Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 52.346
Filtrar
1.
Codas ; 33(2): e20190128, 2021.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-33978101

RESUMEN

PURPOSE: To identify the factors associated with the cognitive development of children from 24 to 42 months of age, as well as to characterize the availability of toys and resources present in the family environment, and the parental practices that signal family stability. METHODS: Cross-sectional analytical study conducted with children regularly enrolled in public and private educational institutions of a medium-sized city. Cognitive development was assessed by means of the Bayley test and the quality of the environment was evaluated using the Adapted Family Environment Resource Inventory (FERI). The children were allocated into two groups based on the cognitive test result and compared regarding activities performed at home; reports of outings and trips in the last year; presence of regular scheduled activities; activities developed with parents; toys the child has or has had; presence of newspapers, magazines, and books at home; the person responsible for monitoring the child during day-care; and routines of the child and family. RESULTS: Of the 104 children evaluated, 72% were enrolled in the public education network and 69% belonged to economic classes C and D. Regarding cognitive development, 55% had above-average development. In the bivariate analysis, it was observed that greater availability of toys and materials for the child and higher economic levels were related to better scores on the cognitive development test. These remained as predictors of cognitive development in binary logistic regression analysis. CONCLUSION: Greater availability of resources in the family environment and economic levels were positively associated with cognitive development in children.


Asunto(s)
Desarrollo Infantil , Medicina Familiar y Comunitaria , Niño , Cognición , Estudios Transversales , Familia , Humanos
2.
BMC Res Notes ; 14(1): 141, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33863380

RESUMEN

OBJECTIVE: Although children from language backgrounds other than English (LBOTE) may be disadvantaged in English-reliant exams, they outperform children from an English language background (ELB) on many Australian National Assessment Program-Literacy and Numeracy (NAPLAN) assessments. Maternal alcohol and tobacco use during pregnancy and/or breastfeeding have been associated with poorer cognitive and academic performance. Using data from the Growing Up in Australia Study, this paper aimed to identify demographic, lifestyle, and prenatal and perinatal risk differences related to maternal tobacco and alcohol use between LBOTE and ELB groups, as a first step in trying to understand the academic performance differences. RESULTS: Only data from breastfed babies was included in the current analyses. Although LBOTE children were disadvantaged in several demographic areas, their NAPLAN performance was the same or superior to ELB children across all Grade 3 and 5 NAPLAN assessments. The LBOTE group were, however, breastfed for longer, and their mothers smoked fewer cigarettes and drank less alcohol on fewer occasions throughout their pregnancy. The LBOTE mothers also had lower or less risky patterns of alcohol consumption while breastfeeding. The longer breastfeeding duration of LBOTE children combined with lower maternal use of alcohol and cigarettes during pregnancy and/or breastfeeding may partially contribute to their exceptional NAPLAN performance.


Asunto(s)
Rendimiento Académico , Consumo de Bebidas Alcohólicas/epidemiología , Lactancia Materna , Fumar Tabaco/epidemiología , Adulto , Australia/epidemiología , Niño , Desarrollo Infantil , Femenino , Humanos , Lactante , Edad Materna , Embarazo , Fumar
3.
Artículo en Inglés | MEDLINE | ID: mdl-33807910

RESUMEN

Gross motor locomotion is the basis of various sensory motor locomotion. Interventions helping preschoolers develop gross motor skills (GMS) could provide a solid foundation for complex motor skills. This study analyzed a table tennis physical activity program's influence on preschoolers' GMS development with 104 preschoolers (experimental group (EG): N = 52, 25 boys, 27 girls; control group (CG): N = 52, 25 boys, 27 girls). The EG conducted table tennis physical activities three times per week for 12 weeks. Preschoolers' GMSs were assessed using the Test of Gross Motor Development (second edition). After 12 weeks, both the male and female EGs had significantly improved scores for GMS, locomotor subtest, gallop, hop, leap, slide, object control subtest, strike a stationary ball, stationary dribble, catch, overarm throw, and underhand roll (p < 0.05, p < 0.01, p < 0.001). The female EG also showed significant improvement for the run, horizontal jump, and catch in the post-test. Both the male and female EGs significantly outperformed the control group in their post-test scores for GMS, locomotor subtest, object control subtest, strike a stationary ball, overarm throw, and underhand roll (p < 0.05). The female EG also showed significant differences in slide scores (p < 0.05). Therefore, table tennis physical activities can promote preschoolers' GMS development, especially object control skills. The research results provide an empirical basis for preschoolers' physical education. Meanwhile, our findings have important implications for preschoolers' GMS development and table tennis' popularization in Chinese kindergartens.


