Comparison of the EQ-5D-Y and the CHU-9D instruments in a general child population based on self-reports and proxy-reports.

OBJECTIVE: This study utilized the EQ-5D-Y and the Child Health Utility 9D (CHU-9D) instruments to empirically investigate a general child population aged 7-8 years in China, with the aim of assessing and comparing the performance, correlation, and agreement between these two instruments. Both self-reported and proxy-reported versions of the instruments were considered in the analysis. METHODS: Data were collected from 7-8-year-old students in the second grade from four schools in Guangxi and Guiyang provinces, China. Children and their proxies independently completed their respective versions of the questionnaires, including the EQ-5D-Y, the CHU-9D, and other socio-demographic information. The psychometric properties of the EQ-5D-Y and the CHU-9D were assessed, including ceiling effects, internal consistency, and known-group validity. Spearman's correlation coefficient, Intraclass Correlation Coefficient (ICC), and Bland-Altman plots were calculated and plotted to assess the correlation and agreement between the EQ-5D-Y and CHU-9D. RESULTS: A total of 369 pairs of valid questionnaires were collected from both children and proxies. Due to the study's focus on a general child population, both EQ-5D-Y and CHU-9D yielded high utility values, with a significant ceiling effect observed, particularly in the EQ-5D-Y proxy-reported results. Compared to the EQ-5D-Y, the CHU-9D demonstrated a higher Cronbach's alpha coefficient and better internal consistency. Both instruments also demonstrated known-group validity, distinguishing different health status groups, except for EQ-5D-Y proxy-reported results. Spearman's correlation coefficient indicated some correlations in similar dimensions and utility values between the EQ-5D-Y and CHU-9D. The ICC of the EQ-5D-Y and CHU-9D utility values was 0.290 for self-reports and 0.383 for proxy-reports, indicating poor agreement between the two instruments. The Bland-Altman plots showed that the mean utility values obtained from EQ-5D-Y were significantly higher than those from CHU-9D. CONCLUSION: The EQ-5D-Y and the CHU-9D demonstrated acceptable performance within the general child population aged 7-8 years in China, except for the EQ-5D-Y proxy-reported version. It suffered from a notable ceiling effect, poor internal consistency, as well as weak known-group validity and discriminative ability. Moreover, although there existed a certain degree of correlation between the EQ-5D-Y and CHU-9D, their utility values exhibited significant differences. Therefore, these instruments are not interchangeable in practice.

Dental care access for children in the United States.

OBJECTIVES: To evaluate access to dental care for children in the United States. METHODS: The study population included children in 48 states and the District of Columbia. Using multiple data sources, dental care access was estimated at the community level by matching dental care supply and demand using mathematical modeling accounting for access constraints. Outcome measures included percent-met demand, travel distance, and percentage of underserved and unserved communities. Multiple scenarios to improve Medicaid/CHIP participation of dentists were evaluated. RESULTS: Medicaid-insured and CHIP-insured children exhibited lower access compared to those privately insured. The percent-met demand was lower than 50% for Medicaid-insured children and CHIP-insured children for 42 and 34 states, respectively. Percent-met demand was higher than 50% for private-insured children except for Texas and West Virginia. Increasing Medicaid/CHIP participation of dentists resulted in improving access for public-insured children. At 100% Medicaid/CHIP participation, all states exhibited different degrees of percent-met demand increase for publicly insured children, from 7% to 46%. The percent-met demand across all children ranged in 23.8%-82.9% under 70% participation rate versus 22%-83% under 100% participation rate. No single participation rate improved access for all children uniformly across all states. CONCLUSIONS: This study found that dental care access was lower for children with public insurance than those with private access across all states, although states responded differently to changes in Medicaid/CHIP participation. Increasing access for children with public insurance would reduce disparities, but overall children's access to dental care would be better improved by expanding the oral health workforce.

[Design and pilot testing of a school-based emotional education program for health promotion and prevention for children from 3 to 5 years of age.] / Diseño y prueba piloto de un programa escolar de educación emocional para la promoción de la salud y la prevención destinado a niños y niñas de 3 a 5 años.

