Child Age Research Articles

Risk and Protective Factors in Children Bullying Perpetration: Application of the Multiple Disadvantage Model.

This secondary study examined bullying perpetration's relationships with social disorganization, social structural factors, social relationships, mental health, and access to health insurance and care. A sample of 30,173 children age 6 to 17 years was extracted from the 2021 National Survey of Children's Health for secondary data analysis. Logistic regression results demonstrated that these children's likelihood of bullying perpetration was positively associated with racial discrimination, child age 6 to 10 years, child age 11 to 13 years, parent education level, employed parent, neighbor support, family violence, difficulty parenting the child, child difficulty with peers, child behavioral/conduct problems, family substance use problem, and child receipt of mental health services; such likelihood also had negative associations with safe neighborhood, Black, Asian, other non-Hispanic ethnic minority, parent age, and family cohesiveness. Implications included interventions to promote awareness of racial discrimination for families as well as bully prevention programs in schools and communities.

Associations of Infant Sleep Characteristics with Childhood Cognitive Outcomes.

The objective of this study was to quantify associations of infant 24-hour sleep duration and nighttime sleep consolidation with later child cognition. This study included children from Project Viva, a prospective cohort in Massachusetts with (1) sleep measures in infancy (median age 6.4 months) and (2) child cognition in early childhood (median age 3.2 years) or mid-childhood (median age 7.7 years). Main exposures were parental reports of infant 24-hour sleep duration and nighttime sleep consolidation (% of total daily sleep occurring at nighttime). Cognitive outcomes were (1) early childhood vocabulary and visual-motor abilities and (2) mid-childhood verbal and nonverbal intelligence quotient (IQ), memory, and visual-motor abilities. We examined associations of infant sleep with childhood cognition using linear regression models adjusted for child sex, age, and race or ethnicity; maternal age, education, and parity; and household income. Early and mid-childhood analyses included 1102 and 969 children, respectively. Most mothers reported infant race or ethnicity as White (69%) and were college graduates (71%). The mean infant 24-hour sleep duration was 12.2 ± 2.0 hours, and the mean nighttime sleep consolidation was 76.8% ± 8.8%. Infant 24-hour sleep duration was not associated with any early or mid-childhood outcomes. Higher infant nighttime sleep consolidation was associated with higher mid-childhood verbal intelligence (β: 0.12 points per % nighttime sleep; 95% CI, 0.01-0.22), but not with any early childhood cognitive measures. In this cohort, higher infant nighttime sleep consolidation was associated with higher verbal IQ in mid-childhood. Future studies should investigate causal relationships of infant sleep consolidation with child cognition among diverse populations.

Perpetrator characteristics and firearm use in pediatric homicides: Supplementary Homicide Reports - United States, 1976 to 2020

BackgroundDescribe trends in perpetrator characteristics and firearm use in pediatric homicides across the United States.MethodsMultiply-imputed data from the Federal Bureau of Investigation’s 1976–2020 Supplementary Homicide Reports were used to estimate perpetrator characteristics (sex, age, and relationship to victim) and firearm use in pediatric homicides. Descriptive analyses were stratified by victim age group, sex, race, and five-year time periods.ResultsFamily members were the most common perpetrator of infant and toddler (ages 0–4) and child (ages 5–12) homicides, whereas acquaintances accounted for the majority of adolescent (ages 13–19) homicides. Perpetrator characteristics vary across victim sex and race, particularly among adolescents. Despite overall stability, there were changes in perpetrator characteristics from 1976 to 2020. There was a sustained increase in the proportion of homicides committed with a firearm. In 2016–2020, the proportion of firearm-involved homicides was an all-time high for infant and toddler (14.8%), child (53.1%), and adolescent victims (88.5%).ConclusionsPolicy interventions that improve family stability and well-being may be most effective at preventing infant, toddler, and child homicides, whereas programs that target peer and community relationships, as well as policies that focus on firearm access, may be more crucial for preventing adolescent homicides.

