Children-Basel最新文献

Background/Objectives: Parental mental health challenges are associated with parenting difficulties and child mental health issues. Parenting interventions can support families; however, parents with mental health challenges face barriers to accessing parenting support, which is not consistently offered within adult mental health settings. Embedding technology-assisted parenting programs into these settings could provide accessible, holistic support. Partners in Parenting Kids (PiP Kids) is a digital parenting program designed to prevent child anxiety and depression, yet its suitability for parents with mental health challenges and fit within mental health services remains unclear. This study aimed to co-design and adapt PiP Kids for future implementation in an Australian adult mental health service. Methods: Parents who recently sought mental health support (n = 8) and service providers (n = 7) participated in co-design workshops to explore needs and preferences for a technology-assisted parenting program and iteratively develop a prototype. Parents (n = 3) trialled the online component of the prototype and participated in qualitative interviews to assess acceptability. Results: The adapted clinician-supported program was designed to facilitate (1) parent and clinician readiness for parenting support; (2) emotional and social support for parents and clinicians; (3) practical, personalised parenting knowledge; (4) parent-led empowerment; and (5) accessible, integrated support. Prototype clinician training was developed to strengthen the clinician-support component. Parents indicated initial acceptability of the online prototype while reiterating the value of including face-to-face support. Conclusions: This study co-designed an online, clinician-supported parenting program for future embedding within adult mental health settings. The findings highlight key considerations for developing and implementing technology-assisted interventions that promote family-focused care for parents seeking mental health support.

Background/Objectives: Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder characterized by social, communication, and behavioral challenges. complementary and alternative medicine (CAM) is widely used by parents worldwide, yet research exploring parents' experiences, particularly in Arab countries, is limited. This study explored mothers' perceptions and experiences of CAM use for children with ASD, information-seeking behaviors and challenges encountered. Methods: A qualitative study using semi-structured interviews was conducted among twenty mothers at Autism Academy of Jordan in 2024. Inclusion criteria were mothers with children diagnosed with ASD for at least six months and those who had used at least one CAM therapy. Interviews were conducted via Skype, transcribed verbatim, and analyzed using NVivo 12 with inductive thematic analysis. Results: Three major themes emerged in this qualitative study: (1) mothers' experiences with CAM and perceptions of benefit; (2) sources of information and decision-making processes; and (3) main challenges in selecting and implementing CAM. Mothers reported using therapies such as honey, black seed, camel milk, Hujama, olive oil, supplements, and region-specific programs like Andalosiah. Faith, cultural beliefs, and the desire for natural, safe interventions strongly influenced CAM selection. Internet searches and social media groups were primary information sources. Challenges included financial, logistical, emotional burdens, and lack of trustworthy, Arabic-language information sources. Conclusions: Mothers in Arab countries navigate CAM use for their children with ASD through culturally and religiously informed practices. Interventions should focus on developing evidence-based guidance, culturally sensitive counseling, and accessible information to support families in safe, informed CAM use.

Background/objective: To evaluate the effectiveness of resin infiltration in managing anterior molar incisor hypomineralization (MIH) defects, focusing on color improvement, lesion size reduction, sensitivity outcomes and patient aesthetic perception. Enamel defects in MIH result from a combination of environmental, systemic, and genetic factors, indicating a multifactorial etiology. These defects, particularly in anterior teeth, pose significant aesthetic and emotional challenges due to their high visibility. This study provides one of the few prospective clinical evaluations of resin infiltration for anterior MIH lesions, assessing not only objective clinical outcomes but also patients' aesthetic perception. It further introduces a patient-centered approach by comparing aesthetic evaluations made by children and dental professionals over time.

