Total Number Of Items Research Articles

Translation and validation of the EORTC QLQ-BR45 among Ethiopian breast cancer patients

This study aimed to examine the validity and reliability of the EORTC QLQ-BR45 questionnaire among breast cancer patients in Ethiopia. This study included 248 breast cancer patients who completed the QLQ-BR45 and QLQ-C30 questionnaires. The internal reliability, test–retest reliability, and the content, concurrent, convergent, divergent, and clinical validity of the tool were examined. The statistical analyses included Cronbach’s α coefficient, Pearson’s correlation coefficient, standardised root mean square residual (SRMR), comparative fit index (CFI), t-test, and root mean square error of approximation (RMSEA). All items were marked as relevant, and item-level content validity index (I-CVI) scores ranged from 0.83 to 1. The S-CVI/Ave was calculated by dividing the sum of I-CVI values by the total number of items, which was found to be 0.94. The average CVR value was 0.76. The Cronbach’s α coefficient was 0.80 for all domains. All subscales met the minimal standards of reliability except the arm symptom scale (0.66). The test–retest reliability coefficient was 0.77 for all domains. Seven out of the 12 hypothesised scales showed positive correlations (r > 0.40) between the QLQ-BR45 and QLQ-C30 scales. Multitrait scaling analysis showed that the item-scale correlations exceeded the 0.40 criterion for item-convergent validity for 11 of the 12 hypothesised scales. The correlation coefficients between an item and its own subscale were significantly higher than with other subscales. The EORTC QLQ-BR45 had good reliability and validity, and it can be used to measure the quality of life of breast cancer patients in Ethiopia.

Competency Framework of Agriculture Educators Vocational College: Measurement Model Using Partial Least Square-Structural Equation Modeling

<p style="text-align: justify;">Competent instructors need to have the skills, abilities, and competencies to perform tasks effectively, which will affect student learning achievement. This study is guided by the theory of Boyatzis developed by Spencer and Spencer. The Iceberg Competency Model was used as a guideline to identify the competency elements of educators from the agricultural stream in vocational colleges (KV). This research study aims to explore and identify the existing competency elements of agricultural educators in KV. This study used a study population comprising 243 respondents of agricultural educators in KV. To answer the research question, the data analysis was done by Partial Least Squares - Structural Equation Modeling (PLS-SEM). This study is a study built to observe the relationship between the latent constructs studied. These constructs consisted of exogenous and endogenous constructs. In this study, exogenous constructs comprised value constructs, social roles, self-image, motives, traits and constraints. At the same time, endogenous constructs involved constructs of skills and knowledge. To ensure that the construct of this study gives meaning to the reflective measurement model, it was evaluated based on internal consistency reliability and validity. Regarding the framework, some indicators that did not qualify were dropped based on factor loading and average variance extracted (AVE). From the analysis conducted, 16 indicators were dropped since they did not meet PLS-SEM requirements. The total number of items retained was 71 indicators. At the final stage of this study, the evaluation model was implemented to form a framework involving the evaluation of the constructs linked to each other.</p>

Using the Retail Distribution of Sellers to Impute Expenditure Shares

Many price indices must be constructed without quantity data at the elementary level. The paper shows that for some consumer goods in the United States and other countries, one can approximate expenditure shares using weights derived from the retail distribution of sellers. These weights are based on the share of outlets selling an item, or the share of outlets adjusted by the total number of items sold in each. Relative to using no weights, the paper finds that using such imputed weights substantially reduces bias in the frequency of price changes, in annual inflation, and in price comparisons across countries. (JEL E31, L11, L81, O11, O14)

