Child Care Health and Development最新文献_第2页

Patterns of Screen Time From Ages 2 to 6-7 Years in South Brazil: A Prospective Study. 巴西南部2至6-7岁儿童屏幕时间模式：一项前瞻性研究。

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-01-01 DOI: 10.1111/cch.70033

Otávio Amaral de Andrade Leão, Thaynã Ramos Flores, Daniela de Oliveira Nava, Pedro San Martin Soares, Joseph Murray, Marlos Rodrigues Domingues, Pedro Curi Hallal

Background: Screen use has become nearly universal, especially in children. Therefore, it is important not only to comprehend its effects on health but also to understand its patterns of use. We aim to describe screen use patterns among children assessed at 2, 4, and 6-7 years, based on device, period of the day, and child/family characteristics.

Methods: Longitudinal study, with participants of the 2015 Pelotas (Brazil) Birth Cohort, a population-based study including all living newborns in the city of Pelotas between 1 January and 31 December 2015. Child/family characteristics used in the study were sex, skin color, family income, and maternal education. Screen time at 2 years was evaluated by TV time. At age 4, TV time and other screens (computer and videogames) was assesed. At 6-7 years, screen use was collected for each device (TV, smartphone, tablet/iPad, computer, and videogames).

Results: At 2, 4, and 6-7 years, 1420, 3963, and 3857 had valid screen time data, respectively. Mean total screen time ranged from ~ 2.5 h per day at age 2 to ~ 5.5 h per day at age 6-7. At 2 years, no difference in screen time was found according to child/family characteristics. In general, boys presented higher screen time values at 4 and 6-7 years. No differences for ethnicity were observed. For family income and maternal education, the extreme groups presented higher use. Higher values of screen time were also observed during the evening and for children who did not attend school nor had home activities during the Covid-19 pandemic.

Conclusions: The results suggest that children are exceeding current screen time guidelines, with different patterns of use according to child/family characteristics. The high use of screens and more concentrated use during the evenings raise concern considering its possible negative effects on health.

背景：屏幕的使用几乎是普遍的，尤其是在儿童中。因此，重要的是不仅要了解其对健康的影响，而且要了解其使用模式。我们的目标是描述在2岁、4岁和6-7岁时评估的儿童的屏幕使用模式，基于设备、一天中的时间段和儿童/家庭特征。方法：对2015年佩洛塔斯（巴西）出生队列的参与者进行纵向研究，这是一项基于人群的研究，包括2015年1月1日至12月31日期间佩洛塔斯市所有活着的新生儿。研究中使用的儿童/家庭特征包括性别、肤色、家庭收入和母亲的教育程度。两岁时的屏幕时间用看电视的时间来评估。在4岁时，对孩子看电视和其他屏幕（电脑和电子游戏）的时间进行了评估。在6-7岁时，收集每种设备（电视、智能手机、平板电脑/iPad、电脑和视频游戏）的屏幕使用情况。结果：在2年、4年和6-7年时，分别有1420人、3963人和3857人有有效的屏幕时间数据。平均总屏幕时间从2岁时每天2.5小时到6-7岁时每天5.5小时不等。在两岁时，根据儿童/家庭特征，屏幕时间没有差异。一般来说，男孩在4岁和6-7岁时屏幕时间值更高。没有观察到种族差异。在家庭收入和母亲教育方面，极端群体的使用率更高。在Covid-19大流行期间，晚上和没有上学或没有家庭活动的儿童也观察到屏幕时间更长。结论：结果表明，儿童超过了目前的屏幕时间指南，根据儿童/家庭的特点有不同的使用模式。考虑到对健康可能产生的负面影响，屏幕的高度使用和夜间更集中的使用引起了关注。

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引用次数: 0

Development of a Self-Care Autonomy in Health Scale for Late Adolescents 晚近青少年健康自理能力量表的编制。

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2024-12-20 DOI: 10.1111/cch.70027

Oxana Mikhaylova, Popov Denis, Chepeleva Maria, Bochkor Anastasia, Serebrennaya Ekaterina, Osipova Polina

Background

This paper describes the development of the Self-Care Autonomy in Health Scale for Late Adolescents (SAHSLA) for use with general samples. It addresses concerns regarding the nonclinical efficacy of self-care health scales for adolescents, particularly their ability to discriminate between lower levels of self-care.

