Child Health Research Articles

A nomogram for predicting postpartum post-traumatic stress disorder: a prospective cohort study

BackgroundPostpartumpost-traumatic stress disorder (PTSD), as a psychological stress disorder, has long-term and widespread harm. Still, compared with other postpartum psychiatric disorders, postpartum PTSD has received relatively littleattention in China. This study aims to investigate the risk factors of postpartum PTSD and to develop a convenient and rapid nomogram screening tool to help clinical staff identify high-risk pregnant womenin time and take preventative and management measures.MethodsRecruited pregnant women hospitalized for delivery in Qingdao Municipal Hospital and Jinzhou Maternal and Child Health Hospital from November 2022 to October 2023 as convenient samples for the questionnaire survey. Telephone follow-up was conducted 42 days after delivery. After univariate analysis, multicollinearity analysis, and logistic regression analysis, the risk factors of postnatal PTSD were obtained, a prediction model was established, and a nomogram was drawn by R software. G*power3.1.9.7 calculated the effectiveness of the test. The model was validated internally using the Bootstrap approach, and external validation was carried out using a verification group. The accuracy of the model's predictions and its clinical application value were evaluated by the area under the curve, calibration plot, and decision curve analysis.ResultsA total of 602 women were recruited in this study, and the incidence of postpartum PTSD was 11.1% (67/602). Multifactorial logistic regression analysis showed that poor self-assessment of sleep status in late pregnancy (OR = 5.336), cesarean section (OR = 2.825), instrumental delivery (OR = 5.994), having fear of labor (OR = 4.857), and a high score of Five Factors Inventory Neuroticism subscale (OR = 1.244) were independent risk factors for developing postpartum PTSD. A high Quality of Relationship Index score (OR = 0.891) was a protective factor for postpartum PTSD. In the training and validation sets, the nomogram model's area under the ROC curve was 0.928 and 0.907, respectively. The calibration curves showed that the nomogram model was well-fitted, and the Decision Curve Analysis indicated that the nomogram model had good value for clinical application.ConclusionsWith its strong predictive capacity, the prediction model built using postpartum PTSD risk factors can help clinical caregivers identify high-risk pregnant women early on and implement timely preventive intervention strategies.

Environmental Health Attitudes, Practices, and Educational Preferences: A National Survey of Reproductive-Aged Women in Canada

Prenatal exposures to environmental toxicants can adversely affect fetal and child development and lead to increased risk of chronic disease. While regulatory action is essential to reduce sources of environmental toxicants, prenatal care presents an opportunity to educate, mobilize, and support prospective parents to reduce exposures to such hazards. As the first phase of an interdisciplinary research collaboration to inform the development of prenatal environmental health education strategy in Canada, we surveyed reproductive-aged female individuals. The online survey (July–September 2021) yielded a nationally representative sample of 1914 reproductive-aged females living in Canada. The questionnaire topics addressed the respondents’ knowledge and perceptions of environmental health risks, preventive actions and related facilitators and barriers, information sources and preferences, reproductive history, and demographics. The analysis included bivariate and multivariate techniques. Our results suggest broad awareness among reproductive-aged females that exposure to toxicants can be harmful, and that reducing prenatal exposures can benefit child health. However, fewer than half of respondents felt that they had enough knowledge to take protective measures. Despite high levels of preference for prenatal care as an ideal context for learning about environmental health risks and protective measures, fewer than one in four respondents had ever discussed environmental health concerns with a healthcare provider. Our findings reveal a knowledge–action gap and a corresponding opportunity to improve environmental health education and advocacy in prenatal care in the Canadian context.

Effects of myopia on health-related quality of life in adolescents: a population-based cross-sectional causal empirical survey

ObjectiveMyopia is a prevalent disease affecting adolescent vision and harms various health outcomes. However, the evidence about the effects of myopia on adolescents’ overall health status is limited. Using health-related...

