Epidemiological Characteristics of Children With Non-Cleft Lip/Palate Craniofacial Anomalies.

ABSTRACT: Non-cleft craniofacial anomalies are not as common as cleft lip and palate but resultant disability can be very severe. Although there are epidemiological studies of the clefts in the medical literature, the non-cleft group is still not well known. This study was to examine the epidemiological characteristics of the non-cleft craniofacial anomalies. Patients younger than 18 years old were included during a 1-year period. Patient information was retrieved from medical records and a questionnaire filled by primary caregivers.There were 139 patients included in the study with an average age of 6 years and 7 months (4-194 months). Fifty-eight percent were male, 56% were first-born children, whereas 61.9% had siblings. Family history was positive in 6.5%. Almost all patients were in age-appropriate educational levels. Using Whitaker classification, Synostoses was the most common at 48.9%, followed by Unclassified, Clefts, Neoplasia-Hyperplasia, and Atrophy-Hypoplasia. Their anomalies were mostly detected at the regional hospitals. Outpatient visits throughout the course ranged from 1 to 100. Eighty-two percent of patients had at least 1 hospitalization, whereas 78% experienced at least 1 surgical treatment.Generally, non-cleft craniofacial anomalies were nonfamilial. We found a wide variety of anomalies. Patients were from all regions of the country. Their geographical location did not prevent access to receiving proper care and education. Having a child with an anomaly did not discourage the family from having more descendants. Among the available classifications, the Whitaker system is easier for clinical use.

Development of healthcare facility standards for Thai female inmates.

Purpose The purpose of this paper is to develop and evaluate the Standards of Healthcare Facility for Thai Female Inmates (SHF-TFI) through healthcare service improvement. Design/methodology/approach This research and quality improvement project was comprised of three phases. Surveying healthcare facilities and in-depth interviews with female inmates as well as prison nurses were employed in Phase I. Expert reviews and public hearing meetings were used for developing the SHF-TFI in Phase II. Satisfaction questionnaires, focus group interviews of the female inmates, and in-depth interviews with nurses and prison wardens were utilized to evaluate feasibility and effectiveness of SHF-TFI implementation in Phase III. Findings The SHF-TFI was elaborated in order to be more specific to the context of the correctional institutes and correspond with healthcare as to the needs of female inmates. It was divided into three main aspects: administrative standards, health service standards and outcome standards. After implementation, nurses reflected on the feasibility and benefits of the SHF-TFI on the organizations, inmates and nurses. The female inmates perceived remarkable improvement in the healthcare services including physical activity promotion and screening programs for non-communicable diseases, the physical environment and sufficiency of medical equipment. Moreover, the pregnant inmates and incarcerated mothers with children shared their views on better antenatal and child developmental care, as well as availability of baby supplies. Originality/value The findings support the feasibility and effectiveness of the SHF-TFI for quality care improvement and applicability of the Bangkok Rules in women's correctional institutes.

Effects of a cognitive adjustment program for Thai parents.

Child physical abuse is recognized as a major public health problem that affects children and is likely to become increasingly common. The objective of this study was to examine the effects of a cognitive adjustment program on parental attitudes toward child rearing and the potential for this abuse. Child-care centers were randomly allocated to either the intervention or the control group. The sample included 116 Thai parents of children aged 1-6 years. The intervention group attended the cognitive adjustment program while the control group received the usual services. The results showed that, after program completion, the intervention group had statistically significantly better parental attitudes toward child rearing, but not a significantly lower potential for CPA than the control group. We concluded that the cognitive adjustment program was effective in altering parental attitudes toward child rearing. However, in order to enhance its efficacy, the program should be modified to be more intensive and it should be studied further for its effect on the potential for abuse.