Parenting Experiences of Cancer Patients with Minor Children and Their Conversations About the Possibility of Death: A Cross-Sectional Web-Based Survey for an Online Cancer Community

Purpose Many cancer patients with minor children experience difficulty when talking about their illness with their children. The aim of this study is to investigate the parenting experiences of cancer patients with minor children and their conversations about the possibility of death. Methods A cross-sectional web-based survey was conducted between April and May 2019. Cancer patients with minor children were recruited from among an online peer support group called “Cancer Parents”. The participants were asked to complete a questionnaire about their experiences talking about their illness with their children. The participants were classified into those who disclosed their cancer to their children (“disclosed group”), and those who didn’t disclose (“undisclosed group”). The association between whether they talked with their children about their cancer and their conversations about the possibility of death were examined. Results A total of 370 participants were analyzed (80.8% female, median age 43.0 years). The disclosed group (n = 274, 74.1%) wanted to know what their child felt than the undisclosed group (p < 0.001). The undisclosed group didn’t want their children to see their suffering (p = 0.002) and didn’t know how to explain their disease condition ( p < 0.002). Both the disclosed (42.1%) and undisclosed (6.5%) groups told their children about the possibility of death. Conclusion This study showed the disclosed group wanted to know their children’s feelings and they tended to have a conversation about the possibility of death with their children, compared to the undisclosed group.

Weaning Failure in Critically Ill Patients Is Related to the Persistence of Sepsis Inflammation

Introduction: Septic patients undergoing mechanical ventilation (MV) often experience difficulty in weaning. Th aim of this study was to determine whether inflammatory biomarkers of sepsis could be indicative of the failure or success of spontaneous breathing trial (SBT) in these patients. Methods: Sixty-five patients on MV (42 septic and 23 intubated for other reasons) fulfilling the criteria for SBT were included in the study. Blood samples were collected right before, at the end of (30 min) and 24 h after the SBT. Serum inflammatory mediators associated with sepsis (IL-18, IL-18BP, TNF) were determined and correlated with the outcome of SBT. Results: A successful SBT was achieved in 45 patients (69.2%). Septic patients had a higher percentage of SBT failure as compared to non-septic patients (85% vs. 15%, p = 0.026), with an odds ratio for failing 4.5 times (OR = 4.5 95%CI: 1.16–17.68, p 0.022). IL-18 levels and the relative mRNA expression in serum were significantly higher in septic as compared to non-septic patients (p < 0.05). Sepsis was independently associated with higher serum IL-18 and TNF levels in two time-point GEE models (53–723, p = 0.023 and 0.3–64, p = 0.048, respectively). IL-18BP displayed independent negative association with rapid shallow breathing index (RSBI) (95% CI: −17.6 to −4, p = 0.002). Conclusion: Sustained increased levels of IL-18 and IL-18BP, acknowledged markers of sepsis, were found to be indicative of SBT failure in patients recovering from sepsis. Our results show that, although subclinical, remaining septic inflammation that sustaines for a long time complicates the weaning procedure. Biomarkers for the estimation of the septic burden and the right time for weaning are needed.

