Search results for: child play

Authors: Samereh Abdoli, Amit Vora, Anusha Vora

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Aim: To qualitatively investigate diabetes burnout in parents of children with Type 1 Diabetes (T1D) who shared their experiences through YouTube videos in order to inform future interventions and improve diabetes practice. Methods: A qualitative descriptive approach was used to explore YouTube videos. Of the 568 videos that were identified, only 9 videos met the inclusion criteria of the study. Results: After the videos were transcribed and analyzed using qualitative content analysis, it was revealed that parents shared common concerns and experiences and they translated into three main themes: I do not ever get a break, I am exhausted, I can’t burn out, and I just need a break Conclusion: All in all, the literature revealed that there are negative psychosocial outcomes associated with caring for a child with T1D, but there is a lack of information on diabetes burnout and how parents’ well-being are affected. Reports of self-neglect and sleep deprivation only confirm the need for intervention for parents of children with T1D. The hope with this study is that burnout can be recognized early on and appropriate interventions put in place to help parents cope with the stressors of caring for a child with a chronic disease.

Keywords: Diabetes burnout, type 1 diabetes, qualitative research, parents

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Authors: Katherine Maurer

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Background and purpose: Violence that occurs within families is a global social problem. Children who are victims or witness to family violence are at risk for many negative effects both proximally and distally. One of the most disconcerting long-term effects occurs when child victims become adult perpetrators: the intergenerational transmission of family violence (ITFV). Early identification of those children most at risk for ITFV is needed to inform interventions to prevent future family violence perpetration and victimization. Only about 25-30% of child family violence victims become perpetrators of adult family violence (either child abuse, partner abuse, or both). Prior research has primarily been conducted using dichotomous measures of exposure (yes; no) to predict ITFV, given the low incidence rate in community samples. It is often assumed that exposure to greater amounts of violence predicts greater risk of ITFV. However, no previous longitudinal study with a community sample has tested a dose-response model of exposure to physical child abuse and parental physical intimate partner violence (IPV) using count data of frequency and severity of violence to predict adult ITFV. The current study used advanced statistical methods to test if increased childhood exposure would predict greater risk of ITFV. Methods: The study utilized 3 panels of prospective data from a cohort of 15 year olds (N=338) from the Project on Human Development in Chicago Neighborhoods longitudinal study. The data were comprised of a stratified probability sample of seven ethnic/racial categories and three socio-economic status levels. Structural equation modeling was employed to test a hurdle regression model of dose-response to predict ITFV. A version of the Conflict Tactics Scale was used to measure physical violence victimization, witnessing parental IPV and young adult IPV perpetration and victimization. Results: Consistent with previous findings, past 12 months incidence rates severity and frequency of interpersonal violence were highly skewed. While rates of parental and young adult IPV were about 40%, an unusually high rate of physical child abuse (57%) was reported. The vast majority of a number of acts of violence, whether minor or severe, were in the 1-3 range in the past 12 months. Reported frequencies of more than 5 times in the past year were rare, with less than 10% of those reporting more than six acts of minor or severe physical violence. As expected, minor acts of violence were much more common than acts of severe violence. Overall, regression analyses were not significant for the dose-response model of ITFV. Conclusions and implications: The results of the dose-response model were not significant due to a lack of power in the final sample (N=338). Nonetheless, the value of the approach was confirmed for the future research given the bi-modal nature of the distributions which suggest that in the context of both child physical abuse and physical IPV, there are at least two classes when frequency of acts is considered. Taking frequency into account in predictive models may help to better understand the relationship of exposure to ITFV outcomes. Further testing using hurdle regression models is suggested.

Keywords: intergenerational transmission of family violence, physical child abuse, intimate partner violence, structural equation modeling

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Authors: Olarinde Olaniran, Oluyomi A. Sowemimo

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Toxoplasmosis is frequently misdiagnosed or underdiagnosed, and it is the third most common cause of hospitalization due to food-borne infection. Intra-uterine infection with Toxoplasma gondii due to active parasitaemia during pregnancy can cause severe and often fatal cerebral damage, abortion, and stillbirth of a fetus. The aim of the study was to investigate the prevalence of T. gondii infection in women of childbearing age in selected communities of Osun State with a view to determining the risk factors which predispose to the T. gondii infection. Five (5) ml of blood was collected by venopuncture into a plain blood collection tube by a medical laboratory scientist. Serum samples were separated by centrifuging the blood samples at 3000 rpm for 5 mins. The sera were collected with Eppendorf tubes and stored at -20°C analysis for the presence of IgG and IgM antibodies against T. gondii by commercially available enzyme-linked immunosorbent assay (ELISA) kit (Demeditec Diagnostics GmbH, Germany) conducted according to the manufacturer’s instructions. The optical densities of wells were measured by a photometer at a wavelength of 450 nm. Data collected were analysed using appropriate computer software. The overall seroprevalence of T. gondii among the women of child-bearing age in selected seven communities in Osun state was 76.3%. Out of 76.3% positive for Toxoplasma gondii infection, 70.0% were positive for anti- T. gondii IgG, and 32.3% were positive for IgM, and 26.7% for both IgG and IgM. The prevalence of T. gondii was lowest (58.9%) among women from Ile Ife, a peri-urban community, and highest (100%) in women residing in Alajue, a rural community. The prevalence of infection was significantly higher (P= 0.000) among Islamic women (87.5%) than in Christian women (70.8%). The highest prevalence (86.3%) was recorded in women with primary education, while the lowest (61.2%) was recorded in women with tertiary education (p =0.016). The highest prevalence (79.7%) was recorded in women that reside in rural areas, and the lowest (70.1%) was recorded in women that reside in peri-urban area (p=0.025). The prevalence of T. gondii infection was highest (81.4%) in women with one miscarriage, while the prevalence was lowest in women with no miscarriages (75.9%). The age of the women (p=0.042), Islamic religion (p=0.001), the residence of the women (p=0.001), and water source were all positively associated with T. gondii infection. The study concluded that there was a high seroprevalence of T. gondii recorded among women of child-bearing age in the study area. Hence, there is a need for health education and create awareness of the disease and its transmission to women of reproductive age group in general and pregnant women in particular to reduce the risk of T. gondii in pregnant women.

