Change in screen time of preschool children according to parental attitudes during the COVID-19 pandemic with an online survey.

The relationship between the change in the screen time of preschool children according to both parent-child characteristics and parental attitudes was investigated in an online study involving 403 mothers. Mothers completed a questionnaire on baseline characteristics and Parent Attitude Scale. Multiple logistic regression and generalized linear models revealed the associations. Change in screen time was grouped as "increase" and "no increase". 70% stated an increase in the screen time during the pandemic period. The overprotective score was low in the group with increased screen time after adjusting parental age, education, and working status, family type, number of the children, the enrolled child's age, gender, daily screen time before the pandemic, and caregiver of the child. The child having longer screen time also had higher risk for the history of an increase in screen time in the lockdown period. This situation shows a need for parental guidance for healthy screen use.

Effect of screen time on behavior of pre-schoolers in Islamabad.

Objective: Early years of childhood form the basis of intelligence, personality, social behaviour, and capacity to learn and nurture oneself as an adult. Our objective was to find out the effects of screen time on behavior of pre-schoolers, which could provide scientific grounds to the control of digital screen time. Method: A cross sectional survey was conducted in four private preschools of Islamabad from June -November 2021. A sample size of 200 children ages three-five years were selected through multistage random sampling using a parental questionnaire. Children were grouped based on daily screen time of ≤60 minutes or >60 minutes. Analysis was made based on the Child behavior checklist for ages eighteen months-five years results. Cronbach's alpha coefficient was found to be 0.925. It was analyzed using SPSS version 22. Chi-square test, independent sample t-test and multi linear regression were applied to determine the association and significance levels between the variables. Results: Study results indicate increased screen time was statistically significant with child's age, education level and employment status of mothers. It was observed that pre-schoolers with screen time of > 60 minutes tend to suffer more from withdrawal syndrome (11.94±3.91, p = 0.014) sleep problems (10.97±3.20, p = 0.010) and Autism spectrum problems (17.66±5.89, p = 0.047) as compared to pre-schoolers with screen time ≤60 minutes. Strongest predictor of outcome variable was found to be mothers education level (ß = 21.53). Conclusion: Study findings revealed that excessive screen time has deleterious effect and is associated with behavioural problems of pre-schoolers.

How do young children eat after an obesity intervention? Validation of the Child Eating Behaviour Questionnaire using the Rasch Model in diverse samples from Australia and Sweden.

Child eating behaviours have consistently been linked to child weight status. Yet, changes in child eating behaviours during early obesity treatment are rarely evaluated. Psychometric evaluation of the Child Eating Behaviour Questionnaire (CEBQ) is common, but results are sample-dependent and included items may not capture the full range of the underlying traits. Rasch analysis can overcome these disadvantages. The aim of this paper was to assess child eating behaviours measured by the CEBQ after a 12-month obesity intervention applying the Rasch model for the validation of the CEBQ. The Rasch-based fit statistics were applied in children from two samples, Australian and Swedish (n = 1724). Changes in eating behaviours amongst children aged 4-6 years were examined in the More and Less RCT for obesity treatment (n = 177), which compared a parenting programme (with and without boosters) against standard treatment. Parents completed the CEBQ at four time points over 12-months. Linear mixed models were applied to estimate treatment effects on the CEBQ, refined according to Rasch, over time. We found that the validity of CEBQ was confirmed after removing 4 items (item fit statistics outside range 0.5-1.5). When the refined CEBQ was used in the assessment of the RCT, there were no differences in parental reports of changes in children's eating behaviours between the parenting programme and standard treatment (group-by-time interactions p > 0.05). However, in the total sample food approach behaviours decreased while fussy eating behaviours increased (p < 0.05). In conclusion, the refined CEBQ proved to be a valid tool for examining parent-reported child eating behaviours. Early obesity treatment may decrease eating behaviours associated with higher child weight. Future research should address the associations between changes in child weight status and eating behaviours.

Comparing different data sources by examining the associations between surrounding greenspace and children's weight status.

