Children Ages Research Articles

Determinants of stunting among children under 5 years in Bangladesh: a quantile regression analysis.

Child undernutrition is a major public health problem in developing countries that contributes to increased incidence of morbidity and mortality. Stunting is a valid and widely acknowledged measure of chronic child malnutrition. This study extracted data of 7778 under-5 children from the 2017-2018 Bangladesh Demographic and Health Survey and aims to explore the relationship between socio-demographic factors and the nutritional status of children under the age of 5. The anthropometric indicator height-for-age z-score (HAZ) was used as the target variable. The quantile regression method was employed to examine the heterogeneous relationship between the covariates and the conditional HAZ distribution across five different quantiles. This study found that 31.4% of children were severely to moderately stunted and a negative association between children's age and their HAZ. Additionally, children whose mothers had attained at least a secondary education exhibited a positive correlation with their HAZ. Another important factor was the mother's body mass index, which had a two-fold effect on the HAZ. Among the administrative divisions, children from the Sylhet division exhibited a negative association with the HAZ. Additionally, children with a high wealth index exhibited a positive association with the HAZ. Collaborative efforts from different organisations, as well as small and large communities in rural and urban areas, are necessary to improve nutritional status of children in Bangladesh.

20 Co-occurring behaviours of concern and sleep problems in children with neurodevelopmental disorders

Abstract Background Many children with neurodevelopmental disorders (NDDs) have behaviours of concern (BoC). These behaviours, such as aggression and self-injury, can impair functioning, cause distress to the child and caregivers, and threaten physical safety. This population also commonly experiences chronic and frequent sleep problems including issues falling asleep and staying asleep. Studies in sub-populations of NDDs suggest insufficient sleep is related to worsening BoC. Therefore, sleep may be a modifiable risk factor in children with NDDs and BoC. However, no studies have systematically characterized co-occurring behaviour and sleep problems in the general NDD population. To our knowledge this is the first study to take a transdiagnostic approach in assessing the co-occurrence of sleep problems and BoC in children with NDDs, and systematically characterizing BoC and sleep problems by their type and severity. Objectives To assess the co-occurrence of BoC and sleep problems in a population of children with diverse NDDs and systematically characterize both BoC and sleep problems. Design/Methods A literature review and clinical experience informed the creation of a REDCap database. Medical information, the nature, frequency, and severity of BoC and sleep problems, and other relevant information (e.g., demographics, medications) were included. Charts from children ages 2-18 years who visited the Child Development Centre for consultation from May – October 2022 and had confirmation of an NDD diagnosis were manually reviewed. Results 241 children met eligibility criteria. Of children with data available for both sleep and behaviour, 55% had co-occurring behaviour and sleep problems. These children displayed aggression (75%) and self-injury (49%) more frequently than children who had behaviours but no sleep problems (66% and 34%, respectively). Children with co-occurring behaviours and sleep problems were more likely to have severe BoC, including severe aggression (48%) and self-injury (45%), compared to children who had behavioural concerns but no sleep problems (21% and 20%, respectively). Conclusion The majority of children with NDDs have co-occurring BoC and sleep problems. This co-occurrence was related to increased frequency and severity of BoC in children with NDDs. Addressing sleep problems may represent a previously underrecognized therapeutic target to address BoC in this population.

40 Trust, belonging and understanding - The experiences of families who use languages other than English (LOE) that are hospitalized on general paediatric inpatient units

