Psychosocial Health Of Children Research Articles

School Health Promotion, the Body Mass Index z-Score, and Psychosocial Health in Primary Schools of the Netherlands.

Childhood overweight and psychosocial issues remain significant public health concerns. Schools worldwide implement health promotion programs to address these issues and to support the physical and psychosocial health of children. However, more insight is needed into the relation between these health-promoting programs and the Body Mass Index (BMI) z-score and psychosocial health of children, while taking into account how school factors might influence this relation. Therefore, we examined whether the variation between primary schools regarding the BMI z-score and psychosocial health of students could be explained by school health promotion, operationalized as Healthy School (HS) certification, general school characteristics, and the school population; we also examined to what extent the characteristics interact. The current study had a repeated cross-sectional design. Multilevel analyses were performed to calculate the variation between schools, and to examine the association between HS certification and our outcomes. Existing data of multiple school years on 1698 schools were used for the BMI z-score and on 841 schools for psychosocial health. The school level explained 2.41% of the variation in the BMI z-score and 2.45% of the variation in psychosocial health, and differences were mostly explained by parental socioeconomic status. Additionally, HS certification was associated with slightly lower BMI z-scores, but not with psychosocial health. Therefore, obtaining HS certification might contribute to the better physical health of primary school students in general. This might indicate that HS certification also relates to healthier lifestyles in primary schools, but further research should examine this.

Evidence Register Green List Prevention: Analysis of the listed effectiveness-tested programmes

In the areas of prevention and health promotion, there is a large number of measures for children and adolescents. One way of facilitating evidence-based action for those involved in these taks is by making available online evidence registers with customised, effectiveness-tested measures. The Green List Prevention is such a register and offers an overview of evidence-based programmes in Germany, currently with a focus on psychosocial health. The aims of this study were (a) to analyse the characteristics of the available and evaluated programmes on the psychosocial health of children and adolescents, (b) to identify priorities and underrepresented areas of the Green List Prevention and (c) to optimise the search functions of the register. The characteristic features were recorded on the basis of the existing upper categories of the register entries which were differentiated into subcategories in an inductive procedure by at least two persons. In addition, deductive categories were added for relevant aspects concerning content and implementation. The upper and lower categories formed were operationalized with characteristic values. All entries were analyzed by using a data sheet and were descriptively evaluated. The 102 programmes listed (as of 2/2024) addressed not only the primary target group of children and youth, but also secondary target groups (mainly teachers and guardians). Social and life skills programmes as well as trainings for guardians represented a focus. Behavioral prevention programmes on the topics of violence (including bullying) (63.7%), addiction (46.1%) and/or mental health (35.3%) were frequently represented, whereas nutrition and/or physical activity (4.9%) were hardly represented. Most of the programmes (88.2%) could be assigned to the eligibility criteria of the statutory health insurers (§20a SGB V). Potentials digital implementation forms and further implementation aspects were identified. The Green List Prevention bundles a large number of different measures and that there is potential for expansion. Processing knowledge about effective measures in a user-friendly manner can be optimised through expanded search functions, so that resource-conserving, evidence-based action can be facilitated.

The assessment of preschool children with ESSENCE symptoms: concordance between parents, preschool teachers and child psychologists

BackgroundIt is important to detect children with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) in order to implement early intervention and support for the child and family. Standardized instruments for assessment in different contexts of behaviour problems, engagement and psychosocial health obtain an objective picture of the preschool child's mental health.AimTo explore and compare parents', preschool teachers' and child health care psychologists' assessment of behaviour, everyday function, engagement, social interaction and psychosocial health in children with ESSENCE symptoms.MethodParents of 152 children (114 boys and 38 girls, 4.5 ± 1 years) with ESSENCE symptoms, 155 preschool teachers and 8 child psychologists participated. Parents and preschool teachers assessed externalizing and internalizing behavioural problems using the Strengths and Difficulties Questionnaire (SDQ), including the SDQ supplement for assessing the impact of behavioral problems on daily function. Preschool teachers also assessed engagement and social interaction using the Children's Engagement Questionnaire (CEQ), and the child psychologists assessed psychosocial health with the Child Psychosocial Health Assessment (LillaLAPS) and template in conversations with parents of children with neurodevelopmental problems.ResultsParents', preschool teachers' and child psychologists' assessment of the child's ESSENCE symptoms overall agreed. Both parents and preschool teachers see a strength in the child's social abilities. Differences in mean values show that parents assess more conduct, emotional symptoms and problems in daily life and more social skills, compared to the preschool teachers rating more peer problems.ConclusionIt is important to consider different contexts to identify the child's need for support in everyday life. Expanded use of validated screening instruments in clinical practice would promote detection of children not already identified as exhibiting neurodevelopmental problems.

