UNASSIGNED: Data from recent years show that the COVID-19 pandemic has significantly reduced the scope of child immunisation worldwide. If the numbers continue to fall, we may have a vaccination crisis. In order to understand the local factors of this phenomenon, we studied parents\' viewpoint towards childhood vaccination in Lithuania. Therefore, the aim of our study was to determine the impact of parental attitudes on children\'s vaccination.
UNASSIGNED: A web-based cross-sectional study was made in Lithuania from October 20th to November 3rd, 2020, using Google Forms. An anonymous questionnaire included both quantitative and qualitative questions. The questionnaire was distributed to the general population in Lithuania via social media and a snowball sampling. Only parents who have at least one child under 18 years old were involved in the study. We analysed the parents\' attitudes towards vaccination by their socioeconomic and demographic determinants using MS Excel and OpenEpi tools. The respondents were considered vaccine supporters if they vaccinated all their children with state-reimbursed vaccines or only vaccinated some of their children, and vaccine sceptics if they did not vaccinate their children with state-reimbursed vaccines.
UNASSIGNED: The population of our research consisted of 775 parents. There were more males against vaccination than females, respectively, 59.6% and 33.2%. 65.0% of all respondents stated that they vaccinated their children with the full course of vaccines, while the remaining 35.0% did not vaccinate. University-level education dominated in both pro-vaccine and anti-vaccine groups. We found that 16.9% of parents who were unvaccinated as children themselves tend not to vaccinate their children. However, in the pro-vaxx group, only 0.7% of parents were unvaccinated during childhood. 50.8% of vaccine sceptics were not fully informed by healthcare professionals about the benefits and risks of vaccination, while only 31.6% of vaccine supporters were not informed. Social environment did not have an impact on the decision whether to vaccinate or not to vaccinate a child among both vaccine advocates and vaccine deniers (accordingly, 51.2% and 42.9%). 29.3% of respondents stated that the cost of paid vaccinations was too high. Open-text survey responses gave us more in-depth insight about the parental decision-making process. Protection of children and society from infectious diseases (31.7%) was mentioned as the main reason for vaccination. Whereas vaccine-hesitant parents were mostly concerned about already-occurring side effects or their risk (43.4%).
UNASSIGNED: Our findings confirmed that vaccine hesitancy was associated with not being vaccinated in childhood themselves, lack of information from medical practitioners and male gender. The price of vaccines also had an impact on immunisation rates - more than one-third of the vaccine supporting parents indicated that the cost of paid vaccinations was too high. The main incentive for vaccine compliance was parents\' desire to protect their children and society from infectious diseases. Whereas vaccine-hesitant parents were mostly concerned about already occurring side effects or their risk. There was no consensus, whether vaccination of children should be mandatory in Lithuania, as the answers to the question were almost evenly distributed. The formation of parents\' attitudes towards children\'s vaccination is a complex process that is determined by parents\' attitudes towards the health care system, lack of trust in doctors, and gaps in communication about the benefits and risks of vaccination. All of this information should be taken into account in health policy-making.
UNASSIGNED: Pastarųjų metų duomenys rodo, kad COVID-19 pandemija labai sumažino vaikų imunizacijos mastą visame pasaulyje. Jei skaičiai ir toliau mažės, gali kilti vakcinacijos krizė. Siekdami suprasti lokalias šio reiškinio priežastis, tyrėme tėvų požiūrį į skiepijimą Lietuvoje. Todėl šiuo tyrimu buvo siekiama nustatyti tėvų požiūrio įtaką vaikų skiepijimui.
UNASSIGNED: Lietuvos populiacijoje buvo atliktas skerspjūvio tyrimas nuo 2020 m. spalio 20 d. iki lapkričio 3 d., internete, naudojant ,,Google“ formas. Anoniminėje anketoje buvo pateikti tiek kiekybiniai, tiek kokybiniai klausimai. Anketa buvo išplatinta per socialinius tinklus bei naudojant „sniego gniūžtės“ atranką. Tyrime galėjo dalyvauti tik tėvai, turintys bent vieną vaiką iki 18 metų amžiaus. Gautus duomenis apie tėvų požiūrį į vaikų skiepijimą pagal socialinius, ekonominius ir demografinius veiksnius išanalizavome naudodami MS Excel ir OpenEpi įrankius. Respondentai buvo laikomi skiepų šalininkais, jei jie skiepijo savo vaikus valstybės kompensuojamomis vakcinomis arba skiepijo tik kai kuriuos vaikus. Tuo tarpu, vakcinacijos oponentais – jei neskiepijo savo vaikų valstybės kompensuojamomis vakcinomis.
UNASSIGNED: Mūsų tyrime dalyvavo 775 tėvai. Vakcinacijos oponentų vyrų buvo daugiau nei moterų, atitinkamai 59.6% ir 33.2%. 65.0% visų apklaustųjų nurodė, kad savo vaikus skiepija visu skiepų kursu, o likę 35.0% – neskiepijo. Universitetinis išsilavinimas dominavo tiek vakcinuojančių, tiek nevakcinuojančiųjų grupėse. Nustatėme, kad 16.9% tėvų, kurie patys vaikystėje buvo neskiepyti, yra linkę neskiepyti savo vaikų. Tačiau vakcinuojančiųjų grupėje tik 0.7% tėvų buvo neskiepyti vaikystėje. 50.8% vakcinacijos skeptikų teigė, jog sveikatos priežiūros specialistai neinformavo jų apie skiepijimo naudą ir riziką, tuo tarpu tik 31.6% vakcinacijai pritariančiųjų nebuvo informuoti. Socialinė aplinka neturėjo įtakos apsisprendimui, ar skiepyti vaiką tiek tarp skiepų šalininkų, tiek skiepų oponentų (atitinkamai: 51.2% ir 42.9%). 29.3% respondentų teigė, kad mokamų skiepų kaina yra per didelė. Atviro klausimo atsakymai suteikė mums išsamesnės informacijos apie tėvų sprendimų priėmimo procesą. Pagrindinis skiepijimo motyvas buvo vaikų ir visuomenės apsauga nuo infekcinių ligų (31.7%). Tuo tarpu skiepyti nesiryžę tėvai nerimavo dėl jau pasireiškusių šalutinių poveikių ar jų rizikos (43.4%).
UNASSIGNED: Mūsų išvados patvirtino, kad nenoras skiepyti savo vaikų buvo susijęs su pačių tėvų vakcinacijos statusu vaikystėje, informacijos iš gydytojų stoka ir vyriška lytimi. Skiepijimo apimtims įtakos turėjo ir skiepų kaina – daugiau nei trečdalis skiepijimui pritariančių tėvų nurodė, kad mokamų skiepų kaina yra per didelė. Pagrindinė paskata skiepyti buvo tėvų noras apsaugoti savo vaikus ir visuomenę nuo infekcinių ligų. Tuo tarpu vakcinacijos oponentai dažniausiai nerimavo dėl jau pasireiškusių šalutinių poveikių ar jų rizikos. Vieningos nuomonės, ar Lietuvoje privaloma skiepyti vaikus, nebuvo, nes atsakymai į klausimą pasiskirstė beveik po lygiai. Tėvų požiūrio į vaikų skiepijimą formavimasis yra sudėtingas procesas, kurį lemia tėvų požiūris į sveikatos priežiūros sistemą, nepasitikėjimas gydytojais bei komunikacijos apie skiepijimo naudą ir riziką spragos. Į visus šiuos aspektus reikėtų atsižvelgti formuojant sveikatos politiką.

