KONSEP SETTING DAN STRATEGI PENGELOLAAN RUANG BERMAIN DALAM PENGEMBANGAN KREATIVITAS ANAK USIA DINI

Penelitian ini untuk mengetahui: 1) konsep setting ruang bermain yang dapat menunjang kreativitas anak; 2) penataan ruang bermain yang dapat menunjang kreativitas anak yang sesuai dengan perkembangannya; 3) pengelolaan elemen fsik ruang bermain dalam mengembangkan kreativitas anak; 4) pola seting ruang bermain (indoor) yang dilakukan di dua tempat penitipan anak (TPA) besar di Yogyakarta. Jenis penelitian ini adalah penelitian lapangan (field research) bersifat deskriptif kualitatif non statistik dengan menggunakan studi kasus (case study). Data diperoleh melalui observasi, dokumentasi, dan wawancara kemudian dianalisis dengan analisis tringulasi Moleong, yakni tringulasi sumber, tringulasi dengan metode, dan tringulasi dengan teori. Penelitian ini dilakukan di dua tempat peneitipan anak (TPA) besar yang ada di Yogyakarta yaitu Taman Pengasuhan Anak (TPA) Beringharjo dan Lembaga Pendidikan Islam Terpadu Untuk Anak Usia Dini Tiara Candra. Hasil penelitian ini menemukan bahwa: 1) konsep setting ruang bermain yang pada setiap lembaga yaitu menggunakan konsep home schooling dengan beyound centre and circle times (BCCT). 2) penataan ruang bermain dengan menggunakan sistem pembelajaran berdasarkan BCCT dan sudut ruang bermain yang disesuaikan dengan peralatan  dan sesuai dengan masa perkembangannya. 3) pengelolaan elemen fisik ruang bermain seperti pemilihan warna dan furniture disesuaikan dengan kebutuhan anak serta tidak mengandung bahan yang berbahaya. 4) pola setting ruang bermain ditata sesuai dengan konsep ruang bermain seperti yang telah diprogramkan. Kata kunci: Ruang Bermain, Anak Usia Dini, Kreativitas

A Randomized-Controlled Trial of Steroid Injection in the Management of Plantar Fasciitis at the Aga Khan University Hospital

Background: Plantar fasciitis is a common painful condition often associated with significant morbidity. Its management varies among clinicians because no single treatment has strong scientific evidence to support its use to improve outcome. Patients present to clinicians with pain and disability but most patients with plantar fasciitis eventually improve over time irrespective of the modality of treatment provided. Steroid injections are one of the more commonly used modalities and the response to the treatment is varied and unpredictable. Objectives: The objective of this study was to compare the effects of two treatment options for plantar fasciitis: steroid injections with conservative treatment (analgesics, stretch exercises, and insoles) and conservative management alone. Design: A double blind randomized controlled trial to compare these two treatment options. Setting: The study was conducted between December 2010 and May 2011 at The Aga Khan University hospital and affiliated outreach centers. Methodology: Eighty eight patients with plantar fasciitis were randomized to two treatment arms, 47 to the steroid injection arm and 41 to the control arm. Both arms received standard conservative management. Visual analogue scales (VAS) and Foot Function Index (FFI) scores of the patients were recorded at study entry, at one month and at two months. Analysis: The change from baseline VAS scores and FFI scores were analyzed using Student’s t-test and chi square analysis. Results: The mean age of the overall study cohort was 42.9 years (SD 9.1). Forty two were male and 46 female. The majority (87%) were active individuals in occupations that required prolonged walking or standing. The mean Body Mass Index (BMI) was 31.7 and eleven (12.5%) of the study cohort had flatfoot. There was a significant reduction in mean pain scores, after one month and after two months in both the steroid and the control arms. The mean VAS scores at study entry were 8.6 (SD 1.4); 7.2 (SD 1.7) at one month and 6.6 (SD 1.7) at two months (P<0.001). The mean morning pain was 7.5 (SD 2.2) at enrollment; 6.2 (SD 1.9) at one month and 5.6 (SD 1.8) at two months (P<0.001). The mean FFI at study entry was 50.5 (SD 18.2). At one month and two months follow-up, the mean FFI scores were 43.4 (SD 16.2), and 41.4 (SD 15.3) respectively (P<0.001). There was no statistically significant difference in pain scores between patients who received steroid injections 7.36 (SD1.6) and those in the control arm 7.22 (SD