A Study of Health Prescribing for Children with Tourette’s Disorders in Children’s Health Education Specialty Care Clinics

Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.

Antibiotics prescribed to febrile under-five children outpatients in urban public health services in Burkina Faso

Appropriate use of antibiotics remains critical for success in achieving MDG4. The aim of this study was to investigate antibiotics prescribing practices to febrile under-five children outpatients in urban public health services in a low income country. Methods: From March to April 2013, a cross-sectional epidemiological study of care facilities visit by under-five age, for febrile illness, was carried out in urban health services in Bobo-Dioulasso, Burkina Faso. Patient demographics, diagnoses and medications were recorded. We calculated for each diagnoses several indicators for antibiotics use. Results: Our study showed an over-prescription of antibiotics at the university teaching hospital (78.08%) and at the first level facilities (57.71%) for under-five outpatients for febrile illness. There was evidence of high antibiotic prescription in children with diarrhea (more than 9 on 10 at university teaching hospital of diarrhea cases and 60% at the first level facilities), in children with Upper respiratory tract infections (respectively 60% and 85.2% of cases at university teaching hospital and at the first level facilities) and in children with malaria (respectively 47.5% and 17.6% of cases at university teaching hospital and at the first level facilities). Overuse, misuse and inappropriately prescribed antibiotic coexisted in our results: at university teaching hospital 90.9% of diarrhea cases, 60% of URTI cases,?47.5% of malaria cases received antibiotic prescription;at first level heath care facilities 85.2% of URTI, 17.6% of malaria cases received an prescribed antibiotic and 11.8% of LRTI did not received a prescribed antibiotic. Developing countries have poor access to newer antibiotics and irrational antibiotics use remains a global problem. Overuse and misuse of antibiotics combat, rigorous infectious diseases diagnosis, antimicrobial resistance consequences education of users and health professional’s prescribers, and improved surveillance of antimicrobial resistance, must be strengthened.

Children’s Health, Parent-Child Activities, Using Digital Devices, and Social Competence: Serial Mediation

Background: Studies have pointed out the influence of different children’s activities and prolonged use of digital products on their social development. However, whether the parent-child activities and using digital devices were serial mediators of the relationship between children’s health and social development needs further verification. Purpose: This study explored how parent-child activities and children’s use of digital devices influence the relationship between children’s health and their social competence. Method: This study used data from Kids in Taiwan: National Longitudinal Study of Child Development and Care. A total sample of 2164 participants was used in this study. Serial mediation analyses were performed using model six of Hayes’ PROCESS (2012). Results: This study found that parent-child activities and the use of digital devices can serially mediate the relationship between children’s health and social competence. Children’s health could directly improve their social competence, but it could also serially mediate social competence by increasing parent-child activities and reducing the use of digital devices. Conclusion: Childcare policy planners and parenting educators should not only call on parents to reduce the use of electronic products for their children, but also encourage parents to spend more time interacting with their children, so that children can learn social skills by interacting with others in their daily lives.

Youth’s Perspectives on a Sustainable Model for the Provision of Youth Friendly Sexual and Reproductive Health Services in Kenya: A Quantitative Approach

Nearly half of the world’s population comprise youths. However, addressing their Sexual and Reproductive Health (SRH) remains a challenge. Globally countries are mandated to continually provide Youth Friendly Sexual and Reproductive Health services (YFSRHs) to the youth. The objective of this study was to assess and describe youth’s perspectives on a sustainable model for the provision of YFSRHs in Kenya. Data was collected among 400 youths aged 18 - 24 years in Embu and Kirinyaga counties, Kenya. A structured questionnaire was utilized as the data collection tool. Collected data was analyzed using SAS statistical software version 9.4. Statistical threshold of P ≤ 0.05 was used. Overall the mean age of the study participants was ±standard deviation (SD) 21.2 ± 1.86 years. Majority of the participants’ perspective on the health care system sustainability was that the waiting time at the facility should be less than an hour, accessible geographically (less than a kilometre), affordable (≤20 Ksh.), and convenient working hours (weekday and weekends ratio 1:1). Advocacy was on health care provider’s attributes of politeness, welcoming, confidential and non-judgmental. The most preferred locations for the youth friendly centres by the participants were community and school based locations. Similarly, parental and community support was reported to highly contribute to sustained utilization and provision of the YFSRHs (P < 0.001). Unlike popular belief, 99.8% did not see the need for recreational facilities at the youth centres to ensure sustainability of the model. To ensure a sustainable model for the provision of YFSRHs, there is need for a multi-sectoral and stakeholder involvement that is;youth, health care system structure, health care service providers, parents and community. Further research is needed on parents and health care service provider’s perspectives on how to sustain the provision of YFSRH services.

