High Children Research Articles

Early life body size, pubertal timing, and risks of benign breast disease in a large cohort of Danish female adolescents and women

A high childhood body mass index (BMI) may be protective against benign breast disease (BBD), but little is known about the effects of other early life body size measures. Thus, we examined associations between birthweight, childhood BMI, height, and pubertal timing and BBD risks. We included 171,272 girls, born from 1930 to 1996, from the Copenhagen School Health Records Register, which contains information on birthweight, childhood anthropometry (7-13years), age at onset of the growth spurt (OGS), and peak height velocity (PHV). During follow-up, 9361 BBD cases (15-50years) were registered in the Danish National Patient Register. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regressions. At all childhood ages, BMI was inversely but non-linearly associated with BBD. The association was slightly stronger in magnitude for BMI z-scores above 0 (HRage 7 = 0.86; 95%CI: 0.83-0.90 per z-score) than below 0 (HRage 7 = 0.95; 95%CI 0.91-0.99 per z-score). Associations between childhoodheight and BBD differed by age; at 7years the association was an inverted U-shape, whereas at 13years height was not associated with BBD. Ages at OGS and PHV were positively associated with BBD. Low and high birthweights were associated with lower BBD risks. Conclusion: A high childhood BMI, a short or tall stature at young childhood ages, an early pubertal onset, and low or high birthweights are associated with reduced risks of BBD. These complex associations suggest that the role of these factors in breast tissue development during early life warrants further investigation in relation to BBD etiology. What is Known: •Benign breast disease (BBD) is common and may be an intermediary marker of breast cancer risks. •Early life body size may relate to the development of BBD, but currently little is known. What is New: •Girls with a high body mass index at school ages or with an early pubertal timing have decreased risks of BBD. •Short and tall heights at young childhood ages and low and high birthweights are associated with lower BBD risks.

602-P: Prenatal Exposure to Gestational Diabetes Mellitus and Autistic Traits among Typically Developing Children

Children exposed to GDM in utero are at increased risk of developing autism spectrum disorder, a neurodevelopmental disorder characterized by social deficits. Limited studies have tested if GDM exposure is associated with higher autistic traits in typically developing children or what the neural substrates are. We used the social responsiveness scale (SRS) to measure differences in autistic traits between GDM-exposed and unexposed children and examined if white matter pathways involved in the social brain network (SBN) were related to autistic traits in children. Children were recruited from Kaiser Permanente Southern California to participate in BrainChild, a study assessing neural programming of disease risk (N=136; 9 ±1.5 years; 63% female; 52% GDM-exposed) . During visits, children completed a brain magnetic resonance imaging scan, demographics were collected, and parents completed the SRS. Maternal GDM diagnosis, glucose levels from a 1-hr 50g glucose challenge completed during pregnancy, and pre-pregnancy BMI were obtained from electronic medical records. Fractional anisotropy (FA) was used to assess white matter microstructure. Linear regression was used to test associations between SRS raw scores with GDM exposure, maternal glucose levels, and SBN white matter pathways, controlling for child age, sex, socioeconomic status, and maternal pre-pregnancy BMI. SRS scores were higher for GDM-exposed children than unexposed (GDM: 35.7±2.1; Unexposed: 29.5±2.3, p=0.03) . Maternal glucose levels were associated with higher child SRS scores (β=0.002, p=0.06) . Higher SRS scores were associated with reduced FA in multiple SBN white matter tracts (p<0.01) . GDM exposure and higher maternal glucose levels were associated with more autistic traits, suggesting that intrauterine exposure to a GDM hyperglycemic environment may affect autistic traits even among typically developing children. Further, SBN white matter tracts may be related to social deficits. Disclosure J.M.Alves: None. B.C.Angelo: None. S.Negriff: None. S.H.Luo: None. T.Chow: None. R.Cabeen: None. S.A.Carter: None. A.Xiang: None. K.A.Page: None. Funding pAmerican Diabetes Association (#1-14-ACE-36) ; R01DK116858

