Randomized Control Group Design Research Articles

Effectiveness of self-re-learning using video recordings of advanced life support on nursing students\u2019 knowledge, self-efficacy, and skills performance

BackgroundNurses are presumably the first to see an in-hospital cardiac arrest patient. This study proposed measuring nursing students’ knowledge, self-efficacy, and skills performance in advanced life support (ALS), 6 months after training, by sending videos taken during their final skills test after the ALS training.MethodsThis is an experimental study using a randomised control group design. This study was conducted from June to December 2018, and the subjects of the study were 4th year students, recruited through a bulletin board at a nursing university. The participants’ knowledge, self-efficacy, and skill performance in ALS were evaluated immediately after the training, and participants were videotaped during the final skills test. Thereafter, the videos were sent to the experimental group through a mobile phone messenger application, once a month, from the third month after training. Approximately six months after training day, a follow-up test was conducted for the measured variables using a blinded method. The paired t-test and Wilcoxon signed-rank test were used to compare the two groups pre-and post-intervention. The statistical significance level was set at p < .05.ResultsSix months after the ALS training, knowledge scores decreased significantly in both groups (p < 0.001). Self-efficacy decreased by about 3 points from 50.55 to 47.18 in the experimental group (p = 0.089), while it decreased by 10 points in the control group, from 50.67 to 39 (p < 0.001). The skills performance decreased from 27.5 to 26.68 in the experimental group, while it decreased significantly from 27.95 to 16.9 in the control group (p < 0.001).ConclusionSelf-study with videos taken during an ALS skills test helps enhance the sustainable effects of training such as knowledge, self-efficacy, and skills performance.

Efek anthiperkolesterol snack bars beras ketan hitam (Oryza sativa var. glutinosa) labu kuning (Cucurbita moschata) pada tikus Sprague dawley

Snack bars from black glutinous rice and yellow pumpkin powder has been developed. The aim of the research was to evaluate the effect of the snack bars to the lipid profile of white male rats Sprague dawley. The experimental design of the research was Pre-Post Test Randomized Control Group Design using 25 male white rats. The rats were divided randomly into 5 groups, which was Group 1 as negative control (standard feed), Group 2 as positive control (feed with lard for hyper cholesterolemia condition, Group 3 was treated with simvastatin (0.18 mg / 200gBB), Group 4 treated with snack bars A (450mg / kgBB) and Group 5 was treated with snack bars B (450mg / kg BB). The differences between snack bar A and B were the proportion of black glutinous rice and yellow pumpkin powder. The snack bar was given orally. Total cholesterol, HDL, LDL, and triglycerides after 14 days of the treatment. According to the statistical analysis (p&lt;0.05), the results showed that group with simvastatin has no significant differences with group with snack bars A. Group with simvastatin, snack bars A, and snack bars B significantly influence blood cholesterol levels, total cholesterol, triglyceride levels, and LDL levels. Mainly, snack bars A could decline blood cholesterol as good as simvastatin. Snack bars A have a higher portion of black glutinous rice than snack bars B.

Role Of Moringa Oleifera Leaf Extract In Increasing Hemoglobin Levels In Pregnant Rats With Anemia

Anemia is one of the epidemic health problems in society and the most common nutritional problem. The Moringa oleifera is rich in excellent dietary content and can complement the body's needs. This study aims to determine Moringa oilefera leaf extract's effectiveness in increasing hemoglobin levels in pregnant rats (Ratus norvegicus) with anemia. This paper used a true experimental research design with a pre-post test randomized control group design. This study utilized female rats (Ratus norvegicus), pregnant 8-12 weeks, weighing 200 grams. Experimental procedures were four treatments with three repetitions. Types of treatment were negative control and positive control (administration of Moringa oilefera leaf extract) at a dose of 0.18 g / head, 0.36 g / head, and 0.72 g/head. Analysis using one way ANOVA with an error rate of 0.05. The results showed p&lt;0.005, which means a significant increase in hemoglobin levels in the group given the treatment of moringa leaf extract at a dose of 0.72 g/head/day. The conclusion and suggestion from this research are public could get information about using natural materials as economically valuable drugs (back to nature)