Predictors of health-related quality of life (HRQoL) for caregivers of children with developmental disabilities in Saudi Arabia: An observational study.

To examine predictors of health-related quality of life (HRQoL) for caregivers of children with developmental disabilities, a cross-sectional design was used. Participants were primary caregivers of children with developmental disabilities. Caregivers completed a demographic form about the child and the family, and the Arabic version of Patient-Reported Outcomes Measurement Information System-Profile 29 (PROMIS-29 v2.0). Descriptive statistics were used to report on demographic data, 1-sample Z tests to compare PROMIS domain scores with the general population, and multiple linear regression analyses to identify predictors of each domain. Participants were 111 primary caregivers, mostly mothers (65.8%). Caregivers reported higher levels of anxiety, depression, fatigue, sleep disturbance, and pain interference, and lower levels of physical function and social participation compared to the general population, P < .05. The regression models for predicting the HRQoL accounted for 12.3% of the variance in the physical function domain (P = .016), 13.9% in the anxiety domain (P = .009), 24.7% in the ability to engage in social activities and roles (P < .001), and 11.4% in the pain interference domain (P = .02). In these models, the severity of the child's disability and/or the child's age were common significant predictors. Specifically, child's age was the only significant predictor in 2 domains, the anxiety domain (β = -.29, P < .01) and ability to participate in social activities and roles domain (β = .42, P < .05). The severity of the child's disability was the only significant predictor in the physical function domain (β = -.52, P < .01). Both the severity of the child's disability and the child's age were significant predictors in the pain interference model (β = .40, P < .05), and (β = -.23, P < .05), respectively. However, the models did not significantly predict depression, fatigue, or sleep disturbance, P > .05. HRQoL is a complex construct and is influenced by multiple child and family factors. Implications of the study emphasize the importance of regular HRQoL screening for caregivers, the development of efficient referral systems for support services, and the exploration of respite care options.

Early childhood risk factors for later onset of pediatric chronic pain: a multi-method longitudinal study

BackgroundPediatric chronic pain (i.e., pain lasting ≥ 3 months) is prevalent, disabling, and costly. It spikes in adolescence, interrupts psychosocial development and functioning, and often co-occurs with mental health problems. Chronic pain often begins spontaneously without prior injuries and/or other disorders. Prospective longitudinal cohort studies following children from early childhood, prior to chronic pain onset, are needed to examine contributing factors, such as early pain experiences and mental health. Using data from a longitudinal community pregnancy cohort (All Our Families; AOF), the present study examined the associations between early developmental risk factors, including early childhood pain experiences and mental health symptoms, and the onset of pediatric chronic pain at ages 8 and 11 years.MethodsAvailable longitudinal AOF data from child age 4 months, as well as 1, 2, 3, 5, 8, and 11 years, were used. Mothers reported their child’s pain experiences (e.g., hospitalizations, vaccinations, gut problems) at each timepoint from 4 months to 8 years, child chronic pain at age 8, and child mental health symptoms at ages 5 and 8 years. Children reported their chronic pain frequency and interference at age 11. Adaptive least absolute shrinkage and selection operator (LASSO) regressions were used to select predictor variables. Complete case analyses were complemented by multiple imputation using chained equation (MICE) models.ResultsGut problems, emergency room visits, frequent pain complaints, and headaches at age 5 or earlier, as well as female sex, were associated with increased risk of maternal reported child chronic pain at age 8. Maternal reported chronic pain at age 8 was associated with higher levels of child-reported pain frequency and pain interferences at age 11. Boys self-reported lower levels of pain interference at age 11.ConclusionsSome, but not all, painful experiences (e.g., gut problems, ER visits, pain complaints) in early life contribute to pediatric chronic pain onset and should be considered for screening and early intervention.

