Child Sex Research Articles

Predicting adolescent psychopathology from early life factors: A machine learning tutorial

ObjectiveThe successful implementation and interpretation of machine learning (ML) models in epidemiological studies can be challenging without an extensive programming background. We provide a didactic example of machine learning for risk prediction in this study by determining whether early life factors could be useful for predicting adolescent psychopathology. MethodsIn total, 9643 adolescents ages 9–10 from the Adolescent Brain and Cognitive Development (ABCD) Study were included in ML analysis to predict high Child Behavior Checklist (CBCL) scores (i.e., t-scores ≥ 60). ML models were constructed using a series of predictor combinations (prenatal, family history, sociodemographic) across 5 different algorithms. We assessed ML performance through sensitivity, specificity, F1-score, and area under the curve (AUC) metrics. ResultsA total of 1267 adolescents (13.1 %) were found to have high CBCL scores. The best performing algorithms were elastic net and gradient boosted trees. The best performing elastic net models included prenatal and family history factors (Sensitivity 0.654, Specificity 0.713; AUC 0.742, F1-score 0.401) and prenatal, family, history, and sociodemographic factors (Sensitivity 0.668, Specificity 0.704; AUC 0.745, F1-score 0.402). Across all 5 ML algorithms, family history factors (e.g., either parent had nervous breakdowns, trouble holding jobs/fights/police encounters, and counseling for mental issues) and sociodemographic covariates (e.g., maternal age, child's sex, caregiver income and caregiver education) tended to be better predictors of adolescent psychopathology. The most important prenatal predictors were unplanned pregnancy, birth complications, and pregnancy complications. ConclusionOur results suggest that inclusion of prenatal, family history, and sociodemographic factors in ML models can generate moderately accurate predictions of adolescent psychopathology. Issues associated with model overfitting, hyperparameter tuning, and system seed setting should be considered throughout model training, testing, and validation. Future early risk predictions models may improve with the inclusion of additional relevant covariates.

Copper and zinc status in cord blood and breast milk and child's neurodevelopment at 18months: Results of the Italian PHIME cohort.

Trace elements, including zinc (Zn) and copper (Cu), although toxic at higher concentrations are known to play important roles in the maintenance of human health and neurodevelopment. Few epidemiological studies have investigated the association between prenatal or early postnatal Cu and Zn levels and child neurodevelopment. The aim of this research is to assess the association between child neurodevelopment at 18 months of age and cord blood and breast milk concentrations of Cu and Zn in Italian mother-child pairs enrolled in the Italian Northern Adriatic Cohort II (NAC-II), a part of the "Public health impact of long-term, low-level, mixed element exposure in susceptible population strata" project PHIME. The study population consisted of 632 children, and their mothers, born within the NAC-II, who were tested with the Bayley Scales of Infant and Toddler Development third edition (BSID-III) at age 18 months. Cu and Zn concentrations were measured in cord blood and breast milk samples. Only children born at term (≥37 gestational week), who completed the BSID-III test and had at least 1 measure of Cu and Zn concentrations were included in the analysis. Information about socio-demographics and lifestyles were collected through questionnaires at different phases of follow-up. Cu and Zn concentrations were log2 transformed because of their skewed distribution. Multiple linear regression models were performed to study the association between each BSID-III composite score (cognitive, motor and language) and each metal concentration. Separate models were applied for each biological sample. The β coefficient (β) and its 95% confidence interval (95% CI) were estimated. Stratified analyses by child's sex were also conducted. The mean±standard deviation (SD) of cognitive, motor and language composite scores were respectively: 106±8, 101±5 and 97±8. The mean±SD of Cu and Zn concentrations (ng/g) were respectively 699.2±129.0 and 2538±589 in cord blood and 607±498 and 3226±1428 in breast milk. No association between metal concentration and cognitive composite score was found. A higher motor composite score was associated with higher Cu concentrations in cord blood (β=4.31 95% CI 2.03; 6.59). No associations were found between language composite score and metal concentrations. The effect of Cu cord blood concentration on motor composite score was confirmed when stratified by sex: males (β=5.49 95% CI 2.15; 8.36) and females (β=3.11; 95% CI 0.00; 6.22). A direct association, in females only, was found between language composite score and Cu concentration in cord blood (β=5.60 95% CI 0.63; 10.57) and in breast milk (β=3.04 95% CI 1.06; 5.03), respectively. The results from this cohort study showed a strong direct association between prenatal Cu levels and child motor neurodevelopment at 18 months. However, for generalizability, future research on the effects of Zn and Cu on neurodevelopment should include a larger range of early-life concentration of trace elements.

