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Objective: To assess differences between traditional paper bag ordering and online ordering from primary school canteens in terms of menu, usage and lunch order characteristics.Design: A cross-sectional study.Setting: New South Wales (NSW) primary schools that offered both paper bag and online canteen ordering.Participants: Students (aged 5-12 years) with a lunch order on the day of the observation.Results: Across the six school canteens, 59-90 % of all available items were listed on both the online and paper menus, with no significant differences in the nutritional quality ('Everyday'/'Occasional') or nutritional content (kJ/saturated fat/sugar/sodium) of menu items. In total, 387 student lunch orders were placed, containing 776 menu items. Most orders (68 %) were placed online. There were no significant differences between order modality in the quantity of items ordered or the cost of orders, or the nutritional quality of orders based on the classification system of the NSW Healthy School Canteen Strategy ('Everyday'/'Occasional'). However, nutritional analysis revealed that paper bag orders contained 222 fewer kJ than online orders (P = 0·001), 0·65 g less saturated fat (P = 0·04) and 4·7 g less sugar (P < 0·001).Conclusions: Online canteens are commonly used to order canteen lunches for primary school children. This is the first study to investigate differences between traditional paper bag ordering and online ordering in this setting. Given the rapid increase in the use of online ordering systems in schools and other food settings and their potential to deliver public health nutrition interventions, additional research is warranted to further investigate differences in ordering modalities. [ABSTRACT FROM AUTHOR]

Background: Childhood immunisation is a critically important public health initiative. However, since most vaccines are administered by injection, it is associated with considerable pain and distress. Despite evidence demonstrating the efficacy of various pain management strategies, the frequency with which these are used during routine infant vaccinations in UK practice is unknown. Aim: This study aimed to explore primary care practice nurses' (PNs) use of evidence-based pain management strategies during infant immunisation, as well as barriers to evidence-based practice. Methods: A questionnaire was developed and distributed to nurses throughout the UK via convenience sampling in paper and online formats. Questions assessed the frequency of pain management intervention use during infant immunisation and barriers to their use. Findings: A total of 255 questionnaire responses were received. Over 90% (n  = 226) of respondents never used topical anaesthetics or sweet solutions during immunisations, while 41.9% advised breastfeeding occasionally (n =  103). Parent-/caregiver-led distraction was the most frequently used intervention, with most nurses using it occasionally (47.9%, n =  116) or often (30.6%, n =  74). Most practices had no immunisation pain management policy (81.1%, n =  184), and most PNs' previous training had not included pain management (86.9%, n =  186). Barriers to intervention use included lack of time, knowledge and resources. Excluding distraction, pain management strategies were infrequently or never used during infant immunisation. Key barriers to using evidence-based strategies were lack of time, knowledge and resources. [ABSTRACT FROM AUTHOR]

The consumption of vegetables is vitally important for children's health and development. However, in many Westernised countries, most children do not eat sufficient quantities of vegetables and consume many energy-dense and high-sugar foods; a health behaviour associated with the onset of non-communicable diseases. To address this important public health concern, it is necessary to think 'outside the box' and consider innovative and pragmatic ways to increase children's daily vegetable intake. In many countries, caregivers implementing best-practice child feeding methods typically offer children vegetables at lunch, dinner and for snacks. It is unusual for children to be routinely offered vegetables for breakfast, yet there is no nutritional, physiological or medical reason why vegetables should not be eaten at breakfast. Indeed, in some countries, children frequently consume vegetables for breakfast. Increasing children's exposure to vegetables at breakfast from an early age would allow for the development of a positive association between eating vegetables and breakfast, thus providing another opportunity in the day where vegetables might be regularly consumed by children. In this paper, we propose a rationale for why vegetables should be routinely offered to young children at breakfast time in countries where this may not be the norm. Future research assessing the feasibility and acceptability of such a public health intervention would provide health policy agencies with evidence about a potentially effective and easily implementable approach for increasing children's vegetable intake, thus improving their overall nutritional status, as well as their heath and development. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the literature with the primary aim of identifying behavioural interventions to improve vitamin D stores in children from at-risk ethnic groups.Design: Review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PROSPERO registration number: CRD42017080932. Health Behaviour Model and Behaviour Change Wheel framework constructs used to underpin evaluation of interventions. Methodological quality evaluated using Cochrane Risk of Bias, Cochrane ROBINS-I and NHLBI tools.Setting: Databases Cochrane Library, MEDLINE, EMBASE, CINAHL with secondary search of Google Scholar. No country limits set. Papers between January 1990 and February 2018, published in English included. Anticipating study heterogeneity, outcome measures not pre-specified and identified from individual full papers. Updated literature search November 2020.Participants: Patient or population including pregnant women, newborns and children aged under 18 years, from Asian or African ethnic groups.Results: Of 10 690 articles screened, 298 underwent full-text review, with 24 ultimately included for data extraction. All identified studies conducted a vitamin D pharmacological supplementation intervention, with two also incorporating a behavioural intervention strategy. No study explicitly defined a primary aim of evaluating a behavioural intervention, undertaken to study its effect on vitamin D supplement uptake.Conclusions: There is a need to address the paucity of data in ethnic at-risk children on how behavioural interventions ideally developed and co-produced with the community under study, affect and help improve vitamin D uptake, within the antenatal and pregnancy phase as well as during childhood. [ABSTRACT FROM AUTHOR]

