Psychomotor Score Research Articles

CKD Associates with Cognitive Decline in Middle-Aged and Older Adults with Long-Standing Type 1 Diabetes.

Key Points We found that development of both albuminuria and reduced eGFR was associated with clinically significant cognitive decline, particularly in the psychomotor and mental efficiency domain.There was also a significant interaction between worsened albuminuria and eGFR, the combination of which augmented cognitive deficits.A more comprehensive longitudinal phenotype of albuminuria showed that regressed albuminuria did not associate with worsened cognitive decline, as opposed to persistent albuminuria. Background Individuals with CKD or type 1 diabetes (T1D) are at risk for cognitive decline, but it is unclear whether these associations are with albuminuria, eGFR, or both. Methods We examined the longitudinal relationships between CKD and change in cognition in 1051 participants with T1D in the Diabetes Control and Complications Trial and its follow-up, the Epidemiology of Diabetes Interventions and Complications study. Albumin excretion rate and eGFR were measured every 1–2 years. Three cognitive domains were assessed repeatedly over a 32-year period: immediate memory, delayed memory, and psychomotor and mental efficiency. Associations between cognitive function and CKD were assessed: (1) longitudinally and (2) in models using eGFR and albuminuria measurements over the first 15–20 years with subsequent change in cognitive function over the ensuing 14 years (when decline in cognition was greatest). Results In fully adjusted longitudinal analyses, the magnitude of decline in the psychomotor and mental efficiency domain score was associated with eGFR <60 ml/min per 1.73 m2 (β −0.449; 95% confidence interval [CI], −0.640 to −0.259) and sustained albumin excretion rate 30 to <300 mg/24 hours (β −0.148; 95% CI, −0.270 to −0.026). This was equivalent to a decrease associated with approximately 11 and 4 years of aging, respectively. In analyses focused on changes in cognition between study years 18 and 32, eGFR <60 ml/min per 1.73 m2 was associated with reduced psychomotor and mental efficiency (β −0.915; 95% CI, −1.613 to −0.217). Conclusions In T1D, development of CKD was associated with a subsequent reduction on cognitive tasks requiring psychomotor and mental efficiency. These data highlight the need for increased recognition of risk factors for neurologic sequelae in patients with T1D, as well as preventive and treatment strategies to ameliorate cognitive decline.

Peningkatan Kompetensi Siswa Kelas XII TITL 1 Keahlian Teknik Instalasi Tenaga Listrik Smk Negeri 2 Depok pada Mata Pelajaran Sistem Pengendali Elektronik Melalui Metode Kooperatif STAD Tahun Pelajaran 2018/2019

This study aims to determine the effectiveness of the Student Team Achievement Division (STAD) cooperative learning method with the help of Electronic Control System learning media in improving the competence of class XII students in Electrical Power Installation Engineering skills at SMKN 2 Depok in the subject of electronic control systems. This research is a classroom action research conducted in two cycles, with three meetings for each cycle. Each cycle in this study consisted of four stages of implementation, namely planning, implementing actions, observing, and reflecting. Data was collected using affective observation sheets, psychomotor observation sheets, and pre-test and post-test instruments. The instrument of affective observation sheet is used to determine students' competence in the affective aspect. The psychomotor observation sheet instrument was used to determine student competence in psychomotor aspects. Pre-test and post-test instruments were used to determine students' competence in cognitive aspects. The data analysis technique used is data reduction, data exposure, and conclusion drawing. The results showed an increase in student competence in the affective, psychomotor, and cognitive aspects after the implementation of the STAD technique cooperative learning method with the help of Electronic Control System learning media. In the affective aspect, there was an increase of 48.21%, with the percentage of students' affective aspects at the first meeting of 56%, increasing to 83% at the sixth meeting. In the psychomotor aspect there was an increase of 22.15%, with the average psychomotor score of students on job sheet 1 of 67.66, increasing to 82.65 on job sheet 4. In the cognitive aspect there was an increase of 110.9%, with a score of the average pre-test cycle 1 was 38.53, increased to 81.26 in the post-test cycle 2.Keywords: student competence, student team achievement division, electronic control system

