Interconsulta en maltrato infantojuvenil: Característica de la población con sospecha de maltrato infantojuvenil del Hospital de Pediatría Juan P. Garrahan / Consultation on child abuse: Characteristics of a population with a high level of suspicion of child abuse at Hospital de Pedatría Juan P. Garrahan

El maltrato infantojuvenil constituye un problema de salud pública, presenta consecuencias negativas en el adecuado desarrollo de los niños y adolescentes. Es consecuencia de una multiplicidad de factores individuales, sociales, psicológicos y culturales que puede incluso desembocar en la muerte del niño o adolescente. El objetivo fue realizar una descripción sociodemográfica e identificar posibles variables específicas de maltrato en la población que realizó alguna consulta al hospital y que fue derivada por el médico tratante al Consultorio Multidisciplinario de Protección Infantojuvenil (CMPIJ). Se trató de un estudio descriptivo, prospectivo de corte transversal, realizado entre julio de 2016 y mayo de 2017 en el Hospital de Pediatría Juan P. Garrahan. El criterio de inclusión fue la población que realizó alguna consulta al hospital, ya sea por sospecha de maltrato o por otros motivos y fue derivada por el médico tratante al CMPIJ. Se evaluaron 96 casos. el 67,7% de las sospechas fueron de abuso sexual infantil (ASI), el 22,9% de maltrato físico y el 9,4% de trastorno facticio aplicado a otro. En los casos de alta sospecha de ASI, el 75% de los pacientes eran de sexo femenino; en el 50% de los casos, el supuesto agresor era conviviente y el 50% de las madres refirió antecedentes de malos tratos en la infancia. En los casos de alta sospecha de maltrato físico, el 53% de los pacientes era de sexo masculino, en el 83,3% de los casos el supuesto agresor era conviviente y el 76,5% de las madres refirió antecedentes de malos tratos en infancia. Se concluye la importancia de contar con datos fidedignos en lo relativo al maltrato Infantojuvenil para permitir elaborar estrategias de prevención tanto a nivel asistencial como de Salud Pública (AU)

Child abuse is a public health problem with a negative impact on the adequate development of children and adolescents. It is a consequence of multiple individual, social, psychological, and cultural factors that may even result in the death of the child or adolescent. The aim of this study was to provide a sociodemographic description and to identify possible specific variables associated with abuse in the population that visited the hospital and was referred to the Multidisciplinary Child Protection Clinic (MDCPC). A prospective, descriptive, cross-sectional study was conducted between July 2016 and May 2017 at Hospital de Pediatría Juan P. Garrahan. The inclusion criterion was the population that visited the hospital, either for suspicion of abuse or for other reasons, who were referred to the MDCPC by the treating physician. Overall, 96 cases were evaluated; 67.7% of the suspicions were of childhood sexual abuse (CSA), 22.9% for child battering, and 9.4% for Munchausen syndrome by proxy. Among the cases with a high level of suspicion of CSA, 75% were female; in 50% of the cases the supposed aggressor lived in the household, and 50% of the mothers reported a history of child abuse. In the cases of a high level of suspicion of child battering, 53% of the patients were male, in 83.3% of the cases the aggressor was living in the household, and 76.5% of the mothers reported a history child abuse. In conclusion, trustworthy data on child abuse are necessary to develop prevention strategies at both the care and public health levels (AU)

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures.

Abstract: In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).

ICRP Publication 111 - Application of the Commission's recommendations to the protection of people living in long-term contaminated areas after a nuclear accident or a radiation emergency.

In this report, the Commission provides guidance for the protection of people living in long-term contaminated areas resulting from either a nuclear accident or a radiation emergency. The report considers the effects of such events on the affected population. This includes the pathways of human exposure, the types of exposed populations, and the characteristics of exposures. Although the focus is on radiation protection considerations, the report also recognises the complexity of post-accident situations, which cannot be managed without addressing all the affected domains of daily life, i.e. environmental, health, economic, social, psychological, cultural, ethical, political, etc. The report explains how the 2007 Recommendations apply to this type of existing exposure situation, including consideration of the justification and optimisation of protection strategies, and the introduction and application of a reference level to drive the optimisation process. The report also considers practical aspects of the implementation of protection strategies, both by authorities and the affected population. It emphasises the effectiveness of directly involving the affected population and local professionals in the management of the situation, and the responsibility of authorities at both national and local levels to create the conditions and provide the means favouring the involvement and empowerment of the population. The role of radiation monitoring, health surveillance, and the management of contaminated foodstuffs and other commodities is described in this perspective. The Annex summarises past experience of longterm contaminated areas resulting from radiation emergencies and nuclear accidents, including radiological criteria followed in carrying out remediation measures.

Effects of dose limits reduction on the Argentine nuclear power plants.

Occupational doses are evaluated in different stages of the fuel cycle and in the operation of nuclear power plants. Trends in individual dose distribution and collective doses are analyzed. The most contributive working conditions to collective dose are identified and the implications of dose limit reduction recommended by the ICRP in 1990 are assessed. It is concluded that no relevant difficulties should appear in accomplishing the new recommendations except for implementation at Atucha I, a nuclear power plant designed in the 1960s. Some options to reduce individual and collective doses in this plant are analyzed. The change of fuel channels by new ones free from cobalt is essential to get effective improvement of occupational exposures.