Methods: A total of 109 MIH-affected anterior teeth were treated using Icon^® resin infiltration (DMG, Hamburg, Germany) in this registered prospective clinical study (ClinicalTrials.gov: NCT05597956). Participants were classified as children (6-12 years) and adolescents (13-17 years) according to standard pediatric age definitions. Of these, 101 teeth were available for evaluation at the 6-month follow-up due to patient loss to follow-up. The evaluation included photographic follow-up, measurement of lesion size and color, and assessment of sensitivity. During follow-up visits, patients rated the appearance of their lesions using the FDI scale.

Results: Before treatment, spectrophotometric analysis showed that lesions exhibited a reddish hue (mean a* = 2.12), were distinctly yellowish (mean b* = 23.20), and clearly differed from surrounding enamel (ΔE = 8.62). The brightness level (L* = 69.81) indicated medium-high luminosity. Lesion size was reduced by an average of 4.5 percentage points. Significant increases in L values and reductions in a* and b* components were observed, with clinically perceptible ΔE changes. Sensitivity improved in 36.6% of patients, who reported a 1-2 point decrease on the SCASS. Moreover, patients' aesthetic perception significantly improved after Icon^® infiltration resin.

Conclusions: Resin infiltration produced noticeable improvements in color, reduced lesion size and sensitivity, and enhanced aesthetic perception, making it a valuable treatment option for managing MIH-affected anterior teeth in children.

Background: Although several studies have reported associations between screentime and shortened sleep duration among adolescents, contextual relationships between different forms of screentime are not well understood. The purpose of this study was to examine how television (TV) watching (passive media use) and video/computer gaming (interactive media use) are associated with short sleep duration among 8th and 11th grade adolescents. Methods: We used data from adolescents (8th and 11th grade students) who participated in the Texas School Physical Activity and Nutrition (Texas SPAN) survey in 2015-2016. Sleep duration was the outcome variable, which was dichotomized into short sleep duration (less than 8 h) and meeting sleep recommendations (more than 8 h). Independent variables included daily TV screentime and video/computer game screentime. We used weighted logistic regression models to understand associations between sleep duration and both TV screentime and video/computer game screentime. Results: Among both 8th grade boys and Hispanic 8th grade girls, spending more than 2 h/day playing video/computer games was associated with greater odds of shorter sleep duration. Among 11th graders, TV screentime was associated with lower odds of shorter sleep duration. Conclusions: Watching TV and playing video/computer games have differential associations with sleep duration among adolescents, and these associations differ by grade, gender, and ethnicity. Researchers and public health agencies interested in associations between meeting sleep recommendations and screentime in adolescents should consider these contextual differences when designing and conducting studies related to electronic media use and sleep.

Background: Visceral adiposity has emerged as a clinically relevant determinant of early cardiometabolic dysfunction in pediatric type 1 diabetes mellitus (T1DM), yet its assessment remains underutilized in routine practice. This study evaluated ultrasonographically measured epicardial adipose tissue thickness (EATT) and perirenal adipose tissue thickness (PrATT) as markers of metabolic risk, insulin sensitivity, and subclinical atherosclerosis in children and adolescents with T1DM. Methods: This cross-sectional study included 150 participants with T1DM and 152 age- and sex-matched healthy controls. Anthropometric data, biochemical parameters, hepatic steatosis grade, and insulin sensitivity indices (eGDR) were collected. EATT and PrATT were measured via standardized echocardiographic and abdominal ultrasonographic protocols. Carotid intima-media thickness (cIMT) was assessed as an indicator of subclinical atherosclerosis. Correlation and multivariable logistic regression analyses were performed to identify independent predictors of T1DM status and cardiometabolic risk. Results: Children with T1DM exhibited significantly higher PrATT and EATT values compared with controls (both p < 0.05). All eGDR indices were markedly lower in the T1DM group, reflecting reduced insulin sensitivity. PrATT and EATT showed strong or moderate correlations with hsCRP, hepatic steatosis, atherogenic index of plasma, and multiple anthropometric markers. Both visceral fat depots were positively associated with cIMT. Logistic regression identified PrATT, EATT, hsCRP, cIMT, and eGDR-BMI as independent predictors of case status. Subgroup analyses demonstrated more pronounced visceral adiposity and metabolic impairment among participants with BMI ≥85th percentile. Conclusions: Ultrasonographically measured PrATT and EATT provide valuable insight into early cardiometabolic risk in youth with T1DM, independent of BMI. Their associations with insulin resistance, inflammation, and subclinical atherosclerosis highlight their potential utility as accessible markers for early risk stratification in pediatric diabetes. Routine incorporation of visceral fat assessment may support earlier identification of high-risk individuals and more targeted preventive strategies.

