Effect of various educational methods on increasing parents' awareness of their children's preventive orthodontic treatments

Aim: Like other fields of health, the main focus in dentistry has shifted from treatment to prevention of diseases. Parents have a vital role in deciding about their children's oral health issues. This study aims to investigate the effectiveness of four educational methods (including printed pamphlets, digital pamphlets, faceto-face education, and educational films) in increasing the awareness of parents about preventive orthodontic treatments. Methods: The study samples were selected from patients who were referred to the Pediatric Dentistry Department. 150 parents of children between 4-12 years old participated in the study. They filled out a questionnaire including demographic data and knowledge about orthodontic problems and their early treatments. Then they were divided into five groups (control, printed pamphlet, digital pamphlet, face-to-face, educational films) and after one month they repeated the test. Results: A total of 102 fathers and 48 mothers were evaluated. There was no statistical difference between different ages, sex, or income in terms of their awareness, but the awareness score between educational groups was different. There has been observed a significant increase in the awareness level of all four groups (except the control group) (P < 0.05). The highest score was seen in the video group. The difference between printed pamphlets and digital pamphlets was not significant. Conclusions: The results indicate that educational films are the most effective way of increasing awareness about preventive orthodontic treatments

Changes in Oral Health-Related Behaviors and Oral Health of Children in Early Childhood during Social Isolation Caused by COVID-19

ABSTRACT Objective: To assess changes in oral health-related behavior and oral health status in Brazilian children in early childhood perceived by their parents/caregivers during social isolation caused by COVID-19. Material and Methods: A cross-sectional study with parents/caregivers of children in southeastern Brazil aged 0-5 years who responded to an online questionnaire about sociodemographic data, dietary changes, oral hygiene, and oral health status of children during the COVID-19 pandemic. Results: Of the 119 parents/caregivers, 54.60% did not observe any changes in eating habits, and 81.50% maintained their children's oral hygiene. Associations were observed between the impact of the pandemic on the family income and changes in eating habits (p=0.02) and between lower family income and dental caries perceived by parents/caregivers (p=0.05). Z tests with Bonferroni correction showed that families with drastic income reduction were more likely to consume lower-cost foods (62.50%) than families with no impact or slight reduction on family income. Parents/caregivers did not identify dental caries (89.10%), toothache (92.40%), and dental trauma (92.40%) in their children. Conclusion: Parents/caregivers of children in southeastern Brazil aged 0-5 years observed behavioral changes in the dietary habits of families whose income was impacted by the pandemic, and their perception of dental caries was significantly associated with family income.

Intervenciones para el desarrollo infantil basadas en el Modelo Touchpoints: revisión de alcance / Interventions for child development based on the Touchpoints Model: scoping review / Intervenções para o desenvolvimento infantil baseadas no Modelo Touchpoints: revisão de escopo

Objetivo: mapear las características de las intervenciones para promover el desarrollo infantil que utilizaron el Modelo Touchpoints. Método: se trata de una revisión de alcance, guiada por las recomendaciones del JBI Reviewer's Manual, realizada en nueve bases de datos, en la literatura gris y en la lista de referencias de los estudios seleccionados. La pregunta de investigación fue "¿cuáles son las características de las intervenciones con padres/cuidadores y niños para promover el desarrollo infantil, desde el embarazo hasta los seis años, con base en el Modelo Touchpoints?". Se utilizó el Rayyan para la selección de los estudios y un guión para la extracción de datos. El análisis se realizó de forma descriptiva. Resultados: se incluyeron doce publicaciones. Las intervenciones fueron heterogéneas; concentradas en el período comprendido entre el embarazo y los tres años de edad; priorizó la difusión del contenido de los Touchpoints según la edad y los aspectos de parentalidad; la mayoría fueron realizadas por enfermeros, en la Atención Primaria de Salud y durante las visitas domiciliarias. Las intervenciones se relacionaron con el desarrollo general, una mayor comprensión del desarrollo y una mayor interacción con el niño. Conclusión: los estudios han demostrado potencial para obtener resultados favorables para el desarrollo infantil y la parentalidad. La variabilidad de las intervenciones dificultó el mapeo de las características más efectivas."

Objective: to map the characteristics of interventions to promote child development that used the Touchpoints Model. Method: this is a scoping review, guided by the recommendations of the JBI Reviewer's Manual, carried out in nine databases, in the gray literature and in the reference list of the selected studies. The research question was "what are the characteristics of interventions with parents/caregivers and children to promote child development, from pregnancy to six years of age, based on the Touchpoints Model?". Rayyan was used for the selection of studies and a standard form for data extraction. The analysis was carried out descriptively. Results: twelve publications were included in the review. Interventions were heterogeneous; concentrated in the period from pregnancy to three years of age; prioritized the dissemination of Touchpoints content according to age, and parenting aspects; most were performed by nurses, in Primary Health Care, and during home visits. Interventions were related to overall development, greater understanding of development and greater interaction with the child. Conclusion: studies have shown potential for favorable outcomes for child development and parenting. The variability of interventions made it difficult to map more effective characteristics.