BACKGROUND: Studies on the association between surrounding greenspace and being overweight in childhood show inconsistent results, possibly because they differ widely in their definition and measurement of surrounding greenspace. Our aim was to evaluate whether the association of greenspace with being overweight depends on the measurement of greenspace in different data sources. METHODS: Based on data from the school entry examinations of 22,678 children in the city of Hannover, Germany, from 2010 to 14, the association between greenspace availability and overweight was examined. Three different sources of greenspace availability were derived for a set of 51 areas of the city: The Normalized Difference Vegetation Index (NDVI), the OpenStreetMap (OSM) dataset, and the European Urban Atlas (UA) dataset. Agreement between the indicators on the quantity of greenspace coverage was compared. The association with children's BMI z-score, including potential interaction terms, was assessed using multilevel regression analysis. RESULTS: Greenspace availability per district area derived by NDVI was on average 42%, by OSM 29% and UA 22%, with OSM and UA being strongly correlated. Only the greenspace availability derived by NDVI showed an association with children's BMI z-score: The higher the greenspace availability was, the lower the BMI. The trend of association was higher for boys and migrant children than for girls and non-migrants and was restricted to the highest levels of greenspace availability. CONCLUSIONS: Associations of greenspace with children's weight status depend on the greenspace measurement chosen. Surrounding greenspace was measured more comprehensively by NDVI. Data sources based on land use categories such as UA and OSM may be less suitable to reflect surrounding greenspace relevant for health outcomes. Potential mechanisms warrant further analysis and investigation.

Evaluation of problematic screen exposure in pre-schoolers using a unique tool called "seven-in-seven screen exposure questionnaire": cross-sectional study.

BACKGROUND: Screen media exposure has been increasing in the preschool years. Risky aspects of screen exposure have many potential negative effects on children's health. We aimed to evaluate problematic screen exposure in Turkish preschool children by using a unique tool called the "Seven-in-Seven Screen Exposure Questionnaire" and to investigate factors associated with problematic screen exposure. METHODS: A questionnaire form was designed including general descriptive questions in the first part. In the second part, a questionnaire we designed called the "Seven-in-Seven Screen Exposure Questionnaire" was conducted to evaluate problematic screen exposure characteristics. The questionnaire included seven items: daily screen time, viewing with parent(s), setting screen limits, screen exposure during meals and in the hour before bedtime, age of onset of screen exposure, and viewing low-quality content. The total problematic screen exposure score (range 0-13) was generated by summing scores from the seven items. Total scores are classified into two categories: low (< 7) and high (≥ 7). Logistic regression was performed to search for independent parameters associated with problematic screen exposure. RESULTS: One thousand two hundred forty-five mother-child pairs participated in this study. The median age of the children was 3.9 (IQR: 2.9-4.7) years and 51% were males. Overall, 280 children (22.5%) had a problematic screen exposure score of ≥7 (high). The median problematic screen exposure score was 4 (IQR: 3-6). Maternal age of < 30 years; paternal age of ≥30 years; maternal educational level of ≤12 years; the age of 24-48 months; home-based daycare; postponing eating, toileting, or sleeping while using a screen; and using touchscreen devices were found to be associated with an increased risk of having a high problematic screen exposure score. CONCLUSION: Developing national scales to monitor problematic screen use in children would be more effective than monitoring screen time alone. All of the screen use characteristics not recommended in children would be evaluated using problematic screen exposure scales. The "Seven-in-Seven Screen Exposure Questionnaire" may serve as an example for further studies.

Cadherin-related family member 3 gene impacts childhood asthma in Chinese children.

BACKGROUND: A missense variant (rs6967330) of the gene encoding cadherin-related family member 3 (CDHR3) was associated with recurrent severe exacerbations in pre-schoolers. However, there were limited data on its relationship with pre-school lung function and school-age asthma. This study replicated the association between polymorphic markers at the region of CDHR3 around rs6967330 and wheezing phenotypes in two independent cohorts of Chinese children. METHODS: Ten tagging SNPs located 10 kb around rs6967330 were selected by HaploView 5.0 based on 1000 Genomes database for Southern Han Chinese. Their associations with wheezing and lung function were examined in 1341 Chinese pre-school children, while those for asthma phenotypes were examined in an independent group of 2079 school-age children. Genotypic and haplotypic associations were analyzed by multivariate regression, and generalized multifactor dimensionality reduction was used to examine epistatic interactions for wheezing traits. RESULTS: The mean (SD) age of pre-school cohort was 4.7 (1.0) years. Rs6967330 was associated with current wheeze (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.09-2.43) and its severity (OR 1.64, 95% CI 1.10-2.44) among pre-school children. This SNP was also associated with school-age asthma (OR 1.32, 95% CI 1.04-1.69). The minor allele of rs408223 was associated with lower FEV0.5 (ß = -2.411, P = .004) and FEV0.5 /FVC (ß = -1.292, P = .015). Lower spirometric indices were also associated with minor allele of rs140154310. GAC haplotype from rs4730125, rs6967330, and rs408223 was associated with pre-school current wheeze and school-age asthma. Epistatic interaction was found between unrelated CDHR3 SNPs for FEV0.5 among pre-schoolers. CONCLUSION: CDHR3 is a candidate gene for early-life wheezing, school-age asthma, and lung function in Chinese children.

