ԵՐԵԽԱՅԻ ԱՌՈՂՋՈՒԹՅԱՆ ՊԱՀՊԱՆՄԱՆ ԻՐԱՎՈՒՆՔԻ ՈՐՈՇ ՀԱՐՑԵՐ

We investigated whether uncertainty about the impact of children's chronic health conditions on their daily lives leads to changes in mothers' and fathers' mental and physical health. Three waves of data were collected over three years from parents of 228 children with chronic health conditions. Parents reported their level of uncertainty about how the child's health condition affected the child's daily life, as well as measures of their own mental and physical health at each wave of data collection. Results of structural equation models indicate that, among mothers, more illness-related uncertainty was associated with a subsequent increase in psychological symptoms relative to other mothers in the study. Psychological symptoms, in turn, were associated with a subsequent increase in physical symptoms among mothers. Uncertainty did not affect fathers' health. Illness-related uncertainty may be a risk factor for psychological and physical symptoms in mothers of children with chronic health conditions. As such, interventions that address uncertainty related to the child's chronic health condition may improve psychological and physical well-being of mothers of children with chronic health conditions.

Racial/Ethnic Disparities in Health-Related Quality of Life and Health in Children Are Largely Mediated by Family Contextual Differences

Background. Assisted reproductive technology (ART) poses an increased risk for preterm birth. Women with high body mass index, who opted for ART, have the elevated levels of the insulin-like growth factor 1 (IGF-1) which is involved in the development of pathologic vasoproliferation in retinopathy of prematurity (ROP). Children with ROP are at increased risk for co-morbid pathology.Objective. The study aims at evaluating physical development and state of health in ART-conceived children with ROP.Methods. This is a population, one-time study to evaluate physical development and state of health in children with ROP. Statistical analysis was carried out using the SPSS v. 14.0 software package, and included determination of normality (Shapiro-Wilk test), descriptive statistics (М — mean value, σ — standard deviation of the mean), and non-parametric methods (Mann-Whitney U-test, Z-test of a proportion).Results. The anthropometric characteristics of infants with ROP did not differ from those in spontaneously conceived babies. Children with ROP born to mothers with high BMI had lower anthropometric parameters (p < 0.001) and required longer dynamic follow-up while being diagnosed as “risk group for ROP”. A significantly higher number (a total of 65) of nosologies has been revealed in the ART-conceived infants. Statistically significant predominant diagnoses (p = 0.0047) included dwarfism and obesity despite the absence of anthropometric differences at birth (p = 0.123).Conclusion. The ART-conceived infants with ROP at birth do not differ in their physical development from infants in the general population, however, on prospective follow-up the former developed dwarfism and obesity significantly more often. Children born to mothers with high BMI have significantly lower parameters of weight and height, and require longer follow-up period while being diagnosed with ROP. The ART-conceived infants with ROP have co-morbid pathology significantly more often than children with ROP in the control group.

BackgroundDirect and indirect associations have been identified among health literacy, health behavior, and health status. Thus, we aimed to investigate the influence of oral health literacy and behaviors in parents on their children's oral health status. Moreover, we aimed to analyze the mentioned mediating effects through oral health behavior management.MethodsOral health information of 1,102 preschool children aged 3 to 6 years was collected from five primary schools in Jinjiang District, Chengdu City, Sichuan Province, China. The decay-missing-filled teeth (DMFT) index and soft scale plaque index (PI) were used by professional dentists aided by school teachers to assess caries and periodontal health among the children. Simultaneously, we conducted a questionnaire-based survey among the parents to determine their oral health literacy and health behavior and their children's oral health behavior. The probit model, instrumental variables, and mediation effect model were used to evaluate the association of parents' oral health literacy and behavior with their children's oral health status.ResultsThe DFMT index was 1.58 among the children, with zero caries in 646 (58.6%) children. The PI was 0.68, with zero gum disease in 517 (46.9%). The univariate analysis suggested that the parents' health literacy and behavior were correlated with their children's oral health status (P < 0.01). Parents' oral health behavior significantly affected their children's oral health status. Simultaneously, a stronger correlation was observed upon using parents' health literacy as an instrumental variable to assess the endogeneity, indicating endogeneity problems. Parents' health-related behaviors exerted a mediating effect on children's oral health, with parents helping children brush their teeth demonstrating the strongest effect.ConclusionParents' oral health-related behaviors can affect their children's oral health status. We recommend enhancing parents' oral health literacy to improve children's oral health status.

