Control Children Research Articles

Myopia Control in Children

<p>本文主要探討了兒童近視的控制方法以及散瞳劑的選擇。根據近年的研究和統計數據，兒童近視在台灣成為重要健康議題，各年齡兒童之近視率皆呈現不斷上升的趨勢。為了減緩近視的進展，多種治療方法被提出，包括鏡片光學矯正、角膜塑型片、散瞳劑等。</p> <p>光學矯正方面，漸近多焦點鏡片和雙光鏡片等被用來改善近視度數的控制。周邊離焦鏡片如DIMS (Defocus Incorporated Multiple Segments)和H.A.L.T. (Highly Aspheric Lenslet Target)技術的鏡片被設計用來穩定形成周邊近視離焦，以減緩近視的進展。多焦點隱形眼鏡也展現出在減緩近視控制方面的效果。此外，角膜塑型片是另一種常見的方法，它能夠改變角膜弧度，減緩近視的發展。</p> <p>長效散瞳劑阿托平Atropine在台灣兒童近視治療中具有重要地位，並被廣泛使用。Atropine可以阻斷眼球對看近物的調節作用，減少近距離看物對眼軸的刺激，進而減少眼軸伸長的可能；然而，使用Atropine時也伴隨著一些副作用，如瞳孔放大、畏光和影像模糊等，以及可能發生如過敏性皮膚炎等不良反應；並由於其抑制副交感神經的作用，在特定病人中禁止使用。不同濃度的Atropine之間其副作用與控制近視的效果有所差異，研究結果顯示濃度越高的Atropine對於近視控制的效果越好，但考慮其相對副作用，眼科醫師會針對每人對不同濃度藥物的反應做出調整。然而，使用Atropine時在停藥後可能出現度數回彈的現象，因此不可驟然停藥。</p> <p>除了治療之外，預防近視也是避免度數加深的重要方法。由於現代兒童長時間接觸近視壓力的環境，因此，對於兒童而言，適當的用眼習慣和生活方式對於預防近視至關重要。例如，保持適當的閱讀距離、定期休息眼睛、以及減少長時間使用電子設備的時間。另外，定期接受眼科檢查也是確保早期檢測和處理近視的重要步驟。</p> <p> </p><p>This article discusses pediatric myopia treatment and selection of mydriatics in Taiwan. Childhood myopia rate has been rising, necessitating interventions like optical correction with glasses, orthokeratology lenses, and mydriatics.</p> <p>Optical correction involves progressive multifocal and bifocal lenses for myopia control. Peripheral defocus lenses like DIMS and H.A.L.T induce peripheral myopic defocus to help slow myopia progression. Multifocal contacts and orthokeratology lenses also help.</p> <p>Extensively used as a mydriatic for childhood myopia in Taiwan, atropine blocks accommodation to near objects, curbing axial elongation. Side effects include pupil dilation and blurred vision. Research favors 0.05% concentration for optimal effect with atropine, but abrupt discontinuation can lead to rebound myopia.</p> <p>Prevention is key. Prolonged exposure of today’s children to environments likely to cause myopia renders prevention measures, notably the development of good eye habits and healthy lifestyles, particularly important. Maintaining reading distance, taking eye breaks, and reducing device use are crucial. Regular eye exams help detect and manage myopia early.</p> <p> </p>

Perceptual training facilitates Mandarin tone production for preschoolers with cochlear implants: Evidence from acoustic analysis

This study primarily aimed to investigate the benefits of an established perceptual training in the production of lexical tones for Mandarin-speaking preschoolers with cochlear implants (CIs). Thirty-two pediatric CI recipients were tested in this study. Half of the child participants received five sessions of high variability phonetic training (HVPT) within a period of three weeks, whereas the other half served as control who did not receive the formal training. Production of Mandarin tones was recorded before the provision (pretest) and after (posttest) the completion of the training protocol, which was coded and analyzed acoustically with automatic pitch tracking implemented in the software of Praat. Results showed significantly enhanced concave characteristic of dynamic pitch contours for the trained children’s Mandarin tones produced in posttest relative to pretest using growth curve analysis. Moreover, a tonal ellipse analysis indicated significantly improved tone differentiability and tone hit rate from pretest to posttest following training. By contrast, no significant changes were observed in the control children between the two test sessions. The findings represent initial acoustic evidence of HVPT-induced benefits in lexical tone production for CI users, which supports the application of this perceptual training protocol to aural rehabilitation practice.

