Association of preschool children behavior and emotional problems with the parenting behavior of both parents

BACKGROUND Parental behaviors are key in shaping children’s psychological and behavioral development,crucial for early identification and prevention of mental health issues,reducing psychological trauma in childhood.AIM To investigate the relationship between parenting behaviors and behavioral and emotional issues in preschool children.METHODS From October 2017 to May 2018,7 kindergartens in Ma’anshan City were selected to conduct a parent self-filled questionnaire-Health Development Survey of Preschool Children.Children’s Strength and Difficulties Questionnaire(Parent Version)was applied to measures the children’s behavioral and emotional performance.Parenting behavior was evaluated using the Parental Behavior Inventory.Binomial logistic regression model was used to analyze the association between the detection rate of preschool children’s behavior and emotional problems and their parenting behaviors.RESULTS High level of parental support/participation was negatively correlated with conduct problems,abnormal hyperactivity,abnormal total difficulty scores and abnormal prosocial behavior problems.High level of maternal support/participation was negatively correlated with abnormal emotional symptoms and abnormal peer interaction in children.High level of parental hostility/coercion was positively correlated with abnormal emotional symptoms,abnormal conduct problems,abnormal hyperactivity,abnormal peer interaction,and abnormal total difficulty scores in children(all P<0.05).Moreover,paternal parenting behaviors had similarly effects on behavior and emotional problems of preschool children compared with maternal parenting behaviors(all P>0.05),after calculating ratio of odds ratio values.CONCLUSION Our study found that parenting behaviors are associated with behavioral and emotional issues in preschool children.Overall,the more supportive or involved the parents are,the fewer behavioral and emotional problems the children experience;conversely,the more hostile or controlling the parents are,the more behavioral and emotional problems the children face.Moreover,the impact of fathers’parenting behaviors on preschool children’s behavior and emotions is no less significant than that of mothers’parenting behaviors.

Attachment Styles and Traumatic Responses: Exploring the Impact of Parental Interaction on Child Development and Coping Mechanisms

This article explores the intricate relationship between attachment styles formed during early childhood and the subsequent responses to traumatic events, particularly the death of a parent. Drawing on the theoretical framework of attachment theory and incorporating contemporary research, the paper discusses how parental interactions shape the neural circuitry of infants and children, influencing their ability to form secure or insecure attachments. These attachment styles, in turn, play a critical role in determining the child’s coping mechanisms when faced with trauma. This paper focuses on trying to understand how attachment theory is connected to the reaction to trauma with a highlight on the four major styles of attachments which are secure, anxious, avoidant, and disorganized to mention but a few, and how they influence stress and adversity in children. Attachment theory holds that human beings’ ability to form affectional bonds in infancy determines their patterns of relatedness across the life cycle. The type of attachment that is secure usually supports healthy adaptation and good coping mechanisms regardless of the trauma in the childhood of the child. While secure attachment mostly facilitates favorable trauma-related outcomes, anxious or avoidant attachment can exacerbate or alter the responses. The caregiving system that is avoidant attachment has implications of autonomous self-functioning which has features of suppression of the emotional response and poor search for emotional support during stress. From the principles of developmental psychology and trauma theory, the paper also focuses on the major significance of the child’s early caregivers’ interactions that define the resilience and vulnerability factor. This knowledge is therefore critical in designing specific interventions based on the improvement of coping behaviors and emotional regulatory systems of children who have been exposed to trauma. Finally, we have the synthesis of new knowledge about the role of secure attachment relationships as its fundamental element in shaping adaptive traumatization and psychological development. The article also delves into the physiological processes involved in emotional regulation and the role of cortisol in disrupting attachment. Finally, the implications of these findings for therapeutic interventions and the challenges of addressing prolonged grief and traumatic responses in clinical settings are considered.

