Short-term Effects of Whey, Creatine, and L-carnitine Supplementation on Muscle Hypertrophy Marker Candidates in Young Males: A Randomized Placebo-controlled Pilot Study

Previous research showed that resistance exercise could induce muscle development, noticeably from the increased level of several markers from blood samples. However, no study had been performed to explore the effect of combination of resistance exercise and proper nutrition supply on those markers. The aim of this study to investigate the effect of whey protein, creatine, and L-carnitine; on potential molecular markers of muscle hypertrophy (arg1 and mmp9) from blood samples. Twelve healthy male participants were randomly categorized into supplement (SUPP) or placebo (PLAC) treatment, and performed resistance training three times in a one-week period. Blood sampling was carried out before (day one) and 2 hours after the exercise (day one, day three and day five). The level of mmp9 gene expression was increased along with the progress of the resistance training program. Moreover, participants who received supplementation (SUPP) showed a higher level of mmp9 gene expression compared to resistance training only (PLAC). A significant difference was observed between two treatments in the first day, 2 hours after the resistance training session (p = .04); and between SUPP group on the fifth day, 2 hours after the resistance training; compared to the first day, before the resistance training session (p = .02). The effect was not observed on arg1 gene. A combination of resistance training with supplementation; was considered to enhance the muscle hypertrophy process, compared to resistance training only. The results also suggested that mmp9 could act as a blood-derived molecular marker of muscle hypertrophy.

Introduction
Resistance training is a kind of sport which can improve general fitness status and induce muscular hypertrophy, by performing movements against force in the opposite direction. Studies showed positive effects of resistance exercise to muscle cross-sectional area, cellular markers, protein markers, and gene expression markers; yet, muscle biopsy was still the method of preference for sampling [1,2,3]. Muscle biopsy is known as an invasive method and potential to cause a scar in the participant's body. Therefore, molecular markers from blood sample are preferable because they give less invasive effect to the participants.
Research showed that there were two genes which upregulated in 2 hours after acute resistance exercise: arg1 and mmp9 [4]. Those genes were analyzed from blood samples. Arginase-1 (Arg1) is an enzyme which metabolizes arginine to ornithine, which furtherly modified to proline, a constituent of collagen which important in hypertrophy process [5,6,7]. Meanwhile, matrix metalloproteinase 9 (MMP9, gelatinase B) is an enzyme which is capable of degrading extracellular matrices, particularly type IV and V collagen [8,9]. This enzyme helps the movement of leukocytes toward the damaged area of muscle tissue, improve the ability of myoblast migration, and help the synthesis of new myofiber [10,11]; thus, the hypertrophy process can occur.
The combination of resistance training and proper nutrition supply will help the body-builders to achieve enhanced muscular development. Administration of nutrients, particularly whey protein, creatine, and L-carnitine would further enhance the process of muscle hypertrophy. Researches showed that whey protein and creatine could improve myoblast proliferation and differentiation [12,13]. Meanwhile, L-carnitine was involved in muscle recovery [14] and reduced muscle tissue damage [15]. However, there had been no study which observes the effect of combination between nutrition and resistance training on muscle hypertrophy, at the level of gene expression. This study was the first to observe the changes of gene expression in blood samples after resistance training, combined with nutrition supplementation. Therefore, the aim of this research was to investigate the effect of nutrient administration (whey protein, creatine, and L-carnitine) towards potential molecular markers of muscle hypertrophy (arg1 and mmp9) from blood samples.

Participants
A total of 12 healthy male participants were recruited, in which each had to fulfill the following criteria: 1) aged between 18 to 35 years old; 2) did not smoke and drink alcoholic beverages; 3) did not consume prescribed medicines; 4) was not overweight; 5) was not diagnosed to have diabetes; 6) had no records of heart disease; 7) less active, which performed less than 2 hours of structured physical activity at free time [16,17]; and 8) had never done resistance training program for the last 2 years prior to this study. The design was double-blind randomized, in which all participants were randomly categorized into supplement (SUPP) or placebo (PLAC) treatment; in which, neither the participants nor the researcher knew about the participant grouping.
During the study period, participants were asked not to drink high protein and ergogenic supplements, apart from the drinks given as treatment. The use of anabolic steroids was not allowed during the study. They were also asked not to perform any resistance exercise in three weeks prior to this study. Before participating in this study; all the participants were provided with written informed consent, which complied with the Declaration of Helsinki and was approved by the ethics committee of Atma Jaya Catholic University of Indonesia.

Body Composition Measurement
Body composition measurement was performed with the InBody720 instrument (Biospace, Gangnam-gu, Seoul, Korea), which utilized bioelectrical impedance method. The measurement was performed at the beginning of the study to screen the compatibility of the prospective participants with the criteria used in this study (not overweight, which BMI ≤ 23 kg/m 2 ).

1-RM Measurement, Resistance Training and Supplementation
All participants performed 1-RM measurement three weeks prior to this study ( Figure 1). 1-RM measurement involved the following exercise: smith machine bench press, smith machine close grip bench press, smith machine bent over row, dumbbell standing reverse curl, and dumbbell one arm standing curl. Every successfully lifted weight was followed by three minutes of rest and additional 2.5 kg weight for the next repetition gradually.
The resistance training was performed in five days period: three days of exercise and two days of resting.
Participants were asked to consume supplement (SUPP) or placebo (PLAC) before and after each resistance exercise session during the three days of exercise; as well as twice a day during the resting day. In total, every participant consumed two servings of drink each day and repeated for five days' period.
The supplement drink consisted of the mixture of whey protein, creatine, and L-carnitine (total calories: 130 cals, total fat: 2.5 g, protein: 23 g, total carbohydrate: 3 g). Meanwhile, placebo drink consisted of the isocaloric amount of maltodextrin (total calories: 130 cals, total fat: 2.5 g, protein: 1 g, total carbohydrate: 26 g). Both of the drinks were made as identical as possible in color, taste, and texture. Participants were asked not to discuss the administrated drinks during the study. Blood samples (6 mL) were collected from antecubital vein before the first resistance exercise session (day 1) and 2 hours after each resistance exercise session (day 1, day 3 and day 5). Blood samples were placed in EDTA vacutainer tubes (Becton, Dickinson, and Company, Franklin Lakes, NJ, USA). The overall experimental design was described in Figure 1.
The resistance exercise of each session consisted of following motions: smith machine bench press, smith machine close grip bench press, smith machine bent over row, flutter kick, plank, leg raise, dumbbell standing reverse curl, and dumbbell one arm standing curl. Each exercise consisted of three sets, with exercise volume of 60% 1-RM with 12 repetitions for the first set; 65% 1-RM with ten repetitions for the second set; 70% 1-RM with eight repetitions for the third set (exception for flutter kick, plank, and leg raise exercises because their 1-RM values were not measured).

qPCR of arg1 and mmp9 Genes
Primer sequences used were described in Table 1. Gene quantification was done with StepOnePlus Real-Time PCR System instrument (Thermo Fisher Scientific, Waltham, MA, USA). The reaction was done with the following condition: predenaturation at 95°C for 2 minutes; denaturation at 95°C for 20 seconds; primer annealing at 55°C (arg1 dan mmp9) or 53°C (β-actin) for 20 seconds; and fluorescence acquisition at 72°C for 30 seconds. The whole reaction was done in 40 cycles. Levels of gene expression measurement were done with 2 -ΔΔCT relative quantification method [18].

Statistical Analysis
Data obtained were statistically analyzed with IBM SPSS Statistics (Version 22 for Windows; IBM, Armonk, NY, USA). Independent t-test was used to analyze the homogeneity of participants (age, BMI, PBF, and SMM) and gene expression difference between different groups. Repeated measures ANOVA with Bonferroni adjustment for multiple comparisons was used to analyze the difference of gene expression between different time points. Significance was considered at p-value < .05.

