bluuebunny/crossref_metadata_2025 huggingface dataset:
HUBUNGAN METODE BERCAKAP-CAKAP DAN METODE BERCERITA DENGAN KEMAMPUAN BERBICARA PADA ANAK DI TAMAN KANAK-KANAK TERATAI KOTA MAKASSAR TAHUN 2016
Authors: - Rusmayadi
Published: August 2020

Penelitian ini bertujuan untuk mengetahui hubungan metode bercakap-cakap dan metode bercerita dengan kemampuan berbicara anak taman kanak-kanak. Pendekatan yang digunakan adalah pendekatan kuantitatif dengan jenis penelitian korelasional. Variabel dalam penelitian ini yaitu metode bercakap-cakap dan metode berbicara sebagai variabel bebas dan kemampuan berbicara sebagai variabel terikat. Populasi dan sampel yang digunakan sebanyak  40 orang dalam kelas yang berbeda.Teknik pengumpulan data yang dilakukan yaitu teknik observasi dan teknik dokumentasi. Data diperoleh melalui instrument observasi dengan alat check list dan dianalisis dengan menggunakan statistik deskriptif dan statistik nonparametrik. Hasil penelitian yang diperoleh bahwa metode bercakap dan metode bercerita mempunyai hubungan positif yang signifikan dengan kemampuan berbicara anak taman kanak-kanak.  Berdasarkan hasil penelitian ini maka disarankan kepada semua Taman Kanak-kanak  untukmenggunakan metode bercakap-cakap dan metode bercerita untuk mengembangkan kemampuan berbicara anak.
Persepsi Guru Terhadap Pendidikan Seksual Untuk Anak Usia Dini
Authors: Magta Mutiara
Published: August 2020

Tujuan penelitian ini adalah untuk mengetahui persepsi guru TK terhadap pendidikan seksual  untuk anak usia dini. Penelitian ini melibatkan 116 guru TK yang ada di Kecamatan Buleleng Kabupaten Buleleng Bali, 2015. Penelitian  dilakukan dengan menggunakan pendekatan deskriptif kuantitatif.  Data dikumpulkan dengan menggunakan kuesioner kemudian dianalisis dengan menggunakan statistik deskriptif yang disajikan dalam bentuk table atau grafik. Hasil penelitian menunjukkan bahwa persepsi guru terhadap pendidikan seksual untuk anak usia dini adalah negatif. Jawaban responden secara keseluruhan 55.17% memiliki persepsi negatif, sedangkan jawaban responden 44.83% memiliki persepsi positif.
KOMPETENSI PEDAGOGIK DOSEN TERHADAP PENGEMBANGAN PEMBELAJARAN
Authors: Sudirman Sudirman
Published: August 2020

Dosen sebagai elemen yang memiliki peranan yang sangat strategis dalam proses pembelajaran, kompetensi pedagogik dosen terdapat aspek penting didalam pengembangan pembelajaran.Oleh karena itu bagaimana peran dan kontribusi kompetensi pedagogik dosen terhadap pengembangan pembelajaran.Penelitian ini menggunakan pendekatan kualitatif dengan menggunakan data sekunder dan data primer, dengan tehnik pengumpulan data sekundernya diperoleh dari referensi dan data yang telah diolah sebelumnya sedangkan data primer di peroleh berdasarkan datahasil  observasi, wawancara dan diskusi terpusat.Penelitian ini bertujuan untuk memberikan informasi tentang bagaimana peran kompetensi pedagogik terhadap pengembangan pembelajaran.Untuk itu penulis memberikan simpulan bahwa kompetensi pedagogikdosen memberikan peran yang sangat besar terhadap pengembangan pembelajaran meliputi beberapa aspek yaitu :Menguasai karakteristik peserta didik, Menguasai teori belajar dan prinsip pembelajaran yang mendidik, Pengembangan kurikulum,Kegiatan pembelajaran, Pengembangan potensi peserta didik,Komunikasi dengan peserta didik,Penilaian dan evaluasi.
PENINGKATAN KEMAMPUAN KOMUNIKASI SISWA KELAS II SD MELALUI METODE DONGENG
Authors: Pupung Puspa Ardini
Published: August 2020

Penelitian ini bertujuan untuk dapat meningkatkan kemampuan komunikasi siswa kelas II Sekolah dasar melalui pelaksanaan metode dongeng. Melalui dongeng siswa akan banyak menyimak perbendaharaan kata baru dan juga berinteraksi dengan pendongeng sehingga kemampuan berkomunikasi siswa dapat meningkat. Subjek penelitian adalah siswa kelas II SDIT AlHusna Bekasi Utara, Jawa Barat. Metode Penelitian yang digunakan dalam penelitian ini adalah Penelitian Tindakan kelas atau Classroom Action Research. Terdiri dari 2 siklus. Dari hasil tindakan dari siklus pertama (1) dan kedua (2) terjadi peningkatan. Peningkatan tersebut terlihat dari perbedaan rata-rata skor aktivitas anak pada siklus 1 dan siklus 2. Adapun peningkatan tersebut pada  siklus 1 memperoleh skor 63 pada kriteria cukup aktif dan siklus kedua skornya meningkat menjadi 97 termasuk kriteria sangat aktif selain itu harapan lain adalah program kegiatan berdongeng dapat diterapkan dalam kegiatan pembelajaran untuk siswa kelas II SD dalam meningkatkan kemampuan komunikasi siswa.
The science of mosquitoes: Youths’ perceptions, engagement, and learning from a Skype in the classroom science communication program
Authors: McLeod-Morin Ashley , Beattie Peyton , Stone Whitney , Kent Kevin , Loizzo Jamie , Telg Ricky
Published: August 2020

