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In a small village in the Ecuadorian Andes called Racar, plastics are intimately woven into social and ecological structures. These entanglements move beyond human control and generate toxic dependencies between humans, plastics, and others. This requires a pedagogical shift in how early childhood educators understand and respond to plastics. Drawing on field research with educators in Racar, this paper attempts to interrupt human-centric discourses of the child as separate from Andean ecologies and resituates childhoods as differentially embedded in complex place relations.

Child trafficking activity often draws on formal administrative and legal resources. Formalisation implies considerable cooperation between public functionaries, lawyers and external actors. I argue that child rights advocates are forceful policy formulators who tend to ignore the public-external link because they focus on the external profit-seeking actors. The danger of this focus is a continuing production of inadequate policies, regulations and laws which are weak instruments in the control of a serious social and moral problem. I exemplify this by cases of irregularities in international adoption from Ecuador from the 1990s onwards.

This paper reports the development and baseline data of a vignettes-based measure of gender equality. Methods: Vignettes were developed through 3-day long focus groups. After piloting in 13 sites and repiloting a revised version in 6 countries, responses were categorized by the construct tapped and a scoring system developed. Finalized vignettes were then tested in DR Congo, Ecuador and China. Results: Young adolescents can successfully respond to vignettes; and can differentiate self from hypothetical protagonists of same and opposite sex. Response differences by sex of respondent and protagonist were statistically significant across a range of scenarios and settings. Conclusion: This is the first vignettes-based measure for young adolescents assessing young adolescent perceptions of relationships differentiated by sex of the protagonist. [ABSTRACT FROM AUTHOR]

In this paper I examine the rhetorics that circulate surrounding the lives of young indigenous women and children who beg on the streets of Quito, Ecuador. I focus particularly on rhetorics being produced and reproduced by urban planners, social workers, religious leaders and the media. Drawing on in-depth interviews, I reveal how these groups regularly imagine indigenous women and children in terms of child exploitation/child delinquency, false manipulation of public sympathies, ignorance, laziness and filth. Indigenous women and children are further understood as being fundamentally 'out of place' in the city. I unravel these rhetorics in order to draw attention to how begging is differentiated according to gender, race and age and to reveal how these rhetorics become inserted into exclusionary policies and practices. Moreover, and as a counterpoint to such rhetorics, I provide an alternative understanding of women's and children's involvement in begging by drawing upon the perspectives of indigenous women and children themselves. I argue that far from being passive victims, indigenous women and children work with and around oppressive conditions and mobilise them to their own advantage. [ABSTRACT FROM AUTHOR]

Public health nutritionists rely on anthropometry for nutritional assessment, program planning, and evaluation. Children are usually heavily clothed at high altitudes and in cold climates. Failing to adjust for clothing weight could underestimate malnutrition prevalence. The objective of this paper is to validate an adjustment process for estimating clothing weight and quantify potential misclassification error. In March and September 2009, 293 and 272 children under 2 years of age, respectively, were measured for weight and length in 14 highlands communities in Ecuador. Weight-for-age z-scores (WAZ) and weight-for-height z-scores (WHZ) were compared using clothing-unadjusted weights and two types of clothing-adjusted weights: individual clothing-weights and population-mean clothing-weights. Modelling showed up to 24% of children’s nutritional status and degree of malnutrition were misclassified for WAZ, and 13% for WHZ, when clothing was not taken into account in this cold climate. Compared with the more time-intensive individual clothing-weight adjustment, the population-mean clothing-weight adjustments had high specificity and sensitivity for WAZ. In cold climates, adjusting for population mean clothing weight provides a better estimate of the prevalence of malnutrition to inform appropriate program decisions for addressing underweight. An individual clothing weight adjustment may also be essential to classify a specific child’s nutritional status when acute malnutrition is a concern. [ABSTRACT FROM PUBLISHER]

