Children's Quality Research Articles

Parents’ Impression On Quality Of Children In Learning Process At Classroom

Parenting style referred to the approach and methods that parents used to raise their children. This research aims to explore parents' perceptions, policies and participation in supporting children's learning process. Descriptive qualitative was used as a research method. The data of this study was a result of questionnaire and interview, and the source of the data was taken from students at MIS AL-QUBA Medan. The result of this study was the role of parents did not influence student learning in class, due to a lack of supporting factors. Various studies show that parental involvement has a positive impact on children's academic achievement, social development and emotional well-being by some factors, communication between parents and students, nutritious food, and other supporting factors such as additional tutoring and learning facilities.

Deteksi Perkembangan Balita di PAUD Cahaya

Growth and development are two different processes that cannot be separated and are equally important for children in the critical period of the first 0-5 years of life because they will have implications for the child's quality of life in the future. This phase is often referred to as the "Golden Age" phase. Golden age is a very important period to pay close attention to a child's growth and development so that abnormalities can be detected as early as possible. This monitoring must be carried out regularly and continuously. Early age is a golden period and an important stage in the child's growth and development process considering that at this stage rapid development occurs and has long-term effects. Therefore, early detection needs to be done so that parents or teachers can anticipate it early so that growth and development disorders do not occur continuously. In Sungai Tuan Ulu village there is a growth measurement service at Posyandu which is carried out every month but so far there has never been a measurement of development, especially for toddlers at Cahaya PAUD. The use of the Pre-Developmental Screening Questionnaire (KPSP) as a developmental screening tool up to the age of 6 years really helps with careful development. Parents and teachers need to know the current development of their toddlers. So that if a developmental delay is found, it can be handled immediately. Therefore, the activities carried out in community service include early detection of toddler development with KPSP.

Early Intervention, Regular Education, and Family: Reciprocal Influences on Communication and Language Disorders.

Families are the primary caregivers and the main source of support for their children. Family resilience involves coping and adapting to stressful situations. This study explored the impact of previous treatment experience on parental resilience, in families, as well as the relationship between family history of communication and language disorders and parental stress. These variables were assessed through the Resilience Scale and the Parental Stress Index in parents of 220 children aged 3 to 6 years attending mainstream schools and early intervention (EI) centers in Caceres (Spain). The results revealed significant differences in resilience between parents who had received previous treatments and those who had not (p = 0.11). Furthermore, a significant association was found between having no family history of communication and language disorders and the Dysfunctional Parent-Child Interaction subscale from the Parental Stress Index (U = -2.079, p = 0.038). These findings highlight the relevance of previous experience in EI to build family resilience as resilient parents are more likely to be actively involved in their children's education and create a supportive environment. Thus, promoting resilience in educational settings may have positive effects on children's and families' quality of life during the EI process.

GAMBARAN STATUS KONTROL ASMA DAN KUALITAS HIDUP ANAK DENGAN ASMA DI RSUP PROF. DR. I.G.N.G NGOERAH DENPASAR DAN RSUD WANGAYA DENPASAR TAHUN 2020-2021

Asthma is a chronic and emergency disease in children. Uncontrolled asthma in children can affect the quality of life of children and even lead to death. Bali is the province with the third highest prevalence of asthma after the Special Region of Yogyakarta and East Kalimantan. However, data regarding the description of asthma control status and quality of life of children with asthma in Bali, especially in Denpasar, are still limited. Therefore, the authors want to know the overview of asthma control status and quality of life of children with asthma at Prof. Dr. I.G.N.G Ngoerah Hospital Denpasar and Wangaya Hospital Denpasar in 2020-2021. The design of this research is descriptive observational with a cross-sectional approach. After the approval of the constitutional ethics committee, all children aged 6-11 years with asthma at the Outpatient and Inpatient Respirology Pediatric Clinic Prof. Dr. I.G.N.G Ngoerah Hospital Denpasar and Wangaya Hospital Denpasar in 2020-2021 which is recorded in a complete medical record and has approval for participation in the study by parents/guardians (n=32) will be given a questionnaire containing the child and parent’s biodata, Childhood Asthma Control Test (C-ACT) to assess asthma control status, and Pediatric Quality of Life (PedsQL) to assess children's quality of life through an electronic form. Based on asthma control status, the results showed that 27 children (84.4%) had fully controlled asthma control status and 5 children (15.6%) had partially controlled asthma control status. In controlled asthma control status, all children were male. The majority of children (3 children) have poor nutritional status and some (2 children) have obese nutritional status. All children have a family history of asthma. Most of the children's parents have the latest education in college (3 children), senior high school (1 child), and elementary school (1 child). All parents of children have jobs and most of them (3 parents of children) have salaries above the minimum wage. Based on the quality of life, there were 4 children (12.5%) with a disturbed quality of life and 28 (87.5%) children with an undisturbed quality of life. In terms of quality of life, there were 2 children, male and female, respectively. The majority of these children had good nutritional status (2 children) and did not have a family history of asthma (3 children). The parents of the 2 children have the last education in elementary school, while the other 2 parents have the last education in college. All of the children's parents have jobs and the majority (3 parents of children) have salaries above the minimum wage. Further research is needed with a larger sample size and should be carried out prospectively so that the data obtained is more complete.

