1
|
Darko EK, Senoo-Dogbey VE, Ohene LA. Play for hospitalized children: A qualitative enquiry of behaviour and motivation of nurses in a secondary level healthcare setting in Ghana. J Pediatr Nurs 2024; 77:e1-e7. [PMID: 38453546 DOI: 10.1016/j.pedn.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND The World Health Organization recommends that healthcare workers, specifically doctors and nurses, utilize play within treatment and care to promote recovery and overall well-being of hospitalized children. This recommendation has extended the roles of nurses in pediatric settings to include play in their routine care for children hospitalized for various childhood illnesses. Nurses need to draw on their skills to use play as an essential tool to aid communication, assessment, diagnosis, and care of the hospitalized child. This study explored the behaviour and motivation of Ghanaian nurses towards the utilization of play for hospitalized children. METHODS Exploratory qualitative design was utilized and 12 registered nurses from the pediatric unit of a secondary-level health institution were selected purposively and interviewed using a semi-structured interview guide. Thematic analysis was done with two themes namely behaviour towards play and motivation to use play emerging with their corresponding sub-themes. FINDING In the study setting, play has not been formalized or fully integrated into the routine care of the sick child. Nurses have a positive attitude and believe in the positive impact of play on the sick child. Participants utilize play as and when there is a need, and they derive satisfaction and fulfilment anytime they engage in play activities with their patients. Lack of administrative support and resources for play interventions affect their motivation to use play for the children. CONCLUSION Formalization of play and integration of play into the routine care of the sick child is needed to motivate nurses to engage hospitalized children in play activities to help them derive the full benefits that play offers to the sick and hospitalized child. IMPLICATIONS TO PRACTICE The positive attitudes and behaviour towards play as demonstrated in this study calls for Ghanaian nurses in general to be empowered through the formalization and integration of play into routine nursing care.
Collapse
Affiliation(s)
- Esther Kumah Darko
- Ghana College of Nurses and Midwives, Ghana; Tetteh Quashie Memorial Hospital-Ghana Health Service, Accra, Ghana
| | - Vivian Efua Senoo-Dogbey
- Department of Public Health, School of Nursing and Midwifery, University of Ghana, Legon, Accra Ghana P. O. Box LG 25 Legon Accra, Ghana; Ghana Institute of Management and Public Administration (GIMPA) School of Public Service and Governance, Ghana.
| | - Lillian Akorfa Ohene
- Department of Public Health, School of Nursing and Midwifery, University of Ghana, Legon, Accra Ghana P. O. Box LG 25 Legon Accra, Ghana.
| |
Collapse
|
2
|
Graber K, O'Farrelly C, Ramchandani P. Centring children's lived experiences in understanding the importance of play in hospitals. Child Care Health Dev 2024; 50:e13287. [PMID: 38958339 DOI: 10.1111/cch.13287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/02/2024] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Children have a right to participate in matters affecting their lives. With increasing regularity, children's perspectives are being sought regarding their health and health care experiences. Though there is evidence that children find play to be one of the 'best' aspects of hospitalisation, studies rarely focus on children's perspectives on play in hospital. METHODS This qualitative study explored children's lived experiences of play during hospitalisation. Over five months, ethnographic observations were conducted on a paediatric oncology ward as well as interviews with 16 children ages 3-13 years. RESULTS Using interpretative phenomenological analysis, children's expressions and experiences illuminated three key points: safety and comfort are integral to children feeling able to play in hospital; the value and efficacy of play is decided by children; and that play is a way for patients to be (and be treated as) children first. CONCLUSION Hospitals can only be child-friendly if children find them friendly. Listening to and integrating children's perspectives in the discourse around the importance of play in hospital is essential for respecting children's rights and delivering person-centred paediatric healthcare.
Collapse
Affiliation(s)
- Kelsey Graber
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Christine O'Farrelly
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Paul Ramchandani
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| |
Collapse
|
3
|
Huang X, Chen Y, Luo J, Wang D, Yang C, Luo W, Zhou Y. The effect of behavioral activation play therapy in adolescents with depression: A study protocol for a randomized controlled trial. PLoS One 2024; 19:e0304084. [PMID: 38900751 PMCID: PMC11189190 DOI: 10.1371/journal.pone.0304084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/30/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Depression is a common psychological problem in adolescents worldwide. Although the World Health Organization recommends that members of this population engage in physical activity to reduce depressive symptoms, compliance with this recommendation is often low. Furthermore, although behavioral activation (BA) is recommended as a treatment for adolescents with depression, the reported effect size is small. Compared with traditional exercises, gamified physical activity (GPA) can be particularly appealing to adolescents because it is perceived as an enjoyable experience. In this study, we integrated BA and GPA to create behavioral activation play therapy (BAPT). We designed a clinical trial to investigate the feasibility, acceptability, and effectiveness of this treatment in adolescents with depression. METHODS This study is a randomized controlled trial (RCT) with a three-arm, assessor-blinded design, conducted to validate the effectiveness and applicability of BAPT for treating adolescent with depression. We will recruit 258 participants and randomly assign them to a BAPT group, BA group, or GPA group using a ratio of 1:1:1. Based on conventional strategies for treatment and care, the three groups will receive nine BAPT sessions, nine BA sessions, or nine GPA sessions, respectively. We will compare the outcomes of the BAPT with those of the BA and GPA interventions. DISCUSSION This is the first RCT to explore the effectiveness and applicability of BAPT in adolescents with depression. This study will provide evidence that may help to decrease depressive symptoms in adolescents, and will demonstrate the treatment effectiveness in terms of increasing levels of physical activity, reducing the rate of non-suicidal self-injury behaviors, and improving sleep quality. We will also assess the presence of side effects and the treatment adherence of patients receiving BAPT. TRIAL REGISTRATION Trial registration: Chinese Clinical Trial Registry, ChiCTR2300072671. Registered on 20 June 2023.
Collapse
Affiliation(s)
- Xiaolong Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Yuqi Chen
- Southern Medical University, Guangzhou, China
| | | | - Dongdong Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Chanjuan Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Wei Luo
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
4
|
Stutvoet MD, Levelt L, Hrehovcsik MM, Van't Veer J, Visch VT, Bramer WM, Hillegers MHJ, Veltkamp RC, Nijhof SL, Estévez-López F. Gamification in eHealth for Chronic Disease Self-Management in Youth: A Systematic Review. Games Health J 2024. [PMID: 38900649 DOI: 10.1089/g4h.2023.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024] Open
Abstract
This systematic review primarily aims to provide a summary of the game mechanics implemented in eHealth tools supporting young people's self-management of their chronic diseases. This review secondarily investigates the rationale for implementing game mechanics and the effects of these tools. A systematic search was conducted in Embase, Medline, PsycINFO, and Web of Science, from inception until August 30, 2022. Studies were eligible if focus was on the utilization of gamification in eHealth self-management interventions for young people (age = 10-25 years) with chronic diseases. Primary quantitative, qualitative, and mixed-method studies written in English were included. We identified 34 eHealth tools, of which 20 (59%) were gamified tools and 14 (41%) were serious games. We found that 55 unique game mechanics were implemented. The most commonly used were rewards (50%), score (44%), creative control (41%), and social interaction (32%). In comparison with gamified tools, the number and diversity of game mechanics applied were higher in serious games. For most tools (85%), a general rationale was provided for utilizing gamification, which often was to promote engaging experiences. A rationale for using specific game mechanics was less commonly provided (only for 45% of the game mechanics). The limited availability of experimental research precludes to test the effectiveness of using gamification in eHealth to support self-management in young people with chronic diseases. In this study, we highlight the importance of reporting the rationale for utilizing specific game mechanics in eHealth tools to ensure a proper alignment with evidence-based practice and the need of conducting experimental research. PROSPERO: CRD42021293037.
Collapse
Affiliation(s)
- Maartje D Stutvoet
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lisa Levelt
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | | | - Job Van't Veer
- Department of Healthcare, NHL Stenden University of Applied Sciences, Leeuwarden, The Netherlands
| | - Valentijn T Visch
- Department of Human Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Remco C Veltkamp
- Department of Information and Computing Sciences, Utrecht University, Utrecht, The Netherlands
| | - Sanne L Nijhof
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Fernando Estévez-López
- Department of Education, Faculty of Education Sciences; SPORT Research Group (CTS-1024); and CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain
- Biomedical Research Unit, Torrecárdenas University Hospital, Almería, Spain
| |
Collapse
|
5
|
Yu C, Weaver S, Walker M, Hess J, Mac A, Ross T. Opportunities for play in paediatric healthcare environments: a scoping review. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1415609. [PMID: 38872999 PMCID: PMC11169685 DOI: 10.3389/fresc.2024.1415609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024]
Abstract
Play spaces are important components of paediatric healthcare environments. They provide children with critical opportunities to experience the social, emotional, and developmental benefits of play while in healthcare settings for appointments or hospitalizations. These spaces can help to mitigate stress, provide a sense of normalcy in unfamiliar environments, and facilitate social engagement for children and their families. Given the benefits of play spaces in paediatric healthcare settings, it is important to understand how these spaces can be designed to enhance children's inclusion and quality of care. The aim of this scoping review was to explore the current understanding of paediatric play space design. Using search terms related to children, health care, and play space, six interdisciplinary databases were searched over a 30-year period. The search found 2,533 records from which eighteen were included for review. Findings suggest that although it is well-documented that play spaces offer valuable social and emotional benefits, little is known about the specific design features that can and should be incorporated to enhance play opportunities and ensure that they benefit all children and families. Further, the literature mostly considers play spaces in the context of designated play or recreational rooms. Scholars are encouraged to consider how play opportunities can be incorporated into the designs of paediatric healthcare environments beyond the boundaries of these rooms. Future studies should also consider the diversity of play space users, including children of varying ages and abilities, to create more accessible and inclusive paediatric play spaces for children and their families. Advancing knowledge on play space design can help to optimize the quality of these important spaces and to ensure their designs meaningfully enhance children's play experiences and quality of care.
Collapse
Affiliation(s)
- Clarissa Yu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Sophie Weaver
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Meaghan Walker
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Julia Hess
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Amanda Mac
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Timothy Ross
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Geography & Planning, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
6
|
Pires S, Borges S, Temudo T. [The Importance of Play]. ACTA MEDICA PORT 2024; 37:320-322. [PMID: 38744236 DOI: 10.20344/amp.20641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/19/2023] [Indexed: 05/16/2024]
Affiliation(s)
- Sofia Pires
- Serviço de Psiquiatria da Infância e Adolescência. Centro Hospitalar de Vila Nova de Gaia/Espinho. Vila Nova de Gaia. Portugal
| | - Sandra Borges
- Serviço de Psiquiatria da Infância e Adolescência. Centro Hospitalar de Vila Nova de Gaia/Espinho. Vila Nova de Gaia. Portugal
| | - Teresa Temudo
- Serviço de Neuropediatria. Centro Hospitalar Universitário de Santo António. Porto. Portugal
| |
Collapse
|
7
|
Bijlsma A, Birza EE, Pimentel TC, Maranus JPM, van Gaans MJJM, Lozeman-van T Klooster JG, Baars AJM, Achterberg EJM, Lesscher HMB, Wierenga CJ, Vanderschuren LJMJ. Opportunities for risk-taking during play alters cognitive performance and prefrontal inhibitory signalling in rats of both sexes. Eur J Neurosci 2024; 59:2748-2765. [PMID: 38511534 DOI: 10.1111/ejn.16313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/22/2024] [Indexed: 03/22/2024]
Abstract
Social play behaviour is a rewarding activity that can entail risks, thus allowing young individuals to test the limits of their capacities and to train their cognitive and emotional adaptability to challenges. Here, we tested in rats how opportunities for risk-taking during play affect the development of cognitive and emotional capacities and medial prefrontal cortex (mPFC) function, a brain structure important for risk-based decision making. Male and female rats were housed socially or social play-deprived (SPD) between postnatal day (P)21 and P42. During this period, half of both groups were daily exposed to a high-risk play environment. Around P85, all rats were tested for cognitive performance and emotional behaviour after which inhibitory currents were recorded in layer 5 pyramidal neurons in mPFC slices. We show that playing in a high-risk environment altered cognitive flexibility in both sexes and improved behavioural inhibition in males. High-risk play altered anxiety-like behaviour in the elevated plus maze in males and in the open field in females, respectively. SPD affected cognitive flexibility in both sexes and decreased anxiety-like behaviour in the elevated plus maze in females. We found that synaptic inhibitory currents in the mPFC were increased in male, but not female, rats after high-risk play, while SPD lowered prefrontal cortex (PFC) synaptic inhibition in both sexes. Together, our data show that exposure to risks during play affects the development of cognition, emotional behaviour and inhibition in the mPFC. Furthermore, our study suggests that the opportunity to take risks during play cannot substitute for social play behaviour.
