In recent years, notified pertussis cases have been increasingly documented in China. It raised a new public health concern of potential optimization in immunization strategy. This study was aimed to ...determine the cost-effectiveness of different immunization strategies against pertussis-containing vaccines for 6-year-old pre-school children in Shanghai.
A Markov-decision tree model was applied to evaluate two pertussis immunization strategies for 6-year-old pre-school children as following: (1) 1 dose of acellular pertussis (aP) contained vaccine (DTaP or Tdap) booster vaccinated at 6 years of age, and (2) no booster at 6 years of age regimen. Primary outcomes included quality-adjusted life years (QALYs), costs, and incremental cost-utility ratios (ICUR). Sensitivity analyses were performed. The analysis was conducted over a study period of 14 years from a societal perspective.
Compared to no booster immunization strategy, administering 1 dose of acellular pertussis (aP) contained vaccine (DTaP or Tdap) booster at 6 years of age, resulted in an average cost reduction of CNY 814.16 (USD 116) per individual, an increase in QALYs by 0.00066, and a rise in per capita net monetary benefit (NMB) by CNY 933.51 (USD 132). The total costs over the study period were reduced by CNY 160.59 million (USD 23 million), utility increased by 130.49 QALYs, and NMB increased by CNY 184.14 million (USD 26 million).
Implementing acellular pertussis booster immunization for 6-year-old pre-school children in Shanghai emerges as a cost-saving immunization strategy, with both cost savings and utility gains.
Insufficient physical activity (PA) is considered a critical contributor to childhood overweight. Parents are a key in influencing their child's PA through various mechanisms of PA parenting, ...including support, restriction of PA and facilitation of enrolment in PA classes or activities. However, study findings are difficult to compare because instruments vary in terms of constructs, psychometric assessment and type of PA assessed. The goal of the current review was to identify existing PA parenting questionnaires and report on the validation of these measures through findings of their psychometric performance and correlation to youth's PA. The search of eligible studies was restricted to instruments with multiple items. Eleven unique PA parenting questionnaires were identified, and 46 studies that used these instruments were included. Extracted data include sample characteristics, as well as type and assessment methods of parental influence and PA. Findings highlight the tremendous variation in the conceptualization and measurement of PA parenting, common use of non‐validated instruments and lack of comprehensive measures. The development of theory‐based PA parenting measures (preferably multidimensional) should be prioritized to guide the study of the parental role in promoting child's PA as well as the design of family‐based PA interventions.
A systematic review was commissioned to support an international expert group charged to update the Food and Agriculture Organisation of the United Nations (FAO)/World Health Organisation (WHO)'s ...vitamin D intake recommendations for children aged 0-4 years.
Multiple electronic databases were searched to capture studies published from database inception to the 2
nd
week of June 2020 according to key questions formulated by the FAO/WHO. Relevant studies were summarised and synthesised by key questions and by health outcomes using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.
The 146 included studies examined the effects of different vitamin D intake levels on a variety of health outcomes (e.g. infectious disease, growth, neurodevelopment, rickets, and bone mineral density), and on outcomes for setting vitamin D upper limits (e.g. hypercalcemia, hypercalciuria, and nephrocalcinosis). For most outcomes, the strength of evidence was low or very low. Evidence was rated moderate for the effect of daily vitamin D supplementation on raising serum 25(OH)D concentrations, and a random-effects meta-regression analysis of 28 randomised controlled trials (mostly in infants 0-12 months) showed that each 100 IU/d increase in vitamin D supplementation was associated with an average of 1.92 (95% CI 0.28, 3.56) nmol/L increase in achieved 25-hydroxy-vitaminn D (25OHD) concentration (n = 53 intervention arms; p = .022) with large residual heterogeneity (I
2
= 99.39%). Evidence was very low on two of the upper limit outcomes - hypercalcemia and hypercalciuria.
The evidence report provided the expert group with a foundation and core set of data to begin their work to set vitamin D nutrient reference values. To move the field forward, future studies should use standardised 25(OH)D assay measurements and should examine the relationship between long-term vitamin D status and health outcomes.
Key Messages
Results of a large complex systematic review suggest the current totality of evidence from trials and prospective observational studies do not reach sufficient certainty level to support a causal relationship between vitamin D intake and asthma, wheeze, eczema, infectious diseases, or rickets (most trials reported no rickets) in generally healthy infants and young children.
In this systematic review, the only body of evidence that reached a moderate level of certainty was regarding the effect of daily vitamin D supplementation (vitamin D
3
or D
2
supplements to infants/children) on increasing serum 25(OH)D concentrations. However, currently there is no consensus on the definitions of vitamin D status, e.g. deficiency, insufficiency, sufficiency and toxicity, based on serum 25(OH)D concentrations.
This systematic review provided an international expert group a foundation and core set of data through intake-response modelling to help set vitamin D nutrient reference values for infants and children up to 4 years of age.
Background
Maternal mental problems can interfere with the overall health and care of the child; some oral health studies have been trying to elucidate whether there is a relationship between ...maternal common mental disorders (CMD) and children's oral health status.
Aim
The aim was to investigate the influence of mothers that present CMD symptoms on their child's dental caries status.
