Health Status Of Children Research Articles

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.

Adverse Childhood Experiences and Health Conditions and Risk Behaviors Among High School Students - Youth Risk Behavior Survey, United States, 2023.

Adverse childhood experiences (ACEs) are preventable, potentially traumatic events occurring before age 18 years. Data on ACEs among adolescents in the United States have primarily been collected through parent report and have not included important violence-related ACEs, including physical, sexual, and emotional abuse. This report presents the first national prevalence of self-reported ACEs among U.S. high school students aged <18 years, estimates associations between ACEs and 16 health conditions and risk behaviors, and calculates population-attributable fractions of ACEs with these conditions and behaviors using cross-sectional, nationally representative 2023 Youth Risk Behavior Survey data. Exposures were lifetime prevalence of individual (emotional, physical, and sexual abuse; physical neglect; witnessed intimate partner violence; household substance use; household poor mental health; and incarcerated or detained parent or guardian) ACEs and cumulative ACEs count (zero, one, two or three, or four or more). Health conditions and risk behaviors included violence risk factors, substance use, sexual behaviors, weight and weight perceptions, mental health, and suicidal thoughts and behaviors. Bivariate analyses assessed associations between individual and cumulative ACEs and demographics. Adjusted prevalence ratios assessed associations between cumulative ACEs and health conditions and risk behaviors, accounting for demographics. Population-attributable fractions were calculated to determine the potential reduction in health conditions and risk behaviors associated with preventing ACEs. ACEs were common, with approximately three in four students (76.1%) experiencing one or more ACEs and approximately one in five students (18.5%) experiencing four or more ACEs. The most common ACEs were emotional abuse (61.5%), physical abuse (31.8%), and household poor mental health (28.4%). Students who identified as female; American Indian or Alaska Native; multiracial; or gay or lesbian, bisexual, questioning, or who describe their sexual identity in some other way experienced the highest number of ACEs. Population-attributable fractions associated with experiencing ACEs were highest for suicide attempts (89.4%), seriously considering attempting suicide (85.4%), and prescription opioid misuse (84.3%). ACEs are prevalent among students and contribute substantially to numerous health conditions and risk behaviors in adolescence. Policymakers and public health professionals can use these findings to understand the potential public health impact of ACEs prevention to reduce adolescent suicidal behaviors, substance use, sexual risk behaviors, and other negative health conditions and risk behaviors and to understand current effects of ACEs among U.S. high school students.

Child health in the first 100 years of Republic of Türkiye: a story of hope, labor and success.

The Republic of Türkiye commemorated its 100th year in 2023. Within one century, a battle weary, poor country has changed into a powerful, game changing leader in the world. This was accomplished by the motivation and overwork of the Turkish nation and a great leader, Mustafa Kemal Atatürk. The status of child health in 1923 can be summarized as high infant and under-five mortality rates, epidemic diseases and hardly any healthcare facilities and health-care professionals. Since a healthy, well educated workforce was one of the main requirements for the development of the young republic, child health was given a great emphasis. With the efforts of the whole nation, many children's hospitals were established, infant mortality decreased, and malaria, neonatal tetanus, polio and diphtheria were eradicated. In this article, the progression of child health in the first 100 years of the Republic of Türkiye will be reviewed.

Characteristics of risk factors and molecular genetic parameters in children with chronic kidney disease

Introduction. Information about the health status of children with nephrological pathology includes many manifestations of functional system disorders. However, early diagnosis of chronic kidney disease (CKD) is rarely carried out due to the lack of reliable predictors of this process.The aim: To analyze the association of anamnestic signs, laboratory and genetic research results with chronic kidney disease in children to identify potential predictors of the disease.Material and Methods. The data were obtained from a single-center retrospective catamnestic cohort study (2011–2022). The main group included 128 children with chronic kidney disease aged 1 to 17 years. The comparison group consisted of 30 children without diagnosed kidney pathology aged from 1 to 17 years. There were no statistically significant differences in sex and age between the two groups. The informative value of more than 150 features, including anamnestic ones, the state of the mother’s health during pregnancy, antenatal and perinatal factors, features of the child’s development and manifestation of the disease, the results of clinical, laboratory, and genetic research methods were evaluated. An integrated approach to the study included methods for hypotheses testing on statistical significance of indicators differences, regression analysis, and ROC analysis.Results. Hereditary burden of nephrological pathology in the family, unfavorable course of pregnancy (anemia, toxicosis of the first half), obstetric and somatic pathology in the mother, the serial number of childbirth are associated with the subsequent development of CKD. Erythrocytes in the urine and daily protein loss were detected only in the group of children with CKD. In this group, a decrease in the number of red blood cells, increased erythrocyte sedimentation rate (ESR), allergies at an early age, otitis media, persistent viral and bacterial infections, and a number of signs of connective tissue dysplasia were more common. The main group statistically significantly differed from the comparison group by a number of polymorphic genetic markers. It can be assumed that the polymorphisms AGT1 Thr174Thr, AGT2 Thr235Thr, NO3 C786T are associated with a predisposition to CKD, and the products of polymorphisms AGT1 Thr174Met, AGT2 Met235Met, R1 AGT2 C1166C, NO3 T786T may have a protective effect according to development of CKD.Conclusion. The risk factors for CKD identified in this study can be used to develop software to support medical decision making for early detection of children at high risk of disease progression.

