OBJECTIVES

The challenges faced by patients with diabetes in rural Philippine communities highlight
the need to look into how we can improve ways of communicating health education and self-management strategies. Patient education materials play a vital role in promoting regimen adherence, yet their acceptability and effectiveness in resource-limited settings remain insufficiently investigated. Therefore, this study aimed to explore participants’ experiences with and perceptions of a community-based diabetes learning module through qualitative inquiry.

METHODS

Using purposive sampling, 13 participants who successfully completed the Blood Sugar Bantayan, Diabetes Malikayan pilot health program from January to July 2022 in a rural community in southern Philippines consented to engage in in-depth interviews. A semi-structured topic guide was developed, validated by experts, and pretested.
Interviews were conducted in the local language, audio-recorded, transcribed, translated, and analyzed using Braun and Clarke's reflexive thematic approach.

RESULTS

Five major themes emerged from the analysis: initial perceptions of the module, aspects of the module found useful, perceived impact on regimen adherence, hindrances to adherence, and overall feedback with likelihood of recommendation. Participants valued the module’s visual appeal, use of local language, and comprehensive coverage of diabetes management. The module served as a guide that enabled participants to gain better control over their condition through improved self-discipline and health practices, often motivated by family support. However, challenges including time constraints, resource limitations, and competing priorities affected consistent implementation of recommended practices. Despite these barriers, participants expressed strong satisfaction with the module and willingness to share it with others, though sharing decisions were often based on perceived relevance to others’ health status.

CONCLUSION

Community-based learning modules can serve as valuable educational tools for diabetes care in rural Filipino communities. Findings underpin the importance of developing culturally appropriate and responsive campaigns for diabetes education in remote
environments, but multi-modal strategies that cut across sectors are still imperative to address persisting structural factors that pervade health program efforts.

Resource-limited Settings ; Residence Characteristics ; Play And Playthings ; Personal Satisfaction ; Family Support ; Self-management

BACKGROUND: Long screen time hours may be associated with behavioral problems in children. To better understand the relationship between children's behavioral problems and screen time, it the associated risk factors must be subdivided based on the purpose underlying screen use. This study examined the relationship between screen time based on intended usage and behavioral problems in Japan. METHODS: This study included 3,332 children aged between 7-17 years from the Hokkaido Study on Environment and Children's Health. From October 2020 to October 2021, the children and their parents answered questionnaires on the children's screen use duration (never used, <30 min, ≥30 min & <1 hour, ≥1 h & <2 h, ≥2 h) based on seven intended usage categories: watching television/video, video gaming, reading books/comics, sending/receiving e-mail/messages, browsing/posting on social networking services, studying for classes/homework, drawing/editing pictures/photos/videos, along with the Strengths and Difficulties Questionnaire (SDQ). Logistic regression was used to analyze the association between screen time, purpose of children's screen use, and behavioral problems across the 13 SDQ total scores. RESULTS: The mean ± standard deviation age of the participants was 12.4 ± 2.4-years-old, 487 (14.6%) children were determined to have behavioral problems, and the duration of screen time increased with their age. The children's primary purposes for screen use were watching television/video, video gaming, sending/receiving e-mail/messages, and browsing/posting on social networking services. Children who reported playing video games for ≥2 hours on weekdays had higher odds of problematic total difficulties scores than never user (Odds Ratio: 2.10, 95% confidence interval: 1.45-3.06). CONCLUSION Long video gaming screen time is associated with behavioral issues, hyperactivity/inattention, and prosocial behaviors in children. Conversely, watching television and videos for 30 min-1 h per day, using e-mail or messaging, and using social networking services were significantly association with reduced odds ratio for peer relationship problems as compared to children who never engaged in these activities. Longitudinal follow-up is needed to further examine screen time and problem behaviors.
Humans ; Screen Time ; Child ; Japan/epidemiology* ; Male ; Female ; Adolescent ; Problem Behavior/psychology* ; Surveys and Questionnaires ; Child Behavior ; Television/statistics & numerical data* ; Video Games/statistics & numerical data*

Aims: We evaluated the efficacy of active video games as weight reduction intervention among obese children and adolescents by synthesizing available published evidence.

