Parental Complaints Research Articles

School maturity and the quest for normalcy: how parental complaints shaped expertise and state policies in socialist Hungary and East Germany, 1960s-1980s

ABSTRACT After World War II, socialist states developed a new schooling system aimed at building an egalitarian society. While there is a solid body of research discussing the relationship between the intent and effect of the egalitarian design of socialist school systems, the importance of school maturity assessments for the socialist project has received only minor attention. This article discusses how the introduction of school maturity assessments developed by experts in medicine, psychology, and pedagogy in 1960s Hungary and East Germany contributed to the visibility of children who were deemed immature. It shows that both socialist states developed institutional solutions beyond the standard school system for tackling the problem of school immaturity in children; these solutions, in turn, evoked different reactions from parents. As the article discusses, parents used various avenues to oppose the official expert assessments with which they disagreed. In both countries, parents increasingly voiced their opinions in complaint letters addressed to the state in a quest to overcome what they perceived as a severe threat to their children’s ‘normal’ development. By tracing parental bottom-up initiatives, the article investigates how parental agency ultimately shaped state policies and expertise despite the asymmetrical power relations that were present in these authoritarian societies. To show the interplay of parental agency, experts, and the state, we employ a combination of two methodological approaches, the sociology of expertise and the concept of Eigensinn, for understanding the spaces of negotiation and the role expertise plays in it. This article thereby sheds light on parental agency and its impact on expertise and state policies concerning school maturity in two socialist states that offered very different institutional answers to the problem; bureaucratic approaches towards complaint letters also varied significantly.

초중등학교에서의 교육행정정보시스템(NEIS) 활용 AI 서면 민원처리시스템 프로토타입 개발 연구

Many teachers are experiencing difficulties in the process of handling parental complaints in schools. In particular, the stress of teachers is increasing as they often have to resolve emotional complaints on their own. The purpose of this study is to develop a prototype of an AI written complaint handling system using the Educational Administration Information System (NEIS) for handling complaints in elementary and middle schools. For the purpose of the study, design and development research methods were used to develop initial design principles based on analysis of prior literature and needs analysis targeting in-service teachers (n=21,310), and final design principles were developed through two rounds of expert validation. After that, based on the final design principles, the initial prototype was developed, and usability evaluations were conducted for teachers (n=16,713) and parents (n=95). The functions applied to the final prototype include ‘civil complaint AI function’ based on AI technology, ‘function of securing various access routes’, ‘step-by-step transfer function at the institutional level’, ‘function of protecting teachers rights’, ‘function of deep counseling’, ‘function of record storage’, ‘function of translation’, and ‘digital one-pass login function’. Based on the study findings, the study discussed the need to prevent malicious complaints or parental complaints. In the results of this study, the necessity of applying educational engineering ideas to develop a attendance system using NEIS or reduce school work was discussed.

Parent–school-community relationship: a comparative study of highly effective schools and schools with low effectiveness in Andalusia

When studying an educational system, the relationship between school and parents is one of its most important components. The literature shows that highly effective schools demonstrate good parent–teacher relationships, while schools with low effectiveness are generally characterised by a lack of good parent–school linkage. The purpose of the research carried out in this article was to identify the differences between parent–school relationships in highly effective and less effective primary schools in the autonomous community of Andalusia. Twenty-five interviews with members of management teams from both types of schools were analysed in order to understand the existing school reality. The results obtained show that parental involvement, parent–school communication, the perceived needs of the parents, the parent–teacher association, the relationships with entities of the educational community and parental complaints about the school are all factors that contribute to differentiate parent–school relationships between highly effective schools and schools with low effectiveness. The conclusions reached reveal that highly effective school management teams perceive greater involvement of parents and better parent–teacher association functioning. However, the people in the schools with low effectiveness highlight the complaints they receive from parents and the needs they present.

