bluuebunny/crossref_metadata_2025 huggingface dataset:
Preventing childhood accidents: an intervention exercise in Clwyd
Authors: Cody Ann , Wainc Norma
Published: November 2016

Childhood accidents cause much suffering in terms of morbidity and death. There are also enormous financial implications. This article describes a training programme in preventive care that formed the basis for a workshop to increase health care workers' awareness of the problem areas.
Health care delivery for people with HIV infection and AIDS
Authors: Arkell Sharon
Published: November 2016

Health care delivery for people with HIV infection and AIDS will need to change in the future to accommodate the expected increasing numbers of people affected. Nurses have an important role in preventing the spread of HIV infection and in caring for this group of people.
Can performance-related pay be adapted for nursing?
Authors: Castledine George
Published: November 2016

Relating pay to performance is a way of rewarding someone for doing good work. The British police force has recently been upset over the possible introduction of performance-related pay. Could the same thing happen in nursing?
Standards of continence care are poor in most hospitals
Authors: Denning Jan
Published: November 2016

I was recently asked to visit an elderly male resident in a long-stay mental health unit. This man had an atonic bladder which required emptying and had been urethrally catheterized. In addition, he was a schizophrenic suffering from dementia and therefore did not understand why this plumbing attachment followed him around.
Nurse-aid management of psychological emergencies: 3
Authors: O'Rourke Mary
Published: November 2016

Anxiety can endanger life and hinder recovery. Early intervention reduces anxiety and therefore limits the risks. This article describes the recognition of anxiety and outlines some nursing interventions. Although it concentrates on the hospitalized patient the methods can be used in a variety of situations, particularly first-aid situations where anxiety can add to the severity of the situation.
Accountancy made simple
Authors: Ramsden Philip
Published: November 2016

A well-run accounts department is a boon to any organization. What are its functions within the NHS and how does it affect the daily lives of NHS professionals?
Service users' views of psychiatric nurses
Authors: Rogers Anne , Pilgrim David
Published: November 2016

With the shifting emphasis in the NHS towards quality assurance and consumerism, user satisfaction has become an important issue for mental health nurses to consider. This article provides some data from a survey of 516 psychiatric patients conducted by the authors on behalf of national MIND in 1990.
Development of a training programme for triage nursing
Authors: Hankey Linda
Published: November 2016

This article describes the preparation and development of a training programme to prepare staff for the implementation of triage nursing. It outlines the essential training needs for this complex role and the use of multidisciplinary group work and experiential learning to promote good communication and holistic individualized patient care.
Clinical supervision and primary nursing
Authors: Barton-Wright Philip
Published: November 2016

To enable primary nursing to function effectively there is a need for a process of clinical supervision. This article defines the concept of clinical supervision, describes how it can be implemented and discusses who will carry it out.
Stuck in a time warp: communication between hospitals and patients
Authors: MacAlister Lanette
Published: November 2016

The Audit Commission (1993) provides clear evidence that communication in the NHS is far from well. In order to study communication between acute general hospitals and patients the Audit Commission, taking the patient's point of view, focused on four major illnesses: breast cancer, benign prostatic hyperplasia, stroke, and rheumatoid arthritis.
A time to die: withdrawal of paediatric intensive care
Authors: Bracegirdle Karen E
Published: November 2016

In order to allow a critically ill child to die a dignified death, it may be appropriate to consider the withdrawal of aggressive treatment. This article discusses the importance of making such a decision, the decision-making process, the effects on the personnel involved, and the importance of individualised care.
Occupational stress in general nurses and midwives
Authors: Wheeler Herman , Riding Richard
Published: November 2016

The current level of stress among clinical nurses and midwives is a matter of interest. This paper examines the determinants of stress as well as the level of job satisfaction and career commitment of general nurses and midwives.
Nurse-aid management of children 1: accidents
Authors: Butler Kath
Published: November 2016

The three main ways in which the safety of children may be compromised are accidents, breathing difficulties and collapse. This article, the first in a two-part series, will describe the nurse-aid management of children following accidents.
The role of nurses in the 21st century
Authors: Castledine George
Published: November 2016

The report The Challenges of Nursing and Midwifery in the 21st Century (Department of Health (DoH), 1994), otherwise known as the Heathrow Debate, was the outcome of a meeting held in May 1993 and was organised by the four Government UK Chief Nursing Officers.
Empowerment through use of the Code of Professional Conduct
Authors: Pyne Reg
Published: November 2016

The UKCC's Code of Professional Conduct is a source of empowerment. It presents a statement of the values of the nursing profession which may be used to promote the interests of patients and clients.
Elder abuse by nurses is on the increase
Authors: Castlcdinc George
Published: November 2016

In response to Nolan's editorial (Vol 32(12): 595) on the implications of the UKCC's (1994) recent report on standards of care in nursing homes, I would like to suggest that the major challenge for nursing today is the nursing care of old people, whatever the setting.
The concept of respect in nursing
Authors: McGee Paula
Published: November 2016

