Comparison of propofol-based sedation and midazolam sedation in pediatric bidirectional endoscopy conducted by pediatric gastroenterologists.

Objectives: The effectiveness and safety of propofol-based sedation and midazolam sedation in pediatric bidirectional endoscopy were compared. Methods: We retrospectively analyzed the cases of pediatric patients (≤15 years old) who had undergone bidirectional endoscopy, esophagogastroduodenoscopy, and colonoscopy by pediatric gastroenterologists. Demographic data, indications, sedatives/dosages, clinical outcomes, endoscopic findings, adverse events, and total patient time requirements (total time in which patients stay in our hospital) were compared in the two sedation groups. Results: Ninety-one children (51 boys, 40 girls, mean age 13 years, range 9-15) treated at our hospital were enrolled. Propofol alone or in combination with midazolam and/or pentazocine was administered to 51 patients (propofol-based sedation group). Midazolam alone or in combination with pentazocine was administered to the other 40 patients (midazolam sedation group). In the propofol group, the following mean doses were used: propofol, 96 mg (range 40-145 mg); midazolam, 4.9 mg (range 3-5 mg); and pentazocine, 7.5 mg. In the midazolam group, the mean doses of midazolam and pentazocine were 6.2 mg (range 4-10 mg) and 15 mg, respectively. All procedures were successfully completed by pediatric gastroenterologists. The total procedure times and endoscopic findings were similar in the two groups, but the median patient time requirement in the propofol group was significantly shorter versus the midazolam group (7.3 h vs. 8.4 h, p < 0.001). No adverse events occurred in either group. Conclusions: Propofol-based sedation in pediatric bidirectional endoscopy was safely and effectively performed by pediatric gastroenterologists, and its patient time requirement was shorter than that for midazolam sedation.

Efficacy and safety of intravenous thiamylal in sedation for colonoscopy in children.

Objectives: Since a standard sedation protocol for pediatric colonoscopy (CS) has not been established, evidence on optimal sedative agents is needed. This study aimed to evaluate the efficacy and safety of thiamylal in sedation for pediatric CS compared to midazolam. Methods: Children from 7 to 16 years of age who underwent CS under sedation with intravenous thiamylal or midazolam at our hospital between June 2010 and March 2024 were included in this retrospective observational study. The primary outcome was the efficacy (success rate of CS without mid-awakening) of the drugs. Meanwhile, the secondary outcomes were the sedation level during CS, procedure time, recovery time, and adverse events related to sedation. Results: Sixty children were included in the study. The success rate of CS without mid-awakening was significantly higher in the thiamylal group (90.6%) than in the midazolam group (64.3%; p = 0.03). The two groups had no significant differences in median sedation depth, procedure time, or recovery time. Adverse events related to sedation in thiamylal group (22%) and midazolam group (25%) were similar. No severe adverse events were reported. Conclusions: Intravenous thiamylal provides effective and safe sedation in children requiring CS, with little or no mid-awakening during the procedure.

Clinical, epidemiological, and care profile of hospitalized patients with retinoblastoma in Brazil

ABSTRACT Purpose: To describe the epidemiological and clinical profile of hospitalized patients with retinoblastoma in Brazil. Methods: Using data from the Hospital Cancer Registry of the Instituto Nacional de Câncer, patients with the morphological codes of retinoblastoma who were diagnosed between 2000 to 2018, aged 0-19 years, and followed up in registered hospitals (analytical cases) were selected. The relative and absolute frequencies of demographic, clinical, diagnostic, therapeutic, and outcome variables were described. Hospital performance indicators were calculated and compared between hospitals qualified and not qualified to treat pediatric oncology cases and between hospitals with different case volumes (<20, 20-75, >75 cases). Results: Of the 2,269 identified analytical cases from 86 institutions, 48% were from the Southeast, 54% were male, and 66% were aged <4 years. The proportion of missing data (NA) was too high for several variables. Approximately 84% of the patients were from the public health system, 40% had a positive family history, and 88% had unilateral involvement. The first treatment included surgery in 58.3% of the patients (NA=2), Approximately 36.6% of these patients achieved complete remission, 10.8% achieved partial remission, and 12.7% died (NA=59%). Hospital performance indicators were within the target in >90% of the patients. The median time between the first appointment and diagnosis (6 days, interquartile range [IQR] 1-14) was significantly lower and the median time to death was longer (343 days, IQR, 212-539) in high-volume hospitals (>75 cases) than in medium- and low-volume hospitals. Conclusions: Despite the high proportion of missing data, we found that the delay in diagnosis is due to prehospital factors. Additionally, there is a need for educational programs for healthcare professionals and families that emphasize early identification and referral to specialized centers. Future studies should focus on the impact of Hospital Cancer Registry data completeness on outcomes, causes of delay in diagnosis, regional inequalities, and barriers to accessing specialized services.

