Farmacoeconomía: análisis de una perspectiva innovadora en la práctica clínica de la enfermería

O objetivo desse artigo é abordar conceitos e métodos de avaliação farmacoeconômica, analisar e discutir as limitações e perspectivas do uso da farmacoeconomia. Trata-se de um estudo analítico e reflexivo cujo objeto é a aplicabilidade da farmacoeconomia no âmbito da enfermagem. No contexto atual, esta disciplina vem se tornando instrumento essencial, viabilizando tomada de decisões fundamentadas em desfechos e custos. Todavia, o seu uso exige conhecimento atualizado acerca da terminologia e da metodologia das análises, no intuito de assegurar a aplicação e a interpretação correta dos resultados. O grande desafio das enfermeiras é aplicar os instrumentos da farmacoeconomia às questões cotidianas da prática clínica e superar as dificuldades metodológicas relativas à identificação, cálculo e comparação dos custos e desfechos.The objective of this study is to outline the concepts, evaluation methods, limitations, and perspectives of the use of pharmacoeconomics within the nursing environment. It is an analytical and reflective study. The object of this study is the applicability of pharmacoeconomics in nursing. In the current context, this discipline has become an essential instrument, making decision-making based on outcomes and costs possible. However, its use demands up-to-date knowledge concerning the terminology and methodology of analyses, with the intent to assure its correct application and interpretation of the results. The great challenge for nurses is to apply pharmacoeconomic instruments to day-to-day questions of clinical practice, as well as overcome the methodological difficulties related to the identification, calculation, and comparison of the outcomes and costs.El objetivo de este articulo es el de abordar conceptos, métodos de evaluación farmacoeconómica y discutir las limitaciones y perspectivas del uso de la farmacoeconomía, en el ámbito de la enfermería. En el contexto actual, esta disciplina se convierte en un instrumento esencial, viabilizando la toma de decisiones fundamentadas en soluciones y costes. Su uso exige conocimiento actualizado acerca de la terminología y de la metodología de los análisis, con el objetivo de garantizar la aplicación y la interpretación correcta de los resultados. El gran desafío de las enfermeras está en la aplicación de los instrumentos de la farmacoeconomía a las cuestiones cotidianas de la práctica clínica, y superar las dificultades metodológicas relativas a la identificación, cálculo y comparación de los costes y efectos

Analisis Kemampuan Berpikir Tingkat Tinggi Peserta Didik dalam Menyelesaikan Soal Suhu dan Kalor

Mendeskripsikan profil kemampuan berpikir tingkat tinggi peserta didik dalam menyelesaikan soal suhu dan kalor berdasarkan aspek kemandirian belajar (rendah, sedang, dan tinggi) merupakan tujuan dari penelitian ini. Jenis penelitian ini yaitu penelitian survei tanpa kelompok pembanding. Pengumpulan data dilakukan dengan memberikan angket kemandirian belajar dan tes kemampuan berpikir tingkat tinggi kepada 126 peserta didik kelas XI MIA di SMA Negeri 1 Sungai Raya. Hasil penelitian ini menunjukkan bahwa kemampuan berpikir tingkat tinggi peserta didik dalam menyelesaikan soal suhu dan kalor tergolong rendah dengan rata-rata 34,08. Profil kemampuan berpikir tinggi peserta didik pada level menganalisis (C4), mengevaluasi (C5), mencipta (C6) berturut-turut  33,6%, 34,0%, 34,4% dari skor ideal. Uji One-Way ANOVA menunjukkan ada perbedaan kemampuan berpikir tingkat tinggi peserta didik antara kelompok kemandirian belajar rendah, sedang, dan tinggi karena nilai Fhitung > Ftabel (9,98 > 3,07). Kesimpulan penelitian ini yaitu kemandirian belajar yang dimiliki peserta didik berpengaruh positif terhadap kemampuan berpikir tingkat tinggi. Kata Kunci:Kemampuan Berpikir Tingkat Tinggi; Suhu dan Kalor; Kemandirian Belajar Analysis of Student’s Higher Order Thinking Ability in Solving Temperature and Heat ProblemsABSTRACTTo describe the higher-order thinking ability profile of students in solving temperature and heat problems based on aspects of learning independence (low, medium, and high) was the aim of this study. This research was survey research without a comparison group. The data was collected through a learning independence questionnaire and a higher-order thinking ability test on 126 students of class XI MIA at SMA Negeri 1 Sungai Raya. The results of this study indicated that the higher-order thinking ability of students in solving temperature and heat problems was low with an average of 34.08. The higher-order thinking ability profile of students at the level of analyzing (C4), evaluating (C5), and creating (C6) were respectively 33.6%, 34.0%, 34.4% from the ideal score. The One-Way ANOVA test showed that there was a difference in the higher-order thinking ability profile of students in the low learning independence group, the medium learning independence group, and the high learning independence groups because the value of Fvalue > Fdistribution (9.98 > 3.07). It was concluded that the learning independence of students had a positive effect on higher order thinking ability

