Theee has been analyzed information of Federal statistics agency for the period from 2007 to 2011 about the distribution of children in health groups, child morbidity and disability in view of all Russian regions. Indices are juxtaposed together in the course of the use of an author's technique "percentile-profile" that gives an evident imagination of the place of the each region according to the each index in the general assembly of Russian regions, about the quality of information on both children's health, and dispensary work and availability of the medico-social care for children (in determination of disability). In the course of the cluster analysis there were selected leading tendencies in the sphere of children's health on Russian territory.
OBJECTIVE: To assess the relation between socioeconomic factors and the use of physician services among children and whether variations of the level of co-payment are correlated with different levels of inequalities in health services use. DESIGN: Description of the socioeconomic differences in the use of health care using data from countrywide postal surveys to parents. SETTING: The five Nordic countries in 1996. SUBJECTS: Samples of 15 000 children aged 2-17 years: 3000 children at random, from the national registry in each country. MAIN OUTCOME MEASURE: Odds ratios of use of GP, specialist, and hospital services between children according to the educational level of both parents and the disposable income of the family, for all countries together and for each country separately. Odds ratios were adjusted for age, sex, urbanisation grade, and health status. RESULTS: There was little difference in the use of GP services according to socioeconomic factors. Parents from lower socioeconomic groups used telephone services of physicians less than parents from the higher groups and children of lower socioeconomic groups were seen less often by specialists. The reverse was true for hospitalisation of the children. The differential use of those three types of services was more marked in Denmark, Finland and Norway than in Iceland and Sweden. When controlled for other socioeconomic factors, the largest differences were observed according to the education of the mother. CONCLUSION: The specialist services and use of telephone services for children in the Nordic countries do not meet the criteria of equal use for equal need whereas the GP services and hospital services do to some extent. The education of the mother is a more important determinant than income for the use of each service.
OBJECTIVE: The objectives were to assess: (1) child health nurses' identification of abuse/neglect of children of preschool age in their districts; (2) overall prevalence of abuse/neglect according to the nurses; (3) determinants of nurse identification; (4) determinants of nurse-reported district prevalences; and (5) determinants of reporting to the child protection services (CPS). METHOD: Questionnaires were mailed to about 3,000 child health centers. RESULTS: Fifty-five percent responded. Of these, 22% identified no case and 33% at least one (mostly five or fewer). The overall prevalence was 1.4%. Identification correlated with general participation rate in the county. Other determinants of identification were acquaintance with the district, large district populations, and three variables assumed to reflect a personal interest. Determinants of prevalences were small district populations, regular contacts with the social services, and two personal interest variables. With large district populations, identification increased, whereas prevalences decreased. Only 30.3% had made a report to the CPS. Regular contacts with the social services correlated with reporting. Personal interest was a determinant of the decision to report, and acquaintance with the district a determinant of reporting rate. CONCLUSIONS: Abuse and neglect did not appear as priorities for the Child Health Services. The method probably led to an underestimation of the true prevalence. Personal interest and social services contacts emerged as important determinants. However, the assumed criteria of "interest" were not validated. For effective identification, no nurse should be responsible for more than 400 to 500 children. Implications for practice and research are discussed.
A population-based language-screening programme started in the western part of Sweden (South Bohuslän) in 1991, with the aim of identifying developmental language disability in 2.5-y-old children. The programme was evaluated during 1998 in an experimental study. A group of 105 2.5-y-old children was recruited from 24 separate Child Health Centres. A sample of 25 children with a positive screening result was selected. For each of the 25 children, 1-4 controls, i.e. children with a negative screening result, were selected. The results were reclassified blindly by three speech and language therapists and used as a gold standard. Positive and negative predictive values were estimated to be 0.52 (95% confidence interval 0.31-0.72) and 0.96 (95% confidence interval 0.89-0.99), respectively. Baye's theorem was used to calculate the sensitivity (0.69) and the specificity (0.93) of the screening. A method of calculating the sensitivity and specificity of the test method by means of three samples was demonstrated. CONCLUSION: The data confirm that it is possible to identify reliably children with developmental language disability at 2.5 y of age through the screening programme.