Abstract Background Despite recognition that social determinants are critical to health outcomes, many groups, including those with lower incomes, racial/ethnic minorities, and other historically marginalized populations, continue to experience significant social and structural barriers to care. There is need for research that incorporates patient and stakeholder engagement in developing, testing, and disseminating interventions to improve outcomes for patient populations that have been marginalized in the health system. Patients who use a language(s) other than English (LOE) for healthcare communication are at increased risk for experiencing adverse events and worse health outcomes in healthcare settings, including in paediatric hospitals. Canadian census data indicates 12.7% of Canadians predominantly speak a language other than French or English. This work aims to generate knowledge to improve health outcomes for children and families who speak LOE. Objectives (1) To understand the lived experience of families who speak LOE around the hospitalization of their child and (2) To understand the perspectives of patients and families who speak LOE on how the healthcare system can improve care during hospitalization. Design/Methods The premise of this study is participatory research. We designed a qualitative study involving children hospitalized in the General Paediatric Inpatient Unit at the Hospital for Sick Children. The study includes family caregivers of children age 0 to 18 years who identify as speaking LOE. Children and families could speak any language that we were able to obtain interpreter support for. We excluded patients that spoke a traditional Indigenous language as we noted this work required a separate study in partnership with the Indigenous community. We conducted semi-structured virtual individual interviews with children and families post-discharge with a medical interpreter. An interview guide was developed and transcripts were analyzed using thematic analysis. We took several steps to ensure an effective study design given our goals of participatory research including ensuring patient and family engagement throughout the design process. Results 19 families participated in the interviews and 16 different languages were represented amongst our participant groups. Our study is unique in especially unique in it's ability to recruit and interview individuals with so many different primary languages. Our study provides rich insight into opportunities within the paediatric inpatient setting for quality improvement to address the health disparities experienced by patients and families who use LOE for healthcare communication. Our analysis of the interviews identify several themes that provide insight into the lived experience of patients and families who use LOE for healthcare communication. 1) Inconsistent interpreter use affects communication “in the moment” and the ability to develop an “overall understanding” of the current clinical situation and broader healthcare context. Our participants note a "snowball effect" when interpreters are not consistently utilized. 2) In addition to language, multiple additional social factors contribute to an increased sense of vulnerability and modulates how families “trust” the healthcare system. 3) Despite families expressing positive experiences, they noted that they did not, nor expect to feel like they “belonged” within the healthcare system. It is critical to recognize the complex interplay between many factors surrounding our participants’ identities. Though they use a LOE for healthcare, the intersectional marginalization they experience was thoroughly represented during our conversations Conclusion Our research aimed to take a participatory approach to consider the lived experience of patients and families who use LOE for healthcare communication. This work builds on the current literature on patient and family centered care, experiences of families who speak LOE and participatory community-based research in the paediatric hospital settings. Our study's findings support the development of a research and intervention agenda in Canada to improve health outcomes for patients and families with LOE.

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 (> 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.

Social inequalities in child mental health trajectories: a longitudinal study using birth cohort data 12 countries

BackgroundSocial inequalities in child mental health are an important public health concern. Whilst previous studies have examined inequalities at a single time point, very few have used repeated measures outcome data to describe how these inequalities emerge. Our aims were to describe social inequalities in child internalising and externalising problems across multiple countries and to explore how these inequalities change as children age.MethodsWe used longitudinal data from eight birth cohorts containing participants from twelve countries (Australia, Belgium, Denmark, France, Germany, Greece, Italy, Netherlands, Poland, Norway, Spain and the United Kingdom). The number of included children in each cohort ranged from N = 584 (Greece) to N = 73,042 (Norway), with a total sample of N = 149,604. Child socio‐economic circumstances (SEC) were measured using self‐reported maternal education at birth. Child mental health outcomes were internalising and externalising problems measured using either the Strengths and Difficulties Questionnaire or the Child Behavior Checklist. The number of data collection waves in each cohort ranged from two to seven, with the mean child age ranging from two to eighteen years old. We modelled the slope index of inequality (SII) using sex‐stratified multi‐level models.ResultsFor almost all cohorts, at the earliest age of measurement children born into more deprived SECs had higher internalising and externalising scores than children born to less deprived SECs. For example, in Norway at age 2 years, boys born to mothers of lower education had an estimated 0.3 (95% CI 0.3, 0.4) standard deviation higher levels of internalising problems (SII) compared to children born to mothers with high education. The exceptions were for boys in Australia (age 2) and both sexes in Greece (age 6), where we observed minimal social inequalities. In UK, Denmark and Netherlands inequalities decreased as children aged, however for other countries (France, Norway, Australia and Crete) inequalities were heterogeneous depending on child sex and outcome. For all countries except France inequalities remained at the oldest point of measurement.ConclusionsSocial inequalities in internalising and externalising problems were evident across a range of EU countries, with inequalities emerging early and generally persisting throughout childhood.

