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Caregivers who interact with children at home can provide a critical, complementary perspective on a childs behaviour functioning. This research used a parent-administered measure of problem behaviours to study perceptions of child behaviours across home situations. We applied latent profile analysis to identify subgroups of children with common behavioural tendencies in a nationally representative sample (N = 709) of 4- to 13-year-old children in Trinidad and Tobago. This study (a) identified latent profiles of childrens over- and underactive behaviour problems in varied home settings and (b) examined how profile membership predicted academic skills and teacher-observed problem behaviours. The best-fitting four-profile model included one profile of adjusted behaviours (56%), one of the elevated attention-seeking behaviours (21%), a profile featuring withdrawn and disengaged behaviours (15%) and a relatively rare profile emphasising aggressive behaviours (8%). Children classified in the last profile displayed the poorest academic outcomes and the highest levels of teacher-observed behaviour problems.

Our study found an association between having children or cohabitants in need of care at home during telework and work functioning impairment. As telework has become a normal working style, strategies are needed to mitigate the burden on workers experiencing significant family-work conflicts during telework. Objectives: To clarify the association between telework with family members at home and work functioning impairment. Methods: A cross-sectional survey was conducted in 27,036 participants. Having children or cohabitants in need of care at home during telework was considered an exposure factor. Multilevel logistic regression analysis was used to calculate odds ratios (ORs) for work functioning impairment, assessed by The Work Functioning Impairment Scale (WFun). Results: Participants living with cohabitants in need of care at home had higher odds of work functioning impairment, whereas those living with preschool children or a spouse had lower odds. Participants living with children or cohabitants in need of care at home during telework had higher odds. Conclusions: We found an association between having children or cohabitants in need of care at home during telework and work functioning impairment. [ABSTRACT FROM AUTHOR]

Current understandings of disability experience are centered around individuals who hold the disability identity and membership in the marginalized group. This perspective does not include the experiences of disability allies, such as parents, who act alongside their children to support their access and engagement in the education setting. This partial perspective is of concern because it does not reflect the depth and complexity of disability experience for those in allyship roles. This paper builds on current understandings of disability experience by introducing an emerging conceptual lens that defines and describes the nature of disability experience for those acting in allyship roles. Attention is focused on children with dyslexia and their parents to illustrate this conceptual lens. Extending on ecological models of interactions and understandings of subjective experience, the authors highlight how the proximity of the parental experience to the child's dyslexic identity shapes parental allyship and present a lens of disability experience that includes primary, vicarious, and primary adjacent experience. The proposed conceptual lens offers researchers and educators an opportunity to view disability experience and allyship from an alternative perspective, and in doing so, consider a broader understanding of disability experience and allyship that would potentially provide insights into parent–school partnerships. [ABSTRACT FROM AUTHOR]

Objectives: People with dementia have several unmet needs during the syndrome progression. More unmet needs are related to hospitalizations, injuries, and death. Little is known about the care needs for people living with dementia in Brazil. This study aims to translate and adapt the Johns Hopkins Dementia Care Needs Assessment (JHDCNA 2.0), a tool design to identify the dementia-related needs of people with dementia and their caregivers, to Brazilian Portuguese, and to verify psychometric properties. Method: JHDCNA 2.0 underwent a translation, back-translation, and cultural adaptation. Preliminary psychometric testing of the Brazilian version (JHDCNA-Br 2.0) included pilot testing and experts' assessment, analyses of reliability, evidence based on test content and relations to other variables. We conducted 140 in-home interviews to assess several sociodemographic and health aspects and to be able to complete the JHDCNA-Br 2.0. Results: The JHDCNA-Br 2.0 is reliable and has evidence based on test content and on relations to other variables for people living with dementia and caregivers. Preliminary results suggest high prevalence of unmet needs. Conclusion: JHDCNA-Br 2.0 is a reliable and valid tool. The availability of this tool brings new opportunities to the study of dementia care, taking into consideration cultural aspects and may help inform future approaches to dementia care delivery to support persons and families affected by these conditions. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates factors associated with the person with dementia and the caregiver to identify those associated with an increased risk of transition to a care home. Method: IDEAL data were collected at baseline and at 12- and 24-month follow-up for 1545 people with dementia and 1305 caregivers. Modified Poisson regressions with an offset for 'person years at risk' were used. Person with dementia factors explored were personal characteristics, cognition, health, self- and informant-rated functional ability, and neuropsychiatric symptoms. Caregiver factors explored were personal characteristics, stress, health, and quality of the dyadic relationship. Results: A 5% people moved into care. Risk of moving into a care home was higher among people with dementia who were ≥80 years, among people with Parkinson's disease dementia or dementia with Lewy bodies, and among those without a spousal caregiver. Poorer cognition and more self-rated or informant-rated functional difficulties increased the risk of moving into care. Conclusion: Factors related to increased dementia severity and greater disability are the primary influences that place people with dementia at greater risk of moving into a care home. Strategies that help to maintain everyday functional ability for people with dementia could help delay people with dementia moving into care. [ABSTRACT FROM AUTHOR]

Purpose: Autistic individuals often display social-communicative differences affecting aspects of daily living. The present study assessed the feasibility and potential efficacy of a dance-based exergame for enhancing autistic children's social-communication skills. Methods: A mixed method, within-subject, pre-test/post-test study design was employed. Children in their home (n = 4; Mage = 8.25 years old, SD = 0.50) and school environments (n = 31; Mage = 10.87 years old, SD = 1.61) participated in a dance-based exergaming intervention (Just Dance) for six weeks. Results: A positive change in children's social-communication skills was observed (p < 0.01). Results suggest Just Dance was easy to implement and enjoyable. Conclusion: A larger randomised control trial is warranted to confirm the effectiveness of the dance-based exergame. [ABSTRACT FROM AUTHOR]

