School-based intervention for anxiety using group cognitive behavior therapy in Pakistan: a feasibility randomized controlled trial.

BACKGROUND: Anxiety and mood disorders are the main cause of illness in people under the age of 25, accounting for 45% of the global disease burden, whereas 4.6% of teenagers aged 15 to 19 are predicted to experience anxiety. Pakistan country, with a population of 200 million, has the worst mental health indicators and fewer than 500 psychiatrists. Despite the existence of various treatments for anxiety, this goes unrecognized and untreated. Due to a lack of awareness, evaluation, prevention, and interventional programs related to being implemented among adolescents in Pakistan, there is a rise in mental health issues in the earlier years of life. It calls for a critical need for indigenous, evidence-based interventions. The present study aimed to evaluate the feasibility of cognitive behavioral therapy (CBT)-based interventions to reduce anxiety symptoms among school children in Pakistan. METHODS: This study was a pre-post design, two-arm, single-blinded, feasibility, randomized controlled trial. Thirty-four participants (experimental group, n = 17; control group, n = 17) were recruited from four semi-government schools in Rawalpindi with a mean age of 15 (M = 15, SD = 0.73). Two instruments Beck Anxiety Inventory for Youth (BAI-Y II) and BASC-3 Behavioural and Emotional Screening System Student (BESS-SF) were used to assess the severity of symptoms. Participants in the intervention arm received eight-group therapy CBT sessions. A two-way factorial analysis was used to examine the efficacy of CBT in reducing symptom severity. RESULTS: This study's findings showed that in comparison to the wait-list control group, CBT successfully improved anxiety symptoms among school children while enhancing their social skills. CONCLUSION: This study will help improve the treatment for anxiety in Pakistan by prioritizing school-based intervention and group-based CBT intervention. TRIAL REGISTRATION: The trial has been registered at the American Economic Association's registry for randomized controlled trials. RCT ID: AEARCTR-0009551 . Registered 2022-07-04.

Chilean children's adherence to sustainable healthy diets and its associations with sociodemographic and anthropometric factors: a cross-sectional study.

PURPOSE: To describe adherence to sustainable healthy diets among a sample of 958 Chilean pre-schoolers (3-6 years) and explore associations between adherence and child and maternal sociodemographic and anthropometric characteristics. METHODS: Children's adherence to sustainable healthy diets was calculated from single multiple-pass 24-h dietary recalls using the Planetary Health Diet Index for children and adolescents (PHDI-C). Higher PHDI-C scores (max score = 150 points) represent greater adherence. Adjusted linear regression models were fitted to explore associations between PHDI-C scores and child and maternal characteristics. RESULTS: Children obtained low total PHDI-C scores (median 50.0 [IQR 39.5-59.8] points). This resulted from low consumption of nuts & peanuts, legumes, vegetables, whole cereals, and vegetable oils; a lack of balance between dark green and red & orange vegetables, inadequate consumption of tubers & potatoes and eggs & white meats, and excess consumption of dairy products, palm oil, red meats, and added sugars. Mean PHDI-C total score was significantly higher (50.6 [95%CI 49.6, 51.7] vs 47.3 [95%CI 45.0, 49.5]) among children whose mothers were ≥ 25 years compared to those with younger mothers. Positive associations were observed between scores for fruits and maternal education, vegetables and maternal age, added sugars and child weight status, while negative associations were observed between fruits and child age, and vegetable oils and maternal education. Scores for dairy products PHDI-C component were lower among girls. CONCLUSION: Adherence to sustainable healthy diets was low among this sample of Chilean children and was significantly associated with maternal age, being lower among children whose mothers were younger.

Parasitosis intestinales en niños de edad escolar en Jancao (Huánuco) Perú / Intestinal parasitosis in school-age children in Jancao (Huánuco) Peru / Parasitose intestinal em crianças em idade escolar em Jancao (Huánuco) Peru

Las infecciones parasitarias intestinales son comunes a nivel mundial, especialmente en naciones en desarrollo, y conllevan una significativa carga de morbilidad. Objetivo. Estimar la prevalencia de parasitismo intestinal en los niños y niñas en edad escolar de 6 a 12 años que residen en el centro poblado Jancao (Huánuco) Perú. Materiales y métodos. Se desarrolló mediante un estudio observacional de cohorte transversal. Se calculó una muestra con un nivel de confianza del 95%, un error estimado del 5% y una proporción esperada de enfermos de 0.2. La muestra calculada fue de 186 personas. Los criterios de inclusión considerados fueron varon o hembra, de 6 a 12 años. Resultados. Fueron positivos 27% de los indviduos muestreados. La Giardía lambia y la Tenia solium tuvieron los mayores porcentajes de prevalencia en la población estudiada 24% y 18% respectivamente, ambos porcentajes difieren significativamente con los de Entoameba histolytica y Enterobius vermicularis para p<2.2e-16. La distribución por sexos de la prevalencia de las parasitosis identíficadas no mostró diferencias significativas en ninguna de las variantes analizadas. La distribución de parasitosis intestinales según tres estratos etareos de forma general no generó diferencias significativas entre los valores observados. Conclusiones. La parasitosis de mayor prevalencia en niños entre las edades comprendidas de 6 a 7 años, 8 a 9 años, 10 a 12 años en el centro poblado Jancao de Huánuco en Perú corresponden a Giardia lambia y Tenia solium.

Intestinal parasitic infections are common worldwide, especially in developing nations, and carry a significant burden of disease. Objective. To estimate the prevalence of intestinal parasitism in school-aged children aged 6 to 12 years residing in the Jancao population center (Huánuco) Peru. Materials and methods. It was developed by means of a cross-sectional observational cohort study. A sample was calculated with a confidence level of 95%, an estimated error of 5% and an expected proportion of patients of 0.2. The calculated sample was 186 persons. The inclusion criteria considered were male or female, aged 6 to 12 years. Results. Twenty-seven percent of the sampled individuals were positive. Giardia lambia and Taenia solium had the highest prevalence percentages in the studied population 24% and 18% respectively, both percentages differed significantly with those of Entoameba histolytica and Enterobius vermicularis for p<2.2e-16. The distribution by sex of the prevalence of identeric parasitosis did not show significant differences in any of the variants analyzed. The distribution of intestinal parasitosis according to three age strata in general did not generate significant differences between the values observed. Conclusions. The most prevalent parasitosis in children between the ages of 6 to 7 years, 8 to 9 years, 10 to 12 years in the Jancao de Huánuco population center in Peru corresponds to Giardia lambia and Taenia solium.

