Search

Issue addressed: Running since 1999, the Sanitarium Weet-Bix Kids TRYathlon (SWKT) is the world's largest triathlon series for children and adolescents up to 16 years. This report seeks to describe participants of the TRYathlon and their perceptions of the event. Methods: An online survey was made available to Australian parents/guardians of participants enrolled in the 2020 SWKT. Organisational data was also employed to describe the reach of the SWKT since its inception. Results: Parents/guardians (n = 568) reported that the average child age was 9.12 (SD = 1.95, range = 6-16) and 58.6% were male. Parents/guardians identified 12 children as Aboriginal and/or Torres Strait Islander (2.0%) and 87 (14.6%) spoke a language other than English. The majority of parents/guardians rated their child's physical activity (PA) competencies as pretty good, or really good, for cycling (87.5%), swimming (80.9%) and running (79.5%). Most parents (66.0%) stated that their child was glowing with pride after completing the event, enjoyed or really enjoyed the event (98.8%), and thought their child would maintain their PA levels following the event (72.9%). Conclusions: The SWKT series has demonstrated longevity and an ability to reach a large number of participants, providing opportunities to build health promotion awareness. Importantly the event instils a sense of confidence and pride related to PA competency in its participants; however, its long-term effectiveness requires further exploration. So what?: Mass participation events such as SWKT could be incorporated into larger health promotion strategies to encourage childhood PA and foster healthy physical and psychosocial development.

Background Globally, acute respiratory infection (ARI) is a leading cause of infant and childhood morbidity and mortality. Currently, it is estimated that 50 million cases of childhood ARI are untreated. In this study, we identified determinants of the type of treatment sought for symptoms of childhood acute respiratory infection (ARI), including non-treatment, amongst a nationally representative sample of children under five years in Ghana. Methods In total, 1 544 children were studied by a secondary analysis of pooled survey data from the 1993, 1998, 2003, 2008, and 2014 Ghana Demographic and Health Surveys (GDHS). Cross-tabulations, chi-square, multinomial logistic regression, and Bayesian hierarchical spatial logistic regression analyses were used to identify relationships between the type of treatment sought and maternal socio-economic and household characteristics. Results Seeking medical care was significantly associated with child age (RRR= 1.928, 95 % CI 1.276 – 2.915), maternal employment status (RRR = 1.815, 95 % CI 1.202 – 2.740), maternal health insurance status, (RRR = 2.618, 95 % CI 1.801 – 3.989), children belonging to middle (RRR = 2.186, 95 % CI 1.473 – 3.243), richer (RRR = 1.908, 95 % CI 1.145 – 3.180) and richest households (RRR = 2.456, 95 % CI 1.363 – 4.424) and the 1998 survey period (RRR = 0.426, 95 % CI 0.240 – 7.58). Seeking self-care or visiting a traditional healer was significantly associated with maternal educational status (RRR = 0.000, 95 % CI 0.000 – 0.000), and the 1998 (RRR= 0.330, 95 % CI 0.142 – 0.765), 2003 (RRR= 0.195, 95 % CI 0.071 – 0.535), 2008 (RRR= 0.216, 95 % CI 0.068 – 0.685) and 2014 (RRR= 0.230, 95 % CI 0.081 – 0.657) GDHS periods. The probability that the odds ratio of using medical care exceeded 1 was higher for mothers/caregivers in the Western, Ashanti, Upper West, and Volta regions. Conclusions Government policies that are aimed at encouraging medical care-seeking for children with ARI may yield positive results by focusing on improving maternal incomes, maternal NHIS enrolment, and maternal household characteristics. Improving maternal education could be a positive step towards addressing challenges with self-care or traditional healing amongst children with ARI.

Objectives We evaluated the effects of the family mindfulness-based intervention (MBI) “MYmind” for children with ADHD and their parents, and examined child and parent predictors of child outcome. Methods Using a pragmatic quasi-experimental waitlist design, children aged 7–19 years (n = 167), clinically referred with a DSM-IV ADHD diagnosis, and both their parents completed waitlist (average waiting time was 8 weeks), pre-test, post-test, 8-week, and 1-year follow-up measurements. MYmind consisted of eight weekly 1.5-h mindfulness-based group sessions for children and parallel for parents, and a follow-up session. We assessed children’s and both parents’ ADHD symptoms and other psychopathology, child executive function, parental stress, parental overreactivity, and mindful parenting. Results Multilevel analyses revealed medium-to-large effect-sized reduced child ADHD symptoms between pre- and post-test, becoming stronger at follow-ups, while no waitlist effects occurred. Parents above the ADHD threshold improved on adult ADHD symptoms with similar sized effects. Children’s and parents’ other psychopathology, child executive function, parental overreactivity, and mindful parenting improved, whereas parental stress only improved at 1-year follow-up. Child age, child gender, ADHD medication, parental ADHD, and parent participation did not predict child outcome. Parent gender however interacted with parental ADHD to predict child outcome; children of fathers (but not mothers) above the ADHD threshold improved more than children of fathers below the ADHD threshold at post-test and at 8-week follow-up. Reduced paternal ADHD from pre- to post-test mediated this effect. Conclusions Family MBI (MYmind) may reduce childhood ADHD and improve parental functioning. Fathers with ADHD symptoms appear important in helping offspring with ADHD.

