Friday, November 4, 2011

[sehat] Digest Number 16418

Messages In This Digest (25 Messages)

1a.
Re: CLOSED == > Ask : hukuman yg mendidik buat anak 5 thn From: Esti Handayani
2a.
Re: Toilet Training Sejak Umur Brp? From: Reniasti S
2b.
Re: Toilet Training Sejak Umur Brp? From: pritha kurniasih
2c.
Re: Toilet Training Sejak Umur Brp? From: Bunda Ririn
2d.
Re: Toilet Training Sejak Umur Brp? From: Inta
2e.
Re: Toilet Training Sejak Umur Brp? From: Baby Febra
2f.
Re: Toilet Training Sejak Umur Brp? From: aries3_dee84@yahoo.com
3a.
Kesepakatan vs Hukuman From: Sam
3b.
Re: Kesepakatan vs Hukuman From: yulianto
3c.
Re: Kesepakatan vs Hukuman From: feby eboy
3d.
Re: Kesepakatan vs Hukuman From: aina
3e.
Re: Kesepakatan vs Hukuman From: /ghz
3f.
Re: Kesepakatan vs Hukuman From: feby eboy
4.
Re: mendidik anak, was :hukuman yg mendidik buat anak 5 thn From: aina
5.
WTA: Recommended dokter THT di Jkt From: zulfi novriandi
6a.
seberapa penting kunjungan pertama setelah baby lahir? belum hep B d From: Qiqie Mama Nayla
6b.
Re: seberapa penting kunjungan pertama setelah baby lahir? belum hep From: wulan
6c.
Bls: [sehat] seberapa penting kunjungan pertama setelah baby lahir? From: Anindita Isa
7.
(CDC) Related Antibiotic Prescribing for Persons Aged ≤ 14 Yea From: /ghz
8.1.
Re: Ask : hukuman yg mendidik buat anak 5 thn From: anindhita
8.2.
Re: Ask : hukuman yg mendidik buat anak 5 thn From: feby eboy
8.3.
Re: Ask : hukuman yg mendidik buat anak 5 thn From: Bunda Farhan & Athar
9a.
demam 3hr tapi anak masih aktif From: Baby Febra
9b.
Re: demam 3hr tapi anak masih aktif From: gendi
10.
Bls: [sehat] demam 3hr tapi anak masih aktif From: 'Ita' Elisabeth Dianita

Messages

1a.

Re: CLOSED == > Ask : hukuman yg mendidik buat anak 5 thn

Posted by: "Esti Handayani" ehandayani@gmail.com   esti_fgj

Thu Nov 3, 2011 6:43 pm (PDT)



Mba-mba,

Silakan bertanya dan berdiskusi menggunakan thread baru. Tujuan thread ini di-closed memang supaya yg bagian melebar itu gak semakin panjang. Bukan demikian, Mods?

Esti



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2a.

Re: Toilet Training Sejak Umur Brp?

Posted by: "Reniasti S" reniasti_simatupang@yahoo.com   reniasti_simatupang

Thu Nov 3, 2011 6:45 pm (PDT)



Setuju banget mba Inta.

Emang harus konsisten.
Susahnya being konsisten itu ya...

regards,
Mami clara n chia

2b.

Re: Toilet Training Sejak Umur Brp?

Posted by: "pritha kurniasih" pritha.saja@gmail.com   aphrodite_flyhigh

Thu Nov 3, 2011 7:23 pm (PDT)



ikutan,,

Asha udah 25 bulan niy,,klo siang udah berhasil TT-nya,,bobok siangpun
jarang bgd ngompol,,tp yg malem,,gmn y moms?masi setia pk pampers,,huhu..
soalnya pernah sekali,,dy gak mw d pampers,,akhirnya sukses ngompol
2x,,selain itu sy paksa bgn dan pipis d ember yg udah sy kasi karbol,,biar
ndak pesing,,kamar mandinya d bwh soalnya,,
gmn y membuat dy kebangun sendiri klo kbelet pipis?soalnya pengalaman,,dy
pipis smbl merem biarpun jongkok,,dipakein celana jg smbl merem,,kasian
jadinya..

Regard,,
Pritha-mamaAsha

[Non-text portions of this message have been removed]

2c.

Re: Toilet Training Sejak Umur Brp?

Posted by: "Bunda Ririn" bunda.ririnungu@gmail.com   ririnungu

Thu Nov 3, 2011 7:23 pm (PDT)



Mba inta,

Anak mba inta kan udah bisa pup sendiri di kloset, kalau pipis nya gmn mba?
sudah bisa minta sendirikah?

