1
|
Dornbusch HJ, Kurz R, del Torso S, Hadjipanayis A, Tenore A. Is there a "European Paediatrics"? Front Pediatr 2024; 12:1326157. [PMID: 38725984 PMCID: PMC11079941 DOI: 10.3389/fped.2024.1326157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
The journey from birth to adulthood is paved with threats to health and wellbeing, rendering this age group with its invaluable future potential particularly vulnerable. Therefore, children and adolescents deserve medical attention of the highest professional level based on solid, well founded training guidelines, the availability of a well-coordinated platform for the continuous acquisition of knowledge, exchange of ideas, and collaboration on research and clinical projects, and comprehensive continuing education. For the European region these crucial specifications are met to varying degrees by three major paediatric organisations: the European Academy of Paediatrics (EAP) with the European Board of Paediatrics (EBP) as the paediatric section of the European Union of Medical Specialists (UEMS PS), the European Paediatric Association (EPA/UNEPSA) and the European Confederation of Primary Care Paediatricians (ECPCP). A major goal of this paper is to call for the closest possible collaboration between these organizations in advocating for the health and rights of European children and adolescents and in effectively fostering the paediatric profession with a strong, unified voice.
Collapse
Affiliation(s)
| | - Ronald Kurz
- University Hospital for Paediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria
| | | | | | - Alfred Tenore
- California University of Science and Medicine, Colton, CA, United States
| |
Collapse
|
2
|
Pettoello-Mantovani M, Vural M. Ten Years of Partnership Between the European Pediatric Association, Union of National European Pediatric Societies, and Associations and The Journal of Pediatrics. J Pediatr 2023; 262:113668. [PMID: 37582459 DOI: 10.1016/j.jpeds.2023.113668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/17/2023]
Affiliation(s)
- Massimo Pettoello-Mantovani
- European Pediatric Association, Union of National European Pediatric Societies and Associations, Berlin, Germany.
| | - Mehmet Vural
- European Pediatric Association, Union of National European Pediatric Societies and Associations, Berlin, Germany
| |
Collapse
|
3
|
Arriola Pereda G, Labarta Aizpún JI, Sánchez MJ, Rodriguez Vázquez Del Rey MDM, Ruiz Del Prado MY. Current situation of Specialized Health Training in pediatrics and its specific areas: Challenges and needs. An Pediatr (Barc) 2023; 99:252-256. [PMID: 37741766 DOI: 10.1016/j.anpede.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 09/25/2023] Open
Abstract
The development of pediatric subspecialties constitutes one of the most outstanding events in pediatrics in our country since the mid-20th century. The FSE in pediatrics is currently based on order SCO/3148/2006, of September 20, which approves and publishes the training program for the specialty of pediatrics and its Specific Areas. It is a training program structured in 4 years that manages to train the resident in the necessary skills of pediatrics, including training in transversal skills, training in general pediatrics and must also include training in different specific areas. In 1995 was approved the Specific Training Area (ACE). In pediatrics, ACEs are necessary to guarantee adequate health care for the child and adolescent population, at the same level as adult medicine, ensuring through regulated training, quality and uniform care. We want to give official recognition to what today is a healthcare reality in all the Spanish hospitals.
Collapse
Affiliation(s)
- Gema Arriola Pereda
- Servicio de Pediatría, Hospital Universitario de Gudalajara, Guadalajara, Spain.
| | | | | | | | | |
Collapse
|
4
|
Villaizán Pérez C, Aparicio Rodrigo M, Kovacs A, Barak S, Calamita P, Dejak Gornik K, Jaeger-Roman E, Kartousova B, Katz M, Rafele I, Reali L, Reingold S, Sauseng W, Fehr F. Entrustable Professional Activities for the Training of Postgraduate Primary Care Pediatricians. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:468-472. [PMID: 36584098 DOI: 10.1097/acm.0000000000005132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PROBLEM Competency-based training is a model of medical education program that uses an organized framework of competencies to develop entrustable professional activities (EPAs) for each specialty. Implementation of EPAs varies by medical specialty and country. Although national models for primary care pediatrics have been suggested in the past, standardized EPAs have not been established. APPROACH The authors, all members of the curriculum working group of the European Confederation of Primary Care Paediatricians, describe the development and design of a training model based on EPAs specifically for pediatricians in primary care. The objective was to facilitate and disseminate a training model that standardizes and improves training in primary care pediatrics. They aimed to make the model flexible enough so that it can be adapted to different training models and different European health systems. OUTCOMES Between May 2017 and December 2019, the authors developed a framework that includes 7 domains of competencies for the training in pediatric primary care and a set of 11 core EPAs to guide the learning process. They structured each EPA as follows: title, activity profile, domains of competence, competencies within each domain, required knowledge and skills, learning objectives described in terms of outcomes, and a 3-stage rating supervision scale to evaluate the level of performance. NEXT STEPS The next step is the progressive implementation of these EPAs into the postgraduate primary care pediatrics training programs of European health systems. To support this implementation, the authors intend to develop training videos to assist in daily teaching of the EPAs. The authors will also develop a pan-European online resident forum designed specifically to facilitate EPA learning by sharing and discussing clinical cases. They plan to launch a pilot study on the use of the EPAs in primary care health centers in 6 European countries.
Collapse
Affiliation(s)
- Carmen Villaizán Pérez
- C. Villaizán Pérez is chair of the European Confederation of Primary Care Paediatricians curriculum working groupa primary care pediatrician, Toledo, Spain
| | - María Aparicio Rodrigo
- M. Aparicio Rodrigo is a primary care pediatrician and associate professor, Department of Pediatrics, Complutense University of Madrid, Madrid, Spain
| | - Akos Kovacs
- A. Kovacs is a primary care pediatrician, Budapest, Hungary
| | - Shimon Barak
- S. Barak is a primary care pediatrician, Maccabi Healthcare Services, and senior pediatrician, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | | | - Elke Jaeger-Roman
- E. Jaeger-Roman was a primary care pediatrician, Berlin, Germany, at the time of writing
| | - Beata Kartousova
- B. Kartousova is a primary care pediatrician, Bratislava, Slovakia
| | - Manuel Katz
- M. Katz is a primary care pediatrician, Be'er Sheva, Israel
| | | | - Laura Reali
- L. Reali is a primary care pediatrician, Rome, Italy
| | - Stephen Reingold
- S. Reingold is medical officer, Maternal and Child Health, Preventive Health Services, Jerusalem, Israel
| | - Werner Sauseng
- W. Sauseng is a primary care pediatrician, Kumberg, Austria
| | - Folkert Fehr
- F. Fehr is a primary care pediatrician and university teacher, Department of Pediatrics, Heidelberg University, Sinsheim, Germany
| |
Collapse
|
5
|
Hu F, Guo S, Lu J, Li Z, Song Y, Pérez-Escamilla R, Lin S, Hu Y. Can a Multi-Component Intervention Improve Pediatric Service Delivery in Guangzhou? Front Public Health 2021; 9:760124. [PMID: 34671589 PMCID: PMC8520973 DOI: 10.3389/fpubh.2021.760124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022] Open
Abstract
Background: Accessible, equitable, and efficient pediatric service is critical to achieve optimal child health. This study aimed to evaluate the effectiveness of a multi-component intervention on the pediatric health system over two different periods in Guangzhou. Methods: Based on the World Health Organization (WHO) "six building blocks" model and Donabedian's "Structure-Process-Outcomes" framework, an intervention package was developed to increase financial and human resouce investment to strengthen basic health care and strive for a better quality of pediatric care. This multi-component intervention package was conducted in Guangzhou to improve the pediatric service delivery during two stages (2011-2014 and 2016-2019). The main outcome indicators were the changes in the allocation of pediatricians and pediatric beds, pediatric service efficiency, and the impact of pediatricians on child mortality. Results: We found that pediatricians per 1,000 children (PPTC) and pediatric beds per 1,000 children (PBPTC) increased from 1.07 and 2.37 in 2010 to 1.37 and 2.39 in 2014, then to 1.47 and 2.93 in 2019, respectively. Infant mortality rate (IMR) and under-5 mortality rate (U5MR) dropped from 5.46‰ and 4.04‰ in 2010 to 4.35‰ and 3.30‰ in 2014 then to 3.26‰ and 2.37‰ in 2019. The Gini coefficients of PPTC and PBPTC decreased from 0.48 and 0.38 in 2010, to 0.35 and 0.28 in 2014, then to 0.35 and 0.22 in 2019, respectively, representing the improvement of pediatric resources distribution according to service population. However, equalities in the spatial distribution were not improved much. The average efficiency of pediatric service fluctuated from 2010 to 2019. A unit increase in PPTC was associated with an 11% reduction in IMR and a 16% reduction in U5MR. Conclusions: Findings suggest this multi-component intervention strategy is effective, particularly on the reduction of child mortality. In future, more rigorous and multi-faceted indicators should be integrated in a comprehensive evaluation of the intervention.
