AIM: To investigate the (dis)agreement between, and compare the determinants of, parent and clinician severity scores.
DESIGN AND SETTING: Secondary analysis of data from a prospective cohort study of 8394 children presenting to primary care with acute (≤28 days) cough and RTI.
METHOD: Data on sociodemographic factors, parent-reported symptoms, clinician-reported findings, and severity assessments were used. Kappa (κ)-statistics were used to investigate (dis) agreement, whereas multivariable logistic regression was used to identify the factors associated with illness severity.
RESULTS: Parents reported higher illness severity (mean 5.2 [standard deviation (SD) 1.8], median 5 [interquartile range (IQR) 4-7]), than clinicians (mean 3.1 [SD 1.7], median 3 [IQR 2-4], P<0.0001). There was low positive correlation between these scores (+0.43) and poor inter-rater agreement between parents and clinicians (κ 0.049). The number of clinical signs was highly correlated with clinician scores (+0.71). Parent-reported symptoms (in the previous 24 hours) that were independently associated with higher illness severity scores, in order of importance, were: severe fever, severe cough, rapid breathing, severe reduced eating, moderate-to-severe reduced fluid intake, severe disturbed sleep, and change in cry. Three of these symptoms (severe fever, rapid breathing, and change in cry) along with inter/subcostal recession, crackles/crepitations, nasal flaring, wheeze, and drowsiness/irritability were associated with higher clinician scores.
CONCLUSION: Clinicians and parents use different factors and make different judgements about the severity of children's RTI. Improved understanding of the factors that concern parents could improve parent-clinician communication and consultation outcomes.
METHODS: A cross-sectional study was conducted in primary healthcare centers in Nablus district from May to July 2015. Data were collected using structured questionnaire interviews with parents to collect information on food safety knowledge, attitudes, and practices, alongside sociodemographic characteristics.
RESULTS: Four-hundred and twelve parents were interviewed, 92.7% were mothers. The median knowledge score was 12.0 with an interquartile range (IQR) of 11.0-14.0. The median attitude score was 11.0 with IQR of 10.0-13.0, while the median practice score was 18.0 with IQR of 16.0-19.0. Significant modest positive correlations were found between respondents' knowledge and attitude scores regarding food poisoning (r = 0.24, p
MATERIALS AND METHODS: A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire.
RESULTS: The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8).
CONCLUSIONS: Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.
DESIGN: Multi-center cross-sectional study.
SETTING: Two tertiary medical centers in Malaysia.
PARTICIPANTS: A total of 59 patients with CAH who were raised as females and more than 10 years old, and their parents.
METHODS: The CAH respondents completed the validated and translated Body Image Disturbance Questionnaires (BIDQ). All CAH respondents and their parents underwent semi-structured interviews to explore their views on FG.
MAIN OUTCOME MEASURES: Body image disturbance score and perspectives on FG.
RESULTS: The 59 CAH respondents consisted of 12 children, 29 adolescents, and 18 adults. The majority were of Malay ethnicity (64.4%) with classical CAH (98.3%) and had undergone FG (n = 55, 93.2%). For the BIDQ scores, the median score (interquartile range) for general body image was 1.29 (0.71), range 1.00-3.29, whereas the genital appearance score was 1.07 (0.39), range 1.00-4.29, revealing a greater concern for general body parts over genitalia. With regards to FG, it was perceived as necessary. Infancy and early childhood were perceived as the best timing for first FG by both respondents and parents, most preferring single-stage over 2-stage surgery.
CONCLUSIONS: General body appearance concerns were greater than for genital appearance, with more impact on the patients' lives. Contrary to much international opinion, feminizing surgery was perceived as necessary and appropriate by CAH respondents and their families, and should be offered in infancy or early childhood. Future qualitative studies are recommended.
METHODS: This study is a pragmatic, cluster-randomised, parallel-group, matched pair, controlled trial with blinded outcome assessment. Randomisation is performed using a computer-generated table with a 1:1 allocation comparing the SIMSP and the POHP involving 28 preschools in the Kampar district, Perak, Malaysia. The intervention consists of preschool visits by a group of dental therapists, in-class oral health lessons and daily toothbrushing conducted by class teacher, child home toothbrushing supervised by parents, and infographic oral health messages to parents. The control consists of the existing POHP that involves preschool visits by a group of dental therapists only. The trial lasts for 6 months. Primary outcome variable is the mean plaque score change after 6 months. To determine the feasibility of the SIMSP, a process evaluation will be conducted using the perspectives of dental therapists, teachers, and parents on the appropriateness, effectiveness, facilitators, and barriers to the SIMSP implementation as well as an audit trail to assess the trial intervention.
