Early Childhood Research Articles

A 17-year-old female with bilateral congenital trigger thumb diagnosed in late adolescence: a rare case report

A 17-year-old female with bilateral congenital trigger thumb diagnosed in late adolescence: a rare case report

Molecular Mechanism of a Novel DMD Treatment Targeting Glucocorticoid and Mineralocorticoid Receptors: Anti-Inflammatory and Cardioprotective Actions

Abstract Text Duchenne muscular dystrophy (DMD) is a chronic devastating muscular dystrophy with an incidence rate of 1 in 5000 boys and an average life expectancy below 30 years. The DMD symptoms begin in early childhood and manifest as weakness and degeneration of muscle tissues in the pelvic area and the upper limbs, ultimately leads to cardiac muscle weakness, hypertrophic cardiomyopathy followed by end-stage dilated cardiomyopathy and heart failure in patients. The membrane instability and myofiber degeneration in DMD trigger the pathological activation of proinflammatory nuclear factor of kappa B (NF-κB), which is observed in the patients at a young age and worsens their symptoms. Vamorolone is a recently discovered drug that represents a most promising treatment by simultaneously suppressing inflammation and cardiomyopathy in DMD patients while avoiding the safety concerns of the corticosteroid class. It acts on both glucocorticoid receptor (GR) and mineralocorticoid receptor (MR). We set to bridge the gap in knowledge of molecular mechanism of vamorolone acting on GR and MR. Our published structural and biochemical studies showed that vamorolone, which lacks the C11-OH group, acts as a partial, dissociative GR agonist. Notably, the absence of the hydrogen bond between Asn564 and C11-OH observed in the GR-vamorolone structure allosterically increases conformational dynamics of the AF-2 site, changes the coregulator binding and alters the gene expression profile to drive dissociation of efficacy from side effects during treatment. Our gene reporter assay showed that the conventional drug prednisolone acts as a strong agonist for both MR and GR while vamorolone is an MR antagonist. X-ray crystal structure of the MR-vamorolone complex reveals the lack of residue Ans770-mediated hydrogen bond compared to prednisolone binding, as observed in the structures of MR with other antagonists. We have used differentiated cardiomyocytes from human DMD induced pluripotent stem cells and analyzed the transcriptional landscape changes using RNA-seq and ATAC-seq. These integrated studies lay the foundation for understanding how subtle chemical changes in ligands drive differential effects on a genome-wide scale and provide molecular insights for more potent GR agonist/MR antagonist design for better cardiac protection for DMD patients. Date of Presentation October 16, 2024

Targeted Cerebral Oxygenation Using Dedicated Treatment Versus Usual Care in Extremely Preterm Infants: Protocol for a Multicentre International Phase II Randomised Controlled Trial.

Near infrared spectroscopy (NIRS) allows continuous monitoring of cerebral oxygenation and therefore has the potential to be neuroprotective. Recurrent episodes of cerebral hypo-and/or hyperoxia may result in brain injury. The Safe-BoosC-II study reported stable cerebral oxygenation in extremely preterm infants by combining a dedicated treatment guideline with NIRS monitoring using several devices and adult sensors. The ability to maintain stable cerebral oxygenation with a dedicated treatment algorithm using one type of NIRS device with neonatal sensors has not been previously investigated. In this multicentre, 2-arm, parallel, single-blinded, phase II RCT, stratified by gestation and hospital site, 100 participants born < 29 weeks' gestation (inborn and outborns, singleton and twins) will be randomised to targeted cerebral oxygenation using dedicated treatment or usual care with blinded cerebral NIRS monitoring for the first 5 days of life. We will exclude infants > 6 h of age, those with congenital anomaly requiring major surgery or a genetic disorder, and triples or higher multiple births. The primary outcome is the burden of cerebral hypoxia and hyperoxia for the first 5 days after birth expressed as percent hours. The findings of this trial will provide essential information on (i) validating results from the Safe-BoosC-II study, considering the differences in the study methodology between the two trials (ii) strengthening support for routine use of cerebral NIRS monitoring in this population and (iii) informing the design of future RCTs on the effects of targeted cerebral oxygenation on neurodevelopment in early childhood as the primary outcome. Australian New Zealand Clinical Trials Registry registration number ACTRN12621000778886.