Families' Orientation of Children towards Science and Children's Perception of Science

This study aimed to examine the levels of families directing their children towards science and children's perception of science in a holistic framework. The research was conducted using mixed methods. Using criterion and convenience sampling methods, 168 parents with preschool children constituted the study group. The study group in the qualitative dimension of the research included 11 families with children between the ages of 3-6 and their children. Three different data collection tools were used in the study. A 5-point Likert-type, 18-item, 3-factor scale developed by Bal and Kaya (2022) was used as a quantitative data collection tool. As a qualitative data collection tool, a 6-question structured interview form developed by the researcher and drawings obtained from children were used. As a result of the study, it was determined that the level of families' orientation of children towards science differed significantly according to the variables of education level and child age, and the level of families' orientation of children towards science had a significant effect on children's perception of science.

Association Between Adverse Childhood Experiences and Sleep Duration in US Children: Analysis of 2020-2021 National Survey of Children's Health.

Adverse childhood experiences (ACEs) and suboptimal sleep both negatively associate with cardiovascular health. Although an association between ACEs and suboptimal sleep in youth has been reported, there has been no investigation for differential effects among ACE subdomains. We examined associations between total and subdomain ACEs and sleep duration, and age as a moderator. Using the 2020-2021 National Survey of Children's Health and the American Heart Association Life's Essential 8 scoring algorithm, we created 3 sleep subgroups: (1) optimal, (2) suboptimal (≥1 to <2 hours below or ≥1 hour above optimal), and (3) very suboptimal (≥2 hours below optimal). We assessed association between ACEs (total and subdomains) and sleep duration using multinomial logistic regression, controlling for sex, age, race/ethnicity, caregiver's education, household income, habitual bedtime, and physical activity. We tested the interactions between ACEs and child's age. In children aged 6 to 17 years (N = 58 964), mean sleep duration score was 77.2 (95% confidence interval, 76.6-77.9). The mean number of ACEs was 0.89 (95% confidence interval, 0.87-0.91). Adjusting for covariates, each additional ACE increased the likelihood of falling into the suboptimal subgroup by 8% and the very suboptimal subgroup by 26%. There was an association between each subdomain of ACE and suboptimal sleep duration, with no significant interaction with age. Our findings show a dose-response relationship between ACEs and suboptimal sleep duration-a new cardiovascular health indicator in Life's Essential 8. Healthcare providers should screen for ACEs and suboptimal sleep in children to reduce future cardiovascular disease risk.

Feasibility of caregiver diabetes distress screening in routine clinical care of youth with type 1 diabetes.

Caregiver diabetes distress (DD) consists of feeling overwhelmed, sad, and/or concerned; one-third of parents of youth with type 1 diabetes (T1D) report severe distress up to 4 years after T1D diagnosis. PAID-PR (Problem Areas in Diabetes Survey-Parent Revised) assesses DD primarily in research settings; however, less is known about its clinical utility. We aimed to identify the feasibility of implementing PAID-PR screening at a diverse, academic US paediatric diabetes center during routine clinic follow-up visits through quality improvement methodologies. The PAID-PR was intended to be offered in English to caregivers at all paediatric T1D appointments, by the front desk during appointment check-in, or through REDCap prior to telehealth appointments or at local sites to all eligible caregivers. Adult psychosocial resources were provided to all, regardless of score. Forms were scored after appointments; scores ≥80 were referred to Diabetes Psychology providers for follow-up. A total of 391 caregivers completed the PAID-PR, though only half of eligible caregivers received it in person. Response rates were highest in person (90%), compared to REDCap (25%). In total, 27% (n = 107) scored ≥56 (DD). Of those with DD, 21% (n = 23) scored ≥80 and were referred to psychology. Demographics are reported in Table1. PAID-PR score was positively correlated to A1c (p = 0.038) and inversely to child age (p = 0.014). Clinic caregiver DD screening was implemented with higher response rates in person; however, expanding in-person screening to all eligible caregivers is necessary. Furthermore, since the PAID-PR was in English, some caregivers with DD were likely missed. Future directions include screening in additional languages.