Keywords: seroepidemiology, Toxoplasma gondii, women, child-bearing, age, communities, Ile -Ife, Nigeria

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Authors: Hajar Aman Key Yekani, Yusra Mushtaq, Behnaz Farahani, Hamed Abdi

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This study explores associations between parental restriction and children's appetitive traits, putting to test the hypothesis that parental 'restriction' is associated with having a child with stronger food approach tendencies (food enjoyment (FE) and food over-responsiveness (FR)). The participants, from 55 nationalities, targeting 1081 parents of 5- to 11-year-old children from 7 private schools in Dubai, UAE, who completed self-reported questionnaires over the 2011-2012 school year. The questionnaire has been a tailored amalgamation of CEBQ and CFQ in order to measure the children’s appetitive traits and parental restriction, respectively. The findings of this quantitative, descriptive, cross-sectional analysis confirmed the hypothesis in that 'parental restriction' was positively associated with child food responsiveness (r, 0.183), food enjoyment (r, 0.102). To conclude, as far as the figures depict, the parents controlling their children’s food intake would seemingly a reverse impact on their eating behaviour in the short term.

Keywords: parental restriction, children, eating behaviour, schools in Dubai

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Authors: Md Monoarul Haque

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Nutritional status is a sensitive indicator of community health and nutrition among preschool children, especially the prevalence of undernutrition that affects all dimensions of human development and leads to growth faltering in early life. The present study is an attempt to assess the food intake pattern and nutritional status of pre-school Chakma tribe children. It was a cross-sectional community based study. The subjects were selected purposively. This study was conducted at Savar Upazilla of Rangamati. Rangamati is located in the Chittagong Division. Anthropometric data height and weight of the study subjects were collected by standard techniques. Nutritional status was measured using Z score according WHO classification. χ2 test, independent t-test, Pearson’s correlation, multiple regression and logistic regression was performed as P<0.05 level of significance. Statistical analyses were performed by appropriate univariate and multivariate techniques using SPSS windows 11.5. Moderate (-3SD to <-2SD) to severe underweight (<-3SD) were 23.8% and 76.2% study subjects had normal weight for their age. Moderate (-3SD to <-2SD) to severe (<-3SD) stunted children were only 25.6% and 74.4% children were normal and moderate to severe wasting were 14.7% whereas normal child was 85.3%. Significant association had been found between child nutritional status and monthly family income, mother education and occupation of father and mother. Age, sex and incomes of the family, education of mother and occupation of father were significantly associated with WAZ and HAZ of the study subjects (P=0.0001, P=0.025, P=0.001 and P=0.0001, P=0.003, P=0.031, P=0.092, P=0.008). Maximum study subjects took local small fish and some traditional tribal food like bashrool, jhijhipoka and pork very much popular food among tribal children. Energy, carbohydrate and fat intake was significantly associated with HAZ, WAZ, BAZ and MUACZ. This study demonstrates that malnutrition among tribal children in Bangladesh is much better than national scenario in Bangladesh. Significant association was found between child nutritional status and family monthly income, mother education and occupation of father and mother. Most of the study subjects took local small fish and some traditional tribal food. Significant association was also found between child nutritional status and dietary intake of energy, carbohydrate and fat.

Keywords: food intake pattern, nutritional status, preschool children, Chakma ethnic community

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Authors: Muhammad Tahir Khalily

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Aim: The purpose of the present study was to examine the effectiveness of alpha-theta brainwave Neuro feedback treatment for the internal self-exploration of individuals with conversion disorder. Method: A Purposive sample technique was used and data collected from Kalsoom International Hospital Islamabad and Al-Malik Medical Center Rawalpindi. 123 participants were examined, Male child = 5, female child = 6, male adult = 64, female adult = 48. This study retrospectively examined the symptomatic changes in clients with a range of psychiatric disorders particularly 13 (Male = 3, Female = 10) conversion disorder clients who have received Neuro feedback treatment. Results: Our results indicated a significant improvement (P < .001) in the amelioration of our clients’ symptoms which have enabled them to bring their emotional memories into conscious awareness for the peaceful resolution without self-detachment. Conclusion: Majority of the clients improved their psychiatric symptoms including the symptoms of conversion disorder and was discharged from therapy with the accomplishment of therapeutic goals.

Keywords: EEG, neurofeedback, conversion, therapy

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Authors: Trenton Hubbard, Kenneth Soyemi, Emily Siffermann

