Parental Concern Research Articles

DEVELOPING PANCASILA AND CITIZENSHIP EDUCATION LEARNING MODEL BASED ON CHARACTER EDUCATION THROUGH COMPREHENSIVE APPROACH

Education aims to educate and create the nation's future generation with character. However, problems like brawls, violence, abuse of narcotics, illegal drugs, and promiscuity still occur among students. It becomes the concern of parents and teachers in educating and leading students to develop their character. The teacher is obligated to develop Pancasila and Citizenship Education learning model suitable for students to have good character. Through character education, it hoped that it would produce a sound generation. The educational process that gives birth to the expected character is, of course, gradual. This study aimed to find out Pancasila and Citizenship Education learning model for developing students' character. Research using mixed methods research with data collection, analysis, and mixing both quantitative data and qualitative. This study used quantitative and qualitative approaches in collecting data through interviews and questionnaires. The results showed that Pancasila and Citizenship Education Learning model based on character education through a comprehensive approach could develop and shape the students' character, such as inculcation, modelling, values facilitation, and skill-building. Through character development, it hoped that good characters expected to form permanently.

Parental experience of prophylactic antibiotics

Background and objectivesLong-term prophylactic antibiotics are often used to prevent bacterial infections. However, supporting evidence for this is not always robust. Including parents in decisions relating to medication is key...

Covid-19 Pandemic and Online Education: Impact on Students, Parents and Teachers

ABSTRACT The sudden outbreak of COVID-19 and resultant lockdown led to the disruption of classical pedagogy methods and a mandatory shift toward online mode. The impact of this unplanned enforcement of online education was assessed on Indian students, parents and teachers. An online survey was designed with questions based on ease of accessibility, attentiveness, learning outcome, stress level, preferred learning mode, and was shared through Gmail and Whatsapp. Almost all the respondents could access virtual platforms; 48.3% found themselves inattentive during the online classes, while 71.6% were not satisfied with respect to understanding the topic. Academic integrity also needs serious assessment, as only 11.3% of students were sure that no unfair means were used during the online assessment. Increased workload (57.7%) and screen time (94.2%) of children have become a concern for parents. Online education has provided a solution in the current scenario, but it cannot replace offline learning which ensures the holistic development of young minds for a better future.

Cultural Views of a Society Through Taylor Swift’s Song

Songs as cultural products function to help people to fulfil their needs. When people listen to the songs, they both enjoy the melody and also lyrics of the songs. Songs serve as tools to achieve different essential objectives such as changing moods, relating, and shaping their own identity. In this research, the writer studies deixis in song lyrics from the selected song in Taylor Swift's Folklore album: Cardigan, the Last Great American Dynasty, August, Illicit Affairs, and Betty. The analysis deixis of this study reveals a variety of life issues is treated directly or is strongly involved in the content of the lyrics of songs. This study found that lyrics have undergone dramatic changes when the influence of other cultures is unavoidable. This is an issue of significant interest and concern for parents and educators.

Parent's self-reported indoor environment-related symptoms and health worry increase symptom reports among their children at school-Study in two independent populations.

Little is known whether parent's indoor environment quality (IEQ)-related symptoms or health perceptions influence the risk of self- or parent-reported symptoms in their children. We assessed (i) the association of parents' IEQ-related symptoms with IEQ-related symptoms in their children at school and (ii) whether parental IEQ-related health worry increases the risk for children's symptoms. We used two Finnish studies: a national, population-based survey of indoor air and related health problems (n=611 parents) and a subset of survey for all primary school pupils (grade 3-6) and their parents in Helsinki, which also included school IEQ-related symptoms reported by children (n=1617 parent-child dyads). In the school survey, parent's own symptoms increased strongly their reporting of their children's symptoms at school (aOR 4.0, 95% CI 2.7-6.0 for parents experiencing a lot of symptoms) and also symptoms reported by the child itself (aOR 2.2, 95% CI 1.5-3.1). Similar, but slightly weaker associations were seen with parental IEQ-related health worries. Results remained unchanged when adjusted for the IEQ of school buildings or parental and children's allergic diseases. Similar associations were seen in the national survey between parent's symptoms at work and child's symptoms at school. The results suggest that parents' health perceptions may increase the reporting of children's IEQ-related symptoms even more than is typically seen for many indoor air contaminants.

