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Introduction: Involving parents of children with cerebral palsy (C-CP) in home exercise programmes (HEP) is globally practiced strategy closely linked to improved physical performance and functional outcomes for the child. Nevertheless, non-adherence to HEP is increasing at an alarming rate, and little is known about the factors influencing adherence to HEP (AHEP) especially in parents of C-CP. This systematic review aimed to identify the factors enhancing AHEP among parents of C-CP to reinforce the efficacy of rehabilitation practices proposed by health professionals, researchers, and educators. Materials and methods: We conducted searches in PubMed, Scopus, CINHAL, PsycINFO, and Embase for articles published up to March 2023, that investigated the factors influencing AHEP among parents of C-CP. A narrative synthesis was conducted using the search results and pertinent material from other sources. Results: Overall, non-adherence rates to HEP were moderate to high, ranging from 34% to 79.2%. Strong evidence suggests that factors enhancing AHEP fall into three categories: child-related (such as younger age and better gross motor function [GMF]), the caregiver-related (including high self-efficacy and knowledge, strong social support, low levels of depression, anxiety and stress symptoms, and a low perception of barriers), and the physiotherapist-related. For the latter category, the parent's perception of a supportive and collaborative relationship with the therapist is one of the conditions most favourably influences AHEP. Conclusion: Our findings highlight that factors influencing AHEP are multifactorial. Some, such as GMF or the economic and social conditions of the family, are challenging to change. However, the relationship between therapist and parent is an aspect that can be strengthened. These results underscore the importance of substantial training and psychosocial support for therapists to enhance their awareness and competence in building supportive relationship with parents. [ABSTRACT FROM AUTHOR]

Background: Mandates provide a relatively cost-effective strategy to increase vaccinate rates. Since 2014, five Australian states have implemented No Jab No Play (NJPlay) policies that require children to be fully immunised to attend early childhood education and childcare services. In Western Australia, where this study was conducted, NJNPlay legislation was enacted in 2019. While most Australian families support vaccine mandates, there are a range of complexities and unintended consequences for some families. This research explores the impact on families of the NJNPlay legislation in Western Australia (WA). Methods: This mixed-methods study used an online parent/carer survey (n = 261) representing 427 children and in-depth interviews (n = 18) to investigate: (1) the influence of the NJNPlay legislation on decision to vaccinate; and (2) the financial and emotional impacts of NJNPlay legislation. Descriptive and bivariate tests were used to analyse the survey data and open-ended questions and interviews were analysed using reflexive thematic analysis to capture the experience and the reality of participants. Results: Approximately 60% of parents intended to vaccinate their child. Parents who had decided not to vaccinate their child/ren were significantly more likely to experience financial [p < 0.001] and emotional impacts [p < 0.001], compared to those who chose to vaccinate because of the mandate. Qualitative data were divided with around half of participants supporting childhood immunisation and NJNPlay with others discussing concerns. The themes (a) belief in the importance of vaccination and ease of access, (b) individual and community protection, and (c) vaccine effectiveness, safety and alternatives help understand how parents' beliefs and access may influence vaccination uptake. Unintended impacts of NJNPlay included: (a) lack of choice, pressure and coercion to vaccinate; (b) policy and community level stigma and discrimination; (c) financial and career impacts; and (d) loss of education opportunities. Conclusions: Parents appreciation of funded immunisation programs and mandates which enhance individual and community protection was evident. However for others unintended consequences of the mandate resulted in significant social, emotional, financial and educational impacts. Long-term evidence highlights the positive impact of immunisation programs. Opinions of impacted families should be considered to alleviate mental health stressors. [ABSTRACT FROM AUTHOR]

Background: Parental feeding practices (PFPs) play a key role in fostering preschoolers' dietary habits and in mitigating the risk of childhood obesity. Nevertheless, parents often employ inappropriate feeding practices, leading to children's potential nutrition-related issues. Thus, research is needed to inform interventions that focus on optimizing feeding practices. Methods: This protocol describes the evaluation of a novel intervention—Empowering Parents to Optimize Feeding Practices (EPO-Feeding Program). The program will be evaluated with a two-arm feasibility randomized controlled trial (RCT) in Yangzhou, China. The program includes four weekly group-based training sessions led by healthcare professionals for parents of preschool children. The intervention incorporates sessions, group discussions, motivational interviewing, and supplementary materials (e.g., key messages and educational videos) aimed at enhancing parents' knowledge, skills, and behaviours related to feeding practices. The primary outcomes include i) implementation feasibility, primarily assessed through retention rates; and ii) program acceptability through a survey and qualitative process evaluation. Secondary outcomes encompass the potential impacts on i) PFPs, ii) parental perception of child weight (PPCW), iii) parenting sense of competence, iv) children's eating behaviours, and v) child weight status. Quantitative analyses include descriptive estimates for evaluating the feasibility and linear mixed regression analysis for testing the potential effects. Qualitative valuation will use thematic framework analysis. Discussion: If this study shows this program to be feasible to implement and acceptable to parents, it will be used to inform a fully powered trial to determine its effectiveness. The research will also help inform policy and practices in the context of child nutrition promotion, particularly regarding implementing group-based training sessions by healthcare providers in similar settings. Trial registration: Clinicaltrials.gov, Protocol #NCT06181773, 20/11/2023. [ABSTRACT FROM AUTHOR]

Objectives: To assess racial and ethnic minority parents' perceptions about barriers to well-child visit attendance. Methods: For this cross-sectional qualitative study, we recruited parents of pediatric primary care patients who were overdue for a well-child visit from the largest safety net healthcare organization in central Massachusetts to participate in semi-structured interviews. The interviews focused on understanding potential knowledge, structural, and experiential barriers for well-child visit attendance. Interview content was inductively coded and directed content analysis was performed to identify themes. Results: Twenty-five racial and ethnic minority parents participated; 17 (68%) of whom identified Spanish as a primary language spoken at home. Nearly all participants identified the purpose, significance, and value of well-child visits. Structural barriers were most cited as challenges to attending well-child visits, including parking, transportation, language, appointment availability, and work/other competing priorities. While language emerged as a distinct barrier, it also exacerbated some of the structural barriers identified. Experiential barriers were cited less commonly than structural barriers and included interactions with office staff, racial/ethnic discrimination, appointment reminders, methods of communication, wait time, and interactions with providers. Conclusions: Racial and ethnic minority parents recognize the value of well-child visits; however, they commonly encounter structural barriers that limit access to care. Furthermore, a non-English primary language compounds the impact of these structural barriers. Understanding these barriers is important to inform health system policies to enhance access and delivery of pediatric care with a lens toward reducing racial and ethnic-based inequities. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate executive function (EF), such as inhibition and working memory, in children with isolated growth hormone deficiency (IGHD) using performance-based tests and parent-report scales. Methods: A total of seventy children between the ages of 7 and 12 years were included in the study. Half (n=35) had children with IGHD and half were healthy controls. To evaluate the EF performances of the participants, the Visual Aural Digit Span Test-B Form (VADS-B) and Stroop task were applied. EF was also evaluated using the Behavior Rating Inventory of Executive Function (BRIEF). Results: Children with IGHD scored lower on the VADS-B form for short-term memory (p<0.05) compared to healthy controls. In addition, the completion time for the Stroop-color/word test was significantly longer in children with IGHD (p<0.05). For children with IGHD, their parents reported higher scores on all sub-scales of the BRIEF scale, with statistically significant differences for all sub-scales with the exception of “organization of materials” (p<0.05). Conclusion: In this study, children with IGHD had poorer EF skills compared to unaffected peers. EF skills may influence academic success by affecting children’s language skills, mathematical comprehension, cognitive flexibility, and hypothetical thinking. We believe that psychiatric evaluation of children with IGHD before and during treatment may positively contribute to both their academic performance and social relationships. [ABSTRACT FROM AUTHOR]

Aim: To explore the perceptions of parents of children with cerebral palsy (CP) participating in a modified sports intervention, Sports Stars Brazil. Method: Parents of children with CP (n = 15, 6–12 years old, nine males, six females), classified in Gross Motor Function Classification System levels I and II, who participated in the Sports Stars Brazil intervention, were recruited for this descriptive qualitative study. Children received the 8‐week (1 hour per week) modified sports intervention. After the intervention, parents participated in a focus group. The F‐word (fitness, family, fun, functioning, friends, and future) interpretation of the International Classification of Functioning, Disability and Health was used to guide the discussion. Participants were invited to report their experience of participating in the intervention using the F‐words for a childhood disability model. Transcripts were coded using content analysis. Results: Parents reported positive experiences of the Sports Stars Brazil intervention, including a decrease in sedentarism (fitness), improvement of motor skills (functioning), greater connection between child and family (family), better socialization (friends), increased participation in pleasurable activities (fun), and awareness of the importance of physical activity (future). All positive experiences were interconnected. Interpretation: This study presents the ability of the Sports Stars Brazil intervention to integrate all aspects of functioning and supports its role as an engaging and promising intervention option for ambulant children with CP. What this paper adds: The parents of children participating in Sports Stars Brazil perceived benefits across all F‐words.This modified sports intervention integrated all F‐words into one concept. [ABSTRACT FROM AUTHOR]