THE EFFECT OF STRATIFIED DOSES OF CURRY LEAF EXTRACT (MURRAYA KOENIGII) ON TOTAL CHOLESTEROL AND TRIGLYCERIDES IN MALE SPRAGUE-DAWLEY RATS INDUCED BY HIGH FAT FEED

Background: High level of total cholesterol and tryglicerides in the blood can cause atherosclerosis. Curry leaves are often used by the society to reduce total cholesterol and trygliceride levels in the blood, but no studies have examinded the effective dosage of curry leaf extract to reduce total cholesterol and triglyceride levels.Aim: This study aims to determine the effect of giving curry leaf extract (Murraya koenigii) on cholesterol and triglyceride levels of male Sprague-Dawley rats induced by high fat feed.Methods: This study was a true experimental study with a pre-post test with randomized control group design. The subjects of the study were male Sprague-Dawley rats induced by high fat feed for 10 days. Cholesterol and triglyceride levels were measured by enymatic methods. Then, the data were analyzed using paired t test and for P3 group total cholesterol using the Wilcoxon test to analyze the differences in total cholesterol and triglyceride levels between before and after given the curry leaf extract, Repeated Anova test to analyzed the differences between groups which was then followed by post hoc bonferoni and One Way Anova to analyze the differences in total cholesterol and triglyceride levels between groups.Results: There was no significant differences in total cholesterol levels between before and after given the curry leaf extract at a dose of 200 mg/KgBW, 300 mg/KgBW, and 400 mg/KgBW (p= 0.641 for the P1 group, p= 0.385 for the P2 group and p= 0.398 for the P3 group). In contrast to triglyceride levels, there were differences in triglyceride levels before and after administration of curry leaf extrcat at a a dose of 300 mg/KgBW (p= 0.012), while the other groups were not significant.Conclusion: The stratified doses of curry leaf extract (Murraya koenigii) in this study could not reduce cholesterol level and triglyceride levelKeywords: Curry leaf extract; Dyslipidemia; Total Cholesterol; Triglyceride

When do errors in reinforcer delivery affect learning? A parametric analysis of treatment integrity.

Treatment integrity is the extent to which components of an intervention are implemented as intended (Gresham, 1989). Recent behavior-analytic literature has begun to evaluate the effects of reduced-treatment integrity on the efficacy and efficiency of skill-acquisition interventions. This study extended the current literature on the effects of errors of omission and commission of reinforcer delivery by replicating and extending Hirst and DiGennaro Reed (2015). Using a randomized-control group design, we compared undergraduate student participants' acquisition of conditional discriminations in a parametric analysis of different error values. A computer program erred in reinforcer delivery on 0%, 5%, 10%, 15%, 20%, 25% and 50% of trials. The purpose of the current study was to identify which levels of reduced integrity slowed or prevented acquisition. Our data replicated the findings of Hirst and DiGennaro Reed, and extended parametric analyses by identifying that errors in reinforcer delivery occurring on 15% or fewer trials (i.e., 85% integrity) were unlikely to prevent participants' responding from meeting the mastery criterion. These results could inform future research on how treatment-integrity errors change behavior-analytic procedures and the effects on skill acquisition for consumers of applied behavior analysis.