Background: Autism Spectrum Disorder is a neurodevelopmental disorder, and its prevalence is estimated at 1% worldwide. The home environment can influence activities and roles for autistic individuals, however there are limited assessments that focus on the home environment for this population. Purpose: To identify existing assessment tools of home environment for autistic individuals in the literature. Methods: We explored five databases. Initial search on databases was made in 2019 and updated in 2022. Documents selection was made in two phases: 1) title and abstract screening, 2) full-text reading of selected publications. The included studies were analyzed. Results: We identified seven home environment-related assessment tools that can be used with the autistic population. Most of the tools included few items related to the non-human environment and do not include specific elements of the environment (e.g.: details about sensory stimuli or assessment of the layout). Six of them are design for children or youths and only one out seven is specific to autistic people. Conclusions: The identified tools do not allow for a detailed assessment of the non-human environment of autistic individuals only the identification of environment-related difficulties. More research and the development of new tools are needed to improve it. [ABSTRACT FROM AUTHOR]

The current study reports the findings of a pilot study on a community-based sample of adolescent males with harmful sexual behaviours (AHSBs) with sibling or non-sibling sexual offending. Specifically, the study aimed to determine whether using the Family Environment Scale (FES) could differentiate between individual, familial and offence characteristics of those who had sibling victims and those with non-sibling victims, and whether using this tool might aid clinical practice. Results indicated that sibling offending AHSBs experienced significantly greater current familial conflict than non-sibling offending AHSBs. No statistically significant differences between groups were present with respect to offence characteristics, victimisation histories and family functioning. These findings indicate that psychological intervention for harmful sexual behaviour between siblings should include assessment of familial conflict and that psychological intervention for this behaviour may constitute a wider focus beyond the sexually harmful behaviour itself. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, voluntary adherence to non-pharmaceutical interventions (NPIs) was imperative to control the spread of the virus. The emergence of pandemic fatigue, however, may militate against public compliance with these interventions. Although existing literature has examined pandemic fatigue, little attention has been given to the spatio-temporal characteristics within a city. Focusing on the stay-at-home recommendation during COVID-19 in Hong Kong, this study employed road speed as a proxy to investigate pandemic fatigue. Temporally, the development of the pandemic and public concerns are investigated. Spatially, variables in four categories (i.e. socioeconomic, home environment, land use and COVID-related) are examined. Despite the same level of NPIs, changes in traffic were observed, indicating the emergence of pandemic fatigue. A positive correlation between adherence to NPIs and public interest in the ‘living with COVID’ policy is found. Spatially, areas with more older people demonstrated a high compliance rate. Findings suggest that by using road speed as a proxy for pandemic fatigue, potential factors in both spatial and temporal dimensions can be unveiled. Policy implications for future public health crises are also discussed. [ABSTRACT FROM AUTHOR]

Background: Telehealth-facilitated models of palliative care are a patient-focused way to deliver specialist care in or closer to home for people with a life-limiting illness. Telehealth can increase access to palliative care and support people experiencing symptoms of advanced disease in their own home, reducing the discomfort of travel. This retrospective cohort study examines the activity and outcomes of a regional telehealth-facilitated palliative care service to (i) describe which patients are most likely to use telehealth; and (ii) explore possible impacts of telehealth on patient outcomes including place of death, timely access to care, responsiveness to urgent needs and pain management. Methods: Analysis of service activity data (patient demographics, care modality, consultation frequency) and Palliative Care Outcomes Collaborative data registry (place of death, timely access to palliative care, responsiveness to urgent needs as measured by time in unstable phase, pain management) were undertaken. Outcomes were compared between patients who had no videoconsultations (n = 683) and those who had one or more videoconsultations (n = 524). Results: Compared to people who had no videoconsultations, those who had at least one appointment via video were: more than twice as likely to die at home and spent a shorter amount of time in the unstable phase of palliation. Mixed results were found regarding timely access to palliative care. There was no significant difference in pain management between consultation modes. Conclusion: Telehealth-facilitated palliative care has multiple benefits, including the increased likelihood of fulfilling someone's wish to die at home, often their preferred place of death. [ABSTRACT FROM AUTHOR]

This study used structural equation model (SEM) to investigate the mechanism of integrated development of rural industries (IDRI) on the performance of college students' returning entrepreneurial enterprises (CSREE). The results show that: (1) IDRI significantly promotes the performance of CSREE, which is consistent with the theory of "sixth industry". (2) The length, width, and depth of rural industrial integration have a significant effect on CSREE. Among them, the depth of rural industrial integration has the greatest degree of direct influence on CSREE, followed by the width of rural industrial integration, and finally the length of rural industrial integration. (3) IDRI indirectly has a positive impact on the performance of CSREE through internal technological innovation ability and cooperative development ability. Seize the great opportunity of rural integration development to further improve the performance of CSREE. The specific ways are as follows: (1) The government should make overall planning, first determine the local leading industries, establish the whole industrial chain, and give full play to the various functions of agriculture. At the same time, the government should actively guide agricultural enterprises to develop in the direction of internal integration of planting and breeding, three-dimensional agriculture, and other industries, extend the length of the industrial chain, broaden the width of the industrial chain, and deepen the depth of industrial integration, so as to optimize the external environment for college students to return home and start businesses. (2) In the process of returning to their hometowns to start businesses, college students should attach importance to improving internal technological innovation capability and cooperation development capability, cultivate "internal strengths", and comprehensively improve enterprise performance. [ABSTRACT FROM AUTHOR]

