Children's Center Research Articles

Exploring the Effectiveness and Sustainability of Trust Based Relational Intervention (TBRI®) as a Trauma-informed Approach in Two Tasmanian Child and Family Learning Centres

The impact of adverse childhood experiences (ACEs) is well documented and poses challenges for all those living and working with children who have experienced early adversity. The need to be trauma-informed when working with children in all educational settings is now recognised as essential if healing and learning are to take place. There are an increasing number of trauma-informed approaches available, but empirical evidence that supports their efficacy, particularly in the early years of education, is currently scarce. This paper presents the findings of a small-scale study which explored early childhood professionals’ perceptions of the effectiveness and sustainability of one trauma-informed approach, Trust Based Relational Intervention (TBRI®). Used widely across the US and Europe, TBRI® is relatively new to Australia and was trialled for the first time in this Tasmanian study. Substance Abuse and Mental Health Services Administration’s (SAMHSA, 2014) concept of trauma and guidance for a trauma-informed approach was used to provide a theoretical framework. Online surveys were used to gather data after each professional learning workshop and three and six-months later. Participants reported several positives of TBRI®, including self-development and improved outcomes for children. Whilst challenges/barriers to using the approach were noted, many related to contextual issues rather than to TBRI® specifically. Findings also showed that equipping families with a similar skill set would be advantageous and integral to effecting sustainable change.

Sleep quality and perinatal depression in pregnant women treated in a primary care centre in Lima, Peru

ObjectiveThe aim is to evaluate the association between sleep quality and perinatal depression in pregnant women between the 12th week of gestation and the 36th week of gestation in a maternity and child centre in Lima. MethodsAnalytical cross-sectional study in pregnant women cared for in a primary care centre between August and December 2019. The data were collected through a self-administered survey. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The evaluation of perinatal depression was performed with the Edinburgh Postnatal Depression Scale (EPDS). For the multivariate analysis, Poisson regression with robust variances was used to calculate the crude and adjusted prevalence ratios and their respective confidence intervals. ResultsThe sample was composed of 200 participants. The median [IQR] age was 26 [22–32] years, and 111 (55.5%) pregnancies were unplanned. 52% presented a poor quality of sleep and the risk of perinatal depression was 31.5%. Poor quality of sleep was associated with a significantly higher frequency of perinatal depression (aPR = 4.8 for those with poor quality of sleep warranting medical attention, and aPR = 6.6 for those with poor quality of sleep warranting medical attention and treatment). ConclusionsThere is a possible association between poor sleep quality and perinatal depression in pregnant women between weeks 12 and 36 of gestation. Operational research should be promoted to assess whether interventions to improve sleep quality could have a positive impact on reducing perinatal depression.

Velaglucerase alfa for treatment in children with Gaucher disease type 1: the Russian experience

The current gold standard for the treatment of Gaucher disease type 1 in children is enzyme replacement therapy. The efficacy and safety of treatment with velaglucerase alfa have been assessed in only a few large studies involving pediatric patients as subjects of research. In the Russian literature, there are no data available on the use of velaglucerase alfa in drug-naïve patients with Gaucher disease type 1. The aim of our study was to assess the efficacy and safety of treatment with velaglucerase alfa in children with Gaucher disease type 1. The study was approved by the Independent Ethics Committee and the Scientific Council of the National Medical Research Center for Children's Health of Ministry of Healthcare of the Russian Federation. All patients and/or their legal representatives gave their informed consent to the study. The efficacy of treatment with velaglucerase alfa in children with Gaucher disease type 1 was assessed by analyzing monitoring data of 15 patients aged 2 to 15 years who had been registered in the Russian Pediatric Gaucher Registry established at National Medical Research Center for Children's Health of Ministry of Healthcare of Russia over the period from 2015 to 2023. None of the patients had ever undergone enzyme replacement therapy before they were included in this study. The median age at the start of treatment was 6.5 years. We analyzed the patients' anthropometric, laboratory and instrumental data at 0, 6, 12, 24 and 36 months. The initial dose of enzyme replacement therapy ranged from 30 to 60 units/kg (with the median of 43 units/kg per infusion) once every 2 weeks based on disease severity. In as little as 6 months after the initiation of therapy with velaglucerase alfa, patients with Gaucher disease type 1 showed a statistically significant improvement in all measured parameters (p < 0.001): normalization of the median hemoglobin concentration and platelet count (from 113 to 125 g/L and from 111 to 163 × 109/L, respectively); a reduction in degree of liver and spleen enlargement (in terms of volume, from 45.1 to 17.9% and from 39.4 to 15.5%, respectively); a reduction in degree of the right liver lobe enlargement (in terms of linear measurements, from 27.2 to 11.1%); a reduction in degree of spleen enlargement (in terms of its length and width, from 73.4 to 37.8% and from 60.3 to 17.5%, respectively). Our patients had a remarkable decrease in biomarker activity after 3 years of therapy: chitotriosidase activity decreased from 2699 to 227 nmol/mL/h and glucosylsphingosine level was reduced from 204.0 to 35.3 ng/mL (р < 0.001). There were no adverse events during the course of treatment. After 6 months and 1 year of regular enzyme replacement therapy with appropriate doses of velaglucerase alfa initiated in a timely manner, children with Gaucher disease type 1 achieve normal hemoglobin concentrations and platelet counts, a reduction in biomarker activity, and a decrease in liver and spleen volumes. After 3 years of enzyme replacement therapy, patients achieve their main therapeutic goals such as the resolution of anemia and thrombocytopenia, an almost complete regression of hepatosplenomegaly and the normalization of bone mineral density and height adjusted for age.

