Higher Average Scores Research Articles

Level of Farmers Satisfaction with Agricultural Extension Services in Gapoktan Mekarjaya Pulomulya Village Lemahabang District Karawang Regency

Agricultural extension is a non-formal education for farmers and their families with the aim of changing knowledge, attitudes, skills, and towards a better. The level of satisfaction is a feeling experienced by someone after making a comparison between the desired level of expectation and the level of service that has been felt. The problem in Gapoctan Mekarjaya is that the counseling that has been running so far is uncertain the role of extension agent when the counseling occurs if there is a program from the government, and when the program ends, there is no follow up of extension activities to meet the needs of farmers by existing counseling that can further increase the capacity of farmers. The sample is determined in a proportional stratified random sampling by using the purposive sampling method for farmers respondents with known population sizes, they can use slovin samples taken by 40 farmer respondents. Quantitative research techniques. The data analysis used is Likert scale, category, customer satisfaction index, importance performance analysis, and descriptive. The results showed that in general, the level of importance of extension services to farmers was included in the criteria for a high average score of 143,64 and a total average of 3,88. The performance of extension services to farmers is included in the medium criteria of an average total score of 120,16 and a total average total score of 120,16 and a total average of 3,11. The farmers satisfaction level is in the satisfied category of CSI value of 77,73. Extension services in meeting the needs and needs of farmers need to be prioritized.
 
 Keywords: extension service performance, importance level, satisfaction level, priority

Development and feasibility of a virtual reality-based exergaming program to enhance cardiopulmonary fitness in children with developmental coordination disorder.

Developmental coordination disorder (DCD) is a neurodevelopmental disorder characterized by motor skill deficits. Such deficits often limit children's participation in physical activities, further affecting their overall health, including through reduced cardiopulmonary fitness. Because virtual reality (VR) devices offer interactive games and activities that require various movements and coordination, they can serve as motivating and enjoyable means for children to perform physical exercise. In this study, we developed a VR-based exergaming system and tested its ability to enhance the cardiopulmonary fitness of children with DCD. A total of 13 children with DCD and 10 young adults were recruited in phase I to examine the test-retest reliability and concurrent validity of our system (including a custom-made heart rate monitor) with a commercial heart rate device. In phase II, we included an additional 13 children with DCD to test the feasibility of the system. We tested the outcomes using the enjoyment rating scale, intrinsic motivation inventory (IMI), and 20-m shuttle run test (20mSRT). In phase I, test-retest reliability was good to excellent in the static task and moderate to good in the dynamic task. Concurrent validity was excellent in both tasks. In phase II, more than half of the children (18 out of 26) assigned the maximum rating for their enjoyment of the game; they also had high average scores on the IMI. Furthermore, after the 8-week training using the VR program, the average running distance of the 26 children in the 20mSRT had increased significantly from 129.23 m to 176.92 m (p < 0.001). Our VR-based exergaming program can serve as an alternative intervention for enhancing cardiopulmonary fitness in children with DCD.

Transformational Styles of Department Heads and Teachers’ Motivation in a Selected University in China

The study covered 235 respondents in a description-comparation-relevant design, and assessed that teachers agreed with the idealized influence, intellectual motivation, and personal and inspirational motivation that department heads exhibit in their transformational leadership style. Across all indicators, the highest average score was for the trait of a department head seeking long-term development for the department, while the lowest average score was for accepting ownership of team decisions. Respondents' overall assessments show that they agree with the transformational leadership style of their department heads. Of all the variables, personal considerations ranked first, followed by idealization, intellectual stimulation, and motivational motivation. There was no significant difference in idealization, motivation, intellectual motivation and personal consideration between male and female respondents on the evaluation of transformational leadership style of their department heads. Respondents' responses on how to rate the transformational leadership style of their respective department heads were age-related. In terms of department affiliation, respondents' evaluations of the transformational leadership style of their respective department heads were comparable, regardless of department affiliation.