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Introduction: According to the American Academy of Pediatrics (AAP) there are different weight-based recommendations for the treatment of Chlamydia trachomatis (CT) in patients who are being evaluated for sexual assault. Current AAP Red Book guidelines recommend that uncomplicated C. trachomatis anogenital infection in prepubertal patients weighing less than =<45 kg be treated with oral erythromycin 50 mg/kg/day QID for 14 days with no alternative therapies, and for patients whose weight => 45 kg are Azithromycin 1 gm PO once. Our study objective was to determine the efficacy of single-dose Azithromycin therapy for the treatment of Chlamydia trachomatis in patients weighing less than 50 kg who were evaluated for child sexual abuse in an urban setting. Methods: We conducted a retrospective chart review of historical medical records (paper and electronic) patients weighing less than 50 kg who were evaluated for child sexual abuse and subsequently treated for C. trachomatis infection with Azithromycin (20 mg/kg PO once up to a maximum 1 gm) and received a Test of Cure (TOC) from 2006-2016. Qualitative variables were expressed as percentages. Quantitative variables were expressed as mean values (+/- standard deviation [SD]) if they followed a normal distribution or as median values (interquartile range[IQR]) if they did not. Wilcoxson two-sample test was used to compare means of Azithromycin Dose, mg/kg, and TOC timing between treatment responders and non-responders. Results: We reviewed records of 34 patients, average age (SD) was 5.4 (2.0) years, 33 (97%) were treated for CT and 1(3%) for both GC and CT. 25 (74%) were females. Urine PCR was the most commonly used test at evaluation and as TOC with 13 (38%) patients completing both tests. The average (SD) dose of Azithromycin at treatment was 470 (136) mg and average (SD) mg/kg dose of 20 (1.9) mg/kg for all patients. Median (IQR) timing for TOC testing was 19 (14-26) days. Of the 33 with complete data 25 (74%) had a negative TOC. When compared with treatment non-responders (TOC failures), treatment responders received higher doses (average dose (SD) received 495 (139) vs 401(110), P 0.06)); similar average (SD) weight base dosing received (20.8(2.0) vs 19.7 (1.5), P 0.15)), and earlier average (SD)TOC test timing (18.8 (5.6) vs 32 (28.6) P 0.02)). Conclusion: Azithromycin dosing appears to be efficacious in the treatment of CT post sexual assault as majority of patients responded. Although treatment responders and non-responders received similar weight based doses, there is need for additional studies to understand variances and predictors of response.

Keywords: child sexual abuse, chlmaydia trachmotis infection, single-dose azithromycin, weight less than or equal to 45 kilograms

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Authors: Jamel Slaughter

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Father involvement across the development of a child has been linked to children’s psychological adjustment, fewer behavioral problems, and higher educational attainment. Conversely, there is much less research that highlights father involvement in relation to childhood development during early childhood period prior to preschool age (ages 1-3 years). Most research on fathers and child outcomes have been limited by its focus on the stages of adolescence, middle childhood, and infancy. This study examined the influence of father involvement, during the toddler stage, on 5th grade cognitive development, rule-breaking, and behavior outcomes measured by Child Behavior Checklist (CBCL) scores. Using data from the Early Head Start Research and Evaluation (EHSRE) Study, 1996-2010: United States, a total of 3,001 children and families were identified in 17 sites (cities), representing a diverse demographic sample. An independent samples t-test was run to compare cognitive development, aggressive, and rule-breaking behavior mean scores among children who had early continuous father involvement for the first 14 – 36 months to children who did not have early continuous father involvement for the first 14 – 36 months. Multiple linear regression was conducted to determine if continuous, or non-continuous father involvement (14 month-36 months), can be used to predict outcome scores on the Child Behavior Checklist in aggressive behavior, rule-breaking behavior, and cognitive development, at 5th grade. A statistically significant mean difference in cognitive development scores were found for children who had continuous father involvement (M=1.92, SD=2.41, t (1009) =2.81, p =.005, 95% CI=.146 to .828) compared to those who did not (M=2.60, SD=3.06, t (1009) =-2.38, p=.017, 95% CI= -1.08 to -.105). There was also a statistically significant mean difference in rule-breaking behavior scores between children who had early continuous father involvement (M=1.95, SD=2.33, t (1009) = 3.69, p <.001, 95% CI= .287 to .940), compared to those that did not (M=2.87, SD=2.93, t (1009) = -3.49, p =.001, 95% CI= -1.30 to -.364). No statistically significant difference was found in aggressive behavior scores. Multiple linear regression was performed using continuous father involvement to determine which has the largest relationship to rule-breaking behavior and cognitive development based on CBCL scores. Rule-breaking behavior was found to be significant (F (2, 1008) = 8.353, p<.001), with an R2 of .016. Cognitive development was also significant (F (2, 1008) = 4.44, p=.012), with an R2 of .009. Early continuous father involvement was a significant predictor of rule-breaking behavior and cognitive development at middle childhood. Findings suggest early continuous father involvement during the first 14 – 36 months of their children’s life, may lead to lower levels of rule-breaking behaviors and thought problems at 5th grade.

Keywords: cognitive development, early continuous father involvement, middle childhood, rule-breaking behavior

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Authors: Mehmet Yanardag, Ilker Yilmaz

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Children with autism spectrum disorders (ASD) enjoy and success the aquatic-based exercise and play skills in a pool instead of land-based exercise in a gym. Some authors also observed that many children with ASD experience more success in attaining movement skills in aquatic environment. Properties of the water and hydrodynamic principles cause buoyancy of the water and decrease effects of gravity and it leads to allow a child to practice important aquatic skills with limited motor skills. Also, some authors experience that parents liked the effects of the aquatic intervention program on children with ASD such as improving motor performance, movement capacity and learning basic swimming skills. The purpose of this study was to investigate the effects of aquatic exercise training on water orientation and underwater working capacity were measured in the pool. This study included in four male children between 5 and 7 years old with ASD and 6.25±0.5 years old. Aquatic exercise skills were applied by using one of the error less teaching which is called the 'most to least prompt' procedure during 12-week, three times a week and 60 minutes a day. The findings of this study indicated that there were improvements test results both water orientation skill and underwater working capacity of children with ASD after 12-weeks exercise training. It was seen that the aquatic exercise intervention would be affected to improve working capacity and orientation skills with the special education approaches applying children with ASD in multidisciplinary team-works.

Keywords: aquatic, autism, orientation, ASD, children

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Authors: Elanz Alimi, Mehdi Ghanadzade

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This current study compared the parents reported treatment and education priorities between verbal and nonverbal children with an autism spectrum disorder (ASD). Participants were 196 parents of 2 to 21-year-old (83 non-verbal and 113 verbal) children and adolescents with an ASD who completed questionnaires measuring parent’s treatment and education priorities, child’s educational and intervention programs and current child’s level of performance according to each skill. Results of this study indicated that parents of verbal children with autism spectrum disorder considered communication skills, community living skills and academic skills correspondingly as their highest intervention and education priorities and parents of non-verbal children with ASD reported communication skills, social relationship skills and self-care skills as the most significant priorities for their children. Findings show that for Iranian parents of both verbal and non-verbal children with ASD, communication skills are the most crucial treatment priority.

