Reducing harm and promoting positive media use strategies: new perspectives in understanding the impact of preschooler media use on health and development

Abstract Most children grow up in homes with easy access to multiple screens. Screen use by children between the ages of 0 to 5 has become a worldwide preoccupation. In the present narrative review, we examine child and parent screen use and its contribution to physical, cognitive, and social developmental outcomes. As research has mostly focused on the adverse consequences of screen media, we aim to depict both the negative and the positive influences of screen usage. To provide a more nuanced portrait of the potential benefits and harms of screen use, we examine how consequences of media use vary according to the content of media (ex., educational, violent), context (ex., using screens during mealtimes), and the nature (ex., passive vs active use) of child screen use. Our review supports existing screen time guidelines and recommendations and suggests that media content, the context of use, and the nature of child use, as well as the parent's own screen use, be considered clinically. Future research should seek to clarify how these dimensions jointly contribute to child screen use profiles and associated consequences. Finally, child sex, behavioral/temperamental difficulties, and family adversity appear to contribute to child screen use and its consequences and should be considered in future research. Suggestions for harm-reduction approaches are discussed.

Discurso narrativo y lectura de cuentos en el hogar por padres a preescolares que presentan trastorno del lenguaje / Narrative discourse and parents' story telling at home to preschool children who present language impairment

RESUMEN El objetivo del estudio es analizar el discurso narrativo productivo de estudiantes de kínder en escuelas de lenguaje de Chile, considerando Trastorno Específico del Lenguaje (TEL) expresivo y mixto junto a la periodicidad de la lectura de cuentos en el hogar. Ambientes naturales enriquecidos en la familia aportan mayores oportunidades de desarrollo favoreciendo la literacidad, las habilidades lingüísticas y sociales. Los niños y niñas con TEL pueden mostrar dificultades en la narración, afectando el desempeño académico, social y en su calidad de vida. El discurso narrativo en una muestra de 150 preescolares es evaluado, utilizando un instrumento formal a través del recontado de 3 cuentos originales. Se examina la etapa del desarrollo narrativo y la lectura de cuentos realizada por padres en el hogar. Se aplica una ficha para recoger información demográfica de las familias. A través de un estudio descriptivo comparativo, se aplica estadística descriptiva e inferencial (ANOVA de dos factores) para analizar las variables. Los resultados muestran que ni el tipo de TEL, ni la frecuencia de lectura o la interacción de ambas, provocan cambios estadísticamente significativos en el discurso narrativo. Sin embargo, se observan hallazgos cualitativos en la cantidad de narración, en función de la lectura de cuentos.

ABSTRACT The study aimed to analyze the productive narrative discourse of students who attended kindergarten in special language schools in Chile, considering the expressive and mixed Specific Language Impairment (SLI) with the periodicity of reading stories at home. Enriched natural environments into the family provide better opportunities to develop early literacy, linguistic and social skills. Children with SLI may show difficulties in narration, affecting academic, social performance, and generally affecting their quality of life. The narrative discourse in a sample of 150 preschoolers was evaluated using a formal instrument that included the retelling of three original stories. The performance of narrative development and reading stories by parents at home were examined. A form was applied to collect demographic information from families. Through a comparative-descriptive study, descriptive and inferential statistics (two-way ANOVA) were used to analyze the variables. The results show that type of SLI, frequency of reading and the interaction of both variables did not cause statistically significant effects in the narrative discourse. However, qualitative findings were observed, in the quantity of oral discourse related to storytelling.

Association of Family Cohesion and Adaptability with Eating Behaviors of Preschoolers / 中山大学学报(医学科学版)

ObjectiveTo examine the current status of preschoolers' eating behaviors and investigate its correlation with family cohesion and adaptability. MethodsA cross-sectional study was conducted involving 21，954 preschoolers and their families from Pingshan District， Shenzhen， between September 2021 and December 2021. A general demographic questionnaire， the Chinese version of Family Adaptability and Cohesion Evaluation Scale Ⅱ （FACESⅡ-CV） and Chinese Preschoolers’ Eating Behavior Questionnaire （CPEBQ） were used to collect the relevant information. Multiple linear regression was used to analyze the association of family cohesion and adaptability with eating behaviors of preschoolers. ResultsTypes of family cohesion and adaptability were significantly correlated with all the 7 dimensions of preschoolers' eating behaviors， including food fussiness （R2=0.252， F=114.457， P<0.001）， food responsiveness （R2 = 0.111， F =24.973， P<0.001）， eating habit （R2= 0.304， F =139.658， P<0.001）， satiety responsiveness （R2 = 0.259， F =105.332， P<0.001）， external eating （R2 = 0.182， F =50.150， P<0.001）， emotional eating （R2 = 0.234， F =91.084， P<0.001） and initiative eating （R2 = 0.349， F =168.608， P<0.001）. After adjusting for confounding factors， our study showed that types of family cohesion and adaptability were independent predictors of preschoolers' eating behaviors （P<0.05）. ConclusionsTypes of family cohesion and adaptability have a significant predictive effect on the 7 dimensions of preschoolers' eating behaviors. Higher scores of family cohesion and adaptability imply stronger initiative eating ability and less poor dietary behaviors in preschoolers.

A latent class analysis of feeding practices among preschoolers’ parents and its correlations with parental depression status / 中华行为医学与脑科学杂志

Objective:To explore the latent classes of parental feeding behaviors in preschool children, and to examine the relationship between potential types of parental feeding behaviors and parental depression status.Methods:From May to July 2021, parents of preschoolers from eight kindergartens in Shanghai were recruited and investigated.A paper-based questionnaire consisting of the Chinese preschooler’s caregivers’ feeding behavior scale (CPCFBS) and the center for epidemiological studies depression scale (CESD-10) was employed.Finally, a total of 1 006 valid questionnaires were retrieved.Mplus 8.0 and SPSS 26.0 were used for statistical analysis.The latent class analysis was used to identify subgroups of parents based on their feeding practices.Multinomial Logistic regression was used to examine the relevant influencing factors.Results:The feeding behaviors of parental of preschool children could be divided into four potential categories: " high responsiveness and high non-responsiveness type" (24.55%), " low responsiveness and high non-responsiveness type" (27.44%), " high responsiveness and low non-responsiveness type" (28.33%) and " low responsiveness and low non-responsiveness type" (19.68%). The parents with depression status were less likely to be categorized as " high responsiveness and low non-responsiveness type" ( OR=0.386, 95% CI: 0.218-0.684). The parents with older children were more likely to be categorized as " low responsiveness and low non-responsiveness type" ( OR=1.318, 95% CI: 1.039-1.672). Conclusion:The feeding practices of parents of preschool children can be categorized into four latent classes.The parents with depression status are more likely to adopt non-responsive feeding practice than responsive feeding practice.Actively paying attention to and improving the depression status of parents may help the feeder to adopt scientific feeding behavior.

