Exploration and practice of hierarchical training model for improving professional ability of primary pediatricians / 中华医学教育探索杂志

At present, the routine specialized training for primary pediatricians (focusing on theoretical learning of public subjects) cannot meet the needs of primary pediatricians. In order to promote the development of children's medical care at the grassroots level and improve the quality, medical and clinical research abilities of regional pediatric medical personnel, the Children's Hospital of Chongqing Medical University has designed and built a "hierarchical training model for improving the professional ability of pediatricians" from the aspects of training objectives, training contents, training methods, construction and evaluation of training programs, and quality control. In addition, the 8-month "Pediatric Professional Basic Training" and the 9-month "Pediatric Professional Ability Improvement Training" were respectively carried out in Xianyang Children's Hospital. In the "Professional Basic Training", 88 trainees were comprehensively evaluated after training, 53 of whom were qualified or above. In the "Ability Improvement Training", 26 of the 29 students actually participated in the evaluation and reached the qualified level or above. Learners provided feedbacks that they have effectively improved their own knowledge structure, expanded their clinical diagnosis and treatment thinking and clinical research ideas, and provided some guidance for clinical work.

Mental Health Status and Influencing Factors of Pediatricians in Guangzhou / 中山大学学报(医学科学版)

ObjectiveTo investigate the mental health of pediatricians in Guangzhou and its influencing factors， and to provide countermeasures for improving the mental health of pediatricians. MethodsA stratified random sampling method was used to randomly select 400 pediatricians in 11 districts of Guangzhou， and they were surveyed using the Symptom Check List（SCL-90） and the Job Stressor Scale. ResultsThe top three job stressors scored by pediatricians in Guangzhou were external environment （3.23±0.59）， workload （3.19±0.56）， and organizational management （2.74±0.55）. All factor scores were higher than those of the clinician group except for career interest， and the difference was statistically significant （P<0.01）. The number of pediatricians with mental health problems was 109， accounting for 27.25%. All factor scores were higher than the physician norm except for anxiety and paranoia. The correlations between each factor of work stressors and each factor of SCL-90 were positive and statistically significant （P<0.05）， except for two pairs of factors， workload and terror as well as external environment and terror. The results of univariate analysis showed statistically significant differences in the mental health scores of pediatricians with different health status， years of work experience， job satisfaction， job stress， and career prospects （P<0.05）. The results of multiple linear regression showed that health status， years of work experience， professional interest， interpersonal relationship， and doctor-patient relationship were influential factors in the mental health of pediatricians （P<0.05）. ConclusionThe mental health of pediatricians in Guangzhou is unsatisfactory， and the factors affecting them are mainly external objective factors such as workload and organizational management.

El rol del pediatra en la prevención de la fecundidad adolescente

La fecundidad adolescente en Cuba es elevada y muestra resistencia a su reducción en los últimos años a pesar de las acciones realizadas. Para promover una sexualidad responsable en los adolescentes, se requiere de un diferente y particular accionar de los pediatras. El objetivo de esta colaboración es aportar elementos que sensibilicen e involucren a los pediatras cubanos para que ofrezcan orientación a los adolescentes sobre el ejercicio de una sexualidad plena, libre y responsable, que contribuya a la reducción de la fecundidad y al cuidado integral de la salud sexual y reproductiva. El método utilizado fue la revisión de las legislaciones vigentes y las recomendaciones de varias sociedades internacionales de pediatría, respecto a la función e importancia de la especialidad en la prevención del embarazo adolescente. Se destacan las ventajas del pediatra para la prevención de la fecundidad adolescente, se explican las habilidades que deben adquirir para informar y orientar a los adolescentes, se analizan las barreras que debe favorecer el acceso del adolescente a la prevención de la fecundidad y se exponen las recomendaciones específicas para su actuación Se concluye que los pediatras cubanos pueden contribuir a la reducción de la fecundidad y mejorar el cuidado integral de la salud sexual y reproductiva de los adolescentes.

