Recent studies have demonstrated a relationship between poor vitamin D status and respiratory infections and diarrhea among young children. Acute lower respiratory infections (ALRI) and diarrhea are among the two most important causes of death in under-5 children. In this analysis, we examine the extent to which vitamin-D deficiency (<10 ng/ml) predicts these outcomes using data from a randomized controlled trial (RCT) of daily folic acid and/ or vitamin B12 supplementation for six months in 6 to 30 months old children conducted in Delhi, India. Of the 960 subjects who had vitamin-D concentrations measured, 331(34.5%) were vitamin-D deficient. We found, after controlling for relevant potential confounders (age, sex, breastfeeding status, wasting, stunting, underweight, anemia status at base line and season), the risk of ALRI was significantly higher among vitamin-D deficient (OR 1.26; 95% CI: 1.03 to 1.55) compared to vitamin-D-replete children in the six months follow-up period. Vitamin-D status was not significantly associated with episodes of diarrhea and clinical pneumonia. The extent of causal relationship of vitamin-D status and ALRI needs to be explored in further studies.

Transmission of values and religious concepts to children is one of the most important issues in the third millennium and it has drawn varied and different views among experts and scholars in the world. Research specialized in religious literature for children and adolescents create new capacities in the presentation of religious concepts to the group. Plans have been considered to transfer values and religious concepts in the curricula of primary school children in the group in Iran. It is one of the topics that the authors note to the introduction of the minutiae of religion in the first three elementary grades. In this study, the collection and analysis methods providing content related to the minutiae of religion in reading books the first till third sections of the years 2013-2015. In addition, the plan includes aspects of other branches of religion in these books on information collected from text books that collected and classified. The result is that "definitely good and forbidding the evil" and "prayer" have the highest frequency of applications in the selected books. Further branches made of branches of religion in these books, represents the values of religious, moral and social as well.

IgE-mediated wheat allergy is a gluten-related disorder. Wheat is one of the five most common food allergens in children. However, the natural history of IgE-mediated wheat allergy has seldom been described in the research literature. This study presents the current state of knowledge about the IgE-mediated wheat allergy in children.

Walking School Buses (WSBs) provide a safe alternative to being driven to school. Children benefit from the contribution the exercise provides towards their daily exercise target, it gives children practical experience with respect to road safety and helps to relieve traffic congestion around the entrance to their school. Walking routes are designed largely based in road safety considerations, catchment need and the availability of parent support. However, little attention is given to the air pollution exposure experienced by children during their journey to school, despite the commuting microenvironment being an important contributor to a child’s daily air pollution exposure. This study aims to quantify the air pollution exposure experienced by children walking to school and those being driven by car. A school was chosen in Bradford, UK. Three adult participants carried out the journey to and from school each carrying a P-Trak ultrafine particle (UFP) count monitor. One participant travelled the journey to school by car while the other two walked, each on opposite sides of the road for the majority of the journey. Data collection was carried out over a period of two weeks, for a total of five journeys to school in the morning and five on the way home at the end of the school day. Results of the study suggest that car commuters experience lower levels of air pollution dose due to lower exposures and reduced commute times. The largest reductions in exposure for pedestrians can be achieved by avoiding close proximity to traffic queuing up to intersections, and, where possible, walking on the side of the road opposite the traffic, especially during the morning commuting period. Major intersections should also be avoided as they were associated with peak exposures. Steps to ensure that the phasing of lights is optimized to minimize pedestrian waiting time would also help reduce exposures. If possible, busy roads should be avoided altogether. By the careful design of WSB routes, taking into account air pollution, children will be able to experience the benefits that walking to school brings while minimizing their air pollution exposure during their commute to and from school.

Rabies is a life-threatening and vaccine-preventable infectious disease and is triggered by an RNA virus, part of the Rhabdoviridae family, Lyssavirus genus. It is transmitted from infected saliva due to biting, but also from contact with infected blood or organs from rabid animals to humans. Children are at high risk due to their inability to defend themselves from infected animals and most deaths occur with a particularly high incidence in this category (under the age of 15 years). Postexposure prophylaxis (PEP) is standard and life-saving if given early after exposure. We are reporting the case of a ten-year-old female child, who was bitten by an unvaccinated cat ten days before admission to the Paediatric Intensive Care Unit at National Institute for Infectious Diseases „Prof. Dr Matei Bals”, Bucharest. The child had category III cat bites and did not receive PEP. Suggestive clinical manifestations such as an altered general state, psychomotor agitation, auditory and visual hallucinations, and hypersomnia followed by aerophobia and hydrophobia were present. Despite the maximal treatment introduced from early admission (Human Rabies Immunoglobulin, anti-rabies vaccination, orotracheal intubation plus mechanical ventilation, vital functions’ support, parenteral feeding, symptomatic drugs) the evolution of the patient was unfavourable, namely death two months after admission. The diagnosis was established in both pre-mortem by identifying the rabies virus in the cerebrospinal fluid based on reverse transcription-polymerase chain reaction (RT-PCR) and post-mortem by a histopathological examination (which reveals the presence of Babes-Negri bodies in the hippocampus). The objective is to understand the mechanism of infection and mortality from rabies virus in children. Conclusion: The most effective prevention methods are early administration of specific prophylaxis (immunoglobulin and vaccination) and, most importantly, early elimination of animal rabies outbreaks, while rapid diagnosis is helpful in the management of human rabies in humans. The rate of human exposure may be significantly decreased by controlling rabies through pet immunization programs.

Reducing sedentary behaviours can help prevent non-communicable diseases, particularly among young adolescents with long term illnesses or disabilities (LTID). Much of young people’s voluntary sedentary time is related to screen-time behaviours (STBs) such as TV viewing, playing computer games, and using the computer for other activities. Although public health data on adolescents’ STB is growing, information about adolescents with LTID is currently lacking in a European context. The purpose of this study is to compare time on STBs between adolescents with and without LTID in European Countries through the HBSC 2013/14 study. Young adolescents (n = 61,329; boys 47.8%) from 15 European countries reported the time spent on TV viewing, playing computer games, and using the computer for other purposes on weekdays and the weekend. STBs were dichotomised based on international recommendations of less than 2 h per day, and Chi-square tests of independence were performed to investigate differences. STB time was combined to produce a sum score as dependent variable in multiple analysis of covariance with age and family affluence as covariates. There were statistically significant differences in computer gaming among boys and other computer use among girls for both weekdays and weekends, whereby adolescents with LTID reported higher use. In addition, both boys and girls with LTID spent more time on STBs than their same sex peers without LTID (Boys, F = 28.17, p < 0.001; Girls, F = 9.60, p = 0.002). The results of this study indicate a need for preventive strategies to address high levels of STB among young adolescents with LTID and reduce the risk of poor health outcomes associated with higher levels of sedentary behaviour.

One of the robust explanation related to sociological educational inequality is Bourdieu’s cultural reproduction theory. Admittedly, prior work investigated that children’s cultural capital (CC) have significant effects on educational success. Although, it remain unclear in the context of developing countries specifically Vietnam. Also, how children’s conversion mechanism of CC works and drive educational success. Meanwhile, Bourdieu theory argue that CC effects educations outcomes largely via teachers biasness by using support of school grades, in contrast some of the scholars argue that absorption of children’s CC may directly transmit into educational abilities and skill development. This study employed partial least square structural equation modelling to analyze 5th grades students’ data collected from educational policy and data center. This study argue that conversion mechanism grounded on CC dimensions. This study provide implications for the policy makers and future researchers.

Background and Objective: In the present study, the purpose was to compare the demographic, clinical and laboratory results of pediatric brucella cases who had liver involvement and who had no specific organ involvement. Material and Methods: The data of 248 patients between 2 and 18 years of age diagnosed with Brucellosis between July 2017 and August 2018 were analyzed retrospectively. The patients who had liver involvement and who did not have other specific organ involvement were compared in terms of presentation, physical examination findings, age, gender, hemogram, AST, ALT, GGT, ALP, bilirubines, sedimentation, CRP, clinical and laboratory findings, and culture and relapse rates. Results: No significant differences were detected between the patients who had liver involvement (n=92) and who did not have specific organ involvement (n=156) in terms of diagnosis age and gender. Loss of appetite, nausea and sensitive stomach were higher in the patients who had hepatic involvement, and weariness was determined to be more in the control group patients. In the patients who had hepatic involvement, the hemoglobin and platelet values were lower, and the sedimentation, CRP and blood culture growth were higher. The relapse rates were lower in patients who had liver involvement. Conclusion: In patients who have liver involvement, in addition to elevated hepatomegaly and transaminase levels, the growth rate of the acute-phase reactants and brucella is higher in blood culture; and the relapse rate is lower after treatment. Brucellosis must be considered in the differential diagnosis of hepatomegaly and transaminase elevation where brucellosis is seen endemically. We believe that early diagnosis of brucellosis is important in treatment response.

Background: The COVID 19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID 19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children’s and adolescent’s mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children’s and adolescent’s mental health. Methodology: We conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included experimental randomized, nonrandomized controlled trials; observational studies; and qualitative studies. Results: Of the 5,828 articles that we retrieved, 18 articles met the inclusion criteria. We thematically analyzed and put up the major findings under the thematic areas of impact of pandemic on children and adolescent’s mental health. These studies reported that pandemics cause stress, worry, helplessness, and social and risky behavioral problems among children and adolescents (e.g., substance abuse, suicide, relationship problems, academic issues, absenteeism from work). Interventions such as art-based programs, support services, and clinician-led mental health and psychosocial services effectively decrease mental health issues among children and adolescents. Conclusion: Children and adolescents are more likely to experience high rates of depression and anxiety during and after a pandemic. It is critical that future researchers explore effective mental health strategies that are tailored to the needs of children and adolescents. Explorations of effective channels regarding the development and delivery of evidence-based, age-appropriate services are vital to lessen the effects and improve long-term capacities for mental health services for children and adolescents.

Teicoplanin is now increasingly used as a first-line prophylactic therapy for major surgical procedures, treatment of methicillin-resistant Staphylococcus aureus infections, and for those with reported penicillin allergy. Teicoplanin is rarely associated with anaphylaxis and there is limited information on the prevalence of teicoplanin- induced perioperative anaphylaxis. Here, we describe a case of a 12-year-old child with teicoplanin anaphylaxis peri-operatively.

Excessive intake of fat and fatty acids is associated with major health hazards such as obesity or chronic diseases. The aim of this study was to provide the first data on total fat, saturated fatty acids (SFA) and trans fatty acids (TFA) intakes and their major food sources in Tunisian children. A total of 1200 children, aged 3 to 9 years old (yo), were randomly selected from primary schools and kindergarten under a cross-sectional design. The 24-hour recall method and food frequency questionnaire were used to assess dietary intake. The energy percentages of total fat, SFA and TFA in Tunisian children were respectively 29.6, 11.4 and 0.15. No sex differences were found. The WHO recommendations for total fat, SFA and TFA were adopted by 58 %, 39 % and 89 % of the study population, respectively. The leading food groups of fat and fatty acids were ultra-processed foods, breakfast cereals and dairy products. The meat, fish, eggs and fish alternatives were the fifth main contributors to the total fat and SFA intakes in Tunisian children. The implementation of a relevant strategy for fat reduction, especially from ultra-processed foods, considered as low nutrient energy-dense products, is needed to promote health among children and prevent diet-related chronic diseases.

Educating children to be informed, responsible, socially adept citizens who care about others is an overarching purpose for schools. A rising variety of preventive and child development initiatives are being implemented in schools. Insufficient coordination with other school activities and neglect of implementation and assessment variables essential for a significant program impact these programs' current implications. They are not doomed to failure in the long term. The other challenges for scholars in school-based action research are identifying practical models to prevent problem characteristics, promoting positive child development, and supporting widespread development and sustainability of evidence-based preschool through educational practice. To conceptualize good youth development programs through Social and Emotional Learning (SEL) in schools, this research presents integrated social, emotional, and intellectual education (ISEIE). School interventions are necessary to implement the social and emotional skills on self-understanding, social knowledge, self-management, relationship management, responsibility, and decision-making. Schools are the best place to implement all these programs to create a better generation. To back up this viewpoint, this study looks at research from illustrative studies and research syntheses. In the end, this paper provides suggestions for implementing programs that combine social, emotional, and intellectual development.

Using digital media has become the most popular leisure activity for children and adolescents. The effects of digital media use on the developing brain and cognitive processes of children are subject to debate. Here, we examine the effect of digital media use on attention subdomains in children aged 6 to 10 years. In total, 77 children participated in the study. Selective and divided attention as well as switching between attentional demands were quantified by the SwAD task. Parents were asked to assess the screen time of their children (TV, smartphone, laptop/PC, game console, tablet). Results show no main or interaction effects of screen time on any of the attention conditions investigated. Based on the present findings, as well as previous studies, we suggest a possible non-linear relationship between the amount of screen time and attention function. Furthermore, we emphasize the relevance of considering the socio-economic background of children and a need for longitudinal studies.

Screen viewing time is the total time spent by a child on any digital/electronic device. The objective of the present study was to determine the incidence and predictors of excessive screen viewing time in children in Ujjain, India. This cross-sectional, community-based study was conducted through house-to-house survey by using the three-stage cluster sampling method in 36 urban wards and 36 villages of Ujjain district, India. Excessive screen viewing time was defined as screen viewing for &gt; 2 h/day. The prevalence of excessive screen viewing time was 17.83%. Risk factors identified using the multivariate logistic regression model were: age (OR: 1.5, P &lt; 0.001); mobile phone use before bedtime (OR: 3.17, P = 0.008); parents’ perception about the child habituated to screen (OR: 14.03, P &lt; 0.001); television in bedroom (OR: 48.69, P &lt; 0.001); morning mobile screen viewing time (OR: 9.27, P &lt; 0.001); not reading books other than textbooks (OR: 9.71, P &lt; 0.001); and lack of outdoor play for &gt;2 h (OR: 4.20, P &lt; 0.001). Presence of eye pain was a protective factor for excessive screen viewing time (OR: 0.12, P = 0.011). The study identified multiple modifiable risk factors for excessive screen viewing time.

