Tatalaksana Penyakit Ginjal Kronik pada Anak

Penyakit ginjal kronis adalah suatu keadaan menurunnya laju filtrasi glomerolus yang bersifat tidak reversible dan terbagi dalam 5 klasifikasi sesuai dengan jumlah nefron yang masih berfungsi. Kasus initidak jarang ditemukan pada anak. Penyakit ginjal kronis pada anak dapat disebabkan penyakit kongenital, didapat, genetik, atau metabolik. Penyebab yang mendasari penyakit ginjal kronik berkaitan erat dengan usia pasien saat penyakit ginjal kronik pertama terdeteksi. The Kidney Disease Outcome Quality Initiative (K/DOQI) telah mengeluarkan pedoman klinis praktis untuk evaluasi, klasifikasi dan stratifikasi Chronic Kidney Disease (CKD)/penyakit ginjal kronis. Clinical Practice Guidelines on CKDK/DOQI tahun 2003 memuat mengenai stadium, penilaian klinis berdasarkan hasil laboratorium, dan pembagian tingkatan risiko akibat penurunan fungsi ginjal. Pedoman ini disusun untuk memudahkan penerimaan secara universal dan dapat memberikan penanganan yang optimal bagi penderita penyakit ginjal kronis. Tujuan dari penulisan sari pustaka ini adalah untuk memperkenalkan definisi penyakit ginjal kronis serta tatalaksana menurut K/DOQI tahun 2003 dan penerapannya pada pasien anak. Prognosis pasien dengan penyakit ginjal kronis adalah bervariasi menurut stadium dan penatalaksanaan yang dilakukan. Dengandeteksi dan penatalaksanaan dini, morbiditas dan mortalitas penyakit ginjal kronis pada anak diharapkan dapat diturunkan

Note on a Micropolar Gas-Kinetic Theory

The micropolar fluid mechanics and its transport coefficients are derived from the linearized Boltzmann equation of rotating particles. In the dilute limit, as expected, transport coefficients relating to microrotation are not important, but the results are useful for the description of collisional granular flow on an inclined slope. (This paper will be published in Traffic and Granular Flow 2001 edited by Y.Sugiyama and D. E. Wolf (Springer))Comment: 15 pages, 0 figure. To be published in Traffic and Granular Flow 2001 edited by Y.Sugiyama and D. E. Wolf (Springer

The challenges of monitoring national climate policy: learning lessons from the EU

One of the most central and novel features of the new climate governance architecture emerging from the 2015 Paris Agreement is the transparency framework committing countries to provide, inter alia, regular progress reports on national pledges to address climate change. Many countries will rely on public policies to turn their pledges into action. This article focuses on the EU’s experience with monitoring national climate policies in order to understand the challenges that are likely to arise as the Paris Agreement is implemented around the world. To do so, the research employs – for the first time – comparative empirical data submitted by states to the EU’s monitoring system. Our findings reveal how the EU’s predominantly technical interpretation of four international reporting quality criteria – an approach borrowed from reporting on GHG fluxes – has constrained knowledge production and stymied debate on the performance of individual climate policies. Key obstacles to more in-depth reporting include not only political concerns over reporting burdens and costs, but also struggles over who determines the nature of climate policy monitoring, the perceived usefulness of reporting information, and the political control that policy knowledge inevitably generates. Given the post-Paris drive to achieve greater transparency, the EU’s experience offers a sobering reminder of the political and technical challenges associated with climate policy monitoring, challenges that are likely to bedevil the Paris Agreement for decades to come

