Children Mean Age Research Articles

Developmental outcomes of children born through ICSI versus conventional IVF (cIVF) in couples with non-male factor infertility.

In non-male factor infertile couples, are there any differences in the developmental outcomes between children born through ICSI and conventional IVF (cIVF)? In this preliminary study, ICSI and cIVF seem to have a comparable effect on developmental outcomes after 12 months in children born to non-male factor infertile couples. ICSI, an invasive technique, has raised concerns about potential developmental abnormalities in children. Limited data are available regarding the developmental outcomes of ICSI-conceived infants born to non-male factor infertile couples. This prospective cohort study involved a follow-up of all children aged 12 months or older who were born from pregnancies resulting from either ICSI or cIVF as part of a previous randomized controlled trial (RCT) (NCT03428919). In the original RCT, 1064 women were randomly assigned to the ICSI or cIVF groups (532 women for each group). Follow-up was conducted with 155 couples (195 children) in the ICSI group and 141 couples (185 children) in the cIVF group. The Vietnamese version of the Ages & Stages Third Edition Questionnaires (ASQ-3) and the Development Red Flags questionnaires were completed by the participants. A total of 141 (90.1%) women (177 children) in the ICSI group and 113 (80.1%) women (145 children) in the cIVF group returned fully completed questionnaires. The primary outcomes were the developmental outcomes based on responses to the ASQ-3 and the Red Flags questionnaire. The mean age of children at follow-up was 19.5 ± 5.0 months in the ICSI group and 19.3 ± 5.5 months in the cIVF group. The mean height and weight of children in both groups were similar. The overall proportion of children with any abnormal ASQ-3 score did not differ significantly between the ICSI and cIVF groups (16.9% vs 13.1%, P = 0.34). The proportion of children with Red Flag signs was also comparable between the two groups (6.2% vs 9.2%, P = 0.36, ICSI vs cIVF, respectively). Despite a reasonably high follow-up response rate, there is a potential risk of sampling bias, and overall, the number of children with developmental abnormalities was very small. The study relied solely on questionnaires as screening tools, rather than incorporating additional behavioral observations or physical developmental tests; this may have affected the statistical power and the significance of between-group comparisons. The current findings contribute to the existing evidence and support the comparative safety of ICSI and cIVF regarding early childhood development. However, more extensive and prolonged follow-up data for these children are needed to draw definitive conclusions. No external funding was received for this study, and no authors reported conflicting interests. NCT04866524 (clinicaltrials.gov).

Parent reported outcomes for idiopathic clubfoot children treated with the Ponseti technique: An analysis of 140 feet followed minimum 5 years

ObjectiveThe treated clubfoot children are often evaluated clinically during follow-up. However, patient reported outcomes (PROM) are seldom analysed for these children. We investigated 87 idiopathic clubfoot children (140 feet) treated by the Ponseti method and followed minimum 5 years to study their clinical outcomes and PROM. Material and methodsThis was a cross-sectional study, based on evaluating treated clubfoot children clinically (Pirani score) and PROM (Oxford Ankle and Foot Questionnaire – Parent Version) and comparing them with the age-matched healthy controls (n = 60). The questionnaire has four main domains related to the child's physical, school and play, emotional and footwear profile. The children having persistent deformity (residual/relapse) were specifically studied for their PROM scores. ResultsThe mean child age at initial treatment was 2.3 months and the mean follow-up duration was 6.9 years. The PROM score of clubfoot children was statistically lower than the healthy controls (p < 0.001). Of the individual domains, the physical domain was the most affected. On calculating the Pirani scores, 10 out of 140 feet (7 %) had some form of persistent deformity. The children with persistent deformity had lower Oxford scores than healthy children or those with corrected feet. The physical domain followed by the emotional domain scored low when persistent deformity was present. ConclusionsMost children (98 %) had a plantigrade foot following Ponseti treatment at follow-up. However, PROM score of the clubfoot children did not correspond to the clinical outcome. Persistent deformity, even minor, was a cause of parental concern and resulted in a low PROM score.