OBJECTIVES: Early home auditory environment plays an important role in children’s spoken language development and overall well-being. This study explored differences in the home auditory environment experienced by children with cochlear implants (CIs) relative to children with normal hearing (NH). DESIGN: Measures of the child’s home auditory environment, including adult word count (AWC), conversational turns (CTs), child vocalizations (CVs), television and media (TVN), overlapping sound (OLN), and noise (NON), were gathered using the Language Environment Analysis (LENA) System. The study included 16 children with CIs (M = 22.06 months) and 25 children with NH (M = 18.71 months). Families contributed 1 to 3 daylong recordings quarterly over the course of approximately one year. Additional parent and infant characteristics including maternal education, amount of residual hearing, and age at activation were also collected. RESULTS: The results showed that whereas CTs and CVs increased with child age for children with NH, they did not change as a function of age for children with CIs; NON was significantly higher for the NH group. No significant group differences were found for the measures of AWC, TVN, or OLN. Moreover, measures of CTs, CVs, TVN, and NON from children with CIs were associated with demographic and child factors, including maternal education, age at CI activation, and amount of residual hearing. CONCLUSIONS: These findings suggest that there are similarities and differences in the home auditory environment experienced by children with CIs and children with NH. These findings have implications for early intervention programs to promote spoken language development for children with CIs.

Background Small-quantity lipid-based nutrient supplements (SQ-LNS) are designed to address undernutrition during the complementary feeding period. SQ-LNS contains added sugars, but limited research has assessed whether infants' acceptance varies between versions with and without sugars. Objectives Our objective was to examine the effects of repeated exposure on children's acceptance of sweetened and unsweetened SQ-LNS. We aimed to understand caregivers' perceptions of children's liking of the 2 SQ-LNS versions and their influences on infant acceptance of SQ-LNS. Methods Caregivers (86% non-Hispanic White) and children (7-24 mo), participated in a randomized, 2-week home-exposure study and baseline and post-home exposure assessments. Children were randomized to receive sweetened or unsweetened SQ-LNS versions, mixed with infant oatmeal. At in-person visits, caregivers fed both SQ-LNS versions to children and rated their child's liking for each. Caregivers fed the SQ-LNS version to which their child was randomized until the child refused to eat more. Acceptance was measured as total grams consumed. Mixed-effects linear models tested the change in SQ-LNS consumed between baseline and postexposure by the SQ-LNS version and number of home exposures. Covariates included the amount of SQ-LNS consumed at baseline, child BMI z-score, child age, and breastfeeding experience. Results Children's acceptance of both SQ-LNS versions increased from baseline to postexposure (β, 0.71 g; 95% CI: 0.54-0.89 g; P = 0.04), regardless of SQ-LNS version (P = 0.88) or number of home exposures (P = 0.55). Caregivers rated children's liking of unsweetened SQ-LNS higher at baseline (P = 0.02). Children with lower liking ratings at baseline showed the greatest increases in acceptance between baseline and postexposure (P = 0.01). Conclusions Children's acceptance of SQ-LNS increased with repeated exposure, whether offered the sweetened or unsweetened version, providing preliminary support that adding sugar to SQ-LNS may not improve acceptance in young children. Children who initially like the supplement less may need repeated experience to learn to accept SQ-LNS. This trial was registered at clinicaltrials.gov as NCT04544332.

Background We leveraged a recent efficacy trial to investigate directionality between parent anxiety and child anxiety at posttreatment and 12-month follow-up, and the potential role of parent psychological control as a mediator. We also explored child age and sex as moderators. Method Two-hundred and fifty-four children were randomized to individual cognitive behavioral therapy (CBT) or to one of two CBT arms with parent involvement. Parent anxiety was not a treatment target in any of the three arms. Results Child anxiety at posttreatment was associated with parent anxiety and psychological control at 12-month follow-up, providing evidence of child-to-parent directionality. Parent anxiety at posttreatment was associated indirectly with child anxiety at 12-month follow-up through associations with parent psychological control, providing evidence of parent-to-child directionality. At posttreatment, parent psychological control contemporaneously mediated the relation between parent and child anxiety. Neither child age nor sex moderated any association. Conclusions Findings highlight the directional effects between child anxiety, parent anxiety, and psychological control from posttreatment to 12-month follow-up, even when parent anxiety is not a treatment target. Research and clinical implications are discussed, with an emphasis on enhancing durability following treatment effects.