The Black Room

A simple parent request unveiled a startling revelation: The principal of Bridgforth Elementary School segregated students by race. Her attempt to establish a culturally responsive framework was met with an Office of Civil Rights (OCR) complaint of racial discrimination. This case will examine the principal’s rationale for creating the framework, the parental complaint, the school community response, and two evidence-based options for increasing student outcomes for African American students and other ethnic minorities.

B - 09 Neuropsychological Impacts and Cognitive Effects of Pediatric Leukemia Treatment.

The current study seeks to investigate the neuropsychological and cognitive late effects of pediatric Acute Lymphoblastic Leukemia (ALL) treatment. A search for peer-reviewed articles was conducted. Google Scholar was searched using keywords including neuropsychology, neuro-cognitive, neuropsychological effects, neuropsychological battery, neuropsychological impacts, cognitive effects, cognitive impacts, pediatric, pediatric leukemia, acute lymphoblastic leukemia treatment, bone marrow transplant, whole brain radiation, whole-body radiation, chemotherapy, cranial radiotherapy, health psychology, and neuropsychological testing. Articles were included if they discussed neuropsychology and ALL. Articles with non-human subjects and case studies were excluded from the study. Fifty-nine studies were included in the study. Treatments for ALL result in impairments in working memory, reduced processing speed, attention deficits, executive functioning deficits, visual-spatial and visuomotor weakness, fine motor weakness, deficits in delayed memory, an initial decline in performance IQ, and a delayed decline in verbal abilities such as attention and reading. The initial decline in performance abilities following a late decline in verbal abilities seen in patients who have undergone CRT may be due to structural changes in the white and gray matter following CRT treatment. Healthcare providers should attend to patients' cognitive complaints, particularly as they pertain to patients' ability to adhere to treatment recommendations and subsequently to their ability to resume attending school or social roles. As patient and parent complaints of cognitive compromise are associated with psychological distress and functional decline, cognitive complaints could justify further in-depth neuropsychological assessment to mobilize comprehensive supportive care or rehabilitative services.

The impact of parental complaints on teachers working within Scottish schools during Covid-19

Abstract This exploratory research examines the impact of everyday parental complaints on teachers working in Scottish Schools during the Covid-19 pandemic. Through interviews with 18 teaching professionals, our findings demonstrate that parental complaints both before and during Covid-19 are a feature of school life, even if they were not conceptualised in that way by teaching professionals. We found that teaching professionals have become accustomed to the everyday informal complaints parents voice about schools to the point only serious situations or repeat complaints were considered to be raising a ‘complaint’. Formal complaints procedures were seen as being a barrier to maintaining good relationships with parents. Complaints during Covid were rationalised as coming from anxious parents due to the pandemic, or a small group of parents with unrealistic expectations, or outdated understandings of education. Despite the fact our research was about complaints experienced by teachers during the pandemic, our respondents frequently referenced complaints prior to this, emphasising the impact complaints can have long after they have been made, which resonates with other research on the long-term practical and emotional impact of complaints.

Factors Associated with Speech and Language Disorder in Children Attending Child Development Center of a Tertiary Care Hospital

Background: Speech and language disorders are amongst the most common developmental difficulties. The current study was aimed to identify the factors associated with speech and language disorder in children attending a child development center. Methods: This cross-sectional, observational study was carried out at Saleh Child Development & Disability Management Centre of ICMH, Dhaka from July 2020 to June 2021. Children with speech and language disorder attending the speech clinic were enrolled. According to complaints of parents and confirmed by a multidisciplinary team, cases were selected purposively and after taking consent a pre-tested questionnaire was filled up by a face-to-face interview. Results: Among participating children majority belonged to age group 4-5 years with male predominance. Almost three fourth patients came from nuclear family. History of perinatal asphyxia and neonatal seizure were found in 9(31.0%) and 8(27.6%) cases, respectively. Majority 28(96.6%) mother was primary care giver. Family history of speech delay was seen in 15(51.7%). Most of the children view TV/play computer games > 2 hours/day. Majority had first meaninful word at 23-36 month and parents had identified speech dealy on 25-36 months. 14 children had poor chewing and 2 had drooling. Majority (37.9%) children were delayed receptive, 13(44.8%) were delayed expressive, 9(31.0%) were both delayed receptive and expressive and 5(17.2%) were stammering. Conclusion: Male gender, care giver other than mother, nuclear family, perinatal asphyxia, neonatal complications, family history of speech delay, TV/Computer/Tab watching >2 hrs were associated with speech and language disorder.