Peran Guru Penjaskes dalam Meningkatkan Minat Belajar Siswa terhadap Pembelajaran PJOK

This study aims to determine whether the use of learning videos using the google meet application during the Covid-19 pandemic can improve learning outcomes in the material of rhythmic motion activities in class V SDN 2 South Loktabat students. The method used in this research is classroom action research (classroom action research), with the model of Kemmis and Taggart (planning, implementing action, observing and reflecting. The subjects of the study were 27 students of class V-A SDN 2 South Loktabat. The data collection instruments were tests (multiple choice) and non-test (observation). Overall data in the form of quantitative data then analyzed descriptively using the percentage formula. The results of the study showed an increase in student learning outcomes from cycle one to cycle two. In the first cycle, the affective value was 67%, then in the second cycle increased by 93%, the cognitive value in the first cycle was 52%, then in the second cycle increased by 89%, the psychomotor score in the first cycle was 56% than in the second cycle is increased by 93%. It can be concluded that learning using google meet by utilizing instructional videos can improve learning outcomes of rhythmic gymnastics activities of class V students of SD Negeri 2 South Loktabat.

Peningkatan Aktifitas dan Hasil Belajar Siswa Melalui Penerapan Model Pembelajaran Creative Problem Solving di SMK

This study aims to determine whether the Creative Problem Solving learning model can improve the competence of class XI TITL students at SMK Negeri 1 Lembah Melintang West Pasaman. This research is classroom action research. The research was carried out in each cycle of three meetings. Each cycle consists of four stages, namely planning, acting, observing, and reflecting. Data collection used the pretest, posttest instrument, last year's student score document to determine the increase in cognitive aspects, observation sheets to determine the increase in affective aspects, and student activity sheets to determine the increase in psychomotor aspects. The data analysis used is descriptive quantitative. The success criteria established for each assessment indicator reached a class average score with a minimum score of 76. The results showed that with the application of the Creative Problem Solving learning model, the competence of student groups had increased. This can be seen with an increase in the affective aspect of the first cycle, the average value of 53.46%, and an increase in the second cycle of the third meeting to 88.68%. The cognitive aspect of students has increased, seen from last year's class score of 63.83, decreasing in posttest cycle 1 to 55.1, increasing in posttest cycle II to 80.1. The average psychomotor score also increased, the psychomotor score in the first cycle of the first meeting was 81.2, increasing to 91.9 in the second cycle of meeting 3. The results of the student's learning achievement had met the minimum completeness criteria.

Genetics education program to help public health nurses improve their knowledge and enhance communities\u2019 genetic literacy: a pilot study

BackgroundAs human genetics knowledge develops, public genetic literacy needs to be increased, though the educational capacity for this purpose has not yet been fully developed. Under this circumstance, the daily work of public health nurses can be viewed as an opportunity to enhance public genetic literacy. However, in Japan, there is not only a lack of public knowledge of human genomics but also a lack of public health nurses’ recognition about genomic literacy. A short-term education program was implemented as a pilot study. This study aimed to examine the effectiveness of the program to support public health nurses’ activity aimed at promoting health services-related genetic literacy.MethodsThe genetics education program was implemented in December 2019, in Kagoshima, Japan. Twenty-three public health nurses cooperated with the research. The program was composed of a case study on consultation, a lecture on hereditary diseases, and a discussion on the role of public health nurses. Familial hypercholesterolemia was used as the topic of the case study. We evaluated scores for cognition, affect, and psychomotor characteristics related to their learning goals before and after the program using Wilcoxon signed-rank tests. Answers in the consultation were qualitatively analyzed.ResultsThe mean cognitive score, capturing provision of explanations of hereditary disease, was 6.3 before the program but increased significantly to 9.3 after the program (p < 0.001). For the affective score, the goal of which was deepening interest in human genetics, the mean score increased significantly from 8.5 before to 11.0 after (p < 0.001). For the psychomotor score, addressing the need for genetic consultation, the mean score increased significantly from 4.4 before to 8.1 after (p < 0.001). Prominent themes extracted from descriptions on the worksheet post training included, “providing advice and accurate information on genetic disorders” and “referral to a specialized organization.”ConclusionsOur findings indicated that this education program helps public health nurses be positively involved in human genetic disorders. Thus, they may connect to their local community to provide accurate genetics knowledge and advice for health management and promoting genetic literacy.

