Successful vertical HIV transmission prevention programmes (VTP) have resulted in an expanding population of HIV-exposed uninfected (HEU) infants whose growth, health and neurodevelopmental outcomes ...could have consequences for future resource allocation. We compared neurodevelopmental and behavioural outcomes in a prospective cohort of 2-3 year old HEU and HIV-unexposed uninfected (HU) children.
Women living with and without HIV and their infants were enrolled within three days of birth from a low-risk midwife obstetric unit in Cape Town, South Africa during 2012 and 2013, under WHO Option A VTP guidelines. HIV-uninfected children aged 30-42 months were assessed using the Bayley scales of Infant Development-Third edition (BSID) and Strengths and Difficulties questionnaire (SDQ).
Thirty-two HEU and 27 HU children (mean birth weight 3048g vs 3096g) were assessed. HEU children performed as well as HU children on BSID cognitive, language and motor domains. Mean scores fell within the low average range. Mothers of HEU children reported fewer conduct problems but stunting was associated with increased total difficulties on the SDQ.
HEU and HU children's performance on the BSID was similar. In this low-risk cohort, HIV exposure did not confer additional risk. Stunting was associated with increased behavioural problems irrespective of HIV exposure.
The present study examined whether maternal diet and early infant feeding experiences relating to being breast-fed and complementary feeding influence the range of healthy foods consumed in later ...childhood.
Data from four European birth cohorts were studied. Healthy Plate Variety Score (HPVS) was calculated using FFQ. HPVS assesses the variety of healthy foods consumed within and across the five main food groups. The weighted numbers of servings consumed of each food group were summed; the maximum score was 5. Associations between infant feeding experiences, maternal diet and the HPVS were tested using generalized linear models and adjusted for appropriate confounders.
The British Avon Longitudinal Study of Parents and Children (ALSPAC), the French Etude des Déterminants pre et postnatals de la santé et du développement de L'Enfant study (EDEN), the Portuguese Generation XXI Birth Cohort and the Greek EuroPrevall cohort.
Pre-school children and their mothers.
The mean HPVS for each of the cohorts ranged from 2.3 to 3.8, indicating that the majority of children were not eating a full variety of healthy foods. Never being breast-fed or being breast-fed for a short duration was associated with lower HPVS at 2, 3 and 4 years of age in all cohorts. There was no consistent association between the timing of complementary feeding and HPVS. Mother's HPVS was strongly positively associated with child's HPVS but did not greatly attenuate the relationship with breast-feeding duration.
Results suggest that being breast-fed for a short duration is associated with pre-school children eating a lower variety of healthy foods.
Introduction: Caries in the deciduous dentition of children under six years of age is termed as early childhood caries (ECC). ECC is prevalent among Indian children and identifying modifiable risk ...factors is important for prevention. This systematic review was undertaken to describe the burden of ECC in India, its prevalence, associated risk factors along with its repercussions on childhood health. Materials and Methods: A search was conducted for published Indian studies on ECC through electronic databases and complemented with hand search. The protocol for the present systematic review was registered at PROSPERO (Ref No. CRD42022306234) Care was taken to include studies which could represent all parts of India- Central, North, South, East and West. Included papers were reviewed for prevalence of ECC and reported risk factors. Results: Overall 37 studies on ECC in India were identified relating to prevalence, 11 reported risk factors and two reported on the association between severe ECC and nutritional health and well-being. The prevalence of ECC in India in these studies varied from16% to 92.2%. This systematic review revealed that ECC is prevalent among Indian children and highlights the need of preventive intervention and early risk assessment by its own caries risk assessment (CRA) tool. Occurrence seems to be firmly connected with age, snacking frequency, feeding and oral hygiene habits and with social determinants of health including parental education level, low socioeconomic status and number of siblings.
To assess the short-term impact of a nutritional intervention aimed at reducing childhood overweight in German pre-school children.
