کودکان

With the occurrence of the Covid-19 epidemic and the high mortality following it, as well as the importance of childhood, which can lead to the occurrence of adverse clinical outcomes in the aforementioned sensitive group; Correct management of corona disease in children is of particular importance. Considering the anti-inflammatory effects of the zinc element, the possible effects of zinc supplementation on clinical outcomes were investigated.

This retrospective cross-sectional study was conducted in Akbar Hospital in the period of 1402-1403. The case of infected children hospitalized in the intensive care unit between 1399 and 1401 was evaluated. Clinical outcomes including the duration of ventilator connection, secondary infection, duration of hospitalization and mortality were recorded. Data analysis was done with SPSS version 27 software.

In this study, a total of 134 patients were evaluated during the study period, of which 76 patients received zinc and 58 patients did not receive zinc. The days of hospitalization in the intensive care unit and the days of hospitalization in the zinc group were significantly higher. The group receiving zinc had a lower mortality rate compared to the group not receiving zinc. Other clinical outcomes were not significantly different between the two groups.

After controlling for possible confounders, the results of our study indicated that the mortality rate increases independently with the lack of zinc intake.

Children are a crucial facet of society, serving as significant agents who play an essential role in shaping future generations and promoting social well-being. Additionally, the individual characteristics of parents, particularly mothers, have a profound impact on their children's development. This study aims to investigate the relationship between the anxiety levels of working mothers and the early maladaptive schemas of children aged 5 to 7 years in Shiraz City, Iran.

This research employed a descriptive-correlational design and utilized a questionnaire survey method. The statistical population consisted of working mothers who visited counseling centers in Shiraz City during the six-month period of the study. A random sampling method was used to select a sample size of 132 participants for the research. Data were collected using Zung Self-Rating Anxiety Scale (SAS) and Young Schema Questionnaire (SQ). Subsequently, the data were analyzed using the Kolmogorov-Smirnov, correlation, and regression tests in SPSS software.

There was a significant relationship between the anxiety levels of working mothers and the early maladaptive schemas of children aged 5 to 7 years (r = 0.425, P < 0.001). Additionally, there was a notable correlation between the anxiety of positively oriented working mothers and the early maladaptive schemas of their children (r = 0.407, P < 0.001). Furthermore, a significant relationship existed between the anxiety of negatively oriented working mothers and their children's early maladaptive schemas (r = 0.433, P < 0.001). The negative anxiety component accounted for 44% of the variance associated with early maladaptive schemas.

The present study demonstrated that the anxiety experienced by working mothers had a significant relationship with children's early maladaptive schemas. Strengthening the behavioral dynamics between mothers and their children necessitates identifying and addressing the primary factors that contribute to maternal anxiety. By fostering a nurturing environment and improving access to mental health resources, it may be possible to mitigate the adverse effects of anxiety on parent-child interactions and reduce the emergence of early maladaptive schemas in children.

Stress is defined as a state of mental or emotional strain. Given the calming effects of music and the emergence of a new genre known as three-dimensional (3D) music, this study aimed to evaluate the effectiveness of 3D music therapy in reducing dental anxiety in 6–7-year-old children.

Methods and Materials:

This applied, quasi-experimental study was conducted with a pre-test/post-test design. The sample was selected from 6-7 year-old children admitting to a private dental clinic in Rafsanjan, Iran. Prior to receiving any treatment, patients were evaluated in terms of dental anxiety using the Spence Children's Anxiety Scale. Children with relatively high or high levels of dental anxiety were included in the study. A total of 60 children were enrolled and were randomly divided into three equal groups (n=20): control, regular music and 3D music groups. All participants underwent the same dental treatment during their second session and pre- and post-treatment anxiety levels were measured for all. Intra- and inter-group comparisons were conducted. P-value<0.05 was considered statistically significant.

