Child Health Research Articles

Oral health of children and adolescents with type 1 diabetes mellitus: a literature review

Relevance. Type 1 diabetes mellitus is a prevalent chronic metabolic autoimmune condition among children and adolescents. The compromised metabolic control associated with this endocrinopathy elevates the risk of various complications, including oral diseases. Establishing an interdisciplinary approach to enhance oral care for young patients with type 1 diabetes mellitus is crucial in contemporary dentistry.Objective. To synthesize information regarding the relationship between type 1 diabetes mellitus and oral health in children and adolescents.Materials and methods. The search strategy involved both electronic and manual searches, querying key databases like PubMed, eLibrary, MEDLINE, and Embase using specific keywords related to the subject. Additionally, a manual search was conducted in the references of relevant articles.Results. The literature review identified the most frequently occurring oral diseases in children and adolescents with type 1 diabetes mellitus. It highlighted key biomarkers for monitoring oral health in these patients. The review uncovered major gaps in understanding the oral manifestations of type 1 diabetes mellitus.Conclusion. Exploring the links between pathogenesis of type 1 diabetes mellitus in young populations and their oral health is pivotal for pediatric dentistry and endocrinology. Addressing this issue could lead to more effective treatment strategies, enhance preventive measures, and improve the diagnostic accuracy of oral diseases. Discrepancies among study findings underscores the imperative for ongoing research and substantiates the value of an interdisciplinary approach in investigating the dental manifestations associated with this endocrine disorder.

Exploring the link between hair elemental composition and oral and general health of children in Northern and Central Dagestan Russia

Relevance. This article presents data on the level of trace elements in hair and oral and general health among various age groups of children (from 2 to 17 years) in Northern and Central Dagestan. It also reports findings on the relationship between oral health indicators and the content of such macro- and microelements as Ca, Cu, Mg, Mn, Zn, As, Fe, F. Identifying concentrations of macro- and microelements in hair proves to be a promising diagnostic method and aids in creating personalized prevention programs.Objective. To investigate the correlation between the elemental composition in children's hair and their oral and general health conditions in the cities of Kizlyar and Makhachkala, situated in Northern and Central Dagestan, Russia.Materials and methods. Established methods and physicochemical techniques were utilized for oral health evaluations to determine the quality indicators of drinking water, levels of elemental composition in hair, and methods to assess the general health of children (questionnaires, analysis of medical records of children).Results. A correlation was established between the levels of specific chemical elements in hair, the dental hard tissues, and mixed saliva with the oral and general health complications observed in children. Water analysis in Makhachkala, central part of the Republic of Dagestan, revealed an unbalanced presence of essential chemical elements such as fluoride, iron, manganese, zinc, and sulfates. In 74–84% of the examined water samples, the fluoride content was below 0.5 mg/l, and only 13–25% were within the normal range. The levels of fluoride and iron in hair and mixed saliva indicate shifts in mineral metabolism in children's bodies. Fluoride is crucial for iron absorption, and its deficiency results in significantly decreased absorption rates. A substantial reduction in water fluoride levels, compared to standard values, correlates with high rates of dental caries and iron deficiency anemia in children from Makhachkala, occurring in about 87% of cases (P < 0.05). This relationship is substantiated by the analysis of medical records from children aged 2 to 17 from hospitals in both Northern and Central Dagestan, highlighting the connection between iron deficiency anemia and the low fluoride levels in drinking water. Further studies into the oral health of children have shown that the incidence and severity of caries in deciduous teeth are greater in the Northern than in the Central Zone of Dagestan. Moreover, conditions such as cheilitis, aphthous stomatitis, and desquamative glossitis are frequently observed in children during the stages of temporary tooth occlusion, affecting on average 38.5% of cases, and this prevalence increases to 78.2% during the mixed and permanent occlusion stages.Conclusion. The conducted studies revealed that the drinking water supplied to the Dagestan population has elevated permissible levels of iron and arsenic. Additionally, there is a noted deficiency of fluoride, zinc, and copper, as well as low water hardness. Research into the quality of drinking water and the health impacts on the pediatric population of Dagestan established a correlation (R = 0.593) between unbalanced water, dietary intake, the severity of dental caries, and reduced immunity in children. High levels of arsenic, germanium, and molybdenum in the water and children's hair contribute to cumulative health effects. Environmental pollution is also linked to a rise in oral health issues, iron deficiency anemia, and broader health problems. Analyzing the chemical composition of children's hair serves as a diagnostic tool for detecting and preventing diseases related to deficiencies and excesses of macro- and microelements.