This study examined the impact of a live, interactive electronic field trip (EFT), called Scientist Online: The Science of Mosquitoes via the Streaming Science platform and Skype in the Classroom network for connecting university entomologists with middle and high school youth around the world. More than 150 students viewed the program, and 60 answered post-quantitative and qualitative questions regarding their perceptions of the EFT and knowledge related to mosquitoes. Students reported an increased knowledge about mosquitoes, mosquito-borne illness, mosquito-borne illness prevention and protection, entomology and related careers, and the mosquito life-cycle. Future research should determine how interactive, synchronous video programs with scientists can impact participants’ behavior intentions, specifically for making lifestyle choices based in science, as well as decision-making for improving their health and the planet.
Persepsi Guru Terhadap Penerapan Sistem Full Day School: Studi Kasus di SMAN 1 Citeureup
Authors: Anggraeni Novi , Rohman Baeti , Sholichah Aas Siti
Published: August 2020

This paper discusses the teacher's perception of the application of the full day school system at SMAN 1 Citeureup. This research is motivated by the existence of an innovation in education set by the government about the school day that is full day school. This type of research is a descriptive qualitative research with field research approach. The research data collection techniques using observation, interviews and documentation. The results of this study indicate that (1) Some teachers respond positively to the full day school policy, if the school is able to support all aspects needed by both teachers and students, starting from the concept of managing a full day school learning that is well planned, structured and directed so that it is more effective in carrying out the learning process and the development of adequate facilities and infrastructure (2) teachers' perceptions about the advantages of full day school systems can be a solution for parents who care about the moral crisis that is being experienced by students at this time. Furthermore, as a means of improving the quality of student morals for the better, and to maximize student time to be more useful by developing students 'talents, interests and creativity (3) teachers' perceptions of the weaknesses of full day school lies in the technical implementation in schools, the lack of student socialization with the surrounding environment inadequate places of residence and facilities and infrastructure (4) management of full day school learning in SMAN 1 Citeureup in accordance with PP No. 19 of 2005 concerning National Education Standards which include program planning, implementation and evaluation.
Kepemimpinan Spiritual dalam Lembaga Pendidikan: Analisis Maqasid Syariah
Authors: Millah Nur Ita A’ini Qudwatal , Far’ia
Published: August 2020

Leadership in an educational institution is one of the determining factors in the success of an educational institution. Through a good system and pattern of leadership, educational institutions will be able to know where they want to go and reach clearly. Spiritual intelligence is needed for a leader to lead an educational institution, especially Islamic educational institutions. In the scope of leadership based on spiritual values, the orientation of all its activities is as a manifestation of worship and a means of devotion to God. Therefore, the journal discusses the concept of spiritual leadership in Islamic educational institutions Maqashid Sharia perspective in terms of dharuriyyat starting from the side of hifdz al-din, hifdz al-nafs, hifdz al-aql, hifdz al-nasl and hifdz al-mal and its implementation in the Da'wah Management Study Program of UIN Sunan Kalijaga Yogyakarta. This research uses descriptive qualitative study methods. Data collection techniques using observation, interviews and documentation. The results showed that the head of the department in this study program had a main program in education and training as part of the development of spiritual leadership. Through this case, the head of the department and the lecturer do not simply abort the administrative obligations, namely to carry out the learning process, but also as a means of devotion to God. In addition, spiritual leadership is demonstrated through exemplary efforts to the characteristics of the Prophet, namely siddiq, amanah, tabligh, and fathanah as well as various forms of policies implemented by the Chair of the Department aiming to achieve mutual benefit.
Motivasi Belajar Siswa SMA pada Pembelajaran Daring di Masa Pandemi Covid-19
Authors: Cahyani Adhetya , Listiana Iin Diah , Larasati Sari Puteri Deta
Published: August 2020

Education system in Indonesia is experiencing new challenges due to the Covid-19 virus outbreak, which has caused the entire learning system in educational institutions to be transferred to online learning methods. The disruption in the learning process causes some changes to students which ultimately affect the motivation to learn. This research uses a quantitative approach, with the sampling technique used is accidental sampling. The population in this study were all high school students who took part in the process online learning. The analytical method used to analyze the data obtained in this study uses the Mann Whitney U analysis method. This type of research uses the foundation of learning motivation theory and aspects from Chernis & Goleman's theory (2011). The results of this study indicate that the significance value of Mann Whitney U is 0,000 which means the motivation to learn in students who take online or online learning in the midst of the pandemic situation of the Covid-19 virus is decreasing, because the significance value of 0,000 is less than 0.05 (p <0,05).
Interaksi Sosial Anak Down Syndrome di TK Nusa Indah Jakarta
Authors: Ayuningrum Desy , Afif Nur
Published: August 2020

