Design and evaluation of child abuse web-based application for parent education & strengthen.

BACKGROUND: Child abuse is one of the major health and social problems in the world and has severe short-term and long-term consequences on children's psychological, social and physical functioning. One of the effective strategies to control and prevent child abuse is training parent through web-based applications. The aim of this study is to design and evaluation of child abuse web-based application for parent education and strengthen. METHODS: This study is an applied-developmental study that performed in Razi Educational and Therapeutic Center in Tabriz. The study consisted of three main phases. The requirements assessment and design phases were completed between November 2022 and February 2023. The research community was parents referring to Razi Center and convenience sampling was used to select the samples. In firststage, a questionnaire was designed by searching in library sources and consulting with specialists for needs assessment and application design. The questionnaire was completed by psychiatric specialists, health information management and health information technology.Finally, the usability of designed application was evaluated with the participation of 30 parents and specialists. RESULTS: Based on the identified information elements and capabilities, a child abuse web-based application was designed. Application capabilities were such as concepts of child abuse, prevention and treatment strategies, parenting skills, childrens behavioral disorders, child abuse laws and interaction with clinical specialists. Finally, the result of the web-based application usability evaluation was evaluated at a good level equal to an average of 7.6 out of a total of 9 points. CONCLUSIONS: The possibility of expressing experiences, exchanging message, attractiveness, ease of use, and accessibility of parents, they were designed as application features. The usability of the web-based application was satisfactory to users in various of overall functionality, display, terminology, learning ability and overall application capability.

Serious educational games for children: A comprehensive framework.

Introduction: Serious educational games are digital games designed to support teaching or learning objectives that have become popular among children. However, a set of principles is needed to develop a successful educational game. Therefore, this study aimed to provide a comprehensive and valid framework for designing children's serious educational games. Methods: The conceptual framework is developed in two phases. First, a scoping review was conducted in PubMed, Ovid (APA PsycInfo), EMBASE, Scopus, Web of Science, ProQuest, and gray literature on August 1, 2022. Papers in English that reported the serious educational games' principles for children were included. Second, the extracted data from the previous step was reviewed and discussed by the research team to develop the initial framework. Then, it was distributed to 20 experts with relevant knowledge and experience in two rounds to validate and apply their comments within the framework. Results: Of the 12916 papers identified, 15 were included in this study. In the proposed framework named CoDHP, the results were classified into four topics, including (a) content aspects, (b) design requirements, (c) highlighted attributes, and (d) children's preferences. Content aspects comprise four classes (goals and limits, child learning content, learning context, and a long-term program) with 16 principles. Design requirements contain 11 classes (stories and storylines, player characters, game mechanics, interactivity, game challenge, game rules, game help, entertaining games, user interface, accessibility, and setting) with 47 principles, of which 15 are highlighted. Regarding children's preferences for the game elements, various similarities and differences were extracted. For instance, both girls and boys prefer fun and popular games. Based on experts' comments, 21 supplementary principles were recommended to complete the content and design requirements. Conclusion: Game designers or researchers can use the proposed framework as a formative guide to design successful serious games or evaluate children's digital games.

Evaluation of factors related to maternal anxiety during pregnancy among women referred to Tabriz primary care centers.

BACKGROUND: Maternal anxiety during pregnancy is sometimes considered a normal mechanism to overcome the mother's mental preoccupation with having a child. However, stress and anxiety might become a medical condition, becoming so severe as to affect the mother's mental health. Therefore, the present study aimed to investigate factors related to maternal anxiety during pregnancy in women referring to prenatal primary care centers in Tabriz. METHODS: The target population in the present cross-sectional study was the pregnant women referring to primary care centers affiliated with Tabriz University of Medical Sciences in 2018-2019 (n = 533). Sampling was carried out using the random cluster technique (separately for municipal centers). The data were collected using the study tools, including a questionnaire on demographic data, prenatal anxiety screening scale (PASS), and researcher-made questions on maternal anxiety during pregnancy. RESULTS: In the present study, 37.5% of pregnant women had anxiety. Of all the demographic and background variables, income (P = 0.015), a history of preterm delivery (P = 0.018), and unintended pregnancy (P = 0.022) were significantly related to anxiety. Of the variables of income, a history of preterm delivery, and unintended pregnancy in the regression model, the odds of anxiety were 41% lower in pregnant women with somewhat adequate income than those with inadequate income after correcting for other variables (P = 0.011). In addition, the variable of unintended pregnancy increased the odds of anxiety up to 49% after correcting for other variables (P = 0.023). CONCLUSION: The present study showed that income and unintended pregnancy significantly affect maternal anxiety during pregnancy. TRIAL REGISTRATION: The protocol of the study was approved by the Ethics Committee of Tabriz University of Medical Sciences under the code (IR.TBZMED.REC.1398.161).

