bluuebunny/crossref_metadata_2025_split huggingface dataset:
PENGEMBANGAN PERANGKAT PEMBELAJARAN UNTUK MENINGKATKAN MOTIVASI BELAJAR DAN KARAKTER BERSAHABAT SISWA KELAS IV SD
Authors: Setyorini Diana , Izzaty Rita Eka 
Published: July 2016

<p class="E-JOURNALAbstrakTitle">Penelitian ini bertujuan untuk (1) menghasilkan perangkat pembelajaran <em>collaborative learning </em>berbasis kearifan lokal yang layak untuk meningkatkan motivasi belajar dan karakter bersahabat siswa dan (2) mengetahui keefektifan perangkat pembelajaran <em>collaborative learning </em>berbasis kearifan lokal untuk meningkatkan motivasi belajar dan karakter bersahabat siswa. Penelitian ini merupakan penelitian dan pengembangan mengacu pendapat Borg dan Gall (1983, p.775), namun desain pengembangan perangkat pembelajaran ini hanya meliputi 9 langkah, yaitu (1) penelitian pendahuluan dan pengumpulan informasi, (2) perencanaan, (3) pengembangan draft produk, (4) uji coba terbatas, (5) merevisi hasil uji coba terbatas, (6) uji coba lapangan, (7) penyempurnaan produk hasil uji coba lapangan, (8) uji coba lapangan operasional, dan (9) penyempurnaan produk akhir. Subyek penelitian adalah siswa kelas IV SD Piyungan Bantul. Hasil penelitian menunjukan bahwa perangkat pembelajaran ini layak digunakan menurut ahli materi dan ahli pembelajaran dengan kategori valid. Berdasarkan hasil penelitian diketahui, bahwa terdapat perbedaan yang signifikan terhadap motivasi belajar dan karakter bersahabat antara siswa yang mengikuti pembelajaran dengan perangkat pembelajaran <em>collaborative learning </em>berbasis kearifan lokal dan yang tidak menggunakan perangkat pembelajaran hasil pengembangan.</p><p> </p><p><strong> </strong></p><p align="center"><strong><em>Abstract</em></strong></p><p>This study aims to (1) produce a collaborative learning kit based on local wisdom that is feasible to increase learning motivation and friendly character and (2) determine the effectiveness of the collaborative learning kit based on local wisdom to improve learning motivation and friendly character. This study is a research and development refering to the opinion of Borg and Gall (1983, p. 775), but this developing learning kit only consisting of nine steps including (1) research and information collection, (2) planning, (3) developing preliminary form of draft product, (4) preliminary field testing, (5 ) main product revision, (6) main field testing, (7) operational product testing, (8) operational field testing, and (9) final product revision. Subjects were fourth grade students Piyungan Bantul. The results show that the learning kit is effective to increase the motivation to learn and friendly character of students according to the material expert and learning expert with valid assessment category. The operational field testing obtained p &lt;0.05, which means that there are significant differences on motivation to learn and friendly character of the students who take the collaborative learning with learning kits based on local wisdom and those who do not use the results of the development of learning kits.<strong></strong></p>
Az Észak-magyarországi régió munkaerő-piaci folyamatainak vizsgálata A
Authors: Lipták Katalin 
Published: July 2016

A tanulmány az Észak-magyarországi régió pozícióját vizsgálja országos viszonylatban a főbb munkaerőpiaci indikátorok figyelembe vételével. Számításokat végeztem a régióban lezajló munkaerő-piaci folyamatok szemléltetésére. A tanulmány célja az Észak-magyarországi régió munkaerő-piaci helyzetének megértéséhez kapcsolódóan a munkanélküliség főbb tényezőinek mélyebb feltárása, valamint afoglalkoztatási szerkezetben bekövetkezett változások számszerűsítése, értékelése.
Journal of Economic Literature (JEL) kódok: J21, R23
Az áfa-rezidensek helye a magyar külkereskedelmi termékforgalomban
Authors: Baghy Eleonóra 
Published: July 2016

