Efetividade de um filme na ansiedade e medo de crianças em idade escolar submetidas a cirurgia / Effectiveness of an educational video in reducing anxiety and fear in school-aged children undergoing surgery / Eficacia de una película sobre la ansiedad y el miedo en escolares sometidos a cirugía

Resumo Enquadramento: A hospitalização e a cirurgia são consideradas pela criança como eventos ameaçadores e com repercussões no seu comportamento, nomeadamente ansiedade e medo. Objetivo: Avaliar a efetividade de um filme preparatório para procedimentos a realizar antes de uma cirurgia de ambulatório visando a redução da ansiedade e medo. Metodologia: Estudo randomizado, controlado, envolvendo 60 crianças (6-14 anos), submetidas a cirurgia de ambulatório. O grupo de intervenção visualizou um filme no período pré-operatório e o grupo de controlo recebeu os cuidados habituais. A efetividade do filme foi medida através da escala de ansiedade Children's Anxiety Meter-State e o medo pela escala Children's Fear Scale. Resultados: Não se observaram diferenças significativas (p > 0,05) entre o grupo de intervenção que visualizou o filme e o grupo de controlo que seguiu os cuidados pré-operatórios habituais. Conclusão: Importa avaliar de forma precisa se os custos envolvidos nesta intervenção compensam os benefícios. Sugere-se mais investigação nesta área, ajustando outros programas que se revelem mais efetivos neste contexto.

Abstract Background: Children often perceive hospitalization and surgery as threatening events that can lead to feelings of anxiety and fear. These feelings may affect their behaviors. Objective: To evaluate the effectiveness of an educational video in reducing anxiety and fear before outpatient surgery. Methodology: A randomized controlled study was conducted with 60 children (6 - 14 years old) undergoing outpatient surgery. The intervention group watched an educational video during the preoperative period, while the control group received standard preoperative care. The effectiveness of the video was measured using the Children's Anxiety Meter-State scale, and fear was measured using the Children's Fear Scale. Results: No significant differences (p > 0.05) were found between the intervention group that watched the video and the control group that received standard preoperative care. Conclusion: An accurate assessment of whether the costs of this intervention outweigh the benefits is essential. Further research is recommended, particularly in adapting other programs that have proven more effective in this context.

Resumen Marco contextual: La hospitalización y la intervención quirúrgica son percibidas por el niño como acontecimientos amenazantes que repercuten en su comportamiento, concretamente en la ansiedad y el miedo. Objetivo: Evaluar la eficacia de una película preparatoria para los procedimientos que deben realizarse antes de la cirugía ambulatoria con el fin de reducir la ansiedad y el miedo. Metodología: Estudio aleatorizado y controlado en el que participaron 60 niños (de 6 a 14 años) sometidos a cirugía ambulatoria. El grupo de intervención vio una película en el periodo preoperatorio y el grupo de control recibió los cuidados habituales. La eficacia de la película se midió con la escala Children's Anxiety Meter-State y el miedo con la Children's Fear Scale. Resultados: No hubo diferencias significativas (p > 0,05) entre el grupo de intervención que vio la película y el grupo de control que siguió los cuidados preoperatorios habituales. Conclusión: Es importante evaluar con precisión si los costes de esta intervención compensan los beneficios. Se sugiere seguir investigando en este ámbito, ajustando otros programas que resulten más eficaces en este contexto.

Fatores intervenientes na gerência do cuidado de enfermagem à criança hospitalizada com cardiopatia reumática / Intervening factors in the management of nursing care for children hospitalized with rheumatic heart disease / Factores que intervienen en la gestión del cuidado de enfermería al niño hospitalizado con cardiopatía reumática

Objetivo: analisar os fatores intervenientes na gerência do cuidado de enfermagem à criança hospitalizada com cardiopatia reumática. Método: estudo descritivo-exploratório com abordagem qualitativa, que utilizou a Teoria Fundamentada em Dados e o Interacionismo Simbólico, respectivamente, como referencial metodológico e teórico. A coleta de dados foi realizada em uma instituição especializada em atendimento cardiológico, no munícipio do Rio de Janeiro. Foram entrevistados 19 profissionais de enfermagem através de um roteiro semiestruturado. Resultado: emergiram os seguintes fatores intervenientes na prática da gerência do cuidado: condição socioeconômica da família, comportamento da criança, condições de trabalho, comunicação ineficaz, educação permanente, trabalho em equipe e experiência profissional. Conclusão: os resultados apontam para a necessidade de proposição de estratégias de ação e interação que facilitem a prática gerencial de cuidado à criança com cardiopatia reumática e sua família face aos fatores intervenientes identificados.