The effect of mindfulness based psychoeducation program on adolescents’ character strengths, mindfulness and academic achievement

The research was conducted to prepare a mindfulness-based psychoeducation program for adolescents and to test the effect of the program on character strengths, mindfulness levels, and academic achievement of high school students. The study was designed as mixed-method research, and consisted of two stages. In the first stage, the relationship between mindfulness, character strengths, and academic achievement was investigated. According to the findings, 24.5% of the variance in grade point average was predicted by mindfulness and three character strengths including persistence, prudence, and openness to learning. In the second stage, a mindfulness-based psychoeducation program was developed and its effects on high school students’ perseverance, prudence, love of learning character strengths, mindfulness, and academic achievements were examined in a pretest- posttest randomized control group design. According to results, the 8-week mindfulness-based psychoeducation program increased the level of mindfulness of participants, while partially increasing their three character strengths, and academic achievement.

Acute Response Moderate Intensity Treadmill Training On Decrease Malondialdehyde In Obesity Women

This study aims to analyze the acute response of moderate intensity treadmill exercise to a decrease in MDA levels in obese women. True experiment research method with the randomized control group design posttest-only design using 21 obese women and randomly divided into three groups, namely K1 (n = 7, control without intervention), K2 (n = 7, moderate intensity interval training) and K3 (n = 7, moderate intensity continuous training). The intervention was carried out at 7-10 a.m. Moderate interval training interventions were carried out for 45 minutes, whereas moderate intensity continuous exercises were carried out for 40 minutes. Blood samples were taken 10 minutes after the intervention. MDA levels were measured using the Thiobarbituric Acid Reactive substance (TBARs) method. The results were obtained at K1 (811,286 ±72,539) ng / mL, K2 (615,571 ± 96,855) ng / mL, K3 (658,429 ± 113,934) ng / mL and (p =0.003)

Acute Moderate Intensity Exercise Decreases Oxygen Saturation In Obese Women

This study aims to analyze acute moderate intensity exercise decreases oxygen saturation in obese women. True experiment with a randomized control group design posttest-only design using 14 obese women aged 19-24 years, body mass index 27-33 kg/m2, percentage body fat (PBF) above 30 % and fasting blood glucose (FBG) below 100 mg/dL, normal hemoglobin, normal systolic and diastolic blood pressure, normal resting heart rate and randomly divided into two groups, namely CON (n=7, control without intervention) and MIE (n=7, moderate intensity exercise). Moderate intensity exercise interventions carried out for 40 minutes using a treadmill. Blood sampling is done 10 minutes after the intervention. Measurement of oxygen saturation using a Pulse Oximeter. The results obtained mean oxygen saturation at CON (98.428±0.534) % and MIE (96.571±0.975) % (p=0.001). Based on the results of the study concluded that moderate moderate intensity acute exercise reduces oxygen saturation in obese women.

EFFECTIVENESS OF TOPICAL APPLICATION OF MIXTURE OF HONEY AND COFFEE IN RADIATION INDUCED ORAL MUCOSITIS AMONG PATIENTS WITH HEAD &amp; NECK CANCER UNDERGOING RADIOTHERAPY AT RADIOTHERAPY DEPARTMENT OF KGMU, LUCKNOW, U.P

Background: Cancers commonly known as head and neck cancers typically begin in the squamous cells that line the moist, mucosal surfaces within the head and neck. Oral mucositis is erythematous and ulcerative lesion of the oral mucosa in patients with cancer being treated with chemotherapy/ radiation therapy in the areas of oral cavity. Objectives: To assess the grade of the oral mucositis among head &amp; neck cancer patients receiving radiotherapy. 2. To evaluate the effectiveness of mixture of honey and coffee application on radiation induced oral mucositis among the study group. 3. To find the association between the radiation induced oral mucositis with selected demographic variables. Method: quasi experimental non randomized control group design was applied and 60 samples (30 in each group) were selected by convenience sampling technique. The mixture of honey and coffee was applied to the study group before and after 15 minutes of radiotherapy till the continuation of radiotherapy and no intervention was given in the control group. Result: The result revealed that the application of honey and coffee mixture was significantly effective on oral mucositis (p&lt;0.001) in the study group. Conclusion: The study concluded that, application of mixture of honey and coffee is an effective method of reducing the onset and severity of oral mucositis in comparison with no intervention.