Challenges in implementing evidence-based standardized home visits for newborns, infants, and their caregivers: Lessons from the Republic of Korea

Objective In Japan, home-visit programs for newborns and infants have been implemented based on the Maternal and Child Health Act and Child Welfare Act. However, these programs vary widely across municipalities. This study aimed to examine the current state and challenges of scientifically designed and standardized home-visit programs in the Republic of Korea and obtain practical implications for Japan.Methods Information was collected through collaboration with individuals affiliated with the Seoul National University College of Medicine and from publicly available sources.Results In the Republic of Korea, the Maternal and Early Childhood Home Visiting Program targets children aged ≤ 2 years and their mothers. Based on "the Family Partnership Model," the program emphasized partnerships between nurses, social workers, and caregivers. Initiated in Seoul in 2013 as the Seoul First Step Project, it expanded nationwide in 2019 as part of the Early Life Health Management Program. The program integrates the social-ecological model, proportionate universal approach, and life course approach, offering basic visits to all applicants and ongoing visits to families requiring additional support. The coverage rate of home-visit programs relative to the number of births has reached approximately 30%.To address the shortage of nurses, group programs in which mothers learn parenting skills together and the distribution of parenting manuals and leaflets were implemented. A standardized 320-h in-service training program was developed to ensure standardized home visits. Regular supervision and reflection opportunities were provided to the staff to ensure the quality of the home visits. Inspired by the U.S. HomVEE framework, multidimensional evaluation indicators assessed home environment, child safety, growth and development, maternal well-being, and community support.Conclusion In the Republic of Korea, partnerships between universities, administrative organizations, and healthcare professionals (nurses, social workers, and physicians) have fostered evidence-based program designs, standardized in-service training, and evaluation outcomes. Although Japan has achieved high implementation rates of meticulous home visits, in-service training and evaluation should be improved. To address health inequalities from early life stages, translate evidence into practical applications, and improve the quality of home-visit programs by leveraging the strengths of all stakeholders involved.

Book Review: Becoming pedagogue: Bergson and the aesthetics, ethics and politics of early childhood education and care by Liselott Mariett Olsson OlssonLiselott Mariett, Becoming pedagogue: Bergson and the aesthetics, ethics and politics of early childhood education and care, Routledge: London, 2023; 292 pp.: ISBN 9781138207585, £35.99 (pbk)

Book Review: <i>Becoming pedagogue: Bergson and the aesthetics, ethics and politics of early childhood education and care</i> by Liselott Mariett Olsson OlssonLiselott Mariett, Becoming pedagogue: Bergson and the aesthetics, ethics and politics of early childhood education and care, Routledge: London, 2023; 292 pp.: ISBN 9781138207585, £35.99 (pbk)

Adolescent ‘re-birth’ at puberty: implications for the development of a relational pedagogy of ‘intentional care’

ABSTRACT Whilst recognising puberty as a period of significant change, this paper argues that, rather than being simply a period of transition on a continuum of ongoing development, puberty is, in fact, a point of rupture of the child concept of self and a ‘re-birth’ into a new, emerging adolescent concept of self. As such, the fledgling adolescent becomes not 10, 11, 12 years of age, but rather, newborn, 1, 2 years of age in terms of their newly forming self-concept. The impact of this on adolescent wellbeing and the implications for pastoral support within school are significant. Part 1 of this paper sets out the arguments supporting the ‘rupture and re-birth’ proposition, including consideration of the biological, neurobiological, behavioural, emotional and cognitive changes that take place. Implications for the development of a new self-concept post puberty are also considered. Part 2 takes learning from the work of English psychoanalyst Donald Winnicott to assess how his early child development theory might be applied to the nurture and support of the ‘newborn’ adolescent. Part 3 considers ways in which this theory might be applied in school as part of a pedagogical approach of ‘intentional care’.

Risk of Early Childhood Dental Caries Associated With Prolonged Breastfeeding: A Systematic Review and Meta-Analysis.

Breastfeeding provides essential nutrients and benefits for newborns. However, its prolonged duration has raised concerns about potential risks for early childhood caries (ECC). To determine if prolonged breastfeeding increases the risk of dental caries in children under 71 months. Eligibility criteria included observational studies comparing ECC risk in children breastfed for over 12 months, with no language restrictions. Databases searched included PubMed, Scopus, and others, up to May 17, 2024. Risk of bias was assessed using the JBI Critical Appraisal Checklist. Meta-analyses were performed using a random-effects model. Twenty-five studies involving 19 681 participants were included. Studies showed an increased risk of ECC in children breastfed for more than 24 months (RR = 2.44; 95% CI, 1.97 to 3.02). For the 12-24 months period, no significant risk increase was found. Meta-analyses also indicated higher ECC prevalence with breastfeeding beyond 12 months (OR = 1.86; 95% CI, 1.48 to 2.35). Prolonged breastfeeding beyond 24 months is associated with an increased risk of ECC. This review highlights the need for future studies to address current research limitations and better understand the relationship between prolonged breastfeeding and ECC. International Prospective Register of Systematic Reviews (PROSPERO): CRD42024509212.

