STRATEGI KEPALA SEKOLAH PEREMPUAN DALAM MENINGKATKAN MUTU PENDIDIKAN DI SD 26 SUNGAI AUR KECAMATAN KUMPEH ILIR KABUPATEN MUARO JAMBI

Skripsi ini didasarkan pada kenyataan bahwa di hampir setiap belahan dunia masih terdapat hubungan dan sikap yang timpang terhadap perempuan dan laki-laki. Kepala Sekolah SD26 Sungai Aur Kec. Kumpeh Ilir Kab. MuaroJambi telah membuktikan bahwa perempuan juga bisa menjadi pemimpin lembaga sekolah, atau kepala simpanan. Tujuan dari studi ini adalah untuk: 1. Deskripsi Strategi Kepemimpinan Kepala Sekolah Dalam Menerapkan Gaya Kepemimpinan untuk Meningkatkan Mutu Pendidikan SD26 SungaiAurKec. Kumpeh Ilir Kab. MuaroJambi 2021/202 2 tahun. 2. Di SD 26 Sungai Aur Kec, jelaskan strategi kepemimpinan kepala sekolah perempuan untuk membantu guru meningkatkan kualitas pendidikan. Kumpeh Ilir Kab. MuaroJambi 2021/202 2 tahun. 3.3. Dalam SD 26 Sungai Aur Kec, jelaskan faktor-faktor yang mendorong dan menghambat efektifitas peran kepemimpinan perempuan sebagai kepala sekolah dalam meningkatkan mutu pendidikan. Kumpeh Ilir Kab. MuaroJambi 2021/202 2 tahun. Metode penelitian ini dilakukan dengan menggunakan pendekatan kualitatif deskriptif, dan peneliti menggunakan metode sampling tertarget dalam menentukan topik penelitian. Cara pengumpulan data seperti observasi, wawancara dan dokumentasi dengan menggunakan sumber data dari kepala sekolah, wakil kepala sekolah, guru dan siswa. Analisis data dalam penelitian ini terdiri dari reduksi data, display data, dan validasi. Triangulasi Sumber dan Teknik Validitas data menggunakan triangulasi. Hasil survei tersebut adalah sebagai berikut. 1. Gaya kepemimpinan kepala sekolah yang diterapkan adalah kepemimpinan transformasional. 2.2. Persetujuan guru oleh pimpinan sekolah untuk meningkatkan mutu pendidikan, yaitu a. Keikutsertaan dalam pendidikan dan pelatihan b. Penghargaan bagi guru yang ditunjuk oleh pemilik sekolah. 3. Faktor pendukung pimpinan sekolah dalam meningkatkan mutu pendidikan adalah organisasi formal dan informal, gotong royong dan kekeluargaan, serta mutu pendidikan yang diumumkan oleh pemerintah. Sarana dan prasarana menjadi kendala peningkatan mutu pendidikan bagi pimpinan sekolah, namun lulusannya kurang kompetitif

Adverse Childhood Experiences in Patients Admitted with Depression at A Tertiary Care Hospital in Pakistan

Objective: To consider adverse childhood experiences in patients admitted to a tertiary care hospital in Pakistan with depressive disorder. Study Design: Comparative cross-sectional study. Place and Duration of Study: Fauji Foundation Hospital, Rawalpindi Pakistan from Sep 2018 to Aug 2020. Methodology: All the patients who were admitted to the psychiatry ward of the hospital after being diagnosed with depression were included in the study. Detailed history and mental state examination were carried out on all patients by a psychiatrist, and the adverse childhood experience questionnaire was administered. Results: Out of 400 patients admitted with a diagnosis of depressive episode in the hospital during the study period, 59(14.75%) were males, and 341(85.25%) were females. The mean age of the study participants was 39.49±8.926 years. 153(38.25%) did not have significant adverse childhood experiences, while 247(61.75%) had significant adverse childhood experiences. The severity of depressive episodes and substance use had a statistically significant relationship with the presence of significant adverse childhood experiences in our study participants (p-value<0.001). Conclusion: The presence of significant adverse childhood experiences was alarmingly high in patients admitted with a depressive episode in our study. These experiences were associated with the more severe forms of depressive illness and comorbid illicit substance use

Idiopathic encapsulating peritonitis revealed by an acute bowel occlusion in a young patient

