New-onset childhood extensive cutaneous lichen planus following asymptomatic COVID-19 infection: report of a case / Líquen plano cutâneo extenso de início recente na infância após infecção assintomática por COVID-19: relato de caso

ABSTRACT Objective: The objective of this study was to describe a case of cutaneous lichen planus (LP) that appeared following COVID-19 infection. Case description: We report a case of extensive cutaneous classic familial LP in a 4-year-old male child after an asymptomatic serologically confirmed COVID-19 infection. The patient developed intensely itchy, purple, flat-topped papules and plaques, mainly on the dorsal surface of the hands, feet, forearms, and shins. Histopathological examination of the skin biopsy showed vacuolar and apoptotic degeneration of the basal cell layer with a band-like lymphocyte infiltrate at the dermo-epidermal junction and confirmed the diagnosis of LP. Comments: LP could be considered among the differential diagnoses of pediatric post-COVID inflammatory skin lesions, either in the patients recovering from COVID-19 infection or in the suspicious asymptomatic cases in close contact with COVID-19-infected patients.

RESUMO Objetivo: Descrever um caso de líquen plano cutâneo (LP) após infecção por COVID-19. Descrição do caso: Relatamos um caso de LP familiar clássico extenso cutâneo em uma criança de quatro anos de idade após uma infecção por COVID-19 assintomática e sorologicamente confirmada. O paciente desenvolveu pápulas e placas intensamente pruriginosas, roxas e achatadas, principalmente na superfície dorsal das mãos, pés, antebraços e canelas. O exame histopatológico da biópsia de pele mostrou degeneração vacuolar e apoptótica da camada basal com infiltrado de linfócitos em faixa na junção dermoepidérmica e confirmou o diagnóstico de líquen plano. Comentários: O líquen plano pode ser considerado entre os diagnósticos diferenciais de lesões cutâneas inflamatórias pós-COVID pediátricas, tanto em pacientes em recuperação de infecção por COVID-19 quanto em casos assintomáticos suspeitos em contato próximo com pacientes infectados por COVID-19.

Anemia y el desarrollo de la psicomotricidad en la primera infancia / Anemia and the development of psychomotor skills in early childhood / Anemia e desenvolvimento psicomotor na primeira infância

Los bajos niveles de hemoglobina se definen como una concentración baja de hemoglobina en la sangre. La activad metabólica cerebral está vinculada con el desarrollo psicomotor. El desarrollo psicomotor durante la infancia se desarrolla a partir de los reflejos innatos, se organizan en esquemas de conducta, se internalizan durante el segundo año de vida como modelos de pensamiento. En Perú, se contabilizan el 50.99% de los niños con bajos niveles de concentración de hemoglobina en menores de 3 años. Objetivo. Identificar la relación entre la anemia y el desarrollo de la psicomotricidad en la primera infancia. Materiales y Métodos. Para evaluar los niveles de hemoglobina se empleó el método de la azidametahemoglobina, con un hemoglobinómetro, y para evaluar el desarrollo psicomotor se empleó la escala del desarrollo psicomotor. En el estudio participaron 32 niños de 6 a 24 meses de edad. Resultados. El 40,6% presenta niveles de hemoglobina entre 14,2 - 17.2 g/dl, el 31,3% presenta niveles de hemoglobina entre 13.2 -14.1 g/dl seguido del 25,0% que presenta niveles de hemoglobina entre 10,2 -13.1 g/dl y el 3.1% presenta niveles de hemoglobina <10.2 g/dl; respecto al desarrollo psicomotor expresados en coeficiente de desarrollo se evidencia que el 59.4% de niños muestran un desarrollo normal seguido del 31.3% de niños que presenta un desarrollo en riesgo y 9.4% en retraso. Conclusiones. El coeficiente de desarrollo del niño(a) se encontró que la mayoría tiene un desarrollo psicomotor normal seguido de riesgo y de retraso, a pesar que mayoría tiene un coeficiente de desarrollo normal

Low hemoglobin levels are defined as a low hemoglobin concentration in the blood. Brain metabolic activity is linked to psychomotor development. Psychomotor development during infancy develops from innate reflexes, which are organized in behavioral schemes and internalized during the second year of life as thought models. In Peru, 50.99% of children under 3 years of age have low hemoglobin concentration levels. Objective. To identify the relationship between anemia and psychomotor development in early childhood. Materials and Methods. To evaluate hemoglobin levels, the azidametahemoglobin method was used, with a hemoglobinmeter, and to evaluate psychomotor development the psychomotor development scale was used. Thirty-two children aged 6 to 24 months participated in the study. Results. 40.6% presented hemoglobin levels between 14.2 - 17.2 g/dl, 31.3% presented hemoglobin levels between 13.2 -14.1 g/dl followed by 25.0% presenting hemoglobin levels between 10.2 -13.1 g/dl and 3.1% presented hemoglobin levels <10. 2 g/dl; with respect to psychomotor development expressed in development coefficient, 59.4% of children show normal development followed by 31.3% of children with development at risk and 9.4% with delayed development. Conclusions. The development coefficient of the child showed that most of the children have a normal psychomotor development followed by at risk and retardation, although most of them have a normal development coefficient.