Collapse
Affiliation(s)
- Fang Hu
- Department of Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Jianjun Lu
- Department of Medical Affairs, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ziang Li
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Yanyan Song
- Department of Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Rafael Pérez-Escamilla
- Office of Public Health Practice, Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Suifang Lin
- Department of Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yifei Hu
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Aparicio Rodrigo M, Carrasco Sanz A, Sánchez Pina C, Villaizán Pérez C, Fernández Rodriguez M, Orejón de Luna G, Aizpurúa Galdeano P, Pettoello-Mantovani M. The Role of Pediatricians in Providing Greater-Quality Care for Children: An Ongoing Debate. J Pediatr 2021; 231:303-304.e1. [PMID: 33373669 DOI: 10.1016/j.jpeds.2020.12.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Affiliation(s)
| | - Angel Carrasco Sanz
- European Confederation of Primary Care Pediatricians, Lyon, France; European Paediatric Association, Union of National European Pediatric Societies and Associations, Berlin, Germany
| | | | | | | | | | | | - Massimo Pettoello-Mantovani
- European Paediatric Association, Union of National European Pediatric Societies and Associations, Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza", University of Foggia, Foggia, Italy.
| |
Collapse
|
7
|
Meric R, Stone RG, Lupu VV, Lomholt S, Slobodanac M, Maár BA, Manca E. The Diversity of Pediatric Residency Programs across Europe: Quality Assurance of Training, Night Shifts, and Wages. J Pediatr 2020; 226:319-320.e2. [PMID: 32768469 DOI: 10.1016/j.jpeds.2020.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Ruya Meric
- Istanbul Medical Faculty-Cerrahpasa, Department of Pediatrics, Istanbul, Turkey.
| | - Roy Gavin Stone
- Children's Health Ireland at Crumlin, Department of Pediatric Respiratory Medicine, Dublin, Ireland
| | - Vasile Valeriu Lupu
- "Grigore T. Popa" University of Medicine and Pharmacy, Department of Pediatrics, Iasi, Romania
| | | | | | - Balázs Andras Maár
- Heim Pál National Pediatric Institute, Department of Pediatrics, Budapest, Hungary
| | - Enrica Manca
- University of Foggia, Department of Pediatrics, Foggia, Italy
| |
Collapse
|
8
|
Aparicio Rodrigo M, Ruiz Canela J, Buñuel Álvarez JC, García Vera C, Esparza Olcina MJ, Barroso Espadero D, González Rodríguez P, Juanes Toledo B, Martínez Rubio V, Ortega Páez E. Paediatricians provide higher quality care to children and adolescents in primary care: A systematic review. Acta Paediatr 2020; 109:1989-2007. [PMID: 32311805 DOI: 10.1111/apa.15324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 02/26/2020] [Accepted: 04/17/2020] [Indexed: 11/29/2022]
Abstract
AIM The number of primary care paediatricians is decreasing in Europe without a justifiable reason. We aimed to compare the clinical practice of paediatricians and family doctors attending children and adolescents in primary care. METHODS MEDLINE, Embase, CENTRAL, TRIP and Google Scholar were searched from December 2008 to February 2018. No language or study design restrictions were applied. Three reviewers assessed eligibility of the studies. Seven pairs of reviewers performed the data extraction and assessed the methodological quality independently. Discrepancies were resolved by consensus. RESULTS Fifty-four, out of 1150 studies preselected, were included. We found that paediatricians show more appropriate pharmacology prescription patterns for the illness being treated; they achieve higher vaccination rates and have better knowledge of vaccines and fewer doubts about vaccine safety; their knowledge and implementation of different screening tests are better; they prescribe psychoactive drugs more cautiously and more in line with current practice guidelines; their evaluation and treatment of obesity and lipid disorders follow criteria more consistently with current clinical practice guidelines; and they perform fewer diagnostic test, show a more suitable use of the test and request fewer referrals to specialists. CONCLUSION According to published data, in developed countries, paediatricians provide higher quality care to children than family doctors.
Collapse
|
9
|
Child healthcare services offered by the Vatican City State in its national territory and in extra-territorial neighboring Italian areas. Turk Arch Pediatr 2020; 55:105-111. [PMID: 32963486 PMCID: PMC7488182 DOI: 10.14744/turkpediatriars.2020.23690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pediatric healthcare activity related to the Vatican City State is carried out at secondary and tertiary levels in the two main pediatric territorial and extra-territorial medical centers, which are administered by the Vatican: the Bambino Gesù Pediatric Hospital and the Mother and Child pediatric Department of the Casa Sollievo della Sofferenza Medical Center. Both centers are recognized by the Italian State and internationally with the formal legal status of Scientific Institutes for Clinical Research. The relations established between the Holy See, in the person of the Secretary of State, the Board of Directors, the President of the Board, and the Board of Auditors regulate the management of the two medical centers. The child healthcare and research activity of the two Vatican State administered medical centers is described in this article.
Collapse
|
10
|
Pettoello-Mantovani M, Pop TL, Hoey H. Child healthcare in Europe, local diversities and collective potentials: A study of the European Paediatric Association/Union of National European Paediatric Societies and Associations. TURK PEDIATRI ARSIVI 2020; 55:1-3. [PMID: 32963475 PMCID: PMC7488186 DOI: 10.14744/turkpediatriars.2020.80106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This introductory article presents the project developed by the EPA-UNEPSA on child healthcare in Europe, emphasizing the role of local diversities as collective potentials. The EPA-UNEPSA is strongly convinced that an effective cooperation among European countries is based on the acknowledgement that diversity is a factor of strength, and not of weakness, and that such a factor may create the basis of an effective cooperation in all fields of public interest. Since its foundation in 1975, EPA-UNEPSA has worked to improve child healthcare and to strength the cooperation of children's caretakers in Europe. The studies published in this volume pursue this line of thought, in the belief that contributing to the efforts of creating an effective platform for cooperation and a multidisciplinary approach to common issues in public health may reduce fragmentation of paediatrics and tackle the legal, economic, and organisational challenges of child healthcare in Europe.