Psychosocial aspects of COVID-19 among women in Hilla general population

Background: We are in the middle of a global health crisis unlike any other in the United Nations' 75-year existence, one that is killing people, inflicting human suffering, and upsetting lives. This isn't just a medical emergency, though. It's a disaster on a humanitarian, economic, and sociological level. The Coronavirus disease (Covid-19), which the World Health Organization has classed as a pandemic, is wreaking devastation in society on medical, psychological, and social levels. Therefore, this study aimed at investigate the psychosocial aspects of COVID-19 among women and associated factors. Methods: A descriptive cross-sectional study conducted by non probability (convenience) sample of 250 women was selected through attended the primary health care centers. The reliability of the questionnaire was achieved through a pilot study and then presented to experts to prove its validity. The total number of items included in the questionnaire was 22-items to investigate psychological aspects and 20-items to social aspects. The data was collected by using the interview method and analyzed by the application of descriptive and inferential statistical data analysis approach. Results: The results of the study indicated that (72.40%) of the women exhibited a significant psychological aspects and (59.20%) exhibited a moderate social burden.

Food awareness among diarrheal children mothers

Background: Food awareness is vital in the prevention and prevalence of diarrhea in children under the age of five. Assessment of maternal food knowledge is a public health priority for children's health. Therefore, thus study aimed to assess food awareness among diarrheal children mothers and determine the associated demographic variables in The-Qar Province/ Iraq. Methods: A cross-sectional study was conducted on a sample of 200 women who had child's with diarrhea. This sample distributed throughout two hospitals include (Bint Al-Huda Teaching Hospital and Martyr Muhammad Al-Moussawi Children's Hospital). The reliability of the questionnaire was achieved through a pilot study and then presented to experts to prove its validity. The total number of items included in the questionnaire was 20-items. The data was collected by using the semi-structured interview and analyzed by the application of descriptive and inferential statistical data analysis approach. Results: The results of the study indicated that (43%) of the mothers exhibited a moderate level of food awareness. There were significant differences in food awareness with regards mothers age, education and residents (p< 0.05). Conclusions: Mothers health awareness leads to decrease the prevalence of diarrhea.

Impact of deep breathing exercise on oxygen saturation of patients with coronavirus disease

An experimental comparative study design was done for 30 patients to assess the impact of deep breathing exercises and chest physiotherapy on the oxygen saturation of patients with COVID19 in Imam Hussein Teaching Hospital and Al Rifai General Hospital/ Thi Qar. The reliability of the questionnaire was achieved through a pilot study and then presented to experts to prove its validity. The total number of items was 40-items in two questionnaires and measure oxygen saturation for five days before and after deep breathing exercises and chest physiotherapy. The data was collected by using simple random methods and analyzed by the application of a descriptive and inferential statistical data analysis approach.Results: The results showed for 30 patients there was significant improvement in oxygen saturation values after chest breathing exercises and deep breathing exercises from 82.3333 ± 2.78337 in first before intervention day to 93.5000 ±1.38340 in day five after chest breathing exercises and deep breathing exercises at P < 0.05. Also there were no significant statistical correlation between patient's age and their oxygen saturation after chest breathing exercises and deep breathing exercises at P ˃ 0.05.

Evaluation of health care providers’ knowledge about physical activity promotion for adults with physical disability in Diyala City

Background: Adults with disabilities are three times more likely than adults without disabilities to suffer from heart disease, stroke, diabetes, or cancer. Despite the fact that physical activity can help minimize the impact of many chronic conditions, approximately half of persons with disabilities do not participate in physical activity in their spare time. Caregivers' knowledge plays an important role in such people's health rehabilitation. Therefore, thus aimed to assess health care providers knowledge about physical activity promotion for disabled adults. Methods: A convenience sample of 47 health care providers was recruited using a non-probability sampling approach in Diyala Hospitals for a descriptive cross-sectional study. The questionnaire's dependability was established through a pilot research, and it was subsequently presented to experts for validation. The total number of items in the questionnaire for knowledge related to physical activity promotion was 23. The data was acquired using a self-reporting method and evaluated using descriptive and inferential statistical data analysis techniques. Results: The study's findings revealed that the majority of respondents were young male caretakers. According to the study's findings, 59.5 percent of caregivers had insufficient understanding about how to promote physical exercise.

