemically and thoroughly evaluate the quality of these apps due to their potential influence on health decisions and outcomes. The Mobile App Rating Scale (MARS) is the only currently available tool that provides a comprehensive, multidimensional evaluation of app quality, which has been used to compare medical apps from American and European app stores in various areas, available in English, Italian, Spanish, and German. However, this tool is not available in Arabic.

OBJECTIVE

This study aimed to translate and adapt MARS to Arabic and validate the tool with a sample of health apps aimed at managing or preventing obesity and associated disorders.

METHODS

We followed a well-established and defined “universalist” process of cross-cultural adaptation using a mixed methods approach. Early translations of the tool, accompanied by confirmation of the contents by two rounds of separate discussions, were included and culminated in a final version, which was then back-translated into English. Two trained researchers piloted the MARS in Arabic (MARS-Ar) with a sample of 10 weight management apps obtained from Google Play and the App Store. Interrater reliability was established using intraclass correlation coefficients (ICCs). After reliability was ascertained, the two researchers independently evaluated a set of additional 56 apps.

RESULTS

MARS-Ar was highly aligned with the original English version. The ICCs for MARS-Ar (0.836, 95% CI 0.817-0.853) and MARS English (0.838, 95% CI 0.819-0.855) were good. The MARS-Ar subscales were highly correlated with the original counterparts (P<.001). The lowest correlation was observed in the area of usability (r=0.685), followed by aesthetics (r=0.827), information quality (r=0.854), engagement (r=0.894), and total app quality (r=0.897). Subjective quality was also highly correlated (r=0.820).

CONCLUSIONS

MARS-Ar is a valid instrument to assess app quality among trained Arabic-speaking users of health and fitness apps. Researchers and public health professionals in the Arab world can use the overall MARS score and its subscales to reliably evaluate the quality of weight management apps. Further research is necessary to test the MARS-Ar on apps addressing various health issues, such as attention or anxiety prevention, or sexual and reproductive health.
International Year of the Periodic Table of Chemical Elements
Authors: Tarasova Natalia P.
Published: November 2019

Year 2019, the International Year of the Periodic Table of Chemical Elements, is of special value for our country. 150 years ago, in 1869, the outstanding Russian scientist D.I. Mendeleev published the first scheme of the Periodic table of chemical elements. The International Year of the Periodic Table of Chemical Elements draws the world community attention to the development of fundamental sciences, to deepening and expansion of education for sustainable development, to global problems that cannot be solved without active use of achievements of modern green chemistry. The quality of everyday life of present and future generations is directly connected with the progress and achievements of chemical science and technology. In 2019, the large-scale events dedicated to D.I. Mendeleev and his scientific heritage will take place both in Russia and throughout the world The International Year of the Periodic Table once again emphasizes the importance of the systematicity in our chaotic world. The System gives an opportunity to understand the idea of regularity and thus arms human beings with the ability to predict.
Variability and Periodicity of Properties of Metal-Organic Frameworks: D.I. Mendeleev’s Periodic System in Action
Authors: Kustov Leonid M. , Kudelin Anton I. , Isaeva Vera I.
Published: November 2019

This mini-review presents the analysis of the structure of metal-organic frameworks in terms of the D.I. Mendeleev’s Periodic Law. Up to date, 69,666 compounds of these coordination polymers, containing 78 elements of the Periodic Table, have been synthesized, and their structure has been established.
The Distribution of Power in The Recruitment of Prospective Head Area by PDI-P in The Election Year 2015 Jember
Authors: Amwaritama Mimin
Published: November 2019

The distribution of power is still a debate in the party's internal politics, especially in terms of recruitment of candidates for regional elections head. Yet the existence of a clear policy related settings portion of authority between the Centre Party and the party in an area is often the cause of difference of interests and the decision appeared, particularly the matter of flying a candidate head of the region. The implication is unavoidable political dynamics. This paper seeks to analyse thoroughly about the distribution of power in the political candidate recruitment head area in PDI-P Jember. The focus of the writing refers to the moment of the Election Year 2015 Jember. Analysis of peeled through the perspective of the theory of political recruitment and distribution of power. The results of the analysis gave an explanation that is not yet a clear subject control distribution of power in the sphere of internal party candidacy candidate in terms of the head area. This implies the existence of the political dynamics of differences at each level of the process candidacy. When the populist nature of the power distribution then the process candidacy running electorate with a more democratic, more inclusive, as well as the representation of social groups can be more assured. Meanwhile, when the distribution of power are elitist by rising degree of exclusivity of candidacy political interests, opportunities to appear much larger due to the interaction between the candidates with the electorate became more and more intensive
Learn about Probolinggo Municipal Government Partnership Pattern with Corporate CSR in order to Realize Probolinggo City Environmentally Friendly
Authors: Aini Qurotal , Winarjo Wahyudi , Masduki M.
Published: November 2019