Factores asociados con la caries de infancia temprana severa en niños peruanos / Factors associated to severe early childhood caries in Peruvian children

Introducción: La caries de infancia temprana severa es un problema de salud pública que afecta a los niños que la padecen y a sus familias. Objetivo: Determinar la asociación de variables sociodemográficas, de higiene y alimentación con la caries de infancia temprana severa en niños peruanos. Métodos: Se realizó un estudio observacional, analítico, de casos y controles, de octubre a diciembre del 2019. La muestra estuvo compuesta por 264 niños de 2-5 años de edad y sus acompañantes (100 del grupo sin caries y 164 del grupo con caries de infancia temprana severa) que asistieron al Departamento de Odontopediatría del Instituto Nacional de Salud del Niño en Lima, Perú. Se realizó una entrevista estructurada directa, con preguntas cerradas sobre variables sociodemográficas, de higiene, de alimentación y una evaluación clínica, utilizando el índice cpo-s. Se utilizaron las pruebas estadísticas de chi cuadrado, Kruskal-Wallis y el modelo de regresión logística binaria. Resultados: De las variables sociodemográficas, experiencia dental negativa y seguro de salud, tuvieron un valor p < 0,05. Igual resultado tuvo el uso de una pasta dental fluorada, alimentación por biberón, tiempo de alimentación por biberón y edad de inicio del cepillado dental. En el modelo de regresión logística binaria solo las variables uso de pasta dental fluorada (OR = 0,578; 95 por ciento IC: 0,495-0,674) y edad de inicio del cepillado dental (OR = 0,924; 95 por ciento IC: 0,850-0,938) tuvieron un p < 0,05. Conclusiones: Las variables edad de inicio del cepillado dental y uso de una pasta dental fluorada están asociadas con la aparición de caries de infancia temprana severa en niños peruanos. Las variables sociodemográficas y de alimentación no están asociadas(AU)

Introduction: Severe early childhood caries is a public health problem affecting sufferers and their families. Objective: Determine the association of sociodemographic, hygiene and food intake variables to severe early childhood caries in Peruvian children. Methods: An observational analytical case-control study was conducted from October to December 2019. The study sample was 264 children aged 2-5 years (100 from the group without caries and 164 from the group with severe early childhood caries) and their companions, who attended the Children's Dental Care Department at the National Children's Health Institute in Lima, Peru. Direct structured interviews were held based on closed-ended questions about sociodemographic, hygiene and food intake variables, and a clinical evaluation was performed using the cpo-s index. Use was made of the chi-square statistical test, the Kruskal-Wallis test and the binary logistic regression model. Results: Among the sociodemographic variables considered, a negative dental care experience and health insurance obtained a value of p < 0.05. The same result was obtained by use of fluoride toothpaste, bottle feeding, bottle feeding time and age at tooth brushing start. In the binary logistic regression model only the variables use of fluoride toothpaste (OR = 0.578; 95 por ciento CI: 0.495-0.674) and age at tooth brushing start (OR = 0.924; 95 por ciento CI: 0.850-0.938) obtained a value of p < 0.05. Conclusions: The variables age at tooth brushing start and use of fluoride toothpaste are associated to the appearance of severe early childhood caries in Peruvian children. Sociodemographic and food intake variables are not associated(AU)

Relación entre la calidad de los cuidados primarios y la caries dental en preescolares / Relationship between primary health care quality and dental caries in preschoolers

Introducción: La atención primaria de salud aporta la resolución de la mayoría de los problemas de salud de la población, proporciona el acceso primario al servicio, la continuidad e integralidad de la atención y la coordinación de los cuidados. Objetivo: Evaluar la relación entre la calidad de los cuidados primarios y la caries dental en preescolares. Métodos: Se realizó un estudio descriptivo de corte transversal en una muestra de 515 preescolares. La selección de las escuelas tuvo lugar a partir de un muestreo aleatorio estratificado, seguido por muestreo aleatorio simple para la selección de los participantes. Se realizó un examen bucal para evaluar caries dental y se aplicó a los padres/responsables un cuestionario de calidad de los servicios primarios utilizados por los niños. Se emplearon chi cuadrado, Wilcoxon y el coeficiente de Spearman (95 por ciento de confianza) para el cálculo de los datos. Resultados: La calidad de la atención primaria tuvo relación con el índice ceod de preescolares (p = -0,19; p < 0,05). Se observó diferencias significativas entre la prevalencia de caries dental cuando comparados servicios de calidad (ceod = 0,50) con el grupo baja calidad (ceod = 1,13). También, la calidad fue asociada con la modalidad del servicio (p < 0,001), obteniéndose en los servicios privado y la estrategia de salud de la familia puntajes mayores (55,31 por ciento y 69,48 por ciento de calidad, respectivamente). Conclusiones: La calidad de la atención primaria está estrechamente relacionada con salud bucal, de esta forma, cuando la calidad de los servicios de atención primaria no es buena, repercute en un mayor índice de caries dental en los preescolares.