A külföldi vállalatok egyre nagyobb volumenű külkereskedelmi forgalmat bonyolítanak le a gazdasági tevékenységet nem folytató, magyar adószámmal rendelkező áfa-rezidenseiken keresztül. Ezek a speciális célra létrehozott vállalkozások a gazdaság több területén vannak jelen – ilyen például a raktározás, vagy a reexport –, legjelentősebb működési területük azonban a különféle bérmunka ügyletek lebonyolításában való részvétel. Különleges jogi helyzetükből fakadóan az áfa-rezidensek tevékenységének megfigyelése a külkereskedelmi statisztikában, valamint a GDP-számításoknál eltérő, ami a különböző területek adatai között lényeges eltérést okoz. Az áru-, a tulajdonjog-, illetve a pénzmozgás napjakban tapasztalható különválása szintén nehezíti a gazdasági folyamatok nyomon követését. Emiatt a gazdaságstatisztika egyik legfontosabb módszertani feladata lett az áfa-regisztrációk tevékenységének mérése, és az adatkonzisztencia megteremtése mind nemzeti, mind nemzetközi szinten. Az egyre bonyolultabbá váló ügyleteket a cikk utolsó részében három esttanulmányon keresztül mutatjuk be.
Journal of Economic Literature (JEL) kódok: F10, F23
Are butyrophenones effective for the treatment of primary headache in the emergency department?
Authors: Leong Lim Beng , Kelly Anne-Maree 
Published: July 2016

ABSTRACTObjectives:Butyrophenones have been reported to provide effective migraine relief in the emergency department (ED). We conducted a systematic review of the evidence for their use in the ED.Data source:We searched theCochrane,Medline,Embase, andCINAHLdatabases.Study selection:Included studies were randomized trials of a parenteral butyrophenone (droperidol, haloperidol) versus placebo or a comparator in migraine or benign headache with results available in English. Study quality was determined using the Jadad score. Six articles were included.Data extraction:Primary outcomes were subjective or objective headache relief (&gt; 50% improvement in visual analogue scale scores). Secondary outcomes included side effects. We reported pooled odds ratios (ORs) with their 95% confidence intervals (CIs) for subjective or objective headache relief for butyrophenones versus placebo or comparator agents.Data synthesis:Three studies reported subjective headache relief with a butyrophenone versus placebo or meperidine in migraine. Two studies reported objective headache relief with droperidol versus prochlorperazine, whereas one study compared droperidol versus olanzapine in benign headache. The pooled OR for subjective headache relief was 8.08 (95% CI 1.54–42.30) for a butyrophenone versus placebo, whereas it was 1.50 (95% CI 0.33–6.77) for droperidol versus meperidine in migraine. The pooled OR for objective headache relief was 2.96 (95% CI 1.36–6.43) for droperidol versus prochlorperazine in benign headache. Rates of side effects were 10 to 45%; akathesia and sedation were the most common.Conclusions:Butyrophenones are effective for the relief of migraine or benign headache. However, adverse effects make it difficult to recommend butyrophenones above agents with similar effectiveness and fewer problems.
Practice variability in the management of complex febrile seizures by pediatric emergency physicians and fellows
Authors: Sales Justin W. , Bulloch Blake , Hostetler Mark A. 
Published: July 2016

ABSTRACTObjective:Febrile seizures are the most common type of childhood seizure and are categorized as simple or complex. Complex febrile seizures (CFSs) are defined as events that are focal, prolonged (&gt; 15 minutes), or recurrent. The management of CFS is poorly defined. The objective of this study was to determine the degree of variability in the emergency department evaluation of children with CFSs.Methods:An online survey questionnaire was developed and sent to physicians identified via the listserv of the emergency medicine section of the American Academy of Pediatrics and the pediatric emergency medicine discussion list. The questionnaire consisted of five hypothetical case vignettes describing children under 5 years of age presenting with a CFS. Following review of the first four vignettes, participants were asked if they would (1) obtain blood and urine for evaluation; (2) perform a lumbar puncture; (3) perform neurologic imaging while the child was in the emergency department; (4) admit the child to the hospital; or (5) discharge with follow-up as an outpatient, with either the primary care provider or a neurologist. The final vignette determined if antiepileptic medication would be prescribed by the physician on discharge.Results:Of the 353 physicians who participated, 293 (83%) were pediatric emergency medicine attending physicians and 60 (17%) were pediatric emergency medicine fellows. Overall, 54% of participants indicated that they would obtain blood for evaluation, 62% would obtain urine, 34% would perform a lumbar puncture, and 36% would perform neurologic imaging. The overall hypothetical admission rate for the case vignettes was 42%.Conclusions:This study indicates that extensive variability exists in the emergency department approach to patients with CFS. Our findings suggest that optimal management for CFS remains unclear and support the potential benefit of future prospective studies on this subject.
Failed validation of the Quebec shoulder dislocation rule for young adult patients in an Australian emergency department
Authors: Ong Siang , Kelly Anne-Maree , Gunn Barry 
Published: July 2016