Impact of mother's care burden, fatigue and child's functional level on quality of life in spastic cerebral palsy.

Cerebral palsy (CP) may be considered one of the most common motor disabilities that require a lot of caregiving from mothers or caregivers; therefore, the mothers of children with CP face a lot of difficulties in their caregiving, which in turn may affect the child's quality of life (QOL). This work was conducted to evaluate the impact of the children's functional level in different types of spastic CP, mothers' care burden (CB), and fatigue on the child's QOL. One hundred thirty-eight children with different types of spastic CP (unilateral and bilateral) with different levels of the gross motor function classification system (GMFCS), with an age range of 6-12years, and their mothers with ages ranged from 25 to 45years, participated in this study. Mother CB, fatigue, and child QOL were measured and compared between different groups by using the Zarit burden Interview (ZBI), Chalder Fatigue Questionnaire (CFQ), and Pediatric Quality of Life Inventory (PedsQL) CP Module, respectively. There were significant differences in all measured variables (ZBI, CFQ, GMFCS, and PedsQL) with p-value <0.001 among the different spastic groups (unilateral and bilateral CP). However, the results revealed a positive impact of the child's GMFCS, mother's CB, and fatigue level on the quality of the child's life, with a greater effect on those with quadriplegic type. The mother's CB and fatigue should be considered in the rehabilitation of spastic CP children based on their GMFCS, as they have a negative impact on child QOL; therefore, helping the mother with her needs should not be ignored, especially in families with severely spastic CP children and low financial income.

A Systematic Review of Misdiagnosis of Pediatric Bipolar Disorder: Assessments and Recommendations.

Bipolar disorders (BP) are a class of psychiatric disorders with a complex symptom presentation. This systematic review aims to summarize literature pertaining to the misdiagnosis of pediatric BP using the DSM-IV and DSM-5 criteria, while emphasizing the negative impact that untreated BP has on life outcomes. This paper also attempts to outline and summarize available recommendations which may aid in improving diagnostic accuracy of pediatric BP. Scholars Portal Journals, PsychINFO, and MEDLINE databases were used to search articles until March 21, 2023. Inclusion criteria limited this review to articles published between 1995 and 2022 using a pediatric (age < 18) sample. Exclusion criteria omitted articles containing samples with self-reported diagnoses. A total of 15 articles are included in this review; study results were synthesized using a narrative summary. Youth with BP are most frequently misdiagnosed with attention-deficit hyperactive disorder (ADHD), schizophrenia, and major depressive disorder (MDD). Misdiagnosis can lead to inappropriate intervention plans and a delay in proper treatment, negatively impacting a child's quality of life by contributing to social, occupational, and economic adversity. Finally, this review addresses the need for future quantitative research on the implications of false negative diagnoses of pediatric BP.

The activity levels and quality of life of physically disabled children who continued or did not continue rehabilitation during the COVID-19 pandemic.

