Relationship between parenting stress and behavioral and emotional problems in preschool children: A mediation effect analysis

BACKGROUND Emotional reactions,such as anxiety,irritability,and aggressive behavior,have attracted clinical attention as behavioral and emotional problems in preschool-age children.AIM To investigate the current status of family rearing,parental stress,and behavioral and emotional problems of preschool children and to analyze the mediating effect of the current status of family rearing on parental stress and behavioral/emo-tional problems.METHODS We use convenience sampling to select 258 preschool children in the physical examination center of our hospital from October 2021 to September 2023.The children and their parents were evaluated using a questionnaire survey.Pearson's correlation was used to analyze the correlation between child behavioral and emotional problems and parental stress and family rearing,and the structural equation model was constructed to test the mediating effect.RESULTS The score for behavioral/emotional problems of 258 preschool children was(27.54±3.63),the score for parental stress was(87.64±11.34),and the score for parental family rearing was(31.54±5.24).There was a positive correlation between the behavioral and emotional problems of the children and the“hostile/mandatory”parenting style;meanwhile,showed a negative correlation with the“support/participation”parenting style(all P<0.05).The intermediary effect value between the family upbringing of parents in parental stress and children's behavior problems was 29.89%.CONCLUSION Parental family upbringing has a mediating effect between parental stress and behavioral and emotional problems of children.Despite paying attention to the behavioral and emotional problems of preschool-age children,clinical medical staff should provide correct and reasonable parenting advice to their parents to promote the mental health of preschool-age children.

Family functioning mediation in tic severity and quality of life for children with Tourette syndrome

BACKGROUND Tourette syndrome(TS)is recognized as a neurodevelopmental disorder profoundly influenced by familial factors,particularly family functioning.However,the relationship among family functioning,tic severity,and quality of life in individuals with TS during childhood and adolescence remains unclear.We hypothesized that family functioning plays a role in the association between the severity of TS and quality of life in children.AIM To determine the role of family functioning in the relationship between TS severity and quality of life.METHODS This study enrolled 139 children(male/female=113/26)with TS.We assessed tic severity using the Yale Global Tic Severity Scale,quality of life via the Tourette Syndrome Quality of Life Scale,and family functioning through the Family Assessment Device.Our analysis focused on correlating these measures and exploring the mediating role of family functioning in the relationship between tic severity and quality of life.Additionally,we examined if this mediating effect varied by gender or the presence of comorbidity.RESULTS We found that family communication dysfunction had a significant mediating effect between tic severity and both psychological symptoms(indirect effect:Β=0.0038,95%confidence interval:0.0006-0.0082)as well as physical and activities of daily living impairment(indirect effect:Β=0.0029,95%confidence interval:0.0004-0.0065).For vocal tic severity,this mediation was found to be even more pronounced.Additionally,in male participants and those without attention deficit hyperactivity disorder,the mediating effect of family communication dysfunction was still evident.CONCLUSION Our study highlights the impact of family functioning on the tic severity and the quality of life in children.This relationship is influenced by gender and comorbid conditions like attention deficit hyperactivity disorder.

The Improving Effects of Diabetes Education on Diabetes Awareness and Management in Children and Adolescents with T1DM

Background: Diabetes education is crucial in empowering persons with Type 1 diabetes (T1DM) and their families to properly manage the condition by providing comprehensive knowledge, tools, and support. It boosts one’s belief in their ability to succeed, encourages following medical advice, and adds to the general enhancement of health. Objective: This study is to investigate the effectiveness of diabetes education in empowering individuals with Type 1 Diabetes Mellitus (T1DM) and their families to effectively manage the condition. Furthermore, it strives to improve nursing care for families whose children have been diagnosed with Type 1 Diabetes Mellitus (T1DM). Design: This research study investigates the efficacy of diabetes education in empowering individuals with Type 1 Diabetes Mellitus (T1DM) and their families to effectively handle the condition. Materials and Methods: A systematic search was conducted between the years 2000 and 2022, utilizing the Medline and Google Scholar databases. The purpose of the search was to uncover relevant papers pertaining to diabetes education, management of Type 1 Diabetes Mellitus (T1DM), nurse care, and empowerment. The search focused on peer-reviewed research, clinical trials, and scholarly articles that evaluated the efficacy of diabetes education in empowering individuals and families. Results: Diabetes education is crucial for understanding and controlling T1DM. It includes personalized sessions, webinars, group classes, and clinics that provide customized therapies. Comprehensive education enhances glycemic control and family dynamics. Nevertheless, the implementation of diabetes education for families requires specific standards, especially in the field of nursing. Conclusion: Diabetes education is essential for effectively managing Type 1 Diabetes Mellitus (T1DM), providing patients and families with crucial knowledge, resources, and confidence. It encourages independence in-home care and provides explicit guidelines for diabetic nurses to improve nursing care.