REMEDIASI MISKONSEPSI SISWA TENTANG USAHA MENGGUNAKAN PENDEKATAN KONSEPTUAL INTERAKTIF BERBANTUAN REFUTATION TEXT DI SMA

Abstract: The aim of the research was to knowed effectiveness about the application of Interactive conceptual intruction assisted refutation text to remedial student misconceptions on work in SMA Negeri 1 Semparuk Grade XII. The method of the research was experimental with one group pretest-posttest design which is 28 students participated. The results of data analysis showed that student misconception reduction after remediation was as much as 31,79 %. Interactive conceptual intruction assisted refutation text  effective to remedial student misconception on heat transfer with effect size Es = 2,48 (categorized was high). This research is expected to be used as an alternative remediation activities for students to be able overcome the misconceptions that experienced by students. Keywords: Remediation, Misconception, Interactive Conceptual Instruction, Refutation Text. Abstrak: Penelitian ini bertujuan untuk mengetahui efektivitas penerapan pendekatan konseptual interaktif berbantuan refutation text dalam meremediasi miskonsepsi siswa pada usaha di kelas XII SMA Negeri 1 Semparuk. Metode penelitian yang digunakan adalah ekperimen dengan rancangan One Group Pretest-Posttest Design dengan sampel penelitian berjumlah 28 siswa. Hasil analisis data menunjukkan bahwa terdapat penurunan miskonsepsi siswa setelah diberikan remediasi sebesar 31,79%. Pendekatan konseptual interaktif dengan bantuan refutation text efektif untuk meremediasi miskonsepsi siswa pada usaha dengan effect size Es = 2,48 (kategori tinggi). Penelitian ini diharapkan dapat digunakan sebagai alternatif kegiatan remediasi bagi siswa agar dapat mengatasi miskonsepsi yang dialami oleh siswa.   Kata kunci : Remediasi, Miskonsepsi, Pendekatan Konseptual Interaktif, Refutation Text

A combination intervention strategy to improve linkage to and retention in HIV care following diagnosis in Mozambique: A cluster-randomized study

Background: Concerning gaps in the HIV care continuum compromise individual and population health. We evaluated a combination intervention strategy (CIS) targeting prevalent barriers to timely linkage and sustained retention in HIV care in Mozambique. Methods and findings: In this cluster-randomized trial, 10 primary health facilities in the city of Maputo and Inhambane Province were randomly assigned to provide the CIS or the standard of care (SOC). The CIS included point-of-care CD4 testing at the time of diagnosis, accelerated ART initiation, and short message service (SMS) health messages and appointment reminders. A pre–post intervention 2-sample design was nested within the CIS arm to assess the effectiveness of CIS+, an enhanced version of the CIS that additionally included conditional non-cash financial incentives for linkage and retention. The primary outcome was a combined outcome of linkage to care within 1 month and retention at 12 months after diagnosis. From April 22, 2013, to June 30, 2015, we enrolled 2,004 out of 5,327 adults ≥18 years of age diagnosed with HIV in the voluntary counseling and testing clinics of participating health facilities: 744 (37%) in the CIS group, 493 (25%) in the CIS+ group, and 767 (38%) in the SOC group. Fifty-seven percent of the CIS group achieved the primary outcome versus 35% in the SOC group (relative risk [RR]CIS vs SOC = 1.58, 95% CI 1.05–2.39). Eighty-nine percent of the CIS group linked to care on the day of diagnosis versus 16% of the SOC group (RRCIS vs SOC = 9.13, 95% CI 1.65–50.40). There was no significant benefit of adding financial incentives to the CIS in terms of the combined outcome (55% of the CIS+ group achieved the primary outcome, RRCIS+ vs CIS = 0.96, 95% CI 0.81–1.16). Key limitations include the use of existing medical records to assess outcomes, the inability to isolate the effect of each component of the CIS, non-concurrent enrollment of the CIS+ group, and exclusion of many patients newly diagnosed with HIV. Conclusions: The CIS showed promise for making much needed gains in the HIV care continuum in our study, particularly in the critical first step of timely linkage to care following diagnosis

