bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence Of The Flipped Classroom Model and Independent Learning on The Critical Thinking Capability Of Science and 5 Class Students in Primary School
Authors: Riska Riska , Marjo Happy Karlina , Purwantiningsih Ary
Published: January 2025

The low quality of education in Indonesia can be seen, among other things, at the basic education level. According to the TIMSS & PIRLS International Study Center survey, it shows that the quality of basic education in Indonesia, especially in the field of science, is only ranked 44th out of 47 countries that took part in the assessment with an average science score of 397. Aim: This research aims to determine the extent of the influence of the flipped classroom model and independent learning on scienceas critical thinking skills. Method: This research is a type of quantitative research that discusses The influence of the flipped classroom model and independent learning on the science and science critical thinking abilities of fifth grade elementary school students. The method used in this research is a quasi-experimental method which is a development of the pure experimental method of analysis of variance (ANOVA) with a 2x2 treatment by level design. The techniques for collecting data are questionnaires, tests and documents. The sampling technique uses a stratified random sampling procedure. Results and discussions: Based on the results of the research conducted, there was an interaction between the flipped classroom model and independent learning on critical thinking skills in Science and Technology. The results of the ANOVA test showed that the Fcount value = 19.28 and the Ftable value = 4.11 at the level  = 0.05. These results show that Fh > Ft so that there is an interaction between the use of the flipped classroom model and independent learning in influencing students' science and science critical thinking abilities. Conclusion: Based on the results of data analysis, hypothesis testing and research discussion results, it can be concluded that there is a positive and significant influence of the flipped classroom model and learning independence on the thinking ability of social science students in grade V of elementary school.
Self-regulated Learning for Elementary School Students' Mathematics Learning Using Think Pair Share
Authors: Astuti Amelia Dwi
Published: January 2025

Background: Students need Self-regulated learning to achieve maximum learning outcomes. In mathematics, students are often faced with challenges in solving complex problems or questions. So, in order for students to be able to face these challenges, students must have the motivation and strategy to solve them. This shows that students must have good Self-regulated Learning skills. The Think Pair Share learning model, can accommodate and have a positive influence on students' self-regulated learning. Aim: This research aims to find out how much difference the influence of the Think Pair Share learning model has on students' Self-regulated Learning in studying Mathematics. Method: This research is quantitative research. The population and sample size are 21 fourth-grade students in one of the state elementary schools in Palangkaraya. Sampling was carried out using a purposive sampling technique. The data collection instrument is a self-regulated learning scale questionnaire. The research conclusion analysis technique used in this research is the paired sample t-test. Results and Discussion: The SRL t_calculation value obtained using TPS learning was 7.074 and a significance value of 0.000. The significance value is 0.000 < 0.05 and t-count > t-table, namely 7.074 > 1.976 so Ho is rejected. Conclusion: There is a positive influence of Think Pair Share learning on the Self-regulated Learning of fourth-grade elementary school students in learning mathematics.
The Role of Pancasila and Citizenship Education Teachers in Multicultural Education in Schools
Authors: Mahendra Irvan
Published: January 2025

Background: The aim of this research was to find out and explain the role of Pancasila and citizenship education teachers in multicultural education. The method belonged to a library research approach. The data collection technique in this research was documentation, namely looking for data regarding variables in the form of books, papers, articles, journals, and so on. The data analysis technique used in this research was the descriptive method,namely research that seeks to describe and interpret what exists, opinions that are growing, ongoing processes, consequences or effects that occur or developing tendencies regarding the idea of ​​the role of Pancasila and citizenship education teachers in multicultural education in schools. The research results showed that the role of Civics teachers is very important in providing multicultural education considering that multicultural education is very important for students who live in a multicultural environment like the Indonesian nation. This helps students used a positive self-concept by providing an understanding of multicultural education, where Civics teachers must have a multicultural education perspective before they teach to students. This is a real challenge for professional Civics teachers. Teachers must be confident and ready to provide multicultural education.
Co-development of a programme to improve physical activity support for women after breast cancer treatment: a pre-protocol for PURE-EX
Authors: Orange Samuel T , Brown Morven C , Hallsworth Kate , Malcomson Fiona , Corfe Bernard , Tweedie Caroline , Cresti Nicola , Cain Henry , Court Paul , Willson Clare , Ross Kelly , Mathers John , Saxton John , Sharp Linda , Smith Samuel
Published: January 2025