Collapse
Affiliation(s)
- Massimo Pettoello-Mantovani
- Department of Pediatrics, Scientific Institute ‘Casa Sollievo della Sofferenza’, University of Foggia, Foggia, Italy
- European Pediatric Association (EPA-UNEPSA), Union of National European Pediatric Societies and Associations, Berlin, Germany
| | - Tudor Lucian Pop
- European Pediatric Association (EPA-UNEPSA), Union of National European Pediatric Societies and Associations, Berlin, Germany
- 2 Paediatric Clinic, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
- Romanian Society of Social Pediatrics, Cluj-Napoca, Romania
| | - Hilary Hoey
- European Pediatric Association (EPA-UNEPSA), Union of National European Pediatric Societies and Associations, Berlin, Germany
- Royal College of Physicians of Ireland, Dublin, Ireland
- Department of Paediatrics, Trinity College Dublin, National Children’s Hospital, Dublin, Ireland
| |
Collapse
|
11
|
Children facing natural, economic and public health crisis in Europe: The risks of a predictable unpredictability. Turk Arch Pediatr 2020; 55:4-9. [PMID: 32963476 PMCID: PMC7488185 DOI: 10.14744/turkpediatriars.2020.55553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This opening article for the volume dedicated to the diversity of paediatric healthcare systems in Europe, discusses the topic of children facing natural, economic, and public health crises in Europe. The natural and economic adversities and public health crises, which have repeatedly stormed the globe during the past twenty years, have often unveiled a low degree of self-sufficiency and a high degree of unpreparedness by European countries. It is always the case that the most vulnerable take the brunt, and these adverse events have shown their effects and a negative direct impact particularly on the population aged 0–18 years, with important implications for families and communities. The article discusses a rational approach to properly confront future public health emergencies and crises in general. The authors stress the concept that such approaches should be built on past negative experiences, in order to explore, identify, and make clear which are the priorities governing the disaster management activities at all levels in this population group. The authors conclude that safeguarding the health of children could be effectively accomplished by developing adequate, shared emergency management strategies. Improving pediatric preparedness approaches with the use of emergency measures and ongoing collaboration will facilitate a better and more efficient response, able to effectively care for the needs of children in actual crises.
Collapse
|
12
|
Meric R, Stone RG, Lupu VV, Lomholt S, Slobođanac M, Maár BA, Manca E. The Diversity of Pediatric Residency Programs across Europe: Admission Procedures, Curricula and Duration of Courses. J Pediatr 2020; 222:266-268.e1. [PMID: 32381467 DOI: 10.1016/j.jpeds.2020.03.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Ruya Meric
- Department of Pediatrics, Istanbul Medical Faculty-Cerrahpasa, Istanbul, Turkey.
| | - Roy Gavin Stone
- Department of Pediatric Respiratory Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Vasile Valeriu Lupu
- Department of Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Søren Lomholt
- Department of Pediatrics, Viborg Regional Hospital, Viborg, Denmark
| | | | - Balázs Andras Maár
- Department of Pediatrics, Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Enrica Manca
- Department of Pediatrics, University of Foggia, Foggia, Italy
| |
Collapse
|
13
|
Mandato C, Siano MA, De Anseris AGE, Tripodi M, Massa G, De Rosa R, Buffoli M, Lamanna A, Siani P, Vajro P. Humanization of care in pediatric wards: differences between perceptions of users and staff according to department type. Ital J Pediatr 2020; 46:65. [PMID: 32430001 PMCID: PMC7238599 DOI: 10.1186/s13052-020-00824-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 04/29/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND As the quality and quantity of patient-centered care may be perceived differently by recipients and independent observers, assessment of humanization of pediatric care remains an elusive issue. Herein we aim to analyze differences between the degrees of verified existing vs. perceived humanization issues of a pediatric ward. Furthermore, we examine whether there is concurrence between the degrees of humanization perceived by users (parents/visitors) vs. staff members. METHODS The study was conducted in the pediatric wards of seven medical centers of the Campania region (Italy) categorized as general (n = 4), children's (n = 1), and university (n = 2) hospitals. The degree of existing humanization was assessed by a multidisciplinary focus group for each hospital through a pediatric care-oriented checklist specifically developed to individuate the most critical areas (i.e., those with scores < 2.5). The degree of perceived humanization was assessed through four indicators: well-being, social aspects, safety and security, and health promotion. RESULTS The focus groups showed that critical areas common to all centers were mainly concerned with welfare, mediation, translation, and interpretation services. Specific critical issues were care and organizational processes oriented to the respect and specificity of the person and care of the relationship with the patient. Perceived humanization questionnaires revealed a lack of recreational facilities and mediation and translation services. As for specific features investigated by both tools, it was found that mediation and interpretation services were lacking in all facilities while patient perceptions and observer ratings for space, comfort, and orientation concurred only in the general hospital evaluations. CONCLUSIONS Future humanization interventions to ensure child- and family-friendly hospital care call for careful preliminary assessments, tailored to each pediatric ward category, which should consider possible differences between perceived and verified characteristics.
Collapse
Affiliation(s)
- C Mandato
- Pediatria Sistematica AORN "Santobono-Pausilipon", Via Fiore, 6, Naples, Italy.
| | - M A Siano
- Cattedra di Pediatria - Dipartimento Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana" Università di Salerno, UNISA, Baronissi, Salerno, Italy
| | - A G E De Anseris
- Pediatria AOU "S. Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
- Clinica Pediatrica AOU "S. Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - M Tripodi
- Cattedra di Pediatria - Dipartimento Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana" Università di Salerno, UNISA, Baronissi, Salerno, Italy
| | - G Massa
- Cattedra di Pediatria - Dipartimento Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana" Università di Salerno, UNISA, Baronissi, Salerno, Italy
| | - R De Rosa
- Cattedra di Pediatria - Dipartimento Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana" Università di Salerno, UNISA, Baronissi, Salerno, Italy
| | - M Buffoli
- Dipartimento di Architettura, Ingegneria delle Costruzioni e Ambiente Costruito Politecnico di Milano, Milan, Italy
| | - A Lamanna
- Agenzia Nazionale per i Servizi Sanitari Regionali. AGENAS, Rome, Italy
| | - P Siani
- Pediatria Sistematica AORN "Santobono-Pausilipon", Via Fiore, 6, Naples, Italy
| | - P Vajro
- Cattedra di Pediatria - Dipartimento Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana" Università di Salerno, UNISA, Baronissi, Salerno, Italy
- Pediatria AOU "S. Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
- Clinica Pediatrica AOU "S. Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| |
Collapse
|
14
|
Looking at the Future, Learning from the Past: Current Activities and Upcoming Goals of the European Paediatric Association, the Union of National European Paediatric Societies and Associations. J Pediatr 2020; 220:272-274.e1. [PMID: 32151391 DOI: 10.1016/j.jpeds.2020.02.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 11/24/2022]
|
15
|
The Health Risks of Electronic Cigarettes Use in Adolescents. J Pediatr 2020; 219:286-287.e3. [PMID: 32033794 DOI: 10.1016/j.jpeds.2020.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 02/08/2023]
|
16
|
The Burden of Depression in Adolescents and the Importance of Early Recognition. J Pediatr 2020; 218:265-267.e1. [PMID: 31932020 DOI: 10.1016/j.jpeds.2019.12.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 02/08/2023]
|
17
|
Pop TL, Namazova-Baranova L, Mestrovic J, Nigri L, Vural M, Sacco M, Giardino I, Ferrara P, Pettoello-Mantovani M. The Role of Healthy Lifestyle Promotion, Counseling, and Follow-up in Noncommunicable Diseases Prevention. J Pediatr 2020; 217:221-223.e1. [PMID: 31740143 DOI: 10.1016/j.jpeds.2019.10.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 02/08/2023]
Affiliation(s)
- Tudor Lucian Pop
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; 2nd Pediatric Clinic, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Leyla Namazova-Baranova
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Russian Medical Research and Scientific Medical University of Moscow, Russian Federation, Moscow, Russia
| | - Julije Mestrovic
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Medical School of Split, University Hospital of Split, Split, Croatia
| | - Luigi Nigri
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Italian Federation of Pediatricians, Rome, Italy
| | - Mehmet Vural
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; University of Istanbul, Istanbul University Cerrahpaşa, Medical Faculty, Istanbul, Turkey
| | - Michele Sacco
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza" SCV, University of Foggia, Foggia, Italy
| | - Ida Giardino
- Department of Biomedical Sciences, University of Foggia, Foggia, Italy
| | - Pietro Ferrara
- Institute of Pediatrics, Catholic University Medical School, Rome, Italy; Service of Pediatrics, Campus Bio-Medico University, Rome, Italy
| | - Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza" SCV, University of Foggia, Foggia, Italy.