Improved Clinic Flow and Satisfaction After Lean Implementation in a Pediatric Ophthalmology Clinic.

To report outcomes using Lean concepts (FlowOne Lean Consulting, LLC) and implemented changes in a single academic pediatric ophthalmology practice. Lean principles such as patient flow, wasted movement, and non-value added visit time were taught to clinic staff. Spaghetti maps to document patient and staff movement during examinations, patient simulation, and clinic flow exercises were performed prior to implementing clinic changes. Clinic changes included maximizing easily reachable equipment and standardizing equipment in each examination room, physician-controlled doorbells to notify staff for help, and implementing a visual real-time electronic board of patients throughout the entirety of their examination. Patient surveys before and after Lean and staff feedback were obtained. Four years of data were collected of patient examination visits after Lean principles were introduced. Prior to Lean implementation, mean pediatric ophthalmology clinic visit times were 120 minutes. Within 3 months of Lean clinic changes, mean visit times reduced to 75 minutes. Four years later, this was sustained at 69 minutes. Clinic templates were modified and increased by 17%. Patient satisfaction surveys before and after demonstrated improved scores from 6.5 to 9.0. Patient survey comments included satisfaction with shorter patient examination visits, less shuffling between examination rooms, less non-value added time, and perception of happier clinic staff. Staff survey comments included receiving fewer parent complaints, feeling less disorganized, being able to troubleshoot in real time, and leaving at an earlier time at the end of the clinic day. Lean improved clinic efficiency, reduced patient visit times, and improved patient and staff satisfaction. These improvements were sustained 4 years after Lean principles were implemented. [J Pediatr Ophthalmol Strabismus. 2024;61(1):14-19.].

Can cry tolerance be increased in mothers of infants with sleep problems, and why does it matter? A quasi-experimental study

Study objectivesInfant sleep problems are one of the most common complaints of new parents. Research to date has demonstrated a relationship between low parental cry tolerance and infant sleep problems. The aim of this study was to explore whether three emotion regulation strategies could increase parental cry tolerance. MethodsThis study utilised a quasi-experimental design. We recruited 83 females (Mage= 32, SD= 5.26) comprising 3 groups: mothers of good sleeping infants aged 6–24 months, mothers of poor sleeping infants aged 6–24 months, and good sleeping women aged 23–40 years without children. Participants were instructed to listen to crying audio segments and indicate when they felt the child needed to be tended to (measured in seconds). This crying audio was paired with one of three emotion-regulation strategies (i.e., music, gaming, reappraisal). Each participant completed all 4 cry conditions which were counterbalanced to control for order effects. ResultsWe found that all three strategies yielded significantly longer reaction times (indicating higher cry tolerance) compared to the control condition (p <.001). We also found that mothers of poor sleepers and good sleeping women benefitted from all three emotion regulation strategies compared to control (p <.001 and p= <.05, respectively). The cry tolerance of mothers of good sleepers, on the other hand, did not differ between the control condition and any of the strategies (all ps >.05). ConclusionsThis demonstrates that cry tolerance can be increased using emotion regulation strategies, such as distraction via music or gaming, and reappraisal. This has clinical implications for families implementing behavioural sleep interventions.