Dampak Perbedaan Pola Asuh Orang Tua Terhadap Pertumbuhan dan Perkembangan anak di Desa Bangun Rejo KecamatanTanjung MorawaTahun 2024

Receiving care from parents is a child's right. However, the absence of parents in a child's life means that a child does not receive care from his parents. The absence of parents is a condition where the whereabouts of the child's parents are unknown or other conditions which prevent the child from getting his right to be cared for. However, this can be overcome by providing alternative care. Alternative care is care that is carried out based on a substitute family or Child Welfare Institution. Service activity method with structured lectures and guidance. The results were that participants were very enthusiastic in participating in service activities by STIKes Mitra Husada Medan lecturers regarding parenting styles for parents in educating their children at home. So that insight and knowledge increase. The following are community service activities, especially parents, starting from providing material by the Lecturer Team headed by Indra Agussamad, S.Kep, M.Kes and members Lisdayanti Simanjuntak, Ingka Kristina and 2 students.

How do childhood and children's rights mean what they mean? Innovating the debate around the social semantics of childhood and children's rights through an interdisciplinary approach

AbstractThis article discusses children's rights as social semantics, approaching them as a form of self‐description of a paradoxical relationship that has emerged from the late twentieth century within several social systems, a relationship between generational order and children's position as holders of human rights. Charles Taylor's theory on the evolution of the semantics of human value is combined with a wide interdisciplinary array of contributions from Childhood Studies, Social Work, Pedagogy, Studies on Constitutionalism to propose an innovative social ontology of children's rights. Although the UNCRC has been the object of critical scrutiny since the early 1990s, the authors are not aware of any previous attempt to approach children's rights as social semantics in an attempt to illuminate the dynamic and paradoxical coupling within discourses on childhood between a fundamental social process, the reproduction of generational order and a fundamental social institution, human rights as codified in western modernity. The authors argue that while describing a paradoxical coexistence between intergenerational order and human rights, the semantics of children's rights maintains its unity as a cultural form because another semantic distinction, between human rights and personal rights continue to generate social meaning. It is hoped that the scholarly debate will benefit from the contribution of this article to enrich the debate around the social ontology of childhood and children's rights.

Effects of digital and non-digital parental distraction on parent-child interaction and communication

Technoference, namely parental screen use in the presence of a child, is a widespread phenomenon that has negative effects on parent-child interaction and communication. When parents use screens around their children there are fewer interactions and parents are less contingent and responsive to the child. Additionally, children show more negative behaviors, such as whining, frustration, and outbursts. Communication is also affected—parents speak and gesture less towards their children and, in turn, children are less likely to develop their language abilities. It remains unclear, however, if parental distraction due to screen use affects parent-child interaction and communication more negatively compared to non-digital parental distraction. Fifty-two parent-child dyads (mean child age = 22 months, range 12–36 months) first played for 5 min (Time 1); then (Time 2), the parent was asked to fill out a questionnaire on a tablet (screen condition), on a printed form (paper-pen condition) or was not interrupted (control condition). Interactive quality was assessed at Time 1 and Time 2 using the Coding Interactive Behavior scale. Communication was assessed by coding the number of word tokens and types during Time 1 and Time 2; child gestures were also coded. Results revealed that when parents were distracted—either by the paper-pen or the screen questionnaire—the quality of the interaction significantly deteriorated (ps ≤ .01) and the quantity of parental communication significantly declined (ps ≤ .012). Importantly, the nature of the distraction did not matter: there were no significant differences between the paper-pen and the screen distraction conditions across Time 2 (ps ≥ .59). Findings suggest that parental distraction matters for the quality of interaction and the amount of communicative bids, independently on whether parents were distracted by a digital or non-digital activity. These findings likely relate to complex factors related to young children's experiences and habits with parental screen use.

Quality of Life and Its Associated Correlates of Parents of Children on the Autism Spectrum in Singapore.