Background The World Health Organization has recently recognized Long COVID, calling the international medical community to strengthen research and comprehensive care of patients with this condition. However, if Long COVID pertains to children as well is not yet clear. Methods An anonymous, online survey was developed by an organization of parents of children suffering from persisting symptoms since initial infection. Parents were asked to report signs and symptoms, physical activity and mental health issues. Only children with symptoms persisting for more than four weeks were included. Results 510 children were included (56.3% females) infected between January 2020 and January 2021. At their initial COVID-19 infection, 22 (4.3%) children were hospitalized. Overall, children had persisting COVID-19 for a mean of 8.2 months (SD 3.9). Most frequent symptoms were: Tiredness and weakness (444 patients, 87.1% of sample), Fatigue (410, 80.4%), Headache (401, 78.6%), Abdominal pain (387, 75.9%), Muscle and joint pain (309, 60.6%), Post-exertional malaise (274, 53.7%), rash (267, 52.4%). 484 (94.9%) children had had at least four symptoms. 129 (25.3%) children have suffered constant COVID-19 infection symptoms, 252 (49.4%) have had periods of apparent recovery and then symptoms returning, and 97 (19.0%) had a prolonged period of wellness followed by symptoms. Only 51 (10.0%) children have returned to previous levels of physical activity. Parents reported a significant prevalence of Neuropsychiatric symptoms. Conclusions Our study provides further evidence on Long COVID in children. Symptoms like fatigue, headache, muscle and joint pain, rashes and heart palpitations, and mental health issues like lack of concentration and short memory problems, were particularly frequent and confirm previous observations, suggesting that they may characterize this condition. A better comprehension of Long COVID is urgently needed..

Play therapy is an approach to providing assistance in overcoming problems using media such as toys, art media, games, and communication. The purpose of this paper is to find out that play therapy can reduce anxiety in children. The research design used in this study was a study-literature review. The data used in this research comes from the results of research that have been conducted and published in national and international online journals. The method of analysis used in this study is the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) method.

Objectives- We prospectively analyzed children with acute chest pain and clinical suspicion of pneumothorax (PNX) evaluated at the pediatric Emergency Department. Methods- After clinical examination and before Chest X-Ray, children underwent LUS to evaluate the presence of PNX. We enrolled 70 children, 13 (18,57%) received a final diagnosis of PNX. Results- In all 13 (100%) patients LUS showed the “bar-code sign”, the absence of lung sliding and the absence of B lines while in 12 (92,3%) there was the lung point, giving a diagnosis of PNX. All cases had PNX features on CXR. The “bar-code sign”, the absence of lung sliding and the absence of B lines had a sensitivity of 100% and a specificity of 100%. The “bar-code sign” had a positive predictive value of 100% and a negative predictive value of 100% for the detection of PNX. Conclusions- LUS is highly accurate in detecting or excluding pneumothorax in children with acute chest pain evaluated in the pediatric emergency department.

Introduction: The purpose of this study was to assess the effectiveness of animal therapy in alleviation of anxiety in pre-school children.Method: The study was carried out as a quasi-experimental study with pre-test and post-test design and control group. The study population consisted of 33 anxious 5-7years old children (participated in a welfare anxiety screening plan held by Counseling Center, Tehran-Iran) between 2018 and 2019. The participants took part in the study voluntarily.The subjects were randomly divided into experimental and control groups (10 in each group). The experimental group was exposed to 8 sessions of animal therapy. The research instrument was Spence Preschool Anxiety Scale (Parent Form) and the data were analyzed on SPSS 21 software.Results: The results showed that animal therapy had a significant effect on general anxiety score after adjusting for post-test scores (f= 32.49 and p= 0.001) with the effect equal to 0.70. In addition, the effect of animal therapy on anxiety of separation (f= 5.63, p= 0.03), generalized anxiety disorder (f= 8.56, p= 0.01), social phobia (f= 14.58, p= 0.002) and specific anxiety (f= 11.63, p= 0.005) was significant with effects equal to 0.30, 0.40, 0.53, and 0.47, respectively. The results also showed that the effect of animal therapy on obsession was not significant (p>0.05).Conclusion: Therefore, it can be concluded that Animal therapy is effective in alleviating anxiety in children.

Seizures are defined as a transient occurrence of signs and symptoms due to the abnormal, excessive or synchronous neuronal activity in the brain characterized by an abrupt and involuntary skeletal muscles activity. An early diagnosis, treatment and specific medical support must be performed to prevent Status Epilepticus (SE). Seizures’ onset, especially in children population, is related to specific risk factors like positive family history, fever, infections, neurological comorbidity, premature birth, mother’s alcohol abuse and smoke in pregnancy. Early death risk in children without neurological comorbidity is similar to the general population. Diagnosis is generally based on the identification of continuous or recurrent seizures but EEG evaluation could be useful if SE condition in suspected. The main goal of therapy is to contrast pathological mechanism which occurs in SE before neural cells are irreversibly damaged. According to latest International Guidelines and Recommendations of seizures’ related diseases, it is proposed a schematic and multi-stage pharmacological and diagnostic approach especially in the management of SE and its related causes in children. First measures should focus on early and appropriate drugs administration at adequate dosage, airway management, monitoring vital signs, PICU admission and management of parents’ anxiety.

The global process of urbanization, and the modification of social interaction determined by the pandemic crisis poses the issue of the place of vulnerable users, and in particular children, within the contemporary city. This research aims to elaborate a theoretical and methodological framework, based on the concepts of affordance and capability, for analyzing the potential of public spaces to enable and support children’s independent activities. This potential, or meaningful usefulness, is expressed by the Index of Meaningful Usefulness of public Urban Spaces (IUIS). The latter is calculated via the tool ‘Opportunities for Children in Urban Spaces’ (OCUS). This methodology is applied to the analysis of significant public spaces within the historic center of the city of Iglesias in Sardinia, Italy. The results reveal adequate usefulness of the selected spaces, while underlining criticalities related to intrinsic spatial and physical attributes. The application to the case study confirms the validity of the theoretical and methodological framework embodied in the OCUS tool for supporting urban design and planning by orienting place-shaping processes towards the acknowledgement of children’s needs.

Taking into account Bar-On’s postulations about social-emotional intelligence, the aim of the current work is to find out the differences in the five dimensions of this intelligence between children that practice organized sport and those children that do not practice it at elementary school level, to show that an increasing in the number of hours per day performing this activity causes differences in some of these dimensions. Hence, a sample of 940 children from elementary schools, ranging in age from 6 to 12 years old, attending different schools from the Autonomous Community of Extremadura (Spain), was used. Results showed that children who practiced organized sport had better coping abilities for stress, adaptability, and mood states, and that they are more emotionally intelligent than those who did not. Moreover, children who practiced for fewer hours daily (up to 2 hours) had better stress coping than those who practiced more. To conclude, it is important to promote the sport federative practice in elementary education, in order to ensure that children learn to better regulate and manage their emotions, without increasing it to an excessive number of hours per day, which may generate greater stress that might be difficult to control.

Stunting, during the Covid-19 pandemic, is increasingly becoming a big problem in the world, especially in poor and developing countries. Observational studies have shown that stunting is associated with poor nutrition, especially a plant-based diet, inflammation, caused by infection, enteric dysfunction, an environment with clean water, inadequate sanitation and hygiene (WASH), and endogenous inflammation associated with excess adiposity. This causes nutritional interventions to be often unsuccessful (Kemenkes RI, 2018).The government intervenes to reduce stunting to the target party, which is divided into two categories. The first category is specific nutrition intervention, namely monitoring children under five at the posyandu, giving immunizations, giving vitamin A, giving Supplementary Foods (PMT), and others. The second category is sensitive nutrition interventions, namely the provision of drinking water and proper sanitation, postnatal family planning (KB) services, providing information related to stunting, food social assistance, conditional cash assistance, and others. (KEMEN-PMK, 2018). WHO states, that the impact of stunting can be divided into short-term and long-term impacts. The short-term impacts are; increased incidence of morbidity and mortality; cognitive, motor, and verbal development in children is not optimal; and increased healthcare costs. While the long-term impact; Posture that is not optimal as an adult (shorter than usual); Increased risk of obesity and other diseases; The decline in reproductive health; Less than optimal learning capacity and performance during school years; and Low productivity and work capacity (Kemenkes RI, 2018). The nursing goal is to help people achieve quality, holistic health. Implementation of Modeling and Role Modeling Theory is an option in implementing nursing care for children with stunting. “Modeling” is gaining an understanding of the client’s world from the client’s perspective. That is to build a “model” of the client’s worldview. “Role‑Modeling” is based on the assumption that all humans want to interact with others, they want to carry out selected roles in society. Role-Modeling is using the client’s model of the world to plan interventions that meet his or her perceived needs, grow, develop and heal. Role-Modeling requires that we aim to build trust, promote a positive orientation and a sense of control, affirm strengths and set specific mutual goals.

Studies show that executive functions and motor development are associated among each other and with learning ability. A more technological lifestyle, related with digital culture, should be considered an important component to stimulate children. In addition, digital games constitute an element of the digital culture in which children are inserted. The aim of this study is to present a systematic mapping of the literature involving executive functions, motor development and the use of digital games in intervention programs for elementary school children, from 6 to 11 years old. Four databases were searched: PubMed, Scielo, Science Direct and SCOPUS, including publications between 2012 and March 2021. The initial results indicated 4881 works. After the selection process, 15 investigations that presented the central theme of the study were selected. The main results indicate that intervention strategies are quite heterogeneous. Most of the studies demonstrated significant positive effects after intervention protocols and were conducted in Europe and 46% of the studies were conducted in a school environment. No researches were identified that involved technological solutions involving executive functions, motor development and digital games in an integrated manner, constituting a field of future scientific research.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by impaired social communication and repetitive or stereotypic behaviours. In utero exposure to environmental chemicals, such as polychlorinated biphenyls (PCBs), may play a role in the etiology of ASD. We examined the relation between plasma PCB concentrations measured during pregnancy and autistic behaviours in a subset of children aged 3–4 years old in the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a pregnancy and birth cohort of 546 mother-infant pairs from Canada (enrolled: 2008-2011). We quantified the concentrations of 6 PCB congeners that were detected in >40% of plasma samples collected during the 1st trimester. At age 3–4 years, caregivers completed the Social Responsiveness Scale-2 (SRS), a valid and reliable measure of children’s reciprocal social and repetitive behaviors and restricted interests. We examined SRS scores as both a continuous and binary outcome, and we calculated Bayesian predictive odds ratios for more autistic behaviours based on a latent variable model for SRS scores >60. We found no association between plasma PCB concentrations and autistic behavior, However, we found small and imprecise increases in the mean SRS score and odds of more autistic behaviour for the highest quartile of plasma PCB concentrations compared with the lowest quartile; for instance, an average increase of 1.1 [95%PCI: −0.5, 2.6] in the mean SRS (exposure contrast 4^th versus 1^st quartile) for PCB138 translated to an odds ratio of 1.6 [95%PCI: 1.0, 2.5]. Our findings illustrate the importance of measuring associations between PCBs and autistic behaviour on both continuous and binary scales.

Background: This study describes the attitudes and practices of Brazilian adults regarding the mandatory vaccination for COVID-19 and the hesitancy to children´s vaccination. Methods: The participants answered an online questionnaire disseminated on social networks. An adaptation of the SAGE-WG questionnaire was used to measure the children's vaccination hesitancy. Results: Among 1,007 participants, 677 (67.4%) believed that vaccination for COVID-19 among adults should be mandatory. Just over half of the participants (51.5%) believe that parents and guardians should be free to decide whether their children should be vaccinated against COVID-19, and 9.1% were unsure about this. Younger, non-religious people who have higher self-perceptions of risk for COVID-19, and who evaluate the federal government's performance in combating the disease as bad or very bad, have a higher agreement with mandatory vaccination, a lower agreement that parents and guardians should be free to vaccinate their children, and lower child vaccination hesitancy scores. Conclusion: In Brazil, mandatory COVID-19 vaccination for adults is far from a consensus, and an expressive part of the population believes that parents and guardians should be free to choose whether or not to vaccinate their children. These perceptions and vaccine hesitancy for children are associated with religious and political inclinations.

Recent research has suggested that working memory training interventions may benefit children with Developmental Language Disorder (DLD). The current study investigated a short and engaging adaptive working memory intervention that targeted executive skills and aimed to improve both language comprehension and working memory abilities in children with DLD. Forty-seven 6- to 10-year-old children with DLD were randomly allocated to an executive working memory training intervention (n=24) or an active control group (n=23). A pre-test/intervention/post-test/9-month-follow-up design was used. Outcome measures included assessments of language (to evaluate far transfer of the training) and working memory (to evaluate near transfer of the training). Hierarchical multiple regression analyses controlling for pre-intervention performance and age found group to be a significant predictor of sentence comprehension and of performance on six untrained working memory measures at post-intervention and 9-month follow-up. Children in the intervention group showed significantly higher language comprehension and working memory scores at both time points than children in the active control group. The intervention programme showed potential to improve working memory and language comprehension in children with DLD and demonstrated several advantages: it involved short sessions over a short period; caused little disruption in the school day; and was enjoyed by children.

Mastocytosis is characterized by pathological accumulation of mast cells (MC) in various organs. In these patients, MC may degranulate and thereby contribute to clinical symptoms, especially when a concomitant allergy is present. However, MC activation can not only be induced by high-affinity receptors for IgE, but also by anaphylatoxins, neuropeptides, IgG immune complexes, complement-components, drugs, products of bacteria or parasites, as well as physical factors such as heat, cold, vibration, stress, sun, or physical effort. Symptoms due to mediators released by activated MC may develop in adults suffering from systemic mastocytosis, but also evolve in children who usually have cutaneous mastocytosis (CM). Clinically, CM is otherwise characterized by typical brown, maculopapular skin lesions or mastocytoma associated with a positive Darier’s sign. Pruritus and flushing are common and blistering may also be recorded, especially in diffuse CM (DCM). Pediatric patients with mastocytosis may also have gastrointestinal, respiratory, and neurologic complaints. Although anaphylaxis is not a typical finding, pediatric patients with massive skin involvement and high tryptase levels have a relatively high risk to develop anaphylaxis. This paper reviews MC mediator-related symptoms and anaphylaxis in children with mastocytosis, with special emphasis on risk factors, triggers, and management.