Asunto(s)
Tenis , Desarrollo Infantil , China , Ejercicio Físico , Femenino , Humanos , Masculino , Destreza Motora
4.
BMJ ; 373: n741, 2021 04 28.
Artículo en Inglés | MEDLINE | ID: mdl-33910920

RESUMEN

OBJECTIVES: To describe neurodevelopment at age 5 among children born preterm. DESIGN: Population based cohort study, EPIPAGE-2. SETTING: France, 2011. PARTICIPANTS: 4441 children aged 5½ born at 24-26, 27-31, and 32-34 weeks MAIN OUTCOME MEASURES: Severe/moderate neurodevelopmental disabilities, defined as severe/moderate cerebral palsy (Gross Motor Function Classification System (GMFCS) ≥2), or unilateral or bilateral blindness or deafness, or full scale intelligence quotient less than minus two standard deviations (Wechsler Preschool and Primary Scale of Intelligence, 4th edition). Mild neurodevelopmental disabilities, defined as mild cerebral palsy (GMFCS-1), or visual disability ≥3.2/10 and <5/10, or hearing loss <40 dB, or full scale intelligence quotient (minus two to minus one standard deviation) or developmental coordination disorders (Movement Assessment Battery for Children, 2nd edition, total score less than or equal to the fifth centile), or behavioural difficulties (strengths and difficulties questionnaire, total score greater than or equal to the 90th centile), school assistance (mainstream class with support or special school), complex developmental interventions, and parents' concerns about development. The distributions of the scores in contemporary term born children were used as reference. Results are given after multiple imputation as percentages of outcome measures with exact binomial 95% confidence intervals. RESULTS: Among 4441 participants, 3083 (69.4%) children were assessed. Rates of severe/moderate neurodevelopmental disabilities were 28% (95% confidence interval 23.4% to 32.2%), 19% (16.8% to 20.7%), and 12% (9.2% to 14.0%) and of mild disabilities were 38.5% (33.7% to 43.4%), 36% (33.4% to 38.1%), and 34% (30.2% to 37.4%) at 24-26, 27-31, and 32-34 weeks, respectively. Assistance at school was used by 27% (22.9% to 31.7%), 14% (12.1% to 15.9%), and 7% (4.4% to 9.0%) of children at 24-26, 27-31, and 32-34 weeks, respectively. About half of the children born at 24-26 weeks (52% (46.4% to 57.3%)) received at least one developmental intervention which decreased to 26% (21.8% to 29.4%) for those born at 32-34 weeks. Behaviour was the concern most commonly reported by parents. Rates of neurodevelopment disabilities increased as gestational age decreased and were higher in families with low socioeconomic status. CONCLUSIONS: In this large cohort of children born preterm, rates of severe/moderate neurodevelopmental disabilities remained high in each gestational age group. Proportions of children receiving school assistance or complex developmental interventions might have a significant impact on educational and health organisations. Parental concerns about behaviour warrant attention.


Asunto(s)
Enfermedades del Prematuro/epidemiología , Trastornos del Neurodesarrollo/epidemiología , Factores de Edad , Estudios de Casos y Controles , Desarrollo Infantil , Preescolar , Estudios de Cohortes , Femenino , Francia , Edad Gestacional , Humanos , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro/diagnóstico , Masculino , Trastornos del Neurodesarrollo/diagnóstico
5.
Sci Rep ; 11(1): 8694, 2021 04 22.
Artículo en Inglés | MEDLINE | ID: mdl-33888748

RESUMEN

Social and mental stressors associated with the pandemic of a novel infectious disease, e.g., COVID-19 or SARS may promote long-term effects on child development. However, reports aimed at identifying the relationship between pandemics and child health are limited. A retrospective study was conducted to associate the SARS pandemic in 2003 with development milestones or physical examinations among longitudinal measurements of 14,647 children. Experiencing SARS during childhood was associated with delayed milestones, with hazard ratios of 3.17 (95% confidence intervals CI: 2.71, 3.70), 3.98 (3.50, 4.53), 4.96 (4.48, 5.49), or 5.57 (5.00, 6.20) for walking independently, saying a complete sentence, counting 0-10, and undressing him/herself for urination, respectively. These results suggest relevant impacts from COVID-19 on child development should be investigated.


Asunto(s)
/psicología , Desarrollo Infantil , Síndrome Respiratorio Agudo Grave/psicología , Niño , Preescolar , China , Femenino , Humanos , Lactante , Masculino , Estudios Retrospectivos
6.
BMC Health Serv Res ; 21(1): 348, 2021 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-33858394

