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Miladi A, Saafi MA, Latiri I. Effects of Ramadan on cognitive functions in young boys. Libyan J Med 2024; 19:2301830. [PMID: 38194430 PMCID: PMC10786423 DOI: 10.1080/19932820.2024.2301830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/31/2023] [Indexed: 01/11/2024] Open
Abstract
Fasting during Ramadan involves abstaining from food and drink from dawn to sunset, potentially influencing cognitive functions essential for the intellectual development of the youth. Therefore, understanding the effects of fasting on these functions in children/adolescents provides valuable perspectives to enhance education and promote mental well-being. However, studies on children/adolescents in this context are still limited. To evaluate the impact of Ramadan fasting on cognitive functions, including information processing speed, inhibition, decision-making, and auditory attention processes among children and adolescents aged 11 to 15 years. This study was conducted with 24 healthy children/adolescents (aged 12.84 ± 0.69 years). The experimental protocol consisted of two sessions: Before-Ramadan (BR) and at the beginning of the second week of Ramadan (R2). At each session, the boys were randomly tested on simple reaction time (SRT), choice reaction time (CRT), negative priming reaction time (NPRT), and auditory discrimination (P300). The tests were administered and scored by the same person in the different sessions. The study found that Ramadan fasting did not have an effect on various reaction times or on electro-physiological data, including P300 amplitude and latency. The current study, conducted with healthy children/adolescents, indicates that Ramadan fasting had no impact on various reaction times (SRT, CRT, NPRT), suggesting the preservation of information processing speed and decision-making, even in the face of increased task complexity. This is evident, on the one hand, through the maintenance of the ability to react to unexpected events, and, on the other hand, through the mastery of resistance to automatism, thus reflecting the preservation of inhibitory function (NPRT). Regarding P300 data, the absence of changes in latencies and amplitudes suggests that Ramadan fasting did not alter either the evaluation time of auditory stimuli or auditory attention processes.
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Affiliation(s)
- Amira Miladi
- Research Laboratory: “Heart Failure” (LR12SP09), Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Ali Saafi
- Department of Neurophysiology, Sahloul University Hospital of Sousse, Sousse, Tunisia
- Research Laboratory “Medical Imaging Technologies” (LR 12ES06), Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Imed Latiri
- Research Laboratory: “Heart Failure” (LR12SP09), Farhat Hached University Hospital, Sousse, Tunisia
- Laboratory of Physiology. Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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Chen L, Liu Q, Xu F, Wang F, Luo S, An X, Chen J, Tang N, Jiang X, Liang X. Effect of physical activity on anxiety, depression and obesity index in children and adolescents with obesity: A meta-analysis. J Affect Disord 2024; 354:275-285. [PMID: 38490590 DOI: 10.1016/j.jad.2024.02.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 02/05/2024] [Accepted: 02/26/2024] [Indexed: 03/17/2024]
Abstract
FOR FULL-LENGTH ARTICLES This study systematically identified the effects of physical activity (PA) on depression, anxiety and weight-related outcomes among children and adolescents with overweight/obesity. EMBASE, The Cochrane Library, Web of Science, and PubMed were searched from January 1, 2000 to August 1, 2022 for peer-reviewed papers. Meta-analyses were conducted to ascertain the effect of physical activity on symptoms of anxiety, depression and weight-related outcomes in overweight/obese children and adolescents. Twenty-five studies representing 2188 participants, with median age 12.08 years old (8.3 to 18.44 years) were included. Depressive and anxiety symptoms, BMI, BMI z-scores, weight, waist circumference and height were evaluated. After incorporating the effects of PA interventions on children and adolescents with overweight/obesity, PA could improve depressive and anxiety symptoms, but not obesity indexes except waist circumference. While, PA combined with other interventions have a significant effect both on anxiety symptoms and BMI compared to pure PA intervention. In terms of intervention duration, we observed that durations falling within the range of 8 to 24 weeks exhibited the most positive effects on reducing depressive symptoms. FOR SHORT COMMUNICATIONS We included 25 articles on the effects of physical activity on psychological states such as depression and anxiety, weight, BMI and other weight-related indicators in children and adolescents with overweight/obesity. We attempted to determine the most appropriate type of physical activity intervention for children and adolescents with overweight/obesity, as well as the most appropriate population characteristics and duration by combining the outcome data from each article. This has a great enlightening effect for health workers to carry out corresponding strategies in the future.
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Affiliation(s)
- Lan Chen
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China; Nursing Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400016, China
| | - Qin Liu
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Fenglin Xu
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Fengming Wang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Shunqing Luo
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Xizhou An
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Jinyu Chen
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Ni Tang
- Nephrology Department, the people's hospital of kaizhou district, Chongqing, China
| | - Xiaoping Jiang
- Nursing Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400016, China.
| | - Xiaohua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China.
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Yang X, Chai M, Lin M. Proportion of vitamin D deficiency in children/adolescents with type 1 diabetes: a systematic review and meta-analysis. BMC Pediatr 2024; 24:192. [PMID: 38493103 PMCID: PMC10943883 DOI: 10.1186/s12887-024-04683-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/01/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The impact of vitamin D on type 1 diabetes has been a controversial topic in public health. Furthermore, significant differences in the proportion of vitamin D have been noted. The purpose of this systematic review was to determine the overall proportion of vitamin D deficiency in children/adolescents with type 1 diabetes (T1D). METHODS Based on six electronic databases (PubMed, Web of Science, Embase, Ovid Medline, ProQuest, and Cochrane Library), eligible studies since the databases' inception up to April 2022 were searched. Reference lists were also manually searched to identify additional studies. Overall, studies with statistical information on vitamin D deficiency in children and adolescents with T1D were included, and a random effects model was applied for the meta-analysis. In addition, subgroup and sensitivity analyses were carried out to evaluate heterogeneity, and publication bias was evaluated by using Egger's test. RESULTS A total of 45 studies involving 6,995 participants met the inclusion criteria; these included 25 countries covering Africa, Oceania, Europe, North America and Asia. The proportion of vitamin D deficiency in children/adolescents with T1D was 45% (95% confidence interval [CI] 37-54%, I2 = 97.94%). Subgroup analysis further revealed that the publication year, study design, vitamin D classification, season and geographical region significantly contributed to the variation in the reported incidence of vitamin D deficiency. CONCLUSIONS The results of the meta-analysis showed that the proportion of vitamin D deficiency among T1D children/adolescents was 45%. In addition, the proportion remains higher, which has important implications for adapting health and social care systems.
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Affiliation(s)
- Xin Yang
- Department of Pediatric Genetics, Metabolism and Endocrinology Nursing, West China Second University Hospital, Sichuan University, No. 1416, Section 1, Chenglong Avenue, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, No. 1416, Section 1, Chenglong Avenue, Chengdu, Sichuan, China
| | - Min Chai
- Department of Pediatric Genetics, Metabolism and Endocrinology Nursing, West China Second University Hospital, Sichuan University, No. 1416, Section 1, Chenglong Avenue, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, No. 1416, Section 1, Chenglong Avenue, Chengdu, Sichuan, China
| | - Meng Lin
- Department of Pediatric Genetics, Metabolism and Endocrinology Nursing, West China Second University Hospital, Sichuan University, No. 1416, Section 1, Chenglong Avenue, Chengdu, Sichuan, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, No. 1416, Section 1, Chenglong Avenue, Chengdu, Sichuan, China.