Background Breast cancer and its treatment can have long-term adverse effects on physical and mental health. Evidence-based guidelines recommend that healthcare professionals (HCPs) advise women with breast cancer to engage in physical activity to improve health outcomes. However, support to be active is not standard care. The PURE-EX (EXpanding into communities to imProve physical activity sUpport foR womEn after breast cancer) programme aims to address this knowledge-practice gap. Aim To co-develop a programme that integrates physical activity referrals into standard care for women after treatment for early-stage and locally-advanced breast cancer. Programme components will include: 1. A referral pathway enabling HCPs to refer women to community-based physical activity programmes after they have completed primary treatment for breast cancer; 2. An online training course to support community providers in adapting their existing physical activity programmes for women who have undergone breast cancer treatment. Work Packages We will co-develop, refine, and evaluate PURE-EX programme components through four work packages (WPs): WP1. Conduct a systematic scoping review to describe the characteristics of community-based physical activity programmes for women with breast cancer reported in the literature. WP2. Undertake qualitative research with: (i) women with breast cancer, (ii) HCPs responsible for their care, and (ii) exercise professionals, to explore barriers and facilitators to incorporating physical activity into breast cancer care from different perspectives. WP3. Hold co-development events to develop and refine components of the PURE-EX programme and gain insights as to how it could be operationalised in practice. WP4. Conduct a feasibility trial in 45 women who have finished primary treatment for breast cancer to assess the feasibility and acceptability of the PURE-EX programme. Discussion The PURE-EX programme will be an evidence-based, theory-informed, and person-centred intervention, with the potential to make physical activity support routinely available for women after breast cancer treatment.
Pulmonary aspiration during pregnancy or immediately postpartum in the UK: A population-based case-control study
Authors: Lucas Nuala , Gooda Alison , Tunn Ruth , Knight Marian ,   The UKOSS Aspiration in Pregnancy investigators
Published: January 2025

Background Pulmonary aspiration of gastric contents is the most frequent cause of death associated with complications of airway management during general anaesthesia. Pregnancy increases aspiration risk owing to factors including delayed gastric emptying and increased intragastric pressure. We describe the incidence, risk factors, management, and outcomes of maternal pulmonary aspiration in pregnancy in the UK. Methods We conducted a population-based surveillance and case-control study. Between September 2013 and August 2016, all UK consultant-led obstetric units prospectively identified cases of pulmonary aspiration among parturient women using a pre-defined case definition, and reported them via the UK Obstetric Surveillance System (UKOSS). Controls (n=1982) were obtained from four UKOSS studies conducted between 2005 and 2014. We calculated the incidence of pulmonary aspiration using 2013–2015 maternities as the denominator. We explored potential risk factors for aspiration using univariable logistic regression and described outcomes. Results We identified 12 cases of pulmonary aspiration, giving an incidence of 5.2 per 1,000,000 maternities (95% CI 2.69-9.09). Cases were significantly less likely than controls to be multiparous (unadjusted odds ratio [uOR] 0.255, 95% CI 0.069-0.946), and significantly more likely to undergo caesarean section (uOR 24.89, 95% CI 3.18-194.85) and to receive general anaesthetic for caesarean section (p<0.001). Gestation was significantly shorter in cases than controls (uOR 0.782, 95% CI 0.702-0.870). Women who aspirated were significantly more likely to be admitted to the intensive therapy unit than controls (p<0.001). Infants of women who aspirated had significantly lower Apgar scores and were more likely to be admitted to the neonatal intensive care unit or to be stillborn compared with infants of women in the control group. Conclusions Pulmonary aspiration is rare in UK obstetric anaesthetic practice; however, it remains a risk of general anaesthesia. Despite a large study population, our analyses lacked power to evaluate many potential risk factors. Future research should focus on developing methods to accurately identify pregnant women at risk of aspiration.
Formation of a new institution of land management
Authors: Golovin Roman
Published: January 2025

Independent land management by landowners in Ukraine is significant. As a rule, such management is shadowy, with higher costs and lower revenues compared to public land management. Landowners and the country’s economy lose from this state of independent land management. Moreover, shadowing in the agricultural sector affects other related industries, which increases the size of the shadow economy.
The article examines the organizational and legal and organizational and production forms of land management. The existing forms of agricultural cooperation are analyzed. The factors influencing agricultural cooperation are identified. It is concluded that the problem of public organized independent land management can be solved through legal, institutional and organizational mechanisms which will ensure cooperation of landowners with a view to reducing the financial and organizational costs required to ensure publicity of land management. To solve the problem of public organized independent management of land resources, the author proposes a new institution of land management which operates on a unifying basis and provides land management entities with a reduction of costs and an increase.
The author proposes a certain organizational and production platform as a model of the new institution of land management. The platform has centralized accounting, unified tax administration, unified statistical reporting, and is managed by organizers with outstanding knowledge and experience, which ensures a reduction in production costs and an increase in profits for the platform participants — land owners. To formalize the relations between the landowner and the organizational and production platform, a land use agreement and a unification agreement are concluded, which regulates the relations between the landowner and the organizational and production platform.
Analysis of preconditions for formation of mechanisms of state policy for strengthening economic security
Authors: Popovych Rostislav
Published: January 2025