Application of Interactive Learning Methods and Character Strengthening in Aisyiyah Penatarsewu Kindergarten

This research aims to explore the role of Real Work Lecture (KKN) students in supporting learning activities at the Aisyiyah Kindergarten in Penatarsewu Village and their contribution in increasing awareness of children's dental health. Using a qualitative descriptive approach, this research assesses the impact of KKN on educational learning, social and cultural introduction, and children's health. The research results show that KKN students have succeeded in applying creative and innovative methods, introducing local social and cultural values, and increasing children's understanding of dental health, including the importance of limiting consumption of sweet foods. The involvement of KKN students makes a significant contribution to improving the quality of education, social knowledge, culture and children's health. This program shows the potential for synergy between higher education and local communities in creating sustainable positive change.

Contextual success and pitfalls of mHealth service for maternal and child health in Africa: An Intervention, Context, Actors, Mechanism, and Outcome (ICAMO) framework guided systematic review of qualitative evidence

IntroductionMobile health (mHealth) interventions have shown potential to improve maternal and child health outcomes in Africa, but their effectiveness depends on specific interventions, context, and implementation quality. Challenges such as limited infrastructure, low digital literacy, and sustainability need to be addressed. Further evaluation studies are essential to summarize the impact of mHealth interventions. Thus, this synthesis focuses on qualitative evidence of the impact of mHealth on maternal and child health in Africa to summarize such evidence to help policy decisions.MethodsA qualitative systematic review guided by the concepts of Intervention, Context, Mechanism, and Outcome (ICAMO) was employed in this study. The GRADE CERQual assessment and methodological constraints tools were utilized in the review to ascertain the level of confidence in the evidence and to examine the methodological limitations. The JBI checklist for qualitative research appraisal was also consulted during the review.ResultsThe current review contains 32 eligible studies from databases such as CINAHL, EMBASE, MEDLINE, Scopus, Web of Science, HINARI, and Cochrane Library. The review demonstrated substantial improvements in the HCP-woman relationship, communication system, maternal and child healthcare uptake, health-seeking behavior, and HCP skills. Economic capacities, maternal education, and the low quality of existing services challenged participants.ConclusionmHealth significantly improves maternal and child health outcomes in Africa. This review showed it can improve healthcare access, empower women, and contribute to the region's goal of universal health coverage. However, the challenges such as low partner support, high costs for services, and poor quality of current care as narrated by women need commitment from health authorities in the continent. The evidence from this review suggests that mHealth can be implemented to improve maternal and child health in Africa.Trial registrationPROSPERO: CRD42023461425.

Air quality disparities and respiratory health risks in critically polluted and relatively non-polluted areas: a prospective child health study.

Air pollution, a significant global health concern, notably impacts human well-being. Children, owing to their distinctive physiology and behavior, are particularly susceptible to its adverse effects. This prospective study examines air quality variations and respiratory risks in children residing in critically polluted areas (CPA) compared to relatively non-polluted areas (NPA), utilizing a prospective design to understand the impacts of air pollution on children's respiratory health, including measures like relative risk (RR) and attributable risk (AR). This prospective study tracked 739 students of 5th- 7th grade residing in CPA and NPA for one year, and measured the ambient and indoor air quality levels in both these areas. Throughout the study, based on the observed respiratory symptoms new episodes of upper and lower respiratory tract illnesses were recorded for each child on a weekly basis. Incidence rate, RR and AR for both the illnesses were compared. Statistical analysis was performed with SPSS 26.0. The study observes higher concentration for particulate matter and gaseous pollutants at CPA in comparison to NPA. Children living in CPA exhibited a notably greater weekly occurrence of both upper and lower respiratory tract illnesses compared to those in NPA, with RR of 1.26 (95% CI: 1.16-1.37) and 1.74 (95% CI: 1.34-2.27), respectively. The AR associated with air pollution for upper and lower respiratory tract illnesses among CPA students was found to be 20.7% and 42.7%, respectively. This research underscores the pressing need to address air pollution in critically polluted areas and its profound effects on children's respiratory health. Public health interventions, such as reducing emissions from industries and creating green spaces, should be prioritized. Furthermore, early respiratory health screening in schools within polluted areas could aid in the timely diagnosis and management of respiratory issues in children.