Adolescent fertility in Cuba is high and shows resistance to its reduction in recent years despite the actions taken. To promote responsible sexuality in adolescents, a different and particular action of pediatricians is required. The objective of this collaboration is to provide elements that sensitize and involve Cuban pediatricians to offer guidance to adolescents on the exercise of a full, free and responsible sexuality, which contributes to the reduction of fertility and comprehensive care of sexual and reproductive health. The method used was the review of current legislation and the recommendations of several international pediatric societies, regarding the role and importance of the specialty in the prevention of adolescent pregnancy. The advantages of the pediatrician for the prevention of adolescent fertility are highlighted, the skills they must acquire to inform and guide adolescents are explained, the barriers that the pediatrician must face to favor the access of adolescents to prevent fertility are analyzed, and the specific recommendations for the action of the pediatrician in the prevention of adolescent fertility are exposed. It is concluded that Cuban pediatricians can contribute to the reduction of fertility and improve the comprehensive care of sexual and reproductive health of adolescents.

Analysis on the equity of pediatrician resource allocation in Beijing / 中华医院管理杂志

Objective:To analyze the equity of pediatrician resource allocation in Beijing from 2010 to 2019, and to provide a reference for optimizing their allocation.Methods:The data of pediatrician resources in Beijing in 2010, 2014, and 2019 were collected. The resource agglomeration degree, Gini coefficient and Theil index method were used to analyze the fairness of resource allocation of pediatricians in functional areas in Beijing.Results:In 2010, 2014, and 2019, the Gini coefficients of Beijing′s overall pediatrician resources by the dimension of the number of children were 0.386, 0.276 and 0.286, respectively, an allocation relatively reasonable. But the Gini coefficients by that of geographic areas were 0.681, 0.578 and 0.537 respectively, still unreasonable. The resource allocation of pediatricians in the four regions was fair, but the aggregation degree of pediatricians in the central area of Beijing were 70.327, 59.243, and 53.220 in the three years, far higher than that in the urban functional development area, urban development new area and ecological conservation development area of the city.Conclusions:Beijing should rationally plan and allocate pediatrician resources, in order to minimize unequal resources allocation induced by regional differences. Such means as advancing the hierarchical diagnosis and treatment system and strengthening the construction of medical alliances are expected to gradually alleviate the conflicts between the growing demand for pediatrician resources and their unreasonable allocation.

An investigation on the cognition of neonatal pain assessment and analgesia management among medical staff in the neonatal intensive care unit / 中国当代儿科杂志

OBJECTIVES@#To investigate the current status of the cognition of neonatal pain assessment and analgesia management among medical staff in the neonatal intensive care unit (NICU).@*METHODS@#A self-made scale was developed according to "Expert consensus on neonatal pain assessment and analgesia management (2020 edition)" and was used to distribute questionnaires to the medical staff in the NICU from the member units of Jiangsu Province Medical Quality Control Centre of Neonatal Department to evaluate their levels of understanding the basic knowledge, assessment, and management of neonatal pain.@*RESULTS@#A total of 957 questionnaires (from 383 doctors and 574 nurses) were collected. Doctors and nurses had mean correct rates of 38% and 39% respectively in answering the questions on the basic knowledge of neonatal pain. They had median correct rates of 0% and 50% respectively in answering the questions on neonatal pain assessment, and mean correct rates of 73% and 68% respectively in answering on analgesia management. Compared with those who did not receive the training on neonatal pain, the medical staff who received such training had significantly higher correct rates in answering the questions on the basic knowledge of neonatal pain and neonatal pain assessment (@*CONCLUSIONS@#The medical staff in the NICU have insufficient cognition of neonatal pain, and thus it is necessary to carry out the special training on neonatal pain, focusing on the promotion and practical application of "Expert consensus on neonatal pain assessment and analgesia management (2020 edition)", in order to improve the level of neonatal pain assessment and analgesia management among medical staff in the NICU.