High childhood serum triglyceride concentrations associate with hepatocellular adenoma development in patients with glycogen storage disease type Ia

Background & AimsGlycogen storage disease type Ia (GSDIa) is an inborn error of carbohydrate metabolism caused by pathogenic variants in the glucose-6-phosphatase catalytic subunit 1 (G6PC1) gene and is associated with hepatocellular adenoma (HCA) formation. Data on risk factors for HCA occurrence in GSDIa are scarce. We investigated HCA development in relation to sex, G6PC1 genotype, and serum triglyceride concentration (TG).MethodsAn observational study of patients with genetically confirmed GSDIa ≥12 years was performed. Patients were categorised for sex; presence of 2, 1, or 0 predicted severe G6PC1 variant (PSV); and median TG during childhood (<12 years; stratified for above/below 5.65 mmol/L, i.e. 500 mg/dl).ResultsFifty-three patients (23 females) were included, of which 26 patients developed HCA at a median (IQR) age of 21 (17–25) years. At the age of 25 years, 48% of females and 30% of males had developed HCA (log-rank p = 0.045). Two-thirds of patients with GSDIa carried 2 PSVs, 20% carried 1, and 13% carried none. Neither the number of PSVs nor any specific G6PC1 variants were associated with HCA occurrence. Childhood TG was 3.4 (3.0–4.2) mmol/L in males vs. 5.6 (4.0–7.9) mmol/L in females (p = 0.026). Childhood TG >5.65 mmol/L was associated with HCA development at younger age, compared with patients with childhood TG <5.65 mmol/L (18 vs. 33 years; log-rank p = 0.001). Cox regression analysis including TG, sex, and TG–sex interaction correction revealed childhood TG >5.65 mmol/L as an independent risk factor for HCA development (hazard ratio [HR] 6.0; 95% CI 1.2–29.8; p = 0.028).ConclusionsIn patients with GSDIa, high childhood TG was associated with an increased risk of HCA, and earlier onset of HCA development, independent of sex-associated hypertriglyceridaemia, and G6PC1 genotype.Lay summaryGlycogen storage disease type Ia (GSDIa) is a rare, inherited metabolic disease that can be complicated by liver tumours (hepatocellular adenomas), which in turn may cause bleeding or progress to liver cancer. Risk factors associated with hepatocellular adenoma formation in patients with GSDIa are largely unknown. In our study, we found that high serum triglyceride concentrations during childhood, but not specific genetic variants, were associated with increased risk of hepatocellular adenoma diagnosis later in life.

Correlates of Aggression in Men With Methamphetamine Use Disorder: Childhood Trauma and Methamphetamine-Use Characteristics.

BackgroundAggression is common among individuals with methamphetamine use disorder (MAUD) and constitutes a serious public health issue. The current study aimed to examine associations of methamphetamine-use characteristics and childhood trauma with aggression in men with MAUD.MethodsThis cross-sectional study was conducted from December 2017 to August 2018. MAUD patients recruited from a compulsory drug rehabilitation center (n = 360) and healthy comparison subjects (n = 604) completed a survey that measured aggression and childhood trauma, using the Chinese version of Buss-Perry Aggressive Questionnaire (AQ-CV), and the short form of Childhood Trauma Questionnaire (CTQ-SF), respectively. MAUD patients also provided information on methamphetamine-use characteristics such as the age of MAUD onset, MAUD severity, and co-occurring alcohol use disorder (AUD) and tobacco use disorder (TUD) using standard or self-designed questionnaires. Chi-square tests and t-tests were used to compare childhood trauma and aggression between the MAUD and comparison groups. Multiple linear regressions were conducted to determine correlates of overall aggression and its five sub-scales among the MAUD group.ResultsThe MAUD group had higher childhood trauma and aggression scores than the comparison group. Within the MAUD group, age of MAUD onset, having severe MAUD, co-occurring AUD, co-occurring TUD, and childhood trauma were associated with overall aggression, with slightly different correlates found for its five sub-scales.ConclusionsOur study shows a high level of childhood trauma and aggression in the MAUD group. Both methamphetamine-use characteristics (age of MAUD onset, severe MAUD, co-occurring AUD/TUD) and childhood trauma were associated with aggression in MAUD. Our findings provide useful information on potential risk factors for aggression and inform future longitudinal research to establish causal relationships between these factors and aggression to guide further prevention and treatment programs.

