bluuebunny/crossref_metadata_2025 huggingface dataset:
Problematizations in Health Policy
Authors: Bacchi Carol
Published: January 2017

This article directs attention to the significance, for health promotion advocates, of reflecting on how “problems” are constituted, or brought into existence, as particular sorts of problems, within policies and policy proposals. To this end, it introduces a poststructural analytic strategy called “What’s the Problem Represented to be?” (WPR approach), and contrasts this perspective to the ways in which “problems” are commonly conceptualized in health policy analyses (e.g., “a problem stream,” “wicked problems”). Such a perspective offers a significant rethinking of the conventional emphasis on agenda setting and policy-making processes in considering the meaning of success or failure in health policy initiatives. The starting point is a close analysis of items that are “successful,” in the sense that they make the political agenda, to see how representations of “problems” within selected policies limit what is talked about as possible or desirable, or as impossible and undesirable. This form of analysis thus enables critical reflections on the substantive content of policy initiatives in health policy. The article takes a step back from policy process theories, frameworks, and models to offer reflections at the level of paradigms. Highlighting potential dangers and limitations in positivism, interpretivism, and critical realism, it uses international, Australian, and South Australian examples in health policy to explore what poststructural policy analysis contributes to understanding the broad political influences shaping contemporary modes of rule.
Claims, Frames, and Blame
Authors: Freeman Bradley C.
Published: January 2017

As economies in Southeast Asia develop, there is renewed interest in the impact such growth has on nature. This study seeks to investigate how environmental issues have been covered in the English-language press of the region. Are some countries providing greater print news coverage versus others? Are there detectable patterns or noticeable biases in the coverage? What sources are relied upon in the print media stories? And what frames do we see in the coverage? This study identified general coverage patterns of the environment over a 10-year period (2002-2012), in several of the region’s English-language newspapers. News stories were analyzed to discern the nature of the coverage, coding for several variables as indicated by previous literature. Results indicate that use of the term climate change became preferred over that of global warming. In addition, coverage increased greatly starting in 2006. Government officials were most often the sources quoted within stories (Claims). Articles contained more “judgments” about the issue than “solutions” (Frames). Finally, though most articles eschewed mentioning a specific actor as causing climate change, “man” was implicated in a number of stories more often than simply “nature” (Blame).
A Sectoral Analysis of Dividend Payment Behavior
Authors: Khan Muhammad Nadeem , Shamim Moona
Published: January 2017

This study analyzes the sector-wise dividend payment behavior of Karachi Stock Exchange (KSE) for the period 2009 through 2013. First, the trend of dividend payment of 5 years with respect to all 32 sectors is assessed through descriptive analysis. Second, the unit root test for panel data and pooled ordinary lest square (POLS) test were used on 15 non-financial sectors. Results show that the earning per share has a positive impact on dividend payment in eight sectors including beverages, travel and leisure, fixed-line telecommunication, food processors, household goods, personal goods, automobiles, and electricity; however, forestry (paper and board) is negatively associated with the dividend payout ratio. In addition, free cash flow has a positive impact on dividend payment in fixed-line telecommunication, and a negative impact on chemical, forestry, construction and material, engineering, beverages, tobacco, travel and leisure, food processor, household goods, pharmaceutical and biotech, and automobiles.
Social Justice Attitudes and Concerns for Labor Standards
Authors: Schulz Michaela , Braekkan Kristian F.
Published: January 2017

This study utilizes an adapted version of the Social Justice Scale to capture and assess the extent to which social-justice-related values and attitudes toward labor standards relate to consumer intentions and behaviors. This social cognitive model assesses, based on Ajzen’s theory of planned behavior, how “perceived behavior control” affects these behaviors either directly or indirectly through consumers’ intentions. It is hypothesized that individuals who value fairness and equity in social interactions are going to be more likely to engage with businesses that are known for ethical business practices and abstain from firms that are known to violate labor rights. The results confirm that consumers who are concerned with social justice are less likely to conduct business with enterprises that have the reputation of violating both human rights and labor rights. However, the results also reveal that consumers with low levels of “perceived behavioral control” justify their consumer behaviors as they do not think that they can make a difference.
A Holistic Approach to Supporting Staff in a Pediatric Hospital Setting
Authors: Schwerman Nichole , Stellmacher Judy
Published: January 2017

Health care professionals experience significant stress in the workplace. Building opportunities for health care professionals to manage stress is essential. Children's Hospital of Wisconsin designed a holistic set of programs called the R&R Series to support the emotional, cognitive, and spiritual health of staff and assist staff in using self-care strategies to build resiliency. Six hundred seventy program evaluations were collected during a 1-year pilot series. Program participants were from a wide variety of departments throughout the health care system. Staff reported feeling more supported, being better able to manage work and life stress, and practicing the self-care techniques they learned. Programs such as the R&R Series are one way to promote the overall health and resiliency of health care professionals.
Workplace Hand Hygiene and Wellness
Authors: Stedman-Smith Maggie , DuBois Cathy L. Z. , Grey Scott
Published: January 2017

Community hand hygiene interventions have reduced the spread of infectious disease in elementary schools, daycare centers, and private homes. Despite this success, and the potential for reducing workplace absenteeism and presenteeism, few peer-reviewed hand hygiene intervention studies among workers have been published. This research used the Theory of Planned Behavior (TPB) to guide the development of a model to understand and predict motivations for performing hand hygiene, and to examine related illness, absenteeism, and presenteeism among employees from 39 bank branches in Ohio. Although the TPB has been used extensively to elucidate hand hygiene practices among employees in the health care and food industries, little is known about the ability of the TPB to predict hand hygiene practices among workers in public settings. These survey findings indicate a need for hand hygiene improvement, and support the use of attitudinal beliefs and social norms to guide multimodal approaches for workplace hand hygiene interventions.
Consulting in Occupational Health Nursing
Authors: Roy Deborah R.
Published: January 2017

