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1.
Comput Math Methods Med ; 2022: 7746374, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35720038

RESUMO

Autism, also known as pervasive developmental disorder or autism spectrum disorder, is a group of clinical syndromes of developmental delay or impairment. Social impairment, verbal communication impairment, and behavioral impairment are the three conditions for the diagnosis of autism spectrum disorder, according to the American Psychiatric Association's Diagnostic and Statistical Manual. According to relevant statistics, about 1 in 100 children is now diagnosed with autism, and their rehabilitation treatment is also valued by people from all walks of life. In the rehabilitation training of autistic children, it is found that the rehabilitation training of autistic children should pay attention to the role of parents and family environment. It is crucial that parents receive systematic training and act as partners in the development of the intervention plan. Research shows that a specific structured education and skills training program for parents of children with autism can be beneficial in improving behavioral problems, functional communication, and symptoms of autism in children with autism. To this end, this paper has completed the following work: Secondly, a portion of the systematic training of CA parents is discussed, followed by an explanation of the structure and principles of BPNN. Finally, the BPNN is utilized to create a model for assessing the impact of systematic parent instruction on CA. The experimental findings suggest that the proposed BPNN outperforms the competition.


Assuntos
Transtorno Autístico , Educação não Profissionalizante , Pais , Inteligência Artificial , Transtorno Autístico/terapia , Criança , Educação não Profissionalizante/métodos , Humanos , Pais/educação , Avaliação de Programas e Projetos de Saúde , Estados Unidos
2.
Enferm Clin (Engl Ed) ; 32 Suppl 1: S64-S72, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35688568

RESUMO

OBJECTIVE: Baby-led-weaning (BLW) is a novel model of complementary feeding. Although there is little scientific evidence to support the suitability or superiority of this complementary feeding model, BLW is followed by many families today. The aim was to evaluate the knowledge and attitudes of a group of parents and health professionals regarding BLW in Spain. METHODS: This research was designed as a cross-sectional study in a sample of 502 parents and 364 health professionals. Two questionnaires generated and disseminated through Google forms were used. The differences between groups of professionals were analyzed using the Chi-Square test. RESULTS: 92.3% of professionals and 93.4% of parents knew about BLW. They recommend BLW "always" in 39.8% and 69.3% of the cases, and "sometimes" in 49.7% and 24.9%, respectively. Of the health professionals, 80.5% recommended starting complementary feeding as of six months, 36% of them using BLW, 24% followed traditional weaning, 3.3% bottle feeding and the remaining 36% did not indicate. Eighty-three percent recommended chewing as soon as the child showed interest. CONCLUSION: Both health professionals and parents recommend BLW and consider it helps promote the developmental milestones of the baby. Providing nurses with an adequate number of resources to guide parents on complementary feeding will continue to improve childcare.


Assuntos
Comportamento do Lactente , Alimentos Infantis , Atitude , Criança , Estudos Transversais , Comportamento Alimentar , Humanos , Lactente , Pais , Desmame
3.
Child Abuse Negl ; 129: 105680, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35644104

RESUMO

BACKGROUND: Child sexual abuse (CSA) prevention is dominated by a focus on child education. However, evidence that this education reduces CSA risk is limited and mixed. OBJECTIVE: We investigated whether participants' history of receiving school-based child sexual abuse prevention (CSAPP) was associated with experiencing CSA. Uniquely, we also investigated whether parent-led CSA education (PLSAE) and received protective parenting were associated with CSA. CSA knowledge was also considered. METHODS: Australian university students (N = 1265, Mage = 22.8, SD = 7.7, Moage = 18, Mdage = 20, 75% female) reported their history of CSAPP and PLSAE, experience of CSA, disclosure of CSA, parenting, and CSA knowledge. RESULTS: CSAPP attendance was reported by 29% of respondents, 72% reported PLSAE, and 24% reported CSA. PLSAE was significantly associated with lower risk of CSA, but was CSAPP attendance was not. PLSAE was significantly associated with higher levels of parental involvement/care and monitoring/supervision. In a multivariate logistic regression model, involvement/care and monitoring/supervision were associated with lower risk of CSA, but PLSAE was not. Neither CSAPP attendance nor PLSAE was associated with CSA disclosure or CSA knowledge. CONCLUSIONS: These findings add to the small body of literature using reports of real-life experiences. Results call into question the over-reliance of child-education in CSA prevention and highlight the role of protective parenting. Building parenting capacity to include parenting practices is most likely to be effective for CSA prevention, such as monitoring and involvement, and should be included in CSA prevention efforts.