Objective: to analyze the factors involved in the management of nursing care for children hospitalized with rheumatic heart disease. Method: this is a descriptive-exploratory study with a qualitative approach, which used Data-Based Theory and Symbolic Interactionism, respectively, as methodological, and theoretical references. Data was collected in an institution specializing in cardiac care in the city of Rio de Janeiro. Nineteen nursing professionals were interviewed using a semi-structured script. Result: the following intervening factors in the practice of care management emerged: the family's socioeconomic status, the child's behavior, working conditions, ineffective communication, continuing education, teamwork, and professional experience. Conclusion: the results point to the need to propose strategies for action and interaction that facilitate management practice in caring for children with rheumatic heart disease and their families, given the intervening factors identified.

Objetivo: analizar los factores que intervienen en la gestión del cuidado de enfermería al niño hospitalizado con cardiopatía reumática. Método: estudio descriptivo-exploratorio con enfoque cualitativo, cuyos marcos metodológico y teórico fueron la Teoría Fundamentada y el Interaccionismo Simbólico, respectivamente. La recolección de datos se realizó en una institución especializada en atención cardiológica, en la ciudad de Río de Janeiro. Fueron entrevistados 19 profesionales de enfermería mediante un cuestionario semiestructurado. Resultado: surgieron los siguientes factores intervinientes en la práctica de la gestión del cuidado: condición socioeconómica de la familia, comportamiento del niño, condiciones de trabajo, comunicación ineficaz, educación continua, trabajo en equipo y experiencia profesional. Conclusión: los resultados indican que es necesario proponer estrategias de acción e interacción que faciliten la práctica de la gestión del cuidado al niño con cardiopatía reumática y a sus familiares, con respecto a los factores intervinientes identificados.

Perspectivas dos pais acerca da interação socialde crianças com cicatrizes de queimaduras / Parents' perspectives on the social interactionof children with burn scars

As queimaduras provocam efeitos físicos e psicológicos devastadores nos indivíduos, sobretudo em crianças e adolescentes, e podem modificar a qualidade de vida da pessoa. O objetivo foi analisar o impacto das cicatrizes por queimaduras em crianças menores de oito anos na interação com amigos, família e escola, na perspectiva dos pais. Estudo quantitativo de corte transversal realizado com os pais de crianças <8 anos de idade, vítimas de queimaduras e internadas em um Centro de Tratamento de Queimados no norte do Paraná e acompanhadas ambulatorialmente, de 2017 a 2020. A coleta de dados ocorreu por meio de dois instrumentos: caracterização sociodemográfica e clínica; e Brisbane Burn Scar Impact Profile. Realizou-se análise descritiva e teste Qui-quadrado utilizando-se o SPSS®. Participaram 34 pais cujas crianças sofreram queimaduras, sendo 52,9% de 1 a 3 anos de idade, 58,8% sexo masculino, 82,2% por agente etiológico térmico e a internação foi de 73,5% devido à Superfície Corpórea Queimada ≤20%. Após a alta os pais identificaram que as cicatrizes de queimaduras tinham "um pouco" e "pouco" impacto nas cicatrizes nas relações de amizade e na interação social. Para os pais, prevaleceu a resposta "nada" de impacto, seguido por "um pouco" e "muito" na escola, nas brincadeiras, nos jogos e nas atividades diárias. Quanto às reações emocionais e ao humor, a maior parte dos pais considerou "nada". Nesse sentido, os pais responderam às questões quanto à própria percepção sobre as atividades diárias do seu filho e, em geral, a cicatriz de queimadura não impactou na qualidade de vida da criança.

Burns cause devastating physical and psychological effects on individuals, especially children and adolescents, and can change a person's quality of life. The objective was to analyze the impact of burn scars in children under eight years of age in the interaction with friends, family and school, from the parents' perspective. Quantitative cross-sectional study carried out with the parents of children <8 years old who were victims of burns and admitted to a Burn Treatment Center in northern Paraná and monitored on an outpatient basis, from 2017 to 2020. Data collection occurred using two instruments: sociodemographic and clinical characterization; Brisbane Burn Scar Impact Profile. Descriptive analysis and Chi-square test were performed using SPSS®. 34 parents participated whose children suffered burns, 52.9% aged 1 to 3 years old, 58.8% male, 82.2% due to thermal etiological agent and 73.5% hospitalization was due to Burned Body Surface ≤ 20%. After discharge, the parents identified that the burn scars had "a little" and "little" impact on the scars in friendship relationships and social interaction. For parents, the answer "nothing" of impact prevailed, followed by "a little" and "a lot" in school, play, games and daily activities. As for emotional reactions and mood, most parents considered "nothing" that impacted the child with burn scars. In this sense, parents answered questions regarding their own perception of their child's daily activities and, in general, the burn scar did not impact the child's quality of life.

