American Journal of Public Health Research

Sleep plays a key role not only in children’s physical growth, behavior, and emotional development, but also in cognitive functioning. The present study was designed to survey the sleep characteristics and to examine the associations between sleep characteristics and child-reported sleep quality in urban school-aged children of China. A random sample of 19,299 children aged 5.08 to 11.99 years old, 49.7% boys and 50.3% girls with a mean age of 9.00 years old, participated in a cross-sectional survey which was conducted in 8 cities of China. A parent-administered questionnaire and the Chinese version of the Children’s Sleep Habits Questionnaire were completed to quantify family and personal information and to characterize sleep behaviors. The mean sleep duration was 9.17h (SD=0.80) on weekdays and 9.80h (SD=1.06) at weekends. Sleep problems were commonly existed with a relatively high prevalence ranging from 14.5% for sleep-disordered breathing to 75.3% for daytime sleepiness. There were significant gender and age differences existed in sleep problems. Various kinds of sleep problems and unhealthy sleep patterns were associated with poor sleep quality in Chinese school-aged children. The mean sleep duration was less than the recommended 10 hours per day for school-aged children. Sleep problems were commonly existed, which was beyond our expectation. Sleep problems and unhealthy sleep patterns were harmful to children’s sleep quality. A longitudinal study is needed to investigate the trends of sleep behaviors and the relative factors including personal lifestyle, family and social environment so as to intervene and improve children’s sleep quality.

American Journal of Public Health Research. 2013, 1(4), 93-100. DOI: 10.12691/ajphr-1-4-3
Pub. Date: May 13, 2013

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Identifying Microdeletion Syndromes in Patients with Intellectual Disability Using Molecular Genetic Testing: An Example for the Brazilian Public Health Care System

by Adriana Rosolio Costa Sabbag, Bruno Garcia Rocha, Lucimar Retto da Silva de Avó, Carla Maria Ramos Germano, Euclides Matheucci Junior and Débora Gusmão Melo

Original Research

Unexplained intellectual disability is a clinical situation in which molecular diagnostic techniques should be indicated. The diagnostic yield of Multiplex Ligation-dependent Probe Amplification (MLPA) in a cohort of patients with intellectual disability and dysmorphic features was investigated to identify microdeletion syndromes. We aimed to provide an example of the utilization of MLPA method in the medical care routine that can be useful for planning the inclusion of molecular genetic testing in the Brazilian public health care system. This study was based on 57 patients who had different degrees of intellectual disability with etiology not determined. All patients had normal brain CT scan or MRI and normal karyotype, and patients with environmental damage history were not included. Two of the 57 patients were referred to molecular genetic testing as they were clinically diagnosed as having Williams syndrome. MLPA test costs were calculated (human resources and equipment costs were not included in the calculation). MLPA revealed chromosomal imbalance in 4 out of 57 patients (7%). These imbalances were associated with well-described microdeletion syndromes: 3 patients had Williams syndrome (1 without clinical diagnosis) and 1 patient had 22q11.21 deletion syndrome. The MLPA analysis cost per individual, considering DNA extraction and laboratory reagents, was US$66.40. In this study, MLPA confirmed its value as a promising technique as it has adequate feasible characteristics to identify microdeletion syndromes in patients who had unexplained intellectual disability. This work suggests that MLPA can be a viable alternative to implement molecular genetic testing in the Brazilian public health care system, considering its cost-effectiveness.

American Journal of Public Health Research. 2013, 1(4), 86-92. DOI: 10.12691/ajphr-1-4-2
Pub. Date: May 25, 2013

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Public and Private Health Insurance in Brazil and European Union Countries

by Silvia Gerschman

Review Article

The following article is a recent bibliographic review of supplementary healthcare policies in Brazil and EU. The main focus is analyzing healthcare policies for the private sector in Brazil, within the context of Brazil’s Unified National Health System (SUS), with the profile of the private sector in European Union countries, which have long had public systems integrated with social security. Our work is based on research conducted in the second decade of the 21st century. It is our understanding that comparing positions and progress made by the private sector, the growth of private and copayment health insurance and consequently the shrinking of public healthcare systems allows us to better understand the reach and meaning of those changes. We will initially analyze healthcare policies of Europe’s private sector. Then we will discuss the supplementary healthcare system in Brazil, which is the main goal of this paper. Finally, we will compare cases according to progress and delays in private and public healthcare systems.

American Journal of Public Health Research. 2013, 1(4), 78-85. DOI: 10.12691/ajphr-1-4-1
Pub. Date: May 11, 2013

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