Changes in parents' health concerns by post-preterm birth period in South Korea: a cross-sectional study.

This study aimed to examine the health concerns of parents regarding their premature infants and to identify changes in these concerns during perinatal period and after discharge. This was a retrospective study performed at a single tertiary center that enrolled 119 premature infants who were discharged from the neonatal intensive care unit (NICU) and visited the outpatient pediatrics department between December 2018 and October 2021. Data on the concerns of 176 parents regarding enrolled premature infants' health from before birth to 1 week after NICU discharge were obtained from outpatient records. The t test and with the chi-squared test were used to analyze the data for this study. The consistently greatest focus of parents' health concerns was the respiratory system. The second focus of parents' health concerns before discharge was the central nervous system. However, during the first week after NICU discharge, the gastrointestinal system was the second-most frequent focus of parents' health concerns among parents of infants without diseases related to prematurity and infants with older gestational ages. The results of this study offer insights into the health concerns among parents of premature infants. Parental health concerns about premature infants vary over time, from before birth to post-discharge, necessitating supportive interventions to enhance parental understanding of their child's health status.

Generalized Anxiety Levels and its Relationship to Quality of Life among Pregnant Women Visitors of Maternal and Child Health Centers at Irbid Governrate

The current study aimed to reveal the generalized anxiety level and its relationship to the quality of life of pregnant women visitors of maternal and child health centers in Irbid governorate. To achieve the objectives of the study, the descriptive correlational methodology was adopted, The researchers used the Sharif scale (2020) and the translation of an international scale, (Dule, et al, 2021). That were distributed to a sample consisted of (350) pregnant women visitors of maternal and child health centers in Irbid governorate. The study results showed that the level of most domains of the generalized anxiety among pregnant women visitors of maternal and child health centers was high. The level of most of quality of life among pregnant women visitors of maternal and child health centers was medium. The results also showed that there were no statisticaly significant differences on the variables of the study except the emotional domain, and these differences in favor of pregnant women of age (less than 30 years). In light of these results, the study recommended the need to reveal the level of quality of life among pregnant women to work on reinforcing and developing them.

영유아를 둔 부모의 자녀 구강건강에 대한 중요도 인식과 실행수준

Purpose: This study was conducted to suggest implications for oral health education for young children by examining the recognition of the importance of young children's oral health and the level of implementation among parents of recognition. Method: A survey was conducted on 320 parents of young children in Region C from July 10 to July 28, 2023. A total of 293 questionnaires were used in the final analysis. The collected data were conducted to frequency analysis, IPA analysis using IBM SPSS Statistics 25.0 Results: First, the question with the highest recognition of the importance of oral health care for children among parents of young children was ‘If a child says their teeth hurt, they receive dental treatment quickly. The item with the highest level of implementation was ‘When purchasing a toothbrush, purchase a children’s toothbrush that matches the size of child’s teeth.’ Second, the question with the highest recognition of the importance of oral health education for children among parents of young children was ‘Instructing children to brush their teeth, tongue, and gums when brushing their teeth.’ The question with the highest level of implementation was ‘Educate child to eat foods that are beneficial to dental health.’ Conclusions: There is a need to improve parents' level of practice regarding oral health of young children, including proper brushing of teeth, oral check-ups, and use of oral products. Nutrition education, oral health and safety parent education, and early childhood teacher retraining are requested.

Prevalence of Childhood Dermatological and Ocular Morbidities: A Cross-Sectional Study

Abstract Introduction: Screening many children within a certain age group for the presence of illnesses can be efficiently conducted through school surveys. This study aims to analyze the prevalence of dermatological and ocular morbidities in school children. Methods: A school-based cross-sectional observational study was conducted in Government and Private schools of Latur, involving 500 school children aged between 5-14 years. Results: The prevalence of dermatological morbidities in our research was found to be 69%, with boys showing a prevalence of 50.6% and girls 18.4%. Prevalence of ocular morbidities was 7.6%, with boys showing a prevalence of 4.2% and girls 3.4%. Among dermatological manifestations, infections and infestations were the most observed (44%), followed by eczema (dermatitis) (13%). Refractive error was the most common ocular morbidity observed in boys (33.3%), followed by Vitamin A deficiency (28.57%). In girls, refractive error was the most common ocular morbidity (35.29%), followed by Vitamin A deficiency (29.41%). Conclusion: Urgent attention is needed to address these health issues early on to improve children's overall well-being. The findings contribute valuable insights for future research and targeted public health interventions aimed at promoting the health of school children.