In today’s conditions of globalization and constant economic turbulence, strengthening economic security becomes an extremely important task for every country. This article emphasizes the necessity of a comprehensive approach to shaping mechanisms of state policy in this area. One of the key aspects under consideration is the thorough assessment of threats. Proper identification of potential risks allows for the development of effective strategies to protect the economy from negative influences. It is important to consider not only economic aspects but also political, social, and technological ones.
Strategic planning is another key element. A distinctive feature of effective policies aimed at strengthening economic security is their ability to adapt to changing conditions and adversities. Active support from political leadership and the development of human capital are also important aspects for the successful implementation of strategies.
Additionally, the stability of the political and social situation in the country plays a crucial role in creating an attractive environment for investors. The interaction between the public and private sectors, as well as the involvement of international partners, are also important.
Collaboration with global partners allows for the exchange of experience and resources, contributing to the stabilization and strengthening of the economy in the face of global challenges. Moreover, fostering innovation and investing in research and development are essential components of enhancing economic security. By promoting innovation, countries can diversify their economies, enhance competitiveness, and create new opportunities for growth. Encouraging entrepreneurship and supporting small and medium-sized enterprises (SMEs) also play a significant role in building resilience and driving economic prosperity.
Furthermore, effective regulation and governance frameworks are necessary to ensure transparency, accountability, and the rule of law, which are vital for maintaining investor confidence and attracting foreign investment.
The prospects of Ukrainian enterprises development under martial law conditions
Authors: Shergina Lidia , Kanivets Taras
Published: January 2025

This article is dedicated to analyzing the current state of Ukrainian enterprises and determining possible development prospects in the conditions of war. It explores the impact of war on the country's economic situation and business environment. The main potential risks and challenges that domestic enterprises may face in extraordinary conditions are highlighted, along with the primary problems and difficulties that Ukrainian businesses face today, including logistical barriers, decreased consumer activity, lack of funds, production challenges, labor shortages, deterioration of the country's investment climate, threats of missile attacks, and more. Additionally, the article discusses the main approaches that enterprises can use to adapt to new operating conditions, including diversification of production, reorientation towards alternative promising areas of activity, participation in public-private partnerships, increasing competitiveness, exploring new markets, changing logistical approaches, and others.
The research aims to outline key opportunities that domestic enterprises can utilize to operate in crisis situations, including during the Russian-Ukrainian war, and to facilitate the development of survival and growth strategies. The article offers specific recommendations for Ukrainian enterprises to adapt to the complex conditions of wartime through real case studies.
Furthermore, the article presents expert opinions and the results of business surveys regarding the main problems faced by Ukrainian enterprises in the market. Emphasis is placed on the importance of cooperation between the state and businesses, the search for optimal solutions, and the creation of favorable conditions for economic growth. Additionally, there is a suggestion for the need to change approaches to enterprise management considering the new realities of the economic situation. Moreover, the article underscores the importance of supporting small and medium enterprises, which form the backbone of the Ukrainian economy, in their adaptation to complex conditions and ensuring their sustainable development.
Actualization of social insurance as a mechanism for protecting the human capital of the working population
Authors: Stozhok Liudmyla
Published: January 2025

One of the main tasks of the country’s socio-economic development is to overcome poverty among the working-age population by investing in human capital. Given the current events, the article focuses on the need to strengthen the mechanism for protecting the human capital of the working-age population. The role and significance of social insurance in protecting the human capital of the working-age population from new social risks caused by the war are substantiated. In analysing the mechanism of human capital development in the working-age population, the author focuses on the main reasons that negatively affect the possibility of exercising social rights, such as poverty, the poverty of households with and without children, the level of social standards, and the state of the labour market. A comparative analysis of the human development index of Ukraine with the post-Soviet countries has shown a decline in Ukraine’s position since independence, in contrast to the improvement in the countries studied. The study of the Global Social Mobility Index focuses on the importance of such areas as social protection and fair division of labour in shaping the country’s position and the need to strengthen tasks in such areas as access to technology and inclusive institutions. During the study, the author substantiates the need to modernize the system of social protection of human capital with due regard for social and insurance principles, since its preservation and increase affect the development of both the previous and the next generation, thus ensuring the socio-economic sustainability of the state. The author emphasizes the need for opportunities to exercise social rights by creating inclusive conditions in which the able-bodied population will be economically independent of the state, considering the period of adaptation to the socio-economic and political situation in the country.
Features of Ukrainian state-owned enterpises' social responsibility policies and practices
Authors: Zinchenko Alla , Oliinyk Maxym
Published: January 2025

The article examines the peculiarities of policies and practices of Ukrainian state-owned enterprises’ social responsibility.
The objective of the study is to reveal the peculiarities of social responsibility policies and practices of Ukrainian state-owned enterprises. Within the stated objective the study of the top 10 largest domestic state-owned companies’ (by revenue gained in 2023) policies and practices was conducted. The study is based on data provided by the data of the analytical platform YouControl.
The authors developed a methodology considering the requirements of Directive 2014/95/EU on the disclosure of non-financial information and the requirements of the Guiding Principles of Corporate Governance at State Enterprises property of the Organization for Economic Cooperation and Development (OECD). Information published on the official websites of the selected enterprises is the source of data. At the same time, it should be noted the following.
Within the wartime, non-financial reports are not made public on the official websites of state-owned enterprises, and the sections with nonfinancial reporting for past years have been closed. It is proven that the level of disclosure of relevant information by enterprises influenced, in particular, by the reform of corporate governance and the provisions established at the national level regarding the mandatory disclosure of information on the impact of their activities on the economy, ecology, society and anti-corruption policy.
Considering the results of the study, the following features of social responsibility policies and practices of domestic state-owned enterprises are identified: the focus on the implementation of principles and mechanisms of corporate governance (anti-corruption programs, ethics and compliance), practices in the area of environmental protection (use of resources and environmental programs/initiatives), as well as social programs for local communities.
DEVELOPMENT OF THE NATIONAL MODAL OF THE HEALTH ECONOMY ALONG GLOBAL TRANSFORMATION
Authors: Zaliska Olha , Irynchyna Inna
Published: January 2025

