Children's Levels Research Articles

Radiographers’ perspectives on immobilisation and restraint mechanisms in paediatric radiography

IntroductionThe utilisation of immobilisation or restraint during paediatric radiography is a multifactorial issue with associated legal and ethical considerations. Current practice regularly presents challenges for radiographers, with a notable absence of any professional best-practice guidance. This study investigated radiographers’ perspectives in Ireland on the use of immobilisation or restraint methods and the factors influencing these choices and aimed to fill the 20-year gap in European radiographers’ perspectives gaining an up-to-date understanding and contribute to the global conversation in this regard. MethodsAn anonymous online survey design was constructed using the Google Forms platform and distributed to hospital radiology departments across the Southern region of Ireland. Additionally, a short survey was send to the head of the nine radiology departments to audit the existing availability of immobilisation and/or restraint devices for paediatric radiography. Descriptive statistics (frequencies and percentages) were undertaken. Bar charts were utilised where appropriate to display trends. ResultsOne hundered and three responses were received. The majority of radiographers reported using immobilisation (95 %) or restraint (89 %) techniques during paediatric radiography, although 70 % acknowledged the lack of training regarding restraint techniques. However, 93 % reported trying alternative techniques such as distraction and negotiation to avoid immobilisation or restraint. A desire for further guidance and training was reported, with 80 % of respondents noting training as essential or potentially beneficial. ConclusionsAmbiguity remains surrounding the distinction between the terms “restraint” and “immobilisation” in paediatric radiography. Radiographers' use of restraint and immobilisation during paediatric radiography is influenced by the child's age, distress level, radiation protection and safety, and the ability of the child to understand instructions. Appropriate up-to-date guidelines and training would be recommended to clarify terminology and promote the safe practice of restraint and immobilisation during paediatric radiography.

Utilization of early therapeutic supports by autistic preschoolers in Australia: A cross-sectional study following implementation of the National Disability Insurance Scheme.

There are many types of support for young autistic children and their families, but service use in this population is not well understood. In this study, primary caregivers of autistic preschoolers were surveyed (n = 95) and a selection were then interviewed (n = 19) to understand how early, therapeutic supports were accessed by families in Australia following the establishment of a National Disability Insurance Scheme (NDIS). This article presents the quantitative data from surveys and interviews. Families usually accessed at least two types of support. The most accessed supports were occupational therapy, speech pathology and psychology, with 43% of the sample accessing some other form of support. Multiple linear regression indicated that children's higher level of support need, living in less remote or less socio-economically disadvantaged areas, and high household income were associated with higher numbers of supports accessed. Services tended to follow an individual, clinic-based model and little use of alternative service delivery was reported. The findings indicate that Australian families are accessing a wider range of support types than before the NDIS and children with more substantial autism-related support needs are likely to access a greater number of types of supports. Socio-economic inequities continue to exist and should be addressed.

Occupational therapy in the Snoezelen® Room: Teachers’ and therapists’ knowledge and perceptions of the changes in children's behaviour and performance

