Health Status Of Children Research Articles

Oral health status of children with intellectual and developmental disabilities in India: a systematic review and meta-analysis

Oral health status of children with intellectual and developmental disabilities in India: a systematic review and meta-analysis

The Impact of Fermentation on Aflatoxin and Fumonisin Levels in Sorghum Kernels and Flour Used to Prepare Complementary Food in Kerio Valley, Kenya

ABSTRACTSorghum is a major ingredient used in the production of complementary foods in Kenya's drylands, particularly in areas like Kerio Valley. However, it is known to be susceptible to aflatoxin and fumonisin contamination, which have adverse effects on human health. The current study aimed to assess the levels of aflatoxin and fumonisin in sorghum kernels and flour from Kerio Valley and to investigate whether fermentation (spontaneous or innoculum facilated) could reduce the levels of toxins. The sorghum samples were obtained through a cross‐sectional survey and subjected to ELISA analysis for quantification of aflatoxin and fumonisin levels. The aflatoxin levels ranged from 0 to 119.91 ppb for sorghum kernels and from 2.70 to 89.36 ppb in the flour, while fumonisin concentrations ranged from 0 to 30.65 ppm in sorghum kernels and 0.22 to 27.27 ppm in the flour. Fermentation significantly reduced the levels of the toxins in sorghum samples (p ≤ 0.05). The type of fermentation (p = 0.001), sample fermented (kernels or flour) (p = 0.004), and duration of fermentation (p = 0.037) significantly impacted the reduction of both toxins. Therefore, there is a need to integrate the adoption of fermentation with other effective postharvest practices to mitigate mycotoxin contamination in sorghum and other cereal‐based foods. In addition to the customary health and nutrition messages, promoting proper food handling, storage, and processing can significantly contribute to improving food safety and the overall health and nutritional status of young children.

Impact of Consumer Wearables Data on Pediatric Surgery Clinicians' Management: Multi-Institutional Scenario-Based Usability Study.

At present, parents lack objective methods to evaluate their child's postoperative recovery following discharge from the hospital. As a result, clinicians are dependent upon a parent's subjective assessment of the child's health status and the child's ability to communicate their symptoms. This subjective nature of home monitoring contributes to unnecessary emergency department (ED) use as well as delays in treatment. However, the integration of data remotely collected using a consumer wearable device has the potential to provide clinicians with objective metrics for postoperative patients to facilitate informed longitudinal, remote assessment. This multi-institutional study aimed to evaluate the impact of adding actual and simulated objective recovery data that were collected remotely using a consumer wearable device to simulated postoperative telephone encounters on clinicians' management. In total, 3 simulated telephone scenarios of patients after an appendectomy were presented to clinicians at 5 children's hospitals. Each scenario was then supplemented with wearable data concerning or reassuring against a postoperative complication. Clinicians rated their likelihood of ED referral before and after the addition of wearable data to evaluate if it changed their recommendation. Clinicians reported confidence in their decision-making. In total, 34 clinicians participated. Compared with the scenario alone, the addition of reassuring wearable data resulted in a decreased likelihood of ED referral for all 3 scenarios (P<.01). When presented with concerning wearable data, there was an increased likelihood of ED referral for 1 of 3 scenarios (P=.72, P=.17, and P<.001). At the institutional level, there was no difference between the 5 institutions in how the wearable data changed the likelihood of ED referral for all 3 scenarios. With the addition of wearable data, 76% (19/25) to 88% (21/24 and 22/25) of clinicians reported increased confidence in their recommendations. The addition of wearable data to simulated telephone scenarios for postdischarge patients who underwent pediatric surgery impacted clinicians' remote patient management at 5 pediatric institutions and increased clinician confidence. Wearable devices are capable of providing real-time measures of recovery, which can be used as a postoperative monitoring tool to reduce delays in care and avoidable health care use.

Using School-Based Teleconsultation Services to Make Community Health Services Accessible in Semirural Settings of Pakistan: Sequential Explanatory Mixed Methods Study.

