Social-emotional Scores Research Articles

Caregiver report of social-emotional functioning in infants and young children after inflicted traumatic brain injury

ABSTRACT Social-emotional difficulties are common sequelae of traumatic brain injury (TBI). Children who have experienced inflicted TBI (iTBI) may be at increased risk for social-emotional problems due to the risk factors associated with both early neurologic injury and with child maltreatment. We characterized the associations among injury severity, caregiver type (i.e., biological parents, non-kinship, kinship), and child social-emotional functioning in 41 infants and young children who had sustained iTBI and were seen in a large, regional children’s hospital. This study was a retrospective analysis, utilizing data collected from the medical record as part of routine clinical care. Social-emotional functioning was assessed with the Bayley Scales of Infant and Toddler Development-Third Edition. Children with more severe injuries were rated as having worse social-emotional functioning. Caregiver type was associated with child social-emotional scores, above and beyond injury and demographic predictors. Biological parents were more likely to report better social-emotional skills than non-kinship caregivers, with the pattern of results suggesting that rater bias plays a role in this difference. In order to ensure that children are accurately identified for supports, these relationships should be considered when interpreting caregiver report of social-emotional skills.

Spanish-English dual language learners' bilingual profiles: Executive function and developmental outcomes

The current study took a strengths-based person-centered approach in examining academic and social-emotional outcomes of Spanish-English Dual Language Learning (DLL) children enrolled in Head Start. The study sample includes a total of 392 Hispanic Spanish-English DLLs (49% girls) between the ages of three and five. Latent profile analyses revealed that four groups of differing levels of bilingual proficiency existed (i.e., Emergent Bilingual, English Dominant, Spanish Dominant, and Proficient Bilingual). Overall, groups with higher language proficiency scored higher on executive functioning (EF), academic, and social-emotional outcomes. There were no differences between English and Spanish Dominant children's performance. Academic and social-emotional scores differed by profile through EF.Findings demonstrate the importance of supporting both languages as proficiency and EF were related and associated with other outcomes. Finally, given the associations found in the current study, EF appears to be a critical skill for young DLL children's academic and social-emotional development.

Associations of father absence and limited access to books and toys with early childhood development among children aged 0-6years in a rural county lifted out of poverty in China.

This study aimed to understand the early development and nurturing care environment of children aged 0-6years in rural China and to evaluate the sex- and age-specific associations of nurturing care environment with child developmental outcomes. A cross-sectional survey involving 2078 children aged 0-6years was conducted using a stratified cluster sampling strategy. We used face-to-face interviews to collect information on child, family and nurturing care. The Ages & Stages Questionnaires-Chinese version and ASQ: Social-Emotional were applied to assess children's neuro- and social-emotional development, respectively. Lower neurodevelopmental scores indicate an increased risk for neurodevelopmental delay, and higher social-emotional scores are indicative to a risk of social-emotional problems. The multiple linear regression model examined the associations of nurturing care environments with childhood development. Among the investigated children, the average age was (42.9 ± 19.8) months and 55.8% were boys; 67.9% of the children had absent fathers because of labour migration and 54.0% had limited access to books and toys. Overall, boys had a lower total neurodevelopmental score than girls; similar gender patterns were also found in the domains of communication, fine motor, problem-solving and person-social. Concurrent absent fathers and limited access to books and toys were significantly associated with reduced neurodevelopmental scores [β - 11.44, 95% CI (-18.20, -4.68)] and increased social-emotional developmental scores [β 5.88, 95%CI (1.35, 10.41)] after controlling for confounding factors. Sex-specific analysis only echoed the results in boys. Additionally, having an absent father and limited access to books and toys was associated with lower neurodevelopmental scores [β - 14.58, 95%CI (-25.41, -3.75)] in children under 3 years of age and higher social-emotional developmental scores among children aged 3-6years [β 10.66, 95%CI (5.09, 16.24)]. Children, especially boys, with absent fathers due to labour migration have poorer neuro- and social-emotional development. Limited access to books and toys and father absence are linked to the children's developmental delay, especially for those under 3 years of age. Our findings suggest that intervention programs in resource-constrained rural areas are desirable; more importantly, such programs should begin before 3 years of age to achieve a benefit-cost outcome.