Children with leukaemia experience difficulties adapting to medical procedures and to the chemotherapy’s adverse effects. Study’s objectives were to identify which coping strategies could be associated with the treatments’ factors and with the dosage of sedation analgesic drugs during bone marrow aspirates. 125 patients (M = 6.79 years; SD = 3.40), majority with acute lymphoblastic leukemia (90.4%) and their parents received, one month after diagnosis, the PPCI. Data on the severe treatment effects and on the dosage of drugs in sedation-analgesia were also collected. An ANCOVA model (R2=0.25) showed that, weighing the age factor (F=3.47; df=3; p=0.02), the number of episodes of fever (F=4.78; df=1; p=0.03), nausea (F=4.71; df=1; p=0.03) and mucositis (F=5.81; df=1; p=0.02) influenced the use of distraction. Cognitive self-instructions (R2=0.22) were influenced by the number of hospitalizations (F=5.14; df=1; p=0.03) and mucositis (F=8.48; df=3; p=0.004) and by child’s age (F=3.76; df=3; p=0.01). Children who sought parental support more frequently (F=9.7; df=2; p=0.0001) and who tended not to succumb to a catastrophic attitude (F=13.33; df=2; p=0.001) during the induction treatment phase required lower drug dosages, especially propofol. The clinical application of these results could be to encourage the use of cognitive self-instructions and search for social support.

The Self-determination theory and The Vallerand's Hierarchical Model has been studied with different types of social factors that can bring different consequences. The purpose of this work was if responsibility and social climate could predict the social and prosocial behaviors and vio-lence. For this, 429 students (M = 11.46, SD = 1.92) participated in this study answering a ques-tionnaire with five variables: school climate, responsibility, motivation, satisfaction of psycholog-ical needs, prosocial and antisocial behaviors and violence. The main results saw that the most part of variables were correlated positive and directly except with antisocial behaviors and vio-lence. On the other hand, prediction model (X2 = 584.145 (98); RMSEA = 0.104 [90% CI = 0.096, 0.112]; TLI = 0.849; CFI = 0.894) showed that responsibility and school climate can predict psy-chological basic needs and these needs, can improve the autonomous motivation and finally have positive consequences improving prosocial behaviors and reducing antisocial behaviors and vio-lence. In conclusion, school climate and responsibility can improve positive consequences to the classroom, specifically, prosocial behaviors and reducing violence and antisocial behaviors.

There is an increasing need for effective anxiety and pain reduction during medical imaging procedures in children. This is a complex issue, addressed by both non-pharmacological or pharmacological approaches. Dexmedetomidine is a fairly recently marketed, selective α2-adrenergic agonist, and can be administered intranasally. To develop an evidence-guided clinical protocol, we investigated its (side)-effects, preconditions and safety aspects following intranasal dexmedetomidine in children (1 month-5 years) for procedural sedation during medical imaging. To do so, a systematic search (PubMed, Embase, CINAHL (12/2021)) was performed to identify clinical studies on intranasal dexmedetomidine for procedural sedation for medical imaging (Computer Tomography, Magnetic Resonance Imaging). Following screening and quality assessment, 8 studies were retained. Nasal nebulization was considered the best administration method, dosing varied between 2 to 4 µg/kg (age-dependent) 30-45 minutes prior to imaging, and contra-indications or restrictions on oral intake were somewhat consistent across studies. Valid sedation scores were routinely used to assess sedation and the need for rescue dosing, while discharge was generally based on the Aldrete score (score ≥9). Heart rate, blood pressure and saturation were routinely monitored, with commonly observed bradycardia or hypotension (decrease by 20%). Based on these findings, a roadmap for evidence-guided clinical protocol was generated.

Children of imprisoned parents have a two times greater risk for health problems, including difficulties in their environment, academic and behavioural problems as well as social stigma. Focusing on children who have parents in prison has not been a priority for research. This review aims to describe current knowledge on children who have imprisoned parents in a global context and highlight areas for additional research. This review highlights the coping strategies that children of imprisoned parents use and explore interventions that exist to support children of imprisoned parents. This review employed a qualitative narrative synthesis. The database search yielded 1989 articles, of which 11 met inclusion and quality criteria. Stigmatizing children due to parental imprisonment was a widespread problem. Children’s coping strategies included maintaining distance from the imprisoned parent, normalizing the parent’s situation and taking better control over their lives through distraction, sports, supportive people and therapy. Children received the best support in school-based interventions or mentoring programmes. The overall low quality of the included studies indicates a need for further research.

Background: Over the past decade, the use of digital tools has grown and research evidence suggests that traditional media and new media offer both benefits and health risks for young children. The abilities to understand and use language represent two of the most important competencies developed during the first 3 years of life through the interaction of the child with people, objects, events, and other environmental factors. The main goal of our study is to evaluate the relationship between digital devices use and language abilities in children between 8-36 month, considering also the influence of several variables. Materials and Methods: We conducted a cross-sectional observational study on 260 healthy children (140 males = 54%) aged between 8-36 months (mean=23.5±7.18 months). All the parents completed a self-report questionnaire investigating the use of digital devices by their children, and a standardized questionnaire for the assessment of language skills (MacArthur). Multiple linear regression was used to evaluate the relationship between different variables. Subsequent moderation analysis were performed to verify the influence of other factors. Results: W found a statistically significant negative correlation between the total daily time of exposure to digital devices and the Actions and Gestures Quotient (ß=-0.397) in children between 8-17 months, and between the total daily time of exposure to digital devices and Language Quotient (ß=-0.224) in children between 18-36 months. Sex, level of education/job of parents, modality of use/content of digital device do not significantly affect these relationships. Conclusion: In our study we found that a longer time of exposure to digital devices was related to lower mimic-gestural skills in children from 8-17 months and to lower language skills in children between 18-36 months, regardless of age, sex, socio-economic status, content and modality of use. Further studies are needed to confirm and better understand this relationship, but parents and pediatricians are advised to limit the use of digital devices by children and encourage the social interaction to support the learning of language and communication skills in this age group.

Abstract: Given the links between parental obesity and eating psychopathology in their children, it is important to understand the mechanisms via which unhealthy relationships with eating are passed from parents to children. The aim was to review research focusing on food-related parenting practices (FPPs) used by parents with overweight/obesity. Web of Science, PubMed and PsycINFO were searched. Twenty studies were included in the review. Single studies suggest differences between parents with healthy-weight vs overweight/obesity with respect to; food accessibility, food availability and modelling. Multiple studies suggest that several parenting strategies do not differ according to parental weight status (child involvement, praise, use of food to control negative emotions, use of food-based threats and bribes, pressure, restriction, meal and snack routines, monitoring, and rules and limits). There was inconclusive evidence with respect to differences in parental control, encouragement and use of unstructured FPPs among parents with healthy-weight vs overweight/obesity. The findings of this review imply some differences between parents with overweight/obesity and healthy-weight and the use of some food-related parenting practices, however they should be interpreted with caution since research remains limited and is generally methodologically weak. The review highlights opportunities for further research and to improve current measures of FPPs and help clarify current study findings.

Rabies is endemic in southern Bhutan and children were reported to be the most frequent victims. We surveyed the knowledge, attitude, and practices on rabies among school children in three schools located in southern Bhutan. Descriptive statistics and logistic regression were performed to analyze the level of knowledge and variation of perception towards rabies among secondary school children. A total of 701 students (57.9% female, 42.1% male) had participated in the survey of which 98.2% heard about rabies. Most of the students demonstrated a good level of knowledge (59.7%) and a favorable perception towards rabies (57.7%). Multivariable logistic regression analysis revealed the importance of previous rabies awareness campaign increasing the likelihood of positive knowledge about rabies at the individual student and the school level. Similarly, higher grades of students’, employed mothers of the students, and students from villages were associated with more favorable perceptions. Overall, our study in rabies endemic areas of Southern Bhutan showed that most of the students have good knowledge and favorable perception towards rabies. However, we identified several knowledge gaps. Therefore, efforts should be made to address the knowledge gaps through regular awareness programs by actively engaging key stakeholders such as school-teachers and parents.

The primary and proven therapy, in cases of celiac disease (CD), is a rigorous gluten-free diet. However, there are reports of its negative effects in the form of nutritional deficiencies, obesity and adverse changes in body composition. The aim of the study was to assess the impact of a gluten free diet (GFD) on the body composition of children with CD. In a case-controlled study (n = 41; mean age 10.81 y; SD = 3.96) children with CD, in various stages of treatment, underwent medical assessment. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. More than half of the examined children (n = 26) followed a GFD. CD children had significantly higher mean values of the fat free mass (FFM% = 80.68 vs. 76.66, p = 0.015), and total body water (TBW% = 65.22 vs. 60.47, p = 0.012), and lower mean values of the fat mass (FM% = 19.32 vs. 23.34, p = 0.015). Children who were on a GFD presented slightly higher, but not statistically significant, mean values of FM and FFM, than children who did not follow dietary recommendations (FM [kg] = 7.48 vs. 5.24, p = 0.064; FM% = 20.81 vs. 16.73, p = 0.087; FFM [kg] = 28.19 vs. 22.62, p = 0.110). After minimum one year of a GFD, CD children showed significantly higher values of FFM [kg] (p = 0.001), MM [kg] (p < 0.001), TBW [L] (p < 0.001) and BCM [kg] (p < 0.001). Furthermore, CD children who were on a GFD presented significantly higher weight (p = 0.034) and body mass index (BMI) (p = 0.021) increase. The children adhering to a GFD demonstrate a tendency towards higher indices of selected body composition components.

This study aimed to assess knowledge and practice of caregivers and its relationship to the disease and nutritional status of children under five years of age in rural areas of Sylhet, Bangladesh. A total of 110 households having 6 to 59 months aged children was selected by simple random method from ten rural communities of three Upazila of Sylhet during September 2019 to February 2020. Descriptive statistics were used to assess the WASH knowledge & practice and multivariate chi-square analyses were performed to assess associations among diseases & nutritional status with WASH following a structured questionnaire. The study found a significant association of WASH with childhood disease and nutritional status, and 65% of children were found to be in a diseased state and 35% of children were found to be in a disease-free state within the last six months. The findings sketched that mother with poor wash knowledge and practice was at greater risk for disease outbreaks, disease frequency and duration. The highest incidence of diarrhea was 17% in children aged 12 to 23 months. Significant effect of WASH was also found in children nutrition status, that was reflected in the ratio of stunted, underweight and wasted children. Integrated convergent work focusing on the provision of clean water within the household, stop open defecation, promotion of hand washing, behavior change and poverty alleviation is needed to improve the situation. Health, nutrition and livelihood programs should be uninterrupted, and mothers or caregivers should be encouraged to participate in these programs.

Stunting in children is a serious problem of nutritional disorders and is strictly monitored by the Indonesian government, it is not only cause physical but also cognitive abnormalities in the form of less intelligence in children so that when they grow up, their productivity will decrease. The incidence of stunting in 2018 in Indonesia was 30.8 %, while in West Java was 29.92%, still at a moderate to high level, consequently, prevention and early detection efforts need to be carried out by various parties, including health professionals and health cadres. Therefore, the aim of this study was to examine the association between the socio demographic characteristics factors as well as the knowledge and motivation of health cadres in the stunting prevention in West Java. A correlational study with a cross-sectional approach was employed with the samples of health cadres from 8 districts/cities in West Java Province: Karawang, Tasikmalaya, Garut, Bandung, Subang, Sukabumi, Cianjur, and West Bandung. A total of 363 health cadres participated and the sampling technique used is the stratified method. The data were collected using a questionnaire developed specifically for this study and were analyzed using a correlation with Chi-Square test and presented in the form of a frequency distribution. The study findings found that majority of the health cadres have good knowledge of 81.27%, which was significantly influenced by education level and marital status with p &lt;0.05. Meanwhile, approximately half of the respondents had moderate motivation with 47.66%, while one-third or 39.12% had high motivation. This motivation was significantly influenced by education level, marital status, and age with p &lt;0.05. It was concluded that health cadres need to further enhance the roles and functions in the prevention and early detection of stunting in West Java by providing continuous guidance, stunting training prevention and award presentations.

Abstract: Objective: Internet gaming disorder (IGD) is an emerging psychiatric disorder that has received attention over the past decade. Few studies have attempted to describe this disorder in the Saudi population. This study aimed to examine the prevalence of IGD and associated factors. A cross-sectional study was conducted using translated Arabic and a validated questionnaire targeting both genders in Saudi Arabia. Methodology: A cross-sectional study using a validated questionnaire (IGD-20) and targeting Arabic-speaking children, youth, and transitional age including both genders. A snowball approach was used to sample our population using an electronic survey. Logistic regression was used to examine factors associated with IGD diagnosis. The study was guided by the STROBE statement. Results: Among 419 individuals who participated in the study, 171 were classified as non-IGD, 167 were at risk for IGD (RIGD), and 72 were IGD. There is no significant association between IGD diagnosis and gender, nationality, residence, and family income. Time playing per week was significantly associated with IGD diagnosis (X2=49.256, p<0.01). There is a significant association between IGD-20 groups and categorical age groups (X2=10.096, p<0.01). Among our sample, the percentages of males (54.2%) and females (45.8%) who met the criteria for IGD were comparable. Conclusion: IGD and RIGD prevalence was significantly high in both age groups. Both males and females were affected similarly.

