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In Brazil, research on access to care in the public health system reveals a number of inequalities in care faced by certain patients - particularly women, the working classes and racialized minorities, during medical consultations. The aim here is to highlight a specific form of prejudicial treatment known as epistemic injustice. Based on observations and consultation’s reporting in health posts, emergency departments and hospitalization services in Franca (Brazil), we will see how these injustices are often co-produced by the existence of negative social prejudices against patients, a lack of awareness of social inequalities in health, a more or less authoritarian exercise of power by the doctor and a rigid application of certain medical procedures. Three forms of 'epistemic silencing' (Dotson, 2011) have been identified: 'not believing', 'not saying' and 'silencing'. [ABSTRACT FROM AUTHOR]

Aim: In preterm neonates, during nursing procedures, body temperature decreases. This study evaluates the interest of polyethylene bag wrapping to prevent this decrease during percutaneous central venous catheter (PCVC) insertion procedure, in preterm neonates under 32 weeks of gestation nursed in closed incubators. Methods: This prospective observational study compared two periods: [May 2009-September 2009]: 'without polyethylene bag wrapping' and [October 2009-March 2010]: 'with polyethylene bag wrapping'. The main criterion was newborn skin temperature at the end of the procedure. Results: There was no difference between the two groups for skin temperature before the procedure (36.9 ± 0.3 °C versus 36.9 ± 0.3 °C; p = NS). The skin temperature at the end of the procedure was lower in the 'without bag wrapping' group (36.0 ± 0.5 °C) compared to the 'bag wrapping' group (36.4 C ± 0.5 °C; p = 0.01). Furthermore, no skin temperature at the end was higher than 37.4 °C in the bag wrapping group. Conclusion: The use of a polyethylene bag was effective in decreasing skin temperature fall during a PCVC insertion procedure in our population. No side effects were observed. The benefit of prolonged wrapping or for shorter procedure should be evaluated. [ABSTRACT FROM AUTHOR]

Aim: In preterm neonates, during nursing procedures, body temperature decreases. This study evaluates the interest of polyethylene bag wrapping to prevent this decrease during percutaneous central venous catheter (PCVC) insertion procedure, in preterm neonates under 32 weeks of gestation nursed in closed incubators. Methods: This prospective observational study compared two periods: [May 2009-September 2009]: “without polyethylene bag wrapping’’ and [October 2009-March 2010]: “with polyethylene bag wrapping’’. The main criterion was newborn skin temperature at the end of the procedure. Results: There was no difference between the two groups for skin temperature before the procedure (36.9 ± 0.3 °C versus 36.9 ± 0.3 °C; p = NS). The skin temperature at the end of the procedure was lower in the “without bag wrapping’’ group (36.0 ± 0.5 °C) compared to the “bag wrapping’’ group (36.4 C ± 0.5 °C; p = 0.01). Furthermore, no skin temperature at the end was higher than 37.4 °C in the bag wrapping group. Conclusion: The use of a polyethylene bag was effective in decreasing skin temperature fall during a PCVC insertion procedure in our population. No side effects were observed. The benefit of prolonged wrapping or for shorter procedure should be evaluated. [ABSTRACT FROM AUTHOR]

Objective: 10% of newborns require positive pressure ventilation (PPV) at birth. There are few data on prenatal or early postnatal factors that are predictive of the need for a paediatrician in the delivery room. The study analysed prenatal obstetric and early postnatal factors associated with the requirement for paediatrician assistance in this setting.Methods: Over a three-month period, all consecutive births in a tertiary hospital's maternity unit were prospectively evaluated with regard to the need for paediatrician assistance (requested either before or after the delivery), the requirement for resuscitation, and transfer to a neonatal intensive care unit (NICU).Results: For a total of 584 consecutive births, paediatrician assistance was requested before delivery in 170 cases (30.5%) and after in 78 cases (13.3%). 78% of the newborns requiring PPV, 95.8% of those requiring endotracheal intubation and 86.3% of those requiring transfer to the NICU matched recently published prenatal criteria for paediatrician assistance. Along with a low Apgar score and a cord blood pH <7.20, these criteria covered 95% of the prenatal and early postnatal requests for paediatrician assistance.Conclusions: These criteria for neonatal resuscitation in the delivery room would enable medical staff to anticipate the need for paediatrician assistance. [ABSTRACT FROM AUTHOR]