This cross-sectional study aimed to assess Quality of life (QoL) of parents of children on the autism spectrum in Singapore and identify its associated factors. Parents of children (age ≥ 5years) completed the Quality of Life in Autism scale which measures parental self-rated QoL (higher scores denote greater QoL), and the perceived impact of the child's autism-related behaviors on parents (higher scores denote lesser impact). Information on the child's degree of autism (measured by the Social Responsiveness Scale, second edition [SRS-2]), community and social participation and cognitive and adaptive functioning were also obtained. Participants were 86 parents with mean child age 6.3years (SD 1.0). Univariate analysis results revealed greater participation in community and social events to be two modifiable factors associated with higher parental QoL. However, these factors were not found to be significant in the multivariate model. Higher autism features (represented by higher parent-rated SRS scores) was associated with a greater perceived impact of the child's behaviors by parents in both univariate and multivariate analyses. Of note, child's cognitive or adaptive skills were not significantly associated with either QoL measure. Equipping parents to handle autism-related behaviors can be useful to reduce their impact on parental QoL. Facilitating community participation for these children may positively influence caregiver QoL as well.

Activin A: a marker of mineral bone disorder in children with chronic kidney disease?

Activin A has been shown to enhance osteoclast activity and its inhibition results in bone growth. The potential role of activin A as a marker of chronic kidney disease-mineral bone disease(CKD-MBD) and its relationship with other markers has not been studied in children with CKD. A cross sectional study was conducted among 40 children aged 2 to 18years with CKD (Stage 2 to 5; 10 in each stage) and 40 matched controls. Activin A, cathepsin K, FGF-23, PTH, serum calcium, phosphorous and alkaline phosphatase in both groups were measured and compared. The correlation of activin A and markers of CKD-MBD was studied. A p value of < 0.05 was considered significant. The mean age of children with CKD was 9.30 ± 3.64years. Mean levels of activin A in cases were 485.55pg/ml compared to 76.19pg/ml in controls (p < 0.001). FGF-23 levels in cases were 133.18pg/ml while in controls it was 6.93pg/ml (p < 0.001). Mean levels of cathepsin K were also significantly higher in cases as compared to controls. There was a progressive increase in activin A and cathepsin K levels with increasing stage of CKD. Activin A had a significant positive correlation with serum creatinine (r = 0.51; p < 0.001). Activin A levels progressively rise with advancing CKD stage. These findings suggest that activin A can be a potential early marker of CKD-MBD in children.

Epidemiology of respiratory syncytial virus in hospitalized children before, during, and after the COVID-19 lockdown restriction measures in Greece.

The COVID-19 pandemic modified the epidemiology and the transmission of respiratory syncytial virus (RSV). We collected data on RSV positivity and incidence from children hospitalized in the largest tertiary paediatric hospital in Greece before (2018-2020, period A), during (2020-2021, period B), and after (2021-2023, period C) the COVID-19 lockdown. A total of 9,508 children were tested for RSV. RSV positivity (%) was 17.6% (552/3,134) for period A, 2.1% (13/629) for period B, and 13.4% (772/5,745) for period C (p < 0.001). The mean age (±SD) of RSV-positive children among the three periods was A: 5.9(±9.3), B: 13.6 (±25.3), and C: 16.7 (±28.6) months (p < 0.001). The peak of RSV epidemiology was shifted from January-March (period A) to October-December (period C). RSV in-hospital incidence per 1,000 hospitalizations in paediatric departments was A:16.7, B:1.0, and C:28.1 (p < 0.001), and the incidence in the intensive care unit was A: 17.3, B: 0.6, and C: 26.6 (p < 0.001). A decrease in RSV incidence was observed during the COVID-19 lockdown period, whereas a significant increase was observed after the lockdown. A change in epidemiological patterns was identified after the end of the lockdown, with an earlier seasonal peak and an age shift of increased RSV incidence in older children.

