CUSTOMISED FETAL GROWTH CHARTS VERSUS POPULATION-BASED GROWTH CHARTS IN IDENTIFYING ADVERSE FETAL OUTCOMES: A SYSTEMATIC REVIEW

One for all antenatal growth charts may not adequately capture risks for adverse fetal outcomes. This review appraises studies on customised growth curves in preventing adverse fetal effects and compares them with population-based growth charts. A review was done on articles published in PubMed database, Cochrane database and Google Scholar. The search criteria were English written described fetal outcomes using a customised fetal growth chart published between 2007 and 2020. All selected articles reported antenatal follow-up data and compared the intervention using the customised antenatal growth chart to the population-based antenatal growth chart. The primary outcome measure was the incidence of small for gestational age (SGA) and stillbirths. The feasibility of using a customised fetal growth chart versus a population-based fetal growth chart was assessed as the process indicator. Twenty-two articles comparing the use of customised growth charts to population-based growth charts were found. Sixteen studies depicted a significant improvement in the detection of pathological SGA over a population-based growth chart ,and another two studies showed significant in detecting large gestational age (LGA). In conclusion, the customised growth charts improve the detection of pathological SGA antenatally. The feasibility of the intervention depends on the training, policy, infrastructure, staffing, awareness and ethics. A summarised framework analysis for implementing customised growth charts is proposed for future research.

PENGARUH EDUKASI EARLY WARNING SYSTEM (EWS) TERHADAP RESPON TIME PERAWAT DI IGD BRSUD KABUPATEN TABANAN

Emergency patient care is a service that requires immediate service, namely fast, precise, and accurate to prevent death or disability. One of the indicators of service quality is in the form of response time, which is a process indicator to achieve the outcome indicator, namely survival. To achieve a fast response time, a systematic approach system is needed in dealing with patients who experience emergencies, one of which is by using the Early Warning System (EWS). This study aims to determine the effect of early warning system education on the response time of nurses in Emergency Room Tabanan Hospital. This study used an experimental method with a pre-experimental design (one-group pre-test-posttest design) involving 39 samples selected by total sampling technique. Data collection in providing EWS education is in the form of modules, and the research material is in the form of a clock used to measure the response time. Data analysis uses a computerized system with univariate and bivariate analysis. This study showed that the response time for nurses before the early warning system education was fast, namely 15 (39.5%). Most of the nurses' response time after the early warning system education was 26 (66.7%). The results of this study can be concluded that there is an effect of early warning system nurse education on the response time of nurses with a significance value (p) of 0.000.

The United States’ Implementation of the Montréal Process Indicator of Forest Fragmentation

The United States’ implementation of the Montréal Process indicator of forest fragmentation presents a case study in the development and application of science within a criteria and indicator framework to evaluate forest sustainability. Here, we review the historical evolution and status of the indicator and summarize the latest empirical results. While forest cover fragmentation is increasing, the rate of increase has slowed since 2006. Most of the fragmentation in the western United States is associated with changes in semi-natural land cover (e.g., shrub and grass) while most of the eastern fragmentation is associated with changes in agriculture and developed (including roads) land covers. Research conducted pursuant to indicator implementation exemplifies the role of a criteria and indicator framework in identifying policy-relevant questions and then focusing research on those questions, and subsequent indicator reporting exemplifies the value of a common language and developed set of metrics to help bridge the gaps between science and policy at national and international scales.

Textbook process as a composite quality indicator for in-hospital hip fracture care

Summary Individual process indicators often do not enable the benchmarking of hospitals and often lack an association with outcomes of care. The composite hip fracture process indicator, textbook process, might be a tool to detect hospital variation and is associated with better outcomes during hospital stay. Purpose The aim of this study was to determine hospital variation in quality of hip fracture care using a composite process indicator (textbook process) and to evaluate at patient level whether fulfilment of the textbook process indicator was associated with better outcomes during hospital stay. Methods Hip fracture patients aged 70 and older operated in five hospitals between 1 January 2018 and 31 December 2018 were included. Textbook process for hip fracture care was defined as follows: (1) assessment of malnutrition (2) surgery within 24 h, (3) orthogeriatric management during admission and (4) operation by an orthopaedic trauma certified surgeon. Hospital variation analysis was done by computing an observed/expected ratio (O/E ratio) for textbook process at hospital level. The expected ratios were derived from a multivariable logistic regression analysis including all relevant case-mix variables. The association between textbook process compliance and in-hospital complications and prolonged hospital stay was determined at patient level in a multivariable logistic regression model, with correction for patient, treatment and hospital characteristics. In-hospital complications were anaemia, delirium, pneumonia, urinary tract infection, in-hospital fall, heart failure, renal insufficiency, pulmonary embolism, wound infection and pressure ulcer. Results Of the 1371 included patients, 753 (55%) received care according to textbook process. At hospital level, the textbook compliance rates ranged from 38 to 76%. At patient level, textbook process compliance was significantly associated with fewer complications (38% versus 46%) (OR 0.66, 95% CI 0.52–0.84), but not with hospital stay (median length of hospital stay was 5 days in both groups) (OR 1.01, 95% CI 0.78–1.30). Conclusion The textbook process indicator for hip fracture care might be a tool to detect hospital variation. At patient level, this quality indicator is associated with fewer complications during hospital stay.