BackgroundThe Great East Japan Earthquake inflicted severe damage on the Pacific coastal areas of northeast Japan. Although possible health impacts on aged or handicapped populations have been highlighted, little is known about how the serious disaster affected preschool children’s health. We conducted a nationwide nursery school survey to investigate preschool children’s physical development and health status throughout the disaster.MethodsThe survey was conducted from September to December 2012. We mailed three kinds of questionnaires to nursery schools in all 47 prefectures in Japan. Questionnaire “A” addressed nursery school information, and questionnaires “B1” and “B2” addressed individuals’ data. Our targets were children who were born from April 2, 2004, to April 1, 2005 (those who did not experience the disaster during their preschool days) and children who were born from April 2, 2006, to April 1, 2007 (those who experienced the disaster during their preschool days). The questionnaire inquired about disaster experiences, anthropometric measurements, and presence of diseases.ResultsIn total, 3624 nursery schools from all 47 prefectures participated in the survey. We established two nationwide retrospective cohorts of preschool children; 53 747 children who were born from April 2, 2004, to April 1, 2005, and 69 004 children who were born from April 2, 2006, to April 1, 2007. Among the latter cohort, 1003 were reported to have specific personal experiences with the disaster.ConclusionsWith the large dataset, we expect to yield comprehensive study results about preschool children’s physical development and health status throughout the disaster.

The main objective of this population-based and cross-sectional study was to determine the validity of maternal perception as an indicator of the 17-month-old child's health status. Data from this study came from the Quebec Longitudinal Study of Child Development (QLSCD, Round 1999) which was based on a representative sample of babies born in Québec in 1997 and 1998. The analyses were based on the 2045 children aged 17 months who participated in the survey in 1999. Maternal perception of the child's health status was examined as a function of a series of children's health indicators, namely the presence of acute health problems (last 3 months), asthma attacks since birth, presence of chronic problem and hospitalizations during the previous 12 months. Confounding influences of both maternal and child-related characteristics were controlled in the analyses. Sequential logistic regressions indicated that maternal perception was strongly associated with the different health indicators even after controlling for confounding variables. However, a significant interaction between the child's gender and the presence of chronic health problems was observed. The association between maternal perception of the child's health and the presence of chronic health problems was stronger for boys than for girls. The analyses confirm that the mother's perception of the health status of her 17-month-old child corresponds with the actual health status of the child as reflected by the presence or absence of selected health problems.

The “Long-arm” of chronic conditions in childhood: Evidence from Canada using linked survey-administrative data

