Parent Management Research Articles

The understated issue of caregiver anxiety for pediatric surgical hospital admissions: opening the blindfolds

Hospitalization is a nerve-wrecking experience for patients and their families (Lam et al. in Int J Nurs Stud 43:535-545, 2006). The financial burden of hospitalization is the prime perpetrator, however, multiple other factors also contribute significantly to the underlying problem which can be eliminated by efforts of the doctors and other healthcare workers and by modifying the hospital policies (Bassett et al. in J Hosp Med 15:652-658, 2020). We can reduce the number of outpatient visits and switch to telemedicine for rescheduling the cases. The pre-anaesthetic clearance and all the relevant investigations can be done on a single OPD visit thereby reducing the requirement of repeated commutes to the hospital. The free of charge category of the hospital can be extended to the patient requiring prolonged hospital stay or for solid tumor patients who require repeated hospital admissions for chemotherapy. Association with child welfare Non-government organizations (NGO's) can also solve major monetary issues for parents of patients suffering from complex congenital anomalies and solid tumors. The pre-operative NPO period can be shortened to 2-4h, antibiotic use can be completely avoided or minimized in clean elective cases, children living in the same city requiring dressing/catheter removal after a few days (e.g. hypospadias, posterior sagittal anorectoplasty) can be discharged and called for a OPD visit after 5-7days if the parents are willing to take care of the child at home. Patients undergoing minor elective surgeries can be followed up on telemedicine visits only. Parents of patients suffering from complex congenital anomalies should be referred to a clinical psychologist and receive periodic counseling sessions. A child psychologist should also be included in the management of cases which have social stigma attached as bladder exstrophy, anorectal malformations, spina bifida requiring lifelong follow-up and bowel washes or repeated clean intermittent catheterisation. Anxiety assessment questionnaires must be incorporated in the management of chronic patients and high-risk parents must be identified (Tiedeman in J Pediatr Nurs 12:110-119, 1997). We hereby propose adoption of family centric approach during the management of a patient as this may minimize the overall burden of the hospitalization of the family. Hospital admission of a child leads to a myriad responses in the parents. Thus, we conducted a hospital-based cross-sectional study to determine the prevalence of anxiety and depression among the primary caregivers of hospitalized children and the factors causing it. Parents of 228 children admitted in the pediatric surgery ward at a tertiary care hospital were interviewed using the HADS-A and Hamilton Anxiety Questionnaire to assess the prevalence of anxiety and depression during hospital admission. They were also subjected to a questionnaire comprising of 52 questions spread over 5 segments-demographic details, monetary burden, effect on siblings and other family members, practical problems faced, and surgery-specific concerns. Thirty percent of the parents had severe anxiety and 20% developed depression due to the hospitalization of their child. We tested the association of this depression and anxiety against 56 variables in this study. Exorbitant loan amounts (ra -0.449, rd-0.557), repeated commute to the hospital (ra -0.274, rd -0.231), monetary burden (ra -0.193, rd -0.186), repetitive sampling (ra -0.248, rd -0.203), prolonged absence from work (ra -0.440, rd -0.424) were found to be the chief perpetrators of this anxiety and depression. The burden of anxiety and depression in the primary caregivers of pediatric surgical patients is enormous. Identification of the implicating factors is essential. Simple reforms such as reduction in the number of OPD visits, extension of free of charge category, association with non-governmental organizations and involvement of a clinical psychologist can significantly meliorate the hospital journey of both the patients and their parents. (rd-correlation coefficient of for depression, ra-correlation coefficient of for anxiety).

Parental Awareness and Management of Bullying in Children with Food Allergies

Children with food allergy (FA) are twice as likely to be bullied compared to children without FA, and parents are often unaware when bullying occurs. Little is known about parental management of FA-related bullying. We sought to evaluate parental awareness and management of bullying in children with FA.

Risk factors of congenital hydrocephalus: a case-control study in a lower-middle-income country (Egypt).