Early Initiation of Antiretroviral Therapy is Protective Against Seizures in Children With HIV in Zambia: A Prospective Case-Control Study.

Seizures are relatively common among children with HIV in low- and middle-income countries and are associated with significant morbidity and mortality. Early treatment with antiretroviral therapy (ART) may reduce this risk by decreasing rates of central nervous system infections and HIV encephalopathy. We conducted a prospective, unmatched case-control study. We enrolled children with new-onset seizure from University Teaching Hospital in Lusaka, Zambia and 2 regional hospitals in rural Zambia. Controls were children with HIV and no history of seizures. Recruitment took place from 2016 to 2019. Early treatment was defined as initiation of ART before 12 months of age, at a CD4 percentage >15% in children aged 12-60 months or a CD4 count >350 cells/mm 3 for children aged 60 months or older. Logistic regression models were used to evaluate the association between potential risk factors and seizures. We identified 73 children with new-onset seizure and compared them with 254 control children with HIV but no seizures. Early treatment with ART was associated with a significant reduction in the odds of seizures [odds ratio (OR) 0.04, 95% confidence interval: 0.02 to 0.09; P < 0.001]. Having an undetectable viral load at the time of enrollment was strongly protective against seizures (OR 0.03, P < 0.001), whereas history of World Health Organization Stage 4 disease (OR 2.2, P = 0.05) or CD4 count <200 cells/mm 3 (OR 3.6, P < 0.001) increased risk of seizures. Early initiation of ART and successful viral suppression would likely reduce much of the excess seizure burden in children with HIV.

Brain Volumes in Opsoclonus-Myoclonus Ataxia Syndrome: A Longitudinal Study.

Little is known about the longitudinal trajectory of brain growth in children with opsoclonus-myoclonus ataxia syndrome. We performed a longitudinal evaluation of brain volumes in pediatric opsoclonus-myoclonus ataxia syndrome patients compared with age- and sex-matched healthy children. This longitudinal case-control study included brain magnetic resonance imaging (MRI) scans from consecutive pediatric opsoclonus-myoclonus ataxia syndrome patients (2009-2020) and age- and sex-matched healthy control children. FreeSurfer analysis provided automatic volumetry of the brain. Paired t tests were performed on the curvature of growth trajectories, with Bonferroni correction. A total of 14 opsoclonus-myoclonus ataxia syndrome patients (12 female) and 474 healthy control children (406 female) were included. Curvature of the growth trajectories of the cerebral white and gray matter, cerebellar white and gray matter, and brainstem differed significantly between opsoclonus-myoclonus ataxia syndrome patients and healthy control children (cerebral white matter, P = .01; cerebral gray matter, P = .01; cerebellar white matter, P < .001; cerebellar gray matter, P = .049; brainstem, P < .01). We found abnormal brain maturation in the supratentorial brain, brainstem, and cerebellum in children with opsoclonus-myoclonus ataxia syndrome.

Genome-wide analysis of spina bifida risk variants in a case-control study from Bangladesh.

Human studies of genetic risk factors for neural tube defects, severe birth defects associated with long-term health consequences in surviving children, have predominantly been restricted to a subset of candidate genes in specific biological pathways including folate metabolism. In this study, we investigated the association of genetic variants spanning the genome with risk of spina bifida (i.e., myelomeningocele and meningocele) in a subset of families enrolled from December 2016 through December 2022 in a case-control study in Bangladesh, a population often underrepresented in genetic studies. Saliva DNA samples were analyzed using the Illumina Global Screening Array. We performed genetic association analyses to compare allele frequencies between 112 case and 121 control children, 272 mothers, and 128 trios. In the transmission disequilibrium test analyses with trios only, we identified three novel exonic spina bifida risk loci, including rs140199800 (SULT1C2, p = 1.9 × 10-7), rs45580033 (ASB2, p = 4.2 × 10-10), and rs75426652 (LHPP, p = 7.2 × 10-14), after adjusting for multiple hypothesis testing. Association analyses comparing cases and controls, as well as models that included their mothers, did not identify genome-wide significant variants. This study identified three novel single nucleotide polymorphisms involved in biological pathways not previously associated with neural tube defects. The study warrants replication in larger groups to validate findings and to inform targeted prevention strategies.