Factors Affecting Children’s Cholesterol Levels with a View to Prevent Cardiovascular Disease—The Unique Benefits of Health Screening at the Elementary School

Background: The prevention of cardiovascular disease (CVD) can substantially contribute to reducing the mortality rate across countries. The level of interest in cholesterol among experts increases when the subjects are elderly and obese individuals. However, specialists do not recommend that children should receive the cholesterol test. The objective of this study was to investigate the distribution of cholesterol levels among the children of public school and their parents’ lifestyles that are associated with cholesterol levels, and to assess the need for and utility of cholesterol testing in school settings. Methods: The study investigated a group of 226 fourth-grade public school children aged between 9 and 10 years and guardians in Akitakatacity of Hiroshima Prefecture, Japan. Multiple regression analyses were performed with the logarithmic value of cholesterol levels as a response variable, awareness about lifestyles and health of children as an explanatory variable, and child’s sex and body mass index (BMI) as moderating variables. Using questionnaires about lifestyles, the step-down procedure was applied in multiple regression analyses to narrow down relevant lifestyle variables. Results: The percentage of children with the high total cholesterol (TC) value was about 15 and with low-density lipoprotein (LDL) cholesterol value was about 10. Children with low high-density lipoprotein (HDL) cholesterol value were 5%. Treatment was not required according to the comprehensive assessment. Cholesterol levels were associated with the situation of the children and their guardians as follows, guardian need to consider the food, and child has the correct knowledge about food like how to eat snacks. Conclusions: Children had poor cholesterol levels. From childhood, along with the parents, there is a need to learn about appropriate level of cholesterol for CVD prevention.

Cultivating global health professionals: evaluation of a training course to develop international consulting service competence in China

Background:China’s accelerating development and increasingly important role in global health engagement create a great demand for global health professionals including international consulting experts.This study reported the detailed development and evaluation of an international consulting training for global health workforce.Methods:Based on Kirkpatrick’s model,a mixed-methods approach was used to evaluate the effectiveness of the training.Quantitative and qualitative data on participants’reaction,learning,and application of the learned knowledge and skills were collected by a training evaluation survey at the ending of training and a follow-up interview in three months after the training.Results:Thirty-six participants attended the training and 34 of them completed quantitative investigation.The training satisfaction evaluations were positive,for which participants rated the training program highly and over 90%of them agreed with the usefulness of the training.About knowledge and skills change,participants showed improved consulting knowledge and skills from pre-to post-training(P<0.001).A total of 23 participants accepted follow-up interview,and most participants applied knowledge and skills learned from the training in their daily work or study.However,only 30.4%of participants applied their learning in the consulting program.The largest barrier of application was the lack of consulting opportunities.In addition,almost all the participants reported that they would be glad to attend more training courses in the future.Conclusion:The international consulting training program was well-received,and was feasible to improve the consulting service competence of global health professionals.According to participants’feedback,it is essential to develop and expand consulting training in the field of global health.