As infecções parasitárias intestinais são comuns em todo o mundo, especialmente nos países em desenvolvimento, e representam uma carga significativa de doenças. Objetivo. Estimar a prevalência de parasitismo intestinal em crianças em idade escolar, com idades entre 6 e 12 anos, residentes no centro da aldeia de Jancao (Huánuco), Peru. Materiais e métodos. Este foi um estudo de coorte observacional transversal. Foi calculada uma amostra com um nível de confiança de 95%, um erro estimado de 5% e uma proporção esperada de doentes de 0,2. A amostra calculada foi de 186 pessoas. Os critérios de inclusão considerados foram: sexo masculino ou feminino, com idades compreendidas entre os 6 e os 12 anos. Resultados. Vinte e sete por cento dos indivíduos da amostra foram positivos. Giardia lambia e Taenia solium apresentaram as taxas de prevalência mais elevadas na população estudada, 24% e 18%, respetivamente, diferindo significativamente das taxas de Entoameba histolytica e Enterobius vermicularis, com p<2,2e-16. A distribuição por sexo da prevalência de parasitoses identéricas não apresentou diferenças significativas em nenhuma das variantes analisadas. A distribuição das parasitoses intestinais segundo os três estratos etários, em geral, não gerou diferenças significativas entre os valores observados. Conclusões. As parasitoses mais prevalentes em crianças de 6 a 7 anos, 8 a 9 anos e 10 a 12 anos no centro populacional de Jancao de Huánuco, no Peru, correspondem a Giardia lambia e Taenia solium.

Anaemia among school children of different socioeconomical status in a city of Southern Brazil.

Background: Iron deficiency is one of the leading causes of anaemia, with those most affected being children and women of childbearing age, in Brazil there is a scarcity of studies involving the local prevalence of anaemia. Aim: To evaluate anaemia and associated factors in schoolchildren in Santa Cruz do Sul through the analysis of biochemical and haematological markers and parasitological examination of faeces. Subjects and methods: School children from 10 to 12 years of age were evaluated through complete blood count, serum ferritin, C-reactive protein and stool parasitological examination, as well as socio-demographic characteristics and prophylaxis with ferrous sulphate in childhood. Results: It was found that 13.0% of the population was anaemic, girls were very slightly overrepresented among the anaemic children. Only 5.3% had altered haematocrit levels; 26.6% had low Mean Corpuscular Volume levels; 18.4% had low ferritin levels; 2.4% had increased C-reactive protein levels, and 21.7% had altered eosinophils. As for the socioeconomic level, classes A2 and D presented lower haemoglobin levels, as well as class D presenting lower ferritin levels, although without statistical significance. Only 6.0% of the population presented iron-deficiency anaemia and 46.0% of the schoolchildren had used ferrous sulphate supplementation in childhood. Conclusion: The prevalence of anaemia in the studied municipality is low, probably due to the high municipal human development index. Epidemiological studies are essential to characterise the population in a systematic form, to prevent future problems.

School-based intervention for anxiety using group cognitive behavior therapy in Pakistan: a feasibility randomized controlled trial

Abstract Background Anxiety and mood disorders are the main cause of illness in people under the age of 25, accounting for 45% of the global disease burden, whereas 4.6% of teenagers aged 15 to 19 are predicted to experience anxiety. Pakistan country, with a population of 200 million, has the worst mental health indicators and fewer than 500 psychiatrists. Despite the existence of various treatments for anxiety, this goes unrecognized and untreated. Due to a lack of awareness, evaluation, prevention, and interventional programs related to being implemented among adolescents in Pakistan, there is a rise in mental health issues in the earlier years of life. It calls for a critical need for indigenous, evidence-based interventions. The present study aimed to evaluate the feasibility of cognitive behavioral therapy (CBT)-based interventions to reduce anxiety symptoms among school children in Pakistan. Methods This study was a pre-post design, two-arm, single-blinded, feasibility, randomized controlled trial. Thirtyfour participants (experimental group, n = 17; control group, n = 17) were recruited from four semi-government schools in Rawalpindi with a mean age of 15 (M = 15, SD = 0.73). Two instruments Beck Anxiety Inventory for Youth (BAI-Y II) and BASC-3 Behavioural and Emotional Screening System Student (BESS-SF) were used to assess the severity of symptoms. Participants in the intervention arm received eight-group therapy CBT sessions. A two-way factorial analysis was used to examine the efficacy of CBT in reducing symptom severity. Results This study's findings showed that in comparison to the wait-list control group, CBT successfully improved anxiety symptoms among school children while enhancing their social skills. Conclusion This study will help improve the treatment for anxiety in Pakistan by prioritizing school-based intervention and group-based CBT intervention. Trial registration The trial has been registered at the American Economic Association's registry for randomized controlled trials. RCT ID: AEARCTR-00095 51. Registered 2022-07-04.

On-Demand ICS + FABA Combinations in 6-11-Year-Old Children.

In recent years, some new concepts have been added to asthma treatment such as "anti-inflammatory reliever" (ß2-agonist use associated to an inhaled corticosteroid (ICS) as a reliever treatment) that combines the benefits of both therapies and provides short- and long-term benefits for treatment in asthma patients. Robust evidence has been presented in patients over 12 years, and the main changes in the international guidelines for asthma treatment were originally made in this age group. However, a few suggestions have been added to treatments in younger patients, in part because of the scarce evidence that exists in this group. We aim to analyze the information regarding the utilization of ICS + fast-acting beta-agonist (FABA) combination in children between 6 and 11 years. Although up until today only three published trials exist (two studies use beclomethasone + albuterol and one study uses budesonide + formoterol), they provide significant information on the benefits of ICS + FABA use in this population.

Specialized active leprosy search strategies in an endemic area of the Brazilian Amazon identifies a hypermutated Mycobacterium leprae strain causing primary drug resistance.

