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1.
Home Healthc Now ; 40(1): 27-39, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34994718

RESUMEN

Despite an increasing demand for pediatric home care nursing, there is no comprehensive or universal standard of care for prescribing pediatric home care nursing hours based on a child's medical complexity. Adoption of a qualification tool (QT) to allocate home care nursing hours based on the medical complexity of a child may mitigate inequality in access to care and improve the patient and family experience. A QT, developed in Minnesota, recommends home care nursing hours based on the level of medical complexity and need for skilled nursing interventions. Four hypothetical case studies demonstrate the use of the QT to calculate recommended nursing hours. To validate the tool, a survey of discharge planners found a percentage difference in calculated hours of 4.1, 5.7, 11.2, and 24.9 in the four case studies. Discharge planners rated the usability of the QT as favorable with a score of 3.6 on a Likert scale of 5. The recommended nursing hours prescribed for families, based on the QT, was perceived as meeting the needs of the child by 56% and 42% of surveyed parents and home care nurses (HCNs), respectively. The need for additional nursing hours was expressed by 33% and 50% of parents and nurses, respectively. In general, HCNs' assessment of allocated nursing hours paralleled that of parents. Further refinement and adoption of a standardized QT to allocate home care nursing hours may improve access and outcomes for children requiring home care nursing.


Asunto(s)
Servicios de Atención de Salud a Domicilio , Niño , Familia , Humanos , Minnesota , Padres , Alta del Paciente , Encuestas y Cuestionarios
2.
Mymensingh Med J ; 31(1): 186-193, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34999701

RESUMEN

This study intended to find out the children's usage of gadgets and the parents' role regarding their usage and finally its influence on grades. This cross-sectional study was conducted using quantitative method. A total of 340 students of class four were selected by a random sampling method from four schools. Data collection was done by face-to-face interview and the study tool was structured by pretested questionnaire. The study took place at Dhanmondi Govt. Boys' High School, Kamrunnessa Govt. Girls School, Dhanmondi, Bangladesh International School and College (BISC), Mohakhali and SOS Hermann Gmeiner College, Mirpur, Dhaka, Bangladesh. Data collection was carried out from May 2019 to October 2019. Then the analysis of data and results were prepared in November and December 2019. Among 340 respondents of this study, a maximum (78.2%) of students watch TV, 55.9% of them play with mobile and a half (50%) of the students use tablet daily. Maximum (91.8%) parents monitor the use and time of gadgets. About 53.8% of parents use gadgets as a parenting tool. The majority of parents have a positive opinion of electronic gadgets on their children's reading (52.9% somewhat positive and 24.7% very positive) and writing (56.8% somewhat positive and 20.3% very positive) skills. The parents had negative opinion regarding attention spans to studies (33.8% somewhat negative), physical activity (38.2% somewhat negative and 16.5% parents are very negative) and sleep (38.8% are somewhat negative and 17.9% are very negative). Children are the future generation of our country. It is the duty of the parents as well as the country to establish a balanced use of this modern invention in our children's life.


Asunto(s)
Padres , Estudiantes , Bangladesh , Niño , Estudios Transversales , Electrónica , Femenino , Humanos , Masculino , Encuestas y Cuestionarios
3.
Trials ; 23(1): 5, 2022 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-34980212

