An Integrative Review of Family Health History in Pediatrics.

The aim of this integrative review is to investigate current literature regarding family health history (FHH) taking practices, attitudes, and challenges in the pediatric outpatient setting. FHH is a known clinical tool for providers; however, there are no explicit standards for pediatric FHH collection. The integrative review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase, CINAHL, PsycINFO, and Cochrane databases were searched for publications between January 2010 and December 2019, and 8 articles were selected for evaluation. Three themes are explored in this review: FHH collection practices, challenges, and tools. FHH collection practices were found to be inconsistent and the most commonly cited challenge was time. No validated FHH collection tools have been identified for the pediatric population. These findings suggest the need for standardization in FHH collection and further development of tools to improve FHH collection.

Analysis of the indicators of the Family Health Program in the Metropolitan Region of São Paulo.

OBJECTIVE: To analyze the Family Health Program replaced by the Family Health Strategy in 2011, based on health indicators and diseases classified as primary care sensitive. METHODS: This was a descriptive, analytical and documental study carried out in the Metropolitan Region of São Paulo between 2002 and 2007. We analyzed data from Health observatory for the Metropolitan Region of São Paulo. Pearson's correlation and the Statistical Package for the Social Sciences software version 17.0 were used to calculate data associations. RESULTS: We used 30 of the 31 health indicators of 24 from the 39 studied municipalities. A total of 720 (100%) health primary care sensitive indicators were analyzed in the Metropolitan Region of São Paulo. CONCLUSION: Percentages of improvements and worsening were low. In addition, some data were not presented. The majority of indicators remained stable.

Vaccination Patterns in Children After Autism Spectrum Disorder Diagnosis and in Their Younger Siblings.

Importance: In recent years, rates of vaccination have been declining. Whether this phenomenon disproportionately affects children with autism spectrum disorder (ASD) or their younger siblings is unknown. Objectives: To investigate if children after receiving an ASD diagnosis obtain their remaining scheduled vaccines according to the Advisory Committee on Immunization Practices (ACIP) recommendations and to compare the vaccination patterns of younger siblings of children with ASD with the vaccination patterns of younger siblings of children without ASD. Design, Setting, and Participants: This investigation was a retrospective matched cohort study. The setting was 6 integrated health care delivery systems across the United States within the Vaccine Safety Datalink. Participants were children born between January 1, 1995, and September 30, 2010, and their younger siblings born between January 1, 1997, and September 30, 2014. The end of follow-up was September 30, 2015. Exposures: Recommended childhood vaccines between ages 1 month and 12 years. Main Outcome and Measure: The proportion of children who received all of their vaccine doses according to ACIP recommendations. Results: The study included 3729 children with ASD (676 [18.1%] female), 592 907 children without ASD, and their respective younger siblings. Among children without ASD, 250 193 (42.2%) were female. For vaccines recommended between ages 4 and 6 years, children with ASD were significantly less likely to be fully vaccinated compared with children without ASD (adjusted rate ratio, 0.87; 95% CI, 0.85-0.88). Within each age category, vaccination rates were significantly lower among younger siblings of children with ASD compared with younger siblings of children without ASD. The adjusted rate ratios varied from 0.86 for siblings younger than 1 year to 0.96 for those 11 to 12 years old. Parents who had a child with ASD were more likely to refuse at least 1 recommended vaccine for that child's younger sibling and to limit the number of vaccines administered during the younger sibling's first year of life. Conclusions and Relevance: Children with ASD and their younger siblings were undervaccinated compared with the general population. The results of this study suggest that children with ASD and their younger siblings are at increased risk of vaccine-preventable diseases.

Analysis of the indicators of the Family Health Program in the Metropolitan Region of São Paulo / Análise dos indicadores do Programa Saúde da Família na Região Metropolitana de São Paulo

ABSTRACT Objective To analyze the Family Health Program replaced by the Family Health Strategy in 2011, based on health indicators and diseases classified as primary care sensitive. Methods This was a descriptive, analytical and documental study carried out in the Metropolitan Region of São Paulo between 2002 and 2007. We analyzed data from Health observatory for the Metropolitan Region of São Paulo. Pearson's correlation and the Statistical Package for the Social Sciences software version 17.0 were used to calculate data associations. Results We used 30 of the 31 health indicators of 24 from the 39 studied municipalities. A total of 720 (100%) health primary care sensitive indicators were analyzed in the Metropolitan Region of São Paulo. Conclusion Percentages of improvements and worsening were low. In addition, some data were not presented. The majority of indicators remained stable.