Adolescents' perceptions of parent and peer norms about externalizing behaviors influence the extent to which they adopt similar attitudes, yet little is known about how the trajectories of perceived parent and peer norms are related to trajectories of personal attitudes across adolescence. Neural development of midline regions implicated in self–other processing may underlie developmental changes in parent and peer influence. Here, we examined whether neural processing of perceived parent and peer norms in midline regions during self-evaluations would be associated with trajectories of personal attitudes about externalizing behaviors. Trajectories of adolescents' perceived parent and peer norms were examined longitudinally with functional neuroimaging (n = 165; ages 11–16 years across three waves; 86 girls, 79 boys; 29.7% White, 21.8% Black, 35.8% Latinx, 12.7% other/multiracial). Behavioral results showed perceived parent norms were less permissive than adolescents' own attitudes about externalizing behaviors, whereas perceived peer norms were more permissive than adolescents' own attitudes, effects that increased from early to middle adolescence. Although younger adolescents reported less permissive attitudes when they spontaneously tracked perceived parent norms in the ventromedial and medial pFCs during self-evaluations, this effect weakened as they aged. No brain–behavior effects were found when tracking perceived peer norms. These findings elucidate how perceived parent and peer norms change in parallel with personal attitudes about externalizing behaviors from early to middle adolescence and underscore the importance of spontaneous neural tracking of perceived parent norms during self-evaluations for buffering permissive personal attitudes, particularly in early adolescence. [ABSTRACT FROM AUTHOR]

Background: Many governments worldwide have established guidelines regarding children's physical activity and sedentary behaviors linked to positive health outcomes. While research has established low adherence to these guideline levels, it is unclear whether parents' knowledge, perceptions, and support around these behaviors might be barriers to adherence. Aims: This study examines parents' knowledge and agreement with guideline levels of physical activity, screen time, and sleep time, as well as their support for these behaviors. Methods: Parents of 5–12-year-old children who presented to a regional general practitioner (GP) office in New South Wales (NSW) responded to a survey regarding their child's physical activity, screen, and sleep time, as well as what they believed to be guideline levels, their perceived ideal levels, and the levels of support they provide for each of these behaviors. Results: Parents' perceived ideal levels for their child's physical activity and screen time were more ambitious than government levels and were consistent with sleep time guidelines. There were, however, few associations between parent support levels and children's actual or perceived ideal levels of these behaviors. Discussion: The findings suggest that parents' perceptions of ideal levels of physical activity and sedentary behavior may not hinder adherence to government guidelines. However, inconsistent, or ineffective support strategies can constrain adherence and thus be a viable intervention target. [ABSTRACT FROM AUTHOR]

Background: The retail market for toddler-specific packaged foods is growing. Many of these products are ultra-processed and high in nutrients of concern for health, yet marketed in ways that may make them appear wholesome. This study aims to assess parents' responses to claims on unhealthy, ultra-processed toddler food products and test whether removing such claims promotes more accurate product perceptions and healthier product preferences. Methods: Parents of toddlers aged 12 to < 36 months (N = 838) were recruited for an online experiment testing four on-pack claim conditions: control (no claim); 'contains "good" ingredient'; 'free from "bad" ingredient'; and unregulated 'child-related' claim. Participants were randomly assigned to one condition, then viewed images of toddler food products that varied in nutrition content and the claims displayed. Participants completed tasks assessing product preferences (unhealthy product displaying claim vs. a healthier option with no claim, across four food categories (banana bars, strawberry snacks, blueberry yogurt snacks and veggie snacks)), purchase intentions and product perceptions. Poisson regression (count variable) and linear regression (continuous outcomes) analyses were employed to test for mean differences by marketing claim conditions. Results: For the overall sample, brief exposure to 'free from "bad" ingredient' claims increased participant's intentions to purchase unhealthy food products for their toddlers, but there was no clear evidence that 'contains "good" ingredient' claims and 'child-related' claims significantly impacted parent's preferences, purchase intentions and perceptions of toddler foods. However, certain claims influenced particular parent subgroups. Notably, parents with three or more children chose more unhealthy products when these products displayed 'contains "good" ingredient' or 'free from "bad" ingredient' claims; the latter claims also promoted stronger purchase intentions and enhanced product perceptions among this subgroup. Conclusions: Findings indicate that 'free from "bad" ingredient' claims on unhealthy toddler foods are of most concern, as they boost the appeal of these products to parents. 'Contains "good" ingredient' claims and 'child-related' claims showed limited effects in this study. Considering available evidence, we recommend claims should not be permitted on child-oriented foods, as they may promote inaccurate product perceptions and unhealthy product choices by parents, that can detract from their children's diets and health. [ABSTRACT FROM AUTHOR]

Background: Due to early synanthropization and ecological and behavioural features, the White Stork Ciconia ciconia became the most cherished of European birds. Rooted in human culture, the species has been well studied; nevertheless, knowledge of people's attitudes and stork-related folk beliefs remain descriptive. Here, we attempt to quantify these issues in the world's largest stronghold of the species, Poland, in the 1950s. Methods: The study is based on recently discovered, original nationwide survey data from the 1958 International White Stork Census. These materials were gathered to assess the population size, but they also included issues belonging to the humanities. We have worked them up in a quantitative manner, which has resulted in an original approach rarely found in ethnological studies. We aim to propose an original typology of stork-related beliefs, their spread and regional diversity in Poland and the relationship with stork abundance. Results: A sample of 2343 questionnaires revealed that affection towards storks was widespread (91.4% positive responses), more so in eastern Poland. The most frequent beliefs relate to respect for the stork (65%) and prophesies (24%), thereafter parental beliefs (7%) and stork biology (3%). Positive attitudes and the dissemination of beliefs increased with stork densities but were unrelated to the respondents' sex. Utilitarian beliefs outweighed those prioritized in ethnographic studies (e.g. the stork's human origins) or popular today (baby-bringing), and expressed the real concerns of country folk. Conclusions: The discovery of long-lost data bordering on ethnology and nature conservation and their novel work-up highlights a realistic dimension of the human–nature relationship and provides a benchmark for further interdisciplinary research. [ABSTRACT FROM AUTHOR]

Background: The newly developed malaria vaccine called "R21/Matrix-M malaria vaccine" showed a high safety and efficacy level, and Ghana is the first country to approve this new vaccine. The present study aimed to evaluate the rate of vaccine hesitancy (VH) towards the newly developed malaria vaccine among parents who currently have children who are not eligible for the vaccine but may be eligible in the near future. Additionally, the study aimed to identify the factors that could potentially influence VH. Methods: A cross-sectional survey using both online-based questionnaires and face-to-face interviews was conducted in Ghana from June to August 2023. The survey specifically targeted parents of ineligible children for vaccination, including those aged less than 5 months or between 3 and 12 years. The Parent Attitudes about Childhood Vaccination (PACV) scale was used to assess parental VH. Results: A total of 765 people participated in this study. Their median age was 36.0 years with an interquartile range of 31.0–41.0 years, 67.7% were females, 41.8% completed their tertiary education, 63.3% were married, 81.6% worked in non-healthcare sectors, and 59.7% reported that their monthly income was insufficient. About one-third (34.5%) of the parents were hesitant to give their children the R21/Matrix-M malaria vaccine. The following predictors were associated with VH: working in the healthcare sector (adjusted odds ratio (AOR) = 0.50; 95% confidence interval (CI) 0.30–0.80; p = 0.005), having the other parent working in the healthcare sector (AOR = 0.54; 95% CI 0.30–0.94; p = 0.034), and not taking scheduled routine vaccinations (AOR = 1.90; 95% CI 1.27–2.84; p = 0.002). Conclusions: Addressing VH is crucial for optimizing R21/Matrix-M vaccine coverage in Ghana's malaria control strategy. By tackling VH issues, Ghana can effectively safeguard children's health in malaria-prone areas. [ABSTRACT FROM AUTHOR]