Hydrocephalus is the most common brain disorder in children and is more common in low- and middle-income countries. Research output on hydrocephalus remains sparse and of lower quality in low- and middle-income countries compared with high-income countries. Most studies addressing hydrocephalus epidemiology are retrospective registry studies entailing their inherent limitations and biases. This study aimed to investigate child-related, parental, and socioeconomic risk factors of congenital hydrocephalus (CH) in a lower-middle-income country. An investigator-administered questionnaire was used to query parents of patients with CH and controls who visited the authors' institution from 2017 until 2021. Patients with secondary hydrocephalus and children older than 2 years of age at diagnosis were excluded. Uni- and multivariable logistic regression was performed to identify the factors affecting CH development. Seven hundred forty-one respondents (312 cases and 429 controls) were included in this study. The authors showed that maternal diseases during pregnancy (OR 3.12, 95% CI 1.96-5.03), a lack of periconceptional folic acid intake (OR 1.92, 95% CI 1.32-2.81), being a housewife (OR 2.66, 95% CI 1.51-4.87), paternal illiteracy (OR 1.65, 95% CI 1.02-2.69), parental consanguinity (OR 3.67, 95% CI 2.40-5.69), a history of other CNS conditions in the family (OR 2.93, 95% CI 1.24-7.34), conceiving a child via assisted fertilization techniques (OR 3.93, 95% CI 1.57-10.52), and the presence of other congenital anomalies (OR 2.57, 95% CI 1.38-4.87) were associated with an independent higher odds of a child having CH. Conversely, maternal hypertension (OR 0.22, 95% CI 0.09-0.48), older maternal age at delivery (OR 0.93, 95% CI 0.89-0.97), and having more abortions (OR 0.80, 95% CI 0.67-0.95) were negatively correlated with CH. Multiple parental, socioeconomic, and child-related factors were associated with higher odds for developing CH. These results can be utilized to guide parental counseling and management, and direct social education and prevention programs.

Strengthening parenting among refugees in Europe (SPARE): initial feasibility in Iceland and Norway

Several European countries have offered refuge to families forced to flee their homes because of violence, war, and other disasters. Stressful factors associated with displacement and relocation place families at risk for disrupted effective child-rearing practices and associated growth in problems for parents and their children. The need to promote healthy adjustment and prevent and ameliorate problems for refugee families is vital. The present study describes SPARE (Strengthening Parenting Among Refugees in Europe), a trauma-informed adaptation of the evidence-based parenting program Generation Parent Management Training Oregon Model (GenerationPMTO). SPARE integrates core parenting components in GenerationPMTO with skills designed to address families’ trauma experiences. A collaborative team of GenerationPMTO experts in Iceland, Norway, Denmark, and the Netherlands have adapted this parent group intervention for Arabic-speaking (Middle Eastern) refugee families who have relocated in Europe. This report describes results from an acceptability and feasibility study based on the first two SPARE groups completed in Iceland and Norway. Overall, attendance was good, parents reported satisfaction with their experiences in the groups and said that the material addressed important family needs. Parents also indicated the need for more time to deepen their understanding, provide greater focus on age-specific needs, and in Norway in particular, more information about the child welfare system.

Effectiveness of Emotional Regulation Training on Parenting Style Related to Parental Obesity and Weight Management in Adolescents with Bulimia Nervosa

Objective: Eating disorders are among the common mental/psychosomatic disorders that cause numerous problems in physical health, psychological functioning, and the quality of life of adolescents. The aim of the present study was to determine the effectiveness of emotional regulation training on the parenting style related to parental obesity and weight management in adolescents with Bulimia Nervosa. Materials and Methods: The current study was a quasi-experimental research with a pre-test, post-test, and control group design. It included adolescents with Bulimia Nervosa and a body mass index above 25 who were referred to comprehensive health service centers in District 7 of Tehran in 2023. The statistical sample consisted of 30 individuals who were randomly divided into two groups of 15, an experimental group and a control group, using random allocation. The intervention group received emotional regulation training in 8 sessions lasting 75 minutes once a week. Data were collected using the Parenting Style Questionnaire (Baumrind, 1973) and the Weight Management Self-Efficacy Questionnaire (Clark et al., 1991). Multivariate analysis of covariance and SPSS software version 22 were used for data analysis. Findings: The results showed that emotional regulation training was effective on the parenting style related to parental obesity (P<0.001) and weight management (P<0.001) in adolescents with Bulimia Nervosa. Conclusion: Based on the current findings, it can be concluded that emotional regulation training for parents leads to changes and improvements in weight management in adolescents with Bulimia Nervosa.

