OBJECTIVES: Access to dental healthcare services is a major determinant of dental health in communities. This meta-analysis was conducted to estimate the global prevalence of dental needs and of unmet dental needs in adolescents.METHODS: PubMed, Web of Science, and Scopus were searched in June 2018. The summary measures included the prevalence of met and unmet dental needs. A meta-analysis was performed using the inverse variance method to obtain pooled summary measures. Out of 41,661 retrieved articles, 57 were ultimately included.RESULTS: The pooled prevalence of orthodontic treatment needs was 46.0% (95% confidence interval [CI], 38.0 to 53.0), that of general treatment needs was 59.0% (95% CI, 42.0 to 75.0), that of periodontal treatment needs was 71.0% (95% CI, 46.0 to 96.0), and that of malocclusion treatment needs was 39.0% (95% CI, 28.0 to 50.0). The pooled prevalence of unmet dental needs was 34.0% (95% CI, 27.0 to 40.0).CONCLUSIONS: The highest and lowest prevalence of unmet dental needs were found in Southeast Asia and Europe, respectively. The prevalence of dental needs was higher in the countries of the Americas and Europe than in other World Health Organization (WHO) regions. The prevalence of unmet dental needs was higher in Southeast Asia and Africa than in other WHO regions.
Adolescent ; Africa ; Americas ; Asia, Southeastern ; Delivery of Health Care ; Dental Health Services ; Europe ; Humans ; Malocclusion ; Methods ; Prevalence ; World Health Organization

PURPOSE: The purpose of this study was to analyze and assess the current situation of Korea's school health education program and to establish measures to efficiently carry out school health education in Korea. METHOD: The survey was conducted through the internet with the health educators of elementary, middle, and high schools nationwide to assess the current condition of school health education programs, and 2,459 samples were collected which accounted for 23.4% of the total respondents. RESULTS: According to school health educators on the enforcement of health education, the higher the education became, the less the health education was enforced. The enforcement rate was 96.9% in elementary schools, 76.7% in middle schools, and 67.3% in high schools. The major reasons were found as difficulty in securing class time (54.5%) and other excessive workloads (20.9%). As a result of the health education awareness survey, over 99% answered that health education is needed, over 80% answered that the education requires independent health textbooks, and over 95% answered that health educators are suitable for the person in charge of the education. CONCLUSION: This study will be a useful in establishing a detailed policy on enhancing school health education in the future.
Adolescent ; Adult ; Aged ; Child ; Health Education/organization & administration/*trends ; Humans ; Korea ; Male ; Middle Aged ; Questionnaires ; School Health Services/*trends

PURPOSE: The purpose of this study was to test the effectiveness of a comprehensive smoking cessation program for Korean adolescents. METHOD: The study design was quasi-experimental with one pre and three post-tests. The three posttests were done immediately after, three months later, and six months after the completion of the program. A total of 43 high school students who smoked participated in the study with 22 in the experimental group and 21 in the control group. The smoking cessation program consisted of 9 sessions with content on enhancement of self-efficacy, stress management, correction of distorted thoughts, consciousness raising, and assertiveness training. The study variables were urine cotinine levels, self-efficacy, stress, and stages of changed behavior. RESULTS: Urine cotinine levels significantly decreased in the experimental group after the program (F=3.02, p=.06) but significantly increased in the control group (F=6.32, p=.004). Self-efficacy and the degree of stress did not change in either group. The stages of smoking cessation behavior tended to change when compared with raw data for the experimental group. For most participants, the stages of change had been precontemplation and contemplation, but changed to action and maintenance stage among the experimental group. CONCLUSION: The program was effective in smoking cessation and influencing stages of change but did not change psychosocial factors such as self-efficacy and stress. It is suggested a program should be developed to change psychosocial variables on a long-term basis. It is also desirable to involve peers and families of adolescents who smoke when planning programs to enhance social support.
Adolescent ; Adolescent Behavior ; Adolescent Health Services/*organization & administration ; Adolescent Psychology ; Analysis of Variance ; Attitude to Health ; Cotinine/urine ; Educational Status ; Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Longitudinal Studies ; Needs Assessment ; Patient Education as Topic/*organization & administration ; Personality Inventory ; Program Development ; Program Evaluation ; Questionnaires ; School Health Services/*organization & administration ; Self Efficacy ; Smoking/*prevention & control/psychology/urine ; Smoking Cessation/*methods/psychology ; Stress, Psychological/complications/psychology