Estimation and linkage between behavioral problems and social emotional competence among Pakistani young school children.

Behavioral problems are commonly occurring concerns in school children and if left unidentified can result in worse outcomes in any society. The research aims to explore the prevalence of behavioral problems and its association with social emotional competence in young school children from a community sample of Islamabad, Pakistan. The cross-sectional study was conducted from April to June 2021 in four public primary schools in Islamabad, Pakistan. Two stage cluster sampling was used to select study sites. The sample comprised 426 school children (males = 182, females = 195) aged 4-8 years (Mean age = 6.5, SD = 1.09), from three different grades kindergarten, 1, and 2, respectively. The Child Behavior Checklist (CBCL) and Social Emotional Development Assessment (SEDA) were used to screen behavioral problems and social emotional competences of children. Data were analyzed using Stata 17. Prevalence for overall behavioral problems accounted for 65.4% (4-6 years) and 36.2% (6-8 years) in the abnormal (borderline and clinical) ranges of total problems. Social emotional competence scores were found significantly negatively associated with behavioral problems of children. The high prevalence necessitates the provision of mental health care to school-aged children. The findings should be taken as a call to Pakistan's policymakers, clinicians, and researchers to develop proper screening and management protocols for early intervention.

Evaluation of the impact of online education on the health-related quality of life of medical students in Lebanon

IntroductionOne of the adopted measures during the Coronavirus disease of 2019 (COVID-19) pandemic in education is the online modality, which can impact students' quality of Life (QoL) and their academic performance. MethodsThis cross-sectional study aims to assess the impact of online education on health-related QoL in a sample of 401 medical students. ResultsMost students attended all the online sessions, and around 32% participated in some of them. Only 16.2% reported high satisfaction from the online sessions, and almost 39% reported low satisfaction. Overall, medical students had moderate QoL. Online education affected medical students psychologically more than physically, translated by higher scores for the physical components than the mental ones. Students who preferred online over in-person education had significantly lower scores for the mental domains, namely lower social functioning and emotional role scores. Academic satisfaction did not influence any SF-36 scores, and students’ preferences (online or in-person education) did not affect any of the physical component scores. ConclusionThe pandemic directly impacted the QoL of medical students, namely their mental health. Medical students in Lebanon had a higher preference for in-person education, possibly due to its novelty and to other technological, technical, or personal challenges. Future research exploring the reasons and viable solutions should be performed to maintain a steady level of education during unanticipated situations.

The Role of Prior Online Learning Experience on Student Community of Inquiry, Engagement, and Satisfaction Scores

The increase in online education creates a need to explore how learning outcomes, student satisfaction, and student perceptions about online courses are affected by prior online learning experiences. This study examined the role of prior online learning experience on students’ perceived cognitive presence, social presence, teaching presence, engagement, and satisfaction. The archival data of online learners at a large midwestern university (a total n=878), including survey responses related to Community of Inquiry (CoI), engagement, and satisfaction, were utilized to conduct statistical analyses to determine whether student responses differed by the number of online courses taken previously. We found that only social presence scores (CoI sub-scale) and emotional engagement scores (engagement sub-scale) differed by the number of the online courses taken. However, the effect size was small. We concluded that student satisfaction, engagement, and perceptions of cognitive and teaching presence are not related to prior online course experiences. Implications are discussed.

Effects of formal center-based care and positive parenting practices on children in foster care

BackgroundThe current study examined whether children in foster care have better cognitive and social-emotional outcomes at kindergarten age when they enroll in formal center-based care and when they receive positive parenting practices at home. ObjectiveTwo primary questions were addressed: (1) Do children in foster care who attended formal center-based care (including Head Start) have higher cognitive and socio-emotional outcomes than children in foster care who did not attend formal center-based care? (2) Does positive parenting practice promote better cognitive and socio-emotional outcomes? Participants and settingBased on the Early Childhood Longitudinal Study-K: 2011 data, 299 children in foster care were selected. MethodsRegression analyses were conducted on children's cognitive and social-emotional scores by types of children's childcare arrangements (formal vs informal care) and positive parenting practices. Active parental involvement was measured based on how frequently parents read books with their children, and authoritarian parenting discipline was measured based on whether parents spanked their children. ResultsChildren in foster care who enrolled in formal center-based childcare at pre-school age have higher cognitive and socio-emotional scores at kindergarten age. Positive parenting practice also promotes children's outcomes. Children in foster care who are both enrolled in formal center-based care and experience positive parenting practice had the most positive outcomes. Conclusions.Parents raising children in foster care should be informed about the positive impacts of certain parenting practices on their children. Foster parents should be connected to available community resources, including formal-center-based preschool programs and required to continuously attend parenting classes to sustain positive impact of parenting practice on foster children.

