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Background: Ubiquitous car ownership may affect children's activity and health. We assessed the cross-sectional and longitudinal associations between household car ownership and children's daily time spent sedentary (SED) and in moderate to vigorous physical activity (MVPA). Methods: Pooled cohort data were from the International Children's Accelerometry Database. Outcome measures were average daily accelerometer-measured SED and MVPA (in minutes per day). Exposures were household car ownership (none, 1, and ≥2) and change in car ownership. Associations were examined using multivariable mixed-effects linear regression. Results: Mean age of participants (N = 4193) was 10.4 years (SD = 2.0), 53.4% were girls, and mean follow-up duration (N = 1333) was 3.3 years (SD = 1.1). Cross-sectionally, household car ownership was associated with higher SED (vs none: 1 car: β = 14.1 min/d, 95% CI, 6.7–21.5; ≥2 cars: 12.8, 95% CI, 5.3–20.4) and lower MVPA (vs none: 1 car: β = –8.8, 95% CI, −11.9 to −5.7; ≥2 cars: β = –8.8, 95% CI, −12.0 to −5.7). Associations were stronger in boys than girls and in children from lower socioeconomic backgrounds (SED only). Prospectively, there were no associations with increased car ownership. Reductions in household car ownership (of which 93.1% had ≥ 2 cars at baseline) were associated with a greater reduction in MVPA (vs no change: β = −8.4, 95% CI, −13.9 to −3.0) but not SED. Conclusions: Children in households with car access were more SED and less active than those without. Losing access to a second car was associated with greater decreases in MVPA, potentially related to losing access to activity-enabling environments. Reducing car access and use are important public health targets (eg, reducing air pollution), but their potential impact on children's activity opportunities should be mitigated. [ABSTRACT FROM AUTHOR]

Background: Twenty-four hour movement behaviors (ie, physical activity [PA], screen time [ST], and sleep) are associated with children's health outcomes. Identifying day-level contextual factors, such as child care, that positively influence children's movement behaviors may help identify potential intervention targets, like improving access to child care programs. This study aimed to examine the between- and within-person effects of child care on preschoolers' 24-hour movement behaviors. Methods: Children (N = 74, 4.7 [0.9] y, 48.9% girls, 63.3% White) wore an Axivity AX3 accelerometer on their nondominant wrist 24 hours per day for 14 days to measure PA and sleep. Parents completed surveys each night about their child's ST and child care attendance that day. Linear mixed effects models predicted day-level 24-hour movement behaviors from hours spent in child care. Results: Children spent an average of 5.0 (2.9) hours per day in child care. For every additional hour of child care above their average, children had 0.3 hours (95% CI, −0.3 to −0.2) less ST that day. Between-person effects showed that compared with children who attended fewer overall hours of child care, children who attended more hours had less overall ST (B = −0.2 h; 95% CI, −0.4 to 0.0). Child care was not significantly associated with PA or sleep. Conclusions: Child care attendance was not associated with 24-hour PA or sleep; however, it was associated with less ST. More research utilizing objective measures of ST and more robust measures of daily schedules or structure is necessary to better understand how existing infrastructure may influence preschool-aged children's 24-hour movement behaviors. In addition, future research should consider how access to child care may influence child care attendance. [ABSTRACT FROM AUTHOR]

PURPOSE OF REVIEW: Environmental chemical exposures may disrupt child development, with long-lasting health impacts. To date, U.S. studies of early environmental exposures have been limited in size and diversity, hindering power and generalizability. With harmonized data from over 60,000 participants representing 69 pregnancy cohorts, the National Institutes of Healths Environmental influences on Child Health Outcomes (ECHO) Program is the largest study of U.S. childrens health. Here, we: (1) review ECHO-wide studies of chemical exposures and maternal-child health; and (2) outline opportunities for future research using ECHO data. RECENT FINDINGS: As of early 2024, in addition to over 200 single-cohort (or award) papers on chemical exposures supported by ECHO, ten collaborative multi-cohort papers have been made possible by ECHO data harmonization and new data collection. Multi-cohort papers have examined prenatal exposure to per- and polyfluoroalkyl substances (PFAS), phthalates, phenols and parabens, organophosphate esters (OPEs), metals, melamine and aromatic amines, and emerging contaminants. They have primarily focused on describing patterns of maternal exposure or examining associations with maternal and infant outcomes; fewer studies have examined later child outcomes (e.g., autism) although follow up of enrolled ECHO children continues. The NICHDs Data and Specimen Hub (DASH) database houses extensive ECHO data including over 470,000 chemical assay results and complementary data on priority outcome areas (pre, peri-, and postnatal, airway, obesity, neurodevelopment, and positive health), making it a rich resource for future analyses. ECHOs extensive data repository, including biomarkers of chemical exposures, can be used to advance our understanding of environmental influences on childrens health. Although few published studies have capitalized on these unique harmonized data to date, many analyses are underway with data now widely available.

This study examined the effects of a motor-skill intervention on children's perceived motor competence (PMC; object control, locomotor, and combined [total]) and explored if effects differed between the sexes. Preschoolers (N = 274; 47.96 months) completed either a motor-skill intervention (the Children's Health Activity Motor Program [CHAMP]) or recess. PMC was measured with the Digital Scale of PMC before and after each condition. Controlling for pretest scores, recess girls had lower posttest object-control PMC scores than CHAMP boys, CHAMP girls, and recess boys (all p <.05). CHAMP children had significantly higher posttest locomotor and total PMC (all p <.001) compared with children who engaged in recess. CHAMP partially eliminates sex differences in PMC, particularly for object-control skills. Girls who participated in recess did not increase PMC like children in CHAMP and boys who engaged in outdoor recess. [ABSTRACT FROM AUTHOR]

Health effects of vegan diets among children and adolescents are a controversial public health topic. Thus, the aim of the present systematic review is to evaluate a broad range of health outcomes among vegan children and adolescents aged 0 to 18 years. 18 studies met the inclusion criteria (17 cross-sectional, 1 RCT). Meta-analyses showed lower protein, calcium, vitamin B2, saturated fatty acid, and cholesterol intakes, and lower ferritin, HDL and LDL levels as well as height in vegan compared to omnivorous children/adolescents. Higher intakes of carbohydrates, polyunsaturated fatty acids, fiber, folate, vitamins C and E, magnesium, iron, and potassium were observed in vegans. Blood levels of vitamin B12 were higher among vegan children due to supplement use. Single study results suggested further differences between vegan and non-vegan children, such as lower bone mineral content or urinary iodine among vegan children. Risk of Bias was rated as high or very high in 7 out of 18 studies. The certainty of evidence for the meta-analyses was low (n = 2) or very low (n = 46). Overall, the available evidence points to both risks and benefits associated with a vegan diet among children, although more and better designed studies are needed. [ABSTRACT FROM AUTHOR]

Children have higher threats due to their exposure and higher susceptibility to the environmental pollutants. The current study put an effort on detecting different heavy metals in children play products and its related effects on children's health. Heavy metals were detected in the selected samples from the local markets of city Lahore by using flame atomic absorption spectrometer (iCE 3000 series). Results showed that the concentrations of heavy metals (Cr, Ni and Zn) except Pb and Cd are below the EU migration limits. The concentration of Pb in all samples and the concentration of Cd in nineteen samples exceeds from the limits. Highest values of Pb and Cd detected in poster paints were (8.33 ± 1 mg/kg) and (0.94 ± 0.1 mg/kg), respectively. In crayons and playing dough highest values of Pb and Cd detected were (10.94 ± 1 mg/kg), (2.75 ± 0.1 mg/kg) and (9.313 ± 01 mg/kg), (1.9 ± 0.1 mg/kg), respectively. Obtained results are further used to calculate both the oral and dermal health risks of these playing products. The value of the total health risk assessment was less than 1 in all the selected playing products. The maximum value of the total health risk assessment is detected in crayon (3.97E-02), which can cause serious health problems. Therefore, it is needed to make laws which limit the use of heavy metals in these playing products in Pakistan. [ABSTRACT FROM AUTHOR]

