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Background: Cohort studies have demonstrated an association between prolonged and/or frequent breastfeeding and early childhood caries (ECC). Aim: To investigate the association between prolonged breastfeeding and ECC at 48 months, while considering the interaction between prolonged breastfeeding and ultraprocessed foods (UPF). Design: Data from a birth cohort study conducted in southern Brazil were used (n = 3645). Poisson regression was used to evaluate the influence of breastfeeding and UPF consumption on the prevalence and experience of caries. To measure the interaction on the additive scale between breastfeeding and UPF consumption on the prevalence and experience of ECC, the relative excess risk due to interaction (RERI) was calculated. Results: Prolonged breastfeeding was associated with higher prevalence (PR = 1.82; CI:1.59–2.08) and experience (RR = 2.47; CI:1.97–3.10) of ECC. Greater prevalence (PR = 1.16; CI: 1.04–1.30) and experience of ECC (RR = 1.22; CI: 1.00–1.48) were found in children who had high consumption of UPFs. Negative RERIs were observed for the prevalence and experience of ECC (−0.25 and −0.001). Conclusion: High UPF consumption and prolonged breastfeeding were associated with ECC. No interaction, however, was observed, showing that the two exposures have independent effects. To prevent ECC, policies and programs are needed to support breastfeeding until the age of 2 years and to limit the consumption of UPF. [ABSTRACT FROM AUTHOR]

This article explores the relationship between venomous animal encounters and climate change. While climate change has been extensively studied, there are still gaps in knowledge regarding accidents involving venomous animals. Snakebites are the most studied, but encounters with scorpions, bees, spiders, caterpillars, and marine animals also pose significant risks. The regulation of body temperature in venomous animals is influenced by environmental factors, and climate change can impact their behavior, reproduction, and activity. Accidents involving venomous animals are not only influenced by climate change but also by other anthropic variables such as deforestation and socioeconomic changes. The use of mathematical prediction models can aid in understanding and mitigating the risks associated with these accidents. Mandatory reporting and the training of health professionals are important for improving the management of venomous animal encounters. Environmental and health education can also play a role in reducing response times and promoting awareness of human impact on biodiversity. [Extracted from the article]

BACKGROUND: Since 2016, the School Food Program in the Buenos Aires Province, Argentina, implemented a nutritional regulatory framework (NRF) and varying administration systems (AS). Here, we examined the association between the interventions (only NRF and NRF + AS) and breakfast nutritional and food indicators between 2016 and 2019. METHODS: Data collected from the Survey of the School Food Program, 2016‐2019, were analyzed. The dependent variables were the energy, macro‐and micronutrients, milk/yogurt, and fruit quantities in school breakfasts. The independent variables were the school's status: (a) control group, (b) Intervention 1 (only NRF), and (c) Intervention 2 (NRF + AS). We preformed crude and adjusted linear regressions with robust variances. RESULTS: We evaluated 4,060 schools (control group: 24%; Intervention 1: 39%; Intervention 2: 37%). Only vitamin A levels increased after Intervention 1, and almost all indicators (80%) showed better values when applying Intervention 2. SCHOOL HEALTH POLICY IMPLICATIONS: Nutritional and food indicator improvements were associated with the implementation of the NRF and AS, emphasizing the significance of design and management of school food public policies, along with the amount of investment/territorial coverage. CONCLUSIONS: Our findings highlight the importance of school food and nutrition policies with a potential impact on improving the nutritional status of children. [ABSTRACT FROM AUTHOR]

