Analisa Biaya dan Penjadwalan pada Proyek Penataan Bangunan Kawasan Strategis Masjid Raya Sumbar Kota Padang

Dalam pelaksanaan Proyek Penataan Bangunan Kawasan Strategis Masjid Raya Sumbar Kota Padang dikerjakan dengan perencanaan yang matang agar proyek selesai sesuai dengan jangka waktu yang telah ditentukan.Pada Kenyataannya proyek selalu mendapat kendala sehingga proyek tersebut tidak berlangsung sesuai rencana. Oleh sebab itu kita dituntut untuk dapat mengendalikan biaya dan penjadwalan agar pelaksanaan proyek berjalan sesuai yang direncanakan.Banyak kendala dilapangan mengakibatkan keterlambatan pekerjaan dilapangan. Dalam dokumen kontrak diberi sanksi dengan ketentuam 1/1000 dari harga kontrak (sebelum ppn), mengacu ke pada permen PUPR Nomor 31/PRT/M/2015 lampiran I standar dan pedoman pengadaan Pekerjaan konstruksi tunggal SSUK pasal 66.4 huruf c.Dan menerapakan metode CPM dalam penjadwalan kembali proyek penataan bangunan kawasan strategis masjid raya Sumbar kota padang dengan mengunakan metode CPM diperoleh waktu pelaksanaan pekerjaan 203 hari untuk menyelesaikan. Sedangkan penjadwalan yang direncanakan oleh pihak pelaksana pekerjaan 210 Har

Meeting Standards Through Integrated Curriculum: Point of View by Sussan M. Drake and Rebecca C. Bruns

Through an integrated curriculum, it is expected that the fulfillment of a maximum standard of learning for students' problems while learning,  the integrated curriculum will determine the content, processes, materials, and learning materials that teachers do to students in the classroom. Students who have problems are expected to be able to overcome the problem both those who lack achievement and are left behind, the evaluation carried out is also expected to be able to measure the ability of students to improve learning that has been done, besides  it can be compared between one school to another with an evaluation. So we need a standard-based approach and an integrated curriculum, the second offers several strategies in developing an integrated curriculum that has been proven in its implementation, thirdly to validate an integrated curriculum by offering examples of integrated curricula that have proven to be successful

Analisis Penyebab Eksploitasi Anak di Bawah Umur pada Saat Pandemi Covid-19

A child is the successor of a nation that must obtain protection in his life by the nation and the state, government, society, and parents, the child must also obtain rights that are upheld as a human being. The purpose of this research is to find out how forms of child exploitation and the factors that cause the emergence of cases of exploitation of minors during the Covid-19 pandemic. This research uses qualitative descriptive research and library research. The result of this study that there are three forms of child exploitation, namely physical exploitation, social exploitation and sexual exploitation. For factors that cause high cases of exploitation of minors during the pandemic, namely, low family economy, low parental education, child abuse and fractures of the parents' households, and environmental influences and online learning. Perpetrators of child exploitation cases do not get a deterrent effect due to the lack of swiftness of the government to make regulations and penalties that provide a deterrent effect for perpetrators. Thus the importance of awareness of parents, society and the importance of law enforcement to protect minors in order to avoid the crimes of exploitation that are currently increasingly happening

Burden and attitude to resistant and refractory migraine: a survey from the European Headache Federation with the endorsement of the European Migraine & Headache Alliance

Background: New treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache Federation (EHF) issued a Consensus document to propose criteria to approach difficult-to-treat migraine patients in a standardized way. The Consensus proposed well-defined criteria for resistant migraine (i.e., patients who do not respond to some treatment but who have residual therapeutic opportunities) and refractory migraine (i.e., patients who still have debilitating migraine despite maximal treatment efforts). The aim of this study was to better understand the perceived impact of resistant and refractory migraine and the attitude of physicians involved in migraine care toward those conditions. Methods: We conducted a web-questionnaire-based cross-sectional international study involving physicians with interest in headache care. Results: There were 277 questionnaires available for analysis. A relevant proportion of participants reported that patients with resistant and refractory migraine were frequently seen in their clinical practice (49.5% for resistant and 28.9% for refractory migraine); percentages were higher when considering only those working in specialized headache centers (75% and 46% respectively). However, many physicians reported low or moderate confidence in managing resistant (8.1% and 43.3%, respectively) and refractory (20.7% and 48.4%, respectively) migraine patients; confidence in treating resistant and refractory migraine patients was different according to the level of care and to the number of patients visited per week. Patients with resistant and refractory migraine were infrequently referred to more specialized centers (12% and 19%, respectively); also in this case, figures were different according to the level of care. Conclusions: This report highlights the clinical relevance of difficult-to-treat migraine and the presence of unmet needs in this field. There is the need of more evidence regarding the management of those patients and clear guidance referring to the organization of care and available opportunities

Public Awareness and Practices Towards Self-Medication with Antibiotics Among Malaysian Population: Questionnaire Development and Pilot Testing

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Management of coronary disease in patients with advanced kidney disease

BACKGROUND Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P=0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P=0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P=0.03). CONCLUSIONS Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction