Birth Order Research Articles

Software educativo basado en neurodidáctica para el aprendizaje de las Ciencias Naturales en cuarto grado de Educación Básica

This research work seeks to promote new knowledge within the subject of natural sciences through neurodidactic software called VIMOVER, due to the low results of the student test applied by INEVAL and the difficulties presented in the classroom. The study aims to design educational software based on the principles of neurodidactics to improve the learning of Natural Sciences in fourth grade students of General Basic Education in an educational institution in the Biblián canton. This quantitative, descriptive and field research used two instruments which were a pre-test and a post-test being the population of 213 students in which a sample of 55 fourth grade children were worked with. A technological resource was used, seeking to replace the traditional methodology with modern methods. Regarding the surveys applied to the students, a great interest was noted for the application of technology within their classes which kept them motivated. Theoretical foundations were investigated to develop educational software, which was successfully applied in an institution, improving learning in Natural Sciences and demonstrating the positive impact of ICT in education.

Promoting effective transitions: Primary school social-emotional competencies predict secondary school reading and numeracy achievement.

The transition from primary to secondary school presents a challenging developmental milestone which often marks a decline in academic performance. Social-emotional skills are recognized as fundamental to academic success but longitudinal research is needed to determine the extent of their association over this transition period. This study sought to determine the association between self-reported social-emotional competencies of students in their final year of primary school (Year 6; age ~11 years) and reading and numeracy performance in their first year of secondary school (Year 7; age ~12 years). The study used a large Australian sample (n = 23,865), drawn from the New South Wales Child Development Study population cohort. The Middle Childhood Survey-Social-Emotional Learning assessment, administered during Year 6, comprises the five competencies defined by the Collaborative for Academic, Social and Emotional Learning (CASEL): Self-Awareness, Self-Management, Social Awareness, Relationship Skills and Responsible Decision-Making. These data were linked with students' Year 7 reading and numeracy scores from the standardized National Assessment Program-Literacy and Numeracy measure. Associations were examined in multi-level structural equation models which accounted for prior (Year 5) academic achievement and sociodemographic covariates. Multi-group analyses explored invariance across girls and boys. Self-Awareness and Self-Management demonstrated significant and meaningful positive relationships with reading and numeracy performance. Associations with reading were invariant by sex but boys demonstrated significantly stronger associations than girls on numeracy. Findings suggest that bolstering primary school students' intrapersonal social-emotional competencies may safeguard their academic achievement over the transition into secondary school.

Child sleep problems mediate prospective associations between fathers' parenting stress and child blood glucose levels.

The present study examined the role of first-time fathers' parenting stress during infancy in relation to children's mean blood glucose via glycated hemoglobin (HbA1c) levels during middle childhood while also exploring the mediating role of child sleep problems in this association. A total of 306 fathers self-reported on parenting stress when their children were 10 months old (49% of girls). Fathers also reported on child sleep problems when their children were 24 months old. Peripheral blood samples were collected via dried blood spots from children when they were ∼7 years old to assess HbA1c, a marker of diabetes risk. Our results revealed that greater paternal parenting stress predicted father-reported child sleep problems. Furthermore, child sleep problems were associated with greater HbA1c levels in children. Although the direct association between paternal parenting stress and child HbA1c levels was nonsignificant, a significant indirect effect was observed from paternal parenting stress to child HbA1c levels via father-reported child sleep problems. These results highlight a potential pathway through which paternal parenting stress may impact child metabolic health, highlighting the potential value of interventions in early childhood targeting both paternal well-being and child sleep problems to mitigate the transmission of paternal parenting stress and associated risks on children's health. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Parents favor daughters: A meta-analysis of gender and other predictors of parental differential treatment.