A 12-year nationwide survey (2008-2019) was performed to investigate the prevalence of Enterobius vermicularis infection among preschool children in Seoul, 4 large cites (Busan, Incheon, Daegu, and Ulsan), and 9 provinces (grouped into 5 localities) in the Republic of Korea (=Korea). The survey was carried out once a year by 16 regional offices of the Korea Association of Health Promotion. The cello-tape perianal swab method (1 smear per child) was applied to detect eggs of E. vermicularis and other helminths. According to the results, the egg positive rate of E. vermicularis infection in 2008-2009 was 1.8-2.0%, but it decreased gradually to 0.6% in 2019 (P

The present study investigated the associations between mothers’ levels of current depressive symptoms and mothers’ socialization of children’s positive affect (PA) regulation, assessed by mothers’ own PA regulation and responses to their child’s PA. The study included 96 mother-child dyads with children ages 7 to 12. Participants completed questionnaires examining emotion socialization constructs (i.e., PA, savoring, dampening) and participated in a mother-child discussion task about a positive event that the child experienced. Structural equation modeling was conducted while controlling for covariates (i.e., education level, household income, child age). Results indicated that mothers with higher depressive symptoms were more likely to dampen their own positive events and less likely to savor their own and their children’s positive events. Mothers with higher depressive symptoms also reported less PA in response to their own and their children’s positive events. In the discussion task, mothers with higher depressive symptoms used fewer PA-related words and were more likely to ignore their children’s PA-related words. These findings highlight the role of maternal depressive symptoms within PA socialization processes. This study may inform future research targeting specific emotion socialization techniques, such as savoring and dampening, in depression interventions for mothers and their children.

We aimed to explore the underlying genetic mechanisms of traumatic events during childhood affecting the risks of adult substance use in present study. Using UK Biobank cohort, linear regression model was first applied to assess the relationships between cigarette smoking and alcohol drinking in adults with traumatic events during childhood, including felt hated by family member (41,648–111,465), felt loved (46,394–124,481) and sexually molested (47,598–127,766). Using traumatic events as exposure variables, genome-wide by environment interaction study was then performed by PLINK 2.0 to identify cigarette smoking and alcohol drinking associated genes interacting with traumatic events during childhood. We found that the frequency of cigarette smoking was significantly associated with felt hated by family member (coefficient = 0.42, P –9), felt loved (coefficient = −0.31, P –9) and sexually molested (coefficient = 0.46, P –9). We also observed weaker associations of alcohol drinking with felt hated by family member (coefficient = 0.08, P = 3.10 × 10–6) and felt loved (coefficient = −0.06, P = 3.15 × 10–7). GWEIS identified multiple candidate loci interacting with traumatic events, such as CTNNA3 (rs189142060, P = 4.23 × 10–8) between felt hated by family member and the frequency of cigarette smoking, GABRG3 (rs117020886, P = 2.77 × 10–8) between felt hated by family member and the frequency of alcohol drinking. Our results suggested the significant impact of traumatic events during childhood on the risk of cigarette smoking and alcohol drinking.

Objective:As part of an update of feeding benchmarks targeting children aged 0–3 years, this study aimed to explore parental perceptions, information-seeking practices and needs concerning infant and young child feeding (IYCF) to design an efficient communication strategy.Design:Participants were recruited using the quota sampling to complete an online survey. Effects of parity, child age, prematurity, parental education and financial situation on parents’ responses were evaluated separately.Setting:France.Participants:A nationally representative sample of 1001 parents of children Results:Parents whose child had any medical condition affecting feeding (children with medical condition (CMC), 17 %) were considered separately from healthy children’s parents. All the healthy children’s parents recognised the importance of IYCF for children’s health and growth; however, one-third considered the available advice contradictory and not guilt-free. The most used information sources were healthcare professionals (HCP, 81 %), internet (72 %) and parental networks (63 %). The most influential sources (mean influence ± sd) included HCP (7·7 ± 1·7/10), childcare professionals (7·3 ± 1·8/10) and parental networks (6·9 ± 1·8/10). Parents searched for practical tips for implementing IYCF starting when their child was 5 months old. Differences regarding the type of source used by parents with higher v. lower educations were small. Search strategies differed according to parity or child age but not to prematurity. The CMC parents reported slightly different practices and needs.Conclusions:Parents receive information from multiple sources, which can lead to confusion when deciding which advice to follow. A public health communication strategy adapted to the current parental needs should target these various sources.

An interview survey was conducted on 639 and 340 mother-child pairs from Ismailia, Egypt and Riyadh, Kingdom of Saudi Arabia [KSA], respectively. The children were 13-36 months old. Mothers were selected randomly from primary health care centers. The study aimed at comparing breast-feeding practices in the study areas and to identify some determinants of exclusive breast-feeding and early complementary feeding. The study has shown that 39.7% of Egyptian mothers and 66.4% of Saudi mothers initiated exclusive breast-feeding at 4-6 months. Most of Egyptian mothers [60.3%] started complementary feeding early [before 4 months] as compared to [33.6%] of the Saudis. Egyptian mothers tended to terminate breast-feeding later than Saudi mothers. More than one-third of Saudi mothers did that during the first 6 months of child age, as compared to only 6.7% in Egypt. The majority of Egyptian mothers [77.2%] gave sugar water or infant formula soon after giving birth, the comparable figure in Saudi mothers was only [34.4%]. Women’s primary sources of information and support for breast-feeding were: nobody [i.e., personal decision], mother or close relatives, and medical personnel. In both study areas, early complementary feeding increased with higher levels of mothers’ education, younger mother’s age, mother’s employment, shorter maternity leave, longer hospital stay after delivery, and narrower inter-pregnancy spacing. Early initiation of breast-feeding within the first hour of birth showed no association with early complementary feeding neither in Egypt nor in KSA. The study recommends that efforts to improve breast-feeding should include a variety of strategies and target groups, as well as modifying key behaviors found to be most detrimental to exclusive breast-feeding by trying innovative strategies in health education and mass media programs.

