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Evidence suggests autistic individuals at elevated familial likelihood of autism spectrum disorder (by virtue of having an autistic sibling) have stronger cognitive abilities on average than autistic individuals with no family history of the condition, who have a low familial likelihood of autism. Investigating phenotypic differences between community-referred infants and toddlers with autism symptoms at elevated or low familial likelihood of autism may provide important insight into heterogeneity in the emerging autism phenotype. This study compared behavioral, cognitive, and language abilities of community-referred infants and toddlers with confirmed autism symptoms at elevated (EL) or low familial likelihood of autism (LL). Participants were 121 children aged 12 to 36 months who participated in two larger randomized trials of parent-mediated interventions for children with autism symptoms. Behavioral phenotypes were compared across three groups: children with at least one autistic sibling (EL-Sibs, n = 30), those with at least one older, non-autistic sibling and no family history of autism (LL-Sibs, n = 40), and first-born children with no family history of autism (LL-FB, n = 51). EL-Sibs had less severe autism symptoms and stronger cognitive abilities than children in LL groups. While the rate of receptive language delay was similar across groups, the rate of expressive language delay was markedly lower among EL-Sibs. After controlling for age and nonverbal cognitive ability, EL-Sibs were significantly less likely to present with expressive language delay than LL-Sibs. Familial likelihood of autism may play an important role in shaping the emerging autism phenotype in infancy and toddlerhood.

ObjectiveTo evaluate the effect of nutritional risk management program on the growth and development of infants and toddlers with congenital heart disease (CHD) after discharge.MethodsInfants and toddlers with CHD discharged from a children's specialized hospital in southeast China were selected as the research subjects. The subjects were divided into the intervention group and the control group. The intervention group underwent a nutritional risk management program combined with traditional follow-up after discharge, whereas the control group received traditional follow-up after discharge. The primary outcome measure were the height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and weight-for-height Z-score (WHZ) at different time point and the percentage of growth and development curves were also recorded and analyzed.ResultsThere were no statistically significant differences in general characteristics between the two groups. However, in the intervention group, the percentages of HAZ

Baseline child characteristics may predict treatment outcomes in children with or at elevated likelihood of developing autism (EL-ASD). Little is known about the role of child sensory and language features on treatment outcome. Participants were randomly assigned to a parent-mediated intervention or control condition. Analyses explored the relationship between baseline child sensory and language characteristics and changes in ASD symptoms over approximately 9 months. Higher baseline sensory hyporeactivity was significantly related to less improvement in social communication (SC) for the treatment group only. More baseline atypical vocalizations were significantly related to less improvement on SC across treatment and control groups. This work provides an initial framework to encourage the tailoring of interventions for EL-ASD children, suggesting sensory reactivity and atypical vocalizations may be useful behaviors to consider in treatment planning.

Context: One of the essential components for successful caries management is caries risk assessment (CRA). Among CRA tools (CRATs) published in the literature: Caries management by risk assessment (CAMBRA) 123 and American Academy of Pediatric Dentistry (AAPD) CRATs are specifically designed for infants and toddlers. Aims: The aim of this study is to compare readily available internationally accepted CRAT for infants and toddlers and check the usability of these tools in assigning caries risk among the Indian population. Settings and Design: The study was conducted at Baby Oral Health Promotion Clinic, Department of Pediatrics, Tertiary Care Hospital using a cross-sectional study design. Subjects and Methods: Data were collected using CAMBRA 123 and AAPD CRATs from 379 children aged 0–6 years. The caries risk of the children was recorded with each CRAT and a comparison was made between the two tools used. Statistical Analysis Used: The percentage of agreement and Cohen's kappa coefficient were used to know the agreement between the CAMBRA 123 and AAPD CRATs using the SPSS statistical tool. The significance level was set at 5% (α = 0.05). Results: For children aged

Context: One of the essential components for successful caries management is caries risk assessment (CRA). Among CRA tools (CRATs) published in the literature: Caries management by risk assessment (CAMBRA) 123 and American Academy of Pediatric Dentistry (AAPD) CRATs are specifically designed for infants and toddlers. Aims: The aim of this study is to compare readily available internationally accepted CRAT for infants and toddlers and check the usability of these tools in assigning caries risk among the Indian population. Settings and Design: The study was conducted at Baby Oral Health Promotion Clinic, Department of Pediatrics, Tertiary Care Hospital using a cross-sectional study design. Subjects and Methods: Data were collected using CAMBRA 123 and AAPD CRATs from 379 children aged 0-6 years. The caries risk of the children was recorded with each CRAT and a comparison was made between the two tools used. Statistical Analysis Used: The percentage of agreement and Cohen's kappa coefficient were used to know the agreement between the CAMBRA 123 and AAPD CRATs using the SPSS statistical tool. The significance level was set at 5% (α = 0.05). Results: For children aged <2 years, the study showed slight agreement between the CAMBRA 123 and AAPD, whereas, for children more than 2 years, there was a fair agreement between the two methods which was statistically significant. This indicates that the agreement between the two methods is still not perfectly established, and AAPD CRA assigns a higher risk category than CAMBRA 123. Conclusions: CAMBRA 123 is a promising user-friendly quantitative method for CRA in clinical practice. Since there is ambiguity in assessing the caries risk in children <2 years, there is a need to establish a CRAT that can be used exclusively for children below 2 years. [ABSTRACT FROM AUTHOR]

ObjectiveTo explore the clinical value of ultrasound examination in evaluating the presence of ovarian torsion in female infants with inguinal ovarian hernia.MethodsWe conducted a retrospective analysis of 91 cases of ovarian hernia diagnosed by ultrasonography at our institution. Among them, 6 cases were identified as ovarian strangulation, while 85 cases were classified as non-ovarian strangulation. All cases underwent high-frequency ultrasound examination. We analyzed whether there were differences in the associated factors between the two groups and compared the disparities in the urgency of surgery between the two groups.ResultsSignificant differences were observed between the ovarian strangulation group and the non- strangulation group in terms of ovarian volume, ovarian blood flow, and the presence of incarceration. The need for emergency surgery was significantly associated with the presence of incarceration and ovarian torsion.ConclusionUltrasound has good clinical value in diagnosing ovarian hernia and determining the presence of ovarian strangulation. It can assist clinical physicians in determining the timing of surgery for children with ovarian hernia.

Objective To investigate the safety, effectiveness and fitting method of rigid gas permeable (RGP) contact lens after cataract surgery in infants and toddlers. Methods A retrospective analysis was performed on 6 eyes of 5 cataract children who visited our Aier Eye Hospital from November 2019 to December 2021. All patients were treated with RGP contact lens after cataract extraction and followed up for 6 months. RGP loss and replacement cycle, as well as changes in nystagmus and visual acuity were observed and evaluated to summarize the experience and analyze the safety and efficacy of lens therapy. Results All patients were healthy in ocular surface condition. One case abandoned to wear the lens. The period of lenses loss and replacement was 2.4~5.4 months per piece; The dropout frequency was 1~3 times per year; Displacement frequency was 3~4 times per day; Nystagmus was observed at 0~23 times per minute before wearing the lenses, and disappeared in the later follow-up period; The vision acuity was 0.5 (case 1 with lenses, optomotor nystagmus) and 0.2~0.67 (at 24 weeks after wearing lenses, self-made short-distance vision test card), respectively. Conclusion RGP contact lens are safe and effective for improving visual function in infants and toddlers after cataract surgery, which can be further popularized. Improving fitting techniques, optimizing examination methods, and strengthening follow-up education can improve the clinical therapeutic effectiveness of RGP and reduce costs in clinical practice.

