Cohort study is an irreplaceable method for studies related to maternal and child health. Compared with other countries, China's maternal and child cohort studies started relatively later but has its unique developing track. This paper summarizes the basic information and characteristics of the maternal and child cohorts with wide and great influence in China in the past 25 years.
Child ; Child Health ; Child Health Services/organization & administration* ; China ; Cohort Studies ; Humans ; Maternal Health ; Maternal Health Services/organization & administration*

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

PURPOSE: Disability is a significant problem and is accepted globally as a health priority in childhood. Like nonvisually impaired children, visually impaired children also need to use health services during childhood. The purpose of this study was to determine the health problems of visually impaired children. METHODS: A descriptive design was used. The subjects were 74 children with visual impairment attending primary school (aged 5e14 years), who agreed to participate and whose parents gave permission. Data were collected via physical examination including questionnaires and a physical assessment form. The health screening included physical measurements for height, weight, blood pressure, dental health, hearing, and scoliosis. RESULTS: The mean age of children was 10.43 +/- 2.9 years. When the health screening results of children were examined, it was found that 25.7% of the children were overweight or obese, 35.1% of them had dental problems, 27.0% had hearing problems, and 39.2% had scoliosis risk. Systolic and diastolic blood pressures were normal in 91.8% and 93.2% of the children, respectively. CONCLUSIONS: These findings showed the important role of school health nurses in performing health screenings directed at visually impaired children who constitute a special group for school health services. Health screening for height, weight, dental health, hearing, and scoliosis is suggested for visually impaired children.
Adolescent ; Blood Pressure ; Body Height ; Body Weight ; Child ; Child, Preschool ; *Disabled Persons ; Female ; Hearing ; Humans ; Male ; Mass Screening/*methods ; Oral Health ; School Health Services/*organization & administration ; Scoliosis/*diagnosis ; Socioeconomic Factors ; Surveys and Questionnaires ; Turkey ; *Visually Impaired Persons

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

Child ; Child Health Services ; organization & administration ; trends ; Forecasting ; Humans ; Singapore

INTRODUCTIONDepression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic.

METHODSA cross-sectional study was conducted in a government-funded primary care clinic in Malaysia. Consecutive adult female patients attending the clinic during the data collection period were invited to participate. The participants completed self-administered questionnaires (including the validated Patient Health Questionnaire [PHQ-9], which was translated into the Malay language).

RESULTSA total of 895 female patients participated in the study (response rate 87.5%). The prevalence of depression (PHQ-9 scores ≥ 10) was 12.1%. Based on multiple logistic regression analysis, certain stressful life events were found to be associated with depression (p < 0.05). These factors, arranged from highest to lowest risk, were financial problems (odds ratio [OR] 3.7, 95% confidence interval [CI] 2.2-6.2), unhappiness in the parent-child relationship (OR 3.0, 95% CI 1.2-7.5), history of serious illness (OR 2.4, 95% CI 1.1-5.2), unhappiness in family relationships (OR 2.3, 95% CI 1.1-4.7) and unhappiness at work (OR 2.2, 95% CI 1.1-4.3) (p < 0.05).

CONCLUSIONThe prevalence of depression among participants in this study was clinically significant and corresponded with the findings of other international studies. Factors associated with depression need to be highlighted and addressed accordingly. Clinicians in Malaysia should be aware of this prevalence when making diagnoses in primary care.

Adolescent ; Adult ; Aged ; Cross-Sectional Studies ; Depression ; diagnosis ; epidemiology ; etiology ; Female ; Humans ; Malaysia ; Middle Aged ; Parent-Child Relations ; Prevalence ; Primary Health Care ; organization & administration ; Regression Analysis ; Risk ; Sex Factors ; Social Class ; Surveys and Questionnaires ; Urban Health Services ; Urban Population

Intellectual disability is known to be associated with a high incidence of psychiatric co-morbidity and problem behaviours. However, there are many challenges in trying to meet the mental health needs of people with an intellectual disability, and these are often not adequately addressed in Singapore's current healthcare system. This article outlines the present service provisions for this area in the country and details the importance of, as well as difficulties in the integration of health and social care measures in service development and delivery.
Adult ; Child ; Education, Special ; Health Services Accessibility ; Health Services Needs and Demand ; Humans ; Intellectual Disability ; epidemiology ; rehabilitation ; therapy ; Intelligence Tests ; Mental Health ; Mental Health Services ; organization & administration ; Mentally Disabled Persons ; Program Development ; Quality of Health Care ; Singapore

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

Early childhood intervention programmes can shift the odds toward more favourable outcomes in development, especially for children at risk. However, there is no quick fix in the world for early childhood interventions. Programmes that work are rarely simple, inexpensive, or easy to implement. Each country must decide its own model and strategies and develop its resources based on existing infrastructures. Since its independence to become a sovereign nation in 1965, Singapore has undergone significant socio-economic changes. The infant and under-5 childhood mortality rates are among the lowest in the world. A number of "new morbidities" have been identified to pose major challenges to child health in the next decades. They are chronic medical illnesses, developmental disabilities, learning problems, injuries and neglect, behavioural disturbances and disorders, sequelae associated with unhealthy life-styles, and social and emotional disorders. The need for a comprehensive child development programme is therefore obvious. The main objectives are identification and treatment of children with developmental and behavioural problems so as to correct developmental dysfunctions, minimise the impact of a child's disability or of prevailing risk factors, strengthen families, and establish the foundations for subsequent development. A child development programme has evolved in Singapore over the last 20 years. The programme is multi-disciplinary, community-based, family-focused, and child-centric, with partnership and integration between government and voluntary community organisations.
Child ; Child Behavior Disorders ; Child Development ; Child Health Services ; history ; organization & administration ; Child, Preschool ; Community Participation ; Disabled Children ; History, 20th Century ; Humans ; Program Development ; Singapore ; Social Support

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