The three groups were homogeneous with respect to potential confounding variables such as the child’s age, parental age, education level, and occupation. According to Kruskal-Wallis test, there was no statistically significant difference between the study groups in terms of baseline anxiety levels (P=0.883). However, after the intervention, the mean anxiety score increased in the control group (2.90 ± 1.12 versus 3.45 ± 1.32), while it decreased in both the regular music (2.90 ± 1.45 versus 2.70 ± 1.45) and 3D music groups (3.05 ± 1.23 versus 2.95 ± 1.31).

Given the reduction in anxiety levels observed in both the music and 3D music groups, the use of  3D music therapy can be recommended as an effective method to alleviate dental anxiety in pediatric patients.

Physical activity plays a critical role in the treatment of childhood obesity; therefore, its promotion is of significant importance in clinical and public health interventions.

This study was conducted to investigate the effect of the play therapy package based on executive functions on physical activity among obese children.

This study employed a quasi-experimental design with pre-test, post-test, and follow-up assessments, including a control group. The study population consisted of all individuals referred to Iranian health centers in Isfahan City between the second half of 2021 and the first half of 2022. A total of 45 parent–child pairs, in which the children were classified as obese, were selected through convenience sampling and randomly assigned to either the experimental group (n = 22) or the control group (n = 23) using simple randomization. All participating parents were female, with a mean age of 34.64 years. The children, of both sexes, had a mean age of 9.41 years. While both groups underwent weekly height and weight measurements, the experimental group also participated in eleven 45-minute sessions of play therapy training, whereas the control group received no intervention. The Physical Activity Enjoyment Scale (PAES) was used as the primary measurement tool. Data analysis was conducted using SPSS version 29, employing chi-square tests and repeated measures multivariate analysis of variance (MANOVA) at a significance level of 0.05.

The findings showed that there was no significant difference between the 2 groups in terms of demographic data. It was also found that the play therapy package had a significant effect (P<0.05) on promoting physical activity in obese children.

Based on the results of this study, play therapy training based on executive functions has a significant effect on promoting physical activity in obese children, and therefore, it can be used to promote physical activity among obese children.

As mentioned, in this study we compared the type of microorganisms causing pyelonephritis and their resistance in two groups of children with and without constipation. This issue is very important in the clinic in initial empirical treatment (before culture results are reported) and antibiotic selection. The number of microorganisms that cause pyelonephritis is large. We cannot limit the identification and comparison of microorganisms that cause pyelonephritis (for example, to two or three types) and also their resistance.

This cross-sectional study investigated the children with pyelonephritis and admitted to Amirkola children hospital in Babol, Iran between 2014-2021. The census method was adopted to include the children in the study based on the inclusion criteria. All children aged between two months and 18 years and without consumption of any oral or injection of antibiotic 48 hours before admission were enrolled. The microorganism sensitivity and drug resistance were evaluated using the disk diffusion antibiogram and the guidelines by Clinical and Laboratory Standard Institute (CLSI). Constipation was diagnosed based on the criteria of ROME III, IV and confirm a gastroenterologist.

Out of 270 children with pyelonephritis, nearly 56 (%20.7) children had functional constipation. Nitrofurantoin (%95.2) and Ampicillin (%67.2) were the most sensitive and resistant drugs. Escherichia coli was the most common microorganism in both groups (P<0.05), and no difference was detected between two groups in terms of the drug sensitivity or resistance (P<0.05).

In sum, roughly one fifth of the children with pyelonephritis had functional constipation. The microorganisms causing pyelonephritis in children with and without functional constipation were not different in terms of the type and antibiotic resistance.

Structured educational programs focused on diabetes self-management can lead to significant improvements in blood sugar control and other diabetes-related outcomes. Diabetes camps provide unique educational experiences for individuals with diabetes. This systematic review aims to investigate the impact of diabetes camps on hemoglobin A1C (HbA1C) in children with type 1 diabetes.

Scopus, ISI Web of Science, PubMed, and Google Scholar databases were systematically searched to find intervention studies that investigated the effect of camp on HbA1C in children with type 1 diabetes. Among the selected studies, the participants’ knowledge and any changes in insulin dosage were also investigated. The random effects model was employed to calculate overall effects, and subgroup analyses were performed to identify potential sources of heterogeneities among the studies.