| |
Collapse
|
18
|
Hadjipanayis A, van Esso D, Del Torso S, Dornbusch HJ, Michailidou K, Minicuci N, Pancheva R, Mujkic A, Geitmann K, Syridou G, Altorjai P, Pasinato A, Valiulis A, Soler P, Cirstea O, Illy K, Mollema L, Mazur A, Neves A, Zavrsnik J, Lapii F, Efstathiou E, Kamphuis M, Grossman Z. Vaccine confidence among parents: Large scale study in eighteen European countries. Vaccine 2019; 38:1505-1512. [PMID: 31848051 DOI: 10.1016/j.vaccine.2019.11.068] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 11/18/2019] [Accepted: 11/26/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Despite the fact that vaccines save 2-3 million lives worldwide every year, a percentage of children are not getting appropriately vaccinated, thus leading to disease outbreaks. One of the major reasons of low vaccine uptake in Europe is vaccine hesitancy, contributing to the recent measles outbreaks. Monitoring of vaccine hesitancy is valuable in early identification of vaccine concerns. METHODS We performed an eighteen country European survey on parents' attitudes and behaviors regarding their children's immunization. Parents having at least one child 1-4 years old were mostly recruited by primary care paediatricians to reply to a web-based questionnaire. The questionnaire was developed by the European Academy of Paediatrics Research in Ambulatory Setting Network steering committee, based on similar surveys. An individual level hesitancy score was constructed using the answers to 21 questions, and correlations of the score with socio-demographic characteristics and types of providers were explored. To assess inter country differences, a country level self -reported confidence was defined. RESULTS Fifty six percent and 24% of 5736 respondents defined themselves as "not at all hesitant", and "somewhat hesitant", respectively. Parents who consulted general practitioners were more hesitant than parents who consulted pediatricians (p < 0.05). Consultation with homeopathists was associated with the highest reported hesitancy (p < 0.05). Vaccine confidence was highest in Portugal and Cyprus, and lowest in Bulgaria and Poland. CONCLUSION The majority of parents in Europe believe in the importance of childhood vaccination. However, significant lack of confidence was found in certain European countries, highlighting the need for continuous monitoring, awareness and response plans. The possible influence of different types of healthcare providers on parental decisions demonstrated for the first time in our survey, calls for further research. Monitoring and continuous medical education efforts aimed mostly at those professionals who might not be likely to recommend vaccination are suggested.
Collapse
Affiliation(s)
- Adamos Hadjipanayis
- Paediatric Department, Larnaca General Hospital, Inomenon Polition, Larnaca 6042, Cyprus; European University Medical School, 6, Diogenis Street, Engomi, 1516 Nicosia, Cyprus.
| | - Diego van Esso
- Primary Care Service, Catalan Institute of Health, Barcelona, Spain
| | | | | | - Kyriaki Michailidou
- Department of Electron Microscopy/Molecular Pathology and Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Cyprus.
| | | | - Ruzha Pancheva
- Department of Hygiene and Epidemiology, Faculty of Public Health, Prof. Paraskev Stoyanov Medical University, Bulgaria
| | - Aida Mujkic
- University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Zagreb, Croatia.
| | | | - Garyfallia Syridou
- Paediatric Department, Thriasio General Hospital of Elefsina Athens, Greece
| | - Peter Altorjai
- Tóth Ilona Healthcare Service, Primary Paediatric Care Offices Görgey Artúr tér 8, Budapest H-1212, Hungary
| | - Angela Pasinato
- Pediatra di libera scelta, Azienda 8 Berica, Pediatra, Vicenza, Italy
| | - Arunas Valiulis
- Vilnius University Faculty of Medicine, Institute of Clinical Medicine and Institute of Health Sciences, Vilnius City Clinical Hospital, Vilnius, Lithuania.
| | - Paul Soler
- Department of Child & Adolescent Health, Mater Dei Hospital Msida, Malta.
| | - Olga Cirstea
- Department of Pediatrics, State University of Medicine and Pharmacy "Nicolae Testemitanu"Chisinau, Republic of Moldova.
| | - Károly Illy
- Department of Paediatrics, Ziekenhuis Rivierenland, Tiel, the Netherlands.
| | - Liesbeth Mollema
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Artur Mazur
- Medical Faculty, University of Rzeszów, Rzeszów, Poland.
| | - Ana Neves
- Pediatric Allergy Unit, Pediatric Department, University Hospital of Santa Maria, Faculty of Medicine, Lisbon University, Portugal
| | - Jernej Zavrsnik
- Community Health Center "dr. Adollf Drolc", Maribor, Slovenia.
| | - Fedir Lapii
- National Medical Academy of Postgraduate Education, Department of Pediatric Infectious Diseases and Pediatric Immunology, Kyiv, Ukraine
| | | | - Mascha Kamphuis
- Dutch Expertise Center Child Abuse, Utrecht, the Netherlands.
| | - Zachi Grossman
- Pediatric Clinic, Maccabi Healthcare Services, Tel Aviv, Israel.
| |
Collapse
|
19
|
Ferrara P, Franceschini G, Namazova-Baranova L, Vural M, Mestrovic J, Nigri L, Giardino I, Pop TL, Sacco M, Pettoello-Mantovani M. Lifelong Negative Influence of School Violence on Children. J Pediatr 2019; 215:287-288.e2. [PMID: 31761142 DOI: 10.1016/j.jpeds.2019.09.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 02/08/2023]
Affiliation(s)
- Pietro Ferrara
- Institute of Pediatrics, Catholic University Medical School, Rome, Italy; Service of Pediatrics, Campus Bio-Medico University, Rome, Italy
| | | | - Leyla Namazova-Baranova
- European Pediatric Association/Union of National European Pediatric Societies and Associations, Berlin, Germany; Russian Medical Research and Scientific Medical University of Moscow, Russian Federation, Moscow, Russia
| | - Mehmet Vural
- European Pediatric Association/Union of National European Pediatric Societies and Associations, Berlin, Germany; University of Istanbul, Istanbul University Cerrahpaşa, Medical Faculty, Istanbul, Turkey
| | - Julije Mestrovic
- European Pediatric Association/Union of National European Pediatric Societies and Associations, Berlin, Germany; Medical School of Split, University Hospital of Split, Split, Croatia
| | - Luigi Nigri
- European Pediatric Association/Union of National European Pediatric Societies and Associations, Berlin, Germany; Italian Federation of Pediatricians, Rome, Italy
| | - Ida Giardino
- Department of Biomedical Sciences, University of Foggia, Foggia, Italy
| | - Tudor Lucian Pop
- European Pediatric Association/Union of National European Pediatric Societies and Associations, Berlin, Germany; 2nd Pediatric Clinic, University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Romania
| | - Michele Sacco
- Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza", University of Foggia, Foggia, Italy
| | - Massimo Pettoello-Mantovani
- European Pediatric Association/Union of National European Pediatric Societies and Associations, Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza", University of Foggia, Foggia, Italy.