Literature Review on Support for Children and Families Experiencing Parental Bereavement

Purpose: This study aimed to understand the actual nursing support in a wide perspective by reviewing overseas literature on support for children who have experienced parental bereavement and their families. The goal was to identify future challenges in nursing support in clinical practice in Japan. Method: Literature searchable as of May 2023 was retrieved using PubMed, resulting in 11 relevant articles. Result: The results revealed the following: 1) For support provided to children, 13 codes were condensed into 5 subcategories and 4 categories. 2) For support provided to families, 36 codes were condensed into 11 subcategories and 4 categories. Conclusion: Open communication was found to be essential for supporting children and their families who have experienced parental bereavement. Moreover, involvement of multiple professions facilitated the provision of specialized support to address diverse needs of children and families, playing a crucial role in overcoming grief. Additionally, the effectiveness of support systems for bereaved families highlighted the need for nursing professionals in Japan to gain knowledge through learning opportunities and to establish a multi-disciplinary approach to support, thus indicating future challenges in nursing support.

The Development of a Feeding Coparenting Scale for Japanese Parents of Fifth- and Sixth-Grade Elementary School Children

Aim: Recently, the role of feeding coparenting has gained attention in the child eating research field. The Feeding Coparenting Scale (FCS), a measure of how caregivers interact with their partners when feeding their children was developed in the United States in 2019. However, there is no valid and reliable measure to assess feeding coparenting among caregivers of school-aged children in Japan. Therefore, this study aimed to develop a Japanese version of the FCS (FCS-J) questionnaire for caregivers with school-aged children. Methods: This was a web-based cross-sectional survey completed by caregivers of children aged 10-12 years. A preliminary survey using interviews and a web-based survey was conducted and found that the translated items of the FCS into Japanese were understandable to Japanese people. The developed survey was administered to parents of children at an elementary school. The reliability of the survey was assessed using both test-retest reliability and internal consistency analysis. Exploratory factor analysis was used to test construct validity, and known population validity was examined in relation to attributes, marital satisfaction, and feeding tasks. Results: Findings with 135 parents of school-aged children showed good internal reliability and validity of the FCS-J. The mean score for the overall FCS-J score was 46.2 (SD = 6.2), with Cronbach’s α of 0.72. For the subscales, Cronbach’s α ranged from 0.75 to 0.79. In sum, the present study’s results support the three-factor structure of the FCS in Japanese caregivers in Japan. Conclusions: The developed FCS-J was found to have a certain degree of reliability and validity. In this study, a Japanese version of the FCS-J was developed. .

Comparative study on emotional behavior and parental job stress of only-child and non-only-child preschool children

BACKGROUND Studies have revealed that Children's psychological,behavioral,and emotional problems are easily influenced by the family environment.In recent years,the family structure in China has undergone significant changes,with more families having two or three children.AIM To explore the relationship between emotional behavior and parental job stress in only preschool and non-only preschool children.METHODS Children aged 3-6 in kindergartens in four main urban areas of Shijiazhuang were selected by stratified sampling for a questionnaire and divided into only and nononly child groups.Their emotional behaviors and parental pressure were compared.Only and non-only children were paired in a 1:1 ratio by class and age(difference less than or equal to 6 months),and the matched data were compared.The relationship between children's emotional behavior and parents'job stress before and after matching was analyzed.RESULTS Before matching,the mother's occupation,children's personality characteristics,and children's rearing patterns differed between the groups(P<0.05).After matching 550 pairs,differences in the children's parenting styles remained.There were significant differences in children's gender and parents'attitudes toward children between the two groups.The Strengths and Difficulties Questionnaire(SDQ)scores of children in the only child group and the Parenting Stress Index-Short Form(PSI-SF)scores of parents were significantly lower than those in the non-only child group(P<0.05).Pearson’s correlation analysis showed that after matching,there was a positive correlation between children's parenting style and parents'attitudes toward their children(r=0.096,P<0.01),and the PSI-SF score was positively correlated with children's gender,parents'attitudes toward their children,and SDQ scores(r=0.077,0.193,0.172,0.222).CONCLUSION Preschool children's emotional behavior and parental pressure were significantly higher in multi-child families.Parental pressure in differently structured families was associated with many factors,and preschool children's emotional behavior was positively correlated with parental pressure.

