Predominance of Trichophyton soudanense as Agent of Dermatophytoses in Cape Verdean School-Age Children.

Dermatophytoses are infectious skin diseases of public health importance because of their transmissibility and high prevalence, especially among children. This is the first study aiming to estimate and report the burden of dermatophytoses on school-age children on the island of Santiago in Cape Verde, an African country that is an archipelago. A total of 249 students attending the afternoon shift of three elementary schools in the city of Achada Igreja were examined. Of these, 60 had suspected lesions of dermatophyte infection. However, from the samples collected from these 60 students, including hair, nails, and skin scrapings, only 18 dermatophyte isolates were obtained, corresponding to a point prevalence of 7.2%. Morphological species identification demonstrated three different species: Trichophyton soudanense, Trichophyton rubrum, and Trichophyton violaceum; re-identification by sequencing the internal transcribed spacer (ITS) 1 and 2 regions of ribosomal DNA, and the 5.8S rDNA encoding gene (ITS-5.8S region), revealed T. soudanense as the most prevalent species, with only one case of T. rubrum. This is the first epidemiological data describing dermatophytoses and dermatophytes in Cape Verde among school-age children on one of the archipelago islands. It reinforces the need of using culture and accurate identification methodologies when gathering epidemiological data on dermatophytoses.

Supporting emotion regulation in children on the autism spectrum: co-developing a digital mental health application for school-based settings with community partners.

OBJECTIVE: KeepCalm is a digital mental health application, co-designed with community partners, that incorporates wearable biosensing with support for teams to address challenging behaviors and emotion dysregulation in children on the autism spectrum. METHODS: We followed a user-centered design framework. Before app development, we conducted design workshops, needs assessment interviews, a systematic review, and created an Expert Advisory Board. Once we had a working prototype, we recruited 73 participants to test and help improve the app across five testing cycles. RESULTS: Participants rated the app across testing cycles as highly acceptable, appropriate, feasible, and with good usability. Qualitative data indicated that KeepCalm helped teachers (a) be aware of students' previously unrealized triggers, especially for nonspeaking students; (b) prevent behavioral episodes; (c) communicate with parents about behaviors/strategies; and (d) equipped parents with knowledge of strategies to use at home. We learned that in order to make the app acceptable and appropriate we needed to make the app enjoyable/easy to use and to focus development on novel features that augment teachers' skills (e.g., behavioral pattern and stress detection). We also learned about the importance of maximizing feasibility, through in-person app training/support especially regarding the wearable devices, and the importance of having aides involved. CONCLUSION: Our findings have informed plans for wider-scale feasibility testing so that we may examine the determinants of implementation to inform adaptations and refinement, and gather preliminary efficacy data on KeepCalm's impact on reducing challenging behaviors and supporting emotion regulation in students on the autism spectrum.

Conversational topic maintenance and related cognitive abilities in autistic versus neurotypical children.

LAY ABSTRACT: Children who struggle to maintain conversation with peers often have fewer friends and lower popularity ratings, which can affect wellbeing. Verbal social communication more broadly is linked to both behavioural difficulties and emotional problems. We carried out three studies to examine children's ability to provide responses which keep a back and forth conversation going. The first study found that while autistic children had on average greater difficulties than their neurotypical peers with certain aspects of conversation topic maintenance, for other aspects the autistic group showed considerable strengths. Both studies 2 (neurotypical children) and 3 (autistic children) found relationships between, on the one hand, conversational ability, and on the other, the ability to consider another's viewpoint and the ability to maintain and update information in short term memory. We suggest support for social conversation skills should be part of mainstream classroom curricula for autistic and neurotypical children alike.

Effectiveness of specialist nurse-led WeChat mini program management for disease control in asthma: A randomized controlled study.

BACKGROUND: Asthma is a common chronic respiratory disease in childhood, requiring effective management strategies. PURPOSE: This study aims to evaluate the effectiveness of a nurse-led WeChat Mini Program in managing asthma among children aged 6 to 11 years. METHODS: This randomized controlled trial adhered to the CONSORT checklist and was conducted at a tertiary hospital in China from January 2023 to August 2023. One hundred and eight children with asthma were randomly assigned to two groups, and 81 children completed the 6-month follow-up. All participants received asthma management from specialist nurses, including routine treatments such as inhaled corticosteroids. The experimental group also utilized the WeChat Mini Program for asthma management. Both groups underwent follow-up assessments at 3 and 6 months post-enrollment, which included the Childhood Asthma Control Test (C-ACT), asthma control levels, frequency of exacerbations, and lung function. RESULTS: At 3 and 6 months, the experimental group showed significantly higher C-ACT scores and a lower exacerbation frequency compared to the control group (p < 0.05). While Peak Expiratory Flow improved, Forced Expiratory Volume in 1 Second Percentage Predicted (FEV1%) and FEV1/FVC did not change significantly. CONCLUSIONS: The WeChat Mini Program significantly improved asthma control and reduced exacerbations but did not substantially enhance all lung function parameters. Further research is required to confirm its long-term effects. APPLICATION TO PRACTICE: Incorporating a specialist nurse-led digital management tool, such as the WeChat Mini Program, into standard pediatric asthma care may offer an effective management strategy.

