Nutrition morbidity interactions in pre-school children

Background & objectives: Research studies in the 1970s reported that in pre-school children, undernutrition increased the risk of infections and infections aggravated undernutrition. Over decades, there has been a reduction in prevalence of undernutrition and improvement in access to healthcare for treatment of infections. A mixed longitudinal study was undertaken to assess whether over time there were any changes from the earlier reported effect of undernutrition prior to infection on the risk of morbidity and effect of morbidity on nutritional status in pre-school children. Methods: Pre-school (0-59 months of age) children from urban low- and middle-income families whose parents were willing to allow their participation in the study were enrolled. Information on sociodemographic profile of the families was collected at enrolment. Weight of all children and length in infants were recorded every month; length/height in children 12-59 months of age was recorded once in three months. Morbidity information was collected through fortnightly visits. Results: 3888 pre-school children were followed up in 74636 home visits. Among these children, underweight and wasting were associated with a small increase in risk of infections. The odds ratio for risk of infection for underweight children was 1.09 (95% CI: 1.02 to 1.16) and for wasting was 1.18 (95% CI: 1.08 to 1.29). The deterioration in Z scores for weight-for-age and body mass index-for-age in children during illness and convalescence was small but significant (P<0.001). Interpretation & conclusions: The increased risk of infections in undernourished children living in overcrowded tenements in areas with poor environmental hygiene was not significant, perhaps because the risk of infection in normally nourished children was also high. The deterioration in nutritional status following infection was small because of the ready access to and utilization of health and nutrition care.

O papel da frequência a instituições de educação infantil e de variáveis do ambiente doméstico no desenvolvimento da criança de zero a seis anos / El papel de la asistencia a las instituciones de educación inicial y las variables del entorno familiar en el desarrollo de los niños de cero a seis años / The Role of Attending Child Daycare Institutions and Domestic Environment in the Development of Children from Zero to Six Years of Age

O desenvolvimento infantil é um campo de estudo complexo e deve ser analisado de maneira integrada, considerando os contextos nos quais a criança está in-serida. A frequência a instituições de educação infantil (iei) é indicada pela literatura internacional como um facilitador dos domínios do desenvolvimento, contudo, não há consenso nos dados brasileiros já apresentados. Pontua-se que outras variáveis do ambiente doméstico, como dispor de brinquedos e materiais variados e o tempo de interação com a mãe, possam influenciar nes-sa relação. O objetivo do estudo é comparar crianças que frequentam ou não iei em relação aos domínios do desenvolvimento, considerando grupo etário, tipo de escola e variáveis do ambiente doméstico. Participa-ram 1.843 mães de crianças de quatro a 72 meses, que responderam a um questionário sociodemográfico e ao Inventário Dimensional de Avaliação do Desenvolvi-mento Infantil. Os resultados apontaram que crianças que não frequentam iei apresentaram melhores médias nos domínios Motricidade Ampla e Linguagem Recepti-va em faixas etárias específicas. Dispor de brinquedos e materiais variados e o tempo que a mãe empregava para brincadeiras com a criança demonstraram um impacto positivo em diferentes domínios do desenvolvimento, no entanto, não houve interação com a frequência à iei. Verificou-se que quanto mais horas a mãe dispõe para brincadeiras durante a semana, melhores são as médias alcançadas em diferentes domínios do desenvolvimento de crianças de iei públicas e privadas. Discute-se o papel da educação infantil no desenvolvimento integral da criança, especialmente sobre a qualidade das iei e a necessidade de práticas baseadas em evidências.

El desarrollo infantil es un campo de estudio complejo y debe ser analizado de forma integrada, consideran-do los contextos del niño. La literatura internacional señala a la asistencia a las instituciones de educación infantil (iei) como un facilitador de los dominios del desarrollo, pero, no hay consenso en los datos brasileños. Otras variables del ambiente doméstico, como tener juguetes y materiales diferentes, y el tiempo de interacción con la madre, podrían influir en esta relación. El objetivo del estudio es comparar a los niños que asisten o no a una iei en relación a los dominios de desarrollo, considerando grupo etario, tipo de es-cuela y variables del ambiente del hogar. Participaron 1.843 madres de niños de cuatro a 72 meses, quienes respondieron un cuestionario sociodemográfico y el Inventario Dimensional para la Evaluación del Desarrollo Infantil. Los niños que no asisten a una iei tienen mejores promedios en los dominios Motricidad Gruesa y Lenguaje Receptivo en grupos de edad específicos. Tener diferentes juguetes y materiales, y el tiempo que la madre dedicaba a jugar con el niño demostró un impacto positivo en diferentes dominios, pero, no hubo interacción con la asistencia a una iei. Mientras más horas tiene la madre para jugar durante la semana, mejores son los promedios en los diferentes dominios de desarrollo de los niños con iei pública y privada. Se discute el papel de la educación inicial en el desarrollo integral, especialmente la calidad de la iei y la necesidad de prácticas basadas en evidencias.

Child development is a complex field that should be ana-lyzed comprehensively, considering children's contexts. The international literature indicates attendance to child daycare institutions (cdi) as a facilitator for child development. However, there is no consensus regarding Brazilian data. Other variables of the child's domestic environment, such as having various toys and materials and the time of interaction with the mother, may influence this relationship. This study aimed to compare children attending or not attending cdi regarding developmental domains and considering age group, type of school, and do-mestic environment variables. A total of 1.843 mothers of children aged zero to 72 months participated, answer-ing a sociodemographic questionnaire and the In-ventário Dimensional de Avaliação do Desenvolvimento Infantil (idadi). The results showed that children who did not attend cdi had better averages in Gross Motor Skills and Receptive Language domains in specific age groups. Having a variety of toys and materials and the time the mother spends playing with the child had a positive impact on different developmental domains; however, there was no interaction with attending cdi. It was found that the more hours the mother played with the child during the week, the better the averages achieved in different domains of development for chil-dren attending public or private cdi. The role of early childhood education in integral child development is discussed, especially the quality of cdi and the need for evidence-based practices.

