1.Anxiety in hospitalised families: lessons from the early phase of the COVID-19 pandemic.
Annushkha SINNATHAMBY ; Siau Hwei NG ; Amanda ZAIN ; Liangjian LU ; Celeste YONG ; Xinyi THONG ; Si Min CHAN
Singapore medical journal 2025;66(6):327-332
INTRODUCTION:
In the early phase of the coronavirus disease 2019 (COVID-19) pandemic, children with COVID-19 in Singapore required hospital isolation. We aimed to explore the psychological experiences of children and their caregivers isolated in a tertiary university hospital due to COVID-19.
METHODS:
A prospective mixed-methods design was used to evaluate the psychological status of hospitalised family units with one or more children aged <18 years who had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patient medical records were reviewed for demographic and clinical information. Parents and children ≥7 years of age underwent a psychologist-administered telephone-based interview. Self-reported, age-appropriate instruments, Short Mood and Feelings Questionnaire, and Screen for Adult/Child Anxiety-Related Disorders, were used to assess anxiety and depression, respectively. Participants were also interviewed qualitatively.
RESULTS:
Fifteen family units were hospitalised between March 2020 and May 2020. Of these, 13 (73%) family units were recruited. The median age of the children and median hospitalisation duration were 57 months and 21 days, respectively. Median number of COVID-19 polymerase chain reaction swabs performed for each child was eight. All children had asymptomatic to mild SARS-CoV-2 disease. The criteria indicative of anxiety disorder were met by 40% of adults and 80% of children, while the criteria indicative of separation anxiety were met by 60% of parents and 100% of children. One child met the criteria indicative of depression. Uncertainty, separation, prolonged hospitalisation and frequent swabs caused significant reported anxiety.
CONCLUSIONS
Families, especially children, had heightened anxiety while in hospital isolation. Therefore, home-based recovery from COVID-19 and psychological support for children and their families, with focus on early recognition of anxiety disorders, are recommended. We support review of paediatric isolation policy as the pandemic evolves.
Humans
;
COVID-19/epidemiology*
;
Male
;
Child
;
Female
;
Singapore/epidemiology*
;
Anxiety/etiology*
;
Prospective Studies
;
Adolescent
;
Hospitalization
;
SARS-CoV-2
;
Adult
;
Child, Preschool
;
Pandemics
;
Parents/psychology*
;
Caregivers/psychology*
;
Family/psychology*
;
Depression
;
Patient Isolation/psychology*
;
Surveys and Questionnaires
2.Parents' perceptions and experiences of physical activity in childhood cancer survivors in Singapore: a qualitative study.
Lindsey Jean Ross WELLER ; Debbie Grant CAVERS ; Neneh ROWA-DEWAR
Singapore medical journal 2025;66(6):314-320
INTRODUCTION:
The survival rate for childhood cancer has increased with advances in medical care. Along with this comes the growing burden of long-term side effects of cancer treatment and cancer survivorship. Childhood cancer survivors are more likely to be sedentary and have a lower quality of life. Physical activity (PA) can promote health and well-being in childhood cancer survivors, but few studies have explored the role of parents of childhood cancer survivors (PCCS) in promoting PA. This qualitative study aims to explore the perceptions of PCCS in Singapore and the role they may have with regard to PA.
METHODS:
Participants were recruited through a local charity via email, social media and posters. One-hour semi-structured interviews were conducted online with seven parents. With consent, the interviews were recorded, transcribed verbatim and analysed using thematic analysis.
RESULTS:
Our study discussed thematically parents' accounts on (1) the barriers and enablers of PA and (2) the complications of cancer that potentially affect the levels of PA in childhood cancer survivors. Parents reported that childhood cancer negatively affects the quality of life and participation in PA. The determinants of participation in PA were multifaceted, and socioecological and health belief models were used to demonstrate how these factors were interlinked.
CONCLUSION
Participation in PA is influenced at an individual, family, community and societal level. The improved understanding facilitated by this research can be used to shape paediatric cancer care practices in Singapore and guide institutional or national policy interventions.
Humans
;
Singapore
;
Parents/psychology*
;
Cancer Survivors/psychology*
;
Qualitative Research
;
Female
;
Male
;
Quality of Life
;
Exercise
;
Child
;
Adult
;
Neoplasms
;
Adolescent
;
Perception
;
Middle Aged
;
Interviews as Topic
3.Impact of parental myopia on myopia in schoolchildren and adolescents in China: A national cross-sectional survey.