Purpose The systematic review study aimed to investigate the following details in the clubfoot children treated with the Ponseti technique: (1) to review the various designs and prescriptions of unilateral limb orthosis described in literature (2) to find the outcome following use of this orthosis, especially patient adherence and recurrence (3) comparison with standard bilateral limb foot abduction orthosis. Material and methods A literature search was performed for articles published in 'Pubmed (includes Medline indexed journals)' electronic databases for broad key words: 'Clubfoot or CTEV or congenital talipes equinovarus', 'orthosis or brace or splint'. Included were studies that addressed the treatment of idiopathic clubfoot in children up to 2 years of age using the Ponseti technique and use of unilateral limb orthosis for the subsequent maintenance phase. We excluded studies reporting Ponseti technique for nonidiopathic clubfoot, child age older than 2 years at the time of primary treatment, studies where unilateral limb orthosis was used as a tool for primary correction of all or some components of clubfoot and design descriptions of orthosis without practical usage data. Results Of the 1537 articles from the database, 10 articles were included in the final review. Most studies were retrospective, underpowered and had a short term follow-up. In some series, the use of this orthosis was driven by personal experiences and regional preferences rather than a just scientific explanation. The tested designs were variable and nonstandardized. Being less restrictive, unilateral limb orthosis may have an edge over bilateral limb orthosis in terms of patient adherence. The available comparative studies however showed inferiority of unilateral orthoses when compared to the bilateral limb orthosis in preventing recurrences in clubfoot treatment. Conclusions There is insufficient evidence to support use of unilateral limb orthosis for maintenance of deformity correction following treatment of clubfoot with the Ponseti technique. Their use was found associated with high recurrence rates.

CONTEXT: Non-urgent emergency department (ED) use contributes to healthcare costs and disrupts continuity of care. Factors influencing patient/guardian decision-making in non-urgent situations are poorly understood. OBJECTIVE: Determine the association of patient/guardian – primary care provider (PCP) relationship with non-urgent ED usage and explore related factors. METHODS: In an urban practice, we recruited 218 parent-child pairs and administered a survey with the PCP relationship (PDRQ-9), caregiver knowledge of office resources, and care-seeking behavior. We performed a 12-month retrospective chart review to document non-urgent ED visits. We evaluated the association of PDRQ9 and non-urgent ED usage by regression analysis. RESULTS: Mean child age was 7.0 ± 5 years, and 32.6% of children had at least one non-urgent ED visit. Mean PDRQ9 score was 39.8 ± 7.3 and was not associated with non-urgent ED use (p=0.46). Lower child age (p

Introduction: A vaccination schedule is complex and dynamic that requires repetitive and timely clinic visits by children and their caretakers. This study investigates whether providing caregivers with one-time tailored information on the vaccination schedule improves the vaccine uptake among children. Methods: The study participants were 534 women each with a child age 8 months or less; they were from 11 settlements in Jada, a local government area in Adamawa state, Nigeria. The study was conducted on September 2019 to June 2020. Women were randomly selected to be assigned to a treatment group to be provided with one-time tailored information on their children’s current vaccination status and the next schedule for vaccination, while women in the control group were provided with generic information on the vaccination schedule. We employed the ordinary least squares (OLS) and logistic regression depending on the type of dependent variables to analyze the treatment effect. Results: After the women received tailored information on the vaccination schedule, the number of clinic visits for vaccination increased. However, the tailored information did not improve the vaccine uptake among children at a particular age nor the full vaccination rate. Conclusion: One-time tailored information has an immediate but no sustainable effect. It might be important for women to be constantly reminded about the vaccination schedule.