Empirical Study on the Empowerment of Families Raising Children with Severe Motor and Intellectual Disabilities in Japan: The Association with Positive Feelings towards Child Rearing

Background: “Children with severe motor and intellectual disabilities” refers to children with markedly limited activity due to severe overlapping of physical and intellectual disabilities. The physical and mental burden placed on families raising severely disabled children, particularly the primary caregivers, is great in home settings. For families to effectively utilize services and over-come child rearing problems, the families themselves need the “strength” to cooperate with others for the purpose of raising a severely disabled child. The ultimate goal of family support is to enable such families to achieve satisfaction and self-growth in child rearing. Methods: We used a questionnaire to survey 75 primary caregivers to empirically elucidate the empowerment and positive feelings towards child rearing of families raising children with severe motor and intellectual disabilities and the related factors. The t-test and Spearman’s rank correlation coefficient were used to examine the association with bivariates. A multiple regression analysis was conducted for empowerment and positive feelings. Results: Results revealed that life events, livelihood, awareness of social support and the child’s sleep problems were factors related to empowerment. Of these, awareness of social support from outside of the family was found to contribute the most to empowerment. Furthermore, improvement and maintenance of positive feelings towards child rearing reaffirmed the existence of empowerment in addition to reducing negative feelings towards child rearing and ensuring social support. Conclusions: Raising children with severe motor and intellectual disabilities requires specialist knowledge and skills. Support from professionals to empower the entire family is therefore important in order to strengthen positive feelings towards child rearing.

Outbreak Information Delivery to Families with (Pre)School Children and Its Contribution

Background: Infection transmission among them occurs easily and sometimes causes outbreaks at facilities where children live in groups. Early response is necessary for infection control measures to avoid larger clusters. In Japan, (Nursery) School Absenteeism Surveillance System ((N)SASSy), which is a kind of school absenteeism surveillance, has activated since 2007 and covers about 60% of all schools and 40% of all nursery schools in 2017. Objective: The objective of the present paper is investigation and demonstration of how caregivers receive information related to infectious diseases in Japan and how (N)SASSy contributes health of children. Method: We randomly selected subjects with children by pre-fecture in October, 2017. The survey questionnaire asked background information and information about infectious diseases to maintain health in children. We regressed health concern variables on background information and information provision situation about community outbreaks using weighted logistic regression. Results: We received responses from 1172 people. Estimation results showed higher concern about a facility providing information about community outbreak. Caregivers whose children attend facilities provided about community outbreak or covered (N)SASSy significantly higher opportunity to arrange a schedule when a child has a high fever. Discussion: The obtained results demonstrated that activation in (N)SASSy affects the possibility of arranging a schedule when a child has a high fever. This capability might improve community health.

Human genes influence the interaction between Streptococcus mutans and host caries susceptibility: a genome-wide association study in children with primary dentition

Streptococcus mutans is a well-known cause of dental caries,due to its acidogenicity,aciduricity,and ability to synthesize exopolysaccharides in dental plaques.Intriguingly,not all children who carry S.mutans manifest caries,even with similar characteristics in oral hygiene,diet,and other environmental factors.This phenomenon suggests that host susceptibility potentially plays a role in the development of dental caries;however,the association between host genetics,S.mutans,and dental caries remains unclear.Therefore,this study examined the influence of host gene-by-S.mutans interaction on dental caries.Genome-wide association analyses were conducted in 709 US children (<13 years old),using the dbGap database acquired from the center for oral health research in appalachia (COHRA) and the Iowa Head Start programmes (GEIRS).A generalized estimating equation was used to examine the gene-by-S.mutans interaction effects on the outcomes (decayed and missing/filled primary teeth due to caries).Sequentially,the COHRA and GEIRS data were used to identify potential interactions and replicate the findings.Three loci at the genes interleukin 32 (IL32),galactokinase 2 (GALK2),and CUGBP,Elav-like family member 4 (CELF4) were linked to S.mutans carriage,and there was a severity of caries at a suggestive significance level among COHRA children (P < 9×10?5),and at a nominal significance level among GEIRS children (P = 0.047–0.001).The genetic risk score that combined the three loci also significantly interacted with S.mutans (P < 0.000 1).Functional analyses indicated that the identified genes are involved in the host immune response,galactose carbohydrate metabolism,and food-rewarding system,which could potentially be used to identify children at high risk for caries and to develop personalized caries prevention strategies.