Food literacy predictors and associations with physical and emergent literacy in pre-schoolers: results from the Training-to-Health Project.

OBJECTIVE: Food literacy (FL) is a crucial need encompassing basic literacy and fundamental movement skills. The present study aimed to investigate the FL level in pre-schoolers and to evaluate the effect of potential predictors and the associations with gross motor and emergent literacy skills. DESIGN: Cross-sectional study conducted within the Training-to-Health Project. SETTING: Kindergartens (n 21) in the Palermo City Council, Italy. PARTICIPANTS: Pre-school children aged 3-6 years (n 921) followed education sessions on nutritional topics, practical activities and compiled prearranged sheets. FL was assessed by the five-domain toolkit 'preschool-FLAT'; gross motor and emergent literacy skills were assessed by the Italian version of the gross motor development test and the PRCR-2/2009, respectively. Correlation and regression analyses were performed to assess relationships between FL scores and gender, age, weight, height, BMI, gross motor and emergent literacy skills. RESULTS: Independent predictors (ß, se) of higher FL were female gender (1·06, 0·315, P < 0·01), older age (0·08, 0·019, P < 0·001) and greater height (0·13, 0·03, P < 0·001). The adjusted coefficients were significant for quotient of gross motor development and in particular for the locomotor component (0·03, 0·01, P < 0·01 and 0·16, 0·046, P < 0·001, respectively). Almost all associations with the emergent literacy skills were significant (ß = -0·02 to 0·47). CONCLUSIONS: The study suggests that children raised in an environment where both cognitive and motor skills are enhanced can have better chances of increasing FL and success at school. Thus, the need for monitoring FL and its predictors since early age is highlighted.

Validation of the Child Feeding Questionnaire among Saudi pre-schoolers in Jeddah city.

OBJECTIVE: To examine the psychometric properties of an Arabic version of the Child Feeding Questionnaire (CFQ-A) in a sample of Saudi pre-schoolers and their mothers. DESIGN: Cross-sectional study. Mothers completed questionnaires over the telephone and child anthropometry was measured objectively using standardized procedures; BMI Z-scores (BMIZ) were calculated based on the age- and sex-specific WHO growth standards and reference data. Confirmatory factor analysis was used to examine the original seven-factor CFQ model, as well as a modified nine-factor model. Cronbach's α was calculated to examine the internal consistency of each factor; Spearman correlation was used to examine 2-week retest reliability. Factor-factor and factor-child BMIZ correlations were examined. SETTING: Jeddah, Kingdom of Saudi Arabia. PARTICIPANTS: A total of 209 mothers and children were recruited from eight different pre-schools. RESULTS: Both the original seven-factor and modified nine-factor CFQ-A exhibited good fit (root-mean-square-error of approximation < 0·05). Six out of nine factors had excellent internal consistency and all factors showed excellent 2-week test-retest reliability. There were significant correlations between child BMIZ and five out of the nine factors; Perceived Child Weight, Perceived Parent Weight, Restriction and Monitoring were each positively correlated with child BMIZ, while Concern about Child's Diet was negatively correlated with child BMIZ. CONCLUSIONS: The study provided evidence supporting the validity and reliability of the original seven-factor and modified nine-factor CFQ-A. Future studies are needed to further establish the psychometric properties of the CFQ-A in addition to other feeding assessment tools.

Associations of nutritional status, sugar and second-hand smoke exposure with dental caries among 3- to 6-year old Malaysian pre-schoolers: a cross-sectional study.

