Psychological outcome and quality of life in children born with congenital diaphragmatic hernia

OBJECTIVE: To assess psychological and social functioning as well as health-related quality of life and its early determinants in children born with congenital diaphragmatic hernia (CDH). DESIGN: Cross-sectional follow-up study. SETTING: Outpatient clinic of a tertiary care hospital. PARTICIPANTS: Thirty-three CDH survivors aged 6-16 years. Main exposure: Patients who developed CDH associated respiratory distress within 24 hours after birth. MAIN OUTCOME MEASURE: Psychological and social functioning assessed with the Wechsler intelligence scale for children (WISC-R), Bourdon-Vos test, Beery Developmental Test of visual motor integration, Child Behaviour Checklist (CBCL) and Teacher Report Form (TRF). Health-related quality of life assessed with the Child Health Questionnaire (CHQ) and the Health Utilities Index (HUI). RESULTS: Normal mean total IQ (100.0 +/- 13.2) and normal visual-motor integration, but significantly lower results for sustained attention (Bourdon-Vos test (38.8 +/- 11.2 points)) were found. Learning difficulties were reported by 30% of the parents. Eight children had scores in the clinical range on the CBCL and/or TRF, indicating clinical significant behavioural problems. Except for the CHQ scale "General health", health status was not different from the reference population. No significant correlations between test results and severity of CDH were found, except an association of general health and physical functioning with length of hospital stay. CONCLUSION: CDH patients are at risk for relevant subtle cognitive and behavioural problems, probably not related to CDH severity. These may contribute to school failure and need for special educational services. Perception of general health is reduced when compared to the reference population indicating that CDH survivors and their parents believe their health is poor and likely to get wors

Help-seeking behaviour for internalizing problems

Objective Although adolescent girls from ethnic minorities are at an increased risk of internalizing problems (e.g. depression), only a small fraction seeks formal help for these problems. To enhance help-seeking for internalizing problems among ethnic minority adolescent girls, insight into their help-seeking behaviour is required. This study explored the perceptions of adolescent girls from different ethnic backgrounds regarding their help-seeking behaviour for internalizing problems. Design A qualitative study using focus group discussions (FGDs) was employed. Eight ethnic-specific FGDs were conducted with 50 adolescent girls of mostly Turkish (n=23), Moroccan (n=13), and Dutch (n=10) backgrounds recruited in Rotterdam, a multicultural city in the Netherlands. FGDs were conceptually framed within a help-seeking model, facilitated by a vignette and analysed using NVivo software. Results When describing the internalizing problems presented in the vignette, participants of non-Dutch FGDs tended to state the causes of the problems (e.g. lack of attention) whereas participants of Dutch FGDs mentioned the emotional state. Participants did not perceive the presented internalizing problems as severe. If participants were to face internalizing problems of their own, their decision to seek help would be hampered by negative attitudes towards professionals and school-based services. Particularly in non-Dutch FGDs the fear of parental and friend's reactions was identified as a barrier. Participants identified their mother and a good friend as primary sources of help.ConclusionIn this study, adolescent girls of Turkish, Moroccan and Dutch backgrounds had difficulty recognizing the severity of internalizing problems, and various barriers could hamper their decision to seek help. To enhance utilization of mental health services by youth, promoting a change in their attitudes towards mental health/school-based services is recommended. Guaranteeing confidentiality within school-based services, and training for professionals in communicating with adolescent girls, may also prove beneficial. In ethnic minorities, tackling the negative reactions of family/friends requires attention

Preventing overweight and improving parenting skills from birth to age 3 years: preliminary results

Background. Parenting has been associated with child weight status. This study aims to evaluate the effects on parenting skills and BMI-SDS of the BBOFT+ overweight prevention program, compared to care-as-usual (CAU). Method. In a cluster-randomized trial, 2500 parents participated. Parent-reported weight and length were used. Parenting was measured with subscales control and reinforcement of the parenting strategies for eating and activity scale (PEAS) and the warmth subscale from the Child Rearing Questionnaire. Results. The first univariate analyses show that at age 15 months, no statistically significant differences in BMI- SDS, parental control, reinforcement or warmth were found between the BBOFT+ and the CAU group. Further cluster analyses need to be conducted. Results from age 36 months will be presented during the conference, which will include all subscales of the PEAS and an assessment of parenting styles. Conclusion. The intervention does not seem to have an effect on BMI-SDS or parenting

