Chilean children's adherence to sustainable healthy diets and its associations with sociodemographic and anthropometric factors: a cross-sectional study.

PURPOSE: To describe adherence to sustainable healthy diets among a sample of 958 Chilean pre-schoolers (3-6 years) and explore associations between adherence and child and maternal sociodemographic and anthropometric characteristics. METHODS: Children's adherence to sustainable healthy diets was calculated from single multiple-pass 24-h dietary recalls using the Planetary Health Diet Index for children and adolescents (PHDI-C). Higher PHDI-C scores (max score = 150 points) represent greater adherence. Adjusted linear regression models were fitted to explore associations between PHDI-C scores and child and maternal characteristics. RESULTS: Children obtained low total PHDI-C scores (median 50.0 [IQR 39.5-59.8] points). This resulted from low consumption of nuts & peanuts, legumes, vegetables, whole cereals, and vegetable oils; a lack of balance between dark green and red & orange vegetables, inadequate consumption of tubers & potatoes and eggs & white meats, and excess consumption of dairy products, palm oil, red meats, and added sugars. Mean PHDI-C total score was significantly higher (50.6 [95%CI 49.6, 51.7] vs 47.3 [95%CI 45.0, 49.5]) among children whose mothers were ≥ 25 years compared to those with younger mothers. Positive associations were observed between scores for fruits and maternal education, vegetables and maternal age, added sugars and child weight status, while negative associations were observed between fruits and child age, and vegetable oils and maternal education. Scores for dairy products PHDI-C component were lower among girls. CONCLUSION: Adherence to sustainable healthy diets was low among this sample of Chilean children and was significantly associated with maternal age, being lower among children whose mothers were younger.

Milk beverages can reduce nutrient inadequacy among Brazilian pre-school children: a dietary modelling study.

BACKGROUND: Previous studies found high prevalence of inadequate intakes of vitamins E, D and K, calcium and potassium among Brazilian pre-school children, with suboptimal consumption of dairy products. Dietary modelling was applied to determine the theoretical impact of improving dairy products consumption on nutrient adequacy in 4-5-year-old Brazilian children. METHODS: Adherence to the dairy recommendation of two servings/day was calculated using data from the Brazil Kids Nutrition and Health Study (KNHS) (n = 228). Two modelling scenarios were applied to test the impact on nutrient intakes of (1) adding one or two servings of a frequently consumed cow's milk or a widely available fortified alternative: pre-school children milk (PCM), and of (2) substituting the current milk consumed by PCM. Mean nutrient intakes and percentage of children adhering to the nutrient recommendations were determined at baseline and after applying modelling scenarios. RESULTS: Seventy-six percent (n = 174) of children did not meet the recommended daily two servings of dairy products, 56% had less than one serving of dairy products on the day of recall. The mean consumption of whole milk (fortified and unfortified) was 147 g/d, yoghurt 114 g/d and cheese 34 g/d. The addition of one serving of cow's milk demonstrated a 17% reduction in calcium inadequacy, 18% reduction in vitamin A and 3% reduction in zinc inadequacy. Adding one serving of PCM further reduced calcium inadequacy from 87 to 41%, vitamin E from 81 to 37%, and zinc inadequacy by 10%. Replacing the child's current milk with a PCM resulted in further reduction of micronutrient inadequacies, including calcium, vitamin D and vitamin E. CONCLUSIONS: Dairy products consumption in pre-school children should be encouraged to reduce nutrient inadequacies. In particular, consumption of PCM would help to reduce calcium, vitamin D and vitamin E inadequacy, nutrients of concern in this population.

Differential Cortical Pattern in Auditory Task Oddball Paradigm in Children Exposed to Alcohol during Pregnancy.

