Children In City Research Articles

A global overview of Bike Bus: A journey toward a child-friendly city

Cities are still far from being child-friendly for cycling. Cycling with children in low-cycling cities poses specific challenges, requiring high confidence and skills. Active travel-to-school programs aim to promote cycling among children, and one of these programs, Bike Bus, has recently captured considerable attention. Bike Bus is an initiative where families cycle together to school following a fixed route and schedule. This study aims to trace the origins of this initiative worldwide, explain the current momentum behind the movement, identify their diversity, and reflect on their long-term sustainability. We reached 431 Bike Buses through a mixed-methods design, including archival analysis, an online survey, and 22 interviews. Bike Bus had a plural origin in Europe in the late twentieth century. Moving more than 35,000 children in a week, its expansion has been driven by the joy it brings to participants, the growing interest in climate action, and social media. This is the first study that examines the characteristics of different Bike Buses and analyzes the particularities of this initiative. On average, the rides have 29 participants and travel 2.8 km. We compare route characteristics, participants, goals, and relationships with their respective city councils. Finally, while not all initiatives aim to last, access to long-term funding and committed organizers are the best enablers for sustainability over time. Bike Bus’ powerful nature lies in its simultaneous purposes: active mobility to school, activism, and joy. To ensure longevity, organizers could collaborate with local administrations to secure resources while maintaining advocacy for child-friendly cities.

Characteristics of the respiratory season in 2022—23 and 2023—24 according to data from the city children's hospital

The end of the COVID-19 pandemic in the respiratory disease season of 2022—23 was characterized by an increase in the number of cases, a shift in the classic peaks of morbidity for various infections, and a predominance of influenza and respiratory syncytial virus infection (RSVI). Materials and methods. When compared with the last pandemic season, a later start of the 2023—24 respiratory season was noted with a gradual shift to the usual pre-pandemic period timing of viral morbidity increases. Results. The currently prevailing SARS-CoV-2 Omicron variant has acquired the properties of a common respiratory viral infection, currently all-season, with a mild course, without the need for hospitalization. The number of patients with influenza has decreased and there were no patients with a severe course of this infection. A feature of the first post-pandemic season was the outbreak of mycoplasma infection, which was a reason of large number of pneumonia cases.

Collaboration to Reduce Sudden Unexpected Infant Death With Child Fatality Review and Outreach.

Sudden unexpected infant death (SUID) is the leading cause of postneonatal infant mortality in the United States, with disproportionately high rates in Baltimore City and Baltimore County in Maryland. This Advocacy Case Study describes the collaboration between the City and County Child Fatality Review teams to decrease infant mortality. B'more for Healthy Babies, formed in 2009 by the Bureau of Maternal Child Health in Baltimore City with the goal of reducing infant mortality through policy change, service improvements, community mobilization, and behavior change has had a sustained effort to respond to SUID. Recognizing that infants born in Baltimore City often reside in Baltimore County (and vice versa), collaboration with Baltimore County has been essential to increasing B'more for Healthy Babies' scope, reach, and effectiveness. Public health messaging campaigns, creation, and dissemination of a "SLEEP SAFE" testimonial video, and Safe Sleep Summits have involved caregivers, healthcare providers, and community partners. Outcomes of this ongoing collaboration demonstrate a decrease in sleep-related infant mortality rates. Our findings also highlight the need for continued, real time monitoring of sleep-related infant mortality trends with a coordinated, multidisciplinary, and crossjurisdictional response. This initiative can serve as a model of cross-sector communication that can be replicated in other similar geographic locations to further reduce SUID.

