Chronic cough in children is a common reason for healthcare visits and affects between 5% and 10% of children in the general population, as estimated based on parental questionnaires. (1) The definition of chronic cough varies among different guidelines. It is defined as a persistent and unremitting cough lasting more than four weeks in the 2020 CHEST consensus statement. (2) The British Thoracic Society guidelines label chronic cough in children as one that lasts beyond eight weeks, while acknowledging the existence of a prolonged subacute cough that lasts between four and eight weeks. (3) HOW RELEVANT IS THIS TO MY PRACTICE?An increase in health-seeking behaviour has been observed among parents of children with chronic cough in this new era of heightened vigilance and surveillance amid the ongoing global COVID-19 pandemic. Prolonged respiratory symptoms could result in the child being isolated, with grave economic and psychological consequences for all individuals involved in the child's care. In Singapore, the 'stay home' notices and quarantine periods to reduce transmission risks among patients or contacts with respiratory symptoms result in the coughing child missing school and necessitate last-minute changes in caregivers' routines to accommodate caring for the child at home. Potential loss in work hours, productivity and household income can cause additional stress to the caregivers. The impact on the family dyad, such as increased caregiver stress, falling academic performance and anxiety over missing major events if subjected to repeated rounds of medical leave, make it crucial for a clinician to develop a sound approach for the management of children with chronic cough. In this article, we suggest an approach to a child with chronic cough in the primary care setting, common causes of chronic cough in children, and indications for referral to a paediatric respiratory specialist for further evaluation and investigations.

Background Nutrition literacy refers to an individual’s knowledge, motivation and competencies to access, process, and understand nutrition information to make nutrition-related decisions. It is known to influence dietary habits of older adults. This cross-sectional study was designed to: (1) understand the nutrition knowledge, competencies and attitudes of community-dwelling older adults in Singapore (2) examine the differences between their nutrition knowledge, and socio-demographic factors, competencies and attitudes, and (3) identify factors associated with better nutrition knowledge in community-dwelling older adults in Singapore. Methods 400 (183 males and 217 females) nourished community-dwelling older adults aged 65 years and above took part in this study. Malnutrition Universal Screening Tool (MUST) was used to determine individuals who were at low risk of undernutrition. Nutrition knowledge, competencies, attitudes and sources of nutrition information were measured using a locally developed scale. Nutrition knowledge scores were summed to form the Nutrition Knowledge Index (NKI). Associations between NKI, competencies, attitudes and socio-demographic variables were examined using Chi-square and Fisher’s Exact tests. Factors associated with NKI were determined using a stepwise regression model with resampling based methods for model averaging. Results Bivariate analyses found significant differences in NKI scores for gender, monthly household earnings, type of housing, the self-reported ability to seek and understand nutrition information and having access to help from family/friends. Females had higher NKI scores compared to males ( p < 0.001). Compared to females, more males left food decisions to others ( p < 0.001), and fewer males reported consuming home cooked food ( p = 0.016). Differences in educational level were found for competencies like the self-reported ability to seek ( p < 0.001) and verify nutrition information ( p < 0.001). Stepwise regression analysis showed that being female, Chinese, self-reported ability to understand nutrition information and having access to help from family/friends were associated with higher NKI scores. Conclusions Our study revealed that nutrition knowledge of older males in Singapore was lower than females and more left food decisions to others. Nutrition education programs could be targeted at both the older male and their caregivers. Trial Registration This study was registered on 7 August 2017 at clinicaltrials.gov (ref. NCT03240952).

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Breastfeeding is the process of feeding a mother's breast milk to her infant, either directly from the breast or after expression. (1) Breastfeeding and breast milk provide an infant with calories and nutrients, including macronutrients (fat, protein and carbohydrates) and micronutrients (vitamins and minerals). (2)