Relationships between work-family conflict and family structure in the lives of working mothers in Hungary – a pilot study

BackgroundThe family, as the basic socialization environment, is a complex dynamic system that - as a whole and through its subsystems - is in relationships with other social systems (Bagdy in Family socialization and personality disorders. Nemzeti Tankönyvkiadó, Budapest, 2002; Lakatos et al. in Mentálhigiéné és Pszichoszomatika 21(1):56–85, 2020). The system with which the family system has long-term relationships is the work system/environment. Creating and maintaining a work-life balance has become a central issue in our societies, as they are two of the most organising forces, and reconciling them is a very difficult task due to the demands and expectations coming from both directions, often simultaneously (Makra et al. in Magyar Pszichológiai Szemle 67(3):491–518, 2012). This kind of “double burden” primarily affects women, but their increasing role in the labour market is not necessarily followed by an equal sharing of work within family life (Engler et al. in Work-life balance in women’s careers. In: Tardos K, Paksi V, Fábri Gy (eds) Scientific careers in the early 21st century. Belvedere Meridionale, Szeged, pp 114–126, 2021). We hypothesise that involvement in work negatively correlates with work-life balance, making it more difficult to integrate into the family. It was expected that the relationship between the number of children and mothers’ professional involvement would be negative. A positive correlation was expected between the age of the youngest child and the mothers’ work involvement. On the other hand, a family united by cohesion and resilience leads to higher job satisfaction.MethodsFor the present analysis, we analysed the relationships between work-family conflict and family structure in working mothers with children in a sample of 273 participants. The self-reported questionnaire included demographic data and 2 standard questionnaires: the Work-Family Conflict Questionnaire and the Olson-Family Test (FACES-IV.). The study was conducted in Hungary.ResultsNo significant relationship was found between work involvement and work-family conflict. A negative relationship was observed between work involvement and family involvement. Similiarily, no significant relationship was found between the number of children, the age of the youngest child and work involvement, contrary to expectations. The findings indicate a positive relationship between good family cohesion, flexibility and job satisfaction.ConclusionStriking a work-family balance is a challenging process for families with young children, especially working mothers. A mutually negative relationship between work and family involvement has been shown. The importance of a well-functioning family, with adequate cohesion and flexibility, is reflected in family and job satisfaction. The relationship between work-to-family conflict and job involvement is moderated significantly only when family flexibility is low. The results from the present pilot study indicate important relationships between variables and point to further research directions worth investigating in a larger sample in the future.

Clinical immunity to malaria involves epigenetic reprogramming of innate immune cells.

The regulation of inflammation is a critical aspect of disease tolerance and naturally acquired clinical immunity to malaria. Here, we demonstrate using RNA sequencing and epigenetic landscape profiling by cytometry by time-of-flight, that the regulation of inflammatory pathways during asymptomatic parasitemia occurs downstream of pathogen sensing-at the epigenetic level. The abundance of certain epigenetic markers (methylation of H3K27 and dimethylation of arginine residues) and decreased prevalence of histone variant H3.3 correlated with suppressed cytokine responses among monocytes of Ugandan children. Such an epigenetic signature was observed across diverse immune cell populations and not only characterized active asymptomatic parasitemia but also correlated with future long-term disease tolerance and clinical immunity when observed in uninfected children. Pseudotime analyses revealed a potential trajectory of epigenetic change that correlated with a child's age and recent parasite exposure and paralleled the acquisition of clinical immunity. Thus, our data support a model whereby exposure to Plasmodium falciparum induces epigenetic changes that regulate excessive inflammation and contribute to naturally acquire clinical immunity to malaria.

COVID-19 Vaccine Hesitancy in Caregivers of Hospitalized Children From 2020 Through 2023.