The mediating effect of DNA methylation in the association between maternal sleep during pregnancy and offspring adiposity status: a prospective cohort study

BackgroundChildhood overweight/obesity is a global public health concern. It is important to identify its early-life risk factors. Maternal poor sleep is common in late pregnancy, and previous studies indicated that poor sleep may influence the offspring’s adiposity status. However, very few studies in humans investigated the effect of the different sleep parameters (sleep quantity, quality, and timing) on the offspring’s adiposity indicators, and long-term studies are even more scarce. In addition, the underlying mechanism remains unclear. The present study therefore aimed to examine the association between the three maternal sleep dimensions in the late pregnancy and the offspring adiposity indicators and to explore the potential mediating effect of the cord blood DNA methylation in the above association.MethodsIncluded participants in the current study were 2211 healthy pregnant women with singleton gestation from the Shanghai Birth Cohort (SBC) and Shanghai Sleep Birth Cohort (SSBC). Maternal nighttime sleep duration, quality, and midpoint (an indicator of circadian rhythm) were assessed by the same instrument in both cohorts during late pregnancy, and the offspring’s body mass index (BMI) and subcutaneous fat (SF) were measured at 2 years old. Additionally, in 231 SSBC samples, the genome-wide DNA methylation levels were measured using the Illumina Infinium Methylation EPIC BeadChip. The multivariate linear regression was used to determine the associations between the maternal sleep parameters and the offspring adiposity indicators. The epigenome-wide association study was conducted to identify the maternal sleep-related CpG sites. The mediation analysis was performed to evaluate the potential intermediate role of DNA methylation in the association between maternal sleep and offspring adiposity indicators.ResultsThe mean maternal nighttime sleep duration and the sleep midpoint for combined cohorts were 9.24 ± 1.13 h and 3.02 ± 0.82, respectively, and 24.5% of pregnant women experienced poor sleep quality in late pregnancy. After adjusting for the covariates, the maternal later sleep midpoint was associated with the increased SF in offspring (Coef. = 0.62, 95% CI 0.37–0.87, p < 0.001) at 2 years old. However, no significant associations of the nighttime sleep duration or sleep quality with the offspring adiposity indicators were found. In the SSBC sample, 45 differential methylated probes (DMPs) were associated with the maternal sleep midpoint, and then, we observed 10 and 3 DMPs that were also associated with the offspring’s SF and BMI at 2 years, of which cg04351668 (MARCH9) and cg12232388 significantly mediated the relationship of sleep midpoint and SF and cg12232388 and cg12225226 mediated the sleep midpoint–BMI association, respectively.ConclusionsMaternal later sleep timing in late pregnancy was associated with higher childhood adiposity in the offspring. Cord blood DNA methylation may play a mediation role in that relationship.

Tetanus seroprotection among children in the Democratic Republic of the Congo, 2013-2014.