Information overload and parental perspectives on information provided to parents/carers of paediatric patients undergoing elective surgical procedures.

When parents are expected to play a significant role in the management of their children's health perioperatively, information overload for parents could have particularly detrimental consequences. Our study investigated information communication and overload in 380 parents of children undergoing any elective surgical procedure at our institution. Participants completed an online questionnaire and were asked to respond to a newly designed Information Overload scale based on a modified 5 item Cancer Information Overload Scale and an 8-item atrial fibrillation information overload scale. Nineteen respondents (5%) identified as Aboriginal or Torres Strait Islander. More than a quarter of respondents (n = 102, 27%) primarily spoke a language other than English at home. 56% of respondents (n = 211) indicated that neither themselves nor any of their children had undergone a similar surgery in the past. Most respondents disagreed or strongly disagreed with the majority of the 5-item Information Overload scale statements. University undergraduates had lower total information overload score on average (-1.63, p = 0.002). People who spoke a language other than English had higher total score on average (0.98, p<0.001). Semi-structured qualitative interviews including the BRIEF health literacy screening tool were conducted with 24 parents. 23 interviewees scored 17-20 points in the BRIEF health literacy screening tool, indicating they were able to read and comprehend patient education materials. Overall, parents were satisfied with the amount of information that they received. Very rarely did any parent complain of 'information overload'. Our results show that parents of children undergoing elective paediatric surgery are not suffering from information overload in general, but they do want more information on immediate and late postoperative recovery.

Prevalence of Bottle‐Feeding Practice and Associated Factors Among Mothers of Children Under Five in the World, 2024: Systematic Review and Meta‐Analysis

ABSTRACTBackgroundChild‐feeding practices, particularly breastfeeding, significantly impact children's health and survival. However, bottle feeding, although historically practiced, presents numerous disadvantages affecting optimal child nutrition and health. Despite World Health Organisation and The United Nations Children's Fund recommendations against bottle feeding, it remains prevalent globally, affecting roughly 59% of infants worldwide and 85% in Australia by 5 months of age.ObjectiveThis study aims to assess the prevalence and determinants of bottle feeding among mothers of children under five globally.MethodsThis systematic review and meta‐analysis adhered to the Preferred Reporting Items for Systematic Review and Meta‐Analysis guidelines. We comprehensively searched electronic databases for English‐language articles published between 2014 and 2024. The quality of studies was assessed using the Joanna Briggs Institute critical appraisal checklist. Data were analysed in STATA version 17, including summary tables, narrative descriptions, forest plots, and statistical heterogeneity and publication bias assessment.ResultsThe pooled prevalence of bottle feeding among mothers was 57%. Subgroup analysis revealed higher prevalence in larger sample sizes (&gt; 2151) and lower prevalence in smaller ones. Factors significantly associated with bottle feeding included mode of delivery (OR = 1.953; 95%, CI: 1.272, 2.635), child hospitalisation (OR = 1.984, CI: 1.593, 2.376), mother's occupation (OR = 1.579; CI: 1.467, 1.690), post‐natal care (OR = 2.965; CI: (1.358, 4.571), age of children (OR = 2.836; CI: 1.895, 3.777), place of residence (OR = 1.423; CI: 0.994, 1.852), and mother's education (OR = 3.366, CI: 1.949, 4.783).ConclusionEfforts to promote optimal child‐feeding practices should address the identified determinants, emphasising the importance of breastfeeding and providing support to mothers, especially those facing challenges such as cesarean delivery, child hospitalisation, and maternal employment.