Assessing Choroidal Thickness in Pediatric Patients With Unilateral Strabismic Amblyopia by Using Spectral Domain-Enhanced Depth Imaging-Optical Coherence Tomography.

Objective In this study, we aimed to evaluate the choroidal thickness in patients with unilateral strabismic amblyopia by usingspectral domain-enhanced depth imaging-optical coherence tomography (SD-EDI-OCT) (Heidelberg EngineeringGmbH, Heidelberg, Germany). Methods Twenty-five children with strabismic amblyopia and 20 age- and sex-matched healthy controls were included in this study. Seven sections were obtained, each comprising 25 repetitive images from each section at 200-micron intervals, and measurements were taken from nine different points at vertical and horizontal lines (1 and 3 mm from the subfoveal, superior, inferior, temporal, and nasal regions), centered on the fovea, using SD-EDI-OCT. Choroidal thickness values were obtained by measuring the distance between the basal border of the retinal pigment epithelium and the choroidoscleral border. The Mann-Whitney U test was used to compare choroidal thickness between the amblyopic and the control groups. Results The mean ageof children with amblyopia and that of controls were 8.4 ±2.7 and 9.9 ±3.3 years, respectively (p=0.120). The mean subfoveal choroidal thickness was 372.8 ±78.9 μm in amblyopic eyes and 372.4 ±79.3 μm in the fellow eyes, both of which were thicker than the control eyes (310.9 ±76.3 μm;p<0.05 for each). Similarly, the mean values for the choroidal thickness of the amblyopic children at 1 mm nasal (320 ±86 μm), 1 mm superior (363 ±70 μm), and 3 mm superior (336 ±62 μm) were also significantly thicker than those of the corresponding control eyes (p<0.05 for each). There was a negative correlation between the subfoveal choroidal thickness and axial length (r=-0.332, p=0.005). There were no correlations between the choroidal thickness, age, and visual acuity. Conclusions The choroidal thicknesses of strabismic and fellow eyes were similar in patients with strabismic amblyopia. However, the choroidal thickness of both eyes in strabismic children was significantly thicker than those of the healthy controls. Emmetropization may be defective in both eyes of strabismic amblyopic patients.

Association between Paediatric Complementary and Alternative Medicine Use and Parental Health Literacy, Child Health, and Socio-Economic Variables: A Prospective Study.

Complementary and Alternative Medicines (CAMs) constitute products and practices not considered allopathic medicine. CAM use is high in children, but little is known about factors that may influence parents using CAM with their child. This study aimed to determine the variables associated with CAM use in children with a prospective study among children and their parents attending a tertiary care hospital in New Zealand (NZ). Outcomes included current CAM use, parental opinions on CAM, parental health literacy and child well-being. This study was completed by 130 parents (85% female), and the mean child age was 6.7 years. CAM use was reported for 59 (45%) children, the most common being oral supplements and body manipulation. Children were more likely to use CAM if their parent had higher health literacy (p = 0.001), and if they had previously attended the emergency department within 12 months (p = 0.03). There was no association between child well-being and CAM use. Parental opinion of using CAM only if a doctor recommended it was associated with CAM use for their child (p = 0.01). Only 40% of parents disclosed their child's CAM use to the medical team. This study highlights that parental health literacy influences the use of CAM for children in NZ, providing insight for translational research to improve CAM safety and disclosure rates in NZ.

Parental Reports of Children's Dental Pain Experience and Associated Factors among Brazilian Children.