BackgroundTetanus is a potentially fatal disease that is preventable through vaccination. While the Democratic Republic of the Congo (DRC) has continued to improve implementing routine vaccination activities throughout the country, they have struggled to maintain high childhood vaccine coverage. This study aims to examine the seroprevalence of tetanus in children 6 to 59 months to identify areas for intervention and improvement of vaccination coverage.MethodsIn collaboration with the 2013–2014 Demographic and Health Survey, we assessed the seroprevalence of tetanus antibodies among children in the DRC. Dried blood spot samples collected from children 6–59 months of age were processed using a prototype DYNEX Multiplier® chemiluminescent automated immunoassay instrument with a multiplex measles, mumps, rubella, varicella and tetanus assay. Multivariable logistic regression was used to determine factors associated with tetanus vaccination and seroprotection.ResultsOverall, 36.1% of children 6–59 months of age reported receiving at least 1 dose of tetanus vaccine while 28.7% reported receiving 3 doses; tetanus seroprotection was 40%. Increasing age in children was associated with decreased tetanus seroprotection, but increased number tetanus vaccinations received. Factors related to increased tetanus seroprotection included number of children in the household, wealth index of the family, urban residence compared to rural, level of maternal education, and province and geography.ConclusionsOur findings in this nationally representative sample indicate that serology biomarkers may help identify children who are not fully immunized to tetanus more accurately than reported vaccination. While children may be captured for routine immunization activities, as children age, decreasing seroprevalence may indicate additional need to bolster routine vaccination activities and documentation of vaccination in school aged children. Additionally, the study highlights gaps in rural residential areas and vaccination coverage based on maternal education, indicating that policies targeting maternal education and awareness could improve the coverage and seroprevalence of tetanus antibodies in the DRC.

What is the concordance between parent- and education professional-reported adaptive functioning in autistic children using the VABS-II?

Adaptive functioning of autistic children is traditionally measured through informant-report, often from parents. Behaviour varies across settings though, and context-specific reports should be considered. Limited and inconsistent results show low parent-education professional concordance, but no research has yet explored item level response variation. We investigated Vineland Adaptive Behaviour Scales-II concordance using 233 lower ability autistic children from the PACT-G sample. Domain and item level agreement was low, but better on objectively measured behaviours. Higher child nonverbal ability improved concordance. Where disagreements occurred, education professionals identified emergent skills more and parents were more likely to rate present/absent. Parents and education professionals view the adaptive abilities of autistic children differently and both should be considered when developing personalised interventions and support.

Marital stress and emotion work in same-sex and different-sex marriages: the moderating role of childhood adversity

ABSTRACT Adverse experiences in childhood may set the stage for future response to stress, emotion regulation, and interaction with partners in intimate relationships. This study examines the moderating role of childhood adversity on the association of daily marital stress with emotion work provision (intentional activities devoted to enhancing others’ emotional well-being) and considers whether the association varies for men and women in same- and different-sex marriages. Specifically, I use ten days of dyadic diary data collected from 378 midlife same- and different-sex married couples (n = 756 individuals) and conduct multilevel regression models. The results show marital stress is positively associated with emotion work provision, and that the association is stronger for respondents who report more adverse childhood experiences. For respondents with low childhood adversity, the association of marital stress with emotion work is greater for same-sex couples compared to different-sex couples; for those with high childhood adversity, the association is equally strong. Findings from this study suggest that both men and women in same- and different-sex relationships do more emotion work in response to increased daily marital stress. Furthermore, early experiences of adversity are linked to stress responses in adulthood, with differing implications for men and women in different-sex and same-sex unions.

Weight status change from birth to childhood and high carotid intima-media thickness in childhood.

High birth weight or childhood overweight increases the risk of high carotid intima-media thickness (cIMT) in childhood. However, no studies have assessed the association between change in weight status from birth to childhood and cIMT in childhood. We examined the association between weight status change from birth to childhood and cIMT in childhood based on a population-based study of Chinese children. Data were from the Huantai Childhood Cardiovascular Health Cohort Study. A total of 1307 primary school children aged 6-11 years were included. Children were categorized into four groups based on their weight status at birth and at childhood: persistently normal weight, weight loss, weight gain, and persistently high weight. Compared with children with persistently normal weight from birth to childhood, those with weight gain (odds ratio [OR]=6.01, 95% confidence interval [CI]=3.36-10.76) and persistently high weight (OR=5.78, 95% CI=2.60-12.82) had increased odds of high cIMT in childhood. In contrast, children who had high birth weight but became normal weight in childhood did not have significantly increased odds of high cIMT in childhood (OR=1.27, 95% CI=0.28-5.67). Overweight in childhood was associated with increased odds of high cIMT irrespective of birth weight status. The odds of high cIMT in childhood could be reversed if newborn with high birth weight become normal weight in childhood.

