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The primary objective of this study is to investigate the cognitive aspects of spatial experiences of paediatric inpatients who receive long-term treatment in a healthcare setting in relation to the syntactic parameters of healthcare environment. It is aimed to investigate how the change in the child’s cognition caused by the environmental stress experienced by the child during his/her stay in the hospital is related to the physical parameters of the treatment space.

The methodology of the study is based on a correlational analysis to identify the cognitive and syntactic factors of the healthcare environment that contribute to changes in the perceptual processes of a sample group of thirty children. The study examined the relationships between the graph and isovist variables, and the cognitive parameters of paediatric inpatients. The two datasets were subjected to regression analyses in order to identify any significant findings, which allowed for a discussion of how the patients’ changing perceptual processes are influenced by the syntactic measures of the healthcare setting.

The study showed that a syntactically intelligible floor plan contributes significantly to reducing environmental stress among paediatric inpatients. The presence of shared spaces within the healthcare environment, where social interaction with peers is possible, emerges as a crucial factor influencing children’s spatial perception. Additionally, the visibility characteristics of shared spaces may also play a key role in enhancing children’s perceptions of safety.

The limitations of the study include the fact that the study was conducted in an oncology and haematology inpatient unit with challenging conditions in terms of the mobility potentials of the children, which might have affected their perceptual processes. A further limitation is that the sample size comprised only 30 children, and the spatial configuration of the healthcare environment was linear and not particularly complex.

By identifying the impact of spatial design on children’s well-being, the study informs the creation and improvement of healthcare environments. Enhanced understanding of factors like intelligible floor plans, shared spaces and isovist values can lead to more child-friendly facilities, potentially alleviating stress for young patients. Consequently, this research may contribute to improved healthcare outcomes, increased comfort for paediatric inpatients, and a more supportive environment for their families, fostering a holistic approach to paediatric care and positively influencing the overall quality of life for children undergoing long-term treatment.

This study contributes to the theoretical discourse on how the constrained physical conditions of a paediatric healthcare environment may influence the perceptual processes of paediatric inpatients. The results of this evidence-based study have the potential to inform the evaluation of design guidelines for healthcare settings, with the ultimate aim of enhancing therapeutic environments.

The prevalence of pediatric anxiety disorders is on the rise but youth have challenges in accessing specialty evidence-based mental health care. As a result, families turn to their pediatric primary care provider (PCP) for assessment and management of anxiety. To increase PCPs’ abilities to manage anxiety, the Extension for Community Healthcare Outcomes (“Project ECHO”) was used. The purpose of this study is to explore the impact of Project ECHO on participating PCPs’ knowledge, self-efficacy and interventions surrounding the assessment and management of anxiety.

Data were collected pre- and post-course across five cohorts. Participants completed a clinical knowledge test, ratings of self-efficacy and self-reported frequencies of in-office interventions. Satisfaction was also measured.

Attendance remained strong, and participants rated high satisfaction. From pre- to post-course, participants demonstrated increased knowledge on almost all objective questions. Participants reported increased self-efficacy across all domains. Finally, participants endorsed increased use of several in-office interventions.

This study highlights the importance of Project ECHO as a continuing education model to enhance PCPs’ abilities and confidence in the assessment and management of anxiety. Future continuing education endeavors should consider Project ECHO as a means of increasing PCPs’ capacity to manage mental health conditions.

To the best of the authors’ knowledge, this is the first study that applied the Project ECHO model to pediatric anxiety as a mechanism of increasing knowledge, self-efficacy and in-office interventions with PCPs.

Mental health problems during the initial years of life are precursors of mental disorders in later life, as well as poor quality of life. However, understanding and assessing the quality of life among children is very challenging and requires appropriate assessment measures. Against this backdrop, this study aims to establish the evidence for the construct and convergent validity of Urdu version of Pediatric Quality of Life Inventory (PedsQL) in Pakistani children.

This study has a cross-sectional study design in which a sample of 291 primary school children (53.3% male children and 44.7% female children) were enrolled from 6 primary schools located in Rawalpindi District in 2021 through random sampling. Children’s ages ranged between 9 and 13 years (M = 10.51 years; SD = 0.73). Urdu translated version PedsQL, Rosenburg self-esteem scale (RSES), strengths and difficulties questionnaire (SDQ), difficulty subscale and socio-demographic form were administered in a group setting.

Confirmatory factor analysis showed model provided a better fit similar to three factors: social/school functioning; psychological functioning; and physical functioning with good alpha reliability for full scale as well for subscales (r = 0.87, r = 0.75, r = 0.77 and r = 0.73), respectively. Pearson’s correlation of the translated version with SDQ_difficulties (r = −0.33; p < 0.01) and RSES (r = −016; p < 0.01) depicted solid discriminant validity (r = −0.33; p < 0.01) and RSES showed good convergent validity (r = −0.16; p < 0.01). Hence; PedsQL, Urdu proved to be a reliable, valid and efficient tool for the assessment of quality of life among Pakistani children, and its three-factor structure model suggested previously for Pakistani children was confirmed.

This study is original work by the researcher as part of their PhD project.