Exploring children's dental pain experiences helps to develop healthcare policies for improving oral health and quality of life. A cross-sectional study involved 300 parents/caregivers of four- to seven-year-old children using snowball sampling. Parents/caregivers self-completed an online questionnaire on sociodemographic characteristics, parenting styles, their child's oral hygiene practices, free sugar consumption, and dental history. The questionnaire was created using Google Forms and was disseminated to parents/caregivers via E-mail and/or WhatsApp©. Descriptive and Poisson regression analyses were performed (p < 0.05). Children's dental pain experience was reported by 20.3% of the parents. The authoritative parenting style was predominant. The child's mean age at the first consumption of sugar was 1.38 (±0.64) years, and 40.3% of the children had high-free sugar consumption. The mean age for the first dental appointment was 2.26 (±1.31) years, and 24.3% of the children never went to a dental appointment. The prevalence of dental pain experience was higher in children who attended their first dental appointment later (PR: 1.02; CI 95%: 1.01-1.03) and among those with high-free sugar consumption (PR: 1.90; CI 95%: 1.21-3.00). High sugar consumption and delay in the first dental appointment may increase the likelihood that children will experience dental pain.

Predicting Social Competence in Autistic and Non-Autistic Children: Effects of Prosody and the Amount of Speech Input.

Autistic individuals often face challenges perceiving and expressing emotions, potentially stemming from differences in speech prosody. Here we explore how autism diagnoses between groups, and measures of social competence within groups may be related to, first, children's speech characteristics (both prosodic features and amount of spontaneous speech), and second, to these two factors in mothers' speech to their children. Autistic (n = 21) and non-autistic (n = 18) children, aged 7-12 years, participated in a Lego-building task with their mothers, while conversational speech was recorded. Mean F0, pitch range, pitch variability, and amount of spontaneous speech were calculated for each child and their mother. The results indicated no differences in speech characteristics across autistic and non-autistic children, or across their mothers, suggesting that conversational context may have large effects on whether differences between autistic and non-autistic populations are found. However, variability in social competence within the group of non-autistic children (but not within autistic children) was predictive of children's mean F0, pitch range and pitch variability. The amount of spontaneous speech produced by mothers (but not their prosody) predicted their autistic children's social competence, which may suggest a heightened impact of scaffolding for mothers of autistic children. Together, results suggest complex interactions between context, social competence, and adaptive parenting strategies in driving prosodic differences in children's speech.

Prepandemic Factors Associated With Pandemic Impact and Psychosocial Distress Among Mothers of Young Children

ObjectiveTo describe the Coronovirus 19 (COVID-19) pandemic impact among mothers of young children (0–8 years) and assess prepandemic factors associated with greater pandemic impact and psychosocial distress. MethodsMothers from 3 US birth cohorts (n = 301, mean child age 2.4 years) reported on demographics and psychosocial distress (anxiety, perceived stress, financial stress) before the pandemic (February 2015–February 2020). During the pandemic (July 2020–June 2021), they completed a supplemental survey about the impact of the pandemic on their families (Coronavirus Impact Scale) and psychosocial distress. Multivariable linear and ordinal logistic regression were used to evaluate prepandemic factors associated with pandemic impact overall and by domain. ResultsCompared to prepandemic reports, maternal anxiety symptoms increased by 9.4%, perceived stress increased by 13.3%, and financial stress increased by 41.7%, of which all were statistically significant changes. Participants reported the most severe pandemic impact in family routines (72.4%), experiences of stress (40.2%), and social support (38.6%). Mothers with some college or a 4-year degree experienced higher overall pandemic impact compared to mothers with the least and highest education. Prepandemic distress was not associated with pandemic impact; however, midpandemic, all 3 distress measures were significantly positively associated with overall Coronavirus Impact Scale, with the largest effect size noted for perceived stress (B = 1.36, 95% CI: 0.90,1.82). ConclusionsWhile, on average, mothers of young children experienced worsening psychosocial stress during the COVID-19 pandemic, prepandemic psychosocial stress alone was not prospectively associated with greater pandemic impact, suggesting that the COVID-19 pandemic may have both elaborated existing systemic social inequalities and created new burdens.

Paternal peri-conceptional physical activity and the risk of congenital heart disease in offspring: A case-control study.

