Mental health clinical pathways for children and young people with long-term health conditions: A systematic review.

RATIONALE: Clinical pathways (CPWs) are structured care plans that set out essential steps in the care of patients with a specific clinical problem. Amidst calls for the prioritisation of integrated mental and physical health care for young people, multidisciplinary CPWs have been proposed as a step towards closer integration. There is very limited evidence around CPWs for young people with mental and physical health needs, necessitating a review of the literature. AIMS AND OBJECTIVES: The aim of this review is to understand how clinical pathways have been used to deliver mental health support to children and young people with long-term physical health conditions and their effectiveness across a range of outcomes. METHODS: The databases MEDLINE, CENTRAL, PsycINFO and CINAHL were searched from inception to 6 September 2023. Keywords linked to children and young people, mental health, long-term physical health conditions and CPWs were used. Studies using either quantitative or qualitative research designs were included. All studies must have evaluated a CPW to provide mental health support to children and young people (up to 25 years old) with long-term health physical conditions. Both mental and physical health outcomes were considered. Pathways were grouped by integration 'model' as described in the wider literature. RESULTS: The initial search returned 4082 studies after deduplication. A total of eight studies detailing six distinct care pathways (232 participants [170 children and young people; 50 caregivers; 12 healthcare professionals]) met eligibility criteria and were included in the analysis. Four pathways were conducted within an 'integrated model'; two were a combination of 'integrated' and 'colocated'; and none within a 'co-ordinated model'. Only pathways within an integrated model reported quantitative health outcomes, with improvements across a range of mental health measures. One negative physical health outcome was reported from an integrated diabetes pathway, but this should be interpreted with caution. CONCLUSION: This review identified a range of CPW designs but most fell under an integrated model. The results suggest that calls for integrated mental health pathways in this population may be appropriate; however, conclusions are limited by a paucity of evidence.

A prática psicológica e a ludicidade na hospitalização pediátrica: relato de experiência / Psychological practice and playing in pediatric hospitalization: experience report / La práctica psicológica y la ludicidad en la hospitalización pediátrica: informe de experiencia

INTRODUÇÃO: A inserção da psicologia e o método lúdico de intervenção na esfera hospitalar surge para promover bem-estar frente às vivências das crianças em condição de internação. O enfrentamento de uma hospitalização no período da infância pode provocar impactos significativos do ponto de vista orgânico, psíquico e ambiental, por ser um momento de estruturação do indivíduo enquanto sujeito psíquico. OBJETIVO: Posto isso, o presente artigo objetiva refletir sobre a relação da família e da equipe de saúde com crianças hospitalizadas e a relevância da utilização dos recursos lúdicos, a partir de um relato de experiência de estagiários de um curso de graduação em psicologia. MÉTODO: Logo, trata-se de um relato de experiência, de abordagem qualitativa e de natureza descritiva, realizado de março de 2022 a junho de 2023, em uma Unidade Pediátrica de um Hospital Público Brasileiro. RESULTADOS E DISCUSSÃO: A partir disso, observaram-se na prática reações de estranhamento dos pacientes ao se depararem com a permanência no hospital, o adoecimento e os procedimentos das equipes multiprofissionais de saúde; bem como evidenciou-se a importância da transmissão das informações e do preparo verbal ante intervenções, visando a participação ativa do paciente em seu tratamento. Também observou-se a significância do uso de ferramentas lúdicas nas intervenções com as crianças, que facilitam a adaptação ao contexto e proporcionam âncora para estas elaborarem suas vivências. CONCLUSÃO: Portanto, conclui-se que a utilização de recursos lúdicos favorece o atendimento psicológico na infância e período de hospitalização.