Results
The level of mmp9 gene expression was increased along with the progress of resistance training program; in which the highest level was found on the fifth day (D5') ( Figure 2). Moreover, resistance training with nutrition supplementation (SUPP -whey protein, creatine, and L-carnitine) further induced the level of mmp9 gene expression in all three time-points measurement (D1', D3', and D5'); compared to resistance training only (PLAC). A significant difference was observed between two treatments in the first day, 2 hours after the resistance training session (*p = .04); and between SUPP group on the fifth day, 2 hours after the resistance training; compared to the first day, before the resistance training session (**p = .02).
The different result was observed in arg1 gene expression. The arg1 gene expression was increased after 2 hours of resistance training on day 1 (D1'); yet, the level was decreased along with the study duration (D3' and D5'). Supplementation of whey protein, creatine, and L-carnitine gave no significant effect on the expression of arg1 gene (Figure 3).

Discussion
The demographic characteristics of participants in this study were homogeneous; in which they were similar in age, BMI, PBF, and SMM (Table 1). Three weeks prior to the clinical study, all the participants were asked to perform the 1-RM measurement. The purpose of 1-RM measurement was to quantify the maximum amount of weight that could be lifted by each person in each exercise; so, the resistance training weights could be adjusted personally. Later, in the clinical study period; we observed the effect of resistance training combined with nutrition (a mixture of whey protein, creatine, and L-carnitine); and resistance training per se, on the expression of mmp9 and arg1 gene.
The study showed that mmp9 gene expression was upregulated in 2 hours after resistance exercise, which in line with a previous study [4]. This study also showed that a combination of resistance training with a mixture of whey protein, creatine, and L-carnitine induced higher expression of mmp9 gene expression, compared to resistance training only. The MMP9 protein played a role in the recruitment of leukocytes to the sites of injury [10] and helped the migration of satellite cells by the degradation of basal lamina [11,22]. Satellite cells were those which responsible for muscle hypertrophy process, by furtherly differentiated or fused to myofibers [6,7,23].
Neutrophils, which were able to synthesize MMP9 [24], were the first immune cells recruited to the area of muscle injury; followed with M1 macrophages [25]. Resistance exercise increased the blood neutrophil count up to 3 hours [26]. The increase of viable neutrophils after whey protein application [27] could lead to more recruitment of neutrophils to the damaged muscle area and led to increased mmp9 gene expression.
Whey protein increased neutrophil responses (superoxide anion formation, chemotaxis, and phagocytic activity) [27] and stimulated the proliferation of resting splenocytes [28]. Moreover, whey protein also increased the levels IL-1Ra and number of cytokines, such as IL-1β, IL-6, MIP-1α, MIP-1β, and TNF-α [29]. TNF-α was known as the activator of MMP9 protein and its mRNA synthesis in leukocyte [30] and in muscle cell [31]. L-carnitine was also able to modulate the expression of mmp9 gene by restoring the chemotaxis [32] and phagocytic ability [33] of neutrophils. Several human studies also showed that L-carnitine increased the ATP production of lymphocytes [34] and TNF-α expression in resting human peripheral blood mononuclear cells [35]. Together, these phenomena could lead to an increased level of mmp9 gene expression.
To date, there was no convincing evidence about the effect of creatine supplementation towards neutrophil. Nevertheless, some researches noted that creatine supplementation played a role in reducing the expression of TNF-α [36,37]. A study showed that the in vitro supplementation of L-carnitine (400 μg/mL) induced high increments of TNF-α expression up to 234 pg/mL from zero levels after 24 hours of incubation [35]; whereas in vivo supplementation of creatine (20 g/day) only reduced 42% of TNF-α increments in 24 hours after heavy exercise [38]. Furthermore, in vitro supplementation of whey protein extract increased TNF-α expression from zero to the level of 0.04 ± 0.01 μg/L [29]. While these studies were not directly comparable, the data suggested that combination of whey protein and L-carnitine elicited a higher impact towards TNF-α expression than creatine. Therefore, we hypothesized that the decreased TNF-α expression effect from creatine was overruled by whey protein and L-carnitine content in the supplement; thus, the level of mmp9 expression could be increased. Taken together, the gene expression increment after resistance training with supplementation suggested that mmp9 could act as a molecular marker of muscular hypertrophy taken from blood samples.
On the other hand, the effect of whey, creatine, and L-carnitine was not substantial in modulating the expression of arg1 gene. This phenomenon might be correlated with the increased expression of nitric oxide synthase (NOS) after resistance exercise. Exercise was known to increase the levels of nitric oxide, which was the result of NOS expression increment [39]. For example, eNOS (endothelial nitric oxide synthase) activity was known to be upregulated after endurance exercise [40] and treadmill running stimuli [41]. On the other hand; iNOS (inducible nitric oxide synthase), which could be produced by neutrophils and macrophages [42], was increased significantly after resistance exercise with blood flow resistance [43] and running exercise [44]. The existence of iNOS was essential for muscle regeneration [42]; which was also a part of the hypertrophy process.

Conclusion
A combination of resistance training with supplementation of whey protein, creatine, and L-carnitine; was considered to enhance the muscle hypertrophy process, compared to resistance training only. This was perceived from the increased level of mmp9 gene expression during the clinical trial duration; which could be due to the effect of whey protein and L-carnitine in improving neutrophil proliferation and chemotaxis, and also upregulating the TNF-α cytokine. The effect was not observed in the arg1 gene expression. The data suggested that mmp9 could act as a blood-derived molecular marker of muscle hypertrophy.


Colleges Students ' Misconception about Type of Bonding

This research is based on writer’s previous misconceptions research on chemical bonding. The study aims to calculate the percentage of misconceptions and misconceptions types about chemical bonding. The method used is descriptive. Samples used in this study was 75 students in college. Data collection tool used in this study was an online modified two-tier diagnostic test. The results showed that types of student misconceptions occur in sub concept: determining the type of bonding of a compound based on the difference in electronegativity, determine the type of bonding may occur if the metal and non-metal bind together and determine two examples of ion or covalent bond compounds.

Introduction
Chemistry is one of the subjects must be taught in natural science program in Senior High School in Indonesia. Based on the ministerial decree of the ministry of education and culture about the national education system, the purpose of learning chemistry is to make the student understand about chemistry concepts and apply it to solve the problem in real life and in science and technology life. Application of chemistry in real life start with an understanding of chemistry concepts, principles, laws, and theories. But, chemistry is one of the subjects that difficult to understand by students and teachers too [1]. Most of the students hate the abstract concept that requires more attention when they learn chemistry. Furthermore, the difference between chemistry word and reality word also make a relational and interpretation problems for the students.
The knowledge level chemistry subject in senior high school can be categorized into three types, that is sub-microscopic (abstract and cannot detectable with ears, eyes, noses, tongue, and skin), macroscopic (can be detectable with our body's instrument) and symbolic (a symbol represents a chemistry formula or subject) [2][3][4].
The complexity of this subject also one of cause the misconception happened in chemical bonding [5]. Chemical bonding is one of difficult concept that student should understand clearly. The concept of chemical bonding also related with another concept such as thermochemistry, chemical equilibrium, and others. The lack of concept in chemical bonding will influence the next topics related each other.
Chemical bonding generally gives many conceptions in teaching and learning the process. There are several correct conceptions we cannot find in a textbook. Glynn and Duit said that the importance of teachers helps not only the commonalities among representations but also their limitations. The teachers' misconception also happened in several countries such as Indonesia [6], Turkey [7], and China [8]. They were assessed with a specific instrument to measure the number of conceptions.
Misconception in a student can be detected using various detection instruments. It includes interview [53][54][55], open reasoning [56][57], and multiple choice [58][59]. Every instrument has different advantages and disadvantages to assess the misconception. The accuracy and precision of the result are can be represented the real if the instrument can represent the real condition in school or subject class. Multiple choice is one of the instrument can be assessed the misconception. The option should be represented the unique of conception. It must not four or five options every question. The option depends on the complexity of the question and opportunity of conception in the subject. The tiered instrument is a way to help more accurate result that consists of two or more tier. It mapped the conception and reduce the guess of the student. The student should choose the first tiered reason and choose the possible reason to their answer.
There were many misconceptions are found by researchers about chemical bonding reviewed by Ozmen [61], but in the type of bonding is not find in specific research. The method used were multiple choice, tiered question and interviews with some of the subjects. But, the interview cannot be recommended during the lack of time although it can detect deep insight about students' conception.
An alternative method to detect college students' understanding in a different place in Indonesia is with online with two-tier question inventories. Two tiers question consist of a multiple-choice question (2-4 options) in the first tier. The second tier is certainty of subjects' reason after answering the option that includes "Yes" for certain answer and "No" for the uncertain question. These questions were developed from previous research about the certainty of response index [62] and multiple-tiered [63]. The test used was adapted from author previous research. Distractors derived alternative conceptions may happen in the subject.

