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In the last few years, there are an increased number of families following a vegetarian diet, including their children. In order to guarantee child heath, paediatricians need to know the characteristics of this diet and the main foods that are used. There are few data on the medium and long-term health outcomes when removing all animal foods from the child's diet, especially at younger ages. Nevertheless, new tools have recently become available to facilitate following a vegetarian diet and decreasing the risk of deficiencies. In this document, the group of foods commonly used in vegetarian diets are reviewed, as well as recommendations for each age group. It also mentions the need to use B 12 supplements at all ages, as well as other nutrients (iodine, iron, vitaminD 3 , poly-unsaturated fatty acid n-3), when required. A vegetarian or a vegan diet, as in any other kind of diet, needs to be carefully designed. After reviewing current evidence, even though following a vegetarian diet at any age does not necessarily mean it is unsafe, it is advisable for infant and young children to follow an omnivorous diet or, at least, an ovo-lacto-vegetarian diet., (Copyright © 2019 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Chronic stress has adverse effects on health. Adults and children from low-income families are subject to multiple sources of stress. Existing literature about economic hardship mostly focuses on either adults or children but not both. Moreover, there is limited knowledge on the relationship between parental generalised stress and child health problems. This study aims to explore the bidirectional relationship between parental stress and child health in Chinese low-income families and to identify other modifiable factors influencing this relationship., Methods and Analysis: This prospective cohort study will sample 254 low-income parent-child pairs and follow them up for 24 months with assessments at three time points (baseline, 12 and 24 months) on parental stress, health-related quality of life (HRQOL) and child health and behaviour using both subjective measures and objective physiological parameters. This study will collect data using standardised measures on HRQOL and behaviours of children as well as on HRQOL, mental health and stress levels of parents along with physiological tests of allostatic load and telomere length. The mediating or moderating effect of family harmony, parenting style and neighbourhood conditions will also be assessed. Data will be analysed using latent growth modelling and cross-lagged path analysis modelling to examine the bidirectional effect of parental stress and child health over time. Mediation and moderation analysis will also be conducted to examine the mechanism by which the variables relate., Ethics and Dissemination: This study was approved by the institutional review board of the University of Hong Kong-the Hospital Authority Hong Kong West Cluster, reference no: UW 16-415. The study findings will be disseminated through peer-reviewed publications and international conferences., Trial Registration Number: NCT03185273; Pre-results., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

As part of an investment by the Bill & Melinda Gates Foundation to support the Government of Bihar to improve reproductive, maternal, newborn and child health and nutrition (RMNCHN) statewide, BBC Media Action implemented multiple communication tools to support front-line worker (FLW) outreach. We analyse the impacts of a package of mHealth audio messaging and paper-based job aids used by FLWs during government-sponsored village health, sanitation and nutrition days (VHSNDs) on knowledge and practices of childbearing women across the RMNCHN continuum of care. Data from two surveys collected between July and September 2016 were analysed using logistic regression to compare health-related knowledge and behaviours between women who had been exposed at VHSNDs to the mHealth GupShup Potli (GSP) audio recordings or interpersonal communication (IPC) tools versus those who were unexposed. Exposure to GSP recordings (n=2608) was associated with improved knowledge across all continuum-of-care domains, as well as improved health-related behaviours in some domains. The odds of having taken iron-folic acid (IFA) tablets were significantly higher in exposed women (OR 1.5, 95% CI 1.1 to 2.2), as was contraceptive use (OR 2.0, 95% CI 1.2 to 3.2). There were no differences in birth preparedness or complementary feeding practices between groups. Exposure to IPC paper-based tools (n=2002) was associated with a twofold increased odds of IFA consumption (OR 2.3, 95% CI 1.7 to 3.2) and contraceptive use (OR 1.8, 95% CI 1.2 to 2.8). Women exposed to both tools were generally at least twice as likely to subsequently discuss the messages with others. BBC Media Action's mHealth audio messaging job aids and paper-based IPC tools were associated with improved knowledge and practices of women who were exposed to them across multiple domains, suggesting their important potential for improving health outcomes for beneficiaries at scale in low-resource settings. NCT02726230.

Physical activity breaks in the classroom are an efficient way of promoting healthy behaviors in students, enhancing the development of their cognitive and academic abilities. The effects of active breaks, which are exclusive to the academic environment, are almost entirely positive, only a few papers did not show significant improvements, but they did not show any negative impact on academic performance either. This research was carried out to identify the properties and consequences of active breaks and physical activity during classes in school age. We have examined multiple databases, and we have selected 41 papers accounting for a time span of 15 years. Psychology, medicine, and education databases were the most browsed. Most papers revealed positive outcomes for improving skills related to mathematics, language, reading, comprehension, as well as cognitive and executive functions. Overall, the results of this review corroborate the theory that physical education in schools is positively associated with academic performance in children. Education researchers keep investigating in order to fully assess the positive impact on academic performance, behavior during classes, and cognitive functions.