Optimal functioning after early mild traumatic brain injury: Evolution and predictors.

Early mild traumatic brain injury (mTBI or concussion sustained between 0 and 5 years old) can lead to post-concussive symptoms, behavioral changes, and cognitive difficulties. Although school-age children (6-17 years old) experience similar consequences, severe neuropsychological deficits are not common, and the majority have no persisting symptoms after one month. Thus, there may be value in focusing on what characterizes optimal functioning (or wellness) after mTBI, but this has not been explored in young children. This study documents the evolution and predictors of optimal functioning after early mTBI. Participants were 190 children aged 18 - 60 months with mTBI (n = 69), orthopedic injury (OI; n = 50), or typical development (TDC; n = 71). Optimal functioning was defined as: (1) no clinically significant behavioral problems; (2) no cognitive difficulties; (3) no persisting post-concussive symptoms; (4) average quality of life or better. Predictors related to sociodemographic, injury, child, and caregiver characteristics included number of acute symptoms, child sex, age, temperament, maternal education, parent-child attachment and interaction quality, and parenting stress. Fewer children with mTBI had optimal functioning over 6 and 18-months post-injury compared to those with OI and TDC. Higher parent-child interaction quality and lower child negative affectivity temperament independently predicted optimal functioning. Children who sustain early mTBI are less likely to exhibit optimal functioning thantheir peers in the long-term. Parent-child interaction quality could be a potential intervention target for promoting optimal function.

Inequalities in measles immunization coverage among two-year-olds in Sierra Leone, 2008-2019.

Measles, a highly contagious and potentially fatal disease, remains a significant public health concern, particularly in low- and middle-income countries. Vaccination is the most effective way to prevent measles and achieving high immunization coverage is crucial for protecting children and communities. This study investigated the trends and inequalities in measles immunization coverage among two-year-olds in Sierra Leone between 2008 and 2019. The study utilized data from the Sierra Leone Demographic Health Surveys conducted in 2008, 2013, and 2019. The World Health Organisation Health Equity Assessment Toolkit was used to calculate various inequality measures, including Difference(D), Ratio(R), Population Attributable Risk (PAR), and Population Attributable Fraction (PAF). An inequality assessment was conducted for six stratifiers: age, economic status, level of education, place of residence, sex of the child, and sub-national province. In Sierra Leone, measles immunization coverage increased between 2008 and 2013 and decreased slightly in 2019. In 2008, 66.2% of two-year-olds were immunized, which increased to 86.2% in 2013 and then fell slightly to 82.2% in 2019. There was a decrease in inequality for age from 4.2 percentage points in 2008 to 3.0 percentage points in 2019(D = 4.2 in 2008 and 3.0 in 2019). Economic-related inequality decreased from 8.1 percentage points in 2008 to 7.5 percentage points in 2019(D = 8.1 in 2008 and 7.5 in 2019). Inequality in education decreased from 10.3 percentage points in 2008 to 7.4 percentage points in 2019based on results from the inequality measure D. For place of residence, inequality decreased from 6.0 percentage points in 2008 to 4.0 percentage points in 2019. For the child's sex, the inequality increased from 1.9 percentage points in 2008 to 4.5 percentage points in 2019. The PAF revealed that the setting average could have been 1.4% higher in 2008 and 2.7% higher in 2019 without the child's sex inequality. Provincial inequality decreased from 19.4 percentage points in 2008 to 16.9 percentage points in 2019(D = 19.4 in 2008 and 16.9 in 2019). The observed fluctuations in national measles immunization coverage for children under two underscore the need for sustained efforts in vaccination programs. While improvements in access based on age, socioeconomic status, education level, and place of residence suggest progress in reducing inequalities, the persistent provincial disparities, with a significant gap in 2019, highlight ongoing challenges that must be addressed to ensure equitable health outcomes. Additionally, the increase in inequalities based on the child's sex during the study period raises concerns about targeted interventions that may inadvertently neglect specific groups. These findings imply that policymakers must prioritize strategies that maintain high vaccination rates and focus on closing the geographical and sex-based gaps, particularly in underserved provinces and among vulnerable populations.