Predicted concentration performance for copper-nickel ores of the Talnakh ore cluster

This paper describes a mineralogical study that looked at the copper-nickel ores of the Talnakh Ore Cluster. It also describes attempts to develop a method for predicting concentration performance on the basis of mapping data. The geological classification of the Talnakh ores developed in 1987–1992 is rather a classification of natural types and varieties as it fails to specify any particular concentration process indicators. The copper-nickel ores of the Talnakh Ore Cluster are multicomponent and it is quite difficult to develop a classification based on concentration performance that would account for the quality of concentrates and the recovery of non-ferrous and noble metals. In the period of 2015–2020, a series of experiments and a mineralogical study were conducted for 107 samples of impregnated ore, 105 samples of copper ore and 60 samples of high-grade ore under the contracts with the R&D Office of Nornickel’s Polar Division. Based on the results of the experiments, a classification was developed for impregnated, copper and high-grade ores based of one selected actual process indicator. Due to the use of a mining information system, each box of a block model representing an ore body (or, each mining unit with known characteristics) can be assigned appropriate concentration indicators. On the basis of geological mapping results, a method was applied for indirect calculation of expected concentration indicators based on a number of attributes. With the help of this method, the authors were able to determine the actual indicators, estimate the calculation error and find a way to improve the predictability of the model through analyzing additional samples and attributes.

Understanding what women want: eliciting preference for delivery health facility in a rural subcounty in Kenya, a discrete choice experiment

ObjectiveTo identify what women want in a delivery health facility and how they rank the attributes that influence the choice of a place of delivery.DesignA discrete choice experiment (DCE) was conducted to elicit rural women’s preferences for choice of delivery health facility. Data were analysed using a conditional logit model to evaluate the relative importance of the selected attributes. A mixed multinomial model evaluated how interactions with sociodemographic variables influence the choice of the selected attributes.SettingSix health facilities in a rural subcounty.ParticipantsWomen aged 18–49 years who had delivered within 6 weeks.Primary outcomeThe DCE required women to select from hypothetical health facility A or B or opt-out alternative.ResultsA total of 474 participants were sampled, 466 participants completed the survey (response rate 98%). The attribute with the strongest association with health facility preference was having a kind and supportive healthcare worker (β=1.184, p<0.001), second availability of medical equipment and drug supplies (β=1.073, p<0.001) and third quality of clinical services (β=0.826, p<0.001). Distance, availability of referral services and costs were ranked fourth, fifth and sixth, respectively (β=0.457, p<0.001; β=0.266, p<0.001; and β=0.000018, p<0.001). The opt-out alternative ranked last suggesting a disutility for home delivery (β=−0.849, p<0.001).ConclusionThe most highly valued attribute was a process indicator of quality of care followed by technical indicators. Policymakers need to consider women’s preferences to inform strategies that are person centred and lead to improvements in quality of care during delivery.

Evaluasi Program English Massive Dalam Upaya Peningkatan Kapasitas Masyarakat di Kota Kediri Tahun 2017-2019