Effectiveness of an Educational Program on Teachers’ Knowledge in The Primary Schools about Coronavirus Disease

Background: In the 2020 coronavirus pandemic, many countries have closed schools. and as the pandemic resurges in second and third waves, causing an ongoing pandemic in many countries and territories and consequence of school closures and reopening is the widening of inequalities in children’s health and education outcomes. Educators are key to preventing the spread of COVID-19 in educational settings. This study aims to evaluate the effectiveness of educational program on teachers’ knowledge in The Primary Schools about Coronavirus disease. Methods: The study was designed as a quasi-experimental design approach for study group and control group participants employed in Al Rusafa Second Education Directorate Schools in Baghdad City being. A non-probability "purposive" sample selected from Primary School’s Teachers to obtain represent and accurate data. The sample consisted of seventy teachers, (35) teachers enrolled as a control group and (35) teachers enrolled as a study group. The questionnaire's dependability was proven through empirical study, and it was then submitted to specialists for validation. The total number of items in the questionnaire was50. Self-reports were used to collect data, which was then evaluated using descriptive and inferential statistical data analysis. The selection criteria included Only Teachers who did not enter coronavirus disease training courses. The period of the study was initiated from 13st of October /2021 till 20th of April /2022, tested in three periods pre-test, post-test-I, and post-test-II. Results: The results shows The teachers in study group became knowledgeable and aware toward concept and cause of COVID-19; signs and symptoms; transmission methods; diagnosis and treatment; risks and complications; as well as the prevention. Where highly significant differences between study and control group about teacher's knowledge, and no a significant association with their socio-demographic characteristics. Conclusions: In order to improve teachers' knowledge about coronavirus, an educational training programs are essential. The finding revealed that after receiving training, teachers' knowledge improved. The training program is highly successful, there are still many people who do not implement the protocols in a disciplined manner, potentially due to a lack of information and awareness within the community and especially the school environment. Thus, teachers need to be well informed and encouraged of preventive measures and that all teachers should receive coronavirus training to gain the information and skills necessary, in addition reconsidering certified safety measures and standards in schools to match the global standards in light of the coronavirus variants and ahead of winter 2022, through providing adequate preventive commodities, improve ventilation and to plan to build supporting infrastructure commodities to ensure compliance. Key-wards: Educational Program, Teachers, knowledge, Primary school, Coronavirus Disease.

Effective of an Intervention Program on Nurses Practices Concerning Infection Control Measures in Pediatric Surgical Wards

Background: Infection control has become a major concern in the health-care system, and health-care personnel, especially nurses, are particularly vulnerable to infection. The goal of this study is to see how effective an intervention program is in changing nurses' practices in pediatric surgery wards when it comes to infection management. Methods: This study used a quasi-experimental design for the pre- and post-test. The sample consisted of 40 persons. The intervention group included twenty nurses from the primary pediatric teaching hospital, while the control group included twenty nurses from the pediatric care teaching hospital. The questionnaire's dependability was proven through empirical study, and it was then submitted to specialists for validation. The total number of items in the questionnaire was 49. Self-reports were used to collect data, which was then evaluated using descriptive and inferential statistical data analysis. Results: According to the findings, 70% of nurses had insufficient practices before implementing the intervention program, while 60% of nurses had adequate practices after implementing the program. In the pre-test period of assessment, there is no statistically significant difference between the intervention and control groups (p>0.05). At the post-test measurement period, there is a statistically significant difference between the intervention and control groups (p0.05). Conclusions: In order to improve nurses' infection control practices, an interventional training program is essential. The findings of this study revealed that after receiving training, nurses' infection control practices improved. This study found that the training program is highly successful, and that all nurses should receive infection control training to gain the information and skills necessary to prevent infection in a hospital context. Health-care executives should recognize the importance of establishing rules to improve nurse working conditions and offer the required training to guarantee infection-control strategies are implemented. Keywords: Intervention Program, Practices, Nurses.