Trend and Determinants of Early Postnatal Care in Nepal with a Focus on Women’s Autonomy

Nepal has made significant strides in improving maternal and child health, notably reducing mortality rates over recent decades. However, challenges persist in meeting the maternal and newborn health targets outlined in the Sustainable Development Goals. Postnatal care is essential for the survival and well-being of both mothers and newborns, yet there is limited research on this topic in Nepal. This study aims to assess trends in early postnatal care coverage and analyze the factors influencing service uptake focusing on women’s autonomy. Using data from the Nepal Demographic and Health Surveys for 2011, 2016, and 2022, which included 10,991 mothers aged 15-49 with at least one live birth, the study revealed significant improvements in postnatal care coverage. The percentage of mothers receiving care within 48 hours increased from 43% in 2011 to 56% in 2016, reaching 72% in 2022. Despite this progress, 28% of mothers and newborns still lack timely postnatal care, which is crucial for their survival and well-being. Regression analysis indicated that women with greater decision-making autonomy are significantly more likely to receive postnatal care (adjusted OR 1.216, P &lt; 0.01), even when accounting for socio-demographic factors. The study highlighted disparities in postnatal care coverage based on age, caste/ethnicity, education, occupation, province, urbanrural residence, wealth, and family size. These findings emphasize the need for targeted interventions to empower women and tailor maternal health programs to address the specific needs. Future research should focus on evaluating complete postnatal care coverage, assessing care quality, and exploring interventions to strengthen maternal health care.

Study of the Association Between Socioeconomic Determinants and Pregnancy Follow-Up Indicators of Mothers of Low-Birth-Weight Infants: Insights for Achieving Sustainable Development Goals

Aims: This study investigates the association between socioeconomic determinants and pregnancy follow-up among 200 mothers of low-birth-weight newborns. By identifying factors influencing maternal care and birth outcomes, the study contributes to achieving Sustainable Development Goals (SDG) 3, 8, and 10, focusing on improving maternal and child health, reducing socioeconomic disparities, and ensuring equitable healthcare access. Methods: A prospective descriptive study was conducted over 12 months (June 2020–July 2021) at the neonatology and nutrition reference center of Rabat Children's Hospital. The study recruited 206 mother-child pairs, focusing on those with low-birth-weight infants. Results: Among the 200 mothers, 92% followed their pregnancies. Distribution of prenatal consultations was as follows: 0.54% had one visit, 5.98% two visits, 33.7% three, 41.85% four, and 17.93% more than four. Analysis revealed significant associations between pregnancy follow-up and socioeconomic factors. Maternal age (p &lt; 0.001), education level (p &lt; 0.001), and place of residence significantly influenced pregnancy monitoring, with urban mothers more likely to receive follow-up care. Single mothers had a 100% non-tracking rate, while married mothers predominantly monitored their pregnancies. Conclusions: This study demonstrates the strong influence of sociodemographic factors on antenatal care use, aligning with findings from other contexts. It contributes new insights into the specific characteristics of our study population and has practical implications for shaping maternal and child health policies, addressing the unique needs of diverse sub-populations. Achieving SDG 3 (Good Health and Well-being), SDG 8 (Decent Work and Economic Growth), and SDG 10 (Reduced Inequalities) requires targeted interventions that improve equitable access to quality maternal care.

Association between maternal perinatal stress and depression and infant DNA methylation in the first year of life

Maternal stress and depression during pregnancy and the first year of the infant’s life affect a large percentage of mothers. Maternal stress and depression have been associated with adverse fetal and childhood outcomes as well as differential child DNA methylation (DNAm). However, the biological mechanisms connecting maternal stress and depression to poor health outcomes in children are still largely unknown. Here we aim to determine whether prenatal stress and depression are associated with differences in cord blood mononuclear cell DNAm (CBMC-DNAm) in newborns (n = 119) and whether postnatal stress and depression are associated with differences in peripheral blood mononuclear cell DNAm (PBMC-DNAm) in children of 12 months of age (n = 113) from the Canadian Healthy Infant Longitudinal Development (CHILD) cohort. Stress was measured using the 10-item Perceived Stress Scale (PSS) and depression was measured using the 20-item Center for Epidemiologic Studies Depression Questionnaire (CESD). Both stress and depression were measured longitudinally at 18 weeks and 36 weeks of pregnancy and six months and 12 months postpartum. We conducted epigenome-wide association studies (EWAS) using robust linear regression followed by a sensitivity analysis in which we bias-adjusted for inflation and unmeasured confounding using the bacon and cate methods. To quantify the cumulative effect of maternal stress and depression, we created composite prenatal and postnatal adversity scores. We identified a significant association between prenatal stress and differential CBMC-DNAm at 8 CpG sites and between prenatal depression and differential CBMC-DNAm at 2 CpG sites. Additionally, we identified a significant association between postnatal stress and differential PBMC-DNAm at 8 CpG sites and between postnatal depression and differential PBMC-DNAm at 11 CpG sites. Using our composite scores, we further identified 2 CpG sites significantly associated with prenatal adversity and 7 CpG sites significantly associated with postnatal adversity. Several of the associated genes, including PLAGL1, HYMAI, BRD2, and ERC2 have been implicated in adverse fetal outcomes and neuropsychiatric disorders. These data further support the finding that differential DNAm may play a role in the relationship between maternal mental health and child health.