Materials and methods: A meta-analysis was performed using nine RCTs based on the PRISMA guidelines. Children less than 18 years of age who are Obese I and Obese II and underwent active video games intervention or standard weight management programs were included. A search was performed in PubMed/MEDLINE, EMBASE, Scopus, Cochrane, and HERDIN databases from inception to September 2024 databases using the MeSH and key words: (“video games” or “digital games” or “console games” or “electronic games”) AND (“weight loss” or BMI or obesity) AND (children OR pediatric OR adolescents) AND (RCT OR trials OR “randomized controlled trial). Pooled mean difference was used to determine effectiveness on reducing weight and BMI.

Results: The pooled mean difference showed significantly lower post-intervention weight (in kg) (MD=-2.97, 95%CI=-5.15 to -0.78, p=0.008) and significantly lower post-intervention BMI z-score (MD=-0.12, 95%CI=-0.13 to -0.10, p<0.000001) on children with AVG intervention. There was also lower post-intervention BMI on children with AVG intervention (MD=-1.27, 95%CI=-2.93 to 0.38). However, the difference was not statistically significant (p=0.13).

Conclusion:Active video games showed a significant benefit in weight reduction among obese children. Usual lifestyle modification interventions may be challenging due to lack of motivation and poor adherence among younger demographics. AVGs present a novel approach by integrating entertainment with physical activity, thereby addressing these barriers.

Human ; Male ; Female ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Randomized Controlled Trial ; Adolescent ; Meta-analysis ; Video Games ; Life Style ; Exercise ; Electronics

BACKGROUND: A kids café is a popular indoor playground in Korea that combines a playground for young children and a café for their caregivers. There have been no national reports about kids café-related injuries in Korea. This study investigated kids café-related injuries in Korea registered in a multicenter injury surveillance database and analyzed the risk factors for significant kids café-related injuries.METHODS: A multicenter cross-sectional study was performed using the Emergency Department-based Injury In-depth Surveillance registry in Korea between 2011 and 2016. Significant injury was defined as an injury requiring hospitalization or surgery. A multivariable logistic regression model was used to obtain the adjusted odds ratios (aORs) for factors associated with significant kids café-related injuries.RESULTS: Among 1,537,617 injured patients, we extracted 891 patients who were injured in kids cafés. Of these, 46 (5.2%) were admitted, and 39 (4.4%) underwent surgery. The most common injured anatomical site, injury type, and mechanism were lower extremity (28.2%), superficial injury (27.2%), and slip (27.1%), respectively. Among injury-inducing factors, significant injuries were most commonly caused by a trampoline (28.1%), and rock climbing equipment was the only risk factor in a kids café that led to significant injury after adjusting for age, sex, injury mechanism, and injured anatomical sites (aOR, 14.94; 95% confidence interval, 1.51–147.72).CONCLUSION: The rock climbing equipment in a kids café can cause serious injury to children. Establishing safety regulations for rock climbing equipment in kids cafés may have the greatest impact in reducing significant injuries requiring hospitalization or surgery.
Caregivers ; Child ; Cross-Sectional Studies ; Emergencies ; Hospitalization ; Humans ; Korea ; Logistic Models ; Lower Extremity ; Odds Ratio ; Play and Playthings ; Risk Factors ; Social Control, Formal ; Wounds and Injuries

PURPOSE: The study aimed to develop a play toolkit to facilitate infants' and toddlers' symbolic thought and fine motor development. METHODS: This study used a methodological study design including two phases of development and evaluation. After reviewing the play culture and developmental health issues in Kyrgyzstan through a literature review and interviews with local experts and parents, the toolkit was developed and evaluated using content validity and utilization tests. RESULTS: The toolkit was based on Westby's symbolic play and the fine motor milestones in the Bright Futures Guidelines. The Toolkits were composed of an overall suggested play schedule according to the child's age, four kinds of play props, and a utilization guidebook for parents. The play props were a felt book, sorting and assembling blocks, cup blocks, and a tangram. The guidebook contained age-appropriate operating methods and alternative ways to use the materials. CONCLUSION: A play toolkit was developed to enhance nurturing practices among parents of infants and toddlers. The findings may help facilitate effective interactions between parents and their children. Considering that nurturing care is critical for achieving better child health outcomes, enhancing parenting resources and parent-child relations could function as an effective strategy for promoting child health.
Appointments and Schedules ; Child ; Child Development ; Child Health ; Humans ; Infant ; Kyrgyzstan ; Methods ; Parent-Child Relations ; Parenting ; Parents ; Play and Playthings