Analisis Perlindungan Hukum Terhadap Anak Korban Kekerasan Seksual di Dinas Pemberdayaan Perempuan dan Perlindungan Anak Kota Tanjungbalai

The aim of this research is to find out how the Office of Women's Empowerment and Child Protection has attempted to implement legal protection in accordance with Law Number 35 of 2014 concerning Amendments to Law Number 23 of 2002 concerning Child Protection against cases of sexual violence against children, as well as to find out efforts made by the Tanjung Balai City Women's Empowerment and Child Protection Service to help child victims of sexual violence. This research was conducted at the Women's Empowerment and Child Protection Service in Tanjungbalai City, North Sumatra. The method used in this research is a qualitative descriptive research method. The qualitative descriptive method has the main characteristics, namely conducting research involving direct involvement in the field, acting as an observer, creating categories of actors, observing phenomena, recording them in an observation book, not manipulating variables, and focusing on scientific observation. The data collection technique used to obtain data is through interviews and documentation. The results of this research found that the efforts of the Tanjung Balai City Women's Empowerment and Child Protection Department have been running optimally, in accordance with Law Number 35 of 2014 concerning Amendments to Law Number 23 of 2002 concerning Child Protection against cases of sexual violence against children. The form of legal protection used is in the form of preventive and repressive legal protection. One of the programs being implemented is synchronizing and coordinating the prevention of violence against children, which is expected to reduce the number of cases of sexual violence against children in Tajung Balai City.

Selective screening for celiac disease in patients with gastrointestinal symptoms: a retrospective study

Background. Currently, the effectiveness of various screening programs for celiac disease remains a matter of debate. According to most researchers, selective screening among patients with characteristic symptoms or at-risk groups is most effective. Aim. To evaluate the effectiveness of selective screening for celiac disease in patients with gastrointestinal symptoms. Materials and methods. In an open retrospective clinical study, the rate of celiac disease among 1,482 children who were examined in the Bashlyaeva Children's City Clinical Hospital and the most significant symptoms of the disease depending on age were identified. Results. The mean rate of celiac disease was 8.26%: from 6 months to 3 years 7.25%, from 4 to 7 years 10.28%, from 8 to 14 years 9.33%, and in adolescents from 15 years and older 4.05%. The most significant symptoms of the disease in young children were abdominal distension/flatulence, asthenia, and weight loss; preschool children had stool disorders (constipation, diarrhea), abdominal distension/flatulence, and anemia. At the age of 8–14 years, only nausea was statistically significantly associated with celiac disease. We have not identified any significant symptoms in the older age group. Conclusion. Our study has shown the high effectiveness of selective screening for celiac disease. The selective screening program is most effective in children of early and preschool age, which defines this age category as a target for introducing screening programs in medical check-ups before enrollment to preschool institutions and schools.

THE EFFECT OF CONSUMING YOGHURT ON THE SALIVARY PH OF MILDLY MENTALLY RETARTED CHILDREN

The percentage of people with disabilities in Indonesia is 56% and the prevalence of dental caries in children with disabilities reaches 82.6%. One alternative to prevent dental caries is by consuming probiotic drinks such as yogurt. Yoghurt is sour milk produced by fermenting milk and the group of probiotic products most accepted by children. Objective: This study aims to determine the effect of consuming yogurt on the pH of saliva of children with mild deformities SLB Patriot Tasikmalaya City. Methods: The type of research used is a quasi experiment research method with a one group pre-test and post-test research design with a sample of 20 mildly retarded children. The research measuring instrument used a pH meter, and the data was analyzed using a paired sample t-test. Results: Based on the results of the paired sample t-test statistical test, the p-value = 0.001 (p < 0.05) means that there is an effect of consuming yogurt on the pH of the saliva of mildly retarded children of SLB Patriot Tasikmalaya City. Conclusion: Consuming yogurt regularly for seven days can increase salivary pH in mildly retarded children.