OBJECTIVE: Increasing emotional competence is a health promotion strategy that can be enhanced through school-based emotional education programs. This study aims to describe the participative process to design the emotional education program 1, 2, 3, emoció! aimed at children aged from 3 to 5 years and to analyze the results of the pilot test. METHODS: Existing international emotional education programs were reviewed. A participative process was carried out for its adaptation and a pilot test of the training and materials. Training and activity evaluation questionnaires were used to calculate mean scores for quantitative responses and percentages for categorical responses, and the Emotional Competence Profile Questionnaire for teaching staff was administered before and after the intervention and for which it was calculated whether there were significant differences between the two scores using Wilcoxon test. RESULTS: Eleven school programs were reviewed. The Social and Emotional Aspects of Learning (SEAL) program was selected. Seventeen professionals participated in working groups to carry out the adaptation to the Barcelona context. Eleven schools participated in the pilot test. The teachers increased their emotional competencies. The teachers' average evaluation of the activities was 8.18 out of 10. The result of the whole is the 1, 2, 3, emoció! program. CONCLUSIONS: The 1, 2, 3, emoció! program is well received by the schools participating in the pilot test. Future studies should evaluate its effectiveness.

OBJETIVO: Incrementar la competencia emocional es una estrategia de promoción de la salud que puede potenciarse mediante programas escolares de educación emocional. El objetivo de este estudio fue describir el proceso participativo del diseño del programa de educación emocional 1, 2, 3, emoció!, dirigido a niños y niñas de 3 a 5 años y analizar los resultados de la prueba piloto. METODOS: Se revisaron los programas de educación emocional existentes a nivel internacional. Se llevó a cabo un proceso participativo para su adaptación y una prueba piloto de la formación y materiales del programa. Se utilizaron cuestionarios de evaluación de la formación y de las actividades, de los que se calcularon puntuaciones medias para las respuestas cuantitativas y porcentajes para las categóricas, y el Cuestionario de Perfil de Competencias Emocionales para el personal docente administrado antes y después de la intervención, para el que se calculó si existían diferencias estadísticamente significativas entre ambas puntuaciones mediante la prueba de Wilcoxon. RESULTADOS: Se revisaron once programas escolares. Se seleccionó el programa Social and Emotional Aspects of Learning (SEAL). Diecisiete profesionales colaboraron en grupos de trabajo para realizar la adaptación. En la prueba piloto participaron once centros educativos. Las maestras aumentaron sus competencias emocionales después de la formación. La valoración media de las maestras con respecto a las actividades fue de 8,18 sobre 10. El resultado del proceso es el programa 1, 2, 3, emoció! CONCLUSIONES: El programa 1, 2, 3, emoció! tiene una buena acogida entre las escuelas participantes en la prueba piloto. En futuros estudios debería evaluarse su efectividad.

Household food insecurity and its association with overweight and obesity in children aged 2 to 14 years.

BACKGROUND: The objective was to estimate the prevalence of household food insecurity (HFI) depending on sociodemographic factors and its association with lifestyle habits and childhood overweight and obesity. METHODS: Data was collected from 1,938 children aged 2 to 14 years who participated in the "Study about Malnutrition" of the Community of Madrid. Weight and height were obtained through physical examination. Body mass index was calculated as weight/height2 (kg/m2) and the criteria of the WHO were used for determining conditions of overweight and obesity. The participants' parents answered a structured questionnaire about their diet, lifestyle (physical activity and screen time), and food insecurity. The diet quality was assessed with the Healthy Eating Index in Spain and food insecurity, defined as the lack of consistent access to sufficient food for a healthy life, was measured via three screening questions and the Household Food Insecurity Access Scale (HFIAS). Odds Ratios (ORs) and Relative Risk Ratios (RRRs) were estimated using logistic regression models and adjusted for confounding variables. RESULTS: The overall prevalence of HFI was 7.7% (95% CI: 6.6‒9.0), with lower values in children 2 to 4 years old (5.7%, 95% CI: 4.0‒8.1) and significantly higher values in households with low family purchasing power [37.3%; OR: 8.99 (95% CI: 5.5‒14.6)]. A higher prevalence of overweight (33.1%) and obesity (28.4%) was observed in children from families with HFI, who presented a lower quality diet and longer screen time compared to those from food-secure households (21.0% and 11.5%, respectively). The RRR of children in families with HFI relative to those from food-secure households was 2.41 (95% CI: 1.5‒4.0) for overweight and 1.99 (95% CI: 1.2‒3.4) for obesity. CONCLUSION: The prevalence of HFI was high in the paediatric population, especially in households with low family purchasing power. HFI was associated with lower diet quality and higher prevalence of childhood overweight and obesity. Our results suggest the need for paediatric services to detect at-risk households at an early stage to avoid this dual burden of child malnutrition.