Collapse
Affiliation(s)
- Ate Bijlsma
- Department of Biology, Faculty of Science, Utrecht University, Utrecht, The Netherlands
- Department of Population Health Sciences, Section Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Evelien E Birza
- Department of Population Health Sciences, Section Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Tara C Pimentel
- Department of Population Health Sciences, Section Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Janneke P M Maranus
- Department of Population Health Sciences, Section Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Marieke J J M van Gaans
- Department of Population Health Sciences, Section Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - José G Lozeman-van T Klooster
- Department of Population Health Sciences, Section Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Annemarie J M Baars
- Department of Population Health Sciences, Section Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - E J Marijke Achterberg
- Department of Population Health Sciences, Section Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Heidi M B Lesscher
- Department of Population Health Sciences, Section Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Corette J Wierenga
- Department of Biology, Faculty of Science, Utrecht University, Utrecht, The Netherlands
- Donders Institute and Faculty of Science, Radboud University, Nijmegen, The Netherlands
| | - Louk J M J Vanderschuren
- Department of Population Health Sciences, Section Animals in Science and Society, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
8
|
Stegenga K, Henley AK, Harman E, Robb SL. Shifting perspectives and transformative change: Parent perspectives of an active music engagement intervention for themselves and their child with cancer. Pediatr Blood Cancer 2024; 71:e30913. [PMID: 38337169 PMCID: PMC10959685 DOI: 10.1002/pbc.30913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Children with cancer (ages 3-8 years) and their parents experience significant, interrelated distress associated with cancer treatment. Active music engagement (AME) uses music-based play and shared music-making to mitigate this distress. To advance our understanding about how AME works and its essential features, we interviewed parents who received the AME intervention as part of a multi-site mechanistic trial. The purpose of this qualitative analysis was to describe parents' experiences of AME for themselves and their child and to better understand how the intervention worked to lower parent-child distress. PROCEDURE We conducted a total of 43 interviews with parents/caregivers, and purposively analyzed all interviews from underrepresented groups based on race/ethnicity and parent role. We used thematic analysis and achieved thematic redundancy after analyzing 28 interviews. RESULTS The following statement summarizes resulting themes: Music therapists skillfully use AME to create a safe and healthy space (Theme 1), where parents/children have transformative experiences (Theme 2) that lead to learning and enactment (Theme 3) of new skills that counteract suffering (Theme 4) through empowerment, connectedness, and sustained relief. CONCLUSIONS This work elucidates how AME works to counteract stressful qualities of cancer treatment. As parents witnessed positive and transformative changes in their child, they experienced relief and reported shifts in their perspective about cancer treatment. This led to learning and use of music as a coping strategy that extended beyond therapist-led sessions. Accessible, music-based interventions, like AME, offer a developmentally appropriate and effective way to support parents and young children during treatment.
Collapse
Affiliation(s)
- Kristin Stegenga
- Children’s Mercy, Kansas City, Division of Hematology/Oncology/BMT, Kansas City, MO
| | - Amanda K. Henley
- Indiana University, Herron School of Art and Design, Indianapolis, IN
| | | | - Sheri L. Robb
- Indiana University, School of Nursing, Indianapolis, IN
| |
Collapse
|
9
|
Parikh N, Hu KG, Allam O, Ihnat JM, Rancu AL, Boroumand S, Persing JA, Alperovich M. Sports participation after craniosynostosis repair: the critical role of post-operative guidance in parental decision-making. Childs Nerv Syst 2024:10.1007/s00381-024-06381-0. [PMID: 38578479 DOI: 10.1007/s00381-024-06381-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Despite previous research supporting patient safety in sports after craniosynostosis surgery, parental anxiety remains high. This study sought to evaluate the role of healthcare providers in guiding patients and families through the decision-making process. METHODS Parents of children with repaired craniosynostosis were asked to assess sports involvement and parental decision-making in children ages 6 and older. Questions were framed primarily on 5-point Likert scales. Sport categorizations were made in accordance with the American Academy of Pediatrics. Chi-squared, linear regression, and Pearson correlation tests were used to analyze associations between the questions. RESULTS Forty-three complete parental responses were recorded. Mean ages at surgery and time of sports entry were 7.93 ± 4.73 months and 4.76 ± 2.14 years, respectively. Eighty-two percent of patients participated in a contact sport. Discussions with the primary surgeon were more impactful on parental decisions about sports participation than those with other healthcare providers (4.04 ± 1.20 vs. 2.69 ± 1.32). Furthermore, children whose parents consulted with the primary surgeon began participating in sports at a younger age (4.0 ± 1.0 vs. 5.8 ± 2.7 years, p = 0.034). The mean comfort level with contact sports (2.8 ± 1.4) was lower than that with limited-contact (3.8 ± 1.1, p = 0.0001) or non-contact (4.4 ± 1.3, p < 0.0001) sports. CONCLUSION This study underscores the critical role that healthcare professionals, primarily surgeons, have in guiding families through the decision-making process regarding their children's participation in contact sports.
Collapse
Affiliation(s)
- Neil Parikh
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Kevin G Hu
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Omar Allam
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Jacqueline M Ihnat
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Albert L Rancu
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Sam Boroumand
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - John A Persing
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Michael Alperovich
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA.
| |
Collapse
|
10
|
Bharuchi VNA, Rasheed MA. Effect of play-based intervention on children's mental status and caregiver involvement during hospitalization: findings from Pakistan. BMC Pediatr 2024; 24:239. [PMID: 38575919 PMCID: PMC10993442 DOI: 10.1186/s12887-024-04659-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/21/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The nurturing care framework (NCF) encompasses responsive caregiving, health, nutrition, safety and security by parents and other caregivers. It improves health, development and wellbeing of children. A hospital environment can be detrimental to the developmental and emotional needs of children hence NCF can be applied to hospitalized children. OBJECTIVE The objective was to determine if (i) play stimulation intervention mediated by non-specialist providers (caregivers) improves mental status of children who are hospitalized; (ii) to examine if difference varies between different providers and iii) if there is variation based on child age and criticalness of illness. METHOD A one-group pretest-posttest research was carried out using purposive sampling in a pediatric unit in Karachi, Pakistan, from November 2017 to December 2019. Children aged 3 months to 6 years were offered play stimulation by trainee psychologists. The outcome was measured through an observation tool, the Mental Status Examination Scale (MSE-S) developed for the study. RESULTS A total of 524 sessions were delivered to 351 children. Significant mean difference was observed on MSE-S before and after the intervention when it was provided by trainees (9.95, CI = 8.11, 11.7), mothers (mean difference = 5.86, CI = 5.30, 6.42), fathers (mean difference = 5.86, CI = 4.48, 7.24) and non-specialist providers [caregivers (mean difference = 5.40, CI = 3.91, 6.89). Significant differences in mean was observed on MSE-S across different age groups and criticalness of illness. CONCLUSION It was concluded that play stimulation not only affects the behaviour of children but also varies when delivered by caregivers and trainees. Hence, interventions that involve parents are feasible.
Collapse
Affiliation(s)
- Vardah Noor Ahmed Bharuchi
- Department of Paediatrics and Child Health, The Aga Khan University, National Stadium Road, Karachi, Pakistan.
| | - Muneera A Rasheed
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| |
Collapse
|
11
|
Bleile ACE, Koppenol-Gonzalez GV, Orech B, Verreault K, Jordans MJD. Evaluating a Movement-Based Mental Health Promotion Intervention for Refugee Children in Uganda: A Quasi-Experimental Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-16. [PMID: 38564186 DOI: 10.1080/15374416.2024.2330073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Mental health promotion interventions are widely implemented in humanitarian settings and low- and middle-income contexts (LMICs), yet evidence on effectiveness is scarce and mixed. This study evaluated the movement-based mental health promotion intervention "TeamUp" in Bidibidi refugee settlement, in Northern Uganda. METHOD A quasi-experimental study including four schools (two per arm) assessed the outcomes of 10- to 15-year-old South Sudanese and Ugandan children (n = 549). Randomly allocated, they either participated in up to 11 TeamUp sessions (n = 265) provided by trained facilitators; or belonged to a control group, which continued care as usual (n = 284). Primary outcomes measured psychosocial wellbeing, friendships and attitude to school; secondary outcomes included traumatic distress, depressive symptoms, quality of life, physical health, bullying, interoceptive awareness, and irritability. Data were collected at baseline and endline. RESULTS Children joining TeamUp, showed significantly more improvements on primary outcomes: emotional and psychosocial wellbeing (Mdiff = -1.49, SE = 0.6, p = .01), satisfaction with and attitude toward school (-0.57, SE = 0.2, p = .004); and secondary outcomes: traumatic stress (2.64, SE = 0.8, p < .001), health-related quality of life (-1.56, SE = 0.4, p = .001), physical health (-0.78, SE = 0.3, p = .014) and the TeamUp mechanisms of action scale (-3.34, SE = 0.9, p < .001), specifically the subscales social connectedness (-0.74, SE = 0.3, p = .007) and sense of agency (-0.91, SE = 0.3, p = .005), compared to the control group. No significant differences were found on bullying, interoceptive awareness, irritability and depressive symptoms. CONCLUSION The results are promising for TeamUp as a mental health promotion intervention for children affected by armed-conflict, displacement and on-going adversity. Further research will need to assess the intervention's effectiveness.
Collapse
Affiliation(s)
- Alexandra C E Bleile
- Research and Development Department, War Child
- Amsterdam Institute of Social Science Research, University of Amsterdam
| | | | - Bruce Orech
- Research and Development Department, War Child
| | | | - Mark J D Jordans
- Research and Development Department, War Child
- Amsterdam Institute of Social Science Research, University of Amsterdam
| |
Collapse
|
12
|
Thestrup J, Sørensen JL, Hybschmann J, Topperzer MK, Graber K, O'Farrelly C, Gibson J, Ramchandani P, Frandsen TL, Gjærde LK. Establishing consensus on principles and competencies for the use of play in clinical practice in hospitals: An international Delphi study. Eur J Pediatr 2024; 183:1595-1605. [PMID: 38183437 PMCID: PMC11001713 DOI: 10.1007/s00431-023-05411-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/20/2023] [Accepted: 12/23/2023] [Indexed: 01/08/2024]
Abstract
Although play has existed in paediatric hospitals for decades, a shared understanding of why and how healthcare professionals use play in clinical practice is lacking. This study aims to reach consensus on a common set of principles and competencies for play interventions and practices in hospitals. We conducted a three-round Delphi study that included healthcare professionals selected by hospital management. The first round comprised open-ended questions on the use of play in clinical practice. Principles and competencies, including learning objectives, were established using content analysis through an iterative process. Participants rated the importance of each principle and learning objective in the second and third rounds. Among the 66 participants, 45 (68%) responded in round 1 and 41 (62%) in rounds 2 and 3. The participants represented ten countries and nine different health professions. After the three rounds, we identified 33 principles and six overall competencies: building trusting relationships; delivering information and increasing understanding; promoting cooperation and participation; reducing procedure-related anxiety and pain; supporting coping and development; and ensuring a professional approach to play, which comprised 20 learning objectives. Conclusion: According to healthcare professionals, play in clinical practice can be used to communicate and build relationships with paediatric patients and thus potentially help provide patient-centred care. Our findings may help guide and prioritize future research initiatives and operationalize play interventions and practices in hospitals. What is Known: • Evidence suggests that using play in clinical practice can help paediatric patients during hospitals stays. • Despite the evidence supporting the use of play, a shared understanding of why and how paediatric healthcare professionals use play is needed. What is New: • This international Delphi study contributes to a shared interprofessional understanding of the principles, competencies and learning objectives for the use of play in clinical practice. • The findings have the potential to aid initiatives in developing training programmes for healthcare professionals in using play to provide care with a patient-centred approach.
Collapse
Affiliation(s)
- Jakob Thestrup
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark.
| | - Jette Led Sørensen
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jane Hybschmann
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
| | | | - Kelsey Graber
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Christine O'Farrelly
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Jenny Gibson
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Paul Ramchandani
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Thomas Leth Frandsen
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
| | - Line Klingen Gjærde
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
| |
Collapse
|
13
|
Griffin A, Bowles T, Solis L, Railey T, Beauti S, Robinson R, Spencer SK, Shaffery JP, Wallace K. Maternal immune suppression during pregnancy does not prevent abnormal behavior in offspring. Biol Sex Differ 2024; 15:27. [PMID: 38532505 DOI: 10.1186/s13293-024-00600-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/04/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Offspring of hypertensive disorders of pregnancy are at an increased risk of developing neurodevelopmental and neurobehavioral disorders compared to offspring from non-affected pregnancies. Using rodent models of Preeclampsia (PreE; new onset of hypertension after 20 weeks gestation) and HELLP (hemolysis, elevated liver enzymes, and low platelets), we studied the behavioral outcome of their offspring in adolescence. METHODS A subset of dams received Orencia, a T-cell activation inhibitor, as T cells have been associated with the induction of hypertension and inflammation during pregnancy. We hypothesized that offspring from hypertensive dams would experience adverse behavioral outcomes in social, cognitive, locomotor, and anxiety tests, and offspring from dams treated with Orencia would demonstrate less adverse behaviors. RESULTS Male offspring of PreE + Orencia dams (p < 0.05) and female offspring from HELLP + Orencia dams (p < 0.05) spent more time playing compared to normal pregnant offspring. All offspring from hypertensive and Orencia-treated dams performed worse on the Barnes Maze test compared to normal pregnant. We also measured adult (postnatal day > 60) myelin basic protein (MBP) and NeuN expression in both the prefrontal cortex and hippocampus. In the hippocampus and prefrontal cortex, there was no difference in expression of either MBP or NeuN in all groups regardless of sex. CONCLUSION The results from this study suggest that offspring of hypertensive disorders of pregnancy have behavioral changes, specifically cognitive differences. This study has shown that there is a sex dependent difference in offspring neurobehavioral development, influenced in part by the type of hypertensive disorder of pregnancy, and alterations in the maternal immune system.