Circulation and Codetections of Influenza Virus, SARS-CoV-2, Respiratory Syncytial Virus, Rhinovirus, Adenovirus, Bocavirus, and Other Respiratory Viruses During 2022–2023 Season in Latvia

This retrospective study analysed the routine data obtained by multiplex real-time RT-qPCR methods for respiratory virus detection. A total of 4814 respiratory specimens collected during 1 September 2022–31 August 2023 were included in the study. A total of 38% of the specimens were positive for at least one target, with the incidence maximum (82%) for the small children (age group 0–4 years). The five dominant virus groups were rhinovirus (RV, 12%), influenza virus A (IAV, 7%), adenovirus (AdV, 6%), respiratory syncytial virus (RSV, 5%), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, 5%). The specimens with multi-detections represented 19% of the positives, unevenly distributed (n = 225, 56, 43, 24) among the age groups 0–4, 5–14, 15–64, and 65< years, respectively. The dominant virus groups in multi-positive specimens were RV (53%), AdV (43%), and bocavirus (BoV, 35%)—in mutual pairs as well as all three together—followed by RSV (21%), and IAV (15%). Our study focused on the specimens with codetections and provides an insight into the variety of the respiratory virus interactions in Latvia during the first year since pandemic-related social restriction measures were eased. The observations also emphasise the need to consider the differentiation between rhinoviruses and enteroviruses, especially for the youngest patients in the age group 0–4.

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.

Trends in New Use of Disease-Modifying Antirheumatic Drugs in Juvenile Idiopathic Arthritis Among Commercially Insured Children in the United States from 2001-2022.

To describe recent trends in DMARD use for children with juvenile idiopathic arthritis (JIA) in the US. We used commercial claims data (2000-2022) to perform a serial cross-sectional utilization study of children ages 1-18 diagnosed with JIA. Initiations of conventional synthetic (cs), biologic (b), or targeted synthetic (ts) DMARDs were identified after a ≥12-month baseline and expressed as percentage of all new DMARD initiations per year, by category, class, and individual agent. Trends were evaluated using linear regression. Secondarily, we examined first b/tsDMARDs initiated after csDMARD monotherapy. We identified 20,258 new DMARD use episodes among 13,696 individuals (median age 14 years, 67.5% female). csDMARDs, while most commonly used overall, declined from 89.5% of new use episodes to 43.2% (2001-2022, p<0.001 for trend). In contrast, bDMARD use increased (10.5-50.0%, p<0.001). For tumor necrosis factor inhibitors (TNFi), etanercept peaked at 28.3% (2006) and declined to 4.2% (2022) (p=0.002). Meanwhile, adalimumab use doubled (7.0-14.0%, 2007-2008) after JIA approval, increasing further following a less painful formulation release (20.5%, 2022, p<0.001). However, overall TNFi use has declined with increasing use of other b/tsDMARDs, particularly ustekinumab, secukinumab, and tofacitinib. By 2022, adalimumab was the most common b/tsDMARD initiated first after csDMARDs (77.8%). Among commercially insured children with JIA in the US, new b/tsDMARD use is rising while new csDMARD use declines. For b/tsDMARDs, adalimumab is most used and the predominant b/tsDMARD initiated first after csDMARDs. Patterns in DMARD use for JIA have evolved relative to multiple factors, including regulatory approvals and tolerability.

Study protocol for a randomized controlled trial of Adapt 2 Asthma (A2A), a culturally relevant coping skills and asthma management intervention for Latinx Families

BackgroundLatinx children in the United States experience disparities in asthma control and asthma-related functional outcomes compared to non-Latinx White children, including more school absences, emergency department visits, and hospitalizations for asthma. Stress appears to play a role in asthma control, but interventions designed to address the role of stress in asthma control for Latinx children are limited.MethodThe current randomized controlled trial tests the effects of Adapt 2 Asthma (A2A), a family-based coping skills and asthma management intervention tailored to the stressors, strengths, and cultural beliefs of Latinx families, compared to an asthma self-management control arm (the Asthma Plan for Kids; APK). Latinx families of children ages 8 to 14 years old with asthma (target N = 280) are identified and enrolled from primary care clinics and randomly assigned to either A2A or APK. The intervention is delivered by lay health workers trained and receiving ongoing consultation from the study team. The primary outcome is child- and parent-reported asthma control, while secondary outcomes are child’s quality of life, lung function, school absences, and emergency department visits, and child and parent coping and family asthma management behaviors. Participants will be assessed at baseline, post-intervention, and at 6- and 12-month follow-up timepoints.DiscussionThis study has the potential to provide new evidence regarding the effects of culturally relevant coping and asthma management intervention strategies for Latinx children with asthma.Trial RegistrationClinicaltrials.gov NCT05118282. Registered on 11 November 2021.