The influence of childhood socioeconomic status on non-communicable disease risk factor clustering and multimorbidity among adults in Botswana: a life course perspective.

Childhood socioeconomic circumstances have a great influence on the health of individuals in adult life. We used cross-sectional data from a non-communicable disease (NCD) survey conducted in 2016, and respondents aged ≥15 y were selected from 3 cities/towns, 15 urban villages and 15 rural areas using a multistage probability-sampling technique. The total sample for the study was 1178. Two multinomial logistic regression models were fitted to data to ascertain the association between childhood socioeconomic status (SES) and NCD risk factor clustering and multimorbidity, using SPSS version 27. All comparisons were considered to be statistically significant at a 5% level. The prevalence of multiple NCD risk factors and multimorbidity was 30.1 and 5.3%, respectively. The odds of reporting NCD risk factor clustering were significantly high among individuals who reported low (adjusted OR [AOR]=1.88, 95% CI 1.21 to 2.78) and middle (AOR=1.22, 95% CI 1.02 to 2.05) childhood SES compared with high childhood SES. Conversely, individuals from a low SES background were more likely to report both single (AOR=1.17, 95% CI 1.00 to 2.01) and multiple NCD conditions (AOR=1.78, 95% CI 1.11 to 2.68) compared with those with a high childhood SES background. There is a need to stimulate policy debate and research to take cognisance of childhood socioeconomic circumstances in health policy planning.

The impact of socioeconomic status on preferences for sustainable luxury brands

AbstractAs consumers become more aware of and concerned about the environmental impact of their consumption choices, an increasing number of luxury brands are now engaging in sustainability practices. This study examines factors influencing the effectiveness of embedding sustainability in luxury brands. Specifically, the research focus is the effect of childhood socioeconomic status on moderating consumer preferences for sustainable (vs. regular, nonsustainable) luxury brands. Four experimental studies using different product categories and luxury brands show that preferences for sustainable (vs. regular, nonsustainable) luxury brands are stronger among consumers with relatively low (vs. high) childhood socioeconomic status (Studies 1–4). Notably, these preference patterns are driven by differences in the perceived importance of cooperation in the community among consumers with low versus high childhood socioeconomic status (Study 3). However, these divergent patterns are attenuated when consumption involves the nonluxury brand category (Study 2), and when consumers experience a high‐threat environment (e.g., the COVID‐19 pandemic; Study 4). As such, the findings of this study contribute to the literature by shedding light on the conditions under which consumers show preferences for sustainable (vs. regular, nonsustainable) luxury brands, establishing a theoretically grounded mediator (importance of cooperation in the community) and moderator (perceived environmental threat).

The role and influence of educational leaders in centres rated as providing high quality early childhood educational programs

Despite the role pedagogical leadership plays in quality early childhood education and care services, limited research to date has explored the appointment and enactment of educational leaders in Australia. This qualitative study explored the role and influence of two educational leaders in a high-quality rated service. Findings revealed that these educational leaders’ exercising of distributed and transformational leadership enabled ongoing quality improvement. Appointing the ‘right’ person; a supportive, effective and cohesive team; the whole-of centre valuing of the educational leaders and their role; investment of resources; and professional autonomy, were identified as key enablers of quality education across the service. As the first study to investigate the educational leader role in an ‘excellent’-rated service in Australia, this study highlights that the effectiveness of an EL is dependent on the person in the EL role and the context in which they are working. Implications for policy and service providers are discussed.