Objective: Chronic aflatoxin exposure has been associated with childhood stunting (length-for-age/height-for-age < -2 sd), while data lacks for Bangladesh, a country with substantial burden of childhood stunting. This paper examined the association between aflatoxin exposure and childhood stunting in a slum setting of Dhaka city.Design: In this MAL-ED aflatoxin birth cohort study, plasma samples were assayed for aflatoxin B1-lysine adduct (AFB1-lys) by MS at 7, 15, 24 and 36 months of age for 208, 196, 173 and 167 children to assess chronic aflatoxin exposure. Relationship between aflatoxin exposure and anthropometric measures was examined by mixed-effects logistic regression models.Setting and Participants: The study was conducted in Mirpur, Dhaka, where children were followed from birth to 36 months.Results: Prevalence of stunting increased from 21 % at 7 months to 49 % at 36 months of age. Mean AFB1-lys concentrations at 7, 15, 24 and 36 months were 1·30 (range 0·09-5·79), 1·52 (range 0·06-6·35), 3·43 (range 0·15-65·60) and 3·70 (range 0·09-126·54) pg/mg albumin, respectively, and the percentage of children with detectable AFB1-lys was 10, 21, 18 and 62 %, respectively. No association was observed between aflatoxin exposure and stunting in multivariable analyses. Factors associated with childhood stunting were age, low birth weight, maternal height, stool myeloperoxidase and number of people sleeping in one room.Conclusions: A relatively lower exposure to aflatoxin may not influence the linear growth of children. This finding indicates a threshold level of exposure for linear growth deficit and further investigation in other areas where higher concentrations of aflatoxin exposure exist. [ABSTRACT FROM AUTHOR]

Background. There is robust evidence that compromised parenting, stemming from persistently high stress, mediates the impact of war and displacement on children's mental health and psychosocial wellbeing. Parenting interventions generally prioritize the acquisition of parenting knowledge and skills, while under-attending to parental stress and distress. This paper describes the development of the Caregiver Support Intervention (CSI), a nine-session group intervention for conflict-affected parents of children aged 3-13, that aims to strengthen parenting both indirectly, by lowering stress and improving psychosocial wellbeing among parents, and directly, by increasing knowledge and skill related to positive parenting. Methods. We describe the multi-phase, iterative process by which we developed the CSI, and illustrate the essential role of community input in shaping the intervention and strengthening its cultural fit and perceived usefulness. We used focus group data from participants in successive cycles of implementation, feedback, and revision, as well as quantitative data and expert consultation to develop a culturally and empirically grounded intervention. Results. This mixed-method, iterative approach to intervention development enabled us to develop a psychosocial intervention for conflict-affected caregivers that is feasible, acceptable, and perceived by participants as useful in addressing their own wellbeing and their parenting. Focus group data support the underlying model in which caregiver wellbeing powerfully influences parenting. Conclusions. Programs aimed at strengthening parenting in conflict-affected communities should substantively address caregiver wellbeing. An iterative approach incorporating community feedback can help ensure intervention acceptability and feasibility. We also illustrate the feasibility of involving men in parenting interventions. [ABSTRACT FROM AUTHOR]