Occupational health nurses work in a variety of settings and some have chosen to practice the profession as consultants. The process of consulting is similar to that of other disciplines but only two small descriptive studies offer functions and roles specific to occupational health nurse consultants. This article provides an overview of consulting practice, the process, the functions, and the roles of occupational health nurse consultants, and presents some common characteristics of successful consultants.
Snapshot of the AAOHN APRN Membership
Authors: Phelps Stephanie
Published: January 2017

In 2012, the American Association of Occupational Health Nurses, Inc. (AAOHN) conducted an online membership survey. This article presents demographic, certification, educational, employment, priority issues, and membership data for advanced practice registered nurse (APRN) AAOHN members. Approximately 8% of the respondents identified themselves as nurse practitioners and/or clinical nurse specialists. The majority of these members are currently employed as APRNs (62.1%) and work full-time (85.7%) as employees of their organizations (85.8%). Critical issues that AAOHN APRN members identified in occupational health nursing practice today included the economy, government regulations, and health care reform.
Health Care Reform and Influenza Immunization
Authors: Tucker Sharon , Poland Gregory A.
Published: January 2017

Health care reform calls for the nursing profession, with a focus on disease prevention and health restoration, to innovate and create new models of care that are client-centric, evidence-based, and cost-effective. To do so, nurses must develop a fundamentally different paradigm and epistemology. New care models are required that focus on issues such as evidence-based prevention. Among the prevention foci for hospitals are hospital-acquired infections, including influenza, which kills 36,000 Americans annually. One crucial step in eliminating hospital-acquired influenza is to require influenza vaccination of all health care workers. This article challenges nursing leadership to seize opportunities to lead health care initiatives and encourage courageous innovative actions that depart from old paradigms; these actions must be based on scientific evidence, reduce costs, and promote patient safety and quality care and outcomes.
Association Between Medicare Star Ratings for Patient Experience and Medicare Spending per Beneficiary for US Hospitals
Authors: Trzeciak Stephen , Gaughan John P , Bosire Joshua , Angelo Mark , Holzberg Adam S , Mazzarelli Anthony J
Published: January 2017

Objective:

To test the association between patient experience and Centers for Medicare and Medicaid Services (CMS) spending at the hospital level.

Methods:

Using CMS Hospital Compare data set, we analyzed 2014 data for CMS patient experience star ratings and the hospital Medicare Spending per Beneficiary (MSPB) Measure, which assesses price-standardized, risk-adjusted payments for services provided to Medicare beneficiaries for an episode of care from 3 days before hospital admission to 30 days following discharge. We tested the association using linear regression, adjusting for complexity of care using hospital Case Mix Index (CMI) and for socioeconomic status of the hospital patient population using Disproportionate Share Hospital (DSH) status.

Results:

The MSPB decreased with increasing hospital patient experience ratings. After adjustment for CMI and DSH, better hospital patient experience was associated with lower spending per episode (5.6% decrease from the lowest to highest patient experience star rating).

Conclusion:

We found that better hospital patient experience was associated with lower health-care spending. Further research is needed to define what specific elements and phases of the episode of care are driving the association.
Using digital rocks and simulations of pore-scale multiphysics to characterize a sandstone reservoir
Authors: Sengupta Madhumita , Kittridge Mark G. , Blangy Jean-Pierre
Published: January 2017

The modeling and prediction of transport and elastic properties for sandstones are critical steps in the exploration and appraisal of hydrocarbon reservoirs, particularly in deepwater settings where seismic data are abundant and well costs are high. Reliable multiphysics modeling of reservoir rocks requires robust models that respect the underlying geologic character and microstructure of the geomaterial and honor the measured properties. We have developed a case study that integrates traditional laboratory measurements with computational methods to quantify and relate physical properties of reservoir sandstones. We evaluate the complementary use of digital rock simulations as a practical technology that adds physical insight into the development and calibration of rock-property relationships. We also determine the challenges faced while applying digital rock physics to interpret laboratory data, and the steps taken to overcome those limitations. Combining physical and computational methods, we achieve an improved understanding of the link between geologic properties (sorting, microporosity) with transport (single-phase permeability, electrical conductivity) and elastic properties (moduli). Combining physical measurements with numerical computations has enhanced our understanding of multiphysics relationships in a heterogeneous sandstone reservoir.
Assessing the Impact of the Anesthesia Medication Template on Medication Errors During Anesthesia: A Prospective Study
Authors: Grigg Eliot B. , Martin Lizabeth D. , Ross Faith J. , Roesler Axel , Rampersad Sally E. , Haberkern Charles , Low Daniel K.W. , Carlin Kristen , Martin Lynn D.
Published: January 2017

BACKGROUND:

Medication errors continue to be a significant source of patient harm in the operating room with few concrete countermeasures. The organization and identification of medication syringes may have an impact on the commission of medication errors in anesthesia, so a team of physicians and designers at the University of Washington created the Anesthesia Medication Template (AMT) to define a formal way of organizing the anesthesia workspace. The purpose of this study is to assess the ability of the AMT to reduce perioperative medication errors by anesthesia providers.

METHODS:

This study evaluated the AMT in 2 phases: (1) 41 anesthesia providers administered medications in 2 prospective, randomized operating room simulations with or without the AMT, while medication errors were directly observed; and (2) around 200 providers prospectively self-reported medication errors from all anesthetizing locations during a 2-year period at Seattle Children’s Hospital, an academic, pediatric medical center.

RESULTS:

In simulated emergencies, the odds of medication dosing errors using the AMT were 0.21 times the odds of medication dosing errors without AMT (95% confidence interval [CI], 0.07, 0.66), controlling for scenario, session, training level, and years at training level. During the year after implementation of the AMT, the mean monthly error rate for all reported medication errors that reached patients decreased from 1.24 (95% CI, 0.85–1.79) to 0.65 (95% CI, 0.39–1.09) errors per 1000 anesthetics. The mean monthly error rate of reported swap, preparation, miscalculation, and timing errors decreased from 0.97 (95% CI, 0.64–1.48) to 0.35 (95% CI, 0.17–0.70) errors per 1000 anesthetics. Medication errors that resulted in patient harm did not change after implementation of the AMT.

