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After a pause, this cycle is repeated again. This rhythm may be caused by drugs such as beta blockers, digoxin, and calcium channel blockers. Type II blocks generally originate from conduction blocks on the path below the AV node Bundle of His, or more distal to the purkinje system.
Block type II is permanent and usually develops to a high degree, even to a total block. The first management is to seek and correct reversible trigger factors, such as myocardial ischemia, increased vagal tone, and drug use.
If no reversible cause is found, it is recommended not to use drugs that can interfere with AV node conduction and the installation of a permanent pacemaker. QRS complexes are usually dilated because they involve blocks in both branches of the bundle. This rhythm often occurs in cardiac ischemia or myocardial infarction 3rd degree AV block Total AV block In grade 3 block, there is no atrial impulse reaching the ventricle P wave is not followed by QRS.
In grade 3 block, atrial electricity is not associated with ventricles, where the atrium is depolarized as a response to the SA node, and the ventricles contract based on escape rhythm below the block. As a result of contraction out of sync, a decrease in cardiac output can occur; patients can experience dizziness, presinkop, or even syncope.
Management of grade 3 block as in grade 2 block, which starts with correcting reversible causes, and if the pacemaker does not improve can be installed.
In the total AV block, a dual chamber pace maker is usually done. Conclusion: Of the many etiologies that cause bradycardia, there is the most dangerous etiology. Both of these rhythms are usually associated with myocardial infarction in the antero septal section Management The Bradycardia algorithm in the ACLS outlines steps to assess and manage patients who present with symptomatic bradycardia or bradycardia which causes symptoms of shortness of breath, chest pain, dizziness, decreased consciousness, weakness, or fainting.
On examination can be found conditions of hypotension, shock, pulmonary edema and cold akral with decreased urine production. Assess and manage patients using primary and secondary surveys: Maintain a patent airway. Helps breathing when needed.
Install lead ECGs History of problem focus and physical examination. Search for and deal with factors that might contribute. Answer two questions to help you decide whether the signs and symptoms of poor perfusion are caused by bradycardia. Are there serious signs or symptoms, such as hypotension, pulmonary congestion, dizziness, shock, ongoing chest pain, shortness of breath, congestive heart failure, weakness or fatigue, or changes in acute mental status?
Are the signs and symptoms associated with a slow heart rate? If perfusion is adequate, monitor and observe the patient. If perfusion is poor, move quickly through the following actions: Preparing transcutaneous pacing. If there is no transcutaneous pacing IV being the first choice.
Consider giving atropine 0. Repeat every 3 to 5 minutes for 3 mg or 6 doses. If atropine is not effective, start pacing. Consider epinephrine or dopamine while waiting for pacing or if pacing is ineffective. Stages of treatment options for bradycardia 1. Atropin In the absence of reversible causes, atropine remains the first-line drug for acute symptomatic bradycardia Class IIa. Atropine is useful for treating symptomatic sinus bradycardia and may be beneficial for any type of AV block.
Atropine dosage is recommended for bradycardia 0. Use atropine carefully in acute coronary ischemia or myocardial infarction.
An increase in heart rate may worsen ischemia or increase the infarction zone. Patients like this need immediate pacing. Transcutaneus Pacing Immediately start transcutaneous pacing in patients who do not respond to atropine. Transcutaneous pacing is a class I intervention for symptomatic bradycardia. If the transcutaneous worm is ineffective for example, inconsistent capture , then it is prepared for transvenous pacing and consult an expert.
For patients with symptomatic bradycardia with signs of low perfusion, transcutaneous pacing is the treatment of choice. The results generally showed that the lecturer drove the students to dominate the class especially in speaking skill during teaching and learning process or the lecturer more emphasizes on communicative activity Setiadi, Most of the students agreed that English drama class provided the activities for their 4Cs skills and language skills.
Even though, some students argued that they have small proportion in speaking and writing skills activities, it was caused by group assignment more than individual assignment.
Critical Skills Survey: Executive Summary. Accessed on January Retrieved from: Bell, S. The Clearing House, Vol. Bender, W. Project-Based Learning. Differentiating instruction for the 21st century. Corwin a SAGE company. Cator, K. Accessed on December Retrieved from: Tools for understanding the process of planning and building projects.
Accesed February Retrieved from: A call for more awareness in Colombia. From Theory to Practice. English Language Teaching, 2, Grant, M. Accessed on December Retrieved from Harrigan, G. A case study of teachers and administrators' experiences integrating project-based learning.