This paper compares how rules of international humanitarian law and rules of Islamic law protect children in armed conflict. It examines areas of convergence and divergence, and areas where there is room for clarification between these two legal systems. This comparative exercise spotlights four key topics marking the wartime experience of children: the unlawful recruitment and use of children by armed forces and armed groups, the detention of children, their access to education, and the situation of children separated from their families. [ABSTRACT FROM AUTHOR]

Objective: Prevalence ranges to classify levels of wasting and stunting have been used since the 1990s for global monitoring of malnutrition. Recent developments prompted a re-examination of existing ranges and development of new ones for childhood overweight. The present paper reports from the WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring.Design: Thresholds were developed in relation to sd of the normative WHO Child Growth Standards. The international definition of 'normal' (2 sd below/above the WHO standards median) defines the first threshold, which includes 2·3 % of the area under the normalized distribution. Multipliers of this 'very low' level (rounded to 2·5 %) set the basis to establish subsequent thresholds. Country groupings using the thresholds were produced using the most recent set of national surveys.Setting: One hundred and thirty-four countries.Subjects: Children under 5 years.Results: For wasting and overweight, thresholds are: 'very low' (≈6 times 2·5 %). For stunting, thresholds are: 'very low' (≈12 times 2·5 %).Conclusions: The proposed thresholds minimize changes and keep coherence across anthropometric indicators. They can be used for descriptive purposes to map countries according to severity levels; by donors and global actors to identify priority countries for action; and by governments to trigger action and target programmes aimed at achieving 'low' or 'very low' levels. Harmonized terminology will help avoid confusion and promote appropriate interventions. [ABSTRACT FROM AUTHOR]

In a world that offers children abundant activities from which to choose, understanding how to motivate children to engage longer in productive activities is crucial. This paper examines how the offered assortment size affects children's engagement with their chosen option. In the first study, I show children prefer to choose from a larger set even though they think doing so is more difficult. Then, in Studies 2 and 3, four-to five-year-old children choose from either a small set (two options) or a large set (six or seven options). In study 2, children choose a book to look at and I measure how long they look at it. In Study 3, children choose a game to play with and I measure how long they play. Children spend more time looking at the book and playing with the game they choose from the small versus the large set. By contrast, the size of the choice set does not affect food consumption. Such findings contribute to our understanding of young children's decision-making and have important implications for determining the optimal assortment size to offer children to increase engagement with desirable activities. [ABSTRACT FROM AUTHOR]

Objective: The present paper examines the influence of age and gender on food patterns of Latino children.Design: Data are from baseline of a 5-year, quasi-experimental obesity prevention study: Niños Sanos, Familia Sana (NSFS; Healthy Children, Healthy Families). In 2012, the researchers interviewed Latino parents, using a thirty-item questionnaire to ask about their children's food consumption and feeding practices. Statistical tests included t tests and ANCOVA.Setting: Rural communities in California's Central Valley, USA.Subjects: Two hundred and seventeen parents (87-89% born in Mexico) and their children (aged 2-8 years).Results: Fifty-one per cent of the children were overweight or obese (≥85th percentile of BMI for age and gender). Mean BMI Z-scores were not significantly different in boys (1·10 (SD 1·07)) and girls (0·92 (SD 1·04); P=0·12). In bivariate analysis, children aged 2-4 years consumed fast and convenience foods less often (P=0·04) and WIC (Supplemental Nutrition Program for Women, Infants, and Children)-allowable foods more often than children aged 5-8 years (P=0·01). In ANCOVA, neither age nor gender was significantly related to food patterns. Mother's acculturation level was positively related to children's consumption of fast and convenience foods (P=0·0002) and negatively related to consumption of WIC foods (P=0·01). Providing role modelling and structure in scheduling meals and snacks had a positive effect on the vegetable pattern (P=0·0007), whereas meal skipping was associated with more frequent fast and convenience food consumption (P=0·04).Conclusions: Acculturation and child feeding practices jointly influence food patterns in Latino immigrant children and indicate a need for interventions that maintain diet quality as children transition to school. [ABSTRACT FROM AUTHOR]