Undernutrition and associated factors among school-age children in Wolaita Zone, South Ethiopia: a comparative cross-sectional study.

Background: Nutritional deficiencies in school-age children are a public health concern, especially in resource-limited countries. A school feeding program involves the provision of food on-site or taken home to reduce hunger. It is implemented in several developing nations; however, little is known about the association of school feeding programs with the nutritional status of school-age children in the study area. Objectives: The study aimed to determine the magnitudes and associated factors of undernutrition among school-age children with school feeding programs (SFPs) and non-school feeding programs (N-SFPs) in Kindo Didaye woreda, South Ethiopia. Methods: A school-based comparative cross-sectional study was conducted in Kindo Didaye district from May to June 2023. A total of 612 participants were included in the study. The data were collected from each selected student's parents by using a structured interviewer-administered questionnaire. The weight and height of the children were measured, and a household dietary diversity assessment was conducted. The data were analyzed using SPSS version 25. A binary logistic regression analysis was carried out. A p-value of <0.05 and 95% confidence interval (CI) were used to establish a statistically significant association. Results: The magnitude of undernutrition among the school-age children was 38.9%: 43.3% in the children from the SFP schools and 34.5% in the children from the N-SFP schools. Stunting was 24.1% among the children in the schools with SFPs and 16% among the children in the N-SFP schools, whereas thinness was 33.8% among the children in the SFP schools and 25.6% among the children in the N-SFP schools. The children who were in the older age group [adjusted odds ratio (AOR) = 4.4, 95%CI; 2.22-8.85], consumed less than three meals per day at home (AOR = 6.03; 95%CI 3.9-9.3), and did not eat breakfast at all before going to school (AOR = 3.5; 95%CI 1.15-10.76) were more likely to become undernourished. The children whose fathers received secondary and above education (AOR = 0.52; 95% CI (0.27-0.971) had lower odds of becoming underweight. Conclusion: The magnitude of undernutrition was high in the current study. Existing interventions that work to improve the nutritional status of school-age children should be strengthened. Children should consume any type of food as breakfast at home before going to school regardless of the presence of school feeding programs and at least three times a day.

Parental Stress and Psychological Distress and Their Association With Spousal Support Among Parents of School-Age Children During the COVID-19 Pandemic in South India: A Cross-Sectional Observational Study.

CONTEXT: The COVID-19 pandemic presented unprecedented challenges to families in the form of social isolation, economic difficulties and inaccessibility of educational and supportive services. AIMS: To assess the levels of parental stress and psychological distress among parents of school-age children during the COVID-19 pandemic and to analyse its correlation with spousal support. MATERIALS AND METHODS: A cross-sectional, web-based study was conducted among the parents of school-age children in south India. One hundred thirty-two completed responses were obtained. Study tools included Parental Stress Scale, Spouse Support Scale and Kessler's psychological distress scale-6 item version. RESULTS: The mean parental stress score was 42.39 ± 9.679. Sixty percent of the participants reported moderate to high levels of psychological distress. Parental stress and psychological distress scores were noted to have a significant negative correlation with spousal support scores (r=-.486, p=.000 and r=-.401, p=.000 respectively). CONCLUSION: Our study findings show that the COVID-19 pandemic has taken a toll on the psychological well-being of parents of school-age children. Supportive interventions to address parenting difficulties need to be undertaken to prevent long-term adverse mental health outcomes. Lessons learnt from the pandemic are important for clinicians and policymakers to take measures to alleviate parental stress as well as to promote the psychological well-being of parents and children.

Influência das práticas dos pais na saúde alimentar das crianças em idade escolar: contributo do enfermeiro de saúde familiar / The influence of parental practices on the dietary health of school-age children: the contribution of family health nurses