RESUMEN

BACKGROUND: Breastfeeding offers many medical and neurodevelopmental advantages for birthing parents and infants; however, the majority of parents stop breastfeeding before it is recommended. Professional lactation support by the International Board Certified Lactation Consultants (IBCLCs) increases breastfeeding rates; however, many communities lack access to IBCLCs. Black and Latinx parents have lower breastfeeding rates, and limited access to professional lactation support may contribute to this disparity. Virtual "telelactation" consults that use two-way video have the potential to increase access to IBCLCs among disadvantaged populations. We present a protocol for the digital Tele-MILC trial, which uses mixed methods to evaluate the impact of telelactation services on breastfeeding outcomes. The objective of this pragmatic, parallel design randomized controlled trial is to assess the impact of telelactation on breastfeeding duration and exclusivity and explore how acceptability of and experiences with telelactation vary across Latinx, Black, and non-Black and non-Latinx parents to guide future improvement of these services. METHODS: 2400 primiparous, pregnant individuals age > 18 who intend to breastfeed and live in the USA underserved by IBCLCs will be recruited. Recruitment will occur via Ovia, a pregnancy tracker mobile phone application (app) used by over one million pregnant individuals in the USA annually. Participants will be randomized to (1) on-demand telelactation video calls on personal devices or (2) ebook on infant care/usual care. Breastfeeding outcomes will be captured via surveys and interviews and compared across racial and ethnic groups. This study will track participants for 8 months (including 6 months postpartum). Primary outcomes include breastfeeding duration and breastfeeding exclusivity. We will quantify differences in these outcomes across racial and ethnic groups. Both intention-to-treat and as-treated (using instrumental variable methods) analyses will be performed. This study will also generate qualitative data on the experiences of different subgroups of parents with the telelactation intervention, including barriers to use, satisfaction, and strengths and limitations of this delivery model. DISCUSSION: This is the first randomized study evaluating the impact of telelactation on breastfeeding outcomes. It will inform the design and implementation of future digital trials among pregnant and postpartum people, including Black and Latinx populations which are historically underrepresented in clinical trials. TRIAL REGISTRATION: ClinicalTrials.gov NCT04856163. Registered on April 23, 2021.


Asunto(s)
Lactancia Materna , Telemedicina , Adulto , Femenino , Humanos , Lactante , Persona de Mediana Edad , Padres , Atención Posnatal , Periodo Posparto , Embarazo , Ensayos Clínicos Controlados Aleatorios como Asunto
4.
J Am Dent Assoc ; 153(1): 94, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34996536

Asunto(s)
Padres , Niño , Humanos
5.
BMC Public Health ; 22(1): 80, 2022 01 13.
Artículo en Inglés | MEDLINE | ID: mdl-35027020

RESUMEN

BACKGROUND: COVID-19 lockdowns have resulted in school closures worldwide, requiring curriculum to be delivered to children remotely (home schooling). Qualitative evidence is needed to provide important context to the positive and negative impacts of home schooling and inform strategies to support caregivers and children as the pandemic continues. This study aimed to explore the experiences of home schooling caregivers at multiple time-points during the pandemic. METHODS: Data were obtained from a longitudinal survey of a representative Australian sample conducted over 8 waves during 2020 and 2021. Participants who had home schooled at least one child during COVID-19 completed open-ended questions at Wave 4 (May 2020; n = 176), Wave 7 (June 2020; n = 145), and Wave 8 (March 2021; n = 57). Participants were asked to describe what they found positive and challenging about home schooling (Wave 4), what they would do differently if they home schooled their children again (Wave 7), and the longer-term impacts of home schooling on caregivers and children (Wave 8). RESULTS: 91% of participants at Wave 4 reported at least one positive and/or negative aspect of home schooling. At Wave 8, 32% and 29% of participants reported no long-term positive or negative impacts of home schooling respectively. Using a qualitative content analysis approach, six themes were developed from the data, encompassing the impacts of home schooling on parents, and the perceived impacts on children. Impacts on parents included connecting with children, managing the work-life-school balance, and the challenge of home schooling when parents are not teachers. Perceived impacts on children included: quieter and safer learning at home, and the negatives of managing schoolwork load and social isolation. At Wave 7, 56 participants (44%) identified at least one thing they would do differently. CONCLUSIONS: Despite some participants reporting positive experiences associated with home schooling, it remains challenging for many parents and their children. Supports for parents and children engaged in home schooling should provide clear and flexible guidance on how to balance schoolwork with other competing demands, assist parents who lack confidence in supporting their children's remote learning, and address risks associated with social isolation.