Assuntos
Abuso Sexual na Infância , Poder Familiar , Adolescente , Adulto , Austrália/epidemiologia , Criança , Abuso Sexual na Infância/prevenção & controle , Revelação , Feminino , Humanos , Masculino , Pais , Adulto Jovem
4.
BMC Pregnancy Childbirth ; 22(1): 455, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641919

RESUMO

BACKGROUND: Access to donor human milk (DHM) has primarily been based on the health and development outcomes of premature infants but there has been little examination of the broader impact of an infant receiving it upon parental mental health. Breastfeeding and mental health are closely tied with women who experience breastfeeding difficulties or are unable to meet their own breastfeeding goals often experiencing feelings of guilt, sadness and anger, alongside an increased risk of postnatal depression. The aim of the current study was to explore how experience of receiving DHM for their baby affected the wellbeing of parents. METHODS: UK parents of infants aged 0 - 12 months who had received screened DHM from a milk bank (typically on the neonatal unit or in some cases in the community) completed an online questionnaire exploring their experiences. The questionnaire included Likert scale items examining perceived impact upon infant health, own wellbeing and family functioning alongside open-ended questions exploring perceptions of how receiving DHM affected wellbeing. RESULTS: Almost all of the 107 participants (women = 102) agreed that receiving DHM had a positive impact upon infant health and development, their own mental and physical health, and their family's wellbeing. Parents felt relieved that their infant was receiving DHM for health reasons but also due to the experience of being listened to, supported and having their infant feeding decisions facilitated. Receiving DHM helped mothers to process some of their emotions at not being able to breastfeed, in part because knowing their baby was being fed gave them the space to focus on recovery and bonding with their baby. Some parents did experience challenges, feeling guilty at receiving DHM, insecure that another woman was able to feed their baby when they could not, or negative reactions from family. Although the impact of receiving DHM upon breastfeeding was not measured, some women who were working to build their own milk supply noted that it helped motivate them to continue. CONCLUSIONS: DHM may play an important role not only in protecting infant health and development but in supporting the mental health and wellbeing of mothers for whom their infant receiving human milk is important.


Assuntos
Bancos de Leite , Leite Humano , Aleitamento Materno , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Pais
5.
BMC Infect Dis ; 22(1): 507, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641926

RESUMO

BACKGROUND: This study aimed to identify differences and similarities among adolescents and parents in various psychosocial factors influencing meningococcal ACWY (MenACWY) vaccination acceptance. Besides, the impact of the Covid-19 pandemic was assessed as well as resulting organizational adjustments. METHODS: We conducted a cross-sectional survey among adolescents that attended the appointment for the MenACWY vaccination in South Limburg between May and June 2020, and their parents. Independent t-tests and χ2 test were performed to explore differences in psychosocial and organisational factors between adolescents and parents. RESULTS: In total, 592 adolescents (20%) and 1197 parents (38%) filled out the questionnaire. Adolescents scored lower on anticipated negative affect towards MenACWY vaccination refusal [t (985.688) = - 9.32; ρ < 0.001], moral norm towards MenACWY vaccination acceptance [t (942.079) = - 10.38; ρ < 0.001] and knowledge about the MenACWY vaccination and meningococcal disease [t (1059.710) = - 11.24; ρ < 0.001]. Both adolescents and parents reported a social norm favouring accepting childhood vaccinations, but adolescent scored higher [t (1122.846) = 23.10; ρ < 0.001]. The Covid-19 pandemic did barely influence the decision to accept the MenACWY vaccination. Only 6% of the participants indicated that Covid-19 influenced their decision. In addition, the individual vaccination appointment was rated very positive. Most adolescents (71.5%) and parents (80.6%) prefer future vaccinations to be offered individually rather than having mass vaccinations sessions. CONCLUSIONS: This study provides an indication of which psychosocial and organisational factors should be addressed in future MenACWY vaccination campaigns. Individual vaccination appointments for adolescents should be considered, taking the costs and logistical barriers into account.


Assuntos
COVID-19 , Neisseria meningitidis , Adolescente , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Humanos , Vacinas Meningocócicas , Pandemias , Pais , Vacinação , Vacinas Conjugadas
6.
J Cardiothorac Surg ; 17(1): 136, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641980