La péritonite encapsulante est une péritonite chronique aboutissant à une membrane fibreuse épaisse, blanc nacré. C’est une affection rare dont la physiopathologie reste mal expliquée et le diagnostic est souvent porté en peropératoire ; elle peut être la cause d’une urgence chirurgicale, le caractère idiopathique est exceptionnel, retrouvé chez l’adolescent provenant des régions tropicales et subtropicales, jamais dans le Maghreb. Nous rapportons l’observation d’une jeune patiente marocaine de 18 ans, opérée pour une occlusion intestinale, chez qui le diagnostic d’une péritonite encapsulante a été posé en peropératoire.Encapsulating peritonitis is a chronic peritonitis leading to the constitution of a thick pearly-white fibrosis membrane. It is a rare affection, which physiopathology is poorly elucidated. Diagnosis is usually assessed during surgery; the idiopathic character is exceptional, occurring in teenagers coming from the tropical and subtropical countries, never in Maghreb. We report an unpublished case of an 18-year-old patient, admitted for bowel obstruction; diagnosis was made during surgery revealing an encapsulating peritonitis

Verneuil’s disease: case report (107 patients)

La maladie de Verneuil est une suppuration chronique fistulisante, sclérosante d’évolution cicatricielle. Son diagnostic est souvent méconnu et confondu avec une autre pathologie suppurative. Cette affection est caractérisée par une évolution longue, un traitement essentiellement chirurgical souvent en plusieurs temps avec un délai de cicatrisation long. C’est une maladie très invalidante au plan social et familial, pouvant entraîner un handicap réel pour le patient. À travers l’analyse de 107 observations de la maladie de Verneuil, nous avons étudié les caractéristiques épidémiologiques et cliniques de cette pathologie.Verneuil's disease is a chronic suppuration fistulizing, sclerosing and scarring. Its diagnosis is often misunderstood and therefore wrongly taken for another fistulizing disease. Verneuil's disease is characterized by its long evolution; treatment is mainly surgical sometimes requiring several operations, and a long healing time. This very invalidating disease may cause real handicap for the patient along with a familial and social impact. Through the analysis of 107 cases of Verneuil's disease, we studied the epidemiological and clinical characteristics of this disease

Do Islamic indices provide diversification to bitcoin? A time-varying copulas and value at risk application

This is an accepted manuscript of an article published by Elsevier in Pacific-Basin Finance Journal on 08/04/2020, available online: https://doi.org/10.1016/j.pacfin.2020.101326 The accepted version of the publication may differ from the final published version.© 2020 The emergence of new asset classes offers avenues to international investment community however understanding relationship between any two assets in a single portfolio is important. We investigate the risk dependence between daily Bitcoin and major Islamic equity markets spanning over from July 2010 to March 2018. We start by examining long memory properties of Bitcoin and sampled Islamic indices and report significant results. The residuals from fractionally integrated models are then used in bivariate time invariant and time varying copulas to investigate dependence structure. Among all Islamic indices, DJIUK, DJIJP and DJICA exhibit time varying dependence with Bitcoin. In addition, we apply VaR, CoVaR and ΔCoVaR as risk measure to examine spillover between Bitcoin and Islamic equity markets. VaR of Bitcoin exceeds from VaR of Islamic indices and CoVaR of both Islamic and Bitcoin exceeds their respective VaR, suggesting presence of risk spillover between each other. Our results also report asymmetry between downside and upside ΔCoVaR suggesting implications for investors with different risk preferences. Finally, the diversification benefits indicate that Islamic equity market serves as an effective hedge in a portfolio along with Bitcoin.Accepted versio

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

The Impact of a 6-Month Mission to the International Space Station (ISS) on Salivary Antimicrobial Proteins and Latent Viral Reactivation: Exercise Training as a Potential Countermeasure