The negative effects of fetal alcohol exposure on child development are well documented. This study investigated the electrophysiological processing of cortical level acoustic signals in a group of 21 children prenatally exposed to alcohol. Participants aged 13-14 years at the time of the study were recruited from a longitudinal cohort sample. The study employed an observational, cross-sectional blind design and participants were divided into two groups: with and without fetal exposure to alcohol. Neurophysiological measures recorded N1, P2, N2, P3, P3a, and P3b components using the Oddball paradigm. Our results showed that the mothers' sociodemographic conditions at the time of birth, as well as the children's birth weights were homogeneous between the groups, though the Apgar score was lower in the exposed group (EG). The neurophysiological components that showed different results in the groups were P2 and P3a. P2 amplitude was higher in the midline central electrode (Cz) compared to the midline parietal electrode (Pz), demonstrating a group interaction for exposed children. For P3a there was an interaction of group and electrode position, and the EG showed higher amplitudes in Cz compared to the unEG. However, the Apgar score did not influence these results. In conclusion, children who had fetal exposure to alcohol presented electrophysiological recordings distinct from the control group. These differences occurred both in the P2 component - which reflects a bottom-up mechanism of auditory processing - as well as the P3a component, which may reflect the participation of supra-modal hearing mechanisms.

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.

Association between Apo B Levels in Mothers and in their Pre-school Age Offspring.

OBJECTIVE: The study aims to determine the association between apo B levels in mothers and their pre-school offspring. METHODS: Anthropometric measurement (e.g. BMI), lipids, lipoproteins, and apolipoproteins (e.g. apo B) levels in mothers and their children were obtained in November 2015 in Buenos Aires. RESULTS: Eighty-four children (42M) aged 5.3±1.6 years and their mothers aged 33.8±7.2 years were examined. The prevalence of overweight was 39.2 % (33) in mothers and 22.6 % (19) in children, and the prevalence of obesity was 38.1% (32) in mothers and 10.7% (9) in children. Multiple linear regression analysis showed that maternal apo B levels were associated with apo B levels in their offspring, adjusted for confounding variables (Beta=0.29; p=0.03; R2=0.25). Furthermore, offspring born to mothers with high apo B levels were six times likelier to have high apo B levels (OR), 5.7; (95% CI 1.3-25.5). CONCLUSION: This study suggests that maternal apo B levels were significantly associated with apo B concentration in their pre-school age children.

Effect of dark discolouration and enamel/dentine fracture on the oral health-related quality of life of pre-schoolers.

AIM: To determine the effect of different types of dental trauma on oral health-related quality of life (OHRQoL) among pre-school children. METHODS: Four hundred fifty-nine Brazilian pre-schoolers aged 3-5 years were submitted to an oral examination in the school environment for the evaluation of dental trauma using the criteria proposed by Andreasen et al. (2007). Parents answered a questionnaire on the OHRQoL of the children using the Early Childhood Oral Health Impact Scale (ECOHIS) and another one on socio-demographic characteristics of the children and their families. The questionnaires were sent to the parents to be answered at home. Descriptive statistics, Mann-Whitney test and Poisson regression were used for statistical analysis. RESULTS: Children with dark discolouration and enamel-dentine fracture without pulp exposure had higher mean ECOHIS scores than those without these alterations. The multivariate regression analysis demonstrated that pre-school children with dark discolouration (PR 1.79; 95% CI 1.24-2.58) and enamel-dentine fracture without pulp exposure (PR 1.89; 95% CI 1.22-2.92) had a higher impact on quality of life than those without these alterations. CONCLUSION: Dark discolouration and enamel-dentine fracture without pulp exposure were associated with a negative impact on the life of pre-schoolers.

El timo y el estado nutricional en niños preescolares residentes de gran altitud / Thymus and the nutritional status in high altitude residents pre-school children