Unpublished doctoral dissertation. Walden University. Larmer, J. Miles, M. Qualitative Data Analysis a Methods Sourcebook. Accessed on August Retrieved from: Punch, K. Introduction to Research Methods in Education. Ravitz, J. Using project based learning to teach 21 st century skills: Findings from a statewide initiative. Setiadi, B. Presented at Bandar Lampung University. Sumarni, W.
Learning for Life in Our Times first. Wallwork, C. Reframing the 4 Cs: Accesed on January Retrieved from: The research follows the design of model of the Branch There are five steps from the design model of the Branch , namely; analysis, design, development, implementation and evaluation ADDIE. To collect the data, the instrument that writer used are the observation, instrument validation and test sheets.
To validate instrument products, expert assessment of the strategies are chosen by using the delphi technique and continued with exploration of the feasibility which is applied by using focus group discussions technique. The data will be analyzed through qualitative and quantitative techniques. In order to get the book of entrepreneurship learning model and the guidebook based on the contextual, the data were analyzed by using qualitative and quantitative methods.
The validity of the product are tested by expert, the practical test by the user, and the effectiveness test trought the students learning outcomes. The results of the development consists of 1 bookentrepreneurship learning model based on contextual, 2 the lecturers guidebook of entrepreneurship learningmodel based on contextual, 3 student handbook learning model based on contextual is valid, practical and effective.
The competitiveness can be owned in the country if the country are supported by a human resources HR which are reliable and has of high quality. The proper effort to preparing the human resource is through the education. The quality of education in Indonesia is still low than other countries.
Based on the data from the Human Development Index HDI , expose that Indonesia is on the position of from countries, from four categories very high human development, high human development, medium human development and low human development. Indonesia is in the category of medium that is still far behind other countries.
According to Fattah, All sorts of efforts already made by the Governments, communities, and schools such as curriculum development, cooperation with non-governmental organizations and revision policy, while at the university level, the problem of the equivalent of evenness increased the quantity to increase the participation of University in development. However, due to various factors that influence, the problem will still need to improve.
Three major problems of education in Indonesia can be addressed by improving the quality of learning. Although learning is in the micro level, but can determine the progress of education, because learning is the core of education. The development of entrepreneurship is seen as a strategic step in an effort to demonstrate its resolve economic problems.
However, the number of entrepreneurs in Indonesia is still relatively low, i. It is therefore that still required additional significant self-employment to accelerate the growth of the socio-economic. The university as one of the leading facilitator and mediator in building the nation's younger generation who has an obligation to teach, to educate, to train and motivate its student to become an independent generation of intelligent, creative, innovative and capable of creating a wide range of job opportunities business.
The process of entrepreneurial education is a process of potential development of individuals pertaining in all aspects of entrepreneurship through management, the implementation of curriculum, pedagogy and assessment in one environment that isstructured and organized.
A lecturer is the main pillar in the development of entrepreneurship in the university. The lecturer who have knowledge and understanding of entrepreneurship will be able to guide the student in developing efforts to initiate and process accelerated so the new entrepreneurial growth.
Refraction Optisi studies program is one of the higher education students in the field of health that makes entrepreneurship courses as compulsory subjects. It is the entrepreneurial courses that make up the entrepreneurial character or at least students add to the knowledge of the ins and outs of the business both in the soft skills or hard skills so that the students are able to take the advantage of the opportunities that exist around them in creating their own business after graduation or when they are in the university level.
The difficulty of students in refraction Optisi is in understanding the entrepreneurial courses due to the still theoretical learning, so that the students feel difficulties and are not interested in learning the entrepreneurial subjects well.
The process of learning in entrepreneurship is still centered on the lecturer teacher centered learning that impact the lack of activity of college students in learning,less motivated in doing the tasks given by the lecturer, less creative and not responsible for given tasks, the results of the learning of students in the subjects of entrepreneurship is still notsatisfactory,that is apparent from the percentage of the results of the study with the most value are the C as For it, is needed for entrepreneurial learning changes continuously towards the better.
One of the way to continue the development of the learning process is by applying the appropriate learning model with changing times where a student is being required to interpret, critical and active learning, so the learning process does not run one the direction. Entrepreneurial education approach is expected to give a real experience to students as models developed by Kolb which is known as Experiential Learning. According to research done by Duval-Couetil et al. Findings indicate that higher perceptions of entrepreneurial knowledge were associated with the number of entrepreneurship courses taken and involvement in experiential learning activities.