Effect of 1 Year of Qigong Exercise on Cognitive Function Among Older Chinese Adults at Risk of Cognitive Decline: A Cluster Randomized Controlled Trial.

Background: The rapidly aging Chinese population is showing an increase in age-related illnesses, including mild cognitive impairment and Alzheimer disease. The best types of physical activity for the improvement of cognition remain unknown. This study aimed to compare the effectiveness of a tailored qigong exercise with that of stretching exercise in the maintenance of cognitive abilities in Chinese elders at risk of cognitive decline. Methods: Seventy-four community-dwelling adults aged ≥60 years were screened for eligibility. Using a randomized control group design, participants with scores ≥19 on the Chinese version of the Montreal Cognitive Assessment-Basic (MoCA) were allocated to a 1-year qigong intervention (n = 33) and a stretching control exercise group (n = 33). The primary outcome was the MoCA score, as a measure of global cognitive function, and secondary outcomes were globe cognition and five domain scores on the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The MoCA and RBANS were administered at baseline and 1 year after intervention to assess the effect of the exercises on cognitive decline. Results: Twenty-five of 33 (75.8%) participants in the qigong group and 26 of 33 (78.8%) participants in the control group completed the 1-year exercise programs. A bivariate test revealed strong correlation between MoCA and RBANS total scores after the intervention (r = 0.517, p < 0.01). Generalized estimating equations revealed a lower risk of progression of cognitive decline at 1 year in the qigong group than in the control group (odds ratio, 0.314; 95% confidence interval, 0.103–0.961; p = 0.04). Two-way repeated-measures ANOVA followed by post hoc t tests with Bonferroni corrections indicated that MoCA and RBANS scores were significantly higher in the qigong group than in the control group (MoCA and RBANS global cognition, memory, visuospatial/constructional ability, and language, all p < 0.01), with the exception of RBANS attention score (p > 0.05). Conclusions: One year of qigong practice was significantly superior to stretching exercise not only for the prevention of cognitive decline progression, but also for the improvement of several cognitive functions, among older Chinese adults at risk of cognitive decline.

Problem-based and thinking talk write learning model, mathematical reasoning, and transformation geometry

Several studies on learning mathematics show that students’ reasoning abilities are still low. Students may be more introduced to the use of formulas and memorizing formulas without involving reasoning. This reason is what underlies researchers to conduct research using the Problem Based Learning and Think Talk Write models. This study aims to 1) determine the effectiveness of mathematics learning by using Problem-Based Learning to improve mathematical reasoning abilities, 2) determine the effectiveness of mathematics learning by using Think Talk Write learning to enhance mathematical reasoning abilities, and 3) determine the difference between Problem-Based Learning and Think Talk Write learning models to improve mathematical reasoning abilities. The research method used in this study is quasi-experimental. The design used a pretest-posttest with a randomized control group design. Data collection techniques use test instruments to measure mathematical reasoning abilities and questionnaires to measure student learning interest. The results showed that mathematics learning with Problem-Based Learning model learning is effective in terms of increasing mathematical reasoning abilities. Mathematical learning with Think Talk Write learning models are effective in terms of increasing mathematical reasoning abilities. And, there is no difference between the Problem-Based Learning and Think Talk Write model for improving mathematical reasoning abilities.

Effect of Rational-Emotive Distress Management Intervention on Work-Related Emotional Distress among Primary Healthcare Workers