Motor, physical, and psychosocial parameters and assessment in preschool children

Managing children's motor, physical, and psychosocial aspects in their formative preschool years is a complex and personalized endeavor, emphasizing early intervention and interdisciplinary collaboration. Motor development management in preschool children underscores the importance of timely intervention. Pediatric physical and occupational therapies play pivotal roles in addressing these challenges, employing engaging activities and exercises tailored to individual needs. The individualized nature of these interventions recognizes each child's unique journey and fosters skill acquisition and development. In parallel, managing physical parameters in preschool children involves growth monitoring, nutritional counseling, and addressing common health concerns. Consistent growth monitoring helps identify deviations from expected patterns, allowing for early intervention in cases of growth-related concerns or nutritional deficiencies. Preschoolers' susceptibility to common health issues necessitates medical management, symptom control, and preventive measures. Psychosocial development management in preschool children centers on emotional resilience, social competence, and cognitive readiness. The discussion also highlights emerging evidence of a link between motor skills and executive functions in preschool-aged children, suggesting opportunities for evidence-based interventions and coordination-demanding activities to optimize motor and cognitive development in this crucial developmental phase.

The association between parent-child quality time and children's flourishing level

PurposeFew studies have examined the association between parental quality time and flourishing measures in young children. This study explored the association between parental quality time and children's flourishing in a national sample of USA children 1–5 years of age. Design and methodsA cross sectional study using data from the 2019–2020 National Survey of Children's Health (N = 17,855). Flourishing was measured with a composite score (values 0–4) derived from 4 questions on attachment with parent, resilience, learning, and contentment with life. Having all 4 items was optimal. Parent-child quality time per week was measured with 3 items: singing or storytelling, reading to child, and family meal with child; using a 4-point scale: 0 days, 1–3 days, 4–6 days, and every day/week. Multivariable logistic regression models were conducted to assess the odds of lower flourishing in SAS 9.4. ResultsAfter controlling for confounding, only the lack of singing and storytelling were negatively associated with greater odds of lower levels of flourishing (0–2 items OR = 5.06, 95% CI 2.11–12.14; 3 items OR = 2.92, 95% CI 1.73–4.93). ConclusionsInsufficient parent-child quality time is associated with lower flourishing levels. Fostering parental opportunities to engage in weekly quality time with their children should be a priority of child health programs seeking to improve child flourishing. Practice implicationsNurses should provide guidance to parents on ways to nurture quality family time and promote children's psychosocial, environmental, and physical well-being. Nurses can advocate for programmatic and policy changes to ensure familial work/life balance and licensing/accreditation of all child centers.

INTRALINGUAL INTERFERENCE IN THE PROCESS OF STUDYING FOREIGN LANGUAGES: SOURCES AND CASES (ON THE BASIS OF THE ENGLISH LANGUAGE)

This article is devoted to the analysis of intralingual interference cases shown by learners who study English as their first foreign language. The paper considers the main concepts and classifications related to the phenomenon of intralingual interference. The author also provides examples of intralingual interference obtained through pedagogical observation at the Foreign Languages Center for Children at Saint Petersburg State University.