The results of this study showed that the ability of the student in entrepreneurship process analytical study using more experiential learning models have development is academic ability compared to other learning model. Based on the theory of experiental learning model, then a new experience and the knowledge gained will be absorbed when students catch the meaning of academic material and applicable to the real life. With contextual learning, students are involved in important activities that can help them to associate the academic lessons with the real life context.
According to Owens , contextual learning practically promising increased thestudents interested in learning from different backgrounds, increase the participation ofstudents by encouraging actively which is provide them the opportunity to connect and apply the knowledge that they get. Learning is not only focused on the ability of knowledge provision granting theoretical only,but how to make the learning experience of the student-owned related to actual problems that occur in the environment.
The contextual learning make teaching and learning process more fun and makes the material useful for the real life of the student in the collage, because the learning process is carried out naturally and students can pay attentionand try to practice it directly in their life.
Contextual learning encourages students to find the meaning and the benefits of every learning process which have been completed, so that will give the motivation to the students to learn more creative, innovative and meaningful. Contextual learning can be followed by all the students from the varying levels of ability in achieving the academic success.
Contextual learning involve the students in every important activities that help them to associate the academic lessons with the real life context that they face Johnson, Many experts have argued that the definitions of entrepreneurship with perspective of each. However the essence essence of the understanding that there are always crucial in every sense expressed by experts and is fundamental.
According to Lambing and Kuehl , enterpreneurship is a human, creative act that builds something of value from practically nothing. It is the pursuit of opportunity regardless of the resources, or lack of resources, at hand. It requires a vision and the passion and commitment to lead others in the pursuit of that vision. It also requires a willingness to take calculated risks. Entrepreneurship is the willingness of entrepreneurs to combine creativity, innovation, risk taking, and sooth working to form and build up trade, maximise the potential as well as take advantage of opportunities that are retrieved BuangdanMurni, The instruments used in this research to collect the data are observational, instrument validation and test sheets.
Need analysis is done while doing the research in order to get a learning model which is valid and practical and appropriate with the teachers needs. The need analysis stage is done in order to make the model eill answer the need of the learning process.
This analysis is important to be done to make the material that will be given to the college students fulfill their needs and the model will be appropriate for the lecturers need. Because of that, need analysis is needed to be done whether to the college students or the lecturers.
There are some processes of validation for the entrepreneurship learning contextual based such as the validation of book model, lecturers and students guidebook, practicality and affectivity instruments, and all of the instruments used are validated by some experts based on their fields of study. The analysis of the students need analysis to the entrepreneurship learning results that it is needed to develop a model where it results an average of 45 with low category and a development is needed.
The result for the validity of the instruments which is done by 3 experts, it results an average The analysis of validity for guidebook for the lecturers for the learning process is valid with number of average The result for students guidebook which is validated by 3 experts is 0.
All of the instruments are tested where they are tested through practicality test model which is filled by the both students and lecturers. Then, this test results that this learning model is practical for both the process and the guidebook. The practicality is seen from the successfulness of the students in the learning process. The test which is given to the entrepreneurship lesson result an average in number and categorized as high.
This research is purposed to explain the influence of contextual based learning and the ability to think critically to the skill for writing argumentative text for the college students.
The population of this research are college students and 52 of them are chosen as the sample in stage of multi-sampling. The research which is done byrobert G.
Berns and Patricia M. The CTL is a concept of learning that will help the lecturers to relate the material with the real situation and how it is used in lives as the member of family, society and work-place.
Pribadi explained that the learning model, usually, uses some stages or procedures that have to be faces in order to create an effective, efficient and interesting learning activity. Iru and Arihi stated that the learning model is the center of learning done is based on such systematically learning patterns. The learning model tends to be prescriptive giving signs and purposed which is hard to be differentiated with learning strategy.
Therefore, a learning model is a plan or pattern that can be used for constructing a curriculum long-term learning plan , construct the learning materials and guide the learning process in the classroom. Joyce and Weil found five important elements that become the components of learning model where those elements are syntax, social system, reaction principal, supporting system and the instructional and guiding impacts. In this case the development of entrepreneurship learning model used is practical and effective.