Genetic and environmental factors have been shown to contribute to the development of congenital heart disease (CHD). To date, the focus of scientific articles has primarily centered on genetics and maternal environmental factors, with comparatively less attention given to paternal risk factors. This study aims to investigate the potential association between paternal pre-conceptional physical activity levels (PA), along with paternal peri-conceptional smoking and alcohol consumption, and the risk of CHD in offspring. An observational case-control study was conducted in Lebanon, with 279 participants, aiming to investigate potential risk factors for CHD. We included children with confirmed CHD, born between 2012 and 2022. Controls born in the same timeframe were selected randomly from the general population using online questionnaire forms. Mean age of children included was 6 years old (0-10). The pre-conceptional PA was assessed using the Global Physical Activity Questionnaire validated in Arabic. In addition, paternal smoking, alcohol consumption, and maternal risk factors were collected. The study included 128 CHD cases (45.9%) and their parents, as well as 151 healthy infants (54.1%) and their parents. There were no statistically significant variations in the alcohol consumption noted between the fathers in the case and control groups (p=0.18). The paternal involvement in recreational-related PA during the peri-conception period was associated with a reduced risk of the CHD development in offspring by 46.9% (OR=0.531, 95% CI: 0.301-0.936, p=0.029). Additionally, increasing paternal total sitting time by 1 h above the average, which was approximately 260 min (4h), increased the risk of CHD in offspring by 0.4% (p=0.001). Moreover, paternal smoking exhibited an apparent association with a 56% increased risk of offspring developing CHD, notwithstanding that the confidence intervals included the null (OR=1.56, 95% CI: 0.86-2.8, p=0.136). This observational study is the first to report a potential association between paternal PA, and CHD in offspring. This study aligns with previous reports, advocating for the paternal engagement in PA and the adoption of healthy lifestyle habits, especially during the critical stages of conception. Such practices are strongly recommended to enhance fertility and promote optimal health for offspring. However, due to the subjectivity in reporting PA and lack of molecular proof, additional prospective and molecular studies are required to validate these findings.

Direct and Indirect Longitudinal Associations of Mother and Father Engagement in Middle Childhood on Adolescent Externalizing and Internalizing Behaviors.

Parent engagement is an important aspect of parenting during childhood. However, little is known about the unique longitudinal associations of mother and father engagement with adolescents' externalizing and internalizing problem behaviors. This study uses Future of Families and Child Wellbeing Study data to examine the potential direct and indirect associations of parent engagement at age 9 on adolescent externalizing and internalizing behaviors at age 15. The analytic sample size is 1349, and at age 9, the mean age of children was 9.40 years (SD = 0.37). Forty-eight percent of children were female and 68% of them were from the married families. The results show that while controlling for mother engagement, higher father engagement at age 9 was directly associated with fewer adolescent internalizing behaviors, only among adolescent boys and in married families. In addition, among adolescent boys, father engagement had an indirect association with externalizing behaviors through father-child closeness. Mother engagement, however, is only found to have an indirect association with adolescents' externalizing and internalizing behaviors through maternal hostility (while controlling for father engagement). The results for mother engagement held for boys and in married families only. The findings indicate that both mother and father engagement during childhood is important and helpful to prevent adolescent problem behaviors directly or indirectly via parent-child relationship.