Decades of research highlight that differential treatment can have negative developmental consequences, particularly for less favored siblings. Despite this robust body of research, less is known about which children in the family tend to be favored or less favored by parents. The present study examined favored treatment as predicted by birth order, gender, temperament, and personality. We also examined whether links were moderated by multiple factors (i.e., parent gender, age, reporter, domain of parenting/favoritism). Multilevel meta-analysis data were collected from 30 peer-reviewed journal articles and dissertations/theses and 14 other databases. In all, the data reflected 19,469 unique participants (Mage = 19.57, SD = 13.92). Results showed that when favoritism was based on autonomy and control, parents tended to favor older siblings. Further, parents reported favoring daughters. Conscientious and agreeable children also received more favored treatment. For conscientious children, favoritism was strongest when based on differences in conflict (i.e., more conscientious children had relatively less conflict with their parents). Parents and clinicians should be aware of which children in a family tend to be favored as a way of recognizing potentially damaging family patterns. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Gender differentials in infant and under-five mortality in India

Perspective vista of child-health in India reclaim within the framework of Sustainable Development Goals to ensure healthy living and well-being for all at all ages. With significant young populace in India, health status of children becomes paramount undoubtedly. Study precisely traces gender differential in child mortality, highlighting role of pointers like IMR and UMR in the context of parental, socio-economic, and environmental settings. Commissioning a comprehensive approach, study evaluates data from National Family Health Survey (NFHS-4) alongside Demographic Health Survey (DHS), USAID spanning over 2015-2016. Risk of mortality was higher among male infants and under-five children compared to female. Birth order, birth spacing, mother’s age at birth, maternal and parental education were observed valuable for child survival. Birth order higher than four with birth-spacing less than two years for mothers bearing child at 35 years of age and above were deleterious for child survival. Certain socioeconomic and environmental factors appeared significantly contributory in gender differences in child mortality. High-risk zone of Central India need critical and incisive surveillance to control child mortality due to preventable causes. Planning and implementation of health programs need to consider gender gap in child mortality for maternal and child health related policies and interventions. Study emphasizes attention of policymakers and public health entrepreneurs to foresee rewarding interventions targeting the cohort of children at risk.

Shakespeare, a huge muscly Triton

ABSTRACT Henry Stuart, elder son of James I, was created Prince of Wales on 4 June 1610. His mother, Anne (Anna) of Denmark, celebrated the investiture in Tethys’ Festival, an aquatic-themed masque at court, written by Samuel Daniel and designed by Inigo Jones. A key performer in the masque was Henry’s younger brother, Charles (the future King Charles I), attended by a pair of huge, half mythic servants, the Tritons. The essay shows these were wholly unlike earlier tritons (unusually, they were bipeds and un-fishlike), and that their roles were performed by public stage celebrities, each a gentleman, well off, and well known. These Tritons had different functions. One spoke all the verse, the other, silent throughout, was part of a crucial ceremonial gift-giving between the Queen and the Princes. The essay investigates a river pageant performed prior to Tethys’ Festival, commissioned by the London Corporation, in which there were also two tritons, played by actors from the King’s Men, one of them Richard Burbage. The argument is made that Burbage was also the speaker Triton in the masque, and that the silent Triton was Shakespeare. The essay looks at traces of the Tritons, their outfits and antitypes in The Tempest.

Prevalence and contributors to anaemia among children aged 6 to 59 months in Kyangwali Refugee settlement, Western Uganda: a cross-sectional study

BackgroundAnaemia is a major cause of morbidity among children under five years in Uganda. However, its magnitude among refugee populations is marginally documented. In this study, the prevalence and contributors to anaemia among children 6 to 59 months in Kyangwali refugee settlement in Western Uganda was determined.MethodsThis was a cross-sectional study that was carried out among 415 mother- child dyads at Kwangwali refugee settlement. Anaemia was determined by measuring haemoglobin concentration using the HaemoCue method, while nutritional status was examined using standard World Health Organisation (WHO) nutritional indices. Data abstraction forms, pretested questionnaires and face to face interviews were used to collect patient data. Associations between the independent variables and anaemia were examined using modified Poisson regression with robust standard errors. In all statistical tests, a P- value of < 0.05 was considered as significant.ResultsThe proportion of children with anaemia was 49.2% (95% CI: 44.4–53.9). Anaemia was 1.4 times (95% CI = 1.13–1.82; p = 0.003) more prevalent among wasted children than the normal children. The prevalence of anaemia was also higher among underweight children than those with normal weight (aPR = 1.37, 95% CI = 1.11–1.70; p = 0.004). Additionally, the prevalence of anaemia was higher among children of birth order of 6 or above (aPR = 2.00, 95% CI = 1.22–3.29; p = 0.006), while anaemia prevalence was lower among children whose mothers’ had attained secondary level of education (aPR = 0.19, CI = 0.04–0.98; p = 0.048) and those who fed on fish (aPR = 0.75, 95% CI = 0.57–0.99; p = 0.039) and meals prepared with oils and fats (aPR = 0.70, 95% CI = 0.51–0.97; p = 0.029). There was no significant relationship between anaemia occurrence and the household dietary diversity score.ConclusionsAbout half of the study children were found to be anaemic. The most significant contributors to anaemia in the study population were malnutrition, maternal education, feeding practices and birth order. The study findings suggest need of screening of children for anaemia at all nutritional clinics, promotion of education, addressing barriers to sustainable food supply and accessibility of nutrient-dense foods, treating anaemia in children alongside other micronutrient deficiencies and addressing the nutritional needs of multiparous mothers in refugee communities.