Using a cluster-randomized study design with waiting-list controls, ...we tested a 6-month intervention administered once weekly by a nutrition expert consisting of joint meal preparation and activities for children and parents such as tasting and preparing nutritious, fresh foods. At baseline, 6 and 12 months, a parent-completed questionnaire assessed fruit and vegetable intakes (primary outcomes) and water and sugared drinks consumption (secondary outcomes). Direct measurement assessed BMI, skinfold thickness and waist-to-height-ratio. An intention-to-treat analysis used random-effects panel regression models to assess the intervention effect, adjusted for each child's age, gender, immigrant background and maternal education.
Eighteen pre-schools from three south German regions.
Healthy children aged 3-6 years.
Three hundred and seventy-seven (80 %) eligible pre-school children participated in the study. Of these, 348 provided sufficient data for analysis. The sample mean age was 4·26 (sd 0·78) years; the majority (53·2 %) were boys. Children's fruit and vegetable intakes increased significantly (P < 0·001 and P < 0·05, respectively); no significant changes in the consumption of water, sugared drinks or anthropometric measurements were noted.
Nutritional interventions in pre-schools have the potential to change eating behaviours in young children, which in the long term might reduce risk for developing overweight.
The aim of this study was to explore communication interactions and identify phases adopted by dental professionals with parents and their young children and to examine the hypothesis that successful ...social talking between the actors together with the containment of worries allows the formation of a triadic treatment alliance, which leads to achieving preventive dental treatment goals. Conversation analysis of the transcribed data from video recordings of dental professionals, parents and preschool children when attending for preventive dental care was conducted. The transcriptions were read, examined and analysed independently to ensure the trustworthiness of the analysis. The transcriptions were explored for interactive patterns and sequences of interaction. Forty-four individual consultations between dental professionals, parents, and preschool children were recorded. The number of communication behaviours was 7,299, with appointment length ranging from 2 min 10 s to 29 min 18 s. Two patterns of communication were identified as dyadic (between two people) and triadic (between three people) interactions within a continuous shifting cycle. The three phases of communication were social talking, containing worries and task-focusing. Social talking was characterised by shifts between dyadic and triadic communication interactions and a symmetry of communication turns and containing worries. This typified the cyclical nature of the triadic and dyadic communication interactions, the adoption of talk-turn pairs, and triadic treatment alliance formation. Task-focusing pattern and structure were different for dentists and extended-duty dental nurses. For dentists, task-focusing was characterised by a dyadic interaction and as an asymmetrical communication pattern: for extended-duty dental nurses, task-focusing was typified by symmetrical and asymmetrical communication patterns within dyadic and triadic interactions. Empathy and understanding of the young child's emotional needs during containing worries allowed the formation of the triadic treatment alliance and with this treatment alliance, the acceptance of interventions to prevent early childhood caries during “task-focusing.” This qualitative exploration suggests that dyadic and triadic communication interactions are of a dynamic and cyclical quality and were exhibited during paediatric dental consultations. The communication phases of social talking, containing worries and task-focusing were evident. Successful social talking signalled the entry to containing worries and triadic treatment alliance formation which permitted the preventive goals of the consultation to be achieved (task-focusing). Future work should generate additional data to support the hypotheses created here namely that, social talking and containing worries triggers an integral pathway to task-focusing and the achievement of preventive dental goals.
Tests of mediation in treatment trials can illuminate processes of change and suggest causal influences in development. We conducted a mediation analysis of a previously published randomised ...controlled trial of parent-mediated communication-focused treatment for autism against ordinary care, with 28 children aged 2–5 years (Aldred et al. in J Child Psychol Psychiatr 45:1–11,
2004
). The hypothesised mediating process, targeted by the intervention, was an increase in parental synchronous response within parent–child interaction. The results showed partial mediation, with change in synchrony accounting for 34% of the positive intervention effect on autism symptomatology (Autism Diagnostic Observation Schedule communication and social domain algorithm); the result was confirmed by bootstrap estimation. Improved parental synchronous response to child communication can alter short-term autism symptom outcome with targeted therapy.
To model effective vegetable parenting practices using the Model of Goal Directed Vegetable Parenting Practices construct scales.