Comparison of the Effectiveness of the Mindfulness Parenting Training Program along with Parent Management Training (Combined Training) with Mindfulness Parenting Training and Parent Management Training alone on Coping Strategies and Marital Satisfaction

Aim: The present study was conducted with the aim of comparing the effectiveness of the mindful parenting training program along with parent management training (combined training) with mindful parenting training and parent management training alone on coping strategies and marital satisfaction in mothers of preschool children. Methods: The current research was a quasi-experimental design with a pre-test, post-test and two-month follow-up with a control group. The statistical population included all the mothers of preschool children in Kashmir city in 2019-2020, from which 120 people were selected by purposive sampling and randomly assigned to four groups include 30 subjects that first group received Mindful Parenting Training and second group received Parent Management Training in 8 sessions 120 to 150 minuties weekley, and last group received Combined Training in 16 sessions 150 minutes, two sessions per week. Control group didn’t recived any program and was wait list. In all three stages of pre-test, post-test and follow-up, all people completed Enrich's (1989) marital satisfaction questionnaires and Lazarus and Folkman's (1984) coping strategies. Finally, the data were analyzed by repeated measurement variance analysis methods with the help of SPSSV19 software. Results: The results showed that none of the educational methods were effective in marital satisfaction (F=0/08, P=0.98). This was despite the fact that in two problem-oriented (F= 6/97, P= 0/0001) and emotion-oriented strategies (F= 8/14, P= 0/001), this amount was significant. This means that in the post-test and follow-up phases, the combined training of parent management and mindful parenting was more effective. Conclusion: The findings of the research show that the combined training of mindful parenting and parenting management training can reduce emotion-oriented strategies and increase problem-oriented strategies, but it has no effect on marital satisfaction, so the awareness of parents, teachers, counselors, psychologists and other professionals about these trainings can be helpful.

Social media addiction and effect on academic performance among library and information science students in universities in Nigeria

The purpose of the study is to investigate the effect of social media addiction on academic performance of undergraduate students in universities in Nigeria. The study adopted a quantitative research method. Online questionnaire was developed by the researchers using Google form to collect data from 1,239 LIS students in Nigerian Universities. The study found that WhatsApp, Facebook, YouTube and Twitter are the commonly used social media tools by the students of Library and Information Science in Nigerian universities. The students mostly used the social media tools for the purpose of entertainment & fun, and social communications (e.g birthdays). The study also revealed that the majority of the students agree and strongly agree to the statements which show their level of social media addiction. The majority of the students agree that the time they spend on social media affect their school grades. The findings of the paper will inform the management of universities, lecturers, university authorities, healthcare practitioners, library staff, library directors, researchers and parents to take rectification measures to avoid facing the perils of social media addiction. The high prevalence of social media addiction among students therefore calls for university authorities to develop a policy on the use of social media among students.

Control and its perception in CEE parent companies and their developed market subsidiaries

Our article examines control perceptions among Central and Eastern European (CEE) parent companies and their subsidiaries in developed markets based on human resource management and corporate social responsibility practices. Through a multiple case study approach, we identify the usage of impersonal and personal control mechanisms across three parent companies from the Czech Republic and their subsidiaries in Germany. We also identify perception gaps regarding the intensity of the asserted parental control of subsidiary practices. Due to isomorphic pressures, parental interference in practices with a high contextuality in the developed host market result in the perception of being tightly controlled in the subsidiary, which is in contrast to the parent’s perception. Nevertheless, we demonstrate that close personal ties between parent and subsidiary managers alleviate the control perception on the subsidiary side and consequently the overall control perception gap.

