Simulated Death: The Perceived Stress And Its Impact On Undergraduate Medical Education

Simulated Death: The Perceived Stress And Its Impact On Undergraduate Medical Education Benjamin Zabar, Kelly L Dodge, Basmah Safdar, Sanziana Roman, John Sather, Christopher Moore, Brian Biroscak, & Leigh V Evans. Yale Department of Emergency Medicine, Yale University School Of Medicine, New Haven CT. Objectives: To determine perceived stress of medical students during simulated patient death, the impact of assigned role, and the effects on learning. Methods: This was a prospective, single blinded, randomized cross over study of third year medical students who participated in a 12 week simulation course using a high fidelity mannequin (Laerdal SimMan®) during a required surgical clerkship. All students completed a standardized multiple choice question examination (MCQE) with nine questions each on acute myocardial infarction (AMI) and pulmonary embolism (PE). Students were initially randomized to two groups: Group PE/AMI and Group AMI/PE. During weekly one hour simulation sessions, each group had five student participants and an assigned team leader in a clinical scenario, while another six students observed; the students switched roles for a second related scenario and were then debriefed. During the second scenario, the simulated patient suffered cardiac arrest. At week 6, all students were exposed to a cardiac arrest scenario for which the patient was successfully resuscitated, while at week 10 the simulated patient expired. After simulation sessions at weeks 6 and 10, the students were debriefed and rated their stress during the arrest scenario on a 0-10 semantic differential scale. All students took the same MCQE at week 12. Results: We enrolled 163 medical students from 09/07-06/08, 79 in Group PE/AMI and 84 in Group AMI/PE. The mean pretest score for Group PE/AMI and Group AMI/PE were comparable for AMI (4.8 v 5.0; P = 0.30) and PE (4.2 v 4.2; P = 0.86). Students did not report significantly different stress for both successful resuscitation and patient death. (4.8 v 4.9; P=0.88) Team leaders reported the most stress followed by participants and then observers for both the successful resuscitation (6.7 v 5.5 v 3.9; P\u3c0.01) and patient death (7.3 v 5.2 v 4.1; P\u3c0.01). Score improvement out of nine possible points was similar between patient survival and death [AMI: 1.3 v 1.7 (P = 0.10); PE: 0.42 v 0.38 (P = 0.50)]. Post-test knowledge scores showed significant improvement for team leaders compared to non leaders for both AMI (2.6 v 1.3; 14% difference, P\u3c0.01) and PE scenarios (1.4 v 0.23; 13% difference, P\u3c 0.01). Conclusions: Medical students did not find simulated death to be more stressful than successful resuscitation. The role of team leader was more stressful than participating or observing cardiac arrest scenarios. No evidence was found that simulated death impairs medical student learning, therefore it may be an appropriate scenario outcome. Assigned team leaders demonstrated the greatest improvement in knowledge

This Fence Makes No Sense: Developing a Community Engagement Curriculum for Swampscott, MA

This project sought to understand the best way to integrate non-exclusionary community engagement into Swampscott, Massachusetts. A curriculum that would encourage municipal officials of Swampscott, MA to develop a more inclusive community engagement process was built and presented to local community engagement practitioners, both affiliated and not affiliated with the municipality, for their feedback. The curriculum suggests creative engagement solutions the town can offer to community members throughout a project\u27s timeline, from idea generation to problem definition, to project development, to post-implementation feedback. These methods of engagement, written under the lens of the Transformative Paradigm, were specifically designed to reduce the barriers to participation marginalized populations often face as well as encourage integration by utilizing a Whole Community approach. Findings suggest a curriculum would enhance community engagement as a municipal priority and reduce barriers to participation for hard-to-reach populations so long as there is adequate and passionate staff and sufficient resources to support these initiatives

PEMBAGIAN WARIS TERHADAP PASANGAN MUSLIM YANG MEMILIKI PERJANJIAN PRA NIKAH

Heirs are entitled to the possessions or relics of the deceased, and the division of the inheritance can mean the property to be Shared with the bereaved, and then the prenup is a covenant couples make in order to make a provision or something in their household. The writing USES normative legal research methods through literature studies. The study explains that, while the marriage covenant has been made, it cannot put off the liabilities of one another, especially in the division of the property, which, although there isa wealth separating agreement, only separates the congenital items, for the possessions obtained during the marriage, when one dies, the share of the heir to the marriage will go in accordance with the islamic scriptures. Key Words; Prenupial Agreements; Heirs; Islamic Law &nbsp