Evaluation of Health Care Providers’ Knowledge about Health Restoration for Adults with Physical Disability in Diyala City

Background: Adults with disabilities are three times more likely than adults without disabilities to suffer from heart disease, stroke, diabetes, or cancer. Despite the fact that physical activity can help minimize the impact of many chronic conditions, approximately half of persons with disabilities do not participate in physical activity in their spare time. Caregivers' knowledge plays an important role in such people's health rehabilitation. Therefore, thus aimed to assess health care providers knowledge about physical activity promotion for disabled adults. Material and Methods: A convenience sample of 47 health care providers was recruited using a non-probability sampling approach in Diyala Hospitals for a descriptive cross-sectional study. The questionnaire's dependability was established through a pilot research, and it was subsequently presented to experts for validation. The total number of items in the questionnaire for knowledge related to health restoration was 13. The data was acquired using a self-reporting method and evaluated using descriptive and inferential statistical data analysis techniques. RESULTS: The study's findings revealed that the majority of respondents were young male caretakers. According to the study's findings, 48.9 percent of caregivers had insufficient understanding about how to promote physical exercise. There were differences in knowledge with regards health restoration and caregivers gender (p=0.059), years of experience (p=0.001), job description (p=0.001) and training courses (p=0.001). Conclusions: The study concludes that the knowledge in terms of health restoration for disabled adults, health care providers expressed a poor level due to influencing factors such as diploma graduated and nurses specialist is significantly associated poor knowledge. The Directorate of Health needs to adopt guidelines related to the international standard in the management of disability and to rely on specializations from those who have a high level of education in caring for the disabled. Keywords: Evaluation, Health Care Provides, Health Restoration.

Development of empirically derived brief program evaluation measures in Pennsylvania first-episode psychosis coordinated specialty care programs.

The Pennsylvania first episode psychosis program evaluation (PA-FEP-PE) core assessment battery was developed as a standard and comprehensive clinical assessment and data collection tool in Pennsylvania coordinated specialty care programs (CSC). To reduce administrative time and maximize clinical utility by maintaining acceptable levels of precision, we aimed to generate a short form using item response theory (IRT)-based computer-adaptive test (CAT) simulation and analyse the implementation and acceptability of the short form among providers from PA-CSC. FEP participants (n=759; age 14-36) from nine coordinated specialty care programs completed 156 items drawn from the PA-FEP-PE battery. Multidimensional IRT-based CAT simulations were used to select the best PA-FEP-PE items for abbreviated forms. A 67-item PA-FEP-PE short form was developed to capture six factors: (1) positive affect and surgency (with negative loadings on Anxious-Misery items); (2) psychiatric services satisfaction; (3) antipsychotic side effect severity; (4) family turmoil and associated traumas; (5) trauma load; and (6) psychosis. The total number of items was reduced more than 50% in the PA-FEP-PE shortened forms. The short form demonstrated good psychometric properties, and it was well accepted by our providers in the implementation. The empirical derivation and implementation of abbreviated measures of key domains and constructs in FEP care have streamlined and facilitated PA-FEP program evaluation. Our work supports potential application of IRT based methods to empirically reduce core assessment battery measures in large-scale data collection efforts such as in the Early Psychosis Intervention Network.

Validity and Reliability of the Postgraduate Self-Determined Learning Questionnaire (PSLQ)

Abstract: Postgraduate students have to play active roles in self-determined learning, as major agent in their own learning and research activities. There is a lack of validated research instruments to measure self-determined learning among postgraduate students. The Postgraduate Self-Determined Learning Questionnaire (PSLQ) was specifically developed to fill in the gaps. This study aims to examine the validity and reliability of the PSLQ through exploratory factor analysis (EFA). The original version of PSLQ has 59 items and it was administered to a sample of 201 postgraduate students from a research-intensive university in Malaysia. The results of EFA revealed that PSLQ measures four distinct factors; learner-centered learning, interactive non-linear learning, double-loop reflection, and capacity development, which accounted for 54.22% of the variance in self-determined learning. The total number of items in PSLQ has been reduced to 42, after 17 items were removed. The instrument demonstrated excellent internal consistency, with a Cronbach’s alpha value of a=.959. The findings suggest that PSLQ is a valid and reliable instrument that can be used to measure self-determined learning among postgraduate students. Implications of the research findings are discussed in this paper.
 