Materials and Methods
The material used in this research were adapted from author previous research. The reliability, validity, and distractor were tested and no more testing needed for this research.
Seventy-five college student of diversity educational background that got chemical bonding as their subject in senior high school. Actually, there were ninety-seven respondents participated in this survey. But, some of them wrote never got that subject in their school. They consisted of 40% of graduate students (18 to 30 years old), 49.3% master degree students (23 to 41 years old) and 10.7% from doctorate degree students (22 to 41 years old).
There were three type of conception in this research that is a good concept, misconception and lack of knowledge. Based on responses given, possible combinations of answer were defined. If the respondents answer correctly and stated sure, then it is possible to conclude that she/he possesses a scientific knowledge of the examined concept. We can be certain that the respondent possesses a misconception if they answer incorrectly and stated sure. Another possibility is she/he answer correctly but stated not sure then can be classified as lucky guess or lack of confidence. The last combination, incorrect-not sure, indicate a lack of knowledge.  Table 1 the questions and explanations of degree of conception from the subject that author got in this research. HBr and KCl c.

Result and Discussion
NaCl and H2O d.
BH3 and NaBr Are you certain with your answer? a.

Yes b. No
There was one misconception type occurred in this question. While two type lack of knowledge. 76% of the subject was chosen ionic bonding when they asked about the type of bonding in sodium chloride molecules. It can be accepted because almost all of literature in chemistry textbook write sodium chloride as their examples for ionic bonding. Furthermore, the subject also remembers this concept all along their life. Previous research said the subject spontaneously answer the question without further thinking when they found this question. They also did not use the electronegativity value written in question ion from metal (Na + ) and ion from non-metal (Cl -) will compose ionic bonding.
Only 5.3% subject certainly chosen sodium chloride is covalent bonding as their answer. This subject can be categorised as a misconception. They can be simplified as forgot the right concept. It same with another research. This is different with science concept that a compound can be categorised an ionic bonding if they have a difference of electronegativity value more than 1.7 [64]. The electronegativity differences between Na (electronegativity value: 0.93) and Cl (electronegativity value: 3.16) is 2.23. This value shows that sodium chloride is ionic bonding when bond each other.
While 18.6% chosen the answers uncertainty for this question. It consists of 13.3% uncertain chosen ionic bonding and 5.3% uncertain chosen covalent bonding as type bonding of sodium chloride. It means the subject in this research cannot remember they have gotten in previous school degree although more than half of them remember.
The scientific concept of this problem is based on Effendy's book entitled "Ikatan Kimia (Chemical Bonding)". A molecule calls have a covalent bonding if the difference of electronegativity value between atom formed is lower than 1.7 in Pauling Scale. Zinc sulphide consists of Zn which is 1.65 value of electronegativity while S is 2.58 so that the electronegativity value differences is 0.93. It indicates that zinc sulphide is formed by covalent bonding.
This question captured student conception about this problem. Almost a quarter of them knows the right concept about covalent bonding. There was a misconception type occurred in this problem, while two type lack of knowledge. 21.3% subject was chosen ionic bonding when they answered about the type of bonding in zinc sulphide molecules. It means they know the concept of covalent bonding without any uncertainty.
40% of subject indicated as a misconception. It similar to author's previous research [65]. Some of the subjects only decided the type of bonding based on metal and non-metal characteristics. They directly answer the question without further thinking when they found this question. They also did not use the electronegativity value written in question.
While 38.7% chosen the answers uncertainty for this question. It consists of 20% uncertain chosen ionic bonding and 18.7% uncertain chosen covalent bonding as type bonding of zinc sulphide. It means the subject in this research is not enough knowledge for this problem.
Subject conceptions' regarding the determination of the type of bonding that may occur between metallic and non-metallic elements in a molecule. Subjects were asked to specify the type of bonding in compounds BeCl2 and CaF2. The conception of scientists' topic is based on the ionic characteristic, metallic and nonmetallic elements can form compounds that bind covalently-ion and depends on the percentage of ionic character. Binary compound that has more than 1.7 electronegativity difference will form compounds that bind ions whereas the compound having electronegativity difference of less than 1.7 will form polar covalent compounds. BeCl2 compound has the electronegativity difference of 1.5 while CaF2 compound electronegativity difference of 3.0 so as to have an ionic bond.
In the first option that mentions the type of BeCl2 and CaF2 is ionic bonding chosen by 36% of the subject. It consists of 28% certain with their answer and 8% uncertain answer this option as their answer. Like previous research, the subject may believe that every element of metal and non-metal will definitely form ionic bonds. They spontaneously answer ionic bond when it finds a molecule concerning the determination of the type of bonding between metallic and non-metallic elements without further thinking. Some of the literature of chemistry textbook in senior high school write this manner to determine the type of bonding.
The scientist conception, B option, only chosen by 17.3%. It consists of 9.3% certain and 8% uncertain when they chose this answer. This means less than 10% is understanding the correct conception about not all the metallic and non-metallic element form ionic bonding. This conception that not all of student understand though it sometimes beryllium chloride wrote in the textbook as covalent bonding. It caused by the example about beryllium chloride never mention as metal and non-metal element. They associated the calcium fluoride formed by ionic bonding too similar as beryllium chloride.
The third and fourth option can be combined because of looks similar which almost a half of subject chosen this answer. As 24% and 22.7% were chosen this option. The "C" option chosen by 10.7% certainty subject and 13.3% uncertainty subject while the "D" option chosen by 10.7% certainty subject and 12% uncertainty subject. This mean subject understood the type of beryllium chloride that sometimes appear in chemistry textbook as covalent bonding, but they did not understand the calcium difluoride bonding type and associated as ionic bonding. It caused by both calcium and fluoride were known as reactive and located in metal and non-metal elements.
In previous research author [65] also found five type of misconception as follow: (1) the subject looked at bonding that occurs when metallic and non-metallic elements bonded by a large electronegativity difference without specify the value of the difference in electronegativity to form ionic bonds, (2) the subject is only looking at ionic bonds based on the properties of metals and non-metals without using the data value of the difference in electronegativity in determining the type of bonding compound, (3) the subject considers the compound BeCl2 two Cl atoms attract electrons from the atoms Be, whereas CaF2 compound F atom attracts two electrons from an atom Ca. Cl atoms and F will be a negative ion is 2Cland 2F -, (4) the subject considers BeCl2 formed from two elements Be 2+ and Cl while CaCl2 is formed of two elements of Ca 2+ and Cl, (5) the subject assumes that the ionic bonds occur in BeCl2 and CaCl2 compound which is metallic and nonmetallic elements causing electrostatic forces.