There is great potential for reducing greenhouse gas emissions (GHGE) from public sector meals. This paper aimed to develop a strategy for reducing GHGE in the Swedish school food supply without compromising nutritional adequacy, affordability, and cultural acceptability. Amounts, prices and GHGE-values for all foods and drinks supplied to three schools over one year were gathered. The amounts were optimized by linear programming. Four nutritionally adequate models were developed: Model 1 minimized GHGE while constraining relative deviation (RD) from observed food supply; Model 2 minimized total RD while imposing stepwise GHGE reductions; Model 3 additionally constrained RD for individual foods to an upper and lower limit; and Model 4 further controlled how ratios between food groups could deviate. Models 1 and 2 reduced GHGE by up to 95% but omitted entire food categories or increased the supply of some individual foods by more than 800% and were deemed unfeasible. Model 3 reduced GHGE by up to 60%, excluded no foods, avoided high RDs of individual foods, but resulted in large changes in food group ratios. Model 4 limited changes in food group ratios but resulted in a higher number of foods deviating from the observed supply and limited the potential of reducing GHGE. Cost was reduced in almost all solutions. An omnivorous, nutritionally adequate, and affordable school food supply, with considerably lower GHGE is achievable with moderate changes to the observed food supply. Trade-offs will always have to be made between achieving GHGE reductions and preserving similarity to the current supply.

The present study was conducted to estimate the exposure and risk characterization of the children population of Serbia to Aflatoxin M1 (AFM1) from milk and milk-based food. A total of 3404 samples comprising of milk and different milk-based food samples were collected from various regions of Serbia from 2017 to 2019. Evaluation of the AFM1 exposure was carried out using the deterministic method, whereas risk characterization was evaluated with the calculation of the Margin of Exposure (MOE) and the risk of Hepatocellular Carcinoma (HCC). Detection rates for AFM1 in milk and milk-based food samples ranged between 2% and 79%, with the highest incidence (79%) and mean level (22.34  0,018 ng kg-1) of AFM1 was detected in pasteurized and UHT milk. According to the three consumption estimates, the values of EDI were higher for toddlers as compared with children. Children aged 1–3 years had the highest risk of exposure to AFM1 in milk, with an estimated daily intake of 0.164 and 0.193 ng kg-1 bw day-1 using a lower bound (LB) and the upper bound (UB) exposure scenarios, respectively. Such difference could result from the higher consumption versus weight. Based on the EDI found in this study, the risk of AFM1 due to consumption of milk and milk-based food was low since MOE values obtained were 10000. In addition, the risk of HCC cases/year/105 individuals of different age groups showed that the value of HCC using potency estimates of 0.0017 (mean) was maximum (0.00034) in the age group 1–3 years which indicates no health risk for the evaluated groups. The present study revealed the importance of controlling and preventing AFM1 contamination in milk through continuous monitoring and regular inspection to reduce the risk of AFM1 exposure, especially in children.

Cognitive function, arthrogryposis, obstetrics palsy, children, motor disorder

Children and adolescents with severe burns require dressing changes, associated with pain. As immersive virtual reality (VR) gained prominence as non-pharmacological adjuvant analgesia, we conducted a systematic review and meta-analysis on the efficacy of full immersive VR on pain experienced during dressing changes in hospitalized children and adolescents with severe burns. This exercise included quality and risk of bias assessment. The systematic reviewsearch resulted in eight studies and 142 patients. This exercise included quality and risk of bias assessment. Due to missing data, four studies were excluded from the meta-analysis. Fixed effects meta-analysis of the four included studies (n = 104) revealed a large effect size (ES) (SMD=0.94; 95% CI=0.62, 1.27; Z=5.70; p&lt;0.00001) for adjuvant full immersive VR compared to standard care. In conclusion, adjuvant full immersive VR significantly reduces pain experienced during dressing changes in children and adolescents with burns. We therefore recommend implementing full immersive VR as an adjuvant in this specific setting and population. However, this requires further research into the hygienic use of VR appliances in health institutions. Furthermore, due to the high cost of the hardware, a cost-benefit analysis is required. Finally, research should also verify the long term physical and psychological benefits of VR.

Background: Little information exists regarding the differences in the clinical and laboratory characteristics of Kikuchi-Fujimoto disease (KFD) according to age. Objective: To evaluate the clinical and laboratory characteristics of KFD according to age. Methods: We retrospectively evaluated patients diagnosed with KFD at Pusan National University Hospital between 2010 and 2020. Results: Eighty patients (46 children and 34 adults) with a mean age of 21.5 ± 11.8 years (range, 3–49 years) were included in the study. Among children, the male sex ratio was higher, in adults, the female sex ratio was higher. Fever, tenderness in the lymph node, and skin rashes were more common in children, while myalgia and weight loss were more common in adults. In children, the recurrence rate was significantly higher among boys than among girls (15.8% vs 0.0%, P=0.001). EBV and ANA positivity rates were higher in boys than in girls. In adults, the recurrence rate was significantly higher in women than in men (18.2% vs 0.0%, P=0.005). ANA positivity rates were higher in women than in men. Conclusion: The clinical features, laboratory findings, and recurrence of KFD may differ depending on age and sex. Clinicians should be aware of this.

Coronavirus is believed to have originated from a wet market in Wuhan, China, and has spread all over the world, resulting in a large number of hospitalizations and deaths. Social scientists are just beginning to understand its consequences on human behavior. One policy that public health officials put in place to help stop the spread of the virus were stay-at-home/shelter-in-place lockdown-style orders. Schools, Colleges and Universities across the country have now been shut down till now due to Covid-19. Some Governments in India impose lockdown to reduce the crises created by this unknown virus. It is now difficult to make final assessments by school, school leaving examinations and entrance tests for undergraduate and post-graduate courses. This disruption implies for students across the socio-economic spectrum, both in terms of learning outcomes , food and economic security. Here the aim is to discuss the implications of lockdown-induced in schools in both urban and rural areas in India.The whole world implemented a nationwide lockdown to curb the transmission of the virus. A survey was over Five hundred families to complete a questionnaire with questions around symptoms of depression, anxiety, stress, and family affluence. The humans who do not have enough supplies to sustain the lockdown were most affected Families with affluence were found to be negatively correlated with stress, anxiety, and depression. Stress, anxiety, and depression more than others are seen in students and healthcare professionals. The main aim of the paper is to find out how symptoms of depression, anxiety and stress on parents due to COVID-19.

The objective of this study was to describe the overall pattern of morbidity and mortality of children seen at the Thai Binh Pediatric Hospital in Vietnam, with a focus on infectious diseases. A retrospective review of hospitalisation records was conducted from 1 January 2015 to 31 December 2019. Data were obtained from a total of 113,999 records. The median age of patients was 18 months, with 83.98% of patients aged <5 years. Infectious diseases accounted for 61.0% of all cases. The most prevalent diseases were lower respiratory tract infections (32.8%), followed by gastrointestinal infections (13.3%) and confirmed influenza (5.4%). Most infections were not microbiologically documented. A total of 81.4% patients received at least one antibiotic. Most patients (97.0%) were hospitalised for less than 15 days. Regarding outcomes, 87.8% patients were discharged home with a favourable outcome. 12.0% were transferred to the Vietnam National Children’s Hospital because their condition had worsened and 0.1% died. In total, infectious diseases accounted for 40.4% of deaths, followed by neonatal disorders (34.6%). Our data serves a basis for the identification of needs for diagnostic tools and for future evaluation of the effect of the targeted implementation of such facilities. Point-of-care tests, including real-time PCR assays to identify common pathogens should be implemented for more accurate diagnosis and more appropriate antibiotic use.

Background: Given the potential for additional development to clarify a better knowledge of the overall impact of COVID-19 on the pediatric population, the clinical symptoms of SARS-CoV-2 infection in children and adolescents are still being explored. Morbidity in children is characterized by a variable clinical course. Our study's goal was to compare clinical aspects of 230 pediatric patients who tested positive for SARS-CoV-2 and were hospitalized between April 2020 and March 2022. Methods: In a retrospective analysis, we compared two groups hospitalized in the infectious diseases clinical ward IX at the National Institute for Infectious Diseases "Prof. Dr. Matei Bals," Bucharest, Romania. The first group of 88 patients was admitted between (April–December 2020) and their clinical manifestations were compared with the second group of 142 children followed between July 2021 and March 2022. Results: Of 230 children, the median age was 4.5 (interquartile range 0.6-17) years, 53.9% were male. 88 (36.21%) patients (first group) were admitted during the second wave in Romania, mostly aged < 5 years old, and experienced digestive manifestations like fever (p=0.001), and diarrhoea (p=0.004). The second group experienced different clinical signs when compared with the first group, with higher temperature and increased respiratory symptoms analogous to those of acute respiratory viral infections. The proportion in the second group increased, and 64.5% had symptoms for a median interval of 5 days; age (0-4 -years old) and length of stay were both proportionally inversely (p<0.01) and with correlation with hospital admission (p = 0.04). We report two Paediatric Inflammatory Multisystem Syndrome (PIMS) in the second group, with favourable evolution under treatment. Comorbidities were risk factors for complications appear (p < 0.001) in both groups. All paediatric cases admitted to our clinic evolved favourably and no death was recorded. Conclusions: In the first group children experienced digestive symptoms, whereas the second group experienced mild and moderate respiratory symptoms. We confirmed risk factors for severe cases as manifestations across the age spectrum, 0-4 (digestive symptoms) and 5-12 years old (for respiratory symptoms), associated comorbidities, fever, and male gender. The potential effects of COVID-19 infection in children older than 5 years should encourage caregivers to vaccinate and improve the prognosis among pediatric patients at risk.

In the end of April nearly 100 cases of children aged between 6 month and 9 years with Kawasaki like disease were reported (mostly in Europe) probably linked to COVID-19. With the increasing awareness of this condition the number of cases reported is increasing worldwide. We aim to sum up the known data about this new entity based on published data (in a case report, a series of 8 cases and in newspapers and society statement) and using our knowledge of classical Kawasaki disease. It seems to be a post infectious disease with an onset between 2-4 weeks after the infection, probably in genetically predisposed children aged between 6 month to 17 years. A very rough estimation of incidence based on current data from Bergamo, Italy, and New York State and a lot assumption is between 0.016% (95% CI:0.013-0.02%) - 0.31% (95% CI: 0.2-0.47%) of infected children. Clinical signs overlaps with Kawasaki disease in some children, but another feature is prominent gastrointestinal manifestations. For the 9 detailed patients most had incomplete presentation for Kawasaki disease (with a mean 1.7 (+/-1.2) criteria per patient for the 5 non fever criterion) and only one had a classical form. In some cases, presentation is closer to toxic shock syndrome or isolated myocarditis. Persistent fever seems to be constant and biological exploration are consistent with inflammation (elevated CRP, ferritin and D-Dimers). Management is described as supportive and children seem to improve rapidly, but can require cardiac or respiratory support. In date of 11 may 2020 there is 4 deaths confirmed linked to these new entities (1 in UK and 3 in New York). Paediatricians and general practitioners need to be aware of these possible evolution following COVID-19 infection. However it seems to be rare and children are probably still spared from most morbidities and mortality linked to COVID-19 infection .There are need of published detailed cohorts to better delineate these entities.

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having “some dehydration” and “dehydration” according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean ± standard deviation age of 25.62 ± 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p<0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p<0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p<0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.

(1) Background: Children who are physically active and involved in organized sport report having the unhealthiest diets. Research suggests excessive calories may be attributed to the prevalence of fast food and candy which are often provided as rewards in sport. This study explored the use of food as a reward in youth sport and the perceived impact it has on children’s motivation to participate in recreational soccer and ice hockey; (2) Methods: A multiple instrumental case study approach was utilized. Children aged 4-12 (n = 64), parents (n = 30), and coaches (n = 18) were recruited within central and northeastern Ontario, Canada to participate in focus groups and individual interviews. Transcribed audio recordings underwent inductive thematic analysis; (3) Results: Key themes included: Fun and fast: The culture of food in youth soccer and hockey; (Un)importance of food rewards: The how and why of motivating children in sport; and Youth sport is expensive: Gratitude for sponsorship in youth sport; (4) Children’s participation and effort would continue without food rewards; however, they continue to be offered food to motivate and celebrate performance in youth sport. Findings highlight the need to increase knowledge and awareness among parents and coaches on what truly motivates children to help foster healthier strategies for celebrating success and supporting lifelong physical activity.

Making life better for Indigenous peoples is a global priority. Although bullying and oral health have always been a topic of concern, there is limited information regarding the impact of this problem in the general population, with no evidence in this regard among the Australian Indigenous population. Thus, we aimed to quantify the relationship between bullying victimization and oral health problems by remoteness among 766 Australian Indigenous children aged between 10–15-year-olds using data from the LSIC study. Bivariate and multilevel mixed-effect logistic regression analyses were employed. Findings indicated children self-reported bullying more than parents reported their children were being bullied (44% vs 33.6%), with a higher percentage from rural/remote areas than urban areas. Parents reported oral health problem increases the probability (OR 2.20, p<0.05) of being bullied in Indigenous children living in urban areas. Racial discrimination, lower level of parental education and poor child oral hygiene increase the risk of bullying victimization. Parental happiness with life and a safe community was associated with a lower risk of bullying. Dental problems are linked with Australian Indigenous children experiencing bullying victimization. Cultural resilience and eliminating discrimination maybe two modifiable paths to ameliorating health issues associated with bullying in the Australian Indigenous community.

Background: Tropheryma whipplei is the causative pathogen of Whipple’s disease and other acute and chronic manifestations. Children have been identified as reservoirs of this bacterium especially in low-middle income countries. No information is currently available on the dissemination of T. whipplei in Iran. Therefore, the aim of this study was to investigate the presence of T. whipplei in children with immunodeficiency. Methods: This cross-sectional study was performed from July 2018 to February 2019 in Qom province (central Iran). Stool samples were collected from immuno-compromised children. T. whipplei was tested by SYBR Green and Taq-Man Real-time PCR assays. For confirmation, sequencing of the isolated bacteria was done. Results: One hundred and 30 children with a mean age of 56.7 months were enrolled. Acute lymphocytic leukemia was the most reported immunodeficient disease (77%), followed by non-Hodgkin lymphoma and retinoblastoma. The majority of the children were undergoing chemotherapy during the study. Thirteen (10%) children had T. whipplei DNA in the collected stools. Sequencing results confirmed T. whipplei identification in all the cases. Eight out of 70 (11.4%) children under 5 years old resulted positive. Conclusion: This is the first study showing the circulation of T. whipplei among immunocompromised children in Iran. More epidemiological studies are needed to evaluate the prevalence of this pathogen in different risk groups in Iran and to increase the knowledge of its rare clinical manifestations.

