Parental Scores Research Articles

Teacher-Rated Mental Health of Siblings of Children with Chronic Disorders

AbstractSiblings of children with chronic disorders are at a heightened risk for internalizing and externalizing problems. Studies on sibling mental health typically use parent report, and sometimes sibling self-report, but do not include the perspectives of teachers. We investigated how teachers and parents in Norway rated sibling mental health to gain a more coherent picture of siblings’ well-being and functioning across the home and school contexts. We compared how siblings aged 8–16 years (45% boys, 54% girls) were scored on the strengths and difficulties questionnaire by teachers (n = 125), mothers (n = 115), and fathers (n = 81) with population norms and clinical cutoffs. For boys, the mean teacher scores did not indicate problems for total difficulties or any subscale except hyperactivity–inattention, but mean parent scores were higher for total difficulties and most subscales (d = .44 to .96). For girls, teachers indicated higher than norm scores for total difficulties, emotional problems, hyperactivity–inattention and peer problems (d = .26 to .46), while parents indicated higher total difficulties and problems across most subscales (d = .31 to .54). Prosocial behavior was as a relative strength of siblings across all raters. Siblings may not display the same level of mental health problems in school as at home, and teachers can offer an important perspective on siblings’ mental health and functioning.

Behavioral and physiological pain structures of PIPP-R and parental stress: structural equation modeling approach.

Although most non-acute pain assessment tools are multi-dimensional (behavioral and physiological measures) in their approach, the outputs of such tools are considered unidimensional. This study aimed to explore and determine the behavioral and physiological pain structures of Premature Infant Pain Profile-Revised (PIPP-R) for neonates and its association with parental stress. This cross-sectional study was conducted in 2022-2023 in Isfahan, Iran. We recruited 400 pre-term infants, i.e. with gestational age (GA) of less than 37weeks who were admitted to the NICU of educational hospitals. PIPP-R and Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU) were used for data gathering. The latent structures of pain and its association with parental stress were explored using latent variable modeling approach. A two-factor model, i.e. behavioral and physiological pain factors, was extracted, explaining 65% of the total variance. The results of confirmatory factor analysis showed that the identified structures in the exploratory factor analysis could be nearly replicated (CFI = 0.99، TLI = 0.98, RMSEA = 0.001). Behavioral pain structure, independent from gestational age had a significant direct association with parental stress score (β = 0.005, SE = 0.002, p = 0.026). The PIPP-R assesses both behavioral and physiological pain factors. We also found that behavioral pain factor was associated with parental stress. These results may provide a potential clue for physicians, nurses, and parents to manage the pain in preterm infant. The PIPP-R scores in preterm infants consist of "Behavioral and Physiological" pain factors. Single dependence on behavioral indicators (such as facial expression) has some limitations. Multidimensional tools may be the optimal method in detecting pain in preterm infants. Parental stress can affect behavioral pain structure in preterm infants. Intensive care nurses play an effective role in reducing the parental stress and pain severity of these preterm infants by including the help of mothers in procedures and providing them with psychological support.

Cognitive Disengagement Syndrome-Clinical Interview (CDS-CI): Psychometric support for caregiver and youth versions.