INTRODUCTION: The integration of psychology and the playing method of intervention in the hospital setting emerges to promote wellbeing in the face of children's experiences during hospitalization. Confronting hospitalization during childhood can lead to significant impacts from organic, psychological, and environmental standpoints, as it represents a pivotal moment in the individual's psychological development. OBJECTIVE: With this in mind, the present article aims to reflect on the relationship between families and healthcare teams with hospitalized children and the relevance of using playful resources, based on an experience report from interns of an undergraduate psychology course. METHOD: Therefore, it constitutes an experiential account, employing a qualitative and descriptive approach, conducted from March 2022 to June 2023, in a Pediatric Unit of a Brazilian Public Hospital. RESULTS AND DISCUSSION: From this perspective, practical observations revealed patients' feelings of unfamiliarity upon facing hospital stays, illness, and procedures performed by multidisciplinary healthcare teams; as well as the significance of conveying information and verbal preparation before interventions was highlighted, aiming to actively involve the patient in their treatment. It was also observed the significance of using playful tools in interventions with children, which facilitates adaptation to the context and provides an anchor for them to elaborate on their experiences. CONCLUSION: Thus, it can be concluded that the use of playful resources enhances psychological care during childhood and the hospitalization period.

INTRODUCCIÓN: La inserción de la psicología y el método lúdico de intervención en el ámbito hospitalario surge con el propósito de promover el bienestar frente a las experiencias de los niños en condiciones de hospitalización. Enfrentar la hospitalización durante la infancia puede generar impactos significativos desde un punto de vista orgánico, psicológico y ambiental, ya que representa un momento de estructuración del individuo como sujeto psíquico. OBJETIVO: En este sentido, el presente artículo tiene como objetivo reflexionar sobre la relación de la familia y el equipo de salud con niños hospitalizados y la relevancia de utilizar recursos lúdicos, a partir de un relato de experiencia de practicantes de un curso de grado en psicología. MÉTODO: Por lo tanto, se trata de un informe de experiencia con enfoque cualitativo y de naturaleza descriptiva, llevado a cabo desde marzo de 2022 hasta junio de 2023 en una Unidad Pediátrica de un Hospital Público Brasileño. RESULTADOS Y DISCUSIÓN: A partir de esto, se observaron reacciones de desconcierto por parte de los pacientes al enfrentar la permanencia en el hospital, la enfermedad y los procedimientos realizados por los equipos de salud multidisciplinarios; así como también se resaltó la importancia de la transmisión de información y la preparación verbal antes de las intervenciones, con el objetivo de involucrar activamente al paciente en su tratamiento. También se observó la importancia del uso de herramientas lúdicas en las intervenciones con niños, ya que facilitan la adaptación al contexto y brindan un punto de referencia para que estos niños elaboren sus experiencias. CONCLUSIÓN: Por lo tanto, se concluye que el uso de recursos lúdicos favorece la atención psicológica durante la infancia y el período de hospitalización.

The Role of Parental Emotional Health and Parenting Practices in Offspring Mental Health.

In the family social environment, children can experience and observe stressful situations, involving mental health and parental practices. The review by Mendes-Sousa et al. examines the relation between family stress, child development, and offspring mental health. Of the main results, we highlight the relationship between maternal depression with developmental delays and child internalizing and externalizing symptoms. Furthermore, negative parenting practices were also related to children's emotional and behavioral problems, while positive practices were beneficial to the socio-emotional development of offspring. The review warns about preventing socio-emotional problems in offspring, through promoting parental mental health, positive parenting practices, and cohesive family environments. Finally, we envision a significant path for subsequent research on maternal emotional overload and the central role of mothers in caring for their offspring, exploring shared care for children and potential public policies aimed at mothers' mental health and social inclusion.

Shaping Smiles: A Narrative Review of Crown Advancements in Pediatric Dentistry.

This review examines the evolution of dental crowns in pediatric dentistry, highlighting the transition from traditional materials such as stainless steel to aesthetic and biocompatible alternatives like zirconia, resin-based composites, and Bioflex crowns. It focuses on their importance in repairing decayed or damaged teeth and improving children's oral health and psychological well-being. The methodology involved a comprehensive literature search over the past two decades, utilizing databases including PubMed, Google Scholar, and Chat.Consensus.App, with keywords related to pediatric dental crowns. The findings indicate that stainless steel crowns (SSCs) are valued for durability and cost-effectiveness, but they may cause hypersensitivity. Zirconia crowns are favored for biocompatibility, resistance, and aesthetics, although they are costlier and require more tooth reduction. Resin-based composite strip crowns offer a balance of aesthetics and function but have challenges in long-term stability. The review also touches on Bioflex crowns, noting their flexibility, but the limited research on their effectiveness. In summary, the review underscores the vital role of various dental crown materials in pediatric dentistry, stressing the importance of ongoing research to enhance clinical outcomes and pediatric patient quality of life. The selection of crown materials should consider efficacy, aesthetics, and the psychosocial effects on young patients.