Social isolation during the COVID-19 pandemic had a harmful impact on the psychological and physical health of children and teenagers. It is known that interruptions in rehabilitation can cause soft tissue contractures, bone deformities and a decline in motor functions among other complications. The aim of this study was to compare the quality of life and physical activity levels of physically disabled children who continued and did not continue rehabilitation during the COVID-19 pandemic. The gross motor levels of 18 children who continued special education and rehabilitation during the COVID-19 pandemic and 18 children who did not continue were determined with the Gross Motor Function Classification System (GMFCS). The International Physical Activity Questionnaire Short Form (IPAQ) and Children's Quality of Life Scale (PedsQL) questionnaires were administered. The study participants comprised 54.1% females and 45.9% males with a mean age of 9.02 years. No significant differences were detected between the two groups in respect of demographic, clinical and functional characteristics (p > 0.05). The walking parameters of PedsQL (p = 0.02) and IPAQ-SF scores (p = 0.03) were determined to be statistically significantly better in the group that continued rehabilitation. The results of this study demonstrated that the quality of life and walking capacity of children who continued rehabilitation during the COVID-19 pandemic were better. Methods should be developed to ensure that rehabilitation is not interrupted during isolation periods of any future pandemic.

The impact of characters like Tony the Tiger and other child-targeted techniques used in food and beverage marketing.

Food marketing's impact is a function of exposure and power, both of which contribute to children's poor diet quality and obesity risk. Children's exposure to food marketing is well documented, however, few studies have assessed the impact of specific persuasive marketing techniques or aspects of 'power' on children. This study administered an online survey to 1,341 Canadian children (9-12 years) aiming to determine the impact of: (1) child-targeted vs. adult-targeted marketing, and (2) licensed characters vs. spokes characters on children's food preferences and behavioral intentions. Participants were randomized to a single condition in each survey part and viewed 3 static food advertisements displaying the features of that condition (e.g., child-targeted advertising or licensed characters), and answered 3 Likert-scale (5-point) questions after each exposure. For each condition within each research question, there were four outcome variables related to the impact of marketing on children: food preference, purchase intent, pester power, and total impact. ANOVA tested the difference in impact (Likert scores) between conditions overall and for each outcome, with Bonferroni post-hoc tests where necessary. A greater average total impact was observed among children exposed to child-targeted ads (mean Likert score 3.36) vs. adult-targeted ads (mean score 2.75; p < 0.001) or no marketing (mean score 2.81; p < 0.001). Children exposed to ads featuring spokes characters had a higher average total impact (mean score 3.98) vs. licensed characters (mean score 3.80; p < 0.001) and the control (i.e., no characters) (mean score 3.19; p < 0.001), and the total impact of licensed characters was greater than that of no characters. Similar trends were observed for all other outcomes. Overall, this study showed that child-targeted ads and those using characters - especially spokes characters - have a strong overall impact on children's food preferences, purchase intents, and pester power, and support the implementation of comprehensive marketing restrictions to protect children.

Application of biophilic natural lighting to reduce blue spectrum exposure in dark rooms on children’s sleep quality

Technology plays an essential role in people's lives, and gadgets have become a prevalent trend for information and communication. However, excessive gadget use among children can have negative side effects. Children often spend extended periods of time engaged with gadgets, disregarding screen brightness and maintaining a close distance to the screen. Some parents resort to gadgets as a quick way to pacify their children during tantrums. To address the challenges posed by advanced technology, this study aims to observe and interview parents with children aged 5 to 12. According to UC Davis Health in California, blue light, which is emitted by electronic devices, has the shortest wavelength and the highest energy. It can disrupt the production of melatonin, the hormone that regulates sleep. Exposure to blue light in a dark room, such as when children use electronic devices at night, further disrupts their sleep patterns. To mitigate this, the study will explore the implementation of biophilic natural lighting, which mimics the lighting found in nature. The goal is to create a harmonious and healthier environment that connects children with the natural world, promoting their well-being. By conducting a case study involving workers in biophilic and non-biophilic environments and a dark room is not an ideal choice for playing with gadgets, the study aims to investigate how biophilic natural lighting can reduce the exposure to blue spectrum in dark rooms, particularly for children. The ultimate objective is to determine the impact of biophilic natural lighting on children's sleep quality and propose effective lighting strategies to improve their overall sleep quality. The results of this study will demonstrate the significant improvement in children's sleep quality with the implementation of biophilic natural lighting, providing valuable design guidelines for creating healthier environments for children.

Protocol Article: A Cross-Sectional Evaluation of Children's Feet and Lower Extremities.