Preoperative radius head dislocation affects forearm rotation after mobilization of congenital radioulnar synostosis

BackgroundThe present study was carried out to answer three questions: 1) How much forearm rotation can be expected after mobilization of congenital radioulnar synostosis (CRUS)? 2) Does preoperative radius head dislocation affect forearm rotation after mobilization? 3) What factors other than radius head dislocation affect postoperative forearm rotation? MethodsWe performed mobilization of CRUS with a free vascularized fascio-fat graft and a radius osteotomy (Kanaya’s procedure) on 26 forearms of 25 patients. The age at the surgery ranged from 5.3 to 13.4 years. The follow-up duration ranged 24–111 months. We classified CRUS into 3 groups according to the dislocation of the radius head: posterior dislocation (N = 13), anterior dislocation (N = 9) and no dislocation (N = 4). Since major complaints of patients and parents were poor forearm rotation and lack of supination, they were evaluated separately. ResultsMean preoperative forearm ankylosis angle was 34.8° (range; neutral to 90° pronation). Preoperative pronation ankylosis angle was higher in the posterior dislocation group (mean 55.3°) than the anterior dislocation (mean 11.6°) and no dislocation groups (mean 5.0°). There was no re-ankylosis after mobilization and the mean postoperative active range of motion (ROM) was 86.5°. The mean active ROM was 75.7° in the posterior dislocation group, 96.1° in anterior dislocation group and 100.0° in no dislocation group. The mean active supination was 6.9, 33.9 and 47.5° respectively. The posterior dislocation group showed less ROM and less supination than other groups. Preoperative pronation ankylosis angle showed negative correlation with postoperative ROM (ρ = − 0.59) and postoperative supination (ρ = − 0.73). ConclusionThe mean postoperative active ROM of this mobilization was 86.5°. Posterior dislocation group showed higher pronation ankylosis angle preoperatively, and less postoperative ROM and less supination than anterior and no dislocation groups. Preoperative pronation ankylosis angle showed negative correlation with postoperative ROM and supination.

Evaluation of pharmaceutically compounded oral caffeine on the impact of medication adherence and risk of readmission among preterm neonates: A single-center quasi-experimental study.

Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age ≥ 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs and inappropriate dosage forms. Pharmaceutically compounded oral caffeine (PCC) could be an appropriate alternate dosage form. The researchers aimed to determine the impact of PCC on medication-related factors influencing medication adherence (MA) and the frequency of hospital readmission with apnea (HRA) in preterm neonates. We conducted a single-center quasi-experimental study for this quality improvement project using PCC among the preterm neonates admitted in a tertiary care level-III NICU at the Aga Khan University Hospital Karachi, Pakistan, received caffeine therapy, and survived at discharge. The researchers compared pre-PCC data (April-December 2017) with post-PCC data (April-Dec 2018) each for nine months, with three months intervals (January-March 2018) of PCC formulation and implementation phase. The study was conducted according to the SQUIRE2.0 guidelines. The Data were collated on factors influencing MA, including the cost of therapy, medication refill rates, and parental complaints as primary outcome measures. The Risk factors of HRA were included as secondary outcomes. After PCC implementation cost of therapy was reduced significantly from Rs. 97000.0 (729.0 USD) to Rs. 24500.0 (185.0 USD) (p&lt;0.001), significantly higher (p&lt;0.001) number of patients completed remaining refills (77.6% pre-phase vs 97.5% post-phase). The number of parental complaints about cost, ampoule usage, medication drawing issue, wastage, inappropriate dosage form, and longer duration of therapy reduced significantly in post-phase. HRA reduced from 25% to 6.6% (p&lt;0.001). Post-implementation of PCC (RR 0.14; 95% CI: 0.07-0.27) was a significant independent risk factor for reducing HRA using a multivariate analysis model. Longer duration of caffeine therapy after discharge (RR 1.05; 95% CI: 1.04-1.04), those who were born in multiple births (RR 1.15; 95% CI: 1.15-1.15), and those who had higher number of siblings were other significant independent risk factors for HRA. PCC dispensation in the appropriate dosage form at discharge effectively reduced cost, non-adherence to therapy, and risk of hospital readmissions. This neonatal clinical and compounding pharmacist-led model can be replicated in other resource-limiting setting.

