RESUMO
BACKGROUND: Primary care paediatricians' perception of migrant children's health in Europe has not been explored before. Our aim was to examine European paediatricians' knowledge on migrant children's health problems, needs, inequalities, and barriers to access health care. METHODS: European primary care paediatricians were invited by the European Academy of Paediatrics Research in Ambulatory Setting Network country coordinators to complete a web-based survey concerning health care of migrant children. A descriptive analysis of all variables was performed. RESULTS: The survey was completed by 492 paediatricians. Sixty-three per cent of the respondents reported that the general health of migrant children is worse than that of nonmigrants, chronic diseases cited by 66% of the respondents as the most frequent health problem. Sixty-six per cent of the paediatricians reported that migrant children have different health needs compared to nonmigrant children, proper oral health care mentioned by 86% of the respondents. Cultural/linguistic factors have been reported as the most frequent barrier (90%).to access health care. However, only 37% of providers have access to professional interpreters and cultural mediators. Fifty-two per cent and 32% do not know whether one or more of the family members are undocumented and whether they are refugees/asylum seekers, respectively. Updated guidelines for care of migrant children are available for only 35% of respondents, and 80% of them have not received specific training on migrant children's care. CONCLUSIONS: European primary care paediatricians recognize migrant children as a population at risk with more frequent and specific health problems and needs, but they are often unaware of their legal state. Lack of interpreters augments the existing language barriers to access proper care and should be solved. Widespread lack of guidelines and specific providers' training should be addressed to optimize health care delivery to migrant children.
Assuntos
Serviços de Saúde da Criança/estatística & dados numéricos , Saúde da Criança/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adolescente , Atitude do Pessoal de Saúde , Criança , Serviços de Saúde da Criança/normas , Pré-Escolar , Competência Clínica , Barreiras de Comunicação , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Europa (Continente) , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Lactente , Recém-Nascido , Pediatria/educação , Atenção Primária à Saúde/normas , Atenção Primária à Saúde/estatística & dados numéricosRESUMO
In this study, we report on the stabilization of a continuous-wave Ti:Sa laser to an optical frequency comb. The laser is emitting at 866 nm to address one of the transitions required for Doppler cooling of a single 40Ca+ ion in a linear Paul trap (2D3/2 âP1/22). The stabilized Ti:Sa laser is utilized to calibrate an ultra-accurate wavelength meter. We certify this self-reference laser source by comparing the results from monitoring the laser-cooled 40Ca+ ion in the linear Paul trap, with those obtained when a HeNe laser is used for calibration. The use of this self-reference is compatible with the simultaneous use of the comb for precision spectroscopy in the same ion-trap experiment.
RESUMO
An 11-year-old girl presented with acute, severe symptoms resembling Tolosa-Hunt syndrome. Response to corticosteroids was rapid and satisfactory, but of short duration. Cranial magnetic resonance imaging demonstrated a supra- and parasellar mass and the abdominal ultrasound demonstrated a round tumor. Histopathologic study of the abdominal mass revealed Burkitt's lymphoma.
Assuntos
Linfoma de Burkitt/diagnóstico , Oftalmoplegia/diagnóstico , Neoplasias Hipofisárias/diagnóstico , Linfoma de Burkitt/tratamento farmacológico , Criança , Dexametasona/administração & dosagem , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Exame Neurológico/efeitos dos fármacos , Oftalmoplegia/tratamento farmacológico , Neoplasias Hipofisárias/tratamento farmacológicoRESUMO
Introducción: la junta directiva de la Asociación Madrileña de Pediatría de Atención Primaria (AMPap) decidió realizar una encuesta a los socios colaboradores en la docencia de residentes de Pediatría cuatro años y medio después de que fuera publicada la resolución conjunta de los Ministerios de Sanidad y Consumo y de Educación y Ciencia, por la que se establecían los requisitos generales para la acreditación de centros de salud vinculados a unidades docentes acreditadas para la formación de especialistas en Pediatría y sus áreas específicas. Material y métodos: en junio de 2011 enviamos a la lista de correo de nuestra sociedad una encuesta diseñada con la herramienta Google Docs® y dirigida a los socios que fueran asiduos colaboradores en la docencia de residentes de Pediatría. Contestaron a 12 preguntas relacionadas con la ubicación de su centro de trabajo, hospital de referencia, número de residentes que reciben, tiempo de rotación y distribución. Resultados: hemos obtenido 47 respuestas y hemos comprobado que menos de la mitad de los residentes de Pediatría hacen la rotación obligatoria en Atención Primaria (AP). Conclusiones: hemos comprobado cómo, a pesar de que más de la mitad de los pediatras madrileños desarrollan su labor en la AP y de que la Comisión Nacional de la Especialidad ha dado importancia a este hecho planteando una rotación obligatoria de tres meses, solo dos de cada cinco residentes de Pediatría en nuestra comunidad la cumplen. Planteamos la necesidad de que algún pediatra colaborador en la docencia o los coordinadores de pediatras de las Direcciones Asistenciales formen parte de las Comisiones de Docencia de los hospitales o de las nuevas Unidades Multiprofesionales y que la labor docente de los pediatras colaboradores sea valorada curricular y profesionalmente(AU)
