scholarly journals Convergência da síndrome de Vogt-Koyanagi-Harada e pré-eclâmpsia

2018 ◽  
Vol 12 (10) ◽  
pp. 2775
Author(s):  
Adriano Da Costa Belarmino ◽  
Larissa Cunha Alves de Holanda ◽  
Antonio Rodrigues Ferreira Junior
Keyword(s):  
Pregnant Women ◽  
Medical Records ◽  
Qualitative Case Study ◽  
Pulse Therapy ◽  
Targeted Interventions ◽  
Calidad De Vida ◽  
Laboratory Confirmation ◽  
Positive Results

RESUMOObjetivo: discutir caso clínico de gestante com síndrome de Vogt-Koyanagi-Harada (SVKH) associada com pré-eclâmpsia (PE) grave. Método: trata-se de estudo qualitativo, do tipo estudo de caso, com dados de prontuário após internação de gestante com SVKH e pré-eclâmpsia grave. Resultados: identificou-se primigesta portadora de SVKH e PE internada por aumento pressórico arterial e amaurose bilateral; instalada a sulfatoterapia e indicada a cesariana após a confirmação laboratorial de síndrome HELLP parcial. A avaliação oftalmológica constatou descolamento de retina e hemorragias oculares leves necessitando de pulsoterapia e com recuperação visual posterior. Conclusão: considerou-se a assistência a gestantes com situações clínicas raras, respaldada no pensamento complexo, que possibilitou a construção de cuidados ampliados, com intervenções direcionadas e resultados positivos, obtendo-se a melhoria da qualidade de vida durante e após o internamento. Descritores: Síndrome Uveomeningoencefálica; Pré-eclâmpsia; Eclâmpsia; Cuidados de Enfermagem; Epistemologia, Filosofia em Enfermagem.ABSTRACT Objective: to discuss the clinical case of pregnant women with Vogt-Koyanagi-Harada syndrome (VKHS) associated with severe pre-eclampsia (PE). Method: this is a qualitative, case-study study with data from the medical records after admission of pregnant women with VKHS and severe pre-eclampsia. Results: primigravid VKHS and PE patients were hospitalized for arterial pressure increase and bilateral amaurosis; sulfate therapy and cesarean section was indicated after laboratory confirmation of partial HELLP syndrome. The ophthalmologic evaluation revealed retinal detachment and mild ocular hemorrhages necessitating pulse therapy and posterior visual recovery. Conclusion: assistance to pregnant women with rare clinical situations, supported by complex thinking, was considered, which enabled the construction of expanded care, with targeted interventions and positive results, resulting in improved quality of life during and after hospitalization. Descriptors: Uveomeningoencephalic syndrome; Preeclampsia; Eclampsia; Nursing care; Epistemology, Philosophy, Nursing.RESUMEN Objetivo: discutir caso clínico de gestante con síndrome de Vogt-Koyanagi-Harada (SVKH) asociada con pre eclampsia (PE) grave. Método: se trata de un estudio cualitativo, del tipo estudio de caso, con datos de prontuario después de la internación de gestante con SVKH y pre eclampsia grave. Resultados: se identificó primigesta portadora de SVKH y PE internada por aumento presórico arterial y amaurosis bilateral; instalada la sulfatoterapia e indicada la cesárea después de la confirmación de laboratorio de síndrome HELLP parcial. La evaluación oftalmológica constató desprendimiento de retina y hemorragias oculares leves necesitando de pulsoterapia y con recuperación visual posterior. Conclusión: se consideró la asistencia a gestantes con situaciones clínicas raras, respaldada en el pensamiento complejo, que posibilitó la construcción de cuidados ampliados, con intervenciones directas y resultados positivos, obteniéndose la mejora de la calidad de vida durante y después del internamiento. Descriptores: Síndrome Uveomeningoencefálico; La preeclampsia; Cuidados de Enfermería; Epistemología; Filosofía en Enfermería.

scholarly journals O cuidador de paciente com insuficiência cardíaca: desafios no cuidar