Objetivo: mapear as características das intervenções para a promoção do desenvolvimento infantil que utilizaram o Modelo Touchpoints. Método: revisão de escopo, guiada pelas recomendações do JBI Reviewer's Manual realizada em nove bases de dados, na literatura cinzenta e na lista de referências dos estudos selecionados. A questão de pesquisa foi: quais são as características das intervenções com pais/cuidadores e crianças para promoção do desenvolvimento infantil, da gestação até os seis anos de idade, baseadas no Modelo Touchpoints? Foram utilizados o Rayyan, para a seleção dos estudos, e um roteiro, para a extração de dados. A análise foi realizada de forma descritiva. Resultados: foram incluídas doze publicações. As intervenções eram heterogêneas; concentradas no período da gestação até os três anos de idade; priorizaram a disseminação de conteúdo dos Touchpoints segundo idade e aspectos de parentalidade; a maioria foi realizada por enfermeiros na Atenção Primária à Saúde e na visita domiciliar. As intervenções foram relacionadas ao desenvolvimento global, à maior compreensão sobre o desenvolvimento e à maior interação com a criança. Conclusão: os estudos evidenciaram potencial para resultados favoráveis ao desenvolvimento infantil e à parentalidade. A variabilidade das intervenções dificultou mapear características mais efetivas.

El pediatra y los padres en la toma de decisiones de tratamiento en plagiocefalia posicional: una revisión narrativa / The pediatrician and parents in treatment decision-making in positional plagiocephaly: A narrative review

La plagiocefalia posicional (PP) es una de las causas más frecuentes de consulta en neurocirugía pediátrica. La incidencia de PP aumentó en los '90, a partir de la campaña Dormir de espaldas. Junto con el aumento de la demanda de atención, se verifica un debate acerca de la eficacia de los distintos tratamientos. La interacción padres ­ pediatra orientada a elegir la mejor terapéutica adquiere importancia, particularmente cuando se trata de decisiones sensibles a la preferencia. Es necesario saber más acerca de la naturaleza de la toma de decisiones de tratamiento de PP, para contribuir al desarrollo de procesos decisorios eficaces. Se realizó una revisión narrativa sobre investigaciones en toma de decisiones de tratamiento en PP. Se identificaron artículos en PubMed y Google Scholar (1990 ­ 2022) en una búsqueda con los descriptores "plagiocephaly", "decision making" y "parents". Se incluyeron artículos cuyo tema central fuera la toma de decisiones en PP, o que la desarrollaran como parte de otro tema. Se excluyeron trabajos en los que la toma de decisiones aparece de modo secundario o tangencial. Se encontraron 3 artículos con distintos diseños metodológicos, en los que la severidad de la presentación, los elementos socioculturales y emocionales, y los aspectos relacionados con el tratamiento son los factores más implicados en la toma de decisiones. Las relaciones entre la ansiedad parental, las expectativas de tratamiento y la percepción subjetiva de la PP, y el rol del pediatra como proveedor de información válida y confiable son temas que necesitan de ulterior investigación (AU)

Positional plagiocephaly (PP) is one of the main reasons for consultation in pediatric neurosurgery. The incidence of PP increased in the 1990s, after the "Back to Sleep" campaign. Concurrently, the growing demand for care has led to a debate regarding the effectiveness of the different treatments. The parent-pediatrician interaction is aimed at choosing the best therapeutic approach becomes important, particularly when it comes to preference-sensitive decisions. There is a need to better understand the nature of PP treatment decision-making in order to contribute to the development of effective decisionmaking processes. In this narrative review, we evaluated the research on treatment decision-making in PP. Articles were identified in PubMed and Google Scholar (1990 - 2022) using the search terms "plagiocephaly", "decision-making" and "parents". Articles were included if their central theme was decision-making in PP, or if they developed it as part of another subject. We excluded articles in which decision-making appeared in a secondary or tangential way. Three articles were identified with different methodological designs, in which the severity of the presentation, sociocultural and emotional aspects, and aspects related to treatment were the factors most implicated in decision making. The relationships between parental anxiety, treatment expectations, subjective perception of PP, and the role of the pediatrician as a provider of valuable and reliable information are topics that require further investigation (AU)

Percepção dos pais quanto aos impactos da pandemia do covid-19 no processo de aprendizagem infantil / Parents' perception of the impacts of the covid-19 pandemic on the process of childhood learning / Percepción de los padres sobre los impactos de la pandemia de covid-19 en el proceso de aprendizaje del niño

Introdução: Em 2020, a pandemia do COVID-19 mudou o cenário mundial quando a OMS declarou Emergência de Saúde Pública. Com as mudanças temporárias decorrentes da pandemia e por consequência do isolamento social, diversos setores sofreram adaptações e reajustes temporários. Pensando em reduzir os impactos, houve o retorno das aulas através do Ensino Remoto Emergencial (ERE). Com essas mudanças abruptas, o papel da família no processo de aprendizagem infantil ficou cada vez mais primordial. Objetivo: Analisar a aprendizagem de crianças do ensino infantil e fundamental da rede privada, sob a perspectiva dos pais quanto às práticas escolares remotas durante o isolamento social. Método: Estudo transversal, exploratório e de caráter quanti-qualitativo realizado a partir de um questionário contendo questões objetivas e discursivas no formato online. A pesquisa foi aprovada pelo Comitê de Ética e Pesquisa com Seres Humanos, sob o número de protocolo 4.473.160. Resultados: Os pais afirmam não terem notado dificuldade na aprendizagem das crianças e que não foi necessário fazer aquisição de aparelhos eletrônicos durante o período. Porém, houve flexibilidade curricular. Os participantes apontam que a maioria das escolas não ofereceram capacitação para utilizar os recursos digitais. E, ainda mencionam que houve mudança de humor e no comportamento das crianças. Conclusão: Em tese, o Ensino Remoto Emergencial foi necessário para a continuidade do processo de aprendizagem, contudo adversidades foram encontradas durante o curso, em virtude das escolas e das famílias não estarem preparadas para essa realidade. (AU)