The rs7404339 AA Genotype in CDH5 Contributes to Increased Risks of Kawasaki Disease and Coronary Artery Lesions in a Southern Chinese Child Population.

Background: Kawasaki disease (KD) is an acute, self-limited febrile illness of unknown cause. And it predominantly affects children <5 years and the main complication is coronary artery lesion (CAL). Studies demonstrated that vascular endothelial cells (VECs) played a very important role in the CAL of KD. VE-cad encoded by CDH5 may exert a relevant role in endothelial cell biology through controlling the cohesion of the intercellular junctions. The pathogenesis of KD remains unclear and genetic factors may increase susceptibility of KD. However, the relationship between CDH5 polymorphisms and KD susceptibility has not been reported before. The present study is aimed at investigating whether the rs7404339 polymorphism in CDH5 is associated with KD susceptibility and CAL in a southern Chinese child population. Methods and Results: We recruited 1,335 patients with KD and 1,669 healthy children. Each participant had supplied 2 mL of fresh blood in the clinical biologic bank at our hospital for other studies. Multiplex PCR is used to assess the genotypes of rs7404339 polymorphism in CDH5. According to the results, we found significant correlated relationship between rs7404339 polymorphism in CDH5 and KD susceptibility [AA vs. GG: adjusted odds ratio (OR) = 1.43, 95% confidence interval (CI) = 1.00-2.05; p = 0.0493; recessive model: adjusted OR = 1.44, 95% CI = 1.01-2.06, P = 0.0431]. In further stratified analysis, we found that children younger than 60 months (adjusted OR = 1.46, 95% CI = 1.01-2.10; p = 0.0424) and male (adjusted OR = 1.70, 95% CI = 1.09-2.65; p = 0.0203) with the rs7404339 AA genotype in CDH5 had a higher risk of KD than carriers of the GA/GG genotype. Furthermore, stratification analysis revealed that patients with the rs7404339 AA genotype exhibited the significantly higher onset risk for CAL than carriers of the GA/GG genotype (adjusted age and gender odds ratio = 1.56, 95% CI = 1.01-2.41; P = 0.0433). Conclusion: Our results showed that rs7404339 AA genotype in CDH5 is significant associated with KD susceptibility. And children younger than 60 months and male with the rs7404339 AA genotype had a higher risk of KD than carriers with the GA/GG genotype. Furthermore, patients with the rs7404339 AA genotype exhibited a significantly higher risk of CAL complication than carriers of the GA/GG genotype.

Psychological Interventions for Children Experiencing PTSD After Exposure to a Natural Disaster: A Scoping Review.

Exposure to a natural disaster can have a myriad of significant and adverse psychological consequences. Children have been identified as a particularly vulnerable population being uniquely susceptible to post-disaster psychological morbidity, including post-traumatic stress disorder (PTSD). Without effective intervention, the impact of natural disasters on children's developmental trajectory can be detrimental, however, research is yet to find evidence to definitively establish the comparative efficacy or unequivocal superiority of any specific psychological intervention. A scoping review was undertaken according to the Preferred Reporting Items extension for Scoping Reviews Guidelines (PRISMA-ScR), to evaluate the current research regarding psychological interventions for children (below 18 years of age) experiencing PTSD after exposure to natural disasters, a single incident trauma. Fifteen studies involving 1337 children were included in the review. Overall, psychological interventions, irrespective of type, were associated with statistically significant and sustained reductions in PTSD symptomatology across all symptom clusters. However, whilst evidence supported the general efficacy of psychological interventions in this population, the majority of studies were considered retrospective field research designed in response to the urgent need for clinical service in the aftermath of a natural disaster. Consequently, studies were largely limited by environmental and resource constraints and marked by methodological flaws resulting in diverse and highly heterogeneous data. As such, definitive conclusions regarding the treatment efficacy of specific psychological interventions, and furthermore their ameliorative contributions constituting the necessary mechanisms of change remains largely speculative. As natural disasters can have a catastrophic impact on human lives, establishing levels of evidence for the efficacy of different psychological interventions for children represents a global public health priority.

