Management of Pain in Children with Burns

Burn injuries are common in children under 10 years of age. Thermal injury is the most common mechanism of injury and scalds account for >60% of such injuries. All children with burns will experience pain, regardless of the cause, size, or burn depth. Undertreated pain can result in noncompliance with treatment and, consequently, prolonged healing. It is acknowledged that the monitoring and reporting of pain in children with burns has generally been poor. Due to the adverse physiological and emotional effects secondary to pain, adequate pain control is an integral and requisite component in the management of children with burns. A multidisciplinary approach is frequently necessary to achieve a robust pain relief. Key to successful treatment is the continuous and accurate assessment of pain and the response to therapy. This clinical review article discusses the essential aspects of the pathophysiology of burns in children provides an overview of pain assessment, the salient principles in managing pain, and the essential pharmacodynamics of commonly used drugs in children with burn injuries. Both pharmacological and nonpharmacological treatment options are discussed, although a detailed review of the latter is beyond the scope and remit of this article

WASP-29b: A Saturn-sized transiting exoplanet

We report the discovery of a Saturn-sized planet transiting a V = 11.3, K4 dwarf star every 3.9 d. WASP-29b has a mass of 0.24+/-0.02 M_Jup and a radius of 0.79+/-0.05 R_Jup, making it the smallest planet so far discovered by the WASP survey, and the exoplanet most similar in mass and radius to Saturn. The host star WASP-29 has an above-Solar metallicity and fits a possible correlation for Saturn-mass planets such that planets with higher-metallicity host stars have higher core masses and thus smaller radii.Comment: 6 pages, submitted to ApJ

Penyebaran Dan Pembauran Inovasi Gizi Melalui Kegiatan Upgk Di Pedesaan Jawa Barat

Kegiatan Usaha Perbaikan Gizi Keluarga (UPGK) di Pos Pelayanan Terpadu (Posyandu) dapat dipandang sebagai upaya pembaruan perilaku (konsumsi) yang bertujuan agar lambat laun ibu-ibbu anak Balita atas bantuan para kader memiliki kemampuan mandiri dalam memelihara dan meningkatkan derajat kesehatan dan gizi anak Balita serta keluarga mereka. Upaya ini akan mempunyai arti positif jika pada sistem sosial masyarakat bertumbuh dan berkembang proses belajar dan pembaruan perilaku yang mengarah pada tindakan masing-masing keluarga untuk hidup lebih sehat dibanding keadaan sebelumnya. Pencapaian keadaan seperti ini tidak lepas dari fungsi dan peranan para pembina serta kader yang terlibat dalam kegiatan tersebut selaku sumber dan penyalur pesan-pesan inovasi gizi. Kenyataan menunjukkan bahwa pelaksanaan program belum mencapai sasaran sebagaimana yang diharapkan. Dalam tulisan ini dikemukakan beberapa faktor penyebab ketidakberhasilan pencapaian sasaran program UPGK, khususnya di Kabupaten Subang, Jawa Barat, dimana identifikasi masalah dilakukan. kemampuan ekonomi keluarga dan tingkat pendidikan ibu anak Balita yang relatif rendah menjadi kendala utama yang mempengaruhi kadar pengetahuan gizi mereka. Para kader dihadapkan pada masalah kurang mengikuti penataran, cakupan wilayah kerja yang terlalu luas, ketidakjelasan keterikatan mereka dalam kegiatan, dan sistem imbalan, suasana yang kurang memadai di Posyandu sebagai tempat penyuluhan gizi bagi ibu-ibu peserta kegiatan UPGK, keterbatasan kesempatan, dana dan sarana untuk kegiatan kunjungan rumah. Petugas gizi selaku pembina kegiatan di Posyandu menghadapi keterbatasan sarana transportasi, disamping tugas rutin yang cukup banyak menyita perhatian dan waktu

Anemi Gizi Pada Wanita Hamil Di Desa Bendungan Kabupaten Bogor

Penyelidikan anemi gizi pada wanita hamil ini meliputi penyedilikan makanan dan sosial ekonomi, pemeriksaan klinis dan penentuan darah. Tidak terdapat banyak variasi dalam macam bahan makanan sehari-hari dan cara memasaknya. Sebanyak 80% dari jumlah kalori didapat dari beras dan 6-7% dari jumlah kalori didapat dari ikan kering asin. Jika dibandingkan dengan daftar kecukupan zat gizi untuk Indonesia terdapat kekurangan dalam jumlah yang dikonsumsi.Tidak semua kadar hemoglobin rendah berkolerasi dengan protein serum rendah, besi serum rendah atau hematokrit rendah. Prosentase rata-rata kejenuhan transferrin terdapat pada tingkat perbatasan.Hasil penyelidikan di desa ini memberikan gambaran adanya prevalensi anemi gizi ringan dan sedang 60 sampai 85%, baik pada wanita hamil maupun tidak hamil