Introduction: In 2020, the pandemic of COVID-19 changed the world scenario when the WHO declared a Public Health Emergency. With the temporary changes resulting from the pandemic and as a consequence of social isolation, several sectors underwent temporary adaptations and readjustments. To reduce the impact, classes have been resumed through Emergency Remote Education (ERE). With these abrupt changes, the family's role in the children's learning process became more and more primordial. Objective: To analyze the learning of children in kindergarten and elementary school in the private network, from the perspective of parents regarding remote school practices during social isolation. Method: Cross-sectional, exploratory, quantitative-qualitative study was carried out using a questionnaire containing objective and discursive questions in an online format. The research was approved by the Ethics and Research with Human Beings Committee, under protocol number 4.473.160. Results: Parents state that they did not notice any difficulty in the children's learning and that it was not necessary to make purchases of electronic devices during the period. However, there was curricular flexibility. The participants pointed out that most schools did not offer training to use digital resources. And, they also mention that there was a change in the mood and behavior of the children. Conclusion: In theory, Emergency Remote Learning was necessary for the continuity of the learning process, but adversities were encountered during the course because schools and families were not prepared for this reality. (AU)

Introducción: En 2020, la pandemia de COVID-19 cambió el escenario mundial cuando la OMS declaró Emergencia de Salud Pública. Los cambios temporales derivados de la pandemia y consecuencia del aislamiento social, varios sectores sufrieron adaptaciones y reajustes temporales. Con el fin de reducir los impactos, se reanudaron las clases a través del Aprendizaje a Distancia de Emergencia (ADE). Con estos cambios abruptos, el papel de la familia en proceso de aprendizaje de los niños se volvió cada vez más importante. Objetivo: Analizar el aprendizaje de los niños en las escuelas de infantil y primaria de la red privada, desde la perspectiva de los padres en relación a las prácticas de la escuela a distancia durante aislamiento social. Método: Estudio transversal, exploratorio y de carácter cuantitativo-cualitativo realizado a partir de un cuestionario conteniendo cuestiones objetivas y discursivas en formato online. La investigación fue aprobada por Comité de Ética e Investigación con Seres Humanos, bajo el número de protocolo 4.473.160. Resultados: Los padres afirman que no notaron dificultad en el aprendizaje de los niños y no fue necesaria adquisición de aparatos electrónicos durante período. Hubo flexibilidad curricular. Los participantes señalan que mayoría de las escuelas no ofrecían formación para utilizar los recursos digitales. También mencionan que hubo cambio de humor y en el comportamiento de los niños. Conclusión: En tesis, el ADE fue necesario para continuidad del proceso aprendizaje, sin embargo, se encontraron adversidades durante el curso, debido que las escuelas y las familias no estaban preparadas para esta realidad. (AU)

Conocimiento, creencias y aceptabilidad de la vacuna contra el Virus del Papiloma Humano en padres de Chihuahua, México / Knowledge, beliefs, and acceptability of human papillomavirus vaccination among parents in Chihuahua, Mexico

Introducción: La cobertura de vacunación contra el virus del papiloma humano no se ha realizado en la totalidad de la población, existen factores que interfieren en que los padres de las adolescentes acepten su aplicación. Objetivo: Relacionar el conocimiento sobre el virus del papiloma humano, el conocimiento sobre la vacuna contra el virus, las creencias sobre la vacuna con la aceptabilidad de la vacuna por los padres de las adolescentes de 9-12 años escolarizadas en Chihuahua, México.Materiales y Métodos: Estudio de tipo descriptivo, correlacional y transversal, la muestra fue de tipo censal, se conformó por 145 padres de niñas entre 9 a 12 años inscritas en tres primarias públicas ubicadas en una zona urbana de Chihuahua, México. Resultados: El conocimiento sobre el virus del papiloma humano se relacionó con la aceptabilidad de la vacuna (p < 0,009), de igual manera con el conocimiento acerca de la vacuna del virus del papiloma humano (p < 0,030) mientras que las creencias sobre el VPH y la vacuna no se relacionaron (p < 0, 747). Discusión: Los resultados coinciden con literatura previa en que el conocimiento sobre el virus y su vacuna es bajo, sin embargo, en este estudio las puntuaciones fueron más bajas. Mientras que la aceptabilidad de la vacuna contra el VPH tiende a ser alta al igual que estudios previos. Conclusiones: El conocimiento sobre el virus del papiloma humano y la vacuna se relacionaron con la aceptabilidad de los padres para aplicar la vacuna a sus hijas.

Introduction: Human papillomavirus vaccination coverage has not been achieved in the general population. There are factors that interfere with the acceptance of the vaccine by the parents of adolescent girls. Objective: To correlate knowledge of human papillomavirus, knowledge of the vaccine against the virus, and beliefs about the vaccine with vaccine acceptance among parents of adolescent girls aged 9-12 years in Chihuahua, Mexico. Materials and Methods: A descriptive, correlational, and cross-sectional study was conducted with a census sample of 145 parents of girls between the ages of 9 and 12 enrolled in three public elementary schools in an urban area of Chihuahua, Mexico. Results: Knowledge of human papillomavirus was related to vaccine acceptance (p < 0.009), as was knowledge of the human papillomavirus vaccine (p < 0.030). In contrast, beliefs about HPV and the vaccine were not related (p < 0.747). Discussion: The results are consistent with previous literature in that knowledge of the virus and its vaccine is low, but the scores were lower in this study. In contrast, HPV vaccine acceptance tends to be high, as in previous studies. Conclusions: Knowledge about human papillomavirus and the vaccine was associated with parental acceptance of giving it to their daughters.