Cognitive disengagement syndrome (CDS), formerly termed sluggish cognitive tempo, is a set of symptoms characterized by excessive daydreaming, mental confusion, and slowed behavior/thinking. CDS is distinct from symptoms of attention-deficit/hyperactivity disorder (ADHD) and other psychopathologies and uniquely associated with functional impairment. However, despite significant progress in developing and evaluating rating scale measures of CDS, no clinical interview of CDS exists with established psychometric properties that can facilitate a multimethod approach assessing CDS. Accordingly, the present study evaluated the psychometric properties of the semistructured Cognitive Disengagement Syndrome-Clinical Interview (CDS-CI). The CDS-CI and the ADHD inattention (ADHD-IN) and hyperactive-impulsivity (ADHD-HI) modules from the Kiddie Schedule of Affective Disorders and Schizophrenia for School-Age Children (K-SADS) were administered to a sample of early adolescents (N = 341, ages 10-12 years) and their caregivers. Adolescents and caregivers also completed rating scale measures of CDS and ADHD symptoms. The CDS-CI demonstrated high internal consistency and interrater reliability. CDS-CI scores showed excellent same-source discriminant validity from K-SADS, ADHD-IN, and ADHD-HI scores and encouraging convergent and discriminant validity with rating scale measures, especially for caregivers. Above and beyond K-SADS, ADHD-IN, and ADHD-HI scores, higher parent and adolescent CDS-CI scores were both significantly associated with greater functional impairment. A threshold of ≥ 6 out of 15 symptoms was selected as an initial threshold for determining clinically elevated CDS using the CDS-CI. Findings provide psychometric support for the CDS-CI as a tool in the multimethod assessment of CDS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The association between screen time exposure, parent depression, and development of social communication skills among preschool children in Qassim Region

BackgroundScreen exposure among children continues to increase worldwide. It has negative effects on children of developmental age, including obesity, poor attention, sleep disorders, vision problems, language delays, and deficits in communication skills. It has been reported that parental depression is associated with both increased screen time for children and poor function and skills in children. However, other studies have reported no association between screen time and parental depression.Research methodologyA cross-sectional study was conducted using a convenience sample of 340 parents of 4- to 6-year-old children in the Qassim Region of Saudi Arabia. Data were collected from the primary health care vaccination clinic by contacting parents of children aged 4 to 6 years to fill out the Social Communication Questionnaire (SCQ) for the child and the Patient Health Questionnaire-9 (PHQ9) for the parents.Research resultsWe conducted a regression analysis to assess the influence of screen time exposure on social communication skills (SCQ score). The results of this study indicated that there was no significant effect observed (B = 0.283, P > 0.05), indicating that a positive correlation between screen time usage and SCQ score may not apply to the entire population. Conversely, we discovered a crucial link between screen time exposure and parental depression (PHQ), as it displayed noteworthy impact values (B = 1.136, P < 0.05), indicating an affirmative correlation between them. In addition, our results also indicated apparent positive associations between parental depression and SCQ scores (B = 0.229, P < 0.05).ConclusionOur findings revealed that there was a significant association between parental depression and both screen time exposure and SCQ score, while there was no correlation between screen time exposure and SCQ score.

Health-related quality of life following aortopexy for tracheomalacia: a cross-sectional study.

The objective was to measure health-related quality of life (HRQoL) of children following treatment of all-cause tracheomalacia with aortopexy. Children ≥5 years and parents of children <18 years who had undergone aortopexy completed the Paediatric Quality of Life Inventory (PedsQL4.0). Scores were compared to published norms. Completed questionnaires were received from 35 parents (65%) and 10 children (38%). Median age at aortopexy was 9.8 months (1 month-12.7 years) and median years of follow-up was 2.6 (4 months-6.9 years). Children who completed questionnaires had a median age of 8.4 (5.7-13.4) years. Parent and child-reported total PedsQL scores were 69.61 (SD : 19.74), and 63.15 (SD : 20.40) respectively. Half of parents and 80% of children reported scores suggesting poor HRQoL outcomes. Parent-reported total, physical and psycho-social scores were lower than those of healthy children and those with acute illness but comparable to children with chronic health conditions and cardiovascular disease. Similarly, children themselves reported comparable total scores to children with chronic illness but child-reported psycho-social scores were lower in the aortopexy group than any other group. There was no association between PedsQL scores and cause of malacia, age or time since aortopexy. The presence of complex congenital comorbidities had a significant (p < 0.05) impact on HRQoL scores. Following aortopexy children remain at risk of poor HRQoL, especially those with complex comorbidities. HRQoL reported by both parent and child provides important insight into the lives of children following this procedure. Further longitudinal and qualitative study are required to better understand this complex group.