ObjectiveTo identify and critique tools that assess Ca and/or dairy intake in children to ascertain the most accurate and reliable tools available.DesignA systematic review of the literature was conducted using defined inclusion and exclusion criteria. Articles were included on the basis that they reported on a tool measuring Ca and/or dairy intake in children in Western countries and reported on originally developed tools or tested the validity or reliability of existing tools. Defined criteria for reporting reliability and validity properties were applied.SettingStudies in Western countries.SubjectsChildren.ResultsEighteen papers reporting on two tools that assessed dairy intake, ten that assessed Ca intake and five that assessed both dairy and Ca were identified. An examination of tool testing revealed high reliance on lower-order tests such as correlation and failure to differentiate between statistical and clinically meaningful significance. Only half of the tools were tested for reliability and results indicated that only one Ca tool and one dairy tool were reliable. Validation studies showed acceptable levels of agreement (<100 mg difference) and/or sensitivity (62–83 %) and specificity (55–77 %) in three Ca tools. With reference to the testing methodology and results, no tools were considered both valid and reliable for the assessment of dairy intake and only one tool proved valid and reliable for the assessment of Ca intake.ConclusionsThese results clearly indicate the need for development and rigorous testing of tools to assess Ca and/or dairy intake in children and adolescents. [ABSTRACT FROM AUTHOR]

ObjectivesUniversal interventions may widen or narrow inequalities if disproportionately effective among higher or lower socio-economic groups. The present paper examines impacts of the Primary School Free Breakfast Initiative in Wales on inequalities in children's dietary behaviours and cognitive functioning.DesignCluster-randomised controlled trial. Responses were linked to free school meal (FSM) entitlement via the Secure Anonymised Information Linkage databank. Impacts on inequalities were evaluated using weighted school-level regression models with interaction terms for intervention × whole-school percentage FSM entitlement and intervention × aggregated individual FSM entitlement. Individual-level regression models included interaction terms for intervention × individual FSM entitlement.SettingFifty-five intervention and fifty-six wait-list control primary schools.SubjectsApproximately 4500 children completed measures of dietary behaviours and cognitive tests at baseline and 12-month follow-up.ResultsSchool-level models indicated that children in intervention schools ate a greater number of healthy items for breakfast than children in control schools (b = 0·25; 95 % CI 0·07, 0·44), with larger increases observed in more deprived schools (interaction term b = 1·76; 95 % CI 0·36, 3·16). An interaction between intervention and household-level deprivation was not significant. Despite no main effects on breakfast skipping, a significant interaction was observed, indicating declines in breakfast skipping in more deprived schools (interaction term b = −0·07; 95 % CI −0·15, −0·00) and households (OR = 0·67; 95 % CI 0·46, 0·98). No significant influence on inequality was observed for the remaining outcomes.ConclusionsUniversal breakfast provision may reduce socio-economic inequalities in consumption of healthy breakfast items and breakfast skipping. There was no evidence of intervention-generated inequalities in any outcomes. [ABSTRACT FROM AUTHOR]

ObjectiveAn increasing focus on legislation, policy and guidance on the nutritional content of school food has in part been in response to the limited impact of more behavioural or educational approaches. However, there is a risk that a sole focus on policy-level action may lead to neglect of the important contribution that more behavioural approaches can make as components of effective, coordinated, multilevel action to improve the dietary intake of schoolchildren. The current paper aims to highlight the potential importance of viewing alternative approaches as complementary or synergistic, rather than competing.DesignThe socio-ecological and RE-AIM frameworks are used to provide a theoretical rationale and demonstrate the importance of explicitly identifying the interdependence of policies, interventions and contextual structures and processes. School food case study evidence is used to exemplify how understanding and exploiting these interdependencies can maximise impact on dietary outcomes.SettingCase studies of trials in schools in the UK (South West England and Wales) and Australia (Victoria).SubjectsSchoolchildren.ResultsThe case studies provide examples to support the hypothesis that the reach, effectiveness, adoption, implementation and maintenance of school food policies and interventions can be maximised by understanding and exploiting the interdependence between levels in the socio-ecological framework.ConclusionsRather than being seen as competing alternatives, diverse approaches to improving the diets of schoolchildren should be considered in terms of their potential to be complementary and synergistic, acting at multiple levels to improve acceptability, fidelity, effectiveness and sustainability. [ABSTRACT FROM AUTHOR]