Respect for patients' privacy, dignity and religious and cultural beliefs is demanded by The Patient's Charter. All levels of nursing are permeated by the concept of respect, and without respect patients are dehumanised and may be abused.
Hidden problems of stoma care
Authors: Black Patricia
Published: November 2016

This article discusses some areas of stoma care that often go unrecognised, namely sexual function and care of patients from ethnic minorities.
The scope of professional practice from a legal perspective
Authors: Lunn Joan
Published: November 2016

Individual nurses are professionally accountable for ensuring that no act or omission on their part is detrimental to patient safety and for recognising any limits in their individual skill and competence. Nurses need to consider these professional obligations in the context of what they can legally be required to do by their employers under their contracts of employment.
Development of the community nurse in learning disability: 1
Authors: Jukes Mark
Published: November 2016

Many accounts have described the role of the community nurse in learning disability and the nature and purpose of intervention in this situation. This article, the first in a two-part series, discusses the development of community nursing education and the need for more research.
Security and nurses' uniforms
Authors: Castlcdine George
Published: November 2016

It is a strange turnaround that uniforms, which were first introduced to protect from patient ills, may now need to be monitored to protect patients from unscrupulous bogus nurses. Following the recent baby abduction case in Nottingham where a child was handed over to a woman posing as a nurse, there have been renewed calls for nurses' uniforms to be less readily available. It is also suggested that it should be just as much an offence for a non-nurse to wear a nurse's uniform as it is for a civilian to pose in police or military attire.
Actisorb Plus
Authors: Williams Clare
Published: November 2016

Wound cleansing and the elimination of odour are two major problems in wound management. This article explains how Actisorb Plus helps to address both of these problems with the use of charcoal and silver.
Is respect for patient autonomy declining?
Authors: Castledine George
Published: November 2016

The news that a doctor is planning to use a computer to help him decide which of his patients should be allowed to die (Hawkcs and De Bruxelles, 1994) has focused attention on the question of patient autonomy.
Blood and urine tests for diagnosis and monitoring of diabetes
Authors: Higgins Christopher
Published: November 2016

The diagnosis of diabetes is made on the evidence of raised blood glucose levels. In diabetic patients, regular monitoring of blood and urine guides decisions about treatment and helps to minimise the risk of complications. This article describes various diagnostic tests that can be used both in the laboratory and outside.
Reducing the incidence of sharps injuries
Authors: Mercier Claire
Published: November 2016

Sharps injuries are the primary route through which health care workers acquire blood-borne diseases occupationally (Lynch et al, 1992). In order to reduce the incidence of such injuries effectively within a hospital, it is vital to first ascertain the frequency and types of injuries and then implement a risk-reduction programme based on the specific problems identified.
Containing incontinence in men: an extra dimension
Authors: Unsworth John , Rowell Rosie
Published: November 2016

The prevalence and nature of incontinence means that all nurses will see patients who suffer from this condition. Many professionals remain unaware of products that can assist in the management of such patients. This article descibes experience with some of the products available, highlighting their clinical usefulness and effectiveness.
Teaching research methods to nursing students
Authors: Adams Trevor
Published: November 2016

This article addresses the teaching of research methods to student nurses. An eclectic approach is advocated within which traditional, experiential and action-oriented methods are used. This approach is illustrated by means of an example in which it was used to help students understand the analysis of qualitative data. Suggestions regarding the integration of research within nursing courses are also given.
Academic credit and professional experience
Authors: Welsh Ian
Published: November 2016

Accreditation of experiential learning is being promoted as a legitimate cost-effective method of short-cutting professional degree courses for qualified practitioners. While there are benefits in giving academic recognition for learning gained from experience, there is a danger that the pressure of market forces may devalue the status of nursing degrees.
Mental illness: diagnosis or value judgment?
Authors: Anderson Bernard , Khoo Richard
Published: November 2016

This article is concerned with the definition of mental illness. Although it seems that it cannot be defined clearly in a legal or scientific way, this does not necessarily mean that health treatment is arbitrary and ill-founded.
Managing change to improve outpatient care
Authors: Harrow Tracey , Lempp Heidi , McDermott Sarah
Published: November 2016

By establishing a quality circle and involving clients it is possible to improve many aspects of outpatient care in the multidisciplinary clinic. This article describes the ramifications of change within the multidisciplinary team and offers some suggestions for setting up similar groups in the inpatient, outpatient or community setting.
Educating a young man to comply with his insulin treatment
Authors: Gallicnan Marilyn
Published: November 2016

Martin, who was approaching the end of his youth training scheme placement with a gardening contractor, had had insulin-dependent diabetes since the age of 11 years. Now aged 20, he had discontinued his insulin treatment and, after several months, had begun to feel permanently exhausted. He realised that he was unwell, but was still very resistant to recommencing his insulin injections. His GP had therefore agreed to allow him to try oral treatment for his diabetes, as he had not been ill enough to take any time off work.
Correspondence
Authors: Warner Lesley , North Christopher , Fairbairn Gavin , Davis Judi
Published: November 2016