DEVELOPMENT OF A FLIPBOOK E-MODULE ON PROJECT-BASED PANCASILA INCORPORATING LOCAL WISDOM TO STRENGTHEN THE VALUES OF MUTUAL COOPERATION AND CREATIVITY IN KINDERGARTEN

This study aims to develop and evaluate the effectiveness of a local wisdom-based e-Module to enhance the dimensions of mutual cooperation (gotong royong) and creativity in early childhood education. The research uses a Research and Development (R&amp;D) method with the ADDIE development model (Analysis, Design, Development, Implementation, Evaluation). Conducted at Taman Kanak-Kanak Pembina Pancung Soal, the study involves children aged 4-6 years and teachers who will implement the e-Module. The analysis phase revealed that existing Pancasila-based modules were insufficient in fostering cooperative behavior among children. Consequently, a local wisdom-based e-Module, focusing on the use of Lokan shells as a creative learning material, was developed to support project-based learning that integrates the values of cooperation and creativity. The design phase involved planning the content, language, and visual design of the e-Module, which was then validated by experts, achieving an average validity score of 94%, indicating the module's high validity. The practicality test by teachers resulted in a 97% feasibility rating, while the effectiveness test with 15 participants showed a 94% effectiveness rate. Final evaluations indicated that the e-Module successfully enhanced cooperation and creativity in children while offering culturally relevant learning. This research provides important implications for the development of interactive learning media in early childhood education, utilizing digital technology and local wisdom to support character development and social skills in young learners.

Clinical outcomes of direct resin-composite restorations in primary maxillary incisors in patients with early childhood caries: a prospective non-controlled cohort study

ObjectivesMaxillary primary anterior teeth are primarily affected by early childhood caries (ECC), and treatments are challenging. The aim of this study was to evaluate the clinical outcomes and risk factors for chairside direct composite restorations of maxillary primary incisor caries in patients with ECC.Materials and methodsA total of 160 maxillary incisors from 54 children aged 23–47 months who were diagnosed with caries and received direct-bonded composite restoration treatments according to the standard protocol were included. At 1 year of follow-up, the restorations were evaluated using the modified United States Public Health Service (USPHS) criteria. A restoration was defined as successful when Alpha or Bravo scores were obtained for all parameters. The presence of secondary caries, fracture or restoration loss, and pulpal or periapical pathosis were recorded as failures.ResultsForty-six patients completed the 1-year follow-up visit, and 133 restorations were analysed, with a recall rate of 83.1% for restorations and 85.2% for patients. Ninety-two restorations (69.2%) were judged as successful. Secondary caries was found in 27 teeth (20.3%), fracture or restoration loss in 35 teeth (26.3%), and pulpal or periapical pathosis in 5 teeth (3.8%). Logistic regression analysis revealed that the number of carious surfaces was a risk factor for outcomes (OR 3.730, 95% CI 1.494 ~ 9.313, P value 0.005).ConclusionsDirect resin-composite could restore primary maxillary incisors in children with one to two caries-involved surfaces.

Partnerships as Professional Learning: Early Childhood Teaching Assistants’ Role Development and Navigation of Challenges Within a Culturally Responsive Robotics Program

Theory and practice related to computing education with racially/ethnically and linguistically diverse groups of preschoolers remain in nascent stages. Accordingly, early childhood educators both require substantial support when integrating culturally responsive computing into curriculum and instruction and offer valuable perspectives on emerging practices. The purpose of this research study is to explore how educator voice-directed efforts support the implementation of a culturally relevant preschool robotics program through multi-year professional development. Through qualitative analyses, we examined how educator voice, conceptualized as perspectives and participation, guided the direction of professional learning situated within a larger research-practice partnership using design-based research (DBR) methodology. By comparing voice across these sessions, we were able to identify what roles educators assumed within the partnership and how those roles shifted over time. Further, we are able to identify the structural and systemic factors that may have affected their participation and implementation. Findings show a contrast in roles across the different stages of the partnership, suggesting implications for embedding professional learning within broader partnership work as a way to cultivate educator leadership and to realize culturally responsive computing education in sustainable ways.