Níveis baixos de hemoglobina são definidos como uma baixa concentração de hemoglobina no sangue. A atividade metabólica do cérebro está ligada ao desenvolvimento psicomotor. O desenvolvimento psicomotor durante a infância se desenvolve a partir de reflexos inatos, que são organizados em padrões de comportamento e internalizados durante o segundo ano de vida como padrões de pensamento. No Peru, 50,99% das crianças com menos de 3 anos de idade têm baixas concentrações de hemoglobina. Objetivo. Identificar a relação entre a anemia e o desenvolvimento psicomotor na primeira infância. Materiais e métodos. Para avaliar os níveis de hemoglobina, foi usado o método da azidameta-hemoglobina, com um hemoglobinômetro portátil HemoCue® Hb 201+ e, para avaliar o desenvolvimento psicomotor, foi usada a escala de desenvolvimento psicomotor. Trinta e duas crianças com idade entre 6 e 24 meses participaram do estudo. Resultados. 40,6% tinham níveis de hemoglobina entre 14,2 - 17,2 g/dl, 31,3% tinham níveis de hemoglobina entre 13,2 -14,1 g/dl, seguidos por 25,0% com níveis de hemoglobina entre 10,2 -13,1 g/dl e 3,1% com níveis de hemoglobina <10. 2 g/dl; com relação ao desenvolvimento psicomotor expresso em coeficiente de desenvolvimento, é evidente que 59,4% das crianças apresentam um desenvolvimento normal, seguido por 31,3% de crianças que apresentam um desenvolvimento em risco e 9,4% em atraso. Conclusões. O coeficiente de desenvolvimento infantil mostrou que a maioria das crianças tem um desenvolvimento psicomotor normal, seguido por risco e atraso, embora a maioria delas tenha um coeficiente de desenvolvimento normal.

Fasciola hepatica en preescolares de un centro poblado en una región altoandina del Perú

Introducción: La infección por Fasciola hepatica es una enfermedad zoonótica de distribución mundial, desatendida y subdiagnosticada. Objetivo: Determinar la frecuencia de Fasciola hepatica en una población preescolar en Tartar Chico, distrito de Baños del Inca, en la región Cajamarca. Métodos: Estudio transversal en 48 niños de una institución educativa inicial. Los padres entregaron 3 muestras de heces para el estudio parasitológico seriado y completaron una encuesta epidemiológica. La identificación de F. hepatica y otros parásitos se realizó con las pruebas de sedimentación rápida de Lumbreras, examen directo y Kato-Katz. Para describir usamos frecuencias y porcentajes, para el análisis bivariado aplicamos Chi-cuadrado o prueba exacta de Fisher. Resultados: La frecuencia de Fasciola hepatica fue 4,17%. Además, estimamos una proporción de 8,33% para Ascaris lumbricoides, 4,17% de Diphyllobothrium pacificum y 2,08% de uncinarias; así como parásitos contaminantes Entamoeba coli, Blastocystis hominis. Conclusión: Encontramos una frecuencia de 4,17% de fascioliasis entre preescolares de una comunidad altoandina del Perú.

Introduction: Fasciola hepatica infection is a globally distributed, neglected and underdiagnosed zoonotic disease. Objectives: To determine the frequency of Fasciola hepatica infection among a preschool population in Tartar Chico, Baños del Inca, Cajamarca. Methods: Cross-sectional study in 48 children of an initial educational institution. Parents delivered 3 stool samples for the serial parasitological study and completed an epidemiological survey. The identification of F. hepatica and other parasites was carried out with the Lumbreras rapid sedimentation tests, direct examination, and Kato-Katz. For descriptive analysis, frequency and percentages were used, for the bivariate analysis, Chi-square or Fisher's exact test was used. Results: The frequency of F. hepatica was 4,17%. In addition, a proportion of 8,33% of Ascaris lumbricoides, 4,17% of Diphyllobothrium pacificum and 2,08% of hookworms; as well as contaminating parasites Entamoeba coli, Blastocystis hominis. Conclusions: A frequency of 4,17% of fascioliasis was found among preschoolers from a high Andean community in Peru.

Programa educativo sobre salud bucal dirigido a familias con hijos preescolares residentes en el Consejo Popular Balboa

Fundamento: la promoción de salud debe comenzar en edades tempranas del desarrollo, para que los niños adquieran estilos de vida saludables, que les resulten beneficiosos en el futuro. Objetivo: implementar un programa educativo de salud bucal, dirigido a las familias de los niños/ñas de tres a cinco años matriculados en el Programa Educa a tu hijo, de los consultorios ocho y nueve del Consejo Popular Ramón Balboa, del municipio Lajas. Métodos: se realizó un estudio de intervención, de septiembre del 2020 a julio del 2021, en la sede del Programa Educa a tu hijo, con 35 miembros de familia y 35 niños/as entre tres cinco años matriculados en dicho programa. Se analizaron las variables: conocimiento sobre higiene bucal, hábitos dietéticos y hábitos deformantes, medidas antes y después de la intervención educativa. Resultados: predominó el sexo femenino y edad de cuatro años. Los familiares tenían entre 20 y 34 años. Los principales factores de riesgo identificados fueron higiene bucal deficiente, cepillado dental incorrecto y dieta cariogénica. Antes de la intervención predominó el conocimiento regular sobre higiene bucal, un conocimiento malo sobre hábitos dietéticos y un mal nivel de conocimiento sobre hábitos deformantes. Después de la intervención se observó un mayor porcentaje de conocimiento bueno sobre higiene bucal, hábitos dietéticos y buen nivel de conocimiento sobre hábitos deformantes. Conclusiones después de aplicada la intervención educativa se evidenció una notable mejoría en los conocimientos sobre salud bucal.

Background: health promotion should begin at an early age of development, so that children acquire healthy lifestyles that will be beneficial in the future. Objective: to implement an educational oral health program, aimed at the families of children from three to five years old enrolled in the Educate your child Program, from clinics eight and nine of the Ramón Balboa neighborhood, in Lajas municipality. Methods: an intervention study was carried out, from September 2020 to July 2021, at the headquarters of the Educate your child program, with 35 family members and 35 children between three and five years old enrolled in this program. The analyzed variables were: knowledge about oral hygiene, dietary habits and deforming habits, measured before and after the educational intervention. Results: the female sex and age of four years prevailed. The relatives were between 20 and 34 years old. The main risk factors identified were poor oral hygiene, incorrect tooth brushing and cariogenic diet. Before the intervention, regular knowledge about oral hygiene, poor knowledge about dietary habits, and a poor level of knowledge about deforming habits prevailed. After the intervention, a higher percentage of good knowledge about oral hygiene, dietary habits and a good level of knowledge about deforming habits was observed. Conclusions: after applying the educational intervention, a notable improvement in knowledge about oral health was evidenced.