Introduction: Leprosy, an infectious disease caused by Mycobacterium leprae, remains a public health concern in endemic countries, particularly in Brazil. In this study, we conducted an active surveillance campaign in the hyperendemic city of Castanhal in the northeastern part of the state of Pará using clinical signs and symptoms combined with serological and molecular tools to diagnose new cases and to identify drug resistance of circulating M. leprae strains and their distribution in the community. Methods: During an active surveillance of one week, we enrolled 318 individuals using three different strategies to enroll subjects for this study: (i) an active survey of previously treated cases from 2006 to 2016 found in the Brazil National Notifiable Disease Information System database (n = 23) and their healthy household contacts (HHC) (n = 57); (ii) an active survey of school children (SC) from two primary public schools in low-income neighborhoods (n = 178), followed by visits to the houses of these newly diagnosed SC (n = 7) to examine their HHC (n = 34) where we diagnosed additional new cases (n = 6); (iii) and those people who spontaneously presented themselves to our team or the local health center with clinical signs and/or symptoms of leprosy (n = 6) with subsequent follow-up of their HHC when the case was confirmed (n = 20) where we diagnosed two additional cases (n = 2). Individuals received a dermato-neurological examination, 5 ml of peripheral blood was collected to assess the anti-PGL-I titer by ELISA and intradermal earlobe skin scrapings were taken from HHC and cases for amplification of the M. leprae RLEP region by qPCR. Results: Anti-PGL-I positivity was highest in the new leprosy case group (52%) followed by the treated group (40.9%), HHC (40%) and lowest in SC (24.6%). RLEP qPCR from SSS was performed on 124 individuals, 22 in treated cases, 24 in newly diagnosed leprosy cases, and 78 in HHC. We detected 29.0% (36/124) positivity overall in this sample set. The positivity in treated cases was 31.8% (7/22), while in newly diagnosed leprosy cases the number of positives were higher, 45.8% (11/23) and lower in HHC at 23.7% (18/76). Whole genome sequencing of M. leprae from biopsies of three infected individuals from one extended family revealed a hypermutated M. leprae strain in an unusual case of primary drug resistance while the other two strains were drug sensitive. Discussion: This study represents the extent of leprosy in an active surveillance campaign during a single week in the city of Castanhal, a city that we have previously surveyed several times during the past ten years. Our results indicate the continuing high transmission of leprosy that includes fairly high rates of new cases detected in children indicating recent spread by multiple foci of infection in the community. An unusual case of a hypermutated M. leprae strain in a case of primary drug resistance was discovered. It also revealed a high hidden prevalence of overt disease and subclinical infection that remains a challenge for correct clinical diagnosis by signs and symptoms that may be aided using adjunct laboratory tests, such as RLEP qPCR and anti-PGL-I serology.

Correlation of body mass index and waist to height ratio with cardiovascular risk factors in Colombian preschool and school children.

Objective: To analyze the agreement between body mass index (BMI) and waist-to-height Ratio (WHtR) to identify preschool and school children with cardiovascular risk factors (CRFs). Methods: Three-hundred-twenty-one kids were divided into preschool (3-5 years) and school children (6-10 years). BMI was used to classify children as overweight or obese. Abdominal obesity was defined with a WHtR ≥0.50. Fasting blood lipids, glucose and insulin were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The presence of CRFs and multiple non-waist circumference (non-WC) metabolic syndrome factors (MetS-Factors) [high HOMA-IR, high triglycerides and low high-density lipoprotein cholesterol (HDL-C)] were analyzed. Results: One-hundred-twelve preschool and 209 school children were evaluated. WHtR ≥0.50 classified abdominal obesity in more than half of the preschool children, exceeding those classified with overweight+obesity by BMI (59.5% vs. 9.8%; p<0.001). There was no agreement between WHtR and BMI to identify preschool kids with CRFs and multiple non-WC MetS-Factors (kappa: 0.0 to 0.23, p>0.05). There were similar proportions of school children classified with abdominal obesity by the WHtR and overweight+obesity by the BMI (18.7% vs. 24.9%; p>0.05). There was substantial agreement between WHtR and BMI to identify school children with high total cholesterol values, low-density lipoprotein cholesterol (LDL-C), triglycerides, non-HDL-C, insulin, HOMA-IR, low HDL-C values, and the presence of multiple non-WC MetS-Factors (kappa: 0.616 to 0.857, p<0.001). Conclusion: In preschool children WHtR ≥0.5 disagree with BMI results, but in school kids, it has good agreement with the BMI to classify the children´s nutritional status and to identify those with CRFs.

Objetivo: Analizar el grado de acuerdo entre el índice de masa corporal (IMC) y la relación/cintura estatura (rCE) para identificar niños con factores de riesgo cardiovascular (FRC). Métodos: Estudio transversal analítico con 112 niños preescolares (3-5 años) y 209 escolares (6-10 años). El sobrepeso y la obesidad se clasificaron con el IMC y la obesidad abdominal con la rCE ≥0.50. Se tomaron muestras sanguíneas en ayuno para análisis de glucosa, insulina, lípidos y cálculo del índice HOMA-IR. Se analizó la presencia de FRC y de múltiples factores del síndrome metabólico (Factores-SinMet) diferentes a la cintura [HOMA-IR elevado, triglicéridos elevados y colesterol de alta densidad (HDL-C) bajo]. Resultados: rCE ≥0.50 clasificó con obesidad abdominal a más de la mitad de los niños preescolares, excediendo el número de niños clasificados con sobrepeso+obesidad por IMC (59.5% vs 9.8%; p<0.001). No hubo acuerdo entre el IMC y la rCE para identificar niños preescolares con FRC o múltiples Factores-SinMet diferentes a la cintura (kappa: 0.0 a 0.23, p>0.05). Fueron similares las proporciones de niños escolares clasificados con obesidad abdominal por la rCE o con sobrepeso+obesidad por el IMC (18.7% vs. 24.9%; p>0.05). Hubo acuerdo sustancial entre la rCE y el IMC para identificar niños escolares con valores elevados de colesterol total, colesterol de baja densidad, triglicéridos, colesterol no-HDL, insulina, HOMA-IR, valores bajos de HDL-C y la presencia de múltiples Factores-SinMet diferentes a la cintura (kappa: 0.616 a 0.857, p<0.001). Conclusión: En niños preescolares la aplicación de rCE ≥0.5 no presenta acuerdo con el IMC, pero en escolares presenta un acuerdo sustancial con el IMC en la clasificación del estado nutricional y en la identificación de niños con FRC.