In the third indicator, determine two examples of ion or covalent bond compounds, two question were established. First question about ionic bonding and second question about covalent bonding. Both of question made with previous author research about chemical bonding topic [65]. But, the subject used here is different with another chemistry teacher instrument and some of the modifications has made. The subject should use the electronegativity value to determine molecule's bonding type. The first question translation show above: Subject conceptions' regarding the determination of sample molecules that bind to ionic bonding in a molecule consist of 56 subjects chosen a single answer for the question and 19 subjects chosen more than one answer. In this question, the subject asked to specify examples of compounds that bind ionic bonding. The subject was allowed to choose one or more answer in this question. The conception of scientists in this matter is a binary compound that has more than 1.7 electronegativity difference will form compounds that bind ionic compound. The Al2O3 has an electronegativity difference 2.0 and the CsCl has an electronegativity difference 2.4 so that the ionic bonds occur in the compounds Al2O3 and CsCl [64].
Only a person or 1.8% subject certainly was chosen aluminium oxide and caesium chloride as an example of ionic bonding. This mean very small amount of subject understand and can determine a pair of the compound in ionic bonding. He/she using difference value of atomic compiling based on electronegativity value each. Another two people (3.6%) were chosen this option with the uncertainty that means they are got a lucky guess or uncertain with their choice.
In the other hand, another option is dominated by subject. The first option, sodium chloride and hydrochloride acid were chosen by about a quarter of subject. It can be accepted because both of them is consists of IA and VIIA groups. Some people assume that this group will make an ionic bonding when two atoms bind a molecule. It similar with author previous research that subject did not use the data value of the difference in electronegativity compounds in determining the type of bond despite having been supplied electronegativity value compound constituent elements. They were thought the formation of ionic bonds based on the position of the element in Table of  Element Periodic. Most of the subject were chosen sodium chloride and silver (I) chloride as an example of ionic bonding. They include 37.5% of the subject. Previous research said that subject assumed the properties of metals and non-metals of an element and by anion and cation will form an ionic bond. This is not in accordance with the conception of scientists who claimed that the binary compound that has more than 1.7 electronegativity difference will form compounds that bind ions [64]. Electronegativity value of Na (0.93) and Cl (3.16), then the difference in electronegativity is 2.23. This value indicates that the compound has the sodium chloride ionic bond after binding [64]. However, silver (I) chloride compounds have an electronegativity difference of 1.07, so it has the properties of a polar covalent bond.
Three people were certainly chosen c and d option as their answer. The c option, BF3 and KCl, chosen by two people and the option d, NaBr, and CH3 chosen by a person as their answer. Unlike previous option, this option chosen by fewer people. It caused by the molecules is unfamiliar. Also, each one person chose these options as uncertainty answer. As a conclusion, their conception in about this question is rarely found. This categorised as minority chosen by subject.
There were 19 people chosen more than one option as their answer count separately. Most answer chosen by subject is NaCl, HCl and AgCl as molecules bind by ionic bonding about 26.3%. The second choice most chosen is NaCl, AgCl, BF3 dan KCl about 15.8%. While other option: NaCl, AgCl, Al2O3 and NH4Cl; NaCl, HCl, BF3 and KCl; NaCl, HCl, AgCl, Al2O3, and NH4Cl; and NaCl, HCl, AgCl, BF3 and KCl, chosen by a person each. It also consists of uncertainty answer: NaCl, HCl, Al2O3, and NH4Cl; NaCl, AgCl, BF3, and KCl; NaCl, HCl, Al2O3, and NH4Cl; NaCl, HCl, AgCl, BF3 KCl, NaBr, and NH3; was also chosen by a people. They dominant uncertainty chose NaCl, HCl, and AgCl as their answer about 15.8%. This data captured the conception happen in the subject was based on metal and non-metallic element only.
Previous research captured that these conceptions caused by: (i) Subject only looking at compounds that bind to ions formed from metal and non-metal elements to the compound. They will answer ionic bond is formed by metal and non-metal elements that spontaneously when they find a compound concerning the determination of the type of bonding between metallic and non-metallic elements without thinking about the truth and electronegativity differences value. (ii) They view about of the positive ions and negative ions form ionic bonds in compounds. They only looked that the bonds between the elements that form the anion and cation will have an ionic bond. This is different with scientist concept that there are several compounds that are formed by ions can form covalent bonds [64] (iii) Compounds are formed from metal and non-metal elements which have a large electronegativity difference. Subject's explanations that assume that every element of metal and nonmetallic elements to form ionic bonds because it has a large electronegativity difference regardless of data values electronegative constituent elements of a compound.
Subject conceptions' regarding the determination of sample molecules that bind to covalent bonding in a molecule consist of 62 subjects chosen a single answer for the question and 13 subjects chosen more than one answer. In this question, the subject asked to specify examples of compounds that bind covalent bonding. The subject was allowed to choose one or more answer in this question. The conception of scientists on this matter binary compounds that have an electronegativity difference of less than 1.7 will form covalent bonds with polar compounds [64]. Both compounds have an electronegativity difference of less than 1.7, ie NaH 1.2 and AgCl of 1.07 so that couples covalently bonded compounds are NaH and AgCl. [64].
This question has several conceptions captured. 6.5% of the subject was certainly given sodium hydride and silver (I) chloride for their answer as an example of covalent bonding. This is mean only small of the subject can understand and determine a pair of a compound bind by covalent bonding. There was 11.3% of subject uncertainly chosen this option as their answer which means they got a lucky guess with their answer.
In the other side, "D" option is more chosen by subject. 37.1% subject certain and 19.4% uncertain chosen NH3 and AlF3 bind by covalent bonding. It indicated that result in this research same with previous author research. Their reason this option at least caused by: (1) Subject are only looking at the compound ammonia covalent bonds due to the sharing of a pair of electrons without specifying the type of bond on aluminium fluoride. However, they associate that aluminium fluoride compounds have the same kind of bond with the compound ammonia is a covalent bond.
(2) Both of ammonia and AlF3 are derived from nonmetallic elements. Subject associate Al including metallic elements will form covalent bonds with the elements. This is contrary to scientist conception that aluminium fluoride is ionic bonding. The differences electronegativity between Al and F about 2.37 so that make aluminium fluoride has ionic bonding. The "B", and "E" option chosen by a fewer subject while the "C" option was chosen by nobody. The "B" option, HBr and KCl as an example of covalent bonding, was chosen by 6.5% of the subject. This mean they do not understand the potassium chloride bind by covalent bonding they did not consider the electronegativity difference for this problem. Only a person chose the option "E". Like previous option, they have a similar problem occurred.
There were 13 people chosen more than one option as their answer count separately. Three people answer chosen NH3, AlF3, BH3 and NaBr as another person chose HBr, KCl, NaCl and H2O as their answer. It also consists of uncertainty answer: NaCl, H2O, NH3 and AlF3; HBr, KCl, BH3 and NaBr; NaCl, H2O, NH3 and AlF3; NaH, AgCl, HBr, KCl, NaCl, H2O, NH3, AlF3, BH3 and NaBr; NaH, AgCl, NaCl and H2O; was also chosen by a people (7.7%). They dominant uncertainty chose NaCl, H2O, NH3 and AlF3 was chosen by two people and NH3, AlF3, BH3 and NaBr was chosen by three people. This data captured the conception happen in the subject was based on metal and non-metallic element only.
The conclusion of this research was found many types of misconception happen in the subject about determination the type of bonding using two-tier diagnostic test. The subjects understand the proper concepts that written in chemistry textbook only. They did not use the electronegativity value to determine the bonding type. Thus, metallic characteristic was a popular concept used by subjects when considering the type of bonding in a molecule.
Below is shows the Table 2, the summary of conception found.