| |
Collapse
|
20
|
The Clinician Scientist, a Distinct and Disappearing Entity. J Pediatr 2019; 212:252-253.e2. [PMID: 31439168 DOI: 10.1016/j.jpeds.2019.06.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 06/25/2019] [Indexed: 11/22/2022]
|
21
|
Namazova-Baranova L, Carrasco-Sanz A, Vural M, Huss G, Mestrovic J, Barak S, Hoey H, Werner A, Schuhmacher M, Pettoello-Mantovani M. European Pediatricians: Speaking with One Voice to Advocate for Children and Their Health. J Pediatr 2019; 211:227-228. [PMID: 31349917 DOI: 10.1016/j.jpeds.2019.05.071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 05/29/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Leyla Namazova-Baranova
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany
| | | | - Mehmet Vural
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany
| | - Gottfried Huss
- European Confederation of Primary Care Pediatricians (EPCP), Lyone, France
| | - Julije Mestrovic
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany
| | - Shimon Barak
- European Confederation of Primary Care Pediatricians (EPCP), Lyone, France
| | - Hilary Hoey
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany
| | - Andreas Werner
- European Confederation of Primary Care Pediatricians (EPCP), Lyone, France
| | - Mario Schuhmacher
- European Confederation of Primary Care Pediatricians (EPCP), Lyone, France
| | - Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany.
| |
Collapse
|
22
|
Ferrara P, Vural M, Cokugras FC, Nigri L, Pop TL, Mestrovic J, Giardino I, Namazova-Baranova L, Pettoello-Mantovani M. The Risk of Gambling Disorders in Children and Adolescents. J Pediatr 2019; 210:245-247.e1. [PMID: 31234986 DOI: 10.1016/j.jpeds.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 04/03/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Pietro Ferrara
- Italian Society of Pediatrics (SIP), Campus Bio-Medico University Medical School, Rome, Italy
| | - Mehmet Vural
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; University of Istanbul, Istanbul University Cerrahpaşa, Medical Faculty, Istanbul, Turkey
| | - Fugen Cullu Cokugras
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; University of Istanbul, Istanbul University Cerrahpaşa, Medical Faculty, Istanbul, Turkey
| | - Luigi Nigri
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Italian Federation of Pediatricians, Rome, Italy
| | - Tudor Lucian Pop
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; 2nd Pediatric Clinic, University of Medicine and Pharmacy Iuliu Hatieganu, Romanian Society of Social Pediatrics, Cluj-Napoca, Romania
| | - Julije Mestrovic
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Medical School of Split, University Hospital of Split, Split, Croatia
| | - Ida Giardino
- Department of Biomedical Sciences, University of Foggia, Foggia, Italy
| | - Leyla Namazova-Baranova
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Russian Medical Research and Scientific medical University of Moscow, Russian Federation, Moscow, Russia
| | - Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza", University of Foggia, Foggia, Italy.
| |
Collapse
|
23
|
Pavo MR, de Inocencio J. Pediatrician Beliefs about Juvenile Idiopathic Arthritis May Result in Referral Delays: A Spanish National Survey. J Pediatr 2019; 209:236-239.e2. [PMID: 30679051 DOI: 10.1016/j.jpeds.2018.12.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/14/2018] [Accepted: 12/18/2018] [Indexed: 12/13/2022]
Abstract
We explored, through a national survey, pediatrician beliefs and misconceptions that could interfere with early referral of patients with juvenile idiopathic arthritis. A total of 831 pediatricians participated. Approximately one-half of the respondents underestimated the incidence of the disease and thought that pain was the leading symptom of oligoarticular forms.
Collapse
Affiliation(s)
- María Rosa Pavo
- Pediatric Primary Care, Centro de Salud García Noblejas, Madrid
| | - Jaime de Inocencio
- Pediatric Rheumatology Unit, University Hospital 12 de Octubre, Madrid, Spain; Department of Public Health and Maternal and Pediatric Health, Complutense University of Madrid, Madrid, Spain.
| |
Collapse
|
24
|
Biasci P, Sanz AC, Pop TL, Pettoello-Mantovani M, D'Avino A, Nigri L. The State of Children's Health in Europe. J Pediatr 2019; 209:260-261.e1. [PMID: 31128729 DOI: 10.1016/j.jpeds.2019.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/04/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Paolo Biasci
- Italian Federation of Pediatricians, Rome, Italy
| | - Angel Carrasco Sanz
- European Confederation of Primary Care Paediatricians (EPCP), Lyon, France; Primary Care Health Centre Potosi, Madrid, Spain
| | - Tudor Lucian Pop
- 2nd Paediatric Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Romanian Society of Social Pediatrics, Cluj-Napoca, Romania; European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany
| | - Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza", University of Foggia, Foggia, Italy.
| | | | - Luigi Nigri
- Italian Federation of Pediatricians, Rome, Italy; European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany
| |
Collapse
|
25
|
Freychet C, Lambert C, Pereira B, Stephan JL, Echaubard S, Merlin E, Chausset A. Medical pathways of children with juvenile idiopathic arthritis before referral to pediatric rheumatology centers. Joint Bone Spine 2019; 86:739-745. [PMID: 31121314 DOI: 10.1016/j.jbspin.2019.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/17/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE A better understanding about the referral pathway of patients suffering from juvenile idiopathic arthritis (JIA) is required The aim of this study was to describe and analyze time from onset of symptoms to first pediatric rheumatology (PR) visit and the referral pathway of children with incident JIA in two French competence centers. METHODS From October 2009 to October 2017, new JIA patients were registered in the "Auvergne-Loire cohort on JIA". We collected referral pathway, symptom onset, biological and clinical data at first assessment in PR department. RESULTS In all, 111 children were included. Median time to first PR visit was 3.3 months [interquartile range (IQR) 1.3, 10.7] with a significant difference between JIA subtypes. After exclusion of systemic JIA, older age at onset of symptoms, and presence of enthesitis or joint pain were significantly associated with a longer time to first PR visit, while joint swelling or limping, abnormal ESR or CRP were associated with a shorter time. The median number of health care practitioners met was 3 [IQR 3, 4]. Orthopedists referred children to a PR center in 64% of cases, pediatricians in 50%, emergency care practitioners in 27% and general practitioners in 25%. Although non-systemic JIAs are not an emergency, 45% were referred to the emergency room. CONCLUSION Time to first PR visit is rather short compared to other countries but remains too long. Pediatric rheumatologists should offer primary care providers basic training on JIA and fast direct access to PR departments if JIA is suspected.
