Animal-assisted interventions (AAIs) for children with developmental disabilities (DD) have traditionally focused on dogs and horses, with less research on cat-centered AAIs. However, many potential AAI participants prefer, or only have access to, cats. The current Randomized Control Trial (RCT) study evaluated a novel Cat-Assisted Training (CAT) intervention designed to promote healthy behaviors in children, while also strengthening child-cat bonds. Participants included 36 children with DD (ages 8-17 years) and their family cats. Participating pairs were randomly assigned to either the CAT intervention (experimental) group or the waitlist control group. Feasibility was supported by 100% session attendance, a 94.4% post-intervention retention rate, and an 81% average homework completion rate. Participants in the CAT group reported increases in health-promoting activities, such as walking with their cat (p = 0.008), and demonstrated a significant increase in cat care responsibility (p = 0.039). Cats showed an immediate increase in sociability toward their child (p = 0.036), and a higher rate of secure attachment to their child partner at the one-year follow-up compared to baseline (p = 0.031). Overall, this initial study suggests that the CAT intervention represents a promising AAI model, providing empirical support that cats can be active and successful AAI partners for children with DD.
Abstract: Background: Flood constitutes almost half of the natural disasters occurring in the last ten years. Children are more vulnerable because of their unique physiological, psychological, and growth characteristics. Methods: The methodology of this scoping review is in accordance with the proposed Arksey and O'Malley method. The primary question of the study was nursing care of children in the face of flood. Using 12 keywords, related articles were extracted from the search engines. Ultimately 18 articles were selected for the final inspection. Results: Findings were classified into six questions: 1. Which psychological problems arise for children and their parents during and after floods? 2. What is the effect of flood on children’s education? 3. Which factors and actions can reduce the flood vulnerability? 4. What are the health problems for children and their families during and after the flood? 5. Which factors affect the consequences of floods? The findings showed that children are much more vulnerable than adults, the most important factors influencing parental education are economic status, gender, age, the parents’ occupation, and other factors such as schools’ buildings, and proximity to rivers. Children suffer from various mental and physical disorders, child abuse, lack of access to health services, malnutrition, and growth and education process during and after the flood. Conclusions: Older children are more affected, maybe due to their greater recall. The next factor is gender, which affects girls more than boys due to their greater self-confidence and presence in rehabilitation activities. Parents' jobs and the family sources of income are important, as the loss of flood-affected jobs such as agriculture threatens the family and children's well-being. Spirituality has been introduced as the protective factor of children from the destructive effects of flood. After a flood, children experience post-traumatic stress disorder, respiratory illness, educational problems, diarrhea, malaria, child abuse, and lack of health facilities. Some of these consequences are preventable. Solutions such as hospital development, drug security, pre-flood vaccination, the education obligation, and preventing child marriage can be effective. In addition, children can acquire the skills needed to manage the situation during a flood and to help parents through the training they receive before a flood occurs. Keywords: Nursing care, Complication, Disaster, Flood, Children
Hoseinzadeh Siboni F, Mohebbi K, Taheri Ezbarami Z
A range of barriers to Physical Activity (PA) participation contribute to autistic children being less physically active than their non-autistic peers. While these barriers have been well documented, further research is needed into methods of overcoming these barriers. This study aimed to create a series of best practice recommendations for the inclusion of autistic children in community-based PA programmes. This was achieved using the Delphi Method involving the opinions of international experts in the area of inclusion of autistic children in PA. Three rounds of questionnaires were distributed to the panel of 22 experts, aiming to reach consensus on a series of topics related to the inclusion of autistic children in community-based PA programmes (consensus ⩾67% agreement). Topics included coaches and volunteers, programme characteristics, and bridging sessions. Sixteen consensus statements were established which were then used to create the 'STARTS' recommendations, which centre around: (1) Skill development, (2) Training for coaches/volunteers, (3) Aims for sessions, (4) Resources to improve children's experiences, (5) Transitioning from bridging programmes to mainstream programmes, and (6) Supports to improve inclusion. The STARTS recommendations will assist clubs/organisations when setting up or modifying community-based PA programmes which include autistic children.Lay abstractAutistic children can often find participation in physical activity programmes difficult and as a result are often less physical active than to non-autistic children. Many studies have explained why these difficulties exist, such as lack of suitable programmes, uneducated coaches, lack of coach, or physicality difficulties, but there is less information available about practical ways to make programmes more inclusive. This study aimed to create clear, practical recommendations to help community sports clubs and physical activity programmes to better include autistic children. To do this, the Delphi Method was used. This involved a group of 'experts' with experience in autism and physical activity to share their views over several rounds of online questionnaires. Twenty-two international experts took part in this study, and over three rounds, they were asked to share suggestions and opinions, answer multiple-choice questions, and rate different ideas. By the end of the process, the experts agreed on 16 key recommendations, which were then used to create the 'STARTS' recommendations. This splits the recommendations into six topics: (1) Skill development, (2) Training for coaches/volunteers, (3) Aims for sessions, (4) Resources to improve children's experiences, (5) Transitioning from autism-specific programmes to mainstream programmes, and (6) Supports to improve inclusion. These recommendations offer practical guidance for clubs and organisations that want to create or adapt community-based physical activity programmes to promote inclusion and help autistic children feel welcomed and supported.
