The majority of febrile children have self-resolving viral infection, but a small proportion have life-threatening bacterial infections. Although culture of bacteria from normally sterile sites remains the gold standard for confirming bacterial infection, culture results may take several days and are frequently negative when infection resides in inaccessible sites or when antibiotics have been previously administered.^1-3 Current practice is to admit ill-appearing febrile children to the hospital and administer parenteral antibiotics while awaiting culture results.^4-6 Because only a minority of febrile children are ultimately proven to have bacterial infection, the process of ruling out bacterial infection results in a major burden on health care resources and in inappropriate antibiotic prescription.⁷

Symbolic interactionism is a theoretical perspective in sociology that addresses the manner in which society is created and maintained through face-to-face, repeated, meaningful interactions among individuals. This article surveys past theory and research in the interactionist tradition. It first provides an overview of three main trajectories in symbolic interactionist thought, focusing on the work of Herbert Blumer (the Chicago School), Manford Kuhn (the Iowa School), and Sheldon Stryker (the Indiana School). A brief summary of each figure’s general perspective on symbolic interactionism is given, followed by a discussion of the research methodology that defines and distinguishes each. The article then reviews and assesses the empirical research that has emerged from these trajectories over the past decades, beginning with the classical studies of the mid-twentieth century and culminating in research programs that have emerged in the contemporary era. Specifically, this article surveys significant contributions to the symbolic interactionist literature in areas such as dramaturgy, cultural studies, postmodernism, gender/status/power, self and identity, collective behavior and social movements, and social context and the environment. It concludes with a discussion of future directions symbolic interactionists should take in continuing to develop the field.

Gender socialization is examined through a social psychological lens by applying identity theory and identity control theory. Current research from the fields of family and sociological social psychology are surveyed to provide a better conception of how the family operates as agents of socialization, and how identities that are cultivated and fostered in youth provide meaning throughout the life course and maintain the social order. The application of identity theory shows how gender is a diffuse status characteristic, which is salient in person, role, and social (group) identities, and also across social situations. Identity control theory is applied to show how emotions operate within an internal control system to stabilize gendered identities and perpetuate the social structure. Both theories are specifically applied to understand socialization dynamics that exist for children and families.

Background Febrile illnesses are pre-eminent contributors to morbidity and mortality among children in South-East Asia but the causes are poorly understood. We determined the causes of fever in children hospitalised in Siem Reap province, Cambodia. Methods and Findings A one-year prospective study of febrile children admitted to Angkor Hospital for Children, Siem Reap. Demographic, clinical, laboratory and outcome data were comprehensively analysed. Between October 12 th 2009 and October 12 th 2010 there were 1225 episodes of febrile illness in 1180 children. Median (IQR) age was 2.0 (0.8–6.4) years, with 850 (69%) episodes in children <5 years. Common microbiological diagnoses were dengue virus (16.2%), scrub typhus (7.8%), and Japanese encephalitis virus (5.8%). 76 (6.3%) episodes had culture-proven bloodstream infection, including Salmonella enterica serovar Typhi (22 isolates, 1.8%), Streptococcus pneumoniae (13, 1.1%), Escherichia coli (8, 0.7%), Haemophilus influenzae (7, 0.6%), Staphylococcus aureus (6, 0.5%) and Burkholderia pseudomallei (6, 0.5%). There were 69 deaths (5.6%), including those due to clinically diagnosed pneumonia (19), dengue virus (5), and melioidosis (4). 10 of 69 (14.5%) deaths were associated with culture-proven bloodstream infection in logistic regression analyses (odds ratio for mortality 3.4, 95% CI 1.6–6.9). Antimicrobial resistance was prevalent, particularly in S. enterica Typhi, (where 90% of isolates were resistant to ciprofloxacin, and 86% were multi-drug resistant). Comorbid undernutrition was present in 44% of episodes and a major risk factor for acute mortality (OR 2.1, 95% CI 1.1–4.2), as were HIV infection and cardiac disease. Conclusion We identified a microbiological cause of fever in almost 50% of episodes in this large study of community-acquired febrile illness in hospitalized children in Cambodia. The range of pathogens, antimicrobial susceptibility, and co-morbidities associated with mortality described will be of use in the development of rational guidelines for infectious disease treatment and control in Cambodia and South-East Asia.

Dengue fever is a re-emerging viral disease commonly occurring in tropical and subtropical areas. The clinical features and abnormal laboratory test results of dengue infection are similar to those of other febrile illnesses; hence, its accurate and timely diagnosis for providing appropriate treatment is difficult. Delayed diagnosis may be associated with inappropriate treatment and higher risk of death. Early and correct diagnosis can help improve case management and optimise the use of resources such as hospital staff, beds, and intensive care equipment. The goal of this study was to develop a predictive model to characterise dengue severity based on early clinical and laboratory indicators using data mining and statistical tools. We retrieved data from a study of febrile illness in children at Angkor Hospital for Children, Cambodia. Of 1225 febrile episodes recorded, 198 patients were confirmed to have dengue. A classification and regression tree (CART) was used to construct a predictive decision tree for severe dengue, while logistic regression analysis was used to independently quantify the significance of each parameter in the decision tree. A decision tree algorithm using haematocrit, Glasgow Coma Score, urine protein, creatinine, and platelet count predicted severe dengue with a sensitivity, specificity, and accuracy of 60.5%, 65% and 64.1%, respectively. The decision tree we describe, using five simple clinical and laboratory indicators, can be used to predict severe cases of dengue among paediatric patients on admission. This algorithm is potentially useful for guiding a patient-monitoring plan and outpatient management of fever in resource-poor settings.