Adverse childhood experiences, positive childhood experiences, suicidal thoughts or behaviors and psychological distress among Kenyan youth-an exploratory analysis of the 2019 Kenya Violence Against Children and Youth Survey (VACS).

Adverse childhood experiences, positive childhood experiences, suicidal thoughts or behaviors and psychological distress among Kenyan youth-an exploratory analysis of the 2019 Kenya Violence Against Children and Youth Survey (VACS).

Factors motivating community participation in the Bushbuckridge municipality in the Mpumalanga province of South Africa

ABSTRACT Participation is a fundamental component of any community enrichment programme. Current knowledge and understanding about what motivates communities to participate in local community initiatives are however limited, especially in a South African context. This study aimed to identify the factors that motivates local community members to participate in the construction and running of early childhood development (ECD) centres in the Bushbuckridge municipality in the Province of Mpumalanga. To achieve this aim, we engaged with Team Frank Africa – a non-profit organization (NPO) that builds and runs early childhood development (ECD) centres in the municipality with the assistance of local community members. Two focus group discussions were held with local community members, and two interviews were held with Team Frank members to identify what motivates local community participation in these ECDs. Findings revealed that community participation in this context is largely driven by self-interest, and a sense of ownership. Overall findings reaffirm the fact that community participation is a complex process, and its determinants are highly influenced by personal and socio-economic circumstances. We believe that the study contributes to our understanding of community participation in a rural South African context as well as contributes knowledge to the sustainability of future community development programmes in similar contexts.

Neuroscience in early childhood education: a content analysis of Australian qualifications

ABSTRACT Over the last two decades, there has been increased interest in neuroscience-informed approaches in early childhood, particularly regarding their potential benefits for early childhood education. However, little is known about the neuroscience-related content early childhood educators and teachers receive in their initial training. This study sought to address this gap by examining early childhood pre-service education qualifications in Australia for neuroscience-related content. Findings revealed an absence of neuroscience-related content within vocational early childhood education programs, and only 20% of university-based initial early childhood teacher education programs contained one or more units with some neuroscience-related content. The limited neuroscience-related content in early childhood education qualifications could have implications for educators’ understanding of young children’s brain development, and their interactions and practices with children within their early childhood education and care programs.

Value-based learning of Tri Kaya Parisudha for the interpersonal skills of students in early childhood education schools

The low level of interpersonal intelligence has implications for disrupted social and pedagogical activities, such as the emergence of problems with students who like to disturb their classmates. This reality was found in Early Childhood Education Institutions in Buleleng Regency, Bali. Therefore, a local value conception is needed for this issue. This research presents the urgency of Tri Kaya Parisudha as a learning paradigm while also focusing on answering two formulated problem statements, namely: a) why is Tri Kaya Parisudha-based learning important to implement as a medium for developing the interpersonal skills of early childhood?; b) how can Tri Kaya Parisudha-based learning develop the interpersonal skills of early childhood? The purpose of this research is to explain the approach of value-based learning using Tri Kaya Parisudha as a medium to produce learning and enhance children's interpersonal skills in interacting within the school environment, both with peers and teachers. The method used is qualitative, emphasizing findings based on observation and interview activities in several schools in Buleleng Regency. Observations and interviews were conducted at Sinar Harapan Kaliasem School, Kasih Ibu School, Panca Dharma Seririt School, and Sathya Sai Kumara Singaraja. The application of these two aspects is used to examine the learning of each school, whether they implement the values of Tri Kaya Parisudha or not. The background of Tri Kaya Parisudha (manacika, wacika, and kayika) creates the construction of interpersonal character in early childhood through cognitive, affective, and psychomotor aspects. With the application of these local values, students' interpersonal skills become applicable because they build social sensitivity (social sensitivity, produced from the internalization of manacika and kayika values), social insight (social insight produced from the implementation of manacika and kayika values), and social communication (social communication produced from the implementation of manacika, kayika, and wacika). Tri Kaya Parisudha becomes a local value that can be synchronized with pedagogical aspects because it creates students' interpersonal skills.

A learning experience design framework for multimodal learning in the early childhood

While the value of multimodal learning experiences is well articulated in the literature, rich examples of learning experience (LX) design aiming to guide research and practice in authentic school classrooms are currently lacking. This study’s first objective was to provide a comprehensive account of the LX design process, aimed at enhancing multimodal learning in kindergarten education. With the aid of two kindergarten teachers, we followed a learning design approach that blended established instructional frameworks such as the learning via multiple representations, the learning stations, and the learning trajectories. This study’s second objective was to conduct an evaluation study. The LX design was implemented with the two teachers and their 33 kindergarten students to assess its effectiveness. Both quantitative and qualitative data were employed for triangulation of the evidence. The study contributes to the literature by offering a replicable LX design framework that addresses calls for structured integration of multimodal digital resources in early childhood education. Furthermore, findings from the evaluation study shed light on teachers’ positive perceptions of the multimodal learning experience based on observed students’ behaviours and achievement. This work is a step forward in addressing a need for LX designs that can facilitate seamless multimodal learning in early childhood.