The effectiveness of a home-based parent management training for preschoolers with oppositional behaviors in Israel: A randomized controlled trial

ObjectiveParent management training (PMT) is a well-established approach for treating young children's disruptive behavior. This randomized controlled trial (RCT) examined the effectiveness of Positive Parenting for Oppositional Preschoolers (PPOP), an Israeli-developed PMT intervention for treating young children's opposition and accompanying disruptive behaviors. MethodEighty-five Israeli parental couples (170 individuals: 85 fathers, and 85 mothers) with a 3–6-year-old child exhibiting non-clinical disruptive behavior were randomly assigned to either an 8-session PPOP (N = 42) or a waitlist control group (N = 43). Parents completed measures of child disruptive behavior, parenting stress, and parental self-efficacy before and after the intervention and at a 3-month follow-up. ResultsThe intervention effects (Cohen's d) were very large for children's disruptive behavior (d = 3.35), parenting stress (d = 1.78), and self-efficacy (d = 1.32). Improvements were only evident for the PPOP group, and all gains were maintained at follow-up. Participants in the waitlist control group did not report changes in their child's behavior, parenting stress, or parental self-efficacy. PPOP had a very low dropout rate (4.76%) and a very high attendance rate for mothers (100%) and fathers (98.7%). Both parents were highly satisfied with the parent training program. ConclusionsThis study provides evidence of the effectiveness of PPOP, a new home-based PMT intervention developed in Israel. In the short and long term, PPOP effectively treats young children's non-clinical disruptive behavior, reduces parenting stress, and increases parental self-efficacy.

Modeling the impact of individual, educational and external factors affecting psychological well-being in children with the mediating role of life skills media education

Aim: The current research was conducted with the aim of modeling individual, educational and external factors affecting psychological well-being in children with the mediating role of life skills media education. Methods: This research is descriptive in terms of its purpose and is considered a survey study in terms of data collection. To conduct the research, all the factors related to the issue of psychological well-being in children were identified in the literature by relying on the theoretical foundations and the literature, and then, in order to validate the items, the factor loadings of the items were presented. The statistical population of the research was the experts in the field of psychology, who especially had studies in the field of children. Purposeful sampling and snowball method were used to select the participants and finally 20 people were considered as a statistical sample. Data analysis was also done using interpretive structural model. Results: The findings of the research showed that the factors underlying well-being are divided into three personal, educational and external dimensions, which include factors such as emotional intelligence, personality traits, self-regulation, responsibility, self-efficacy, emotion regulation, perceived social support, mindfulness, communication patterns, stress and anxiety. social for the individual dimension, parent management training, academic performance, positive intelligence training, life skills training and family performance for the educational dimension and finally, parent-child relationship, family cohesion and flexibility, socio-economic status, social networks, parental employment, Internet addiction and computer games have been proposed as external factors affecting children's psychological well-being in the model. Conclusion: Therefore, it is recommended that families strengthen the spirit of expressing feelings and experiences in their children by increasing their presence in social environments and trusting their children, because this issue strengthens the psychological well-being of children

Comparison of the Effectiveness of Kendall's Coping Cat Group Program and Parent Management Training on Anxiety and Resilience of Elementary School Students

Comparison of the Effectiveness of Kendall's Coping Cat Group Program and Parent Management Training on Anxiety and Resilience of Elementary School Students

가상현실(VR)을 활용한 교정상담과 재활의 함의

본 연구의 목적은 “가상현실(VR)을 활용한 교정상담(Correctional Counseling)과 재활 (Rehabilitation)의 함의”를 리뷰하는 데 있다. 미국 형사사법제도(Criminal Justice System)에 서는 가상현실(VR)을 적극적으로 활용하고 있는 실태이다. 특히, 교정상담(Correctional Counseling)과 재활(Rehabilitation), 범죄자재활(Offender Rehabilitation), 범죄자재통합 (Offender Reintegration), 범죄피해자(Crime Victims) 등에 가상현실(VR)이 적용되고 있다. 범죄자(Offenders)의 왜곡인지(distorted cognitions)가 반사회적 활동(antisocial activities) 을 조절하는 과정이 교정상담(correctional counseling)의 핵심 관건이다. 가상현실(VR)을 사용 한 범죄자의 사회현실인지(cognition of social reality) 교육은 사고, 감정, 행동에 대한 정신적 표상(mental representations)뿐만 아니라 자신과 타인에 대한 정서적 공감과 행동의 결과예측 도 포함한다. 아울러 국내에 주의력결핍 및 과잉행동장애(ADHD), 품행장애(CD), 간헐적 폭발장 애(IED) 등 부모의 정신건강을 위한 가상현실(VR) 부모관리교육(Parent Management Training) 프로그램 개발 및 개입이 절실하다. 향후 연구는 가상현실(VR)에서 습득한 친사회적· 긍정적 기술이 실제 행동으로 어떻게 변환되는지에 대한 이해를 높이고 형사사법제도(Criminal Justice System)에서 범죄자의 행동(behavior), 태도(attitudes), 사고(thinking)에 대한 가상 현실노출치료(VRET)와 분노조절 가상현실 인지행동치료(AM-VR-CBT)의 장기적인 효과를 확 립할 필요가 있다. 효과적인 사회복귀 프로그램 개입 없이 처벌과 감시체제는 범죄자의 재범에 한계를 가져올 수 있다. 따라서 국내에서도 다양한 가상현실치료(VRT) 프로그램을 적용한 위험성 -욕구-반응성(Risk-Needs-Responsivity) 기반 교정상담(Correctional Counseling)과 재활 (Rehabilitation)은 새로운 치료적 형사사법제도(Criminal Justice System)의 강화와 개혁에 이 바지할 것이다.