UNASSIGNED: Various factors are thought to be involved in the development of depression, but the mechanisms are not yet clear. Although several reports have demonstrated that parental attitude experienced in childhood, depressive rumination, and sleep disturbances each influence depressive symptoms, and the association between two of these four variables, to our knowledge, no reports to date have investigated the association among the four variables.
UNASSIGNED: A questionnaire survey was administered to 576 adults who agreed to participate in this study between April 2017 and April 2018. Questionnaires assessed parental attitudes experienced in childhood, depressive rumination, sleep disturbances, and depressive symptoms in adulthood. The associations among the four variables were tested by structural equation modeling.
UNASSIGNED: Regarding the direct effects, the parental attitude of \"care\" had a negative influence on depressive rumination and depressive symptoms, whereas \"overprotection\" had a positive influence on depressive rumination. Depressive rumination had a positive influence on sleep disturbance and depressive symptoms, whereas sleep disturbances had a positive influence on depressive symptoms. Regarding indirect effects, depressive rumination mediated the association between parental attitudes and sleep disturbances or depressive symptoms. Furthermore, sleep disturbances mediated the association between depressive rumination and depressive symptoms. Care and overprotection showed opposite effects. The goodness of fit of this model was high.
UNASSIGNED: The results of this study demonstrated that there were associations among the four variables. Clinical assessment and intervention of depressive rumination and sleep disturbances that are closely associated with previous parental attitudes may lead to an improvement of depressive symptoms.