Association of Breastfeeding Duration with Body Composition in Children Aged 3-5 Years / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to assess the relationship between the body composition of children aged 3-5 years and breastfeeding status and duration.@*METHODS@#The study was conducted using data from the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC), a nationwide cross-sectional study. Breastfeeding information and potential confounders were collected using standardized questionnaires administered through face-to-face interviews. The body composition of preschool children was measured using bioelectrical impedance analysis. A multivariate linear regression model was used to assess the relationship between breastfeeding duration and body composition after adjusting for potential confounders.@*RESULTS@#In total, 2,008 participants were included in the study. Of these, 89.2% were ever breastfed and the median duration of breastfeeding was 12 months (IQR 7-15 months). Among children aged 3 years, the height-for-age Z-score (HAZ) for the ever breastfed group was lower than that for never breastfed group (0.12 vs. 0.42, P = 0.043). In addition, the weight-for-age Z-score (WAZ) of the ever breastfed group was lower than that of the never breastfed group (0.31 vs. 0.65, P = 0.026), and the WAZ was lower in children aged 4 years who breastfed between 12 and 23 months than in those who never breastfed. Compared to the formula-fed children, the fat-free mass of breastfed infants was higher for children aged 3 years (12.84 kg vs. 12.52 kg, P = 0.015) and lower for those aged 4 years (14.31 kg vs. 14.64 kg, P = 0.048), but no difference was detected for children aged 5 years (16.40 kg vs. 16.42 kg, P = 0.910) after adjusting for potential confounders. No significant difference was detected in the weight-for-height Z-score (WHZ), body mass index (BMI)-for-age Z-score (BAZ), fat-free mass index, and body fat indicators in the ever breastfed and never breastfed groups and among various breastfeeding duration groups for children aged 3-5 years.@*CONCLUSION@#No obvious associations were detected between breastfeeding duration, BMI, and fat mass indicators. Future prospective studies should explore the relationship between breastfeeding status and fat-free mass.

Teoría de Luria y su relación con los fundamentos pedagógicos de la evaluación en la infancia preescolar / Luria's theory and its relation to the pedagogical basics of assessment in pre-school childhood

Fundamento: La teoría de Luria permite analizar el desarrollo psicológico después de una lesión cerebral, tanto en adultos como en niños. Objetivo: Analizar el contenido de un grupo de artículos donde se haya realizado la evaluación del niño preescolar desde la teoría de Luria para relacionarla con los fundamentos de la educación de la primera infancia. Desarrollo: La selección de los artículos se realizó considerando: (1) el tema, (2) una ecuación para seleccionar los artículos en las diferentes bases de datos, (3) publicados desde 2015 hasta el 2022, (4) provenientes de ocho bases de datos. La experiencia de Luria y sus seguidores le ha permitido trabajar con los factores neuropsicológicos como indicadores para valorar las alteraciones neurológicas del hombre, aunque la revisión de los artículos permitió concluir que los aportes de Luria tienen relación con los objetivos de la educación de la primera infancia: una evaluación con un enfoque integral. Desde esta perspectiva, los autores del artículo proponen cinco ejecuciones para analizar el desarrollo integral del niño preescolar. Conclusiones: La teoría de Luria puede emplearse en la educación de la primera infancia para realizar la evaluación del niño preescolar con un enfoque integral.

Background: Luria's theory allows analyzing psychological development after brain injury, both in adults and children. Objective: To analyze the content of a set of articles where the evaluation of pre-school children has been done from Luria's theory in order to relate it to the basics of early pre-school education. Development: The selection of articles considered: (1) the topic, (2) an equation to select the articles in dissimilar databases, (3) published from 2015 to 2022, (4) coming from eight databases. The experience of Luria so followers has allowed to work with neuropsychological factors as the indicators to assess neurological alterations in man, although the articles review has led to the conclusion that Luria's contributions are related to the objectives of early pre-school education: an assessment with a comprehensive approach. From this perspective, the authors of the article propose five implementations to analyze the integral development of the pre-school child. Conclusions: Luria's theory can be employed in early pre-school education to assess the pre-school child with a comprehensive approach.

INTRA-FAMILY DIFFERENCES IN NUTRITIONAL STATUS BETWEEN PRE-SCHOOL AND SCHOOL AGE CHILDREN

Currently under- and over-nutrition are public health problems in Indian children. A community-based study in 3249 children was undertaken to assess the magnitude of intra-family differences in nutritional status between pre-school and school age children from urban low middle income families. Length/height and weight were measured; nutritional status was computed using WHO Anthro and Anthro Plus software. One-fourth of children were stunted, 1/5th underweight, 1/10th wasted and less than 5% were overweight. Prevalence of stunting, underweight and wasting was higher in children whose elder siblings were stunted, underweight or wasted. However, majority of the younger siblings of under-nourished elder siblings were normally nourished; majority of the elder siblings of undernourished younger sibling were normally nourished. In view of this, it is essential to screen all children, identify those who are under- or overnourished using BMI-for-age and provide appropriate interventions.

Hepatitis B Vaccination Coverage of Preschool Children in Libreville, Gabon: Prevalence and Determining Factors

Objective: We aimed to assess hepatitis B vaccination coverage (vaccine coverage) among preschool children in Libreville, Gabon, and determine associated factors. Methods: A cross-sectional study was done evaluating hepatitis B vaccination records, by cluster random sampling of children aged 4 months to 5 years from 5 medical centres Results: Of the 500 children (243 males) included, we found a hepatitis B vaccine coverage of 78.6% (95% CI 75% to 82.2%). Factors significantly associated with vaccine coverage included parental confidence in the vaccine (OR=2.2;95% CI 1.4-5.5), the number of children at home lower than the median (aOR=1.6; 95% CI ; 1.3-3.7). and working mothers/fathers. Conclusion: Hepatitis B vaccine coverage in Libreville is lower than WHO objectives. Healthcare providers have a crucial role in building up confidence among parents.