Association between meeting the 24-h movement guidelines and psychosocial health in children: A cross-sectional study.

Emerging evidence suggests that meeting the 24-h movement guidelines is associated with optimal mental health. However, there remains some uncertainty regarding this association in children. Therefore, this study aimed to examine the association between meeting the 24-h movement guidelines and psychosocial health in children. A cross-sectional study design was employed to investigate 2005 children aged 9-12 years from four districts of Shanghai, China. The 24-h movement behaviours were assessed using selected items from the Health Behaviour in School-aged Children (HBSC) survey questionnaire. Children's self-rated psychosocial health was evaluated using the Strengths or Difficulties Questionnaire (SDQ). Generalised Linear Models with the ordinal logistic module were employed to analyse the association between meeting the 24-h movement guidelines and psychosocial health. The overall prevalence of meeting all three 24-h movement recommendations was 10.2%. Among children, 7.9% of them exhibited abnormal total difficulties, with a notable difference between sex (boys: 11.2%, girls: 7.0%, p = 0.001). Meeting all three 24-h movement behaviour recommendations was associated with reduced total difficulties, emotional symptoms, conduct problems, hyperactivity and peer problems. Furthermore, a dose-response association was observed, indicating that meeting a greater number of 24-h movement behaviour recommendations was associated with enhanced psychosocial health, particularly in boys. The findings of this study highlight the positive association between meeting the 24-h movement guidelines and psychosocial health in children. Notably, meeting more of these recommendations was associated with a lower likelihood of experiencing psychosocial problems, with greater benefits observed in boys compared with girls.

Interventions to build resilience and to ameliorate negative psychosocial effects of the COVID-19 pandemic on children and adolescents: a systematic review and meta-analysis.

The psychosocial health of children and adolescents has been particularly affected by the COVID-19 pandemic. Containment measures have restricted social development, education and recreational activities, may have increased family conflicts and, in many cases, led to feelings of loneliness, sleep disturbances, symptoms of anxiety and depression. We conducted a systematic review to identify interventions that seek to ameliorate these detrimental effects of the COVID-19 pandemic and to build resilience in children and adolescents. Literature searches were conducted in the databases MEDLINE, EMBASE, PsycINFO, CENTRAL, WHO COVID-19 Global literature on coronavirus disease and Cochrane COVID-19 Study Register (up to 30 June 2022). The searches retrieved 9557 records of which we included 13 randomized-controlled trials (RCTs) for evidence synthesis. Included studies predominantly implemented online group sessions for school-aged children with either a psychological component, a physical activity component, or a combination of both. A meta-analysis of seven studies on anxiety and five on depressive symptoms provided evidence for a positive effect of interventions by reducing anxiety (Standardized Mean Difference (SMD) (95% CI): -0.33 (-0.59; -0.06)) and depressive symptoms (SMD (95% CI): -0.26 (-0.36; -0.16)) compared to the control interventions. Studies also showed improvements in positive mental health outcomes, such as resilience (n = 2) and mental and psychological wellbeing (n = 2). Exploratory subgroup analyses suggested a greater effectiveness of interventions that (i) are of higher frequency and duration, (ii) enable personal interaction (face-to-face or virtually), and (iii) include a physical activity component. Almost all studies were judged to be at high risk of bias and showed considerable heterogeneity. Further research may focus on the contribution of different intervention components or distinct subgroups and settings, and should examine children and adolescents over longer follow-up periods.