Immediate Effect of Mental Practice on Performance of a Neurodynamic Skill in Physiotherapy Students: A Randomized Control Trial

Background: Mental Practice (MP), "the cognitive rehearsal of a task in the absence of overt physical movement," has been used successfully in teaching and rehearsing complex psychomotor tasks in several domains, including sports; music; and recently, in surgical skills acquisition. This study investigates the implementation of MP on performance of a neurodynamic skill in third year undergraduate Physiotherapy students. Method: It was a randomized control trial (single-blind) conducted in a Physiotherapy institute. A convenient sample of 40 III year undergraduate students who were novice for the topic were recruited. Some important preliminary steps involved development and validation of the tools used in the study viz. an audio script to guide mental imagery practice and an OSPE checklist to assess the outcome. The OSPE checklist was procedural specific for ULNT-1 and included stations for cognitive, psychomotor and affective domains. A neurodynamic skill (ULNT-1 Median nerve) was taught to all the students (n = 38, 2 drop outs) by a teacher as a didactic lecture followed by physical practice which was supervised and guided by the same teacher. After randomization, the intervention group (n=19) received MP guided by a structured audio script as a single session for 20 minutes delivered to all the participants together in a group. The control group participants (n=19) intended to serve as a basis of comparison and received no intervention. Pre- and post-intervention assessment was done by a set of examiners who were blinded to the intervention. Comparative analysis was done within the group using Wilcoxon sign rank test and between the groups using unpaired t test. Results: MP group showed significant improvement in cognitive, psychomotor, affective domain and total score of OSPE post intervention whereas the control group did not show significant difference except for the total score. Between group comparison showed significant differences in all the domains and total score in favor of the MP group. Also, the extent of improvement (effect size calculated using Cohen’s d) was more in the mental practice group than in the control group. Conclusion: MP as an adjunct to physical practice is a time-and cost-effective strategy to augment traditional training and enhance performance of a neurodynamic skill in Physiotherapy students. This preliminary evidence supported by robust scientific base and ease of integration should facilitate adoption of MP in Physiotherapy education. We recommend future studies to further explore the potential of this promising tool.

Enhancing students’ learning outcomes using guided inquiry learning model

This study aims to find out the enhancement of students’ performance and motivation using guided inquiry model in High School 2 Bandar, Simalungun. The methodology used is classroom action research with quantitative and qualitative approach. This study also used pretest and posttest as data collection which done in two cycle. The result showed that guided inquiry model could increase students’ performance and learning outcomes. The enhancement can be seen from (a) their average psychomotor score in the end of first cycle for 63 to be 71 in the second cycle; (b) their affective score that increased from zero to 19% in second cycle; (c) their high response toward guided inquiry model which showed that half of the students had very positive response and the other half had positive response. The analysis of students’ cognitive study obtained through pretest and posttest had average score in first cycle for 73 and increase to 76 in second cycle. Therefore, the guided inquiry learning model can increase students’ performance and learning outcomes.