Quality of life in children and adolescents with beta thalassemia

IntroductionChildren and adolescents with thalassemia suffer from chronicity of the disease and its treatment, including transfusion dependence and complications of iron overload.ObjectivesTo investigate the quality of life of children and adolescents with Beta Thalassaemia.MethodsThis study is a cross-sectional study conducted at the Greek public Children’s Hospital. PedsQL ™ 4.0 Generic Core Scale (Greek version) was used to evaluate HRQOL in 41 thalassemia patients aged between 5 and 18 years and in 41 healthy controls of the same age range. For the analysis, the Statistic Package (SPSS ver.24) was used. Using Spearman’s correlation coefficient, t-test and MannWhitney tests were used, while for variables with three or more levels the Anova and Kruskall-Wallis. In order to investigate the relationship between two quantitative variables, Spearman’s correlation coefficient was used, while the relationship between two qualitative variables was used to control x2. As a statistical significance level, α = 5% was defined.Results Of the 41 children with beta Thalassemia who participated in the study, 48.8% (n = 20) were boys and 51.2% (n = 21) girls. The mean age of children was 10.02 ± 4.10 years. For healthy children who participated in the study 51.2% (n = 21) were boys while 48.8% (n = 20) were girls. The mean age of the children was 9.63 ± 3.77 years. Children with Beta Thalassaemia have a lower quality of life in Physical Health and Activity(&lt;0,001), Emotional Health(0,031), School Activities(0,008), Psychosocial Health(0,014), and the overall PedsQL 4.0 (&lt;0,001)questionnaire compared to healthy children. Children between the ages of 5 and 7 have higher levels of quality of life in physical health and activity than older children(&lt;0,001). In addition, children aged 5 to 7 have higher quality of life and overall PedsQL 4.0 score than older children(0,033) Children receiving combination therapy show better quality of life than children receiving subcutaneous therapy (total PedsQL 4.0 &lt;0,001).ConclusionsChildren and adolescents in all five categories had a better quality of life, after improved iron chelating methods and other psychosocial interventions.Disclosure of InterestNone Declared

Low birth weight, household socio-economic status, water and sanitation are associated with stunting and wasting among children aged 6-23 months: Results from a national survey in Ghana.

Stunting and wasting are key public health problems in Ghana that are significantly linked with mortality and morbidity risk among children. However, information on their associated factors using nationally representative data is scanty in Ghana. This study investigated the influence of Infant and Young Child Feeding (IYCF) indicators, socio-demographic and economic related factors, and water and sanitation on stunting and wasting, using nationally representative data in Ghana. This is a secondary data analysis of the most recent (2017/2018) Ghana Multi-Indicator Cluster Survey (MICS) datasets. The multi-indicator cluster survey is a national cross-sectional household survey with rich data on women of reproductive age and children under the age of five. The survey used a two-stage sampling method in the selection of respondents and a computer-assisted personal interviewing technique to administer structured questionnaires from October 2017 to January 2018. The present study involved 2529 mother-child pairs, with their children aged 6 to 23 months. We used the Complex Sample procedures in SPSS, adjusting for clustering and stratification effects. In a bivariate logistic regression, variables with P-values ≤ 0.05 were included in a backward multivariate logistic regression to identify the significant factors associated with stunting and wasting. The mean age of children was 14.32 ± 0.14 months, with slightly more being males (50.4%). About 12% and 16% of the children were wasted and stunted, respectively. There were 39.4%, 25.9%, and 13.7% of children who, respectively, satisfied the minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). None of the IYCF indicators was significantly associated with stunting or wasting in the multivariate analysis but low socio-economic status, low birth weight, being a male child and unimproved toilet facilities were significantly associated with both wasting and stunting. Our findings suggest that aside from the pre-natal period, in certain contexts, household factors such as low socio-economic status and poor water and sanitation, may be stronger predictors of undernutrition. A combination of nutrition-specific and nutrition-sensitive interventions including the pre-natal period to simultaneously address the multiple determinants of undernutrition need strengthening.

The Outcome of Emergency Admissions and Associated Factors Among Children Admitted to the Pediatric Emergency Unit at Selected Public Hospitals at Addis Ababa, Ethiopia — Retrospective Cross-Sectional Study

