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Barriers impacting organizational immunization policy implementation in U.S. and Canadian summer camps 影响美国和加拿大夏令营组织免疫政策实施的障碍
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-04-03 DOI: 10.1080/02739615.2020.1870118
B. Garst, Alexsandra Dubin, C. Bunke, Natalie Schellpfeffer, T. Gaslin, Michael Ambrose, Andrew N. Hashikawa
ABSTRACT While immunization practice guidelines for children have been applied within primary schools, little research exists about how immunization practice guidelines are applied within summer camp settings and barriers to policy implementation within those settings. To identify perceived barriers to effective immunization policy implementation in summer camps, data were collected from a purposeful sample of 925 unique summer camp representatives using the CampDoc.com online electronic health record system. Fifty-nine percent (n = 541) of the sample completed an open-ended question about immunization policy barriers, including directors (38%, n = 205), nurses (26%, n = 140), other (20%, n = 106), office staff (13%, n = 73), and physicians (3%, n = 17). Inductive analyses and coder triangulation were used to develop themes. Constructed themes included a lack of parental support for vaccination, difficulties collecting and verifying immunization documentation, variable immunization policy guidelines, immunization exemptions, and organizational focus on financial outcomes. In addition, one-fifth of responding camps perceive no barriers. Camp administrators should work with pediatricians to implement clear and consistent immunization policies emphasizing parent education and informed by local and state guidelines.
虽然儿童免疫实践指南已经在小学中应用,但关于免疫实践指南如何在夏令营环境中应用以及在这些环境中实施政策的障碍的研究很少。为了确定在夏令营中有效实施免疫政策的感知障碍,使用CampDoc.com在线电子健康记录系统从925个独特的夏令营代表中收集数据。59% (n = 541)的样本完成了关于免疫政策障碍的开放式问题,包括主任(38%,n = 205)、护士(26%,n = 140)、其他(20%,n = 106)、办公室工作人员(13%,n = 73)和医生(3%,n = 17)。采用归纳分析和编码器三角法开发主题。构建的主题包括缺乏父母对疫苗接种的支持,收集和验证免疫文件的困难,可变的免疫政策指南,免疫豁免以及组织对财务结果的关注。此外,五分之一的回应营地认为没有障碍。营地管理人员应与儿科医生合作,实施明确和一致的免疫政策,强调家长教育,并根据地方和州的指导方针。
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引用次数: 3
Assessing mental health in children and adolescent with MTHFR polymorphisms: psychiatric disorders, executive functioning, and symptom profile in a Turkish clinical sample 评估患有MTHFR多态性的儿童和青少年的心理健康:土耳其临床样本中的精神障碍、执行功能和症状概况
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-04-03 DOI: 10.1080/02739615.2021.1871616
Onur Tuğçe Poyraz Fındık, Duygu Murat, Funda Gümüştaş, Ayşe Rodopman Arman, I. Özer
ABSTRACT This study investigated behavioral phenotype, executive functions profile, and the existence of comorbid psychiatric disorders in children and adolescents with methylenetetrahydrofolate reductase (MTHFR) polymorphisms admitted to pediatric metabolism outpatient clinic. Internalizing problems, especially somatic complaints were common in patients with MTHFR. More than half of the cases had emotional control and initiating problems as executive function deficits. Attention-deficit/hyperactivity disorder was the most common psychiatric diagnosis, followed by anxiety disorder. Current findings emphasize that health care providers should be aware of the mental health needs of cases with MTHFR polymorphism in order to make plans of integrative physical and mental health care.