Associations Between Sleep Health and Child Behavior at Age 6 Years in the INSIGHT Study.

Suboptimal sleep is associated with disruptive behaviors in childhood. We evaluate associations of mean and variability (SD) of sleep duration, quality, and timing with emotion regulation, impulsivity, and prosocial and antisocial behavior in children. Intervention Nurses Start Infants Growing on Healthy Trajectories, a randomized controlled trial designed for obesity prevention, compared a responsive parenting intervention delivered in the first 2.5 years after birth with a home safety control group. At age 6 years, children wore an actigraphy device for 7 days and participated in behavioral tasks evaluating behavioral control, emotion regulation, and prosocial and antisocial behaviors. Separate linear regression models examined associations between sleep and behavioral variables, adjusting for study group, child sex, and household income. Moderation analysis investigated whether the study group moderated relationships between sleep and positive age-appropriate behavior. Children (N = 143, age 6.7 ± 0.3 years) were predominantly non-Hispanic White (95%). Mean actigraphic sleep duration, quality, and timing were not associated with behavioral variables. By contrast, greater variability in sleep onset timing was associated with greater impulsivity (B = 0.85, p = 0.004) and poorer emotion regulation (B = -0.65, p = 0.01). Greater variability in sleep midpoint timing was associated with greater impulsivity (B = 0.80, p = 0.03). The study group moderated the effect of sleep onset variability on behavior; only the home safety control group exhibited a significant negative relationship between variability in sleep onset timing and emotion regulation (B = -1.28, p = 0.0002). Findings support the importance of consistency in sleep timing and how this may play a greater role in children's behavioral and emotional outcomes than mean actigraphic sleep duration and quality.

Timing sensitivity of prenatal cortisol exposure and neurocognitive development.

Prenatal glucocorticoid exposure has been negatively associated with infant neurocognitive outcomes. However, questions about developmental timing effects across gestation remain. Participants were 253 mother-child dyads who participated in a prospective cohort study recruited in the first trimester of pregnancy. Diurnal cortisol was measured in maternal saliva samples collected across a single day within each trimester of pregnancy. Children (49.8% female) completed the Bayley Mental Development Scales, Third Edition at 6, 12, and 24 months and completed three observational executive function tasks at 24 months. Structural equation models adjusting for sociodemographic covariates were used to test study hypotheses. There was significant evidence for timing sensitivity. First-trimester diurnal cortisol (area under the curve) was negatively associated with cognitive and language development at 12 months and poorer inhibition at 24 months. Second-trimester cortisol exposure was negatively associated with language scores at 24 months. Third-trimester cortisol positively predicted performance in shifting between task rules (set shifting) at 24 months. Associations were not reliably moderated by child sex. Findings suggest that neurocognitive development is sensitive to prenatal glucocorticoid exposure as early as the first trimester and underscore the importance of assessing developmental timing in research on prenatal exposures for child health outcomes.

Analysis of Contributing Factors to Stunting in Poso Regency: A Perspective from the Special Stunting Handling Index

Introduction: The prevalence of stunting in children in Indonesia, including Poso Regency, remains relatively high despite a decrease in recent years. This study aims to analyze factors associated with stunting in Poso Regency. Methods: This study employed a cross-sectional analytical method with a sample size of 250 mothers and their children under 2 years old, using structured questionnaires and direct measurements to collect data. Univariate analysis, chi-square tests and binary logistic regression were performed with a final report of adjusted odds ratios (AORs) and 95% confidence intervals (CI). All of the analyses used Stata version 15. Results: Results indicate a significant association between stunting and the child's gender, maternal education, immunization, and breastfeeding. Boys face a 2.3 times higher risk of stunting, while children of mothers with primary education have a 4.7 times higher risk compared to those with higher education. Non-immunized and non-breastfed children also exhibit significantly higher stunting risks. Conclusion: The study underscores the impact of factors such as the child's sex, maternal education, immunization, and breastfeeding on stunting in Poso Regency. The study emphasizes the need for targeted educational programs by healthcare professionals, policy-driven nutritional support initiatives, and community-based awareness campaigns to effectively address stunting in Poso Regency.