The impact of maternal depression, anxiety, and stress on early neurodevelopment in boys and girls

ObjectiveTo examine the effects of prenatal maternal depression, anxiety and stress, and postnatal depression on infant early neurodevelopment, and the sex dimorphism. Study designWe used data from 3379 mother-infant pairs from the Shanghai Birth Cohort. Maternal mental health was assessed using the Center for Epidemiological Studies-Depression Scale, Zung Self-Rating Anxiety Scale, Perceived Stress Scale at mid-pregnancy, and the Edinburgh Postnatal Depression Scale at postpartum. Infant neurodevelopment was evaluated using the Ages & Stages Questionnaires and Bayley Scales at ages 6, 12, and 24 months, respectively. Linear mixed models and linear regression models were used. ResultsAmong 3379 mothers, 11.07 %, 5.42 %, and 34.85 % of women experienced depression, anxiety, and elevated stress, separately. As maternal prenatal mental scores increased per 1SD, infant social-emotional scores decreased −2.82 (−3.86, −1.79) vs −2.86 (−3.94, −1.79) for depression, −2.34 (−3.38, −1.31) vs −2.72 (−3.81, −1.64) for anxiety, and −2.55 (−3.60, −1.50) vs −3.41 (−4.48, −2.35) for stress among boys and girls at age 24 months, respectively. Associations were also observed on social-emotional and communication scores in boys and girls, and fine motor in girls at age 6 and 12 months. These associations were not observed for postpartum depression. LimitationGeneralizability of the results to other population remains to be determined. ConclusionsPrenatal maternal depression, anxiety, and stress were negatively associated with infant early neurodevelopment, which were not observed for postpartum depression. We underscore the importance of maternal prenatal mental health in optimizing infant neuropsychiatric development.

Adolescents experience increased problems, and also increased resilience as a result of COVID‐19

Adolescents claim they have more behavioral problems, less social emotional skills, and are less prosocial because of COVID-19. A study found reductions in social emotional skills, prosocial behavior, and resilience scores. Still, the study found that the changes are not significant, and that changes in adolescents’ social emotional skills are negatively and significantly related to changes in internalized and externalized problems and positively and significantly related to changes in prosocial behavior and resilience. The implication is that adolescents who experienced larger development in social emotional learning also experienced more increase in resilience and prosocial behavior and a decrease in difficulties. [Martinsone B, et al. Adolescent social emotional skills, resilience and behavioral problems during the COVID-19 pandemic: A longitudinal study in three European countries. Front Psychiatry 2022 Aug 1; 13:942692. doi: 10.3389/fpsyt.2022.942692.]

Sex-specific associations among infant food and atopic sensitizations and infant neurodevelopment.

Food sensitization is a first and strong indicator of immune deviation in the progression to other allergic conditions. Sensitization to food or other allergens and related inflammation during critical windows of infant development may adversely affect neurodevelopmental milestones. However, additional research is needed to test this association further. Associations between atopic (any food or aeroallergen) or food sensitization (specific to egg, soybean, peanut, and milk) at age 1 year and neurodevelopment up to 2 years of age were evaluated in the national CHILD Cohort Study, with a secondary aim examining whether these associations were sex-specific. Food and atopic sensitization were assessed by skin prick tests (SPT) in 1-year-old infants, with neurodevelopment assessed using the cognitive, language, motor, and social-emotional subscales of the Bayley Scales of Infant Development (BSID-III) administered at 1 and 2 years of age. Atopic sensitization was present among 16.4% of infants, while 13.4% had food sensitizations. Only socioemotional scores reached statistical significance among the four BSID-III domains. Both atopic and food sensitization at 1 year of age was associated with lower social-emotional scores, independent of the infant's ethnicity. These findings were sex-specific and only observed among boys, among whom social-emotional scores were lowered by 5 points if atopic sensitization was present (-5.22 [95% CI: -9.96, -0.47], p = 0.03) or if food sensitization was present (-4.85 [95% CI: -9.82,0.11], p = 0.06). Similar results were observed using the standard SPT cut-off of ≥3 mm - for atopic sensitization (-5.17 [95% CI: -11.14, -0.80], p = 0.09) and for food sensitization (-4.61 [95% CI: -10.96, 1.74], p = 0.15). In our study of term infants, we found an inverse, cross-sectional association between atopic and food sensitization status and social-emotional development scores in male children but not female children.