Asunto(s)
COVID-19 , Pandemias , Australia/epidemiología , Niño , Control de Enfermedades Transmisibles , Humanos , Padres , SARS-CoV-2
6.
BMC Health Serv Res ; 22(1): 77, 2022 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-35033068

RESUMEN

BACKGROUND: The Scottish Intercollegiate Guidelines Network (SIGN) is the leading national clinical guideline producer in Scotland. Improved design and dissemination of guidelines produced for the public can empower people to take an active role in self-management and shared decision-making. The public version of the guideline examined covered getting assessed and diagnosed with autism, and approaches that can help. The aim of this study was to test a public version of a guideline for the parents of children and young people with autism, implement improvements, and identify what works in making it usable and accessible. METHODS: We recruited mothers from across Scotland. User testing involved formal 'think aloud' semi-structured interviews that guided users through the booklet. Interviews took place individually and were recorded and transcribed. Key findings were identified and themed using the honeycomb user experience model. RESULTS: Fourteen user-testing interviews were conducted. Facilitators for usability and desirability of the guideline included the chunking of text, consistent use of colour and boxes to highlight important information. Simple language, written in a tone of partnership, helped to engage mothers. Value arose from the guidelines ability to explain the process of diagnosis and make mothers feel empowered in their relationships with healthcare professionals. There was a lack of consensus on the usefulness of rating the strength of evidence and recommendations. CONCLUSION: There was a marked similarity between what was important to the mothers and what has been found to be important to other groups. The involvement of service users and carers in the guidelines development was key to its credibility. One size does not fit all in presenting evidence-based recommendations to the public and it is a challenge to provide sufficient information while avoiding information overload. Recommendations and evidence levels are suitable for use in public versions, but these should be kept as simple as possible.


Asunto(s)
Trastorno Autístico , Adolescente , Cuidadores , Niño , Personal de Salud , Humanos , Lenguaje , Padres
7.
Psicothema ; 34(1): 56-65, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35048896

RESUMEN

BACKGROUND: The role of homework in students' academic performance is a widely debated topic about which there is no definitive answer. The objective of this study was to analyse the importance of parental help with homework in academic achievement, testing its cultural invariance (by country), academic invariance (by subject), and the stability of its effects over time. METHOD: A meta-analysis was performed using the results of PISA evaluations from 2009, 2012, 2015, and 2018 from countries which applied the family PISA questionnaire. We analysed 180 effects and confirmed the fit of the model and the heterogeneity of the effects, performing an analysis of moderators and multimodal inference. RESULTS: Students who had more help with homework had lower academic achievement, with an overall effect (d) = 0.23, 95% CI [0.21, 0.25]. The effects were greater in Europe than in Asia. We did not find differences by subject type, and the results were stable over time. CONCLUSIONS: Family help with homework does not ensure students' academic success, and it is more important how that help is given than how much. This conclusion is valid for different types of subjects and is stable over time, with some variation between cultures.


Asunto(s)
Éxito Académico , Instituciones Académicas , Niño , Escolaridad , Humanos , Padres , Estudiantes
8.
BMC Public Health ; 22(1): 119, 2022 01 17.
Artículo en Inglés | MEDLINE | ID: mdl-35039044

RESUMEN

BACKGROUND: The COVID-19 pandemic has been highly disruptive, with the closure of schools causing sudden shifts for students, educators and parents/caregivers to remote learning from home (home-schooling). Limited research has focused on home-schooling during the COVID-19 pandemic, with most research to date being descriptive in nature. The aim of the current study was to comprehensively quantify the psychosocial impacts of home-schooling on parents and other caregivers, and identify factors associated with better outcomes. METHODS: A nationally representative sample of 1,296 Australian adults was recruited at the beginning of Australian COVID-19 restrictions in late-March 2020, and followed up every two weeks. Data for the current study were drawn from waves two and three. Surveys assessed psychosocial outcomes of psychological distress, work and social impairment, and wellbeing, as well as a range of home-schooling factors. RESULTS: Parents and caregivers who were home-schooling during the COVID-19 pandemic experienced significantly higher levels of psychological distress and work/social impairment compared to those who were not home-schooling or had no school-aged children. A current mental health diagnosis or lower levels of perceived support from their child's school negatively affected levels of psychological distress, work and social impairment, and wellbeing in parents and caregivers involved in home-schooling. CONCLUSIONS: The mental health impacts of home-schooling were high and may rise as periods of home-schooling increase in frequency and duration. Recognising and acknowledging the challenges of home-schooling is important, and should be included in psychosocial assessments of wellbeing during periods of school closure. Emotional and instrumental support is needed for those involved in home-schooling, as perceived levels of support is associated with improved outcomes. Proactive planning by schools to support parents may promote better outcomes and improved home-schooling experiences for students.