INTRODUCTION: A descriptive epidemiological study of children aged 0-36 months. METHODS: Diagnoses reported from the child psychiatric departments to The National Psychiatric Register were collected from a three-year period 1996, 1997, and 1998. The child psychiatric departments in Denmark filled in a questionnaire concerning referral, assessment, treatment, and consultant/liason functions. All the child psychiatric departments took part in the study. RESULTS: 529 children aged 0-3 years were reported to the National Psychiatric Register. In the period studied, there was a 30% increase in the number of children reported. Adjustment reactions were the commonest diagnosis in the youngest children, aged 0-12 months. Pervasive developmental disorders, particularly infantile autism, were commonest used in the age group 2-3 years. Twenty-four per cent of the children reported, especially the youngest children, had no specific psychiatric diagnosis. The increase in the number of children aged 0-1 year with adjustment reactions and non-specific diagnoses is discussed. Children aged 0-3 years are mainly treated as outpatients or by a consultant/liason child psychiatric service. The children referred to the child psychiatric departments in 1997 varied from fewer than 10 to about 100 children. Infant psychiatric units were established in two places in Denmark, in 1992 and 1997. DISCUSSION: The increasing number of children aged 0-3 years reported to the National Psychiatric Register in the period 1996-1998 reflects an increase in the children aged 2-3 years diagnosed with pervasive developmental disorders, and in the case of the youngest children, aged 0-1 year, a more extensive child psychiatric intervention in relation to populations at risk, such as infants with mentally ill mothers.
INTRODUCTION: Parents' knowledge of and experience with illness in their children are often limited. They find it difficult to take the responsibility when their children are ill. They seek help immediately from the health care system, although the symptoms are mild. We wanted to discover whether teaching parents about minor illness in children and counselling over the telephone during acute illness would mean that parents sought help less often from the health care system, when their children became ill. This article deals with the teaching of the parents. MATERIAL AND METHODS: The project had an intervention group of 91 children aged 12-35 months and a control group of 400 children aged 9-33 months. The intervention group was instructed for two hours twice in the local day nursery and telephone counselling from a nurse trained in children's acute illnesses was made available from 4 pm to 11 pm on weekdays and from 10 am to 11 pm at weekends during the period 20th October 1998 to 1st May 1999. RESULTS: No visible change was seen in the use of the health care system in either group, but there was a small change in favour of the intervention group in the use of a general practitioner instead of calling the emergency medical service. Eighty per cent of the counselling dealt with common acute illnesses; 75% ended without referral. DISCUSSION: There was no visible difference in the use of the health care system in either group. Parents were happy with the offer of teaching and telephone counselling, but it should have been given when the infants started at the nursery. They felt their children were too old at the time the project started. We suggest a continuation of antenatal classes in the form of "parent preparation classes", where one subject could be minor acute illnesses in children.
Team collaboration in Swedish paediatric habilitation was analysed by means of a nation-wide sample of 202 professionals, representing all seven professions normally working in these teams. Provision of paediatric habilitation services as a part of the county secondary level health care is required by law, and has gradually been built up from the 1950s. The study focused on professional cooperation and interaction during different types of formal team meetings. The basic obstacles for the meetings were lack of time, poor meeting technique, and too large a group. The professionals appeared to interact on a fairly equal basis, able to challenge other's views and gaining a hearing for their own views, with the physiotherapists and the paediatricians perceived as being the most dominant team members. The perceived significance of the contribution from the different team members' dominance varied according to the age of the child and to changing needs. The prerequisites for interdisciplinary team working exist as far as meeting structure and a 'democratic' pattern of communication during meetings.
This study is part of a project focusing on co-operation between receivers of habilitation services (families) and professionals. The study focuses on the organisation and co-ordination of the services, and compares two structures for their accomplishment. The first is the typical multiprofessional habilitation team (MHT), and the second is the individualised team (ISP). MHT teams are organised within the habilitation agency, while ISP teams span institutional boundaries. An ISP team is formed around the individual child who receives services from the habilitation centre, and includes parents (sometimes the child), professionals from the habilitation centre, and professionals from other service-providing institutions that are actively involved (for instance pre-school teacher, schoolteacher etc.). The team maps child and family needs, organises assessments and services and formulates goals that subsequently are monitored and followed up. A questionnaire (Measures of Processes of Care) was used to assess the experiences of 385 service receivers. The questionnaire focuses on service receivers' experiences of the family-centredness of the service, operationalised in 56 items, along with five items concerning perceptions of level of control over service provision. The experiences of families having individualised teams were compared to those not having these teams. Significant differences were obtained, suggesting the impact of the form of service organisation on the content. Families having ISP teams report both more family-centred service, and a greater level of control over service provision. Results are discussed in terms of organising structures and co-ordination of services, and in terms of family participation.