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Pediatric Cardiology Jun 2024Congenital heart disease (CHD) is one of today's leading birth anomalies. Children with CHD are at risk for adaptive functioning challenges. Sleep difficulties are also...
Congenital heart disease (CHD) is one of today's leading birth anomalies. Children with CHD are at risk for adaptive functioning challenges. Sleep difficulties are also common in children with CHD. Indeed, sleep-disordered breathing, a common type of sleep dysfunction, is associated with increased mortality for infants with CHD. The present study examined the associations between adaptive functioning and sleep quality (i.e., duration and disruptions) in children with CHD (n = 23) compared to healthy children (n = 38). Results demonstrated associations between mean hours slept and overall adaptive functioning in the CHD group r(21) = .57, p = .005 but not in the healthy group. The CHD group demonstrated lower levels of adaptive functioning in the Conceptual, t(59) = 2.12, p = .039, Cohen's d = 0.53 and Practical, t(59) = 2.22, p = .030, Cohen's d = 0.55 domains, and overall adaptive functioning (i.e., General Adaptive Composite) nearing statistical significance in comparison to the healthy group, t(59) = 2.00, p = .051, Cohen's d = 0.51. The CHD group also demonstrated greater time awake at night, t(56) = 2.19, p = .033, Cohen's d = 0.58 and a greater instance of parent-caregiver reported snoring, χ (1, N = 60) = 5.25, p = .022, V = .296 than the healthy group. Further exploration of the association between adaptive functioning and sleep quality in those with CHD is required to inform clinical practice guidelines.
PubMed: 38942985
DOI: 10.1007/s00246-024-03565-y -
Dental Materials : Official Publication... Jun 2024Streptococcus mutans (S. mutans) is a major contributor to dental caries, with its ability to synthesize extracellular polysaccharides (EPS) and biofilms. The gcrR gene...
OBJECTIVE
Streptococcus mutans (S. mutans) is a major contributor to dental caries, with its ability to synthesize extracellular polysaccharides (EPS) and biofilms. The gcrR gene is a regulator of EPS synthesis and biofilm formation. The objectives of this study were to investigate a novel strategy of combining gcrR gene over-expression with dimethylaminohexadecyl methacrylate (DMAHDM), and to determine their in vivo efficacy in reducing caries in rats for the first time.
METHODS
Two types of S. mutans were tested: Parent S. mutans; and gcrR gene over-expressed S. mutans (gcrR OE S. mutans). Bacterial minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were measured with DMAHDM and chlorhexidine (CHX). Biofilm biomass, polysaccharide, lactic acid production, live/dead staining, colony-forming units (CFUs), and metabolic activity (MTT) were evaluated. A Sprague-Dawley rat model was used with parent S. mutans and gcrR OE S. mutans colonization to determine caries-inhibition in vivo.
RESULTS
Drug-susceptibility of gcrR OE S. mutans to DMAHDM or CHX was 2-fold higher than that of parent S. mutans. DMAHDM reduced biofilm CFU by 3-4 logs. Importantly, the combined gcrR OE S. mutans+ DMAHDM dual strategy reduced biofilm CFU by 5 logs. In the rat model, the parent S. mutans group had a higher cariogenicity in dentinal (D) and extensive dentinal (D) regions. The DMAHDM + gcrR OE group reduced the D and D caries to only 20 % and 0 %, those of parent S. mutans + PBS control group (p < 0.05). The total caries severity of gcrR OE + DMAHDM group was decreased to 51 % that of parent S. mutans control (p < 0.05).
SIGNIFICANCE
The strategy of combining S. mutans gcrR over-expression with antibacterial monomer reducing biofilm acids by 97 %, and reduced in vivo total caries in rats by 48 %. The gcrR over-expression + DMAHDM strategy is promising for a wide range of dental applications to inhibit caries and protect tooth structures.
PubMed: 38942710
DOI: 10.1016/j.dental.2024.06.018 -
Journal of the American Academy of... Jul 2024Anxiety is one of the most common mental health problems in childhood, and causes severe and persistent impairment in children's lives. Parents can play a key role in...