BACKGROUND: Dental caries in primary teeth is a serious oral health concern among children. It can lead to detrimental impacts on a child's growth, development, and quality of life. Therefore, this cross-sectional study aimed to examine the prevalence of dental caries and its associations with nutritional status, sugar and second-hand smoke exposure among pre-schoolers. METHODS: A total of 26 pre-schools in Seremban, Malaysia were randomly selected using the probability proportional to size sampling. Dental examination was performed by a dentist to record the number of decayed teeth (dt). Weight and height of the pre-schoolers were measured. The mother-administered questionnaire was used to gather information pertaining to the sociodemographic characteristics and second-hand smoke exposure. Total sugar exposure was calculated from a 3-day food record. RESULTS: Among the 396 participating pre-schoolers, 63.4% of them had at least one untreated caries, with a mean ± SD dt score of 3.56 ± 4.57. Negative binomial regression analysis revealed that being a boy (adjusted mean ratio = 1.42, 95% CI = 0.005-0.698, p = 0.047), exposed to second-hand smoke (adjusted mean ratio = 1.67, 95% CI = 0.168-0.857, p = 0.004) and those who had more than 6 times of daily total sugar exposure (adjusted mean ratio = 1.93, 95% CI = 0.138-0.857, p = 0.013) were significantly associated with dental caries among pre-schoolers. CONCLUSION: A high prevalence of dental caries was reported in this study. This study highlights the need to reduce exposure to second-hand smoke and practice healthy eating behaviours in reducing the risk of dental caries among pre-schoolers.

Prevalence of objectively measured sedentary behavior in early years: Systematic review and meta-analysis.

BACKGROUND: The early years have been identified as a critical period during which sedentary habits may be established, as this behavior appears to track throughout life. OBJECTIVE: The purpose of this systematic review and meta-analysis is to summarize the current literature on the prevalence of sedentary behavior in children aged 1-5.99 years, reporting differences between boys and girls, weekdays and weekend days, childcare hours and nonchildcare hours, and between time spent indoors and outdoors while children attended childcare. METHODS: Five databases were searched until 26.10.2017 and meta-analyses were conducted to estimate prevalence and calculate mean differences in prevalence between groups. RESULTS: Fifty studies representing 14 598 children (2-5.99 years) were included. Children spent 51.4% of their waking time in sedentary behaviors. Boys spent less time being sedentary than girls (estimate difference = -1.4%; 95%CI = -2.0: -0.7; P < .001). No significant differences were found between weekdays/weekend days (estimate difference = -0.4; 95%CI = -2.0: 1.2; P = .61) nor between childcare hours/nonchildcare hours (estimate difference = %; 95%CI = -0.9: 6.6; P = .136). While attending childcare centers, children were more sedentary indoors than outdoors (estimate difference = 14.4%; 95%CI = 11.8: 16.9; P < .001). CONCLUSIONS: Our results suggest that young children spend a significant portion of their waking hours in sedentary behaviors. While at childcare, young children accumulated more sedentary behavior indoors than outdoors. Girls were more likely to be more sedentary than boys. No significant differences were found between weekdays and weekends, or between childcare and nonchildcare hours. There is a need for higher-quality studies with strong designs, using age and device appropriate cut-off points, to improve evidence-base and to better establish prevalence of sedentary behavior in young children.

Environmental characteristics of early childhood education and care centres and young children's weight status: A systematic review.

The aim of this systematic review was to summarize ECEC environmental correlates of weight status in children under the age of 6years. Six databases (PubMed, PsycINFO, CINAHL, SPORTDiscus, Scopus, and Web of Science) were searched until March 2017. Observational studies examining the relationship between ECEC environmental characteristics and weight status in children aged 0-6years were included. Data was extracted using a predesigned form. Eight studies, representing 4862 children, met the inclusion criteria. Twenty-two environmental characteristics were identified and classified into four domains (physical, political, economic, and sociocultural); of these, six correlates were found. 'Active environment' 'sedentary opportunities', 'active play time', 'high sugar and high fat served', 'educators' weight' and 'educators' habitual physical activity level' were associated with weight status in young children. However, for most environmental characteristics examined, strong evidence is not available yet, due to variations across studies on the measures of environmental characteristics and analytical methodologies. Stronger empirical evidence in greater quantity is needed. Future studies in this area are recommended to investigate the environmental influence using an ecological approach and to examine the potential mediators, with a focus on the settings of family-based centres and samples representing toddlers and/or infants.

The role of cardiac vagal tone and inhibitory control in pre-schoolers' listening comprehension.