Can parental simulation improve neonatal CPR performance? A pilot study.

Basic life support training and instruction is recommended for parents of premature infants discharged from the hospital. In order to assess the short-term efficacy of basic life support simulation, in addition to the institutional training, a prospective single-blinded randomized interventional study was performed. The study group received, besides the institutional training, an additional simulation training. The control group had only traditional training. A test assessment was followed approximately a week later and evaluated by two investigators. Fifty parents participated. Nineteen (38%) were in the study group. The study group showed a significant improvement in all the parameters assessed.Conclusion: The addition of a simulation encounter before discharge may improve short-term parental performance of basic life support. What is Known: • Parents of newborns at risk receive institutional training in basic life support. • The retention of knowledge from this training is a point of concern for parents. What is New: • A single simulation encounter for parents improved resuscitation performance. • Simulation for parents may be an important and useful tool to improve the efficacy of basic life support training.

684 Use of Overnight Pulse Oximetry and STBUR Questionnaire for Paediatric OSA In A District General Setting

Abstract Introduction Overnight pulse oximetry (OPO) is often used to support the diagnosis of obstructive sleep apnoea (OSA) and stratify risk of peri-operative breathing difficulties in children undergoing adenotonsillectomy for OSA. Our objective was to audit our indications for OPO and the impact on subsequent ENT management. We sought to assess the correlation of STBUR (Snoring, Troubled-breathing, Unrefreshed Questionnaire) score with OPO values in these patients. Method Retrospective review of 32 OPO reports over a 7-month period. Data collected included age, weight, indication, mean spO2, number of dips >4%, outcome and STBUR score. Results The commonest indication (19) for OPO was to assess severity of OSA in children <3 or those with significant comorbidity to determine best setting for surgery; 50% were ultimately managed in a tertiary centre. 10 children underwent OPO due to diagnostic uncertainty but significant parental concern; all studies normal and parents reassured. STBUR score correlated poorly with number of dips >4% (R = 0.0109) and mean nadir >4% (R = 0.0031) Weight poorly recorded (19%). Conclusions Referrals were generally appropriate and influenced management in all cases. STBUR scores insufficiently sensitive to stratify severity of OSA. New protocol developed.

Parental worry, family-based disaster education and children's internalizing and externalizing problems during the COVID-19 pandemic.

Objective: Internalizing and externalizing problems are prevalent in disaster-exposed children but few studies have investigated these problems in relation to parental factors. This study examined how parental worry and family-based disaster education related to children's internalizing and externalizing problems during the outbreak of COVID-19 in China. Method: Parents reported parental worry, family-based disaster education and their children's (5-8-year-old young elementary schoolchildren [n = 245] and 245 9-13-year-old early adolescents [n = 245]) internalizing and externalizing problems. Results: Data analysis showed that (a) across ages, parental worry related to children's internalizing and externalizing problems significantly and positively; (b) the significant and negative relationships between family-based disaster education and internalizing and externalizing problems were only supported in young elementary schoolchildren; and (c) high level of parent worry attenuated the negative link between family-based disaster education and young elementary schoolchildren's internalizing problems. Conclusion: This study expands our knowledge about relationships between parental worry and children's disaster-related well-being, and highlights the importance of adapting family-based disaster education to different ages. Data suggest that parents of young elementary schoolchildren and early adolescents both should avoid showing excessive worry in front of their children during the pandemic to help reduce their children's internalizing and externalizing problems. Effective family-based disaster education can mitigate young elementary schoolchildren's emotional distress and behavioral problems, the effect of which may be maximized if parents can avoid being overly worried. Parents of early adolescents should support their children in acquiring pandemic-related information independently and encourage them to seek support outside the family. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Clinician Gestalt in Managing Pediatric Pneumonia: Can We Predict the Future?

