Parental Educational Expectations,Academic Pressure,and Adolescent Mental Health:An Empirical Study Based on CEPS Survey Data

Background:This study aimed to investigate the relationship between parental educational expectations and adolescent mental health problems,with academic pressure as a moderating variable.Methods:This study was based on the baseline data of the China Education Panel Survey,which was collected within one school year during 2013–2014.It included 19,958 samples from seventh and ninth graders,who ranged from 11 to 18 years old.After removing missing values and conducting relevant data processing,the effective sample size for analysis was 16344.The OLS(Ordinary Least Squares)multiple linear regression analysis was used to examine the relationship between parental educational expectations,academic pressure,and adolescents’mental health problems.In addition,we established an interaction term between parents’educational expectations and academic pressure to investigate the moderating effect of academic stress.Results:The study found that adolescents whose parents had high educational expectations reported less mental health problems.(β=−0.195;p<0.001).Additionally,adolescents who had high academic pressure reported more mental health problems.(β=0.649;p<0.001).Furthermore,the study found that academic pressure had a significant moderating effect on the relationship between parental educational expectations and adolescents’mental health problems(β=0.082;p<0.001).Conclusion:Parental educational expectations had a close relationship with adolescents’mental health problems,and academic pressure moderated this relationship.For those adolescents with high levels of academic pressure,the association between high parental educational expectations and mental health problems became stronger.On the contrary,for those adolescents with low levels of academic pressure,the association between high parental educational expectations and mental health problems became weaker.These findings shed new light on how parental educational expectations affected adolescent mental health problems and had significant implications for their healthy development.

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.

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. .

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.

Association between glucose levels of children with type 1 diabetes and parental economic status in mobile health application

BACKGROUND The glycemic control of children with type 1 diabetes(T1D)may be influenced by the economic status of their parents.AIM To investigate the association between parental economic status and blood glucose levels of children with T1D using a mobile health application.METHODS Data from children with T1D in China's largest T1D online community,Tang-TangQuan■.Blood glucose levels were uploaded every three months and parental economic status was evaluated based on annual household income.Children were divided into three groups:Low-income(<30000 Yuan),middle-income(30000-100000 Yuan),and high-income(>100000 yuan)(1 Yuan=0.145 United States Dollar approximately).Blood glucose levels were compared among the groups and associations were explored using Spearman’s correlation analysis and multivariable logistic regression.RESULTS From September 2015 to August 2022,1406 eligible children with T1D were included(779 female,55.4%).Median age was 8.1 years(Q1-Q3:4.6-11.6)and duration of T1D was 0.06 years(0.02-0.44).Participants were divided into three groups:Low-income(n=320),middle-income(n=724),and high-income(n=362).Baseline hemoglobin A1c(HbA1c)levels were comparable among the three groups(P=0.072).However,at month 36,the low-income group had the highest HbA1c levels(P=0.036).Within three years after registration,glucose levels increased significantly in the low-income group but not in the middle-income and high-income groups.Parental economic status was negatively correlated with pre-dinner glucose(r=-0.272,P=0.012).After adjustment for confounders,parental economic status remained a significant factor related to pre-dinner glucose levels(odds ratio=13.02,95%CI:1.99 to 126.05,P=0.002).CONCLUSION The blood glucose levels of children with T1D were negatively associated with parental economic status.It is suggested that parental economic status should be taken into consideration in the management of T1D for children.