Keywords: autism, communication skills, Iran, parent’s priorities

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Authors: Lenell D. Walton

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African American families have consistently contended that their child’s special education team does not provide the services necessary to meet their child’s academic goals. Special education teams must guide and mentor African American students and their families through the special education process. This qualitative study examined African American female caregivers' perceptions, experiences, and expectations regarding the special education process. Data collection methods utilized in the study included a survey, semi-structured interviews, and three focus groups. Data were analyzed and compared to identify themes. Three themes emerged from the survey: education and training, participation, and challenges. Six major themes emerged: (a) differences in treatment and cultural disconnect, (b) lack of support and resources, (c) participants’ experiences of the special education process, (d) parent participation, (e) barriers and concerns, and (f) expectations. Implications for policy and practice to improve the special education process are discussed.

Keywords: African American, caregivers, critical race theory, special education

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Authors: Rukhsana Kausar, Nida Zafar

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The present research investigated socio-demographic predictors of divorce adjustment in Pakistani women. The sample comprised of 80 divorced women from different areas of Lahore. Self developed Socio-Demographic predictor scale and Divorce Adjustment Scale by (Fisher, 2001) was used for assessment. Analyses showed that working divorced women living with joint family system are more adjusted as compared to non-working divorced women living with joint family system. Women having one child are more adjusted as compared to women having more than one child. Findings highlight importance of presence of father for healthy development of adolescents. Adjustment of divorcee women was positively associated with income, social support from the family, having favorable attitudes toward marital dissolution prior to divorce, and being the partner who initiated the divorce. In addition, older women showed some evidence of poorer adjustment than did younger women. Findings highlight importance of support for divorce adjustment.

Keywords: socio-demographic, adjustment, women, divorce

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Authors: Hee Soo Kim, Ha Young Kyung

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This paper examines the role of positive emotions in human psychology. By understanding Fredrickson and Lyubomirsky et al.’s on positive emotions, one can better understand people’s intuitive understanding, mental health and well-being. Fredrickson asserts that positive emotions create positive affects and personal resources, and Lyubomirsky et al. relate such positive resources to the creation of happiness and personal development. This paper finds that positive emotions play a significant role in the learning process, and they are instrumental in creating a long-lasting repertoire of personal resources and play an essential role in the development of the intuitive understanding of life variables, resilience in coping with life challenges, and ability to build more successful lives.

Keywords: Positive emotions, positive affects, personal resources, negative emotions, development

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Authors: Ahmad Torkaman, Suogol Shomtob, Hadi Akbari Seddigh

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In this paper it has been attempted to investigate the lack of attention to how specific spatial characteristics of the children except existing places such as nurseries. In order to achieve the standard center to faster children understanding their mentality is the first issue that must be studied. Exploring the spiritual characteristics and complexities of children cannot be possible except in accordance with the different aspects and background of their growth in various age periods. In order to achieving the standard center for fostering children, the first issue that must be studied understands their mentality. Exploring the spiritual qualities and complexities of children are not provided except in accordance with the characteristics and their different growth backgrounds in different age periods. According to previous researches game or playing is the most important activity that helps children to communicate and educate and sometimes therapy in specific fields. Investigating game as a proper way to train, the variety of games, the various kind of play environment and how to treat some abnormalities thereby are the issues discussed in recent research. Another consideration concerns the importance of artistic activities among children which is very evident in studying identification of their abnormalities. At the end of this study after investigating how to understand child and communicate with him/her, aiming to recognize Specific spatial characteristics for better training children, the physical and physiological criteria and characteristics is Reviewed and ends up to a list of required spaces and dimensional characteristic of spaces and needed children's equipment.

Keywords: children, space, interior design, development, growth

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Authors: Sheng-Fen Fan, Sung-Hui Tseng

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Attention deficit hyperactivity deficit (ADHD) child display diverse sensory processing difficulty behaviors. There is less evidence to figure out how the association between executive function and sensory deficit. To determine whether sensory deficit influence the executive functions, we examined sensory processing by SPM and try to indicate hot/cold executive function (EF) by BRIEF2, respectively. We found that the hot executive function deficit might associate with auditory processing in a variety of settings, and vestibular input to maintain balance and upright posture; the cold EF deficit might opposite to the hot EF deficit, the vestibular sensory modulation difficulty association with emotion shifting and emotional regulation. These results suggest that sensory processing might be another consideration factor to influence the higher cognitive control or emotional regulation of EF. Overall, this study indicates the distinction between hot and cold EF impairments with different sensory modulation problem. Moreover, for clinician, it needs more cautious consideration to conduct intervention with ADHD.

Keywords: hot executive function, cold executive function, sensory processing, ADHD