Background: Posttraumatic stress (PTS) and anxiety are common mental health problems among parents of babies admitted to a neonatal unit (NNU). This review aimed to identify sociodemographic, pregnancy and birth, and psychological factors associated with PTS and anxiety in this population. Method: Studies published up to December 2022 were retrieved by searching Medline, Embase, PsychoINFO, Cumulative Index to Nursing and Allied Health electronic databases. The modified Newcastle–Ottawa Scale for cohort and cross-sectional studies was used to assess the methodological quality of included studies. This review was pre-registered in PROSPERO (CRD42021270526). Results: Forty-nine studies involving 8,447 parents were included; 18 studies examined factors for PTS, 24 for anxiety and 7 for both. Only one study of anxiety factors was deemed to be of good quality. Studies generally included a small sample size and were methodologically heterogeneous. Pooling of data was not feasible. Previous history of mental health problems (four studies) and parental perception of more severe infant illness (five studies) were associated with increased risk of PTS, and had the strongest evidence. Shorter gestational age (≤ 33 weeks) was associated with an increased risk of anxiety (three studies) and very low birth weight (< 1000g) was associated with an increased risk of both PTS and anxiety (one study). Stress related to the NNU environment was associated with both PTS (one study) and anxiety (two studies), and limited data suggested that early engagement in infant's care (one study), efficient parent-staff communication (one study), adequate social support (two studies) and positive coping mechanisms (one study) may be protective factors for both PTS and anxiety. Perinatal anxiety, depression and PTS were all highly comorbid conditions (as with the general population) and the existence of one mental health condition was a risk factor for others. Conclusion: Heterogeneity limits the interpretation of findings. Until clearer evidence is available on which parents are most at risk, good communication with parents and universal screening of PTS and anxiety for all parents whose babies are admitted to NNU is needed to identify those parents who may benefit most from mental health interventions. [ABSTRACT FROM AUTHOR]

This cross-sectional study, conducted between January 2020 and July 2023, aimed to assess the knowledge, attitude, and post-traumatic stress symptoms (PTSS) among parents with children undergoing extracorporeal membrane oxygenation (ECMO) treatment. Out of 201 valid questionnaires collected, the median knowledge score was 3.00, the mean attitude score was 27.00 ± 3.20, and the mean PTSS score was 3.50 ± 1.54. Logistic regression identified associations between PTSS and parents with lower education levels, particularly junior high school and high school/technical secondary school education, as well as those occupied as housewives. Structural equation modeling highlighted direct effects, such as the impact of residence on education, education on employment status, and associations between knowledge, attitude, PTSS, employment status, monthly income, and parental demographics. The findings indicated inadequate knowledge and suboptimal attitudes among parents, especially those with lower education levels, emphasizing the need for educational resources. Furthermore, addressing parental PTSS through psychosocial support and screening was deemed essential, providing valuable insights for tailored interventions in this context. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the factor structure and measurement invariance of the three-factor (nurturance, monitoring, discipline) 29-item Parenting Practices Scale across four Caribbean islands—Jamaica, St. Kitts and Nevis, The Bahamas, and St. Vincent and the Grenadines—with data from 1948 adolescent Caribbean grade 10 students. Exploratory factor analysis and confirmatory factor analysis were conducted, and the findings supported the original three-factor model, and factor loading invariance was found across the four Caribbean islands. These findings suggest that this parenting measure may be used to compare perceptions of parental behaviors among adolescents in the English-speaking Caribbean with some limitations that are discussed. [ABSTRACT FROM AUTHOR]

PURPOSE The experience of ethnically diverse parents of children with serious illness in the US health care system has not been well studied. Listening to families from these communities about their experiences could identify modifiable barriers to quality pediatric serious illness care and facilitate the development of potential improvements. Our aim was to explore parents' perspectives of their children's health care for serious illness from Somali, Hmong, and Latin-American communities in Minnesota. METHODS We conducted a qualitative study with focus groups and individual interviews using immersion-crystallization data analysis with a community-based participatory research approach. RESULTS Twenty-six parents of children with serious illness participated (8 Somali, 10 Hmong, and 8 Latin-American). Parents desired 2-way trusting and respectful relationships with medical staff. Three themes supported this trust, based on parents' experiences with challenging and supportive health care: (1) Informed understanding allows parents to understand and be prepared for their child's medical care; (2) Compassionate interactions with staff allow parents to feel their children are cared for; (3) Respected parental advocacy allows parents to feel their wisdom is heard. Effective communication is 1 key to improving understanding, expressing compassion, and partnering with parents, including quality medical interpretation for low-English proficient parents. CONCLUSIONS Parents of children with serious illness from Somali, Hmong, and Latin-American communities shared a desire for improved relationships with staff and improved health care processes. Processes that enhance communication, support, and connection, including individual and system-level interventions driven by community voices, hold the potential for reducing health disparities in pediatric serious illness. [ABSTRACT FROM AUTHOR]

This article presents a study that investigated the effects of using the Innowalk Pro robotic rehabilitation trainer on the quality of life of children with severe cerebral palsy. The study found that the use of this trainer had positive impacts on the children's quality of life, range of movement, and functional goals. The article also provides summaries of various research studies on cerebral palsy, covering topics such as interventions, cognitive functioning, visual impairments, school readiness, parenting experiences, urinary incontinence, assessment tools, motor function, and participation. The findings emphasize the importance of early intervention, understanding diverse needs, and providing support for individuals with cerebral palsy and their families. However, further research is needed to fully apply these findings in clinical practice. [Extracted from the article]

In this study, an investigation was conducted into the types of attitudes that parents may have of gifted students and gifted education, and the predictors of these attitudes. Using data collected from 331 parents of students enrolled in a Christian faith-based school system in one of the eight states/territories of Australia, multiple analyses, including exploratory factor analysis and latent profile analysis, were performed. The results revealed three subgroups of parents, each representing distinct attitude profiles (i.e., "strong", "moderate" and "weak" supporters of gifted students and gifted education). Furthermore, we found nine variables to be potential predictors of parent attitudes, including perceptions of the giftedness of one's child, and the anticipated socio-emotional and academic impacts of giftedness and gifted education. Some of the important contributions of the study to the research literature included the distinction made by parents between attitudes toward gifted education adaptations and attitudes toward special gifted education settings, and the comparatively large number of parents who are moderately (rather than strongly or weakly) supportive of gifted students and gifted education. [ABSTRACT FROM AUTHOR]

Background: Parents of preterm infants in the Neonatal Intensive Care Unit (NICU) environment may experience psychological distress, decreased perceived self-efficacy, and/or difficulties in establishing an adaptive parent-infant relationship. Early developmental care interventions to support the parental role and infant development are essential and their impact can be assessed by an improvement of parental self-efficacy perception. The aims were to assess the effects of an early intervention provided in the NICU (the Joint Observation) on maternal perceived self-efficacy compared to controls (primary outcome) and to compare maternal mental health measures (perceived stress, anxiety, and depression), perception of the parent-infant relationship, and maternal responsiveness (secondary outcomes). Methods: This study was a monocentric randomized controlled trial registered in clinicatrials.gov (NCT02736136), which aimed at testing a behavioural intervention compared with treatment-as-usual. Mothers of preterm neonates born 28 to 32 6/7 weeks gestation were randomly allocated to either the intervention or the control groups. Outcome measures consisted of self-report questionnaires completed by the mothers at 1 and 6 months after enrollment and assessing perceived self-efficacy, mental health, perception of the parent-infant relationship and responsiveness, as well as satisfaction with the intervention. Results: No statistically significant group effects were observed for perceived maternal self-efficacy or the secondary outcomes. Over time, perceived maternal self-efficacy increased for mothers in both groups, while anxiety and depression symptoms decreased. High satisfaction with the intervention was reported. Conclusions: The joint observation was not associated with improved perceived maternal self-efficacy or other mental health outcomes, but may constitute an additional supportive measure offered to parents in a vulnerable situation during the NICU stay. [ABSTRACT FROM AUTHOR]

Background: Children Snoring is a common childhood disorder that affects the growth and development of children and is detrimental to their health. Increasing awareness of Children Snoring among parents is important. Aim: To develop the Knowledge-Attitude-Practice of Parents towards Children Snoring Scale and test the reliability and validity of the scale. Methods: The development of the tool was divided into two phases involving 1257 parents from China. In the first phase, an initial project bank was created through a literature review. This was followed by a Delphi expert consultation, group discussion and pre-survey. The second stage screened the items and conducted an exploratory factor analysis, then conducted a confirmatory factor analysis and tested for reliability and validity. Results: Support was found for the 25-item Knowledge-Attitude-Practice toward Children Snoring scale. Exploratory and confirmatory factor analyses provide support for four subscales: (parental basic cognition toward Children Snoring; parents' perception of complications of Children Snoring; parents' attitude towards Children Snoring; parents' concern and prevention of Children Snoring). Internal consistency for the total scale was high (Cronbach's α = 0.93). The intraclass correlation coefficient of test-retest reliability was 0.92 (95%CI: 0.85 to 0.95), which provided support for the stability of the scale. Conclusion: The Knowledge-Attitude-Practice of Parents towards Children Snoring scale shows promise as a measure that may be used by medical workers and community children's health managers. [ABSTRACT FROM AUTHOR]