Effect of the COVID-19 pandemic on infants' development: analyzing the results of developmental assessments at ages 10-11 and 18-24 months.

The purpose of this study was to determine the effect of the COVID-19 pandemic on infant development. The study investigated the development of infants at 10-11 months of age between 2020 and 2023 by using the Kyoto Scale of Psychological Development-2020 (KSPD2020), an individualized developmental scale, and the Kinder Infant Developmental Scale (KIDS), a developmental questionnaire. We compared the results of the KSPD2020 with those of a pre-pandemic developmental research and compared the developmental age (DA) of KIDS with children's chronological age (CA). Moreover, the same developmental research was conducted again on the same children at 18-24 months of age. DA for receptive language and expressive language was lower in the KIDS compared to CA in the investigation at 10-11 months. However, in the investigation at 18-24 months, there were no areas where KIDS' DA was lower than CA, and DA in the areas of manipulation, receptive language, social relationship with adults, discipline, and eating was higher than CA. On the other hand, using the KSPD2020, there were no differences when compared to pre-pandemic data in the investigation at 10-11 months. Furthermore, the investigation at 18-24 months showed that developmental quotient (DQ) was lower in the Language-Social (L-S) areas than in the investigation at 10-11 months. The lower DQ of L-S in this study was also evident in comparison to the 18-24 months pre-pandemic data. These results suggested that to investigate the medium- and long-term effects of the COVID-19 pandemic on children's development, it is necessary to use not only parent-filled questionnaires but also individualized developmental scales. In addition, the finding that results may differ depending on the method of developmental assessment is considered important not only for developmental researchers but also for professionals involved in supporting children's development.

ASSESSEMENT OF BONE AGE AGREEMENT BETWEEN THE SAUVEGRAIN AND GREULICH AND PYLE METHODS.

Objective: To evaluate the intra and inter observer agreement of the Sauvegrain, Greulich and Pyle methods. Material and methods: This is an observational, retrospective and cross-sectional study ethically approved by opinion 6,192,391. 100 radiographic images of the elbow and 100 of the left wrist and hand were collected from children whose images were selected by a researcher who did not carry out the evaluations. The Sauvegrain, Greulich and Pyle methods were used to determine bone age. We provided a detailed explanation of each method and the evaluators received a file with the study images. After three weeks, the exams were randomized and the radiograms were reevaluated. Of the 100 patients in group A, 61 (61%) were boys and 39 (39%) were girls. In group B, 67 (67%) were boys and 33 (33%) were girls. Four statistical analyzes were used: correlation; intraclass correlation; analysis using the Bland-Altman graph; differences between groups. Results: Intra and interobserver agreement between groups was considered excellent. Conclusions: Despite the excellent agreement, group A presented a significantly better value than B. Biological ages show a greater difference compared to chronological ages in group A. In group B, skeletal and chronological ages do not show statistical difference according to the accuracy test. Level of Evidence III, Cross-Sectional Observational Study.

Objetivo: Avaliar a concordância intra e interobservadores dos métodos de Sauvegrain e Greulich e Pyle. Material e métodos: Trata-se de um estudo observacional, retrospectivo e transversal, aprovado eticamente pelo parecer 6.192.391. Foram coletadas cem imagens radiográficas do cotovelo e cem do punho e mão esquerdos de crianças, selecionadas por um pesquisador que não realizou as avaliações. Utilizou-se os métodos de Sauvegrain e Greulich e Pyle para determinar a idade óssea. Uma explicação detalhada de cada método foi realizada, e os avaliadores receberam um arquivo com as imagens do estudo. Após três semanas, os exames foram randomizados e os radiogramas reavaliados. Dos cem pacientes do grupo A, 61(61%) eram meninos e 39(39%) meninas. No grupo B, 67(67%) eram meninos e 33(33%) meninas. Quatro análises estatísticas foram utilizadas: correlação; correlação intraclasse; análise pelo gráfico de Bland-Altman; e diferenças entre grupos. Resultados: A concordância intra e interobservador entre os grupos foi considerada excelente. Conclusões: Apesar da concordância excelente, o grupo A apresentou valor significantemente melhor que o B. As idades biológicas apresentam maior diferença frente as idades cronológicas no grupo A. No grupo B, as idades esqueléticas e cronológicas não apresentam diferença estatística segundo o teste de acurácia. Level of Evidence III, Cross-Sectional Observational Study .

