Patterns of anxiety symptoms in toddlers and preschool-age children: Evidence of early differentiation

The degree to which young children’s anxiety symptoms differentiate according to diagnostic groupings is under-studied, especially in children below the age of 4 years. Theoretical (confirmatory factor analysis, CFA) and statistical (exploratory factor analysis, EFA) analytical methods were employed to test the hypothesis that anxiety symptoms among 2–3-year-old children from a non-clinical, representative sample would differentiate in a manner consistent with current diagnostic nosology. Anxiety symptom items were selected from two norm-referenced parent-report scales of child behavior. CFA and EFA results suggested that anxiety symptoms aggregate in a manner consistent with generalized anxiety, obsessive–compulsive symptoms, separation anxiety, and social phobia. Multi-dimensional models achieved good model fit and fit the data significantly better than undifferentiated models. Results from EFA and CFA methods were predominantly consistent and supported the grouping of early childhood anxiety symptoms into differentiated, diagnostic-specific categories

Percepción del personal de salud sobre la adecuación intercultural de los servicios maternos en establecimientos de la Micro Red Cono Sur de la Dirección Regional de Salud Tacna, 2016

OBJETIVO: Determinar si existen diferencias en la percepción del personal de salud sobre la adecuación intercultural de los servicios maternos en establecimientos de la Micro Red Cono Sur de la Dirección Regional de Salud Tacna en el 2016. MATERIAL Y MÉTODOS: El presente estudio es de tipo no experimental, la población objeto de estudio fue el personal profesional de salud que labora en los establecimientos de salud de la Micro Red Cono Sur de Tacna. (N: 149), construyéndose la muestra por 108 personas que laboran en, el C.S San Francisco, el P.S. 5 de noviembre, P.S. Vista Alegre, P.S. Viñani y P.S. Las Begonias, de la Micro Red Cono Sur de la Dirección Regional de Salud Tacna en el 2016. RESULTADOS: En los establecimientos de la micro Red de Cono Sur, el personal de salud tiene una percepción poco favorable con un 50.9%, sobre la adecuación intercultural de los servicios maternos. En el establecimiento de Salud; C.S. San Francisco, de la micro Red de Cono Sur, el personal de salud tiene una percepción en su mayor porcentaje como poco favorable con un 71.4%. En el establecimiento de Salud; P.S. Las Begonias, de la micro Red de Cono Sur, el personal de salud tiene una percepción en su mayor porcentaje como poco favorable con un 57.1%. En el establecimiento de Salud; P.S. 5 de noviembre, de la micro Red de Cono Sur, el personal de salud tiene una percepción en su mayor porcentaje como favorable con un 75.0%. En el establecimiento de Salud; P.S. Vista Alegre, de la micro Red de Cono Sur, el personal de salud tiene una percepción equivalente entre sus porcentajes como favorable con un 50.0% y poco favorable con un 50%. En el establecimiento de Salud; P.S. Viñani, de la micro Red de Cono Sur, el personal de salud tiene una percepción en su mayor porcentaje como favorable con un 57.1%. CONCLUSIÓN: en los establecimientos de la Micro Red de Cono Sur, el personal de salud en su conjunto tiene una percepción poco favorable, por ello se concluye que si existen diferencias en la percepción del personal de salud sobre la adecuación intercultural de los servicios maternos

Relación entre el nivel de conocimientos y actitudes sobre la alimentación saludable y el nivel de anemia en gestantes en Tacna

La anemia es una complicación frecuente en el embarazo; por tanto, se requiere conocimientos y actitudes sobre alimentación saludable para superarla. Objetivo: Determinar la relación entre el nivel de conocimientos y actitudes sobre alimentación saludable en gestantes anémicas y el nivel de la anemia en la Microred Metropolitana de la Red de Salud Tacna. Material y métodos: Estudio correlacional y de corte transversal en 74 gestantes con anemia, de 18 a 45 años, pertenecientes a la Microred Metropolitana de la Red de Salud Tacna, con reciente dosaje de hemoglobina y consentimiento informado. Los datos se recolectaron en un cuestionario en el consultorio de obstetricia de los cinco establecimientos de salud que conforman la microred, mediante una entrevista a las gestantes. Para el procesamiento y análisis estadístico se utilizó los softwares microsoft excel y SPSS versión 20 para windows. Se presentan tablas y gráficos con pruebas estadísticas Fisher y Chi-cuadrado x2. Resultados: El 62,2 % de las gestantes cursaban el tercer trimestre de gestación, el 35,1 % fueron primigestas, el 44,6 % presentaron sobrepeso, el 33,8 % normopeso y el 6,7 % delgadez. Se encontró que el 58,1 % tenía anemia leve y el 41,9 % anemia moderada. El 56,8% de las gestantes en general presentaron medio o regular nivel de conocimiento sobre alimentación saludable; de esta cantidad, el 31,1 % fue de gestantes con anemia leve y 25,7 % fue de gestantes con anemia moderada. El 67,6 % de gestantes con anemia presentaron actitud favorable sobre alimentación saludable, de las cuales el 40,6 % presentaba anemia leve y el 27,0 % presentaba anemia moderada. Conclusiones: Existe relació n estadísticamente significativa entre el nivel de conocimiento y actitud sobre alimentación saludable y nivel de la anemia en las gestantes

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Linking Universal Developmental/Behavioral Health Screening and On-Site Mental Health Consultation: Examining Gaps in Service Delivery