Objective To evaluate physical health status of left-behind children in some rural areas of China, and to provide evidence-based medical evidence for left-behind children′s health care services. Methods Cross-sectional studies about physical health status of left-behind children in China were searched from China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), VIP, and Wanfang Database. Retrieval time was set from the inception of each database to August 2019. Two researchers independently screened the studies according to the inclusion criteria and exclusion criteria of this study, and evaluated the quality of each literature and extracted data from each literature. After cross-checking by these two researchers, Meta-analysis of physical health status of left-behind children in some rural areas of China was conducted by RevMan 5.3 software. The Agency for Healthcare Research and Quality (AHRQ) recommendation for cross-sectional study analysis criteria was used to evaluate the methodological quality of included literature. I2 test was used for the heterogeneity analysis among the studies. Fixed effect model Meta-analysis was used when P≥0.10 and/or I2≤50%, and random effect model Meta-analysis was used when P 50%. The evaluation indexes of health situation of left-behind children included detection rate of nutritional diseases (nutritional anemia, malnutrition and zinc deficiency) and detection rate of growth retardation, and rate of underweight. Results ①A total of 9 articles involving 14 588 cases of children were included. They were from Anhui, Guangdong, Henan, Hubei, Hunan, Shandong, and Shaanxi Province, respectively. According to the definition of left-behind children in this study, they were divided into left-behind children group (n=8 010) and non-left-behind children group (n=6 578). ②The methodological quality evaluation results of included studies showed that there were 1 low-quality study, 5 medium-quality studies and 3 high-quality studies. ③Meta-analysis showed that there was no statistical difference between two groups in detection rate of malnutrition, and detection rate of growth retardation (P>0.05). The detection rate of nutritional anemia, detection rate of zinc deficiency, and rate of underweight in left-behind children group all were significantly higher than those in non-left-behind children group, and all the differences were statistically different (OR=1.93, 1.64, 1.22; 95%CI: 1.20-3.11, 1.19-2.27, 1.03-1.44; P=0.006, 0.003, 0.200). Conclusions Current evidence shows that left-behind children still have more health problems than non-left-behind children in parts of China. The detection rates of nutritional anemia and zinc deficiency, and rate of underweight are higher than those of non-left-behind children. However, due to the limitation of quantity and quality of studies included in this research, and the heterogeneity among the studies, large-sample, multi-center and high-quality studies are still needed to conduct to fully grasp the health problems of left-behind children in China, and then providing better health care services for them. Key words: Micronutrients; Health status; Health surveys; Health status indicators; Anemia, nutritional; Child nutrition disorders; Cross-sectional studies; Child care; Child health services; Left-behind children in rural area

Parents are the principal decision-makers regarding their child's health. Awareness of mothers' view about their children's health, particularly with special health care needs (SHCN) (include hearing impaired children), is essential for health care providers. Therefore, the present study aimed to assess the mothers view about oral health status, oral hygiene practices, and dental services utilization of their children with hearing impairment attending special schools. A cross-sectional study was conducted between May and September 2020 among mothers of students with hearing impairment attending special schools. Also, the telephone structured interview was used to gathering mothers view. 57.4% of the mothers rated their children's oral health status as excellent or good, 27.9% as moderate, and 14.7% as poor. About half of the mothers (49.2%) stated that their children used toothbrushes once daily, and 15% use dental floss. Also, 54% of the children visited the dentist before this survey's conduct. The findings of the present study suggest that children with hearing impairment can also have good oral health status and behaviors. These results may be attributed to the fact that the study sample was taken from two special schools. Also, only the mothers' perception assessment of students' oral health status was done. Further studies are required to increase the strength of evidence.

Overall, the results of these analyses support the notion of adverse selection and retention in the SCHIP program. This is unlikely to be the result of aggressive marketing in enrollment sites that serve children with more medical problems, as Florida health care providers rank third as a source of information about the Title XXI program after family and friends and the schools. In addition, Florida has active outreach and single-page application process for Medicaid and an aggressive program to move children to Title V, which also should minimize the numbers of children with special health care needs enrolled in SCHIP. Nevertheless, these findings suggest that the children being enrolled in Florida's SCHIP program are not the largely healthy population that was envisioned. If replicated in other SCHIP programs, these findings raise questions about the basic underlying assumptions concerning the health of potential enrollees and could have implications for the long-term fiscal viability of the program.

