Difficulties Score Research Articles

Association Between Sports Participation and Psychosocial Wellbeing of Australian Children: An 8-year Longitudinal Study

PurposeSports participation is associated with children’s health and wellbeing; however, existing evidence is predominantly based on cross-sectional studies. This study examined the longitudinal association of sports participation with psychosocial wellbeing of Australian children. MethodsData were from five waves of the Longitudinal Study of Australian Children aged 6–7 years in 2010 (n = 4,242) and followed up until 2018. Outcomes were assessed using the Strengths and Difficulties Questionnaire and the Pediatric Quality of Life Inventory. Sports participation was measured using two items assessing regular participation in team and individual sports. ResultsMultilevel mixed effects modeling showed that any sports participation was beneficially associated with psychosocial wellbeing. Boys who participated in team sports had 1.78 point lower difficulties score (β = −1.78; 95% confidence interval: −-2.01,−1.55), while this was 0.58 points lower for individual sports (β =−0.58; −0.81,-0.34). In girls, difficulties score was 1.22 point lower for team sports (β = −1.22; −1.44,-1.00) and 0.49 point lower for individual sports (β = −0.49; −0.71,-0.26). Sports participation was positively associated with better quality of life with team sports (β = 4.72; 4.15,5.28 for boys; β = 3.44; 2.87,4.00 for girls) offering more benefits than individual sports (β = 1.00; 0.83,1.98 for boys; β = 1.40; 0.83,1.98 for girls). Participation in both team and individual sports had the strongest benefits. Prolonged engagement in sports was associated with better psychosocial wellbeing in a dose-dependent manner. DiscussionRegular participation in any sports can benefit children's wellbeing with team sports being more beneficial than individual sports. Encouraging children to regularly participate and remain engaged in sports can help to optimize their psychosocial wellbeing.

Maternal oxidative stress during pregnancy associated with emotional and behavioural problems in early childhood: implications for foetal programming

Childhood mental disorders, including emotional and behavioural problems (EBP) are increasingly prevalent. Higher maternal oxidative stress (OS) during pregnancy (matOSpreg) is linked to offspring mental disorders. Environmental factors contribute to matOSpreg. However, the role of matOSpreg in childhood EBP is unclear. We investigated the associations between (i) matOSpreg and offspring EBP; (ii) social and prenatal environmental factors and matOSpreg; and (iii) social and prenatal factors and childhood EBP and evaluated whether matOSpreg mediated these associations. Maternal urinary OS biomarkers, 8-hydroxyguanosine (8-OHGua; an oxidative RNA damage marker) and 8-hydroxy-2′-deoxyguanosine (8-OHdG; an oxidative DNA damage marker), at 36 weeks of pregnancy were quantified by liquid chromatography-mass spectrometry in a population-derived birth cohort, Barwon Infant Study (n = 1074 mother-infant pairs). Social and prenatal environmental factors were collected by mother-reported questionnaires. Offspring total EBP was measured by Child Behavior Checklist Total Problems T-scores at age two (n = 675) and Strengths and Difficulties Questionnaire Total Difficulties score at age four (n = 791). Prospective associations were examined by multivariable regression analyses adjusted for covariates. Mediation effects were evaluated using counterfactual-based mediation analysis. Higher maternal urinary 8-OHGua at 36 weeks (mat8-OHGua36w) was associated with greater offspring total EBP at age four (β = 0.38, 95% CI (0.07, 0.69), P = 0.02) and age two (β = 0.62, 95% CI (−0.06, 1.30), P = 0.07). Weaker evidence of association was detected for 8-OHdG. Five early-life factors were associated with both mat8-OHGua36w and childhood EBP (P-range < 0.001–0.05), including lower maternal education, socioeconomic disadvantage and prenatal tobacco smoking. These risk factor-childhood EBP associations were partly mediated by higher mat8-OHGua36w (P-range = 0.01–0.05). Higher matOSpreg, particularly oxidant RNA damage, is associated with later offspring EBP. Effects of some social and prenatal lifestyle factors on childhood EBP were partly mediated by matOSpreg. Future studies are warranted to further elucidate the role of early-life oxidant damage in childhood EBP.