Background/objectives: Infantile epileptic spasms syndrome (IESS) is a severe epilepsy of infancy. Corticotropin (ACTH) and vigabatrin are the only FDA-approved therapies. The efficacy of ACTH together with the strong convulsant effects of corticotropin-releasing hormone (CRH) suggests that excess CRH, secondary to impaired ACTH feedback, may contribute to spasms. We therefore hypothesized that CRH receptor 1 (CRHR1) antagonists would suppress spasms in a route- and drug-dependent manner.

Methods: Using our validated rat model of IESS, in which prenatal priming with betamethasone was followed by postnatal triggering of spasms with N-methyl-D-aspartic acid (NMDA), we tested two CRHR1 antagonists, CP376395 and SN003, delivered intracranially (via intracerebroventricular or intraparenchymal infusion) or systemically.

Results: Intracerebroventricular infusion of both antagonists suppressed spasms, with CP376395 providing more consistent effects. Intraparenchymal administration into the hypothalamic arcuate nucleus also reduced spasms, whereas misses into the mammillary bodies were ineffective, highlighting site specificity. Systemic administration yielded divergent results: SN003 robustly suppressed spasms, whereas CP376395 unexpectedly exacerbated them. No sex differences were observed.

Conclusions: These findings demonstrate that CRHR1 blockade modifies experimental spasms in a route- and drug-specific manner and implicates discrete hypothalamic circuits, particularly those including the arcuate nucleus, in spasm generation. The divergent systemic responses between CP376395 and SN003 likely reflect differences in CRHR1 engagement (competitive and non-competitive antagonism, respectively) as well as differences in binding properties that may include differential network interactions beyond local CRH signaling or duration of receptor occupancy. In conclusion, SN003 may be a better option than CP376395 for further development as a CRHR1-targeted therapy pending additional pharmacokinetic/pharmacodynamic studies. Further work should explore dosing paradigms of CP376395 to determine if a therapeutic range for CP376395 exists.

Background/Objectives: Community violence remains a pervasive public health challenge that disproportionately affects Black youth, with lasting impacts on physical and mental health. Traditional models often conceptualize resilience as individual "bounce back" capacity, overlooking how adaptation unfolds amid chronic violence and structural inequity. This study examined how Black youth and trauma clinicians understand, navigate, and redefine resilience within contexts of ongoing community violence exposure. Methods: Using a phenomenological qualitative design, the study drew on semi-structured interviews and focus groups with Black youth and clinicians participating in a community violence trauma recovery program in Chicago, Illinois. Data were analyzed thematically to identify patterns in how resilience was described, practiced, and supported. Results: Black youth redefined resilience through adaptive survival strategies-such as hypervigilance, avoidance, and emotional regulation-that functioned as protective responses to continuous threat. Clinicians recognized resilience as relational and context-dependent but reported limited training to address trauma rooted in chronic, community-level conditions. Both groups highlighted the role of collective and structural supports, including family, peers, and community networks, in sustaining adaptation. Conclusions: Findings highlight the need to expand trauma-informed care beyond individual treatment to address structural conditions that perpetuate community violence. Integrating ecological and culturally grounded models of resilience into clinical training and community programming can improve support for Black youth navigating chronic exposure to violence.