ABSTRACTObjective:The Quebec shoulder dislocation rule is a recently derived clinical decision rule to guide physicians on the selective use of radiography in patients with shoulder dislocation. The aim of this studywas to validate the Quebec shoulder dislocation rule.Methods:This was a secondary analysis of data collected in a retrospective cohort study. All patients presenting to the emergency department (ED) between January 1, 2003, and October 31, 2008, with a diagnosis of shoulder dislocation or fracture-dislocation were identified from ED management databases. Data collected included demographics, mechanism of injury, and presence of fracture. The outcome of interest was predictive performance of the Quebec shoulder dislocation rule for patients aged under 40 years on this cohort. Data analysis is descriptive.Results:Of the 346 patients identified, 196 were aged under 40 years, and 174 (89%) were male; the median age was 25 years (interquartile range 21–29 years), and 58 were recurrent dislocations. One hundred sixteen patients (59%) met the Quebec high-risk criteria, and 80 (41%) were classified as low risk. In the 196 patients aged less than 40 years, 12 fractures as defined were identified (6%). When applied to this cohort, the Quebec clinical decision rule had a sensitivity of 0.42 (95% CI 0.16–0.71), a specificity of 0.40 (95% CI 0.33–0.47), and a negative predictive value of 0.91 (95% CI 0.82–0.96).Conclusion:The Quebec shoulder dislocation rule had poor sensitivity for clinically significant fractures associated with shoulder dislocations in young patients (aged 16–39 years) presenting to an Australian emergency department. Its use cannot be recommended.
Neuropathic ankle fractures
Authors: Tucker Allison , Stone N. Craig 
Published: July 2016

ABSTRACTA 65-year-old diabetic female presented with a 3-week history of a left swollen foot after a minor inversion injury and was found to have a minimally displaced fibular fracture. Despite casting and strict instructions to remain non-weight bearing, the patient continued to bear weight and later developed a significantly more displaced fracture with a draining ulcer. This injury eventually required a tibiotalocalcaneal arthrodesis using a retrograde hindfoot nail. Neuropathy and neuropathic fractures can be devastating complications of diabetes and thus require early diagnosis and intervention because they may result in significant morbidity for the patient. Thorough assessment involving imaging, a complete history and physical examination, and tools such as a 129 Hz tuning fork and the 10 g Semmes- Weinstein monofilament are paramount to establishing an accurate initial diagnosis. These tactics aid in future followup of the patient's injury and can be employed in both the clinic and the emergency department. Although management remains controversial for neuropathic ankle fractures because both conservative and surgical treatment regimens have high complication rates, open reduction and internal fixation continues to be the treatment of choice once closed reduction has been attempted and fails. Education is essential because diabetic patients have compromised pain and pressure sensation, which can lead to injuries and subsequent complications of which they are simply unaware. Physicians must be diligent when evaluating the diabetic foot and be explicit when providing instructions to these patients because preventing these injuries and their complications is the best patient care available.
How do I improve the quality of in-training assessment of learners?
Authors: Bandiera Glen 
Published: July 2016

ABSTRACT
Assessing a learner in the course of a hectic emergency department (ED) rotation is a daunting task for both experienced and new supervisors. This is particularly true if the learner is not doing well. In light of numerous impediments provided by the modern ED environment, sticking to basic principles can result in marked improvement in both the process and the outcome of in-training assessment. This article addresses these important principles for assessment as they apply in the clinical realm of the ED, with a focus on matching expectations to both the trainee and the available assessment strategies. It is critical that teachers strive for clarity, consistency, honesty, and adherence to due process in their learner assessments. This article provides an evidence-informed approach to succeeding with such an approach to clinical assessment.
Use of the Ottawa Ankle Rules in children: a survey of physicians’ practice patterns
Authors: Dowling Shawn K. , Wishart Ian 
Published: July 2016

ABSTRACT:

Introduction:
A number of studies have assessed the diagnostic accuracy of the Ottawa Ankle Rules (OAR) in children; however, the role of the OAR in guiding physician radiograph use is unclear.