Entangled relationship:Chinese parents’involvement in young learners’English tests

Young learners’English(YLE)tests have become increasingly prevalent among and important to Chinese English learners and their parents.In China,parents are actively involved in their children’s education and test-taking decisions,and their participation has given rise to a series of social impacts.Although parent involvement has received increasing public and academic attention in newspaper and scholarly articles,there exists no thorough analysis of current research on parents’roles in young learners’test-taking.To address this gap,we systemically analyzed Chinese newspaper articles and academic articles between 2011 and 2021 to elicit Chinese parents’roles in YLE test-taking.Our thematic analysis of the literature identifies the ways in which parents influence their children’s test-taking experiences,and how the tests affect this influence.Specifically,our results elicit 1)parents’engagement in YLE testing;2)parents’understanding of the intended uses of YLE tests;3)parents’perception and consequences of their involvement in YLE testing;and 4)parents’backgrounds.This analysis reveals the popularity of YLE tests among young learners and their parents in China and public concern over test-related issues.It also broadens our understanding of YLE testing impact and suggests future potential research directions.

Evaluation of the Application Effect of Enteral and Parenteral Nutrition Therapy Combined with a Health Belief Education Model in Patients with Inflammatory Bowel Disease

Objective:To evaluate the application effect of enteral and parenteral nutrition therapy combined with a health belief education model in patients with inflammatory bowel disease.Methods:80 patients with inflammatory bowel disease admitted to the Shanghai Zhangjiang Institute of Medical Innovation were chosen.This study was carried out from August 2022 to October 2023.The patients were randomly divided into a study group(40 cases)and a control group(40 cases).The treatment plan for the control group was the conventional treatment model,while the treatment plan for the study group was to provide enteral and parenteral nutrition therapy combined with a health belief education model based on the control group.The efficacy of both groups was compared.Results:In the study group,the therapeutic effect for 31 patients(77.50%)was markedly effective and 7 was effective(17.50%),accounting for 95.0%of the total,which was higher than the control group at 80.0%(P<0.05).The relief time of relevant symptoms in the study group was shorter than that of the control group(P<0.05).Before treatment,there were no differences in the high-sensitivity C-reactive protein(hs-CRP),interleukin 10(IL-10),and tumor necrosis factor-α(TNF-α)between both groups(P>0.05).After treatment,the levels of inflammatory factors in the study group(hs-CRP(8.02±1.13)mg/L,IL-10(9.24±1.25)pg/mL,and TNF-α(7.19±1.04)ng/L)were lower than those in the control group(P<0.05).Conclusion:Enteral and parenteral nutritional therapy combined with a health belief education model showed significant efficacy in inflammatory bowel disease patients.Patient symptoms were relieved and inflammatory reactions were reduced.This method is worthy of popularization.

Socio-Cultural Representations and Therapeutic Itineraries of Parents of Autistic Children Followed in the INSP’s Children’s Mental Health Services

Pervasive developmental disorders (PDD) remain little known to populations in developing countries. In black Africa their social representations remain strongly influenced by local belief systems. The general objective of this study was to understand the perceptions and representations of Ivorian parents vis-à-vis PDD. This was a mixed (qualitative and quantitative) prospective cross-sectional study with a descriptive aim that involved a sample of 49 parents. The sampling was of the qualitative type by multiple cases with reasoned choice by saturation. Our results showed that male parents were mostly aged between 40 - 49 years (48.98%) with a higher level of education (67.34%) while mothers were mostly aged between 30 - 39 (61.22%) and a higher level (30.61%). Autistic children were negatively perceived by their parents: either as a source of psychological suffering (82.85%), or as mysterious children who sacrificed their parents (44.66%), or as “bobo” children (mute children in common Ivorian language) (16.66%) or like rude children (13.34%). The supposed origin of the disorder according to the parents was mystical-religious (60.94%);natural (25%);hereditary (6.25%). In 6.25% of cases, PDD were assumed to be of unknown or iatrogenic origin attributable to vaccination (1.56%). 75.51% of parents said that in addition to conventional medical therapies, they also used traditional therapies. The use of this therapeutic alternative would be linked to the perceptions and beliefs that feed the socio-cultural representations of our respondents.