Data from recent studies have shown an increase in substance use and addictive behaviours in Singapore. However, training and services still lag behind this trend, which means the provision of adequate treatment is lacking in spite of good evidence that treatment approaches for addiction disorders are effective. There is a need to train more manpower for this purpose, especially in primary healthcare. Another challenge is to ramp up services as quickly as possible to manage the growing number of addicts. Research should also focus on special populations, while public health education and national policies can be improved, particularly to curb binge drinking. We need to be open to the use of harm-reduction therapies and substitution treatments, as addiction is a chronic relapsing disorder with significant health and psychosocial morbidity.
Adolescent ; Adult ; Alcoholism ; therapy ; Behavior, Addictive ; epidemiology ; therapy ; Female ; Humans ; Male ; Mental Health Services ; organization & administration ; trends ; Prevalence ; Primary Health Care ; organization & administration ; Public Health ; Singapore ; Substance Abuse Treatment Centers ; Substance-Related Disorders ; epidemiology ; therapy

OBJECTIVES: This study was performed to evaluate the effectiveness of 'village health worker training program' which aimed to build community participatory health promotion capacity of community leaders in villages of low developed country and to develop methods for further development of the program. METHODS: The intervention group were 134 community leaders from 25 barangays (village). Control group were 149 form 4 barangays. Intervention group participated 3-day training program. Questionnaire was developed based on 'Health Promotion Capacity Checklist' which assessed capacity in 4 feathers; 'knowledge', 'skill', 'commitment', and 'resource'. Each feather was assessed in 4 point rating scale. Capacity scores between intervention group and control group were examined to identify changes between the pre- and post-intervention periods. A qualitative evaluation of the program was conducted to assess the appropriateness of the program. The program was conducted in Tuguegarao city, Philippine in January, 2009. RESULTS: The result showed significant increases in the total health promotion capacity and each feather of health promotion capacities between pre and post assessment of intervention group. But there was no significant change in that of control group. Participants marked high level of satisfaction for preparedness, selection of main subjects and education method. Qualitative evaluation revealed that training program facilitated community participatory health promotion capacity of participants. CONCLUSIONS: This study suggested that the Village health worker training program is effective for building health promotion capacity of community leaders and it can be a main method for helping low developed countries with further development.
Adolescent ; Adult ; Community Networks/*organization & administration ; Female ; Health Knowledge, Attitudes, Practice ; Health Personnel/*education ; *Health Promotion ; Humans ; Hygiene ; Male ; Middle Aged ; Philippines ; *Program Evaluation ; Public Health/manpower ; Qualitative Research ; Questionnaires ; Rural Health Services/*manpower ; Sanitation ; Water Supply ; Young Adult

OBJECTIVEThis study aimed to compare the prevalence of mental disorders and services for people with mental health problems in Shaoxing city between 1991 and 2001 in order to provide scientific bases for prevention and treatment.

METHODSA population size of 339 651 were investigated in the urban and rural areas with "Psychosis Index Investigate Schedule" plus visit to their homes.

RESULTSThe overall prevalence rates of mental disorders were 10.17 per thousand and 13.85 per thousand and the point prevalence rates of mental disorder were 9.15 per thousand and 12.77 per thousand, respectively in 1991 and 2001. The point prevalence rates in the population aged 15 years and above were 11.70 per thousand and 14.60 per thousand. Prevalence rates of neurosis and alcohol dependence and drug dependence increased significantly from 1991 and 2001. The anterior three mental disorders were neurosis, schizophrenia and dementia in all mental disorders. Situation was better in the city than in the rural areas in terms of receiving care for mental disorder, their work ability, economy condition and gardianship.

CONCLUSIONThere was an increase of prevalence on mental disorder in Shaoxing city during the ten-year period. The increase in the prevalence of mental disorder was related to local economy, socialization and culture.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Dementia ; epidemiology ; Female ; Humans ; Male ; Mental Disorders ; epidemiology ; Mental Health Services ; organization & administration ; Middle Aged ; Prevalence ; Schizophrenia ; epidemiology ; Substance-Related Disorders ; epidemiology

The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service (CHS) under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor-patient relationships, information and support, organization of care, and accessibility (P < 0.001). One or more factors such as gender and self-perceived health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients' satisfaction with CHS by strengthening their awareness of the gatekeeper policy.
Adolescent ; Adult ; China ; Community Health Services ; organization & administration ; Data Collection ; Female ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; statistics & numerical data ; Young Adult

OBJECTIVETo study the efficacy of community management model of bronchial asthma in children.

METHODThrough community outreach and clinic, 120 cases of children with asthma were enrolled from the 11 000 children aged 0 to 14 in Zhanlanlu area, and a community management model of asthma was established according to the Global Initiative for Asthma requirements combined with the actual situation of the community, both physicians and patients participated in case identification, file creation, and long-term standardized management. Through repeated medical education, the telephone hotline and interactive network of asthma among physicians, children and parents, a physician-patient relationship was established. The data of standardized medication, scheduled re-visit to the hospital, frequency of asthma attacks, antibiotic use, medical expenses, the loss of parents work hours etc. before and after the implementation of community management model were analyzed and compared.