Introdução: A cobertura vacinal contra o papilomavírus humano não tem sido realizada em toda a população, existem fatores que interferem na aceitação da sua aplicação pelos pais de meninas adolescentes. Objetivo: Relacionar o conhecimento sobre o papilomavírus humano, o conhecimento sobre a vacina contra o vírus, as crenças sobre a vacina com a aceitabilidade da vacina pelos pais de meninas adolescentes de 9 a 12 anos que frequentam a escola em Chihuahua, México. Materiais e Métodos: Estudo descritivo, correlacional e transversal, a amostra foi do tipo censitária, composta por 145 pais de meninas entre 9 e 12 anos matriculadas em três escolas primárias públicas localizadas em uma área urbana de Chihuahua, México. Resultados: O conhecimento sobre o papilomavírus humano esteve relacionado com a aceitabilidade da vacina (p < 0,009), da mesma forma com o conhecimento sobre a vacina contra o papilomavírus humano (p < 0,030), enquanto as crenças sobre o HPV e a vacina não foram relacionadas (p < 0,747). Discussão: Os resultados coincidem com a literatura anterior na medida em que o conhecimento sobre o vírus e sua vacina é baixo, porém, neste estudo as pontuações foram inferiores. Embora a aceitabilidade da vacina contra o HPV tenda a ser elevada como em estudos anteriores. Conclusões: O conhecimento sobre o papilomavírus humano e a vacina esteve relacionado à aceitabilidade dos pais em aplicar a vacina em suas filhas.

Características sociodemográficas e sinais de depressão e ansiedade em mães/pais/cuidadores de autistas / Sociodemographic characteristics and signs of depression and anxiety in mothers/fathers/caregivers of autistic children / Características sociodemográficas y signos de depresión y ansiedad en madres/padres/cuidadores de niños autistas

Objetivo: avaliar o impacto de características sociodemográficas sobre a intensidade de sinais de depressão e ansiedade em mães/pais/cuidadores de pessoas no espectro autista. Método: estudo transversal, analítico e quantitativo, realizado com 31 mães/pais/cuidadores de pessoas no espectro autista. Aplicou-se um formulário sociodemográfico e os inventários de Depressão e de Ansiedade de Beck. A análise foi realizada por meio de estatística descritiva e regressão linear, com método backward. Resultados: verificou-se que ser natural de Caxias (MA), ter maior escolaridade e maior quantidade de horas trabalhadas semanalmente contribuem para menor intensidade de sinais de depressão e ansiedade. Outrossim, o fato de desenvolver atividades laborativas diminui as chances de depressão e praticar alguma religião demonstrou-se relevante para a diminuição de sinais de ansiedade. Conclusão: algumas características sociodemográficas contribuem positivamente para a diminuição de sinais de depressão e ansiedade em mães/pais/cuidadores de pessoas autistas, o que denota a necessidade de conhecê-las e otimizá-las.

Objective: to evaluate the impact of sociodemographic characteristics on the intensity of signs of depression and anxiety in mothers/fathers/caregivers of people on the autistic spectrum. Method: cross-sectional, analytical and quantitative study, carried out with 31 mothers/fathers/caregivers of people on the autistic spectrum. A sociodemographic form and Beck's Depression and Anxiety inventories were applied. The analysis was performed using descriptive statistics and linear regression, with the backward method. Results: it was found that being born in Caxias (MA), having higher education and more hours worked weekly contribute to lower intensity of signs of depression and anxiety. Furthermore, the fact of carrying out work activities decreases the chances of depression and practicing a religion has been shown to be relevant for the reduction of signs of anxiety. Conclusion: some sociodemographic characteristics contribute positively to the reduction of signs of depression and anxiety in mothers/fathers/caregivers of autistic people, which denotes the need to know and optimize them.

Análise comparativa entre a influência da amamentação e hábitos bucais deletérios no crescimento craniofacial / Comparative analysis between the influence of breastfeeding and deleterial oral habits on craniofacial growth

A adoção da chupeta e mamadeira pelos pais podem trazer problemas no desenvolvimento craniofacial da criança. A sucção digital é outro fator influenciador da má formação da face, este pode ser antecedido pela mamadeira e chupeta. O conhecimento sobre o desenvolvimento facial correto ajuda no reconhecimento de desvios da normalidade. Foi realizada uma revisão da literatura a fim de analisar e comparar os efeitos no crescimento facial entre os hábitos deletérios e a amamentação fisiológica. Muitos registros de malformações causadas por hábitos deletérios foram encontrados. Conclui-se que a amamentação natural ainda é a melhor forma de alimentação para crianças, e nenhuma outra opção será melhor que a fisiológica, sendo aconselhável evitar o uso dos demais(AU)

The adoption of pacifiers and bottles by parents can bring problems in the child's craniofacial development. Finger sucking is another factor influencing the malformation of the face, which can be preceded by the bottle and pacifier. Knowledge about correct facial development helps in recognizing deviations from normality. A literature review was carried out in order to analyze and compare the effects on facial growth between harmful habits and physiological breastfeeding. Many records of malformations caused by deleterious habits were found. It is concluded that natural breastfeeding is still the best form of feeding for children, and no other option will be better than the physiological one, being advisable to avoid the use of the others(AU)

El difícil camino al diagnóstico del paciente con atrofia muscular espinal / The difficult path to diagnosis of the patient with spinal muscular atrophy

Introducción. Con las nuevas terapias, el diagnóstico temprano de la atrofia muscular espinal (AME) es esencial. El objetivo de este estudio es analizar los distintos componentes que influyen en el retraso diagnóstico. Población y métodos. Se incluyeron pacientes con un diagnóstico molecular de AME tipo I, II y III. Se estudiaron varios parámetros, como la edad al momento de la aparición del primer signo, qué signo fue y el intervalo entre este y el diagnóstico confirmado. Neurólogos especialistas realizaron entrevistas que se complementaron con la revisión de historias clínicas cuando fue necesario. Resultados. Se entrevistaron 112 pacientes. AME I n = 40, AME II n = 48, AME III n = 24. La mediana de edad en meses al momento del reporte del primer signo fue AME I: 1,5 (R 0-7), AME II: 9 (R 2-20), AME III: 18 (R 8-180). Los primeros signos fueron reconocidos por los padres en el 75 % al 85 % de las veces en todos los subtipos. La mediana del tiempo transcurrido entre el primer signo y la primera consulta médica fue menor a un mes en los tres tipos. La mediana de tiempo transcurrido en meses entre el primer signo y el diagnóstico molecular confirmado fue en AME I: 2 (R 0-11), en AME II: 10 (3-46) y en AME III: 31,5 (R 4-288). Conclusiones. Existe un significativo retraso en el diagnóstico de la AME relacionado fundamentalmente a la falta de sospecha clínica. La demora es menor en AME I y mayor en AME III. Otros factores incluyen deficiencias en el sistema de salud.

