Assessment of the knowledge of United Arab Emirates dentists of Child Maltreatment, protection and safeguarding.

AIM: Child safeguarding is society's responsibility. Dentists are uniquely positioned to recognise Child Abuse and Neglect (CAN) in dental practice and the wider society. The United Arab Emirates (UAE) introduced a child protection law in 2016. We aimed to assess the awareness of UAE dentists of child maltreatment, protection and safeguarding. Study Design A cross-sectional survey. MATERIALS AND METHODS: We surveyed 381 UAE dentists about the knowledge and practice of CAN and safeguarding issues using a self-administered anonymous questionnaire. Statistical analysis was carried out using Chi-square, t-test, ANOVA and Pearson's correlation test and statistical significance was set as p <0.05. RESULTS: Over 39 % (n=152) of the responders suspected CAN; male dentists suspected more CAN than females (p=0.015). Orthodontists, paediatric dentists (p<0.001) and female dentists (p=0.001) were more knowledgeable about diagnosing CAN. Paediatric dentists attended more CAN-related postgraduate training (p<0.001) than other specialties. Over 90% (n=346) believed that CAN should be addressed, 58.1% (n=224) and 54.1% (n=206) had CAN undergraduate and postgraduate training respectively but 53.5% (n=204) were unaware of local child protection guidelines. Dentists barriers to child protection reporting were; fear of family violence (59.6%, n=227), lack of knowledge of referral process (60.2%, n=228) and lack of diagnosis certainty (54.9%, n=206). UAE dentists qualified in Western and Asian countries had fewer barriers for child protection reporting (p=0.022) than the Arab and Gulf Cooperation Council qualified dentists. CONCLUSIONS: A large minority of UAE dentists suspected CAN. Factors influencing child protection reporting were identified. Dentists' gender, specialty, and country of qualification affected their knowledge of CAN and practice of safeguarding. Child protection training is recommended.

[300 breech delivery in continuity (author's transl)]. / Accouchements par le siège. Résultats sur une série de 300 cas.

In this study of 300 breech deliveries in continuity, the authors after a review of the principal attitudes and of the results of other publications; bring their attitude and their results, by a more detailed analysis of cases and specially the small for date--the preterm deliveries and the breech associated with multiple pregnancy, because these associated risks are the most important. Systematic casarian section must not be systematic on term breechs if obstetrical explorations are normal--in these cases 60 0/0 of trials labor perform well with a minimal morbidity and with mortality no account. In the other hand, in cases where risk increase cesarian section is the best solution.

[Intra-uterine growth retardation and prenatal nutrition. I. Review of the literature]. / Retard de croissance intra-utérin et nutrition prénatale. I.--Revue de la littérature.

The authors have carried out a review of the literature about the consequences of alimentary deficiency in the mother on the growth of the fetus. The effects of under nutrition in the animal kingdom are well known. In the human species studies have been made in developing countries and also in countries that are developed in times of food rationing. These show that when the ration is deficient in calories there is a drop in the birthweight of the newborn. All the same, the effects of moderate malnutrition are not well established. A discussion therefore is started on the methods by which the diet is examined and the patients have been selected. Whenever there is suspicion of failure of intra-uterine growth during pregnancy, the place of enquiring into the mother's diet is emphasized, together with the other methods of investigation of the causes.

[Intrauterine growth retardation and prenatal nutrition. II. Personal cases]. / Retard de croissance intra-utérin et nurtition prénatale. II. Nos observations.

We have carried out an enquiry into feeding in mothers in whom failure of intra-uterine growth of the fetus has been suspected around the thirtieth week of amenorrhoea according to clinical criteria (23 cases with a mean birth weight of 2564 g). We used a special questionnaire in the third trimester of pregnancy. The special feature of these failures of intra-uterine growth were that they did not appear to have any known cause. The calory intake of the mother was compared at the same time with a control group (39 cases where the mean birth weight was 3333 g). A significant difference was found in the calory intake (2241 Kcal as against 2553 Kcal) and this was especially connected with a low carbohydrate intake. The consequences of this deficiency in maternal carbohydrates on the birth weights of the newborn is discussed taking into account other factors that could interfere with fetal growth.

[Perforation of the uterus after voluntary termination of pregnancy using the aspiration technique. Two serious cases (author's transl)]. / Perforation utérine après interruption volontaire de grossesse suivant les méthodes par aspiration. A propos de deux cas graves.

The authors formulate some safety rules in view of two case histories of bowel complications following voluntary termination of pregnancy using suction techniques. Where it is not certain that a perforation has occurred laparoscopy is necessary. When perforation has been confirmed a laparotomy is undertaken in order to check the state of the bowel throughout its length, because when lesions of the digestive tract are treated rapidly the results are good whereas when they have to be treated for peritonitis the outlook is poor.

[Combined hydramnios with fetal ascites due to intra-uterine meconium peritonitis (authors' transl)]. / Une association hydramnios-ascite foetale relevant d'une péritonite méconiale intra-utérine.

It is possible with echotomography to make out fetal ascites in the last months of pregnancy. One of the causes of combined fetal ascites and hydramnios among several other possible ones is primary meconium peritonitis, which diagnosis can be confirmed after birth.

[Iron deficiency in the pregnant woman. Its repercussions on the newborn. The influence of systematic iron treatment (author's transl)]. / La carence martiale chez la femme enceinte. Etude de son retentissement chez le nouveau-né. Influence d'un traitement martial systématique.

We have studied the haematological and iron state of 203 women from the sixth month of pregnancy till two months after delivery, and of their newborn from birth to the age of two months. Iron deficiency affects more than a third of women with a higher risk for multipara and for immigrants. The only sure way of screening for this is by estimating the plasma ferritin. When iron was given routinely as a supplement we found that the tissue reserves of iron rose from the third trimester onwards and two months later were entirely normal in treated women, but an iron deficiency persisted in women who were not treated. The transfer of iron to the fetus in the third trimester of pregnancy is related to the quantity of iron given to the mother in her diet. The iron reserves in the tissues of these children were higher at two months of age when the mothers had been treated with iron during the pregnancy. The value of estimating ferritin in the blood as an indicator of tissue reserves should be considered in the neo-natal period.

[Peritonitis and cerclage of the cervix uteri]. / Péritonite et cerclage du col utérin.

Authors report a case of peritonitis following uterine cervical cerclage in a patient with twins. This observation leads to two problems: complications of cerclage and its real indications. Two recent controlled studies conclude that in a singleton pregnancy, there is no advantage in cervical cerclage in prolonging the gestation period and in decreasing the perinatal mortality. However, the last MRC/RCOG study, still in progress, shows that in a preliminary study, there is a small advantage in cervical cerclage in high-risk-pregnancy with two previous mid trimester spontaneous abortions and/or with premature labor. In multiple pregnancies especially in twin pregnancy, the problem remains unsolved.

[The antibacterial activity of amniotic fluid with a correlation between zinc phosphorus concentrations (author's transl)]. / Activité antibactérienne du liquide amniotique corrélation avec la zincamnie et la phosphoramnie.

Antibacterial activity of 22 amniotic fluids collected at different stage of pregnancy have been tested against different types of staphylococci: 209 P, 2961 and Escherichia Coli OMS and 83. At the same time zinc and phosphorus concentration in these fluids have been measured. 77 p. 100 of those fluids present an antibacterial activity, but no correlation has been found with their concentration in zinc and phosphorus. Probably this activity is multifactorial and further studies need to be done to identify the factor or factors responsible for that antibacterial activity.