Objective The transition from the neonatal intensive care unit (NICU) to the home is complex and multifaceted for families and infants, particularly those with ongoing medical needs. Our hospital utilizes a remote monitoring program called Growing @ Home (G@H) to support discharge from the NICU with continued nasogastric tube (NGT) feeds. We aim to describe the experience of the transition from NICU to home for families enrolled in G@H. Study Design Using a semistructured interviewing technique, parents of infants discharged on G@H were interviewed at NICU discharge, at 1 month, and at 6 months after NICU discharge. Interviews were recorded and transcribed into data analysis software. Conventional content analysis was used to analyze qualitative data. Codes were assigned to describe key elements of the interviews and used to identify major themes. Results Parents (n = 17) identified three major themes when discussing the effect of G@H on the transition to home. The program provided a means of escape from the NICU, allowing families to stop living split lives between their homes and the NICU. It acted as a middle ground between the restrictive yet supportive NICU environment, and the normal yet isolated home environment. G@H served as a safety net for families, providing a continued connection to the NICU for their still-fragile infants. Conclusion G@H utilizes telehealth to positively support the complex transition from NICU to home for families and infants discharged with NGT feeds. Key Points G@H program supported parents in their transition from NICU to home. G@H program provided a means of escape from the NICU. G@H program was a middle ground between the NICU and home. G@H program created a safety net after discharge. Follow-up with a consistent provider was essential to a positive parent experience. [ABSTRACT FROM AUTHOR]

Background: In the United Kingdom, specialist teams managing crises in dementia make efforts to reduce inpatient admissions by supporting people to live for longer in their own homes. However, fluctuations in the health and social circumstances of both the person with dementia and/or their family caregiver can lead to 'crisis': a breakdown in home care often leading to inpatient admissions. At this point, a team managing crises in dementia (TMCD) might become involved. These multidisciplinary teams begin with a rapid assessment to establish the needs of the person with dementia and their caregiver(s), followed by intensive but short-term interventions to reduce the risk of inpatient admission. There is little evidence as to how family caregiver experience input from a TMCD. Methods: A thematic analysis of qualitative interviews with caregivers supporting a family member with dementia to live at home and who have received support from a TMCD. Results: The personal troubles of family caregivers are intertwined with their experience of engaging with and trying to gain support from human services, particularly TMCDs. While respondents describe how specific individuals have addressed or added to the troubles they face, the most impactful interventions from their perspectives are medication for managing challenging behaviour and knowing that there is a service they can telephone in a crisis. Conclusions: Efforts to reduce inpatient admissions by supporting people to live in their own homes for as long as is practicable, even when carers may have reached the limits of their caring capacities, can, at best, only delay inpatient to long-stay residential accommodation. This is because when one frail older person has the responsibility of caring for another frail older person, even with support from TMCD and other health and social care services, crises are difficult to manage. [ABSTRACT FROM AUTHOR]

Background/Objectives: With the gradual increase in population aging and the prevalence of the empty nest, community elderly care services have become an effective service model for responding to population aging because they can alleviate the decline in family care function and meet the needs of elderly homecare patients. This paper aims to identify the influence mechanism of the accessibility of community elderly care services on the quality of life of the elderly. Methods: This paper surveyed a total of 949 elderly people and adopted the interview questionnaire survey method, and it used ordered logistic regression to analyze the impact of accessibility on the quality of life of the elderly. Results: The study finds that approachability, availability, acceptability, and accommodation affect the living environment satisfaction of the elderly. Accessibility affects environmental satisfaction by influencing the service utilization frequency, and accessibility affects the psychological health and environmental satisfaction of the elderly by influencing service utilization satisfaction. Conclusions: The improvement of accessibility can increase service utilization and, thus, improve the welfare of the elderly. So, the government should improve the accessibility of community elderly care services. [ABSTRACT FROM AUTHOR]

Background: Evaluating individual health outcomes does not capture co-morbidities children experience. Purpose: We aimed to describe profiles of child neurodevelopment and anthropometry and identify their predictors. Methods: Using data from 501 mother-child pairs (age 3-years) in the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a prospective cohort study, we developed phenotypic profiles by applying latent profile analysis to twelve neurodevelopmental and anthropometric traits. Using multinomial regression, we evaluated odds of phenotypic profiles based on maternal, sociodemographic, and child level characteristics. Results: For neurodevelopmental outcomes, we identified three profiles characterized by Non-optimal (9%), Typical (49%), and Optimal neurodevelopment (42%). For anthropometric outcomes, we observed three profiles of Low (12%), Average (61%), and Excess Adiposity (27%). When examining joint profiles, few children had both Non-optimal neurodevelopment and Excess Adiposity (2%). Lower household income, lower birthweight, younger gestational age, decreased caregiving environment, greater maternal depressive symptoms, and male sex were associated with increased odds of being in the Non-optimal neurodevelopment profile. Higher pre-pregnancy body mass index was associated with increased odds of being in the Excess Adiposity profile. Conclusions: Phenotypic profiles of child neurodevelopment and adiposity were associated with maternal, sociodemographic, and child level characteristics. Few children had both non-optimal neurodevelopment and excess adiposity. [ABSTRACT FROM AUTHOR]

We developed a deep learning–based extraction of electrocardiographic (ECG) waves from ballistocardiographic (BCG) signals and explored their use in R–R interval (RRI) estimation. Preprocessed BCG and reference ECG signals were inputted into the bidirectional long short-term memory network to train the model to minimize the loss function of the mean squared error between the predicted ECG (pECG) and genuine ECG signals. Using a dataset acquired with polyvinylidene fluoride and ECG sensors in different recumbent positions from 18 participants, we generated pECG signals from preprocessed BCG signals using the learned model and evaluated the RRI estimation performance by comparing the predicted RRI with the reference RRI obtained from the ECG signal using a leave-one-subject-out cross-validation scheme. A mean absolute error (MAE) of 0.034 s was achieved for the beat-to-beat interval accuracy. To further test the generalization ability of the learned model trained with a short-term-recorded dataset, we collected long-term overnight recordings of BCG signals from 12 different participants and performed validation. The beat-to-beat interval correlation between BCG and ECG signals was 0.82 ± 0.06 with an average MAE of 0.046 s, showing practical performance for long-term measurement of RRIs. These results suggest that the proposed approach can be used for continuous heart rate monitoring in a home environment. [ABSTRACT FROM AUTHOR]