RESUMO

BACKGROUND: Standards generally reported in the literature about informing children and respecting their consent or refusal before elective heart surgery may differ from actual practice. This research aims to summarize the main themes in the literature about paediatric anaesthesia and compare these with research findings on how health professionals counsel young children before elective heart surgery, respect their consent or refusal, and maintain patient-centred care. METHODS: This qualitative research involved: literature reviews about children's consent to surgery and major interventions; observations of wards, clinics and medical meetings in two paediatric cardiology departments, October 2019 to February 2020; audio-recorded semi-structured interviews with 45 hospital staff, including 5 anaesthetists, and related experts, November 2019 to April 2021; interviews with 16 families, with children aged 6- to 15-years and their parents shortly after elective heart surgery, and some months later (reported in other papers); thematic data analysis; and research reports on how different professions contribute to children's informed decisions for heart surgery. RESULTS: The medical, ethics and English legal literature tend to assume legal minors cannot refuse major recommended treatment, and cannot consent until they are 12 years or older. Little is said about informing pre-competent children. If children resist, some anaesthetists rely on sedation and distraction, and avoid much informed discussion, aiming to reduce peri-operative anxiety. However, interviewees reported informing young children, and respecting their consent or refusal before elective surgery. They may delay elective surgery and provide further information and support, aiming to reduce fear and promote trust. Six years of age was commonly cited as the threshold for respecting consent to heart transplantation. CONCLUSION: Differing views about younger children's competence, anxiety and best interests support different reactions to children's consent and refusal before elective heart surgery. This paper reports the zero-restraint policy followed for over a decade in at least one leading surgery centre. The related law and literature need to be updated, to take more account of evidence of actual practice.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Consentimento Livre e Esclarecido , Criança , Pré-Escolar , Procedimentos Cirúrgicos Eletivos , Humanos , Pais , Pesquisa Qualitativa
7.
Clin Perinatol ; 49(2): 503-520, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35659100

RESUMO

Infants in the neonatal intensive care unit (NICU) frequently have feeding difficulties with the root cause remaining elusive to identify. Evaluation of the provider/parent/infant feeding process may provide objective clues to sources of feeding difficulty. Specialized testing may be necessary to determine if the infant's swallowing skills are dysfunctional, immature, or maldeveloped, and to determine the risk of feeding failure or chronic tube feeding. Current evidence-based diagnostic and management approaches resulting in successful oral feeding in the NICU infant are discussed.


Assuntos
Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Deglutição , Nutrição Enteral , Humanos , Lactente , Recém-Nascido , Pais
8.
PLoS Negl Trop Dis ; 16(6): e0010438, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35666720

RESUMO

BACKGROUND: School-based de-worming is advocated as a strategy for reducing the burden of soil-transmitted helminth (STH) infections among children. However, re-infection tends to occur rapidly, suggesting that comprehensive water, sanitation, and hygiene (WASH) improvements may be needed to prevent this. We qualitatively assessed the influence of parental engagement activities on parents' motivation to improve WASH infrastructure and hygiene practices at home in the context of a school-based de-worming programme. METHODOLOGY: We conducted a longitudinal qualitative study nested within the Mikono Safi trial, designed to assess the effect of a WASH intervention on STH infection prevalence in children. Meetings were organized for parents/guardians at schools where they were given information about STH infection, the role of WASH in STH infection prevention, and actionable steps they could take at home. During the meetings, parents/guardians received information about their own child's STH infection status. Twenty purposively selected households were visited and interviewed 3 times over a period of about 8-months. We employed thematic analysis; findings are reported following the Capability-Opportunity-Motivation and Behaviour (COM-B) framework. PRINCIPAL FINDINGS: The engagement strategy improved parents'/guardians' knowledge and skills about handwashing with soap and its benefits. Parents/guardians reported that the sessions had motivated them to improve WASH infrastructure at home. Of 20 households included in this study, 17 renovated or built new latrines and 18 installed handwashing facilities. However, only 8 households established and maintained handwashing stations with both soap and water at 8 months. CONCLUSIONS: The engagement of parents/guardians in a school-based WASH education intervention as part of the Mikono Safi trial resulted in increased knowledge and motivation about handwashing and sanitation. This led to improvements in sanitation facilities and handwashing opportunities at home. However, long-term success in provision of water and soap was limited, indicating that sustained engagement may be required to encourage households to ensure these materials are consistently available at home.


Assuntos
Helmintíase , Helmintos , Animais , Criança , Desinfecção das Mãos , Helmintíase/epidemiologia , Humanos , Pais , Saneamento , Sabões , Solo , Tanzânia/epidemiologia , Água
9.
Nutrients ; 14(11)2022 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-35684147

RESUMO

Feasible interventions addressing unhealthy changes in energy balance-related behavior (EBRB) during pregnancy and early postpartum are needed. This study identified the needs and wishes of expecting and first-time parents concerning EBRB interventions during the transition to parenthood. Thirteen focus group discussions (n = 74) were conducted. Couples provided information about whether an intervention targeting unhealthy EBRB changes during pregnancy and postpartum would be acceptable, how such an intervention should look like, and in which way and during which period they needed support. Guided by the TiDIER checklist, all quotes were divided into five main categories (i.e., 'what', 'how', 'when and how much', 'where', 'for and from whom'). Interventions should aim for changes at the individual, social, environmental and policy levels. The accessibility and approach (indirect or face-to-face) together with communicational aspects should be taken into account. A focus should go to delivering reliable and personalized information and improving self-regulation skills. Interventions should be couple- or family-based. Authorities, healthcare professionals, the partner and peers are important sources for intervention delivery and support. In the prevention of unhealthy EBRB changes around childbirth, the involvement of both parents is needed, while health care professionals play an important role in providing personalized advice.