全健康(One Health)视角下绿色健康社区景观设计体系构建

以全健康(OneHealth)视角为出发点,保障人、环境和动物的健康对于社区健康环境规划与设计具有重要意义。在现有健康社区景观设计体系中,人、环境、物种三者关系虽被提及,但未被系统探究,健康社区建设实践也需要系统性的景观设计体系支持。基于全健康理念中人、环境和物种的相互关系,结合生态系统服务功能、康复景观理论和园艺疗法,进一步探讨人、环境、物种健康之间的关联途径。通过对全健康理念视角下的3个层次进行演绎发展,归纳总结了人的健康、环境健康和物种健康的组成要素及内容,构建了以人的健康需求为导向的社区健康设计框架,提出了以人与人际、人与环境和人与物种为三大圈层的健康社区景观设计体系。全健康视角为社区健康环境设计提供了一个系统性、整合性且具有操作性的框架,未来应重视健康社区体系中各类疗愈空间的设计与使用,以增进社区居民共享的健康福祉。

Challenges in Work-Family Balance and Support Needs of Japanese Parents with Nursery School-Aged Children

We aimed to identify the challenges parents face raising preschool-aged children when trying to maintain a good work-family balance. We also highlight how public health nurses can support the community in this regard. Seven Japanese parents volunteered to participate, and individual in-depth interviews were conducted from May to October 2021. We analyzed the recorded interview data using qualitative descriptive methods. Three main themes concerning work-family balance challenges were extracted: 1) conflicts between parents’ childcare and work roles, 2) issues related to institutions and social systems, and 3) a lack of informal support. Factors contributing to the difficulties were a lack of time to spend with their children;an imbalance in the division of housework and childcare roles between married couples;the employment environment in Japan that makes it difficult to pursue a career while raising children;a lack of childcare services, including childcare for sick children;inadequate consultation systems;and an aging grandparents’ generation owing to late marriages. To solve this problem, we suggest that in addition to establishing a reliable system for providing childcare, local public health nurses should work with childcare workers to create an environment in which parents feel comfortable discussing work-family balance, considering the time constraints of parents during the childrearing period, and use nursery schools as a place for parent-child support.

Mental health of parents of children with autism spectrum disorder during COVID-19 pandemic: A systematic review

BACKGROUND Children diagnosed with autism spectrum disorder(ASD)may have great difficulties when their routines change,and this may affect the psychological wellbeing of their parents.For this reason,it is important to examine studies that address the mental health of parents in order to adapt to the coronavirus disease 2019(COVID-19)pandemic.AIM To determine the mental health status of parents with children diagnosed with ASD in the COVID-19 pandemic.METHODS The study,which is a systematic review,was conducted between December 15,2020 and December 30,2020 by scanning articles in English.The Scopus,Science Direct,PubMed,Cochrane,Web of Science,and Google Scholar databases were used for scanning.The keywords COVID-19 AND(“autism”OR“autistic”OR“autism spectrum disorder”)AND parent AND(“mental health”OR“anxiety”OR“stress”)were used in the search process.The inclusion criteria in the study were findings regarding the mental health of parents with children diagnosed with ASD in the COVID-19 pandemic,addressing their anxiety and stress situations,being a research article,and accessing the full text of the article.RESULTS In the study,a total of 6389 articles were reached,and the full texts of 173 articles were evaluated for eligibility.After the articles excluded by the full-text search were eliminated,12 studies involving 7105 parents were included in the analysis.The findings obtained from the articles containing data on mental health in the COVID-19 pandemic of parents with children with autism spectrum disorder were discussed in three groups.These were findings on the experiences of parents with children with ASD in the COVID-19 pandemic regarding the areas where parents with children with ASD need support in the COVID-19 pandemic and methods of coping with the COVID-19 pandemic for parents with children with ASD.In the systematic review,it was determined that the anxiety and stress of the parents increased,they needed more support compared to the pre-pandemic period,and they had difficulty coping.CONCLUSION In this systematic review,it was concluded that the COVID-19 pandemic negatively affected the mental health of the parents of children with ASD.