Access to psychiatric services for homeless mentally ill people

Christopher North's reply

Ethical and legal issues in suicide

Judi Davis replies
Blood transfusion: risks and benefits
Authors: Higgins Christopher
Published: November 2016

This article describes the basic science involved in the provision of a blood transfusion service. Apart from the lifesaving properties of blood transfusion following acute blood loss, much modern surgery could not be contemplated without the availability of safe and compatible blood for transfusion. In addition there are many medical conditions whose therapy depends on blood products.
Initial nursing assessment and management of burn-injured children
Authors: Kelly Helen
Published: November 2016

Following a burn injury, children can deteriorate very quickly and prompt accurate assessment by the accident and emergency nurse is therefore essential. This article outlines the initial assessment and management of paediatric burns.
Problem solving using soft systems methodology
Authors: Land Lucy
Published: November 2016

This article outlines a method of problem solving which considers holistic solutions to complex problems. Soft systems methodology allows people involved in the problem situation to have control over the decision-making process.
Should we have an unrestricted right to reproduce?
Authors: Castledine George
Published: November 2016

Whatever George Orwell predicted for 1984, 1994 has begun with ethical questions about advances in reproduction and genetics. There are those who believe that all human beings should enjoy an unrestricted and fundamental right to reproductive and life-giving liberty. Support for their claims comes in such documents as the United Nations' Declaration of Human Rights which states that every person ‘of full age’ has the right ‘to marry and found a family’.
Community psychiatric nursing: promoting health in a community setting
Authors: Hostick Tony
Published: November 2016

With the development of care in the community, some mental health nurses have adopted approaches focused on health. This article explores one model of this approach which is aimed at secondary and tertiary health promotion in a community setting.
Alzheimer's disease 1: pathology, aetiology and treatment
Authors: Stewart Jeanette
Published: November 2016

Alzheimer's disease is a progressive disorder which accounts for a large proportion of people diagnosed with dementia. This article, the first in a two-part series, discusses the pathology, aetiology and possible treatment of the condition.
Examining the role of the practitioner-teacher in nursing
Authors: Mason Geraldine , Jinks Annette
Published: November 2016

This article examines the difficulties faced by specialist nurses when they attempt to combine practice and teaching roles. It gives a detailed analysis of the emergence of fulltime practitioner-teachers in nursing, including the role of joint appointees. It is recommended that the practitioner-teacher role should be promoted, and this will necessitate research into the feasibility of such roles.
25 years of primary nursing
Authors: Castledine George
Published: November 2016

It is 25 years since Marie Manthey established primary nursing at the University of Minnesota Hospital.
Educational issues in transcultural nursing
Authors: McGee Paula
Published: November 2016

Transcultural nursing education is an essential element of the nursing curriculum. There are a number of curriculum designs available but a combination of approaches seems to be the most desirable way forward.
What is clinical supervision?
Authors: Castledine George
Published: November 2016

The word ‘supervision’ means different things to different nurses. For example, to a nurse manager, it means the inspection and checking of a worker's performance by someone who is looking only for things that are being done wrong.
The role of the patient in standard setting and audit
Authors: Cooke Hannah
Published: November 2016

This article examines some of the problems and issues involved in quality assurance of nursing care and the measurement of patients' views of health care. It argues that these two endeavours can and indeed should be related.
A ‘cycle of care’: a model of community and hospital HIV/AIDS services
Authors: Lempp Heidi , deBoard Louise , Brown Joanna
Published: November 2016

Care study

Clare, a 25-year-old married woman, had come from Uganda with her husband in 1986. They were both political refugees. In 1987, while Clare was an inpatient and pregnant with her first child, she was tested (with informed consent and counselling) for HIV antibodies and was found to be positive. Her husband David was confirmed to be HIV antibody negative and so was their child, although this was not established conclusively until 18 months later. After discharge Clare was followed up in the HIV outpatient clinic of the Communicable Diseases Unit every 4 weeks, but was unable to attend regularly. She said she did not like attending the clinic because she was worried that other clients would learn about her diagnosis. For this reason she refused any community contact with the community liaison nurses of the HIV/AIDS team and also declined any support from the voluntary and statutory services.
Why does nursing theory fail in practice?
Authors: Scott Helen
Published: November 2016

It has been suggested that there is a large gap between what nurses know and what nurses do, which contributes to their diminished professional status.
Moral and ethical dilemmas in relation to research projects
Authors: Eddie Flora CT
Published: November 2016

Nurses involved in ward-based research projects may face many moral and ethical dilemmas. As the number of research studies increases, nurses must be aware of their responsibilities to the research team, their patients and their profession.
Implications of the Allitt inquiry
Authors: Limn Joan
Published: November 2016

The case of Beverly Allitt (Glasper and Whiting, 1993) highlights the issue of preemployment health screening and its relationship to psychiatric illness. The main purpose of pre-employment health screening is to assess a particular job applicant's health. Theoretically, such screening should identify psychiatric illness if there is a known history. However, if an illness has not been diagnosed, routine screening procedures may not be effective for ascertaining psychiatric disorders, such as Munchausen syndrome.
UKCC's standards for education and practice
Authors: Castledinc George
Published: November 2016