O-223 Can the theory of planned behavior predict parents’ disclosure of donor conception to their children within 5-9 years?

Abstract Study question Does application of the theory of planned behavior (TPB) help predict heterosexual-couple parents’ disclosure of donor conception (DC) to their children? Summary answer According to TPB, parents with a stronger will to act in accordance with social norms favoring disclosure were more likely to start the disclosure process. What is known already In contrast to same-sex couples and single mothers by choice, heterosexual couples need to make an active decision to disclose, or not disclose, their use of DC to their child. While disclosure at an early age is encouraged by international and national guidelines, many heterosexual-couple parents struggle with this. A previous study has found an association between parental scores of TPB factors and disclosure intention, but so far, no study has applied the TPB to predict parents’ de facto disclosure behavior. Study design, size, duration The present study is based on the fourth (2014-2017) and fifth (2022-2023) waves of data collection in the prospective, longitudinal Swedish Study on Gamete Donation (SSGD). The project collects survey data at five timepoints from acceptance to be donor-recipient, to the children were adolescents. Participating parents had conceived through identity-release oocyte donation (OD; n = 68, response rate 65%) and sperm donation (SD; n = 62, response rate 56%) as part of a heterosexual couple. Participants/materials, setting, methods The SSGD includes all parents seeking gamete donation treatment at Swedish university hospitals between 2005-2008, the present study including parents’ data when the children were 7-8 years (T4), and 13-17 years (T5). Parents completed the TPB Disclosure Questionnaire (TPB-DQ) at T4, and disclosure behavior was assessed at both T4 and T5. Data from the participants who had not yet disclosed at T4 were analyzed using survival analysis with Cox regressions. Main results and the role of chance Forty participants (31%) had not disclosed the DC to their children at T4 and out of these, 13 had still not disclosed at T5. The TPB-DQ consists of four factors affecting intent to disclose; Attitudes, Subjective norms, Perceived behavioral control and Behavioral intent. The use of Cox regression enabled us to estimate how the parents disclosing to their children related to TPB-DQ, as well as the effect of adjusting for possible confounders. We found a significant association between scores on the TPB-DQ factor Subjective norms at T4 and the subsequent disclosure behavior at T5 (HR = 2.019; 95% CI: 1.36 to 3.01). None of the other factors were significantly associated with disclosure behavior. Adjusting for potential confounders did not affect the outcomes. Our results show that parents with a stronger will to act in accordance with social norms favoring disclosure were more likely to start the disclosure process within the next 5-9 years. In particular, the co-parent’s opinion about disclosure was found to be an important motivating factor in disclosure behavior. Limitations, reasons for caution The present study concerns heterosexual-couple parents with children conceived following treatment with gametes from open-identity donors, which limits the generalizability of our findings to other groups and contexts. Other limitations include the risk of systematic attrition due to the longitudinal study design and decreased statistical power due to few participants. Wider implications of the findings Our findings highlight the importance of perceived subjective norms for parents’ disclosure behavior and indicate that the co-parent’s opinion about disclosure is particularly relevant. Counselors should focus on supporting prospective parents to initiate and maintain a healthy and open dialogue about concerns around family building with DC. Trial registration number Not applicable

Assessing the Impact of Different Levels of Parental Involvement in the NICU on Neonatal Outcomes and Parental Mental Health

ABSTRACT Background: Parental involvement in the neonatal intensive care unit (NICU) has been recognized as crucial for neonatal outcomes and parental mental health. Materials and Methods: A retrospective cohort study was conducted, involving 300 neonates admitted to the NICU over 1 year. Parental involvement was categorized into three levels: high, moderate, and low, based on the frequency and intensity of parental participation in neonatal care. Neonatal outcomes including the length of hospital stay, incidence of complications, and parental mental health outcomes measured through standardized scales were compared among the three groups. Results: Neonates with high parental involvement had a significantly shorter length of hospital stay (mean difference = 5 days, P &lt; 0.001) compared to those with moderate or low involvement. Complication rates were also lower in the high involvement group (20%) compared to moderate (35%) and low (45%) involvement groups. Parental mental health scores were the highest in the high involvement group (mean score = 75), followed by moderate (mean score = 60) and low (mean score = 45) involvement groups. Conclusion: Higher levels of parental involvement in the NICU are associated with improved neonatal outcomes and better parental mental health.