Perceptions of the Professionals and Parents of Children with Autism Spectrum Disorders About Autism Services; A Qualitative Study.

In this qualitative study, we aimed to explore the challenges of providing services and supports for children with autism spectrum disorders (ASD) and their families from the perceptions of professionals and parents of children with ASD. We classified the results of the study into three key categories including shortcomings in the management of children with ASD; shortcomings of supportive programs and facilities for children with ASD and their families; and organizational challenges in providing services for these children. We analyzed data using the content analysis method. The results showed that there is a wide range of challenges in providing sufficient and high-quality services for children with ASD and empowerment programs for their parents.

A report on the blended short-term supplementary course on "Developmental Care for infants and toddlers" taught with a multidisciplinary approach for pediatricians -qualitative and quantitative study.

BACKGROUND: The implementation of follow-up programs for high-risk infants and toddlers aimed to promptly diagnose developmental delays and disorders and initiate early intervention to help improve their developmental status, reduce their care costs in the future, as well as improve their productivity as members of society. There is a lack of qualified specialists in the infant and toddler development field in Iran. To compensate for the lack of training in this area, for the first time, Tabriz University of Medical Sciences has designed a short-term supplementary course of "Developmental Care for Infants and Toddlers". Due to the multidisciplinary nature of the field of child development, this course has been designed as such. The current study aimed to evaluate this course and explain the graduates' relevant experiences using a multidisciplinary approach. METHODS: The current study is a quantitative/qualitative study conducted in two phases. In the first step, the learners were asked to assess the teaching quality of the short-term supplementary course of "Developmental Care for Infants and Toddlers" in 5 areas of "educational design," "course administrators' support", " learners' motivation ", "acquisition of general learning and specialized skills" using the Australian Course Experience Questionnaire (CEQ). All graduates completed the questionnaires. The data from the questionnaires were analyzed using descriptive statistics of medians, and interquartile ranges in SPSS software. The second step was a qualitative study to explain the graduates' experiences of this course with a multidisciplinary approach. The samples were selected using a purposive sampling technique. The samples were those who had completed the course mentioned above, had rich experiences in this field, and were willing to share them. The data were collected through semi-structured interviews and analyzed using conventional content analysis. RESULTS: In general, the graduates' satisfaction with the course in terms of the five areas studied was evaluated as follows: Educational design, motivating participants to do their best had the greatest median. 5(4-5), Learning objectives; in all items, the median was 4. Course content and resources; all items median were 4 .Relevant learner assessment methods; in all items, the median was 4.The median learners' satisfaction in the areas of "course administrators' support" in all items was 4 and "learners' motivation ", was 5. Learner's motivation" in all items it was 4, indicating the highest level of satisfaction with the "acquisition of specialized skills". In the area of education design, the highest satisfaction was found with the appropriateness of teaching strategies. The codes extracted from the analysis of interviews with the graduates, are divided into four categories: "Ethical and professional commitment of course teachers", "Being a role model in the observance of patients and their caregivers' rights", "Course planning with a multidisciplinary approach and teamwork" as well as "The use of virtual platforms to strengthen and maintain team communication between learners". CONCLUSION: This course was the first experience of applying a multidisciplinary approach in an interprofessional course. Ideally, it is indispensable for the Iranian medical education system to move away from specialization and connect all related specialties and disciplines to achieve its educational and therapeutic goals. Therefore, the design of this course can be applied as an educational model for other disciplines and clinical courses.

