Child Care Health and Development最新文献

Background: Sand play (SP) is a global phenomenon that may be linked to children's health outcomes, but limited evidence exists. The purpose was to synthesize evidence on the association between SP and 0- to 8-year-old children's physical, cognitive and socioemotional outcomes.

Methods: CINAHL, Academic Search Premier, PsycINFO, SPORTDiscus with Full Text, ERIC, Medline, Scopus and Google Scholar were searched. Studies were eligible if 0- to 8-year-old children's outcomes were reported while attending SP. Synthesis was performed using effect direction (quantitative), thematic (qualitative), narrative and results-based convergent synthesis incorporating the risk of bias and confidence in the evidence assessments. Studies were grouped by SP exposure context as education, leisure and rehabilitation.

Results: The effect direction (Nstudies = 17; Nchildren = 677), thematic (Nstudies = 8; Nchildren = 131) and narrative (Nstudies = 8; Nchildren = 11 784) syntheses included 28 studies published in 1993-2023 (Ntotal = 12 646; Mchildage = 3-6 years; Mgirls 41%; Methnicity Asian 3%, African American/Black/Hispanic 8%, European American/White/Non-Hispanic 56%, Multi-ethnic 36%). Based on very low to moderate confidence in the evidence, findings indicated inconsistent associations between educational, rehabilitational and leisure SP and children's physical, cognitive and socioemotional outcomes. There was inconsistent evidence on the occurrence of SP by children's gender and age.

Conclusion: SP may enhance some childhood outcomes. However, high-quality controlled designs describing the exposure to SP are needed to inform the effectiveness of SP on children's health and development.

Background: Those with neurological disorders like cerebral palsy (CP) may experience an altered impact of social determinates of health on child functioning and well-being. We investigated the relationship between relative social advantage and medical and functional outcomes in a large cohort of children, adolescents and young adults with CP (n = 1269, aged 2-84 years).

Methods: We extracted data from the Cerebral Palsy Research Registry and dichotomized a range of independent factors (income, ethnicity and race) into advantaged and disadvantaged/vulnerable and a range of medical and functional outcomes (gross motor, manual ability, behaviour, breathing, nutritional intake, hearing, seizures, language and vision) and computed odds ratios using logistic regression.

Results: We found significantly more gross and fine motor functional limitations for those with disadvantage in income (p = 0.002 and 0.006), marginalized race (p < 0.001 and 0.062) or ethnicity (p = 0.013 and 0.014). Ethnicity was further implicated in gestational age, whereas minority race played a role in more severe impairments in breathing, nutritional intake, language functioning and low birth weight status.

Conclusion: We found evidence of more health and functional challenges for children with CP and social disadvantage in our cohort. Additional access to equitable resources may improve these imbalances and should be prioritized.

Background: The objective of this study encompasses two distinct facets. First, it aims to provide a comprehensive analysis of the comparative assessment of psychosocial wellbeing and oral health status among Syrian and Turkish children in Türkiye. Secondly, it aims to elucidate the factors that play a role in shaping the sociocultural adaptation of Syrian children.

Methods: A cross-sectional survey assessing self-esteem, social anxiety and resilience and clinical examination were conducted on a convenience sample of Syrian refugee and Turkish children. The sample consisted of 396 participants (55.7% male and 44.3% female), including 173 Syrian individuals (43.7%) with a mean age of 14.12 years (SD = 2.24), and 223 Turkish individuals (56.3%) with a mean age of 12.44 years (SD = 2.47). Sociocultural adaptation and perceived discrimination scales were also taken by refugee children.

Results: Overall, psychosocial wellbeing, academic success and oral health outcomes of refugee participants were lower than those of the Turkish general population. Specifically, independent samples t-test revealed that Syrian refugee children exhibited higher levels of social anxiety (t(384) = 3.138, p < 0.005), higher resilience (t(384) = 3.866, p < 0.001), lower self-esteem (t(389) = 4.614, p < 0.001) and poorer academic performance (t(370.981) = -8.441, p < 0.001) compared to Turkish children. In terms of oral health, Syrian children exhibited significantly higher levels of dental health problems, including DMFT (t(394) = 4.203, p < 0.001), DMFS (t(394) = 4.858, p < 0.001) and PPD (t(394) = 15.09, p < 0.001) than their Turkish counterparts. A one-way ANOVA showed that socio-economic status was an important factor in psychosocial and oral health outcomes, except for psychological resilience (F(2,378) = 0.029, p = 0.971). Children from low socioeconomic backgrounds showed higher levels of social anxiety (F (2,376) = 10.704, p = 0.00), lower academic performance (F(2,365) = 33.119, p = 0.00) and poorer oral health outcomes including DMFT (F(2,381) = 7.230, p = 0.001), DMFS (F(2,381) = 4.983, p = 0.007) and PPD (F(2,381) = 22.463, p = 0.00). Pearson correlation analyses indicated that sociocultural adaptation of refugees was positively associated with their resilience (r = 0.45, p < 0.01), and negatively associated with perceived discrimination (r = -0.34, p < 0.01).

