EFEKTIFITAS PENDEKATAN PEMBELAJARAN KONTEKSTUAL DAN PEMECAHAN MASALAH DITINJAU DARI KONSEP DIRI SISWA PADA PELAJARAN MATEMATIKA KELAS VIII SMP NEGERI DI KABUPATEN SRAGEN TAHUN PELAJARAN 2011/2012

 Abstrak Penelitian ini bertujuan untuk mengetahui: (1). Manakah yang memberikan prestasi belajar matematika siswa yang lebih baik, pendekatan pembelajaran Kontekstual, Pemecahan Masalah atau Pembelajaran Langsung. (2). Manakah yang memberikan prestasi belajar matematika siswa yang lebih baik, siswa dengan konsep diri tinggi, sedang atau rendah. (3). Apakah  pada masing-masing konsep diri siswa (tinggi, sedang dan rendah) pendekatan pembelajaran Kontekstual lebih baik dibanding Pemecahan Masalah dan Pembelajaran Langsung, dan Pemecahan Masalah lebih baik dibanding Pembelajaran Langsung. (4). Apakah pada masing-masing pendekatan pembelajaran (Kontekstual, Pemecahan Masalah dan Pembelajaran Langsung) pada siswa dengan konsep diri tinggi lebih baik dibanding dengan konsep diri sedang dan rendah serta apakah siswa dengan konsep diri sedang lebih baik dibanding dengan konsep diri rendah.Penelitian ini merupakan penelitian eksperimen semu dengan desain faktorial 3x3. Populasi dari penelitian ini adalah siswa kelas VIII SMP Negeri di Kabupaten Sragen semester genap tahun pelajaran 2011/2012. Pengambilan sampel dilakukan dengan cara stratified cluster random sampling dengan sampel penelitian adalah siswa-siswi SMP Negeri 2 Sragen, SMP Negeri 1 Karangmalang, dan SMP Negeri 2 Karangmalang masing-masing terdiri dari tiga kelas, satu kelas sebagai kelas Pembelajaran Kontekstual, satu kelas sebagai kelas Pembelajaran Pemecahan Masalah dan satu kelas sebagai kelas Pembelajaran Langsung. Banyak anggota sampel seluruhnya adalah 265 siswa. Uji instrumen yang digunakan adalah uji validitas, reliabelitas, daya beda dan tingkat kesukaran. Uji normalitas menggunakan Lilliefors, uji homogenitas dengan uji Bartlett dan uji keseimbangan menggunakan uji-F. Uji hipotesis menggunakan uji anava dua jalan dengan sel tak sama.Berdasarkan hasil pengujian hipotesis dalam penelitian ini dapat disimpulkan. (1). Pendekatan pembelajaran kontekstual memberikan prestasi belajar lebih baik daripada pembelajaran pemecahan masalah dan pembelajaran langsung, dan pembelajaran pemecahan masalah memberikan prestasi belajar lebih baik daripada pembelajaran langsung. (2). Siswa yang memiliki konsep diri tinggi mempunyai prestasi belajar lebih baik daripada siswa yang memiliki konsep diri sedang dan rendah, dan siswa dengan konsep diri sedang memberikan prestasi belajar lebih baik daripada siswa dengan konsep diri rendah. (3a). Pada siswa dengan konsep diri tinggi, pembelajaran pemecahan masalah memberikan prestasi belajar lebih baik daripada pembelajaran langsung. Sedangkan pendekatan pembelajaran kontekstual sama baiknya dengan pembelajaran pemecahan masalah dan pembelajaran langsung. (3b). Pada siswa dengan konsep diri sedang, pembelajaran kontekstual memberikan prestasi belajar lebih baik daripada pembelajaran langsung. Sedangkan pendekatan pembelajaran pemecahan masalah sama baiknya dengan pembelajaran kontekstual dan pembelajaran langsung. (3c). Pada siswa dengan konsep diri rendah, pendekatan pembelajaran kontekstual memberikan prestasi belajar lebih baik daripada pembelajaran pemecahan masalah. Sedangkan pendekatan pembelajaran pemecahan masalah dan kontekstual sama baiknya dengan pembelajaran langsung. (4a). Pada pendekatan pembelajaran kontekstual, semua siswa dengan beragam konsep diri memiliki prestasi belajar yang sama. (4b). Pada pendekatan pembelajaran pemecahan masalah, siswa dengan konsep diri tinggi memiliki prestasi belajar lebih baik daripada siswa dengan konsep diri sedang dan siswa dengan konsep diri tinggi memiliki prestasi belajar lebih baik daripada konsep diri rendah, dan siswa dengan konsep diri sedang akan lebih baik daripada siswa dengan konsep diri rendah. (4c). Pada pendekatan pembelajaran langsung, semua siswa dengan beragam konsep diri memiliki prestasi yang sama. Kata kunci :     Pendekatan Pembelajaran Matematika, Kontekstual, Pemecahan Masalah, Pembelajaran Langsung, Prestasi Belajar, Konsep Diri