Psychological Maladjustment in Siblings of Children with Type 1 Diabetes Mellitus in An Egyptian Cohort

Background Diabetes is a chronic life-changing event, not just for the sick child but for the entire family. It poses a number of challenges to family units as a whole Objective To assess frequency of psychological maladjustment among siblings of children with Type 1 diabetes (T1D). Subjects and Methods A cross-sectional study was conducted on 100 families with a child diagnosed with T1D; for each family one healthy sibling and one parent were included. All parents and siblings had face to face questionnaire. The Arabic version of the parent reported Strengths and Difficulties Questionnaire (SDQ) was used to assess sibling appraisal of living with a child with T1D and his/her adjustment. Siblings aged (11-18years) took the questionnaire on their own as well. Results On evaluating the parent reported SDQ, 60% of the healthy siblings scored within the normal range, 26% were borderline and 14% showed scores in the abnormal range. Comparing data from the current study with the UK norms, healthy sibling from the current study experienced more total difficulties (p &amp;lt; 0.001). Regarding SDQ- self report, 40 % of healthy sibling were normal and 40% and 20% showed scores in the borderline and abnormal range respectively. Similarly, self- reported SDQ showed significantly higher total difficulties scores compared to UK norms (p &amp;lt; 0.001). A significant positive correlation was found between poor glycemic control, as evidenced by HbA1C, as well as diabetes related complications and total difficulties reported by older healthy siblings (p &amp;lt; 0.05). Conclusion Siblings of children with type 1 diabetes are at risk of psychological maladjustment and special attention must be directed to identify siblings at risk who may benefit from psychological support.

Impact of problem-solving skills and attributional retraining intervention on conduct disorder among junior male students at public secondary school in Nigeria: a non-randomized control study

PurposeThis paper aims to report a non-randomized control study undertaken to investigate prevalence and correlates of conduct disorder among male secondary education students in South-West Nigeria and to assess the impact of a problem-solving skills and attributional retraining (PSSAR) intervention with this population.Design/methodology/approachIn total, 787 male students from two schools were screened for conduct disorder. All participants who met criteria for the disorder were allocated to either treatment (n = 55) or control (n = 47) groups. Outcome measures comprised the strengths and difficulties questionnaire (SDQ; teacher and student versions) and the teacher rating of students’ aggressive behaviors.FindingsOf the sample, 13% were found to present with difficulties that met criteria for conduct disorder. The presence of these difficulties correlated with several demographic variables, including parental conflict and alcohol use. A statistically significant reduction in mean scores was observed for the treatment group in the student rating of the SDQ emotional subscale and total difficulties scores. Teacher ratings were less consistent in that conduct problems, prosocial behavior and total difficulties increased following the intervention, whereas peer problems and aggressive behavior were reported by teachers to reduce. No statistically significant change was found in the outcome measures for the control group.Practical implicationsIn resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed.Originality/valueIn resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed. This study’s findings offer some preliminary support for the PSSAR intervention for conduct disorder in this context and indicate areas for further research.

The relationship between professional self-concept and career decision-making difficulties among postgraduate nursing students in China: the mediating role of career decision-making self-efficacy.

In the context of a global shortage, uneven distribution, and structural imbalance of nursing talent, postgraduate nursing students must make appropriate decisions about their careers not only for the nursing profession but also for society as a whole. However, little research has been reported on the current status and factors influencing career decision-making difficulties among postgraduate nursing students. Exploring the mediating role of career decision-making self-efficacy between professional self-concept and career decision-making difficulties among postgraduate nursing students in China based on the social cognitive career theory. 276 postgraduate nursing students from 25 universities in seven administrative regions of China were selected by stratified random sampling. Data were collected with the Career decision-making difficulties Questionnaire, Career Decision-making Self-Efficacy Scale, and Nursing Professional Self-concept Scale through an online survey, and were analyzed by univariate analysis, correlation analysis, multiple linear regression analysis, and PROCESS macro. The score for career decision-making difficulties was 2.84 (SD = 0.54). Professional self-concept (r = -0.496, p < 0.01) and career decision-making self-efficacy (r = -0.551, p < 0.01) were negatively associated with career decision-making difficulties. Career decision-making self-efficacy played a partial mediating role between professional self-concept and career decision-making difficulties (p < 0.01), with the mediating effect (Effect Value = -0.253, Bootstrap 95% CI: -0.349, -0.156) accounting for 53.82% of the total effect. The high scores of career decision-making difficulties among postgraduate nursing students demand widespread attention. Nursing educators need to develop a complete and standardized career counseling curriculum for postgraduate nursing students, and should pay attention to the cultivation and development of positive professional self-concept and career decision-making self-efficacy of postgraduate nursing students to reduce their career decision-making difficulties and help them make effective career decision-making.