As the international space community plans for manned missions to Mars, spaceflight associated immune dysregulation has been identified as a potential risk to the health and safety of the crew. Spaceflight has consistently been shown to dysregulate the normal functioning of the immune system including; latent viral reactivation, altered cytokine profiles, reduction in T-cell and NK-cell function. However, less is known about salivary antimicrobial proteins (sAMPs)- which act as a first line of innate immune defense against multiple pathogens. This dissertation sought to determine the effects of spaceflight on salivary markers of innate immunity and latent herpes virus reactivation. Additionally, suitable countermeasures are necessary to mitigate the space flight induced immune dysregulation. As moderate intensity exercise has consistently been shown to exert positive effects on the immune system, we determined whether pre-flight physical fitness, or its maintenance reduced the risk of viral reactivations. The aims of this dissertation were divided into three hypotheses: 1) Astronaut’s salivary immunity will be diminished during and immediately after spaceflight and they will encounter more latent viral reactivations than their ground based controls; 2a) Astronauts with higher fitness status will exhibit fewer incidences of viral reactivation compared to their lower fit counterparts; 2b) Astronauts who better maintain their fitness levels in flight will exhibit fewer incidences of viral reactivation compared to those who show greater physical fitness decline. To test Hypothesis 1 we collected saliva samples from 8 international space station (ISS) crewmembers and 7-ground-based controls pre-flight, mid-flight and post-flight. We measured several sAMPs by ELISA as well as detected shedding of cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus type 1 (HSV-1) and varicella zoster virus (VZV) DNA by RT-PCR. We found that salivary sIgA, lysozyme, LL-37, and the cortisol to DHEA ratio were elevated in the ISS crew before and during the mission. ‘Rookie’ crewmembers embarking on their first spaceflight mission had depressed levels of salivary sIgA but increased levels of α- amylase, lysozyme and LL-37 during and after the mission compared to the ‘veteran’ crew who had flown on a previous spaceflight mission. Crewmembers who shed a latent herpes virus during the mission had higher cortisol levels compared to those who did not shed. All salivary biomarkers remained unchanged in the ground-based controls. To test Hypothesis 2, we retrospectively analyzed scores on standardized tests of strength, muscular endurance, flexibility and aerobic fitness (V ̇O2Max) in 22 ISS crewmembers before launch and after a ~6-month mission. The incidences and severity of CMV, EBV and VZV were also determined. We found that crewmembers with higher levels of aerobic fitness [American College of Sports Medicine (ACSM) classification of ‘superior’ or ‘excellent’] prior to the mission had a 31% reduced risk of latent viral reactivation compared to their lower ranked counterparts. We also found that higher levels of pre-flight upper body muscular endurance was associated with a 39% lower risk of latent viral reactivation. Crewmembers who better maintained V ̇O2Max scores after returning from the ISS tended to have a lower incidence of a viral reactivation. All crewmembers in the lower pre-flight aerobic fitness category who also demonstrated higher losses in V ̇O2Max reactivated all latent viruses. From the results of this dissertation, we conclude that long duration spaceflight alters the concentration and/or secretion of several sAMPs, some of which are related to crewmember flight experience, biomarkers of stress and latent viral reactivation. Additionally, we found that a pre-flight V ̇O2max score above the 80th percentile for age and sex, maintaining aerobic capacity during flight, and/or having above average scores of upper-body muscular endurance, may protect against latent viral reactivation during long duration space travel.Health and Human Performance, Department o

Impact of parenting styles on psychological flexibility among adolescents of Pakistan

The parenting styles and psychological flexibility have been significant variables; however, little empirical work has addressed the impact of parenting in terms of the expansion of psychological flexibility. The present study investigated the impact of different parenting styles as a predictor of psychological flexibility in the adolescent population. A total sample of 100 adolescents (50 boys and 50 girls) whose ages ranged between 12 and 18 years without any previous psychiatric and medical history were recruited from different educational institutes of Pakistan. Results revealed that parenting styles are positively associated with psychological flexibility ($\it r$ = 0.75, $\it p$ < 0.05). Moreover, parenting styles significantly predict psychological flexibility among adolescents ($\it p$ < 0.05). However, no gender differences were found across both variables among adolescents. These findings have highlighted the significance of parenting styles and psychological flexibility with respect to the mental health of adolescents

Medication safety: analysis the use of drug alerts after conversion to a commercial electronic health record

BACKGROUND AND OBJECTIVE: Interruptive clinical decision support (CDS) integrated to computerized prescriber order entry can alert physicians about potential risks and suggest suitable alternatives. Physicians bypass most of them, limiting their effectiveness. The study assesses the effects of conversion to a commercial electronic health record (EHR) (Epic®) on the use of drug alerts. [...

Clinical decision support systems to optimize prescription in hospitalized older patients

BACKGROUND AND OBJECTIVE: Inappropriate prescriptions (IP) are common among hospitalized older adults. Reducing IP is a major and global challenge. Incorporating clinical decision support systems (CDSS) into electronical medical records across hospitals might be a good strategy to optimize prescription in hospitalized older patients. The aim of this study is to develop, implement and assess a CDSS based on STOPP/START (Screening Tool of Older People’s Prescription/Screening Tool to Alert to Right Treatment) Version 2 in order to reduce the number of potentially inappropriate prescriptions (PIP) among older patients. [...