The Effectiveness of Emotion Validation Pop-Up Books on the Emotional Development of Preschool Children as a Control for Children’s Mental Health Emergencies

One of the psychological problems experienced by children is emotional mental problems which can result in unhealthy emotional and mental disorders. The incidence of this disorder is around 3-10%, in the United States it is around 3-7% while in Germany, Canada and New Zealand it is around 5-10%. In Indonesia, there are still no definite figures regarding the incidence, even though this disorder occurs quite often. The Emotion Validation Pop-Up Book Research contributes to Preschool Children increasing their understanding of felt emotions through an attractive display. This research uses a quasi-experimental design. The number of samples used in the treatment group and control group was 30 students at Kindergarten N Pembina Kab. Kendal uses a simple random sampling technique. Statistical analysis uses independent T test and paired T test. The results showed that the research showed an independent T test (0.000&lt;α) and paired T test (0.000&lt;α). This study concluded that there were differences in the emotional development of preschool children between the control and treatment groups and there were differences before and after in the treatment group in the use of the Preschool Children’s Emotion Validation Pop-Up Book.

An Investigation of Pediatric Case-patients With Invasive Haemophilus influenzae in Alaska, 2005-2011.

Haemophilus influenzae (Hi) can cause severe disease in children. This study aimed to identify risk factors related to invasive Hi disease in Alaska children and evaluate carriage in people around them. From 2005 to 2011, we investigated episodes of invasive, typeable Hi disease in Alaska children <10 years old. Three age-matched control children were enrolled for each case-patient. We evaluated oropharyngeal Hi carriage in people in close contact with Hi case-patients (contacts) as well as control children and their household members. Individual and household risk factors for illness and carriage were evaluated using questionnaires and chart reviews. Thirty-eight of 44 (86%) children with invasive, typeable Hi disease were recruited: 20 Hi serotype a (53%), 13 serotype b (Hib) (34%) and 5 serotype f (13%). Children with the invasive Hi disease were more likely than controls to have underlying health problems (67% vs. 24%, P = 0.001), other carriers of any Hi in their household (61% vs. 15%, P < 0.001), and inadequate Hib vaccination (26% vs. 9%, P = 0.005). People who carried Hi were younger than noncarriers (mean 12.7 vs. 18.0 years, P = 0.008). The carriage was clustered within case-patient households, with carriage in 19% of household contacts, while only 6.3% of nonhousehold contacts and 5.5% of noncontacts carried the Hi serotype of interest ( P < 0.001). Factors associated with invasive Hi disease in children included underlying health problems, household carriage and inadequate Hib vaccination. The high level of carriage in case-patient households is important to consider when evaluating treatment and prophylaxis strategies.

Effects of Task Interference on Kinematics and Dual-Task Cost of Running in Early Childhood.