The impact of COVID-19 on the well-being of Victorian children born with cleft lip and/or palate.

A longitudinal cohort study was established to investigate the well-being of children born with cleft lip and/or palate (CL/P) during the COVID-19 pandemic, in Victoria, Australia. The Royal Children's Hospital cleft service database was used to identify children aged between 4 and 17 years old born with an isolated CL/P. Families of eligible children who consented to participate were asked to complete the Strengths and Difficulties Questionnaire (SDQ) between October and December 2020 and again 6-month later. SDQ results from typically developing Australian children during the COVID-19 pandemic were utilized from a previously published study. 63 parents completed the baseline questionnaire, with 44 completing the 6-month follow-up. For participants at baseline, the mean age was 8.9 years, with 55% male. All outcome domains of the SDQ improved between baseline and timepoint 2, with the difference in total difficulties scores being statistically significant, indicating a reduction in total difficulties at timepoint 2, associated with the easing of COVID-19 restrictions. When compared with the Australian population during the COVID-19 pandemic, Victorian children born with CL/P had lower SDQ scores for all difficulties outcome domains, with statistically significant results for conduct problems, hyperactivity, peer problems and total difficulties, indicating fewer difficulties for children born with CL/P. Children born with CL/P experienced fewer difficulties when compared with the typically developing Australian population during the COVID-19 pandemic. The level of restrictions imposed because of the pandemic also had little influence on the well-being of these children.

Students’ digital addiction and learning difficulties: shortcomings of surveys in inclusion

Students have been distance learning to a considerable extent during the Covid years and the primary concerns are teenagers’ learning difficulties, digital addiction and long screen time. Our aim was thus to study teenagers’ perceived learning difficulties, digital addiction and screen time. The current study was a part of a larger e-survey. The data were collected across Estonia from 8,486 teenagers who studied in the inclusive education system during spring 2022. The students were 11–20 years old. While analysing the data, we had to exclude the answers of 315 students. Those students had answered carelessly or inaccurately, had written an inaccurate age, illogical answers or similar answers throughout the test. We studied teenagers’ level of learning difficulties, digital addiction and screen time. The study shows positive correlations between learning difficulties, digital addiction and screen time. Digital addiction and screen time predict 11% of the variability of perceived learning difficulties scores based on a Linear Regression model. The model shows a poor prediction for students whose scores are very different from the mean. We describe the weaknesses of an e-survey method in inclusive education. Linear statistical models predict well for average students, but do not predict well for respondents who are very different from the mean. The so-called residuals need special attention or, paradoxically, exclusion from the statistical analysis. The outliers are often the students who need help in the inclusive system. Here, we will share our insights, what we have learned as researchers from conducting the study. We cannot collect reliable data about special needs students with any wide scale e-survey if we do not address the developmentally heterogeneous group of students and their needs while participating in the survey. This is significant for study reliability as well as gathering data from children with special needs.

Oral motor weakness: a possible clinical marker for sleep-related difficulties in Down syndrome children — a preliminary study

BackgroundThere is an increasing incidence of sleep difficulties in Down syndrome children. Identifying the clinical symptoms that are correlated with sleep difficulties for early diagnosis and treatment is critical.AimTo investigate whether oral motor weakness could be considered as an underlying factor for sleep-related difficulties in Down syndrome patients not previously treated with oral motor therapy to prioritize them for definitive objective testing.Material and methodsThe study included 45 Down syndrome children with and without congenital heart disease or hypothyroidism aged 2.5 years to 7 years without a history of prior oral motor therapy, adenotonsillar hypertrophy, and with an average body mass index. The parents were asked to fill in a questionnaire on sleep difficulties involving seven sections. The children were also subjected to 4 oral motor tasks.ResultsSymptoms of sleep-related difficulties were reported in 66.70 to 100% of the DS children. The highest percentage had severe oral motor weaknesses. There is no significant correlation between scores of sleep difficulties and scores of oral motor skills except for a significant negative correlation between scores of restless sleep and frequent awakening with score of Chewy Tubes.ConclusionThe current study did not prove a significant correlation between oral motor skills and the symptoms of sleep difficulties.