ABSTRACT Introduction: Primary health care solves most of the health problems of the population, provides primary access to the service, ensures the continuity and comprehensiveness of health care, and coordinates its different forms. Objective: Evaluate the relationship between primary health care quality and dental caries in preschoolers. Methods: A cross-sectional descriptive study was conducted of a sample of 515 preschoolers. Participant schools were selected by stratified random sampling, followed by simple random sampling for the selection of participant children. Oral examination was performed to evaluate dental caries, and parents / guardians were given a questionnaire about the quality of the primary services attended by their children. Data were estimated with the chi-squared test, the Wilcoxon test and Spearman's coefficient (95 percent confidence). Results: A relationship was found between primary health care quality and the ceod index of preschoolers (p = -0.19; p < 0.05). Significant differences were observed in the prevalence of dental caries when quality services (ceod = 0.50) were compared with the low quality group (ceod = 1.13). Quality was also associated to the service mode (p < 0.001). Private services and the family health strategy obtained higher quality scores (55.31 percent and 69.48 percent, respectively). Conclusions: Primary health care quality is closely related to oral health, in such a way that when the quality of primary health care services is not good, a higher dental caries rate is observed among preschoolers(AU)

Offline exhaled nitric oxide in children: chemiluminescence vs. electrochemical devices / Óxido nítrico exhalado «fuera de línea¼ en niños: comparación entre equipos de quimioluminiscencia y electroquímicos

Abstract Background: Exhaled nitric oxide (eNO) is a noninvasive marker of airway inflammation that has been used in children, using the "offline" technique. To the extent of our knowledge, no article reported in literature compares the concordance and correlation between the two different technologies used to measure eNO at tidal volume offline. This study aimed to report the concordance and correlation of the eNO measured "offline" at tidal volume, using chemioluminiscence (cl) vs electrochemical devices (eq). Methods: A cross-sectional, observational, and prospective study was conducted in the National Institute of Respiratory Diseases (Instituto Nacional de Enfermedades Respiratorias), Mexico City. Healthy children and those with a lung disease between 1 and 11 years of age were included. The exhaled air sample at tidal volume was obtained by attaching a mask connected to a Mylar® bag. Results: We studied 36 children. The mean ± standard deviation (SD) age of the study population was 6 ± 2.6 years; 25% of the subjects included were healthy, and the rest had a lung disease. The concordance correlation coefficient between the two measuring devices was 0.98 (p < 0.001), with a mean difference of 1.46 ± 3.5 ppb and 95% limits of agreement from -5.3 ppb to 8.3 ppb. The linear regression model equation for the estimation of eNO was eNOcl = (eNOeq·1.0718) - 0.1343 (r2 = 0.97). Conclusions: The measurement of eNO at tidal volume by the offline method can be analyzed by electrochemical devices, and the results are interchangeable with those analyzed by chemiluminescence technology.

Resumen Introducción: El óxido nítrico exhalado (eNO) es un marcador no invasivo de inflamación de la vía aérea que se ha utilizado en niños mediante técnica «fuera de línea¼. Por lo que sabemos, en la literatura no existen reportes que comparen la concordancia y la correlación entre dos técnicas diferentes a volumen corriente. El objetivo de este trabajo es informar la concordancia y la correlación del eNO obtenido por la técnica fuera de línea a volumen corriente en los equipos de quimioluminiscencia (cl) y electroquímico (eq). Métodos: Se realizó un estudio transversal, observacional y prospectivo en el Instituto Nacional de Enfermedades Respiratorias, en Ciudad de México. Se incluyeron niños sanos y con enfermedad pulmonar de 1-11 años de edad. La muestra de aire exhalado se obtuvo a volumen corriente mediante una máscara con conexión a una bolsa de Mylar®. Resultados: Se estudiaron 36 niños. La edad promedio con su desviación estándar de la población de estudio fue de 6 ± 2.6 años. El 25% de los sujetos incluidos estaban sanos y el resto tenían alguna enfermedad pulmonar. El coeficiente de correlación de concordancia entre los dos equipos fue de 0.98 (p < 0.001), con una diferencia media de 1.46 ± 3.5 ppb y unos límites de concordancia del 95% de −5.3 a 8.3 ppb. La ecuación del modelo de regresión lineal del eNO fue eNOcl = (eNOeq·1,0718) − 0.1343 (r2 = 0.97). Conclusiones: La medición del eNO por el método fuera de línea a volumen corriente puede analizarse en dispositivos electroquímicos. Los resultados son intercambiables con los de quimioluminiscencia.

Predictive Utility of Anthropometric Based Cut-offs in Assessing Excess Adiposity among Preschool Children in a Multiethnic Population

ABSTRACT Objective: Screening for childhood obesity is a necessary step in developing appropriate and effective interventions. We evaluated the diagnostic performance of various recommended international anthropometric cut-offs based on body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), triceps skinfold (TSF), and mid-upper arm circumference (MUAC) in predicting excess adiposity (body fat ≥ 25%) in a random sample of Trinidadian preschoolers. Methods: After obtaining written parental consent, weight, height, WC, TSF, and MUAC were measured in 596 children using standard procedures. These were used to calculate BMI for age, WHtR, TSF-for-age z-scores, and MUAC-for-age z-scores. Percentage body fat was measured using a Tanita-531 foot-to-foot bioelectrical impedance analyser (BIA). Sensitivities, specificities and area under the receiver-operating curve analysis and predictive values were then computed in reference to BIA estimates. Results: The prevalence of excess adiposity was 12.2% and 5.1% among males and females, respectively. Sensitivities for the various cut-offs ranged from 20.0% to 75.0% and 57.1% to 96.9% among males and females, respectively. WHO-BMI recommended cut-offs and those based on MUAC z-scores had significantly higher sensitivities in females than in males. TSF z-scores had significantly lower sensitivities compared to those based on BMI and WHtR among males. Similarly, specificities ranged from 81.3% to 99.9% and 79.8% to 99.9% among males and females, respectively. In girls, cut-offs based on TSF z-scores had a higher likelihood ratio than cut-offs from Centers for Disease Control, International Obesity Task Force and WHtR. Diagnostic performance was not associated with ethnicity. Conclusion: Our results suggest that diagnostic performance was associated with gender and the cut-offs used; however, it was not associated with ethnicity.