Digital games and virtual reality applications in child abuse: A scoping review and conceptual framework.

Child abuse refers to any form of maltreatment, including physical abuse, sexual abuse, emotional abuse, and neglect that occurs to children under 18 years of age. Digital games and virtual reality (VR) can be used as beneficial solutions for dealing with child maltreatment concerns. This study aimed to present a conceptual framework for showing the applications of these technologies in managing child abuse. The framework is developed in two stages: (1) a scoping review to gather digital games and VR applications for child abuse issues through the search in PubMed, Ovid (APA PsycInfo), Scopus, Web of Science, ProQuest, Institute of Electrical and Electronics Engineers (IEEE), Cochrane Database of Systematic Reviews, and grey literature and (2) developing a conceptual framework based on the review results and validating it by 12 experts. The proposed conceptual framework shows that digital games and VR have been used for six main topics: (1) medical education, (2) prevention, (3) screening, (4) diagnosis, (5) treatment, and (6) forensic medicine in response to child abuse issues. Studies have more focused on child sexual abuse prevention, behavioral monitoring of sexual offenders in forensic medicine, and knowledge or performance assessment of students in medical education. Serious games (SGs), computer simulation, and immersive VR were common technologies for children, students, and forensic medicine, respectively. The experts believe the combination of immersive features of VR with SGs can further encourage user engagement. It appears that digital games and VR can play a positive role in child abuse management. Given the extensive capabilities of these technologies, further studies are needed to show all their potential applications for child abuse problems.

The Characteristics and Results of Parent Training Interventions in Children with Autism Spectrum Disorder: A Systematic Review.

Background: The role of parents in taking care of children with Autism Spectrum Disorder (ASD) is critical. This systematic review aimed to investigate the characteristics and results of parent training interventions for autistic children. Methods: All relevant studies were searched using Boolean operators such as "AND" and "OR" with the keywords such as "Autism Spectrum Disorders," "Autism," "Autistic disorder," "Asperger syndrome," "Rett's syndrome", "Childhood disintegrative disorder", "Non-specific pervasive disorder", Parent*, Education*, train*, teach*, indoctrinate*, and instruct* in electronic databases such as PubMed, Scopus, Google Scholar, Cochrane Library, Science Direct, Web of knowledge, and also via manual searching in relevant journals, checking the reference list of articles, expert contact, and grey literature from 1 Jan 2000 to 30 Feb 2020. The retrieved studies were screened and reviewed then quality assessed by CONSORT checklist. The qualitative data were analyzed using content analysis method. Results: Eventually, 53 articles were considered in which 1758 parents with autistic children participated. Overall, 49 studies were conducted in high-income countries, 19 at home, 25 in training centers, 14 carried out only in training way, 39 in training along with practices and assignments, 30 individual interventions, and 21 in groups. Moreover, the effectiveness of interventions was studied in both parents and children groups. The results for parents show direct and indirect favorable impacts of interventions on them. The results for the children indicate direct and indirect favorable effects of the parents-based interventions on the child and the symptoms of their disorder. Conclusion: According to the included studies, parents-based training interventions significantly impact parents and their children's behavior.

A Qualitative Study on the Establishment of an Interpersonal Violence Registry System in Iran.