PENERAPAN PEMBELAJARAN TARI DENGAN METODE DEMONTRASI MENGGUNAKAN MEDIA APLIKASI WHATSAPP DI SMA NEGERI 7 PADANG

This research aims to explain and describe the use of demonstration method using WhatsApp application in class XI IPS 3 at SMA Negeri 7 Padang. This is a qualitative research. The evaluation of the students’ outcomes in this research consists of the evaluation of Knowledge (cognitive) and Dance Practice (psychomotor). The data used were primary and secondary data. The data were collected through literature, observation, and documentation/ shooting studies. The data was analyzed by using the percentage formula. The results of the study show that the implementation of demonstration method in Cultural Arts learning in class XI IPS 3 at SMA Negeri 7 was conducted in online learning. Both theory learning and dance practice could be carried out well. This is evidenced by the grades students got in the theory learning at the second meeting. The average score got is 78.7. Meanwhile, at the dance practice learning, students got 76.7 in the meeting 4. In addition, at the meeting 5, the score increases to 82.9. It can be concluded that the average psychomotor score of students at the end of the study is 79.8 and it is categorized good.Keywords: Dance Learning, Demonstration Method, WhatsApp App

Peer Trainers Compared with Basic Life Support Trainers in Delivering Effective Cardiopulmonary Resuscitation Training to Secondary School Students

Teaching cardiopulmonary resuscitation (CPR) skills to the public is essential in improving cardiac arrest survival. American Heart Association suggested to incorporate it into the school curriculum. Peer trainers is a low cost and effective method in achieving this. The objective of this 3 months prospective controlled study was to compare the effectiveness of teaching compression only CPR between peers and certified basic life support (BLS) trainers to secondary school students. Improvement in knowledge and psychomotor skills of CPR compression were the primary outcome evaluated. Twelve peer trainers aged 16-years-old and twelve certified BLS trainers were recruited into the study. Compression only CPR was taught to 36 randomized secondary school students by either peer trainers (Group P) or BLS trainers (Group B). A pre-test, immediate post-test and 3 months retention test on knowledge and psychomotor skill were conducted. There was no statistically a significant difference in the mean scores of knowledge and psychomotor at pre-test, post-test and 3 months retention between Group P and Group B. There was significant increase of knowledge score between pre-test and post-test in Group P (mean difference 5.8+2.7, p<0.001) and in Group B (mean difference 4.7+2.7, p<0.001). Psychomotor score was significantly increased between pre-test and post -test in Group P (mean difference 7.11+1.49, p<0.001) and Group B (mean difference 7.22+1.5, p<0.001). Peer trainers is non-inferior to BLS trainers in teaching CPR to secondary school students as both groups showed significant improvement at post-test.

Penerapan Modifiksi Alat Bantu Pembelajaran Bokortasko terhadap Hasil Belajar Permainan Bulutangkis Siswa Kelas VIII A di SMPN 18 Kota Jambi Tahun 2017/2018

Lack of student involvement in participating in physical education learning which results in learning outcomes becoming less, it is necessary to do an action that can increase student participation so that the goals of learning can be achieved. The purpose of this study was to determine the improvement in learning outcomes of badminton games in class VIII A students through the application of modifications to the bokortasko learning aids in Jambi City Middle School 18 of the academic year 2017/2018. In this study, the research design used was classroom action research (CAR) by taking action through cycle I and cycle II. Cognitive learning outcomes have increased. In the first cycle the average value of the written test was 7.8 and in the second cycle the average score of the written test was 9, so the cognitive learning results from cycle I to cycle II increased by 15.4%. Affective learning outcomes also increase. The affective average value in cycle I is 7.9, and the affective average value in cycle II is 8.2. So affective learning outcomes from cycle I to cycle II have increased by 3.8%. Psychomotor learning outcomes also increased, in the first cycle the psychomotor score was 7.6 and in the second cycle was 8.1. So psychomotor learning outcomes from cycle I to cycle II increased by 6.6%.

Briquettes production as teaching aids physics for improving science process skills

The aim of this research is production briquettes as teaching aids in order to improve students’ science process skill. Research design used in this study was using experimental methods. One of the learning methods that can be used to equip student’s science process skill is the experimental method. In this study, students utilize agricultural waste and plantations around the school. Then they make the briquettes from the waste. This research used waste rice husk waste, durian leather and coconut fiber. After that, the results of briquettes will be assessed as the feasibility of teaching aids. The results of students’ affective and psychomotor ratings show excellent results. Among them are: classical affective average score for group 1 is 82.80; group 2 is 87.20; and group 3 is 85.20. While the classical average psychomotor score for group 1 is 82.80; group 2 is 86.20; and group 3 is 84.20.