Introduction: Deep brain stimulation (DBS) is approved under a humanitarian device exemption to manage treatment-resistant obsessive-compulsive disorder (TR-OCD) in adults. It is possible that DBS may be trialed or used clinically off-label in children and adolescents with TR-OCD in the future. DBS is already used to manage treatment-resistant childhood dystonia. Evidence suggests it is a safe and effective intervention for certain types of dystonia. Important questions remain unanswered about the use of DBS in children and adolescents with TR-OCD, including whether mental health clinicians would refer pediatric patients for DBS, and who would be a good candidate for DBS. Objectives: To explore mental health clinicians' views on what clinical and psychosocial factors they would consider when determining which children with OCD would be good DBS candidates. Materials and Methods: In depth, semi-structured interviews were conducted with n = 25 mental health clinicians who treat pediatric patients with OCD. The interviews were transcribed, coded, and analyzed using thematic content analysis. Three questions focused on key, clinical, and psychosocial factors for assessing candidacy were analyzed to explore respondent views on candidacy factors. Our analysis details nine overarching themes expressed by clinicians, namely the patient's previous OCD treatment, OCD severity, motivation to commit to treatment, presence of comorbid conditions, family environment, education on DBS, quality of life, accessibility to treatment, and patient age and maturity. Conclusions: Clinicians generally saw considering DBS treatment in youth as a last resort and only for very specific cases. DBS referral was predominantly viewed as acceptable for children with severe TR-OCD who have undertaken intensive, appropriate treatment without success, whose OCD has significantly reduced their quality of life, and who exhibit strong motivation to continue treatment given the right environment. Appropriate safeguards, eligibility criteria, and procedures should be discussed and identified before DBS for childhood TR-OCD becomes practice. [ABSTRACT FROM AUTHOR]

Gesture recognition has a crucial role in Human–Computer Interaction (HCI) and in assisting the elderly to perform automatically their everyday activities. In this paper, three methods for gesture recognition and computer vision were implemented and tested in order to investigate the most suitable one. All methods, machine learning using IMU, machine learning on device, and were combined with certain activities that were determined during a needs analysis research. The same volunteers took part in the pilot testing of the proposed methods. The results highlight the strengths and weaknesses of each approach, revealing that while some methods excel in specific scenarios, the integrated solution of MoveNet and CNN provides a robust framework for real-time gesture recognition. [ABSTRACT FROM AUTHOR]

This case study explores the story of Eva, a 37-year-old woman who has embarked on a journey of psychotherapy to navigate the complexities of her past traumas and their manifestations in her present inability to set boundaries and assert her needs. The narrative unfolds through the intersubjective therapeutic relationship with a novice therapist who is also grappling with personal issues of competence and parallel dynamics of past abuse. The case illuminates the complexities of Eva's life, from her violent childhood and oppressive family environment that demanded success at all costs to her traumatic experiences in academia and romantic relationships. Through the lens of intersubjective-systems theory and focusing on Brandchaft's systems of pathological accommodation, the paper explores the patient's struggle with self-cohesion and the internalized need to accommodate others to maintain a sense of security and attachment. The therapeutic encounter, characterized by a twinship in trauma becomes a site of transformation in which both patient and therapist navigate their vulnerabilities and strengths. The turning point in therapy occurs when the therapist inadvertently assumes the role of an authoritative figure, prompting Eva to express her own experience assertively. [ABSTRACT FROM AUTHOR]

The possibilities of the Ambient Assisted Living (AAL)/Enhanced Living Environments (ELE) concept in the environment of a smart home were investigated to improve accessibility and improve the quality of life of a person with disabilities. This paper focuses on the concept of predictive information for a person with disabilities in a smart home environment concept where artificial intelligence (AI) and machine learning (ML) systems use data on the user's preferences, habits, and possible incident situations. A conceptual mathematical model is proposed, the purpose of which is to provide predictive user information from defined data sets. This paper defines the taxonomy of communication technologies, devices, and sensors in the environment of the user's smart home and shows the interaction of all elements in the environment of the smart home. Through the integration of assistive technologies, it is possible to adapt the home to users with diverse types of disabilities and needs. The smart home environment with diverse types of sensors whose data are part of sets defined by a mathematical model is also evaluated. The significance of establishing data sets as a foundation for future research, the development of ML models, and the utilization of AI is highlighted in this paper. [ABSTRACT FROM AUTHOR]

Reintegrating forensic mentally ill patients back into their families is difficult. This study explored the factors contributing to the reluctance of families to accept forensic mentally ill rehabilitated patients. The study engaged five families of rehabilitees who have undergone rehabilitation at Hayani Psychiatric Hospital. The findings highlighted the persistent trauma and anxiety among caregivers, leading to a preference for continued institutional care or halfway house placement. The study highlighted the significance of integrated service programs addressing caregivers' specific challenges faced by family caregivers of mental relatives to facilitate successful family reunification and community integration. [ABSTRACT FROM AUTHOR]

Objectives: Infant temperament is assumed to be primarily innate. However, newer research suggests that maternal affection impacts ratings of temperament and environmental factors, including feeding method, can also influence infant temperament. This study investigates child temperament and its relationships with maternal psychiatric symptoms, environmental variables and feeding method longitudinally in a cohort of children followed from 6 to 72 months. Differences in temperament by feeding group are also investigated. We hypothesized that maternal psychiatric symptoms, environmental stressors, and impaired family dynamics would have negative impact on child temperament, whereas breastfeeding would have a positive impact on child temperament. Method: Mothers' ratings of child's temperament, own psychiatric symptomatology, environmental stresses and family cohesion were obtained in 504 mother‐infant dyads via rating scales completed by mothers. Infants were breastfeed (BF), fed soy‐based infant formula (SF) or dairy‐based infant formula (MF). Linear mixed effect models investigated the relationship of variables on child's temperament while controlling for significant covariates and repeated measurements. Results: Mothers in this study did not endorse clinical‐level psychiatric symptomatology; however, when adjusted for significant covariates, higher psychiatric symptomatology significantly correlated with environmental stressors, impaired family dynamics and elevations in temperament ratings of infants' adaptability and mood. There were no lasting differences for temperament between feeding groups. However, some significant transient increases in rhythmicity and adaptability were found between SF and BF children. Conclusion: Positive relationships between family environment stressors and maternal psychiatric ratings were found. Transient differences were found in child temperament based upon feeding method. Key messages: This study population was comprised of mothers with subthreshold self‐ratings of psychiatric difficulties. However, ratings showed more psychiatric difficulties correlated with environmental stressors, impaired family dynamics and elevations in some temperament ratings when adjusted for significant covariates.Infants stratified based upon feeding groups (breastfed; soy fed; milk‐fed) showed transient difficulties in rhythmicity and adaptability between soy and breastfed children, but these differences did not remain.Results suggest that environmental stress and subthreshold maternal psychological well‐being should be taken into account when exploring child temperament and feeding practices at young ages. [ABSTRACT FROM AUTHOR]