Dietary patterns and cognitive achievement among school children in socio-cultural context, a case of Montevideo, Uruguay.

PURPOSE: The benefits of a healthy diet on children´s cognition have been described in several studies. However, many previous studies have analyzed the effect on general cognitive domains (e.g. intelligence), used measures based almost exclusively on local examinations, and rarely consider social context. OBJECTIVE: The objective of the present study was to examine the relationship between two diet patterns and contextualized cognitive performance measures of children aged 6-8 years from low-average income neighborhoods in Montevideo, Uruguay. METHODS: 270 first-grade children with complete data participated in the study. Consumption of foods was determined via two averaged 24-h dietary recalls with the mother. Two dietary patterns were identified via principal component analysis: "processed (high calorie) foods" and "nutrient dense". Children´s cognitive performance, including general cognitive abilities, achievement in mathematics and reading, and discrepancy scores between predicted and actual achievement was assessed with the Woodcock-Muñoz Cognitive and Achievement scales. The association of dietary patterns and cognitive endpoints was analyzed in multilevel models, clustered by children´s school. Sociodemographic and biological variables were used as covariates. RESULTS: The nutrient dense foods pattern, characterized by higher consumption of dark leafy and red-orange vegetables, eggs, beans & peas, potatoes, was associated with better performance in reading, with beta coefficient 3.28 (95% CI 0.02, 6.54). There was also an association between the nutrient dense foods factor and the Discrepancy in reading, 2.52 (0.17, 4.87). Processed (high calorie) foods pattern, characterized by higher consumption of breads, processed meats, fats and oils, sweetened beverages, and sweetened yogurt/dairy products; reduced intake of milk, pastries and pizza dinners was not associated with cognitive performance. CONCLUSIONS: Nutrient dense food pattern was positively associated with children's reading achievement. A nutrient-rich diet may benefit written language acquisition at the beginning of schooling.

Milk beverages can reduce nutrient inadequacy among Brazilian pre-school children: a dietary modelling study.

BACKGROUND: Previous studies found high prevalence of inadequate intakes of vitamins E, D and K, calcium and potassium among Brazilian pre-school children, with suboptimal consumption of dairy products. Dietary modelling was applied to determine the theoretical impact of improving dairy products consumption on nutrient adequacy in 4-5-year-old Brazilian children. METHODS: Adherence to the dairy recommendation of two servings/day was calculated using data from the Brazil Kids Nutrition and Health Study (KNHS) (n = 228). Two modelling scenarios were applied to test the impact on nutrient intakes of (1) adding one or two servings of a frequently consumed cow's milk or a widely available fortified alternative: pre-school children milk (PCM), and of (2) substituting the current milk consumed by PCM. Mean nutrient intakes and percentage of children adhering to the nutrient recommendations were determined at baseline and after applying modelling scenarios. RESULTS: Seventy-six percent (n = 174) of children did not meet the recommended daily two servings of dairy products, 56% had less than one serving of dairy products on the day of recall. The mean consumption of whole milk (fortified and unfortified) was 147 g/d, yoghurt 114 g/d and cheese 34 g/d. The addition of one serving of cow's milk demonstrated a 17% reduction in calcium inadequacy, 18% reduction in vitamin A and 3% reduction in zinc inadequacy. Adding one serving of PCM further reduced calcium inadequacy from 87 to 41%, vitamin E from 81 to 37%, and zinc inadequacy by 10%. Replacing the child's current milk with a PCM resulted in further reduction of micronutrient inadequacies, including calcium, vitamin D and vitamin E. CONCLUSIONS: Dairy products consumption in pre-school children should be encouraged to reduce nutrient inadequacies. In particular, consumption of PCM would help to reduce calcium, vitamin D and vitamin E inadequacy, nutrients of concern in this population.

Neuropsychological Alterations in Patients with Congenital Hypothyroidism Treated with Levothyroxine: Linked Factors and Thyroid Hormone Hyposensitivity.

Eighty-five percent of the studies of patients with congenital hypothyroidism (CH) treated with Levothyroxine (L-T4) report neuropsychological sequelae throughout life. In neonates and infants, there is a deficit in sensorimotor skills (impaired balance). In preschool and elementary school children and adolescents, there are alterations in intellectual quotient (low scores), language (delayed phonological acquisition), memory (visual, verbal, visuospatial, visuoconstructive, autobiographical, and semantic), sensorimotor skills (impaired fine and gross motor control), and visuoconstructive-visuospatial domain (low scores in spatial location, block design, and object assembly). These neuropsychological domains are also affected in young adults, except for language (adequate verbal fluency) and visuoconstructive-visuospatial domain (no data). The onset and severity of neuropsychological sequelae in patients with treated CH depend on several factors: extrinsic, related to L-T4 treatment and social aspects, and intrinsic, such as severity and etiology of CH, as well as structural and physiological changes in the brain. In this review, we hypothesized that thyroid hormone hyposensitivity (THH) could also contribute to neuropsychological alterations by reducing the effectiveness of L-T4 treatment in the brain. Thus, further research could approach the THH hypothesis at basic and clinical levels to implement new endocrinological and neuropsychological therapies for CH patients.

Hábitos alimentarios, calidad nutricional y concentraciones de hierro sérico en escolares con y sin anemia / Dietary habits, nutritional quality and serum iron concentrations in school children with and without anemia / Hábitos alimentares, qualidade nutricional e concentrações de ferro sérico em crianças anêmicas e não anêmicas em idade escolar

El inicio de buenos hábitos alimenticios en el aspecto nutricional contribuye en el desarrollo del niño escolar, evitando con ello, la anemia la cual se estima que posee un impacto a nivel mundial de 600 millones de niños que padecen de esta enfermedad según datos registrados por la Organización Mundial de la Salud. Con este estudio se busca demostrar los hábitos alimenticios, calidad nutricional y concentración de hierro sérico en estudiantes con anemia por deficiencia de hierro en el Cantón Jipijapa en Ecuador. La metodología empleada en el análisis del estudio fue de tipo descriptiva observacional, de corte transversal. Para ello, se aplicó un muestreo no probabilístico voluntario, se contó con la participación de 63 escolares del Cantón con previa autorización. Entre los resultados se encontraron que en los 63 escolares predomina el consumo diario (76,4%) en los hábitos alimenticios, mientras tanto que en la calidad nutricional se observó poco saludable (24 y 37 ME) en ciertos alimentos necesarios para el consumo estudiantiles en los rangos establecido, en la anemia se obtuvo un resultado de (10,2%) de escolares con anemia, mientras que para la deficiencia de hierro el (11,1%) de los niños. Se concluye que en los escolares es prevalente los malos hábitos alimenticios, sin embargo, hay casos en los que escolares muestran anemia con deficiencia de hierro y escolares sin anemia con déficit del mismo lo que es elemental las practicas alimenticia tanto en los hábitos como en la calidad nutricional.