Introduction. News treatments, make early diagnosis of spinal muscular atrophy (SMA) critical. The objective of this study is to analyze the different factors that influence delay in diagnosis. Population and methods. Patients with a molecular diagnosis of types I, II, and III SMA were included. Several parameters were studied, such as age at onset of first sign, what sign it was, and the time from recognition of first sign to confirmed diagnosis. Neurologists specialized in SMA conducted interviews, supported by the review of medical records when deemed necessary. Results. A total of 112 patients were interviewed. SMA I n = 40, SMA II n = 48, SMA III n = 24. The median age in months at the time of reporting the first sign was SMA I: 1.5 (R: 0­7), SMA II: 9 (R: 2­20), SMA III: 18 (R: 8­180). In all subtypes, first signs were identified by parents from 75% to 85% of the times. The median time from first sign to first medical consultation was less than a month in all 3 types. The median time in months, from first sign to confirmed molecular diagnosis in SMA I was: 2 (R: 0­11), in SMA II: 10 (R: 3­46), in SMA III: 31.5 (R: 4­288). Conclusions. There is a significant delay in SMA diagnosis mainly related to the absence of clinical suspicion. The delay is shorter in SMA I and longer in SMA III. Other factors include deficiencies in the health care system.

Conocimientos de madres y padres sobre lactancia materna exclusiva / Knowledge level of parents on exclusive breast feeding i:en

Introducción: La leche materna es considerada la vacuna perfecta de todos los tiempos y la mejor fuente de nutrición para los niños. Objetivo: Determinar el nivel de conocimientos de madres y padres sobre lactancia materna exclusiva. Métodos: Se realizó un estudio descriptivo y transversal de 27 madres y 27 padres de lactantes con destete precoz, pertenecientes al área de salud del Policlínico Docente Camilo Torres Restrepo de Santiago de Cuba, desde enero hasta diciembre del 2021, para lo cual el instrumento empleado fue la encuesta. Resultados: Se halló que los conocimientos sobre lactancia materna fueron considerados altos en 13 madres (48,1 %) y medios en 11 padres (40,7 %). Todos los integrantes de la serie recibieron información sobre el tema y las vías fundamentales para ello fueron los medios de difusión masiva (85,0 %), seguidos de los familiares y amigos (55,0 %). Conclusiones: El conocimiento acerca de la lactancia materna exclusiva en los padres resultó insuficiente y, en las madres, fue necesario ampliar dichos conocimientos sobre las técnicas para amamantar.

Introduction: Breast milk is considered the perfect vaccine of all times and the best nutrition source for children. Objective: To determine the knowledge level of mothers and fathers on exclusive breast feeding. Methods: A descriptive and cross-sectional study was carried out of 27 mothers and 27 fathers of early weaning infants. They were from the health area of Camilo Torres Restrepo Teaching Polyclinic in Santiago de Cuba, from January to December, 2021, for which the survey was used. Results: It was found that knowledge on breast feeding was considered high in 13 mothers (48.1 %) and medium in 11 fathers (40.7 %). All members of the series received information on the topic and the fundamental ways were mass media (85.0 %), followed by relatives and friends (55.0 %). Conclusions: The knowledge about exclusive breast feeding in fathers was insufficient and, in mothers, it was necessary to increase this knowledge on the techniques to breastfeed.

Effects of the math anxiety of parents and peachers on students / Efeito da ansiedade matemática de pais e professores em escolares / Efecto de la ansiedad matemática de padres y profesores en estudiantes

The aim of the study was to demonstrate a relationship between the math anxiety (MA) of parents and teachers and the MA of children and the effects on the children's performance in arithmetic. 286 children aged between 7 and 10 years and their parents and mathematics teachers participated in the study. The instruments used were: Math Anxiety Questionnaire; School Performance Test - Arithmetic subtest; Mathematical Anxiety Scale; and Raven's Colored Progressive Matrices. The results showed that advanced age of the teacher was a predictor of high levels of MA, which influenced the children's performance in arithmetic. Low parental education was associated with high MA, however, there were no correlations between parents' and children's MA. A significant difference was found between the MA mean scores for girls and boys, with the girls presenting higher levels of MA. (AU)

O objetivo do estudo foi evidenciar a relação entre a ansiedade matemática (AM) dos pais e dos professores com a AM das crianças e o desempenho destas em aritmética. Participaram do estudo 286 crianças com idade entre 7 e 10 anos e seus respectivos pais e professores de matemática. Os instrumentos utilizados foram: Questionário de Ansiedade Matemática, Teste de Desempenho Escolar - Subteste de Aritmética, Escala de Ansiedade Matemática e Matrizes Progressivas Coloridas de Raven. Os resultados mostraram que a idade avançada dos professores é um fator preditor para altos níveis de AM, o que influencia no desempenho das crianças em aritmética. A baixa escolaridade dos pais está associada a alta AM, porém não foram encontradas correlações significativas entre AM de pais e crianças. Também foi encontrada uma diferença significativa entre as médias de AM para o sexo feminino e masculino, evidenciando que meninas possuem maiores níveis de AM. (AU)