2017 ◽  
Vol 7 (19) ◽  
pp. 3
Author(s):  
Liliane Gomes de Oliveira ◽  
Thais De Assis Souto ◽  
Aline Mirema Ferreira Vitorio
Keyword(s):  
Heart Failure ◽  
Qualitative Case Study ◽  
Support Network ◽  
Descriptive Research ◽  
Methodological Research ◽  
Calidad De Vida ◽  
Patients With Heart Failure ◽  
Insuficiencia Cardiaca

O estudo objetivou identificar e analisar as pesquisas relacionadas à temática cuidadores de pacientes com Insuficiência Cardíaca (IC). Trata-se de revisão integrativa no qual os artigos estavam disponíveis nas bases de dados CINAHL e Medline e LILACS via portal Biblioteca Virtual de Saúde (BVS) publicados entre 2010 e 2015 com os descritores Insuficiência Cardíaca e Cuidador dentre outros. Nove estudos foram analisados. Quanto a metodologia dos estudos selecionados, 7 foram pesquisas descritivas de abordagem qualitativa, uma pesquisa metodológica e um estudo de caso qualitativo. Mudanças nas rotinas dos cuidadores em função do cuidado ao paciente, o sofrimento com a falta de suporte social dos familiares e dos profissionais de saúde em relação ao cuidado foram assuntos prevalentes abordados nos artigos. Recomenda-se oferecer aos cuidadores de paciente com IC uma rede de suporte; e a realização de estudos que avaliem a qualidade de vida destes indivíduos.Descritores: Cuidadores, Insuficiência Cardíaca, Prática Clínica Baseada em Evidências.AbstractThe caregiver of a patient with heart failure: challenges in caringThe study aimed to identify and analyze research related to the theme caregivers of patients with heart failure (HF). This is an integrative review in which the articles were available in CINAHL databases and Medline and LILACS via portal Virtual Health Library (VHL) published between 2010 and 2015 with the descriptors heart failure and Caregiver among others. Nine studies were analyzed. The methodology of the selected studies, 7 were descriptive research of qualitative approach, a methodological research and a qualitative case study. Changes in routines caregivers due care to the patient, suffering from a lack of social support from family and health professionals regarding care were prevalent issues addressed in the articles. It is recommended to provide patient caregivers with IC a support network; and studies that assess the quality of life of these individuals.Descriptors: Caregivers, Heart Failure, Evidence-Based Practice.ResumenEl cuidador de paciente con insuficiencia cardíaca: desafíos en el cuidadoEl estudio tuvo como objetivo identificar y analizar las investigaciones relacionadas con los cuidadores de pacientes con Insuficiencia Cardiaca (IC). Tratase de una revisión integradora en el cual los artículos estaban disponibles en las bases de datos CINAHL y MEDLINE y LILACS a través del portal de la Biblioteca Virtual en Salud (BVS) publicados entre 2010 y 2015 con los descriptores Insuficiencia Cardíaca y Cuidador entre otros. Fueron analizados nueve estudios. Cuanto la metodología de los estudios seleccionados, 7 eran de investigación descriptiva con un abordaje cualitativo, una investigación metodológica y un estudio cualitativo de casos. Los cambios en las rutinas de los cuidadores en función del cuidado al paciente, el sufrimiento sumado a la falta de soporte social de los familiares y de los profesionales de la salud respecto a la atención, fueron los temas prevalentes abordados en los artículos. Se recomienda ofrecer a los cuidadores de pacientes con IC una red de soporte; la realización de estudios que evalúan la calidad de vida de estos individuos.Descriptores: Cuidadores, Insuficiência Cardíaca, Práctica Clínica Basada en Evidencias.

scholarly journals Registros de enfermagem e suas implicações para a qualidade do cuidado

2019 ◽  
Vol 9 (26) ◽  
pp. 3
Author(s):  
Beatriz Da Silva Sousa ◽  
Ana Clara Maciel Barroso
Keyword(s):  
Medical Records ◽  
Electronic Records ◽  
Structured Interviews ◽  
Health Records ◽  
Study Case ◽  
Artery Disease ◽  
Study Type ◽  
Nursing Professionals