485 Sleep disturbance impacts physical and psychosocial health of children with atopic dermatitis

485 Sleep disturbance impacts physical and psychosocial health of children with atopic dermatitis

Organization of motor activity of younger schoolchildren with impaired health in the conditions of the NUSH

The article highlights the importance of motor activity in the motor and psychological development of junior school children. It has been proven that a person's motor skills mature gradually over time. This depends on several factors, including, but not limited to, individual differences, health status, quality of neuromuscular structures, and stimulating factors.
 Research included in this review shows that different types of physical activity, including aero- bic training, strength training, dance, yoga, and walking programs, improve mood and mental health. Aerobic physical activity has the greatest effect on reducing the symptoms of anxiety and stress. Habits related to the physical activity, acquired in childhood, can be maintained in adulthood, which contributes to the better health and quality of life. Extensive literature indicates that regular physical activity encourages growth and development and has multiple benefits for the mental, physical, cognitive and psychosocial health of children.
 Children capacities for exercise change in accordance within defined developmental periods. Young children are active at short intervals and their capacity for continuous activity increases as they grow and mature. The health benefits of sporadic exercise at a younger age are not well established, stressing the short-term benefits of physical activity for some aspects of cognitive and mental health, indicating that maximum benefit can be achieved by frequent bouts of exercise during the day.

Adherence to 24-Hour Movement Recommendations and Health Indicators in Early Adolescence: Cross-Sectional and Longitudinal Associations in the Adolescent Brain Cognitive Development Study

PurposeAdherence to 24-hour movement guidelines of ≥60 minutes of physical activity, ≤2 hours of screen time, and 9–11 hours of sleep has been shown to benefit cognitive, physical, and psychosocial health in children and young adolescents aged 5–13 years. However, these findings have mostly been based on cross-sectional studies or relatively small samples and the associations between adherence to guidelines and brain structure remain to be evaluated. MethodsData from the Adolescent Brain Cognitive Development℠ (ABCD) study of 10,574 early adolescents aged 9–14 years from September 2016 to January 2021 were used to examine whether adherence to 24-hour movement guidelines benefits cognition (general cognitive ability, executive function, and learning/memory assessed by the National Institutes of Health Toolbox neurocognitive battery), body mass index, psychosocial health (internalizing, externalizing, and total problems from the parent-reported Child Behavior Checklist), and magnetic resonance imaging–derived brain morphometric measures at baseline (T1), ∼2 years later (T2), and longitudinally from T1 to T2 (T2-T1). Multivariable linear mixed models were used, with adjustments for sociodemographic confounders. Time elapsed and T1 outcome measures were also controlled for in longitudinal models. ResultsBetter cognitive scores, fewer behavioral problems, lower adiposity levels, and greater gray matter volumes were observed in those who met both sleep and screen time recommendations compared to those who met none. Longitudinal follow-up further supports these findings; participants who met both recommendations at T1 and T2 evidenced better outcome measures than those who met none. DiscussionThese findings support consideration of integrated rather than isolated movement recommendations across the day in early adolescence for better cognitive, physical and psychosocial health. Although the associations between physical activity and health indicators were less consistent in this study, the significant findings from sleep and screen time demonstrate the importance of considering movement recommendations in an integrated rather than isolated manner for adolescent health. It is recommended that movement behaviors be simultaneously targeted for better developmental outcomes.

Associations Between Perceived Social Support, Perceived Competence And Physical Activity In Hong Kong Children With Disabilities During The Covid-19 Pandemic