Investigation of care burden and musculoskeletal pain of parents of paediatric palliative care patients in Turkey.

Caring for a paediatric patient is associated with psychological, physical and social challenges. It may be easy to identify the emotional effects of caregiving burden on parents, but the physical effects are often not known. We aimed to examine the relationship between caregiver burden and musculoskeletal pain in caregiver parents of children accessing palliative care services. This was a cross-sectional study among caregiving parents of paediatric palliative care patients, conducted between 15 July 2020 and 15 January 2021. The care burden was examined using the Zarit Caregiver Burden Questionnaire, and the physical complaints of parents with the Extended Nordic Musculoskeletal Questionnaire. A total of 69 caregiving parents were included in the study. The median Zarit Caregiver Burden score was 54.0. In parents with pain complaints, the most common pain areas were lower back (62.3%), back (60.9%) and neck (42.0%). Pain was statistically significantly associated with the duration of the disease in the child, especially shoulder pain (P = 0.023) and wrist pain (P = 0.024). Lower back pain was observed at a higher rate among caregiving parents. As the duration of the child's illness increased, the number of caregiver parents with shoulder and wrist pain increased. It is important to extend support to caregivers of paediatric palliative care patients to alleviate their physical difficulties.

Children’s agentic capacity, schoolification and risk: competing discourses and young children’s experiences in pre-school settings

ABSTRACT In the Republic of Ireland there has been substantial investment in Early Years provision. The number of different types of settings for pre-school children and the associated research has grown significantly. This paper contributes to existing knowledge by reporting the findings of a qualitative participatory study carried out in the Republic of Ireland and involving a comparative analysis of the views of 90 pre-school children from three different types of setting. Within a conceptual framework that acknowledges the impact of neo-liberalism, the paper argues that despite the growing diversity of settings, provision is underpinned by three main dominant discourses, namely schoolification, risk avoidance and quality assurance. The influence of these on the lived experiences of young children is then explored focusing in particular on how, and in what ways, children exercise their agentic capacity. It is argued that young children’s opportunities to exercise their social agency is at times constrained because of the influence of the combined discourses, which creates a sense of fear in staff (fear of parental complaint, fear of losing job, status and setting registration). Implications for provision and practice are explored.

0817 Conquering Two Sleep Birds with One Iron stone: The Case of Resolved Restless Sleep Disorder and Parasomnia with Iron Therapy

Abstract Introduction Restless Sleep Disorder (RSD) is characterized by frequent nocturnal movements of large muscle groups or a complaint of restless sleep by observers with associated daytime dysfunction.1 RSD, like other movement disorders of sleep, is associated with low iron stores.2 Children with RSD have increased NREM sleep instability and a propensity for parasomnia.2 No reports to date have demonstrated the use of iron therapy for parasomnia in patients with RSD. Furthermore, studies are limited in very young children with this disorder as they currently fall outside proposed diagnostic criteria.1 Report of Cases: A 2 year-old male presented to the sleep clinic with parental complaints of nightly sleep initiation and maintenance difficulty, mild snoring, restless sleep, episodes of sleepwalking and night terrors multiple times per week. Symptoms worsened over 6 months and were associated with daytime irritability and behavioral problems. Sleep quality measures assessed progress between visits: the PROMIS Sleep Disturbance (PROMIS SD) and Sleep Related Impairment (PROMIS SRI). Serum ferritin was initially 20ug/L. Polysmnogram demonstrated no significant sleep related breathing disorder, a large muscle group movement index of 14, periodic limb movement index of 3. Initial treatment included oral iron therapy, scheduled awakenings, and hypnotic dose melatonin. The sleep psychologist addressed limit setting and negative sleep associations with improved insomnia symptoms but parasomnia and restless sleep continued. The parent noted reduction in both movements and parasomnia frequency after one month of iron therapy. After a 3 month period on treatment, the parent reported complete cessation of the parasomnia, drastic reduction in restlessness, and near resolution of insomnia. Sleep quality measure PROMIS SD improved by 11, demonstrating reduced sleep disturbance. PROMIS SRI did not change. Ferritin level increased to 47ug/L. Conclusion RSD in a very young child with NREM parasomnia responded to oral iron therapy improving overall sleep quality. This case demonstrates the relationship between relative iron deficiency, RSD and associated parasomnia. Support (If Any) 1. DelRosso LM, Ferri R, Allen RP, et al. Consensus diagnostic criteria for a newly defined pediatric sleep disorder: restless sleep disorder(RSD).SleepMed.2020;75:335-340. 2. Leung W, Singh I, McWilliams S, Stockler S, Ipsiroglu OS. Iron deficiency and sleep - A scoping review. SleepMedRev.2020;51:101274