Na medida em que a enfermagem de saúde familiar pretende ser uma resposta dinâmica às necessidades multidimensionais da família, é essencial cuidar da família, enquanto unidade de cuidados e de cada um dos seus membros ao longo do ciclo vital e aos diferentes níveis de prevenção. As intervenções devem estar centradas na qualidade de vida das famílias ao longo do ciclo vital. É nas famílias que cada membro encontra o apoio no enfrentamento de necessidades nos vários processos de transição. Gerir, articular e mobilizar recursos são situações presentes no quotidiano profissional que exige competências especializadas. Neste sentido, pretendendo desenvolver competências especializadas no âmbito da enfermagem de saúde familiar, optamos por realizar em Estágio de Natureza Profissional (ENP), numa Unidade de Saúde Familiar (USF), de forma a um cuidar com qualidade, centrado nas necessidades multidimensionais das famílias. No decurso do estágio desenvolvemos competências especializadas no âmbito da prestação de cuidados, atendendo às áreas essenciais da enfermagem de saúde familiar. Delineamos intervenções de âmbito multidimensional que tinham como propósito serem uma resposta ativa aos problemas presentes das famílias Cuidar da família, enquanto unidade de cuidados e de cada um dos seus membros, ao longo do ciclo vital e aos diferentes níveis de prevenção, liderar e colaborar nos processos de intervenção no âmbito da enfermagem de saúde familiar exige do enfermeiro de saúde familiar uma abordagem sistêmica da família que envolve uma interação dinâmica entre o sistema como um todo e suas partes, procurando a adaptação nos processos de saúde e doença. No domínio da investigação, verificamos através do diagnóstico de situação em contesto da pratica de cuidados e da nossa experiência profissional, a necessidade de investigar a prática quotidiana dos pais na saúde alimentar das crianças em idade escolar, com o objetivo geral de conhecer as práticas quotidianas dos pais na saúde alimentar das crianças em idade escolar, com o propósito da melhoria das práticas das equipas de saúde, nomeadamente para inovação/mudança das práticas de cuidados dos cuidados de saúde primários que trabalham com as crianças e famílias sobretudo na saúde alimentar das crianças em idade escolar. Estudo qualitativo, exploratório-descritivo, utilizando a entrevista semiestruturada dirigida a familiares da criança em idade escolar da Unidade de Saúde Familiar, para a recolha de dados. Utilizamos a análise de conteúdo segundo Bardin (2016), como procedimento para a análise dos dados. Os procedimentos ético-moral foram respeitados. Verificamos que os participantes do estudo conceptualizam as práticas alimentares como algo que vai exigir um processo de reorganização do seu quotidiano. Constatou-se que a maioria dos participantes, consideram importante aumentar as informações sobre as necessidades nutricionais das crianças e mostrar o impacto que as estratégias de alimentação infantil podem ter nas preferências e no consumo de alimentos por parte das crianças. As famílias apelam a que exista formação à comunidade escolar para uma maior integração do seu filho na escola e na comunidade, maior apoio das equipas de saúde, nomeadamente do enfermeiro, e que este apoio seja de proximidade. A prática alimentar dos pais em relação às crianças em idade escolar requer uma articulação efetiva entre todos os parceiros, tanto da área da saúde quanto da educação. No domínio da formação, desenvolvemos atividades quer como formadora quer como formanda. No domínio da gestão, foi detetada a necessidade de conhecer detalhadamente os processos organizacionais da unidade de saúde, incluindo o Regulamento interno, Plano de Ação, Manual de procedimentos e protocolos; entender a dinâmica da equipa e os papéis e funções de cada membro; identificar problemas, formular diagnósticos de enfermagem, e desenvolver planos de intervenção; priorizar a utilização eficiente dos recursos materiais e humanos disponíveis; colaborar estreitamente com outras equipas multiprofissionais, especialmente em situações que requerem acompanhamento especializado fora da área de atuação dos enfermeiros; desenvolver intervenções na área da liderança, com foco na organização e orientação dos cuidados de saúde às famílias, considerando os recursos internos e externos e colaborar na gestão do processo de implementação, operacionalização da vacinação, especialmente em resposta ao contexto pandémico atual, seguindo as orientações da Direção-Geral da Saúde (DGS). Essas necessidades destacam a importância de uma gestão bem estruturada e colaborativa, que integra o conhecimento organizacional, a dinâmica de equipa, a eficiência de recursos e a resposta a situações emergentes como a pandemia.