Maternal pre-pregnancy body mass index and gestational weight gain on adverse birth outcomes in Chinese newborns: a retrospective study

BackgroundMaternal and child health is an important measure of national well-being. This study further explored the individual and combined effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on adverse birth weight-related outcomes.MethodsA retrospective study was carried out at a maternal and child health hospital from 2018 to 2021, and a total of 17,506 eligible women were invited to participate. The associations of pre-pregnancy BMI and GWG with adverse birth outcomes were examined by using restricted cubic spline regression and binary logistic regression.ResultsPre-pregnancy BMI and GWG had non-linear associations with low birth weight and macrosomia. They were associated with an increased risk of macrosomia (Pre-pregnancy BMI for OR = 1.170, 95%CI:1.144 to 1.197, P < 0.001, and GWG for OR = 1.071, 95%CI:1.054 to 1.089, P < 0.001) and large for gestational age infant (LGA) (Pre-pregnancy BMI for OR = 1.125, 95%CI:1.111 to 1.141, P < 0.001, and GWG for OR = 1.045, 95%CI:1.036 to 1.054, P < 0.001). The high risk of low birth weight and preterm birth was observed among the group of women with inadequate GWG. The risks of macrosomia and LGA increased with pre-pregnancy BMI from low weight to overweight and obesity, and GWG from inadequate to overabundance, while small for gestational age infant was more prevalent in the low pre-pregnancy BMI group.ConclusionsPre-pregnancy BMI and GWG exhibited non-linear associations with low birth weight and macrosomia. The various combinations of pre-pregnancy BMI and GWG had different effects on adverse birth weight-related outcomes.

Harnessing the Link between Climate Change and Traditional Food Preservation Methods: Implications for Global Food Security and Public Health

Climate change is a global issue, which impacts the different geographical zones in different levels. It is also linked to numerous human health issues, which are a concern to human health. The impact of climate change on traditional methods of food preservation in Nigeria and the consequences for food security and health are examined in this research. Information from the Nigerian Meteorological Agency (NIMET) and the National Emergency Management Agency (NEMA) show that average temperatures are increasing and rainfall is decreasing, which are effects of climate change that affect agriculture, water resources, and traditional food preservation methods that are detrimental to public health.Traditional food preservation methods are critical for understanding the link between climate change and food security.This paper uses a case study of Nigeria to examine the effects of climate change on traditional food preservation practices and public health. The research focuses on the shifts in the conventional preservation techniques, the impact of these shifts on nutrition, and policy interventions for enhancing sustainable preservation of food. Climate change indicators such as temperature and rainfall were used as surrogates for climate change, food insecurity such as undernourishment rates were used for food security and nutritional health outcomes such as child stunting and micronutrient malnutrition. The study shows that climate change has a negative effect on food security since it reduces crop yields and enhances post-harvest losses. Sun-drying and smoking are the common preservation techniques that are now less efficient because of high humidity and unpredictable weather. As such, people are experiencing increased incidences of food wastage, nutritional imbalance, and food borne diseases especially with those people in rural regions. Furthermore, the study confirms the relationship between climate change and food insecurity, which has a negative impact on the health of pregnant women and children, especially under five years, and high under-five mortality despite a decrease in child mortality in the last decade.The results provide important regional information relevant to the entire Sub-Saharan Africa and useful to the international community in matters of climate change, food security and health. This study calls for the use of innovation that combines the conventional and contemporary methods of food preservation in order to mitigate the impacts of climate change on food security systems. Furthermore, it underlines the need for the policy interventions that may prevent food borne illness and other diseases. These insights are in line with the United Nations Sustainable Development Goals (UN-SDGs) 2, 3, and 13, namely; Zero Hunger, Good Health and Well-being, and Climate Action, respectively.This research addresses a significant gap in the literature by linking climate change effects with food preservation practices and offering recommendations for improving food system vulnerability to climate change. It provides a clear picture of the prospects and constraints of mitigating climate change impacts on food insecurity and enhancing food security and health in the world.