The abstract is devoted to the scientific and practical substantiation of the directions of development and principles of formation of national health economies. Modern globalization transformations actualize the finding of the optimal model of interaction of the health care systems of the countries within the world economic system. Top-level research that the likelihood of developing systems evolving in order for people to work in the economy using a technology database, using an efficient market, innovatively developed, budget-allocated health care, well-known health professionals, requires rapid and effective responses to Global threats and various actions of the Global Health Economy.
The article proves the need for responsibility of the national economy for qualitative and quantitative indicators of public health. The factors that should be the basis for the formation of unique models of the national health economy are proposed, taking into account the peculiarities of the development of national health care systems and global trends. The functioning of the structural units of the health economy model should be based on: 1) indicators of medical efficiency, 2) economic efficiency, 3) necessity and 4) probability of realization/feasibility of its components and their filling.
The paper presents an analysis of global health development trends based on ISPOR (International Society of Pharmacoeconomic and outcome research) data, which should be monitored on an ongoing basis.
The role of collaboration as the most effective technology of interaction of scientists and practitioners of many spheres of the national and international economic system for the sake of balance of approaches at decision-making is covered. Cooperation between the spheres of economy and medicine in solving the problem of competitiveness of the national health economy is able to solve the crisis of interaction of national economies in many other areas, in particular, foreign economic, foreign trade.
Strafprozessordnung §§ 1 bis 209b - Das österreichische Strafrecht, Zweiter Teil
Authors: Mayerhofer Christoph , Salzmann Harald
Published: January 2025

Das Österreichische Strafrecht besteht aus vier Teilen: - StGB - Strafgesetzbuch, Erster Teil - StPO - Strafprozessordnung, Zweiter Teil (in zwei Bänden) - Nebenstrafrecht, Dritter Teil - Verordnungen und Erlässe, Vierter Teil (Loseblattsammlung) Dieser Band umfasst mit den §§ 1 bis 209b StPO die Grundsätze des Strafverfahrens, das strafrechtliche Vorverfahren und die diversionsrechtlichen Bestimmungen. Der Gesetzestext berücksichtigt natürlich alle seit dem Inkrafttreten der Vorverfahrensreform am 1. Jänner 2008 erfolgten Novellierungen. Die prägnant herausgearbeiteten Leitsätze der neuesten Judikatur bieten den gewohnt vollständigen und dennoch kompakten Leitfaden für jeden mit strafprozessualen Fragen befassten Benutzer. Die systematische Darstellung des Kerngehaltes der zitierten Gerichtsentscheidungen mit übergreifenden Hinweisen auf andere im Zusammenhang bedeutsame Fundstellen stellt auch im Internet-Zeitalter einen nach wie vor unentbehrlichen Arbeitsbehelf dar.
Österreichisches Bankvertragsrecht Band VI: Kapitalmarkt
Authors: Apathy Peter , Iro Gert , Koziol Helmut
Published: January 2025

Das in diesem Band schwerpunktmäßig zusammengefasste Kapitalmarktrecht hat eine besonders rasante Entwicklung erfahren, die überwiegend auf gemeinschaftsrechtlichen Vorgaben beruht. So wurden nicht nur das BörseG, KMG und InvFG umfangreichen Änderungen unterworfen, sondern auch neue einschlägige Gesetze erlassen, wie das WAG und das ImmInvFG. Diese Neuerungen in der Gesetzeslage und die darauf Bezug nehmende Beschäftigung von Lehre und Rechtsprechung haben zu einer grundlegenden Überarbeitung und Ausweitung der Darstellung geführt. Das Emissionsgeschäft wurde wieder von o. Univ.-Prof. Dr. iR. H. Koziol, diesmal unter Mitarbeit von Syndikus Dr. Sommer, bearbeitet. Das Effektengeschäft und das Investmentgeschäft stammen von Rechtsanwalt Mag. Dr. M. Oppitz, der durch zahlreiche Veröffentlichungen als hervorragender Fachmann dieser Gebiete ausgewiesen ist und auch seine praktischen Erfahrungen einzubringen vermag.
Обізнаність фармацевтів-інтернів щодо побічних ефектів нових цукрознижувальних препаратів (частина 1)
Authors: Деримедвідь Л. В. , Риженко І. М. , Бутко Я. О.
Published: January 2025