The current study investigated potentially toxic elements (PTE) contaminations in the water of alpine lakes of Gilgit-Baltistan, Northern Pakistan. Water samples (n = 46) of various alpine lakes were collected and analysed for PTE determination through atomic absorption spectroscopy (AAanalyst 700, PerkinElmer, USA). Arsenic (As) in water was measured using a mercury hydride generation system. PTE concentrations in water of alpine lakes were observed below the upper limit of the world health organisation (WHO) drinking water guidelines, except for iron (Fe, 14%), chromium (Cr, 10%), and As (2%) of samples. The highest mean concentrations of Fe (233 ± 22.4 µg/L) and Cr (36.3 ± 4.20 µg/L) were noted in the water of Rama Lake and the As (6.20 ± 0.65 µg/L) in the Lower Kachura Lake. PTE concentrations in the water of alpine lakes was evaluated for the elements pollution index (EPI), elements evaluation index (EEI), and risk indices. The values of EPI and EEI for PTE in the water of alpine lakes were found far below the threshold limits. Higher mean chronic daily intake (CDI) values were observed for Fe and zinc (6.67 ± 1.09 and 4.95 ± 2.65 µg/kg-day) in the Rama and Upper Kachura Lakes, respectively. Determined hazard quotient (HQ) values for PTE were noted as> 1. However, the HQ value for As was (1.4 ± 0.06) which may have a detrimental effect on the health of children. Cancer risk of As and HQ values for other elements were found within the allowable limits of consumption in drinking water. Statistical analysis revealed that geogenic sources are the main PTE contaminations contributors in the water of alpine lakes. [ABSTRACT FROM AUTHOR]

Meeting 24-h movement behaviors (24-HMB: physical activity [PA], screen time [ST], and sleep [SL]) recommendations may be associated with positive health outcomes among youth with specific mental, behavioral, and neurodevelopmental (MBD) conditions. However, temporal trends and disparities in meeting 24-HMB guidelines in these higher-risk groups have not been investigated, hampering the development of evidence-based clinical and public health interventions. Serial, cross-sectional analyses of nationally National Survey of Children's Health (NSCH) data (including U.S. youth aged 6–17 years with MBD conditions) were conducted. The time-trends survey data was conducted between 2016 and 2021. The prevalence of 24-HMB adherence estimates were reported for the overall sample and for various sociodemographic subgroups. The subgroups analyzed included: age group (children[aged 6 to 13 years], adolescents[aged 14 to 17 years]), sex, socioeconomic status, and ethnicity. Data on 52,634 individuals (mean age, 12.0 years [SD,3.5]; 28,829 [58.0 %] boys) were analyzed. From 2016 to 2021 the estimated trend in meeting PA + ST + SL guidelines declined (−0.8 % [95%CI, −1.0 % to −0.5 %], P for trend <0.001), whereas meeting none of 24-HMB guidelines increased (2.2 % [1.8 % to 2.6 %], P for trend <0.001). White participants, children, and boys reported higher estimated prevalence of meeting full integrated (PA + ST + SL) guidelines. The temporal trends observed in this study highlight the importance of consistently monitoring movement behavior among MBD youth and identifying variations by sociodemographic groups in meeting 24-HMB guidelines for health promotion within these vulnerable groups. • The prevalence of MBD youth (aged 6 to 17 years) not meeting any of guidelines increased over the six-year period. • The prevalence of meeting all 24-HMB guidelines showed a significant decline among MBD youth over six years. • Boys, children, and White participants showed higher prevalence of meeting all 24-HMB guidelines, suggesting that disparities may have widened across time. [ABSTRACT FROM AUTHOR]

Informed by models of resilience in military families, we explored factors theorized to be associated with social-emotional resilience and risk among young military-connected children. Our secondary analysis of cross-sectional data from 199 military-connected families (n = 346 parents) with at least one preschool-age child in the home (n = 199) led to the empirical identification of two distinct clusters: families with children demonstrating healthy social-emotional functioning and those showing indicators of less healthy social-emotional functioning when compared to the first group. We then identified factors associated with membership in each cluster to determine which deployment and parental well-being variables were salient for young child adjustment. Parent psychological symptoms, parenting, child behavior, and parent-child relationships were measured by parent report and observed interaction. Children with healthier social-emotional functioning were found to be residing with families experiencing less stress and distress. The importance of maternal trauma history is highlighted in our study, as elevated maternal symptoms across all three posttraumatic stress disorder symptom domains were associated with child social-emotional risk. Basic family demographic characteristics did not contribute significantly to the cluster distinctions, nor did military service factors such as active duty, reserve or veteran status, military rank or parent deployment history. These findings are important as the results deemphasize the importance of military service characteristics and highlight the importance of parent well-being when considering social-emotional risk and resilience of young children within military families. Highlights: Military-connected families with lower levels of stress were more likely to have preschoolers with positive social-emotional adjustment. Elevated maternal symptoms in all three posttraumatic stress disorder domains were associated with child behavioral risk. Family military service and demographic characteristics did not contribute significantly to social-emotional child adjustment. [ABSTRACT FROM AUTHOR]

Early literacy promotion in pediatric primary care supports parents and caregivers in reading with their children from birth, offering counseling in interactive, developmentally appropriate strategies and providing developmentally and culturally appropriate and appealing children's books. This technical report reviews the evidence that reading with young children supports language, cognitive, and social-emotional development. Promoting early literacy in pediatric primary care offers a strengths-based strategy to support families in creating positive childhood experiences, which strengthen early relational health. An increasing body of evidence, reviewed in this report, shows that clinic-based literacy promotion, provided with fidelity to an evidence-based model, has benefits for children, for parents and caregivers, and for pediatric physicians and advanced care providers as well. Reading with young children supports early brain development and the neural "reading network," and improves school readiness. High-quality literacy promotion is especially essential for children who face disparities and inequities because of social factors, systemic racism, and socioeconomic risk. All families benefit from high-quality and diverse books and from developmentally appropriate guidance supporting interactions around books and stories. Thus, literacy promotion can be a universal primary prevention strategy to strengthen families and support healthy development. Partnerships at community, local, and state levels offer opportunities for integration with other programs, services, and platforms. Literacy promotion in primary care pediatric practice, recognized by the American Academy of Pediatrics as an essential component since 2014, has become increasingly common. There are successful models for public funding at federal, state, county, and municipal levels, but sustainable funding, including payment to pediatric physicians and advanced care providers, remains a need so that the benefits of pediatric early literacy promotion and the joys of books and shared reading can truly be offered on a population level. [ABSTRACT FROM AUTHOR]

The article provides information on the Family Media Plan (FMP), which provides families with an interactive online tool that allows them to consider and select specific rules and guidance that meet their family's needs, consistent with the guidelines and recommendations from the American Academy of Pediatrics (AAP) media policies. Topics include background on the initial FMP, key aspects of media use in families, and priorities for FMP updates.