The health of children's lower extremities and feet is a focus area for caregivers and healthcare professionals such as doctors, school nurses, and podiatrists. Our study aims to investigate the general health status of Danish children's lower extremities and feet to identify anthropometric parameters that might be preconditions for pain and evaluate for foot diseases and whether they are associated with pain intensity and location, three-dimensional foot dimensions and foot pressure mapping, shoe dimensions, types and intensity of sports activity, quality of life, and foot health. The aim is that we will be able to identify parameters pre-dispositioning for pain, thus providing recommendations for sports activities in relation to the anthropometric conditions of a child as a potential preventive measure for pain. This analysis will be stratified by socioeconomic status on a group level, and this perspective will be able to provide preventative recommendations to prevent pain. This study is a cross-sectional examination of a thousand children in the first, fifth, and ninth grades in randomized selected Danish primary schools. We will perform a clinical examination of the lower extremities and feet for misalignments, deformities, and diseases as well as rotational status and range of motion. Moreover, we will evaluate their pain levels, sports activities, three-dimensional foot dimensions, plantar pressure, footwear, and patient-related outcome measures (PROMs) for foot health and quality of life. We aim to provide an anthropometrical overview of the lower extremities and feet in children. The obtained basic understanding of healthy normal material in children will be analyzed for its relationships with pain level, sports activities, and socioeconomic status on a group level. This could potentially provide us with an understanding of the factors that impact lower extremity and foot diseases in children. In conclusion, examining children's lower extremities and feet in Danish primary schools is a step toward identifying areas of improvement in self-care and shoe fitting, mapping podiatry-related needs of care in children's feet, and providing parental recommendations for preventive actions on shoe fitting and the choice and intensity of sports activity concerning pain. The tenet of this study is a long-term follow-up to evaluate the long-term socioeconomic course on a group level, foot status, and sports activity, using patient-related outcome measures evaluating quality of life and other lifestyle factors such as emotional functioning, social functioning and interaction, and school functioning. Potentially, this will improve children's quality of life and prevent future diseases.

Diet Quality of Young Children in the US-Affiliated Pacific's Children's Healthy Living (CHL) Program.

Childhood diet can impact health outcomes over the life course. Few studies have assessed dietary quality among infants and children in the US-Affiliated Pacific (USAP) region. The aim of this study was to examine the differences in diet quality among Pacific children in the Children's Healthy Living (CHL) program by Pacific jurisdiction and by their World Bank Income Group (WBIG) level. This cross-sectional study used dietary records collected from 2012 to2015. Data were collected on 2- to 8-year-old children (n= 3,529) enrolled in the Children's Healthy Living Program for Remote Underserved Minority Populations in the Pacific region, conducted in the USAP jurisdictions of Alaska, Hawai'i, American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Guam, Federated States of Micronesia (FSM islands include Chuuk, Kosrae, Pohnpei, Yap), Republic of the Marshall Islands (RMI), and Republic of Palau. Diet quality was assessed using the Healthy Eating Index-2005 (HEI-2005). This HEI version was commensurate with the time of dietary data collection for the CHL project and previous studies, thus allowing cross-study comparisons. Means of total HEI-2005 scores between jurisdictions and their WBIG level were compared using linear models, with and without adjustment for age, sex, and dietary energy. Differences in mean HEI-2005 scores among children were found between jurisdictions and their WBIG level. Alaska had the highest adjusted mean score (63.3). RMI had the lowest adjusted mean score (50.1). By WBIG, lower-middle income jurisdictions had the lowest adjusted mean HEI-2005 score (56.0), whereas high income jurisdictions had the highest adjusted mean HEI-2005 score (60.5). Variation in children's diet quality was found between USAP jurisdictions, notably between jurisdictions of different WBIG levels. Future research is needed to deepen understanding of these differences in diet quality by WBIG level, such as whether differences may be attributable to the jurisdictions' varying food systems, and possibly explained by the nutrition transition. Understanding childhood diet quality in this region can inform approaches for nutrition programs in the Pacific region.