Nanofibers and Electrospinning Method

As a result of their peculiar features like extremely high surface area to weight ratio, low density, as well as high pore volume and controllable pore size, which may not be present in other structures, nanofibers have taken centre stage in nanotechnology. The indicated properties, consequently, make non-woven nanofibers as appropriate materials for wide-spread applications. Electrospinning, because of its high productivity, simplicity, low cost, reproducibility and its potentialities of being utilised at the industrial level is regarded as one of the most potential processes in nanotechnology. This method implies the application of high voltage electric field aiming to extract very thin fibres from a polymeric fluid stream (solution or melt) potentially deliverable through a millimetre-scale needle. Electrospinning, as a technique, is reliant on various processing standards like solution properties and processing parameters. Consequently, altering these parameters could exert a considerable degree of influence on the nanofiber size, shape and morphology. Thus, by controlling those parameters well, specific fibres can be produced to benefit various applications

Air-Cored Linear Induction Motor for Earth-to-Orbit Systems

The need for lowering the cost of Earth-to-Orbit (ETO) launches has prompted consideration of electromagnetic launchers. A preliminary design based on the experience gained in an advanced type of coilgun and on innovative ideas shows that such a launcher is technically feasible with almost off-the-shelf components

Peran Muhammad Opang dalam melestarikan Tradisi Manaqiban di Desa Cimahpar Jampang Kulon Kabupaten Sukabumi Tahun 1968-2016

Dakwah adalah penyampaian ajaran Islam yang tujuannya agar orang-orang melaksanakan ajaran Islam dengan sepenuh hati. Metode dakwah adalah cara-cara tertentu yang dilakukan oleh seorang da’i kepada mad’u untuk mencapai tujuan atas dasar hikmah dan kasih sayang. Ada berbagai metode dakwah yang dilakukan oleh seorang da’i, diantaranya adalah melalui tradisi manaqiban yang dilakukan oleh Muhammad Opang di Desa Cimahpar Jampang Kulon Kabupaten Sukabumi. Beliau berhasil berdakwah melalui tradisi manaqiban disebabkan karena beberapa faktor, diantaranya adalah: faktor aqidah, faktor karomah, faktor tokoh dan faktor ceramah. Berdasarkan uraian di atas, terdapat beberapa rumusan masalah sebagai berikut: pertama, bagaimana riwayat hidup Muhammad Opang? Kedua, bagaimana peran Muhammad Opang dalam melestarikan tradisi manaqiban di Desa Cimahpar Jampang Kulon Kabupaten Sukabumi tahun 1968-2016?. Penelitian ini bertujuan untuk mengetahui kondisi Desa Cimahpar Jampang Kulon Kabupaten Sukabumi, mengetahui riwayat hidup Muhammad Opang dan untuk mengetahui Peran Muhammad Opang dalam Melestarikan Tradisi Manaqiban di Desa Cimahpar Jampang Kulon Kabupaten Sukabumi tahun 1968-2016. Adapun metode yang dilakukan dalam penelitian ini adalah dengan menggunakan metode penelitian sejarah, dalam pelaksanaannya langkah-langkah yang dilakukan peneliti meliputi empat tahapan yaitu sebagai berikut: tahapan heuristik, tahapan kritik, tahapan interpretasi dan tahapan historiografi. Dari hasil penelitian tersebut, penulis dapatkan beberapa kesimpulan diantaranya adalah: pertama, berkembangnya syari’at Islam di Desa Cimahpar tidak terlepas dari peranan Muhammad Opang sebagai seorang da’i, beliau berhasil dalam menyebarkan syariat Islam disana diantaranya melalui tradisi manaqiban Syekh Abdul Qadir Jailani. Kedua, tradisi manaqiban bertujuan untuk bertawasul dengan Syekh Abdul Qadir Jailani dengan harapan agar permohonan dan do’anya dikabulkan oleh Allah SWT, untuk melaksanakan nadzar semata-mata karena Allah SWT dan bukan karena maksiyat, untuk memperoleh berkah dari Syekh Abdul Qadir Jailani, untuk mencintai, menghormati dan memuliakan para ulama salafus shalihin, auliya, syuhada, memuliakan dan mencintai dzuriyyah Rasulullah SAW. Ketiga, tradisi manaqiban yang dibawa oleh Muhammad Opang di Desa Cimahpar terbagi kedalam dua periode. Periode pertama diawali dari tahun 1957 sampai dengan 1967 ketika beliau baru pulang dari pesantren dan masih mukim di Kampung Cikiwul. Periode kedua yaitu dimulai dari tahun 1968 sampai dengan 2016 yaitu ketika beliau menikah dengan Nisah orang Cicangkuang sampai beliau meninggal dunia tahun 2016