The impact of maternal influences on childhood obesity

There was a lack of detailed information about maternal influences on their children’s body mass index (BMI) in Taiwan. The aim of this study was to find the evidence to describe how mothers’ factors could affect their 2 to 9-year-old children’s BMI, with data collected from May 2021 to June 2021. Anonymous self-administered questionnaires were completed by 1035 participants from Taiwan’s six metropolitan cities and eight counties. After controlling for children’s factors, such as number of children in a family, children’s constitution, children’s age and gender, hierarchical regression models were used to analyze the effects of five maternal factors on their children’s BMI: maternal BMI, age, education level, monthly household income, and marital status (single parent or not). The results were found as follow: maternal BMI [β = .24], maternal educational level [β = −.141], and monthly household income [β = .071], significantly (p < 0.05) influenced their children’s BMI. Higher maternal BMI was associated with a higher children’s BMI. Mothers with lower levels of education background were more likely to have children with a higher BMI. Monthly household income was a positive factor influencing children’s BMI. In conclusion, this study is the first detailed description of maternal influences on their 2–9 years old children’s BMI in Taiwan. Although the study could not cover all of the factors influencing Taiwan’s childhood obesity, we have discovered maternal BMI, education level, and monthly household income were significant factors associated with children’s BMI.

Childhood socioeconomic status and social integration in later life: Results of the Japan Gerontological Evaluation Study

Older people's social integration is important for their health and well-being. However, few studies have investigated the determinants of older adults' social integration through childhood socioeconomic status (SES). This study investigated the association between childhood SES and each aspect of social integration among Japanese older people. We used data from the Japan Gerontological Evaluation Study 2010, a self-reported survey of 23,320 functionally independent people aged 65 or older across Japan (response rate: 66.3%). Childhood SES was assessed based on respondents' subjective assessment of their SES at the age of 15. Social integration was identified as participation in community groups, social networks, being homebound, and being married. We used Poisson regression analysis with robust variance to investigate the association between childhood SES and each social integration measurement, adjusted for potential mediators; namely, adult sociodemographic characteristics, health status, health behavior (smoking), living status, and personality. Lower childhood SES had long-lasting impact on the social integration of this older Japanese cohort. In the fully adjusted model, older people with lower childhood SES were less likely to participate in community groups (Non-membership sports group or club, adjusted prevalence ratio [APR]: 1.03, 95% confidence interval [CI]: 1.00–1.06; (Non-membership hobby group, APR: 1.04; 95% CI: 1.00–1.09), almost never met friends (APR: 1.17, 95% CI: 1.11–1.24), had a smaller social network (APR: 1.13; 95% CI: 1.08–1.19), and were more likely to be homebound (APR: 1.24; 95% CI: 1.05–1.45) than those with high childhood SES. Lower childhood SES negatively affected social integration in older age. Mitigating childhood poverty might be important to increase social integration in later life, thereby improving health outcomes.

Clinico-Demographic characteristics, morbidity and mortality patterns of sickle cell disease in a tertiary institution

Introduction: Sickle cell disease (SCD) is the most common hereditary hematological disorder in Nigeria with an annual incidence of more than 100,000 new births which contributes to the high Nigerian under-five childhood morbidity and mortality. Sufferers of the disease are frequently admitted into emergency rooms for presentations and complications such as pain crisis, anemia, stroke, and acute chest syndrome, in addition to other childhood infections such as severe malaria, sepsis, and acute respiratory tract infections. The aim of the study was to describe the clinicodemographic features and morbidity and mortality patterns of children with SCD in a tertiary institution. Methods: The study was a retrospective review of case records of children with SCD admitted with various diagnoses. Results: Complete records of 460 patients were reviewed and this constituted 10.1% of all new admissions during the period. There were more males, 286 (62%), than females, 174 (38%). The mean age was 6.3 ± 5.1 years and 249 (54.1%) were under the age of 5 years. The most common admitting diagnosis was a pain crisis comprising 168 cases (36.5%). The mean packed cell volume was 20.6 ± 4.1 inclusive of hemoglobin SC phenotype, and 197 (42.8%) had simple top-up transfusion, while 28 (6.1%) had exchange transfusion. A total of 438 (95%) patients were discharged, 21 (4.6%) died, and the highest mortality was from severe anemia (47.6%). Conclusion: This study describes the high burden of SCD constituting 10.1% of admissions, as well as the pattern of morbidity and mortality largely from severe anemia in the area under study.