Risk factor, consequence, or common cause? Linking lower self-regulation and internalizing symptoms during middle childhood in a random intercept cross-lagged panel model.

This study investigates whether lower self-regulation (SR) facets are risk factors for internalizing symptoms (vulnerability models), consequences of these symptoms (scar models), or develop along the same continuum and thus share common causes (spectrum models) during middle childhood. To analyze these models simultaneously, a random intercept cross-lagged panel model was estimated using Mplus. Data were assessed at three measurement time points in a community-based sample of N = 1657 (52.2% female) children in Germany, aged 6-13. Internalizing symptoms were measured via parent report by the emotional problems scale of the Strengths and Difficulties Questionnaire. Seven SR facets were assessed behaviorally, via parent report and teacher report. At the within-person level, internalizing symptoms were concurrently associated with emotional reactivity at all measurement time points, while no cross-lagged paths reached significance. At the between-person level, internalizing symptoms were associated with working memory updating (r = -.29, p < .001), inhibitory control (r = -.29, p < .001), planning behavior (r = -.49, p < .001), and emotional reactivity (r = .59, p < .001). As internalizing symptoms and SR facets were primarily associated at the between-person level, the results lend support to spectrum models suggesting common causes of internalizing symptoms and impaired SR.

Social and economic patterning in UPF intake in toddlerhood and middle childhood: longitudinal data from the UK Gemini cohort.

Children's consumption of ultra-processed food (UPF) may contribute to inequalities in obesity and wider health. Socioeconomic patterning in younger UK children's UPF intake is unknown. To investigate socioeconomic patterning of UK toddlers' (21-months) and children's (7-years) UPF intake across several household and neighbourhood indicators. Secondary analysis of data from a prospective longitudinal cohort study using parent-report sociodemographic data and 3-day diet diaries. /setting: Participants were children from the UK Gemini study of n=4,804 twins born in 2007. At 21-months and 7-years, n=2,591 and n=592 children had at least 2-days of dietary data, respectively. Percentage energy from UPF at 21-months and 7-years-of-age, classified using the NOVA system. Unadjusted linear regression models were run for household socioeconomic position (SEP) composite score, Index of multiple deprivation decile, income, occupation level, mother's age, education of mother and partner, child's ethnicity, sex, and age. Adjusted multivariable linear regression models were adjusted for ethnicity and all SEP indicators except SEP composite score (Adjusted 1), in addition to child sex and age (Adjusted 2). Missing data were addressed with multiple imputation and inverse probability weighting. Confidence intervals and P-values were adjusted to account for clustering within families. Children of lower SEP had higher UPF intake across several indicators. Mother's education was the strongest predictor, with postgraduate education associated with 8.64% (95% CI -12.08 to -5.20; P<0.001) and 10.12% (95% CI -15.68 to -4.56; P<0.001) less energy from UPF at 21-months and 7-years, respectively, compared to no educational qualifications in Adjusted model 2. UK children from more disadvantaged backgrounds consumed a greater proportion of their energy from UPF. Mother's education seemed the most influential factor. Socioeconomic inequalities, particularly in maternal education, may drive disparities in diet quality and associated health outcomes. Addressing these gaps is essential to reduce childhood obesity and improve long-term health in socioeconomically disadvantaged populations.

