Peran Pendidikan dalam Membentuk Karakter Bangsa Menghadapi Era Masyarakat Ekonomi ASEAN (Mea)

MEA yang merupakan akronim dari Masyarakat Ekonomi ASEAN yang sejatinya merupakan kesepakatan dari Negara-negara di ASEAN untuk membentuk sebuah kawasan bebas keluar masuk barang dan orang tanpa dikenakan bea masuk, salah satu efek yang lain adalah setiap warga anggota negara ASEAN bisa sekolah atau bekerja di tiap negara anggota ASEAN, dan ini yang menjadi tantangan bagi kita. Maka peran pendidikan sangat penting dan krusial dalam membentuk karakter bangsa yang baik dalam untuk menghadapi tantangan globalisasi, sebagaimana diamanatkan dalam Pasal 3 Undang-Undang No. 20 Tahun 2003 tentang Sistem Pendidikan Nasional yang menyatakan bahwa pendidikan nasional berfungsi mengembangkan kemampuan dan membentuk karakter serta peradaban bangsa yang bermartabat dalam rangka mencerdaskan kehidupan bangsa. Oleh karena itu peran pendidikan yang baik akan membuat Indonesia bisa bertahan, membentukan dan membangun karakter agar dapat meningkatkan daya saing dalam menyongsong MEA (Masyarakat Ekonomi ASEAN)

A double blind, randomised placebo controlled trial of topical 2% viscous lidocaine in improving oral intake in children with painful infectious mouth conditions

<p>Abstract</p> <p>Background</p> <p>Painful infectious mouth conditions are a common presentation to emergency departments. Although self limiting, painful ulcerative lesions and inflamed mucosa can decrease oral intake and can lead to dehydration. Oral analgesia is of limited efficacy and is often refused by the patient. Despite widespread use of oral 2% viscous lidocaine for many years, there is little evidence for its efficacy as an analgesic and in aiding oral intake in children with painful infectious mouth conditions. This study aims to establish the effectiveness of 2% viscous lidocaine in increasing oral intake in these children by comparing it with placebo.</p> <p>Methods/Design</p> <p>This study is a randomised double-blind placebo controlled trial of children between 6 months and 8 years of age with painful infectious mouth conditions defined as gingivostomatitis (herpetic or non herpetic), ulcerative pharyngitis, herpangina and hand foot and mouth disease as assessed by the treating clinician in association with a history of poor oral fluid intake. It will be conducted at a single tertiary paediatric emergency department in Melbourne Australia.</p> <p>20 patients have already been randomised to receive 2% lidocaine or placebo in a pilot study to determine the sample size in a preplanned adaptive design. A further 80 patients will be randomised to receive either 2% lidocaine or placebo. The placebo agent is identical to lidocaine in terms of appearance, flavour and smell. All clinical and research staff involved, patients and their parents will be blinded to treatment allocation.</p> <p>The primary endpoint is the amount of fluid ingested by each child, expressed in ml/kg, within 60 minutes from the time of administration of the study mixture. Secondary endpoints are the proportion of patients ingesting 5 ml/kg and 10 ml/kg at 30 and 60 minutes after drug administration and the incidence of adverse events. Longer term outcomes will include the proportion of patients requiring hospital admission and length of emergency department stay.</p> <p>Discussion</p> <p>This trial will define the role of 2% lidocaine in the treatment of painful infectious mouth conditions</p> <p>Trial registration</p> <p>The trial is registered with the Australian and New Zealand Clinical Trials Registry - <a href="http://www.anzctr.org.au/ACTRN12609000566235.aspx">ACTRN12609000566235</a>.</p