Factores asociados al covid-19 desencadenantes de infecciones bucodentales en la población infantil / Factors associated with covid-19 that trigger oral infections in the child population

La presencia de un nuevo coronavirus se propagó de manera inesperada alrededor de todo el mundo, desencadenando una crisis mundial sin precedentes. Ya para el año 2020, habían más de 7,9 millones de casos, y 434.796 muertes, en más de 200 países. En ese momento, se implementaron medidas de aislamiento y distanciamiento social en todo el mundo para contener el acelerado propagación de covid-19; entre las consecuencias, las clínicas dentales, se cerraron temporalmente y se suspendió la atención dental electiva, lo que conllevó a un aumento en el desarrollo de enfermedades bucodentales. Con relación a los niños y jóvenes, hubo un aumento en este tipo de enfermedades. Los niños se vieron obligados a pasar la mayor parte de su tiempo en el hogar con la adquisición de hábitos alimentarios incorrectos, ingesta de refrescos y bebidas energéticas que, además de contener altas cantidades de azúcares, su contenido ácido produce erosión dental y hace que el esmalte tejido menos resistente al ataque de bacterias cariogénicas. En este trabajo se analizó una población de 96 niños en edad escolar durante un periodo de dos años de 2020 al 2022. Los resultados mostraron que 100% de los escolares presentaron caries dentales al momento de su evaluación en enero 2022, mientras que 47% del total presentaron dientes obturados y el 64% del total de casos, perdieron algunas de sus piezas dentales. Estos resultados son, posiblemente, debido al desconocimiento de los escolares sobre la higiene para la prevención de las caries dental y sus consecuencias, siendo la más perjudicial la pérdida prematura de dientes temporales, lo que hace necesario implementar programas sobre la promoción y prevención en la salud bucodental en escolares, docentes, y padres y representantes(AU)

The presence of a new coronavirus spread unexpectedly around the world, triggering an unprecedented global crisis. By 2020, there were more than 7.9 million cases, and 434,796 deaths, in more than 200 countries. At that time, isolation and social distancing measures were implemented around the world to contain the accelerated spread of covid-19; Among the consequences, dental clinics were temporarily closed, and elective dental care was suspended, which led to an increase in the development of oral diseases. In relation to children and young people, there was an increase in this type of illness. The children were forced to spend most of their time at home with the acquisition of incorrect eating habits, intake of soft drinks and energy drinks that, in addition to containing high amounts of sugar, their acid content produces dental erosion and makes the enamel tissue less resistant to attack by cariogenic bacteria. In this work, a population of 96 school-age children was analyzed during a two-year period from 2020 to 2022. The results showed that 100% of the schoolchildren had dental caries at the time of their evaluation in January 2022, while 47% of the total had filled teeth and 64% of the total cases lost some of their teeth. These results are possibly due to the lack of knowledge of schoolchildren about hygiene for the prevention of dental caries and its consequences, the most damaging being the premature loss of temporary teeth, which makes it necessary to implement programs on promotion and prevention in the oral health in schoolchildren, teachers, and parents and representatives(AU)

Una mirada demográfica a la población infantil afectada por la COVID-19 en Cuba / A demographic look to the children´s population affected by COVID-19 in Cuba

Introducción: La población en los grupos de edades más bajos no ha constituido un grupo vulnerable ante los efectos de la COVID-19. No obstante, se considera importante explicar el estado de la enfermedad en este grupo de edad. Objetivo: Caracterizar demográficamente la población infantil afectada por la COVID-19 en Cuba, desde el 11 de marzo hasta el 22 de junio de 2020. Métodos: Estudio descriptivo de corte transversal. Se incluyeron en el estudio 246 niños de 0-18 años de edad cumplida contagiados con la COVID-19 en Cuba. Las variables de estudio fueron: provincia de residencia, sexo, edad, tipo de contagio, número de contactos y letalidad. Los resultados se presentan mediante tasas y porcentajes principalmente. Resultados: Los diagnosticados con la COVID-19 en Cuba, de 0 a 18 años, representan el 10,6 por ciento del total de confirmados. El 50,4 por ciento son del sexo masculino y el 49,6 por ciento del femenino. La tasa de incidencia a nivel nacional es aproximadamente de 10,63 infantes de 0 a 18 años infectados con la COVID-19, por cada 100 000 habitantes del grupo de edad. El 5,7 por ciento del total de enfermos analizados corresponde a niños menores de un año de edad. Conclusiones: Hasta el 22 de junio de 2020 se han enfermado en Cuba 246 niños de 0 a 18 años de edad. Las mayores cifras se concentran en el sexo masculino, en el subgrupo de 15-18 años de edad y en las provincias La Habana y Villa Clara(AU)

