Paediatrician最新文献

Perinatal and infant mortality is a serious public health problem throughout the world. Its prevention has major social, medical, and economic implications. Prospective and retrospective studies of pregnancy and infancy in many populations of the world have resulted in the definition of risk factors correlated with perinatal morbidity and mortality. Early recognition of these risk factors is extremely important for the prevention of perinatal morbidity and mortality. The most important risk factors are related to the age of the pregnant mother, parity, race, previous fetal loss, medical care, poverty, illegitimate or unwanted pregnancy, education of the mother, multiple births and maternal morbidity.

Calcium and phosphorus disturbances in childhood are discussed in vitamin D deficiency rickets, neonatal tetany and beta-homozygous thalassaemia. The nutritional, epidemiological, hereditary and other factors facilitating the development of the disease in these three groups of children are illustrated. The level of culture and sociability of the community must be taken into consideration for the success of the preventive medicine services, especially with regard to vitamin D deficiency rickets. The administration of phosphorus and vitamin D or metabolites of vitamin D to thalassaemic children would probably produce beneficial effects on bone and muscle changes.

The use of hydrogen peroxide as a labile and safe food preservative in fish cake and boiled noodles has recently been restricted by the Japanese government, since hyperplasia has been found in the duodenum of mice after long-term peroral study. The action of compounds with resembling mode of action, potassium bromate as an improving agent in bread, and sodium chlorate as a weed killer are discussed in this paper in view of developmental and environmental pharmacology.

Mental retardation is a very important health problem since it affects approximately 3% of the population. Prevention should begin by public education and complemented by measures taken during the preconceptional, the prenatal, the perinatal and the postnatal periods. Health and family planning, recognition of "at risk" situations, genetic counseling, prenatal care, antenatal diagnosis, neonatal screening and pediatric care are just a few of the preventive actions to safe-guard the birth of normal children and secure normal mental development.

In the Greek milieu the ingroup has played the central role for psychosocial development. Under transition the ingroup becomes decreasingly effective in providing this function. If malfunctioning is to be prevented and if functioning is to spiral to higher levels of creating, producing and sharing, a training problem is required which includes extensive work along the lines of secondary and primary groups. The proposed training is based on the actualization of the dialectic between individual and group processes leading to their mutual differentiation. The development of skills for cooperation becomes possible. The program represents an effective way of promoting functioning and preventing the malfunctioning due to the currently accelerating socioeconomic and technological processes. Its effectiveness will be directly related to the degree to which the latter will be following cooperative directions also.

This paper has identified nurse practitioners, physician's assistants and, potentially, nurse-midwives, as nonphysician health care providers who might have a significant impact on physician manpower requirements in pediatrics in the United States. These providers are capable of providing well child care, as well as care for minor illnesses. Patient acceptance and the quality of care rendered by these providers appear to be high. Physician acceptance is also high, especially when the physician has actually employed a nonphysician provider. State legislation and reimbursement procedures may interfere with the full utilization of nonphysician providers, but when nurse practitioners and physician assistants are employed in pediatric care, they deliver a wide range of services efficiently and economically. There are estimated to be a total of approximately 5,500 nonphysician providers specializing in pediatric care, but other nonphysician providers who may also care for children are discussed. The total number of these providers for 1980 is estimated at 7,232 and for 1990, at 15,512.