Школа в период самоизоляции: что мешает и что помогает подросткам учиться?

The coronavirus pandemic led to a massive transition to distance learning at schools. All participants in the educational process adapt their lifestyle, workplace, communication methods and leisure forms to the new circumstances. Nowadays the consequences of this phenomenon begin to be studied. This article is devoted to the study of the experience of learning, communication and leisure of teenagers in conditions of social isolation and school closure and approbation of the risk and protective factors model in the context of adaptation to the distance learning. Thematic analysis of semi-structured interviews with adolescents aged 13-17 from Moscow, Ryazan, Tomsk, Moscow and Sverdlovsk regions allows us to characterize five thematic categories in terms of the main factors that make it more difficult or easier for schoolchildren to adapt to the distance learning. The categories include: school and teacher relations; supplementary education and hobbies; relationships with peers; family context; individual and personal characteristics of schoolchildren. The pilot nature of this study and a small sample limit the possibilities of extrapolating the conclusions to all groups of Russian schoolchildren, but allow us to problematize the complex nature of the difficulties faced by adolescents and demonstrate a wide range of resources that allow them to cope with them. Based on the results, we developed short recommendations that can be used by the management of educational organizations, teachers, and parents to reduce stress and simplify the adaptation of students during distance learning.

Children’s Sleep and Externalizing Problems: A Day-to-day Multilevel Modeling Approach

ABSTRACT Background Sleep problems and externalizing problems tend to be positively associated, but the direction of this association is unclear. Method Day-to-day associations between sleep and behavior were examined in children (N = 22) ages 3–8 with clinical levels of externalizing problems. These children were enrolled in Parent Management Training and behavioral sleep intervention. During assessments before and after treatment, children wore actigraphs for seven days and parents concurrently completed sleep diaries and daily tallies of noncompliance, aggression, and tantrums. Multilevel modeling was used to account for the nested structure of the data, at the day-to-day level (level 1), within assessment points (level 2), and within children (level 3). Results Late sleep timing and fragmentation were predictive of next-day noncompliance and tantrums, respectively. There were fewer associations for a given day’s behavior predicting that night’s sleep, although children who showed more aggression and noncompliance at baseline tended to have later bedtimes and sleep onset times compared to other children.

“Are They Going to Play Nicely?” Parents’ Evaluations of Young Children’s Play Dates

Over the last 20 years, opportunities for young children to engage in self-directed free play with peers outdoors or during the school day has dramatically declined. Consequently, it is likely that play dates, defined as pre-arranged social contact at home, have become increasingly significant play environments for children. Preliminary research suggests that play dates are positively associated with young children’s social and emotional development, but that access can be strongly influenced by parental social networking priorities. However, little is currently known about the nature and frequency of play dates, the types of play children engage in, or the impact of parental management and supervision on children’s play in this context. Exploratory qualitative research is essential to understand the extent to which parental gatekeeping may limit opportunities for children and families perceived to have low social capital, and to begin to define the nature and content of young children’s play dates more broadly. Parents of children aged 5-6 years old took part in a semi-structured interview to describe common practices and attitudes (N = 11). Inductive thematic analysis indicated that play dates are complex play environments that parents associate with a range of social, emotional, and cognitive benefits for children. However, close parental monitoring and supervision may limit the extent to which play dates provide opportunities for self-directed free play. Findings also show that access to play dates is strongly influenced by parents’ motivations to enhance children’s social status which restricts access to some children. Implications for future research are discussed.