Avaliar o registro dos enfermeiros nos prontuários do paciente eletrônico e convencional, com vista à melhoria da qualidade do cuidado. Estudo descritivo, tipo estudo de caso. Foram realizadas entrevistas semiestruturadas com 8 enfermeiros da enfermaria de coronariopatias e a análise dos registros nos dois tipos de prontuários do paciente. Nos 25 prontuários revistos, constatou-se o número de 51 registros, sendo 37 do prontuário eletrônico e 14 do prontuário convencional, média de 31 dias de internação. Atrelou-se a não realização ao número insuficiente de profissionais de enfermagem no setor em comparação à complexidade dos pacientes atendidos. Destaca-se como obstáculo o quantitativo de pessoal da equipe de enfermagem e sua carga de trabalho. Consequentemente, há necessidade de ajustes quantitativo e qualitativo no processo de trabalho relacionados a execução desta e das demais tarefas para que possam ser adequadamente conduzidas.Descritores: Cuidados de Enfermagem, Registros Eletrônicos de Saúde, Carga de trabalho. Nursing records and their implications for the quality of careAbstract: To evaluate nurses' records in the electronic and conventional patient charts, with a view to improving the quality of care. Descriptive study, case study type. Semi-structured interviews were carried out with 8 nurses from the coronary artery disease ward and the analysis of the records in the two types of patient records. In the 25 revised records, the number of 51 records was verified, being 37 of the electronic records and 14 of the conventional medical records, average of 31 days of hospitalization. There was a lack of achievement of the insufficient number of nursing professionals in the sector compared to the complexity of the patients attended. The number of nursing staff and their workload stands out as an obstacle. Consequently, there is a need for quantitative and qualitative adjustments in the work process related to the execution of this and other tasks so that they can be properly conducted.Descriptors: Nursing Care, Eletronic Health Records, Workload. Registros de enfermería y sus implicaciones para la calidad de la atenciónResumen: Evaluar el registro de los enfermeros en los prontuarios del paciente electrónico y convencional, con objetivo la mejora de la calidad del cuidado. Estudio descriptivo, tipo estudio de caso. Se realizaron entrevistas semiestructuradas con 8 enfermeros de la enfermería de coronariopatias y el análisis de los registros en los dos tipos de prontuarios del paciente. En los 25 prontuarios revisados, se constató el número de 51 registros, siendo 37 del prontuario electrónico y 14 del prontuario convencional, promedio de 31 días de internación. La no realización se debe al número insuficiente de profesionales de enfermería en el sector en comparación a la complejidad de los pacientes atendidos. Se destaca como obstáculo el cuantitativo de personal del equipo de enfermería y su carga de trabajo. En consecuencia, hay necesidad de ajustes cuantitativos y cualitativos en el proceso de trabajo relacionados con la ejecución de ésta y de las demás tareas para que puedan ser adecuadamente conducidas.Descriptores: Atención de Enfermería, Registros Electrónicos de Salud, Carga de Trabajo.

scholarly journals EDUCAÇÃO E RESISTÊNCIA CAMPONESA NA AMAZÔNIA PARAENSE

2021 ◽  
Vol 7 (20) ◽  
pp. 202127
Author(s):  
Chirles da Silva Monteiro ◽  
Gutemberg Armando Diniz Guerra
Keyword(s):  
Qualitative Approach ◽  
The Political ◽  
Political Resistance ◽  
Daily Lives ◽  
Calidad De Vida ◽  
The Social ◽  
Peasant Resistance