Abstract Child and spousal abuse rates have been shown to increase during various types of disasters. This study sought to determine the prevalence and determinants of older adults’ experiences of increased verbal or physical conflict (+VPC), as a proxy for elder abuse, during the COVID-19 pandemic. Data are from the Canadian Longitudinal Study on Aging (CLSA), a cohort study of 51,338 Canadians aged 45–85 at enrollment (2012-15) with follow-up every 3 years until 2033.. We analyzed data of participants aged 65 or above at follow-up1 who took part in a COVID-19 sub-study (n=24,306). Experiencing +VPC was the main outcome variable; explanatory variables included gender identity, sexual orientation, age group, race/ethnicity, educational attainment, marital status, household income, working status, living alone, social support availability, cohesion with community, self-rated physical and mental health, anxiety, depression, and previous history of elder abuse. The overall weighted prevalence of +VPC was 7.4%. Gay/bisexual men, 55-64 age-group, not living alone, low social support, poor social cohesion, low self-rated health, poor mental health, and past history of psychological or physical abuse were all significantly associated with +VPC. Weighted multivariable logistic regression revealed gender, not living alone, higher scores of depression and anxiety, and past history of psychological abuse to be independent predictors of +VPC. Implications for post-pandemic recovery and for prevention strategies during future disasters include targeted outreach programs for the most vulnerable group which includes males, persons age 55-64, those with self-rated poor mental health and/or history of elder psychological abuse.
ABSTRACT Objectives Explore the perspectives of primary caregivers towards pediatric tissue-based research participation. Design Cross-sectional. Setting Two academic pediatric gastroenterology sites in the United States, including one serving a largely rural referral population and one urban clinic population. Participants Primary caregivers of children who underwent endoscopy between 2017-2018 at UVA or were seen in the clinic setting between 2024-2025 at Tulane and referred by their child’s gastroenterologist to complete an electronic survey. Measures and Analysis Primary caregiver attitudes, motivations, and concerns toward pediatric tissue-based research were explored using descriptive-focused coding in NVivo and a large language model (LLM) processing pipeline based on OpenAI’s GPT-4 for thematic, emotional, and sentiment analyses. Results Data were analyzed from 92 primary caregivers. Overall, respondents were amenable to having their children provide specimens for research. Primary motivations included a desire to help others or advance science, and perceived medical benefits for their child so long as specimen collection did not cause additional distress. Discomfort with participation was often linked to prior traumatic clinical experiences, concerns about additional biopsies causing unnecessary discomfort, or privacy issues. A desire to help others and potentially their own child was the strongest motivator for participation, while scheduling constraints and perceived risks to the child’s health were the main barriers. Conclusions At both sites, primary caregivers expressed strong willingness to participate in pediatric research. Primary concerns included perceived invasiveness of biospecimen collection and potential for additional discomfort. Limitations of the study included the unstructured nature of the data making the analysis and interpretation challenging. Strengths included two demographically diverse sites, intentional enrollment of primary caregivers of children both with and without invasive diagnostic testing, and use of LLM based analyses.