Behavioral Correlates of Caregiver-Reported Oral Health of Children with Cleft Lip and/or Cleft Palate Ages 14 to 48 Months: An Observational Study.

To identify behaviors associated with poor caregiver-reported oral health in a population of young children with cleft palate with or without cleft lip (CP ± L). Observational cross-sectional study. U.S. Cleft Outcomes Research NETwork (CORNET) Consortium Eight hundred thirty-four caregivers of US children with CP ± L ages 14 to 48 months who provided demographic and medical information and answered 8 items on oral health behaviors (eg, sugar-sweetened beverage intake frequency, having a regular source of dental care, toothbrushing, and fluoride exposure). Caregiver-reported oral health status of the child (poor/fair vs good/very good). Logistic regression models were used to generate confounder-adjusted odds ratios (OR) and evaluate associations between oral health behaviors and caregiver-reported oral health status of the child. The mean age of children was 25.5 ± 7.5 months, 82.7% were white, and 24.1% were Hispanic/Latino. About 16.7% of caregivers reported their child's oral health as fair/poor. Children consuming 2+ servings of juice and/or sugar-sweetened beverages daily (OR: 2.18; 95% confidence interval [CI]: 1.2, 4.0; P = 0.011), those drinking bottled water (OR: 1.75; 95% CI: 1.0, 3.1; P = 0.049), and those consuming 1+ servings of meal replacement drinks daily (OR: 2.86; 95% CI: 1.2, 6.5; P = 0.015) had increased odds of fair/poor caregiver-reported child oral health. Sugar-sweetened beverages and meal replacement drinks, as well as bottled water intake, were associated with poorer caregiver-reported oral health for children with CP ± L. Future research should focus on ways to improve beverage-related behaviors in children with CP ± L to prevent dental diseases and promote oral health.

Nutrition nurturers: Empowering primary school children through innovative dietary education and parental engagement

Purpose: This research aims to examine effective pedagogical methods for promoting healthy dietary practices among elementary students. By reviewing the literature, the study will identify key factors influencing children's eating habits, assess treatment impacts on eating patterns and metabolism in obese children, and explore how breakfast quality affects the health of children and teenagers. Method: This study analyses pertinent literature on encouraging healthy eating habits in primary school students using a systematic review and meta-analysis methodology. Comprehensive searches of electronic databases, such as PubMed, PsycINFO, and Web of Science, are part of the systematic review process to find pertinent research published in peer-reviewed journals. The inclusion criteria cover research on instructional methods, tactics, and interventions intended to encourage primary school students to eat healthily. Result: The outcomes of the meta-analysis and systematic review point to several successful instructional methods and tactics for encouraging primary school students to eat healthily. Children's eating habits are influenced by several factors, and treatments that focus on diet and metabolic responses, especially in obese kids, seem to be working well. The study also emphasizes how important a healthy breakfast is to kids' and teens' overall health and well-being. Conclusions: The study concludes that raising lifelong good eating habits in primary school students requires comprehensive strategies incorporating nutritional education, parental involvement, and community support. The results have significant ramifications for educators, legislators, and medical professionals who work to encourage children to adopt healthy habits. To investigate the long-term impacts of interventions and create specialized tactics for a range of populations, more study is necessary.

