Klimatske promjene koje utječu na zdravlje djece u svijetu i Europi

The natural, economic and public health crises that have periodically struck the world over the past two decades have often revealed a low degree of self-sufficiency and a high degree of unpreparedness on the part of European and non-European countries. It is generally the most vulnerable who suffer the consequences, and adverse events have shown their effects and direct negative impact mainly on the population aged 0–18 years, with major implications for families and communities. Climate change and environmental pollution are certainly prominent among the natural disasters impacting children’s health. This brief commentary is aimed at raising the attention of general pediatricians on the serious insult caused by climate change to children’s health, emphasizing that climate change will affect the health of children born today throughout their live

The social and environmental dimensions of nutrition science

AbstractObjectiveTo emphasise the importance of defining a new nutrition science and food policy that includes social and environmental dimensions.DesignNutrition science and food policy is put in the context of sustainable development. Examples are presented to show that a number of factors including exploitation of resources, disrespect for land and food insecurity contribute to the decline of a culture. The fate of cultures that lack implemented sustainable development strategies is discussed.ConclusionPressure from low-income and economically challenged countries combined with the efforts of not-for-profit private institutions is proposed. The goal is to produce and provide science-based evidence and guidelines to be used as a tool to encourage institutions and organisations to redefine their policies to deal effectively with global issues

Diversity of child health care in Europe

The health of a nation depends on the health of its children, and it is now evident that child health underpins health in adolescents, later life and also in subsequent generations for a variety of reasons including environmental, metabolic and epigenetic changes. There are many challenges in child health in Europe and globally Inequalities in health status and health outcomes of children and adolescents within Europe are of great concern to pediatric societies and all those working in child health. Diversity, or noticeable heterogeneity, for many years has generated controversy on whether it is a resource for success or a barrier to improvement. Many feel uncomfortable with the term diversity and some academics and businesses have replaced it with ‘inclusion’ and ‘equity’. Diversity is difficult to interpret in many European contexts, including science and particularly in the care of children, due to differing historical, cultural, social and economic influences. This may lead to misunderstandings, detrimental conflicts, resentment and resistance, so that its benefits are not always realized. The article deals with the concept of diversity and inclusion suggesting that it should be perceived as a valuable resource to help provide optimum healthcare for European children living in different social, cultural and economic environments

Changes in Routine Pediatric Practice in Light of Coronavirus 2019 (COVID-19)

The outbreak of severe acute respiratory syndrome coronavirus or coronavirus 2019 (COVID-19)1 in the city of Wuhan, China, in December 2019 has rapidly emerged into a pandemic affecting national communities throughout the world.2 As of May 17, 2020, more than 4.5 million people have been infected globally at a pace of 100 000/d, and 307 395 have died.3 We will briefly discuss the effects of COVID-19 on routine pediatric practice that have surfaced during the months after the onset of the pandemic and the implications for children’s health. Our aim is to raise awareness about the likely need to remodel routine pediatric practice, both in hospital and ambulatory services, in light of COVID-19, and in the event of future similar infectious emergencies

Family-oriented and family-centered care in pediatrics

<p>Abstract</p> <p>Background</p> <p>To humanize the management of children in hospitals has become a serious concern of civil society and one of the main goals of public and private health centers, health care providers and governments.</p> <p>Discussion</p> <p>The concepts of family-centered and family-oriented care are discussed with the aim to emphasize their importance in pediatrics. Notions related to family-centered care, such as cultural diversity and cultural competence, are also discussed given the importance they have gained following the recent transformations of socioeconomic, demographic and ethnic characteristics of economically advantaged Countries. Family-centered care has developed as a result of the increased awareness of the importance of meeting the psychosocial and developmental needs of children and of the role of families in promoting the health and well-being of their children. Family-oriented care aims at extending the responsibilities of the pediatrician to include screening, assessment, and referral of parents for physical, emotional, social problems or health risk behaviors that can adversely affect the health and emotional or social well-being of their child.</p> <p>Summary</p> <p>Family-centered and family-oriented care concepts should be incorporated into all aspects of pediatricians' professional practice, whether it is private practice or in public hospitals, to better serve the needs of ill children.</p

Diversity of Pediatric Workforce and Education in 2012 in Europe: A Need for Unifying Concepts or Accepting Enjoyable Differences?