Introduction: The Snoezelen® room, a multisensory environment (MSE), is often used in conjunction with sensory integrative techniques. Therefore, it may be of support in school-based occupational therapy intervention. Research has documented positive changes in children’s performance in the MSE. However, research to suggest that changes could be carried over to external environments is limited. This study aimed to investigate the knowledge and perception of teachers and therapists regarding changes in children's behaviour and performance after therapy in the Snoezelen® room. Methodology: A descriptive quantitative cross-sectional survey design by purposive sampling was used. Teachers and therapists working with children who received occupational therapy intervention in the Snoezelen® room participated. Results: Descriptive and inferential statistics were utilized to determine strong positive, significant correlations found between the total impact of the Snoezelen® room and the children’s level of arousal, as well as their behaviour and scholastic performance, as conveyed by 30 participants. After therapy in the Snoezelen® room, improvement in level of arousal was ranked as the biggest change, which appeared to improve for hours upon return to the classroom. Conclusion: Children’s arousal levels changed positively due to sensory input, which carried over to the external environment. Due to this, most teachers and therapists perceived that the Snoezelen® room positively changed behaviour and scholastic performance, through improved level of arousal. Implications for practice: The use of Snoezelen® rooms in schools, combined with sensory integration therapy (SIT), enhances children's self-regulation, which in turn positively impacts behaviour and academic performance. Strong, positive correlations were found between children's level of arousal and improvements in their behaviour and scholastic performance. Thus, Occupational therapy interventions in the Snoezelen® room significantly contribute to children’s ability to self-regulate, a key factor in achieving positive classroom behaviour and learning outcomes. Teachers and therapists perceive Snoezelen® rooms as beneficial, with 96.7% supporting their presence on school campuses to improve child behaviour through better self-regulation. Consistent with extensive research surrounding self-regulation of children, acquiring self-regulation skills in the early years lays the foundation for positive classroom behaviour and academic performance later.

Clinical Validation of a Custom Wearable Patch for Accurate and Comfortable Vital Sign Monitoring in Pediatric Patients

Background/Purpose: Measuring vital signs in pediatric patients requires special consideration and adaptation due to varying anatomy and wide age range. In addition, children's anxiety, uncooperativeness, and high activity levels further complicate measurements, necessitating devices and algorithms designed to minimize the inaccuracies and discomfort. In this work, the performance of a custom wearable patch mounted on the mid-sternum was validated in uncontrolled settings on a cohort including 84 pediatric patients. Methods: Three-minute-long electrocardiogram (ECG), seismocardiogram (SCG) and photoplethysmogram (PPG) signals were acquired using the custom patch. First, pre-processing and signal smoothing algorithms were employed to suppress the out-of-band and motion noise. Two different tasks were then studied: (i) Heart rate (HR) and respiration rate were derived from the ECG, PPG and SCG signals individually. During HR derivation from the SCG, a novel Teager-energy-based HR estimation algorithm was proposed. (ii) Clinical relevance of the SCG signals was shown through mapping the SCG characteristics to body mass index (BMI) and blood pressure values. Results: While the best HR estimation was achieved through the PPG-infrared signal with an absolute error of 2.22.1 bpm, the best respiration estimation was achieved with PPG-Red signal with an error of 2.62.2 breaths/min. On the other hand, regression models resulted in a minimum of 85% confidence interval, revealing that the SCG characteristics indeed have salient correlation with the BMI and blood pressure values. Conclusion: Overall, such a system can potentially be leveraged in clinical practices to achieve more comfortable and accurate measurements.

CSF Interleukins-12, 17 and Interferon-γ Levels in Children with Subacute Sclerosing Panencephalitis.

Subacute sclerosing panencephalitis (SSPE) is a devastating fatal condition caused by mutated measles virus. It predominantly affects children of younger age and invariably leads to mortality. Though reported rarely, the disease continues to cause significant morbidity in children. The authors conducted an observational study in which CSF was withdrawn from 24 cases of confirmed SSPE (Dyken's criteria) and interleukin levels were estimated by ELISA method. On analysis, IL-12 was significantly elevated in CSF of stage 3 SSPE patients with p value of 0.02. It was elevated in only 2 patients of stage 3 which is the major limitation of this study. No significant difference was seen in IL-17 and interferon-γ levels between different stages of SSPE in serum and CSF. This study highlights the significant elevation of IL-12 cytokine while other studied cytokines (IL-17/ IFN-γ) were not significantly altered in these patients.

