Child Age Research Articles

The relationship between feeding practices and stunting among children under two years in Tanzania mainland: a mixed-method approach

BackgroundProper infant and young child feeding practices have gained attention over the years as one of the interventions to reduce childhood stunting. However, there is still a gap in research to determine these relationships in children under two years and the reasons for improper feeding.ObjectiveThis study aimed to assess the relationship between feeding practices, stunting and barriers among children under two years.MethodologyUtilizing a mixed-method approach, the study involved secondary analysis of 1806 records of children aged 6–23 month, from the Next Generation Nutrition Program conducted in Tanzania (2015–2019). Both quantitative and qualitative data analyses were employed. Frequency distribution tables were utilized to describe study participants stratified by their stunting status. Subsequently, modified Poisson regression models identified predictors of stunting. Qualitative analysis encompassed deductive and inductive approaches, to extract themes that address the behaviors contributing to inappropriate feeding practices.ResultsStunting prevalence was 28.8% among children aged 6–23 months, with the majority (65%) of stunted children aged 1 year or older. Dietary diversity was low: 88.3% and 86.3% of stunted and non-stunted children, respectively, consumed less than 5 food groups. Surprisingly, early initiation of breastfeeding, time of stopping breastfeeding, and minimum dietary diversification were not significantly associated with child stunting (p-value > 0.05). Barriers to proper feeding practices identified were inadequate knowledge of feeding, maternal condition, economic hardship, cultural issues, and seasonality.ConclusionEarly breastfeeding and minimum dietary diversity were not significant predictors of stunting. However, the mother’s age and height > 150 cm reduced stunting risk while child sex, age, birth weight, marital status, and place of delivery also influenced stunting risk. It is crucial for initiatives to emphasize good feeding practices while addressing the complex factors that may hinder optimal feeding practices in this age group to reduce childhood stunting effectively.

Prenatal Cannabis Exposure and Executive Function and Aggressive Behavior at Age 5 Years

Cannabis use during pregnancy is increasingly common in the US and may affect the development and behavior of preschool-aged children. To prospectively investigate the association of prenatal cannabis exposure with executive function and aggressive behavior at age 5 years. This cohort study was conducted from 2016 through 2020. Data analysis was conducted from 2022 through 2024. Patients aged 16 through 50 years who were able to communicate in English and intended to deliver at the Ohio State University Wexner Medical Center were enrolled in a pregnancy research repository. Participants (n = 355) who gave consent for future contact and whose child(ren) was presumed to be alive were invited to participate again at child age 5 years (children born May 25, 2010, through February 7, 2016) and 250 children participated (70%). Cannabis exposure was measured prospectively by urine toxicology, maternal self-report, and obstetric record abstraction. Executive function and aggressive behavior, measured via multimodal assessment by staff masked to exposure status. Outcomes were chosen a priori. Of 250 children, 80 were exposed to cannabis (32%). Use of tobacco, other drugs, and alcohol during pregnancy was common (22% to 39% each). Most families were living in poverty. There were 155 children who were Black/African American, non-Hispanic (62%); 11 were Hispanic (4%); 34 indicated more than one race or another race, non-Hispanic (14%); and 50 were White, non-Hispanic (20%). Age-corrected standard scores for children's attention and inhibitory control (National Institutes of Health Toolbox) were about 0.4 SDs lower for those exposed to cannabis compared with unexposed (β = -6.1 points; 95% CI, -10.8 to -1.4), following propensity score weighting and adjustment for confounders. Exposed children also exhibited poorer task-based planning ability and more observed aggression. Caregiver ratings of executive function and behavior and laboratory assessments of other aspects of executive functioning showed no differences by exposure status. Results from this contemporary US cohort where prenatal cannabis exposure was common and indicated that exposed children exhibited some differences in aspects of executive function and behavior relevant to long-term academic success and adaptive functioning. These results may be considered in refining clinical recommendations regarding cannabis use during pregnancy.

