RESUMO
Pediatric traumatic brain injury (pTBI) represents a major cause of child injuries in the Middle East and North Africa (MENA) region. This review aims to assess pTBIs in the MENA region and reports their clinical severity and outcomes. A search was conducted using major electronic databases, including Medline/Ovid, PubMed, EMBASE, Web of Science, and SCOPUS. Abstracts were screened independently and in duplicate to detect original research. The objective and study findings for each article were recorded, along with the mechanism of pTBI, patient age and sex, injury assessment tool(s) used, and outcome. A total of 1345 articles were retrieved, of which 152 met the criteria for full-text review, and 32 were included in this review. Males predominantly suffered from pTBIs (78%). Motor vehicle accidents, followed by child abuse, were the leading causes of pTBI. Overall, 0.39% of cases were mild, 0.58% moderate, 16.25% severe, and 82.27% unclassified. The mortality rate was 13.11%. Most studies used the computed tomography scan, Glasgow Coma Scale, Abbreviated Injury Scale, and Injury Severity Score as investigation methods. This review reports on the alarming rate of child-abuse-related pTBI and offers further understanding of pTBI-associated risk factors and insight into the development of strategies to reduce their occurrence, as well as policies to promote child well-being.
RESUMO
BACKGROUND: The postpartum period is an important phase in a woman's life. Yet, there is a paucity of validated instruments that assess maternal postpartum quality of life issues. The aim of this study is to describe the adaptation and validation of the Arabic version of the Maternal Postpartum Quality of Life (MAPP-QOL) questionnaire. METHODS: This instrument validation cohort study tested an adapted Arabic version of the MAPP-QOL questionnaire on a convenience sample of 485 healthy Lebanese postpartum women. The MAPP-QOL reliability and validity were investigated by conducting Exploratory Factor Analysis using Principal Component Analysis, and by correlating the participants' MAPP-QOL scores with their scores on the Arabic Maternal Breastfeeding Evaluation Scale (MBFES-A), age, and education. Confirmatory Factor Analysis was conducted to examine how well the original factor structure of MAPP-QOL fits with our observed data using STATA 14. All other statistical analyses were done using SPSS version 23. RESULTS: The Cronbach's alpha reliability coefficient of the Arabic MAPP-QOL was 0.90. Exploratory factor analysis revealed the following five components: Functioning (11 items, Cronbach's alpha of 0.82), Socioeconomic (9 items, Cronbach's alpha of 0.81), Relational (9 items, Cronbach's alpha of 0.75), Psychological (4 items, Cronbach's alpha of 0.74), and Health (6 items, Cronbach's alpha of 0.59). The overall Arabic MAPP-QOL score was positively but weakly correlated with the MBFES-A score (r = 0.177, p < 0.001), its Maternal Enjoyment/Role Attainment subscale score (r = 0.108, p = 0.023), and Lifestyle/Body Image subscale score (r = 0.286, p < 0.001). There was no significant association between the type of infant feeding at one month and the Arabic MAPP-QOL score (p = 0.932). Similarly, the Arabic MAPP-QOL score was not correlated with the participant's age (r = 0.043, p = 0.362) or education (p = 0.451). After modification of indices, Confirmatory Factor Analysis revealed that the goodness of fit indices corresponding to the 5-factor model in the original questionnaire indicate a reasonable fit with RMSEA = 0.052, CFI = 0.847 and SRMR = 0.062. CONCLUSIONS: The Arabic MAPP-QOL has good psychometric properties and may be a useful tool for clinicians and researchers interested in measuring maternal postpartum quality of life. Further replication of our findings in other Arab contexts is needed.