In Pakistan's remote areas, quality health care and experienced professionals are scarce. Telehealth can bridge this gap by offering innovative services like teleconsultations. Schools can serve as effective platforms for introducing these services, significantly improving health service access in semirural communities. This study aims to explore the feasibility of introducing school-based teleconsultation services (TCS) to strengthen community health in a semirural area of Karachi, Pakistan. This study used a mixed methods design. A total of 393 students were enrolled for the quantitative component, while 35 parents, teachers, and community stakeholders participated in the qualitative arm (focused group discussion). Proportional computation for the quantitative data was done using SPSS (version 24; IBM Corp), while qualitative data underwent thematic analysis. A total of 1046 successful teleconsultations were provided for 393 students over 28 months. The demographic data showed that the mean age of the students availing TCS was 9.24 (SD 3.25) years, with the majority being males (59.3%, 233/393). Only 1.24% (13/1046) of cases required referrals. The qualitative analysis yielded three themes: (1) transformation of the health care experience, (2) escalating demands for teleconsultation, and (3) the psychological aspect of care. This study demonstrated the efficacy of integrating TCS in a semiurban school in Karachi to address health care accessibility gaps. Implementing TCS through the school platform improved the overall health status of school children while reducing school absences and financial burdens on families. The study highlighted TCS's cost-effectiveness, time efficiency, and quality, with community support for 24/7 availability, expansion to adults, and a reimbursement model. School health nurse-led TCS offers a scalable solution to health care challenges, enhancing health outcomes for school-going children in Pakistan and globally, particularly in low- and middle-income countries, where accessibility is a major issue.

Inequalities and Differences in Health Status of Pre- and Perinatal Periods in Hungarian Long-Term Series Analysis (1997–2019)

Objectives: The main goal of this study is to publish findings on the lifestyle factors of pregnant women in Hungary and their impact on early childhood health status by examining changes over time and regional/geographical disparities. Methods: The source of the data is the raw indicators reported by health visitors as per mandatory annual report data for the period of 1997–2019. To examine the association, we used indicators of pregnant women’s states as explanatory variables (for example, pregnant women in very late care, prenatal smoking habits, and pregnant women without care), and the outcome indicators were prematurity, intrauterine malnutrition, and newborn babies with developmental disorders. A univariate Poisson regression was used to examine the correlations. Results: Our results show a decreasing trend in the proportion of pregnant women who smoke and of pregnant women who apply late for care (after 28 weeks of pregnancy), with an increasing indicator of regional differences. The research results of the prenatal and perinatal indicators show that the counties Borsod-Abaúj-Zemplén and Szabolcs-Szatmár-Bereg are the most critical areas in terms of health status in Hungary. The number of pregnancies attended very late (after 28 weeks) and the number of women who gave birth without health visitor care are associated with the number of preterm births (R2 = 0.7313; p &lt; 0.001; R2 = 0.5519; p &lt; 0.001) and intrauterine growth restrictions (R2 = 0.3306; p &lt; 0.001; R2 = 0.2632; p &lt; 0.001). Conclusion: Interventions to improve early childhood health in some counties of Hungary are urgently needed to reduce regional disparities. Such counties include Borsod-Abaúj-Zemplén, Szabolcs-Szatmár-Bereg, Heves, Somogy, Bács-Kiskun, and Nógrád. Health education for pregnant women and activities to strengthen the compliance of pregnant women are key to improving early childhood health outcomes.

Functioning profile and related impairments of children and adolescents with cerebral palsy - PartiCipa Brazil preliminary results.