Oral Health Status in Children with Black Tooth Stain

Oral Health Status in Children with Black Tooth Stain

Health status of Italian children living close to cultivations sprayed with pesticides.

<sec><title>BACKGROUND</title>Pesticides are used to control pests, but they are toxic and may severely harm children's health. We assessed health outcomes in Italian children living close to cultivations sprayed with pesticides.</sec><sec><title>METHODS</title>In 2011-2012, 2,367 schoolchildren (6-14 years) living in eight Italian cities participated in the Indoor-School observational study. Parents filled in a standardised questionnaire on children's health and related risk factors. Children were classified as exposed to pesticides if living close to cultivations sprayed with pesticides. The association between the last three months of respiratory, allergic or systemic symptoms and pesticide exposure was assessed by multinomial logistic regression models, accounting for host/environmental risk factors.</sec><sec><title>RESULTS</title>Overall, 14% of children were exposed to pesticides, with significant differences among geographical areas: 21.2% in Northern Italy, 11.6% in Central Italy, and 9.7% in Southern Italy. Pesticide exposure was significantly associated with having: 1) 'often': eye symptoms (OR 3.81, 95% CI 2.06-7.05), skin symptoms (OR 2.60, 95% CI 1.34-5.03), lower airway symptoms (OR 2.38, 95% CI 1.41-4.01), systemic symptoms (OR 1.56, 95% CI 0.96-2.53, borderline); 2) 'daily': upper airways symptoms (OR 2.25, 95% CI 1.25-4.07) and systemic symptoms (OR 2.76, 95% CI 1.43-5.34).</sec><sec><title>CONCLUSIONS</title>Self-reported pesticide exposure was associated with respiratory, allergic or systemic symptoms in children. Public authorities should be aware of and intervene to mitigate this health risk.</sec>.

Implication of Exclusive Breastfeeding in Early Childhood Dental Disorders: Large Cohort Evidence, US National Survey of Children Health.

Purpose/Objective: Frequent consumption of fermented carbohydrates and bottle feeding contribute to the development of early childhood caries (ECC). There are no substantial findings on the effects of breastfeeding patterns on oral health conditions in children in the United States. We aimed to assess the nexus between exclusive breastfeeding during the first 6 months and oral health disorders, namely toothache, decayed teeth, or unfilled cavities in early childhood. Materials and Methods: Design: Cross-sectional epidemiologic design of nationally representative data collected via telephone surveys in the United States was utilized. Setting: National Survey of Children's Health, 2012 Participants: Population-based random sample of parents/guardians of 24,655 children aged 6 months to 5 years. Main Outcome and Measure: The primary outcome was the presence of oral health disorders (OHD) in children, defined as the parent-reported occurrence of one or more of the following conditions in the past 12 months: toothache, decayed teeth, or an unfilled cavity. This was assessed through a single composite question in the survey, asking parents/guardians if their child had experienced any of these specific oral health issues within the previous year with a binary (yes/no) response option. Results: Among 24,655 children aged 6 months to 5 years, 2392 (9.7%) had experienced an oral health disorder (OHD) in the previous 12 months. In unadjusted analysis, children exclusively breastfed for 6 months were 28% less likely to present with OHD compared to never-breastfed children (OR = 0.72, 95% CI, 0.52-0.98). However, after adjusting for key factors, including maternal health and race/ethnicity, this association was no longer statistically significant (aOR = 1.11, 95% CI 0.79-1.57). Significant predictors of OHD included maternal health (aOR for fair/poor vs. excellent/very good maternal health = 1.79, 95% CI 1.08-2.69) and race/ethnicity, with a higher prevalence among non-Hispanic Black (12.9%) and multi-racial children (12.6%) compared to non-Hispanic White children (7.7%). Conclusions and Relevance: While exclusive breastfeeding for the first six months of life was not found to be a significant predictor of pediatric oral health outcomes after adjustment, maternal health and race/ethnicity were significant determinants of oral health disorders. These findings underscore the importance of comprehensive healthcare approaches that consider maternal well-being and socio-demographic factors. Future research should explore interventions targeting these factors to improve pediatric oral health outcomes.