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Authors: Divya Palaniappan

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Early Childhood assessment tools must measure the quality and the appropriateness of a curriculum with respect to culture and age of the children. Preschool assessment tools lack psychometric properties and were developed to measure only few areas of development such as specific skills in music, art and adaptive behavior. Existing preschool assessment tools in India are predominantly informal and are fraught with judgmental bias of observers. The World of Discovery TM curriculum focuses on accelerating the physical, cognitive, language, social and emotional development of pre-schoolers in India through various activities. The curriculum caters to every child irrespective of their dominant intelligence as per Gardner’s Theory of Multiple Intelligence which concluded "even students as young as four years old present quite distinctive sets and configurations of intelligences". The curriculum introduces a new theme every week where, concepts are explained through various activities so that children with different dominant intelligences could understand it. For example: The ‘Insects’ theme is explained through rhymes, craft and counting corner, and hence children with one of these dominant intelligences: Musical, bodily-kinesthetic and logical-mathematical could grasp the concept. The child’s progress is evaluated using an assessment tool that measures a cluster of inter-dependent developmental areas: physical, cognitive, language, social and emotional development, which for the first time renders a multi-domain approach. The assessment tool is a 5-point rating scale that measures these Developmental aspects: Cognitive, Language, Physical, Social and Emotional. Each activity strengthens one or more of the developmental aspects. During cognitive corner, the child’s perceptual reasoning, pre-math abilities, hand-eye co-ordination and fine motor skills could be observed and evaluated. The tool differs from traditional assessment methodologies by providing a framework that allows teachers to assess a child’s continuous development with respect to specific activities in real time objectively. A pilot study of the tool was done with a sample data of 100 children in the age group 2.5 to 3.5 years. The data was collected over a period of 3 months across 10 centers in Chennai, India, scored by the class teacher once a week. The teachers were trained by psychologists on age-appropriate developmental milestones to minimize observer’s bias. The norms were calculated from the mean and standard deviation of the observed data. The results indicated high internal consistency among parameters and that cognitive development improved with physical development. A significant positive relationship between physical and cognitive development has been observed among children in a study conducted by Sibley and Etnier. In Children, the ‘Comprehension’ ability was found to be greater than ‘Reasoning’ and pre-math abilities as indicated by the preoperational stage of Piaget’s theory of cognitive development. The average scores of various parameters obtained through the tool corroborates the psychological theories on child development, offering strong face validity. The study provides a comprehensive mechanism to assess a child’s development and differentiate high performers from the rest. Based on the average scores, the difficulty level of activities could be increased or decreased to nurture the development of pre-schoolers and also appropriate teaching methodologies could be devised.

Keywords: child development, early childhood assessment, early childhood curriculum, quantitative assessment of preschool curriculum

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Authors: Jacquelyn Irene Eidson

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Women who leave the workforce due to motherhood and wish to return are a valuable, untapped resource for organizations. Levinson’s theory of adult development defines life as a sequence of transitions requiring difficult decisions that prompt humans to question their identity and their self-efficacy. The experience of being a working mother and the experience of workplace mentorship have received extensive research attention. Merging the two experiences and focusing on feelings of identity and self-efficacy provides a unique and focused opportunity for learning. Through one-on-one interviews and focus group discussion with working mothers that had previously left the workforce for an extended leave due to child-rearing, a meaningful description of their experiences will be obtained. Data is currently being collected via a collaboration with state banking associations in the United States. Results from the study will enable organizations worldwide to more effectively provide mentorship opportunities built around a culture of understanding while more effectively recruiting, supporting, developing, and retaining this valuable talent pool.

Keywords: identity, mentorship, self-efficacy, working mother

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Authors: Ali Kassem, Aly Taha, Abeer Hassan, Kazuhide Higuchi

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Introduction: Trans arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is usually followed by hepatic dysfunction that limits its efficacy. L-carnitine is recently studied as hepatoprotective agent. Our aim is to evaluate the L-carnitine effects against the deterioration of liver functions after TACE. Method: 53 patients with intermediate stage HCC were assigned into two groups; L-carnitine group (26 patients) who received L-carnitine 300 mg tablet twice daily from 2 weeks before to 12 weeks after TACE and control group (27 patients) without L-carnitine therapy. 28 of studied patients received branched chain amino acids granules. Results: There were significant differences between L-carnitine Vs. control group in mean serum albumin change from baseline to 1 week and 4 weeks after TACE (p < 0.05). L-Carnitine maintained Child-Pugh score at 1 week after TACE and exhibited improvement at 4 weeks after TACE (p < 0.01 Vs 1 week after TACE). Control group has significant Child-Pugh score deterioration from baseline to 1 week after TACE (p < 0.05) and 12 weeks after TACE (p < 0.05). There were significant differences between L-carnitine and control groups in mean Child-Pugh score change from baseline to 4 weeks (p < 0.05) and 12 weeks after TACE (p < 0.05). L-carnitine displayed improvement in (PT) from baseline to 1 week, 4 w (p < 0.05) and 12 weeks after TACE. PT in control group declined less than baseline along all follow up intervals. Total bilirubin in L-carnitine group decreased at 1 week post TACE while in control group, it significantly increased at 1 week (p = 0.01). ALT and C-reactive protein elevation were suppressed at 1 week after TACE in Lcarnitine group. The hepatoprotective effects of L-carnitine were enhanced by concomitant use of branched chain amino acids. Conclusion: L-carnitine and BCAA combination therapy offer a novel supportive strategy after TACE in HCC patients.

Keywords: hepatocellular carcinoma, L-carnitine, liver functions , trans-arterial embolization

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Authors: B. Nair, S. Singh

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Oral health behaviors such as dietary preferences and tooth brushing are acquired during a child’s primary socialization period yet many oral health promotion interventions are implemented without taking into account the role and impact of parental influence in supporting healthy oral health behaviors. The aim and objective of this study was to determine the relationship between parental income and level of education with knowledge, attitudes and perceptions of oral health care practices. Methods: The study design was cross-sectional and exploratory, and data collection occurred in two phases. Phase 1 comprised of a self-administered questionnaire. The sample consisted of parents of 313 Grade 1 learners aged between 5-6 years old attending one of twelve selected public primary schools in the Chatsworth Circuit, Durban, South Africa. Phase 2 comprised of focus group discussions held at 5 purposively selected schools. Data collection comprised of a semi-structured face-to-face group interview with the objective of obtaining a deeper understanding of parental knowledge, attitudes and perceptions of dental caries. Results and Discussion: Almost 56% of participants earned a monthly income of less than R6000 (600 US dollars). Nearly three quarters (77.5%) of participants indicated that they did not have medical aid/insurance scheme. More than three-quarters of the participants (76.6%) identified diet as being the primary cause of decayed teeth. More than half of the study sample (56.1%) indicated that milk teeth were important and that rotten teeth (74.6%) could affect the child’s health. Almost half (49.8%) of participants reported that “bad teeth” were inherited. With more than two-thirds of the participants (77.7%), having at most a high school education, there was a correlation between the level of the caregiver’s education and the oral health care of the child. The analysis of the correlation between a child having decayed teeth and income (p=.007); and the manner in which the income is received (p=.003) was statistically significant. The results indicate that more effort needs to be placed in understanding parental knowledge, perceptions and attitudes towards dental caries. Parental level of education, income and oral health literacy is shown to be related to attitudes, and perceptions towards dental caries and its subsequent preventive measures. These findings have important implications for oral health planning at community and facility-based levels.