Prediction values of fat-soluble vitamin of growth retardation in children aged 1–6 years

BackgroundRetardation among children is a persistent global health concern. Vitamin deficiency in childhood may contribute to growth retardation; however, its causal effects are not fully understood.ObjectiveHere, we aimed to explore the prediction values of fat-soluble vitamin levels on GR in children aged 1–6 years.Methods614 children aged from 1 to 6 years at Nantong Maternal and Child Care Health Hospital between January 2021 and December 2022 in this retrospective observational study participated in the assessment of developmental status and blood detection of vitamin from peripheral blood (PB). The relationship between vitamin levels and GR was analyzed by Multivariable logistic regression analysis.ResultsDevelopmental assessment results showed that 132 cases from 614 with growth retardation (21.50%). Statistical analysis showed children with GR were more likely to be males (59.45% vs. 40.55%, p = 0.191). The age of children with GR was significantly higher than those without GR (p &amp;lt; 0.01). Importantly, the levels of various fat-soluble vitamins in GR individuals were significantly lower than those in normal individuals. ROC analysis showed that vitamin E, vitamin A and 25(OH) D3 were less effective in predicting GR model (AUC: 0.87, 0.74, and 0.65,). However, the combination of vitamin E, vitamin A and 25(OH)D3 with age was effective in predicting GR. (AUC: 0.84, 0.77, 0.75).ConclusionThe combination of 25(OH)D3, Vitamin E, Vitamin A with age may have good predictive performance for children GR aged 1–6 years.

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.

Детское население Дивногорска 1960-х – 1990-х гг.[1

The article examines the processes of formation and development of the child population in the young small town of Divnogorsk (Krasnoyarsk Territory) during the 1960s and 1990s, based on data from population censuses conducted. The authors compare changes in average age, number, and proportion of children between Divnogorsk and Krasnoyarsk as well as the urban population as a whole, taking into account the fact that Divnogorsk arose in a sparsely populated area near Krasnoyarsk in the late 1950s, grew, and developed primarily as an industrial city. The formation of Divnogorsk’s child population occurred in three stages. The first is primary, with a high proportion of younger children in the population. The second is transitional, with a stable distribution of children by age groups and a significant percentage of pre-adolescent populations. And the final one is the third, at which point the children’s population in Divnogorsk ceases to differ qualitatively from that of other cities in terms of its characteristics.

Risk Factors and Outcome of Acute Kidney Injury in Children with Diabetic Ketoacidosis

Background: Children with diabetic ketoacidosis (DKA) suffer from several complications. Among them acute kidney injury (AKI) is one of the grave complications. Objectives: To determine the risk factors for development of AKI in children (age &lt;15 years) with DKA and observe the outcome of these children. Method: An observational study was done in Department of Paediatrics, BIRDEM General Hospital, Dhaka, Bangladesh from January 2019 to December 2020. During study period, we observed all children with DKA who developed AKI. Data of clinical and biological variables were taken from hospital records and analysed. The parameters of children with AKI were compared with children with DKA who did not develop AKI. Then outcome of the children with AKI were measured. Statistical analysis was done by using SPSS version 23. Results: Among 73 children with DKA, 16 (21.9%) children developed AKI. Children were divided into two groups, DKA with AKI and DKA without AKI. No statistically significant differences were found in demographic features of children in both groups. We observed that, delay in initiation of treatment, low Glasgow Coma Scale (score- &lt;8), haemodynamic failure, severe acidosis and sepsis were significant risk factors of developing AKI. Out of 16 children with AKI, 9(56.2%) patients needed peritoneal dialysis and 7(43.7%) responded to fluid resuscitation. Complete resolution occurred in 13(81.2%). Total mortality in DKA children was 13(17.8%). Among them 84.6% children died due to AKI. Conclusions: This study documented that 21.9% of children with DKA developed AKI. Among them mortality was 84.5%. BANGLADESH J CHILD HEALTH 2023; VOL 47 (1) : 30-33

Changes in healthcare seeking behaviors among caretakers of children in the previously occupied ISIS territory: Hadeetha, Anbar, Iraq: a cross-sectional survey of 415 households.