Xiaoran YU ; Huan WANG ; Sheng MA ; Yanhui DONG ; Yinghua MA ; Yi SONG ; Jun MA ; Zhiyong ZOU
Chinese Medical Journal 2025;138(23):3168-3175
BACKGROUND:
Parental myopia is an important risk factor for myopia in Chinese children and adolescents. This study aimed to assess the influence of parental myopia and the severity of myopia on offspring and to evaluate whether adopting healthy lifestyles can mitigate the effects of parental myopia on offspring.
METHODS:
This cross-sectional study analyzed data from children and adolescents aged 6-17 years with complete vision assessments and parental history of myopia from six provinces in China during 2013-2014. Parental demographic information, children's outdoor activity time, sleep time, and sedentary time were collected via questionnaire. Parental myopia was classified as no myopia, paternal myopia, maternal myopia, and both. The offspring were categorized into 10 groups based on parental myopia prescription. Associations of the above factors with myopia in children and adolescents were evaluated by logistic regression analysis.
RESULTS:
Among 40,864 children and adolescents (50.3% boys and 49.7% girls), 22,537 (55.2%) were diagnosed with myopia. In comparison to offspring devoid of parental myopia, children with one parent affected by myopia exhibited odds ratio (OR) of 1.75 (95% confidence interval [CI]: 1.62-1.88) for myopia, while those with both parents affected showed OR of 2.27 (95% CI: 2.02-2.55) after adjusted for lifestyle factors. The likelihood of myopia in offspring increased with increasing severity of parental myopia, with a 3.08-fold increase in risk observed when both parents presented high myopia. Nonetheless, children adhering to two or more healthy lifestyle factors demonstrated a diminished risk of myopia compared with those with fewer than two lifestyle factors, especially among offspring of non-myopic or mildly myopic parents.
CONCLUSIONS
Parental myopia has a dose-dependent association with their offspring. Healthy lifestyles may reduce the impact of parental factors on myopia in offspring. The observed associations suggest that although the genetic burden of parental myopia cannot be ignored, healthy lifestyles and nurturing are also very important.
Humans
;
Myopia/epidemiology*
;
Child
;
Male
;
Female
;
Adolescent
;
Cross-Sectional Studies
;
China/epidemiology*
;
Parents
;
Surveys and Questionnaires
;
Risk Factors
4.Hematological Characteristics of Neonates with Abnormal Hemoglobin and Their Parents in Guangzhou Area.
Yan-Fen GE ; Yue ZHAO ; Ya-Xuan HUANG ; Jun-Ru LIU ; Ting LIN ; Lu-Hua XIAN
Journal of Experimental Hematology 2025;33(1):180-186
OBJECTIVE:
To analyze the incidence of abnormal hemoglobin (Hb) in neonates in Guangzhou area, as well as the results of quantitative analysis of Hb in neonatal umbilical cord blood and genetic diagnosis of thalassemia in neonates with abnormal Hb; And to explore the hematological phenotypes and clinical characteristics of neonates with abnormal Hb and their parents, providing a reference for eugenics and childcare.
METHODS:
650 neonates born at Guangdong Provincial People's Hospital who underwent Hb electrophoresis were included in this study. The results of routine blood test of umbilical cord blood , Hb electrophoresis and α-, β-thalassemia gene detection of the neonates were collected. The genotype distribution of thalassemia in the neonates was analyzed. Additionally, the abnormal Hb content of α and β variants was studied. Furthermore, the differences in hematological parameters between abnormal Hb neonates and normal neonates and α-thalassemia neonates, as well as between the parents of abnormal Hb neonates and normal adults were compared.