Challenges Of Obtaining Reliable Eyewitness Testimony from Children and Practical Implications

The reliability of eyewitness testimony provided by children has always been a controversial area in research. This paper addresses the challenges of obtaining reliable eyewitness testimony from children and explores its practical implications. The research background highlights the importance of understanding children's developmental stage, memory and language skills, and how these factors influence their ability to provide accurate testimony. The review explores the different aspects that influence the reliability of children's testimony, including verbal and non-verbal factors, cognitive instructions, and how to build trust. As children have high emotional needs, it is important to provide support while obtaining eyewitness testimony. The final section summarizes the main findings, highlighting the effectiveness of multiple interviews, flexible questioning strategies and the importance of parent and interviewer support. Disadvantages include differences in children's anxiety levels and the need to adapt interview techniques to children. Future research should focus on refining these techniques and studying the impact of different support systems on children from different backgrounds.

Relationship Between Early Childhood Caries And Iron Levels In Children: A Systematic Review

Background: Early childhood caries (ECC) is one of the most common diseases in early years of life. It is considered a serious public health problem. Though preventable, globally over 530 million children have decay in their primary teeth, and the condition is highly prevalent in both developed and developing countries. It has also been reported to have a close relationship with other systemic deficiencies. Materials and Methods: A systematic review on ECC and iron deficiency was done based on published articles in PubMed and Google scholar databases. The search profiles included ECC/risk factor, ECC/anemia, ECC/ferritin, and ECC/iron. Inclusion criteria comprised of all studies that focused on ECC and iron. Results: A significant relationship was observed between iron deficiency (ID) and occurrence of ECC. Several theories have been laid down in this regard. Our listed studies states that children with ECC appear to be at greater odds of having low iron and haemoglobin levels depicting iron deficiency anemia as compared to the control groups. Conclusions: Based on our findings, it is concluded that the incidence of ECC in young children appears to be associated with iron deficiency even in its mildest form. It is one of the risk factors for ID in children. More research needs to be done to examine lifestyle and socioeconomic risk factors that are associated with malnourishment.

PP406 Topic: AS14–Infections: Sepsis and Septic Shock/Antimicrobial Stewardship/Tropical and Parasite Infections/Other: ANTIPHOSPHOLIPID ANTIBODY LEVELS IN CHILDREN WITH SEVERE COVID-19 INFECTION

PP406 Topic: AS14–Infections: Sepsis and Septic Shock/Antimicrobial Stewardship/Tropical and Parasite Infections/Other: ANTIPHOSPHOLIPID ANTIBODY LEVELS IN CHILDREN WITH SEVERE COVID-19 INFECTION

Golden Breath: Feasibility and acceptability of a biofeedback-based virtual reality game on reducing children's needle-related pain and fear

BackgroundNeedle procedures can cause pain and fear in children. Current literature reports that biofeedback-based virtual reality applications may help alleviate children's pain and fear. This study aims to evaluate the feasibility, acceptability, and safety of the newly developed game Golden Breath, which uses biofeedback-based virtual reality to reduce children's needle-related pain and fear. MethodsThe development of Golden Breath includes; (1) development of the application's features based on needs assessment, (2) gamification of the application content based on literature, (3) development of the prototype, (4) expert evaluation and feedback on the application content, (5) usability testing by 11 children (4–12 years). ResultsRegarding acceptability, the expert evaluation showed a high usability of the system. All children provided positive feedback and reported high satisfaction with Golden Breath. The game was feasible and effective for reducing children's pain and fear levels during needle procedures. Golden Breath was deemed safe for children because it did not cause symptoms such as dizziness, vomiting, or nausea. ConclusionThe expert evaluation, children's feedback, and pilot study results showed that the Golden Breath game is feasible, acceptable, and safe for children during the needle-related procedure. The pilot study revealed that the Golden Breath game effectively reduced pain and fear during blood sampling in children. Practice to implicationsIt is recommended that healthcare professionals use Golden Breath to optimize the well-being of children receiving treatment for chronic and acute diseases.