The COVID-19 pandemic and the ongoing lockdowns might have had a strong impact on mental health of mothers and their infants/toddlers. For example, families had to deal with health issues and social isolation, which might have affected mental health and parent-child interactions. The aim of this study is to evaluate differences in (1) infantile regulatory disorders, (2) maternal mental health, (3) the impact of maternal mental health on infantile regulatory disorders, and (4) alterations in the mother-child interaction for participants recruited before versus after the onset of the first German lockdown. For this reason, mother-child dyads have been divided into two groups and were compared by analyzing clinical interviews on psychopathology of mother and child (M.I.N.I. & DC:05) and mother-child-interactions (Emotional Availability Scales). Results showed that (1) differences in infantile sleeping disorders emerged (phi = 0.243; p = 0.016) compared to the pre-lockdown group, while (2) the occurrence of maternal panic and anxiety increased in the post-lockdown group (phi = 0.229; p = 0.022). Moreover, there was (3) an association for maternal panic and child's sleep disorder, and (4) specific associations with maternal non-hostility in the mother-child-interaction. In conclusion, the present study highlights the differences of maternal mental health occurrences and infants' regulatory problems, as well as the possible effects of the COVID-19 pandemic for infants. In the pre-lockdown group, maternal non-hostility might have acted as a promotive factor against regulatory disorders, while this mechanism was mitigated in the post-lockdown group. [ABSTRACT FROM AUTHOR]

Introduction: Caries risk assessment (CRA) is essential as the basis for successful management of dental caries. Of the many published CRA tools, four well-known ones are CAMBRA, Cariogram, American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD) CRAs. The predictive accuracy of CAMBRA and Cariogram CRA tools have been examined in clinical outcomes studies in thousands of patients and the tools are widely used all over the world. The purpose of the present paper is three-fold, namely (1) to briefly review, compare and contrast these four CRA methods, (2) to provide a concise method for CRA introducing a quantitative component to the CAMBRA forms (CAMBRA 123), and (3) to guide the choice of CRA methods that will support caries management decisions. Comparison of Caries Risk Assessment Methods: In the present evaluation, the above-mentioned four CRA methods for ages 0-6 years and 6 years-adult were compared using 26 hypothetical patients (13 per age group). Comparison results show that Cariogram and CAMBRA categorized patients into identical risk categories. Each of the ADA and AAPD tools gave different results than CAMBRA and Cariogram in several comparison examples. CAMBRA 123 gave the same caries risk level results as the Cariogram and the CAMBRA methods for all hypothetical patients for both age groups. Conclusions: Both the Cariogram and the CAMBRA CRA methods are equally useful for identifying the future risk of dental caries. CAMBRA 123 shows promise as an easy-to-use quantitative method for CRA in clinical practice. The health care providers will be the ones to decide which CRA method will allow them to establish individualized, successful caries management therapies and how to combine these for the best care of their patients.

Introduction: The purpose of the present paper is to provide step-by-step guidelines for dental healthcare providers to manage dental caries based upon caries risk assessment (CRA) for ages 0-6 years and 6 years through adult. The manuscript reviews and updates the CAMBRA (caries management by risk assessment) system which includes CRA and caries management recommendations that are guided by the assessed risk level. Caries Risk Assessment: CAMBRA CRA tools (CRAs) have been evaluated in several clinical outcomes studies and clinical trials. Updated CAMBRA CRAs for ages 0-6 years and 6 years through adult are provided. These CRAs have been refined by the addition of a quantitative method that will aid the health care provider in determining the caries risk of individuals. Caries Management Based Upon Risk Assessment: Guidelines for individualized patient care are provided based upon the caries risk status, results of clinical exams and responses of the patient to questions in the CRA. These guidelines are based upon successful outcomes documented in several clinical outcomes studies and clinical trials. The paper includes a review of successful caries management procedures for children and adults as previously published, with additional emphasis on correct use of silver diamine fluoride (SDF) for children. The caries management plan for each individual is based upon reducing the caries risk factors and enhancing the protective factors with the additional aid of behavior modification. Beneficially altering the caries balance is coupled with minimal intervention restorative dentistry, if appropriate. These methods are appropriate for the management of dental caries in all patients.

Abstract Background The WHO recommends daily use of micronutrient powder for infants and toddlers at risk of micronutrient deficiencies in low-and-middle-income countries. China has established a micronutrient powder distribution program in many rural townships and villages, yet adherence to micronutrient powder remains suboptimal; a little is known about the behavioral inputs that may influence adherence. This study examines direct and indirect behavioral inputs in micronutrient powder adherence among caregivers in rural western China following the Integrated Behavioral Model (IBM) framework. Methods Cross-sectional data were collected from April to May 2019 among 958 caregivers of children aged 6 to 24 months in six counties. Data were collected on micronutrient powder adherence behavior, direct behavioral inputs (knowledge and skills, intention, salience, environmental constraints, and habits), and indirect behavioral inputs (attitudes, perceived social norms, and personal agency). Structural equation modeling (SEM) adjusted for sociodemographic covariates was used to evaluate the IBM framework. Results Mean micronutrient powder adherence in the previous seven days was 53.02%, and only 22.86% of caregivers consistently fed micronutrient powder from the start of micronutrient powder distribution at six months of age. The SEM model revealed small- to medium-sized effects of salience (β = 0.440, P

Background: Developmental delays (DDs) in children are rising and necessitate routine screening for early recognition and management. Objective(s): To estimate the prevalence of developmental delays among children 2-36 months of age in a Primary Health Care (PHC) center in Cairo, Egypt. Methods: This cross-sectional study was conducted in Saraya El-Koba PHC center involving 193 children 2-36 months of age. Data were collected using Ages and Stages Questionnaire (ASQ-3) to assess five domains of development: communication, gross motor, fine motor, problem-solving, and personal-social. Some parents’ characteristics were also included. Results: Frequency of developmental delays was 9.3%. The domains with the most frequent delays were the communication and gross motor (3.1% each) and the least was the fine motor domain (1.04%). Girls scored significantly higher than boys in the problem-solving domain (p=0.037). First to third order of birth had higher communication and social scores (p=0.025, p=0.003 respectively). Highly educated mothers had children with higher fine motor and total developmental scores (p < 0.001 and 0.014 respectively), while highly educated fathers had children with higher communication scores (p=0.009). Duration of breast feeding was positively correlated with gross motor and social scores (p=0.001, p=0.042 respectively). Conclusion: The frequency of DDs was 9.3%. This prevalence is considered high compared to previous studies. It showed several associated factors and recommended early screening of preschool children for prompt recognition and timely intervention.