OBJECTIVE: To determine and evaluate the accuracy of methods physicians use to detect diagnostic criteria for pediatric hypertension (hypertensive BPs on ≥3 occasions) in electronic health records (EHRs). METHODS: Methods used by pediatric-trained physicians (n=12) to detect diagnostic criteria for hypertension in a simulation using a child’s EHR data were directly observed, timed, and evaluated for accuracy. All physicians were given the same information regarding diagnostic criteria to eliminate knowledge gaps. Then, computer modeling and EHR data from 41,654 3–18-year-olds were used to simulate and compare the accuracy of detecting hypertension criteria using an observed-shorthand method vs. the guideline-recommended/gold-standard method. RESULTS: No physician used the guideline-recommended method of determining multiple time-of-care hypertension thresholds for child age/height at the time of each BP measure. One physician estimated the child’s BP diagnosis without computing thresholds; 11/12 physicians determined the child’s hypertension threshold from age/height data at the time of a current visit and applied/imputed this threshold to BP measured at all visits (current-visit threshold used to assess historical-visit BPs) to detect three separate BP elevations. Physicians took 2.3 minutes (95% CI, 1.5–3.0) to declare a diagnosis. Sensitivity was 83.1% when applying the current-visit threshold to detect the guideline-recommended-BP-threshold diagnosis using EHR data. Specificity and positive-/negative-predictive values ranged from 98.5–99.9%. CONCLUSIONS: Physicians applied a shorthand method to evaluate pediatric BPs. Computer-simulated comparison of the shorthand and guideline methods using clinical data suggests the shorthand method could yield an inaccurate impression of a child’s BP history in 17% of pediatric ambulatory visits. CONDENSED ABSTRACT: Complex computation of blood-pressure thresholds during outpatient visits has been cited as an impediment to diagnosing pediatric hypertension. Guidelines recommend clinicians recognize blood pressures exceeding hypertension thresholds at ≥3 separate visits. It was unclear if physicians use this method. Observation of physicians identified use of a single hypertension threshold indexed to a child’s age and height at an active visit, not the threshold for age/height at the time of previous visits to detect if a child meets diagnostic criteria for hypertension. Comparison of this practical-though-imperfect method with the guideline-recommended method revealed physicians may miss many children meeting guideline-recommended hypertension criteria.

Objectives: Past research has not examined secondhand and thirdhand smoke (THS) exposure in children of cigar smokers. We examined hand nicotine and cotinine levels in children of cigar smokers to explore the contribution of cigar smoke to tobacco smoke exposure (TSE). Methods: Participants were children (N = 24; mean (SD) age = 6.5 (3.6) years) whose parents smoked cigars only or poly-used cigars and/or cigarettes. Primary outcomes were hand nicotine and urinary cotinine levels. Results: All children had detectable hand nicotine (range: 7.6-312.5ng/wipe) and cotinine (range: 0.3-100.3ng/ml). Positive correlations were found between hand nicotine and cotinine (r = 0.693, p = .001), hand nicotine and parents who also smoked cigarettes (r = 0.407, p = .048), and hand nicotine and number of smokers around the child (r = 0.436, p = .03). Hand nicotine (r = -0.464, p = .02), but not cotinine (r = -0.266, p = .26), was negatively correlated with child age. Multiple regression results indicated a positive association between hand nicotine and cotinine (p = .002; semi-partial r2 = 0.415), irrespective of child age. Conclusions: The significant association of hand nicotine with urinary cotinine suggests that THS pollution should be assessed in evaluating children's overall TSE to cigars and other tobacco products, and hand nicotine may be a proxy for overall TSE. Younger children may have increased THS pollutant uptake.

OBJECTIVES On the basis of the data from school-aged children, there is consistent evidence that there is a prolonged course of auditory development for perceiving speech embedded in competing background sounds. Furthermore, age-related differences are prolonged and pronounced for a two-talker speech masker compared to a speech-shaped noise masker. However, little is known about the course of development during the toddler and preschool years because it is difficult to collect reliable behavioral data from this age range. The goal of this study was to extend our lower age limit to include toddlers and preschoolers to characterize the developmental trajectory for masked speech detection thresholds across childhood. DESIGN Participants were 2- to 15-year-old children (n = 67) and adults (n = 17), all with normal hearing. Thresholds (71%) were measured for detecting a two-syllable word embedded in one of two maskers: speech-shaped noise or two-talker speech. The masker was presented at 55 dB SPL throughout testing. Stimuli were presented to the left ear via a lightweight headphone. Data were collected using an observer-based testing method in which the participant's behavior was judged by an experimenter using a two-interval, two-alternative testing paradigm. The participant's response to the stimulus was shaped by training him/her to perform a conditioned play-based response to the sound. For children, receptive vocabulary and working memory were measured. Data were fitted with a linear regression model to establish the course of development for each masker condition. Appropriateness of the test method was also evaluated by determining if there were age-related differences in training data, inter-rater reliability, or slope or upper asymptote estimates from pooled psychometric functions across different age groups. RESULTS Child and adult speech detection thresholds were poorer in the two-talker masker than in the speech-shaped noise masker, but different developmental trajectories were seen for the two masker conditions. For the speech-shaped noise masker, threshold improved by about 5 dB across the age span tested, with adult-like performance being reached around 10 years of age. For the two-talker masker condition, thresholds improved by about 7 dB between 2.5 and 15 years. However, the linear fit for this condition failed to achieve adult-like performance because of limited data from teenagers. No significant age-related differences were seen in training data, probe hit rate, or inter-rater reliability. Furthermore, slope and upper asymptote estimates from pooled psychometric functions were similar across different child age groups. CONCLUSIONS Different developmental patterns were seen across the two maskers, with more pronounced child-adult differences and prolonged immaturity during childhood for the two-talker masker relative to the speech-shaped noise masker. Our data do not support the idea that there is rapid improvement of masked speech detection thresholds between 2.5 and 5 years of age. This study also highlights that our observer-based method can be used to collect reliable behavioral data from toddlers and preschoolers-a time period where we know little about auditory development.