PURPOSE: The COVID-19 pandemic has caused adverse impacts on physical activity (PA) and psychosocial health in children with disabilities. The aim of this study was to examine the associations among their perceived social support, perceived competence, and participation in PA, and to determine the predicting effects of perceived social support and perceived competence towards PA during the lockdown of the COVID-19 pandemic. METHODS: Participants were 291 children with a physician diagnosis of physical disabilities (PD) and intellectual disabilities (ID) aged 6-17 years. They were asked to complete measures that assessed their perceptions of social support, perceived competence, and participation in PA. RESULTS: Significant differences were found in age, BMI and perceived competence between children with PD and ID (ID>PD). BMI was the most significant co-founding variable (p = 0.001) in the total sample of participants. After controlling for demographic variables, perceived competence explained more significance (an additional 17% variance) for PA participation (p < 0.05), rather than social support in the total sample. The total variance explained by the model was 24%, F (2, 240) = 12.42, p < 0.001. No significance was found for their interaction effect. CONCLUSIONS: Larger predictions were found for PA on perceived competence in children with PD and ID. Perceived social supports are essential, but needs to specify the role of significant others, such as mothers/fathers, siblings/peers during the COVID-19 outbreak. Future studies should target on these predictors to inform the intervention design to encourage PA participation in children with disabilities in Hong Kong.

The Relationship Between Physical Activity Level And Quality of Life of Children with Autism Spectrum Disorder

Objective: The aim of this study is to determine the quality of life levels of children with Autism Spectrum Disorder and the relationship between quality of life and physical activity level. Materials and Methods: 28 children with a diagnosis of Autism Spectrum Disorder participated in the study. A sociodemographic form consisting of 25 questions about the child and parents, the " Pediatric Quality of Life Inventory- Parent Form " consisting of 23 questions to assess the quality of life of children and adolescents, and the "Physical Activity Scale for Children" consisting of 9 questions to determine the level of physical activity was administered to the participants. Results: 28 children with Autism Spectrum Disorder, including 8 girls and 20 boys, participated in the study. The mean PedsQL score of the children diagnosed with Autism Spectrum Disorder was found to be 49.87±19.08. Pearson Correlation analysis was performed to determine the relationship between children's physical activity level and quality of life. No statistically significant correlation was found between the PedsQL total score and the PAQ-C score (p&amp;gt;0.05). A statistically significant positive correlation was found between psychosocial health and PAQ-C, one of the sub-scores of PedsQL. (p&amp;lt;0.05) Conclusion: According to the findings; We can state that the psychosocial health of children with Autism Spectrum Disorder and the social function parameter among the sub-parameters are more negatively affected. There is no significant relationship between children's physical activity levels and quality of life, but there is a significant relationship between psychosocial quality of life and physical activity levels.

Childhood food insufficiency and adulthood cardiometabolic health conditions among a population-based sample of older adults in Puerto Rico

Childhood food insufficiency negatively influences physical and psychosocial health in children, but less is known about long-term health implications. This study aimed to elucidate the association of childhood food insufficiency with older adulthood cardiometabolic conditions. We conducted cross-sectional analyses using data from the Puerto Rican Elderly: Health Conditions Project (n = 2712), a population-based sample of elderly adults (>60 y) living in Puerto Rico. Childhood food insufficiency was ascertained with a proxy question on childhood economic hardships that prevented eating. Participants self-reported hypertension, diabetes, and cardiovascular disease (CVD; including heart attack, heart disease, or stroke). Obesity was assessed as body mass index using measured height and weight. Multivariable-adjusted, sex-stratified, complex survey logistic regression models tested associations of childhood food insufficiency with each condition, number of cardiometabolic conditions (0–6), and age of onset. Nearly a third (29.4%) of the sample reported childhood food insufficiency; 68.7% reported hypertension, 29.6% reported type 2 diabetes, 34.2% reported CVD, 29.9% were categorized with obesity, and 55.4% had two or more cardiometabolic conditions. In men, but not women, childhood food insufficiency was associated with higher odds of hypertension (Odds Ratio (OR) (95% Confidence Intervals (CI)): 1.7 (1.1, 2.7)), CVD (1.7 (1.1, 2.6)), and having two (1.9 (1.0, 3.4) or three to four (2.3 (1.2, 4.4)) cardiometabolic conditions. Childhood food insufficiency was marginally associated with higher odds of early age of onset of CVD among men (2.2 (1.0, 4.7)). Childhood food insufficiency may increase the likelihood of having cardiometabolic conditions in Puerto Rican older men. Programs that enable access to sufficient, healthy food in childhood may help prevent eventual cardiovascular-related diseases.