The cranium from the Octagon in Ephesos

During excavations in 1929, a well-preserved skeleton was discovered in a sarcophagus in the Octagon at Ephesos (Turkey). For the following century, archaeologists have speculated about the identity of this obviously notable person. Repeated claim is that the remains could represent Arsinoë IV, daughter of Ptolemy XII, and younger (half-)sister of Cleopatra VII. To address these questions we undertook state-of-the-art morphological, genetic and dating analyses of the cranium and further analyses of bone samples from a femur and a rib of the skeleton found in the same tomb. We confirm based on genetic analyses from the cranium and the femur that they derive from the same person. 14C-dating of the cranium provides a most likely time range between 205−36 BC. The connection with Arsinoë IV can be excluded because we confirmed that the individual is a male. The cranium represents an 11-14-year-old boy who suffered from significant developmental disturbances. Genetics suggest an ancestry from the Italian peninsula or Sardinia. The fate of the body of Arsinoë IV, who reportedly was killed in 41 BC in Ephesos, remains open. In contrast, investigations regarding the fate and social background of the boy from the Octagon can now proceed free of speculation.

Children's executive functioning and health behaviors across pediatric life stages and ecological contexts.

Executive functioning (EF) has been linked to chronic disease risk in children. Health behaviors are thought to partially explain this association. The current cross-sectional study evaluated specific domains of EF and varied health behaviors in three pediatric life stages. Pediatric participants (early childhood n = 2074, Mage = 6.4 ± 0.9y; middle childhood n = 3230, Mage = 9.6 ± 1.2y; adolescence n = 1416, Mage = 15.2 ± 1.7y) were part of the Environmental influences on Child Health Outcomes (ECHO) Program. They completed neurocognitive tasks measuring cognitive flexibility, behavioral inhibition, and working memory. Parent- and/or child-report measures of dietary intake, physical activity, sleep duration and quality, income, and positive parenting were also collected. Neighborhood crime and greenspace were calculated from publicly available census-tract level indices. After adjusting for study site, child body mass index, and demographics, working memory was related in the hypothesized direction to several dietary behaviors within all pediatric life stages. Working memory and cognitive flexibility were positively related to physical activity in middle childhood and adolescence. In adolescence, behavioral inhibition was positively related to physical activity and inversely related to sugar-sweetened beverage and total caloric intake. Associations with sleep were all non-significant. All significant associations reflected small effect sizes. Income, positive parenting, greenspace, and crime did not significantly influence any of the EF-health behavior associations. Findings highlight the need to consider EF domains, specific health behaviors, and developmental stage in creating intervention strategies that target EF to improve health behaviors. The small effect sizes reinforce the need for multi-tiered interventions to maximize health.

Prenatal exposure to particulates and anthropometry through 9 years of age in a birth cohort.

Previous research observed links between prenatal air pollution and risk of childhood obesity but the timing of the exposure is understudied. We examined prenatal particulate matter (PM10, PM2.5) exposure and child anthropometry. Children's body mass index z-scores (zBMI) at 0-3 (N = 4370) and 7-9 (n = 1191) years were derived from reported anthropometry at paediatric visits. We ran linear mixed models for six windows, adjusting for maternal, child, and neighbourhood factors. PM10 exposure across pregnancy and at multiple windows was associated with higher zBMI in both early and middle childhood. For instance, one interquartile range increase in PM10 exposure during the first 2 weeks of pregnancy was associated with higher zBMI at 0-3 (0.05, 95% CI: 0.01, 0.10) and 7-9 (0.14, 95% CI: 0.02, 0.23). PM2.5 exposure during the final 2 weeks of gestation was associated with higher zBMI at 7-9 years (B: 0.12, 95% CI: 0.04, 0.22). Even at low levels of air pollution, prenatal PM10 exposure was associated with higher zBMI in childhood.