Annually, millions of people (including children) across the world face minor to severe impact from natural or human-induced disasters. Diverse models have been conceptualized and adopted at global scale to increase resiliency of children from disasters focusing on preparedness, response and recover. As children spend most of their lives at school or at home, this paper discusses on factors contributing towards improving or degrading resiliency of children from disasters. Giving low priority to institutional resilience, this paper highlights the behavioral aspects of children which becomes their strength on demonstrating appropriate practices to mitigate disaster risks on self at school, home and community. While doing so, attributes from Ajzen’s Theory of Planned Behavior has been linked with the components of resilience to explain the causative factors. Adopting desk review, this paper describes behavioral attributes of children and emphasizes on need of having multi-dimensional framework to enhance resiliency of children.

Background: Kawasaki disease (KD) is a form of vasculitis that primarily affects children under the age of 5 years old. Patients may be missed diagnosis when initial clinical symptoms do not fulfill the traditional criteria. We aimed to analyze factors that clinicians could use to differentiate febrile children suspected of KD. Method: We retrospectively enrolled a total of 83 febrile children who were initially suspected of KD, but they did not meet the American Heart Association (AHA) criteria for a diagnosis. However, some of these patients were diagnosed with KD during their second visit. We analyzed patients' characteristics, clinical symptoms, and laboratory data. Results: In total, 50 patients were enrolled in the study. Of those, ten patients were diagnosed with KD on their second visit (group 1), while the other 40 patients still did not fit a KD diagnosis (group 2). A patient with a neutrophil to lymphocyte ratio greater than 1.33 combined with a C-reactive protein more than 33 mg/L was more likely to have KD. Conclusion: Among patients suspected of KD that did not initially meet the criteria, clinicians should pay special attention to elevated neutrophil-to-lymphocyte ratios and CRP levels and closely follow up such patients.

Having valid and reliable tools that help health professionals to assess fear in children undergoing medical procedures is essential to offer humanized and quality of care in the paediatric population. The aim of this study was to develop the cross-cultural adaptation and the evaluation of the psychometric properties of the Spanish version of the “Child Medical Fear Scale” in its shortened version (CMFS-R). The design consisted of two phases, first of cross-cultural adaptation and second of the psychometric validation of the CMFS-R with a sample of 262 children from Spain. Confirmatory factor analysis was conducted to assess construct validity and the Cronbach alpha and the adjusted item-total score correlation coefficients were performed to study reliability. The results confirmed internal consistency and construct validity of the Spanish version of the CMFS-R, indicating that the scale has an acceptable level of validity and reliability. Therefore, this study brings a new version of the scale to assess fear related to medical procedures for use in the Spanish paediatric population.

We assessed the prevalence and correlates of stunting among children aged 6-23 months from poor households in Rwanda. A cross-sectional study was conducted among 817 mother-child dyads living in poor households from five districts with a high prevalence of stunting. We used descriptive statistics to determine the prevalence of stunting, bivariate analysis, and a multivariate logistic re-gression model to measure the strength of the Association between childhood stunting and exposure variables. Stunting was at 34.1%. Children aged 19-23 months (AOR = 4.410, 95% CI: [1.911-10.173], p-value=0.01), children aged 13-18 months (AOR=2.788, 95% CI: [1.302-5.968], p-value=0.08), children from households that do not have a vegetable garden (AOR=2.165, 95% CI: [1.201-3.905], p-value<0.01) were more likely to be stunted. On the other hand, children whose mothers were not exposed to physical violence (AOR= 0.145, 95% CI: [0.074-0.287], p-value<0.001), children whose fathers were working (AOR=0.036, 95% CI: [0.005-0.242], p-value=0.001), children whose both parents were working (AOR=0.208, 95% CI: [0.051-0.851], p-value=0.029) and children whose mothers had good hand-washing practice (AOR=0.181, 95% CI: [0.091-0.362], p-value<0.001) were less likely to be stunted. Our findings underscore the importance of integrating the promotion of hand-washing practices, owning vegetable gardens, and intimate partner violence prevention in the interventions to fight stunting.

Background: The relationship between adherence to the Mediterranean Diet (MD) and both physical fitness (PF) and physical activity (PA) level has been analysed in several studies. The aim of this research was to describe, compare and analyse the level of PF and PA in schoolchildren aged 6-13 in the Region of Murcia, according to adherence to the MD. Methods: A descriptive and cross-sectional study was performed. A total of 370 schoolchildren (44.9% girls) aged 6-13 (8.7±1.8) from six primary schools in the Region of Murcia (Spain). Results: Only 25.9% of the schoolchildren had optimal adherence to the MD. Regarding the scores of the different PF tests in MD groups, only statistically significant differences were found for CRF (p=0.048) in boys. PA level, showed statistically significant differences in both boys (p=0.040) and girls (p=0.016). A positive relationship was found between the KIDMED index and CRF (ρ=.127), standing broad jump (ρ=.133) and PA level (ρ=.235). A higher probability of having a greater CRF (OR=1.17; CI95%=1.02–1.34) and PA level (OR=7.84; CI95%=2.84–21.60) was found in High MD group. Conclusion: These results suggest that an optimal adherence to the MD is associated with higher CRF and PA level in the selected schoolchildren.

Background: Residents of a large area of North-Eastern Italy were exposed for decades to high concentrations of perfluoroalkyl and polyfluoroalkyl substances (PFAS) via drinking water. Despite the large amount of evidence in adults of a positive association between serum PFAS and metabolic outcomes, studies focusing on children and adolescents are limited. We evaluated the associations between serum PFAS concentrations and lipid profile, blood pressure and body mass index (BMI) in highly exposed adolescents and children. Methods: A cross-sectional analysis was conducted in 6669 adolescents (14-19 years) and 2693 children (8-11 years) enrolled in the health surveillance program of the Veneto Region. Non-fasting blood samples were obtained and analyzed for perfluorooctanoic acid (PFOA) perfluorooctane sulfonate (PFOS), perfluorohexanesulfonic acid (PFHxS), perfluorononanoic acid (PFNA), total cholesterol (TC) high-density lipoprotein cholesterol (HDL-C) and triglycerides. Low-density lipoprotein cholesterol (LDL-C) was calculated. Systolic and diastolic blood pressure (BP) were measured and BMI z-score accounting for age and sex was estimated. The associations between ln-transformed PFAS (and categorized into quartiles) and continuous outcomes were assessed using generalized additive models. Analyses were stratified by gender and adjusted for potential confounders. Results: Among adolescents, significant associations were detected between all investigated PFAS and TC, LDL-C, and to a fewer extent HDL-C. Among children, PFOS and PFNA had significant associations with TC, LDL-C and HDL-C, while PFOA and PFHxS had significant associations with HDL-C only. Increased serum concentrations of PFAS, particularly PFOS, were associated with decreased BMI z-score. No statistically significant associations were observed between PFAS concentrations and BP. Conclusions: Our study supports a consistent association between PFAS concentration and serum lipids, stronger for PFOS and PFNA and with a greater magnitude among children compared to adolescents, and a negative association of PFAS with BMI.

The objective of this study was to identify circulating miRNAs affected by disease duration in newly diagnosed children with type 1 diabetes. Forty children and adolescents from The Danish Remission Phase Cohort were followed with blood samples drawn at 1, 3, 6, 12 and 60 months after diagnosis. Pancreatic autoantibodies were measured at each visit. Cytokines were measured only the first year. miRNA expression profiling was performed by RT-qPCR and quantified for 179 human plasma miRNAs. The effect of disease duration was analyzed by mixed models for repeated measurements, adjusted for sex and age. Eight miRNAs (hsa-miR-10b-5p, hsa-miR-17-5p, hsa-miR-30e-5p, hsa-miR-93-5p, hsa-miR-99a-5p, hsa-miR-125b-5p, hsa-miR-423-3p and hsa-miR-497-5p) were found to significantly change expression (adjusted p-value < 0.05) with disease progression. Three pancreatic autoantibodies ICA, IA-2A, GADA65 and 4 cytokines IL-4, IL-10, IL-21, IL-22 were associated with the miRNAs at different time points. Pathway analysis revealed association with various immune-mediated signaling pathways. Eight miRNAs, involved in immunological pathways changed expression levels during the first five years after diagnosis in children with type 1 diabetes, and were associated with variations in cytokine and pancreatic antibodies, suggesting a possible effect on the immunological processes in the early phase of the disease.

Anemia is a significant public health problem among children, especially school-age children because their body quickly produces red blood cells to provide sufficient blood volume with plasma expansion to maintain blood concentration. This research aimed to study the anemia situation, knowledge about anemia, food consumption behaviors, and the association between knowledge, food consumption behaviors, and hematocrit level among school-age children in primary school, in Thasala district, Nakhon Si Thammarat Province. This is a descriptive study among 408 students, Grades 4 to 6, aged 9-12 years. Research instruments included the demographic data of the children and their knowledge about anemia, food consumption behaviors, and hematocrit assessment. Data were analyzed using descriptive, Spearman’s rank correlation coefficient, and logistic regression statistics. The results revealed that 23.2% of the samples had anemia, whereas 22.22% had mild anemia and 0.98% had moderate anemia. The children knew about anemia, where the mean score was at a moderate level (Mean= 6.63; SD= 2.51) out of 10. The mean score on food consumption behaviors was in the moderate level (Mean= 17.49; SD= 3.68) out of 24. There were significantly positive correlations between the knowledge about anemia and the hematocrit level at a moderate level (r= 0.45, p< 0.001). Correlation analysis revealed moderate food consumption behaviors with the hematocrit level (r= 0.40, p< 0.001). When confirm with Logistic regression found that knowledge about anemia (OR = 9.15, 95% CI: 4.57-18.34), and food consumption behaviors (OR = 19.09, 95% CI: 9.71-37.53) were significantly associated with the hematocrit level. Conclusions: This study showed that knowledge and appropriate food consumption behaviors are associated with hematocrit levels. Enhancing knowledge about anemia and food consumption behaviors may be reduced the prevalence of anemia in school-age children. The health care providers in primary care should be encouraged children to have health education and eat sufficient food.

The COVID-19 pandemic has created extraordinary challenges and prompted remarkable social changes around the world. The implications of the novel coronavirus and the public health control measures that have been implemented to mitigate its impact are likely to be accompanied by a unique set of consequences for specific populations living in low income-countries that have fragile health systems and pervasive social-structural vulnerabilities. This paper discusses the implications of COVID-19 and related public health interventions for children and young people living in Eastern and Southern Africa. Actionable prevention, care, and health promotion initiatives are proposed to attenuate the negative effects of the pandemic and government-enforced movement restrictions on children and young people.

Health locus of control is the set of beliefs a person has about his or her personal influence on health. The current study aimed at identifying types of locus of control in parents of leukemia children and possible association with depressive symptomatology and current life perception. 104 parents were recruited at the Haematology-Oncologic Clinic of Padua post 1 month from the leukemia diagnosis. Participants were Caucasian with a mean age of 37.28 years (SD=5.89), mostly mothers (87.5%) and with a mean of 12.16 years of education (SD=3.82). After signing the informed consent, they filled in the Ladder of Life questionnaire, the BSI-18 and the Parents Health Locus Of Control (PHLOC). Paired-samples t-test (t= -14.42; df=103; p=0.0001) showed that parents of leukemia children were more inclined to have an external locus of control than an internal one. Hierarchical regression analysis model (R2=0.34; F=4.32; p=0.0001) identified health professional influence (ß= -0.28; p=0.004), current life perception (ß= -0.3; p=0.013) and future life perception (ß= -0.26; p=0.012) as significantly predictors on Parental depression. Improving trust in the medical staff care and parental life perceptions could be a preventive program to cope with parental depression symptomatology.

Zinc deficiency, a common malnutrition in children and women is a global public health problem.Burden of zinc deficiencyis more in countries with low meat and high cereal food consumption like Nepal. Nationally representative data on zinc status in Nepal is lacking at present. This study analysed the data from the recent Nepal National Micronutrient status survey 2016(NNMSS-2016) to determinethe prevalence of zinc deficiency and associated risk factors among children aged 6-59 months (n=1462) and non-pregnant women aged 15-49 years(n=1923) from three ecological zones, Hill, Terai, and Mountainof the country. Venous blood was collected from the participants to measure micronutrients such as zinc, markers of anaemia, vitamin A, and markers of inflammation. Stool was collected to assessthe soil-transmitted helminths (STHs) and Helicobacterpylori infection. Socio-demographic, household and other relevant information were collected by a structured questionnaire. Logistic regression was used to examine the predictors of zinc deficiency among the participants.The overall zinc deficiency in children was found to be 22.9% while it was higher in non-pregnant women (24.7%). Predictors associated with zinc deficiency among enrolled children in the study were,living in rural areas (AOR=2.25, 95% CI, [1.13, 4.49]),occurrence of diarrhoea during the two weeks preceding the survey (AOR=1.57, 95% CI, [1.07, 2.30]), household wealth quintile (AOR= 0.48, 95% CI,[0.25, 0.92]) and vitamin A status (AOR=0.49, 95% CI,[0.28, 0.85]. Risk factors associated with zinc deficiency among the non-pregnant women were being underweight (AOR=1.60, 95% CI,[1.15, 2.23]), fever occurrence during two weeks preceding the survey (AOR=1.45, 95% CI,[ 1.06, 1.99]), H. pylori in the stool (AOR=1.32, 95% CI, [1.03, 1.70]), being rich (AOR=0.64, 95% CI,[0.42, 0.98]) and being in the risk of folate deficiency (AOR=0.60, 95% CI,[0.37, 0.96]). We conclude that community focused intervention programs including health and nutrition counselling and livelihood opportunities focusing groups at high-risk may improve the zinc status in Nepal.