Factors associated with food security in rural communities across the globe

Food security is a global issue that affects millions of people worldwide. Several studies have been carried out to understand the dynamics of food security resulting from emerging issues across the globe such as climate change, conflict, etc. The authors have reviewed in this article the factors associated with food security in rural communities considering the socio-economic characteristics of individuals, livelihood concerns, inflation in the economy and purchasing power of households, the use of technology, governmental or non-governmental support and the effect of food insecurity on individuals and households. The studies have shown that lack of employment opportunities, low income of households, climate change, inflation and instability of food prices, poor rural infrastructure, inefficient government policies, and lack of technology at household level are major contributing factors to rural food insecurity. Moreover, one of the key conclusions of the published studies is that food insecurity negatively impacts health in both adults and children.

A Journey into the Evolution of Human Host-Oral Microbiome Relationship through Ancient Dental Calculus: A Scoping Review

One of the most promising areas of research in palaeomicrobiology is the study of the human microbiome. In particular, ancient dental calculus helps to reconstruct a substantial share of oral microbiome composition by mapping together human evolution with its state of health/oral disease. This review aims to trace microbial characteristics in ancient dental calculus to describe the evolution of the human host-oral microbiome relationship in oral health or disease in children and adults. Following the PRISMA-Extension for Scoping Reviews guidelines, the main scientific databases (PubMed, Scopus, Lilacs, Cochrane Library) have been drawn upon. Eligibility criteria were established, and all the data collected on a purpose-oriented collection form were analysed descriptively. From the initial 340 records, only 19 studies were deemed comprehensive enough for the purpose of this review. The knowledge of the composition of ancient oral microbiomes has broadened over the past few years thanks to increasingly well-performing decontamination protocols and additional analytical avenues. Above all, metagenomic sequencing, also implemented by state-of-the-art bioinformatics tools, allows for the determination of the qualitative-quantitative composition of microbial species associated with health status and caries/periodontal disease. Some microbial species, especially periodontal pathogens, do not appear to have changed in history, while others that support caries disease or oral health could be connected to human evolution through lifestyle and environmental contributing factors.

Optimal fluoride levels in pediatric toothpastes: A review of the literature

Aim:Through this literature review, we seek to determine the optimal level of fluoride present in pediatric toothpastes, identifying the recommended amount according to scientific literature, in addition to evaluate the effects of fluoride on children's dental health and its effectiveness in prevention of caries and also identify the risks of excessive fluoride exposure. Materials and methods: Searches were carried out for articles published in the last 5 years in electronic databases such as PubMed, Scopus, Scielo, ScienceDirect, UpToDate, Google Academic. The search used a combination of the following keywords: "toothpaste" AND "pediatrics" AND "dosage" AND "fluoride". Results: 14,118 abstracts were registered: 1,407 from PubMed, 1,043 from Scopus, 355 from ScienceDirect, 10,200 from Google Academic, 913 from Scielo, 200 from UpToDate. After reviewing the abstracts, 14,095 records were removed according to the inclusion and exclusion criteria, leaving 31 full-text articles for examination. Finally, 19 full-text articles were included and evaluated in this review. Conclusion: The presence of adequate concentrations of fluoride in toothpastes has a positive influence in oral health, especially on the prevention of dental caries. Several reviewed studies reveal that the optimal amount of fluoride in pediatric toothpastes should be greater than 1000 ppm but not exceed 1500 ppm to obtain the maximum anti-caries effect and prevent adverse effects such as dental fluorosis.