El objetivo del estudio fue resaltar la relación entre la ansiedad matemática (AM) de padres y docentes con la AM de los niños y su desempeño en aritmética y de los niños. Participaron en el estudio 286 niños entre 7 y 10 años y sus respectivos padres y profesores de matemáticas. Los instrumentos utilizados fueron: Cuestionario de AM; Prueba de Rendimiento Escolar: Subprueba aritmética; Escala de AM; Matrices Progresivas Escala Coloreada de Raven. Los resultados mostraron que la edad avanzada de los docentes es un factor predictivo para altos niveles de AM, lo que influye en el rendimiento de los niños en aritmética. La baja educación de los padres se asocia con un alto AM, pero no se encontraron correlaciones significativas entre AM de padres e hijos. Asimismo, se encontró una diferencia significativa entre las medias de AM de niñas y niños, lo que demuestra que las niñas tienen niveles más altos de AM. (AU)

Emotional aspects of parents of children with dysphagia / Aspectos emocionais dos pais de crianças com disfagia

Dysphagia is a common swallowing disorder in the pediatric population, which may influence the quality of life and well-being of the family. The literature points to stress, guilt, and social isolation of family members. However, the management of psychosocial aspects involved in the treatment of pediatric dysphagia is rarely discussed. This study aimed to carry out an integrative review of the literature regarding the emotional aspects of parents of children with dysphagia. Therefore a search in the databases SciELO and PubMed was made, from January 2013 to June 2020, using the descriptors in Health Sciences (DeCs): "deglutition disorders" and "child". The search was performed with English and Portuguese language limiters using associated descriptors. The selection of the studies was performed by reading the title, abstract and, if necessary, full text, applying the inclusion and exclusion criteria. There were 2,169 publications, and 8 met the inclusion criteria. The included studies were examined according to the author, type of study, goals, emotional aspects involved in the treatment of swallowing disorders, and conclusions. The analysis was performed according to the presence of certain variables of the emotional aspects presented in the face of swallowing disorders, namely, parental stress, negative impact on parent/child interaction, guilt and frustration, and social isolation. The literature points out that pediatric dysphagia causes an emotional impact on the parents; indicating that it is necessary to offer emotional support and to adapt the clinical management to the different demands present in the clinic.

A disfagia é um distúrbio de deglutição comum na população pediátrica, podendo influenciar na qualidade de vida e no bem-estar da família. A literatura aponta estresse, culpa e isolamento social dos familiares. Entretanto, o manejo dos aspectos psicossociais envolvidos no tratamento da disfagia pediátrica raramente é discutido. Este estudo teve como objetivo realizar uma revisão integrativa da literatura sobre os aspectos emocionais de pais de crianças com disfagia. Para tanto, foi realizada uma busca nas bases de dados SciELO e PubMed, no período de janeiro de 2013 a junho de 2020, utilizando os descritores em Ciências da Saúde (DeCs): "distúrbios da deglutição" e "criança". A busca foi realizada com limitadores dos idiomas inglês e português usando descritores associados. A seleção dos estudos foi realizada por meio da leitura do título, resumo e, se necessário, texto completo, aplicando-se os critérios de inclusão e exclusão. Houve 2.169 publicações e 8 preencheram os critérios de inclusão. Os estudos incluídos foram examinados quanto ao autor, tipo de estudo, objetivos, aspectos emocionais envolvidos no tratamento dos distúrbios da deglutição e conclusões. A análise foi realizada de acordo com a presença de algumas variáveis ​​dos aspectos emocionais apresentados diante dos distúrbios da deglutição, a saber, estresse parental, impacto negativo na interação pais/filhos, culpa e frustração e isolamento social. A literatura aponta que a disfagia pediátrica causa impacto emocional nos pais; indicando que é necessário oferecer suporte emocional e adequar o manejo clínico às diferentes demandas presentes na clínica.

Comparación del desempeño de dos pruebas para la evaluación del neurodesarrollo infantil en un hospital pediátrico de la Ciudad Autónoma de Buenos Aires / Comparison of the performance of two tests for the assessment of child neurodevelopment in a children's hospital in the City of Buenos Aires

Introducción. La detección precoz de los trastornos del desarrollo permite aplicar acciones que mejoren su evolución y pronóstico. En nuestro país, la Prueba Nacional de Pesquisa (PRUNAPE) requiere de un profesional certificado. El Instrumento de Observación del Desarrollo Infantil (IODI) es una herramienta de vigilancia sistematizada del desarrollo que no requiere especialización para su aplicación. La utilización del IODI como herramienta de evaluación del neurodesarrollo sería de utilidad por su fácil aplicabilidad. Objetivo. Evaluar el desempeño del IODI como prueba de vigilancia de trastornos del desarrollo utilizando la PRUNAPE como patrón de oro. Población y métodos. Estudio prospectivo analítico de prueba diagnóstica. Se incluyeron de forma aleatoria pacientes de 1 mes a 4 años, cuyos padres dieron el consentimiento para participar. Se evaluó el desempeño del IODI usando la PRUNAPE como patrón de oro. Se estimaron los valores de clivaje de sensibilidad (S), especificidad (E), valores predictivos positivo y negativo (VPP y VPN), y las razones de verosimilitud positiva y negativa (RVP y RVN, respectivamente). Resultados. Se evaluaron 91 pacientes; 24 no pasaron la PRUNAPE, de los cuales 21 tampoco pasaron el IODI (sensibilidad: 87,5 %; especificidad: 79,1 %; valor predictivo positivo: 60,1 %; valor predictivo negativo: 94,6 %). Razón de verosimilitud positiva: 4,2; negativa: 0,2. Conclusión. El IODI mostró un desempeño aceptable como prueba de vigilancia de trastornos del desarrollo en comparación con la PRUNAPE.