Data on US caregiver perceptions on coronavirus disease 2019 (COVID-19) and COVID-19 vaccination are limited. We identified trends in and associations with COVID-19 vaccine hesitancy in caregivers of hospitalized children. Cross-sectional surveys on pediatric COVID-19 disease and vaccine attitudes, behaviors, and beliefs were administered across study years (December 8, 2020-April 5, 2021, November 30, 2021-March 15, 2022, and October 26, 2022-March 15, 2023). English and Spanish-speaking caregivers of hospitalized children ages 6 months to 11 years were included. General vaccine hesitancy was assessed using the Parent Attitudes about Childhood Vaccines survey. Of 1268 caregivers from diverse backgrounds, one-third vaccinated or intended to vaccinate their child. Half endorsed fear of their child receiving the COVID-19 vaccine and were concerned the vaccine was new. Over time, more believed "the COVID-19 vaccine does not work" and fewer agreed "children who are otherwise healthy can die from COVID-19." Study season (2022-2023), older child age, higher income, child receipt of influenza vaccine, caregiver receipt of COVID-19 vaccine, and not being worried about vaccine novelty were positively associated with child vaccination. Intent to vaccinate was negatively associated with study season (2022-2023), Parent Attitudes about Childhood Vaccines score ≥50, lack of child influenza and caregiver COVID-19 vaccination, lack of fear of their child "getting COVID-19" and being "worried that the COVID-19 vaccine is new." The majority who intended to vaccinate were willing to immunize before discharge. Vaccine novelty and perceived lack of need were associated with refusal. Caregiver COVID-19 and child influenza vaccine acceptance were positively associated with COVID-19 vaccine acceptance. The inpatient setting offers the opportunity to improve vaccine uptake.

Impact of dental caries and Self-perceived oral health on daily lives of children and mothers in rural Egypt: a household survey

BackgroundThe present study assessed the impact of oral health on the daily lives of children and mothers living in a rural area in Northwestern Egypt.MethodsA cross-sectional household survey including children between 6 and 12 years old and their mothers was conducted in rural Egypt, 2019–2020. Data were collected using clinical examination and interview-based questionnaires of children and mothers. Three binary logistic regression models were used to assess the relationship between the dependent variables (oral health impact (yes, no) on avoiding smiling, chewing problems, and missing school (children) and avoiding social events (mothers)), and the explanatory variables: oral health (clinically-assessed caries experience and self-reported oral health) controlling for sociodemographic profile (child age and sex, mother’s education), daily toothbrushing and village of residence.ResultsA total of 211 households with 355 children and 211 mothers were included (91.5% response rate). About 54% of the children were girls, mean (SD) age = 8.7 (2.05) years and 82.3% did not brush their teeth daily. Mother’s mean (SD) age was 31.70 (5.45) years. Because of dental problems, 31.3% of children reported chewing difficulties, 31% avoided smiling compared to 76.3% and 43.6% of mothers. Also, 30.4% of children missed school and 76.8% of mothers reported reduced participation in social activities. In children, the number of decayed anterior teeth was associated with significantly higher odds of avoiding smiling (AOR = 1.22, 95%CI: 1.03, 1.44). In mothers, a greater number of posterior missing teeth was associated with significantly higher odds of chewing difficulties (AOR = 1.21, 95%CI: 1.01, 1.45), and a greater number of all missing teeth was associated with significantly higher odds of reduced participation in social events (AOR = 1.30, 95%CI: 1.30, 1.57). Good/ very good reported oral health in children and mothers was associated with lower odds of avoiding smiling and chewing problems (p < 0.05).ConclusionDecayed anterior teeth in children have a negative impact on smiling whereas missing teeth in mothers affect the ability to chew food and socialize. The psychological, functional, and social impacts of caries in this rural setting needs to be mitigated by improving oral health literacy and access to care.

Navigating the Unique Challenges of Caregiving for Children with Rare Diseases: Are the Care Experiences of All Caregivers the Same? A Focus on Life-Limiting Rare Diseases.