EDUCATION AND PEASANT RESISTANCE IN THE PARAENSE AMAZONIAEDUCACIÓN Y RESISTENCIA CAMPESINA EN LA AMAZONIA PARAENSERESUMOEste artigo é fruto dos apontamentos da pesquisa de mestrado desenvolvida no Programa de Pós-Graduação em Agriculturas Amazônicas (PPGAA) da Universidade Federal do Pará – UFPA. Aborda os desafios da luta pela terra no Sudeste Paraense, refletindo sobre o papel da educação nesse processo. Ele aponta a educação que permeia o cotidiano das pessoas, como elemento que fortalece a resistência política dos camponeses, por isso, não está apenas relacionada à conquista da terra, mas também, à permanência na mesma e à mudança da qualidade de vida nos acampamentos e assentamentos. O artigo é resultado de um estudo de caso, desenvolvido no Acampamento Sem Terra, denominado de Dalcídio Jurandir, localizado no Sudeste Paraense e encaminhado por uma abordagem qualitativa. Entende-se que o movimento social busca uma educação que dê conta de compreender as circunstâncias vividas a partir de suas contradições sociais, tendo a mesma lógica de resistência do campesinato, porque é nele que ela tem sua raiz histórica. Trata-se de uma educação que antecede à escola e vai muito além dela.Palavras-chave: Educação; Luta pela Terra; Resistência Camponesa.ABSTRACTThis article is the result of the master's research notes developed in the Postgraduate Program in Amazon Agriculture (PPGAA) of the Federal University of Pará – UFPA. It addresses the challenges of the struggle for land in Southeast Pará, reflecting on the role of education in this process. This paper points out the education that permeates people's daily lives, as an element that strengthens the political resistance of the peasants, therefore, it is not only related to the conquest of the land, but also to the permanence in it and to the change in the quality of life in the encampments and settlements. The article is the result of a case study, developed at the agrarian reform camp, called Dalcídio Jurandir, located in Southeast Pará and guided by a qualitative approach. It is understood that the social movement seeks an education that is able to understand the circumstances experienced from its social contradictions, having the same logic of resistance as the peasantry, because it has its historical roots in it. It is an education that precedes school and goes far beyond it.Keywords: Education; Struggle for Land; Peasant Resistance.RESUMENEste artículo es el resultado de las notas de investigación de maestría desarrolladas en el Programa de Posgrado en Agricultura Amazónica (PPGAA) de la Universidad Federal de Pará – UFPA. Aborda los desafíos de la lucha por la tierra en el sureste de Pará, reflexionando sobre el papel de la educación en este proceso. Señala la educación que permea la vida cotidiana de las personas, como un elemento que fortalece la resistencia política de los campesinos, por lo tanto, no solo se relaciona con la conquista de la tierra, sino también con la permanencia en ella y con el cambio de la tierra. Calidad de vida en los campamentos y asentamientos. El artículo es el resultado de un estudio de caso, desarrollado en el Campamento Sem Terra, llamado Dalcídio Jurandir, ubicado en el sureste de Pará y guiado por un enfoque cualitativo. Se entiende que el movimiento social busca una educación que sea capaz de comprender las circunstancias vividas desde sus contradicciones sociales, teniendo la misma lógica de resistencia que el campesinado, porque tiene en ella sus raíces históricas. Es una educación que precede a la escuela y la va mucho más allá.Palabras clave: Educación; Lucha por la Tierra; Resistencia Campesina.

scholarly journals Budaya Mamfatin Ukunrai Sebagai Paradoks Partisipasi Masyarakat Dalam Perencanaan Pembangunan Desa

2020 ◽  
Vol 3 (1) ◽  
pp. 114-127
Author(s):  
Donna Isra Silaban ◽  
Imelda Nahak
Keyword(s):  
Community Participation ◽  
Qualitative Case Study ◽  
Public Awareness ◽  
Development Planning ◽  
Cultural Factor ◽  
Development Communication ◽  
Development Programs ◽  
The Government