Nationwide trends in the use of ADHD medications in the period 2006–2022: a study from the Norwegian prescription database

BackgroundThe use of medication for Attention-Deficit/Hyperactivity Disorder (ADHD) increased globally throughout the early 2000s. This study examine trends in prevalences and incidences of medication use in Norway from 2006 to 2022.MethodsData from the Norwegian Prescription Database were used to present one-year-prevalence and incidence rates of ADHD medication (ATC-group N06BA and C02AC02) for the overall population (ages 6–64) and within sex and age subgroups of children (ages 6–17) and adults (ages 18–64). Incident use was defined as the dispensing of medication, with no recorded use in the previous two calendar years.ResultsThe overall prevalence of ADHD medication use in 6- to 64-year-olds increased from 5.2 to 19.4 per 1000 in the period, most pronounced from 2020 and onwards. While males experienced a nearly threefold increase in use (from 7.3 to 20.6 per 1000), the use among females increased almost sixfold during the study period (from 3.0 to 18.1 per 1000). Consequently, the male-to-female prevalence-ratio decreased from 2.4 to 1. Children exhibited a higher prevalence of use compared to adults throughout the period, although the largest relative increase was observed in adults, particularly in female adults. In children the male-to-female ratio decreased from 3.2 to 2.0, primarily due to an increasing use in 13–17-year-old females. Among adults, prevalences were similar across most age groups, with the highest rates observed among those aged 18–24, where female use exceeded male use by the end of the period. The male-to-female prevalence-ratio in adults decreased from 1.6 to 0.9 during the period. Parallel to prevalent use, overall incident use increased from 1.4 to 5.0 per 1000 during the period, with the most pronounced increase occurring from 2020 and onwards. From this point, incident use among females aged 13–17, 18–24, and 25–34, exceeded that of males. The male-to-female incidence-ratio decreased from 1.8 to 0.9. The overall incidence to prevalence ratio remained similar throughout the period, being 0.27 in 2006 and 0.25 in 2022.ConclusionA sustained increase in the prevalence of ADHD medication use was observed, with the most pronounced rise occurring among females and adults from 2020 and onwards. By 2022, the overall gender disparity in ADHD medication use had diminished, which should be considered in the context of a steep increase in incident use among adolescent and young adult females starting from 2020.

Prenatal exposure to ambient fine particulate matter and child lung function in the CANDLE cohort

Background Ambient fine particulate matter (PM2.5) exposure adversely impacts child airway health; however, research on prenatal PM2.5 exposure, and child lung function is limited. We investigated these associations in the ECHO-PATHWAYS Consortium, focusing on the role of exposure timing during different phases of fetal lung development. Methods We included 675 children in the CANDLE cohort born between 2007 and 2011 in Memphis, TN, USA. Prenatal exposure to ambient PM2.5 was estimated using a spatiotemporal model based on maternal residential history and averaged over established prenatal periods of lung development. Forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) were measured by spirometry at age 8–9 years. We used linear regression and Bayesian Distributed Lag Interaction Models (BDLIM) to estimate associations between exposure and lung function z-scores, adjusting for maternal/child characteristics, prenatal/postnatal tobacco exposure, and birth year/season, and evaluating effect modification by child sex and allergic sensitization. Results The average ambient concentration of PM2.5 during pregnancy was 11.1 µg/m3 (standard deviation:1.0 µg/m3). In the adjusted linear regression and BDLIM models, adverse, but not statistically significant, associations were observed between exposure during the pseudoglandular (5–16 weeks of gestation) and saccular (24–36 weeks) phases of lung development and FEV1 and FVC. The strongest association was between a 2 μg/m3 higher concentration of PM2.5 during the saccular phase and FEV1 z-score (−0.176, 95% Confidence Interval [CI]: −0.361, 0.010). The FEV1/FVC ratio was not associated with PM2.5 in any exposure window. No effect modification by child sex or allergic sensitization was observed. Conclusions We did not find strong evidence of associations between prenatal ambient PM2.5 exposure and child lung function in a large, well-characterized study sample. However, there was a suggested adverse association between FEV1 and exposure during late pregnancy. The saccular phase of lung development might be an important window for exposure to PM2.5.