Anxiety is one of the most common mental health problems in childhood, and causes severe and persistent impairment in children's lives. Parents can play a key role in the development of children's anxiety symptoms; yet, the evidence of parent-focused interventions is relatively thin. This may be because little is known about what the optimal content of these interventions should be. Interventions typically either use parents as lay therapists, or target multiple different family risk factors at the same time. Traditional randomized trials of these "package deal" interventions provide little insight into what specific parental risk factors should be targeted to most effectively reduce children's anxiety. We will examine the effects of targeting distinct parental risk factors to provide more information on the role of these factors in children's anxiety, and to guide the development of intervention programs.
Topics: Humans; Child; Risk Factors; Parents; Female; Male; Anxiety; Anxiety Disorders; Parent-Child Relations
PubMed: 38942499
DOI: 10.1016/j.jaac.2024.01.013 -
The Journal of Pediatrics Jun 2024
PubMed: 38942356
DOI: 10.1016/j.jpeds.2024.114173 -
Journal of the Academy of Nutrition and... Jun 2024Body dissatisfaction is associated with poor psychological and physical health, particularly among young people. However, limited data exist on body size perceptions...
BACKGROUND
Body dissatisfaction is associated with poor psychological and physical health, particularly among young people. However, limited data exist on body size perceptions across countries and factors associated with dissatisfaction.
OBJECTIVE
This study examined dissatisfaction prevalence and associations with sociodemographics and social media use among youth in six countries.
DESIGN
Repeat cross-sectional national online surveys were conducted as part of the 2019 and 2020 International Food Policy Study Youth Survey.
PARTICIPANTS
The sample included 21,277 youth aged 10-17 from Australia, Canada, Chile, Mexico, the United Kingdom, and the United States. Youth were recruited to complete the online survey through parents/guardians enrolled in the Nielsen Consumer Insights Global Panel and their partners' panels.
MAIN OUTCOME MEASURES
Figural drawing scales assessed self-perceived and ideal body images, with differences between scales representing body dissatisfaction.
STATISTICAL ANALYSES PERFORMED
Multinomial logistic regression models examined differences in body dissatisfaction by country, and associations with sociodemographics and either social media 'screen time' or platforms used, including 2-way interactions with country.
RESULTS
Overall, approximately 45% of youth reported the same perceived and ideal body sizes, while 35% were 'larger than ideal' (from 33% in Canada and Australia to 42% in Chile) and 20% were 'thinner than ideal' (from 15% in Chile to 22% in Mexico). Greater social media screen time was associated with a higher likelihood of moderate-severe dissatisfaction for being 'thinner than ideal' and at least mild dissatisfaction for being 'larger than ideal' (p<0.003 for all contrasts), with greater dissatisfaction among users of YouTube and Snapchat than non-users (p≤0.005 for both contrasts). Modest differences in body dissatisfaction between countries were observed for age, ethnicity, body mass index, and weight-based teasing.
CONCLUSION
Body dissatisfaction is prevalent among youth across diverse countries. These findings highlight the need to promote healthy body image in youth, particularly among social media users.
PubMed: 38942287
DOI: 10.1016/j.jand.2024.06.223 -
Journal of Pain and Symptom Management Jun 2024Home-based pediatric palliative and hospice care (PPHC) supports the hundreds of thousands of children with serious illness and complex care needs and their families in...
CONTEXT
Home-based pediatric palliative and hospice care (PPHC) supports the hundreds of thousands of children with serious illness and complex care needs and their families in the home setting. Considerable variation, however, exists in the provision and quality of home-based PPHC in the U.S. Ensuring equitable, high-quality home-based PPHC for all children requires the evaluation of families' care experiences and assessment of whether these experiences are aligned with their needs and priorities.
OBJECTIVES
To evaluate the psychometric properties of the previously developed 23-item home-based PPHC EXPERIENCE Measure for use with families of children receiving home-based PPHC in the U.S.
METHODS
Participants included families recruited from the Children's Hospital of Philadelphia, Courageous Parents Network, and several other hospital- and community-based PPHC programs across the U.S. who provide home-based PPHC services. Participants completed the EXPERIENCE Measure at baseline and again at retest. We evaluated the factor structure of the EXPERIENCE Measure, as well as evidence regarding score reliability and validity.