This study aims to examine development communication in community participation in village development planning. Community participation is very important because it can guarantee the effectiveness of development programs. There are a number of obstacles to community participation in development planning. Some identified barriers are the absence of legal support (Rumensten, 2012), lack of public awareness, low quality of human resources, length of stay and hours employment type (Wijaksono, 2013), lack of socialization from the government (Sagita, 2016), poverty and limited access provided by the government (Ompusunggu, 2017), and interest of bureaucracy in planning (Mbeche, 2017). These studies, indeed, have not considered yet cultural factor leading to disinvolvement. This qualitative case study extends previous studies by revealing the culture of mamfatin ukunrai discouraging community participation in development planning in Naran Village (pseudonym), Raimanuk Subdistrict, Belu Regency. Mamfatin ukunrai is a custom considering development planning is government's duties and responsibilities. Villagers are merely the executor of development programs. This custom is a legacy of royal government system and dominates the mindset of villagers. The tradition of highly appreciating the government unwittingly creates an invisible distance between government and society. It has discouraged villagers’ participation.

scholarly journals The Learning Environment of Student Nurses During Clinical Placement: A Qualitative Case Study of a Student-Dense Ward

2021 ◽  
Vol 7 ◽  
pp. 237796082110523
Author(s):  
Siri Vestby Bøe ◽  
Jonas Debesay
Keyword(s):  
Nursing Education ◽  
Learning Environment ◽  
Qualitative Case Study ◽  
Collective Responsibility ◽  
Clinical Placement ◽  
Clinical Placements ◽  
Student Community ◽  
Good Learning

Introduction Ensuring the quality of clinical placements has long been a challenge in nursing education. This is partly due to a growing aging population requiring health services, and an increased need for nursing workforce. Both in Norway and internationally, there is a rise in the use of student-dense models, wherein several students are placed together on the same ward at the same time where the supervision of the students is the collective responsibility of the nurses. Objective The aim of this study was to explore factors that promote or inhibit learning in a student-dense ward when used as a model for clinical placement in hospitals. We examined how clinical placement is experienced in a student-dense ward, as well as how learning is facilitated. Methods A qualitative case study design was used to capture the learning environment on the student-dense ward in a comprehensive way. We used focus group interviews, in-depth interviews, and observations with students and employees at a major hospital in Norway. Results Our findings showed that the orientation days and the teaching activities in student-dense wards, the feedback students receive, the clinical facilitator's role and the student community were factors that had particular importance for good learning environments in this placement model. Conclusions To ensure the quality of clinical placements, more attention should be paid to these factors in the planning, organization, and facilitation of new and existing student-dense wards. It is paramount to provide students with thorough written feedback and to secure the clinical facilitators with enough time to conduct student supervision when organizing clinical placement as student-dense wards.

scholarly journals A prospective evaluation of inter-rater agreement of routine medical records audits at a large general hospital in São Paulo, Brazil

2020 ◽  
Author(s):  
Ana Carolina Cintra Nunes Mafra ◽  
João Luiz Miraglia ◽  
Fernando Antonio Basile Colugnati ◽  
Gilberto Soares Lourenço Padilha ◽  
Renata Rafaella Santos Tadeucci ◽  
...  
Keyword(s):  
Medical Records ◽  
Sao Paulo ◽  
São Paulo ◽  
Rater Agreement ◽  
Prospective Longitudinal Study ◽  
Targeted Interventions ◽  
Prospective Longitudinal ◽  
The Impact ◽  
Over Time

AbstractBackgroundThe quality of the patient’s medical records is strictly related to patient safety. Besides, its data are widely used in observational studies. However, the reliability of the information extracted from them is a matter of concern in audit processes to ensure inter-rater agreement (IRA). Thus, the objective of this study is to evaluate the IRA among members of the Patient’s Health Record Review Board (PHRRB), in routine auditing of medical records, and the impact of periodic discussions of results with raters.MethodsProspective longitudinal study conducted between July of 2015 and April of 2016 at Hospital Municipal Dr. Moysés Deutsch, a large public hospital in São Paulo. The PHRRB was composed of 12 physicians, 9 nurses and 3 physiotherapists, who audited medical records, monthly, with the number of raters changing throughout the study. It was carried out PHRRB meetings to reach a consensus on criteria that the members have to rate in the auditing process. It was created a review chart that raters should verify the registry of patient’s secondary diagnosis, chief complaint, history of presenting complaint, past medical history, medication history, physical exam and diagnostic testing. It was obtained the IRA every three months. The Gwet’s AC1 coefficient and Proportion of Agreement (PA) were calculated to evaluate the IRA for each item over time.ResultsThe study included 1884 items from 239 records with an overall full agreement among raters of 71.2%. A significant IRA increase by 16.5% (OR=1.17; 95% CI=1.03—1.32; p=0.014) was found in the routine PHRRB auditing, with no significant differences between the PA and the Gwet’s AC1, that showed a similar evolution over time. The PA decreased by 27.1% when at least one of the raters was absent from the review meeting (OR=0.73; 95% CI=0.53—1.00; p=0.048).ConclusionsMedical record quality has been associated with the quality of care and could be optimized and improved by targeted interventions. The PA and the Gwet’s AC1 are suitable agreement coefficients that are feasible to be incorporated in the routine of PHRRB evaluation process.