Pediatricians after residency: a survey of personal/professional data and issues / Pediatras após a residência médica: um questionário sobre dados e problemas pessoais/profissionais

ABSTRACT Objective: To assess personal, professional, medical, and scientific educational characteristics and issues reported by pediatricians. Methods: Cross-sectional study based on an online survey including 614 pediatricians who graduated in the last 15 years at a University Pediatric Department in Brazil. Results: The response rate was 331/614(54%). The majority were females (82%), the median age was 33 years (27-40) and median years of pediatric practice was 5 (1-13). High workload (>60 hours/week) occurred in 25% and 47% earned ≥15 minimum wages/month. The most work-related issues reported were long working hours, poor social life and a sedentary lifestyle (>50%). Pediatricians were further divided into two groups, according to years of pediatric clinical practice: group 1 (≤5 years) and group 2 (>5 years). The median of overall satisfaction with pediatric residency [8(0-10) vs. 9 (4-10); p=0.002] was significantly reduced in group 1. The frequencies of workload >60 hours, work on pediatric ward and pediatric intensive care were significantly higher in the first group (p<0.05). Regarding main issues related to clinical practice in the last year, long working hours (73 vs. 53%; p<0.001), poor social life (75 vs. 62%; p=0.018) and harassment (23 vs. 4%; p=0.003) were significantly higher in the first group. Conclusions: Very early career pediatricians (≤5 years) reported higher workload, lower income, work-related issues and different location of pediatric practice compared to early career pediatricians (>5 years). The overall satisfaction with pediatric residency was good, however, reduced in very early career pediatricians.

RESUMO Objetivo: Avaliar características e problemas pessoais, profissionais, médicos e de educação científica reportados por pediatras. Métodos: Estudo transversal com base em uma pesquisa online, incluindo 614 pediatras formados nos últimos 15 anos no Departamento de Pediatria de uma universidade brasileira. Resultados: A taxa de resposta foi de 331/614 (54%). A maioria dos participantes era do sexo feminino (82%), a mediana de idade foi de 33 anos (27-40 anos) e a mediana de tempo de prática pediátrica foi de 5 anos (1-13). Jornada de trabalho elevada (>60 horas/semana) foi relatada por 25% dos entrevistados e 47% recebiam ≥15 salários mínimos/mês. Os problemas relacionados ao trabalho mais frequentes foram jornadas longas de trabalho, vida social insatisfatória e sedentarismo (>50%). Os pediatras foram divididos em dois grupos de acordo com os anos de prática clínica pediátrica: grupo 1 (≤5 anos) e grupo 2 (>5 anos). A mediana de satisfação geral com a residência pediátrica [8 (0-10) versus 9 (4-10); p=0,002] foi significativamente menor no grupo 1. As frequências de jornada de trabalho >60 horas, trabalho na enfermaria pediátrica e na terapia intensiva pediátrica foram significativamente maiores no primeiro grupo (p<0,05). Quanto aos principais problemas relacionados à prática clínica no ano anterior, jornadas longas de trabalho (73 versus 53%; p<0,001), vida social insatisfatória (75 versus 62%; p=0,018) e assédio (23 versus 4%; p=0,003) foram significativamente mais elevados no grupo 1. Conclusões: Pediatras em início de carreira (≤5 anos) relataram maior jornada de trabalho, menor renda, problemas relacionados ao trabalho e diferentes locais de trabalho em comparação com pediatras mais experientes (>5 anos). A satisfação geral com a residência pediátrica foi boa, porém menor em pediatras do primeiro grupo.

Experiencia de las madres de niños con síndrome de Down al momento del diagnóstico / Experience of mothers with Down syndrome children at the time of diagnosis

Introducción. El síndrome de Down (SD) es un trastorno genético frecuente. Las familias de los niños con SD en general no reciben suficiente información al momento del diagnóstico. El objetivo de este estudio fue evaluar las experiencias de las madres de niños con SD al momento que le dieron el diagnóstico y la comunicación que brindaron los profesionales de la salud. Población y métodos. Se incluyeron madres de niños con síndrome de Down. Se evaluaron sus experiencias con la información del diagnóstico y las actitudes de los profesionales, mediante una entrevista semiestructurada. Resultados. La muestra fue 43 madres. Se diagnosticó SD durante el control prenatal en ocho niños y en 35 después del nacimiento. Dieciocho madres recibieron el diagnóstico en la clínica pediátrica, y a 16 les informaron en la maternidad. Más de la mitad de las madres recibieron la primera información sobre el diagnóstico de su hijo del pediatra. Solo cinco de las 43 madres habían recibido información detallada. De 32 madres, 23 dijeron que percibieron una actitud negativa. La mayoría de los informes del diagnóstico a las familias, duraron menos de cinco minutos. Conclusiones. Las madres de niños con SD desean recibir más información sobre el SD de parte de los profesionales de la salud. Además, desean que esta información se brinde de manera comprensiva y sensible. Los profesionales de la salud, en especial los pediatras, necesitan dedicar el tiempo suficiente para conversar con la familia sobre el SD y los desafíos que presenta.