Neuropsychological features in RASopathies: A pilot study on parent training program involving families of children with Noonan syndrome.

Noonan syndrome (NS) is a clinical variable multisystem disorder caused by mutations in genes encoding proteins involved in the RAS/mitogen-activated protein kinase signaling pathway. NS is characterized by a distinctive facies, short stature, and congenital heart defects. Psychomotor delay, learning difficulties, and social deficits are also common. Furthermore, behavioral and attention problems can be reckoned as a key symptom in NS, with functioning resembling the patterns observed in attention deficit hyperactivity disorder (ADHD). The complex behavioral phenotype has great impact on the quality of life and raises demanding management issues also for patients' families. Parent management training (PMT) is recommended as first-line treatment for ADHD; however, no study has been performed to test the efficacy of PMT in NS, thus far. The aim of this pilot study is the implementation and evaluation of a PMT dedicated to NS families. Parents of seven children with NS were recruited and underwent to a 10-session PMT. Three different questionnaires were administered to both parents: Conners Parent Rating Scales, Parenting Stress Index Short Form (PSI-SF), and Alabama Parenting Questionnaire (APQ). Our findings on this first small cohort of families indicate that positive perception and satisfaction about the child and the interaction with him increased in mothers after the intervention, as measured respectively by PSI-SF difficult child (DC) and PSI-SF parent-child dysfunctional interaction (PCDI), while mothers' level of stress decreased after the PMT, as indicated by PSI-SF total scores. Furthermore, APQ positive parenting, which measures behaviors of positive relationship with the child, increased in mothers after the intervention. Statistical analysis on fathers' questionnaires did not show significant differences after the PMT sessions. This pilot study suggests that PMT is a promising intervention for parents of NS children with behavioral and ADHD symptoms. Changes in mothers' attitudes and distress indicate that behaviorally oriented programs may help parents to manage with NS phenotype.

The effectiveness of systemic psychological interventions for young people with intellectual disabilities and behavioural problems: A systematic review

Antisocial behaviour in young people is a widespread issue. Young people with borderlinemild Intellectual Disabilities (ID) are often not recognised or provided with support for their learning and are more likely to engage in antisocial behaviour than young people without ID (Hall, 2000). Research has indicated that these young people benefit from systemic psychological interventions which target the systems around them (Tausendfreund et al., 2016). Whilst the literature base for interventions that reduce behaviour problems is vast, there has been limited research for young people with borderline-mild ID and there have been no previous systematic reviews focused on this group. The objective was to discover which systemic psychological interventions are effective for young people with borderline-mild ID and significant behaviour problems. PsychINFO and Web of Science databases were searched and after duplicates removal, 4018 articles were screened via titles and abstracts. 3862 records were excluded at that stage, and a further 150 were excluded at the full text screening stage. One additional paper was identified, resulting in seven studies included in this review. The Quality Appraisal Checklist for Quantitative Intervention Studies (QACQIS) (NICE, 2012) was used to analyse methodological quality. Methodological quality varied in accordance with study design. Six different systemic psychological interventions were identified, and even though the research indicated positive results for all interventions, it was concluded that Parent Management Training, Mindfulness Based Positive Behaviour Support, Non-Violent Resistance-Intellectual Disabilities, and Multisystemic Therapy-ID showed most promise as equitable systemic psychological interventions for reducing behaviour problems in young people with borderline-mild ID. It was difficult to draw direct comparisons between studies due to variation in study design and outcome measurements. Multi-site, multi-informant randomised research should be carried out in the future.