Prácticas y creencias de enseñanza y estimulación del lenguaje desde la Cultura Mapuche en niños y niñas rurales en la Región de La Araucanía / Teaching practices and beliefs and language stimulation from the Mapuche Culture in rural children in the Araucanía Region

Resumen: Introducción: El lenguaje es una de las tareas cognitivas más relevantes en el desarrollo infantil cuya adquisición está mediada, entre otros, por factores étnicos y culturales. Objetivo: Caracterizar las prácticas y creencias sobre la enseñanza y estrategias de estimulación del lenguaje de niños/as Mapuche rurales de 0 a 4 años desde una perspectiva intracultural. Sujetos y Método: Estudio cualitativo basado en Teoría Fundamentada que produce una comprensión del problema a partir de las percepciones de los suje tos de investigación. Se utilizaron técnicas etnográficas como observación y notas de campo además de 20 entrevistas en profundidad y 4 grupos focales con cuidadores (madres, padres, abuelos/as), educadores interculturales, asesores culturales y agentes ancestrales de la cultura (longko y machi). Participaron 41 personas Mapuche de los territorios rurales de Ercilla, Curarrehue, Puerto Saave dra, Cholchol y Boroa de la región de La Araucanía/Chile. Resultados: Se obtuvieron 4 dimensiones que caracterizaban las prácticas y creencias en torno a la adquisición y uso del lenguaje en niños/as Mapuche: a) los/as niños/as y el aprendizaje de la lengua representan la mantención de la identidad Mapuche; b) el habla es un proceso concreto y pragmático; c) existen técnicas tradicionales para estimulación del habla, y d) existen dificultades y facilidades para el desarrollo de la lengua indígena en los niños/as pequeños. Conclusiones: La mantención y recuperación de la lengua indígena es un proceso de reforzamiento de la identidad cultural para el pueblo Mapuche, que no ha sido valorado como un patrimonio cultural en la sociedad nacional.

Abstract: Introduction: Language is one of the most relevant cognitive tasks in child development and its acquisition is me diated, among others, by ethnic and cultural factors. Objective: To characterize the practices and be liefs about language teaching and stimulation strategies of rural Mapuche Children aged between 0 to 4 years from an intracultural perspective. Subjects and Method: Qualitative study based on Groun ded Theory, which generates an understanding of the study issue from the perceptions of the research subjects. Ethnographic techniques such as observation and field notes were used, and 20 in-depth in terviews and four focus groups were conducted with caregivers (mothers, fathers, and grandparents), intercultural teachers and people with cultural roles (longkos, machis, and intercultural facilitators). 41 Mapuche people from the Ercilla, Curarrehue, Puerto Saavedra, Cholchol and Boroa territories of the Araucanía region, Chile participated. Results: Four dimensions were obtained that characte rized the practices and beliefs regarding the acquisition and use of language in Mapuche children: a) Mapuche culture transcends through children and language, b) speech is a concrete and pragmatic process, c) there are traditional techniques for speech stimulation, and d) there are difficulties and easiness for the development of the indigenous language in young children. Conclusions: The preser vation and recovery of the indigenous language is a process of reinforcing the cultural identity for the Mapuche people, which has not been valued as a cultural heritage in the national society.

Variabilidad en el patrón de consumo de alimentos en una población de preescolares de Asunción, de nivel socioeconómico alto y su relación con el estado nutricional / The variability in feeding patterns of pre-schoolers living in Asunción, from families with high socioeconomic status and the relation with their nutritional status

Introducción: La diversidad alimentaria constituye una medida cualitativa del consumo de alimentos, tiene una asociación positiva con la calidad de la dieta y es un factor importante para alcanzar los requerimientos nutricionales. Objetivo: Evaluar la variabilidad en el patrón de consumo de los alimentos de niños pre escolares residentes en Asunción, de condición socioeconómica alta y su relación con el estado nutricional. Metodología: Diseño observacional, trasversal, cualitativo. Se realizó la evaluación de niños prescolares de 2-6 años de nivel socio económico alto de Asunción, de setiembre a octubre de 2014 mediante medición antropométrica y con dos encuestas: una de datos demográficos y otra con la lista de todos los alimentos disponibles en el mercado, mediante entrevista directa. Se evaluó estado nutricional y su relación con la diversidad alimentaria. Se utilizó medidas de frecuencia y el programa Anthro 3.2 de la Organización Mundial de la Salud. Resultados: Se estudiaron 67 niños, con predominó del sexo femenino. El 89,5 % de madres tuvo estudios terciarios concluidos. Se encontraban eutróficos (63% de los niños) y 31,5 % con malnutrición por exceso (sobrepeso y obesidad) Un 19% presentó riesgo de talla baja y el 1,5% talla baja. Se hallaron un total de 172 tipos de alimentos que se distribuyeron en 9 grupos, la media de número de alimentos consumidos por los niños pre escolares fue de 69,19 (IC 95%: 63,79- 74,59). El rango mínimo fue de 28 alimentos y el máximo 126 alimentos. No se encontró diferencias significativas con el Índice de Masa Corporal y la diversidad alimentaria; sin embargo la relación fue estadísticamente significativa entre diversidad de la alimentación y la talla alta. Conclusión: Se constató que existe poca variabilidad en el consumo de alimentos de niños pre escolares sin restricción socio económica. Se encontró relación significativa entre diversidad Alimentaria y la talla del niño

Introduction: Food diversity can be used to measure the quality of the feeding habits. It has a positive association with diet quality and constitutes an important factor to reach the nutritional requirements. Objectives: Assess the variability in feeding patterns of pre-schoolers living in Asunción, from families with high socioeconomic status and the relation with their nutritional status. Methodology: Observational, transversal in time, qualitative study. The researchers evaluated children from 2-6 years of age, from families with high socioeconomic status living in Asunción, from September to October of 2014, using antromopetric measures and two questionnaires applied in direct interview format: the first one with demographic data and the second one with a list of locally available food. The nutritional status and its relation with food diversity were assessed, measuring frequency. World's Health Organization's Software Anthro 3.2 was used for anthropometric evaluation. Results: In total, 67 children were included in the study, mainly female. 89,5% of the patient's mother had concluded tertiary education. 63% of patients were well-nourished and 31,5% had excess weight (overweight and obese). 19% were in risk of stumpting and 1,5% were in the range of stumpting. A total of 172 food varieties were found, distributed in 9 groups, the mean quantity of food varieties consumed by children was of 69,19 (CI: 95%, 63,79-74,59), ranging from 28 to 126 food varieties. Significant differences were not found in Body Mass Index and food diversity; but a statistically significant relation was found between food diversity and height. Conclusion: Low variability in feeding patterns was found in children with high socioeconomic status. There was a significant relation between food diversity and the child's height