Relevance. Rheumatic diseases strongly influence the condition of the oral cavity, salivary glands and the temporomandibular joint, that, along with poor oral hygiene in children and active growth, increases the risk of oral disease development. The growing number of rheumatic diseases in children requires evaluation of the oral cavity condition and assessment of the provided dental services; enhancement of the professional oral care in children with rheumatic diseases through the comprehensive evaluation of the quality of the performed dental procedures and development of caries prevention measures based on the analysis of the epidemiological survey results.Materials and methods. 316 children with rheumatic pathology aged 1 to 18 years were examined. The children were divided into three age groups: group I – 1-5 years, group II – 6-12 years, group III – 13-17 years. The Oral hygiene and past dental experience questionnaire was developed for each group. Hard dental tissue condition and caries intensity level (df – in group I, df+DMF – in group II, DMF – in group III) were assessed, the oral hygiene index was calculated by the child age. On dental examination, past caries treatment and its complications were considered, the level of dental care (LDC) according to Leus was assessed.Results. The received data on caries intensity in all age groups and all medical conditions were analyzed. The values corresponded to the high and very high intensity (4.2 to 13); the values were 1.89 – 3 times higher than the values received during the epidemiological survey in children of the same age groups in Russia. Multiple primary and secondary (as a complication after the previous dental treatment) caries, associated with poor oral hygiene, was detected. The data revealed that the dental care level in children with rheumatic diseases was ‘poor’ and ‘insufficient’ The interview of the children and their parents showed that 91% of children had never had preventive treatment and 89% of children visited the dentist less than twice a year. The examination revealed that secondary caries, that had developed in 50% of children after the treatment of caries and its complications, and bad fillings, that had to be replaced.Conclusions. Thus, indirect influence of the main disease on the hard dental tissues in children was revealed – motivation for dental treatment and good oral hygiene was decreased for the lack of knowledge. The analysis of dental treatment quality in such children was insufficient. Only emergency dental visits as well as inappropriate materials and methods used for the treatment of caries and its complications result in secondary caries. So, customized treatment approach and prevention programs should be developed and introduced for the oral care in children with rheumatic diseases according to the main disease course, administered background therapy and the level of dental health education.

We aimed to further the understanding of maternal depressive symptoms on temporal dynamics of child emotion regulation by applying the process model of emotion regulation to preschoolers and incorporating insights from children’s moment-to-moment emotional expressions. Following 108 mother–child dyads (57 girls; 72 mothers identified as White, 23 mothers as Black or African American, 10 mothers as multi-racial, 3 mothers did not report their race) from child age three (T1; Mchild age = 3.23; SD = 0.19) to four years old (T2; Mage = 4.21; SD = 0.15), we asked whether T1 maternal depressive symptoms predicted T2 boys' and girls' faster transitions into and slower transitions out of negative emotion displays when children were frustrated. The results from multilevel Cox Regression models for latencies and durations of emotion displays showed that child gender moderated the associations between maternal depressive symptoms and latencies of child emotion displays for sadness but not anger. Higher levels of maternal depressive symptoms predicted faster transitions into sadness only for girls but not for boys. The findings suggested that girls of mother with elevated depressive symptoms showed impairment in antecedent-focused emotion regulation of sadness.

The article considers the issues of statistical accounting of of persons of child age who have fallen into difficult life situation. The paper сarries out a comparison of the conceptual apparatus, revealing such a public category as “children” and gradation parameters of specified population groups from the point of view of revealing the object of study. The authors justify the need to characterize the subject of the study – a difficult life situation in which both an adult and a child can get, highlight particularly the age group “teenagers”. The study presents features of difficult life situations in which children and adolescents can get. The article lists the areas of occurrence of complex circumstances in which difficult life situations are formed and developed. Based on the analysis, the authors propose and substantiate an original system of indicators for assessing persons of child age who have fallen into a difficult life situation.

Higher anxiety and depression in females becomes more pronounced in the transition from childhood to adolescence. Although previous research indicates that parental anxiety may predict anxiety and depression more strongly in girls than boys, there is a lack of longitudinal research investigating these relationships. The current study utilized longitudinal data (N = 940) to investigate our hypotheses that 1) mothers’ and fathers’ anxiety (at child age 7) would be more strongly associated with symptoms of adolescent anxiety and depression in girls than in boys, and 2) that greater increases in both mothers’ and fathers’ anxiety (from child age 7 to child age 15) would be more strongly associated with symptoms of adolescent anxiety and depression in girls than in boys. Structural equation modeling results indicated that higher mothers’ anxiety at child age 7, as well as higher increases in fathers’ anxiety (from child age 7 to child age 15), were associated with girls’ anxiety and depression at age 15, but not boys’ anxiety and depression at age 15. There were no child gender differences found in the associations between 1) fathers’ anxiety at child age 7 and child anxiety and depression at child age 15, or 2) change in mothers’ anxiety (from child age 7 to child age 15) and child anxiety and depression at child age 15. These results highlight important gender differences that may influence the development of anxiety and depression in adolescence.