A total of 11 clinical trials were included in the meta-analysis. The study results indicated a significant reduction in HbA1c levels [95% confidence interval (CI): -0.904 to -0.144, mean difference: -0.524, P: 0.007]. Additionally, the intervention did not have a significant effect on the insulin dosage required by the patients (mean difference: -0.02, 95% CI: -0.07 to -0.04). However, it did significantly enhance patients' knowledge and awareness (mean difference: 16.95, 95% CI: 4.95-28.94).

The camp can be beneficial for improving blood sugar levels in individuals with type 1 diabetes while also enhancing their knowledge.

Urinary tract infections (UTIs) are among the most common infections in children, with the potential to cause permanent renal damage. Technetium-99m-DMSA scanning is considered the gold standard for the diagnosis of pyelonephritis. The present study aimed to assess DMSA scan findings and investigate their correlation with clinical and paraclinical parameters in children diagnosed with pyelonephritis.

This descriptive-analytical study was conducted on 109 children aged between 6 months and 12 years who were hospitalized with a diagnosis of pyelonephritis at Shahid Motahari Hospital in Urmia, Iran, from September 2023 to May 2024. Demographic characteristics, clinical symptoms, laboratory findings white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and DMSA scan results were collected and analyzed. Statistical analysis was performed using SPSS software version 27.0, applying the Chi-square test. A p-value of less than 0.05 was considered statistically significant.

The mean age of the patients was 5.82±2.34 years, and the majority of the participants (n=83, 76.15%) were female. The most common clinical symptoms were fever, anorexia, pain and irritability, as well as nausea and vomiting. DMSA scan findings revealed bilateral renal involvement in 57 (52.30%) patients. Leukocytosis was present in 31 (28.44%) cases, positive CRP in 69 (63.30%) cases, and elevated ESR in 73 (66.97%) cases. Elevated ESR or positive CRP showed no significant association with the severity of renal damage. However, severe renal involvement had a significant association with elevated leukocytosis and high-grade fever (>38°C).

The results of this study showed that clinical indicators such as high-grade fever may serve as early warning signs of renal damage in children with pyelonephritis. Nevertheless, DMSA scanning remains indispensable for the definitive detection of renal parenchymal injury.

Enlarged adenoids are a common problem in childhood and the most common cause of upper airway obstruction and sleep apnea in children. If untreated, they can cause widespread cardiovascular complications. This study aimed to investigate the prevalence and severity of increased pulmonary artery pressure in children with enlarged adenoids who were referred to the Asthma and Allergy Clinic of Shahid Motahari Hospital in Urmia from 2022 to 2023.

In this descriptive-analytical study, all children referred to the Asthma and Allergy Clinic of Urmia University of Medical Sciences during 2022 with a diagnosis of enlarged adenoids, confirmed by a doctor using a special mirror or a flexible camera (nasal endoscopy), were evaluated. Information such as age, gender, place of residence, clinical symptoms of the patients (sleep disturbance, frequent colds, etc.), and previous medical history were collected in special data collection forms. The collected data were entered into SPSS version 22 software and statistically analyzed.

The mean age of the 19 patients in the study was 7.4 years, and 63.2% were girls. The mean pulmonary artery pressure was 11.36 mmHg, and the mean ANR among the patients was 0.78. Most patients had severe adenoid enlargement (63.2%). There was no significant difference in pulmonary artery pressure between patients with severe, moderate, and mild adenoid enlargement
(P = 0.53). There was no significant association between ANR and pulmonary artery pressure
(r = 0.02, p = 0.92).

The prevalence of increased pulmonary artery pressure in children with enlarged adenoids was 5.2%, and there was no significant relationship between the severity of enlarged adenoids and pulmonary artery pressure.