Introduction. Down's syndrome (DS) is a common genetic disorder. The families of children with DS generally do not receive sufficient information at the time of the diagnosis. They are dissatisfied with the manner of healthcare professionals. The objective was to evaluate the experiences of mothers of children with DS at the time of the diagnosis and the communicative attitudes of healthcare professionals. Population and methods. Mothers who had children with Down syndrome were included. The experiences of the mothers at the time of diagnosis and the attitudes of the healthcare professionals were evaluated by a semistructured interview. Results. The study sample was 43 mothers. Eight children had been diagnosed with DS prenatally, and 35 had been diagnosed postnatally. Eighteen of the mothers had received the diagnosis in a pediatric clinic, and 16 had been told of the diagnosis in an obstetric clinic. More than half the mothers had received the first information about their child's diagnosis from a pediatrician. Only five of the 43 mothers had received detailed information. Twenty-three of 32 mothers said that they were met with a negative attitude. Generally, the time put aside to inform the families about the diagnosis was less than 5 min. Conclusions. Mothers of DS children want more information about DS from healthcare professionals. Furthermore, they want this information to be delivered in a supportive and sensitive manner. Healthcare professionals, especially pediatricians need to allocate sufficient time to discuss DS and its challenges with the family.

A comparative analysis of clinical operation system and continuing education of pediatricians between Chinese and American children's hospitals / 中华医学教育探索杂志

For provincial children's hospitals and children's hospitals affiliated to medical colleges and universities with a high level of the diagnosis and treatment,they are the center of referral and need to retain pediatricians and build a high-level team of pediatricians.With the authors' own experience in Cincinnati Children's Hospital Medical Center in the US,this article briefly introduces the current clinical operation mode in American children's hospitals,especially the consultation system mainly composed of attending physicians and the mode of continuing medical education based on both clinical and scientific research.Such experience provides a reference for pediatricians in China.

Investigation on the turnover intention of pediatricians in Shenzhen and its influencing factors / 中华医院管理杂志

Objective@#To understand the intention of pediatricians turnover in Shenzhen and its influencing factors.@*Methods@#From September to December 2016, a multi-stage stratified cluster sampling method was used to select 948 pediatricians from Shenzhen to conduct a questionnaire survey. The questionnaire cover the following: 1. Basic information: general demographic characteristics(gender, age, marriage, education, etc.); 2. Work status survey: turnover intention, experiences with violence against medical workers, professional job satisfaction, and work stress, etc. Univariate analysis and multivariate analysis were used to identify factors for pediatrician′s turnover intention.@*Results@#Among the 948 pediatricians in Shenzhen, 62.5% had turnover intention; age, title, education, seniority, monthly income, medical institution nature, medical institution level, length of sleep, job satisfaction, work stress, experience with violence and family support all affect the pediatrician′s turnover intention(P<0.05); multivariate logistic regression analysis showed that age, education, monthly income, job satisfaction, work stress and experience with violence were the influencing factors of pediatrician′s turnover intention(P<0.05).@*Conclusions@#The pediatrician′s turnover intention in Shenzhen is not low. Relevant measures should be taken by the government, hospital administrators, children patients and their family to ensure the supply of children′s medical services.