Multi-informant evaluation of Cognitive Disengagement Syndrome (formerly Slow Cognitive Tempo). Children's self-reported measures in relation to parents / Evaluación multi-informante del Síndrome de Desconexión Cognitiva (anteriormente Tempo Cognitivo Lento). Medidas autoinformadas de los niños con relación a padres

El objetivo fue examinar, desde una aproximación multi-informante, las medidas del Síndrome de Desconexión Cognitiva (SDC) de padres/madres e hijos/as y su relación con síntomas internalizantes y externalizantes. 279 niños/as (9-13 años), y sus padres/madres completaron las evaluaciones sobre SDC, la inatención del trastorno por déficit de atención e hiperactividad (TDAH) y otras medidas internalizadas y externalizadas. Los ítems de las tres medidas de SDC convergieron razonablemente bien en el factor SDC. Se aportaron pruebas discriminantes de la validez de las relaciones entre las puntuaciones de las pruebas y las medidas de los tres constructos diferentes (SDC, soledad y preferencia por la soledad). La asociación más estrecha estuvo entre la evaluación parental de las medidas de SDC con ansiedad y depresión, y entre inatención con hiperactividad/impulsividad y trastorno negativista desafiante. Se observó capacidad predictiva de la medida de SDC sobre la soledad y preferencia por estar solo autoinformadas. Se encontró una posible asociación entre la medida del SDC evaluado por padres/madres y sexo y edad de los niños. En conclusión, los datos apoyan la inclusión de medidas autoinformadas en la evaluación del SDC. Las medidas del SDC en niños se vinculan con medidas internalizantes y, la inatención con las externalizantes.(AU)

A Population-Based Epidemiologic Study of Symptomatic SARS-CoV-2 Infections and Fatalities in Brazilian Children over 3 Years.

OBJECTIVE: To provide a comprehensive overview of the epidemiologic characteristics, outcomes, and risk factors of COVID-19-related deaths in children and adolescents in Brazil. STUDY DESIGN: We conducted a population-based, retrospective cohort study that included all patients aged <18 years with laboratory-confirmed, symptomatic SARS-CoV-2 infection as registered in official Brazilian national surveillance systems for COVID-19 between February 2020 and February 2023. The primary outcome was COVID-19-related deaths. Odds ratios (ORs) of risk factors associated with death were estimated using multivariable logistic regression. RESULTS: Over a 3-year period, 2 855 704 pediatric patients with symptomatic SARS-CoV-2 infection were registered in Brazil. Of these, 59 179 (2.1%) were hospitalized, 13 844 (0.48%) were admitted to the intensive care unit, and 4943 (0.17%) received mechanical ventilation. A total of 4740 (0.17%) patients had fatal outcomes. The case fatality rate increased to 7.9% among patients who required hospitalization; 2102 (44.3%) patients who died did not receive advanced critical support. Notably, 2 (65%, 95% CI 58-71) or 3 doses (86%, 95% CI 81-89) of the vaccine provided strong protection against death. The following adjusted covariates were significantly associated with increased odds of death: age (0-4 and 11-17 years), ethnicity (Brown and Indigenous), region (Northeast or North), dyspnea, nosocomial infection, and comorbidities. Conversely, living in the South or Central-West regions, admission in the later period of the pandemic, and receiving a vaccine were all associated with protection against death. CONCLUSIONS: Our findings suggest that a complex interplay between individual factors and social inequities has shaped the impact of COVID-19 on Brazilian children and adolescents.