RESULTS:
Among the 650 neonates, 332 (51.08%) were diagnosed with thalassemia, including 235 cases of α-thalassemia (36.15%), 79 cases of β-thalassemia (12.15%), and 18 cases of compound αβ-thalassemia (2.77%). Among all the α-thalassemia genotypes, the most prevalent one was -- SEA/αα (48.94%), followed by -α3.7/αα (20.00%), -α4.2/αα (11.06%), and ααCS/αα (8.94%). The four most common genotypes of β-thalassemia were βCD41-42 (32.91%), βIVS-Ⅱ-654 (26.58%), β-28 (21.52%), and βE (10.13%), respectively. 275 cases of abnormal bands were found in Hb electrophoresis of umbilical cord blood, with a detection rate of 42.31%. The abnormal Hb content of α-variant in the neonates was significantly higher than that of β-variant (P < 0.001). The levels of Hb, MCV, MCH, Hb A, and Hb F in neonates with abnormal Hb were lower than those in normal neonates, while the RDW-CV was higher than that in normal neonates, with statistical significantce (P < 0.05). The levels of RBC and Hb A in neonates with abnormal Hb were lower than those in neonates with α-thalassemia, while the level of MCH was higher than that in neonats with α-thalassemia, with statistical significance (P < 0.05). The levels of Hb, MCV, MCH, and Hb A in parents of neonates with abnormal Hb were lower than those in normal adults, while the RDW-CV was higher than that in normal adults, and the differences were statistically significant (P < 0.05).
CONCLUSION
The abnormal Hb content of α-variant in the neonates is significantly higher than that of β-variant in the neonates in Guangzhou, which can help to presume whether it is α chain or β chain based on the abnormal Hb content, providing a reference for globin gene sequencing. Meanwhile, analysis of various hematological screening-related indicators in neonates in the early stage is beneficial for early warning of the occurrence of abnormal Hb combined with thalassemia, reducing missed diagnoses to a certain extent.
Humans
;
Infant, Newborn
;
Genotype
;
Hemoglobins, Abnormal/genetics*
;
China/epidemiology*
;
alpha-Thalassemia/epidemiology*
;
beta-Thalassemia/genetics*
;
Parents
;
Female
;
Male
;
Fetal Blood
5.Association between parent-reported salt-related behaviors and estimated urinary salt excretion: a cross-sectional study of health checkups in 4-year-old children.
Takafumi ABE ; Minoru ISOMURA ; Shozo YANO
Environmental Health and Preventive Medicine 2025;30():39-39
Although salt-related behaviors may influence urinary salt excretion in early childhood, this relationship remains unclear. This study aimed to examine salt-related behaviors using data from a salt check sheet and urinary salt excretion parameters using spot urine samples from 4-year-old children. This cross-sectional study included all 4-year-old children who underwent health checkups in Ohnan Town, Shimane Prefecture. The study sample consisted of 109 children (49 boys). Measures from spot urine samples included estimated salt excretion (g/day) and the sodium-potassium (Na/K) ratio. Salt-related behaviors were assessed using a salt check sheet that was completed by the parents or guardians. The associations between salt-related behaviors and urinary salt excretion parameters were analyzed using a generalized linear model. The median (M) and interquartile range (IQR) for urinary measures in 4-year-old children were as follows: estimated salt excretion (M = 4.4, IQR: 3.3-6.2) and Na/K ratio (M = 2.3, IQR: 1.4-3.3). The low frequency of consumption of high-salt foods ("such as pickles, pickled plums, etc." and "noodles such as udon and ramen") was associated with low salt excretion and low Na/K ratio. However, in the case of "consumption of udon, ramen, or other soups", the Na/K ratio was higher for "About half a bowl" and "Some" than for "An entire bowl." Additionally, for "eating out or having convenience-store-bought bento (lunch plate) for lunch", the Na/K ratio was higher for "No" than for "Almost every day." In conclusion, the frequency of high-sodium food intake was associated with both urinary sodium excretion and the Na/K ratio in 4-year-old children. Longitudinal investigations using the 24-hour urine collection method are needed to confirm these salt-related behaviors.
Humans
;
Child, Preschool
;
Male
;
Cross-Sectional Studies
;
Female
;
Sodium Chloride, Dietary/urine*
;
Parents
;
Sodium/urine*
;
Japan
;
Potassium/urine*
6.Comparison and study of multiple scales results in children with cochlear reimplantation, mainly the speech, spatial, and other qualities of hearing scale for parents.