Introduction: the board of directors of the Madrid Primary Care Paediatrics Association (AMPap) decided to conduct a survey to partner teachers of pediatric residents four and a half years after the joint resolution of the Ministries of Health and Consumer Affairs and Education and Science was published. In this resolution, the general requirements for accreditation of health centers linked to accredited training units for specialists in pediatrics were stablished. Material and methods: in June 2011 a survey designed with Google docs was sent to the mailing list of our society, and directed to partners who were regulars in the teaching of pediatric residents. They answered 12 questions related to their workplace location, reference hospital, number of residents received, distribution, and turnover time. Results: we obtained 47 answers and found that less than half of the pediatric residents do the mandatory rotation in primary care. Conclusions: we have seen that, despite the fact that more than half of Madrids pediatricians develop their work in primary care and that the Specialty National Commission gives importance to this fact, hence considering a mandatory rotation of three months, only two out of five pediatric residents in our community met this requirement. We arise the need that a pediatrician teaching collaborator or the Pediatricians Coordinators in care Management take part in the new Multiprofessional Units and that the pediatric teaching collaboration be valued in the curriculum and the profession(AU)
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Humanos , Masculino , Feminino , Adulto , Assistentes de Pediatria/educação , Pediatria/educação , Pediatria/organização & administração , Educação Médica Continuada/métodos , Educação Médica Continuada/tendências , Internato e Residência , Internato e Residência/organização & administração , Educação Médica Continuada/organização & administração , Educação Médica Continuada/normas , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde , Enquete Socioeconômica , Apoio Social , Impacto PsicossocialRESUMO
The development of high-power cw fiber lasers has triggered a great interest in the phenomena of nonlinear pump spectral broadening and cw supercontinuum generation. These effects have very convenient applications in Raman amplification, optical fiber metrology, and fiber sensing. In particular, it was recently shown that pump incoherence has a strong impact in these processes. We study experimentally the effect of pump incoherence in nonlinear pump spectral broadening and cw supercontinuum generation in optical fibers. We show that under certain experimental conditions an optimum degree of pump incoherence yields the best performance in the broadening process. We qualitatively explain these results, and we point out that these results may have important implications in cw supercontinuum optimization.
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No disponible
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Humanos , Masculino , Feminino , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Sociedades/métodos , Sociedades/políticas , Sociedades/estatística & dados numéricos , Pediatria/educação , Pediatria/organização & administração , Pediatria/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Atenção Primária à Saúde/normasRESUMO
El Mycoplasma pneumoniae es una causa frecuente de infecciones respiratorias superiores e inferiores en niños y adultos jóvenes. Se presenta un brote de neumonía, y urticaria asociada en algunos de los casos, en 41 niños de un municipio del sur de la Comunidad de Madrid. Los casos se agruparon fundamentalmente en torno a dos colegios, con 26 niños afectados en un colegio y 9 en otro. Se produjeron pocos casos por clase y pocos casos secundarios en las familias, lo que puede indicar, en este caso, la baja transmisión del microorganismo. Se describen los síntomas clínicos, los hallazgos radiológicos y analíticos de estas neumonías adquiridas en la comunidad: todos los casos cursaron con tos seca intensa, 14 (34,1%) niños afectados presentaron neumonía sin fiebre llamativa, 5 (12,1%) niños asociaron urticaria, solo 2 niños presentaron polipnea (4,8%) y ninguno de ellos rinitis. En las imágenes radiológicas predominó claramente el patrón alveolar en lóbulos inferiores. Ningún niño presentó leucocitosis ni neutrofília en la analítica. Una paciente con anemia hemolítica hereditaria presentó una crisis de hemólisis coincidiendo con la neumonía. Otra paciente presentó artralgias, urticaria, leucopenia y neutropenia. Hubo un único ingreso hospitalario. El diagnóstico etiológico de la infección pudo efectuarse en 21 niños (51,2%), y se realizó por técnicas serológicas. La realización de una prueba serológica rápida y de fácil ejecución que permita detectar los anticuerpos IgM anti-Mycoplasma pneumoniae puede constituir una herramienta útil para realizar el diagnóstico etiológico de este tipo de infecciones. En la bibliografía existen descritos pocos brotes de infección por M. pneumoniae en centros escolares. El objetivo de este estudio es describir las características clínicas de la infección respiratoria producida por M. pneumoniae para facilitar su reconocimiento y el tratamiento precoz, actitudes que contribuyen al control del brote y a la disminución de la transmisión entre los contactos (AU)
Mycoplasma Pneumoniae causes mild respiratory infections in children and young adults. We present a pneumonia outbreak with related urticaria in some children in a village located in the south of the Community of Madrid. The majority of the cases were grouped in two schools, with 26 affected children in one school and 9 in the other. There were few cases in each class and few secondary cases in the families what can indicate, in this case, germ low infectiousity. We describe clinical symptoms, radiographic and analytic findings in these community- acquired pneumonias (CAP): all the cases had intense hacking cough, 14 (34.1%) children presented pneumonia without fever, 5 (12.1%) children had urticaria, only 2 children had polipnea (4.8%) and none of them had rhinitis. In the chest x-ray findings was a clear predominance of alveolar infiltrate in the lower lobes. None of the children had high white blood cell count nor high neutrophils count. One patient with hereditary haemolytic anemia had a haemolytic crisis coinciding with pneumonia. One patient suffered arthralgia, urticaria, leucopenia and neutropenia. There was a unique hospital admission. Twenty-one (51.2%) children were diagnosed by serological essays. A quick and easy serological test for IgM Mycoplasma pneumoniae antibodies could be a useful tool for diagnosis. In medical literature we have found few Mycoplasma outbreaks described in schools. The goal of this study is to describe the clinical appearance of M. pneumoniae infection in order to make easier its diagnosis and early treatment, attitudes that contribute to control the outbreak and lower the transmission between contacts (AU)