This study investigated the role of basal cardiac activity and inhibitory control at the beginning of the school year in predicting oral comprehension at the end of the year in pre-schoolers. Forty-three, 4-year-olds participated in the study. At the beginning of the school year children's electrocardiogram at rest was registered followed by the assessment of inhibitory control as well as verbal working memory and verbal ability. At the end of the year all children were administered a listening comprehension ability measure. A stepwise regression showed a significant effect of basal cardiac vagal tone in predicting listening comprehension together with inhibitory control and verbal ability. These results are among the first to show the predictive role of basal cardiac vagal tone and inhibitory control in pre-schoolers' oral text comprehension, and offer new insight into the association between autonomic regulation of the heart, inhibitory control, and cognitive activity at a young age.

Water intake and beverage consumption of pre-schoolers from six European countries and associations with socio-economic status: the ToyBox-study.

OBJECTIVE: To study the quantity and quality of water intake from beverages among pre-schoolers and investigate associations with gender and socio-economic status (SES). DESIGN: Kindergarten-based cross-sectional survey within the large-scale European ToyBox-study. A standardized protocol was used and parents/caregivers filled in sociodemographic data and a semi-quantitative FFQ. SETTING: Kindergartens in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). SUBJECTS: European pre-schoolers (aged 3·5-5·5 years) and their parents/caregivers (n 7051). RESULTS: Mean water intake was 1051 ml/d; plain water, 547 ml/d; plain milk, 241 ml/d; other fruit juice, 104 ml/d; pure fruit juice, 59 ml/d; soft drinks, 55 ml/d; tea, 45 ml/d; sugared and chocolate milk, 37 ml/d; smoothies, 15 ml/d; and light soft drinks, 6 ml/d. Boys had a higher water intake than girls due to a higher consumption of plain water, but more importantly to the consumption of beverages of less quality. Lower-SES pre-schoolers scored better on quantity than high-SES pre-schoolers, but as a consequence of consumption of sugared beverages. Nevertheless, the associations differed by country. CONCLUSIONS: The water intake from beverages did not meet the European Food Safety Authority standard of 1280 ml/d; especially in Western European countries water intake from beverages was low. The most important water sources were plain water, milk and fruit juices. Interventions aiming at a proper and sufficient water intake should focus on both quantity and quality. Messages about water and water sources should be clear for everyone and interventions should be sufficiently tailored.

Diet quality in European pre-schoolers: evaluation based on diet quality indices and association with gender, socio-economic status and overweight, the ToyBox-study.

OBJECTIVE: To study diet quality among pre-schoolers using the Diet Quality Index (DQI) and to investigate differences according to gender, socio-economic status (SES) and overweight/obesity status. DESIGN: Kindergarten-based cross-sectional survey within the ToyBox-study. A standardized protocol was used and parents/caregivers self-reported sociodemographic data and a semi-quantitative FFQ. A total DQI and its four subcomponents (diversity, quality, equilibrium and meal index) were calculated based on this FFQ. High total DQI scores indicate better diet quality than low scores. Results of the total DQI and the subcomponents were reported as percentages of maximum scores (100 %). SETTING: Kindergartens in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). SUBJECTS: European pre-schoolers (aged 3·5-5·5 years) and their parents/caregivers (n 7063). RESULTS: The mean total DQI score was 68·3 %. Mean scores of the subcomponents were 61·7 % for diversity, 56·5 % for quality, 65·4 % for equilibrium and 89·7 % for the meal index. Pre-schoolers of lower-SES backgrounds had lower scores on the total DQI and all its subcomponents. No clear differences were found by gender and overweight status. Results differed slightly according to country. CONCLUSIONS: Pre-schoolers scored low on the total DQI and especially on dietary quality, as energy-dense, low-nutritious food items were more often consumed than highly nutritious food items. Furthermore, already in pre-schoolers lower-SES mothers were less likely to provide a good diet quality and this was consistent for all four subcomponents of the total DQI. Food intake in pre-schoolers should be enhanced, especially in pre-schoolers of lower-SES backgrounds.

Characterisation of anaemia and associated factors among infants and pre-schoolers from rural India.