A comparison of binocular and monocular surgery on the effect of eye-covering pretreatment on emergence delirium after general anesthesia in pre-school aged children / 中国实用护理杂志

Objective:To evaluate the effect of eye-covering pretreatment on acute delirium in ophthalmology preschool-age children who underwent binocular and monocular surgery by general anesthesia.Methods:The 300 preschool-age children who underwent general anesthesia of elective ophthalmic surgery in the Second Affiliated Hospital, Zhejiang University School of Medicine, from August 2019 to February 2021 were selected as the research object. They were divided into control group and blindfold group with 150 cases each by random number-table. Children in the control group received regular education on cartoon animation videos before surgery; children in the blindfold group received eye-covering pretreatment on the basis of cartoon animation videos(monocular surgery with monocular cover, binocular surgery with binocular cover). The Modified Yale Preoperative Anxiety Scale (m-YPAS) , the Nursing Delirium Screening Scale(NU-DESC), the incidence rate of delirium and the score of postoperative nursing difficulty were compared between two groups.Results:The 271 cases were completed in this study, including 129 cases(monocular surgery 66 cases, binocular surgery 63 cases) in the blindfold group and 142 cases (monocular surgery 73 cases, binocular surgery 69 cases) in the control group. The preoperative m-YPAS score, the postoperative NU-DESC score, the incidence rate of acute delirium and postoperative nursing care difficulty score of monocular surgery in the blindfold group , monocular surgery was (40.28 ± 15.02) points, 1.00 (0.00, 2.00) points, 27.3%(18/66), 1.00 (1.00, 2.00) points,and binocular surgery was (41.69 ± 16.35) points, 1.00 (0.00, 2.00), 39.7%(25/63), 1.00(1.00, 2.00); in the control group, monocular surgery was (46.28 ± 15.76) points, 2.00 (1.00, 3.00) points, 67.1% (49/73), 2.00 (1.00, 3.00) points, and binocular surgery was (47.77 ± 14.82) points, 3.00 (2.00, 4.00) points, 82.6% (57/69) and 2.00 (1.50, 3.00) points respectively. The difference between the two groups was statistically significant ( t= -2.29, -2.24, Z values were -5.74 - -2.95, χ2= 32.94, 25.78, all P<0.05). The preoperative m-YPAS score, the postoperative NU-DESC score, the incidence rate of acute delirium and postoperative nursing care difficulty score of monocular surgery patients in the blindfold group had no significantly statistical difference with that of binocular surgery patient (all P>0.05) . Conclusions:Monocular/ binocular eye-covering pretreatment can effectively decrease the preoperative m-YPAS score, the postoperative NU-DESC score, incidence rate of acute delirium and the postoperative nursing care difficulty in preschool-age children who underwent general anesthesia both monocular or binocular surgery. There was no difference in the application effect of monocular or binocular surgery.

Experiência de Implantação de um Programa de Educação Alimentar e Nutricional para Pré-escolares / Experience of Implementing a Food and Nutrition Education Program for Preschoolers

A Educação Alimentar e Nutricional (EAN) incentiva a promoção de hábitos alimentares saudáveis desde os primeiros anos de vida, peça fundamental em programas para prevenção e controle da obesidade infantil. Neste contexto, além da família, a escola é o ambiente ideal, pois é um local propício para a aprendizagem, onde as crianças passam a maior parte do seu tempo e fazem suas refeições. O objetivo foi implantar o Programa "Crescer Saudável na Escola", através de metodologias problematizadoras utilizando o Arco de Charles Maguerez (ACM), para pré-escolares numa escola de educação infantil (SP/SP). O desenho do estudo é longitudinal de natureza quali-quantitativa. A amostra foi composta por 151 crianças, 4-6 anos, após consentimento dos pais, durante 2018-2019. As etapas do ACM compreendem observação da realidade, identificação dos pontos chave, teorização, formulação de hipóteses e aplicação na realidade. Desta forma, foram aplicadas 39 atividades de EAN e oferecidas uma porção de fruta, semanalmente; e enviadas mensagens educativas para os pais sobre alimentação saudável, quinzenalmente. Como resultados, as crianças participaram com muito entusiasmo e interesse, e aceitaram muito bem as frutas. Embora exista limitação em mensurar os resultados relacionados ao consumo alimentar, por serem percebidos a longo prazo, as crianças se mostraram muito interessadas e dispostas a replicar os conhecimentos aprendidos, demonstrando que este Programa possui aplicabilidade prática, podendo ser repetido em outras escolas. Para tanto, é necessário recursos permanentes e metodologias contínuas que abordem a conscientização da comunidade escolar, o planejamento e o consumo regular de alimentos saudáveis pelos alunos.

Food and Nutrition Education (FNE) promotes healthy eating habits starting from the first years of life, which is a fundamental part in programs for the prevention and control of childhood obesity. In this context, in addition to the family, the school is an ideal environment, as it is a conducive place for learning, and where children spend most of their time, as well as eat their meals. The objective of this study was to implement the "Grow Healthy at School" Program through problematization methodologies using the Charles Maguerez Arch (CMA), for preschoolers in a school for early childhood education (SP/SP). The study design is longitudinal in nature, qualitative, and quantitative. The sample consisted of 151 children, 4-6 years old, after parental consent, during 2018-2019. The steps of the CMA comprise observation of reality, identification of key points, theorization, formulation of hypotheses, and application in reality. Therefore, 39 FNE activities were applied, and a portion of fruit was offered weekly while educational messages were sent to parents about healthy eating, biweekly. As a result, the children participated with great enthusiasm and interest, and accepted the fruits very well. Although, there is a limitation in measuring the results related to food consumption, as they are perceived in the long term, the children were very interested and willing to replicate the knowledge learned, demonstrating that this Program has practical applicability and can be repeated in other schools. Thus, permanent resources and continuous methodologies are needed that address the awareness of the school community, as well as the planning and the regular consumption of healthy foods by students.