High-intensity interval training (HIIT) is an emerging exercise strategy to improve health and fitness, but previous studies have evaluated HIIT interventions across different populations and outcomes. This review aimed to comprehensively synthesize published evidence on the effects of HIIT on key cardiometabolic health parameters in children and adolescents. We searched seven databases until February 2024. Systematic reviews were eligible if they 1) compared HIIT and active/non-active control conditions with meta-analysis, 2) examined cardiorespiratory fitness, body composition and cardiometabolic risk biomarkers, and 3) examined children and adolescents. We included 18 systematic reviews with meta-analysis, including 223 original studies and 13,900 unique participants. HIIT is effective for cardiorespiratory fitness in children and adolescents with diverse health and weight status (median standardized mean difference [SMD] = 0.75). Improvements in body composition and several cardiometabolic risk biomarkers, including systolic blood pressure (median SMD = −0.40), diastolic blood pressure (median SMD = −0.22), triglyceride (median SMD = −0.30), low-density lipoprotein cholesterol (median SMD = −0.90), and high-density lipoprotein cholesterol (median SMD = 0.34), have also been observed following HIIT, with a notably more pronounced effect in youth with overweight/obesity or metabolic disorders. Our umbrella review supports the effectiveness of HIIT in enhancing cardiometabolic health, suggesting its integration into physical activity promotion programmes in schools and communities. [ABSTRACT FROM AUTHOR]

The present study of 6- to 13-year-old children in the United States examined bullying victimization's relationships with social disorganization, social structural factors, social relationships, mental health, access to health insurance, and caregiver types. A sample of 12,966 children aged 6 to 13 years was extracted from the 2018 National Survey of Children's Health for secondary data analysis. Logistic regression results indicated that these children's likelihood of being bullied was positively associated with racial discrimination, family violence, child mental health problems (depression, anxiety, attention-deficit/hyperactivity disorder, and behavioral/conduct problems), girls, children aged 6 to 10 years, caregiver education level, and nonrelative caregivers; such likelihood also had negative associations with Blacks, Hispanics, Asians, other ethnic minorities, family cohesiveness, caregiver mental health, and caregiver age. Implications included interventions for family support and bullied children's mental health problems. [ABSTRACT FROM AUTHOR]

Objective: Participating in physical activity during pregnancy has benefited a lot from maternal and child health. However, there are few longitudinal studies describing activity patterns and related factors during pregnancy. The aim of this study is to investigate longitudinal physical activity changes and the influencing factors of Chinese pregnant women. Methods: From January to August 2020, 240 pregnant women were recruited in Hangzhou, China. Physical activity during pregnancy was assessed in the first, second, and third trimesters of pregnancy by using the Pregnancy Physical Activity Questionnaire. Results: The daily energy consumption during first, second, and third trimesters was 20.55, 20.76, 17.19 METs-h/d. The results of repeated-measure analysis of variance and pairwise comparison showed that the total daily energy consumption of physical activity in the third trimester was significantly lower than that in the first and second trimesters, with statistical significance (p < 0.001). The generalized estimation equation showed that education level, pre-pregnancy BMI, gravidity, unnaturally conceived and pre-pregnancy exercise habits were the influencing factors of physical activity during pregnancy (p < 0.05). Conclusion: Physical activity levels of pregnant women during different trimester were not optimistic. In order to improve physical activity during pregnancy and promote the health status of both mother and the developing baby, more attention should be paid on pregnant women with low education level, high BMI before pregnancy, primipara, unnaturally conceived and no good exercise habits before pregnancy. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the associations of outdoor playtime, screen time, and sleep duration with ball bouncing skills in a sample of 3- to 5-year-old children. Participants were young children (N = 11,121; 48.8% female) whose parent/guardian completed the 2022 National Survey of Children's Health. The dependent variable was one item that asked about the child's ability to bounce a ball repeatedly. The primary independent variables were the National Survey of Children's Health items asking about hours of weekday and weekend outdoor play, screen time, and sleep duration. The primary analysis consisted of robust Poisson regression models to calculate adjusted prevalence ratios by regressing competent (high) ball bouncing skills with reported hours of weekday and weekend outdoor play, screen time, and sleep. After covariate adjustment, two or more hours spent in weekday outdoor play was associated with a 15%–41% higher prevalence of competent ball bouncing skills (p <.01), and three or more hours of weekend outdoor play was associated with a 14%–28% higher prevalence of competent ball bouncing skills (p <.05). More hours of outdoor play were associated with competency in ball bouncing skills in young children. Mechanisms for this association are unclear and warrant further investigation. [ABSTRACT FROM AUTHOR]

This systematic review evaluates studies focusing on parenting and feeding practices, children's feeding behavior, and growth stunting in Asian countries. Eight electronic databases were searched to screen studies published between Jan 2015 and May 2021. There were contradictory findings related to gender differences in growth stunting and factors that reinforce/facilitate or inhibit acquisition of optimum growth in children. Theme of parenting practices showed that time spent on childcare, traditional beliefs about child-care feeding and responsive feeding were also contributing factors. Amidst economic improvement, political, social changes, and worldwide execution of various nutritional programs, stunting continues to be relentlessly persistent and widespread in Asia. Undernutrition disturbs areas of the mind involved in reasoning, reminiscence, locomotor skills and also an adverse influence on the physical and psychological growth of children and ensuing learning capabilities. Stunted children have more anxiety and depression and lower self-esteem than non-stunted children. A public health strategy is required to: (i) properly examine stunting with time through collaborated efforts of community members and various sectors, (ii) tackle malnutrition with steps to enhance maternal nutrition during pregnancy, infant feeding practices and (iii) involvement of effective multi-sectoral partnership programs for management of stunting. [ABSTRACT FROM AUTHOR]

The health risks of smoking are widely known, but the impact of secondhand smoke on children and adolescents is often underestimated. Despite efforts to reduce smoking, exposure to secondhand smoke remains a significant public health concern, especially for young individuals. This systematic review aims to explore the health impacts of secondhand smoking on children and adolescents. Following PRISMA guidelines, 18 eligible studies from 8 countries published between 2015 and 2023 were identified through PubMed, SCOPUS, and Web of Science databases. Findings revealed that passive smoking is associated with respiratory issues like asthma and respiratory infections in children and adolescents aged 4 months to 18 years. Significant correlations were found between asthma severity and cotinine levels, a marker of passive smoking. Additionally, metabolic issues, cardiovascular effects, and ophthalmological changes, and alterations in neurocognitive functions, were noted. Urgent public health interventions are needed to reduce smoking prevalence and protect this vulnerable demographic. [ABSTRACT FROM AUTHOR]

Background: Parents' low health literacy (HL) has negative impacts on child health. Parental interventions may improve parents' HL and thus impact child health positively. Objectives: This study aimed to gain knowledge about associations between parents' comprehensive HL (CHL) and child health after an extended postnatal home visiting program in Swedish multicultural, disadvantaged settings compared to parents receiving regular child healthcare (CHC). Materials and Methods: This quasi‐experimental study used a case–control sampling method to recruit first‐time parents through two CHC centres in Stockholm (2017–2020). Participants (N = 151) were interviewed twice through structured questionnaires when their child was <2 months and 15–18 months old. HLS‐EU‐Q16 assessed parents' CHL. Children's medical records (0–18 months) were reviewed regarding breastfeeding, children's exposure to smoking, language development and healthcare utilisation. Data were analysed with regression models and non‐parametric tests. Results: No significant association was found between parents' CHL and child health. However, significantly fewer unplanned visits to the CHC centre were observed among children (0–18 months) in the intervention group irrespective of CHL, compared with children to parents with improved CHL in the comparison group (F = 3.856, p = 0.011). Conclusions: Postnatal home visiting interventions practicing proportional universalism and family‐centred care may reduce unplanned visits within CHC in disadvantaged settings despite parents' CHL. Further studies with long‐term follow‐up are suggested to explore associations between parents' CHL and child health. Trial Registration: As a clinical study (not a clinical trial) with appropriate ethical permission with participants' consents, this study was retrospectively registered (18 February 2020) in the ISRCTN registry (ISRCTN10336603). [ABSTRACT FROM AUTHOR]

The article discusses the 43rd Annual Conference of the Society for Reproductive and Infant Psychology (SRIP) held from 7th to 8th September 2023 in Dresden, Germany. Topics discussed include integrating different perspectives and methodologies in family mental health research, exploring psychobiological aspects of human development, and examining how early environmental experiences influence child development and well-being.