Children aged 3-8 are in a critical period for motor development and postural control. Running is a basic motor skill that children need to master in early childhood. While running, children are prone to dangerous events such as falls. This study investigates the kinematic characteristics of running by children associated with different interference tasks, i.e., normalized running, cognitive dual-tasks, and obstacle crossing tasks, and provides a theoretical foundation for the interference mechanism of children's dynamic postural control and for screening of motor disorders. Two hundred children aged 3-8 were recruited. The BTS Bioengineering infrared motion capture system was used to collect spatiotemporal and kinematic running data under three tasks. Repeated measures of variance analysis were used to compare the effects of different interference tasks and ages on children's running signs. The main and interaction effect tests were compared by the Bonferroni method. The results and conclusions are as follows: (1) Running characteristics of early childhood are influenced by interference tasks and age. With interference tasks, the overall characteristics of running by children aged 3-8 showed an increasing trend in running cycle time and a decreasing trend in stride length, step length, cadence, and speed. (2) Both cognitive and obstacle crossing tasks had costs, and cognitive task costs were greater than obstacle crossing costs. Children adopted a "task first" running strategy with different interference tasks. When facing cognitive tasks, their overall joint motion decreased, and they reduced joint motions to promote task completion. When facing obstacle crossing tasks, because of the characteristics of the task itself, children increased joint motions to cope with interference. (3) In terms of age, the running characteristics showed a nonlinear development trend in various indicators, with a degree of recurrence and high variability in adjacent age groups. (4) The dual-task interference paradigm of "postural-cognition" can be used as a motor intervention tool to promote the development of basic motor skills in early childhood.

Effects of Helicopter Parenting, Tiger Parenting and Inhibitory Control on the Development of Children's Anxiety and Depressive Symptoms.

Helicopter parenting and tiger parenting may increase the risks of anxiety and depression in children. However, it is unclear how these parenting styles affect the developmental outcomes and trajectories of anxiety and depressive symptoms, and how children's internal inhibitory control (IC) moderates such effects. The present study aimed to examine this issue. A sample of 172 typically developing children (77 girls; Mage = 7.14, SDage = 0.33) and their parents participated in the study. Parents reported children's anxiety and depressive symptoms using the Child Behavior Checklist each year from the first measurement (T1) to the third measurement (T3) and reported their helicopter parenting and tiger parenting at T1. Children completed the Go/No-go task at T1 to measure their IC. Higher T1 helicopter parenting impeded the declines in anxiety and depression over time, and higher T1 tiger parenting predicted more anxiety and depressive symptoms at T3. However, such effects were only observed in children with low IC, and higher IC buffered the adverse impacts of both helicopter parenting and tiger parenting on children's anxiety and depressive symptoms. These findings revealed that helicopter parenting and tiger parenting had negative impacts on the developmental trajectories and outcomes of anxiety and depression in children and suggest that IC plays an important role in alleviating the risks of anxiety and depression among children in adverse environments.

Autistic children and control children use similar strategies when answering false belief questions

Abstract Difficulties in false belief reasoning are associated with autism spectrum. False belief tasks tend to be easy to administer and code, and thus are often used for testing purposes. However, the amount of information that can be gleaned from this type of assessment task goes beyond correct/wrong score attribution. Instead, fine-grained information may be derive from a detailed qualitative analysis of the content of the answers, as well as the strategies used to produce them. Moreover, the testing situation contains other interesting aspects, such as a child’s orientation to the task. Therefore, we examined both qualitatively and quantitatively the various ways children (15 autistic and 15 control children; mean age 7;5 years) responded to a false belief question. The false belief question was more difficult for the autistic than for the control children, but there was no statistically significant difference among the answering strategies between the groups. The answering strategies were mostly similar between the groups. Autistic children preferred to use nouns or locative pro-adverbs while answering, whereas control children used more versatile ways of answering, even though the length of the answers did not differ between the groups. When considering the orientation to the ongoing task, the autistic children had longer reaction times than the control children did. Some autistic children needed the researcher’s support to focus on the task, but in general, expressions of uncertainty or commenting during the task were not frequent among the children. The results of this study can be utilized in deepening our understanding of the abilities of autistic individuals and to develop sensitive ways to assess and support autistic children.