Prevalence and Determinants of Hoarseness in School-Aged Children.

Hoarseness in school-aged children may affect their educational achievement and interfere with their communication and social skills development. The global prevalence of hoarseness in school-aged children ranges between 6% and 23%. To the best of our knowledge, there is a scarcity of studies describing the prevalence or determinates of hoarseness in Saudi school-aged children. Our aim was to measure the prevalence of hoarseness among school-aged children and to identify its determinants. A cross-sectional questionnaire-based survey was used that included randomly selected primary and early childhood schools from private and governmental sectors in Saudi Arabia. The data were collected using a questionnaire which was self-completed by the children’s parents and covered the following aspects: sociodemographic features, health and its related comorbidities about children and their families, attendance and performance in school, child’s voice tone, past history of frequent crying during infancy, history of letter pronunciation problems and stuttering, the Reflux Symptom Index (RSI) and the Children’s Voice Handicap Index-10 for parents (CVHI-10-P). Determinants of hoarseness were investigated using the SPSS software (version 20). The mean age of the study children (n = 428) was 9.05 years (SD = 2.15), and 69.40% of them were male. The rate of hoarseness in the participants was 7.5%. Hoarseness was significantly common in children with a history of excessive infancy crying (p = 0.006), letter pronunciation issues (especially ‘R’ and ‘S’; p = 0.003), and stuttering (p = 0.004) and in those with a previous history of hoarseness (p = 0.023). In addition, having the symptoms of gastrointestinal reflux increased the risk of hoarseness by four times (OR = 4.77, 95% CI = 2.171, 10.51). In summary, hoarseness in children may be dangerously underestimated, as it may reflect the presence of speech problems, in addition to the presence of laryngopharyngeal reflux (LPR). Hoarseness was assumed on the basis of parental complaints. Therefore, further research with diagnoses based on a clinical assessment is needed to understand the magnitude of the hoarseness problem and its consequences in children.

Clinical and anatomical characteristics associated with obstructive sleep apnea severity in children