Collapse
Affiliation(s)
- Caroline Freychet
- Health services and performance research (HESPER) laboratory, Claude-Bernard university, 8, avenue Rockefeller, 69003 Lyon, France; Service de pédiatrie, CHU de St-Étienne, 42000 St-Étienne, France.
| | - Céline Lambert
- Délégation de la recherche clinique et de l'innovation, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - Bruno Pereira
- Délégation de la recherche clinique et de l'innovation, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - Jean L Stephan
- Service de pédiatrie, CHU de St-Étienne, 42000 St-Étienne, France
| | - Stéphane Echaubard
- Inserm CIC 1405, service de pédiatrie, CHU Estaing, 63003 Clermont-Ferrand, France
| | - Etienne Merlin
- Inserm CIC 1405, service de pédiatrie, CHU Estaing, 63003 Clermont-Ferrand, France
| | - Aurélie Chausset
- Inserm CIC 1405, service de pédiatrie, CHU Estaing, 63003 Clermont-Ferrand, France
| |
Collapse
|
26
|
Lupu A, Erfidan E, Ferreira-Magalhaes M, Lewis S, Lupu VV, Fitzgerald M, Manca E, Beșer ÖF. The Evolution of the European Young Pediatricians Association (EURYPA). J Pediatr 2019; 207:267-268.e1. [PMID: 30922499 DOI: 10.1016/j.jpeds.2019.01.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Ancuta Lupu
- Pediatrics Department, "Grigore. T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Erkan Erfidan
- Division of Pediatrics, University of Health Sciences, Kanuni Sultan Süleyman Education and Training Hospital, Istanbul, Turkey
| | | | - Sarah Lewis
- Royal College of Physicians in Ireland, University of Limerick, Limerick, Ireland
| | - Vasile Valeriu Lupu
- Pediatrics Department, "Grigore. T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
| | - Michael Fitzgerald
- Royal College of Physicians in Ireland-Children's University Hospital, Dublin, Ireland
| | - Enrica Manca
- Board member of the Osservatorio Nazionale Specializzandi Pediatria, Padua, Italy; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza," University of Foggia, Foggia, Italy
| | - Ömer Faruk Beșer
- Department of Pediatrics, University of Health Sciences, Okmeydani Education and Training Hospital, Istanbul, Turkey
| |
Collapse
|
27
|
Harper BD, Nganga W, Armstrong R, Forsyth KD, Ham HP, Keenan WJ, Russ CM. Where are the paediatricians? An international survey to understand the global paediatric workforce. BMJ Paediatr Open 2019; 3:bmjpo-2018-000397. [PMID: 30815583 PMCID: PMC6361365 DOI: 10.1136/bmjpo-2018-000397] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/23/2018] [Accepted: 12/26/2018] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Our primary objective was to examine the global paediatric workforce and to better understand geographic differences in the number of paediatricians globally. Secondary objectives were to describe paediatric workforce expectations, who provides children with preventative care and when children transition out of paediatric care. DESIGN Survey of identified paediatric leaders in each country. SETTING Paediatric association leaders worldwide. MAIN OUTCOME MEASURES Paediatrician numbers, provision of primary care for children, age of transition to adult care. RESULTS Responses were obtained from 121 countries (73% of countries approached). The number of paediatricians per 100 000 children ranged from a median of 0.5 (IQR 0.3-1.4) in low-income countries to 72 (IQR 4-118) in high-income countries. Africa and South-East Asia reported the lowest paediatrician density (median of 0.8 paediatricians per 100 000 children, IQR 0.4-2.6 and median of 4, IQR 3-9, respectively) and fewest paediatricians entering the workforce. 82% of countries reported transition to adult care by age 18% and 39% by age 15. Most countries (91%) but only 64% of low-income countries reported provision of paediatric preventative care (p<0.001, Cochran-Armitage trend test). Systems of primary care provision varied widely. A majority of countries (63%) anticipated increases in their paediatric workforce in the next decade. CONCLUSIONS Paediatrician density mirrors known inequities in health provider distribution. Fewer paediatricians are entering the workforce in areas with already low paediatrician density, which may exacerbate disparities in child health outcomes. In some regions, children transition to adult care during adolescence, with implications for healthcare training and delivery. Paediatrician roles are heterogeneous worldwide, and country-specific strategies should be used to address inequity in child health provision.
Collapse
Affiliation(s)
- Beth D Harper
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Waceke Nganga
- Department of Paediatrics and Child Health, Aga Khan University, Nairobi, Kenya
| | | | - Kevin D Forsyth
- Flinders University Faculty of Medicine Nursing and Health Sciences, Adelaide, South Australia, Australia
| | - Hazen P Ham
- Global Pediatric Education Consortium, Chapel Hill, North Carolina, USA
| | - William J Keenan
- Department of Pediatrics, Saint Louis University, St Louis, Missouri, USA
| | - Christiana M Russ
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| |
Collapse
|
28
|
Ehrich J, Burla L, Sanz AC, Crushell E, Cullu F, Fruth J, Gerber-Grote A, Hoey H, Illy K, Janda J, Jansen D, Kerbl R, Mestrovic J, Mujkic A, Namazova-Baranova L, Nicholson A, Pettoello-Mantovani M, Pilossoff V, Sargsyans S, Somekh E, Trošelj M, Vural M, Werner A. As Few Pediatricians as Possible and as Many Pediatricians as Necessary? J Pediatr 2018; 202:338-339.e1. [PMID: 30360877 DOI: 10.1016/j.jpeds.2018.07.074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Jochen Ehrich
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Children's Hospital, Hannover Medical School, Hannover, Germany.
| | - Laila Burla
- Swiss Health Observatory (Obsan), Neuchâtel, Switzerland
| | - Angel Carrasco Sanz
- European Confederation of Primary Care Paediatricians (ECPCP), Rheinfelden, Germany; Primary Care Pediatrician, Primary Care Health Centre Potosi, Madrid, Spain
| | - Ellen Crushell
- Children's Hospital, Hannover Medical School, Hannover, Germany; School of Medicine Our Lady's Children's Hospital Crumlin, Dublin, Ireland
| | - Fügen Cullu
- Children's Hospital, Hannover Medical School, Hannover, Germany; University of Istanbul, Istanbul University Cerrahpaşa, Medical Faculty, Neonatology, Istanbul, Turkey
| | | | - Andreas Gerber-Grote
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Hilary Hoey
- Children's Hospital, Hannover Medical School, Hannover, Germany; Royal College of Physicians of Ireland, The University of Dublin Trinity College, Dublin, Ireland
| | - Karoly Illy
- Dutch Pediatric Association, Utrecht, the Netherlands; Ziekenhuis Rivierenland, Tiel, the Netherlands
| | - Jan Janda
- Children's Hospital, Hannover Medical School, Hannover, Germany; Second Medical School, Charles University, Prague, Czech Republic
| | - Danielle Jansen
- University Medical Center Groningen, Department of Health Sciences, University of Groningen, Groningen, the Netherlands; University of Groningen, Department of Sociology and Interuniversity for Social Science Theory and Methodology, University of Groningen, Groningen, the Netherlands; Section Child and Adolescent Public Health, European Public Health Association, Utrecht, the Netherlands
| | - Reinhold Kerbl
- Department of Pediatrics and Adolescent Medicine, General Hospital Leoben, Leoben, Austria
| | - Julije Mestrovic
- Children's Hospital, Hannover Medical School, Hannover, Germany; Medical School of Split, University Hospital of Split, Split, Croatia
| | - Aida Mujkic
- School of Medicine, Andrija Stampar School of Public Health, University of Zagreb, Zagreb, Croatia
| | - Leyla Namazova-Baranova
- Children's Hospital, Hannover Medical School, Hannover, Germany; Federal State Budgetary Institution "Scientific Center of Children's Health" Moscow, Moscow, Russian Federation
| | - Alf Nicholson
- Temple Street Children's University Hospital, Dublin, Ireland
| | - Massimo Pettoello-Mantovani
- Children's Hospital, Hannover Medical School, Hannover, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza", University of Foggia, Foggia, Italy
| | | | - Sergey Sargsyans
- Institute of Child and Adolescent Health at "Arabkir" Medical Centre, Yerevan State Medical University, Yerevan, Armenia
| | - Eli Somekh
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Maynei Hayeshuah Medical Center, Bnei Brak, Israel; The Sackler School of Medicine, Tel Aviv, Israel
| | - Mario Trošelj
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Mehmet Vural
- AFPA, French Association of Ambulatory Pediatricians, Saint-Germain-en-Laye, France
| | - Andreas Werner
- AFPA, French Association of Ambulatory Pediatricians, Saint-Germain-en-Laye, France
| |
Collapse
|
29
|
Završnik J, Stiris T, Schrier L, Russell RR, Del Torso S, Valiulis A, Mercier JC, Illy K, Hadjipanayis A. Basic training requirements for health care professionals who care for children. Eur J Pediatr 2018; 177:1413-1417. [PMID: 29696474 DOI: 10.1007/s00431-018-3150-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/05/2018] [Accepted: 04/08/2018] [Indexed: 11/25/2022]
Abstract
UNLABELLED The European Academy of Paediatrics (EAP) is the paediatric section of the European Union of Medical Specialists (UEMS). The UEMS is responsible for the supervision and approval of training programmes in paediatrics and in its subspecialties. This implies also that EAP has the responsibility to address the training of all professionals working with children, to ensure that their paediatric competences and skills are adequate when dealing with children. The EAP has developed syllabi for paediatricians that provide standards of practice, and criteria for the assessment of competencies in trainees and training centres across Europe. The EAP recommends that all health care professionals working with children should have an officially approved training in child health in addition to formal qualifications in their own field. Moreover, the existing paediatric workforce must maintain their knowledge and skills with relevant continuous professional development and medical education in child health. CONCLUSION There is a need to reassess the training of all health care professionals caring for children, ensuring that it supports new models of integrated and multidisciplinary care and focuses on the needs of the child and the family. A standardised, competency-based minimum paediatric training programme/curriculum should be part in the specialty curriculums.
