BACKGROUND AND OBJECTIVES

The etiology of pneumonia in the pediatric population varies by age group. Among patients one month to 59 months old, viral pathogens are the most common cause of lower respiratory infections. The study aims to determine the frequency distribution of antibiotic prescription among patients one month to 59 months old and to determine the adherence of primary care facilities to local guidelines with recommended antibiotics.

A descriptive retrospective study using electronic medical records was conducted at two primary care sites. Patients aged 1 month to 59 months old seeking consult via telemedicine or face-to-face diagnosed with community acquired pneumonia from April 2019-March 2020 in the rural facility and May 2019-April 2020 in the remote facility were included in the study. The primary outcome was to determine the patterns of antibiotic use in pneumonia in remote and rural areas and adherence to the recommended antibiotics by the 2016 Philippine Academy of Pediatric Pulmonologists pediatric community-acquired pneumonia clinical practice guidelines (CPG).

There were 30 pediatric patients diagnosed with pneumonia in the rural facility and 213 in the remote facility. Of these patients with pneumonia, 96.7% and 94.8% were prescribed antibiotics in the rural and remote sites, respectively. The most commonly prescribed antibiotic in the rural facility was co-amoxiclav (26.7%), while amoxicillin (51.6%) was the most common in the remote facility. Adherence to the CPG in the rural site was lower at 23.3% (n=8/30) compared to the remote site which was 55.9% (n=119/213).

Primary care physicians prescribed antibiotics in over 90% of the time upon the diagnosis of pneumonia in children aged one month to 59 months old, despite viral pneumonia being the more common in primary care setting. Adherence to recommended antibiotics was higher in the remote setting than in the rural setting. Use of EMR to monitor quality of care can improve patient outcomes and safety, pointing out the importance of improving the quality of documentation in the study sites.

BACKGROUND

Child-rearing is challenging for adolescent mothers at risk of providing limited care to their children because of the challenges and demands of simultaneously being an adolescent and a mother. Children aged 0-2 years depend on caregivers like their young mothers to promote their physical, emotional, social, and cognitive growth and development.

The study aimed to determine the effectiveness of the Child-rearing Information Booklet (CRIB) among adolescent mothers with children aged 0-2 years on the three dimensions of knowledge, attitude, and practices.

The study utilized the quasi-experimental non-equivalent pre-test-post-test control group design to investigate 30 intervention and 30 comparison adolescent mothers with children aged 0-2 years who met the study criteria in Baguio City from January 2019 to January 2021. The fishbowl sampling technique was used in selecting the population and the specific barangays. A validated self-made questionnaire (I-CVI of 0.95 with Cronbach's α of 0.96) determined both groups' knowledge, attitude, and practices (KAP). The study used the weighted mean for adolescent mothers' KAP while an independent sample t-test analyzed the significant change in the scores of both groups and to answer the significant difference in the pre- and post-test scores between the two groups.

The results revealed that both groups are knowledgeable about child-rearing skills. Both groups have a favorable attitude when caring for their children and have a very satisfactory practice in childcare. The study also yielded a significant difference in the change of scores in the pre-and post-test scores of the two groups, specifically in knowledge and practice, while no significant difference in their attitude. It also presented a significant difference in the post-test scores between the two groups along with their knowledge (large effect size), attitude (medium effect size), and practices (large effect size).

Adolescent mothers have pre-existing KAP in child-rearing. The CRIB effectively enhances adolescent mothers' child-rearing knowledge and practice. Also, the increase of scores in KAP in child-rearing during the posttest may not be solely caused by the CRIB but also influenced by their age, level of education, living environment, experience in child-rearing, and age of their child. The CRIB has a high practical significance in improving the knowledge and practices among adolescent mothers but not in their attitude.

Childhood obesity is a global public health problem, which can not only endangers children's health, but also might be an important cause of chronic diseases in adulthood. In recent years, with the in-depth development of precision medicine research, more and more research evidences have shown that there are interactions between environmental factors, such as early intrauterine environment, children's diet, physical activity and children's gene factor on the incidence of childhood obesity, which can result in or inhibit the incidence and development of childhood obesity. This paper summarizes the progress in research in this field to reveal the effects and potential mechanisms of genetic factors and environmental factors on the incidence of childhood obesity in order to provide reference for the precise prevention and control of childhood obesity under different genetic backgrounds.
Child ; Humans ; Pediatric Obesity/genetics* ; Diet ; Causality ; Exercise ; Public Health