Мета дослідження – оцінити обізнаність фармацевтів-інтернів щодо побічних ефектів нових цукрознижувальних препаратів і шляхів їхнього попередження та корекції.
Цукровий діабет (ЦД) входить до 4 найбільших неінфекційних пандемій у світі та до 5 основних ризик-факторів розвитку кардіоваскулярних порушень. За даними ВООЗ, кількість хворих на ЦД у віці 20–79 років за останнє десятиліття зросла майже в 2 рази, причому 90 % випадків припадає на ЦД ІІ типу. Аналогічна тенденція спостерігається й в Україні.
З огляду на прогресуючий характер ЦД ІІ типу, нерідко з поступовою втратою відповіді на цукрознижувальну терапію, значну кількість поліморбідних станів тощо проблема своєчасної діагностики та лікування є досить актуальною. Також розвитку ЦД ІІ типу може сприяти тривала терапія глюкокортикостероїдами, атиповими антипсихотиками, тіазидами, інгібіторами протеази, нуклеозидними інгібіторами зворотної транскриптази, протисудомними засобами, високими дозами антидепресантів тощо.
Результати останніх досліджень в ендокринології відносно нових механізмів розвитку ЦД та його ускладнень сприяли появі на фармацевтичному ринку нових класів цукрознижувальних ліків. Низка цукрознижувальних засобів за рахунок своїх полімодальних властивостей увійшли до схем лікування інших патологій, включаючи серцево-судинні захворювання, нейродегенерацію, захворювання нирок тощо. З’явились нові комбіновані цукрознижувальні засоби для лікування ЦД ІІ типу, зокрема й комбінації інсулінів з аналогами глюкагоноподібного пептиду 1.
Аналіз фармацевтичного ринку показав, що в Україні наявні практично всі класи цукрознижувальних засобів для лікування ЦД ІІ типу. 52,6 % усіх зареєстрованих в Україні препаратів для лікування ЦД ІІ типу це препарати метформіну (як монокомпонентні, так і в комбінаціях).
Проте засоби для лікування ЦД ІІ типу, попри свою клінічну ефективність, мають і низку побічних ефектів та протипоказань щодо їхнього застосування.
Результати дослідження можуть бути застосовані для оптимізації викладання дисциплін «Клінічна фармація та фармацевтична опіка», «Клінічна фармакологія», «Побічна дія ліків» та підготовки в інтернатурі за спеціальністю «Фармація».
Anthropometry and Metabolic Abnormalities in Obese Children with Non Alcoholic Fatty Liver Disease
Authors: Shelim Rumana , Ikram Shuma , Ratan Naim Hossain , Hossain Mohammod Moqbul , Mohsin Fauzia
Published: January 2025

Background: Obesity has emerged as a global epidemic in children with a spectrum of psycho-social and medical consequences manifesting across the lifespan. Obesity-related morbidities that emerge early in childhood are an alteration in glucose metabolism and fatty infiltration of the liver. Non-alcoholic fatty liver disease (NAFLD), chronic liver disease is a metabolic complication of obesity. 
Objective: To identify the prevalence of NAFLD  among obese children and anthropometric and metabolic abnormalities among these obese children  with NAFLD.
Methodology: This was a cross sectional study included 50 obese children and adolescents, attending Paediatric Endocrine OPD, BIRDEM from June 2010 to December 2010. BMI e” 95th centile for age and sex was used as an anthropometric marker to diagnose obesity. Obesity with dismorphism, endocrine, chromosomal abnormalities, chronic liver diseases due to infectious or metabolic causes were excluded from the study. Fasting blood samples were collected for measurement of blood glucose, lipid profile, FT4, TSH and SGPT. Fatty liver was diagnosed by USG which includes increased echogenicity of liver, blurring of vascular margins and increased acoustic attenuation.
Results: The prevalence of  fatty liver disease among obese children was 36% with male predominance(M72.2%, F 27.8%). Mild NAFLD was 72% followed by moderate 28%.  High Cholesterol, high LDL and high SGPT were more prevalent in obese children with NAFLD which was statistically significant (P <0.004, <0.05and <0.04 respectively.
Conclusion: Obesity with liver disease can get overlooked among the plethora of adverse outcomes related to childhood obesity. Our study was attempted to find out the obese children with NAFLD and related metabolic abnormalities, so that delebarate strategies could be taken to prevent this irreversible liver damage among obese children.
EWMCJ Vol. 13, No. 1, January 2025: 17-22
Peoples’ Perception about Childhood Nephrotic Syndrome
Authors: Miah Mohammad Abu Sayed , Hasan ANM Saiful , Patowary Md Asaduzzaman , Morshed Md Mahamudul Haque , Kabir ARM Luthful , Paul Shanjoy Kumar , Gupta Sudip Das , Begum Homayra
Published: January 2025