Caries patterns in primary dentition in 3- to 5-year-old children. Medellín, Colombia / Patrones de caries en la dentición primaria de niños de 3 a 5 años de edad. Medellín, Colombia

ABSTRACT Introduction: early childhood caries (ECC) is a public health problem. Recognizing caries patterns in affected children can help improve oral health programs focused on the preschool population. The aim of this study was to identify caries patterns in 3- to 5-year-old children in a low to middle-low socioeconomic area. Methods: a calibrated dentist recorded caries lesions using ICDAS criteria in 548 children attending four day-care centers in a low to middle-low socioeconomic area. ECC and S-ECC prevalence and the proportion of affected teeth/surfaces by lesion type for homologous teeth were calculated. Results: a total of 419 (76.5%) and 238 (43.4%) children had ECC and S-ECC, respectively. Average dmft was 3.7±3.7 and average affected surfaces were 5.8±7.7. Occlusal surfaces showed the highest caries experience, varying from 17.7% to 36.1%, showing statistical significance when compared to other molar surfaces. The upper smooth anterior surfaces were affected from 0.2% to 17.2%, while lower smooth anterior surfaces showed values between 0.0% and 6.8%. The percentage of dental caries experience in second molars varies from 37.1% to 42%, while in lower central and lateral incisors the values range from 1.8% to 4.6%. Conclusion: the specific caries pattern in preschool children with high prevalent ECC from a middle-low-income area indicate the need to design programs aimed at detecting early sings of dental caries in specific locations, as well as disease control strategies.

RESUMEN Introducción: la caries de la infancia temprana (CIT) es un problema de salud pública. Identificar el patrón de caries en los niños afectados puede ser útil para mejorar los programas de salud bucal centrados en la población preescolar. El objetivo del presente estudio consistió en identificar patrones de caries en niños de 3 a 5 años de edad en un área socioeconómica baja y media-baja. Métodos: un dentista calibrado registró lesiones de caries utilizando criterios ICDAS en 548 niños que asisten a cuatro guarderías de un área socioeconómica baja y media-baja. Se calculó la prevalencia de CIT y CIT-S (severa) y la proporción de dientes/superficies afectados por tipo de lesión para dientes homólogos. Resultados: hubo un total de 419 (76,5%) CIT y 238 (43,4%) CIT-S. El cpod promedio fue de 3,7 ± 3,7 y el promedio de superficies afectadas fue de 5,8 ± 7,7. Las superficies oclusales presentaron la mayor experiencia de caries, en un rango de entre 17,7% y 36,1%, lo que indica una significación estadística en comparación con otras superficies molares. Las superficies lisas anteriores superiores se vieron afectadas entre el 0,2% y el 17,2%, mientras que las superficies lisas anteriores inferiores mostraron valores entre 0,0% y 6,8%. El porcentaje de experiencia de caries dental en los segundos molares varía del 37,1% al 42%, mientras que en los incisivos centrales y laterales inferiores oscila entre el 1,8% y el 4,6%. Conclusión: el patrón específico de caries en niños en edad preescolar con alta prevalencia de CIT en un área de ingresos medios-bajos indica la necesidad de diseñar programas que incluyan acciones destinadas a detectar caries dentales en lugares específicos, así como estrategias para el control de la enfermedad.

Caracterización de hábitos alimentarios y estado nutricional de preescolares / Characterization of Alimentary Habits and the Nutritional State of Preschoolers

RESUMEN Introducción: La buena salud depende de factores como la nutrición, determinante para garantizar un adecuado estado físico, mental y académico, aspectos indispensables para el desarrollo individual y social de cualquier persona. Objetivo: Caracterizar los hábitos alimentarios y estado nutricional de los preescolares de un centro de educación inicial. Métodos: Estudio descriptivo de corte transversal correlacionar, en un centro de educación inicial en Santa Elena, Ecuador, durante 2016. Universo constituido por 125 binomios padres-escolares, entre tres y cinco años. Se utilizó el método observacional y encuesta, las variables estudiadas fueron edad, hábitos alimentarios, nivel de instrucción, adquisición de alimentos, peso, talla. Para el análisis de datos, se utilizó el software IBM-SPSS-Statistics-21.0; en el descriptivo se utilizaron promedios, media, moda, desviación estándar, valores máximos y mínimos. Para la comparación entre los grupos, se utilizó prueba de Anova de muestras independientes y Χ2, considerando significativo p < 0,05. Para comparar el estado nutricional se analizó la concordancia e índice Kappa, considerándose una buena concordancia un valor ≥ 0,80. Resultados: En cuanto a los padres: 53,60 pòr ciento eran jóvenes, 32,00 por ciento entre 21 a 25 años de edad, 85,00 por ciento con nivel de instrucción medio, 26,40 por ciento con dificultad para adquirir alimentos. El estado nutricional en los niños fue deficiente, debido al consumo de proteínas de alto valor biológico (3,97 por ciento) y 8,32 por ciento, 7,94 por ciento y 4,70 por ciento demostraron alto consumo en alimentos de baja calidad nutricional. Conclusiones: Los hábitos alimentarios de los preescolares se caracterizaron por una alimentación hiperglucídica e hipoproteica, alta en sodio, deficiente en hierro y zinc, evidenciando baja calidad nutricional en los alimentos consumidos(AU)

ABSTRACT Introduction: Good health depends on factors such as nutrition, a determinant to guarantee proper physical, mental and academic state, essential aspects for the individual and social development of any person. Objective: To characterize the eating habits and nutritional status of preschoolers in an initial education center. Methods: Descriptive, cross-sectional, correlation study carried out in an initial education center in Santa Elena, Ecuador, during 2016. The study population consisted of 125 parent-schoolchild binomials, the school children aged between three and five years. The observational method and the survey were used. The variables studied wereage, eating habits, school level, food acquisition, weight, height. The software IBM-SPSS-Statistics-21.0 was used for data analysis. The results were expressed in average, median, mode, standard deviation, maximum and minimum values. For the comparison between the groups, the Anova test of independent samples and the chi-square test were used, considering p bellow 0.05 significant. To compare the nutritional status, the concordance and Kappa index were analyzed, considering a good value as being higher or equal than 0.80. Results: As for the parents, 53.60 percent were young; of them, 32 percent were between 21 and 25 years old, 85 percent had completed the average education level, and 26.40 percent expressed difficulties in acquiring food. The nutritional status in children was poor, due to the consumption of proteins of high biological value (red meat, 3.97 percent) and foods of poor nutritional quality such as soft drinks (8.32 percent), sweets (7.94 percent) and snacks (4.71 percent). Conclusions: The preschooler's eating habits were characterized by a hyperglycidic and hypoproteic diet, high in sodium, deficient in iron and zinc, which shows low nutritional quality in the food consumed(AU)