Wednesday 23 February 1994 was an historic day for nursing and midwifery in the UK. At long last the Council of the UKCC agreed on the final details for the standards for postregistration education, including the requirements for maintaining an effective registration. The project that was set up to do this work has become known to us all as PREPP — the Post-Registration Education and Practice Project.
Accountability and the mental health services
Authors: Darcy Patrick
Published: November 2016

The consultation paper Guidance on the Discharge of Mentally Disordered People and Their Continuing Care in the Community (Department of Health, 1994) is the cynical reaction to bad publicity on the care of the mentally ill in the community. It makes no attempt to address serious failings in the mental health service.
Preventing Staph, aureus infection on a surgical ward: the nurse's role
Authors: Davidson Alison
Published: November 2016

This article describes the distinguishing features of Staphylococcus aureus and shows how, in a surgical ward, antibiotics are used to treat or prevent the infections that it causes.
House of Lords' response to end-of-life issues
Authors: Castlcdine George
Published: November 2016

If you care about what will happen in the future to dying patients, read volume 1 of the report of the Select Committee on Medical Ethics (House of Lords, 1994). The Committee was set up to consider: ‘The ethical, legal and clinical implications of a person's right to withhold consent to lifeprolonging treatment and the position of the persons who are no longer able to give or withhold consent.’
Nurse teachers must improve their academic background and skills
Authors: Whyte Lawrence A
Published: November 2016

I read with interest the Castledine column ‘Future standards for teaching in nursing’ (Vol 3 (6): 297-8) which reflected the UKCC's current position on standards of teaching and proposed recommendations for its improvement (UKCC, 1994). It suggests that the Council is going to require nurse teachers to have relevant and up-to-date clinical experience to enable them to teach students of nursing. While such a requirement appears to be based on a great deal of commonsense, the conventional wisdom of this approach needs to be challenged because it may in fact be based on erroneous assumptions about the nature of nursing and nurse education.
Demographic details and family background of nursing recruits
Authors: Soothill Keith , Bradby Mary , Williams Catherine
Published: November 2016

This article provides current information on the demographic history and family background of those entering the conventional, degree and diploma (Project 2000) courses. This may have implications for the future recruitment of individuals into nursing.
Fertility and the menopause
Authors: Chalmers Charlotte
Published: November 2016

With the development of techniques to transplant ovarian follicles in mice, the reality of extending the reproductive life span of women beyond the menopause is a step closer. This article examines proposed treatments for the symptoms and causes of the menopause, and discusses the ethical questions that are raised.
Using the Myers Briggs Type Indicator — part of the solution
Authors: Allen Judy
Published: November 2016

The Myers Briggs Type Indicator, which is based on the work of Jung, is used in an infinite variety of settings to enhance learning, personal development and team building. This article describes its particular relevance to the nursing profession.

(N.B. Isabel Myers used the name Isabel Briggs Myers for publication purposes. The Indicator is termed Myers Briggs in order to indicate the involvement of her mother in its development.)
Using immunohistochemistry to help diagnose challenging tumours
Authors: Dobromylskyj Melanie
Published: November 2016

Immunohistochemistry (IHC) is a molecular technique that is widely available within veterinary diagnostic laboratories and can be used for diagnosis and/or prognostication. This article aims to give an overview of the technique and some of the potential uses of IHC within a diagnostic setting. Specifically, it discusses the use of IHC in the diagnosis of poorly differentiated tumours that may be difficult to accurately diagnose based on routine histopathology alone, as well as some of the potential issues with the technique.
The Jane Goodall Institute
Authors:   The Jane Goodall Institute
Published: November 2016

The Jane Goodall Institute combines scientific research with chimpanzees with management of sanctuaries and a range of conservation, environmental and educational programmes.
New forms of employment in a globalised world: three figures of knowledge workers
Authors: Marie-Christine Bureau  , Antonella Corsani
Published: November 2016

This article analyses three figures of knowledge workers – performing arts workers, salaried entrepreneurs and makers – examined through their institutional regulation and, mainly, their practices of appropriation of knowledge. All of these workers are positioned outside the regular rules of employment, but their activity is framed by different institutional architectures. Performing art workers are formally salaried but concretely they are almost independent, salaried entrepreneurs are quasi-entrepreneurs even when they are formally salaried, while makers produce autonomous spaces out of employment relationships. These figures are not analysed as professional groups, but through their practices of appropriation of knowledge. This analysis leads to the conclusion that, contrary to the neoliberal model of ‘self-entrepreneurship’, these experiences open up the possibility of producing a new form of autonomy gained by collective action, far from the idealised concept of individualistic autonomy.
Taking the public service remit forward across the digital boundary
Authors: Trappel Josef
Published: November 2016