Educative Video Game Based Android System for Learning Early Reading for Children with Hearing Impairment

This aim of this research is to describe how to use video game as an educative media based on android system that used to increase early reading ability for children with hearing impairment in Special Kindergarten. The backgrounds of this research are from the language ability of children with hearing impairment as we know because of they can not hear anything, their language is limited . Children with hearing impairment use the visual stimulus more than audio stimulus for reading, early reading exactly. Early reading for children with hearing impairment started with identifying word by picture and after that, we start to read the sentences. This research use research and development (R&D) method, and use ADDIE models to make an educative video game. The steps are analyse, development, design, implementation, and evaluation. Based on the other research before, we know that children with hearing impairment have to reading, writing, and speaking with integration learning and do it in early children. Therefore, it is necessary to developed video games education for media to help children with hearing impairment to learn the early reading that can be used anywhere and anytime in a smartphone. By using this media, children with hearing impairment is easier to learn early reading that can increase the process of language acquisition. Media uses it should be under contiguous by parents or adults.

Introduction
Reading is complicated activities involving a lot of activity limbs, as visual, auditory, motoric, and cognitive. Because of that, reading is difficult to do. Reading has important function in our life, like to obtain information, participate in social life, and culture. Accordingly, reading is basic competence that everyone must be owned to learn and also hold our life.
Reading has steps to reach whole reading competence. One of step is early reading. Early reading is the first step that people must have in order that they can read. But early reading is not easy to have. People must have phoneme awareness and know the mean of the word.
Children, include children with hearing impairment must have early reading skill. This skill linked to a whole reading skill. But, children with hearing impairment have trouble in early reading because they are not hear.
Trouble in their hearing skill makes children with hearing impairment difficult to master early reading skill. To master early reading skill, children with hearing impairment have to memorize the word and its concrete sample. For example is word "book", children with hearing impairment have to memorize the word, the letter, and look the book.
Because of children with hearing impairment have the language destitution, they have trouble to understand the meaning of the word, and know letter by letter of the word. Learning media roles is so needed. Visual learning media easier to use for children with hearing impairment.
The fact is until now learning media like educative video game to help children with hearing impairment to learning their early reading is not available. So that, they can not optimal to learn.
From the above description, learning media like educative video game is needed and urged to develop to improve the early reading skill of children with hearing impairment. It is hoped the educative video game could be increased the result study of children with hearing impairment. According to background has been told,so the formulation of this research is: 1) How early reading skill of children with hearing impairment in SLB-B in DKI Jakarta ? 2) How learning process early reading skill children with hearing impairment in SLB-B in DKI Jakarta? 3) What learning media used to learning early reading for children with hearing impairment in SLB-B in DKI Jakarta. 4) How to develop and use educative video game as learning media that can increase early reading skill children with hearing impairment in SLB-B in DKI Jakarta.

Definition of Hearing Impairment
Allen stated that hearing impairment divided into two namely, hearing loss and deaf. Deaf is hearing loss heavy that someone can not process verbal language even they use hearing aids. While hearing loss is lower than deaf, but it still have an influence on social, cognitive, and individual development. In her statement, Aleen said that no matter how obstacles that occurs in hearing, fixed it constrained the development of someone with hearing impairment. [1] Similar statement also expressed by Moores, hearing impairment divided two specifications, they are less hearing and deaf. Less hearing is someone who has problems in hearing but their communication development still increased by hearing aids. They can understand the conversation and their communication and language development are ballance. In less hearing , these individuals can still use their remnants hearing. but they still need practice to use it. The other specification is deaf. Deaf is someone who have heavy problems in hearing and cannot understand speech oral.

Clasification of Hearing Impairment Prelingual Deafness
Prelingual deafness is obstacles hearing that happens before language and speech developing. So that, language and oral skill someone has not been established but input function of language reduced. Prelingual deafness children's vocabulary is too few. They usually learn vocabulary by the real picture.

Post Lingual Deafness
Post lingual deafness is hearing obtacles that had occured a few years after speech and language skill develop. So that these individuals have known language and have listened language. So they have a language although a little and they keep have to practice to addition their vocabulary.

Characteristic of Hearing Impairment
Children with hearing impairment having characteristics that often random speaking or unmatch word. For example like "rumahsakit" they said "sakit rumah". Because of their impairment in their ear, they difficult to learn intonation and verbal communication. When they communicate with common people, they usually use their visual power to see their partner lip motion. Children with hearing impairment usually have problem in their vocabulary, beside vocabulary, they have problem in syntax and morphology.
In cognitive skill, children with hearing impairment usually under than common children because their hearing impairment. Most children with hearing impairment have problem in any subject in academic skill, reading and math especially (ASHA). Problem in academic skill is not caused low in intelligence,but it caused their hearing impairment.
Children with hearing impairment sometimes feel isolated, they have no friends, not happy in their school and feel lonely. That is all because they can not hear anything. The other effect of their disability is they have high impulsive and egocentric in their surroundings.

Definition of Media
Media is from Latin "Medium" means mediator and refers to communication tools. Smaldino said that media refers to everything who bring about the information from source into receiver. So media is between the source and receiver. [2] Similar definition revealed by Association for Educational Communication and Technology reveal that media is everything that used to distribute the information. This statement told that every tools that facilitate to distribute information from source to receiver is media. [3] Media not only needed in communication, but also in learning, learning media used to student make easier knowing the subject.
Audio visual media or video has important role in learning process. Video can motivate the students to learn and make easier to remembering the subject. Audio visual media has picture and sound as output, so we can look and listen like film, and television. Video is media that display the movement, including DVD, video record, computer animation, and so on. Video game that which sounds and images produces are good media for student with hearing impairment. This media used to learn speaking and reading lip movement process for student with hearing impairment. Beside that, this media can increase student's vocabularry deposite, specially verb. The benefits of video as a media is: 1) Movement Movement picture (animation) has clearly than not movement picture. To explain the concept, animation is very important in learning. Picture that used in video game is animation picture that make student interested to play.
2) Process Movement consecutive served in video games it is movement in pronuncing verb. So, student with hearing impairment can see how pronuncing the word.
3) Skill Learning To be expert on physical skill, requires exercise over and over. Through a video, we can see feedback and improvement. Physical skill refers to how student with hearing impairment try and try pronuncing the word.

4) Afective Learning
Video has big effect to influence emotionsl of student. Video has beneficial in form student attitude and social.

5) Cognitive Learning
Video must based on empiric and factual knowledge.

Definition of Educative Games
Games educative an outgrowth from video game. Video games develops rapidly that made him as an interactive media and developed by many companies game design. Many educators think to teach based game. So the game that made for learning called educative game or education game. Educative game according to Hurd and Jenuings is game designed to teach the user about knowledge, developing the concept, understanding, guide them to train their competence, and motivate them to play. [4] Educative game has to designed by interest design in order to give motivate for student to play. In addition to give the motivation, educative game made to stimulate children were and concentration, so they encourage to win the game. Word video game that made to increase the early reading skill for student with hearing impairment made with rules. The rules for making educative games is (a) right on the target, (b) multifunction, (c) according to the purpose, (d) train basic concept, (e) creativity stimulus.