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Marra A, Bondesan A, Caroli D, Grugni G, Sartorio A. The neutrophil to lymphocyte ratio (NLR) positively correlates with the presence and severity of metabolic syndrome in obese adults, but not in obese children/adolescents. BMC Endocr Disord 2023; 23:121. [PMID: 37237368 DOI: 10.1186/s12902-023-01369-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Metabolic syndrome (MetS) associated with obesity is a pathological condition increasing worldwide. Recent studies have demonstrated that the neutrophil to lymphocyte ratio (NLR) can be successfully used to stage MetS in obese adults. The aim of the study was to evaluate NLR values in 552 children/adolescents (M 219, F 333; 14.8 [12.9-16.3] years) and 231 adults (M 88, F 143; 52.3 [36.4-63.3] years) with morbid obesity, subdivided into subgroups according with the presence or absence of MetS. Adult patients with obesity showed a higher prevalence of MetS compared to the pediatric population (71% vs 26%), associated with a greater number of subjects with 3 and 4-5 altered components for MetS. NLR was higher (P-value = 0.041) in adults with MetS compared with those without. NLR values also positively correlated with the severity grade of the syndrome (P-value = 0.032). By contrast, in pediatric subjects with obesity with MetS, NLR values were comparable with those recorded in subjects without MetS (P-value = 0.861), no correlation being found with MetS severity (P-value = 0.441). Our study confirms the importance of NLR as an inflammatory indicator associated with MetS in adult subjects with severe obesity, while it excludes a similar role in children/adolescents.
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Affiliation(s)
- Alice Marra
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy.
| | - Adele Bondesan
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
| | - Diana Caroli
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
| | - Graziano Grugni
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
- Istituto Auxologico Italiano, IRCCS, Division of Auxology, Piancavallo-Verbania, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, Italy
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Marques CC, Matos AP, do Céu Salvador M, Arnarson EÖ, Craighead WE. Reliability and Validity of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): Portuguese Version. Child Psychiatry Hum Dev 2022; 53:1119-1128. [PMID: 34050391 DOI: 10.1007/s10578-021-01196-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2021] [Indexed: 10/21/2022]
Abstract
This study examined the test-retest reliability, consensual, convergent and divergent validities, sensitivity, specificity, positive and negative predictive values, and accuracy of the Portuguese version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL). Eighty-nine children/adolescents (65 psychiatric outpatients and 24 healthy controls) were interviewed with K-SADS-PL and completed measures of depressive and anxiety symptoms. The child's parent/caretaker completed the Child Behavior Checklist. Good to excellent values were obtained for test-retest reliability and consensual validity. For the convergent validity, moderate correlations between the K-SADS-PL and the corresponding self-report measures were observed. Divergent validity was acceptable for the K-SADS-PL diagnoses. The lowest values of sensitivity, specificity, and accuracy of the K-SADS-PL were 88, 88, and 91, respectively. The Portuguese version of K-SADS-PL proved to be a valid and reliable assessment instrument for children and adolescents, and was sensitive, specific and accurate when diagnosing mood, anxiety, adjustment, and attention-deficit/hyperactivity disorders.
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Affiliation(s)
- Cristiana Campos Marques
- Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal.
| | - Ana Paula Matos
- Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Maria do Céu Salvador
- Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Eiríkur Örn Arnarson
- School of Health Sciences, Faculty of Medicine, University of Iceland, Landspítali -University Hospital, 101, Reykjavik, Iceland
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Department of Psychology, Emory University, Atlanta, GA, USA
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Wallace Chi Ho C, Grace Suk Man L, Miranda Mei Mui L, Molin Kwok Yin L, Clare Tsz Kiu Y, Jody Ka-Wing W. Facing the loss of siblings in childhood: Interactions and dynamics between bereaved siblings and their parents. J Pediatr Nurs 2022; 66:e1-e8. [PMID: 35817622 DOI: 10.1016/j.pedn.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/23/2022] [Accepted: 07/02/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The loss of a child in a family is a painful experience. Despite this, most studies focus on the grieving experience of parents. Our understanding of sibling bereavement therefore remains underexplored. This study aims to address this gap by exploring the bereavement experience of younger bereaved siblings from the perspective of the bereaved child and the parents. METHOD This study is a qualitative study conducted in Hong Kong. We recruited eleven bereaved families from 2019 to 2020. Semi-structured interviews were conducted separately with bereaved children and parents. Thematic analyses were performed. FINDINGS Eleven bereaved siblings, aged 5 to 11, and their parents were interviewed. Four themes were generated: Parents' unawareness of bereaved siblings' grief, protecting parents from grief, comparison with the deceased siblings, and learning how to grieve. CONCLUSION Our findings suggest that the family dynamics and interactions in the grieving experience are complex. The impact of grief on the bereaved child could emanate from the loss of the sibling or from the grief of the parents or from family interactions. PRACTICE IMPLICATIONS This study highlights the importance of viewing the sibling bereavement experience in a family context and of enhancing sibling bereavement services. Helping professionals should not only provide more bereavement support to the bereaved siblings individually, but they should also enhance parents' capacity to support their bereaved children.
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Affiliation(s)
| | | | - Leung Miranda Mei Mui
- Fellow of the Hong Kong Academy of Nursing (Hong Kong College of Paediatric Nursing), Hong Kong
| | | | - Yu Clare Tsz Kiu
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong.
| | - Wu Jody Ka-Wing
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
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Zhang L, Xu H, Liu L, Bi Y, Li X, Kan Y, Liu H, Li S, Zou Y, Yuan Y, Gong W, Zhang Y. Related factors associated with fear of hypoglycemia in parents of children and adolescents with type 1 diabetes - A systematic review. J Pediatr Nurs 2022; 66:125-135. [PMID: 35716460 DOI: 10.1016/j.pedn.2022.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/09/2022] [Accepted: 05/27/2022] [Indexed: 12/16/2022]
Abstract
PROBLEM Fear of hypoglycemia is a significant concern for parents of children/ adolescents with type 1 diabetes. Although some studies have explained the parental fear of hypoglycemia, the related factors were yet to be determined. This systematic review aims to identify the related factors of fear of hypoglycemia in the parents of children and adolescents with type 1 diabetes and provide a theoretical basis for further intervention. ELIGIBILITY CRITERIA PubMed, MEDLINE, EMBASE, Scopus, CINAHL, EBSCO, Web of Science, and Cochrane Library were systematically searched from 2010 to 2021. Studies evaluating the fear of hypoglycemia of parents and its associated factors were included. SAMPLE Twenty-three observational articles met the criteria. RESULTS Significant associations were found between fear of hypoglycemia and specific factors, including motherhood, nocturnal hypoglycemia, and the number of blood glucose monitoring. Psychological factors, including anxiety, depression, pediatric parenting stress, mindfulness, self-efficacy, quality of life, and sleep disorders, were conclusive and associations with parental fear of hypoglycemia. CONCLUSIONS Understanding parental fear of hypoglycemia can help parents prevent potential problems in diabetes management, thus promoting children's growth. According to current evidence, effective targeted interventions based on modifiable relevant factors can be developed to reduce the fear of hypoglycemia in parents while maintaining optimal blood glucose control in children/ adolescents. IMPLICATIONS Health professionals should pay more attention to the mental health of parents, and parents should be involved in the care plan and have the opportunity to discuss their fear of hypoglycemia in the most appropriate way to manage type 1 diabetes.