Differences of Salivary Ph, Feature, And Volume Of Children At Three Kindergartens With Different Socioeconomic Standard / Diferenças do Ph Salivar, Característica e Volume, de Crianças Em Três Jardins De Infância Com Diferentes Padrões Socioeconômicos

Introduction: Saliva is the most important biological factor to protect against dental caries. When saliva flow is reduced, oral health problems such as dental caries and oral infections can develop. It was suggested that the effect of low salivary pH is more in plaque close to the area of susceptible tooth surface. The presence of saliva in pre-school age children is a significant indicator in oral health assessment oral health. There has been an association between salivary cortisol and socioeconomic variable. Descriptions above have encouraged us to examine the salivary pH, feature, and volume of pre-school-aged community. Thus, this study was aimed to describe the differences in salivary pH, feature, and volume of the children in the three pre-school with different location and socioeconomics aspect. Methods: Descriptive survey, with a population of pre-school students in 3 different kindergartens with different socioeconomic environment. Inclusion criteria were the pre-school-aged community and got permission from parents. Exclusion criteria were a pre-school-aged community under medication treatment causes hyposalivation or hypersalivation and children who did not want to be involved in the study, with total sampling as the sampling technique, resulted in as much a 101 respondents as the study sample. The saliva was collected with unstimulated technique. Data analysis was performed using relative frequency distribution. Results: The salivary pH was slightly higher in male children than female by 0.1. The average pH value was 7.25. The salivary feature was mostly frothy bubbly, followed by thin and watery, and the sticky bubbly feature was found the least. The salivary volume of the pre-school-aged community was mostly in the very less category, followed by the less category, with no normal category was found. the p-values of salivary pH and salivary features were below 0.05 There are no significant differences between the salivary pH and salivary feature of children from the three studied kindergartens. However, there is a significant difference in the salivary volume found in children from kindergartens located in high socioeconomic standard and middle socioeconomic standard areas, which have a higher salivary volume than the children from kindergartens situated in areas with lower socioeconomic standard. Conclusion: since the reduced salivary volume was associated to children with lower socioeconomic standard, this association can justify the higher risk for caries described in the literature (AU)

Introdução: A saliva é o fator biológico mais importante na proteção contra a cárie dentária. Quando o fluxo salivar é reduzido, podem ocorrer problemas na saúde bucal, como cáries e infecções orais. Foi sugerido que o efeito do baixo pH salivar é aumentado na placa, próxima à área de superfície dentária suscetível. A presença de saliva em crianças em idade pré-escolar é um indicador significativo na avaliação da saúde bucal. Houve associação entre cortisol salivar e variáveis socioeconômicas. As descrições acima nos encorajaram a examinar o pH salivar, características e volume da comunidade em idade pré-escolar. Assim, este estudo teve como objetivo descrever as diferenças de pH, característica e volume salivar das crianças de três pré-escolas com localização e aspectos socioeconômicos distintos. Material e Métodos: Pesquisa descritiva, com população de estudantes da pré-escola de três diferentes jardins de infância com diferentes ambientes socioeconômicos. Os critérios de inclusão foram comunidade em idade pré-escolar e permissão dos pais. Os critérios de exclusão foram comunidade em idade pré-escolar sob tratamento medicamentoso que causa hipossalivação ou hipersalivação e também crianças que não quiseram se envolver no estudo, com amostragem total resultando em 101 entrevistados como a amostra do estudo. A saliva foi coletada com a técnica não estimulada. A análise dos dados foi realizada usando distribuição de frequência relativa. Resultados: O pH salivar foi ligeiramente superior nas crianças do sexo masculino do que no feminino em 0,1. O valor médio do pH foi de 7,25. O aspecto salivar era principalmente espumoso com bolhas, seguido de aspecto tênue e aguado, e o aspecto pegajoso e espumante foi o menos encontrado. O volume salivar dos estudantes em idade pré-escolar encontrava-se majoritariamente na categoria inferior a todas, seguida da categoria menos, não sendo encontrada nenhuma categoria normal, onde os valores de p do pH salivar e características salivares estavam abaixo de 0,05. Não há diferenças significativas entre o pH salivar e a característica salivar das crianças dos três diferentes jardins de infância estudados. No entanto, existe uma diferença significativa no volume salivar encontrado em crianças de creches localizadas em áreas de médio e alto padrão socioeconômico, que apresentaram maior volume salivar do que as crianças de creches situadas em áreas de menor padrão socioeconômico. Conclusão: O volume salivar reduzido esteve associado a crianças com menor padrão socioeconômico, logo essa associação pode justificar o maior risco de cárie descrito na literatura. (AU)

Predictors of low perceptual-motor skills in children at 4-5 years of age / Preditores da baixa habilidade percepto-motora em crianças de 4-5 anos de idade

Abstract Objectives: the purpose of this study was to evaluate the predictors of low perceptual-motor skills in children at preschool age. Methods: this is a cross-sectional study nested in a birth cohort involving mother-child pairs. The children's perceptual-motor skills were assessed individually in their homes when they were 4-5 years old using the Pre-Literacy Skills and Knowledge Test (THCP®), a vali-dated Brazilian instrument. Logistic regression analysis was used to estimate the association between cognitive perceptual-motor skills and potential maternal and child risk factors. Results: of the 199 children included in the study, 53.8% were boys, 90.8% attended school, and 91.1% were enrolled in a public school. Among the children, 114 (57.3%), 41 (20.6%) and 44 (22.1%) had low, moderate and high perceptual-motor skills, respectively. Multivariate logistic regression analysis revealed greater odds of children at preschool age having low perceptual motor skills for boys (OR=2.10; CI95%= 1.14-3.88), children who did not attend school (OR=4.61; CI95%= 1.21-17.49), and those with a household income <5 minimum wages (MW) (OR=4.28; CI95%= 1.49-12.26). Conclusions: our study showed that male gender, not attending school and a monthly household income <5 MW were predictors of low perceptual-motor skills in children at 4-5 years of age.