Relationship between Family Characteristics and Aggressive Behaviors of Children and Adolescents

In order to identify family factors obviously relevant to aggression, and offer a theoretical foundation for the prevention of aggression, 4010 students from primary and secondary schools in 5 different areas in Hubei province were surveyed. The Child Behavior Checklist ＂ parents＂ form＂ （Chinese version） and the four scales of Family Environment Scale were used. A multiple logistic regression was used to identify risk factors of children＇s and adolescents＂ aggressive behavior. The results showed that maternal education, paternal occupation, family type, parental child-rearing attitude and patterns, students＂ interpersonal relationship were significantly associated with the childreffs and adolescents＂ aggression. The risk factors of aggression were parental child-rearing patterns, peer relationship, teacher-student relationship, and family conflicts.

Assessment of Quality of Life, Family Function and Family Empowerment for Families Who Provide Home Care for a Child with Severe Motor and Intellectual Disabilities in Japan

Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these children. A top priority is to understand quality of life (QoL), family function, and family empowerment to effectively support these families. We aimed to assess current living situations of families with a SMID child, and to reveal the relationships between QoL, family function, and family empowerment. Methods: Sixty-five family members from 34 families with a SMID child participated in this study. We assessed 5 parameters using the Japanese versions of the following instruments: World Health Organization Quality of Life 26 (WHOQOL26), Kinder Lebensqualitats Fragebogen (KINDL), Family Assessment Device (FAD), Family Adaptability and Cohesion Evaluation Scale KG-4 (FACESKG-4), and Family Empowerment Scale (FES). Correlation and multiple regression analyses were conducted;QoL score was the objective variable. Results: Participants included 54 parents (34 mothers, 20 fathers) and 11 siblings. The mean age of SMID children was 10.4 ± 5.03 years. Twenty-two children needed multiple types of medical care. The mean age of parents and siblings was 41.5 ± 6.16 years and 15.5 ± 2.35 years, respectively. The mean QoL score (3.28 ± 0.5) was similar to the Japanese average. The mean KINDL score (77.2 ± 12.1) was higher than those of previous studies. The mean FAD score was 1.97 ± 0.32. For FACEKG-4, the score of adaptability was correlated with WHOQOL score (r = 0.459, p < 0.05). The mean score of FES was 113.6 ± 14. As the result of multiple regression analysis, lower family FAD scores ([sb] = ?0.61, p < 0.01) indicated higher family function and greater age of participants (sb = 0.495, p < 0.01) was correlated with higher WHOQOL scores (F = 15.208, p < 0.01). Conclusions: Our results indicated that the individual QoL depended on the age of participants (equals the years of experience caring for a SMID child) and the recognition of family function as a whole. Thus, to improve family members’ QoL, we should focus on individuals and also approach the family as a whole.

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.

Practical Experience of Establishing German Standard Level 1 Perinatal Center in Chongqing Health Care for Women and Children

Germany,as a western developed country,has an advanced medical level,especially in the health care of very immature premature infants.We trace the medical history of perinatology to understand the development of perinatal centers in Germany.After analyzing the classification and function,hierarchical management and quality control systems of German perinatal centers,we established a German standard level 1 perinatal center in the Chongqing Health Center for Women and Children(CHCWC).During more than two years of practice,we changed concepts,continuously updated clinical knowledge and skills,developed a series o f high-quality work processes and supervision systems and introduced advanced medical equipment.We believe that the experience of establishing a German standard level 1 perinatal center and perinatal center network in Chongqing is worthy of being promoted to the Chinese maternal and child health care system.