Collapse
Affiliation(s)
- Ashley Griffin
- Program in Neuroscience, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Teylor Bowles
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Lucia Solis
- Department of Obstetrics & Gynecology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Teryn Railey
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Samer Beauti
- Master's in Biomedical Science program, School of Graduate Studies in Health Sciences, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Reanna Robinson
- Department of Obstetrics & Gynecology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Shauna-Kay Spencer
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - James P Shaffery
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Kedra Wallace
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
- Department of Obstetrics & Gynecology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| |
Collapse
|
14
|
Guala MM, Bikic A, Bul K, Clinton D, Mejdal A, Nielsen HN, Stenager E, Søgaard Nielsen A. "Maze Out": a study protocol for a randomised controlled trial using a mix methods approach exploring the potential and examining the effectiveness of a serious game in the treatment of eating disorders. J Eat Disord 2024; 12:35. [PMID: 38429839 PMCID: PMC10908122 DOI: 10.1186/s40337-024-00985-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/06/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Eating Disorders (ED) are severe and costly mental health disorders. The effects of existing treatment approaches are limited and there is a need to develop novel interventions, including digital strategies that can increase engagement and effectiveness. Maze Out is a new serious game coproduced by patients and ED therapists, which allows patients to "play" with the reality of an ED and reflect on associated challenges. OBJECTIVES The present study has two main objectives: (1) to evaluate the effectiveness of adding Maze Out to treatment as usual (TAU) in a randomised controlled trial (RCT); and (2) to examine in depth the potential of Maze Out by examining how it is perceived and used in the context of an RCT. METHODS Participants will be recruited from mental health care services, endocrinology departments or Community Centres offering treatment for ED. Patients suffering from ED (N = 94) will be randomised to either TAU or TAU plus Maze Out. Primary outcome will be measured in terms of changes in self-efficacy, measured by a 5-item self-efficacy questionnaire (5-item SE_ED). Secondary outcome measures will include feelings of ineffectiveness and self-image, as measured by Eating Disorder Inventory, version 3 (EDI-3), Brief INSPIRE-O and Structural Analysis of Social Behaviour Intrex Questionnaire (SAS-B). Data will be collected at baseline (enrolment in the study), and subsequently 8 and 15 weeks after inclusion. Experiences of playing Maze Out will be examined in a sub-sample of participants, utilising both quantitative user analytics and qualitative interview data of patients, interview data of significant others, and healthcare professionals to explore the possible impact of Maze Out on disorder insight, communication patterns between patients and therapists and understanding of their disorder. DISCUSSION To our knowledge Maze Out is the first serious game coproduced by patients and therapists. It is a novel and theoretically grounded intervention that may significantly contribute to the healing process of ED. If found effective, the potential for wide-spread impact and scalability is considerable. Trial registration ClinicalTrials.gov NCT05621018.
Collapse
Affiliation(s)
- Maria Mercedes Guala
- Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 18, 5000, Odense, Denmark.
| | - Aida Bikic
- Department of Regional Health Research, Faculty of Health, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Psychiatric Services Southern Jutland, Region of Southern Denmark, Aabenraa, Denmark
| | - Kim Bul
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - David Clinton
- Department of Medical Epidemiology and Biostatistics (MEB), Centre for Eating Disorders Innovation (CEDI), Karolinska Institute, Stockholm, Sweden
| | - Anna Mejdal
- Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 18, 5000, Odense, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Helene Nygaard Nielsen
- Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 18, 5000, Odense, Denmark
| | - Elsebeth Stenager
- Department of Regional Health Research, Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 18, 5000, Odense, Denmark
| |
Collapse
|
15
|
Okelo K, Murray AL, King J, Kitsao-Wekulo P, Onyango S, Nampijja M, Auyeung B. Parental stress and child stimulation practices: examining associations with child developmental outcomes over time in Kenya and Zambia. BMC Psychol 2024; 12:50. [PMID: 38279153 PMCID: PMC10811884 DOI: 10.1186/s40359-024-01533-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/11/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Parental stress often arises when parenting demands exceed the expected and actual resources available for parents to succeed in the parenting role. Parental stress is an important contributor to parent-child relationships. This, in turn, affects opportunities to engage their children in stimulating activities which could improve their development outcomes. However, limited evidence exists from sub-Saharan Africa (SSA) on the association between parental stress, caregiving practices, and child developmental outcomes. METHODS The findings reported in this paper were derived from data collected through previous longitudinal work on nurturing care evaluation studies in Kisumu and Nairobi Counties in Kenya, and Chisamba District in Zambia. A total of 341 caregivers and their children who participated in the three rounds of data collection were included in this study. The children's mean age was 9.3 (SD = 8.2) months pre-intervention, 25.5 (SD = 8.6) months in mid-intervention, and 36 (SD = 10.0) months post-intervention. The Ages and Stages Questionnaire (ASQ), Parental Stress Scale (PSS), and caregiving tools were used to assess children's developmental outcomes, parental stress, and stimulation practices, respectively. A Random Intercept Cross-Lagged Panel model (RI-CLPM) was used to determine the association between caregivers' parenting stress, child stimulation practices, and child developmental outcomes. RESULTS The findings showed that caregiver stimulation practices were positively associated with developmental outcomes. Findings on the associations between parental stress and caregivers' stimulation practices and children's developmental outcomes were not universally supported. CONCLUSION The findings show that improved caregiver stimulation practices are likely to improve children's developmental outcomes. The policy implications of the findings from this study focus on improving parenting practices by addressing the predictors of parental stress. This includes subsidising childcare services to reduce costs. TRIAL REGISTRATION Pan African Clinical Trials Registry ( https://pactr.samrc.ac.za/ ) database (ID number: PACTR20180774832663 Date: 26/July/2018.
Collapse
Affiliation(s)
- Kenneth Okelo
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, EH8 9JZ, Edinburgh, UK.
| | - Aja Louise Murray
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, EH8 9JZ, Edinburgh, UK
| | - Josiah King
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, EH8 9JZ, Edinburgh, UK
| | | | - Silas Onyango
- African Population and Health Research Center, Nairobi, Kenya
| | | | - Bonnie Auyeung
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, 7 George Square, EH8 9JZ, Edinburgh, UK
| |
Collapse
|
16
|
Policastro F, Yahya NB, Rossi A, Silli G, Galeoto G, Taib NI. Motor Development of Children in the Kurdistan Region of Iraq: Parent Survey. CHILDREN (BASEL, SWITZERLAND) 2024; 11:162. [PMID: 38397274 PMCID: PMC10886958 DOI: 10.3390/children11020162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/14/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
The actual literature highlights the importance of the socio-cultural context in the development of children. However, there is a lack of specific evidence about the middle East, especially regarding the development of Kurdish children who are living in a post-war scenario, in a country which is experiencing continuous instability due to the different crises. The main aim of this study is to identify the features of the motor development of Kurdish children according to parents' opinion. A comparison with Italian children is provided as a Western example, which reflects data from the literature. In the study, 331 parents of Kurdish and Italian children aged between 3 and 7 years were involved. Parents filled the questionnaire at kindergartens, after providing consent. The questionnaire was conceptualized, designed, tested and provided ad hoc for this study; it focused on the timing of development, concerning major milestones like head control, sitting and standing-up. The questionnaire consists of 15 questions and has not been standardized yet. A logistic regression showed several differences between Kurdish and Italian children, like head control (p = 0.007) or the manipulation of big objects (p < 0.0001). These results identify the effect of the socio-cultural context and the impact of the growing environment of the child. Moreover, the results of this survey show the need for introducing different adapted, translated and validated assessment tools for motor development, considering differences related to the socio-cultural context.
Collapse
Affiliation(s)
- Francesca Policastro
- Department of Medicine and Health Science, University of Trieste, 34127 Trieste, Italy;
| | - Nizar Bakir Yahya
- College of Medicine, University of Duhok, Duhok 42001, Kurdistan Region, Iraq;
| | - Alessandra Rossi
- Italian Association for Solidarity Among People (AISPO) NGO, Duhok 42001, Kurdistan Region, Iraq;
| | - Giorgia Silli
- Department of Medicine and Health Science, University of Trieste, 34127 Trieste, Italy;
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Neuromed IRCCS, 00185 Rome, Italy;
| | - Nezar Ismet Taib
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, 75105 Uppsala, Sweden;
| |
Collapse
|
17
|
Lee HM, Mercimek-Andrews S, Horvath G, Marchese D, Poulin RE, Krolick A, Tierney KL, Turna J, Wei J, Hwu WL. A position statement on the post gene-therapy rehabilitation of aromatic I-amino acid decarboxylase deficiency patients. Orphanet J Rare Dis 2024; 19:17. [PMID: 38238766 PMCID: PMC10797739 DOI: 10.1186/s13023-024-03019-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare genetic disorder of monoamine neurotransmitter synthesis that presents with a range of symptoms, including motor dysfunction and limited attainment of developmental motor milestones. The approval of eladocagene exuparvovec, a gene therapy for AADC deficiency with demonstrated efficacy for motor improvements, now expands the range of motor outcomes possible for patients with this disorder. However, recommendations and guidelines for therapy following treatment with gene therapy are lacking. To ensure patients can reach their full potential following treatment with gene therapy, it is essential they receive rehabilitation therapies designed specifically with their impairments and goals in mind. Therefore, we highlight specific rehabilitative needs of patients following gene therapy and propose a set of recommendations for the post-treatment period based on collective experiences of therapists, physicians, and caregivers treating and caring for patients with AADC deficiency who have been treated with gene therapy. These recommendations include a focus on periods of intensive therapy, facilitating active movements, training for functional abilities, cognitive and communication training, parent/caregiver empowerment, collaboration between therapists and caregivers to develop in-home programs, and the incorporation of supplemental forms of therapy that patients and their families may find more enjoyable and engaging. Many of these rehabilitative strategies may be employed prior to gene therapy. However, these recommendations will be valuable for therapists, caregivers, and wider treatment teams as they prepare for the post-treatment journey with these patients. Furthermore, the considerations and recommendations presented here may prove beneficial outside the AADC deficiency community as gene therapies and other treatments are developed and approved for other rare diseases.
Collapse
Affiliation(s)
- Hui-Min Lee
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung-Shan South Road, Taipei, 100226, Taiwan
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Linong St. Beitou Dist, No. 155, Sec. 2, Taipei, 112304, Taiwan
| | - Saadet Mercimek-Andrews
- Department of Medical Genetics, University of Alberta, 8613 114 Street, Edmonton, AB, T6G 2H7, Canada
| | - Gabriella Horvath
- Division of Biochemical Genetics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Diana Marchese
- Department of Pediatric Rehabilitation, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA
- Department of Pediatrics, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO, 64108, USA
| | - Richard E Poulin
- Thai-Chinese International School, 101/177 Moo 7 Soi Mooban Bangpleenives, Prasertsin Road, Bangplee Yai, Samut Prakan, 10540, Thailand
| | - Alexis Krolick
- PTC Therapeutics Inc, 100 Corporate Ct #2400, South Plainfield, NJ, 07080, USA
| | - Kati-Lyn Tierney
- Texas Children's Hospital, 6621 Fannin Street, Houston, TX, 77030, USA
| | - Jasmine Turna
- PTC Therapeutics Inc, 100 Corporate Ct #2400, South Plainfield, NJ, 07080, USA
| | - Judy Wei
- Ruamrudee International School, 6 Soi Ramkhamhaeng 184, Khwaeng Min Buri, Min Buri, Bangkok, 10510, Thailand
| | - Wuh-Liang Hwu
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung-Shan South Road, Taipei, 100226, Taiwan.