Background: Diagnosis of life threatening childhood illness or injury can lead to significant distress reactions in parents, with many experiencing clinically significant levels of post-traumatic stress symptoms. These symptoms can have long-term adverse impacts on parent mental health, family functioning, and the adjustment of the ill child. Independent studies have found such reactions in several different illness groups. However, very little research has systematically compared the prevalence, impact and trajectories over time of post-traumatic stress symptoms in parents across different childhood illness groups with an acute life threat. The current study seeks to map the course of post-traumatic stress reactions in parents of children with various life threatening illnesses over an 18 month period, and identify factors that predict successful adaptation in families., Method/design: The current study described is of a prospective, longitudinal design. The sample included parents of children admitted to four major hospital departments at the Royal Children's Hospital, Melbourne, Australia, for a life threatening illness or injury. Eligible parents were those who were caregivers of children aged 0-to 18-years admitted to the Oncology, Cardiology, Neurology and Pediatric Intensive Care Unit. Parents were recruited acutely, and completed self-report questionnaires at four time-points: within the first 4 weeks (T1:); then at 4 months (T2); 7 months (T3); and 19 months (T4) after admission. Questionnaires assessed parent and child mental health and wellbeing, and a number of risk and reliance factors such child illness factors, parent demographic factors, and psychosocial factors., Discussion: This study is one of the first to document the trajectory of post-traumatic stress responses in parents of very ill children, across illness groups. Given that it will also identify risk and resilience factors, and map the course of parent outcomes over an 18 monthperiod, it has the potential to inform novel strategies for intervention.

Unsafe and violent schools are a widespread problem in South Africa. This paper argues that Adverse Childhood Experiences (ACEs) contribute to this phenomenon. While various individual and community-level interventions to address ACEs have been reported on, the contribution of safe parks towards preventing school violence has not yet been explored. To support schools in dealing with violence, the Adopt-a-School Foundation introduced a pilot project at eight schools in Botshabelo in the Free State Province. The programme included psychosocial support services, establishing safe parks, and ensuring community involvement. The goal was to improve school communities by creating environments that are empowering, academically effective, gender sensitive and free from violence. Although there are safe parks in communities around South Africa, they are an uncommon sight at schools. This paper reports on the quantitative study conducted on safe parks' contribution to making schools safer and less violent. Results show that safe park activities improve community well-being, including reduced gangsterism, enhanced learner safety, and decreased disciplinary problems. It is recommended that safe parks continue to provide psychosocial services to children at schools and that their programmes be expanded to include more services.

Over the recent years, a significant increase has been observed in screen-based media use among different age groups. Unregulated and excessive use of technological instruments such as smart phones, tablets or computers also leads to a number of health problems. Vision problems induced by the use of technological instruments among youth and children are gradually increasing in several countries across Europe. When we examine Eastern Asian countries, we see that the prevalence is much higher. A study based in Taiwan discovered that 84% of children have vision disorders. Apart from this, excessive screen-based media use is known to cause other problems during early childhood period at various ages including attention deficit, sleep disorders, depression, anxiety, academic inadequacy and linguistic development disorders. Unregulated and excessive screen-based media use demonstrates an incline with an increasing acceleration every day. The objective of this brief evaluation article is to investigate the problem in its current state in general, to highlight brain plasticity during the early childhood period, and to open the effects of excessive screen-based media use particularly on linguistic development to discussion in light of current studies. [This paper was presented at the 2nd Eurasian Conference on Language & Social Sciences, Antalya, Turkey.]

Background: Nutrition is important in autism spectrum disorder (ASD). Because nutritional problems of children with ASD can lead to nutritional deficiencies and this can also directly or indirectly affect symptoms related to autism. We investigated the effect of diet and supplementation treatments on gastrointestinal, behavioral or sleep problems based on the results of literature review. Background: Methods: We generated four questions based on literature. We carried out title and abstract-based search using the Web of Science database. Of 4580 abstracts were identified, 192 papers were reviewed and 55 papers precisely meeting the inclusion criteria. Methods: Results: The studies examining the effects of vitamins, minerals, probiotics, and other supplements on ASD symptoms had different dosages, different treatment durations, small sample sizes and used different scales for evaluation. The results of the studies of the effectiveness of Gluten-Free and Casein-Free (GFCF) and ketogenic diet to reduce gastrointestinal, behavioral and sleeping problems in children and adolescents were contradictory. Results: Conclusions: It is not possible to suggest the GFCF and/or ketogenic diet, vitamins, minerals and probiotics to individual with ASD based on the available evidence. By planning a sufficient and balanced diet, it should be aimed to prevent nutrient deficiency and to ensure growth in accordance with the age in children with ASD. Conclusions