Physical Literacy for Communities (PL4C): physical literacy, physical activity and associations with wellbeing

BackgroundPhysical literacy (PL) is considered an important determinant of children's physical activity through which health benefits may be derived. The purpose of this study is to describe a sample of Canadian children’s baseline levels of PL and movement behaviors, and explore whether the associations between PL and their mental wellbeing, if any, are mediated by moderate-to-vigorous physical activity (MVPA).MethodsAll grade two children in 14 elementary schools in the West Vancouver School District, Canada were invited to participate in a two-year longitudinal project. PL was assessed through PLAYfun and PLAYself tools. Physical activity was measured by wrist-worn accelerometers (GT3X + BT) for seven days. Children's mental well-being was assessed using the Strengths and Difficulties Questionnaire (SDQ). A score of total difficulties was aggregated for internalizing and externalizing problems.ResultsA total of 355 children aged 7–9 (183 boys, 166 girls, 6 non-binary) participated with 258 children providing valid accelerometer data. Children exhibited an average of 111.1 min of MVPA per day, with 97.3% meeting the physical activity guidelines. Approximately 43% (108/250) of participants were meeting the Canadian 24-h movement guidelines. Children were at an ‘emerging’ level of overall physical competence (45.8 ± 5.6) and reported a mean score of 68.9 (SD = 12.3) for self-perceived PL, with no significant differences between boys and girls. PL was significantly associated with MVPA (r = .27) and all SDQ variables (rs = -.26—.13) except for externalizing problems. Mediation analyses showed PL was negatively associated with internalizing problems and total difficulties when the association with MVPA was considered. However, the mediating role of MVPA was found only between PL and internalizing problems, β = -.06, 95%CI [-.12, -.01].ConclusionsAlthough most of our sample was physically active and showed higher adherence to 24-H movement guidelines than comparable population data, the motor competence and self-perceived PL of our sample were similar to those of previous studies. PL has an independent association with children’s internalizing problems and total difficulties. Ongoing assessment will investigate the relationships between PL and children’s mental health from a longitudinal perspective.

Introducing Routine Assessment of Adverse Childhood Experiences For Looked-After Children: The Use and Properties of the Trauma and Adverse Life Events (TALE) Screening Tool

The present study aims to illustrate the process of developing, implementing, and clinically validating a new assessment measure, the Trauma and Adverse Life Events (TALE) screening tool, to assess Adverse Childhood Experiences (ACEs) among looked-after children. The TALE was developed by adapting existing ACEs measures to reflect the experiences of looked-after children. The TALE was completed by the local authority social worker for 218 children placed with Five Rivers Child Care (a UK fostering agency, residential, and educational care provider). Reliability was examined and exploratory factor analysis was conducted. Correlations between TALE scores, background variables, and psychosocial wellbeing using the carer-report Strengths and Difficulties Questionnaire (SDQ) and Child Dissociative Checklist (CDC) were also explored. The TALE was found to have acceptable reliability (α = .71). A three-factor solution was found which explained 46.24% of the variance, with factors labelled ‘Direct Experience of Abuse’, ‘Witnessing Harm’, and ‘Household Dysfunction’. Exposure score was significantly associated with total difficulties score on the SDQ (rs = .24, p < .001) and Impact score was associated with the SDQ’s impact score (rs = .33, p < .001). Exposure and Impact scores were both positively correlated with CDC scores (rs = .16, p = .021 and rs = .22, p = .002). This paper presents evidence of the importance of screening looked-after children for ACEs and demonstrates that the TALE is a valid and reliable tool for this purpose. Adverse and traumatic experiences were highly prevalent in this population and appeared to be closely related with children’s psychosocial wellbeing. Results emphasise the importance of routine assessment of past experiences within trauma-informed psychological care and intervention planning for looked-after children.

Housing and psychosocial factors associated with mental health in children aged 6–12 years from homeless families in the Greater Paris area, France: the ENFAMS cross-sectional study

ObjectiveThis study aimed to identify the housing and psychosocial factors associated with mental health disorders in children aged 6–12 years living in sheltered homeless families in the Greater Paris area (France), with a view to guiding the development of actions that could improve their mental health.MethodThe cross-sectional study ENFAMS (“Enfants et familles sans logement”) was conducted between January and May 2013 on a random sample of sheltered homeless families in the Greater Paris area using face-to-face questionnaires administered by trained interviewers and psychologists in 17 languages. The questionnaires collected data on socio-demographics, living conditions, and health characteristics for the child and one of the parent selected. Mental health disorders were assessed in 198 children using the Dominic Interactive tool. Statistical analyses were performed using multiple linear regression on complete data.ResultsThe Dominic Interactive mean score was 28.8 (SD = 17.5), and it showed that 25.3% of the children had a possible or probable mental health disorder. Factors associated with higher children total difficulties scores, as measured by the Dominic Interactive, were parents' irregular administrative status, the child sleeping in the parents' bed, the child having been hospitalized in the past 12 months, and the child being bullied at school.ConclusionOur findings highlight the importance of psychosocial determinants in children's mental health, and underline the need for prevention actions for homeless families which focus on improving living, schooling, and healthcare conditions, especially greater access to mental health care.