Background: Due to the COVID-19 pandemic, most faculty in science, technology, engineering, mathematics, and medicine (STEMM) began working from home, including many who were simultaneously caring ...

This study examined the variables predicting South Korean mothers’ psychological distress and the difference in their effect on maternal distress by child age. Data were extracted from the Panel Study on Korean Children (PSKC). Participants included 1292 mothers at the first time point (4 months after childbirth) and 1094 mothers at the second time point (when their children were 6 years old). Decision Tree Analysis was conducted using PASW 12.0. The results of the study are as follows. The variables segregating South Korean mothers into two groups with normal levels of psychological distress and with mild to severe distress symptoms differed by child age. The mothers’ psychological distress was affected by their negative self-efficacy, self-esteem, parenting stress, and marital conflict, when their child was 1 year old. However, their parenting stress and marital conflict were found to predict mothers’ psychological distress when their child was 6 years old. This study suggests that tailoring an intervention to consider specific characteristics at different stages of parenting is effective in order to alleviate mothers’ psychological distress.

Supportive maternal and paternal caregiving have been found to be associated with children’s effortful control abilities. However, many studies did not assess both maternal and paternal parenting in the same analytic model, making it difficult to parse out the unique contributions of mothers versus fathers. Thus, we aimed to simultaneously assess the role of parent gender in associations between observations of supportive caregiving in the preschool years and observations of children’s effortful control abilities in the early school-age years. At approximately age 3 years, children (N = 113) participated in videotaped father–child and mother–child interactions, as well as a battery of effortful control tasks. At approximately age 6 years, children participated in another battery of effortful control tasks. Covariates included parental education, child age, child preschool-age effortful control, and child gender. Structural equation modeling revealed that maternal and paternal supportive caregiving behaviors in the preschool years were independently associated with children’s school-age effortful control abilities. In sum, we found that supportive caregiving in the preschool years was associated with children’s early school-age effortful control abilities, regardless of parent gender. Findings have implications for the development of interventions aimed at improving children’s effortful control abilities through improvements in both paternal and maternal parenting.

Child undernutrition is a major health problem in Malawi. We assessed the association between maternal autonomy and child stunting in Malawi. We utilized nationally representative pooled cross-sectional data from the 2010 and 2015/16 Malawi Demographic and Health Surveys (MDHS), which included 7348 mother (28.1 ± 6.8 years, range 15–49 years)—child (27.6 ± 16.7 months, range 0–59 months) pairs. Maternal autonomy composite scores captured decision-making power, tolerance of domestic violence, and financial independence. The nutritional outcome measure was stunting (height-for-age z score p = 0.002). However, this association was probably mediated by other factors associated with improved child nutrition, including maternal education and family wealth, which, along with child age, were associated with stunting in the dominance analysis. Concurrent interventional programs may also have contributed to the decrease in stunting between the surveys, thus moderating the effect of maternal autonomy.

This meta-analysis examined associations between the quantity and quality of parental linguistic input and children's language. Pooled effect size for quality (i.e., vocabulary diversity and syntactic complexity; k = 35; N = 1,958; r = .33) was more robust than for quantity (i.e., number of words/tokens/utterances; k = 33; N = 1,411; r = .20) of linguistic input. For quality and quantity of parental linguistic input, effect sizes were stronger when input was observed in naturalistic contexts compared to free play tasks. For quality of parental linguistic input, effect sizes also increased as child age and observation length increased. Effect sizes were not moderated by socioeconomic status or child gender. Findings highlight parental linguistic input as a key environmental factor in children's language skills.

Early attachment quality may be a lasting source of vulnerability or protection in children's development. In this study, we examine whether attachment quality at age three moderates the impact of subsequent exposure to maternal depression (at age five or nine) on children's externalizing symptoms at age nine. The sample included 1,917 low-income families (mean child age = 9.28; 55.9% African-American, 20.6% White, 20.0% Latina, 3.5% Other) from the Fragile Families and Child Well Being Study. At age three, 23.9% of children were categorized as insecurely attached based on maternal report of their child's attachment behaviors. At age nine, mothers, teachers, and children reported on the child's externalizing behaviors. Mothers also completed measures of maternal depression at child age three, five, and nine. Controlling for age three externalizing (by maternal report) and age three maternal depression as well as various demographic factors, attachment quality interacted with exposure to subsequent maternal depression in predicting externalizing behaviors at age nine. Interaction effects were evident in mother, teacher, and child report of externalizing. Across all three reporters, exposure to maternal depression was associated with greater externalizing behaviors in children who exhibited insecure attachment behaviors at age three. These findings highlight the potential benefit of interventions to improve early parent-child relationships for families at elevated risk because of maternal mental health.