  Infection is a cause of fever and seizures, and urinary tract infections are common in childhood. Delayed diagnosis may lead to severe complications. Given the conflicting results in studies examining the relationship between febrile seizures and urinary tract infection in children, this study aimed to investigate the prevalence of urinary tract infections in children with fever and seizures at the Shahid Motahari Educational Center, Urmia.

This retrospective cross-sectional study included 790 patients aged 6–60 months with fever and seizures who were referred to Shahid Motahari Hospital, Urmia, between April 2021 and March 2022. Demographic characteristics and clinical parameters were extracted and analyzed from the patient records. Urinary tract infections were characterized by the presence of more than 100,000 bacterial colonies per milliliter of urine.

The prevalence of urinary tract infections in children with fever and seizures was 9.87%. The mean age of patients with urinary tract infection was 35.85±12.96 months, with a urinary tract infection frequency of 57.69% in boys and 42.30% in girls. Fever of 38.5–39°C was most frequent, and the mean duration was 31.59±10.63 hours, with most patients experiencing high fever for 24 to 36 hours. The interval between fever onset and seizures was 12.97±3.09 hours, with most seizures occurring within 9 to 12 hours of fever onset. Escherichia coli was the most prevalent urinary microorganism. Among the patients, 6 (7.69%) had a family history of fever and seizures, 9 (11.53%) had a history of fever and seizures, and 14 (17.94%) had a history of urinary tract infection.

This study indicated a significant prevalence of urinary tract infections in children with febrile seizures and provided insights into the demographic and clinical characteristics of this population. These findings emphasize the importance of routine screening for urinary tract infections in children with febrile seizures and the need for prompt treatment to prevent recurrent episodes and associated complications.

Crimean Congo hemorrhagic fever (CCHF) is a hemorrhagic fever caused by a viral agent. Among Asian countries, Iran is an endemic region for CCHF. Reports about this infection in Iran show that adults are more affected by this disease than children. However, rural children, especially boys, are at a higher risk of CCHF than other children due to contact with livestock and their secretions. In areas with higher prevalence, it is necessary to consider the diagnosis of this disease in children who mention the symptoms of fever, petechiae and purpura, ecchymosis, decreased level of consciousness, and a history of contact with animals. Since there is no definitive treatment for this disease, timely diagnosis and hospitalization of the patient is the only way to increase the probability of survival in severe cases. The present case report presents a fatal case of definitive CCHF in a six-year-old boy with confirmed CCHF by PCR

Upper Crossed Syndrome (UCS) is a postural imbalance that leads to abnormal patterns in joints and soft tissues. This study aimed to compare neck and shoulder pain, as well as scapulohumeral rhythm, in female students with and without UCS.

In this causal-comparative study, 60 female students aged 10-12 years from Khalkhal city, during the academic year 2022-2023, were selected as the research sample and screened using a posture assessment grid. Based on quantitative physical assessments, participants were divided into two groups: healthy (n=30) and UCS (n=30). Forward head and shoulder angles were evaluated using photographic analysis, kyphosis angle was measured with the Goniometer-pro app, pain index by Visual Analog Scale (VAS), and scapulohumeral rhythm was assessed using the Lateral Scapular Slide Test (LSST).

The findings revealed significant differences in neck pain, shoulder pain, and scapulohumeral rhythm between students with UCS and healthy subjects (p < 0.05).

UCS is associated with increased neck and shoulder pain and disrupted scapulohumeral rhythm. Therefore, implementing corrective interventions and preventive programs is recommended for students at risk of postural abnormalities and impaired musculoskeletal function.

Since ancient times, humans have used images as a means of conveying concepts. Today, with the advancement of visual technologies such as animation, virtual spaces, and the internet, children's interaction with images has increased more than ever before. Utilizing these capabilities in teaching moral virtues can contribute to the development of various psychological and social aspects of children. This study aimed to investigate the effectiveness of teaching moral intelligence concepts through images on children's self-efficacy.