OBJECTIVE: In India, national databases indicate anaemia prevalence of 80 % among 6-35-month-old children and 58 % among 36-59-month-old children. The present study aimed to characterise anaemia and the associated factors among infants and pre-schoolers living in rural India. DESIGN: Multivariate logistic regression analysis of data collected prior to an intervention trial. Fe-deficiency with anaemia (IDA), Fe deficiency with no anaemia (IDNA) and anaemia without Fe deficiency were defined. Serum ferritin, soluble transferrin receptor (sTfR) and sTfR/log ferritin index were used to indicate Fe status. SETTING: Twenty-six villages of Nalgonda district, Telangana, India. Data were collected in community sites. Participants Four hundred and seventy-six infants (aged 6-12 months), 316 pre-schoolers (aged 29-56 months) and their mothers. RESULTS: Prevalence of anaemia among infants and pre-schoolers was 66·4 and 47·8 %, prevalence of IDA was 52·2 and 42·1 %, prevalence of IDNA was 22·2 and 29·8 %, prevalence of anaemia without Fe deficiency was 14·2 and 5·7 %. Among infants, anaemia was positively associated with maternal anaemia (OR=3·31; 95 % CI 2·10, 5·23; P<0·001), and sTfR/log ferritin index (OR=2·21; 95 % CI 1·39, 3·54; P=0·001). Among pre-schoolers, anaemia was positively associated with maternal anaemia (OR=3·77; 95 % CI 1·94, 7·30; P<0·001), sTfR/log ferritin index (OR=5·29; 95 % CI 2·67, 10·50; P<0·001), high C-reactive protein (OR=4·39; 95 % CI 1·91, 10·06, P<0·001) and young age (29-35 months: OR=1·92; 05 % CI 1·18, 3·13, P=0·009). CONCLUSIONS: Anaemia prevalence continues to be high among infants and pre-schoolers in rural India. Based on sTfR/ferritin index, Fe deficiency is a major factor associated with anaemia. Anaemia is also associated with inflammation among pre-schoolers and with maternal anaemia among infants and pre-schoolers, illustrating the importance of understanding the aetiology of anaemia in designing effective control strategies.

Increased prevalence of Mycoplasma pneumoniae serological positivity in Chilean young children.

BACKGROUND: Mycoplasma pneumoniae is a frequent cause of respiratory infections in school children and adolescents. Epidemiological suspicion is important, since there are no specific symptoms or signs to help in diagnosing infection caused by this agent. OBJECTIVE: To determine the variation in prevalence over the last 10 years of M. pneumoniae IgM seropositivity according to age, particularly in pre-schoolers. METHOD: The results of M. pneumoniae IgM serological testing between January 2004 and December 2013 were analysed. Variables such as gender and month and year of sample processing were studied according to age groups (<5, 5-18, 19-50, 51-70 and >70 years of age). RESULTS: Of a total of 20,020 serological samples, 31.9% proved positive for M. pneumoniae. All age groups showed increases in percentage seropositivity over the last 10 years, although the most significant increase corresponded to the 5-18 years group (from 15.8% to 54%), followed by children <5 years of age (from 8.6% to 30%). Seropositivity was significantly higher in women in all age groups, except in those over 50 years of age. CONCLUSION: Children under five years of age were the group with the second highest increase in seropositivity.

I want it all and I want it now: Delay of gratification in preschool children.

On the delay-of-gratification choice paradigm, 4-year-olds typically choose the larger, delayed reward, exhibiting delay of gratification, whereas 3-year-olds typically choose the small, immediate reward. Despite this highly replicated finding, the cognitive mechanism(s) underlying 3-year-olds' failure on the choice paradigm remain unclear. Recently, several researchers have proposed the involvement of the "hot" affective system and the "cool" cognitive system in pre-schoolers' performance on the choice paradigm. Using this "hot" and "cool" systems framework, we tested 112 3- and 4-year-olds on a modified choice paradigm that was designed to help young children better utilize their "cool" system, allowing them to make more mindful and future-oriented decisions. In the modified paradigm, 3-year-olds made choices consistent with those of 4-year-olds, exhibiting delay of gratification. These findings have important implications for previous theoretical accounts of 3-year-old children's failure to delay gratification. Additionally, they highlight the critical role that the method plays in young children's performance on cognitive paradigms.

Dietary patterns and risk of developing asthma among pre-schoolers.