Methods

A survey was constructed based on literature review and subsequently evaluated in two studies. Parents (N = 57, 53 parents of girls, 4 of boys, M_age = 15.96) participated in Study 1, which investigated the internal with Cronbach's alpha and coefficient omega (ω), and convergent validity with regard to adolescent age. In Study 2, the SAHSLA scores of adolescents (N = 339, 268 girls, 73 boys, M_age = 15.87) were examined using confirmatory factor and convergent validity analyses in relation to age, gender, smoking and alcohol consumption patterns, and self-compassion assessments.

Results

In Study 1, the scale total and a child's age did not substantially correlate. Both omega and alpha were moderate. Study 2 revealed a two-factor model with physical and psychological components. There were minor yet statistically significant associations found between self-judgement and psychological SAHSLA. Physical SAHSLA was not connected with age, overidentification, isolation or self-judgement, but it was statistically strongly correlated with total self-compassion.

Conclusions

The scale and study findings can be applied to health monitoring and interventions in schools and adolescent campaigns aimed at alcohol- and tobacco-use cessation.

背景：本文介绍了晚近青少年健康自理能力量表（SAHSLA）的编制及其在一般样本中的应用。它解决了对青少年自我保健健康量表的非临床功效的关注，特别是他们区分较低水平自我保健的能力。方法：在文献回顾的基础上进行问卷调查，并对两项研究进行评价。研究1采用Cronbach’s alpha和ω (ω)系数对青少年年龄的内部效度和收敛效度进行了调查，其中女生家长57人，男生家长53人，男生家长4人，Mage = 15.96。研究2采用验证性效度分析和收敛效度分析，对青少年（N = 339，女生268，男生73，男生15.87）的SAHSLA得分与年龄、性别、吸烟和饮酒模式、自我同情评估的关系进行检验。结果：在研究1中，量表总分与儿童年龄无显著相关性。和都是中等的。研究2揭示了一个包含生理和心理因素的双因素模型。在自我判断和心理SAHSLA之间发现了轻微但有统计学意义的关联。身体上的SAHSLA与年龄、过度认同、孤立和自我判断无关，但与总体自我同情有统计学上的强相关。结论：该量表和研究结果可应用于学校健康监测和干预措施以及旨在戒烟和戒酒的青少年运动。

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引用次数: 0

Longitudinal Associations Between Movement Behaviours and Development Among Infants Using Compositional Data Analysis 使用成分数据分析的婴儿运动行为与发育之间的纵向关联。

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2024-12-20 DOI: 10.1111/cch.70025

Valerie Carson, Zhiguang Zhang, Madison Boyd, Lesley Pritchard, Kylie D. Hesketh

Background

The study examined the longitudinal associations of sleep time, restrained time, back time and tummy time with development in a sample of infants using compositional data analysis.

Methods

Participants were a subsample of 93 parent–infant dyads from the Early Movers project in Edmonton, Canada. Parents completed a 3-day time-use diary at 2, 4 and 6 months of age. Time spent in four mutually exclusive movement behaviours were calculated representing sleep (i.e., sleep time), sedentary behaviour (i.e., restrained time and back time) and physical activity (i.e., tummy time). Communication, fine motor, gross motor, personal-social, problem solving and total development were measured at 2, 4 and 6 months of age with the Ages and Stages Questionnaire (ASQ-3). Gross motor development was also measured by a physiotherapist using the Alberta Infant Motor Scale (AIMS) at 6 months. The age six major gross motor milestones (i.e., independent sitting, crawling, assisted standing, assisted walking, independent standing, independent walking) were achieved according to World Health Organization criteria, in the first 18 months of life, were calculated.

Results

The composition of movement behaviours across time points was significantly associated with: ASQ-3 gross motor, problem solving and total development scores over time, total and percentile AIMS scores at 6 months and independent standing and walking milestones (ilr model p-value: < 0.001–0.045; model R²: 0.02–0.15). More sleep time or tummy time relative to other movement behaviours was associated with more advanced development and earlier achievement of some milestones. The opposite was observed for back time. Associations with restrained time were mixed. The optimal movement behaviour durations (minutes/day) for AIMS and WHO milestone outcomes, were 38–43 of tummy time, 51–54 of back time, 43–96 of restrained time and 845–900 of sleep time.

Conclusions

Targeting healthy movement behaviour patterns in infants may be a promising health promotion strategy.