Evaluation of the health services provided by the primary schools in southwest Districts of Mogadishu, Somalia

Purpose: This study set out to evaluate the state of the School Health Services SHS in primary schools across the Southwest Districts of Mogadishu, Somalia. Methods: The Southwest Districts of Mogadishu City, which are made up of the four districts "Wadajir, Dharkenley, Kahda, and Deyniile," served as the study site. In Mogadishu, these four districts rank among the biggest. The population was estimated around a million. A cross sectional descriptive study conducted from January to July 2024. A School Health Evaluation Scale Questionnaire was completed for each school by direct interview, there were about 100 elementary schools in the Area that were officially registered, comprising 60 private and 40 public schools. Results: Of the Teachers in the schools surveyed, 8 (30.8%) were trained to assess the physical status of children. Only 6 (23%) schools observe and assess health status of school children regularly. Overall, twenty-one schools (80.7%) has no sick bay/health center. 80.8% has no a policy on first aid and emergency treatment. First Aid boxes were present only 2 schools (7.7%). Only 6 schools (23%) used their dispositions to exclude and re-admit students suffering from communicable diseases from school. 7 Schools 26.9% require students to be immunized against communicable diseases. Conclusion: both public and private elementary schools in Mogadishu southwest districts, the quality of the school health services was generally poor. Thus, we would like to encourage that the management of the elementary schools be given immediate attention. First aid should be taught to at least one member of staff in every elementary school. The Ministry of Education ought to make this a requirement for registration and a policy.

Factors affecting the level of parental knowledge about their children's congenital heart diseases and their care.

To assess parental knowledge about their children's congenital heart disease using a newly-designed scale. The cross-sectional study was conducted from June 2020 to May 2021, at Alkhansaa maternity and child hospital, Mosul Iraq; after approval from the ethics review committee of Ninevah Medical College, Ninevah University, Iraq, and comprised parents with children having congenital heart disease. Data, including age, gender, type of congenital heart disease as well as parents' educational and socioeconomic levels, residence, internet use and knowledge of the disease with respect to type, burden, bacterial endocarditis, outcome, etc. was noted. Parental knowledge levels were measured using a self-designed scoring scale, having a total score of 18 and 4 categories; <6 = some knowledge, 7-12 = good knowledge, 13-17 = very good knowledge, and 18 = full knowledge. Data was analysed using SPSS 26. There were 364 children with mean age 83.72±47.4 months and a male-female ratio of 0.98. The mean age at diagnosis was 12.1±8.32 months. The overall mean parental knowledge level was 8.41± 3.88, with 126(34.6%) parents having some knowledge, 178(48.9%) having good, 58(16%) having very good, and 2(0.5%) having full knowledge about their children's health condition (p<0.001) There was a significant association of parental knowledge with educational level, socioeconomic status and the type of doctor caring for the child (p<0.05). The duration of the illness showed a significant correlation with knowledge level (p=0.021). Heart Defects, Congenital, Endocarditis, Bacterial, Social Class.

The potential effectiveness of community health and nutrition volunteers on mothers’ infant and young children feeding knowledge and practice in remote areas, Hajjah, Yemen

