Laura Brunton

Background: Cerebral palsy (CP) is a neurodevelopmental disability in which 75% of youth with CP report experiencing pain. Caregiver mental health, parenting style (e.g., authoritarian) and protective responses to pain (i.e., responses that reinforce pain behaviours and avoidance) have been linked to child pain outcomes. Although caregivers of children with neurodevelopmental disabilities experience heightened stress, little is known about the influence of caregiver mental health and parenting style on pain outcomes in youth with CP. Objectives: The present study investigated if caregiver mental health symptoms (i.e., depression and anxiety) and general parenting style (i.e., authoritarian, authoritative and permissive) were associated with child‐reported pain (i.e., pain intensity and pain interference), and whether protective responses to pain mediated these proposed associations. Methods: Forty‐three pairs of youth with CP and their caregiver were recruited from Canadian agencies, organizations and social media advertisements. Participants completed cross‐sectional measures of child‐reported pain and caregiver‐reported mental health, parenting style and protective responses to pain. Results: Caregiver mental health and authoritarian parenting style were significant predictors of youth pain interference ( p 's ≤ 0.05); however, unexpectedly, protective responses to pain did not mediate these associations (confidence intervals containing 0). Conclusions: These findings highlight the need for future investigations of family‐based interventions targeting general parenting style and caregiver mental health and their potential to reduce symptoms associated with secondary conditions, such as pain, that youth with CP experience.

To conduct an environmental scan of known peer support programs implemented for adults with chronic health conditions and/or their caregivers in Ontario, Canada and synthesize these results, to inform future efforts to co-design peer support programs with and for adults with special health care needs (ASCN). A systematic online search was performed, to identify peer support programs for individuals with chronic health conditions and their caregivers in Ontario. Relevant program details were extracted from peer support group webpages and where possible peer support program coordinators were contacted for additional information. Twenty programs met inclusion criteria. There was considerable variation in the type of peer support programs offered across Ontario. Despite this heterogeneity, the environmental scan identified several important trends across program offerings. Key amongst these are inclusive programming for both patients and family, and individualized/flexible service delivery. Program and outcome evaluation was lacking across programs. Peer support programs in Ontario used diverse strategies but shared the goal of creating safe spaces for individuals with similar lived experiences to connect. Future research on peer support programs for people with chronic health conditions should assess short- and long-term outcomes to evaluate their impact on populations served.

Introduction: La pandemia de COVID-19 introdujo varias prácticas de salud pública nuevas, como el uso de mascarillas, el distanciamiento social, el lavado de manos más frecuente y la desinfección de superficies. La aplicación de estas medidas preventivas podría haber afectado especialmente a las madres solteras. Objetivo: Los objetivos de este estudio cualitativo son describir las experiencias de las madres solteras canadienses con la aplicación de las prácticas COVID-19; e identificar las barreras y los facilitadores de los comportamientos clave de salud pública, el uso de mascarillas, el distanciamiento social, el lavado de manos y la desinfección de superficies. Sujetos y métodos: Doce madres solteras de entre 18 y 51 años de edad fueron reclutadas mediante muestreo intencional a partir de plataformas de medios sociales. Se realizaron entrevistas individuales utilizando una guía de entrevista semiestructurada. Luego, se transcribieron textualmente y se analizaroncualitativamente la información utilizando el análisis temático y el enfoque de la descripción interpretativa. Resultados: Se observaron los siguientes problemas en los comportamientos de salud pública: el volumen de las mascarillas y mantener limpias las mascarillas de tela fueron barreras para el uso de mascarillas, la soledad y el cierre de los colegios fueron obstáculos para practicar el distanciamiento social, estar fuera de casa fue un obstáculo para lavarse las manos, el cansancio y la falta de tiempo fueron dificultades para desinfectar las superficies. Las madres solteras destacaron los siguientes facilitadores: los mandatos gubernamentales y los mensajes de salud pública facilitaron el uso de mascarillas, la rutina diaria y la tecnología permitieron el distanciamiento social, los tipos de jabón de manos proporcionaron el lavado de manos, el acceso a suministros y equipos de limpieza facilitó la desinfección de superficies. Además, las actitudes sociales y el estigma, las normas culturales y familiares preexistentes, el impacto de la edad de los niños y la incertidumbre relacionada con el cambio de conocimientos sobre el virus fueron cuestiones generales que afectaron a todos los comportamientos de salud pública. Conclusión: Las prácticas COVID-19 no fueron sencillas de aplicar ni de adherir para las madres solteras. Hubo una amplia gama de barreras y facilitadores que informan de la necesidad de crear sistemas de apoyo. Otros estudios deberían tener en cuentalas cuestiones genéricas y las barreras específicas del comportamiento a la hora de evaluar las intervenciones de promoción de la salud y aplicar las políticas de salud pública COVID-19.