The idea and concept of public service broadcasting was born in the first half of the twentieth century and has undergone fundamental changes ever since. Digitization challenges PSBs fundamentally and requires PSBs to transpose their practices into the circumstances of the twenty-first century. This article scrutinizes the development of key public service values on this journey by studying key public players from Europe and beyond. This research finds that key principles such as diversity, independence, universality and serving the public interest need re-establishment by active media and broadcast policy. The article recommends policy to allow PSBs to become public service media (PSMs), to allow for constant delivery of news in addition to pre-packaged formats, to enable PSMs to enter into dialogue and conversation with its audience, and to allow for sufficient entrepreneurial flexibility towards new business opportunities.
Public service media, civil society and transparency
Authors: Thomass Barbara
Published: November 2016

The contribution looks at a recent decision of the constitutional court in Germany according to which the number of politicians represented within the television council and administrative council of the ZDF (the second nationwide public service broadcaster [PSB] in Germany) should be limited to one third of the whole council with more representatives of civil society coming in, and the councils should act with more transparency. It is argued that the concepts of civil society and transparency are interrelated. It reviews the role of civil society in modern democracies and looks at how and with which benefit public service media (PSM) can relate to it. It is shown that two different interpretations of civil society – a moderate one and an emphatic one – are at the base of the German case regarding the reform of the broadcasting council. The emphatic one – and this is the normative argument – is the present need in order to bring public service broadcasting closer to the public sphere and sustain its existence. In a second step the contribution looks at the value of transparency as one important instrumental element of democratic governance and how this is implemented by different European PSBs. Thus, with the example of the German case, civil society and transparency are discussed in relation to normative orientations for PSM in Europe.
Clearing the skies: European spectrum policy and future challenges of DTT in Finland and Spain
Authors: Ala-Fossi Marko , Bonet Montse
Published: November 2016

Digital terrestrial television (DTT) in Europe is facing a serious challenge as it will lose about 30 per cent of its current spectrum resources for mobile services by 2020. European countries originally agreed to release only the 800 MHz band from TV to mobile as the digital dividend. However, over European opposition, the release of the 700 MHz band as the second digital dividend was accepted at the World Radiocommunication Conference (WRC) in 2012 and confirmed in 2015. This article analyses the development of broadcasting and spectrum policies in two DTT pioneer countries to understand their different capacities in adapting to this change in European spectrum policy. Whereas Finland was the first country to decide on rapid release of the second digital dividend, Spain was still struggling to clear the first one. We argue that any geographic and demographic differences explain only a part of the contrast, which is based on divergent national broadcast and spectrum policy contexts.
Diagnosis of pediatric tuberculosis using The Indonesian National Concencus for Pediatric Tuberculosis
Authors: Nataprawira Heda Melinda D. , Kartasasmita Cissy B. , Rosmayudi Oma , Agustini Hudiyati
Published: November 2016

Diagnosing tuberculosis (TB) in children correctly is critical to appropriate treatment. However, diagnosing TB in children may be difficult and can be imprecise. As our national TB control program has not adequately covered TB in children and adult TB cases still in high rank, our national consensus for pediatric population may facilitate TB diagnosed especially in the field. This cross sectional study as part of longitudinal cohort study of epidemiology of Respiratory Syncitial Virus (RSV) in Indonesia (still ongoing) was conducted to know whether criteria used in the algorithm in the consensus compatible to suspected TB diagnosis. The study covered 1000 children under five randomly selected in two districts (Cikutra and Ujung Berung Indah) located in West Java. By using algorithm of The Indonesian National Consensus For Pediatric Tuberculosis (INCPT) with history of known or suspected adult source of TB or early reaction of BCG vaccination and certain general clinical symptoms associated TB as entry criteria for a higher index of suspicion, we diagnosed suspected TB in 57 children. We found that, history of known or suspected adult source of TB and certain general clinical symptoms are two main criteria for suspected TB diagnosis. It appeared that Mantoux test gave a smallest contribution to the diagnosis of suspected TB in the field. No other criterium except known or suspected adult source of TB fulfilled for other five children and prophylactic treatment for TB were given. Those children with suspected TB were given oral anti-tuberculosis (OAT) by Directly Observed Treatment Short course (DOTS) done by local trained persons.
Nephritogenicity of glomerular basement membrane: a molecular aspect
Authors: Rauf Syarifuddin
Published: November 2016

Glomerular basement membrane (GBM) has multifunctions. One of its functions is having nephritogenicitywhich means the ability of an antigen originally from GBM in causing glomerulonephritis, either in experimental animal or in human being. Recent studies on GBM have revealed that its main component is type IV collagen, consists of 6 different isoforms, α1 (IV) to α 6 (IV) chains. Genetic studies show that all of the six α chains are encoded by genes located in 2, 13, and X chromosomes. Nephritogenic antigen in GBM has been identified as α3, α4, α5 chains. They are molecules of type IV collagen located in globular domain (NC1 domain) at the carboxyl terminus of the type IV collagen of GBM. They are thought to assemble into a α3- α4- α5 (IV) chain helical molecules in human GBM. Other α chains, namely α1 and α2 chain, are not nephritogenic or poorly nephritogenic, while the α6 chain is not located in GBM. The nephritogenicity of GBM has been elucidated as a cause in experimental anti-GMB nephritis, and in Goodpasture and Alport syndromes.
Nasopharyngeal bacterial carriage and antimicrobial resistance in underfive children with community acquired pneumonia
Authors: Kartasasmita Cissy B. , Duddy Heda Melinda , Sudigdoadi Sunaryati , Agustian Dwi , Setiowati Ina , Ahmad Tri Hanggono , Panigoro Ramdan
Published: November 2016

