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Introduction: Bleeding disorders (BDs) may influence health-related quality of life (HRQoL) in children and caregivers. Measuring HRQoL gives insight into domains requiring support and provides an opportunity to evaluate the effects of novel therapies. Aim: To gain insight in the current body of literature on HRQoL in children with BDs in order to identify knowledge gaps for research and further development of this field. Methods: Scoping review. Results: We included 53 articles, describing studies mainly performed in Europe and North–America (60.4%) and mostly within the last ten years. Only 32% studies included children <4 years. Almost all studies (47/53, 88.7%) were performed in boys with haemophilia, pooling haemophilia A and B (n = 21) and different disease severities (n = 20). Thirteen different generic and five disease-specific HRQoL-questionnaires were applied; all questionnaires were validated for haemophilia specifically. Six (11,3%) combined generic and disease-specific questionnaires. Self-reports were most frequently applied (40/53, 75.5%), sometimes combined with proxy and/or parent-reports (17/53, 32.1%). Eleven studies used a reference group (20.8%). Statistical analyses mostly consisted of mean and SD (77.4%).Conclusion: HRQoL-research is mainly performed in school-aged boys with haemophilia, treated in developed countries. Pitfalls encountered are the pooling of various BDs, subtypes and severities, as well as the application of multiple generic questionnaires prohibiting comparison of results. More attention is needed for broader study populations including other BDs, young children, feminine such as young children, feminine bleeding issues and platelet disorders, as well as the use of HRQoL as an effect-measurement tool for medical interventions, and more thorough statistical analysis.

Introduction: We aimed to assess the associated factors for adolescent depression, problem behavior and cognitive level in China. Methods: A total of 2,584 adolescents aged from 10 to 15 years old in 2018 were included for analyses. Information on a comprehensive set of potential determinants was collected by the questionnaire, including demographic, health-, school- and family-related factors. Differences in average scores of depression, problem behavior, and cognitive level across subgroups were assessed by two independent sample t-tests and one-way analysis of variance (ANOVA). The clinical relevance among subgroups was assessed by the effect size. Multivariate linear regression models were applied to identify the statistically significant determinants. Results: School-related factors and parental depressive status were strongly associated with depression. Low maternal education, poor/bad health of adolescents, high academic pressure, and parental depression were significantly associated with behavior problems. The socioeconomic factors, poor academic performance and father’s depression were significantly associated with adolescent cognitive level. Discussion: Multiple associated factors were identified for depression, problem behavior, and cognition of Chinese adolescents, which will provide insights into developing more targeted public health policies and interventions to improve their mental health.