Asunto(s)
COVID-19 , Adulto , Australia/epidemiología , Cuidadores , Niño , Humanos , Pandemias , Padres , SARS-CoV-2
9.
Eur J Paediatr Neurol ; 36: 151-158, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34996019

RESUMEN

BACKGROUND: Among all of the studied potential causes of autism, vaccines have received some of the most scrutiny and have been the topic of many evidence-based studies. These efforts have led the great majority of scientists, physicians, and public health researchers to refute causation between vaccines and autism. RATIONALE: This presumed association and concern has been a major contributor to parents' refusal to immunize their children and has become a major threat to public health in secluded populations over the last two decades, even prior to the COVID-19 pandemic. With the emergence of COVID-19 immunizations, sentiments towards this topic were addressed as a public health concern that may influence the ability to overcome the Corona virus worldwide. SCIENTIFIC REVIEW OF DATA: Despite the overwhelming data demonstrating that there is no link between vaccines and autism, many parents are hesitant to immunize their children because of the alleged association. Other contributing factors to the myths and conspiracy theories surrounding the association between vaccines and autism include the fact that the diagnosis of autism is typically made after the age of receiving the main childhood immunizations, as well as the occasional occurrence of regression after the age of first year vaccinations. In spite of vast evidence that the main contribution to the increase in incidence is from improvement of the diagnostic process, this rapid and publicized rise in autism diagnoses feeds parental concerns regarding any medical intervention that may be associated with the health of their children. RECOMMENDATIONS: It is plausible that with more evidence-based studies linking autism to specific etiologies the myth will diminish and disappear eventually. In an era where conspiracy theories are prevalent on social media, it is critical that evidence-based studies relating autism to specific etiologies be made public, and that information concerning autism diagnosis and causes be made more readily available through social media and parental organizations.


Asunto(s)
Trastorno Autístico , COVID-19 , Trastorno Autístico/epidemiología , Trastorno Autístico/etiología , Niño , Humanos , Pandemias , Padres , SARS-CoV-2 , Vacunación/efectos adversos
10.
Health Qual Life Outcomes ; 20(1): 1, 2022 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-34991598

RESUMEN

BACKGROUND: For many adults, their role as a parent is a vital part of their lives. This role is likely to be associated with a parent's health-related quality of life (HRQOL). The aim of this study was to explore the associations between gender, demographic and psychosocial variables, pain, and HRQOL in parents of 14-15-year-old adolescents. METHODS: This was a cross-sectional study that included 561 parents. Data on demographic, psychosocial variables and pain were collected using validated instruments. HRQOL was assessed using the RAND-36. Data were analysed using univariate and hierarchical multiple linear regression analyses. RESULTS: Four hundred and thirty-six (78%) mothers and 125 (22%) fathers with a mean age of 45 (SD = 5) years were included. Eighty-one per cent were married/cohabiting, 74% worked full time, and 50% had university education of more than 4 years. Almost one-third reported daily or weekly pain, and more than half (58%) reported using pain analgesics during the previous 4 weeks. Mothers reported significantly lower scores on self-efficacy, self-esteem and for all RAND-36 domains, including the physical component summary (PCS) and mental component summary (MCS) and experienced greater stress than fathers. Hierarchical regression analyses showed that working part-time (beta = 0.40) or full time (beta = 0.52) (reference: not working) had the strongest positive effect on PCS. Absence from work for > 10 days (beta = -0.24) (reference: no absence), short-term pain (beta = -0.14), chronic pain (beta = -0.37) (reference: no pain), and stress (beta = -0.10) had the strongest negative effects on PCS. High self-esteem (beta = 0.11) had the strongest positive effect, whereas stress (beta = -0.58) and absence from work for > 10 days (beta = -0.11) (reference: no absence) had the strongest negative effects on MCS. CONCLUSION: Mothers reported significantly lower scores on self-efficacy, self-esteem, and HRQOL, and experienced greater stress than the fathers. A high proportion of parents reported pain. Pain, stress, and low work affiliation were strongly associated with decreased HRQOL in parents. We recommend that parents of adolescents should be provided guidance about coping with pain and stress, and facilitation of a strong work affiliation because these seem to be important to parents' HRQOL.