How to perform better intervention to prevent and control diabetic retinopathy among patients with type 2 diabetes

This meta-analysis of randomized controlled trials (RCTs) aims to investigate how to perform better interventions targeting modifiable risk factors of diabetic retinopathy (DR) to prevent and control DR in patients with type 2 diabetes by comparing different intervention types and follow-up intervals. Literature published before June 1st, 2019 were searched on Pubmed, Embase and ScienceDirect. RCTs targeting modifiable risk factors of DR (including blood glucose, blood pressure, lipid, dietary, physical activity and smoking) were selected by two reviewers and double checked for accuracy. Random effects models were estimated to calculate pooled Odds Ratios (OR). Twenty-two RCTs (n = 22,511) were included. In general, interventions targeting modifiable risk factor of DR reduced the risk of developing DR (I 2 = 26.7%; OR = 0.60; 95% CI 0.45 to 0.79) and DR worsening (I 2 = 0.0%; OR = 0.62; 95% CI 0.47 to 0.80; P < 0.001). Multifactorial interventions had better effect on reducing the risk of development and progression of DR in comparison with other interventions, while only blood-pressure-control interventions showed significant effect on slowing down DR worsening. Additionally, interventions with follow-up >5 years had better effect on reduction of DR development, and interventions with follow-up >2 years had better effect on reducing the risk of DR worsenin

Adolescents and MP3 Players: Too Many Risks, Too Few Precautions

OBJECTIVE. The goal was to assess risky and protective listening behaviors of adolescent users of MP3 players and the association of these behaviors with demographic characteristics and frequency of use. METHODS. In 2007, 1687 adolescents (12–19 years of age) in 68 classes in 15 Dutch secondary schools were invited to complete questionnaires about their music-listening behaviors. RESULTS. Ninety percent of participants reported listening to music through earphones on MP3 players; 32.8% were frequent users, 48.0% used high volume settings, and only 6.8% always or nearly always used a noise-limiter. Frequent users were _4 times more likely to listen to high-volume music than were infrequent users, and adolescents in practical prevocational schools were more than twice as likely to listen to high-volume music as were those attending preuniversity education. CONCLUSIONS. When using MP3 players, adolescents are very likely to engage in risky listening behaviors and are unlikely to seek protection. Frequent MP3 player use is an indicator of other risky listening behaviors, such as listening at high volumes and failing to use noise-limiter

Do children report differently from their parents and from observed data? Cross-sectional data on fruit, water, sugar-sweetened beverages and break-time foods

textabstractBackground: Reliable assessment of children's dietary behaviour is needed for research purposes. The aim of this study was (1) to investigate the level of agreement between observed and child-reported break-time food items; and (2) to investigate the level of agreement between children's reports and those of their parents regarding children's overall consumption of fruit, water and sugar-sweetened beverages (SSB). Methods: The children in this study were 9-13 years old, attending primary schools in Rotterdam, the Netherlands. Children were observed with respect to foods brought for break-time at school. At the same day, children completed a questionnaire in which they were asked to recall the food(s) they brought to school to consume during break-time. Only paired data (observed and child-reported) were included in the analyses (n = 407 pairs). To determine each child's daily consumption and average amounts of fruit, water and SSB consumed, children and their parents completed parallel questionnaires. Only paired data (parent-reported and child-reported) were included in the analyses (n =275 pairs). The main statistical measures were level of agreement between break-time foods, fruit, water and SSB; and Intra-class Correlation Coefficients (ICC). Results: More children reported bringing sandwiches and snacks for break-time than was observed (73 % vs 51 % observed and 84 % vs 33 % observed). The overall agreement between observed and child-reported break-time foods was poor to fair, with ICC range 0.16-0.39 (p < 0.05). Children reported higher average amounts of SSB consumed than did their parents (1.3 vs 0.9 L SSB, p < 0.001). Child and parent estimations of the child's water and fruit consumption were similar. ICC between parent and child reports was poor to good (range 0.22-0.62, p < 0.05). Conclusion: Children report higher on amount of break-time foods as compared to observations and children's reports of SSB consumption are higher than those of their parents. Since the level of agreement between the observed breaktime foods and that reported by children and the agreement of child's intake between parent and child reports are relatively weak, future studies should focus on improving methods of evaluating children's consumption behaviour or on ways on how to best use and interpret multiple-source dietary intake data