Hubungan Kebiasaan Konsumsi Makanan Kariogenik dengan Kejadian Karies Gigi pada Anak Sekolah Dasar Kelas V di SDN 1 Bukit Tunggal Palangka Raya

Background: Tooth decay can affect the health of other parts of the body, thereby hampering daily activities. One of the factors that can damage teeth is the habit of consuming food and drinks, some of which are healthy, some of which damage teeth, causing dental caries. The current phenomenon is that children entering school age are generally at high risk of experiencing dental caries, because at that age they are used to consuming various types of food and drinks that cause dental caries (such as candy, chocolate, pastries, etc.). Purpose: this research is to determine the correlation between cariogenic food consumption habits and dental caries in grade V elementary school children at SDN 1 Bukit Tunggal Palangka Raya. Methods: The sampling technique used total sampling to obtain 62 respondents, data collection used a questionnaire on habits of consuming cariogenic foods and a dental caries examination observation sheet which had gone through validity and reliability tests, for data analysis using the chi-square statistical test. Results: Based on the analysis, the results of statistical tests using the chi-square method show a sig (2-tailed) number with a p- value of 0.00 with a degree of significance of p < 0.05, so the decision is that H1 is accepted, meaning there is a Habit Correlation Consumption of Cariogenic Foods with Dental Caries. Conclusion: There is a correlation between cariogenic food consumption habits and dental caries. It is recommended that parents pay more attention to maintaining their children's dental health and know the types of food or snacks that can cause caries. Furthermore, it is recommended that schools carry out promotive and preventive efforts regarding dental and oral health carried out by teachers, especially UKS and UKGS supervisors.

Do Parents Dental Neglect and Anxiety Affect Their Children s Dental Neglect and Anxiety

Aim: Dental neglect is an obstacle to obtaining the necessary dental care in protecting and maintaining basic oral health. Dental anxiety can cause difficulties in behavior management, maintenance of dental treatments, and poor oral hygiene. In this study, it was aimed to examine the relationship between dental neglect and anxiety levels of both parents and their children. Material and Methods: 220 people including 110 parents and 110 children were included in the study. The Dental Neglect Scale (DNS), Modified Dental Anxiety Scale (MDAS), and Visual Analogue Scale (VAS) were used for parents. In addition, the Dental Neglect Scale (DNS), the Faces version of the Modified Child Dental Anxiety Scale (MCDASf), and the Wong Baker Faces Pain Rating Scale (WBFS) were applied to children. The statistical analysis was performed using Spearman Correlation test and Mann Whitney-U test. Results: In the study, a positive correlation was found between parent’s and children's neglect scores (r=0.261; p=0.006). Likewise, a positive correlation was observed between the DMFT and anxiety scores of the children (r=0.237; p= 0.013). In addition, it was observed that there was a statistical correlation between the level of pain felt at the last dental treatment and anxiety in children (r=0.316; p=0.001). Conclusion: It was observed that the dental neglect of the children of parents who neglected their own oral health increased. It is thought that informing parents about the importance of oral health and the consequences of dental neglect will have positive effects on their children's oral health.

Implementation of Stimulation, Early Detection, and Intervention Programs for Monitoring the Growth and Development of Children Aged 2-3 Years

Starting from growth that supports development, in the end growth and development go hand in hand. An important period in a child's growth and development begins in infancy because basic growth is what will influence and determine the child's subsequent development. The aim of this research is to detect deviations in the development of early childhood children aged 2-3 years at the ECCE Rahmah El Yunusiyyah Padang Panjang through the Stimulation, Detection and Early Intervention of Child Growth and Development (SDICGD) instruments in the Android feature. This research was conducted using a cross-sectional approach. Participants in this study were 26 children aged 2-3 years using a consecutive sampling technique of 10 children whose growth and development were monitored using the SDICGD android application. The results of this study showed that several partisipants experienced malnutrition, one partisipant out of nine normal partisipants. The Developmental Pre-Screening Questionnaire (DPSQ) instrument of the ten child participants contained nine children (90%) who were according to the developmental stage aged 24-36 months, and one child was not according to the developmental stage. The results of the Attention Deficit and Hyperactivity Disorder (ADHD) test showed that three children (60%) were normal, and two children (40%) were hyperactive. Early detection of children's growth and development must be carried out regularly every month, and according to the child's age. For further research, it is hoped that early detection will also be carried out on the development of children's mental health, not just growth and development which is common and widely researched. Schools and parents must play an active role in children's growth and development so that no developmental stages are missed, and children grow and develop according to their age. Keywords: simulation, detection, early intervention, child growth and development, development of children aged 2-3 years