Coronavirus Disease 2019 (COVID-19) Vaccination for Children: Position Statement of Indian Academy of Pediatrics Advisory Committee on Vaccination and Immunization Practices

JustificationData generated after the first wave has revealed that some children with Coronavirus 19 (COVID-19) can become seriously ill. Multi-inflammatory syndrome in children (MIS-C) and long COVID cause significant morbidity in children. Prolonged school closures and quarantine have played havoc with the psychosocial health of children. Many countries in the world have issued emergency use authorisation (EUA) of selected COVID-19 vaccines for use in children. In India, a Subject Expert Committee (SEC) has recommended the use of Covaxin (Bharat Biotech) for children from the ages of 2–18 years. The recommendation has been given to the Drugs Controller General of India (DCGI) for final approval.ObjectiveTo provide an evidence-based document to guide the pediatricians on the recommendation to administer COVID vaccines to children, as and when they are available for use.ProcessFormulation of key questions was done by the committee, followed by review of literature on epidemiology and burden of COVID-19 in children, review of the studies on COVID vaccines in children, and the IAP stand on COVID-19 vaccination in children. The available data was discussed in the ACVIP focused WhatsApp group followed by an online meeting on 24 October, 2021, wherein the document was discussed in detail and finalized.RecommendationsThe IAP supports the Government of India’s decision to extend the COVID-19 vaccination program to children between 2–18 years of age. Children with high-risk conditions may be immunized on a priority basis. The IAP and its members should be a partner with the Government of India, in the implementation of this program and the surveillance that is necessary following the roll-out.

A Perspective on Reprioritizing Children’s’ Wellbeing Amidst COVID-19: Implications for Policymakers and Caregivers

The present work presents an analytical and investigatory view of the existing issues regarding COVID-19 with attention to children and their overall well-being during the second quarter of 2020. The authors conducted an extensive content analysis of media reports, government briefings, social platforms, and provide some recommendations to the policymakers and care providers for building more robust responses for the pandemic affected children. The article contributes to the existing field of study in the following ways. Firstly, the present manuscript describes the impact of COVID-19 on the psychosocial health of children. Secondly, the authors offered some outcome-based responses to policymakers and caregivers to mitigate the negative impact of the pandemic on COVID affected families and children. Thirdly, the article highlights the importance of social media, the role of storytelling, and using the concept of mandalas in handling the pandemic affected sensitive sections of the society. Lastly, the authors furnish some response initiatives to combat the novel COVID-19 pandemic based on real-world observations. These initiatives can influence policymakers as well as help caregivers to design efficient and adequate response programs for the pandemic affected children.

Family Management Style and Psychosocial Health of Children with Chronic Conditions

This study aimed to examine the associations among variables related to the sociocultural context (including social support, parenting stress, and parents’ perceived severity of their child’s condition), the ease or difficulty of family management, and psychosocial outcomes of children with chronic conditions. This cross-sectional study analyzed a convenience sample of 277 parents of children with chronic diseases who had been receiving follow-up care for at least 6 months at a university hospital located in a metropolitan area. Family members answered a questionnaire on demographics, illness characteristics, perceived severity of the child’s chronic condition, social support, the Parenting Stress Index, the Pediatric Symptom Checklist, and the Korean version of the Family Management Measure (FaMM). The six scales of the FaMM were divided into two domains, corresponding to ease and difficulty of family management, respectively. PASW version 18.0 and AMOS version 22.0 with bootstrapping analysis were used. Social support, parenting stress, and perceived disease severity significantly affected both ease and difficulty of family management. Sufficient social support, low parenting stress, and a less severe chronic condition of the child were associated with ease of family management. Both ease and difficulty of family management explained 73.9% of the variance in children’s psychosocial problems and showed significant direct effects. Care plans for chronically ill children and their families should be designed to promote positive aspects of family management by decreasing parenting stress and enhancing social support, thereby making family management easier and reducing the risk of psychosocial problems in children with chronic conditions.