Definition of Android
Android is software in mobile phone that currently used by a lot of people in the world because it practic and modern. According to Gargenta android is a comprehensive open source platform that was designed for a mobile device. [5] Comprehensive platform is a complete software pile that used in mobile device. So, android is specially made for mobile phone.
According to Darcey and Conder, android isthe first complete mobile platform, open source, and graphics software developed by comprehensive and complete Software Development Kit (SDK) to develop the powerfull aplication. In his opinion, Conder and Darcey stated that android software is contained in most complete mobile phone until now. [6] Strength of android: 1) Multitasking. Android can working a lot of programs in the same time without you close the other programs. 2) Notification. Android always display the notification on their home screen like SMS, Email, or newest articles from RSS reader. 3) Accessable. From app store in android, the user can download everything they want, and free. 4) A lot of varian smartphone 5) Rom can modified 6) Widget to make easier and faster setting 7) Google app has integrated with email Weekness of android : 1) Internet connection always running 2) A lot of advertisement in aplication

Definition of Early Reading
Reading is the complex activity that involve visual activity, thinking, psikolinguistic, and metacognitive. As a visual process, reading is translate letters into verbal. Then, thinking include word identification, literal comprehension, interpretation, critical reading, and creativity comprehension. Based on it, reading is complex activity involve many activities that coordinated each other.
Reading is a vital activity to know about everything, especially for student with hearing impairment that have visual skill more than audio skill. According Learner that copied by Mulyono said that reading is basic to masterthe various field of study. If a child at the beginning of the school not immediately have reading skill, they will difficult to learn more. So reading is complex processing activity involve the physic and mental activity that very important to developing the academic skill of children.
Early reading skill is very important for academic progress. There are three reasons according to Choate in an effort to increase entanglement letters and early reading, there is (a) that literate received with the sound of the proper letters and knowledge about what the word, (b) early reading is basic skill to reading comprehension, (c) early reading skill very needed in academic learning in the school. [7] According to Stahl that quoted by Santrock, early reading helps students to identifying the words automatically, text comprehension, and motivated to read and reading operations. [8] Early reading skill is the first step to reach whole reading competence. Early reading skill is the first competence in school age that children must have, because if student can not read, they have problem to master the advance knowledge. Early reading skill means identifying letter, word, and meaning of the word. There were 6 steps in early reading. According Chard and Osborn, the steps is (1) letter concept awareness, (2) sounds language, (3) phoneme awareness, (4) phoneme, (5) vocabulary, and (6) read and the comprehension. [9]

Methods
This research use R&D (Research and Development) method. Borg and Gall stated to preliminary study as the needs analysis use descriptive method, and to development video game use ADDIE (analysis, development, design, implementation, and evaluation) method. This research done in SLB (Sekolah Luar Biasa) Pangudi Luhur for student with hearing impairment, in West Jakarta. Object of this research is student with hearing impairment in Kindergarten.
Data analysis result of this research use qualitaive approach and use data triangulation technique based on the result of observation, interview, and analysis data files. Media development carried out with this steps : (1) an analysis of the needs of early reading skill of children with hearing impairment in special kindergarten, (2) Media development were carried out based on the result of the analysis of needed, need special media that is designed to improve the early reading skill of children with hearing impairment in special kindergarten, (3) Make design learning media video game that appropriate with the characteristic of children with hearing impairment in special kindergarten, (4) the next step is validation. Validation carried out by 3 experts, they were from media expert, hearing impairment expert, and the expert of technology. After validation, we testing to student with hearingimpairment in special kindergarten with the limited sample, and then repaired media in line with the testing until created the final product to suit the needs of in the field, (5) Evaluation was the last step before products disseminated, assessment the result of the implementation of product that has tested. Is it an accordance with children with hearing impairment needs, and is it effective to use, or need some repairs.

Results
The result of this research to analysis what student needed in early reading learning and the result of this research is: 1) Early reading skill of children with hearing impairment in special kindergarten carried out by conversation and use Maternal Reflective Method 2) Early reading skill children with hearing impairment started from identifying the word to syllable. For example, for the word /" meja"/ you read "meja" and yo divided to /"me"/ and /" ja"/. 3) Media that used in early reading learning is word card that filled the topic picture and under the picture, ther is a name of picture written as cursive. 4) Teacher of special kindergarten not use information technology when they taught, so learning situation is so monotone. 5) Learning media development to increase early reading skill is needed to teach children with hearing impairment in special kindergarten more variative, happier and get optimal scores. Based on result of the research, analysis necessary in the field is learning media development is needed, early reading media exactly. Then researcher bargain early reading media learning, that is video game educative based android system use ADDIE models, and the steps is : 1) Need analysis to early reading skill for children with hearing impairment, 2) Media learning development designed by the analysis of need to increase early reading skill children with hearing impairment in special kindergarten, 3) Design of educative video game is according to characteristic children with hearing impairment in special kindergarten, 4) Implementation. Next step is validation. Validation carried out by 3 experts, they were from media expert, hearing impairment expert, and the expert of technology. After validation, we testing to student with hearingimpairment in special kindergarten with the limited sample, and then repaired media in line with the testing until created the final product to suit the needs of in the field, 5) Evaluation was the last step before products disseminated, assessment the result of the implementation of product that has tested known that educative video game will be effective work if there were teacher, parents, or the adult on children side.

Discussion
To overcome children with hearing impairment needs in learning early reading skill the researcher gives descriptions about early reading skill ability for children with hearing impairment in special kindergarten. Based on the result of this research need to develop learning media in learning early reading, this research set out to answer four questions 1. How early reading skill of children with hearing impairment in SLB-B DKI Jakarta? 2. How learning early reading skill of children with hearing impairment process in SLB-B DKI Jakarta? 3. What media use for the learning early reading skill of children with hearing impairment in SLB-B DKI Jakarta? 4. How to developt learning media video games educative based on android to increase children with hearing impairment needs early reading skill in SLB-B DKI Jakarta?

Children with Hearing Impairment Early
Reading Skill.
The result of this research found that early reading skill in children with hearing impairment still on indentification vocabulary and pictures. Early reading skill ability is a first step that the children had to comprehend within to reading learning, including the children with hearing impairment. This identification is a first step in the process of early reading skill.
Vocabulary identification process is doing by matching the letters with the pictures, after that the children should be say that letters so when the letters appear in their daily life children can read and know the meaning of the letters. In this identification process, commonly when the children can identifying vocabulary or picture so the children can say that.
Based on the result of this research found that process of identification vocabulary is doing by memories a type of word. Teachers should be true wrote a vocabulary because when the shape of the word is wrong, students with hearing impairment can not understand the meaning of the word.
Early reading children of hearing impairment in SLB B Pangudi Luhur Jakarta teach since Early Intervention. In this research showed the process and ability owned by children with hear impairment level Early Intervention in SLB B DKI Jakarta. First day in class Early Intervention commonly the children with hear impairment have not competention to reading and identifying vocabulary. Early reading learning start with conversation in school.
Conversation started when students say something spontaneously, then it will be topic for the conversation. And then teacher give directions the conversation in order to be a specific theme. So what be used as a conversation is what the student spontaneously said and other students can interested with the topic. Commonly the topic in Early Intervation is about something around the students.
Topic in these conversation afterwards can be used by the teacher to develop conversation. Preparation conducted by dramaticalisation a vocabulary of, say a new vocabulary, and read together. Dramaticalisation a conversation by practicaly new vocabulary ( verb or event) and touch concrete things. After that, children were asked to say and teachers wrote on the board and ask children with hear impairment to read again or practices the new vocabulary. As a result of this as long as children can understand how to read words in a card, so that words belonging to them.