Investigation on Drugs for Asthma Control Administered by Pediatric Clinicians-Selection of Inhaled Corticosteroids and Compliance Evaluation of Patients / 中国药房

OBJECTIVE： To provide reference for the selection of inhaled corticosteroids （ICS） in clinic. METHODS： A questionnaire survey was conducted among pediatricians from medical institutions of 11 provinces （districts， cities） to analyze the drug selection and reasons， dosage form selection [by comprehensive score （CS）] of 3 kinds of ICS as budesonide （BUD）， beclomethasone （BDP） and fluticasone （FP）， medication compliance and influential factors （by CS）. RESULTS： A total of 200 questionnaires were sent out， and 196 valid questionnaires were collected with effective rate of 98.00％. Pediatric clinicians preferred BUD as a control drug for asthma in children （158 cases， 80.61％）， followed by FP （22 cases， 11.22％） and BDP （2 cases， 1.02％） and the rest had no tendency （14 cases， 7.14％）. Clinicians who chose BUD mainly believed that the drug had better clinical efficacy， and was more recommended by guidelines and experts， more recognized by patients and so on. In addition， of all inhalation equipment for children asthma， pediatric clinicians believed that parents or children were more easier to master atomizer （CS： 4.04）， followed by pressurized metered dose inhalers （pMDI） （with spacer） （CS： 2.75）， pMDI （without spacer） （CS： 1.71）， dry powder inhalers （DPI） （turbuhaler） （CS： 1.46） and DPI （accuhaler） （CS： 1.08）. For the evaluation of patients’ medication compliance， 48 （24.49％）， 88 （44.90％）， 58 （29.59％） pediatricians thought that the actual administration accounted for ＜50％， 50％-74％， 75％-99％ of the medical order dosages， respectively. Only 2 （1.02％） subjects thought that the patients would fully obey. The main factors affecting children’s medication compliance were worrying about side effects of long-term medication （CS： 9.19）， drug withdrawal after improvement （CS： 8.16）， and children’s treatment incompatibility （CS： 7.82）. CONCLUSIONS： Pediatricians tend to choose BUD as drug for asthma control， and atomizer is treated as the easiest inhalation equipment for children. At the same time， pediatricians have low evaluation on the medication compliance of parents and children.

Investigation on the turnover intention of pediatricians in Shenzhen and its influencing factors / 中华医院管理杂志

Objective To understand the intention of pediatricians turnover in Shenzhen and its influencing factors.Methods From September to December 2016,a multi-stage stratified cluster sampling method was used to select 948 pediatricians from Shenzhen to conduct a questionnaire survey.The questionnaire cover the following:1.Basic information:general demographic characteristics (gender,age,marriage,education,etc.);2.Work status survey:turnover intention,experiences with violence against medical workers,professional job satisfaction,and work stress,etc.Univariate analysis and multivariate analysis were used to identify factors for pediatrician's turnover intention.Results Among the 948 pediatricians in Shenzhen,62.5％ had turnover intention;age,title,education,seniority,monthly income,medical institution nature,medical institution level,length of sleep,job satisfaction,work stress,experience with violence and family support all affect the pediatrician's turnover intention (P ＜ 0.05);multivariate logistic regression analysis showed that age,education,monthly income,job satisfaction,work stress and experience with violence were the influencing factors of pediatrician's turnover intention (P ＜ 0.05).Conclusions The pediatrician's turnover intention in Shenzhen is not low.Relevant measures should be taken by the government,hospital administrators,children patients and their family to ensure the supply of children's medical services.

Understanding“One Health”to actively and steadily promote pediatrician training after graduation / 中国实用儿科杂志

Medicine is a highly practical science. A high-quality clinical doctor must go through strict college education,post-graduation education and follow-up continuing education. Since the implementation of standardized resident training in 2014,great achievements have been achieved:great attention has been paid to residential training,about 500 pediatric professional training bases have been set up nationwide,and software and hardware(e.g. simulation centers and teacher training)have been upgraded. Since 2017,the state has gradually launched specialty training. In the process of promoting resident and specialty training,some problems were exposed. Hence,pediatrician training needs to be in line with the“top-level design”of national health,such as the system of tiered medical services,and family physician contract system;to handle the phases and continuity of different stages of medical education;to learn foreign excellent experience based on the national conditions of China. With good top-level design,medical and educational collaboration,learning international advanced experience based on our national conditions,a standardized medical training system with Chinese characteristics will be built,which will enhance the overall level of our medical team.

