Parents

Objectives To explore how parents navigate urgent and emergency care (U&EC) services when their child <5 years old has a feverish illness, their views of that experience and whether services are meeting their needs and triaging in line with national guidance. Design Parents of a febrile child <5 years old contacting any U&EC service in three localities during a 6-month period were invited to participate in a telephone questionnaire supplemented by case note review. A subset participated in an in-depth interview. Results Of 556 parents expressing an interest, 220 enrolled, making 570 contacts (median 3, range 1-13) with services during the child's illness which lasted 3 days on average. Parents' fi rst preference for advice in hours was to see a general practitioner (GP) (67%; 93/138) and when unavailable, National Health Service Direct (46%; 38/82). 155 made more than one contact and 63% of the repeat contacts were initiated by a service provider. A range of factors infl uenced parents' use of services. Parents who reported receiving 'safety netting' advice (81%) were less likely to re-present to U&EC services than those who did not recall receiving such advice (35% vs 52%, p=0.01). Parents identifi ed a need for accurate, consistent, written advice regarding fever and antipyretics. Conclusion Parents know the U&EC service options available, and their fi rst choice is the GP. Multiple contacts are being made for relatively well children, often due to repeated referrals within the system. Safety netting advice reduces re-attendances but parents want explicit and consistent advice for appropriate home management.

This study utilized growth mixture modeling to examine the impact of parents, child care providers, teachers, and peers on the prediction of distinct developmental patterns of classroom externalizing behavior in elementary school. Among 241 children, three groups were identified. 84.6% of children exhibited consistently low externalizing behavior. The externalizing behavior of the Chronic High group (5.8%) remained elevated throughout elementary school; it increased over time in the Low Increasing group (9.5%). Negative relationships with teachers and peers in the kindergarten classroom increased the odds of having chronically high externalizing behavior. Teacher-child conflict increased the likelihood of a developmental pattern of escalating externalizing behavior. Boys were overrepresented in the behaviorally risky groups, and no sex differences in trajectory types were found.

Introduction: Regarding to the importance of educational interventions to increase the preventive behaviors of urinary tract infection in children, this study was conducted aimed to investigate the effect of home care education to parents according to the HBM, on recurrence of urinary tract infection in children.

Materials & Methods: In this quasi-experimental study with a pre and post design, 120 children with UTI who were hospitalized in the pediatric department of Imam Khomeini Hospital in Boroujerd from 23/9/2017 to 23/12/2017 with their parents were selected by simple sampling method and assigned to control and case groups by random block method. The parents of the experimental group received the educational intervention.The data collection tool was questionnaire designed based on health belief model than distributed before and one month after educational intervention. Urin culture was also performed to determine the recurrence. Data were analyzed by SPSS 21 software, multivariate analysis, independent T-test, paired T-test, Chi-square and two-ratio comparison tests.

Findings: education reduced the recurrence of UTI in children) P˂0.001). Also, the mean scores of the whole dimensions of the model increased after training in the two groups (P˂0.001). While the difference in mean scores after training in the two groups was significant only in the dimensions of perceived threat (in the case group 3.84±1.21, in the control group 3.03±1.07) (P=0.039), benefits (in the case group 18.78±3.14, in the control group 20.1±2.8) (P=0.019), behavior (in the case group 30.81±3.77, in the control group 30.16±3.47)(P<0.001), and self-efficacy (in the case group 29.53±3.49, in the control group 25.2±3.07)(P<0.001).

Discussion & Conclusions: According to the effectiveness of home-based caring education based on the HBM to parents of children with UTI,on reducing the recurrence of UTI in children, it is better to before of children discharge with urinary tract infection from the hospital, Providing parenting education about the principles of child care, in order to prevent recurrence of UTI.

Can a parent adjust to the idea that its child is at risk for a sudden death? This question is raised by a diagnostic procedure in which children were tested for an inherited Long QT Syndrome (LQTS). This potentially life-threatening but treatable cardiac arrhythmia syndrome may cause sudden death, especially in children and young adults. The long-term psychological effects are described for parents whose children were tested for inherited LQTS. The adverse short-term impact of such testing has been described previously. The goal of this investigation is to determine whether this distress endures. Thirty-six parents completed measures of psychological distress. With the twenty-four parents of carrier children, a semistructured interview was held 18 months after DNA disclosure. Parents of carrier children reported more distress than parents of non-carrier children. Parents of carrier children remained vulnerable to high levels of distress; up to onethird of these parents showed clinically relevant high levels of distress. High levels of distress were reported by parents of carrier children who (1) were highly distressed at previous assessments, (2) were familiar with the disease for a longer time, (3) had experienced a sudden death in the family, (4) were lesser educated, and who (5) were unsatisfied with the given information.