Distinct features of three clinical subtypes in 533 patients with primary hypertrophic osteoarthropathy

BackgroundPrimary hypertrophic osteoarthropathy (PHO) is a rare genetic disorder classified into clinical subtypes and genetic subtypes. Previous clinical studies have primarily focused on case reports and family analyses, largely characterizing the genetic subtypes. However, there remains a long-standing gap in understanding the characteristics of the different clinical subtypes of PHO. This study aimed to determine the distribution of the three clinical subtypes of PHO and compare their clinical characteristics using a large global sample.MethodsA systematic literature search was conducted in multiple databases to categorize cases into complete form (CO), incomplete form (IN), and fruste form (FR). Statistical analyses were performed to assess clinical differences in a retrospective study design.ResultsMales predominated across all subtypes, whereas females were most prevalent in IN patients (51.1%). IN patients had the highest family history rate (62.1%). Age at onset peaked in adolescence for CO and FR patients, while IN patients exhibited bimodal peaks in early childhood and adolescence. Congenital diseases were more frequent in IN patients (7.8%, P = 0.021), while CO patients had a higher prevalence of digestive system diseases (12.2%, P = 0.007). Urinary prostaglandin E2 (PGE2) and PGE Metabolite (PGEM) were consistently elevated in CO and FR patients. In IN patients, urinary PGE2 levels were also increased, but the urinary PGEM levels showed equal proportions of elevation and reduction. Genetic analysis revealed that solute carrier organic anion transporter family member 2A1 (SLCO2A1) mutations were predominant in CO (95 cases, 73.1%) and FR (22 cases, 57.9%) patients, whereas hydroxyprostaglandin dehydrogenase (HPGD) mutations were most frequently associated with IN (25 cases, 73.5%).ConclusionsThe three clinical subtypes of PHO exhibited distinct characteristics with no clear correlation between clinical and genetic subtypes. These findings highlighted the clinical significance of PHO typing and provided valuable insights for diagnosis, differential diagnosis and subtype-specific management strategies.

Evaluation of Teachers' Role in Engineering Design Process Learning in Early Childhood

Evaluation of Teachers' Role in Engineering Design Process Learning in Early Childhood

Early childhood education and care teacher students’ experiences of learning for sustainable development through social entrepreneurship

ABSTRACT Faced with the global challenges of our time, higher education institutions are expected to be at the forefront in enabling transformation and capacity building for a more sustainable future. However, it has been argued that this necessitates a significant shift in higher education towards education that facilitates collaborative, problem-based, interdisciplinary, and student-active pedagogical approaches to teaching and learning. Using a multimethod approach and thematic analysis, this article draws attention to how social entrepreneurship and innovation in Early Childhood Teacher Education (ECTE) can help foster a sustainable mindset, enabling learners to develop knowledge, skills, and motivations needed to engage in shaping a sustainable development in their communities. The article offers insights into how sustainability-driven entrepreneurship in ECTE can be a driving force for a transformation towards a sustainable future, by giving hands-on experience in creating sustainable solutions through collaborative work in real-world learning environments.

Parental health shocks, and upward mobility of children’s income in China

ABSTRACT This study examines the relationship between early parental health shocks and children’s future income upward mobility in China. We employ the timing of major acute health events to measure the parental health shocks and use CEM-PS matching to control for potential endogeneity between parental health and children’s economic outcomes. We find strong evidence of a negative effect of parental health shocks on children’s initial income levels upon entering the workforce. This effect is more pronounced for those from low-income families, families without medical insurance, and those with parents working in the non-public sector. Our results suggest that parental health shocks decrease the probability of children attaining higher education levels. We find that the impact of the father’s health shocks is more pronounced than that of mothers, and the upward mobility of female children is more affected than that of male children. This study contributes to the literature on intergenerational impacts of health shocks, human capital transfer, and coping mechanisms in developing countries.

ChildWeCare: An Innovative System for the Surveillance and Care of Early Childhood Development Disorders in Thailand

ChildWeCare: An Innovative System for the Surveillance and Care of Early Childhood Development Disorders in Thailand