The purpose of this research paper was to highlight the factors students and school staff identify as contributors to mental health issues students attending rural, low socioeconomic high schools experience and the specific mental health issues they witness most. A collective case study was conducted in four rural high schools, two in Kansas and two in West Virginia. Field work at each school involved observations, document collection, and semi-structured focus group interviews with students and school staff. The factors identified as contributors to poor student mental health were pressure, technology, home life, bullying, and stigma. Anxiety, stress, depression, lack of health coping, and suicidal comments emerged as the specific mental health struggles students deal with the most. Recommendations for practice include practical ways to address the identified contributors of poor student mental health in rural schools and strategies to normalize mental health in the rural school environment.

Background: The African continent hosts many industrial mining projects, and many more are planned due to recent prospecting discoveries and increasing demand for various minerals to promote a low-carbon future. The extraction of natural resources in sub-Saharan Africa (SSA) represents an opportunity for economic development but also poses a threat to population health through rapid urbanisation and environmental degradation. Children could benefit from improved economic growth through various channels such as access to high-quality food, better sanitation, and clean water. However, mining can increase food insecurity and trigger local competition over safe drinking water. Child health can be threatened by exposure to mining-related air, noise, and water pollution. To assess the impact of mines on child health, we analyse socio-demographic, health, and mining data before and after several mining projects were commissioned in SSA., Results: Data of 90,951 children living around 81 mining sites in 23 countries in SSA were analysed for child mortality indicators, and 79,962 children from 59 mining areas in 18 SSA countries were analysed for diarrhoea, cough, and anthropometric indicators. No effects of the launch of new mining projects on overall under-five mortality were found (adjusted Odds Ratio (aOR): 0.88; 95% Confidence Interval (CI): 0.68-1.14). However, activation of mining projects reduced the mortality risk among neonates (0-30 days) by 45% (aOR: 0.55; 95% CI: 0.37-0.83) and risk for a child to develop diarrhoeal diseases by 32% (aOR: 0.68; 95% CI: 0,51-0.90). The timing analysis of observed changes showed that there is a significant decline in the risk for childhood diarrhoea (aOR: 0.69; 95% CI: 0.49-0.97), and the mean height-for-age z-scores by 28 percentage points, during the prospection and construction phase; i.e., within four years to the initiation of extraction activity. No effects were found for cough and weight-for-height., Conclusion: The results presented suggest that the impacts of mining on child health vary throughout the mine's life cycle. Mining development likely contributes positively to the income and livelihoods of the impacted communities in the initial years of mining operations, particularly the prospection and construction phase; these potential benefits are likely to be at least partially offset by food insecurity and environmental pollution during early and later mining stages, respectively. Further research is warranted to better understand these health impacts and to identify policies that can help sustain the positive initial health impacts of mining projects in the long term., (© 2022. The Author(s).)

Background and aims: Play-based interventions are used ubiquitously with children with social, communication, and language needs but the impact of these interventions on the mental health of this group of children is unknown. Despite their pre-existing challenges, the mental health of children with developmental language disorder (DLD) and autism spectrum disorder (ASD) should be given equal consideration to the other more salient features of their condition. To this aim, a systematic literature review with meta-analysis was undertaken to assess the impact of play-based interventions on mental health outcomes from studies of children with DLD and ASD, as well as to identify the characteristics of research in this field. Methods: The study used full systematic review design reported to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines (PRISMA prisma-statement.org) with pre-specified inclusion criteria and explicit, transparent and replicable methods at each stage of the review. The study selection process involved a rigorous systematic search of seven academic databases, double screening of abstracts, and full-text screening to identify studies using randomised controlled trial (RCT) and quasi-experimental (QE) designs to assess mental health outcomes from interventions supporting children with DLD and ASD. For reliability, data extraction of included studies, as well as risk of bias assessments were conducted by two study authors. Qualitative data were synthesised narratively and quantified data were used in the metaanalytic calculation. Main contribution: A total of 2,882 papers were identified from the literature search which were double screened at the abstract (n = 1,785) and full-text (n = 366) levels resulting in 10 papers meeting the criteria for inclusion in the review. There were 8 RCTs and 2 QEs using 7 named play-based interventions with ASD participants only. Meta-analysis of 5 studies addressing positive mental health outcomes (e.g. positive affect and emotional functioning) found a significant overall intervention effect (Cohen's d = 1.60 (95% CI [0.37, 2.82], p = 0.01); meta-analysis of 6 studies addressing negative mental health outcomes (e.g., negative affect, internalising and externalising problems) found a non-significant overall intervention effect (Cohen's d = 0.04 -0.17 (95% CI [-0.04, 0.51], p = 0.88). Conclusions: A key observation is the diversity of study characteristics relating to study sample size, duration of interventions, study settings, background of interventionists, and variability of specific mental health outcomes. Play-based interventions appear to have a beneficial effect on positive, but not negative, mental health in children with ASD. There are no high quality studies investigating the efficacy of such interventions in children with DLD. Implications: This review provides good evidence of the need for further research into how commonly used play-based interventions designed to support the social, communication, and language needs of young people may impact the mental health of children with ASD or DLD.