BACKGROUND: Early childhood dietary patterns have been identified as potential factors that can influence the development of asthma in children. The objective of the study was to determine the association between dietary patterns, identified through principal component analysis (PCA), and asthma in pre-schoolers. METHODS: This unmatched case-control study used data from 3145 pre-schoolers participating in the parent population-based observational study conducted in a District Municipality, Province. The study consisted of 189 pre-schoolers (63 with asthma, 126 controls) between 1 and 8 years. We identified primary dietary patterns by conducting a PCA on reported food consumption data from the Quantitative Food Frequency Questionnaire (QFFQ). Multivariate logistic regression models determined the relationship between food patterns and asthma. RESULTS: The results of our study identified four primary dietary patterns that defined the dietary preferences of the pre-schoolers: Meat general and dressings pattern, Healthy dietary pattern, Sugary and/or sweetened drinks pattern, and Mixed dietary pattern. The consumption of sugary and sweetened drinks (adjusted OR 7.0, 95% CI: 2.3-21.1-1; p = 0.00) as well as a Mixed dietary pattern (adjusted OR 4.0, 95% CI: 1.4-11.1; p = 0.03) were positively associated with a higher probability of developing asthma. A Healthy dietary pattern (adjusted OR 0.02, 95% CI: 0.00-0.09; p = 0.00) was negatively associated with an increased likelihood of presenting with asthma. CONCLUSIONS: In the current study, a Healthy dietary pattern was negatively associated with an increased likelihood of presenting with asthma. Diet modification may be a potential intervention to impact the increasing prevalence of this disease.

Exposure to Violence and Mental Health Outcomes Among Pre-schoolers in a South African Birth Cohort.

Little is known about the relationship between violence exposure and mental health in preschoolers living in low- and middle-income countries (LMICs). Multiple regression analyses investigated associations between violence exposure and mental health in the Drakenstein Child Health Study (N = 978), a South African birth cohort. Lifetime violence exposure was assessed at age 4.5 years using the parent-report Child Exposure to Community Violence Checklist (CECV). Mental health was assessed at age 5 years using the Child Behaviour Checklist (CBCL 1.5-5). Eighty-three percent of the children were exposed to some form of violence. Internalising and externalising behaviours were positively associated with overall violence exposure (ß per one unit change in the overall score = 0.55 [0.16, 0.94] and ß = 0.53 [0.23, 0.84], respectively), domestic victimisation (ß per one unit change in the subscore = 1.28 [0.28, 2.27]; ß = 1.14 [0.37, 1.90]) and witnessing community violence (ß = 0.77 [0.15, 1.39]; ß = 0.68 [0.19, 1.18]). There was a positive association between polyvictimisation and externalising (ß = 1.02 [0.30, 1.73]) but not internalising (ß = 0.87 [-0.06, 1.80]) behaviour problems. Evidence for an association of witnessing domestic violence with internalising (ß = 0.63 [-0.97, 2.24]) or externalising (ß = 1.23 [-0.04, 2.50]) behaviours was less robust. There was no association between community victimisation and internalising or externalising behaviours (ß = 0.72 [-1.52, 2.97; ß = 0.68 [ -1.06, 2.41]). Observations highlight the risk for mental health problems among preschoolers living in high-violence contexts and emphasize the need for early interventions.

Associations between basic motor competencies and physical fitness in Spanish pre-schoolers: a cross-sectional study.

BACKGROUND: Basic motor competencies (BMC) play a vital role in child development and are a primary focus of physical education. However, there is a lack of research on BMC in preschool-aged children, making this study particularly significant. The present study aims to examine the relationship between BMC and physical fitness components in Spanish preschool children. METHODS: This cross-sectional study was conducted on 101 children (n = 52 boys, average age of 4.80 years) living in Pamplona, North Spain. Components of physical fitness (handgrip strength, standing long jump, speed-agility, and cardiorespiratory fitness) were assessed using the PREFIT Battery. Overall physical fitness was computed from the four selected fitness components separately for boys and girls. Higher z-scores values in physical fitness indicate better fitness performance. To assess BMC, the MOBAK KG test battery was applied (subscales of object control and self-movement). Sex, age, and body mass index were used as main confounders. RESULTS: After adjustment for confounding factors, the BMC was positively associated with single (z-scores) components and overall physical fitness sum of z-scores (R2 from 0.178 to 0.469, all P-values < 0.05). Additional percentile scores weakened the associations, but they still remained significant (R2 from 0.146 to 0.337, all P-values < 0.05). Compared with participants in the lowest tertile, those in the highest tertile of the MOBAK KG sum score, and in both object movement and self-movement test subscales had significantly higher scores in single fitness component (z-scores or percentile) and overall physical fitness sum of z-scores (all P for trend < 0.001). CONCLUSIONS: Our results revealed that higher BMC is associated with better physical fitness in Spanish preschool children. The findings emphasize the crucial role that basic motor competence plays in promoting physical activity in preschool children.