Penelitian ini bertujuan untuk mengetahui pelaksanaan program English Massive (E-Mas) dalam upaya peningkatan kapasitas masyarakat di Kota Kediri tahun 2017-2019 dengan teori Evaluasi model CIPP menurut Stufflebeam diantaranya: Context; Input, Process, Product. Penelitian ini menggunakan metode penelitian kualitatif deskriptif. Subjek penelitian diantaranya penyelenggara program, partisipan, tutor dengan menggunakan teknik purposive. Hasil Penelitian menunjukkan evaluasi program English Massive berdasarkan: Context, latar belakang dan tujuan ialah ingin memberdayakan masyarakat melalui pembelajaran Bahasa Inggris supaya meningkatkan daya saing dan kapasitas masyarakat kota Kediri; syarat E-Mas mudah dan target sasaran seluruh warga Kota Kediri. Input, kesesuaian partisipan telah sesuai namun hanya kategori children memiliki jumlah partisipan tiggi; Tutor disediakan oleh Dinas Pendidikan dan sesuai dengan kriteria namun jumlah tutor menurun; materi yang diberikan sesuai dengan silabus dan kemampuan partisipan dengan fokus conversation dan speaking; anggaran telah mencukupi untuk kebutuhan dan operasional program; sarana dan prasarana sudah cukup memadai karena dikelola oleh masyarakat sendiri; informasi sudah jelas diberikan melalui sosialisasi, media sosial dan internet. Process, penjadwalan telah sesuai sebab jadwal direncanakan oleh partisipan dan tutor; proses pembelajaran cukup efektif melalui diskusi dan fun game; aktivitas selain pembelajaran yaitu outing class, COIN EMAS, outbond dan sebagainya; hambatan yaitu kesadaran masyarakat kurang, adanya kesibukan, spot kurang kondusif, jarak yang jauh antara spot dengan tempat tinggal tutor, honor tidak cair tiap bulan, modul tidak dibagikan ke partisipan. Product, dampak yang dirasakan partisipan adanya peningkatan kemampuan partisipan dalam berbahasa inggris; meningkatkan IPM Kota Kediri.This study aims to investigate the implementation of the English Massive (E-Mas) program as an effort to improve social capacity in Kediri City, year 2017-2019 by utilising Stufflebeams’s theory of evaluation. This research uses descriptive qualitative research methods. Research subjects include program organizers, participants, tutors by using purposive techniques. The results of the study show that the background and purpose of the English Massive program based on the first indicator in which Context is to empower the society through learning English in order to improve the competitiveness and capacity of the Kediri’s citizens; E-Mas requirements are easy and target for all residents of Kediri City. Based on Input Indicator, participants are arguably fit with the standar but only the children category has a high number of participants; Tutors were provided by the Education Office (Dinas Pendidikan); the material provided is in accordance with the syllabus and the ability of participants focusing on conversation and speaking. The budget is sufficient for program’s expenses and operations; facilities and infrastructure are good enough because they are managed and provided also by the society itself; information has clearly been provided through outreach, social media and the internet. Based on Process Indicator, scheduling is appropriate because the schedule is planned by participants and tutors; the learning process is quite effective through discussion and fun games; activities other than learning, namely outing class, COIN EMAS, outbound and so on; the obstacles are lack of public awareness, busyness, less conducive spot, long distance between spot and tutor's residence, monthly non-payment of honorarium, modules are not distributed to participants. Product Indicator, the impact felt by the participants is an increase in the ability of participants in speaking English as well as improving the HDI of Kediri City.

PENGEMBANGAN PERANGKAT PEMBELAJARAN MODEL GROUP INVESTIGATION DENGAN ADVANCE ORGANIZER UNTUK MENINGKATKAN HASIL BELAJAR DAN KETERAMPILAN PEMECAHAN MASALAH PADA SISWA SMP

This research aims to develop a learning material of group investigation model with advance organizer to improve learning output and student’s problem solving skills in SMPN 1 Tanjungbumi. This study would be expected to be applied using the several assessing of instruments. The experiment design of the material resources used one group pretest-posttest design. The assessing of instruments consist of lesson plan, BAS, worksheet, observing activity, test (product, process, and psychomotor), and questionnaire. The validity result showed that lesson plan, BAS, and LKS had in feasible category, LP product and LP process had in feasible category. The assessment of BAS and LKS showed that BAS and LKS had in understandable material by students. Learning feasibility of group investigation model with advance organizer is in excellent category. Reliability of students’ activity observation from the lesson plan with the percentage 92,32%. The completeness of product’s indicator with the percentage 83,33%, and the completeness of process’ indicator (problem solving skills) with the percentage 73,33%. The completeness of the individual output product with the percentage 93,33%, the completeness of the individual output process (problem solving skills) with the percentage 93,33%, the completeness of the individual output psikomotor with the percentage 100%, and the completeness of the individual output afektif with the percentage 100%. Group investigation model with advance organizer got positive respond from the students. The difficulties found during this study was group investigation model with advance organizer was a new thing for the students so the teacher should give information about group investigation model with advance organizer for the students.

Process indicator-of-scale metrics – PRISMs

Process indicator-of-scale metrics – PRISMs