BackgroundThe Infant and young child feeding (IYCF) practices directly affect the health, development and nutritional status of children under two years of age. However, IYCF counseling is one of the Community Health and Nutrition Volunteers (CHNVs) activities provided, which may contribute to improving the IYCF knowledge and practice among mothers. Since establishment of the CHNVs program in Yemen, its outcome has never been evaluated. Therefore, the aim of this study was to evaluate the role of CHNVs in improving the IYCF knowledge and practice among mothers in Hajjah governorate.MethodsA comparative cross-sectional study design was conducted in Bani Qais and Al-Maghrabah districts, Hajjah governorate between January and April 2023. A three-stage cluster sampling method was used to select districts, volunteer villages and households. A total of 926 mothers were interviewed. A pre-tested structured questionnaire was used to collect data. SPSS 26 was used for data analysis. The multinomial logistic regression and Chi-Square test were used to compare the IYCF knowledge and practices among mothers between the volunteer and non-volunteer villages. Odds Ratio (OR) with 95% Confidence Interval (CI) were calculated. A p-value < 0.05 was considered statistically significant.ResultsThe mothers in volunteer villages had significantly better breastfeeding and complementary feeding (CF) knowledge than mothers in non-volunteer villages. The OR of having good and moderate knowledge of breastfeeding were 3.5 (95%CI: 2.4–5.2) and 1.6 (95% CI: 1.2–2.2), respectively. The OR for good and moderate knowledge of CF were 1.7 (95% CI: 1.1–2.7) and 2.2 (95% CI: 1.5-3.0), respectively. Moreover, there is a statistically significant association in prevalence of Exclusively breastfed for the first two days after birth (EBF2D), Mixed milk feeding under six months (MixMF) and Bottle feeding 0–23 months (BoF) between volunteer and non-volunteer villages [(OR = 1.4, 95% CI: 1.0-1.8), (OR = 0.4, 95% CI: 0.2–0.8) and (OR = 0.5, 95% CI: 0.4–0.7), respectively].ConclusionsThe study found that CHNVs play a significant effect in improving the breastfeeding and CF knowledge, and prevalence of EBF2D, MixMF and BoF practices among mothers in their villages compared to non-volunteer villages. Future follow-up study and expansion to other settings in different governorates is recommended.

Psychometric Properties of Telugu Version of Scale of Oral Health Outcomes for 5-year-old Children.

Only a finite number of standard oral health-related quality of life (OHRQoL) measures are available for young children. However, instead of using parents as proxies to report a child's oral health status, children's self-reported oral health measures would be more accurate in providing their own perceptions of oral impacts. The study aimed to evaluate the psychometric properties of the Telugu version of the scale of oral health outcomes (SOHO-5T) for 5-year-old children in Telangana. The forward-backward translated SOHO-5T was pilot-tested among thirty children. The tested questionnaire was administered to 419 children, followed by a clinical oral examination using dentition status to evaluate dental caries (DC). Children (n = 30) were readministered the same questionnaire after a 2-week interval to test reliability. Internal consistency and test-retest reliability were determined by Cronbach's α and intraclass correlation. Correlation with global ratings of oral health questions was done to assess construct validity. Discriminant validity was evaluated based on the presence or absence of DC. A p < 0.05 was considered statistically significant. The mean SOHO-5T score was 4.70, and the mean decayed teeth score was 2.48, with 49.16% of children having DC. Cronbach's α scores and the intraclass correlation (ICC) coefficient for overall SOHO-5T were 0.90 and 0.91, respectively. SOHO-5T also demonstrated good construct validity with a significant positive correlation with global ratings of oral health. SOHO-5T showed good discrimination between the presence (9.43 ± 3.10), or absence (0.14 ± 1.01) of DC. This study shows good internal consistency and test-retest reliability. It also exhibited good construct and discriminant validity. Meghana D, Sukhabogi JR, Doshi D, et al. Psychometric Properties of Telugu Version of Scale of Oral Health Outcomes for 5-year-old Children. Int J Clin Pediatr Dent 2024;17(8):933-937.

Regional Variations in Physical Fitness in Children and Adolescents in Shaanxi Province.

Objectives: This study aims to examine the geographical variation in physical fitness levels among Chinese children and adolescents in Shaanxi province. Methods: A total of 19,175 children from Shaanxi province with physical fitness data in 2019, participated in the study. Physical fitness was assessed using body mass index, force vital capacity, 50 m sprint, sit and reach, 1 min rope skipping, sit-ups, 50 m × 8 round-trip running, standing long jump, pull-ups, 800 m, and 1000 m running, and their standardized scores were aggregated to form a summary score. The total score is used to classify the physical fitness levels into four grades (excellence to failure). Results: The Guanzhong (GZ) region scored the highest, while Northern Shaanxi (NS) scored the lowest. The excellence rate for physical fitness was highest in GZ and lowest in NS, while the failure rate was highest in NS and lowest in GZ. Notably, children and adolescents in NS demonstrated the best endurance levels despite their overall lower fitness scores. The comprehensive physical fitness among Chinese children and adolescents in Shaanxi province showed significant regional disparities. GZ region exhibited the highest physical fitness levels, while Northern Shaanxi had the lowest. Conclusions: Region-specific interventions and targeted health policies are essential to address these disparities and improve the overall physical health status of children and adolescents in Shaanxi province.