0932 Sleep Difficulties: Prevalence, relationship with psychological outcomes, and interindividual differences in student-athletes

Abstract Introduction Mental health issues are a leading cause of decreased academic and athletic performances when left untreated. Recently, the International Olympic Committee (IOC) and the National Collegiate Athletic Association (NCAA) have highlighted the fundamental importance of mental health among young athletes. Sleep represents a core feature of mental health, and student-athletes represent a vulnerable population for sleep restriction and disruption due to the demands of their courseload and training schedule. This investigation was performed to identify differences in sleep and mental health across gender, race/ethnicity, and sport type. Methods Data were obtained throughout the academic semester from Canadian institutions, with student-athletes completing the Athlete Sleep Screening Questionnaire (ASSQ), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire (PHQ-9). ASSQ captured sleep and circadian health, while GAD-7 and PHQ-9 assessed anxiety and depressive symptoms, respectively. Linear regression determined gender, race/ethnicity, and sport type differences across ASSQ sleep problems score, ASSQ sleep items, GAD-7 score, PHQ-9 score, and PHQ-9 item #9 (suicidal ideation). Results Final sample (N=559) was 53.0% female, 79.1% white, comprised of young individual (Mean Age = 18.9 ± 3.21), and included student-athletes from basketball, field-hockey, football, ice-hockey, soccer, volleyball, track &amp; field and swimming. Females reported more overall sleep difficulties (p=0.01), medication use (p=0.04) and WASO (p=0.001) compared to males. Females also reported higher anxiety (p &amp;lt; 0.0001), depression (p&amp;lt; 0.0001), and suicidal ideation (p=0.03). Significant variance in total sleep time (TST) (p=0.001) and sleep satisfaction (p=0.04) was observed across race/ethnicity, with student-athletes identifying as Black or African American reporting the lowest TST, while Asian or Pacific Islander student-athletes reported the lowest sleep satisfaction. Significant variance in sleep difficulties score (p&amp;lt; 0.0001), TST (p &amp;lt; 0.0001), and satisfaction (p&amp;lt; 0.0001), as well as anxiety (p &amp;lt; 0.0001) and depression (p&amp;lt; 0.0001) was observed across sport type. Football student-athletes reported the highest sleep difficulties score, and lowest TST satisfaction. Field-hockey student-athletes reported the highest anxiety and depression. Conclusion Results suggest that sleep and mental health challenges present differently across gender, race/ethnicity, and sport type. Clarifying these unique and specific challenges to student-athlete sleep and mental health is necessary to enhance and personalize interventions. Support (if any) Mitacs #IT23469

84 The Association between Family Relations and School Outcomes in School-Aged Children 5-12 years old

Abstract Introduction School-aged children between the ages of 5 and 12 years face new environments and experiences as they transition through grade school. They are still developing and learning as they engage within their home and carry these experiences into their school environment. This study is an assessment of the association between family relations and school outcomes in children 5 to 12 years of age as measured by the field-tested SA-LIBRE5-12 (School-Aged Life Impact Burn Recovery Evaluation), a new parent-reported outcome measure. Methods Within the social and family functioning domain of the SA-LIBRE5-12, 10 family relations and 13 school items were scored on a scale from 0 (Never) to 4 (Always). Scores were re-coded so that higher scores denote better functioning. An exploratory factor analysis (EFA) was conducted to confirm model fit. A regression model assessed the relationship between the school and family factors, controlling for demographic and clinical characteristics (child sex, race, ethnicity, age at survey completion, burn size, burns to critical areas, and pain severity). Results A total of 356 parents completed these items from the SA-LIBRE5-12. EFA resulted in four sub domains of family engagement, family stress impact, school success, and school difficulties. A univariate analysis of the demographic characteristics showed that the child being female (p=0.008) and non-white (p=0.0216) had a better mean score in school success (3.33 vs. 3.19 + 0.78 (SD) and 3.38 vs. 3.21 + 0.75 (SD), respectively). In addition, children with a burn size &amp;lt; 1% had better school difficulties score (3.76 vs 3.61 + 0.38, p=0.0018). Regression analysis showed positive correlations between family engagement and school difficulties (r=0.26, p&amp;lt; .0001), family engagement and school success (r = 0.56, p&amp;lt; .0001), family stress impact and school success (r=0.21, p&amp;lt; .0001) and family stress impact and school difficulties (r=0.49, p&amp;lt; .0001). Conclusions This study indicates that a cohesive family relationship and home life may promote productive school outcomes in children between the ages of 5 and 12 based on parent reported outcomes. Applicability of Research to Practice This research will provide burn care providers, parents, and teachers with greater insight into the relationship between a child’s current family relations and their success in school. Results will guide caregivers in fostering a productive and healthy family environment.