Background: India contributes to the maximum of the world's health burdens attributable to tobacco use. Exposure to secondhand smoke (SHS) is also associated with adverse health effects, causing 1.2 million deaths worldwide each year. In Delhi, 28.0% had SHS exposure at public places. About one-fifth experienced exposure to SHS at workplace. This study aimed to determine the prevalence of SHS exposure among adults in an urbanized village in Delhi. Materials and Method: It was a community-based cross-sectional house-to-house survey conducted between January 2020 and June 2021 in Aliganj, an urbanized village in Delhi. A total of 490 residents ≥15 years were included using simple random sampling. The interview was conducted by the primary author using the Global Adult Tobacco Survey (GATS). Each subject enrolled in the study was explicitly informed of the purpose of the study by the investigator and provided written informed consent before enrolment. Data were checked for errors, entered in Microsoft Excel, and analyzed in Statistical Package for the Social Sciences (SPSS). Results: Of the 490 participants, 14.7% were exposed to SHS in their house and 16.1% were exposed to SHS outside the house in the last 1 month. The majority (85.3%) believed secondhand smoking is harmful, 6.5% disagreed, and the rest were unaware. Conclusion: Though most participants knew that exposure to SHS can cause serious illness, further awareness sessions need to be conducted to improve knowledge and understanding and reduce exposure to secondhand tobacco smoke in homes. Strict adherence to no-smoking policies should be implemented as per law to reduce exposure to SHS in public areas. [ABSTRACT FROM AUTHOR]

The daily reminders of life's fragility can lead to moral, emotional, and psychological distress. Establishing clear boundaries between work and non-work environments is a suggested approach to mitigate these adverse effects. Drawing on van Gennep's work on rites of passage, this paper explores the rituals and strategies employed by professionals dedicated to the dying/deceased to transition between their work and home environments. Through a qualitative interpretive phenomenological analysis of 23 in-depth semi-structured interviews with Israeli hospice social workers and undertakers, two main strategies emerged as "rites of passage": Physical Purification and Escapism. However, participants noted that these rituals were not always foolproof, with instances of "leakage" where elements from the realm of death and dying carried over into their personal lives. The study suggests that engaging in idiosyncratic rituals plays a crucial role in facilitating the reintegration of professionals involved in the care of the dead and dying, offering a means of expressing and containing challenging emotions and providing structure during the transitional phase. [ABSTRACT FROM AUTHOR]

Poor-quality diets are a major risk factor for noncommunicable diseases. Few studies in Mexico have tested whether higher expenditures are needed to purchase high-quality food. The objective of the study was to assess how dietary quality of food purchases was associated with household food at home expenditures. This study was a secondary analysis of cross-sectional data from the National Household Income and Expenditure Survey (Encuesta Nacional de Ingresos y Gastos de los Hogares [ENIGH] 2018). The study included 74 469 households with information on food and beverage purchases in Mexico in 2018. Quarterly household food at home expenditures by adult equivalent (AE) for all food groups that were scored with the Global Dietary Quality Score (GDQS) for food purchases expressed in dollars/quarterly/AE. Adjusted generalized linear models were used to evaluate the association between GDQS for food purchases (expressed in tertiles: low, mid, and high) and quarterly food expenditures. The analyses were performed at the national level by place of residence and income quintile. At the national level, the difference in food expenditures between the high- and the low-GDQS groups was +$13.85/AE. By place of residence, the difference between the high- and the low-GDQS groups was +$17.31/AE in urban and +$5.12/AE in rural areas. For income quintile 1 (lowest), there was a statistical difference of –$4.79/AE and +$43.25 for quintile 5 (highest). Quality of food purchases can be associated with higher or lower expenditures depending on the specific food purchased. High GDQS is associated with lower expenditures among the lowest-income households as they purchase less expensive options compared with high-income households. [ABSTRACT FROM AUTHOR]

Usability of home use medical devices is complex, multidimensional and multifactorial. The design of such devices must accommodate a range of users, including patients, caregivers, and hospital staff, as well as the potential impact of human-human interaction through the device. In this study, we analyse the impact of the hospital context on the usability of a medical device used for post-ambulatory monitoring. We enrolled 28 patients and 20 student physicians in an ambulatory surgery system simulation. After the simulation, we conducted both focus groups and interviews to gather both quantitative and qualitative data to measure the usability of the medical device. The results show that exchanges during the consultation with the anaesthetist have a definite impact on the device's usability by modifying the user's perceived risk. Even if the device is intuitive to use, its usability is dependent on the context of use and the projection of the users. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has affected working women's well-being in different ways due to contrasting national responses. This article focuses on the specific context of Singapore, which implemented differentiated rules for workers: essential workers continued to report to workplaces, while non-essential workers were required to work from home. This policy had far-reaching implications for working women, who are more likely than husbands to juggle paid work and household duties. The article uses longitudinal data collected in 2018 and during the pandemic in 2020, specifically during Singapore's lockdown period, to measure changes in 287 working women's self-reported levels of stress, fatigue, and quality of interpersonal relationships by essential worker status. While all workers were affected by the pandemic, female essential workers were more likely than their non-essential peers to report declines in stress levels from 2018 to 2020, and less likely to report changes in spousal relationships, both positive and negative. Findings suggest that the differences were driven by exposure to quarantine conditions faced by non-essential workers. Our results highlight the importance of policies supporting frontline workers and more gender-equitable labour market policies to support married women juggling the twin demands of employment and household responsibilities. [ABSTRACT FROM AUTHOR]