Classroom Instructional Management. The McGraw-Hill Company. Branch, Robert Maribel. Buang, Nor Aishah. Pedagogi Pengajian Keusahawanan. Laser Press Sdn. Selangor Darul Ehsan. Coulter, Marry. Entrepreneurship in Action. New Jersey: Prentice Hall. Dean, D. How to use focus groups.
Wholey, H. Newcomer Eds. San Francisco: Jossey-Bass Publishers. Rahasia Kewirausahaan. Hasani, Aceng. Dasar-Dasar Kewirausahaan. Dalam Forum Vol. Johnson, Elaine B. Contextual Teaching and Learning: Corwin Press. Kold, D. Models, Strategies, and Methods. For EffectiveTeaching.
Pearson Education, Inc. Linstone, H. The delphi method techniques and applications. Electronic version. Nurhadi dkk. UM Press. Owens, T. Rajawali Press. Zimmerer, Thomas W dan Norman M.
Edisi Keempat. It is a series of actions driven by international trade and investment and aided by sophisticated information technology. Understanding and knowledge of one or several languages empowers to perceive new horizon, to think globally, and to increase our understanding of ourselves and of our neighbors.
It also leads to the extinction of other languages and cultures with globalization allowing languages and their cultures to spread and dominate on other languages.
Today, English is well-known from the other languages by having very considerable numbers of non-native speakers and it is one of the most affected by globalization. Many languages are disappearing on daily basis and many are wiped out already. The use of language is used as characteristics to be part of the new world system and this develops new global phenomena.
Imported cultures are taking place everywhere and pushing out indigenous ones. The paper attempted to look at how globalization has affected the Bodo language and its cultures.
The outcomes and narratives are extremely important and well timed to understand the causes of declining use of the said language and how the indigenous cultures were immensely affected. Survival of the language in coming decades in the face of globalization is highly questionable and if prepared, we can reverse the trend. Though it is not an altogether new phenomenon but the intensity and the speed at which it has changed and affected the world is unparalleled.
In every sphere of life be it economic, political, social or cultural it is leaving its indelible mark. It would not be wrong exaggeration if we say that no part of the life on this world has escaped from the influence of globalization. With the advancement and ever expansion of the globalization, it has highly increased the exposure to the international environment which in turn increases the possibility of international influences and exploitation. Globalization has become fiercely contested and discussed issue in current political, social and human rights discourses.
At one level it has been tremendously much-admired for delivering goods to the people and society at large by ushering in a new era of economic growth, technological advancement and by bridging the geographical boundaries, but at the other level it is blamed as a major reason and source of all the existing ills.
While for some it is the very expression of social and economic transformation, for others it poses an impediment to the governance of the world and a serious intimidation to social cohesion. Likewise, economic globalization now dominates international relations and development strategy consists of liberal trading regimes, with a reduced role for the state.
International relations now involve states, the market, multinational corporations and international organizations. Bodo is a language of North East India spoken by the Bodo people, a prominent ethnic group inhabiting Assam.
The language is spoken by more than 20, 00, twenty lakhs people and adopted Devanagari script as their writing system. The early history of Bodos is largely unknown. By definition, Bodos do not display tribalisitic culture or rituals in that they do not live in caves or jungles or go hunting wild animals. The majority of the Bodos have remained as cultivators, farmers, and peace loving society for centuries.
It is a developing language in the field of education and literature. The said language was recognized as the Associate State Language of Assam in the year and it was also recognized as the medium of instruction in the school level from and as one of the Modern Indian Languages from under Gauhati University in Assam.
The Bodos are numerically and sociologically one of the most important tribes of the North-Eastern India, particularly Assam. While they are spread all over the plains of lower Assam and contiguous areas of North Bengal, they have intimate family ties with many other tribes living in other parts of Assam and also in Tripura a neighboring state. Bodos are living in a scattered manner throughout the North-Eastern region of India.
There are some small Bodo pocket areas also outside India i. The current wave of globalization has brought new paradigm shift to the said language. The brutal developments of the English language including the many interior areas at the cost of own language and new trend development of cultural appropriation has raised certain fundamental questions before the community leaders.
The timely execution of some policy and understanding its nature is very much needed and vital. Many a time, we also observed serious human rights violations and though human rights are now internationalized and there are various agencies and organizations which are working towards the fulfillment of human rights, it is still the responsibility of the individual state to implement them.