Introduction. An early detection of developmental disorders allows to implement actions to improve their course and prognosis. In Argentina, the administration of the National Screening Test (Prueba Nacional de Pesquisa, PRUNAPE) requires a certified professional. The Child Development Observation Instrument (Instrumento de Observación del Desarrollo Infantil, IODI) is a systematized developmental surveillance tool that does not require specialization for its administration. The use of the IODI as a neurodevelopmental assessment tool would be useful because of its easy applicability. Objective. To assess the performance of the IODI as a surveillance test for developmental disorders using the PRUNAPE as a gold standard. Population and methods. Analytical, prospective study with a diagnostic test. Patients aged 1 month to 4 years, whose parents gave consent to participate, were included randomly. The IODI performance was assessed using the PRUNAPE as the gold standard. Sensitivity (S), specificity (Sp), positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (PLR and NLR) were estimated. Results. Ninety-one patients were assessed; 24 failed the PRUNAPE, of these, 21 also failed the IODI (S: 87.5%, Sp: 79.1%, PPV: 60.1%, NPV: 94.6%). PLR: 4.2, NLR: 0.2. Conclusion. The IODI showed an acceptable performance as a developmental disorders surveillance test compared to the PRUNAPE.

Experiências de luto parental após um natimorto: uma síntese temática no contexto da América Latina / Parental grieving experiences after stillbirth: a thematic synthesis in the context of Latin America

OBJETIVO: Sintetizar estudos qualitativos sobre as experiências de luto após um natimorto em pais que vivem na América Latina. MÉTODO: Revisão sistemática qualitativa realizada em quatro bases de dados eletrônica e que utilizou o Guideline Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). A qualidade metodológica dos estudos incluídos foi avaliada usando o Critical Appraisal Skills Programme e uma síntese temática foi realizada. RESULTADOS: Um total de 110 estudos foram encontrados e quatro estudos eleitos com base nos critérios de elegibilidade. Quatro temas apresentam a experiência de luto parental: impacto, sofrimento e transformação após a morte fetal; preocupação com o corpo do bebê falecido; insatisfação com a qualidade da assistência em saúde; e família e religião como principais fontes de apoio. CONCLUSÃO: A natimortalidade na América Latina precisa ser explorada em pesquisas futuras e ainda é marcada pela desassistência no processo de luto.

OBJECTIVE: To synthesize qualitative studies on Latin American parents' grieving experiences after a stillbirth. METHOD: A systematic qualitative review was conducted in four electronic databases using the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guideline. The methodological quality of included studies was assessed using the Critical Appraisal Skills Programme, and a thematic synthesis was performed. RESULTS: One hundred ten studies were found, and four were chosen based on the eligibility criteria. Four themes were identified concerning the experience of parental grieving: impact, suffering, and transformation after fetal death; preoccupation with the deceased baby's body; dissatisfaction with the quality of health care; and family and religion as the primary sources of support. CONCLUSION: Stillbirth in Latin America must be explored in future research, and a lack of assistance still marks the grieving process.

General anesthesia versus deep sedation for dental treatment in children: comparison of parental acceptance, oral health-related quality of life, and treatment efficacy / 南方医科大学学报

OBJECTIVE@#To compare the parental acceptance of dental treatment under general anesthesia and deep sedation in children and assess the changes in postoperative oral health-related quality of life and treatment efficacy.@*METHODS@#The parents of 131 children undergoing dental treatment in the Department of Stomatology of Sichuan Provincial People's Hospital from January, 2022 to June, 2022 were surveyed using a questionnaire of children's advanced oral behavior management, and 83 children receiving general anesthesia or deep sedation for dental treatment between January, 2018 and December, 2021 were also investigated for changes in quality of life after the treatment using a questionnaire. The treatment efficacy was assessed at the 1-year follow-up visit in 149 children who received dental treatment under general anesthesia or deep sedation during the same period.@*RESULTS@#The survey of perantal acceptance showed that 62.6% of the parents preferred deep sedation, 29.01% preferred general anesthesia, and 8.4% preferred compulsory treatment. Dental treatments under general anesthesia and deep sedation both significantly improved oral health-related quality of life of the children. While dental surgeries under general anesthesia resulted in the most significant improvement of pain symptoms, deep sedation was associated with both obvious relief of the children's pain symptoms and reduction of the parents' pressure level. No significant difference was found in the efficacy of treatments under general anesthesia and deep sedation at the 1-year follow-up.@*CONCLUSION@#Dental treatment in children under deep sedation has the highest parental acceptance, followed by treatment under general anesthesia, and the acceptance of compulsory treatment is the lowest. The treatments under general anesthesia and deep sedation significantly improve the quality of life of the children and their parents and both have good treatment efficacy.