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Affiliation(s)
- Lu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Huiwen Xu
- School of Nursing, Yangzhou University, Yangzhou, China; Nagano College of Nursing, Komagane, Nagano 399-4117, Japan
| | - Lin Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yaxin Bi
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Xiangning Li
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yinshi Kan
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Hongyuan Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Shuang Li
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yan Zou
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yuan Yuan
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Weijuan Gong
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China.
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AlRasheed R, Woodard GS, Nguyen J, Daniels A, Park N, Berliner L, Dorsey S. Transitioning to Telehealth for COVID-19 and Beyond: Perspectives of Community Mental Health Clinicians. J Behav Health Serv Res 2022; 49:524-530. [PMID: 35538275 PMCID: PMC9090117 DOI: 10.1007/s11414-022-09799-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 11/11/2022]
Abstract
In response to COVID-19, mental health clinics transitioned to telehealth to maintain psychotherapy delivery. Community mental health (CMH) settings, which are often under-resourced, likely experienced many barriers. This study examined CMH clinicians’ experiences transitioning to telehealth. Data came from a state-funded initiative training CMH clinicians in cognitive behavioral therapy. Participants (N = 197) completed pre-training and post-consultation surveys which included questions about their experiences with telehealth. Most clinicians found telehealth beneficial and effective. Clinicians strongly endorsed wanting telehealth as an option even after in-person services resume. CMH clinicians rated “engaging younger children” as the most significant barrier to telehealth. Despite some telehealth barriers, clinicians generally viewed telehealth favorably and prefer having it as a long-term option. Future work should continue to understand when telehealth may be advantageous and for whom in order to improve the accessibility and quality of behavioral health services.
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Affiliation(s)
- Rashed AlRasheed
- Department of Psychology, University of Washington, 119A Guthrie Hall, Box 351525, Seattle, WA, 98105, USA.
| | - Grace S Woodard
- Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL, 33124, USA
| | - Julie Nguyen
- Department of Psychology, University of Washington, 119A Guthrie Hall, Box 351525, Seattle, WA, 98105, USA
| | - Alayna Daniels
- Department of Psychology, University of Washington, 119A Guthrie Hall, Box 351525, Seattle, WA, 98105, USA
| | - Niya Park
- Department of Psychology, University of Washington, 119A Guthrie Hall, Box 351525, Seattle, WA, 98105, USA
| | - Lucy Berliner
- Harborview Center for Sexual Assault and Traumatic Stress, 401 Broadway, Suite 2027, Seattle, WA, 98122, USA
| | - Shannon Dorsey
- Department of Psychology, University of Washington, 119A Guthrie Hall, Box 351525, Seattle, WA, 98105, USA
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Théodore FL, López-Santiago M, Cruz-Casarrubias C, Mendoza-Pablo PA, Barquera S, Tolentino-Mayo L. Digital marketing of products with poor nutritional quality: a major threat for children and adolescents. Public Health 2021; 198:263-269. [PMID: 34492506 DOI: 10.1016/j.puhe.2021.07.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/08/2021] [Accepted: 07/24/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To identify general characteristics, the use of persuasive techniques, and the nutritional quality of Mexican digital marketing of food and beverages/brand with the greatest number of followers and views (Facebook, Twitter, and YouTube) with specific appeal to children/adolescents. STUDY DESIGN Cross sectional, quantitative, exploratory, and descriptive study. METHODS Multistep process to select a sample of 46 products with a Mexican website and major audiences on social networks. The energy and nutrient content of the foods and beverages were analyzed with the Pan American Health Organization Nutrient Profile Model. RESULTS Cola and soft drinks, sweetened juices were the products with the greatest number of followers on Facebook and Twitter (13,321,274 and 1,020,504). Companies used diverse persuasive techniques combining promotional characters (79.1%), incentives (65.1%), and digital techniques (78.3%). Products with excess critical nutrients were most frequently advertised regardless of the type of social network and the marketing techniques used. CONCLUSION Digital Marketing represents a major threat for children and adolescents in Mexico, and probably all over the world, because of its persuasive techniques, and it shall be regulated.
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Affiliation(s)
- F L Théodore
- National Institute of Public Health of Mexico, Nutrition and Health Research Center, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C. P. 62100, Cuernavaca, Morelos, México
| | - M López-Santiago
- National Institute of Public Health of Mexico, Nutrition and Health Research Center, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C. P. 62100, Cuernavaca, Morelos, México
| | - C Cruz-Casarrubias
- National Institute of Public Health of Mexico, Nutrition and Health Research Center, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C. P. 62100, Cuernavaca, Morelos, México
| | - P A Mendoza-Pablo
- School of Dietetics and Nutrition ISSSTE, Callejón Vía San Fernando No. 12, San Pedro Apóstol, 14070, CDMX, México
| | - S Barquera
- National Institute of Public Health of Mexico, Nutrition and Health Research Center, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C. P. 62100, Cuernavaca, Morelos, México
| | - L Tolentino-Mayo
- National Institute of Public Health of Mexico, Nutrition and Health Research Center, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C. P. 62100, Cuernavaca, Morelos, México.
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Iacomino G, Lauria F, Russo P, Venezia A, Iannaccone N, Marena P, Ahrens W, De Henauw S, Molnár D, Eiben G, Foraita R, Hebestreit A, Kourides G, Moreno LA, Veidebaum T, Siani A. The association of circulating miR-191 and miR-375 expression levels with markers of insulin resistance in overweight children: an exploratory analysis of the I.Family Study. Genes Nutr 2021; 16:10. [PMID: 34243726 PMCID: PMC8272322 DOI: 10.1186/s12263-021-00689-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/18/2021] [Indexed: 02/08/2023]
Abstract
Background In recent years, the exciting emergence of circulating miRNAs as stable, reproducible, and consistent among individuals has opened a promising research opportunity for the detection of non-invasive biomarkers. A firm connection has been established between circulating miRNAs and glycaemic as well as metabolic homeostasis, showing that levels of specific miRNAs vary under different physio-pathological conditions. Objective In this pilot study, we investigated the expression of candidate miRNAs, hsa-miR-191-3p and hsa-miR-375, in relation to biomarkers associated with insulin sensitivity in a subgroup (n=58) of subjects participating to the European I.Family Study, a project aimed to assess the determinants of eating behaviour in children and adolescents and related health outcomes. The sample included overweight/obese children/adolescents since overweight/obesity is a known risk factor for impaired glucose homeostasis and metabolic disorders. Biological targets of candidate miRNAs were also explored in silico. Results We observed a significant association of the two miRNAs and early changes in glycaemic homeostasis, independent of covariates including country of origin, age, BMI z-score, puberty status, highest educational level of parents, total energy intake, energy from fats, energy from carbohydrates, and energy from proteins. Conclusion Identification of circulating miRNAs associated with insulin impairment may offer novel approaches of assessing early variations in insulin sensitivity and provide evidence about the molecular mechanisms connected to early changes in glycaemic homeostasis. Trial registration ISRCTN, ISRCTN62310987. Retrospectively registered, http://isrctn.com/ISRCTN62310987 Supplementary Information The online version contains supplementary material available at 10.1186/s12263-021-00689-1.