Background: The robustness of sero-surveillence has delineated the high burden of SARS-CoV-2 infection in children; however, these existing data showed wide variation. This study aimed to identify the serostatus of antibodies against SARS-CoV-2 and associated factors among children following the fourth pandemic wave in Vietnam. Methods: A cross-sectional study was conducted at Vietnam National Children’s Hospital (VNCH) between March 13 and April 3, 2022. 4,032 eligible children seeking medical care for any medical condition not related to acute Covid-19 infections was tested for IgG SARS-CoV-2 Antibodies by ADVIA Centaur® SARS-CoV-2 IgG (sCOVG) assay using the residuals of routine blood samples. Results: The median age of enrolled children was 39 (IQR=14-82) months. The overall seropositive prevalence was 59.2%, and the median antibody titer was 4.78 [IQR 2.38-9.57] UI/mL. The risk of seropositivity and the median antibody titer was not related to gender (58.6% versus 60.1%, 4.9 versus 4.6 UI/mL, all p&gt;0.05). Among age groups, the highest seroprevalence was reported in the children aged 13 to &lt;36 months old. Children aged ≤12 months were likely to be seropositive compared to children aged 36 to &lt;60 months (59.2% versus 57.5%, p=0.49) and those aged ≥144 months (59.2% versus 65.5%, p=0.16). Children aged ≥144 months exhibited a significantly higher titer of protective COVID-19 antibodies than other age groups (p &lt;0.001). In multivariate logistic regression, we observed independent factors associated with SARS-CoV-2 seropositivity, including the age 13 to &lt;36 months (OR=1.29, 95%CI=1.06-1.56, p=0.01), 60 to &lt;144 months (OR=79, 95%CI=0.67-0.95, p=0.01), ≥144 months (OR=1.84, 95%CI=1.21-2.8, p=0.005), the presence of infected household members (OR=2.36, 95%CI=2.06–2.70, p&lt;0.001), participants from Hanoi (OR=1.54, 95%CI=1.34-1.77, p&lt;0.001), underlying conditions (OR=0.71, 95%CI=0.60-0.85, p&lt;=0.001), and using corticosteroids or immunosuppressants (OR=0.64, 95%CI=0.48-0.86, p=0.003). Conclusions: This study highlights a high seroprevalence of antibodies against SARS-CoV-2 among children seeking medical care for non-COVID-19-related conditions in a tertiary children’s hospital in Hanoi, Vietnam. In the context of reopening in-person schools and future emerged COVID-19 variants, this point will also be a key message about the necessity of “rush-out” immunization coverage for children, especially those under the age of three years.

Background: Vaccinating children against COVID-19 is an essential public health strategy in order to reach herd immunity and prevent illness among children and adults. Parents are facing tremendous stress in relation to the COVID-19 pandemic and the effectiveness of the COVID-19 vaccination program for children. In this study, we aimed to investigate parents’ willingness to vaccinate their children against COVID-19 in North Kivu province (DRC). Methods: A cross-sectional survey between December 01, 2021 to January 20, 2022 in 6 health zones (Goma, Karisimbi, Butembo, Beni, Kamango and Katwa) was conducted in the province of North Kivu. In each health zone, we selected 5 clusters (Health area) using the method of probabilistic selection proportional to population size. In total, 522 parents participated in our study. Results: Overall, 32.8% of parents intended to vaccinate their children. In the multivariate analysis, younger age of parents (aOR : 2.40, CI : [1.50-3.83]), higher level of fear that “a member of my family” could contract COVID-19 (aOR : 2.35, CI : [1.38-4.02]), higher level of perceived vulnerability to COVID-19 within the family (aOR : 1.70, CI : [1.005-2.2881]), higher level of perceived susceptibility to COVID-19 within the family (aOR : 3.07, CI : [1.80-5.23]), and history of vaccination against COVID-19 among parents (aOR : 16.47, CI : [8.39-32.33]), were significantly associated with the intention to have their children or adolescents vaccinated. Conclusion: Willingness of parents to vaccinate their children against the COVID-19 vaccination was low in North Kivu. There is undeniably in this region a need to reinsure the populations about vaccine safety for both children and adults. Public health authorities should also address widespread misinformation about vaccines in a timely manner.

This study aimed to verify the sex differences in early syntactic development among Cantonese-speaking children by Tse et al. (2002), with the same corpus design but a different Chinese language: Mandarin. The utterances produced during half-hour play activities by 192 Beijing children, ranging from 3 to 6 years, were collected in the Early Child Mandarin Corpus (Li &amp; Tse, 2011) and analyzed for this study. Their syntactic development was measured in terms of mean length of utterance (MLU), sentence type and structure, syntactic complexity, and verb pattern. The statistical analyses indicated significant age differences in MLU, sentence types and structures, and syntactic complexity. However, no sex or age-by-sex differences were found. This negative evidence indicates that sex difference is neither universal nor cross-language. The implications for early childhood education and future studies are discussed.

In the current Sars-CoV-2 pandemic, wearing a face mask was mandatory and is still desired during school lessons. There are no controlled studies in children to date indicating an effect on cognitive performance wearing face masks. In a randomized controlled trial, we analysed the influence of face masks on cognitive performance of pupils during regular school lessons. Pupils (n=133, 5th to 7th grade) were randomized by alternating allocation into control (with masks, n=65) and intervention groups (without mask, n=68). After two school lessons with (control) and without (intervention) face masks in class all pupils performed digital tests for cognitive performance regarding attention and executive functions (Switch, CORSI block tapping, 2-back and flanker task). Overall, there were no significant differences in cognitive performance between both groups, masks vs. no masks. Wearing face masks has no significant influence on attention and executive functions of pupils and can still be recommended during school lessons.

In recent years, lung ultrasound (LUS) has been increasingly used for the diagnosis of respiratory diseases in both adult and pediatric patients. However, asthma is a field in which the use of LUS is not yet well defined or is in development. In the following case series, we describe clinical, laboratory, radiological results as well as detailed lung ultrasound findings of 6 children with asthma: some of them with acute asthma attack and with inadequately controlled allergic asthma or childhood asthma; others with acute asthma and allergic or infantile asthma adequately controlled by preventive therapy. Finally we describe the clinical, laboratory and imaging parameters of a child with severe allergic asthma in the absence of exacerbation. In these cases, albeit at different times, LUS played an important role in both the initial diagnostic process and follow-up. It also showed different ultrasound features depending on the severity of the individual asthma based on the type of asthmatic phenotype and control of it.

Introduction: Cerebral palsy is the most common childhood disability Aims: Analyze and determine the main risk factors for the development of cerebral palsy in the population of Kazakhstan Materials and methods: Retrospective, analytical "case" - "control". Core group "case" - medical records of 100 pregnant women whose children at different ages has been diagnosed with cere-bral palsy Results: Thus, a retrospective analysis revealed the following features and complications in the perinatal period, which could promote the formation of cerebral palsy in children. Analytical results of the study are set significant results in cerebral palsy development Conclusion: Premature birth and urinary tract infections turned out to be the largest contribu-tors to the development of cerebral palsy, however, according to statistics, the rate of preterm birth, as well as the detection of infections, stably remains at the same level, while the number of cerebral palsy has been steadily growing since the early 1990s in Kazakhstan.

Advertising is a very important tool in influencing the customer´s buying behaviour. However, customers tend to have various levels of understanding and decoding advertising messages. Even though children do not have purchasing power themselves, they still create a key customer segment that can influence the purchase decision of the whole family. The paper focuses on how media usage by children and their attitudes towards advertisements determines their buying behavior. We analyze the development of their advertising literacy and the most important predictors of this development. The empirical study was carried out by designing a questionnaire which was filled by Slovak children between the age of 11 and 15. We evaluated the impact of advertising and the degree of influence of the selected types of advertising media on children's consumer behavior. We also evaluated the degree of the disruptive effect of the selected types of advertising media on children and the perception of a selected medium within gender. We identified the most and the least influential type of media and we found out that there is no significant difference within gender in the case of advertising media perception by children. According to the results, we can state that children´s buying behaviour is mostly influenced by advertising on social media platforms. Therefore, the study recommends for marketers also take into account children as consumers when they employ an advertising strategy on social media.

Wearable and mobile technology has advanced in leaps and bounds in the last decade with technological advances creating a role from enhancing healthy living to monitoring and treating disease. However, the discussion about the ethical use of such commercial technology in the community, especially in minors, is lacking behind. In this paper, we first summarize the major ethical concerns that arise from the usage of commercially available wearable technology in children, with a focus on smart watches, highlighting issues around the consent process, mitigation of risk and potential confidentiality and privacy issues, as well as the potential for therapeutic misconceptions when used without medical advice. Then through a relevant thought experiment we move on to outline some further ethical concerns that are connected to the use of wearables by minors, to wit the issue of informed consent in the case of minors, forcing them to live in the spotlight, and compromising their right to an open future. We conclude with the view that mitigating potential pitfalls and enhancing the benefits of wearable technology especially for minors requires brave and comprehensive moral debates.

Histamine intolerance is defined as disequilibrium of accumulated histamine and the capacity for histamine degradation. This clinical term addresses a non-immunologically mediated pathology when histamine ingested with food is not particularly high, but its degradation is decreased. Clinical picture of histamine intolerance in children is similar to that observed in adults apart from male predominance found in paediatric patients. Both in children and adults, histamine-free diet seems to be the treatment of choice. Diamine oxidase supplementation offers another treatment option. There is no symptom and\or test pathognomonic for histamine intolerance. Nevertheless, manifestations of chronic gastrointestinal symptoms, measurement of diamine oxidase deficits, positive results of histamine provocation tests and improvement of symptoms with histamine-free diet greatly increase the probability of histamine intolerance diagnosis. These factors have been included in the proposed in this paper diagnostic algorithm for histamine intolerance. In children histamine intolerance probably co-occur with allergies and bowel diseases, which creates an additional diagnostic challenge. As the evidence for children is weak, further research is needed the establish epidemiology, validate diagnostic algorithms and establish possible treatment options regarding histamine intolerance.

The prevalence of autism in children in the world is estimated as one per 62 children, higher levels reported in some countries. These children experience significant problems with the development of social, behavioural and verbal and non-verbal communication skills. The skills impairment levels varies from an individual to another and that made teaching autistics a challenge for caregivers such as teachers and relatives. Hence, there are quite a number of frameworks of a software learning systems which focus on gaining the children’s attention using representational visual illustration as a learning method instead of the textual form. However, majority of these tools are lacking the personalisation ability to suite everyone in the spectrum. Assistive technology offers an alternative way to attract children with autism to use. Therefore, this research is proposing Autism Content Management Learning System (ACMLS) Framework to assist caregivers to produce, design and fine-tune or customise the learning materials appropriately so that the system interface and the materials are suitable for every individual in the spectrum according to each child personal profile aiming to make learning attractive and to contribute in improving their social, communication and behavioural skills and nonetheless, their attention level to the delivered educational topics. The ACMLS framework design adopts four main components which are: (1) Design component: which covers the visual design, design principles and the mental model of the children with autism. (2) Technology component: which covers the assistive technology tools and the architecture of the ACMLS system. (3) Education component: Which covers the learning objectives, styles, strategies, methods and the cognitive model. (4) Participants component: which covers the main participants who’re playing a role in the ACMLS framework such as: caregivers and children with autism.

This study investigates five-year-old learners’ vocabulary retention through case studies, on a one week, one month, three months, and five months basis. It concerns the vocabulary learning of kindergarten children learning English as a second language (L2). This study attempts to seek answers to the questions of to what extent the presentation of the three different sets of words more effective than the other two is, both on recall and recognition and whether the recall and recognition levels showed differences in the three sets of words in course of time. In the literature, some studies have favoured semantic mapping in which new words are presented and organized in terms of associated lexical meanings. Some other studies have disfavoured semantic mapping. This study has administered three different sets of vocabulary: semantically related, cognates and semantically unrelated words. This study indicated that all participants were more successful with semantically related words on word recall and with cognates on word recognition. The results of this study do not support those which claim that making semantic associations may cause interference and hinder vocabulary learning. This study further suggests that semantically related words should be taught thematically to facilitate vocabulary teaching, particularly on word recall.

Introduction: The top priority of active immunoprophylaxis of pertussis is immunisation of infants as they can develop severe multiple-organ complications or even die from this disease. Objectives: The aim of the work is the identification of factors negatively affecting vaccine immunity to pertussis in preschool children prior to the administration of the first booster. Patients and Methods: The research was conducted on 352 children from 4.5 to 5.9 years of age who were hospitalised in the University Children’s Hospital in Lublin (Poland) from 1 January 2012 to 31 December 2015. The children taking part in the study had been administered all the mandatory vaccines from their birth to the age of 2 or 2.5 years old according to the Polish Immunisation Program 2008-2009. The immunoenzymatic method ELISA was applied to assess vaccine immunity to tetanus, diphtheria, pertussis, Haemophilus influenzae type b (Hib), poliomyelitis (IPV), mumps, rubella and measles. The level of vaccine antibodies to hepatitis type B was determined chemilumiscently. Results: The protective antibody titer was not found in 41 (11.65%) children before the administration of the booster. To verify the collective impact of parameters analised on antibody titer to pertussis, the Generalized Linear Model (GLZ) was used. Gender, type of vaccine, asthma, Hib and mumps antibody titers have been shown to be predicators of vaccine immunity to pertussis. Conclusions: Immunomodulation considered on the example of titer of IgG antibody to pertussis can serve as a useful model of the assessment of development of acquired immunity after mandatory vaccinations.

