scholarly journals 886 Melatonin prescription practice for children and adolescents with sleep difficulties in a community child health outpatient clinic: scope for cost-savings

2021 ◽  
Author(s):  
Michael Ogundele ◽  
Sultana Khan
Keyword(s):  
Child Health ◽  
Children And Adolescents ◽  
Outpatient Clinic ◽  
Cost Savings ◽  
Sleep Difficulties ◽  
Prescription Practice

scholarly journals Human toxocariasis: frequency of anti-Toxocara antibodies in children and adolescents from an outpatient clinic for lymphatic filariasis in Recife, Northeast Brazil

2004 ◽  
Vol 46 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Ana Maria Aguiar-Santos ◽  
Luiz D. Andrade ◽  
Zulma Medeiros ◽  
Pedro Paulo Chieffi ◽  
Suzana Z. Lescano ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Outpatient Clinic ◽  
Wuchereria Bancrofti ◽  
Northeast Brazil ◽  
Intestinal Helminths ◽  
Igg Antibody ◽  
Present Sample ◽  
Elisa Technique ◽  
The Difference ◽  
Transversal Study

In a transversal study on a sample of 386 children and adolescents from an outpatient clinic for filariasis in Recife, Northeast Brazil, the frequency of anti-Toxocara antibodies and its relation to age, gender, number of peripheral eosinophils, Wuchereria bancrofti microfilariae and intestinal helminths was determined. The total anti-Toxocara IgG antibody frequency was 39.4%, by ELISA technique. The difference in frequency between males (40.1%) and females (37.6%) was not statistically significant. The 6 to 10-year-old subset presented the highest frequency of anti-Toxocara antibodies (60%), and within this age group there was a statistically significant male bias. There was also a significant association between the number of eosinophils and the presence of anti-Toxocara antibodies. Intestinal parasite frequency was 52.1%, but no association was found between this data and the presence of anti-Toxocara antibodies. In the present sample, 42.2% of the patients were Wuchereria bancrofti carriers, however, again this was not associated with the presence of anti-Toxocara antibodies. In conclusion, anti-Toxocara antibodies were highly prevalent in this sample. The present data show that there is no cross correlation between anti-Toxocara IgG antibody and the presence of intestinal helminths and filariasis.

scholarly journals Women, children and adolescents in conflict countries: an assessment of inequalities in intervention coverage and survival

2020 ◽  
Vol 5 (1) ◽  
pp. e002214 ◽  
Author(s):  
Nadia Akseer ◽  
James Wright ◽  
Hana Tasic ◽  
Karl Everett ◽  
Elaine Scudder ◽  
...  
Keyword(s):  
Maternal Health ◽  
Child Health ◽  
Children And Adolescents ◽  
Child Mortality ◽  
Breast Feeding ◽  
Low Income ◽  
Mortality Rates ◽  
Health Interventions ◽  
Data Set ◽  
And Child Health

IntroductionConflict adversely impacts health and health systems, yet its effect on health inequalities, particularly for women and children, has not been systematically studied. We examined wealth, education and urban/rural residence inequalities for child mortality and essential reproductive, maternal, newborn and child health interventions between conflict and non-conflict low-income and middle-income countries (LMICs).MethodsWe carried out a time-series multicountry ecological study using data for 137 LMICs between 1990 and 2017, as defined by the 2019 World Bank classification. The data set covers approximately 3.8 million surveyed mothers (15–49 years) and 1.1 million children under 5 years including newborns (<1 month), young children (1–59 months) and school-aged children and adolescents (5–14 years). Outcomes include annual maternal and child mortality rates and coverage (%) of family planning services, 1+antenatal care visit, skilled attendant at birth (SBA), exclusive breast feeding (0–5 months), early initiation of breast feeding (within 1 hour), neonatal protection against tetanus, newborn postnatal care within 2 days, 3 doses of diphtheria, pertussis and tetanus vaccine, measles vaccination, and careseeking for pneumonia and diarrhoea.ResultsConflict countries had consistently higher maternal and child mortality rates than non-conflict countries since 1990 and these gaps persist despite rates continually declining for both groups. Access to essential reproductive and maternal health services for poorer, less educated and rural-based families was several folds worse in conflict versus non-conflict countries.ConclusionsInequalities in coverage of reproductive/maternal health and child vaccine interventions are significantly worse in conflict-affected countries. Efforts to protect maternal and child health interventions in conflict settings should target the most disadvantaged families including the poorest, least educated and those living in rural areas.