Obtaining a genetic diagnosis of a primary mitochondrial disease (PMD) is often framed as a diagnostic odyssey. Yet, even after receiving a diagnosis, parents of affected children experience ongoing therapeutic and prognostic uncertainty and considerable psychosocial challenges. Semi-structured interviews (N = 24) were conducted with parents of 13 children (aged 2-19 years) with a genetically confirmed PMD. Paternal (N = 11) and maternal (N = 13) perspectives were obtained, and thematic analysis was performed on all interviews. A genetic diagnosis was valuable and empowering for parents, despite eliciting varied emotional responses. While the diagnosis helped focus management decisions, families often felt overwhelmed and unsupported in navigating the healthcare system. Most parents reported a serious impact on their romantic relationship. The sources of social support varied, with a preference for established friendship and family support networks over disease-specific community support groups. Most parents favored prenatal genetic testing in the event of a future pregnancy. This study provides insight into the lived experiences of parents after a genetic diagnosis of PMD in their children. The findings draw awareness to supportive care needs and highlight important gaps that should be addressed to ensure that parents feel supported within a holistic framework of management for PMDs.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; yet, despite the availability of safe and effective HPV vaccines, only half of eligible adolescents have completed the vaccine series. School-entry requirements are one proven strategy to increase vaccination rates among children and youth and reduce the burden of HPV-related cancer. This study investigated community perceptions of an HPV vaccine school-entry mandate in Virginia and the consequences of a low threshold exemption option included in the legislation. We conducted 40 interviews with community members including 15 interviews with parents, 19 with healthcare providers, and 6 with community leaders. Interviews asked about knowledge, beliefs, and attitudes concerning the HPV vaccine and mandate. Interviews were recorded, transcribed, and thematically analyzed. Despite healthcare provider support for the mandate, there was widespread confusion over the school-entry policy and concern that the exemption option undermined vaccination efforts. Understanding variations in community-level perceptions and response to school-based vaccination mandates is crucial for designing effective public health strategies. Findings suggest statewide vaccination initiatives should preemptively identify low uptake areas and provide targeted information to communities. Future mandates should avoid the use of ambiguous and contradictory language in vaccine-related legislation.

(1) Background: We aimed to analyze the dimensionality, internal consistency, and structural validity of the Preschool Eating, Lifestyle, and Sleeping Attitudes Scale (PRELSA Scale), which is an instrument that was designed to measure obesogenic behaviors. (2) Methods: We carried out an observational study by means of an online survey. The PRELSA Scale consists of 13 dimensions and 60 items relating to the most common obesogenic behaviors and attitudes. Additionally, we obtained sociodemographic characteristics and concrete habits from the sample. We obtained the responses of 791 parents and caregivers of preschool children between 2 and 6 years of age in Andalusia (southern Spain). We analyzed dimensionality through an Exploratory Factor Analysis (EFA), consistency through Cronbach\'s Alpha, structural validity through a Confirmatory Factor Analysis (CFA), and measurement invariance with multigroup CFA models. (3) Results: The EFA showed a 14-dimensional structure with 48 items. The internal consistency was acceptable in all dimensions (Cronbach\'s Alpha range of 0.72 to 0.97). The structure was confirmed in the CFA with good fit indices (CFI and TLI > 0.9 and RMSEA < 0.05). We ensured that the scale had measurement invariance regarding education, income, and marital status. (4) Conclusions: The PRELSA Scale shows promising properties that have the potential to measure obesogenic behaviors in Spain, which could be the basis for future interventions associated with the prevention of childhood obesity in healthcare and educational settings.

The relationship between parental attitudes towards health and child development has been a topic of interest for many years; however, research results in this field are still inconsistent. This study aimed to develop a structural equation model of the Parental Attitudes toward Child Oral Health (PACOH) scale, using this model to analyse the relationship between parental attitudes with demographic variables and the oral health-related behaviour of parents and children. A total of 302 parents (87% mothers) answered questions regarding their own and their children\'s, aged 4-7 years, oral health-related actions and completed the 38-item PACOH scale. The structural equation model indicated that parental attitudes captured by the PACOH scale can be fitted to a second-order factorial model, even with the scale shortened to 21 items. The model demonstrated good fit characteristics (CFI = 0.925; IFI = 0.927; GFI = 0.915; RMSEA = 0.049), making it a reliable tool for examining the structure of parental attitudes. This model was employed in the multi-group analysis, revealing the close relationship between positive parents\' attitudes towards their child\'s oral health and oral health-promoting behaviour both in parents and children, such as regular tooth brushing (p < 0.001), visiting the dentist (p = 0.027), and parents helping their child brush his/her teeth (p < 0.001). In light of these findings, it was concluded that Parental Attitudes towards Child Oral Health should be considered an essential factor influencing the development of oral health-promoting behaviour in children.