RESUMEN

BACKGROUND: HIV-positive mothers who face the dual burden of HIV-positive status and motherhood, may benefit from holistic services that include early childhood development (ECD). We evaluated the acceptability and impact of integrated ECD-PMTCT interventions for mothers and their children. METHODS: We implemented an integrated ECD-PMTCT intervention in 4 health facilities in Malawi for HIV-positive mothers and their infants. WHO/UNICEF Care for Child Development (CCD) education and counseling sessions were offered during routine PMTCT visits between infant age 1.5-24 months. From June-July 2019, we conducted in-depth interviews with 29 mothers enrolled in the intervention for ≥6 months across 4 health facilities. The interview guide focused on perceived impact of the intervention on mothers' ECD and PMTCT practices, including barriers and facilitators, and unmet needs related to the program. Data were coded and analyzed using constant comparison methods in Atlas ti.8. RESULTS: The vast majority of mothers believed the ECD-PMTCT intervention improved their overall experience with the PMTCT services, strengthened their relationship with providers, and excited and motivated them to attend PMTCT services during the postpartum period. Unlike prior experience, mothers felt more welcome at the health facility, and looked forward to the next visit in order to interact with other mothers and learn new ECD skills. Mothers formed new social support networks with other mothers engaged in ECD sessions, and they provided emotional and financial support to one another, including encouragement regarding ART adherence. Mothers believed their infants reached developmental milestones faster compared to non-intervention children they observed at the same age, and they experienced improved engagement in caregiving activities among male caregivers. Nearly half of women requested additional support with depression or anxiety, coping mechanisms to deal with the stresses of life, or support in building positive dynamics with their male partner. CONCLUSION: The integrated ECD-PMTCT intervention improved mother's experiences with PMTCT programs and health care providers, increased ECD practices such as responsive and stimulating parenting, and created social support networks for women with other PMTCT clients.


Asunto(s)
Infecciones por VIH , Complicaciones Infecciosas del Embarazo , Niño , Desarrollo Infantil , Preescolar , Femenino , Infecciones por VIH/prevención & control , Humanos , Lactante , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Malaui , Masculino , Madres , Embarazo
7.
Medicine (Baltimore) ; 100(17): e25695, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33907147

RESUMEN

RATIONALE: The chikungunya virus (CHIKV) was first isolated in a Tanzanian epidemic area between 1952 and 1953. The best description of the CHIKV transmission during pregnancy can be found in a well-documented epidemic in 2005, in the "La Reunion" island, a French territory located in the Indian Ocean, in which about one-third of the population was infected. Reports of arbovirus infections in pregnancy are increasing over time, but the spectrum of clinical findings remains an incognita among researchers, including CHIKV. PATIENT CONCERNS: In this report, it was possible to verify 2 cases exposed to CHIKV during foetal period and the possible implications of the infection on gestational structures and exposed children after the birth. DIAGNOSIS: In both cases, the mothers were positive by laboratory tests in serologic analysis for CHIKV, as ezyme-linked immunossorbent assay (ELISA), plaque reduction neutralisation testing (PRNT) and immunofluorescence (IF); but there were no positive tests in quantitative polymerase chain reaction (qPCR) for mothers or children. INTERVENTIONS: The exposed children were followed up in a paediatrics clinic in order not only to provide the medical assistance, but also to verify child development and the possible implications and neurocognitive changes caused by gestational infection. OUTCOMES: There were neurological and developmental changes in one of the children followed up on an outpatient basis. There was an improvement in the neurological situation and symptoms only 3 years and 1 month after birth. LESSONS: Based on the cases presented, we can conclude that clinical symptoms of CHIKV maternal infection may occur late in new-borns and can affect their development.


Asunto(s)
Fiebre Chikungunya , Virus Chikungunya , Complicaciones Infecciosas del Embarazo , Efectos Tardíos de la Exposición Prenatal , Trastornos Psicomotores , Tiempo , Anticuerpos Antivirales/sangre , Fiebre Chikungunya/diagnóstico , Fiebre Chikungunya/inmunología , Fiebre Chikungunya/transmisión , Virus Chikungunya/inmunología , Virus Chikungunya/aislamiento & purificación , Desarrollo Infantil , Preescolar , Continuidad de la Atención al Paciente , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Pruebas de Estado Mental y Demencia , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/inmunología , Efectos Tardíos de la Exposición Prenatal/diagnóstico , Efectos Tardíos de la Exposición Prenatal/fisiopatología , Trastornos Psicomotores/diagnóstico , Trastornos Psicomotores/etiología , Pruebas Serológicas/métodos
8.
Scand J Med Sci Sports ; 31 Suppl 1: 35-46, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33871084

RESUMEN

Longitudinal designs enhance our understanding of children's development and its influence on movement behaviors and health. This three-year follow-up study aimed to develop profiles according to perceived and actual motor competence (MC) (locomotion, object control, and overall) and physical fitness in boys and girls longitudinally including children's temporal migrations among clusters in terms of profiling trends. A secondary aim was to compare physical activity participation and weight status at each time point according to these profiles. One hundred and four typically developing Spanish children (45.8% girls) between 4 and 9 years old at baseline participated in this study. Data were collected at three time points one year apart, between January 2016 and May 2018. A self-organizing map and K-means cluster analysis were used to classify and visualize the values and temporal trajectories longitudinally. The study of the profiles in three consecutive years revealed five profiles, three for boys [ie, profile 1 (aligned-high), profile 2 (aligned-partially-low perception-medium actual MC and fitness), and profile 3 (non-aligned-medium perception-low actual MC and fitness)]; and two for girls [ie, profile 4 (aligned-high) and profile 5 (aligned-low)]. For highly perceived and capable children, boys (profile 1) and girls (profile 4), there was a tendency for higher physical activity participation and lower body mass index and waist circumference over time compared to their counterparts who had medium and/or low levels in perception and actual MC and fitness (P < .05). As children age, those with low values in perceived and actual MC and fitness in object control skills will present a higher probability of maintaining unhealthy lifestyles. So, prior intervention, children's profiles identification should be analyzed according to the type of MC.