The initiation of good nutritional eating habits contributes to the development of school children, thus avoiding anemia, which is estimated to have a worldwide impact of 600 million children suffering from this disease according to data recorded by the World Health Organization. This study seeks to demonstrate the dietary habits, nutritional quality and serum iron concentration in students with iron deficiency anemia in the Jipijapa Canton in Ecuador. The methodology used in the analysis of the study was descriptive observational, cross-sectional. For this purpose, a voluntary non-probabilistic sampling was applied, with the participation of 63 schoolchildren from the Canton with previous authorization. Among the results, it was found that in the 63 schoolchildren there was a predominance of daily consumption (76.4%) in eating habits, while in nutritional quality, unhealthy was observed (24 and 37 ME) in certain foods necessary for student consumption in the established ranges, in anemia a result of (10.2%) of schoolchildren with anemia was obtained, while for iron deficiency (11.1%) of the children. It is concluded that bad eating habits are prevalent in schoolchildren, however, there are cases in which schoolchildren show anemia with iron deficiency and schoolchildren without anemia with iron deficiency, which is elementary in the nutritional habits as well as in the nutritional quality.

O início de bons hábitos alimentares no aspecto nutricional contribui para o desenvolvimento das crianças em idade escolar, evitando assim a anemia, que se estima ter um impacto mundial de 600 milhões de crianças que sofrem desta doença, segundo dados registrados pela Organização Mundial da Saúde. Este estudo procura demonstrar os hábitos alimentares, qualidade nutricional e concentração sérica de ferro em estudantes com anemia ferropriva no Cantão de Jipijapa, no Equador. A metodologia utilizada na análise do estudo foi descritiva, observacional e transversal. Para este fim, foi aplicada uma amostragem voluntária não-probabilística, com a participação de 63 crianças escolares do cantão com autorização prévia. Entre os resultados, verificou-se que nas 63 crianças em idade escolar havia uma predominância do consumo diário (76,4%) nos hábitos alimentares, enquanto que na qualidade nutricional, observou-se uma deficiência alimentar pouco saudável (24 e 37 EM) em certos alimentos necessários para o consumo dos alunos nas faixas estabelecidas, na anemia foi obtido um resultado de (10,2%) das crianças em idade escolar com anemia, enquanto que na deficiência de ferro (11,1%) das crianças foram encontradas deficiências. Conclui-se que os maus hábitos alimentares são predominantes em crianças em idade escolar, porém, há casos em que as crianças em idade escolar apresentam anemia com deficiência de ferro e crianças em idade escolar sem anemia com deficiência de ferro, razão pela qual é essencial melhorar as práticas alimentares tanto em termos de hábitos alimentares quanto de qualidade nutricional.

Patterns of Attention and Anxiety in Predicting Arithmetic Fluency among School-Aged Children.

Although the interaction between anxiety and attention is considered crucial for learning and performance in mathematics, few studies have examined these cognitive and affective predictors in a single framework or explored the role of sustained attention in promoting children's arithmetic performance, using traditional linear analyses and latent profile analysis (LPA). In this paper, state anxieties (in a math test and in an attention test situation), general anxiety traits, sustained attention (performance-based test and attention deficit/hyperactivity disorder (ADHD) self-ratings) and math achievement of 403 fourth and fifth graders (55.8% girls) were assessed. A negative correlation between state anxiety prior to the math test and arithmetic achievements was identified, even when controlling for other non-math related state anxieties and general anxiety. Sustained attention was a strong predictor of arithmetic achievement and functioned as a moderator in the anxiety-performance link. LPA identified six distinct profiles that revealed a complex relationship with arithmetic fluency. The weakest achievement was found for a specific math anxiety subgroup. The findings highlight the important role of the interaction of anxiety and sustained attention in children's ability to perform math and enable new conclusions about the specific nature of math anxiety. Implications for future research are discussed.

Monounsaturated Fat Intake Was Associated with Lower Abdominal Obesity but Poor Dietary Quality Remains in Elementary School Children from Northwest Mexico.

Overweight and obesity in Mexican elementary school children increased ten percentage points in the last 30 years; one of the factors attributed is inadequate dietary quality. The objective of this study was to evaluate the association of monounsaturated fat intake with abdominal obesity and nutrient intake and obesity and overweight with dietary quality of elementary school children from Northwest Mexico. A cross-sectional study was conducted with 218 first grade elementary school children. A socioeconomic survey and two nonconsecutive 24-HR were applied, and anthropometric measurements were taken. Dietary quality was evaluated and classified as: healthy, medium and poor. Children consumed fewer servings of fruits, vegetables, legumes, dairy products and water than recommended by the Mexican food guidelines. A negative association was found among monounsaturated fat intake and abdominal obesity (p = .032). Only 1.4% of the children presented healthy dietary quality, 44.5% showed a medium dietary quality, and 54.1% had poor dietary quality. Poor dietary quality was associated with a lower intake of fiber (p = .002), protein (p = .002), potassium (p = .001) and vitamin E (p = .002). Elementary school children from Northwest Mexico have inadequate dietary quality that compromises their nutritional and health status, while monounsaturated fat intake could be a protective factor for abdominal obesity.

A latent profile analysis of math anxiety and core beliefs toward mathematics among children.