ObjectivePast research has identified increases in national income and urbanization as key drivers of the global obesity epidemic. That work further identified educational attainment and urban residence as important moderators of the effects of national income. However, such work has tended to assume that children and adults respond in the same way to these factors. In the present paper, we evaluate how the socio-economic and country-level factors associated with obesity differ between children and their mothers.DesignWe modelled the associations between maternal education, country-level income and urban residence with mother's and children's weight status.SettingWe analysed ninety-five nationally representative health and nutrition surveys conducted between 1990 and 2008 from thirty-three less developed countries.SubjectsOur sample included children aged 2–4 years (n 253 442) and their mothers (n 228 655).ResultsConsistent with prior research, we found that mothers’ risk of overweight was positively associated with economic development, urban residence and maternal education. Additionally, economic development was associated with steeper increases in mothers’ risk of overweight among those with low (v. high) levels of education and among those living in rural (v. urban) areas. However, these associations were different for children. Child overweight was not associated with maternal education and urban residence, and negatively associated with national income.ConclusionsWe speculate that the distinctive patterns for children may arise from conditions in low- and middle-income developing countries that increase the risk of child underweight and poor nutrition. [ABSTRACT FROM AUTHOR]

ObjectiveThe serious consequences of obesity and eating disorders (ED), difficulties encountered in treatment and the high prevalence of these conditions are important reasons to develop efforts aimed at their prevention. The implementation of integrated interventions aimed at preventing risk factors for both obesity and ED constitutes a very exciting development. In the present paper we discuss and review the main reasons for an integrated approach to the spectrum of eating- and weight-related problems, which include anorexia nervosa, bulimia nervosa, anorexic and bulimic behaviours, unhealthy dieting practices, body dissatisfaction, binge-eating disorder, overweight and obesity. Given differences between the fields with regard to current perspectives and objectives, key barriers to an integrated approach to prevention are discussed. In order to show the possibilities of development of this approach, we review the main contributions made to date in the fields of both obesity and ED prevention. In particular, environmental approaches in the prevention of obesity and ED are reviewed, given their potential for preventing a broad spectrum of eating- and weight-related problems. Furthermore, several examples of initiatives that have utilized an integrated approach to prevention are discussed.DesignNarrative review.ConclusionsWe recommend a scenario in which the two fields share knowledge to enhance the difficult work of preventing and treating both ED and obesity. [ABSTRACT FROM PUBLISHER]

ObjectiveDairy food consumption is important for Australian children as it contributes key nutrients such as protein and Ca. The aim of the present paper is to describe dietary intake from dairy foods for Australian children aged 2–16 years in 2007.DesignSecondary analysis of a quota-sampled survey using population-weighted, 1 d (24 h) dietary recall data.SettingAustralian national survey conducted from February to August 2007.SubjectsChildren (n 4487) aged 2–16 years.ResultsMost Australian children consumed dairy foods (84–98 %), with the proportion consuming tending to decrease with age and males consuming significantly more than females from the age of 4 years. Milk was the most commonly consumed dairy food (58–88 %) and consumed in the greatest amount (243–384 g/d). Most children consumed regular-fat dairy products. The contribution of dairy foods to total energy intake decreased with age; from 22 % of total energy at age 2–3 years to 11 % at age 14–16 years. This trend was similar for all nutrients analysed. Dairy food intake peaked between 06.00 and 10.00 hours (typical breakfast hours) corresponding with the peak in dairy Ca intake. Australian children (older than 4 years) did not reach recommendations for dairy food intake, consuming ≤2 servings/d.ConclusionsThe under-consumption of dairy foods by Australian children has important implications for intake of key nutrients and should be addressed by multiple strategies. [ABSTRACT FROM PUBLISHER]