Limited information is available about functioning and related impairments of children and adolescents with Cerebral Palsy (CP) in low- and middle-income countries (LMIC) like Brazil. The aim of this study is to describe the characteristics, functioning, and impairments of Brazilian children and adolescents with CP. Cross-sectional preliminary study as part of the PartiCipa Brazil multicentered cohort study. Families of children and adolescents with CP from Brazil, 4 months to 15 years, were enrolled. They responded to an online survey with questions about their child's health condition, impairments, contextual factors, and functioning according to the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). Data were described as frequencies, percentages, means, and standard deviations, according to age bands. Of the 404 participants (6.5±3.6 years) enrolled in this preliminary analysis, 54.7% are male, 90.4% under 12 years of age, 77.7% have bilateral CP, 49% in GMFCS levels IV and V, and 50.7% in MACS levels II and V. Most participants are from Southeast (63.4%) and Centre-west (19.5%) of Brazil. Regarding the impairments and functioning limitations: 1 in 2 did not talk; 1 in 2 has epilepsy; 2 of 5 reports pain, 1 of 4 has visual impairments, 3 out of 5 did not feed themselves, 1 out of 20 has a hearing impairment and 1 of 4 did not go to school. This first preliminar Brazilian study shows a high prevalence of children at MACS levels II and V and GMFCS levels IV and V, representing almost half of the group, indicating more impairments and limitations than children/adolescents from high-income countries. This study provides a preliminary deeper understanding of the key impairments and limitations in activities among children and adolescents with CP from various Brazilian regions.

Exploring the oral health status of children living with hypoxic ischemic encephalopathy (HIE): A caregiver described self-report.

Hypoxic Ischemic Encephalopathy (HIE) is a birth complication due to loss of oxygen flow, resulting in a wide range of physical and cognitive differences often requiring support from multidisciplinary healthcare teams. Despite this population's increased need, little is known about their oral health status and the role of the dentist as a member of the care team. A 32-item oral health questionnaire was shared to 8700 members within the patient advocacy non-profit, Hope for HIE's, Facebook group. The survey assessed caregiver-reported oral health status and facilitators and barriers to receiving dental care. Two hundred sixty-two individuals responded to the survey. The majority were white (90%, 177/196) parents of children with HIE (99%, 259/262) that lived in the U.S. (76%, 148/195) and cared for children under 3 (42%, 106/251). 36% (85/236) reported cavity experience, 81% (180/223) reported visiting the dentist for a dental check-up, however, 58% (147/255) considered the dentist to be a member of their child's care team. Children diagnosed with HIE likely experience similar oral health status as their peers, however, qualitative developmental work is necessary to assess facilitators and barriers to receiving dental care, and how to integrate the dentist into the care team.

Factors associated with perceived health of school-aged children in rural Rwanda: an opportunity to leverage community health workers to enhance school health promotion and primary healthcare systems linkages

BackgroundIn many low-income countries, enhancing the health of school-aged children is often impeded by insufficient or limited knowledge regarding their health status. Further, hands-on health promotion interventions are nearly non-existent due to the lack of designated health workers. The disconnection between schools and primary care facilities further exacerbates this issue. To address these challenges, the World Health Organization has introduced the Health Promoting School (HPS) framework, a comprehensive model designed to integrate health into all aspects of school life and promote physical, mental, and social well-being. We sought to assess the perceived health status of school-aged children, identify associated factors, and explore the role of community health workers (CHWs) in public schools in rural Rwanda.MethodsWe carried out a convergent mixed methods study among teachers and community members in rural areas of Musanze, Rwanda. Data collection instruments were adapted from the World Health Organization’s HPS framework and the literature. We conducted six in-depth interviews and three focus group discussions. We performed a logistic regression analysis to examine the factors associated with perceived health. Thematic analysis was used to analyze the qualitative data.ResultsA total of 479 individuals participated in this survey. Of these, 425 (89%) were community members, while 54 (11%) were employed as teachers at Nyabirehe or Rwinzovu public schools. Almost half of respondents 221 (46%) described the children’s health as poor. Many factors were associated with perceived children’s health, including having an established leadership team for school-based health promotion (OR = 1.97, 95%CI: 1.01,3,84), and being familiar with school-based health promotion (OR = 4.77, 95%CI: 2.27,10.0). Qualitative results described the CHW as a bridge between communities, schools, and primary healthcare centers.ConclusionThis study revealed that the health of schoolchildren needs particular attention. In resource-limited settings, HPS presents a promising opportunity to address the health and well-being of children at rural public schools. However, adapted policies, the establishment of health promotion teams, and hands-on orientation for teachers and community members are necessary to ensure an effective implementation of HPS. In Rwanda and other low-income countries where public schools lack nursing staff, CHWs could play a vital role in enhancing HPS and the linkage between schools and primary healthcare facilities.