MINISTOP 3.0: Implementation of a mHealth obesity prevention program within Swedish child healthcare - study protocol for a cluster randomized controlled trial.

BACKGROUND: Previously, we have reported on the efficacy and real-world effectiveness of a parent-oriented mobile health intervention (MINISTOP 1.0 and 2.0), which have shown improvements in pre-school children's lifestyle behaviours. However, there is a need for implementation evidence. The overall aims of this study are to: (i) compare two different implementation strategies for MINISTOP 3.0 (Basic vs. Enhanced) on: acceptability, appropriateness, feasibility, organizational readiness to implement MINISTOP 3.0 within Swedish child healthcare (primary outcomes) as well as reach, costs, and adoption of MINISTOP 3.0 (secondary outcomes); (ii) evaluate cost-effectiveness of MINISTOP 3.0; (iii) explore the sustainability of MINISTOP 3.0; (iv) evaluate the determinants of effectiveness of MINISTOP 3.0 on children's key lifestyle behaviours; and (v) investigate the long-term effects of MINISTOP 3.0 on children's body mass index. METHODS: A hybrid type III implementation-effectiveness design will be used. A cluster randomized controlled trial will be conducted to compare the effects of basic versus enhanced implementation strategies on the outcomes at the child healthcare level. A minimum of 50 child healthcare centers across Sweden will participate and we aim to recruit 120 nurses. Child healthcare nurses in both groups will offer the MINISTOP 3.0 app to the families at the 2.5/3-year routine visit. Basic implementation strategies include educational meeting with nurses, formal implementation blueprint, develop/distribute educational materials and enhanced implementation includes all aforementioned strategies plus auditing/providing feedback and ongoing training for nurses. All outcomes will be assessed at baseline and 12 months post-implementation. Implementation outcomes will be assessed quantitatively using questionnaires and sustainability will be assessed qualitatively at 12 months. Children's key lifestyle behaviours will be collected through a parental questionnaire within the MINISTOP app at baseline and 6 months after they have received the app. Children's weight/height will be measured at routine visits at 2.5/3 (baseline), 4 and 5 years of age. DISCUSSION: This study will provide important implementation evidence with regards to implementing mHealth interventions within Swedish child healthcare at scale and these results have the potential to be generalized to other digital interventions being implemented in child healthcare. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05667753. Registered December 29, 2022.

Association between domestic animal exposure and diarrhea prevalence in under- five children in low- and middle-income countries: a systematic review and meta-analysis.

BACKGROUND: Diarrheal disease is still the leading cause of morbidity and mortality in children, despite significant progress in diarrhea interventions. Zoonotic transmission is the main cause of the emergence and re-emergence of diseases. Domestic animals are often close to humans, particularly in resource-poor countries. Despite evidence of environmental contamination, there have been limited studies conducted to examine the association between domestic animal exposure and diarrheal disease in low- and middle-income countries (LMIC). Therefore, this systematic review and meta-analysis examines the association between domestic animal exposure and diarrheal disease in children under five years of age in LMIC. METHODS: The search strategy followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for the reporting of systematic reviews. All appropriate databases were searched to find relevant articles. Research studies were selected for review if they reported an outcome variable that measured diarrhea and exposure variables of any domestic animals. A data extraction form was used to extract information from each study. The quality of the individual articles was assessed using the Joanna Briggs Institute (JBI's) critical appraisal tools. Publication bias was checked using a funnel plot, Egger's regression test, and Begg's test. The heterogeneity of studies was checked using the Galbraith plot and the I-squared test. A sensitivity analysis was conducted, and a meta-analysis was conducted using STATA 17. RESULTS: After reviewing 113 articles, 11 articles fulfilled the inclusion criteria hence considered for meta-analysis. The finding of these 11 studies revealed that study participants who had animal exposure had 1.95 higher odds of diarrhea as compared to participants who hadn't animal exposure (OR: 1.95, 95%CI: 1.25, 2.66). CONCLUSIONS AND RECOMMENDATIONS: This study reported that diarrheal disease was associated with study subjects who had domestic animal exposure. Therefore, more comprehensive research is needed on specific behaviors and interventions surrounding animal husbandry that may affect the transmission of pathogens between animals and humans; this would facilitate the design and implementation of measures to reduce animal exposure in the domestic environment.