Aim: The aim of the study is to find the association between child socioeconomic background (SEB) and health conditions of children of south Mumbai of Maharashtra. Methodology: Ahospital cross-sectional research design was used by selecting 40 children from selected hospitals of south Mumbai using probability simple random technique. Data were collected with the help of structured interviews, structured questionnaires, and rating scale. Data get analyzed using descriptive and inferential statistics. Results: For parameter, “body mass index (BMI),” the beta value is (0.03), it means when we increase value of independent variable (child SEB) by 1, the value of dependent variable (BMI) will increase by 0.03, and there is very poor positive relation among BMI and composite score of socioeconomic background parameters. For parameter, “behavioral difficulty,” the beta value is −0.42, it means when we increase independent variable (child SEB) by 1, the value of dependent variable (behavioral difficulty) will decrease by 0.42. It indicated that there is inverse relation among behavioral difficulties and composite score of socioeconomic background parameters. For parameter, “sleep problem,” the beta value is (−0.67), it means when we increase independent variable (child SEB) on X axis by 1, the value of dependent variable (sleep problem) on Y axis will decrease by 0.67 and that’s why there is an inverse relationship among composite score of socioeconomic background parameters and sleep problems. Conclusion: Study has shown that there is a strong positive relation between child socioeconomic status and health condition of children.

Children and adolescents with medical conditions present special issues with respect to participation in athletic activities. The pediatrician can play an important role in determining whether a child with a health condition should participate in certain sports by assessing the child's health status, suggesting appropriate equipment or modifications of sports to decrease the risk of injury, and educating the athlete and parents on the risks of injury as they relate to the child's condition. This statement updates a previous policy statement and provides information for pediatricians on sports participation for children and adolescents with medical conditions.

To compare children with mental and physical health problems regarding (1) perceived disease severity; (2) the impact of their condition on their families; (3) their utilization of health care services (including satisfaction with care); and (4) parents' health literacy about their child's condition and its treatment. Furthermore, we examined whether parents' health literacy differs between types of mental health condition. Parental reports about their 9- to 14-year-old children with mental (n=785) or physical health problems (n=475) were analyzed from the population-based National Survey of Children with Special Health Care Needs in Switzerland. Mental health problems were perceived as being more severe (p<0.001) and exerting a larger impact upon the family (e.g., financial impact) than physical health problems. Furthermore, fewer parents of children with a mental health problem mentioned having a particular person or place to contact if they needed information or advice regarding the child's condition (p=0.004) and were satisfied with the health care services their child received (p<0.001). The odds of low health literacy was higher among parents with children suffering from mental health problems vs. parents of children with physical health problems (OR in the adjusted model=1.92; 95% CI 1.47-2.50; p<0.001); this finding held generally for mental health problem (although only a trend was observable for internalizing problems). The large impact of children's mental health conditions on themselves and their families might be reduced by adapting the provision of health care and by increasing parents' health literacy.

This study investigates the effect of the Temporary Aid to Needy Families (TANF) program on children's health outcomes using data from the Survey of Income and Program Participation over the period 1994 to 2005. The TANF policies have been credited with increased employment for single mothers and a dramatic drop in welfare caseload. Our results show that these policies also had a significant effect on various measures of children's medical utilization among low-income families. These health measures include a rating of the child's health status reported by the parents, the number of times that parents consulted a doctor, and the number of nights that the child stayed in a hospital. We compare the overall changes of health status and medical utilization for children with working and nonworking mothers. We find that the child's health status as reported by the parents is affected by the maternal employment status.

Natural disasters have an enormous impact on the lives and well-being of people in many parts of the world. When a disaster occurs, it causes massive damage to people's livelihoods. Although a household is automatically disrupted after experiencing a natural disaster (floods, earthquakes, mudslides, etc.), the accessibility of food commodities is often the most negatively impacted. Since pre-disaster periods are already challenging in the context of providing sufficient food within poverty-stricken areas, natural disasters leave a trail of vulnerable and disadvantaged people who cannot acquire an adequate amount of nutritious food necessary for survival. The inability to maintain consumption levels exposes households to food insecurities – insecurities experienced particularly by women, who head households. Women are more susceptible to food scarcity and lose the ability to sustain their families’ livelihood due to the loss of seeds, livestock, and food, in general. Natural cataclysms, however, not only hamper access to nutritious food, but also considerably affect women's and children's health conditions. In countries like Tajikistan, there is a small body of research that assesses the impact of hazardous events on women's and children's health and nutrition in the aftermath of disasters. This study seeks to provide insights into the access of balanced diets to families in post-disaster situations and analyzes how disasters impact the health of affected people.