Resumo Objetivos: avaliar os preditores da baixa habilidade percepto-motora em crianças em idade pré-escolar. Métodos: trata-se de um estudo transversal aninhado a uma coorte de nascimentos envol-vendo pares de mães-crianças. A habilidade percepto-motora das crianças foi avaliada indi-vidualmente em suas residências quando completaram 4-5 anos de idade, utilizando-se o Teste de Habilidades e Conhecimento Pré-Alfabetização (THCP®), um instrumento brasileiro validado. Análise de regressão logística foi utilizada para estimar a associação entre a baixa habilidade percepto-motora das crianças e potenciais fatores de risco materno-infantil. Resultados: das 199 crianças incluídas no estudo, 53,8% eram meninos, 90,8% frequen-tavam a escola, e 91,1% estudavam em escola pública. Entre as crianças, 114 (57,3%), 41 (20,6%) e 44 (22,1%) revelaram baixa, moderada e elevada habilidade percepto-motora, respectivamente. A análise de regressão logística ajustada revelou maior chance de crianças em idade pré-escolar apresentar baixa habilidade percepto-motora quando em meninos (OR=2,10; IC95%=1,14-3,88), crianças que não frequentavam a escola (OR=4,61; IC95%=1,21-17,49), e possuíam renda familiar <5 salários mínimos (SM) (OR=4,28; IC95%=1,49-12,26). Conclusões: nosso estudo revelou que sexo masculino, renda familiar <5 SM, e não frequentar a escola foram preditores significativos da baixa habilidade percepto-motora em crianças de 4-5 anos de idade.

Prevalencia de niños preescolares con alteraciones cognitivas en la provincia de Cienfuegos / Prevalence of pre-school children with cognitive alterations in Cienfuegos province

Introducción: Existen pocos estudios sobre alteraciones cognitivas en niños realizados en las provincias centrales cubanas. Objetivo: Determinar la prevalencia de niños preescolares con alteraciones cognitivas. Métodos: De un universo de 25 600 niños de la provincia de Cienfuegos entre 0-6 años, se seleccionaron 825 niños preescolares entre 4 y 6 años de varias instituciones educativas y médicas. Todos se evaluaron con la prueba neuropsicológica Luria Inicial. Se usó la norma cubana de la prueba para obtener la prevalencia: percentiles 30 - 35, niños con trastornos del neurodesarrollo, y percentiles 40 - 45, niños con alteraciones cognitivas asociadas a factores psicosociales. Resultados: El 3,9 por ciento de los niños presentaron alteración cognitiva asociada a factores psicosociales, mientras que 1,4 por ciento presentaron alteraciones asociada a trastornos del neurodesarrollo. Las principales alteraciones se resumieron en cuatro tareas: cálculos sencillos, psicomotricidad, lenguaje y memoria de trabajo. En las instituciones educativas, 1 de 10 niños presentaron trastorno del neurodesarrollo, mientras que 3 de 10 niños presentaron alteraciones explicadas por causas educativas. En las instituciones médicas, el 58,0 por ciento de los niños presentó alteraciones explicadas también por causas educativas. Conclusiones: En la provincia de Cienfuegos la prevalencia de niños preescolares con alteraciones cognitivas es moderadamente alta. En especial, las alteraciones se encuentran en las funciones ejecutivas, lingüísticas y en las habilidades relacionadas con el procesamiento numérico. En las instituciones médicas, el niño con alteraciones en las funciones ejecutivas y lingüísticas es frecuente, mientras que en las instituciones educativas prevalecen las alteraciones en las funciones ejecutivas y en el procesamiento numérico(AU)

Introduction: There are few studies on cognitive alterations in children that have been carried out in the Cuban provinces of the central region. Objective: To determine the prevalence of pre-school children with cognitive alterations. Methods: From a group sample of 25 600 children from 0 to 6 years old of Cienfuegos province, there were selected 825 pre-school children in the ages from 4 to 6 years from different educational and health institutions. All the children were evaluated with the Luria Incial neuropsychological test. It was used the Cuban standard of the test to obtain the prevalence data: percentiles 30 - 35, children with neurodevelopmental disorders, and percentiles 40 - 45, children with cognitive alterations related to psychosocial factors. Results: The 3.9 percent of the children presented cognitive alterations related to psychosocial factors, while the 1.4 percent presented alterations related to neurodevelopmental disorders. The main alterations were comprised in 4 tasks: simple calculations, psychomotricity, language and working memory. In the educational institutions, 1 of 10 children presented a neurodevelopmental disorder, while 3 of 10 children presented alterations due to educative causes. In the health institutions, 58,0 percent of the children presented alterations due to educative causes. Conclusions: In Cienfuegos province, the prevalence of pre-school children with cognitive alterations is moderately high. The alterations are specially found in the executive and linguistic functions and in the abilities related with the numbers processing. In the health institutions, it is common to have children with alterations in the executive and linguistic functions, while in the educative institutions prevail the alterations in the executive functions and the numbers processing(AU)

Habilidades mentalistas en niños argentinos de 4 a 6 años: Adaptación de una escala de desarrollo de Teoría de la Mente / Mentalizing Skills In Argentine Children Between The Ages Of Four And Six: Adaptation Of A Development Scale Of Theory Of Mind