Prevalence and Determinants of Developmental Delay in Children of 12-36 Months in the Area of Primary Health Centre, Bela, Nagpur.

Developmental delay happens when a child fails to attain age-appropriate milestones. Identification of developmental delay in children is important to initiate early intervention in them which will facilitate the children to have a productive life in their later years. The objective was to study the prevalence of developmental delay among 12-36-month-old children from the area of Primary Health Centre, Bela, in rural Nagpur, Maharashtra. This was a community-based cross-sectional study design. A total of 314 children were selected through simple random sampling and assessed for delay using the Pediatric Development Screening Tool (PDST). 14.9% had developmental delay in at least any one domain and 3.5% had global developmental delay. Domain-specific developmental delay was highest for language delay (10%) followed by fine motor (5%). Gross motor and personal social delays had the same prevalence (3.1%). On multivariable lower literacy, level of mother and Composite Index of Anthropometric Failure were significant variables for any developmental delay. Hospitalization of the child during the 1st month of life and lower parenting scores were the significant factors associated with global delay. Development delay is present in a sizeable proportion of children <3 years of age which affects their future growth and achievement. We recommend annual community-based screening for delays to detect and manage such children.

Improving parental self-efficacy in parents of children awaiting neurodevelopmental assessment: A parent group waiting list intervention

Background: Increased parental self-efficacy has been found to have positive effects on parental skills and stress levels, as well as behavioural outcomes for children. This is particularly relevant in relation to neurodivergent children and young people, who tend to present with more behavioural challenges related to emotion regulation difficulties. To assist with the issue of long wait times, a pilot parent group intervention was delivered to parents of children awaiting neurodevelopmental assessment who were presenting with emotion regulation difficulties. The aim of this study was to increase parental self-efficacy. Method: Psychoeducational parent group sessions were delivered online over five sessions to nine families. The sessions included psychoeducation around emotion regulation difficulties and strategies for managing these at home. Results: Parental self-efficacy scores significantly increased following intervention. Conclusions: Parental self-efficacy can be increased via group psychoeducation sessions aimed at understanding and improving emotion regulation.

Adaptation of SafeCare, an evidence-based parenting program, for caregivers of infants in the neonatal intensive care unit

BackgroundWhile there are several parenting programs for NICU caregivers, no studies, to our knowledge, have developed parenting programs aimed at preventing child maltreatment that specifically address these parental factors: parental stress, parental self-efficacy, and positive parent-infant interaction. ObjectivesThe objectives of this study were to: 1) Identify adaptations and/or augmentations needed to optimize SafeCare® for NICU caregivers, and 2) Examine the acceptability and preliminary effects of the adapted SafeCare NICU (SCNC) program with NICU caregivers. MethodsThis study consisted of two phases: formative (phase one) and pilot (phase two). For phase one, 5 NICU former caregivers and 5 NICU staff were interviewed to make relevant, NICU-specific adaptations for SCNC. Phase two consisted of a pilot study, where 13 current NICU caregivers were enrolled in the adapted SCNC program. Outcomes included acceptability and preliminary effects of parental stress, parental self-efficacy, and parent-infant interaction. ResultsAdaptations to SafeCare consisted of adding a pre-session to discuss individualized experiences, incorporation of adjusted developmental milestones, a NICU-specific resource sheet, and individualized adaptations to activities based on relevant medical concerns. Out of the 13 participants, 8 completed SCNC (61.5 % retention rate). Participants indicated significant reductions in stress after SCNC (Parental stress index score = 61.7) compared to baseline (79.2, p = 0.02). Among participants who completed SCNC (n = 8), all stated they supported this program for implementation among NICU caregivers. DiscussionThe adapted SCNC demonstrated acceptability among NICU caregivers.