Asunto(s)
Dolor Crónico , Calidad de Vida , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Padres , Encuestas y Cuestionarios
11.
Trials ; 23(1): 17, 2022 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-34991701

RESUMEN

BACKGROUND: Early childhood caries is a highly prevalent disease affecting young children. Parental brushing of children's teeth is recommended during preschool years. Interventions to promote parental brushing of children's teeth are assessed as a package in randomized clinical trials and the efficacy of separate components is not known. METHODS AND ANALYSIS: The aim of this study is to develop an optimized behavior modification intervention to increase parents' brushing of their pre-school children's teeth using the multi-phase optimization strategy (MOST) guided by the Theory of Planned Behavior. Behavior change will be assessed by the percent reduction in children's dental plaque index after 6 months and parents reporting of toothbrushing frequency. Two phases of MOST will be carried out. First, the preparation phase comprises the development of a conceptual framework, identifying candidate components, conducting a feasibility pilot study to assess the acceptability and the design features of three intervention components (motivational interviewing (MI), and two mobile health (mHealth) components: oral health promotion messages and storytelling videos delivered using WhatsApp messenger) in addition to setting an optimization objective. Second, the optimization phase constitutes a factorial trial assessing the three intervention components and developing the intervention by selecting the most effective components within the optimization constraint. Each component will be set at two levels: yes (the intervention is applied) and no (the intervention is not applied). A linear regression model will be used to assess the effect of the intervention components on the percent reduction in dental plaque index (primary outcome measure). The secondary outcome measure is the change in the frequency of parents' brushing of the child's teeth. The combination of components making up the new optimized intervention will be selected. DISCUSSION: This will be the first study to apply the MOST framework in the field of dentistry. The results of this study can guide the development of an optimized behavior modification interventions using mHealth and MI. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04923581, Registered 11 June 2021.


Asunto(s)
Caries Dental , Telemedicina , Niño , Preescolar , Caries Dental/prevención & control , Humanos , Padres , Proyectos Piloto , Ensayos Clínicos Controlados Aleatorios como Asunto , Instituciones Académicas , Cepillado Dental
13.
Ann Med ; 54(1): 121-131, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-35001740

RESUMEN

INTRODUCTION: Neonatal intensive care unit is important to save the lives of a sick neonate; however, parents are challenged by several stressful conditions during their stay. Therefore, this study aimed to explore the lived experiences of parents in neonatal intensive care units in Ethiopia. METHODS: We used a phenomenological study design. The data were collected using an in-depth interview method from purposively selected parents. In addition, we followed a thematic analysis approach and used Open Code Software Version 4.02 to process the data. RESULTS: In this study, 18 parents were interviewed. The researchers have identified six themes. Parents complained of psychological problems like anxiety, stress, worries, hopelessness, and a state of confusion. In addition, anger, crying, sadness, frustration, dissatisfaction, regret, disappointment, feeling bad, self-blaming, nervousness, disturbance, and lack of self-control were major emotional problems raised by the parents. Parents expressed that health care providers showed indiscipline, lack of commitment, and uncooperative behaviour. Likewise, shortage of medicines, money, and limited time to visit their neonates were the other concerns of many parents. At the same time, parents were provided minimal information and limited cooperation from health care providers. CONCLUSION: Parents whose infants admitted to the NICU were suffered from various psychological and emotional problems. Researchers recommend that health care providers should be supported parents with psycho-emotional problems, strengthen parents-healthcare workers' interaction, and scale up neonatal intensive care unit services to the primary health care centres.KEY MESSAGESParents whose infants admitted to the NICU were suffered from psychological and emotional problems.Poor NICU environment, shortage of equipment, long hospital stay, the presence of pandemic COVID-19, and lack of parental involvement in the care were identified barriers that affected parents' stay.