RESULTS
82 family participants completed the baseline and 53 completed the retest questionnaire from 15 states across the U.S. We found evidence for the score reliability and validity of a four-domain EXPERIENCE measure.
CONCLUSION
The EXPERIENCE Measure is a tool with evidence for reliable and valid scores to evaluate family-reported home-based PPHC experiences at the time care is being received. Future work will evaluate the usability (i.e., acceptability, feasibility, and clinical actionability) of EXPERIENCE, including the sensitivity of the instrument to change over time and its impact on real-time clinical actions.
PubMed: 38942094
DOI: 10.1016/j.jpainsymman.2024.06.018 -
Brazilian Journal of Anesthesiology... Jun 2024Preoperative anxiety in children causes negative postoperative outcomes. Parental presence at induction is a non-pharmacological strategy for relieving anxiety;...
BACKGROUND
Preoperative anxiety in children causes negative postoperative outcomes. Parental presence at induction is a non-pharmacological strategy for relieving anxiety; nevertheless, it is not always possible or effective, namely when parents are overly anxious. Parental presence via video has been demonstrated to be useful in other contexts (divorce, criminal court). This study reports the feasibility of a randomized controlled trial to investigate the effect of video parental presence and parental coaching at induction on preoperative anxiety.
METHODS
The study was a randomized, 2 × 2 factorial design trial examining parental presence (virtual vs. physical) and coaching (provided vs. not provided). Feasibility was assessed by enrollment rate, attrition rate, compliance, and staff satisfaction with virtual method with the NASA-Task Load Index (NASA-TLX) and System Usability Scale (SUS). For the children's anxiety and postoperative outcomes, the modified Yale Preoperative Anxiety Scale (mYPAS) and Post-Hospitalization Behavioral Questionnaire (PHBQ) were used. Parental anxiety was evaluated with the State-Trait Anxiety Inventory (STAI) questionnaire.
RESULTS
A total of 41 parent/patient dyads were recruited. The enrollment rate was 32.2%, the attrition rate 25.5%. Compliance was 87.8% for parents and 85% for staff. The SUS was 67.5/100 and 63.5/100 and NASA-TLX was 29.2 (21.5-36.8) and 27.6 (8.2-3.7) for the anesthesiologists and induction nurses, respectively. No statistically significant difference was found in mYPAS, PHBQ and STAI.
CONCLUSION
A randomized controlled trial to explore virtual parental presence effect on preoperative anxiety is feasible. Further studies are needed to investigate its role and the role of parent coaching in reducing preoperative anxiety.
PubMed: 38942079
DOI: 10.1016/j.bjane.2024.844533 -
American Journal of Veterinary Research Jun 2024To evaluate the effects of aging on phenylbutazone (PBZ) disposition in older horses (≥ 25 years old) compared to young adults (4 to 10 years old) by characterizing...
OBJECTIVE
To evaluate the effects of aging on phenylbutazone (PBZ) disposition in older horses (≥ 25 years old) compared to young adults (4 to 10 years old) by characterizing the pharmacokinetic profile of PBZ and its active metabolite, oxyphenbutazone (OPBZ), following a 2.2-mg/kg dose, IV. We hypothesized that the disposition of PBZ will be affected by age.
ANIMALS
16 healthy horses (8 young adults aged 4 to 10 years and 8 geriatric horses ≥ 25 years old).
METHODS
Horses were administered a single 2.2-mg/kg PBZ dose, IV. Plasma samples were collected at designated time points and frozen at -80 °C until assayed using liquid chromatography-tandem mass spectrometry. Pharmacokinetic analyses were performed using Phoenix WinNonlin, version 8.0 (Certara). Both clinical and pharmacokinetic data were compared between age groups using independent samples t tests, with P < .05 considered significant.
RESULTS
Baseline characteristics did not differ between groups, with the exception of age, weight, and plasma total solids. Plasma concentrations of PBZ were best described by a two-compartment model. The maximum plasma concentration of OPBZ was reached at 5 hours for both age groups, and the metabolite-to-parent-drug area-under-the-curve ratios were approximately 20% for both groups. None of the pharmacokinetic parameters of PBZ or its metabolite, OPBZ, differed significantly between age groups.