Objective: To examine the relationship of 6-n-propylthiouracil (PROP) sensitivity to BMI while statistically controlling for demographic characteristics in two age groups of children: 9-10 years and 17-18 years (n 1551). Design: Cross-sectional design with a multi-ethnic (White, African-American, Hispanic, Other) sample of 813 children aged 9-10 years and 738 children aged 17-18 years. Children were recruited from local elementary and high schools with at least 30% minority ethnic enrolment. Children's height, weight and waist circumference were measured along with their PROP taster status. PROP was measured using two paper discs, one impregnated with NaCl (1·0 mol/l) and the other with PROP solution (0·50 mmol/l). Results: A significant PROP sensitivity by socio-economic status (SES) interaction term (P=0·010) was detected wherein supertasters had the largest BMI percentile and Z-score, but only among the group with highest SES. Conclusions: The results suggest that other factors overwhelmed the influence of PROP sensitivity on adiposity in lower-SES groups. The percentage of variance accounted for by the interaction term was about 1%. Thus, PROP supertasters had the largest BMI percentile and Z-score, but only among the highest-SES group. [ABSTRACT FROM AUTHOR]

Public- and private-sector initiatives to promote healthy eating and physical activity, called 'healthy lifestyles', are a relatively recent response to the global obesity pandemic. The present paper explores different views about marketing healthy lifestyles with a special emphasis on private-sector initiatives and public-private partnerships designed to reach young people. We discuss aspects of these initiatives and partnerships from three perspectives: (i) the potential for commercial marketing practices to have a favourable influence on reversing global obesity trends (termed prospects); (ii) unresolved dilemmas and challenges that may hinder progress (termed pitfalls); and (iii) the implementation and evaluation of coordinated and systematic actions (termed priorities) that may increase the likelihood that commercially marketed healthy-lifestyle initiatives and public-private partnerships can make a positive contribution to reverse the rise in overweight and obesity among young people globally. [ABSTRACT FROM AUTHOR]

AbstractAimThe present paper examines the relationship between social factors, food consumption during television viewing, and overall television viewing and how these are associated with BMI when the role of familial and social factors are considered in a population-based birth cohort of pre-school children from Qu?bec (Canada).MethodsThe analyses were performed using data from the Longitudinal Study of Child Development in Qu?bec (1998?2002) (LSCDQ). The study follows a representative sample (n2103) of children born in 1998 in the Canadian province of Qu?bec. A nutrition assessment was conducted on 1549 children aged 4?5 years and included a 24 h dietary recall, an eating behaviour and television viewing questionnaire, and a measurement of children?s heights and weights. Statistical analyses were performed.ResultsNearly one-quarter of children ate at least twice daily in front of the television. Children who consumed snacks while watching television on a daily basis had higher BMI than children who did so less frequently. Children who ate snacks in front of the television every day, or some times during the week, ate more carbohydrates (total), more fat and less protein, fewer fruits and vegetables, and drank soft drinks more often than children who never ate snacks in front of the television.ConclusionsHealth professionals should target parents of children at risk of overweight/obesity with focused strategies to help children change the types of foods consumed during television viewing and to reduce the time spent watching television, particularly during meal times, which may change children?s dietary intake and eating patterns. [ABSTRACT FROM AUTHOR]

ObjectiveThis background paper was prepared in response to a request to review the concepts related to measurement of body composition, to discuss laboratory and field methods of assessing body composition and to discuss the practical applications of the methods – how they might be used singly or in combination to provide data for a selected population.DesignThe common laboratory and field methods are described and discussed, with particular attention to the assumptions involved and the applicability of the methods to the different population groups. Most measurements of body composition are made in the field, at the bedside or clinic as opposed to in the laboratory. The laboratory methods have a role to play in their own right, in research into new concepts, models and methods. However, they are particularly important in establishing the accuracy of the field methods.SettingField, bedside and laboratory studies.SubjectsChildren, adults, the elderly, ethnic groups.ResultsLaboratory estimates of body compositions are best performed by multi-component methods or by 2-component methods adjusted for to the populations under investigation. There is a scarcity of data for most of the populations in the world.ConclusionsEnergy requirements based on body weight are an approximation since they do not take into account differences in body composition, which will better determine the true requirements. The measurement of body composition occurs in many branches of biology and medicine. It is used in the assessment of nutritional and growth status and in disease states and their treatment. Energy stores, skeletal muscle and protein content can be determined and changes monitored. In human energetics, body composition is widely used for the standardisation of other variables, such as basal metabolic rate (BMR), in the assessments of ethnic and environmental differences and of variability and adaptation to different levels of nutrition. Choosing a method is very problematic. Users want simple, inexpensive, rapid, safe accurate methods to measure body composition but speed and simplicity come at the expense of accuracy. Recommendations are made for age, sex, and in some cases, fatness and ethnic specific methods. [ABSTRACT FROM AUTHOR]