82 Comparison of Parent vs. Burn-Injured Youth Scores on the Strengths and Difficulties Questionnaire

Abstract Introduction Research regarding the prevalence of psychopathology issues in burn-injured youth is limited. The Strength and Difficulties Questionnaire (SDQ) is valid for both self- and parent-report, and is widely used. This study sought to evaluate the level of agreement between the youth self-report and parental response. Methods Respondents included 36 adolescent/parent dyads. The youth included 11-18 years old, 14% African American, 19% Hispanic and 44% White, 19 females, 17 males with 58% reporting both visible &amp; hidden scars. The SDQ is a widely used behavioral screening tool assessing children’s positive &amp; negative attributes on 5 scales: 1) Emotional Symptoms, 2) Conduct Problems, 3) Hyperactivity/Inattention, 4) Peer Problems, 5) Prosocial Behavior as well as a Total Difficulties Score. Results Youth reported significantly higher scores than parents on Total Difficulty (P &amp;lt; 0.001). They had significantly higher scores on all scale scores – Emotional Problems (P = 0.01), Hyperactivity (P = 0.001), Conduct Problems (P = 0.041), Peer Problems (P=0.041), Internalizing (P = 0.005), and Externalizing Behaviors ((P &amp;lt; 0.001), but not the Pro-Social Scale (P=0.303). Correlations between self- and parent-report were significant only for the Hyperactivity scale, r=.40, p=0.017. Conclusions The large difference in youth vs. parent responses is of concern because study parents appear to be unaware of psychosocial issues challenging their children. This study mirrors other research which has documented a lack of awareness of parents regarding children’s reported anxiety disorder symptomology. Applicability of Research to Practice Healthcare providers &amp; parents should discuss burn-injured youths’ feelings regarding their progress. Providers should not rely solely on parents when determining the well-being of pediatric survivors. This survey can be completed easily by youth and parents in the aftercare setting and used as a tool for recommending intervention when difficulties are present.

Influence of sleep fragmentation in infancy and toddler period on emotional and behavioral problem at the age of 6 years: a birth cohort study

Objective: To investigate the influence of sleep fragmentation in infancy and toddler period on emotional and behavioral problems at the age of 6 years. Methods: Using a prospective cohort design, 262 children were extracted from mother-child birth cohort recruited from May 2012 to July 2013 in Renji Hospital, School of Medicine, Shanghai Jiao Tong University. Children's sleep and physical activities were assessed using actigraphy at 6, 12, 18, 24, and 36 months of age, from which the sleep fragmentation index (FI) at each follow-up point was calculated. Children's emotional and behavioral problems at 6 years of age were assessed using the strengths and difficulties questionnaire. Group-based trajectory model was applied to determine sleep FI in infancy and toddler period trajectory groups with Bayesian information criteria being used to determine the best fitting model. Children's emotional and behavioral problems between groups were examined with independent t test and linear regression models, etc. Results: A total of 177 children, with 91 boys and 86 girls, were included in the final analysis and were divided into 2 groups: high FI group (n=30) and low FI group (n=147). Compared with children in the low FI group, those in the high FI group presents with higher total difficulties score and higher hyperactivity or inattention score ((11.0±4.9) vs. (8.9±4.1), (4.9±2.7) vs. (3.7±2.3) scores, t=2.17, 2.23, both P<0.05, respectively), with the differences remaining significant after adjusting for covariates (t=2.08, 2.09, both P<0.05 respectively). Conclusion: High sleep fragmentation in infancy and toddler period is associated with more emotional and behavioral problems, especially hyperactivity or inattention problems, at 6 years of age.