Positive parenting and appropriate interaction with children are globally recognized as pivotal in enhancing children's quality of life. Evaluating family intervention programs is therefore vital, particularly in regions that lack reliable tools for assessment. This manuscript details a study conducted in Ecuador, a country noted for its scarcity of validated instruments to assess the impact of such interventions, especially for vulnerable preschool children. We focused on the application of the North Carolina Family Assessment Scale (NCFAS), a well-established measure to evaluate family functioning internationally, to Ecuadorian families with preschool children who are deemed vulnerable. The Spanish translation of the original scale was administered by trained evaluators to 470 preschool children in Machala, Ecuador. Our examination of the psychometric properties of the NCFAS in this context demonstrated high internal consistency. Additionally, factor analysis corroborated the reliability and validity of this adapted version of the NCFAS, albeit with a reduced item count. This research supports the effectiveness of the NCFAS in the Ecuadorian setting and underscores its potential utility in further studies involving varied demographic groups within the country. The results of this study have substantial implications for the enhancement of children's quality of life in Ecuador through family intervention programs. Highlights: The Ecuadorian study used the NCFAS to assess 470 vulnerable preschoolers' environments. High internal consistency and reliability were confirmed in this context. The adapted version with fewer items was validated through factor analysis. The results are pivotal for designing interventions in areas lacking reliable tools. [ABSTRACT FROM AUTHOR]

(1) Background: pregnant women in underprivileged areas may face challenges that affect their oral health. The analysis of these issues such as toothaches or cavities, among others could be crucial for them. However, no studies have been conducted in Cuenca, Ecuador. Thus, this study aimed to create a model explaining how social factors and healthy habits impact oral health in Cuenca, Ecuador. (2) Methods: An observational study was performed using a questionnaire developed from scratch. Principal component factor analysis was performed to calculate the oral disease index based on the oral health issues reported by women during pregnancy. (3) Results: 1971 women participated in the research. In total, 88% reported at least one oral health problem, with cavities (34%) and bleeding gums (33%) as the most prevalent. The rate of preventive visits and frequent brushing were the two variables that most impacted the oral disease index. The consumption of sweets, age, and the belief that visiting the dentist harms their unborn child were also important factors. However, income, education, and ethnic background showed little to no effect. (4) Conclusions: The most beneficial determinants of oral health factors in pregnant women in Cuenca, Ecuador, are preventive dentist visits, frequent brushing, and a contained consumption of sweets. The main harmful factors are age and the misconception that dental visits can harm their unborn child. Surprisingly, income, education, and ethnic background have little effect. This study can be replicated in other countries and cultures. [ABSTRACT FROM AUTHOR]

Qualitative research with children has gained recognition in recent years. Nevertheless, special considerations should be analyzed before conducting focus groups with children from developing countries where methodological guidelines are scarce. This article provides methodological guidelines for conducting focus groups with children from developing countries based on an extensive literature review and our experience in urban and rural areas in Ecuador. Peculiarities of urban and rural contexts are highlighted, and childfriendly strategies are proposed. We conclude that focus groups can be conducted successfully with urban and rural children from low-and-middleincome countries if their specific circumstances, such as language and cultural diversity, are contemplated and all the materials are tested beforehand. [ABSTRACT FROM AUTHOR]

Background: Most studies assessing pathophysiological heterogeneity in asthma have been conducted in high-income countries (HICs), with little known about the prevalence and characteristics of different asthma inflammatory phenotypes in low-and middle-income countries (LMICs). This study assessed sputum inflammatory phenotypes in five centres, in Brazil, Ecuador, Uganda, New Zealand (NZ) and the United Kingdom (UK).Methods: We conducted a cross-sectional study of 998 asthmatics and 356 non-asthmatics in 2016-20. All centres studied children and adolescents (age range 8-20 years), except the UK centre which involved 26-27 year-olds. Information was collected using questionnaires, clinical characterization, blood and induced sputum.Results: Of 623 asthmatics with sputum results, 39% (243) were classified as eosinophilic or mixed granulocytic, i.e. eosinophilic asthma (EA). Adjusted for age and sex, with NZ as baseline, the UK showed similar odds of EA (odds ratio 1.04, 95% confidence interval 0.37-2.94) with lower odds in the LMICs: Brazil (0.73, 0.42-1.27), Ecuador (0.40, 0.24-0.66) and Uganda (0.62, 0.37-1.04). Despite the low prevalence of neutrophilic asthma in most centres, sputum neutrophilia was increased in asthmatics and non-asthmatics in Uganda.Conclusions: This is the first time that sputum induction has been used to compare asthma inflammatory phenotypes in HICs and LMICs. Most cases were non-eosinophilic, including in settings where corticosteroid use was low. A lower prevalence of EA was observed in the LMICs than in the HICs. This has major implications for asthma prevention and management, and suggests that novel prevention strategies and therapies specifically targeting non-eosinophilic asthma are required globally. [ABSTRACT FROM AUTHOR]