Objectives:
The primary purpose of this study was to determine the extent to which Canadian pediatric emergency physicians report using the OAR. Secondary goals included determining current diagnostic and management strategies for Salter-Harris 1 (SH-1) injuries of the ankle and which fractures physicians deem to be clinically significant.

Methods:
A self-administered piloted survey was distributed by mail to 215 Canadian pediatric emergency physicians using a modified Dillman technique. Participants were selected through Pediatric Emergency Research Canada (PERC), a national network of health care professionals with an interest in pediatric emergency medicine research.

Results:
Of 209 surveys, 144 were returned, for a response rate of 68.9%. Of those, 87.5% (126 of 144) reported applying the OAR in children to determine the need for radiographs in acute ankle or midfoot injuries. Of those, 65.1% reported using the OAR always or usually, and 64.5% (93 of 144) of physicians stated that they believe all ankle fractures are clinically significant. Although physicians report that they most commonly order the radiographs, 36.2% of participants indicated that radiographs were requisitioned by nurses or other health care providers at their facilities. SH-1 fractures were reported to be most commonly managed by immobilization (83.3%; 120 of 144), with most patients going on to follow-up with an orthopedic surgeon.

Conclusions:
The majority of Canadian pediatric emergency physicians indicate that they use the OAR when assessing children with acute ankle and midfoot injuries. Most physicians believe that all ankle fractures, including SH-1, are clinically significant and have a management preference for immobilization and orthopedic follow-up.
Bedside ultrasonography detects significant femoral vessel overlap: implications for central venous cannulation
Authors: Beaudoin Francesca L. , Merchant Roland C. , Lincoln James , Gardiner Fenwick , Liebmann Otto , Cohn Jamieson 
Published: July 2016

ABSTRACTObjective:Our goal was to gain a better understanding of the femoral vessel anatomy as it relates to central venous cannulation. The primary objective of this study was to use bedside ultrasonography to determine the amount of exposed femoral vein at three sites corresponding to surface anatomy of the landmark-based procedure.Methods:This cross-sectional study enrolled a random sample of 180 adult patients presenting to a large urban academic emergency department. Subjects underwent standardized ultrasonography to identify and measure the depth and diameter of the femoral vessels and amount of exposed femoral vein at the level of the inguinal ligament (0 cm) 2 cm and 4 cm below. Repeated measures analysis of variance was used to determine significant relationships between vessel measurements and distance from the inguinal ligament.Results:The median age was 44.5 (range 19–90) years; 101 patients were male. The mean (± SD) percentage of exposed vein at the inguinal ligament was 83% (± 21). This decreased significantly (p&lt; 0.01) with increasing distance from the inguinal ligament: 65% (± 25) at 2 cm and 56% (± 30) at 4 cm. At every distance away from the inguinal ligament, there were some subjects with no vein exposed.Conclusion:This study demonstrates significant overlap of the femoral vessels at sites where landmark-based femoral vein cannulation is often attempted. Our results suggest that ultrasound guidance would be beneficial as femoral vein cannulation may be difficult or impossible in certain individuals owing to anatomic variations.
Bell palsy in Lyme disease–endemic regions of Canada: a cautionary case of occult bilateral peripheral facial nerve palsy due to Lyme disease
Authors: Ho Karen , Melanson Michel , Desai Jamsheed A. 
Published: July 2016

ABSTRACTLyme disease caused by the spirocheteBorrelia burgdorferiis a multisystem disorder characterized by three clinical stages: dermatologic, neurologic, and rheumatologic. The number of known Lyme disease–endemic areas in Canada is increasing as the range of the vectorIxodes scapularisexpands into the eastern and central provinces. Southern Ontario, Nova Scotia, southern Manitoba, New Brunswick, and southern Quebec are now considered Lyme disease–endemic regions in Canada. The use of field surveillance to map risk and endemic regions suggests that these geographic areas are growing, in part due to the effects of climate warming. Peripheral facial nerve palsy is the most common neurologic abnormality in the second stage of Lyme borreliosis, with up to 25% of Bell palsy (idiopathic peripheral facial nerve palsy) occurring due to Lyme disease. Here we present a case of occult bilateral facial nerve palsy due to Lyme disease initially diagnosed as Bell palsy. In Lyme disease–endemic regions of Canada, patients presenting with unilateral or bilateral peripheral facial nerve palsy should be evaluated for Lyme disease with serologic testing to avoid misdiagnosis. Serologic testing should not delay initiation of appropriate treatment for presumed Bell palsy.
Ontario children have outgrown the Broselow tape
Authors: Milne William Ken , Yasin Abeer , Knight Janine , Noel Daniel , Lubell Richard , Filler Guido 
Published: July 2016