智力与发展性残疾儿童心理健康服务:基于WHO-FICs的研究

目的 系统分析智力与发展性残疾(IDD)儿童典型的心理健康状况及相关心理功能障碍,探讨如何构建针对IDD儿童的典型心理健康状况心理健康服务体系及心理干预方法。方法 基于世界卫生组织国际分类家族(WHO-FICs)架构,分析IDD儿童的心理健康状况和相关功能,构建心理健康服务架构并提出心理健康干预方法。结果 IDD儿童面临的典型的心理健康状况及相关疾病主要有6类:情绪障碍(焦虑症和抑郁症)、行为障碍(破坏性障碍、挑战性行为、攻击性行为)、创伤障碍(创伤后应激障碍)、精神障碍(精神分裂症)、自杀和自我伤害、学习障碍(发育性学习障碍、注意缺陷多动障碍)。为IDD儿童提供的心理健康服务涉及6个方面:领导力与治理、筹款、人力资源、服务提供、心理健康技术以及信息和研究。精神卫生服务贯穿从预防、治疗、康复到健康促进的连续卫生服务。为IDD儿童提供3个方面的心理健康服务:识别和诊断心理健康状况,分析导致心理健康问题的主要因素,以及分析环境因素。心理健康服务干预主要涉及抗抑郁药、心理治疗、压力管理培训、体育锻炼训练,以及健康生活方式的教育、建议和支持5类;心理健康服务可以在医院、康复机构、家庭和学校环境中提供。针对IDD儿童的各类心理健康问题,可以采取不同类型的心理健康干预方法。结论 本研究系统分析了IDD儿童典型的心理健康状况及相关心理功能障碍,根据世界卫生组织健康服务体系构建了IDD儿童心理健康服务架构,参照世界卫生组织健康服务连续体构建了IDD儿童心理健康干预方法体系,并且运用WHO-FICs对IDD儿童的功能进行描述和编码,运用ICHI-β3对相关的心理干预进行编码和分析。

健康中国背景下“G-U-S”公益性体育服务模式的构建与实施

基于“健康中国”时代背景,对政府购买服务、高校提供服务和社会大众享受服务的“G-U-S”公益性体育服务模式构建的理论基础、主体框架及运行机制进行阐释,并以青少年体育服务为案例进行具体实施和效果检验。结果表明:“G-U-S”模式成效显著,服务对象满意度高,不仅能够达到提高其体育运动成绩,还能够促进体育兴趣培养和体育锻炼参与,具有校内和其他社会体育培训机构所不具备的优势。模式发展策略包括“G-U-S”的稳定发展有赖于高校资源共享的良性循环、高效运行离不开政府有效的组织监管、高质量服务必须坚持以服务对象需求为导向。

Lived experiences with unmet supportive care needs in pediatric cancer:Perspective of Chinese children and their parents

Objective:Unmet supportive care needs(SCNs)impact pediatric cancer patients and their parents.This study aimed to explore the unmet SCNs from the perspective of Chinese children with cancer and their parents through lived experiences.Methods:The data of this study was collected using face-to-face semi-structured interviews.The participants were recruited from the oncology units of three children’s hospitals in China’s cities(Shanghai,Guangzhou,and Hefei)from October 2020 to December 2021.Data were analyzed using Colaizzi’s sevenstep phenomenological analysis method.Results:Eight pediatric cancer patients and twenty-four parents were enrolled in the study.Four main themes and eight subthemes(both children’s and parent’s perspectives)were generated:1)meeting the ongoing needs along the cancer trajectory(can you tell me what comes next;our needs are growing);2)communicating with a family focus(they only talk to my parents;let each family member have a voice);3)providing care beyond the treatment(I am bigger than my body[the children’s needs for emotional consolidation and information about their prognosis];there are things beyond treatment);4)getting support from the community(I am not a monster[the children were unhappy about being treated differently];we want to connect with the resources near us).Conclusion:This study revealed multiple unmet SCNs from the perspective of Chinese children with cancer and their parents.The findings call for comprehensive and in-depth supportive care beyond treatment,integration of the family member voice in pediatric cancer care,and a coordinated pediatric cancer support mechanism in the Chinese healthcare system.

Recreation of Agricultural Landscape for Children with Nature-deficit Disorder

Promoting human health is a basic value of landscape architecture. It is theoretically feasible to rebuild the link between children with nature-deficit disorder and nature via artificially-made natural environment. This paper explored the relationship between children's health and nature from the perspective of landscape architecture theories and practices. First, impact of nature-deficit disorder on children's health; second, basic appeals of children with nature-deficit disorder were sorted out; finally, specialized gardens for children with nature-deficit disorder under the instruction of the above theories were designed.