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Affiliation(s)
- Giuseppe Iacomino
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy.
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
| | - Paola Russo
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
| | - Antonella Venezia
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
| | - Nunzia Iannaccone
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
| | - Pasquale Marena
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Achterstraße 30, 28359, Bremen, Germany
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Sahlgrenska Academy at the University of Gothenburg, Medicinaregatan 3, 413 90, Göteborg, Sweden
| | - Ronja Foraita
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Giannis Kourides
- Research and Education Institute of Child Health, ave, #205 2015, Strovolos, 138, Limassol, Cyprus
| | - Luis A Moreno
- University of Zaragoza, Domingo Miral, s/n, 50009, Zaragoza, Spain
| | - Toomas Veidebaum
- National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Alfonso Siani
- Institute of Food Sciences, National Research Council, ISA-CNR, via Roma 64, 83100, Avellino, Italy
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Ramdhonee-Dowlot K, Balloo K, Essau CA. Effectiveness of the Super Skills for Life programme in enhancing the emotional wellbeing of children and adolescents in residential care institutions in a low- and middle-income country: A randomised waitlist-controlled trial. J Affect Disord 2021; 278:327-338. [PMID: 32980656 DOI: 10.1016/j.jad.2020.09.053] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 06/07/2020] [Accepted: 09/11/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND The present study examined the effectiveness of a transdiagnostic prevention programme, Super Skills for Life (SSL), among children and adolescents with emotional problems in residential care institutions (RCIs) in the low- and middle-income country of Mauritius using a randomised waitlist-controlled trial (RCT). SSL is based on the principles of cognitive behavioural therapy, behavioural activation, social skills training, and uses video-feedback and cognitive preparation as part of the treatment. METHODS The RCT involved 100 children and adolescents aged 9 to 14 years, from six RCIs, randomly allocated to either an SSL intervention group (IG) or a waitlist-control (WLC) group. A set of questionnaires measuring internalising and externalising problems, emotion regulation and self-esteem, and experimental tasks measuring attentional bias and inhibitory control, were completed at baseline, post-intervention and 3-month follow-up. Participants also completed a 2-min video speech task during the first and final sessions of the SSL intervention. RESULTS Children and adolescents in the IG showed significant improvements in internalising symptoms (e.g. anxiety and depression), externalising symptoms (e.g. conduct problems and hyperactivity), and inhibitory control, and an increase in adaptive (except putting into perspective strategy) and decrease in maladaptive emotion regulation strategies, at both post-intervention and follow-up. These findings were not replicated among children in the WLC. LIMITATIONS The small sample size and lack of an active control group were the major limitations of this study. CONCLUSIONS This study provides evidence for the effectiveness of a transdiagnostic prevention programme for emotional problems in RCIs in a low- and middle-income country.
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Loos S, Tutus D, Kilian R, Goldbeck L. Do caregivers' perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents. Eur J Psychotraumatol 2020; 11:1753939. [PMID: 32537097 PMCID: PMC7269039 DOI: 10.1080/20008198.2020.1753939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 03/07/2020] [Accepted: 03/29/2020] [Indexed: 11/02/2022] Open
Abstract
Background: Caregivers play a key role in the success of trauma-focused cognitive behavioural therapy (TF-CBT). Yet, the effect of their alliance on treatment outcomes besides the other parties in treatment has hardly been studied. Objective: This study examined the working alliance (WA) of therapists, patients and caregivers in TF-CBT and its contribution on treatment outcome over time. Methods: N = 76 children and adolescents (mean age = 12.66 years, range 7-17, M/F ratio: .43) participated in the TF-CBT arm of a randomized controlled trial. The WA was assessed with the Working Alliance Inventory Short Version (WAI-S) at two measurement points, while symptom level of posttraumatic stress symptoms (PTSS) was assessed with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Paired sample t-tests, intraclass correlations (ICC), and mixed-effects regression models for longitudinal data were performed. Results: The alliance rating was high across all informants, with caregivers achieving the highest rating. The average level of cross-informant agreement on the alliance was low between therapists and caregivers (ICC = .26) and moderate between therapists and patients (ICC =.65). A significant contribution of an alliance improvement to the reduction of PTSS over time was found in each of the two tested models: therapists with patients model (b = .682) and therapists with caregivers model (b = .807). However, these effects were not detected with all four perspectives in one comprehensive model. Conclusion: In summary, the potential of caregivers' views should receive more attention in the therapeutic process of trauma-focused therapy.
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Affiliation(s)
- S Loos
- Department of Psychiatry and Psychotherapy II, University Clinic Ulm, Ulm, Germany.,Department of Child and Adolescent Psychiatry/Psychotherapy, University Clinic Ulm, Ulm, Germany
| | - D Tutus
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Clinic Ulm, Ulm, Germany
| | - R Kilian
- Department of Psychiatry and Psychotherapy II, University Clinic Ulm, Ulm, Germany
| | - L Goldbeck
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Clinic Ulm, Ulm, Germany
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Schepisi MS, Motta I, Dore S, Costa C, Sotgiu G, Girardi E. Tuberculosis transmission among children and adolescents in schools and other congregate settings: a systematic review. New Microbiol 2019; 41:282-290. [PMID: 30252926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 06/08/2023]
Abstract
Children, especially those aged <5 years, and adolescents are at increased risk of progression to active TB disease when infected. Management of childhood TB outbreaks is crucial for TB elimination especially in low burden countries. We searched the electronic databases MEDLINE-CINHAL-EMBASE up to July 2017 for primary studies reporting on TB incidents which involved teacher/child-caregiver, relative or students diagnosed with TB in a school/childcare setting or in other congregate settings attended by children and adolescents. Out of 10,481 citations, 74 studies, published mostly in low TB burden countries from 1950 to 2017, describing 128 incident investigations, were included. Overall 5025 (14.2%) LTBI and 811 (2.3%) TB cases were diagnosed among 35,331 screened individuals. Incidents occurred mainly in schools (89.1%) where index cases were more frequently students (63.3%) than teachers/caregivers; almost all of the incidents exposing children aged 2-5 were attributable to a teacher/caregiver index case. In 68 individual contact investigations the pooled proportions of TB and LTBI among those exposed were 0.03 (95%CI 0.02-0.04) and 0.15 (95%CI 0.13- 0.18). The overall risk of developing TB disease in school-congregate settings seems slightly lower than in high-income country household settings. Public health interventions targeting school-congregate settings may be critical to overall TB control and towards TB elimination in low-burden countries.