Background: In the context of healthcare, satisfaction is the attainment of adequate or acceptable treatment and serves as both a benchmark for quality and the ultimate objective of providing care. In neonatal care facilities, parent satisfaction is a key measure of the quality of the services offered to the newborns and aids in improving healthcare delivery. This is the first systematic review aiming to address critical knowledge gaps regarding factors influencing parental satisfaction with neonatal intensive care unit services, and determine pooled prevalence in Ethiopia. Methods: After comprehensive systematic search for full texts in the English language through an electronic web-based search strategy from databases of PubMed, CINAHL, Embase, African Journals Online, PsycINFO, and Google Scholar, included a total of 8 articles. Checklists from the Joanna Briggs Institute were used to assess the studies' quality of methodology. STATA version 14 software for windows was used for all statistical analyses and meta-analysis was done using a random-effects method. Subgroup and sensitivity analyses were performed to clarify the source of heterogeneity. Results: Pooled national level of parents' satisfaction with neonatal intensive unit service was 57.87% (95% CI (49.99, 65.75%)). Age of respondents and availability of chair were significantly associated with parents' satisfaction with neonatal intensive unit service. Conclusions and recommendation: In our review we found that nearly half of parents expressed dissatisfaction with neonatal intensive unit service, which is high. Age of respondents and availability of chair in neonatal intensive unit waiting area were significantly associated with neonatal intensive unit service. Efforts to enhance parental satisfaction with neonatal intensive unit services are crucial, given that nearly half of parents reported dissatisfaction. Necessary infrastructure should be fulfilled to increase parental satisfaction with neonatal intensive unit service. (PROSPERO) International prospective register of systematic reviews: CRD42023483474 [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) pandemic has rapidly spread worldwide and affected the healthcare system, including the deferral of surgical practice. There are various reactions regarding delayed surgeries, but parental viewpoints towards circumcision remain scarce. In light of the pandemic, this study aimed to evaluate how parents feel about circumcision and the probable determining variables. Materials and Methods: This study is a cross-sectional study based on an online questionnaire available from March to April 2022. The factors affecting the decision were analysed using logistic regression. Results: Of 1,218 (26.28%) parents who completed the survey, 879 (18.96%) met the inclusion criteria and were included in this study. Among them, 615 (70.00%) parents agreed to delay circumcision during the COVID-19 pandemic. These respondents were more likely to be non-Muslim (P = 0.01), have no relatives whose work is related to medicine or paramedicine (P = 0.02) and have monthly income equal to or below the regional minimum wage (P = 0.03). After adjusting the potential confounder, non-Muslim religion (odds ratios, 2.87; 95% confidence interval, 1.27-6.49; P = 0.012) was found to be the only independent predictor for agreeing to the deferral of circumcision amid the pandemic. Conclusion: Most parents agreed to postpone circumcision due to the fear of COVID-19 exposure. In order to help them feel less apprehensive about this matter, it is important to educate them about the medical benefits of circumcision and the safety of this procedure. [ABSTRACT FROM AUTHOR]

Background: A high incidence of children with congenital heart disease (CHD) was found in Saudi Arabia (SA). International literature reports that children with CHD exhibit behavioural and emotional issues due to experiencing hospitalisation and clinical treatments combined with a dearth of qualitative understanding of the experiences of younger children with CHD. Therefore, the aim was to explore the behaviour and emotions of 4–10‐year‐olds with CHD in SA through children's accounts of their own experiences and parental proxy reports of children's behaviour and emotions. Methods: Charmaz's constructivist grounded theory (GT) approach was used. Twenty single semi‐structured interviews of 10 child/parent dyads were undertaken at a hospital clinic in SA. Children's interviews were combined with an arts‐based approach using drawings, pictures and faces of emotions (emojis). Constant comparison analysis was undertaken. Consolidated Criteria for Reporting Qualitative Research guidelines was followed in reporting this study. Findings: A substantive GT: children's behavioural and emotional reactions towards stressors related to living with CHD was developed and provides new insights into children's and parents' perceptions of the children's behavioural and emotional reactions to living with CHD in SA. The theory proposes that children's reactions to living with CHD relate to medical treatment stressors, sociocultural stressors and physical change stressors. Several further factors influenced children's responses to these stressors. Conclusion: Children and parents in SA contributed to a new understanding of the relationship between CHD and children's behavioural and emotional reactions. In addition, findings support the need for early assessment of behaviour and emotions among children with CHD and the application of preventative and supportive measures for the children and their families in SA. Patient or Public Contribution: Before the research commenced, the developmental appropriateness of the proposed arts‐based data collection tools was tested with three healthy children aged 6–9 years old; the tools were then revised accordingly before the interviews were undertaken. [ABSTRACT FROM AUTHOR]

Background: The beginning of the COVID-19 pandemic marked a period of uncertainty as public health guidelines, diagnostic criteria, and testing protocols or procedures have continuously evolved. Despite the virus being declared a worldwide pandemic, little research has been done to understand how parents manage caring for their child diagnosed with COVID-19. We sought to understand parents' experiences and information need when caring for a child diagnosed with COVID-19. Methods: A qualitative descriptive study with an inductive and exploratory approach was completed. Participants were recruited through social media and local public health clinics. Data collection and analysis were concurrent. Semi-structured virtual interviews were conducted with 27 participants. Thematic analysis was conducted. Findings: Four major themes emerged: a) dealing with uncertainty; b) anxiety; c) social stigma and stress; d) a sense of community. Conclusion: Our study highlights that parent experiences were diverse and multi-faceted, and their experiences evolved and shifted over the course of the pandemic. Parents would benefit from clear and consistent evidence-based online information. Understanding the perspectives of parents caring for a child with COVID-19 is an important step in developing future resources tailored to meet their unique experiences and information needs. [ABSTRACT FROM AUTHOR]

Many physical education teachers and teachers of students with visual impairments have difficulty including children with visual impairment and additional disabilities. The lack of appropriate opportunities by teachers places this burden on parents to be more involved in their child's physical education programming. Parents can be key stakeholders in helping their children know the solutions to the barriers to involvement in physical activity and sports. As a result of parental involvement in their child's physical education, the child's motor competence may improve. Therefore, the purpose of this study was to determine the perceptions of parents with children with visual impairments and additional disabilities regarding their child's physical education. A survey was developed and validated by experts in the field. The analyses of this mixed methods survey included frequency analyses of the quantitative data and themes from the open-ended questions. Seventy-four parents/guardians with children with visual impairment including moderate to severe disabilities participated. Parental responses indicated that most children were provided physical education services; however, only 50% are satisfied with their child's physical education experiences. While most parents indicated they were actively involved with their child's programming, many barriers and support needs indicated a dire need for more training to support both parents and educators of youth with visual impairments and additional disabilities. [ABSTRACT FROM AUTHOR]

Middle school (MS) parents may benefit from education supporting timely concussion identification and care-seeking in their young children (aged approximately 10 to 15 years). However, such education may not consider individual needs and different social context factors, including lower socioeconomic status, disadvantaged social determinants of health, and different racial and ethnic backgrounds. To examine the relationship between social context factors and concussion knowledge, attitudes, and communication in MS parents and to explore the possible role of race and ethnicity (Black or White) as an effect measure modifier. Cross-sectional study. Online survey. A nationally representative sample of MS parents who completed an online survey (n = 1248). Parent outcomes were a history of concussion education, concussion symptom knowledge and attitudes, and communication with children about concussion. Main exposures were parental race and ethnicity (Black or White) and social context factors. Uni- and multivariable statistical analyses were performed to achieve the study aims. Black parents were more likely than White parents to have received concussion education (69.5% versus 60.5%, P =.009), although median concussion knowledge scores were higher for White parents than for Black parents (40 versus 37, P <.001). Few associations were found for social context factors with concussion knowledge, attitudes, and communication in Black and White parents separately. Among MS parents, race and ethnicity may not influence the association between social context factors and concussion-related knowledge, attitudes, or communication. However, differences were present by race and ethnicity regarding previous concussion education and other parental outcomes, concussion symptom knowledge in particular. [ABSTRACT FROM AUTHOR]