The Relationship between Parental Stress and Child Conformity:The Mediating Role of Resilience

Background:In today’s society,parental stress has become a prevalent and significant issue,impacting not only parents’mental health but also potentially profoundly affecting children’s growth and education.This topic has garnered continuous attention from scholars.The present study aims to delve into the relationship between parental stress and children’s behavior,particularly focusing on children’s conformity and discipline development during crucial stages.This study aims to explore the relationship between parental stress,child conformity,and resilience,and further examines the mediating role of resilience in the relationship between parental stress and child conformity.Methods:We used three scales:the Parental Stress Scale,the Child Conformity Scale,and the Resilience Scale,to survey 890 elementary school students(aged 6–12)and their parents in the Beijing-Tianjin-Hebei region of China.We employed SPSS 26.0 software for data analysis,conducting descriptive statistics,correlation analysis,and mediation effect tests sequentially.In the mediation effect tests,we utilized structural equation modeling(SEM)and regression analysis to examine the mediation effects,ensuring the accuracy and scientific nature of our analysis.Results:Through descriptive statistics,correlation analysis,regression models,and mediation effect tests,we found that parental stress significantly negatively predicts child conformity,while resilience shows a significant positive prediction.Further mediation analysis indicates that resilience plays a partial mediating role between parental stress and child conformity,with the mediation effect accounting for 36.67%.Conclusion:These findings highlight the importance of the family environment on child behavior and provide valuable insights and recommendations for family education practices in the Beijing-Tianjin-Hebei region.Therefore,we suggest future research should further explore the complex relationships among parental stress,child conformity,and resilience,and examine regional differences to better promote children’s overall development.

Relationship between Authoritative Parenting Style and Preschool Children’s Emotion Regulation:A Moderated Mediation Model

An authoritative parenting style has been shown to promote children’s emotion regulation in European-American family studies.However,little is known about how sleep problems and the child’s sibling status in Chinese families affect this relationship.Based on family system theory,this study attempts to better understand the relationship between authoritative parenting style and emotion regulation.Mothers of preschool children in Chinese kindergartens completed questionnaires about their children’s sleep habits,their authoritative parenting styles,and children’s emotion regulation.A total of 531 children participated in this study.Results showed that authoritative parenting was positively associated with emotional regulation.Sleep problems mediated the effects of authoritative parenting style on emotion regulation.The child’s sibling status moderated the mediating effects of sleep problems in authoritative parenting and emotion regulation relationships.Specifically,the relationship between the authoritative parenting style and sleep problems was significant for only children,while birth order had no significant influence on the authoritative parenting style and sleep problems in two-child families.These findings suggest that a lowauthoritative parenting style predicts low emotion regulation through sleep problems,and this depends on the child’s sibling status,indicating that children without siblings may impair emotion regulation due to increased sleep problems.

Parental Knowledge of Pre-Hospital Management of Avulsed Permanent Tooth in Children at Kath

BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered as the treatment of choice. OBJECTIVE: The study was undertaken to assess the knowledge of parents who accompany their children to the pediatric dental clinic, KATH on the pre-hospital management of avulsed permanent tooth in children. METHODS: A researcher administered structured questionnaire was used to collect data on the knowledge of pre-hospital management of avulsed permanent tooth from 83 parents who accompanied their wards to the pediatric dental clinic at KATH. RESULTS: A total of 83 parents were involved in the study. 30 (36%) were males while 53 (64%) were females. The majority of the parents (57%) were either university trained or had attended college of education. Only 32 parents (39%) were aware of the possibility of replantation. Majority of the parents chose non-physiologic media as the transport media of choice and only 10% would attempt self-replantation before seeking professional help. 76 parents (92%) had no previous education on pre-hospital management of avulsed tooth. CONCLUSION: The results obtained from this study indicate that parental knowledge on pre-hospital management of avulsed permanent tooth is low hence the need for massive public educational campaigns.