The existence of industry in a city has an important role in the survival of society. Industry managers, as well as industrial environment are closely related to the regional government, because it is one of the planning of the city layout of an area. The importance of maintaining good relations has been realized by every company. How they foster good relations with the local government, the community, and the environment around the company. The existence of CSR (Corporate Social Responsibility) helps the company to establish such good relationships, besides the mutually beneficial relationships between companies and communities, companies with local governments that such things can help mitigate and minimize conflicts that occur. In the drafting of Perda CSR, the DPRD and the government sometimes do not pay attention to the parties who become the object subject to the responsibility of Perda, in this case the company. The government should understand the construction of corporate thinking, because it will be contradictory when on the one hand the region seeks to attract investors to invest their capital, while on the other hand due to too many rules, formal and informal costs, even make investors reluctant to invest. In this research use social control theory, and social action, also institutionalism organizational.In this study using the type of qualitative research with phenomenology approach which of the phenomenon is doing an observation, then use field notes as well as in-depth interviews of informants who are selected based on purposife. The data obtained will be analyzed using qualitative descriptive technique and the data is checked for validity by triangulation.
Regional Government Cooperation in Keeping Brantas River Basin with Sumber Brantas Village Community, Bumiaji Sub-District, Batu City
Authors: Hodaifah N , Masduki M. , Sulistyangingsih Tri
Published: November 2019

Awareness of Batu City residents to keep the Brantas River is still low, whereas Batu Regional Government has Regional Regulation (PERDA) No. 7 of 2011 on Spatial Planning for Year 2010-2030 and Regional Regulation No 16 Year 2011 on Protection, Conservation and Environmental Management. From the existing regulations should be enough to help the existence of forests that support the Brantas watershed, but the systematization of natural resource management is still not communicated well by the surrounding community. Lack of understanding and awareness in cooperation is a gap that makes the goal in protecting and preserving the Brantas River Basin did not materialize. The importance of growing mutual attitude among the community is needed to control the problems that occur in the Brantas River Basin. This raises the question for the researcher as stated in the formulation of the problem in this research, that is (1) How Local Government Action in effort to tackle Brantas Watershed? (2) How is the cooperation between the Regional Government and SumberBrantas Village Communities in maintaining the Brantas River? (3) How is the social life of SumberBrantas Village community in maintaining the Brantaswatershed?The type of research is descriptive qualitative research (Description Research). The research area was chosen purposively, in SumberBrantas Village, Bumiaji District, Batu City. This study uses field notes and in-depth interviews of informants namely the Local Government and the Brantas River Basin community. The data obtained will be analyzed using qualitative descriptive technique and the data is checked for validity by triangulation. The findings of the research results, the cooperation between the Government and the SumberBrantas Village Communities are still not optimal, because the community participation is still weak, this makes the problems that occur in the Brantas watershed protracted in handling. The village community of SumberBrantas is categorized as a farmer community which is known to still be thick with work together, it can be seen in the daily life of the community as well as the capital to increase people's understanding of the importance of keeping the Brantas watershed together.
COMPARING ANTIBACTERIAL POTENTIAL AND PHYTOCHEMICAL CONSTITUENTSOF TWO SPECIES OF GENUS URTICA
Authors: RAJPUT PRIYANKA , CHOUDHARY MAITRY , R.A. SHARMA
Published: November 2019