Objective To evaluate differences in child health care service delivery in Europe based on comparisons across health care systems active in European nations. Study design A survey involved experts in child health care of 40 national pediatric societies belonging both to European Union and non-European Union member countries. The study investigated which type of health care provider cared for children in 3 different age groups and the pediatric training and education of this workforce. Results In 24 of 36 countries 70%-100% of children (0-5 years) were cared for by primary care pediatricians. In 12 of 36 of countries, general practitioners (GPs) provided health care to more than 60% of young children. The median percentage of children receiving primary health care by pediatricians was 80% in age group 0-5 years, 50% in age group 6-11, and 25% in children >11 years of age. Postgraduate training in pediatrics ranged from 2 to 6 years. A special primary pediatric care track during general training was offered in 52% of the countries. One-quarter (9/40) of the countries reported a steady state of the numbers of pediatricians, and in one-quarter (11/40) the number of pediatricians was increasing; one-half (20/40) of the countries reported a decreasing number of pediatricians, mostly in those where public health was changing from pediatric to GP systems for primary care. Conclusions An assessment on the variations in workforce and pediatric training systems is needed in all European nations, using the best possible evidence to determine the ideal skill mix between pediatricians and GPs

The State of Children's Health in Europe

The health status of the European population is supervised constantly through the national public health agencies in their respective countries and monitored by the several nongovernmental organizations dedicated to public health active in Europe.In particular, the European Union (EU) supervises the health of the population in its 28 member nations by means of the Directorate for Health and Food Safety. The Directorate bases its proposals and legislative interventions both on data from the single nations and the statistical analysis provided by Eurostat, the official statistical office of the EU, situated in Luxembourg, whose mission is to provide high-quality statistics for Europe. On February 5, 2019, Eurostat released its most recent general report on children’s health in the EU. The document, which describes the status of health of the population 0-16 years of age, includes reassuring information, which were collected from household members. This commentary briefly discusses the significant positive data reported by Eurostat. Our aim is to share the encouraging information included in the report while emphasizing the importance for pediatricians not to rely exclusively on the family members’ perception to assess the quality of pediatric care. We believe that it is important to never lower one’s guard on children’s health and therefore to regularly follow social and legislative changes to constantly provide adequate children’s care that is focused and organized around the needs and expectations of their families

Genetic analysis of Italian patients with congenital tufting enteropathy

BACKGROUND: Congenital tufting enteropathy (CTE), an inherited autosomal recessive rare disease, is a severe diarrhea of infancy which is clinically characterized by absence of infl ammation and presence of intestinal villous atrophy. Mutations in the EpCAM gene were identified to cause CTE. Recent cases of syndromic tufting enteropathy harboring the SPINT2 (19q13.2) mutation were described. METHODS: Four CTE Italian patients were clinically and immunohistochemically characterized. Direct DNA sequencing of EpCAM and SPINT2 genes was performed. RESULTS: All patients were of Italian origin. Three different mutations were detected (p.Asp219Metfs*15, Tyr186Phefs*6 and p.Ile146Asn) in the EpCAM gene; one of them is novel (p.Ile146Asn). Two patients (P1 and P2) showed compound heterozygosity revealing two mutations in separate alleles. A third patient (P3) was heterozygous for only one novel EpCAM missense mutation (p.Ile146Asn). In a syndromic patient (P4), no deleterious EpCAM mutation was found. Additional SPINT2 mutational analysis was performed. P4 showed a homozygous SPINT2 mutation (p.Y163C). No SPINT2 mutation was found in P3. CLDN7 was also evaluated as a candidate gene by mutational screening in P3 but no mutation was identifi ed. CONCLUSIONS: This study presented a molecular characterization of CTE Italian patients, and identified three mutations in the EpCAM gene and one in the SPINT2 gene. One of EpCAM mutations was novel, therefore increasing the mutational spectrum of allelic variants of the EpCAM gene. Molecular analysis of the SPINT2 gene also allowed us to identify a SPINT2 substitution mutation (c.488A>G) recentl