Programa de salud bucodental orientado a la prevención en la primera infancia

Fundamento el cuidado de la salud bucal en infantes es indispensable, pues en esta edad se establecen hábitos de una adecuada nutrición e higiene, los cuales permiten un correcto desarrollo cultural y psicosocial. Objetivo: evaluar un programa odontológico orientado a la atención de la salud bucodental en infantes. Métodos: estudio cuasiexperimental, con intervención educativa, aplicado en 100 infantes, en Nogoyá, los cuales participaron junto con sus tutores en tres talleres educativos. Se realizó una evaluación al inicio y final de estos. Para comparar el antes y después de la población se usó la prueba de U de Mann Whitney, con un nivel de significación del 95 %. Resultados: respecto a la intervención inicial y final, se estableció que el programa mejoró significativamente los resultados respecto al índice O'leary de distribución de la placa (p<0,001), índice gingival (p<0,001), e higiene bucal (p<0,001). Posterior a la realización de talleres educativos, se redujo el consumo de alimentos cariogénicos. Conclusiones: el programa realizado permitió reducir los niveles de placa, gingivitis, mejoró la higiene y alimentación saludable en los infantes.

Background oral health care in infants is essential, since at this age habits of adequate nutrition and hygiene are established, which allow a correct cultural and psychosocial development. Objective: to evaluate a dental program aimed at oral health care in infants. Methods: quasi-experimental study, with educational intervention, applied to 100 infants, in Nogoyá, who participated together with their tutors in three educational workshops. An evaluation was carried out at the beginning and end of these. To compare the before and after population, the Mann Whitney U test was used, with a significance level of 95%. Results: when analyzing the initial and final evaluation, it was established that the program significantly improved the results regarding the O'leary index of plaque distribution (p<0.001), gingival index (p<0.001), and oral hygiene (p< 0.001). After conducting educational workshops, the consumption of cariogenic foods was reduced. Conclusions: the program carried out allowed reducing the levels of plaque, gingivitis, improving hygiene and healthy eating in infants.

Assessment of eating habits of preschool children and parent attitudes / Avaliação dos hábitos alimentares de pré-escolar e atitudes dos pais

ABSTRACT Objective The purpose of this study is to investigate preschoolers' eating behaviors and parents' attitudes. Methods This descriptive observational study employed a convenience sampling method to investigate the eating behavior of preschool children aged 3-6 years. Data was collected through a Personal and Parent Information Form and the Children's Eating Behavior Inventory. The study included 206 participants, and the findings provide insights into parental attitudes toward feeding and children's eating behaviors in 3-6 age group. Results The study sample included 206 parents of children between the ages of 3 and 6, with the majority of children having a normal weight. Parents' responses to the survey questions revealed significant correlations between children's weight percentiles and parental education level, maternal body mass index level, and income level. Positive eating behaviors in children were positively correlated with parental age and education level, income level, child age, and child percentile level, while negative eating behaviors were negatively correlated with parental age, educational status, income level, and positively correlated with maternal body mass index level. Gender differences were observed, with male children exhibiting lower mean scores in negative eating behaviors, maternal views and behaviors, child food preparation behavior, and negative meal situations compared to female children. Conclusion We found that parental education level and income level were correlated with children's positive eating behavior, while they were negatively associated with negative eating behavior. Negative eating behavior and food preparation behavior were lower in boys than in girls.

RESUMO Objetivo Este estudo observacional descritivo teve como objetivo investigar os comportamentos alimentares de crianças em idade pré-escolar e as atitudes dos pais. Métodos Foi utilizado um método de amostragem por conveniência para coletar dados sobre o comportamento alimentar de crianças com idades entre 3 e 6 anos. Foram aplicados um Formulário de Informações Pessoais e de Pais e o Inventário de Comportamento Alimentar Infantil, e a análise estatística foi realizada utilizando o programa IBM®SPSS® 16.0. O estudo contou com a participação de 206 pais fornecendo informações sobre as atitudes dos pais em relação à alimentação e os comportamentos alimentares das crianças na faixa etária de 3 a 6 anos. Resultados A amostra do estudo incluiu 206 pais de crianças com idades entre 3 e 6 anos, sendo a maioria das crianças com peso normal. As respostas dos pais às perguntas da pesquisa revelaram correlações significativas entre os percentis de peso das crianças e o nível educacional dos pais, índice de massa corporal materno e nível de renda. Comportamentos alimentares positivos nas crianças foram positivamente correlacionados com a idade e nível educacional dos pais, nível de renda, idade da criança e percentil de peso da criança, enquanto comportamentos alimentares negativos foram negativamente correlacionados com a idade dos pais, nível educacional, nível de renda e positivamente correlacionados com o índice de massa corporal materno. Foram observadas diferenças de gênero, com as crianças do sexo masculino apresentando pontuações médias mais baixas em comportamentos alimentares negativos, visões e comportamentos maternos, comportamento de preparação de alimentos infantis e situações negativas durante as refeições em comparação com as crianças do sexo feminino Conclusão Demonstra-se que o nível educacional e o nível de renda dos pais estão relacionados ao comportamento alimentar positivo das crianças, enquanto estão inversamente associados ao comportamento alimentar negativo. Comportamentos alimentares negativos e comportamentos de preparação de alimentos foram menores em meninos em comparação com meninas.

