Search Results (141)

Background: Adolescents with a chronological age of less than 15 years or a gynecological age of less than 2 years may have a higher probability of complications because they are more likely to conceive within 1 to 2 years of menarche and, therefore, are still growing and maturing. This could impair their ability to adapt to the physiological demands of pregnancy. Objective: To evaluate the relationship between chronological age and gynecological age with low birth weight and small for gestational age among adolescent mothers in Mexico City. Methods: A retrospective cohort design of adolescent mother–child dyads was conducted. The study followed 1242 adolescents under 19 years of age and their children, collecting data on physical, socioeconomic, and clinical characteristics, including hemoglobin levels. Low birth weight was assessed using the Intergrowth-21st project standards and categorized as above or below 2500 g. The mothers were grouped by chronological age (<15 years and ≥15 years) and gynecological age (<3 years and ≥3 years). Adjusted odds ratios were calculated using binary logistic regression models. The outcome variables were low birth weight and small for gestational age. The independent variables included gynecological age, chronological age, age at menarche, hemoglobin concentration, and gestational weight gain, among others. All independent variables were converted to dummy variables for analysis. Calculations were adjusted for the following variables: marital status, maternal education, occupation, educational lag, family structure, socioeconomic level, pre-pregnancy body mass index, and initiation of prenatal care. Results: The average age of the participants was 15.7 ± 1 years. The frequency of small for gestational age and low birth weight was 20% and 15.3%, respectively. Factors associated with small for gestational age included gynecological age < 3 years [aOR = 2.462, CI 95%; 1.081–5.605 (p = 0.032)], hemoglobin < 11.5 g/dL [aOR = 2.164, CI 95%; 1.08–605 (p = 0.019)], insufficient gestational weight gain [aOR = 1.858, CI 95%; 1.059–3.260 (p = 0.031)], preterm birth [aOR = 1.689, CI 95%; 1.133–2.519 p = 0.01], and living more than 50 km from the care center [aOR = 2.256, CI 95%; 1.263–4.031 (p = 0.006)]. An early age of menarche [aOR = 0.367, CI 95%; 0.182–0.744 (p = 0.005)] showed a protective effect against small for gestational age. Factors associated with low birth weight included gynecological age < 3 years [aOR = 3.799, CI 95%; 1.458–9.725 (p = 0.006)], maternal age < 15 years [aOR = 5.740, CI 95%; 1.343–26.369 (p = 0.019)], preterm birth [aOR = 54.401, CI 95%; 33.887–87.335, p = 0.001], living more than 50 km from the care center [aOR = 1.930, CI 95%; 1.053–3.536 (p = 0.033)], and early age of menarche [aOR = 0.382, CI 95%; 0.173–0.841 (p = 0.017), which demonstrated a protective effect, respectively. Conclusions: The study concludes that biological immaturity, particularly early gynecological age, significantly contributes to adverse birth outcomes during adolescent pregnancies. Interestingly, early menarche appeared to have a protective effect, whereas chronological age was not a significant predictor of small for gestational age. Chronological age has an even greater impact: women younger than 15 years are 5.7 times more likely to have low birth weight infants. However, chronological age did not increase the likelihood of having an SGA newborn. Full article

Pediatric palliative care (PPC) is an evolving field that focuses on supporting children with life-limiting conditions, where the quality of care is vital. This study is a retrospective observational investigation that examines the experiences of caregivers to inform health and social service planning and enhance PPC quality. Methods: Data of pediatric patients aged 3 months to 18 years admitted to a PPC inpatient unit over two years were retrospectively reviewed. Sociodemographic characteristics of primary caregivers, including age, gender, number of siblings, education, income, occupation, and marital status, were recorded. Caregiver burden and burnout were assessed using the Zarit Burden Interview and the Maslach Burnout Inventory, respectively. Associations between caregiver characteristics and these measures were analyzed. Results: A total of 118 patients and caregivers were evaluated; 54.2% of patients were male. The most common diagnoses were neurological diseases (44.9%), followed by syndromic–genetic disorders (28.8%). About 34% of patients required more than three medical devices. Most caregivers were female (91.5%), mainly mothers and 53% had only primary education. No significant differences in care burden or burnout were found based on caregiver gender, marital status, or child’s diagnosis. However, the use of nasogastric tubes and multiple medical devices was associated with higher burnout. Lower income was significantly linked to higher care burden, while longer caregiving duration correlated with both increased burden and burnout. A moderate positive correlation was found between Zarit and Maslach scores. Conclusions: The complexity of PPC patients’ care increases caregiver burden and burnout. Expanding specialized PPC services is crucial to support caregivers and sustain home-based care. Full article