Asunto(s)
COVID-19 , Unidades de Cuidado Intensivo Neonatal , Etiopía , Humanos , Lactante , Recién Nacido , Padres , SARS-CoV-2
14.
Codas ; 34(3): e20200326, 2022.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-35043858

RESUMEN

PURPOSE: To identify relationships between Remote Microphone System (RMS) use in the classroom and the schools' and teachers' characteristics. METHODS: We analyzed 120 subjects aged 5 to 17 years with hearing loss who had received an RMS from a health service accredited by the Unified Health System (SUS). The teachers of RMS users were the other subjects in the study. We analyzed the patients' medical records and interviewed their parents/guardians at the follow-up visit to verify issues related to the RMS and its use at school. We contacted the schools over the phone and visited some of them. RESULTS: Of the students, 54% used the device at school; 22% involuntarily did not use it; and 24% voluntarily did not use it. The Speech Intelligibility Index pattern of those who used the RMS was similar to those who involuntarily did not use it. There was a significant difference between the type of school and educational level - 86% of regular school students and elementary school students tend to use the device more often (62%). CONCLUSION: Most subjects use the RMS at school. The students' educational level also interfered with the adherence to RMS use, as elementary school students had a higher adherence. The data suggest that the coordination between health services and schools favors RMS use. However, when the parents mediate this relationship, other factors interfere with the systematic RMS use in the school routine.


OBJETIVO: Identificar relações entre a utilização sistemática do Microfone Remoto (MR) em sala de aula de estudantes com deficiência auditiva e características das escolas e dos professores. MÉTODO: Foram analisados 120 sujeitos, entre cinco e 17 anos, com deficiência auditiva que foram adaptados MR em um Serviço de Saúde credenciada pelo Sistema Único de Saúde (SUS). Também foram sujeitos, professores de usuários de MR. Realizou-se uma análise de prontuários e no momento que os sujeitos compareceram para acompanhamento foi realizado entrevista com os pais/responsáveis para caracterizar rotina de utilização do MR na escola. Foram realizados contatos telefônicos e visitas presenciais em algumas escolas. RESULTADOS: Quanto ao uso, observa-se que a maioria dos sujeitos utilizava o dispositivo na escola. Aqueles que não utilizavam involuntariamente e voluntariamente consistiu na minoria dos sujeitos. Houve uma similaridade no padrão do Speech Intelligibility Index -SII dos sujeitos que 'usam' e 'não usam involuntariamente' o MR. Houve diferença significativa entre o tipo de escola e o nível de escolaridade, a maioria dos sujeitos que frequentavam escola regular e estavam matriculados no ensino fundamental I tendem a usar mais o dispositivo. CONCLUSÃO: A maioria dos sujeitos faz uso do MR na escola. O nível educacional do estudante também foi um fator que interferiu na adesão ao uso dos MR, com maior adesão em estudantes do Ensino Fundamental I. Os dados sugerem que a articulação entre serviço de saúde e escola favorece a utilização do MR, entretanto quando essa relação é intermediada pelos pais, outros fatores acabam interferindo no uso sistemático no cotidiano da escola.


Asunto(s)
Sordera , Pérdida Auditiva , Adolescente , Niño , Humanos , Padres , Maestros , Instituciones Académicas , Estudiantes
15.
Afr J Paediatr Surg ; 19(2): 73-77, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35017375