Tian NI ; Jinyuan SI ; Haotian LIU ; Xinyi YAO ; Xiangling ZHANG ; Huilin YIN ; Lin ZHANG ; Xiuyong DING ; Yu ZHAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(5):433-442
Objective:To compare the outcomes of multiple scales, primarily the speech, spatial, and other qualities of hearing scale for parents(SSQ-P), in children with ipsilateral vs. Contralateral cochleareimplantat ion(CRI). Methods: A total of 69 children who received cochlear implantation surgery from April 1999 to June 2024 were included. Patients were divided into two groups based on whether the implantation was on the same side. General information such as gender, age, age at initial implantation and reimplantation was collected. The primary caregivers of the children were followed up by telephone using the categories of auditory performance(CAP), speech intelligibility rating(SIR), and SSQ-P questionnaires. Statistical methods including stepwise regression, linear regression, and permutation tests were employed to investigate if there were any statistically significant differences in the scores of CAP, SIR, SSQ-P total, SSQ-P speech perception, SSQ-P spatial hearing, and SSQ-P auditory quality dimensions between the ipsilateral and contralateral reimplantation groups. Results:Of the 69 children included, 62 were in the ipsilateral reimplantation group with a mean age of 11.1 years, and 7 were in the contralateral reimplantation group with a mean age of 11.7 years. Statistical analysis showed that patients in the contralateral reimplantation group had significantly lower SSQ-P total scores (P<0.05) and spatial hearing dimension scores (P<0.05) than those in the ipsilateral reimplantation group after controlling for the corresponding confounders. Conclusion:The effect of ipsilateral reimplantation of cochlear implants is superior to that of contralateral reimplantation in terms of overall auditory function and spatial hearing in daily life for children, but the mechanisms require further investigation.
Humans
;
Cochlear Implantation
;
Child
;
Parents
;
Speech Perception
;
Male
;
Cochlear Implants
;
Female
;
Hearing
;
Surveys and Questionnaires
;
Speech
;
Child, Preschool
7.The trend of birth weight of full-term newborns and its association with parental reproductive age in Chongqing municipality from 2010 to 2022.
Nu TANG ; Lan WANG ; Wen Zheng ZHOU ; Xiao Jun ZHOU
Chinese Journal of Preventive Medicine 2023;57(11):1794-1800
To analyze the trend of abnormal birth weight of full-term newborns and its correlation with parental reproductive age in Chongqing municipality from 2010 to 2022. Based on the Chongqing Birth Certificate System, full-term newborns born from January 2010 to December 2022 were selected. Parental information and birth weight were abstracted from the system. The joinpoint regression model was used to assess the trend of incidence of low birth weight (LBW) and macrosomia in the offspring from 2010 to 2022. The logistic regression model was utilized to analyze the association between parental reproduction age and birth weight of newborns. The average birth weight of 3 155 542 newborns was (3 305.8±410.5) g. The joinpoint regression model showed a decreasing trend for the incidence of LBW from 2010 to 2016 (APC=-4.26%, P<0.05), and an increasing trend from 2020 to 2022 (APC=8.99%, P<0.05). The incidence of macrosomia exhibited a decreasing trend from 2015 to 2022 (APC=-3.37%, P<0.05). The logistic regression model showed that, compared to the group with parents aged 20-34 years, the risk of LBW increased in other age groups. The risk of macrosomia decreased when either parent was aged<20 years, and increased when both parents were aged≥20 years. In conclusion, from 2010 to 2022, the incidence of LBW in full-term offspring in Chongqing municipality decreased first and then increased, and the incidence of macrosomia increased first and then decreased. Both young and advanced parental age were associated with an increased risk of LBW in offspring, and advanced parental age was also associated with an increased risk of macrosomia in offspring. Attention should be paid to the effects of advanced maternal and paternal age on offspring birth weight. Further efforts to control childbearing at a young age were needed.
Female
;
Infant, Newborn
;
Humans
;
Birth Weight
;
Fetal Macrosomia/epidemiology*
;
Infant, Low Birth Weight
;
Reproduction
;
Weight Gain
;
Parents
8.TCOF1 Gene variation in Treacher Collins syndrome and evaluation of speech rehabilitation after bone bridge surgery.