Background: The perception of the people in the community about nephrotic syndrome is varied. This was not previously studied in Bangladesh.
Objective: To know the Peoples' perception about childhood nephrotic syndrome. Methods: A cross-sectional study was conducted in the inpatient department of pediatrics, Sir Salimullah Medical College & Mitford hospital for 06 months (From November 2013 to April 2014). Purposively 50 children with diagnosed case of nephrotic syndrome were included for the study. Four groups of people were interviewed, e.g. father, mother, one relative and one neighbor/attendant of adjacent bed patient. Total 200 persons were interviewed (father-50, mother-50, relatives-50 (Uncle, Aunt, Brother, Sister, Grandfather, Grandmother), neighbor-18, attendants of adjacent bed patient-32). A semi-structured questionnaire was developed for this purpose. The investigator collected data through face-to face interview in the hospital and telephonic interview from neighbors. Data were analyzed with the help of software SPSS version 16.0.
Results: Among the patients, 2-6 years age group were 60.0% and 7-11 years age group were 40.0%. Seventy two percent patients were male. Among all patients 20(40%) were first attack and 30(60%) were relapse case. Among the respondents, 45.5% were within 28-37 years age, 30.5% were 18-27 years age. More than 50% respondents had idea that the disease was caused by infectious agent and other 45.5% had no idea about the cause of the disease. Perception about passing 'white element' (albumin) in urine was significantly different between first attack and relapse cases (p=0.02). Perception about management of the disease between first attack and relapse was statistically significant (p=0.00). Perception about side effects of the drug (prednisolone) among attendants of first attack (16.7%) and relapse (83.3%) were highly significant statistically (p=0.00). Perception about complications of the disease among first attack and relapse was not statistically significant (p=0.106). Perceptions about special diet for the disease and follow-up plan of the disease among attendants of first attack and relapse were highly significant (p=0.00).
Conclusion: There is lack of knowledge as to the nature of disease nephrotic syndrome, its etiology, course & prognosis of the disease. Respondents of relapse cases of nephrotic syndrome had better perception in some aspects of the disease than those of first attack. There are still information gap among the respondents which reflect that our counseling is not up to the mark.
EWMCJ Vol. 13, No. 1, January 2025: 43-49
Factors of Acute Malnutrition among Under Five Years Children in Northern Bangladesh
Authors: Aktar Mst Shabnaz , Israt Afsana , Shahrear Md Ashab , Macsud Md Anjim
Published: January 2025

Background: The developmental, medical, economic and social impacts of acute malnutrition in children are serious and long lasting for individuals, families, communities and countries. Malnutrition in childhood damages a child’s both physical and cognitive development and this damage is largely irreversible. These ultimately perpetuate illness, poverty and inequality. Childhood acute malnutrition is multifactorial in origin and majority of them are preventable. Objective: The purpose of this study was to identify the factors of acute malnutrition among under five years children in northern Bangladesh. Methods: This case-control study was carried out in Chapainawabganj general hospitals, Chapainawabganj. Total 180 children aged 6-59 months (90 cases-WHZ < -2 and 90 control-WHZ ≥ -2) were included for this study based on selection criteria. Informed written consent was taken from the guardians of all children. Data were recorded by using a semi-structured questionnaire. Height and weight of children and their parents were measured by measuring tape and weight machine. BMI of children and parents, and weight-for-height Z scores of children were calculated. Collected data were analyzed by the SPSS 23.  Chi-squared (ꭓ2) test and unpaired t-test were performed to compare the frequencies and means between the groups. Results: The mean age of the acute malnourished children was 25.84±15.09 months with slight male predominance (male female ratio 1.14:1). The mean weight for height Z score of the cases was -2.93±0.41. Monthly family income <10000 BDT, younger mother (age ≤20 years), younger father (age ≤20 years), less educated mother (Illiterate or upto primary), less educated father (Illiterate or up to primary), undernourished mother (BMI <18.50 kg/m2) and predominant breast feeding stop before 4 months had found to be significantly associated with acute malnourishment (p<0.05). Conclusion: Acute malnutrition was found to be significantly associated with low monthly family income, younger mother and father, less educated mother and father, undernourished mother and early stop of predominant breast feeding.
EWMCJ Vol. 13, No. 1, January 2025: 35-42
Predicting the Risk of Dengue Shock Syndrome with Neutrophil-Lymphocyte Ratio on the Third Day of Dengue Infection
Authors: Wazib Amit , Rahman Shaila , Al Mamun Kazi Abdullah , Ahmed Md Rayhan , Aman Safwanul , Babu Md Asaduzzaman , Tahmid Ahnaf , Nishat Tasfia Hossain , Ira Israt Jahan
Published: January 2025

Background: Dengue is an endemic infection in Bangladesh with frequent outbreaks. Dengue shock syndrome (DSS) contributes to the majority of mortality in dengue infection. Neutrophil-lymphocyte ratio (NLR) was found as a predictor of severe dengue in a recent study.
Objective: This study was conducted to assess the association of NLR and the development of DSS.
Methods: This case-control study was conducted on 42 dengue patients admitted under the Department of Medicine of Shaheed Monsur Ali Medical College Hospital from July to October 2023. Association of NLR on the third day of fever with DSS was assessed following appropriate statistical procedures.
Results: Mean NLR on the third day of fever was higher in DSS patients. NLR≥2 was associated with a statistically significant higher proportion of DSS. 
Conclusion: An NLR≥2 on the third day of fever possesses a higher risk of developing DSS. These patients should have close monitoring and be discharged from the hospital after complete recovery.
EWMCJ Vol. 13, No. 1, January 2025: 50-53
Assessment of Cardiac Risk Factors and Socio Demographic Feature of Rheumatoid Arthritis in Bangladesh
Authors: Mamun Mohammad Al , Chowdhury M A Jalil , Sultana Fouzia , Islam Lohani Md Tajul , Kadir ANM Monowarul , Jamali Mohammod Zafar Iqbal , Fatema Nilufar
Published: January 2025