Peningkatan Aktivitas dan Hasil Belajar Siswa dalam Pembelajaran IPA dengan Menggunakan Model Discovery Learning di Kelas V SDN 149/VIII Muara Tebo Jambi

This research is done due to students’ low activities in learning natural science. The teacher focused on the concepts found in the text book which have to be memorized by the students. As a result, the students’ learning outcomes were low. This research aims to describe the improvement of students’ natural science activities and learning outcomes by using the discovery learning model. The design of the research was class action research using both qualitative and quantitative approaches. The research was done at SDN 149/VIII Muara Tebo. The subjects were twenty four fifth grade students of the school. It is found that the discovery learning model improves students’ activities and learning outcomes. The activities that were observered in this research involved listening, oral, mental, and emotional.the score of the students’ activities increased from 67,12 in cycle I to 81,76 in cycle II. Meanwhile, the improvement of students’ learning outcomes was found from their cognitive score of 60 in cycle I to 71 in cycle II. Their affective score enhanced from 67,90 in cycle I to 75,88 in cycle II. Finally, their psychomotor score increased from 67,72 in cycle I to 75,88 in cycle II. It is concluded that the discovery learning model can be used as one alternative to improve students’ activities and learning outcomes in learning natural science.

Pengaruh Model Pembelajaran Kooperatif Tipe Think-Pair-Share Dengan Metode Eksperimen Terhadap Hasil Belajar Peserta Didik MAN Lombok Barat Tahun Pelajaran 2017/2018

Abstract - This research is aimed to find the effect of cooperative model learning think pair share type with experiment method toward learning physics result of the students at man west Lombok in academic year 2017/2018. The kind of this research is quasi experiment with Untreated control group design with pretest-posttest research design. The population of this research is all of the XI students of MAN West Lombok which consist of 34 students. Sampling jenuh technique is a way of taking the sample, while XI IPA 1 students as experiment class and XI IPA 2 as control class. The instruments that used are; multiple choice test and observation sheet. The amount of the multiple choice test are 25 questions where the test before has been through validity test, reliability, different capacity and standard of questions difficulty, while the observation sheet used to measure the affective and psychomotor score. Based on the result of the research that achieved from the mean score for pretest of experiment class is 40,19 and control class is 37,45, while the mean score of post-test experiment class is 73,52 and control class is 51,27. The hypothesis of the research is tested using t-test polled varians with significant standard 5% and achieved tresult 7,646 and ttable  2,021. Based on the criteria of hypothesis test, if tresult &gt; ttable, it means Ho released and Ha accepted, where it can conclude that there is a effect of cooperative model learning think pair share type with experiment method toward learning physics result of the students at man west Lombok in academic year 2017/2018.

Increased The Cognitive, Effective, and Psychomotor Aspects of Nurses in The Practice of Developmental Care

Background: The cause of high infant mortality rate is low birth weight (LBW). Optimal LBW treatment needed that the baby can pass the transition from intrauterine to extrauterine. One of the efforts done is developmental care. Implementation of developmental care requires knowledge, attitudes and skills of nurses. Objective: This study aims to identify the cognitive, affective and psychomotor aspects of nurses in treating LBW before and one month after being given developmental care information at RS Roemani Semarang. Methodology: The design of this research are pre experiment pre and post design. The sample of the study was all nurses in high risk infant room Roemani Hospital Semarang . Sample amounted to 12 respondents. Researchers identify the cognitive, affective and psychomotor aspects of nurses in treating LBW with questionnaires and observations before being given developmental care information. A month after being given information about developmental care researchers re-identify the cognitive, affective and psychomotor aspects of the nurse. Result: Cognitive score of respondent before health education 11.75 and after 13.83 with total score 22, mean affective score of respondent before health education 48,83 and after 52,92 with total score 60, mean of psychomotor score of respondent before health education 2.58 and after 4 with a total score of 4. Based on the results of statistical analysis each show p value 0.00 so that it can be concluded there are differences cognitive, affective and psychomotor nurses in the application of developmental care both before and a month after being given health education. Discussion: In this study post intervention is done month after health education like input from previous researcher Zubaidah, rustina &amp; Sabri (2013) to know the right time in repeating the same information. The results showed that after 30 days showed a cognitive, affective and psychomotor increase, this could be because after given the health education nurses apply in the care of LBW so that knowledge and skills increase.