The present study was conducted to evaluate and compare the in-vitro bioactive potential of various organic extracts of the root, stem and leaves of Urtica dioica and Urtica urens on growth of tested Gram Positive (+ve) and Gram negative (–ve) bacteria.The present investigation also includes the comparative chemical constituency of the crude extract of root, stem and leaves of both plants. The comparative bioactive potential of Urtica dioica and Urtica urens was tested against both pathogenic and non-pathogenic strains of bacteria that are Gram positive (Staphylococcus aureus and Bacillus subtilis) and Gram negative (Pseudomonas aeruginosa and E. Coli) conducted by using agar well diffusion method .The Minimum Inhibitory Concentrations (MICs)-the lowest concentration of antimicrobial agent that will inhibit any visible growth of microbein chloroform and methanol extracts of root, stem and leaves of both plants was determined using micro-well dilution method. For the phytochemical evaluation of plants metabolites- ascorbic acid, flavonoids, phenols and proteins has been quantitatively estimated. The MIC has been to be most effective in case of methanolic extract of root against both gram positive and gram negative bacteria. Significant antimicrobial activity has been observed against gram negative bacteria E. coli and both the gram positive bacteria testedexpressed by U. dioica comparatively more effective than U. urens. Only a moderate amount of activity is exhibited against P. aeruginosa by both the plants. The non-polar extracts were found to have comparatively higher bactericidal potential than the polar extracts. The phytochemicals analysis suggested the presence of ascorbic acid, phenols and proteins to be found in U. urens in significantly higher concentration than U. dioica. On the other hand, U. dioica has been found to be more abundant in flavonoid concentration comparatively.
Comparative Analysis of Parallel Brain Activity Mapping Algorithms for High Resolution Brain Models
Authors: Molina-Machado Cristhian D. , Cuartas Ernesto , Martínez-Vargas Juan D. , Giraldo Eduardo
Published: November 2019

This paper proposes a comparative analysis between regular and parallel versions of FISTA and Tikhonov-like optimizations for solving the EEG brain mapping problem. Such comparison is performed in terms of computational time reduction and estimation error achieved by the parallelized methods. Two brain models (high- and low-resolution) are used to compare the algorithms. As a result, it can be seen that, if the number of parallel processes increases, computational time decreases significantly for all the head models used in this work, without compromising the reconstruction quality. In addition, it can be concluded that the use of a high-resolution head model produces an improvement in any source reconstruction method in terms of spatial resolution.
Evaluating the Career Impact of Faculty Development Using Matched Controls
Authors: Morzinski Jeffrey , Simposon Deborah , Marcdante Karen , Meurer Linda A. , Gilligan Mary Ann , Chandler Tess
Published: November 2019

Background and Objectives: Faculty development (FD) is required for medical educators, yet few studies address its long-term career impact on graduates. This project presents the impact of FD on career development, as perceived by physician faculty graduates of a longitudinal primary care FD educator program, compared to nonenrollees.
Methods: Between 2011 and 2016, 33 physician faculty from three departments participated in monthly half-day in-class FD for 20 months, emphasizing educator skills and career development. After physician-graduates were stratified by year, 10 were randomly selected and matched with 10 nonparticipants (controls) by specialty, gender, academic rank, and time in academic medicine. Narrative responses from semistructured interviews were recorded in a common template. Qualitative analysis methods identified themes, with agreement obtained by researchers.
Results: Median time in academic medicine for FD graduates (50% male) was 5.5 years; controls 7.5 years (40% male). Common themes across all respondents included that they: value their roles as clinical teachers; define success as training high-quality, competent physicians; align their professional aims with organizational priorities; manage commitments; develop and sustain colleague networks; and seek continued growth. Within themes, FD graduates differed from controls, detailing greater perceived success and growth as educators, placing higher value on scholarly products and academic promotion, and having more expansive local and national colleague networks.
Conclusions: FD graduates, compared to matched controls, report expanded clinician-educator scope and roles, and a greater value on scholarly activity. This evaluation provides the groundwork for further investigations.
PENGARUH APE DARI BAHAN ALAM TERHADAP ASPEK PERKEMBANGAN ANAK USIA 4-6 TAHUN
Authors: Nurjanah Elis , Masidah Imas , Fifiet Fifiet
Published: November 2019

Teachers must have high creativity in developing visuals to support student learning in accordance with its provisions, namely learning while playing. Media such as safe, healthy and clean, make according to size, can to explore, can to experiment, can develop, encourage students to be creative, develop ability to use. Media from natural materials that can be developed by kindergarten students. Although natural materials are considered simple, but if there is high creativity by the teacher, the teacher will be able to produce a fun learning spirit. and can be involved. The existence of creative learning will stimulate achievement. from aspects of religious morality, physical motoric, language, cognitive, social emotional and art. Creativity at school will be the creativity that is done while playing. because the results for the material and the ease of being able to be in the surrounding environment.
OPTIMALISASI KETERAMPILAN BERBICARA UNTUK MENINGKATKAN KEYAKINAN DIRI ANAK USIA DINI DI TK BAITURRAHMAN KABUPATEN BANDUNG
Authors: Nuraeni Siti , Maesaroh Ai , Sumitra Agus
Published: November 2019