As family health nursing aims to be a dynamic response to the multidimensional needs of the family, it is essential to care for the family, as a care unit and for each of its members throughout the life cycle and at different levels of prevention. Interventions must be focused on the quality of life of families throughout the life cycle. It is in families that each member finds support in facing needs in the various transition processes. Managing, articulating and mobilizing resources are situations present in everyday professional life that require specialized skills. In this sense, intending to develop specialized skills within the scope of family health nursing, we chose to undertake a Professional Internship in a family health unit, in order to provide quality care, focused on the multidimensional needs of families. During the internship we develop specialized skills in the provision of care, covering the essential areas of family health nursing. We outlined multidimensional interventions that were intended to be an active response to families' current problems Caring for the family, as a unit of care and for each of its members, throughout the life cycle and at different levels of prevention, leading and collaborating in intervention processes within the scope of family health nursing requires the family health nurse to have an approach family system that involves a dynamic interaction between the system as a whole and its parts, seeking adaptation in health and disease processes. In the field of research, we verified, through the diagnosis of a situation in dispute with the practice of care and our professional experience, the need to investigate the daily practice of parents in the nutritional health of school-age children, with the general objective of knowing the daily practices of parents in the nutritional health of school-age children, with the purpose of improving the practices of health teams, namely to innovate/change care practices in primary health care that work with children and families, especially in children's nutritional health of school age. Qualitative, exploratory-descriptive study, using semi-structured interviews aimed at family members of the school-age child at the Family Health Unit, to collect data. We used content analysis according to Bardin (2016), as a procedure for data analysis. Ethical-moral procedures were respected. We found that study participants conceptualize eating practices as something that will require a process of reorganization of their daily lives. It was found that the majority of participants consider it important to increase information about children's nutritional needs and show the impact that child feeding strategies can have on children's food preferences and consumption. Families call for training to be provided to the school community for greater integration of their child into the school and community, greater support from healthcare teams, particularly nurses, and that this support be local. Parents' dietary practices in relation to school-age children require effective coordination between all partners, both in the health and education areas. In the field of training, we develop activities both as a trainer and as a trainee. In the management domain, the need for detailed knowledge of the health unit's organizational processes was detected, including the Internal Regulations, Action Plan, Procedures and Protocols Manual; understand team dynamics and the roles and functions of each member; identify problems, formulate nursing diagnoses, and develop intervention plans; prioritize the efficient use of available material and human resources; collaborate closely with other multidisciplinary teams, especially in situations that require specialized support outside the nurses' area of activity; develop interventions in the area of leadership, focusing on the organization and guidance of health care for families, considering internal and external resources and collaborate in the management of the implementation process, operationalization of vaccination, especially in response to the current pandemic context, following the guidelines of the Directorate-General for Health (DGS). These needs highlight the importance of well-structured and collaborative management, which integrates organizational knowledge, team dynamics, resource efficiency and response to emerging situations such as the pandemic.

Socio-demographic and other factors contributing to excessive leisure screen time in preadolescent children.

OBJECTIVES: Excessive screen use in early school age is associated with worsened health habits and negative child development in later age. We aimed to assess the time spent on modern and traditional screen-based devices and examine its associations with socio-demographic characteristics. METHODS: This population-based cross-sectional observation study was conducted in Czechia, Slovakia and Finland between April and June 2021. Participants (N = 1,915) were parents/caregivers of children attending elementary school grades 1 to 3, selected by stratified random sampling. Children's daily leisure screen time (LST) based on parental reports was the main outcome. Descriptive statistics, mean comparison and linear regression analysis were used for the analysis. RESULTS: The average daily LST was found to be as high as 3.5 hours and significantly associated with most socio-demographic variables. Eighty percent of children exceeded the threshold of two hours of LST per day, which was formerly introduced by the American Academy of Pediatrics. The most important predictor of LST in children was having their screen-based device(s) for their exclusive personal use (EPU). Linear regression with all predictors assessed together confirmed the significant effect of the screen-based devices' EPU, the child's sex and grade, the child's birth order and the parent's education, even when controlled for media parenting practices. CONCLUSIONS: Given the widespread availability of smartphones for exclusive personal use among young children, the regulation of EPU and the reinforcement of effective media parenting practices, particularly in families with lower education and income, are critical public health strategies to mitigate the negative impact of excessive screen time on child development and overall well-being.

Association between hallucinations and sensory processing difficulties in children and adolescents.

Introduction: Hallucinations are serious symptoms that can lead to high levels of distress, functional impairment, and increased risk of suicide in both adults and children. However, their etiology and treatment remain unclear. Hallucinations and sensory processing difficulties (SPDs) are associated with various psychiatric disorders, including mood, anxiety, and post-traumatic stress disorder. This study aimed to investigate the potential association between hallucinations and SPDs in a pediatric population. Methods: We conducted a cross-sectional study with 335 children aged 6-18 years who visited the child psychiatry outpatient clinic at Osaka Metropolitan University Hospital between April 2020 and March 2023 and continued treatment for at least three months. After excluding those with intellectual disabilities or uncontrolled epilepsy, 304 participants were included in the analyses. The presence of hallucinations was assessed through interviews with the children and their parents. SPDs were evaluated using the Short Sensory Profile. Binomial logistic regression analysis was conducted to assess the association between hallucinations and SPDs, adjusting for age, sex, autism spectrum disorder, socioeconomic difficulties (low-income, single-parent households), and the presence of mood and anxiety disorders. Results: Hallucinations were present in 64 children (21%). Logistic regression analysis showed a significant positive association between SPDs and hallucinations, even after adjusting for age, sex, autism spectrum disorder, socioeconomic difficulties, and the presence of mood and anxiety disorders (odds ratio, 1.02; 95% CI, 1.008-1.036; p = 0.002). Conclusion: The results of this study suggest a potential association between hallucinations and SPDs in pediatric patients. Further prospective studies are needed to explore the causal relationship between these factors and determine whether interventions for SPDs can alleviate hallucinations in children.