Massive internal migration in China has greatly disadvantaged children who are left behind. This study unravels the mechanism underlying the association between parental migration and children's mental health through the lenses of social networks and gender. Using data collected in Sichuan, one of the provinces with the largest number of left-behind children in China, this study finds that maternal and paternal migration differ in their associations with left-behind children's depressive symptoms. While paternal migration is not associated with children's mental health, maternal migration is found to be significantly correlated with children's depressive symptoms. Moreover, the negative association is also detected in children with mothers who returned from migration destinations. However, such an association does not vary between sons and daughters. We also find that the negative association between maternal migration and left-behind children's mental health is partly explained by children's delinquent social ties. Children who have experienced or are experiencing maternal migration are more likely to make friends who exhibit delinquent behavior. Such friendships are further associated with left-behind children's vulnerability to depressive symptoms. This demonstration of the intersectionality of social networks and gender contributes to the literature on family, migration, and health. [ABSTRACT FROM AUTHOR]

Aim: To examine the relationship between preterm birth and hospitalisation for paediatric complex chronic conditions. Methods: We conducted a cohort study of 1 269 745 children born between 2006 and 2022 in Quebec, Canada. We classified preterm birth as extreme (<28 weeks), very (28–31 weeks), and moderate (32–36 weeks). The outcome was hospitalisation for complex chronic conditions, including neurologic, neuromuscular, cardiovascular, respiratory, renal, gastrointestinal, haematologic, immunologic, endocrine, and neoplastic disorders up to 16 years of age. We computed adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the association between preterm birth and complex chronic conditions during 9 948 734 person‐years of follow‐up. Results: Hospitalisation rates for complex chronic conditions were higher for children born preterm than at term (6.88 vs. 2.24 per 1000 person‐years). Preterm birth was associated with all complex chronic conditions, especially respiratory (HR 4.64, 95% CI 4.01–5.37), cardiovascular (HR 3.68, 95% CI 3.47–3.90), and neurologic disorders (HR 3.48, 95% CI 3.21–3.77). Associations were present at all ages and for all degrees of prematurity, but were strongest with extreme prematurity. Conclusion: Preterm birth increases the risk of hospitalisation for complex chronic conditions up to age 16 years. Preterm children may benefit from enhanced care throughout childhood and adolescence. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorder (ASD) poses a significant challenge due to its diverse impact on individuals, emphasizing the need for personalized treatment plans. The financial burden of ASD-related healthcare is substantial, necessitating a comprehensive understanding of its prevalence and evolving trends. Methods: This study aims to analyze the prevalence and trends of ASD, treatment patterns, gender differences, and racial-ethnic disparities in the United States from 2017 to 2020, utilizing nationally representative data from the National Survey of Children's Health (NSCH). The NSCH, a leading annual national survey, provided rich data on child health. A total of 108,142 participants aged 3–17 years were included, with ASD prevalence assessed based on self-reported diagnoses. Results: Between 2017 and 2020, ASD prevalence in children aged 3–17 was 2.94% (95% confidence interval: 2.68–3.18). Significant disparities were observed: older age and male gender correlated with higher prevalence, while family income-to-poverty ratio and insurance coverage influenced prevalence. Racial/ethnic disparities existed, with Hispanics showing the highest prevalence. Treatment trends showed stability overall, but age influenced behavioral and medication interventions. The prevalence remained stable from 2017 to 2020, with variations in age groups and a significant increase among non-Hispanic Whites. Conclusions: This study highlights a higher but stable overall ASD prevalence, with nuanced disparities among different demographic groups. Gender differences persist, emphasizing the need for tailored interventions. Racial-ethnic disparities call for targeted healthcare strategies. The stability in treatment trends underscores the persistent challenge of addressing core ASD symptoms. [ABSTRACT FROM AUTHOR]

This study aims to examine the association between different versions of a provegetarian food pattern and micronutrient adequacy in a population of children from the SENDO Project. Children aged 4–5 years old were recruited and baseline information on diet, lifestyle and socio-demographic characteristics was collected through self-administered online questionnaires completed by their parents. Scores were calculated for overall, healthful, and unhealthful provegetarian food patterns (FP) using an a priori approach. Participants were categorized into tertiles according to their scores. Micronutrient adequacy was assessed using the Estimated Average Requirement (EAR) cut-off point. Multivariate analyses were performed to evaluate the relationship between tertiles of each provegetarian FP and the risk of inadequate micronutrient intake (failing to meet ≥ 3 requirements). Despite lower intakes of certain micronutrients, children with higher scores in the healthful provegetarian FP did not exhibit a higher prevalence of inadequacy. Children in the highest tertile of this index had 0.47-fold lower odds (95%CI 0.23–0.95) of having ≥ 3 inadequate micronutrient intakes than their peers in the lowest tertile, after adjusting for potential confounders. In contrast, children in the highest tertile of the unhealthful provegetarian FP had 20.06-fold higher odds (95%CI 9.19–43.79) of having ≥ 3 inadequate micronutrient intakes compared to children in the lowest tertile. Conclusions: Adherence to a healthful provegetarian food pattern is associated with improved nutritional adequacy in preschoolers, while following an unhealthful pattern is detrimental to micronutrient adequacy. These results suggest that moderate reductions in animal food consumption within a healthy diet may not compromise micronutrient adequacy in young children. Further research is needed to explore the impact of diets reduced in animal food intake on the health of children. What is Known: • There's a notable trend towards plant-based diets due to health and sustainability concerns. • Research links plant-based diets in adults with lower risks of obesity, cardiovascular disease, and cancer. What is New: • A new study examines how different versions of a provegetarian food pattern affect micronutrient adequacy in children, using a moderate and stepwise approach. • Following a healthful provegetarian food pattern enhances nutritional adequacy in preschoolers, whereas an unhealthful pattern negatively impacts micronutrient adequacy. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is a major global health problem, expensive to manage, and its associations with negative pediatric health outcomes have been clearly demonstrated. One of the most fundamental questions to consider as we use previous epidemiological information to advance research and care paradigms is the strength of the causal link between pediatric AKI and health outcomes. In this review, we apply the foundational framework of the Bradford Hill criteria to evaluate the extent to which a causal link exists between AKI and the associated adverse outcomes in children. Available data in children support a causal link between AKI and short-term outcomes including mortality, length of stay, and ventilation time. Clarifying the causal nature of longer term associations requires further high-quality observational studies in children, careful consideration of what defines the most meaningful and measurable longer term outcomes after pediatric AKI, and integration of evolving biological data related to mechanisms of disease. Preventing or mitigating AKI should lead to improved outcomes. Demonstrating such reversibility will solidify confidence in the causal relationship, improve child health, and highlight an aspect which is highly relevant to clinicians, scientists, and policy makers. [ABSTRACT FROM AUTHOR]

A growing body of research reveals a connection between maternal incarceration and various child development outcomes. Even so, little is known about how the timing of maternal incarceration may shape the social–emotional development of young children and the role of maternal mental health in mediating this association. Using a sample of 1097 mothers (18–52 years old, 47.6% white) and children (aged 12–48 months) receiving home visiting services in Wisconsin, this study examined the intergenerational effect of incarceration before a child's birth on child social–emotional development, and whether this association was mediated by maternal mental health. While incarceration prior to a child's birth was not directly associated with child social–emotional outcomes, path analysis revealed an indirect association between mother's incarceration prior to a child's birth and child social–emotional problems through maternal mental health problems. Findings suggest that formerly incarcerated mothers may experience long-lasting mental health concerns that can undermine child social–emotional development. To optimize outcomes, practitioners may consider services that address the mental health, social support, and instrumental needs of mothers and children who have been impacted by mass incarceration. [ABSTRACT FROM AUTHOR]