Collapse
Affiliation(s)
- Jernej Završnik
- Community Health Center "dr. Adolf Drolc" Maribor, Vošnjakova 2-4, 2000, Maribor, Slovenia
- European Academy of Paediatrics, Brussels, Belgium
| | - Tom Stiris
- European Academy of Paediatrics, Brussels, Belgium
- Department of Neonatology, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lenneke Schrier
- European Academy of Paediatrics, Brussels, Belgium
- Pediatric Department, Willem Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert Ross Russell
- European Academy of Paediatrics, Brussels, Belgium
- Department of Paediatrics, Cambridge University Hospitals NHS Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Stefano Del Torso
- European Academy of Paediatrics, Brussels, Belgium
- Pediatra di Famiglia, ULSS6 Euganea, Padua, Italy
| | - Arunas Valiulis
- European Academy of Paediatrics, Brussels, Belgium
- Vilnius University Clinic of Children's Diseases and Public Health Institute, Vilnius, Lithuania
| | - Jean-Christophe Mercier
- European Academy of Paediatrics, Brussels, Belgium
- Service de Pédiatrie-Urgences, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris & Université Paris Diderot, Paris, France
| | - Károly Illy
- European Academy of Paediatrics, Brussels, Belgium
- Pediatric Department, Ziekenhuis Rivierenland Tiel, Tiel, The Netherlands
| | - Adamos Hadjipanayis
- European Academy of Paediatrics, Brussels, Belgium.
- Department of Paediatrics, Larnaca General Hospital, Larnaca, Cyprus.
- Medical School, European University of Cyprus, Nicosia, Cyprus.
| |
Collapse
|
30
|
Ehrich J, Pettoello-Mantovani M. Never-Ending Stories, the Loop in Pediatrics-How Many Pediatricians Need to be Trained in European Countries to Keep the Pediatric Workforce Stable? J Pediatr 2018; 196:332-333.e3. [PMID: 29703370 DOI: 10.1016/j.jpeds.2018.01.063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 01/22/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Jochen Ehrich
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Children's Hospital, Hannover Medical School, Hannover, Germany.
| | - Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza," University of Foggia, Foggia, Italy
| |
Collapse
|
31
|
Ehrich J, Somekh E, Pettoello-Mantovani M. The Importance of Expert Opinion-Based Data: Lessons from the European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA) Research on European Child Healthcare Services. J Pediatr 2018; 195:310-311.e1. [PMID: 29643017 DOI: 10.1016/j.jpeds.2017.12.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 12/19/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Jochen Ehrich
- European Paediatric Association/Union of National Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Children's Hospital, Hannover Medical School, Hannover, Germany.
| | - Eli Somekh
- European Paediatric Association/Union of National Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Wolfson Medical Center, Holon Israel, and The Sackler School of Medicine, Tel Aviv, Israel
| | - Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza," University of Foggia, Foggia, Italy
| |
Collapse
|
32
|
Urban-Rural Disparity in Geographical and Temporal Availability of Pediatric Clinics: A Nationwide Survey in Taiwan. Pediatr Neonatol 2017; 58:344-349. [PMID: 28126449 DOI: 10.1016/j.pedneo.2016.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/14/2016] [Accepted: 07/28/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The shortage and maldistribution of pediatricians affected after-hours pediatric services, especially in rural areas. Our study aimed to examine the urban-rural disparity in geographical and temporal availability of the pediatrician workforce in Taiwan by analyzing opening time schedules of all pediatric clinics throughout the country. METHODS The opening time schedules of nonhospital pediatric clinics were downloaded from the website of the National Health Insurance Administration in Taiwan for analysis. The geographical and temporal availability of pediatric clinics was calculated and stratified by urbanization level and opening time, which was divided into daytime and evening sessions over 1 week. Each of 368 towns in Taiwan was also regarded as a unit of measurement to estimate the local availability of at least one pediatric clinic open in after-hours sessions. RESULTS Among 1483 nonhospital pediatric clinics in Taiwan, the overwhelming majority were situated in urban (65.8%) and suburban (30.6%) areas. On average, a pediatric clinic provided 16.3 (standard deviation=3.04) sessions of services per week. One-third (34.7%, n=50) of 144 suburban towns and over three-fourths (77.4%, n=120) of 155 rural towns had no pediatric clinic. Most pediatric clinics remained open on weekday evenings (91.1%) and during Saturday daytime (91.8%). The percentage of open clinics gradually decreased over the weekend: Saturday evening (58.1%), Sunday daytime (33.4%), and Sunday evening (19.4%). Rural pediatric clinics remained closed mostly on weekends. On Sunday evenings, pediatric clinics were open only in 5.2% of rural towns, with a decline of 77.1%, whereas they were open in 78.3% of urban towns, with a decline of 18.2%. CONCLUSION Pediatric clinics in Taiwan were unevenly distributed between urban and rural areas. The disparity of pediatric services became more obvious at weekends. The consequences of undersupplied rural pediatric care deserve further investigation.