Maternal Immune Activation and Child Brain Development: A Longitudinal Population-based Multimodal Neuroimaging study

Maternal Immune Activation (MIA) has been hypothesized to have an adverse effect on child neurodevelopment, but only a few neuroimaging studies have been performed to date, mostly in neonates. In this population-based cohort study, we investigated the association between MIA and multiple neuroimaging modalities depicting brain development from childhood to adolescence. We used data of mother-child pairs from the Generation R Study. To define our exposure, we measured IL-1β, IL-6, IL-17a, IL-23 and IFN-γ, and CRP at two time points during pregnancy. Given that levels of these 5 cytokines were highly correlated, we were able to compute a Cytokine index. We used multiple brain imaging modalities as outcomes, encompassing global and regional measures of brain morphology (structural MRI, volume, n=3,295), white matter microstructure (diffusion MRI, FA and MD, n=3,267), and functional connectivity (functional MRI, graph theory measures and network-level connectivity, n=2,914) at child mean ages 10 and 14 years. We performed mixed-effects models using the child's age as continuous time variable. We found no significant association or time interaction between MIA and any neuroimaging outcomes in children over time. These associations were similar for the Cytokine index, CRP, and individual cytokines. We observed no evidence for differential effects of timing of prenatal MIA or child sex after multiple testing correction. This longitudinal population-based study reports no evidence for an association between MIA and child brain development in the general population. Our findings differ from prior research in neonates showing structural and functional brain abnormalities after MIA.

Identifying cognitive, affective, and developmental mechanisms linking threat and deprivation with adolescent psychopathology.

The mechanisms linking early-life adversity with psychopathology over the life-course are complex. In this prospective study, we collectively examined cognitive, affective, and developmental mediators previously found to individually link childhood threat and deprivation experiences to adolescent psychopathology to identify the most potent mechanisms. Data came from a community sample of 227 children (mean child age 11.5 ± 0.5 years, 48.5% female) from the Seattle metro area with recruitment designed to reflect diversity in family income. Candidate mechanisms included self-rated pubertal development and task-measured attention bias to threat, emotion regulation, theory of mind, fear learning, inhibitory control, language ability, reasoning, and reward sensitivity. Using a high-dimensional mediation approach, we determined which mediating pathways linking threat and deprivation to psychopathology persisted after controlling for all candidate mechanisms associated with psychopathology. Models additionally controlled for the child's age, sex, early-childhood emotional and behavioral symptoms, poverty, and maternal depression. Blunted reward sensitivity mediated the prospective relationship between threat and internalizing psychopathology, explaining 17.25% (95% CI 1.08%, 69.96%) of this association. Advanced pubertal development was associated with increases in internalizing and externalizing symptoms (standardized associations of 0.16 (95% CI 0.03, 0.29) and 0.17 (95% CI 0.05, 0.29), respectively), but not with adversity. Although deprivation was strongly related to psychopathology, no mechanisms were empirically identified. In a well-characterized community sample, we isolated reward sensitivity as a robust mediator of the prospective association between early-life threat and adolescent internalizing psychopathology. Interventions aimed at bolstering reward sensitivity may mitigate the impact of early-life threat experiences on internalizing problems.

Lability in parent-child warmth and hostility and adolescent externalizing behaviors.

Both longer term developmental changes (increases in hostility, decreases in warmth) and lability (year-to-year fluctuations) in parent-child relationship quality across childhood and adolescence have been linked to adolescent externalizing behaviors. Using a prospective longitudinal study of 561 children who were adopted into nonrelative families at birth (57% male, 56% White, 19% multiracial, 13% Black, 11% Hispanic) where parental warmth and hostility reflect environmental influences or child-evoked reactions, we examined associations between parent-child relationship measures and externalizing behaviors at age 11 and across adolescence (i.e., from age 11 to 13-15 years). Because studies considering gene-environment interplay especially in associations between lability and child externalizing behaviors are sparse and parent-child relationship measures support the intergenerational transmission of psychopathology, we also tested whether parent psychopathology of both adoptive parent (AP; environmental intergenerational transmission) and birth parents (genetic intergenerational transmission) moderated these associations in multivariate regression models. Findings generally supported more effects of fathers' than mothers' warmth and hostility. Although there were some linear associations of increased lability with externalizing behaviors, these did not persist in the context of a multivariate model. Associations between both parents' increasing hostility across childhood on age 11 externalizing behaviors and for fathers increasing hostility and decreasing warmth on increases in externalizing behaviors across adolescence more likely reflect a combination of bidirectional evocative and parenting environmental associations than purely parenting environmental transmission. Moderation by parent psychopathology was sparse, and sensitivity tests revealed no differences by child sex. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Influence of maternal and infant technology use and other family factors on infant development