Regional Disparities, Economic Development, and Neonatal Mortality and Hospital Delivery in China

A negative association between neonatal mortality and hospital delivery has been found in some low- and lower-middle-income countries but not in rural settings characterized by poor quality of maternal and child health care. To examine the association between neonatal mortality and hospital delivery in China across urban and rural regions, regional disparities, and varying levels of economic development. This retrospective cohort study used county-level data from 2008 to 2020 from the National Maternal & Child Health Statistics across mainland China. Statistical analysis was conducted from March to December 2023. Since 2008, China has strategically leveraged hospital deliveries with national subsidies to diminish neonatal mortality, particularly in rural areas. Neonatal mortality and hospital delivery rates were calculated, and their association was estimated using multivariable fixed-effects linear models of county-level cohort data to adjust for time-invariant differences across counties and controls for gross domestic product (GDP) per capita, women's years of education, hospital beds, and health workers. The analysis included data from 2930 counties, with 198.7 million live births across 36 255 county-year records between 2008 and 2020. The mean (SD) neonatal mortality rate per 1000 live births decreased in rural areas from 12.3 (7.5) in 2008 to 3.9 (2.7) in 2020 and decreased in urban areas from 5.0 (3.1) in 2008 to 2.0 (1.3) in 2020. Hospital delivery rates increased in rural areas from a mean (SD) of 93.4% (11.8%) in 2008 to 99.9% (0.6%) in 2020 and increased in urban areas from 97.7% (6.1%) in 2008 to 100.0% (0.1%) in 2020. In rural areas, an increase of 10 percentage points in hospital deliveries was associated with a neonatal mortality rate of -1.4 (95% CI, -1.9 to -1.0; P < .001) per 1000 live births, whereas this negative association was not observed in urban areas. When the analysis was stratified by regions and incomes, the negative association became considerably stronger in the western and central regions of China, as well as in counties with lower GDP per capita. This cohort study of more than 2900 counties in China suggests that an increase in hospital deliveries was associated with reduced neonatal mortality in rural and economically underdeveloped areas in China. To further reduce neonatal mortality and improve newborn health, it is imperative to increase the accessibility of hospital delivery services.

A quasi-experimental study assessing the effectiveness of a community-based egg intervention in the nutritional and health status of young children from rural Honduras.

This community-public-private-academic coalition project implemented and evaluated the effectiveness of a rural, community-based egg intervention that aimed to support the nutrition and health of children living in rural, poor communities from Intibucá, Honduras, during the COVID-19 pandemic. This investigator-blind, non-randomized, controlled study was informed by a community health improvement process and participatory research. Women from 13 communities were given a microloan to start an egg farm that supplied 1 egg daily to 201 children ages 6-24 months for 1 year (intervention group). Control communities (n = 14) were selected from neighboring municipalities with similar sociodemographic backgrounds based on size. Sociodemographic-, anthropometric-, and morbidity data were collected biannually between January 2021 to January 2022. Outcome changes were compared with linear-, generalized- or Poisson- mixed models adjusted by sex, age, maternal education, breastfeeding status, assets, adults living at home, baseline outcomes, and community-cluster. Baseline to 6- and 12-month weekly frequency of egg intake significantly increased in the intervention vs. the control group: 6-month change = 1.86; 95%CI (1.61, 2.14); 12-month change = 1.63; 95%CI (1.42, 1.87 p<0.001), respectively. Baseline to 12-month changes in the intervention group were not significant for length/height-for-age-z-scores = 0.12, p = 0.187; weight-for-length/height-z-scores = -0.02, p = 0.78; and diarrhea prevalence, AOR = 1.69; 95%CI (0.53, 5.42), p = 0.378. Lower odds of respiratory infections were observed for the intervention vs. the control group at 6- and 12-month post: AOR = 0.28; 95%CI (0.12, 0.63), p = 0.002; AOR = 0.30; 95%CI (0.12, 0.75), p = 0.010, respectively. Children in the intervention group reported consuming eggs more days per week relative to the control group. Lower odds of respiratory infections were observed in the intervention group throughout the study. Ongoing follow-up will offer more insights on the intervention's effectiveness in linear growth, dietary diversity, food security, and other nutritional outcomes.