Emotional distress is associated with irrational beliefs, psychopathological conditions, and maladaptive behaviors. The objective of this study was to investigate the effect of rational-emotive distress management intervention -REDMI on work-related emotional distress among primary healthcare workers -PHCWs in Nigeria. A pretest-posttest randomized control group design was adopted by the investigators. Using convenient sampling procedure, 52 PHCWs were studied. These participants were assigned to either treatment (n=26) or control (n=26) groups respectively. Only the treatment group received rational-emotive distress management intervention. The profile of emotional distress &amp;ndash;PED (internal consistency=0.94) was used for the pretest and posttest data collection. The IBM SPSS version 22 was employed for all statistical data analysis. The study participants in treatment group scored lower (10.87&amp;plusmn;2.63) in the posttest measure when compared to pretest scores (18.24&amp;plusmn;2.88). This implied that REDMI was effective in managing work-related emotional distress in a sample of primary healthcare workers in Nigeria. The REDMI is effective in managing work-related emotional distress among PHCWs in Nigeria. Professionals and experts in emotional health are therefore encouraged to adopt management intervention programs such as REDMI in helping workers and clients to manage emotional distress.Emotional distress is associated with irrational beliefs, psychopathological conditions, and maladaptive behaviors. The objective of this study was to investigate the effect of rational-emotive distress management intervention -REDMI on work-related emotional distress among primary healthcare workers -PHCWs in Nigeria. A pretest-posttest randomized control group design was adopted by the investigators. Using convenient sampling procedure, 52 PHCWs were studied. These participants were assigned to either treatment (n=26) or control (n=26) groups respectively. Only the treatment group received rational-emotive distress management intervention. The profile of emotional distress &amp;ndash;PED (internal consistency=0.94) was used for the pretest and posttest data collection. The IBM SPSS version 22 was employed for all statistical data analysis. The study participants in treatment group scored lower (10.87&amp;plusmn;2.63) in the posttest measure when compared to pretest scores (18.24&amp;plusmn;2.88). This implied that REDMI was effective in managing work-related emotional distress in a sample of primary healthcare workers in Nigeria. The REDMI is effective in managing work-related emotional distress among PHCWs in Nigeria. Professionals and experts in emotional health are therefore encouraged to adopt management intervention programs such as REDMI in helping workers and clients to manage emotional distress.

Physical Exercises By Giving Glutathione for Changes of Leukocytes, Neutrophils, and Lymphocytes Amounts

Physical exercise changes the antibody endurance of each person. This study aims to determine in depth changes in the number of leukocytes, neutrophils, and lymphocytes using physical exercise after being given glutathione. The method used experimentally using a posttest randomized control group design. The study was conducted in three groups where each group consisting of men and women who are in the age range of 20-30 years. Each group consisted of 10 people (n), K1 was given a placebo, K2 was given glutathione 54 mg / kg BW, K3 given 108 mg / kg BW. All treatments are given intraperitoneally twice a day until the third day. Maximum physical exercise is swimming. On the third day after 3 hours of treatment (placebo or glutathione), then participants take a leukocyte profile measurement. The findings show that the number of leukocytes: K2&gt; K1; P = 0.005; K2 - K3; P = 0.168; - K3; P 0.105, neutrophils: Kl, K2 and K3 are not different, even though K2 is highest, lymphocyte: K2&gt; K1; P = 0.003, K1 - K3 and K2 - K3 is not different even though K2 is highest. The conclusion of this study is the number of leukocytes and lymphocytes treated with glutathione 54 mg / kg BW (K2) is significantly higher than K1 after strenuous physical exercise. Thus, the content of glutathione must be balanced with the body’s needs so that the body is healthy and is able to do the heavy activities.

Reducing Senior High School Students’ Misconceptions through Inquiry Learning Model on Thermochemistry Material

Misconception is a serious problem faced by high school students. Through the application of inquiry learning model, this study tries to reduce students' misconceptions, especially on thermochemical material. The experimental method with the pretest-posttest randomized control group design was used in this study. The samples of the research were 72 eleventh-grade high school students. The inquiry model was applied to the experimental class and the scientific approach was applied to the control class. The three-tier multiple choice with the Certainty of Response Index (CRI) was used to look at misconceptions experienced by the students. The results of the statistical calculation found that the toserved was greater than tcritical. The reduction of misconception categories and the percentage of reduction of misconceptions in the experimental class was 47.53 % in the medium category. Based on the results, it can be concluded that the inquiry learning model helped the students to overcome the misconceptions in thermochemical material. The researcher recommends that the inquiry learning model can be applied to other chemistry materials because their learning can help students find the correct concepts and reduce misconceptions.