Resumen Este trabajo presenta los resultados del estudio sobre habilidades mentalistas en niños preescolares argentinos. Su interés reside en la importancia que revisten los logros conceptuales en el desarrollo de la Teoría de la Mente y el método adecuado para medirlos, dada la escasez de estudios sobre el tema en el ámbito local. Con un diseño descriptivo transeccional se examinaron 105 niños (4 a 6 años de edad) con la Escala de Teoría de la Mente de Wellman y Liu (2004), compuesta por 7 tareas diferenciadas, adaptada al español rioplatense. Entre los resultados de este estudio se destaca que, al igual que los hallazgos reportados por los autores de la escala, los porcentajes de respuestas correctas aumentan con la edad cronológica y disminuyen de acuerdo a la complejidad de la tarea. La secuencia y la dificultad creciente de las tareas son consistentes, aunque tal como lo proponen Wellman y Liu es necesario limitar las siete tareas originalmente propuestas a cinco, para ajustarse a los requerimientos de un escalograma. Los porcentajes de respuestas correctas hallados son menores a los encontrados en la investigación original teniendo en cuenta, además, que no se incluyeron niños de 3 años. La escala resulta un instrumento adecuado en la medida que proporciona evidencia empírica de la complejidad de las habilidades involucradas, así como de su progresión, imposibles de ser aprehendidas a través de una tarea única, tal como sucede en las evaluaciones que incluyen solo tareas de falsa creencia.

Abstract This work introduces the results obtained in the study of mentalizing skills in pre-school Argentine children. Interest in this lies on the importance of conceptual achievements marking the normal development of the Theory of Mind (TM) and the appropriate way to measure them, and on the lack of studies on the subject in the region. The TM is understood as the capacity to infer emotions, beliefs and desires, and to use such inferences to predict and explain one's behavior as well as that of others. This theory has been studied thoroughly for the past 40 years due to its implications for communicative competence and social interaction, given that if a child fails to understand the relations between behavior and mental states, he or she will have difficulties understanding social situations in everyday life. Its assessment has changed based on how this theory has been conceptualized in connection with its birth and development. The initial conception, which considered it as a single capacity acquired once and for all, was replaced by a more gradualist approach. This enabled the enlargement of the notion of TM to a series of increasingly elaborate and flexible conceptual acquisitions formed throughout a child's psychological development. Based on the hypothesis that a series of mentalist achievements following a predictable sequence occur during a child's normal development, Wellman and Liu (2004) designed a scale which operationalizes the TM. The instrument, which was to be used with pre-school children, consisted of 7 tasks which examine various skills: 1. Diverse desires, 2. Diverse beliefs, 3. Knowledge access, 4. Contents false belief, 5. Explicit false belief, 6. Belief-emotion and 7. Real-aparent emotion. The aim of this paper is to present the results obtained with Wellman and Liu's TM Scale in pre-school children living in the city of La Plata, Province of Buenos Aires (Argentina), and to compare them against the results obtained by the authors. With a cross-sectional descriptive design, 105 children aged between 4 and 6 were tested using the TM Scale adapted to Rioplatense (River Plate) Spanish. Wechsler Preschool and Primary Scale of Intelligence (WPPSI III) was also used in order to check intellectual level and exclude the protocols of the children who scored below 70 in the Total IQ. Among the results of this study, as well as the findings reported by the authors of the scale, it is noteworthy that the percentage of right answers increases with chronological age and decreases in relation to task complexity. The sequence and the increasing difficulty of the tasks are consistent, however, as proposed by Wellman & Liu, it is necessary to limit the original 7 tasks to 5, to conform with the requirements of a scalogram within the ages taken into consideration. The percentages of correct answers found in this study are lower than those found in the original investigation, taking into account, in addition, that 3 years old children were not included. The scale constitutes an adequate instrument in that it provides empirical proof of the complexity of the skills involved as well as of their progression, both of which are impossible to apprehend through a single task, as is the case of the assessments including only false belief tasks. All in all, the differences found in the performance of the participants included with respect to the original study require further research in not only cross-sectional but also longitudinal studies of clinical and non-clinical populations.

Docência na educação infantil: neoliberalismo, desumanização e adoecimento na república inacabada brasileira / Teaching in pre-school education: neoliberalism, dehumanization and illness in the unfinished brazilian republic / Docencia en la educación infantil: neoliberalismo, deshumanización y enfermedad en la república inacabada brasileña

Resumo A pesquisa que deu origem a este artigo situa-se no contexto da categoria teorética 'repúblicas inacabadas.' Teve como objetivo analisar a percepção de professores(as) de uma unidade escolar de educação infantil de um município catarinense, sobre a produção de dignidade pelo trabalho e foi realizada no segundo semestre de 2018. A coleta de dados se deu por meio de três instrumentos: entrevistas individuais, grupos focais e diários de campo. Os dados indicaram a solidão na interface entre docência na educação infantil, neoliberalismo e dignidade pelo eco das vozes dos professores que anunciam a destituição de sua produção de dignidade pelo trabalho, o que afeta direta e negativamente sua condição de saúde. Apontam-se condições para o estabelecimento dessa condição desumanizante e propõem-se o reconhecimento e o estímulo ao trabalho coletivo como ferramentas de transformação.

Abstract The research that originated the present article is related to the context of the theoretical category of 'unfinished republics.' It had the goal of analyzing the perception of the teachers of a pre-school education unit of a municipality in the state of Santa Catarina, Brazil, regarding the production of dignity through work, and was performed in the second semester of 2018. The data was collected using three instruments: individual interviews, focus groups and field journals. The data indicate the loneliness in the interface among teaching in pre-school education, neoliberalism and dignity through the echo of the voices of the teachers who announced the dismissal of their production of dignity through work, which affects directly and negatively their health condition. We indicate the conditions for the establishment of this dehumanizing situation and propose the recognition and stimulus to collective work as tools for transformation.