Patient with Rheumatoid Arthritis(RA)shows an increased risk of cardiovascular diseases. This study was to find out cardiac risk factorsand socio demography related with Rheumatoid Arthritis in hospital Bangabandhu Sheikh Mujib Medical University (BSMMU)from July 2014 to December 2015. The present study, among 384 RA patients, mean age of the patients was 42.54±1.22 years whereas 32% represented from 41-50 years. Most of the patients (82.6%) were female.Regarding education more than half of the patients (57.8%) completed primary education followed by illiterate (12.5%), secondary (12.8%), highersecondary (8.9%) and graduation (8.1%). About 71.1% were housewife followed by service holder (14.6%), business (3.1%), student (2.1%) and farmer (2.1%). Mean yearly income was 133341.14±105056.94 BDT. Almost 95.1% were married. Mean age of disease onset was 35.53±10.89 years where minimum age of disease onset was 17 years and maximum was 61 years. About 29.2%, 28.4% and 24.7% patients started disease within 31-40 years, 21-30 years and 41-50 years respectively.82% patients had no extra articular manifestations. About 13%, 1.8%, 1% patients had musculoskeletal, hematological and systemic manifestations as well.77.9% patients had no co-morbidity conditions. About 10.4%, 3.1%, 1.8% and 1.3% patients had hypertension, diabetes mellitus, hypothyroidism and ischemic heart disease as well.Cardiac risk factors were found in RA such as hypertension, diabetes mellitus, hypothyroidism and ischemic heart disease respectively.
University Heart Journal 2024; 20(1): 14-17
Residua, Sequelae and Complications of Cardiac Defects in Adult Congenital Heart Disease after Repair at an Early Age
Authors: Sultan Mohammad Ashraf Uddin , Sheikh Naveen
Published: January 2025

A cardiac malformation, also known as a congenital heart defect, is a structural problem with the heart or blood vessels that is present at birth. These abnormalities occur when the heart or blood vessels don’t form correctly in the womb. They are formed during the intra-uterine life and become visible between the 3rd and 8th week of pregnancy, when the heart is formed. Cardiac malformations include: Ventricular Septal defects, Transposition of the great vessels and Coarctation of the aorta. In most cases, the cause of cardiac malformations in unknown. Some know causes include: Maternal diabetes, Teratogens. It has been estimated that 45% of adults with congenital heart defects do not need routine follow-up in a specialized unit. For another 30%, the responsibility for care must be shared between the specialized unit and clinical cardiologist.
University Heart Journal 2024; 20(1): 31-35
Challenging Management of Pregnancy Complicated by Eisenmenger Syndrome; A Case Report
Authors: Kulsuma Umme , Qumruzzaman KH , Shameem Md Kibria , Parveen Tabassum , Islam Nilufar , Wahid Fatima , Afroj Romena
Published: January 2025

Women with diagnosed case of Eisenmenger syndrome are usually advised to avoid pregnancy because of high mortality rate 30% to 50%, which increase up to 65% in case of caesarean section. Literature survey showed, few case reports on successful pregnancy outcome with proper multidisciplinary approach in tertiary hospital those who wanted to continue pregnancy with informed written consent about high mortality rate patient with Eisenmenger syndrome who become pregnant are at a particular risk of rapidly progressive cardiopulmonary decompensation, thrombotic complications and sudden death2,3, because pregnancy related physiological changes are poorly tolerated in Eisenmenger syndrome. Prevention and early termination is advisable3,5. For patient who present in later stages of pregnancy, carefully coordinated multidisciplinary care involving experienced specialists from obstetrics, anesthesiology, cardiology, neonatology and critical care medicine is necessary to optimize the chances of survival for both mother and baby. We here present a case report of a 25- year -old 2nd gravida, P:1(VD-IUD) admitted in Fetomaternal medicine department, BSMMU with 36 weeks pregnancy with uncorrected ventricular septal defect(VSD), Eisenmenger syndrome, severe pulmonary hypertension ( 94mmHg), left ventricular dysfunction (EF-<39%), Fetal growth retardation (Wt-1600gm), oligohydramnios (AFI-5.6cm), Gestational diabetes mellitus (on diet) with Hypothyroidism. By meticulous multidisciplinary approach Caesarean section done and shifted to Coronary care unit (CCU). She delivered a growth restricted (birth wt1500gm) male baby with Apgar score: 8 and managed in Neonatal care unit (NICU).
University Heart Journal 2024; 20(1): 36-39
Carga Laboral y Bienestar Psicológico en el personal de enfermería en un establecimiento de salud
Authors: Huamani Llallahue Brigitte Maryori Estrellita , Esquerre Villalobos Adriana Yasmine , Velasquez Porras Paul Cesar , Merino Zelada Maribel
Published: January 2025