The Estimation of Copper Serum Level Among Obese Children

Background: Obesity means an excess amount of body fat. No general agreement exists on the definition of obesity in children as it does adults. Most professionals use published guidelines based on the body mass index (BMI), or a modified BMI for age, to measure obesity in children. Others define obesity in children as body weight at least 20% higher than a healthy weight for a child of that height, or a body fat percentage above 25% in boys or above 32% in girls Objective: to estimate the serum level of copper among obese children. Methods: This comparative study was conducted on fifty of overweight and/or obese children (based on BMI) and thirty of clinically healthy, age and sex matched children's served as controls also, the cases and controls were selected randomly from the pediatrics outpatient clinic of Benha University Hospital and Sheben El Kom Educational hospital, in the period between 2013 to 2015. Parental consent was obtained for all children included in the study. Results: In the current study there were no significant difference found between patients and control group regarding age, sex and residence, but there was significant difference between the two groups regarding income and socioeconomic state. P=0.04. Also, there were no static difference in height in patient when compared to control group, and patients had a higher statically significant Weight, BMI and Skin fold thickness when compared to control group. Additionally, that there were significantly higher rate of frequent bad nutritional habits including shipping breakfast (p=0.022) consumption of energy- dense food and food consumption during TV watch in patients than controls. P< 0.001 and the children's physical activity levels were lower in the patient’s group than the control group. P<0.001. Conclusion: The obesity varied remarkably with different socioeconomic levels. Obese children had a characteristic nutritional pattern like skipping breakfast and consumption of energy dense food

Pilot study of a parent-based intervention for functional somatic symptoms in children.

Functional somatic symptoms are associated with significant distress and impairment for children and their families. Despite the central role that families play in their children's care, there is little clinical research to guide how parents can support their children with functional somatic symptoms and promote better functioning. To address this gap, we developed a parent-based intervention for functional somatic symptoms in children and obtained preliminary data on acceptability, feasibility, treatment satisfaction, and clinical outcomes. The intervention was adapted from SPACE (Supportive Parenting for Anxious Childhood Emotions), an evidence-based treatment for anxiety and related disorders in children. The intervention, SPACE-Somatic, was delivered to parents of 16 children (Mage = 14.50 years; 75% girls) with a range of functional somatic symptoms. Parents participated in seven weekly group sessions conducted via telehealth. We found that SPACE-Somatic was acceptable, feasible, and satisfactory to parents. There were significant improvements in several clinical outcomes from baseline to posttreatment, including children's level of functional impairment, with some gains maintained at 3-month follow-up. Parents also reported improvements in their own stress and their accommodation of children's symptoms. This pilot study provides preliminary evidence that a parent-based intervention is viable and beneficial to children with functional somatic symptoms and their parents.

Influence of physical activity home environment on fundamental movement skills development in Chinese preschoolers: mediating role of moderate-to-vigorous physical activity.

Research on how the physical activity home environment affects fundamental movement skills (FMS) in preschool children in China is limited. However, the role of moderate-to-vigorous physical activity (MVPA) in this relationship is still unclear. This study aims to analyze gender differences in FMS, explore associations between the physical activity home environment, MVPA, and FMS, and investigate MVPA's mediating role in these relationships. We recruited 169 preschool children (95 boys, 74 girls; mean age 4.9 years) from four kindergartens in Hengyang, China. The Family Environment Scale on Motor Development for Preschool Urban Children (FESMPD) assessed physical activity home environment. Objective measurement of MVPA used ActiGraph wGT3-BT accelerometers. The Test of Gross Motor Development-3 (TGMD-3) evaluated FMS. Statistical analyses were conducted using the PROCESS macro in SPSS, with sociodemographic variables as controls. Boys exhibited significantly higher levels of MVPA, parenting style, locomotor skills, and object control skills compared to girls (P < 0.05). MVPA, parenting style, and FMS showed positive correlations (R = 0.355-0.568, P < 0.05). Similarly, MVPA was positively correlated with the physical activity home environment (β = 0.237-0.568, P < 0.05). Parenting style emerged as a significant predictor of children's MVPA levels (β = 0.956, P < 0.001), and MVPA was a predictor of the development ofFMS and its subdomains (β = 0.097-0.207, P < 0.05). Furthermore, MVPA partially mediated the relationship between parenting style and the development of FMS in preschool children. The physical environment was also a significant predictor of children's MVPA (β = 0.637, P < 0.05), and in turn, MVPA predicted the development of FMS and its subdomains (β = 0.188-0.343, P < 0.01). Notably, MVPA fully mediated the relationship between the physical environment and the development of FMS. Overall, this study highlights the important roles of physical activity home environments and individual levels of MVPA in developing FMS in preschool children, noting significant gender differences. Parenting style greatly affects both MVPA and FMS development, while the physical environment fully mediates this relationship. Collaborative efforts among kindergartens, families, and communities are essential to support MVPA and improve FMS development.