Speaking is one of the language skills in daily life. People often choose to speak to communicate, because communication is more effective if done by speaking because speaking plays an important role in daily life. speaking skills in general can be interpreted as conveying the intentions of ideas, ideas, thoughts or contents of one's heart to others by using spoken language so that it can be understood by others. faced with a feeling of insecurity about many things. Likewise speaking skills are very limited because of fear of being mistaken. This research was conducted by the method of classroom action research to determine children's speaking skills influence the self-confidence of a child. Based on these results the results that optimize children's speaking skills have their own challenges, especially with different characteristics of children. This article was written with the aim of studying the process of children's speaking skills to improve children's self-confidence.Berbicara merupakan salah satu keterampilan berbahasa dalam kehidupan sehari hari seseorang lebih sering memilih berbicara untuk beromunikasi, karena komunikasi lebih efektif jika dilakukan dengan berbicara karena berbicara memegang peranan penting dalam kehidupan sehari hari. kemampuan berbicara secara umum dapat diartikan suatu penyampain maksud ide, gagasan, pikiran, atau isi hati seseorang kepada orang lain dengan menggunakan bahasa lisan sehingga dapat dipahami oleh orang lain kemampuan berbicara anak sangat berpengaruh terhadap keyakinan diri seorang anak, dalam kehidupan sehari hari setiap manusia akan dihadapkan pada rasa tak percaya diri akan banyak hal. Demikian juga keterampilan bebicara yang sangat terbatas hal ini dikarenakan takut diangap salah. Penelitian ini dilakukan dengan metode penelitian tindakan kelas untuk mengetahui keterampilan berbicara anak berpengaruh terhadap keyakinan diri seorang anak. Berdasarkan hasil tersebut diperoleh hasil bahwa mengoptimalkan keterampilan berbicara anak memiliki tantangan tersendiri, terlebih dengan karakteristik anak yang berbeda beda. Artikel ini ditulis dengan tujuan untuk mengkaji proses keterampilan berbicara anak untuk meningkatkan keyakinan diri anak.
IMPROVING STUDENT’S MATHEMATICS LEARNING ACTIVITIES AND OUTCOMES USING MATHEMATICAL BAGATRIX AND POWER POINT SOFTWARE
Authors: Sudarsono Andri , Supiyanto Supiyanto , Batori Batori , Hidayat Teguh Imam Agus
Published: November 2019

The purpose of this study is to analyze students’ mathematics learning activities and outcomes using mathematics instruction assisted by ICT mathematical Bagatrix software and PowerPoint. This study is a classroom action research in three cycles, on a linear equation of one variable (LEOV) and involves 20 seventh grade students of SMP Citra Cemara in Bandung.  The study found that students’ mathematics learning activities increased during each cycle, likewise, students’ mathematics learning outcomes and percentage of the number of students who reached mastering LEOV (more than 70% out of ideal score) heightened at end of each cycle. Another finding is that students perform positive opinion toward implementation of mathematics instruction assisted by ICT mathematical Bagatrix software and  PowerPoint.
THE ROLE OF MATHEMATICS REALISTIC EDUCATION APPROACH ON STUDENTS’ MATHEMATICAL CRITICAL THINKING AND RESILIENCY
Authors: Murni Sukma , Sugandi Asep Ikin
Published: November 2019

The purpose of this study is to analyze  the role of mathematics realistic education (RME)  approach on students’ mathematical critical  thinking  and resiliency. This study is an experiment with pre test-post test control group design and involves 62  eleventh grade students, a mathematical critical  thinking test, a mathematical  resiliency scale, and a perception on RME approach scale. The study found, on mathematical critical   thinking  ability (MCTA), its N Gain, and  mathematical resiliency (MR) students getting treatment with RME approach attained better grades than the grades  of students taught by conventional teaching. The first group students attained at medium grade level on MCTA and fairly good grade level on MR, while the second group students  obtained  at low grade level on MCTA, medium grade level on MR, and they realized difficulties in some  items of  mathematical critical  thinking tasks. The other findings, there was no association between MCTA and MR, and students learned actively, thought critically and creatively, were unafraid to pose their opinion and performed to be  self confident during  RME approach.
INDUCTIVE-DEDUCTIVE LEARNING APPROACH TO DEVELOP STUDENTS’ MATHEMATICAL PROBLEM SOLVING SKILLS AND SELF EFFICACY
Authors: Hidayat Teguh Imam Agus , Sabandar Jozua , Syaban Mumun
Published: November 2019