Asunto(s)
Desarrollo Infantil/fisiología , Destreza Motora , Percepción , Aptitud Física/psicología , Índice de Masa Corporal , Peso Corporal , Niño , Preescolar , Ejercicio Físico , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Circunferencia de la Cintura
9.
Scand J Med Sci Sports ; 31 Suppl 1: 47-55, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33871086

RESUMEN

This study aimed to (1) estimate age-at-mid-growth spurt (age-at-MGS) in Portuguese boys from two different regions-the Azores islands and Viana do Castelo, and (2) identify spurts in a variety of physical fitness (PF) components aligned by age-at-MGS in the two samples. A total of 176 (Azores, n = 91; Viana do Castelo, n = 85) boys aged 6 years old were followed annually to 10 years of age. Age-at-MGS and spurts in PF components (speed, explosive muscular strength, abdominal muscular strength, agility, and flexibility) were identified for each sample. The timing and intensities of the spurts were estimated using a non-smooth mathematical procedure. In Azorean boys, age-at-MGS occurred at 7.8 years (6.99 cm y-1 ), whereas in Viana do Castelo it occurred at 7.9 years (6.20 cm y-1 ). Spurt in speed was attained 12 months after the MGS in both samples (0.53 and 0.35 cm y-1 in Azores and Viana do Castelo, respectively), whereas spurts in explosive muscular strength and flexibility occurred 12 months before the MGS and at the MGS (Azores: 21.59 and 5.52 cm y-1 and Viana do Castelo: 14.12 and 2.5 cm y-1 , respectively). Agility and abdominal muscular strength peaked between 0 and 12 months after the MGS (Viana do Castelo: 0.37 m s-1  y-1 and 6.71 reps y-1 and Azores: 0.28 m s-1  y-1 and 19.36 reps y-1 , respectively). Results indicate that developmental spurts in explosive strength and flexibility occur before, or are coincident with, the mid-growth spurt in height, whereas spurts in speed, agility, and abdominal muscular strength occur after, or coincident with, the mid-growth spurt in height.


Asunto(s)
Desarrollo Infantil/fisiología , Aptitud Física , Músculos Abdominales/fisiología , Estatura , Niño , Humanos , Estudios Longitudinales , Masculino , Fuerza Muscular , Portugal
10.
Int J Mol Sci ; 22(6)2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33808655

RESUMEN

Chronic stress is encountered in our everyday life and is thought to contribute to a number of diseases. Many of these stress-related disorders display a sex bias. Because glucocorticoid hormones are the main biological mediator of chronic stress, researchers have been interested in understanding the sexual dimorphism in glucocorticoid stress response to better explain the sex bias in stress-related diseases. Although not yet demonstrated for glucocorticoid regulation, sex chromosomes do influence sex-specific biology as soon as conception. Then a transient rise in testosterone start to shape the male brain during the prenatal period differently to the female brain. These organizational effects are completed just before puberty. The cerebral regions implicated in glucocorticoid regulation at rest and after stress are thereby impacted in a sex-specific manner. After puberty, the high levels of all gonadal hormones will interact with glucocorticoid hormones in specific crosstalk through their respective nuclear receptors. In addition, stress occurring early in life, in particular during the prenatal period and in adolescence will prime in the long-term glucocorticoid stress response through epigenetic mechanisms, again in a sex-specific manner. Altogether, various molecular mechanisms explain sex-specific glucocorticoid stress responses that do not exclude important gender effects in humans.


Asunto(s)
Glucocorticoides/metabolismo , Caracteres Sexuales , Estrés Fisiológico , Estrés Psicológico , Adolescente , Animales , Niño , Desarrollo Infantil , Desarrollo Embrionario/genética , Estudios de Asociación Genética , Hormonas Gonadales/metabolismo , Humanos , Hidrocortisona/metabolismo , Pubertad/genética , Pubertad/metabolismo , Factores Sexuales , Esteroides/metabolismo , Estrés Fisiológico/genética , Estrés Psicológico/genética
11.
Medicine (Baltimore) ; 100(15): e25421, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847641