MENINGKATKAN HASIL BELAJAR SISWA PADA MATERI FISIKA MELALUI PEMBELAJARAN KONTEKSTUAN BERBANTUAN ANIMASI DI SMP

Abstrak: Penelitian ini bertujuan untuk meningkatkan hasil belajar siswa pada materi getaran dan gelombang melalui pembelajaran kontekstual berbantuan animasi yang dilaksanakan di SMP Negeri 14 pontianak di kelas VIII I dengan subjek penelitian 40 orang. Penelitian tindakan kelas dilaksanakan sebanyak dua siklus dengan indikator keberhasilan untuk setiap siklusnya minimal 70% dari siswa yang mengikuti tes  mencapai nilai ≥75 yang dilaksanakan setiap akhir siklus. Berdasarkan teknik pengumpulan data dilihat dari hasil tes siswa yang berbentuk essay dan lembar observasi saat proses pembelajaran. Hasil tes yang dilaksanakan disetiap akhir siklus diperoleh persentasi indikator keberhasilan pada siklus I sebesar 72,22%, sedangkan persentasi indikator keberhasilan siklus II sebesar 77,50%, maka terjadi peningkatan dari siklus I ke siklus II sebesar 5,28%. Berdasarkan hasil penelitian menunjukkan bahwa  pembelajaran kontekstual berbantuan animasi dapat meningkatkan hasil belajar siswa pada materi getaran dan gelombang. Pembelajaran kontekstual berbantuan animasi dapat menjadi alternatif untuk meningkatkan hasil belajar pada materi getaran dan gelombang. Kata Kunci : Hasil Belajar, Pembelajaran Kontekstual, Animasi. Abstract: This aims research to improve student results learning outcomes in material vibration and waves through contextual learning assisted animation implemented at SMP 14 Pontianak class VIII I with  research 40 subjects students. This classroom action research conducted by two cycles whit indicator of the success of least cycles of at least 70% of students who take the test  reachad a value of  ≥75 which is held each end of the cycle. Based collection techniques seen from the test results of students in the from of essays and observation sheets during the learning process. Results of tests conducted at each end of the cycle perscentage success indicators obtained in cycle I at 72,22%, while the percentage indicator of the success of the second cycle II of 77,50%, then an increase from the cycle I  of the cycle II of 5,28%. Based on the results of the study indicate that  contextual learning asssisted animation as to improve student learning in the pressure of the vibration and waves material. Contextual learning assisted animation can be alternatif to student learning outcomes in material vibration and waves. Keywords : Learning Outcomes, Contextual Learning,  Animation

Head and neck squamous cell carcinoma in young patients : a 26-year clinicopathologic retrospective study in a Brazilian specialized center

To describe the clinicopathologic profile of young patients with head and neck squamous cell carcinoma (HNSCC) and compare to middle-aged and elderly adults. Patients? individual records were reviewed for clinicopathologic data. Eighty-nine patients with age 18-45 years old met the inclusion criteria of the study. Two additional groups of middle-aged (n=89) and old (n=89) adults were set to comparative analysis. Young patients represented 11.9% of all patients diagnosed with HNSCC. Women were more affected by HNSCC in the young and elder groups (p= 0.04), and young patients were more prone to be non-smokers (p= 0.01) and have lymph node metastasis at the time of diagnosis (p=0.04). In the young group, patients diagnosed with the disease in advanced stages were more prone to have a positive familial history of cancer (p= 0.04), a positive status of alcohol consumption (p= 0.03), and to be heavy drinkers (p= 0.01). Survival was not different for the young group in comparison to the other groups. HNSCC in young patients had a different profile when compared to older patients, especially regarding sex and exposure to the classic risk factors for this disease. The survival of the young group is similar to the older groups and advanced clinical stage is predictor of worse survival