Stress and Perception of Nurse Support in Parents Whose Babies are Hospitalized in The Neonatal Intensive Care Unit

Aim: The aim of this study is to determine the stress status and nurse-parent support perception in parents whose babies are in the neonatal intensive care unit. Material and Method: This research is of descriptive type. 127 parents whose babies were in the neonatal intensive care unit constituted the sample of the study. Data were collected with Parent Information Form, the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU) and the Nurse Parent Support Tool (NPST). Results: The stress level of the parents was found to be 3.24 ± 1.21 and the NPST score was 3.65 ± 0.82. Those who live in the same city as the neonatal intensive care unit and who have a baby boy, and those whose babies receive respiratory support were found to have a higher parental role alterations mean subscale score. As the education level of the father decreased, the support for respect and quality caregiving scores increased. Perceived nursing support increased in parents of breastfed and formula-fed babies. Conclusion: It was determined that there was a positive relationship between the stress level perceived by parents and the perception of nurse support. Nursing support should be given to all parents admitted to the NICU.

Sociodemographic predictors of parenting stress among mothers in socio-economically deprived settings in rural and urban Kenya and Zambia

Parental stress occurs when parenting demands exceed the resources available to cope with parenting. Previous research has identified household wealth, educational level, marital status, age, and number of dependent children as predictors of parental stress. However, limited evidence exists from sub-Saharan Africa. This study investigated the sociodemographic predictors of parenting stress among mothers in Kenya and Zambia. This cross-sectional study utilised baseline secondary data from parenting intervention programs implemented in Kisumu County (rural Kenya), Nairobi County (Urban Kenya), and Chisamba District (rural Zambia). Out of 913 caregivers recruited for the parenting program, 844 with complete data were included in the analysis. The mean age was 1.0 (SD = 0.7) years. Parental stress was measured using the Parental Stress Score (PSS) tool and demographic questionnaires were used to collect demographic information. Mean PSS were compared across study sites, and a multiple linear regression model was used to examine associations between sociodemographic predictors (household income, educational level, marital status, maternal age, child age, and number of children aged < 5 years) and PSS, adjusting for clustering and other predictors. From the results, the mean PSS in rural Kenya was 37.6 [SD = 11.8], in urban Kenya was 48.4 [SD = 4.2], and in rural Zambia was 43.0 [SD = 9.1]. In addition, the significant association between PSS and mothers’ income and educational level was only observed in Kenyan study sites (income: Kenya rural β = -0.40, p < 0.001**; Kenya urban, β = − 0.33, p = .02*; Zambia rural, β = − 0.01, p = 0.7) education: Kenya rural, β = − 0.25, p = .005**; Kenya urban, β = − 0.14, p = 0.07; Zambia rural, β = 0.04, p = 0.3). However, marital status, mother’s age, child’s age, and the number of children below five years were not associated with PSS. The results revealed that mothers’ income and education level were negatively associated with PSS, indicating that higher socioeconomic status can buffer the effects of parental stress.Trial registration Pan African Clinical Trials Registry (https://pactr.samrc.ac.za/) database (ID Number: PACTR20180774832663 Date: 26/July/2018; (ID number: PACTR201905787868050 Date: 06/May/2019.

Caregiver burden among parents of school-age children with asthma: a cross-sectional study.