Background: Caregiving experiences in rare diseases (RDs) vary based on factors such as specific clinical entity, disease severity, the child's age, and available support and resources, leading to challenges that significantly impact caregivers' lives. This study investigates whether caregivers of children with different RDs encounter varied aspects of care. Methods: This study was conducted as a self-administered, anonymous, computer-assisted online survey, focusing on the challenges of caregiving for children with RDs. Questions covered aspects such as information availability on RDs, diagnostic processes, modern treatment accessibility, family physicians and specialists, the impact of caregiving on personal life, family dynamics, and financial challenges. To achieve our study objectives, we categorized caregivers of children with RDs into two groups to compare various aspects of caregiving: caregivers of children with phenylketonuria (PKU) (n = 175) and those caring for children with life-limiting rare diseases (LLRD) (n = 226). Results: Caregivers of children with LLRD reported greater emotional challenges, personal sacrifices, and financial burdens compared to caregivers of children with PKU. Significant differences included heightened emotional distress, more frequent conflicts, and lower assessments of healthcare support among LLRD caregivers. Although family support ratings were similar between the groups, perceptions of financial concerns and interactions with the healthcare system varied significantly. Conclusions: This study, representing the inaugural systematic comparison of specific caregiver cohorts overseeing children with RDs across a substantial sample size, provides valuable insights. The findings lay a crucial foundation for precisely tailoring assistance and support initiatives to meet the unique needs of caregivers facing various RDs in diverse contexts.

Family management styles for children with asthma: A latent profile analysis.

To identify the latent profiles and predictors of family management styles for children with asthma. This is a secondary data analysis. The demographic data of 506 primary caregivers of children with asthma and their scores of the Family Management Scale in a cross-sectional study were used. Latent profile analysis and multiple logistic regression analyses were employed. Three family management styles were identified: Thriving (Profile 1), Accommodating (Profile 2), and Enduring (Profile 3) Family Management Style. The child's age, gender, mother's education level, family structure, influence of illness on parents' work and family life, whether they had follow-up plans and whether their parents had read disease and health knowledge pamphlets were found to be the predictors of different styles. Three distinct family management styles exist for children with asthma. Future interventions designed to enhance family management for children with asthma should be based on their demographic characteristics and family management styles. The precise classification of family management styles in this study can serve as a guide to form multi-disciplinary teams of physicians and nurses to provide individualized care and conduct in-depth research to explore the mechanisms of biomedicine and the social psychology of asthma in the future. This paper aims to identify the latent profiles and predictors of family management styles of children with asthma. Thriving, accommodating, and enduring family management styles were identified in this paper. Child's characteristics, family and organizational factors were the predictors of different family management styles. Findings of this paper provide guidance for physicians and nurses to offer individualized care and conduct in-depth research to explore the mechanisms of biomedicine and the social psychology of asthma in the future. The article was reported according to the STROBE Checklist. No Patient or Public Contribution.

Raising a child with cancer: Impact on parents’ health-related quality of life

Background: Having a child with a serious illness like cancer has a detrimental and negative impact on the parents’ health-related quality of life (HRQOL). Many factors have been identified as being associated with poorer HRQOL. Acquiring knowledge about these factors is essential to enhancing the quality of life (QOL) of children as well as their parents. Aim: This study aims to analyze HRQOL in parents of children with cancer and to explore relationships between parent and child variables and parental quality of life. Materials and Methods: A total of 80 parents of children with cancer were enrolled in this cross-sectional study. To evaluate the parental HRQOL, the Short Form 36 Health Survey Questionnaire (SF-36) was used. Results: Child age and time since diagnosis showed a positive correlation with all domains of HRQOL on Spearman’s correlation. A statistically significant difference in SF-36 scores across four cancer groups was seen on the Kruskal–Wallis test. Mothers showed poorer quality of life in the physical role functioning domain as compared to fathers (U = 248, P &lt; 0.01). Conclusion: The present study shows poor HRQOL for parents of children with cancer, despite learning to cope and adjust over time. Parents of children with retinoblastoma demonstrate a poorer QOL as compared to other cancer groups. The study suggests close monitoring of parents’ QOL and the provision of appropriate treatment and psychosocial support for parents along with the treatment of children.