Značaj fizičke aktivnosti za razvoj motoričkih veština dece mlađeg školskog uzrasta

Physical activity plays an important role in the motor and psychological development in a pediatric population. The maturation of human motor skills is gradual over the time. It depends on several factors, including but not limited to: individual differences, health condition, quality of neuromuscular structures and stimulating factors. Research included in this review shows that different types of physical activity, including aerobic training, strength training, dance, yoga, and walking programs, improve mood and mental health. Aerobic physical activity has the greatest effect on reducing the symptoms of anxiety and stress. Habits related to the physical activity, acquired in childhood, can be maintained in adulthood, which contributes to the better health and quality of life. Extensive literature indicates that regular physical activity encourages growth and development and has multiple benefits for the mental, physical, cognitive and psychosocial health of children. Children capacities for exercise change in accordance within defined developmental periods. Young children are active at short intervals and their capacity for continuous activity increases as they grow and mature. The health benefits of sporadic exercise at a younger age are not well established, stressing the short-term benefits of physical activity for some aspects of cognitive and mental health, indicating that maximum benefit can be achieved by frequent bouts of exercise during the day.

The Consequences of Delaying Telling Children with Perinatal HIV About Their Diagnosis as Perceived by Healthcare Workers in the Eastern Cape; A Qualitative Study.

Although the benefits of disclosure are considerable, informing children with perinatal HIV of their own HIV status is often delayed to late adolescence. This study examined the social and contextual challenges that influence delaying disclosure to children and assessed the outcomes of delayed disclosure on the psychosocial health of children as perceived by the healthcare workers (HCWs) providing care to these children. Data were collected from HCWs via focus group discussions. Nurses, lay counsellors, social workers, and dieticians were selected from facilities in a rural South African health district. Thematic analysis was performed. The caregivers’ social context was the main barrier against informing children timely about their HIV diagnosis. The extent of the internalised HIV stigma influenced the delay in disclosing to the children. Delaying disclosure contributes to children’s refusing to take their medication, leads to the accidental disclosure of HIV, give rise to anger and resentment towards the caregiver, increase the risk of secondary transmitting of HIV, and poor health outcomes. It is essential to train HCWs to support caregivers and children through the disclosure process to ensure that caregivers realise the benefits of disclosure. Strategies to encourage caregivers to disclose early should be sensitive to their concerns about the negative impacts of disclosure.

Impact of Pacemakers and Implantable Cardioverter Defibrillators on the Psychosocial Functioning of Paediatric Patients.

Although implanted cardiac devices improve patients' physical health, long-term psychosocial effects especially in the paediatric population are still unknown. The aim of this study was to evaluate the psychosocial effects of cardiac devices in a paediatric population.Pediatric Quality of Life Questionnaire (PedsQoL) was used to evaluate life quality, Connor-Davidson Resilience Scale was used to evaluate resilience and Brief Symptom Inventory was used to evaluate psychiatric symptoms in a paediatric population with cardiac devices.Seventy-one patients were enrolled in the study. Fifty of them (70.5%) had a cardiac pacemaker and 21 of them (29.5%) had implantable cardioverter defibrillator. When compared to the control group both implantable cardioverter defibrillator and pacemaker using patients had lower quality of life (79.5 ± 12.4 versus 86.7 ± 12.1, p = 0.001) but no difference was observed in resilience and psychological pathologies. Age, gender, family size, and education level had no effect on quality of life. Implantable cardioverter defibrillator bearing patients had higher levels of anxiety than pacemaker patients (0.58 versus 0.30 p = 0.045), and implantable cardioverter defibrillator patients who had received shock in the last year had higher levels of somatisation than the group that did not receive device shock (0.17 versus 0.44 p = 0.022).In conclusion study showed that cardiac devices have negative effects on the psychosocial health of children. Cardiologist working with these patients should be aware of these pathologies and monitor not only physical health but also psychosocial health too.