Exemplars in vaccine delivery protocol: a case-study-based identification and evaluation of critical factors in achieving high and sustained childhood immunisation coverage in selected low-income and lower-middle-income countries

IntroductionIncreases in global childhood vaccine delivery have led to decreases in morbidity from vaccine-preventable diseases. However, these improvements in vaccination have been heterogeneous, with some countries demonstrating greater levels of...

Knowledge, attitude, and practices regarding childhood tuberculosis detection and management among healthcare providers in Cambodia: a cross-sectional study

BackgroundThe World Health Organization (WHO) estimated that 29% of global tuberculosis (TB) and almost 47% of childhood TB cases were not reported to national TB programs in 2019. In Cambodia, most childhood TB cases were reported from health facilities supported by the Global Fund to Fight AIDS, Tuberculosis, and Malaria in 2019. This study aimed to compare the healthcare providers' knowledge, attitude, and practices (KAP) on childhood TB case detection in operational districts (ODs) with high and low childhood TB case detection in Cambodia.MethodsWe conducted a cross-sectional study between November and December 2020 among healthcare providers in 10 purposively selected ODs with high childhood TB case detection and 10 ODs with low childhood TB case detection. A total of 110 healthcare providers from referral hospitals (RHs) and 220 from health centers (HCs) were interviewed. We collected information on socio-demographic characteristics, training, and KAP on childhood TB. Pearson's Chi-square or Fisher's exact and Student's t-tests were performed to explore the differences in KAP of healthcare providers from ODs with low vs. high childhood TB detection.ResultsOf the 330 respondents, 193 were from ODs with high childhood TB case detection, and 66.67% were from HCs. A significantly higher proportion (46.11%) of respondents from ODs with high childhood TB case detection received training on childhood TB within the past two years than those from low childhood TB case detection ODs (34.31%) (p = 0.03). Key knowledge on childhood TB was not significantly different among respondents from ODs with high and low childhood TB case detection. A significantly higher proportion of respondents from ODs with high childhood TB case detection had a good attitude (98.96 vs. 97.08%, p = 0.002) and performed good practices (58.55 vs. 45.26%, p = 0.02) on contact investigation in the community than those from low childhood TB case detection ODs.ConclusionsHealthcare providers from ODs with high childhood TB detection had better attitudes and practices towards childhood TB. The attitudes and practices need to be improved among healthcare providers in ODs with low case detection. Further investment in training and experience sharing on childhood TB case detection among healthcare providers is needed to improve childhood TB case detection.

Childhood cardiorespiratory fitness and the early markers of kidney disease in middle age: A population-based cohort study