Objective: Games promoting nutrition education are helpful tools to improve nutrition knowledge. Healthy Foodie is an interactive web-based nutrition game for Filipino children. This study aimed to determine the effectiveness of Healthy Foodie on the nutrition knowledge of children aged 7 to 10 years old. Methodology: This study had 2 phases. In Phase 1, we developed and validated the Healthy Foodie nutrition game application and Nutrition Knowledge Questionnaire involving 46 participants. The Nutrition Knowledge Questionnaire was divided into 2 15-item questionnaires: Part 1 pertained to Food Group Knowledge and Part 2 on Food Frequency Knowledge. Phase 2 was the implementation of the game and questionnaire. This was a randomized controlled trial conducted in two elementary schools in Manila, involving 360 participants divided equally into control and experimental groups. Results: For Phase 1, internal consistency of the questionnaire using the Kuder-Richardson Formula 20 was 0.75 for part 1 and 0.70 for Part 2. In Phase 2, comparing the adjusted posttest mean Food Group Knowledge scores, there was statistically higher score (F=111.84, p=0.0001) in the experimental group (11.57±0.20) compared to the control (8.51±0.20). In the adjusted posttest mean Food Frequency Knowledge scores, there was a statistically higher score (F=56.12, p=0.0001) in the experimental group (10.70±0.15) compared to the control (9.07±0.15). Conclusion A nutrition game-based intervention such as Healthy Foodie is effective as a reinforcement intervention to previous standard nutrition education of school-aged children
Health Education ; Video Games

The causal relationship between cigarette smoking during pregnancy and adverse maternal and child health outcomes, such as preterm birth, low birth weight, and sudden infant death syndrome are well known. In addition, cigarette compounds are neurotoxic even at extremely low levels. Thirdhand smoke (THS) is the contamination that persists after secondhand tobacco smoke has been emitted into air. It refers to the tobacco-related gases and particles that become embedded in materials such as carpets, walls, furniture, blankets, and toys. THS is not strictly smoke but chemicals that adhere to surfaces from which they can be released back into the air, undergo chemical transformations, and/or accumulate. The concept of THS is a relatively new phenomenon in the environmental and public health field. Currently, the hazards of THS are not as well documented as the hazards of secondhand smoke. Furthermore, its health effects and biological effects are largely unknown. This review summarizes recent research progress in reproductive toxicology studies that use animal models and in vitro systems, studies of environmental contamination by THS, human exposure studies, and priorities for further research. Future research must be conducted to facilitate hazard identification, and exposure and risk assessment to address its health effect on susceptible populations, such as pregnant women and children. In addition, policies and laws concerning tobacco smoke will need to be reviewed and possibly revised with the role of THS considered as an indispensable component of a broader tobacco control strategy in maternal and child health.
Child Health ; Child ; Female ; Floors and Floorcoverings ; Gases ; Humans ; In Vitro Techniques ; Infant, Low Birth Weight ; Infant, Newborn ; Interior Design and Furnishings ; Jurisprudence ; Maternal Health ; Models, Animal ; Play and Playthings ; Pregnancy ; Pregnant Women ; Premature Birth ; Public Health ; Risk Assessment ; Smoke ; Smoking ; Sudden Infant Death ; Tobacco ; Tobacco Products ; Tobacco Smoke Pollution ; Toxicology