Deficiencia de vitamina A y factores asociados en niños preescolares de la periferia de la ciudad de La Plata, Buenos Aires / Vitamin A deficiency and associated factors in preschoolers from the outskirts of La Plata, Buenos Aires

Introducción. La deficiencia de vitamina A (DVA) ha sido reconocida como un importante problema de salud pública en países en vías de desarrollo. Los niños en edad preescolar son grupos de riesgo en poblaciones vulnerables. El objetivo fue determinar la prevalencia de DVA y los factores asociados en una muestra de niños de edad preescolar. Material y métodos. Estudio de corte transversal que incluyó a niños de 1 a 6 años beneficiarios de planes sociales, atendidos en centros de atención primaria de la periferia de la ciudad de la Plata, Buenos Aires. Se determinó el contenido de vitamina A midiendo retinol sérico, por cromatografía líquida, y se registraron parámetros antropométricos e ingesta alimentaria. Se utilizó un modelo de regresión logística multinomial para evaluar la asociación entre las variables. Resultados. Se analizaron datos de 624 niños. La media geométrica de retinol fue 23,8 pg/dl (IC 95 %: 23,3-24,3). Las prevalencias de DVA y riesgo de DVA fueron 24,3 % y 57,4 %, respectivamente. Los niveles de retinol fueron significativamente menores en niños varones, con bajo peso y aquellos con bajo consumo (menor del primer tercilo de distribución). El análisis multivariable mostró asociación significativa entre DVA y el sexo masculino (OR: 1,93; IC 95 %: 1,15-3,24) y con el bajo consumo (OR: 1,48; IC 95 %: 1,15-2,62). Conclusión. La prevalencia de DVA hallada (24,3 %) constituye un importante problema de salud pública en esta población. Los factores asociados a dicha deficiencia fueron el sexo masculino y el bajo consumo.

Introduction. Vitamin A deficiency (VAD) has been recognized as an important public health problem in developing countries. Preschoolers account for risk groups within vulnerable populations. The objective of this study was to determine the prevalence of VAD and associated factors in a sample of preschoolers. Material and methods. Cross-sectional study with children aged 1-6 years receiving social assistance and seen at primary health care centers in the outskirts of the city of La Plata, Buenos Aires. Vitamin A levels were determined by measuring serum retinol with a liquid chromatography; anthropometric parameters and dietary intake were recorded. A multinomial logistic regression model was used to assess the association among outcome measures. Results. Data from 624 children were analyzed. The geometric mean of retinol was 23.8 pg/dL (95 % CI: 23.3-24.3). The prevalence of VAD and the risk for VAD were 24.3 % and 57.4 %, respectively. Retinol levels were significantly lower among boys, low-weight children, and those with low intake (below the first tertile of distribution). The multivariate analysis showed a significant association between VAD and male sex (odds ratio: 1.93; 95 % CI: 1.15-3.24) and between VAD and low intake (odds ratio: 1.48; 95 % CI: 1.15-2.62). Conclusion. The prevalence of VAD (24.3 %) is a major public health problem in this population. VAD-associated factors were male sex and low vitamin A intake.

Maternal Care and Attachment Security in Preschool Children / Cuidado Materno e Apego em Crianças Pré-escolares / Cuidado Materno y Seguridad del Apego del Niño Preescolar

Abstract This study assessed and compared the relationship between maternal sensitivity and child attachment in two groups of mother-child dyads from Lima, Peru, one group with children 4 years old and older and a second group with younger children. Fifty-six dyads participated in the study. The mothers ages ranged between 22 and 45 years (M = 33.14, SD = 5.50); 82.1% of them had higher education and 73.2% were in a partner relationship. Of the children, 53.6 were boys and 41.1% were an only child. The study used AQS and MBPQS to rate child and maternal behavior respectively. Our results show a high correlation between attachment security and maternal sensitivity in both groups, as well as specific manifestations of these variables in the context studied.

Resumo O objetivo do presente estudo foi comparar a relação entre a qualidade da vinculação que as crianças estabelecem com a figura materna e a sensibilidade destas com filhos/as menores e maiores de 4 anos na cidade de Lima, Peru. Participaram 56 díades mãe-criança. A média de idades das mães é de 33,14 (DP = 5,50), 82,1% tinham ensino superior, 73,2 % estavam numa relação estável. 53,6% das crianças eram do sexo masculino e 41.1% filhos únicos. O AQS e o MBPQS foram utilizados para caracterizar os comportamentos de base segura das crianças e a sensibilidade materna. Constatou-se que a qualidade de vinculação está positiva e significativamente correlacionada com a sensibilidade materna. Estes resultados sugerem manifestações particulares do contexto peruano.

Resumen Se evaluó la relación entre la sensibilidad materna y la seguridad del apego del niño/a en diadas madre-niño/a de Lima, Perú; esta relación se comparó entre díadas con hijos mayores y con hijos menores de 4 años. Participaron 56 díadas; las madres tenían entre 22 y 45 años (M = 33.14, DE = 5.50), 82.1% reportó estudios superiores y 73.2% una relación de pareja; 53.6% fueron niños y 41.1% eran hijos únicos. Se utilizaron el AQS y el MBPQS para la calificación de la conducta del niño y de la madre respectivamente. Se halló una alta correlación entre ambas variables en ambos grupos. Se describen manifestaciones particulares de la seguridad del apego y la sensibilidad en el contexto estudiado.