Mindfulness and mental health: the importance of a clinical intervention to prevent the effects of a traumatic event. A pilot study.

Numerous research studies show that mindfulness can mitigate the negative impact of trauma on mental health by reducing symptoms of anxiety, mediating the relationship between trauma exposure and mental health, and treating symptoms resulting from traumatic events. During the COVID-19 pandemic, which was considered a traumatic event, the wellbeing of adults and children was severely compromised. Although children seem less vulnerable to the physical effects of the virus, this does not seem to be true for the psychological effects. Indeed, a prolonged period of loss of family activities and routines can have a negative impact on the mental health of children and adolescents. To investigate how mindfulness can help preschool children cope with the effects of COVID-19, a study was conducted on 46 children aged 4-5 years. The programme, based on the work of Jon Kabat-Zinn and adapted to the age of the participants, consisted of eight weekly 45-min sessions. Qualitative and quantitative results showed positive feedback, indicating that mindfulness helps children make sense of their experiences and achieve functional post-traumatic growth. This approach is seen as a challenge to guide children toward the restoration of psychological wellbeing, which is essential for good psychological balance.

Predictors and number of antenatal care visits among reproductive age women in Sub-Saharan Africa further analysis of recent demographic and health survey from 2017-2023: Zero-inflated negative binomial regression.

Antenatal care (ANC) is an important component of maternal and child health care. To reduce perinatal mortality and improve women's experience of care, the World Health Organization (WHO) recommends pregnant women should attend at least eight ANC visits. However, in Sub-Saharan Africa (SSA), the mean number of ANC visits among reproductive-age women using Demographic and Health Surveys (DHS) data following the new WHO recommendation is so far limited. Therefore, the study aimed to determine the mean number of ANC visits and its predictors among reproductive-age women in SSA. Community-based cross-sectional study was conducted among 188,880 weighted reproductive-age women in SSA using a recent round of DHS data from 2017-2023. Zero-inflated negative binomial regression (ZINB) was conducted and statistical significance was declared at p-value <0.05 and adjusted incidence rate ratio(AIRR) for count model part and adjusted odds ratio for logit model inflated part of ZINBR with 95% confidence interval (CI) were reported. The mean number of ANC visits among reproductive-age women in SSA was 4.08 with 95%CI [4.07, 4.09]. Among reproductive-age women who gave birth in the last five years before the survey, 7.3% had eight or more ANC visits during pregnancy. Age of women, maternal and husband educational status, types of pregnancy, birth order, household size, number of under-five children, and wealth index were associated with the numbers of ANC visits among reproductive-age women in Sub-Saharan. The mean number of ANC visits among reproductive-age women in SSA is too lower than the new WHO recommendation of ANC visits for a positive pregnancy experience. This study also highlights that the proportion of at least eight ANC visits is low and there are still disparities in the mean of ANC visits across different regions of SSA. The increasing maternal age, higher maternal and husband educational status, wanted pregnancy, the number of household members, the number of under-five children, and higher wealth index increase the number of ANC visits. Unwanted pregnancy, no more fertility desire, and rural residences were contributed for zero ANC visits in SSA. Therefore, efforts should be geared towards improving maternal and husband's educational status. We strongly recommend that the governments of SSA countries should empower women economically and educationally to achieve the goals of ANC as recommended by the WHO.

Change in Child Opportunity Index in Early Childhood Is Associated with Youth BMI Growth.