A Study to Assess Effectiveness of Educational Intervention on Knowledge Regarding Child Abuse among Parents of School Children at Selected Community Areas at Perinthalmanna

Objectives: Assess pre test and post test level of knowledge regarding child abuse among parents of school children in both control and experimental group,Evaluate effectiveness of educational intervention on child abuse among parents of school children,Find association between knowledge of parents on child abuse and selected demographicvariables. Methodology: Quantitative research approach was used for the study . The study was conducted in 11,12&amp;13 wards of Perinthalmanna municipality using quasi experimental non- equivalent control group pretest-post test desgin.Data was collected from a total of 60 parents of which 30 were in control an d30 in experimental group by using convenient sampling.data were collected by using knowledge questionnaire. Data were analyzed by using descriptive and inferential statistics. Result: Among 60 samples in pretest, 24(40%) have average level of knowledge, 23(38.33%) have good level of knowledge, 13( 21.66%) have poor knowledge and there is no participants in excellent category. In post test, 36(60%) got good level of knowledge, 12(20%) had average knowledge, 9( 15%) had poor knowledge and 3 ( 5%) got excellent knowledge. The educational intervention on child abuse was effective in improving level of knowledge among parents of school children. (t value 5.547 p value 0.0001) And the demographic variables age, gender, marital status, education, job, residence, previous source of knowledge, type of family, religion and number of children

Depression, anxiety, and hopelessness in a sample of Egyptian children diagnosed with cystic fibrosis

BackgroundEven though current therapeutic approaches have significantly increased the longevity and standard of living for children suffering from cystic fibrosis (CF), the crucial psychological components of this illness have not received the same level of attention as other chronic illnesses. The aim of the research was to assess depression, anxiety, and hopelessness in cystic fibrosis-affected children and their relation to the duration of illness. In this study, we compared 40 healthy control children between the ages of 7 and 12 with 40 cystic fibrosis children who were matched for age and sex. All patients had detailed clinical and psychometric evaluations using the Children’s Depression Inventory (CDI), the Anxiety Scale for Children (ASC), and the Hopelessness Scale for Children (HSC).ResultsThe CDI, ASC, and HSC revealed a significant difference between both groups. Positive correlations between depression, anxiety, and hopelessness and disease duration were found.ConclusionsPatients with CF experienced significantly increased depression, anxiety, and hopelessness, and there is an association between these symptoms and the duration of the illness. We advise making psychiatric screening a standard part of evaluating and monitoring CF patients.

Functional connectivity and complexity analyses of resting-state fMRI in pre-adolescents demonstrating the behavioral symptoms of ADHD

Attention deficit hyperactivity disorder (ADHD) has been characterized by impairments among distributed functional brain networks, e.g., the frontoparietal network (FPN), default mode network (DMN), reward and motivation-related circuits (RMN), and salience network (SAL). In the current study, we evaluated the complexity and functional connectivity (FC) of resting state fMRI (rsfMRI) in pre-adolescents with the behavioral symptoms of ADHD, for pathology-relevant networks.We leveraged data from the Adolescent Brain and Cognitive Development (ABCD) Study. The final study sample included 63 children demonstrating the behavioral features of ADHD and 92 healthy control children matched on age, sex, and pubertal development status. For selected regions in the relevant networks, ANCOVA compared multiscale entropy (MSE) and FC between the groups. Finally, differences in the association between MSE and FC were evaluated.We found significantly reduced MSE along with increased FC within the FPN of pre-adolescents demonstrating the behavior symptoms of ADHD compared to matched healthy controls. Significant partial correlations between MSE and FC emerged in the FPN and RMN in the healthy controls however the association was absent in the participants demonstrating the behavior symptoms of ADHD.The current findings of complexity and FC in ADHD pathology support hypotheses of altered function of inhibitory control networks in ADHD.

The effect of topical atropine 0.05% compared to atropine 0.01% for Myopia control in Children : A Meta-analysis

Introduction &amp; Objectives : Myopia is the most common ocular anomaly manifesting during primary school and progresses until a mean age of 16, but rarely beyond age of 25. Atropine, a nonselective muscarinic antagonist, has been studied widely in recent years as an option for myopia control. To analyse the efficacy of Atropine 0,05% compared with Atropine 0,01 % for myopia control in children aged 4-16 years toward the axial length examination through a meta-analysis.&#x0D; Methods : A systematic search was performed using Medline and Cochrane database up to December 2022. Review was performed according to the PRISMA Statement. The eligible studies were RCTs which comparing Atropine concentration 0.05% with 0.01%.&#x0D; Results : From 101 retrieved articles, 5 trials involving total 1035 patients were included. The follow-up period of the studies was 1-2 year. The analysis shows Atropine 0,05% significantly decrease axial length (Mean Difference [MD]: -0.11, 95%CI [-0.15-0.07], p&lt;0.00001, I2= 99 %) comparing to Atropine 0,01%.&#x0D; Conclusion : In myopia control in children, atropine 0,05 % was more effective to reduce myopia progression in controlling axial length elongation over a period of 1-2 year comparing to atropine 0,01%.