Share yah... anakku (23bln) juga skrg udah mulai pup di kloset. jadi dia
bilang setiap mau pup dan minta ke kloset. Tapi waktu mau aku terapin
toilet training buat pipis, masih susah. Waktu itu pernah aku coba lepas
pampers, ternyata dia pipis 1 jam sekali bahkan kurang dari sejam. Akhirnya
anaknya sendiri kesel dan capek, akhirnya minta pake pampers. Apa dia belum
siap yah untuk toilet training? atau ada saran lain?

regards,
ririn

2011/11/4 Inta <dini.maesarinta@gmail.com>

> **
>
>
> Mba Reniasti,
>
> Sebenarnya tips yang paling nendang tapi susah dilaksanakan buat TT ini
> cuma satu kok: Konsisten.
>
> Contoh aja yah:
> Bita mulai saya tatur pup sejak umur 5 bulan. Karena saya dan pengasuhnya
> kompakan konsisten, sejak 7 bulan bita selalu pup ditoilet (dikloset). Gak
> pernah pup di pampers. Dan sejak itu juga jadwal pup teratur, bita hampir
> gak pernah konstipasi. Sejak itu juga bita gak pernah mau pup dipampers.
>
> Naaah untuk Alluna saya kurang konsisten, walaupun udah mulai dari sekitar
> 6 bulanan, tapi on off, karena yang dirumah agak susah nerapin si konsisten
> ini :D. Jadi aja sampe sekarang jadwal pupnya berubah rubah terus. Masih
> sering kebablasan pup di pampers walaupun sesekali masih pup di kloset.
>
> Jadi memang cuma konsisten yang bikin sukses menerapkan TT. Yang jelas
> kalau saat TT anak kebablasan pup/pipis gak ditoilet wajarlaah tapi jangan
> pernah berhenti taturnya.
>
> Gud luck yah ibu ibu.
>
> Cheers, Inta
> @Intamaesarinta
> terkirim dari henponkuh
>
>

[Non-text portions of this message have been removed]

2d.

Re: Toilet Training Sejak Umur Brp?

Posted by: "Inta" dini.maesarinta@gmail.com

Thu Nov 3, 2011 7:33 pm (PDT)



Mba Ririn,

Kalau Bita (4y) saya TT pipis nya sejak 20M. Sekitar 4-6 bulanan lah prosesnya untuk bener2 bebas pampers termasuk berpergian yang jaraknya cukup jauh waktu itu. Bita udah mulai minta pipis ditoilet sendiri sejak 24M.

Cheers, Inta
@Intamaesarinta
terkirim dari henponkuh

2e.

Re: Toilet Training Sejak Umur Brp?

Posted by: "Baby Febra" babynajla@gmail.com

Thu Nov 3, 2011 7:39 pm (PDT)



Kayaknya ga ada patokan khusus ya umur brp harus mulai TT mom.

Kalo menurutku sih makin cepet makin bagus hehe. Anakku sendiri baru bbrp minggu ini 'lulus' TT, umurnya 22bln.
Kalo aq sih caranya cm dikasih tau terus aja 'kakak udh gede ga bole ngompol lg ya, malu kan' lama2 anaknya ngerti sih. Kadang disentil dikit pantatnya kalo masih ngompol (tp ga sakit kok).
Trus rajin2 pakein training pants jadi dia geli dan ngerasa ga nyaman sendiri kalo pipis di celana. Awalnya emg 'danau buatan' dimana2 tp lama2 makin berkurang kok.
Anakku sendiri masih kadang kelepasan ngompol jg (tapi jarang bgt). Selebihnya udh bilang dan minta pipis dan poop di toilet. Kalo poop di toilet udh dari umur 6bln-an pas mulai bisa duduk, tp pipis baru2 aja mba. Emg menurut pengalamanku dan bbrp temen2ku sih emg lebih mudah kalo udh bisa poop di toilet dulu, selanjutnya tinggal pas pipisnya.

Semoga berhasil.
Mohon maaf kalo ada yg kurang berkenan. Sekedar sharing pengalaman aja.

Salam,

Baby
Mama Najla (22mos)
Bªbў
MamaNajlita
Šent from ♏ỳ βlªςќвεrrў™
2f.

Re: Toilet Training Sejak Umur Brp?

Posted by: "aries3_dee84@yahoo.com" aries3_dee84@yahoo.com   aries3_dee84

Thu Nov 3, 2011 7:48 pm (PDT)



Ikut sharing ya, Akhtar mulai toilet training ga pup di diapers dr usia 9 bulan, pipis di kamar mandi mulai usia 12 bulan, bener2 lepas diapers sepanjang hari saat usia 18 bulan, intinya mengajarkan anak untuk bisa toilet training adalah konsisten dan kerjasama, kita kudu rela tuh bangun malam2 gotong2 si anak ke ke kamar mandi saat di udah mulai bilang "bunda pipis", atau malah alarm tiap dua jam bunyi waktunya gotong ke kamar mandi untuk pipis, langsung gotong ke kamar mandi, kdg gantian sama suami untuk ajak pipis ke kamar mandi, dan sampai sekarang udah dua tahun bener2 no diapers, dan selalu bilang klo mau pipis atau pup.


Rgds
Dian-bunda Akhtar

Sent from my AXIS Worry Free BlackBerry� smartphone
3a.

Kesepakatan vs Hukuman

Posted by: "Sam" samsulna@gmail.com   samsul_na

Thu Nov 3, 2011 6:47 pm (PDT)



Yoi, saya bikinin yg baru, silakan dilanjut ... SOL

Thanks,
@samsulna

----- Original Message -----
From: "Esti Handayani" <ehandayani@gmail.com>
To: <sehat@yahoogroups.com>
Sent: Friday, November 04, 2011 8:43 AM
Subject: Re: [sehat] CLOSED == > Ask : hukuman yg mendidik buat anak 5 thn

>
> Silakan bertanya dan berdiskusi menggunakan thread baru. Tujuan thread ini
> di-closed memang supaya yg bagian melebar itu gak semakin panjang. Bukan
> demikian, Mods?

