ObjectiveTo identify aetiologies of childhood community-acquired pneumonia (CAP) based on a comprehensive diagnostic approach.Design‘Partnerships for Enhanced Engagement in Research-Pneumonia in Paediatrics (PEER-PePPeS)’ study was an observational prospective cohort study conducted from July 2017 to September 2019.SettingGovernment referral teaching hospitals and satellite sites in three cities in Indonesia: Semarang, Yogyakarta and Tangerang.ParticipantsHospitalised children aged 2–59 months who met the criteria for pneumonia were eligible. Children were excluded if they had been hospitalised for >24 hours; had malignancy or history of malignancy; a history of long-term (>2 months) steroid therapy, or conditions that might interfere with compliance with study procedures.Main outcome(s) measure(s)Causative bacterial, viral or mixed pathogen(s) for pneumonia were determined using microbiological, molecular and serological tests from routinely collected specimens (blood, sputum and nasopharyngeal swabs). We applied a previously published algorithm (PEER-PePPeS rules) to determine the causative pathogen(s).Results188 subjects were enrolled. Based on our algorithm, 48 (25.5%) had a bacterial infection, 31 (16.5%) had a viral infection, 76 (40.4%) had mixed bacterial and viral infections, and 33 (17.6%) were unable to be classified. The five most common causative pathogens identified were Haemophilus influenzae non-type B (N=73, 38.8%), respiratory syncytial virus (RSV) (N=51, 27.1%), Klebsiella pneumoniae (N=43, 22.9%), Streptococcus pneumoniae (N=29, 15.4%) and Influenza virus (N=25, 13.3%). RSV and influenza virus diagnoses were highly associated with Indonesia’s rainy season (November–March). The PCR assays on induced sputum (IS) specimens captured most of the pathogens identified in this study.ConclusionsOur study found that H. influenzae non-type B and RSV were the most frequently identified pathogens causing hospitalised CAP among Indonesian children aged 2–59 months old. Our study also highlights the importance of PCR for diagnosis and by extension, appropriate use of antimicrobials.Trail registration numberNCT03366454

The purpose of this study was to determine how the level of numeracy literacy skills of students based on cognitive style, namely reflective-impulsive. The method used in this study was a quantitative research with a survey method. The object of the study or population was the 2018 PGSD Bone student class using the MFFT test to see cognitive style and written test related to numeracy literacy skills. The result of the research and discussion showed that the numeracy literacy ability of students was still not maximal, namely 34.7%. Judging from the cognitive style, 55% entered into reflective cognitive style and 22.08% entered an impulsive style. The reflective cognitive style in solving the questions takes a long time, but the results obtained to be correct or accurate, while the impulsive cognitive style is said to rush in answering and tend to be wrong. Another finding is that there are reflective cognitive style with a long time used but the answers are also many wrong and about 10% impulsive style answers correct in a short time. To improve numeracy literacy skills, a learning strategy or model is needed in accordance with the characteristics of students to develop creative, critical, high-order thinking by integrating 21st century

Perguruan tinggi bukan saja menjadi sarana transformasi pengetahuan tetapi juga menjadi dinamisator masyarakat. Perguruan tinggi keagamaan Islam yang tersebar dari Banda Aceh sampai ke Jayapura sekaligus menjadi sarana pengembangan masyarakat. Pelbagai bentuk program yang dijalankan dalam rangka menunjukkan bentuk lebih teknis dari moderasi Islam. Pengembangan keilmuan termasuk pembukaan jurusan-jurusan yang variatif memberikan keleluasaan mahasiswa untuk belajar ilmu secara teknis. Makalah ini menunjukkan bahwa perguruan tinggi keagamaan Islam turut mengembangkan program-program yang tidak berfokus pada perguruan tinggi. Namun pada saat yang sama terdapat tantangan yang perlu diatasi sehingga pengembangan pendidikan tinggi keagamaan Islam tidak hanya pada lembaga negeri tetapi juga swasta.

BackgroundDiscrimination of bacterial and viral etiologies of childhood community-acquired pneumonia (CAP) is often challenging. Unnecessary antibiotic administration exposes patients to undue risks and may engender antimicrobial resistance. This study aimed to develop a prediction model using epidemiological, clinical and laboratory data to differentiate between bacterial and viral CAP.MethodsData from 155 children with confirmed bacterial or mixed bacterial and viral infection (N = 124) and viral infection (N = 31) were derived from a comprehensive assessment of causative pathogens [Partnerships for Enhanced Engagement in Research-Pneumonia in Pediatrics (PEER-PePPeS)] conducted in Indonesia. Epidemiologic, clinical and biomarker profiles (hematology and inflammatory markers) were compared between groups. The area under the receiver operating characteristic curve (AUROC) for varying biomarker levels was used to characterize performance and determine cut-off values for discrimination of bacterial and mixed CAP versus viral CAP. Diagnostic predictors of bacterial and mixed CAP were assessed by multivariate logistic regression.ResultsDiarrhea was more frequently reported in bacterial and mixed CAP, while viral infections more frequently occurred during Indonesia’s rainy season. White blood cell counts (WBC), absolute neutrophil counts (ANC), neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), and procalcitonin (PCT) were significantly higher in bacterial and mixed cases. After adjusting for covariates, the following were the most important predictors of bacterial or mixed CAP: rainy season (aOR 0.26; 95% CI 0.08–0.90; p = 0.033), CRP ≥5.70 mg/L (aOR 4.71; 95% CI 1.18–18.74; p = 0.028), and presence of fever (aOR 5.26; 95% CI 1.07–25.91; p = 0.041). The model assessed had a low R-squared (Nagelkerke R2 = 0.490) but good calibration (p = 0.610 for Hosmer Lemeshow test). The combination of CRP and fever had moderate predictive value with sensitivity and specificity of 62.28 and 65.52%, respectively.ConclusionCombining clinical and laboratory profiles is potentially valuable for discriminating bacterial and mixed from viral pediatric CAP and may guide antibiotic use. Further studies with a larger sample size should be performed to validate this model.

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