Assessment of Postural Control in Children with Movement Disorders by Means of a New Technological Tool: A Pilot Study.

Considering the variability and heterogeneity of motor impairment in children with Movement Disorders (MDs), the assessment of postural control becomes essential. For its assessment, only a few tools objectively quantify and recognize the difference among children with MDs. In this study, we use the Virtual Reality Rehabilitation System (VRRS) for assessing the postural control in children with MD. Furthermore, 16 children (mean age 10.68 ± 3.62 years, range 4.29-18.22 years) were tested with VRRS by using a stabilometric balance platform. Postural parameters, related to the movements of the Centre of Pressure (COP), were collected and analyzed. Three different MD groups were identified according to the prevalent MD: dystonia, chorea and chorea-dystonia. Statistical analyses tested the differences among MD groups in the VRRS-derived COP variables. The mean distance, root mean square, excursion, velocity and frequency values of the dystonia group showed significant differences (p < 0.05) between the chorea group and the chorea-dystonia group. Technology provides quantitative data to support clinical assessment: in this case, the VRRS detected differences among the MD patterns, identifying specific group features. This tool could be useful also for monitoring the longitudinal trajectories and detecting post-treatment changes.

Enhancing Respiratory Muscle Strength and Asthma Control in Children with Asthma: The Impact of Balloon-Breathing Exercise

Enhancing Respiratory Muscle Strength and Asthma Control in Children with Asthma: The Impact of Balloon-Breathing Exercise

The Impact of Expanding Diabetes Services on the Trend of Glycemic Control in Children and Adolescents with Type 1 Diabetes

Objectives. Our aim is to evaluate the impact of initiating a specialized children’s hospital and expanding the diabetes service for children with type 1 diabetes (T1D) on their glycemic control and on acute–diabetes-related complications over a 4-year follow-up period. Methods. This was a retrospective cohort study that included children aged 1–16 years with T1D, diagnosed for at least 1 year, and treated with multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). The study period extended from January 1, 2016 to December 31, 2019. Outcomes included the trend of glycemic control measured by HgbA1c and acute–diabetes-related complications, such as hypoglycemia, hyperglycemia, and diabetic ketoacidosis (DKA), reflected by the number of emergency room (ER) visits. Additionally, the number of visits per patient per year was captured over the 4-year study period. Results. Four hundred ninety-nine patients with T1D were included in the study (48.9% female). The mean age was 13.4 years (±2.0) in the CSII group and 12.4 years (±2.2) in the MDI group. Three thousand nine hundred and six visits were reviewed, with 618 in the CSII group and 3,288 in the MDI group. The mean hemoglobin A1c (HgbA1c) for the whole cohort was 10.56% at the start of the study period in 2016 and dropped by 0.67% to a mean of 9.89% in 2019 (p-value = 0.025). There was a 0.67% decline in the HgbA1c of the MDI group and a 0.47% decrease in the CSII group (p=&lt;0.001). The average number of clinic visits per patient per year increased from 2.6 in 2016 to 2.8 in 2019. ER visits slightly decreased throughout the 4-year period (p-value = 0.46). Conclusion. Increased accessibility of the diabetes care team to children and adolescents with T1D and their families, with more frequent contact with team members, contributes significantly to the improvement of glycemic control.

Sports and Weight Control in Children.