Assessing the Impact and Challenges of SMEs on Albania's Economy

The SME sector in Albania has a significant impact on the country's economy. The total number of economically active enterprises in Albania increased by 1.4% in 2021 compared to 2020, reaching 104,031 enterprises. Microenterprises experienced a decrease of 5.8% compared to 2016, while small and medium-sized enterprises showed growth with an increase of 27.09% and 23.24%, respectively, in 2021 compared to 2016. SMEs in Albania play a vital role in employment generation, accounting for 60.3% of total employment in the country. While microenterprises constitute over 92% of SMEs in Albania, they employ a relatively smaller proportion of the total number of employed individuals compared to their number. Small and medium-sized enterprises have shown an increasing trend in employment, with increases of 26.79% and 22.86% respectively compared to 2016. The SME sector in Albania contributes approximately 55% of the total turnover realized in the economy. Microenterprises will generate 21.97% of the total turnover, small enterprises will contribute 30.55%, and medium-sized enterprises will account for 26.50% of the turnover in 2021. The value added by SMEs in Albania has shown an increasing trend. Micro, small, and medium-sized enterprises experienced growth rates of 30.12%, 66.84%, and 66.63% respectively compared to 2016. Small enterprises consistently accounted for the highest percentage of investment during the analyzed years. However, there have been fluctuations, with large enterprises taking the lead in investment in 2017 and 2018. Overall, there has been a decreasing trend in investment growth in Albania, with negative growth rates observed in 2020 and 2021. Productivity: The labor productivity of SMEs in Albania has increased every year from 2016 to 2021. Larger enterprises generally exhibit higher labor productivity compared to smaller ones, benefiting from economies of scale, resource allocation, and access to advanced technologies and systems. Albania has made progress in implementing the Small Business Act (SBA) and has achieved high average scores in areas related to SME policy and support. Efforts to create a supportive ecosystem for SMEs include improvements in the institutional and regulatory framework, operational environment, public procurement, standards and technical regulations, and internationalization of SMEs. Limited accessibility to finance, technology, and knowledge remains a significant challenge for SMEs in Albania. Addressing this challenge requires efforts to improve access to finance through specialized lending programs and loan guarantee schemes and enhance financial literacy among SME owners. In conclusion, while SMEs in Albania make a significant contribution to the economy in terms of employment, turnover, and value-added, there are areas that require further attention and support, such as access to finance and investment. Efforts to address these challenges and promote a favorable environment for SMEs can contribute to their growth, competitiveness, and overall economic development.

Comparative study of virulence potential, phylogenetic origin, CRISPR-Cas regions and drug resistance of Escherichia coli isolates from urine and other clinical materials

IntroductionUrinary tract infections (UTI), among which the main etiological factor is uropathogenic Escherichia coli (UPEC, E. coli), remain an important issue for clinicians. The aim of the study was to demonstrate clear differences in the pathogenic properties of urine-derived E. coli compared to other extraintestinal E. coli clinical isolates (derived from: blood, lower respiratory tracts, sputum, reproductive tract, body fluids, perianal pus, other pus, wound, postoperative wound and other sources).MethodsThe collection of 784 E. coli isolates was collected from various materials of hospitalized patients. They were analyzed in terms of virulence-associated genes (papC, sfaD/sfaE, cnf1, usp., fimG/H, hlyA), belonging to phylogenetic groups and the presence of CRISPR-Cas regions using PCR. In addition, the epidemiological data and the antibiotic resistance profiles provided by the hospital’s microbiology department were included for statistical analyses.ResultsUrine-derived E. coli showed significantly greater virulence potential compared to other isolates, but they were generally unremarkable in terms of drug resistance. The isolates most often belonged to phylogenetic group B2. Drug resistance was negatively correlated with CRISPR 2 presence and high average virulence score, but positively correlated with CRISPR 4 presence. To the best of our knowledge, we are the first to report significant differences in sputum-derived isolates—they revealed the lowest virulence potential and, at the same time, the highest drug resistance.DiscussionIn conclusion, we demonstrated significant differences of urinary-derived E. coli compared to other clinical E. coli isolates. We would like to suggest excluding penicillins from use in E. coli infection at this time and monitoring strains with a high pathogenicity potential.