The Evidenced Effects of Early Childhood Interventions to Promote Mental Health and Parenting in the Nordic Countries: A Systematic Review

Thefirst years of life and the family context are key to the promotion and protection of children’s health and well-being,emphasizing the need for interventions aimed to support families with young children.This review aimed to explore the effectiveness of early childhood interventions developed for promoting mental health and parenting among families with young children in the Nordic countries.Six electronic databases were systematically searched,and 20 articles covering 16 studies applying various quantitative and qualitative methods met the study inclusion criteria.The studied interventions were assessed as universal health-promoting interventions and health-promoting interventions with elements of prevention.Outcomes of interest encompassed mental health,related risk and protective factors among the parents and/or the children,or child-parent interaction.The results from studies applying statistical methods show significant improvements in parents’self-efficacy,self-esteem,and parental satisfaction,while few improvements in parents’social support or parental relationship were identified.Improvements in social support and parental relationships were however reported in qualitative studies.Most quantitative studies reporting on parents’mental health problems and stress found a significant decrease,and qualitative studies highlighted experienced positive effects on mental health and well-being.The majority of stu-dies reporting on children’s mental health and/or development as well as strengths and difficulties indicated a statistically significant positive development.No significant changes were however found for existing behavioral problems.The majority of studies examining parenting strategies and/or parent-child interaction found signifi-cant positive changes after the interventions.In sum,althoughfindings are heterogeneous,early childhood inter-ventions show various positive effects on the parenting and mental health of both children and their parents.The fact that different types of initiatives have been developed and implemented can be seen as an advantage,con-sidering the varying needs and expectations of different families.

Children’s Health, Parent-Child Activities, Using Digital Devices, and Social Competence: Serial Mediation

Background: Studies have pointed out the influence of different children’s activities and prolonged use of digital products on their social development. However, whether the parent-child activities and using digital devices were serial mediators of the relationship between children’s health and social development needs further verification. Purpose: This study explored how parent-child activities and children’s use of digital devices influence the relationship between children’s health and their social competence. Method: This study used data from Kids in Taiwan: National Longitudinal Study of Child Development and Care. A total sample of 2164 participants was used in this study. Serial mediation analyses were performed using model six of Hayes’ PROCESS (2012). Results: This study found that parent-child activities and the use of digital devices can serially mediate the relationship between children’s health and social competence. Children’s health could directly improve their social competence, but it could also serially mediate social competence by increasing parent-child activities and reducing the use of digital devices. Conclusion: Childcare policy planners and parenting educators should not only call on parents to reduce the use of electronic products for their children, but also encourage parents to spend more time interacting with their children, so that children can learn social skills by interacting with others in their daily lives.

Education of Parents When a Child Born with an Imperforate Anus;Does It Improve the Health of the Child?

Objectives: To describe and investigate the value of an education program for parents of children born with an imperforate anus in order to help them cope with the new situation of having a stoma. A comparison is made with a group of parents following routine hospital. A secondary aim was to illuminate the parents’ feelings and concerns in the first month after the birth of the child. Subjects and methods: The program was tested in 20 Vietnamese mothers of babies born with an imperforate anus;10 followed an intervention comprising an education program and 10 the ordinary routine hospital. The study design is both qualitative and quantitative. The mothers were interviewed, using open-ended questions, within a week of their child’s birth and then repeatedly for up to one month. Finally, the conditions of children were accessed on their return to the hospital for the second operation after one month of care at home. The qualitative data were subjected to content analysis. Results: All mothers felt sad and worried in the beginning, but this quickly changed to confidence, particularly among mothers in the intervention group who received education. While at home, mothers in both groups had financial concerns, as they were unable to work as much as expected and also had to buy equipment for colostomy care. The mothers in the control group complained about a lack of knowledge and how it affected the care of their child. The mothers in the intervention group, however, felt confident in their caring even at home. When the families returned for the second operation, the children in the intervention group were significantly healthier, had increased more in weight, and had fewer complications and emergency return visits to hospital compared to the control group. In the control group skin problems around the stoma, diarrhea, bleeding or constipation while at home were reported (p < 0.01). Conclusion: The education improved the care at home resulting in healthier children and more confident parents.