Realism, Objectivity, and Evaluation

I discuss Benacerraf's epistemological challenge for realism about areas like mathematics, metalogic, and modality, and describe the pluralist response to it. I explain why normative pluralism is peculiarly unsatisfactory, and use this explanation to formulate a radicalization of Moore's Open Question Argument. According to the argument, the facts -- even the normative facts -- fail to settle the practical questions at the center of our normative lives. One lesson is that the concepts of realism and objectivity, which are widely identified, are actually in tension

Setting targets for HIV/AIDS-What lessons can be learned from other disease control programmes?

Our analysis of experience from programmes targeting malaria, leprosy and TB shows the importance of drawing broadly on research and implementation expertise, and civil society more broadly, when setting targets for HIV control. The engagement of stakeholders from the highest burden settings, including affected populations, is crucial, to ensure that disease control efforts uphold human rights and tackle HIV-related stigma and discrimination. An appropriate balance is needed between ambitious, galvanising global targets that drive funding and political/public engagement, and targets that reflect the complexities and local epidemiological variations in disease profile. Ethical issues and unintended consequences need to be considered when setting targets—particularly around local effects and opportunity costs of having foregone other areas of disease control and public health. Intermediate and adaptable targets are needed that allow for course corrections to programmes. Overly burdensome reporting requirements for individual local programmes and countries should be avoided, as well as potential for overlapping and sometimes conflicting targets both within and across vertical disease programmes. Process targets should be distinguished from outcome targets, which should be measurable and based on high-quality data. Retention of expert healthcare worker skills and specialist services is vital, while moving towards integrated health systems if effective disease control programmes are to be maintained. Target development should seek areas of programme delivery where an opportunity to codevelop targets and integrate services exists. Global efforts to move to universal health coverage (UHC), for example, could be factored in when developing targets. Sustaining investment and continuing political interest in the end phase of any elimination or eradication strategy, once incidence and prevalence are low, are critical to achieve success. Equity- and access-based service delivery targets become increasingly important as the elimination strategy nears its end and should be factored into planning. Achieving disease elimination and/or eradication is only possible with sufficient investment in research to develop new prevention tools such as vaccines, point-of-care diagnostics, and treatments to counteract the effects of increasing drug resistance and the challenging latency period of diseases; public health infrastructure upgrades that address wider determinants of health; and health and surveillance systems that allow for equitable delivery and access to services

Qatar-1b: a hot Jupiter orbiting a metal-rich K dwarf star

We report the discovery and initial characterisation of Qatar-1b, a hot Jupiter orbiting a metal-rich K dwarf star, the first planet discovered by the Alsubai Project exoplanet transit survey. We describe the strategy used to select candidate transiting planets from photometry generated by the Alsubai Project instrument. We examine the rate of astrophysical and other false positives found during the spectroscopic reconnaissance of the initial batch of candidates. A simultaneous fit to the follow-up radial velocities and photometry of Qatar-1b yield a planetary mass of 1.09+/-0.08 Mjup and a radius of 1.16+/-0.05 Rjup. The orbital period and separation are 1.420033 days and 0.0234 AU for an orbit assumed to be circular. The stellar density, effective temperature and rotation rate indicate an age greater than 4 Gyr for the system.Comment: 8 pages, 5 figures, submitted to Monthly Notices of the Royal Astronomical Societ

WASP-30b: a 61 Mjup brown dwarf transiting a V=12, F8 star

We report the discovery of a 61-Jupiter-mass brown dwarf, which transits its F8V host star, WASP-30, every 4.16 days. From a range of age indicators we estimate the system age to be 1-2 Gyr. We derive a radius (0.89 +/- 0.02 RJup) for the companion that is consistent with that predicted (0.914 RJup) by a model of a 1-Gyr-old, non-irradiated brown dwarf with a dusty atmosphere. The location of WASP-30b in the minimum of the mass-radius relation is consistent with the quantitative prediction of Chabrier & Baraffe (2000), thus confirming the theory.Comment: As accepted for publication in ApJL (6 pages, 2 figures, 3 tables