RESUMEN

OBJECTIVE: This study aimed to assess the accuracy of ultrasonic grading in determining brain injury in very premature infants and analyze the affecting factors of these neonatal morbidity and mortality, and to investigate the relationship between serial cranial ultrasound (cUS) classification and Mental Developmental Index (MDI)/Psychomotor Developmental Index (PDI) in premature infants. METHODS: A total of 129 very preterm infants (Gestational Age ≤ 28 weeks) were subjected to serial cUS until 6 months or older and classified into 3 degrees in accordance with classification standards. The MDI and PDI (Bayley test) of the infants were measured until the infants reached the age of 24 months or older. The consistency between Term Equivalent Age (TEA)-cUS and TEA- magnetic resonance imaging (MRI) was calculated. Ordinal regression was performed to analyze the relationship among severe disease, early cUS classifications, psychomotor and mental development, and death. Operating characteristic curve were used to analyze the relationship between serial cUS grades and MDI/PDI scores. RESULTS: The mortality and survival rates of 129 very preterm infants were 32.8% and 67.3%, respectively. Among the 86 surviving infants, 20.9% developed mild cerebral palsy (CP) and 5.8% to 6.9% developed severe CP. The consistency between TEA-cUS and TEA-MRI was 88%. Grades 2 and 3 at first ultrasound were associated with adverse mental (OR = 3.2, OR = 3.78) and motor (OR = 2.25, OR = 2.59) development. cUS classification demonstrated high sensitivity (79%-96%). Among all cUS classifications, the specificity of the first cUS was the lowest and that of TEA-cUS was the highest (57% for PDI and 48% for MDI). CONCLUSIONS: Moderate and severe brain injury at first ultrasound is the most important factor affecting the survival rate and brain development of very premature infants. The cUS classification had high sensitivity and high specificity for the prediction of CP, especially in TEA-cUS.


Asunto(s)
Lesiones Encefálicas/epidemiología , Discapacidades del Desarrollo/epidemiología , Recien Nacido Extremadamente Prematuro/crecimiento & desarrollo , Trastornos Psicomotores/epidemiología , Lesiones Encefálicas/diagnóstico por imagen , Lesiones Encefálicas/mortalidad , Desarrollo Infantil/fisiología , Femenino , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Índice de Severidad de la Enfermedad , Ultrasonografía
12.
Artículo en Inglés | MEDLINE | ID: mdl-33804888

RESUMEN

A poor start in life shapes children's development over the life-course. Children from low- and middle-income countries (LMICs) are exposed to low levels of early stimulation, greater socioeconomic deprivation and persistent environmental and health challenges. Nevertheless, little is known about country-specific factors affecting early childhood development (ECD) in LMICs. Using data from 68 LMICs collected as part of the Multiple Indicator Cluster Surveys between 2010 and 2018, along with other publicly available data sources, we employed a multivariate linear regression analysis at a national level to assess the association between the average Early Childhood Development Index (ECDI) in children aged 3-5 and country-level ecological characteristics: early learning and nurturing care and socioeconomic and health indicators. Our results show that upper-middle-income country status, attendance at early childhood education (ECE) programs and the availability of books at home are positively associated with a higher ECDI. Conversely, the prevalence of low birthweight and high under-5 and maternal mortality are negatively associated with ECDI nationally. On average, LMICs with inadequate stimulation at home, higher mortality rates and without mandatory ECE programs are at greater risks of poorer ECDI. Investment in early-year interventions to improve nurturing care and ECD outcomes is essential for achieving Sustainable Development Goals.


Asunto(s)
Países en Desarrollo , Renta , Niño , Desarrollo Infantil , Preescolar , Humanos , Mortalidad Materna , Pobreza
13.
Artículo en Inglés | MEDLINE | ID: mdl-33805965

RESUMEN

BACKGROUND: The Early Development Instrument (EDI) was developed as a population-level assessment of children's developmental health at school entry. EDI data collection has created unprecedented opportunities for population-level studies on children's developmental outcomes. The goal of this narrative review was to synthesize research using the EDI to describe how it contributes to expanding the understanding of the impacts of social determinants on child development and how it applies to special populations. METHODS: Select studies published in peer-reviewed scientific journals between 2015 and 2020 and incorporating the social determinants of health perspectives were chosen to highlight the capability of the EDI to monitor children's developmental health and contribute knowledge in the area of early childhood development. RESULTS: A number of studies have examined the association between several social determinants of health and children's developmental outcomes, including hard-to-reach and low-frequency populations of children. The EDI has also been used to evaluate programs and interventions in different countries. CONCLUSIONS: The ability of the EDI to monitor children's developmental outcomes in various populations has been consistently demonstrated. The EDI, by virtue of its comprehensive breadth and census-like collection, widens the scope of research relating to early childhood development and its social determinants of health.