Abstract The aim of our study is to analyse the perception of the families and concerned social workers. The research was conducted in an underprivileged and disadvantaged microregion in North Hungary. The main focus was the perception on the available health, educational, child welfare and social services and supports. The starting point was to enquire the target group’s knowledge of these services. The study examines the extent to which social work is able to provide support to disadvantaged, marginalized families with children, and the way how the dysfunctional operation of the system contributes to the perpetuation of the clients’ life conditions. Analysing the quality of these services and supports is crucial to understand the social mobility chance of the children living in this microregion. The results show that without capability and talent development for the children and given the lack of welfare services, the mobility chance and opportunities of these families are extremely low in Hungary.

Background: Cancer has been one of the most critical health problems during the past decades which require serious consideration, especially in developing countries. Methods: 80 parents of the children with different types of cancers were studied via both questionnaire and person-to-person interview after announcing their informed consent. Results: The highest delay in patients' initial referral was due to the following factors: lack of attention or ignoring the first symptoms, delay in referring to the physician, low economic status and even lack of family support for the patient. In addition, visiting several doctors after the initial diagnosis, uncertainty about the first proposed method, and high cost of treatment can be mentioned as the main causes of delays in the start of treatment. Conclusion: Education plays an important role in identifying the signs of cancer. In addition, proper relationship and cooperation between the health system and physicians as well as provision of adequate information to patients could lead to the long-term cooperation of these patients in continuing their treatment.

It is already well known that infants and children infected with COVID-19 develop mild to mod-erate forms of the disease, with fever and oropharyngeal congestion being the most common symptoms. Nevertheless, there are cases in which the patients accuse respiratory symptoms. These cases need lung evaluation, which can be done using lung ultrasound (LUS), because it is a non-irradiating and repeatable imaging technique. 19 children with COVID-19 pneumonia were eval-uated using LUS. The LUS score (LUSS) for each patient varied between 1 to 8 points from a max-imum of 36 points. The arithmetic mean was 4.47 ± 2.36 (S.D), while 95% CI for the Arithmetic mean was 3.33 to 5.61. The lung changes were correlated with their biomarkers, specifically in-flammatory markers. The correlation between LUSS and LDH, D-dimers and IL-6 was a strong positive one with r=0.66 (p=0.01, 95% CI 0.147 to 0.896) between the LUSS and LDH level at symptomatic infants and children (with cough present) and r=0.66 (p=0.01, 95% CI 0.140 to 0.895) between LUSS and D-dimers level at symptomatic infants and children (with cough pre-sent). The results suggest that LUS could be a good imaging technique that can be used both in ini-tial evaluation of children with respiratory diseases, and, also in their follow-up, correlated with symptoms and biomarkers.

Aim: Exposure to polycyclic aromatic hydrocarbons (PAHs) has been in the past associated with adverse effects on human health among which belong also respiratory diseases. Our study is focused on the evaluation of PAH exposure by measuring the concentrations of their monohydroxylated metabolites (OH-PAHs) in urine and comparing their concentrations with the incidence of respiratory diseases in 2-year-old children from two locations of the Czech Republic – a control locality Ceske Budejovice and a previously highly contaminated mining district Most. Methods: The total number of 248 participants were sampled for urine samples that were analysed for the presence of 11 OH-PAHs using liquid-liquid extraction with ethyl acetate and clean-up employing dispersive solid phase extraction with a sorbent Z-Sep. Separation, identification and quantification of the target compounds was achieved by ultra-high performance liquid chromatography coupled to tandem mass spectrometry. The incidence of respiratory diseases was evaluated according to the questionnaires provided by the paediatricians. Results and discussion: The concentrations of measured OH-PAHs were higher in the urine samples collected from 2-year-old children living in Most compared to 2-year-old children from Ceske Budejovice. The same trend was observed also when the urine samples were analysed when these children were studied as newborns in our previous study. From all of the monitored respiratory diseases, only influenza due to unidentified influenza virus showed a difference between tested locations where the 2-year-old children living in Most were more frequently diagnosed with this disease. Conclusion: Even though the air pollution and lifestyle in both cities is very similar, we have observed higher incidence of respiratory diseases as well as higher concentration of OH-PAHs in urine of the 2-year-old children from Most. Therefore, we hypothesize that the population living in this previously highly contaminated location (in 1970s and 1980s) can carry some long-term health burden.

1) Background: Intellectual disability is more common in low- and middle-income countries than in high-income countries. Stigma and discrimination have contributed to barriers to people with intellectual disability accessing healthcare. As part of a larger study on caregiving of children with intellectual disability in urban Cape Town, South Africa, we interviewed a sub-group of families who had never used the intellectual disability services available to them, or who had stopped using them; 2) Methods: We employed a qualitative research design and conducted semi-structured interviews to explore the views and perspectives of parents and caregivers of children with intellectual disability who are not using specialised hospital services. We developed an interview guide to help explore caregivers’ and parents’ views; 3) Results: Results revealed that caregivers and parents of children with intellectual disability did not use the service due to financial difficulties, fragile care networks and opportunity costs, community stigma and lack of safety, lack of faith in services and powerlessness at effecting changes, and self-stigmatisation; 4) Conclusion: Current findings highlight a need for increased intervention at community level and collaboration with community-based projects to facilitate access to services, and engagement with broader issues of social exclusion.

Digital wellbeing concerns the balance and health we may experience in digital use, and the existing studies have focused on adolescents and adults. However, young children are more vulnerable to digital overuse and addiction than adults; thus, their digital wellbeing deserves empirical exploration. This scoping review synthesized and evaluated 35 collected studies on young children’s digital use and their wellbeing that were published until October of 2022 to understand the definitions, measurements, contributors, and interventions. The synthesis of evidence revealed that: (1) there was no consensus about its definition; (2) there were no effective measurements of young children’s digital wellbeing; (3) both child factors (duration and place of digital use, child demographic characteristics) and parent factors (digital use, parental perception, and mediation) contribute to young children’s wellbeing; and (4) there were some effective applications and interventions. This review contributes to the theoretical development by mapping the existing work on young children's digital wellbeing, proposing a model, and identifying the research gaps for future studies.

Despite considerable progress in the diagnosis of various diseases, an ideal, simple tool for diagnosing patients with respiratory tract infections has not yet been invented. Many simple diagnostic tests are widely available to most doctors, provided they are aware of the prevalence of primary immunodeficiency. Other, more accurate studies are available only to immunologists. The aim of the study was to investigate the occurrence of dependence between selected physical parameters of serum such as: electrical conductivity, electrical permeability, dielectric loss factor, and selected parameters of the immune system. In addition, we have also included the ionogram (Na, K, Cl, Ca, Mg) and glucose concentration. As a result of research, the statistically significant, but very weak correlations between impedance magnitude |Z| and platelet counts (PLT), mean platelet volume (MPV) and chloride ions (Cl-) were found. The statistically significant differences according |Z| between children with and without deficiency in parameters of the immune system were noticed. Values of |Z| are higher in the case of children without deficiency in parameters of the immune system. The method of impedance measurements presented in our work is significantly easier then biosensors presented by other scientists. Taking into account our results, it can be stated that this method is promising for fast and easy detection of immunological disorders.

Abstract Background COVID-19 vaccination program among Adults in India is one of the highly successful vaccination drives globally. Indian children aged 15–18 years old became eligible for COVID-19 vaccination on 3rd January, 2022 followed by 12-14 years old children on 16th March, 2022. As parents are primary decision-makers for their children, we aimed to assess parents' perceptions and intentions regarding COVID-19 vaccination for children in India. Aim To assess parental perceptions and intention to get COVID-19 vaccination for their children (aged<18 years), Materials and Methods A cross-sectional anonymous web-based survey was designed. Healthcare workers of a tertiary care institute in Eastern U.P. having any children aged <18 years were the study population. They were recruited through snowball sampling and were sent the study questionnaire in Google form through email and WhatsApp. Cross-tabulation was performed by parents' intention to vaccinate their children against COVID-19 virus with socio-demographic characteristics and their risk perception toward COVID-19, trust in the healthcare system, and their history of vaccine hesitancy behavior routine childhood immunization. Bi-variate analysis was performed to find out the predictors of child vaccination intention among the parents. Results A total of 388 healthcare workers parents (HCWPs) having A child < 18 years of age completed the survey. Mean age of the parents were 40.28 ±11.34 years with majority(97.0%) completing recommended 2 doses of COVIID-19 vaccine. Around 91% of the parents agreed that COVID-19 vaccines are important for child’s health whereas about 89% agreed to the statement that COVID-19 vaccines are effective. A total 356 (91.7%) participants were willing to vaccinate their child against COVID-19, 91.3% of them liked to do so as soon as possible. The factors significantly associated with the stated likelihood of child vaccination among the participants were younger age, female gender, urban residence, absence of any chronic illness, lower monthly income, history of COVID-19 in child and the child/children completed with routine childhood vaccines. Parental concerns mainly centered around vaccine need, safety and side effects. Conclusion The healthcare worker parents(HCWPs) have good knowledge and positive attitude towards COVID-19 vaccination for children. Around 92% of them were willing to vaccinate their children with COVID vaccine currently, which implies very low vaccine hesitancy among the HCWPs . Further longitudinal studies are required to be conducted to assess the trend of parental acceptance of COVID vaccine.

Introducing children to sustainable and healthy school meals can promote a long-term dietary shift to lower climate impact and improve population health. The aim of the OPTIMAT study was to optimize meals for minimum deviation from the current food supply while reducing greenhouse gases and ensuring nutritional adequacy without increasing cost. Optimized menus were tested in four primary schools in Sweden and effects on daily food consumption and waste evaluated. Pupils received their usual menu plan for three weeks and then the isocaloric optimized menu plan for another three weeks. Nutritional recommendations for a school lunch and a maximum of 500 grams of CO2eq/meal were applied as constraints during linear programming. Pulses, Cereals, Meat and Eggs increased, while Fats and Oils, Dairy, Sauces and Seasonings decreased. The amount of ruminant meat was reduced in favor of other meat products. The new menu was 28% lower in greenhouse gas emissions and slightly less costly than the original. No significant changes in mean food consumption or plate waste were found in interrupted time series analysis between the two periods. This pragmatic approach for combining linear optimization with meal planning could accelerate sustainable development of the meal sector in Sweden and abroad.

Educators' subject-matter knowledge and their understanding of the many ways in which technology may be used to enhance student learning can both benefit from the usage of pedagogical technology, which is the primary goal of this kind of technology. The goal of this study is to determine the extent to which kids with special needs might benefit academically by adopting various forms of technology into their daily routines. This work makes use of descriptive qualitative research together with the methodology and processes that come with case study research. The emphasis of this study was placed on three institutions that welcome students of all abilities. According to the results of the qualitative research, inclusive schools do not universally possess the resources necessary to successfully incorporate technology into the classroom. The results suggest that this teacher occupies a position that is about equivalent to the center of the acceptable range. This displays the instructor's existing proficiency in the use of technology to enhance the results for their students.

Despite the impact that climate change is having on our planet and considering its consequences for future generations, much of the academic literature focuses on adolescent and adult percep-tions, giving little relevance to children's perceptions. Children's voices have the potential to in-fluence public opinion, which may in turn determine the direction of a new policy on the cli-mate crisis. In this context, it is urgent that we understand how children perceive this problem. This quantitative study was based on the application of 245 questionnaires to children aged be-tween 9 and 13 years old from five schools in north-eastern Portugal, more specifically in the region of Trás-os-Montes. To collect the data, we used a questionnaire with 26 questions, being 24 of closed response, Likert type, one of them open response, and one multiple choices. The da-ta were statistically treated using SPSS software. The results show that most of the children ex-press concern about the study's potential problem. However, they show some doubts and a lack of knowledge about some of the themes. We found differences between the two study cycles, with children in the 6th grade having a higher average in the understanding of the phenomenon, as well as the level of education of the parents being positively correlated with a more ecocen-tric posture. The female students also showed a slightly more ecological posture, i.e., an eco-friendlier posture. From the results obtained, we can open new paths for future research and contribute to the definition of policies and educational practices since the school has the respon-sibility to cooperate in the production of values, attitudes, and pro-environmental behaviours.

(1) Background: When the Omicron variant of SARS-CoV-2 first emerged in Germany in January 2022, data on related disease severity among children and adolescents was not yet available. Given Omicron’s high transmissibility, the ability to assess its impact on admission and hospitalization rates in children’s hospitals is critical for the purpose of understanding the scope of its burden on the German health care system. (2) Methods: From January 24, 2022 to July 31, 2022, SARS-CoV-2 cases admitted to German pediatric hospitals were monitored via a national, clinician-led reporting system (CLRS) established by the German Society for Pediatric Infectious Diseases (DGPI). Cases treated on general wards and intensive care units, as well as patient age and need for respiratory support were recorded. (3) Results: From January to July 2022, a median of 1.7 cases (range 0.4–3) per reporting pediatric hospital per day were hospitalized on general wards, whereas a median of 0.1 cases (range 0–0.4 cases) were on intensive care units. Of all hospitalized patients, 4.2% received respiratory support. (4) Conclusions: Despite the high incidence rates documented in connection with the Omicron variant in early 2022, the number of pediatric hospital admissions, and especially the number of cases with need for intensive care treatment and respiratory support due to a symptomatic SARS-CoV-2 infection, remained relatively low. Higher Omicron incidence rates had only a modest impact on SARS-CoV-2-related admissions and hospitalization in German children’s hospitals.

Abstract: Background: Stunting is primarily a public health concern in LMIC. The involvement of Integrated Service Post cadres is one of the strategies to combat stunting in Indonesia. Objective: This study aimed to determine the effect of a short course on cadres knowledge. Method: A single group pre-post test design was conducted in Yogyakarta, Indonesia, from March to May 2022. Thirty cadres were selected based on the following criteria: willingness to participate, the number of stunted children in their Integrated Service Post (Posyandu), and full attendance at short course. The knowledge scores were measured by a structured questionnaire after short course (post-test 1) and 4 weeks later (post-test 2). We apply STATA 16 to calculate the mean difference (MD) using a t-test and Generalized Estimated Equation (GEE). Furthermore, the adequacy of the short course was evaluated with in-depth interviews. Result: On post-tests 1 and 2, cadres' knowledge of IYCF, children growth monitoring (CGM) and children development monitoring (CDM) significantly improved. The GEE analysis showed that a short course significantly improves cadres' knowledge after age control, education, occupation, and years of experience. Conclusion: Short course in-creased their affection, self-efficacy, and confidence, hence, they are capable of assisting children through home visits.