Caring Under Pressure: Investigating Parental Attitudes in Mother–Child Chronic Illness Dynamics

Background: The presence of chronic illnesses in both a mother and a child poses a significant challenge for mothers in managing these conditions, yet how maternal attitudes adapt to dual illness remains poorly understood. This study aims to explore parenting styles in families dealing with mother–child chronic illnesses. Methods: Mothers of children aged 2–6 were recruited from three pediatric clinics and categorized based on the health status of both the mother and the child. Data collection included case files and the Parental Attitude Scale (PAS), which assessed democratic, authoritarian, overprotective, and permissive attitudes. The interaction between mother–child health status and higher levels of parental subscales was analyzed using the chi-square test. Multiple logistic regression analysis was then performed to evaluate this interaction, controlling for confounding baseline characteristics. Results: In total, 878 mother–child pairs were included. Mothers exhibited varying attitudes based on education, employment, and the child’s age. Chronic illness in both mother and child and only the child having an illness were significantly associated with higher overprotective scores (p &lt; 0.001). The percentage of mothers with high permissive scores was higher when only the mother had an illness and when both were healthy, compared to the case of both mother and child having an illness (p = 0.018). After adjusting for confounding factors, having a sick child showed a 1.6-fold increase in the likelihood of a high overprotective score, and both the mother and child having an illness showed a 2.94-fold increase. Similarly, after adjusting for the same confounding factors, the likelihood of a high permissive score was 2.56 times lower when both were ill compared to when both were healthy. Conclusions: This study reveals that when a child is affected by a chronic illness—whether or not the mother is also ill—mothers tend to exhibit higher levels of overprotection and lower levels of permissiveness, while their levels of authoritarianism and democratic attitudes in parenting remain relatively stable.

Longitudinal Associations Between Physical Health Conditions in Childhood and Attention-Deficit/Hyperactivity Disorder Symptoms at Age 17

ADHD is associated with lower birth weight, but also with obesity in childhood. Findings on the direction of this association are mixed. This study investigated the relationship between weight and ADHD from birth across development. We used data from the Millennium Cohort Study (MCS), collected at seven time points between 9 months and 17 years. ADHD diagnosis status and scores on the Strength and Difficulties Questionnaire (SDQ) were used to create an ADHD group and a control group. Random intercept cross-lagged panel models were conducted in females (N=4051) and males (N=3857) to examine bidirectional associations between BMI z-scores and SDQ scores between ages three and 17. Analyses were adjusted for common risk factors for ADHD and obesity, such as sex assigned at birth, multiple births, and ADHD medication status. Children in the ADHD group were significantly lighter at birth than the control group (t(5674)=2.65, 95% CI [0.02, 0.14] p=.008) and significantly more likely to have obesity at age five onwards (OR range 1.57-2.46, RR range 0.98-2.29). Path analyses conducted separately for males and females showed that higher ADHD symptoms in females at ages 7, 11 and 14 significantly predicted higher BMI z-score at ages 11, 14 and 17 respectively. In males, this association was only seen between age 11 and 14 (β= 0.07; 95% CI, 0.04-0.10, p < .001). Results suggest that interventions for children with ADHD, and their parents, should begin as soon as possible, prenatally if possible. Developmental sex differences should be considered.

The effects of casein glycomacropeptide on general health status in children with PKU: A randomized crossover trial