Prediction of correlation between preoperative parents' anxiety and their child's anxiety before elective surgery under anaesthesia: An observational study.

Background and Aims: Preoperative parental anxiety can have a profound impact on their children undergoing surgery. The present study was done to analyse the correlation between preoperative parental anxiety and their child's anxiety in paediatric patients undergoing elective surgery. Methods: Paediatric patients aged 2-12 years, scheduled for elective surgeries under general anaesthesia, were included in the study. The child's behaviour and anxiety were assessed in the preoperative area using the modified Yale Preoperative Anxiety Scale (m-YPAS). The parent filled out the demographic questionnaire and the Spielberger State-Trait Anxiety Inventory (STAI) form in the preoperative area on the day of surgery. Statistical analysis was conducted using Statistical Package for the Social Sciences (SPSS) statistics software version 23.0 (IBM Corp, Armonk, NY, USA). Results: A total of 150 children undergoing elective surgery were analysed. Our results showed a strong positive correlation between a child's m-YPAS and his/her parents' anxiety on the day of the surgery (STAI-state) (r = 0.545, P < 0.001). However, the correlation between a child's m-YPAS and his/her parents' anxiety levels (STAI-trait) was not found to be significant (r = 0.109, P = 0.188). A positive correlation was observed between a parent's STAI-state and STAI-trait (r = 0.366, P < 0.001). Factors like area of residence, type of surgery and previous hospitalisation had an influence on the anxiety levels of the child. The birth order of the child, previous hospitalisation and gender of the parent also influenced parental anxiety. Conclusion: Parental anxiety has a significant impact on the child's anxiety during the preoperative period.

A randomised controlled trial to compare the occurrence of postoperative nausea and vomiting in early versus conventional feeding in children undergoing daycare surgery under general anaesthesia.

Background and Aims: The time paediatric patients should resume oral intake after surgery is still ill-defined. No specific evidence suggests that the usual practice of postoperative fasting of 4-6 h to reduce postoperative nausea and vomiting (PONV) is beneficial. The primary objective of this study was to assess the occurrence of PONV with early oral feeding compared to conventional feeding in children undergoing daycare surgery under general anaesthesia. Methods: A randomised controlled trial was conducted in 300 children undergoing daycare surgery under general anaesthesia. Children were randomised into the early feeding group (Group EF, n = 150) or the conventional feeding group (Group CF, n = 150). Group EF received carbohydrate-containing oral fluids when the child demanded feed in the postoperative period. Group CF received oral fluids 4 h post-anaesthesia. All patients were monitored for occurrence of PONV, postoperative pain, duration of hospital stay and parental satisfaction. The incidence of PONV was compared using the Chi-squared test, while other continuous variables were compared using the Student's t-test. Results: Both groups were comparable regarding PONV (12% in Group EF vs. 18.7% in Group CF, P = 0.109). The Face, Legs, Activity, Cry, Consolability scores were significantly lower in Group EF at 0 min (P = 0.011), 30 min (P = 0.001) and 1 h (P < 0.001). Patients in Group EF had a significantly shorter duration of hospital stay, that is, 6.31 [standard deviation (SD): 3.52] [95% confidence interval (CI): 1.45-12.24] h in EF versus 10.13 (SD: 2.99) (95% CI: 5.12-16.33) h in CF (P < 0.001). Parents of the children in Group EF had significantly better parental satisfaction scores (P < 0.001). Conclusion: Early postoperative feeding in children undergoing lower abdominal, non-gastrointestinal surgery under general anaesthesia does not increase the incidence of PONV.

Research on aerobic fitness in children and adolescents: a bibliometric analysis based on the 100 most-cited articles.

Introduction: This study aims to conduct a bibliometric analysis of the 100 most-cited articles to examine research trends, hot topics, and gaps in aerobic fitness research in children and adolescents, addressing the lack of evidence synthesis. Methods: The Web of Science Core Collection database was used for literature search, and bibliometric characteristics of the included research articles were imported and calculated. Descriptive statistics and visualizations by the VOS viewer were used for the presentation of bibliometric characteristics. Results: The 100 most cited articles received an average of 104 citations. British Journal of Sports Medicine and Medicine and Science in Sports and Exercise were the two top journals that published aerobic fitness research in children and adolescents. The United States was the top country that contributed to the most-cited research articles. Three top research topics were identified from the analysis, such as neuroscience, developmental psychology, and aerobic health. Conclusion: Aerobic fitness research in children and adolescents has received much attention and interest since 2000. The most contributing authors in this research field were from developed countries, such as the United States, and cognition and health-related research were priorities.