- Center for Precision Medicine, China Medical University Hospital, 2 Yude Road, 404, Taichung City, Taiwan.
| |
Collapse
|
18
|
Smythe T, Chen S, Rotenberg S, Unger M, Miner E, Seghers F, Servili C, Kuper H. Do children with disabilities have the same opportunities to play as children without disabilities? Evidence from the multiple indicator cluster surveys in 38 low and middle-income countries. EClinicalMedicine 2024; 67:102361. [PMID: 38169717 PMCID: PMC10758749 DOI: 10.1016/j.eclinm.2023.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
Background Play is essential for the cognitive, social, and emotional development of all children. Disparities potentially exist in access to play for children with disabilities, and the extent of this inequity is unknown. Methods Data from 212,194 children aged 2-4 years in 38 Low and Middle-Income Countries were collected in the UNICEF supported Multiple Indicator Cluster Survey (2017-2020). Disability was assessed by the Washington Group-Child Functioning Module. Logistic regression models were applied to investigate the relationship between disability and play opportunities, controlling for age, sex, and wealth status. Meta-analysis was used to pool the estimates (overall, and disaggregated by sex), with heterogeneity assessed by Cochran's Q test. Findings Children with disabilities have approximately 9% fewer play opportunities than those without disabilities (adjusted RR [aRR] = 0.88, 95% CI = 0.82-0.93), and this varied across countries. Mongolia and Democratic Republic of São Tomé and Príncipe had the lowest likelihood of play opportunities for children with disabilities ((aRR = 0.26, 95% CI = 0.09-0.75; aRR = 0.46, 95% CI = 0.23-0.93, respectively). Moreover, children with disabilities are 17% less likely to be provided with opportunities to play with their mothers (aRR = 0.83, 95% CI: 0.73-0.93), which is further reduced for girls with disabilities (aRR = 0.74, 95% CI: 0.60-0.90) compared to their peers without disabilities. The associations varied by impairment type, and children with communication and learning impairments are less likely to have opportunities for play with aRR of 0.69 (95% CI: 0.60-0.79) and 0.78 (95% CI: 0.71-0.86), compared to those without disabilities, respectively. Interpretation Children with disabilities are being left behind in their access to play and this is likely to have negative impacts on their overall development and well-being. Funding HK and TS are funded by HK's NIHR Global Research Professorship (NIHR301621). SR is funded by a Rhodes Scholarship. This study was funded by the Programme for Evidence to Inform Disability Action (PENDA) grant from the UK Foreign, Commonwealth and Development Office.
Collapse
Affiliation(s)
- Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel st, WC1E 7HT, London, UK
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, 8000, South Africa
| | - Shanquan Chen
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel st, WC1E 7HT, London, UK
| | - Sara Rotenberg
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, OX2 6GG, UK
| | - Marianne Unger
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, 8000, South Africa
| | - Emily Miner
- Clinton Health Access Initiative, Boston, MA, 02127, USA
| | | | - Chiara Servili
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel st, WC1E 7HT, London, UK
| |
Collapse
|
19
|
Vita-Barrull N, Estrada-Plana V, March-Llanes J, Guzmán N, Fernández-Muñoz C, Ayesa R, Moya-Higueras J. Board game-based intervention to improve executive functions and academic skills in rural schools: A randomized controlled trial. Trends Neurosci Educ 2023; 33:100216. [PMID: 38049295 DOI: 10.1016/j.tine.2023.100216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/22/2023] [Accepted: 09/24/2023] [Indexed: 12/06/2023]
Abstract
INTRODUCTION This research intends to increase the knowledge about the use of board games in the classroom to train executive functions and academic skills. 99 children from rural schools were assessed in executive functions and academic skills. METHODS Through a randomized controlled trial, they were assigned to a playing group (n = 51) and an active control group (regular classes without games, n = 48). Play program consisted of 12 sessions for 6 weeks with eight commercial board games. RESULTS In flexibility, the playing group was significantly faster after the program (p= = .01, d = 0.76), but not the control group (p = .23; d = 0.35). Both groups improved in the academic tasks, but the significance in calculus was greater in the playing group (p = .00; d = 2.19) than in the control group (p = .01; d = 0.97). DISCUSION The use of board games during school hours could be as good or better methodology for cognitive training and learning academic skills than regular classes.
Collapse
Affiliation(s)
| | | | | | | | | | - Rosa Ayesa
- Center for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Research Group on Mental Illnesses, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain
| | - Jorge Moya-Higueras
- Department of Psychology, University of Lleida, Lleida, Spain; Center for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| |
Collapse
|
20
|
Ramdaniati S, Lismidiati W, Haryanti F, Sitaresmi MN. The effectiveness of play therapy in children with leukemia: A systematic review. J Pediatr Nurs 2023; 73:7-21. [PMID: 37597401 DOI: 10.1016/j.pedn.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023]
Abstract
PROBLEM Leukemia is the most common form of childhood cancer worldwide. Children living with leukemia experience various problems because of the disease's progression, harmful effects of treatment, and prolonged hospitalization process. To increase their well-being and alleviate their problems, these children require ongoing support. One solution that both parents and professionals can use is play therapy. This systematic review aimed to identify the type and effectiveness of play therapy in children living with leukemia. ELIGIBILITY CRITERIA We searched PubMed, Scopus, ScienceDirect, and ProQuest databases. Additionally, we performed manual searches on Google Scholar, Google Web, and grey literature. Inclusion criteria comprised: 1) Studies that implemented play therapy on leukemia children, 2) Full-text articles available in English or Indonesian languages from January 2000 to December 2021 and updated until July 2023, and 3) Intervention studies employing quasi-experimental or randomized controlled trial (RCT) designs. SAMPLE From 1099 articles, 16 studies were selected. Several forms of play therapy were found, including pretend, music, art, and sand play therapy. RESULTS Of the sixteen studies in this systematic review, fifteen demonstrated beneficial effects on psychological issues, particularly anxiety, despair, stress, and physical problems (fatigue and pain). CONCLUSION Play therapy effectively alleviates some physical and psychosocial problems in children living with leukemia. IMPLICATION Nurses can utilize play therapy as an intervention for children living with leukemia. Additionally, comparative research is recommended with a similar research strategy concerning studies with the same design. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022318549.
Collapse
Affiliation(s)
- Sri Ramdaniati
- Doctorate Program of Medical and Health Science, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Department of Nursing, Bandung Health Polytechnic, Bandung, Indonesia.
| | - Wiwin Lismidiati
- Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Fitri Haryanti
- Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Mei Neni Sitaresmi
- Department of Pediatrics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Department of Pediatric, Dr. Sarjito Hospital, Yogyakarta, Indonesia.
| |
Collapse
|
21
|
Estévez-López F, Dall’Aglio L, Rodriguez-Ayllon M, Xu B, You Y, Hillman CH, Muetzel RL, Tiemeier H. Levels of Physical Activity at Age 10 Years and Brain Morphology Changes From Ages 10 to 14 Years. JAMA Netw Open 2023; 6:e2333157. [PMID: 37796507 PMCID: PMC10556964 DOI: 10.1001/jamanetworkopen.2023.33157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/02/2023] [Indexed: 10/06/2023] Open
Abstract
Importance Physical activity may promote healthy brain development in children, but previous research was predominantly cross-sectional and included small samples, providing limited knowledge. Objective To investigate the longitudinal associations of physical activity with brain morphology changes. Design, Setting, and Participants A 4-year longitudinal population-based cohort study in Rotterdam, the Netherlands, embedded in Generation R, a cohort from fetal life onward. From the women enrolled during pregnancy, children who had repeated measures of brain structure at ages 10 (range 8 to 12) years and 14 (range 13 to 15) years were included. Data were collected from March 2013 to November 2015 (baseline) and from October 2016 to January 2020 (follow-up). Data were analyzed from April to December 2022. Exposure At age 10 years, both the child and their primary caregiver reported the child's levels of physical activity with regard to sport participation, outdoor play, and total physical activity. Primary analyses were based on an average multi-informant report. Main outcomes and measures Brain morphology was quantified by magnetic resonance imaging. Hypothesized regions of interest were the bilateral amygdala and hippocampal volumes. Global brain measures were studied to test the specificity of the hypothesis. Results Data were available for 1088 children (566 girls [52%]; 693 [64%] Dutch). Their mean (SD) age at baseline was 10.1 (0.6) years. For amygdala volume change, positive associations with multi-informant reports of total physical activity (β = 2.6; 95% CI, 0.3-4.9) were found. Total physical activity was associated with hippocampal volume increases only when reported by the child (β = 3.1; 95% CI, 0.4-5.8). No robust associations with global brain measures were found. Conclusions and relevance In this cohort study of 1088 children, more physical activity at 10 years was consistently associated with an increase in amygdala volume in children aged 10 to 14 years. Physical activity and increases in hippocampal volume were found using child reports of physical activity only. These findings suggest physical activity in late childhood was prospectively associated with volumetric changes in specific subcortical structures, but not to global brain development, from late childhood to early adolescence. These findings may inform the design of future public health interventions to best facilitate neurodevelopment with physical activity.
Collapse
Affiliation(s)
- Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Education, Faculty of Education Sciences, SPORT Research Group and CERNEP Research Center, University of Almería, Almería, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Lorenza Dall’Aglio
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - María Rodriguez-Ayllon
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Bing Xu
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Yueyue You
- Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Charles H. Hillman
- Department of Psychology, Northeastern University, Boston, Massachusetts
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts
| | - Ryan L. Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| |
Collapse
|
22
|
Nguyen A, Bavelier D. Play in video games. Neurosci Biobehav Rev 2023; 153:105386. [PMID: 37683988 DOI: 10.1016/j.neubiorev.2023.105386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/27/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
Video game play is remarkably ubiquitous in today's society given its recent emergence only in the late 1950s. While this fast evolution could exemplify the power of play, video games exploit but also extend other types of play. Here, we review a classification of the ecosystem of video games useful in the emerging field of the cognitive neuroscience of video games. We then discuss how video games may leverage different play types, considering first locomotor-rotational, object, and social play before highlighting the importance of role, rule, and pretend play in video games. With an eye toward comparative studies of the neural bases of play across species, we discuss whether video games may fulfil the five criteria from Burghardt (2005) to identify play. Finally, in line with play's possible preparatory role for adulthood, we review the positive impact on cognition and future learning of action-like video games. Highlighting that not all video games have this impact, we note more granular hypotheses about the biological functions of play are to be encouraged.
Collapse
Affiliation(s)
- Arthur Nguyen
- Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d'Arve 40, 1211 Geneva 4, Switzerland; Brain and Learning Lab, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland
| | - Daphné Bavelier
- Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d'Arve 40, 1211 Geneva 4, Switzerland; Brain and Learning Lab, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland.
| |
Collapse
|
23
|
Fraser K, Kuhn M, Swanson R, Coulter DW, Copeland C, Zuniga JM. Low Motor Dexterity and Significant Behaviors Following Hospitalized Isolation in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1287. [PMID: 37628286 PMCID: PMC10453062 DOI: 10.3390/children10081287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023]
Abstract
The main objective of this study was to describe the cortical patterns of brain activity during a gross dexterity task and develop a behavioral profile of children experiencing isolation. A cross-sectional assessment was conducted during one visit. Sample: Four pediatric patients who had undergone isolation within a hospital comprised the full data collection. During the collection, participants completed the Box and Blocks Test of gross manual dexterity while undergoing imaging of the motor cortex using functional near-infrared spectroscopy. Participants also completed a Behavioral Assessment System for Children, Third Edition (BASC-3) self-report, which was analyzed along with a parent report to quantify their emotional and social behaviors. All participants displayed lower gross dexterity levels than normative data. Furthermore, three out of the four participants displayed ipsilateral dominance of the motor cortex during the dexterity task. Three of the participants displayed behavioral measures reported within clinically significant or at-risk scores. Clinically significant behavioral scores coupled with lower than expected manual dexterity values and ipsilateral hemispheric dominance indicate that neuroplastic changes can occur in populations undergoing hospitalized isolation. While the impacts of the treatments and isolation in this case cannot be separated, further studies should be conducted to understand these impacts of isolation.
Collapse
Affiliation(s)
- Kaitlin Fraser
- Department of Biomechanics, University of Nebraska Omaha, Omaha, NE 68182, USA (C.C.)
| | - Miriam Kuhn
- Department of Special Education and Communication Disorders, University of Nebraska Omaha, Omaha, NE 68182, USA
| | - Rebecca Swanson
- Pediatric Hematology and Oncology Clinic, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Don W. Coulter
- Division of Pediatric Hematology and Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Children’s Hospital & Medical Center Specialty Pediatric Center, Omaha, NE 68114, USA
| | - Christopher Copeland
- Department of Biomechanics, University of Nebraska Omaha, Omaha, NE 68182, USA (C.C.)
| | - Jorge M. Zuniga
- Department of Biomechanics, University of Nebraska Omaha, Omaha, NE 68182, USA (C.C.)
| |
Collapse
|
24
|
Kavlakci M, Ogce F, Yavan T. The effects of playing digital games on children's pain, fear, and anxiety levels during suturing: A randomized controlled study. Turk J Emerg Med 2023; 23:162-168. [PMID: 37529788 PMCID: PMC10389094 DOI: 10.4103/tjem.tjem_8_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVE The aim was to determine the effects of digital game play on children's pain, fear, and anxiety levels during suturing. METHODS Data were obtained from 84 children between the ages of 8 and 17 years at the pediatric emergency department between January 16 and March 19, 2020, using the Socio-Demographic and Clinical Characteristics Form, the Wong-Baker Faces Pain Rating Scale (WBFPS), the Visual Analogue Scale (VAS), the Fear of Medical Procedures Scale (FMPS), and the State-Trait Anxiety Inventory for Children (STAI-CH). A four-block randomization system was used. The study group (n = 42) played digital games during the suturing procedure, unlike the control group (n = 42). Ethical permissions were obtained from the ethical committee, hospital, and families. RESULTS Before the suturing procedure, there was no statistically significant difference between the groups' mean scores. The intervention group was found to have statistically significantly lower WBFPS and VAS pain scores than the control group during the suturing procedure, and after the procedure, statistically significantly lower WBFPS, VAS, FMPS, and STAI-CH mean scores than the control group. CONCLUSIONS The digital game-playing approach applied before and during the suture procedure was found to be effective in reducing children's pain, fear, and anxiety levels.