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Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study aimed to examine the prospective association between psychological well‐being and overweight and obesity reversal. Methods: We analyzed data of UK children with overweight or obesity at ages 11 (n = 4556, baseline), 14 (n = 3791, baseline), and 17 years (follow‐up). Psychological well‐being‐related measures were characterized into indexes of caregiver‐reported child mental health and child‐reported psychosocial well‐being, with a higher score indicating better mental health or psychosocial well‐being. Weight changes were presented as reversal versus persistence of overweight or obesity and residualized‐change BMI z scores. Data were analyzed using regression analysis. Results: Better child mental health and psychosocial well‐being at age 11 years were independently associated with increased odds of reversal versus persistence (odds ratio [OR] = 1.16, 95% CI: 1.03 to 1.29; OR = 1.29, 95% CI: 1.15 to 1.44, respectively) and decreased BMI z scores (β = −0.08, 95% CI: −0.13 to −0.03; β = −0.07, 95% CI: −0.11 to −0.03, respectively) at age 17 years. However, neither of the indexes was associated with weight changes when measured at age 14 years. Analyses between psychological well‐being‐related measures and timing of measures indicated that psychological well‐being‐related measures were more likely to prospectively predict weight changes when measured at age 11 versus age 14 years. Conclusions: Better psychological well‐being at age 11 years is a prognostic factor that may be associated with an increased likelihood of reversing childhood overweight and obesity by age 17 years. [ABSTRACT FROM AUTHOR]

Efficiency analysis of the Maternal, Newborn, and Child Services Network (MNCSN) is crucial for achieving SDG 2030. However, the mortality rates of maternal, newborn, and child have not reduced since 2018, and there have been limited studies conducted in Morocco on this subject. This study aims to analyze the technical efficiency of 82 MNCSN across primary healthcare Establishments Network (PHCEN) in Morocco in 2021 and identify factors influencing their efficiency. Technical efficiency was estimated using the Data Envelopment Analysis (DEA) method with an input orientation. Tobit regression was employed to analyze factors affecting the technical efficiency of maternal and child healthcare. In the initial stage, the average efficiency score of the 82 MNCSN was 0.779 for constant returns, with 36 MNCSN achieving a score of 1. However, the Boujdour MNCSN recorded the lowest efficiency score of 0.033. In the second stage, Tobit regression revealed that Model 2 was more significant than Model 1. Specifically, the explanatory variable Rural Dispensary exhibited strong statistical significance and a positive impact on maternal and child health, followed by variables such as High-risk Pregnancies Supported and High-risk Pregnancies. The study findings suggest that the resources allocated for MNCSN in Morocco are not being efficiently utilized compared to some other African and European countries. Therefore, the Ministry of Health in Morocco should review the functions of MNCSN, aiming to improve the delivery of maternal, newborn, and child healthcare, regardless of the setting, be it urban or rural. [ABSTRACT FROM AUTHOR]

Exposure to stressful life events (SLE) around the time of pregnancy is associated with adverse health outcomes for mothers and children. Previous New Zealand research found Indigenous Māori women are more likely to be exposed to SLE than non-Māori, and are exposed to a higher number of SLE. The consequences of this for ethnic inequities in child health outcomes are unknown. This paper examines the relationship between patterns of maternal SLE exposure with child health and development outcomes at age 3 years, for Indigenous and non-Indigenous children. We found most children had a stressful early life environment at least sometimes, but more than a quarter of Māori children had a mother experiencing multiple SLE on all occasions measured. We found a clear association between maternal experiences of SLE and disordered child sleep and development concerns. While not able to fully assess the contribution of maternal SLE to ethnic inequities in child health outcomes, we did clearly demonstrate that more Māori children have mothers exposed to multiple SLE, and that these maternal SLE are associated with poorer child outcomes. The impacts of chronic SLE exposure need to be better understood, especially given the large ethnic disparity in chronic SLE exposure. [ABSTRACT FROM AUTHOR]

Consultations with children and their families are complex and require soft skills. However, there is a gap in the medical curriculum concerning these skills, especially as encounter training is often adult-centered. We developed, validated, and applied simulation scenarios that prioritize active participation of children to train soft skills in child-centered care for undergraduate medical students. This is a methodological study to develop three scenarios and a checklist of what is expected. The content was validated by 18 experts. A pre-test was carried out for adjustments. Then, the simulations were applied and evaluated by 18 medical undergraduate students. They included the participation of 6 pediatric simulated patients aged 9–12 years trained by a drama teacher. According to the results, the scenarios and checklist proved to be valid instruments in content terms (ICV-I > 0.8). The scripts were followed by the simulated pediatric patients, but they had difficulty mimicking a hypoactive state. Some were anxious, but everyone enjoyed participating in the feedback. The simulated parents had difficulty participating and giving space to the child's speech. Participants assessed that the simulations performed as they were proposed and, after experimenting them, felt more prepared. The simulations provided an opportunity for students to practice soft skills by interacting with children in a safe environment. Using children as simulated patients is feasible but presents some challenges. Our study has expanded the ways in which children's health content can be taught. We are investigating whether this training leads to better patient outcomes in real clinical settings. [ABSTRACT FROM AUTHOR]

A lack of resistance resources in the family, such as a lack of sibling support, might cause the family to be more prone to family crises; however, little if anything is known about whether being the only child will influence the experience of work–family conflict (a family crisis). Using an online questionnaire sample of 622 Chinese employees, we investigated the influence of only child status on work–family conflict and further explored the moderating effect of only child status on the relationship between work–family conflict and its performance outcomes. Analyses revealed that being the only child would spend less time on family responsibilities, thereby decreasing the level of family-to-work conflict; in addition, being the only child would ease the negative impact of work-to-family conflict on family performance. The recommendations for future studies, implications of this study, and the need for further research on only child's work–family conflict experience are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Previous studies have demonstrated poor oral hygiene in children with attention deficit hyperactivity disorder (ADHD). However, the association between ADHD and periodontitis is still unclear. Methods: In all, 16,211 adolescents with ADHD and 162,110 age- and sex-matched controls participated in the study between 2001 and 2011. To identify the occurrence of periodontitis, the participants were followed up till the end of 2011. Confounding factors, including smoking, diabetes, and depressive disorder, were assessed and adjusted in the Cox regression models. Results: Adolescents with ADHD (HR : 2.29) were more likely to develop periodontitis later in life than controls. We additionally observed the beneficial effect of atomoxetine (HR : 0.42) on the periodontitis risk among adolescents with ADHD. However, this finding should be interpreted cautiously given the small sample (n = 290) of children taking atomoxetine in the present study. Conclusions: ADHD is an independent risk factor for subsequent periodontitis development. Oral health should be closely monitored in adolescents with ADHD. Future investigation of the shared pathomechanisms between periodontitis and ADHD is warranted. [ABSTRACT FROM AUTHOR]

Background: Poor child health and hygiene practices are persistent issues in resource-constrained settings, particularly in low-income countries. This study assessed the impact of skill-based health education (SBHE) on school and child hygiene practices in rural Bangladesh. Methods: A cluster-randomised-controlled intervention with cross-cutting/factorial design was conducted in 180 randomly selected primary schools, stratified by school type, in Jhenaidah District, Bangladesh. Weekly SBHE sessions were delivered to half of the schools by locally recruited para-teachers for one year. A cross-cutting soap provision treatment was given monthly to half of the SBHE-treatment schools and half of the SBHE-control schools. Treatment assignment was masked to all baseline and endline surveyors. Data were collected at both the school and child levels, with child-level data aggregated at the school level. Outcome measures were grouped into five thematic families. The primary outcome families were school hygiene practice & maintenance, school-aggregated child handwashing and school-aggregated child dentalcare. Utilising the difference-in-differences estimator with seemingly unrelated regression, we estimated the average treatment effect for each family of multiple outcomes. The intervention spillover effect to neighbouring schools along with the time-period effect were also evaluated. The project's cost-effectiveness was additionally assessed. Results: Our findings revealed that SBHE had a positive impact on primary outcomes related to healthy practices and behavioural changes, resulting in a 0.32SD improvement in school hygiene practices and maintenance (p < 0.001), a 0.47SD increase in child handwashing (p < 0.001), and a 0.43SD enhancement in child dentalcare (p < 0.01). Despite its imperfect implementation, the provision of soap itself showed no significant effect. Furthermore, significant spillover effects of healthy practices were observed in neighbouring non-treatment schools. The cost-effectiveness analysis indicated that our SBHE program was cost-effective. Conclusions: Our study provides compelling evidence of the positive impact of SBHE on school hygiene and child health practices in rural Bangladesh, with notable spillover effects. The cost-effectiveness analysis underscores the value of SBHE, affirming its potential as an effective intervention method in improving school health and hygiene practices in primary schools and beyond. [ABSTRACT FROM AUTHOR]