Adolescent social emotional skills, resilience and behavioral problems during the COVID-19 pandemic: A longitudinal study in three European countries.

ObjectivesThe consequences of long-lasting restrictions related to the COVID-19 pandemic have become a topical question in the latest research. The present study aims to analyze longitudinal changes in adolescents’ social emotional skills, resilience, and behavioral problems. Moreover, the study addresses the impact of adolescents’ social emotional learning on changes in their resilience and behavioral problems over the course of seven months of the pandemic.MethodsThe Time 1 (T1) and Time 2 (T2) measuring points were in October 2020 and May 2021, characterized by high mortality rates and strict restrictions in Europe. For all three countries combined, 512 questionnaires were answered by both adolescents (aged 11-13 and 14-16 years) and their parents. The SSIS-SEL and SDQ student self-report and parent forms were used to evaluate adolescents’ social emotional skills and behavioral problems. The CD-RISC-10 scale was administered to adolescents to measure their self-reported resilience. Several multilevel models were fitted to investigate the changes in adolescents’ social emotional skills, resilience, and behavioral problems, controlling for age and gender. Correlation analysis was carried out to investigate how changes in the adolescents’ social emotional skills were associated with changes in their resilience and mental health adjustment.ResultsComparing T1 and T2 evaluations, adolescents claim they have more behavioral problems, have less social emotional skills, and are less prosocial than perceived by their parents, and this result applies across all countries and age groups. Both informants agree that COVID-19 had a negative impact, reporting an increment in the mean internalizing and externalizing difficulties scores and reductions in social emotional skills, prosocial behavior, and resilience scores. However, these changes are not very conspicuous, and most of them are not significant. Correlation analysis shows that changes in adolescents’ social emotional skills are negatively and significantly related to changes in internalized and externalized problems and positively and significantly related to changes in prosocial behavior and resilience. This implies that adolescents who experienced larger development in social emotional learning also experienced more increase in resilience and prosocial behavior and a decrease in difficulties.ConclusionDue to its longitudinal design, sample size, and multi-informant approach, this study adds to a deeper understanding of the pandemic’s consequences on adolescents’ mental health.

Quality of life and cervical cancer chemoradiation treatment compliance at a safety-net hospital (500)

<b>Objectives:</b> The purpose of this study was to utilize a validated cervical cancer quality of life survey to investigate the relationship between patient-perceived quality of life (QOL) and radiation therapy compliance in a safety-net hospital since noncompliance with scheduled radiation significantly increases local recurrence risk for each day treatment is extended. <b>Methods:</b> This prospective, single-institution study included 94 patients undergoing definitive concurrent chemoradiation for cervical cancer from November 2017 to July 2021. The Functional Assessment of Cancer Therapy - Cervical Cancer Version 4 (FACTCx) was used to assess QOL based on four subscales applicable to a broad population (Physical, Functional, Social/Familial, and Emotional) and one cervical cancer-specific subscale. Higher scores were associated with a higher quality of life. The survey was provided at the initial radiation consult, weekly during external beam radiation therapy, and follow-up appointments. FACT-Cx scores were evaluated over time and compared between compliant and noncompliant patients at baseline and each week of treatment using independent t-test analysis. Patient compliance and other clinical factors were abstracted from chart review. Noncompliance was defined as patient initiating (i.e., not due to weather closure or machine malfunction) and missing at least two radiation treatments. Time to noncompliance was defined as the radiation fraction at which the patient became noncompliant. <b>Results:</b> Twenty-seven of the 94 enrolled patients (28.7%) were non- compliant. Physical QOL of noncompliant patients was significantly impaired compared to compliant patients at baseline (Physical QOL, p=0.007) and at each of the first four weeks of radiation therapy. The functional QOL and cervical QOL scores of noncompliant patients were lower at baseline than compliant patients' scores, and the differences were statistically significant at each of the first four and five weeks, respectively. Differences between social QOL and emotional QOL scores at baseline and at each week of radiation were not statistically significant. The total QOL score of noncompliant patients was significantly lower compared to that of the compliant patients at baseline (Total QOL, p=0.010) and at each of the first five weeks. The median fraction when patients become noncompliant was 10 (IQR: 6-18). Change in QOL from baseline during treatment was not associated with patient-initiated noncompliance. <b>Conclusions:</b> This longitudinal prospective analysis suggests that multiple indicators of QOL, including physical, functional, and cervical well-being, are associated with noncompliance to therapy. The median fraction at which patients become noncompliant also suggests 2-3 weeks of treatment as the highest-risk time frame for patient-initiated noncompliance. Therefore, these results may be used to identify patients at risk of missing treatments and allow their physicians to intervene in a timely manner to improve treatment course and outcome.

