PubMed · 10437503
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E Leach. Practical dreamers.. https://pubmed.ncbi.nlm.nih.gov/10437503/
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For the implementation of the proposed European standardized vaccination, total quality management (TQM) and reengineering could be powerful tools with a potentially synergistic effect. In the case examined, nonexplicit TQM prepared the organization in several ways for reengineering: providing the human capital, making people think beyond their daily tasks, and pulling the inertial professional organization in the direction of an "adhocracy." The quiet role management played, the incentive supplied by a high authority, the quick creation of solutions, and the existence of a realistic crisis represent other success factors.
BACKGROUND: Demand for emergency services is increasing, especially among children from non-Caucasian ethnic groups. OBJECTIVES: To objectify this observation and to determine the healthcare and social differences between the gypsy and Caucasian populations. METHODS: We performed a descriptive, observational study in the Pediatric Emergency Unit of a tertiary care hospital. Systematic sampling was performed and 420 children were selected. Data on age, sex, compliance with primary healthcare preventive programs, reason for attendance, type of healthcare center, diagnosis and familial characteristics were collected through a questionnaire. RESULTS: The median age of the patients was 24 months. The percentage of patients of gypsy race was 16.4 %. Most of the gypsy population (68.1 %) attended small, local healthcare centers compared with 34.8 % of the Caucasian population (p 0.0001). Only 58 % of the gypsy children were taken to healthcare centers for regular check-ups compared with 96.7 % of the non-gypsy population (p 0.0001). The percentage of gypsy children who had never being vaccinated was 18.8 %. There were no such cases among the non-gypsy population (p 0.0001). The percentage of gypsy children visiting the emergency unit who were hospitalized was 11.6 % compared with 1.9 % of non-gypsy children. Illiteracy rates were 30.4 % and 15.9 % in gypsy mothers and fathers, respectively, compared with 0.6 % and 0.3 % in non-gypsy mothers and fathers, respectively (p 0.0001). CONCLUSIONS: This study reveals significant differences between the gypsy and Caucasian pediatric populations in terms of healthcare and identifies a group at high health risk.
This year marks the centenary of infant welfare centres in the Netherlands. In 1901, Plantenga opened the first infant welfare centre in The Hague, the Netherlands. Initially, only advice about feeding was given and the growth of the infant was monitored. To support mothers, extra milk was supplied in so-called 'milk kitchens'. Over the years the tasks have been extended to include a wide range of preventive measures. At first the doctors in infant welfare clinics were predominantly paediatricians but later general practitioners and doctors specialised in infant primary health care followed. In their 100-years existence, infant welfare clinics have grown into an intricate network which sees 98% of Dutch infants.