A comparison of WPPSI-IV performance between Finland-Swedish minority children and the Scandinavian test norms: Findings from The FinSwed Study.

OBJECTIVE: The Swedish Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) is commonly used for assessing young children belonging to the Swedish-speaking minority in Finland (Finland-Swedes), but there is no information about the generalizability of this test and its norms to this minority. Cross-cultural comparisons of WPPSI-IV are also scarce. We compared the performance of Finland-Swedish children to the Scandinavian norms of the Swedish WPPSI-IV and explored the relationship between sociodemographic factors (age, sex, parental education level, bilingualism) and the performance. METHOD: The Swedish WPPSI-IV was administered to 79 typically developing 5-6-year-old Finland-Swedish children assessed for The FinSwed Study. Their performance was compared to the Scandinavian norms using MANOVA, t-test, and confidence interval comparisons. Associations with sociodemographic variables were explored using regression analyses. RESULTS: Finland-Swedish children performed, on average, 1/3 SD higher than the Scandinavian norms, a difference which was statistically significant with medium-sized effects. However, individual subtests and indexes did not differ significantly from the norms. Significant associations with sociodemographic factors were found for some but not all index scores. CONCLUSIONS: This study provides clinically important information for using the Swedish WPPSI-IV with the Finland-Swedish minority and demonstrates aspects that clinicians working with this minority should take into account. The results are presumably partly explained by characteristics of the present sample, and partly by cultural and linguistic differences between the Finland-Swedish population and the Scandinavian countries. The findings also illustrate that cross-cultural differences in cognitive performance may be present even between similar cultures with the same language.

Toy Preferences among 3-to-4-Year-Old Children: The Impact of Socio-Demographic Factors and Developmental Characteristics.

Background: Today's common typologies and categories of children's toys are mainly decided by the manufacturers and retailers of children's products. Such categorizations are not based on a theoretical understanding of child development and therefore cannot provide information about the opportunities that toys provide for the young. Objective: This study proposed three criteria for categorizing toys based on the cultural-historical approach: their degree of realism; their degree of anthropomorphism; and their degree of detail. These criteria were chosen as a result of an analysis of theoretical works carried out in the framework of cultural-historical approach. Design: The proposed criteria were tested through an experiment measuring children's toy preferences. The participants were 129 children of ages 3-4 years. Experimental data confirmed that most children do prefer realistic and detailed toys rather than those with fewer of these properties. The contribution of socio-demographic factors and the children's individual developmental indicators to their toy preference was also analyzed. Results: The study revealed that among various socio-demographic factors, only the child's gender and the number of siblings in the family acted as significant predictors for the toy preferences. None of child's developmental characteristics (nonverbal intelligence, executive functions, and emotional understanding) were found to be significant predictors of preference for particular toys. Conclusions: The assumption that toys can be assessed in terms of their realism and degree of detail found empirical support. The results of this study may be useful in designing further research and in the practical issue of toy selection for children age 3-4 years.

How do the identities of ethnic and left-behind children influence their depression? Evidence from ethnic minority areas of Sichuan Province, China.

Millions of ethnic children in China live without their parents due to financial constraints and the lure of job opportunities elsewhere, staying in their hometowns primarily for education. Yet, current research inadequately addresses the mental health status of these left-behind children from ethnic minority communities in China. This study aimed to explore the effects of the combined identities-ethnic and left-behind-on depression among children in rural ethnic minority areas. We recruited a sample of 1131 children aged 12 to 16 from the Garzê Tibetan Autonomous Prefecture (also known as Ganzi Prefecture) in Sichuan Province. The Children's Depression Inventory was employed to assess depression levels. Results indicated that left-behind children in this region exhibited significantly higher depression levels than their counterparts who lived with their parents. Notably, children of Han ethnicity were more depressed than other ethnic groups. However, no interactive effects were observed between the dual identity factors. Intriguingly, Han children, despite being the majority ethnicity in China, perceived themselves as ethnic minorities in these areas. Their self-perception of ethnic pressure and differences, coupled with a potential lack of acceptance of their ethnic differences from the native minorities, might be subdued. This study underscores that parental relocation poses a risk to the mental health of adolescents in rural China. While policies and programs supporting left-behind children are crucial, further research is imperative to comprehend the nuances of their experiences fully.