Conclusion: The findings underscore the need for integrated healthcare interventions that address the multifaceted health needs of vulnerable populations in diverse societies.

Background: Children with medical complexity (CMC) require complex care that parents must independently provide and manage when discharged home from hospital. It is important that parents are adequately prepared to safely transition home from hospital with their child.

Method: A synthesis of findings from research articles was conducted to map and summarize available evidence on CMC and their parents' experiences of discharge from hospital to home. A total of 32 studies were included in this review. Thematic analysis was used to analyze and describe the data.

Results: The following key themes were developed during data analysis: preparation and readiness, aids for discharge, overwhelmed with the transition, frustration with time to get home, difficulties with transitions and discharge interventions.

Conclusion: These findings demonstrate the importance of taking steps to ensure CMC and their parents undergo a thorough and planned discharge process to prepare parents to confidently provide safe care to their children in the home. Approaches and strategies for comprehensive and safe discharge are provided.

Background: Since 2001, the American Academy of Pediatrics has released and twice revised guidelines tasking paediatricians with screening children for developmental disorders, but diagnoses are often delayed. Paediatricians in the United States are also responsible for referring patients with identified concerns for services and for managing their long-term care.

Objectives: This review aims to chronologically synthesize available literature about paediatricians' perspectives surrounding their roles in identifying and managing early childhood disorders and to identify how future interventions can best address these perspectives.

Methods: Early childhood disorders (ECDs) were defined as developmental delays and autism spectrum disorder. A literature search was performed on PubMed and Google Scholar. Surveys, interviews, focus groups and analyses of paediatricians' perspectives on their roles in identifying and managing children with ECDs were included if they were performed in the United States and published in a peer-reviewed journal in or after 2001. Literature was reviewed and analysed by sorting key findings into categories of 'knowledge', 'attitudes' and 'confidence', then organizing chronologically within each category.

Results: Of the 122 publications identified, 19 were selected and reviewed, revealing some overlying themes. First, paediatricians desire more training on ECDs, especially in assisting with navigation of intervention programs. Second, negative attitudes towards roles in identifying and managing ECDs have remained relatively consistent since 2001. Third, paediatricians' confidence declines from identification to long-term management of ECDs.

Conclusions: This review chronologically synthesizes paediatricians' knowledge, attitudes and confidence surrounding their roles in identifying children with ECDs, referring them to other professionals and managing their long-term care. Paediatricians are not solely responsible for these tasks, as other medical professionals, families, therapists and educators work together to care for these children. This review provides recommendations, such as enhancing training programs and utilizing care coordinators, to address perspectives that may result in suboptimal patient care.

Background: Interactive electronic devices (IEDs) are ubiquitous in young children's lives. However, research on their impact on learning and development is still limited. The aim of this study was to understand the perspectives of early years practitioners (EYPs) and public health consultants (PHCs) on the use of IEDs in children aged 3-5.

Methods: Using purposive sampling techniques, we recruited four EYPs and two PHCs from children's nurseries and a government organisation in the northwest of England. Semi-structured interviews were used to collect data, which were audio-recorded, transcribed verbatim and anonymised. Data were analysed using reflective thematic analysis.

Results: EYPs and PHCs noted that although IEDs could negatively impact child development and behaviour, they could also aid in learning. EYPs expressed concerns about the impact of parents' own IED habits on children's communication and social skills. On the other hand, PHCs stressed that substituting outdoor play with the use of these devices could affect children's social and physical skills and reduce physical activity levels, which are crucial for development. Finally, both EYPs and PHCs agreed that there was a need to improve parents' and EYP's knowledge and to develop interactive interventions to promote an understanding of how IEDs should be used with young children.

Conclusion: EYPs and PHCs acknowledge the potential advantages of using IEDs as a teaching tool for children. However, they have concerns about the long-term effects on communication, social and physical skills and how children are impacted by their parents' use of these devices. To support policy statements, future research should offer further evidence of the benefits and harms of IED use.

Background: This study investigated the factor structure of the parenting sense of competence (PSoC), a measure of parenting self-efficacy, in a sample of parents recruited when their infants were under 2 months old. Due to the lack of longitudinal analysis of the PSoC's factor structure over time, the study sought to establish if the published two-factor structure was consistent over an 18-month period.

Methods: Data collected from 536 parents who had participated in a randomised controlled trial of universal proportionate parenting support, delivered in five sites in England, were subject to confirmatory factor analysis (CFA).

Results: CFA revealed that a three-factor model was the best fit for the data. Longitudinal measurement invariance testing examined the stability of the three-factor model across an 18-month period. The results suggest that while the PSoC appeared to have configural variance, the metric and scalar variance were not supported. PSoC may be unstable across time and might be unreliable as a measure of parenting competence in parents of infants.