Background: The neighborhood-level child opportunity index (COI) has been used in policy-based initiatives to identify and improve low-resource neighborhoods in order to impact child health. Understanding of how changes in COI can impact child growth, however, is lacking. Methods: Participants were 1124 children from the Family Life Project, a longitudinal birth cohort of families in rural, high-poverty areas. Youth anthropometrics were measured at eight assessments (ages 2 months through 12 years). Neighborhood COI was obtained at seven assessments (ages 2 months through 5 years) and used to create seven trajectory groups representing a change in COI: stayed low on all seven assessments, stayed moderate, stayed high, left low, declined from moderate, declined from high, and bounced around. Results: As hypothesized, moving from high COI neighborhoods into lower COI neighborhoods was associated with greater BMI growth and increased risk for obesity and severe obesity at 12 years. As hypothesized, the opposite effect, which approached significance at p = 0.056, was found among children who moved from low COI neighborhoods into higher COI neighborhoods. Specifically, moving into higher COI neighborhoods was associated with reduced BMI growth, and lower risk for severe obesity at 12 years. Conclusions: Moving into higher COI neighborhoods may be associated with healthier BMI growth, while the opposite effect may occur when moving into lower COI neighborhoods. Given the use of the COI in public health initiatives and growing evidence for its potential positive impact on child growth, future work is needed to replicate our findings among larger diverse samples.

The relationships between resilience and child health behaviors in a national dataset.

Resilience mechanisms at the individual, family, and environmental levels may improve health outcomes despite potentially harmful stress exposure partly through the practice of positive health behaviors. We performed a secondary analysis of 2016-2021 National Survey of Children's Health data to assess the relationships between three resilience domains - child, family, neighborhood - and six health behaviors using multiple regression models adjusted for the other resilience domain(s) and potential confounders. Analysis revealed significant associations between each resilience domain and multiple health behaviors in a total weighted analytic sample of 70,156,540 children. For each outcome, the odds of better health behaviors were highest with high resilience in all possible domains. For example, among children ages 0-5 years, the adjusted odds of having "good quality" vs. "poor quality" sleep for those with "high" resilience in all domains were 2.21 times higher (95% CI 1.78, 2.63) than for those with "low" resilience in all domains. This line of research may help to inform the design of resilience and health behavior promotion interventions by targeting multiple socio-ecological domains of influence to improve health and development outcomes in children exposed to experiences or sources of potential stress. This study assessed the associations between three socio-ecological resilience domains (child, family, and neighborhood) and six child and family health behaviors in a national dataset. Resilience exists within multiple socio-ecological levels and supports healthy functioning despite experiencing stress. Studies in adults and limited pediatric sub-populations show associations between resilience and health behaviors, which in turn influence numerous health outcomes. Resilience at three levels of socio-ecological levels was found to be associated with the performance of multiple child and family health behaviors in a nationally representative general pediatric population. These findings have important implications for child and family health promotion efforts.

Application of whey protein microparticulates in the production of ice cream and other dairy products

The aim of this paper is to systemize data on the use of whey protein microparticulates (WPMP) in production of ice cream and other dairy products. Information about the essence of the microparticulation process and methods for WPMP production is given. Data on the composition and physico-chemical properties of liquid and dry WPMP are presented. An effect of sizes of WPMP particles on quality characteristics of products made with their use is described. The majority of the analyzed studies indicate that the diameter of particles is 1.0–2.5 µm. However, contradictory data were obtained for this indicator — if the results of all studies are taken into consideration, a size of conglomerates can be 0.5 to 12 µm. These sizes are comparable with parameters of fat globules, which allow receptors of the human oral cavity to perceive them identically. Due to this, WPMP can be used as an imitator of milk fat. It is noted that the microparticulation process enables producing WPMP with targeted functional properties, namely, with particular characteristics by indicators “solubility”, “water holding capacity”, “gel formation”, “emulsifying and foam forming properties”. Information about the specific features of using and dosing WPMP in fermented milk products, such yogurt, kefir, curd cheese and cheese, is given. A special attention is paid to the results of the investigation of using WPMP in ice cream. It is noted that most often scientists used WPMP to make up for the sensation of fatness in defatted and nonfat dairy products. The ability of WPMP to increase the biological value of food products is highlighted. It has been concluded that WPMP enables formation of soft and elastic structure in low-fat dairy products, intensification of milky color and restriction of ice crystal growth in frozen desserts by binding and equally distributing moisture. The data were obtained about the clinical investigation of an effect of ice cream with WPMP on the health of children and adults. The negative effect of WPMP on the indicators of clinical analyses of humans and their health was not revealed.