scholarly journals Potential for health economics to influence policies on tobacco use during pregnancy in low-income and middle-income countries: a qualitative case study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e045624
Author(s):  
Tuba Saygın Avşar ◽  
Louise Jackson ◽  
Hugh McLeod
Keyword(s):  
Health Economics ◽  
Pregnant Women ◽  
Tobacco Use ◽  
Low Income ◽  
Tobacco Cessation ◽  
Qualitative Case Study ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Specific

IntroductionTobacco control during pregnancy is a policy priority in high-income countries (HICs) because of the significant health and inequality consequences. However, little evidence exists on interventions to reduce tobacco use in low-income and middle-income countries (LMICs), especially for pregnant women. This study aimed to assess how health economics evidence, which is mainly produced in HICs, could be adopted for tobacco cessation policies for pregnant women in LMICs.MethodsA qualitative case study was conducted in an international public health organisation. The organisation was chosen due to its capacity to influence health policies around the world. Tobacco control experts working in the organisation were identified through purposeful sampling and snowballing. Semistructured interviews were conducted with 18 informants with relevant experience of countries from all of the regions covered by the organisation. Data were analysed using the framework method.ResultsIn practice, tobacco cessation during pregnancy was not viewed as a priority in LMICs despite international recognition of the issue. In LMICs, factors including the recorded country-specific prevalence of tobacco use during pregnancy, availability of healthcare resources and the characteristics of potential interventions all affected the use of health economics evidence for policy making.ConclusionThe scale of tobacco use among pregnant women might be greater than reported in LMICs. Health economics evidence produced in HICs has the potential to inform health policies in LMICs around tobacco cessation interventions if the country-specific circumstances are addressed. Economic evaluations of cessation interventions integrated into antenatal care with a household perspective would be especially relevant in LMICs.

scholarly journals Access to and Quality of Primary Healthcare: a Multi-Country Qualitative Case Study in West and East Africa

2020 ◽  
Author(s):  
Soter Ameh ◽  
Bolarinwa Oladimeji Akeem ◽  
Caleb Ochimana ◽  
Abayomi Olabayo Oluwasanu ◽  
Shukri F Mohamed ◽  
...  
Keyword(s):  
East Africa ◽  
Universal Health Coverage ◽  
Primary Healthcare ◽  
Qualitative Case Study ◽  
Financial Burden ◽  
Cost Of Care ◽  
Health Coverage ◽  
Universal Health

Abstract Background: Universal health coverage is one of the Sustainable Development Goal targets known to improve population health and reduce financial burden. There is little qualitative data on access to and quality of primary healthcare in West and East Africa. We elicited in-depth viewpoints of healthcare users and providers, and other stakeholders regarding access to and quality of healthcare.Methods: A qualitative case study was conducted in four communities in Nigeria, and one community each in Kenya, Uganda and Tanzania in 2018. Purposive sampling was used to recruit 155 participants for 24 focus group discussions, 24 in-depth interviews, and 12 key informant interviews. The conceptual framework in this study combined elements of the Health Belief Model, Health Care Utilisation Model, four ‘As’ of access to care, and pathway model to better understand health-seeking behaviours of the study participants. The data were analysed with MAXQDA 2018 qualitative software to identify three themes identified a priori and one emerging theme.Results: Access to primary healthcare in the seven communities was limited. Quality of care was perceived to be unacceptable in public facilities whereas cost of care was unaffordable in private facilities. Patients and health providers and stakeholders highlighted shortage of equipment, frequent drug stock-outs and long waiting times as major issues, but had varying opinions on satisfaction with care. Use of herbal medicines and other traditional treatments delayed or deterred seeking modern healthcare in Nigerian sites. Conclusions: There was a substantial gap in primary healthcare coverage and quality in the selected communities in rural and urban East and West Africa. Alternative models of healthcare delivery should be used to fill this gap and facilitate achieving universal health coverage.