背景：本研究利用成分数据分析的方法，调查了一组婴儿的睡眠时间、约束时间、背部时间和俯卧时间与发育之间的纵向关系。方法：参与者是来自加拿大埃德蒙顿早期运动项目的93对父母-婴儿二联体的子样本。父母在孩子2、4和6个月大时完成了为期3天的时间使用日记。计算了四种相互排斥的运动行为所花费的时间，分别代表睡眠（即睡眠时间）、久坐行为（即约束时间和背部时间）和身体活动（即俯卧时间）。在2、4、6个月时用年龄与阶段问卷（ASQ-3）测量沟通、精细运动、大肌肉运动、个人社交、问题解决和全面发展。大运动发展也由物理治疗师在6个月时使用阿尔伯塔婴儿运动量表（AIMS）进行测量。根据世界卫生组织的标准，计算婴儿在出生后18个月内达到6岁大运动里程碑（即独立坐、爬行、辅助站立、辅助行走、独立站立、独立行走）。结果：跨时间点运动行为的组成与ASQ-3大肌肉运动、问题解决和总发展得分、6个月时AIMS总分和百分位数得分以及独立站立和行走里程碑显著相关（ilr模型p值：2:0.02-0.15）。相对于其他运动行为而言，更多的睡眠时间或俯卧时间与更高级的发育和更早实现某些里程碑有关。过去的情况正好相反。与时间限制的联系是复杂的。AIMS和WHO里程碑结果的最佳运动行为持续时间（分钟/天）为俯卧时间38-43分钟，背部时间51-54分钟，约束时间43-96分钟和睡眠时间845-900分钟。结论：针对婴儿健康的运动行为模式可能是一种有希望的健康促进策略。

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引用次数: 0

Preschool Vision Screening and Policy: Availability, Awareness and Perceptions of Stakeholders in Selected Locations in Harare and Mashonaland East Provinces 学前视力筛查和政策：在哈拉雷和马绍纳兰东部省份选定地点的利益相关者的可用性、意识和看法。

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2024-12-20 DOI: 10.1111/cch.70024

Vanessa Ama Asifuaba Koomson, Claudio Ngoni Mtuwa, Samuel Kyei, Michael Agyemang Kwarteng

Background

This study aimed to determine the availability, awareness and perceptions of preschool vision screening (PSVS) and policies among stakeholders in Zimbabwe.

Methods

A descriptive cross-sectional survey was carried out, and a multi-stage sampling was used to select the schools from private and public schools. The study involved stakeholders (parents/guardians, teachers, principals, proprietors/owners and administrators) and data was collected using a validated questionnaire.

Results

The mean age of the respondents was 36.68 ± 7.84 years. Out of the 213 stakeholders, 83.1% had not heard of PSVS. Among the 36 (16.9%) who had heard of PSVS, 20 (55.6%) were female. Some (1.9%) of the participants had a policy written in their facilities for PSVS. Awareness of PSVS was significantly associated with the respondents' designation and experience with children (p < 0.05). Support for PSVS was high, with 83.1% in favour, although 13.6% were undecided about implementing it. Support for PSVS was high, with 83.1% in favour, although 13.6% were undecided about implementing it in all schools. Overall, 55.9% of the respondents were prepared to consider PSVS as a mandatory part of the admission process.

Conclusion

Few stakeholders are aware of PSVS while majority had a positive perception in Harare and Mashonaland East provinces, and the schools had no written policies on PSVS. The findings of this study should provide a blueprint for stakeholders regarding PSVS.

背景：本研究旨在确定津巴布韦利益相关者对学前视力筛查（PSVS）和政策的可得性、认识和看法。方法：采用描述性横断面调查法，采用多阶段抽样法，从民办学校和公办学校中选取学校。研究涉及利益相关者（家长/监护人、教师、校长、业主/业主和行政人员），数据收集采用有效的问卷调查。结果：调查对象平均年龄36.68±7.84岁。在213名利益相关者中，83.1%的人没有听说过psv。在听说过PSVS的36例（16.9%）中，女性20例（55.6%）。一些（1.9%）的参与者在他们的设施中为PSVS制定了政策。对PSVS的认识与受访者的指定和与儿童的经历显著相关(p结论：很少有利益相关者意识到PSVS，而在哈拉雷和马绍纳兰东部省份，大多数人有积极的看法，学校没有关于PSVS的书面政策。这项研究的结果应该为利益相关者提供一个关于psv的蓝图。

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引用次数: 0

The Role of Timing and Amount of Outdoor Play in Emotional Dysregulation in Preschool Children 户外游戏时间和数量在学龄前儿童情绪失调中的作用。

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2024-12-20 DOI: 10.1111/cch.70020

Jane J. Lee, Eirini Flouri, Yo Jackson

Background

Currently, the time children spend playing outdoors is at an all-time low. However, the existing literature suggests that outdoor play may have cognitive and emotional benefits for children.