Introduction: Handwriting disorder is considered to be one of the major public health problems among school-aged children worldwide. All the scales in the literature use handwriting tasks but it could be interesting to investigate a more accurate assessment of handwriting difficulties before the development and acquisition of handwriting as such. Objectives: The objective of our study is to examine the validity of a prescriptural task consisting of copying a line of cycloid loops in the diagnosis of handwriting disorders. Methods: 35 children with handwriting disabilities and 331 typically developing right-handed children in primary school, aged 6-11 years old, were included in the study. They performed a copy of a line of cycloid loops, in an ecological setting, with a paper sheet put on the table. The kinematic measures were recorded with a digital pen. A Receiver Operating Characteristic method (ROC curve) was used to determine whether the loops line copy may be a sensitive test to diagnose handwriting disorders. Results: Six kinematic variables recorded during the prescriptural task were found to be relevant markers of handwriting disorders with a sensibility between 0.743 and 0.880: strokes number, total and effective drawing time, in-air pauses times, loops number, number of peaks velocity. Conclusions: The graphomotor task of copying a line of cycloid loops showed a good sensitivity to diagnose handwriting disorders and appeared to be a good predictor test, more particularly with the variables reflecting the strokes temporal organization. Drawing loops is a rapid graphomotor task, useful for exploring prerequisites of handwriting in screening for handwriting disorders. [ABSTRACT FROM AUTHOR]

Introduction: Borderline Personality Disorder (BPD) is an increasingly recognised diagnosis in children and adolescents (C&A). Various psychological interventions have been evaluated in BPD but no firm recommendations have been made for this age group. Objectives: To systematically review the literature on psychological interventions for BPD in children and adolescents. Methods: In April 2019, the electronic databases Embase, Medline, Psych Info, CINAHL and CENTRAL were searched for randomised controlled trials (RCT) including patients aged below 19 who received psychological intervention for BPD. Cochrane risk assessment was used to assess quality of papers. The primary outcome was the reduction in borderline symptomatology including the self-harm and suicide. Secondary outcomes included: use of health services and reduction in affective symptoms. Results: A total of 7 RCTs were identified, evaluating Cognitive Analytic Therapy (CAT; n=1), Dialectical Behaviour Therapy (DBT-A; n=1 + follow-up), Mentalization Based Therapy (MBT-A; n=1), Emotional Regulation Training (ERT; n=2) and Integrative Borderline Personality Disorder-oriented Adolescent Family Therapy (IBAFT; n=1). Only MBT-A was significantly better in borderline symptoms reduction compared to treatment as usual (TAU). Compared to TAU, MBT-A and DBT-A were superior in reducing self-harm frequency at the end of treatment and for DBT-A at one-year follow-up, DBT-A in reducing suicidal ideation at the end of treatment and symptoms of depression at the end of treatment and at one-year follow-up, and MBT-A in reducing symptoms of depression at the end of treatment. Conclusions: DBT-A was associated with greater long-term reduction in self-harm and depressive symptoms. MBT-A significantly reduced borderline symptomatology, affective symptoms and suicidal ideation. [ABSTRACT FROM AUTHOR]

This paper describes the challenges in starting a service for the diagnosis of and intensive therapeutic intervention for children with autism in a provincial town in western Greece (Messolonghi). Personnel had to be trained, the community had to be educated to accept and use the new service, and stigma had to be dealt with. Currently, fully developed 10 years after the beginning of the effort, in any one week the Day Centre serves on average 35 children with autism and 20 children with specific language impairment. The treatment programme runs along behavioural lines and the results are presently encouraging. Of 32 children referred consecutively to the Centre, after 5 years eight (25%) were attending regular school classes without a diagnosis of autism and eight (25%) with milder symptoms were attending classes with academic assistance. The limited impact of the Centre on the wider community is discussed. [ABSTRACT FROM AUTHOR]