Child health is defined by a complex, dynamic network of genetic, cultural, nutritional, infectious, and environmental determinants at distinct, developmentally determined epochs from preconception to adolescence. This network shapes the future of children, susceptibilities to adult diseases, and individual child health outcomes. Evolution selects characteristics during fetal life, infancy, childhood, and adolescence that adapt to predictable and unpredictable exposures/stresses by creating alternative developmental phenotype trajectories. While child health has improved in the United States and globally over the past 30 years, continued improvement requires access to data that fully represent the complexity of these interactions and to new analytic methods. Big Data and innovative data science methods provide tools to integrate multiple data dimensions for description of best clinical, predictive, and preventive practices, for reducing racial disparities in child health outcomes, for inclusion of patient and family input in medical assessments, and for defining individual disease risk, mechanisms, and therapies. However, leveraging these resources will require new strategies that intentionally address institutional, ethical, regulatory, cultural, technical, and systemic barriers as well as developing partnerships with children and families from diverse backgrounds that acknowledge historical sources of mistrust. We highlight existing pediatric Big Data initiatives and identify areas of future research. IMPACT: Big Data and data science can improve child health. This review highlights the importance for child health of child-specific and life course-based Big Data and data science strategies. This review provides recommendations for future pediatric-specific Big Data and data science research., (© 2022. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

The COVID-19 pandemic created an unprecedented disruption to education and schooling at the end of the 2019-20 school year. Operating in a context of great uncertainty, education leaders were tasked with making key decisions with potentially far-reaching impacts on the educational and mental and physical health of students and families. Drawing on 9 cross-sectoral focus groups with school board administrators, representatives from education industry partners, and K-12 educational policy research organizations, this paper provides a historical record of the evolution of decision-making and points to promising lines of inquiry and lessons that can be learned from this moment in education.

Purpose: The purpose of this paper is to explore the experience of the weight of a backpack as represented in typical Chinese children's songs through a kind of phenomenological approach. Design/Approach/Methods: The core issue pertaining to Chinese children's songs about backpacks is how the weight sense of backpacks is generated and developed in the field of song phenomenology. Findings: The "whatness" of a backpack in typical songs has varied over the past six decades, meanwhile, the backpack and its songs conceal not only the secrets of childhood but also those of China's educational system. Originality/Value: The originality of this paper embodies the unique perspective to provide a new insight into the current scholarship of the micro-politics of song-singing and the weight sense of backpack.

Objective: To identify and describe caregiver perspectives on factors important for the health and wellbeing of urban Aboriginal children., Methods: Caregivers of Aboriginal children participating in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH) were asked to describe the single most important factor that would help their children to be healthy and well. Responses were analysed using thematic and content analysis., Results: Of the 626 carers in SEARCH, 425 (68%) provided a response. We identified 13 factors related to: loving family relationships, culturally competent healthcare, food security, active living, community services, education, social and emotional connectedness, safety, breaking cycles of disadvantage, housing availability and affordability, positive Aboriginal role models, strong culture, and carer wellbeing., Conclusions: Aligning with holistic concepts of health, caregivers believe that a broad range of child, family and environmental-level factors are needed to ensure the health and wellbeing of Aboriginal children. Implications for public health: This study highlights the importance of providing public health initiatives that enable equal access to the social determinants of health for carers of Aboriginal children. Affordable and adequate housing, food security, culturally appropriate healthcare, and family and community connectedness remain critical areas for targeted initiatives., (© 2020 The Authors.)