The Effect of Vitamin D Administration on Leptin, Adiponectin and mRNA MCP-1 Levels in Adipose Tissue of Obese Female Wistar Rats

In obesity, there is an accumulation of adipocytes which produces adipokine that are pro-inflammatory substance, such as leptin and MCP-1 and anti-inflammatory substance, such as adiponectin, while the bioavailability of vitamin D is decreased. This research aimed to study the effect of vitamin D administration on leptin, MCP-1, and adiponectin levels in adipose tissue rats with obesity. Vitamin D was administered to the obese model of 6-9 months old female Wistar rats. This experiment was a randomized control group design with a post-test group design only. Twenty-seven (27) female obese Wistar rats were included in this study. The animals were divided randomly into 3 groups: 9 rats were given 2400 IU vitamin D (group A), 9 rats were given 800 IU vitamin D (group B) and 9 rats were given a placebo as control (group C). The administration of Vitamin D was given once daily for 8 weeks. The visceral adipose tissue was taken to measure the level of leptin, adiponectin and mRNA MCP-1. Data among groups was analyzed by using one-way ANOVA and followed by LSD test, at a significance level of p &lt;0.05. The lowest level of leptin (1059.15+135.20 pg/ml) and mRNA MCP-1 (2.36 + 0.75 fg/ml) and the highest adiponectin level (3.43 + 0.47 ng/ml) were found in group A. In conclusion, oral administration of vitamin D (2400 IU) decreased pro-inflammatory substances, such as leptin and mRNA MCP-1 and increased anti-inflammatory substances, such as adiponectin, in visceral adipose tissue of obese female Wistar rats.

Lipid profile comparison of tomato extract and atorvastatin supplementation in atherosclerosis rats

The use of synthetic drugs, such as atorvastatin and simvastatin, often cause health problems caused by side effects. Tomatoes are a food source that contains antioxidants such as vitamins A, C and E in high amounts and increase because of the processing. The nutritional content of tomatoes in preventing hypercholesterolemia arising from oxidative stress as a result of accumulation of LDL-cholesterol in the endothelium. Therefore, this study considers steamed tomatoes in overcoming the condition of hypercholesterolemia. The study design uses the Post Test Randomized Control Group Design. Before being given as many as 24 white rats that were made hypercholesterolemia, then divided into 4 groups, namely K1 (negative control group), K2 (atherosclerosis rat control group), K3 (atherosclerosis group called atorvastatin), K4 (atherosclerosis group supplemented with 16 mg / tail / day). ANOVA-LSD test results showed the differences shown (p <0.05) between the control group (K) and the consultation group (K3 and K4).

The Effect of Processed Tempeh Gembus Administration on Blood Glucose in Obese Women

Tempeh gembus is a local functional food from Indonesia which made from fermented tofu residues from Rhizopus oligosporus and containing high fibre. The fibre content in tempeh gembus are three times higher than soybean tempeh. Dietary fibre is thought to reduce blood glucose levels. The aim this study is to analyze the effect of giving variations of processed tempeh gembus on fasting blood glucose level. This study was an experimental study with a pre-post randomized control group design. The number of control and treatment group subjects was 20 people each who met the inclusion criteria. The control and treatment groups received 1500 kcal isocaloric diet. In addition, treatment group received additional variations of processed tempeh gembus 150 grams for 28 days. The average intake of processed tempeh gembus treatment group during the study was 58.9%. The average fibre intake of the treatment group was twice higher than the control group. There was no statistically significant difference in fasting blood glucose levels between the control and treatment groups after the intervention. There was no statistically significant difference on fasting blood glucose levels in both the control group and the treatment group (p> 0.05) but clinically it was able to reduce fasting blood glucose levels 4.5 mg / dl in the treatment group. Changes in blood glucose levels showed no significant differences between the control and treatment groups (p> 0.05). Processed tempeh gembus administration for 28 days increase fibre intake but could not been able to reduce fasting blood glucose levels.