3b.

Re: Kesepakatan vs Hukuman

Posted by: "yulianto" yuliantosk@gmail.com   anto_sk

Thu Nov 3, 2011 7:25 pm (PDT)



dear all,
wah topik parenting memang menarik :) ikutan belajar.

di web ada highlights parenting, tidak mencakup semua namun mungkin bs
jadi bahan bacaan atau bisa diupdate bila ada info terbaru
http://milissehat.web.id/?cat=3&paged=53
<http://milissehat.web.id/?cat=3&paged=53>

happy parenting,
-anto-

3c.

Re: Kesepakatan vs Hukuman

Posted by: "feby eboy" fetriplef@gmail.com

Thu Nov 3, 2011 8:05 pm (PDT)



Makasih om mod buat threadnya..

Mo nanya skalian.. Kalo dari email2 seblumnya pemikiran saya adalah
"kesepakatan "berlaku utk kesalahan kecil kalo untuk kesalahan besar
bagaimana? Apakah " kesepakatan" itu juga berlaku?

Thanks
Feby

[Non-text portions of this message have been removed]

3d.

Re: Kesepakatan vs Hukuman

Posted by: "aina" aina.anwar@yahoo.com   aina.anwar

Thu Nov 3, 2011 8:24 pm (PDT)



Kesalahn besar contohnya apa mom feby?

merci beaucoup
wassalamu'alaikum wr wb,

aina f.

3e.

Re: Kesepakatan vs Hukuman

Posted by: "/ghz" ghozan10032005@gmail.com

Thu Nov 3, 2011 8:28 pm (PDT)



numpang tanya

kesepakatan.
tentu bukan sepakat utk tidak sepakat.
artinya : cukup anak yg bersepakat, orang tuanya emoh/ sianak 'dipaksa'
utk bersepakat dengan orang tuanya.
idealnya tentu kesepakatan deal antara anak dan orang tuanya.

contoh kecil : nak, kalau minum ndak baik kalau sambil berdiri, lihat
tuh nak kambing minumnya sambil berdiri.
jawab si anak : iya pap..mam..i agree.
suatu ketika anak lihat,papanya habis pulang
kantor, ceritanya habis kena macet haus bangetttttt....
kebetulan minuman sudah ada di meja.......dah
melambai..lambai......belum sempet ganti baju.....secepat kilat
.....glekek.....hmmmm....alhamdulillah........segerrrrrrrrr.
tp lupa si papa ini minumnya sambil berdiri.
si anak lihat lantas nyelethuk....papa kaya kambing.

kira2 respon papanya gimana yah?

kembali ke subject.
akankan kita orang tua mau menghukum dirinya sendiri mana kala
kesepakatan itu kita langgar?

terkadang saya heran dengan diri saya sendiri.
menuntut anak disiplin bangun pagi tp kitanya sendiri bangunnya matahari
dan nonggol.

eee.....maaf..oot ga sih.

salamku
bapakeghozan

3f.

Re: Kesepakatan vs Hukuman

Posted by: "feby eboy" fetriplef@gmail.com

Thu Nov 3, 2011 8:28 pm (PDT)



Berantem atau mengambil barang temannya.. Karna itu yg bikin sy menghukum
fathan tanpa menunggu 3 kali warning :-(

[Non-text portions of this message have been removed]

4.

Re: mendidik anak, was :hukuman yg mendidik buat anak 5 thn

Posted by: "aina" aina.anwar@yahoo.com   aina.anwar

Thu Nov 3, 2011 6:47 pm (PDT)



Dear all,
Kl sdh spt ponakan mba kronic...apa yg hrs kita sbg ortu lakukan yah.??

merci beaucoup
wassalamu'alaikum wr wb,

aina f.

5.

WTA: Recommended dokter THT di Jkt

Posted by: "zulfi novriandi" zulfi.sehat@gmail.com   zulfi_novriandi

Thu Nov 3, 2011 7:02 pm (PDT)



Dear all,

Mohon masukannya untuk dokter THT yg recommended di Jakarta. Keluhannya
udah beberapa bulan ini telinga saya berdenging terus (Tinnitus), sudah
konsultasi beberapa kali dengan beberapa dokter THT ko nga beres-beres.
Jangankan beres, penyebab berdengingnya aja nga jelas/blm ketemu sampai
sekarang.

So jika ada dokter THT yg bisa direkomendasikan mohon di japri ke saya

Thanks in advance,
Z

[Non-text portions of this message have been removed]

6a.

seberapa penting kunjungan pertama setelah baby lahir? belum hep B d

Posted by: "Qiqie Mama Nayla" deswita.nashwa@gmail.com   rizkie3

Thu Nov 3, 2011 7:15 pm (PDT)



dear SPs n docs..

anak saya kemarin pulang paksa dari RS setelah lahir senin lalu..
dsanya tidak mau mengimunisasi hep B dan polio dengan alasan baby
kuning dan sebelumnya saya menolak terapi sinar dan tes bilirubin
ulang.. (BR 10,8 usia 48 jam)

bagaimana kalau saya ingin langsung ganti dokter dan tidak kontrol
dengan dokter yang sama setelah pulang dari RS? apakah tidak ada
masalah? saya ingin sekalian imun hepB, polio dan BCG (tetapi
kebanyakan dokter disini BCG setelah 1 bulan)

salam,
qiqie

6b.