Limitations and possibilities on health assessment to women in violence situation

The aim was to know how health assessment to women in violence situation is developed. Literature review on LILACS and MEDLINE databases was conducted in April 2013 with the descriptors: “domestic violence” and “women’s health”, on a 1994-2012 timeframe. Statistics characterization and content theme analysis of the scientific production were developed. Results showed that the assessment is permeated by institutional limitation and an approach strictly clinical that makes identification and diagnosis of violence difficult, reinforcing invisibility in health care. Professional assessment is influenced by socio-cultural and the naturalization of the phenomena, which is not considered a public health issue. Technical knowledge is insufficient, making the possibility of promoting violence cycle rupture difficult. However, we envisage reception as a possibility to assess female demands. We conclude the need to include the theme in health undergraduate courses and also the urgency of this learning experience to support a multidisciplinary and intersectoral work web. Thus, rethinking assessment as a way of (re)organizing how health care is structured in order to compose an assessment web to women and guarantee reception of their demands is needed. Else, constructing competence allied to coping public policy to the problem and guaranteeing a human and full assistance will stay only on the academic field, constituting itself as a limit on protecting life of these women and their families.

基于ICF的听力障碍儿童言语与语言康复服务:理论架构与服务体系

目的 基于《国际功能、残疾和健康分类》(ICF)的生物-心理-社会功能和健康模式,系统分析世界卫生组织(WHO)康复相关的政策文件,探讨听力障碍儿童言语与语言康复的理论与政策原则、服务体系以及优先发展领域、主要政策和技术措施。方法 采用文献研究和政策研究法,系统梳理ICF的功能和健康架构、WHO康复相关政策报告和美国语言听力协会技术文件,结合我国听障儿童康复服务的现状和需求,提出构建基于ICF的听障儿童言语与语言康复服务体系的理论框架、优先领域和主要政策与技术措施。结果 发展听障儿童言语与语言康复需要遵循八大原则:以儿童为中心、尊重个体差异;全生命周期支持和促进持续发展;开展循证实践,确保干预的科学性和有效性;多学科团队合作并提供全面支持;构建家庭参与的支持网络;促进儿童的融合教育与社会参与;关注文化敏感性;技术赋能康复创新。听障儿童言语与语言康复要构建五大服务体系:早期筛查、诊断与干预综合体系;家庭和社会支持体系;多学科团队服务体系;全方位、多层次的听障儿童言语与语言康复服务体系;数字赋能服务构建新的康复服务模式。并讨论了优先发展领域以及主要政策和技术措施。结论 基于ICF的生物-心理-社会的功能和健康架构,通过加强政策支持、完善服务体系、构建多学科团队服务、推广数字赋能技术、加强社会支持等措施,可以为听障儿童提供全方位、个性化、持续性的高质量、全覆盖康复服务,促进儿童的全面发展和社会参与,提高儿童的生活质量。

0~6岁儿童眼保健和视力检查服务现状及对策研究

目的了解0~6岁儿童眼保健和视力检查服务现状,为相关部门提供决策依据。方法采用方便抽样方法,于2019年9—12月从北京市、安徽省、青海省抽取15家区县级妇幼保健院及基层卫生机构进行问卷调查,并采用现场观察及小组访谈的方式了解儿童眼保健服务现状及存在的问题等。结果被调查的区县级妇幼保健机构均配备了开展儿童眼保健服务的基本用房及设备;基层卫生机构均配备了开展儿童眼保健服务的基础设备,但有些设备陈旧破损、闲置未用。被调查机构儿童眼保健人员均不足,区县级妇幼保健院、社区卫生服务中心和乡镇卫生院的儿童眼保健人员分别占卫生技术人员的9.5%、5.5%和2.4%,不同类型卫生机构的儿童眼保健人员占比差异有统计学意义(χ^(2)=8.966,P=0.011)。社区卫生服务中心无眼科医生,该岗位由儿保人员兼职。被调查机构儿童眼保健人员接受上级指导及培训的机会普遍较少,年人均1~3次。各地儿童眼保健及视力检查服务覆盖率均在90%以上,但现场观察发现儿童眼保健人员操作技能尚不熟练、不规范。结论各卫生机构均需进一步完善儿童眼保健及视力检查服务设备,提高儿童眼保健人员的知识技能及服务质量。