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Affiliation(s)
- Monica Sañé Schepisi
- L Spallanzani National Institute for Infectious Diseases (INMI), Clinical Epidemiology, Rome, Italy
| | - Ilaria Motta
- University of Turin, Infectious Diseases Unit, Department of Medical Sciences, Torino, Italy
| | - Simone Dore
- University of Sassari, Clinical Epidemiology and Medical Statistics Unit, Department of Clinical and Experimental Medicine, Sassari, Italy
| | - Cecilia Costa
- University of Turin, Infectious Diseases Unit, Department of Medical Sciences, Torino, Italy
| | - Giovanni Sotgiu
- University of Sassari, Clinical Epidemiology and Medical Statistics Unit, Department of Clinical and Experimental Medicine, Sassari, Italy
| | - Enrico Girardi
- L Spallanzani National Institute for Infectious Diseases (INMI), Clinical Epidemiology, Rome, Italy
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Mpango RS, Rukundo GZ, Muyingo SK, Gadow KD, Patel V, Kinyanda E. Prevalence, correlates for early neurological disorders and association with functioning among children and adolescents with HIV/AIDS in Uganda. BMC Psychiatry 2019; 19:34. [PMID: 30665382 PMCID: PMC6341558 DOI: 10.1186/s12888-019-2023-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 01/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the prevalence of neurological disorders and their associated correlates and relations with clinical and behavioural problems among children and adolescents with HIV/AIDS (CA-HIV). METHODS This study involved a sample of 1070 CA-HIV/caregiver dyads who were evaluated at their 6-month follow-up visit as part of their participation in the longitudinal study, 'Mental health among HIV infected CHildren and Adolescents in KAmpala and Masaka, Uganda (the CHAKA study)'. Participants completed an extensive battery of measures that included a standardized DSM-5- referenced rating scale, the parent version (5-18 years) of the Child and Adolescent Symptom Inventory-5 (CASI-5). Using logistic regression, we estimated the prevalence of neurological disorders and characterised their associations with negative clinical and behavioural factors. RESULTS The overall prevalence of at least one neurological disorders was 18.5% (n = 198; 95% CI, 16.2-20.8). Enuresis / encopresis was the most common (10%), followed by motor/vocal tics (5.3%); probable epilepsy was the least prevalent (4%). Correlates associated with neurological disorders were in two domains: socio-demographic factors (age, ethnicity and staying in rural areas) and HIV-related factors (baseline viral load suppression). Enuresis/encopresis was associated with psychiatric comorbidity. Neurological disorders were associated with earlier onset of sexual intercourse (adjusted OR 4.06, 95% CI 1.26-13.1, P = 0.02). CONCLUSIONS Neurological disorders impact lives of many children and adolescents with HIV/AIDS. There is an urgent need to integrate the delivery of mental and neurological health services into routine clinical care for children and adolescents with HIV/AIDS in sub-Saharan Africa.
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Affiliation(s)
- Richard Stephen Mpango
- Department of Psychiatry, Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Makerere College of Health Sciences, P. O. Box 49, Entebbe, Uganda. .,Department of Psychiatry, Mbarara University of Science and Technology, P. O. Box 1410, Mabarara, Uganda.
| | - Godfrey Zari Rukundo
- 0000 0001 0232 6272grid.33440.30Department of Psychiatry, Mbarara University of Science and Technology, P. O. Box 1410, Mabarara, Uganda
| | - Sylvia Kiwuwa Muyingo
- Department of Psychiatry, Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Makerere College of Health Sciences, P. O. Box 49, Entebbe, Uganda ,Statistical Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Kenneth D. Gadow
- 0000 0001 2216 9681grid.36425.36Department of Psychiatry, Health Sciences Centre, Stony Brook University, Stony Brook, New York, NY 11794-8790 USA
| | - Vikram Patel
- 000000041936754Xgrid.38142.3cDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, MA USA
| | - Eugene Kinyanda
- Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, P. O. Box 49, Entebbe, Uganda
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Hari Chandra BP, Ramesh MN, Nagendra HR. Effect of Yoga on Immune Parameters, Cognitive Functions, and Quality of Life among HIV-Positive Children/Adolescents: A Pilot Study. Int J Yoga 2019; 12:132-138. [PMID: 31143021 PMCID: PMC6521755 DOI: 10.4103/ijoy.ijoy_51_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Context: HIV/AIDS individuals have problems relating to immune system, quality of life (QOL), and cognitive functions (CFs). Yoga is found to be useful in similar conditions. Hardly, any work is reported on yoga for HIV-positive adults/adolescents. Hence, this study is important. Aim: The aim of the study is to determine the effect of yoga on immune parameters, CFs, and QOL of HIV-positive children/adolescents. Settings and Design: Single-group, pre–post study with 4-month yoga intervention. Methods: The study had 18 children from an HIV/AIDS rehabilitation center for children/adolescents. CD4, CD8, CD4/CD8 ratio, and viral loads were studied. CF tests included six letter cancellation test, symbol digit modalities test, digit-span forward backward test, and Stroop tests. QOL was assessed using PedsQL-QOL and fatigue questionnaire. Depression was assessed using CDI2-SR. Statistical Analysis Used: t-test and Wilcoxon signed-rank tests, as applicable. Results: The study included 18 children/adolescents. There was improvement in general health of the participants. There was statistically significant increase in CD4 cells counts (p = 0.039) and significant decrease in viral load (p = 0.041). CD4/CD8 ratio moved to normal range. QOL significantly improved. CFs had mixed results with improved psychomotor performance (PP) and reduced executive functions. Conclusions: There was improvement in general health and immune parameters. While depression increased, QOL improved. CFs showed mixed results with improved PP and reduced executive functions.
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Affiliation(s)
- B P Hari Chandra
- Department of Life Sciences, S-VYASA Yoga University, Bengaluru, Karnataka, India
| | - Mavathur N Ramesh
- Department of Life Sciences, S-VYASA Yoga University, Bengaluru, Karnataka, India
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McAdams RJ, Swidarski K, Clark RM, Roberts KJ, Yang J, Mckenzie LB. Bicycle-related injuries among children treated in US emergency departments, 2006-2015. Accid Anal Prev 2018; 118:11-17. [PMID: 29843009 DOI: 10.1016/j.aap.2018.05.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 04/17/2018] [Accepted: 05/20/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE One of the leading causes of non-fatal injury among children is bicycling. Past studies indicate that helmets are protective against bicycle-related injuries and involvement of motor vehicles is associated with severe injuries, but research utilizing a nationally representative data set for this population and focusing on these risk factors does not exist. The objective of this study was to describe the epidemiology of bicycle-related injuries among children treated in hospital emergency departments (EDs) in the United States (US). METHODS A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System for children 5-17 years of age who were treated in US EDs from 2006 through 2015 for a bicycle-related injury. Helmet use and motor vehicle involvement were two variables that were created and coded using keyword searches of the case narratives. Rates of injuries over time were described. Multivariate logistic regression along with 95% confidence intervals (CIs) were used to contrast types of injuries sustained among injured helmet users with non-users. RESULTS An estimated 2 219 742 (95% CI: 1 871 120-2 568 363) children 5-17 years of age were treated in US EDs for bicycle-related injuries over the 10-year study period, an average of 608 injuries per day. Most injuries (45.7%) involved children 10-14 years of age. The rate of bicycle-related injuries significantly decreased from 447.4 per 100 000 children in 2006 to 321.1 per 100 000 children in 2015 (P < 0.001). Helmet use at the time of injury was significantly associated with lower likelihood of head and neck injuries (OR: 0.52 [95% CI: 0.40-0.59]) and hospitalizations (OR: 0.71 [95% CI: 0.54-0.94]), but there was no significant change in the rate of injury among helmet users over the study period (P = 0.224). Motor vehicle involvement increased the odds of bicycle-related traumatic brain injuries (TBIs) (OR: 1.98 [95% CI: 1.49-2.64]) as well as injury-related hospitalizations (OR: 4.04 [95% CI: 3.33-4.89]). CONCLUSIONS Despite decreasing injury rates, bicycling remains an important source of injury for children. Helmet use has demonstrated significant protective effects for TBIs, head and neck injuries, and hospitalizations. Motor vehicle involvement increased the risk of hospitalization. More efforts are needed to promote use of helmets and to reduce the possibility of bicycle-motor vehicle collisions to prevent bicycle-related injuries among children.