Differences in the work-family experience of mothers and fathers of a southern European country

Abstract Background The intense childrearing years often coincide with the heightened work demands and responsibilities of the career-building years. We aimed to evaluate the association between family-life stage and men’s and women’s experience of work and private demands, and the conflict between these demands. Methods We evaluated 3532 mothers and 731 fathers as part of the Portuguese population-based birth cohort Generation XXI (2018-2020). Data on family-life stage (exposure), work demands, private demands, and work-to-family conflict (outcomes) were retrieved at the 13-year follow-up wave, as well as data on sociodemographic and household characteristics. Family-life stage was operationalized according to the age of the youngest child: stage 1 (≤5 years), stage 2 (6-11 years), and stage 3 (≥12 years). Ordinal logistic regression models were used to estimate associations. Results Men reported more frequently long working hours, while women spent more time on household and child-related tasks. After adjustment for parents’ and household characteristics, mothers and fathers with younger children were more likely to report spending more time on child-related tasks (ORmothers = 1.83; 95%CI 1.44, 2.33; ORfathers = 2.36; 95%CI 1.41, 3.94), compared to those with older children. Fathers with younger children were also more likely to report spending more time on household tasks (OR = 2.20; 95%CI 1.30, 3.73 for routine tasks and OR = 1.75; 95%CI 1.03, 2.97 for sporadic tasks). Mothers exhibited a significant association between family-life stage and time-based work-to-family conflict when they had younger children (OR = 1.24; 95% CI 1.05, 1.47 for family-life stage 2 and OR = 1.28; 95% CI 1.00, 1.63 for family-life stage 1). Conclusions Both fathers and mothers with young children experienced increased private demands, but only mothers experienced work-to-family conflict. This reveals that family and working arrangements remain marked by a gendered pattern against women.

Early life social predictors of longitudinal relations between childhood BMI and overeating

Abstract Introduction The progression of obesity is a continuous process involving a complex system of genetic, environmental, and behavioural factors. Socioeconomic disadvantage as well as psychological distress may lead to overeating, subsequently associated with increased energy intake and weight gain. Recent evidence indicated that the association between childhood obesity and overeating might be bidirectional. Therefore, this study aimed to longitudinally investigate the directionality of the association between childhood BMI and overeating and to identify antecedent early childhood predictors. Methods The study sample included 5,777 children from the European Longitudinal Study of Parents and Children (ELSPAC), collected between 18 months and 11 years of child age. The outcomes were child BMI and overeating. Predictors included maternal BMI, maternal education, single-parent households, financial difficulties, and adverse childhood experiences (ACEs). The random intercept cross-lagged panel model (RI-CLPM) was applied. Results The results showed temporal stability in the development of overeating and BMI, with a bidirectional relationship that strengthened over time. The child’s BMI was predicted by maternal BMI (β = 0.37, p < 0.001). The child’s overeating was predicted by maternal BMI (β = 0.13, p < 0.001), but a stronger effect was found for ACEs (β = 0.24, p < 0.001). ACEs mediated the impact of maternal education, financial difficulties, and single parenthood on overeating with indirect effects of β = -0.01 (p = 0.005), β = 0.04, (p < 0.001), and β = 0.07 (p < 0.001), respectively. Conclusions We observed stable bidirectional longitudinal effects, with a stronger association from BMI to overeating. The results suggested two main pathways: one linked to maternal BMI and early childhood BMI increase followed by overeating, and the other associated with ACEs mediating the effect of early childhood socioeconomic factors on overeating, leading to gradual BMI gain. #NGEU Key messages • The study revealed a stable bidirectional association between childhood BMI and overeating, with a stronger association from BMI to overeating. • There are two potential pathways in childhood obesity development, one involving maternal BMI, and the second associated with social disadvantage and ACEs.

School travel behaviors: How the pandemic impacted communities

The global pandemic in early 2020 significantly disrupted life for many families, and the trip to and from school was not immune to these disruptions. Parents and children alike made travel adjustments depending on their preferences with regard to personal health and safety, social distancing, and aversion to risk. Each school district and individual school also made decisions with regard to in-person or remote learning during this period of uncertainty.In this study, a research gap was filled by examining the effect of the pandemic on school transportation-related decisions for hundreds of families living in the United States. An online survey was developed and administered with the help of Qualtrics, an experience management company. Over 600 responses were gathered from across three Pacific Northwest states. In addition to collecting demographic data about the respondents, the survey asked about travel mode choices and characteristics of the trip to and from school. The collective results were then analyzed to determine which factors directly contributed to pandemic-related changes in travel behavior.The study concluded that parent education level, household income, and age of child were all statistically significant variables that affected behavioral change. Additionally, common travel assumptions associated with rural students, when compared with urban students, were confirmed. These factors included a greater reliance on a yellow school bus and lesser availability of critical infrastructure.