The COVID-19 pandemic and the ongoing lockdowns might have had a strong impact on mental health of mothers and their infants/toddlers. For example, families had to deal with health issues and social isolation, which might have affected mental health and parent-child interactions. The aim of this study is to evaluate differences in (1) infantile regulatory disorders, (2) maternal mental health, (3) the impact of maternal mental health on infantile regulatory disorders, and (4) alterations in the mother-child interaction for participants recruited before versus after the onset of the first German lockdown. For this reason, mother-child dyads have been divided into two groups and were compared by analyzing clinical interviews on psychopathology of mother and child (M.I.N.I. & DC:05) and mother-child-interactions (Emotional Availability Scales). Results showed that (1) differences in infantile sleeping disorders emerged (phi = 0.243; p = 0.016) compared to the pre-lockdown group, while (2) the occurrence of maternal panic and anxiety increased in the post-lockdown group (phi = 0.229; p = 0.022). Moreover, there was (3) an association for maternal panic and child’s sleep disorder, and (4) specific associations with maternal non-hostility in the mother-child-interaction. In conclusion, the present study highlights the differences of maternal mental health occurrences and infants’ regulatory problems, as well as the possible effects of the COVID-19 pandemic for infants. In the pre-lockdown group, maternal non-hostility might have acted as a promotive factor against regulatory disorders, while this mechanism was mitigated in the post-lockdown group.

Background: The WHO recommends daily use of micronutrient powder for infants and toddlers at risk of micronutrient deficiencies in low-and-middle-income countries. China has established a micronutrient powder distribution program in many rural townships and villages, yet adherence to micronutrient powder remains suboptimal; a little is known about the behavioral inputs that may influence adherence. This study examines direct and indirect behavioral inputs in micronutrient powder adherence among caregivers in rural western China following the Integrated Behavioral Model (IBM) framework.Methods: Cross-sectional data were collected from April to May 2019 among 958 caregivers of children aged 6 to 24 months in six counties. Data were collected on micronutrient powder adherence behavior, direct behavioral inputs (knowledge and skills, intention, salience, environmental constraints, and habits), and indirect behavioral inputs (attitudes, perceived social norms, and personal agency). Structural equation modeling (SEM) adjusted for sociodemographic covariates was used to evaluate the IBM framework.Results: Mean micronutrient powder adherence in the previous seven days was 53.02%, and only 22.86% of caregivers consistently fed micronutrient powder from the start of micronutrient powder distribution at six months of age. The SEM model revealed small- to medium-sized effects of salience (β = 0.440, P < 0.001), intention (β = 0.374, P < 0.001), knowledge and skills (β = 0.214, P < 0.001), personal agency (st. effect = 0.172, P < 0.001), environmental constraints (β=-0.142, P < 0.001), and caregiver generation (β = 0.119, P < 0.05) on micronutrient powder adherence. Overall, 54.7% of the variance in micronutrient powder adherence was explained by the IBM framework. Salience had the largest impact on micronutrient powder adherence (Cohen's f 2 = 0.227). Compared to parent caregivers, grandparents had a higher degree of micronutrient powder adherence on average (P < 0.001), and behavioral inputs were consistent among both parent and grandparent caregivers.Conclusion: There is a need to improve micronutrient powder adherence among rural caregivers. The IBM framework showed a high degree of explanatory power in predicting micronutrient powder adherence behavior. The findings suggest that increased reminders from doctors regarding micronutrient powder and coaching to improve personal agency in micronutrient powder feeding may increase adherence. [ABSTRACT FROM AUTHOR]

Supplementation of infant and follow-up formula with probiotics or synbiotics has become a common practice. In 2011 and 2017, the evidence regarding the impact of these interventions was analysed systematically. Recently new evidence was published. To evaluate through a systematic review with network meta-analysis the evidence on the impact of infant formula supplemented with probiotics or synbiotics for healthy infants and 36-month-old toddlers. RCTs published between 1999–2019 for infant formulas supplemented with probiotics alone or synbiotics in healthy infants and toddlers were identified. Data analysis included clinical (gastrointestinal symptoms, risk reduction of infectious diseases, use of antibiotics, weight/height gain and frequency of adverse events) and non-clinical outcomes (changes in faecal microbiota and immune parameters). A random effect model was used. Hedges' standard mean difference (SMD) and risk ratio (RR) were calculated. Rank analysis was performed to evaluate the superiority of each intervention. Twenty-six randomised controlled trials with 35 direct comparisons involving 1957 children receiving probiotic-supplemented formula and 1898 receiving control formula were reviewed. The mean duration of intervention was 5.6 ± 2.84 months. Certain strains demonstrated a reduction in episodes of colic, number of days with fever and use of antibiotics; however, there was considerable heterogeneity which reduced the level of certainty of effect. No significant effects were observed on weight, height or changes in faecal proportions of Bifidobacteria, Lactobacillus, Bacteroides or Clostridia. Although there is some evidence that may support a potential benefit of probiotic or synbiotic supplementation of infant formulas, variation in the quality of existing trials and the heterogeneity of the data preclude the establishment of robust recommendations. [ABSTRACT FROM AUTHOR]

Objective: This study sought to explain results of the Water Up!@Home randomised controlled trial where low-income parents were randomised to receive an educational intervention +a low-cost water filter pitcher or only the filter. Parents in both groups had reported statistically significant reductions in sugar-sweetened beverages (SSB) and increases in water intake post-intervention.Design: Qualitative explanatory in-depth interviews analysed thematically and deductively.Setting: Washington, DC metropolitan area, USA.Participants: Low-income Latino parents of infants/toddlers who had participated in the Water Up! @Home randomised controlled trial.Results: The filter-stimulated water consumption in both groups by (1) increasing parents' perception of water safety; (2) acting as a cue to action to drink water; (3) improving the flavour of water (which was linked to perceptions of safety) and (4) increasing the perception that this option was more economical than purchasing bottled water. Safe and palatable drinking water was more accessible and freely available in their homes; participants felt they did not need to ration their water consumption as before. Only intervention participants were able to describe a reduction in SSB intake and described strategies, skills and knowledge gained to reduce SSB intake. Among the comparison group, there was no thematic consensus about changes in SSB or any strategies or skills to reduce SSB intake.Conclusions: A low-cost water filter facilitated water consumption, which actively (or passively for comparison group) displaced SSB consumption. The findings have implications for understanding and addressing the role of water security on SSB consumption. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore current practices adopted by frontline healthcare providers for the early detection of developmental delays in infants and toddlers in Saudi Arabia, with a specific focus on motor and speech delays and caregivers' perceptions of early detection of developmental delays and their awareness of well-child visits. Methods: Two cross-sectional surveys were conducted and distributed. The first survey was performed among healthcare providers who worked directly with infants and toddlers in the first 3 years of life, and the second survey was performed among caregivers of infants and toddlers who received healthcare services. Participants were recruited via online groups, social media platforms, and clinics. Results: Overall, 60% of the healthcare providers played a role in identifying medical conditions that could be associated with delays and disabilities. However, they did not consistently check for normal development or developmental delays. Furthermore, the healthcare providers reported low frequencies of documenting developmental growth. The caregivers' survey results showed that 67% were familiar with the concept of "well-child visits", and the most frequently discussed topic by the healthcare providers was motor development. Conclusions: Well-defined, government-supported standards are needed to encourage regular well-child visits and implement efficient practices for the early detection of developmental delays. [ABSTRACT FROM AUTHOR]