Amenazas al bienestar de la infancia venezolana: un reto para el pediatra ante una emergencia humanitaria compleja / Threats to the well-being of the Venezuelan child: a challenge for the pediatrician faced with a complex humanitarian crisis

Venezuela atraviesa una emergencia humanitaria compleja de acuerdo a la Organización de Naciones Unidas, la cual es el resultado de una combinación de inestabilidad política, conflictos y violencia, desigualdades sociales y una pobreza subyacente. El impacto de esta situación en las condiciones de vida de la población, en especial, de la infancia, ha sido registrado por organizaciones internacionales y nacionales no gubernamentales ante el silencio cómplice del Estado. Se revisan los indicadores que permiten evaluar el grado de bienestar de la población infantil venezolana en cuanto a nivel de pobreza, nutrición y seguridad alimentaria, salud, educación y otros determinantes sociales. Conclusión: Como consecuencia de la emergencia humanitaria compleja, la infancia venezolana está amenazada por el incremento de la pobreza, a partir de la cual, se ha generado un aumento de todas las formas de desnutrición e inseguridad alimentaria, un incremento de la mortalidad materna, neonatal e infantil, la aparición de enfermedades prevenibles por vacunas y aquellas transmitidas por artrópodos, un grave deterioro del sistema educativo y la obligación de muchas familias a migrar para sobrevivir. El pediatra cumple un papel fundamental en la atención de niños, niñas y adolescentes al identificar factores de riesgo, denunciar la violación de sus derechos y aglutinar esfuerzos para garantizar su bienesta(AU)

Venezuela through a complex humanitarian emergency, according to the Organization of United Nations, which is the result of a combination of political instability, conflicts and violence, social inequality and underlying poverty. The impact of this situation on the living conditions of the population, especially children, has been registered by national non-governmental and international organizations to silence an accomplice of the State. Reviews of the indicators that allow evaluating the degree of welfare of the Venezuelan child population in terms of level of poverty, nutrition and food security, health, education and other social determinants. Conclusion: As result of the complex humanitarian emergency, Venezuelan children is threatened by the increase in poverty, from which it has generated an increase in all forms of malnutrition and food insecurity, an increase of the maternal, neonatal and child mortality, the emergence of diseases preventable by vaccines and those transmitted by arthropods, a serious deterioration of the educational system and the obligation of many families to migrate to survive. The pediatrician has an important role in the care of children and adolescents to identify risk factors denounce the violation of their rights and unite efforts to ensure their well-being(AU)

Opiniones, prácticas y conocimientos de pediatras sobre la prevención de lesiones no intencionales / Pediatricians' opinions, practices and knowledge about unintentional injuries prevention

El objetivo fue describir opiniones, prácticas y conocimientos de pediatras sobre prevención de lesiones no intencionales (LNI) Metodología: estudio descriptivo y analítico por encuesta anónima y auto-administrada a pediatras, en Mendoza, en 2015. Resultados: N: 210. La edad media de los pediatras fue 44, 55 años, 65, 2% mujeres. Doscientos (95, 22%) realizan prevención de lesiones, 76% lo hace en la mayoría de las consultas, usando método verbal principalmente. El 94, 29% (198) opinaron que la prevención mejora la seguridad en el hogar y 185 (88, 1%) que debiera hacerse en todas las consultas. Entre pediatras con menos de 10 años de antigüedad (N= 84), el 79, 6% respondió correctamente sobre sillitas, ahogamiento, andador y caídas; entre los de mayor antigüedad (N= 126) hubo 61, 9% de respuestas correctas (p= 0, 007) Conclusiones: Los pediatras son conscientes de su rol en prevención de LNI, refieren realizar actividades de prevención y conocen sobre el tema, sobre todo los más jóvenes.

Introduction: The objective of this study was to address the pediatrician's opinions, practices and knowledge on the prevention of unintentional injuries. Design: descriptive and analytical study by anonymous and self-administered survey to pediatricians, in Mendoza, in 2015. Results: N: 210. The mean age of pediatricians was 44.55 years old, 65.2% were women. 200 (95.22%) performed injury prevention, 76% did it in most of the visits, using verbal method mainly. 198 (94.29%) believed that prevention improves home safety and 185 (88.1%) should be done in all consultations. There were 79.6% correct answers among pediatricians less than 10 years' seniority (N= 84) about child car restraint system, drowning, baby walker use and falls; among the oldest (N= 126) there were 61.9% of correct answers (p= 0.007) Conclusions: Pediatricians are aware of their role in injury prevention, realized prevention activities and knew about the subject, especially the younger ones.