Improving science learning achievement and creativity through surrounding natural environment approach

The research aimed to improve the learning process on science competence, improve the students’ creativity, and improve the students’ science learning achievement of grade V SD Negeri Karangreja 01, Cipari district, Cilacap regency through surrounding natural environment approach. The research was Classroom Action Research. The study was conducted in two cycles. This research was conducted in SDN Karangreja 01 Cipari, Cilacap from November to December 2014. The objects were all students of grade V consisting of 17 students. The data were collected using observation, paper and pencil tests, interviews, and documentation. The results showed the implementation of surrounding natural environment approach in science instruction could improve the students’ creativity and science learning achievement of grade V. The improvement of learning process indicated through the mean score at cycle I and II which are 13 and 14 respectively. The improvement of students’ creativity and learning achievement was indicated through the mean score of creativity test, the mean score of learning achievement on the aspects of affective, psychomotor, and cognitive at cycle I and cycle II. The improvement of creativity test score at cycle I and II were 11.56 and 13.31 respectively. The improvement of affective score at cycle I and II were 2.99 and 3.58 respectively. The improvement of psychomotor score at cycle I and II were 2.50 and 3.42 respectively. The improvement of cognitive score at cycle I and II were 75.36 and 86 respectively.

Effets de la plagiocéphalie posturale au cours des 12 premiers mois sur le développement psychomoteur à 4 ans des enfants nés très prématurément

The link between deformational plagiocephaly and psychomotor development is a recurrent question in medical publications. Main publications concentrate on term infants, but there is a lack of data on the impact of deformational plagiocephaly on the long-term neurodevelopment of premature infants. We attempted to establish a possible relation between deformational plagiocephaly during the 1styear of life and the psychomotor score at 4years in prematurely born infants. Other risk factors potentially impacting the psychomotor score were also studied. A retrospective study of the files of the children followed by the "Naître et Devenir Région PACA Ouest Corse Sud" healthcare network and included in the database allowed us to select a cohort of 594infants born prematurely at under 33weeks of gestational age. These children were developmentally evaluated during the 1styear of life and at 4years or age using the "EVAL Mater" test. The "Naître et Devenir" network is following up infants born prematurely at under 33weeks of gestation in the West Provence Alpes Côte d'Azur and South Corsica region, from discharge to 7years. A group of 170specially trained pediatricians follow these infants developmentally at term, 3, 6, 9, 12, 18, and 24months of corrected age and 3, 4 5, 6, and 7years. Data are collected in a specially designed database. There was no significant link between deformational plagiocephaly during the 1styear of life and a pathological psychomotor score at age4, but some risk factors were demonstrated: male gender, birth at under 28weeks of gestational age, weight at birth under 1000g, having a Latal and Ferriero neuromotor score equal to or greater than 2 at 3months of corrected age, and to a lesser extent having a prescription for physiotherapy during the 1styear. The research on deformational plagiocephaly in the full-term infant suggests a relation between deformational plagiocephaly and developmental delay predominantly on the motor side, with an increased rate of special needs services at school age. The question is raised of whether deformational plagiocephaly is the cause of the delay or an early sign of cerebral anomaly with an early motor delay in full-term infants. The results suggest that deformational plagiocephaly in the prematurely born infant may not be related to neurodevelopmental delay but simply to the extended time spent in the supine position because of the early birth associated with physiological hypotonia and axial extension. Other risk factors such as male gender, birth before 28weeks of gestation, weight less than 1000g, a Latal and Ferriero neuromotor score greater than 2 at 3months of corrected age, and having a prescription for physiotherapy during the 1styear of life are strongly related to delayed psychomotor development at age4.

