Developing A Cultural Intelligence Instrument for Guidance and Counseling Teachers

Abstract. The study aimed to produce a self-report instrument using a cultural intelligence scale for Guidance and Counseling teachers. It employed Research and Development design adopting the model of Adam and Wieman (2011). Operationally, the development of the instrument was divided into five stages, 1) determining the question format; 2) determining the question construction; 3) determining the guidance of assessment, expert judgment, and revision of the question; 4) expert judgment by the experts of culture and instrument development; and 5) analyzing instrument using the Rasch model. Data analysis showed that in the development of cultural intelligence instrument: 1) the instrument construct was correctly determined, and it could measure one variable of Guidance and Counseling teachers' cultural understanding; 2) there were five items of cultural intelligence instrument categorized as very difficult and five items were in the very easy category; 3) all items of cultural intelligence instrument of Guidance and Counseling teachers were fit, meaning that it functioned normal, could be understood by the Guidance and Counseling teachers, and can measure what it should measure; and 4) The Cronbach Alpha was 0,96, indicating that the instrument was in the Very Good category with the Person Reliability of 0,92 and Item Reliability of 0,99. Therefore, based on the Rasch model analysis, the cultural intelligence instrument of Guidance and Counseling teachers, which was developed, had fulfilled the set standard and Good criteria, and it could be used to collect data about the cultural intelligence of Guidance and Counseling teachers

MEMBANGUN PERILAKU HIDUP SEHAT DAN BERSIH BAGI SISWA/I PAUD DI LANGSA KOTA MELALUI PENYEDIAAN WASTAFEL PORTABEL CUCI TANGAN

This community service aims to educate early childhood in a healthy and clean lifestyle. The lack of health facilities at the Early Childhood Education/ PAUD level during the COVID-19 pandemic has an impact on the continuity of the teaching and learning process. This program is implemented for 4 months. The target of this program is 4 PAUDs located in Langsa Kota sub-district, namely PAUD Nadya Rabila, PAUD Az-Zikra, PAUD Syakirah and PAUD My Baby School. The main problem faced by the target group is the lack of knowledge in making environmentally friendly portable sinks and the absence of preventive action for children by education providers on early health education for children. The method used in this activity was participatory active discussion and participants through adult learning. Activities carried out include: coordination of activities, provision of tools and materials, assembling a portable sink starting from the stage of determining the design, size and capacity, testing portable sinks, handing over portable sinks to partners and monitoring and evaluating activities with target partners. The results of the activity show that the portable sinks distributed to partners have been used as well as possible in accordance with health protocols and were able to build healthy and clean living habits for PAUD students through the use of portable hand washing sinks.Pengabdian kepada masyarakat ini bertujuan untuk mengedukasi anak usia dini dalam perilaku hidup sehat dan bersih. Kurangnya fasilitas kesehatan pada tingkat Pendidikan Anak Usia Dini (PAUD) selama pandemi COVID-19 berdampak terhadap kelangsungan proses belajar mengajar. Program ini dilaksanakan selama 4 bulan. Sasaran program ini adalah 4  PAUD yang terletak di kecamatan Langsa Kota yakni PAUD Nadya Rabila, PAUD Az-Zikra, PAUD Syakirah dan PAUD My Baby School. Permasalahan utama yang dihadapi oleh kelompok sasaran  adalah lemahnya pengetahuan dalam pembuatan wastafel portabel ramah lingkungan serta  belum adanya tindakan preventif bagi anak-anak oleh pihak penyelenggara pendidikan terhadap edukasi kesehatan dini bagi anak-anak. Metode yang digunakan dalam kegiatan ini adalah diskusi dan partisipatif aktif peserta melalui pembelajaran orang dewasa. Kegiatan yang dilaksanakan meliputi: koordinasi kegiatan, penyediaan alat dan bahan, perakitan wastafel portabel mulai dari tahap penentuan desain, ukuran dan kapasitas, Ujicoba wastafel portabel, Serah terima wastafel portabel kepada mitra serta monitoring dan evaluasi kegiatan bersama mitra sasaran. Hasil kegiatan memperlihatkan bahwa wastafel portabel yang didistribusikan kepada mitra telah dipergunakan sebaik mungkin sesuai dengan protokol kesehatan dan mampu membangun perilaku hidup sehat dan bersih bagi siswa/i PAUD melalui pemanfaatan wastafel portabel cuci tangan

Potential role of differential medication use in explaining excess risk of cardiovascular events and death associated with chronic kidney disease: A cohort study