CLINICAL RELEVANCE
The hypothesis was rejected as there was no significant difference in PBZ disposition in young-adult horses compared to geriatric horses. Our data do not support the need for dose adjustments of PBZ in clinically healthy geriatric horses.
PubMed: 38942059
DOI: 10.2460/ajvr.24.01.0012 -
Journal of Pediatric Nursing Jun 2024Rural Australian families report lower access to specialist early parenting services than urban families. To address the early parenting needs of rural families with...
BACKGROUND
Rural Australian families report lower access to specialist early parenting services than urban families. To address the early parenting needs of rural families with children aged 0-3, a novel specialist-nursing early parenting service, Tresillian To You, was implemented for five rural communities in New South Wales, Australia. This study aimed to investigate the initial impact and reach of the service.
METHODS
Convenience sampling was used to recruit 36 parents who attended the service. Of these, 34 completed structured pre-and-post intervention phone interviews. Additional data were collected from the parent and child health record. Data were imported into SPSS for descriptive and inferential data analysis.
FINDINGS
All parent participants were mothers, with a mean age of 31.5 (SD 4.582). Sleep and settling was the primary reason for referral (78%, n = 28). Following service engagement, statistically significant improvements were seen in parent adjustment (95% CI = -1.71, -0.52, p < .001), parent comprehensibility (95% CI = -1.81, -0.42, p = .003), and parent perception of child sleep (95% CI = 16.3, 34.9, p < .001). Families from non-target communities (n = 15) reported a higher level of need at baseline, compared with families from target rural communities (n = 21). Following service engagement, a similar level of benefit was reported between both groups.
DISCUSSION
Preliminary evidence suggests that this new service may be an effective method of providing specialist early parenting intervention for families in rural communities.
PRACTICE IMPLICATIONS
The provision of effective nurse-led specialist early child and family interventions may help to alleviate early parenting difficulty for rural families, leading to improvements in child and family outcomes.
PubMed: 38941961
DOI: 10.1016/j.pedn.2024.06.013 -
European Journal of Paediatric... Jun 2024The internet has become an integral part of daily life, impacting various aspects, especially among children and adolescents. Internet overuse has been associated with... (Review)
Review
BACKGROUND
The internet has become an integral part of daily life, impacting various aspects, especially among children and adolescents. Internet overuse has been associated with numerous physical and mental health issues. Despite its significant implications, there is no universally accepted assessment tool for internet addiction. This study focuses on validating the Georgian version of the Internet Addiction Test (IAT) among pediatric patients aged 9 to 17, specifically the Internet Addiction Test - Adolescence (IAT - A).
METHODS
The study, conducted in 2022-2023, involved pediatric patients from Givi Zhvania Pediatric Academic Clinic, generally healthy but with parental concerns about screen time. The IAT-A, a self-administered questionnaire, was adapted for cultural relevance. Translation-back-translation was employed for linguistic validation. Data was collected twice, with a 6-month interval. Statistical analyses included the Kappa coefficient, Kendall's tau test, paired t-test, and Bland-Altman plots.
RESULTS
The translation process ensured linguistic accuracy and cultural relevance. The study included 100 participants (59 % boys, 41 % girls) with a mean age of 12 years. The mean IAT - A score remained consistently high over both testing periods. Kendall's tau correlation coefficient indicated a strong correlation (0.97), and Bland-Altman plots confirmed repeatability. The cut-off of 40 points identified 84 % as problematic internet users. Individual question analysis showed strong correlation and agreement.
CONCLUSION
The Georgian version of the IAT - A demonstrated reliability and consistency in assessing internet addiction among pediatric patients. The prevalence of problematic internet use among children referred to a university hospital because parents were worried about their internet use was indeed high. The study contributes valuable insights into internet addiction research in Georgia and underscores the importance of a standardized assessment tool. The repeatability of the scores of each question was strong among both groups of problematic internet users and non-problematic internet users, confirming that the Georgian version of IAT - A has high level of accuracy and can be used in internet addiction research.
PubMed: 38941878
DOI: 10.1016/j.ejpn.2024.06.006