Research on the Influence of Family Education on Children’s Behavioral Habits

Under the background of the all-round deepening of quality education,the cultivation of comprehensive quality has become the main theme of contemporary education reform.Good behavior and habits are of great significance to children’s future learning,growth,and development.Through literature review and other methods,this paper analyzes the current situation of children’s family education and the influence of family education on the cultivation of children’s behavioral habits and provides some strategies for cultivating children’s good behavioral habits in family education.

Cross-sectional population based study examining the impact of children with asthma on US rural families

Introduction: Approximately 7.1 million US children have asthma. The burden of asthma is disproportionate with ruralUSpopulations experiencing a higher prevalence of the disease. Rural populations experience additional disparities regarding health care access, job availability, and daily living resources. Hence, the family impact of having a child with asthma may be influenced by geographic locale. This impact could be a result of health insurance tied to employment, out of pocket costs, and health care provider availability. Few studies have assessed the impact a child’s asthma has on a family. This study sought to answer the question: What is the impact of children with asthma on US rural families? Methods: Multivariate techniques were performed to examine a single year of data from two connected population-based datasets, the 2007-2008 National Survey of Children’s Health and the 2009-2010 Children with Special Health Care Needs Survey. Children with current asthma defined the study population for both datasets. A logistic regression model was performed for each database. The dependent variable for the first model was child in family currently has asthma, for the second it was rural children with current asthma. Results: The first logistic regression model confirmed that rural children were more likely to have asthma than non-rural children. The second logistic regression model yielded that rural families with a child diagnosed with asthma had greater odds of: not having health insurance, having a parent who stopped working, avoided a job change, or experienced financial problems because of the child’s health. Conclusions: This study demonstrated that rural families experience a disproportionate financial hardship as a result of their child’s asthma. Pharmacist intervention in asthma care in rural areas has the potential to decrease the financial burden for a family while also improving a child’s health.

Mutual Experiences of Japanese Parents and Their Children When Late School-Age Children Engage in Meal-Related Family Routines: A Qualitative Analysis of Parent and Child Dyads

Purpose: The objective of the present study was to identify the type of experiences that parents and their children have with each other when late-school age children take on roles in family routines related to daily meals. Methods: A grounded theory approach was used. The participants were children in the 4th, 5th, and 6th grades of elementary school and their main caregivers. First, 10 parent and child dyads were interviewed using a semi-structured schedule. Next, online group interviews were conducted for 17 parent and child dyads to deductively confirm the categories. Results: The average age of the subjects was 41.9 years for parents and 10.4 years for children in parent-child interviews, and 41.1 years for parents and 9.6 years for children in group interviews. Six categories emerged with nineteen subcategories. Conclusions: Experiences mutually nurtured by parents and their children included experiences in which children used negotiation and conversation skills to consensually engage in family routines related to meals. It also included experiences that socialized the children in family life and fostered good communication. The six categories will be useful for healthcare professionals and school authorities in providing health guidance that addresses health functions of late school-age children and their families.

Nutrition and Healthcare for Children from Rural Tibetan Households

Three major programs have been implemented in rural Tibetan areas in order to improve children's nutrition and healthcare,namely antenatal care,infant and young child feeding,as well as school feeding.In terms of effectiveness of service provision,the school feeding program has been put into practice more effectively than the other two for two reasons.First,rural Tibetan families are accustomed to traditional infant and young child feeding practices.Secondly,the lack of incentives for healthcare workers and the shortage of funding have hindered the provision of healthcare to rural families.Therefore,this paper proposes an adjustment of the incentive structure for healthcare providers,a fortification of the village level network of healthcare services,an improvement in the approach to healthcare education for farmers and herders,and the coordination of training courses targeted at the officials and service teams of the healthcare system.

A Study of the Effects of Family Precepts,Rules and Ethics on Children’s Education During the Tang Dynasty

From the perspectives of the prosperity of the Sui and Tang dynasties,the rise and fall of the aristocrats and the prevalence of the imperial examination,this paper studies the impact of family precepts,rules,and ethics on children’s education.I believe that an important feature of family precepts in the Tang Dynasty was the development of the cultural tradition of poetry and literature study within the family,which promoted virtues like loyalty,filial piety,diligence,frugality and modesty and had a profound influence on future generations.The rise and fall of Tang Dynasty families was closely related to family precepts,rules,ethics,and learning.Famous and respectable families often regarded these traits as important means to maintain the family’s status,which objectively promoted the development of family scholarship and the importance of children’s education in the Tang Dynasty.The concept of learning as a“carry-on treasure”has become a common belief among scholars and has played a positive role in educating Chinese society,enriching our culture,and keeping society in order.