Introduction: The population in lower age groups has not been a vulnerable group to the effects of COVID-19. However, it is considered important to do a review of the disease´s state in this age group. Objective: Characterize demographically the children´s population affected by COVID-19 in Cuba, from March 11 to June 22, 2020. Methods: Descriptive cross-sectional study. 246 children aged 0-18 who were infected with COVID-19 in Cuba were included in the study. The study variables were: province of residence, sex, age, type of contagion, number of contacts and lethality. Results are presented by rates and percentages, mainly. Results: Those diagnosed with COVID-19 in Cuba, in the ages from 0 to 18 years, account for 10.6 percent of the total confirmed. 50.4 percent are male and 49.6 percent female. The incidence rate at the national level is approximately 10.63 infants aged 0 to 18 infected with COVID-19 per 100,000 inhabitants of the age group. 5.7 percent of the total number of patients tested represents children under one-year-old. Conclusions: Until June 22, 2020, 246 children aged 0 to 18 have got ill in Cuba. The highest numbers are concentrated in the male sex, in the subgroup of 15-18 years old, and in the provinces Havana and Villa Clara(AU)

Estimación de la ingesta de calcio y fosfato a partir de bebidas analcohólicas / Calcium and phosphate intake from analcoholic beverages

El calcio (Ca) es un nutriente crítico para la salud, especialmente en los períodos de crecimiento. Sin embargo, la mayoría de los individuos argentinos no alcanzan la ingesta diaria recomendada. Por su parte, el fósforo (P) es un nutriente cuya ingesta suele estar por encima de la recomendada. Este tipo de desequilibrio en la ingesta de ambos nutrientes conlleva a una pérdida de masa ósea. El consumo de bebidas analcohólicas (BA) se ha incrementado en los últimos años, sobre todo en la población infantil, desplazando el consumo de agua y lácteos. El objetivo de este trabajo fue estimar el aporte de Ca y P a partir de BA diferentes de agua. Se evaluaron 59 muestras, cuya mediana y rango de Ca fue de 7,74 [0,00 a 111,29] mg/l y de P 55,17 [0,16 a 957,00] mg/l. Los jugos en polvo son los que mayor contenido de Ca presentaron y las bebidas deportivas aquellas donde se halló el mayor contenido de P. Considerando un consumo de 500 ml/día de BA se estarían incorporando 3,87 mg Ca y 27,59 mg P. El creciente consumo de BA, su bajo contenido de Ca y la concomitante reducción del consumo de lácteos contribuyen a una inadecuada ingesta de Ca. (AU)

Calcium (Ca) is a critical nutrient, especially during periods of growth. However, the majority of Argentine individuals do not reach the recommended daily intake. On the other hand, phosphorus (P) is a nutrient with an intake usually above the recommended values. This type of imbalance between the intake of the nutrients leads to loss of bone mass. Soft drinks consumption (BA) has increased in recent years, especially in children, displacing the consumption of water and dairy products. The aim of this work was to estimate the Ca and P content in BA other than water. 59 samples were evaluated, with a median and range of Ca of 7.74 [0.00 to 111.29] mg/l and of P of 55.17 [0.16 to 957.00] mg/l. Powdered juices are the ones with the highest Ca content, and sports drinks are the beverages in which the highest P content was found. Based on a BA consumption of 500 ml/day, 3.87 mg Ca and 27.59 mg P would be incorporated. Therefore, the increased consumption of BA, their low Ca content, and the concomitant reduction in dairy consumption contribute to an inadequate intake of Ca. (AU)