Children learn language by listening to speech from caregivers around them. However, the type and quantity of speech input that children are exposed to change throughout early childhood in ways that are poorly understood due to the small samples (few participants, limited hours of observation) typically available in developmental psychology. Here we used child‐centered audio recorders to unobtrusively measure speech input in the home to 292 children (aged 2–7 years), acquiring English in the United States, over 555 distinct days (approximately 8600 total hours of observation, or 29.62 h/child). These large timescales allowed us to compare how different dimensions of child‐directed speech input (quantity, burstiness) varied throughout early childhood. We then evaluated the relationship between each dimension of input and children's concurrent receptive vocabulary size. We found that the burstiness of speech input (spikes of words) was a stronger correlate with age than the quantity of speech input. Input burstiness was also a stronger predictor than input quantity for children's vocabulary size: children who heard spiky, more intense bouts of input had larger vocabularies. Overall, these results reaffirm the importance of speech input in the home for children's language development and support exposure–consolidation models of early language development. [ABSTRACT FROM AUTHOR]

Background: Regular physical activity (PA) decreases the risk of comorbidities associated with a sedentary lifestyle in individuals with intellectual disabilities (IDs). They also may experience additional barriers that may prevent PA, including access, proper instruction and support. At‐home PA programming is a feasible alternative to long‐term adherence. This study aimed to determine (1) how an at‐home DVD programme affects PA adherence and (2) the extent to which caregiver support influences PA. Methods: Thirty‐one adolescent or adult‐aged participants with mild or moderate ID were randomised into a DVD or control group exercise intervention. Participants were given autonomy to choose what type of PA modality from the intervention they would like to participate in. Caregiver support during the PA was also measured. Results: The two‐way repeated‐measures MANOVA demonstrated that the intervention DVD group was statistically significant, with a large effect size in PA minutes (P = 0.014, ηP2 = 0.236) and rate of perceived exertion (P = 0.002, ηP2 = 0.342) compared with the control group. Conclusions: The findings demonstrated that using an adapted DVD increased PA minutes and the rate of perceived exertion without high levels of caregiver support. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Numerous studies have investigated the associations between the home literacy environment (HLE) and children's word reading skills. However, these associations may partly reflect shared genetic factors since parents provide both the reading environment and their child's genetic predisposition to reading. Hence, the relationship between the HLE and children's reading is genetically confounded. To address this, parents' reading abilities have been suggested as a covariate, serving as a proxy for genetic transmission. The few studies that have incorporated this covariate control have made no distinction between the HLE reported by each parent or controlled for different skills in parents and children. We predicted children's reading development over time by the reading abilities of both parents as covariates and both parents' self‐reported HLE as predictors.We analyzed data from 242 unrelated children, 193 mothers, and 144 fathers. Children's word reading was assessed in Grades 1 and 3, and parents' word reading was assessed on a single occasion. Predictors of children's reading development included literacy resources and shared reading activities.Children's reading in Grade 3 was predicted by mothers' engagement in reading activities and by literacy resources at home, even after controlling for the genetic proxy of parental reading abilities. The longitudinal rate of change from Grades 1 to 3 was not associated with the HLE or parental reading.Our finding that parental reading skills predicted children's word reading beyond children's initial word reading underscores the importance of considering genetic confounding in research on the home environment. Beyond parental reading abilities, children's skills were predicted by literacy resources in the home and by how often mothers engage in reading activities with their children. This suggests true environmental effects. [ABSTRACT FROM AUTHOR]

Aim: To develop a trigger tool for parents and lay caregivers of children with medical complexity (CMC) at home and to validate its content. Design: This was a multi‐method study, using qualitative data, a Delphi method and a concept mapping approach. Methods: A three‐round electronic Delphi was performed from December 2021 to April 2022 with a panel of 23 expert parents and 30 healthcare providers, supplemented by a preliminary qualitative exploration of children's signs of deterioration and three consensus meetings to develop the PArents' Trigger Tool for Children with Medical Complexity (PAT‐CMC). Cognitive interviews with parents were performed to assess the comprehensiveness and comprehensibility of the tool. The COREQ checklist, the COSMIN guidelines and the CREDES guidelines guided the reporting respectively of the qualitative study, the development and content validity of the trigger tool and the Delphi study. Results: The PAT‐CMC was developed and its content validated to recognize clinical deterioration at home. The tool consists of 7 main clusters of items: Breathing, Heart, Devices, Behaviour, Neuro‐Muscular, Nutrition/Hydration and Other Concerns. A total of 23 triggers of deterioration were included and related to two recommendations for escalation of care, using a traffic light coding system. Conclusion: Priority indicators of clinical deterioration of CMC were identified and integrated into a validated trigger tool designed for parents or other lay caregivers at home, to recognize signs of acute severe illness and initiate healthcare interventions. Impact: The PAT‐CMC was developed to guide families in recognizing signs of deterioration in CMC and has potential for initiating an early escalation of care. This tool may also be useful to support education provided by healthcare providers to families before hospital discharge. Patient or Public Contribution: Parents of CMC were directly involved in the selection of relevant indicators of children's clinical deterioration and the development of the trigger tool. They were not involved in the design, conducting, reporting or dissemination plans of this research. [ABSTRACT FROM AUTHOR]