OP55 Health Technology Assessment In Children And Adolescents: Adolescent Preferences For Child Health Utility 9D Health States

2017 ◽  
Vol 33 (S1) ◽  
pp. 24-25 ◽  
Author(s):  
Julie Ratcliffe ◽  
Gang Chen ◽  
Elisabeth Huynh ◽  
Frank Xu ◽  
Katherine Stevens ◽  
...  
Keyword(s):  
Child Health ◽  
Health Technology Assessment ◽  
Children And Adolescents ◽  
Technology Assessment ◽  
Latent Class ◽  
Health Utility ◽  
Health Technology ◽  
Class I ◽  
Health States ◽  
Percent Female

INTRODUCTION:Preference-based measures of health-related quality of life play a key role in the calculation of Quality-Adjusted Life Years (QALYs) for Health Technology Assessment (HTA). The Child Health Utility 9D (CHU9D) is a new preference-based instrument designed specifically for application in children and adolescents (aged 7 to 17 years). This study aimed to compare Chinese and Australian adolescent population preferences for CHU9D health states using profile case best worst scaling (BWS) methods.METHODS:Fifty CHU9D health states (blocked into five survey versions) were generated for valuation using a fractional factorial design. Study participants were recruited through an online panel company in Australia, and through primary and secondary schools in China. A latent class modelling framework was adopted for econometric analysis.RESULTS:A total of 1,982 respondents (51 percent female) in Australia and 902 respondents (43 percent female) in China provided useable survey responses. Latent class analysis indicated the existence of preference heterogeneity for both population groups. In the Australian sample, respondents in Class I placed the most importance on the mental health dimensions of the CHU9D (for example, Worried and Annoyed) and the least importance on daily activities (for example, Activities, Daily routine, Sleep), whilst respondents in Class II placed equal weights on all attributes. In the Chinese sample, respondents in Class I placed the most importance on the Activities dimension of the CHU9D and the least importance on the Annoyed dimension, whist Class II placed the most importance on the Schoolwork dimension and the least importance on Pain.CONCLUSIONS:This study has provided important cross-country insights into the use of profile case BWS methods to elicit health state preferences with young people for application in HTA in children and adolescents. The differential latent classes identified between Australia and China highlights the necessity to derive country-specific adolescent scoring algorithms for the CHU9D instrument for application in HTA.

Effect of early palliative care on health care costs in patients with metastatic NSCLC.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6004-6004 ◽  
Author(s):  
Joseph A. Greer ◽  
Pamela M McMahon ◽  
Angela Tramontano ◽  
Emily R. Gallagher ◽  
William F. Pirl ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Outpatient Clinic ◽  
Cost Savings ◽  
Care Group ◽  
Early Palliative Care ◽  
Metastatic Nsclc ◽  
Chemotherapy Administration ◽  
The Difference ◽  
Mean Cost

6004 Background: Introducing palliative care soon after diagnosis for patients with metastatic non-small cell lung cancer (NSCLC) leads to improvements in quality of life, mood, end-of-life care, and possibly survival. We sought to investigate whether early palliative care is also associated with health care cost savings. Methods: This secondary analysis is based on a randomized controlled trial of 151 patients with newly-diagnosed, metastatic NSCLC presenting to an outpatient clinic at a tertiary cancer center between 6/2006 and 7/2009. Participants received either early palliative care integrated with standard oncology care or standard oncology care alone. We queried participants’ electronic health records as well as our institution’s billing database to collect data on frequency and costs of outpatient clinic visits, inpatient hospitalizations, chemotherapy administration, and hospice services. The primary outcome was the difference in average resource use costs during the final month of life between groups. Results: By 18-month follow up, 133 (88.1%) participants had died, and 125 (82.8%) had available data for this analysis. Participants in the early palliative care group had a mean cost savings of $2,282 (median=$2,432) per patient in total health care expenditures during the final month of life compared to the standard care group. The difference was primarily accounted for by lower costs for inpatient visits (mean saving per patient=$3,110) and chemotherapy administration (mean saving per patient=$640). Although expenditures for outpatient clinic visits were similar between groups, the costs for hospice services were greater for the early palliative care group because of the longer lengths of stay in hospice care (mean cost per patient=$1,125). Conclusions: Early palliative care for individuals diagnosed with metastatic NSCLC not only improves multiple patient outcomes but also may be associated with lower hospital resource use costs, primarily through decreased inpatient visits and chemotherapy administration at the end of life.