Recent findings on the negative impacts of math anxiety (MA) have raised questions for educational and clinical research regarding effective intervention programs. One basic approach for developing intervention programs in the field of cognitive behavioral therapy is to gain an in-depth understanding of the cognitive beliefs of children with a specific mental problem. By applying latent profile analysis (LPA), the present study aimed at identifying different patterns of MA and providing further insights into its cognitive phenomenology. For this purpose, trait-MA, state-MA, attitudes toward math, academic self-concepts, fixed/growth mindsets, executive functions, and math performance of 475 fourth and fifth graders (48.2% girls) were assessed. LPA indicated seven distinct profiles characterized by different dimensions and patterns of state-MA, trait-MA, and core beliefs toward math. Furthermore, the profiles showed clearly different math performances. The weakest performances were found for a profile with highest state-MA, high trait-MA, and negative cognitive beliefs toward math and a profile with average state-MA, high trait-MA, and negative cognitive beliefs toward math, whereas the highest achieving profile had no state-MA, high trait-MA, and very positive cognitive beliefs toward math. The findings underline the complexity of MA and emphasize the necessity to develop interventions with careful consideration of the heterogeneous patterns.

Prevalence of cestodes infection among school children of urban parts of Lower Dir district, Pakistan / Prevalência de infecção de cestóides entre crianças em idade escolar de partes urbanas do distrito de Lower Dir, Paquistão

Tapeworms of zoonotic importance have been described as a leading public health problem. Current research was aim to assess the prevalence of tapeworms among 5-12years school children residing in district Lower Dir, Pakistan from January 2019-December 2019. The wet mount preparation in saline/iodine/methods were used for stool examination. Data was analyzed using appropriate descriptive, static methods. Of the 400 children studied 71.7% were infected with one or more species of intestinal parasites. Single infection of cestode species was found in 69 individuals with 17.2% prevalence and multiple parasitic infections were identified in 19.7% (n=79/400) individuals. The multiple infection were comprised as 10% (n=40) double, 6.75% (n=27) triple and 3% (n=12) quadruple. A total of 9 species of helminths and one species of protozoan infection. Among the helminths Ascaris lumbricoides was the most prevalent 33.1% (n=95), Taenia saginata 22.6% (n=65), hookworm 19.8% (n=57), Hymenolepis nana 18.8% (n=54), Enterobius vermicularis and Hymenolepis diminuta 1.39% (n=4each), Trichuris trichura 1.04% (n=3), Toxocara spp 0.69% (n=2) and Schistosoma japonicum 0.34% (n=1) were reported. One protozoan species was Cryptosporidium spp 0.69% (n=2) in current study. In case of A.lumbricoides, hookworm, E.vermicularis, T.trichura, T.saginata, H.nana and H.diminuta the male children of below 8 years of age were highly infected. Other infections are reported in the same prevalence with slight difference if any. We conclude that there is a need for mass scale campaigns to create awareness regarding health and hygiene in children and the need for development of effective poverty control programs because deworming alone is not adequate to control parasitic infections.

As tênias de importância zoonótica têm sido descritas como um dos principais problemas de saúde pública. A pesquisa atual teve como objetivo avaliar a prevalência de tênias entre crianças em idade escolar de 5 a 12 anos que residem no distrito de Lower Dir, Paquistão, de janeiro de 2019 a dezembro de 2019. Os métodos de preparação para montagem úmida em solução salina/iodo foram usados para exame de fezes. Os dados foram analisados usando métodos descritivos e estáticos apropriados. Das 400 crianças estudadas, 71,7% estavam infectadas com uma ou mais espécies de parasitas intestinais. Infecção única de espécies de cestóides foi encontrada em 69 indivíduos com prevalência de 17,2% e infecções parasitárias múltiplas foram identificadas em 19,7% (n = 79/400) indivíduos. As infecções múltiplas foram compostas por 10% (n = 40) dupla, 6,75% (n = 27) tripla e 3% (n = 12) quádrupla. Um total de 9 espécies de helmintos e uma espécie de infecção por protozoários. Entre os helmintos, Ascaris lumbricoides foi o mais prevalente 33,1% (n = 95), Taenia saginata 22,6% (n = 65), ancilóstomo 19,8% (n = 57), Hymenolepis nana 18,8% (n = 54), Enterobius vermicularis e Hymenolepis diminuta 1,39% (n = 4cada), Trichuris trichura 1,04% (n = 3), Toxocara spp 0,69% (n = 2) e Schistosoma japonicum 0,34% (n = 1). Uma espécie de protozoário foi Cryptosporidium spp 0,69% (n = 2) no estudo atual. No caso de A.lumbricoides, ancilostomíase, E.vermicularis, T.trichura, T.saginata, H.nana e H.diminuta, as crianças do sexo masculino com menos de 8 anos de idade estavam altamente infectadas. Outras infecções são relatadas na mesma prevalência, com ligeira diferença, se houver. Concluímos que há uma necessidade de campanhas em massa para criar consciência sobre saúde e higiene em crianças e a necessidade de desenvolvimento de programas eficazes de controle da pobreza, porque a desparasitação por si só não é adequada para controlar infecções parasitárias.

Prevalence of intestinal parasitic diseases in school children of rural areas of district Lower Dir, Pakistan / Prevalência de doenças parasitárias intestinais em escolares de áreas rurais do distrito de Lower Dir, Paquistão

Present study was conducted among school children to recognize the prevalence of IPIs in rural communities of district Dir Lower, Pakistan. A sum of 324 samples of stool were collected (210 boys and 114 girls). Used direct smear method and formol ether sedimentation concentration technique for processing the samples. The result shows that 82% (n=266) were found infected comprised 64.8% male and 35.1% females. Children of the age group 10 to 12 years were found extremely infected 94.2% while 4-6 year age group were having minimum ratio of infection 72%. Current study shows mono parasitism in 50.6% of the students while 22.2% were infected with 2 species and 7.40% were infected with three species of parasites. Seven species of intestinal parasites were reported include Ascaris lumbricoid in male (n=122) 58.0% and in female (n=65) 57.0% followed by Hook worm (n=88) 41.9% and (n=44) 38.5%; Tania saginata (n=44) 20.9% and (n=24) 21.0%; Entrobius vermicularis (n=32) 15.2% and (n=16) 14.0%; Trichuris trichura (n=25) 11.9% and (n=22) 19.2%; Hymenolepis nana (n=24) 11.4% and (n=18) 15.7% and Entameoba histolytica (n=16) 7.61% and (n=14) 12.2% in male and females respectively. The study indicates that most occurring intestinal parasite in the current study were Ascaris lumbricoides 58.0% (n=122) followed by hookworms 41.9% (n=88). Male students were more infected than females in the present study.