Keywords: oral health prevention, parental education, dental caries, attitudes and perceptions

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Authors: Amaal Almigal

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Neurotypical children learn to ask questions from natural exposure and this skill is fundamental for their academic success. However, children with autism spectrum disorder may not learn to ask in the same way due to earlier communication impairments, and some may need to use Augmentative and Alternative Communication systems (AAC) to ask questions. This paper aims to highlight issues related to questioning skills in children with autism giving a specific attention to asking questions within preverbal or minimally verbal children. Different procedures have been employed to teach these children, including AAC users, to ask questions. Therefore, these procedures will also be discussed to administrate how they were used and what they were aimed to teach. This paper also provides a suggested procedure to assist preverbal or minimally verbal children to ask questions using an iPad application for communication (Proloquo2Go) as AAC. This suggested procedure was used with 3 children with autism. Initial results will be discussed to clarify ways in which this procedure was used with each child based on his skills and which questioning skills each child has acquired using this procedure.

Keywords: AAC, autism, communication, information, iPad, requesting

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Authors: Rachelle M. Johnson, Jenna E. Finch

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Motivation, persistence, and learning disability status are all associated with academic performance, but to the author's knowledge, little research has been done on how these variables interact with one another and how that interaction looks different within children with and without learning disabilities. The present study's goal was to examine the role motivation and persistence play in the academic success of children with learning disabilities and how these variables interact. Measurements were made using surveys and direct cognitive assessments on each child. Analyses were run on student's scores in motivation, persistence, and ability to learn compared to other fifth grade students. In this study, learning ability was intended as a proxy for learning disabilities (LDs). This study included a nationally representative sample of over 8,000 fifth-grade children from across the United States. Multiple interactions were found among these variables of motivation, persistence, and motivation as they relate to academic achievement. The major finding of the study was the significant role motivation played in academic achievement. This study shows the importance of measuring the within-group. One key finding was that motivation was associated with academic success and was moderated by the other variables. The interaction results were different for math and reading outcomes, suggesting that reading and math success are different and should be addressed differently. This study shows the importance of measuring the within-group differences in levels of motivation to better understand the academic success of children with and without learning disabilities. This study's findings call for further investigation into motivation and the possible need for motivational intervention for students, especially those with learning disabilities

Keywords: academic achievement, learning disabilities, motivation, persistence

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Authors: Katherine Karayianis

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Children with Attention Deficit Hyperactivity Disorder (ADHD) have trouble learning in traditional classrooms. These children miss out on important developmental opportunities in school, which leads to challenges starting in early childhood, and these problems persist throughout their adult lives. Despite receiving supplemental support in school, children with ADHD still perform below their non-ADHD peers. Thus, there is a great need to find better ways of facilitating learning in children with ADHD. Evidence has shown that children with ADHD learn best through interactive engagement, but this is not always possible in schools, given classroom restraints and the large student-to-teacher ratio. Redesigning classrooms may not be feasible, so informal learning opportunities provide a possible alternative. One popular informal learning opportunity is educational TV shows like Sesame Street. These types of educational shows can teach children foundational skills taught in pre-K and early elementary school. One downside to these shows is the lack of interactive dialogue between the TV characters and the child viewers. Pseudo-interaction is often deployed, but the benefits are limited if the characters can neither understand nor contingently respond to the child. AI technology has become extremely advanced and is now popular in many electronic devices that both children and adults have access to. AI has been successfully used to create interactive dialogue in children’s educational TV shows, and results show that this enhances children’s learning and engagement, especially when children perceive the character as a reliable teacher. It is likely that children with ADHD, whose minds may otherwise wander, may especially benefit from this type of interactive technology, possibly to a greater extent depending on their perception of the animated dialogic agent. To investigate this issue, I have begun examining the moderating role of inattention among children’s learning from an educational TV show with different types of dialogic interactions. Preliminary results have shown that when character interactions are neither immediate nor accurate, children who are more easily distracted will have greater difficulty learning from the show, but contingent interactions with a TV character seem to buffer these negative effects of distractibility by keeping the child engaged. To extend this line of work, the moderating role of the child’s perception of the dialogic agent as a reliable teacher will be examined in the association between children’s attention and the type of dialogic interaction in the TV show. As such, the current study will investigate this moderated moderation.

Keywords: attention, dialogic TV, informal learning, educational TV, perception of teacher

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Authors: Tamene Keneni, Tibebu Yohannes

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The prevalence of autism spectrum disorder (ASD) in general and autism in particular is on the rise globally, and the need for evidence-based intervention and care for children with autism has grown, too. However, evidence on autism is scanty in developing countries, including Ethiopia. With the aim to help fill the gap and paucity in research into the issue, the main purpose of this study is to explore, better understand, and document the experiences and perceptions of parents of children with autism. To this end, we used a qualitative survey to collect data from a convenient sample of parents raising a child with autism. The data collected were subjected to qualitative analysis that yielded several themes and subthemes, including late diagnosis, parents’ reactions to diagnosis, sources of information during and after diagnosis, differing reactions to having a child with autism from siblings, extended family members, and the larger community, attribution of autism to several causes by the community, lack of recognition and open discussion of autism and lack of appropriated public educational and health care services for children with autism and their parents. The themes and subthemes identified were discussed in light of existing literature, and implications for practice were drawn.