Child's Externalizing and Internalizing Problems and Caregiver Strain: Mediation of Child's Executive Functions.

The aim of the study is to explore the role of child's executive functions in the relation between child's externalizing and internalizing problems and caregiver strain in early school age children. The caregiver strain refers to providing nurture and care for a dependent family member. A sample includes 175 caregiver-child dyads and 36 school teachers. Participants completed the Family Strain Index which measures caregiver strain or burden (caregivers), the Strengths and Difficulties Questionnaire which measures child's externalizing and internalizing problems (teachers), and behavioral tasks that measure executive functions (children). Using structural equation modelling, the analysis resulted in a full mediation of the child's externalizing problems on the caregiver strain by child's executive functions. However, the association of child's internalizing problems with caregiver strain has not been confirmed. These results indicate that better child's executive functions buffer the negative effect of child's externalizing problems on caregiver perceived burden. Based on these results, we can suggest that interventions should be focused on programmes to improve the child's executive functions in the family and educational context, along with caregiver training aimed at providing emotional and social support, or individual therapy.

Comparing eating and mealtime experiences in families of children with autism, attention deficit hyperactivity disorder and dual diagnosis.

LAY ABSTRACT: Children with neurodevelopmental conditions like autism and attention deficit hyperactivity disorder may experience eating difficulties and related health issues later in life. Sharing family meals can help prevent these issues developing, but most studies have looked at families with neurotypical children. Our goal was to learn more about how families of children with autism, attention deficit hyperactivity disorder and both conditions (autism + attention deficit hyperactivity disorder) experience mealtimes. We developed an online survey asking caregivers about their child's eating, mealtime experience and if they experienced stress. We tested it with nine caregivers and made improvements based on their feedback before recruiting 351 caregivers to complete the main survey. We found that families of children with neurodevelopmental conditions experienced greater food fussiness, emotional undereating, 'problematic' child mealtime behaviours, dietary concerns, higher stress for caregivers and spouses and less frequent conventionally structured mealtimes compared to those without these conditions. Families of children with attention deficit hyperactivity disorder and autism + attention deficit hyperactivity disorder reported greater appetite, 'problematic' mealtime behaviours and increased stress for caregivers and spouses compared to families of children with autism. Meanwhile, families of children with autism and autism + attention deficit hyperactivity disorder reported less enjoyment of food and less structured mealtimes compared to those with attention deficit hyperactivity disorder. Our findings highlight that families of children with neurodevelopmental conditions, particularly those with autism + attention deficit hyperactivity disorder, have different mealtime experiences and eating behaviours compared to those with neurotypical children. These families may benefit from support at mealtimes. Learning why people do or do not participate in shared family meals will be crucial to developing improved mealtime support in the future.

Assessment of attention-deficit / hyperactivity disorder signs among Palestinian school-age children.

PURPOSE: The study aimed to identify the prevalence of Attention-Deficit / Hyperactivity Disorder (ADHD) signs exhibited in Palestinian school-age students while comparing their sociodemographic characteristics. DESIGN AND METHODS: A cross-sectional descriptive correlation study was conducted. The study included children aged 6-12 in West Bank schools, without a previous ADHD diagnoses or other neurodevelopmental disorders. This study used a parent questionnaire with three sections: child's sociodemographic data, parents' data, and Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS), which has a Cronbach's alpha values of 0.94 for total ADHD. All collected data were analyzed using SPSS version 25, with confidence interval of 95 %. RESULTS: A total 487 school-aged children participated in the study (46.4 % females and 53.6 % males). The results showed that 8.7 % of the children exhibited ADHD signs, with ADHD-I being the most prevalent subtype (3.3 %). Significant associations were found between ADHD signs and the following factors: males (P = 0.003); children with lower academic averages (less than 79.9 %) (P = 0.000); children speaking only one language (P = 0.002); children of mothers exposed to tobacco during pregnancy (P = 0.004); children whose mothers faced complications during pregnancy (P = 0.000); children whose mothers were 19 years old or younger at childbirth scores (P = 0.05); and children with relatives having ADHD (P = 0.000). No significant associations were found with variables such as child's age, birth weight, gestational age, number of countries lived in, school class, place of residency, parents' marital status, educational level, employment status, average income, number of children, or child's birth order. A moderate negative correlation was found between ADHD signs and poor academic performance (r = -0.169, P = 0.000). CONCLUSION: The study found a significant prevalence of ADHD signs in Palestinian school-age children (8.7 %), with ADHD-I having the highest prevalence. Risk factors included gender, languages, maternal exposure to tobacco, maternal complications, mother's age, and relatives with ADHD. Early detection is crucial to mitigate its impact on academic performance. PRACTICE IMPLICATIONS: Nurses play a crucial role in managing ADHD in school-aged children. They conduct educational programs, early screening programs, and work with a multidisciplinary team to evaluate and monitor suspected ADHD cases. They also advocate for research and policy development to improve ADHD care and outcomes. This ensures children receive necessary treatment and support services.