Impact of Maternal Selenium Status on Infant Outcome during the First 6 Months of Life

Pregnant women and infants are at risk for selenium deficiency, which is known to have negative effects on immune and brain function. We have investigated selenium levels in 158 healthy never-pregnant women and in 114 pregnant and lactating women and their infants at age 6 months and related this to clinical outcomes during the first 6 months of life. Neurodevelopment was assessed with the parental questionnaire Ages and Stages (ASQ) at 6 months. A maternal selenium level ≤0.90 µmol/L in pregnancy week 18 was negatively related to infant neurodevelopment at 6 months (B = −20, p = 0.01), whereas a selenium level ≤0.78 µmol/L in pregnancy week 36 was associated with an increased risk (odds ratio 4.8) of having an infant infection during the first 6 weeks of life. A low maternal selenium status in pregnancy was found to be associated with an increased risk of infant infection during the first 6 weeks of life and a lower psychomotor score at 6 months. We suggest a cutoff for maternal serum selenium deficiency of 0.90 µmol/L in pregnancy week 18 and 0.78 µmol/L in pregnancy week 36. This should be reevaluated in an intervention study.

“Effect of prenatal exposure to fine airbone particles on child mental and psychomotor development: an analysis based on propensity score matching”

Introduction: Maternal exposure to ultrafine airborne particulate matter during pregnancy has recently been identified as a potential risk factor for infant neuropsychological development. This study estimated the causal effect of prenatal exposure to high concentrations of particles less than 2.5 μg/m3 in diameter (PM2.5) on children’s psychomotor and mental scores during their second year of life, in a birth cohort from the province of Guipúzcoa (The Basque Country, Spain). Methods: We performed the analysis under a potential outcome approachon 438 mother-children pairs. We focused on the average PM2.5 level during the whole pregnancy and we considered a binary version of this exposure in respect to the median: PM2.5&lt;17 μg/m3 (control), PM2.5≥17 μg/m3 (treatment). A logistic model on this binary exposure was specified to estimate the propensity score,including the available background variables as predictors. The average treatment effect on the exposed children (Average Treatment effect on the Treated, ATT) was estimated for both the outcomes, following a nearest-neighbor matching procedure based on the estimated propensity score. Due to the presence of missing exposures, separated analyses were performed on five complete data sets obtained applying a Multiple Imputation procedure and the five results were combined in a final ATT estimate. Results: The final ATT estimate was equal to -2.3 (90% CI: -7.1; 2.5) for mental score and -3.1 (90% CI: -7.9; 1.7) for psychomotor score, indicating that, when exposed to high level of PM2.5, children get lower test scores. The large confidence intervals partly reflect the variability due to the presence of missing data. Conclusions: Our results suggest the existence of a negative causal effect of exposure to high PM2.5 levels during pregnancy on the infant psychomotor and mental development.

Virtual reality training for improving the skills needed for performing surgery of the ear, nose or throat.