Re: seberapa penting kunjungan pertama setelah baby lahir? belum hep

Posted by: "wulan" wulan.wuls@gmail.com   wulanokey

Thu Nov 3, 2011 7:19 pm (PDT)



Ga ada masalah mba. Yg penting mintakan medical report anak mba.

Good luck!

Rgds,
- Wulan -
@wulsnih

6c.

Bls: [sehat] seberapa penting kunjungan pertama setelah baby lahir?

Posted by: "Anindita Isa" mamahararya@yahoo.co.id   anind3x

Thu Nov 3, 2011 7:42 pm (PDT)



Ga ada masalah utk pindah dsa Mbak...
saya pun kemarin begitu.
jgn lupa medical record nya yah Mbak
-anind-

[Non-text portions of this message have been removed]

7.

(CDC) Related Antibiotic Prescribing for Persons Aged ≤ 14 Yea

Posted by: "/ghz" ghozan10032005@gmail.com

Thu Nov 3, 2011 7:34 pm (PDT)





fyi

-------- Original Message --------
Subject: Centers for Disease Control and Prevention (CDC) Kids' Health
E-Newsletter Update
Date: Thu, 03 Nov 2011 13:03:39 -0500
From: Centers for Disease Control & Prevention
<cdc@service.govdelivery.com>
Reply-To: Centers for Disease Control & Prevention
<cdc@service.govdelivery.com>
To: ghozansehat@yahoo.com.sg

Kids Health E-Newsletter
*September - October 2011*

Kids' Health E-Newsletter

New from CDC

*Office-Related Antibiotic Prescribing for Persons Aged ≤ 14 Years -
United States, 1993-1994 to 2007-2008*
<http://links.govdelivery.com:80/track?type=click&enid=bWFpbGluZ2lkPTE0OTMzNDMmbWVzc2FnZWlkPVBSRC1CVUwtMTQ5MzM0MyZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2ODY3MTcmZW1haWxpZD1naG96YW5zZWhhdEB5YWhvby5jb20uc2cmdXNlcmlkPWdob3phbnNlaGF0QHlhaG9vLmNvbS5zZyZmbD0mZXh0cmE9TXVsdGl2YXJpYXRlSWQ9JiYm&&&114&&&http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a1.htm?source=govdelivery>

The findings in this report show an overall decrease in both
population-based and visit-based antibiotic prescribing rates for
persons aged ≤14 years in the United States from 1993-1994 to 2007-2008.

Office-Related Antibiotic Prescribing for Persons Aged ≤14 Years ---
United States, 1993--1994 to 2007--2008

/

Weekly

/*September 2, 2011 / 60(34);1153-1156*

In 2003, the Institute of Medicine identified antibiotic resistance as a
key microbial threat to health in the United States and recommended
promoting appropriate antibiotic use as an important strategy to address
this threat (/1/). Antibiotic use contributes to development of
antibiotic resistance on both the individual and country level (/2/). To
examine trends in pediatric antibiotic prescribing in physician offices,
CDC analyzed data from the National Ambulatory Medical Care Survey
(NAMCS) for the period 1993--1994 to 2007--2008. This report summarizes
the results of that analysis, which found that antibiotic prescribing
rates for persons aged ≤14 years who had visited physician offices
decreased 24% from 300 antibiotic courses per 1,000 office visits in
1993--1994 to 229 antibiotic courses per 1,000 office visits in
2007--2008. Among the five acute respiratory infections (ARIs) examined,
antibiotic prescribing rates decreased 26% for pharyngitis and 19% for
nonspecific upper respiratory infection (common cold); prescribing rates
for otitis media, bronchitis, and sinusitis did not change
significantly. Although the overall antibiotic prescribing rate for
persons aged ≤14 years has decreased, the rate remains inappropriately
high. Further efforts are needed to decrease inappropriate antibiotic
prescribing for persons aged ≤14 years.

NAMCS is a national probability sample survey of visits to nonfederal,
office-based physicians conducted annually by CDC. NAMCS samples visits
during randomly assigned 1-week reporting periods throughout the year
and collects patient demographic information, diagnostic codes for up to
three diagnoses, and prescription information from the medical record.
Diagnoses of the five ARIs, most episodes of which do not require
antibiotic treatment, were identified using the following /International
Classification of Diseases, Ninth Revision, Clinical Modification/ codes
for the primary diagnosis: 381.0, 381.4, 382.0, 382.4, 382.9 (otitis
media); 466.0, 490 (bronchitis); 462, 463 (pharyngitis); 461, 473
(sinusitis); and 460, 465 (nonspecific upper respiratory infection
[common cold]). Details of NAMCS methodology have been described
previously.* To quantify and assess antibiotic prescribing practices,
the first five drug prescriptions recorded for each visit were examined,
and the number of antibiotic prescriptions counted. Data were weighted
to produce national estimates, and combined in 2-year periods to improve
the reliability of estimates.