BackgroundDigital technology is ubiquitous in the lives of many children and parents. To better understand any influence of technology use by infants, and mothers, on child development, technology use should be considered within the broader family system context in which children develop. This study aimed to investigate associations between infant and maternal technology use and infant 12-month development, taking into consideration other family factors.MethodsThis cross-sectional study used data from ORIGINS participants, collected at 12-months of age: maternal and child technology use (TechU-Q), sociodemographic factors (e.g. child sex, household income), parental mental health (DASS-21), and child development (Ages and Stages Questionnaire). Linear regression was used for analyses.ResultsWhen family factors were considered, higher infant mobile touchscreen device (MTSD) use was associated with poorer infant development for gross motor, problem-solving, and total ASQ-3 scores. In contrast there were no associations between infant television (TV) watching or maternal technology use and total ASQ-3 scores. Higher maternal technology use was associated with higher infant technology use. Poorer maternal and paternal mental health were associated with poorer infant development. Poorer maternal mental health was also associated with higher infant TV watching and higher maternal MTSD use.ConclusionThere is a complex relationship between technology use, parental mental health and other family factors that together influence infant development. To improve infant development outcomes, less focus should be on infant or maternal technology use, and more on supporting the family as a whole, and parental mental health in particular.

Longitudinal analysis of growth and nutritional disparities across socio-demographics from early childhood to adolescence: Findings from the Indian cohort of the Young Lives Survey.

Previous studies generally used cross-sectional data and focused on under-five children to assess the risk factors for malnutrition among Indian children. Some recent studies have reported that recovery from or faltering in malnutrition is possible after five years of age, but socio-demographic subgroup disparities have not been explored. This study aims to find the longitudinal disparity in height-for-age Z-scores (HAZ) and body-mass-index-for-age Z-scores (BMIAZ scores) across various sub-groups of a cohort from childhood to adolescence. This study used a cohort from the Young Lives Survey, which followed children aged of 1-15 years between 2002 and 2016-17 in the states of Andhra Pradesh and Telangana, India. Mixed-effect models were applied to find the main, time, and interaction effects of HAZ scores and BMIAZ scores. In addition, an extended Kitagawa-Oaxaca-Blinder decomposition approach to assess group-based differences over time was used. The cross-sectional prevalence of stunting reduced across all subgroups, while thinness rose during the same period. The interactions of child sex, mother's education, place of residence, wealth index, and antenatal care with time were statistically significant at p <0.05. The gender disparity in adjusted HAZ score decreased from 0.214 units at 1 year to 0.011 units at 15 years, whereas BMIAZ score differential increased from 0.106 to 0.538 units over same timeframe. Disparities in scores were also observed across rural-urban, maternal education, social group, religion, socioeconomic status, maternal age at birth, antenatal care, and premature birth status. The study sheds light on the nuanced dynamics of paediatric growth, emphasising the importance of longitudinal approaches in understanding and addressing the health disparities across different stages of childhood and adolescence.

The relationship between feeding practices and stunting among children under two years in Tanzania mainland: a mixed-method approach

BackgroundProper infant and young child feeding practices have gained attention over the years as one of the interventions to reduce childhood stunting. However, there is still a gap in research to determine these relationships in children under two years and the reasons for improper feeding.ObjectiveThis study aimed to assess the relationship between feeding practices, stunting and barriers among children under two years.MethodologyUtilizing a mixed-method approach, the study involved secondary analysis of 1806 records of children aged 6–23 month, from the Next Generation Nutrition Program conducted in Tanzania (2015–2019). Both quantitative and qualitative data analyses were employed. Frequency distribution tables were utilized to describe study participants stratified by their stunting status. Subsequently, modified Poisson regression models identified predictors of stunting. Qualitative analysis encompassed deductive and inductive approaches, to extract themes that address the behaviors contributing to inappropriate feeding practices.ResultsStunting prevalence was 28.8% among children aged 6–23 months, with the majority (65%) of stunted children aged 1 year or older. Dietary diversity was low: 88.3% and 86.3% of stunted and non-stunted children, respectively, consumed less than 5 food groups. Surprisingly, early initiation of breastfeeding, time of stopping breastfeeding, and minimum dietary diversification were not significantly associated with child stunting (p-value > 0.05). Barriers to proper feeding practices identified were inadequate knowledge of feeding, maternal condition, economic hardship, cultural issues, and seasonality.ConclusionEarly breastfeeding and minimum dietary diversity were not significant predictors of stunting. However, the mother’s age and height > 150 cm reduced stunting risk while child sex, age, birth weight, marital status, and place of delivery also influenced stunting risk. It is crucial for initiatives to emphasize good feeding practices while addressing the complex factors that may hinder optimal feeding practices in this age group to reduce childhood stunting effectively.