BACKGROUND: A pediatric emergency condition is a life-threatening process that, without timely and standard clinical intervention, may lead to death. Therefore, this study aimed to assess the outcomes of emergency admissions and associated factors among children admitted to the pediatric emergency of selected public hospitals. METHODS: An institutional-based retrospective cross-sectional study design was conducted on children admitted to the emergency unit of randomly selected public hospitals from January 02, 2020, to January 08, 2022. Data were extracted from admitted Childrens’ chart using prepared checklists from February 1 to March 1, 2022. RESULT: A total of 303 admitted children’s charts were reviewed with 100% coverage. The mean age of children was 37.47 months, and the male-to-female ratio was 1.16:1. The study revealed that the most common causes of emergency admission were pneumonia (22.4%), surgical emergencies (14.5%), and late-onset sepsis (9.2%), respectively. More than half (53.8%) of children were admitted to the Pediatric Emergency Department for less than 24 hours, and the mean length of stay was 2 days. 39.6% of children were discharged with clinical improvement. Known comorbidity and length of stay less than 24 hours were strongly associated with the health care intervention. CONCLUSION: The study indicates that mortality rate of children at the Pediatric Emergency Department of study hospitals is high, with known comorbidity showing a significant association with mortality. FMOH recommended to develop national pediatric emergency care guidelines as standard document and providing skill gap training for healthcare workers.

Invalidating environment and meaning in life: The Chain Mediating Effects of regulatory emotional self-efficacy and basic psychological needs satisfaction

BackgroundAlthough people strive for meaning in life, life is full of experiences that challenge meaning. According to Bowen's family systems theory, the family is both a relational and an emotional system in which family members influence and are influenced by each other. Invalidating environment, reflecting a deficient family emotional setting, may be a key influencing factor in diminishing meaning in life. Existing studies have not directly explored the effects of the invalidating environment on meaning in life and its underlying mechanism. ObjectiveGuided by Bowen's family systems theory, this study aims to explore the relationship between invalidating environment and meaning in life, as well as the mediating effects of regulatory emotional self-efficacy and the satisfaction of basic psychological needs. MethodsA sample of 555 university students (62.5 % female, 37.5 % male; Mage =19.13 years old, SD = 1.72) completed questionnaires regarding demographics, invalidating environment, meaning in life, regulatory emotional self-efficacy, and basic psychological needs satisfaction. ResultsResults revealed that: (a) invalidating environment negatively predicts meaning in life; (b) regulatory emotional self-efficacy and basic psychological needs satisfaction serve as both independent and chain mediators between invalidating environment and meaning in life. ConclusionInvalidating environment affects meaning in life through regulatory emotional self-efficacy and basic psychological needs satisfaction. This finding has significant theoretical implications and provides a feasible pathway to improve children's meaning in life at both the parent and child levels.

Effect of non-vascularized fibular harvest on the donor limb: radiological evaluation at a mean follow-up of twelve point eightyears.

The study is aimed at evaluating the long-term (at a minimum follow-up of 10years) impact of non-vascularized fibular harvest on the donor limbs. There were 27 donor limbs (n = 19 children) available for retrospective radiological review. The graft was obtained bilaterally in eight patients. The following parameters were evaluated in the follow-up radiographs: continuity/non-continuity of fibular regenerate, width of the regenerated fibula, distal fibular station, medial proximal tibial angle, posterior proximal tibial angle, lateral distal tibial angle (LDTA), anterior distal tibial angle, and tibia diaphyseal angulation (interphyseal angles). For analysis and comparisons, the donor limbs were compared to the healthy limbs (controls) of the children with unilateral harvest. Additionally, the impact of continuous and non-continuous fibular regeneration was separately analyzed. The mean child's age at the time of fibular harvest was fouryears. The mean follow-up was 12.8years. The fibula was found regenerated in continuity in 22 limbs of 15 children (81.5%). When analyzed as a combined group (both continuous and non-continuous fibular regenerations), all the donor limb radiological parameters matched those of healthy limbs except LDTA (p = 0.04). In the subgroup analysis between non-continuous and continuous fibulae, significant abnormalities were again obvious in LDTA (p = 0.0001). The non-continuous fibulae were significantly lesser in width. All limbs with non-continuous fibular regeneration manifested ankle valgus. The non-vascularized fibula emerged as a relatively safe procedure in the long term with minimal affections of the knee, ankle, or tibial anatomy when longitudinal integrity of fibula was restored. The non-regenerations of the fibula may be prone to developing ankle valgus.