Impact of Parental Beliefs on Child Developmental Outcomes: A Quasi-Experiment in Rural China.

This paper examines the impact of parental beliefs on child development outcomes (for both cognitive and social–emotional skills) based on a three-wave longitudinal survey in rural China. The survey waves were conducted when the sample children were 18–30 months, 22–36 months, and 49–65 months, respectively. A total of 815 children and their primary caregivers who participated in all three wave surveys were enrolled in this study. Using difference-in-differences and propensity score matching approaches, the results indicate that strengthened parental beliefs have a positive and significant impact on child social–emotional development. Specifically, between the periods of the Wave 1 survey (when children were 18–30 months old) and the Wave 3 survey (when children were 49–65 months old), and between the Wave 2 survey (when children were 22–36 months old) and the Wave 3 survey, strengthened parental beliefs were causally associated with more favorable child social–emotional scores by 0.44 SD (p < 0.01) and 0.49 SD (p < 0.01), respectively. No significant impact, however, was found between the period of the Wave 1 survey and the Wave 2 survey. In contrast, weakened parental beliefs had a negative and significant impact on child social–emotional development. Specifically, weakened parental beliefs were causally associated with worse child social–emotional abilities by 0.35 SD (p < 0.01), 0.30 SD (p < 0.01), and 0.22 (p < 0.05) for the time period of the Wave 1 to Wave 2, Wave 1 to Wave 3, and Wave 2 to Wave 3, respectively. No significant impact of parental beliefs, however, was found on child cognitive development. In addition, the findings of the mediation analysis show that only a marginal impact of parental beliefs on child social–emotional development can be indirectly explained by parental beliefs through parenting practices. This study calls on policy makers to improve parental beliefs and parenting practices in the hope that it will lead to better child development in rural China.

Associations of Maternal and Child Fatty Acid Status With Child Growth and Development Outcomes in Ghana

ObjectivesMaintaining adequate fatty acid intake during pregnancy and lactation is necessary to support fetal and infant growth. Low maternal intake may lead to decreased transfer of fatty acids to the fetus. Our objective was to examine associations of individual fatty acid status at three different time points with child growth and development outcomes at 18 months. MethodsA cohort of 1,320 women were enrolled in the International Lipid-Based Nutrient Supplements Dyad Ghana trial (iLiNS-DYAD-G). Fatty acids were measured in maternal plasma at 36 weeks gestation (n = 130), maternal breast milk six months postpartum (n = 303), and child plasma at 18 months (n = 369) and quantified as weight percentage of total identified fatty acids of the sample (% weight). We examined correlations between time points (maternal, breastmilk, and child) for five indicators of fatty acid status: % weight of four individual fatty acids (alpha-linolenic acid, ALA; linolenic acid, LA; docosahexaenoic acid, DHA; arachidonic acid, AA) and the n6: n3 ratio (ratio of LA & AA to ALA, DHA & EPA). We then examined whether each fatty acid indicator was associated with child growth (head circumference for age, length for age, weight for length z-scores) or developmental outcomes (motor, language, and social-emotional scores) at 18 months. Adjusted regressions included child sex, food insecurity scores, socioeconomic status, intervention group, and years of maternal education. ResultsMaternal plasma and breast milk were positively correlated for % weight AA, LA, and n6: n3 ratio. Maternal and child plasma were positively correlated for % weight DHA and n6: n3 ratio. Breast milk and child plasma fatty acids were positively correlated for % weight AA, ALA, DHA, and n6: n3 ratio. Associations of fatty acid status indicators with child growth and developmental outcomes were not significant after correcting for multiple comparisons. ConclusionsAlthough maternal fatty acid status was associated with breastmilk and child fatty acid status, maternal and child fatty acid status was not generally associated with child growth and development at 18 months of age in this sample of mother-child dyads in Ghana. Funding SourcesBill & Melinda Gates Foundation; National Institute of Child Health and Human Development & Fogarty International Center R01HD099811.