* Abbreviation: CAP — : community acquired pneumonia > It’s tough to make predictions, especially about the future. > > Yogi Berra In this issue of Pediatrics , Gao et al1 examine the value of clinical gestalt in predicting the progression to severe disease in children presenting to an urban pediatric emergency department with suspected community acquired pneumonia (CAP). CAP is one of the most common serious infections of childhood, accounting for ∼2 million annual ambulatory visits and 124 000 annual hospitalizations in the United States alone.2–5 Globally, childhood pneumonia accounts for significant morbidity and mortality, particularly in low- and middle-income countries.6 Complications of CAP include pleural effusions, empyema, sepsis, and others that may require additional procedures, ICU stays, and prolonged antibiotic courses. The management of CAP relies on appropriate diagnosis as well as thoughtful risk stratification to inform decisions, such as antimicrobial choice, patient disposition, and follow-up timing. Clinicians are often required to make these types of diagnoses and initial management decisions on the basis of brief encounters with patients. The impressions made on these visits often rely on a heuristic (ie, shortcut) approach to diagnosis and management. Much of medical decision-making relies on pattern recognition, which can include gestalt, gut feeling, or intuition.7 In this prospective cohort study, pediatric emergency medicine physicians were asked to estimate the probability that patients with suspected pneumonia (based on initial patient encounter and chest radiograph findings) will develop a complicated and/or severe pneumonia.1 The authors found that clinician gestalt was most sensitive (>90%) when the estimate for a complicated pneumonia was low and most specific (>90%) when the probability for complications to develop was judged to be … Address correspondence to Louis M. Bell, MD, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104. E-mail: belll{at}chop.edu

Hearing Screening in Pediatric Primary Care.

1. Jordan K. Yoeli, MD*,† 2. Daniel Nicklas, MD*,† 1. *Children’s Hospital Colorado, Aurora, CO 2. †University of Colorado, Aurora, CO Screening for congenital and acquired deafness and hearing loss (HL) represents a significant responsibility for clinicians in all newborn units and medical homes. Approximately 1 to 3 infants of 1,000 born in a well infant nursery setting and 2 to 4 of 100 born in a NICU have significant bilateral HL. Outcomes in various developmental domains depend on the early recognition and subsequent intervention for HL. Developmental delay is present in 30% to 40% of children with HL; the goal of hearing screening (HS) and prompt intervention is to optimize a child’s language acquisition, cognitive development, literacy, social-emotional maturity and academic success. This article reviews the most up-to-date standards and practices to aid medical providers in the early detection and intervention for pediatric HL. In the United States, universal screening begins in the neonatal period. According to the American Academy of Pediatrics (AAP) Joint Commission on Infant Hearing (JCIH), all infants should be screened for congenital HL before 1 month of age. Most infants are screened in nursery or NICU settings, except for those born outside of a medical facility. For the latter population or for infants with no documented HS, screening should be completed by the medical home before 1 month of age. In a well nursery setting, most HSs are performed by otoacoustic emission (OAE) testing. During an OAE screen, a sensitive microphone in the ear canal records the cochlear responses (“acoustic emissions”) to acoustic stimuli, thereby testing the peripheral auditory system from the outer/middle ear (conduction zones) to the cochlear outer hair cells (sensory organ). A “pass” indicates that hearing is functional to the level of …

Parent Experience of Communication about Children's Surgery: A Qualitative Analysis.

Introduction:Parent experience is a core component of the quality of pediatric care and an increasingly common focus of quality improvement initiatives. However, the parent experience of communication in the pediatric surgical setting remains unexplored.Methods:We conducted semi-structured interviews with 20 parents of children undergoing surgery. Interviews were analyzed using directed qualitative content analysis.Results:Content analysis revealed 3 overarching themes. The theme of “provider–parent communication” included interpersonal behaviors and communication-originating skills of the surgeon. Parents valued surgeons incorporating multimodal information-sharing techniques, recognizing children’s psychological needs, providing reassurance, engaging in teamwork, and including parents. The theme of “parental emotional experiences” included domains of parent worry, intimidation, offense, self-doubt, mistrust, and strength surrounding their child’s surgery. Parents felt simultaneously responsible for their child’s welfare and for understanding medical information. The theme of “process improvement” included preparation for surgery, efficiency, managing delays, anesthesia induction, emergence from anesthesia, privacy, and preparation for recovery.Conclusions:Themes identified through these parental narratives and proposed solutions inform quality improvement efforts related to surgeon communication strategies and facilitate family-centered surgical care for children. Parents often provided solutions after they described concerns, which attests to the utility of parent perspectives.