Parents' Recognition of Center for Children's Food Service Management and Preschoolers' Satisfaction with Menu Provided by Childcare Centers and Food Life Regarding Vegetable Intake

This study was conducted to determine parents' recognition of the Center for children's foodservice management (CCFSM) and to compare preschoolers' satisfaction for meals served by childcare centers and some aspects regarding the vegetable intake according to the parents' recognition of CCFSM. The subjects were 255 parents, whose children were 2~5 year old and attended a childcare center, were grouped according to the recognition of CCFSM (high recognition, HR, 27.5%; medium recognition, MR, 47.4%; low recognition, LR, 25.1%). Information was obtained by a self-administered questionnaire and data were analyzed by SPSS 25.0. Only 58.6% of HR and 10.7% of MR answered the they had participated education/event held by the CCFSM. More parents in the HR group (88.6%) acknowledged the helpfulness of CCFSM on the children's food habits compared to those in the MR group (63.6%) (P<0.001). Compared to the MR and LR groups, more parents in the HR group answered not only that they were ‘satisfied’/‘very satisfied’ with the meals served by childcare centers (P<0.05), but also they tended to think that their children were also satisfied (P=0.061). Up to 31.2% of parents in the LR group answered that there was no need for education to increase the vegetable intake of their child compared to 14.3% and 17.4% in the HR and MR groups, respectively (P<0.05). Moreover, up to 26.6% of parents answered that school cook planned menus compared to 5.7% and 13.2% in the HR and MR group, respectively (P<0.001). In conclusion, the results provided the association between parents' high recognition of CCFSM and preschoolers' satisfaction for meals from childcare centers as well as a better chance for a desirable food life regarding vegetable intake.

Medidas declaradas por padres y cuidadores de lactantes y preescolares para prevenir la exposición a humo de tabaco ambiental / Measures stated by parents and caregivers of infants, toddlers, and preschoolers to prevent environmental tobacco smoke exposure

Introducción. La exposición a humo de tabaco ambiental constituye un problema de salud pública por sus potenciales riesgos en los niños. Objetivo. Determinar las acciones preventivas adoptadas por padres y/o cuidadores de lactantes y preescolares respecto de la exposición a humo de tabaco ambiental. Métodos. Estudio transversal analítico en padres y cuidadores de lactantes y preescolares escolarizados, residentes en la ciudad de Valdivia, Chile. Se aplicó un cuestionario sobre medidas preventivas del humo de tabaco ambiental. Se analizó con estadística descriptiva y de asociación usando el test exacto de Fisher y la regresión logística para calcular odds ratio (OR) y sus respectivos intervalos de confianza del 95% (IC95%) como estimación de riesgo de no adopción de medidas preventivas en el hogar. Resultados. Participaron 469 padres y cuidadores. La prevalencia de hogares con un miembro fumador fue 51,8%. La mayoría fumaba fuera del hogar (92,2%). La medida más adoptada fuera del hogar fue evitar lugares con gente fumando. En este ambiente, hubo diferencia significativa entre hombres y mujeres en no prevenir la exposición (7,6% vs. 2,2%; p= 0,040). Se constató mayor riesgo de no prevenir el consumo en el hogar (dentro o fuera) cuando hubo algún miembro fumador (OR 3,55; IC95%: 2,05-6,14). Y menor riesgo cuando hubo dos o más niños en el hogar (OR 0,46; IC95%: 0,26-0,83). Conclusiones. La mayoría de los padres y cuidadores piden que se fume fuera del hogar y evitan los lugares con gente fumando, aunque, en los hogares con miembros fumadores, la prevención es menor.

Introduction. The exposure to environmental tobacco smoke is a public health problem because of its potential risks for children. Objective. To determine the preventive actions taken by parents and/or caregivers of infants, toddlers, and preschoolers regarding environmental tobacco smoke exposure. Methods. Cross-sectional, analytical study in parents and caregivers of infants, toddlers, and preschoolers from Valdivia, Chile. A questionnaire on preventive measures regarding environmental tobacco smoke was administered. The questionnaire was analyzed with descriptive and association statistics using Fisher's exact test and logistic regression to calculate the odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) as an estimation of the risk for not taking preventive measures at home. Results. A total of 469 parents and caregivers participated. The prevalence of households with one member who smoked was 51.8%. Most of them smoked outside the house (92.2%). The most common measure taken outside the household was to avoid places where people smoked. In this setting, a significant difference was observed between men and women in relation to avoiding exposure (7.6% versus 2.2%; p= 0.040). A higher risk for not avoiding tobacco use inside or outside the housewas confirmed when a household member smoked (OR: 3.55; 95% CI: 2.05-6.14). Also, a lower risk was observed when there were two or more children in the household (OR: 0.46; 95% CI: 0.26-0.83). Conclusions. Most parents and caregivers ask others to smoke outside and avoid places where people smoke; however, the level of prevention is lower among households with smokers.

Effectiveness Of Vision Screening Program Conducted By Preschool Teachers

@#Vision impairment when undetected early can affect the social and mental development of a child. Early detection of visual impairment can provide better prognosis and can be conducted through vision screening at pre-school. Vision screening performed using pre-school teachers would allow cost and time savings while providing greater access to perform this screening. The objective of this study was to determine the effectiveness of vision screening conducted by pre-school teachers. A total of sixty pre-school teachers from KEMAS Tabika’s and Taska’s in the Klang Valley were randomly selected and divided into two groups i.e. a Study Group and a Control Group. The Study Group was given participative and handson vision screening training whereas the Control Group was only given brief verbal instructions on conducting the screening. Each of these pre-school teachers was asked to conduct vision screening on 15 pre-school children aged 4 to 6 years old. Trained optometrists then repeated the vision screening on the same children. The results showed that there was a higher validity in the vision screening findings from the Study Group (sensitivity = 79%, specificity = 95%) compared to the Control Group (sensitivity = 26%, specificity = 95%). The level of agreement concurrence between the pre-school teachers in the Study Group and the optometrist was high for all tests (AC1 ≥ 0.89). In conclusion, the vision screening program conducted by pre-school teachers was effective but needed proper training for the screeners. This program is seen to be able to empower pre-school teachers using vison screening techniques to allow them to identify pre-school children with vision impairment who would then require further examination and management by an eye-care professional. This program would be able to reduce the prevalence of vision impairment among pre-school children in Malaysia in the long term.