Design
This cross‐sectional study was carried out in Pelotas with 530 mother/child (aged 2‐5 years old) dyads recruited from an epidemiological survey in August 2015 during the national vaccination campaign. A questionnaire was used to determine mother's CMD symptoms using the Self‐Reporting Questionnaire (SRQ‐20) and socioeconomic/demographic variables which were used for adjustment. Dental caries examination was performed. The outcome was obtained using the dmfs (decayed, missing, filled surfaces) index, based on OMS guidelines. Poisson regression with robust variance was used to estimate the risk ratio and 95% confidence interval (CI).
Results
Maternal CMD was positively associated with dental caries prevalence in children; the adjusted relative risk for every 1 SRQ‐20 score increase was 1.06 (95% CI 1.00‐1.12).
Conclusions
Our findings suggest that maternal mental health can impair children's oral health in relation to dental caries.
OBJECTIVESTo develop a tool to assess pre-writing skills of 2-5 y old children in India. METHODSThe tool development process followed the recommendations by Fitzpatrick et al. and the Consensus based ...Standards for the selection of health Measurement Instruments (COSMIN), and included 4 phases. In Phase I, an initial 35-item draft tool was developed by an expert panel for the tool-development. In Phase II, the 35-item draft tool was prevalidated through peer and expert reviews, pilot-study to assess the tool-comprehensibility, and assessment of test-retest and inter-rater reliability. In Phase III, the 35-item draft tool was administered on the 575 typically developing children aged 2-5 y, recruited from rural, urban, slum, and coastal areas through stratified random sampling. In Phase IV, the normative age-range for development of each item was generated by calculating the age-percentiles (10th, 25th, 50th, 75th, 90th). Factor analysis and item reduction was done for items in 2-3, 3-4, and 4-5 y age-groups. The final tool was converted to graphic format with 10th-90th age-percentile bars. RESULTSThe final tool had 26 items with a three-factor structure. Cronbach's alpha was within acceptable limits for all three age-groups (0.723, 0.778, and 0.823 in 2-3 y, 3-4 y, and 4-5 y respectively). Kappa coefficients of the items ranged from 0.6-1 in interrater reliability and 0.64-1 test-retest reliability analysis reflecting substantial agreement between ratings. CONCLUSIONSA 26-item screening tool "Prewriting skills Assessment Tool" (PAT) to assess writing readiness of 2-5 y old children was developed. Tool reliability and construct validity have been established.
Aim
To assess vitamin D status and its predictors in a representative population sample of pre‐school children in Adelaide (latitude of 35°S).
Methods
Cross‐sectional survey of children aged between ...1 and 5 years from areas of low, medium and high socio‐economic status as identified from the 2001 Census data, Australian Bureau of Statistics. Children were recruited between September 2005 and July 2007 using a door knocking protocol based on a stratified sampling method to obtain a representative sample of this age group. Serum 25‐hydroxyvitamin D (25(OH)D) was determined using a radio‐immunoassay kit. Vitamin D deficiency was defined as serum 25(OH)D) <30 nmol/L and insufficiency defined as serum 25(OH)D ≥30 and <50 nmol/L according to the Institute of Medicine.
Results
Fifty‐two per cent of eligible children took part in the study. Mean (standard deviation) serum 25(OH)D was 73 (26) nmol/L (n = 221). The prevalence of vitamin D deficiency and insufficiency was 4% and 16%, respectively, with the prevalence being higher in winter (8% and 22%, respectively). Season of the year of blood collection and mother being born in Australia were significant predictors of serum 25(OH)D concentration, but age, sex, socio‐economic status, BMI category or dietary supplement use were not related to vitamin D status.
Conclusions
Vitamin D status of this representative sample of pre‐school children in Australia is adequate, and the prevalence of vitamin D deficiency is low based on the Institute of Medicine criteria.
Objectives: The study aims to identify the obstacles and problems of using educational media in kindergartens in Palestine from the point of view of the principals and teachers of these ...kindergartens.
Methods: A descriptive field survey method was employed. Data was collected through a questionnaire consisting of (30) items applied to a sample of (48) principals and (83) female teachers working in kindergartens for the academic year 2019/2020.
Results: The results showed that most kindergartens in Palestine suffer from many obstacles and problems in using educational media. Moreover, there are no statistically significant differences between the views of kindergarten principals and teachers in Palestine towards the obstacles and problems of using educational media due to the nature of job, specialization, years of experience, and marital status. The results also show the presence of statistically significant differences in the obstacles and problems of using educational media in kindergartens in Palestine due to educational qualification.
Conclusion: The study recommends paying attention to educational media available in kindergartens and making them more effective and accessible to children. It also recommends using modern media in kindergartens in Palestine due to its great importance in developing mental abilities.
Because of the COVID-19 pandemic, the Indonesian Government enacted a study at home policy for all students. This policy also applied to preschool children aged 2 to 6 years old. The purpose of the ...research was to examine the duration and impact of digital media use by preschool children in urban areas in Indonesia during weekdays and weekends. Data were collected using a validated questionnaire called the Surveillance of digital-Media hAbits in earLy chiLdhood Questionnaire (SMALLQ®). A total of 951 parents or guardians (17-70 years old) who had preschool children volunteered to complete the questionnaire online. Preschool children have been using screen media since infancy, and the time they spend on-screen time is more than 1 hour per day. The digital media most used were mobile phones (91.6%), followed by television (86.1%) and computers (61%). The parents realized the impact and the importance of limiting time of screen media, but it difficult to prevent their children from using it, especially when learning from home. Hence, there is a need different approach to learning from home, especially to manage the duration of screen time for preschool children.