Effectiveness of an Integrated Nutrition Rehabilitation on Growth and Development of Children under Five Post 2018 Earthquake in East Lombok, Indonesia.

Background: In August 2018 Lombok Island in Indonesia was hit by a 7 Richter scale earthquake. This study aimed to assess the effectiveness of comprehensive nutrition disaster rehabilitation, based on the holistic integrated early child development concept, on the growth and development of children under five. Methods: A community-based intervention was performed in the East Lombok district; four villages in two sub-districts were randomly allocated into intervention or control groups. Mothers of 6–49-month-old children in the intervention group (n = 240) attended parenting classes (twice weekly) and received shredded fish/liver/anchovy and optimized complementary feeding/food-based recommendations, developed using linear programming. Health staff from the public health center and teachers from early childhood education (ECE) centers delivered parenting sessions on health–nutrition and care–education. The control group (n = 240) received existing health services. Indicators measured at baseline and the end line point were weight, length/height, hemoglobin, feeding practices, psychosocial care (HOME) and maternal stress (SRQ). At the end line point, child development was assessed using BSID-III. Results: At the end line point, maternal stress and child morbidity (cough) were lower and dietary diversity (+1) in 6–23-month-old children, and weight-for-age Z-score (+0.26) and social emotional score (+10 points) in ≥24-month-old children were higher in the intervention group. Conclusions: The nutrition rehabilitation intervention delivered through ECE centers has a positive effect on the growth and development of children under five in post-disaster conditions.

Sleep and social-emotional problems in preschool-age children with developmental delay.

Sleep problems and social-emotional (SE) problems are common in preschooler children and may be affected by culture. However, little is known about the link between sleep and social-emotional problems in non-Western countries. This study aims to compare sleep problems and their association with SE problems in Turkish children with either typical development (TD) or neurodevelopmental delay (NDD). In this case-control study, children with NDD (n = 126) and children with TD (n = 102) were included. Parents completed the Children's Sleep Habits Questionnaire (CSHQ), and the Ages and Stages Questionnaire: Social-Emotional (ASQ:SE). More than half of the TD and NDD groups had sleep problems when assessed by CSHQ (54.4%, 72.2%, respectively). Thecorrelation between CSHQ and ASQ:SE scores in the NDD and TD groups was r = 0.44 and r = 0.352, respectively (both p < 0.001). Children who slept less than 9 h had lower ASQ:SE scores in the NDD (p = 0.003) and TD group(p = 0.023). In the TD group, those who slept after 23:01h had lower ASQ:SE scores compared to early sleepers (p = 0.04). Multivariate analysis revealed associations between SE problems and male gender, lower family income, bedtime resistance, and shorter sleep duration in the NDD group. In the TD group, male gender, sleep onset delay, sleep duration of CSHQ subscale were found to be associated with SE problems. Sleep problems were identified in more than half of all preschooler children, regardless of developmental delay, and were associated with increased SE problems.Interventions to correct sleep problems may have a positive impact on children's emotional development.