Educational technologies for accident prevention due to falls in childhood: a scoping review / Tecnologías educativas para la prevención de accidentes por caídas en la infancia: revisión de alcances / Tecnologias educacionais para a prevenção de acidentes por quedas na infância: revisão de escopo

ABSTRACT Objectives: to map evidence on educational technology use for accident prevention due to falls in childhood. Methods: a scoping review, carried out in October and November 2022, in the MEDLINE, Web of Science, BDENF and CINAHL databases and LILACS bibliographic index. There was no delimitation of language or time. Data were extracted and analyzed descriptively by two independent researchers. The research protocol was registered in the Open Science Framework. Results: twenty-six studies were selected. Booklets, pamphlets and leaflets were the most used technologies, presenting health services as the most frequent environment to develop research on fall prevention. The technologies developed were important outcomes: increased knowledge of children, family members, caregivers, health and education professionals. Conclusions: educational technology use makes it possible to increase knowledge, adopt safe practices and reduce falls.

RESUMEN Objetivos: mapear evidencias sobre el uso de tecnologías educativas para la prevención de accidentes por caídas en la infancia. Métodos: revisión de alcance, realizada en octubre y noviembre de 2022, en las bases de datos MEDLINE, Web of Science, BDENF y CINAHL e índice bibliográfico LILACS. No hubo delimitación de idioma ni de tiempo. Los datos fueron extraídos y analizados descriptivamente por dos investigadores independientes. El protocolo de investigación fue registrado en el Open Science Framework. Resultados: se seleccionaron 26 estudios. Los cuadernillos, folletos y volantes fueron las tecnologías más utilizadas, presentando los servicios de salud como el ámbito más frecuente para desarrollar investigaciones sobre la prevención de caídas. Las tecnologías desarrolladas fueron resultados importantes: mayor conocimiento de los niños, familiares, cuidadores, profesionales de la salud y la educación. Conclusiones: el uso de tecnologías educativas posibilita aumentar los conocimientos, adoptar prácticas seguras y reducir las caídas.

RESUMO Objetivos: mapear evidências sobre a utilização de tecnologias educacionais para a prevenção de acidentes por quedas na infância. Métodos: revisão de escopo, realizada nos meses de outubro e novembro de 2022, nas bases de dados MEDLINE, Web of Science, BDENF e CINAHL e índice bibliográfico LILACS. Não houve delimitação de idioma e de tempo. Os dados foram extraídos e analisados descritivamente por dois pesquisadores independentes. O protocolo de pesquisa foi registrado na Open Science Framework. Resultados: selecionaram-se 26 estudos. As cartilhas, panfletos e folhetos foram as tecnologias mais utilizadas, apresentando os serviços de saúde como o ambiente mais frequente para desenvolver pesquisa sobre prevenção de quedas. As tecnologias desenvolvidas constituíram desfechos importantes: aumento do conhecimento das crianças, dos familiares, cuidadores, profissionais de saúde e de educação. Conclusões: a utilização de tecnologias educacionais possibilita o aumento de conhecimento, adoção de práticas seguras e redução de quedas.

Impact of deprivation of school physical space on child development during the pandemic: the perception of preschoolers' families / Impacto da privação do espaço físico escolar no desenvolvimento infantil durante a pandemia: percepção de familiares de crianças em idade pré-escolar

ABSTRACT Purposes: to characterize the family and school contexts of children enrolled in nursery schools, preschools, or kindergartens in 2020, during the COVID-19 pandemic, and verify the effects of deprivation of school physical space on their development, in the perception of families regarding cognitive-linguistic, socioemotional, and motor aspects. Methods: the sample comprised 139 families of children aged 1 year to 5 years and 11 months, living in the state of São Paulo, Brazil, who answered an online questionnaire on the characterization of the family and school contexts and the impacts on cognitive-linguistic, socioemotional, and motor aspects. The study used the chi-square, Kruskal-Wallis, and Mann-Whitney statistical tests, with the significance set at p-values ≤ 5%. Results: older children were associated with being transferred to other schools (p = 0.0192) and greater socioemotional impairment (p = 0.0011). Smaller children felt fewer positive effects on the cognitive-linguistic aspect (p = 0.0137). The absence from the school environment and the overall effects of the pandemic negatively influenced them (p = 0.0404; p = 0.0134). Conclusion: the mean age of the parents/guardians was 36 years, with a Bachelor's degree, and working from home. The children enrolled in public or private schools had online activities. All children were exposed to screens, most of them for 4 or more hours per day. The socioemotional aspect was the most impaired one, followed by the cognitive-linguistic aspect. The negative effects outweighed the positive ones.

RESUMO Objetivos: caracterizar o contexto familiar e escolar de crianças matriculadas em pré-escolas durante a pandemia de COVID-19 em 2020 e verificar os efeitos da privação do ambiente físico escolar no desenvolvimento infantil, na percepção dos familiares, em relação aos aspectos cognitivo-linguísticos, socioemocionais e motores. Métodos: participaram 139 familiares de crianças com idade entre um e cinco anos e 11 meses, residentes no estado de São Paulo, que responderam um questionário online sobre a caracterização do contexto familiar e escolar e impacto nos aspectos cognitivo-linguístico, socioemocional e motor. Utilizaram-se os testes estatísticos Qui-quadrado, Kruskal-Wallis e Mann-Whitney, com valores significantes para p≤5%. Resultados: para as crianças maiores, houve associação entre aumento de mudança de escola (p=0,0192) e maior prejuízo no aspecto socioemocional (p=0,0011). No aspecto cognitivo-linguístico, as crianças menores sentiram menos efeitos positivos (p=0,0137). A ausência do ambiente escolar e os efeitos gerais da pandemia influenciaram negativamente (p=0,0404; p=0,0134). Conclusão: os familiares apresentavam em média 36 anos, nível superior de instrução e atividades laborais remotas. As crianças, matriculadas em escolas públicas ou privadas, recebiam atividades online. Todas as crianças foram expostas a telas e a maioria por quatro horas ou mais. O aspecto socioemocional foi mais prejudicado, seguido do cognitivo-linguístico. Os efeitos negativos superaram os positivos.