Swimming Sports: Parental Management In Children With Asthma

This study aims to determine the management of parents through physical activity, in this case, swimming, to reduce asthma symptoms. This swimming activity is collaborated with other activities such as cycling, walking and running. This research method uses Qualitative Research with one participant who is a parent of asthmatics. The instrument used is an interview, and the data was analyzed using Health Literacy Theory. The results show that by managing health-literate parents, the program will impact reducing asthma symptoms in children

Parent training for the treatment of irritability in children and adolescents: a multisite randomized controlled, 3-parallel-group, evaluator-blinded, superiority trial

BackgroundIrritability is common in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and with anxiety/depressive disorders. Although youth irritability is linked with psychiatric morbidity, little is known regarding its non-pharmacological treatments. Developing non-pharmacological treatments for children with severe, chronic irritability is an important target for clinical research. To achieve this goal, we will test the benefits of parent-focused therapies in reducing irritability. The aim of the study is to compare Parent Management Training (PMT) and Non-Violent Resistance Training (NVR) programs with treatment-as-usual (TAU) on the improvement of irritability in children and adolescents with a baseline Parent-rated Affective Reactivity Index of 4 or higher, in the context of ADHD and other emotional and behavioural disorders. Additionally, we will assess (i) improvement of irritability at different times and according to different informants (parents, children, clinicians); (ii) improvement of parental strategies; and (iii) acceptability of the interventions, exploring possible mechanisms of the therapeutic effect.MethodsTwo hundred and seventy participants between 6 and 15 years with ADHD and other emotional and behavioural disorders will be recruited and randomly assigned with their parents to the PMT, NVR, and TAU groups. PMT and NVR programs have 10 online sessions and two booster sessions at 1 and at 3 months. The primary outcome measure is the change from baseline at 3 months after completion of the program of the Clinician-rated Affective Rating Scale (CL-ARI) assessed by a blind evaluator. Secondary outcome measures include the change from baseline from those scales: the CL-ARI, the Clinical Global Impression Improvement scale, the Parenting and Familial Adjustment Scales, the Child-rated Cranky thermometers and the Parent-rated ARI. We will assess the parent’s expressed emotions and reflexivity during the online five-minute speech sample, clinical dimensions through the Child Behavior Checklist 6–18 and the Inventory of Callous Unemotional traits. Evaluations will be done remotely at baseline and at 1- and 3-months follow-up visits.DiscussionWe expect a benefit in controlling irritability in the treatment groups. This will constitute an important achievement in promoting parental support programs in the treatment of irritability in the context of emotional and behavioural disorders.Clinicaltrials.gov. Number: NCT05528926. Registered on the 2nd of September, 2022.

Secular trends of birth weight and its associations with obesity and hypertension among Southern Chinese children and adolescents.

The association of low or high birth weight (L/HBW) with obesity and hypertension in childhood remains unclear. We aimed to identify the secular trend ofbirth weight distribution and its relationship to obesity and hypertension in Southern Chinese children and adolescents. 6,561 individuals (6-17-year-old) were enrolled by multistage cluster sampling to observed the trend of birth weight distribution and its associated factors. 1,218 were further selected by group matching to investigate thecorrelation between birth weight and obesity or hypertension. Between 1997 and 2008, a significant decline inthe LBW rate and no significant change in the HBW ratewas found. LBW was associated with maternal BMI<18kg/m2 (OR1.79, 95% CI 1.08-2.97) during pregnancy, while maternal BMI between 25.0 and 27.9kg/m2 (OR1.62, 95% CI 1.04-2.52) and paternal BMI>28kg/m2 (OR1.64, 95% CI 1.02-2.63) during pregnancy were associated with HBW. The prevalence of obesity was significantly higher with HBW than normal birth weight (NBW) or LBW (16.73, 6.25 and 5.50%, respectively). The prevalence rates ofsuspected hypertension were 1.62, 1.25 and 1.49% amongLBW, NBW and HBW, respectively (p>0.05). LBW decreased the risks of childhood overweight (OR0.31, 95% CI 0.18-0.54), but had no effect on suspected hypertension. HBW increased the risks of childhood obesity (OR2.19, 95% CI 1.50-3.20), but decreased the risks of suspected hypertension (OR0.22, 95% CI 0.09-0.58). HBW was positively associated with childhood obesity, and parental BMIs management might be one of the measurements to control birth weight to lessen childhood obesity.