Mental health status of students’parents during COVID-19 pandemic and its influence factors

Background During the outbreak of COVID-19,the national policy of home quarantine may affect the mental health of parents.However,few studies have investigated the mental health of parents during the COVID-19 pandemic.Aims To investigate the depression,anxiety and stress of the students'parents during the COVID-19 pandemic,and to explore the influence factors,especially the influence of social support and family-related factors.Methods The Generalised Anxiety Disorder-7,Patient Health Questionnaire-9,Perceived Stress Scale-10 and Social Support Rating Scale were applied to 1163 parents to measure the parents'depression,anxiety,stress and social support.Results(1)The detection rates of depression and anxiety in parents were 6.1%and 4.0%.The depression,anxiety and perceived stress of parents in central China were significantly higher than those in non-central China.The anxiety of college students'parents was lower than that of parents of the primary,middle and high school students.The depression,anxiety and perceived stress of parents with conflicts in the family were significantly higher than those with a harmonious family.Other factors that influence parents’depression,anxiety and perceived stress include marital satisfaction,social support,parents*history of mental illness and parenting style,etc.(2)The regression analysis results showed that perceived stress,social support,marital satisfaction,family conflicts,child's learning stage as well as parents'history of mental illness had significant effects on parents'anxiety and depression.Conclusion During the COVID-19 pandemic,the mental health of parents was affected by a variety of factors.Good marital relationships,good social support,family harmony and parents without a history of mental illness may be protective factors for parents*mental health,while perceived stress and child in middle or high school are risk factors for parents’mental health.

Impact of parenting styles on preschoolers’behaviors

In this editorial,I comment on the article“Association of preschool children behavior and emotional problems with the parenting behavior of both parents”which was published in the latest issue of“World Journal of Clinical Cases”that demonstrates the prevalence of behavioral disorders in preschool children.Therefore I am focused on parenting which is the most effective factor shown to affect the development and continuity of these behaviors.The management of child behavior problems is crucial.Children in early ages,especially preschoolers who are in the first 5 years of life,are influenced by dramatic changes in various aspects of development,such as social,emotional,and physical.Also,children experience many changes linked to different developmental tasks,such as discovering themselves,getting new friendships,and adapting to a new environment.In this period,parents have a critical role in supporting child development.If parents do not manage and overcome their child’s misbehavior,it could be transformed into psychosocial problems in adulthood.Parenting is the most powerful predictor in the social development of preschool children.Several studies have shown that to reduce the child’s emotional and behavioral problems,a warm relationship between parents and children is needed.In addition,recent studies have demonstrated significant relationships between family regulation factors and parenting,as well as with child behaviors.

A Blockchain and CP-ABE Based Access Control Scheme with Fine-Grained Revocation of Attributes in Cloud Health

The Access control scheme is an effective method to protect user data privacy.The access control scheme based on blockchain and ciphertext policy attribute encryption(CP–ABE)can solve the problems of single—point of failure and lack of trust in the centralized system.However,it also brings new problems to the health information in the cloud storage environment,such as attribute leakage,low consensus efficiency,complex permission updates,and so on.This paper proposes an access control scheme with fine-grained attribute revocation,keyword search,and traceability of the attribute private key distribution process.Blockchain technology tracks the authorization of attribute private keys.The credit scoring method improves the Raft protocol in consensus efficiency.Besides,the interplanetary file system(IPFS)addresses the capacity deficit of blockchain.Under the premise of hiding policy,the research proposes a fine-grained access control method based on users,user attributes,and file structure.It optimizes the data-sharing mode.At the same time,Proxy Re-Encryption(PRE)technology is used to update the access rights.The proposed scheme proved to be secure.Comparative analysis and experimental results show that the proposed scheme has higher efficiency and more functions.It can meet the needs of medical institutions.