Abstract Background Infant and young child feeding practices (IYCF) impact the early and later health status of the population. Limited data is available regarding IYCF in the United Arab Emirates (UAE). This study aimed to evaluate the nutritional status and adequacy of feeding practices, energy, food, and nutrient intakes of UAE infants and toddlers ages 0-23.9 months. Methods This study is a population-based cross-sectional survey of 276 infants and toddlers aged 0-23.9 months of which 180 were nationals and 96 were Arab non-nationals living in the UAE. Data were collected from the three major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometry was collected and assessed using WHO Anthro-Survey Analyzer, and a multicomponent age-specific questionnaire was used to evaluate IYCF and sociodemographic characteristics. Usual intake of energy, micronutrients, and macronutrients, including supplements, were collected using multiple-pass 24-h dietary recall and analyzed using the PC-side software. IYCF practices were assessed using the WHO indicators. Results Overall, 4% of children were malnourished, 8% wasted, 15% stunted, 18% at risk of overweight, and 7% overweight and obese. 95% of infants were ever breastfed and 37% exclusively breastfed at 6 months. Around 98% of infants had a timely introduction of complementary food. Macronutrient intake exceeded AMDR for fat, carbohydrates, and protein for 27%, 8% and 2% of toddlers respectively. As for the percentage of those exceeding the ESPGHAN cut-off for free sugars set at 5% of energy intake, 28.6% had excessive intakes overall, 10% in 0-5.9, 21.9% in 6-11.9 and 56.7% in 12-23.9 month. Usual iron intake was below the Estimated Average Requirement (EAR) in 47% of infants 6-11.9 months. Above 12 months, the usual intake of iron and vitamin D were below EAR in 11% and 49% of toddlers respectively. Usual intake exceeded the tolerable upper intake levels (UL) for vitamin A (14 to 18%) and zinc (11 to 22%) across all ages. Approximately 93% of toddlers ages 12–23.9 months did not meet food groups’ recommendations for vegetables, 87% for fruits, 48% for milk/dairy, 54% for lean meat and beans, and 33% for grains. Conclusions This study revealed that a high percentage of infants and toddlers aged 0-23.9 m suffer from a double burden of malnutrition, which is the coexistence of both undernutrition, and overweight and obesity in the same population. In addition to suboptimal feeding practices and inadequate/overconsumption of various nutrients. The findings highlight the need for the development of culturally specific programs aiming to improve the nutritional status of infants and toddlers in the UAE.

Childhood trauma continues to be a silent epidemic in South Africa. Institutional childcare centres do not have sufficient funding or resources to render daily therapeutic services for abandoned children. The first line of professional care for these children encompasses their daily interactions and relationships formed with the centre caregivers. This article advances a greater understanding of the views, perceptions and experiences of caregivers caring for abandoned infants and toddlers living in institutional care, on the basis of information obtained from 15 participants interviewed through semi-structured interviews in this qualitative study. Understanding their views, perceptions and experiences provides vital information to develop social work practices. [ABSTRACT FROM AUTHOR]

Objective: To investigate and analyze the current status and challenges of infant and toddler nutritional services in urban and rural medical facilities in Sichuan Province., Methods: In 2022, a questionnaire survey was conducted to collect data on infant and toddler nutritional services, including feeding guidance, physical growth assessment, and micronutrient deficiency screening, as well as information on personnel and tools in medical facilities throughout Sichuan Province. The provision of nutritional services was analyzed and the urban-rural disparities were assessed., Results: A total of 2206 medical facilities (29.1% from urban areas and 70.9% from rural areas) were investigated. Only 35.8% of medical facilities provided all three types of nutritional services. Specifically, the overall service provision rates were high for feeding guidance (94.6%) and physical growth assessment (85.0%), but lower for micronutrient deficiency screening (37.4%). Rural facilities exhibited significantly lower rates than their urban counterparts for both physical growth assessment and micronutrient deficiency screening ( P <0.05). The provision rates of feeding guidance ranged from 70.6% to 93.2%, with responsive feeding guidance being the least implemented (70.6%), particularly in rural areas compared to urban areas ( P <0.05). Rates for physical growth assessment and micronutrient deficiency screening ranged from 75.3% to 81.8% and 23.6% to 30.8%, respectively, both showing lower rates in rural settings compared to urban ones ( P <0.05). Nutrition service providers were predominantly nurses (52.3%) and clinical practitioners (43.4%). The availability of dietary assessment tools ranged from 7.7% to 15.9%, significantly lower in rural areas compared to urban areas ( P <0.001), while physical measurement tools were widely available at rates of 94.6% to 98.5%., Conclusion: At present, the infant and toddler nutritional service provisions of medical facilities in Sichuan Province are incomplete, particularly so in the implementation of feeding guidance, physical growth assessment, and micronutrient deficiency screening. There is a notable shortage of personnel and necessary tools, with rural areas facing more significant challenges. Enhancing the overall capacity of infant and toddler nutritional services in Sichuan Province is essential, with specific attention needed for rural healthcare settings., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Office of Journal of Sichuan University (Medical Sciences).)

Childhood trauma continues to be a silent epidemic in South Africa. Institutional childcare centres do not have sufficient funding or resources to render daily therapeutic services for abandoned children. The first line of professional care for these children encompasses their daily interactions and relationships formed with the centre caregivers. This article advances a greater understanding of the views, perceptions and experiences of caregivers caring for abandoned infants and toddlers living in institutional care, on the basis of information obtained from 15 participants interviewed through semi-structured interviews in this qualitative study. Understanding their views, perceptions and experiences provides vital information to develop social work practices.

Background: Developmental delays (DDs) in children are rising and necessitate routine screening for early recognition and management. Objective(s): To estimate the prevalence of developmental delays among children 2-36 months of age in a Primary Health Care (PHC) center in Cairo, Egypt. Methods: This cross-sectional study was conducted in Saraya El-Koba PHC center involving 193 children 2-36 months of age. Data were collected using Ages and Stages Questionnaire (ASQ-3) to assess five domains of development: communication, gross motor, fine motor, problem-solving, and personal-social. Some parents' characteristics were also included. Results: Frequency of developmental delays was 9.3%. The domains with the most frequent delays were the communication and gross motor (3.1% each) and the least was the fine motor domain (1.04%). Girls scored significantly higher than boys in the problem-solving domain (p=0.037). First to third order of birth had higher communication and social scores (p=0.025, p=0.003 respectively). Highly educated mothers had children with higher fine motor and total developmental scores (p<0.001 and 0.014 respectively), while highly educated fathers had children with higher communication scores (p=0.009). Duration of breast feeding was positively correlated with gross motor and social scores (p=0.001, p=0.042 respectively). Conclusion: The frequency of DDs was 9.3%. This prevalence is considered high compared to previous studies. It showed several associated factors and recommended early screening of preschool children for prompt recognition and timely intervention. [ABSTRACT FROM AUTHOR]

