Pembelajaran Problem Posing Berstruktur Modalitas Siswa untuk Mengembangkan Keterampilan Problem Solving di SMP

The purpose of this study was to describe the results of the application of problem posing learning structured of students modalities to develop problem solving skills in a rectangular material in class VII SMPI Al-Asy\u27ariyyah Pontianak. The Forms of research used in this study is a quasi experimental. The population in this study were students of class SMPI Al-Asy\u27ariyyah Pontianak which consists of three classes of VII A, VII B, VII C. Sample was taken by purposive sampling and the selected class is class VIIC SMPI Al-Asy\u27ariyyah Pontianak. The result showed that the modalities owned by the students of class VII C SMPI Al-Asy\u27ariyyah Pontianak as many as 10 students have a visual modality, 8 students have auditory modality and 12 students have kinesthetic modalities. After being given a problem posing structured learning modality, the student is able to resolve the issue more than one way of solving then the student is able to formulate questions and then finish it. This condition is growing at a meeting of the second and third

PEMBELAJARAN PROBLEM POSING BERSTRUKTUR MODALITAS SISWA UNTUK MENGEMBANGKAN KETERAMPILAN PROBLEM SOLVING DI SMP

Abstrak: Penelitian ini bertujuan untuk menjelaskan hasil penerapan pembelajaran problem posing berstruktur modalitas siswa untuk mengembangkan keterampilan problem solving dalam materi segiempat di kelas VII SMPI Al-Asy’ariyyah Pontianak. Bentuk penelitian yang digunakan dalam penelitian ini adalah quasy eksperimental. Populasi dalam penelitian ini adalah siswa kelas VII SMPI Al-Asy’ariyyah Pontianak yang terdiri dari tiga kelas yaitu VII A, VII B, VII C.  Sampel diambil secara purposive sampling dan kelas yang terpilih yaitu kelas VIIC. Hasil analisis data menunjukkan bahwa modalitas yang dimiliki siswa-siswi kelas VII C SMPI Al-Asy’ariyyah Pontianak yaitu  sebanyak 10 orang siswa memiliki modalitas visual, 8 orang siswa memiliki modalitas auditorial dan 12 orang siswa memiliki modalitas kinestetik. Setelah diberikan pembelajaran problem posing berstruktur modalitas, siswa mampu menyelesaikan  masalah dengan lebih dari satu cara penyelesaian kemudian siswa mampu dalam merumuskan soal kemudian menyelesaikannya. kondisi ini semakin berkembang pada pertemuan kedua dan ketiga.   Kata Kunci :Problem Posing, Modalitas Siswa, Problem Solving   Abstract : The purpose of this study was to describe the results of the application of problem posing learning structured of students modalities to develop problem solving skills in a rectangular material in class VII SMPI Al-Asy’ariyyah Pontianak. The Forms of research used in this study is a quasi experimental. The population in this study were students of class SMPI Al-Asy’ariyyah Pontianak which consists of three classes of VII A, VII B, VII C. Sample was taken by purposive sampling and the selected class is class VIIC SMPI Al-Asy’ariyyah Pontianak. The result showed that the modalities owned by the students of class VII C SMPI Al-Asy’ariyyah Pontianak as many as 10 students have a visual modality, 8 students have auditory modality and 12 students have kinesthetic modalities. After being given a problem posing structured learning modality, the student is able to resolve the issue more than one way of solving then the student is able to formulate questions and then finish it. This condition is growing at a meeting of the second and third. Keywords: Problem Posing, Students Modality, Problem Solvin

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Feasibility of preoperative chemotherapy for locally advanced, operable colon cancer: The pilot phase of a randomised controlled trial