An Internet survey was conducted with parents of pre-school children ...to assess their agreement with effective vegetable parenting practices and Model of Goal Directed Vegetable Parenting Practices items. Block regression modelling was conducted using the composite score of effective vegetable parenting practices scales as the outcome variable and the Model of Goal Directed Vegetable Parenting Practices constructs as predictors in separate and sequential blocks: demographics, intention, desire (intrinsic motivation), perceived barriers, autonomy, relatedness, self-efficacy, habit, anticipated emotions, perceived behavioural control, attitudes and lastly norms. Backward deletion was employed at the end for any variable not significant at P<0·05.
Houston, TX, USA.
Three hundred and seven parents (mostly mothers) of pre-school children.
Significant predictors in the final model in order of relationship strength included habit of active child involvement in vegetable selection, habit of positive vegetable communications, respondent not liking vegetables, habit of keeping a positive vegetable environment and perceived behavioural control of having a positive influence on child's vegetable consumption. The final model's adjusted R 2 was 0·486.
This was the first study to test scales from a behavioural model to predict effective vegetable parenting practices. Further research needs to assess these Model of Goal Directed Vegetable Parenting Practices scales for their (i) predictiveness of child consumption of vegetables in longitudinal samples and (ii) utility in guiding design of vegetable parenting practices interventions.
This empirical study contributes towards a better understanding of the educational reality in kindergartens. It explores the after-school activities and interests of Czech nursery schools (NS) ...children. The topic focuses on the disharmony and subsequent fine-tuning of interests of both the family and the kindergarten, set against the background of parents’ requirements and the kindergarten’s reaction to them. The goal is to shed light on how kindergartens reflect parents’ requirements pertaining to their children’s extracurricular activities, the kindergarten’s perception and interpretation of this situation, and what sort of approach is used for implementation. The research and survey method used is content analysis. Fifteen kindergarten teacher thematic reports, 3,000-5,000 words each, and forty inspection reports, the results of Czech kindergarten inspections, were analyzed. The analytical techniques of Grounded Theory - open and axial coding - were used in the processing of the source materials. The results of the analysis set in a paradigm model depict the state of administration and relationships between variables, which determine after-school activities in kindergartens. It was demonstrated that kindergartens select various approaches when negotiating a solution to extracurricular activities. The educational reality then includes kindergartens that do organize after-school activities as well as those that do not. Kindergartens which do offer after-school activities, however, differ in the degree of acceptance of such programs in terms of need for child development and how they perceive the benefits of such an above-standard approach towards their customers.
OBJECTIVES: To find out the etiology and outcome in terms of clinical improvement among children having esophageal stricture (ES). METHODS: This prospective study was conducted from July 2019 to ...March 2020 at Children’s Hospital, Multan, Pakistan on diagnosed patients of ES, ageing <15 years. Demographic details, different etiologies, location of the ES and treatment outcome were recorded. After initial management, endoscopy and dilatation was done at 6 weeks. Patients were followed-up for at least 12 weeks. RESULTS: Out of 32 children with ES, 19 (59.4%) were males. Mean age of children was 36.58±19.6 months. Twenty-four (75%) patients had proximal and 8 (25%) had distal stricture. Chemical burn (n=23; 71.9%) and esophageal atresia (n=4: 12.5%) were commonest causes of ES. Dilatation and surgery were performed in 21 (65.6%) cases followed by dilatation only in 10 (31.3%) cases and surgery alone in one (3.1%) case. In patients with chemical burns, majority (n=16/23; 69.6%) required both dilatation and surgery. Overall outcome of treatment options was good in 62.5% (n=20/32) patients. Outcome was good in 61.9% (n=13/21) of patients requiring both dilatation and surgery and 70% (n=7/10) in patients having dilatation alone (p=0.385). Outcome was good in 69.6% (n=16/23) of patients with chemical burns and 70% (n=7/10) in patients with dilatation only (p=0.385). Mortality rate was 3.1% (n=1). CONCLUSION: Chemical burn and esophageal atresia were the commonest causes of ES. Outcome of all procedures was good in 62.5% cases and had no significant relationship with causes and site of ES or types of treatment.
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