Alexa,let's train now!——A systematic review and classification approach to digital and home-based physical training interventions aiming to support healthy cognitive aging

Background:There is mounting evidence that regular physical activity is an important prerequisite for healthy cognitive aging.Consequently,the finding that almost one-third of the adult population does not reach the recommended level of regular physical activity calls for further public health actions.In this context,digital and home-based physical training interventions might be a promising alternative to center-based intervention programs.Thus,this systematic review aimed to summarize the current state of the literature on the effects of digital and home-based physical training interventions on adult cognitive performance.Methods:In this pre-registered systematic review(PROSPERO;ID:CRD42022320031),5 electronic databases(PubMed,Web of Science,Psyclnfo,SPORTDiscus,and Cochrane Library)were searched by 2 independent researchers(FH and PT)to identify eligible studies investigating the effects of digital and home-based physical training interventions on cognitive performance in adults.The systematic literature search yielded 8258 records(extra17 records from other sources),of which 27 controlled trials were considered relevant.Two reviewers(FH and PT)independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise(TESTEX scale).Results:Of the 27 reviewed studies,15 reported positive effects on cognitive and motor-cognitive outcomes(i.e.,performance improvements in measures of executive functions,working memory,and choice stepping reaction test),and a considerable heterogeneity concerning study-related,population-related,and intervention-related characteristics was noticed.A more detailed analysis suggests that,in particular,interventions using online classes and technology-based exercise devices(i.e.,step-based exergames)can improve cognitive performance in healthy older adults.Approximately one-half of the reviewed studies were rated as having a high risk of bias with respect to completion adherence(≤85%)and monitoring of the level of regular physical activity in the control group.Conclusion:The current state of evidence concerning the effectiveness of digital and home-based physical training interventions is mixed overall,though there is limited evidence that specific types of digital and home-based physical training interventions(e.g.,online classes and step-based exergames)can be an effective strategy for improving cognitive performance in older adults.However,due to the limited number of available studies,future high-quality studies are needed to buttress this assumption empirically and to allow for more solid and nuanced conclusions.

COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China: An online cross-sectional study

Objective:To examine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang,China.Methods:An online cross-sectional study was conducted among parents of teenagers in Zhejiang,China from May 1 to 31,2022.Data were interpreted via univariate and multivariate analyses using the statistical package for the social sciences(SPSS)program.Results:A total of 11115(96.11%)participants and 11449(99.00%)of their children in Zhejiang,China had been vaccinated against COVID-19.Children whose parents did not receive COVID-19 vaccination were 19 times(aOR 18.96,95%CI 12.36-29.08)more likely to be unvaccinated than their counterparts.In addition,children with no previous influenza vaccination,those whose parents doubted the COVID-19 vaccine’s safety or effectiveness,were 6.11 times(aOR 6.11,95%CI 2.80-13.34),8.27 times(aOR 8.27,95%CI 5.33-12.83),and 2.69 times(aOR 2.69,95%CI 1.11-6.50)more likely to be unvaccinated than their counterparts,respectively.COVID-19 vaccine uptake varied between different sociodemographic groups.However,the odds of receiving the COVID-19 vaccine decreased as age and education level increased.The main refusal reasons claimed by participants were that they had medical conditions that may not qualify them for vaccination(53.78%),followed by safety concerns about the vaccine(13.56%),not knowing where to get vaccinated(6.44%),and concerns about fertility issues(5.56%).Conclusions:Despite a highly encouraging level of COVID-19 vaccine uptake in Zhejiang,China,the elderly and highly educated people had lower COVID-19 vaccine uptake.It is suggested that tailored health education strategies should be taken to increase the COVID-19 vaccine uptake in such groups.Furthermore,with vaccination rates at such a high level,the pandemic is still ongoing,and public confidence in vaccines may decline.Thus,sufficient evidence-based information regarding COVID-19 vaccines should be provided to the public.