Koning (United States)

Penelitian ini bertujuan untuk mengeksplorasi pelaksanaan program bimbingan dan konseling (BK) di SMA N 1 Takengon, Aceh Tengah. Penelitian ini menggunakan metode kualitatif deskriptif dengan teknik pengumpulan data melalui wawancara, dokumentasi, dan observasi. Penelitian dilakukan dari Mei hingga Juni 2024. Subjek penelitian terdiri dari dua guru BK dan kepala sekolah. Hasil penelitian menunjukkan bahwa program BK di SMA N 1 Takengon mencakup berbagai kegiatan yang dirancang untuk memenuhi kebutuhan siswa dalam aspek akademik, karir, pribadi, dan sosial. Program harian, mingguan, bulanan, dan semesteran diimplementasikan dengan baik meskipun terdapat beberapa kendala dalam pelaksanaannya. Dukungan dari pihak manajemen dan staf sekolah sangat berperan dalam kesuksesan program ini. Temuan ini memberikan wawasan penting tentang efektivitas program BK di sekolah dan dapat berkontribusi pada pengembangan ilmu pengetahuan di bidang pendidikanKata kunci : Pelaksanaan Program, Bimbingan dan Konseling

Ethnotheories of immigrant parents residing in the Netherlands are reshaped in response to the multiple and diverse educational practices they come in contact with after migration. Network analyses of “parenting relationships” of first generation Dutch‐Moroccan parents living in the Netherlands show that they borrow from diverse resources including professionals and nonprofessionals in their construction of new ethnotheories. Through media as well as through interacting with family in their country of origin, with same‐generation peers in the Netherlands, and with Dutch professionals and neighbors, these mothers develop “modern” notions of parenting such as stimulating child independence, while also using building blocks from traditional practices such as respect for the elderly. Individual variability is evident in parents’ processes of adaptation, with some parents seeming stuck between these alternative and seemingly contradictory practices and ideas while others learn to use them to position themselves optimally in their multi‐ethnic environment. The paper argues that recognizing these parents as creative producers of their own solutions, and becoming conscious of their self‐made support networks and the resources they provide, can offer professionals and policy makers a new paradigm for the design of social services and support for immigrant parents.

This study retrospectively analyzed the mean glandular dose (MGD) to 133 breasts from 132 subjects, all women, who participated in a clinical trial evaluating dedicated breast CT in a diagnostic population. The clinical trial was conducted in adherence to a protocol approved by institutional review boards and the study participants provided written informed consent. Individual estimates of MGD to each breast from dedicated breast CT was obtained by combining x-ray beam characteristics with estimates of breast dimensions and fibroglandular fraction from volumetric breast CT images, and using normalized glandular dose coefficients. For each study participant and for the breast corresponding to that imaged with breast CT, an estimate of the MGD from diagnostic mammography (including supplemental views) was obtained from the DICOM image headers for comparison. This estimate uses normalized glandular dose coefficients corresponding to a breast with 50% fibroglandular weight fraction. The median fibroglandular weight fraction for the study cohort determined from volumetric breast CT images was 15%. Hence, the MGD from diagnostic mammography was corrected to be representative of the study cohort. Individualized estimates of MGD from breast CT ranged from 5.7 to 27.8 mGy. Corresponding to the breasts imaged with breast CT, the MGD from diagnostic mammography ranged from 2.6 to 31.6 mGy. The mean (± inter-breast SD) and the median MGD (mGy) from dedicated breast CT exam were 13.9 ± 4.6 and 12.6, respectively. For the corresponding breasts, the mean (± inter-breast SD) and the median MGD (mGy) from diagnostic mammography were 12.4 ± 6.3 and 11.1, respectively. Statistical analysis indicated that at the 0.05 level, the distributions of MGD from dedicated breast CT and diagnostic mammography were significantly different (Wilcoxon signed ranks test, p = 0.007). While the interquartile range and the range (maximum–minimum) of MGD from dedicated breast CT was lower than diagnostic mammography, the median MGD from dedicated breast CT was approximately 13.5% higher than that from diagnostic mammography. The MGD for breast CT is based on a 1.45 mm skin layer and that for diagnostic mammography is based on a 4 mm skin layer; thus, favoring a lower estimate for MGD from diagnostic mammography. The median MGD from dedicated breast CT corresponds to the median MGD from four to five diagnostic mammography views. In comparison, for the same 133 breasts, the mean and the median number of views per breast during diagnostic mammography were 4.53 and 4, respectively. Paired analysis showed that there was approximately equal likelihood of receiving lower MGD from either breast CT or diagnostic mammography. Future work will investigate methods to reduce and optimize radiation dose from dedicated breast CT.

We thank Drs Lecoultre and Tam

Although a wealth of literature links dietary factors and coronary heart disease (CHD), the strength of the evidence supporting valid associations has not been evaluated systematically in a single investigation. We conducted a systematic search of MEDLINE for prospective cohort studies or randomized trials investigating dietary exposures in relation to CHD. We used the Bradford Hill guidelines to derive a causation score based on 4 criteria (strength, consistency, temporality, and coherence) for each dietary exposure in cohort studies and examined for consistency with the findings of randomized trials. Strong evidence supports valid associations (4 criteria satisfied) of protective factors, including intake of vegetables, nuts, and "Mediterranean" and high-quality dietary patterns with CHD, and associations of harmful factors, including intake of trans-fatty acids and foods with a high glycemic index or load. Among studies of higher methodologic quality, there was also strong evidence for monounsaturated fatty acids and "prudent" and "western" dietary patterns. Moderate evidence (3 criteria) of associations exists for intake of fish, marine omega-3 fatty acids, folate, whole grains, dietary vitamins E and C, beta carotene, alcohol, fruit, and fiber. Insufficient evidence (< or =2 criteria) of association is present for intake of supplementary vitamin E and ascorbic acid (vitamin C); saturated and polyunsaturated fatty acids; total fat; alpha-linolenic acid; meat; eggs; and milk. Among the dietary exposures with strong evidence of causation from cohort studies, only a Mediterranean dietary pattern is related to CHD in randomized trials. The evidence supports a valid association of a limited number of dietary factors and dietary patterns with CHD. Future evaluation of dietary patterns, including their nutrient and food components, in cohort studies and randomized trials is recommended.