Down syndrome is one of the children with special needs, where the child has an intellectual level that is low or below average. This study aims to find out, provide an overview, and explain about the forms of social interaction carried out by a child with special needs with Down syndrome with teachers and friends in regular school. This is done in order to provide a true view and picture of the social behavior that appears from children with Down syndrome, where it has not been widely known by educators and the public. This research is a qualitative research with case study method, this research uses purposive sampling technique. This study uses one subject with certain characteristics. Data collection techniques used are: non-participant observation, interviews, questionnaires, and documentation. Data analysis techniques include: (1) data reduction (2) data presentation, and (3) conclusion drawing. The results of data collection conducted from January to March 2017, found that there are four forms of behavior that appear classified in social behavior and forms of behavior classified as asocial behavior. The intended social behaviors are friendly behavior, sympathetic behavior, cooperative behavior, and competitive behavior. Existing asocial behaviors consist of resistance behavior and attack behavior.
Expert System Analysis of TIG Molten Weld Metal Fluidity Using the Bond Dimensionless Number
Authors: K Okhigbochie. , J.I Achebo . , A Ozigagun
Published: August 2020

The different modes of molten metal transfer makes up a critical aspect of welding behavior which significantly affects weld quality, so having basic understanding of the fluidity behavior of the molten weld metal will help Fabrication experts to produce weld structures with optimal strength and quality. In this present work, the Expert analysis of TIG molten weld metal fluidity using the Bond dimensionless Number was achieved. An expert experimental design was done generating 30 sets of experimental runs considering current voltage wire diameter and wire feed rate and the bond dimensionless number as response. The second order quadratic model was developed employing the response surface methodology. A model having 89% coefficient of determination and p-value of < 0.0001. The result obtained showed that current has a very significant effect on the bond number indicating that a higher current will minimize the bond which translates into an improved fluidity of the TIG molten weld metal.
Hospitalized Infections in People With Osteoarthritis: A National US Study
Authors: Singh Jasvinder A. , Cleveland John D.
Published: August 2020

Objective.

To study the incidence, time trends, and outcomes of serious infections in people with osteoarthritis (OA).

Methods.

We used 1998–2016 US National Inpatient Sample (NIS) data. Using recommended weights, we examined the epidemiology of 5 types of serious infections requiring hospitalization in people with OA (opportunistic infections [OIs], skin and soft tissue infections [SSTIs], urinary tract infections [UTIs], pneumonia, and sepsis/bacteremia). We performed multivariable-adjusted logistic regression analyses to analyze factors associated with healthcare utilization (hospital charges, length of hospital stay, discharge to nonhome setting), and in-hospital mortality.

Results.

Of all serious infection hospitalizations, 46,708,154 were without OA and 3,258,416 had OA. People with OA were 16.4 years older, more likely to be female (52% vs 65%), White (59% vs 70%), have a Deyo-Charlson Comorbidity Index (DCCI) ≥ 2 (42% vs 51%), receive Medicare (54% vs 80%), and less likely to receive care at an urban teaching hospital (45% vs 39%). Serious infection rates per 100,000 NIS hospitalizations increased from the study period of 1998–2000 to 2015–2016: OI (from 4.5 to 7.2); SSTI (from 48.4 to 145.9); UTI (from 8.4 to 104.6); pneumonia (from 164.0 to 224.3); and sepsis (from 39.4 to 436.3). In multivariable-adjusted analyses, older age, higher DCCI, sepsis, northeast region, urban hospital, and medium or large hospital bed size were significantly associated with higher healthcare utilization outcomes and in-hospital mortality; Medicaid insurance, non-White race, and female sex were significantly associated with higher healthcare utilization.

Conclusion.

Serious infection rates have increased in people with OA. Association of demographic, clinic, and hospital variables with serious infection outcomes identifies potential targets for future interventions.
Maintaining Hepatitis B Protection in Immunocompromised Pediatric Rheumatology and Inflammatory Bowel Disease Patients
Authors: Aljaberi Najla , Ghulam Enas , Smitherman Emily A. , Favier Leslie , Dykes Dana M.H. , Danziger-Isakov Lara A. , Brady Rebecca C. , Huggins Jennifer
Published: August 2020

Objective

Hepatitis B virus (HBV) infection remains a significant public health challenge, particularly for immunocompromised patients. Our aim was to evaluate the serologic immunity in immunocompromised rheumatology and inflammatory bowel disease (IBD) patients, assess factors for serologic nonimmunity, and evaluate their response to 1 HBV booster dose.

Methods

Immunocompromised rheumatology and IBD patients with completed HBV screening were identified. A chart review was performed to collect demographics, clinical information, baseline HBV serology results, and serologic response to booster vaccination. Serologic nonimmunity was defined as a negative/indeterminate hepatitis B surface antibody (anti-HBs) level.

Results

Among 580 patients, 71% were nonimmune. The highest portion of nonimmune patients were 11–18 years old (P = 0.004). There was no significant difference between immune and nonimmune patients with regards to diagnosis (P = 0.34), age at diagnosis (P = 0.64), duration of treatment (P = 0.07), or type of medications (P = 0.08). Sixty-two percent of those who received a booster vaccine were rescreened, and most (68%) seroconverted. In those 18 years or older, only half seroconverted.

Conclusion

Results of this study support the benefit of HBV screening in immunosuppressed patients. Beginning at age 11 years, most patients lacked serologic immunity to HBV. Seroconversion for most patients 11–18 years occurred after 1 booster vaccine. Thus, for immunocompromised patients without recent HBV serologic data, obtaining the HBV serology beginning at age 11 years might be considered. Those 18 years and older were least likely to seroconvert after 1 booster, indicating that they may benefit from receiving the 3-dose HBV vaccine series.
Use of Disease-modifying Antirheumatic Drugs, Biologics, and Corticosteroids in Older Patients With Rheumatoid Arthritis Over 20 Years
Authors: Hanly John G. , Lethbridge Lynn
Published: August 2020

Objective.