Assuntos
Metabolismo Energético , Pais , Feminino , Grupos Focais , Humanos , Grupo Associado , Período Pós-Parto , Gravidez
10.
Eur J Psychotraumatol ; 13(1): 2079874, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35695884

RESUMO

Background: In China, bereaved parents who have lost their only child are known as Shidu parents, and they tend to present high levels of prolonged grief reactions. To date, a widespread focus has been placed on positive social support, while potential negative experiences have been relatively neglected. Additionally, the role of social support from different sources (i.e. close family members [partner, siblings, grandchildren], peers, and others [relatives, friends, colleagues]) has not been examined thoroughly. Objective: The present study investigated whether social support from different sources has a differential impact on postloss adaptation (i.e. prolonged grief and growth). The loss-orientated and restoration-orientated coping strategies of the dual process model were also tested for their mediating roles. Methods: A total of 277 Chinese Shidu parents were recruited to complete a series of questionnaires including social support from different sources, prolonged grief symptoms, posttraumatic growth, and dual process coping strategies. Correlation analyses, paired sample t tests and structural equation modelling were conducted. Results: More positive support were related to less prolonged grief symptoms and more posttraumatic growth, while more negative support was only related to more prolonged grief. Positive support from close family members and others was significantly related to prolonged grief/growth, and negative support from these sources was significantly positively associated with prolonged grief. Positive or negative support from people who shared a similar experience was unrelated to prolonged grief/growth. Positive and negative support were related to prolonged grief and growth through loss-oriented coping strategies. Conclusion: Overall, the present study indicated that positive and negative support experiences from different sources functioned differently in the recovery of Chinese Shidu parents and that loss-oriented coping played a mediating role. These findings highlight the importance of differentiating social support by traits in coping with grief and the crucial mediating role of loss-oriented coping. HIGHLIGHTS: More positive support correlated with less prolonged grief and more growth, while more negative support correlated with more prolonged grief.Support from family members and friends was more potent than that from peers.Social Support correlated with prolonged grief/growth through loss-oriented coping.


Antecedentes: En China, los padres en duelo que han perdido a su único hijo se conocen como padres Shidu y tienden a presentar altos niveles de reacciones de duelo prolongado. Hasta la fecha, se ha puesto general atención en el apoyo social positivo, mientras que las posibles experiencias negativas se han descuidado relativamente. Además, el papel del apoyo social de diferentes tipos (es decir, familiares cercanos [pareja, hermanos, nietos], compañeros y otros [parientes, amigos, colegas]) no se ha examinado a fondo.Objetivo: El presente estudio investigó si el apoyo social de diferentes tipos tiene un impacto diferencial en la adaptación posterior a la pérdida (es decir, duelo prolongado y crecimiento). Las estrategias de afrontamiento orientadas a la pérdida y orientadas a la restauración del modelo de proceso dual también fueron probadas por sus roles de mediación.Métodos: Un total de 277 padres chinos Shidu fueron reclutados para completar una serie de cuestionarios que incluían apoyo social de diferentes tipos, síntomas de duelo prolongado, crecimiento postraumático y estrategias de afrontamiento de procesos duales. Se realizaron análisis de correlación, pruebas t de muestras pareadas y modelos de ecuaciones estructurales.Resultados: Más apoyo positivo se relacionó con síntomas de duelo menos prolongados y mayor crecimiento postraumático, mientras que un apoyo mas negativo solo se relacionó con duelo más prolongado. El apoyo positivo de familiares cercanos y otras personas se relacionó significativamente con el duelo/crecimiento prolongado, y el apoyo negativo de estos tipos se asoció significativamente de manera positiva con el duelo prolongado. El apoyo positivo o negativo de personas que compartieron una experiencia similar no estuvo relacionado con el duelo/crecimiento prolongado. El apoyo positivo y negativo se relacionó con el duelo prolongado y el crecimiento a través de estrategias de afrontamiento orientadas a la pérdida.Conclusión: En general, el presente estudio indicó que las experiencias de apoyo positivas y negativas de diferentes tipos funcionaron de manera diferente en la recuperación de los padres chinos Shidu y que el afrontamiento orientado a la pérdida desempeñó un papel mediador. Estos hallazgos resaltan la importancia de diferenciar el apoyo social por rasgos para afrontar el duelo y el papel mediador crucial del afrontamiento orientado a la pérdida.