Resumen La pesquisa que dio origen a este artículo se relaciona al contexto de la categoría teórica "repúblicas inacabadas". Tuvo como objetivo analizar la percepción de profesores(as) de una unidad escolar de educación infantil de un municipio del estado de Santa Catarina, Brasil, sobre la producción de dignidad por el trabajo, y fue realizada en el segundo semestre de 2018. La recolección de datos se dio por medio de tres instrumentos: entrevistas individuales, grupos focales y diarios de campo. Los datos indicaron la soledad en la interconexión de docencia en la educación infantil, neoliberalismo y dignidad por el eco de las voces los profesores que anuncian la destitución de su producción de dignidad por el trabajo, lo que afecta directa y negativamente su condición de salud. Se indican condiciones para el establecimiento de esa situación deshumanizante y se proponen el reconocimiento y el estímulo al trabajo colectivo como herramientas de transformación.

Coexistencia de trastornos gastrointestinales funcionales en lactantes y preescolares latinoamericanos / Coexistence of functional gastrointestinal disorders in Latin American infants and preschoolers

Resumen Introducción: se ha descrito la coexistencia de trastornos gastrointestinales funcionales (c-TGF) en lactantes y preescolares (LactPre); sin embargo, hay poca literatura sobre los principales c-TGF y sus características. Objetivo: describir la prevalencia y posibles asociaciones de c-TGF en un mismo LactPre latinoamericano. Metodología: estudio de prevalencia en LactPre de Colombia, Ecuador, Nicaragua y Panamá de consulta externa y urgencias, a quienes, según los criterios de Roma III en español, se identificaron regurgitación, síndrome de rumiación, síndrome del vómito cíclico, cólico, diarrea funcional, estreñimiento funcional y disquecia. Se tuvieron en cuenta la edad, el sexo y el origen. La estadística incluyó t de Student, chi cuadrado, prueba exacta de Fisher, análisis uni y multivariados y el cálculo de los OR e IC 95%, siendo una p <0,05 significativa. Resultados: se analizaron 2417 niños (2,4±19,8 meses de edad, 51,3% masculinos, con diagnóstico de por lo menos algún TGF del 35,7%). Se presentó c-TGF en el 3,6%, siendo el principal el síndrome de rumiación del lactante (SRL) más estreñimiento funcional (EF). Hubo predomino del género masculino en los lactantes y ser colombiano. Conclusión: la principal c-TGF en este grupo de LactPre de Latinoamérica es el SRL más EF, presentándose principalmente en el sexo masculino y en lactantes menores de 24 meses.

Abstract Introduction: Coexistence of functional gastrointestinal disorders (FGID) in infants and preschool children has been described, but there is little literature on the main types of FGID coexistence or their characteristics. Objective: This study describes the prevalence and possible associations of FGID coexistence among Latin American infants and preschool children. Methodology: This is a prevalence study of infants and preschool children conducted in Colombia, Ecuador, Nicaragua and Panama. Children included were outpatients and emergency patients who were identified according to the Rome III Criteria in Spanish as suffering from regurgitation, rumination syndrome, cyclic vomiting syndrome, colic, functional diarrhea, functional constipation and/or dyspepsia. Age, sex and origin of patients were registered. Statistical analyses included Student's T test, chi squared test, Fisher's exact test, univariate analysis, multivariate analysis and calculation of odds ratios and 95% confidence intervals with p <0.05 set as significant. Results: Two thousand four hundred and seventeen children were included. Their age range was 2.4 months to 19.8 months of age, and 51.3% were male. The proportion of patients with a diagnosis of at least one FGID was 35.7%. FGID coexistence was found in 3.6% of the patients. The most frequent combination was rumination syndrome plus functional constipation. There were predominances of males, infants and Colombian children in the total sample. Conclusion: The most commonly coexisting FGIDs in this group of Latin America infants and preschool children were infant rumination syndrome and functional constipation which were found together most frequently among boys who were under 24 months old.

Effect of education and socio-economic status on parenting among pre-school and school going children

Background: Parenting is the process of promoting and supporting the physical, emotional, social and intellectual development of a child from infancy to adulthood. Parenting is a complex activity that includes much specific behavior that works individually or together to influence child's outcomes.Methods: It is prospective observational study carried out in the Department of Pediatrics, Shyam Shah Medical College and associated Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India during the period from July 2008 to June 2010. Parents were interviewed with predesigned proforma. Parenting was graded in to three grades (1, 2 and 3) according to the performance of parents in various aspects of parenting.Results: In this study, 60 parents had 155 children constituting 2.5 children per family and male to female ratio was 1.18:1. We observed that literate parents performed well in all aspects of parenting (i.e. behavioral, physical, emotional, mental, spiritual, nutritional), but illiterate parents could not score on these points especially in spiritual and nutritional aspects. 33% graduate parents fulfilled the criteria for grade 3 parenting in nutritional aspects, 55% intermediate passed parents in nutritional aspects were in grade 3, whereas there were more than 50% parents in behavioral, physical and emotional aspects who had education level up to primary class.Conclusions: Educational status of parents has a positive impact on almost all aspects of parenting and the educational status of mothers appeared to be even more influential. Socioeconomic status of parents and residential area have a great influence on all aspects of parenting.

Impact Study of Institutional Food Supplementation on Nutritional Status of Pre-school Children

Aims: To assess the Nutritional status of urban and semi-urban pre-school children of Dharwad, at baseline and after institutional supplementation. Study Design: Nutritional status of the pre-school children was assessed based on anthropometry and clinical examination. Urban pre-school children were treated as control and semi-urban pre-school children were supplemented with institutional food for three months (experimental). Nutritional status were measured before and after institutional food supplementation. Place and Duration of Study: Department of Food Science and Nutrition, College of Community Science, University of Agricultural Science, Dharwad, Karnataka, India. The experiment was conducted between July 2017 and July 2018. Methodology: A sample size of 100 pre-school children (3-6 years) were selected, out of which, 50 children from urban and another 50 children from semi-urban school were randomly selected from Dharwad district. Nutritional status of the pre-school children was assessed based on anthropometry and clinical examination. Nutritional status were measured before and after institutional food supplementation, in both schools. Results: Results revealed that, at baseline nutritional status were higher in urban pre-school children compare to semi-urban pre-school children, but after supplementing with the institutional food, significant improvement in anthropometric measurements were observed in semi-urban group and they were on par with the urban children in terms of nutritional status. Conclusion: The weight for age is an indicator of current nutritional status, whereas height for age is an indicator of past nutritional status, so height improvement was observed in urban group and weight improvement was observed in semi-urban group. Finally concluded that food intervention can go long way in changing the current malnutrition scenario.