Conclusion: These findings are particularly salient for researchers and clinicians who are utilising the PSoC as a measure of change in routine practice or as part of evaluations of interventions. Further investigation of individual items is needed to refine the PSoC and improve its psychometric validity. Additional analyses are also needed to establish the invariance of the measure across different groups (age, sex, ethnicity and socioeconomic status).

Background and objectives: Some families faced difficulties accessing speech therapy in some areas of Malaysia and/or during the COVID-19 lockdown. Therefore, parent-mediated intervention could be one of the ways to solve this issue, as it has been proven to effectively improve communication skills among children with communication disorders. Hence, a Mandarin parental guidebook comprising a series of language stimulation activities was developed to explore the perception of parents of children with communication disorders, ranging from 3 to 6 years old, regarding the feasibility of (1) conducting speech-language home programs and (2) using a home-based parental guidebook as a tool to deliver a speech-language home program.

Design, setting and participants: Semistructured interviews were conducted with nine Malaysian parents of child (ren) with communication disorders, who fulfilled the inclusionary criteria. Parents had attempted the speech-language home program by using the guidebook prior to the interview. The participants were subjected to 45-min to 1-h interviews. The interviews were audio- or video-recorded for verbatim transcription. Thematic analysis was used for data interpretation.

Results: Four main themes were identified: (1) 'Golden Period': a guidebook to deliver speech-language home program, (2) perception of the speech-language home program among parents of children with communication disorders, (3) challenges faced by parents when practicing speech-language home program and (4) suggestions for improvements: parent's needs. The themes informed the perspective of parents towards the user experience of the parental guidebook, the feasibility of the speech-language home program and their recommendations. Overall, participants conveyed positive responses on the parental guidebook.

Conclusions: Malaysian parents face difficulties in accessing speech therapy because of limited numbers of SLTs, geographical barriers, financial constraints, availability of facilities and so forth. Findings could assist SLTs in adopting a family-centred approach in their service delivery, thus increasing the cost-effectiveness of their service delivery.

Objectives: We aim to quantify the performance of accelerometry in objectively measuring physical activity (PA) intensity among infants and toddlers.

Methods: Thirty-eight 6- to 24-month-olds participated in a 30-min, semistructured lab visit. Twenty-three (61%) children could walk independently. Children engaged in a variety of activities while wearing accelerometers on each ankle and at the waist. Visits were video recorded, and study team members independently coded the first three 5-s epochs of each minute for PA intensity using a 5-level scale ranging from 1 = completely sedentary to 5 = moderate-to-high intensity. Interrater agreement for PA classifications was excellent (median kappa per child = 0.85). A series of logistic regression models were fit to find the vector magnitude threshold per 5-s epoch that differentiated activity intensity above each PA level with ≥ 80% sensitivity.

Results: Analyses included 3191 epochs; a median of 88 epochs per child. The classification performance applying all thresholds concurrently for the five PA intensity levels was poor for each wear location (agreement < 50%, kappa < 0.25). Classification improved when concatenating intensity levels, with the best performance comparing sedentary (levels 1-2) to nonsedentary (levels 3-5) and using data from the left ankle device: agreement ≥ 77.6%, kappa ≥ 0.44. Applying those novel thresholds to predict the total time spent in level 3-5 activities over all coded epochs using linear regression performed as well as using the sum of vector magnitude across epochs when using data from the left ankle device. Overall, the performance of the left ankle wear location was similar to the right ankle wear location and superior to the waist location.

Conclusions: Ankle-worn accelerometry had adequate validity to classify in-the-moment nonsedentary behaviours and total time spent nonsedentary over a time interval among this sample of infants and toddlers. While caution is warranted when generalizing these lab-based findings to naturalistic settings, findings provide insight into objective measures of PA for this age range.

Background: Malaria remains a major cause of preventable deaths among children worldwide, despite the availability of several interventions for controlling and eliminating the disease. The WHO recommended the first malaria vaccine, RTS, S/AS01 in October 2021 to immunize children in sub-Saharan Africa. In this study, we set out to evaluate the knowledge, awareness and acceptability of the malaria vaccine among mothers of under 5 in south-west Nigeria before the vaccine's rollout in Nigeria.

Methods: We employed a hospital-based cross-sectional study for this study. A pretested semistructured, interviewer-administered questionnaire was used to elicit information from the study participants. Data obtained were analysed using the Statistical Package for Social Sciences (SPSS version 20.0).

Results: A total of 797 respondents participated in the study. Only 26.0% of the respondents were aware of the new vaccine. However, the majority (90.0%) were willing to accept the malaria vaccination and to pay for it (82.1%). The crude odds ratio reveals that the odds of awareness of the malaria vaccine were more than 5 times higher among those who have tertiary education (OR = 5.470, CI = 1.224-24.444) compared with those with primary education.

Conclusion: The level of awareness of the malarial vaccine is low among the caregivers of under 5 children living in south-western Nigeria. However, the willingness to accept the vaccine is high. Recruiting, training and retraining of healthcare providers and other stakeholders with the designated role of providing health education on malaria prevention and vaccines are key in ensuring the success of malaria vaccination.