Sources of Variability in Remote Communication Between Deployed Military Fathers and Their Children

SYNOPSIS Objective. The extents to which external barriers to communication, parental stress and intimacy, child psychological adjustment and age together and uniquely are associated with the frequency and quality of remote communication between deployed military fathers and their children were explored. Findings based on data reported by deployed fathers and at-home mothers were also compared. Design. Survey data were collected from 72 military deployed fathers and their wives/partners about the fathers’ communication with their 4- to 17-year-old children. Questions concerned the frequency and relationship quality of father-child remote communication and hypothesized predictors of communication extracted from the parent-child communication literature. Results. Regression analyses revealed that, as a group, external barriers to communication, parental stress and intimacy, child psychological adjustment and age predicted the quality but not the quantity of father-child remote communication and that lower quality father-child communication as reported by both parents was associated with child externalizing behavior problems. Parental stress was associated with lower father-reported quality of communication, and parental intimacy was associated with higher mother-reported quality of communication. Child older age was associated with father reported lower quality of communication. Conclusions. The quality of deployed father-child communication is associated with parental and child variables known to be associated with father-child communication when parent and child are in the same location, suggesting that interventions for improving co-located father-child relationships may be adaptable for use when military fathers and children are separated.

Desmopressin dosing in children using real-world data and pharmacokinetic/pharmacodynamic model simulations.

Variability in pediatric dosing of desmopressin (ddAVP) in AVP-deficiency (AVP-D) is well-documented but dosing recommendations are limited. This study evaluates and optimizes ddAVP dosing regimens in children with AVP-D using pharmacokinetic and pharmacodynamic (PK/PD) simulations. Retrospective electronic health record review was done to identify children (<18 years) with AVP-D on ddAVP evaluated in the outpatient setting using ICD 9 and 10 codes. A previously developed PK/PD model from Michelet et al was used to simulate ddAVP concentrations and urine rates based on a child's age and ddAVP dose. The effects of demographic characteristics (age, weight, etc.) on dose and urine rate were investigated through simulations to optimize doses of ddAVP for children who were wet overnight. A total of 276 dosing records were identified among 53 children with AVP-D. Simulations indicated that in children under 5 years of age who were wet overnight, increasing the outpatient dose to 50 mcg was predicted to decrease urine rate to a pattern similar to those who remained dry. An initial outpatient dose of at least 50 mcg for children between 1 and 5 years of age would improve efficacy of ddAVP. 50 mcg is likely a safe initial outpatient dose of oral desmopressin tablet for young children 1-5 yrs of age with central Diabetes Insipidus/AVP-Deficiency. We confirmed that desmopressin doses vary greatly in children with central Diabetes Insipidus/AVP-deficiency. Real-world clinical data can be leveraged to improve medication dosing in rare diseases.

Participation in the Missouri Parents as Teachers Parent Education Program and third grade math and English language arts proficiency

The Missouri Parents as Teachers (PAT) Parent Education Program is a voluntary and universal home visiting program available to all Missouri families who are expecting a child or who have a child ages birth to kindergarten entry. Families participating in the Missouri PAT Parent Education Program receive a variety of family support services, including family personal visits with trained parent educators to develop parent practices and child school readiness. Research indicates that home visiting components of parent education programs support child academic outcomes. However, studies have not extensively examined how variation in participation, including the developmental period of exposure—the child's age upon entry and duration of participation—and number and frequency of home/family visits, is associated with child outcomes. In this study, we used linear probability regression to examine associations between variation in participation in the Missouri PAT Parent Education Program and child third grade proficiency in math and English language arts (ELA) (n = 9777), while controlling for relevant child, parent, family, and school-level factors. We also tested the potential moderating role of family low-income status at enrollment into the program. We found that the number of family personal visits was positively associated with third-grade math and ELA proficiency, whereas no significant findings emerged for developmental period of program exposure. Our findings indicate that increased exposure to the Missouri PAT Parent Education Program was positively associated with third-grade academic achievement for all children, including those from low-income families.

Evaluating the Economic Impact of the PedAMINES App in Reducing Medication Errors in Pediatric Emergency Care: Cost-Effectiveness Analysis.