Learning Process Early Reading in Children with Hear Impairment
Based on the result of the research uses Maternal Reflektive Method children in kindergarten started learning to read by says something spontaneously and than teacher figure it out. Learning process to read in children with hear impairment according to Maternal Reflektive Method is; conversation in school, preparation conversation, read speech, and reflective learning. Conversation activity in school started by stimulation from teacher in order to make children one by one to say a new vocabulary, after that teacher write down the new vocabulary with pictures. All of the student with hear impairment have to participate in every conversation process. It is meant that students had a experiences.
The next level in early reading learning is word processing. Word processing could do with reading guidance and dramatize conversation substance. Word processing started with reading guidance by showing and read sentences which is found in literature after than asked childrens to read. After this step teacher do processing by asked back what is the main ideas in the conversation by showed up sentences to children with hear impairment with combination questions (what or how many). In addition students was also have to speech the new vocabulary that showed on a board in which student with hear impairment can compare what the teacher speech with the existing sentences.
The next word processing is dramatize conversation content/new vocabulary, do with practicing that vocabulary (if vocabulary have the form of activity or incident) and contact with the object (if vocabulary have to form of object). Students are required to understand the meaning of the vocabulary. This situation caused by children with hear impairment have a poor vocabulary so in the word processing students are required to understand the meaning of the new vocabulary even meaning of a conversation.
In early reading activity, after processing the word the next step is speech read speech. Read speech conducted by teacher teach student how to read word a in certain code/accustom students to read the motion of the lips toward a certain code. When student with hear impairment had a lot of experience in reading word speech, than they can understand how to read syllable with the codes that had teach before.
Reflective practice is the next early reading activity process. Reflective practice that can excercise the early reading students is pictures matching, picture identification, write vocabulary, read speech, write expresive, copying text, and answer a question. However, in the level of early intervention felection practice only until read speech and uses a few of vocabulary so children with hear imparment can easy to understand that vocabulary. There is some activity used in reflective practice; matching a picture with a word, identifying a picture, write a vocabulary of the picture, copying vocabulary/write down a new vocabulary, and read speech. Reflective exercise having a major role in early reading, because reflective exercise can measure ability of early reading in children with hear impairment and to know how many vocabulary that they have really nailed. In every learning process always had a reflective practice.
Learning process early reading in children with hear impairment is very necessary to paid attention because every children with hear impairment have a different ability in early reading learning so the way of treating for every children is different to. Very necessary to develop a learning media that can be used by children to learn everywhere with anybody.

Video Game Educative Uses For Early Reading Learning Process
Media is the important thing in learning process, according to Kemp and Dayton learning process requires an connections between a stimulus and the response. Stimulus is the message that contained early reading learning process material who will be transfer to children. To make it easy for delivering early reading learning process material we need a media.
Children with hear impairment uses identification card to lear early reading skill. Identification card obtained from newest vocabulary in everyday conversation. There is a picture and a word in identification card. Pictures is the most important thing that children with hear impairment used to learning early reading because they relying on the sense of visual third than the others sense that still function properly. Therefor, when learning early reading children with hear impairment always showed many different pictures in every vocabulary, for example: bag, there are many kind pictures of bag. The aim of this measure is children can get a lot of vocabulary that can belong to them. This could make more easier to learing early reading skill.

Product Development (Product Specification)
This product named Game Educative For Early Reading Learner. This games measuring about 43 Mb and designed in the android studio, photoshop software for the graphic and only can used in android operating system. This games designed for early reading learner specially for children with hear impairment. Content in this games is a words, pictures, sentences, and also compose a sentence. This games also contained sentences with hyphen that are characterize of children with hear impairment. A picture on this game they were followed by a syllable , so easy to understand. And in every word were followed by a sound for example in word car so they are voices car appears to.
On a menu composing sentence there is a pictures that can guide children to composing sentences properly. This is games there is more over 120 words from various category and 42 sentences practice which is devide into 7 categories. A category in sentence options is " my school, my environment, my self, colours, activity, fruits, and animals. This game is very simple to play, parent need to accompany so that early reading learning can do well. The following is step to play: 1) Download and install from Playstore.
2) Open games application. 3) Choose "Word" menu for starts learning reading starting from words and syllable.

4)
Choose button to continue, use button to repeat voice in every word, and button to go back to display previously. 5) Be sure to read all a word that is available until can be understood by the children. 6) If the word menu has understood, next choosing menu and then select centences menu then choose category desired. 7) Arrage sentence in a order of the picture on the coloums and than choose word that avalaible. If the arranged correct they can continues and if it is wrong they can repeating again. Guide book is avalaible to make easier for user.

Conclude
Conclusion of this research is: 1) Early reading children with hearing impairment in special kindergarten through the conversation with maternal reflective method. 2) Early reading skill children with hearing impairment started from identifying word to syllable. For the example we divided /meja/ to /me/ + /ja/. 3) Media that used in early reading learning is flash card that there were a picture and under the picture there is a letter of that picture. The letter use cursive. 4) Early reading learning in special kindergarten have not use information technology media learning, so the learning activity might be monotone and not enough variation. 5) Media learning development for children with hearing impairment use ADDIE model with the step: 1) Need analysis to early reading skill for children with hearing impairment, 2) Media learning development designed by the analysis of need to increase early reading skill children with hearing impairment in special kindergarten, 3) Design of educative video game is according to characteristic children with hearing impairment in special kindergarten, 4) Implementation. Next step is validation. Validation carried out by 3 experts, they were from media expert, hearing impairment expert, and the expert of technology. After validation, we testing to student with hearingimpairment in special kindergarten with the limited sample, and then repaired media in line with the testing until created the final product to suit the needs of in the field, 5) Evaluation was the last step before products disseminated, assessment the result of the implementation of product that has tested known that educative video game will be effective work if there were teacher, parents, or the adult on children side. Based the conclusion that have explained, advices from the researcher for teacher in special kindergarten is use educative video game to support learning process early reading children with hearing impairment, make a whole reading easier for children with hearing impairment. Beside that, teacher hoped be more creative to use learning media, so that students more enthusiast to learn early reading.


The Relationship Between Ostracism and Turnover Intention: Role of Commitment as a Mediator

The basic objective of this study is to examine the mediating role of OC between WO and TI among the teaching faculty of universities of KP, Pakistan. Data were collected via questionnaires from 207 teachers. SPSS and Amos were used to analyze the data. The results revealed a significant positive relationship between WO and turnover intention, while a significant negative relationship between WO and OC and between OC and TI was confirmed. The results also revealed a significant partial mediation of OC between WO and turnover intention.