RESUMEN

Background: Although circumcision in male neonates is one of the most common procedures performed in neonatal surgery, mothers' preferences concerning the aspects of circumcision are not well-known. Since mother is the likely parent to present child for circumcision, her preferences should be given adequate consideration. Objectives: The objective of this study is to evaluate maternal preferences for neonatal male circumcision in Enugu. Methodology: A cross-sectional study where questionnaire was distributed by the researchers to consenting pregnant women attending antenatal clinics in two teaching hospitals in Enugu. Data analysis was performed using the SPSS. The results presented as means, percentages and tables. Test for significance was done using the Chi-square test. Results: Four hundred and sixty-one pregnant women participated in the study. Ninety-five percent (438/461) wanted circumcision and 83.5% (385/461) wanted it on or before the 8th day of life. The reasons were cultural/religious in 69% (302/447). Fifty-four percent (250/461) had no preferences as to methods, but for those who had, Plastibell was most preferred method in 28% (129/461) while 76% (235/309) preferred circumcision to be done in hospital. In 49.2% (227/461) preferred personnel were nurses but 79.6% (367/461) wanted doctors to attend to post-circumcision complications. In 79.2% (365/461), mothers will not insist on the use of anaesthesia for circumcision. Mothers with circumcised husbands were significantly more willing to circumcise a male child (P = 0.0018). Higher educational status of mother was significantly related to willingness to insist on the use of anaesthesia (P = 0.046) and use of analgesics after circumcision (P = 0.001). Conclusions: Most mothers prefer neonatal male circumcision by nurses, while preferring doctors for post-circumcision complications. These choices are not affected by parents' educational status. Mothers with circumcised husbands accepted circumcision more than those with uncircumcised husbands. Higher maternal education encourages anaesthesia during circumcision and post-circumcision analgesia.


Asunto(s)
Circuncisión Masculina , Niño , Estudios Transversales , Femenino , Humanos , Recién Nacido , Masculino , Nigeria , Padres , Embarazo , Encuestas y Cuestionarios
16.
Codas ; 34(2): e20210058, 2022.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-35019080

RESUMEN

PURPOSE: To verify the association between family resources, sociodemographic aspects, and school performance in middle school students. METHODS: Observational, analytical, cross-sectional study with a probabilistic sample stratified by sex, age, and grade in school. A total of 124 adolescents of both sexes, aged 11 to 14 years, enrolled in a private middle school participated in the study. We sent to their parents/guardians an online form with the Home Environment Resources Scale (HER), Brazilian Economic Classification Criteria (CCEB), and sociodemographic questions. The school performance was furnished by the institution. We used frequency distribution analysis of categorical variables and measures of central tendency and dispersion of the continuous ones. We used the Mann-Whitney, Kruskal-Wallis, and Spearman correlation coefficient tests and set the significance level at p ≤ 0.05. RESULTS: Most of the sample was 11 years old, females, sixth graders, with very good school performance, belonging to social class A, and whose householder had a bachelor's degree. Age and grade in school were associated with interaction with the parents, "family-school connection", and total HER score. The "proximal processes" had a moderate positive correlation with outings and toys. There was a moderate positive correlation between total HER score and "predictable activities that indicate stability". The "proximal processes" had a strong positive correlation with "family-school connection". There was a weak positive correlation between books available at home and school performance. CONCLUSION: The family resources were related to the adolescents' school performance.


OBJETIVO: Verificar a associação entre recursos do ambiente familiar, aspectos sociodemográficos e desempenho escolar de estudantes do Ensino Fundamental. MÉTODO: Estudo observacional analítico transversal, com amostra probabilística estratificada por sexo, idade e ano escolar. Participaram 124 adolescentes, de ambos os sexos, entre 11 e 14 anos, matriculados no Ensino Fundamental II de uma instituição particular. Os responsáveis receberam um formulário online contendo: Inventário dos Recursos do Ambiente Familiar (RAF), Critério de Classificação Econômica Brasil (CCEB) e questões sociodemográficas. O desempenho escolar foi fornecido pela instituição. Realizou-se distribuição de frequência das variáveis categóricas e medidas de tendência central e de dispersão para as contínuas. Utilizou-se os testes Mann-Whitney, Kruskal-Wallis e coeficiente de correlação de Spearman, sendo considerados significantes os que apresentaram valor de p≤0,05. RESULTADOS: A maioria da amostra possuía 11 anos, do sexo feminino, cursava o 6º ano do Ensino Fundamental, obteve desempenho escolar muito bom, apresentava classificação A e declarou que a/o chefe de família possuía Ensino Superior completo. Houve associação entre idade e ano escolar com a interação com os pais, ligação família-escola e RAF total. Os processos proximais demonstraram correlação positiva de magnitude moderada com passeios e brinquedos. Houve correlação positiva moderada entre total do RAF e atividades previsíveis que sinalizam estabilidade. Os processos proximais se correlacionaram de maneira positiva forte com a ligação família-escola. Ter livros em casa revelou correlação positiva fraca com o desempenho escolar. CONCLUSÃO: Os recursos do ambiente familiar apresentaram relação com o desempenho escolar dos adolescentes.