Analysis of influencing factors of Helicobacter pylori infection in obese preschool children / 中国医师杂志

Objective:To explore and analyze the influencing factors of Helicobacter pylori (HP) infection in obese preschool children.Methods:From May 2020 to May 2022, 50 obese preschool children with HP infection and 50 obese preschool children without HP infection were prospectively selected from Tangshan Maternal and Child Health Hospital. We collected and collected basic data on two groups of children, including gender, age, eating habits, and family related information. Single factor analysis was used to screen for possible influencing factors of HP infection in obese preschool children, and logistic regression analysis was performed on the selected influencing factors.Results:Single factor analysis of variance showed that there were statistically significant differences in the prevalence of HP infection among obese preschool children of different ages, body mass index (BMI), sharing tableware, per capita monthly income of families, using public chopsticks, washing hands before meals, partial eating, habit of biting fingers, family population, binge eating, family history of HP infection, etc. (all P<0.05). Multivariate logistic analysis showed that BMI ( OR=1.576, 95% CI: 1.119-2.221), shared tableware ( OR=1.317, 95% CI: 1.018-1.702), per capita monthly income of households ( OR=1.330, 95% CI: 1.021-1.733), no use of public chopsticks ( OR=1.408, 95% CI: 1.019-1.945), washing hands before meals ( OR=1.206, 95% CI: 1.041-1.397), habit of biting fingers ( OR=1.470, 95% CI: 1.064-2.031), binge eating ( OR=1.443, 95% CI: 1.004-2.074) and family history of HP infection ( OR=1.317, 95% CI: 1.051-1.649) were the influencing factors of HP infection in obese preschool children (all P<0.05). Conclusions:BMI, shared tableware, per capita monthly income of families, failure to use public chopsticks, washing hands before meals, habit of biting fingers, binge eating, family history of HP infection, etc. are the influencing factors of HP infection in obese preschool children. If there are children with abnormal related factors, attention should be paid to them. If there are related infection symptoms, targeted interventions can be taken in time to prevent and control children′s HP infection.

Association of pre school children physical activities and sedentary behaviors on calcanues bone density / 中国学校卫生

Objective@#To investigate the effects of physical activity (PA) intensity and sedentary behavior (SB) on calcanues bone mineral density (BMD) in preschool children, so as to provide a basis for rationalizing the daily physical activity of preschool children to promote bone health.@*Methods@#A total of 673 pre school children aged 3-6 years from nine kindergartens in Pingxiang City, Ganzhou City and Yingtan City of Jiangxi Province, were selected from September to December 2021 by using the whole stratified cluster random sampling method. The PA levels and SB were measured by using a three axis acceleration sensor, and left calcanues BMD was measured by an ultrasound bone densitometer. Multiple linear regression was used to explore the effects of changes in PA on calcanues BMD in pre school children of all ages.@*Results@#Of the 673 preschoolers surveyed, 498 (74.0%) achieved an average of ≥60 min of moderate to vigorous physical activity (MVPA) per day, there were 265 boys (71.2%), and 233 girls ( 77.4 %). The difference between genders was not statistically significant ( χ 2=2.77, P >0.05). There was no statistically significant difference in the BMD test of the calcaneus bones of preschoolers by gender ( Z=0.42, P >0.05). The difference in BMD results of pre school children with 3, 4, 5 to 6 years was statistically significant ( H=2.65, P <0.05). Correlation analysis revealed a negative correlation between SB duration and calcaneus BMD ( r =-0.13), and a positive correlation between low intensity physical activity (LPA) duration, MVPA duration, and calcaneus BMD ( r =0.14, 0.25 ) ( P <0.05). Multivariate linear regression analysis showed that SB duration negatively correlated with calcaneus BMD, whereas LPA and MVPA duration positively correlated with calcaneus BMD ( P <0.05).@*Conclusions@#MVPA duration is positively correlated with the growth of BMD in the heel bone and negatively correlated with SB. The kindergartens can adjust their curricula according to the physical and mental developmental characteristics, gender and age differences of pre school children, increase the time of outdoor activities, and reduce the sedentary time to promote the bone health of young children.

Association of screen time with psychological and behavioral development problems in children aged 3-6 years / 中国学校卫生

Objective@#To investigate the distribution of various types of screen time and examine the association of screen time with psychological and behavioral development problems in children aged 3-6 years, so as to provide scientific basis for children s screen use and mental health promotion.@*Methods@#A total of 3 875 mother child dyads who completed the follow up in Shanghai Maternal-Child Pairs Cohort were included. The daily usage time of children s tablet, mobile phone, TV, projectors, and other types of screens were obtained in questionnaire survey. Children s psychological and behavioral development problems were evaluated by Age-Stage Questionnaire, Third Edition (ASQ-3) and Strengths and Difficulties Questionnaire (Parent version) (SDQ). The Chi-square test, Mann Whitney U and Kruskal Wallis rank sum test were used to compare the detection rate of psychological and behavioral development problems and screen time in children with different characteristics. Multivariate binary Logistic regression was used to analyze the association of screen time with psychological and behavioral development problems.@*Results@#There were 49.91% of children having screen time more than 1 h/d. Children s TV, tablet and mobile phone screen time were 0.39(0.25, 0.96 ), 0.25(0,0.61) and 0.18(0,0.25) h/d. The detection rates of suspected developmental delay in fine motor, problem solving and personal-social domains and pro social behavior deficiency and externalizing behaviors in boys (8.54%, 6.77%, 5.46%, 30.07 %, 27.39%) were higher than that in girls (4.64%, 4.85%, 2.48%, 22.10%, 22.36%) ( χ 2=23.76, 6.49, 22.37, 31.81, 13.06, P <0.05). There were statistically significant differences in the detection rates of suspected developmental delay in communication, fine motor and problem solving, as well as internalizing behavior and externalizing behavior of children with different parents educational levels ( χ 2=14.37, 15.18, 21.10, 11.66, 9.27; 16.34, 26.75, 32.89, 16.97, 6.37, P <0.05). There were significant differences in the detection rates of suspected developmental delay in problem solving, prosocial behavior deficiency, internalizing behavior and externalizing behavior of children whose mothers had anxiety/depression symptoms during pregnancy ( χ 2= 5.61 , 9.05, 21.90, 7.17; 8.75, 6.06, 12.76 , 5.55, P <0.05). The average total screen time of boys was longer than that of girls (1.07, 1.00 h/d, Z=-2.08, P =0.04). Compared with children with other educational levels of their parents, the total screen time, mobile phone and TV screen time of children whose parents had college education or above were short (father: H =42.01, 44.49 , 21.24, mother: H =42.31, 39.21 , 26.47, P <0.01). Among all types of screen time, mobile phone screen time had the most impact on psychological and behavioral development. More mobile phone screen time increased the risk of suspected developmental delay and abnormal emotional behavior ( P < 0.05). Screen time of tablet, mobile phone and TV were positively correlated with externalizing behavior ( OR=1.36, 1.57, 1.27 , P <0.05).@*Conclusions@#Screen time is related to children s psychological and behavioral development problems and mobile phones affect the most. Parents should limit their children s screen time to avoid excessive screen time affecting their psychological and behavioral development.