Methods

The present study carried out a mediation analysis to explore whether amount and timing of outdoor play affects children's emotion regulation and whether working memory mediates these relations among 325 preschool children (M_age = 4.19, SD = 0.85) residing in a large Midwestern city in the United States.

Results

Results showed that greater amounts of outdoor play very early (i.e., wake-up to noon) and very late (i.e., 6 PM to bedtime) in the day were related to greater emotional dysregulation. By contrast, greater amount of outdoor play from noon to 6 PM was related to lower emotional dysregulation. Importantly, the effect of amount of outdoor play from noon to 6 PM on emotion regulation was fully mediated by working memory.

Conclusion

The findings of the present study suggest that in early childhood outdoor play that supports children's circadian rhythms may have cognitive and, in turn, emotional benefits.

背景：目前，孩子们在户外玩耍的时间处于历史最低水平。然而，现有的文献表明，户外游戏可能对儿童的认知和情感有好处。方法：本研究对美国中西部某大城市325名学龄前儿童（Mage = 4.19, SD = 0.85）进行中介分析，探讨户外游戏的数量和时间是否影响儿童的情绪调节，以及工作记忆是否在这些关系中起中介作用。结果：结果表明，每天在户外玩耍的时间越早（即从起床到中午）和时间越晚（即从下午6点到就寝时间），情绪失调的程度越高。相比之下，从中午到下午6点的户外活动时间越长，情绪失调的程度越低。重要的是，从中午到下午6点的户外游戏量对情绪调节的影响完全由工作记忆介导。结论：本研究的结果表明，在儿童早期，支持儿童昼夜节律的户外游戏可能对认知和情绪有好处。

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引用次数: 0

Aquatic Compared With Land-Based Exercises on Gross Motor Function of Children/Adolescents With Cerebral Palsy: A Systematic Review With Meta-Analysis 水上运动与陆上运动对脑瘫儿童/青少年大肌肉运动功能的影响：一项meta分析的系统综述

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2024-12-17 DOI: 10.1111/cch.70023

Elton Pauluka, Luize Souto Ceolin, Laís Coan Fontanela, Adriana Neves dos Santos

Aim

This study aimed to compare gross motor function between aquatic- and land-based exercises in children and adolescents with cerebral palsy (CP).

Methods

The authors conducted an electronic search of nine databases from their inception to 21 November 2024 (PROSPERO registration: CRD42020194121). Inclusion criteria were randomized controlled trials involving aquatic-based exercises for children and adolescents with CP, assessing gross motor function using standardized scales or tests. Three authors independently extracted data using a predetermined Excel form. The risk of bias was assessed with the PEDro scale. The body of evidence was synthesized using the GRADE approach. Meta-analysis was conducted using the Revman 5.3 program.

Results

A total of 369 children aged 2–18 years from 15 studies were included. Most participants were ambulatory and classified as having spastic hemiparetic or diparetic CP. The majority of studies had a high risk of bias and small sample sizes. Aquatic-based exercises were categorized as aquatic physical therapy, Halliwick, swimming exercises, gait training and exercises. Low-quality evidence indicated that aquatic physical therapy resulted in higher gross motor function than land-based exercises (SMD = 0.47, n = 93, 4 trials, I² = 5%, p = 0.03), with a small effect size. No significant differences were found for Halliwick or swimming exercises.

Interpretation

There is low-quality evidence, because of high risk of bias, imprecision and inconsistency, suggesting that aquatic-based exercises are comparable with land-based exercises. Future research should focus on well-designed interventions with adequate sample sizes to compare the combination of aquatic- and land-based therapies with land-based therapy alone.

目的：本研究旨在比较水上运动和陆上运动对脑瘫（CP）儿童和青少年的粗大运动功能的影响：作者对九个数据库（PROSPERO 注册号：CRD42020194121）进行了电子检索，检索时间从数据库建立之初至 2024 年 11 月 21 日。纳入标准是针对CP儿童和青少年的水上运动随机对照试验，使用标准化量表或测试评估大运动功能。三位作者使用预先确定的 Excel 表格独立提取数据。偏倚风险采用 PEDro 量表进行评估。采用 GRADE 方法对证据进行综合。使用 Revman 5.3 程序进行 Meta 分析：共纳入 15 项研究中的 369 名 2-18 岁儿童。大多数参与者都可以行走，并被归类为痉挛性偏瘫或双瘫 CP。大多数研究的偏倚风险较高，样本量较小。水上运动分为水上理疗、哈利维克、游泳练习、步态训练和练习。低质量证据表明，水上物理疗法比陆上练习能带来更高的大运动功能（SMD = 0.47，n = 93，4 项试验，I2 = 5%，p = 0.03），但影响较小。哈利维克运动和游泳运动没有发现明显差异：由于存在较高的偏倚风险、不精确性和不一致性，有低质量的证据表明水上运动与陆上运动具有可比性。未来的研究应侧重于设计良好、样本量充足的干预措施，以比较水上疗法和陆上疗法的结合与单独的陆上疗法。