Almost Forgotten Research Contexts: William Stern's Giftedness Research.

This article examines the concept of intelligence and giftedness of the German psychologist and philosopher William Stern, the leading intelligence and giftedness researcher in Germany from the early 20th century to 1933. Stern developed a multifactorial giftedness model that integrated empirical and philosophical perspectives and was thus far ahead of his time. This concept was not taken up for a long time-not least because of the break that the research on giftedness suffered in Germany in 1933-and has not yet been presented with the required complexity and interdisciplinarity. In the USA, Stern's research has so far been reduced to the IQ formula he created. The author presents Stern's concept of giftedness in the context of the particular scientific-historical and educational-political situation in Germany in the first third of the 20th century. The pedagogical conclusions that Stern associated with the research on giftedness, and which essentially referred to the requirement to support all gifted children, regardless of social class, are also illuminated.

O desenvolvimento emocional infantil na formação médica: uma análise documental / Children's emotional development in medical education: a documentary analysis

As Diretrizes Curriculares Nacionais do Curso de Graduação em Medicina defendem que o médico deve promover a saúde integral. Na pediatria, a importância do cuidado integral é ainda maior, pois a criança é um ser em desenvolvimento físico, cognitivo e socioemocional e o desenvolvimento infantil envolve o corpo e o psiquismo indissociavelmente. O objetivo deste estudo foi investigar disciplinas que abordem conteúdos de desenvolvimento emocional infantil, saúde mental na infância e constituição psíquica do indivíduo na formação médica. Trata-se de uma pesquisa documental, na qual Projetos Pedagógicos das Escolas Médicas do estado de Minas Gerais foram analisados. Dentre um total de 39 escolas, apenas 18 atenderam aos critérios de inclusão. As categorias temáticas analisadas foram: Objetivo do curso e o perfil do egresso; A presença da interdisciplinaridade; Psicologia Médica; Psicologia infantil nas disciplinas de Pediatria; A saúde mental infantil. Constatou-se que não há padronização do ensino médico em relação ao oferecimento de conteúdos da psicologia e saúde mental infantil, desenvolvimento emocional e constituição psíquica do sujeito. Essa constatação traz a reflexão sobre os prejuízos na assistência integral à infância que poderiam ser evitados e a necessidade de iniciativas de um ensino interdisciplinar.

The National Curriculum Guidelines for Undergraduate Medicine Education state that physicians should promote integral health. In pediatrics, the importance of integral care is even greater, as the child is a being in physical, cognitive and socioemotional development, and child development involves the body and the psyche inextricably. The aim of this study was to investigate subjects that address childhood emotional development, mental health in childhood, and psychic constitution of the individual in medical training. This is a documentary research, in which Pedagogical Projects of Medical Schools in the State of Minas Gerais were analyzed. Among a total of 39 schools, only 18 met the inclusion criteria. The thematic categories were: 1. Course objective and graduate profile; 2. The presence of interdisciplinarity; 3. Medical Psychology; 4. Child psychology in Pediatrics; and 5. Child health. It was found that there is no standardization of medical education in terms of offering content on child psychology and mental health, emotional development, and psychic constitution of the subject. This finding brings a need for teaching about integral education in childhood that can be designed to be an interdisciplinary initiative.

Do executive function and family factors predict children's preference for trendy over classic toys? An experimental investigation.

In the last decade, global trends and social media have covered almost the entire world, including children population. The toy industry is filled with new items whose popularity has been triggered by viral publications on social networks or by popular animated films. The present experimental study is the first to (i) describe the characteristics of toy choice in the context of the spread of global trends, and (ii) examine the influence of family and individual child characteristics on the dependence on trends in toy choice. The sample consisted of N = 127 children aged 3-4 years. Children had individual assessment of non-verbal intelligence main executive function skills (cognitive flexibility, working memory and inhibition control) and took part in the experiment, while their parents completed a questionnaire on family background. Analysis of children's answers about the reason for choosing a particular toy indicates uncertain motivation in choosing a trendy toy in contrast to the classic ones. It is reflected in the fact that children do not know what exactly and how they will play with it. It is revealed that boys are 1.66 times more likely to prefer the trendy toy than girls. It was also found that as inhibitory control increased, children were less dependent on tendencies to choose toys.