To efficiently organize large quantities of acoustic multibeam bathymetric point clouds, this paper proposes an improved oriented quadtree-based method for establishing a data indexing structure stored on a hard disk. First, the spatial characteristics of the multibeam swath data are integrated into the traditional quadtree structure, resulting in an oriented quadtree for data organization. Then, the primary orientation of the root node’s bounding box, which reflects the main orientation of the swath, is consistently applied to all child nodes, eliminating the need to calculate the orientation for each individual child node by the conventional oriented quadtree. Finally, index files containing the point cloud offset, oriented bounding box, and child node information for root, child, and leaf nodes are designed and stored in external storage. Experimental results indicate that, in terms of tree construction time, although the traditional quadtree reduces time consumption by approximately 50% compared to the improved oriented quadtree, the improved oriented quadtree still achieves a 70% reduction in time consumption compared to the conventional oriented quadtree. Regarding point cloud retrieval, within the same retrieval range, the improved oriented quadtree achieves similar average retrieval times as the conventional oriented quadtree but reduces the maximum time consumption by approximately 20.83% compared to the traditional quadtree. Furthermore, by storing the constructed index in binary format on external storage, the space occupancy was reduced by 50%. The approach effectively organizes acoustic multibeam bathymetric point clouds, providing valuable insights for enhancing point cloud retrieval efficiency and reducing data memory usage. Full article

Intensive parenting is a parenting style in which parents, especially mothers, devote significant portions of their time, money, and energy to their children. An intensive parenting attitude questionnaire has been developed that assesses five dimensions of intensive parenting attitude: (1) Essentialism, (2) Fulfillment, (3) Challenging, (4) Stimulation, and (5) Child-centered. Psychologists suggest this attitude can negatively impact maternal mental health or well-being, with the impact varying according to cultural and societal values or socioeconomic and occupational status. There is a need to investigate the effect of intensive parenting attitude on mothers with a focus on a specific culture and maternal background, especially in societies with strongly gendered division of labor. The questionnaire survey examined whether housewives with at least one infant or preschool-aged child (n = 467) and part-time working mothers (n = 148) were affected by intensive parenting attitude in Japan, where there is strongly gendered division of labor and mothers usually take on the burden of housework and childcare responsibilities. In this study, the effects of maternal socioeconomic status and perceived social support were controlled for in order to elucidate the link between intensive parenting attitudes and maternal well-being and self-efficacy. Results showed that, when controlling for socioeconomic status and perceived social support, each dimension of intensive parenting attitude was significantly associated with perceived maternal stress, general life satisfaction, and self-efficacy. Most surprisingly, Essentialism was negatively associated with perceived stress and positively associated with self-efficacy. These findings suggest that the effects of intensive parenting attitude on mothers depend on current child-rearing circumstances and societal or country values. Future research on intensive parenting attitude should consider social variables of mothers. Full article

School bullying is a pervasive issue with significant physical, mental, and social consequences for victims and bullies. Occupational therapy practitioners are uniquely positioned to address bullying due to their expertise in mental health, social participation, and child development. This systematic review synthesizes evidence on school bullying interventions to identify strategies that are relevant to occupational therapy practice. A systematic search was conducted across nine databases and identified 187 studies on occupation-based school bullying interventions. The review included studies employing a wide range of interventions, categorized into three tiers. Universal interventions (Tier 1) were the most effective, often following Social and Emotional Learning frameworks to foster positive school climates and address systemic bullying dynamics. Targeted interventions (Tier 2), such as peer mentoring and social skills training, demonstrated moderate effectiveness for at-risk populations. Intensive interventions (Tier 3) were less effective as standalone approaches but provided essential individualized support. This review highlights the potential for occupational therapy practitioners to play a pivotal role in addressing school bullying through evidence-based, occupation-focused interventions. Full article