CONCLUSIONS:

Standardizing medication organization with the AMT is an intuitive, low-cost strategy with the potential to improve patient safety through reducing medication errors by anesthesia providers.
African Americans, the Racial State, and the Cultus of War
Authors: Johnson Sylvester A.
Published: January 2017

This essay examines Black support for US militarism from the 1890s to the First World War amid devastating forms of institutional racism. As the first African American soldiers were deployed to France to liberate Europe’s White citizens, the US government hanged thirteen Black soldiers because they sought to defend themselves from mob violence at the hands of White soldiers and civilians. Despite this, the nation’s strident racism did not prevent Blacks from seeking entry into the armed forces. This article explains why African Americans willingly risked their lives to support the military imperatives of the very White government that subjected them to the assaults of racism through legal sanction. Central to this problem was the ritual power of civil religion, particularly the role of death in warfare. By risking their lives through military service, African American soldiers sacrificed themselves, thereby participating in a cultic form of nationalism that transformed them into heroes and that promised to forge their inclusion in the nation’s political body. Black military service in this way transcended the mundane level of conundrum and stoked powerful expressions of loyalty to a racial state that reinscribed the racist order of White supremacism.
What Have We Learned from the Imaging in Carotid Angioplasty and Risk of Stroke (ICAROS) Study?
Authors: Biasi Giorgio M. , Froio Alberto , Deleo Gaetano , Piazzoni Claudia , Camesasca Valter
Published: January 2017

Carotid artery stenting (CAS) is used widely to treat carotid lesions. Indication to CAS is mostly based, both in trial and in clinical practice, on the percentage of stenosis and the presence or absence of preprocedural neurologic symptoms, whereas the features of the plaque are somehow disregarded and ignored.

The most severe complication of CAS is stroke, related to cerebral embolization from carotid plaque. Several studies showed that echolucent plaques generate a higher number of embolic particles following carotid stenting. Echolucency can be measured using the gray scale median, which is an objective and quantitative computer-assisted grading of the echogenicity of carotid plaques.

As previously demonstrated in the ICAROS study, carotid plaque echolucency is an independent risk factor for stroke in carotid stenting. Carotid plaque echolucency is one of the parameters that should be mandatory to be considered for indication to treatment.
Spontaneous Regression of a Large Iatrogenic Dissection of the Ascending Aorta
Authors: Roumy Aurélien , Kirsch Matthias , Prêtre René , Niclauss Lars
Published: January 2017

A 74-year-old woman was admitted for right coronary angioplasty. During the procedure, she complained about chest pain, and contrast injection showed an iatrogenic dissection of the ascending aorta. A contrast computed tomography (CT) scan confirmed the diagnosis via visualization of a large non-circulating false lumen, which involved nearly the entire ascending aorta. The patient remained hemodynamically stable and asymptomatic while receiving medical therapy alone. Another CT scan performed 3 days later showed complete regression of the false lumen. This case suggests that uncomplicated iatrogenic dissection of the ascending aorta, even when large, may be managed successfully by medical therapy.
The experiences of black and minority ethnic nurses working in the UK
Authors: Pendleton John
Published: January 2017

Evidence suggests that black and minority ethnic (BME) midwives are more likely to face fitness to practise hearings than white registrants and BME NHS staff are less likely to be in senior positions. This literature review critically evaluates the literature published since a systematic review on the topic was conducted in 2005. It found that BME nurses and midwives, especially those who registered abroad and subsequently came to live and work in the UK are ‘underemployed’ and consequently expressed feelings of loss of self-confidence. This was further compounded by accounts of excessive scrutiny and punishment. Many felt excluded from white networks of power and opportunities for staff development and promotion. The literature also describes experiences of covert as well as overt racism between the white majority and BME staff as well as ‘horizontal racism’ between BME staff of differing ethnicities.
Towards resilience and wellbeing in nurses
Authors: Brennan Emma Jane
Published: January 2017

Nursing is a physically and emotionally demanding profession. High role expectations and difficult working conditions place some nurses at risk of burnout and stress-related illness. In spite of the challenges in the current healthcare system, nurses continue to deliver high-quality patient care, retain resilience and progress professionally in the face of adversity. This article provides an overview, with discussion of the evidence in the literature, of some of the suggested methods to improve resilience and enhance staff wellbeing in the nursing profession at an individual and organisational level.
Career development for all ages
Authors: Foster Sam
Published: January 2017

Sam Foster, Chief Nurse at Heart of England NHS Foundation Trust, considers the issues around career progression and staff retention and how they differ between generations
A friend to take away your woes
Authors: Francis-Pester Dawn
Published: January 2017

As well as an inspirational art and craft activity, ‘worry dolls’ can be linked to other curriculum areas and can help raise children's awareness of their emotional health.
J is for joints that hold us together…
Authors: Hammond Paula , Lillie Stephen
Published: January 2017

This month, we continue our series that takes the form of an extended alphabetical adventure around the body, helping children to get to know themselves a little better.
Let your year 6 pupils play!
Authors: Knight Shahana
Published: January 2017

Play can be an important outlet for children, but by the time they reach key stage 2 it has often all but stopped. Play therapist Shahana Knight argues the importance of play in all year groups, especially year 6
Attainment in year 4
Authors: Murphy Ciara
Published: January 2017

In a bid to bridge the gap between years 2 and 6, school leader Ciara Murphy focused on outcomes in year 4, implementing four key strategies to improve attainment in reading and writing
Unions demand recognition of teacher recruitment crisis
Authors: Henshaw Pete
Published: January 2017

In a strongly worded joint submission to the STRB, six education unions have attacked the DfE and demanded action on teachers' pay
Ensuring SEND education is a whole-school responsibility
Authors: Burns Elizabeth
Published: January 2017

All teachers are teachers of SEND and as such SEND education is a whole-school responsibility. SENCO Elizabeth Burns discusses how her school ensures that all staff are equipped to support students with SEND
La domesticidad compartida. Apuntes para una arquitectura no solicitada en Nueva York o en yorks nuevas
Authors: Francés Tortosa Verónica
Published: January 2017