Effects of grandparent involvement in parenting on health related behaviors among urban preschoolers / 中国学校卫生

Objective@#To explore the effects of grandparent involvement in parenting on health related behaviors among urban preschool children, so as to provide a basis for the development of interventions for unhealthy behaviors among preschool children with different parenting pattern.@*Methods@#A total of 5 431 preschool children aged 3-6 years old in Xinbei District, Changzhou City, were selected by census method during January to October, 2022. General household characteristics and health related behaviors of children were investigated by questionnaires, and the differences in health related behaviors with different parenting pattern involving grandparents were explored by the χ 2 test. A multifactorial Logistic regression model was used to analyze the effects of grandparenting on preschool children s health behaviors.@*Results@#About 51.2% of preschoolers were raised by both parents, 46.1 % were co parented by grandparents, and 2.7% were raised by grandparents. After multifactorial Logistic regression analysis controlling for age, gender, annual household income, and family structure, children co parented by grandparents had a reduced risk of screen exposure time>1 h/d ( OR =0.79, P <0.05), with increased risks of outdoor activity time<2 h/d ( OR =1.30, P < 0.05 ), sleep duration <10 h/d ( OR =1.31, P <0.05), sleep difficulties ( OR =1.39, P <0.05) and adverse eating behaviors ( OR =1.20， P < 0.05), compared with children parented by both parents. Children raised by grandparents were at increased risk for outdoor activity time<2 h/d ( OR =2.19) and unhealthy eating behaviors ( OR =1.39) ( P <0.05).@*Conclusions@#Compared with children raised by both parents, the incidence of unhealthy behaviors is increased in children raised by parents and grandparents and in children raised by full grandparents. Active intervention should be focused on unhealthy behaviors of preschool children with pareting involving grandparents to promote the physical and mental health of preschool children.

Relationship between father s emotional symptoms and emotional and behavioral problems in preschool children / 中国学校卫生

Objective@#To explore the relationship between father s emotional symptoms with offspring s emotional and behavioral problems, so as to provide reference for the prevention and intervention of emotional and behavioral problems in preschool children.@*Methods@#Using the method of multi stage sampling, two kindergartens from each of the two counties, two districts and two development zones were selected from Hefei during February to April 2023. A total of 3 672 children aged 3 to 6 years old and their fathers were selected from 12 kindergartens. Fathers filled out the Depression Anxiety and Stress Scale (DASS-21) and mothers filled out the Strength and Difficulty Questionnaire (SDQ). Multivariate Logistic regression model was established to analyze the relationship between father s emotional symptoms and preschool children s emotional and behavioral problems.@*Results@#The detection rate of emotional and behavioral problems in preschool children was 18.65%, and the detection rates of stress, anxiety and depression in fathers were 4.82%, 10.05% and 6.64%, respectively. Multivariate Logistic regression model analysis showed when fathers had negative emotions of stress, anxiety and depression, the detection rate of emotional and behavioral problems in their offspring was higher than children with father without negative emotion group ( OR =1.77-2.13, P <0.01). Father s stress symptoms were associated with increased risk of emotional and behavioral problems in boys, while father s anxiety and depressive symptoms were associated with increased risk of emotional and behavioral problems in boys and girls ( OR =1.45-2.69, P <0.05). Father s stress symptoms were associated with increased risk of emotional and behavioral problems in the first child, while father s anxiety and depressive symptoms were associated with increased risk of emotional and behavioral problems in the first child, second child and above ( OR =1.81-2.49, P <0.05).@*Conclusions@#Father s negative emotional symptoms are important factors affecting preschool children s emotional and behavioral problems. Early detection and targeted intervention of father s negative emotional symptoms are beneficial to the prevention and control of preschool children s emotional and behavioral problems.

Physical health status and influencing factors of preschool children in Tibet / 中国学校卫生