The western province of Anbar, and the district of Hadeetha, have suffered direct impacts from the second United States led invasion (2003) through the ISIS invasion (2014-2017). With the primary health care centers being closed or inaccessible, the remaining population experienced changes in health seeking. The area of Anbar, Iraq remains largely remote from the discourse of health system recovery post-conflict. The objective of this study was to describe changes in health seeking behaviors of caregivers of children ages 12-72months of age in Hadeetha, Anbar, Iraq from the conflict period of ISIS (Islamic State of Syria and Iraq), 2014-2017, to the post-conflict period, 2021. This was a mixed-methods study composed of a cross-sectional 415 household survey and focus groups in Hadeetha, Anbar, Iraq. Caretakers of children were interviewed from February to April 2021. Children were sampled from a list of children who missed at least one vaccination appointment without a return for follow-up from the birth cohorts of 2014 to 2020. Healthcare workers focus groups and key informant interviews occurred from 2019 to 2021 centered around experiences from the 2014 to 2021 period. In the post-conflict period, there were no differences in health seeking based upon provider type between respondents. Physicians were primary healthcare providers in the post-conflict period for 79% of respondents versus only 47% in the conflict period. Healthcare workers described major barriers to delivering services in Hadeetha during the ISIS occupation due to infrastructure damage, threats of violence, decreased medical personnel, lack of compensation and disruptions in medical supplies from 2014 to 2017. This study provides insight into health seeking challenges among the many individuals who remained in Hadeetha during the ISIS occupation. Health use patterns by provider type mirror the concerns the healthcare providers shared: limited availability, efflux of professional workers, limited resources and security challenges to providing care. Positive trends toward increased access to physicians during periods of peace are an encouraging marker for continued population resilience during the post-conflict period. Recovery efforts continue to be hampered by internal sectarian discord within Iraq as well as insufficient resources to maintain health services as well as provide catch-up health services, such as immunizations.

Association Between Adequate Sleep and Participation in Occupational Areas in School-Age Children.

Adequate sleep tailored to children's age is important for their well-being. This study aimed to examine the association between adequate sleep and children's participation in occupational areas. This study was a retrospective cross-sectional analysis of secondary data obtained from the 2020 National Survey of Children's Health in the United States. This study included 6,818 children aged 6 to 11 years. The mean age was 8.48 years (standard deviation = 1.72). Multivariate regression models revealed that adequate sleep was significantly associated with increased participation in occupational areas (17% more in leisure, 95% confidence interval [CI]: 1.11-1.23; 15% more in play, 95% CI: 1.07-1.22; 11% more in education, 95% CI: 1.01-1.22) in school-age children, but not with participation in work and social participation. Adequate sleep is associated with increased participation of school-age children in occupational areas.

Immigration‐related stress, depression, and positive parenting among undocumented Central American immigrant mothers

AbstractObjectiveThe purpose of the current study was to examine whether immigration‐related stress is associated with reduced positive parenting and whether this association is mediated by depressive symptoms in undocumented Central American immigrant mothers.BackgroundIn the context of “illegality,” parents can face myriad stressors related to their immigration status, which may lead to heightened emotions, including depressed mood. These experiences may affect family life, including the ways in which immigrant mothers parent their children.MethodThis study examined survey data generated in 2016–2017 by researchers using a community‐based participatory action research approach in partnership with Central American immigrant mothers residing in the Washington, DC, region. The sample for this study included 117 undocumented Central American immigrant mothers of children aged 3 to 11 years.ResultsControlling for age of child, mother's education, and relationship status, analyses revealed that immigration‐related stress was associated with heightened levels of depressive symptoms for mothers. However, mothers' symptoms of depression were not associated with positive parenting. Additionally, no association between immigration‐related stress and positive parenting was found.ConclusionsFindings suggest that mothers, although affected by immigration‐related stress in terms of their own mood symptoms, may deploy mechanisms such as parental self‐sacrifice to protect their children from anti‐immigrant harms.ImplicationsFindings hold implications for future research, including research approaches, and practice.

Predictors of polytrauma outcome in children on the first day of treatment in ICU

The objective was to identify predictors of polytrauma outcome in children on the first day of treatment in ICU.Materials and methods. Design – multicenter, cohort, retrospective, observational study. 225 children with polytrauma were examined. The average age of children was 10 (4–14) years. There were 148 (65.8%) boys. In 65.2% of cases, the injury was received as a result of a traffic accident, catatrauma occurred in 32.6% of polytrauma. The AIS score was 34 (25–48) and the PTS score was 5 (2.0–8.0). The duration of artificial lung ventilation was 12 (0–97) hours, and treatment in ICU – 5 (2–8) days. Death was in 14.2% of cases. Results. An increase in Glasgow Coma Scale (GCS) and SpO2 by one unit (1 point, 1%) was found to reduce the risk of adverse outcome by 44% and 9%, respectively, and an increase in creatinine concentration and international normalized ratio by one unit increased the probability of patient death by 4.3 and 15.8 times, respectively. A mathematical formula was developed to assess the risk of an unfavorable outcome of polytrauma in children at the time of admission to the ICU: OR = exp (3.74–0.58 · [GCS score] – 0.09 · [SpO2] + 0.06 · [Creatinine] + 2.62 · [INR]. Its accuracy is 96.4%; sensitivity 83.4%; specificity 98.7%.Conclusion. Predictors of unfavorable outcome of polytrauma in children at admission to ICU are low scores on the Glasgow Coma Scale, severe hypoxemia, coagulopathy and kidney damage.