Assessment of Low-density Lipoprotein Cholesterol Levels and Non-invasive Vascular Health in School-aged Children: A Study in Ogasa District, Shizuoka Prefecture.

AIM: The present study assessed low-density lipoprotein cholesterol (LDL-C) levels in school-aged children from the Ogasa District of Shizuoka Prefecture and evaluated the utility of non-invasive vascular tests, namely flow-mediated dilation (FMD) and intima-media thickness (IMT), in pediatric patients with familial hypercholesterolemia (FH). METHOD: We analyzed the lipid test results of 8,568 students screened for prevention of lifestyle-related diseases and 78 children under 15 years old with cholesterol levels exceeding 220 mg/dL who visited Chutoen General Medical Center. We examined the LDL-C distribution from school-age screenings and conducted FMD and IMT assessments on those meeting the 2022 Pediatric FH Guidelines criteria. RESULTS: Among the screened students, 186 (2.2%) exhibited LDL-C levels above 140 mg/dL, including 123 fourth-graders (2.8%) and 63 first-year junior high students (1.5%). The mean LDL-C level across all students was 90.0 mg/dL (standard deviation: 21.3 mg/dL), with the 95th percentile at approximately 125.0 mg/dL. Of the 78 children who visited the hospital, 65 met the FH diagnostic criteria. In children ≥ 10 years old, no significant IMT differences were observed between the Definitive and Probable FH groups and the Possible FH group; however, a significant difference in the FMD percentage was noted between these groups (9.9% [8.1%-11.9%] vs. 14.2% [11.6%-16.3%], P=0.003). CONCLUSIONS: Our findings highlight the LDL-C distribution in FH screening and suggest a potential reduction in FMD in pediatric FH patients ≥ 10 years old. These results emphasize the importance of initiating pharmacological interventions in school-aged children to maintain optimal LDL-C levels for lifelong cardiovascular health.

Exploring the Association between Socioeconomic Environment, Eating Habits and Level of Nutrition in Children of High School Age: A Part of National Survey.

BACKGROUND/OBJECTIVES: One of the raising public health problems in the adolescent population is obesity, which has reached epidemic proportions worldwide. The aim of this work is to determine the prevalence of obesity in the population of children of secondary school, age 15 to 19 years in Serbia and the determinate connection with demographic and socio-economic characteristics of the respondents and their eating habits and physical activity. METHODS: The research is part of the fourth National Population Health Survey conducted in 2019, which was conducted by the Republic Institute of Statistics, in cooperation with the Institute of Public Health of Serbia and the Ministry of Health of the Republic of Serbia. As a research instrument, questionnaires were used in accordance with the methodology of the European Health Survey. For the purposes of this research, data on the adult population aged 15-19 and over were used. RESULTS: The association of overweight with demographic and socioeconomic characteristics was examined using binary regression. In the univariate model, male gender (OR = 1.95), younger age (OR = 1.57) and Region of Vojvodina (OR = 2.47) stood out as significant predictors of overweight, which was confirmed by the multivariate model. CONCLUSIONS: The results of our study emphasize that the prevalence of obesity in the population of high school youth is at a significant level and that a lot more needs to be done to promote healthy lifestyles and raise awareness of their benefits on health status.

Effect of Centrality on Physical Activity in Late Childhood: A 1-Year Prospective Cohort Study.

BACKGROUND/OBJECTIVES: Engaging in physical activity (PA) is crucial for children's physical and mental health, with PA in childhood influencing lifelong activity levels. However, PA during childhood tends to decrease with age. Childhood friendship networks influence various health behaviors, including physical activity. Centralities are objective measures of an individual's position and role in friendship networks. The relationship between centrality and PA is inconsistent. This study aimed to determine how centrality affects changes in PA in late childhood longitudinally and to investigate the distribution of centrality in the network. METHODS: This prospective cohort study recruited fourth- and fifth-grade children (9-11 years old). A total of 143 children participated. We calculated three centralities-in-degree, closeness, and betweenness-based on social network analysis (SNA). PA was assessed using the physical activity questionnaire for older children (PAQ-C). To explore the relationship between centralities and the percentage change in PA, a multivariate logistic regression analysis was performed. RESULTS: Children with higher closeness had a significantly higher rate of decrease in PA after adjusting for confounding factors. There was no significant association between betweenness and percentage change in PA (p = 0.66) or in-degree and percentage change in PA (p = 0.21). CONCLUSIONS: This study highlights the importance of considering social network dynamics in PA interventions, particularly for children with high social closeness. Future research should incorporate objective PA measures and explore broader social networks to enhance intervention strategies, especially for Generation Z and Alpha, who experience unique opportunities and motivations for PA due to pervasive digital environments.