PurposeTo determine the clinical and anatomical characteristics associated with obstructive sleep apnea severity in children with adenotonsillar hypertrophy. MethodsThe authors conducted a cross-sectional multidisciplinary survey and selected 58 Brazilian children (4‒9 years old) with adenotonsillar hypertrophy, parental complaints of snoring, mouth-breathing, and witnessed apnea episodes. The authors excluded children with known genetic, craniofacial, neurological, or psychiatric conditions. Children with a parafunctional habit or early dental loss and those receiving orthodontic treatment were not selected. All children underwent polysomnography, and three were excluded because they showed an apnea-hypopnea index lower than one or minimal oxygen saturation higher than 92%. The sample consisted of 55 children classified into mild (33 children) and moderate/severe (22 children) obstructive sleep apnea groups. Detailed clinical and anatomical evaluations were performed, and anthropometric, otorhinolaryngological, and orthodontic variables were analyzed. Sleep disorder symptoms were assessed using the Sleep Disturbance Scale for Children questionnaire. All children also underwent teleradiography exams and Rickett's and Jarabak's cephalometric analyses. ResultsThe mild and moderate/severe obstructive sleep apnea groups showed no significant differences in clinical criteria. Facial depth angle, based on Ricketts cephalometric analysis, was significantly different between the groups (p = 0.010), but this measurement by itself does not express the child's growth pattern, as it is established by the arithmetic mean of the differences between the obtained angles and the normal values of five cephalometric measurements. ConclusionsThe clinical criteria and craniofacial characteristics evaluated did not influence the disease severity.

Results of osteopathic treatment of infants with psychomotor developmental disorders

Aim. To compare the effectiveness of osteopathic treatment of infants with psychomotor development disorders with standard treatment in terms of functional status.&#x0D; Methods. The study was conducted at the Yaroslav-the-Wise Novgorod State University and the Institute of Osteopathic Medicine named after V.L. Andrianov, between 2020 and 2021. The study included 49 children with delayed psychomotor development, of which: the main group consisted of 26 children receiving osteopathic treatment; the control group consisted of 23 children treated with standard therapies. Data gathered included the indicators of the functional health state, complaints of parents, assessed neurological, vegetative, and osteopathic statuses, the psychomotor development in the children according to the ZhurbaMastyukova scale, performed neurosonography. The results were processed using descriptive statistics followed by checking for the significance of the difference by using the Student's t-criterion for related samples.&#x0D; Results. A comparison of the effectiveness of osteopathic and standard treatment of infants with a delay in psychomotor development by indicators of the functional status was carried out. The need for an integrated approach to therapeutic and diagnostic procedures was substantiated. The number of subjective complaints about the health of children from parents in the main group decreased, while in the control group, it remained the same. Neurological status in children of both groups improved, but the changes are more pronounced in the main group (p 0.05). The outcomes of the treatments indicate for improving psychomotor development of the children in the main group, in the control group, such an increase was only 13.0% (p 0.001).&#x0D; Conclusion. The results of the study showed that osteopathic treatment of infants with psychomotor development disorders is more effective than standard complex treatment, which is reflected in the improvement of functional health indicators.

INCARCERATED INGUINAL HERNIA IN NEWBORNS AND INFANTS

Introduction. Inguinal hernias (IG) in children are a congenital pathology of the processusvaginalis and a local manifestation of the syndrome of mesenchymal insufficiency. Incarcerated IG is the most common and dangerous complication, the risk of which is significantly higher in children during the first 3 months of life. To date, there is no perfect method of pinched IG treatment in newborns and infants. Data on the optimal timing of herniotomy in newborns and infants are also insufficient and contradictory.The aim of this study is to provide our own experience in the treatment of infants with pinched inguinal hernias.Material and methods. The material of this study is 97 newborns and infants with irreducible and incarcerated inguinal hernias. Diagnosis was based on anamnesis data, physical examination methods and ultrasound data with inguinal and scrotal Doppler. Indications for review radiography of the abdominal cavity were clinical signs of acute intestinal obstruction.Results and discussion. Analyzing the obtained results, we have found that the diagnosis of hernias in 91 (93.81%) children was based on anamnestic data, complaints of parents about the presence of bulging in the groin area and physical examination of a child. The most important condition for effective diagnosis is the thorough collection of anamnestic data to determine the duration of the acute condition in a child and its dynamics. It is important to examine a child in a horizontal and vertical position. Differential diagnosis of incarcerated IG in infants was performed with acute hydrocele, torsion of the spermatic cord, inguinal lymphadenitis, etc., which are very similar to incarcerated IG in small children.Treatment of incarcerated inguinal hernias in newborns and infants has been carried out using a combined strategy, which involved the use of conservative invagination of hernia contents (49.48% of patients) followed by delayed surgical correction and emergency surgery according to urgent indications (42.27% of infants).Among 48 children treated conservatively, non- operative manual hernia invagination (Taxis - method) was effective in 46 of them or 95.83%. We used this method in children with a strangulation period up to 12 hours in the absence of inflammation signs in the pinched area.Indications for urgent herniotomy were: strangulation period of more than 12 hours (12 children), ineffectiveness of conservative treatment for 1 hour (2 patients), intractable hernia protrusion in girls (27 patients).As for the planned surgery, we support surgical correction of inguinal hernias at the age of 6-12 months, which we consider optimal.Conclusions1. Conservative manual invagination of an incarcerated inguinal hernia in newborns and infants is used in terms of pinching the contents of the hernia lasting up to 12 hours and is effective in 95.83% of cases.2.Surgical intervention for incarcerated hernia in infants should be performed in children with a duration of pinching more than 12 hours, in cases of impossibility and / or ineffectiveness of conservative invagination for 1 hour and in girls.3. Correction of a incarcerated inguinal hernia in girls is not recommended due to the high risk of ovarian damage.