Early diagnosis of stroke risk factors in high school students in Makassar, South Sulawesi, Indonesia

The number of stroke patients in Indonesia is ranked as the first country to experience the most strokes in all of Asia. The prevalence of stroke in Indonesia reaches 8.3 out of 1000 population. This prevalence rate increases with increasing age. Indonesian national data shows that stroke is the highest cause of death, at 15.4%, with approximately 750,000 strokes per year in Indonesia and 200,000 recurrent strokes. People who are physically inactive (those who exercise less than three times per week, each for 30 minutes) have an almost 50% increased risk of stroke compared to those who are active. Physical inactivity can lead to weight problems and increased blood pressure and is associated with diabetes, all of which are important risk factors for stroke. Inactivity also contributes to the onset of early atherosclerosis and other cardiovascular diseases, such as heart attacks. This study is an analytical observational study with a cross sectional design to see and observe the risk factors for stroke that exist in school children in Makassar city. Data processing was carried out using computer application programs and SPSS version 22.0 with data analysis methods using the Chi Square Test with the Yate's Correlation formula in SPSS called Continuity Correction and Risk. The number of respondents studied was 896 people. Hypertension is a major risk factor for health problems in society, especially in socioeconomic transition. Hypertension is a primary risk factor for the onset of heart disease and stroke. Doing physical activity will prevent us from various diseases, by doing adequate physical activity we can suppress the increase in blood sugar levels, cholesterol levels, and avoid obesity and strengthen the heart. All of which are risk factors for stroke. So thus by doing adequate physical activity we can avoid stroke. There is a relationship between gender, obesity, hypertension, family history of disease, stress, physical activity, risky diet and smoking on stroke risk factors and there is no relationship between age and knowledge with stroke risk factors.

Effectiveness of the Walkbot system in patients with infantile cerebral palsy

BACKGROUND: Estimating the effectiveness of robotic mechanotherapy is crucial in the rehabilitation of children with cerebral palsy. AIM: To evaluate the effectiveness of the Walkbot robotic complex (Walkbot, Korea) in children with cerebral palsy. MATERIALS AND METHODS: The study included 35 patients with infantile cerebral palsy who received courses of rehabilitation therapy based on the state autonomous institution “City Children’s Polyclinic No. 7.” A comparative analysis of the functional motor outcomes between two groups of children with cerebral palsy was performed. Group 1 was treated with locomotor therapy on the Walkbot, whereas group 2 was not prescribed with the apparatus. RESULTS: The effect of using the Walkbot mechanotherapeutic complex on functional motor outcomes in patients with infantile cerebral palsy was evaluated. Better dynamics of the level of motor skills development on the GMFM-66 scale was noted in group 1 (by 6.8% in group 1 and 4.1% in group 2; p=0.006). The Hauser index (p=0.05) indicated an improvement in locomotor function, which increased the level of independence in everyday life according to the FIM scale (p=0.044), compared to the data of children in the control group. Attaining the effect depends on the number of procedures and total number of rehabilitation courses. CONCLUSION: Children with cerebral palsy who received the Walkbot therapy have better motor outcomes, primarily relating to locomotor function.

Dental fear and anxiety of preschools Ha'il city children

Dental fear and anxiety of preschools Ha'il city children

The Effect Of Playing Collage On The Development Of Fine Motorics In Preschool Children

The low development of children's fine motor skills preschool. This can be seen when children do collage play activities, many children are not neat in making collage patterns.To determine the effect of playing collage on the fine motor development of preschool children in the kindergarten Keiynan Dan Mawadah Warohmah Palembang City In 2021.This type of research is pre-experimental design with one group pretest posttest. The study population was all children in KB keiynan dan KB Mawadah Warohmah Kota Palembang. The sampling technique is Simple Random Sampling. The number of samples is 26 respondents who have met the inclusion and exclusion criteria. Data analysis techniques using the Wilcoxon. Based on the results of bivariate test results using the Wilcoxon, a significant value is obtained (ρ-value = 0,000), so <0.05.There is an effect of playing collage on the fine motor development of preschool children in the kindergarten Keiynan Dan Mawadah Warohmah Palembang City In 2021.The results of this study can be used as consideration and reference for those who want to further develop research in the same field, especially in improving the fine motor skills of preschool children.