The population-based antibiotic prescription rate was defined as the
average annual number of antibiotic prescriptions recorded for persons
aged ≤14 years during the 2-year period, divided by the population aged
≤14 years during the same period. Population denominators were the
average of the Census Bureau's postcensal estimates of the civilian,
noninstitutionalized population of the United States for each July
during the 2-year period (/3/). The visit-based antibiotic prescription
rate was defined as the average annual number of antibiotic
prescriptions recorded for persons aged ≤14 years during the 2-year
period, divided by the average annual number of physician office visits
by persons in that age group during the same period. In addition, an
average annual office visit rate, regardless of antibiotic prescribing,
was calculated for patients aged ≤14 years. Significance of trends (at
p<0.05) was tested by assuming a linear trend in weighted least-squares
regression analysis. The two-tailed t-test was used to compare
proportions (p<0.05 level of significance).

The number of participating physicians and average annual response rates
for each 2-year period of the study ranged from 2,500 to 3,500 and from
62% to 72%, respectively. The number of completed patient record forms
for patients aged ≤14 years ranged from 6,500 to 9,400, and the number
of these forms showing an antibiotic prescribed ranged from 1,300 to
2,500 for each 2-year period.

From 1993--1994 to 2007--2008, the overall average annual office visit
rate, regardless of antibiotic prescribing, increased significantly
(p<0.05), from 2,180 (95% confidence interval [CI] = 1,974--2,386) per
1,000 persons aged ≤14 years to 2,581 (CI = 2,291--2,871), an increase
of 18%. However, the visit rate for the five ARIs examined decreased
during the same period by 14%, from 654 (CI = 574--734) per 1,000
persons aged ≤14 years to 560 (CI = 471--648).

From 1993--1994 to 2007--2008, the overall average annual
population-based rate of antibiotic prescriptions decreased 10%, from
655 (CI = 570--739) per 1,000 persons aged ≤14 years to 592 (CI =
492--691) (Figure 1
<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a1.htm?source=govdelivery#fig1>).
However, this decline was not constant; the rate decreased from
1995--1996 to 1999--2000 and was stable thereafter. For the five ARI
diagnoses examined, the average annual population-based prescribing rate
decreased 24%, from 448 (CI = 387--510) antibiotic prescriptions per
1,000 persons aged ≤14 years in 1993--1994 to 342 (CI = 277--406) in
2007--2008.

Physician office visit--based antibiotic prescribing rates decreased 24%
during the study period, from 300 (CI = 276--324) antibiotic
prescriptions per 1,000 visits by persons aged ≤14 years to 229 (CI =
206--253) (Figure 2
<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a1.htm?source=govdelivery#fig2>).
The average annual decrease was 6.7%. The antibiotic prescription rate
per 1,000 office visits decreased 11% for the ARI diagnoses, including
19% for nonspecific upper respiratory infection and 26% for pharyngitis.
Prescribing rates for the other three ARIs did not change significantly.
Despite the decrease, in 2007--2008, ARIs still accounted for 58% of
office visits where an antibiotic was prescribed for a person aged ≤14
years (Figure 3
<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a1.htm?source=govdelivery#fig3>).
However, this proportion was smaller than the 69% of office visits
calculated for 1993--1994 (Figure 3
<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a1.htm?source=govdelivery#fig3>).

Reported by

/Linda F. McCaig, MPH, Ambulatory and Hospital Care Statistics Br,
National Center for Health Statistics; Lauri A. Hicks, DO, Rebecca M.
Roberts, MS, Div of Bacterial Diseases, National Center for Immunization
and Respiratory Diseases; Tarayn A. Fairlie, MD, EIS Officer, CDC.
/*/Corresponding contributor:/*/ Tarayn A. Fairlie, tfairlie@cdc.gov
<mailto:tfairlie@cdc.gov>, 404-639-4849. /

Editorial Note

The findings in this report show an overall decrease in both
population-based and visit-based antibiotic prescribing rates for
persons aged ≤14 years in the United States from 1993--1994 to
2007--2008. Changes in the population-based prescribing rates likely
reflect a combination of factors, including a decreased need for
antibiotics because of introduction of pneumococcal conjugate vaccine
and decreased office visits for ARI (/4/). The 24% decrease overall and
11% decrease in ARI-related visit-based antibiotic prescribing rates
also suggest that physician prescribing behavior has changed.

Although these changes in physician behavior are encouraging, several
areas require further intervention. First, 58% of the antibiotics
prescribed in the office setting in 2007--2008 were for five ARIs, most
episodes of which do not require antibiotic treatment but are common
outpatient diagnoses for which patient expectations, as well as
physician behavior, contribute to inappropriate antibiotic use (/5/).
Second, prescribing antibiotics for otitis media has not decreased
significantly, despite the American Academy of Pediatrics 2004 release
of guidelines recommending watchful waiting for otherwise healthy
children aged ≥2 years without severe symptoms of otitis media or with
an uncertain diagnosis (/6/). The results for otitis media contrast with
those for pharyngitis, where a significant decrease in antibiotic
prescribing was observed from 1993--1994 to 2007--2008, perhaps because
rapid diagnostic testing for group A streptococcus improved prescription
decision-making. With expanding resistance profiles among common
pathogens, treatment options are dwindling, and reducing inappropriate
use of antibiotics is increasingly important.

Similar issues are being addressed in Europe, where young children also
are the main recipients of antibiotics and most antibiotics are given
for upper respiratory infections (/7/). Studies in Germany, where the
volume of antibiotic use is in the bottom third among countries in the
European Union (/8/), have shown that more than one third of the
population had taken antibiotics in the previous year (/9/). Far higher
rates of antibiotic use have been observed in southern and eastern
Europe (/9/). The European Union has made reducing antibiotic use among
children a priority with creation in October 2009 of the Antibiotic
Resistance and Prescribing in European Children network (/10/).