Incidence of loss to follow-up and its predictors among HIV-infected under-five children after initiation of antiretroviral therapy in West Amhara Comprehensive Specialized Referral Hospitals, Northwest Ethiopia: a multicenter retrospective follow-up study.

BACKGROUND: Loss to follow-up (LTFU) among under-five children from HIV care profoundly affects the treatment outcomes of this vulnerable population. It is a major factor that negatively affects the benefits of antiretroviral therapy (ART). Current information about LTFU among HIV-positive under-five children on ART is essential for effective treatments. To far, nevertheless, limited research has been done in Ethiopia to address this issue. Thus, this study aimed to assess the incidence and predictors of LTFU among HIV-infected under-five children receiving ART in West Amhara Comprehensive Specialized Referral Hospitals. METHODS: A multicenter institution-based retrospective follow-up study was conducted among 435 HIV-infected under-five children on ART selected by simple random sampling from January 1, 2010 to December 31, 2019, and data were collected between December 1, 2021, and January 31, 2022. A standardized data extraction tool adapted from the ART entry and follow-up forms was used. The event of interest for this study was LTFU, whereas the absence of LTFU was censored. Before being transferred to STATA version 14 for analysis, the data were entered into Epi-Data version 3.1. The Kaplan‒Meier curve was used to estimate an individual's survival-free probability at each specific point in time. The Cox proportional hazards model was used to identify predictors of LTFU. RESULTS: Among the 420 records included in the final analysis, 30 (7.14%) of the individuals were LTFUs. The incidence rate of LTFU was 3.4 per 1000 person-months of observation (95% CI: 2.43-4.87). The survival probabilities of children after 12, 24, 36, and 48 months were 0.97, 0.92, 0.88, and 0.77, respectively. The independent predictors of LTFU were HIV infection in under-five children who lived in rural areas (AHR = 3.64; 95% CI: 1.41, 9.37), poor adherence to ART (AHR = 4.37; 95% CI: 1.59, 12.02), not receiving cotrimoxazole preventive therapy (AHR = 3.75; 95% CI: 1.39, 10.08), not receiving isoniazid prophylaxis (AHR = 3.4; 95% CI: 1.29, 9.01), and having a severe WHO clinical stage (AHR = 5.43; 95% CI: 1.38, 11.43). CONCLUSION AND RECOMMENDATION: The incidence of loss to follow-up was high, especially in the first two years after ART initiation. The risk of LTFU was greater for those who were rural residents, had poor adherence, lacked cotrimoxazole preventive therapy, not given isoniazid prophylaxis, and presented with WHO clinical stages III and IV. Therefore, clinicians should emphasize for cotrimoxazole preventive therapy and isoniazid prophylaxis, for those living in rural areas, who present with poor adherence and WHO clinical stages III and IV.

Infective endocarditis in children with heart diseases at Jakaya Kikwete Cardiac Institute, Tanzania: a cross-sectional study.

BACKGROUND: Infective endocarditis (IE) in children with pre-existing heart conditions is a life-threatening disease entity associated with significant morbidity and mortality. In our cardiac setting, the management outcomes of children with IE are not well documented. We therefore aimed to document the clinical profile and treatment outcomes of children with IE attended at the Jakaya Kikwete Cardiac Institute (JKCI). METHODS: This was a hospital-based cross-sectional study with longitudinal follow-up conducted among children with IE diagnosed by Modified Duke's Criteria at the JKCI from November 2021 to November 2023. A structured questionnaire was used to collect patients' socio-demographic and clinical data. RESULTS: During the study period, 1,546 children were admitted to the JKCI. A total of 30 children with IE were enrolled, of these half (n = 16, 53%) were aged 10 to 18 years, with a median of 10 yrs (Inter quartile range, IQR: 6.5-12.2 yrs). Twelve children (40%) and nearly half (n = 14, 47%) had fever and used antibiotic therapy respectively. Majority of participants had anaemia (n = 26, 87%) and heart failure (n = 21, 70%). Nine children (30%) had positive blood cultures and S. aureus was the most frequently isolated organism (n = 7). Ten patients (33%) developed acute kidney injury (AKI), and eleven (37%) children died during the hospital stay. CONCLUSION: In our setting, in-hospital mortality due to IE among children with heart diseases is high. Heart failure and anaemia were the common presentations of IE. Furthermore, AKI was observed to be the leading in-hospital non-cardiac complication.