Background: Family planning (FP) is part of Ethiopia's essential health service package. However, integrating FP into other health care services is a relatively new concept. Integrated service can minimize missed opportunities and allow health workers to provide FP services and Reproductive, Maternal, Newborn, Child, Adolescent, and Nutrition (RMNCAH-N) services simultaneously. Thus, the objective of this study was to assess the levels of FP integration into maternal and child health (MCH) services at primary health care service delivery units in Ethiopia. Methods: This was a facility-based cross-sectional study conducted from July to October 2022. We conducted a nationally representative survey of primary health care (PHC) facilities selected from seven regions and two-city administrations in Ethiopia to assess the current level of FP integration across four service delivery units (antenatal care unit, postnatal care unit, post-abortion care unit, and immunization unit) of the facilities. We collected data from selected health facilities through interview with health facility managers, healthcare providers in the selected service units, clients seeking health services, and extraction of data from facility records. We employed descriptive analysis, and categorized the degree of FP integration according to the FP information and services provided in the selected service delivery units. Results: This national FP integration survey included 122 health facilities (39 primary hospitals, 42 health centers, and 41 health posts) from seven regions and two city administrations. The study found a huge discrepancy regarding FP counselling given at ANC, PNC, PAC, and immunization service delivery units as reported by health care providers and clients. The proportion of PNC and immunization clients who received FP counselling was higher at health post compared to hospitals and health centers. Moreover, the proportion of PAC clients who received FP information was higher in primary hospitals compared to health centers. Conclusion: Data from facility records and provider interviews showed significant FP integration within ANC, PNC, and immunization units of PHC facilities. However, client exit interviews indicated low FP counselling integration. Facility records revealed few PNC and PAC clients received contraceptives in the past year. The study found high FP counselling and provision of at least one short- or long-acting contraceptive at PNC and PAC units. No facility offered contraceptives at immunization units, indicating missed FP integration opportunities. [ABSTRACT FROM AUTHOR]

DNA methylation (DNAm) is the most commonly measured epigenetic mechanism in human populations, with most studies using Illumina arrays to assess DNAm levels. In 2023, Illumina updated their DNAm arrays to the EPIC version 2 (EPICv2), building on prior iterations, namely the EPIC version 1 (EPICv1) and 450K arrays. Whether DNAm measurements are stable across these three generations of arrays has yet not been investigated, limiting the ability of researchers—especially those with longitudinal data—to compare and replicate results across arrays. Here, we present results from a study of 30 child participants (15 male; 15 female) from the Drakenstein Child Health Study, who had DNAm measured on all three of the latest arrays: 450K, EPICv1, and EPICv2. Using these data, we created an annotation of probe quality across arrays, which includes the intraclass correlations, interquartile ranges, correlations, and array bias (i.e., the extent to which DNAm levels were explained by array type) of all CpGs. We also present results from an analysis of sex differences, where we found that CpGs with lower replicability across arrays had higher array-based variance, suggesting this variance metric help guide replication efforts. We also showed that epigenetic age estimates across arrays were more stable when using the principal component versions of epigenetic clocks. Ultimately, this collection of results provides a framework for investigating the replicability and longitudinal stability of epigenetic changes across multiple versions of Illumina DNAm arrays. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusions Childhood height is commonly used to measure children's health and nutritional status. It is used to define stunting, where a child is considered stunted if their height is shorter than two standard deviations below the Child Growth Standards median. Studies have shown that genetic and environmental factors contribute to childhood height, so understanding these contributions is important for stunting research. This systematic review and meta‐analysis examined the contribution of these factors across study designs and ancestries.A systematic search found 28 twin and 26 family studies spanning from birth to 17 years. We identified 162 293 twin, 380 195 parent‐offspring, and 19 965 sibling pairs born between 1929 and 2004. These datasets were meta‐analyzed using a random effects model. The review is registered in PROSPERO (ID CRD42023432550).The estimated heritability (h2) of height from twin design increased from birth to 17 years. For children under 5 years, the estimated heritability was 0.57 (95%CI, 0.52–0.61) for European, 0.48 (0.39–0.57) for Asian, and 0.46 (0.40–0.51) for multi ancestries. Heritability estimated from parent‐offspring design was 0.46 (95%CI, 0.28–0.62) at birth and 0.76 (95%CI, 0.70–0.80) at 17 years. Meanwhile, the estimated heritability from sibling design remained constant across ages at 0.70 (95%CI, 0.52–0.83).The heritability estimates of childhood height were slightly higher in European ancestries, but in general, they did not significantly differ across ancestry groups. While the shared environmental effects on height peak in early childhood, the estimated heritability increase in late teens. Unique environmental factors play a small, but significant role throughout childhood. [ABSTRACT FROM AUTHOR]

In this study, we estimate the effect of prepregnancy obesity and excessive pregnancy weight gain on infant and maternal health outcomes. We rely on a large sample of maternally linked restricted data from 2004 to 2019 South Carolina birth certificates, which allow us to track the same mothers during multiple pregnancies over a period of more than 15 years. To address possible limitations of previous research, we account for genetic confounders and unobservable maternal and environmental factors by relying on a maternal fixed effects strategy. We find that gaining above recommended amounts of weight increases the likelihood of delivering a high weight infant by 2.34 percentage points, while being obese increases this likelihood by 2.58 percentage points. These large negative effects of weight gain outside recommended ranges, as well as the effects of being obese, are present in White and Black mothers. Also, our results indicate that mothers who gained too much weight, or were obese, had a higher likelihood of cesarean section and higher likelihood of being induced. Finally, among the subsample of Medicaid mothers, excessive pregnancy weight gain as well as inadequate weight gain increased the likelihood of NICU admission. [ABSTRACT FROM AUTHOR]

Introduction: Growth monitoring and promotion services are strategies to promote child health and reduce child mortality. Even though Ethiopia is attempting different strategies to cope with the low rate of GMP utilization, the problem is still unresolved. Objective: Determine the pooled proportion of GMP utilization and its contributing factors among children less than two years in Ethiopia. Method: The review protocol was registered with PROSPERO, number CRD42023472746. The PRISMA-2020 statement guided the conduct of this review. Electronic databases and grey literature were used. Heterogeneity was evaluated using I2. Subgroup analysis was conducted. The random effect model was used to summarize the pooled effect sizes with their respective 95% CI with STATA version 17. To test the small study effect, the funnel plot and Egger's test were applied. Result: A total of seven (7) studies with 4027 participants were considered in this meta-analysis. The pooled proportion of GMP utilization reported by seven studies was 25.71% (95%CI: 24.39, 27.04). ANC follow-up (AOR = 2.11; 95% CI: 1.47, 2.76), PNC follow-up (AOR = 1.96; 95% CI: 1.44, 2.49), counseling (AOR = 2.88; 95% CI: 2.09, 3.68), maternal education (AOR = 2.89; 95% CI: 1.66, 4.13), paternal education (AOR = 3.78; 95% CI: 2.25, 5.32), family health card (AOR = 2.31; 95% CI: 1.67, 2.96), and mothers good knowledge towards GMP (AOR = 2.90; 95% CI: 1.72, 4.07) variables were positively associated with GMP service utilization. Conclusion and recommendation: The pooled proportion of GMP remains low in Ethiopia. ANC and PNC follow-up, counseling, maternal and paternal education, family health cards, maternal knowledge towards GMP were significantly associated. Findings are essential for evidence-based policy making, intervention, and input for ongoing research. [ABSTRACT FROM AUTHOR]