摘要:本研究调查了儿科代谢门诊收治的亚甲基四氢叶酸还原酶(MTHFR)多态性儿童和青少年的行为表型、执行功能概况和共病精神障碍的存在。内化问题,尤其是躯体抱怨在MTHFR患者中很常见。超过一半的病例有情绪控制和执行功能缺陷的初始问题。注意力缺陷/多动障碍是最常见的精神诊断,其次是焦虑症。目前的研究结果强调,卫生保健提供者应了解MTHFR多态性病例的心理健康需求,以便制定综合身心卫生保健计划。
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引用次数: 0
The relationships of parent- and child-related psychiatric conditions with oppositional defiant disorder and conduct disorder symptoms in children with ADHD 父母及儿童相关精神状况与ADHD儿童对立违抗障碍及行为障碍症状的关系
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-04-01 DOI: 10.1080/02739615.2021.1894938
A. Bilgiç, N. Uzun, Ü. Işık, S. Açıkel, Fatma Çoşkun, Ö. Akça
ABSTRACT This cross-sectional study evaluated the impacts of maternal and paternal affective temperament traits, maternal and paternal ADHD, depression and anxiety symptoms, parenting styles, child’s depression and anxiety disorder symptoms, and child’s autistic traits on the oppositional defiant disorder (ODD) and conduct disorder (CD) symptoms of children with attention-deficit/hyperactivity disorder (ADHD). Analysis showed a positive relation of maternal anxious and irritable temperament and child inattention, hyperactivity–impulsivity and obsessive-compulsive disorder (OCD) scores on ODD scores. However, there was a negative relationship between parental acceptance/involvement and ODD scores. Regarding CD scores, maternal irritable and paternal cyclothymic and hyperthymic temperament scores and child ODD and autistic trait scores showed a positive relationship, whereas maternal ADHD showed a negative relationship on CD scores. Certain parental affective temperaments, parenting styles, child’s OCD and autistic traits, and maternal ADHD may be important for the severity of disruptive behavioral disorder symptoms in children with ADHD.
本研究旨在探讨父母情感气质特征、父母ADHD、抑郁焦虑症状、父母教养方式、儿童抑郁焦虑症状和儿童自闭症特征对注意缺陷/多动障碍(ADHD)儿童对立违抗障碍(ODD)和品行障碍(CD)症状的影响。分析发现,母亲焦虑易怒的性情与儿童注意力不集中、多动冲动和强迫症(OCD)得分呈正相关。然而,父母接受/参与与ODD得分呈负相关。在CD评分方面,母亲易怒、父亲躁郁、亢奋性情评分与儿童ODD、自闭症特征评分呈正相关,母亲ADHD与CD评分呈负相关。父母的某些情感气质、教养方式、孩子的强迫症和自闭症特征以及母亲的多动症可能对多动症儿童破坏性行为障碍症状的严重程度很重要。
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引用次数: 1
“Your son has Klinefelter syndrome.” How parents react to a prenatal diagnosis “你儿子得了克氏综合症。”父母对产前诊断有何反应
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-03-29 DOI: 10.1080/02739615.2021.1903325
L. Zampini, F. Dall’ara, G. Silibello, P. Ajmone, F. Monti, C. Rigamonti, F. Lalatta, M. A. Costantino, P. Vizziello
ABSTRACT The study investigates the experience of the parents of 48 children who have prenatally diagnosed with Klinefelter syndrome [KS] using a specifically developed questionnaire. Fifty percent of the participants were satisfied with the disclosure process, particularly those who received the diagnosis by an experienced geneticist. One of the aims of genetic and psychological counseling should be showing the advantages of a gradual and early disclosure with their child and underlining the possible advantages and disadvantages of spreading the diagnosis with other people to optimize support and minimize stigmatization.