An expert consensus on managing cough in Indian pediatric practice: airway disease education and expertise 2.0 (2024)

Cough in children is one of the most frequent presenting symptoms in health care settings. Coughing can significantly affect a child's sleep and level of activity, which often causes parents’ distress. Promptly addressing chronic cough may enhance the quality of life in children and reduce the considerable stress on parents. In 2017, airway disease education and expertise (ADEX) NEXT recommendations for diagnosis, management, and follow-up of persistent (chronic) cough were published. For the present work 27 modified Delphi consensus statements were prepared, and a survey was undertaken involving 30 expert pediatricians from across India. The opinions of the expert panel on the updates related to pediatric chronic cough awareness, diagnosis, and management were collected. Consensus was predetermined to be obtained if more than 75% of the participants agreed or remained neutral for the statement. All the statements were supported by the latest data from the literature search. All the statements reached consensus after an agreement of more than 75%. Consequently, all the opinions from experts were consolidated and expert recommendations were framed. Children presenting with cough should be treated in accordance with child-specific guidelines. The present expert recommendations can be utilized by pediatricians to make well-informed decisions when treating pediatric patients with cough. The management of cough in children should be determined by the underlying cause, where a prompt and efficient therapy can result in early resolution.

Preliminary study on the feasibility of approximating children's engagement level from their emotions estimation by a picture-based, three-model AI in a family-robot cohabitation scenario

Haru4Kids (H4K) is a system that emulates the physical, social, family-oriented robot Haru, designed with the goal of cohabitating with children in their homes for extended periods of time. In a previous experiment [Garcia GA, Perez G, Levinson L, et al. Living with Haru4Kids: study on children's activity and engagement in a family-robot cohabitation scenario. In: 2023 IEEE ROMAN; 2023 Aug. p. 1428–1435], seven families kept H4K for a span of two weeks in their homes. Throughout this period of cohabitation, we collected child-robot interaction data, including images that were later hand-annotated to estimate user engagement. In this present work, we used a novel AI-based, four-stage framework available from Roboflow for the automatic estimation of children's level of engagement from their inferred emotions. We did a deep study of the performance and behaviour of that framework over our dataset of users' pictures and characterized its response in order to understand its advantages and limitations, including the technique used to translate emotions into engagement levels. We also tested a different approach for that mapping, using a machine learning technique based on Support Vector Machine (SVM). The framework yielded promising results just ‘off-the-shelf’: 0.47–0.68 accuracy and 0.46–0.70 F1 using the original mapping, and 0.39–0.75 and 0.37–0.78 respectively using SVM. Therefore, we propose this emotion-based approach for engagement estimation from pictures.

Child-Centered Care: A Qualitative Study Exploring Pediatric Hospitalization Through Children's Perspectives.