Diagnosis of Headache in Childhood and Adolescence: A Study in 437 Patients

Cephalalgia ◽  
1995 ◽  
Vol 15 (1) ◽  
pp. 13-21 ◽  
Author(s):  
C Wöber-Bingöl ◽  
C Wöber ◽  
A Karwautz ◽  
C Vesely ◽  
C Wagner-Ennsgraber ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Outpatient Clinic ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Childhood And Adolescence ◽  
Highly Sensitive ◽  
Ihs Criteria ◽  
Type Headache ◽  
Structured Questionnaire

We investigated whether the criteria for idiopathic headache published by the International Headache Society (IHS) are useful in childhood and adolescence and compared the diagnoses according to this classification with those of Vahlquist. We used a semi-structured questionnaire to examine a total of 437 children and adolescents referred consecutively to a headache outpatient clinic. Twenty-eight of 437 patients were excluded because of symptomatic or unclassifiable headache. Of 409 patients with idiopathic headache, 70.4% had definite migraine or tension-type headache (IHS 1.1, 1.2, 2.1, 2.2), 20.5% had a migrainous disorder (IHS 1.7) and 9.1% had headache of the tension-type not fulfilling the criteria (IHS 2.3). In the differential diagnosis of migraine and tension-type headache the intensity of pain, aggravation of headache by physical activity, nausea and vomiting were the most important features. The quality of pain, photo- and phonophobia were less helpful and location least important. The duration of migraine attacks was less than 2 h in 19.0% of the migraine patients. In general, the diagnostic criteria of migraine were highly specific but less sensitive, and those of tension-type headache highly sensitive but less specific. The agreement between IHS criteria and those of Vahlquist was marked (kappa = 0.57). We conclude that the IHS criteria are useful for classifying headache in children and adolescents referred to a headache outpatient clinic. A forthcoming modification of the IHS criteria should consider a reduction of the minimum duration of migraine attacks from 2 h to I h and should try to increase the sensitivity of the criteria for migraine and the specificity of the criteria for tension-type headache.

Incidence of Catatonia in Children and Adolescents in a Paediatric Psychiatric Clinic

2003 ◽  
Vol 37 (2) ◽  
pp. 200-203 ◽  
Author(s):  
Anupam Thakur ◽  
K. Jagadheesan ◽  
Siddartha Dutta ◽  
Vinod Kumar Sinha
Keyword(s):  
Mental Retardation ◽  
Children And Adolescents ◽  
Affective Disorder ◽  
Outpatient Clinic ◽  
Rating Scale ◽  
Psychiatric Clinic ◽  
Entire Sample ◽  
Adolescent Population ◽  
Psychiatric Outpatient Clinic ◽  
The Mean

Objective: To investigate the incidence and phenomenology of catatonia in a child and adolescent population. Method: Children and adolescents who had attended a paediatric psychiatric outpatient clinic between April and July 2001 were examined for catatonic signs with a formal catatonia rating scale, and patients who had at least two catatonic signs were included. Results: Eleven patients met the criteria (5.5% of the entire sample and 17.7% of the patients with affective and nonaffective psychotic disorder); of them eight had an affective disorder and three a nonaffective disorder. The mean catatonic scores were significantly high for males and patients with mental retardation. Conclusion: This study shows that catatonia occurs in children and adolescents. Further studies are essential to clarify the distribution of catatonia across various diagnoses and the outcome of paediatric catatonia.

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