Objective Design Setting Population Methods Main outcome measures Results Conclusions To describe the mortality risks by fine strata of gestational age and birthweight among 230 679 live births in nine low‐ and middle‐income countries (LMICs) from 2000 to 2017.Descriptive multi‐country secondary data analysis.Nine LMICs in sub‐Saharan Africa, Southern and Eastern Asia, and Latin America.Liveborn infants from 15 population‐based cohorts.Subnational, population‐based studies with high‐quality birth outcome data were invited to join the Vulnerable Newborn Measurement Collaboration. All studies included birthweight, gestational age measured by ultrasound or last menstrual period, infant sex and neonatal survival. We defined adequate birthweight as 2500–3999 g (reference category), macrosomia as ≥4000 g, moderate low as 1500–2499 g and very low birthweight as <1500 g. We analysed fine strata classifications of preterm, term and post‐term: ≥42+0, 39+0–41+6 (reference category), 37+0–38+6, 34+0–36+6,34+0–36+6,32+0–33+6, 30+0–31+6, 28+0–29+6 and less than 28 weeks.Median and interquartile ranges by study for neonatal mortality rates (NMR) and relative risks (RR). We also performed meta‐analysis for the relative mortality risks with 95% confidence intervals (CIs) by the fine categories, stratified by regional study setting (sub‐Saharan Africa and Southern Asia) and study‐level NMR (≤25 versus >25 neonatal deaths per 1000 live births).We found a dose–response relationship between lower gestational ages and birthweights with increasing neonatal mortality risks. The highest NMR and RR were among preterm babies born at <28 weeks (median NMR 359.2 per 1000 live births; RR 18.0, 95% CI 8.6–37.6) and very low birthweight (462.8 per 1000 live births; RR 43.4, 95% CI 29.5–63.9). We found no statistically significant neonatal mortality risk for macrosomia (RR 1.1, 95% CI 0.6–3.0) but a statistically significant risk for all preterm babies, post‐term babies (RR 1.3, 95% CI 1.1–1.5) and babies born at 370–386 weeks (RR 1.2, 95% CI 1.0–1.4). There were no statistically significant differences by region or underlying neonatal mortality.In addition to tracking vulnerable newborn types, monitoring finer categories of birthweight and gestational age will allow for better understanding of the predictors, interventions and health outcomes for vulnerable newborns. It is imperative that all newborns from live births and stillbirths have an accurate recorded weight and gestational age to track maternal and neonatal health and optimise prevention and care of vulnerable newborns. [ABSTRACT FROM AUTHOR]

Objective Design Setting Population Methods Main Outcome Measures Results Conclusions We aimed to understand the mortality risks of vulnerable newborns (defined as preterm and/or born weighing smaller or larger compared to a standard population), in low‐ and middle‐income countries (LMICs).Descriptive multi‐country, secondary analysis of individual‐level study data of babies born since 2000.Sixteen subnational, population‐based studies from nine LMICs in sub‐Saharan Africa, Southern and Eastern Asia, and Latin America.Live birth neonates.We categorically defined five vulnerable newborn types based on size (large‐ or appropriate‐ or small‐for‐gestational age [LGA, AGA, SGA]), and term (T) and preterm (PT): T + LGA, T + SGA, PT + LGA, PT + AGA, and PT + SGA, with T + AGA (reference). A 10‐type definition included low birthweight (LBW) and non‐LBW, and a four‐type definition collapsed AGA/LGA into one category. We performed imputation for missing birthweights in 13 of the studies.Median and interquartile ranges by study for the prevalence, mortality rates and relative mortality risks for the four, six and ten type classification.There were 238 203 live births with known neonatal status. Four of the six types had higher mortality risk: T + SGA (median relative risk [RR] 2.6, interquartile range [IQR] 2.0–2.9), PT + LGA (median RR 7.3, IQR 2.3–10.4), PT + AGA (median RR 6.0, IQR 4.4–13.2) and PT + SGA (median RR 10.4, IQR 8.6–13.9). T + SGA, PT + LGA and PT + AGA babies who were LBW, had higher risk compared with non‐LBW babies.Small and/or preterm babies in LIMCs have a considerably increased mortality risk compared with babies born at term and larger. This classification system may advance the understanding of the social determinants and biomedical risk factors along with improved treatment that is critical for newborn health. [ABSTRACT FROM AUTHOR]