The findings in this report are subject to at least two limitations.
First, only the primary diagnosis was examined, and antibiotic
prescriptions were attributed to that diagnosis. Antibiotics also might
have been prescribed for the second or third diagnoses, which might have
resulted in misclassification. Second, only antibiotic prescribing
related to office visits was considered; prescribing related to
telephone or e-mail encounters was excluded, thus potentially
underrepresenting the frequency of antibiotic prescribing for children.

In 1995, CDC launched the Campaign for Appropriate Antibiotic Use in the
Community, which in 2003 was renamed Get Smart: Know When Antibiotics
Work. The purpose of the program is to educate parents and health-care
providers about the importance of appropriate antibiotic use. In
November 2009, recognizing the need for increased global cooperation in
combating antibiotic resistance, the United States and European Union
created the Trans-Atlantic Task Force on Antimicrobial Resistance.† In
November 2010, CDC's third annual Get Smart About Antibiotics Week was
held in the United States at the same time Antibiotic Awareness Day was
held in the European Union. CDC also launched a companion program
focused on in-patient settings called Get Smart for Healthcare.

These observances stress that inappropriate antibiotic use anywhere
leads to antibiotic resistance everywhere, and that reducing
inappropriate antibiotic use is a global responsibility. CDC's Get Smart
program encourages local and state health departments, individual
practitioners, and public and private organizations to partner with them
to reduce inappropriate antibiotic use by participating in Get Smart
Week 2011, which will be held November 14--20, 2011. Additional
information is available at http://www.cdc.gov/getsmart or via e-mail
(getsmart@cdc.gov <mailto:getsmart@cdc.gov>).

References

1. Harrison PF, Lederberg J. Antimicrobial resistance: issues and
options. Workshop report. Washington DC: National Academy Press;
1998.
2. Bronzwaer S, Cars O, Buchholz U, et al. A European study on the
relationship between antimicrobial use and antimicrobial
resistance. Emerg Infect Dis 2002;8:278--82.
3. US Census Bureau. National population estimates by age, sex, race,
and Hispanic origin: 1980--1999. Washington, DC: US Census Bureau;
2000. Available at
http://www.census.gov/popest/national/asrh/natasrh.htmlExternal
Web Site Icon. Accessed August 24, 2011.
4. Grijalva CG, Griffin MR. Population-based impact of routine infant
immunization with pneumococcal conjugate vaccine in the USA.
Expert Rev Vaccines 2008;7:83--95.
5. Barden LS, Dowell SF, Schwartz B, Lackey C. Current attitudes
regarding use of antimicrobial agents: results from physicians'
and parents' focus group discussions. Clin Ped 1998;37:665--71.
6. American Academy of Pediatrics Subcommittee on Management of Acute
Otitis Media. Diagnosis and management of acute otitis media.
Pediatrics 2004;113:1451--65.
7. Moro ML, Marchi M, Gagliotti C, Di Mario S, Resi D. Why do
paediatricians prescribe antibiotics? Results of an Italian
regional project. BMC Pediatr 2009;9:69.
8. Goossens H, Ferech M, Coenen S, Stephens P. Comparison of
outpatient systemic antibacterial use in 2004 in the United States
and 27 European countries. Clin Infect Dis 2007;44:1091--5.
9. European Commission. Special Eurobarometer 338: antimicrobial
resistance. Brussels, Belgium: European Commission; 2010.
Available at
http://ec.europa.eu/health/antimicrobial_resistance/docs/ebs_338_en.pdf
Adobe PDF fileExternal Web Site Icon. Accessed August 24, 2011.
10. Henderson KL, Muller-Pebody B, Johnson AP, Goossens H, Sharland M.
First set-up meeting for Antibiotic Resistance and Prescribing in
European Children (ARPEC). Euro Surveill 2009;14(45).

* Available at http://www.cdc.gov/nchs/ahcd/ahcd_scope.htm#namcs_scope.

† Additional information available at
http://www.whitehouse.gov/the-press-office/us-eu-joint-declaration-and-annexesExternal
Web Site Icon.

What is already known on this topic?

Inappropriate antibiotic use contributes to antimicrobial resistance, a
major health threat in the United States. Children frequently are
prescribed antibiotics in U.S. physician offices and most typically for
acute respiratory infections (ARIs), even though most ARI episodes do
not require antibiotic treatment.

What is added by this report?

The antibiotic prescribing rate for persons aged ≤14 years in U.S.
physician offices decreased 24%, from 300 antibiotic courses per 1,000
office visits in 1993--1994 to 229 antibiotic courses per 1,000 office
visits in 2007--2008. However, in 2007--2008 ARIs still accounted for
58% of all office-based antibiotic prescribing, and prescribing rates
for otitis media, sinusitis, and bronchitis had not changed significantly.

What are the implications for public health practice?

Antibiotic prescribing for persons aged ≤14 years in the United States
remains inappropriately high. Further intervention is needed to decrease
inappropriate antibiotic prescribing for this population.