Protocol for a phase 1 homeopathic drug proving trial

<p>Abstract</p> <p>Background</p> <p>This study protocol adapts the traditional homeopathic drug proving methodology to a modern clinical trial design.</p> <p>Method</p> <p>Multi-centre, randomised, double-blind, placebo-controlled phase 1 trial with 30 healthy volunteers. The study consists of a seven day run-in period, a five day intervention period and a 16 day post-intervention observation period. Subjects, investigators and the statisticians are blinded from the allocation to the study arm and from the identity of the homeopathic drug. The intervention is a highly diluted homeopathic drug (potency C12 = 10²⁴), Dose: 5 globules taken 5 times per day over a maximum period of 5 days. The placebo consists of an optically identical carrier substance (sucrose globules). Subjects document the symptoms they experience in a semi-structured online diary. The primary outcome parameter is the number of specific symptoms that characterise the intervention compared to the placebo after a period of three weeks. Secondary outcome parameters are qualitative differences in profiles of characteristic and proving symptoms and the total number of all proving symptoms. The number of symptoms will be quantitatively analysed on an intention-to-treat basis using ANCOVA with the subject's expectation and baseline values as covariates. Content analysis according to Mayring is adapted to suit the homeopathic qualitative analysis procedure.</p> <p>Discussion</p> <p>Homeopathic drug proving trials using the terminology of clinical trials according GCP and fulfilling current requirements for research under the current drug regulations is feasible. However, within the current regulations, homeopathic drug proving trials are classified as phase 1 trials, although their aim is not to explore the safety and pharmacological dynamics of the drug, but rather to find clinical indications according to the theory of homeopathy. To avoid bias, it is necessary that neither the subjects nor the investigators know the identity of the drug. This requires a modification to the informed consent process and blinded study materials. Because it is impossible to distinguish between adverse events and proving symptoms, both must be documented together.</p> <p>Trial registration</p> <p>ClinicalTrials.gov identifier: NCT01061229.</p

The politicisation of evaluation: constructing and contesting EU policy performance

Although systematic policy evaluation has been conducted for decades and has been growing strongly within the European Union (EU) institutions and in the member states, it remains largely underexplored in political science literatures. Extant work in political science and public policy typically focuses on elements such as agenda setting, policy shaping, decision making, or implementation rather than evaluation. Although individual pieces of research on evaluation in the EU have started to emerge, most often regarding policy “effectiveness” (one criterion among many in evaluation), a more structured approach is currently missing. This special issue aims to address this gap in political science by focusing on four key focal points: evaluation institutions (including rules and cultures), evaluation actors and interests (including competencies, power, roles and tasks), evaluation design (including research methods and theories, and their impact on policy design and legislation), and finally, evaluation purpose and use (including the relationships between discourse and scientific evidence, political attitudes and strategic use). The special issue considers how each of these elements contributes to an evolving governance system in the EU, where evaluation is playing an increasingly important role in decision making

Research on nonlinear optical materials: an assessment

The seven papers making up this assessment are based on the Workshop on Nonlinear Optical Materials held in April 1986

On modified simple reacting spheres kinetic model for chemically reactive gases

Versão dos autores para esta publicação.We consider the modiffed simple reacting spheres (MSRS) kinetic model that, in addition to the conservation of energy and momentum, also preserves the angular momentum in the collisional processes. In contrast to the line-of-center models or chemical reactive models considered in [1], in the MSRS (SRS) kinetic models, the microscopic reversibility (detailed balance) can be easily shown to be satisfied, and thus all mathematical aspects of the model can be fully justi ed. In the MSRS model, the molecules behave as if they were single mass points with two internal states. Collisions may alter the internal states of the molecules, and this occurs when the kinetic energy associated with the reactive motion exceeds the activation energy. Reactive and non-reactive collision events are considered to be hard spheres-like. We consider a four component mixture A, B, A*, B*, in which the chemical reactions are of the type A + B = A* + B*, with A* and B* being distinct species from A and B. We provide fundamental physical and mathematical properties of the MSRS model, concerning the consistency of the model, the entropy inequality for the reactive system, the characterization of the equilibrium solutions, the macroscopic setting of the model and the spatially homogeneous evolution. Moreover, we show that the MSRS kinetic model reduces to the previously considered SRS model (e.g., [2], [3]) if the reduced masses of the reacting pairs are the same before and after collisions, and state in the Appendix the more important properties of the SRS system.Fundação para a Ciência e a Tecnologi

Neoliberalism and the origins of public management

There is a rich literature on the emergence of new public management in the 1980s yet surprisingly little about the historical and social lineages of this movement. The scholarship on public management generally suggests that it was born out of the neoliberal critique of the state. The public sector would have thus borrowed corporate practices concerned with performance in order to instil market-like competition and make efficiency gains. This article challenges this reading by showing that concerns with performance management emerged instead from new planning technologies developed in the US military sector. I argue that these planning practices, initially developed at the RAND corporation, would radically transform governance by changing the way in which decision makers consider data about performance and use it to develop strategies or policies. I then explore the impact of this new approach on both corporate and public governance. I show how these ideas were translated for business studies and public administration in order to radically transform both fields and ‘make them more scientific’. As I show, this process contributed directly to the rise of what became called public management and provided new planning tools that radically transformed how we think about governance