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引用次数: 0

A Nationwide Cross-Sectional Survey of the Prevalence of and Association of Physical Activity With Suicidal, Psychosocial and Health-Risk Indicators Among Adolescents in Bangladesh 关于孟加拉国青少年中体育活动的流行程度及其与自杀、心理社会和健康风险指标之间关系的全国性横断面调查。

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2024-12-10 DOI: 10.1111/cch.70021

Mohammad Jobair Khan, Mohammed Usman Ali, Sayma, Balasankar Ganesan, Auwal Abdullahi, S. M. Mahmudul Hasan, Atiqur Rahman Khan, Mohammad Delwer Hossain Hawlader, Stanley John Winser

Purpose

This study investigated the associations between physical activity (PA) and suicidal behaviours, psychosocial outcomes and indicators of health risks.

Methods

This was a secondary analysis of data from the Global School-Based Student Health Survey (GSHS) database. A total of 2058 adolescents aged 11–17 years in Grades 7–10 completed a self-administered questionnaire. Sex-stratified logistic regression was used to evaluate the associations between PA and suicidal behaviours, psychosocial outcomes and indicators of health risks. We used the least absolute shrinkage and selection operator (LASSO) regression to test whether PA-related factors predicted suicidal, psychological and lifestyle-related behaviours. A generalized linear mixed model (GLMM) examined the contributions of PA to these factors.

Findings

Half of the adolescents (18.9% boys and 30.3% girls) indicated satisfactory PA per the World Health Organization guidelines. The most active group in terms of frequency of activity and walking or bicycling to school was positively associated with suicidal behaviour. Isolated adolescents reported anxiety despite frequent PA. Reduced frequency of PA was significantly associated with sexual activity, smoking, tobacco product use (girls), alcohol abuse (boys) and other drug use (boys and girls). The LASSO revealed that different PA-related factors predicted suicidal, psychological and lifestyle-related behaviour among girls and boys. The GLMM showed a significant contribution of PA to selected predictors.

Conclusion

Increased PA may lower suicidal behaviour among adolescents. The most physically active groups were associated with predictors that varied by sex; boys were bullied, whereas girls experienced physical abuse.

目的：本研究探讨了身体活动（PA）与自杀行为、心理社会结局和健康风险指标之间的关系。方法：这是对全球校本学生健康调查（GSHS）数据库数据的二次分析。共有2058名7-10年级11-17岁的青少年完成了自填问卷。使用性别分层逻辑回归来评估PA与自杀行为、心理社会结局和健康风险指标之间的关系。我们使用最小绝对收缩和选择算子（LASSO）回归来检验pa相关因素是否预测自杀、心理和生活方式相关行为。一个广义线性混合模型（GLMM）检验了PA对这些因子的贡献。结果：一半的青少年（18.9%的男孩和30.3%的女孩）根据世界卫生组织的指导方针表示满意的PA。就运动频率和步行或骑自行车上学而言，最活跃的一组与自杀行为呈正相关。孤立的青少年报告焦虑，尽管经常PA。PA频率降低与性活动、吸烟、烟草产品使用（女孩）、酗酒（男孩）和其他药物使用（男孩和女孩）显著相关。LASSO显示，不同的pa相关因素预测了女孩和男孩的自杀、心理和生活方式相关行为。GLMM显示PA对所选预测因子有显著贡献。结论：PA升高可降低青少年自杀行为。最活跃的群体与不同性别的预测因子相关；男孩被欺负，而女孩遭受身体虐待。

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引用次数: 0

Assessment of Affordances in the Home Environment and Neurodevelopment of Children With Congenital Zika Syndrome 先天性寨卡综合征儿童家庭环境和神经发育的评估

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2024-12-10 DOI: 10.1111/cch.70015

Raíne Borba, Juliane Falcão, Tatiane Freitas, Cláudia Marques, Lucélia Nóbrega, Liana O. Ventura, Juliana Sallum, Camila V. Ventura, Taciana Higino, Camilla Rocha, Anne C. Wheeler