This study was a pretest-posttest designed control group experiment, aimed at reviewing the role of inductive-deductive approach on Islamic Junior High School students’ skills in mathematical problem solving and self efficacy. This research involved 56 grade eight students, a set of problem solving ability tests and a set of self efficacy scale. The result found that in the extent of mathematical problem solving skills and self efficacy, students who received problem solving-based learning achieved better quality than students who received conventional learning, either overall or based on the early mathematical ability (EMA). The interaction between learning and EMA in achieving and increasing problem solving skill showed no significant difference. Other than that, we found robust association between mathematical problem solving skills and self efficacy.
IMPROVING THE ABILITY OF MATHEMATIC STUDY PROBLEMS AND DISPOSITIONS SMP STUDENTS THROUGH IMPROVE METHOD
Authors: Rijaya Rijaya , Sumarmo Utari , Kurniawan Rudy
Published: November 2019

This study aims to: 1) know the achievement of problem-solving abilities and mathematical disposition of students, 2) the interaction between the learning model and the level of students' abilities to the achievement of problem-solving abilities and mathematical dispositions and 3) the association of problem ability and mathematical disposition students. This research uses the quantitative approach with the experimental method. The instrument used is a type of description test. Data analysis was done quantitatively by using t-test and two-track ANOVA test. The result of this research concludes that the achievement of problem-solving ability and mathematical disposition of students who gain learning with method Improve is better than students who get conventional learning either reviewed based on the whole students and based on students' early math ability. There is no interaction between learning method factors and the level of students' early mathematical ability toward the achievement of mathematical problem-solving abilities. There is no interaction between the learning method and the students' early mathematical ability towards achieving mathematical disposition abilities. Students have a positive attitude towards the learning of mathematics and Improve Method.
The Role of Problem Solving Approach on Student’s Mathematical Critical Thinking Ability and Disposition
Authors: Mulyana Asep , Sumarmo Utari , Kurniawan Rudi
Published: November 2019

This study was a pre test-post test experimental control group design having a goal to analyze  the role of prior mathematics ability (PMA) and Problem Solving Approach (PSA) on student’s mathematical critical  thinking ability (MCTA)  and disposition (MCTD). The study involved 65  eleventh grade students, a prior mathematics ability (PMA), a MCTA test, a  MCTD scale. The study found that PMA and PSA took roles on obtaining student’s MCTA and MCTD, those were the higher student’s PMA the study found the higher students MCTA and MCTD. Beside that, on MCTA and its N Gain, entirely and with low and medium PMA students  getting treatment with PSA attained  better grades than the grades of students taught by conventional teaching (CT);  and for entirely and with medium and high PMA, student recieving treatment with PSA obtained higher grades on MCTA and MCTD than student  taught by CT and those grades were at good grade level. The other findings, there was no association between MCTA and MCTD, and no interaction between PAM and teaching approaches toward MCTA and on MCTD and student  learn  actively during PSA
IMPROVE MATHEMATICAL LEARNING CREATIVITIES OF JUNIOR HIGH SCHOOL STUDENTS THROUGH SNOWBALL THROWING TYPE OF COOPERATIVE LEARNING MODEL
Authors: Ma'sum Moch Hasbi Ridlo , Nurkolis Nurkolis
Published: November 2019

The overall success of the study included the level of student creativity increased, seen from the four creative indicators namely fluency (fluency), flexibility (flexibility), originality (authenticity) and elaboration (decomposition) which always experienced an increase in each cycle. In line with this research is based on problems found in schools, especially in mathematics learning needs to be pursued a learning strategy, one of which is using the cooperative type snowball throwing learning model. Based on the results of the research evaluation, it can be concluded from the results of the study that snowball throwing models can enhance students' creativity, provide a good and pleasant atmosphere, and produce a positive response to mathematics learning activities. Keywords:  Mathematical Learning Creativity and Cooperative Learning Model Type Snowball Throwing
Fiscal and monetary policy effectiveness in Turkey: A comparative analysis
Authors: Arestis Philip , Şen Hüseyin , Kaya Ayşe
Published: November 2019