Objetivo: Determinar la relación entre la Carga Laboral y el Bienestar Psicológico del personal de enfermería en un establecimiento de salud Lima 2024. Materiales y métodos: Investigación tipo básica, diseño no experimental, corte transversal, enfoque cuantitativo, correlacional, realizado en 2024. Con una población de 108 personal de enfermería. Se utilizaron dos cuestionarios: carga laboral, con validez de 0.92 por V-Aiken y confiabilidad (α=0.813), y bienestar psicológico, con validez de 0.91 por V-Aiken y confiabilidad (α=0.893). Para la prueba de hipótesis se utilizó el estadístico de relación Rho Spearman. Resultados: Tras los análisis, el 48.1% presentó un nivel medio carga laboral y de igual manera en bienestar psicológico se presentó un nivel medio con un 49.1%. Estadísticamente, no se evidencia una relación entre ambas variables (p=0.519).  Conclusiones: no se evidenció una relación entre la carga laboral y el bienestar psicológico en un establecimiento de salud, esto se debe a que el personal no está acostumbrado a la atención a un número excesivo de pacientes constante, lo que impacta negativamente en su bienestar psicológico.
Interaction of Mathematics Learning in Inclusive School
Authors: Rahmadini Widya , Fatimah Siti
Published: January 2025

Interaction becomes a very important thing in mathematics learning activities because it can help students gain good conceptual understanding, including in inclusive schools that involve regular students and students with special needs in the same scope. This study aims to describe the interaction in mathematics learning in grade VII at one of the inclusive middle schools in Bandar Lampung, Lampung Province. The subjects in this study were 23 regular students, 2 slow learners, and 1 autistic student. This study used a qualitative approach with a case study method on teacher-student interaction in mathematics learning. The research instruments used were observation sheets, Flanders Interaction Analysis Category System (FIACS) matrix, and unstructured interviews. Furthermore, data analysis was carried out through three stages, namely data reduction, data presentation, and conclusion drawing. The results showed that the dominance of teacher talk proportion was in the aspect of encouraging with an average of 34.31% and the aspect of closed response in student talk to the teacher amounted to 70.65% which appeared during the core learning activities in understanding mathematical concepts and problems, while discussions conducted by students with special needs dominated the aspect of discussion during learning activities involving peer tutors, which was 21.88%. This means that mathematics learning in this study forms student activities in following procedural instructions from the teacher, students and teachers communicating mathematics, and jointly constructing mathematical truths. The interaction that occurs in mathematics learning forms a multi-directional pattern involving reciprocal interactions between teachers, regular students, and students with special needs.
Meta Analysis: Reciprocal Teaching Learning Model to Improve Mathematics Learning Outcomes
Authors: Ulfiyati Ulya , Scolastika Mariani , Mariani Isnaini Rosyida , Pujiastuti Emi , Mulyono Mulyono
Published: January 2025

The success of an education is associated with the high and low learning outcomes that have been achieved. The results of mathematics learning are very important, because they measure whether the learning that has been carried out so far has been successful or not. One learning model to improve mathematics learning outcomes is the reciprocal teaching learning model. The aim of this research is to analyze articles on the topic of mathematics learning outcomes in the reciprocal teaching model. The method used in this research is the meta analysis method. The research obtained results that there were three articles with effect sizes in the medium category and three articles with effect sizes in the strong category. The average effect size value of the six articles analyzed was 1.27 in the strong category. So it shows that the reciprocal teaching learning model has a strong influence in improving students' mathematics learning outcomes. Apart from that, the results of hypothesis testing were carried out using the t test, namely t test = 10.89 > 1,968 = t table.  This shows that the average mathematics learning outcomes of students using the reciprocal teaching learning model are better than the average mathematics learning outcomes of students using the conventional learning model.
Analysis of TPS Learning (Think, Pair, Share) Based on Differentiation Process on Students' Numeration Abilities
Authors: Cahyani Aulia Febi Dwi , Nuriyatin Siti , Kusumawati Intan Bigita
Published: January 2025

Numeracy is a skiil in applying number concepts, artihmetic operations skiils and solving mathematical problems in various contexts related to real life. So cooperative learning type TPS (Think, Pair, Share) based on process differentiation is learning that is able to adapt to the needs and level of understanding of each student and has the potential to improve students’ numeracy abilities. This research aims to find out if there is a difference in increasing the numeracy skills of the low group, the middle group and the high group before and after treatment and aims to evaluate students’ numeracy abilities in cooperative learning type TPS (Think, Pair, Share) based on process differentiation. The research method used is One Group Pretest-posttest. The subjects in this research were students in class VIII-B of SMP Plus Arroudhoh with a total of 32 students. The data collection techique uses a pretest-posttest of data content and uncertainty in the event material, involving a total of 6 descriptive questions. Based on the research results, there were differences in the increase in numeracy skills of the low group, middle group, and high group before and after treathment. This is based on the results of the One-Way Anova test analysis of the N-Gain Score of the pretest-posttest data for the three group showing that the Sig. equal to 0.004< 0.05 then H0 s rejected. As well as the average posttest score for each group, it can be seen that the indicator most mastered by students is the 1st indicator and the indicator less mastered by students is the 3rd indicator.