Collapse
|
33
|
Ehrich JHH, Pettoello-Mantovani M. Views of the presidents of national European pediatric societies on evolving challenges of child health care. J Pediatr 2016; 177:336-337.e1. [PMID: 27666080 DOI: 10.1016/j.jpeds.2016.04.090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jochen H H Ehrich
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Children's Hospital, Hannover Medical School, Hannover, Germany.
| | - Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Institute of Pediatrics, University of Foggia, IRCCS "Casa Sollievo", Foggia, Italy
| |
Collapse
|
34
|
Ehrich J, Namazova-Baranova L, Pettoello-Mantovani M. Introduction to "Diversity of Child Health Care in Europe: A Study of the European Paediatric Association/Union of National European Paediatric Societies and Associations". J Pediatr 2016; 177S:S1-S10. [PMID: 27666257 DOI: 10.1016/j.jpeds.2016.04.036] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The field of pediatrics in Europe is characterized by the diversities, variations, and heterogeneities of child health care services provided in 53 European countries with more than 200 million children below 18 years of age. Managing the health care of infants, children, and adolescents in Europe requires balancing clinical aims, research findings, and socioeconomic goals within a typical environment characterized by cultural and economic complexity and large disparity in availability, affordability, and accessibility of pediatric care. Since its foundation in 1976, the European Paediatric Association-Union of National European Paediatric Societies and Associations has worked to improve both medical care of all children and cooperation of their caretakers in Europe. Such a report has been conceived in the strong belief that broadening of the intellectual basis of the European Paediatric Association-Union of National European Paediatric Societies and Associations and creating a multidisciplinary society will be necessary to reduce fragmentation of pediatrics and tackle the legal, economic, and organizational challenges of child health care in Europe.
Collapse
Affiliation(s)
- Jochen Ehrich
- Children's Hospital, Hannover Medical School, Hannover, Germany; EPA-UNEPSA, Berlin, Germany
| | | | - Massimo Pettoello-Mantovani
- EPA-UNEPSA, Berlin, Germany; Institute of Pediatrics, University of Foggia, Istituto di Ricovero e Cura a Carattere Scientifico "Casa Sollievo", Foggia, Italy
| |
Collapse
|
35
|
Abstract
We provide an overview of Swiss child health care, describe the organizational structures of primary care services and hospital care in pediatrics, and analyze such significant challenges as the decline of the number of primary care physicians in communities and the economic and regulatory pressures on hospitals. We also offer thoughts and ideas for future directions, initiatives, and innovations to ensure that each child achieves the best possible health and quality of life, which is the ultimate goal of health care professionals. New developments should be promoted from a position of strength because Swiss pediatrics is well positioned, and its future remains bright.
Collapse
Affiliation(s)
- Oskar G Jenni
- Children's Research Center and the Child Development Center, University Children's Hospital Zürich, Zurich, Switzerland
| | - Felix H Sennhauser
- Children's Research Center and the Child Development Center, University Children's Hospital Zürich, Zurich, Switzerland
| |
Collapse
|
36
|
Abstract
PURPOSE OF REVIEW The review briefly describes the current state of adolescent health globally, and highlights current educational and training opportunities in Adolescent Medicine for healthcare providers worldwide. RECENT FINDINGS Despite a growing body of literature demonstrating a shift toward recognizing Adolescent Medicine as a subspecialty, there are very few countries that offer nationally recognized Adolescent Medicine training programs. In recent years, several countries have begun to offer educational programming, such as noncredentialed short training programs, conferences, and online courses. Challenges, including cultural barriers, financing, and lack of governmental recognition and support, have hindered progress in the development of accredited training programs globally. SUMMARY It is crucial to support efforts for sustainable training programs, especially within low and middle-income countries where a majority of the world's adolescent population lives. Sharing knowledge of existing curriculums, programs, and systems will increase opportunities globally to build regional capacity, increase access to interdisciplinary services, and to implement health-promoting policies for youth worldwide.
Collapse
|
37
|
Odundo GO, Ngwiri T, Otuoma O, Laigong P, Mukhwana R, Limbe MS, Chanzu NM. The Impact and Successes of a Paediatric Endocrinology Fellowship Program in Africa. Int J Endocrinol 2016; 2016:1560248. [PMID: 26904118 PMCID: PMC4745291 DOI: 10.1155/2016/1560248] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 12/24/2015] [Indexed: 12/29/2022] Open
Abstract
Background. The prevalence and distribution of endocrine disorders in children in Africa are not well known because most cases are often undiagnosed or diagnosed too late. The awareness of this led to the launch of the Paediatric Endocrinology Training Center for Africa (PETCA) designed to improve quality and access to health care by training paediatricians from Africa in paediatric endocrinology. Methods. The fellowship is undertaken over an 18-month period: six months of clinical and theoretical training in Kenya, nine months of project research at the fellow's home country, and three months of consolidation in Kenya. Upon completion, certified paediatricians are expected to set up centers of excellence. Results. There have been two phases, phase I from January 2008 to October 2012 and phase II from January 2012 to April 2015. Fifty-four fellows from 12 African countries have been certified, 34 (phase I) and 20 (phase II). Over 1,000 patients with wide ranging diabetes and endocrine disorders have been diagnosed and treated and are being followed up at the centers of excellence. Conclusion. The successes of the PETCA initiative demonstrate the impact a capacity building and knowledge transfer model can have on people in resource-poor settings using limited resources.
Collapse
Affiliation(s)
- Gordon Otieno Odundo
- Gertrude's Children's Hospital, P.O. Box 42325, Nairobi 00100, Kenya
- *Gordon Otieno Odundo:
| | - Thomas Ngwiri
- Gertrude's Children's Hospital, P.O. Box 42325, Nairobi 00100, Kenya
| | - Olivia Otuoma
- Gertrude's Hospital Foundation, Gertrude's Children's Hospital, P.O. Box 42325, Nairobi 00100, Kenya
| | - Paul Laigong
- Department of Paediatrics and Child Health, University of Nairobi, P.O. Box 460, Nairobi 00202, Kenya
| | - Renson Mukhwana
- Gertrude's Children's Hospital, P.O. Box 42325, Nairobi 00100, Kenya
| | - Mary Slessor Limbe
- Department of Paediatrics and Child Health, Aga Khan University, P.O. Box 30270, Nairobi 00100, Kenya
| | - Nadia Musimbi Chanzu
- Institute of Child Health and Research, Gertrude's Children's Hospital, P.O. Box 42325, Nairobi 00100, Kenya
| |
Collapse
|
38
|
Ehrich JHH, Kerbl R, Pettoello-Mantovani M, Lenton S. Opening the Debate on Pediatric Subspecialties and Specialist Centers: Opportunities for Better Care or Risks of Care Fragmentation? J Pediatr 2015; 167:1177-8.e2. [PMID: 26603716 DOI: 10.1016/j.jpeds.2015.07.060] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Jochen H H Ehrich
- European Paediatric Association (EPA-UNEPSA), Berlin, Germany; Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Reinhold Kerbl
- Department of Pediatrics and Adolescent Medicine, General Hospital Leoben, Leoben, Austria; Political Pediatric Medicine, Vienna, Austria
| | - Massimo Pettoello-Mantovani
- European Paediatric Association (EPA-UNEPSA), Berlin, Germany; Institute of Pediatrics and Pediatric Residency Program, University of Foggia, Foggia, Italy
| | - Simon Lenton
- European Paediatric Association (EPA-UNEPSA), Berlin, Germany; Child Health Department, Bath, United Kingdom
| |
Collapse
|
39
|
Stapleton FB. How Do We Create the Best Pediatric Workforce? Questions Abroad and at Home. J Pediatr 2015; 167:227-8. [PMID: 25976590 DOI: 10.1016/j.jpeds.2015.04.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 04/20/2015] [Indexed: 11/24/2022]
Affiliation(s)
- F Bruder Stapleton
- Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington.
| |
Collapse
|