Parents’ attitudes and practices may support the children’s reactions to treatments for leukemia and their general adjustment. This study has two aims: to explore parenting depending on child's age and to develop and test a model on how family processes influence the psycho-social development of children with leukemia. Patients were 118 leukemic children and their parents recruited at the Haematology-Oncologic Clinic of the Department of Pediatrics, University of Padua. All parents were Caucasian with a mean age of 37.39 years (SD = 6.03). Children’s mean age was 5.89 years (SD = 4.21). After the signature of the informed consent, the parents were interviewed using the EFI-C from which we derived Parenting dimension and 3 parental perceptions on child’s factors. One year later, the clinical psychologist interviewed again parents using the VABS scales. The analyses revealed the presence of a significant difference in parenting by child’s age: Infants required a higher and more intensive parenting. Child’s coping to medical procedures at the second week after the diagnosis, controlled for parenting effect, impacted upon child’s adaptation one-year post diagnosis. Specific intervention programmes are proposed in order to help children more at risk just after the diagnosis for developmental delays.

(1) Background: Research has shown that thoughts about pain are important for the management of chronic pain in children. In order to monitor changes in thoughts about pain over time and evaluate the efficacy of treatments, we need valid and reliable measures. The aims of this study were to develop a questionnaire to assess a child’s concept of pain and to evaluate its psychometric properties; (2) Methods: This is a cross-sectional, two-phase, mixed-method study. A total of 324 individuals aged 8 to 17 years old responded to the newly created questionnaire. The Survey of the Concept of Pain (SOCOPA) was calibrated using the Rasch model. The chi-square test was used for the fit statistics. Underfit and overfit of the model were determined and a descriptive analysis of infit and outfit was conducted to identify who responded erratically. Internal consistency was measured using the Person Separation Index (PSI); (3) Results: Fit to the Rasch model was good. Suitable targeting indicated which items were simple to answer; Person Fit identified 9.56% children who responded erratically; PSI=0.814; (4) Conclusions: The findings suggest that SOCOPA is a measure of a child’s concept of pain that is easy to administer and respond to. It has a good fit and a good internal consistency.

During this epidemic of COVID-19, children are in need of much concentration and profound love of the senior family members. Although the measures taken by the organizations are necessary to prevent the spread of the novel coronavirus, they may be causing widespread mental health issues, including depression and loneliness. Therefore, it is imperative that parents have to spend the lion-share of time with children while listening to them cordially. Parents can participate in sports with them to help them stay fit so that they can enjoy commemorating moments. However, in this additional time, the parents can also make them habituated to practice the rules of health, so does social distancing.

Background: The question of whether children are less likely to pass on SARS-CoV-2 is important for planning society’s response to the pandemic. A document available on the Charité hospital website has not been formally published but is frequently referred to as supporting the notion that viral loads are similar in children and adults. Methods: The summary data from this document was extracted and used to produce summary statistics for three age groups: younger children (ages up to 11), older children (ages 12 to 19) and adults (ages 20 and above). Viral loads between the two children’s groups and the adult group were compared using Welch’s t test, which only requires group means and standard deviations and which is robust against moderate departures from normality. Findings: Viral loads were significantly lower than in adults for both younger children (p=0.04) and older children (p=0.04). Overall, viral loads were lower in children than adults (p=0.005). Interpretation: For both younger and older children, on average those with detectable SARS-CoV-2 have significantly lower viral loads than adults. Funding: No funding was received for this analysis.

Robots for communication are developed extensively with emphasis on sympathy. This study deals with the growth of character and the control of its operation accordingly. The child has time to be alone with the nature of his/her robot friend. The child can interact with other people's emotional expressions through a robot. Step by step, the robot character will grow as the child grows. Through design studies, qualitative processes such as {customer experience audit, eye tracking, mental model diagrams, semantic differences} have been executed for the results. The participatory behavior research approach through user travel is mapped from the user's lead to the evidence-based design. This research considers how the synthetic characteristics can be applied to the physical growth of robot toys through the product design process. With the development of robot toy "Buddy", we tried making two variations on the robot to achieve recognizable growth. (1) A one-dimensional height scaling and (2) facial expression including the distance between two eyes on the screen. Observations represented children's reactions when "Buddy" was released to with the children. As an independent synthetic character, the robot was recognized by children who had the designed function. Robots for training may require more experimentation.

There is still little research on psychological wellbeing and reported problems in preadolescents and adolescents under therapy for leukemia, also comparing them with their healthy peers. The present study aims to analyze the life perceptions, psychological well-being and problems’ intensity in these patients during the first year of therapy and to compare these reports with those of matched healthy peers adopting a battery of self-report questionnaires. Mann-Whitney tests identified the younger patients more at risk than older ones in their problems’ intensity and psychological symptoms. Older patients resulted instead more vulnerable regarding past life perceptions. Wilcoxon test with 2 dependent samples analyses showed that: healthy peers have a better perception of current life and lower percentage of somatization symptoms than patients after 6-months post-diagnosis. On the other hand, healthy peers reported more problems dealing with impulsivity, mood, disorganization, concentration and memory than patients both at 6-months and 1-year from diagnosis. Healthy peers reported also more anxiety and depression symptoms than patients and worse past and future life perceptions than patients at 1-year from diagnosis. The clinical aim is to perform a psychological screening of preadolescents and adolescents in order to prepare ad hoc psychological interventions.

Background: Left ventricular noncompaction (LVNC) is a genetically determined cardiomyopathy, that occurs following a disruption of endomyocardial morphogenesis. The purpose of this study was to identify the clinical characteristics and genetic profile of children with LVNC. Methods: From February 2008 to July 2020, a total of 32 children (median 11.5 years) with LVNC were prospectively enrolled and followed up for the median of 4.02 years. Diagnosis was made based on characteristic features of LVNC in echocardiography and cardiovascular magnetic resonance (CMR). Patients’ clinical symptoms, family history, ECG, Holter ECG and genetic tests were also evaluated. Results: The most common presenting symptom was heart failure (31% of children). ECG abnormalities were noted in 56% of patients. The most prominent features were ventricular arrhythmias, sinus bradycardia and paroxysmal third-degree atrioventricular block. Most of the patients (94%) met the criteria for LVNC and CMR confirmed this diagnosis in 82% of cases. The molecular etiology was found in 53% of children. Conclusion: Although heart failure and arrhythmias were very frequent in our study group, thromboembolic events and genetic syndromes were rare. For accurate and reliable assessment of children with LVNC, it is necessary to get to know their family history and detailed clinical profile.

Background: Low-income families often depend on fuels such as wood, coal, and animal dung for cooking. Such solid fuels are highly polluting and are a primary source of indoor air pollutants (IAP). We examined the association between solid fuel use (SFU) and acute respiratory infection (ARI) among under-five children in Afghanistan and the extent to which this association varies by socioeconomic status (SES) and gender. Materials and Methods: This is a cross-sectional study based on de-identified data from Afghanistan’s first standard Demographic and Health Survey conducted in 2015. The sample consists of ever-married mothers with under-five children in the household (n=27,565). We used mixed-effect Poisson regression models with robust error variance accounting for clustering to examine the associations between SFU and ARI among under-five children after adjusting for potential confounders. We also investigated potential effect modification by SES and sex. Additional analyses were conducted using an augmented measure of the exposure to IAP accounting for both SFU and the location of cooking/kitchen (High Exposure, Moderate, and No Exposure). Results: Around 70% of households reported SFU, whereas the prevalence of ARI was 17.6%. The prevalence of ARI was higher in children living in households with SFU compared to children living in households with no SFU (adjusted prevalence ratio [aPR]= 1.10; 95%CI: 0.98, 1.23). We did not observe any effect modification by SES or child sex. When using the augmented measure of exposure incorporating the kitchen’s location, children highly exposed to IAP had a higher prevalence of ARI compared to unexposed children (aPR 1.17; 95% CI: 1.03, 1.32). SES modified this association with the strongest associations observed among children from the middle wealth quintile. Conclusion: The findings have significant policy implications and suggest that ARI risk in children may be reduced by ensuring clean cookstove as well as clean fuels and acting on the socio-environmental pathways.

School meals can have a key function in promoting children’s health. However, simply providing a free school meal is not a guarantee that pupils will actually eat the food. The purpose of this study was to explore factors influencing pupils’ participation in free school meal schemes in Oslo The study has a qualitative research design, inspired by grounded theory. Data were collected through interviews with pupils, teachers and parents, and participant observations in two schools participating in a pilot project funded by Oslo Municipality. Line-by-line coding, memo writing and a constant comparative technique were used to analyse the data. One primary school and one lower-secondary school in different districts in Oslo that were implementing two different free school meal models. 39 pupils (5th–10th grade), 15 parents and 12 school employees were included. Four main factors related to pupils’ participation to free school meals emerged from the analysis: the popularity of the food served, the attraction to the nearby shopping centre, social aspects and predictability. To promote pupils’ participation in free school meal schemes, schools need to solve the challenges of balancing between healthy food and popular but often unhealthy food. Children and parents involvement, regularity of the meals provision, a good flow of information and the creation of a friendly eating environment are recommended

This paper describes a research project carried out in an Italian public school to assess whether parents were willing to take part in food procurement decisions, as well as their ability to accurately predict what foods children would pick at school lunch and their propensity to support sustainable food choices made by the school. The methodology included a questionnaire to 500 parents and an in-depth study of 138 child/parent pairs. The study comprised: (i) presentation of an innovative recipe in the weekly menu of the school canteen; (ii) meal observations of children’s intake at school lunch during the week of the menu modification; (iii) collection of both parents’ and children’s reports on their choices of recipes from the modified weekly menu. The results are commented in light of two important changes that have recently affected Italian public school food procurement: the opening of school canteens to lunches brought from home and the measures adopted since 2020 to contain the Covid-19 pandemic. Both events go in the direction of delegating to parents the multifaceted role of the school in the food arena. The article concludes that the results of the study should discourage this approach.

Mental health could worsen in children and adolescents with autism spectrum disorder during the Covid19 pandemic. In addition, their parents could be more at risk for an increase in anxiety and depression symptomatology. This study aims to understand the adaptation and the psychosocial well-being in a sample of 16 males aged 10-21 years old with Asperger syndrome after the quarantine for Covid19 when they return to school and partially to their activities in September 2020, The approach adopted is multi-informant with a battery of questionnaires on psychological health and adaptation given by a secure online web data Qualtrics both to adolescents and also to their parents. Paralleling matched peers with typically development were assessed adopting the same methodology. The results evidenced several difficulties in Asperger’s psychological health, especially in anxiety and socialization. Also adaptation is put in crisis, even if they reported a good comprehension and adoption of the behaviors anti-Covid19. Parents of children with Asperger reported similar psychological difficulties and general health than those of the group of children typically developing. Some clinical indications could be discussed for psychologists who follow children and adolescents with Asperger.

Lead, known as a metal with high neurotoxicity to children, cadmium, which is a carcinogenic and bioaccumulative contaminant, and arsenic, a class 1 carcinogenic according to the International Agency for Research on Cancer, are toxic elements (TEs) whose relevant route of exposure may be diet. We determined the bio-accessible fraction of lead, cadmium, and arsenic from the diet of preschool children from two day care centers (DCC). A cross-sectional study was conducted with 64 one–four-year-old children from two DCCs where the 24-h duplicate diet samples were collected. The diet samples were analyzed by ICP-MS for lead, cadmium, and arsenic total concentrations (n = 64) and their bio-accessibility were analyzed for a subsample (n = 10). The dietary intake (DI) mean for lead, cadmium, and arsenic were 0.18 ± 0.11 µg kg⁻¹ bw, 0.08 ± 0.04 µg kg⁻¹ bw, and 0.61 ± 0.41 µg kg⁻¹ bw, respectively. All DI calculated for TEs, considering total intake, were found lower than the tolerable limits (TL) (European Union, or World Health Organization, WHO, when applicable) except for one child’s Pb intake. Bio-accessibilities ranged between 0% to 93%, 0% to 103%, and 0% to 69%, for lead, cadmium, and arsenic, respectively. Although DI for TEs has been found lower than TL, these reference values have been recently decreased or withdrawn since it was for lead and arsenic whose TL were withdrawn by WHO.

Background: Chronic disease is the leading cause of death and disability in children. Various complex stressors faced by children due to illness and a series of treatments can negatively impact children's welfare, which can negatively affect children's quality of life.Objectives: This literature aims to study the philosophy of spiritual-based care interventions to improve the quality of life of children with chronic diseases viewed from three philosophical perspectives, namely ontology, epistemology, and axiology.Methods: A literature search was performed on five databases, namely SCOPUS, PubMed, ProQuest, ScienceDirect, and SAGEPub. Population limitations and diagnoses in this literature of children with chronic disease. This research is a quantitative study focusing on publications between 2017-2021.Results: The philosophy of spiritual care intervention is humanistic, pragmatic, and religious intervention. Humanistic interventions are interventions in which nurses are actively involved in spiritual care. Pragmatic intervention is the activeness of a nurse in assessing the spiritual needs of patients. Meanwhile, religious intervention is an intervention that is directly related to the practice or ritual of a specific belief system. Spiritual care is an essential part of holistic care, which is considered an indicator of improving the quality of care. It will ultimately affect the optimal quality of life of children.Conclusion: Spiritual-based care interventions are essential to improve the quality of life of children with chronic diseases. Spiritual care given to children with chronic illnesses must consider all aspects such as developmental stage, life experience, and socio-cultural of the child.