Product Development of Fish Crisp from Sucker Mouth Fish (Hypostomus plecostomus)

The study aimed to develop a standard formula and process for baking sliced Sucker Mouth Fish and maintaining its quality at room temperature. The chemical components of the fish were analyzed, revealing moisture level, protein, fat, coarse fiber, and carbohydrate to be 83.20±0.24, 14.63±0.51, 0.48±0.61, 0.61±0.03, 1.40±0.20, and 0.11±0.12, respectively. During the study, testers preferred the second formula for baked sliced fish production and gave it higher average scores in all aspects, so the second formula was used. Testers unanimously preferred the 0:100 ratio when assessing palatability using various ratios (100:0, 25:75, 50:50, 75:25, and 0:100). The physical qualities of the product were also analyzed, including lightness (L*), red value (a*), and yellow value (b*), resulting in values of 43.11±0.3, 15.70±0.30, and 18.96±0.48, respectively. The water activity (aw) and crispiness level were measured at 0.41±0.00 and 7.08±1.10, respectively, both within the standardized range. The packaged foil bag with absorbent was kept at room temperature for 2 weeks and analyzed using sensory evaluation, with results showing no significant difference (p&gt;0.05).

Teacher Well-Being among English Lecturers and Instructors in Saudi Arabia

In the recent years, the importance of teacher well-being (TWB), which plays a key role in teaching quality and students’ educational outcomes, has encouraged a plethora of empirical studies across various disciplines. However, there are four notable gaps in the literature on TWB: (i) most studies focus on TWB in terms of negative psychological states and ignore the impact of positive states; (ii) few studies examine TWB in the Saudi Arabian context; (iii) most researchers have failed to propose how TWB can be improved; (iv) maintaining TWB among foreign language (FL) and English as a second language (ESL) teachers is challenging because of the unique demands of their roles. Therefore, to address these gaps in the literature, the current study examined TWB among Saudi ESL lecturers and instructors in terms of the positive aspects of their work life that measured their sense of personal accomplishment via a valid survey instrument and proposed ways to improve TWB. A sample (n=129) of Saudi lecturers and instructors completed a three-part survey designed to measure TWB in terms of both negative and positive psychological states: emotional exhaustion, depersonalisation, and personal accomplishment. The results highlight that on average, the Saudi ESL teachers sampled had relatively high levels of TWB as indicated by their low depersonalisation scores and relatively high personal accomplishment scores. That said, the teachers’ relatively high average emotional exhaustion score (20) indicated that they felt moderately overworked, exhausted, and emotionally exhausted. On the light of outcome, the study represents an effort to improve teaching effectiveness, student outcomes, and educational governance and provide useful insights for Saudi Arabian educational stakeholders to enable them to better provide all students with highly motivated, well-supported, and well-qualified teachers.

The perceived self-efficacy of senior, middle, and operations managers of the incident command system dealing with emergencies and disasters during the COVID-19 pandemic

BackgroundNatural disasters, health, terrorism, infectious diseases, and social unrest affect more than 200 million people worldwide each year. The present study is an attempt to evaluate the self-efficacy of senior, middle, and operational managers of the Incident Command System (ICS) of Zahedan University of Medical Sciences in Iran.MethodsThe study examined the perceived self-efficacy of 103 senior, middle, and operational managers of the Incidence Command System (ICS) of Zahedan University of Medical Sciences in 2021. Sampling was done by census using a designed questionnaire based on Bandura’s self-efficacy concepts. Based on Factor Analysis, 4 factors were extracted. The factors were labeled and analyzed.ResultsThe number of people who had passed the crisis management course was 57. Seventy-one participants reported their participation in crisis management. The score obtained by men in Factor 3 (F3) was significantly higher than women, but not in other factors. People with stable employment scored far higher in Factor 1 (F1) than those with unsustainable employment conditions. Those who had passed the Crisis Management courses had a higher average score, but only in the three factors 1, 2, and 4, this difference was significant.ConclusionEven training the temporary staff is an organizational investment that can return benefits to the system. This enhances their perceived self-efficacy and promotes their commitment to the organization. Therefore, empowering these managers should be a priority.