O presente estudo foi conduzido entre crianças em idade escolar para reconhecer a prevalência de IPIs em comunidades rurais do distrito de Dir Lower, Paquistão. Foram coletadas 324 amostras de fezes (210 meninos e 114 meninas). Método de esfregaço direto usado e técnica de concentração de sedimentação de formol éter para processar as amostras. O resultado mostra que 82% (n = 266) dos infectados eram 64,8% do sexo masculino e 35,1% do feminino. Crianças da faixa etária de 10 a 12 anos foram encontradas extremamente infectadas 94,2%, enquanto a faixa etária de 4 a 6 anos apresentava proporção mínima de infecção de 72%. O estudo atual mostra monoparasitismo em 50,6% dos alunos, enquanto 22,2% estavam infectados com 2 espécies e 7,40% estavam infectados com três espécies de parasitas. Sete espécies de parasitas intestinais foram relatadas incluindo Ascaris lumbricoid em machos (n = 122) 58,0% e em fêmeas (n = 65) 57,0% seguido por anzol (n = 88) 41,9% e (n = 44) 38,5%; Tania saginata (n = 44) 20,9% e (n = 24) 21,0%; Entrobius vermicularis (n = 32) 15,2% e (n = 16) 14,0%; Trichuris trichura (n = 25) 11,9% e (n = 22) 19,2%; Hymenolepis nana (n = 24) 11,4% e (n = 18) 15,7% e Entameoba histolytica (n = 16) 7,61% e (n = 14) 12,2% em homens e mulheres, respectivamente. O estudo indica que os parasitas intestinais que mais ocorreram no presente estudo foram Ascaris lumbricoides 58,0% (n = 122), seguidos por ancilóstomos 41,9% (n = 88). Estudantes do sexo masculino foram mais infectados do que do sexo feminino no presente estudo.

Prevalence of intestinal parasitic diseases in school children of rural areas of district Lower Dir, Pakistan / Prevalência de doenças parasitárias intestinais em escolares de áreas rurais do distrito de Lower Dir, Paquistão

Present study was conducted among school children to recognize the prevalence of IPIs in rural communities of district Dir Lower, Pakistan. A sum of 324 samples of stool were collected (210 boys and 114 girls). Used direct smear method and formol ether sedimentation concentration technique for processing the samples. The result shows that 82% (n=266) were found infected comprised 64.8% male and 35.1% females. Children of the age group 10 to 12 years were found extremely infected 94.2% while 4-6 year age group were having minimum ratio of infection 72%. Current study shows mono parasitism in 50.6% of the students while 22.2% were infected with 2 species and 7.40% were infected with three species of parasites. Seven species of intestinal parasites were reported include Ascaris lumbricoid in male (n=122) 58.0% and in female (n=65) 57.0% followed by Hook worm (n=88) 41.9% and (n=44) 38.5%; Tania saginata (n=44) 20.9% and (n=24) 21.0%; Entrobius vermicularis (n=32) 15.2% and (n=16) 14.0%; Trichuris trichura (n=25) 11.9% and (n=22) 19.2%; Hymenolepis nana (n=24) 11.4% and (n=18) 15.7% and Entameoba histolytica (n=16) 7.61% and (n=14) 12.2% in male and females respectively. The study indicates that most occurring intestinal parasite in the current study were Ascaris lumbricoides 58.0% (n=122) followed by hookworms 41.9% (n=88). Male students were more infected than females in the present study.(AU)

O presente estudo foi conduzido entre crianças em idade escolar para reconhecer a prevalência de IPIs em comunidades rurais do distrito de Dir Lower, Paquistão. Foram coletadas 324 amostras de fezes (210 meninos e 114 meninas). Método de esfregaço direto usado e técnica de concentração de sedimentação de formol éter para processar as amostras. O resultado mostra que 82% (n = 266) dos infectados eram 64,8% do sexo masculino e 35,1% do feminino. Crianças da faixa etária de 10 a 12 anos foram encontradas extremamente infectadas 94,2%, enquanto a faixa etária de 4 a 6 anos apresentava proporção mínima de infecção de 72%. O estudo atual mostra monoparasitismo em 50,6% dos alunos, enquanto 22,2% estavam infectados com 2 espécies e 7,40% estavam infectados com três espécies de parasitas. Sete espécies de parasitas intestinais foram relatadas incluindo Ascaris lumbricoid em machos (n = 122) 58,0% e em fêmeas (n = 65) 57,0% seguido por anzol (n = 88) 41,9% e (n = 44) 38,5%; Tania saginata (n = 44) 20,9% e (n = 24) 21,0%; Entrobius vermicularis (n = 32) 15,2% e (n = 16) 14,0%; Trichuris trichura (n = 25) 11,9% e (n = 22) 19,2%; Hymenolepis nana (n = 24) 11,4% e (n = 18) 15,7% e Entameoba histolytica (n = 16) 7,61% e (n = 14) 12,2% em homens e mulheres, respectivamente. O estudo indica que os parasitas intestinais que mais ocorreram no presente estudo foram Ascaris lumbricoides 58,0% (n = 122), seguidos por ancilóstomos 41,9% (n = 88). Estudantes do sexo masculino foram mais infectados do que do sexo feminino no presente estudo.(AU)

Prevalence of cestodes infection among school children of urban parts of Lower Dir district, Pakistan / Prevalência de infecção de cestóides entre crianças em idade escolar de partes urbanas do distrito de Lower Dir, Paquistão

Tapeworms of zoonotic importance have been described as a leading public health problem. Current research was aim to assess the prevalence of tapeworms among 5-12years school children residing in district Lower Dir, Pakistan from January 2019-December 2019. The wet mount preparation in saline/iodine/methods were used for stool examination. Data was analyzed using appropriate descriptive, static methods. Of the 400 children studied 71.7% were infected with one or more species of intestinal parasites. Single infection of cestode species was found in 69 individuals with 17.2% prevalence and multiple parasitic infections were identified in 19.7% (n=79/400) individuals. The multiple infection were comprised as 10% (n=40) double, 6.75% (n=27) triple and 3% (n=12) quadruple. A total of 9 species of helminths and one species of protozoan infection. Among the helminths Ascaris lumbricoides was the most prevalent 33.1% (n=95), Taenia saginata 22.6% (n=65), hookworm 19.8% (n=57), Hymenolepis nana 18.8% (n=54), Enterobius vermicularis and Hymenolepis diminuta 1.39% (n=4each), Trichuris trichura 1.04% (n=3), Toxocara spp 0.69% (n=2) and Schistosoma japonicum 0.34% (n=1) were reported. One protozoan species was Cryptosporidium spp 0.69% (n=2) in current study. In case of A.lumbricoides, hookworm, E.vermicularis, T.trichura, T.saginata, H.nana and H.diminuta the male children of below 8 years of age were highly infected. Other infections are reported in the same prevalence with slight difference if any. We conclude that there is a need for mass scale campaigns to create awareness regarding health and hygiene in children and the need for development of effective poverty control programs because deworming alone is not adequate to control parasitic infections.(AU)