Background The transition from a predominantly milk-based diet to a diverse family diet is a window of opportunity for optimal child growth and development. Objectives The study aims to examine the nutritional status and food-consumption patterns of children under 4 y of age in the United Arab Emirates (UAE) and their adherence to nutrient and dietary recommendations. Methods A population-based cross-sectional survey of 525 children aged 0–47.9 mo was conducted in 3 major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometric measurements were obtained, and dietary assessment was conducted using the 24-h dietary recall approach. Usual intakes of energy, macronutrient, and micronutrients, including from supplements, were assessed using PC-SIDE software. Adherence to food-group recommendations was evaluated based on the American Heart Association/American Academy of Pediatrics dietary guidelines. Results Among 0–4-y-old children, 10% were stunted, 6% were wasted, 17% were at risk of overweight, 5% were overweight, and 3% were obese. The contribution of sweets and sugar sweetened beverages to energy intake increased from 5% in 6–11.9-mo-old children to 17% in 36–47.9-mo-old children. Compared with dietary guidelines, the lowest adherence was for fruit (13–18%) and vegetables (7–12%), while protein was within the recommendations, and 92% and 89% of children (aged 24 to 35.9 mo and 36 to 47.9 mo, respectively) had high intakes of saturated fat. Almost all toddlers failed to meet the Adequate Intake for fiber. The proportions of children exceeding the free-sugar upper limit increased from 10.6% in infants (0–5.9 mo) to 56.7% in toddlers (12– 23.9 mo). Micronutrient inadequacies were observed, particularly for calcium, zinc, folate, and vitamins A and D. Conclusions This study suggests a triple burden of malnutrition among infants and young children in the UAE. Results call for national nutrition intervention strategies aimed at improving dietary quality in the pediatric population. [ABSTRACT FROM AUTHOR]

This study examined the patterns and characteristics of non-parental child care arrangements for Chinese very young children before they enter preschool and the extent to which families' utilization of non-parental child care influenced parenting stress. A total of 3,842 Chinese parents of infants and toddlers were selected from 10 provinces to participate in this study. The results indicated that (1) Chinese families relied heavily on grandparents to care for their children; (2) a set of family demographics predicted the utilization of non-parental child care arrangements, including parents' educational level, household income, labor force participation, and maternal age; (3) there existed a clear parental preference for publicly funded, affordable, and high-quality child care services; and (4) families' use of non-parental child care was generally not linked to parenting stress. These findings shed light on the development of the infant-toddler non-parental child care system in the Chinese sociocultural context. [ABSTRACT FROM AUTHOR]

Malnutrition (undernutrition) and related faltering growth in young children are common medical problems, which in developed countries are mainly associated with underlying diseases, chronic conditions, injuries, burns, and surgeries. Malnutrition and faltering growth can also be of a “non-organic” origin and arise due to behavioral, socioeconomic, and environmental factors. To date, there are no generally accepted definitions of malnutrition and faltering growth in children, which complicates the diagnosis and study of the epidemiology of these conditions. Under such circumstances, it is advisable to use the diagnostic criteria of the World Health Organization and leading international professional associations. Know­ledge of risk factors and preconditions for malnutrition, as well as the corresponding nutritional needs allows timely adjusting the diet, especially of sick children, through the use of special milk formulas with a high content of energy, protein and micronutrients. These food products have proven clinical effectiveness, are available on the Ukrainian market, and are recommended not only for prevention but also for the treatment of children with faltering growth.

This study examined the patterns and characteristics of non-parental child care arrangements for Chinese very young children before they enter preschool and the extent to which families’ utilization of non-parental child care influenced parenting stress. A total of 3,842 Chinese parents of infants and toddlers were selected from 10 provinces to participate in this study. The results indicated that (1) Chinese families relied heavily on grandparents to care for their children; (2) a set of family demographics predicted the utilization of non-parental child care arrangements, including parents’ educational level, household income, labor force participation, and maternal age; (3) there existed a clear parental preference for publicly funded, affordable, and high-quality child care services; and (4) families’ use of non-parental child care was generally not linked to parenting stress. These findings shed light on the development of the infant-toddler non-parental child care system in the Chinese sociocultural context.

Objective: To explore the trend and associated factors of neuropsychological development of infants and toddlers in China. Methods: A longitudinal study was conducted among 619 infants and toddlers (2914 person-times) aged 0 to 36 months from different provinces or cities in China from January 2013 to December 2019. Results: The development age of each area increased with the extension of follow-up time, but this upward trend slowed down with physiological age at first measurement increasing. Among a low age group and each area, most of the development qualification rates in different follow-up periods were higher than that in the baseline (p < 0.05); however, many of them were not higher than that in the baseline among the medium or high age group (p > 0.05). For the areas of gross motor and self-care, the growth of qualification rate with the extension of follow-up was not obvious in the medium and high age group (both p trend > 0.05). Some impact factors of development in all areas were identified. Conclusions: The neuropsychological development delay of various areas of infants and toddlers, especially that of gross motor and self-care, should be paid early (within 1 years old) and constant attention. The impact of gender and maternal age on the development of young children has been further confirmed in the present study. [ABSTRACT FROM AUTHOR]

Supplementation of infant and follow-up formula with probiotics or synbiotics has become a common practice. In 2011 and 2017, the evidence regarding the impact of these interventions was analysed systematically. Recently new evidence was published. To evaluate through a systematic review with network meta-analysis the evidence on the impact of infant formula supplemented with probiotics or synbiotics for healthy infants and 36-month-old toddlers. RCTs published between 1999–2019 for infant formulas supplemented with probiotics alone or synbiotics in healthy infants and toddlers were identified. Data analysis included clinical (gastrointestinal symptoms, risk reduction of infectious diseases, use of antibiotics, weight/height gain and frequency of adverse events) and non-clinical outcomes (changes in faecal microbiota and immune parameters). A random effect model was used. Hedges’ standard mean difference (SMD) and risk ratio (RR) were calculated. Rank analysis was performed to evaluate the superiority of each intervention. Twenty-six randomised controlled trials with 35 direct comparisons involving 1957 children receiving probiotic-supplemented formula and 1898 receiving control formula were reviewed. The mean duration of intervention was 5.6 ± 2.84 months. Certain strains demonstrated a reduction in episodes of colic, number of days with fever and use of antibiotics; however, there was considerable heterogeneity which reduced the level of certainty of effect. No significant effects were observed on weight, height or changes in faecal proportions of Bifidobacteria, Lactobacillus, Bacteroides or Clostridia. Although there is some evidence that may support a potential benefit of probiotic or synbiotic supplementation of infant formulas, variation in the quality of existing trials and the heterogeneity of the data preclude the establishment of robust recommendations.

Background: This study aimed to explore current practices adopted by frontline healthcare providers for the early detection of developmental delays in infants and toddlers in Saudi Arabia, with a specific focus on motor and speech delays and caregivers’ perceptions of early detection of developmental delays and their awareness of well-child visits. Methods: Two cross-sectional surveys were conducted and distributed. The first survey was performed among healthcare providers who worked directly with infants and toddlers in the first 3 years of life, and the second survey was performed among caregivers of infants and toddlers who received healthcare services. Participants were recruited via online groups, social media platforms, and clinics. Results: Overall, 60% of the healthcare providers played a role in identifying medical conditions that could be associated with delays and disabilities. However, they did not consistently check for normal development or developmental delays. Furthermore, the healthcare providers reported low frequencies of documenting developmental growth. The caregivers’ survey results showed that 67% were familiar with the concept of “well-child visits”, and the most frequently discussed topic by the healthcare providers was motor development. Conclusions: Well-defined, government-supported standards are needed to encourage regular well-child visits and implement efficient practices for the early detection of developmental delays.