Developing a Quality Control System in a Continuous Hot Air Heating Process in Surimi Seafood Processing Using Image Analysis and Artificial Intelligence

In this study, the feasibility of classifying surimi gels during a continuous heating process using an artificial intelligence (AI) algorithm on labeled images was investigated. Surimi paste with varying corn starch concentrations (0%, 5%, and 10%) and moisture content levels (78% and 80%) from Alaska pollock were analyzed for the subtle physical changes. Rheological characterization and K-means clustering analysis performed on entire images captured from different batches of heated surimi gel indicated a four-stage transformation from its initial state to gel formation with the temperature ranges spanning 25 to &lt;40 °C, 40 to &lt;50 °C, 50 to &lt;55 °C, and 55 to 80 °C. Subsequently, a Convolutional Neural Network (CNN) model based on the temperature classification was designed to interpret and classify these images. A total of 1000 to 1200 images were used for the training, testing, and validation purposes in the ratio 7:1:2. The CNN architecture incorporated essential elements including an input layer, convolutional layers, rectified linear unit (ReLU) activation functions, normalization layers, and max-pooling layers. The CNN model achieved validation accuracy &gt;92.67% for individual mixture composition, 94.53% for classifying surimi samples based on moisture content, and gelation level, and 89.73% for complex classifications involving moisture content, starch concentration, and gelation stages. Additionally, it exhibited high average precision, recall, and F1 scores (&gt;0.92), indicating precision and sensitivity in identifying relevant instances. The success of CNN in non-destructively classifying surimi gels with different moisture and starch contents is demonstrated in this work.

Comparison of Answers between ChatGPT and Human Dieticians to Common Nutrition Questions.

More people than ever seek nutrition information from online sources. The chatbot ChatGPT has seen staggering popularity since its inception and may become a resource for information in nutrition. However, the adequacy of ChatGPT to answer questions in the field of nutrition has not been investigated. Thus, the aim of this research was to investigate the competency of ChatGPT in answering common nutrition questions. Dieticians were asked to provide their most commonly asked nutrition questions and their own answers to them. We then asked the same questions to ChatGPT and sent both sets of answers to other dieticians (N = 18) or nutritionists and experts in the domain of each question (N = 9) to be graded based on scientific correctness, actionability, and comprehensibility. The grades were also averaged to give an overall score, and group means of the answers to each question were compared using permutation tests. The overall grades for ChatGPT were higher than those from the dieticians for the overall scores in five of the eight questions we received. ChatGPT also had higher grades on five occasions for scientific correctness, four for actionability, and five for comprehensibility. In contrast, none of the answers from the dieticians had a higher average score than ChatGPT for any of the questions, both overall and for each of the grading components. Our results suggest that ChatGPT can be used to answer nutrition questions that are frequently asked to dieticians and provide encouraging support for the role of chatbots in offering nutrition support.

Improving Creative Problem-Solving Abilities of English Students through HyFlex Learning Management and Project-Based Learning

Creative problem-solving ability is one of the important skills that need to be developed within learners through appropriate and supportive learning experiences. This research aims to 1) assess the students&amp;rsquo; creative problem-solving abilities after engaging in HyFlex learning combined with project-based learning; 2) evaluate the students&amp;rsquo; innovations after engaging in HyFlex learning combined with project-based learning; and 3) study students&amp;rsquo; opinions regarding HyFlex learning combined with project-based learning. The sample group employed cluster random sampling consisting of 30 second-year English major students. The research tools included an assessment of creative problem-solving abilities, an assessment of innovation, and a questionnaire about students&amp;rsquo; opinions regarding HyFlex learning combined with project-based learning. Statistical analysis involved means and standard deviations. The research findings were as follows: 1) Students have the highest level of creative problem-solving abilities; 2) Innovations created by students have the highest average score; 3) Students&amp;rsquo; opinions toward HyFlex learning combined with project-based learning are at the highest level.