Computer-Assisted Learning in Pediatrics Program (CLIPP) and National Board of Medical Examiners Pediatric Subject Examination (NBMEPSE) are used to assess students’ performance during pediatric clerkship. International Foundations of Medicine (IFOM) assessment is organized by NBME and taken before graduation. This study explores the ability of CLIPP assessment to predict students’ performance in their NBMEPSE and IFOM examinations.

This cross-sectional study assessed correlation of students’ CLIPP, NBMEPSE and IFOM scores. Students’ perceptions regarding NBMEPSE and CLIPP were collected in a self-administered survey.

Out of the 381 students enrolled, scores of CLIPP, NBME and IFOM examinations did not show any significant difference between genders. Correlation between CLIPP and NBMEPSE scores was positive in both junior (r = 0.72) and senior (r = 0.46) clerkships, with a statistically significant relationship between them in a univariate model. Similarly, there was a statistically significant relationship between CLIPP and IFOM scores. In an adjusted multiple linear regression model that included gender, CLIPP scores were significantly associated with NBME and IFOM scores. Male gender was a significant predictor in this model. Results of survey reflected students’ satisfaction with both NBMEPSE and CLIPP examinations.

Although students did not perceive a positive relationship between their performances in CLIPP and NBMEPSE examinations, this study demonstrates predictive value of formative CLIPP examination scores for their future performance in both summative NBMEPSE and IFOM. Therefore, students with poor performance in CLIPP are likely to benefit from feedback and remediation in preparation for summative assessments.

This study aims to examine the dietary compliance of children and adolescents with celiac disease (CD) and their diet quality (DQ) and dietary acid load (DAL) and to determine the relationship of these dietary parameters with health-related quality of life (HRQoL).

Ninety-one children and adolescents with CD and 144 healthy peers were included in this cross-sectional study. Anthropometric measurements were conducted by researchers. DQ and DAL were calculated from participants’ 24-h dietary recall records. HRQoL was assessed using the Pediatric Quality of Life Inventory, and compliance with a gluten-free diet (GFD) was obtained using the GFD score. Data was collected through a face-to-face questionnaire.

Of celiac patients, 53.1% were strictly compatible with the GFD, and 35.8% were non-compliant with the diet. The DQ scores of participants with CD were higher than their healthy peers, and the DAL scores were lower (p < 0.01). Finally, no relationship was found between the DQ and DAL with HRQoL scores in celiac patients (p > 0.05). However, better dietary compliance with the GFD was associated with improved HRQoL (p < 0.05).

While DQ and DAL had no association with HRQoL, better dietary compliance improved the HRQoL of celiac patients. This may help develop solutions to the problems experienced by celiac patients, thereby improving the management of CD.

To the best of the authors’ knowledge, this study is the first to investigate the association of DQ and DAL with HRQoL in children with CD.

This study aims to investigate the attitude of students toward domestic violence (DV) and children’s rights.

A quantitative cross-sectional descriptive questionnaire design method was used to collect data. The participants of the study were university levels of associate degree students in Eastern Turkey.

Results showed that female students were more likely to approve of DV, and this difference was statistically significant. The structural equation modeling analysis revealed a positive and significant relationship between students' attitude toward children’s rights and their overall attitude toward DV.

This research suggests that the participants had a positive view of DV and a moderate attitude toward children’s rights. Therefore, it is recommended to enhance the attitude and awareness of future health professionals about children’s rights and DV.

This study aims to evaluate the health literacy level of the parents of children diagnosed with Down syndrome (DS) within one institution in Turkey.

A cross-sectional survey measuring demographics, information of the child and the parent and health literacy was administered to participants. The health literacy levels in the study were measured with the European Health Literacy Scale (EHLS), which consists of 47 questions.

Of the 65 participants who completed the questionnaire, 56.9% were mothers, 68.1% were diagnosed in the neonatal outpatient clinic examination after birth, and 58.5% stayed in the neonatal intensive care unit after birth. The mean score of the IHLS scale was 25.06 ± 6.59. Of the parents, 63.1% were found to be inadequate, 18.5% problematic-limited, and 18.5% adequate health literate. Any parent with excellent health literacy level was identified. High education level (p < 0.001), high income level (p < 0.001), living in the city center (p < 0.05), planned pregnancy (p < 0.05) and being a health worker (p < 0.001) were found to be statistically significant with a high EHSL score.

The presence of Down syndrome (DS) in a child also necessitates ongoing monitoring for a range of conditions, including eye diseases and heart disease. Some surgical procedures, such as heart or gastrointestinal surgeries, may also be required. Additionally, the child may require the administration of various medications. Finally, due to the potential lifelong need for assistance, the child may require the support of an adult throughout their lifetime. This is because of the child's inability to live independently due to their mental state. Therefore, parent education is the most important issue in the follow-up of the disease.

To the best of the authors’ knowledge, this is the first study to determine that parents of children diagnosed with DS have very limited knowledge of the disease and health literacy. Explanation of current diseases, treatments and training of parents should also be included in genetic counseling.

DS is a chromosomal disease that requires multidisciplinary care. Parents have to know the course of the disease and its complications.