Are child and youth population at lower risk of COVID-19 fatalities? Evidences from South-East Asian and European countries.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has revealed many lacunas of public health preparedness, especially in lower and middle-income countries and fatality differentials between European and South-East Asian countries. The case fatality rate (CFR) in most of the South-East Asian countries is much lower than the European countries. The percentages of child and youth population are more in South-East countries. OBJECTIVE: The study aims to show the impacts of age composition on fatality differentials in European and South-East Asian countries by age-structure, especially the percentage share of child and youth population. DATA AND METHODS: This study has been done based on data provided by UNDP, WHO and worldometers. The case fatality rate (CFR) has been calculated to find out the mortality differentials of countries, and the higher fatality risk countries have been identified by the composite Z score technique. RESULTS: It is revealed that the COVID-19 case fatality rates are substantially high in highly developed countries of the European countries compared to the South-East Asian countries. Our study shows that there is an issue of child and youth population which affects the lower CFR in SE Asian countries. In France, the CFR was 16.72% which was nearly 7 times more than India (2.31%). The COVID-19 fatality risk ratio was highest in Germany (0.77) while the lowest risk ratio was observed in Bangladesh (-0.71). CONCLUSION: Despite of having a very high level of human development and preparedness, the current pandemic COVID-19 has revealed that there exist significant differentials among fatality status of European and South-East Asian countries. The CFR is lower in the SE Asian countries where the child and youth population are more than the older population.

[Main directions of activity of the institute of the Commissioner for the Rights of the Child in assistance of protection of health and formation of the environment of "safe childhood" from positions of public health].

In a rapidly changing world, legal protection of children from the standpoint of public health, namely from the standpoint of protecting the health of the child population from the adverse effects of various factors, including social ones, is of particular importance, thereby complementing the concept of "safe childhood" in terms of risk management safety of a child's life and his health. Despite the fact that the institution of the Commissioner for the Rights of the Child in Russia was established more than ten years ago and is active in promoting the protection of children's health, many medical workers, specialists in healthcare and preventive medicine, unfortunately, are not fully aware of functions of this state structure and, accordingly, do not use its resource capabilities in the implementation of key installations of national projects. The aim of this work was to analyze the types of activities of the institution of the Presidential Commissioner for the Rights of the Child to identify and present the modern features of his human rights and operational-organizational assistance in protecting health and creating an environment for "safe childhood" from the standpoint of public health.

An Economic Analysis of Intensive Multidisciplinary Interventions for Treating Medicaid-Insured Children with Pediatric Feeding Disorders.

Background. Intensive multidisciplinary intervention (IMI) represents a well-established treatment for pediatric feeding disorders (PFDs), but program availability represents an access care barrier. We develop an economic analysis of IMI for weaning from gastronomy tube (G-tube) treatment for children diagnosed with PFDs from the Medicaid programs' perspective, where Medicaid programs refer to both fee-for-service and managed care programs. Methods. The 2010-2012 Medicaid Analytic eXtract claims provided health care data for children aged 13 to 72 months. An IMI program provided data on average admission costs. We employed a finite-horizon Markov model to simulate PFD treatment progression assuming 2 treatment arms: G-tube only v. IMI targeting G-tube weaning. We compared the expenditure differential between the 2 arms under varying time horizons and treatment effectiveness. Results. Overall Medicaid expenditure per member per month was $6814, $2846, and $1550 for the study population of children with PFDs and G-tube treatment, the control population with PFDs without G-tube treatment, and the no-PFD control population, respectively. The PFD-diagnosed children with G-tube treatment only had the highest overall expenditures across all health care settings except psychological services. The expenditure at the end of the 8-year time horizon was $405,525 and $208,218 per child for the G-tube treatment only and IMI arms, respectively. Median Medicaid expenditure was between 1.7 and 2.2 times higher for the G-tube treatment arm than for the IMI treatment arm. Limitations. Data quality issues could cause overestimates or underestimates of Medicaid expenditure. Conclusions. This study demonstrated the economic benefits of IMI to treat complex PFDs from the perspective of Medicaid programs, indicating this model of care not only holds benefit in terms of improving overall quality of life but also brings significant expenditure savings in the short and long term.

Botswana children's needs: orphans and vulnerable children dominated child welfare system.

Children's needs in Botswana received considerable attention in the past three decades owing to the HIV/AIDS epidemic in the country. These decades of legal and policy practice processes focused on orphan and vulnerable children (OVC), ensured that the needs of the general population of Botswana children are grossly understudied, underestimated, and therefore, remain unaddressed. This study sought to determine the needs of the general population of children. Fifty-two visual arts, six semi-structured interviews, twenty-six in-depth interviews and two focus group discussions were conducted in two purposively selected sites with children, policy-makers, practitioners, community leaders and caregivers. The data were analyzed using deductive content analysis approach. Children expressed the need for basic, safety, love and belonging needs. Given some pockets of poverty that exists in Botswana, it is likely that children in the general population have needs similar to those of OVC. Therefore, child welfare program should also target children who are not considered OVC.