Impacts of Blood Gas Concentration, Heart Rate, Emotional State, And Memory in School‐Age Children with And without The Use of Facial Coverings in School during The COVID‐19 Pandemic

Although researchers from hospitals, universities, and government agencies have concluded that facial coverings (masks) could be one of the most cost‐effective tools to slow the spread of COVID‐19 and accelerate economic recovery (Greenhalgh et al., 2020), parental concern for elementary school children wearing masks is still an issue. Face masks can cause discomfort which may lead to general irritation resulting in potential anxiety and subsequent distraction from instructional material delivered in a school setting (Lee et al., 2005). The purpose of this study was to examine the effects of wearing a facial covering and the impacts on memory, heart rate, oxygen saturation, and emotional state on a 5‐point Likert scale (Buron & Curtis, 2003) throughout 30 minutes of regularly scheduled academic content in students grades K‐5. All participants (N=60) were recruited from the same school and data were analyzed via paired samples t‐tests. There was a trend in students to rate their emotional state as more positive at 0 minutes in the non‐masked condition compared to the masked condition (1.23 ± 0.54 vs. 1.15 ± 0.363; p=0.058). However, vocabulary memory recall was more accurate in the masked condition (8.06 words ± 2.20 vs. 6.72 words ± 2.43; p=0.001). Upon further investigation, this significance was driven by the students in grades 3‐5 (N=27) (9.41 ± 0.80 words vs. 7.85 ± 1.29 words; p=0.001) opposed to students in grades K‐2 (N=26) (6.65 ± 2.31 words vs. 5.54 ± 2.77 words; p=0.12) in masked vs. non‐masked conditions. Heart rate and oxygen saturation fluctuations between the masked and non‐masked students over the 30 minutes of instructional time were nonsignificant (p˃0.05). We concluded that though there were no apparent adverse biological (heart rate and peripheral oxygen saturation) effects on elementary school children while wearing a cloth face covering in the classroom for 30 consecutive minutes of instructional time, there appears to be some cognitive benefit to wearing a facial covering in memory recall for students particularly in grades 3‐5 that warrants further exploration.

Infant oral health care: a review on parent’s role in infant oral health

The maintenance and prevention of oral health is one of major concern of parents. Dental caries is one of most common oral manifestation because of lack of knowledge and improper techniques. The first visit should be planned at early ages only so that proper guidance and knowledge should be imparted to the parent to prevent oral diseases. The first visit should include oral screening, oral habit monitoring, Brushing technique demonstration and fluoride application if needed. There should be more involvement to strengthen the role of pediatricians’ in children’s oral health requires an understanding of their current knowledge and practice. In this scoping review, we aimed to comprehensively map what is known about the knowledge and practice of parents regarding children’s oral health.

Get SET Early to Identify and Treatment Refer Autism Spectrum Disorder at 1 Year and Discover Factors That Influence Early Diagnosis

To examine the impact of a new approach, Get SET Early, on the rates of early autism spectrum disorder (ASD) detection and factors that influence the screen-evaluate-treat chain. After attending Get SET Early training, 203 pediatricians administered 57 603 total screens using the Communication and Symbolic Behavior Scales Infant-Toddler Checklist at 12-, 18-, and 24-month well-baby examinations, and parents designated presence or absence of concern. For screen-positive toddlers, pediatricians specified if the child was being referred for evaluation, and if not, why not. Collapsed across ages, toddlers were evaluated and referred for treatment at a median age of 19months, and those screened at 12months (59.4% of sample) by 15months. Pediatricians referred one-third of screen-positive toddlers for evaluation, citing lack of confidence in the accuracy of screen-positive results as the primary reason for nonreferral. If a parent expressed concerns, referral probability doubled, and the rate of an ASD diagnosis increased by 37%. Of 897 toddlers evaluated, almost one-half were diagnosed as ASD, translating into an ASD prevalence of 1%. The Get SET Early model was effective at detecting ASD and initiating very early treatment. Results also underscored the need for change in early identification approaches to formally operationalize and incorporate pediatrician judgment and level of parent concern into the process.