DISCUSSION: Cluster randomisation may lead to a random effect and cluster selection bias. These factors will be accounted for when analysing the data and interpreting the outcomes. The effectiveness of the SIMSP will be evaluated by comparing the results with those of the POHP.
TRIAL REGISTRATION: ClinicalTrials.gov NCT04339647 . Registered on 5 April 2020 - Retrospectively registered.
MATERIALS AND METHODS: Systematic searches of PubMed, Scopus and Web of Science databases were conducted. Independent reviewers screened the title, abstract and full texts according to predetermined inclusion and exclusion criteria. Articles published in English from January 2012 to March 2022 reporting the QoL of non-syndromic young patients aged 7-18 years with CL/P were included. Review articles and articles reporting the psychological adjustment of parents or other family members with CL/P were excluded.
RESULTS: 975 publications were identified, of which 20 studies met our inclusion criteria. The majority of studies reported that the CL/P condition has a negative impact on the QoL. Psychological health, functional well-being, socialemotional well-being and school environment are domains that are affected. Compared with typically developing young patients, those with CL/P had lower QoL scores even though QoL was assessed using different instruments across studies. The impact of CL/P on overall QoL scores varied by age but not gender or cleft type.
CONCLUSION: Our reviews had shown the presence of CL/P negatively affects the QoL of young patients. Psychological health is the most affected QoL domain. Understanding the impacted domain will help in planning and delivering better health care for individuals with CL/P and reducing the stigma commonly associated with CL/P. Future studies should target intervention on psychological health and consider resilience factors towards positive adjustment.
METHODS: The cross-sectional Family Diet Study (n = 236) was conducted at five primary schools in central of Peninsular Malaysia. Each family consisted of a Malay child, aged 8-12 years, and their main caregiver(s). Information on socio-demographics, dietary intake and anthropometry were collected. Correlations and regression analyses were used to assess dietary relationships within family dyads.
RESULTS: Approximately 29.6% of the children and 75.0% parents were categorised as being overweight or obese. Intakes of nutrients and food groups were below the national recommended targets for majority of children and adults. A large proportion of energy intake mis-reporters were identified: mothers (55.5%), fathers (40.2%) and children (40.2%). Children's body mass index (BMI) was positively associated with parental BMI (fathers, r = 0.37; mothers, r = 0.34; P < 0.01). For dietary intakes, moderate-to-strong (0.35-0.72) and weak-to-moderate (0.16-0.35) correlations were found between mother-father and child-parent dyads, respectively. Multiple regression revealed that maternal percentage energy from fat (β = 0.09, P < 0.01) explained 81% of the variation in children's fat intake.
CONCLUSIONS: Clear parental dietary relationships, especially child-mother dyads, were found. Despite a significant proportion of families with members who were overweight or obese, the majority reported dietary intakes below recommended levels, distorted by energy mis-reporting. The findings of the present study can inform interventions targeting parent-child relationships to improve family dietary patterns in Malaysia.
MATERIALS AND METHOD: The Family Diet Study was conducted with urban Malay families and included a child aged 8-12 years and their main carer(s). Seven domains of parent-child feeding practices were assessed using the child feeding questionnaire and familial demographics, including socio-economic status, child anthropometry and dietary intake were collected. Inferential statistics were used to explore the relationships between variables.
RESULTS: Of the 315 families enrolled, 236 completed all measures, with the majority of parent-reporters being mothers (n = 182). One-third of the children were classified as overweight/obese. Three domains of parent-child feeding practices had median scores of 4.0 out of 5.0 [concern about child overweight (CCO) (Interquartile range (IQR): 3.3, 4.7); pressure-to-eat (PTE) (IQR: 3.3, 4.5) and food monitoring (IQR: 3.0, 5.0)]. The domain of 'perceived child overweight' was positively associated with child age (r = 0.45, p