Assuntos
Luto , Filho Único , Criança , Pesar , Humanos , Pais , Apoio Social
11.
J Dev Behav Pediatr ; 43(3): e145-e152, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35703857

RESUMO

OBJECTIVE: To test the association of parents' concerns with early intervention (EI) developmental services outcomes including evaluation, eligibility, and enrollment in services. METHOD: We collected survey data on parents' concerns and EI service use data from a sample of 428 children referred to EI from 2016 to 2018 in 6 Oregon primary care clinics serving lower-income families as part of a developmental and autism spectrum disorder screening intervention. We assessed EI service use trajectories and associations of the presence of parent concern, age of child at the time of parents' concerns, number of concerns, and type of provider concern, with EI evaluation, EI eligibility, and enrollment in EI services, using bivariate testing and multivariable logistic regression. RESULTS: Only 22.9% of children referred to EI were enrolled in services 6 months later. Children whose parents had developmental and/or behavioral concerns were more likely to receive an EI evaluation and were also more likely to be eligible for services, compared with children whose parents had no concerns. There was no association between age, number of concerns, and type of concern with EI evaluation, eligibility, or services enrollment. CONCLUSION: Although only a minority of children referred to EI enrolled in services, the presence of parent concern is strongly associated with EI services evaluation and eligibility outcomes. Study results suggest that providers should assess the presence of parent concern when deciding on EI referrals and provide more support to parents who are not concerned at all.


Assuntos
Transtorno do Espectro Autista , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/terapia , Criança , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/terapia , Intervenção Educacional Precoce , Humanos , Renda , Lactente , Pais , Encaminhamento e Consulta
12.
Int J Palliat Nurs ; 28(5): 208-213, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35648683

RESUMO

BACKGROUND: The grieving process following perinatal loss caused by life-limiting conditions presents some particularities associated with the family's culture and the symbolic relationship with the deceased. OBJECTIVE: To reflect on the symbolic meaning attributed to mementos, particularly pictures taken immediately after birth. METHOD: Case study-a qualitative analysis of the data collected through semidirected interviews. RESULTS: Of the three women that took part in the study, one woman chose not to take a picture but opted to take home the hat with her son's name on it that was provided as a regular procedure for every birth at the maternity centre. During the interview, she questioned her decision. The two other women took pictures and still look at them affectionate. One of the women keeps the picture of her child in a shrine at home, thus attributing a symbolic religious meaning to the whole experience that alleviates her pain. CONCLUSION: The symbolic meaning attributed to pictures of the deceased can help parents process grief.


Assuntos
Morte Perinatal , Feminino , Pesar , Humanos , Recém-Nascido , Núcleo Familiar , Pais , Gravidez
13.
Am J Occup Ther ; 76(4)2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35671507

RESUMO

IMPORTANCE: Persistence on task-the voluntary continuation of a goal-directed action despite difficulties-is described as a behavioral component of involvement in an occupation; however, it has not yet been extensively studied in the context of pediatric occupational therapy. OBJECTIVE: To describe persistent children, compared with their less persistent peers, in terms of age, sex, executive functions (EF), and perceived meaning of occupations and to assess whether intrapersonal factors, EF, and the perceived meaning of occupations can predict persistence. DESIGN: Cross-sectional. SETTING: A community in Israel. PARTICIPANTS: Typically developing healthy children (N = 180) ages 6.0 to 12.5 yr and their parents. OUTCOMES AND MEASURES: The Tower of Hanoi task (TOH; seven discs) was used to assess persistence on task. EF were assessed with the TOH (three discs) and the Verbal Working Memory test. Occupational meaning-challenge, value, sense of time, and autonomy-was assessed with the Perceived Meaning of Occupation Questionnaire. RESULTS: Twenty-six children (14%) completed the task. They were older than their peers, performed better on most of the EF tests, and perceived more autonomy in their everyday activities (Mann-Whitney U = 1,185.0, p < .001). However, only the perceived autonomy of occupations was found to be a statistically significant factor that predicted persistence on task (B = -0.12, SE = 0.05, Wald = 7.60, p = .01). CONCLUSIONS AND RELEVANCE: Perceived autonomy in everyday activities is crucial for persistence on task. Occupational therapy practitioners can promote children's involvement and persistence in cognitive tasks by supporting a sense of autonomy in everyday activities, although further study is needed. What This Article Adds: This article highlights the contribution of perceived autonomy in everyday activities to children's involvement and persistence on task by providing empirical data on children's persistence on task with regard to their EF and perceived meaning of occupations. Children who persisted longer and completed tasks differed from their less persistent peers in terms of age and EF. However, perceived autonomy in everyday activities was the only predictor of task completion.