Introduction: India has committed to the Sustainable Development Goals (SDGs) 2030 principle of "Leave No One Behind", which seeks to reduce disparities and vulnerabilities. The dearth of data on the oral health conditions of children with intellectual and developmental (IDD) disabilities in India is significant. Our systematic review intended to collate and synthesise data on the oral health status of children with IDD. Methods: Online electronic databases such as PubMed-MEDLINE, Embase, and Scopus were searched using appropriate keywords from the earliest available data until 31st March 2024, with no language restriction. Cross-sectional studies conducted amongst individuals below 18 years of age with intellectual, or developmental disabilities, in India were included. Quality assessment and meta-analysis using a random-effects model for variables reported from four or more studies and a prediction interval was calculated. Results: Out of 2388 studies, a total of 15 studies were included. Our study showed that 91% (95% [confidence interval] CI: 0.80–0.96) of IDD children use toothbrushes regularly. However, poor oral hygiene was found among 38% (95% CI = 0.21–0.59) of IDD children. The pooled prevalence of dental caries among children was found to be 64% (95% CI: 0.45–0.79). Periodontal disease was reported in only one study among 54.20% of IDD children. Conclusions: Our findings suggest that despite brushing regularly the incidence of caries and poor oral hygiene in children with IDD is high. Flexible, tailored interventions that go beyond a uniform approach must be implemented to effectively address oral health requirements of children with IDD. Specific Health Programmes should be established for their preventive oral care. [ABSTRACT FROM AUTHOR]

Background: Vision screening as part of well-child visits is recommended annually for US children 3 to 6 years. However, 63% of children do not get a vision screening in well-child visits. The Patient-Centered Medical Home (PCMH) improves the receipt of preventive care visits in other medical specialties but it is unknown if it improves receipt of vision screening. The objective of this study is to determine whether caregiver-reported receipt of care in a PCMH is associated with receiving a vision screening test in a well-child visit for children 3 to 6 years in a pediatrician/general doctor's office ('primary care'). Method: Population-based data for US children aged 3 to 6 years was derived from the National Survey of Children's Health (2018–2019). Children were excluded if they did not have a well-child visit in the previous 12 months. The primary exposure was receipt of care in a PCMH ('PCMH care'), and the primary outcome was receipt of a vision screening in primary care. Adjusted odds ratios (aOR) and predicted probabilities were computed for children with and without PCMH care. Results: Among 9,587 children with well-child visits, 4,984 (50.9%) were males. There were 1,107 (23.3%) Hispanic, 6704 (52.8%) White/Non-Hispanic and 545 (11.8%) Black/Non-Hispanic children. There were 5,482 (51.8%) children who received PCMH care. Of those with PCMH care, 2,629 (52.2%) received a vision screening in primary care. Those with PCMH care (52.2%) had a higher odds of receiving a vision screening (aOR, 1.31; 95% CI 1.11, 1.55) in primary care compared to children without PCMH care (42.8%). The predicted probability of vision screening in primary care was 50.8% (95% CI 48.2, 53.5) for children that received PCMH care, and 44.3% (95% CI 41.3, 47.3) without PCMH care. Conclusions: Caregiver-reported receipt of PCMH care was associated with a greater likelihood of vision screening for children 3 to 6 years in a well-child visit. Further studies are needed to understand the mechanisms through which PCMH care contributes to the greater odds of vision screening in primary care to inform the creation of strategic interventions to prevent vision loss and its long-term implications. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is an ongoing public health crisis, and recent clinical practice guidelines identify addressing the role of social inequities in the disparity of health among children with obesity as an area to address. This study aimed to assess the feasibility of a community navigation intervention in a pediatric weight management clinic. Methods: A single-center pilot randomized controlled trial (RCT) recruiting families from a tertiary hospital pediatric weight management program to evaluate the feasibility of a community navigation intervention. The primary feasibility outcomes were recruitment rates (goal to recruit 80% of the sample in 6 months), uptake of the intervention (goal > 80% of participants in the intervention group to have a visit with the navigator), and acceptability (goal > 90% of families in the intervention group complete all follow-up). Results: Eighty participants completed the social needs screening, and 42 (52.5%) participants screened positive for an unmet social need. In the first 6 months of recruitment, 18 participants were recruited out of a goal of 40 participants (the recruitment rate was 45% vs. the goal of 80% in 6 months), and complete recruitment was achieved in 12 months. Of the 21 participants randomized to the intervention arm, 20 completed the intervention (uptake of intervention was 95% vs. goal 80%). Ten participants in the intervention arm completed all four planned follow-up study visits (the acceptability of follow-up was 48% vs. the goal of 90%). Conclusion: We completed a pilot RCT of implementing a community navigator program in a pediatric weight management program. We found feasibility in the intervention's uptake but limited feasibility in recruiting participants and the acceptability of the follow-up. Trial registration: Clinicaltrials.gov, NCT04711707, https://clinicaltrials.gov/ct2/show/NCT04711707 [ABSTRACT FROM AUTHOR]

Background: Treating children's eyes is not just a privilege for a child, it is an essential requirement for their visual health. Parents, as caregivers, have a paramount responsibility to make decisions regarding their children's eye health. Thus, this review aims to identify and summarise published information about parents' knowledge and practices on children's eye health care. Methods: Relevant articles searches were performed through a systematic search of databases (EBSCOhost, PubMed, and Scopus) using the keywords 'knowledge', 'practice', 'parent', 'eye', 'problem', and 'children'. This review was conducted and reported in line with the PRISMA-ScR. The methodological quality of the listed studies was assessed using A Modified McMaster Critical Review form based on the total score. Result: From a total of 235 studies retrieved through literature review and pearling, 219 remained after removing duplicates. After screening titles and abstracts, 204 irrelevant studies were excluded, leaving 15. After a detailed full-text review, four studies were excluded due to not meeting inclusion criteria. Thus, this review includes the remaining 11 studies. All eleven studies (n = 11) show that parents's knowledge and practices vary. Some parents display good knowledge regarding children's eye health care, for example, understanding the importance of wearing spectacles, the significance of children having normal vision, and where to seek eye examinations. Five studies (n = 5) showed that parents have good practices such as consulting doctors and seeking eye examinations and treatment at the hospital. Six studies (n = 6) showed that parents have misconceptions regarding knowledge, practices, and treatment of children's eye health. Conclusion: This scoping review found that parents' knowledge and practices regarding children's eye health are poor. Parents' perceptions and practices about the cause and treatment of eye problems were tainted with misconceptions. Therefore, implementing structured programs to enhance awareness and promote the adoption of healthy practices for children's eye health is required. [ABSTRACT FROM AUTHOR]