And it puts the onus on the states and on the international community to safeguard the rights of its respective citizens and ethnic community. Culture refers to behavior which is specifically human and also to the distinctive ways of life found in different human populations. As we are well aware that in this dynamic world, alongside the languages that have become worldwide, there are certainly others the huge majority which have remained limited and confined in size and scope. There are close to 6, living languages in the world, and half of them have fewer than 7, speakers each, less than a village.
The worst suffer are smaller languages of all over the world and they are miserably failed to attract the younger generation and language shift is taking place at a rapid pace.
Now the question: Is it globalization and the consequent spread of the global languages, to say at English language which is responsible for the endangerment of other languages? It has had a very unfathomable impact on our culture and has dug its way to the roots of our culture. As we are well aware, westernization has been the by-product of globalization and needless to say, it has had an impact on the Indian way of life.
Without a doubt, it has brought great changes in the culture and the rate at which westernization is happening to India is astonishing. Regional languages are on the verge of extinction and many minority languages have already disappeared.
Many minority languages have already been replaced by English or other international languages such as French, German or Spanish. Indian youngsters have started getting obsessions with western attire, languages, mannerisms and everything else western. As the world becomes more connected and shrinking in space than ever before, language diversity is reducing at an unparalleled pace. Languages are endangered by many other external forces such as military, economic, religious, cultural or educational subjugation, or by internal forces such as a community's negative attitude towards its own language.
Even the internet languages, on grounds of a digital divide that locks out some groups and privileges others and their language. The Bodo language is also not an exception and could not escape from the heat of globalization. The new trend which is being adopted by current generation is completely devoid of cultural touch and many of them have already lost its roots. The contemporary Assam is witnessing a new trend which is developing very forcefully.
The mushrooming of English Medium schools in every nook and corner and abandoning vernacular medium schools is a very much dangerous trend. As a result, only the children from the poor and less informed families are opting for Bodo Medium BM schools. It has a tumbling effect on the BM schools and the survival of these schools is at great a stake.
Moreover there is no serious attempt to develop the Bodo languages and literature and though developmental activities are being carried out in the said language the pace of development is not encouraging In spite of being one of the major languages of India, it has several problems including the survival as a medium of instruction and development of language and literature.
There is still certain pressing issue which needs to be addressed immediately. The shortage of Bodo language teachers in the educational institutions and huge number of Bodo Medium venture schools demands an immediate solution from the provincial government.
Many a time, the school textbooks never reach on time to students. The dignified silence on the part of provincial government and education department is maintaining a distinguished silence over these serious problems. The Government s apathetic attitude towards Bodo medium was very unfortunate. The state legislation on provincialization completely violates the right to education national legislation provision of ensuring free and compulsory education to children from lower primary to upper primary level.
The government, and especially the education department, did not pay any attention to address the problem of Bodo medium education. The terrible condition of vernacular medium schools also hugely motivated parents to send their kids to the well equipped private EM schools. Since its inception, the United Nations Educational, Scientific and Cultural Organization UNESCO are consistently working hard on the cultural preservation of cultural minorities, education, indigenous culture and other areas.
Several resolutions have been declared regarding the rights of cultural minorities. It is highly praiseworthy that UNESCO has always been promoting languages and multilingualism by involving education, culture, science, communication and information and social and human science. In , UNESCO passed an International treaty to preserve the rich diversity of the world s means of cultural expression from the dangers of globalization, including its many languages. This treaty is a great clarion call and holds significant meaning in maintaining world s cultural diversity.
The globalized and transparent nature of today s trend demands other minorities to interact with the culture majority by working for global companies and accessing technology. Nation-states are on the lookout for solutions to deal with diverse societies, on ensuring the unity and inclusion with various national, ethnic, religious and linguistic groups.
As we know, cultural identity is an essential part of peaceful cooperation. People with a strong good judgment of identity are more expected to interact with other world cultures. And languages play a pivotal role in constructing the identity. Today, the world is losing languages every other day at an unimaginable rate and one of the greatest reasons of languages vanishing is due to lack of education provided in school to pursue students continue speaking in their own mother tongue.
Never before we were living in a more globalized and transparent world in history. The aversion of the state, either for political or economic reasons or cultural hegemony is also why minority culture was not officially implemented in schools.
These are serious implications on the minority languages and as a result loss of cultural values disappearing or total assimilation to the dominant cultures. Consistent efforts were being made to impose western ideas as universal and leading to what is essentially cultural imperialism.