IMPLIKASI PEMBERLAKUAN PASAL 117 UNDANG-UNDANG NOMOR 21 TAHUN 2020 TENTANG CIPTA KERJA JO PERATURAN PEMERINTAH NOMOR 11 TAHUN 2021 TENTANG BADAN USAHA MILIK DESA TERHADAP STRUKTUR DAN PRODUKTIVITAS BADAN USAHA MILIK DESA

Negara republik Indonesia merupakan negara yang kaya akan sumber daya alam, Oleh Sebab itu setiap wilayah dalam bingkai negara kesatuan republik Indonesia memiliki hak yang sama untuk mengelola berbagai macam sumber daya alam yang terdapat di wilayah masing-masing. Sebagai ujung tombak dalam pengelolaan sumber daya alam, maka pemerintahan desa memiliki peranan yang sangat penting untuk meningkatkan kemakmuran dan kesejahteraan di tengah-tengah masyarakat. Sebagai implementasi dalam peningkatan kesejahteraan masyarakat maka dalam ketenruan Pasal 87 Undang-Undang Nomor 6 Tahun 2014 tentang pemerintahan Desa dinyatakan bahwa Pemerintahan Desa dapat mendirikan Badan Usaha Milik Desa (BUMDES). Akan tetapi dengan pemberlakuan Pasal 117 Undang-Undang Nomor 21 Tahun 2020 tentang Ciptakerja Jo. Peraturan Pemerintah Nomor 11 Tahun 2021 Tentang Badan Usaha Milik Desa telah menimbulkan beberapa implikasi terhadap struktur dan produktivitas Badan Usaha Milik Desa.  Adapun metode penelitian yang penulis gunakan dalam penelitian ini adalah metode deskriptif analisis yaitu metode yang melukiskan dan menggambarkan realitas yang terjadi ditengah-tengah masyarakat kemudian dihubungkan dengan peraturan perundnag-undangan yang berlaku. Sedangkan metode pendekatan menggunakan yuridis normative. Hasil penelitian  ini adalah bahwa pemberlakuan pasal 117 Undang-Undang Nomor 21 Tahun 2020 tentang Cipta Kerja Jo Peraturan Permerintah Nomor 11 Tahun 2021 tentang Badan usaha Milik Desa telah memberikan dampak terhadap struktur dan produktivitas badan usaha milik Desa diantara dampak yang ditimbulkan dari Undang-Undang Cipta kerja terhadap BUMDES antara lain bahwa setiap BUMDES harus merubah badan usahanya menjadi badan huku

KEAMANAN HTTP DAN HTTPS BERBASIS WEB MENGGUNAKAN SISTEM OPERASI KALI LINUX

Pada awal perkembangannya jaringan komputer hanya digunakan untuk pengiriman e-mail antar perguruan tinggi untuk keperluan riset dan untuk berbagi penggunaan printer dalam suatu perusahaan. Untuk memenuhi tujuan tersebut, aspek keamanan jaringan pada saat itu tidak mendapat perhatian penting. Seiring dengan perkembangan, jaringan komputer telah digunakan sejak lama untuk hal-hal yang lebih kompleks seperti untuk perbankan, untuk perdagangan dan masih banyak lainnya. Dan semua itu menggunakan media Internet. Aspek keamanan dalam komunikasi melalui jaringan komputer menjadi semakin penting terutama karena banyaknya aktivitas pertukaran informasi rahasia melalui Internet. Untuk menghindari penyadapan atau tindak kejahatan lainnya, maka dibuatlah jurnal ini untuk membahas perbandingan keamanan antar HTTP dan HTTPS

Stability and Toxicity of Selected Chlorinated Benzophenone-type UV Filters in Waters

In our study, the transformation of two most widely used UV filters, benzophenone-3 (BP3) and benzophenone-4 (BP4), in chlorinated water with disinfection reagents sodium hypochlorite (NaClO) and trichloroisocyanuric acid (TCCA) was studied. Based on the HPLC/MS and UV-Vis analysis the formation of two different chlorinated products (5-chloro-2-hydroxy-4-methoxybenzophenone and 3,5-dichloro-2-hydroxy-4-methoxybenzophenone) was established. Identity of chlorinated products was confirmed by means of comparison of retention times with independently synthesized standards. Photostability study showed that dichloro-derivative in water is less stable then parent compounds, which is not the case for monochloro-derivatives. Toxicity of chlorinated compounds tested by Vibrio fischeri was found to be in the same range as that of the starting compounds. Preliminary testing of real water samples from swimming pools and sea swimming areas confirmed the presence of BP3 and its 3,5-dichloro derivative