ObjectiveThis study aimed to examine social gradients in ADHD during late childhood (age 9-11 years) using absolute and relative relationships with socioeconomic status exposure (household income, maternal education) during early childhood (<5 years) in seven cohorts from six industrialised countries (UK, Australia, Canada, The Netherlands, USA, Sweden). MethodsSecondary analyses were conducted for each birth cohort. Risk ratios, pooled risk estimates, and absolute inequality, measured by the Slope Index of Inequality (SII), were estimated to quantify social gradients in ADHD during late childhood by household income and maternal education measured during early childhood. Estimates were adjusted for child sex, mother age at birth, mother ethnicity, and multiple births. FindingsAll cohorts demonstrated social gradients by household income and maternal education in early childhood, except for maternal education in Quebec. Pooled risk estimates, relating to 44,925 children, yielded expected gradients (income: low 1.83(CI 1.38,2.41), middle 1.42(1.13,1.79), high (reference); maternal education: low 2.13(1.39,3.25), middle 1.42(1.13,1.79)). Estimates of absolute inequality using SII showed that the largest differences in ADHD prevalence between the highest and lowest levels of maternal education were observed in Australia (4% lower) and Sweden (3% lower); for household income, the largest differences were observed in Quebec (6% lower) and Canada (all provinces: 5% lower). ConclusionFindings indicate that children in families with high household income or maternal education are less likely to have ADHD at age 9-11. Absolute inequality, in combination with relative inequality, provides a more complete account of the socioeconomic status and ADHD relationship in different high-income countries. While the study design precludes causal inference, the linear relation between early childhood social circumstances and later ADHD suggests a potential role for policies that, Funding Agencies|Canadian Institutes of Health Research [OCO-79897, MOP-89886, MSH-95353, ROG-110537, MOP-123079, HDF70335]; County Council of Ostergotland; Swedish Research Council [K2005-72X-11242-11A, K2008-69X-2082601-4]; Swedish Child Diabetes Foundation (Barndiabetesfonden); Juvenile Diabetes Research Foundation; Wallenberg Foundation [K 98-99D12813-01A]; Medical Research Council of Southeast Sweden(FORSS); Swedish Council for Working Life and Social Research [FAS20041775]; Ostgota Brandstodsbolag; Australian Government Department of Social Services; Australian Institute of Family Studies (AIFS); Australian Bureau of Statistics (ABS); Erasmus Medical Center, Rotterdam; Erasmus University Rotterdam; Netherlands Organisation for Health Research and Development (ZonMw) [ZonMw 907.00303, 916.10159]; Netherlands Organisation for Scientific Research (NWO); Ministry of Health, Welfare and Sport; Ministry of Youth and Families; lInstitut de la statistique du Quebec; Fondation Lucie et Andre Chagnon; Ministere de leducation et de lEnseignement superieur; Ministere de la Sante et des Services sociaux; Ministere de la Famille; GRIP Research Unit on Childrens Psychosocial Maladjustment; QUALITY Cohort Collaborative Group; Centre hospitalier universitaire SainteJustine; Institut de recherche Robert-Sauve en sante et en securite au travail; lInstitut de recherche en sante publique de lUniversite de Montreal; Centre de recherche du Centre hospitalier de lUniversite de Montreal (CRCHUM); Fonds de recherche du Quebec Sante (FRQS); Fonds de recherche du Quebec Socie te et culture (FRQSC); Social Sciences and Humanities Research Council (SSHRC); Human Resources and Skills Development Canada (HRSDC); Canadian Institute for Health Research (CIHR); Canadian Foundation for Innovation (CFI); Statistics Canada; Economic and Social Research Council; Office of National Statistics; U.S. Bureau of Labor Statistics; National Institute for Child Health and Human Development

Objectives Timely parental help-seeking regarding their child's socioemotional development is associated with a lower rate and lower severity of psychosocial problems in later life. This study aimed to examine the correlates of parental help-seeking for the socio-emotional development of 3-year-old children. Design Retrospective cohort study. Setting Community-based survey in Rotterdam. Participants Of 2305 parents and their 2-year-old children at baseline, 1507 who completed follow-up questionnaires were included in the analyses when children were 3 years old. Outcome measures Parental help-seeking regarding their child's socioemotional development and types of formal and informal help sources (eg, general practitioner, internet) used in the past 12 months were measured. Hierarchical logistic regression models were applied to identify factors correlates of parental help-seeking among 13 predisposing, enabling and need factors according to Andersen's behavioural model. Results In total, 22.6% of parents reported help-seeking in the past 12 months for socioemotional development of their 3-year-old child; 6.8% addressed formal help sources and 17.5% addressed informal help sources. General practitioner (2.7%) and family (12.5%) were the most frequently used formal and informal sources, respectively. In the full model, predisposing factors associated with higher odds of parental help-seeking were child's other western ethnic background (OR=1.66, 95% CI 1.02 to 2.68) and parental age ≤29 years old (OR=1.71, 95% CI 1.01 to 2.92). No associated factors were found among enabling factors. The need factors associated with higher odds of parental help-seeking were having previous help-seeking (OR=2.52, 95% CI 1.83 to 3.48) and discussing child's socioemotional development in the well-child visit (OR=2.47, 95% CI 1.73 to 3.53). Conclusions Predisposing and need factors were associated with parental help-seeking for socioemotional development of 3-year-old children. The find