MBOK: ITS DISTRIBUTION, MEANING, AND FUNCTION

Mbok, in Javanese language, has not only a ’mother’ in meaning. As a lexicon in the language, mbok in one side truly means a ‘mother’ and still has the same meaning although it experiences the morphological process to be, at least, embok, simbok, or mboke. The variations exist and is spoken by Javanese native speakers throughout the Javanese dialects such as Suroboyoan, Solo, Yogyakarta, Bagelen, and Banyumasan dialects spread from the East Java, Yogyakarta, and Central Java. However, mbok, as a particle has different meaning, even different various meanings relying on its distribution in a sentence. Then the meanings bear its different various functions as well in the sentence based on the context of the sentence (grammatical-semantics meaning). Through Teknik Balik (Converse Technique) the data gained was analyzed to distinguish the position of the particle in the sentence in order to reach its significant different meanings and functions. At least, from the analysis, we have three positions of mbok in the sentences, that are in the initial, middle, and the end of the sentences. These positions affect the meanings and functions that can be seen as follows; ‘, is not it?’ (Tag Question) and ‘is/are” (Verbal Question) for emphasizing, ‘please’ for requesting a help, ‘may be’ and ‘in case’ for expressing possibility, and ‘causing’ for expressing cause-effect

A mistake not to be repeated: What can we learn from the underutilization of statin therapy for efficient dissemination of cardioprotective glucose lowering agents?

Purpose of review: To review the factors contributing to underutilization of guideline-directed therapies, identify strategies to alleviate these factors, and apply these strategies for effective and timely dissemination of novel cardioprotective glucose-lowering agents.Recent findings: Recent analyses demonstrate underutilization of cardioprotective glucose lowering agents despite guideline recommendations for their use. Major contributors to underutilization of guideline-directed therapies include therapeutic inertia, perceptions about side effects, and factors found at the level of the clinicians, patients, and the healthcare system. The recent emergence of several novel therapies, such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists, for use in cardiovascular disease provides a unique avenue to improve patient outcomes. To effectively utilize novel cardioprotective glucose lowering agents to improve cardiovascular outcomes, clinicians must recognize and learn from prior barriers to application of guideline-directed therapies. Further endeavors are prudent to ensure uptake of novel agents

Long-Term Mortality of Older Patients With Acute Myocardial Infarction Treated in US Clinical Practice.

BackgroundThere is limited information about the long-term survival of older patients after myocardial infarction (MI).Methods and resultsCRUSADE (Can rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the ACC/AHA guidelines) was a registry of MI patients treated at 568 US hospitals from 2001 to 2006. We linked MI patients aged ≥65&nbsp;years in CRUSADE to their Medicare data to ascertain long-term mortality (defined as 8 years post index event). Long-term unadjusted Kaplan-Meier mortality curves were examined among patients stratified by revascularization status. A landmark analysis conditioned on surviving the first year post-MI was conducted. We used multivariable Cox regression to compare mortality risks between ST-segment-elevation myocardial infarction and non-ST-segment-elevation myocardial infarction patients. Among 22&nbsp;295 MI patients ≥ age 65 years (median age 77&nbsp;years), we observed high rates of evidence-based medication use at discharge: aspirin 95%, β-blockers 94%, and statins 81%. Despite this, mortality rates were high: 24% at 1&nbsp;year, 51% at 5&nbsp;years, and 65% at 8&nbsp;years. Eight-year mortality remained high among patients who underwent percutaneous coronary intervention (49%), coronary artery bypass graft (46%), and among patients who survived the first year post-MI (59%). Median survival was 4.8&nbsp;years (25th, 75th percentiles 1.1, 8.5); among patients aged 65-74&nbsp;years it was 8.2&nbsp;years (3.3, 8.9) while for patients aged ≥75&nbsp;years it was 3.1&nbsp;years (0.6, 7.6). Eight-year mortality was lower among ST-segment-elevation myocardial infarction than non-ST-segment-elevation myocardial infarction patients (53% versus 67%); this difference was not significant after adjustment (hazard ratio 0.94, 95% confidence interval, 0.88-1.00).ConclusionsLong-term mortality remains high among patients with MI in routine clinical practice, even among revascularized patients and those who survived the first year

Long-Term Mortality of Older Patients With Acute Myocardial Infarction Treated in US Clinical Practice.