Aims: To describe the process of breastfeeding relationships among stay‐at‐home mother and infant dyads at 1, 3, 5 and 6 months. Design: A longitudinal qualitative online survey design was used. Methods: Data were obtained at 1, 3, 5 and 6 months from 26 breastfeeding mothers who stayed home with their infants and directly breastfed at least once a day for the first 6 months between June 2022 and August 2023. Mothers' written responses to 3 open‐ended questions were analysed to assess breastfeeding experiences at home, thoughts/comments while directly breastfeeding and breastfeeding concerns/problems and strategies they used. Based on grounded theory, inductive content analysis was used to analyse the data. Trustworthiness of results was established by coding to consensus, formal peer debriefing and maintaining an audit trail. Results: 'Breastfeeding Relationships at Home,' the core construct, was identified and organized the process of breastfeeding relationships into 5 domains: (1) mothers' emotional well‐being while breastfeeding, (2) infant‐led feeding, (3) alternatives to breastfeeding, (4) evaluation of breastfeeding and (5) changes in breastfeeding as infants grow older. Conclusion: Breastfeeding is not simply about feeding breast milk but also involves nurturing and developing a relationship between mother and infant. Across the domains, mutual responsiveness, a central element of the breastfeeding relationship was clear. Mothers who were committed to breastfeeding with embedded infant suckling reached emotional well‐being in return for their engagement which has potential to reduce maternal stress and prevent postpartum depression. Impact: Findings from the current study add to nurses' knowledge about the relationship building process between stay‐at‐home mothers and their infants in the first 6 months of breastfeeding during the COVID‐19 pandemic. Nurses must remain sensitive to aid the development of breastfeeding relationships in the home environment to maximize mutual responsiveness. Patient or Public Contribution: No patients or public involved. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore home care nurses' experience of enablers and barriers for planned home death in municipal health care. Design: A focused ethnography. Methods: This qualitative study collected data from 20 semi‐structured interviews of home care nurses and 8.5 h of participant observations. Data was analyzed using thematic analysis. Results: The findings in our study show that home care nurses consider supportive cultures, a commitment to safety and continuity when facilitating planned home deaths and family rotations to be enablers for planned home deaths. Barriers to planned home deaths involve a lack of palliative experience affecting confidence, shortages of nurses and medical supplies and night shift challenges. Conclusion: This study underscores the need for supportive organizational cultures, ongoing education and improved communication and staffing policies to enhance the quality of care and the experiences of patients and home care nurses, especially in the context of planned home deaths. Impact: The study adds knowledge to the evidence base of the practice of facilitating planned home deaths. The findings of the study could offer valuable insights for shaping future policies or devising effective implementation strategies. Reporting Method: Adherence to the COREQ guidelines for reporting qualitative research was maintained. Patient or Public Contribution: No patient or public contribution. What Does this Article Contribute to the Wider Global Clinical Community?: Identified enablers and barriers provide a new perspective, contributing to a comprehensive understanding of planning home deaths.The study emphasizes supportive cultures, safety commitment and family rotations as crucial for planned home deaths, guiding healthcare professionals to adopt best practices and enhance palliative care quality. [ABSTRACT FROM AUTHOR]

With the outburst of social medias in current life, problematic use is prevalent in adolescents and has become a contemporary concern. Although family environment has been identified as a risk factor, little is known how family environment is associated with problematic social media use (PSMU). Drawing on Snyder's hope theory and Davis's cognitive-behavioral model, this study examines how family function is linked with PSMU via hope. The study also investigates the moderating effect of perceived social support (PSS) by analyzing how PSS, interacts with family function, affects hope and further influences PSMU. The moderated mediation analyses of data from 1373 adolescents from vocational schools (343 boys and 1030 girls, Mage = 15.56) reveal family function is negatively associated with adolescents' PSMU, and the association is partially mediated by hope. Furthermore, PSS buffers the negative relation between family function and hope. [ABSTRACT FROM AUTHOR]

Purpose: This study develops the evidence-base of interventions for inappropriate sexualised behaviour following brain injury involving adolescents. Materials and Methods: We describe a Single-Case Multiple Baseline Design intervention of Positive Behavioural Support (PBS) across settings. It involves a 16 year old adolescent who had a severe Traumatic Brain Injury (TBI) and presented with sexualised talk and touch. PBS may potentially be a successful intervention to remediate this. The aim of the article was to determine whether PBS could reduce the frequency and impact of the sexualised behaviour in a variety of his key daily settings. Visual and quantitative analyses were completed before and after the introduction of the PBS intervention within home and school settings. Results: Findings showed reduction in the frequency of sexualised talk and touch alongside subjective impact ratings in the home. Downward trends were encouraging in the school settings, but demonstrated smaller effects than home. The Overt Behaviour Scale showed a reduction in overall severity and the impact on others. Conclusions: This study shows the promising impact on behaviour of introducing the PBS intervention within the home and school settings to support positive clinical change evidenced in the reduction in target behaviours and subjective response for caregivers. IMPLICATIONS FOR REHABILITATION: Positive Behavioural Support is an effective intervention for managing inappropriate sexualised behaviour in a young person with a traumatic brain injury. Positive Behavioural Support can improve the subjective experience of the young person and their caregivers in parallel to managing behaviour. Single Case Experimental Design can be utilised across care and home settings for measuring change in person-centred interventions. [ABSTRACT FROM AUTHOR]