THE USE OF PRO-GEAR INNOVATION IN IMPROVING THE UNDERSTANDING OF PROBABILITY TOPICS OF STATISTICS COURSES IN THE DEPARTMENT OF COMMERCE, PORT DICKSON POLYTECHNIC

The purpose of this study is to identify students' interest in and understanding of the probability topic in the Statistics courses after engaging in a demonstration learning session using the Pro-Gear innovation. The research methodology used is a descriptive and experimental method. A total of 42 first-semester Diploma in Marketing students were separated into two equal groups, A and B. Group A experienced demonstration learning that utilized Pro-Gear innovation, while Group B experienced conventional learning that lacked Pro-Gear innovation. The average score from the End of Chapter (EOC) evaluation of both groups was used to assess student understanding. The level of interest of students is analyzed using the survey form distributed to Group A, which went through demonstration learning using Pro-Gear innovation. Based on the average EOC score analysis, group A had a higher average score than group B. The average difference in EOC score is 7.7%. This shows that the level of understanding of a group of students who utilize Pro-Gear innovation is more advanced than that of a group that does not use Pro-Gear innovation. Meanwhile, the survey form analysis reveals a high average mean value for the eight items investigated. Thus, demonstration learning using the Pro-Gear innovation can enhance the understanding and interest of students in the probability topic.&#x0D; Keywords: Demonstration; Innovation; Probability

Personality Type Of Efl Learners On Reading Comprehension At Smp N 2 Tapian Dolok

This research aim to investigate the personality type of EFL learners on reading comprehension at SMP N 2 Tapian Dolok. This research method is design as qualitative. The sample of research is taken from IX-2 class that consist of 9 to purposively. The characteristics of the sample are three learners with the highest average scores, three learners with middle average scores, and three learners with the lowest average score. The technique collecting data is interview. The researcher gives some question to the learners and the total questions of question are eight question. The questions are related to the personality type in reading comprehension. The result of this research showed that personality types of learners are different. The researcher found extroverted personality is less often than introverted personality.. From the nine learners, 3 learners are extroverted Personality and 6 learners are introverted personality. The learners with extrovert personality type get higher score on reading comprehension than introvert personality type.

SELF-REGULATED LEARNING STRATEGIES AND THEIR RELATIONSHIP TO GRAMMAR ACHIEVEMENT OF UNDERGRADUATE ENGLISH DEPARTMENT STUDENTS

Self-regulated learning is an educational process that enables students to self-regulate when determining ideas or concepts and evolving their learning strategies to accomplish attainable outcomes. The present study investigated self-regulated learning strategies undergraduate English department students used and examined the significant relationship with students' grammar achievement. The researchers conducted a quantitative correlational design on 70 undergraduate English department students. The researchers collected the data through a self-regulated learning strategies questionnaire and students' grammar scores. The first result showed that the peer learning strategy was the dominant strategy used by students with the highest average score (M= 3.48, SD= 1.14), and the less dominant strategy with the lowest average score is time and study environment (M= 3.03, SD= 0.99). This study applied descriptive statistics using the SPSS program to describe the first research problem. The second result was analyzed using Pearson correlation, indicating a low negative correlation between self-regulated learning strategies and students' grammar achievement. Thus, this study concluded that the higher the grammar achievement students' got, the less self-regulated learning strategies they used, and the less grammar achievement students' got, the more learning strategies they used.

Factors Affecting the Environmental Awareness of Vietnamese Citizens

This study aims to investigate the environmental awareness of Vietnamese citizens and identify its affecting factors through the survey of a total of 825 households in the North and the South of Vietnam. Descriptive statistics, comparative analysis and linear regression were mainly used to analyze the survey data. The study results show that the respondents’ positive attitudes on environment protection and the high average score on environmental awareness proxy reflected the relatively high environmental awareness of Vietnamese citizens. Gender, education, household income and accessibility to the information on environmental issues were statistically found to be the significant contributing factors to the environmental awareness through both comparative analysis and linear regression model. More dissemination on environmental issues through various means will probably help improve the Vietnamese citizens’ environmental awareness in the future.

Ventricular Tachycardia.