Establishment of an interpersonal-violence registry system (IPVRS) is a promising initiative to tackle violence. This qualitative study aimed to fill the gap in knowledge regarding the feasibility of establishing the IPVRS in the East-Azerbaijan province of Iran. This qualitative study using content analysis was conducted to explore the importance, challenges, and facilitating factors of establishing the IPVRS from the viewpoints of stakeholders. Forty-six individuals from the Forensic Medical Organization, the University, the Welfare Organization, the Training and Education Organization, hospitals, and primary health centers participated in the study. Six themes and 13 sub-themes were identified. The importance of the establishment of the IPVRS was sub-categorized into two main themes, including violence as a public health priority and severe consequences of violence including intensive health and social outcomes and high use of medical services. The most critical challenges of establishing the IPVRS were categorized into two main themes including victims' under-reporting due to financial difficulties as well as psychosocial barriers and structural barriers such as organizational barriers and methodological challenges. Inter-sectoral partnership was identified as the main facilitating factor in the successful establishment of the IPVRS. The participants recommended improving the development of the IPVRS by stepwise development of the program, resource absorption from other beneficiary organizations, and making more coverage in the registry system. In conclusion, the establishment of the IPVRS is identified as an effective strategy to tackle violence-related issues. Close collaboration with different governmental and non-governmental sectors and the gradual development of the registry system can pave the way for establishing the IPVRS. This study has several implications for identifying potential challenges and facilitators of the IPVRS applicable to other developing countries with similar contexts.

Disparities in the quality of and access to services in children with autism spectrum disorders: a structural equation modeling.

BACKGROUND: Socioeconomic disparities in health and healthcare are global issues that affect both adults as well as children. Children with exceptional healthcare needs, especially those with developmental impairments, including Autism Spectrum Disorders (ASD), encounter major disparities in access to and quality of health services. However, disparities in the population of children are rarely studied. The main aim of this paper is to study the socioeconomic disparities in children with ASD by examining the association between their Social Determinants of Health (SDH) status and access to and the quality of services. METHODS: This is a cross-sectional study on 202 children with ASD conducted in 2019 in two provinces including Ardabil and East-Azerbaijan, in the North-West of Iran. A structured, valid questionnaire was used to collect data on demographic, SDH status, quality of services, and access to services in a population of children with ASD aged 2-16-year-old. Around 77% participants were male and the mean age of children was 2 years and 6 months. Structural Equation Modeling (SEM) were used to assess the relationship. RESULTS: Based on the results of this study, the overall mean scores of the quality of services, access to services, and SDH status were 61.23 (30.01), 65.91 (21.89), and 29.50 (22.32) out of 100, respectively. All the associations between the quality and access dimensions and quality (B: 0.464-0.704) and access (B: 0.265-0.726) scales were statistically significant (P < 0.001). By adjusting to covariates, the access was also significantly related to service quality (P = 0.004). Finally, the associations between SDH score with service quality (P = 0.039) and access (P < 0.001) were positively significant. CONCLUSIONS: There are socioeconomic disparities in the quality of and access to services among children with ASD, who use ASD services, in the North-West of Iran. We recommend health/medical centers, where children are diagnosed with ASD, conducting SDH screening and providing families of low-SDH status with specific information about the quality of and access to services for children with ASD. Additionally, medical universities must have a plan to routinely monitor the quality of and access to services provided for the children with low SDH.

Considerations about the implementation of an autism screening program in Iran from the viewpoints of professionals and parents: a qualitative study.

BACKGROUND: The aims of this study were to explore to explore the viewpoints of parents of children with Autism Spectrum Disorders (ASD) and professionals regarding the implementation of screening programs for ASD, to explore the challenges of the implementation of a universal screening program for ASD in Iran from their viewpoints, and, to explore their recommendations to overcome the potential challenges. METHOD: This qualitative study was conducted using an inductive content analysis, between June 2018 and December 2018, in East-Azerbaijan province of Iran. Data was collected through in-depth interviews and focus group discussions. The participants were purposively selected among two groups: representatives of health system and representatives of children with ASD. A sample of 32 parents and 30 professionals were recruited in this study. RESULTS: Totally, 9 main themes and 23 sub-themes were extracted in three main areas including: viewpoints of the participants about universal screening for ASD, challenges in implementation of the universal screening program, and participants' recommendations about how to overcome the potential challenges. Main challenges in implementation of the universal screening program included: shortages of ASD screening tools, weakness of the health system, lack of coordination among the ASD service providers, and social and ethical issues. CONCLUSION: The parents and the professionals had different viewpoints about the implementation of ASD universal screening program in Iran. According to the professionals, there is not enough rational to implement ASD screening program for all children. However, the parents believed that universal screening program is inevitable, and it should be implemented in primary health centers during the early child-care visits. The results of this study open up unspoken issues that could help in initiating the screening program not only in Iran but also in other low- and middle-income countries as well.