Children with autism spectrum disorder (ASD) are at elevated risk of suicidal ideation, particularly those with comorbid anxiety disorders and/or obsessive-compulsive disorder (OCD). We investigated the risk factors associated with suicidal ideation in 166 children with ASD and comorbid anxiety disorders/OCD, and the unique contribution of externalizing behaviors. Suicidal ideation was reported in the child sample by 13% of parents. Controlling for child age, sex, and IQ, perceived loneliness positively predicted the likelihood of suicidal ideation. In addition, externalizing behaviors positively predicted suicidal ideation, controlling for all other factors. Reliance on parental report to detect suicidal ideation in youth with ASD is a limitation of this study. Nonetheless, these findings highlight the importance of assessing and addressing suicidal ideation in children with ASD and comorbid anxiety disorders/OCD, and more importantly in those with elevated externalizing behaviors and perceptions of loneliness.

Objective:Examine mother–son, mother–daughter, father–son and father–daughter resemblance in weight status, and potential modifying effects of socio-demographic and childcare characteristics.Design:Cross-sectional study.Setting:School.Participants:1973 school-age children and their parents from five mega-cities across China in 2017.Results:Pearson correlation coefficients (r) for BMI of father–son, father–daughter, mother–son and mother–daughter pairs were 0·16, 0·24, 0·26 and 0·24, respectively, while their weighted kappa coefficients (k) were 0·09, 0·14, 0·04 and 0·15, respectively. Children aged 6–9 years (r ranged from 0·30 to 0·35) had larger BMI correlation with their parents than their counterparts aged 10–14 years or 15–17 years (r ranged from 0·15 to 0·24). Children residing at home (r ranged from 0·17 to 0·27) had greater BMI correlations with their parents than children residing at school/other places. BMI correlation coefficients were significant if children were mainly cared for by their mothers (r ranged from 0·17 to 0·29) but non-significant if they were mainly cared for by others. Only children who ate the same meal as their parents ‘most times’ (r ranged from 0·17 to 0·27) or had dinner with their parents ‘at most times’ (r ranged from 0·21 to 0·27) had significant BMI correlation with their parents. Similarly, children who had dinner with their parents ‘most times’ but not ‘sometimes,’ had significant BMI correlation coefficients.Conclusions:Parent–child resemblance in weight status was modest and varied by child age, gender, primary caregiver, whether having similar food or dinner with parents in China.

Caregivers play a central role in promoting emotion regulation throughout infancy, childhood, and adolescence. However, there are no existing psychometric measures to assess how parents assist children in employing emotion regulation strategies for negative emotions. We therefore developed the Parental Assistance with Child Emotion Regulation (PACER) Questionnaire to assess the degree to which parents assist their children in their use of ten different regulation strategies. In this paper, we describe the development of the PACER and examine its psychometric properties (N = 407 parents of children ages birth to 17 years). In so doing, we also use the PACER to comprehensively explore the links between parent-assisted emotion regulation and indices of parent and child stress, symptomatology, and attachment. Confirmatory factor analyses of the PACER items supported its intended ten-factor structure (corresponding to ten specific regulation strategies), which was invariant across different child age and sex categories. PACER scale scores had excellent internal consistency and generally acceptable test–retest reliability over a one-week period. Convergent validity was established via correlations between PACER scales and indices of parental emotion sensitivity, expressivity, and regulation, as well as parents’ perception of the efficacy of their assistance with children’s execution of emotion regulatory strategies. Lower parental facilitation of stereotypically adaptive emotion regulatory strategies was associated with higher child internalizing and externalizing problems and with poorer parent–child relationship quality. Overall, these findings suggest that the PACER may be a useful tool for the assessment of parental assistance with child emotion regulation across development.

OBJECTIVE: To examine the association among 24-hour movement guidelines and fundamental motor skills (FMS) in preschoolers. DESIGN: Prospective cohort study with one-year follow-up. METHODS: Parents of 3–4-year-old children reported child age, sex, race, and time spent viewing screens (hours/day). Accelerometers measured preschooler physical activity (PA) and sleep. The 24-hour movement guidelines were examined (≥3 hours/day total PA including ≥1 hour/day of moderate-to-vigorous [MVPA], 10–13 hours/day of sleep, and ≤1 hour/day of screen-time). Trained researchers administered the Test of Gross Motor Development-Third Edition (TGMD-3) to assess FMS. Linear regression was used to assess guidelines met and raw locomotor, ball skills, and total TGMD-3 scores with adjustment for covariates. RESULTS: One hundred and seven preschoolers provided complete cross-sectional data, and 53 preschoolers provided complete longitudinal data. Of the 107 preschoolers, they were 3.4±0.6 years of age, 44% were male, 50% were White, and the mean age-and-sex adjusted TGMD-3 total score percentile was below average (41±22). Many preschoolers met the PA guideline (91%) and sleep guideline (83%), but few preschoolers met the screen-time guideline (8%) or all three guidelines (6%). MVPA was positively associated with locomotor and total TGMD-3 scores in cross-sectional analysis (p