The administration of drugs in pediatric emergency care is a time-consuming process and is associated with a higher occurrence of medication errors compared with adult care. This is attributed to the intricacies of administration, which involve calculating doses based on the child's weight or age. To mitigate the occurrence of adverse drug events (ADEs), the PedAMINES (Pediatric Accurate Medication in Emergency Situations; Geneva University Hospitals) mobile app has been developed. This app offers a step-by-step guide for preparing and administering pediatric drugs during emergency interventions by automating the dose calculation process. Although previous simulation-based randomized controlled trials conducted in emergency care have demonstrated the efficacy of the PedAMINES app in reducing drug administration errors, there is a lack of evidence regarding its economic implications. This study aims to evaluate the cost-effectiveness of implementing the PedAMINES app for 4 emergency drugs: epinephrine, norepinephrine, dopamine, and midazolam. The economic evaluation was conducted by combining hospital data from 2019, previous trial outcomes, information extracted from existing literature, and PedAMINES maintenance costs. The cost per avoided medication error was calculated, along with the number of administrations needed to achieve a positive return on investment. Subsequently, Monte Carlo simulations were used to identify the key parameters contributing to result uncertainty. The study revealed the number of preventable errors per administration for the 4 examined drugs: 0.513 for epinephrine, 0.484 for norepinephrine, 0.500 for dopamine, and 0.671 for midazolam. The cost-effectiveness ratios per ADE prevented were computed as follows: US $4808 for epinephrine, US $9705 for norepinephrine, US $6957 for dopamine, and US $2074 for midazolam. Accounting for the economic impact of ADEs, the analysis estimated that 16 administrations of epinephrine, 17 of norepinephrine and dopamine, and 13 of midazolam would be required to attain a positive return on investment. This corresponds to roughly one-third of the annual administrations at a major university hospital in Switzerland. The primary factors influencing the uncertainty in the estimated cost per ADE include the cost of maintenance of the app, the likelihood of an ADE resulting from an administration error, and the frequency of underdosing in the trial's control group. A dedicated mobile app presents an economically viable solution to alleviate the health and economic burden of drug administration errors in in-hospital pediatric emergency care. The widespread adoption of this app is advocated to pool costs and extend the benefits on a national scale in Switzerland.

Early Childhood Cholestasis, Causes &amp; Associated Factors in Children

Background: Newborn cholestasis is explained as a persisted rise of the serum conjugated bilirubin outside the first two weeks of life. There are many etiologies of newborn cholestasis that must be differentiated since immediate interference may give a better outcome. Objective: Newborn cholestasis is explained as a persisted rise of the serum conjugated bilirubin outside the first two weeks of life. There are many etiologies of newborn cholestasis that must be differentiated since immediate interference may give a better outcome. Patients and Methods: A cross-sectional research of forty-eight children consulting the Childhood Wellbeing Teaching Hospital in Baghdad/Medical City from 1st of November 2018 to the 30th of November 2021, complete evaluation by full history, physical checkup and laboratory studies. Cholestasis was demarcated as an extended raise of the levels of conjugated bilirubin outside the 1st 2 weeks of age above 1.0mg/dl(17.1µmol/l) if the whole serum bilirubin(TSB) is &lt;5.0 mg/dL or above 20% of the TSB if the TSB is &gt;5.0 mg/dl. Results: Out of 48 children involved in the study ,62.5% resided in Baghdad, and the remainder was belonged to other districts. The mean age of children was 11.1 months. The males constituted 58.3% of them. Eleven cases (22.9%) were caused by congenital infection, nine 18.8% had no cause detected, while 16.7% caused by biliary atresia and 16.7% had unidentified etiology, however 10.4% was related to sepsis. Biliary atresia was more frequent in boys in 62.5% compared to 37.5% in females. Family history was positive only in11.1% of idiopathic neonatal hepatitis. It was found that 81% of cholestatic jaundice were caused by congenital infection. In comparison, 62.5% caused by biliary atresia and 60% caused by sepsis appeared on the second week of the child's age, and this difference was significant statistically P-value 0.01. Conclusion: Innate infections are the most frequent source, where CMV contagion is the most commonly detected. Clinical findings included clay colored stool &amp; elevated alkaline phosphatase concentrations observed primarily on biliary atresia. There are no specific test to identify the etiology of newborn cholestasis.