Objective@#To explore physical health status and influencing factors of preschool children in Tibet, so as to provide a scientific reference and theoretical basis for the healthy development of physical fitness.@*Methods@#Data were collected from children (3-6 years old) of Xizang national physical fitness monitoring, and a total of 1 521 preschool children were recruited who received questionnaire survey and physical fitness test. Independent sample t-test and one-way ANOVA were used to compare the differences in physical fitness indexes of preschool children in different groups. Chi square test and binary Logistic regression model were used to analyze the factors affecting physical health of preschool children.@*Results@#The total qualified rate of physical fitness was 79.75%, among which the excellent rate was 3.16%, the good rate was 15.12%, the qualified rate was 61.47% and the unqualified was 20.25%. From the perspective of BMI, the excellent physical fitness rate (3.74%) and good physical fitness rate ( 17.47% ) were highest in healthy weight preschool children, and the qualified physical fitness rate of overweight preschool children (69.03%) was higher than that of obese (55.88%) and healthy weight preschool children (60.68%)( χ 2=53.56, P <0.01). From the perspective of ethnic, Tibetan children s physique proficiency (3.69%), good rate ( 17.13% ) than with the elevation of the Han nationality (0.74%, 5.88%), fraction defective (16.97%), lower than that of Han nationality (35.29%) ( χ 2=53.71, P <0.01); The results of chest circumference, skinfold thickness, body fat percentage, tennis throw distance, continuous jump of both feet, sitting forward bend and balance beam walking of Tibetan children were higher than those of Han children, and the results of quiet heart rate and standing long jump were lower than those of Han children ( t = 2.72 , 10.95, 9.66, 3.68, 3.88, 8.04, 3.56, 8.70, -4.39 , -4.40, P <0.01). Binary Logistic regression analysis showed that Tibetans ( OR =2.29), breastfeeding ( OR =1.51), body dynamics outdoor daily exercise duration 30-90 min (30-<60 min ;OR = 2.03 ; 60-90 min: OR =2.22) were positively correlated with physical health of preschool children ( P <0.05).@*Conclusions@#The total physical qualification rate of preschool children aged 3-6 years old in Tibet is lower than the national average. Ethnic group, feeding pattern during infancy, and physical activity are all factors that affected the physical fitness of preschool children in Tibet. It is of great significance to improve the physique of preschool children in Tibet to promote their sustainable and healthy development.

Preschool Children Feeding Patterns And Early Childhood Oral Health Impact In Tanah Merah, Kelantan, Malaysia

@#Introduction: Poor feeding patterns increase risk of Early Childhood Caries (ECC), which can cause negative impacts on oral health-related quality of life (OHQoL) of preschool children and parents. This study aims to assess feeding patterns of preschool children and OHQoL of the children and their parents in Tanah Merah. Methods: A cross-sectional study was conducted involving 134 preschool children aged 5-6 years old from eight private preschools, chosen by multi-staged stratified cluster sampling. Parents answered adopted self-administered questionnaire on feeding patterns and oral health-related impacts. Mann-Whitney U test and Kruskal-Wallis test were used to compare the median between groups of feeding patterns. Results: A total of 122 parents responded. Majority of the children had history of bottle-feeding (97.5%) and being given solid food during infancy (61.2%). Many children were still using bottle to drink (38.5%). Majority were still given formula milk at least three times daily (51.1%) and were feed with bottle to put to sleep (97.9%). The Child Impact Section (CIS), Family Impact Section (FIS) and Overall ECOHIS mean scores were 2.39 (SD=3.41), 0.71 (SD=1.45) and 3.10 (SD=4.41), respectively. Most common impact reported in CIS was ‘oral pain’ (26.2%) whereas in FIS, ‘parents felt guilty’ (7.4%). None of feeding patterns were found significantly different in terms of ECOHIS score median (p-value>0.05). Children OHQoL reporting by proxy should be treated as complementary. Conclusion: Many preschool children were involved in prolonged, frequent and nocturnal bottle-feeding. No significant difference in median ECOHIS scores found according to feeding patterns.

Cluster characteristics of physical activities among children inside and outside kindergartens and its relationship with athletic abilities / 中国学校卫生

Objective@#Based on physical activity (PA) and sedentary behavior (SB) variables on weekdays and weekends, the study aims to cluster the physical activities inside and outside kindergartens and to explore the cluster characteristics of different children using physical fitness indicators, so as to provide new strategies and methods for early childhood education and health.@*Methods@#From March to June 2019, 291 children aged 3-6 years from 6 kindergartens in Nanchang were recruited by a stratified cluster random sampling method. The ActiGraph GT3X-BT triaxial accelerometer was used to measure and analyze the PA and SB levels inside and outside the kindergarten. A twostep clustering algorithm model was employed for cluster analysis. Physical fitness were measured and evaluated according to the "National Physical Fitness Measurement Standard Manual (Preschool Section)". Differences in physical fitness among different clusters of children were compared, and the cluster characteristics of different children were analyzed.@*Results@#The clustering algorithm model indicated that based on six indicators, including PA and SB inside the kindergarten on weekdays, and PA and SB outside the kindergarten on both weekdays and weekends, children could be divided into three categories:active inside (high PA, low SB inside), active outside (high PA outside), and inactive (low PA, high SB both inside and outside). The average silhouette coefficient of the model was 0.3, indicating good clustering results. Both the active inside and active outside children showed significantly higher PA inside on weekdays, PA outside on weekdays and weekends, daily low intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) than the inactive children ( F=157.91, 80.79 , 95.86, 95.52, 124.74, P <0.05). After adjusting for gender and age, the physical fitness scores of both active outside ( 19.03 ±0.47) and active inside (19.11±0.40) were significantly higher than those of the inactive children (17.94±0.31). Additionally, active inside children (3.91±0.14) also showed significantly better performance in continuous double-leg jumps, compared to inactive children (3.45±0.11) ( P <0.05).@*Conclusion@#Children active inside and those active outside perform well in PA. Future research should focus on the proportion of structured and unstructured PA time to enhance the overall physical fitness of children.