Pediatric vs Adult or Mixed Trauma Centers in Children Admitted to Hospitals Following Trauma

Adult trauma centers (ATCs) have been shown to decrease injury mortality and morbidity in major trauma, but a synthesis of evidence for pediatric trauma centers (PTCs) is lacking. To assess the effectiveness of PTCs compared with ATCs, combined trauma centers (CTCs), or nondesignated hospitals in reducing mortality and morbidity among children admitted to hospitals following trauma. MEDLINE, Embase, and Web of Science through March 2023. Studies comparing PTCs with ATCs, CTCs, or nondesignated hospitals for pediatric trauma populations (aged ≤19 years). This systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Review and Meta-analysis and Meta-analysis of Observational Studies in Epidemiology guidelines. Pairs of reviewers independently extracted data and evaluated risk of bias using the Risk of Bias in Nonrandomized Studies of Interventions tool. A meta-analysis was conducted if more than 2 studies evaluated the same intervention-comparator-outcome and controlled minimally for age and injury severity. Subgroup analyses were planned for age, injury type and severity, trauma center designation level and verification body, country, and year of conduct. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess certainty of evidence. Primary outcomes were mortality, complications, functional status, discharge destination, and quality of life. Secondary outcomes were resource use and processes of care, including computed tomography (CT) and operative management of blunt solid organ injury (SOI). A total of 56 studies with 286 051 participants were included overall, and 34 were included in the meta-analysis. When compared with ATCs, PTCs were associated with a 41% lower risk of mortality (OR, 0.59; 95% CI, 0.46-0.76), a 52% lower risk of CT use (OR, 0.48; 95% CI, 0.26-0.89) and a 64% lower risk of operative management for blunt SOI (OR, 0.36; 95% CI, 0.23-0.57). The OR for complications was 0.80 (95% CI, 0.41-1.56). There was no association for mortality for older children (OR, 0.71; 95% CI, 0.47-1.06), and the association was closer to the null when PTCs were compared with CTCs (OR, 0.73; 95% CI, 0.53-0.99). Results remained similar for other subgroup analyses. GRADE certainty of evidence was very low for all outcomes. In this systematic review and meta-analysis, results suggested that PTCs were associated with lower odds of mortality, CT use, and operative management for SOI than ATCs for children admitted to hospitals following trauma, but certainty of evidence was very low. Future studies should strive to address selection and confounding biases.

Biochemical Profile of People with Down syndrome: About 25 Cases

Down syndrome or trisomy 21 is a genetic disease resulting from an additional gain of chromosome 21. It predisposes to multiple pathologies including obesity, infections, diabetes, or hypothyroidism, responsible for various biological abnormalities. This work aimed to determine biochemical profile of congolese persons with Down syndrome, living in Brazzaville (Congo). The study was carried out on 25 persons with Down syndrome. They are cared for in four specialized centers for disabled children. The methodology was based on the determination of glycaemia, proteins and lipids by spectrophotometric and electrophoretic methods. Globally, normal values of total cholesterol, triglycerides, and glucose (except for one person who had moderate hyperglycaemia), were observed. We noted an hyperlipidemia associated with low levels of HDL, LDL, albumin, and alpha 1 globulin. In Conclusion: there is a disturbance in biochemical profile in subjects with Down syndrome, which predispose to diabetes, cardiovascular diseases and opportunistic infections.

Sleep disturbances are associated with feeding practices and age in preterm infants

BackgroundPreterm infants are under risk of several shortcomings including sleep disturbances (SD). This cross-sectional study evaluated factors associated with SD in preterm and low birth weight infants in a reference center for preterm children at a University Hospital, southeastern Brazil. MethodsA hundred-four dyads of mothers-infants 0–3 years participated. Mothers answered an online questionnaire (Google Forms®) evaluating childbirth characteristics, gestational age, breastfeeding, bottle feeding, non-nutritive sucking habits and sociodemographic information. The Brazilian version of the Brief Infant Sleep Questionnaire (BISQ) evaluated SD. Bivariate and Logistic Regression analyses were performed (p < 0.05). ResultsSD was present in 45.2% of the sample. Multivariate Logistic Regression Model showed that infants breastfed ≥3 times at night had 5.006 more chances to have SD (CI 95% = 1.229–20.400) compared to those who did not breastfeed at night. Infants who were bottle-fed 3 ≥ times at night had 6.952 more chances to have SD (CI = 95% = 1.364–35.427) compared to those who were bottle fed less frequently. The chance of SD decreased 6.6% (CI 95% = 0.889–0.982) for each increase of a month in infant's age, and infants from families with higher income had 3.535 more chances to have SD (CI 95% = 1.006–12.416). ConclusionThe younger the child, a higher frequency of night feeding and belonging to higher income families were associated with SD. Recognizing the associated factors with SD in newborns and infants can aid families to better deal with this issue, promote better sleep quality and individualized counseling.

