Dtsch Arztebl Int
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Review Meta Analysis
Obesity in disabled children and adolescents: an overlooked group of patients.
There is an ongoing debate concerning the relationship between disability and obesity in childhood and adolescence. ⋯ Since a high proportion of disabled children and adolescents are overweight or obese, effective strategies for preventing and managing excess weight need to be developed so as not to further endanger their social participation. Moreover, risk factors for overweight in disabled children and adolescents should be identified and their weight status carefully monitored.
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The findings of studies on the frequency of violence against children imply that many cases go undetected. ⋯ At the beginning of the 21(st) century, well-established normative structures are in place to protect children against abuse and neglect, and the available help from social organizations can also have a preventive effect. Further improvements will depend on interdisciplinary coordination and better training of specialists in all of the involved disciplines.
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From the 1990's onward, it has been possible to assess changes in the lacrimal duct by direct, minimally invasive diagnostic inspection with the aid of miniaturized endoscopes originally used in gastroduodenal surgery. It has been shown in this way that mechanical lacrimal duct stenosis often develops gradually as the result of recurrent chronic inflammation. Absolute stenoses are often located at a single point rather than extending over a longer segment of the duct. ⋯ With the methods described here, it is now possible for the first time to perform surgery that obviates the need for a bypass procedure and maintains or restores the normal physiological function of the lacrimal system.
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Despite calls for improved quality and efficiency in medical emergency departments, there exist hardly any quality indicators, and no methods of calculating efficiency have been published to date. The present study illustrates a means of presenting numerical parameters of a medical emergency department and of identifying potential quality indicators. ⋯ Numerical parameters and quality indicators for a hospital emergency department can be presented in transparent fashion. DA and DE can be used as parameters for diagnosis-related and intradepartmental quality assessment.