BackgroundThere is limited information about the long-term survival of older patients after myocardial infarction (MI).Methods and resultsCRUSADE (Can rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the ACC/AHA guidelines) was a registry of MI patients treated at 568 US hospitals from 2001 to 2006. We linked MI patients aged ≥65 years in CRUSADE to their Medicare data to ascertain long-term mortality (defined as 8 years post index event). Long-term unadjusted Kaplan-Meier mortality curves were examined among patients stratified by revascularization status. A landmark analysis conditioned on surviving the first year post-MI was conducted. We used multivariable Cox regression to compare mortality risks between ST-segment-elevation myocardial infarction and non-ST-segment-elevation myocardial infarction patients. Among 22 295 MI patients ≥ age 65 years (median age 77 years), we observed high rates of evidence-based medication use at discharge: aspirin 95%, β-blockers 94%, and statins 81%. Despite this, mortality rates were high: 24% at 1 year, 51% at 5 years, and 65% at 8 years. Eight-year mortality remained high among patients who underwent percutaneous coronary intervention (49%), coronary artery bypass graft (46%), and among patients who survived the first year post-MI (59%). Median survival was 4.8 years (25th, 75th percentiles 1.1, 8.5); among patients aged 65-74 years it was 8.2 years (3.3, 8.9) while for patients aged ≥75 years it was 3.1 years (0.6, 7.6). Eight-year mortality was lower among ST-segment-elevation myocardial infarction than non-ST-segment-elevation myocardial infarction patients (53% versus 67%); this difference was not significant after adjustment (hazard ratio 0.94, 95% confidence interval, 0.88-1.00).ConclusionsLong-term mortality remains high among patients with MI in routine clinical practice, even among revascularized patients and those who survived the first year

KAMPUCHEA 1975-1985

Konflik-konflik di Kamboja -sejak masa berlangsungnya gerakan kemerdekaan utuk mengakhiri ko1onialisme sampai ke pecahnya perang saudara pada tahun 1970-1975, dan sampai pula ke terjadinya invasi Vietnam ke Kamboja- semuanya memperlihatkan satu pola yang sama; yaitu, bahwa yang sebenarnya selalu menjadi penyebab utama konflik-konflik tersebut tak lain adalah pertikaian-pertikaian internal antara kekuatan-kekuatan politik yang ada di kamboja. konflik-konflik di Kamboja ini selalu menjadi semakin rumit dan meluas karena pihak-pihak yang bertentangan di Kamboja selalu mengundang campur tangan pihak luar. mereka yang bersengketa berharap bahwa campur tangan pihak 1uar itu akan dapat membantu dan menguntungkan pihaknya; padahal negara-negara 1uar yang diundang untuk campur tangan itu dapat dipastikan akan sela1u berniat untuk memperjuangkan kepentingan sendiri, baik kepentingan di Kamboja atau kepentingannya di Indonesia pada umumnya

The controversial natural history of oral herpes simplex virus type 1 infection

The natural history of oral herpes simplex virus type 1 (HSV-1) infection in the immunocompetent host is complex and rich in controversial phenomena, namely the role of unapparent transmission in primary infection acquisition, the high frequency of asymptomatic primary and recurrent infections, the lack of immunogenicity of HSV-1 internalized in the soma (cell body) of the sensory neurons of the trigeminal ganglion, the lytic activity of HSV-1 in the soma of neurons that is inhibited in the sensory neurons of the trigeminal ganglion and often uncontrolled in the other neurons, the role of keratin in promoting the development of recurrence episodes in immunocompetent hosts, the virus\u2013host Nash equilibrium, the paradoxical HSV-1-seronegative individuals who shed HSV-1 through saliva, the limited efficacy of anti-HSV vaccines, and why the oral route of infection is the least likely to produce severe complications. The natural history of oral HSV-1 infection is also a history of symbiosis between humans and virus that may switch from mutualism to parasitism and vice versa. This balance is typical of microorganisms that are highly coevolved with humans, and its knowledge is essential to oral healthcare providers to perform adequate diagnosis and provide proper individual-based HSV-1 infection therapy