Introduction The article is devoted to the study of adaptation to the covid-19 pandemic conditions in Russian men and women in the first part of 2020. Respondents assessed the degree of potential danger of various types of social threats caused by the pandemic, as well as the level of their adaptation to changed living conditions during the first lockdown. Objectives The purpose of this study was to identify key differences in adaptation to pandemic conditions in groups of men and women. Methods The author’s methodology was developed to assess the level of adaptation to COVID-19. The questionnaire included 6 scales on different aspects of life during the lockdown (for example, physical and emotional state, communication, employment during the pandemic, etc.). The sample was N = 80 (residents of Russia age 18-37). Results Men significantly higher estimated the potential danger of an epidemic threat to themselves than women. The level of adaptation to conditions caused by the COVID-19 pandemic also differed in two gender groups according to t-test on the scale “Employment in a pandemic”: men were better adapted to work or study in conditions caused by the COVID-19 pandemic than women. Conclusions This can be interpreted from the point of view of the stereotype existing in Russian culture which postulates the performance of household duties and child care is more perceived as a woman’s responsibility. The adaptation of women to remote work during the lockdown was forced to be combined with an increased workload in the family and household sphere. Disclosure No significant relationships.
Belinskaya E, Tihomandritskaya O, Dubovskaya E et al.
Background Population aging and declining fertility have transformed family life courses, yet their long-term implications for women's health remain insufficiently understood. This study examined whether distinct marital and fertility trajectories were associated with subsequent changes in depressive symptoms and physical functional limitations among Chinese women. Methods We used data from the China Health and Retirement Longitudinal Study (CHARLS), including 5,871 women aged 45-65 years at baseline. Retrospective marital and fertility histories from ages 15 to 49 were reconstructed using sequence-based methods and grouped into trajectory typologies through Ward's clustering. Depressive symptoms were assessed using the CES-D-10, and physical functional limitations were measured using the Nagi Disability Scale. Associations with longitudinal health outcomes were estimated using linear mixed-effects models. Robustness analyses additionally adjusted for childhood contexts, and sensitivity analyses restricted the sample to women with at least two valid outcome observations. Results Four trajectory groups were identified: Stable Marriage & Two-Child (40.0%), Early Marriage & High-Parity (43.3%), Stable Marriage & One-Child (15.6%), and Predominantly Married & Childless (1.2%). Compared with the Stable Marriage & Two-Child group, the Early Marriage & High-Parity group had higher baseline depressive symptoms (β = 0.858, 95% CI: 0.560 to 1.157) and higher physical functional limitations (β = 0.206, 95% CI: 0.143 to 0.269), with a faster increase in physical functional limitations over time (β = 0.025, 95% CI: 0.012 to 0.038). The Stable Marriage & One-Child group had lower baseline depressive symptoms (β = -0.858, 95% CI: -1.271 to -0.445) and lower physical functional limitations (β = -0.163, 95% CI: -0.251 to -0.076), with a marginally slower increase in physical functional limitations (β = -0.018, 95% CI: -0.036 to 0.000). The Predominantly Married & Childless group did not differ significantly from the reference group. These associations were broadly consistent in robustness and sensitivity analyses. Conclusions Women's marital and fertility trajectories were associated with later depressive symptoms and physical functional limitations from midlife to early old age. Early marriage and high parity were linked to poorer depressive and functional outcomes, whereas the Stable Marriage & One-Child trajectory was associated with relatively better depressive and functional outcomes. These findings suggest that the timing and structure of family formation may have lasting implications for women's later-life depressive symptoms and physical functional limitations.