To examine changes in prescribing patterns, especially the use of corticosteroids (CS), in patients with rheumatoid arthritis (RA) over 2 decades.

Methods.

This was a secondary analysis of health administrative data using a previously validated dataset and case definition for RA. Cases were matched 1:4 by age and sex to controls within a population of approximately 1 million inhabitants with access to universal health care. Longitudinal data for incident and prevalent RA cases were studied between 1997 and 2017.

Results.

There were 8240 RA cases (all ≥ 65 yrs) with a mean (SD) age 72.2 (7.5) years and 70.6% were female. Over 20 years, annual utilization of coxibs in prevalent RA cases fell with a concomitant increase in disease-modifying antirheumatic drugs (DMARDs) and biologics. Over the same period, CS use was largely unchanged. Approximately one-third of patients had at least 1 annual prescription for CS, most frequently prednisone. The mean annual dose showed a modest reduction and the duration of utilization in each year shortened. Rheumatologists prescribed CS less frequently and in lower doses than other physician groups. For incident RA cases, there was a significant fall in annual prescribed dose of prednisone by rheumatologists over time.

Conclusion.

In older adults with RA, the utilization of DMARDs and biologics has increased over the past 20 years. However, the use of CS has persisted. Renewed efforts are required to minimize their use in the long-term pharmacological management of RA.
L’argument d’Anselme
Authors: Brouwer Christian
Published: August 2020

Cette étude s’attache à comprendre l’argument d’Anselme dans le contexte de l’oeuvre de son auteur. Après un exposé de la ligne argumentative, il s’agit de réexaminer le projet d’Anselme, d’abord dans le Proslogion , puis par rapport à la démarche discursive du Monologion . Ce qui émerge est une tentative de la créature raisonnable de s’élever vers Dieu en pensant rationnellement la modalité d’existence de son créateur. Sur ce chemin, elle expérimente et identifie les limites de son intelligence.
Le retour étrange de la preuve ontologique chez Kant
Authors: Marzolf Hedwig
Published: August 2020

Cet article se demande pourquoi Kant évoque une preuve ontologique de l’existence de Dieu dans l’ Opus postumum après l’avoir abandonnée dans la Critique de la raison pure . Il met d’abord en lumière l’importance des critiques des Schwärmer pour qui la religion n’est pas une affaire de la raison. Puis il montre comment Kant y répond en posant un lien analytique entre Dieu et la loi morale dans la Critique de la raison pratique et en érigeant la théologie en « principe suprême » de la philosophie transcendantale dans l’ Opus postumum . Il conclut que Dieu existe dans la reconnaissance du sujet dans le monde.
L’enrôlement différencié des usagers dans les living labs en santé et autonomie en France
Authors: Berthou Valentin , Gaglio Gérald
Published: August 2020

Les Living Labs (LL) sont des organisations qui se proposent de promouvoir des nouveautés, souvent de nature technologique, par de la co-construction avec des usagers. Pour ce faire, elles dupliquent des lieux du quotidien et/ou utilisent des plateformes techniques. Dans cet article, nous nous focalisons sur deux LL en santé et autonomie (LLSA). Après avoir retracé par quel cheminement l’usager est devenu une figure centrale, nous indiquons la façon dont les acteurs concernés projettent l’utilité desdits usagers dans la conception d’artefacts et pour l’institutionnalisation des LLSA. Via une comparaison, nous montrons ensuite que ces usagers sont à « trouver ». Il s’agit de définir leur identité, de les faire venir dans les LL puis de les mobiliser concrètement dans des projets. Cela donne à voir des processus d’enrôlement des usagers différenciés, soit très artisanaux et fluctuants, soit plus stabilisés et répétés.
Assessment and Management of Delirium in Critically Ill Veterans
Authors: Kresevic Denise M. , Miller Donna , Fuseck Carole W. , Wade Mia , Whitney Laura , Conley Mary , Rimac Joanne , Jacono Frank , O’Leary-Wilson Heather L. , Burant Christopher J.
Published: August 2020

Background

Delirium is a complex syndrome prevalent in the intensive care unit. It has been associated with significant morbidity including distress, longer hospital stays, prolonged cognitive impairment, and increased mortality.

Objective

To describe a nurse-led interdisciplinary quality improvement initiative to increase nurses’ knowledge of delirium, documentation of delirium assessment, and patient mobility.

Methods

Sixty-seven nurses in medical and surgical intensive care units were required to attend an interactive education program on delirium assessment and management. Scores on tests taken before and after the education program were used to evaluate knowledge. Medical records and bedside rounds were used to validate Confusion Assessment Method for the Intensive Care Unit documentation and interventions. Descriptive statistics were used to describe changes over time. A delirium resource team composed of nurses, physicians, and therapists provided didactic education paired with simulation training and bedside coaching. Mobility screening tests and computer templates guided assessments and interventions.

Results

Documentation of the Confusion Assessment Method improved from less than 50% to consistently 99%. Mobilization in the surgical intensive care unit increased from 90% to 98% after intervention. Days of delirium significantly decreased from 51% before intervention to 31% after intervention (χ12=7.01, P = .008).

