Paediatric health

  • 文章类型: Journal Article
    尽管针对普通人群的补充和替代医学(CAM)的研究正在扩大,仍然缺乏研究CAM实践的有效性和利用率的研究,特别是在儿科人群中。根据世界卫生组织(WHO),父母在其家属中使用CAM的患病率估计高达80%。这篇文献综述确定了广泛的,异质,以及关于CAM的应用和有效性的不确定证据,主要归因于社会人口因素的差异和国家医疗保健系统的差异。此外,审查发现主流专业人员在行动机制方面缺乏共识和两极分化的立场,应用程序,CAM的有效性。这篇叙述性综述提出了关于大多数CAM疗法及其应用的疗效的不同结果;然而,一些证据表明针灸的潜在益处,瑜伽,太极,和按摩改善身心健康。此外,现有证据表明冥想可以增强心理健康,而灵气可能只会影响患者的舒适度。鉴于草药的复杂性和多面性,必须逐案评估其功效,考虑到所涉及的具体化合物和程序。这项全面的审查是卫生专业人员的宝贵资源,为考虑患者价值观和信念的个性化医疗保健方法提供指导,从而促进一体化,旨在提高医疗服务质量和患者满意度的循证实践。
    While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM\'s applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients\' perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.
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  • 文章类型: Journal Article
    We are witnessing a momentous cultural shift in how we understand, respond to, and resist sexual violence. Rise of the #MeToo movement has ignited a viral wave of consciousness raising, dialogue, and advocacy on an international scale. Women and girls have been empowered to share their stories of sexual assault, bringing to light the widespread prevalence of gender-based violence. As the shame and blame that have silenced victims gradually diminish, we anticipate a continued upward trend in sexual assault disclosure among youth, and corresponding increase in demand for trauma-informed paediatric sexual assault services. It is our collective responsibility to prevent revictimization and retraumatization by the very systems designed to help. In this critical lens commentary, we strongly advocate for heightened awareness and improved responsiveness among paediatric health care providers and policymakers to effectively and ethically meet the diverse needs of the growing number of young survivors who take the brave step of speaking out and reaching out.
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  • 文章类型: Journal Article
    怀孕和出生队列已被广泛用于调查健康和疾病的发育起源,特别是在了解肥胖和相关心脏代谢紊乱的病因方面。出生和怀孕队列已被广泛用于调查这一研究领域。本综述的目的是双重的:首先概述测量儿童心脏代谢风险的必要性;其次概述如何评估。被认为具有重要发育成分的主要结果是CVD,胰岛素抵抗和相关代谢结果。比如代谢综合征,2型糖尿病和CHD在中年和老年个体中的患病率均达到高峰,但评估儿童和青少年时期的心脏代谢风险对于确定早期致病因素和确定预防措施的特征非常重要.通常,调查前瞻性队列研究的研究人员依赖于心血管危险因素,比如血脂异常,高血压和肥胖,从童年到成人生活。本综述总结了这些因素的一些证据,当在童年测量时,可能对评估成人心脏代谢疾病的风险有价值,因此,继续描述一些评估儿童心脏代谢风险的方法。
    Pregnancy and birth cohorts have been utilised extensively to investigate the developmental origins of health and disease, particularly in relation to understanding the aetiology of obesity and related cardiometabolic disorders. Birth and pregnancy cohorts have been utilised extensively to investigate this area of research. The aim of the present review was twofold: first to outline the necessity of measuring cardiometabolic risk in children; and second to outline how it can be assessed. The major outcomes thought to have an important developmental component are CVD, insulin resistance and related metabolic outcomes. Conditions such as the metabolic syndrome, type 2 diabetes and CHD all tend to have peak prevalence in middle-aged and older individuals but assessments of cardiometabolic risk in childhood and adolescence are important to define early causal factors and characterise preventive measures. Typically, researchers investigating prospective cohort studies have relied on the thesis that cardiovascular risk factors, such as dyslipidaemia, hypertension and obesity, track from childhood into adult life. The present review summarises some of the evidence that these factors, when measured in childhood, may be of value in assessing the risk of adult cardiometabolic disease, and as such proceeds to describe some of the methods for assessing cardiometabolic risk in children.
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  • 文章类型: Journal Article
    BACKGROUND: In spite of significant risks, as well as non-clinical importance due to loss of potency, stiff penalties against administration of expired medications are still not appropriately enforced by health policy makers in many developing countries, possibly because of little evidence to support that expired medications are hazardous. The purpose of this study therefore, was to investigate the effect of expiration dates on in vitro bacteriostatic potentials of oral paediatric antibiotics.
    METHODS: Comparative bacteriostatic potentials of 31 expired and seven corresponding unexpired oral paediatric antibiotics were determined on infantile diarrhoeagenic bacteria, using a modification of agar well-diffusion method.
    RESULTS: Verall total percentage in vitro resistance rates against expired and unexpired paediatric antibiotics respectively were - E. coli (≤100% vs. ≤15.9%), Klebsiella pneumoniae (≤100% vs. ≤31.3%), Proteus mirabilis (≤91.7% vs. ≤41.7%) and Staphylococcus aureus (≤100% vs. ≤18.2%). Resistance rates of 45.5-55.8% (sulfamethoxazole + trimethoprim 5), 39.5-63.6% (amoxycillin 6), 46.5-54.5% (cotrimoxazole 7), 37.5-63.6% (ampicillin + cloxacillin 18), and higher resistance rates of ≥75.0-100% were exhibited towards remaining expired antibiotics. Higher total resistance and multiple antibiotic resistance (MAR) rates were also recorded against expired antibiotics (45.2-93.5%) compared to unexpired antibiotics (28.6-57.2%), except for few strains of E. coli and Proteus mirabilis. Furthermore, unexpired paediatric antibiotics exhibited wider zones of inhibition towards the test diarrhoeagenic bacteria (≥25.0 mm diameter).
    CONCLUSIONS: This study provided preliminary microbiological results on the appreciable reduction in in vitro bacteriostatic potentials, as well as higher resistance and multiple antibiotic resistance rates among expired oral paediatric antibiotics on infantile diarrhoeagenic bacteria. Apart from less-efficacy, administration of expired antibiotics can lead to increased antibiotic resistance and clinical treatment failure, as well as adverse drug reactions.
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