Background/Objectives: Childhood overweight and obesity are influenced by family-level behaviors related to nutrition, physical activity, and daily routines. This study aimed to In contrast to screen time family nutrition and physical activity practices for overweight and obesity among children aged 6-17 years in Türkiye. Methods: A cross-sectional study was conducted with 214 children recruited from a community setting. Sociodemographic data and anthropometric measurements were collected, and family practices were assessed using the Family Nutrition and Physical Activity Scale-Turkish version (FNPA-TR). Binary logistic regression analyses were performed separately for overweight and obesity outcomes. Results: Healthier beverage choices were the only significant predictor of overweight, reducing the odds by 62%. Obesity was predicted by three FNPA domains: family meal frequency, family eating habits, and screen time. Frequent family meals and healthier eating habits were associated with lower obesity risk, whereas higher screen exposure increased the likelihood of obesity. Conclusions: Beverage choices, family meal patterns, eating habits, and screen exposure emerged as key behavioral predictors of unhealthy weight status in children. These findings highlight key family-centered prevention targets for pediatric nursing and public health, including promoting healthy beverage consumption, strengthening structured family eating routines, and reducing screen exposure in children.

Background: Parents caring for preterm infants during hospital admission have unique needs. How these are addressed plays an important role in parents' ability to cope with caregiving responsibilities. Educational programmes have proven beneficial to parents during their infant's stay in the neonatal intensive care unit (NICU), for both parental and neonatal outcomes. Key components of parenting education during the NICU stay have been described; however, less is known about our understanding of parents' educational needs, specifically in the South African context.

Objectives: To explore parental needs and perceptions regarding a parenting education intervention provided to them while in the NICU, with a focus on programme content, structure, and mode of delivery.

Methods: Three focus group discussions were conducted with mothers of preterm infants admitted to the NICU of a referral hospital in the North West province, South Africa. Inclusion criteria comprised parents of infants born in the hospital, singletons or multiples, with a gestational age below 37 weeks, and expected to stay in the NICU for at least 7 days. Discussions centred on mothers' perceived needs regarding parenting education based on their experiences during their baby's NICU admission.

Results: Twenty-five mothers of singletons or multiples born before 37 weeks of gestation participated in the study. Three main themes were identified: (1) preference for content topics to include basic infant care, infant health and behaviours, and post-discharge related information; (2) education programme structure, which included instructional approaches and training logistics; and (3) support needs, including intrapersonal motivators, communication, and psychosocial and physical support.

Conclusions: Participants recognised educational content needs that align with existing literature. However, they also emphasised the importance of addressing basic physical and emotional needs while receiving educational content, ensuring that parents feel empowered and capable of engaging with the information.

Introduction: Middle adolescence involves increasingly complex stressors, yet it remains unclear how coping strategies cluster into distinct profiles, how those profiles change across time, and whether profile structure is comparable across gender. We used latent class and transition analysis across three annual waves to identify coping profiles, model transitions, and examine perceived stress, depressive symptoms, and general self-efficacy by profile.

Methods: Participants were 964 adolescents (mean age = 16.1 years; 56% female) from public high schools in Texas who completed surveys in spring 2011 with two annual follow-ups. The sample self-identified as Hispanic (32%), White (30%), African American (27%), or other (11%). Latent class/transition models estimated profile membership, transitions, and gender differences in prevalence and transition probabilities.

Results: Four coping profiles emerged: Minimal Copers, Maximum Copers, Introverted Approach-Avoidant Copers, and Independent Problem-Solving Copers. Profile structure was comparable for females and males, although prevalence and transition differed. At Wave 4, Introverted Approach-Avoidant Copers reported the highest perceived stress and depressive symptoms, whereas Minimal and Independent Problem-Solving Copers reported lower perceived stress and depressive symptoms. Independent Problem-Solving and Maximum Copers reported higher general self-efficacy, whereas Minimal Copers reported the lowest.

Conclusions: Coping in adolescence is heterogeneous and shifts over time, with gender differences in profile prevalence and transitions; findings highlight potential targets for tailored support and self-efficacy enhancement.