PERSALINAN PADA IBU DENGAN RIWAYAT KEKURANGAN ENERGI KRONIS

Ibu hamil yang mengalami KEK akan mengalami kekurangan gizi, tubuh mudah lelah, pucat, lemas, dan mengalami kesulitan salah satunya dalam proses persalinan. Pengaruh KEK terhadap proses persalinan dapat mengakibatkan persalinan sulit dan lama, persalinan sebelum waktunya (prematur), pendarahan setelah persalinan, serta persalinan dengan operasi. Puskesmas Sadananya data ibu hamil yang mengalami KEK sebanyak 70 orang (9,49%) dan berlanjut ke penyulit lainnya yaitu mengalami Abortus 5 0rang (3,5%), BBLR 9 bayi (6,3%). Jenis Penelitian ini merupakan penelitian deskriptif. Populasi dalam penelitian ini adalah seluruh ibu bersalin dengan riwayat KEK pada masa kehamilan di Wilayah Kerja Puskesmas Sadananya Kabupaten Ciamis Tahun 2019 sebanyak 70, Teknik pengambilan sempel mengunakan Simple Random Sampling. Analisa dalam penelitian ini adalah Univariat. Hasil penelitian menunjukan sebanyak 3 oang mengalami persalinan sebelum waktunya (4,3%), 1 orang mengalami perdarahan paska salin disebebkan atonia uteri (1,4%), dan 8 orang proses persalinan dengan Operasi (SC) (11,4%). Kesimpulan dari penelitian ini adalah Ibu hamil dengan riwayat KEK mengalami penyulit persalinan, meskipun secara jumlah tidak terlalu signifikan, namun hal ini tentunya tetap harus menjadi perhatian khususnya bagaimana bisa mencegah ibu hamil untuk tidak mengalami anemia, dan apabila sudah terjadi sebagai seorang bidan tentunya harus dapat mendeteksi penyulit yang akan terjadi denganmelakukan penapisan awal persalinanPregnant women who experience KEK will experience malnutrition, body easily tired, pale, weak, and experience difficulties, one of which is in the delivery process. The effect of KEK on the labor process can result in difficult and prolonged labor, preterm labor, bleeding after delivery, and delivery by surgery. Puskesmas Sadananya data on pregnant women who experience KEK as many as 70 people (9.49%) and continue to other complications, namely experiencing 5 0rang abortion (3.5%), LBW 9 babies (6.3%). This type of research is a descriptive study. The population in this study were all 70 women who gave birth with a history of KEK during pregnancy in the Work Area of the Sadananya Health Center, Ciamis Regency in 2019, the sampling technique used was Simple Random Sampling. The analysis in this research is Univariate.. The results showed as many as 3 people experienced premature labor (4.3%), 1 person experienced post-saline bleeding due to uterine atony (1.4%), and 8 people went into labor by surgery (11.4%). The conclusion of this study is that pregnant women with a history of KEK experience difficulty in childbirth, although the numbers are not too significant, this of course still has to be a concern, especially how to prevent pregnant women from experiencing anemia, and if it has occurred as a midwife, of course they must be able to detecting impending complications by performing an early screening of labor.

ENHANCING STUDENTS’ SPEAKING SKILL IN FACING THE REVOLUTION ERA 4.0

Many people think learning a language is easy because they assume we are using the language every day. Learning a language is not just being able to communicate with the language, but also knowing and understanding the meaning contained in the word or phrase that is pronounced. In study languages, especially English, most of the students experience difficulty in speaking or talking. Difficulty talk is usually caused by the difficulty to express ideas orally, limited vocabulary, limited knowledge of grammar so it is difficult to talk with the correct rules, limited ability to properly pronounce vocabulary (pronunciation), so it is difficult to pronounce a word with true, the lack of courage to speak out because of fear of being wrong. To facilitate the ability to speak(speaking), there is some pretty effective way to try, among them: expand the vocabulary, read aloud, get to know simple English, read English, conversation English, listening to English songs, watching English movies,love the subjects English. In this paper also discussed methods teaching role-play and media pictorial story to improve the ability of English-speaking students.

Writing, History, and Power in the Classroom

Many students experience difficulty with the tensions and disjunctures between their vernacular ways of communication and standardized college English. The history of linguistic standardization in European imperialism, however, provides a pedagogically helpful critical heuristic for examining with students the power relations inherent in college writing instruction. By historicizing the entanglements of language and power, students are empowered to choose how and what they want to learn based on an awareness of their educational situatedness and with the support of a open and reflexive instructor.

The Innovative Learning of Square and Rectangle using Macanan Traditional Indonesian Game

Geometry is one of the essential mathematics materials, such as square and rectangle. However, most elementary school students experience difficulty in understanding it due to the abstractness of the geometric material. Furthermore, teachers teaching in the remote areas of Indonesia still encounter problems exploring this abstract material to make students understand caused by the limited learning resources. On the other hand, students in remote areas are familiar with traditional games, such as Macanan. Hence, the objective of this study is to design learning activities utilizing Macanan game in assisting students understand the concept of the perimeter and area of squares and rectangles for fourth-grade students. A design research approach was implemented and performed at one of the elementary schools in Jambi, Indonesia. The research results presented that Macanan could be a context for a starting point in this learning design of both square and rectangular learning. Employing this context, it would be fun, enjoyable, and easy to understand the perimeter and area of squares and rectangles for students. This game could be a context for teachers in remote areas in teaching geometry and be a reference for identifying other contexts which can make mathematics learning easy in remote areas.