¿Qué papel juega lo doméstico en la construcción de lo común? Nos ponemos el traje de Stalker para un viaje de ida y vuelta Nueva York {} yorks nuevas, escala [1:1], presente [perpetuo ensanchado], ciudad [anverso y envés espe(cta)cular]. En la deriva extradisciplinar buscamos articulaciones Institucional {} doméstico. Atravesamos cuartos propios – apropiados – de cuerpos, casas, plazas, escuelas, mundos. Ensamblamos un cuarto con otro cuarto con otro cuarto, conectamos prácticas afectivas como proceso emancipador. Con los ingredientes sobre la mesa de cocina, tanteamos recetas que promuevan líneas de fuga y desborde de lo disciplinar. Exploramos herramientas culinarias de registro y disección de arquitecturas no solicitadas. Sazonamos en proyección, tejiendo narrativa coral de hilos imagen-palabra-acción, agenciando alteridades, ausencias, paradojas, fabulaciones, disidencias. Cocinamos atlas de domesticidades compartidas, disección ida y vuelta, un ‘salir’ de la academia para ‘volver’, intencionadamente nos-Otros, desdibujando cotidiano-técnico, sujeto-objeto, investigador-investigado, extranjero-habitante, devenir menor, llegar a ser siendo mundos otros. Y en esa trama y urdimbre de retales del aquí ahora, coordenadas compartidas entre yo y otro, la arquitectura y otros cajones de saberes se descentran del marco disciplinar para devenir respuesta de lo común.
La contribución del aprendizaje de los procesos creativos en la conciencia política de los estudiantes.
Authors: Psegiannaki Katerina , García Triviño Francisco
Published: January 2017

La principal hipótesis del presente artículo es que el aprendizaje de los procesos creativos puede contribuir no solamente en el desarrollo de las aptitudes y destrezas artísticas sino también en el desarrollo de la conciencia política de los estudiantes.Para desarrollar esta hipótesis de partida se explora qué es la educación, cuál es su relación con la democracia, cuáles han sido los modelos educativos más influyentes y cuál es o puede ser su vinculación con la actitud política de los ciudadanos. De forma más concreta se acude a la argumentación que establece Ranciere entre arte y política para identificar campos de trabajo en el aprendizaje de los procesos creativos. Se analiza brevemente para este tipo de aprendizaje; la concienciación de los prejuicios y el cuestionamiento de las ideas, pues tienen una fuerte vinculación con la política.Por último, se propone el diálogo analítico como herramienta con la que trabajar en estos campos, capaz de reconstruir un espacio de disenso política y artística.
Reflexiones sobre un PFC en Lima. Arquitectura y Urbanismo como convivencia y cooperación
Authors: Gutiérrez Mozo María Elia
Published: January 2017

Este artículo cuenta una historia real y plural, comunitaria y compleja, polifónica: la del proceso de gestación de un proyecto de cooperación para el diseño y la construcción colaborativos del comedor comunitario de San Martín del Once, en el Barrio Cultural La Balanza, Distrito de Comas, Lima, Perú, concebido como un catalizador del desarrollo urbano y social de su entorno. En tanto que arquitectura en fase de proyecto, el objetivo del trabajo se centra en el proceso y no en el resultado, entendido aquél, por su variedad y alcance a distintas escalas, como el verdadero motor de la regeneración producida en el medio físico y humano, a la vez que motivo de reflexión acerca de la relación actual entre el arquitecto y el habitante, en ausencia del promotor, tema relevante tanto para la investigación interdisciplinar como para la transmisión de conocimiento que está en la base misma de esta experiencia.
Dampak Lama Fototerapi Terhadap Penurunan Kadar Bilirubin Total pada Hiperbilirubinemia Neonatal
Authors: Kosim M Sholeh , Soetandio Robert , Sakundarno M
Published: January 2017

Latar belakang. Fototerapi dapat menurunkan kadar bilirubin total namun lama pemberian fototerapi masih belum jelas. Fototerapi di RS dr Kariadi biasanya dilakukan selama 12-24 jam berturut-turut tanpa memandang kadar bilirubin total awal.Tujuan. Menganalisis perbedaan rata-rata penurunan kadar bilirubin total dalam 6 jam, 12 jam, 18 jam, dan 24 jam setelah pemberian fototerapi.Metode. Penelitian kuasi eksperimental pada 40 neonatus hiperbilirubinemia, dibagi 4 kelompok (kelompok I: bilirubin total 13-15 mg/dL, fototerapi 6 jam; kelompok II: 16-17 mg/dL, fototerapi 12 jam; kelompok III: 18-20 mg/dL, fototerapi 18 jam dan kelompok IV: >20 mg/dL, fototerapi 24 jam), menggunakan 4 buah lampu biru khusus fluoresen (Philips TL52/20W), dengan jarak 50 cm. Keadaan hemolitik dan ASI merupakan variabel perancu yang mempengaruhi efek fototerapi. Uji Wilcoxon signed ranks test digunakan untuk menganalisa perbedaan rerata penurunan kadar bilirubin total terhadap lamanya fototerapi.Hasil. Tidak terdapat perbedaan bermakna penurunan kadar bilirubin total pada kelompok II dan III (p>0,05), sebaliknya ada perbedaan bermakna penurunan kadar bilirubin total pada kelompok IV (p<0,05). Setelah enam jam penurunan kadar bilirubin total terbesar terjadi pada kelompok IV (4,83±2,42 mg/dL). Pada akhir fototerapi, penurunan kadar bilirubin total pada kelompok I, II, III, dan IV adalah 3,14±1,86 mg/dL, 4,89±1,82 mg/dL, 7,96±1,94 mg/dL, dan 13,41±3,27 mg/dL. Tidak ada perbedaan bermakna kadar bilirubin total setelah fototerapi antara kelompok berdasarkan gambaran hemolitik atau pemberian ASI.Kesimpulan. Rerata penurunan kadar bilirubin total secara berurutan terdapat pada kadar bilirubin total >20mg/dL yang diberikan fototerapi selama 24 jam.
Fusi Gen Translocation Ets Leukemia-Acute Myeloid Leukemia 1 (Tel-Aml1) Sebagai Faktor Prognosis pada Leukemia Limfoblastik Akut Anak
Authors: Mulatsih Sri , Sunarto Sunarto , Sutaryo Sutaryo
Published: January 2017