In the last year, there have been many remarkable articles published in the Italian Journal of Pediatrics. This review highlights papers that can be potentially helpful in healthcare practice among the most cited or accessed papers on the journal website. We have chosen key articles on allergy, analgesics, cardiology, endocrinology, gastroenterology, genetics, global health, infectious diseases, neonatology, neurology and pulmonology. Advances in understanding risk factors, mechanisms, diagnosis, treatment options and prevention of pediatric diseases have been discussed and in the context of the subsequent steps. We think that progresses achieved in 2023 will have a significant impact on the management of diseases in childhood. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions This study compared the efficacy of cyclopentolate hydrochloride at 10‐, 20‐ and 30‐min post‐instillation in White 6‐ to 7‐year‐olds, with and without prior instillation of proxymetacaine hydrochloride. The primary aim was to determine if accurate autorefraction values can be obtained sooner than the current standard of 30‐min post‐cycloplegia. The secondary aim was to investigate whether proxymetacaine hydrochloride enhances the efficiency of cyclopentolate.Participants were 112 White 6‐ to 7‐year‐olds from the Child Eye Health Study. The right eye received 0.5% proxymetacaine hydrochloride and 1.0% cyclopentolate hydrochloride, and the left eye received only 1.0% cyclopentolate hydrochloride. Non‐cycloplegic and cycloplegic refractive error (at 0, 10, 20 and 30 min) was measured using a binocular, open‐field autorefractometer. Data were analysed through paired t‐tests, concordance analysis, linear regression, equivalence testing and Bland–Altman analysis, using the 95% limits of agreement.Mean spherical equivalent refraction (SER) (SD) in the right eye at 0‐, 10‐, 20‐ and 30‐min post‐instillation was 0.62 (1.45) D, 1.52 (1.80) D, 1.64 (1.81) D and 1.72 (1.80) D, respectively. Mean left eye SER (SD) were 0.68 (1.24) D, 1.42 (1.66) D, 1.56 (1.66) D and 1.68 (1.72) D, respectively. Bland–Altman analysis showed a high level of agreement, and equivalence testing confirmed that there was no clinically significant difference in SER at 20 and 30 min in both eyes (within ±0.50 D), with mean differences of 0.08 (0.23) D in the right eye and 0.13 (0.30) D in the left eye (p = 0.21). However, SER at 10 and 30 min were equivalent in the right eye only.Accurate autorefraction values can be obtained 20‐min post‐instillation of 1.0% cyclopentolate in white children aged 6–7 years, potentially reducing clinical testing times. Proxymetacaine pre‐instillation allows for reliable measurements as early as 10‐min post‐instillation of cyclopentolate. Further research is needed to validate these findings in non‐White populations and to determine the safe discharge time post‐proxymetacaine instillation. [ABSTRACT FROM AUTHOR]

The article discusses the persistent inequities in children's health, development, and well-being, despite global efforts over the past decade. It emphasizes the need to address these inequities to generate substantial savings across budgets and improve societal productivity. The text suggests a path forward that involves multidisciplinary collaborations and radical pragmatism to close the child equity gap within a generation. It also highlights the importance of data systems and key indicators to inform more precise and effective approaches in addressing and monitoring inequities. [Extracted from the article]

Objectives: The objective of this study was to specifically investigate Separation Anxiety Disorder (SAD), as one of the noteworthy disorders within the spectrum of anxiety disorders, among children and adolescents, after overcoming the crises caused by the Coronavirus Disease 2019 (COVID-19) pandemic. Efforts were also made to identify socio-demographic factors that could be associated with changes in SAD level and also to assess the effect of different constituting dimensions of SAD on the severity of this disorder. Methods: In this cross-sectional study, face-to-face interviews were conducted with the parents of 317 (7-13-year-old) Iranian students, who were selected through a multi-stage random sampling method in the city of Shiraz. During the interviews, socio-demographic data were collected, and subsequently, SAD symptoms and dimensions were assessed using the Separation Anxiety Assessment Scale (Parent Version) (SAAS-P) questionnaire. Later, employing the Partition Around Medoids (PAM) statistical method, the participants were categorized into two groups with low and high levels of SAD. Also, to understand the interaction between the different dimensions of SAD, the network analysis method was employed. Finally, univariate analysis and logistic regression were utilized, with a significance level of 0.05, to determine potential associating factors with the level of SAD. Results: The sample included 128 girls and 189 boys with a mean age of 9.63 ± 2.63 and 9.63 ± 1.95 years respectively. Based on the PAM method, 51.1% of the participants presented a high level of SAD. According to network analysis, it was demonstrated that the "fear of abandonment" dimension plays a central role in high levels of SAD. Based on logistic regression, female gender, age ≥ 10 years, parents' unacademic educational background, mother's employment, and child's history of physical/mental problems were significantly associated with the high level of SAD. Conclusions: A considerable number of the participants in this study presented a high level of SAD with the "fear of abandonment" being a key influential dimension of elevated levels of this disorder. Maternal employment, female gender, child's history of health issues, and low parental education were identified as important contributors to the high SAD level. Considering these factors allows for more effective diagnostic and therapeutic interventions. However, the need for further studies remains crucial. [ABSTRACT FROM AUTHOR]

Background: In many low-income countries, enhancing the health of school-aged children is often impeded by insufficient or limited knowledge regarding their health status. Further, hands-on health promotion interventions are nearly non-existent due to the lack of designated health workers. The disconnection between schools and primary care facilities further exacerbates this issue. To address these challenges, the World Health Organization has introduced the Health Promoting School (HPS) framework, a comprehensive model designed to integrate health into all aspects of school life and promote physical, mental, and social well-being. We sought to assess the perceived health status of school-aged children, identify associated factors, and explore the role of community health workers (CHWs) in public schools in rural Rwanda. Methods: We carried out a convergent mixed methods study among teachers and community members in rural areas of Musanze, Rwanda. Data collection instruments were adapted from the World Health Organization's HPS framework and the literature. We conducted six in-depth interviews and three focus group discussions. We performed a logistic regression analysis to examine the factors associated with perceived health. Thematic analysis was used to analyze the qualitative data. Results: A total of 479 individuals participated in this survey. Of these, 425 (89%) were community members, while 54 (11%) were employed as teachers at Nyabirehe or Rwinzovu public schools. Almost half of respondents 221 (46%) described the children's health as poor. Many factors were associated with perceived children's health, including having an established leadership team for school-based health promotion (OR = 1.97, 95%CI: 1.01,3,84), and being familiar with school-based health promotion (OR = 4.77, 95%CI: 2.27,10.0). Qualitative results described the CHW as a bridge between communities, schools, and primary healthcare centers. Conclusion: This study revealed that the health of schoolchildren needs particular attention. In resource-limited settings, HPS presents a promising opportunity to address the health and well-being of children at rural public schools. However, adapted policies, the establishment of health promotion teams, and hands-on orientation for teachers and community members are necessary to ensure an effective implementation of HPS. In Rwanda and other low-income countries where public schools lack nursing staff, CHWs could play a vital role in enhancing HPS and the linkage between schools and primary healthcare facilities. [ABSTRACT FROM AUTHOR]

Background: the independent association between parental obesity, sleep and lifestyle habits with cardiometabolic risk factors in children and adolescents has been widely explored in the literature. Our study represents a novel approach to comprehensively investigate a complex model encompassing various aspects associated with cardiometabolic risk in youth. Thus, the aim of the present study was to verify the relationship between parental obesity and cardiometabolic risk in children and adolescents, considering the mediator role of health indicators according to sleep time. Methods: This cross-sectional study was conducted on 3,973 children and adolescents aged 6 to 17 years attending public and private schools in a city located in Southern Brazil. Sleep duration, lifestyle, physical activity, natural food consumption, and parental obesity were evaluated through self-reported questionnaires. Physical fitness was evaluated according to the protocols of Projeto Esporte Brasil. The body fat percentage was evaluated through the measures of tricipital and subscapular folds, and the body mass index was calculated. The clustered metabolic risk score (cMetS) considered the summing z-scores of waist circumference, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and fasting glucose, divided by five. A structural equation model was applied for statistical analysis. Results: The relationship between parental obesity and cardiometabolic risk was observed in children and adolescents with adequate sleep, being significant (p < 0.05) mediated by physical activity, natural food, physical fitness, and lifestyle. This was also observed when parental education was included in the inadequate sleep cluster model. Conclusion: Present findings underscore the importance of sufficient sleep duration as a critical factor in understanding the complex interplay between parental obesity and cardiometabolic risk in children and adolescents. [ABSTRACT FROM AUTHOR]