Lung puncture is the best way to determine the etiology of pneumonia since it yields the highest rate of positive cultures. However, this procedure is difficult, especially for a study in the community. According to WHO, isolates to be tested for antimicrobial resistance in the community should be obtained from nasopharyngeal (NP) swabs. Previous studies support the use of NP isolates to determine antimicrobial resistance patterns of isolates from children with pneumonia. The aim of our study was to know the bacterial patterns of the nasopharynx in underfive children with community acquired pneumonia and their antimicrobial resistance. The study was carried out in 4 Primary Health Clinics in Majalaya sub-district, Bandung, Indonesia. All underfives with cough or difficult breathing and classified as having non-severe pneumonia (WHO guidelines), were included in the study. Nasopharyngeal swabs (CDC/WHO Manual) were obtained by the doctor, the swabs were placed in Amies transport medium and stored in a sterile jar before taken to the laboratory in the same day. All children were treated with co-trimoxazole. During the nine month study, 698 children with clinical signs of non-severe pneumonia were enrolled. About 25% of the nasopharyngeal specimens yielded bacterial isolates; the two most frequently found were S. pneumoniae and S. epidermidis. The antimicrobial resistance test to co-trimoxazole showed 48.2% S. pneumoniae strain had full resistance and 32.7% showed intermediate resistance to co-trimoxazole. This result is almost similar to other studies from Asian countries. It seems that H. influenzae is not a problem in the study area; however, further studies are needed.
Factors affecting school performance in children with rheumatic heart disease
Authors: S. Arief Hermanu , Sastroasmoro Sudigdo , Madiyono Bambang , Oesman Ismet N.
Published: November 2016

The aim of this study was to determine the association between school performance and age, sex, duration of illness, educational achievement prior to illness, socioeconomic status of family, parent’s educational level, number of children in the family and severity of the disease of patients with rheumatic heart disease (RHD). Subjects were patients with RHD treated at the Division of Cardiology, Department of Child Health, Cipto Mangunkusumo Hospital Jakarta. The parameters of school performance were educational achievement, absent of school and dropout. All data were processed by using Epi-Info program to find out bivariate analysis and Statistic Program for Social Sciences (SPSS) for multivariate analysis. We obtained 80 patients with RHD; most of them were of mild severity (64 of 80%) and the remainder 16 (20%) with severe disease. There were 44 (55%) males and 36 (45%) females. Most parents (42 or 53%) had junior high school educational level, most of them, 23 (29%) had elementary school education, and 3 (4%) illiterate. Bivariate and multivariate analyses showed that severity of disease and parental educational level were associated withschool performance of patients with RHD, but age, sex, duration of disease, premorbid educational achievement, socio-economic level of the family and number of children in family were not.
A simple estimation of glomerular filtration rate in children
Authors: Rauf Syarifuddin , Akbar Husein
Published: November 2016

Background The estimation of glomerular filtration rate (GFR) is routinely used in the assessment of renal function in children. An accurate measurement of GFR is very helpful in detecting renal disease.Objective The aim of this study was to compare GFR calculated by Schwartz's formula and that assessed by creatinine clearance measurement.Methods A study to evaluate GFR calculated by the Schwartz's fonnula and by the conventional creatinine clearance method was done on 114 (57%) boys and 86 (43%) girls aged 6-13 years hospitalized in the Department of Child Health, Hasanuddin University, Wahidin Sudirohusodo Hospital, Makassar in 1996.Results This study showed that there was no significant difference between the value of GFR determined by the conventional creatinine clearance method and that calculated by the Schwartz's fonnula according to age and sex. Our findings also did not show any  difference of GFR assessed by both methods according to nutritional status of children. In regard to the accuracy of Schwartz's fonnula, the sensitivity, specificity, positive, and negative predictive values were 87.5%, 98.86%, 9 1.3%, and 98.3%, respectively.Conclusion It seems that Schwartz's fonnula might be used for assessing GFR in children particularly if either there is no facility for measuring creatininuria or there is difficulty in collecting complete and accurate-timing urine samples. The formula is a very simple and inexpensive method for determining GFR in children compared to the conventional creatinine clearance method.
Vitamin E effect on osmotic fragility in β thalassemia major
Authors: Fitrianto Agus , Tamam Moedrik , Widyastiti Nyoman Suci
Published: November 2016