Asunto(s)
Padres , Instituciones Académicas , Adolescente , Brasil , Niño , Estudios Transversales , Femenino , Humanos , Masculino
19.
Pediatr Obes ; 17(1): e12840, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34396714

RESUMEN

BACKGROUND: Access to evidence- and family-based childhood obesity (FBCO) treatment interventions is a challenge, especially in underserved regions where childhood obesity disparities persist. OBJECTIVE: Compare two 6-month FBCO treatment interventions, iChoose (high intensity, parent-child dyads) and Family Connections (low intensity, parents only), in one underserved US region. METHODS: This unblinded, RCT reports on effectiveness and implementation outcomes. Eligibility included children ages 5-12 with BMI ≥85th percentile. Analyses included descriptive statistics and intention-to-treat Heckman treatment effect models. RESULTS: Enrolled children (n = 139, mean age 10.1 ± 1.7 years, 30% with overweight, 70% with obesity, 45% black, 63% Medicaid) were randomly assigned to iChoose (n = 70) or Family Connections (n = 69). Retention rates were 63% for iChoose and 84% for Family Connection. Among children, 6-month BMI z-score changes were not statistically significant within iChoose [BMI z-score 0.03 (95% CI = -0.13, 0.19)] or Family Connections [BMI z-score 0.00 (95% CI = -0.16, 0.16)]. Likewise, parents' BMI changes were not statistically significant. No adverse events were reported. Both programmes were delivered with high fidelity (77%-100%). Engagement in core components was 25%-36% for iChoose and 52%-61% for Family Connections. Implementation costs per child with improved BMI z-score were $2841 for iChoose and $955 for Family Connections. CONCLUSIONS: Neither intervention yielded significant improvements in child BMI z-score or parent BMI, yet both were delivered with high fidelity. Relative to iChoose, descriptive data indicated higher retention, better engagement, and lower costs for Family Connections-suggesting that a lower intensity and parent-focused programme may better fit the intended audience's context.


Asunto(s)
Obesidad Pediátrica , Índice de Masa Corporal , Niño , Preescolar , Familia , Humanos , Área sin Atención Médica , Sobrepeso , Padres , Obesidad Pediátrica/epidemiología , Obesidad Pediátrica/prevención & control
20.
Res Dev Disabil ; 121: 104154, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34954670

RESUMEN

BACKGROUND: The increased life expectancy of persons with profound intellectual and multiple disabilities (PIMD) raises questions regarding the medical decisions related to life and death, made on their behalf during their later lives. However, little is known about how parents make such decisions for their ageing child. AIM: Explore parents' views on medical decisions related to life and death for their ageing child with PIMD. METHODS: We interviewed 27 parents of persons with PIMD (≥ 15 years) and analyzed the data thematically. RESULTS: Parents who were convinced that their ageing child's quality of life (QoL) was good, stated that their child "deserved the same treatment as any other person". Others rejected life-prolonging treatments for their child because they believed such treatment would diminish their child's QoL. Some of the parents who thought their child's QoL was poor, mentioned that withholding treatment is only an option in a crisis situation and contemplated other options to shorten their child's life. CONCLUSIONS: Parents feel equipped to take on a central role in medical decisions related to life and death for their ageing child with PIMD, and desire understanding from medical professionals for their views on their child's interests, which sometimes includes physician-assisted death.


Asunto(s)
Padres , Calidad de Vida , Envejecimiento , Niño , Familia , Humanos , Investigación Cualitativa
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