Prevalence of urinary tract infection in febrile preschool children

Background: Children with fever is a common and comprise a substantial proportion of the practice in outpatient department and emergency department. Little attention has been focused on the identification of urinary tract infection (UTI) in febrile in infants and children in the emergency department, despite recent information that suggests a high prevalence of urinary tract infections and significant associated morbidity in these patients. The present study is undertaken to estimate the prevalence of urinary tract infection in febrile preschool children (less than 5 years of age) in febrile children.Methods: Febrile children less than 5 years attending outpatient department or admitted in Department of Paediatrics were enrolled into the study. Children below 1 month and above 5 years; any child who has received antibiotics 48 hours prior to evaluation; children with known congenital genitourinary anomalies; and were excluded from the study. Children with symptoms suggestive of UTI were interviewed using structured case record form (CRF). All symptomatic children were referred for urine routine microscopy and culture tests.Results: The prevalence of culture positive cases for UTI was 6.36%. Male infants and female infants affected equally. But females affected more in the age between 1 years to 5 years as compared to males. Apart from fever, the commonest symptoms were dysuria, abdominal pain, vomiting, chills and rigors and loss of appetite. More than two-third of the patients with CP-UTI have E. coli as causative organism for UTI. Overall most sensitive antimicrobials were Ceftriaxone.Conclusions: UTIs in preschool children are often having vague and variable symptoms, often fever is the only symptoms. An untreated UTI can lead to subsequent damage and impairment of renal structure and function, it is very important to diagnose and treat UTI in preschool children.

Prevalence of anemia in under five-year-old children: a hospital-based study

Background: Anemia affects individuals of both gender and all ages, there is a need for localized and age- and context-specific studies to improve our knowledge of prevalence patterns and associated risk factors of Indian population. The present study was done to determine the prevalence of and associated risk factors for anemia in under five-year-old children in a tertiary care teaching hospital.Methods: A prospective observational study was carried out among under five-year-old children suffering from anemia. For the diagnosis of anemia, WHO criteria for haemoglobin (Hb) threshold in different age group were used. The growth and development statuses of children were evaluated by WHO's Child Growth Standards 2006.Results: Total 240 anaemic children were enrolled into the study. Children of age group of between 2-5 years was more affected. A majority of the mother of anaemic children had primary level of school education. More than half of the children belong to lower socioeconomic classes (Class IV + Class V). Nutritional deficiency was the single most important causative factor in the development of anemia. Infectious diseases found to be more prevalent.Conclusions: Nutritional deficiency, particularly, iron deficiency is the leading cause of anemia in the present study. In addition to nutritional deficiency, socioeconomic factors like, gender, maternal education and SE class also play an important role in development of anemia.

Healthy Hands: Development and Evaluation of a Knowledge Transfer Program

Abstract@#Introduction: Children in pre-schools are at high risk of getting infections due to overcrowding, minimal awareness of basic hygiene and lack of immunity against microorganisms. Hand hygiene practice should be started at home where parents set good example, followed by formal education in pre- schools, primary and secondary school. This study aimed to develop a comprehensive program on hand hygiene practice in pre-schools. This paper presents the developmental aspects of the program material and the results of its evaluation process in a selected pre-school. Methods: Stage of development involved preparation of song, lyric, video clip, infographic and tablet application. The module was introduced during an intervention day called ‘Healthy Hands’ day. The acceptance of the module was evaluated before and after the intervention day. Evaluation was done by assessing pre-school children by faceto-face interview about knowledge on hand hygiene techniques and routine, such as before or after certain activities. Results: We managed to compose a song in three languages (Malay, English & Arabic), produced a video clip, an infographic and tablet application. A total of 227 children participated. Post intervention evaluation showed significant (p<0.001) increase of knowledge for eight out of eleven handwashing steps. The knowledge on hand hygiene routine i.e. after toilet, after playing outdoor, after sneezing and after playing with pet was also increased significantly. Conclusion: This comprehensive knowledge transfer program significantly improved the children’s hand hygiene techniques and routine and is recommended to be integrated into pre-school curriculum.

An investigation on the need, the utilization, and the influencing factors of dental services for pre-school children in selected areas in Chongqing province / 华西口腔医学杂志

OBJECTIVE@#The aim of this study is to survey the need, the utilization, and the influencing factors of dental services for children in selected areas in Chongqing province by investigating their oral health status. The survey will provide references for preventive oral health care in targeted Chongqing areas, which may improve the level of oral health among pre-school children.@*METHODS@#Random cluster sampling was utilized according to standards of the Fourth National Oral Health Epidemiological sampling survey, and 1 300 children between the ages of three and four years old from 24 kindergartens in 12 subdistricts of three areas in Chongqing were interviewed for free dental checkups and to participate in the survey. The questionnaires were designed according to the Anderson model and were answered by the children's parents. The results were analyzed utilizing Chi-square test logistic regression.@*RESULTS@#The prevalence rate of caries among the pre-school children in selected areas of Chongqing was 55.4%, the decay, missing, filled surface (dmfs) was 6 696, the mean dmfs was 5.2, and the caries filling constituent ratio was 2.3%. A total of 1 173 questionnaires were analyzed. The ratio for seeing a dentist for therapeutic reasons was 6.31% (74/1 173) and for prevalence was 22.93% (269/1 173).@*CONCLUSIONS@#The oral health service needs of pre-school children in selected areas of Chongqing are large and the oral health service utilization rate is low. Oral health care processes are arduous; thus, targeted oral prevention policies should be created.