PARENTING EDUCATION; MEWUJUDKAN BDR YANG AKTIF DAN MENYENANGKAN BAGI ANAK

Parenting education activities are carried out with the theme of realizing an active and fun study from home, as a mentoring activity for teachers and parents of children. Complaints of parents when accompanying their children to study at home, became the main basis for carrying out these parenting activities. Many parents feel overwhelmed to build children's enthusiasm in learning and completing the tasks given by the teacher. This condition bring out the initiative to provide assistance to teachers in providing parenting education activity material to children's parents and also directly provide material about the study from home method in parenting education activities carried out at RA Al Hidayah Kapongan Situbondo, so that even though learning activities were carried out at home , the children are still enthusiastic to do it actively and fun. The most important thing in this mentoring activity is to bring back the essence of parents/mothers as madrasas for their children, so that parents can hone, love, and nurture their children well. In the end, a nation will be born as khaira ummah who is anfauhum linnas.

Prevalence of Sleep Disorders in Children with Cerebral Palsy; A Questionnaire-based Observational Study.

Cerebral palsy (CP), the most common developmental disorder, has many comorbidities (epilepsy and behavioral issues). Sleep disturbances are common complaints of parents and are usually neglected in pediatric populations in comparison to other well-documented co-morbidities of CP but may have a significant effect on the quality of life of children and their parents. To study the prevalence and pattern of sleep disorders (SD) in children with CP. Questionnaire-based observational study. Pediatric tertiary care center. The study was done over 6 months. In total, 200 children with CP between the ages of 1 year to 14 years were included in the study by convenience sampling. Co-morbid health problems involving cardiorespiratory system, other illness (e.g. epilepsy and gastroesophageal reflux disease), or children on anticonvulsant medications altering sleep patterns were excluded. The Sleep Disturbance Scale for Children (SDSC) was administered to assess the presence of pathological sleep and type of SD ranging between Disorders of Initiation and Maintenance of Sleep (DIMS), Sleep Breathing disorders (SBD), Disorders of Arousal (DA), Sleep-Wake Transition Disorders (SWTD), Disorders of Excessive Somnolence (DES), and Sleep Hyperhydrosis (SHY). Sixty-two percentage of children (124) had a pathological total sleep score (score >39). DIMS are the most common, occurring in 78.2% of subjects with a pathological sleep score (score >39). Quadriplegics [n = 96, mean score = 49.86(16.38)] and GMFCS V [n = 19, mean score = 58.00(17.10)] are most severely affected. Children with CP have under-reported SD and DIMS is the most common type of SD. There is a linear correlation between the extent of topographical and motor afflictions and SD.