Asunto(s)
Desarrollo Infantil , Determinantes Sociales de la Salud , Niño , Salud del Niño , Preescolar , Grupos Étnicos , Humanos , Instituciones Académicas
14.
Isr Med Assoc J ; 23(4): 233-238, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33899356

RESUMEN

BACKGROUND: Evaluation of children's anthropometrics poses challenges due to age-related changes. The main focus is on height and weight. However, since weight is height-dependent, body mass index (BMI) is the best surrogate measurement of adiposity. Israel has not developed national growth tables; therefore, researchers and clinicians utilize either World Health Organization (WHO) or U.S. Centers for Disease Control and Prevention (CDC) tables as benchmarks. OBJECTIVES: To evaluate the anthropometrics of Israeli children benchmarked by CDC and WHO tables. METHODS: A retrospective review was conducted of the 1987-2003 birth cohort (age 4-18 years) from Clalit Health Services databases. Anthropometrics were retrieved twice: at study entry and one year later. We evaluated them as separate cohorts. Gender-specific age-matched median height and BMI were compared with CDC and WHO height and BMI tables. RESULTS: he study consisted of 15,650, mean age at study entry 9.5 years (range 4-18). Gender-specific median heights of the Israeli children were similar to CDC and WHO values at younger ages, but were slightly shorter than the age-matched CDC and WHO toward the age of final height in both cohorts. However, gender-specific median BMI was considerably and statistically significant higher compared to CDC and WHO values consistently along the entire age range in both cohorts. CONCLUSIONS: Israeli children were slightly shorter toward the age of final height, compared to WHO and CDC. However, BMI in Israeli children was significantly higher compared to the CDC and WHO consistently along the age range, which raises an alarm regarding obesity patterns.


Asunto(s)
Antropometría/métodos , Estatura , Índice de Masa Corporal , Obesidad , Pediatría , Adolescente , Factores de Edad , Niño , Desarrollo Infantil , Estudios de Cohortes , Femenino , Humanos , Israel/epidemiología , Masculino , Obesidad/diagnóstico , Obesidad/epidemiología , Obesidad/prevención & control , Pediatría/métodos , Pediatría/normas , Estándares de Referencia , Factores Sexuales , Organización Mundial de la Salud
15.
Artículo en Inglés | MEDLINE | ID: mdl-33669588

RESUMEN

In the early years of life, children's interactions with the physical and social environment- including families, schools and communities-play a defining role in developmental trajectories with long-term implications for their health, well-being and earning potential as they become adults. Importantly, failing to reach their developmental potential contributes to global cycles of poverty, inequality, and social exclusion. Guided by a rights-based approach, this narrative review synthesizes selected studies and global initiatives promoting early child development and proposes a universal intervention framework of child-environment interactions to optimize children's developmental functioning and trajectories.


Asunto(s)
Desarrollo Infantil , Pobreza , Adulto , Niño , Preescolar , Escolaridad , Familia , Humanos , Instituciones Académicas
16.
Cochrane Database Syst Rev ; 3: CD013732, 2021 03 17.
Artículo en Inglés | MEDLINE | ID: mdl-33729556

RESUMEN

BACKGROUND: Mechanical ventilation is a potentially painful and discomforting intervention that is widely used in neonatal intensive care. Newborn infants demonstrate increased sensitivity to pain, which may affect clinical and neurodevelopmental outcomes. The use of drugs that reduce pain might be important in improving survival and neurodevelopmental outcomes. OBJECTIVES: To determine the benefits and harms of opioid analgesics for neonates (term or preterm) receiving mechanical ventilation compared to placebo or no drug, other opioids, or other analgesics or sedatives. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 9), in the Cochrane Library; MEDLINE via PubMed (1966 to 29 September 2020); Embase (1980 to 29 September 2020); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 29 September 2020). We searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: We included randomised and quasi-randomised controlled trials comparing opioids to placebo or no drug, to other opioids, or to other analgesics or sedatives in newborn infants on mechanical ventilation. We excluded cross-over trials. We included term (≥ 37 weeks' gestational age) and preterm (< 37 weeks' gestational age) newborn infants on mechanical ventilation. We included any duration of drug treatment and any dosage given continuously or as bolus; we excluded studies that gave opioids to ventilated infants for procedures. DATA COLLECTION AND ANALYSIS: For each of the included trials, we independently extracted data (e.g. number of participants, birth weight, gestational age, types of opioids) using Cochrane Effective Practice and Organisation of Care Group (EPOC) criteria and assessed the risk of bias (e.g. adequacy of randomisation, blinding, completeness of follow-up). We evaluated treatment effects using a fixed-effect model with risk ratio (RR) for categorical data and mean difference (MD) for continuous data. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS: We included 23 studies (enrolling 2023 infants) published between 1992 and 2019. Fifteen studies (1632 infants) compared the use of morphine or fentanyl versus placebo or no intervention. Four studies included both term and preterm infants, and one study only term infants; all other studies included only preterm infants, with five studies including only very preterm infants. We are uncertain whether opioids have an effect on the Premature Infant Pain Profile (PIPP) Scale in the first 12 hours after infusion (MD -5.74, 95% confidence interval (CI) -6.88 to -4.59; 50 participants, 2 studies) and between 12 and 48 hours after infusion (MD -0.98, 95% CI -1.35 to -0.61; 963 participants, 3 studies) because of limitations in study design, high heterogeneity (inconsistency), and imprecision of estimates (very low-certainty evidence - GRADE). The use of morphine or fentanyl probably has little or no effect in reducing duration of mechanical ventilation (MD 0.23 days, 95% CI -0.38 to 0.83; 1259 participants, 7 studies; moderate-certainty evidence because of unclear risk of bias in most studies) and neonatal mortality (RR 1.12, 95% CI 0.80 to 1.55; 1189 participants, 5 studies; moderate-certainty evidence because of imprecision of estimates). We are uncertain whether opioids have an effect on neurodevelopmental outcomes at 18 to 24 months (RR 2.00, 95% CI 0.39 to 10.29; 78 participants, 1 study; very low-certainty evidence because of serious imprecision of the estimates and indirectness). Limited data were available for the other comparisons (i.e. two studies (54 infants) on morphine versus midazolam, three (222 infants) on morphine versus fentanyl, and one each on morphine versus diamorphine (88 infants), morphine versus remifentanil (20 infants), fentanyl versus sufentanil (20 infants), and fentanyl versus remifentanil (24 infants)). For these comparisons, no meta-analysis was conducted because outcomes were reported by one study. AUTHORS' CONCLUSIONS: We are uncertain whether opioids have an effect on pain and neurodevelopmental outcomes at 18 to 24 months; the use of morphine or fentanyl probably has little or no effect in reducing the duration of mechanical ventilation and neonatal mortality. Data on the other comparisons planned in this review (opioids versus analgesics; opioids versus other opioids) are extremely limited and do not allow any conclusions. In the absence of firm evidence to support a routine policy, opioids should be used selectively - based on clinical judgement and evaluation of pain indicators - although pain measurement in newborns has limitations.