 Keywords: Heutagogy, Postgraduates, Reliability, Self-determined learning, Validity

Assessing Essential Unidimensionality of Scales and Structural Coefficient Bias.

Percentage of uncontaminated correlations (PUC), explained common variance (ECV), and omega hierarchical (ωH) have been used to assess the degree to which a scale is essentially unidimensional and to predict structural coefficient bias when a unidimensional measurement model is fit to multidimensional data. The usefulness of these indices has been investigated in the context of bifactor models with balanced structures. This study extends the examination by focusing on bifactor models with unbalanced structures. The maximum and minimum PUC values given the total number of items and factors were derived. The usefulness of PUC, ECV, and ωH in predicting structural coefficient bias was examined under a variety of structural regression models with bifactor measurement components. Results indicated that the performance of these indices in predicting structural coefficient bias depended on whether the bifactor measurement model had a balanced or unbalanced structure. PUC failed to predict structural coefficient bias when the bifactor model had an unbalanced structure. ECV performed reasonably well, but worse than ωH.

Minimum threshold determination method based on dataset characteristics in association rule mining

Association rule mining is a technique that is widely used in data mining. This technique is used to identify interesting relationships between sets of items in a dataset and predict associative behavior for new data. Before the rule is formed, it must be determined in advance which items will be involved or called the frequent itemset. In this step, a threshold is used to eliminate items excluded in the frequent itemset which is also known as the minimum support. Furthermore, the threshold provides an important role in determining the number of rules generated. However, setting the wrong threshold leads to the failure of the association rule mining to obtain rules. Currently, user determines the minimum support value randomly. This leads to a challenge that becomes worse for a user that is ignorant of the dataset characteristics. It causes a lot of memory and time consumption. This is because the rule formation process is repeated until it finds the desired number of rules. The value of minimum support in the adaptive support model is determined based on the average and total number of items in each transaction, as well as their support values. Furthermore, the proposed method also uses certain criteria as thresholds, therefore, the resulting rules are in accordance with user needs. The minimum support value in the proposed method is obtained from the average utility value divided by the total existing transactions. Experiments were carried out on 8 specific datasets to determine the association rules using different dataset characteristics. The trial of the proposed adaptive support method uses 2 basic algorithms in the association rule, namely Apriori and Fpgrowth. The test is carried out repeatedly to determine the highest and lowest minimum support values. The result showed that 6 out of 8 datasets produced minimum and maximum support values for the apriori and fpgrowth algorithms. This means that the value of the proposed adaptive support has the ability to generate a rule when viewed from the quality as adaptive support produces at a lift ratio value of > 1. The dataset characteristics obtained from the experimental results can be used as a factor to determine the minimum threshold value.

Menu Audit of Vegetable-Containing Food Offering in Primary School Canteens in Sydney, Australia: A Preliminary Study.

Children’s vegetable intakes are too low, and school canteens could provide an equitable environment to improve their intake. This study aimed to develop and apply a systematic method to quantify the proportion and variety of vegetable-containing items on primary school canteen menus and examine differences between schools of different socio-economic statuses, sizes and types. Online canteen menus from 112 primary schools in Sydney, Australia, were collected, and data were extracted on a total number of items and vegetable-containing items across different menu categories. Further, data on preparation type and variety were extracted. Differences in the proportion of vegetable items between socio-economic status, school size and type were tested. On average, 80.4 ± 34.0 items were listed, with 30% of items containing vegetables. Most sandwiches (60%) and hot foods (54%) contained no vegetables. The variety of raw vegetables (4.9 ± 1.8 types) was greater than for cooked vegetables (1.3 ± 1.2 types; p < 0.01). Limited differences were observed by socio-economic status and school type. Small schools offered fewer vegetable-containing items than large schools. While primary school canteen menus listed a large variety of items, only one-third contained vegetables. Data from this study can be used to track changes and to develop new opportunities to increase the vegetable supply in schools.