Keywords: ASD, autism, children with autism, raising children with autism

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Authors: Bronwen Wade

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Over the last half-century, child welfare systems have increasingly relied on quantitative risk assessment tools, such as actuarial or predictive risk tools. These tools are developed by performing statistical analysis of how attributes captured in administrative data are related to future child maltreatment. Some scholars argue that attributes in administrative data can serve as proxies for race and that quantitative risk assessment tools reify racial bias in decision-making. Others argue that these tools provide more “objective” and “scientific” guides for decision-making instead of subjective social worker judgment. This study performs a systematic review of the literature on the impact of quantitative risk assessment tools on racial disproportionality; it examines methodological biases in work on this topic, summarizes key findings, and provides suggestions for further work. A search of CINAHL, PsychInfo, Proquest Social Science Premium Collection, and the ProQuest Dissertations and Theses Collection was performed. Academic and grey literature were included. The review includes studies that use quasi-experimental methods and development, validation, or re-validation studies of quantitative risk assessment tools. PROBAST (Prediction model Risk of Bias Assessment Tool) and CHARMS (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies) were used to assess the risk of bias and guide data extraction for risk development, validation, or re-validation studies. ROBINS-I (Risk of Bias in Non-Randomized Studies of Interventions) was used to assess for bias and guide data extraction for the quasi-experimental studies identified. Due to heterogeneity among papers, a meta-analysis was not feasible, and a narrative synthesis was conducted. 11 papers met the eligibility criteria, and each has an overall high risk of bias based on the PROBAST and ROBINS-I assessments. This is deeply concerning, as major policy decisions have been made based on a limited number of studies with a high risk of bias. The findings on racial disproportionality have been mixed and depend on the tool and approach used. Authors use various definitions for racial equity, fairness, or disproportionality. These concepts of statistical fairness are connected to theories about the reason for racial disproportionality in child welfare or social definitions of fairness that are usually not stated explicitly. Most findings from these studies are unreliable, given the high degree of bias. However, some of the less biased measures within studies suggest that quantitative risk assessment tools may worsen racial disproportionality, depending on how disproportionality is mathematically defined. Authors vary widely in their approach to defining and addressing racial disproportionality within studies, making it difficult to generalize findings or approaches across studies. This review demonstrates the power of authors to shape policy or discourse around racial justice based on their choice of statistical methods; it also demonstrates the need for improved rigor and transparency in studies of quantitative risk assessment tools. Finally, this review raises concerns about the impact that these tools have on child welfare systems and racial disproportionality.

Keywords: actuarial risk, child welfare, predictive risk, racial disproportionality

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Authors: Reshma P. Nuri, Ebenezer Dassah

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Introduction: Raising a child with a disability can affect family members in different ways. However, this can be determined by the way in which a family member copes with the situation. There is little research that explores how families develop coping strategies to overcome barriers in raising CWDs. Objective: This study explored family members’ coping mechanism in raising a child with disability in Bangladesh. Method: A qualitative approach that involved 20 interviews with family members of CWDs. A purposive sampling procedure was used in selecting the study participants. A digital recorder was used to record all the interviews. Transcriptions were done in Bengali, translated into English, and then imported to NVivo software 12 for analysis. Thematic analysis was used to analyze the data. Results: The study revealed that family members adopted different coping strategies for their CWDs, including seeking support from formal (e.g., service providers) and informal sources (family members and friends); relying on religious beliefs; accepting the situation. Additionally, to cope with extra cost in raising CWDs, family members strategies included relying on overtime work; borrowing money from financial institutions; selling or mortgaging assets; and replying on donations from community members. Finally, some families had to reduce spending on food and buying toys for their CWDs. Conclusion: This qualitative study highlighted a range of coping mechanism adopted by family members in Bangladesh. The information provided in this study is potentially important to policy makers and service providers as it presents evidence on the coping mechanism of families in raising their CWDs. This underscores the need for policy design and service delivery in government support system in Bangladesh and potentially in other low- and middle-income contexts.

Keywords: Bangladesh, children with disabilities, coping mechanism, family members

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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A preliminary systematic review shows that health professionals experience a tension when communicating with the parents and family members of children with life-threatening and life-limiting conditions. On the one hand, they want to promote open and honest communication, while on the other, they are apprehensive about fostering an unrealistic sense of hope. Defining the boundaries between information that might offer reasonable hope versus that which results in false reassurance is challenging. Some healthcare providers worry that instilling a false sense of hope could motivate parents to seek continued aggressive treatment for their child, which in turn might cause the patient further unnecessary suffering. To date, there has been a lack of research in the Middle East regarding how healthcare providers do or should communicate bad news; in particular, the issue of hope in the field of paediatric palliative care has not been researched thoroughly. This study aims to explore, from the perspective of patients’ mothers, physicians, and nurses, the experience of communicating and receiving bad news in the care of children with palliative care needs. Data were collected using a collective qualitative case study approach across three paediatric units in a Jordanian hospital. Two data collection methods were employed: participant observation and semi-structured interviews. The overall number of cases was 15, with a total of 56 interviews with mothers (n=24), physicians (n=12), and nurses (n=20) completed, as well as 197 observational hours logged. The findings demonstrate that mothers wanted their doctors to provide them with hopeful information about the future progression of their child’s illness. Although some mothers asked their doctors to provide them with honest information regarding the condition of their child, they still considered a sense of hope to be essential for coping with caring for their child. According to mothers, hope was critical to treatment as it helped them to stay committed to the treatment and protected them to some extent from the extreme emotional suffering that would occur if they lost hope. The health professionals agreed with the mothers on the importance of hope, so long as it was congruent with the stage and severity of each patient’s disease. The findings of this study conclude that while parents typically insist on knowing all relevant information when their child is diagnosed with a severe illness, they considered hope to be an essential part of life, and they found it very difficult to handle suffering without any glimmer of it. This study finds that using negative terms has extremely adverse effects on the parents’ emotions. Hence, although the mothers asked the doctors to be as honest as they could, they still wanted the physicians to provide them with a positive message by communicating this information in a sensitive manner including hope.