Background: Parental vaccine hesitancy could lead to outbreaks of vaccine-preventable diseases. Although parental vaccine hesitancy exists in the Vietnamese community, no research has directly investigated this social phenomenon in Vietnam. Among the validated measures, the 15-item Parent Attitudes About Childhood Vaccines survey tool (PACV) was reliable for predicting vaccine-hesitant parents. However, the PACV was not available in Vietnamese. This study aimed to develop a Vietnamese version of the PACV and examine factors associated with parental vaccine hesitancy in Hue city, Vietnam. Methods: This study was a cross-sectional study. The English PACV was translated into Vietnamese with content and face validation. Self-administered questionnaires were distributed to 400 parents at ten commune health centres in Hue city, Vietnam. The parents were asked to answer the questionnaire again after two weeks for the test–retest reliability. The Vietnamese PACV reliability was assessed using Cronbach's alpha and McDonald's omega, and the intra-class correlation (ICC) coefficients were used for the test–retest reliability. The construct validity was tested by the hypothesis that parental vaccine hesitancy would be related to the intention of getting the children vaccinated. Exploratory factor analysis was also undertaken to determine the construct validity. Bivariate and multivariable logistic regression were used to identify the factors associated with parental vaccine hesitancy. Results: The Vietnamese PACV final version (PACV-Viet) contained 14 items. Three hundred and fifteen parents returned completed questionnaires, giving a response rate of 78.8%. The Cronbach's alpha and McDonald's omega were 0.72 and 0.70, respectively. Out of 315 parents, 84 responses were returned for test–retest reliability. All ICCs were good to excellent, ranging from 0.81 to 0.99. The PACV-Viet was confirmed to have construct validity. Using the PACV-Viet, 8.9% of the parents were found hesitant to childhood vaccination. Being unemployed and having seen the news about adverse events following immunisation were associated with parental vaccine hesitancy, with AOR = 3.2 (95% CI 1.3–8.0) and AOR = 4.5 (95% CI 1.2–16.7), respectively. Conclusions: The PACV-Viet is a valid and reliable tool. Community outreach is necessary to alleviate parents' concerns about childhood vaccination. [ABSTRACT FROM AUTHOR]

Inclusive education is very important for all children especially for those with special needs. In the Republic of Kosovo, the inclusion it is an approach in progress. This study aimed to explore the attitudes of parents of children with special needs towards inclusive education. The current findings of inclusiveness, challenges, risks, benefits and achievements of inclusive education in the Kosovo education system were also analysed. Through a semi-structured interview, ten parents whose children attend regular classes in various schools in pre-university education in Kosovo were interviewed. The results of the research indicate that parents of children with special needs have similar attitudes towards inclusion. In their opinion, it should occur, but they are worried about the challenges that appear. Inclusion is seen as a good opportunity, capacity building, equality, socialization and part of the overall development of the child. Parents recommend improvements in infrastructure conditions and human resources for successful inclusion. [ABSTRACT FROM AUTHOR]

Being a parent of a child who exhibits atypical developmental patterns and encounters numerous difficulties necessitates parents to assume the roles of advocates and coordinators for their child's services, thereby limiting the scope for personal fulfillment. This research endeavors to ascertain whether disparities exist in the quality of life between parents of typically developing children and parents of children with autism. Additionally, it aims to explore parental satisfaction with parenthood and the experience of parental stress. The study encompassed a cohort of 90 families, comprising 45 families with typically developing children and 45 families with children diagnosed with autism. To facilitate data collection, a comprehensive questionnaire was devised, capturing fundamental information. Furthermore, two scales, namely the Parental Satisfaction Scale and the Parental Stress Scale, were employed to assess parental perspectives. The results, obtained through nonparametric group comparison techniques, substantiate a significantly heightened level of parental stress among parents of children with autism. Moreover, noteworthy discrepancies were observed across essential domains of parental satisfaction. An unprecedented finding arising from this investigation, not documented in extant literature, pertains to the prevalent inclination of parents whose firstborn and solitary child has autism to conceive another child, motivated by apprehensions of autism recurrence and concerns surrounding their capacity to devote sufficient attention to a child with autism. [ABSTRACT FROM AUTHOR]

Aim: To identify and analyse ways in which parents are supported to deliver rehabilitation exercises to their child after traumatic brain injury (TBI), conceptualized as strategies. Method: A systematic search was completed using seven online databases and three grey literature databases, from inception to November 2021. The included studies focused on physical rehabilitation in children after TBI with the involvement of parents as hands‐on deliverers or facilitators of rehabilitation (e.g. supervising the exercise). Intervention descriptions were reviewed to identify strategies; this was followed by fine‐grained analysis using the Behaviour Change Wheel to identify intervention components. Risk of bias was analysed using the revised Cochrane Risk‐of‐Bias Tool for Randomized Trials or the Risk Of Bias In Non‐randomized Studies ‐ of Interventions. Results: Six interventions including 211 participants and one trial protocol met the inclusion criteria. All studies included a proportion of children diagnosed with TBI and four studies included mixed samples of acquired brain injury or cerebral palsy. All interventions included elements of goal setting and instruction. Interpretation: Interventions focus heavily on the initiation of physical rehabilitation, but focus less on the longer‐term maintenance of rehabilitation delivery. Further research should integrate perspectives from parents to inform the development of new interventions. What this paper adds: Parents need support to deliver or supervise rehabilitation exercises.The interventions identified in this review supported goal setting, action planning, and learning rehabilitation exercises.Interventions focused primarily on the initiation of exercises but less on maintenance.Rehabilitation is complex and new approaches are needed to better support parents. [ABSTRACT FROM AUTHOR]

Despite efforts to promote gender diversity, the construction industry in Australia remains one of the most male-dominated industries. Women, compared to their male counterparts, progress more slowly and encounter major obstacles to career development in the construction industry. Existing research tends to focus on broad factors that impact women's career development in all career stages despite the fact that women's career priorities often change as they progress through different career stages. This study applied Super's career development model to investigate the influential factors on women's career development across four career stages: explore (precareer), establishment (early career), midcareer, and late career. By conducting a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this research identified influential factors related to women's career development in the construction industry, namely, attitude, capability, interest, past experiences, family responsibilities, parental influences, role models, support, culture, organizational practice, and policies and regulations. Based on the women's empowerment framework, the identified factors were coded and synthesized into three dimensions: individual, relational, and environmental. The research finds there is a significant focus on providing relational and environmental support to women in construction, and less attention is given to individual factors. The review revealed that personal interest and parental perceptions in construction influence women's career development in precareer and early career stages, while masculine culture significantly impacts women's career development in all career stages. This study also summarizes the theoretical contributions and practical implications drawn from existing research on different stages of women's career development and provides guidance for further research. [ABSTRACT FROM AUTHOR]

Background: The human papillomavirus (HPV), a prevalent sexually transmitted infection, is linked to a wide range of diseases, with cervical cancer being the most common and serious one. HPV vaccination is crucial for preventing cervical cancer and other HPV-related problems. The low acceptability of HPV vaccination among teenagers globally is largely due to a lack of understanding and information about HPV among parents. Our study aimed to evaluate the level of knowledge, attitude, intention, and HPV vaccination among parents in Lebanon as well as the variables influencing Lebanese mothers' intentions to vaccinate their children. Methods: A cross-sectional survey-based study involving 392 participants was conducted between May and June 2022. The study assessed parents' intention to vaccinate their children against HPV, their knowledge about HPV, and the HPV vaccine. The data was collected through an anonymous electronic questionnaire. A bivariate analysis was conducted using Student t-test and ANOVA to examine the relationship between the dependent variable "Intention to vaccination" and the secondary variables. The level of statistical significance was set at 0.05 for all data. Results: Our findings showed that only 63% of the 392 participants claimed they would give their child the HPV vaccination. A positive significant association was demonstrated between "Intention to vaccinate against HPV" and mother's nationality, father's educational level, family income per month, information received about the HPV vaccine, parents' HPV vaccination, insurance coverage of the HPV vaccine, children's vaccinations with all required vaccines, knowledge of HPV, and knowledge of the HPV vaccine. Furthermore, when parents know about HPV, their desire to vaccinate their child increases by a factor of 1.832 times, and by 1.207 times when their knowledge level increases by one point. Conclusion: The majority of parents lacked a general understanding of most HPV-related statements, which highlights the requirement for educational interventions to raise parental awareness, understanding, and attitudes toward HPV and, as a result, increase parental acceptance of vaccinating their children. To increase the vaccination rate among adolescents, government authorities should ensure that the HPV vaccine is available in all hospitals and clinics and should be provided free of charge. [ABSTRACT FROM AUTHOR]

Body odors change during development, and this change influences the interpersonal communication between parents and their children. The molecular basis for this chemical communication has not been elucidated yet. Here, we show by combining instrumental and sensory analyses that the qualitative odorant composition of body odor samples is similar in infants (0-3 years) and post-pubertal children (14-18 years). The post-pubertal samples are characterized by higher odor dilution factors for carboxylic acids and by the presence of 5α-androst-16-en-3-one and 5α-androst-16-en-3α-ol. In addition to the olfaction-guided approach, the compounds 6-methylhept-5-en-2-one (6MHO), geranyl acetone (GA) and squalene (SQ) were quantified. Both age groups have similar concentrations of 6MHO and GA, whereas post-pubertal children tend to have higher concentration of SQ. In conclusion, sexual maturation coincides with changes to body odor chemical composition. Whether those changes explain differences in parental olfactory perception needs to be determined in future studies with model odors. Body odor (BO) changes during human development, however, the molecular basis for this has not been fully elucidated. Here, the authors investigate the odorant composition of BO samples in infants and post-pubertal children, revealing qualitative and quantitative differences in the composition of the samples. [ABSTRACT FROM AUTHOR]