Asunto(s)
Analgésicos Opioides/uso terapéutico , Dolor Asociado a Procedimientos Médicos/prevención & control , Respiración Artificial/efectos adversos , Analgésicos Opioides/efectos adversos , Sesgo , Desarrollo Infantil/efectos de los fármacos , Fentanilo/efectos adversos , Fentanilo/uso terapéutico , Heroína/efectos adversos , Heroína/uso terapéutico , Humanos , Hipnóticos y Sedantes/efectos adversos , Hipnóticos y Sedantes/uso terapéutico , Lactante , Mortalidad Infantil , Recién Nacido , Recien Nacido Prematuro , Midazolam/efectos adversos , Midazolam/uso terapéutico , Morfina/efectos adversos , Morfina/uso terapéutico , Placebos/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Remifentanilo/efectos adversos , Remifentanilo/uso terapéutico , Respiración Artificial/estadística & datos numéricos , Sufentanilo/efectos adversos , Sufentanilo/uso terapéutico
17.
Curr Psychiatry Rep ; 23(5): 23, 2021 03 12.
Artículo en Inglés | MEDLINE | ID: mdl-33712922

RESUMEN

PURPOSE OF REVIEW: Despite increased literature on the impact of racism in the past decades, relatively few studies have focused on the effects of racism on younger children. This article reviews research from the past 5 years focusing on the impact of racism on infant and early childhood mental health and socioemotional development. RECENT FINDINGS: Longitudinal studies provide evidence that very young children are highly influenced by exposure to multiple and interconnecting levels of racism and discrimination. These forms of exposure (structural and personally mediated, which can be further divided into direct and indirect exposure) are particularly nefarious to young children's socioemotional development and have implications for adolescent and adult mental health with lasting sequelae. Furthermore, the effects of racism on parenting practices and maternal/caregiver mental health appear to indicate mechanisms through which racism affects young children. Although more studies are needed in this area, recent literature indicates that racism is a social determinant of health that adversely impacts infant and early childhood socioemotional, and behavioral development. Future studies should focus on understanding the mechanisms through which racism impacts early childhood development and health, and interventions to prevent and mitigate the effects of racism.


Asunto(s)
Racismo , Determinantes Sociales de la Salud , Adolescente , Adulto , Niño , Desarrollo Infantil , Preescolar , Humanos , Estudios Longitudinales , Salud Mental
18.
J Equine Vet Sci ; 99: 103359, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33781428

RESUMEN

This study examined the effects of 15 sessions of hippotherapy (HPOT) on gross motor skills in children (aged 2-3 years) with gross motor developmental delay (DD) (n = 11) in comparison with age-based controls without DD (n = 6). Gross motor skills in both groups were assessed with the Battelle Developmental Inventory 2nd Edition, and gait parameters were measured using a computerized gait analysis system prestudy and poststudy. The DD group took part in 15 sessions of HPOT, and the control (CON) group did not participate in any equine activities. The statistical analysis examined preintervention and postintervention data in the DD group and compared testing data at the same intervals in controls. Functional motor skills significantly improved after HPOT intervention. Mean percent motor delay score decreased by 24.1 points from pretest to post-test in the DD group, indicating significantly (P < .001) less delay after HPOT. In contrast, mean Battelle Developmental Inventory 2nd Edition motor scores of the CON group were unchanged pre-study to post-study. The two groups' scores were significantly (P < .001) different indicating more improvement in the DD HPOT group when compared with the control group. Gait performance measures did not change significantly (P > .05) from pre-test to post-est in the DD group after HPOT; however, improvement trends were seen in step width and step length after HPOT. The results suggest that HPOT intervention in young children with DD can improve gross motor skills. These data provide important quantitative information concerning the efficacy of early HPOT intervention for children with DD during this critical stage of child development.