Sexual dysfunction and associated factors among exclusively breastfeeding Malaysian women

Introduction: Sexual dysfunction is prevalent among postpartum women. It has been attributed to multifactorial cause. This study aims to assess sexual dysfunction and its associated factors among exclusively breastfeeding postpartum women. Methods: Exclusively breastfeeding women who had given birth during the previous 6 months were invited to participate in this study. A questionnaire included a background section and Malay version of the Female Sexual Function Index (MVFSFI) was used. Responses from 197 women were analyzed. Results: More than a third of women (37.6%) reported that they had experienced sexual dysfunction during the first 6 months of exclusively breastfeeding. The most prevalent types of sexual dysfunction reported by affected women are lubrication disorder (53.3%), pain disorder (49.7%) and desire disorder (41.1%). We found no correlation between female sexual dysfunction with age, parity, mode of delivery and duration of breastfeeding among exclusively breastfeeding women. Conclusions: This study found that the prevalence of female sexual dysfunction is moderate among exclusively breastfeeding women. Sexual satisfaction should be encouraged to be discussed during postnatal visits by women and healthcare provider

College of Radiology, Academy of Medicine of Malaysia position on whole body screening CT scans in healthy asymptomatic individuals (2008)

To date, the College of Radiology (CoR) does not see any clear benefit in performing whole body screening computed tomography (CT) examinations in healthy asymptomatic individuals. There are radiation risk issues in CT and principles of screening should be adhered to. There may be a role for targeted cardiac screening CT that derives calcium score, especially for asymptomatic medium-risk individuals and CT colonography when used as part of a strategic programme for colorectal cancer screening in those 50 years and older. However, population based screening CT examinations may become appropriate when evidence emerges regarding a clear benefit for the patient outweighing the associated radiation risks

Microarray analysis revealed different gene expression patterns in HepG2 cells treated with low and high concentrations of the extracts of Anacardium occidentale shoots

In this study, the effects of low and high concentrations of the Anacardium occidentale shoot extracts on gene expression in liver HepG2 cells were investigated. From MTT assays, the concentration of the shoot extracts that maintained 50% cell viability (IC50) was 1.7 mg/ml. Cell viability was kept above 90% at both 0.4 mg/ml and 0.6 mg/ml of the extracts. The three concentrations were subsequently used for the gene expression analysis using Affymetrix Human Genome 1.0 S.T arrays. The microarray data were validated using real-time qRT–PCR. A total of 246, 696 and 4503 genes were significantly regulated (P < 0.01) by at least 1.5-fold in response to 0.4, 0.6 and 1.7 mg/ml of the extracts, respectively. Mutually regulated genes in response to the three concentrations included CDKN3, LOC100289612, DHFR, VRK1, CDC6, AURKB and GABRE. Genes like CYP24A1, BRCA1, AURKA, CDC2, CDK2, CDK4 and INSR were significantly regulated at 0.6 mg/ml and 1.7 mg but not at 0.4 mg/ml. However, the expression of genes including LGR5, IGFBP3, RB1, IDE, LDLR, MTTP, APOB, MTIX, SOD2 and SOD3 were exclusively regulated at the IC50 concentration. In conclusion, low concentrations of the extracts were able to significantly regulate a sizable number of genes. The type of genes that were expressed was highly dependent on the concentration of the extracts used

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children &lt;18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p&lt;0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p&lt;0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p&lt;0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Mendidik dengan cerita

Mendongeng atau bercerita adalah salah satu keterampilan yang sangat imajinatif dan komunikatif bagi anak sebagai pendengar dan pendongeng itu sendiri. Di dalam nya terdapat muatan-muatan mendidik yang tersirat dan tidak menggurui. Anak pun bisa mencerna sesuai perkembangan jiwanya dan membuatnya sangat peka terhadap cerita yang dibawakan. rnNamun, kini budaya mendongeng atau bercerita yang dulu menjadi pengantar tidur anak, telah mengalami degradasi yang cukup mengkhawatirkan. Kini, istilah mendongeng ini sudah menjadi sesuatu yang sangat asing dan tidak menarik lagi bagi seorang anak. Mereka tidak membutuhkan lagi peninabobo yang mengantar tidur mereka, karena sang anak telah menemukan pengganti baru, seperti play station, VCD player dan sebagainya. Mengapa demikian? Apa yang menyebabkan terjadi hal seperti itu?rnBuku ini menawarkan solusi jitu dan menghadapi permasalahan ini. Penulis memberikan 'kisi-kisi' agar sebuah cerita bisa diminati atau Lewat cerita yang bermuatan petuah-petuah agar anak sangatlah besar peranannya. Dengan demikian, diharapkan budaya mendongeng yang memiliki banyak nilai positif ini bisa membudaya kembali.xiii, 205 hlm.: ilus.; 21 cm