Virtual reality simulation uses computer-generated imagery to present a simulated training environment for learners. This review seeks to examine whether there is evidence to support the introduction of virtual reality surgical simulation into ear, nose and throat surgical training programmes. 1. To assess whether surgeons undertaking virtual reality simulation-based training achieve surgical ('patient') outcomes that are at least as good as, or better than, those achieved through conventional training methods.2. To assess whether there is evidence from either the operating theatre, or from controlled (simulation centre-based) environments, that virtual reality-based surgical training leads to surgical skills that are comparable to, or better than, those achieved through conventional training. The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 6); PubMed; EMBASE; ERIC; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 27 July 2015. We included all randomised controlled trials and controlled trials comparing virtual reality training and any other method of training in ear, nose or throat surgery. We used the standard methodological procedures expected by The Cochrane Collaboration. We evaluated both technical and non-technical aspects of skill competency. We included nine studies involving 210 participants. Out of these, four studies (involving 61 residents) assessed technical skills in the operating theatre (primary outcomes). Five studies (comprising 149 residents and medical students) assessed technical skills in controlled environments (secondary outcomes). The majority of the trials were at high risk of bias. We assessed the GRADE quality of evidence for most outcomes across studies as 'low'. Operating theatre environment (primary outcomes) In the operating theatre, there were no studies that examined two of three primary outcomes: real world patient outcomes and acquisition of non-technical skills. The third primary outcome (technical skills in the operating theatre) was evaluated in two studies comparing virtual reality endoscopic sinus surgery training with conventional training. In one study, psychomotor skill (which relates to operative technique or the physical co-ordination associated with instrument handling) was assessed on a 10-point scale. A second study evaluated the procedural outcome of time-on-task. The virtual reality group performance was significantly better, with a better psychomotor score (mean difference (MD) 1.66, 95% CI 0.52 to 2.81; 10-point scale) and a shorter time taken to complete the operation (MD -5.50 minutes, 95% CI -9.97 to -1.03). Controlled training environments (secondary outcomes) In a controlled environment five studies evaluated the technical skills of surgical trainees (one study) and medical students (three studies). One study was excluded from the analysis. Surgical trainees: One study (80 participants) evaluated the technical performance of surgical trainees during temporal bone surgery, where the outcome was the quality of the final dissection. There was no difference in the end-product scores between virtual reality and cadaveric temporal bone training. Medical students: Two other studies (40 participants) evaluated technical skills achieved by medical students in the temporal bone laboratory. Learners' knowledge of the flow of the operative procedure (procedural score) was better after virtual reality than conventional training (SMD 1.11, 95% CI 0.44 to 1.79). There was also a significant difference in end-product score between the virtual reality and conventional training groups (SMD 2.60, 95% CI 1.71 to 3.49). One study (17 participants) revealed that medical students acquired anatomical knowledge (on a scale of 0 to 10) better during virtual reality than during conventional training (MD 4.3, 95% CI 2.05 to 6.55). No studies in a controlled training environment assessed non-technical skills. There is limited evidence to support the inclusion of virtual reality surgical simulation into surgical training programmes, on the basis that it can allow trainees to develop technical skills that are at least as good as those achieved through conventional training. Further investigations are required to determine whether virtual reality training is associated with better real world outcomes for patients and the development of non-technical skills. Virtual reality simulation may be considered as an additional learning tool for medical students.

THE EFFECT OF COOPERATIVE LEARNING MODEL TYPE GROUP INVESTIGATION (GI) TO STUDENTS’ LEARNING OUTCOME ON LINEAR MOTION TOPIC

ABSTRACT The objectives of this research is to know whether students’ learning outcome by using cooperative learning model type group investigation is better than conventional learning in the subject matter linear motion in class X SMA Santo Thomas 3 Medan A.Y. 2014/2015. The research method was quasi experimental. The populations were all X IPA grade students in first semester that consist of 3 classes SMA Santo Thomas 3 Medan. The samples of this research conduct two classes and consist of 62 students, 31 from experiment class and 31 from control class and define by random cluster sampling. The results that were obtained: pre-test mean value of experiment class was 42.26 and 41.45 for control class and then post-test mean value of the experiment class was 80.48 and 64.03 was the mean value for control class. Standard deviation in pre-test were 7.62 in experiment class and 7.55 in control class and standard deviation in post-test for two classes were 6.87 and 8.89. Then, based on observation that done by observers by using observation sheet of students’ affective and psychomotor. Students’ affective score on last meeting of experiment and control class are 91.83 and 87.10 and students’ psychomotor score on last meeting of experiment and control class are 85.01 and 80.78 . From hypothesis test, concluded that students’ learning outcome after taught by using cooperative learning model type group investigation is better conventional learning. Key word: Cooperative Learning Model Type Group Investigation, Students’ Learning Outcome