Assuntos
Função Executiva , Terapia Ocupacional , Criança , Estudos Transversais , Humanos , Ocupações , Pais
14.
BMC Pediatr ; 22(1): 330, 2022 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-35672684

RESUMO

BACKGROUND: There is limited information on the association of parental weight change with overweight and obesity in offspring. This study aimed to investigate the association between parental weight change and incident overweight and obesity in offspring. METHODS: This longitudinal cohort study included 2,963 parent-offspring trios who participated in at least two waves of the China Health and Nutrition Survey. The children without overweight and obesity defined by the International Obesity Task Force were included at the initial survey. Parental overweight and obesity were defined as body mass index ≥ 25 kg/m2. RESULTS: The incidence of overweight and obesity in offspring was 5.8% during a mean follow-up of 5.4 years. Paternal and maternal overweight and obesity at baseline were associated with this condition in offspring at follow-up (both Ps < 0.05). Compared with the persistent normal group, the persistent overweight and obesity group and incident overweight and obesity group (normal weight to overweight and obesity), but not the reversion group (overweight and obesity to normal weight), were more likely to report overweight and obesity in offspring at follow-up, regardless of father's or mother's condition. Additionally, compared with offspring whose both parents remained normal weight, those whose both parents changed from overweight and obesity to normal weight or whose one parent changed from overweight and obesity to normal weight while the other remained normal weight had no higher risks of overweight and obesity. CONCLUSION: This study highlights the importance of parental weight management in the prevention of overweight/obesity in offspring.


Assuntos
Obesidade , Sobrepeso , Índice de Massa Corporal , Criança , Pai , Humanos , Incidência , Estudos Longitudinais , Masculino , Obesidade/epidemiologia , Obesidade/etiologia , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Sobrepeso/prevenção & controle , Pais , Fatores de Risco
15.
BMJ Open ; 12(6): e059689, 2022 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-35715176

RESUMO

INTRODUCTION: Patient engagement in healthcare research is a necessity to ensure that research objectives align with priorities, outcomes and needs of the population under study, and to facilitate ease of implementation and adoption of findings. In clinical trials, there is an increasing focus on patient engagement during the planning and conduct of clinical trials due to the potential for ethical and methodological benefits. As patient engagement in clinical trials increases, there is a need to evaluate the approaches of these activities to contribute evidence on what is most appropriate and successful. The purpose of this study is to evaluate patient engagement processes and the activities of patient partners during and after a paediatric mental healthcare trial. METHODS AND ANALYSIS: Using a mixed-methods study design, we will evaluate patient partners' engagement activities across set time-points during the trial and after trial completion. In this study, the term 'patient partner' is inclusive of two groups of people with lived experience: (1) caregivers (parents, formal/informal caregivers and family), and (2) youth (aged 15-24 years). Engagement will be evaluated using the participant and project questionnaires of the Public and Patient Engagement Evaluation Tool (PPEET), followed sequentially by semi-structured interviews. Quantitative data from the PPEET questionnaire will be analysed and reported using descriptive statistics. Data from open-ended questions from the PPEET questionnaires and semi-structured interviews will be analysed using thematic analysis. ETHICS AND DISSEMINATION: Approval from Athabasca University Research Ethics Board will be obtained for this project. Findings will be disseminated at both academic and public venues whether in-person or online, and using platforms that are caregiver and youth friendly. TRIAL REGISTRATION NUMBER: NCT04902391.


Assuntos
Serviços de Saúde Mental , Pais , Adolescente , Cuidadores , Humanos , Participação do Paciente , Projetos de Pesquisa , Adulto Jovem
16.
Rev Fac Cien Med Univ Nac Cordoba ; 79(2): 132-140, 2022 06 06.
Artigo em Espanhol | MEDLINE | ID: mdl-35700460