This scenario was developed to educate emergency medicine residents on the diagnosis and management of ventricular tachycardia (VT) that is refractory to single dose anti-arrhythmic management. Electrical storm, defined as three or more episodes of sustained VT, ventricular fibrillation, or appropriate shocks from an implantable cardioverter defibrillator within 24 hours,1 has a mortality rate up to 14% in the first 48 hours.2 Ventricular tachycardia may present in a heterogenous fashion, not only with stable versus unstable clinical presentations, but also with different electrocardiographic morphologies and etiologies.1 Understanding how to rapidly diagnose, treat, and utilize second or third-line treatments is vital in the setting of refractory ventricular tachycardia rather than relying on the success of first-line agents. Appreciation for what medications are readily available in your crash cart and medication dispensing cabinet is critical for timely management for refractory ventricular tachycardia. At the conclusion of the simulation session, learners will be able to: 1) identify the different etiologies of VT, including structural heart disease, acute ischemia, and acquired or congenital QT syndrome; 2) describe confounding factors of VT, such as electrolyte abnormalities and sympathetic surge; 3) describe how to troubleshoot an unsuccessful synchronized cardioversion, including checking equipment connections, increasing delivered energy, and changing pad placement; 4) compare and contrast treatments of VT based on suspected underlying etiology; 5) describe reasons to activate the cardiac catheterization lab other than occlusive myocardial infarction; and 6) identify appropriate disposition of the patient to the cardiac catheterization lab. This session was conducted using high-fidelity simulation, followed by a debriefing session and lecture on the diagnosis, differential diagnosis, and management of VT. Debriefing methods may be left to the discretion of participants, but the authors have utilized advocacy-inquiry techniques. This scenario may also be run as an oral board case. Our residents are provided a survey at the completion of the debriefing session so they may rate different aspects of the simulation, as well as provide qualitative feedback on the scenario. The local institution's simulation center's electronic feedback form is based on the Center of Medical Simulation's Debriefing Assessment for Simulation in Healthcare (DASH) Student Version Short Form3 with the inclusion of required qualitative feedback if an element was scored less than a 6 or 7. Twelve learners completed a feedback form. This session received 6 and 7 scores (consistently effective/very good and extremely effective/outstanding, respectively) other than three isolated 5 scores. The lowest average score was 6.67 for "Before the simulation, the instructor set the stage for an engaging learning experience." The highest average score was 7 for "The instructor helped me see how to improve or how to sustain good performance." The form also includes an area for general feedback about the case at the end. Illustrative examples of feedback include: "Excellent care and debrief." Specific scores are available upon request. This is a cost-effective method for reviewing VT diagnosis and management. The case may be modified for appropriate audiences, such as describing what medications may be readily available in a free-standing emergency department or pre-hospital setting. Medical simulation, ventricular tachycardia, cardiac emergencies, dysrhythmias, cardiology, emergency medicine.

Characteristics of cognitive functioning in persons with chronic sensorineural hearing loss

Aim to identify the features of cognitive status in chronic sensorineural hearing loss (CNHL) by analyzing the subscales of the Montreal Cognitive Assessment test.&#x0D; Material and methods. The study involved 45 people (aged 44 - 86 years, average age 57.8711.74 years) with chronic sensorineural hearing loss. The study design included assessment of complaints and anamnesis, examination of ENT organs, tonal threshold audiometry (AC-40, Interacoustics, Denmark), tympanometry (AC 226, Interacoustics, Denmark). Cognitive status was assessed using the Montreal Cognitive Assessment tool (MoCA) on seven subscales: Executive and visuospatial function, Naming, Attention, Language, Abstraction, Delayed recall, and Orientation.&#x0D; Results. The average total score for MoCA in persons with chronic SNHL (n=45) was 25.092.86 points out of 30 possible points, which indicates a trend towards a decrease in cognitive function. Cognitive impairments in individuals with SNHL were more pronounced on the subscales Executive and visuospatial function, Language and Delayed recall. Despite rather high average scores on the subscale Executive and visuospatial function, 100% completion was noted less than in half of the subjects in 46.66% (n = 21).&#x0D; Conclusion. Considering the cognitive characteristics of individuals with SNHL may improve the effectiveness of rehabilitation.