Firearm-Related Unintentional Childhood Injury in Israel.

The rise in demand for firearm licenses in Israel due to the ongoing 2023-2024 Israel-Gaza War, coupled with the easing of regulations for issuing weapons, is expected to lead to a significant increase in the incidence of firearms among civilians. This situation calls for a special awareness of civilian populations of the dangers posed to children by the high prevalence of firearms. We therefore present trends in firearm-related incidents resulting in unintentional mortality and morbidity of children ages 0-17 between the years 2008-2023 in Israel. In total, 202 accidents involving firearms were reported, with an average age of 12.2 (median: 13), and with the youngest child being 2 years old. Of these, 24 cases resulted in fatalities18 of which of children of Arab descent. We provide several recommendations concerning changes and additions to current bylaws concerning firearms licensing and storage in Israel, in order to decrease the risk of child injury due to irresponsible firearm handling.

Evaluation of Complementary Feeding Indicators Among Children Aged 6–23 Months According to the Health Literacy Status of Their Mothers

Background/Objectives: Infant and young child feeding (IYCF) practices directly affect child health, development, and survival, especially under 2 years of age and ultimately affect adult life well-being. As the primary caregivers of the children, mothers with higher health literacy may better perceive the benefits of optimal complementary feeding practices, leading to improved health outcomes for their children. In this study, we aimed to assess complementary feeding practices among children aged 6–23 months in Turkey according to 2021 World Health Organization IYCF indicators [minimum dietary diversity (MDD); minimum meal frequency (MMF); minimum acceptable diet (MAD); egg and/or flesh food consumption (EFF); sweet beverage consumption (SwB); unhealthy food consumption (UFC); zero vegetable or fruit consumption (ZVF); and bottle feeding (BoF)] and investigate their associations with sociodemographic characteristics and mothers’ health literacy. Methods: With a descriptive study design, we reached 572 mothers of children aged 6–23 months from five regions of Turkey. We used the Turkey Health Literacy Scale-32 (TSOY-32) to assess mothers’ health literacy. Results: While maternal and child age are significantly associated with more complementary feeding practices, specifically MDD, MAD, and EFF, having multiple children has negative impacts on several complementary feeding indicators, including MDD, MMF, MAD, UFC, and ZVF. The only indicator associated with mothers’ TSOY-32 scores was zero fruit and vegetable consumption. Conclusion: Raising awareness among mothers about the importance of complementary feeding practices and identification of vulnerable groups will guide practitioners and policymakers to improve child health and nutrition.

Evaluation of the ActiMotus Software to Accurately Classify Postures and Movements in Children Aged 3–14

Background: ActiMotus, a thigh-accelerometer-based software used for the classification of postures and movements (PaMs), has shown high accuracy among adults and school-aged children; however, its accuracy among younger children and potential differences between sexes are unknown. This study aimed to evaluate the accuracy of ActiMotus to measure PaMs among children between 3 and 14 years and to assess if this was influenced by the sex or age of children. Method: Forty-eight children attended a structured ~1-hour data collection session at a laboratory. Thigh acceleration was measured using a SENS accelerometer, which was classified into nine PaMs using the ActiMotus software. Human-coded video recordings of the session provided the ground truth. Results: Based on both F1 scores and balanced accuracy, the highest levels of accuracy were found for lying, sitting, and standing (63.2–88.2%). For walking and running, accuracy measures ranged from 48.0 to 85.8%. The lowest accuracy was observed for classifying stair climbing. We found a higher accuracy for stair climbing among girls compared to boys and for older compared to younger age groups for walking, running, and stair climbing. Conclusions: ActiMotus could accurately detect lying, sitting, and standing among children. The software could be improved for classifying walking, running, and stair climbing, particularly among younger children.