How Do Family Structure and Family Process Matter?A Comparative Study on the Impacts of Military Deployment and Single Parenthood on Children’s Psychological Well-Being

Children from two-parent families have better outcomes,on average,than children from single-parent families.Yet the mechanisms associated with family structure and family process that produce divergent outcomes are less well understood.Based on data from the 2011-2015 National Health Interview Survey(N=26,783),I leverage the case of military families with deployment and examine the impacts of parenting quality,economic capital,and social capital on children’s psychological well-being.The regression results show that single parenthood produced by divorce,separation,and birth out of wedlock leads to worse child outcomes than single parenthood produced by military deployment,and family process partially explains the variation in children’s well-being beyond family structure.Married families,military or civilian,deployed or not,enjoy advantages that translate into positive child outcomes.Marriage,therefore,emerges as the primary axis of inequality,and maintaining a healthy marriage better promotes children’s well-being.

Nonalcoholic steatohepatitis and insulin resistance in children

Various pathological conditions can cause fatty liver in children. Nonalcoholic steatohepatitis(NASH) in children has been known since 1983. However, NASH diagnosed in childhood does not have a favorable outcome.The pathological characteristics of NASH are significantly different between children and adults. Nonalcoholic fatty liver disease(NAFLD)/NASH is accompanied by insulin resistance, which plays a pivotal role in its pathophysiology in both children and adults. In NASH,a "two-hit" model involving triglyceride accumulation(first hit) and liver damage(second hit) has been accepted. Insulin resistance was found to correlate with changes in fat levels; however, it did not correlate with fibrosis or NAFLD activity score in children. Therefore,insulin resistance may be important in the first hit.Because there is obvious familial clustering in NASH,genetic predisposition as well as environmental factors including diet might be the second hit of NAFLD/NASH.

The relationship of family separation and nutrition status among under-five children: a cross-sectional study in Panti Public Health Center, Jember Regency of East Java, Indonesia

Background:Nowdays,both of parents are working to fulfill their family needs and family financial.However,this condition effected separation of family that have a negative impact for children.Children can lose of a primary caregiver who can endanger the welfare of children.Purpose:To analyzed the relationship between family separation and nutritional status of under-five children aged in Panti District of Jember Regency.Methods:A cross-sectional design was conducted among 53 families using total sampling.A family background questionnaire was used to measure sociodemographics and separation of family.Among 53 families were 78.2%of separation with father,while 38.6%of children with a good nutrition status.Kruskal Wallis and One-Way Anova was performed to answer the objective of this study.Results:The result showed that,there were no correlation between length of separation with nutritional status(F=0.377;P-value=0,688).Meanwhile,distance of separation wascorrelated with nutritional status(c2=8.310;P-value=0,016).Conclusion:Parents need to improve relationships,communication and the distribution of proper autonomy in family.It can make the nutritional status and health level of the child becomes better.

Family Support Situation and Educational Strategies for Primary School Children with Intellectual Disabilities Learning in Regular Class

This paper aims to verify the family support situation for primary school children with intellectual disabilities learning in regular class and to explore various educational strategies to promote their development.A self-made questionnaire was used in this survey,and the parents of 380 intellectual disabled students were the subjects of this survey.It turns out that the overall family support for intellectual disabled children learning in regular class in China is good,but it is affected by the degree of obstacles.Factors such as grade,gender,and parental education had no significant effect on family support.It is the shared responsibility of the government,schools,and parents to promote the level of family support.Governments at all levels must implement family support projects,schools must carry out family education guidance to impart scientific parenting knowledge,and parents must take note of their own responsibilities,so as to promote the physical and mental development of children with intellectual disabilities.

On the Lawful Rights and Interests of Mentally Retarded Children——A case study of a rehabilitation center in Liaoning Province

Mentally retarded children are the most disadvan- taged among disabled children. Since the reform and opening up, with sup- port from the Communist Party of China, the government and the public, the legitimate rights and interests of mentally retarded children have greatly improved. But problems in this respect remain serious, and vari- ous levels of government, relevant departments and the public should attach much importance to these problems. This paper, taking a reha- bilitation center in Liaoning Province for mentally retarded children as a single case, studies the protection of these children＇s lawful rights and in- terests in a systematic manner.