Analisis Sentimen Aplikasi Primaku Menggunakan Algoritma Random Forest dan SMOTE untuk Mengatasi Ketidakseimbangan Data

The Primaku application is an application that can be used as a tool to monitor the growth of children under five, this application can be used to collect data on the growth of children under five, apart from that this application can also provide clear information and visualization about the growth of children under five, including nutritional status and growth development In accordance with the standards that have been set, the Primaku application can help parents or health workers in routinely monitoring the growth of children under five and early detecting the potential risk of stunting. Stunting is a growth disorder that occurs in children under five due to malnutrition which is characterized by the child's height. which is shorter than the age standard. Stunting can have a long-term impact on a child's quality of life, such as disrupting physical, cognitive and social development, as well as increasing the risk of chronic disease in adulthood. The primaku application has been widely used, more than 500,000 users have downloaded this application and 44,700 reviews have been given by users to this application, however, reading all the reviews may take time, but if there are few reviews read, then the review results will be biased. Therefore, sentiment analysis aims to overcome this problem by automatically grouping user reviews into positive and negative reviews. Therefore, research on toddler growth detection to determine the public's response to the Primaku application can be of great benefit in efforts to prevent stunting in children under five in Indonesia. In this research, the random forest algorithm with the SMOTE technique was used to carry out sentiment analysis of Primaku application reviews. The random forest algorithm is a machine learning algorithm based on decision trees. The SMOTE technique is used to overcome data imbalance problems and is able to reduce overfitting while increasing the performance of the Random Forest algorithm. The data used in this research is Primaku application review data obtained from scrapping results from the Google Play Store. This data contains comments from application users, namely positive and negative. The results of this sentiment analysis show a deep understanding of user perceptions of the Primaku application. This sentiment analysis can be a basis for further improvement and development of the Primaku application, with a focus on aspects that influence user satisfaction and the research results show that the random forest algorithm with the SMOTE technique can produce quite good accuracy in sentiment analysis of the Primaku application. obtained in this study was 88%.

Assessment of Parental Needs and Quality of Life in Children with a Rare Neuromuscular Disease (Pompe Disease): A Quantitative-Qualitative Study.

Pompe disease (PD) is a rare metabolic disorder with progressive neuromuscular consequences that negatively impact a child's development and quality of life (QoL). Despite an improved prognosis with treatment, the risk for early death due cardiorespiratory crisis remains. Parents not only face physical fatigue and family distress in coping with the child's special needs but also experience emotions, worries, and unexpressed needs (a "humanistic burden") that require supportive interventions. Fourteen parents of children with PD completed an online self-report questionnaire assessing their child's QoL, their own parental burden of care, and disease-related issues. The aim was to estimate the associations between the child's QoL and the caregiver's burden levels. Three mothers were also interviewed. A total of 57.1% of parents lived with moderate/severe burden conditions; worse QoL for the child was associated with higher levels of caregiver burden (rS[N = 14] = -0.67, p < 0.01). Uncertainty about the child's future was a state commonly described by mothers. However, the child's resilience, normalization of disease, and coping strategies (primarily positive appraisal and focusing on the present) alleviated suffering and helped mothers maintain family functioning. Finally, dissatisfaction with communication in relationships with professionals emerged. In conclusion, a typical pediatric palliative care approach is recommended since it manages to guarantee parents empathetic and supportive communication from healthcare professionals, alleviating feelings of isolation and loneliness in parents.

Arrangement of residence before hospital discharge for children on home-invasive mechanical ventilation.

Children on long-term home mechanical ventilation are a growing population due to clinical and technological advances and the benefit for the child's quality of life. Invasive home ventilation is one of the most complex therapies offered in the home setting, requiring adequate home environment and appropriate equipment and supplies before discharge.The transition from hospital to home represents a vulnerable period that can be facilitated with an established transition plan with multidisciplinary team involvement. Readiness for home care is achieved when the patient is stable and has been transitioned from a critical care ventilator to a home mechanical ventilator. In parallel, comprehensive competency-based training regarding the knowledge and skills needed to help families use the equipment confidently and safely. Before discharge, families should be counseled on an adequate home environment to ensure a safe transition. The residence arrangement may include physical space modifications, verifying electrical installation, or moving to another home. Durable medical equipment and supplies must be ordered, and community healthcare support arranged. Parents should receive practical advice on setting up the equipment at home and on preventive measures to minimize complications related to tracheostomy and ventilator dependence, including regular maintenance and replacement of necessary equipment.Given the overall impact of invasive ventilation on home life, a structured home care action package is essential to alleviate the burdens involved.