Parental burden of food-allergic children's parents and influencing factors / 한국영양학회지

PURPOSE: Recently, there has been a worldwide increase in the prevalence of food allergies in children and it may cause nutritional imbalance and poor quality of life for growing children due to dietary restrictions. This study was conducted to quantitatively measure the life burden and related factors of mothers who are the primary caretakers of food-allergic children. Moreover, we generated data for use as a scientific basis for the development of a disease management program to reduce the burden on life from raising food-allergic children. METHODS: Mothers of 2,005 children aged 2 years or older and enrolled in Seoul Metropolitan Atopy Free Schools in 2016 who have had diagnosis of food allergy in their lifetime were surveyed. The burden on life of parents with food-allergic children was measured using 17 questions from the Food Allergy Quality of Life-Parental Burden (FAQL-PB) questionnaire, and subjects were asked to respond with a scale of 1 ~ 7. RESULTS: We analyzed the effects of sociodemographic factors of parents and children and the accompanying allergic disease factors on the lives of parents. The number of restricted food items due to food allergy of a child and accompanying diagnosis of atopic dermatitis had a positive (+) effect on the life burden of the parents. CONCLUSION: Accurate oral food challenge for food allergies should be administered to prevent excessive restriction of food intake. Moreover, efforts should be taken to prevent morbidity accompanying food allergy and relieve symptoms of asthma, allergic rhinitis and atopic dermatitis.

Overweight and obesity in preschoolers: Prevalence and relation to food consumption / Excesso de peso e obesidade em pré-escolares: prevalência e relação com consumo alimentar

Summary Objective: To determine overweight and obesity prevalence in preschool children from public education, and to determine their relation to food consumption. Method: Cross-sectional study with children aged between 2 and 5 years, of both sexes, enrolled at municipal day care centers. Socioeconomic, demographic and anthropometric data were collected, in order to calculate the body mass index (BMI) for age. Data on food consumption were assessed using a Food Frequency Questionnaire. χ2 test, Kruskal-Wallis test, Student's t-test and Pearson's correlation were used at a significance level of 5%. Results: Of 548 children, 52% were male, with mean age of 4.2 years old. Most families had incomes between 1 and 2 minimum wages (59.7%), in addition to 10 years (mothers) of education. Anthropometric parameters did not differ significantly between sexes. According to the BMI-for-age, it was found that most of children were well-nourished (85.2%), 8.2% had the risk of becoming overweight, and 4.2% were overweight. The most consumed foods were: rice (100%), beans (99.4%), bread (98.5%), fruit (98.5%), red meat (97.1%), butter and margarine (95.4%), biscuits, cakes and sweet pies (94.1%), dairy products (94.1%), chocolate milk (91.7%), and soft drinks (90.2%). Consumed foods that were strongly correlated (r > 0.7) to the risk of/excess weight were, as follows: bread; biscuits, cakes, sweet pies; dairy products; chocolate milk; sausages. Conclusion: There was low prevalence of overweight and absence of obesity among the population assessed. The risk of overweight was greater among girls. Data from the study showed deviations in food consumption.

Resumo Objetivo: Determinar a prevalência de excesso de peso e obesidade em pré-escolares de instituições públicas de ensino e sua relação com consumo alimentar. Método: Estudo transversal com crianças de 2 a 5 anos, de ambos os sexos, atendidas em creches municipais. Coletaram-se dados socioeconômicos, demográficos e antropométricos, para cálculo do índice de massa corpórea (IMC) por idade. Os dados sobre consumo alimentar foram avaliados por meio de Questionário de Frequência Alimentar. Utilizaram-se os testes do χ2, Kruskal-Wallis, t de Student e correlação de Pearson, com nível de significância de 5%. Resultados: Das 548 crianças, 52% eram do sexo masculino, com média de idade de 4,2 anos. A maioria das famílias apresentou renda entre 1 e 2 salários mínimos (59,7%) e escolaridade materna de 10 anos. Os parâmetros antropométricos não apresentaram diferença significativa entre os sexos. Segundo o IMC/I, verificou-se que a maioria das crianças estava eutrófica (85,2%); 8,2%, com risco de excesso de peso; 4,2%, com excesso de peso. Os alimentos mais consumidos foram: arroz (100%), feijão (99,4%), pães (98,5%), frutas (98,5%), carne vermelha (97,1%), manteiga e margarina (95,4%), bolachas, bolos, tortas doces (94,1%), leite e derivados (94,1%), achocolatado (91,7%) e refrigerantes (90,2%). Os alimentos consumidos que apresentaram forte correlação (r > 0,7) com o risco/excesso de peso foram: pães; bolachas, bolos, tortas doces; leite e derivados; achocolatados e embutidos. Conclusão: Observaram-se baixa prevalência de excesso de peso e ausência de obesidade entre o público pesquisado. O risco de excesso de peso foi maior entre as meninas. O estudo mostrou desvios no consumo alimentar.

Factors Influencing Parenting Stress in Mothers of Preschoolers Born Prematurely

PURPOSE: This study was conducted to describe parenting stress in mothers of preschoolers who were born prematurely and to determine factors affecting parenting stress in child's problem behavior, mother-child interaction and parenting alliance. METHODS: An exploratory survey study was conducted with 66 mothers of preschool children (5~6 years) with preterm births (PTB). Data were collected using Parenting Stress Index (PSI), Child Behavior Checklist (CBCL), Mother-Preschool Child Interaction Scale (MPIS), and Parenting Alliance Inventory (PAI). RESULTS: Of the 66 mothers, 8(12.1%) showed high scores that were more than borderline for the PSI total score. In the multiple linear regression analysis, lower scores on the PAI (β=−.41, p<.001), higher scores on the externalizing problem behavior of the CBCL (β=.40, p=.001), and lower scores on the MPIS (β=−.21, p=.043) were statistically significant contributors to maternal parenting stress. CONCLUSION: Findings indicate that mothers of PTB preschool children are at risk for parenting stress. Child's externalizing problem behavior, poor maternal-child interaction and parenting alliance were independent factors raising maternal parenting stress. More attention is needed on paternal parenting support, child's behavioral development, interaction with children for effective prevention and management of maternal parenting stress of PTB young children.