The colloid labyrinth media to improve students motivation and learning achievement on chemistry lessons

The colloid labyrinth media is a game media that can be used in learning chemistry topics taught in high school. The type of this research was experiment research with design randomized control group pretest-posttest design. This research object is students of SMA 8 Pekanbaru. The sample of this research consisted of 32 students of XI IPA 9 as the experiment group and 35 students of XI IPA 10 as the control group at the 2016/2017 academic year which were determined randomly after conducting normality and homogeneity test. The experiment class was treated with the use of labyrinth media while the control class without the use of labyrinth media. The data analysis was using the analysis of descriptive statistic and t-test. Based on analysis of the data obtained tcount > ttable is 2.63 > 1.67, it’s mean that the use of labyrinth media can improve students learning outcomes on the subject of colloid in XI IPA SMA Negeri 8 Pekanbaru. Based on the data analysis, it is obtained students motivation in experiment groups (66.14%) than control group (40.95%), means that the use of labyrinth media can improve students motivation on the subject of colloid in XI IPA SMA Negeri 8 Pekanbaru. The category improvement of students learning achievement at experiment group was high category with N-gain normalized is 0.8633.

Efficacy of a training programme to support the application of the guideline evidence-based health information: study protocol of a randomised controlled trial

BackgroundThe evidence-based guideline entitled guideline evidence-based health information emerged from the German Network for Evidence-based Medicine (DNEbM) and was published in February 2017. The guideline addresses providers of health information and its goal is to improve the quality of health information. In addition, we explored the competences of providers of health information and developed a training programme.The aim of this study is to evaluate the efficacy of a training programme addressing providers of health information to support the application of the guideline evidence-based health information. We expected the intervention to improve the quality of health information in comparison to the provision of the guideline on its own.Methods/designThe trial uses a superiority randomised control group design with 10 months’ follow-up. Twenty-six providers of health information (groups with up to ten members) will be enrolled to compare the intervention (guideline and training programme) with usual care (a publicly available guideline). The 5-day training programme comprises an evidence-based medicine training module and a module to prepare the application of the guideline. The primary outcome parameter is the quality of the health information. Quality is operationalised as the extent of adherence to the guideline’s recommendations. Each provider will prepare a single health information item informing a health-related decision on a topic freely chosen before randomisation. The quality of this information will be rated using the Mapping Health Information Quality (MAPPinfo) Checklist. An accompanying process evaluation will then be conducted.DiscussionThe study results should show whether the efficacy of the intervention justifies implementation of the training programme to enhance health information developers’ competences in evidence-based medicine and to ensure high-quality evidence-based health information (EBHI) in the long term.Trial registrationISRCTN registry, ID: ISRCTN96941060. Registered on 7 March 2019.

The Effect of Realistic Mathematics Education Approach Oriented Higher Order Thinking Skills to Achievements’ Calculus

The goal of this research is to determine the influence of the realistics mathematics education (RME) approach by oriented higher order thinking skills (HOTS) on the results of students’ mathematics learning on the subject of the calculus in SMAN 10 and SMAN 12 Padang. The method used is the experimental research with pre and post-test design randomized control group. The data analysis technique used is the test for normality and homogeneity test followed by using a t-test. The results revealed that there were an increase in student mathematic learning outcomes approach realistic mathematics education oriented higher order thinking skills in class XI MIPA SMAN 10 and SMAN 12 Padang. There is impact-oriented approach to realistics mathematics education approach by oriented higher order thinking skills to understanding student learning in class XI SMAN 10 and 12 MIPA Padang.