Collapse
Affiliation(s)
- Muhammet Kavlakci
- Department Pediatric Emergency, T. R. Ministry Health, İzmir Provincial Health Directorate, Izmir University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Filiz Ogce
- Department of Nursing, Faculty of Health Sciences, Izmir University of Economics, Izmir, Turkey
| | - Tulay Yavan
- Department of Nursing, Faculty of Health Sciences, Izmir University of Economics, Izmir, Turkey
| |
Collapse
|
25
|
Curran T, Losi R, Pymm J, O’Neill JA, Goveia N, Flanagan A, Jakkam R, Hansen K, Gauvreau K, Gauthier N. Positive mindset and exercise capacity in school-aged children and adolescents with congenital heart disease. Front Pediatr 2023; 11:1133255. [PMID: 37334214 PMCID: PMC10272603 DOI: 10.3389/fped.2023.1133255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/09/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Patients with congenital heart disease (CHD) have variable degrees of peak oxygen consumption (VO2) that can be improved with supervised fitness training. The ability to exercise is affected by anatomy, hemodynamics, and motivation. Motivation is in part related to mindset, or personal attitudes and beliefs, and a more positive mindset around exercise has been associated with better outcomes. It is unknown whether variations in measured peak VO2 in patients with CHD are related to having a positive mindset. Methods Patient's ages 8-17 years with CHD were administered quality of life and physical activity questionnaires at the time of their routine cardiopulmonary exercise test. Those with severe hemodynamic burden were excluded. Patients were grouped based on disease classification. Mindset was evaluated via validated questionnaires including a PROMIS Meaning and Purpose (MaP) survey and an Anxiety survey. Pearson correlation coefficients were calculated to estimate the magnitude of the association between percent predicted peak oxygen consumption (pppVO2) and questionnaire scores overall and within CHD subgroups. Results Eighty-five patients participated; median age was 14.7 years, 53% were female, 66% had complex CHD, 20% had simple CHD, and 14% had single ventricle heart disease. Mean MaP scores were significantly lower in all CHD groups compared to population norms (p < 0.001). As a group, MaP scores were positively associated with the amount of reported physical activity (p = 0.017). In patients with simple CHD, MaP scores were positively associated with pppVO2 (p = 0.015). The association was even stronger for MaP:Anxiety, with worse ratios associated with lower pppVO2 (p = 0.005). Patients with complex and single ventricle CHD did not show a similar association. Conclusions Patients with CHD, regardless of severity, had lower meaning and purpose scores than the general population, and these scores were associated with amount of reported physical activity. In the simple CHD subset, having a more positive mindset was associated with higher peak VO2 and a more negative mindset with lower peak VO2. This relationship was not seen with more significant CHD. While underlying CHD diagnoses are not modifiable, mindset and peak VO2 are, and consideration should be given to measuring both as each may be a target for intervention.
Collapse
|
26
|
White DA, Layton AM, Curran T, Gauthier N, Orr WB, Ward K, Vernon M, Martinez MN, Rice MC, Hansen K, Prusi M, Hansen JE. ehealth technology in cardiac exercise therapeutics for pediatric patients with congenital and acquired heart conditions: a summary of evidence and future directions. Front Cardiovasc Med 2023; 10:1155861. [PMID: 37332590 PMCID: PMC10272804 DOI: 10.3389/fcvm.2023.1155861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/18/2023] [Indexed: 06/20/2023] Open
Abstract
Many children and adolescents with congenital and acquired heart disease (CHD) are physically inactive and participate in an insufficient amount of moderate-to-vigorous intensity exercise. Although physical activity (PA) and exercise interventions are effective at improving short- and long-term physiological and psychosocial outcomes in youth with CHD, several barriers including resource limitations, financial costs, and knowledge inhibit widespread implementation and dissemination of these beneficial programs. New and developing eHealth, mHealth, and remote monitoring technologies offer a potentially transformative and cost-effective solution to increase access to PA and exercise programs for youth with CHD, yet little has been written on this topic. In this review, a cardiac exercise therapeutics (CET) model is presented as a systematic approach to PA and exercise, with assessment and testing guiding three sequential PA and exercise intervention approaches of progressive intensity and resource requirements: (1) PA and exercise promotion within a clinical setting; (2) unsupervised exercise prescription; and (3) medically supervised fitness training intervention (i.e., cardiac rehabilitation). Using the CET model, the goal of this review is to summarize the current evidence describing the application of novel technologies within CET in populations of children and adolescents with CHD and introduce potential future applications of these technologies with an emphasis on improving equity and access to patients in low-resource settings and underserved communities.
Collapse
Affiliation(s)
- David A. White
- Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, United States
- School of Medicine, University of Missouri Kansas City, Kansas City, MO, United States
| | - Aimee M. Layton
- Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
| | - Tracy Curran
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Naomi Gauthier
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - William B. Orr
- Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Kendra Ward
- Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States
| | - Meg Vernon
- Division of Cardiology, Department of Pediatrics, Seattle Children’s Hospital, Seattle, WA, United States
| | - Matthew N. Martinez
- Division of Pediatric Cardiology, Department of Pediatrics, Hassenfeld Children’s Hospital at NYU Langone, New York, NY, United States
| | - Malloree C. Rice
- Division of Pediatric Cardiology, Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Katherine Hansen
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Megan Prusi
- Division of Pediatric Cardiology, Department of Pediatrics, C.S. Mott Children’s Hospital, Ann Arbor, MI, United States
| | - Jesse E. Hansen
- Division of Pediatric Cardiology, Department of Pediatrics, C.S. Mott Children’s Hospital, Ann Arbor, MI, United States
| |
Collapse
|
27
|
Lampis V, Mascheretti S, Cantiani C, Riva V, Lorusso ML, Lecce S, Molteni M, Antonietti A, Giorgetti M. Long-Lasting Effects of Changes in Daily Routine during the Pandemic-Related Lockdown on Preschoolers’ Language and Emotional–Behavioral Development: A Moderation Analysis. CHILDREN 2023; 10:children10040656. [PMID: 37189908 DOI: 10.3390/children10040656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023]
Abstract
The quantity and quality of environmental stimuli and contexts are crucial for children’s development. Following the outbreak of SARS-CoV-2 (COVID-19), restrictive measures have been implemented, constraining children’s social lives and changing their daily routines. To date, there is a lack of research assessing the long-lasting impacts that these changes have had on children’s language and emotional–behavioral development. In a large sample of preschoolers (N = 677), we investigated (a) the long-lasting effects of changes in family and social life and in daily activities over the first Italian nationwide COVID-19-pandemic-related lockdown upon children’s linguistic and emotional–behavioral profiles and (b) how children’s demographic variables and lifelong family characteristics moderated these associations within a multiple-moderator framework. Our findings showed a relationship between the time spent watching TV/playing video games and affective problems that was moderated by the number of siblings. Our findings showed that children who could be at high risk in more normal circumstances, such as only children, have been particularly harmed. Therefore, assessing the long-term effects of lockdown-related measures and how these could have been moderated by potential risk/protective factors added significant information to the existing literature.
Collapse
Affiliation(s)
- Valentina Lampis
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, PV, Italy
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, LC, Italy
| | - Sara Mascheretti
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, PV, Italy
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, LC, Italy
| | - Chiara Cantiani
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, LC, Italy
| | - Valentina Riva
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, LC, Italy
| | - Maria Luisa Lorusso
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, LC, Italy
| | - Serena Lecce
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, PV, Italy
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, LC, Italy
| | - Alessandro Antonietti
- Department of Psychology, Catholic University of the Sacred Heart, 20123 Milan, MI, Italy
| | - Marisa Giorgetti
- Department of Psychology, Catholic University of the Sacred Heart, 20123 Milan, MI, Italy
| |
Collapse
|
28
|
Parent-Reported Caregiving Roles of Siblings of Children with Inborn Errors of Metabolism. J Dev Behav Pediatr 2023; 44:e300-e308. [PMID: 37126774 DOI: 10.1097/dbp.0000000000001168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 11/30/2022] [Indexed: 03/01/2023]
Abstract
OBJECTIVES Research examining sibling caregiving contributions to medically complex pediatric patients, including those with inborn errors of metabolism (IEMs), is limited. We assess caregiving roles and attributes of siblings and hypothesize that there will be differences in parent-reported contributions among siblings of children with IEMs and siblings of typically developing (TD) children. STUDY DESIGN A convergent parallel mixed-methods study design guided analysis of data from parental surveys and semistructured interviews. Interviews were conducted with parents (n = 49) of children with IEMs and parents (n = 28) of exclusively TD children. We used inductive thematic analysis to identify themes related to sibling caregiving. The caregiving and support roles for siblings (n = 55) of children with IEMs and siblings (n = 42) of TD children were coded to assess each sibling's caregiving contributions and personal attributes. RESULTS Logistic regressions, using generalized estimating equations, were fitted. Results showed that siblings of children with IEMs were significantly more likely to provide monitoring (odds ratio [OR]: 3.62, confidence interval [CI]: 1.30-10.07) and emotional/social support (OR: 4.02, CI: 1.67-9.67) than siblings of TD children. Themes arising from interviews with parents of children with IEMs focused on sibling attributes, parental expectations regarding sibling caregiving, and challenges to the sibling-sibling and parent-sibling relationships. Themes revealed nuances in the sibling caregiving experience. CONCLUSION Siblings of children with IEMs make meaningful caregiving contributions and may provide care differently than siblings of TD children. Understanding childhood caregiving roles may inform how health care providers and parents encourage sibling caregiving contributions into adulthood.
Collapse
|
29
|
Pellis SM, Pellis VC, Ham JR, Stark RA. Play fighting and the development of the social brain: The rat's tale. Neurosci Biobehav Rev 2023; 145:105037. [PMID: 36621585 DOI: 10.1016/j.neubiorev.2023.105037] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/29/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023]
Abstract
The benefits gained by young animals engaging in play fighting have been a subject of conjecture for over a hundred years. Progress in understanding the behavioral development of play fighting and the underlying neurobiology of laboratory rats has produced a coherent model that sheds light on this matter. Depriving rats of typical peer-peer play experience during the juvenile period leads to adults with socio-cognitive deficiencies and these are correlated with physiological and anatomical changes to the neurons of the prefrontal cortex, especially the medial prefrontal cortex. Detailed analysis of juvenile peer play has shown that using the abilities needed to ensure that play fighting is reciprocal is critical for attaining these benefits. Therefore, unlike that which was posited by many earlier hypotheses, play fighting does not train specific motor actions, but rather, improves a skill set that can be applied in many different social and non-social contexts. There are still gaps in the rat model that need to be understood, but the model is well-enough developed to provide a framework for broader comparative studies of mammals from diverse lineages that engage in play fighting.
Collapse
Affiliation(s)
- Sergio M Pellis
- Department of Neuroscience, University of Lethbridge, Lethbridge, Alberta T1K3M4, Canada.
| | - Vivien C Pellis
- Department of Neuroscience, University of Lethbridge, Lethbridge, Alberta T1K3M4, Canada
| | - Jackson R Ham
- Department of Neuroscience, University of Lethbridge, Lethbridge, Alberta T1K3M4, Canada
| | - Rachel A Stark
- Department of Neuroscience, University of Lethbridge, Lethbridge, Alberta T1K3M4, Canada
| |
Collapse
|
30
|
Hoffmann-Lamplmair D, Gram A, Krottendorfer K, Peyrl A, Leiss U, Czech T, Slavc I, Pletschko T. Sociocultural variables have a major impact on participation in patients treated for paediatric posterior fossa tumours. Child Care Health Dev 2023; 49:106-118. [PMID: 35708465 PMCID: PMC10083959 DOI: 10.1111/cch.13023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/21/2022] [Accepted: 06/13/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study investigates the severeness of participation barriers in patients surviving paediatric posterior fossa tumours (PFT) many years after treatment. In the past, aetiological studies on adverse outcome have primarily focused on pathobiological risk factors. The current analysis aims to investigate the importance of environmental variables. METHODS On average, 10 years after diagnosis, educational and social difficulties of 42 patients surviving paediatric PFT (mean age 17 years) were inquired using a self-constructed questionnaire following the Psychosocial Resource-Orientated Assessment (PREDI). Educational or social participation barriers were defined by self- and/or proxy-reported difficulties in school or in peer relationships. Accordingly, the children and adolescents were categorized into groups of adequate and limited participation. Subsequently, the study identified potential pathobiological (treatment type, hydrocephalus, tumour relapse, gender, age at diagnosis, seizures and cerebellar mutism) and environmental (parental and maternal education, siblings, main language, discrepancies between personal and environmental values, regular physical activity and private living space) risk factors and investigated whether patients with adequate and limited participation differed in the number of risk factors. RESULTS Almost one decade after treatment, two thirds of patients experienced educational and/or social difficulties. Patients with limited participation were more frequently associated with environmental factors such as low maternal education degree, siblings, main language other than German, discrepancies between societal and personal values and irregular physical activity, as well as the pathobiological risk factors treatment type, hydrocephalus, tumour relapse, cerebellar mutism and seizures. These variables significantly discriminated between patients with and without limited participation. CONCLUSIONS Limited participation in patients treated for paediatric PFT is common. Next to pathobiological, also environmental risk factors play a major role in educational and social participation barriers. This highlights the fact that solely considering pathobiology is not sufficient when investigating risk factors for the emergence of late sequelae. Future aetiological studies must adopt a biopsychosocial perspective.