The Effect of Screen Time and Positive School Factors in the Pathway to Child and Youth Mental Health Outcomes.

Beyond achievement, educational settings offer informal supports that may be critical for child and youth mental health. However, children's educational environments have experienced significant disruption with the coronavirus pandemic. School settings offer unique opportunities to support children's mental health, but research must identify powerful points of intervention. This study examined school factors (aspirations, perceived competence, sense of belonging, and emotional engagement) as predictors of children's mental health, and the potential consequences of increasing screen time in and outside of school. Participants (N = 707) were parents and their children (6-18 years) from community and clinical settings who completed prospective surveys about children's school experiences and mental health symptoms (November 2020-May 2022). Standardized measures of depression, anxiety, irritability, inattention, and hyperactivity were collected. Structural equation modelling tested longitudinal associations between screen time, school factors, and mental health outcomes. Positive associations between each of the school factors (B = 0.14 [SE = 0.04] to B = 0.43 [SE = 0.04]) suggested they may reinforce one another. Longitudinally, sense of belonging and emotional engagement at school predicted lower severity for symptoms of depression, anxiety, irritability, and inattention (B=-0.14 [SE = 0.07] to B =-0.33 [SE = 0.10]). Greater screen time was associated with lower aspirations and perceived competence (B = - 0.08 [SE = 0.04] to B = - 0.13 [SE = 0.06]). Results suggest that school factors beyond achievement may be key correlates of child and youth mental health. While curriculum expectations emphasize academic achievement, an investment in supporting positive attitudes and aspirations at school is also warranted.

A parallel investigation of trauma exposure, maladaptive appraisals and posttraumatic stress reactions in two groups of trauma-exposed adolescents.

Background: Maladaptive appraisals, such as thoughts about experiencing a permanent and disturbing change and about being a fragile person in a scary world, are associated with posttraumatic stress reactions (PTSR) for trauma-exposed children and adolescents. Less is known about what puts young people at risk for developing such appraisals, and the differential relationship between the types of appraisals and PTSR.Objective: The primary aim was to examine the role of age, gender and exposure to potentially traumatizing events (PTEs) for the levels of maladaptive appraisals. The secondary aim was to investigate the association between the levels of maladaptive appraisals (appraisals of a permanent change and appraisals about a scary world) and PTSR.Methods: We investigated these aims in two samples: survivors after the terror attack at Utøya island in Norway in 2011 (N = 165, mean age 17.65, SD = 1.19) and adolescents referred to treatment after mainly interpersonal trauma (N = 152, mean age 15.08, SD = 2.18). The aims were investigated using linear regression and partial correlation.Results: In the terror-exposed sample, female gender was significantly associated with higher levels of scary-world appraisals, witnessing or learning that someone close were exposed to physical violence was significantly associated with more permanent-change appraisals, and a higher number of PTEs was significantly associated with higher levels of both types of appraisals. For the clinical sample, we found no significant associations between exposure to PTEs, gender, age, and the level of maladaptive appraisals. Both types of maladaptive appraisals were highly associated with PTSR in both samples, and there was no significant difference in the strength of the associations between the types of appraisals and PTSR.Conclusions: The results have implications for identifying adolescents at risk for developing harmful maladaptive appraisals. Both scary-world appraisals and permanent-change appraisals were strongly associated with PTSR in both groups of trauma-exposed adolescents.

Factors associated with elevated levels of maladaptive appraisals, and associations between maladaptive appraisals and posttraumatic stress reactions were investigated in two samples of trauma-exposed adolescents.Both appraisals about experiencing a permanent and disturbing change and appraisals about being a fragile person in a scary world were significantly associated with posttraumatic stress reactions.Exposure to a higher number of potentially traumatizing events (PTEs), being female, and witnessing or learning that someone close was exposed to physical violence were significantly associated with a higher level of maladaptive appraisals among terror-exposed adolescents.

Hospitalisations for chronic conditions among care experienced and general population children and young people: evidence from the Children's Health in Care in Scotland (CHiCS) cohort study, 1990-2016.