중국 학령후기 아동이 지각한 어머니의 과보호와 학교적응 간의 관계: 아동의 기본심리욕구 만족 및 좌절의 이중 매개효과

Objective: This study examines the dual mediating effects of basic psychological needs satisfaction and frustration on the relationship between maternal overprotection as perceived by Chinese late school-age children and their school adjustment. Methods: The subjects encompassed 329 fifth to sixth grade children in city R, China. Pearson correlation and mediation analyses were performed on the collected data using Process macro (Model 4) in SPSS 25.0Results: First all major variables showed significant correlations with each other. Second, the analysis of the dual mediating effects revealed that the satisfaction of basic psychological needs mediated the relationship between maternal overprotection and school adjustment whereas frustration did not. Conclusions: Maternal overprotection and children's basic psychological needs are important in Chinese children’s school adjustment. Basic psychological needs satisfaction and frustration emerged as different mediating paths in the relationship between maternal overprotection and children's school adjustment.

Risk Factors Associated With COVID-19 Infection Among Schools’ Children in Basrah City / Iraq

Background: COVID-19 pandemic has been the most important global issue since December 2019. has led to overloading of health systems all over the world. Objective: The study aims to identify the risk factors associated with COVID-19 infection among schools’ children in Basrah city / Iraq. Methods: A cross-sectional study was carried out by using a pre-tested applied structured questionnaire among 1980 children. This sample was distributed throughout fifteen schools were selected using simple random sampling techniques. Finally, a simple random sampling method was used to select study participants. conducted from March1st, 2022, to May 1st, 2024. Both descriptive and inferential statistics were used in the data collection and analysis process. Results: The findings showed the distribution of participants according to Corona infection: The children included in the study suffered from Corona infection at a rate of 27.2%. 60.3% do not have Corona infection, and 12.5% answered “possibly infection.” The children at risk of contracting Corona infection were under 18 years of age and had middle school as an educational level respectively, 81.9% and 51.8%. They suffered from chronic diseases and also suffered from an allergy to the vaccine: 34.8% and 27%. They received the Corona vaccine type Pfizer, respectively, 37.9% and 36.3%. They had symptoms similar to the disease when taking the vaccine, 22.6%, and they used sterilization to sterilize hands, 42.8%. Also, 31.1% of them always avoid touching their noses and eyes with unwashed hands, 27.8% always maintain a social distance of no less than two meters, and 45.8% avoid shaking hands, hugging, and kissing during greetings. Conclusions: This study concludes that among the risk factors studied, there was a relationship between these factors and the Corona infection in children.

Evaluation of attempted suicide events through oral intake among children in a metropolitan city: A single-center study

Evaluation of attempted suicide events through oral intake among children in a metropolitan city: A single-center study

Epidemiological investigation of allergic rhinitis in children aged 6-12 years in Bayannur City, China.

Allergic rhinitis (AR) is an inflammatory condition of the nasal mucosa triggered by exposure to non-harmful substances. Over the past decade, the prevalence of AR in Chinese children has been steadily increasing. However, detailed epidemiological data on AR in children from Bayannur City are lacking. This study randomly selected six primary schools in Bayannur City. Electronic questionnaires were distributed via the web, and parents and children completed the questionnaires by scanning the two-dimensional code within a designated timeframe. Statistical analysis was performed on the collected data. A total of 4,754 valid responses were obtained. The self-reported prevalence of AR among children in Bayannur city was 39.79%. Multivariate analysis revealed that male gender, belonging to an ethnic minority, a history of food or drug allergies, frequent antibiotic use (≥3 times per year in the past two years, with each course lasting ≥3 days), and residence in urban or pastoral areas was associated with an increased prevalence of AR in children. The proportion of children experiencing moderate to severe AR hat impacted their studies or daily life was 48.78%. Chronic AR was reported in 56.71% of cases. Among AR patients with other allergic conditions, the incidence rates were as follows: bronchial asthma 35.99%, upper airway cough syndrome (UACS) 64.32%, secretory otitis media (SOM) 22.41%, obstructive sleep apnea hypopnea-syndrome (OSAHS) 49.58%, allergic dermatitis (AD) 48.72%, and allergic conjunctivitis (AC) 85.20%. The prevalence of AR was 50.30% in urban areas, 13.733% in rural areas and 20.90% in pastoral areas. Seasonal effects on AR prevalence were notably significant in urban and pastoral regions. The prevalence of AR among children in Bayannur city was 39.80%. Of those with AR, 48.72% experienced significant impacts on their learning or daily life, while only 14.80% had no other allergic conditions. There were significant variations in the prevalence and onset of AR among children between urban, agricultural and pastoral areas.

