Readability of health care literature

Abstract A sample of health care literature produced for parents was analysed, using the Flesch method, for readability and human interest. As a comparison, the readability and human interest scores were also calculated for Sydney daily newspapers. It was found that the pamphlets produced by government agencies were more readable than those produced by non-government agencies. Those pamphlets written with input from parents were the most readable of all. Similar results were found for the human interest level of the pamphlets. The readability and the human interest scores of the government-produced pamphlets were similar to those of the larger circulation daily newspapers. Health care literature for parents needs to be of good quality and easily understood. The involvement of parents in their production may improve the effectiveness of these leaflets.     

Child and youth mental health: Integrated health care using contemporary competency-based teams

Mental health teams have long been the foundation for mental health services provided to children and youth. Changes in professional practices, the emergence of evidence-based care, the importance of integrating mental health into primary health care delivery, the decrease in professional ‘ownership’ of mental health care competencies and other factors now challenge the traditional structure and function of these teams. New and novel frameworks will be needed to address mental health care needs for problems that do not require ‘traditional’ mental health service interventions, to enable integration of mental health care into usual health services, to promote specialist mental health care delivery for those in need, and to facilitate the development and translation of mental health research into practice. In all of these new team structures, the active participation of young people and their families will be necessary.     

Newborn care at peripheral health care facilities

Primary health centres, sub-district hospitals (first referral units) and district hospitals constitute the backbone of the health services in the country. These facilities are expected to cater to the care of the newborn infants who are delivered there, as well as those brought from the community with sickness. This paper, based on a survey in Orissa, and studies in a district hospital in Himachal Pradesh and a sub-district hospital in Haryana, is an attempt to piece together the present status of neonatal care at these facilities. In Orissa, the district and sub-district hospitals cater to a median of 100 and 30 deliveries per month, respectively. Most of the deliveries at these facilities are conducted by the nurses and not the physicians. Neonates are generally kept in the facility only for a day. Hardly any deliveries take place at primary health centres. Cesarean deliveries are mostly confined to the district hospitals. The commonest diagnosis of neonates admitted in the district and sub-district facilities is sepsis (septicemia pneumonia, skin infections, diarrhea and meningitis). Primary health centres seldom admit a sick neonate. It is reassuring to note that the outcome of sick neonates admitted at a functional district or sub-district hospital manned by a pediatrician is highly rewarding with low mortality rates.     

儿童保健临床研究进展

随着人民生活水平的提高和医学模式的转变,对保健服务的需求和利用日益扩大。儿童保健医疗服务的内容也得以不断拓展,新知识、新技术、新的服务理念不断引入。2010年儿童保健学组组织专家在全国5个城市(北京、上海、广州、武汉、成都)进行3项《建议》(生长发育评估建议、正常儿喂养建议、多种维生素补充建议)的解读与推广[1-2],     

Medical genetics in primary health care

Medical genetics has been at the forefront of developments in medicine for the last 50 years. This progress has mainly benefited industrialized countries. Due to continuing improvements in the socio-economic and health indices in developing nations more than half of them have now reached a stage where it has become relevant for them to initiate and develop medical genetic services. The WHO foresaw this eventuality in 1985 and further recognised the need to develop community based medical genetic services that are relevant to and can be incorporated into primary health care. The need for primary health care based medical genetic services has subsequently also been accepted in industrialized nations. This paper summarises those primary health care based interventions that can be undertaken to ensure the control of genetic disorders and birth defects.     

Evaluating and providing quality health information for adolescents and young adults with cancer

Adolescents and young adults (AYAs, 15‐39 years old) are an ideal population to benefit from the ever‐expanding number and variety of cancer information and health resources available via the Internet and other digital platforms. However, the ability of individual AYAs to fully utilize such resources depends on their degree of health literacy. Across the trajectory of cancer care, an important role for the oncology clinician is assisting AYAs and caregivers in accessing quality health information consistent with their level of health literacy. Working from the premise that all AYAs with cancer and their caregivers deserve to be empowered with maximal knowledge about their condition, this review provides information to assist oncology clinicians in (1) understanding the variety of contemporary online resources that are currently available, including their strengths and limitations; (2) evaluating the quality of health information; and (3) recommending specific health information resources to their AYA patients.     