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Affiliation(s)
- Rebecca J McAdams
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, United States.
| | - Katherine Swidarski
- Division of Health Behavior and Health Promotion, The Ohio State University, College of Public Health, 1841 Neil Avenue, Columbus, OH, 43210, United States.
| | - Roxanne M Clark
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, United States.
| | - Kristin J Roberts
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, United States.
| | - Jingzhen Yang
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, United States; Department of Pediatrics, The Ohio State University, College of Medicine, 700 Children's Drive Columbus, OH, 43205, United States; Division of Epidemiology, The Ohio State University, College of Public Health, 1841 Neil Avenue, Columbus, OH, 43210, United States.
| | - Lara B Mckenzie
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, United States; Department of Pediatrics, The Ohio State University, College of Medicine, 700 Children's Drive Columbus, OH, 43205, United States; Division of Epidemiology, The Ohio State University, College of Public Health, 1841 Neil Avenue, Columbus, OH, 43210, United States.
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Abstract
OBJECTIVE The purpose of this study was to systematically review the literature to assess if serious games impact health outcomes for children less than 18 years of age with chronic diseases. Additionally, the impact of self-efficacy, adherence, knowledge, use of theory, parent involvement, and study quality was also examined. MATERIALS AND METHODS Searches were conducted in databases EBSCO, PubMed, and Web of Science between June and August 2016. Randomized controlled trials using a serious game as an intervention, for participants under 18 years of age, to improve their chronic disease were included. RESULTS Data were extracted by two independent researchers, including: Title, author, and publication year; chronic disease; game description; number and age of participants; intervention duration; significant findings; parent involvement; theory; and study quality. Any disagreements were tackled and consensus was achieved. Eighteen studies were included in the review. The areas of health addressed included cerebral palsy, asthma, diabetes, developmental coordination disorders, and vision disorders. In these articles, eight health outcome variables were measured, including: lung function, glycemic control, hospital visits, motor proficiency, and visual acuity. Psychosocial variables that were assessed included self-efficacy and knowledge. Two articles included parents in the intervention, and three articles used theory. Six studies had significant health outcome finding, and four studies found a significant change in one psychosocial variable. CONCLUSION This review demonstrates the potential for games to improve health outcomes of young individuals. However, the mixed results suggest that more serious game interventions need to be better designed and rigorously tested to support their impact on improving health outcomes.
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Affiliation(s)
- Bree E Holtz
- 1 Department of Advertising and Public Relations, Michigan State University , East Lansing, Michigan
| | - Katharine Murray
- 1 Department of Advertising and Public Relations, Michigan State University , East Lansing, Michigan
| | - Taiwoo Park
- 2 Department of Media and Information, Michigan State University , East Lansing, Michigan
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Mpango RS, Kinyanda E, Rukundo GZ, Levin J, Gadow KD, Patel V. Prevalence and correlates for ADHD and relation with social and academic functioning among children and adolescents with HIV/AIDS in Uganda. BMC Psychiatry 2017; 17:336. [PMID: 28938881 PMCID: PMC5610431 DOI: 10.1186/s12888-017-1488-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 08/30/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Aim of this study was to determine the prevalence of attention-deficit/hyperactivity disorder (ADHD), its associated correlates and relations with clinical and behavioural problems among children and adolescents with HIV/AIDS (CA-HIV) attending five HIV clinics in central and South Western Uganda. METHODS This study used a quantitative design that involved a random sample of 1339 children and adolescents with HIV and their caregivers. The Participants completed an extensive battery of measures including a standardized DSM-5 referenced rating scale, the parent version (5-18 years) of the Child and Adolescent Symptom Inventory-5 (CASI-5). Using logistic regression, we estimated the prevalence of ADHD and presentations, correlates and its impact on negative clinical and behavioural factors. RESULTS The overall prevalence of ADHD was 6% (n = 81; 95%CI, 4.8-7.5%). The predominantly inattentive presentation was the most common (3.7%) whereas the combined presentation was the least prevalent (0.7%). Several correlates were associated with ADHD: socio-demographic (age, sex and socio-economic status); caregiver (caregiver psychological distress and marginally, caregiver educational attainment); child's psychosocial environment (quality of child-caregiver relationship, history of physical abuse and marginally, orphanhood); and HIV illness parameters (marginally, CD4 counts). ADHD was associated with poor academic performance, school disciplinary problems and early onset of sexual intercourse. CONCLUSIONS ADHD impacts the lives of many CA-HIV and is associated with poorer academic performance and earlier onset of sexual intercourse. There is an urgent need to integrate the delivery of mental health services into routine clinical care for CA-HIV in Sub-Saharan Africa.
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Affiliation(s)
- Richard Stephen Mpango
- Mental Health Project, MRC/UVRI Uganda Research Unit on AIDS, P. O. Box 49, Entebbe, Uganda. .,Department of Psychiatry, Mbarara University of Science and Technology, P. O. Box 1410, Mabarara, Uganda.