Quality of life assessment with SIBDQ in children with upper gastrointestinal pathology

Functional and organic diseases of the digestive system today occupy one of the leading places in the structure of somatic pathology of childhood and adolescence and negatively impact young patients’ quality of life. Among the gastrointestinal tract diseases, the first place is occupied by the pathology of the gastroduodenal zone in children. Gastrointestinal diseases rarely occur in isolation in the form of damage to only the upper or lower parts of the digestive system, especially in childhood. Therefore, in the presence of dysfunction symptoms and pathological changes in the upper gastrointestinal tract, it is advisable to use non‑invasive means to diagnose pathological changes in the lower gastrointestinal tract. Objective — to analyze the quality of life using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) in children and adolescents with upper gastrointestinal tract pathologies. Materials and methods. The study involved 174 children who visited the Kharkiv city children’s clinical hospital No 19 with complaints about upper gastrointestinal disorders (7—18 years old). Patients were interviewed using the self‑reported inflammatory bowel disease quality of life questionnaire SIBDQ, which assesses physical, social and emotional well‑being (the result is determined from 10 to 70 points, where 10 is the worst condition). Results. The median SIBDQ score for the entire sample was 51 points [Q1; Q3: 45; 58], with 47.1±3.7% of respondents having up to 50 points. In girls, the median was significantly lower than in boys — 49 [40; 55] versus 55 [49.0; 65.5] (pU=0.05). According to the nature of the endoscopic picture, 55% of children with gastroesophageal and duodenogastric reflux, 38.6% of children with erythematous duodenopathy, 45.9% of children with erosive and ulcerative changes and 61.5% of patients with esophagitis had a low SIBDQ score. Boys with low SIBDQ scores were more prone to gastroesophageal and duodenogastric reflux. All other endoscopic changes were significantly more common (p <0.05) in girls with less than 50 points according to the survey results. Conclusions. In 47% of children with complaints of upper gastrointestinal dysfunction, the quality of life score was low by the SIBDQ (< 50). The median SIBDQ score in girls was significantly lower than in boys: 49 [40; 55] versus 55 [49.0; 65.5] points (pU=0.05), respectively. Girls with instrumentally confirmed esophagitis had significantly lower SIBDQ scores compared to boys with esophagitis and girls with other gastrointestinal disorders — 41.5 [37; 46] (p <0.05). The use of the SIBDQ questionnaires in school‑age children and adolescents is advisable not only for lower gastrointestinal tract diseases but also for gastroduodenal zone diseases.

Basic principles of treatment and follow-up of children with acute odontogenic infection and insulin-dependent diabetes mellitus