Cross-sectional analysis of risk factors associated with the coexistence of three undernutrition indicators among children aged 0–23 months in Tanzania

BackgroundUndernutrition in children under two years is a persistent challenge in Tanzania. This study investigates demographic, maternal, and child-related factors associated with stunting, wasting, and underweight coexistence.MethodsSecondary data from 2,158 children aged 0–23 months in the 2022 Tanzania Demographic and Health Survey (TDHS) were analyzed. Risk factors assessed included child age, birth weight, size at birth, birth order, and maternal education. Multinomial regression analysis was conducted to determine associations.ResultsThe risk of coexisting undernutrition was significantly higher among children aged 12–17 months (RRR = 8.297, 95% CI = 1.768–38.931, p = 0.007) and 18–23 months (RRR = 12.860, 95% CI = 2.661–62.152, p = 0.001). Protective factors included birth weight < 2,501 g (RRR = 0.211, 95% CI = 0.056–0.783, p = 0.02), average size at birth (RRR = 0.262, 95% CI = 0.076–0.908, p = 0.035), and higher birth order (2nd–4th: RRR = 0.372, p = 0.023; 5th: RRR = 0.340, p = 0.048). Maternal education emerged as a significant risk factor (RRR = 1.327, 95% CI = 1.128–6.841, p = 0.02).ConclusionThis study highlights critical risk factors, including maternal education, child age, and birth characteristics, for the coexistence of stunting, wasting, and underweight. Interventions should target the 12–23-month age group and address maternal education to eradicate child malnutrition in Tanzania.

Marcello Malpighi (1628-1694): His life, discoveries and struggles with the detractors of microscopic anatomy.

Marcello Malpighi is widely recognized as the founder of microscopic anatomy. His seminal discoveries of the pulmonary alveoli, blood capillaries, and renal glomeruli revolutionized existing medical knowledge, earning him fame and international recognition. He discovered the respiratory system of insects and described, for the first time, their excretory apparatus. He laid the foundations of modern embryology by characterizing the early stages of organ development in the chick embryo and was among the first to study the anatomy and biology of plants. Malpighi also faced family challenges, including his younger brother's involvement in a homicide, and relentless attacks by followers of traditional medicine. The purpose of this paper is to revisit Malpighi's extraordinary life and works, focusing on his struggles with detractors, who questioned the usefulness of his microscopic observations and resisted the new ideas of modern medicine.

Medication Hazards and Outcome Patterns of Pediatric Drug-Associated Liver Injury in Taiwan: An Analysis of 1998-2017 Spontaneous Adverse Drug Reaction Reports.

Accumulating pediatric efficacy and safety data on drug use is inherently challenging yet essential. This study aimed to analyze the frequency and compute the odds of pediatric drug-associated liver injury across age groups (early childhood, middle childhood, and adolescence) and therapeutic categories using adverse drug reactions (ADRs) reporting data spanning nearly two decades. We analyzed the reports of suspected ADRs occurring in children and adolescents in the Taiwan National Adverse Drug Reaction Reporting System during the period from May 1998 until July 2017. Standardized Medical Dictionary for Regulatory Activities Queries were utilized to identify suspected hepatic ADRs. Outcome patterns across age groups were compared using the chi-squared test, and disproportionality analysis was employed to calculate reporting odds ratios (RORs) of hepatic versus nonhepatic reports. Among 16,673 reports, 484 (2.9%) were identified as suspected hepatic ADRs, involving 193 distinct drugs. The mean age of affected individuals was 8.2 years. Outcome types in adolescents were predominantly serious (91.8%). Antibacterials for systemic use (18.8%) and antiepileptics (8.7%) were the most frequently implicated therapeutic categories. Drugs with high ADR occurrence rates and significant RORs included oxacillin (5.2%; ROR: 12.07), methotrexate (4.1%; ROR: 9.07), and phenobarbital (2.7%; ROR: 5.04). Some medications exhibited higher ratios of used-versus-recommended doses, suggesting inappropriate dosing. Pediatric drug-associated liver injury was not uncommon and may result in serious outcomes. This study underscores the need for heightened vigilance in administering certain high-risk drugs and attentiveness in proper dosing for children, including adolescents.