This study aimed to explore the factors influencing food hygiene behaviours among child caregivers in Chikwawa district, Malawi. This research focused on three specific hygiene behaviours: keeping utensils on an elevated surface, using soap to clean kitchen utensils, and washing hands with soap at critical times. These practises are known to contribute to the reduction in diarrhoeal disease. To understand these behaviours, this study utilised multilevel binary logistic models to examine variations at both the household and village levels. The findings reveal that educational background, age group, occupation, self-confidence, intervention, self-will, and perception were the most significant factors influencing food hygiene behaviours. Notably, there were significant variations at the village level (p < 0.00001), while no significant variations were observed at the household level (p > 0.1). Additionally, caregivers from areas where interventions were implemented showed a positive response to these interventions. Full article

Side impacts tend to produce more severe injuries than frontal collisions, particularly for vulnerable occupants such as children. Despite this, there is a limited number of studies and developments focused on side impact protection systems, and existing airbag evaluations often rely on destructive and high-cost test methods. This study introduces a novel, cost-effective, and nondestructive experimental testbed designed to evaluate curtain airbags for vehicles in segments B, C, D, and E. The main objective is to develop an adjustable mechanical structure that replicates the side frame geometry of multiple vehicles, allowing the mounting and evaluation of various curtain airbags under realistic conditions. The prototype, capable of withstanding deployment forces of up to 7000 N, was tested with a 3-year-old child dummy, recording a peak head acceleration of 136.17 g, corresponding to AIS level 2. Deployment speeds reached 7.77 m/s, with inflation times between 29 and 36 ms—values that fall within the range reported in previous experimental and numerical studies. The testbed demonstrated consistency in its performance metrics and offers a valuable tool for enhancing child occupant safety in side impacts. Furthermore, it provides a measurable Head Injury Criterion (HIC) range that can be used to interpret injury severity in child occupants. This work contributes significantly to the development of flexible and safe testing methodologies for side airbag systems, reducing the reliance on full-scale crash testing. Full article

Background: To effectively promote physical activity (PA) participation in preschool-aged children with disabilities (PACD), a comprehensive understanding of the associated factors is necessary. Consequently, this study aims to examine the factors influencing PA participation in PACD using the socio-ecological model. Methods: The Disability Status Survey 2020 in South Korea has been used for the current study. PACD aged below five years were selected, resulting in 5825 children. Variables were selected across each level of the socio-ecological model: (1) intrapersonal level (child’s sex, chronic condition, disability level, perceived health), (2) interpersonal level (siblings’ status, grandparents’ status, satisfaction with number of friends), (3) organizational level (enrollment in physical therapy, enrollment in occupational therapy), and (4) environmental level (residential area, government support). The decision tree analysis was conducted using chi-square automatic interaction detection to examine multi-level associated factors of PA participation in PACD. Results: The decision tree analysis produced a three-level model with six terminal nodes. In the study sample, 48.4% of participants reported participating in PA. The most common location for PA was at home, with balance exercises being the most frequent type of activity, followed by stretching. Frequent barriers to regular PA participation included a lack of professionals who are knowledgeable about disabilities and the absence of disability-specific programs. The decision tree analysis identified living with grandparents, the child’s sex, having a sibling, and enrollment in physical therapy as common predictors of PA participation in PACD. Conclusions: This study’s strength lies in its thorough examination of the socio-ecological factors influencing PA participation in PACD. The associated factors span both intrapersonal and interpersonal levels. To enhance PA participation among PACD, interventions should target these levels. Full article

Objective: The aim of this study was to assess the association between the Dietary Inflammatory Index (DII) and depression in mid-pregnancy and the mediating effect of sleep quality according to the Edinburgh Postnatal Depression Scale (EPDS). Methods: This was a cross-sectional study conducted in 2017–2019 at a maternal and child health centre in Hunan Province. After applying the inclusion and exclusion criteria, 749 pregnant women were finally included in this study. A multifactorial logistic regression model was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of the mid-pregnancy DII on mid-pregnancy depression. Restricted cubic spline plot regression was used to analyse the nonlinearity of the association between DII and depression. Mediation effects models were used to analyse the mediating role of sleep quality. Results: The average age of the 749 pregnant women was 29.42 ± 4.22 years. The mean mid-pregnancy DII was 0.21 ± 1.48 and the overall presenting rate of mid-pregnancy depression was 9.35%. In the final model adjusted for covariates such as maternal age, race, mid-pregnancy body mass index (BMI), occupation, literacy, and mean monthly income, the risk of depression in mid-pregnancy DII Q3 was 3.51 times higher than the mid-pregnancy DII Q4 [OR = 3.51, 95% CI = (1.45 to 8.53)]. A high DII in mid-pregnancy was a risk factor for depression in mid-pregnancy (p < 0.05). Restricted cubic spline plot regression analyses showed that the association between mid-pregnancy DII and depression could not be considered nonlinear. Sleep quality may play a mediating role between DII and depression in pregnant women in mid-pregnancy (25.26% of the total effect). Conclusions: A high DII is a risk factor for mid-pregnancy depression. The Dietary Inflammatory Index can influence depression not only directly but also indirectly through the mediating effect of sleep quality on mid-pregnancy depression. Full article