This was a quasi-experimental study with a pretest-posttest design and follow-up with a control group, conducted on fifth-grade female students from public elementary schools in Isfahan. First, using simple random sampling, two elementary schools were selected, and from each school, a randomly chosen group of 20 students (total sample: 40 students) participated in the study. Then, using the block random allocation method, students were assigned to the experimental and control groups. Next, moral intelligence and social self-efficacy questionnaires were administered to the participants. The experimental group attended nine educational sessions, during which they received educational packages containing images related to the seven virtues of moral intelligence; meanwhile, the control group did not receive any intervention. Upon completing the sessions, the same questionnaires were re-administered to both groups, and one month later, a follow-up assessment was conducted to evaluate the sustainability of the intervention effects. Statistical analyses were performed using SPSS version 26 usin g multivariate analysis of covariance.

Teaching moral concepts through images significantly improved children's moral intelligence and social self-efficacy scores. The mean moral intelligence score in the experimental group increased from 42.35±3.12 in the pre-test to 57.15±2.94 in the post-test (p<0.001), while the mean social self-efficacy score rose from 38.40±4.10 to 53.25±3.85 (p<0.001). The score difference between the experimental and control groups were 14.80 points for moral intelligence and 14.85 points for social self-efficacy.

The findings indicated that teaching moral concepts through images significantly enhanced children's social self-efficacy. Given the effectiveness of this method, it is recommended that educational planners and policymakers utilize engaging and purposeful images as a powerful tool for fostering children's social self-efficacy in educational environments.

Attention-deficit hyperactivity Disorder (ADHD) can negatively impact perceptual reasoning, processing speed, and working memory in children. Cognitive rehabilitation has emerged as a potential intervention for improving these cognitive functions. This study aimed to investigate the effect of cognitive rehabilitation on perceptual reasoning, processing speed, and visual and auditory working memory in children with ADHD.

This research was semi-experimental with a pre-test-post-test and follow-up design. The study population included children aged 8 to 12 years diagnosed with ADHD in Urmia during the 2023-2024 academic year. From this population, 30 children were selected using a purposive sampling method based on inclusion and exclusion criteria and were randomly assigned to experimental and control groups (15 children each). Participants completed the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) and the N-Back working memory test before and after the cognitive Rehabilitation intervention and at the follow-up stage. The Captain's Log cognitive rehabilitation program was implemented for the experimental group in 20 sessions of 45 minutes each over 2 months. Data were analyzed using mixed analysis of variance via SPSS-25 software.

Results indicated that the cognitive rehabilitation program significantly improved perceptual reasoning, increased processing speed, and strengthened visual and auditory working memory in the experimental group compared to the control group (p<0.01), and these effects were stable during the follow-up phase (p<0.01).

The findings of the present study indicate a high effectiveness of cognitive rehabilitation in enhancing cognitive functions in children with ADHD. Therefore, clinical specialists and psychotherapists can utilize this intervention to effectively treat cognitive issues in this age group.
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 Ethanol poisoning is one of the most common poisonings in the toxicologic emergency department. This study aimed to investigate the clinical symptoms of ethanol poisoning in children and the outcome of treatment of these patients.

This retrospective cross-sectional study was conducted in 1402. The inclusion criteria were ethanol-poisoned patients (children under 18 years old) who were admitted to Imam Hossein Children's Specialized Hospital and Khurshid Hospitals in Isfahan from the beginning of 2015 to the end of November 2014. Demographic information, clinical symptoms, length of hospitalization, and the outcome of treatment of the patients were recorded.

364 patients were included in this study, of which 320 were in Khurshid Hospital and 44 were in Imam Hossein (AS) Hospital. These patients had an age range of 1 to 18 years and an average of 14.73 ± 3.77 years (P = 3.7), of which 85.2% were boys. 86.1% of patients were older than 12 years old. The highest manifestation of the disease was related to nausea and vomiting in 196 cases (53.8%), followed by a decreased level of consciousness in 123 cases (33.8%). Most of the patients (98.1%) were discharged from the hospital in less than 24 hours and with the improvement of their symptoms. Also, 3 cases of patients were hospitalized in the intensive care unit of the ICU.

