This article discusses about what conceptual understanding is in learning of mathematics and how conceptual understanding could be developed in a student’s thinking. As we know, generally, at least there are two types of learning that we have already experienced until right now, they are rote learning and meaningful learning, where each type has itself characteristic different from each other. The fundamental difference between the two types of learning is that rote learning emphasizes on memorizing structurally meanwhile meaningful learning focusing on understanding concepts learned. Therefore, teachers should carefully consider suitable strategies of teaching before deciding which types of learning could be developed in students’ thinking, and teachers need to pay attention to the effectiveness of teaching and learning in order to help students achieving a conceptual understanding.
ObjectiveSeveral studies reported that infection of extended-spectrum β lactamase (ESBL)-producing Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae) contributed to higher mortality rates but others found it was not associated with mortality. A prospective cohort study which involved 72 patients was conducted to assess the risk of mortality of bloodstream infection due to ESBL-producing K. pneumoniae or E. coli as compared to those infected by either K. pneumoniae or E. coli which not produce ESBL.ResultMortality in the group of patients infected with ESBL-producing bacteria was 30.6%, whereas in another group which was infected with non ESBL-producing bacteria was 22.2% (p = 0.59). Kaplan–Meier’s analysis showed that the survival rate during 14-days follow-up among these two group was not significantly different (p = 0.45) with hazard ratio 1.41 (95% CI 0.568–3.51). Stratification analysis found that adult and elderly patients, patients with sign of leukocytosis, and patients treated with carbapenem were modifier effect variables.
The propriate management of acute infarction stroke will be able to reduce the morbidity and mortality of the disease. In diagnosingand managing the diseases, for the detection of the risk or prognostic factors information’s such as the history physical findings,confirmation and other supporting tests are needed. One of the supporting test is the laboratory examination i.e. platelet aggregationtest. Platelet aggregation is suggested having an important role in haemostasis especially to prevent excessive bleeding by forming plateletplug. Finally, further hyperactivity of platelet in terms of platelet hyper aggregation can create a thrombus and moreover lead to obstructthe vessels. The occlusion will give a negative outcome of an acute infarction stroke. The aim of this study is to know whether platelethyper aggregation has a contribution in the outcome of the disease or not by certain testing. A prospective cohort study was carried out,to compare between two groups of exposed and non-exposed group in Sardjito hospital Yogyakarta during the period of March up toearly July 2007. Eighty four subjects who met the inclusion and exclusion criteria were involved in this study. The exposed group was agroup of acute infarction stroke patient who were exposed to platelet hyper aggregation 48 (57%), on the other hand, patients who didnot have platelet hyper aggregation was separated as non-exposed group is 36 (43%). Inception of cohort was applied when the patientwas admitted to the emergency unit during 72 hours of the onset, before receiving antithrombotic drugs and had no previous history ofstroke. The patients were followed after 7 days hospitalization in the stroke unit and neurology unit and the outcome was measured byevaluating the score using Gadjah Mada stroke scale. The characteristics of the subjects were grouped by baseline data X2 test. Unvariedanalysis and multivariate analysis were taken to get the relative risk of having acute infarction stroke. In this case logistic regressionanalysis was used to know the relative risk (RR) measurement. Prognostic factors had influenced the outcome of acute infarction strokein patients who had a history of cardiovascular disease and aggregation status. The outcome of the platelet hyper aggregation grouphad a RR=2.15 (95% CI: 2.01–4.07) and the history of cardiovascular disease had a RR=1.78 (95% CI: 1.18–13.28).
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