Objective: To explore the clinical value of ultrasound examination in evaluating the presence of ovarian torsion in female infants with inguinal ovarian hernia., Methods: We conducted a retrospective analysis of 91 cases of ovarian hernia diagnosed by ultrasonography at our institution. Among them, 6 cases were identified as ovarian strangulation, while 85 cases were classified as non-ovarian strangulation. All cases underwent high-frequency ultrasound examination. We analyzed whether there were differences in the associated factors between the two groups and compared the disparities in the urgency of surgery between the two groups., Results: Significant differences were observed between the ovarian strangulation group and the non- strangulation group in terms of ovarian volume, ovarian blood flow, and the presence of incarceration. The need for emergency surgery was significantly associated with the presence of incarceration and ovarian torsion., Conclusion: Ultrasound has good clinical value in diagnosing ovarian hernia and determining the presence of ovarian strangulation. It can assist clinical physicians in determining the timing of surgery for children with ovarian hernia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Gu and Liu.)

The period of infancy and early childhood is a critical time for interventions to prevent future mental health problems. The first signs of mental health difficulties can be manifest in infancy, emphasizing the importance of understanding and identifying both protective and risk factors in pregnancy and the early postnatal period. Parents are at a higher risk of developing mental health problems during the perinatal period. An understanding of the evidence around prevention and intervention for parental anxiety and depression is vital to the process of prevention of early mental health disorders in infants and young children. Here we review the existing prevention and treatment interventions in the early years focusing on the period from conception to 3 years – the majority targeting parents in order to improve their mental health, and that of their infants. Elements of successful programs for parents include psychoeducation and practical skills training, as well as work on the co-parenting relationship, developing secure attachment, and enhancing parental reflective functioning. While both targeted and universal programs have produced strong effect sizes, universal programs have the added benefit of reaching people who may otherwise not have sought treatment. In synthesizing this information, our goal is to inform the development of integrated models for prevention and novel early intervention programs as early in life as possible. [ABSTRACT FROM AUTHOR]

The period of infancy and early childhood is a critical time for interventions to prevent future mental health problems. The first signs of mental health difficulties can be manifest in infancy, emphasizing the importance of understanding and identifying both protective and risk factors in pregnancy and the early postnatal period. Parents are at a higher risk of developing mental health problems during the perinatal period. An understanding of the evidence around prevention and intervention for parental anxiety and depression is vital to the process of prevention of early mental health disorders in infants and young children. Here we review the existing prevention and treatment interventions in the early years focusing on the period from conception to 3 years – the majority targeting parents in order to improve their mental health, and that of their infants. Elements of successful programs for parents include psychoeducation and practical skills training, as well as work on the co-parenting relationship, developing secure attachment, and enhancing parental reflective functioning. While both targeted and universal programs have produced strong effect sizes, universal programs have the added benefit of reaching people who may otherwise not have sought treatment. In synthesizing this information, our goal is to inform the development of integrated models for prevention and novel early intervention programs as early in life as possible.

Introduction: The purpose of the present paper is to provide step-by-step guidelines for dental healthcare providers to manage dental caries based upon caries risk assessment (CRA) for ages 0–6 years and 6 years through adult. The manuscript reviews and updates the CAMBRA (caries management by risk assessment) system which includes CRA and caries management recommendations that are guided by the assessed risk level.Caries Risk Assessment: CAMBRA CRA tools (CRAs) have been evaluated in several clinical outcomes studies and clinical trials. Updated CAMBRA CRAs for ages 0–6 years and 6 years through adult are provided. These CRAs have been refined by the addition of a quantitative method that will aid the health care provider in determining the caries risk of individuals.Caries Management Based Upon Risk Assessment: Guidelines for individualized patient care are provided based upon the caries risk status, results of clinical exams and responses of the patient to questions in the CRA. These guidelines are based upon successful outcomes documented in several clinical outcomes studies and clinical trials. The paper includes a review of successful caries management procedures for children and adults as previously published, with additional emphasis on correct use of silver diamine fluoride (SDF) for children. The caries management plan for each individual is based upon reducing the caries risk factors and enhancing the protective factors with the additional aid of behavior modification. Beneficially altering the caries balance is coupled with minimal intervention restorative dentistry, if appropriate. These methods are appropriate for the management of dental caries in all patients.

Introduction: Caries risk assessment (CRA) is essential as the basis for successful management of dental caries. Of the many published CRA tools, four well-known ones are CAMBRA, Cariogram, American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD) CRAs. The predictive accuracy of CAMBRA and Cariogram CRA tools have been examined in clinical outcomes studies in thousands of patients and the tools are widely used all over the world. The purpose of the present paper is three-fold, namely (1) to briefly review, compare and contrast these four CRA methods, (2) to provide a concise method for CRA introducing a quantitative component to the CAMBRA forms (CAMBRA 123), and (3) to guide the choice of CRA methods that will support caries management decisions.Comparison of Caries Risk Assessment Methods: In the present evaluation, the above-mentioned four CRA methods for ages 0–6 years and 6 years-adult were compared using 26 hypothetical patients (13 per age group). Comparison results show that Cariogram and CAMBRA categorized patients into identical risk categories. Each of the ADA and AAPD tools gave different results than CAMBRA and Cariogram in several comparison examples. CAMBRA 123 gave the same caries risk level results as the Cariogram and the CAMBRA methods for all hypothetical patients for both age groups.Conclusions: Both the Cariogram and the CAMBRA CRA methods are equally useful for identifying the future risk of dental caries. CAMBRA 123 shows promise as an easy-to-use quantitative method for CRA in clinical practice. The health care providers will be the ones to decide which CRA method will allow them to establish individualized, successful caries management therapies and how to combine these for the best care of their patients.

Abstract Background Prader-Willi syndrome (PWS) is a rare complex genetic disorder and is characterized by short stature, muscular hypotonia, abnormal body composition, psychomotor retardation, and hyperphagia. Recombinant human growth hormone (rhGH) treatment improves the symptoms in children with PWS, and early treatment results in more favorable outcomes. However, systematic studies in infants and toddlers under 2 years of age are lacking. This multicenter, randomized, active-controlled, parallel-group, open-label, Phase III study aimed to evaluate the safety of rhGH (Eutropin, LG Chem, Ltd.) and its efficacy on growth, body composition, and motor and cognitive development in infants and toddlers with PWS compared with a comparator treatment (Genotropin, Pfizer, Inc.). Eligible Korean infants or toddlers with PWS were randomly assigned to receive Eutropin or comparator (both 0.24 mg/kg/week, 6 times/week) for 1 year. Height standard deviation score (SDS), body composition, and motor and cognitive development were measured. Results Thirty-four subjects (less than 24 months old) were randomized into either the Eutropin (N = 17) group or the comparator (N = 17) group. After 52 weeks of rhGH treatment, height SDS and lean body mass increased significantly from baseline in both groups: the mean height SDS change (SD) was 0.75 (0.59) in the Eutropin group and 0.95 (0.66) in the comparator group, and the mean lean body mass change (SD) was 2377.79 (536.25) g in the Eutropin group and 2607.10 (641.36) g in the comparator group. In addition, percent body fat decreased significantly: the mean (SD) change from baseline was − 8.12% (9.86%) in the Eutropin group and − 7.48% (10.26%) in the comparator group. Motor and cognitive developments were also improved in both groups after the 1-year treatment. The incidence of adverse events was similar between the groups. Conclusions rhGH treatment for 52 weeks in infants and toddlers with PWS improved growth, body composition, and motor and cognitive development, and efficacy and safety outcomes of Eutropin were comparable to those of Genotropin. Hence, Eutropin is expected to provide safe and clinically meaningful improvements in pediatric patients with PWS. Trial registration The study was registered at ClinicalTrials.gov (identifier: NCT02204163) on July 30, 2014. URL: https://clinicaltrials.gov/ct2/show/NCT02204163?term=NCT02204163&rank=1