Mental and neurodevelopmental health needs of Aboriginal children with experience of in out-of-home care: a Western Australian data-linkage study.

OBJECTIVE: To identify additional mental and neurodevelopmental health needs of Aboriginal children born in Western Australia, who are placed in out-of-home care (OOHC), relative to Aboriginal children born in Western Australia who were not placed. METHODS: Data-linkage of hospitalisations, health registries and child protective services data for all Aboriginal children born in WA between 2000 and 2013 was used. Children placed in out-of-home care between 2000 and 2019 were matched to children never placed and prevalence and cumulative incidence estimates of mental and neurodevelopmental health conditions were compared. RESULTS: Children placed in out-of-home care had a three times greater prevalence of mental and neurodevelopmental health conditions generally. The prevalence of foetal alcohol spectrum disorder was ten times higher, and post-traumatic stress disorder was seven times higher for those placed in out-of-home care. Cumulative incidence plots highlighted for different conditions the ages at which the rate of diagnosis diverges between the two groups. CONCLUSIONS: Children placed in out-of-home care had greater mental and neurodevelopmental health needs generally when compared to children never placed in out-of-home care . IMPLICATIONS FOR PUBLIC HEALTH: Child protective services must ensure culturally safe, comprehensive, wrap-around services for Aboriginal children and their families are provided. Approaches should build on the strength of children, families and culture and avoid stigmatising children and their parents.

Normative data on nasalance scores for French speaking children.

INTRODUCTION: The objectives of this study are to establish normative nasalance values in European French for children aged 8-10 years, to study the factors likely to influence nasalance values, and to ensure that the nasometer allows the differentiation of control subjects from subjects with velopharyngeal insufficiency. METHODS: Nasal balance scores were calculated using the Nasometer II 6450 (KayPENTAX) for 50 control subjects producing 31 verbal stimuli specifically designed for the French language. Nasalance scores were analyzed and compared with 7 subjects with velopharyngeal insufficiency. RESULTS: This study provided nasalance norms for each verbal stimulus. The phonetic content of the stimuli (nasality, vowel height, voicing) was a major factor influencing the nasalance score. However, the characteristics of the speaker (gender and age) had a non-significant effect, with the major exception of the presence or absence of velopharyngeal insufficiency. CONCLUSION: This study confirmed the need to use established normative values in the patient's language and for each verbal stimulus. Although the effect of vowel height on the nasalance score has been demonstrated, this study is the first to show an effect of voicing. Once normative nasalance scores are established, a validation study with a larger pathological population will be necessary. This study establishes normative nasalance scores in European French in children.

Breakfast consumption and associated factors and barriers among school-aged children.