Conclusions

The success of this quality improvement project to enhance recognition of delirium and increase mobility (critical components of the pain assessment, breathing, sedation choice, delirium, early mobility, and family education bundle) was contingent on nursing leaders hip, interdisciplinary team collaboration, and interactive education.
Early Mobility for Critically Ill Patients: Building Staff Commitment Through Appreciative Inquiry
Authors: Fernald Michelle M. , Smyrnios Nicholas A. , Vitello Joan
Published: August 2020

Background

Immobility contributes to many adverse effects in critically ill patients. Early progressive mobility can mitigate these negative sequelae but is not widely implemented. Appreciative inquiry is a quality improvement method/change philosophy that builds on what works well in an organization.

Objectives

To explore whether appreciative inquiry would reinvigorate an early progressive mobility initiative in a medical intensive care unit and improve and sustain staff commitment to providing regular mobility therapy at the bedside. Secondary goals were to add to the literature about appreciative inquiry in health care and to determine whether it can be adapted to critical care.

Methods

Staff participated in appreciative inquiry workshops, which were conducted by a trained facilitator and structured with the appreciative inquiry 4-D cycle. Staff members’ attitudes toward and knowledge of early progressive mobility were evaluated before and after the workshops. Performance of early progressive mobility activities was recorded before and 3 and 10 months after the workshops.

Results

Sixty-seven participants completed the program. They rated the workshops as successfully helping them to understand the importance of early progressive mobility (98%), explain their responsibility to improve patient outcomes (98%), and engender a greater commitment to patients and the organization (96%). Regarding mobility treatments, at 3 months orders had improved from 62% to 88%; documentation, from 52% to 89%; and observation, from 39% to 87%. These improvements were maintained at 10 months.

Conclusion

Participation in the workshops improved the staff’s attitude toward and performance of mobility treatments. Appreciative inquiry may provide an adjunct to problem-based quality improvement techniques.
Holding and Mobility of Pediatric Patients With Transthoracic Intracardiac Catheters
Authors: Lisanti Amy Jo , Helman Stephanie , Sorbello Andrea , Fitzgerald Jamie , D’Amato Annemarie , Zhang Xuemei , Gaynor J. William
Published: August 2020

Background

Nursing care of pediatric patients after cardiac surgery consists of close hemodynamic monitoring, often through transthoracic intracardiac catheters, requiring patients to remain on bed rest and limiting holding and mobility.

Objectives

The primary aim of this quality improvement project was to determine the feasibility of safely mobilizing pediatric patients with transthoracic intracardiac catheters out of bed. Once feasibility was established, the secondary aim was to increase the number of days such patients were out of bed.

Methods and Interventions

New standards and procedures were implemented in July 2015 for pediatric patients with transthoracic intracardiac catheters. After initiation of the new policies, complications were tracked prospectively. Nursing documentation of activity and positioning for all patients with transthoracic intracardiac catheters was extracted from electronic health records for 2 fiscal years before and 3 fiscal years after the new policies were implemented. The Cochran-Armitage test for trend was used to determine whether patterns of out-of-bed documentation changed over time.

Results

A total of 1358 patients (approximately 250 to 300 patients each fiscal year) had activity and positioning documented while transthoracic intracardiac catheters were in place. The Cochran-Armitage test for trend revealed that out-of-bed documentation significantly increased after the new policies and procedures were initiated (P < .001). No major complications were noted resulting from patient mobility with transthoracic intracardiac catheters.

Conclusion

Pediatric patients with transthoracic intracardiac catheters can be safely held and mobilized out of bed.
Implementation of an Interdisciplinary AACN Early Mobility Protocol
Authors: Schallom Marilyn , Tymkew Heidi , Vyers Kara , Prentice Donna , Sona Carrie , Norris Traci , Arroyo Cassandra
Published: August 2020

Background

Increasing mobility in the intensive care unit is an important part of the ABCDEF bundle. Objective To examine the impact of an interdisciplinary mobility protocol in 7 specialty intensive care units that previously implemented other bundle components.

Methods

A staggered quality improvement project using the American Association of Critical-Care Nurses mobility protocol was conducted. In phase 1, data were collected on patients with intensive care unit stays of 24 hours or more for 2 months before and 2 months after protocol implementation. In phase 2, data were collected on a random sample of 20% of patients with an intensive care unit stay of 3 days or more for 2 months before and 12 months after protocol implementation.

Results

The study population consisted of 1266 patients before and 1420 patients after implementation in phase 1 and 258 patients before and 1681 patients after implementation in phase 2. In phase 1, the mean (SD) mobility level increased in all intensive care units, from 1.45 (1.03) before to 1.64 (1.03) after implementation (P < .001). Mean (SD) ICU Mobility Scale scores increased on initial evaluation from 4.4 (2.8) to 5.0 (2.8) (P = .01) and at intensive care unit discharge from 6.4 (2.5) to 6.8 (2.3) (P = .04). Complications occurred in 0.2% of patients mobilized. In phase 2, 84% of patients had out-of-bed activity after implementation. The time to achieve mobility levels 2 to 4 decreased (P = .05). Intensive care unit length of stay decreased significantly in both phases.