Navigating Silence: A Comprehensive Review of Parental Roles in the Rehabilitation of Children with Hearing Loss

This narrative literature review delves into the multifaceted realm of parental involvement in the rehabilitation of children with permanent hearing loss. While existing research has made strides in elucidating parental roles in this context, critical gaps persist, necessitating a comprehensive exploration to inform future endeavors. Our review synthesizes a wide array of studies, identifying these gaps and emphasizing the significance of addressing them. Themes emerging from the literature include the varying degrees of parental engagement, the impact of cultural and socio-economic factors, and the challenges faced by families navigating rehabilitation processes. The synthesis of this literature not only highlights the current state of knowledge but also provides a roadmap for future research efforts. By addressing these gaps, we aim to contribute to a more nuanced understanding of parental involvement in the rehabilitation of children with permanent hearing loss, ultimately fostering improved support systems and holistic care for affected families.

Does Parental Migration Affect Left-Behind Children’s Social Anxiety?A Systematic Review and Meta-Analysis

Social anxiety is a common psychological problem among left-behind children(LBC)and has been a popular issue in recent years.Children with higher levels of social anxiety have more emotional and behavioral problems and are prone to negative life events.Although several studies have explored the differences in social anxiety between LBC and non-left-behind children(N-LBC),the findings have not been consistent.In this study,a systematic review and meta-analysis method was used,with 411 papers retrieved on October 01,2023,from Pubmed,Embase,Web of Science,and Chinese databases(CNKI,VIP,and Wanfang)(PROSPERO registry number:CRD42023472463).Twenty-one studies met the research criteria and included 11,254 LBC and 13,096 N-LBC.LBC scored significantly higher for social anxiety([WMD(95%CI):0.35[0.23,0.48],p<0.001])and social avoidance and distress([WMD(95%CI):0.35[0.23,0.48],p<0.001]).Subgroup analyses showed significant differences in effect sizes for the overall proportion of children left behind(p=0.02).In addition,different types of parental migration may influence the social anxiety of LBC,double-parent migration was associated higher social anxiety than father migration(p<0.001).Future research should focus on treatments to decrease social anxiety of left-behind children.These findings suggest that due to the long-term absence of parental migration,LBC are more vulnerable to negative emotional experiences and behaviours such as anxiety,distress,and avoidance during social interaction,especially for those with both parents absent from the home.Future research should focus on treatments to reduce social anxiety in LBC.

Main focus of parents of children with attention deficit hyperactivity disorder and the effectiveness of early clinical screening

BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a common mental and behavioral disorder among children.AIM To explore the focus of attention deficit hyperactivity disorder parents and the effectiveness of early clinical screening METHODS This study found that the main directions of parents seeking medical help were short attention time for children under 7 years old(16.6%)and poor academic performance for children over 7 years old(12.1%).We employed a two-stage experiment to diagnose ADHD.Among the 5683 children evaluated from 2018 to 2021,360 met the DSM-5 criteria.Those diagnosed with ADHD underwent assessments for letter,number,and figure attention.Following the exclusion of ADHD-H diagnoses,the detection rate rose to 96.0%,with 310 out of 323 cases identified.RESULTS This study yielded insights into the primary concerns of parents regarding their children's symptoms and validated the efficacy of a straightforward diagnostic test,offering valuable guidance for directing ADHD treatment,facilitating early detection,and enabling timely intervention.Our research delved into the predominant worries of parents across various age groups.Furthermore,we showcased the precision of the simple exclusion experiment in discerning between ADHD-I and ADHD-C in children.CONCLUSION Our study will help diagnose and guide future treatment directions for ADHD.

Knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter

Objectives:The objectives of this study were to assess the knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter.Materials and Methods:This cross-sectional study was conducted from June 1,2021,to September 11,2021,in a tertiary hospital in north India.Purposive sampling was used to select 50 participants.Three instruments were employed for data collection after fulfilling sample criteria;for baseline information demographic tool,knowledge questionnaires,and a practice checklist.Data were analyzed using descriptive and inferential statistics.Results:On assessment of 50 participants,the majority of parents aged above 30 years(74%).Most of the participants were male(82%),graduated(38%),and working in the private sector(58%).Similarly,two-thirds of participants were residing in a nuclear family(64%)with a single child 32(64%)and family income<5000 rupees per month(60%).The mean score of knowledge was 1.94±0.81 and that of practice skills was 1.98±0.85 on home-based care.Regression analysis showed that knowledge of parents was significantly associated with qualification(β:1.821,P=0.002).Similarly,association of practice skills of parents with gender(β:1.235,P=0.050)and qualification(β:1.889,P=0.00)was significant.Conclusion:The general findings of our study showed that parents’education and occupation played a significant role in a child’s care.Parental education and catheter care skills positively affect the child and reduce readmission rates.