Apuntes sobre la vida y obra del Dr. Angel Arturo Aballí Arellano / Notes on the life and work of Ph.D. Angel Arturo Aballí Arellano

Angel Arturo Aballí Arellano es considerado como uno de los pediatras más importante de la historia de la medicina cubana, hasta el punto que resulta prácticamente imposible acometer la historia de esta disciplina en nuestro país, sin el estudio profundo de su vida y obra, toda ella dirigida a la defensa de los intereses de la nueva generación, al estado de salud de la niñez, y a luchar por los recursos requeridos para su atención, bienestar y felicidad. Dedicó estudios a las enfermedades diarreicas, a la desnutrición y a la tuberculosis. Para estos fines inauguró el Dispensario Antituberculoso para Niños ¨Calmette¨; el Preventorio ¨Grancher¨ para Lactantes, una sala destinada para niños tuberculosos en el Hospital La Esperanza, y más tarde el Hospital Infantil Antituberculoso, que ostenta hoy su nombre, convertido al triunfo de la Revolución en Hospital Pediátrico General (AU).

Angel Arturo Aballí Arellano is considered one of the most important pediatricians of the Cuban medicine history, up to the point that it is almost impossible to write the history of this discipline in our country without deeply studying his life and work, all of it devoted to the defense of the new generations interests, the childhood health status, and to struggle for obtaining the resources required for their attention, welfare and happiness. He studied diarrheic diseases, malnutrition and tuberculosis. With this aim he inaugurated the Anti-tuberculosis Dispensary for Children Calmette, the Grancvher Preventer for Nursing Infants, a ward for tuberculous children at the hospital La Esperanza and later the Infantile Antituberculous Hospital that today is named after him and after the triumph of the revolution became a General Pediatric Hospital (AU).

Dynamic analysis of pediatricians′ resource allocation in China from 2010 to 2015 / 中华医院管理杂志

Objective To analyze the dynamic flow of pediatricians from 2010 to 2015, their present deployment and workload as compared with physicians across the country, in order to provide reference for their effective allocation.Methods Selecting data indexes from Chinese Statistical Yearbook and China Health and Family Planning Yearbook, and using Excel for statistics of relevant index data.By means of horizontal and vertical comparisons, a dynamic analysis was made on such indexes as the number of pediatricians, that of pediatricians per thousand children, and the number of hospital admissions and the number of hospitalizations per pediatrician.Results The total of pediatricians only increased by 2.32% from 2010 to 2015.On the other hand, the number of pediatricians per thousand population only accounted for 23.42% of physicians per thousand population in 2015.These five years witnessed a 40.58% workload increase of outpatient/emergency visits per pediatrician, and 36.70% increase of discharged inpatients.Conclusions China is faced with the challenges of shortage and insufficient supply of pediatricians, worsened by excessive workloads.It is advisable to improve pediatrician development pattern, raise their remuneration, and ease their workload, for the sake of better healthcare for children.

Introduction and reflections of the British pediatrician training model / 中华医学教育探索杂志

This paper introduces pediatrician training model in Britain, from medical students to consults, including its step-by-step training methods, multi angle multi-level evaluation methods, and em-phasis on the professionism and clinical competence. Through the comparison of the current pediatrician training model in China, this paper provides a reference for Chinese pediatrician training model in future.