scholarly journals EFL LEARNERS � FACED PROBLEMS IN LISTENING COMPERHENSION

2017 ◽  
Vol 2 (1) ◽  
pp. 53
Author(s):  
Seli Siti Syadiah
Keyword(s):  
Learning Strategies ◽  
Listening Comprehension ◽  
Qualitative Case Study ◽  
Private University ◽  
Efl Learners ◽  
Effective Learning ◽  
Efl Teachers ◽  
Efl Students

This research focuses on the EFL learners� problems in listening comprehension. The present research attempts to investigate listening problems encountered by a group of low level at seniors of a private university in Kuningan. This qualitative case study involved 10 participants who took TOEFL course in 7th semester. The data was gathered by means of questionnaires and interviews. The result of the research showed that accent, pronunciation, speed of speech, insufficient vocabulary, different accent of speakers, lack of concentration, anxiety, and bad quality of recording were the major listening comprehension problems encountered by EFL students. This research also found that most students (60%) used compensation strategy to overcome the problems by guessing the answer, while the others (30%) used memory strategy by using their knowledge or experiences, and the rest 10% of the students used affective strategy by motivating themselves to try answering the questions. Knowing students� learning difficulties may enable EFL teachers to develop the effective learning strategies and ultimately improve their English listening abilities. Suggestion is made for addressing problems regarding how students can help themselves and the teachers can help their students to overcome the listening comprehension problems encountered by the students.Keywords: EFL Learner, listening comprehension, listening problem

scholarly journals The Effect of Referral Process and Complications to Maternal Mortality

2015 ◽  
Vol 3 (3) ◽  
pp. 400
Author(s):  
Indah Handriani ◽  
Soenarnatalina Melaniani
Keyword(s):  
High Risk ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Medical Records ◽  
Multivariable Analysis ◽  
Secondary Data ◽  
Case Control ◽  
Referral Process

ABSTRACTMaternal Mortality Rate (MMR) in East Java was still high. in 2013, MMR in sidoarjo district has readed 96.27 per 100,000 live birth. This aim of this study was to the effect of the referral process to maternal mortality in RSUD Sidoarjo. This research was analytic observational with case control design. The Samples of this study were 25 pregnant women who were referred to RSUD Sidoarjo and death. The case controls were 50 pregnant women who were referred to RSUD Sidoarjo who did not experience death. Techniques of data collection using secondary data from the register book maternal and neonatal Emergency (MNE) and medical records and interviews with the mother/family/husband of respondents. The data was analyzed by using univariable, bivariable and multivariable analysis with logistic regression. The results of this study confirmed that the referral process was poor (OR=9,783,95% CI: 2,275 to 42,072, p=0,002) and the complications (OR=0,005,95%CI: 0,001-0,057, p=0,000).thus, the incidence maternal mortality increased. The conclusion of this study is the referral process and the complications to maternal mortality affect the occurrence of maternal mortality. Midwives need to conduct health education should be given to women in their productive age, increase the participation of families, communities and cadres in the process of early detection of complications during pregnancy, childbirth and postpartum, the quality of antenatal care (ANC) and the quality of referrals should be improved by creating a close referral system in a region associated with a high risk pregnant women were detected inventoried and scheduled control/termination and monitored (follow-up) so that high risk always monitored.Keywords: maternal mortality, referral process, complications

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