Ethanol poisoning was significantly higher in boys under 18 than in girls. A significant percentage of poisoning cases are abuse cases. Although the prognosis of ethanol poisoning in children was a complete recovery, a small percentage required long-term hospitalization.

 Obesity has been recognized as a risk factor for COVID-19 infection in children. Multisystem Inflammatory Syndrome in Children (MIS-C) is a multisystem inflammatory disease following COVID-19, characterized by the involvement of at least two organs. Considering the significant role of obesity in the severity of COVID-19, this study investigates the prevalence of obesity and the factors affecting it in MIS-C patients.

This descriptive study included MIS-C patients younger than 21 years of age from December 2019 to September 2023. The patients were identified using the Centers for Disease Control and Prevention (CDC) checklist. Based on growth charts developed by the World Health Organization (WHO), the classification of overweight and obese children was determined according to the age and sex of each child. The demographic characteristics, clinical features, and outcomes were collected from the medical records. Data were analyzed using the t-test (or Mann-Whitney), Chi-square test, and logistic regression in STATA 14.

A total of 174 MIS-C patients were referred to hospitals, of whom height and weight measurements were documented for 149 patients. Of these, 11.41% of patients were overweight, and 17.45% were classified as obese. The median age was 62 months, and most of the patients were boys. The most common symptoms were gastrointestinal. In terms of clinical outcomes, ICU admission, death, and the median hospital stay in the obese group were 60%, 2%, and nine days, respectively, while in the non-obese group, they were 22%, 0.94%, and eight days, respectively. Significant differences were observed between the two groups in cardiac symptoms, comorbidity, duration of hospitalization, length of ICU stay, and need for ICU care (P<0.05). In the adjusted model, comorbidity was identified as a significant predictor (OR= 6.17; 95% CI: 0.34, 16.24).

The study's results indicate that obesity is associated with more severe clinical presentations and outcomes among MIS-C patients. Consequently, early intervention is crucial for preventing complications in obese MIS-C patients.

 Constipation is a significant health issue among children, requiring prompt screening and early diagnosis due to its substantial contribution to disease burden. Probiotics, which colonize the bowel, are known to exert positive effects on the gut microbiota. While probiotics have been extensively studied in relation to various gastrointestinal disorders, there is limited research specifically addressing their efficacy in managing pediatric constipation. To address this gap, we designed a study to evaluate the impact of probiotics on the treatment of constipation in children attending the Imam Sajad hospital clinic in Ramsar, Iran.

This double-blind clinical trial involved 90 children diagnosed with constipation, who were randomly assigned to either an intervention or a control group. For each child, a checklist was first completed, and all children received toilet training conducted by the researcher. The control group received standard treatment for constipation, which included 0.7-1.5 grams per kilogram of Polyethylene Glycol (PEG) powder (Pidrolox). The intervention group received the same standard treatment in addition to a probiotic supplement (Kidy Lact). The study duration was four weeks and all the patients were clinically examined at two and four weeks after the intervention. The primary assessment criteria included stool consistency, the frequency of incontinence episodes per week, the presence of abdominal pain, and painful bowel movements. Secondary evaluations focused on treatment success and any adverse effects, such as diarrhea and vomiting.

After two weeks, no significant differences were observed between the intervention
and control groups regarding stool frequency, painful defecation, incontinence, and abdominal pain (P=0.30, P=0.85, P=0.53, and P=0.23, respectively). Furthermore, after four weeks, stool frequency and incontinence did not show significant differences between the two groups (P=0.22 and P=0.53, respectively). However, the frequency of painful bowel movements in the intervention group was significantly lower than in the control group (P=0.04).

Based on the findings of this study, adding probiotics to the standard treatment for functional constipation, such as Polyethylene Glycol powder, may be beneficial for children. To obtain more precise results, it is recommended that long-term studies be conducted using probiotics.

Acute lymphoblastic leukemia (ALL) is one of the most common childhood
malignancies with a prevalence of 40 per million children under 15 years old. This study aimed to investigate the expression of myopathic markers following the use of chemotherapeutic agents in children with leukemia and the role of inflammatory cytokines in this disorder.