| | - Eugene Kinyanda
- 0000 0004 1790 6116grid.415861.fMental Health Project, MRC/UVRI Uganda Research Unit on AIDS, P. O. Box 49, Entebbe, Uganda ,Department of Psychiatry, Makerere College of Health Sciences, Kampala, Uganda
| | - Godfrey Zari Rukundo
- 0000 0001 0232 6272grid.33440.30Department of Psychiatry, Mbarara University of Science and Technology, P. O. Box 1410, Mabarara, Uganda
| | - Jonathan Levin
- 0000 0004 1790 6116grid.415861.fStatistical Section, MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda ,0000 0004 1937 1135grid.11951.3dSchool of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Kenneth D. Gadow
- 0000 0001 2216 9681grid.36425.36Department of Psychiatry, Health Sciences Centre, Stony Brook University, Stony Brook, NY 11794-8790 USA
| | - Vikram Patel
- 000000041936754Xgrid.38142.3cDepartment of Global Health and Social Medicine, Harvard Medical School, Massachusetts, USA
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Niba LL, Aulinger B, Mbacham WF, Parhofer KG. Predictors of glucose control in children and adolescents with type 1 diabetes: results of a cross-sectional study in Cameroon. BMC Res Notes 2017; 10:207. [PMID: 28606170 PMCID: PMC5469010 DOI: 10.1186/s13104-017-2534-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 06/05/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In sub-Saharan Africa the prognosis of children with type 1 diabetes is poor. Many are not diagnosed and those diagnosed have a dramatically reduced life expectancy (less than one year). The purpose of this study was to identify the predictors of glucose control in children and adolescents with type 1 diabetes. METHODS This hospital based cross-sectional study involved 76 children/adolescents (35 boys and 41 girls, mean age of 15.1 ± 3.1 years) with type 1 diabetes included in the "Changing Diabetes in Children" (CDiC) program and attending the clinics for children living with type 1 diabetes in the North West Region of Cameroon. Data on glycosylated haemoglobin (HbA1c) was obtained from hospital records of participants. Information on socio-demographic characteristics and diabetes related practices were obtained from participants using a structured questionnaire. Odds ratios (OR) were calculated using logistic regression models to assess the association between determinants and good glyceamic control. RESULTS The study population had a mean HbA1c of 10.3 ± 2.9%. Bivariate analysis indicated that having a mother as the primary caregiver (OR 0.07, 95% CI 0.02-0.2), being on 2 daily insulin injections (OR 0.2, 95% CI 0.1-0.5) and good blood glucose monitoring (BGM) adherence (OR 0.1, 95% CI 0.04-0.3) were significantly (p < 0.001) associated with better HbA1c. Minimal/moderate caregiver involvement in BGM (OR 7.7, 95% CI 2.7-22.0) and insulin injection (OR 14.9, 95% CI 4.8-46.5) were significantly (p < 0.001) associated with poor outcome. Multivariate analysis showed that having a mother as the primary caregiver (OR 0.02, 95% CI 0.002-0.189) was an independent predictor of good glucose control. CONCLUSIONS This study has shown that the mother's involvement in the diabetes management of their children and minimal/moderate caregiver involvement in the task of insulin injection are the most important determinants for good and poor glucose control respectively. It is currently unclear whether the direct involvement of the mother is causal or whether "mother as a primary caregiver" is just an indicator for a setting in which good diabetes treatment is possible.
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Affiliation(s)
- Loveline L. Niba
- CIHLMU Center for International Health at Ludwig-Maximilians-Universität, Munich, Germany
- Department of Biochemistry, Catholic University of Cameroon (CATUC), P.O. Box 782, Bamenda, Cameroon
| | - Benedikt Aulinger
- CIHLMU Center for International Health at Ludwig-Maximilians-Universität, Munich, Germany
- Department of Medicine II-Grosshadern, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377 Munich, Germany
| | - Wilfred F. Mbacham
- Department of Physiology and Biochemistry, Faculty of Medicine, University of Yaoundé I, P.O. Box 8094, Yaoundé, Cameroon
| | - Klaus G. Parhofer
- CIHLMU Center for International Health at Ludwig-Maximilians-Universität, Munich, Germany
- Department of Medicine II-Grosshadern, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377 Munich, Germany
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20
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Lin PZ, Bai HY, Sun JW, Guo W, Zhang HH, Cao FL. Association between child maltreatment and prospective and retrospective memory in adolescents: The mediatory effect of neuroticism. Child Abuse Negl 2017; 65:58-67. [PMID: 28113085 DOI: 10.1016/j.chiabu.2017.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 12/30/2016] [Accepted: 01/11/2017] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to examine the relationship between child maltreatment and prospective and retrospective memory in children/adolescents by investigating the mediating role of neuroticism. In total, 662 children/adolescents aged 10-16 years were recruited from a middle school in China, and they completed questionnaires comprising the Childhood Trauma Questionnaire, Prospective and Retrospective Memory Questionnaire, and the Neuroticism subscale of the NEO Five-Factor Inventory. The severity of maltreatment was positively associated with the severity of impairment of memory (prospective and retrospective considered together) in children/adolescents. Children/adolescents exposed to maltreatment tended to display higher levels of neuroticism. Neuroticism partially mediated the association between child maltreatment and memory in all the subjects. The results of multigroup analyses showed neuroticism fully mediated the relationship between child maltreatment and memory for boys, in which the effect size of indirect effect was 0.52, and partially mediated the association for girls with 0.44 effect size of indirect effect. Early intervention aimed to reduce neuroticism might contribute to a better prognosis in children/adolescences with poor memory function.
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Affiliation(s)
- Ping-Zhen Lin
- School of Nursing, Shandong University, Jinan, Shandong 250012, PR China.
| | - Hua-Yu Bai
- School of Nursing, Shandong University, Jinan, Shandong 250012, PR China.
| | - Ji-Wei Sun
- School of Nursing, Shandong University, Jinan, Shandong 250012, PR China.
| | - Wei Guo
- Shandong Women's University, Jinan, Shandong 250300, PR China.
| | - Hui-Hui Zhang
- School of Nursing, Shandong University, Jinan, Shandong 250012, PR China.
| | - Feng-Lin Cao
- School of Nursing, Shandong University, Jinan, Shandong 250012, PR China.
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21
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Poloczek S, Henry LA, Danielson H, Büttner G, Mähler C, Messer DJ, Schuchardt K, Molen MJVD. Strategic verbal rehearsal in adolescents with mild intellectual disabilities: A multi-centre European study. Res Dev Disabil 2016; 58:83-93. [PMID: 27598423 DOI: 10.1016/j.ridd.2016.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 08/08/2016] [Accepted: 08/29/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND There is a long-held view that verbal short-term memory problems of individuals with intellectual disabilities (ID) might be due to a deficit in verbal rehearsal. However, the evidence is inconclusive and word length effects as indicator of rehearsal have been criticised. AIM & METHOD The aim of this multi-site European study was to investigate verbal rehearsal in adolescents with mild ID (n=90) and a comparison group of typically developing children matched individually for mental age (MA, n=90). The investigation involved: (1) a word length experiment with non-verbal recall using pointing and (2) 'self-paced' inspection times to infer whether verbal strategies were utilised when memorising a set of pictorial items. RESULTS The word length effect on recall did not interact with group, suggesting that adolescents with ID and MA comparisons used similar verbal strategies, possibly phonological recoding of picture names. The inspection time data suggested that high span individuals in both groups used verbal labelling or single item rehearsal on more demanding lists, as long named items had longer inspection times. CONCLUSIONS The findings suggest that verbal strategy use is not specifically impaired in adolescents with mild ID and is mental age appropriate, supporting a developmental perspective.