What parents want to know about caring for their preterm infant: A longitudinal descriptive study

ObjectivesTo describe the characteristics of parent knowledge needs and skill acquisition over the course of their infant’s neonatal intensive care unit hospitalization. Methods148 parents/guardians of infants ≤33 week gestation enrolled during the usual care phase of a multi-site quasi-experimental study, completing weekly surveys about their learning needs for the coming week and skills learned in the past week. ResultsThe topics of most interest or concern for parents included feeding their infant and their infant’s medical course. Knowledge needs varied by phase of hospitalization (early, middle, late) and by parent age, prior parenting experience, infant gestational age and hospital length of stay. The most common skills learned related to feeding and basic infant care. The number of skills parents reported learning each week varied by parent age, gender, and education. ConclusionsParents of preterm infants expressed specific learning needs and acquisition of skills that varied over the course of the hospitalization and by parent and infant characteristics. Practice implicationsThe findings can be used to improve parent learning experiences so that they can become full partners in their infant’s caregiving and are better prepared to care for their infant after discharge. Study registrationClinicalTrials.gov, ID NCT03418870.

Nail changes in children with idiopathic congenital clubfoot deformity.

Nail alterations are commonly seen in cases of idiopathic clubfoot and may cause parental concern. The nature of and whether these changes are congenital or develop secondary to treatment has been poorly investigated. The aim of this study was to evaluate toenail morphology in clubfoot patients at presentation, to re-evaluate them during the course of treatment for the clubfoot, and to analyze findings in the light of the few literature reports for healthy children of the same age. Thirty infants (21 males and 9 females) with idiopathic clubfoot were prospectively enrolled at the Anna Meyer Children's University Hospital. Nails of affected and non-affected feet were evaluated by a team of pediatric dermatologists at presentation and re-evaluated once per patient during the bracing period of Ponseti treatment. Toenails of affected (47) and non-affected (13) feet were abnormal at presentation in 43.3% of patients, in both clubfeet (40.4%) and non-affected feet (38.5%), but most changes were physiologic or transitory alterations, commonly found in healthy children, with nail concavity (koilonychia) being the most common finding (29.7%). Changes were not related to clubfoot severity or laterality (P>.05). In most (76.9%) unilateral cases, there was concordance of nail changes between clubfoot and non-affected foot. At re-evaluation (follow-up time 410±207days), nail problems were more frequent (53.3%); ingrown toenail was the most common (21.6%). The presence of nail alterations seems not to be caused by clubfoot pathology and could be related to unfavorable local condition in the brace.

Findings in physical examination of the external genitalia in pediatric age − different is not always pathological - Part II (female)

Introduction: Findings in the physical examination of the external genitalia in children are often a source of concern for parents and caregivers, not only for the emotional significance that people unconsciously attribute to these structures (partly due to their reproductive function), but also for the physical and psychological impact in the child. Due to the child’s close monitoring and periodic surveillance, the family physician has a key role in the identification and initial guidance of these cases. Objectives: To review the evidence about main variations and anomalies of the external male genitalia in pediatric age regarding diagnosis and clinical approach in primary health care. Results: In most cases, anomalies in the external male genitalia represent variants of normal and/or do not significantly affect function, thus only requiring clinical surveillance and no intervention. However, some cases − as epispadias, hypospadias, and urethral duplication − require surgical intervention and early action is crucial for the success of implemented measures. Conclusion: Physical examination is a key aspect of child assessment. Although changes in physical examination of the external male genitalia mostly represent normality variants, clinicians should be able to recognize pathological changes and properly refer those cases without overloading health services or causing unnecessary anxiety to children and caregivers.

Findings in physical examination of the external genitalia in pediatric age − different is not always pathological − Part I (male)

Introduction: Findings in the physical examination of the external genitalia in children are often a source of concern for parents and caregivers, not only for the emotional significance that people unconsciously attribute to these structures (partly due to their reproductive function), but also for the physical and psychological impact in the child. Due to the child’s close monitoring and periodic surveillance, the family physician has a key role in the identification and initial guidance of these cases. Objectives: To review the evidence about main variations and anomalies of the external male genitalia in pediatric age regarding diagnosis and clinical approach in primary health care. Results: In most cases, anomalies in the external male genitalia represent variants of normal and/or do not significantly affect function, thus only requiring clinical surveillance and no intervention. However, some cases − as epispadias, hypospadias, and urethral duplication − require surgical intervention and early action is crucial for the success of implemented measures. Conclusion: Physical examination is a key aspect of child assessment. Although changes in physical examination of the external male genitalia mostly represent normality variants, clinicians should be able to recognize pathological changes and properly refer those cases without overloading health services or causing unnecessary anxiety to children and caregivers.