Parents’s knowledge and awareness about hepatitis B can influence the vaccination of their children

BACKGROUND Birth-dose(Hep-BD)followed by three additional doses(Hep-B3)of hepatitis B virus(HBV)vaccine are key to eliminating HBV by 2030.Unfortunately,Hep-BD and Hep-B3 coverage in our country is poor.AIM To studied the parent’s knowledge and awareness about HBV infection,its prevention,consequences and vaccination.METHODS Parents of 6 months to 8 years old children were interviewed to assess their knowledge&awareness about hepatitis B,its transmission,prevention,illness caused by this,and vaccination.Eighteen close-ended questions were admini-stered,and responses were recorded as‘yes’,‘no’,or‘not sure’.HBV knowledge score was calculated based on the sum of correct answers.Each correct response scored one point and incorrect,missing or‘not sure’responses received no points.Categorical data are presented as number(%)and numerical data are expressed as median.Data were compared using Chi2 tests and level of significance was kept as P<0.05.RESULTS Parents(58.3%mothers)of 384 children(89.9%age<5 years;82%age-appropriately vaccinated)were included.Three hundred and twenty-two(83.9%)children were Hep-B3 vaccinated.94.3%,87.5%,and 29.2%parents knew about polio,tetanus,and hepatitis B vaccine.Overall,41.2%,15.8%,and 23%parents knew about hepatitis B transmission,consequences of infection,and prevention respectively.Only 7.6%parents knew about three-dose schedule of hepatitis B vaccination.Only 23%parents believed that vaccine could prevent HBV,15.7%knew that HBV affects liver.Parents of Hep-B3 vaccinated children were significantly more aware about HBV than the parents of unvaccinated children(P<0.05 for 17/18 questions).CONCLUSION The knowledge and awareness among the parents about hepatitis B is poor.The Increasing knowledge/awareness about HBV among parents may improve Hep-B3 vaccination coverage.

Parental Anxiety and Quality of Life of Epileptic Children

Objective To investigate the prevalence of parental anxiety associated with epileptic children, and to explore whether and how this specific condition affects children＇s quality of life （QOL）, and what are the significant determinants for parental anxiety. Methods Three hundred and forty parents whose children were affected with known epilepsy were enrolled in the study. Questionnaires for quality of life in childhood epilepsy （QOLCE）, and hospital anxiety and depression （HAD） of parents were used to collect demographic data of both children and their parents, as well as clinical manifestations of epilepsy and family status. Results Parental anxiety （of any severity） was observed in 191 subjects at interview, giving a prevalence rate of 56.2%. Of the 191 subjects, 18.5% reported mild anxiety, 24.4% moderate anxiety, and 13.2% severe anxiety. Factors associated with parental anxiety included frequency of seizure in children, average monthly income per person and parents＇ knowledge about epilepsy （P〈O.05）. Parental anxiety significantly （P--O.O00） correlated with quality of life of children with epilepsy. Conclusion Parents of children with epilepsy are at high risk of having anxiety. Factors associated with parental anxiety originate both from children and from parents. Parental anxiety is significantly related with children＇s QOL. It is important for experts concerned to recognize such a relationship to improve the QOL of children and their parents.