北京市与深圳市儿童分级诊疗相关政策对比分析

背景为了解决儿童“看病难”“看病贵”的医疗困境,我国推行了分级诊疗制度。目前国内对儿童分级诊疗相关政策分析的系统研究献见报道。目的作为分级诊疗第一批试点城市,北京市和深圳市社区卫生服务机构(以下简称社区卫生机构)儿童接诊情况差异较大,本研究通过分析两地儿童分级诊疗相关政策,探索政策对社区卫生机构接诊儿童的影响。方法根据研究小组制定的分级诊疗政策研究框架(社区首诊制、双向转诊、医联体、薪酬激励、儿科培训、宣传、农村医疗可及性),在北京市政府、北京市卫生健康委员会、深圳市政府在线、深圳市卫生健康委员会官方网站检索儿童分级诊疗相关政策文件。筛选符合纳入、排除标准的政策,比较两市纳入政策的数量与内容,分析异同点。结果从6953篇政策文件中筛选出35篇符合分级诊疗政策研究框架的政策文件,其中北京市27篇、深圳市8篇。在医联体、薪酬激励、儿科培训方面,两市都有相关政策。在差异性方面北京市在分级诊疗的宣传和农村医疗可及性方面有相关政策,深圳市在社区首诊制和双向转诊制有相关政策。结论通过落实社区首诊制或加大医保支付比例差距方法促进儿童基层首诊、完善双向转诊指征、完善医联体、薪酬激励和儿科培训相关分级诊疗政策可能对改善社区卫生机构接诊儿童现况有重要意义。

丹麦中小学生心理健康教育指导和服务研究

丹麦中小学生随着社交媒体的发展,出现了日益严重的心理健康问题,引起了丹麦政府及社会各界的广泛关注和重视。文章探究了丹麦中小学生心理健康问题的主要类型及表现,详述了丹麦在加强中小学生心理健康教育方面的预防措施及政策管理,聚焦疫情时期的应对措施和信息化手段的运用及效果。此外,还描述了丹麦天才儿童的心理健康情况和特别针对性的心理健康服务措施。总体上,丹麦政府、社会、学校以及家庭层面都致力于提供多样化的心理健康服务,共同促进学生的心理健康和幸福感。

重庆市区县级妇幼保健机构男科服务能力分析

目的分析和评估重庆市区县级妇幼保健机构男科服务能力,为进一步推进男科工作提供数据支撑。方法于2021年6月9日至10日举办男科疾病诊疗培训班,采用问卷调查形式收集重庆市39家区县级妇幼保健机构的男科服务提供情况和人力资源数据,对数据进行描述性分析。结果重庆市39家区县级妇幼保健医院均有男科医师,有27家医院开设男科专科门诊,其中10家男科门诊为近5年新开设,22家男科门诊中超过75%的就诊人群为孕前检查、婚前检查者,因疾病就诊者较少,尚无医院开展男科显微外科手术。其余12家机构虽然配置了男科医师,但仅能开展婚前检查及孕前优生项目,不能提供男科常见疾病诊疗。结论重庆市区县级妇幼保健机构男科发展尚处于起步阶段,人力资源配置不足,但就诊者有其独特的人群特征,男科发展前景具有一定优势。

用关爱和包容建设儿童青少年的心理安全网——新加坡儿童青少年心理健康服务研究

儿童青少年的心理健康成为新加坡社会特别关注的问题。文章概括了新加坡儿童青少年心理健康状况,梳理了新加坡心理健康政策发展历程,重点论述了新加坡学校、家庭、社会组织的针对性心理健康服务。新加坡通过多方联动的REACH模式对儿童青少年的心理健康进行干预,利用信息化手段应对新冠疫情带来的心理危机并助力心理健康服务创新发展,努力为儿童青少年的健康发展构建充满关爱与温暖的安全网,为世界贡献了新加坡经验。

韩国精准调查下的智能化心理健康服务体系构建

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