Yonghua LI ; Wenyue CHI ; Ken LIN ; Jinyan ZU ; Hua SHAO ; Zhiyong MAO ; Quandong CHEN ; Jing MA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(9):748-754
Objective:By analyzing the clinical phenotypic characteristics and gene sequences of two patients with Treacher Collins syndrome(TCS), the biological causes of the disease were determined. Then discuss the therapeutic effect of hearing intervention after bone bridge implantation. Methods:All clinical data of the two family members were collected, and the patients signed the informed consent. The peripheral blood of the proband and family members was extracted, DNA was extracted for whole exome sequencing, and Sanger sequencing was performed on the family members for the mutation site.TCOF1genetic mutations analysis was performed on the paitents. Then, the hearing threshold and speech recognition rate of family 2 proband were evaluated and compared under the sound field between bare ear and wearing bone bridge. Results:In the two pedigrees, the probands of both families presented with auricle deformity, zygomatic and mandibular hypoplasia, micrognathia, hypotropia of the eye fissure, and hypoplasia of the medial eyelashes. The proband of Family 1 also presents with specific features including right-sided narrow anterior nasal aperture and dental hypoplasia, which were consistent with the clinical diagnosis of Treacher Collins syndrome. Genetic testing was conducted on both families, and two heterozygous mutations were identified in the TCOF1 gene: c. 1350_1351dupGG(p. A451Gfs*43) and c. 4362_4366del(p. K1457Efs*12), resulting in frameshift mutations in the amino acid sequence. Sanger sequencing validation of the TCOF1 gene in the parents of the proband in Family 1 did not detect any mutations. Proband 1 TCOF1 c. 1350_1351dupGG heterozygous variants have not been reported previously. The postoperative monosyllabic speech recognition rate of family 2 proband was 76%, the Categories of Auditory Performance(CAP) score was 6, and the Speech Intelligibility Rating(SIR) score was 4. Assessment using the Meaningful Auditory Integration Scale(MAIS) showed notable improvement in the patient's auditory perception, comprehension, and usage of hearing aids. Evaluation using the Glasgow Children's Benefit Inventory and quality of life assessment revealed significant improvements in the child's self care abilities, daily living and learning, social interactions, and psychological well being, as perceived by the parents. Conclusion:This study has elucidated the biological cause of Treacher Collins syndrome, enriched the spectrum of TCOF1 gene mutations in the Chinese population, and demonstrated that bone bridge implantation can improve the auditory and speech recognition rates in TCS patients.
Child
;
Humans
;
Mandibulofacial Dysostosis/genetics*
;
Quality of Life
;
Speech
;
Parents
;
Mutation
;
Nuclear Proteins/genetics*
;
Phosphoproteins/genetics*
9.Attaching great importance to the scientific assessment of short stature in children.
Chinese Journal of Contemporary Pediatrics 2023;25(11):1095-1100
Short stature is a common physical developmental abnormality in children. Without timely and accurate diagnosis, as well as early intervention, it can impose a heavy burden on the children and their families. There are numerous causes for short stature, and the diagnostic process essentially involves identifying its underlying causes. Based on a thorough understanding of the regular patterns of child physical development and the characteristics of individuals at high risk of short stature, a scientific definition of short stature needs to be established, along with standardized diagnostic and treatment protocols, to achieve early diagnosis or referral for short stature. Furthermore, it is necessary to enhance scientific awareness of short stature among parents and primary care pediatricians, in order to avoid over-treatment, missed diagnoses, and misdiagnoses arising from "misconceptions", and to improve the scientific assessment of short stature.
Humans
;
Child
;
Dwarfism/diagnosis*
;
Child Development
;
Parents
;
Body Height
;
Growth Disorders/etiology*
10.A case of Congenital disorder of glycosylation due to SSR4 gene deletion.
Lingwei WENG ; Qingqing DENG ; Xiuli CHEN ; Kai WANG ; Jie SHAO
Chinese Journal of Medical Genetics 2023;40(3):364-367
OBJECTIVE:
To explore the clinical and molecular characteristics of a child with Congenital disorders of glycosylation (CDG).
METHODS:
A 4-month-old boy who had presented at the Children's Hospital Affiliated to Zhejiang University Medical School on December 31, 2019 due to feeding difficulties after birth was selected as the study subject. High-throughput sequencing was carried out for the patient, and real-time qPCR was used for validating the suspected deletion fragments and the carrier status of other members of his family.
RESULTS:
High-throughput sequencing revealed that the child had lost the capture signal for chrX: 153 045 645-153 095 809 (approximately 50 kb), which has involved 4 OMIM genes including SRPK3, IDH3G, SSR4 and PDZD4. qPCR verified that the copy number in this region was zero, while that of his elder brother and parents was all normal.
CONCLUSION
The deletion of the fragment containing the SSR4 gene in the Xq28 region probably underlay the SSR4-CDG in this child.
Aged
;
Child
;
Humans
;
Infant
;
Male
;
Gene Deletion
;
Glycosylation
;
High-Throughput Nucleotide Sequencing
;
Neoplasm Proteins
;
Parents
;
Siblings

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