Interpersonal Relationship Between Parents and Its Impact on Mental Health of Children

The family plays an important role in the development of a person as an active participant in the life of society. When a child is born and grows up in a family, the system of relationships in the family that has been developing for years has an impact on the child's psychology. They are influenced by the interpersonal relationships of adults in the family with each other and with their children, i.e. communication, behavior, and attitude toward the child. This effect ultimately affects the child's way of understanding the world, his attitude toward the environment, and even his way of thinking. It would be wrong to consider this effect as negative or positive in the same direction. Because under certain conditions, a child's susceptibility to family influence can have different results depending on how he reacts to these influences. If the educational influence exerted by adults can be compared with existing social norms, the child will most likely follow the model that is considered positive for him. But life experience and observations show that the educational power of the family, especially in the child's preschool age, is high, and during this period the influence of adults in the family on the child can be of primary importance. Therefore, we have sufficient grounds to speak about a direct connection between personality traits and even the formation of a way of thinking and methods of educational influence in the family. Keywords: interpersonal relationship, parents, mental health of children, development

Maternal Obesity and Differences in Child Urine Metabolome.

Background/objective: Approximately one-third of pregnant individuals in the U.S. are affected by obesity, which can adversely impact the in utero environment and offspring. This study aimed to investigate the differences in urine metabolomics between children exposed and unexposed to maternal obesity. Methods: In a study nested within a larger pregnancy cohort of women-offspring pairs, we measured untargeted metabolomics using liquid chromatography-mass spectrometry in urine samples from 68 children at 4-8 years of age. We compared metabolite levels between offspring exposed to maternal obesity (body mass index [BMI] ≥ 30.0 kg/m2) vs. unexposed (maternal BMI 18.5-24.9 kg/m2) and matched them on covariates, using two-sample t-tests, with additional sensitivity analyses based on children's BMI. This study reports statistically significant results (p ≤ 0.05) and potentially noteworthy findings (fold change > 1 or 0.05 < p < 0.15), considering compounds' involvement in common pathways or similar biochemical families. Results: The mean (SD) maternal age at study enrollment was 28.0 (6.3) years, the mean child age was 6.6 (0.8) years, 56% of children were male, and 38% of children had a BMI in the overweight/obese range (BMI ≥ 85th percentile). Children exposed to maternal obesity had lower levels of 5-hydroxyindole sulfate and 7-hydroxyindole sulfate and higher levels of secondary bile acids. Phenylacetic acid derivatives were lower in offspring exposed to obesity and in offspring who had a current BMI in the overweight/obese range. Exposure to maternal obesity was associated with lower levels of androgenic steroid dehydroepiandrosterone sulfate (DHEA-S). Conclusions: In this preliminary study, children exposed to maternal obesity in utero had differences in microbiome-related metabolites in urine suggestive of altered microbial catabolism of tryptophan and acetylated peptides. Some of these differences were partially attributable to the offspring's current BMI status. This study highlights the potential of urine metabolomics to identify biomarkers and pathways impacted by in utero exposure to maternal obesity.

Maternal childhood trauma, caregiving behavior, and child cognitive development in the context of drug addiction.

Exposure to childhood trauma confers intergenerational risk on child development. However, the mechanism linking a mother's childhood trauma with her child's cognitive development remains poorly understood. This study recruited 71 mother-child dyads affected by substance use disorder from local, community-based, outpatient substance use treatment programs. Maternal exposure to childhood trauma, caregiving behavior, and child cognitive development were assessed in each mother-child dyad. These were measured through a comprehensive biopsychosocial interview, an observed dyadic interaction coded using the Coding Interactive Behavior system, and the Bayley Scales of Infant and Toddler Development, Screening Test, respectively. We hypothesized that compromised caregiving behavior would mediate a negative relationship between maternal childhood trauma and child cognitive development. Analyses did not support this hypothesis. Specifically, maternal childhood trauma was not significantly associated with child cognitive development nor the four dimensions of maternal caregiving behavior. However, caregiving behavior (specifically maternal sensitivity and limit setting) was associated with child cognitive development, when controlling for maternal childhood trauma and child age. The lack of associations observed suggests that protective factors may buffer the intergenerational impact of childhood trauma. Furthermore, the relationship between quality of caregiving and child cognitive development highlights the importance of interventions which foster sensitive caregiving behaviors that may bolster child cognitive development in the context of maternal substance use disorder and maternal childhood trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The housing environment and its effect on Hispanic children with asthma