<div> <section> <h3> Background</h3> <p>Congenital Zika syndrome (CZS) is characterized by brain abnormalities caused by in utero exposure to the Zika virus (ZIKV), resulting in significant neurodevelopmental, motor and visual impairments in affected children. These impairments hinder their ability to engage in social interactions and explore their surroundings. However, personalized and continuous sensory stimulation, particularly within the home environment, may play a crucial role in supporting motor and visual development in these children. Therefore, this study aimed to explore the relationship between sensory stimulation in the home environment and the motor and visual development of children with CZS.</p> </section> <section> <h3> Method</h3> <p>This cross-sectional study included children with CZS. The Affordances in the Home Environment for Motor Development (AHEMD) instrument was administered to caregivers to assess motor stimulation opportunities at home. All children underwent neurodevelopmental milestone assessments using the Brazilian Portuguese version of the Bayley Scales of Infant Development-Third Edition (BSID-III). Gross motor function was further assessed with the Gross Motor Function Measure (GMFM), and functional vision was evaluated by using the functional vision developmental milestones test (FVDMT).</p> </section> <section> <h3> Results</h3> <p>Eighty-five children with a mean age of 39.9 ± 2.3 (24.0–42.0) months were included. Forty-one children (48.2%) lived in homes with ‘very weak’ environmental stimulation. The children showed profound developmental delays in all domains of the BSID-III with an average neurodevelopmental age of 39.9 ± 2.3 (24–42) months. On the GMFM, over 90.0% of children could not initiate or maintain the required movements and postures for sitting, crawling, standing, walking, running and jumping. A significant positive correlation was found between the variety of home sensory stimulation with the AHEMD and the scores at the BSID-III motor scales as well as the GMFM. More fine motor materials in the home context correlated with better gross motor scores on the BSID-III (<i>p</i> = 0.016), increased likelihood of passing the ‘sitting’ (<i>p</i> = 0.041) and ‘standing’ (<i>p</i> = 0.019) items of the GMFM. Children with less visual impairment in parameters of the FVDMT [‘eye contact’ (<i>p</i> = 0.032), ‘social smile’ (<i>p</i> = 0.031) and ‘movements to achieve’ (<i>p</i> = 0.007)] had more stimulating home environment.</p> </section> <section> <h3> Conclusion</h3> <p>Nearly half of the children with CZS who exhibited neurodevelopmental delays lived in homes lacking appropriate sen

背景：先天性寨卡综合征（CZS）的特点是在子宫内接触寨卡病毒（ZIKV）导致大脑异常，导致受影响儿童出现严重的神经发育、运动和视觉障碍。这些缺陷阻碍了他们参与社会互动和探索周围环境的能力。然而，个性化和持续的感官刺激，特别是在家庭环境中，可能在支持这些儿童的运动和视觉发展方面发挥关键作用。因此，本研究旨在探讨家庭环境感官刺激与cz儿童运动和视觉发展的关系。方法：本横断面研究纳入cz患儿。对护理人员使用家庭环境中运动发展的支持度（AHEMD）来评估家庭中的运动刺激机会。所有儿童均采用巴西葡萄牙语版Bayley婴儿发育量表第三版（BSID-III）进行神经发育里程碑评估。采用大运动功能量表（GMFM）评估大运动功能，采用功能视觉发展里程碑测验（FVDMT）评估功能视力。结果：85例患儿入组，平均年龄39.9±2.3（24.0-42.0）个月。41名儿童（48.2%）生活在环境刺激“非常弱”的家庭。这些儿童在BSID-III的所有领域都表现出严重的发育迟缓，平均神经发育年龄为39.9±2.3（24-42）个月。在GMFM测试中，超过90.0%的儿童不能发起或保持所需的坐、爬、站、走、跑、跳等动作和姿势。家庭感官刺激与AHEMD的多样性与BSID-III运动量表和GMFM得分之间存在显著的正相关。在家庭环境中，更多的精细运动材料与更好的BSID-III大运动得分相关（p = 0.016），增加了通过GMFM“坐着”（p = 0.041）和“站着”（p = 0.019）项目的可能性。在FVDMT参数(“目光接触”（p = 0.032）、“社交微笑”（p = 0.031）和“实现动作”（p = 0.007）中，视觉障碍较小的儿童拥有更刺激的家庭环境。结论：近半数表现出神经发育迟缓的CZS患儿生活在缺乏适当感觉刺激的家庭中。这项研究表明，运动和视觉的发展，包括精细和大运动技能以及功能性视觉，可能会受益于家庭中游戏和刺激机会的数量和质量。