Parents,infants and health care: utilization of health services in the first 12 months of life

OBJECTIVE: To describe patterns of health-service use in the first 12 months of life. METHODS: In this prospective cohort study, 173 first-born infants and their families living in two middle socio-economic urban areas of Melbourne were enrolled consecutively when presenting for their initial maternal and child health nurse (MCHN) visit (at approximately 4 weeks of age). Families kept a daily "health diary" for the entire 12-month period, recording use of all health services for their infant, and reasons for the contact. RESULTS: There was an 87% completion rate of diaries. The mean number of visits to any health service, including medical, hospitals, MCHN services, pharmacists, allied health services and naturopaths, was 35.7 (95% CI 34.7-36.6) during the 12 months. Of these, 31% (mean 10.9 visits) were visits to a general practitioner (GP) and 41.5% (mean 14.3 visits) were visits to the MCHN. Infants' visits to the MCHN were far more frequent in the first 6 months of life compared with the second 6 months (10.3 vs 3.6, P < 0.001). Rates of GP use were constant over the same periods (5.3 vs 5.7, P = 0.8). CONCLUSIONS: In a universal health-care system, this high rate of health-service use equates to approximately one visit to a health service every 2 weeks in the first year of life. The majority of these visits appeared unrelated to illness. This previously undocumented data has implications for future integrated service delivery, health-professional training and policy development for this age group.     

Primary care practice and health professional determinants of immunisation coverage

Aim: To identify primary care factors associated with immunisation coverage. Methods: A survey during 2005–2006 of a random sample of New Zealand primary care practices, with over‐sampling of practices serving indigenous children. An immunisation audit was conducted for children registered at each practice. Practice characteristics and the knowledge and attitudes of doctors, nurses and caregivers were measured. Practice immunisation coverage was defined as the percentage of registered children from 6 weeks to 23 months old at each practice who were fully immunised for age. Associations of practice, doctor, nurse and caregiver factors with practice immunisation coverage were determined using multiple regression analyses. Results: One hundred and twenty‐four (61%) of 205 eligible practices were recruited. A median (25th–75th centile) of 71% (57–77%) of registered children at each practice was fully immunised. In multivariate analyses, immunisation coverage was higher at practices with no staff shortages (median practice coverage 76% vs 67%, P= 0.004) and where doctors were confident in their immunisation knowledge (72% vs 67%, P= 0.005). Coverage was lower if the children's parents had received information antenatally, which discouraged immunisation (67% vs 73%, P= 0.008). Coverage decreased as socio‐economic deprivation of the registered population increased (P < 0.001) and as the children's age (P= 0.001) and registration age (P= 0.02) increased. Conclusions: Higher immunisation coverage is achieved by practices that establish an early relationship with the family and that are adequately resourced with stable and confident staff. Immunisation promotion should begin antenatally.     

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2011年国务院发布的《中国妇女发展纲要(2011——2020年)》和《中国儿童发展纲要(2011——2020年)》,把妇女和儿童健康纳入国民经济和社会发展规划,作为优先发展的领域之一。卫生部先后制定了婚前、孕前、孕产期和新生儿期保健等一系列配套规章和规范性文件,使母婴保健服务在行政管理、监督检查和技术规范等各个环节,基本实现了有法可依。     