Birth order moderates the association between adverse childhood experiences and externalizing behavior symptoms in adolescence

Adverse childhood experiences (ACEs) are associated with externalizing behaviors. Whereas some ACEs affect individual children (i.e., child-specific; e.g., failing a grade), others affect the family unit (i.e., family-wide; e.g., parent losing a job); effects of ACEs on externalizing behavior may manifest differently across groupings of ACEs. Moreover, birth order may modify the association between child-specific and family-wide ACEs and externalizing behavior due to differences in the experience of being a younger versus older sibling. This study examined the externalizing behavior of siblings in relation to their experiences of child-specific and family-wide ACEs to test the hypothesis that younger siblings are at greater risk for developing externalizing symptoms following familial ACE exposure. Participants were 61 sibling pairs (younger sibling Mage = 11.37 years, 44.1% male; older sibling Mage = 13.1 years, 52.5% male) recruited from six schools in the northeastern United States. Parents rated each child’s externalizing behaviors (e.g., bullying, meanness) and retrospectively reported on each child’s experience of 34 ACEs; two raters categorized ACEs as child-specific (n = 10) or family-wide (n = 24). Multilevel modeling revealed that both child-specific and family-wide ACEs were associated with increased externalizing behaviors. Birth order moderated the effect of family-wide (but not child-specific) ACEs on externalizing behaviors, independent of sex and age. Externalizing behavior was higher for younger siblings as compared with older siblings, particularly when a high number of ACEs (6+) were reported. This research should prompt future exploration of mechanistic theories of the impact of family-wide and child-specific ACEs and the role of birth order.

Trajectories and social determinants of child cognitive development: a prospective cohort study from infancy through middle childhood in Dhaka, Bangladesh

Over a third of children globally do not meet their developmental potential, and children living in low and middle-income countries (LMICs) are most vulnerable. Understanding the contextual factors that influence cognitive development for children in LMICs is crucial to inform and develop interventions. We sought to characterize developmental trajectories of cognition in Bangladeshi children and identify salient social determinants. We used a longitudinal design and included 542 children living in Dhaka, Bangladesh. Social determinants (maternal and paternal education, housing risks, household assets, and food security) were assessed at baseline visits using a combination of oral interviews and home assessments. Cognitive development was assessed at 6 months, 2, 3, 4, 5, and 7 years. A total of 1397 cognitive assessments were completed across all participants. Growth curve models and mixed effect models were used. In children living above the poverty line, there was increasing deviation from expected cognitive scores from 6 months to 2 years (-12.85, p<0.001) with stable scores from 2 to 7 years. For those below the poverty line, there were widening disparities from expectations in scores from 6 months to 4 years (-24.58, p<0.001) with stable scores from 4 to 7 years. Higher levels of maternal education (t=2.22, p=0.03) and more food security (t=4.48, p<0.001) were protective for cognition longitudinally. Interaction effects between poverty level and maternal education and food security respectively were observed. Cognitive development trajectories showed increasing disparities from expectations in the first two years of life, with more pronounced and lasting effects through 4 years for children below the poverty line. Maternal education and food security had promotive/protective effects on longitudinal cognitive development scores for the full sample. Maternal education and food security had stronger effects on cognitive development for children living below the poverty line compared to those living above the poverty line. Funding for the study was provided by a grant from the Bill and Melinda Gates Foundation (OPP1111625) toCAN.

The role of the hippocampus in working memory and word reading: Novel neural correlates of reading among youth living in the context of economic disadvantage.

A left-lateralized cortical reading circuit underlies successful reading and fails to engage in individuals with reading problems. Studies identifying this circuit included youth from economically advantaged backgrounds and focused on cortical, not subcortical, structures. However, among youth with low scores on reading tests who are living in the context of economic disadvantage, this brain network is actively engaged during reading, despite persistent reading problems. This finding suggests that other brain circuits may underlie reading in these youth. A hippocampal circuit is one likely candidate, as it has recently been shown to support domain-general processes like working memory (WM) that are also associated with reading. Given age-related increases in hippocampal volume, WM, and reading, and known associations between WM and reading, we hypothesized that hippocampal volume would be associated with reading via WM processes. Using a cross-sectional developmental design, we explored this in middle childhood (average age at MRI scan ∼10; N = 50) and adolescence (average age at MRI scan ∼17; N = 175). Results suggest that the hippocampus is a critical contributor to word reading in adolescents living in economically disadvantaged contexts, and that this operates through working memory processes. Such findings point to new targets for reading intervention in adolescents.