Background: Data from randomized trials evaluating the effectiveness of tuberculosis (TB) preventive treatment for contacts of multidrug-resistant (MDR)-TB are lacking. Two recently published randomized trials that did not achieve statistical significance provide the opportunity for a meta-analysis. Methods: We conducted combined analyses of two phase 3 trials of levofloxacin MDR-TB preventive treatment -- Levofloxacin for the Prevention of Multidrug-Resistant Tuberculosis (VQUIN) trial and the Levofloxacin preventive treatment in children exposed to MDR-TB (TB-CHAMP) trial. Following MDR-TB household exposure, VQUIN enrolled mainly adults in Vietnam; TB-CHAMP enrolled mainly young children in South Africa. Random assignment in both trials was 1:1 at the household level to daily levofloxacin or placebo for 6 months. The primary outcome was incident TB by 54 weeks. We estimated the treatment effect overall using individual participant data meta-analysis. Results: The VQUIN trial (n=2041) randomly assigned 1023 participants to levofloxacin and 1018 participants to placebo; TB-CHAMP (n=922) assigned 453 participants to levofloxacin and 469 participants to placebo. Median age was 40 years (interquartile range 28 to 52 years) in VQUIN and 2.8 years (interquartile range 1.3 to 4.2 years) in TB-CHAMP. Overall, 8 levofloxacin-group participants developed TB by 54 weeks versus 21 placebo-group participants; the relative difference in cumulative incidence was 0.41 (95% confidence interval [CI] 0.18 to 0.92; P=0.03). No association was observed between levofloxacin and grade 3 or above adverse events (risk ratio 1.07, 95% CI 0.70 to 1.65). Musculoskeletal events of any grade occurred more frequently in the levofloxacin group (risk ratio 6.36, 95% CI 4.30 to 9.42), but not among children under 10 years of age. Overall, four levofloxacin-group participants and three placebo-group participants had grade 3 events. Conclusions: In this meta-analysis of two randomized trials, levofloxacin was associated with a 60% relative reduction in TB incidence among adult and child household MDR-TB contacts, but with an increased risk of musculoskeletal adverse events. (Funded by the Australian National Health and Medical Research Council, UNITAID, and others.) [ABSTRACT FROM AUTHOR]

Background The incidence of delay language development in early childhood is high, and the early recognition rate is low, which has a significant negative impact on the early childhood development of other dimensions. The family cognitive environment is a key factor affecting early childhood language development. Objective This study aimed to explore the influence of family cognitive environment on early childhood language development, and provide theoretical basis for promoting early childhood language development from the perspective of community intervention on family cognitive environment. Methods A retrospective case-control study was conducted on 4 307 children who were admitted to a community child healthcare department in Shanghai from 2018 to 2020. The Shanghai Pediatric Development Screening Scale Ⅱ (DenverⅡ) was used for developmental screening, which was conducted at the child's age of 1, 2, and 3 years old. A total of 172 children with delay language development were selected as the case group, and 516 children with normal language development were included in the control group, which was determined by the matching factor of age, with a ratio of the number of children in the case and control groups being 1∶3. The following information of children in both groups were collected, including children's basic birth characteristics, parental demographic characteristics, maternal pregnancy and childbirth characteristics, and family cognitive environment characteristics. The Logistic regression analysis was used to explore the influencing factors of delay early childhood language development. Results A total of 172 children with delayed early language development had an incidence rate of 3.99%, among them ,1-year-old, 2-year-old, and 3-year old children accounted for 33.14% (57 cases), 53.49% (92 cases), and 13.37% (23 cases), respectively. The proportions of male children, children with premature birth, and children with maternal education of high school and below were higher in the case group than those in the control group (P

The article focuses on the essential factors that enable people with dementia to live independently and securely. Topics include the importance of social support and meaningful activities in fostering a sense of belonging, the role of safe and accessible environments in reducing disorientation, and the need for greater societal inclusion to ensure that people with dementia are valued and heard.

The indoor environment refers to the conditions within a building, including thermal comfort, air quality, lighting, and noise levels. However, the association between the indoor environment and the intention to enter nursing homes among older adults with functional limitations remains unclear. Therefore, this study examined the association of indoor environmental factors with intention to enter nursing homes within this population. Cross-sectional data from the Japan Gerontological Evaluation Study-Home Care 2022. This study included 3202 adults aged ≥65 years, certified under the Japanese long-term care insurance system, and living at home. Intention to enter nursing homes was assessed by asking the participants if they were considering entering a nursing home. The indoor environment was assessed using the Comprehensive Assessment System for Built Environment Efficiency Housing Health Checklist, which includes 5 items: cooling, heating, acoustic, odor, and lighting environments. Logistic regression was used to examine the association between these 5 items and consideration of nursing home admissions. Approximately 43.0% of participants had considered nursing home admission. After adjusting for sociodemographic factors, economic status, health, and long-term care–related factors, the overall indoor environment score, which includes 5 items, was negatively related to nursing home admission. The results of this study revealed that better indoor environments in terms of cooling, heating, acoustics, odor, and lighting could potentially delay nursing home admission. Integrating the assessments of these indoor environmental factors into policy frameworks may enhance the effectiveness of long-term care strategies and promote aging. [ABSTRACT FROM AUTHOR]

• Race may moderate the relationship between suicidality, criminal behavior, and home gun access. • The association between criminal behavior and home gun access is similar in magnitude by race. • The association between suicidality and home gun access is stronger for Black adolescents. • Findings have implications for racially-informed means reduction strategies. Prior empirical research has generally focused on suicidality or criminal behavior as possible correlates of household gun access among adolescents but not both, and this extant research has also not generally addressed whether race or ethnicity moderates these possible correlates even though gun ownership, violence, and suicide in the U.S. are especially defined by race. This research uses data from the first (1994 and 1995; n = 16,525) and second (1996; n = 12,016) in-home waves of the National Longitudinal Study of Adolescent to Adult Health to test two hypotheses which conceptually assert that the effects of prior suicidality and criminal behavior on home gun access vary by race. Consistent with the existing research, the current findings indicate that prior criminal behavior is associated with home gun access, and the magnitude of this empirical association is similar for White, Black, and Hispanic adolescents. In contrast, the current findings indicate that the effect of prior suicidality is moderated by race in that a prior suicide attempt is more positively associated with home gun access among Black relative to White adolescents, an empirical finding that commands greater attention especially given the recent rise in gun suicides among Black children and teens in the U.S. The implications of the current findings for future research and policy are discussed. [ABSTRACT FROM AUTHOR]