Collapse
Affiliation(s)
- Doris Hoffmann-Lamplmair
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Alexandra Gram
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Kerstin Krottendorfer
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Andreas Peyrl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Ulrike Leiss
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Thomas Czech
- Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria.,Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Irene Slavc
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| | - Thomas Pletschko
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics Vienna, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
31
|
Taylor LG, Primucci M, Vanderloo LM, Arbour-Nicitopoulos KP, Leo J, Gilliland J, Tucker P. A scoping Review of Tools to Evaluate Existing Playgrounds for Inclusivity of Children with Disabilities. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1102490. [PMID: 36910877 PMCID: PMC9995607 DOI: 10.3389/fresc.2023.1102490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/31/2023] [Indexed: 02/25/2023]
Abstract
Introduction Children with disabilities may be unable engage playground spaces due to barriers exacerbating exclusion. Therefore, clarity on how to evaluate existing playgrounds for inclusivity of children with disabilities is required. Methods A scoping review was undertaken to explore auditing tools. Results Fourteen white and grey literature resources were identified. The term "inclusion" was operationalized differently across tools, primarily focusing on physical accessibility. Characteristics of the tools were synthesized into 13 inclusive design recommendations for playgrounds. Two tools showed promise, evaluating 12/13 recommendations. Discussion The results of this review provide guidance on existing tools for evaluating playgrounds for inclusion for community stakeholders and researchers. Systematic Review Registration https://osf.io/rycmj.
Collapse
Affiliation(s)
- Leah G Taylor
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.,Child Health and Physical Activity Laboratory, Western University, London, Ontario, Canada
| | - Mara Primucci
- Child Health and Physical Activity Laboratory, Western University, London, Ontario, Canada
| | - Leigh M Vanderloo
- Child Health and Physical Activity Laboratory, Western University, London, Ontario, Canada.,School of Occupational Therapy, Western University, London, Ontario, Canada.,ParticipACTION, Toronto, Ontario, Canada
| | - Kelly P Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, Mental Health and Physical Activity Research Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Leo
- Steadward Centre for Personal and Physical Achievement, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Jason Gilliland
- Department of Geography and Environment, Western University, London, Ontario, Canada.,Department of Paediatrics, Schulich School of Medicine, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine, London, Ontario, Canada.,School of Health Studies, Western University, London, Ontario, Canada.,Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Patricia Tucker
- Child Health and Physical Activity Laboratory, Western University, London, Ontario, Canada.,School of Occupational Therapy, Western University, London, Ontario, Canada.,Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
| |
Collapse
|
32
|
Montreuil M, Gendron‐Cloutier L, Laberge‐Perrault E, Piché G, Genest C, Rassy J, Malboeuf‐Hurtubise C, Gilbert E, Bogossian A, Camden C, Mastine T, Barbo G. Children and adolescents' mental health during the COVID-19 pandemic: A qualitative study of their experiences. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2022; 36:65-74. [PMID: 36566357 PMCID: PMC9880751 DOI: 10.1111/jcap.12404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/03/2022] [Accepted: 12/04/2022] [Indexed: 12/26/2022]
Abstract
TOPIC Public health measures implemented in response to the COVID-19 pandemic severely disrupted children and adolescents' (C&A) lives, affecting their sense of structure, predictability, and security. PURPOSE To examine C&A' experiences during the COVID-19 pandemic to better understand how this context and its associated public health measures affected them and their mental health, and to identify helpful coping strategies. SOURCES USED The study was guided by a participatory hermeneutic framework. Semistructured interviews were conducted with 25 C&A aged 6-17 years during the first and second pandemic waves. Participants' interviews were analyzed following a narrative synthesis approach, through which C&A' experiences were contrasted and contextualized to highlight relevant themes. CONCLUSIONS Participants described a distinct pattern related to their mental health as the pandemic unfolded, which followed the severity of the pandemic in the province. Negative repercussions on their mental health were linked to the loss of social activities, imposed public health measures, transition to online learning, and challenges with family relationships. Certain youth shared positive societal and moral reflections triggered by the pandemic context. Coping strategies reported include: having a variety of hobbies; expressing their emotions; and accessing financial and material resources. This study highlights the importance of supporting C&A' mental health during crisis situations such as a pandemic. Their perspectives are vital for clinical practice and policy improvement, particularly to find means for social engagement while maintaining safety.
Collapse
Affiliation(s)
- Marjorie Montreuil
- Ingram School of NursingMcGill UniversityMontrealQuebecCanada,Centre de recherche de l'Institut universitaire en santé mentale de MontréalMontréalQuebecCanada,Centre de recherche de l'Institut universitaire en santé mentale DouglasMontréalQuebecCanada
| | | | | | - Geneviève Piché
- Université du Québec en Outaouais, Campus de Saint‐JérômeGatineauQuebecCanada
| | - Christine Genest
- Centre d'étude sur le trauma du Centre de recherche de l'Institut universitaire en santé mentale de Montréal et le Centre de recherche et d'intervention sur le suicide, les enjeux éthiques et pratiques de fin de vie, Faculté des sciences infirmièresUniversité de MontréalMontrealQuebecCanada
| | - Jessica Rassy
- École des sciences infirmièresUniversité de Sherbrooke, Campus de LongueuilLongueuilQuebecCanada
| | | | - Elsa Gilbert
- Département des sciences de la santéUniversité du Québec à RimouskiRimouskiQuebecCanada
| | - Aline Bogossian
- École de travail socialUniversité de MontréalMontrealQuebecCanada
| | - Chantal Camden
- School of Physical and Occupational TherapySherbrooke UniversitySherbrookeQuebecCanada
| | | | - Geneveave Barbo
- Ingram School of NursingMcGill UniversityMontrealQuebecCanada
| |
Collapse
|
33
|
Effects of Eight Weeks of Selected Virtual-Assisted Montessori-Based Games on Motor Proficiency and Perceived Self-Control in Children with Spastic Hemiplegia during the Coronavirus Outbreak. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5792094. [DOI: 10.1155/2022/5792094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/15/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
This study is aimed at examining the effect of eight weeks of selected virtual-assisted games based on Montessori pedagogical principal on the motor proficiency and perceived self-control in the children with spastic hemiplegia during the coronavirus outbreak. In this quasi-experimental study, the children (
) with hemiplegia were randomly selected and assigned to either the experimental group or the control group. In the pretest, motor skills and self-controlling were evaluated using 36-item Lincoln-Oseretsky Motor Development Scale and Children’s Perceived Self-Control Scale (CPSC) (ss, 1982), respectively. The experimental group then engaged in three 45-minute sessions of virtual game play over the course of eight weeks. 24 hours following the last practice session, the posttest was given on the same day as the pretest. After ensuring the normal distribution of collected data with Shapiro-Wilk test, the data were analyzed using Analysis of Covariance test (ANCOVA). Results showed that the experimental group compared to the control group was better in the motor proficiency and perceived self-control after performing selected virtual-assisted Montessori games can significantly improve motor proficiency and perceived self-control (
). This pattern of data revealed that the virtual-assisted intervention based on Montessori pedagogical principles may increase motor proficiency and self-control in children with hemiplegia, particularly when confronted with the limitations imposed on by the coronavirus epidemic.
Collapse
|
34
|
Acolin J, Hajat A, Nurius PS, Lengua LJ. Playgrounds are for children: Investigating developmentally-specific "Green Space" and child mental health. SSM - MENTAL HEALTH 2022; 2:100087. [PMID: 38292754 PMCID: PMC10826856 DOI: 10.1016/j.ssmmh.2022.100087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
"Green space" effects on health have been amply demonstrated, but whether specific features of green space exert differential effects remains unknown. Driven by developmental psychology theory highlighting the importance of play for young children, we investigated the association between parks with playgrounds, as a subtype of "green space", and young child mental health. After adjusting for individual race, sex, income, and cumulative risk as well as neighborhood disadvantage, we find that children (N=95) living near parks with playgrounds have better mental health than those near parks without playgrounds (β ˆ = - 1.22 (95% CI: -3.82 - 1.38, p=0.36) Child Behavior Checklist scale). While not statistically significant, the observed difference, which is equivalent to 11% of the baseline mean score, is meaningful. Our results, while only suggestive, indicate that moving beyond "green space" to investigate developmentally-specific features may be worthwhile.
Collapse
Affiliation(s)
- Jessica Acolin
- Department of Health Systems and Population Health, School of Public Health, University of Washington, 3980 15 Ave NE, Seattle WA USA
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, 3980 15 Ave NE, Seattle WA USA
| | - Paula S. Nurius
- School of Social Work, University of Washington, 4101 15 Ave NE, Seattle WA USA
| | - Liliana J. Lengua
- Department of Psychology, University of Washington, 3751 W. Stevens Way NE, Seattle WA USA
| |
Collapse
|
35
|
Chai CWE, Lau BT, Tee MKT, Al Mahmud A. Evaluating a serious game to improve childhood cancer patients' treatment adherence. Digit Health 2022; 8:20552076221134457. [PMID: 36339903 PMCID: PMC9630903 DOI: 10.1177/20552076221134457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Childhood cancer patients need to have good treatment adherence.
Unfortunately, treatment non-adherence often occurs due to high side-effect
burdens of treatment and the lack of knowledge of one's illness and
treatment. Therefore, a serious game intervention based on the Protection
Motivation Theory (PMT) was designed and developed to motivate childhood
cancer patients to undergo treatment and to motivate them to undergo
treatment, perform daily self-care and educate them about their illness. Methods Childhood cancer patients (6–17 years old) and their caregivers were
recruited in a multi-centre, single-arm intervention in Malaysia. A total of
24 child-caregiver dyads have completed the study. This study used PMT-based
surveys to collect quantitative data regarding children's motivation to
adhere to treatment and perform daily self-care. Additionally, a 20-question
multiple-choice quiz was used to determine children's knowledge levels.
These surveys were conducted pre-test and post-test. Children's and
caregivers' feedback were also gathered post-test as qualitative data. Results The results showed that overall, the children's intention to undergo cancer
treatment had increased significantly. A significant increase in the
intention to perform daily self-care was found among younger children, while
older children showed significant improvement in their cancer knowledge
levels. The post-test feedback suggested that the game was liked by both
children and caregivers and it provided various benefits to children with
cancer. Conclusions Findings suggest that the intervention has the potential to improve childhood
cancer patients’ motivation for treatment adherence and daily self-care, in
addition to educating them about cancer and treatment.
Collapse
Affiliation(s)
- Carmen Wang Er Chai
- Faculty of Engineering, Computing and Science, Swinburne University of Technology -
Sarawak Campus, Kuching, Sarawak, Malaysia,Carmen Chai, Swinburne University of
Technology Sarawak Campus, Jalan Simpang Tiga, 93350 Kuching, Sarawak, Malaysia.
;
| | - Bee Theng Lau
- Faculty of Engineering, Computing and Science, Swinburne University of Technology -
Sarawak Campus, Kuching, Sarawak, Malaysia
| | - Mark Kit Tsun Tee
- Faculty of Engineering, Computing and Science, Swinburne University of Technology -
Sarawak Campus, Kuching, Sarawak, Malaysia
| | - Abdullah Al Mahmud
- School of Design and Architecture, Swinburne University of
Technology, Melbourne, Victoria, Australia
| |
Collapse
|
36
|
Davis SL, Soistmann HC. Child's perceived stress: A concept analysis. J Pediatr Nurs 2022; 67:15-26. [PMID: 35882112 PMCID: PMC10167593 DOI: 10.1016/j.pedn.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/26/2022]
Abstract
PROBLEM Child's perceived stress is a term used widely in literature, yet it is poorly defined. Perceived stress in childhood has been linked to negative health outcomes throughout the lifespan. Therefore, the ability of researchers and healthcare providers to conceptualize child's perceived stress and form accurate measures of the concept is of utmost importance. ELIGIBILITY CRITERIA Following the eight steps identified by Walker and Avant, a literature review was conducted to identify studies that measured perceived stress in school-age children over the last 10 years. SAMPLE Of 914 records identified, 136 were screened, and 16 met inclusion criteria. RESULTS Child's perceived stress is best defined as any actual or imagined threat, personal and specific to childhood, which overwhelms the child and leads to changes in emotional, psychological, developmental, and/or physiological domains. CONCLUSIONS While the concept of child's perceived stress is understood similarly throughout studies, there is notable variation in the way child's perceived stress is measured. Because of the specificity of perceived stress to childhood, and the wide range of what may be perceived as stressful by the child, the child is the best reporter of child's perceived stress. IMPLICATIONS Researchers and clinicians must use child self-report tools to measure the concept of child's perceived stress. Opportunities exist for healthcare workers to intervene, educate, and help children and families recognize and manage child's perceived stress. This concept analysis includes many resources that practitioners may use to help alleviate stress in children.