Background/Objectives: Hospitalization can be stressful for children due to the influence of unfamiliar environments, separation from family, and interactions with healthcare professionals. This study aimed to explore children's hospitalization experiences from a child-centered care perspective to develop interventions that better meet their emotional and psychological needs. Methods: This qualitative study employed Husserl's descriptive phenomenology to explore hospitalization experiences among children aged 9-13 years. Conducted at a primary health center in Spain from October 2022 to June 2023, the study used purposive sampling to select participants hospitalized within the past six months. Data were collected through in-depth interviews and children's self-created drawings, analyzed using thematic analysis with ATLAS.ti software. Results: A total of 10 school-age children (five boys and five girls) were interviewed. Three main themes emerged: (1) Emotions and Feelings-children described fear, anxiety, and loneliness during their hospital stay; (2) Experiences of Pain and Discomfort-participants reported physical pain and discomfort; (3) Interactions with Medical Staff-children expressed a need for more detailed explanations and clearer communication. Conclusions: The findings highlight the importance of family-centered care and improved communication between healthcare providers and children. Strategies like art therapy and flexible visiting hours could provide better emotional support. Tailored communication to children's developmental levels is crucial. Integrating these strategies into clinical practice could enhance the well-being of hospitalized children. Future research should focus on evaluating these interventions to improve pediatric care.

How do fathers' educational level contribute to children's school problems? Overparenting and children's gender and surgency in a moderated mediation model.

This study aims to investigate (a) the mediating role of overparenting between father's educational level and children's school problems, and (b) the joint moderating role of children's gender and surgency in the indirect relationship between father's educational level and school problems. Participants were 203 school children, 96 boys (47.3%) and 107 girls (52.7%), aged 7-8 years (M = 92.42 months, SD = 3.52). Fathers reported their educational level, age and employment status and their children's gender and number of siblings, as well as their overparenting behaviors by Anticipatory Problem Solving (APS) scale. Teachers informed children's school problems by the Behavior Assessment System for Children (BASC T-2). Parents together informed their children's surgency levels by a subscale of Children's Behavior Questionnaire (CBQ). Results showed that, in girls, the father's educational level was negatively related to the child's school problems via overparenting behaviors, controlling the number of siblings and father's age and employment status. However, among boys, fathers' overparenting protect their shy sons from the risk of a low educational level for school problems. These findings highlight the relevance of considering the gender and surgency to a better understanding of the effects of contextual factors on children's outcomes.

Effectiveness of Activity Supported Earthquake Awareness Education Program in Primary School Children: "I Know What I Need to Do, I'm Not Falling Even If We Shake" Project.

The objective of this study was to enhance the knowledge base of primary school children regarding earthquake preparedness through the implementation of an activity-based earthquake awareness education program. The study was conducted as pre-posttest semi-experimental design with one group of 333 children in a primary school between January and May 2024. A Descriptive Information Form and Earthquake Awareness Knowledge Level Form were the data collection tools. The children were provided with a 6-week (modules) education program. Measurements were made before and after the education. The mean age of the children was 7.16±0.73 years (6-9), 56.8% were girls, 43.2% were boys, and 25.8% were second-grade children. Earthquake Awareness Knowledge Level Form total score was higher after the education (18.31±1.52) than before (15.51±3.73) (t=-16.144, p<0.001). The study revealed an increase in children's knowledge regarding appropriate behaviors in the context of earthquakes, encompassing actions to be taken before, during, and after such events. Modular education and applied activities are effective in increasing children's knowledge levels in the context of teaching a concept such as earthquake preparedness, where the acquisition of life-based skills is of paramount importance.

The who, when, and why of pacifier use.