Relying on the Autoregressive Distributed Lag cointegration technique, this paper assesses the comparative effectiveness of the fiscal and monetary policy on output growth in Turkey for the period 2003:q1-2019:q1. The empirical evidence shows that both policies are effective in promoting output growth but with varying degrees, revealing that the impact of monetary policy on output growth is greater than that of fiscal policy. Overall, based on our empirical evidence, it can be suggested that the Turkish authorities should set sight on monetary policy to achieve higher output growth while seeking ways to improve the output growth-enhancing role of fiscal policy. To that end, among many others, budgetary flexibility can be increased through creating fiscal space and growthfriendly tax and spending reforms can be undertaken without jeopardizing the trade-off between growth and equity while giving priority to proper coordination of fiscal policy with monetary policy.
Should Audit Committee Directors Serve on Multiple Audit Committees? Evidence from Cost of Equity Capital
Authors: Sharma Divesh S. , Sharma Vineeta D. , Tanyi Paul N. , Cheng Xiaoyan
Published: November 2019

We find a significant negative association between cost of equity and audit committee directors' simultaneous service on multiple audit committees (ACNUM). However, this association is not linear, as we find that cost of equity begins to increase when ACNUM is 1.50 for non-retired directors compared to 3.50 for retired directors. Further analyses reveal the negative association is more pronounced when a firm's information environment is strong and widely used firm-level measures of multiple directorships are not related to cost of equity. The evidence we present is consistent with the notion that investors positively perceive audit committee directors' service on multiple audit committees, but only to the extent such service does not undermine directors' ability to effectively discharge their governance responsibilities. Our study informs policymakers, boards, and nominating committees and advances the literature on multiple directorships, audit committees, and cost of equity.

JEL Classifications: G12; G14; M40; M41.

Data Availability: All data are publicly available from sources identified in the text.
PRACTITIONER SUMMARY When does utilizing valuation specialists reduce auditors' litigation risk?
Authors: Brown J. Owen , Grenier Jonathan H. , Pyzoha Jonathan S. , Reffett Andrew , Zielinski Natalie
Published: November 2019

This article summarizes "The effects of specialist type and estimate aggressiveness on juror judgments of auditor negligence" (Brown, Grenier, Pyzoha, and Reffett 2019), which examines two critical factors auditors consider when auditing complex estimates: the type of specialist to engage and the relative aggressiveness of the estimate. In an experiment involving an alleged audit failure, jurors were less likely to find auditors negligent when the auditors consulted with a valuation specialist, but only when managements' estimate was deemed to be more aggressive. The study does not find similar litigation benefits of using a specialist for a less aggressive estimate. A second experiment extended these results by demonstrating jurors were less likely to find auditors negligent when the auditors consulted with an external rather than an internal specialist, because jurors perceived external specialists as having greater independence from the client. Further, the litigation benefits of using an external specialist extended to circumstances when auditors who initially engaged an internal specialist also brought in an external specialist to review the internal specialist's work. The study concludes that utilizing external specialists, to either test management estimates or to review internal specialists' work, can limit auditors' litigation exposure, especially when auditing aggressive management estimates.
Editorial
Authors: Maria Helena Roxo Beltran Deividi Marcio Marques &
Published: November 2019

Editorial v.19
Skills and knowledge as a basis for safety competence in teacher education curriculum
Authors: Somerkoski Brita Marianne
Published: November 2019

Enhancing the safety culture in school context sets new challenges to prospective teachers, their need for safety skills, knowledge and competence. Based on the latest studies, the paper describes the factors of safety culture in the educational institutions. These factors are risks, processes, learning environments, learning, normative guidance, actors, target groups and tools. As a case study, further analysis is provided about the factor of learning. The data is teacher education curriculum text of one Finnish teacher education unit.

In the content analysis, the data was first classified with themes in the context of safety. During the second round of analysis, special attention was paid to the verbs. Further, two groups, skills (S) and knowledge (K) were established.

The analysis showed that there were more knowledge based (K) than skills based (S) meaning units. As the university studies are based on theoretical issues, this is understandable. Based on the analysis, it seems that the curriculum describes safety one-sided as the social issues and the interaction were in focus in both groups, knowledge and skills. This could mean that safety is valued in the teacher education. However, the results raise some concerns, whether the future teachers are able to provide decent education for their pupils in the various safety and security areas, such as traffic safety, injuries or occupational safety, or whether they are able to respond in the sudden crisis situations during the school day, for instance in case of violence or fire.