ABSTRACTObjective:The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshire, IL) (BT) is a well-established length-based tool for estimation of body weight for children during resuscitation. In view of pandemic childhood obesity, the BT may no longer accurately estimate weight. We therefore studied the BT in children from Ontario in a large recent patient cohort.Methods:Actual height and weight were obtained from an urban and a rural setting. Children were prospectively recruited between April 2007 and July 2008 from the emergency department and outpatient clinics at the London Health Science Centre. Rural children from junior kindergarten to grade 4 were also recruited in the spring of 2008 from the Avon Maitland District School Board. Data for preschool children were obtained from three daycare centres and the electronic medical record from the Maitland Valley Medical Centre. The predicted weight from the BT was compared to the actual weight using Spearman rank correlation; agreement and percent error (PE) were also calculated.Results:A total of 6,361 children (46.2% female) were included in the study. The median age was 3.9 years (interquartile range [IQR] 1.56-7.67 years), weight was 17.2 kg (IQR 11.6-25.4 kg), and height was 103.5 cm (IQR 82-124.4 cm). Although the BT weight estimate correlated with the actual weight (r = 0.95577, p &lt; 0.0001), the BT underestimated the actual weight by 1.62 kg (7.1% ± 16.9% SD, 95% CI -26.0-40.2). The BT had an ≥ 10% PE 43.7% of the time.Conclusions:Although the BT remains an effective method for estimating pediatric weight, it was not accurate and tended to underestimate the weight of Ontario children. Until more accurate measurement tools for emergency departments are developed, physicians should be aware of this discrepancy.
Emergency physician estimates of the probability of acute coronary syndrome in a cohort of patients enrolled in a study of coronary computed tomographic angiography
Authors: Lee Chuen Peng , Hoffmann Udo , Bamberg Fabian , Brown David F. , Chang Yuchaio , Swap Clifford , Parry Blair A. , Nagurney John T. 
Published: July 2016

ABSTRACT

Introduction:
Little information exists regarding how accurately emergency physicians (EPs) predict the probability of acute coronary syndrome (ACS). Our objective was to determine if EPs can accurately predict ACS in a prospectively identified cohort of emergency department (ED) patients who met enrolment criteria for a study of coronary computed tomographic angiography (CCTA) and were admitted for a “rule out ACS” protocol.

Methods:
A prospective observational pilot study in an academic medical centre was carried out. EPs caring for patients with chest pain provided whole-number estimates of the probability of ACS after clinical review. This substudy was part of the now published Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) study, a study of CCTA and admission of patients for a rule out ACS protocol after a nondiagnostic evaluation. Predictions were grouped into probability groups based on the validated Goldman criteria. ACS was determined by an adjudication committee using American Heart Association/American College of Cardiology/European Society of Cardiology guidelines.

Results:
A total of 334 predictions were obtained for a study population with a mean age of 54 (SD 12) years, 63% of whom were male. There were 35 ACS events. EPs predicted ACS better than by chance, and increasingly higher estimates were associated with a higher incidence of ACS (p = 0.0004). The percentage of patients with ACS was 0%, 6%, 7%, and 17%, respectively, for very low, low, intermediate, and high probability groups. EPs' estimates had a sensitivity of 63% using a &gt; 20% probability of ACS to define a positive test. Lowering this threshold to &gt; 7% to define a test as positive increased the sensitivity of physician estimates to 89% but lowered specificity from 65% to 24%

Conclusions:
Our data suggest that for a selected ED cohort meeting eligibility criteria for a study of CCTA, EPs predict ACS better than by chance, with an increasing proportion of patients proving to have ACS with increasing probability estimates. Lowering the estimate threshold does not result in an overall sensitivity level that is sufficient to send patients home from the ED and is associated with a poor specificity.