Pediatric COVID-19 Response in the Philippines

The COVID-19 pandemic has been an unprecedented global health crisis, affecting individuals of all ages. In thePhilippines, as we continue to combat the virus, we put focus on one particularly vulnerable group: our children.1 As weconfront the complexities of pediatric COVID-19 management, we provide insight into the response strategies establishedto protect the health of our youngest population. At the beginning of the pandemic, the Philippines undertook a comprehensive approach that encompassed travel restrictions,community interventions, robust risk communication, and rigorous testing procedures. These measures were implementedwith the overarching goal of mitigating the impact of COVID-19 and safeguarding the nation’s healthcare system.2 On March 30, 2020, the Philippine General Hospital (PGH) officially became the COVID-19 Referral Center inthe country. It has been more than four years since that fateful day when we had to brace ourselves for what was about tohappen. All of the departments, including the pediatrics department, had risen to the challenge with change in infrastructure,creation of clinical guidelines for COVID-19 management, formulation of infection control measures, and allocation ofprotective equipment and training for health workers.3 The PGH Transfer Command Center (TCC) was in-charge of triaging, decking, and admitting patients to thehospital.3 During the surges, the TCC was besieged with calls from desperate doctors and relatives with COVID-19 ofvarying severity – critical, severe, moderate, mild, and asymptomatic. Several projects and programs have sprung to help withthe pandemic. An algorithm was created at the time by the Class of 1991 UP College of Medicine, which was a quick,simple, complete, easy-to-understand guideline which navigate patients in their homes.4,5 Through a number of medicalprofessional volunteers, the Philippine General Hospital (PGH) COVID Gabay Program was launched to guide families via ateleconsultation platform.6 A community preventive approach included the promotion of mask-wearing, physical distancing, and hand hygiene,aligning with recommendations from global health organizations like the World Health Organization (WHO) andthe Centers for Disease Control and Prevention (CDC).7,8 Locally, the Philippine Pediatric Society has issued a parentsCOVID-19 prevention guide to disease prevention, symptoms, home care, and breastfeeding9, and treatment guidelinesregarding the disease in children were formulated by the Pediatric Infectious Disease Society to be used by the communityand pediatricians10. Initially, COVID-19 vaccines in the Philippines were primarily administered to adults. The vaccination campaigntargeted healthcare workers, senior citizens, and individuals with comorbidities, as well as its level of acceptability in thecommunity.11 The eligibility for pediatric vaccination depended on regulatory approvals and vaccine availability then. Currently,the vaccination program has expanded to include younger age groups along with COVID-19 booster doses. However,vaccine hesitancy especially by the parents has been a challenge brought about by different factors such as exposure to falseinformation amplified by the media, the community, and the health system.12,13 The disruptions caused by the COVID-19 pandemic in the education sector have had profound effects on childrenas Philippines had one of the longest lockdown period worldwide.14 As education was reinstated in October 2020, theeducation department’s approach was a combination of remote learning alternatives, including online platforms, educationaltelevision and radio broadcasts, and printed study materials. However, the significant challenge lies in the disparities insocial circumstances and the absence of adequate resources at home, which has adversely affected numerous students andeducators.14,15 The apprehension and worry about contracting the virus, the cessation of in-person classes, the disturbance of theirusual daily routines, and the reduction in social interactions with schoolmates all contribute to an increased strain on themental health of children.16 In anticipation of the mental health challenges at the pandemic’s outset, the PsychologicalAssociation of the Philippines compiled a roster of complimentary telemedicine consultations. Furthermore, the PhilippineRed Cross initiated a COVID-19 hotline to attend to mental health issues and related concerns. Additionally, theDepartment of Health has launched nationwide campaigns during the National Mental Health Week.17 Our commitment to the well-being of our children during this pandemic is a reflection of our society’s resilience andcompassion. By addressing these challenges and implementing solutions, we can protect the future of our nation. In conclusion, the pediatric COVID-19 response in the Philippines is a critical endeavor that demands our collective effort.We must prioritize the health, education, and emotional well-being of our children as we navigate these challenging times.Let us work together to ensure that no child is left behind in our journey towards a safer and healthier future.