Background Blood transfusion remains the main therapy for anemia in β thalassemia major patients. However, frequent transfusions can cause oxidative stress in response to iron overload. Vitamin E is considered to be the best lipid-soluble exogenous antioxidant in humans. It can protect phospholipid membrane from peroxidarion. Erythrocyte osmotic fragility is a useful test to assess for the improvement of red blood cells in thalassemia patients after vitamin E supplementation.Objective To investigate the effect of vitamin E for improving erythrocyte osmotic fragility in β thalassemia major and for decreasing the need for frequent transfusions.Methods T his was a double blind placebo controlled randomized clinical trial on children aged 2-14 years with thalassemia major who received frequent blood transfusions. Fifty subjects were divided into 2 groups: group I with vitamin E supplementation and group II with placebo, as a control group, for a period of 1 month. Pre- and post-treatment data on erythrocyte osmotic fragility and hemoglobin level were analyzed with non-paired T-test.Results Improved erythrocyte osmotic fragility was found: in group I, pre-treatment 31.59 (SD 6.342)% to post-treatment 38.08 (SD 7.165)%, compared to the control group pre-treatment 34.40 (SD 6.985)% to post-treatment 29.26 (SD 9.011)% (P=0.0001). Comparison of the mean delta Hb level in group  I was 0.94 (SD 0.605) gr% and that of group II was - 0.23 (SD 1.199) gr% (P=0.0001).Conclusion Vitamin E supplementation improves erythrocyte fragility and Hb level in β thalassemia major pediatric patients.
Association between bronchial asthma in atopic children and their number of siblings
Authors: Siregar Johan El Hakim , Irsa Lily , Supriatmo Supriatmo , Loebis Sjabaroeddin , Evalina Rita
Published: November 2016

Background The prevalence of asthma in children has increased in many countries. Environmental factors are believed to play an important role and an inverse relationship between number of siblings and atopic disorders has been observed.Objective To assess for an association between bronchial asthma in atopic children and their number of siblings.Methods A cross-secrional study was conducted from June to November 2010 in three elementary schools in Medan, North Sumatera. Trace cards from the Allergy-Immunology Indonesian Pediatric Association (IDAI) Working Group and questionnaires on the clinical history of atopy were used to screen children with the risk of atopy. The International Study of .Asthma and Allergies in Childhood (ISAAC) questionnaire to screen for bronchial asthma was distributed to children aged 7-10 years with a history of asthma, allergic rhinitis or atopic dermatitis. Subjects were divided into two groups, those with <3 siblings and those with 2:3 siblings. Chi-square test was used to analyze differences in bronchial asthma prevalence between the two groups.Results Ninety-six subjects enrolled in the study, with 48 subjects per group. The prevalence of bronchial asthma was significantly higher in atopic children who had <3 siblings than in children with 2:3 siblings (73.5% and 26.5%, respectively; P=0.04).Conclusion Bronchial asthma was significantly more frequent in children with less than 3 siblings compared to those with 3 or more siblings.
Mentzer index as a screening tool for iron deficiency anemia in 6-12-year-old children
Authors: Alam Sri Lestari S. , Purnamasari Rini , Bahar Erial , Rahadian Kemas Ya'kub
Published: November 2016

Background There is a high prevalence of iron deficiency anemia (IDA) in Indonesia. Iron deficiency anemia impairs the growth and development process in children. The reference standard to diagnose IDA is serum ferritin level. Since this test is expensive and rare not widely available, an inexpensive, simpler testis needed. The Mentzer index (mean corpuscular volume/red blood cell or MCV JRBC) has been used to identitY hypochromic-microcytic anemia with good validity.Objective To assess the validity of the Mentzer index for diagnosing IDA by comparing Mentzer indexes to serum ferritin and to define an optimal Mentzer index cut off point with good sensitivity and specificity.Methods The study was a diagnostic test with cross-sectional design. Subjects were collected by multistage, random sampling, from April to May 2013 at 18 elementary schools in Palembang. The study had a survey phase and diagnostic test phase. Subjects were aged 6-12 years with hypochromic-microcytic anemia. We examined complete blood counts to diagnose hypochromic-microcytic anemia, calculated Mentzer indexes, and measured serum ferritin levels of our subjects. We analyzed the validity of Mentzer index compared to serum ferritin level for diagnosing IDA.Results There were 100 children in our study, consisting of 51boys and 49 girls with a mean age of 9.1 (SD 2.02) years. From the receiver-operator curve (ROC) curve analysis, the area under the curve (AUC) was 91.5)010 for a Mentzer index cutoff point of 13.51. Diagnostic test analysis revealed a sensitivity of93%, specificity 84 %, and accuracy 90%.Conclusion Mentzer index has good validity as an inexpensive and simple screen for IDA in 6-12-year-old children with hypochromic-microcytic anemia.
Hypertension, high-dose corticosteroids, and renal infiltration in children with acute lymphoblastic leukemia
Authors: Juliansen Andry , Andriastuti Murti , Pardede Sudung , Sekartini Rini
Published: November 2016