Background: Human papillomavirus (HPV) infection in pediatric populations is an emerging area of interest due to its potential role in early viral transmission and long-term oncogenic risk. The oral cavity may serve as a reservoir for high-risk HPV types; however, its prevalence in children remains under-investigated and unclear. The HOPE (Human papillomavirus Oral infection in PEdiatric population) project aims to assess the prevalence of oral HPV using an innovative salivary sampling method, also exploring the influence of social determinants on parental awareness and attitudes toward HPV vaccination. This paper presents the findings from a cross-sectional pilot study. Methods: This pilot investigation included a total of 70 children (0–14 years) who underwent an oral examination and non-invasive salivary sampling using the novel LolliSponge device. HPV detection was performed using INNO-LiPA^® HPV genotyping. Parents completed a questionnaire assessing socio-demographic factors and HPV-related knowledge. Associations between oral health status, social determinants, and HPV awareness were analyzed. Results: The LolliSponge device demonstrated excellent acceptability among the pilot population. The mean age at recruitment of the children thus far (8 years) appears to correlate with the absence of oral HPV infection. Regarding parental knowledge and attitudes, 51 out of the 70 respondents (72.9%, 95% CI: 62–83%) reported having heard of HPV; however, 94.3% (66/70) were unaware of its transmission routes, and 60% (42/70) did not know that it can cause cancer. Only 4 out of the 70 participants (5.7%) reported that their child had received the HPV vaccine. Lower awareness of the HPV vaccine was significantly associated with a lower educational level (p = 0.001), being married (p = 0.03), and having three or more children (p = 0.039). Awareness of the vaccine’s existence also varied significantly by parental occupation (p = 0.02). Conclusions: The pilot findings of the HOPE project highlight both the potential of innovative strategies for detecting oral HPV infection in children and critical gaps in parental knowledge and vaccine uptake. Preliminary data also reveal an age-related bias in HPV status, suggesting the need for further investigations in a larger cohort of younger children (<5 years). Full article

This paper investigated how parents’ informal work relates to their children’s academic performance. We interviewed the heads of households with 83 school-aged children in peri-urban Kathmandu to obtain information on parental occupation and child schooling. We also interviewed key informants and conducted focus group discussions to investigate the relationship between working parents’ job profiles and their impression of their child’s school achievement. Parent characteristics, such as work status (formal or informal), educational attainment, family size, and number of children, were recorded. The primary variable of interest was the children’s academic performance, measured as improved or otherwise compared to the previous year. Our analysis confirmed that parents in informal jobs spent more time with their school-going children than their counterparts in formal employment. We found that the parents in informal jobs were relatively more educated in the sample area. The existing literature concurs that parental support significantly influences children’s educational outcomes. Parents in informal jobs, while spending more time with their children, expressed pessimism regarding their children’s school performance and future opportunities. We also found that household wealth, past performance, school type, and the level of supporter education in the family played significant roles in shaping parental perceptions of the child’s school performance. At the same time, we found the nature of the parent’s job did not significantly determine the child’s school performance, ceteris paribus. Full article

Background/Objectives: There is a paucity of research that explores the effectiveness of the Sequential Oral Sensory (SOS) Approach to Feeding. The purpose of this feasibility study was to evaluate the necessary components for the implementation of a treatment effectiveness study on the Sequential Oral Sensory (SOS) Approach to Feeding. The primary aims were to develop a fidelity measure, determine the feasibility of video coding, create an observational coding scheme, and determine if the outcome measures were sensitive to change. Methods: Over a 4-year period, data were collected from twelve participants aged 4 to 8 years with developmental disorders, with the assistance of four occupational therapy doctoral students. A fidelity measure was created, and inter-rater reliability was established among the four coders. Videotapes were collected at home and in the clinic. A behavioral coding system, consistent with the SOS Steps to Eating hierarchy, was developed for scoring feeding behaviors. Results: The preliminary inter-rater reliability was reported, and the coding results were represented graphically. Two additional outcome measures were piloted—a visual analog scale (VAS) and the Parenting Stress Index (PSI). The VAS was sensitive to changes in each parent’s ability to support their child, as well as in each client’s progress. The PSI also showed sensitivity to changes in the decline of parent-reported stress and child stress indices. Conclusions: Findings demonstrate fidelity to the SOS Approach, as well as sensitive outcomes, using behavioral coding and parent-reported measures. These evidence-based tools and procedures offer researchers and clinicians objective and meaningful feeding outcomes. Full article