Measuring the effects of nurse-led frailty intervention on community-dwelling older people in Ethiopia: a quasi-experimental study

BackgroundDespite the critical need, interventions aimed at frailty in sub-Saharan Africa are scarce, attributed to factors such as insufficient healthcare infrastructure, the pressing need to address infectious diseases, maternal and child health issues, and a general lack of awareness. Hence, the aim of this research was to develop, implement, and evaluate the effect of a nurse-led program on frailty and associated health outcomes in community-dwelling older individuals in Ethiopia.MethodsThis study utilised a pre-test, post-test, and follow-up single-group quasi-experimental design. The main outcome measure was to determine changes in the frailty levels of older individuals living in communities at three different intervals: initially (T0), immediately after the intervention (T1), and 12 weeks following the intervention (T2). Secondary outcomes were the observed changes in daily living activities, nutritional status, depression levels, and quality of life (QOL), evaluated at each of these data collection points. To analyse changes in frailty and response variables over these periods, Friedman’s ANOVA and Cochran’s Q test were employed, setting the threshold for statistical significance at P < 0.05.ResultsSixty-six older people with a high adherence rate of 97% completed the intervention and the follow-up measurements. Participants had an average age of 66.7 ± 7.9 years, with females comprising 79.4% of the group. Notably, 12 weeks post-intervention, there was a marked decrease in frailty (χ2(2) = 101.05, p < 0.001) and depression scores (χ2(2) = 9.55, p = 0.008) compared to the baseline. However, the changes in depression, physical, mental, and environmental domains of QOL were not sustained for 12 weeks post-intervention. Study participants showed an improvement in nutritional status (χ2(2) = 25.68, p < 0.001), activity of daily living (χ2(2) = 6.00, p = 0.05), and global quality of life (χ2(2) = 20.64, p < 0.001).ConclusionsThe nurse-led intervention notably, 12 weeks post-intervention reduced frailty and depression. The intervention improved the nutritional status and some components of the quality of life of the participants. There is a need for further studies, especially with larger participant groups and stronger research designs such as randomized controlled trials (RCTs).Trial registrationClinicalTrials.gov: NCT05754398 (03/03/2023).

Large-scale production of non-conventional edible plants for biodiverse school meals.

School feeding programs are important for ensuring food security and promoting child health and development, particularly in low-income countries. In view of this importance, it is possible to increase the quality of these meals by diversifying the vegetables offered and incorporating underutilized plants to improve dietary diversity and nutritional quality into school meals. This study was carried out using the action research methodology following the implementation and development of the "Inova na Horta" project in the city of Jundiaí, São Paulo, Brazil. The project was based on the existing and functioning physical and organizational structure of a municipal organic farm. Vegetables were selected from among 210 non-conventional species and varieties, which were further selected for continuous production based on 8 nutritional, culinary and cultivation criteria. Thirty-four vegetables were selected for continuous cultivation and provisions to the school kitchens. Nine tons of vegetables were produced and provided to 90 municipal schools from 2020-2023. Leafy vegetables accounted for most the production, with a total weight of 6441 kg corresponding to 71.6% of the total harvest. Kitchen teams were trained throughout the project duration. The feasibility of the production and culinary use of 34 biodiverse, nutrient-rich and underutilized food vegetables for school meals was demonstrated. The selected vegetables are nutrient-rich and contain higher amounts of minerals and proteins than the control vegetables (conventional vegetables), thus complementing several nutrients in school meals. This methodology can be replicated by municipalities of various sizes as a public policy of food and nutritional security associated with the valorization of local biodiversity.

Family resilience and caregiver's well-being across different age groups of children with ADHD in the United States: a cross-sectional study.

This study aimed to investigate the impact of family resilience on caregiver well-being across various age groups of children diagnosed with ADHD (attention-deficit/hyperactivity disorder) groups (0-5, 6-11, and 12-17 years). Utilizing secondary data from the 2022 US National Survey of Child Health, this cross-sectional study involved 2,752 children who were formally diagnosed with ADHD. Statistical analysis included descriptive analysis, Spearman's rank correlation, chi-square tests, and linear regression, conducted using SPSS version 27. The study revealed a moderate positive correlation (r=.35, p<.001) between family resilience and caregiver well-being. Controlling for covariates, family resilience accounted for 25.2%, 21.1%, and 22.1% of caregiver well-being variance in age groups 0-5, 6-11, and 12-17 years, respectively. Additionally, factors like employment status, family structure, and caregiver age showed varying influences on caregiver well-being across these developmental stages. A consistent pattern emerged across these age groups: unemployment and non-traditional family structures were associated with negative impacts on caregiver well-being, whereas older caregiver age positively influenced well-being. This research underscores the importance of age-specific family resilience strategies to improve caregiver well-being and family interactions in ADHD contexts. Investigating these aspects through qualitative studies across various cultures could deepen our understanding of well-being and inform culturally sensitive interventions.