Practice of teaching ward round based on clinical teaching unit in standardized training of pediatric residents / 中华医学教育探索杂志

Objective To explore the application of clinical teaching unit (CTU) in the process of pediatric resident standardization training. Method From August 2015 to December 2015, trainers in the department of neonatology were randomly divided into the experimental group and the control group; two groups had the same basic training plan and the same training time. The experimental group needed to par-ticipate in CTU activities outside the rule training plan. Trainers of the experimental group were evaluated by the formative evaluation method, and the theoretical assessment and questionnaire survey were carried out at the end of training. SPSS 18.0 was used for t test. Results The ability of clinical thinking of the experimental group trainers in the practice of CTU was improved, and the scoring rate rose from 57.0％ to 85.7％; the test scores of experimental group had different increase, in which case analysis reflected the ability of clinical thinking was significantly higher than the control group (P<0.05). Conclusion CTU can improve the trainers' independent clinical thinking and other abilities, and gradually help them complete the transition from medical students to physicians.

Family relationships with pediatricians: the maternal views / As relações da família com os pediatras: as visões maternais

Abstract Objective: To analyze the perception of pediatric guidelines by mothers at the time of consultation in private offices, in order to know how they assimilate, process and use the information received from the pediatricians. Methods: Data collection was carried out by a questionnaire sent to participants by a total of 200 mothers from a virtual community in social networks participated in the research. The answers were transcribed using the Discourse of the Collective Subject method. The analyses were supported by the research qualitative perspective, from the viewpoint of the social representation theory. Results: Three categories were obtained through data analysis: (1) assessing the pediatric guidelines, (2) confronting theory and practice and (3) developing a critical view of the pediatric guidelines. These categories have elucidated that the level of knowledge of pediatric issues by mothers and their ability to use them when making decisions about the care of their babies, have a direct association between following or not the pediatric guidelines. Conclusions: The mother's decision on following the pediatrician's recommendations depends on two main factors: (a) certification of the updated and proven recommendations, according to the official health agencies; (b) support and recognition by the pediatrician of the maternal empowerment during the follow-up process. The mothers' practice of accessing knowledge through social networks hinders the pediatric monitoring.

Resumo Objetivo: Analisar a percepção das orientações pediátricas pelas mães na ocasião do atendimento em consultórios particulares, para conhecer de que maneira assimilam, processam e usam as informações recebidas de seu pediatra. Métodos: A coleta de dados foi feita por questionário enviado às participantes. Participaram da pesquisa 200 mães de uma comunidade virtual nas redes sociais. As respostas foram transcritas por meio do método do discurso do sujeito coletivo. As análises foram respaldadas na perspectiva qualitativa de pesquisa, sob a ótica da teoria das representações sociais. Resultados: Obtiveram-se três categorias por meio da análise de dados: (1) avaliação das orientações pediátricas, (2) confronto da teoria e prática e (3) desenvolvimento de um olhar crítico acerca das orientações pediátricas. Tais categorias elucidaram que o nível de conhecimento de temas pediátricos por parte das mães e a sua capacidade de usá-los na tomada de decisões sobre os cuidados dos seus bebês apresentam uma relação direta entre seguir ou não as orientações pediátricas. Conclusões: A decisão das mães quanto a seguir as recomendações do pediatra depende de dois fatores principais: (a) certificação das recomendações atualizadas e comprovadas, de acordo com os órgãos oficiais de saúde; (b) apoio e reconhecimento por parte do pediatra do papel materno durante o processo de acompanhamento. A prática do acesso ao conhecimento das mães por meio de redes sociais dificulta o acompanhamento pediátrico.

The Internet versus pediatricians as a source of infant teething information for parents in Turkey

OBJECTIVES: Parents are increasingly searching the Internet to gather information about their children’s health care. This study compared infant teething information obtained from publically employed pediatricians in Istanbul with that obtained from different Turkish websites (parenting, health, professional, news and commercial). METHODS: This study had two parts. The first part used a descriptive design, with two checklists to assess the quality and comprehensiveness of the teething-specific content on 62 parenting or health websites. The second part was a cross-sectional study of 75 pediatricians at public hospitals who completed a structured self-administered questionnaire. RESULTS: In total, 54 websites (87.1%) described infant teething as a normal developmental process. The lists that were found on the websites identified the most frequent signs of infant teething as fever and drooling/perioral rash. The most frequent management strategies were chewing non-chilled and chilled objects. For teething problems, some pediatricians recommended teething rings and oral benzocaine, while 23 pediatricians recommended nothing. CONCLUSIONS: Parents should be informed by health professionals, especially regarding specific treatment strategies.