To investigate the caregiver burden of parents of school-age children with asthma and analyze the factors influencing their caregiver burden. A convenience sampling method was used to select 366 parents of school-age children with asthma who visited the outpatient departments of three tertiary hospitals in Sichuan Province, China, from January 2021 to July 2021. A general information questionnaire and the Caregiver Burden Inventory (CBI) were used to assess the current caregiver burden and analyze the influencing factors. The caregiver burden score of parents of school-age children with asthma was 27 (17, 39), with 40.43% of parents experiencing moderate to high levels of burden. Detailed results of univariate analysis showed that there were significant differences in caregiver burden scores based on parents' gender, highest education level, number of children, occupation, family history of asthma, monthly family income, annual medical expenses for the child, child's gender, whether the child had undergone lung function tests, number of emergency visits due to asthma exacerbation in the past 3 months, and whether the child had missed school due to asthma exacerbation in the past 3 months (p < 0.1). Detailed results of multivariate analysis showed that parents' gender, occupation, family history of asthma, monthly family income, annual medical expenses for the child, number of emergency visits due to asthma exacerbation in the past 3 months, and whether the child had missed school due to asthma exacerbation in the past 3 months were independent risk factors for caregiver burden in parents of school-age children with asthma (p < 0.05). Parents of school-age children with asthma experience a certain level of caregiver burden, with over one-third of parents experiencing moderate to high levels of burden. Being a mother, being a worker, having no family history of asthma, having low monthly family income, having high annual medical expenses for the child, having frequent emergency visits due to asthma exacerbation in the past 3 months, and having missed school due to asthma exacerbation in the past 3 months are independent risk factors for caregiver burden in parents of school-age children with asthma, healthcare providers should develop feasible coping strategies, such as paying attention to caregivers' psychological condition to reduce the burden of caring for parents of school-age children with asthma. The entire society should also make efforts in improving social support and strengthening healthcare coverage in order to achieve the aforementioned goals.

The Knowledge, Attitudes, and Practices of Parents Regarding Sun Protection for Their Children.

To evaluate the knowledge, attitudes, and practices of parents toward protecting their children against skin cancer and the sun. This cross-sectional study was performed in Turkey from March through October 2022. The authors used a questionnaire investigating the parents' and children's characteristics, attitudes, and practices toward sun protection and the Skin Cancer and Sun Knowledge (SCSK) scale to collect data. Of 465 parents, 60.2% were women, 83.2% were light-skinned, 20.2% perceived their children as risk-free, 43.8% perceived their children as low risk in terms of skin cancer, 14.6% examined their children from head to foot, 62.3% applied sunscreen to their children, 9.7% made them wear long-sleeved clothing, 60.0% made them wear headgear, 61.1% made them remain in the shade or under a sunshade, and 32.3% made them wear sunglasses. The mean parental SCSK scale score was 14.3 ± 4.1. Scale scores were higher among those who perceived their children as being at high risk for skin cancer (P = .000), whose children had not experienced red or painful sunburn in the previous year (P = .000), and who informed their children about sun protection (P = .000). Although knowledge of skin cancer and solar protection was high, parental perception of the risk of skin cancer was very low, and attitudes toward skin examination were also very relaxed.

Associations between sleep problems in children with ADHD and parental insomnia and ADHD symptoms.

Sleep problems are common in children with attention deficit hyperactivity disorder (ADHD). Children's sleep problem may influence, and be influenced by, parents' sleep problems as well as parents' ADHD symptoms. In the current study we examined the associations of parent-rated sleep quality and sleep timing of pre-adolescent children with parental insomnia symptoms, parental ADHD symptoms and dysfunctional attitudes and beliefs about sleep in a convenience sample recruited by advertisement (N = 120). Childhood sleep problems were common in the sample, with 82% of children exceeding the threshold for the presence of a paediatric sleep disorder. Children's sleep quality showed minimal association with their sleep timing and chronotype. Parental insomnia symptoms, ADHD symptoms and dysfunctional beliefs and attitudes about sleep all associated with their children's sleep quality, and with the sleep subdomains of sleep anxiety and parasomnias. In multiple regression analysis only parental insomnia score was a significant predictor of children's sleep quality. Children's bedtimes, wake times, sleep duration, chronotype or social jetlag did not associate with parents' ADHD or insomnia symptoms. Sleep quality was significantly poorer in children whose parents scored as both consistent for adult ADHD and probable for insomnia disorder compared to parents who scored as either ADHD consistent or insomnia probable, or those who parents scored as neither. We discuss the putative nature of the relationships between sleep quality of children with ADHD and parental ADHD and insomnia symptoms, and suggest that clinicians consider parental sleep when attending to children with ADHD.