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Affiliation(s)
- Sebastian Poloczek
- Department of Psychology, Goethe University Frankfurt and Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany.
| | - Lucy A Henry
- Language and Communication Science, City University London, London, UK.
| | - Henrik Danielson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden and The Swedish Institute for Disability Research, Sweden.
| | - Gerhard Büttner
- Department of Psychology, Goethe University Frankfurt and Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany.
| | - Claudia Mähler
- Department of Educational Psychology, Hildesheim University, Hildesheim, Germany.
| | - David J Messer
- Faculty of Education and Language Studies, Open University, Milton Keynes, UK.
| | - Kirsten Schuchardt
- Department of Educational Psychology, Hildesheim University, Hildesheim, Germany.
| | - Mariët J van der Molen
- Department of Clinical, Neuro- & Developmental Psychology, and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands.
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22
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Kolasa MS, Stevenson J, Ossa A, Lutz J. Does closure of children's medical home impact their immunization coverage? Public Health 2014; 128:1106-11. [PMID: 25443105 DOI: 10.1016/j.puhe.2014.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 07/23/2014] [Accepted: 08/04/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Little is known about the impact closing a health care facility has on immunization coverage of children utilizing that facility as a medical home. The authors assessed the impact of closing a Medicaid managed care facility in Philadelphia on immunization coverage of children, primarily low income children from racial/ethnic minority groups, utilizing that facility for routine immunizations. STUDY DESIGN Observational longitudinal cohort case study. METHODS Eligible children were born 03/01/05-06/30/07, present in Philadelphia's immunization information system (IIS), and were active clients of the facility before it closed in September 2007. IIS-recorded immunization coverage at ages 5, 7, 13, 16 and 19 months through January 2009 was compared between clinic children age-eligible to receive specific vaccines before clinic closing (preclosure cohorts) and children not age-eligible to receive those vaccines prior to closing (postclosure cohorts). RESULTS Of 630 eligible children, 99 (16%) had no additional IIS-recorded immunizations. Third dose DTaP vaccine coverage at age seven months among preclosure cohorts was 54.4% vs. 40.3% among postclosure cohorts [risk ratio 1.31 (1.15,1.49)]. Fourth dose DTaP coverage at 19 months was 65.9% vs. 57.7% [risk ratio 1.24 (1.08,1.42)]. MMR coverage at 16 months was 79.5% vs. 69.9% [risk ratio 1.47 (1.22, 1.76)]. Coverage for the 431331 vaccination series at 19 months was 63.8% vs. 53.8% [risk ratio 1.28 (1.12,1.88)]. CONCLUSIONS Immunization coverage declined at key age milestones for active clients of a Medicaid managed care that closed as compared with preclosure cohorts of clients from the same facility. When a primary health care facility closes, efforts should be made to ensure that children who had received vaccinations at that facility quickly establish a new medical home.
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Affiliation(s)
- M S Kolasa
- Health Services Research and Evaluation Branch, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, 1600 Clifton Rd, A19, Atlanta, GA 30333, USA.
| | - J Stevenson
- Health Services Research and Evaluation Branch, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, 1600 Clifton Rd, A19, Atlanta, GA 30333, USA.
| | - A Ossa
- Philadelphia Department of Public Health, 500 S Broad St, 2nd Floor, Philadelphia, PA 19146, USA.
| | - J Lutz
- Program Operations Branch, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, 1600 Clifton Rd, A19, Atlanta, GA 30333, USA.
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23
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Saether R, Helbostad JL, Adde L, Brændvik S, Lydersen S, Vik T. Gait characteristics in children and adolescents with cerebral palsy assessed with a trunk-worn accelerometer. Res Dev Disabil 2014; 35:1773-1781. [PMID: 24679701 DOI: 10.1016/j.ridd.2014.02.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 02/10/2014] [Accepted: 02/14/2014] [Indexed: 06/03/2023]
Abstract
This study aimed to investigate gait characteristics reflecting balance and progression in children and adolescents with cerebral palsy (CP) compared with typically developing (TD) children. Gait characteristics variables representing aspects of balance were trunk acceleration, interstride regularity and asymmetry of accelerations while gait characteristics representing progression were gait speed, cadence, step time and step length. Children in the age range 5-18 years (mean age 11.1 years) with spastic CP (n=41) and a gross motor function corresponding to GMFCS I-III and children with TD (n=29) were included. The children walked back and forth along a 5m pathway with a tri-axial accelerometer worn on the lower back to allow assessment of their gait characteristics. Data were recorded along the anterioposterior (AP), mediolateral (ML), and vertical (V) axes. To assess the magnitude of potential differences in gait characteristics, standard deviation scores were calculated, using TD children as reference. Gait parameters related to balance, such as AP, ML, and V accelerations, were higher in the children with CP (z-scores between 0.4 and 0.7) and increased with increasing GMFCS levels. The differences in accelerations in the AP and V directions increased between children with CP and TD children with increasing speed. Also asymmetry in trunk accelerations differed significantly between the two groups in all three directions (z-scores between 0.8 and 1.8 higher in the CP group), while interstride regularity differed only slightly between children with CP and TD children, and only in the AP direction. Gait characteristics also differed between children with the spastic subtypes unilateral and bilateral CP, for accelerations and asymmetry in the AP and ML directions. Our results showed significant differences in gait characteristics between children with CP and TD children. The differences may be more related to balance than progression, and these problems seem to rise with increasing gross motor impairment and speed.
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Affiliation(s)
- Rannei Saether
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Trondheim, Norway.
| | - Jorunn L Helbostad
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Clinic for Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Lars Adde
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Clinic for Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Siri Brændvik
- Clinic for Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Human Movement Science Programme, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Stian Lydersen
- Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Trondheim, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Torstein Vik
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Trondheim, Norway.
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Gaspar T, de Matos MG, Luszczynska A, Baban A, Wit J. The impact of a rural or urban context in eating awareness and self-regulation strategies in children and adolescents from eight European countries. Int J Psychol 2014; 49:158-66. [PMID: 24821504 DOI: 10.1002/ijop.12046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 01/28/2014] [Indexed: 11/11/2022]
Abstract
Complex relationships exist between eating behaviour and personal and environmental factors. Rural and urban geographic contexts seem to play a role in eating behaviour, and therefore deserve a deeper study. A healthy eating behaviour and the conditions that promote it are a major issue in the promotion of adolescent health. The study aims to investigate the associations between the area of residence (urban vs. rural), self-regulation strategies (TESQ-E) and eating behaviours among children and adolescents. A total of 11,820 adolescents (50.6% girls) participated in the study, with a mean age of 13.30 years (SD= 2.13). Nine countries (The Netherlands, United Kingdom, Poland, Portugal, Denmark, Romania, Germany, Finland and Belgium) completed a questionnaire in the school context, asking about the use of self-regulation strategies, eating behaviour awareness/care and sociodemographic questions such as age, gender and residential area. Both areas of residence (urban vs. rural) are associated with eating awareness/care in Romania and Portugal, controlling for age, gender and self-regulation strategies. In some European countries at least, and most probably around the world, health promotion should focus on an ecological approach that includes the understanding of the effect of both environmental factors and personal skills on eating behaviour/awareness.
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Affiliation(s)
- Tania Gaspar
- CMDT/Institute of Hygiene and Tropical Medicine, New University of Lisbon, Lisbon, Portugal; Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal; Psychology and Education Sciences Institute, Lusiada University of Lisbon, Lisbon, Portugal
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