Parent-reported measure of repetitive behavior in Phelan-McDermid syndrome

BackgroundPhelan McDermid syndrome (PMS) is a neurogenetic condition associated with a high prevalence of intellectual disability (ID) and autism spectrum disorder (ASD). This study provides a more comprehensive and quantitative profile of repetitive behaviors within the context of ID seen with the condition.MethodsIndividuals age 3–21 years with a confirmed PMS diagnosis participated in a multicenter observational study evaluating the phenotype and natural history of the disorder. We evaluated data collected from this study pertaining to repetitive behaviors from the Repetitive Behavior Scales-Revised (RBS-R).ResultsThere were n = 90 participants who were part of this analysis. Forty-seven percent (n = 42/90) were female, and the average age at baseline evaluation was 8.88 ± 4.72 years. The mean best estimate IQ of the cohort was 26.08 ± 17.67 (range = 3.4–88), with n = 8 with mild ID (or no ID), n = 20 with moderate ID, and n = 62 with severe-profound ID. The RBS-R total overall score was 16.46 ± 13.9 (compared to 33.14 ± 20.60 reported in previous studies of ASD) (Lam and Aman, 2007), and the total number of items endorsed was 10.40 ± 6.81 (range = 0–29). After statistical correction for multiple comparisons, IQ correlated with the RBS-R stereotypic behavior subscale score (rs = − 0.33, unadjusted p = 0.0014, adjusted p = 0.01) and RBS-R stereotypic behavior total number of endorsed items (rs = − 0.32, unadjusted p = 0.0019, adjusted p = 0.01). IQ did not correlate with any other RBS-R subscale scores.ConclusionsThe RBS-R total overall score in a PMS cohort appears milder compared to individuals with ASD characterized in previous studies. Stereotypic behavior in PMS may reflect cognitive functioning.

Does the combination of physical activity and attention training affect the motor skills and cognitive activities of individuals with mild intellectual disability?

Individuals with mild intellectual disability (MID) were worse than their peers who typically develop in motor skills and attention-demanding assignments. In this study, effect of a 14-week physical activity and attention training practise on the motor skills, visual retention, perception and attention levels of students with MID were analysed. Twenty-two individuals between 7 and 14 ages participated voluntarily. Activities based on developing attention skills and physical activities enhancing fine-gross motor skills (40 + 60 min./2 days/14 weeks) were given to the experimental group. d2 Test of Attention, Benton Visual Retention and Bruininks-Oseretsky Test of Motor Proficiency-2nd version tests were used as data collection tools. There was significant difference in terms of total number of items processed, commissions, raw score of errors, total number of items minus error scores, concentration performance, Benton visual retention test and perception, fine motor skill precision, fine motor skill integration, manual dexterity and upper-limb coordination values regarding group and time dependant (p< .05). However, there was no significant difference in omissions and fluctuation rate values (p> .05). As a result; it is determined that the combination of physical activity and attention training practises features a positive effect on visual retention, perception, attention and motor skill levels of students with MID.