The findings of this study indicate that parents of children with Down syndrome exhibit a profound lack of knowledge regarding the nature of their child's condition and the available healthcare options. It is therefore imperative that genetic counseling incorporates an explanation of the diagnosed diseases, treatments, and educational resources for parents.

Evidence-based practice is a professional standard for occupational therapists, but limited time, resources and knowledge challenge its implementation. This study aims to identify what free evidence summary sources (FESS) can be found through a simple online search, related to child/youth interventions surrounding cerebral palsy (CP), autism spectrum disorder (ASD), developmental coordination disorder (DCD), mental health or attention-deficit/hyperactivity disorder (MH/ADHD). Evidence summaries share research in concise, time-efficient manners.

An internet-based scoping review was conducted between February 2022 and July 2022, using Google, and known evidence summary producers. Evidence summaries meeting the inclusion criteria were located and catalogued. Type of agency, target audiences, purpose and distribution of evidence summaries related to diagnosis were identified for each FESS.

Ten FESS were found, which produced 113 intervention-focused evidence summaries within the past 10 years. These FESS were aimed at a variety of target audiences: service providers, service users, parents/families, researchers and commissioners, and were produced primarily by non-profit/charity organisations (6 of 10) who were trying to fill a gap in evidence. Forty-eight evidence summaries were related to ASD, 34 to CP, 29 to MH/ADHD and two to DCD.

A catalogue of FESS that exist online was produced, to support evidence-based practice for paediatric occupational therapists with limited resources, and may support improved health promotion and informed decision-making for service users. No consistent framework for FESS evidence summaries exists at this time.

The paper investigates how the engagement of a group of actors (the volunteers), previously unexplored in service ecosystems literature, contributes to generating new co-creation activities and well-being outcomes in the healthcare service ecosystem (HSE). Moreover, the study analyses how the provision and integration of volunteers’ resources help to explain the HSE self-adjustment favouring the re-humanisation of service.

The article zooms in on the volunteers’ activities in an HSE. A qualitative approach is adopted, and an empirical investigation is grounded in data gathered from Kids Kicking Cancer (KKC) Italia, a volunteer association operating in the paediatric oncology ward of Italian hospitals. Data are collected and triangulated through in-depth interviews, volunteers’ diaries and observations. The analysis is conducted by adopting an interpretative thematic analysis technique.

The study provides a conceptual framework explaining how volunteers’ value co-creation activities influence the HSE’s self-adjustment by leading to a re-humanisation of services. The paper also contributes to the state of knowledge by identifying seven categories of volunteers’ value co-creation activities, two of which are completely new in the literature (co-responsibility and empowerment).

The paper contributes to the service research literature by identifying empirically grounded value co-creation activities extending the understanding of self-adjustment and re-humanisation of the service ecosystem.

Despite significant progress in Iran's immunization programs, vaccine policymaking in the country still faces various challenges and shortcomings. To address these issues and ensure sustained progress toward achieving comprehensive vaccination policies, it is essential to identify the critical factors influencing vaccine policies in Iran. Our study aims to provide evidence-based insights that can inform the development of effective and equitable vaccine strategies, leading to a more sustainable and efficient approach to vaccination in the country.

This mixed-method study aimed to analyze the factors influencing the future of human vaccine policy using Cross Impact Analysis. Firstly, a scoping review was conducted to identify the factors affecting the future of human vaccine development. Secondly, a semi-structured interview was conducted with experts in this field to add more factors and confirm the identified factors within the Iranian context. Finally, a Cross-Impact Analysis (CIA) approach was applied to comprehend the complex relationships between the identified factors. Thematic analysis was used for the qualitative data, and MICMAC analysis was applied to characterize the relationships between the factors.

Seventeen key driving force factors were identified through comprehensive review and interviews. These factors were assigned weighted values ranging from zero to three and subsequently analyzed using MICMAC software. Employing the Cross-Impact Analysis (CIA) technique, the study characterized the impact of each factor on vaccine policy and elucidated the intricate interactions between them. The findings underscored that robust leadership and governance, an innovative ecosystem, and well-established immunization information systems emerged as pivotal driving forces shaping vaccine policy in Iran.

While this study contributes valuable insights into the driving factors influencing vaccine policy in Iran, it is important to acknowledge several limitations. The results rely on the subjective perceptions of a diverse group of specialists, and future research could delve into additional factors in other countries to identify common themes and differences.

This study provides evidence to assist policymakers in making informed decisions regarding vaccines in Iran. The findings suggest that enhancing access to vaccines, fostering trust in the healthcare system, and prioritizing equity in distribution can contribute to increased vaccination rates and a reduction in vaccine-preventable diseases.

This study provides a unique contribution to the field of vaccine policy by utilizing the cross-impact analysis to examine the complex interactions among various factors. The results of this analysis demonstrate that these interactions can significantly impact the overall system, highlighting the need for policymakers to consider multiple factors when formulating effective strategies. By revealing the significance of these interactions, this research offers valuable insights into the development of successful policies that can shape a desirable future for vaccine policy in Iran. Future studies could ratify the findings from this research by applying other methodological approaches.