In PKU, it is suggested that casein glycomacropeptide based protein substitute (GMP) may have physiological advantage when satiety, oxidative stress, renal function and inflammation are considered. Its prebiotic properties may also help gastrointestinal (GI) tolerance.In children with PKU, a randomized/crossover trial comparing phenylalanine-free amino acids (AA) vs GMP as the single source of protein substitute for 12-weeks in each arm was conducted. There was a 4-week wash out period with AA in-between. At baseline and end of each intervention, blood and fecal samples were taken to monitor gut health, oxidative stress, renal function, inflammatory markers and plasma amino acids. Satiety and Pediatric Quality of Life (PedsQL) GI symptoms questionnaires were completed. Usual weekly blood spots for phenylalanine and tyrosine were done.Twelve patients (8 males; aged 4-9y) with PKU participated. GMP improved the following GI symptoms: stomach pain (p = 0.003), heartburn and reflux (p = 0.041) and wind/ bloating (p = 0.018). With GMP, there was also a trend for less constipation (p = 0.068), discomfort with eating (p = 0.065) and nausea and vomiting (p = 0.087). There was no changes on stool gut health markers (IgA, short chain fatty acids and fecal calprotectin). There were no statistically significant differences for renal, oxidative stress, inflammatory and gut health markers or measures of satiety except for adiponectin (p = 0.028) and total antioxidant capacity (p = 0.049), although the latter was possibly without clinical significance. Mean dried blood spot Phe was 114 μmol/L higher with GMP vs AA (p < 0.001). There was no difference in tyrosine levels. In conclusion, GI symptoms significantly improved with GMP versus AA. The phenylalanine content of GMP may present challenges when it is used as the only protein substitute in children with classical PKU with low Phe tolerance.

Analysis Of Occupational Safety and Health Promotion Implementation On Employees At Pt. Siantar Ice Factory

Background: Mortality rates over time can describe the state and development of public health. Maternal Mortality Rate is one of the important indicators in determining the health of the community. Improving the health status of mothers and children (KIA) is still one of the main priorities in health development in Indonesia, due to the still high Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Indonesia.Objectives: o analyze the implementation of occupational safety and health promotion for Employees at PT. Pabrik Es Siantar.Research method: ualitative method with a qualitative descriptive approach that does not provide treatment to research subjects with qualitative research that aims to explore a problem with detailed limitations, as well as in-depth data collection.Results: The number of informants in this study was 7 people. Data collection was carried out using an in-depth interview method equipped with a voice recorder to 7 informants. Based on the results of the research conducted, the results of the analysis showed that there were still many employees who worked but still ignored the importance of K3 such as not using PPE while working which is one of the things that must be worn while working. this can endanger workers because the risk of work accidents while working is very high, including in the production section.Conclusion: promotion and occupational safety and health facilities are quite good, only employee awareness is still lacking. Suggestions that can be given are Suggestions that can be given are to carry out supervision of all work processes that are further improved so that workers do things outside of work procedures, and to equip personal protective equipment in each division according to their work.

Hospital-recorded chronic health conditions in children with and without Down syndrome in England: a national cohort of births from 2003 to 2019.

The objective is to describe age-specific cumulative incidence for hospital-recorded indicators of chronic health conditions (CHCs) in children with Down syndrome (DS) compared with children without DS. National birth cohort using hospital admission and death records. National Health Service (NHS)-funded hospitals in England. Liveborn, singleton infants born in NHS-funded hospitals between 2003 and 2019. Cumulative incidence of nine categories of hospital-recorded CHCs, multimorbidity and mortality. We identified 10 621 infants with DS among 9 631 646 liveborn, singleton infants (0.11%). Among children with DS, the cumulative incidence for any indicated CHC was 90.1% by age 16, as compared with 21.2% of children without DS. By age 16, a third of children (33.1%) with DS had CHCs affecting four or more body systems; only 6.0% of children without DS had CHCs indicated in more than one body system. The most common CHCs in children with DS were severe congenital heart defects, indicated in 57.2% (0.8% in children without DS). The estimated HR for mortality up to age 16 comparing children with versus without DS was 15.26 (95% CI: 14.15, 16.45). Children with DS had a higher cumulative incidence for CHCs in each body system category and subcategory, at all ages, than children without DS. Multimorbidity and mortality were higher among children with DS. Administrative data can be used to examine the health needs and healthcare use of children with DS throughout childhood and adolescence.

Outcomes of Providing Children Aged 7-12 Years With Access to Evidence-Based Anxiety Treatment Via a Standalone Digital Intervention Using Immersive Gaming Technology: Real-World Evaluation.