*FIGURE 1. Average annual antibiotic prescribing rates for physician
office--related visits per 1,000 population aged ≤14 years --- National
Ambulatory Medical Care Survey, United States, 1993--1994 to 2007--2008*

The figure shows the average annual antibiotic prescribing rates for
physician office-related visits per 1,000 population of persons aged <14
years, in the United States from 1993-1994 to 2007-2008. From 1993-1994
to 2007-2008, the overall average annual population-based rate of
antibiotic prescriptions decreased 10% from 655 per 1,000 persons aged
≤14 years to 592.

*Alternate Text:* The figure above shows the average annual antibiotic
prescribing rates for physician office-related visits per 1,000
population of persons aged <14 years, in the United States from
1993-1994 to 2007-2008. From 1993-1994 to 2007-2008, the overall average
annual population-based rate of antibiotic prescriptions decreased 10%
from 655 per 1,000 persons aged ≤14 years to 592.

*FIGURE 2. Average annual antibiotic prescribing rates for persons aged
≤14 years per 1,000 physician office visits --- National Ambulatory
Medical Care Survey, United States, 1993--1994 to 2007--2008*

The figure shows the average annual antibiotic prescribing rates for
persons aged <14 years per 1,000 physician office visits, in the United
States from 1993-1994 to 2007-2008. Physician office visit-based
antibiotic prescribing rates decreased 24% during the study period, from
300 antibiotic prescriptions per 1,000 visits by persons aged ≤14 years
to 229.

*Alternate Text:* The figure above shows the average annual antibiotic
prescribing rates for persons aged <14 years per 1,000 physician office
visits, in the United States from 1993-1994 to 2007-2008. Physician
office visit-based antibiotic prescribing rates decreased 24% during the
study period, from 300 antibiotic prescriptions per 1,000 visits by
persons aged ≤14 years to 229.

*FIGURE 3. Average annual percentage of physician office visits by
persons aged ≤14 years where an antibiotic was prescribed, by primary
diagnosis --- National Ambulatory Medical Care Survey, United States,
1993--1994 and 2007--2008*

The figure shows the average annual percentage of physician office
visits by persons aged <14 years where an antibiotic was prescribed, by
primary diagnosis, in the United States from 1993-1994 and 2007-2008.
The antibiotic prescription rate per 1,000 office visits decreased 11%
for five acute respiratory infection (ARI) diagnoses, including 19% for
nonspecific upper respiratory infection and 26% for pharyngitis. Despite
the decrease, in 2007-2008, ARIs still accounted for 58% of office
visits where an antibiotic was prescribed for a person aged ≤14 years.

*Abbreviations:* ARI = acute respiratory infection; URI = upper
respiratory infection.

*Alternate Text:* The figure above shows the average annual percentage
of physician office visits by persons aged <14 years where an antibiotic
was prescribed, by primary diagnosis, in the United States from
1993-1994 and 2007-2008. The antibiotic prescription rate per 1,000
office visits decreased 11% for five acute respiratory infection (ARI)
diagnoses, including 19% for nonspecific upper respiratory infection and
26% for pharyngitis. Despite the decrease, in 2007-2008, ARIs still
accounted for 58% of office visits where an antibiotic was prescribed
for a person aged ≤14 years.

Use of trade names and commercial sources is for identification only and
does not imply endorsement by the U.S. Department of Health and Human
Services.

References to non-CDC sites on the Internet are provided as a service to
/MMWR/ readers and do not constitute or imply endorsement of these
organizations or their programs by CDC or the U.S. Department of Health
and Human Services. CDC is not responsible for the content of pages
found at these sites. URL addresses listed in /MMWR/ were current as of
the date of publication.

All /MMWR/ HTML versions of articles are electronic conversions from
typeset documents. This conversion might result in character translation
or format errors in the HTML version. Users are referred to the
electronic PDF version (http://www.cdc.gov/mmwr) and/or the original
/MMWR/ paper copy for printable versions of official text, figures, and
tables. An original paper copy of this issue can be obtained from the
Superintendent of Documents, U.S. Government Printing Office (GPO),
Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for
current prices.

----------------------------------------------------------

[Non-text portions of this message have been removed]

8.1.

Re: Ask : hukuman yg mendidik buat anak 5 thn

Posted by: "anindhita" inidhita@yahoo.com   inidhita

Thu Nov 3, 2011 7:36 pm (PDT)



Dear smart parents..

Ada rekomendasi buku2 yang oke ngga ttg mendidik anak ini? Sekalian beli nya dimana..japri aja biar ga dibilang promosi yaa..
Anakku cowo udah 2y3m sebenernya mulai sering "cari2 perhatian" sejak adiknya lahir 2 bulan yang lalu..
Bodohnya saya sering bgt pake kata NO..JANGAN..GA BOLEH..dan berbagai ancaman seperti "kalo ga nurut nanti mainannya mama ambil" huhuhuhu salah bgt ya..

Mohon rekomendasi buku2nya ya moms n dads..moga2 belom telat ni mendisiplinkan..

Many thanx,
Dhita

8.2.

Re: Ask : hukuman yg mendidik buat anak 5 thn

Posted by: "feby eboy" fetriplef@gmail.com

Thu Nov 3, 2011 7:50 pm (PDT)



Hehehehe
Masih disini kok mbak cella.. lagi nyimak banget email2 yg masuk.. Terima
kasih semua buat saran2nya.. Mudah2an bisa saya terapin ke fathan,mungkin
saya juga perlu lebih sabar..