Fungsi fusi gen TEL-AML1 dalam leukemogenesis adalah mempengaruhi kunci proses pengaturan, termasuk kenaikan proses cell-renewal yang tidak terkontrol, menghentikan proliferasi dan diferensiasi yang menyebabkan resistensi terhadap proses apoptosis. Banyak studi menghasilkan data bahwa prognosis pasien leukemia limfoblastik akut (LLA) dengan fusi gena TEL-AML1 masih kontroversi, khususnya prognosis jangka panjang. Banyak penelitian yang menghubungkan adanya fusi gena ini dengan resistensi terhadap kemoterapi, dan lainnya menggunakan minimal residual disease (MRD) untuk melihat respons terhadap pengobatan. Adanya co-existences gena lain bisa memberikan kontribusi terhadap prognosis pasien LLA dengan fusi gen TEL-AML1. Dibutuhkan lebih banyak studi translasional untuk lebih memahami peran fusi gen dalam klinik. Pengetahuan mendasar mekanisme molekular pada leukemia sangat penting, khususnya dalam penanganan pasien. Pemahaman yang lebih baik tentang patogenesis leukemia bisa menghasilkan pengertian dan pengetahuan baru untuk menyusun strategi baru dalam penanganan pasien LLA yang didasarkan kaidah molekular
Perubahan Epidemiologi Demam Berdarah Dengue Di Indonesia
Authors: Karyanti Mulya Rahma , Hadinegoro Sri Rezeki
Published: January 2017

Dengue berdarah dengue yang ditularkan melalui vektor nyamuk Aedes aegypty masih merupakan masalah kesehatan penting di dunia. Di Indonesia, demam berdarah dengue mulai dikenal pertama kali pada tahun 1968 di DKI Jakarta dan Surabaya, dan terus menyebar ke seluruh tiga puluh tiga propinsi di Indonesia. Pola epidemiologi infeksi dengue mengalami perubahan dari tahun ke tahun, jumlah kasus memuncak setiap siklus 10 tahunan. Dari tahun 1968-2008 angka kesakitan demam berdarah dengue terus meningkat. Pada tahun 2008 didapatkanangka kesakitan 58,85/ 100.000 penduduk. Angka kematian menurun dengan stabil dari 41% pada tahun 1968 menjadi kurang dari 2% sejak tahun 2000, dan pada tahun 2008 angka kematian menurun menjadi 0,86%.Semua serotipe virus dengue ditemukan di Indonesia, namun serotipe virus den-3 masih dominan menyebabkan kasus dengue yang berat dan fatal. Surveilans epidemiologi, dukungan edukasi masyarakat dan program pengendalian vektor diperlukan untuk mencegah transmisi. Pengembangan vaksin dengue merupakan salah satu upaya mencegah penyakit dengue.
Penggunaan Acute Illness Observation Scale (AIOS) sebagai Prediktor Infeksi Serius pada Anak 3-36 Bulan dengan Demam
Authors: Pratiwi A.A.A. Putu Indah , Nagrani Dimple V. , Balfast Yusuf , Tumbelaka Alan R. , Nurhamzah Waldi
Published: January 2017

Latar belakang. Anak dengan infeksi bakterial serius seringkali tidak menunjukkan gejala khas sehinggasulit dibedakan dengan infeksi ringan. Instrumen tunggal untuk mendiagnosis demam belum ditemukannamun beberapa skala sudah digunakan secara luas untuk memprediksi infeksi bakterial serius pada anak.Acute illness observation scale (AIOS) adalah salah satu skala observasi yang sering digunakan. Skala AIOSsederhana, mudah, dan tidak invasif. Penelitian sebelumnya menunjukkan AIOS memiliki nilai diagnostikyang baik.Tujuan. Mengetahui nilai diagnostik AIOS dalam memprediksi penyakit infeksi bakterial serius pada anakusia 3-36 bulan dengan demam.Metode. Uji diagnostik dilakukan di Departemen Ilmu Kesehatan Anak FKUI/RSCM, RSUP Fatmawati,dan RSAB Harapan Kita, pada bulan Maret sampai dengan Mei 2010. Subjek adalah anak usia 3-36 bulandengan demam 􀁤7 hari.Hasil. Terdapat 270 subjek yang diikutsertakan dalam penelitian dan 256 subjek di antaranya dapat dianalisis.Sebagian besar subjek berusia 3-12 bulan. Infeksi serius ditemukan pada 62 subjek dengan diagnosispneumonia sebagai diagnosis tersering. Skor AIOS >10 memiliki sensitivitas, spesifisitas, nilai duga positif(NDP), nilai duga negatif (NDN), rasio kemungkinan positif (RKP), dan rasio kemungkinan negatif (RKN)berturut-turut 58,06%, 94,33%,76,6%; 87,56%; 10,24; dan 0,44 untuk memprediksi infeksi serius padaanak 3-36 bulan dengan demam. Ditemukan titik potong baru yaitu skor AIOS >8 dengan sensitivitas,spesifisitas, NDP, NDN, RKP, dan RKN 69,35%; 90,2%; 69,35%; 90,2%; 7,08; dan 0,34.Kesimpulan. Skor AIOS >10 dapat digunakan untuk memprediksi infeksi serius pada anak 3-36 bulan.Ditemukan nilai titik potong baru, yaitu skor AIOS >8 yang memiliki nilai diagnostik lebih baik dari AIOS>10 namun diperlukan penelitian lebih lanjut dengan menggunakan titik potong tersebut
Nefritis Tubulointerstisialis pada Kasus Anak yang Menjalani Biopsi Ginjal
Authors: Lestari Hertanti Indah , Trihono Partini Pudjiastuti
Published: January 2017

