One of the most widespread cellular organelles in nature is cilium, which is found in many unicellular and multicellular organisms. Formerly thought to be a mostly vestigial organelle, the cilium has been discovered in the past several decades to play critical motile and sensory roles involved in normal organogenesis during development. The role of cilia has also been implicated in an ever increasing array of seemingly unrelated human diseases, including blindness, kidney cysts, neural tube defects and obesity. In this article we review some of the recent developments in research on cilia, and how defects in ciliogenesis and function can give rise to developmental disorders and disease.
Abnormalities, Multiple ; pathology ; Animals ; Cerebellar Diseases ; genetics ; pathology ; Cilia ; physiology ; ultrastructure ; Flagella ; physiology ; Hedgehog Proteins ; metabolism ; Humans ; Models, Animal ; Polycystic Kidney Diseases ; pathology ; Protein Transport ; Signal Transduction ; Wnt Proteins ; metabolism

INTRODUCTIONA significant percentage of paediatric emergency department (ED) attendances worldwide are nonurgent, adversely affecting patient outcomes and healthcare systems. This study aimed to understand the reasons behind nonurgent ED visits, in order to develop targeted and effective preventive interventions.

METHODSIn-depth interviews were conducted with 49 caregivers to identify the decision-making factors related to taking children to the ED of KK Women's and Children's Hospital, Singapore. Interviews were carried out in the emergency room of the hospital after the children had been diagnosed with nonurgent conditions by the attending physician. Interview transcripts were analysed based on grounded theory principles.

RESULTSThe demographics of our study cohort were representative of the target population. The main reasons given by the caregivers for attending paediatric EDs included perceived severity of the child's symptoms, availability of after-hours care, perceived advantage of a paediatric specialist hospital and mistrust of primary care physicians' ability to manage paediatric conditions. Insurance or welfare was a contributing factor for only a small portion of caregivers.

CONCLUSIONThe reasons provided by Singaporean caregivers for attending paediatric EDs were similar to those reported in studies conducted in Western countries. However, the former group had a unique understanding of the local healthcare system. The study's findings may be used to develop interventions to change the knowledge, attitudes and behaviours of caregivers in Singapore.

Adolescent ; Caregivers ; Child ; Child, Preschool ; Cohort Studies ; Craniocerebral Trauma ; therapy ; Decision Making ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; organization & administration ; Epistaxis ; therapy ; Fathers ; Female ; Hospitals, Pediatric ; Humans ; Infant ; Infant, Newborn ; Male ; Mothers ; Patient Acceptance of Health Care ; Pediatrics ; organization & administration ; Respiratory Tract Infections ; therapy ; Singapore