Background: Little is known about factors influencing children's access to and use of oral healthcare services in the Galapagos Islands, a resource‐limited setting. Aim: We sought to understand caregivers' experiences and factors influencing their children's use of dental services on San Cristobal Island in the Galapagos Archipelago. Design: A community‐based qualitative interview study was carried out among 25 caregivers of children aged 6 months to 10 years. Participants were recruited via a random walk door‐to‐door approach in 10 neighborhoods, and interviews were conducted by a trained research assistant who is native of the Galapagos Islands. We employed a grounded theory‐based qualitative data analysis based on inductive coding to identify and report major emerging themes and illustrative participant quotes. Results: Two major themes emerged related to children's oral health care. Participants expressed their preference for care provided by paediatric versus general dentists and recognized the important role of school‐based dental care programs, acknowledging their strengths and weaknesses. Conclusions: Participants' lived experiences were informative and helped improve our understanding of factors influencing children's use of dental services in the Galapagos Islands. Above and beyond their local relevance, these themes and insights are likely applicable to other global communities that experience similar barriers of access to oral healthcare services. [ABSTRACT FROM AUTHOR]

We examine the relationship between early cognitive development, socio-economic status (SES), child health, and parenting quality in a developing country. We use a sample of more than 3,000 predominantly poor preschool-aged children from Ecuador, and analyze determinants of their scores on a widely used test of language ability. We find that household wealth and parental education are associated with higher scores, and that these associations are larger among older children. Child health and measures of parenting quality are associated with test performance, and account for a fraction, although not the majority, of the association between SES and cognitive development. [ABSTRACT FROM AUTHOR]

Background: The rapid spread of extended-spectrum beta-lactamase-producing E. coli (ESBL-EC) is an urgent global health threat. We examined child caretaker knowledge, attitudes, and practices (KAP) towards proper antimicrobial agent use and whether certain KAP were associated with ESBL-EC colonization of their children. Methods: Child caretakers living in semi-rural neighborhoods in peri-urban Quito, Ecuador were visited and surveyed about their KAP towards antibiotics. Fecal samples from one child (less than 5 years of age) per household were collected at two time points between July 2018 and May 2019 and screened for ESBL-EC. A repeated measures analysis with logistic regression was used to assess the relationship between KAP levels and child colonization with ESBL-EC. Results: We analyzed 740 stool samples from 444 children living in households representing a range of environmental conditions. Of 374 children who provided fecal samples at the first household visit, 44 children were colonized with ESBL-EC (11.8%) and 161 were colonized with multidrug-resistant E. coli (43%). The prevalences of ESBL-EC and multidrug-resistant E. coli were similar at the second visit (11.2% and 41.3%, respectively; N = 366). Only 8% of caretakers knew that antibiotics killed bacteria but not viruses, and over a third reported that they "always" give their children antibiotics when the child's throat hurts (35%). Few associations were observed between KAP variables and ESBL-EC carriage among children. The odds of ESBL-EC carriage were 2.17 times greater (95% CI: 1.18–3.99) among children whose caregivers incorrectly stated that antibiotics do not kill bacteria compared to children whose caregivers correctly stated that antibiotics kill bacteria. Children from households where the caretaker answered the question "When your child's throat hurts, do you give them antibiotics?" with "sometimes" had lower odds of ESBL-EC carriage than those with a caretaker response of "never" (OR 0.48, 95% CI 0.27–0.87). Conclusion: Caregivers in our study population generally demonstrated low knowledge regarding appropriate use of antibiotics. Our findings suggest that misinformation about the types of infections (i.e. bacterial or viral) antibiotics should be used for may be associated with elevated odds of carriage of ESBL-EC. Understanding that using antibiotics is appropriate to treat infections some of the time may reduce the odds of ESBL-EC carriage. Overall, however, KAP measures of appropriate use of antibiotics were not strongly associated with ESBL-EC carriage. Other individual- and community-level environmental factors may overshadow the effect of KAP on ESBL-EC colonization. Intervention studies are needed to assess the true effect of improving KAP on laboratory-confirmed carriage of antimicrobial resistant bacteria, and should consider community-level studies for more effective management. [ABSTRACT FROM AUTHOR]