As tênias de importância zoonótica têm sido descritas como um dos principais problemas de saúde pública. A pesquisa atual teve como objetivo avaliar a prevalência de tênias entre crianças em idade escolar de 5 a 12 anos que residem no distrito de Lower Dir, Paquistão, de janeiro de 2019 a dezembro de 2019. Os métodos de preparação para montagem úmida em solução salina/iodo foram usados para exame de fezes. Os dados foram analisados usando métodos descritivos e estáticos apropriados. Das 400 crianças estudadas, 71,7% estavam infectadas com uma ou mais espécies de parasitas intestinais. Infecção única de espécies de cestóides foi encontrada em 69 indivíduos com prevalência de 17,2% e infecções parasitárias múltiplas foram identificadas em 19,7% (n = 79/400) indivíduos. As infecções múltiplas foram compostas por 10% (n = 40) dupla, 6,75% (n = 27) tripla e 3% (n = 12) quádrupla. Um total de 9 espécies de helmintos e uma espécie de infecção por protozoários. Entre os helmintos, Ascaris lumbricoides foi o mais prevalente 33,1% (n = 95), Taenia saginata 22,6% (n = 65), ancilóstomo 19,8% (n = 57), Hymenolepis nana 18,8% (n = 54), Enterobius vermicularis e Hymenolepis diminuta 1,39% (n = 4cada), Trichuris trichura 1,04% (n = 3), Toxocara spp 0,69% (n = 2) e Schistosoma japonicum 0,34% (n = 1). Uma espécie de protozoário foi Cryptosporidium spp 0,69% (n = 2) no estudo atual. No caso de A. lumbricoides, ancilostomíase, E. vermicularis, T. trichura, T. saginata, H. nana e H. diminuta, as crianças do sexo masculino com menos de 8 anos de idade estavam altamente infectadas. Outras infecções são relatadas na mesma prevalência, com ligeira diferença, se houver. Concluímos que há uma necessidade de campanhas em massa para criar consciência sobre saúde e higiene em crianças e a necessidade de desenvolvimento de programas eficazes de controle da pobreza, porque a desparasitação por si só não é adequada para controlar infecções parasitárias.(AU)

Prevalence of intestinal parasitic diseases in school children of rural areas of district Lower Dir, Pakistan / Prevalência de doenças parasitárias intestinais em escolares de áreas rurais do distrito de Lower Dir, Paquistão

Present study was conducted among school children to recognize the prevalence of IPIs in rural communities of district Dir Lower, Pakistan. A sum of 324 samples of stool were collected (210 boys and 114 girls). Used direct smear method and formol ether sedimentation concentration technique for processing the samples. The result shows that 82% (n=266) were found infected comprised 64.8% male and 35.1% females. Children of the age group 10 to 12 years were found extremely infected 94.2% while 4-6 year age group were having minimum ratio of infection 72%. Current study shows mono parasitism in 50.6% of the students while 22.2% were infected with 2 species and 7.40% were infected with three species of parasites. Seven species of intestinal parasites were reported include Ascaris lumbricoid in male (n=122) 58.0% and in female (n=65) 57.0% followed by Hook worm (n=88) 41.9% and (n=44) 38.5%; Tania saginata (n=44) 20.9% and (n=24) 21.0%; Entrobius vermicularis (n=32) 15.2% and (n=16) 14.0%; Trichuris trichura (n=25) 11.9% and (n=22) 19.2%; Hymenolepis nana (n=24) 11.4% and (n=18) 15.7% and Entameoba histolytica (n=16) 7.61% and (n=14) 12.2% in male and females respectively. The study indicates that most occurring intestinal parasite in the current study were Ascaris lumbricoides 58.0% (n=122) followed by hookworms 41.9% (n=88). Male students were more infected than females in the present study.

O presente estudo foi conduzido entre crianças em idade escolar para reconhecer a prevalência de IPIs em comunidades rurais do distrito de Dir Lower, Paquistão. Foram coletadas 324 amostras de fezes (210 meninos e 114 meninas). Método de esfregaço direto usado e técnica de concentração de sedimentação de formol éter para processar as amostras. O resultado mostra que 82% (n = 266) dos infectados eram 64,8% do sexo masculino e 35,1% do feminino. Crianças da faixa etária de 10 a 12 anos foram encontradas extremamente infectadas 94,2%, enquanto a faixa etária de 4 a 6 anos apresentava proporção mínima de infecção de 72%. O estudo atual mostra monoparasitismo em 50,6% dos alunos, enquanto 22,2% estavam infectados com 2 espécies e 7,40% estavam infectados com três espécies de parasitas. Sete espécies de parasitas intestinais foram relatadas incluindo Ascaris lumbricoid em machos (n = 122) 58,0% e em fêmeas (n = 65) 57,0% seguido por anzol (n = 88) 41,9% e (n = 44) 38,5%; Tania saginata (n = 44) 20,9% e (n = 24) 21,0%; Entrobius vermicularis (n = 32) 15,2% e (n = 16) 14,0%; Trichuris trichura (n = 25) 11,9% e (n = 22) 19,2%; Hymenolepis nana (n = 24) 11,4% e (n = 18) 15,7% e Entameoba histolytica (n = 16) 7,61% e (n = 14) 12,2% em homens e mulheres, respectivamente. O estudo indica que os parasitas intestinais que mais ocorreram no presente estudo foram Ascaris lumbricoides 58,0% (n = 122), seguidos por ancilóstomos 41,9% (n = 88). Estudantes do sexo masculino foram mais infectados do que do sexo feminino no presente estudo.