OBJECTIVE: There is limited evidence on how the physical health of children and young people (CYP) who are care experienced (eg, in foster or out-of-home care) compares to the general population. UK research suggests that the prevalence of some chronic conditions may be similar for these groups. DESIGN: We undertook longitudinal population-wide data linkage of social care, prescription and hospitalisation records for care experienced and general population CYP born 1990-2004, followed from birth to August 2016. We compared prevalence estimates for asthma, diabetes (type 1) and epilepsy between the cohorts and used Poisson and survival models to estimate the association between social care and hospitalisations for these conditions. RESULTS: Care experience was not associated with a higher prevalence of asthma and diabetes, but epilepsy was more prevalent. Care was associated with increased hospitalisation rates for all three conditions, particularly for males. HRs for hospitalisations were highest before and after care and lower while the child was in care, for diabetes these were, respectively 1.88 (95% CI 1.28 to 2.77), 2.40 (95% CI 1.55 to 3.71) and 1.31 (95% CI 0.91 to 1.88) for care experienced CYP compared with general population. CONCLUSIONS: Hospitalisations for chronic conditions are higher among care experienced CYP, particularly for males, and outside care episodes. Families with children with chronic conditions should be offered support to manage these conditions and help keep families together. Higher hospitalisations after care suggest that care leavers should be provided more support to help manage their health.

How two-child policy affects cesarean section in women with advanced maternal age (AMA): using the Robson classification system.

OBJECTIVES: To study the possible associations between advanced maternal age and cesarean section(CS) under the two child policy. METHODS: This study used a cohort study from Dongguan People's Hospital in Guangdong Province, China from 2017 to 2020. The cohort was restricted to women aged ≥ 20 who give birth to babies with a gestational age of > 28 weeks and a weight of > 1000 g. Divide the advanced maternal age (AMA) pregnant women into two age groups: 35-39 years old and 40 years old or older age. We analyzed CS rate and CS contribution using the modified Robson classification system. Frequency of cesarean was determined for each group and compared by using χ2 and prevalence ratio. RESULTS: Overall, 47654 women were included, of which 7924 (16.63%) were between the ages of 35 and 39, and 1529 (3.21%) were aged 40 or older. The total CS rate is 40.64%, with 36.10% for mothers aged 20 to 34, 57.90% for women aged 35 to 40, and 64.75% for women aged 40 or older age. In the AMA groups (n = 9453), Robson group 2' was the most common, followed by groups 5 and 10. Women at 40 years or older age were 3 times more likely to undergo a cesarean delivery in Robson group 1', and 1.76 times more likely in group 10. The CS rate in group 2' were statistically significantly higher in the very AMA group. CONCLUSIONS: The CS rates increased noticeably with maternal age under the two child policy. Based on the modified Robson classification system, AMA women should pay more attention to primiparous women with single pregnancy, uterine scars, and premature birth in multiple pregnancies.

The apple does not fall far: stable predictive relationships between parents' ratings of their own and their children's self-regulatory abilities.

Having control over your own behavior and impulses is a critical skill that influences children's academic, social, and emotional development. This study investigates the stability and predictive relationships between parents' ratings of their own and their children's executive function and delay aversion. Using data from approximately 1700 families collected during the COVID-19 pandemic, we employed hierarchical structural equation models and cross-lagged panel models to analyze the temporal stability and directional influences of executive function and delay aversion assessments.Our analysis revealed a substantial latent correlation (r = 0.48, p < 0.001) between parents' and children's executive function problems, indicating a shared variance of approximately 23%. Significant cross-lagged effects were found, with parental executive functions at T1 predicting child executive functions at T2 (ß = 0.16, p = 0.005). For delay aversion, we found a latent correlation of r = 0.53 (p < 0.001) and significant within-timepoint and temporal stability, but no cross-lagged effects.These findings suggest that higher levels of executive function problems reported by parents at T1 correspond to an increased perception of similar problems in their children at T2. This highlights the importance of parental self-perception in assessing children's abilities. Our results highlight the importance of incorporating family dynamics into interventions targeting executive function difficulties and delay aversion in children, and understanding this interplay enables the development of more effective, individualized approaches to support positive developmental outcomes.

Development of the Culturally Affirming and Responsive Experiences (CARE) Measure: Observing Responsiveness and Ethnic-Racial Cultural Socialization in Mother-Child Interactions.

The existing literature on the importance of maternal responsiveness and the growing body of literature supporting early ethnic-racial cultural socialization highlight the need for an observational measure of how they co-occur during mother-child interactions. This study presents the development and initial validation of the Culturally Affirming and Responsive Experiences (CARE) measure, an observational measure of the presence and quality of responsiveness and ethnic-racial cultural socialization within early mother-child interactions. Pilot study results with 103 racially and ethnically diverse mother-child dyads demonstrated initial reliability and validity of the CARE measure. Implications of applying the CARE measure to early mother-child interactions to assess quality of responsiveness and ethnic-racial cultural socializations are discussed.