Keep Calm: Does parental preoperative anxiety affect post-tonsillectomy pain scores in children?

PurposeTo understand if high parental anxiety leads to increased post-tonsillectomy pain in children.MethodsProspective study including parents of children aged 3–10 years old submitted to tonsillectomy with or without adenoidectomy. To evaluate anxiety, parents were asked to fill the State-Trait Anxiety Inventory form-Y, with postoperative pain being evaluated with the Wong-Baker FACES pain scale at postoperative days 1, 3 and 7. Parents were also asked to register the number of days during which children took analgesic and the number of analgesic intakes needed.Results41 parents were enrolled, of which 95.1% (n = 39) were female with a mean age of 35.64 years (SD 5.751), with 41 children also being enrolled, of which 85.4% of children (n = 35) underwent tonsillectomy and adenoidectomy. 43.9% (n = 18) of parents presented State anxiety scores above the cut-off level and 53.7% (n = 22) above the Trait anxiety scores above the cut-off. Children of parents with high State anxiety presented statistically higher pain scores in both the third (p = 0.035) and the seventh postoperative days (p = 0.006), with significantly longer use of analgesic medication (p = 0.043) being found, as well as a statistically higher number of analgesic intakes (p = 0.045) (Table 4).ConclusionThe present study establishes an association between preoperative parental anxiety, postoperative pain scores and the need for longer analgesic use in children undergoing tonsillectomy. This reinforces the importance of reducing parental anxiety and opens the door for further strategies to better post-tonsillectomy outcomes.

Effects of oral dexmedetomidine on incidence of anxiety and emergence delirium in surgical and non-surgical anesthesia in preschool children

ABSTRACT Background Anxiety and emergence delirium (ED) are common complications of anesthesia in preschool children. Several causes had been attributed to them. Emergence delirium might be related to preoperative anxiety. We aimed to detect the incidence of anxiety and emergence delirium in anesthesia for surgical and non-surgical procedures, also to detect if oral dexmedetomidine as a premedication affects the incidence and severity of them in these procedures. Methods The study involved 180 children undergoing anesthesia who were randomly assigned to one of four groups, with each group containing 45 children. The study was clinical, controlled, comparative, and prospective. Groups A1&A2 had surgical intervention, while groups B1&B2 had MRI scanning. Groups A1&B1 were given 20 ml plain apple juice (Placebo) and groups A2&B2 received oral Dexmedetomidine (4 µg/kg) inserted in 20 ml apple juice 45 minutes prior to anesthesia induction. Anxiety was assessed pre-procedural, emergence delirium and pain at different intervals post-anesthesia. Results Incidence of anxiety and emergence delirium showed no difference between surgical and non-surgical procedures. Patients who received oral dexmedetomidine in groups A2 and B2 had significantly lower Parental Separation Anxiety scores than corresponding control groups A1 and B1 (p = 0.001). Occurrence of emergence delirium and severe pain were much decreased in groups received dexmedetomidine. PAED and FLACC exhibited significantly reduced scores in groups received dexmedetomidine than groups received Placebo drug (p < 0.05) in both surgical and non-surgical procedures. Rescue analgesia was needed more significantly for patients in groups A1 and B1 relative to other groups (p = 0.002). The incidence of complications revealed no statistical significance. Conclusion Anxiety and emergence delirium were similar in surgical and non-surgical procedures. Premedication of preschool children with oral dexmedetomidine lowered the frequency and intensity of anxiety, emergence delirium and severe pain. Emergence delirium was correlated to pain, especially in surgical procedures.