Exclusive Enteral Nutrition for the Treatment of Pediatric Crohn's Disease: The Patient Perspective.

Crohn's disease (CD) is a chronic, incurable and relapsing disease involving any part of the gastrointestinal tract and exclusive enteral nutrition (EEN) is first-line therapy. Few studies have examined the patient experience of EEN. The aim of this study was to assess the child' s experiences of EEN, to identify problematic themes and understand the child's mindset. Children with CD who previously completed EEN were recruited to complete a survey. All data were analyzed using Microsoft Excel and reported as N (%). Forty-four children (mean age 11.3 years) consented to participate. Sixty-eight percent of children reported limited formula flavors as the most challenging aspect and 68% of children identified 'support' to be important. This study highlights the psychological impact of chronic disease and its therapies on children. Providing adequate support is essential to insure EEN is successful. Further studies are required to determine psychological support strategies for children taking EEN.

Perfil cognitivo y social en niños y niñas con Trastorno del Espectro Autista / Cognitive and social profile in children with autism spectrum disorder

El Trastorno del Espectro Autista (TEA) es una condición que se caracteriza por presentar fallas en la conducta social y comportamientos repetitivos. Su perfil neuropsicológico muestra hallaz-gos heterogéneos que dependen de la severidad del trastorno. El objetivo del presente trabajo es describir el funcionamiento neuropsicológico de una muestra de niños y niñas con TEA que asisten al Instituto para el Desarrollo Integral del Niño en condición de Autismo (DINA). La muestra estuvo conformada por 78 participantes, 15.4% de género femenino y 84.6% de géne-ro masculino, con edades entre los 6 y los 16 años. Los instrumentos utilizados fueron protocolo neuropsicológico adaptado de la ENI, prorrateo de inteligencia del WISC-IV, Test de Sally y Ann, Test de Expresiones faciales adaptadopor Paul Ekman y el Test de la Mirada para niños, El Test de Metidas de Pata, e Historias Extrañas de Happé. Los resultados se discuten a la luz de la li-teratura científica sobre el tema.

Autism Spectrum Disorder (ASD) is a condition that is characterized by failures in social behav-ior and repetitive behaviors. The neuropsychological profile shows heterogeneous findings that depends on the severity of the disorder. The objective of this paper is to describe the neuropsychological functioning of a sample of children with ASD who attend the Institute for the Integral Development of Children with Autism (DINA). The sample consisted of 78 partici-pants, 15.4% female and 84.6% male, aged between6 and 16 years. The instruments used were the neuropsychological protocol adapted from the ENI, intelligence apportionment from the WISC-IV, Sally and Ann Test, Facial Expressions Test adapted by Paul Ekman and Reading the Mind in the Eye for children, Faux Pas Test, and The Happé’s Strange Stories test. The re-sults are discussed considering the scientific literature on the subject. (AU)

Don't judge a book by its cover: Exploring low self-reported distress and repressive coping in a pediatric chronic pain population.

Repression has been linked to greater illness, somatic symptoms, and poorer physical health, both in adult and pediatric populations. The current study examined psychological and pain profiles of children with chronic pain who may under-report levels of psychological distress at a first interdisciplinary chronic pain assessment. Children and their caregiver completed measures of psychopathology and pain intensity, while clinicians rated their levels of disability. Based on self-report measures, children were classified as "repressors" (low anxiety/high social desirability) or as "true low anxious" (low anxiety/low social desirability). Groups were then compared on psychological and pain characteristics. Compared to children with true low anxiety, repressors reported lower levels of depressive and somatic symptoms but provided higher ratings on pain intensity, pain-unpleasantness, and self-oriented perfectionism. Caregivers of repressors rated their children as having higher levels of adaptability compared to caregivers of children in the true low anxious group. Groups did not differ on clinician-rated level of disability. Children classified as repressors exhibited different profiles than children classified as having true low anxiety on both psychological outcomes and pain characteristics. Repression may be an important factor to consider for those assessing and treating children with chronic pain.