Background Hypertension is a rarely recognized complicationof acute lymphoblastic leukemia (ALL). The incidence ofhypertension in ALL patients in Indonesia remains unknown,but the most common risk factors are corticosteroid use duringinduction-phase chemotherapy and renal leukemic infiltration.Objective To determine the incidence of hypertension in childrenwith ALL, and to assess for associations of high-dose corticosteroids,renal infiltration, and hyperleukocytosis to hypertension.Methods This was a cross-sectional study involving 100 childrenaged 2-18 years. Subjects were newly diagnosed ALL patients andthose underwent induction-phase chemotherapy in the PediatricWard or Outpatient Clinic at Cipto Mangunkusumo or DharmaisHospitals.Results Hypertension occurred in 6 (10%) of 60 newly diagnosedALL patients and 8 (20%) of 40 patients who had receivedhigh-dose corticosteroids, but the difference was not statisticallysignificant (OR=2.25; 95%CI 0.72 to 7.07; P=0.239). Hypertensionwas reported in 8 of 29 subjects who received dexamethasone,but in none of the subjects who received prednisone. However, thedifference in these subgroups was also not statistically significant.Renal enlargement was found in 1 of 14 hypertensive patients, butit was not associated with hypertension (OR=0.80; 95%CI 0.52to 1.24; P=0.417). Hyperleukocytosis was also not associated withhypertension (OR= 0.79; 95% CI 0.20 to 3.11; P=1.000).Conclusion The incidence of hypertension in ALL patients was14%. Hypertension is not associated with renal infiltration orhyperleukocytosis. Furthermore, hypertension is not associatedwith corticosteroid dose, though is found only in subjects whoreceive dexamethasone. [Paediatr Indones. 2014;54:372-6.].
Gut wall integrity in exclusively breastfed vs. formula-fed infants
Authors: Hayati Nur , Kadim Muzal , Mangunatmadja Irawan , Soedibyo Soepardi , Ifran Evita Bermansyah , Sjakti Hikari Ambara
Published: November 2016

Background Breast milk has bioactive substances that modulate gastrointestinal maturation and maintain mucosal integrity of the gut in infants. Markers that are both non-invasive and reliable, such as fecal alpha-1 antitrypsin (AAT), calprotectin, and secretory immunoglobulin A (sIgA) have been used to assess gut integrity in adults. Higher AAT levels may imply greater enteric protein loss due to increase intestinal permeability of immaturity gut.Objective To assess and compare gut integrity of exclusively breastfed (BF) and exclusively formula fed (FF) infants aged 4-6 months.Methods Subjects were 80 healthy infants (BF=40; FF=40), aged 4-6 months who visited the Pediatric Polyclinic at St. Carolus Hospital, and lived in Pasar Minggu or Cempaka Putih Districts, Jakarta. The fecal AAT was analyzed by an ELISA method. Mann-Whitney and unpaired T-test were used to analyze possible correlations between feeding type and gut integrity.Results The BF group had significantly higher mean fecal AAT than the FF group (P=0.02). Median sIgA levels were not significantly different between groups (P=0.104). The FF group had a higher mean fecal calprotectin level but this difference was also not significant (P=0.443). There was a significant correlation between breastfeeding and mean fecal AAT level (P=0.02), but no significant correlation with calprotectin (P=0.65) or sIgA (P=0.26).Conclusion The breastfed group shows better mucosal integrity compared to the formula fed group. Higher mean fecal AAT level in the BF group is related to the AAT content of breast milk. Therefore AAT content of BF group is actually lower than formula fed group which shows greater mucosal integrity in BF group.
Impact of an antimicrobial resistance control program: pre- and post-training antibiotic use in children with typhoid fever
Authors: Rachmah Elfrida A. , Rochmanti Maftuchah , Puspitasari Dwiyanti
Published: November 2016

Inappropriate use of antibiotics may lead to antimicrobial resistance. In 2012, Dr. Soetomo Hospital conducted training for pediatric residents on the proper use of antibiotics to limit antimicrobial resistance.Objective To evaluate the impact of a rational, antibiotic-use training program for pediatric residents on their antibiotic prescriptions for patients with typhoid fever.Methods A cross-sectional, analytic study was conducted. We collected data from children with typhoid fever who were hospitalized in Dr. Soetomo Hospital, pre- and post-training on antibiotic prescriptions. Children with other known bacterial infections or who were discharged on request were excluded. Antibiotic prescriptions were evaluated using Gyssens algorithm based on the local protocol. Chi-square test was used to compare the quality of antibiotic prescriptions, before (year 2012) and after (year 2013) the training.Results Forty-nine patients with 67 prescriptions in 2012 and 34 patients with 48 prescriptions in 2013 fulfilled the inclusion criteria. Patients’ ages ranged from 1-18 years. Diagnoses of uncomplicated and complicated typhoid were found in 74% and 26% of subjects, respectively. First line (chloramphenicol, thiamphenicol, ampicillin, trimetroprim and sulfametoxazol) and second line (ceftriaxone and cefixime) use were 72% and 28%, respectively. All patients were discharged in good condition. Appropriate use of antibiotics was noted in 61% of subjects in 2012 and in 81% of subjects in 2013 (P=0.036). The most common type of error in 2012 and 2013 was dosage imprecision (25% and 17%, respectively).Conclusion Training on appropriate use of antibiotics significantly improved the quality of antibiotics prescribed in children with typhoid fever in Dr. Soetomo Hospital.