Background: Preterm birth is a risk factor for a variety of detrimental health outcomes. Previous studies have identified recalled (or remembered) parental rearing behaviour as a potential modifier of preterm individuals' mental health in adulthood. However, no investigations to date have contrasted the parents' and children's views, explored whether their congruence is associated with preterm individuals' mental health, or tested associations with maternal self-reported first skin-on-skin contact. Methods: This cohort study involved 199 participants of the Gutenberg Prematurity Eye Study (GPES), with prospective clinical examination and psychological assessment data available for individuals born preterm and term and their mothers' perspective on recalled parental rearing behaviour. Participants also completed the Patient Health Questionnaire-9 (PHQ-9). Results: There were substantial similarities between reported recalled maternal rearing behaviour of individuals born preterm and at term and their mothers, with individuals born preterm with lower gestational age (age of the pregnancy from the woman's last menstrual period) recalling mothers as comparatively more controlling and overprotective. Incongruence in recalled rejection/punishment was associated with more depressive symptoms. Late first skin-to-skin contact was related to more recalled maternal rejection/punishment, less emotional warmth, and more control/overprotection. Conclusions: this study expands the knowledge about the interrelations of preterm birth, maternal rearing behaviour, and mental health, underscoring the relevance of first relationship experiences, including close intimate contact. [ABSTRACT FROM AUTHOR]

In the present study, we investigated the relationship between personality and motivation for physical activity while introducing perceived parental support and social physical anxiety in adolescent girls (N = 318, Mage: 16.19 ± 0.51 years). The present study was a retrospective correlational study that was conducted to analyze of a path model. Dark triad traits: Machiavellianism, narcissism, and psychopathy, student's motivation for physical activity, social physique anxiety, and participants' perceptions of parents' behaviors were measured. The findings indicated that psychopathy and Machiavellianism were directly and indirectly associated with motivation for physical activity, but Narcissism could only directly predict the motivation for physical activity. Also, need-thwarting (the most), need-supportive and social physical anxiety could predict motivation for physical activity. This model of the result suggests that among adolescent girls, dark triad personality could, directly and indirectly, predict motivation with need-supportive and need-thwarting and also social physical anxiety. It seems that the sense of importance and more attention to oneself in adolescent girls, which exists in the narcissistic personality, can directly lead to more motivation for physical activity. Also, the duplicitous ways of Machiavellian people in pursuing their motives were confirmed in this research. [ABSTRACT FROM AUTHOR]

Background: There is extensive research indicating that transdiagnostic interventions are effective for adults and children with anxiety and depressive disorders; however, limited research has been conducted on the efficacy of such programs targeting parents of children with anxiety and depressive symptoms delivered via the Internet. This study aims to investigate the preliminary efficacy of a transdiagnostic Internet-delivered intervention for Romanian parents of children with elevated anxiety and depressive symptoms. Methods: We conducted a single-blinded pilot randomized controlled trial. Forty-two parents of children with anxiety and depressive symptoms (Mage = 39.79, 78.6% women) from Romania were randomly assigned to one of the two groups, to ParentKIT, an Internet-delivered intervention based on Rational Emotive and Behavioral Therapy (n = 21), or to a delayed treatment condition (waitlist group) (n = 21). ParentKIT consisted of a brief transdiagnostic intervention delivered through nine modules with therapist guidance. Results: A significant Group by Time effect was found for child emotional problems as reported by parents (Cohen's d = − 0.85) and for parental self-efficacy (Cohen's d = 0.71). Conclusion: A transdiagnostic Internet-delivered intervention addressed to parents of children with elevated anxiety and depressive symptoms is a promising approach. Future research should include blind assessments as well as multiple outcome assessors and investigate the long-term efficacy of the intervention. Trial registration: NCT05341297. [ABSTRACT FROM AUTHOR]

(1) Background: Our study explores the relationship between expected, perceived, and measured effects of botulinum toxin A (BoNT-A) treatment and saline (placebo) in children and adolescents with cerebral palsy (CP) in the calf muscles of 20 children and adolescents with cerebral palsy (CP), aged 4–15 years, using the Gross Motor Function Classification System (GMFCS) I–II. (2) Methods: A mixed methods parallel database design was used. Quantitative and qualitative data were collected at baseline and four weeks after treatment. The primary quantitative measure was gross energy cost (EC) during walking, obtained from a 5-Minute Walk Test (5MWT), while qualitative semi-structured interviews were performed with each parent and child/adolescent individually. (3) Results: Four weeks after treatment, we did not find any correspondence between expected, measured, and perceived effects. Interestingly, parental perceptions of treatment effects were more consistent than the measured outcomes. We also observed a connection between parental treatment expectations and perceived effects, often related to reduced energy expenditure. Children tended to view their parents as treatment experts and had fewer expectations and perceptions themselves. (4) Conclusions: These findings support the importance of child-centered care, which entails actively listening to children's expectations and perceptions during the treatment process. [ABSTRACT FROM AUTHOR]

Our study examined parental knowledge, attitudes, efficacy, and protective behaviors about thirdhand smoke and the toxic mixture of chemicals left in indoor environments after smoking stops. This study also explored the associations with household characteristics. Participants (N = 363) were parents in California who had at least one child <18 years. Parents were recruited via Facebook and completed a cross-sectional survey. Data were analyzed using multiple linear regression. Parents with children 0-12 years had signifi cantly higher knowledge (sr² = .025, p < .05), attitudes (sr² = .022, p < .01), efficacy (sr² = .031, p < .001), and protective behaviors (sr² = .013, p < .05) than did parents with children 0-17 years. In addition, statistical modeling signifi cantly accounted for thirdhand smoke-related parent behaviors (R² = .548, p < .001), with the strongest independent associations being attitudes, smoking status, reaction to the smell of tobacco smoke, home ownership, and age. Overall, families with adolescents are in need of education to protect all children from exposure to thirdhand smoke. [ABSTRACT FROM AUTHOR]

Background: Any delay in diagnosis, surgical intervention, or referral might irreparably damage the testicles since testicular torsion is an emergency vascular accident brought on by the spermatic cord spinning, which blocks the blood supply to the testis. Objectives: To assess parents’ knowledge and attitudes towards testicular torsion. To assess the relationship between the level of parents’ knowledge and their demographic characteristics. To assess the relationship between the level of parents’ attitudes and their demographic characteristics. Methodology: A descriptive (cross-sectional) study was carried out during a period starting from February to April 2023. A probability simple–random sample including (106) participants including the teaching staff, employees, and married students participated in the study. Data were analyzed through the use of the statistical package of Social Sciences (SPSS) version 26. Results: Overall, all assessment of the knowledge of respondents towards TT was fair, and overall, all assessment of the attitudes of respondents towards TT was good. Conclusion: Parents’ knowledge toward TT was fair regarding identifying the condition but it was very poor regarding identifying the time frame in which TT must be managed and the age group most affected by TT. Parents’ attitudes towards TT were very good, especially regarding the belief that it is an urgent condition. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aimed to evaluate how the COVID-19 pandemic affected the psychological well-being of parents of pediatric oncology patients two years after the pandemic started. The authors' objective was to make a detailed comparison between the data collected in the current study and the data gathered in the previous research with the aim of observing any changes, whether for better or worse, at the psychological level in the caregivers of the patients in question. This research could be of great use for monitoring the psychological health of the sample and for being able to intervene promptly in the event of the worsening of the reported symptoms. Background: Family members dealing with the devastating impact of a cancer diagnosis are now facing even greater vulnerability due to the COVID-19 pandemic. Alongside the already overwhelming trauma, they must also bear the distressing burden of the infection risks. The purpose of this study was to examine and explore the effects in parents of pediatric cancer patients two years after the start of the COVID-19 pandemic to compare these data with the previous data. Methods: We conducted a single-center prospective observational study, enrolling 75 parents of 42 pediatric oncology patients. Four questionnaires (IES-R; PSS; STAI-Y and PedsQL) were given to the parents 2 years after the first evaluation. Results: The bivariate matrix of correlation found a strong significant positive correlation between IES-R and PSS scores (r = 0.526, p < 0.001) as in T1. Stress symptoms (t = 0.00, p < 0.001) and levels of anxiety (trait) (t = 0.32, p < 0.001) remained unchanged; anxiety state levels appeared to have increased (t = 0.425, p < 0.001); there was a significant decrease in the PedsQL tot (t = 5.25, p < 0.001). Conclusions: The COVID-19 pandemic has influenced the levels of stress and anxiety of parents and the quality of life of patients, also correlating with the traumatic impact of the diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Physical restraints are often a debatable and misunderstood aspect of dental healthcare practice. They are frequently used in dental care settings to immobilise children and reduce the risk of injury during procedures. It is essential to assess parents' knowledge, awareness, and attitudes towards physical restraints and provide accurate information about them. This is important to ensure that they are used appropriately and ethically. Aim: To assess parents' knowledge, awareness, and attitudes towards physical restraints in dental care settings before and after a multimedia intervention, and to provide precise information about the same. Materials and Methods: The study was conducted at the Department of Paediatric and Preventive Dentistry, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India using a pretest and post-test quasi-experimental study design on 400 parents whose children were between 3 and 16 years of age. The survey was conducted between December 2022 and March 2023. The data collection methods used in the present study consisted of a pre-education questionnaire and a post-education questionnaire administered after a multimedia educational intervention. The collected data were subjected to statistical analysis, including measures such as mean, Standard Deviation (SD), Chi-square goodness of fit test, Wilcoxon's signed-rank test, and Kruskal-Wallis tests. Results: When questioned about various stabilisation methods like direct and indirect methods, 379 (94.8%) of the study parents were unaware of them. However, after education, the majority of parents, 393 (98.3%), became aware that there were two types of stabilisation methods. Initially, 294 (73.5%) of parents refused to provide permission for doctors to treat their children using various stabilisation techniques. However, after being thoroughly educated about the various methods and their benefits, 383 (95.8%) agreed to let the dentist employ different stabilisation techniques when treating their children. This assurance helped alleviate concerns about potential harm to the child caused by using these stabilisation methods. Conclusion: The study suggests that there is a significant knowledge gap among parents. However, the implementation of multimedia educational intervention methods during dental visits by dentists played a crucial role in increasing their knowledge and resulted in a significant improvement in their attitude towards stabilisation methods. [ABSTRACT FROM AUTHOR]