Anxiety disorders are among the most common mental health conditions in childhood, but most children with anxiety disorders do not access evidence-based interventions. The delivery of therapeutic interventions via digital technologies has been proposed to significantly increase timely access to evidence-based treatment. Lumi Nova (BfB Labs Limited) is a digital therapeutic intervention designed to deliver evidence-based anxiety treatment for those aged 7-12 years through a mobile app incorporating immersive gaming technology. We aimed to evaluate the real-world impact of providing access to Lumi Nova through UK National Health Service-funded mental health services. We analyzed precollected anonymized data routinely captured through the implementation of Lumi Nova from children aged 7-12 years, who lived in the United Kingdom and had the opportunity to use the intervention for at least 1 week over an 18-month period. Engagement indices included whether the game key was activated, number of unique sessions, time spent engaging, and number of "challenges" completed. Clinical outcomes were assessed using the Goal-Based Outcomes measure and Child Outcome Rating Scale. Demographic data were analyzed to assess the health equality implications of Lumi Nova. Of 1029 eligible families invited to use Lumi Nova, 644 (62.5%) activated their game key, of whom 374 (58.1%) completed at least one in-game graded exposure challenge. The median number of unique sessions was 6 (IQR 3-12) and the median time spent engaging with the intervention was 42 (IQR 15-79) minutes. For the subset of young people with paired outcomes, there were statistically significant small to medium improvements in goal-based outcome scores (n=224; t223=5.78, P<.001; d=0.37, 95% CI 0.25-0.52) and Child Outcome Rating Scale scores (n=123; t122=5.10, P<.001; d=0.46, 95% CI 0.27-0.65) between the first and last data points. Two in 5 young people's scores reflected a change that would be considered reliable. Analysis of demographic characteristics tentatively suggested that children from ethnic minority backgrounds and those living in the most deprived neighbourhoods may be less likely to access Lumi Nova, but children from socioeconomically deprived areas were more likely to successfully complete a challenge once they accessed the intervention (P=.02). However, the level of missing data and small number of children in some demographic groups limited meaningful statistical comparisons. This study provides initial evidence that Lumi Nova may be associated with improved outcomes for those aged 7-12 years seeking anxiety treatment in real-world settings. However, the lack of a control comparator group and information about concurrent treatments accessed by the young people, in addition to substantial attrition, limited the analysis that could be conducted and confidence in the conclusions drawn.

Long-Term Mental Health Outcomes of Bronchopulmonary Dysplasia in Neonates: An 18-Year National Cohort Study

To evaluate the association between neonatal bronchopulmonary dysplasia and the subsequent development of mental health conditions in children and adolescents. This was a retrospective cohort study, utilizing data from individuals born in South Korea between 2002 and 2005 and followed up until 2021, using the National Health Insurance Database. The cohort included 1,893,314 participants born during that period, with 927 diagnosed with bronchopulmonary dysplasia during the neonatal period (the exposed cohort). They were matched 1:10 with 9,270 unexposed individuals (the unexposed cohort) based on key demographic factors. The median age at the first mental health disorder diagnosis was 9 years (interquartile range, 5-15 years), with 5,698 individuals (55.9%) being male. During an average follow-up of 15.2 years, the incidence rate was 481/10,000 person-years in the exposed and 138/10,000 person-years in the unexposed cohort. By the age of 18 years, the cumulative incidence in the exposed cohort was 54% (95% confidence interval [CI]; 50%-57%), with an adjusted hazard ratio of 3.18 (95% CI; 2.81-3.60) compared with the unexposed cohort, and adjusted hazard ratios for early- and late-onset mental health disorders of 4.48 (95% CI; 3.84-5.22) and 1.89 (95% CI; 1.61-2.22), respectively. Sensitivity analyses confirmed these findings, and a subgroup analysis revealed a higher risk among individuals with bronchopulmonary dysplasia who required prolonged respiratory support or oxygen. Half of children with bronchopulmonary dysplasia in our cohort developed mental health disorders by the age of 18 years, emphasizing the need for interventions and support for such individuals.