Universal screening and on-site mental health consultant (MHC) support within pediatric primary care settings may improve problem identification and service receipt, thus reducing children\u27s unmet developmental and behavioral health (DBH) needs. However, there is limited research about universal DBH screening and on-site MHC support in pediatric settings. The overarching aim of this mixed-method study was to describe the effectiveness and characteristics of a model that placed MHCs in primary care pediatric settings to facilitate universal DBH screening and referrals. The investigation was conducted within the framework of Project RI LAUNCH (Linking Actions for Unmet Needs in Children\u27s Health), a study involving the integration of universal screening and on-site MHC support into pediatric practices in Providence, RI. Quantitative aims were focused on describing: 1) the effectiveness of universal screening, 2) the profile of DBH problems and parent concerns identified during screening; 3) referral dispositions following screening; and 4) predictors of attendance at the MHC appointment. Qualitative aims were focused on better understanding screening and collaborative care from the perspective of parents, staff, and providers. Parents of children less than 9 years with a scheduled screen-eligible visit (1,451) were included in the quantitative sample. Interviews were conducted with 16 parents and 29 staff members. Findings suggest that integrating universal DBH screening and MHC support is feasible and can improve problem detection. Yet despite the benefits, findings suggest several gaps in service delivery. Due to a variety of reasons, many families do not receive/complete screening nor attend MHC appointments. While parental DBH concerns are often well founded, there are limitations in the extent to which parental concerns should be relied on as a proxy for child behavior, particularly for younger children. Young children were found to be at increased risk of falling through service delivery gaps compared with older children given that their parents were less likely to report behavioral concerns (even when screening indicated the presence of problems), providers referred them to MHCs at lower rates and, among those referred, were less likely to attend these appointments. Recommendations include decreased screener length and increased information for parents about DBH, screening, and referrals

Improving Show Rates for Mental Health Appointments in an Integrated Pediatric Primary Care Clinic

Background: Integrated mental health (MH) is relatively new in pediatrics but shows promise for increasing access to MH services. Barriers for families engaging in MH care are well described for traditional settings and include stigma, logistical barriers (e.g., child care), socioeconomic status, and parental MH problems. Families may face similar barriers when accessing MH care in the primary care setting. Little is known about ways to improve family engagement in an integrated setting. Objective: 1) Determine the current show rate for psychology appointments at two academic health centers within Children’s National Health System: the Children’s Health Center (CHC) and Adolescent Health Center (AHC). 2) Improve the psychology appointment show rate through creation of a pre-appointment, personal phone call reminder. Design/Methods: We used QI methodology with a PDSA cycle to implement a phone call reminder system one business day prior to a week’s worth of psychology appointments. A retrospective chart review allowed us to determine appointment show rates and no-show rates pre- and post-intervention. Results: At baseline, the psychologist saw 176 patients April-May, 2017, which reflects a combination of same-day and scheduled appointments. The show rate over this time period for scheduled appointments was 48%, the no-show rate was 43%, and 9% canceled/rescheduled. For context, the average show rate for medical visits is ~70%. The average interval between scheduling date and MH appointment date was 14.02 days (±8.49). The length of this interval did not impact attendance. There was also no difference in show rates for new consults vs. follow-ups. We were able to reach 54% of the families we attempted to contact to remind them of their scheduled MH appointment. The subsequent show rate for the following week was 33%, the no-show rate was 38%, and 29% canceled/rescheduled. Although the show rate did not improve, the no-show rate decreased as patients were able to reschedule appointments during the reminder phone calls. This intervention shows promise for improving utilization of the integrated psychologist by affording increased flexibility to provide same-day consultations during known cancellations. Conclusion(s): Families do seem to face barriers to attending MH appointments even in an integrated setting. This PDSA cycle laid a foundation for regularly collecting data on show rates for the psychologist and for future interventions to increase family engagement in MH care

Internet and mobile technology use among urban African American parents: Survey study of a clinical population

Background: There is considerable potential for mobile technologies to empower pediatric patients and families by improving their communication with health professionals. National surveys suggest minority parents frequently communicate via mobile technology, but it is uncertain how amenable they are to receiving health care information in this format. Although the low cost and far reach characteristics of mobile health (mHealth) technology makes it advantageous for communication with minority parents, data on acceptance are needed.Objective: The objective of the study was to determine utilization of mobile and Internet technology by African American parents in an urban, underserved population, and to assess their interest in receiving health information via text messaging or other technologies (eg, social media and the Internet). Methods: A survey was administered to parents of children aged 1-12 years covered by public insurance receiving care at 3 pediatric primary care centers in Washington, DC. Results: The African American sample (N=302) was composed of primarily single (75.8%, 229/302) mothers. Almost half had more than a high school education (47.7%, 144/302) and incomes above US $25,000 per year (43.0$25,000 annually were 4 times as likely to own a tablet computer than their lower income counterparts. Of the participants, 80.8% (244/302) used social networking, primarily Facebook, and 74.2% (224/302) were interested in joining a social networking group about a health topic concerning their child. Although relatively few African American mothers (17.9%, 54/302) shared health information via texting, there was strong interest in receiving health information via mobile phones (87.4%, 264/302). There was no significant difference in Internet/mobile device use or interest in using these outlets to send/receive information about their children’s health between parents of healthy children and parents of children with chronic health conditions. Conclusions: Urban African American parents are active users of the Internet and mobile technology for social interactions, but they are less likely to use it for accessing or communicating health information. However, most parents expressed an interest in receiving health information or utilizing social networking to learn more about health topics. Mobile technology and social networks may be an underutilized method of providing health information to underserved minority populations