{"title":"Assessment of Affordances in the Home Environment and Neurodevelopment of Children With Congenital Zika Syndrome","authors":"Raíne Borba, Juliane Falcão, Tatiane Freitas, Cláudia Marques, Lucélia Nóbrega, Liana O. Ventura, Juliana Sallum, Camila V. Ventura, Taciana Higino, Camilla Rocha, Anne C. Wheeler","doi":"10.1111/cch.70015","DOIUrl":"10.1111/cch.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Congenital Zika syndrome (CZS) is characterized by brain abnormalities caused by in utero exposure to the Zika virus (ZIKV), resulting in significant neurodevelopmental, motor and visual impairments in affected children. These impairments hinder their ability to engage in social interactions and explore their surroundings. However, personalized and continuous sensory stimulation, particularly within the home environment, may play a crucial role in supporting motor and visual development in these children. Therefore, this study aimed to explore the relationship between sensory stimulation in the home environment and the motor and visual development of children with CZS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This cross-sectional study included children with CZS. The Affordances in the Home Environment for Motor Development (AHEMD) instrument was administered to caregivers to assess motor stimulation opportunities at home. All children underwent neurodevelopmental milestone assessments using the Brazilian Portuguese version of the Bayley Scales of Infant Development-Third Edition (BSID-III). Gross motor function was further assessed with the Gross Motor Function Measure (GMFM), and functional vision was evaluated by using the functional vision developmental milestones test (FVDMT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-five children with a mean age of 39.9 ± 2.3 (24.0–42.0) months were included. Forty-one children (48.2%) lived in homes with ‘very weak’ environmental stimulation. The children showed profound developmental delays in all domains of the BSID-III with an average neurodevelopmental age of 39.9 ± 2.3 (24–42) months. On the GMFM, over 90.0% of children could not initiate or maintain the required movements and postures for sitting, crawling, standing, walking, running and jumping. A significant positive correlation was found between the variety of home sensory stimulation with the AHEMD and the scores at the BSID-III motor scales as well as the GMFM. More fine motor materials in the home context correlated with better gross motor scores on the BSID-III (<i>p</i> = 0.016), increased likelihood of passing the ‘sitting’ (<i>p</i> = 0.041) and ‘standing’ (<i>p</i> = 0.019) items of the GMFM. Children with less visual impairment in parameters of the FVDMT [‘eye contact’ (<i>p</i> = 0.032), ‘social smile’ (<i>p</i> = 0.031) and ‘movements to achieve’ (<i>p</i> = 0.007)] had more stimulating home environment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nearly half of the children with CZS who exhibited neurodevelopmental delays lived in homes lacking appropriate sen","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Services Addressing Mental Health Needs of Youth in Physical Rehabilitation: Perspectives of Clinicians, Youth and Family Members 在身体康复中解决青少年心理健康需求的服务：临床医生、青少年和家庭成员的观点

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2024-12-04 DOI: 10.1111/cch.70019

Stephanie M. Tremblay, Shalini Lal, Mark A. Ferro, Dana Anaby

Background

Knowledge about services addressing mental health provided in a rehabilitation setting to youth with physical disabilities is limited. This study aimed to better understand the needs, supports, challenges and potential solutions to optimize rehabilitation services for co-occurring physical and mental health needs, from the perspectives of youth, family members and clinicians.

Methods

A qualitative descriptive approach using 22 individual interviews with youth, parents and clinicians from five rehabilitation centres in a large Canadian city was employed. Inductive thematic analysis was conducted.

Results

Three themes were identified across the three stakeholder groups: (1) available clinical resources for mental health (access to mental health professionals, impact of organizational structures and mandates and continuity of services during transition to adult care); (2) clinician workforce capacity (mental health knowledge, skills and professional development, and therapeutic rapport between clinician and youth); and (3) links and partnerships with key players (improved pathways to access mental health services across programmes and organizations, and family involvement and advocacy).

Conclusion

This study provides insights to barriers for mental health care (such as limited mental health knowledge, tools and professional development and access to specialists within the team, restrictive organizational mandates and disruption of services during the transition to adult care), illustrating important aspects to address. Clinicians can be better equipped to address mental health in rehabilitation settings via training opportunities and peer and organizational support in addition to establishing links with external partners. Organizations can also ensure adequate staffing and create pathways within and beyond their institutions to deliver well-coordinated mental health services in a more accessible way.