Neglect and associated factors among children aged 3-6 years in families with non only children in Beijing-Tianjin-Hebei Region / 中国学校卫生

Objective@#To analyze the neglect status of children aged 3-6 years old from non-only-child families in Beijing-Tianjin-Hebei region and influencing factors, so as to provide assistance for the healthy growth of preschool children from non-only-child families.@*Methods@#From April to June 2022, 2 882 parents of preschool children from 15 kindergartens were selected in urban areas of Beijing-Tianjin-Hebei by randomized cluster sampling method, and were investigated with general information and neglect experiences. The χ 2 test, t-test and ANOVA were used to compare the neglect status of different categories of preschool children, and the binary Logistic regression method was used to analyze the influencing factors of the neglect of preschool children who were not only children.@*Results@#The detection rate of neglect among children aged 3-6 years from non-only-child families in the Beijing-Tianjin-Hebei region was 33.47%, the detection rate of neglect among children from only-child families was 9.24%, and the difference was statistically significant ( χ 2=261.94, P <0.01). The neglect score for children aged 3-6 years in non-only-child families was (42.35±7.52), the neglect score for onechild families was (38.16±6.56), and the difference was also statistically significant ( t=15.95, P <0.01). Binary Logistic regression analysis showed that family income <4 000 yuan/month ( OR= 2.75, 95%CI =1.18-6.32), grandparents or other relatives as the primary guardian ( OR=2.18, 95%CI =1.35-3.52), and poor parental relationship ( OR=2.64, 95%CI =1.42-3.87), average ( OR=2.31, 95%CI =1.32-4.01) non-only-child preschoolers had a higher risk of neglect ( P <0.05).@*Conclusion@#Neglect is prevalent among 3-to 6-year-old children from non-only-child families in the Beijing-Tianjin-Hebei region. Targeted intervention measures based on influencing factors should be taken to reduce neglect among preschool children.

Effectiveness of sex education curriculum on sex-related knowledge, attitude and practice of preschool children in senior class / 中国学校卫生

Objective@#To evaluate the effectiveness of sex education curriculum on sex related knowledge, attitude and practice of preschool children in senior class, so as to provide a reference basis for the comprehensive development of early childhood sex education in the future.@*Methods@#From December 2021 to July 2022, the two stage stratified sampling method was used to select 12 kindergartens in Luzhou City, of which 6 senior classes were chosen as the intervention group (360 before the intervention, 354 after the intervention), and the other 6 senior classes as the control group (416 before the intervention, 326 after the intervention). The intervention group was conducted with early childhood sex education classes in the form of a series of courses, with a total of four topics including one parent course and three child courses every month, while the control group received routine teaching schedule. A survey was conducted on the knowledge, attitude and practice of early childhood sex education among preschool children and their parents before and after the intervention. χ 2 text analysis was used to carry out the effect.@*Results@#There was no statistically significant difference in sexual education related knowledge, attitude and practice between the intervention group and the control group before intervention ( P >0.05). There were statistically significant differences in the awareness rate of sexual knowledge (77.4%, 69.6%), positive attitude rate (73.7%, 10.1%), good practice rate (59.3%, 38.0%), and good knowledge, attitude and practice rate (37.9%,1.8%) between the intervention group and the control group after intervention ( χ 2=5.28, 279.77, 30.77, 134.62, P <0.05). Similar findings were observed in the intervention group before and after the intervention ( χ 2=63.39, 344.31 , 41.41, 161.03, P <0.05). The difference in the awareness rate of sexual related knowledge between the control group before and after intervention was statistically significant ( χ 2=44.29, P <0.05).@*Conclusion@#The early childhood sex education curriculum might help improve sex related knowledge, attitude and practice. Kindergartens should be encouraged to actively promote sex education, training, and guidance for preschool children and their parents, in order to improve the sex related knowledge, attitude and practice.

Eating behaviors and associated factors among preschool children in Tongling City / 中国学校卫生

Objective@#To examine the eating behaviors and associated factors among preschool children from multiple child families, so as to provide a basis for promoting healthy eating habits in this population.@*Methods@#From April to June 2022, a stratified random cluster sampling method was employed to selected 2 647 guardians of preschool children in 11 kindergartens in Tongling City. Parenting style questionnaire, Identification and Management of Feeding Difficulty Questionnaire (IMFeD), Caregiver s Feeding Style Questionnaire (CFSQ) and a self designed questionnaire were administered. Multiple linear regression was performed to analyze the factors influencing eating behaviors among preschool children.@*Results@#In the study, the detection of eating behavior problems among preschool children was 71.4%, and the detection of reduced appetite was the highest (55.6%). The detection rates of anorexia, picky eating, poor eating and improper eating behavior in only child families were higher (60.6%, 41.0%, 32.0%, 19.5%), compared with those in multiple child families (51.7%, 36.4%, 27.2%, 16.6%) ( χ 2=20.05, 5.95, 7.16, 3.92, P < 0.05 ). Among multiple child families, the detection rates of fear of eating and underlying disease were the lowest in 5-<10-year-old group (2.3%, 0.6%) ( χ 2=11.54, 8.51, P <0.05). In multiple child families, the detection rates of picky eating and poor eating habits for the first-born child were higher (42.0%, 32.5%), compared with second born and third born child (34.6%, 25.6%)( χ 2= 6.15, 6.38, P <0.05). The results of multiple linear regression analysis showed that multiplechild families ( β =-1.40), democratic parenting style ( β =-0.07), higher feeding response scores ( β =-0.33) were negatively associated with eating behavior problems among preschool children ( P <0.05). Eating behavior problems among preschool children were positively correlated with less educated mothers [high and junior high school education ( β =0.87), primary school education and below ( β =3.69)], longer average daily screen time ( β =0.10), higher feeding requirements scores ( β =0.64), doting parenting styles ( β =0.21), permissive parenting styles ( β =0.27) and inconsistent parenting styles ( β =0.14)( P <0.05).@*Conclusion@#The detection rate of the eating behaviors problems among preschool children is high in schools. Greater attention should be paid to only child and first born child of multiple child families, and appropriate feeding and parenting styles, so as to promote healthy eating habits among this population.

Research progress on the association between screen exposure and autism spectrum disorder in preschool children / 中国学校卫生

Abstract@#Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder. Early life social experience assessment before symptoms of ASD might be helpful for determining the causal link between social experiences and early childhood ASD. Younger children are exposed to excessive screen time in recent years. This paper summarizes the association between screen exposure with ASD in preschool children, and proposes future research directions and provides evidencebased guidance to optimize and support children s early media experiences.