摘要:本研究使用一份专门开发的问卷调查了48名产前诊断为Klinefelter综合征(KS)儿童的父母的经历。50%的参与者对披露过程感到满意,特别是那些从经验丰富的遗传学家那里得到诊断的人。遗传和心理咨询的目标之一应该是向他们的孩子展示逐步和早期披露的好处,并强调与其他人传播诊断的可能的利弊,以优化支持和减少污名化。
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引用次数: 1
Psychological outcomes after pediatric hospitalization: the role of trauma type 儿科住院后心理结局:创伤类型的作用
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-03-16 DOI: 10.1080/02739615.2021.1890077
M. G. Meentken, J. van der Ende, R. del Canho, I. V. van Beynum, Elisabeth W. C. Aendekerk, J. Legerstee, R. Lindauer, M. Hillegers, W. Helbing, H. Moll, E. Utens
ABSTRACT Physical injury and illness are common potentially traumatic events during childhood and adolescence. Many children experience psychosocial difficulties after medical events. The sample consisted of 399 children aged 4 to 15 who had been hospitalized for physical illness or injury. Elevated psychological symptomatology (PTSS, depression, anxiety) was more frequent after multiple (type II) compared to single (type I) medical events, but only a few differences were statistically significant. The strongest risk factor of child PTSS was parental stress. Type II trauma and low parental education were significant risk factors only for parent report of child PTSS (not for child report). The analyzed risk factors did not differ for type I versus II trauma. We recommend standardized screening and monitoring for mental health in the standard pediatric health care. Furthermore, pediatricians should be trained in signaling stress signs of parents.
身体损伤和疾病是儿童和青少年时期常见的潜在创伤性事件。许多儿童在医疗事件后经历心理社会困难。样本包括399名4至15岁的儿童,他们因身体疾病或受伤而住院。与单次(I型)医疗事件相比,多次(II型)医疗事件后心理症状(ptsd、抑郁、焦虑)升高的频率更高,但只有少数差异具有统计学意义。儿童创伤后应激障碍的最大危险因素是父母压力。II型创伤和父母教育程度低是家长报告的儿童创伤后应激障碍的显著危险因素(对儿童报告没有影响)。分析的风险因素在I型和II型创伤中没有差异。我们建议在标准的儿科卫生保健中对心理健康进行标准化筛查和监测。此外,儿科医生应该接受关于父母压力信号的培训。
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引用次数: 5
Internalized stigma and self esteem of mothers of children diagnosed with attention deficit hyperactivity disorder 被诊断为注意缺陷多动障碍儿童的母亲的内化耻辱和自尊
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-03-04 DOI: 10.1080/02739615.2021.1891071
Ahmet Özaslan, Murat Yıldırım
ABSTRACT Evidence suggests that caregivers of children with attention deficit hyperactivity disorder (ADHD) experience greater internalized stigmatization. However, there is no evidence of how self-esteem influences the levels of internalized stigma among parents of children with ADHD in Turkey. This study investigated for the first time the relationship between internalized stigma and self-esteem of mothers of children with ADHD and examined the relationship between mothers’ internalized stigma and ADHD severity of children. The sample included mothers of 86 children (65 boys and 21 girls) diagnosed with ADHD. Age of children was between 6 and 17 years old (M = 11.05, SD = 2.62). Participants completed the Conners’ Parent Rating Scale–Revised Short Form, the Clinical Global Impression, the Parents’ Internalized Stigma of Mental Illness Scale and the Rosenberg Self-Esteem Scale. The results showed that mothers with higher education level reported lower internalized stigma, while ADHD severity of children was positively correlated with mothers’ internalized stigma level. The results also indicated that children with ADHD severity predicted a significant amount of variance in stigma. Furthermore, self-esteem uniquely predicted mother’s internalized stigma over and above the mother’s education level and ADHD severity of children. The results suggest the importance of self-esteem on internalized stigma and contribute to development of interventions focusing on the role of self-esteem on parents’ internalized stigma.