PREGUNTA DE INVESTIGACIÓN: Cuál será la superficie del timo obtenida mediante la ecografía comparados con mediciones antropométricas en niños y niñas preescolares de zonas periféricas, residentes de gran altitud? OBJETIVO: Establecer la comparación entre la superficie del timo obtenida a través de la ecografía y mediciones antropométricas en niños y niñas preescolares de zonas periféricas, residentes de gran altitud. DISEÑO: Estudio transversal con componente analítico. MATERIAL Y MÉTODOS: Se estudió a 94 preescolares de 3 a 6 años de edad, provenientes de zonas periurbanas de la ciudad de La Paz, Bolivia, a 3700 metros de altitud. Se realizó, examen clínico pediátrico, peso, talla, perímetro de cintura y cadera, perímetro cefálico, área muscular de brazo, área total de brazo, longitud de miembro inferior, longitud de hueso largo y se determinó por calorimetría indirecta el consumo de energía. Se realizó la ultrasonografía del timo. RESULTADOS: Se encontróun 20 % de retraso del crecimiento y la superficie del timo no presentó diferencias estadísticamente significativas entre varones y mujeres. Mediante el umbral de 350 mm2 de superficie del timo, el 55 % de los preescolares presentarían un inmunocompromiso, existiendo una diferencia estadísticamente significativa, con deterioro o menor kilocalorías/día, en el área muscular y total del brazo, e incremento del índice cintura/cadera. El indicador antropométrico Talla/Edad (T/E) presentó diferencia estadísticamente significativa, con menor valor (-1.5 puntaje Z) en los preescolares inmunocomprometidos. Así mismo, talla, peso, longitud de miembro inferior, hueso largo, y el perímetro cefálico, fueron menores en los niños y niñas con inmunocompromiso. CONCLUSIONES: Preescolares de gran altitud de nivel socioeconómico bajo, presentaron inmunocompromiso, valorado mediante ecografía del Timo. Existe inmunocompromiso en más de la mitad de niños. Indicadores del crecimiento longitudinal infantil, como T/E, el crecimiento de hueso largo, de miembros inferiores, el perímetro cefálico, y el consumo energético en reposo por día estaban disminuidos en estos preescolares. La prevención primaria de factores de riesgo en la salud integral del preescolar deben ser el principal propósito, de alta prioridad, a ser cuidados en las políticas de salud infantil en nuestro medio de altitud.

RESEARCH QUESTION: Which will be the surface of the thymus obtained by ultrasonography compared with anthropometric measurements in pre-school children in peripheral areas of La Paz city, Bolivia? OBJECTIVE: To determine the comparation of the surface of the thymus obtained by ultrasonography compared with anthropometric measurements in pre-school children in peripheral areas of La Paz city, Bolivia DESIGN: A descriptive, cross-sectional study with analytical component. METHODS: A study was conducted in periurban areas of La Paz city, of Bolivia at 3700 meters above sea level. The study included 94 pre-school children from 3 to 6 year´s old. A pediatric clinic examination and anthropometric measurements such as weight, length, head circumference, waist and hips circumferences, total arm area, muscular arm area, knee-heel lengths, inferior length; energy consumption was determinatedby indirect colorimetry and thymus ultrasonography. RESULTS: It was found stunting in 20% of pre-school children (Height for age Z-score< -2 SD), and the thymus ultrasonography did not show statistically significant differences in the measurements of thymus size for sex. The 350 mm2 size of the surface thymus identify 55% of the immune-compromise in pre-school children, existing statistically significant differences with less kilocalorie/day, at the total arm area, muscular arm area, and inversely with the waist/hips index. The Height for age index Z-score< -1.5 SD presented a statistically significant difference with minor values in immune-compromise pre-school children although with length, weight, inferior length, knee-heel lengths and head circumference. CONCLUSIONS: At high altitude environment, low socioeconomic level pre-school children showed immune-compromise by thymus ultrasonography evaluation, most of half presented it. These children have minor levels in the length, inferior length, knee-heel lengths, head circumference which are indicators of linear growth and the energy consumption. The primary prevention of risk factors in the global health of pre-school children is the priority of the public health policies in our altitude environment.

Impact of the two different iron fortified cookies on treatment of anemia in preschool children in Brazil.