Latar belakang. Nefritis tubulointerstisialis (NTI) adalah sindrom yang merupakan spektrum penyakit akutdan kronik, yang secara histologis ditandai oleh inflamasi dan kerusakan struktur tubulus dan interstisial,dengan sedikit pengaruh pada elemen glomerular dan vaskular. Diagnosis pasti ditegakkan berdasarkanbiopsi ginjal, karena tidak ada pemeriksaan klinis dan penunjang non invasif yang spesifik dan sensitif.Tujuan. Mengetahui gambaran histopatologi yang menunjukkan keterlibatan tubulointerstisialis sertahubungannya dengan gambaran klinis dan laboratorium pada kasus anak usia kurang dari 18 tahun yangmenjalani biopsi ginjal pada periode 2005-2009.Metode. Penelitian retrospektif deskriptif dengan sumber data sekunder rekam medik Departemen IlmuKesehatan Anak dan Departemen Patologi Anatomi Fakultas Kedokteran Universitas Indonesia – RS Dr.Cipto Mangunkusumo Jakarta.Hasil. Terdapat 45 kasus anak yang menjalani biopsi ginjal, terdiri dari 24 orang laki-laki dan 21 perempuanyang berusia 6 bulan sampai 16 tahun. Indikasi biopsi adalah glomerulonefritis akut, sindrom nefrotik,nefritis lupus, dan tumor ginjal. Gambaran klinis yang ditemukan yaitu edema, hipertensi, oliguria, demam,pucat, dan muntah. Gambaran laboratorium yaitu peningkatan kreatinin, asidosis metabolik, hipokalemia,proteinuria, hematuria, dan leukosituria steril. Gambaran nefritis tubulointerstisialis adalah infiltrasi selradang kronik, atrofi tubulus, fibrosis interstisialis, dan edema interstisialis. Beberapa gejala yang lebihbanyak terjadi pada pasien dengan lebih atau sama dengan satu kelainan tubulointerstisialis yaitu demam(p<0,05), anemia, muntah, dan asidosis metabolik.Kesimpulan. Nefritis tubulointerstisialis sebagai suatu entitas diagnosis cukup banyak ditemukan dan perludiberikan lebih banyak perhatian, dalam upaya menurunkan morbiditas dan mortalitas dari penyakit ginjalpada anak.
Perbandingan Kemampuan Kriteria WHO 1997 dan Klasifikasi DENCO dalam Diagnosis dan Klasifikasi Infeksi Dengue
Authors: Samsi Kiki MK , Phangkawira Evelyn , Samsi Tatang K
Published: January 2017

Latar belakang. Sejalan dengan kemajuan ilmu pengetahuan, spektrum klinis infeksi dengue semakin luas danbervariasi yang diikuti oleh beberapa klasifikasi infeksi dengue baru. Sejauh mana Kriteria WHO-1997 danklasifikasi baru ini mampu mendeteksi infeksi dengue pasien di RS Sumber Waras, belum pernah dinilai.Tujuan. Membandingkan kesesuaian antara hasil konfirmasi laboratorium untuk infeksi dengue dengankriteria WHO-1997, Klasifikasi DENCO, dan modifikasi WHO-1997 di RS Sumber Waras. Selain itudinilai kemampuan ketiga kriteria/klasifikasi dalam mengelompokkan spektrum klinis infeksi dengue.Metode. Merupakan penelitian diskriptif retrospektif dengan menggunakan data penelitian kami terdahulu(cluster study untuk dengue).Hasil. Dalam periode tahun 2004-2008, terdapat 107 subjek penelitian terdiri 98 kasus infeksi virus dengue(serologi dan/atau virology positif) dan 9 sakit namun bukan kasus infeksi virus. Data menunjukkanbahwa dari 98 kasus terbukti infeksi dengue, 96 sesuai dengan Kriteria WHO 1997, 97 sesuai KlasifikasiDenco, dan 97 sesuai Modifikasi WHO-1997 di RS Sumber Waras. Terdapat 24 subjek yang tidak dapatdiklasifikasikan dengan kriteria WHO 1997 yang ternyata 19 subjek dengue dengan tanda peringatan dan5 subjek dengue berat berdasarkan Klasifikasi DENCO, sedangkan dengan modifikasi WHO-1997 RSSW(perdarahan bukan syarat mutlak), didapat 19 subjek DBD, SSD 2 subjek, DBD ensefalopati 1 subjek,dan SSD ensefalopati 2 subjek.Kesimpulan. Kriteria WHO-1997 masih merupakan kriteria yang sesuai dalam diagnosis infeksi dengue,namun untuk dapat mengelompokan spektrum klinis infeksi dengue perlu dipertimbangkan agar manifestasiperdarahan tidak digunakan sebagai syarat mutlak.
Seroproteksi Antibodi Anti-pertusis pada anak usia 6 - 7 Tahun dengan Riwayat Vaksinasi DTP Dasar Lengkap dan Ulangan di Sekolah Dasar di Jakarta
Authors: Deasiyanti Runi
Published: January 2017