The purpose of the study is to substantiate the basic principles of treatment and clinical dental observation of children with acute odontogenic inflammatory disease and insulin-dependent diabetes mellitus as an accompanying disease. Material and methods. A medical examination was conducted for 213 children who were treated at the St. Petersburg city children’s hospital of K.A. Raukhus of. The dental status of children with insulin-dependent diabetes mellitus and children of the control group without concomitant diseases was assessed using the Fedorov-Volodkina index, the KPU index and analysis of the caries intensity according to the T.F. Vinogradova table, periodontal conditions according to the PMA index (papillary-marginal-alveolar). The state of microhemocirculation of periodontal tissues was also assessed using Doppler ultrasound and the use of a reflex cold test. In children diagnosed with “Acute odontogenic osteomyelitis of the jaws,” laboratory blood parameters, the composition of the microbial flora of wound discharge, and the length of hospitalization were studied. Results. Based on the data obtained, an algorithm for treatment and dispensary dental observation of children with diabetes was presented. The detection of diabetes mellitus in children of any age should be accompanied by increased attention to the dental health of these patients. If teeth affected by caries are identified during a preventive examination, immediate treatment is required. It is necessary to ensure constant follow-up of the child by an endocrinologist. Doppler examination of the microhemocirculatory bed vessels of the mucosa of the alveolar process of the jaw revealed that an adequate response to a reflex cold test was detected only in the control group patients, those who do not have insulin-dependent diabetes mellitus. With the development of acute odontogenic osteomyelitis of the jaw in children suffering from insulin-dependent diabetes mellitus, hospitalization is necessary when the first clinical symptoms of the inflammatory process appear. Immediately after hospitalization and immediate surgical sanitation of a purulent focus of infection in the oral cavity, drug therapy should be started: antibacterial, infusion, symptomatic, as well as insulin therapy. The results of this study are especially relevant in the treatment of children with a duration of insulin-dependent diabetes mellitus of more than 5 years and a decompensated course of endocrine disease. Conclusions. The results of the study allowed us to expand our understanding of the impact of diabetes on the oral health of children, to establish risk factors for the development of acute odontogenic osteomyelitis of the jaws in children of different age categories with insulin-dependent diabetes mellitus, as well as the characteristics of the course of odontogenic osteomyelitis of the jaws in each of the cases. Based on the identified features, the principles of diagnosis and treatment of acute odontogenic osteomyelitis of the jaws in children with insulin-dependent diabetes mellitus have been formulated.

Molar Incisor Hypomineralization: Prevalence and Treatment Needs in 7- to 9-year-old Children of Lucknow City.

Molar incisor hypomineralization (MIH) is one of the most common developmental disturbances that dental practitioners encounter, which may influence the child's quality of life and can impact their future dental health. To determine prevalence and treatment needs of MIH in children of Lucknow. A total of 800 children aged 7 to 9 years were clinically screened for the presence of MIH. All demographic details were filled in by the examiner in communication with the parents, and examination was performed using the Würzburg MIH concept. The overall prevalence of MIH in the children examined was 5.12%. A higher prevalence was found in males (7%) than in females (3.25%). The distribution of MIH was higher in the mandibular arch than in the maxillary arch. Mandibular molars were the most affected teeth, followed by maxillary incisors, and the least affected teeth were maxillary molars. On the basis of severity, 55.14% of teeth with MIH had no breakdown or hypersensitivity followed by 30.14% of teeth with hypersensitivity but no breakdown, and 7.35% of teeth had both hypersensitivity and breakdown. Based on severity, in 39.70% of teeth, the intervention suggested was fluoridated toothpaste, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) remineralizing agent, and varnish application. This was followed by the application of sealants and low-viscosity glass ionomer cement (GIC) in 38.97% of teeth, and in 7.35% of teeth, short- and long-term restorations, including stainless steel crown (SSC), were recommended. Prevalence of 5.12% was observed in children of Lucknow city. The characteristics of MIH defects were predictive of the treatment of the affected first permanent molars and incisors and can guide their management. Chowdhury AR, Singh N, Rathore M. Molar Incisor Hypomineralization: Prevalence and Treatment Needs in 7- to 9-year-old Children of Lucknow City. Int J Clin Pediatr Dent 2024;17(7):790-795.

Clinical and laboratory characteristics of Toxocara canis infection among children in Ho Chi Minh City, Vietnam.