The level of intake of essential polyunsaturated fatty acids (PUFAs) in pregnant, newborns and young children affects the quality of growth, state of the cardiovascular system, neurological and immune functions in childhood and later life. Child receives PUFAs through the placenta and with the mother's milk, and therefore the peculiarities of the mother's diet affect the supply of these fetal acids, as well as their content in breast milk. In the vast majority of countries with limited resources the use of docosahexaenoic and arachidonic acids in pregnant women, infants and young children may be significantly lower than recommended. Numerous randomized, controlled studies examined the effect of additional PUFAs consumption during pregnancy, lactation and postnatal period on physical, psychomotor, speech and mental development of children, their behavior, visual acuity, cardiovascular function and immune responses. Available data suggests that the additional consumption of long-chain PUFAs for children on breast or artificial feeding does not improve visual acuity, physical development or speech development. Additional n-3 PUFA may also affect some aspects of motor development, cardiovascular health, behavior and immunity with a more positive effect on breast-feeding children than children fed with milk nutrition. There is also evidence that an additional use of n-3 long-chain PUFA, in particular docosahexaenoic acid and eicosopentaenoic acid may reduce the incidence or severity of the most commonly occurring diseases specific to premature infants. In 2013, the European Food Safety Authority considered adequate daily intake levels of double-stranded PUFAs for most infants and young children to be adequate: 100 mg of docosahexaenoic acid and 140 mg of arachidonic acid from birth to 6 months, 100 mg of docosahexaenoic acid from 6 to 24 months and 250 mg eykozopentaenovoy + docosahexaenoic acid later than 24 months of age.

Abstract Background Early parent- child relations play an important role in children’s development. Therapeutic intervention towards infants and toddlers at high-risk intends to prevent mental health problems. In this work, the parent-child-dyad is crucial. The video interaction guidance method, Marte Meo, is one among different methods used in attachment-based treatment in an outpatient infant mental health clinic. Parental sensitivity towards infants and toddlers needs is considered significant in developing secure attachment. Secure attachment is further considered decisive for mental health and the extent to which children are at risk of developing mental health problems. Different treatment methods aim at strengthening parents’ sensitivity. This study’s purpose was to gain further understanding about parent’s experiences with Marte Meo – therapy and highlight the importance for parental sensitivity. Methods This is a cross-sectional phenomenological hermeneutical study. Four biological parents of three infants and toddlers aged 0–20 months who received Marte Meo- therapy in a clinical context were selected. Data was collected using semi structured interviews. Results This article presents the study’s key-finding; we suggest that sensitivity increases. The key components of this are: watching edited video interaction in a therapeutic context, emotional activation, mutuality, self-esteem / self-confidence and reflective function. These are further elaborated and discussed. Conclusion The findings indicate that Marte Meo contributes to facilitate development-supportive interaction, strengthen parental sensitivity, emotional availability, reflective functioning and coping - experience.

To evaluate if valproic acid (VPA) therapy is associated with vitamin D deficiency among infants and toddlers with epilepsy, a cross-sectional clinical study was conducted in 25 children with epilepsy taking VPA. Blood levels of calcium, phosphorus, alkaline phosphatase, and 25-hydroxy vitamin D [25(OH)D] and plasma VPA level were measured at 1- to 3-month intervals. At the initial and final measurements, vitamin D deficiency or insufficiency was recognized in 8 (32%) and 12 (42%), respectively. In girls, a decreasing trend in serum 25(OH)D levels (P<0.05) was observed. Polytherapy had a significant negative effect on the longitudinal change of 25(OH)D (P<0.05) in girls. In conclusion, our study indicates that a high proportion of girls after VPA therapy had hypovitaminosis D. [ABSTRACT FROM AUTHOR]

Background: Typhoid causes significant mortality among young children in resource-limited settings. Conjugate typhoid vaccines could significantly reduce typhoid-related child deaths, but only one WHO-prequalified typhoid conjugate vaccine exists for young children. To address this gap, we investigated the safety, immunogenicity and dose-scheduling of Vi-DT typhoid conjugate vaccine among children aged 6-23 months. Methods: In this single center, observer blind, phase II trial, participants were randomly assigned (2:2:1) to receive one or two doses of Vi-DT or comparator vaccine. Anti-Vi IgG titer and geometric mean titers (GMT) were determined at 0, 4, 24 and 28 weeks. Data were analyzed using per-protocol and immunogenicity (a subset of intention-to-treat analysis) sets. The trial is registered with ClinicalTrials.gov (NCT03527355). Findings: Between April and July 2018, 285 children were randomized; 114 received one or two doses of Vi-DT while 57 received comparator. 277 completed the study follow-up per protocol; 112 and 110 from single- and two-dose Vi-DT schedules, respectively and 55 from the placebo group were included in the per protocol analysis. Safety profile is satisfactory. Thirteen serious adverse events were reported during the 28-week follow-up, none of which were related to Vi-DT. The seroconversion rate four weeks after the first dose was 100% (95% CI 98·3-100) in Vi-DT recipients and 7·0% (95% CI 2·8-16·7) in comparator recipients (p

OBJECTIVES: We aimed to study the prevalence of the early onset Type 1 diabetes in Slovakia during the years 1996-2017. BACKGROUND: Prevalence of Type 1 diabetes in young children is increasing worldwide. However, recent data from Slovakia are missing. METHODS: All children with newly diagnosed Type 1 diabetes included in the study were diagnosed in the Children Diabetes Centre in Bratislava during the years 1996-2017. The incidence of T1D in children aged below 3 and below 5 years was calculated and compared to the T1D incidence in older children. Incidence trends were calculated with the Poissed regression. RESULTS: Gender-adjusted incidence of T1D annually increased by 5.4% (CI: 3.9-6.8; p < 0.001) in children <3 years, and by 3.4% (95% CI 2.2-4.6; p<0.001) in children <5 years during the last two decades. Moreover, the proportion of young children <3 years of age among all newly diagnosed children and adolescents increased over time (4.2±2.8% in years 1996-1998; 12.2±5.8% in years 2004-2008, and 13.7±7.4% during the years 2013-2017). CONCLUSION: We found a significant increase in the incidence and proportion of T1D in young children during the last two decades. Similar data were also found in other European countries. This could be explained by changing environmental conditions (Fig. 1, Ref. 32). Text in PDF www.elis.sk. [ABSTRACT FROM AUTHOR]