Collapse
Affiliation(s)
- Sara L Davis
- University of South Alabama College of Nursing, 5721 Dr. N., Mobile, AL 36608, USA.
| | - Heather C Soistmann
- Penn State Health Children's Hospital, 500 University Dr, Hershey, PA 17033, USA.
| |
Collapse
|
37
|
Pellis SM, Pellis VC, Ham JR, Achterberg EJM. The rough-and-tumble play of rats as a natural behavior suitable for studying the social brain. Front Behav Neurosci 2022; 16:1033999. [PMID: 36330048 PMCID: PMC9623181 DOI: 10.3389/fnbeh.2022.1033999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/03/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Sergio M. Pellis
- Department of Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
- *Correspondence: Sergio M. Pellis
| | - Vivien C. Pellis
- Department of Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
| | - Jackson R. Ham
- Department of Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
| | - E. J. M. Achterberg
- Division of Behavioural Neuroscience, Unit Animals in Science and Society, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| |
Collapse
|
38
|
Kacar D, Ayaz-Alkaya S. The effect of traditional children's games on internet addiction, social skills and stress level. Arch Psychiatr Nurs 2022; 40:50-55. [PMID: 36064245 DOI: 10.1016/j.apnu.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 04/13/2022] [Accepted: 04/17/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Traditional children's games can protect the physical, emotional, and mental health of children. This study was conducted to determine the effect of traditional children's games on internet addiction, social skills, and stress level. METHODS A pre-test/post-test quasi-experimental design with a control group was used. The population of the study consisted of a fifth- and sixth-grade students studying at two secondary schools in a city of Turkey. A total of 42 students - 20 in the intervention group and 22 in the control group - were included in the study. The Family-Child Internet Addiction Scale, the Social Skills Assessment Scale, the Social Skills Scale, and the Perceived Stress Scale in Children (8-11 years) were used to collect the data. The intervention group received eight weeks of traditional children's games. RESULTS There was no significant difference between the intervention and control groups in terms of internet use, social skills, and stress level in the pre-test (p > 0.05). There was a statistically significant difference between groups in terms of daily and weekly internet use in the post-test (p < 0.05). The mean scores regarding social skills of the intervention group increased after the games compared with the control group (p < 0.05). There was no statistically significant difference between the groups in terms of stress-level mean scores (p > 0.05). CONCLUSIONS The results showed that traditional children's games may be effective in reducing internet use and increasing social skills, however they do not affect stress level. Childhood is important for physical, cognitive, and psychosocial development. Therefore, in the school settings, traditional children's games can be used for the protection and promotion of children's health.
Collapse
Affiliation(s)
- Dilek Kacar
- Çivril Şehit Hilmi Öz State Hospital, Denizli, Turkey
| | - Sultan Ayaz-Alkaya
- Gazi University, Faculty of Health Sciences, Department of Nursing, Ankara, Turkey.
| |
Collapse
|
39
|
Estévez-López F, Levelt L, van 't Veer J, Hrehovcsik MM, Visch V, Bramer WM, Hillegers MHJ, van de Putte E, Veltkamp RC, Nijhof SL. Game mechanics in eHealth interventions promoting self-management in young people with chronic diseases: a protocol for a systematic review and meta-analyses from the eHealth Junior Consortium. BMJ Open 2022; 12:e059581. [PMID: 36167372 PMCID: PMC9516077 DOI: 10.1136/bmjopen-2021-059581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Young people (aged 10-25 years) with chronic diseases are vulnerable to have reduced social participation and quality of life. It is important to empower young people to engage in their chronic diseases self-management. In comparison with traditional face-to-face care, interventions delivered through the internet and related technologies (eHealth) are less stigmatising and more accessible. Gamified eHealth self-management interventions may be particularly promising for young people. This systematic review aims at identifying (1) the game mechanics that have been implemented in eHealth interventions to support young people's self-management of their chronic (somatic or psychiatric) diseases, (2) the investigators' rationale for implementing such game mechanics and, if possible, (3) the effects of these interventions. METHODS AND ANALYSIS The Preferred Reporting Items for Systematic reviews and Meta-Analysis statement guidelines will be followed. A systematic search of the literature will be conducted in Embase, Psycinfo and Web of Science from inception until 30 August 2022. Studies will be eligible if focused on (1) young people (aged 10-25 years) with chronic diseases and (2) describing gamified eHealth self-management interventions. When possible, the effects of the gamified interventions will be compared with non-gamified interventions or care-as-usual. Primary quantitative, qualitative or mixed-method studies written in English will be included. Two independent reviewers will (1) select studies, (2) extract and summarise the implemented game mechanics as well as the characteristics of the intervention and study, (3) evaluate their methodological quality and (4) synthesise the evidence. The reviewers will reach a consensus through discussion, and if required, a third researcher will be consulted. ETHICS AND DISSEMINATION As systematic reviews use publicly available data, no formal ethical review and approval are needed. Findings will be published in peer-reviewed journals, presented at conferences and communicated to relevant stakeholders including patient organisations via the eHealth Junior Consortium. PROSPERO REGISTRATION NUMBER CRD42021293037.
Collapse
Affiliation(s)
- Fernando Estévez-López
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Lisa Levelt
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Job van 't Veer
- Department of Healthcare, NHL Stenden University of Applied Sciences, Leeuwarden, Fryslân, The Netherlands
| | | | - Valentijn Visch
- Department of Human Centered Design, Faculty of Industrial Design Engineering, TU Delft, Delft, Zuid-Holland, The Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Zuid-Holland, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, Zuid-Holland, The Netherlands
| | - Elise van de Putte
- Department of Paediatrics, Wilhelmina Children's Hospital University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Remco C Veltkamp
- Department of Information and Computing Sciences, Utrecht University, Utrecht, The Netherlands
| | - Sanne L Nijhof
- Department of Paediatrics, Wilhelmina Children's Hospital University Medical Centre, Utrecht, The Netherlands
| |
Collapse
|
40
|
Pouplier A, Larsen HB, Christensen J, Schmidt-Andersen P, Winther H, Fridh MK. The rehabilitation including structured active play (RePlay) model: A conceptual model for organizing physical rehabilitation sessions based on structured active play for preschoolers with cancer. Front Pediatr 2022; 10:980257. [PMID: 36238603 PMCID: PMC9551994 DOI: 10.3389/fped.2022.980257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/01/2022] [Indexed: 11/25/2022] Open
Abstract
Anti-cancer treatments, as well as cancer itself, reduce children's cardiorespiratory fitness, muscle strength, and gross motor functions. Early rehabilitation programs, including physical activity for childhood cancer patients, can counteract these adverse effects. Previous studies of school-aged children (6-18 years old) indicate that physical activity, including aerobic and resistance training, is safe, feasible, and effective. The goal of structured physical activity rehabilitation for preschool children (1-5 years old) is to support gross motor development and opportunities to move freely in various ways. Specific rehabilitation for preschoolers diagnosed with cancer is needed to promote physical-, social-, and personal development. This paper introduces a conceptual model-The RePlay (Rehabilitation including structured active play) Model-for organizing physical rehabilitation sessions based on structured active play for preschoolers with cancer. The theory and empirically based model combine knowledge of early childhood development, play, physical activity and rehabilitation for children with cancer, and cancer treatment. With this model, we propose how to structure rehabilitation sessions, including goal-oriented, age-sensitive, fun movement activities that facilitate preschoolers to develop gross motor skills while enhancing their social and personal skills, through four core principles: (1) ritual practices, (2) reinforcement of movement through repetition, (3) development through appropriate challenge, and (4) adjusting activities to accommodate treatment-related side effects. This model holds promise for use with preschoolers diagnosed with cancer, as it is scalable and pragmatic and accounts for the children's fluctuating physical capacity and daily wellbeing during cancer treatment.
Collapse
Affiliation(s)
- Anna Pouplier
- Department of Pediatric and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Baekgaard Larsen
- Department of Pediatric and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Center of Head and Orthopedic Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Peter Schmidt-Andersen
- Department of Pediatric and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Occupational Therapy and Physiotherapy, Center of Head and Orthopedic Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Helle Winther
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Pediatric and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
41
|
Yamaji N, Suzuki D, Suto M, Sasayama K, Ota E. Communication Tools Used in Cancer Communication with Children: A Scoping Review. Cancers (Basel) 2022; 14:cancers14194624. [PMID: 36230548 PMCID: PMC9563078 DOI: 10.3390/cancers14194624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Despite the potential benefits of effective communication, telling children about unpredictable and life-threatening conditions such as cancer is challenging. This scoping review aimed to map the potential communication tools for children with cancer, their families, and healthcare professionals. We found 25 studies and 21 communication tools. Communication tools might support children to improve their knowledge and psychological outcomes. However, we found a lack of communication tools that were (1) accessible and validated, (2) designed for healthcare professionals, (3) targeted children, families, and healthcare professionals, and (4) were designed to meet the needs of children and families. This review identified areas for further research. Abstract Background: Although communication tools might guide healthcare professionals in communicating with children about cancer, it is unclear what kind of tools are used. This scoping review aimed to map the communication tools used in cancer communication among children with cancer, families, and healthcare professionals. Methods: A comprehensive search using PubMed (including MEDLINE), Embase, CENTRAL, PsycINFO, and CINAHL was conducted on 1 August 2021. We mapped communication tools and their impacts. Results: We included 25 studies (9 experimental studies and 16 feasibility studies) of 29 reports and found 21 communication tools. There was a lack of communication tools that were (1) accessible and validated, (2) designed for healthcare professionals, (3) targeted children, families, and healthcare professionals, and (4) were designed to meet the needs of children and families. Experimental studies showed that the communication tools improved children’s knowledge and psychological outcomes (e.g., health locus of control, quality of life, self-efficacy). Conclusion: We mapped communication tools and identified areas that needed further research, including a lack of tools to guide healthcare professionals and share information with children and families. Further research is needed to develop and evaluate these communication tools. Moreover, it is necessary to investigate how communication tools support children, families, and healthcare professionals.
Collapse
Affiliation(s)
- Noyuri Yamaji
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
- Correspondence:
| | - Daichi Suzuki
- Department of Nursing, Faculty of Health and Medical Sciences, Kanagawa Institute of Technology, 1030 Shimo-ogino, Atsugi 243-0292, Japan
| | - Maiko Suto
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Kiriko Sasayama
- Global Health Nursing, International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba 286-8686, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
- Tokyo Foundation for Policy Research, Roppongi Grand Tower 34F, 3-2-1 Roppongi, Minato-ku, Tokyo 106-6234, Japan
| |
Collapse
|
42
|
Lament C. What COVID-19 Laid Bare About What Children Need to Live and Grow. THE PSYCHOANALYTIC QUARTERLY 2022; 91:273-291. [PMID: 36036943 DOI: 10.1080/00332828.2022.2078637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
The author explores the unconscious meanings of the physical absence of the three-dimensional world of people and how these play a critical role in children's reactions to restrictions in human contact during the COVID-19 pandemic. When children are deprived of the corporeality of loved ones, the children's continuously emerging and unstable self-and-other arrangements may trap normative feelings of envy, jealousy, hatred, rivalry, love, and idealization. During lockdowns, there is no place where these raw emotions can be tested, so they remain untempered by the real presence of others and by interactivity with them, feeding aggression that is turned back against the child with frightening ferocity. How do children who must reside in such abstinence during a pandemic pull themselves up the ladder of growth when others whom they rely upon to help them discover who they are, are not there? A description of an observation of a young child attending a Zoom classroom is included, with accompanying commentary.
Collapse
|
43
|
A Comprehensive Analysis of the Relationship between Play Performance and Psychosocial Problems in School-Aged Children. CHILDREN 2022; 9:children9081110. [PMID: 35892613 PMCID: PMC9329709 DOI: 10.3390/children9081110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022]
Abstract
During childhood, play contributes to the physical, emotional, cognitive and social development of infants and children and may enhance future mental health. The aim of this study was to examine the relationship between play performance factors and psychosocial problems in school-aged children. A total of 142 typical Spanish children aged 5 to 9 years were included. Play performance was measured with the My Child’s Play questionnaire, while the Strengths and Difficulties Questionnaire was used to evaluate internalizing and externalizing problems. The findings showed that personal, environmental and activity factors of play performance were associated with psychosocial problems and prosocial behavior in children. Moreover, children with high psychosocial difficulties reported significantly poorer play performance. As executive functioning during play was the factor that was most strongly associated with internalizing and externalizing psychosocial difficulties, it is possible that executive functions have a decisive role on both social cognition and self-regulation during play performance.