Cluster Analysis of Migraine-associated Symptoms (CAMS) in youth: A retrospective cross-sectional multicenter study.

To conduct a retrospective cross-sectional multicenter study to validate the relationships between migraine-associated symptoms. Symptoms associated with headache-photophobia and phonophobia, nausea, and/or vomiting-are required criteria for migraine diagnosis based on the International Classification of Headache Disorders-Third Edition (ICHD-3). However, individuals with migraine report high rates of other symptoms (e.g., lightheadedness, difficulty thinking). We recently completed a single-center study assessing the relationships between an expanded set of migraine-associated symptoms. A pre-registered cross-sectional multicenter retrospective analysis was conducted on standardized questionnaire data of youth ages 6-17 years from two headache registries at pediatric tertiary care centers. Cluster Analysis of Migraine-associated Symptoms (CAMS) was implemented to assess associations between 11 migraine-associated symptoms. We explored differences between the two centers, and how CAMS was associated with demographics, including sex and age, and headache burden. There were 10,721 participants who were 66.5% female and had a median (interquartile range) age of 13 (10-15) years. The first three CAMS dimensions accounted for 46.5% of the variance and were consistent across sites. The first dimension indicated those reporting any migraine-associated symptoms were likely to report multiple. The second dimension separated symptoms into those included in ICHD-3 migraine diagnostic criteria and non-ICHD symptoms (e.g., lightheadedness, difficulty thinking). The third dimension separated sensory hypersensitivity and vestibular symptoms. An abundance of migraine-associated symptoms correlated with greater headache severity (Spearman's ρ = 0.18, 95% confidence interval [CI] 0.17-0.20; small effect size) and disability (ρ = 0.26, 95% CI 0.25-0.28; small effect size). We also observed differences in associated symptoms across age and sex. Associations between an expanded set of migraine-associated symptoms are informative for headache burden and reveal intriguing changes across child development and sex. We were able to replicate findings across two centers, indicating that these symptom clusters are inherent to migraine.

Multiple dimensions of immorality

ABSTRACT We conducted a four-part study to map out the conceptual space of a diverse set of immoral items, including those that are extreme and/or intergroup (e.g. child sex abuse, genocide, slavery), with the goal of identifying attributes spontaneously used in moral judgment. In Part 1, we identified 56 immoral items. In Part 2, participants completed a similarity-based card sort task of the 56 immoral items. Multidimensional scaling (MDS) indicated that three-dimensional space was needed to capture the perceived differences among the items. In Part 3, regression analysis indicated that perceived similarity among the immoral items related to their commonness, objectivity, forgivability, and legality. In Part 4, regression analysis indicated that the configuration of immoral items corresponded to the amount of anger and disgust the items elicited and items’ perceived harmfulness. We attempt to synthesize these results and answer questions about the roles of anger, disgust, and harm in moral judgment.

Law Enforcement Agency Practices and Policies for the Investigation of Child Sex Trafficking: Are Agencies Using Victim-Centered Approaches?