To critically review, analyze, and synthesize the literature surrounding the impact of parental burden, stress, and burnout on children and youth with cerebral palsy (CP). Background Parents of children with CP experience more stress and symptoms of burnout compared to parents of children without a disability. Although the impact of a child’s disability on the parent has been examined, little is known about the subsequent impact their stress has on their kin. Methods Databases including CINAHL, Embase, Medline, Nursing and Allied Health, PsycInfo, and Scopus were searched. Title, abstract, and full manuscript review were completed by two reviewers. Studies were evaluated for quality using the Joanna Briggs Institute Critical Appraisal Tools. Data from individual studies were synthesized and charted according to developmental domain. Results Overall, 18 articles met inclusion criteria. After quality appraisal, 15 with low to moderate risk of bias were included in the final analysis. Overall, studies included determined that parental stress worsens a child’s outcome, regardless of developmental domain assessed. Conclusion Parental stress has a negative influence on behavioural, physical, and occupational outcomes for children with CP. Additional research is needed to better understand the impact prolonged parental stress has on these and other developmental domains.

Purpose: This study assessed physical activity (PA) and body composition of ambulatory children and adolescents with cerebral palsy (CP) and their typically developing peers. Methods: Participants included youth with CP (ages 8–18 y and Gross Motor Function Classification System [GMFCS] levels I–III) and their typically developing peers. Outcomes included PA (actigraphy) and fat/lean mass index (FMI/LMI; dual-energy X-ray absorptiometry). Statistical analyses included linear mixed effects models with Bonferroni adjustment. Fixed effects were study group (CP and typically developing); random effects were participant clusters (sex and age). Exploratory analyses included association of body composition and PA, GMFCS level, and CP involvement (unilateral and bilateral). Results: Seventy-eight participants (CP: n = 40, girls: n = 29; GMFCS I: n = 20; GMFCS II: n = 14; GMFCS III: n = 6) met inclusion criteria. Individuals with CP had lower moderate to vigorous PA (MVPA; β = −12.5; 98.3% confidence interval, −22.6 to −2.5 min; P = .004) and lower LMI (β = −1.1; 97.5% confidence interval, −2.1 to −0.0 kg/m²; P = .020). Exploratory analyses indicated increased LMI with greater MVPA (P = .001), reduced MVPA for GMFCS II (P = .005) and III (P = .001), increased sedentary time for GMFCS III (P = .006), and greater fat mass index with unilateral motor impairment (P = .026). Conclusions: The findings contribute to the knowledge base of increasing MVPA and LMI deficits with the greater functional impact of CP. Associations of increasing LMI with greater MVPA support efforts targeting enhanced PA participation to promote independent mobility.

To summarize the available evidence for the delivery of synchronous virtual rehabilitation intervention services for preschoolers and to identify key factors associated with virtual intervention.Fi... The COVID-19 pandemic has increased the need for effective, evidence-based virtual interventions.This study summarizes the available literature to support preschool rehabilitation clinicians in mak...

Interventions such as painted designs on school tarmacs may increase children’s physical activity during school hours. This mixed-methods study examined the influence of a painted designs (e.g., traditional games, random circles) intervention on the physical activity experiences of elementary school children. Systematic observations and accelerometer data were collected to evaluate the type and quantity of student physical activity. Interviews were used to explore teacher and student experiences. Observed physical activity was not significantly different between intervention and control schools (t(43) = 0.22, p = 0.83), and children at the intervention schools undertook less physical activity (steps, moderate, vigorous, and combined moderate-to-vigorous activity) as compared with the control school (t = 2.71–4.35, p < 0.05). Teachers and students commented that the painted designs were confusing but held potential for inclusiveness, physical activity, and learning. Additional resources and instruction may assist in better use of painted designs for physical activity and academic learning.

Children and adolescents with cerebral palsy (CP) are at heightened risk for mental health problems. Physical activity is an effective strategy to promote quality of life (QoL) and reduce mental he...