Background: Engagement in before-school physical activity can potentially enhance health and learning-related outcomes for children and adolescents. However, influencing factors and stakeholder perceptions of before-school physical activity remain under-researched. This qualitative study aimed to examine stakeholder perceptions of: a) the suitability of the before-school segment for physical activity, b) barriers and facilitators associated with before-school physical activity, and c) strategies for schools to support before-school physical activity. Methods: Twelve focus groups and one interview were conducted with 38 participants from a range of school stakeholder groups—students, parents, teachers, school leaders, external physical activity providers, and school health and physical activity experts. Focus groups were analysed using template analysis, guided by a social-ecological model. Results: Stakeholders perceived before-school physical activity as valuable, for reasons including perceptions of meaningful contributions to students' cognitive functioning, classroom behaviours, and wellbeing. Factors influencing before-school physical activity were identified across multiple social-ecological levels, including the critical role of school leadership support, availability of facilities, and provision of qualified supervision. Proposed strategies highlighted the need for sustainable design, contextual relevance, and community engagement in before-school initiatives. Additionally, communication of the manifold benefits identified by stakeholders was suggested as a means to drive support and engagement in before-school physical activity. Conclusions: This study provides insight for schools seeking to enhance opportunities for physical activity in the before-school hours and may inform future intervention research on the subject, taking into account its multi-faceted influences and the need for context-specific strategies. [ABSTRACT FROM AUTHOR]

Background: Actigraphy offers a promising way to objectively assess pediatric sleep. Aim of the study was investigating the extent to which actigraphy used in children and adolescents with life-limiting conditions is consistent with two other measures of sleep diagnostics. Methods: In this monocentric prospective study N = 26 children and adolescents with life-limiting conditions treated on a pediatric palliative care unit were assessed. For three consecutive nights they wore an actigraph; the 24-hours sleep protocol documented by nurses and the Sleep Screening for Children and Adolescents with Complex Chronic Conditions (SCAC) answered by parents were analyzed. Patient characteristics and the parameters sleep onset, sleep offset, wake after sleep onset (WASO), number of wake phases, total sleep time (TST) and sleep efficiency (SE) were descriptively examined. Percentage bend correlations evaluated the three measures' concordance. Results: Descriptively, and except for the number of waking episodes, the different measures' estimations were comparable. Significant correlations existed between actigraphy and the sleep protocol for sleep onset (r = 0.83, p = < 0.001) and sleep offset (r = 0.89, p = < 0.001), between actigraphy and SCAC for SE (r = 0.59, p = 0.02). Conclusion: Agreement of actigraphy with the focused sleep measures seems to be basically given but to varying degrees depending on the considered parameters. [ABSTRACT FROM AUTHOR]

The study aimed to investigate parental satisfaction and acceptance of silver diamine fluoride (SDF) treatment for permanent molars affected by molar incisor hypomineralisation (MIH). This study was conducted in the pediatric dental department at Damascus University, Syria. This study was performed at the period from Jan 2023 to April 2023. In this cross-sectional study, a validated questionnaire employing a 5-point Likert scale was used to evaluate esthetics, ease of application, pain perception, and taste acceptability. Participants included 100 parents or guardians of children aged 6–9 years who had received SDF treatment in the past year. The findings of this study revealed high satisfaction levels (77.5%) with the treatment. Parents expressed contentment with the appearance of their child's molars after SDF application (58% agreed or strongly agreed) and found the application process easy and pain-free (100% agreed or strongly agreed). However, taste acceptability posed a challenge, with over half of the parents (53%) finding it unacceptable. Regression analysis underscored the significant impact of esthetics, ease of application, pain perception, and taste on parental satisfaction. Moreover, parents with higher education levels (graduate or postgraduate) exhibited higher acceptance rates compared to those with lower education levels (63.1% vs. 33.6%). Notably, parental gender and age did not significantly influence SDF treatment acceptance. This study provides critical insights into parental satisfaction and acceptance of SDF treatment for MIH-affected permanent molars. Despite concerns about tooth discoloration, the high satisfaction levels suggest that SDF holds promise as an effective treatment option. Parental education significantly influenced acceptance rates. This research highlights the importance of considering parental perspectives and tailoring communication strategies in pediatric dentistry, ultimately contributing to improved care for young patients with MIH. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic inequalities in health and their determinants have been studied extensively over the past few decades. However, the role of parenting style and parents' couple relationships in explaining mental health inequalities is limited. Therefore, this study aims to investigate the distributional impact of parenting style (angry parenting, consistent parenting, and inductive parenting) and parents' couple relationships (e.g., argumentative, happy relationships) on socioeconomic inequalities and by extension on mental health status of Australian children and adolescents. Methods: This study utilized data from the Longitudinal Study of Australian Children (Waves 1–7), specifically focusing on intact biological parent families, while excluding single-parent and blended-family households. We applied the decomposition index and the Blinder Oaxaca method to investigate the extent of the contribution and temporal impact of parenting style and parents' couple relationships on the mental health status of Australian children and adolescents. Results: This study revealed that poor parenting style is the single most important factor that leads to developing mental health difficulties in children and adolescents, especially from low socioeconomic status, and it contributes almost 52% to socioeconomic inequalities in mental health status. Conversely, household income, maternal education, employment status, and parents' couple relationships contributed 28.04%, 10.67%, 9.28%, and 3.34%, respectively, to mental health inequalities in children and adolescents. Conclusion: Overall, this study underscores the importance of parenting style and parents' couple relationships as significant predictors of mental health outcomes in children and adolescents. These results highlight the need for targeted interventions to support families from low socioeconomic backgrounds to address the significant mental health inequalities observed in the study population. [ABSTRACT FROM AUTHOR]

E-cigarette use among adolescents is a national health epidemic spreading faster than researchers can amass evidence for risk and protective factors and long-term consequences associated with use. New technologies, such as machine learning, may assist prevention programs in identifying at risk youth and potential targets for intervention before adolescents enter developmental periods where e-cigarette use escalates. The present study utilized machine learning algorithms to explore a wide array of individual and socioecological variables in relation to patterns of lifetime e-cigarette use during early adolescence (i.e., exclusive, or with tobacco cigarettes). Extant data was used from 14,346 middle school students (Mage = 12.5, SD = 1.1; 6th and 8th grades) who participated in the Utah Prevention Needs Assessment. Students self-reported their substance use behaviors and related risk and protective factors. Machine learning algorithms examined 112 individual and socioecological factors as potential classifiers of lifetime e-cigarette use outcomes. The elastic net algorithm achieved outstanding classification for lifetime exclusive (AUC =.926) and dual use (AUC =.944) on a validation test set. Six high value classifiers were identified that varied in importance by outcome: Lifetime alcohol or marijuana use, perception of e-cigarette availability and risk, school suspension(s), and perceived risk of smoking marijuana regularly. Specific classifiers were important for lifetime exclusive (parent's attitudes regarding student vaping, best friend[s] tried alcohol or marijuana) and dual use (best friend[s] smoked cigarettes, lifetime inhalant use). Our findings provide specific targets for the adaptation of existing substance use prevention programs to address early adolescent e-cigarette use. [ABSTRACT FROM AUTHOR]