The Impact of Exposure to Iodine and Fluorine in Drinking Water on Thyroid Health and Intelligence in School-Age Children: A Cross-Sectional Investigation.

Iodine and fluorine, as halogen elements, are often coexisting in water environments, with nearly 200 million people suffering from fluorosis globally, and, in 11 countries and territories, adolescents have iodine intakes higher than that required for the prevention of iodine deficiency disorders. It has been suggested that excess iodine and/or fluorine can affect thyroid health and intellectual development, especially in children, but their combined effect has been less studied in this population. This study investigated 399 school-age children in Tianjin, China, collected drinking water samples from areas where the school-age children lived, and grouped the respondents according to iodine and fluorine levels. Thyroid health was measured using thyroid hormone levels, thyroid volume, and the presence of thyroid nodules; intelligence quotient (IQ) was assessed using the Raven's Progressive Matrices (CRT) test; and monoamine neurotransmitter levels were used to explore the potential relationship between thyroid health and intelligence. Multiple linear regression and restricted cubic spline (RCS) analyses showed that iodine and fluorine were positively correlated with thyroid volume and the incidence of thyroid nodules in school-age children, and negatively correlated with IQ; similar results were obtained in the secondary subgroups based on urinary iodine and urinary fluoride levels. Interaction analyses revealed a synergistic effect of iodine and fluorine. A pathway analysis showed that iodine and fluorine were negatively associated with the secretion of free triiodothyronine (FT3) and free tetraiodothyronine (FT4), which in turn were negatively associated with the secretion of thyroid-stimulating hormone (TSH). Iodine and fluorine may affect IQ in school-aged children through the above pathways that affect thyroid hormone secretion; of these, FT3 and TSH were negatively correlated with IQ, whereas FT4 was positively correlated with IQ. The relationship between thyroid hormones and monoamine neurotransmitters may involve the hypothalamic-pituitary-thyroid axis, with FT4 hormone concentrations positively correlating with dopamine (DA), norepinephrine (NE), and 5-hydroxytryptophan (5-HT) concentrations, and FT3 hormone concentrations positively correlating with DA concentrations. Monoamine neurotransmitters may play a mediating role in the effects of iodine and fluoride on intelligence in schoolchildren. However, this study has some limitations, as the data were derived from a cross-sectional study in Tianjin, China, and no attention was paid to the reciprocal effects of iodine and fluorine at different doses on thyroid health and intelligence in schoolchildren in other regions.

Impact of wearing dual-focus soft contact lenses on myopia progression: a one-year randomized clinical trial in Chinese school-age children.

BACKGROUND: Myopia is prevalent in China; however, trials involving Chinese children wearing dual-focus soft contact lenses (DFSCL) are limited. Thus, the purpose of this study is to investigate the efficacy of DFSCL among Chinese school-age children. METHODS: Sixty-four children aged 8-12 years with spherical equivalent refraction (SER) between - 0.75D and - 4.00D were recruited in this randomized controlled clinical study. The control group (32 subjects) wore single-vision spectacles (SVS), while the DFSCL group (32 subjects) wore daily disposable + 2.00 D defocus MiSight DFSCL. Follow-up examinations were performed every 3 months to compare the axial length (AL) growth and SER change between the groups for a period of 12 months by using the independent samples t-test or the Mann-Whitney U test. Statistical differences with a P < 0.05, when compared to the control group, are considered indicative of an effective intervention. Multivariate analysis and regression analysis were used to eliminate the effects of confounding factors on the results. RESULTS: A total of 58 subjects, with 30 in the SVS group and 28 in the DFSCL group, completed the follow-up. After adjusting for baseline age, gender, AL and SER, AL growth was 0.33 ± 0.02 mm in the SVS group and 0.23 ± 0.03 mm in the DFSCL group (P = 0.004). SER change was - 0.53 ± 0.06 in the SVS group and - 0.44 ± 0.06 in the DFSCL group (P = 0.308). In the DFSCL group, AL and SER increased 0.11 mm and 0.09 D less than in the SVS group, respectively. Moreover, initial wear of DFSCL may cause occasional blurriness in near vision, and prolonged wear may lead to increased ocular discomfort symptoms such as dryness, itchiness, and foreign body sensation. CONCLUSION: MiSight DFSCL showed a reduction in AL growth during the first three months of wear. However, no significant benefits were observed during the subsequent nine months. No significant differences in the changes of SER were found. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2200064731. Registered 15 October 2022, http://www.chictr.org.cn/.

Developmental changes in numerosity and area perception in school-age children.