The effects of Moringa oleifera leaves on the nutritional status of children under five years

Children's health status is important for determining the human quality of life. Thus, the first life of a newborn child is critical because the consequences of disturbances that occur in children can be permanent. Moringa oleifera has been known as a miracle tree with many health benefits, including for children. The study aimed to evaluate the effect of Moringa oleifera in different forms (boiled soup and biscuit) in improving the nutritional status of children under five years old. The study was a quasi-experiment with a pre-posttest non-equivalent control group design. The sampling technique used was purposive sampling, with a total of forty-eight participants divided into two groups (24 participants for the Moringa soup group and 24 participants for the Moringa biscuit group). The interventions were given for 30 days. The result shows that children's weight was significantly altered after the intervention in both groups (p&lt;0.001). Height was not significantly changed after the intervention in the Moringa soup group (p = 0.100) and in the Moringa biscuit group (p = 0.317). In conclusion, both Moringa soup and biscuits effectively improve weight in children under five years of age.

Factors associated with caregivers’ food safety knowledge, behavior, perception of food safety control, and the nutrition status of under-5 children in Nigeria

BackgroundHousehold-level food safety practices may have a long-term outcome on the nutrition and health status of under-five children. This study explores the relationships between caregivers’ self-reported food safety knowledge, behavior, perception of food safety control, and their young child’s (< 5 years) nutrition status.MethodsIn a cross-sectional study design, 664 caregivers from five Local Government Areas (LGAs) in Ibadan, Nigeria were surveyed using an interviewer-administered questionnaire on their food safety knowledge, behavior and perceived food safety control. Anthropometric measurements of the household’s index child (aged 6–59 months) were also taken. Variables for food safety knowledge and behavior score were selected using principal component analyses. The nutritional status of the children (Z-scores for weight-for-height (WAZ), height-for-age (HAZ), and weight-for-age (WHZ)) were calculated. Description statistics were run on all variables and logistic regression models examined associations between the three food safety constructs and the children’s nutritional status. Covariates such as LGAs, caregiver’s age, household size, wealth index, child’s gender, and age were adjusted.ResultsHigh-level of food safety knowledge, behavior and lots of perceived control on food safety issues were reported by 77.7%, 76.7%, and 81.1% of the caregivers. Using WAZ, HAZ and WHZ that are ≤ -2, acute malnutrition (6.0%), chronic malnutrition (42.5%), and underweight (22.0%), respectively were prevalent among the children. Perceived food safety control was the only food safety construct associated with acute malnutrition. Wealth index, caregivers’ age, number of under 5 at home, child age, and gender were associated with acute malnutrition. Caregiver’s age, child’s age, and gender were associated with chronic malnutrition. Furthermore, caregiver’s age, education and child’s age were associated with a child being underweight. The significance level was at P < 0.05.ConclusionFactors associated with food safety and children’s nutritional outcomes are multi-faceted in nature. Future studies should explore access to resources and other intermediate factors that may explain the linkage between childhood malnutrition and caregivers’ food safety awareness, knowledge, and behavior. Public health and food safety initiatives to bridge the gap between perceived food safety control and actual food safety behavior/practices.

Evolution of the Correlation Between Body Mass Index (BMI) and Agility of Primary School Students in North-Eastern Romania

Interacting with children's cognitive processes and mental health status, body mass index (BMI) could be analyzed in relation to motor performance. This study aims to analyse the relationship between BMI and agility of primary school students in the northeast of Romania. Hypothesis testing was done by analyzing data obtained from 3250 pupils (1605 girls and 1645 boys) aged 6 to 11 years old from the North-East of Romania. BMI was calculated based on height and weight, as well as agility through the 505 change of direction speed test. The sample was divided according to gender and age, and the differences and correlations were analysed. We assumed that our sample has a significant correlation of BMI with agility and that its strength increases with age, based on neural maturation. Children's results showed gender- and age-determined differences in anthropometric as well as motor skills. The development of Romanian girls and boys differs punctually at this stage, with the two genders having close BMI values at age 11. The time to complete the 505 test is close at age 6, with boys performing better by age 11. The correlation between BMI and agility has weak strength in the 6-11 years age group of Romanian students. It is significant in girls at 9 (r = 0.20) and 10 years (r = 0.15), and in boys from 7 (r = 0.20) to 10 years (r = 0.22). The data partially confirm our hypothesis, with the correlation existing in the 7-10 years age range, its strength having a fluctuating evolution. At 11 years the link between BMI and agility ceases to exist.