Dispute over contact with a child as the result of unresolved divorce-related conflicts

Parting and divorce are situations that are not only the result of conflicts, but also their causes, especially if they concern parents of minor children. A problem then arises regarding the establishment of contact between the secondary parent and the child, which may be difficult if the disputes that led to the separation remain unresolved or other court cases are pending at the same time. The parties, during or after divorce, often submit a request to the court to regulate the frequency and form of meetings between the secondary parent and the child, which seems to be the main issue of misunderstandings. After a deeper analysis of the relationship between former partners, it turns out, that the lack of ability to establish contact with the child is the result of the accumulation of other disputes and unresolved misunderstandings. The presented fragments of qualitative analyzes of psychological and pedagogical opinions prepared by the Opinion Team of Forensic Specialists, illustrating the assumption that the dispute over contact may be related to other conflicts between former spouses, are part of a qualitative project focused around divorce-related conflicts. The aim of the research is to identify the effects of strong conflict between parents and the lack of communication between them after divorce for family relationships and the child functioning.

Examining the Problems and Concerns of Parents with Disabled Children in the Context of Gender Roles

Bu çalışmanın amacı, engelli çocuğu olan ebeveynlerin toplumsal cinsiyet rolleri doğrultusunda çocuklarıyla ilişkilerinde rol ve sorumlulukları, yaşanılan sorunların ve kaygıların ortaya konulmasıdır. Araştırmada özellikle toplumsal cinsiyet bağlamında inceleme yapılmasından dolayı aynı aile içerisinde olan 10 anne ve 10 baba olmak üzere 20 ebeveyn ile görüşülmüştür. Çalışma nitel araştırma yöntemlerinden fenomenolojik yöntem ile yürütülmüştür. Araştırmanın verileri literatür taraması ve alan bilgisi doğrultusunda araştırmacılar tarafından hazırlanan görüşme soruları aracılığıyla yarı yapılandırılmış görüşme yöntemiyle toplanmış ve nitel yöntem ile analiz edilmiştir. Araştırma sonucunda ebeveynlerin çocuklarına dair yaşanan sorunlar ve kaygılara dair görüşlerinin anne ve babalarda çok fazla değişiklik göstermediği ancak anlık sorun alanları doğrultusunda yaşanan kaygıların anneleri daha fazla etkilediği, engelli çocuklarının sorumluluklarına dair kadınların daha fazla rol aldığı, yaşanan sorunların anlık çözümlerinde babaların daha olumlu şeyler düşünebildikleri ancak bu sorunların genellenmesi ya da geleceğe dönük olmasında onların da çözüm getirme konusunda anneler kadar zorluk yaşadıkları görülmüştür. Annelerin sosyal destek aldıklarına dair daha olumlu görüşleri olduğu, babaların sosyal destek göremedikleri ya da çevrelerindeki bireylerin meşgul olmalarından kaynaklı destek alamadıkları sonucu ortaya çıkmaktadır. Ebeveynlerin yaşadıkları sorunlarda ise annelerin çocuklar ile daha fazla ilgilenmesinden kaynaklı kendi iyilik halleri ile ilgili problemler yaşadıkları, çocuklarına dair yapılan ayrımcı ve olumsuz tavırları babalara oranla daha fazla içselleştirdikleri ve bu sorunlarla baş edebilmek adına psiko-sosyal destek ihtiyacı duydukları sonucuna ulaşılmıştır. Psiko-sosyal desteğin ediniminde ise babaların daha isteksiz olduğu, annelerin ise bu destek sistemini almayı istedikleri görülmüştür. Bu bağlamda, sunulmakta olan sınırlı psiko-sosyal destek hizmetleri arttırılarak, sosyal hizmetin savunucu, ara bulucu, vaka yöneticisi ve danışman rollerinin de yerine getirilmesiyle, engelli çocukların da ailelerinin de iyilik halinin sağlanması gerekmektedir.