AbstractOver the past decade, efforts have been made to reform the way in which law enforcement responds to child sex trafficking (CST). Law enforcement agencies are being urged or required to use victim-centered approaches that provide exploited youth with support and services. However, researchers have yet to empirically examine law enforcement’s recognition of CST at the agency-level, their arrest practices, or the services that are being offered to CST victims. We have little information about the utilization and effectiveness of various law enforcement agency policies, practices and training programs related to CST. The National Law Enforcement Agency Child Sex Trafficking (LEA-CST) Study aimed to address these gaps through a national survey of law enforcement agencies around the U.S. The current study reports on mail survey data collected from a sample of 1,306 agencies that provided feedback on the use of up to nine victim-centered approaches to CST at their agency. Data were analyzed along with information about whether their agency investigated at least one case of CST in the year 2021. Almost all agencies (97.5%) said they used or had access to at least one victim-centered approach to CST investigations, with larger agencies reporting a greater number of approaches. Two policies were significantly related to a greater likelihood of investigating at least one case of CST in 2021: Access to a CST-specific task force and access to a CST-specific victim service agency. Findings document a growing orientation to these cases by law enforcement that recognizes youth victimization, with innovative approaches to identification and support. Community collaboration appears to be critical to helping to identify, support and provide justice to CST victims.Research Summary This study examined law enforcement’s recognition of CST at the agency-level, their arrest practices, and the services that are being offered to CST victims. Among 1,306 agencies across the United States, almost all (97.5%) said they used or had access to at least one victim-centered approach to CST investigations, with larger agencies reporting a greater number of approaches. Two policies were significantly related to a greater likelihood of investigating at least one CST case in 2021: Access to a CST-specific task force and access to a CST-specific victim service agency.Policy Implications Findings from the current study underscore the importance of victim-centered approaches to CST that feature connections and collaborations across communities. These collaborations champion the wellness of youth who have experienced this unique and egregious form of sexual victimization while simultaneously allowing for criminal investigations to proceed, ideally with minimal re-traumatization of the victim.

The housing environment and its effect on Hispanic children with asthma

IntroductionSubstandard housing in Hispanic minority communities has been associated with detrimental effects on children with asthma that is affected by diverse indoor triggers. Identifying those triggers and offering adequate medical treatment and ways to prevent exposure to triggers will help reduce the number of asthma attacks among children who reside in Hispanic minority communities.ObjectiveOur study aimed to identify the influence of substandard housing quality and its effect on asthma symptoms. Our objectives included assessing the impact of building, flooring types, heating sources, window shading, parental smoking behaviors, moisture and mold in the home, ventilation, and owning a pet on asthma symptom occurrence.Materials and methodsOur study was based on a cross-sectional analytical study involving 353 individuals, their parents, and their homes. Logistic regression modeling was conducted to explain the dependence of each asthma symptom on the investigated independent variables, with child age and sex being investigated as covariables. A post hoc test was employed to ensure goodness of fit, and a pseudo-R square was calculated for each regression model. The Hosmer-Lemenshow test was performed post hoc to ensure goodness of fit, and models were preserved if p > 0.05.ResultsThe overall prevalence of asthma-related symptoms in our study sample was 19.37%, and sleeping quality was affected due to asthma in 23% of participating children. We also found that children living with asthma near agricultural fields were more prone to asthma-related symptoms, as well as those children living in homes with excessive moisture and those who kept stuffed toys or pets inside their rooms.ConclusionsOur study highlights how a variety of environmental factors, such as living near an agricultural area and having curtains, increases shortness of breath. Having leaks and excessive moisture in houses increases shortness of breath, wheezing, coughing, and rates of colds. Another important exposure is having a pet inside the house which increases chest tightness. A comprehensive understanding of these factors and how they impacted targeted participants, especially those who are Hispanic minorities and living in substandard housing, is essential for informing the design of effective interventions and improving respiratory health in the home environment.

Disparities in Child Development by Maternal Birthplace and Child Sex among Kindergarten Children in Manitoba, Canada: A Population-Based Data Linkage Study.

Little is known about differences in child developmental vulnerability before school entry according to maternal birthplace and sex. Official immigration records were linked with the Early Development Instrument assessments among children in kindergarten in the province of Manitoba, Canada (2005-2017). Logistic regression was used to estimate odds ratios of vulnerability in five developmental domains associated with maternal birthplace and child sex. Children of immigrant mothers from most birthplaces had higher adjusted odds of developmental vulnerability than non-immigrants in domains related to language and communication skills, except those of the rest of North America & Oceania. Children of Sub-Saharan African mothers were more vulnerable in four domains. Boys were consistently more vulnerable than girls across domains and maternal birthplaces. Children of immigrant mothers exhibited higher developmental vulnerability than non-immigrants in domains related to language and communication skills, potentially reflecting exposure to English and French as second languages.