A relação entre estilos parentais e desenvolvimento auditivo em crianças com implante coclear / The relationship between parenting styles and hearing development in children with cochlear implants

RESUMO Objetivo O objetivo deste estudo foi investigar a relação entre estilos parentais e habilidades auditivas em crianças usuárias de implante coclear. Métodos Este é um estudo analítico observacional. Os participantes foram os cuidadores principais das crianças divididos em grupo estudo (N=50) e grupo controle (N=28). As idades das crianças estavam entre 3 e 7 anos. Os indivíduos do grupo estudo forneceram uma história médica pregressa (HMP) e preencheram o Questionário de Estilos e Dimensões Parentais (QEDP) e a Escala de Integração Auditiva Significativa Infantil-Toddler (IT-MAIS) ou a Escala de Integração Auditiva Significativa (MAIS). Os sujeitos do grupo controle também forneceram um PMH e preencheram o QEDP. O teste de Mann Whitney, o coeficiente de Spearman e o teste de Kruskal-Wallis foram utilizados para análise dos dados, utilizando-se os softwares JASP 0.8 e SPSS 23. Resultados Os grupos estudo e controle não apresentam diferenças significativas em relação aos estilos parentais (p<0,05). A dimensão estilo parental autoritário e punição revelou significância estatística, com escores mais elevados para crianças com desenvolvimento auditivo alterado. Conclusão No presente estudo foi possível verificar que a prática do estilo parental autoritário com dimensões punitivas e coerção física esteve relacionada ao desenvolvimento auditivo alterado em crianças usuárias de implante coclear.

ABSTRACT Purpose The purpose of this study was to investigate the relationship between parenting styles and hearing skills in children with hearing loss who use cochlear implants. Methods This is an observational analytical study. The participants were the children's main caregivers divided into a study group (N=50) and a control group (N=28). The children's ages were between 3 and 7 years old. Subjects in the study group provided a past medical history (PMH), and completed the Parenting Styles and Dimensions Questionnaire (PSDQ) and the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) or the Meaningful Auditory Integration Scale (MAIS). Subjects in the control group also provided a PMH and completed the PSDQ. The Mann Whitney test, the Spearman coefficient, and the Kruskal-Wallis test were used for data analysis, utilizing the JASP 0.8 and SPSS 23 softwares. Results Results showed that The authoritarian parenting style and punishment dimension revealed a statistical significance, with higher scores for children with altered auditory development. Conclusion It was concluded that the practice of authoritarian parenting style with punitive dimensions and physical coercion were related to altered hearing development. Regulation dimension presented a significant correlation with hearing development. The outcome suggested the importance of psychotherapeutic strategies for caregivers who are responsible for children with hearing loss.

Manejo do comportamento infantil no atendimento odontológico: manual de orientações para abordagem clínica / Manual of the management of child behavior for dental care: guidelines for clinical approach

Na odontopediatria as técnicas de manejo comportamental são de suma importância para o controle do medo e da ansiedade no atendimento infantil. Técnicas não farmacológicas como falar-mostrar-fazer, controle de voz, comunicação não verbal, reforço positivo, distração, estabilização protetora, são algumas das maneiras de se obter uma boa colaboração, e êxito na execução de tratamentos, além de formar vínculos entre profissional e criança. Com o passar das gerações, e os seres humanos em constante desenvolvimento e evolução, nota-se que essas técnicas têm se tornado cada vez mais desafiadoras na aplicabilidade clínica. A busca pelos pais e responsáveis por soluções de tratamento tecnológicas, ágeis, e que não gerem traumas e contrariedade para as crianças vem crescendo de forma exponencial. Porém há carência de cirurgiões-dentistas atualizados sobre o manejo do comportamento infantil durante o atendimento odontológico, tornando ainda mais difícil o profissional atender as expectativas dos pais e responsáveis no atendimento. Frente aos desafios no atendimento odontopediátrico, o objetivo desse trabalho foi a realização de 2 manuais de orientações atualizado sobre o manejo do comportamento infantil no atendimento odontológico, a fim de orientar os cirurgiões-dentistas, pais e responsáveis na abordagem da criança durante a rotina clínica (AU)