有证据表明,注意缺陷多动障碍(ADHD)儿童的照顾者经历了更大的内化污名化。然而,没有证据表明自尊如何影响土耳其多动症儿童父母的内化耻辱程度。本研究首次探讨了ADHD儿童母亲的内化耻辱与自尊的关系,并探讨了母亲的内化耻辱与儿童ADHD严重程度的关系。样本包括86名被诊断患有多动症的孩子(65名男孩和21名女孩)的母亲。儿童年龄为6 ~ 17岁(M = 11.05, SD = 2.62)。被试完成了Conners父母评定量表(修订简表)、临床总体印象量表、父母精神疾病内化污名量表和Rosenberg自尊量表。结果显示,受教育程度越高的母亲内化污名水平越低,而儿童ADHD严重程度与母亲内化污名水平呈正相关。研究结果还表明,患有ADHD严重程度的儿童在耻辱感方面有很大的差异。此外,自尊比母亲的教育水平和儿童的多动症严重程度更能预测母亲的内化耻辱。研究结果提示自尊对内化病耻感的重要性,并有助于研究自尊对父母内化病耻感的影响。
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引用次数: 10
A multidisciplinary approach to the management of phagophobia 一个多学科的方法来管理吞噬恐惧症
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-02-17 DOI: 10.1080/02739615.2020.1870117
Andrea M. Begotka, A. Silverman, P. Goday
ABSTRACT Choking phobia, better referred to as phagophobia, leads to significant dietary restriction or complete refusal to eat and drink, which may result in dehydration, and/or malnutrition. Current literature is limited to case reports. Therefore, the current study is a summary of the outcomes from a multidisciplinary approach including medical and behavioral intervention to treat phagophobia. Participants included eight children (4 females) with a mean age of 9.63 years, who consumed nothing to minimal intake orally. A medical workup and appropriate interventions were completed prior to behavioral treatment. Participants completed outpatient behavioral feeding treatment with one requiring intensive outpatient therapy. Three of eight participants started an anti-anxiolytic medication due to significant anxiety. There was a statistically significant increase in food consumption (t = -4.275, p = .004) and weight pre- to post-treatment (t = -4.004, p = .005). The present study is a preliminary investigation supporting the use of a brief multidisciplinary treatment for children with phagophobia so they can resume an age-appropriate diet again. Limitations of this study include a small sample size, convenience sampling, and protocol that is not yet standardized.
摘要窒息恐惧症,更确切地说是吞噬恐惧症,会导致严重的饮食限制或完全拒绝进食和饮水,从而可能导致脱水和/或营养不良。目前的文献仅限于病例报告。因此,目前的研究是对包括医学和行为干预在内的多学科方法治疗吞噬恐惧症的结果的总结。参与者包括8名平均年龄为9.63岁的儿童(4名女性),他们只摄入少量的食物。在行为治疗之前完成医学检查和适当的干预措施。参与者完成了门诊行为喂养治疗,其中一项需要门诊强化治疗。八名参与者中有三人因严重焦虑而开始服用抗焦虑药物。治疗前后的食物消耗量(t=-4.275,p=0.004)和体重(t=-4.004,p=0.005)在统计学上显著增加。本研究是一项初步调查,支持对患有吞噬恐惧症的儿童进行简短的多学科治疗,以便他们能够再次恢复适龄饮食。本研究的局限性包括样本量小、采样方便以及尚未标准化的方案。
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引用次数: 2
Postpartum depressive symptoms as a linking mechanism between maternal sleep and parenting stress: the conditional indirect effect by social support 产后抑郁症状在母亲睡眠与育儿压力之间的关联机制:社会支持的条件间接效应
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-01-02 DOI: 10.1080/02739615.2020.1824675
E. Camisasca, P. Di Blasio, Luca Milani, Sarah Miragoli
ABSTRACT Research has shown the associations between maternal depressive symptoms, sleep difficulties, and parenting competences and supports the importance of social support during the post-partum period. Nevertheless, the investigation of sleep difficulties as antecedents of depressive symptoms and parenting and the exploration of perceived social support in these links is a new research topic. Using a sample of 95 mothers, the present study explored: the effects of maternal sleep difficulties on parenting stress through the mediation of depressive symptoms; and the protective role of social support in these associations. Results suggested indirect effects of maternal sleep difficulties on parenting stress through depressive symptoms that were conditioned by social support. Implications for clinical care are discussed.