Patterns of Poly-Victimization Among Early Adolescents: A Latent Class and Two-Wave Latent Transition Analysis.

Background: Poly-victimization involves more than just counting incidents; it varies in severity and type among adolescents and can change over time. Objective: The aim is to identify latent classes of poly-victimization among children in early adolescence, investigate transition probabilities between these latent categories, and examine the influencing factors. Methods: We used stratified cluster random sampling to select 2275 junior high students from five rural middle schools in Shantou and Jieyang, China, and surveyed them in two waves. Latent Class Analysis (LCA) and Latent Transition Analysis (LTA) identified latent classes of poly-victimization, and multi-factor logistic regression examined factors influencing the probability of students transitioning between these latent classes. Results: LCA identified three categories of poly-victimization: low poly-victimization, group, and high child maltreatment and peer and sibling victimization. The probabilities of remaining in the high child maltreatment and peer and sibling victimization group, transitioning to the transition group, or shifting to the low poly-victimization group were 37.00%, 29.20%, and 33.80%, respectively. Most transition group members remained in the same group, with a conversion probability of 77.10%, followed by transitioning to the low poly-victimization group with a probability of 15.80%. Physically healthy children, compared to those with disabilities or illnesses, were less likely to switch from the low poly-victimization group to the transition group (OR=0.034) or the high child maltreatment and peer and sibling victimization group (OR=0.14). Non-left-behind children, compared to left-behind children, have a higher probability of switching from the high child maltreatment and peer and sibling victimization group to the low poly-victimization group (OR=6.905). Conclusion: The high child maltreatment and peer and sibling victimization group had similar probabilities of transitioning into other categories. Physical illness or disability, as well as being left behind, are significant risk factors for children transitioning from the low-harm group to the high-harm group.

D-dimer is a prognostic marker for 1-year mortality in patients with chronic liver failure and hepatic encephalopathy.

Background and Aim: Hepatic encephalopathy (HE) is a neuropsychiatric complication of liver failure with poor outcomes. The present study aimed to evaluate the predictive values of D-dimer in patients with HE. Materials and Methods: Patients with chronic liver failure (CLF) and HE were enrolled. Univariate and multivariate logistic analysis was performed to investigate the risk factors for 1-year mortality of HE. Results: During the first year after diagnosis, 39.2% (65/166) of the patients died. D-dimer was significantly higher in non-survivors (Z=2.617, p<0.01). Both D-dimer and international normalized ratio (INR) positively correlated with Child-Pugh and MELD scores, and negatively correlated with sodium (all p<0.01). Moreover, there was a negative relationship between D-dimer and HE grades (r=-0.168, p=0.031), while the relationship between INR and HE grades was not significant (r=0.083, p=0.289). Multivariate analysis showed that age (odds ratio (OR):1.035, 95% CI:1.004-1.067, p=0.03), D-dimer (OR=1.138, 95% CI:1.030-1.258, p=0.01), ALT (OR=1.012, 95% CI:1.001-1.022, p=0.03), and sodium (OR=0.920, 95% CI:0.858-0.986, p=0.02) were independent risk factors for 1-year mortality. Then, a new model Model(Age_DD_ALT_Na) incorporating age, D-dimer, ALT, and sodium was developed. AUROC of Model(Age_DD_ALT_Na) was 0.732, which was significantly higher than MELD and Child-Pugh scores (AUROC: 0.602 and 0.599, p=0.013 and 0.022). Conclusion: D-dimer is a prognostic marker for 1-year mortality in patients with CLF and HE.

Routine third-trimester ultrasonography and child neurodevelopmental outcomes: a follow-up of a pragmatic cluster-randomised controlled trial.