In pediatric dentistry, behavioral management techniques are of paramount importance for the control of fear and anxiety in childcare. Non-pharmacological techniques such as talking-showing-doing, voice control, non-verbal communication, positive reinforcement, distraction, protective stabilization, are some of the ways to obtain good collaboration and success in the execution of treatments, in addition to forming bonds between professional and child. With the passing of generations, and human beings in constant development and evolution, it is noted that these techniques have become increasingly challenging in clinical applicability. The search by parents and guardians for technological, agile treatment solutions that do not generate trauma and annoyance for children has been growing exponentially. However, there is a lack of dentists who are up to date on the management of children's behavior during dental care, making it even more difficult for professionals to meet the expectations of parents and guardians in care. In view of the challenges in pediatric dental care, the objective of this study was to develop 2 updated guidance manuals on the management of child behavior in dental care, toguide dentists, parents and guardians in the approach to the child during the clinical routine. (AU)

Programa ACT com casais: repercussões na dinâmica familiar / ACT program with couples: repercussions on family dynamics / Programa ACT con parejas: repercusiones en la dinámica familiar

Este estudo qualitativo buscou compreender as repercussões de um treinamento parental (Programa ACT) na parentalidade, coparentalidade, conjugalidade e no comportamento infantil. O Programa tem como foco a melhoria das práticas educativas dos pais e a sigla ACT significa ação, devido ao caráter dinâmico da intervenção, que abrange orientações, atividades e discussões em grupo. Os dados foram coletados por meio de entrevistas semiestruturadas com três casais heteroafetivos que participaram da intervenção e foram submetidos à análise categorial temática. Os resultados indicaram melhoria na parentalidade e redução de problemas de comportamento dos filhos. A participação de ambos os pais promoveu repercussões favoráveis não apenas na coparentalidade e na conjugalidade, mas na dinâmica familiar como um todo. Este estudo sugere que a participação de duplas coparentais em programas de treinamento tende a potencializar a aplicação do conhecimento, beneficiando o desenvolvimento da criança.

This qualitative research sought to understand the repercussions of the ACT Program on parenting, coparenting, conjugality, and child behavior. ACT is a parenting training program focused on improving parenting practices. Data were collected through semi-structured interviews with three heteroaffective couples who participated in the intervention and submitted to thematic categorical analysis. The results indicated an improvement in parenting and a reduction in children's behavior problems. The participation of both parents promoted favorable repercussions not only on coparenting and conjugality but on family dynamics as a whole. This study suggests that the participation of coparental pairs in training programs tends to enhance the application of knowledge, benefiting the child's development.

Esta investigación cualitativa buscó comprender las repercusiones del Programa ACT en la crianza, la crianza compartida, la conyugalidad y el comportamiento del niño. ACT es un programa de capacitación para padres enfocado en mejorar las prácticas de crianza. Los datos fueron recolectados a través de entrevistas semiestructuradas con tres parejas heteroafectivas que participaron de la intervención, y sometidas a análisis temático categórico. Los resultados indicaron una mejora en la crianza de los hijos y una reducción en los problemas de conducta de los niños. La participación de ambos progenitores promovió repercusiones favorables no solo en la coparentalidad y la conyugalidad, sino en la dinámica familiar en su conjunto. Este estudio sugiere que la participación de parejas coparentales en los programas de capacitación tiende a mejorar la aplicación del conocimiento, beneficiando el desarrollo del niño.

Experience of the 'Ear Glove' in children with microtia.