Behavioral and emotional difficulties and HIV treatment outcomes among HIV-infected children in rural southwestern China

BackgroundPrevious studies have not clearly demonstrated the impact of behavioral and emotional problems (BEDs) on treatment outcomes among HIV-infected children on antiretroviral therapy (ART). This study aimed to describe the prevalence of BEDs among this population and identify the factors associated with HIV treatment outcomes.MethodsThis cross-sectional study was conducted in Guangxi, China, between July and August 2021. HIV-infected children answered questionnaires about BEDs, physical health, social support, and whether they have missed doses in the past month. BEDs were assessed using the Chinese version of the self-reported Strengths and Difficulties Questionnaire (SDQ-C). The self-reported survey data were linked to participants’ HIV care information that was obtained from the national surveillance database. Univariate and multivariate logistic regression models were used to identify factors that were associated with missed doses in the past month and virological failure.ResultsThe study sample was 325 HIV-infected children. HIV-infected children had a higher proportion of abnormal scores on SDQ-C total difficulties compared to their peers in the general population (16.9 vs 10.0%; P = 0.002). An abnormal SDQ-C total difficulties score (AOR = 2.06, 95%CI: 1.10–3.88) and infrequency of receiving assistance and support from parents over the past 3 months (AOR = 1.85, 95%CI: 1.12–3.06) were significantly associated with missed doses in the past month. Between the ages of 14–17 years (AOR = 2.66, 95% CI: 1.37–5.16), female (AOR = 2.21, 95% CI: 1.20–4.08), and suboptimal adherence (AOR = 2.45, 95% CI: 1.32–4.57) were significantly associated with virological failure.ConclusionsChildren’s mental health plays a role in HIV treatment outcomes. Psychological interventions should be promoted in pediatric HIV care clinics to improve children’s mental health status and HIV treatment outcomes.

The post-discharge coping difficulty of puerperal women in a middle and low-income tourist city during the COVID-19 pandemic

BackgroundSince the coronavirus disease 2019 (COVID-19) pandemic outbreak, the incidence of mental health problems in perinatal women has been high, and particularly prominent in China which was the first country affected by COVID-19. This paper aims to investigate the current situation and the related factors of maternal coping difficulties after discharge during COVID-19.MethodsGeneral information questionnaires (the Perinatal Maternal Health Literacy Scale, Postpartum Social Support Scale and Post-Discharge Coping Difficulty Scale-New Mother Form) were used to investigate 226 puerperal women in the third week of puerperium. The influencing factors were analyzed by single factor analysis, correlation and multiple linear regression.ResultsThe total score of coping difficulties after discharge was 48.92 ± 12.05. At the third week after delivery, the scores of health literacy and social support were 21.34 ± 5.18 and 47.96 ± 12.71. There were negative correlations among health literacy, social support and coping difficulties after discharge (r = -0.34, r = -0.38, P < 0.001). Primipara, family income, health literacy and social support were the main factors influencing maternal coping difficulties after discharge.ConclusionDuring the COVID-19 pandemic, puerperal women in a low- and middle-income city had moderate coping difficulties after discharge and were affected by many factors. To meet the different needs of parturients and improve their psychological coping ability, medical staff should perform adequate assessment of social resources relevant to parturients and their families when they are discharged, so they can smoothly adapt to the role of mothers.

Characterization of Premigration and Postmigration Multidomain Factors and Psychosocial Health Among Refugee Children and Adolescents After Resettlement in Australia