Keywords: health professionals, children, communication, hope, information, mothers, palliative care

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Authors: Anushree S. Panikkassery

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The paper analyses the pattern and trend of maternal health care in south Indian states. It studies the interstate disparities in terms of maternal health care. It also compares the trends in terms of achieving the target of sustainable development Goal is related to maternal health. The maternal health care (MHC) development is one of the key indicators for the development of health sector in the country and assumes significance from the socioeconomic and developmental perspectives. Maternal health care mainly consists of composite care during pregnancy, child birth as well as postpartum period. Antenatal care, identification, referral and management of high risk pregnancies, safe and healthy child birth and early postnatal care are some of the important issues pertaining to maternal health. Data is collected from national family health survey 1992-93, 1998-99, 2005-06, and 2015-16. A concentration index is used to study the disparities in equity of maternal health among south Indian states. The study shows that there has been an improvement in maternal health care in south Indian states with Kerala topping among the states. But there exist disparities among the south Indian states.

Keywords: antenatal care, disparities, equity, maternal health

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Authors: Ankita Shukla

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The promotion and support of breastfeeding is a global priority with benefits for maternal and infant health, especially in low income and middle-income countries where the probability of child survival is still very low. In India too it has been well established that breastfeeding increases the survival of the child. However, the breastfeeding levels are quite low in the country. Examining the socio-economic inequality in breastfeeding pattern can help to the causal pathways responsible for early breastfeeding termination. This paper tries to understand the socio-economic differential in breastfeeding patterns among Indian women. Data is used from nationally representative National Family Health Survey-3. Using Cox regression modelling techniques, the analysis found that the likelihood of having small breastfeeding duration increased with increasing household wealth status similarly education also has negative effect on breastfeeding duration. The considerable gender difference is also visible in India, likelihood of stopping breastfeeding was significantly higher among female children compared with male children. To understand the cultural factors or norms responsible for the early termination of breastfeeding more in depth/qualitative studies are needed.

Keywords: breastfeeding, India, socio-economic inequality, women education

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Authors: Sigrid James

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Purpose and Background: Despite a global policy push for deinstitutionalization, residential care for children and youth remains a relevant and highly utilized out-of-home care option in many countries, fulfilling functions of care and accommodation as well as education and treatment. While many youths are placed in residential care programs temporarily or during times of transition, some still spend years in programs that range from small group homes to large institutions. How residential care is used and what function it plays in child welfare systems is influenced by a range of factors. Among them are sociocultural and historical developments, available resources for child welfare, cultural notions about family, a lack of family-based placement alternatives as well as a belief that residential care can be beneficial to children. As part of a larger study that examined differences in residential care across 16 countries along a range of dimensions, this paper reports findings on utilization rates of residential care, i.e., the proportion of out out-of-home care dedicated to residential care relative to forms of family-based foster care. Method: Using an embedded multiple-case design study approach where a country represents a case, residential care in 16 countries was studied and compared. The comparison was focused on countries with developed social welfare systems and included Spain, Denmark, Germany, Ireland, the Netherlands, England, Scotland, Australia, Italy, Israel, Argentina, Portugal, Finland, France, the United States and Canada. Experts from each country systematically collected data on residential care based on a common matrix developed by the author. A range of sources were accessed depending on the information sought, including administrative data, government reports, research studies, etc. Utilization rates were mostly drawn from administrative data or government reports. While denominators may slightly differ, available data allowed for meaningful comparisons. Beyond descriptive data on utilization rates, analysis allowed to also capture trends in utilization (increasing, decreasing, stable) as well as the rate change. Results: Results indicate high variability in the utilization of residential care, covering the entire spectrum from a low of 7% to a high of 97%, with most countries falling somewhere in between. Three utilization categories were identified: high-users of residential care (Portugal, Argentina and Israel), medium-users (Denmark, France, Italy, Finland, Spain, Netherlands, Germany), and low-users (England, Scotland, Ireland, Canada, Australia, the United States). A number of countries experienced drastic reductions in residential care during the past few years (e.g. US), while others have seen stable rates (e.g., Portugal) or even increasing rates (e.g., Spain). Conclusions: Multiple contextual factors have to be considered when interpreting findings. For instance, countries with low residential care rates have, in most cases, undergone recent legislative changes to drastically reduce residential care. In medium-utilization countries, residential care reforms seem to be primarily focused on improving standards and, thus, the quality of care. High utilization countries generally face serious obstacles to implementing alternative family-based forms of out-of-home care. Cultural acceptance of residential or foster care and notions of professionalism also appear to play an important role in explaining variability in utilization.

Keywords: residential youth care, child welfare, case study, cross-national comparative research

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Authors: Annika Barzen

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In this article, the collection and analysis of drawings are implemented and discussed as a methodological approach to reconstruct children's perspective on horse-assisted interventions. For this purpose, drawings of three children (8-10 years old) were included in the research process in order to clarify the question of what insights can be derived from the drawings about the child's perspective on the intervention. The children were asked to draw a picture of themselves at the horse stable. Practical implementation considerations are disclosed. The developed analysis steps consider the work of two art historians (Erwin Panofsky and Max Imdahl) to capture the visual sense and to interpret the children's drawings. Relevant topics about the children's perspective can be inferred from the drawings. In the drawings, the following topics are important for the children: Overcoming challenges and fears in handling the horse, support from an adult in handling the horse and feeling self-confident and competent to act after completing tasks with the horse. The drawings show the main topics which are relevant for the children and can be used as a basis for conversation. All in all, the child's drawing offers a useful addition to other survey methods in order to gain further insights into the experiences of children in a horse-assisted setting.

Keywords: children's perspective, interpret children's drawings, equine-assisted-intervention, methodical analysis

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