ObjectivesTo investigate the relationship of childhood cardiorespiratory fitness with early markers of chronic kidney disease, glomerular hyperfiltration and albuminuria, in midlife. DesignProspective cohort study. MethodsThis study included 1371 participants aged 36–49 years who participated in the 1985 Australian Schools Health and Fitness Survey when they were 7–15 years of age. Childhood cardiorespiratory fitness was estimated by the time taken to complete a 1.6- km run. Blood and urine samples were collected at follow-up. Log-binomial regression was used to determine the associations of childhood cardiorespiratory fitness with glomerular hyperfiltration [estimated glomerular filtration rate (mL/min/1.73 m2) > 95th percentile standardized for age and sex] and albuminuria (urine albumin-to-creatinine ratio ≥ 2.5 mg/mmol in males or ≥3.5 mg/mmol in females) in midlife. ResultsCompared with women with high childhood cardiorespiratory fitness, those with lower childhood cardiorespiratory fitness had a higher risk of glomerular hyperfiltration in midlife after adjusting for childhood age, the duration of follow-up, and midlife smoking status [adjusted relative risk = 2.86, 95% confidence interval, 1.04–7.86 for individuals with moderate childhood cardiorespiratory fitness (P = 0.04), and adjusted relative risk = 3.38, 95% confidence interval, 1.13–10.14 for individuals with low childhood cardiorespiratory fitness (P = 0.03)]. Further adjustment for childhood and midlife body mass index resulted in a slightly attenuated and statistically non-significant association. No significant associations were found with glomerular hyperfiltration in males or albuminuria in either males or females. ConclusionsLow cardiorespiratory fitness in childhood may increase the risk of glomerular hyperfiltration in midlife in females, possibly via a path through adult cardiorespiratory fitness.

A study of a pre-school teacher professionalism in order to improve the quality of educational work

The problem and the aim of the study. High quality early childhood education (ECE) enables children to enjoy the experience and have nurturing environment that promotes holistic development. The teachers quality have been predicted to produce desirable outcomes. However, the challenge is to identify the predictors that can quantify the definition of a quality teacher. This study was formulated to identify the best practice of quality pre-school teachers. Research methods. This study applied a quantitative approach involving survey to answer the research questions. The quantitative approach with a descriptive analysis. This study uses questionnaire to assess individual perceptions and views on quality of early childhood pre-school education. The sample size was 1817 teachers from four types of pre-school or TADIKA (kindergartens). The surveys were conducted in Malaysia starting with random sampling of groups to select representatives of the statewide zones. Each identified zone then underwent a stratified sampling method to ensure that all critical groups of informants were included Results. The study's findings revealed that the gap analysis related to the upgrading of professionalism of pre-school teachers based on in-service course and teaching and learning course attended beyond the standard 7 days a year except MOE pre-school. Second, all pre-school agencies in Malaysia have not reached the best quality benchmarks. However, more than half of MOE pre-school teachers have a bachelor’s degree. The result shown differences between the ratio of teacher from the agencies. The gap ratio of children to teachers between private kindergartens with best practice benchmarks is 2.0 times, while 2.1 times for pre-schools MOE 2.6 times for KEMAS kindergartens, and 3.3 times for JPNIN kindergartens. Conclusion. In conclusion, these findings are important to be given attention and remedial action in order the improvement and quality of teacher achieve the minimum standard especially in participating in adequate professional development programs.

Smoking during pregnancy is associated with child overweight independent of maternal pre-pregnancy BMI and genetic predisposition to adiposity

High maternal body mass index (BMI) and smoking during pregnancy are risk factors for child overweight. Maternal smoking tends to reduce her BMI and the association of smoking with child overweight may be confounded by or interacting with maternal genetic predisposition to adiposity. In the Danish National Birth Cohort, we investigated whether smoking during pregnancy is associated with child BMI/overweight independent of pre-pregnancy BMI and maternal genetic predisposition to adiposity estimated as total, transmitted and non-transmitted genetic risk scores (GRSs) based on 941 common genetic variants associated with BMI. Smoking during pregnancy was associated with higher child BMI and higher odds of child overweight in a dose–response relationship. The odds ratio (95% CI) for smoking 11 + cigarettes in third trimester versus no smoking was 2.42 (1.30; 4.50), irrespective of maternal BMI and maternal GRSs (total, transmitted or non-transmitted). There were no statistically significant interactions between maternal GRSs and smoking (all p-values for interactions > 0.05). In conclusion, in this study, smoking during pregnancy exhibits a dose–response association with increased child BMI/overweight, independent of maternal pre-pregnancy BMI, maternal transmitted, and non-transmitted genetic predisposition to adiposity. Avoidance of smoking during pregnancy may help prevent childhood obesity irrespective of the mother–child genetic predisposition.