12: Results of ECMO training for pediatric ICU staff: a report from China National Children Center

12: Results of ECMO training for pediatric ICU staff: a report from China National Children Center

지역아동센터 아동들의 행복 증진을 위한 연극놀이 집단프로그램 개발 및 적용

The purpose of this study was to develop a happiness-enhancing theatrical play group program based on the ADDIE model for children at a local children's center. First, sub-factors related to happiness were analyzed to derive strategies for program development. Second, a draft program was developed based on the program design principles. Third, the program was revised and supplemented after an expert review of the program. Fourth, the program was implemented for 30 children at a local children's center in K city. Finally the program effectiveness was analyzed through children's satisfaction with the program, interviews, and social worker evaluations. The results showed that the group program based on theater play had a positive impact on the children's happiness. These results suggest that it is necessary to explore the approach of group programs based on theatrical play to improve the happiness of children in local children's centers.

지역아동센터 종사자의 감정노동과 조직몰입의 관계에서사회적 지지의 매개효과

The purpose of this study was to analyze the effect of their emotional labor on organizationalcommitment through social support for local children's center workers. In order to do it, 229copies of the survey data of the workers were used to verify the mediating effect. The mainresults were as follows. First, emotional labor and organizational commitment showed a positivecorrelation. Second, emotional labor directly affected organizational commitment. Emotionallabor affected social support, and this social support affected organizational commitment. Third,except for continuous commitment, the relationship between emotional labor and thesub-variables of organizational commitment was completely or partially mediated by thesub-variables of social support. Based on these results, plans were proposed to improve theorganizational commitment of social workers in local children’s center.

PUSAT TERAPI ANAK AUTIS DI MARTAPURA KALIMANTAN SELATAN

During the period of cognitive development, some children not a few who experience some problems at the stage of their cognitive development, one of which is the presence of Autism Spectrum Disorder (ASD). It was recorded in January 2018 that there were 500 cases of children with autism in South Kalimantan. In South Kalimantan itself, therapy centers for autistic children are still very few and the facilities they provide are still very limited. And there are still many parents who think therapy for autistic children doesn't make any changes to their children. Meanwhile, in therapy it takes a long time and consistently in therapy and the active cooperation of parents must be active at home. So it is felt that there is a need for an Autistic Children Therapy Center in South Kalimantan at this time. This is realized by the method of Psychological Architecture and the concept of applying the principles of Healing Environment to create an Autistic Child Therapy Center that can improve the behavior of autistic children for the better and provide education to parents.

함께 성장하는 아이들 : 합창 프로그램에 참여한 지역아동센터 소속 다문화 및 비다문화 가정 아동 이야기

함께 성장하는 아이들 : 합창 프로그램에 참여한 지역아동센터 소속 다문화 및 비다문화 가정 아동 이야기

Development of a child rights-based cultural diversity program for children in community child centers

Development of a child rights-based cultural diversity program for children in community child centers

The clinical presentation of avoidant restrictive food intake disorder in children and adolescents is largely independent of sex, autism spectrum disorder and anxiety traits

Avoidant restrictive food intake disorder (ARFID) is a new eating disorder with a heterogeneous clinical presentation. It is unclear which patient characteristics contribute to its heterogeneity. To identify these patient characteristics, we performed symptom-level correlation and driver-level regression analyses in our cross-sectional study in up to 261 ARFID patients (51% female; median age=12.7 years) who were assessed at the Maudsley Centre for Child and Adolescent Eating Disorders, London between November 2019 and July2022. Symptoms across the three drivers 1) avoidance based on sensory characteristics of food; 2) apparent lack of interest in eating; and 3) concern about aversive consequences positively correlated with each other. Patients' anxiety traits showed the greatest positive correlations with symptoms of concern about aversive consequences of eating. Patient sex was not significantly associated with any of the three ARFID drivers. Patients with comorbid autism spectrum disorder (ASD; 28%) showed more food-related sensory sensitivities (RR=1.26) and greater lack of interest in eating (RR=1.18) than those of patients without ASD (49%). In our clinical sample, the ARFID drivers occurred together and did not show clinically meaningful differences between the sexes. ASD may accentuate food-related sensory sensitivities and lack of interest, but may not drive a completely different symptom presentation. ARFID is multi-faceted and heterogenous, requiring a comprehensive multidisciplinary assessment to sufficiently understand the drivers of the restrictive eating behaviour. Results need replication in larger samples with more statistical power. None.