Regional disparities of full pentavalent vaccine uptake and the determinants in Ethiopia: Mapping and spatial analysis using the EDHS data.

The full pentavalent (DPT-HepB-Hib) vaccination is the main strategy to prevent five communicable diseases in early childhood, especially in countries with huge communicable disease burdens like Ethiopia. Exploring spatial distributions and determinants of full pentavalent vaccination status in minor ecological areas in Ethiopia is crucial for creating targeted immunization campaigns and monitoring the advancement of accomplishing sustainable development goals. This study aimed to investigate the spatial disparities and determinants of full pentavalent vaccination among 12-23-month-old children in Ethiopia. The data on pentavalent vaccine uptake was found in the Ethiopian Health and Demographic Survey (EDHS, 2019). A two-stage cluster sampling method was applied to collect the EDHS data. The enumeration area was the primary sample unit while the household served as the secondary sampling unit. The geographical variations of full pentavalent vaccine uptake were explored using Quantum Geographic Information System (QGIS) software. The significant predictors of full pentavalent vaccination were identified using a simple logistic regression model through R version 4.1 software. The national full pentavalent vaccine uptake was 59.2%. The spatial distribution of full pentavalent vaccine uptake was not uniform in Ethiopia. Spatial cluster analysis revealed that most of low coverage regions for full pentavalent vaccine uptake were Afar, Somali, and Harari. The regions with the highest and lowest rates of vaccine uptake were Tigray and Harari region, respectively. Maternal age of 35-49 years (AOR = 3.42; 95% CI: 1.99, 5.87), and 25-34 years (AOR = 1.55; 95% CI: 1.17, 2.19), primary education attended (AOR = 1.51; 95%CI: 1.07, 2.11), richness wealth index (AOR = 1.96; 95% CI: 1.40, 2.75), birth order of 1-3 (AOR = 1.88; 95% CI: 1.19, 2.96), and delivery in the health facility (AOR = 3.41: 95% CI: 2.52, 4.61) were the determinants of full pentavalent vaccine uptake in Ethiopia. Ethiopia's full pentavalent vaccine uptake was far lower than the global target. Older maternal age, maternal education, wealth index, birth order, and giving birth in a health facility were the determinants of full pentavalent vaccine uptake. Special attention should be given to Afar, Somali, and Harari regions, to strengthen the vaccine uptake. Moreover, improved socioeconomic status and getting maternal health services during delivery are necessary to enhance vaccine uptake.

Factors Influencing the Willingness of Hospitalized Children's Parents to Engage in Patient Safety: A Cross-Sectional Study.

Hospitalized children's patient safety incidents can have a significant long-term impact on their physical, psychological, cognitive, and social development. Family-centered care emphasizes engaging parents, and parental involvement is an effective way to ensure child safety. This study aims to identify the factors influencing parents of children with hospitalization experiences in their willingness to engage in patient safety. In this cross-sectional study, we surveyed 210 parents whose children had been hospitalized within the past one year in South Korea. We used a structured questionnaire including patient safety knowledge, patient safety literacy, children's hospitalization experience, and the willingness to engage in patient safety. The collected data were analyzed using descriptive statistics, t-test, chi-square test, analysis of variance, correlational analysis, and regression analysis. The willingness to engage in patient safety had significant positive correlations with patient safety knowledge (r=0.36,p<0.001) and patient safety literacy (r=0.24,p<0.001). The variables that had a statistically significant influence on the willingness to engage in patient safety were the birth order of the hospitalized child (β=0.41, p=0.014), patient safety knowledge (β=0.25, p<0.001), communication with the child (β= -0.25, p=0.018), and attention to safety and comfort (β=0.21, p=0.026). This study found that the birth order of the hospitalized child, patient safety knowledge, and children's hospitalization experience are important factors in parents' willingness to engage in patient safety. The findings indicated the need to develop patient safety education programs for parents, considering the facilitators of and barriers to their willingness to engage in patient safety.