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Objective: There is limited knowledge on vitamin D status of children residing in the Andes and its association with undernutrition. We evaluated the vitamin D status of children residing in a low socio-economic status (SES) setting in the Ecuadorian Andes and assessed the association between vitamin D status, stunting and underweight. We hypothesized that children who were underweight would have lower serum 25-hydroxyvitamin D (25(OH)D) levels and lower 25(OH)D levels would be associated with a higher risk of stunting. Design: We conducted a cross-sectional secondary analysis of a randomized controlled trial, the Vitamin A, Zinc and Pneumonia study. Children had serum 25(OH)D concentrations measured. A sensitivity analysis was undertaken to determine a vitamin D cut-off specific for our endpoints. Associations between serum 25(OH)D and underweight (defined as weight-for-age Z -score ≤ − 1) and stunting (defined as height-for-age Z -score ≤ − 2) were assessed using multivariate logistic regression. Setting: Children residing in five low-SES peri-urban neighbourhoods near Quito, Ecuador. Subjects: Children (n 516) aged 6–36 months. Results: Mean serum 25(OH)D concentration was 58·0 (sd 17·7) nmol/l. Sensitivity analysis revealed an undernutrition-specific 25(OH)D cut-off of <42·5 nmol/l; 18·6 % of children had serum 25(OH)D<42·5 nmol/l. Children who were underweight were more likely to have serum 25(OH)D<42·5 nmol/l (adjusted OR (aOR)=2·0; 95 % CI 1·2, 3·3). Children with low serum 25(OH)D levels were more likely to be stunted (aOR=2·8; 95 % CI 1·6, 4·7). Conclusions: Low serum 25(OH)D levels were more common in underweight and stunted Ecuadorian children. [ABSTRACT FROM AUTHOR]

In accordance with the social model of disability, this study proceeded from the assumption that parents’ experiences of a child’s hearing impairment reflect the circumstances of their lives rather than anything innate in the impairment itself. Few studies have explored the influence both of culture and social structure and of families’ economic and social resources. We studied families’ experiences of the diagnosis of hearing loss in Ecuador, a multicultural country in which family ties are strong but where pronounced social and economic inequalities persist and where many people have no access to health care. The study shows how inequality – and in particular the experience of poverty – shapes families’ experiences of acquiring a diagnosis and of trying to accommodate a child with special needs. [ABSTRACT FROM PUBLISHER]

The fear that children may grow up to become 'antisocial,' or deviant, directs mothers' behaviors in Ecuador. Mothers teach children about appropriate involvement in society through their continuous engagements. Based on fieldwork with urban, middle-class mothers in Ecuador's largest city, Guayaquil, I document discipline achieved through expressions of disappointment that arise from the removal of usual reinforcements. A previously established set of positive experiences within the child's social milieu provides comparisons that make a mother's rewards or withdrawal of rewards notable to the child. This comparative frame is established through a balance between disciplining and 'consenting,' where mothers acquiesce to children's demands to demonstrate the consideration one must have for others. When mothers give in to children's requests this practice itself exemplifies a positive orientation to others intended to prevent future antisocial behavior. Using ethnographic analysis I reveal the subtle dynamics that shape children's socialization in Ecuador to advance understanding of how cultural ideologies guide mothers' behaviors. With this step I offer a reconsideration of existing developmental theory on discipline. [mothering, children, socialization, practice, Ecuador] [ABSTRACT FROM AUTHOR]