INTRODUCTION: Microtia is a congenital condition which can be found in isolation or as part of a syndrome. The key factors to consider when treating a child with microtia are hearing, speech and language development, cosmesis, and the psychological impact on the patient as well as the family. As children age and become more self-aware, the anxiety about transition from primary to secondary school can often be a trigger for carers and child to want a cosmetic solution at a younger age. Any form of cosmetic surgery ideally requires a child with an understanding of what is involved, as well as sufficient growth and anatomy to provide soft tissue resources for surgery. An additional issue for some children with microtia is the concern about adding to their already 'different' appearance by using a bone conduction solution/hearing implant. We present the outcomes of a novel non-surgical prosthesis 'Ear Glove' offered to pediatric patients with microtia. METHODS: Children with microtia are seen in the multidisciplinary outpatient clinic and reviewed by the team which includes an Otolaryngologist, Audiologist, Plastic surgeon and Maxillofacial prosthetist. When discussing cosmesis, all reconstruction options are explored. These include a 'no treatment' option, both adhesive and implant-retained prosthetic ears, and autologous and/or MedporⓇ ear reconstruction (age appropriate). All children who chose to undergo the adhesive non-surgical prosthetic option 'Ear Glove' for microtia were identified by our prosthetic department (n = 9), and their outcomes reviewed. RESULTS: Nine children have been fitted with the 'Ear Glove', with all 9 achieving excellent symmetry and aesthetics. Seven patients continue to successfully use their prostheses either daily or for special occasions. Two of these patients also decided to undergo bone anchored hearing implant surgery. One patient opted to change his treatment plans and chose 'no treatment' after feeling he preferred his 'little' ears. Finally, one patient reported the daily use of adhesive to be a deterrent. No skin reactions to the adhesive were reported in any patient. CONCLUSIONS: The 'Ear Glove' is increasingly being used by microtia patients in our department to good effect. This non-surgical alternative allows young patients to appreciate the cosmetic results of the surgical options before committing to an invasive procedure.

Social-emotional and behavioural issues after very preterm birth: Parental and teachers experiences.

Preterm infants are at risk of developing social-emotional and behavioural difficulties. To understand the experiences of their caregivers in day-to-day life, parents (at 2 and 10 years) and teachers (at 10 years) completed a behavioural questionnaire and answered two open-ended questions addressing their concerns and the most positive aspects regarding their child and/or pupil (born <32 weeks gestation). Their answers were analyzed using thematic content analysis. Parental concerns at two years related equally to themes in the clusters Developmental Milestones, Physical Development and Development in Relation to the Self and Others. At 10 years, both parents and teachers reported mainly within the cluster Development in Relation to the Self and Others, but the underlying themes differed. While parents more often mentioned their child's emotional development, teachers were more concerned about their pupils' difficulties interacting with their peers, due to a lack of social skills. In-depth qualitative analysis of what parents and teachers experience from day-to-day improves our understanding of the social-emotional and behavioural development of children born very preterm, revealing important topics that should be addressed during follow-up.

Risk Factors Associated With Increased Anxiety Sensitivity in Children and Adolescents in Northwest China During COVID-19 Pandemic Lockdown.

Purpose: A large body of evidence has revealed that the sudden outbreak of public health emergencies induces dramatic effects on the mental health of the general public. We aimed to investigate the level of anxiety sensitivity and its risk factors in children and adolescents from northwest China during the COVID-19 pandemic lockdown in early 2020. Methods: A cross-sectional survey was conducted through the Wenjuanxing platform using a convenience sampling method between 18 and 26 February 2020. The self-designed questionnaire contained sociodemographic characteristics, factors associated with the COVID-19 pandemic, and the Childhood Anxiety Sensitivity Index (CASI) scale. The data from 1,091 valid questionnaires from students aged 9-17 years were analyzed using ANOVA, multiple linear regression, and binary logistic regression. Results: The average CASI scores were 11.47 ± 6.631, and 642 students (58.9%) had prominent anxiety sensitivity. Gender, education level, family members participating in anti-COVID-19 work, getting ill and needing medical help during the lockdown, feeling afraid or having heart palpitations on hearing things associated with COVID-19, believing that COVID-19 would have adverse impacts on themselves or their family in the future, and fear of infection were identified as significant factors for elevated levels of anxiety sensitivity (p < 0.05). We established a multiple linear regression model for the anxiety sensitivity score. Risk factors found for anxiety sensitivity in children and adolescents during the COVID-19 lockdown included studying in secondary or high school, becoming ill during the pandemic, feeling afraid or experiencing rapid heartbeat or palpitations on hearing about the COVID-19 pandemic, thinking that COVID-19 would have an adverse impact on themselves or their family in the future, and fear of infection. Conclusions: During the COVID-19 pandemic and home quarantine, scores measuring the prevalence of anxiety sensitivity in children and adolescents from northwest China were elevated. We should develop measures that especially target possible risk factors to intervene against and prevent anxiety sensitivity in children and adolescents in both the current and future pandemics.