Humans can quickly estimate the quantity of objects in their environment through the Approximate Number System (ANS). However, the developmental trajectories of numerical and spatial perception in school-aged children are not well understood. This study aimed to address this issue by examining the performance of 7-year-olds, 9-year-olds, and 11-year-olds in the dot-number and dot-area tasks. In each trial, participants were presented with pairs of dots array simultaneously and were asked to indicate which array had a greater quantity of dots in the dot-number task, and which array had a larger overall area of dots in the dot-area task. We manipulated number cues and area cues of the dots array in these two tasks, creating three different relationships between dot-number and dot-area: congruent, neutral, and incongruent. Our results showed school-aged children's ability to estimate numerosity improved significantly after the age of 7, with no apparent improvement observed between the ages of 9 and 11. This indicates a marked growth in acuity in the perception of numerical quantities. Conversely, the capacity to estimate area showed consistent stability across the various age groups examined. Additionally, our results demonstrated a pronounced difficulty among participants in ignoring numerical cues when assessing dot quantity or dot area, as opposed to non-numerical cues. This highlights a preferential sensitivity to numerical information in cognitive processing. These findings provide valuable insights into the cognitive development underlying quantity perception and may offer practical guidance for educational practices.

Prevalence and Correlates of Double and Triple Burden of Malnutrition Among Children and Adolescents in India: The Comprehensive National Nutrition Survey.

BACKGROUND: Limited information on the co-prevalence of undernutrition, micronutrient deficiencies, overnutrition, and abnormal levels of noncommunicable disease biomarkers at the same time in children and adolescents in India hinders efforts to comprehensively address their health. OBJECTIVES: This study aimed to examine the prevalence and correlates of double burden of malnutrition (DBM) and triple burden of malnutrition (TBM) among children and adolescents (5-19 y) to inform policies and programs. METHODS: A total of 17,599 children (5-9 y) and 16,184 adolescents (10-19 y) with available biomarker data from the Comprehensive National Nutrition Survey were included. Malnutrition was defined based on either undernutrition based on anthropometry, overnutrition/abnormal metabolic markers, and anemia/micronutrient deficiency. DBM was defined as the coexistence of any 2 forms of malnutrition. DBM+ was defined as the coexistence of undernutrition and/or micronutrient deficiency along with overnutrition. TBM was defined as having the coexistence of all 3 forms of malnutrition. The prevalence of DBM, DBM+, and TBM was estimated accounting for probabilistic selection. We used mixed-effect binomial regression to determine correlates of DBM/TBM in children and adolescents separately. RESULTS: The prevalence of DBM, DBM+, and TBM was 50.8%, 37.2%, and 14.4%, respectively, in children and 53.4%, 36.1%, and 12.7%, respectively, in adolescents. The prevalence of DBM+ was significantly higher in girls compared to in boys in the 5-9 y age group. In children, being in a disadvantaged caste group, having a lower wealth index, having inadequate diet diversity, having no maternal schooling, and having a recent history of acute illness were associated with DBM. In adolescents, being in a disadvantaged caste group, maternal occupation, and lower paternal age were correlated with DBM. A similar set of variables was associated with TBM in both age groups. CONCLUSIONS: The prevalence of DBM and TBM is substantial in children and adolescents in India and varies across states. Socioeconomic factors and acute illness were the main correlates for DBM and TBM.

Problematic use of the internet as a predictor of oral health-related quality of life: the mediating role of lifestyles in Peruvian schoolchildren.

BACKGROUND: The pervasiveness of the Internet in everyday life, especially among young people, has raised concerns about its effects on mental health, education, and, recently, oral health. Previous research has suggested a complex relationship between Problematic Internet Use (PIU), lifestyles, and oral health-related quality of life, highlighting the need to examine these interactions further. This study seeks to explore the PIU as a predictor of oral health-related quality of life and examine the mediating role of lifestyles between both in a sample of Peruvian schoolchildren. METHODS: A cross-sectional study was carried out with 293 Peruvian students aged 12 to 17 years (M = 14.42, SD = 1.5), using structural equations to analyze the relationship between PIU, lifestyles, and quality of life related to oral health. The data collection procedure was through a face-to-face survey. Validated instruments measured PIU, lifestyles, and oral health-related quality of life. The study's theoretical model was analyzed through structural equation modeling with the MLR estimator. The fit assessment was performed using the comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). RESULTS: They indicated significant correlations between PIU, lifestyles, and oral health-related quality of life. A negative influence of PIU on lifestyles (ß = -0.30, p < .001) and on oral health-related quality of life (ß = -0.35, p < .001) was observed, as well as a positive relationship between PIU and oral health-related quality of life (ß = 0.29, p < .001). The mediation of lifestyles was statistically significant, suggesting that they mediate the relationship between PIU and oral health-related quality of life. CONCLUSIONS: The study confirms that PIU can negatively affect adolescents' oral health-related quality of life, mediated by unhealthy lifestyles. It underlines the importance of promoting balanced Internet use and healthy lifestyles among young people to improve their oral well-being.