IntroductionSubstandard housing in Hispanic minority communities has been associated with detrimental effects on children with asthma that is affected by diverse indoor triggers. Identifying those triggers and offering adequate medical treatment and ways to prevent exposure to triggers will help reduce the number of asthma attacks among children who reside in Hispanic minority communities.ObjectiveOur study aimed to identify the influence of substandard housing quality and its effect on asthma symptoms. Our objectives included assessing the impact of building, flooring types, heating sources, window shading, parental smoking behaviors, moisture and mold in the home, ventilation, and owning a pet on asthma symptom occurrence.Materials and methodsOur study was based on a cross-sectional analytical study involving 353 individuals, their parents, and their homes. Logistic regression modeling was conducted to explain the dependence of each asthma symptom on the investigated independent variables, with child age and sex being investigated as covariables. A post hoc test was employed to ensure goodness of fit, and a pseudo-R square was calculated for each regression model. The Hosmer-Lemenshow test was performed post hoc to ensure goodness of fit, and models were preserved if p > 0.05.ResultsThe overall prevalence of asthma-related symptoms in our study sample was 19.37%, and sleeping quality was affected due to asthma in 23% of participating children. We also found that children living with asthma near agricultural fields were more prone to asthma-related symptoms, as well as those children living in homes with excessive moisture and those who kept stuffed toys or pets inside their rooms.ConclusionsOur study highlights how a variety of environmental factors, such as living near an agricultural area and having curtains, increases shortness of breath. Having leaks and excessive moisture in houses increases shortness of breath, wheezing, coughing, and rates of colds. Another important exposure is having a pet inside the house which increases chest tightness. A comprehensive understanding of these factors and how they impacted targeted participants, especially those who are Hispanic minorities and living in substandard housing, is essential for informing the design of effective interventions and improving respiratory health in the home environment.

80 Yearly change in child zBMI and the COVID-19 pandemic in Canada: A cohort study

Abstract Background Emerging literature suggests accelerated weight gain in children during the pandemic; however, data from Canadian children are limited and individual factors underlying this trend remain unclear. Objectives To determine whether the COVID-19 pandemic was associated with increased yearly change in age- and sex-standardized body mass index (zBMI) in Canadian children and whether staying at home during the pandemic was associated with increased change in zBMI per year. Design/Methods A repeated-measures longitudinal study was conducted with children from an existing practice-based research network in Canada age 1-18y with at least one zBMI measurement pre- and post-onset of the pandemic. Height and weight were measured through primary care office visits and supplemented with at-home parent measurements post-pandemic. Weekly questionnaires were used to measure days stayed at home per week. Piecewise linear mixed effects models accounting for repeated measures through random effects were used to assess yearly change in zBMI. A knot location was placed at the start of the pandemic (March 14, 2020) to compare slopes pre- and post-pandemic onset. Similar mixed effects models were used to explore the association between days at home per week and change in zBMI post-pandemic onset. Stratification by sex and a sensitivity analysis in children with clinic-measured anthropometrics were explored. All models were adjusted for covariates identified a priori. Results In the overall population (n=849 children, 5070 observations), there was no significant difference in slope for yearly change in zBMI post-pandemic (Mar 2020-Sept 2022) compared to prior (Oct 2004-Mar 2020) in fully adjusted models accounting for child age, sex, maternal ethnicity, maternal BMI, family income, birthweight, breastfeeding duration, anthropometrics measurement method (clinic vs parent) and pre-COVID zBMI (post-COVID β=0.03; 95%CI -0.02,0.08; pre-COVID β=0.009; 95%CI-0.009,0.027; p-interaction=0.46). In children with clinic-measured anthropometrics (n=849, 4318 observations), there was a significant increase in yearly change in zBMI after the onset of the pandemic in the fully adjusted model (β=0.07; 95%CI 0.02,0.12) compared to prior (β=0.004; 95%CI -0.01,0.02; p-interaction=0.01). This was driven by changes in boys (post-COVID β=0.08; 95%CI 0.007,0.15; pre-COVID β=-0.003; 95%CI-0.03,0.02; p-interaction 0.04). In boys with clinic-measured anthropometrics post-pandemic onset (n=77 children, 85 observations), there was marginal evidence for increase in yearly zBMI change for every additional day at home per week in the fully adjusted model (β=0.16; 95%CI -0.006,0.32; p=0.06). Conclusion The COVID-19 pandemic was associated with accelerated increase in zBMI per year in Canadian children with clinic-measured height and weight, particularly among boys. Potential competing interests Funding was obtained by J.J. Joseph Jamnik for consultant work for Nutrigenomix Inc, a University of Toronto start-up which offers evidence-based genetic testing for personalized nutrition. Consulting work terminated July 1, 2023. This relationship is unrelated to the work submitted. Research funding: Understanding and mitigating the impacts of the COVID-19 pandemic on children, youth and families in Canada - Operating Grant. CIHR grant 468613. 2021-2024.