A better understanding of the psychosocial health of resettled child and adolescent refugees and associated premigration and postmigration factors may help this population integrate effectively. To estimate the associations of premigration and postmigration multidomain factors with psychosocial health after resettlement among young refugees of different ages. This cross-sectional study used wave 3 data from the Building a New Life in Australia (BNLA) cohort study, as they represented the first time a BNLA study included a child module targeting children and adolescents in the migrating unit as a nested component of the broader study. The study population consisted of children aged 5 to 10 years and adolescents aged 11 to 17 years. The caregivers of the children, the adolescents themselves, and the adolescents' caregivers were invited to complete the child module. Wave 3 data were collected from October 1, 2015, to February 29, 2016. Statistical analysis was performed from May 10 to September 21, 2022. Premigration and postmigration multidomain factors, including individual (child and caregiver), family, school, and community levels, were measured. Social and emotional adjustment and posttraumatic stress disorder (PTSD) were the dependent variables measured by the Strengths and Difficulties Questionnaire (SDQ) and an 8-item PTSD scale. Weighted multilevel linear or logistic regression models were used. Of the 220 children aged 5 to 10 years (mean [SD] age, 7.4 [2.0] years), 117 (53.2%) were boys; of the 412 adolescents aged 11 to 17 years (mean [SD] age, 14.1 [2.0] years), 215 (52.2%) were boys. Among the children, compared with no exposure, exposure to premigration traumatic events (β = 2.68 [95% CI, 0.51-4.85]) and having family conflicts after resettlement (β = 6.30 [95% CI, 2.97-9.64]) were positively associated with SDQ total difficulties score; school achievement was negatively associated with SDQ total difficulties score (β = -5.02 [95% CI, -9.17 to -0.87]). Among the adolescents, being treated unfairly (β = 3.32 [95% CI, 1.41-5.22]) and parenting harshness after resettlement (β = 0.25 [95% CI, 0.11-0.40]) were positively associated with SDQ total difficulties score; engagement in extracurricular activities (β = -3.67 [95% CI, -6.83 to -0.50]) was negatively associated with SDQ total difficulties score. Exposure to premigration traumatic events (adjusted odds ratio [aOR], 2.49 [95% CI, 1.10-5.63]), being treated unfairly (aOR, 3.77 [95% CI, 1.60-8.91]), and facing English language barriers (aOR, 6.41 [95% CI, 1.98-20.79]) after resettlement were positively associated with the presence of PTSD. In this study of refugee children and adolescents, apart from premigration traumatic experiences, several postmigration family- and school-related factors and social integration factors were associated with psychosocial health after resettlement. The findings suggest that family- and school-centered psychosocial care and social integration programs targeting related stressors merit increased attention for improving the psychosocial health of refugee children and adolescents after resettlement.

Quantified Striatal Dopaminergic Denervation as Predictor for Motor Outcomes in Parkinson's Disease.

A hallmark of Parkinson's disease (PD) is progressive loss of dopamine terminals in the basal ganglia, with clinical symptoms including motor and non-motor manifestations such as bradykinesia, rigidity, and cognitive impairment. Dopamine transporter single-photon emission computed tomography (DaT-SPECT) can be used to assess dopaminergic denervation by detecting loss of striatal dopamine transporters (DaT). We examined DaT binding scores' (DaTbs) association with motor outcomes in PD and explored its usefulness as a predictor of disease progression. Faster dopaminergic denervation in the basal ganglia was hypothesized to have stronger correlation and predictive value for poor motor outcomes. Data was analyzed from the Parkinson's Progression Markers Initiative. DaTbs in the putamen and caudate nucleus were correlated with Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scores for walking and balance difficulties, gait difficulties, and presence of dyskinesias. A predictive model using baseline speed of drop in DaT binding score was performed for each motor outcome. All motor outcomes had mild, significantly negative correlation with DaTbs in the putamen and caudate nucleus, with similar degree of correlation per region. Speed of drop was predictive of only substantial gait difficulties when evaluated in the putamen but not the caudate. These findings suggest that analyzing speed of drop in DaTbs, which occurs early in the motor phase of the disease, may be helpful for predicting clinical outcomes in PD. Longer observation of this cohort may provide further data to investigate DaTbs as a prognostic marker in PD.

The Healing through Arts (HeARTS) program for children bereaved by cancer: Pilot study findings from Singapore.

The article aims to investigate the feasibility, acceptability, and initial efficacy of a short-term 3-day art therapy group for children who have experienced parental death to cancer. The study utilized a pretest-posttest design and included children (n=20) aged 7-12years. The feasibility of the intervention was measured by recruitment ability, study compliance, and intervention adherence, while acceptability was assessed using a child-reported satisfaction survey. Efficacy was examined using the child-reported Pediatric Quality of Life Inventory (PedsQL), while the emotional, social, and behavioral functioning of children was measured using the parent-reported Strengths and Difficulties Questionnaire. Paired sample t-tests were used for analyses. The intervention was found to be feasible (80% recruitment rate and 100% session adherence). Acceptability was high, and all participants were satisfied and found the intervention to be helpful. While results did not reach statistical significance, improvements in psychosocial and physical quality of life were reported by all the children post-intervention and at the 3-month follow-up. Parent-reported a decrease in behavioral difficulties scores and an increase in prosocial behavior scores at post-intervention and at the 3-month follow-up. The 3-day art therapy group intervention was shown to be feasible to conduct and acceptable to the recipients. The intervention shows promise in improving post-death adjustment and quality of life outcomes of children bereaved by parental death due to cancer that were maintained after 3months. The use of art therapy groups to ameliorate difficulties associated with parental loss and to assist children in coping day-to-day difficulties should be further investigated.