Preoperative Anxiolytic and Sedative Effects of Intranasal Remimazolam and Dexmedetomidine: A Randomized Controlled Clinical Study in Children Undergoing General Surgeries.

Remimazolam, anultra-short-acting and fast-metabolized sedative, has only been sporadically investigated in children. This study was performed to determine the beneficial effects of intranasal remimazolam or dexmedetomidine on preoperative anxiety in children undergoing general surgeries. Ninety children were randomly and equally assigned to Group R (intranasal remimazolam 1.5mg kg-1), Group D (intranasal dexmedetomidine 2 mcg kg-1), and Group C (intranasal distilled water). The primary outcomes were the preoperative anxiety scores using the modified Yale preoperative anxiety scale (m-Ypas). The secondary outcomes included the cooperation behaviour of intranasal drug application, preoperative sedation levels, parental separation anxiety scores (PSAS), and mask acceptance scores (MAS). Group R showed a significant low anxiety at 10 min after intranasal premedication (vs group C, P=0.010; vs group D, P = 0.002) and at anaesthesia induction (vs group C, P = 0.004). Group D showed a significantly low anxiety score only prior to anaesthesia induction (vs group C, P = 0.005). Most children in group R achieved mild sedation at 10 min (vs group C, P < 0.001; vs group D, P < 0.001), with a few progressing to deep sedation afterwards, while group D tended toward deep sedation. Compared to Group C, patients in Group R performed significantly better on the MAS (P = 0.014) and PSAS (P = 0.008). However, remimazolam did cause poor cooperation behavior to the intranasal application due to its mucosal irritation (vs group C, P = 0.001; vs group D, P = 0.010). Both intranasal remimazolam and dexmedetomidine can effectively alleviate preoperative anxiety in children. While intranasal remimazolam has a rapid onset, it produces only mild sedation and causes substantial nasal irritation. NCT04720963, January 22, 2021, ClinicalTrials.Gov.

Working Mothers: Good mothering, Parental Guilt and Work Volition

Abstract: Working mothers experience marked work-family conflict which negatively affects their career progression and mental well-being. This study aimed to determine the interrelationship between good mothering expectations, parental guilt and work volition in working mothers. The participants included a total of 150 working mothers between the ages of 21 and 59. The inclusion criterion was working mothers with children of ages 21 or below. The study included participants primarily from India (90.8%), with a smaller representation from Australia (0.7%), the UK (2%), the US (0.7%), Egypt (0.7%), Turkey (0.7%) and Romania (5.4%). Three scales were utilized: the Good mothering Expectations Scale, the Guilt about Parenting Scale, and Work Volition. The results indicate a weak significant correlation between traditional roles and parental guilt (Rho = .345). The significant F-statistic (14.137) with a very low p-value (000) suggests that there are statistically significant differences in parental guilt scores among the traditional roles. No statistically significant relationships were found between guilt about parenting and work volition. The results of the study indicate that working mothers who subscribe to traditional mothering roles face increased amounts of guilt.

Learning Attitude Mediates the Relationship Between Parental Educational Expectations and Academic Performance of Junior High Students: Evidence from China

With the rapid development of China, parents are placing higher and higher expectations on their children’s education. Drawing upon baseline data from the China Education Panel Survey (CEPS2013), this study delves into the mechanisms through which the learning attitude of junior high school students affects the association between parental educational expectations and academic performance. The results of the present study show that students’ learning attitude is a significant factor that impacts the academic performance of junior high school students and plays a substantial mediating role in the relationship between parental educational expectations and academic performance. Our analyses reveal that parental educational expectations have a greater impact on test scores compared to cognitive ability. Additionally, the mediating effect of learning attitude on the relationship between parental educational expectations and test scores is considerably stronger than the relationship between parental educational expectations and cognitive ability. These results contribute to a better understanding of the mechanism by which parental educational expectations affect children’s academic performance, which has implications for educational policy and practice in China.