Arthroscopy has become an attractive modality in the diagnosis and treatment of joint diseases in toy breed dogs. However, the application of arthroscopy is limited by small joint space. Our objective was to evaluate the efficacy of a stifle lever for joint distraction during stifle arthroscopy in toy breed dogs. Paired stifles (n = 32 each) collected from 16 cadavers of toy breed dogs were randomly assigned to one of two groups: the stifle lever group or the external manipulation group. All stifles underwent arthroscopic cranial cruciate ligament transection, and the visualization of the medial meniscus was evaluated. Medial meniscal release (MMR) was then performed. Following arthroscopic examination, the success rates of MMR and damages of tibial and femoral cartilages were evaluated. Visualization of the medial meniscus was significantly better, and meniscal probing was significantly easier, in the stifle lever group than in the external manipulation group (p = 0.001). There were no significant differences between groups for MMR success or articular cartilage damage. Using the stifle lever on arthroscopic examination improved visualization and probing on the medial meniscus in toy breed dogs. The stifle lever can be used as a good modality in assessing medial meniscal pathology in toy breed dogs.
Animals ; Anterior Cruciate Ligament ; Arthroscopy ; Cadaver ; Cartilage ; Cartilage, Articular ; Diagnosis ; Dogs ; Joint Diseases ; Joints ; Menisci, Tibial ; Pathology ; Play and Playthings ; Stifle

OBJECTIVE: To investigate the dose-related effect of trunk control training (TCT) using Trunk Stability Rehabilitation Robot Balance Trainer (TSRRBT) in chronic stroke patients with poor sitting balance. METHODS: This was a retrospective study of 38 chronic stroke patients with poor sitting balance that underwent TCT with TSRRBT. The participants were assigned either to the low-dose training (LDT) group (n=18) or to the highdose training (HDT) group (n=20). In addition to the conventional rehabilitation therapy, the LDT group received 5 sessions of TSRRBT intervention per week, whereas the HDT group received 10 sessions of TSRRBT intervention per week. The outcome measures were the scores on the Trunk Impairment Scale (TIS) and its subscales, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC), and the Korean version of Modified Barthel Index (K-MBI). All outcome measures were assessed before the training and at the end of the 4-week training. RESULTS: After the 4-week intervention, TIS, BBS, FAC, and K-MBI scores showed improvement in both LDT and HDT groups. Furthermore, the improvements in TIS scores and its subscales were significantly greater in the HDT group than in the LDT group (p < 0.05). CONCLUSION: TCT using TSRRBT could be an additional treatment for the conventional rehabilitation therapy of chronic stroke patients with poor sitting balance. HDT may provide more beneficial effects on improving patients’ sitting balance than LDT.
Biofeedback, Psychology ; Classification ; Humans ; Outcome Assessment (Health Care) ; Rehabilitation ; Retrospective Studies ; Stroke* ; Video Games* ; Walking

OBJECTIVES: There is evidence to suggest that sedentary behavior is associated with a higher risk of metabolic disease. The aim of this study was to investigate cross-sectional joint associations of physical activity (PA) and screen time (ST), with the risk of obesity in Korean adults. METHODS: The Korea Media Panel Study consisted of a household interview and a self-administered diary survey on media usage over 3 days. ST (hours/day) was defined as the reported daily average hours spent watching television, computing (i.e., desktop, notebook, netbook, tablets), smartphone and video game console use. Cross-sectional associations of obesity (BMI ≥ 25 kg/m2) and the amount of daily ST and PA were examined by logistic regression models adjusting for other possible confounders including alcohol consumption, smoking, depressive symptoms and demographic information. There were 7,808 participants included in the analyses. RESULTS: Increased ST was significantly associated with the risk of obesity (controlling for other possible confounders), but PA level was not found to be significantly linked. Participants who engaged in screen time > 6 hours per day had a higher incidence of obesity. CONCLUSION: This study provides evidence of the association between ST and the increased incidence of obesity measured by BMI, independent of PA amongst Korean adults.
Adult ; Alcohol Drinking ; Depression ; Family Characteristics ; Humans ; Incidence ; Joints* ; Korea* ; Logistic Models ; Metabolic Diseases ; Motor Activity* ; Obesity* ; Smartphone ; Smoke ; Smoking ; Television ; Video Games