Latar belakang. Angka kejadian pertusis semakin meningkat selama dua dekade terakhir walaupun cakupanvaksinasi DTP sudah cukup tinggi. Peningkatan insidens kasus pertusis terutama terlihat pada usia remajadan dewasa, sehingga menjadi sumber penular yang penting terhadap bayi kecil. Kekebalan yang menurunmerupakan salah satu penyebab peningkatan insidens pertusis sehingga kebutuhan booster pertusis padausia remaja dan dewasa menjadi perhatian para peneliti.Tujuan. Mengetahui proporsi seroproteksi dan rerata kadar antibodi anti-pertusis pada anak usia 6-7 tahundi Jakarta, baik yang mendapatkan vaksinasi dasar DTP (3 kali) maupun yang mendapatkan vaksinasi dasardan ulangan (lebih dari 3 kali).Metode. Uji potong lintang deskriptif dilakukan di enam sekolah dasar di Jakarta selama Mei-Juli 2010.Subjek adalah anak usia 6-7 tahun (siswa SD kelas 1) yang telah mendapatkan vaksinasi DTP 3 kali ataulebih. Pada setiap subjek dilakukan pemeriksaan kadar antibodi anti-pertusis.Hasil. Subjek 75 orang anak, 38 lelaki dan 37 perempuan diikutsertakan dalam penelitian, rerata usia (6,2+0,41)tahun. Sebagian besar subjek (68%) memiliki status gizi baik dan 1 subjek (1,3%) dengan gizi buruk. Tigapuluh delapan (50,7%) subjek dengan riwayat vaksinasi DTP sebanyak 3 kali, 31 (41,3%) subjek denganriwayat vaksinasi 4 kali, dan 6 (8%) subjek dengan riwayat vaksinasi 5 kali. Didapatkan proporsi antibodi antipertusisdengan seropositif 56%. Seroproteksi antibodi anti-pertusis pada subjek yang mendapatkan vaksinasiDTP 3 kali adalah 50%, pada subjek dengan riwayat vaksinasi 4 kali 54,8% dan pada subjek dengan riwayatvaksinasi 5 kali 100%. Rentang kadar antibodi anti-pertusis (0-1437,2) EU/mL. Nilai median seroproteksiantibodi anti-pertusis pada subjek dengan riwayat vaksinasi DTP 3 kali adalah 43,6 EU/mL, riwayat vaksinasi4 kali 104 EU/mL, dan riwayat vaksinasi 5 kali 104,9 EU/mL.Kesimpulan. Kekebalan yang didapat dari vaksinasi tidak dapat bertahan lama, sehingga diperlukanpemberian vaksinasi ulangan (booster), baik pada usia 18-24 bulan dan usia sekolah (SD kelas 1). Selain itujuga perlu dipertimbangkan pemberian booster pada usia remaja.
Pola Penyakit dan Karakteristik Pasien Hemato- Onkologi Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana/RS Sanglah Denpasar Periode 2000-2005
Authors: Mudita Ida Bagus
Published: January 2017

Latar belakang. Data epidemiologi kasus hematologi onkologi anak di Indonesia belum ada, hal inikarena sistem registrasi dilakukan secara nasional. Data tersebut penting karena selain memberikan gambaransituasi kesehatan juga dapat digunakan bagi peningkatan pelayanan dan penelitian.Tujuan Penelitian. Mengetahui pola penyakit dan karakteristik pasien hemato-onkologi di Bagian/SMFIlmu Kesehatan Anak RS Sanglah.Metode. Penelitian deskriptif, restropektif dari Januari 2000 sampai Desember 2005.Hasil. Didapatkan 215 kasus yang terdiri dari 39 jenis penyakit. Leukemia limfoblastik akut (LLA)merupakan kasus hemato-onkologi terbanyak (23,7%) yang juga merupakan kasus hematologi terbanyak(29,8%), sedangkan retinoblastoma merupakan kasus onkologi terbanyak (38,6%). Terbanyak kasus (48,4%)berusia 1-5 tahun. Didapatkan 8,4% kasus meninggal terutama kasus LLA.Kesimpulan. Leukemia limfoblastik akut dan retinoblastoma merupakan kasus hematologi dan onkologiterbanyak. Usia terbanyak adalah usia 1-5 tahun. Angka kematian sebesar 8,4% terbanyak kasus LLA
Kadar Svcam-1 pada Penderita Sindrom Nefrotik Kambuh
Authors: Sekarwana Nanan
Published: January 2017

Latar belakang. Sindrom nefrotik pada anak umumnya sensitif terhadap pengobatan, walaupun demikian60%–80% akan mengalami kekambuhan; 20% jenis kambuh jarang, 40% jenis kambuh sering. Prognosispada sindrom nefrotik kambuh sering kurang baik dikaitkan dengan peningkatan kadar profil lemak kecualiHDL. Untuk petanda aterosklerosis dapat digunakan kadar VCAM-1 dalam serum. Dengan meningkatnyakadar profil lemak pada anak dengan sindrom nefrotik, muncul pertanyaan apakah anak dengan sindromnefrotik juga memiliki risiko menderita aterosklerosis.Tujuan. Mengetahui kadar sVCAM-1 pada sindrom nefrotik kambuh sering dibandingkan dengan sindromnefrotik kambuh jarang dan anak sehat.Metode. Penelitian menggunakan pendekatan cross-sectional yang dilakukan pada 29 anak dengan sindromnefrotik kambuh jarang, 21 anak dengan sindrom nefrotik kambuh sering dan 50 anak sehat.Hasil. Rerata sVCAM-1 masing-masing pada sindrom nefrotik jenis kambuh sering, kambuh jarang dankontrol 871,01; 1038,31 dan 715,30 ng/dl.Kesimpulan. Terdapat perbedaan kadar sVCAM yang bermakna pada ketiga kelompok (F=22,43;p.<0,001). Jenis sindrom nefrotik, baik kambuh sering maupun kambuh jarang, tidak mempunyai kontribusiyang besar terhadap kadar sVCAM-1 (adjusted R2 8,9%), walaupun diketahui bahwa prognosis sindromnefrotik kambuh sering lebih buruk dibandingkan dengan kambuh jarang karena adanya faktor risikoaterosklerosis yang berulang.
Trakeomalasia pada Anak
Authors: Pratiwi I G. A. P. Eka , Purniti Putu Siadi , Subanada I. B.
Published: January 2017

Trakeomalasia merupakan suatu keadaan kelemahan trakea yang disebabkan karena kurang dan atau atrofiserat elastis longitudinal pars membranasea, atau gangguan integritas kartilago sehingga jalan napas menjadilebih lemah dan mudah kolaps. Trakeomalasia pada anak dapat diklasifikasikan menjadi dua yaitutrakeomalasia primer (penyakit kongenital) dan sekunder (penyakit didapat). Untuk menegakkan diagnosistrakeomalasia dapat dilakukan dengan anamnesis, pemeriksaan fisik, dan pemeriksaan pencitraan.Manifestasi klinis trakeomalasia antara lain riwayat stridor ekspirasi, kesulitan minum, suara parau, afonia,riwayat breath holding, riwayat intubasi berkepanjangan, trakeostomi, trauma dada, trakeobronkitisberulang, penyakit kartilago (polikondritis relaps), dan reseksi paru. Sebagian besar anak dengantrakeomalasia tidak memerlukan intervensi. Terapi bedah diperlukan jika terapi konservatif tidak mencukupiatau jika terjadi refleks apne, mengalami kesulitan peningkatan berat badan dan perkembangan, mengalamipneumonia atau apne berulang, menunjukkan obstruksi jalan napas yang memerlukan dukungan jalannapas kronik. Gejala kinis akan menghilang secara spontan pada usia 18-24 bulan.
Profil Kasus Artritis Idiopatik Juvenil (AIJ) Berdasarkan Klasifikasi International League Against Rheumatism (ILAR)
Authors: Pribadi Ariz , Akib Arwin AP , Tambunan Taralan
Published: January 2017