RESUMEN A partir de investigación histórica y etnográfica llevada a cabo en Quito, Ecuador, el artículo describe los cambios operados en las políticas de adopción y de bienestar infantil durante la segunda mitad del siglo veinte. El autor sostiene que las prácticas relativas a la transferencia del cuidado y potestad de los niños han estado t estado históricamente basadas en relaciones asimétricas y en contextos caracterizados por diferencias de clase y de raza. De esta manera, se argumenta que las políticas y prácticas administrativas vinculadas a temas de bienestar infantil y adopción formaban parte de un proyecto civilizatorio que implicaba la exclusión de ciertos grupos y categorías de personas. El artículo analiza estas prácticas de exclusión a través de la observación de los cambios en los discursos públicos sobre parentesco (relatedness) y niñez. Asimismo, se comparan las políticas y la legislación sobre bienestar infantil con las prácticas tradicionales de circulación de los niños en los Andes. Finalmente, se sostiene que a medida que el proyecto de ciudadanía se acerca más a los ideales de inclusión universal, la distancia entre los principios básicos de la adopción formal y las prácticas populares se ha incrementado. In this article, I draw from historical and ethnographic research in Quito, Ecuador, to describe changes in adoption and child welfare policies from the mid to the late 20th century. Child care transference practices were carried out in relations marked by power inequalities, and in contexts characterized by class difference and defined by racial oppositions. I argue that child welfare policies and the administration of adoptions formed part of civilizing projects of citizenship which implied the exclusion of specific groups and categories of persons. These exclusionary practices are analyzed through a focus on shifting public understandings of relatedness and childhood. I also compare child welfare policies and legislation with Andean child circulation practices, and discuss how the distance between the basic principles of formal adoption and popular practices has increased as the project of citizenship comes nearer to an ideal of all-inclusiveness. [ABSTRACT FROM AUTHOR]

Early identification of children with autism is necessary to support their social and communicative skills and cognitive, verbal, and adaptive development. Researchers have identified several barriers to early diagnosis. Data collected in low- and middle-income contexts—where the vast majority of children in the world live—is scarce. In Ecuador, as in many other countries, estimates are lower compared to the global prevalence. Health authorities estimate a prevalence of 0.28% (0.18%–0.41%) in children aged five years old or less. Based on the hypothesis that, as in many parts of the world, children in Ecuador are not routinely screened and that this situation may result from poor recognition of this condition, our objective was to identify potential obstacles to case identification in pediatric settings. Several barriers, consistent with those identified in other countries, were reported by 153 participants on a survey, including lack of time, lack of resources to refer, fear of unnecessarily alarming families, and lack of information to guide families with concerns. The vast majority of participants are aware of the need for a screening tool for autism detection but report a lack of knowledge of its formal application. Most of the barriers reported in this study could be overcome by educational programs tailored to professional needs in order to support the well-being of children with autism and their families. [ABSTRACT FROM AUTHOR]

Ecuadorian emigration to the United States reveals a classic male-led exodus from rural regions faced by long-term economic decline. Occupational results reflect this model, and the general openness of the American labour market. Jobs are gender-segregated, but human capital effects are evident; niches do not dominate male or female experience, nor do they seem likely to persist. Recent emigration to Spain is distinct: sparked by a sudden economic collapse, it emerges from an urban population with relatively high human capital. It was initially led by women, many of whom left families behind, a rare event in migration history. The labour market in Spain is not only segmented by sex but, for women, characterised by an extraordinary concentration in the lowest occupational category, domestic service. This differential comparative outcome can be explained by the historical setting of the two flows and the gender distinction in migration leadership. [ABSTRACT FROM AUTHOR]

Examines patterns of growth in height and weight among children under 60 months of age of highland and coastal agricultural communities of Ecuador. Comparable linear growth rates; Compromise in the linear growth over and above growth in body weight; Implications of the similarity in growth rates; Pattern of growth retardation during the first 24 postnatal months.