摘要研究表明,母亲的抑郁症状、睡眠困难和养育能力之间存在关联,并支持产后社会支持的重要性。然而,将睡眠困难作为抑郁症状和养育子女的前因进行调查,并探索这些环节中感知到的社会支持是一个新的研究课题。本研究以95名母亲为样本,探讨了母亲睡眠困难通过调节抑郁症状对养育压力的影响;以及社会支持在这些协会中的保护作用。结果表明,母亲睡眠困难通过社会支持条件下的抑郁症状对父母压力产生间接影响。讨论了对临床护理的影响。
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引用次数: 4
Effectiveness of dental visual aids in behavior management of children with autism spectrum disorder: a systematic review 牙科视觉辅助在自闭症谱系障碍儿童行为管理中的有效性:系统回顾
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-01-02 DOI: 10.1080/02739615.2020.1831389
Ala Aljubour, M. AbdElBaki, O. E. El Meligy, Basma Al Jabri, H. Sabbagh
ABSTRACT Autism Spectrum Disorder is a developmental disorder that affects communication and behavior. We aimed to evaluate the effectiveness of the dental visual aids in behavior management of children with ASD. Electronic search for English scientific papers was accomplished using ScienceDirect, Wiley, Scopus, Cochrane, Google Scholar and PubMed. Search terms were “Autism Spectrum Disorder,” “Dental visual aids,” “Dental visual guide,” and “Dental audiovisual modeling.” Full text and their references were reviewed and evaluated. Due to its effectiveness in increasing cooperation, modeling behavior and reducing anxiety, visual aids are effective during dental treatment of children with ASD compared to Tell–Show–Do.
自闭症谱系障碍是一种影响沟通和行为的发育障碍。我们旨在评估牙科视觉辅助在ASD儿童行为管理中的有效性。使用ScienceDirect、Wiley、Scopus、Cochrane、Google Scholar和PubMed完成了对英文科学论文的电子搜索。搜索词为“自闭症谱系障碍”、“牙科视觉辅助工具”、“牙齿视觉指南”和“牙科视听建模”。对全文及其参考文献进行了审查和评估。由于视觉辅助在增加合作、塑造行为和减少焦虑方面的有效性,与Tell–Show–Do相比,视觉辅助在ASD儿童的牙科治疗中是有效的。
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引用次数: 5
Employment and well-being among caregivers of children with autism spectrum disorder 自闭症谱系障碍儿童照顾者的就业和幸福感
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-01-02 DOI: 10.1080/02739615.2020.1810576
Sarah Watson, Fritz Stine, D. Tumin, K. M. Stiles
ABSTRACT We used the 2016–2018 National Survey of Children’s Health to assess restricted work participation among caregivers of children with autism spectrum disorder (ASD) and special health care needs (SHCN). Caregivers of children with ASD (N = 2,041) were especially likely to avoid changing jobs to keep health insurance coverage (20%; 95% CI: 16%, 24%), compared to either caregivers of children with other SHCN (N = 18,189) or children without SHCN (N = 68,499). Identifying effective strategies to mitigate the effects of a child’s ASD diagnosis on parents’ withdrawal from the workforce would add an important piece to comprehensive, family-centered care for this at-risk population.
我们使用2016-2018年全国儿童健康调查来评估自闭症谱系障碍(ASD)和特殊卫生保健需求(SHCN)儿童的照顾者的限制性工作参与。自闭症儿童 的照顾者(N = 2041)尤其有可能避免换工作以保持健康保险(20%;95% CI: 16%, 24%),与患有其他SHCN的儿童(N = 18,189)或没有SHCN的儿童(N = 68,499)的照顾者相比。确定有效的策略来减轻儿童ASD诊断对父母退出工作的影响,将为这一高危人群提供全面的、以家庭为中心的护理。
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引用次数: 1
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Childrens Health Care
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