AIMS/BACKGROUND: Routine third-trimester ultrasonography is increasingly conducted to screen for foetal growth restriction (FGR) and reduce adverse perinatal and child neurodevelopmental outcomes using timely obstetric management. While it did not reduce adverse perinatal outcomes in previous trials, evidence regarding its association with child neurodevelopmental outcome is absent. We examined whether routine third-trimester ultrasonography is positively associated with child developmental and behavioural/emotional outcomes compared to usual care. DESIGN/METHODS: Dutch mothers with a low-risk pregnancy participating in a subsample (n = 1070) of a nationwide cluster-randomised trial reported infant (age 6 months) and toddler (age 28 months) developmental milestones (Ages and Stages Questionnaire) and toddlers' internalising and externalising problems (Child Behavior Checklist). Usual care (n = 380) comprised selective ultrasonography. The intervention strategy (n = 690) included two routine third-trimester ultrasounds next to usual care. Both strategies applied the same interdisciplinary protocol for FGR detection and management. RESULTS: Adjusted linear mixed-level regressions revealed that routine third-trimester ultrasonography was positively but modestly related to z-standardised infant developmental milestones at 6-month follow-up, B = 0.20, 95%CI [0.07; 0.32], p = 0.003, compared to usual care. At 28-month follow-up, these strategies did not differ in child developmental outcome and internalising and externalising problems. CONCLUSION: Routine third-trimester ultrasonography was positively but modestly associated with infant development. In toddlerhood, routine ultrasonography was not related to child developmental and behavioural/emotional outcomes. Overall, these findings do not support the implementation of routine third-trimester ultrasonography for low-risk pregnant women for reasons concerning children's early neurodevelopmental outcomes.

High prevalence of xerophthalmia linked to socio-demographic and nutritional factors among vitamin A-deficient rural primary schoolchildren in Malaysia.

Vitamin A deficiency (VAD) remains a major health issue in developing nations, contributing to preventable childhood blindness. However, there is lack of recent data on xerophthalmia, especially among school-aged children in Malaysia. We hypothesized that xerophthalmia persists among rural schoolchildren in Malaysia and potentially associated with socio-demographic status and malnutrition. We conducted a cross-sectional study on 596 schoolchildren (8-12 years) from ten rural primary schools located in five states across Malaysia. Children meeting the criteria for xerophthalmia assessment included those diagnosed with vitamin A deficiency (VAD) (plasma retinol < 0.70 µmol/L) and marginal VAD (plasma retinol 0.70 to < 1.05 µmol/L). The overall prevalence of xerophthalmia was 48.8%, with the most common ocular sign being conjunctival xerosis (38.9%). The occurrence of xerophthalmia was negatively associated with retinol-binding protein 4 (RPB4) (P=0.003), alpha-carotene (P=0.04), hemoglobin (P=0.004), weight (P=0.02), body mass index (BMI) (P=0.04) and WAZ (weight-for-age z-score) (P=0.04) status. Based on multivariate logistic regression analysis, a higher risk of xerophthalmia was observed in boys (Adjusted odd ratio [AOR]: 1.7, 95% confidence interval [CI]: 1.2-2.5) and Orang Asli (OA, indigenous) schoolchildren (AOR: 2.0, 95% CI: 1.3-3.0), while schoolchildren with overweight/obesity status (AOR: 0.5, 95% CI: 0.3-0.8) were associated with a reduced risk of xerophthalmia. The present study unveils a high prevalence of xerophthalmia among vitamin A-deficient primary schoolchildren in rural areas of Malaysia, especially among the indigenous community. The identified socio-demographic and nutritional factors associated to xerophthalmia would facilitate the implementation of more targeted interventions in addressing these issues.

Exploring under-five mortality disparities: a comparative analysis of rural and urban areas in Punjab-Pakistan, using Multiple Indicator Cluster Survey data.

OBJECTIVES: Child health is a social and economic development indicator. Pakistan is one of the countries with a high rate of under-five mortality. This research aims to examine several demographic, geographical, socioeconomic, health-related, and environmental factors related to under-five mortality in both rural and urban areas of Punjab, Pakistan. STUDY DESIGN: This is a cross-sectional study. METHODS: We used data from the Multiple Indicator Cluster Survey 2017-18 of children aged between 0 and 59 months (n = 39,024), steered by the Punjab Bureau of Statistics. Children who died before reaching the age of five were considered as outcome variables. The bivariate relationship of the outcome variable with each socio-economic, demographic, health-seeking, and environmental variable is estimated with a P-value of <0.01. We used logistic regression analysis separately. Inclusive descriptive statistics were used for the detailed analysis, i.e., compare means, cross-tabulations, independent sample t-tests, and comparison across rural-urban areas. RESULTS: Results showed that in the mother-level variables, mother education plays a substantial role in reducing mortality; the higher the level of education, the lower the mortality rate. CONCLUSION: The study revealed that improving drinking water sources, such as tap and bottled water, can reduce the incidence of mortality, particularly in low-income households. Therefore, interventions targeting children are likely to be most effective for reducing the under-five mortality rate in Pakistan.