Nutritional assessment of under-three years children availing Anganwadi services from rural areas of Puducherry, India.

Undernurition stands as a significant contributor to childhood mortality, particularly in developing nations such as India. At the grass root level, anthropometric monitoring indicators such as stunting, underweight and wasting take place within Anganwadi centres (village courtyard). The scrutiny of growth records, utilising these markers, not only quantifies the burden but also informs corrective measures. This study aimed to assess the prevailing growth monitoring records within the rural vicinity of Puducherry. A community-based cross-sectional study design was implemented to examine the health condition of children below 3 years of age, who were enrolled and utilising services in Anganwadi centres. The anthropometric data, such as weight and height, were collected from growth monitoring records maintained in Anganwadi. The proportions of undernutrition indicators such as stunting, underweight and wasting were presented with a 95% confidence interval (CI). Within our rural service area encompassing 13 Anganwadis, a total of 572 children aged 3 or less were registered. Notably, approximately 14.2% (95% CI: 11.5-17.3) of these children experienced underweight, 16.4% (95% CI: 13.6-19.7) were stunted and 13.3% (95% CI: 10.8-16.3) were wasted. In terms of gender disparities, the prevalence of undernurition was notably higher among boy children, with 15.4% being underweight, 16.9% stunted and 14.7% wasted. The prevalence of childhood undernurition is a public health concern, demanding the enhancement of existing nutritional initiatives to ameliorate the healthy well-being of these children. The timely identification of malnourished children holds paramount importance, as intensified interventions can be promptly employed to uplift the health status of these vulnerable individuals.

The Health of Children in U.S. Military Families: Evaluation of the 2020-21 National Survey of Children's Health.

The health of children and adolescents, particularly children of military families, is instrumental for military departments; yet, there has not been an examination on the overall physical health status, or access to health care, among children of military families compared to children of civilian families. This study used the 2020-2021 National Survey of Children's Health, children aged 0-17 years, to examine the association between military status of the caregiver of the child and the child's health status, financial stability, and health care access via health insurance coverage (n = 90,711 children). Bivariate analyses used Pearson's chi-squared tests and were weighted to be nationally representative. Multivariable regression analyses were used to examine the association between military status and selected health outcomes. In unadjusted analyses, we found that children who had ever had a caregiver serve on active duty were overall more financially stable than children with a civilian caregiver, with children of military families less likely to reside below the federal poverty level and more likely to have continuous health insurance coverage. We also found that children with a caregiver who has ever been on active duty were more likely to have reported mental health needs and more likely to have special health care needs than their civilian counterparts. In adjusted analyses, children with a caregiver who has ever been on active duty were more likely to have special health care needs (adjusted odds ratio [aOR] 1.22; 95% confidence interval [CI] 1.10-1.36) and mental health needs (aOR 1.22; 95% CI 1.10-1.35). This is the first study, to our knowledge, to do a national examination of overall physical and mental health, as well as specific health conditions and access to health care, among children of military families compared to their civilian counterparts. The findings from this study may be instructive for policymakers and stakeholders in evaluating special needs and mental health resources for military families and improve continuity of health care access through insurance coverage to improve the health of all U.S. children and adolescents.

Conflict between parents, physicians, and healthcare professionals in medical decision-making: How to address it-A systematic review from the ESPGHAN Ethics Committee.

Medical decisions about pediatric gastroenterology pathologies often involve collaboration between the medical team and the family. On occasions, conflict may arise between the individuals involved in decision making (team-family conflict) causing delays in managing a child's health condition. Little is known on the strategies that can be implemented to address such conflicts. Using the systematic review model by McCullough et al., an electronic literature search was conducted using PUBMED databases and SCOPUS. Studies published between 2001 and 2022 were analyzed to identify high-risk families, the barriers and facilitators involved in the team-family conflict and the circumstances in which healthcare professionals can be ethically justified to override parents' medical decisions and to trigger the state intervention. The present review provides recommendations on the more suitable ways to manage team-family conflict and gives a practical approach using a case vignette.