Measuring care coordination in German primary care \u2013 adaptation and psychometric properties of the Medical Home Care Coordination Survey

BackgroundContinuity of care is associated with many benefits for patients and health care systems. Therefore measuring care coordination - the deliberate organization of patient care activities between two or more participants - is especially needed to identify entries for improvement. The aim of this study was the translation and cultural adaptation of the Medical Home Care Coordination Survey (MHCCS) into German, and the examination of the psychometric properties of the resulting German versions of the MHCCS-P (patient version) and MHCCS-H (healthcare team version).MethodsWe conducted a paper-based, cross-sectional survey in primary care practices in three German federal states (Schleswig-Holstein, Hamburg, Baden-Württemberg) with patients and health care team members from May 2018 to April 2019. Descriptive item analysis, factor analysis, internal consistency and convergent, discriminant and predictive validity of the German instrument versions were calculated by using SPSS 25.0 (Inc., IBM).ResultsResponse rates were 43% (n = 350) for patients and 34% (n = 141) for healthcare team members. In total, 300 patient questionnaires and 140 team member questionnaires could be included into further analysis. Exploratory factor analyses resulted in three domains in the MHCCS-D-P and seven domains in the MHCCS-D-H: “link to community resources”, “communication”, “care transitions”, and additionally “self-management”, “accountability”, “information technology for quality assurance”, and “information technology supporting patient care” for the MHCCS-D-H. The domains showed acceptable and good internal consistency (α = 0.838 to α = 0.936 for the MHCCS-D-P and α = 0.680 to α = 0.819 for the MHCCS-D-H).As 77% of patients (n = 232) and 63% of health care team members denied to have or make written care plans, items regarding the “plan of care” of the original MHCCS have been removed from the MHCCS-D.ConclusionsThe German versions of the Medical Home Care Coordination Survey for patients and healthcare team members are reliable instruments in measuring the care coordination in German primary care practices. Practicability is high since the total number of items is low (9 for patients and 27 for team members).

Improving the Quality of Clinical Care of Children with Diabetic Ketoacidosis in General Emergency Departments Following a Collaborative Improvement Program with an Academic Medical Center

To evaluate the impact of a collaborative initiative between a group of general emergency departments (EDs) and an academic medical center (AMC) on the process of care provided to patients with diabetic ketoacidosis (DKA) across these EDs. A retrospective cohort study (January 2015 to December 2018) of all pediatric patients <18years who presented with DKA to participating EDs and were subsequently admitted to the pediatric intensive care unit at the AMC. Our multifaceted intervention included simulation with postsimulation debriefing, targeted assessment reports, distribution of DKA best practices, pediatric DKA module, and scheduled check-in visits. The process of clinical care was measured by adherence to the pediatric DKA 9-item checklist. Adherence was scored based on the number of items performed correctly and calculated using equal weight for items and dividing by the total number of items. Patients' clinical outcomes also were collected. A total of 85 patients with DKA were included in the analysis; 38 patients were in the preintervention, and 47 were in the postintervention. There was a statistically significant improvement in adherence to the DKA checklist from 77.8% to 88.9%. Two of the 9 checklist items (hourly glucose check and appropriate fluid rate) showed statistically significant improvement. No significant change in patient clinical outcomes was noted. Our collaborative initiative resulted in significant improvements in adherence to pediatric DKA best practices across a group of general EDs. A collaborative approach between general EDs and AMCs is an effective improvement strategy for pediatric emergency care.

Locus of control and Student Achievement

Abstract. Locus of control is one of the personality characteristics possessed by humans. Locus of control can be divided into two, namely internal locus of control and external locus of control. Locus of control is a predictor of several other variables, such as learning achievement. The purpose of this study was to determine the relationship of locus of control with learning achievement. This research uses descriptive and correlational methods. The instrument filling is done online by using the google form application considering the increasing spread of COVID-19. Finally, as many as 36 students participated in filling this instrument. In this study, researchers used the Rotters Internal-External Locus of Control (IE Scale) inventory consisting of 29 items, of which there were 6 filler items, so that the total number of items that could be processed was 23 items, while to see learning achievement using the Grade Point Average (GPA) that researchers get from the Academic Information System (SIAKAD). Research findings show that locus of control has a strong negative relationship with student learning achievement. We advise students to have an internal locus of control while continuing to believe in God; The counselor is expected to be able to arrange an intervention program for students who have an external locus of control and have low learning achievement.