Pediculus humanus capitis infestation is one of the most underestimated parasitoses still constituting a current epidemiological and social problem. Haematophagous insects, the etiological factor of pediculosis capitis, spread most easily in preschool children, which is determined by social and behavioural aspects. The study aimed to search for factors contributing to pediculosis capitis persistence in kindergartens located in south-eastern Poland. For this purpose, anonymous surveys among the management staff of preschool institutions were conducted. Head lice infestations were reported in 87.0% of the 561 surveyed facilities. A positive correlation was confirmed between the prevalence of head lice and a higher number of children in these facilities. Additionally, in 69.3% of the facilities where cases of pediculosis capitis were reported, it was noted that the infestation was associated with the child’s attendance at preschool. Familial and occupational transmission was observed in 78.5% and 25.2% of the facilities, respectively. In contrast, in 93.2% of preschools where no cases of infestation were reported, all parents consented to periodic head inspections. Parents’ attitudes and their perception of head lice as a health issue, rather than an embarrassing problem, appear to be key factors in effectively limiting the spread of head lice in the studied kindergartens. Full article

Background/Objectives: Cerebral palsy (CP) is the most common childhood motor disorder, with unilateral cerebral palsy (UCP) presenting with asymmetrical motor function that can cause decreased upper limb function. Constraint-Induced Movement Therapy (CIMT) is an evidence-based intervention that addresses upper limb functional limitations, but further study on combining interventions with CIMT is warranted. Combining CIMT with virtual reality (VR) is hypothesized to enhance engagement and therapeutic outcomes. This study compared the effectiveness of CIMT alone versus CIMT combined with VR (CIMT + VR) in improving upper limb function and occupational performance in children with UCP. Methods: A blinded, randomized, controlled trial included children aged 5–13 years with Manual Ability Classification System (MACS) levels I–III. The participants were randomized into CIMT or CIMT + VR groups and completed a standardized 10-day camp protocol (60 h). Pre-intervention and post-intervention assessments included the Assisting Hand Assessment (AHA) and the Canadian Occupational Performance Measure (COPM). Secondary measures included acceptability ratings of VR devices and fidelity. Results: Thirty-two participants, with a mean age of 9 years and 3 months (3 years 1 month), MACS I = 4, II = 20, and III = 8, completed this study. CIMT and CIMT + VR led to significant improvements in upper limb function, with no statistically significant differences between the groups in bilateral hand use and occupational performance. Conclusions: These findings reinforce the efficacy of CIMT while highlighting the potential of VR to enhance engagement when the child prefers to interact with the technology, underscoring the importance of individualized approaches that consider a child’s preferences and responsiveness to different intervention modalities. Full article

The Jordan Valley in the West Bank in Palestine provides a unique social, environmental, and geopolitical context in regard to the global challenge of water insecurity, where its impacts on child and maternal health are only partly understood. Existing research has been largely limited to investigations of water quantity/quality and direct health outcomes, such as infectious disease. This qualitative study aimed to provide a holistic perspective of the challenge of water insecurity and child health, by investigating household water insecurity in Palestine. Focus group discussions explored the lived experiences of women from marginalized communities. These were then thematically analyzed, in reference to social theory. The study identified context-specific aspects of water insecurity, shaped by the background in Palestine involving the occupation and ongoing violent conflict in the area. These challenges disproportionately affect women, who are primarily responsible for water management within their communities, leading to embodied experiences, heightened negative emotions, and increased conflict, both within households and the broader community. Consequently, these stressors heavily impact children: limited caretaking time, due to economic pressures, children’s involvement in water-related tasks, and the disruption of social cohesion at both the community and household level, ultimately affect their physical and mental health and their ability to learn and play. Our findings could guide research and policy efforts in developing context-sensitive tools, such as a child water stress index for Palestine. Full article