Disparity of perception of quality of life between head and neck cancer patients and caregivers

BackgroundCaregivers are invaluable sources of support for individuals recovering from head and neck cancer (HNC). Accordingly, minimizing caregiver distress is essential to promote the well-being of both caregivers and their patients. This study assessed if psychosocial distress (i.e., anxiety and depression) among HNC caregivers is associated with a difference in how caregivers and their patients perceive patients’ quality of life (QOL) after treatment completion.MethodsCaregivers’ and patients’ perceptions of patient QOL were assessed using the University of Washington QOL Questionaire (UWQOL), a validated HNC-specific health-related QOL questionnaire. The survey is interpreted in terms of its two composite scores: a physical QOL score and a social-emotional QOL score with higher scores indicating better QOL. Caregiver anxiety was assessed using the Generalized Anxiety Questionaire-7 (GAD-7) and caregiver depression was assessed using the Patient Health Questionaire 8 (PHQ-8). Patients completed the UWQOL as part of clinic intake while caregivers were asked to complete the UWQOL for their patients in addition to the PHQ-8 and GAD-7 in private. Linear regression was used to analyze the association between differences in caregivers’ and patients’ QOL scores (both social-emotional and physical QOL subscale scores) and GAD-7 and PHQ-8 scores.ResultsOf 47 caregivers recruited, 42.6% (n = 20) viewed patients’ social-emotional QOL more negatively than patients themselves, while 31.9% viewed patients’ physical QOL more negatively. After controlling for covariates, differences in perception of social-emotional QOL (p = .01) and differences in perception of physical QOL (p = .007) were significantly associated with caregiver depression, but not anxiety. Caregivers who disagreed with patients regarding patients’ social-emotional QOL scored 6.80 points higher on the PHQ8 than agreeing caregivers. Caregivers who disagreed regarding patients’ physical QOL scored 6.09 points higher.ConclusionCaregivers commonly view patients’ QOL more negatively than patients themselves. These caregivers tend to have greater psychosocial distress than caregivers who agree with their patients. Interventions designed to identify and aid at-risk caregivers are critically needed. We propose screening for differences in perception of patient QOL as a way of identifying distressed caregivers as well as provider-facilitated communication between patients and caregivers as possible interventions that should be examined in future research.

Neurodevelopmental outcomes of healthy Chinese term infants fed infant formula enriched in bovine milk fat globule membrane for 12 months - A randomized controlled trial.

Human milk fat globule membrane (MFGM) has multifunctional health benefits. We evaluated neurodevelopment and growth of healthy term infants fed bovine milk-derived MFGM-enriched formula (MF) over 12 months. A prospective, multi-center, double-blind, randomized trial was conducted in Fuzhou, China. Healthy term infants (n=212), aged <14 days, were assigned randomly to be fed MF or a standard formula (SF) for 6 months and then switched to stage 2 MF and SF formula until 12 months. A reference group (n=206) contained healthy breastfed infants (BFR). Neurodevelopment was assessed with Bayley-III Scales. At 12 months, the composite social emotional (+3.5) and general adaptive behaviour (+5.62) scores were significantly higher in MF than SF (95% CIs 0.03 to 6.79 and 1.78 to 9.38; p=0.048 and 0.004, respectively). Mean cognitive (+2.86, 95% CIs -1.10 to 6.80, p=0.08), language (+0.39, 95% CIs -2.53 to 3.30, p=0.87) and motor (+0.90, 95% CIs -2.32 to 4.13, p=0.49) scores tended to be higher in MF than SF, but the differences between the two groups were not significant. BFR scored higher on Bayley-III than either MF or SF at 6 and 12 months. Cognitive scores were significantly higher in BFR than SF (95% CI 0.05 to 7.20; p=0.045), but not MF (p=0.74) at 6 months. Short-term memory was significantly higher in MF than SF at 12 months (95% CI 1.40 to 12.33; p=0.002). At 4 months, serum gangliosides were significantly higher in MF and BFR than SF (95% CI 0.64 to 13.02; p=0.025). Milk intake, linear growth, body mass and head circumference were not significantly different between formula-fed groups. MFGM supplementation in early life supports adequate growth, increased serum gangliosides concentration and improves some measures of cognitive development in Chinese infants.