Conclusions

Implementing the American Association of Critical-Care early mobility protocol in intensive care units with ABCDEF components in place can increase mobility levels, decrease length of stay, and decrease delirium with minimal complications.
Utilization of endobronchial electrocautery for removal of an impacted airway foreign body
Authors: Nongpiur Vijay Noel , Mittal Saurabh , Madan Karan , Mohan Anant , Hadda Vijay
Published: August 2020

Dear Editor,

Aspiration of a foreign body into the tracheobronchial tree can occur at any age, though it occurs more commonly in children. In small children, the foreign body commonly gets lodged in the central airways (trachea and mainstem bronchi); hence, the presentation is usually sudden onset of cough and dyspnea or even lifethreatening respiratory failure in an otherwise healthy child. A witnessed aspiration or a history of aspiration can usually be elicited.
La bomba atómica después de Hiroshima y Nagasaki. El difícil camino hacia el control de la energía nuclear
Authors: Sola Ayape Carlos , Sotelo Fuentes María Fernanda
Published: August 2020

RESUMEN: Si bien es cierto que el lanzamiento de la bomba atómica sobre Hiroshima y Nagasaki, 6 y 9 de agosto de 1945 respectivamente, supuso la inmediata rendición de Japón y la finalización de la Segunda Guerra Mundial —el conflicto bélico más devastador de la historia de la humanidad—, el mundo se vio atrapado de inmediato entre la incertidumbre y el miedo como consecuencia del inicio de la era atómica. Dada su trascendencia histórica, en el presente artículo daremos cuenta no sólo del proceso de fabricación de la bomba atómica en el marco del Proyecto Manhattan y de su lanzamiento sobre estas dos ciudades niponas, sino del gran reto que supuso alcanzar un acuerdo para preservar el control atómico en un difícil escenario internacional que pronto desembocaría en la Guerra Fría.
Ficciones de la violencia de Imanol Caneyada: una lectura del hiperrealismo
Authors: Pardo-Fernández Rodrigo
Published: August 2020

La novelística de Imanol Caneyada (San Sebastián, 1968) refiere al mundo del narco en sus múltiples aristas. Un escritor español afincado en México desarrolla una obra que lo mismo habla de una ciudad estándar del norte de México donde suceden actos de corrupción que de la desapacible Quebec canadiense en invierno: en ambas geografías la violencia asociada al narcotráfico se conforma como eje narrativo y marco cultural. Este trabajo, en tanto lectura crítica de dos de sus novelas, enmarcadas dentro de la novela criminal, permite apreciar convergencias en su construcción narrativa en torno a una construcción hiperrealista que trasciende los límites geográficos.
¿Dónde está Dante ahora? Street art: conservación, rechazo y eliminación. El caso de la de los mosaicos de Street art en Rávena, Italia
Authors: Quintero Balbás Diego Iván
Published: August 2020

El street art o arte urbano presenta nuevos retos para la conservación del patrimonio artístico de una ciudad. El problema se revela complejo y requiere de un abordaje interdisciplinario que sigue en proceso de desarrollo. Varias son las preguntas que se presentan. ¿Quién tiene la propiedad legal de dichas obras? ¿Cuáles son los instrumentos legales para protegerlas? ¿Qué hacer cuando las obras son rechazadas por la sociedad? Este artículo explora dos casos particulares de rechazo, vandalismo y eliminación de mosaicos de street art, en Rávena, Italia: los mosaicos de Invader y Dicky Cock..
Excavar en la imagen/estrato. Una introducción a la arqueología de la imagen
Authors: Huerta Martinez Canek
Published: August 2020

Los ejercicios de observación, registro y visualización arqueológicos, en el horizonte que Sudeshna Guha denomina como post postprocesual, plantean diversos medios de acceso a la complejidad del pasado (con una perspectiva experiencial y cognitiva) y rebasan el carácter representacional que define el tratamiento de las fotografías en esta disciplina. Una de las emergentes vertientes de arqueología de la imagen abreva fundamentalmente de lecturas entrecruzadas de Michel Foucault, (1977), Arjun Appadurai, (1986) y Walter Benjamin, (2005). A partir de las categorías de tiempo y de la propuesta de imagen/estrato, el objetivo de este artículo es enunciar someramente las premisas teóricas que fundamentan la tentativa arqueológica-visual para excavar en las imágenes fotografiadas.
El modelo argumentativo de Toulmin como elemento epistémico para la participación ciudadana: una aproximación en tiempos de pandemia
Authors: García-Cruz Juan Carlos
Published: August 2020

Este trabajo propone una serie de argumentos filosóficos y epistémicos que incentiven la participación ciudadana fundamentada en las prácticas epistémicas y en el modelo argumentativo planteado por Stephen Toulmin. En la primera parte se dilucida la noción de conocimiento y la manera en que se fundamenta a través de las razones objetivamente suficientes desde las comunidades epistémicas. Posteriormente se desarrolla el concepto de práctica (Wittgenstein, 1988; Turner, 1994; Schatzki, 1996; Olivé, 2008) como argumento epistémico para fortalecer la participación ciudadana. Finalmente, apoyándonos en el contexto de la pandemia por SARS-CoV-2 y la enfermedad COVID-19, retomamos elementos del modelo argumentativo de Toulmin para evidenciar que es fundamental una base epistemológica y filosófica para establecer una legítima participación ciudadana para el desarrollo de sociedades basadas en el conocimiento.
Combined approach of multiloculated hydrocephalus and isolated fourth ventricle
Authors: dos Santos Lucas de Souza Rodrigues , Matias Leo Gordiano , Maeda Fernando Luís , De Aquino Humberto Belem , Ghizoni Enrico
Published: August 2020