Reliability and validity of the Chinese version of adverse childhood experiences international questionnaire in parents of preschool children / 北京大学学报(医学版)

OBJECTIVE@#To test the reliability and validity of the Chinese version of adverse childhood experiences international questionnaire (ACE-IQ) in Chinese parents of preschool children.@*METHODS@#The parents of preschool children in 6 kindergartens in Tongzhou District of Beijing were selected by stratified random cluster sampling, and the Chinese version of ACE-IQ after translation and adaptation was used for survey online. The collected data were randomly divided into two parts. One part of the data (n=602) was used for exploratory factor analysis (EFA), to screen items and evaluate structural validity, and then form the final Chinese version of ACE-IQ. The other part of the data (n=700) was used for confirmatory factor analysis (CFA), criterion validity analysis and reliability analysis. At the same time, experts investigation method was used to evaluate the content validity of the final Chinese version of ACE-IQ.@*RESULTS@#After deleting four items of collective violence, the Chinese version of ACE-IQ with twenty-five items indicated good structural, criterion and content validity. Analysis results showed that the Chinese version of ACE-IQ presented a seven-factor model dimension, namely emotional neglect, physical neglect, family dysfunction, family violence, emotional and physical abuse, sexual abuse and violence outside the home, and the total score of the binary version of ACE-IQ Chinese version was positively correlated with the total score of childhood trauma questionaire-28 item short form (CTQ-SF, r=0.354, P < 0.001) and the center for epidemiological studies depression scale (CES-D, r=0.313, P < 0.001) respectively. Results from five experts showed that the item-level content validity index (I-CVI) of 25 items was between 0.80 and 1.00, and the average of all I-CVIs on the scale (S-CVI/Ave) of the scale was 0.984. At the same time, the internal consistency (Cronbach's α coefficient) of the whole scale was 0.818, and the split-half reliability (Spearman-Brown coefficient) was 0.621, which demonstrated good reliability.@*CONCLUSION@#This study has formed a Chinese version of ACE-IQ with 25 items and 7 dimensions, which has good reliability and validity among the parents of preschool children in China. It can be used as an evaluation instrument for measuring the minimum threshold of the adverse childhood experiences in the parents of preschool children in the cultural background of China.

Effects of screen exposure on language skills in children / 中华儿科杂志

Objective: To investigate the association between screen exposure and language skills in children aged 2-5 years. Methods: There were 299 children aged 2-5 years, recruited by convenience sampling from those who visited the Center of Children's Healthcare, Children's Hospital, Capital Institute of Pediatrics for routine physical examination from November 2020 to November 2021. Their development status were evaluated by the children neuropsychological and behavioral scale (revision 2016). A self-designed questionnaire for parents was conducted to collect demographic and socioeconomic information and screen exposure characteristics (time and quality). One-way ANOVA and independent sample t test were applied to compare the differences in language development quotient of children with different screen exposure time and quality. Multiple linear regression was used to analyze the correlation between screen exposure time and quality with language developmental quotient. Multivariate Logistic regression was used to analyze the risk of language underdevelopment in children with different screen exposure time and quality. Results: Among 299 children, 184 (61.5%) were boys and 115 (38.5%) were girls, with the age of (3.9±1.1) years. The number of children with daily screen time <60, 60-120 and>120 min was 163 children (54.5%), 86 children (28.8%) and 50 children (16.7%), respectively, with the language development quotients of 94±13, 90±13, 84±14, respectively, demonstrating a statistically significant difference (F=8.92, P<0.001). Logistic regression analysis revealed that screen exposure time of 60-120 and >120 min per day were both risk factors for children's language developmental quotients (OR=2.28, 95%CI 1.00-5.17, P=0.043; OR=3.96, 95%CI 1.86-9.17, P<0.001), and co-viewing and exposure to educational programs were both protective factors for children's language developmental quotients (OR=0.48, 95%CI 0.25-0.91, P=0.024, OR=0.36, 95%CI 0.19-0.70, P=0.003). Conclusions: Excessive exposure screen time and inappropriate screen exposure habits are associated with children's poorer language development. Screen exposure time should be limited and screen use should be rational to promote children's language skills.

Analysis of a child with X-linked intellectual disability due to a maternal de novo splicing variant of the PAK3 gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic etiology for a child with profound intellectual disabilities and obvious behavioral abnormalities.@*METHODS@#A male child who had presented at the Zhongnan Hospital of Wuhan University on December 2, 2020 was selected as the study subject. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing. Short tandem repeat (STR) analysis was carried out to determine its parental origin. The splicing variant was also validated in vitro with a minigene assay.@*RESULTS@#WES results revealed that the child had harbored a novel splicing variant of c.176-2A>G in the PAK3 gene, which was inherited from his mother. The results of minigene assay have confirmed aberrant splicing of exon 2. According to the guidelines from the American College of Medical Genetics and Genomics, it was classified as a pathogenic variant (PVS1+PM2_Supporting+PP3).@*CONCLUSION@#The novel splicing variant c.176-2A>G of the PAK3 gene probably underlay the disorder in this child. Above finding has expanded the variation spectrum of the PAK3 gene and provided a basis for genetic counseling and prenatal diagnosis for this family.

Identification of a NONO gene variant in a child with congenital heart disease and global developmental delay / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a child with congenital heart disease (CHD) and global developmental delay (GDD).@*METHODS@#A child who was hospitalized at the Department of Cardiac Surgery of Fujian Children's Hospital on April 27, 2022 was selected as the study subject. Clinical data of the child was collected. Umbilical cord blood sample of the child and peripheral blood samples of his parents were collected and subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing and bioinformatic analysis.@*RESULTS@#The child, a 3-year-and-3-month-old boy, had manifested cardiac abnormalities and developmental delay. WES revealed that he had harbored a nonsense variant of c.457C>T (p.Arg153*) in the NONO gene. Sanger sequencing showed that neither of his parents has carried the same variant. The variant has been recorded by the OMIM, ClinVar and HGMD databases, but not in the normal population databases of 1000 Genomes, dbSNP and gnomAD. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), it was rated as a pathogenic variant.@*CONCLUSION@#The c.457C>T (p.Arg153*) variant of the NONO gene probably underlay the CHD and GDD in this child. Above finding has expanded the phenotypic spectrum of the NONO gene and provided a reference for the clinical diagnosis and genetic counseling for this family.