RESUMO Objetivo Analisar o Programa Saúde da Família, substituído pela Estratégia Saúde da Família em 2011, considerando os indicadores de saúde e as doenças classificadas como sensíveis à Atenção Primária. Métodos Trata-se de estudo descritivo, analítico e documental, realizado na Região Metropolitana de São Paulo, no período de 2002 a 2007. Foram analisados dados fornecidos pelo Observatório de Saúde da Região Metropolitana de São Paulo. Após a coleta, calcularam-se, com base na correlação de Pearson e por meio do software SPSS, versão 17.0, as associações entre os dados. Resultados Foram usados 30 dos 31 indicadores de saúde de 24 dos 39 municípios pesquisados. Foram analisados 720 (100%) indicadores de saúde sensíveis à Atenção Primária na Região Metropolitana de São Paulo. Conclusão Foram baixos os percentuais de melhoras e pioras, ou, ainda, os dados não foram apresentados. A maioria permaneceu estável.

Quality of Life in Brazil's Family Health Strategy: Common Mental Disorders, Use of Psychotropic Drugs and Sociodemographic Factors.

The aim of the study was to evaluate the patients' quality of life in Brazil's Family Health Strategy and its association with sociodemographic factors, presence of common mental disorders, and use of psychotropic drugs. Were interviewed 442 patients. Tools were: World Health Organization Quality of Life Assessment-Bref and Self Reporting Questionnaire. Male and low education were strongly associated with higher quality of life. Use of psychotropic drugs and the presence of CMD were strongly associated with poor quality of life. There is a pressing need for primary health care professionals to invest in tracking, and in holistic interventions that are able to cover the healthcare needs of these vulnerable groups.

Family Spirituality and Family Health Among Korean-American Elderly Couples.

Spirituality has been regarded as an individual and private matter; consequently, research on spirituality as a family phenomenon has been largely neglected. In addition, most published research has been focused on Western cultures. The purpose of this study was to explore the experience of family spirituality and how it influences health among Korean-American elderly couples who are the first generation to reside in the Southeastern USA. A thematic and interpretive data analysis method was used. Thirteen elderly couples (N = 26) participated in in-depth individual interviews in Korean with the primary author. Interviews were audio-taped, transcribed, and then translated by two bilingual researchers with a background in Korean and American culture. Three main themes of family spirituality were identified: (1) family togetherness, (2) family interdependence, and (3) family coping. Also, participants reported that family spirituality strengthened family health by fostering family commitment, improving emotional well-being, developing new healthy behaviors, and providing healing experiences. This finding implies that healthcare providers need to assess family spiritual issues of elderly couples to maximize their strengths for coping with health problems. As our society becomes more culturally diverse, healthcare providers should seek to understand family spirituality from different cultural perspectives to develop a more holistic approach to care.

Hospitalizations of children due to primary health care sensitive conditions in Pernambuco State, Northeast Brazil.

Admissions due to primary health care sensitive conditions from 1999 to 2009 among children < 5 years old were analyzed for municipalities in Pernambuco State, Brazil. Using data from the Brazilian Unified National Health System's Hospital Information System, a negative binomial regression was applied to estimate rate ratio (RR) and 95%CI for the effect on primary health care sensitive condition rates (admissions/10,000 inhabitants) of the Family Health Program (FHP) coverage (%), some demographic variables and living conditions. Hospitalizations due to primary health care sensitive conditions represented 44.1% of 861,628 admissions and the rate declined from 557.6 to 318.9 (-42.8%), a reduction three times greater than the rate due to all other causes. Increased FHP coverage was protective against primary health care sensitive conditions (RR = 0.94; 95%CI: 0.89-0.99). A decline in hospitalizations due to primary health care sensitive conditions indicated improvements in health status and may be associated with the consolidation of primary health care. Studies on access and quality of primary health care in relation to child morbidity and hospitalizations are needed.

Childhood illness in households using biomass fuels in India: secondary data analysis of nationally representative national family health surveys.