Pediatric obesity is a global concern with distressing comorbid conditions, including mood disturbance, cardiovascular changes, endocrine imbalance, liver disease, sleep apnea, and orthopedic conditions. The primary treatment of this condition includes physical activity. Participating in organized sports has been shown to reduce weight and the complications of pediatric obesity more effectively than individual exercise.

A Functional Magnetic Resonance Imaging Meta-Analysis of Childhood Trauma

BackgroundTraumatic experiences during childhood significantly impact the developing brain and contribute to the development of numerous physical and mental health problems. To date, however, a comprehensive understanding of the functional impairments within the brain associated with childhood trauma histories does not exist. Previous functional magnetic resonance imaging (fMRI) meta-analytical tools required homogeneity of task types and the clinical populations studied, thus preventing the comprehensive pooling of brain-based deficits present in children who have trauma histories. We hypothesized that the use of the novel, data-driven Bayesian author-topic model approach to fMRI meta-analyses would reveal deficits in brain networks that span fMRI task types in children with trauma histories. MethodsTo our knowledge, this is the first study to use the Bayesian author-topic model approach to fMRI meta-analyses within a clinical population. Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we present data-driven results obtained by combining activation patterns across heterogeneous tasks from 1428 initially screened studies and combining data from 14 studies that met study criteria (285 children with trauma histories, 297 healthy control children). ResultsAltered brain activity was revealed within 2 clusters in children with trauma histories compared to control children: the default mode/affective network/posterior insula and the central executive network. Our identified clusters were associated with tasks pertaining to cognitive processing, emotional/social stress, self-referential thought, memory, unexpected stimuli, and avoidance behaviors in youths who have experienced childhood trauma. ConclusionsOur results reveal disturbances in children with trauma histories within the modulation of the default mode and central executive networks—but not the salience network—regardless of whether children also presented with posttraumatic stress symptoms.

Healthy together Victoria and childhood obesity study: effects of a large scale, community-based cluster randomised trial of a systems thinking approach for the prevention of childhood obesity among secondary school students 2014–2016

BackgroundHealthy Together Victoria (HTV) was a Victorian Government initiative that sought to reduce the prevalence of overweight and obesity through targeting chronic disease risk factors including physical activity, poor diet quality, smoking, and harmful alcohol use. The intervention involved a boosted workforce of > 170 local-level staff in 12 communities; employed to deliver system activation around health and wellbeing for individuals, families and communities. A cluster randomised trial (CRT) of a systems thinking approach to obesity prevention was embedded within HTV. We present the two-year changes in overweight and obesity and associated behaviours among secondary school students across Victoria, Australia.MethodsTwenty-three geographically bounded areas were randomised to intervention (12 communities) or comparison (11 communities). Randomly selected secondary schools within each community were invited to participate in the trial in 2014 and 2016. Students in Grade 8 (aged approximately 13–15 years) and Grade 10 (aged approximately 15–16 years) at participating schools were recruited using an opt-out approach across July–September 2014 and 2016. Primary outcomes were body mass index (BMI) and waist circumference. Secondary outcomes were physical activity, sedentary behaviour, diet quality, health-related quality of life, and depressive symptoms. Linear mixed models were fit to estimate the intervention effect adjusting for child/school characteristics.ResultsThere were 4242 intervention children and 2999 control children in the final analysis. For boys, the two-year change showed improvement in intervention versus control for waist circumference (difference in change: − 2.5 cm; 95% confidence interval [CI]: − 4.6, − 0.5) and consumption of sugar-sweetened beverages per day (< 1 serve: 8.5 percentage points; 95% CI: 0.6, 16.5). For girls, there were no statistically significant differences between conditions.ConclusionsHTV seemed to produce favourable changes in waist circumference and sugar-sweetened beverage consumption for boys, however, no effect on BMI was observed. Although the HTV intervention was cut short, and the period between data collection points was relatively short, the changes observed in HTV contribute to the growing evidence of whole-of-community interventions targeting childhood obesity.Trial registrationThis trial is unregistered. The intervention itself was a policy setting delivered by government and our role was the collection of data to evaluate the effect of this natural experiment. That is, this study was not a trial from the classical point of view and we were not responsible for the intervention.