Comparing the Effectiveness of Physical Exercise Intervention and Melatonin Supplement in Improving Sleep Quality in Children with ASD.

Previous studies have demonstrated that physical exercise can modulate the endogenous melatonin level in children with autism spectrum disorder (ASD) and improve their sleep quality. However, it remains unclear whether physical exercise or melatonin supplement, or a combination of both, is more effective in improving sleep quality in this population. The purpose of this study is to answer this research question by comparing the effectiveness of three types of interventions (physical exercise vs. melatonin supplement or a combination of both) in improving sleep quality in children with ASD. Sixty-two (62) children diagnosed with ASD were randomly assigned to one of four groups: cycling (n = 18), melatonin supplement (n = 14), a combination of both (n = 12), and placebo control group (n = 18). Four (4) sleep parameters (sleep efficiency, sleep onset latency, sleep duration, and wake after sleep onset) were assessed. The results revealed a significant improvement in sleep efficiency, sleep onset latency, and sleep duration in all of the interventions, but not in the placebo control group. However, no significant group differences were found among the interventions (ps > .05). Our findings suggest similar effectiveness of physical exercise and melatonin supplementation in improving sleep quality in children with ASD.

The Impact of Ankyloglossia Beyond Breastfeeding: A Scoping Review of Potential Symptoms.

The purpose of this study was to evaluate the spectrum of pediatric quality-of-life sequelae associated with ankyloglossia that may affect children who do not undergo tongue-tie release (frenotomy) during infancy. This study contains data from PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar (1961-January 2023). The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews reporting guidelines. Experimental and observational studies were eligible if they reported baseline outcomes associated with ankyloglossia in children above a year of age. Two reviewers independently screened studies, extracted data, and assessed quality. Low-quality studies were excluded. Twenty-six of 1,568 screened studies (> 1,228 patients) were included. Six studies were high quality and 20 were medium quality. Studies identified various symptoms that may be partially attributable to ankyloglossia after infancy, including speech/articulation difficulties, eating difficulties, dysphagia, sleep-disordered breathing symptoms, dental malocclusion, and social embarrassment such as oral hygiene issues. Multiple comparative studies found associations between ankyloglossia and risk factors for obstructive sleep apnea; a randomized controlled trial found that frenotomy may attenuate apnea severity. Ankyloglossia may also promote dental crowding. Ankyloglossia may be associated with myriad effects on children's quality of life that extend beyond breastfeeding, but current data regarding the impact are inconclusive. This review provides a map of symptoms that providers may want to evaluate as we continue to debate the decision to proceed with frenotomy or nonsurgical therapies in children with ankyloglossia. A continuing need exists for controlled efficacy research on frenotomy for symptoms in older children and on possible longitudinal benefits of early frenotomy for maxillofacial development. https://doi.org/10.23641/asha.23900199.

Empowering and Supporting the Families of Exceptional Children and its Positive Impact on Improving

This article explores the profound impact of empowering and supporting families of exceptional children on their quality of life and the broader society. Exceptional children, encompassing diverse abilities and challenges, require specialized care and attention. We delve into the emotional, financial, and social challenges these families often face, shedding light on their unwavering resilience. Highlighting essential support services, including early interventions, therapies, and advocacy, we emphasize how these resources transform lives. Personal anecdotes and case studies illustrate how empowered families witness significant improvements in their children's quality of life, fostering not only their growth but also the overall well-being of the entire family unit. Moreover, we discuss the pivotal role of inclusive environments, inclusive education, and personalized learning plans in unlocking the potential of exceptional children. These approaches promote acceptance, social development, and academic growth while preparing them for a more inclusive and compassionate society. Looking to the future, we anticipate innovative technologies, legislative changes, and global cooperation as catalysts for progress. Our shared commitment to empowering families of exceptional children is not merely a moral imperative; it's a societal one. By fostering their well-being and celebrating their unique contributions, we collectively work towards a brighter, more inclusive future, where every individual is valued and has the opportunity to thrive, enriching the fabric of society as a whole.

Urban-rural difference in factors associated with childhood functional difficulty in Bangladesh: a cross-sectional study.