Background: Breakfast provides the energy and nutrition we need to function at best, both mentally and physically. It is also plausible to propose that children's general development is impacted when they skip breakfast. Objective: To assess the prevalence of breakfast consumption and associated factors and predictors among public primary school children in Debremarkos Town, Northwestern Ethiopia, 2020. Methods: A community-based cross-sectional study was conducted among school-aged children in Debremarkos, Northwest Ethiopia. A multistage random sampling technique was used to select 609 study participants. The children's parents were interviewed using a pretested, structured questionnaire. For the rest of the analysis, SPSS version 20 was used. Logistic regression analysis was performed to assess the factors associated with breakfast consumption. Statistical significance was determined at a p value <0.05. Results: Out of the sampled children, 600 respondents participated in the study, for a response rate of 98.5%. The prevalence of regular breakfast consumption among school-aged children was 67.5%. Higher odds of regular breakfast consumption were found among respondents who were females (AOR = 1.72, 95% CI = 0.118-1.773), those who lived in high-income families (AOR = 7.33, 95% CI = 1.036-8.110), and those who had an educated family (AOR = 13.05, 95% CI = 0.019-13.1). However, lower odds of regular breakfast intake were found among respondents aged 9-12 years (AOR = 0.54, 95% CI = 0.369-0.79). Conclusion: Breakfast is a major health concern for school-aged children in Debremarkos city. Breakfast eating is associated with several factors; the most notable factor is being female, having a high income, and having an uneducated family. Therefore, to prevent children from skipping breakfast, stakeholders must move swiftly.

Development and Validation of the Adolescent and Children Risk of Abuse and Maltreatment Unaccompanied Scale (ACRAM-US).

Independent migration of children and adolescents is becoming a political and social issue in recent years. Literature documents that the migration process of young people without an adult referent entail serious psychological problems. Moreover, the lack of coherence in the assessment and care processes aggravates the damage suffered by minors, which requires a greater investment of institutional resources. The aim of this research is to describe the development and provide psychometric properties of Adolescent and Children Risk of Abuse and Maltreatment Unaccompanied Scale (ACRAM-US), a 9-items scale for the assessment of risks factors of child abuse and neglect in the specific population of unaccompanied asylum-seeking children and adolescents. Structural validity, reliability and convergent-related validity were studied for this measure in a sample of 128 unaccompanied children and adolescents. The sample included cases of 14 different nationalities. Children's mean age was 16.94 (SD = 1.84), and 96.9% were male and 3.1% were female. Cases were informed by child welfare workers from different protective services in the XXXX Community (XXXX). The results of Exploratory Factor Analyses (EFA) indicate performance better solution with 2-dimensions which was also in line with theoretical formulation (χ 2 = 31.55, df = 19, p = .035, CFI = 0.991, SRMR = 0.081, RMSEA = 0.072, [90% CI: 0.019 - 0.115]). Results of convergent validity showed significant correlation with the Children Trauma Questionnaire-Short Form (CTQ-SF). Therefore, this study provides data of the first scale that assess risks factors of maltreatment for the unaccompanied asylum-seeking children and adolescents.

What Predicts COVID-Specific Symptoms of Stress in Children and Adolescents, Virus Threats or Social Distancing?

The COVID-19 crisis may have deleterious effects on children's and adolescents' mental health. However, there have been no published studies in which the COVID-related stress symptoms were investigated in a French ordinary pediatric population. The main objective of this study was to examine virus threats and social distancing measures to determine which were more disturbing for children and adolescents, and which were better predictors of post traumatic stress symptoms (PTSS). 1639 parents of children aged between 1 and 18 participated in an online survey. Parents completed questionnaires regarding their children's and adolescents' mental health while in the first French confinement. The data showed that most children and adolescents had PTSS, such as irritability and tantrums, intrusive thoughts or memories, difficulties in falling asleep, aggression, trouble concentrating, and negative emotions. Multiple linear models supported that both virus threats and social distancing- related disturbances were predictors of PTSS scores, with social distancing being a stronger predictor of PTSS scores than virus threats. Additional analyses across age groups revealed that social distancing measures predicted two times more PTSS than virus threat measures in toddlers, while virus threat measures were a stronger predictor of PTSS in adolescents. This is the first study that has investigated stress symptoms in a French pediatric population during the first French confinement episode because of the COVID-19 crisis.

Effectiveness of a game-based high-intensity interval training on executive function and other health indicators of children with ADHD: A three-arm partially-blinded randomized controlled trial.