RESUMO

Introduction: Congenital abnormalities could be caused by copy number variation or homozygous variants inherited of parental consanguineous. Purpose. Objetive: To show copy number variants and regions of homozygosity in neonates with malformative syndrome or one congenital anomaly major associated to facial dysmorphia or hypotonia. Methodology: Performed chromosomal microarray analysis (CGH/SNP) to 60 neonates with congenital anomalies born in Hospital Antonio Lorena and Hospital Regional Cusco. Results: 70% of the newborns had an abnormal test (n=42); 48,3% (n=29) patients had with regions of homozygosity above to 0,5% (endogamy coefficient up to 1/64). Pathogenic or likely pathogenic copy number variations with or without region of homozygosity were present in 14,2% (n=6) newborns with congenital abnormalities. We founded five patients with uncertain pathogenic copy number variations that have not been described previously and might correlate with phenotype. Conclusion: We founded a similar frequency of CNV in newborns with congenital abnormalities compared to previous reports. Nonetheless, parental consanguinity was increased compared to other countries of South America. This is the first report in Peru that showed to CMA as a useful diagnostic method in patients with congenital abnormalities and is pioneer in relation to other countries in Latinoamerica.


Introducción: Las variantes en el número de copias son un tipo de cambios en el genoma provocan anomalías congénitas. Objetivo: Determinar las variantes en el número de copias y el grado de consanguinidad parental en neonatos con síndromes malformativos o una anomalía congénita mayor asociado a dismorfia facial o hipotonía. Materiales y métodos: Se realizó el análisis cromosómico por micromatrices a 60 neonatos con anomalías congénitas evaluados en los Hospitales Antonio Lorena y Regional de Cusco. Resultados: Del total de pacientes estudiados, el 70% tuvo un resultado anómalo; de los cuales en el 14,2% de los recién nacidos se encontraron variantes en el número de copias patogénicas o probablemente patogénicas asociadas o no a regiones de homocigosidad que tuvieron relación con las anomalías congénitas descritas. En el 48,3% de los recién se encontró regiones de homocigosidad mayores a 0,5% (coeficiente de endogamia superior a 1/64). Por otro lado, encontramos cinco variantes en el número de copias de patogenicidad desconocida que no se han descrito anteriormente y podrían estar relacionadas con el fenotipo. Conclusión: Nuestra tasa de detección de las variantes en el número de copias está en relación con los reportes internacionales previos. Sin embargo, el porcentaje de neonatos con consanguinidad parental se encuentra por encima de lo reportado previamente, siendo superior a otras regiones de Sudamerica. Este es el primer reporte en el Perú, y es pionero en Latinoamérica al utilizar el análisis cromosómico por micromatrices en esta cohorte específica de pacientes.


Assuntos
Altitude , Variações do Número de Cópias de DNA , Consanguinidade , Humanos , Recém-Nascido , Pais , Peru , Estudos Retrospectivos
17.
JAMA Netw Open ; 5(6): e2217641, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35713902

RESUMO

Importance: Manipulative design features (known as dark patterns) are common in video games and adult-directed technologies, but their prevalence in children's interactive media has not been described. Objectives: To develop a reliable coding scheme for gathering data on manipulative digital designs, describe their prevalence within apps used by a community-based sample of young children, and test hypotheses about associations of manipulative design features with socioeconomic status (SES). Design, Setting, and Participants: This cross-sectional study of a convenience sample of parents of children aged 3 to 5 years was conducted online. Eligible parents were legal guardians of a 3-to-5-year-old child, lived with their child at least 5 days per week, understood English, and were part of a family that owned at least 1 Android or iOS tablet or smartphone. For each participant, the 3 apps used for the longest duration by children with their own mobile devices were downloaded, played, and coded. Data were analyzed between April and August 2021. Exposures: Child SES, operationalized as parent educational attainment and household income-to-needs ratio. Main Outcomes and Measures: Researchers assigned each child a prevalence score for manipulative design features (overall, gameplay pressure, purchase pressure, and advertisement viewing pressure) within the apps children played. Results: Of 160 children in the sample, mean (SD) age was 4.0 (0.6) years; 120 children (75.0%) were non-Hispanic White, and 96 (60.0%) had a parent with a college degree or more. Manipulative designs promoted prolonged gameplay or purchases through 4 user experience typologies: parasocial relationship pressure occurred in 33 (24.8%) and 25 (18.8%) apps with characters; time pressure in 23 (17.3%) and 14 (10.5%) apps; navigation constraints in 61 (45.9%) and 49 (36.8%) apps; and attractive lures in 60 (45.1%) and 61 (45.9%) apps, respectively. Children from households whose parents had lower education levels had higher manipulative design prevalence scores than children whose parents had graduated from college (median [IQR] 3.7 [2.5-5.0] vs 3.0 [2.0-4.0]; P = .02), gameplay-prolonging design (2.3 [1.6-3.0] vs 2.0 [1.5-2.8]; P = .047), and purchase pressure (1.0 [0.5-1.5] vs 0.6 [0-1.3]; P = .02). Purchase pressure prevalence scores were higher for children from households with lower income (R = -0.18; P = .02). Conclusions and Relevance: Design features that encourage monetization of children's digital experiences were common in this sample and disproportionately occurred in apps used by children with lower SES.