Background: The prevalence of autism spectrum disorders (ASDs) has increased over the recent years; however, little is known about the experience of parents of children with autism in Africa such as Somalia. The aim of this study is to understand the knowledge on autism of Somali parents of children with autism and their perceptions of causes and treatment of ASD. Methods: We conducted a qualitative study involving 22 parents of children with autism who lived in Mogadishu and Hargeisa; the two largest cities in Somalia. In-depth interviews were used to collect the data. Of the 22 participants, 9 were returned immigrants and 13 were local people (non-immigrants). Data were analysed using thematic analysis. Results: The data revealed that most of the parents hold the belief that their children's autism were caused by the measles vaccine. The findings demonstrated that parents sought diagnosis and treatment care from outside Somalia due to the lack of experience of health providers in the diagnosis and treatment of autism. The data also revealed a lack of knowledge about autism among the public with resultant stigma and discrimination against children with autism and their families. Conclusions: Efforts to increase public knowledge on autism, its causes and treatments are of paramount importance, while a public health campaign designed to eliminate the stigma subjected to children with autism is necessary to improve the quality of life of children with autism and their caregivers. Finally, to counteract vaccine hesitancy, particularly in response to the measles vaccine, health policy makers should take steps to separate the cooccurrence of the onset of autism symptoms and the provision of the measles vaccine. [ABSTRACT FROM AUTHOR]

Background: The prevalence of autism spectrum disorders (ASDs) has increased over the recent years; however, little is known about the experience of parents of children with autism in Africa such as Somalia. The aim of this study is to understand the knowledge on autism of Somali parents of children with autism and their perceptions of causes and treatment of ASD. Methods: We conducted a qualitative study involving 22 parents of children with autism who lived in Mogadishu and Hargeisa; the two largest cities in Somalia. In-depth interviews were used to collect the data. Of the 22 participants, 9 were returned immigrants and 13 were local people (non-immigrants). Data were analysed using thematic analysis. Results: The data revealed that most of the parents hold the belief that their children's autism were caused by the measles vaccine. The findings demonstrated that parents sought diagnosis and treatment care from outside Somalia due to the lack of experience of health providers in the diagnosis and treatment of autism. The data also revealed a lack of knowledge about autism among the public with resultant stigma and discrimination against children with autism and their families. Conclusions: Efforts to increase public knowledge on autism, its causes and treatments are of paramount importance, while a public health campaign designed to eliminate the stigma subjected to children with autism is necessary to improve the quality of life of children with autism and their caregivers. Finally, to counteract vaccine hesitancy, particularly in response to the measles vaccine, health policy makers should take steps to separate the cooccurrence of the onset of autism symptoms and the provision of the measles vaccine. [ABSTRACT FROM AUTHOR]

Introduction: Throughout the coronavirus disease 2019 (COVID‐19) pandemic, parents and children faced significant challenges as a result of prevention measures implemented to control the spread of the disease. Ensuring that families have access to essential health information is critical for improving health outcomes and adherence to public health recommendations. Understanding parents' experiences and information needs related to the pandemic and associated health measures (e.g., vaccination, mask wearing, social distancing, etc.) will inform the development and dissemination of resources tailored to parents' needs to support informed decision making. Methods: We conducted a qualitative descriptive study. Between September and November 2021, parents across Canada were recruited online via social media and community organisation newsletters and listservs to participate in focus groups via Zoom. Focus groups were audio‐recorded and transcribed verbatim. Data were coded and analysed using thematic analysis. Participants completed a demographic questionnaire before the focus groups (via SimpleSurveys). Results: Sixty‐seven parents participated in 12 focus groups between October and November 2021. In relation to experiences, parents felt they were (1) constantly trying to balance everything, and (2) trying to do their best with the information they had at the time when making decisions. Regarding information needs, parents reflected on (1) how difficult it was navigating copious amounts of changing information and finding credible sources to rely on, (2) the need for resources that were easily accessible, credible and in plain language and (3) the need for resources that were tailored to their needs to support them and their children make informed decisions. Conclusions: Trying to mitigate the risk of COVID‐19 infection and adhere to public health recommendations, while balancing various factors (work, online learning, and social interactions) and navigating changing information, was overwhelming for many parents. Reflecting on their needs, parents suggested tailored resources that provided concise, credible information in plain language to help them make informed decisions and navigate conflicting information. These findings reveal important knowledge gaps and highlight areas that need to be addressed to support parents during the pandemic period and beyond. Patient or Public Contribution: Members of our established Paediatric Parent Advisory Group (P‐PAG) were involved as collaborators throughout the planning (grant proposal), development and execution of the study. P‐PAG members gave input on the design of the questionnaire, interview guide, recruitment strategy and interpretation of findings. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal care is complex, involving multiple people and technologies within a community of care. When preterm babies are cared for far from home and/or transferred between units, the whole community of care (and particularly parent participation) is disrupted. Although previous studies have captured subjective experiences of parents, there has been little research exploring the material practices undertaken by parents as a consequence of place‐of‐care decisions, or the social organisation of those practices. Methods: As part of a wider study exploring optimal place‐of‐care, semistructured interviews were conducted between July 2018 and October 2019 with 48 parents (36 families) with one or more preterm babies (born at 27–31 weeks gestation) cared for in a neonatal unit in the last 12 months. Findings: We highlight parents' labour‐intensive and stressful work to: (1) parent in the neonatal care community (an oversight role that goes beyond contemporary notions of 'involvement'); (2) create continuity amid place‐of‐care disruptions; and (3) adapt to the managerial logics of neonatal care settings. Our analysis focuses on the work generated by managerial systems that organise place‐of‐care decision‐making and other efficiency‐focused practices. Parents are absorbed into negotiating institutional systems and diverted from routine parenting activities. Conclusion: Those involved in the organisation and management of neonatal care should take account of how managerial systems impact parents' workload, ability to participate in their baby's community of care and, ultimately, on the wellbeing and development of babies and their families. Patient or Public Contribution: The OPTI‐PREM study embedded parents' experiences of neonatal care into the research, through a discrete workstream that employed qualitative methodology to capture parents' experiences—as reported in this paper. The OPTI‐PREM project was also supported by a Bliss volunteer parent panel, which was involved in designing and overseeing the research. Bliss 'champion[s] the right for every baby born premature or sick to receive the best care by supporting families, campaigning for change and supporting professionals and enabling life‐changing research' (https://www.bliss.org.uk/about-us/about-bliss). A representative of Bliss is a co‐author of this manuscript, and a parent representative (named in the Acknowledgements) provided feedback during its preparation. [ABSTRACT FROM AUTHOR]

Objectives: Children with intellectual disability experience patient safety issues resulting in poor care experiences and health outcomes. This study sought to identify patient safety issues that pertain to children aged 0–16 years with intellectual disability admitted to two tertiary state‐wide children's hospitals and a children's palliative care centre; to describe and understand these factors to modify the Australian Patient Safety Education Framework to meet the particular needs for children and young people with intellectual disability. Design, Setting and Participants: Parents of children with intellectual disability from two paediatric hospitals and a palliative care unit participated in semi‐structured interviews to elicit their experiences of their child's care in the context of patient safety. Thirteen interviews were conducted with parents from various backgrounds with children with intellectual, developmental and medical diagnoses. Results: Eight themes about safety in hospital care for children and young people with intellectual disability emerged from thematic analyses: Safety is not only being safe but feeling safe; Negative dismissive attitudes compromise safety, quality and care experience; Parental roles as safety advocates involve being heard, included and empowered; Need for purposeful and planned communication and care coordination to build trust and improve care; Systems, processes and environments require adjustments to prevent patient safety events; Inequity in care due to lack of resources and skills, Need for training in disability‐specific safety and quality issues and Core staff attributes: Kindness, Patience, Flexibility and Responsiveness. Parents highlighted the dilemma of being dismissed when raising concerns with staff and being required to provide care with little support. Parents also reported a lack of comprehensive care coordination services. They noted limitations within the healthcare system in accommodating reasonable adjustments for a family and child‐centred context. Conclusions: The development of an adapted Patient Safety Education Framework for children with intellectual disability should consider ways for staff to transform attitudes and reduce bias which leads to adaptations for safer and better care. In addition, issues that apply to quality and safety for these children can be generalised to all children in the hospital. Patient and Public Contribution: Parent advocates in the project advisory team were shown the questions to determine their appropriateness for the interviews. [ABSTRACT FROM AUTHOR]