Functional Brain Connectivity Differences Between Different ADHD Presentations: Impaired Functional Segregation in ADHD-Combined Presentation but not in ADHD-Inattentive Presentation.

INTRODUCTION: Contrary to Diagnostic and Statistical Manual of Mental Disorders (DSM-5), fifth edition, some studies indicate that ADHD-inattentive presentation (ADHD-I) is a distinct diagnostic disorder and not an ADHD presentation. METHODS: In this study, 12 ADHD-combined presentation (ADHD-C), 10 ADHD-I, and 13 controls were enrolled and their resting state EEG recorded. Following this, a graph theoretical analysis was performed and functional integration and segregation of brain network was calculated. RESULTS: The results show that clustering coefficient of theta band was significantly different among three groups and significant differences were observed in theta global efficiency between controls and ADHD-C. Regarding the alpha band, a lower clustering coefficient was observed in control subjects. In the beta band, clustering coefficient was significantly different between the control and children with ADHD-C and also between ADHD-I and ADHD-C. The clustering coefficient, in the subjects with ADHD-C, demonstrated a rapid decline and was significantly lower than the subjects with ADHD-I and control. CONCLUSION: Decreased clustering, in high thresholds, may be associated with hyperactivity while increased segregation in low thresholds with inattentiveness. A different functional network occurs in the ADHD-C brain that is consistent with several studies that have reported ADHD-I as a distinct disorder.

Sequences of mind development in boys with autism spectrum disorder.

Autism is a pervasive neurodevelopment disorder, primarily encompassing difficulties in the social, language, and communicative domains. One of the most common social cognitive theories of autism is based on theory of mind (ToM), the "mentalizing" ability needed to infer that others have their own beliefs and desires in order to understand their behavior. In the current study, this hypothesis was tested using Wellman and Liu's scaled ToM tasks. These were employed in the assessment of ToM development of verbal, school-aged high-functioning boys with autism spectrum disorder (ASD). The results indicated that children with ASD performed significantly worse than normal children on ToM tasks (Z = 4.7; P < 0 .001). However, it was shown that some of the ASD children were able to pass desire and false-belief tasks whereas none of them could succeed in knowledge and real-apparent emotion tasks.

Disordered Eating Attitudes and Their Correlates among Iranian High School Girls.

BACKGROUND: Disordered eating attitudes are contributing factors to the development of eating disorders. Adolescent girls are at high risk for eating diseases. In Iran, there is few data on the subject, especially in Azarian adolescent girls, so we did this study for assessing disordered eating attitudes and their correlates among Iranian Azarbaijani high school girls. METHODS: In a cross-sectional study, 1887 high school girls were selected. Eating Attitude Test-26 (EAT-26) and socio economical questionnaires were used. The EAT-26 score of 20 or higher defined as disordered eating attitudes. Data were analyzed using the Statistical Program for Social Sciences, by using from descriptive and analytical statistics. RESULTS: Reliability and validity of the translated EAT-26 were 0.80, 0.76, respectively. In studied subjects, mean (SD) of EAT-26 was 11.71(8.48). Totally, 16.7% (C.I with 95%: 15.1- 18.3%) of students had disordered eating attitudes. About half of the participants were unhappy with their body weight and considered themselves as obese. Mean of EAT-26 was higher in this group. Groups, who intent to weight loss, were smoker, and who had age of menarche less than 11 years, also had higher EAT-26 scores. Parent's literacy or job, birth order, family size or income and house ownership had not any significant effect on EAT-26 score. CONCLUSIONS: Persian version of EAT-26 has good reliability and validity for assessing disordered eating attitudes in Azarian girl adolescents. Prevalence of disordered eating attitudes among Azarian adolescent girls are in the range of some studies, but are less than Arabian countries, and some European ones. In adolescent girls, body weight dissatisfaction, smoking and early menarche has important role in eating attitudes.