Early childhood functional difficulty poses a substantial worldwide public health challenge, leading to adverse effects on children's quality of life and overall productivity. Moreover, it represents a significant social and economic problem in Bangladesh. Therefore, the current study aimed to identify factors contributing to childhood functional difficulty in Bangladesh within the context of urban-rural areas. A nationally representative cross-sectional survey data from Multiple Indicator Cluster Survey (MICS), 2019 in Bangladesh was used in this study. Chi-square test and multivariable logistic regression analyses were carried out to identify factors associated with childhood functional difficulty. Functional difficulties were found in approximately 3.3% of children 2-4 years of age in urban areas and 2.5% in rural areas. Having a mother with functional difficulties and undernutrition were identified as significant factors common in both urban and rural areas. Further, mothers who had no formal education (AOR = 2.76, 95%CI = 1.18-6.45) and experienced infant death (AOR = 1.94, 95%CI = 1.01-3.70) were identified as significant factors of functional difficulty in urban areas. On the other hand, in rural areas, no access to mass media, children with acute respiratory infection (ARI) (AOR = 2.13, 95%CI = 1.39-3.28), female sex (AOR = 0.69, 95%CI = 0.53-0.91), child undernutrition (AOR = 1.73, 95%CI = 1.32-2.27) and poorer socio-economic status (AOR = 1.95, 95%CI = 1.08-3.55) were found significant factors. Functional difficulty was found to be present in one out of every 35 children age 2 to 4 years in Bangladesh. Childhood functional difficulties were reported slightly higher in urban areas as compared to rural areas. Reducing childhood difficulties in urban areas demands comprehensive strategies: quality healthcare, inclusive education, community support, better information systems, and collaboration. To achieve urban-rural parity in child health, address disparities in economic development, healthcare, and education, especially for girls.

Specialties Providing Ambulatory Care and Associated HealthCare Utilization and Quality for Children With Medical Complexity.

Although children with medical complexity (CMC) have substantial health care needs, the extent to which they receive ambulatory care from primary care versus specialist clinicians is unknown. We aimed to determine the predominant specialty providing ambulatory care to CMC (primary care or specialty discipline), the extent to which specialists deliver well-child care, and associations between having a specialty predominant provider and health care utilization and quality. In a retrospective cohort analysis of 2012-17 all-payer claims data from Colorado, New Hampshire, and Massachusetts, we identified the predominant specialty providing ambulatory care for CMC <18 years. Propensity score weighting was used to create a balanced sample of CMC and assess differences in outcomes, including adequate well-child care, continuity of care, emergency visits, and hospitalizations, between CMC with a primary care versus specialty predominant provider. Among 67,218 CMC, 75.3% (n=50,584) received the plurality of care from a primary care discipline. Body system involvement, age >2 years, urban residence, and cooccurring disabilities were associated with predominantly receiving care from specialists. After propensity score weighting, there were no significant differences between CMC with a primary care or specialist "predominant specialty seen" (PSS) in ambulatory visit counts, adequate well-child care, hospitalizations, or overall continuity of care. Specialists were the sole providers of well-child care and vaccines for 49.9% and 53.1% of CMC with a specialist PSS. Most CMCreceived the plurality of care from primary care disciplines, and there were no substantial differences in overall utilization or quality based on the PSS.

HUBUNGAN KEJADIAN KARIES GIGI DENGAN KUALITAS HIDUP ANAK

Dental caries in children can interfere with the chewing process and result in reduced nutritional intake, resulting in suboptimal growth and development. The emersion of teeth caries impair the digest process and as the result it decreased dietary admission therefore it effect the childrens gowth and developmental. This study aimed to analyze the connection between dental caries and the quality of childrens life. This study was a cross sectional, the subject was 81 elementary students at SDIT Al Fatwa Bandung using simple random sampling method. Tests were accepted involving arbitrary inspecting technique upwards of 81 understudies. The results showed caries status in children obtained an average def-t value of 4.9, average DMF-T value obtained as much as 2.43, the average pufa value obtained as much as 4, and the average PUFA value obtained as much as 2. A total of 59 students have a moderate quality of life. Test analysis using the chi-square test showed a significant relationship between dental caries status and children's quality of life (p &lt;0.05). It is hoped that special attention will be paid to children's dental health problems by visiting dental health services at least once every 6 months.