Background: Children with ADHD demand for effective intervention with minimum side effect to improve executive function (EF) and health well-being. Method: This study used a three-arm partially-blinded randomized controlled trial to test the effects of two different kinds of 8-week game-based training programs (game-based HIIT program, GameHIIT; and game-based structured aerobic exercise program, GameSAE) on EF and other health indicators of children with ADHD, which was compared with a non-treatment control group. Results: A total of 49 children with ADHD completed the program. Analyses of EF tests and parental survey indicated that (i) there is no significant intragroup difference among all measures between pre-/post-intervention tests for two game-based intervention groups. The only significant intergroup difference was observed in self-monitor score of parent-reported child's EF between GameSAE group and the control (large effect). Similarly, cerebral hemodynamic responses also found no significant group effect for all EF tests. However, the time effects were observed in several channels in the GameHIIT group in two EF tests (Color Words Stroop Test and Tower of London Test). No significant change of participants' overall ADHD symptoms was found in the pre-/post-tests for three groups. Nonetheless, further analyses revealed that both of two game-based training programs exhibited the significant positive effects on child's PA levels and the large effects on levels of physical fitness, when they were compared to the control. Conclusion: By this study, a significant enhancement in physical fitness and PA levels were found in both game-based PA interventions when they were compared with control group. However, the effectiveness of game-based PA interventions on improving EF or reducing ADHD symptoms remains unclear. This implies that a larger intervention dosage or a tailored intervention design may be warranted to improve the EF of children with ADHD.

Exploring the multifaceted vulnerabilities of female street child labor in the capital city of Bangladesh.

Numerous children experience vulnerability due to their families' profound economic and socio-economic hardships. Among this demographic, females face heightened susceptibility, particularly those engaged in child labor. Dhaka, the capital city of Bangladesh, hosts a substantial population of female child laborers, compounding their precarious circumstances. Hence this study utilizes a qualitative phenomenological approach to investigate the vulnerabilities affecting these female child laborers thoroughly. A total of 25 in-depth interviews were conducted with female child laborers in Dhaka city, following a semi-structured format. NVivo 14 software was instrumental in the systematic coding and analysis of the extensive text data, enhancing the reliability and validity of the findings. This study, therefore, explores various vulnerabilities faced by female child laborers in Dhaka city, including risky health behavior, abusive behavior, sexual harassment, school dropout, unhygienic dietary habits, hazardous work conditions, and substandard living environments. Their socio-economic conditions make them susceptible to physical and mental setbacks, exploitation, and loss of dignity. The study emphasizes the necessity for comprehensive support and breaking the cycle through educational, health, and social initiatives. It offers a detailed portrayal of the living conditions of female child laborers in Dhaka city, providing valuable insights and evidence-based policy prescriptions for policymakers and Non-Government Organizations to formulate effective policies and measures to safeguard this vulnerable community.

Body composition, cardiovascular fitness and attention of school-aged male children practicing sports club activities: A cross-sectional.

BACKGROUND: The positive effects of physical activity on physical fitness, bone health, academic achievement, cognitive functions, mental health, and reduced obesity have been proven. This study aims to investigate the relationship between sports club activities, physical activity selected health-related fitness, and the d2 attention test. MATERIALS AND METHODS: A cross-sectional study was conducted in different sports clubs. A total of 78 male students aged 10-13 years participating in various branches of sports clubs were included in the study, 42 of whom were assigned to the sports group and 36 to the control group. Questionnaires were administered to assess sports club participation and attention levels, while physical health profiles were tested with body composition and Yo-Yo IR1C performance measures. Data were analyzed according to sports participation and the five most frequently reported sports. The means and standard deviation of each study value were calculated for the total subjects and by participating in sports activity using the IBM SPSS (version 23) analysis program. Data normality was checked and confirmed by the Skewness and Kurtosis Tests. RESULTS: The results showed that boys enrolled in a sports activity had lower body mass (-17.9%, P < 0.05 d = 0.72), body mass index (-13.4%, P < 0.05, d = 0.87), and body fat (%) (-54.1%, P < 0.05, d = 1.38) and higher VO2max 32.3% (P < 0.05, d = 3.67), than the non-active group. The boys active in sports clubs also had better results in the total number of items processed (11%, P < 0.05 d = 0.50) and in concentration performance (17.7%, P < 0.05 d = 0.56) than the non-active group. In correlation analyses, VO2max was negatively associated with body mass, body mass index, and body fat (P = 0.011; P = 0.001 and P = 0.00, respectively) and positively related to the total number of items processed and concentration performance (P = 0.003 and P = 0.015, respectively). In the Pearson Correlation analyses, body fat showed a lower negative correlation with TN (r = 0.33; P = 0.003) and CP (r = 0.28; P = 0.015). CONCLUSIONS: Boys participating in regular sports have lower body mass, BMI, and BF values. In addition, boys who participated in sports showed higher imaginary fitness and selective attention and concentration capacity results, as expected, for any sports part compared to their body peers. Another attempt from this study is that body mass and body fat percentage recovery are negatively associated with fitness. Considering the increasing prevalence of obesity in children and adolescents due to sedentary living, which has become a worldwide epidemic, it is recommended that pedagogical and public health strategies and policies be developed based on the physical fitness level of children.