不同Child-Pugh分级肝硬化患者血清TSP-1、球蛋白/胆碱酯酶的表达水平差异及其疾病预后危险因素分析

目的分析不同Child-Pugh分级肝硬化患者血清凝血酶敏感蛋白-1(TSP-1)、球蛋白/胆碱酯酶的表达水平差异及其疾病预后危险因素。方法回顾性选取2020年2月至2023年2月新疆医科大学第一附属医院收治的70例肝硬化患者作为主要研究对象,根据Child-Pugh分级将其分为Child-Pugh A级组(n=20),Child-Pugh B级组(n=34),Child-Pugh C级组(n=16),另选取同期在本院进行体检的50名健康人群作为对照组。采用酶联免疫吸附试验法检测4组及肝硬化不同预后患者的血清TSP-1、球蛋白、胆碱酯酶、球蛋白/胆碱酯酶表达水平;采用双变量Spearman相关性检验血清TSP-1、球蛋白、胆碱酯酶、球蛋白/胆碱酯酶与肝硬化患者Child-Pugh分级和预后的相关性;建立多因素Logistic模型分析影响肝硬化患者预后的独立危险因素,并绘制受试者工作特征(ROC)曲线分析血清TSP-1、球蛋白/胆碱酯酶对肝硬化预后的预测价值。结果与对照组比较,Child-Pugh A级组、Child-Pugh B级组、Child-Pugh C级组患者的血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低;与Child-Pugh A级组患者比较,Child-Pugh B级组、Child-Pugh C级组患者的血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低;与Child-Pugh B级组比较,Child-Pugh C级组患者的血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低,差异均有统计学意义(P<0.05)。与预后良好组比较,预后不良组血清TSP-1、球蛋白、球蛋白/胆碱酯酶表达水平较高,血清胆碱酯酶表达水平较低,差异均有统计学意义(P<0.05)。肝硬化患者血清TSP-1、球蛋白/胆碱酯酶与Child-Pugh分级和预后均呈正相关(P<0.05)。多因素Logistic分析结果显示,Child-Pugh分级、TSP-1、球蛋白/胆碱酯酶均是影响肝硬化患者预后的独立危险因素(P<0.05)。血清TSP-1、球蛋白/胆碱酯酶与TSP-1+球蛋白/胆碱酯酶预测肝硬化患者预后的曲线下面积值分别为0.814、0.824、0.885。结论血清TSP-1、球蛋白/胆碱酯酶异常表达与肝硬化Child-Pugh分级及其预后均存在一定关联,可作为肝硬化患者的Child-Pugh分级及预后的辅助预测指标。

Associations between near work, outdoor activity, parental myopia and myopia among school children in Aba, Nigeria

●AIM:To assess the influence of near work,time outdoor and parental myopia on the prevalence of myopia in school children in Aba,Nigeria.●METHODS:Primary and secondary school children aged between 8 and 15 y were randomly recruited from 12 schools in Aba.Information on family history,near work and outdoor activity was obtained using myopia risk factor questionnaire.Cycloplegic refraction was performed using autorefraction technique.Myopia was defined as spherical equivalent refraction(SER)≤-0.50 D in the poorer eye.Data were analysed for 1197(male:538 and female:659)children with full relevant data.●RESULTS:Risk of developing myopia was positively associated with parental myopia[odds ratio(OR):6.80;95%CI,2.76-16.74;P<0.01)for one myopic parent and(OR:9.47;95%CI,3.88-23.13;P<0.01)for two myopic parents,longer daily reading hour(OR:1.21;95%CI,1.03-1.42;P=0.02)and less time outdoors(OR:0.8;95%CI,0.74-0.87;P<0.01).●CONCLUSION:Parental history of myopia is the most important risk factor associated with myopia.In addition,children with both parents being myopic has increased odds of developing myopia than those with one myopic parent.It is recommended therefore,that children spend more time outdoors as this could reduce the prevalence and progression of myopia.