This descriptive-analytical study was conducted on children with ALL with and without symptoms of myopathy who were hospitalized at Shahid Baghaei 2 Hospital. These two groups were compared in terms of aldolase, creatine kinase, tumor necrosis factor (TNF-α), and interferon-gamma (INF-γ) by ELISA. Statistical analysis was performed using SPSS version 22 software.

Of the 40 children with ALL with and without symptoms of myopathy, the mean age was 8.68 ± 3.89 years. There was no significant relationship between inflammatory cytokines and age; however, there was a significant difference in gender between the case and control groups (P=0.047), with inflammatory cytokines being higher in boys than girls. The serum aldolase level in the case group did not differ significantly from the control group (P=0.947). The serum creatine kinase level was significantly reduced in the case compared to the control group (P=0.009). Also, the serum levels of inflammatory factors TNF-α and INF-γ were not significantly different between the case and control groups.

Since inflammation caused by malignancies is one of the factors causing myopathy, inflammatory markers can be used to evaluate the effectiveness of therapeutic interventions in patients with various types of malignancies.

Oral health is a crucial component of general health. However, statistics and indicators have not shown improvements in dental health in Iran in recent years. Enhancing the quality of dental services in the country requires comprehensive knowledge of the current state of dental care provision. Therefore, this study aimed to evaluate dental services for children in Tabriz over the past five years and to propose strategies for improvement.

This qualitative study employed a phenomenological approach and was conducted in Tabriz in 2021 (1400 Persian Calendar year). Data were collected through focus group discussions with 13 participants and semi-structured individual interviews with six participants. Among the 19 participants, 11 were general dentists, and five were pediatric dentists. Data were analyzed using Diekelmann's seven-stage phenomenological analysis method, and the main and sub-themes were categorized.

Six main themes and 33 sub-themes were identified. The main themes were: stewardship and leadership, service delivery, human resources, facilities and equipment, information recording, and economic issues. Seven sub-themes were found under stewardship and leadership, eight sub-themes emerged under service delivery, seven sub-themes were identified under human resources, one sub-theme was found under facilities and equipment, emphasizing their adequacy and appropriateness, five sub-themes emerged under information recording, highlighting its weaknesses, and finally, five sub-themes were identified under economic issues.

  The provision of dental equipment and facilities was identified as a major strength. However, inadequate preventive and educational dental services for children, along with deficiencies in the recording and utilization of health information, were the primary weaknesses in the delivery of dental services to children in Tabriz over the past five years.

 Children are a particularly vulnerable group, and mothers' knowledge and awareness play a crucial role in fostering their developmental progress. Insufficient knowledge of the cognitive, emotional, and social aspects of child development may lead to a decrease in parental self-efficacy. This study aims to investigate the effect of a family-centered empowerment model on mothers' self-efficacy regarding the growth and development of toddlers. 

This quasi-experimental study was conducted in 2022 at Amir Kabir Hospital in Arak. A total of 72 mothers of hospitalized toddlers were selected and randomly assigned to either a control group (n=36) or an intervention group (n=36) through block randomization. The control group received standard hospital care, while the intervention group participated in a five-session, family-centered empowerment model program, with each session lasting 60 minutes. Data were collected using demographic questionnaires and parenting self-efficacy assessments, administered before the intervention, immediately after, and one month post-intervention. Analysis was performed using SPSS version 26, incorporating both descriptive and inferential statistics.

The results showed that the mean self-efficacy scores before the intervention had no statistically significant difference between the two groups (P=0.416). However, post-intervention, the mean parenting self-efficacy scores demonstrated a statistically significant difference between the groups (P<0.001). Additionally, the mean parenting self-efficacy scores measured one month after the intervention also showed a statistically significant difference (P<0.001).

The family-centered empowerment model significantly improved mothers' self-efficacy. It is recommended as an effective approach for improving the management of children's growth and development.