Maaf yah om mod.. Nambah2in thread

Feby

[Non-text portions of this message have been removed]

8.3.

Re: Ask : hukuman yg mendidik buat anak 5 thn

Posted by: "Bunda Farhan & Athar" radya_cute@yahoo.co.id   icha_grtlo

Thu Nov 3, 2011 7:54 pm (PDT)



@mba Fitri
Hehehe.. Tama nya pinterr yaa mom :)
Jd inget anak klakuan si kk (21m)

Seruuu ni treat..
Saya jd byk blajar dri comment2nya para mommy soal ini..

Icha



Powered by Farhan&Athar~Berry�
9a.

demam 3hr tapi anak masih aktif

Posted by: "Baby Febra" babynajla@gmail.com

Thu Nov 3, 2011 8:02 pm (PDT)



Dear sps dan para dokter,

Anak saya 22bln udh 3hari ini demam on-off (biasanya pas siang lg main2 sih turun demamnya) demam pas malam sekitar 38-39 dercel. Fisiknya sih masih aktif main2 sperti biasanya cuma pagi ini memang agak sayu walopun masih main2. Sebelumnya memang sempet pilek disusul batuk tp setelah demam ini malah gejala batpil tersebut berangsur menghilang. Makan masih mau spt biasa. Selalu minta minum terus (nenen, susu UHT, air putih, jus) dan saya kira ini wajar ya karena demamnya itu jd minta minum terus utk mencegah dehidrasi juga ya.

Dikasih parcet (pas demam 38.9 dercel) ga mau , dimuntahin terus. Malah pernah saya kasih tempr* abis makan, malah dimuntahin dan semua makanannya yg udh masuk keluar lg :(

Emg saya perhatikan ada kemungkinan anaknya kecapean krn bbrp hari terakhir ini kami sekeluarga berpergian hampir tiap hari. Apalagi skrg ini musim hujan ya. Apa ada hub nya ya?

Mohon masukannya para sps dan dokter:
1. Apa saya perlu ke dokter mengingat demamnya udh 3hr? (Suami saya udh mendesak terus spy anaknya dibawa ke dokter krn takut demam berdarah, yang saya yakin sih bukan kalo dicocokan dg symptoms-nya)
2. Kira2 sakit apa ya dia? Apa common cold saja?
3. Sebaiknya apa yang harus saya lakukan skrg? Apa tes urin utk singkirkan ISK atau blm perlu?

Terima kasih banyak sebelumnya.

Salam,

Baby
Mama Najla (22mos)

Šent from ♏ỳ βlªςќвεrrў™
9b.

Re: demam 3hr tapi anak masih aktif

Posted by: "gendi" gendij@gmail.com

Thu Nov 3, 2011 8:25 pm (PDT)



*1. Apa saya perlu ke dokter mengingat demamnya udh 3hr? (Suami saya udh
mendesak terus spy anaknya dibawa ke dokter krn takut demam berdarah, yang
saya yakin sih bukan kalo dicocokan dg symptoms-nya)*

Mengingat anaknya masih aktif, msh normal makan minumnya dan tidak ada
gejala yang berat, menurut saya belum perlu ke dokter. Perbanyak cairan &
istirahatnya dan terus lakukan observasi. Oh iya, jgn lupa
dikompres/berendam air hangat u/ membantu menurunkan suhunya dan membuat
anak comfortable.

Sebaiknya sama suami dibahas apa itu demam berdarah dan gejala2nya. Kenapa
saat ini belum perlu dibawa ke dokter.

Karena ketidak tahuannya wajar dia menjadi cemas ketika anaknya demam sudah
3 hari. Beritahu bahwa walau tidak dibawa ke dokter bukan berarti kita
tidak melakukan sesuatu. Perbanyak cairan, istirahat & observasi itu adalah
bagian dr treatment.

Coba jelaskan juga bahwa fever is part of growing up.

Semoga dari diskusi, suami menjadi mengerti dan kalian bisa do the tango.

*
2. Kira2 sakit apa ya dia? Apa common cold saja?*

Saat ini dugaan saya sama spt mba, common cold

*
3. Sebaiknya apa yang harus saya lakukan skrg? Apa tes urin utk singkirkan
ISK atau blm perlu?*

Karena jelas ada gejala batpil, sptnya belum perlu tes ISK. Tes ISk
dilakukan ketika si anak demam tanpa ada gejala yang jelas atau ketika
BBnya ada hambatan tanpa adanya gejala yang jelas pula.

CMIIW / MKJK yah temans. Sdh lamaaaaa ngga reply jadi kagok rasanya

Regards,
Gendi J - Father of 2

[Non-text portions of this message have been removed]

10.

Bls: [sehat] demam 3hr tapi anak masih aktif

Posted by: "'Ita' Elisabeth Dianita" ita_sehat@yahoo.com   ita_sehat

Thu Nov 3, 2011 8:17 pm (PDT)



Kalau dilihat dari behaviournya, sepertinya sih cc aja yah.. Terusi aja HT nya.
Parcet bisa diberikan HANYA kalau dibutuhkan saja. Kapan butuhnya? Kalau anak dah rewel gak nyaman. Selama anak masih pecicilan mah gak perlu walopun demam tinggi.
Cmiiw ya SP yang lain.


salam sehat,
ita (ibuke Saka & Ambar)
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