A combination strategy for enhancing linkage to and retention in HIV care among adults newly diagnosed with HIV in Mozambique: study protocol for a site-randomized implementation science study

Despite the extraordinary scale up of HIV prevention, care and treatment services in sub-Saharan Africa (SSA) over the past decade, the overall effectiveness of HIV programs has been significantly hindered by high levels of attrition across the HIV care continuum. Data from “real-life” settings are needed on the effectiveness of an easy to deliver package of services that can improve overall performance of the HIV care continuum. We are conducting an implementation science study using a two-arm cluster site-randomized design to determine the effectiveness of a combination intervention strategy (CIS) using feasible, evidence-based, and practical interventions—including (1) point-of-care (POC) CD4 count testing, (2) accelerated antiretroviral therapy initiation for eligible individuals, and (3) SMS reminders for linkage to and retention in care—as compared to the standard of care (SOC) in Mozambique in improving linkage and retention among adults following HIV diagnosis. A pre-post intervention two-sample design is nested within the CIS arm to assess the incremental effectiveness of the CIS plus financial incentives (CIS + FI) compared to the CIS without FI on study outcomes. Randomization is done at the level of the study site, defined as a primary health facility. Five sites are included from the City of Maputo and five from Inhambane Province. Target enrollment is a total of 2,250 adults: 750 in the SOC arm, 750 in the CIS cohort of the intervention arm and 750 in the CIS + FI cohort of the intervention arm (average of 150 participants per site). Participants are followed for 12 months from time of HIV testing to ascertain a combined endpoint of linkage to care within 1 month after testing and retention in care 12 months from HIV test. Cost-effectiveness analyses of CIS compared to SOC and CIS + FI compared to CIS will also be conducted. Study findings will provide evidence on the effectiveness of a CIS and the incremental effectiveness of a CIS + FI in a “real-life” service delivery system in a SSA country severely impacted by HIV. Trial registration: Clinicaltrials.gov, NCT0193008

A multi-targeted approach to suppress tumor-promoting inflammation

Cancers harbor significant genetic heterogeneity and patterns of relapse following many therapies are due to evolved resistance to treatment. While efforts have been made to combine targeted therapies, significant levels of toxicity have stymied efforts to effectively treat cancer with multi-drug combinations using currently approved therapeutics. We discuss the relationship between tumor-promoting inflammation and cancer as part of a larger effort to develop a broad-spectrum therapeutic approach aimed at a wide range of targets to address this heterogeneity. Specifically, macrophage migration inhibitory factor, cyclooxygenase-2, transcription factor nuclear factor-κB, tumor necrosis factor alpha, inducible nitric oxide synthase, protein kinase B, and CXC chemokines are reviewed as important antiinflammatory targets while curcumin, resveratrol, epigallocatechin gallate, genistein, lycopene, and anthocyanins are reviewed as low-cost, low toxicity means by which these targets might all be reached simultaneously. Future translational work will need to assess the resulting synergies of rationally designed antiinflammatory mixtures (employing low-toxicity constituents), and then combine this with similar approaches targeting the most important pathways across the range of cancer hallmark phenotypes

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

Search for stop and higgsino production using diphoton Higgs boson decays

Results are presented of a search for a "natural" supersymmetry scenario with gauge mediated symmetry breaking. It is assumed that only the supersymmetric partners of the top-quark (stop) and the Higgs boson (higgsino) are accessible. Events are examined in which there are two photons forming a Higgs boson candidate, and at least two b-quark jets. In 19.7 inverse femtobarns of proton-proton collision data at sqrt(s) = 8 TeV, recorded in the CMS experiment, no evidence of a signal is found and lower limits at the 95% confidence level are set, excluding the stop mass below 360 to 410 GeV, depending on the higgsino mass