Systemic intervention for computer-supported collaborative learning

This paper presents a systemic intervention approach as a means to overcome the methodological challenges involved in research into computer-supported collaborative learning applied to the promotion of mathematical problem-solving (CSCL-MPS) skills in schools. These challenges include how to develop an integrated analysis of several aspects of the learning process; and how to reflect on learning purposes, the context of application and participants' identities. The focus of systemic intervention is on processes for thinking through whose views and what issues and values should be considered pertinent in an analysis. Systemic intervention also advocates mixing methods from different traditions to address the purposes of multiple stakeholders. Consequently, a design for CSCL-MPS research is presented that includes several methods. This methodological design is used to analyse and reflect upon both a CSCL-MPS project with Colombian schools, and the identities of the participants in that project

Effect of Aspirin Resistance with Dyslipidemia Against VerifyNOW® Measurement in Bethesda Hospital YOGYAKARTA

Background: Aspirin is first line drug of choice to prevent ischemic stroke. However, some cases are found occuring of aspirin resistance. Objective: This study was to examine the effect of dyslipidemia on the risk of antiplatelet resistance with VerifyNOW ® at Bethesda Hospital Yogyakarta. Method: This research was observational analysis using a nested casecontrol study design. The subjects were ischemic stroke patients who underwent tests of platelet function by VerifyNOW® (Accumetrics, San Diego, CA, USA). The Case group was ischemic stroke patients who has history of aspirin resistance. The control group was ischemic stroke patients who response on aspirin therapy. Both groups were analyzed and compared to the state of dyslipidemia. Results: Bivariate analysis on the incidence of aspirin resistance indicate that dyslipidemia had OR = 0.979 (95% CI; 0.378 to 2.531), p = 0.572. Hypercholesterolemia had OR = 0,909 (CI 95%; 0,377-2,190) p = 0,500; hypertrigliceride had OR = 0,838 (CI 95%; 0,331-2,119) p = 0,409; abnormal HDL had OR = 1,468 (CI 95% 0,564-3,817) p = 0,238; abnormal LDL had OR = 0,937 (CI 95% 0,374-2,345) p = 0,500. Patient factors such as age >55 years (p = 0.168) and female gender (p = 0.226) showed a nonsignificant results. Conclusion: Ischemic stroke patients at Bethesda Hospital Yogyakarta who had dyslipidemia were not evident to have a greater risk of aspirin resistance than ischemic stroke patients who did not undergo dyslipidemia

Evaluasi Dampak Penerapan Automated Dispensing Machine terhadap Dispensing Error di Farmasi Rawat Jalan Instalasi Farmasi Rumah Sakit Bethesda Yogykarta

Dispensing error is not uncommon in the medication proccess. Otomatisation of outpatient pharmacy services decrease the incidence of dispensing error, as well as improving the efficiency of picking, packing and labeling process. Since August 2014 an automated dispensing machine was installed in outpatient pharmascy Bethesda Hospital Yogyakarta, integrated with electronic prescribing and hospital information system. The objective of the study was to evaluate the impact of automated dispensing machine on the dispensing error at outpatient pharmacy Services using before and after study method. The procentage of drugs deliver by automated dispensing machine at the third and sixth month of implementation was 46% and 59%. Failure mode and effeect analysis of dispensing process done before the implementation, and the integration with electronic prescription and hospital information system, as well as the development of smart pack is the key of successed. The average of medications picked after the implementation of automated dispensing machine was (37,915.33 ± 3,160.12), higher than before implementation (36,812.67 ± 2,890.81), but not significant. The average of dispensing error after implementation (15,67 ± 6,28) was reduced significantly (p<0,05) than before (50.33 ± 34.47). The most frequent type of dispensing error were wrong quantity dispensed, wrong drug dispensed and wrong strength dispensed. The implementation of automated dispensing machine significantly reduce the incidence of dispensing error. Further investigaation needed to know the incidence of dispesning error cause by the machine and manual and factors that influenced

Cerebral ischemic damage in diabetes: an inflammatory perspective

Stroke is one of the leading causes of death worldwide. A strong inflammatory response characterized by activation and release of cytokines, chemokines, adhesion molecules, and proteolytic enzymes contributes to brain damage following stroke. Stroke outcomes are worse among diabetics, resulting in increased mortality and disabilities. Diabetes involves chronic inflammation manifested by reactive oxygen species generation, expression of proinflammatory cytokines, and activation/expression of other inflammatory mediators. It appears that increased proinflammatory processes due to diabetes are further accelerated after cerebral ischemia, leading to increased ischemic damage. Hypoglycemia is an intrinsic side effect owing to glucose-lowering therapy in diabetics, and is known to induce proinflammatory changes as well as exacerbate cerebral damage in experimental stroke. Here, we present a review of available literature on the contribution of neuroinflammation to increased cerebral ischemic damage in diabetics. We also describe the role of hypoglycemia in neuroinflammation and cerebral ischemic damage in diabetics. Understanding the role of neuroinflammatory mechanisms in worsening stroke outcome in diabetics may help limit ischemic brain injury and improve clinical outcomes

Measurement of absorption and charge exchange of π+\pi^+ on carbon

The combined cross section for absorption and charge exchange interactions of positively charged pions with carbon nuclei for the momentum range 200 MeV/c to 300 MeV/c have been measured with the DUET experiment at TRIUMF. The uncertainty is reduced by nearly half compared to previous experiments. This result will be a valuable input to existing models to constrain pion interactions with nuclei.Comment: 29 figures, 7 tables. To be submitted to PR

Dynamics of Aboveground Phytomass of the Circumpolar Arctic Tundra During the Past Three Decades

Numerous studies have evaluated the dynamics of Arctic tundra vegetation throughout the past few decades, using remotely sensed proxies of vegetation, such as the normalized difference vegetation index (NDVI). While extremely useful, these coarse-scale satellite-derived measurements give us minimal information with regard to how these changes are being expressed on the ground, in terms of tundra structure and function. In this analysis, we used a strong regression model between NDVI and aboveground tundra phytomass, developed from extensive field-harvested measurements of vegetation biomass, to estimate the biomass dynamics of the circumpolar Arctic tundra over the period of continuous satellite records (1982-2010). We found that the southernmost tundra subzones (C-E) dominate the increases in biomass, ranging from 20 to 26%, although there was a high degree of heterogeneity across regions, floristic provinces, and vegetation types. The estimated increase in carbon of the aboveground live vegetation of 0.40 Pg C over the past three decades is substantial, although quite small relative to anthropogenic C emissions. However, a 19.8% average increase in aboveground biomass has major implications for nearly all aspects of tundra ecosystems including hydrology, active layer depths, permafrost regimes, wildlife and human use of Arctic landscapes. While spatially extensive on-the-ground measurements of tundra biomass were conducted in the development of this analysis, validation is still impossible without more repeated, long-term monitoring of Arctic tundra biomass in the field