Introduction
Employees' turnover problems are faced by almost all organizations of the world irrespective of their location and business type (Long, Thean, et al. 2012). Contemporary organizations make strong efforts for searching qualified employees and striving for retention of the available staff (García-Chas, Neira-Fontela, et al. 2014). They are giving more attention to effective human resources because it is an essential component among organizational components for its smooth running.
Employees` turnover has long term negative effects such as decreased efficiency and an increase in unnecessary costs (Allen & Griffeth 2001). It also disturbs operational stability and endangers organizational goals` attainment (Hom & Kinicki 2001). Hollman, Abbasi, et al. (2008) suggest that organizations are cost by turnover in terms of employee quit, searching for new employees, and expenses incur on new employee(s) selection process. Additionally, it deteriorates Global Social Sciences Review (GSSR) the organization`s reputation, decreases customers' loyalty towards the organization, and increases the workload on the employees.
Employees` turnover affects the organization through direct as well as indirect costs. Direct costs refer to the expenses made on advertisement, recruitment, selection, training, etc. of new employees. Indirect costs refer to workload, low productivity, overtime expenses, and spoiled morale of the workers (Martin, 2011). Additionally, non-monetary costs such as an organization`s tarnished image, customers` decreased loyalty, and these would be connected with a lasting negative impact on the organization (Long, Thean, et al. 2012). Therefore, it is indispensable for the organizations to manage employees` TI effectively, to cope with the problems associated with employees` turnover.
WO is shunning as a kind of relational abuse investigated to welcome adverse consequences on workforce' perspectives toward work, for example, increased TI, decreased individual prosperity, such as psychological distress and emotional exhaustion (Ferris, Brown, et al. 2008, Wu, Yim et al. 2012. Given the negative attitudinal effect, working ostracism exclusion can be adverse to organizational effectiveness, as ostracized employees may lessen their commitment to citizenship behavior that can individually and collectively benefit the organization (Ferris, Lian, et al. 2015). Variables in the studies have a relationship between WO and TI with a mediating role of OC.
A study examined workforce exclusion. The results indicated that in the last 6 months, 13% of the workers eliminated (Hitlan, Kelly, et al. 2006). Similarly, another study in the United States endured to find out the association between racism and workplace bullying. It was found that over five years' period, 66% of the workforce complained about poor treatment. Out of that 29 % communicated that others left the room upon their entry and 18% were moved to isolation at their workplace (Fox and Stallworth 2005). Attention and recognition are sought by humans since inception. However, being ignored and isolated is experienced by many in society and the workplace. Ostracism reported being an important facet of human life in the ancient recorded history. For example, Greek would vote to isolate individuals from their community as punishment. Even if the degree of ostracism is nominal still it would have a significant association with a sense of belongingness. Ostracism resembles social death (Sommer, Williams, et al. 2001). It portrays the scenario of the world after one's death, thus, adversely affecting human's sense of meaningful existence (Pyszczynski, Greenberg, et al. 2004). Similarly, a study based on the data collected from 304 supervisors and subordinated of different hotels operating in china; aimed to investigate the impact of ostracism on employees' performance and workplace engagement. The model of the study was based on the Conservation of Resources Theory with the longitudinal model. It was found that WO had a negative relationship with work engagement and service quality of the workers (Leung, Wu et al. 2011). Conservation of resources theory suggests that people endeavor for protection and preservation of the valuable things, termed as resources. The research revealed an optimal combination of personal and job resources improved employees' effectiveness (Wright and Hobfoll 2004).
Organizational commitment is the harmony between an employee and organizational goals where the employee realizes organizational goals as personal and exerts efforts in achieving them (Alimohammadi & Neyshabor, 2013). It refers to an employee's willingness and desire to contribute to an organization`s success (Supriyanto, 2013). The reasons behind this commitment could be emotional attachment, moral attachment, and willingness to keep employment in the organization (Balassiano & Salles, 2012;Dey, 2012;Ellenbecker & Cushman, 2012). Organizational commitment has three types which are normative, affective, and continuance commitment (Mouhamadou, 2015).In normative commitment, employee realizes to stay with the organization as a moral obligation (Balassiano & Salles, 2012).
Replete literature identified organizational commitment role in retaining employees. High committed employees are more likely to stay with the working organization (Larkin, 2015). In words of (Aamodt, 2007), employees who have more commitment towards the firm like to stay in the firm, like work attainment, perform well, and show positive behaviors. Employees having a high degree of organizational commitment demonstrate satisfaction with the organization(Azeem & Akhtar, 2014) and satisfaction with the organization decreases the intention to live the organization. Organizational commitment works like handcuffs in resisting employee`s departure from the corporation (Siders, George, & Dharwadkar, 2001). Wan (2012) suggests that an employee with a high degree of organizational commitment not only tries to be connected for a long time with the organization but also proves as an asset for the organization with enhanced efficiency and vigor. In light of the above proof, organizational commitment plays a vital role in reducing employee intention to quit.
workplace ostracism is defined as the inner perceptions of the employees that he or she is being ignored by coworkers or superiors in the organization (Ferris, Brown, et al. 2008). Impact of workplace ostracism call for the detailed investigation to be determined, either ostracism is deliberately or unintentionally (Sommer, Williams, et al. 2001). Being social in nature, group acceptance is the fundamental needs of humans. In the modern era of teamwork and increased performance, mutual communication in the workplace got more importance. Workplace ostracism might cause more pain and harmful and result in the unpleasant situation in the workforce (Sundstrom, McIntyre, et al. 2000). The perceptions of ignorance reduced the social interactions and mutual communications among the workforce in the organization leads to deviating the employees to get their psychological needs at the workplace .
Research shows that workplace ostracism has a negative relationship with job satisfaction, organizational commitment, and turnover intentions, anxiety, and depression have a positive relationship (Ferris, Berry, et al. 2008).
Similarly, another study attempted to examine the phenomenon of ostracism in China. The study was based on self-esteem and participation theories. Employees of the two firms dealing with petroleum and gas were the target population. To remove data bias, three waves were with a gap of four months, used to collect the data form respondents. 443 subordinates working under 120 supervisors were selected as a sample through a random sampling technique. at the final wave, final responses were received from 208 respondents under 96 supervisors utilized from the final analysis. It was found that agreeableness and extraversion were significantly positively related. However, a negative relationship was seen with job performance and self-esteem within the organization (Wu, Wei et al. 2011).
Another study examined workplace ostracism and solicitous behavior in Singapore. The focus of the study was to determine the reaction of the participants who have got ostracized. Data were collected in three steps i.e. scenario, experimental, and field study. The participants of the scenario study were 184 students studying in the universities of Singapore. 140 students were examined in the experimental study segment while in the last segment of the study pairs of the focal participants were contacted with reference to university students of universities in Singapore. It was reported that people with less future orientations have less prosocial behavior with more future orientations with higher prosocial behavior. (Balliet, & Ferris, 2013) Ostracism is considered to be the most powerful indicator culminating in TI, OC, and job stress. A recent review on ostracism and incivility urge analysts to take a more extensive perspective on abuse develops and to research segregation inside the hypothetical systems of incivility (Ferris, Brown, et al. 2008;Hideg & Ferris, 2017).
Employees commonly experience being ignored in the workplace. Ostracism is considered less harmful than it is in reality; as it affects the well-being, attitude among the workforce and caused turnover . It could be concluded from the above literature that WO leads to turnover intentions and finally, the employees leave the job which is very costly for the organization. Assessing the correlation between WO and TI with the mediating process and role of OC would add to fill the gap in the existing literature. The study contains three variables i.e. WO, TI, and OC.

Data Collection Procedure
Data was collected through a self-administered, time tested and validated questionnaire adapted from previous studies. Sample of the study consist of the faculty members of public sector universities in KP. A total of 320 questionnaires were distributed. Responses were received from 224 faculty members, out of which 17 were incomplete and disposed-off.

Organizational Commitment
To assess organization commitment data was collected through a questionnaire consists of 18 questions adopted from the study of Meyer, Allen et al. (1993). Organizational commitment has three dimensions; each dimension was measured through six questions.

WO
WO scale was used to measure WO. It consists of 10 questions adopted from Ferris, Berry, et al. (2008). For this study, the same scale was adopted to collect the data regarding ostracism in the university teachers of KP.

Turnover Intention
TI among the faculty member of the universities in KP was measured through a 3 point questionnaire adopted from the study of (Camman, Fichman, et al. 1979). The results show that WO has a significant positive relationship with employees' turnover intention. Furthermore, it is also confirmed that all dimensions of OC have a significant negative correlation with WO.

Results
Global Social Sciences Review (GSSR)  The results show that WO has a significant positive correlation with employees' TI. Furthermore, it is also confirmed that all dimensions of OC have a significant negative correlation with TI.

Conclusion and Recommendations
The study aimed to examine the relationship between WO and turnover intentions. Furthermore, the mediating role of the OC was investigated in the relationship. The sample was selected from the faculty members of the public senator universities of KP. Data was collected through a questionnaire adopted from the previous studies. A significant positive association exists between WO and TI while a negative correlation was found between OC and TI. Furthermore, a significant partial mediation of OC between WO and TI was seen.

Global Social Sciences Review (GSSR)
Based on the results of the study a significant positive relationship was seen between ostracism and turnover intention, it is recommended for the policymakers to focus on ostracism to overcome the problem of turnover. Moreover, the partial mediation of OC reveals that by focusing on it the turnover problems would be minimized.