Associations between parent-adolescent attachment relationship quality, negative life events and mental health

Purpose: The aim of this study was to examine the association of negative life events and parent-adolescent attachment relationship quality with mental health problems and to explore an interaction between the parent-adolescent attachment relationship and one or multiple negative life events on the mental health of adolescents. Methods: A two-year longitudinal study was conducted among first-year secondary school students (N = 3181). The occurrence of life events and the quality of parent-adolescent attachment were assessed at baseline and mental health status at two-year follow-up by means of self-report questionnaires. Binary logistic regression analyses were conducted to assess associations between life events, parent-adolescent attachment and mental health problems. Relative Excess Risk due to Interaction techniques were used to determine the interaction effects on the additive scale. Results: Life events were related to mental health status, as was parent-adolescent attachment. The combined effect of an unfavourable parent-adolescent attachment with life events on mental health was larger than the sum of the two individual effects. Among adolescents with one life event or multiple life events, an unfavourable parent-adolescent attachment increased the risk of mental health problems at follow-up compared to the group without life events. Conclusion: Results supported an interaction effect between parent-adolescent attachment and negative life events on mental health. Especially adolescents with one or multiple life events and an unfavourable parent-adolescent attachment seems to be a vulnerable group for mental health problems. Implications for further research are discussed

Trajectories and predictors of women's health-related quality of life during pregnancy

The objective of this study was to identify distinct trajectories and their predictors of healthrelated quali

Parenting style, the home environment, and screen time of 5-year-old children; the 'be active, eat right' study

Introduction: The global increase in childhood overweight and obesity has been ascribed partly to increases in children's screen time. Parents have a large influence on their children's screen time. Studies investigating parenting and early childhood screen time are limited. In this study, we investigated associations of parenting style and the social and physical home environment on watching TV and using computers or game consoles among 5-year-old children. Methods: This study uses baseline data concerning 5-year-old children (n = 3067) collected for the 'Be active, eat right' study. Results: Children of parents with a higher score on the parenting style dimension involvement, were more likely to spend >30 min/day on computers or game consoles. Overall, families with an authoritative or authoritarian parenting style had lower percentages of children's screen time compared to families with an indulgent or neglectful style, but no significant difference in OR was found. In families with rules about screen time, children were less likely to watch TV>2 hrs/day and more likely to spend >30 min/day on computers or game consoles. The number of TVs and computers or game consoles in the household was positively associated with screen time, and children with a TV or computer or game console in their bedroom were more likely to watch TV>2 hrs/day or spend >30 min/day on computers or game consoles. Conclusion: The magnitude of the association between parenting style and screen time of 5-year-olds was found to be relatively modest. The associations found between the social and physical environment and children's screen time are independent of parenting style. Interventions to reduce children's screen time might be most effective when they support parents specifically with introducing family rules related to screen time and prevent the presence of a TV or computer or game console in the child's room

Contextual determinants associated with children's and adolescents' mental health care utilization:a systematic review

Determinants at the contextual level are important for children's and adolescents' mental health care utilization, as this is the level where policy makers and care providers can intervene to improve access to and provision of care. The objective of this review was to summarize the evidence on contextual determinants associated with mental health care utilization in children and adolescents. A systematic literature search in five electronic databases was conducted in August 2021 and retrieved 6439 unique records. Based on eight inclusion criteria, 74 studies were included. Most studies were rated as high quality (79.7%) and adjusted for mental health problems (66.2%). The determinants that were identified were categorized into four levels: organizational, community, public policy or macro-environmental. There was evidence of a positive association between mental health care utilization and having access to a school-based health center, region of residence, living in an urban area, living in an area with high accessibility of mental health care, living in an area with high socio-economic status, having a mental health parity law, a mental health screening program, fee-for-service plan (compared to managed care plan), extension of health insurance coverage and collaboration between organizations providing care. For the other 35 determinants, only limited evidence was available. To conclude, this systematic review identifies ten contextual determinants of children's and adolescents' mental health care utilization, which can be influenced by policymakers and care providers. Implications and future directions for research are discussed PROSPERO ID: CRD42021276033.</p