Poliomyelitis, or polio, is a highly infectious disease and can result in permanent flaccid paralysis of the limbs. Singapore was certified polio-free by the World Health Organization (WHO) on 29 October 2000, together with 36 other countries in the Western Pacific Region. The last imported case of polio in Singapore was in 2006. Fortunately, polio is vaccine-preventable-the world saw the global eradication of wild poliovirus types 2 and 3 achieved in 2015 and 2019, respectively. However, in late 2022, a resurgence of paralytic polio cases from vaccine-derived poliovirus (VDPV) was detected in countries like Israel and the US (specifically, New York); VDPV was also detected during routine sewage water surveillance with no paralysis cases in London, UK. Without global eradication, there is a risk of re-infection from importation and spread of wild poliovirus or VDPV, or new emergence and circulation of VDPV. During the COVID-19 pandemic, worldwide routine childhood vaccination coverage fell by 5% to 81% in 2020-2021. Fortunately, Singapore has maintained a constantly high vaccination coverage of 96% among 1-year-old children as recorded in 2021. All countries must ensure high poliovirus vaccination coverage in their population to eradicate poliovirus globally, and appropriate interventions must be taken to rectify this if the coverage falters. In 2020, WHO approved the emergency use listing of a novel oral polio vaccine type 2 for countries experiencing circulating VDPV type 2 outbreaks. Environmental and wastewater surveillance should be implemented to allow early detection of "silent" poliovirus transmission in the population, instead of relying on clinical surveillance of acute flaccid paralysis based on case definition alone.
Child ; Humans ; Infant ; Public Health Surveillance ; Pandemics ; Wastewater ; Wastewater-Based Epidemiological Monitoring ; COVID-19/epidemiology* ; Poliomyelitis/prevention & control* ; Poliovirus ; Poliovirus Vaccine, Oral ; Vaccination ; Global Health

Humans ; Child ; Glioma/pathology* ; Brain Neoplasms/pathology* ; Central Nervous System/pathology* ; World Health Organization ; Central Nervous System Neoplasms/pathology* ; Mutation

Child ; Humans ; Consensus ; Quality of Health Care

Conception of public health was firstly put forward by American professor Winslow. Ensuring and promoting the health of general population is the key connotation for the definition of public health. Oral disease has become a public health problem. Caries which preventable and curable is the most common oral disease and the etiology is also clear. Oral health comprehensive intervention program for children in central and western regions was set up in 2008 by Chinese government. The program included sealing on the first permanent molar and oral health education towards primary school children covering mid-west area. This was the first oral health program invested by government and managed by Chinese Stomatological Association. Six years later, the program was popularized to the whole nation, and renamed as national oral health comprehensive intervention program for children in China. The program had made deep impact on development of oral health service in China. The study tries to analyze the challenges of oral health service through reviewing the background, content, organization and effectiveness of the program, aiming to provide suggestions on policy, financing, system, ability and technology for the future development.
Child ; Humans ; China ; Dental Caries/epidemiology* ; Oral Health ; Public Health ; Dental Health Services

Pain disrupts neonatal vital signs and internal environment homeostasis and affects the recovery process, and recurrent pain stimulation is one of the important risk factors for neurodevelopmental disorders and some chronic diseases. In order to standardize pain management practice in neonatal wards in China and effectively prevent and reduce the adverse effects of pain on the physical and mental development of neonates, National Clinical Research Center for Child Health and Diseases (Children's Hospital of Chongqing Medical University) convened a multidisciplinary panel to formulate the evidence-based guideline for neonatal pain management in China (2023 edition) following the principles and methods for the guideline development issued by the World Health Organization. Based on the best evidence and expert consensus, this guideline gives 26 recommendations for nine clinical issues, i.e., the classification and definition of neonatal pain, common sources of pain, pain assessment principles, pain assessment methods, analgesic principle, non-pharmaceutical analgesic methods, pharmaceutical analgesic methods, parental participation in pain management, and recording methods for pain management, so as to provide medical staff with guidance and a decision-making basis for neonatal pain assessment and analgesia management.
Child ; Infant, Newborn ; Humans ; Pain Management ; Pain ; China ; Child Health ; Consensus

Child ; Humans ; Adult ; Child Health

Healthcare delivery is moving towards a more personalised and patient-centric approach. There is now an appropriate emphasis on providing value in our healthcare system. Patient-reported outcome measures (PROMs) assess our patients' perceptions of the status of their health and quality of life, measured over a period of time. PROM is an integral component of a value-driven and value-based healthcare system and is key if we want to practise value-based medicine. In paediatrics and child health, PROMs, if implemented well with appropriate measurement tools that are regularly updated and validated in a self-learning healthcare ecosystem, will help to enhance personalised healthcare delivery and collectively improve the health of the community at large. This review covers the role of PROMs in paediatrics, as well as their role in value-based medicine.
Humans ; Child ; Quality of Life ; Ecosystem ; Delivery of Health Care ; Patient Reported Outcome Measures ; Pediatrics