<p>Abstract</p> <p>Background</p> <p>Patients with chronic kidney disease (CKD) are less likely to receive cardiovascular medications. It is unclear whether differential cardiovascular drug use explains, in part, the excess risk of cardiovascular events and death in patients with CKD and coronary heart disease (CHD).</p> <p>Methods</p> <p>The ADVANCE Study enrolled patients with new onset CHD (2001-2003) who did (N = 159) or did not have (N = 1088) CKD at entry. The MDRD equation was used to estimate glomerular filtration rate (eGFR) using calibrated serum creatinine measurements. Patient characteristics, medication use, cardiovascular events and death were ascertained from self-report and health plan electronic databases through December 2008.</p> <p>Results</p> <p>Post-CHD event ACE inhibitor use was lower (medication possession ratio 0.50 vs. 0.58, P = 0.03) and calcium channel blocker use higher (0.47 vs. 0.38, P = 0.06) in CKD vs. non-CKD patients, respectively. Incidence of cardiovascular events and death was higher in CKD vs. non-CKD patients (13.9 vs. 11.5 per 100 person-years, P < 0.001, respectively). After adjustment for patient characteristics, the rate of cardiovascular events and death was increased for eGFR 45-59 ml/min/1.73 m²(hazard ratio [HR] 1.47, 95% CI: 1.10 to 2.02) and eGFR < 45 ml/min/1.73 m²(HR 1.58, 95% CI: 1.00 to 2.50). After further adjustment for statins, β-blocker, calcium channel blocker, ACE inhibitor/ARB use, the association was no longer significant for eGFR 45-59 ml/min/1.73 m²(HR 0.82, 95% CI: 0.25 to 2.66) or for eGFR < 45 ml/min/1.73 m²(HR 1.19, 95% CI: 0.25 to 5.58).</p> <p>Conclusions</p> <p>In adults with CHD, differential use of cardiovascular medications may contribute to the higher risk of cardiovascular events and death in patients with CKD.</p

Western Indian Ocean marine and terrestrial records of climate variability: a review and new concepts on land-ocean interactions since AD 1660

We examine the relationship between three tropical and two subtropical western Indian Ocean coral oxygen isotope time series to surface air temperatures (SAT) and rainfall over India, tropical East Africa and southeast Africa. We review established relationships, provide new concepts with regard to distinct rainfall seasons, and mean annual temperatures. Tropical corals are coherent with SAT over western India and East Africa at interannual and multidecadal periodicities. The subtropical corals correlate with Southeast African SAT at periodicities of 16–30 years. The relationship between the coral records and land rainfall is more complex. Running correlations suggest varying strength of interannual teleconnections between the tropical coral oxygen isotope records and rainfall over equatorial East Africa. The relationship with rainfall over India changed in the 1970s. The subtropical oxygen isotope records are coherent with South African rainfall at interdecadal periodicities. Paleoclimatological reconstructions of land rainfall and SAT reveal that the inferred relationships generally hold during the last 350 years. Thus, the Indian Ocean corals prove invaluable for investigating land–ocean interactions during past centuries

The burden and risk factors of Sexually Transmitted Infections and Reproductive Tract Infections among pregnant women in Zimbabwe

<p>Abstract</p> <p>Background</p> <p>Sexually transmitted infections (STIs) and Reproductive tract infections (RTIs) are responsible for high morbidity among women. We aim to quantify the magnitude of the burden and risk factors of STI/RTI s among pregnant women in Zimbabwe.</p> <p>Methods</p> <p>A cross sectional study of pregnant women enrolled at 36 weeks of gestation from the national PMTCT program. Study was conducted from three peri-urban clinics around Harare Zimbabwe offering maternal and child health services.</p> <p>Results</p> <p>A total of 691 pregnant women were enrolled. Prevalence of HSV was (51.1%), HIV (25.6%) syphilis (1.2%), <it>Trichomonas vaginalis </it>(11.8%), bacterial vaginosis (32.6%) and Candidiasis (39.9%). Seven percent of the women had genital warts, 3% had genital ulcers and 28% had an abnormal vaginal discharge. Prevalence of serological STIs and vaginal infections were 51% and 64% respectively.</p> <p>Risk factors for a positive serologic STI were increasing age above 30 years, polygamy and multigravid; adjusted OR (95% CI) 2.61(1.49-4.59), 2.16(1.06-4.39), 3.89(1.27-11.98) respectively, partner taking alcohol and number of lifetime sexual partners. For vaginal infections it was age at sexual debut; OR (95% CI) 1.60(1.06-2.42). More than 25% of the women reported previous STI treatment. Fifty two percent reported ever use of condoms and 65% were on oral contraceptives. Mean age gap for sexual partners was 6.3 years older.</p> <p>Conclusions</p> <p>There is a high morbidity of STI/RTIs in this cohort. There is need to continuously screen, counsel, treat and monitor trends of STI/RTIs to assess if behaviour changes lead to reduction in infections and their sustainability.</p