Effects of Parental Education on Screen Time, Sleep Disturbances, and Psychosocial Adaptation Among Asian Preschoolers: A Randomized Controlled Study

PurposeA recent increase in screen time during early childhood has adversely affected the sleep and psychosocial health of children; however, limited information is available regarding effective interventions to reduce the screen time among them. This study aimed to investigate the effect of a parental educational program on screen use, sleep quality, and psychosocial adaptation among preschoolers. Design and methodsA clustered randomized controlled study with a parallel-group design was conducted. Preschoolers with a screen time of ≥2 h/day and their parents were recruited. In total, 14 kindergartens containing 129 parent–child dyads were randomly allocated to either the experimental group (receiving parental education, N = 63 dyads) or the control group (daily activities, N = 66 dyads). Data were collected before and after the intervention. A screen time questionnaire, the Children's Sleep Habits Questionnaire, and the Pediatric Symptom checklist-17 were provided to the participants. A linear mixed-model analysis was performed to examine the efficacy of the intervention. ResultsAfter the intervention, the screen time of children in the experimental group was significantly reduced (effect size: 0.83, p < .001), and they presented improved sleep quality (effect size: 0.57, p = .01) and attention score (effect size: 0.77, p = .02) for psychosocial adaptation. ConclusionsParental education is an effective intervention for reducing screen time and improving sleep quality and attention among preschoolers. Practice implicationsHealthcare professionals should consider implementing parental educational programs to reduce screen time, and thus improve the sleep quality and psychosocial health of preschoolers.

Exercise and Arterial Modulation in Children: The EXAMIN YOUTH Study.

Background: Cardiovascular disease (CVD) remains to be one of the most frequent causes of death worldwide. Cardiovascular (CV) risk factors such as hypertension and obesity often manifest in childhood. The study examines the associations of blood pressure, body mass index and physical activity with cardiopulmonary, metabolic, and psychosocial health of children in a systems physiology approach.Methods/Design: This cross-sectional study will be performed in a cohort of 6 to 8 year old school children (n = 1000). As a measure of vascular health, retinal microvascular diameters and large artery pulse wave velocity will be examined. Anthropometric parameters, such as weight, height, body mass index, and blood pressure will be assessed according to standardized protocols for children. Physical fitness and activity will be measured by a 20 m shuttle run, a 20 m sprint and a proxy-reported questionnaire on lifestyle behavior. Spirometry, assessment of heart rate variability and skin advanced glycation end products as well as a flanker test will be performed to determine systemic end organ alterations.Discussion: The study offers a unique integrative primary prevention concept that aims to set the grounds for a healthy and active lifestyle approach during childhood. It will help optimize CV risk stratification to identify children at risk of disease progression later in life. The study will demonstrate the importance of specific CV screening programs in children to reduce the growing burden of CV disease in adulthood. Prospective follow-up studies will have to prove the efficacy of primary prevention programs in children to achieve healthier aging as a long-term goal.

Assessing the Perceptions of Inspiratory Muscle Training in Children With Cystic Fibrosis and Their Multidisciplinary Team: Mixed-Methods Study.

BackgroundLittle is known about the opinions or perceived benefits of an inspiratory muscle training intervention in patients with cystic fibrosis and their multidisciplinary team.ObjectiveThe aim of this qualitative study was to examine patients' and multidisciplinary teams' views on inspiratory muscle training to inform and tailor future interventions.MethodsIndividual, semistructured interviews were conducted to evaluate participants’ perspectives of a 4-week inspiratory muscle training intervention. In this study, 8 of 13 individuals involved in the inspiratory muscle training program (5 children aged 11-14 years; 2 physiotherapists; and 1 respiratory physician) participated. Interviews were transcribed verbatim, analyzed using thematic analyses, and then coded into relevant themes.ResultsFour key themes emerged: acceptability, facilitators, barriers, and recommendations. While fun, enjoyment, and improved perceived physical ability were reported by children and their multidisciplinary team following the inspiratory muscle training program, the multidisciplinary team identified factors such as time and cost as key barriers.ConclusionsA short inspiratory muscle training program was perceived to have positive effects on the physical ability and psychosocial health of children with cystic fibrosis. These findings highlight the importance of obtaining participants’ and multidisciplinary teams' perceptions and recommendations to ensure the efficacy and optimal design of future inspiratory muscle training protocols.