Assuntos
Aplicativos Móveis , Adulto , Pré-Escolar , Estudos Transversais , Humanos , Pais , Prevalência , Smartphone
18.
AMA J Ethics ; 24(6): E463-471, 2022 Jun 01.
Artigo em Inglês, Árabe | MEDLINE | ID: mdl-35713913

RESUMO

This commentary examines 4 ethical issues in a case of clinicians considering conducting research on children in conflict zones: (1) whether any time or resources should be taken away from treating acute injuries in order to conduct research; (2) obtaining consent for children to participate in research, which is particularly challenging given that children can be separated from parents or guardians; (3) whether the research is feasible at the moment, since starting research that stands little chance of being completed is ethically questionable; and (4) maintaining neutrality, impartiality, and humanity. Research that puts participants and researchers at risk of additional harm must be considered carefully. Here, we propose that both research and clinical care might occur simultaneously when researchers engage humbly with involved communities as the research is being designed, conducted, and reported in order to understand and resolve ethical issues involved.


Assuntos
Pais , Pesquisadores , Criança , Humanos , Consentimento Livre e Esclarecido
19.
BMC Health Serv Res ; 22(1): 787, 2022 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-35715804

RESUMO

BACKGROUND: The use of webcam technology in neonatal intensive care units (NICUs) enables parents to see their child when the parents cannot be present at the NICU. The webcam's use has been gaining increasing attention. Lead physicians and lead nursing staff play a key role in the decision of whether to implement webcams. This study investigates factors that are associated with the readiness for the implementation of a webcam system among lead NICU staff. METHODS: A postal survey was conducted among all lead physicians and lead nursing staff in all German NICUs between December 2020 and April 2021 (total N = 416, one lead physician and one lead nursing staff per NICU, N = 208). On the basis of normalization process theory, personal (technology acceptance) and organizational (innovation climate) attributes were chosen to determine their association with the readiness for the implementation of a webcam system. The association of these factors was determined using multiple linear regression models for both lead physicians and lead nurses. RESULTS: Overall, a response rate of 66.59% (n = 277) was achieved. Technology acceptance proved to be a significant factor associated with the readiness for the implementation of a webcam system among lead physicians. Furthermore, staff already working with webcams in their NICUs indicated a significantly higher level of technology acceptance than staff without webcam experience and without any desire to use a webcam in the future. No significant association was found between innovation climate and the readiness for the implementation of a webcam system. CONCLUSIONS: Technology acceptance was identified as a factor associated with the readiness for the implementation of a webcam system. The insights from this study can be used to manage potential barriers regarding the readiness for implementation of webcams in NICUs. TRIAL REGISTRATION: The Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00017755 . Date of Registration in DRKS: 25-09-2019.


Assuntos
Unidades de Terapia Intensiva Neonatal , Médicos , Hospitais , Humanos , Recém-Nascido , Pais , Inquéritos e Questionários
20.
Orphanet J Rare Dis ; 17(1): 233, 2022 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-35717227

RESUMO

BACKGROUND: People living with rare disease often have protracted journeys towards diagnosis. In the last decade, programs have arisen around the world that are dedicated to ending this 'diagnostic odyssey', including the Undiagnosed Diseases Program Western Australia (UDP-WA), which has a focus on finding diagnoses for children and young adults. To explore the lived experience of the diagnostic journey semi-structured interviews were conducted with parents of 11 children at commencement of their involvement in the UDP-WA. RESULTS: Thematic analysis revealed three main themes that captured parents' experiences and perspectives. Parents reported (i) the need to respond to significant care needs of their children, which span not only the health system but other systems such as education and disability services. In doing so, parents become the navigator, expert and advocate for their children. Meanwhile, parents are on (ii) the diagnostic odyssey-the rollercoaster of their journey towards diagnosis, which includes various names applied to their child's condition, and the impact of no diagnosis. Parents described their views on (iii) the value of a diagnosis and the outcomes they expect to be associated with a diagnosis. CONCLUSION: Analysis showed an overall significant perceived value of a diagnosis. Our study provides new perspectives on the concept of diagnosis and indicates that parents may benefit from supports for their child's care needs that are beyond the scope of the UDP-WA.


Assuntos
Pais , Doenças Raras , Criança , Humanos , Doenças Raras/diagnóstico , Difosfato de Uridina , Austrália Ocidental , Adulto Jovem
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