OBJECTIVE: To investigate the socio-economic and personal factors that impact parental decisions regarding orthodontic treatment for their children in Madinah, Saudi Arabia.
METHODS: A digital self-administered questionnaire was employed to collect data from 414 parents, focusing on their motivations and barriers that influence their decision-making process regarding orthodontic treatment.
RESULTS: Income level was the most significant factor in orthodontic decisions. Parents with higher incomes were twice as likely to choose orthodontic treatment for esthetic reasons compared to parents with middle incomes. The main incentive for seeking treatment was getting advice from dental professionals, with 60% of participants rating it as the most important factor. 34.5% of respondents identified cost as the main barrier, with middle-income parents being 151% more inclined to perceive it as a significant barrier compared to high-income parents. Gender dynamics revealed that mothers exhibited 48.9% greater concern regarding treatment costs compared to fathers, whereas fathers placed 2.105 times more importance on the orthodontist\'s reputation than mothers.
CONCLUSIONS: Income levels, along with other socio-economic factors and gender dynamics, have a significant influence on parental decisions regarding orthodontic care. Personalized consultations that address these variations are crucial for improving communication between patients and practitioners and increasing the accessibility of treatment.

Nutrition education is a long-term process that should cover various population groups. A special focus should be placed on children, adolescents and their parents. The aim of this research was to find out the opinions of parents of primary school pupils aged 7-12 on their expectations towards school education in the areas of food and nutrition, addressed to both pupils and their parents. The research was conducted among 101 parents of primary school pupils with the use of the Focus Group Interview (FGI) method. It demonstrated that what is most needed are hands-on activities relating to basic theoretical issues. While parents see the need for nutrition education for their children, educating pupils in this area is of interest to only some of the respondents for whom nutrition aspects are quite important. All parents would like formal nutrition education at school, but at the same time, they do not want classes to take up too much of their children\'s time, due to the already excessive number of school subjects. It seems appropriate to include everyone in regard to nutrition education, regardless of their declared interest in this issue. The need for consistent presentation of educational content addressed to teachers and parents is very important, so that they can, in a uniform way, shape the attitudes towards food and nutrition of children and adolescents.

To assess whether genetic test results identifying the cause of a child\'s autism, when accompanied by other neurodevelopmental disorders (NDD), including intellectual disability, alter how parents perceive and treat their child. 28 parents of 22 individuals with autism (mean age: 15 years), usually with other NDDs, were interviewed after receiving genetic diagnoses indicating a de novo mutation through the Simons Foundation Powering Autism Research for Knowledge study. Diagnosis of a de novo genetic variant can alter parental perceptions of offspring with autism and other NDDs. Parents often blamed their child less, saw their child as less in control of symptoms, and developed more patience, framing expectations accordingly. Parents had mixed feelings about receiving genetic diagnoses, with sadness sometimes accompanying reframed expectations. Genetic diagnoses could change views of the child among extended family members, teachers, social service agencies, insurers, and broader communities and society. Genetic testing might also reduce delays in diagnoses of autism among African American, Latino and other children. These data, the first to examine several critical aspects of how parents and others view children with autism and other NDDs after receiving genetic diagnoses, highlight vital needs for education of multiple stakeholders (including geneticists, other physicians, genetic counselors, parents, individuals with autism, social service agencies, insurers, policymakers, and the broader public), research (to include perspectives of extended family members, insurers, social service agencies and teachers) and practice (to increase recognition and awareness of the potential benefits and effects of genetic testing for such children).

Cleft lip and palate are the most common developmental anomalies that affect the mouth and related structures. They can both affect children physiologically, socially, and functionally and lead to psychological distress in their parents. The present study aims to understand the challenges parents of cleft lip and palate patients face in Egypt, elucidate how they cope with these challenges, and assess their concerns for the future.
For the present phenomenological qualitative exploration, the parents of cleft lip and palate patients attending the cleft care clinic were invited to participate in the study through face-to-face recruitment at the clinic. An interview guide about the research question was developed to include standardized open-ended questions providing a framework for structured discussions. The interviews were audio-recorded after obtaining written informed consent from participants then collected data were transcribed for data analysis.
Of the 12 participants, there were nine mothers and three fathers. Their children\'s ages ranged from 1.5 years to 19 years and had different presentations of cleft lip and palate from unilateral cleft lip to complete bilateral cleft lip and palate. Feeding difficulty was one of the main challenges encountered by the parents. At the same time, fear of being subjected to bullying was the main concern for the future of their children. Six themes were noted that were continually reported: Health & Wellbeing; Parental emotions; Parental attitudes & behaviors; Financial aspects; Relationship aspects; and Career/Education.
There were 4 factors that directly impacted the themes, namely: the type of cleft, gender of the child, gender role of the parent, and the age of the child impacted the parental concerns and the challenges faced under the influence of sociocultural beliefs and existing support systems.