Demography of adolescent health care delivery and training in Europe

Background  We aimed to determine the status of and factors associated with adolescent health care delivery and training in Europe on behalf of the European Paediatric Association—UNEPSA. Materials and methods  A questionnaire was mailed to the presidents of 48 national paediatric societies in Europe. For statistical analyses, non-parametric tests were used as appropriate. Results  Six of the countries had a paediatric (PSPCA), 14 had a combined and nine had a general practitioner/family doctor system for the primary care of adolescents (GP/FDSA). Paediatricians served children 17 years of age or older in 15 and 17, up to 16 years of age in three and six, and up to 14 years of age in six and six countries in outpatient and inpatient settings, respectively. Fifteen and 18 of the countries had some kind of special inpatient wards and outpatient clinics for adolescents, respectively. Twenty-eight of the countries had some kind of national/governmental screening or/and preventive health programmes for adolescents. In countries with a PSPCA, the gross national income (GNI) per capita was significantly lower than in those with a GP/FDSA, and the mean upper age limit of adolescents was significantly higher than in those with the other systems. In the eastern part of Europe, the mortality rate of 10–14 year olds was significantly higher than that in the western part (p=0.008). Training in adolescent medicine was offered in pre-graduate education in 14 countries in the paediatric curriculum and in the context of paediatric residency and GP/family physician residency programmes in 18 and nine countries, respectively. Adolescent medicine was reported as a recognised subspecialty in 15 countries and as a certified subspecialty of paediatrics in one country. In countries with a PSPCA, paediatric residents were more likely to be educated in adolescent medicine than paediatric residents in countries with a GP/FDSA. Conclusion  The results of the present study show that there is a need for the reconstruction and standardisation of adolescent health care delivery and training in European countries. The European Paediatric Association—UNEPSA could play a key role in the implementation of the proposals suggested in this paper. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Maternal relationship style, paediatric health care use and infant health

OBJECTIVE:

The aim of the current exploratory study was to examine the relationships between maternal relationship style, paediatric health care use and infant health variables in a sample of middle-class and ethnically diverse mother-infant dyads.

METHODS:

An initial cross-sectional cohort study obtained demographic and self-report data on mothers’ relationship styles. As an extension of the original study, infants’ patient files were reviewed for the year following initial recruitment to obtain data regarding the use of paediatric health care services and infant health. The final sample included 64 mothers and their infants.

RESULTS:

Correlational analyses revealed that mothers’ higher endorsement of a dismissive relationship style were associated with fewer acute care visits and fewer reported infant illnesses.

CONCLUSIONS:

Compared with other relationship styles, mothers who highly endorsed a dismissive relationship style tended to use fewer acute paediatric health care services and reported fewer infant health problems. However, further longitudinal research is needed to clarify these relationships.     

Primary health care for Indo-Chinese children in Australia

This study reports the detailed analysis of 61 consecutive presentations by recent immigrants from Indo-China to the Casualty Department of a modern Australian Children's Hospital. The parents/guardians were interviewed either in the Casualty Department or in their homes. Indo-Chinese children coming to a Casualty Department manifested the same age distribution and spectrum of illnesses that is seen in the general Australian paediatric population. However, significantly fewer presentations to hospital occurred due to accidents/trauma when the group was compared with the general population attending the Casualty Department. Only 21%-of the Vietnamese and Cambodian families can communicate satisfactorily with hospital staff without interpreter help. Fifty-one per cent of parents reported that they did not have enough English for a medical interview without an interpreter. Twenty-eight per cent did riot have enough English to communicate at all. Parents of Vietnamese children reported that on occasions they had not sought medical care for their children because of language difficulties. Many families do not know that an Interpreter Service is available, and many believe that access to such a service is available only through a doctor. Many of these children also use traditional Chinese remedies in the context of their contemporary Australian lives. We have found no evidence that this practice causes late presentation with deleterious effects, or any evidence that it compromises modern 'Western' treatment.     

Medical liability, risk management, and the quality of health care

The medical malpractice situation in many countries is reaching epidemic proportions. This paper examines the concepts of medical liability and professional risk management, as well as the relationship they play in determining the quality of healthcare services. The role of documentation and accurate record keeping is also stressed. High-risk clinical situations and medication errors are also addressed.