Aims 1. To evaluate clinicians’ experiences of the newly implemented remote ASD assessment process (due to COVID-19), including the long-term sustainability and potential standardisation of this approach; 2. To establish areas for improvement in this process and make further recommendations. Methods Members of the Neurodevelopmental MDT completed an online survey, whereby feedback was collected regarding the use of the Child Observation of Social Communication (COSC), which had been adapted for online use from the standardised Autism Diagnostic Observation (ADOS) Schedule by a senior Psychologist[.Participants also responded to questions on other assessment domains, including the Developmental, Dimensional and Diagnostic interview, feedback and formulation meetings. Questions included their comfort with performing the assessment, theirs views on the quality of care provided and any difficulties they faced. Survey data were collected on two occasions: between November and December 2020 and between July and August 2021. Results Positive Experiences 63% of respondents in November-December 2020 reported that COSC was a good alternative whilst standardised ADOS was unavailable. This increased to 100% in July-August 2021. Quality of care delivered by COSC was rated to be the same as ADOS in 70% of participants November-December 2020; 25% felt quality of care delivered by COSC was better than ADOS in July-August 2021. 73% of participants reported they would continue to use the remote assessment in the November-December 2020 survey. This increased to 88% in July-August 2021. 33% of the clinicians were very comfortable with administering the COSC in July-August 2021, 56% were somewhat comfortable. Negative Experiences 27% of the clinicians reported being somewhat uncomfortable with administering the COSC assessment in November-December 2020; 11% remained somewhat uncomfortable in July-August 2021. 30% of the participants rated the quality of care delivered by COSC worse than ADOS in November-December 2020. 37.5% rated this to be worse in July-August 2021. 77% of the respondents had technical or organisational difficulties, which could result in missing non-verbal cues during the assessment. Conclusion Clinicians’ experiences improved over time and with practice (34% had delivered over 10 COSC assessments in July-Aug 2021). A hybrid model may increase the quality of care of the approach, as well as careful selection of cases which would be suitable for an online assessment. There is scope for the continued use of the remote ASD pathway, taking into account patient and clinician preferences, however patient feedback will be necessary as a next step in this evaluation.
Public policy in Canada develops through deliberative democracy and, increasingly, public engagement. Children and youth ('young people') remain largely excluded from these processes however; this exclusion is especially evident in health arenas where two conceptual tools, autonomy and agency, are used to justify it. To date, there has not yet been an examination of how these concepts function in children's palliative and end-of-life (P-EOL) care. This narrative review aimed to explore how autonomy and agency are constructed, conveyed, and employed in related literature. To situate and compare understanding of agency and autonomy, we used principles from Childhood Ethics. We scanned four databases using the search terms: young people; P-EOL care; agency; and autonomy. Studies were included if they were peer-reviewed, in English/French, and focused on young people's agency and/or autonomy in P-EOL care. Exclusion criteria included an exclusive focus on neonates. Data were extracted from 52 sources focusing on study location, population, classification of P-EOL experiences, whether and how agency and autonomy were described, and barriers and facilitators to agency/autonomy expression. Analysis highlighted the prominence of autonomy in the literature in comparison to agency, and the conflation of these concepts. The mobilization of both concepts could bolster or thwart young people's engagement in P-EOL care. Several modalities for expressing agency and autonomy were exemplified across the literature, including acute treatment decisions, research participation, decisions regarding sexuality and fertility, and prioritization of play. Overall, this study describes how interpretations of agency and autonomy can inform young people's P-EOL care. Future research would benefit from prioritizing young people's inclusion in P-EOL care research and generating communication-related training for clinicians.
Background Meaning making is increasingly recognized as an important determinant of psychosocial adjustment in adult oncology. However, how school-aged children make meaning of cancer and how developmental, relational, and sociocultural influences shape this process remain insufficiently characterized, particularly because frameworks are largely derived from adult research and centered on intrapersonal processes. Aims To synthesize evidence on meaning making among school-aged children with cancer and examine these findings through Park's meaning-making model while identifying dimensions not fully captured by the model. Methods A scoping review was conducted according to PRISMA-ScR guidelines. Four databases and reference lists were searched for peer-reviewed studies examining meaning making through direct reports from children aged 6-12 years with cancer. Park's meaning-making model informed study selection, data extraction, and deductive coding, while inductive coding identified dimensions not represented in the model. Results Thirty-nine studies were included. Children's meaning making encompassed global beliefs and developmental and healthcare-related goals; appraisals of threats to the self, normalcy, relationships, and future; and cognitive, emotional, socially informed, spiritual, experiential, and avoidance-related processes. Meaning making emerged as a dynamic, developmentally grounded, and relational process shaped by caregivers, healthcare professionals, and sociocultural contexts across the cancer trajectory. Evidence regarding children's sense of meaning or purpose and meanings made was limited. Conclusions School-aged children actively construct meaning throughout the cancer trajectory. Integrating interdisciplinary support for meaning making that is child-centered and developmentally and culturally responsive into psychosocial care, serious illness communication, and pediatric palliative care may strengthen children's participation, coping, and psychosocial-spiritual well-being.