背景：在康复环境中为身体残疾的青少年提供的心理健康服务的知识是有限的。本研究旨在从青少年、家庭成员和临床医生的角度，更好地了解身心健康共存的康复服务的需求、支持、挑战和潜在解决方案。方法采用定性描述方法，对加拿大某大城市5个康复中心的22名青少年、家长和临床医生进行访谈。进行归纳主题分析。结果三个利益相关者群体确定了三个主题：(1)可用的精神卫生临床资源（获得精神卫生专业人员、组织结构和任务的影响以及向成人护理过渡期间服务的连续性）；(2)临床医生队伍能力（心理健康知识、技能和专业发展，以及临床医生与青年之间的治疗关系）；(3)与主要参与者建立联系和伙伴关系（改善各规划和组织获得精神卫生服务的途径，以及家庭参与和宣传）。本研究提供了对精神卫生保健障碍的见解（如有限的精神卫生知识、工具和专业发展以及获得团队内专家的机会、限制性的组织任务和向成人护理过渡期间服务的中断），说明了需要解决的重要方面。临床医生除了与外部合作伙伴建立联系外，还可以通过培训机会以及同伴和组织的支持，更好地解决康复环境中的心理健康问题。各组织还可以确保配备足够的人员，并在机构内外开辟途径，以更容易获得的方式提供协调良好的精神卫生服务。

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引用次数: 0

Nonpharmacological Interventions Aimed at Promoting the Mental Health of Children and Adolescents During the COVID-19 Pandemic: A Systematic Review 旨在促进COVID-19大流行期间儿童和青少年心理健康的非药物干预措施：系统综述

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2024-12-04 DOI: 10.1111/cch.70013

Carolina Villanova Quiroga, Anna Clara Sarmento Leite Caobelli, Gabriela Veiga Alano Rodrigues, Thiago Wendt Viola

Background

Interventions to promote mental health in paediatrics need to be effective, especially in crisis contexts. This systematic review proposes to compile and analyse the findings of nonpharmacological interventions conducted in samples of children and adolescents during the COVID-19 pandemic, focusing on mental health.

Methods

The research was carried out in PsycINFO, PubMed and Web of Science databases for empirical studies, including interventions in which measures of outcome variables were collected at least twice (pre and post). The studies' samples were children and adolescents up to 19 years old, and interventions were developed throughout the COVID-19 pandemic. After eligibility analyses, 16 studies were included in this review.

Results

Studies used different theoretical approaches, focusing on the promotion, prevention and treatment of mental health in specific contexts. Some were delivered online, in-person or in hybrid formats. Particularly, depression, the most frequently assessed outcome, demonstrated more favourable results within the interventions than other evaluated outcomes. However, due to the considerable risk of bias, the qualitative analysis of the results of many included studies should be performed with caution.

Conclusions

Most of the interventions necessitate further validation, highlighting the ongoing need for research in this area. However, the emergence of interventions during crises, such as the COVID-19 pandemic, provides an opportunity to expand evidence-based mental health practices, paving the way for their application in other crisis situations. Given that mental health prevention and promotion practices can be integrated into the roles of all healthcare providers, possessing insight into the most suitable evidence-based interventions can elevate the quality of care delivered.

背景：促进儿科精神卫生的干预措施必须有效，特别是在危机背景下。本系统综述建议汇编和分析在COVID-19大流行期间对儿童和青少年样本进行的非药物干预的结果，重点是心理健康。方法在PsycINFO、PubMed和Web of Science数据库中进行实证研究，包括至少两次（前后）收集结果变量测量值的干预措施。这些研究的样本是19岁以下的儿童和青少年，在COVID-19大流行期间制定了干预措施。经过合格性分析，本综述纳入了16项研究。结果研究采用了不同的理论方法，重点关注特定情境下的心理健康促进、预防和治疗。有些课程是在线授课、面对面授课或以混合形式授课。特别是，抑郁症，最常被评估的结果，在干预措施中显示出比其他评估结果更有利的结果。然而，由于存在相当大的偏倚风险，对许多纳入研究的结果进行定性分析时应谨慎。大多数干预措施需要进一步验证，突出了该领域研究的持续需求。然而，在2019冠状病毒病大流行等危机期间出现干预措施，为扩大基于证据的精神卫生做法提供了机会，为在其他危机局势中应用这些做法铺平了道路。鉴于精神卫生预防和促进实践可以纳入所有卫生保健提供者的职责，了解最合适的循证干预措施可以提高所提供护理的质量。

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引用次数: 0