BACKGROUND: Half of the world's population uses solid fuels for energy and cooking, resulting in 1.5 million deaths annually, approximately one-third of which occur in India. Most deaths are linked to childhood pneumonia or acute lower respiratory tract infection (ALRI), conditions that are difficult to diagnose. The overall effect of biomass combustion on childhood illness is unclear. OBJECTIVES: To evaluate whether type of household fuel is associated with symptoms of ALRI (cough and difficulty breathing), diarrhea or fever in children aged 0-36 months. METHODS: We analyzed nationally representative samples of households with children aged 0-36 months from three national family health surveys conducted between 1992 and 2006 in India. Households were categorized as using low (liquid petroleum gas/electricity), medium (coal/kerosene) or high polluting fuel (predominantly wood/agricultural waste). Odds ratios adjusted for confounders for exposure to high and medium polluting fuel were compared with low polluting fuel (LPF). RESULTS: Use of high polluting fuel (HPF) in India changed minimally (82 to 78 %), although LPF use increased from 8% to 18%. HPF was consistently associated with ALRI [adjusted odds ratio (95% confidence interval) 1.48 (1.08-2.03) in 1992-3; 1.54 (1.33-1.77) in 1998-9; and 1.53 (1.21-1.93) in 2005-6). Fever was associated with HPF in the first two surveys but not in the third survey. Diarrhea was not consistently associated with HPF. CONCLUSIONS: There is an urgent need to increase the use of LPF or equivalent clean household fuel to reduce the burden of childhood illness associated with IAP in India.

Associations between family history of cardiovascular disease, knowledge of cardiovascular disease risk factors and health behaviours.

The objective of the study was to examine associations between family history of premature cardiovascular disease (CVD), knowledge of CVD risk and protective factors, and health behaviours. The design was via administration of a questionnaire to 307 participants from four general practice centre waiting rooms in the Sydney West area. The most recognised CVD risk factor was smoking (97.7%) and the most recognised CVD protective factor was omega-3 fatty acids (78.5%). After adjustment for age, sex, education attainment and personal history of CVD, a strong family history of premature CVD was associated with being more likely to interpret a blood pressure of 130/85 as a CVD risk factor (OR 2.77, 95% CI 1.07-7.14), but less likely to identify being an ex-smoker (compared with never having smoked before) as a risk factor (OR 0.32, 95% CI 0.12-0.90). Those with a strong family history of premature CVD, on average, had smoked 0.82 pack years more than those with an average family history of premature CVD (s.e. 4.22, P=0.04). In conclusion, there continues to be both strengths and deficits in the community's overall knowledge of CVD risk and protective factors, and a strong family history of premature CVD appears to be an independent risk factor for smoking.

Measuring financial protection for health in families with chronic conditions in Rural China.

BACKGROUND: As the world's largest developing country, China has entered into the epidemiological phase characterized by high life expectancy and high morbidity and mortality from chronic diseases. Cardiovascular diseases, chronic obstructive pulmonary diseases, and malignant tumors have become the leading causes of death since the 1990s. Constant payments for maintaining the health status of a family member who has chronic diseases could exhaust household resources, undermining fiscal support for other necessities and eventually resulting in poverty. The purpose of this study is to probe to what degree health expenditure for chronic diseases can impoverish rural families and whether the New Cooperative Medical Scheme can effectively protect families with chronic patients against catastrophic health expenditures. METHODS: We used data from the 4th National Health Services Survey conducted in July 2008 in China. The rural sample we included in the analysis comprised 39,054 households. We used both households suffering from medical impoverishment and households with catastrophic health expenditures to compare the financial protection for families having a chronic patient with different insurance coverage statuses. We used a logistic regression model to estimate the impact of different benefit packages on health financial protection for families having a chronic patient. RESULTS: An additional 10.53% of the families with a chronic patient were impoverished because of healthcare expenditure, which is more than twice the proportion in families without a chronic patient. There is a higher catastrophic health expenditure incidence in the families with a chronic patient. The results of logistic regression show that simply adding extra benefits did not reduce the financial risks. CONCLUSIONS: There is a lack of effective financial protection for healthcare expenditures for families with a chronic patient in rural China, even though there is a high coverage rate with the New Cooperative Medical Schemes. Given the coming universal coverage by the New Cooperative Medical Scheme and the increasing central government funds in the risk pool, effective financial protection for families should be possible through systematic reform of both financing mechanisms and payment methods.