Latar belakang. Skema yang dibuat oleh American college of rheumatology (ACR) tentang juvenilerheumatoid arthritis dan skema yang dibuat oleh European league against rheumatism (EULAR) tentangjuvenile chronic arthritis, sering dipertentangkan dalam membuat klasifikasi dan kriteria diagnosis.International League Against Rheumatism (ILAR), berupaya untuk mempertemukan ketidaksepahamanini dengan membuat klasifikasi dan kriteria diagnosis artritis idiopatik juvenil (AIJ).Tujuan. Mengetahui proporsi dan profil pasien reumatik anak berdasarkan klasifikasi ILARMetode. Penelitian deskriptif potong lintang dilakukan untuk memperoleh profil pasien AIJ berdasarkankriteria dan klasifikasi ILAR di RSCM. Populasi anak dengan keluhan artritis diambil dari data rekammedis sejak 1 Januari 2001 hingga 31 Desember 2006.Hasil. Penelitian menemukan 71 pasien AIJ (35,9%) dari 198 pasien dengan keluhan utama artritis.Enampuluh delapan pasien merupakan pasien artritis reumatoid juvenil (ARJ) (34,3%), sedangkan 3 pasienditemukan dari pasien artritis juvenil lainnya. Tipe oligoartritis persisten merupakan jenis terbanyak yangditemukan (40,8%).Kesimpulan. Penggunaan klasifikasi dan kriteria diagnosis ILAR pada penelitian ini hanya mampumenangkap tiga pasien (1,6%) yang tidak tertangkap jika menggunakan klasifikasi dan kriteria ACR
Faktor Risiko Kejadian Distres Pernapasan pada Anak dengan Pneumonia
Authors: Anggrek Karel , Runtunuwu Ari Lukas , Wahani Audrey , Margaretha Lusiana
Published: January 2017

Latar belakang. Distres pernapasan pada pneumonia merupakan kegawatan medis pada anak yang seringterjadi akibat berbagai faktor.Tujuan. Mengetahui faktor-faktor risiko yang berhubungan dengan kejadian distres pernapasan padaanak dengan pneumonia.Metode. Desain penelitian analitik observasional, cross sectional. Subjek penelitian adalah semua anakpneumonia berusia 2-24 bulan yang dirawat di Bagian Ilmu Kesehatan Anak RSU Prof. Dr. R.D.KandouManado Juni - Nopember 2005. Subjek dibagi menjadi kelompok pneumonia dengan dan tanpa distrespernapasan.Hasil. Dari 68 kasus pneumonia, didapatkan 35 (51,5%) disertai distres pernapasan dan 33 (48,5%)tanpa distres pernapasan. Lama pendidikan ayah, lama pendidikan ibu, jumlah leukosit saat masuk rumahsakit, lama sakit di rumah, keluarga perokok dan hasil biakan darah mempengaruhi terjadinya distrespernapasan pada anak dengan pneumonia.Kesimpulan. Lama pendidikan ayah, lama pendidikan ibu, jumlah leukosit, lama sakit di rumah dankeluarga perokok mempengaruhi terjadinya distres pernapasan pada anak dengan pneumonia. Secarabersama-sama faktor lama sakit di rumah, keluarga perokok dan hasil biakan mempunyai hubungan dengankejadian distres pernapasan pada anak dengan pneumonia
SELF-ABSORPTION CORRECTIONS BASED ON MONTE CARLO SIMULATIONS
Authors: Johnová Kamila
Published: January 2017

The main aim of this article is to demonstrate how Monte Carlo simulations are implemented in our gamma spectrometry laboratory at the Department of Dosimetry and Application of Ionizing Radiation in order to calculate the self-absorption within the samples. A model of real HPGe detector created for MCNP simulations is presented in this paper. All of the possible parameters, which may influence the self-absorption, are at first discussed theoretically and lately described using the calculated results.
ASSESSMENT OF BURNABLE ABSORBER FUEL DESIGN BY UWB1 DEPLETION CODE
Authors: Lovecky Martin , Jirickova Jana , Skoda Radek
Published: January 2017

UWB1 depletion code is being developed as a fast computational tool for the study of burnable absorbers in University of West Bohemia in Pilsen, Czech Republic. Research of fuel depletion aims at development and introduction of advanced types of burnable absorbers in nuclear fuel. Burnable absorbers compensate for the initial excess reactivity and consequently allow for lower power peaking factors and longer fuel cycles with higher fuel enrichments. The paper describes the depletion calculations of CANDU, PWR and SFR nuclear fuel doped with rare earth oxides as burnable absorber. Uniform distribution of burnable absorber in the fuel is assumed. Based on performed depletion calculations, rare earth oxides are divided into two groups, suitable burnable absorbers and poisoning absorbers. Moreover, basic economic comparison is performed based on actual stock prices.
NUMERICAL MULTIGROUP TRANSIENT ANALYSIS OF SLAB NUCLEAR REACTOR WITH THERMAL FEEDBACK
Authors: Osuský Filip , Vrban Branislav , Ballo Peter , Čerba Štefan , Lüley Jakub , Farkas Gabriel
Published: January 2017

The paper describes a new numerical code for multigroup transient analyses with thermal feedback. The code is developed at Institute of Nuclear and Physical Engineering. It is necessary to carefully investigate transient states of fast neutron reactors, due to recriticality issues after accident scenarios. The code solves numerical diffusion equation for 1D problem with possible neutron source incorporation. Crank-Nicholson numerical method is used for the transient states. The investigated cases are describing behavior of PWR fuel assembly inside of spent fuel pool and with the incorporated neutron source for better illustration of thermal feedback.