Research on the Application of Machine Learning Algorithm and Fuzzy Logic in Eating Assistive Robot

More than 110 million people in this world are facing some kind of disability, for which they experience difficulty while eating food. Eating Assistive Robots could meet the needs of the elderly and people with upper limb disabilities or dysfunctions in gaining independence in eating. We are researching making a robot, which can assist the disabled in eating their meals. Our Eating Assistive Robot will detect the face of the disabled and process it for whether his/her mouth is opened or closed. Our robot will put a pre-prepared replaceable spoon of food in his/her mouth iteratively until the food lasts in the food container. The methodology we used for it i.e. firstly there is a live camera feed through which we are detecting human faces, after this, a library of Affectiva calculates how much mouth is open. We have set a certain threshold after which the program starts the stepper motor which brings the pre-filled spoon of food into the mouth of the disabled.

No-Reference Image Quality Assessment Of Large FLAIR MRI Datasets

<div>The study of neurodegenerative diseases have found promise through white matter lesions best visualized in FLAIR MRI; however, algorithms experience difficulty in generalizing to large multicenter datasets due to the variance of image quality and characteristics. This thesis presents a quality control tool that combines image quality assessment with outlier rejection algorithms; this tool is unique as it is specifically designed for large multicenter FLAIR MRI datasets. An image processing approach evaluates each volume by: intensity-based features, sharpness/blur-based features, signal- and contrast-to-noise ratios, noise field characteristics, motion artifact prevalence</div><div>and a total IQ score. The performance of this tool was evaluated on labelled ADNI and CCNA data reporting F1 scores of 0.82, and 0.85, respectively. Applications for this tool include potential rescan or longitudinal scanner study alongside the immediate application of outlier removal for</div><div>large FLAIR datasets.</div>

No-Reference Image Quality Assessment Of Large FLAIR MRI Datasets

<div>The study of neurodegenerative diseases have found promise through white matter lesions best visualized in FLAIR MRI; however, algorithms experience difficulty in generalizing to large multicenter datasets due to the variance of image quality and characteristics. This thesis presents a quality control tool that combines image quality assessment with outlier rejection algorithms; this tool is unique as it is specifically designed for large multicenter FLAIR MRI datasets. An image processing approach evaluates each volume by: intensity-based features, sharpness/blur-based features, signal- and contrast-to-noise ratios, noise field characteristics, motion artifact prevalence</div><div>and a total IQ score. The performance of this tool was evaluated on labelled ADNI and CCNA data reporting F1 scores of 0.82, and 0.85, respectively. Applications for this tool include potential rescan or longitudinal scanner study alongside the immediate application of outlier removal for</div><div>large FLAIR datasets.</div>

Overcoming Challenges in Assessing Mathematical Reasoning

Despite mathematical reasoning being necessary for in-depth understanding of mathematical concepts, many teacher experience difficulty in assessing it. Data were collected from 34 primary teachers at 4 Victorian government schools at two post- lesson reflective sessions following lessons with a focus on reasoning. These sessions facilitated teachers’ collaborative efforts to assess their students’ reasoning from students’ work samples. The data included transcripts of all the reflective sessions; written work samples; and associated completed rubrics. Analysis of these data enabled identification of seven challenges teachers experienced in assessing reasoning: Limited guidance provided by curriculum documents; Teachers’ knowledge of reasoning; Teacher noticing and interpretation of student reasoning; Students’ difficulties in articulating their reasoning; Assessing progress in reasoning; Inadequacy of work samples; and Challenges in tracking and reporting student progress in reasoning. The discussion presents strategies to overcome these challenges.