Asunto(s)
Terapía Asistida por Caballos , Trastornos de la Destreza Motora , Animales , Desarrollo Infantil , Marcha , Caballos , Destreza Motora
19.
Am J Clin Nutr ; 113(4): 874-883, 2021 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-33677532

RESUMEN

BACKGROUND: Naturally occurring aflatoxins may contribute to poor growth and nutritional statuses in children. OBJECTIVES: We analyzed the relationship between contemporary and lagged aflatoxin exposure and 1) length-for-age z-score (LAZ); and 2) length, knee-heel length, stunting, weight-for-age z-score (WAZ), and weight-for-length z-score (WLZ). METHODS: We conducted a longitudinal birth cohort study involving 1675 mother-infant dyads in rural Nepal. Participants were repeatedly visited from pregnancy to 2 years of age (2015-2019). One blood sample was collected during pregnancy and 4 samples were collected from the children at 3, 6, 12, and 18-22 months of age to measure concentrations of aflatoxin B1 (AFB1)-lysine adduct. Multivariate linear fixed-effects and logistic models with generalized estimating equations were used to identify associations between child growth and aflatoxin exposure. RESULTS: AFB1-lysine adducts were detected in the majority of children (at 3 months, 80.5%; at 6 months, 75.3%; at 12 months, 81.1%; and at 18-22 months, 85.1%) and in 94.3% of pregnant women. Changes in contemporary ln child AFB1-lysine adduct concentrations were significantly associated with changes in LAZ (ß, -0.05; 95% CI, -0.09 to -0.02; P = 0.003), length (ß, -0.19; 95% CI, -0.29 to -0.10; P < 0.001), knee-heel length (ß, -0.09; 95% CI, -0.13 to -0.05; P < 0.001), and WAZ (ß, -0.04; 95% CI, -0.07 to -0.005; P = 0.022). Serum aflatoxin concentrations were associated with stunting (OR, 1.18; 95% CI, 1.05-1.32; P = 0.005). Similar results were found in the models using changes in contemporary ln AFB1 adjusted for changes in child weight, with significant associations with changes in WLZ (ß, -0.07; 95% CI, -0.10 to -0.03; P < 0.001). Changes in time-lagged ln AFB1 (unadjusted and adjusted for changes in child weight) were associated with changes in length and knee-heel length. CONCLUSIONS: Our results add to the growing body of evidence confirming chronic aflatoxin exposure and suggest that exposure is significantly correlated with various negative growth outcomes, which may vary by child weight status. This trial was registered at clinicaltrials.gov as NCT03312049.


Asunto(s)
Aflatoxinas/administración & dosificación , Aflatoxinas/toxicidad , Desarrollo Óseo/efectos de los fármacos , Fenómenos Fisiológicos Nutricionales Infantiles , Exposición a Riesgos Ambientales , Adolescente , Adulto , Desarrollo Óseo/fisiología , Niño , Desarrollo Infantil , Preescolar , Estudios de Cohortes , Femenino , Trastornos del Crecimiento , Humanos , Lactante , Masculino , Persona de Mediana Edad , Nepal , Embarazo , Adulto Joven
20.
Dev Psychopathol ; 33(2): 684-699, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33752765

RESUMEN

Edward Zigler's groundbreaking research on child development resulted in the historic Head Start program. It is useful to examine the theoretical implications of his work by applying a human development theoretical perspective. Phenomenological variant of ecological systems theory (PVEST) is a strengths-based theoretical framework that engages the variability of resource access and coping strategies that promote positive identity development for diverse children. While skill acquisition is a key focus of human capital theory's engagement of early childhood needs, this article highlights the on-going status of human vulnerability that undergirds identity development over the life course. The authors note that "inequality presence denial" combines with high-risk contexts, framed by geography and psychohistoric moments (e.g., The Great Recession, COVID-19), to alter diverse children's developmental pathways. The acknowledgement of "morbid risk" motivates the urgency for research that builds upon Zigler's innovations and privileges human development imperatives. The case study explores these concepts by examining the challenges and assets available to mothers in a low-income community. The article's closing notes developments in the field of economics that ameliorate human capital theory's conceptual limitations, underscoring human development's theoretical strength in motivating research and policies that are maximally responsive to children's positive identity development.


Asunto(s)
Salud del Niño , Niño , Desarrollo Infantil , Preescolar , Femenino , Humanos , Pobreza
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...