Parental myopia, near work, hours of sleep and myopia in Chinese children

Background/Aims: Juvenile myopia is a serious problem in China, the prevalence of which stays at a high level and shows an upward trend. The target of this study was to explore the factors associated with myopia in Chinese children. Methods: A cross-sectional analysis in a random sample survey was conducted in Beijing in 2008. The data collected from 15,316 Chinese school students aged 6 to 18 years, randomly selected from 19 schools were evaluated, including noncycloplegic refraction and possible genetic, environmental and behavioral factors, to explore the key risk factors for myopia. Univariate and multiple logistic regression analyses were performed to compare the OR values, and receiver operator characteristic (ROC) curves were generated to compare the differences among the areas under the ROC curves using the method of multiple comparison with the best. Results: Myopia was associated with shorter sleep times versus longer sleep times (adjusted OR = 3.37;95%CI 3.07-3.70), and the multivariate OR for two compared with no parents with myopic was 2.83 (95%CI 2.47-3.24) and 1.95 (95%CI 1.69-2.24) for reading or writing distances less than33 cmcompared to distances greater than33 cm. Controlling for other factors, children that slept for shorter periods of time had significantly more myopic refractions (?1.69D vs ?1.29D for children with longer sleeping time per day). Analysis of the areas under the ROC curves showed five variables with predictable values better than chance: age, sleeping time, reading or writing distance, hours of studying, and parental myopia. Conclusion: It was not surprising, as proved by other studies, that parental myopia, reading or writing distances, time spent on studying or other activities by using eyes were dominant risk factors associated with juvenile myopia. Our findings indicated that hours of sleeping were also closely related to juvenile myopia, in which the underlying mechanism should be explored in the future study.

Associations between parental support for physical activity and moderate-to-vigorous physical activity among Chinese school children： A cross-sectional study

Purpose: The objective of this study was to examine the associations between parental support for physical activity(PA) and levels of moderate-to-vigorous physical activity(MVPA) among Chinese school children.Methods: Study participants were 81,857 school-aged children(aged 9–17 years; mean age = 13 years; 49.0% boys) and their parents or guardians who took part in the 2016 Physical Activity and Fitness in China—The Youth Study project. The independent variables included various forms of parental support for PA ascertained through a survey completed by parents or guardians. The dependent variable was the children's average MVPA in minutes per day by self-report. Structure equation modeling was used to examine the associations between parental support for PA and children's MVPA minutes.Results: The overall mean for MVPA participation time for the child participants was 48.82 ± 28.71 min/day. Significant associations between various forms of parental support and MVPA among children were found. Parental encouragement, accompanying, financial support, involvement,and role modeling for PA were positively associated with a high level of student MVPA participation. Parental PA knowledge-sharing was not associated with MVPA. The patterns of the associations were similar across sex, residence locale(i.e., urban and rural), and school grades(primary,junior middle, and junior high schools).Conclusion: Findings from this study suggest that, among Chinese school children, parental support for PA is important in promoting and facilitating children's participation in MVPA.

经动脉化疗栓塞联合免疫和靶向药治疗Child-Pugh B级肝细胞癌研究

目的 探讨经动脉化疗栓塞(TACE)联合免疫检查点抑制剂(ICI)和分子靶向治疗对Child-Pugh(CP)分级B级肝细胞癌(HCC)的疗效和安全性。方法 筛选2018年1月至2021年5月在东南大学附属中大医院等3中心接受TACE联合ICI和分子靶向治疗(联合治疗组)或TACE单独治疗(单独治疗组)的CP B级HCC患者。主要终点为总生存期(OS),次要结局包括无进展生存期(PFS)、客观缓解率(ORR)和安全性。结果 126例患者纳入研究,其中联合治疗组64例,单独治疗组62例。联合治疗组、单独治疗组中位OS比较差异无统计学意义[17.7个月(95%CI:11.9~29.9)比13.2个月(95%CI:7.8~19.9),P=0.160],联合治疗组中CP评分7分患者获得了明显更好的OS[19.0个月(95%CI:13.6~NR)比13.2个月(95%CI:8.0~NR),P=0.024]。两组中位PFS、ORR比较差异均无统计学意义(P=0.720、P=0.960)。联合治疗组、单独治疗组分别有9例(14.1%)、6例(9.7%)患者出现3级/4级不良事件。结论 TACE联合免疫和靶向治疗CP B级HCC患者并未显示出比TACE单独治疗更好的预后,而联合治疗组CP评分7分患者OS明显更好。