Baseline Normative and Test-Retest Reliability Data for Sideline Concussion Assessment Measures in Youth.

Tools used for the identification, evaluation, and monitoring of concussion have not been sufficiently studied in youth or real-world settings. Normative and reliability data on sideline concussion assessment measures in the youth athlete population is needed. Pre-season normative data for 515 athletes (93.5% male) aged 5 to 16 on the Standardized Assessment of Concussion (SAC/SAC-Child), modified Balance Errors Scoring System (mBESS), Timed Tandem Gait (TTG), and the King-Devick Test (KDT) are provided. A total of 212 non-injured athletes repeated the measures post-season to assess test-retest reliability. Mean performance on the SAC-C, mBESS, TTG, and KDT tended to improve with age. KDT was the only measure that demonstrated good to excellent stability across age ranges (ICC = 0.758 to 0.941). Concentration was the only SAC/SAC-C subtest to demonstrate moderate test-retest stability (ICC = 0.503 to 0.706). TTG demonstrated moderate to good (ICC = 0.666 to 0.811) reliability. mBESS demonstrated poor to moderate reliability (ICC = -0.309 to 0.651). Commonly used measures of concussion vary regarding test-retest reliability in youth. The data support the use of at least annual sport concussion baseline assessments in the pediatric population to account for the evolution in performance as the child ages. Understanding the variation in the stability and the evolution of baseline performance will enable improved identification of possible injury.

Air Pollution and Mortality in India: Investigating the Nexus of Ambient and Household Pollution Across Life Stages.

Air pollution in India is a foremost environmental risk factor that affects human health. This study first investigates the geographical distribution of ambient and household air pollution (HAP) and then examines the associated mortality risk. Data on fine particulate matter (PM2.5) concentration has been extracted from the Greenhouse Gas Air Pollution Interactions and Synergies (GAINS) model. HAP, mortality and socio-demographic data were extracted from the National Family and Health Survey-5, India, 2019-2021. Regression models were applied to see the difference in age-group mortality by different pollution parameters. The districts with PM2.5 concentration above the National Ambient Air Quality Standard (NAAQS) level of 40μg/m3 show a higher risk of neonatal (OR-1.86, CI 1.418-2.433), postneonatal (OR-2.04, CI 1.399-2.971), child (OR-2.19, CI 0.999-4.803) and adult death (OR-1.13, CI 1.060-1.208). The absence of a separate kitchen shows a higher probability of neonatal (OR: 1.18, CI 1.074-1.306) and adult death (OR-1.06, CI 1.027-1.088). The interaction between PM2.5 levels above NAAQS and HAP leads toa substantial rise in mortality observed for neonatal (OR 1.19 CI 1.051-1.337), child (OR 1.17 CI 1.054-1.289), and adult (OR 1.13 CI 1.096-1.168) age groups. This study advocates that there is a strong positive association between ambient and HAP and mortality risk. PM2.5 pollution significantly contributes to the mortality risk in all age groups. Children are more vulnerable to HAP than adults. In India, policymakers should focus on reducing the anthropogenic PM2.5 emission at least to reach the NAAQS, which can substantially reduce disease burden and, more precisely, mortality.

Sex-specific associations of a ferroalloy metal mixture with motor function in Italian adolescents.