Summary: Background Preoperative (neoadjuvant) chemotherapy and radiotherapy are more eff ective than similar postoperative treatment for oesophageal, gastric, and rectal cancers, perhaps because of more eff ective micrometastasis eradication and reduced risk of incomplete excision and tumour cell shedding during surgery. The FOxTROT trial aims to investigate the feasibility, safety, and effi cacy of preoperative chemotherapy for colon cancer. Methods In the pilot stage of this randomised controlled trial, 150 patients with radiologically staged locally advanced (T3 with ≥5 mm invasion beyond the muscularis propria or T4) tumours from 35 UK centres were randomly assigned (2:1) to preoperative (three cycles of OxMdG [oxaliplatin 85 mg/m², l-folinic acid 175 mg, fl uorouracil 400 mg/m² bolus, then 2400 mg/m² by 46 h infusion] repeated at 2-weekly intervals followed by surgery and a further nine cycles of OxMdG) or standard postoperative chemotherapy (12 cycles of OxMdG). Patients with KRAS wild-type tumours were randomly assigned (1:1) to receive panitumumab (6 mg/kg; every 2 weeks with the fi rst 6 weeks of chemotherapy) or not. Treatment allocation was through a central randomisation service using a minimised randomisation procedure including age, radiological T and N stage, site of tumour, and presence of defunctioning colostomy as stratifi cation variables. Primary outcome measures of the pilot phase were feasibility, safety, and tolerance of preoperative therapy, and accuracy of radiological staging. Analysis was by intention to treat. This trial is registered, number ISRCTN 87163246. Findings 96% (95 of 99) of patients started and 89% (85 of 95) completed preoperative chemotherapy with grade 3–4 gastrointestinal toxicity in 7% (seven of 94) of patients. All 99 tumours in the preoperative group were resected, with no signifi cant diff erences in postoperative morbidity between the preoperative and control groups: 14% (14 of 99) versus 12% (six of 51) had complications prolonging hospital stay (p=0·81). 98% (50 of 51) of postoperative chemotherapy patients had T3 or more advanced tumours confi rmed at post-resection pathology compared with 91% (90 of 99) of patients following preoperative chemotherapy (p=0·10). Preoperative therapy resulted in signifi cant downstaging of TNM5 compared with the postoperative group (p=0·04), including two pathological complete responses, apical node involvement (1% [one of 98] vs 20% [ten of 50], p<0·0001), resection margin involvement (4% [ four of 99] vs 20% [ten of 50], p=0·002), and blinded centrally scored tumour regression grading: 31% (29 of 94) vs 2% (one of 46) moderate or greater regression (p=0·0001). Interpretation Preoperative chemotherapy for radiologically staged, locally advanced operable primary colon cancer is feasible with acceptable toxicity and perioperative morbidity. Proceeding to the phase 3 trial, to establish whether the encouraging pathological responses seen with preoperative therapy translates into improved long-term oncological outcome, is appropriate

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Patient lifter mechanisms : forces, trajectories, and adjustments for customer and mechanism variations.

New Zealand’s population is ageing; it is predicted, by 2051, 25 percent of the population will be aged 65 or over. This increase in elderly population is expected to put a larger demand on nursing staff, increasing the amount of patient handling required. Patient handling is defined as the moving and transporting of people with mobility issues. Musculoskeletal injuries during patient handling tasks are currently the most common injury affecting nursing staff in New Zealand. While it is largely documented that these injuries can be decreased by the implementation of lifting programs and installation of lifting equipment, some staff remain resistant to their use due to the time taken and complexity of existing devices. To address this need, a fully mechanical patient lifter has been developed. It is anticipated that the simplicity and compactness of a fully mechanical lifter would be advantageous, allowing the device to be effective in a large range of situations. The lifter’s key benefit is predicted to be the reduction in time taken to complete a lift. The absence of electrical componentry removes the need for regular electrical certification, ongoing battery charging and maintenance, and results in a reduced footprint, allowing easier storage and manoeuvring of the device. Using carer-driven lifting force allows the speed of the lift to be tailored to each patient, reducing the time required to lift more able patients. Due to the simplicity and intuitiveness of a fully mechanical lifter, the training time would be reduced with less refresher and retraining sessions required. The objective of this study was to assess the performance of a fully mechanical patient lifter and provide recommendations on possible developments. Key performance indicators were developed into an evaluation matrix to evaluate developed mechanisms against transfer aids already available to the public. A key focus of this development was the assessment of handle force required to lift a patient. Theory regarding patient and mechanism forces has been developed and validated using motion capture and a load cell to validate this theory. The impact of anthropometric variation in patients was also assessed. It was found that, while the main diversity factors were height and weight, a patient’s centre of mass location was also important. To this end, it was found the most suitable configuration for a fully mechanical patient lifter was a double pivot mechanism. This mechanism gave the ability to adjust the gradient of the patient’s lifted centre of mass (LCM) trajectory, to decrease handle forces, while allowing the total change in height of the LCM to be greater, providing greater patient comfort. Mechanism characteristics, including kneepad, chest pad and pivot placement, type of mechanism, chest pad, and mechanism dimensions, were also assessed to ensure that a suitable balance was achieved between handle forces and patient comfort