This study determines the clinical and paraclinical characteristics of children with Toxocara canis infection and serum eosinophil cut-off values for predicting toxocariasis in the group displaying symptoms of itching, urticaria and erythema. A cross-sectional study was conducted during March and April 2023 with a sample size of 986 children aged 3-15 y. In total, 140 (14.2%) of the 986 participants had anti-T canis antibodies. The most frequently experienced symptoms in this group were itching (10.1%), abdominal pain (8.2%) and urticaria (3.3%). The rate of IgE increased (37%), and the rates of mild and high eosinophilia were 38% and 2.2%, respectively. There were significant differences in IgE concentration and eosinophil count, and for both IgE concentration and eosinophil count between the two groups with and without toxocariasis. The optimal threshold for eosinophil to predict toxocariasis was 0.38 K/µL, with itching, urticaria and erythema resulting in a sensitivity of 61.5%, a specificity of 82.1% and a receiver operating characteristic curve (area under the curve) of 0.71. This study confirmed a positive association between IgE concentration, eosinophil count and positive serology for T. canis. A general blood count, including eosinophils, is a simple test that can be performed in hospitals. Clinicians should target and screen for T.oxocara canis infection when children display clinical symptoms of itching, urticaria, erythema and eosinophilia. NCT05208333.

The effects of heavy screen viewing on the health of secondary school-aged children in Duhok city

Background and objectives: Although there has been a remarkable increase in screen time among children over recent years, the literature includes contradictory reports on its effects of the individuals' health. In this regard, the present study was an attempt to figure out the effects of heavy screen time on the health of secondary school-aged children in Duhok city, Kurdistan-Iraq. Methods: A cross-sectional study was conducted on 850 secondary school students aged 14- 18 years, from September 2022 to September 2023 in Duhok secondary schools. Data about screen viewing were gathered through a questionnaire. then data were analyzed via SPSS (version 25.0). Chi-square were used and 0.05 was set a level of significant. Results: The students aged 14-18 years, with the largest group being 18 years of age (38.4%). Most of the students (59.4%) were females. Grade 12 students were the largest group (57.3%). Most of them (76.2%) were from middle-income families and (65.4%) had healthy body mass index. Significant associations were found between the students' screen time and their age (P-value<0.001), gender (p-value<0.001), parents' education (P-value<0.001), parents' occupation (P-value<0.05), and socioeconomic status (p-value=0.014). Moreover, significant associations were found between their screen time duration and their medical problems (P-value<0.001), previous surgical operation (p-value=0.008), mood during the day (P-value<0.001), relationship with parents (p-value=0.003), sleep difficulties (p-value=0.002), and eating during screen viewing (p-value<0.001). Conclusions: Most adolescence in Duhok city have excessive screen time (more than two hours) in which affects their health and quality of life adversely. Health practitioners and families should consider these factors while designing and implementing adolescent health promoting programs.

Gunshot Wounds to the Head: 29 Cases of Monocenter Children's Trauma Hospital Experience and Predictor Scales in Pediatric Population

Gunshot wounds to the head (GSWTH) in children remain an underexplored area, and all clinical guidelines extrapolated from adult experiences. A key challenge in treating these patients is age stratification, as pediatric survival rates are notably higher than in adults. The objective of the study is to compare 2 groups of patients based on the severity of their condition and to analyze the impact of various factors on the outcomes of these conditions. A single-center retrospective cohort study was conducted. Patient records of individuals (from birth to 18years old) with craniocerebral injuries caused by GSWTH and treated at Morozov Children's City Hospital between 1992 and 2015 were comprehensively reviewed. Data analysis included clinical presentation, computed tomography scan findings, injury site and trajectory, Glasgow Coma Scale and Glasgow Outcome Scale scores, and the St. Louis Scale. A total of 29 pediatric patients (79% male, 21% female, median age 8years) with GSWTH were analyzed. The mortality rate was 17%. A transventricular wound trajectory was found in 17% of patients and was associated with a poor prognosis (P < 0.001). The Glasgow Coma Scale showed insufficient specificity in injury severity assessment. A multiple logistic regression model predicting injury severity based on bullet type, gender, and time to admission had an accuracy of 80%, while a Decision Tree model improved accuracy to 96.6%. A stacking model combining multiple logistic regression and Decision Tree increased sensitivity to 87.5% and explained 65.5% of the variance. The findings emphasize the importance of a multifactorial approach in children with GSWTH, highlighting its effectiveness for precise outcome prediction.