Motor function is critical for children's health, yet remains an understudied neurodevelopmental domain. Exposure to metals has been linked with motor function, but no study has examined the joint effects of metal mixtures. We evaluated cross-sectional associations between a metal mixture and motor function among 569 adolescents (10-14 years old) living near the ferroalloy industry. Concentrations of blood lead, hair manganese, hair copper, and hair chromium were quantified using inductively coupled plasma mass spectrometry. Neuropsychologists administered multiple fine motor function assessments: pursuit aiming, finger tapping, visual reaction time (VRT), and subtests from the Luria Nebraska battery. We estimated associations between motor function and the metal mixture using quantile-based g-computation and multivariable linear regression, adjusting for child age, sex, and socioeconomic status. We explored sex-specific associations in stratified models. Associations between the metal mixture and motor function were mostly null but were modified by sex. We observed a beneficial association among females: a quartile increase in all metals in the mixture was associated with a 2.6% faster average response time on the VRT (95% confidence interval [CI] = -4.7%, -0.5%), driven by Cu and Cr. In contrast, this association was adverse among males (ß = 1.5% slower response time [95% CI = -0.7%, 3.9%]), driven by Cu and Mn. Results suggest that males may be more susceptible to the adverse effects of metal exposure on motor function during adolescence than females. Future studies, particularly prospective study designs, are warranted to further understand the associations of metal mixtures with motor function.

Teologi Trauma: Trauma Pada Anak Dampak Dari Perceraian Orangtua

Divorce is rarely seen as a way out of various household problems. Divorce is not the right solution to resolve the conflict; of course, a divorce can hurt others, especially the child; the divorce of parents can cause trauma to the child. In fact, the wounds that a child may have suffered will probably continue to carry it to adulthood; The impact on each child may vary, depending on the child's age at the time of the parents' divorce, the circumstances of the divorce, and the personality of the child. When a divorce occurs within a family, the child is the primary victim who is most affected by the negative impact of the divorce; The purpose of this writing is to explain that divorce is a phenomenon of social change taking place in today's society; divorce results in damage to relationships between family members that do not support the growth and development of the child; divorces cause family dysfunction; divorcing creates an emotional distance between the child and the parent; and divorce can also result in trauma to the child. The author uses a qualitative method to analyze this research problem using interviews and literature.

PREDICTING UNDERNUTRITION RISK FACTORS USING MACHINE LEARNING TECHNIQUES IN NIGERIAN UNDER FIVE CHILDREN

Childhood undernutrition remains a critical global health challenge with far-reaching consequences. This study developed and compare predictive models for three key indicators of under-five child undernutrition in Nigeria: stunting, wasting, and underweight. By leveraging various machine learning (ML) algorithms, we identified the most significant socio-demographic determinants of these nutritional outcomes. The study utilizes data from the Nigerian Multiple Indicator Cluster Survey (MICS6) 2021, a comprehensive nationwide survey. Four ML algorithms were employed to predict the risk factors for the under-5 child nutritional status: k-nearest neighbors (KNN), random forest (RF), decision tree (DT), and logistic regression (LR). These models were evaluated and compared based on their predictive performance. The study encompasses households across Nigeria, providing a broad representation of the country's diverse population. Preliminary analysis reveals significant regional disparities in the prevalence of stunting, wasting, and underweight among Nigerian children. Among the four ML algorithms tested, the KNN model demonstrated superior predictive capability across all evaluation metrics, including accuracy (89.65%, 95.00%, 80.04%), precision (91.02%, 87.79%, 93.53), recall (99.98%, 100%, 100%), and F1-score (94.44%, 98.83%, 88.60%). This outperformance was consistent for all three undernutrition indicators. The KNN model, identified as the most effective predictor, highlighted several key determinants of childhood undernutrition. These factors varied somewhat across the three outcomes but commonly included: household wealth index, geopolitical zone, source of drinking water, child age, birth size, mother's education level, and residential area (urban/rural) among others. This study demonstrates the efficacy of machine learning approaches, particularly the KNN algorithm, in predicting and understanding the determinants of children undernutrition in Nigeria. The findings provide valuable insights for targeted interventions and policy formulation. These results can inform evidence-based decision-making and resource allocation in Nigeria's efforts to improve child nutrition and achieve related Sustainable Development Goals.