Suboptimal asthma care for immigrant children: results of an audit study

<p>Abstract</p> <p>Background</p> <p>Little is known on the scope and nature of ethnic inequalities in suboptimal asthma care for children. This study aimed to assess (1) ethnic differences in suboptimal asthma care for children with an asthma exacerbation who consulted a physician, and (2) ethnic differences in the nature of suboptimal care.</p> <p>Methods</p> <p>All children aged 6–16 years who during a period of six months consulted the paediatric department of the Academic Medical Centre-University of Amsterdam or one of the six regional primary care centres with an asthma exacerbation were included. Clinical guidelines were systematically converted to review criteria following the strategy as proposed by the Agency for Health Care Policy and Research. Based upon these review criteria and their experience experts of two multidisciplinary panels retrospectively assessed the quality of care and its (possible) failure to prevent the occurrence of asthma exacerbation.</p> <p>Results</p> <p>Only a small number of children (n = 35) were included in the analysis as a result of which the ethnic differences in suboptimal care were not significant. However, the results do indicate immigrant children, in particular 'other non-Western' children (n = 11), more frequently to receive suboptimal care related to the asthma exacerbation when compared to ethnic Dutch children. Furthermore, we found the nature of suboptimal care to differ with under-prescribing in the 'other non-Western' group (n = 11), lack of information exchange between physicians in the Surinamese/Antillean group (n = 12) and lack of education, and counselling of patients and parents in the ethnic Dutch (n = 12) as the most relevant factor.</p> <p>Conclusion</p> <p>Ethnic inequalities in the scope and nature of suboptimal asthma care for children in the Netherlands seem to exist. For the non-western immigrant groups the results indicate the importance of the prescription behaviour of the medical doctor, as well as the supervision by one health care provider.</p

The optical performance of the PILOT instrument from ground end‐to‐end tests

International audienceThe Polarized Instrument for Long‐wavelength Observation of the Tenuous interstellar medium (PILOT) is a balloon‐borne astronomy experiment designed to study the linear polarization of thermal dust emission in two photometric bands centred at wavelengths 240 mu m (1.2 THz) and 550 mu m (545 GHz), with an angular resolution of a few arcminutes. Several end‐to‐end tests of the instrument were performed on the ground between 2012 and 2014, in order to prepare for the first scientific flight of the experiment that took place in September 2015 from Timmins, Ontario, Canada. This paper presents the results of those tests, focussing on an evaluation of the instrument's optical performance. We quantify image quality across the extent of the focal plane, and describe the tests that we conducted to determine the focal plane geometry, the optimal focus position, and sources of internal straylight. We present estimates of the detector response, obtained using an internal calibration source, and estimates of the background intensity and background polarization

Inflight performance of the PILOT balloon-borne experiment

International audienceThe Polarized Instrument for Long-wavelength Observation of the Tenuous interstellar medium (PILOT) is a balloon-borne experiment that aims to measure the polarized emission of thermal dust at a wavelength of 240 µm (1.2 THz). A first PILOT flight of the experiment took place from Timmins, Ontario, Canada, in September 2015 and a second flight took place from Alice Springs, Australia in April 2017. In this paper, we present the inflight performance of the instrument. Here we concentrate on the instrument performance as measured during the second flight, but refer to the performance observed during the first flight, if it was significantly different. We present a short description of the instrument and the flights. We measure the time constants of the detectors using the decay of the observed signal during flight following high energy particle impacts (glitches) and switching off the instrument's internal calibration source. We use these time constants to deconvolve the timelines and analyze the optical quality of the instrument as measured on planets. We then analyze the structure and polarization of the instrumental background. We measure the detector response flat field and its time variations using the signal from the residual atmosphere and from the internal calibration source. Finally, we analyze the spectral and temporal properties of the detector noise. The inflight performance is found to be satisfactory and globally in line with expectations from ground calibrations. We conclude by assessing the expected inflight sensitivity of the instrument in light of the measured inflight performance