A recipe for simulating the interannual variability of the Asian summer monsoon and its relation with ENSO

Author Posting. © The Authors, 2006. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in Climate Dynamics 28 (2007): 441-460, doi: 10.1007/s00382-006-0190-0.This study investigates how accurately the interannual variability over the Indian Ocean basin and the relationship between the Indian summer monsoon and the El Nino Southern Oscillation (ENSO) can be simulated by different modelling strategies. With a hierarchy of models, from an atmospherical general circulation model (AGCM) forced by observed SST, to a coupled model with the ocean component limited to the tropical Pacific and Indian Oceans, the role of heat fluxes and of interactive coupling is analyzed. Whenever sea surface temperature anomalies in the Indian basin are created by the coupled model, the inverse relationship between the ENSO index and the Indian summer monsoon rainfall is recovered, and it is preserved if the atmospherical model is forced by the SSTs created by the coupled model. If the ocean model domain is limited to the Indian Ocean, changes in the Walker circulation over the Pacific during El Nino years induce a decrease of rainfall over the Indian subcontinent. However the observed correlation between the ENSO and the Indian Ocean Zonal Mode (IOZM) is not properly modelled and the two indices are not significantly correlated, independently on season. Whenever the ocean domain extends to the Pacific, and ENSO can impact both the atmospheric circulation and the ocean subsurface in the equatorial Eastern Indian Ocean, modelled precipitation patterns associated both to ENSO and to the IOZM closely resemble the observations.The experiments described were performed as a contribution to the ENSEMBLES project funded by the European Commission’s 6th Framework Programme, contract number GOCE-CT-2003-505539

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation

Absence of VHL gene alteration and high VEGF expression are associated with tumour aggressiveness and poor survival of renal-cell carcinoma

International audienceBACKGROUND: The von Hippel-Lindau gene (VHL) alteration, a common event in sporadic clear-cell renal-cell carcinoma (CCRCC), leads to highly vascularised tumours. Vascular endothelial growth factor (VEGF) is the major factor involved in angiogenesis, but the prognostic significance of both VHL inactivation and VEGF expression remain controversial. The aims of this study were to analyse the relationship between VHL genetic and epigenetic alterations, VHL expression and VEGF tumour or plasma expression, and to analyse their respective prognostic value in patients with CCRCC. METHODS: A total of 102 patients with CCRCC were prospectively analysed. Alterations in VHL were determined by sequencing, Multiplex Ligation-dependent Probe Amplification (MLPA) and methylation-specific MLPA. Expression of pVHL and VEGF was determined by immunohistochemistry. Plasma VEGF was measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: VHL mutation, deletion and promoter methylation were identified in 70, 76 and 14 cases, respectively. Overall, at least one VHL-gene alteration occurred in 91 cases (89.2%). Both VEGF tumour and plasma expression appeared to be decreased in case of VHL alteration. Median progression-free survival and CCRCC-specific survival were significantly reduced in patients with wild-type VHL or altered VHL and high VEGF expression, which, therefore, represent two markers of tumour aggressiveness in CCRCC. CONCLUSION: Stratifying CCRCCs according to VHL and VEGF status may help tailor therapeutic strategy

Usefulness of molecular biology performed with formaldehyde-fixed paraffin embedded tissue for the diagnosis of combined pulmonary invasive mucormycosis and aspergillosis in an immunocompromised patient

Immunocompromised patients who develop invasive filamentous mycotic infections can be efficiently treated if rapid identification of the causative fungus is obtained. We report a case of fatal necrotic pneumonia caused by combined pulmonary invasive mucormycosis and aspergillosis in a 66 year-old renal transplant recipient. Aspergillus was first identified during the course of the disease by cytological examination and culture (A. fumigatus) of bronchoalveolar fluid. Hyphae of Mucorales (Rhizopus microsporus) were subsequently identified by culture of a tissue specimen taken from the left inferior pulmonary lobe, which was surgically resected two days before the patient died. Histological analysis of the lung parenchyma showed the association of two different filamentous mycoses for which the morphological features were evocative of aspergillosis and mucormycosis. However, the definitive identification of the associative infection was made by polymerase chain reaction (PCR) performed on deparaffinized tissue sections using specific primers for aspergillosis and mucormycosis. This case demonstrates that discrepancies between histological, cytological and mycological analyses can occur in cases of combined mycotic infection. In this regard, it shows that PCR on selected paraffin blocks is a very powerful method for making or confirming the association of different filamentous mycoses and that this method should be made available to pathology laboratories