Occurrence and molecular characterization of Giardia duodenalis in child population from Colombia.

Giardia duodenalis is one of the most prevalent human intestinal parasite, with children living in developing countries being particularly at risk of infection. The occurrence and molecular diversity of G. duodenalis was investigated in stools specimens from 307 individuals aged one to nineteen years in Colombia. Samples were collected in three educational establishments (n: 163) and two hospital laboratories (n: 144) from urban and rural areas. Feces were concentrated using a biphasic sedimentation method and wet mounts of the sediment were examined by light microscopy. G. duodenalis assemblages and sub-assemblages were determined on positive samples by PCR of the triose phosphate isomerase (tpi), ß-giardin (bg) and small-subunit (ssu) rRNA genes. G. duodenalis infection was detected by microscopy in 23 individuals (7.5%). The protozoan was more prevalent among specimens collected in educational establishments (11.6%) than in those obtained from hospital laboratories (2.8%). Infection was most common in individuals from urban areas and children aged 1-5 years. No significant association between diarrhea and infection could be demonstrated. Twenty Giardia-positive samples were successfully allocated to assemblage B (n: 11), sub-assemblage AII (n: 7), and assemblage A (n: 2). Results indicate the potential for transmission of G. duodenalis infection in children attending educational establishments and individuals from urban areas, where transmission seems to be primarily anthroponotic.

Parenteral viral hepatitis infection risk assessment by teenagers.

OBJECTIVE: Introduction: Developing strategy of parenteral viral hepatitis prevention among adolescents and youth is becoming an urgent issue. The aim of the research was to study the available data on the risk factors and ways of parenteral viral hepatitis transmission among adolescents and youth, as well as their attitude toward the problem of infection process spread by parenteral way and awareness of the personal risk of contamination. PATIENTS AND METHODS: Materials and methods: Primary source of research became the data of anonymous sociologic studies (questionnaire) among teenagers in the Kirovograd Region. The following methods were used to reach the set goals: systemic approach, medico-statistical, sociological (questionnaire). RESULTS: Results: The sociologic research showed a low level of awareness of the threat of personal infection with parenteral viral hepatitis in a teenage environment. It actualizes the need for development of systemic measures to prevent the infection of adolescents by parenteral way, since informing only is insufficient. CONCLUSION: Conclusions: Alertness to the spread of parenteral viral hepatitis and the risk of personal infection remains immature among teenagers and adolescents. The obtained results prove the expediency of the scientific substantiation of the cross-sectoral complex approach to solving the problem of preventing the spread of parenteral viral hepatitis among adolescents at the regional level.

Heavy metals as criteria of health and ecological well-being of the urban environment.

The study of the content of Pb, Cd, Ni, Zn, Mn, Cr, and Cu in biological media (the hair) of children living in the zones of the city of Kazan with different pollution levels was carried out. The identification of the zones in the city of Kazan was performed on the basis of the snow cover and soils pollution with heavy metals, which are natural accumulators of chemical substances and heavy metals (HM). Statistically significant differences (р < 0.01) in the content of certain metals in the hair, lead and cadmium in particular, were revealed in children living in the technologically polluted zone (Teplocontrol). Microelement composition of the hair in children with respiratory diseases (RD) varied widely in the content of lead (р < 0.05), and a statistically significantly lower level of zinc (р < 0.01) and copper (р < 0.05) compared with all the rest groups of children was determined in genitourinary diseases (GUD). However, relatively high values of toxic elements in the control zone show that the ecological status of the city and region is instable, and implies additional measures of the environmental monitoring and activities on chemical safety in certain city zones.

Assessing the heterogeneity of autism spectrum symptoms in a school population.

The aim of the present study was to assess whether the nature of the main autistic features (i.e., social communication problems and repetitive and restrictive patterns) are better conceptualized as dimensional or categorical in a school population. The study was based on the teacher ratings of two different age groups: 2,585 children between the ages of 10 and 12 (Primary Education; PE) and 2,502 children between the ages of 3 and 5 (Nursery Education; NE) from 60 mainstream schools. The analyses were based on Factor Mixture Analysis, a novel approach that combines dimensional and categorical features and prevents spurious latent classes from appearing. The results provided evidence of the dimensionality of autism spectrum symptoms in a school age population. The distribution of the symptoms was strongly and positively skewed but continuous; and the prevalence of high-risk symptoms for autism spectrum disorders (ASD) and social-pragmatic communication disorder (SCD) was 7.55% of NE children and 8.74% in PE. A categorical separation between SCD and ASD was not supported by our sample. In view of the results, it is necessary to establish clear cut points for detecting and diagnosing autism and to develop specific and reliable tools capable of assessing symptom severity and functional consequences in children with ASD. Autism Res 2018, 11: 979-988. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The results of the present study suggest that the distribution of autism spectrum symptoms are continuous and dimensional among school-aged children and thus support the need to establish clear cut-off points for detecting and diagnosing autism. In our sample, the prevalence of high-risk symptoms for autism spectrum disorders and social-pragmatic communication disorder was around 8%.