Early Life Exposure to Ambient Air Pollutants is Associated with Decreased Cognitive Development in Hispanic Infants from Southern California

BACKGROUND AND AIM: Previous research has established an association between postnatal ambient air pollution (AAP) exposure and cognitive development in preschoolers and school-aged children. However, this association has not been examined during infancy, a critical neurodevelopmental window. The purpose of this study was to explore relationships between postnatal AAP exposure and cognitive development in infants. METHODS: This study examined 118 Hispanic mother-infant pairs from the longitudinal Mother’s Milk Study in Southern California. Average individual residential exposure to AAP, including nitrogen dioxide (NO2) and particulate matter smaller than 2.5 and 10 microns in diameter (PM2.5 and PM10 respectively), in the first month of life was estimated from central site monitors. Infant cognitive outcomes at 24-months were measured using the Bailey-III Scales of Infant and Toddler Development. Multivariate linear regression was used to examine relationships between postnatal AAP exposure and age scaled cognitive scores, adjusting for socioeconomic status, breastfeeding frequency, time of delivery (early/late/on-time) as a proxy for gestational age, pre-pregnancy BMI, birthweight, and sex. Effects are reported for each standard deviation increase in exposure. RESULTS:NO2 was negatively associated with fine motor score (β=-0.55, p=0.006), motor score (β=-0.90, p =0.007), and cognitive score (β=-0.55, p=0.01). PM2.5 and PM10 were negatively associated with social emotional scores (β=-0.77, p=0.009 and β=-0.66, p=0.01 respectively). The association between NO2 and cognitive score varied by infant sex (p-interaction = 0.046), where NO2 was negatively associated with cognitive score among females (β=-0.16, p=0.0006) but not males (β=-0.01, p=0.81). CONCLUSIONS:Higher postnatal exposure to AAP in the first month of life was inversely associated with scaled motor, cognitive, and social-emotional scores at 24-months of age. Sex-specific findings for scaled cognitive score may suggest differential impacts of AAP exposure among females. These results indicate that AAP may negatively impact neurodevelopment in early life. KEYWORDS: Air Pollution, Neurodevelopmental Outcomes, Multi-pollutant, Environmental Disparities, Short-term Exposure

Gender inequalities in perceived stress and the factors affecting it in infertile couples in Iranian society: a case in one of the provinces of Iran

PurposeThe aim of this study is to investigate the gender inequalities in perceived stress and the influencing factors in infertile couples in Iranian society.Design/methodology/approachThis cross-sectional study was conducted on infertile couples who were referring to Kurdistan Infertility Diagnosis and Treatment Medical Center in 2019. Demographic and clinical information questionnaire, Newton's Infertility perceived stress questionnaire, Rosenberg's standard self-confidence questionnaire and the multidimensional scale of social support were used. Multiple linear logistic models were also used.FindingsA total of 560 couples (1,120 people) participated in the study. The average perceived infertility-related stress, self-esteem scores and social support and social-emotional loneliness were 173.95 ± 41.87, 13.99 ± 2.29 and 27.81 ± 7.33, respectively, which were significantly different scores across infertility cause and sex (P < 0.05). Males compared to females had lower perceived infertility-related stress (169.93 ± 42.51 vs 177.97 ± 40.86, P = 0.001) and self-esteem scores (14.33 ± 2.29 vs 13.66 ± 2.24, P < 0.001) and social support and social-emotional loneliness (32.92 ± 9.31 vs 30.94 ± 9.04, P < 0.001). The partners who reported themselves as infertile, compared significantly higher in perceived infertility-related stress than those who reported their spouse being infertile (194.24 ± 35.33 vs 141.90 ± 39.28), lower self-esteem scores (12.77 ± 2.21 vs 13.94 ± 1.56) and social support and social-emotional loneliness score (27.81 ± 7.33 vs 30.11 ± 7.70). Also, after taking potential confounders into account with increase in each score of self-esteem, 12.19 units of stress decreases (P < 0.001, 95% CI: 11.40–12.99) and with increase in each score of social support and social-emotional loneliness, 3.45 units of stress decreases (P < 0.001, 95% CI: 3.28–3.63).Originality/valueThere is perceived stress among infertile couples, and this rate is higher among infertile people and women. Therefore, it seems that specific intervention programs for infertile couples should be implemented based on the results of this study, and their stress levels in a way that self-esteem and support for both partners be increased and the perceived stress among women and infertile individuals be decreased.