RESULTAfter implementation of community management model, the use of systemic corticosteroids (19.4%), oral medication (31.6%) was significantly lower than those before implementation (68.3% and 90.0%) (χ(2) = 51.9, 41.1, P < 0.01), use of inhaled corticosteroids (76.5%) and oral leukotriene receptor antagonist (79.6%) was significantly higher compared with control and before management level (10.0%), χ(2) = 106.0, P < 0.01. The days of attacks of asthma (4.6 ± 2.3), the use of antibiotics (16.2 ± 6.1), (5.7 ± 2.9) and the cost of treatment significantly decreased. In 16 cases (13.3%) two-way referral was applied. In this study, the dropout rate was 18.3%, by telephone and network supervision of lost cases, re-education, made some children return to management, eventually the dropout rate was 9.2%.

CONCLUSIONEnrollment of children with bronchial asthma into community management model made the children adhere to the management regularly and a standardized management was achieved.

Adolescent ; Adrenal Cortex Hormones ; administration & dosage ; therapeutic use ; Anti-Asthmatic Agents ; administration & dosage ; therapeutic use ; Asthma ; drug therapy ; therapy ; Child ; Child Health Services ; methods ; organization & administration ; Child, Preschool ; Community Health Services ; methods ; organization & administration ; Community Networks ; Disease Management ; Drug Administration Schedule ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Patient Compliance ; Patient Education as Topic ; organization & administration ; Self Care

Community-based rehabilitation for those people with a physical disability is a policy promoted by the World Health Organization. In order to assess whether such a program might be useful to the disabled people of the highlands of Papua New Guinea a survey was conducted which first identified those people with a severe physical disability and then investigated the degree that they were handicapped in terms of their social and physical environment. The survey was performed in the Tari area of the Southern Highlands Province in conjunction with the Papua New Guinea Institute of Medical Research (PNGIMR). By using the PNGIMR demographic surveillance system it was possible to calculate a prevalence level of physical disability (including walking disability, deafness and blindness) of 46 per 10,000 (0.46%). A significant physical disability was identified in 114 people, of whom 54 were given personal interviews to establish their quality of life. The survey found the social and economic situation of disabled people to be generally good although there is a lack of basic material aids for handicapped people. The disabled people and their families do not need extra knowledge about how to care for their disabilities and a formal community-based rehabilitation program would be inappropriate, but they would find mobility aids such as wheelchairs and artificial limbs of enormous help. The regular health care services are widely used although both people with a disability and health service staff are not always aware of the types of treatment which can usefully be provided.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent ; Adult ; Aged ; Altitude ; Attitude to Health ; Child ; Child, Preschool ; Community Health Services ; organization & administration ; utilization ; Disabled Persons ; rehabilitation ; statistics & numerical data ; Female ; Health Priorities ; Health Services Needs and Demand ; Health Services Research ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Papua New Guinea ; epidemiology ; Residence Characteristics ; Self-Help Devices ; supply & distribution ; Socioeconomic Factors

AIMThe objective of this discussion paper is to investigate whether the experience gained through the German paradigm shift in dental care can be of benefit in China's deliberations on the introduction of universal dental care for its people. METHODOLOGY A comparison of representative oral health outcome data from China and Germany, two countries at different stages in their development, is presented here in order to analyse whether the findings meet expected outcome and confirm the presumption that more developed countries perform better.

RESULTSThe epidemiological comparison reveals surprising findings concerning the severity of dental diseases and, in particular, missing teeth per person in adults and rates of total edentulousness in seniors. In all of these areas German adults and seniors show significantly inferior outcomes compared with the Chinese population. The main reason for these striking discrepancies, as it turned out, is the decisive role played by the treatment philosophies and strategies of German dentists.

CONCLUSION AND RECOMMENDATIONSIf dentists take a less interventionist approach, checking as well as treating dental diseases with preventive and strictly tooth-preserving methods, dental treatment results in oral health. Under these conditions it can be assumed that modern dentistry is generally good for the teeth. These findings are important for developing countries that are seeking to integrate dental care into their health care system. On the basis of long-term experience from highly industrialized Western countries and especially from Germany we will attempt to put forward proposals for creating an effective and efficient dental care system in China.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Community Dentistry ; Delivery of Health Care ; organization & administration ; Dental Caries ; epidemiology ; Dental Health Services ; organization & administration ; Dentists ; supply & distribution ; Germany ; epidemiology ; Health Care Reform ; Health Policy ; Health Priorities ; Health Transition ; Humans ; Insurance, Health ; Middle Aged ; Mouth, Edentulous ; epidemiology ; Oral Health ; Outcome Assessment (Health Care) ; Periodontal Diseases ; epidemiology ; Philosophy, Dental ; Preventive Dentistry ; Reimbursement Mechanisms ; Tooth Loss ; epidemiology ; Universal Coverage ; organization & administration ; Young Adult