Pain and Complications Assessment in Gynecological Cancer Brachytherapy Patients Under Spinal Anesthesia

Background: Brachytherapy is a radiation therapy that can deliver radiation to cancer by minimizing radiation exposure to adjacent organs or tissues. In its implementation, brachytherapy can cause pain so that adequate anesthesia is needed in order to get optimal results. This study was aimed to determine the adequacy of anesthesia and complications that occur in gynecological cancer patients undergoing brachytherapy with spinal anesthesia. Methods: A descriptive observational study using primary data that taken by interviewing the patients who underwent gynecological brachytherapy under spinal anesthesia at dr. Mohammad Hoesin Palembang. The number of samples in this study that met the inclusion criteria was 18 subjects. Pain was assessed using an 11-point numeric rating scale. Data were collected in 5 different times, before procedure, during applicator insertion, during radiation process, during applicator removal, and 4 hours after brachytherapy. in addition, all complications that occurred during the procedure were recorded. Data were analyzed to describe the mean, median, minimum, and maximum of pain scores. Result: The average pain score before brachytherapy was 0.78, at the time of applicator insertion was 0, 0.28 at irradiation, 0,11 at removal of the applicator and 1.33 after the brachytherapy procedure. The most common complications were back pain (27.8%) and urinary retention (27.8%). Conclusion: For most patients, high dose rate (HDR) brachytherapy under spinal anesthesia was well tolerated, in fact most patients experienced no pain and no significant life-threatening complications. The post-brachytherapy pain score had the highest average score. Then, back pain and urinary retention were the most common complications.

Public Perceptions of Ecotourism in Bagek Kembar Mangrove Essential Ecosystem Area, Sekotong, West Lombok

Bagek Kembar mangrove ecotourism is a new tourist destination. Therefore, further management is needed by involving the public and related parties. In this regard, a study aimed to analyze public perceptions of ecotourism in the mangrove in Bagek Kembar. Public perception data was collected through a questionnaire combined with interviews. Respondents were determined by purposive technique and grouped into the general public, ecotourism managers, and tourists. Research data were analyzed descriptively and inferential statistics. Interpretation of the average value of respondents' perceptions of the Bagek Kembar mangrove ecotourism is grouped into four categories: low, moderately low, moderately high, and high. The results showed that the public perception of the Bagek Kembar mangrove ecotourism is moderately high (average score of 0.60). Meanwhile, the increase in facilities and infrastructure, as well as access to ecotourism, was perceived by respondents as moderately low, with an average score of 0.49 (facilities and infrastructure) and 0.48 (road access to ecotourism). All respondents (100%) stated that the Bagek Kembar mangrove ecotourism must be further managed and developed. Although most respondents (75%) stated that the Bagek Kembar mangrove ecotourism had been well managed

Resident Physicians' Knowledge of Emergency Medical Services: A Comparison Between Emergency Medicine and Non-Emergency Medicine Resident Physicians.

Background and objective Emergency medical services (EMS) are often assumed to only involve bringing patients to physicians for treatment in the emergency department. However, EMS staff are also responsible for responding to physicians in the primary care setting when medical emergencies arise. While emergency medicine (EM) residents are exposed to EMS as part of their curriculum, little is known about the knowledge of other resident physicians who may interact with EMS. In light of this, we conducted this study to address the scarcity of data related to this topic. Methods A quantitative cross-sectional knowledge assessment was conducted among resident physicians in emergency medicine, internal medicine, family medicine, pediatric, and combined medicine and pediatric residencies at the Penn State Milton S. Hershey Medical Center. Results Eighteen EM residents and 26 non-EM residents completed the assessment. The EM residents had a higher average score when compared to non-emergency medicine residents (69.2% vs. 53.8%, p=0.0012). Conclusion Variations in scores between EM and other specialties thatinteract with EMS highlight the need for further training and familiarization related to EMS for residents in non-EM specialties.