Collapse
|
44
|
Kanewischer E, Mueller C, Pylkkanen M, Tunks S. Hardships & Resilience: Families in a Pandemic. FAMILY JOURNAL (ALEXANDRIA, VA.) 2022; 30:366-375. [PMID: 35855734 PMCID: PMC9277313 DOI: 10.1177/10664807211054182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic created unique hardships for families with school-aged children. To better understand these hardships, we asked the question: How did family units of various racial and socioeconomic backgrounds experience the pandemic? Qualitative phenomenology was the methodological basis for this study, and the Double ABC-X Model of Family Behavior was applied to analyze how the pandemic and racial tensions that occurred in the past 18 months affected families. We specifically focused on including the voices of minoritized populations as they are less often represented in phenomenological research. Semi-structured virtual interviews were conducted with families from Minnesota and Illinois. NViVo was used to code and analyze the interviews. Five themes were identified which demonstrated family strength and experience of hardship: resilience, boundaries, community support, fear, and communication.
Collapse
Affiliation(s)
- Erica Kanewischer
- Department of Social Work &
Family Studies, St. Olaf College, Northfield, MN, USA
| | - Claire Mueller
- Department of Social Work &
Family Studies, St. Olaf College, Northfield, MN, USA
| | - Mia Pylkkanen
- Department of Social Work &
Family Studies, St. Olaf College, Northfield, MN, USA
| | - Samirah Tunks
- Department of Social Work &
Family Studies, St. Olaf College, Northfield, MN, USA
| |
Collapse
|
45
|
Alves Feitoza de Andrade I, Castanheira Nascimento L, Albuquerque de Paula WK, Rocha Guimarães TM, Leite Meirelles Monteiro EM, Pereira Linhares FM, De Moraes Lima M, de Lavor Coriolano Marinus MW. Socio-emotional repercussions of severe haemophilia A in the daily lives of children. Haemophilia 2022; 28:1000-1006. [PMID: 35768907 DOI: 10.1111/hae.14611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 06/03/2022] [Accepted: 06/11/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIM Haemophilia A, in its most severe form, can have serious repercussions, including issues that are physical, emotional, affective, and social, particularly in childhood. This qualitative study aims to understand the socio-emotional repercussions of severe haemophilia A in children, based on their own testimonies and subjective expressions of their daily lives, in the contexts of the family, school and health service. METHODS Individual qualitative interviews were carried out using a playful approach through puppets with 15 children, aged 6-12 years old, in a service for the treatment of haemophilia, located in the northeast of Brazil. Data were analysed using inductive thematic analysis. RESULTS Four themes were elaborated: (a) Reflecting how I am and how I relate to others; (b) Enjoying family moments; (c) Experiencing the school context: learning, affectivity and play; and (d) Dealing with haemophilia: acceptance and overcoming strategies. CONCLUSION The experiences shared by children with severe haemophilia A and their daily needs should be the basis for guiding child-centred care. Encouraging self-care, including self-administration of the deficient factor, requires a partnership between health professionals, family members, school and child in the construction of therapeutic plans that consider the child's active participation.
Collapse
|
46
|
Deed C, Cardellino P, Matthews E, Southall A. A qualitative exploration of cardboard architecture in post-pandemic schools. INTERNATIONAL JOURNAL OF EDUCATIONAL RESEARCH OPEN 2022; 3:100186. [PMID: 35783226 PMCID: PMC9235394 DOI: 10.1016/j.ijedro.2022.100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
Governments have responded to the COVID-19 pandemic with social distancing measures, school closures and society lockdowns. The disruption in the functioning of schools have evoked a myriad of emotions among students including the pervasive fear of others and anxiety about a virus that cannot be controlled. As schools reopen, one immediate focus is to ensure proper sanitary measures in classrooms. While important, it is also equally critical that schools effectively support students' transition back to the classroom environment. This paper considers how cardboard architecture may support transitions between remote home learning and formal school-based education. We use a case study of the Unboxy project, a kit of cardboard shapes and connectors, provided to 18 schools in Australia following the school reopening after covid lockdown. The case study reports a qualitative analysis of how a cardboard architecture project aided students' transition back to school. Key themes revealed that students created safety structures and spaces for collaboration, thus highlighting the processes with which students interacted with spatial materials to narrate their affective response during the pandemic. Drawing on both research literature and our case study we identify design features of future cardboard architecture resources that can influence student wellbeing upon return to school.
Collapse
Affiliation(s)
- Craig Deed
- School of Education, La Trobe University, Australia
| | - Paula Cardellino
- Facultad de Arquitectura, Universidad ORT Uruguay, Montevideo, Uruguay
| | | | | |
Collapse
|
47
|
Recommendations for Resuming PA after Prolonged Rest in Children and Adolescents: A Systematic Integrative Review of Relevance for Immunity. J Funct Morphol Kinesiol 2022; 7:jfmk7020047. [PMID: 35736018 PMCID: PMC9224580 DOI: 10.3390/jfmk7020047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022] Open
Abstract
This systematic integrative review aims to summarize the protective effect of PA on children and adolescents, with special reference to the immune system. Periods of prolonged inactivity in children and adolescents are rare and due to exceptional events, such as illness or environmental circumstances, e.g., natural disasters, wars, or epidemics. The recent COVID-19 pandemic forced billions of children in developmental ages into inactivity. This exceptional event was the reason for studying the compensational behavioral strategies adopted by children and adolescents to counteract physical inactivity. Several studies showed the rise of spontaneous physical activity (PA) among children and adolescents to compensate for sedentarism. However, for some children, sedentarism could in turn foster other sedentarism. With the restart of "normal daily life" worldwide, a question is posed on both how to resume PA without causing damage and how to improve the immune response. Some key points emerged from the literature. Children must resume PA gradually using different methods, considering age, sex, health status, and the presence of overweight conditions. Immunity can be stimulated with PA by aerobic exercise, resistance training, flexibility exercise, relaxation, and coordinative exercises.
Collapse
|
48
|
Olorunyomi OO, Liem RI, Hsu LLY. Motivators and Barriers to Physical Activity among Youth with Sickle Cell Disease: Brief Review. CHILDREN 2022; 9:children9040572. [PMID: 35455616 PMCID: PMC9032398 DOI: 10.3390/children9040572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/17/2022]
Abstract
Purpose: Health disparities for minority groups include a low rate of physical activity and underserved urban minority youth with chronic disease are among the least active population segments, as exemplified by sickle cell disease (SCD). “Exercise prescriptions” for youth with chronic diseases need to be evidence based and align with psychologic motivators and barriers. This scoping review sought evidence for psychosocial motivators or barriers to physical activity (PA) in youth with SCD and other chronic disease that could be relevant to SCD. Methods: Five databases were searched for studies on urban minority youth published between 2009 and 2022. Results: Keyword searching yielded no papers on SCD and PA motivation and barriers. Adding health-related quality of life (HRQL) in SCD found eleven relevant papers. Widening the search to chronic disease in minority youth resulted in a total of 49 papers. Three thematic categories and seven sub-themes emerged. PA barriers added by chronic disease include fear of triggering disease complications, negative relationships due to disease limitations on performance in sports, and lack of suitable environment for PA that accommodates the chronic disease. PA motivators are similar for youth without chronic disease: self-efficacy, autonomy, positive relationships with peers and parents and coach/teacher. Conclusion: Direct descriptions of PA motivations and barriers to PA in SCD are limited to fatigue and fear of sickle vaso-occlusive pain. The PA barriers and motivators found for urban youth with chronic disease overlap with themes in healthy adolescents from underserved minorities. Community-based interventions could strengthen PA motivators (self-efficacy, autonomy, positive relationships with peers and parents and coach/teacher) but need disease accommodations to overcome the barriers (fear of triggering disease complications, environmental limitations, and negative relationships). Evidence-based exercise prescriptions might incorporate educational modules to overcome disease stigma and misconceptions. Prospective studies of PA motivators and barriers could improve HRQL in SCD.
Collapse
Affiliation(s)
| | - Robert Ie Liem
- Division of Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA;
| | - Lewis Li-yen Hsu
- Division of Pediatric Hematology-Oncology, University of Illinois at Chicago, Chicago, IL 60612, USA;
- Correspondence: ; Tel.: +1-312-996-6143; Fax: +1-312-413-9484
| |
Collapse
|
49
|
Kim YN, Gray N, Jones A, Scher S, Kozlowska K. The Role of Physiotherapy in the Management of Functional Neurological Disorder in Children and Adolescents. Semin Pediatr Neurol 2022; 41:100947. [PMID: 35450664 DOI: 10.1016/j.spen.2021.100947] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 12/17/2022]
Abstract
Children and adolescents with functional neurological (conversion) disorder (FND) present with symptoms of impaired motor and sensory function. FND involves complex interactions between the brain, mind, body, and lived experience of the child. The gold standard for treatment is therefore a holistic, biopsychosocial approach with multimodal interventions delivered by a multidisciplinary team. In this narrative review we examine the role of physiotherapy in managing FND in children. We searched Embase, Medline, PsycINFO, and PubMed (back to 2000) for relevant physiotherapy articles and also manually searched their reference lists. Two review articles and ten observational studies were identified. Data were extracted concerning the type of study, therapies involved, outcome measures, and comorbid mental health outcomes. FND symptoms resolved in 85% to 95% of the patients, and about two-thirds returned to full-time school after completing the multidisciplinary intervention. Ongoing mental health concerns at follow-up were associated with poorer functional outcomes. Key themes included the following: use of psychological interventions embedded in the physiotherapy intervention; integration of play, music, and dance; role of physical exercise in modulating physiological, neural, and endocrine systems; need for FND-specific outcome measures; ethical issues pertaining to randomized trials; and need to develop alternate study methodologies for assessing combined treatments. Clinical vignettes were included to highlight a range of physiotherapy interventions. In conclusion, the emerging literature suggests that physiotherapy for children with FND is a useful intervention for improving motor dysfunction and for addressing other concurrent issues such as physical deconditioning, neuroprotection, chronic pain, disturbed sleep, anxiety and depression, and resilience building.
Collapse
Affiliation(s)
- Yu-Na Kim
- Department of Psychological Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Nicola Gray
- Department of Physiotherapy, Sydney Children's Hospital Network, NSW, Australia
| | - Anna Jones
- Advance Rehab Centre, Artarmon, NSW, Australia
| | - Stephen Scher
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA; University of Sydney Medical School, NSW, Australia
| | - Kasia Kozlowska
- Department of Psychological Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia; University of Sydney Medical School, NSW, Australia; Westmead Institute for Medical Research, Westmead, NSW, Australia.
| |
Collapse
|
50
|
Topothai T, Suphanchaimat R, Topothai C, Tangcharoensathien V, Cetthakrikul N, Waleewong O. Self-Reported Parental Interactions through Play with Young Children in Thailand: An Analysis of the 2019 Multiple Indicator Cluster Survey (MICS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063418. [PMID: 35329102 PMCID: PMC8954988 DOI: 10.3390/ijerph19063418] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/08/2022] [Accepted: 03/12/2022] [Indexed: 01/27/2023]
Abstract
Parental interactions through play contributes significantly to child development of cognitive and executive functioning skills. In Thailand, there is little evidence of factors contributing to parental–child interactions. In response to SDG target 4.2.3 monitoring (the percentage of children under 5 years experiencing positive and stimulating home learning environments), this study aimed to assess the prevalence and profile of parental interactions with their children under the age of five. We analysed data from the 6th Multiple Indicator Cluster Survey (MICS) conducted by the National Statistical Office in 2019. Face-to-face interviews with mothers and/or legal guardians were conducted. A total of 8856 children under the age of five were enrolled in this survey. Most participants, 90.3%, had engaged in at least four out of six activities with their children. Multivariate logistic regression analysis showed that children raised by parents with secondary or post-secondary educations had a significantly greater chance to have parental interactions than children raised by parents who completed primary education (adjusted odds ratio (AOR) = 1.66, and AOR = 2.34 for secondary and post-secondary education). Children who possessed three or more children’s books and had experience of toy play had a significantly higher chance of having parental interactions (AOR = 3.08 for book possessing, and AOR = 1.50 for the experience of toy play). Children who spent 1–3 h daily screen time had a significantly lower chance of having parental interactions than those who spent less than one hour of screen time (AOR = 0.67). In conclusion, with the emerging influence of digital technology, we recommend family and community promote parental interactions through play with young children.
Collapse
Affiliation(s)
- Thitikorn Topothai
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand; (R.S.); (C.T.); (V.T.); (N.C.); (O.W.)
- Division of Physical Activity and Health, Department of Health, Ministry of Public Health, Nonthaburi 11000, Thailand
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
- Correspondence: ; Tel.: +66-2590-2366
| | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand; (R.S.); (C.T.); (V.T.); (N.C.); (O.W.)
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Chompoonut Topothai
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand; (R.S.); (C.T.); (V.T.); (N.C.); (O.W.)
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
- Bureau of Health Promotion, Department of Health, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Viroj Tangcharoensathien
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand; (R.S.); (C.T.); (V.T.); (N.C.); (O.W.)
| | - Nisachol Cetthakrikul
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand; (R.S.); (C.T.); (V.T.); (N.C.); (O.W.)
| | - Orratai Waleewong
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand; (R.S.); (C.T.); (V.T.); (N.C.); (O.W.)
| |
Collapse
|