A female newborn patient presents with meningitis and hydrocephalus after lumbosacral myelomeningocele repair and skin closure. An external ventricular drain was used during the meningitis treatment. Patient had a late onset multiloculated hydrocephalus and isolated fourth ventricle on CT scan follow-up. We performed combined approach with a craniotomy, dissection of intraparietal sulcus entering in the atrium of left lateral ventricle and used endoscopic assistance to fenestrate intraventricular septations and to put a ventricular catheter through tentorium to drain both supra and infratentorial ventricles. The patient improved clinically and radiologically.
Ventricular shunt infection
Authors: Nunes Matos Isabella , Barros Taumaturgo Livia , Quidute Arrais Rocha Maria Eduarda , Pessoa Freire Maria Victoria , Ferrer Augusto Gonçalves Sarah , Barros Jucá Carlos Eduardo
Published: August 2020

Ventricular shunt (VS) is still the main therapy for hydrocephalus in children.Although many lives can be saved with this procedure, shunts are notoriously proneto complications. Among these, infection is the most difficult to deal with. This paperevaluates most aspects of shunt infection, such as etiology, risk factors, diagnosis,treatment and associated complications. Literature shows that the majority ofinfections are caused by Staphylococcus, although other microorganisms can beinvolved, like gram-negatives and Mycoplasma. Etiology is thus variable and medicalpersonel should be aware of it. Due to the potential of VS infection o provokeincreasing morbidity and mortality in children, it should be stressed the importance ofa correct and fast diagnosis to secure a suitable treatment. Additionally, there isn't anuniform protocol worldwide regarding the use of antibiotics, so it often depends onthe physicians suggestion and the preference of the hospital's microbiology team. Thissituation reinforces the need for frequent update to the most recent literature available.
Shunt Technology in Pediatric Neurosurgery: Current options and Scientific Evidence
Authors: Furlanetti Luciano Lopes , Ballestero Matheus Fernando Manzolli , De Oliveira Ricardo Santos
Published: August 2020

Introduction: Hydrocephalus is the most common neurosurgical condition among children worldwide and shunt diversion of the cerebral-spinal fluid (CSF) has been widely available. The aim of the present study was to perform a systematic review on types and models of shunt devices available and critically evaluate scientific evidence in favor of the usage of specific technologies.
Methods: Searches of the PubMed database were performed for relevant articles published from until March 2020. Appropriate keywords were used to identify all studies, including: “shunt”, “technology”, “hydrocephalus”, “children”, “pediatric”. The indications and scientific evidence in favor of the usage of specific shunt technology for the treatment of hydrocephalus according to age, underlying pathology and other features of specific patients were discussed under the light of the current literature.
Results: A total of 178 peer-reviewed papers were found. Out of them, only 21 matched our inclusion criteria and were finally selected. The papers were reviewed and described technology discussed below. A summary of the main types of shunts commercially available worldwide, including their respective working mechanism and construction was also included.
Conclusion:Shunt technology has evolved during the last decades and continues to be intensively developed. Despite of the huge arsenal of different types of shunt systems currently available on the market, the treatment of hydrocephalus remains challenging. Investment in research, education and training, as well as prospective randomized multicentric controlled trials evaluating the role of specific valves in the treatment of individual group of hydrocephalic pediatric patients are urgently needed.
Cerebral dysautonomy as a clinical repercussion in children with traumatic brain injury
Authors: Da Silva Jassiara Soares , Pereira Carlos Umberto , Rabelo Nicollas Nunes
Published: August 2020

Introduction: Dysautonomia or Paroxysmal Sympathetic Hyperactivity (PSH) affects more than 50% of patients suffering from severe traumatic brain injury (TBI), which is a major cause of morbidity and mortality in children under 12 years. The goal is to demonstrate that PSH is established as a consequence in children with severe brain trauma. 

Methodology: Forty articles were found in databases such as LILACS, Elsevier and Scielo that address the theme, excluding those that addressed the TBI in adults and including those that addressed the theme in the pediatric context and published about the PSH, published until the year of 2019.

Results: Severe TBI is established as a common cause of hospitalization of children and PSH as a common consequence. Diagnosis and management of this complication require the help of tools such as "PSH-Assessment Measure (PSH-AM)", which has criteria that facilitate the exclusion of other possible causes and guide the treatment. Non-pharmacological therapeutic measures include control of room temperature and low sensory and pharmacological stimuli to deal with symptoms, such as drugs such as opioids, gabaergic agonists, benzodiazepines and adrenergic antagonists. 

Conclusion: Severe TBI, a common pediatric emergency, can be considered a predictor of PSH. Even though there is no consensus on the diagnosis, PSH-AM proves to be a reliable alternative to professionals dealing with conditions that may or may not correspond with post trauma dysautonomia. This makes it possible to determine not only the child's clinical condition but also the best therapy to apply.
Assessment of Animal Bites in Selected Veterinary Establishments in Plateau State: A Three Year Review
Authors: Akosu TJ , Afolaranmi TO , Fayenuwo JO , Kumbak FD , Okorie CG , Adamu U , Iduh DE , Ntung S , Zoakah AI
Published: August 2020