Cluster sampling methodology to evaluate immunization coverage.

BACKGROUND: Immunization is a key component of primary health care and an indisputable human right. Vaccines are critical to the prevention and control of infectious disease outbreaks. The coronavirus disease 2019 (COVID-19) pandemic and associated disruptions over the past two years have strained the health systems, with many children missing out on essential childhood vaccines. AIM: To evaluate the immunization coverage among 12-23-month-old children in the rural areas of Community Health Centre (CHC) Dighal and to determine the factors influencing the existing immunization coverage. METHODS: A coverage evaluation survey was conducted according to the 30-cluster sampling technique, which is the standard methodology for such surveys devised by World Health Organization. A total of 300 children aged 12-23 months were included, whose immunization details were noted from their immunization cards. RESULTS: Full immunization rate was noted in 86.7% of the children, with partial and non-immunized children accounting for 9% and 4.3% respectively. The full immunization dropout rate was 4.2%. The common reasons for partial or non-immunization were family problem including illness of mother, vaccine not being available and child being ill. Place of birth (P = 0.014) and availability of immunization card (P < 0.001) were significant predictors of the immunization status. Since the study was conducted in 2020/2021, health services were disrupted due to the COVID-19 lockdown. CONCLUSION: Due to the coverage being higher than the national average, it was concluded that the immunization coverage was optimal and not affected by the COVID-19 pandemic.

Analysis of exacerbating factors of pediatric asthma before and after the COVID-19 pandemic.

Purpose: The incidence of the existing respiratory virus and air pollutants had disappeared or decreased due to social distancing during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, there was no increase in asthma exacerbations in 2020. This study aimed to analyze the emergency department (ED) visits of children and adolescent patients with asthma before and after the COVID-19 outbreak and examine the effects of respiratory virus infection and air pollutants. Methods: This study included pediatric and adolescent patients with asthma aged 2-18 years who visited 419 EDs nationwide during February to December in 2018, 2019, and 2020. The patients who were diagnosed with asthma, ie, J45 or J46 (International Classification of Diseases, 10th revision) in the ED medical history, diagnosis history at discharge, and diagnosis at discharge after hospitalization through the ED were included using the National Emergency Department Information System. Data were analyzed by dividing the period as follows: pre-COVID-19 (from February to December 2018 and 2019) and COVID-19 pandemic (from February to December 2020). Results: The monthly average of 673 visiting patients (95% confidence interval [CI], 474-872) during the pre-COVID-19 period decreased to 176 (95% CI, 113-239) during the COVID-19 pandemic, which is a 73.8% decrease (p < 0.001).In the pre-COVID-19 period, peaks were observed in spring and autumn. Meanwhile, during the COVID-19 pandemic, a peak was observed only during autumn. During the COVID-19 pandemic, no relationship was found between the rhinovirus infection and asthma exacerbations (p < 0.001). Conclusions: Respiratory virus infections are strongly associated with asthma exacerbations in children and adolescents. In this study, air pollution is not a major factor for ER visits due to asthma exacerbations. Even though the prevalence of respiratory viruses is decreasing, ED visits due to worsening asthma are trending in the fall. This phenomenon may indicate that asthma has worsened due to other causes such as pollen or fluctuations in temperature and air pressure.