Prevalence and Predictors of Stress Among Caregivers of Children with Developmental Disorders.

Medical care advances pose challenges with rising caregiving costs and fewer informal caregivers, shifting healthcare responsibilities to families. Healthcare systems adapt to technological changes, stressing person-centered care but lack support for caregivers. Addressing parental stress is crucial, given its impact on both parent and child well-being, highlighting the necessity for customized support. The study aimed to evaluate caregivers' perceived stress and its connection with socio-demographic factors and children's characteristics. Conducted at a Rehabiltation Institute's Psychology Outpatient Department, 200 mothers were enrolled using non-probability consecutive sampling. Ethical clearance was obtained, and demographic data were collected. The mean perceived stress score (PSS-10) was 31.94, indicating a positive correlation between stress and socio-demographic and disability-related variables. Significant differences in stress levels were observed between joint and nuclear family caregivers, p < .01, and those with daughters versus sons with disabilities < 0.001. Pearson's correlation analysis revealed positive correlations between perceived stress and caregiver p = < 0.001 and child age p = < 0.001, number of children p = < 0.001, and time since diagnosis p = < 0.001, with negative correlations with caregiver education p = < .001and income p = < 0.001. Multiple linear regression indicated that caregiver and child age, time since diagnosis, and the number of children positively predicted while income and education of the caregiver negatively predicted perceived stress. No significant association was found between other variables like family volunteers' education, disability type, and caregiver stress. Caregivers exhibited high perceived stress levels, highlighting the reciprocal relationship between child characteristics and parental stress, emphasizing the need for comprehensive family interventions.

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.

Obesity in childhood - literature review and educational recommendations

Introduction and purpose Childhood obesity is a major global health concern. The World Health Organization reports that the prevalence of obesity in children and adolescents has increased significantly from 4% in 1975 to over 18% in 2016. The aim of the study is to conduct a comprehensive review of the literature on obesity among children and adolescents, emphasizes the importance of prevention, identification and effective management of childhood obesity. Materials and methods An extensive examination of articles published in scientific journals was carried out through online research platforms PubMed and Google Scholar. We searched articles by entering keywords in appropriate configuration: “childhood obesity”, “pediatric overweight”, “physical activity”, “activity and health”, “diet and obesity", "bariatric surgery" and "obesity medication". State of knowledge Treating childhood obesity requires following a personalized weight loss program, as well as adopting healthy eating habits and lifestyle practices. Improvements in metabolic and anthropometric indices can be achieved through complex interventions including dietary modification and physical activity, behavioral therapy, health promotion education, pharmacological treatment and bariatric surgery A step-by-step approach to managing weight is recommended, considering the child's age, the severity of obesity, and any accompanying health conditions. Dietary interventions focus on promoting a balanced, nutrient-rich diet that is calorie-appropriate for the child's age and gender. Summary Further research is still necessary to develop additional pharmaceutical options, refine surgical techniques, and better understand long-term outcomes in this patient population.To effectively prevent this disease, a comprehensive approach is necessary, considering both education and changes in the social environment.

The Relationship Between Hair Zinc Levels, Feeding Patterns, and Infectious Diseases on The Incidence of Stunting in Children Aged 24-59 Months in The City of North Jakarta, Province of DKI Jakarta

Globally, stunting is a severe public health concern, especially in low- and middle-income nations like Indonesia. It is typified by stunted growth and development due to recurrent infections and chronic malnutrition. North Jakarta has a 19.8% stunting incidence, according to the 2023 Indonesian Health Survey. This indicates the critical need for additional research into the factors contributing to stunting, such as hair zinc levels, dietary habits, and infectious infections. This study employs an observational case-control design conducted in North Jakarta in March 2024. Stunting incidence and hair zinc levels are significantly correlated (p=0.000), affecting 87.5% of children with low hair zinc levels. Stunting is also correlated considerably (p=0.000) with incorrect feeding patterns; 75.7% of children who exhibit these patterns are stunted. On the other hand, there was no statistically significant correlation (p=0.806) between the incidence of stunting and a history of infectious illnesses. The mother's level of education, the child's age, gender, and family income did not significantly correlate with stunting.

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.