Evaluation of exposure to fluoride in child population of North Argentina.

Fluoride is an important element for humans. It inhibits initiation and progression of dental caries and stimulates bone formation. However, excessive intake may lead to the appearance of dental and/or skeletal fluorosis and a decrease in intellectual coefficient in child populations. This study evaluates exposure to fluoride in the child population of Chaco province (Argentina) by analysis of drinking water, food and its bioaccessible fraction (quantity of fluoride solubilised by gastrointestinal digestion and available for intestinal absorption) and urine as a biomarker of internal dose. The concentration of fluoride in drinking water varied between 0.050 and 4.6 mg L-1, and 80% of the samples exceeded the WHO drinking-water guideline value (1.5 mg L-1). Fluoride concentrations in food ranged between 0.80 and 3.0 mg kg-1 fresh weight (fw), being lower in bioaccessible fraction (0.43-1.9 mg kg-1, fw). On the basis of the consumption data declared for the young child population, fluoride intake varies between 4.1 and 6.5 mg day-1, greater than the level recommended for this age group. Moreover, in some cases, concentrations of fluoride found in urine (0.62-8.9 mg L-1) exceeded those reported in areas with declared fluorosis. All data obtained show the worrying situation of child population in this area of Argentina.

[Comparative analysis of dynamics of health status indexes among school age children of Ukraine in modern conditions].

INTRODUCTION: In the last time, there is a negative dynamics of indicators of the health of the child population in Ukraine in connection with socio-economic problems. AIM: The analysis of the data of the incidence and the prevalence of diseases among the children of the Poltava region in comparison with those of Ukraine for the period 2011-2015. MATERIALS AND METHODS: In our work are used data of State statistics of incidence and prevalence of diseases among the child population of Ukraine. RESULTS: Analysis of the health status of children in the Poltava region and the country as a whole shows that due last 5 years there has been a destabilization of children's health - the incidence and prevalence of diseases, despite the positive trend, remain high. CONCLUSIONS: In the Poltava region for the period of 2011-2015 years there is a steady natural declining of the population (especially among rural residents), which is due to a decreasing in the birth rate and the increase in mortality. The incidence among children in rural areas of the Poltava region is 1000.8 per 1,000 children, which is lower than the average regional rate (1200.4) and significantly lower than the incidence of children in urban areas (1304.7).

Trends in Child Obesity and Underweight in Spain by Birth Year and Age, 1983 to 2011.

INTRODUCTION AND OBJECTIVES: The prevalences of child obesity and overweight are increasing worldwide and are a significant public health issue, particularly in terms of long-term cardiovascular risk profiles, which continue into adulthood unless obesity is reversed. Accurately identifying trends and at-risk subgroups is crucial to correctly target public health initiatives. The objective of this study was to examine changes in the prevalences of child obesity and underweight in Spain from 1983 to 2011 taking into consideration both age and birth year. METHODS: A series of cross-sectional studies representative of the pediatric population in Spain between 1987 and 2011 was used to calculate the prevalence and trends of excess weight and underweight in girls and boys aged 2 to 14 years per survey year and per birth year. RESULTS: The overall prevalence of overweight and obesity remained relatively stable. The prevalence of overweight in boys aged 10 to 14 years increased from 13.9% to 22.2%. The prevalence of obesity in girls aged 2 to 5 years decreased from 30% to 19.8%, whereas the prevalence of underweight in this group increased from 13.7% to 22.6%. CONCLUSIONS: Child obesity trends in Spain over the last 2 decades appear to be stable with some fluctuations, but the trends differ depending on age and sex, and have stabilized at too high a level. The prevalence of underweight also appears to have increased and should be considered alongside excess weight when designing and implementing child health and weight measures.