The Situation of Unaccompanied Migrant Minors and Young People in Shelters and Protection Centers in Andalusia (Spain)

ABSTRACT This article aims to determine the situation of unaccompanied immigrant minors and young people in reception and protection centers for children in Andalusia, Spain. The study design is qualitative exploratory. The fieldwork was carried out in three provinces of Andalusia and involved interviews and focus groups with minors and young people in shelters and protection centers. The results show the participants’ perception of the care they receive in the centers. Situations of conflict between minors and professionals, disputes generated by cultural differences, lack of quality food, and cases of violence, among other issues, are the experiences reported by those interviewed. The research concludes that there is a need for more significant work inspections in reception and protection centers and more excellent proximity to urban environments that help social inclusion.

Validation of a renal risk score in a cohort of children with ANCA-associated glomerulonephritis.

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is extremely rare in children. Renal involvement is a common and severe complication of AAV as it can cause end stage kidney disease (ESKD). ANCA renal risk score (ARRS) is helpful in predicting long-term ESKD in patients with ANCA-associated glomerulonephritis (AAGN). This retrospective study included 61 consecutive patients with kidney biopsy specimen-proven AAGN from Clinical Center for Children's Kidney Disease in China. Each patient was assessed by eGFR, normal glomeruli, and tubular atrophy/interstitial fibrosis, and the renal outcome was evaluated using the ARRS. Based on the ARRS, 27 (44.26%), 21 (34.43%), and 13 (21.31%) patients were divided into the low-risk, medium-risk, and high-risk groups, respectively. The median follow-up period was 46.36 (14.58-95.62) months. The high-risk group had worse renal outcomes than the low-risk group (p< 0.05) and the medium-risk group (p < 0.05). COX multivariate regression analysis showed that eGFR ≤ 15 ml/min/1.73 m2 (p = 0.015, Hazard Ratio (HR) = 9.574, 95% CI 4.205-25.187) and ARRS (p = 0.012, HR = 2.115, 95% CI 1.206-4.174) were independent risk factors for ESKD.The area under the curve for ESKD prediction of ARRS was 0.880, and the best cutoff value was 5.50. Delong test result showed that ARRS exhibited better predictive value for ESKD than the Berden classification (p < 0.001) and rapidly progressive glomerulonephritis (p < 0.001). This is the first study to investigate the value of the ARRS for predicting renal prognosis among Chinese children. The ARRS is a preferred index that can predict ESKD in Chinese children with AAGN.

THE ROLE OF INTERLINGUAL AND INTRALINGUAL INTERFERENCE IN FOREIGN LANGUAGE LEARNING

This article is devoted to the study of language interference cases shown by learners who study a foreign language. The paper considers the phenomenon of interlingual and intralingual interference, analyses the types and sources of interference phenomena. The paper also provides examples of interlingual and intralingual interference influence obtained in terms of pedagogical observation at the Foreign Languages Center for Children at Saint Petersburg State University.

Exchange of Extracorporeal Membrane Oxygenation Cannulas for Hemodialysis Catheters in Children Requiring Renal Replacement Therapy.

Pediatric patients requiring extracorporeal membrane oxygenation (ECMO) may require renal replacement therapy even after decannulation. However, data regarding transition from ECMO cannulation to a hemodialysis catheter in pediatric patients is not currently available. Patients <18years old who had an ECMO cannula exchanged for a hemodialysis catheter during decannulation at a tertiary care children's center from January 2011 to September 2022 were identified. Data was collected from the electronic medical record. A total of 10 patients were included. The cohort was predominantly male (80.0%, n = 8) with a median age of 1day (IQR 1.0, 24.0). All ECMO cannulations were veno-arterial in the right common carotid artery and internal jugular vein. The median time on ECMO was 8.5days (IQR 6.0, 15.0). One patient had the venous cannula exchanged for a tunneled hemodialysis catheter during decannulation, two were transitioned to peritoneal dialysis, and seven had the temporary hemodialysis catheter converted to a tunneled catheter by Interventional Radiology (when permanent access was required) at a median time of 10days (IQR 8.0, 12.5). Of these 7 patients, 28.6% (n = 2) developed catheter-associated infection within 30days of replacement, with one requiring catheter replacement. Transient bloodstream infection occurred in 10.0% (n = 1) within 30days of ECMO cannula exchange. Venous ECMO cannula exchange for a hemodialysis catheter in children requiring renal replacement therapy after decannulation is possible as a bridge to a permanent hemodialysis or peritoneal catheter if renal function does not recover, while supporting vein preservation.