Objective : There are few lung function tests available to evaluate bronchial asthma in infants and toddlers. The objective of this study was to test the hypothesis that the measurement of exhaled carbon monoxide (eCO) levels is applicable to evaluate infants and toddlers with stable asthma and during acute asthma attack. Methods : A one-way valve breath sampling bag was developed to collect the exhaled air of infants and toddlers. A total of 483 infants (under 2 years) and toddlers (2-5 years) were studied ; 355 had an established diagnosis of asthma (182 suffering mild asthma attacks and 173 without active asthmatic symptoms), 119 had upper respiratory infection (URI) including acute bronchitis, and 9 were healthy. Results : In infants and toddlers, eCO levels of those with asthma attacks [median (interquartile range) = 2.0 (2.0-3.25) ppm, n=182] were significantly higher than those of subjects with asymptomatic asthma [2.0 (1.0-2.0) ppm, n=173, P < 0.0001], URI [2.0 (1.0-3.0) ppm, n=119, P < 0.0001], and healthy children [1.0 (0.0-1.0) ppm, n=9, P < 0.0001]. In 75 children with asthma petit mal, eCO levels during asthma attacks [3.0 (2.0-4.0) ppm] significantly decreased after therapy [1.0 (1.0- 2.0) ppm, P < 0.0001]. In infants and toddlers with an established diagnosis of asthma (n=355), eCO cut-off >2 ppm discriminated asthma attack from an asymptomatic state with a sensitivity of 95.6%, a specificity of 43.3%, and an area under the curve (AUC) of 0.71 (95% CI : 0.65-0.76, P < 0.0001). In 401 infants and toddlers with some respiratory symptoms, of which 285 cases were finally diagnosed as asthma [eCO level = 2.0 (2.0-3.0) ppm] and 116 cases were not asthma [eCO level = 2.0 (1.0-3.0) ppm, P < 0.0001], eCO cut-off >3 ppm supported the final diagnosis of asthma with a sensitivity of 38.9%, a specificity of 74.1%, and AUC of 0.63 (95% CI : 0.56-0.69, P < 0.0001). Conclusion : The measurement of eCO by a novel method is applicable to evaluate asthmatic activity and treatment responsiveness, and to diagnose asthma in infants and toddlers. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We aimed to study the prevalence of the early onset Type 1 diabetes in Slovakia during the years 1996-2017. BACKGROUND: Prevalence of Type 1 diabetes in young children is increasing worldwide. However, recent data from Slovakia are missing. METHODS: All children with newly diagnosed Type 1 diabetes included in the study were diagnosed in the Children Diabetes Centre in Bratislava during the years 1996-2017. The incidence of T1D in children aged below 3 and below 5 years was calculated and compared to the T1D incidence in older children. Incidence trends were calculated with the Poissed regression. RESULTS: Gender-adjusted incidence of T1D annually increased by 5.4 % (CI: 3.9-6.8; p < 0.001) in children <3 years, and by 3.4 % (95 % CI 2.2-4.6; p<0.001) in children <5 years during the last two decades. Moreover, the proportion of young children <3 years of age among all newly diagnosed children and adolescents increased over time (4.2±2.8 % in years 1996-1998; 12.2±5.8 % in years 2004-2008, and 13.7±7.4 % during the years 2013-2017). CONCLUSION: We found a significant increase in the incidence and proportion of T1D in young children during the last two decades. Similar data were also found in other European countries. This could be explained by changing environmental conditions (Fig. 1, Ref. 32). [ABSTRACT FROM AUTHOR]

Descriptions of the implementation of community-based participatory mixed-methods research (CBPMMR) in all phases of the engagement approach are limited. This manuscript describes the explicit integration of mixed-methods in four stages of CBPR: (1) connecting and diagnosing, (2) prescribing-implementing, (3) evaluating, and (4) disseminating and refining an intervention that aimed to motivate Latino parents (predominantly Central American in the US) of infants and toddlers to replace sugary drinks with filtered tap water. CBPMMR allowed for co-learning that led to the identification of preliminary behavioral outcomes, insights into potential mechanisms of behavior change, and revisions to the intervention design, implementation and evaluation.

Recent research has provided evidence on genome-wide alterations in DNA methylation patterns due to trisomy 21, which have been detected in various tissues of individuals with Down syndrome (DS) across different developmental stages. Here, we report new data on the systematic genome-wide DNA methylation perturbations in blood cells of individuals with DS from a previously understudied age group—young children. We show that the study findings are highly consistent with those from the prior literature. In addition, utilizing relevant published data from two other developmental stages, neonatal and adult, we track a quasi-longitudinal trend in the DS-associated DNA methylation patterns as a systematic epigenomic destabilization with age.

Early childhood is a critical period for developing children's abilities. Non-cognitive abilities are comparable to or even stronger than cognitive abilities in predicting many socioeconomic outcomes. Usually, most scholars take personality as the core indicator of non-cognitive abilities. While temperament is also an important component of children's non-cognitive abilities, it was often ignored in previous studies. Based on the panel data from the 2018 and 2020 China Family Panel Studies (CFPS), this study investigates the effects of parental marital satisfaction on the non-cognitive development of children aged one to three; meanwhile, the heterogeneous effects and mechanisms were also examined. The results show that young children exhibit more negative emotions when their parents reported dissatisfaction with their marriages. Parental depression was an important mechanism of parental marital satisfaction affecting children's non-cognitive development, while the frequency of parent-child interaction was not. The effects of marital dissatisfaction on non-cognitive abilities were heterogeneous across child age and gender, as well as parental genders and education levels. The findings shed some light on the early interventions and offer important reference values for public policies aimed at improving family welfare and children's non-cognitive development. • Highlighting the significance of temperament in children's non-cognitive abilities. • Exploring how parental marital satisfaction affects non-cognitive development in children aged 1-3. • Noting that marital dissatisfaction can lead to increased negative emotions in children aged 1-3. • Recognizing parental depression's role in the link between marital satisfaction and children's non-cognitive development. • Showing diverse effects of marital dissatisfaction on non-cognitive abilities among child age, gender and parental factors. [ABSTRACT FROM AUTHOR]

Implementing relationships-based pedagogies in infant and toddler settings might assume that teachers’ experiences of emotional labour will be acknowledged. This assumption may be complicated by assessment practices that both rely on and detract from relationship-building opportunities with infants and toddlers. Assessment also relies on reciprocal relationships between teachers, and between teachers and families. Drawing on sociocultural theoretical perspectives, this article illustrates how one team of infant-toddler teachers in Aotearoa-New Zealand reframed their assessment understandings and practices to acknowledge their experiences of emotional labour with infants and toddlers. Consequently, positive changes in the teachers’ relationships with children, with families and with each other eventuated. The author argues that reconceptualising relationships in infant-toddler settings requires an understanding of assessment as a reflexive, relational process that can occur during everyday interactions, and emotional labour as central to relationship-building. Implications include teachers’ need for time, reflective dialogue and support to address tensions between assessment and relational pedagogy, so that relationships might be reconceptualised and the importance of emotional labour acknowledged. [ABSTRACT FROM AUTHOR]