Differences in medically assisted reproduction use by sexual identity and partnership: a prospective cohort of cisgender women.

Differences in medically assisted reproduction use by sexual identity and partnership: a prospective cohort of cisgender women.

Factors associated with inadequate urinary iodine concentration among pregnant women in Mbeya region Tanzania.

Background Insufficient and above WHO-recommended levels of iodine intake during pregnancy can lead to serious health outcomes. This study aimed to assess median urine iodine concentration and its associated risk factors among pregnant women in the Mbeya region, Tanzania. Method A cross sectional survey involving 420 pregnant women (n=420) aged 15-49, registered in Reproductive and Child Health Clinics was conducted. Socio-demographic and dietary factors were assessed by structured questionnaire and the urine samples were analyzed using the ammonium persulfate digestion method. Results Median urinary iodine concentration (mUIC) was 279.4μg/L and it ranged from 26.1 to 1915μg/L. Insufficient mUIC (below 150μg/L) was observed in 17.14% of participants, sufficient mUIC was 24.29% and 58.57% had mUIC above the recommended level (&gt;250μg/L). Sample women who reported consuming fish in the last 24 hours had an increased risk of insufficient mUIC [Adjusted OR= 2.60 (95%CI 1.31-5.15)] while the risk was lower for those who attended at least primary education [AOR= 0.29 (CI 0.08-0.99)]. Further, sample women resident in Mbarali district, in the oldest age group (35-49) and having a higher socio-economic status were associated with an increased risk of having MUIC above recommended level [AOR=4.09 (CI 1.85-9.010], [AOR=2.51 (CI 0.99-6.330] and, [AOR=2.08 (CI 0.91-4.71) respectively. Conclusion This study demonstrated a significant association between geographical, age and socio-economic factors and median urine iodine concentration above the WHO-recommended level. Further, this study found association between inadequate iodine in diet and insufficient median urine iodine concentration. Therefore, educational programs on iodine intake should be strengthened.

Healthcare System Sustainability Challenges in Nepal and Opportunities Offered by Alternative Healthcare Delivery Arrangements

The burden of chronic diseases in Nepal is increasing due to demographic and epidemiological transitions; alongside the persistent impact of communicable, maternal, newborn, and child health diseases, this critical situation acts as the precursor to rising healthcare costs. Nepal struggles to sustain its healthcare system amidst political instability, pandemics, natural disasters, and slow economic growth, particularly when healthcare funding is mainly dependent on out-of-pocket payments. Nepal requires lower-cost alternative healthcare delivery arrangements to provide high-value care while relieving economic sustainability pressures. Alternative healthcare delivery arrangements have a broad potential scope; they can involve strategic changes in how care is delivered and by whom, or they can also involve the application of information and communication technologies, e.g., telemedicine. This paper highlights the specific challenges to healthcare system sustainability in Nepal and the potential for high-value, lower-cost alternative healthcare delivery models to improve system performance in the longer term.

Preoperative Hepatitis B seroprevalence and AntiHbs Levels in Children Consulted for Dental Procedures Under Anaesthesia

Background/Aims: Hepatitis B virus infection continues to be a major global and national public health concern. The aim of this study was to examine the seroprevalence of hepatitis B virus in children who were consulted to child health and diseases before dental intervention and to share our findings with the healthcare personnel involved on this subject. Methods: A total of 932 children were enrolled in the study, of which 533 (57.2%) were boys and 399 (42.8%) were girls. In the blood samples taken; hepatitis B virus tests were studied with the Enzyme Linked Immuno Sorbent Assay method. The results of blood samples and demographic data of the patients were evaluated. Results: HBsAg positivity was not found in any of the patients (0%). AntiHbs seropositivity was found in 73.8% of the whole patient population. No statistically significant difference was detected when comparing the anti-HBs levels based on gender. The average age of children with antiHbs seropositive was found to be statistically significant lower than that of those with antiHBs negative. The median anti-HBS antibody levels were significantly higher in the group of children under 5 years old than in the other two age groups older than five years old in our study. When investigating the association between the level of antiHBs and age, a weak negative correlation was found. Conclusions: Our study showed that the antiHbs seropositivity is higher in Konya compared to previous studies. It suggests that the national vaccination program has a positive impact on antiHbs seroprevalence. Our study revealed that children under the age of five displayed the highest levels of anti-HBs seropositivity, while the anti-HBs levels diminished with advancing age.