Social and familial consequences of pacifier use remain poorly understood. The present study attempts to shed more light on the characteristics of parents using pacifiers with their infants and to explore how pacifier use affects perceptions of infant emotionality, maternal stress, and parental efficacy. The study sample consisted of 428 mothers (range: 17-49 years) of infants (0-36 months) who completed a comprehensive questionnaire assessing infant and parent characteristics as well as parenting practices and pacifier use. We compared attitudes toward pacifiers, parenting stress, children's levels of reactivity and self-regulation, and maternal efficacy among Pacifier Users, Never-Users, and families that Tried-Pacifiers. The reported results reveal benefits of pacifier use for the family relationships, namely reduced parenting stress (p = 0.018), better parent-child dynamics (p < 0.001), and more positive perceptions of child's affectivity (p = 0.006), which are all important aspects of infant development. Our findings highlight developmental benefits of pacifier use, a practice that is known to have both positive and negative long-term consequences for healthy child development. It is, therefore, important for health professionals to have discussions about the pros and cons of pacifier use with parents. The study provides novel insights into how and why mothers use pacifiers and into the psychological consequences of this practice. We found pacifier use is associated with less maternal stress, better mother-child dynamics, and more positive perceptions of child's affectivity. Our findings document developmental benefits of pacifier use adding a new perspective to the debate on pacifiers. Doctors, health visitors, pediatric nurses, and midwives may consider this evidence when advising parents on pacifier use.

Effectiveness of Universal Community Engagement Childhood Obesity Interventions at Improving Weight-Related and Behavioral Outcomes among Children and Adolescents: A Systematic Review and Meta-Analysis.

Universal community engagement interventions can address childhood obesity. This review aimed to evaluate the effectiveness of these interventions in improving body mass index (BMI) (primary outcome) as well as dietary choices and activity levels (secondary outcomes) among children and adolescents. Eight electronic databases were searched from inception dates to January 2024. A meta-analysis was conducted using the random-effect model, when appropriate; otherwise, the findings were narratively synthesized. Heterogeneity was determined by the I2 statistics and Cochran's Q chi-squared test. The Cochrane ROB tool and the GRADE approach were used to assess the quality appraisal at the study and outcome levels, respectively. Twenty-two studies were included in this review. The results showed that these interventions had a limited effect in improving children's standardized BMI (BMI-z) scores post-intervention. A meta-analysis on BMI-z scores showed that the intervention group had a statistically non-significantly lower BMI-z score than the control group (MD = -0.02, 95%CI = [-0.07, 0.03], Z = 0.83, p = 0.40) at immediate post-intervention. It was also reported that universal community engagement interventions had a limited effect in improving children's dietary choices and activity levels. Only the meta-analysis on children's daily sugar-sweetened beverage intake measured using continuous data reported a statistically significant small effect favoring the intervention group (SMD = -0.25, 95%CI = [-0.38, -0.13], Z = 3.98, p < 0.0001) at immediate post-intervention. Universal community engagement interventions have the potential to address childhood obesity. Children and adolescents could benefit more from interventions that focus on implementing both environmental and behavioral changes, and interventions that include parental involvement.

Illness-related communication between siblings and parents of children with chronic illness and life-limiting conditions: A qualitative analysis.

Having a brother or sister who has a chronic illness (lasting >6 months and requiring long-term care) or life-limiting condition (LLC; where cure is highly unlikely and the child is expected to die) has major impacts on siblings. Parent-sibling illness-related communication may contribute to siblings' capacity to cope. In this study, we aimed to explore parent-sibling illness-related communication, from the perspectives of parents and siblings. We also aimed to qualitatively compare participants' responses according to illness group (chronic illness vs. LLCs). We collected qualitative data from siblings (32 with a brother/sister with a chronic illness, 37 with a brother/sister with an LLC) and parents of a child with a chronic illness (n = 86) or LLC (n = 38) using purpose-designed, open-ended survey questions regarding illness-related communication. We used an inductive qualitative content analysis and matrix coding to explore themes and compare across illness groups. Two-thirds of siblings expressed satisfaction with their family's illness-related communication. Siblings typically reported satisfaction with communication when it was open and age-appropriate, and reported dissatisfaction when information was withheld or they felt overwhelmed with more information than they could manage. Parents generally favored an open communication style with the siblings, though this was more common among parents of children with an LLC than chronic illness. Our findings show that while many siblings shared that they felt satisfied with familial illness-related communication, parents should enquire with the siblings about their communication preferences in order to tailor illness-related information to the child's maturity level, distress, and age.