Background: Animal bites are common and sometimes result in the transmission of preventable diseases with high morbidity and fatality. This study sought to determine the pattern of animal bites reported in selected veterinary establishments in Plateau State and the vaccination status of the animals involved. Methods: This was a 3 year retrospective study of vertebrate animal bites of humans reported to 2 public veterinary centres in Jos. Data were extracted from the records of the centres and analysed using SPSS version 21.0.  Results:  There were 898 bites reported during the period, about one third (33.3%) of which were in children 1-10 years old. Over half of the victims (52.6%) were males and most (72.2%) resided in urban areas. Almost all the bites (97.9%) were from dogs, with local dogs accounting for 67.7% of dog bites.  The lower limbs were the commonest site of bites and 80% of bites were unprovoked. Though 80.2% of animals responsible for the bites had identifiable owners, 56.7% had no record of rabies vaccination. Among the animals with vaccination records, 78.9% had either never been vaccinated or their vaccinations had expired. Only 21.1% were fully vaccinated. Median time from bite to presentation at the veterinary centres was 1 day (IQR 0.5-2.0 days) Conclusion: Bite injuries from unvaccinated dogs remain a major public health problem in Plateau State. Urgent efforts should be made to enlighten dog owners and reduce the incidence of bites
Knowledge and Perception of Genetically Modified Foods among Agricultural workers in Jos Metropolis, Plateau State
Authors: Daboer J , Bulus NG , Ayiga EG , Yako JB , Zoakah AI
Published: August 2020

Background: Genetically modified foods are agricultural products with specific changes introduced into their DNA by genetic engineering techniques so as to favour the production of a desired biological product. Knowledge of genetically modified foods among agricultural workers remains largely unknown in our environment. The objective of this study was to assess the knowledge and perception of these products among agricultural workers in Jos.Methods: This was a cross sectional study using a structured self-administered questionnaire. Respondents were selected through stratified sampling technique. Data collected were analysed using Statistical Package for Social Sciences version 23 software. Knowledge and perception of genetically modified foods were scored. Factors influencing the observed knowledge and perception were also assessed and a p value of ≤ 0.05 was considered statistically significant.Results: The mean age of respondents was 41.9 ± 8.6 years with 66.1% of them being males. One hundred and sixty five (94.8%) had tertiary education and the median years of work experience was 12 years (interquartile range 6.0-20.3). There was good knowledge and perception of genetically modified foods in 48.3% and 29.9% of the respondents respectively. Statistically significant associations were found between the length of work experience and both knowledge (p=0.039) and perception (p=0.011) of genetically modified foods.Conclusion: Both the knowledge and perception of genetically modified foods were low. Duration of work significantly influenced both knowledge and perception of genetically modified foods. It is recommended that agricultural institutions improve the knowledge of their workers on genetically modified foods by regular and continuous training.
Knowledge and Practices of Meat Hygiene among Meat Handlers and Microbial Profile of Meat in the Jos Abattoir, Plateau State
Authors: Miner CA , Agbo HA , Dakhin AP , Udoh P
Published: August 2020

Background: Meat handling and sanitation practices can have resultant effects on the quality of meat sold to the public. The study aimed to determine the knowledge and practices of meat hygiene amongst meat handlers. It also sought to determine the microbial profile of meat sold in the Jos abattoir of Plateau State. Methodology: It was a cross sectional study conducted among 128 butchers and meat handlers in the Jos abattoir selected by total population sampling technique. Data on knowledge and practice was collected using a semi-structured interviewer-administered questionnaire. Sampled meat products were analysed for bacterial load using Serial Dilution technique and bacterial pathogens identified by standard procedures. Epi Info statistical software was used for data analysis at a 95% confidence limit. Results: The mean age of respondents was 32.8 ± 10.4 years and all were males. A fair knowledge of meat hygiene was found among 55.5% of respondents while 8.6% were adjudged to have good meat hygiene practices. The mean bacterial load for sampled meat for sale was 2.5 x 103 ± 3.4 cfu/ml. Main bacterial isolates identified were Escherichia coli, Pseudomonas spp and Enterobacter spp.Conclusion: In this study knowledge of meat hygiene was mostly fair among respondents with a low level of meat hygiene practices and a high level of meat bacterial contamination. The study recommended training for meat handlers for hygiene maintenance, increased inspection of meat sold to the public and provision of standard facilities to ensure the maintenance of a good level of meat hygiene.
Environmental education action with urban tree planting in order to neutralize greenhouse gases
Authors: Martelli Anderson
Published: August 2020

Nowadays, concern for the environment is present in the lives of a large part of the population. Due to anthropogenic actions the concentration of greenhouse gases (GHG) has been increasing and boosting the global temperature of the planet. Thus, this article aims to describe an Environmental Education (EA) action with members of the Municipal Council for the Defense of the Environment - COMDEMA municipality of Itapira-SP where a tree planting was carried out in the urban area aiming at the neutralization of GHGs released during its activities plenary sessions held in 2019. The results show that the theme is little debated and studied between public power and civil society. The planting was carried out according to the GHG emission calculation, neutralizing the gases released during the activities of this council, characterizing plausible actions regarding the sensitization of the advisors regarding the mitigation actions related to the detachment and sequestration of these gases, serving as a link. participation in environmental education actions, increase and preservation of existing trees in the urban space.
Mitigating measures carried out by the environment secretariat of the Municipality of Itapira-SP in relation to greenhouse gases
Authors: Martelli Anderson , Cachiba Sérgio
Published: August 2020

Nowadays, concern for the environment is present in the lives of a large part of the population. We are experiencing the hottest period since the last glaciation. Thus, this article aimed to describe actions taken by the Secretariat of Agriculture and Environment (SAMA) aiming at reducing and sequestering the gases that cause the greenhouse effect - GHG in the city of Itapira-SP. For this, a data survey was carried out at SAMA in the municipality and other departments, responsible for carrying out the actions. The results showed that the topic is little debated and studied in the municipalities of Brazil and the activities developed in this study characterize plausible actions with regard to raising awareness of public power and civil society regarding the mitigating actions related to these gases, as well as the benefits their execution, serving as a link of participation in the construction of sustainable cities.