INTRODUCTION: Nutritional intervention in pre-school children using cookies prepared with wheat flour enriched with iron and folic acid (CWFFeFA) and cookies prepared with cowpea (Vigna unguiculata (L.) Walp) flour fortified with iron and zinc and wheat flour enriched with iron and folic acid (CCFFeZn + WFFeFA). OBJECTIVE: To assess the impact of the ingestion of CWFFeFA and CCFFeZn + WFFeFA by pre-school children, using the cowpea variety BRS-Xiquexique, to control iron-deficiency anaemia. METHODS: Nutritional intervention was conducted in municipal day care centres selected at random (n = 262) involving pre-school children aged 2 to 5 years living in Teresina, state of Piauí, Brazil. To assess the socioeconomic data, BMI-for-age, haemoglobin levels before and after intervention, and dietary intake, the children were divided into group 1 (G1), which received CWFFeFA (30 g), and group 2 (G2), which received CCFFeZn + WFFeFA (30 g). Food acceptance was evaluated daily. RESULTS: The prevalence of anaemia in G1 and G2 before the nutritional intervention was 12.2% (n = 18) and 11.5% (n = 30), respectively. After intervention, the prevalence decreased to 1.4% in G1 (n = 2) and to 4.2% in G2 (n = 11). Food acceptance by pre-school children in G1 and G2 was 97.4% and 94.3%, respectively. CONCLUSION: The use of both types of cookie formulations decreased the prevalence of anaemia among pre-school children, and CCFFeZn + WFFeFA yielded the greatest decrease.

La coexistencia de problemas nutricionales en niños menores de 5 años en el Perú 2007-2010 / Coexistence of nutritional disorders in children under the age of 5 in Peru 2007-2010

Introducción. La transición que vive el país es de tipo no occidentalizada, por cuanto persisten problemas que no han sido solucionados (deficiencias nutricionales) con otros emergentes (sobrepeso y obesidad). Objetivos. Describir la presencia de coexistencia de desnutrición crónica (OC) con obesidad (O), anemia nutricional (AN) y deficiencia de vitamina A (OVA), así como de obesidad (O) con AN y OVA en niños menores de 5 años. Diseño. Análisis secundario de datos del MONIN 2007-2010. Lugar. Estudio nacional. Participantes. Niños menores de 5 años. Intervenciones. Un total de 3 764 niños fueron pesados y tallados. A 2 808 niños se les dosó hemoglobina (Hb) y a 1 524 retinol sérico. Se consideró AN una Hb debajo de 11 g/dL. Se tomó en cuenta las correcciones por altitud. El punto de corte de OVA fue un retinol sérico < de 20 ug/dL. Se estableció la DC y O con la relación talla/edad y peso/talla, con los niveles de corte de ≤ de 2 DE y ≥ de 2 DE, respectivamente, según la referencia de la OMS. El análisis fue con muestras complejas. Se calculó estadísticas descriptivas y regresión logística con IC del 95% y un nivel de significancia del < 0,05. Resultados. El 22,4% de DC era anémico, 21,7% presentó DVA y 4,8% obesidad. El ser anémico representó cuatro veces más riesgo de ser DC. El 5% de obesos fue anémico y 4,2% tuvo DVA; no se encontró asociación. Conclusiones. Se halló un escenario más complejo del que representan los problemas en forma individual, planteando un reto para las personas que tienen la responsabilidad de diseñar las políticas nutricionales, ya que amerita una nueva visión en el enfrentamiento de esta problemática, en especial en los Programas de Asistencia Alimentaria.

Introduction. Our country's transition is the non-westernized type, because problems that have not been solved persist (nutritional deficiencies) along with emerging problems (overweight and obesity). Objective. To describe the presence of coexisting chronic malnutrition (CM) with obesity (O), nutritional anemia (NA) and vitamin A deficiency (VAD) and obesity (O) with NA and VAD in children under the age of 5. Design. Secondary analysis of the MONIN 2007-2010 survey. Setting. National study. Participants. Children under the age of 5. Interventions. A total of 3 764 children were weighed and measured. Hemoglobin dosage was obtained in 2 808 children, serum retinol in 1 524. Hb below 11 g/dL was diagnosed as NA. Correction by altitude was taken into account. The cutoff for VAD was serum retinol <20 ug/dL. The relation of CM and O with heightlage ratio and weightlheight, with cutting levels ≤ 2 SD and ≥ 2 SD, respectively, were done according to the WHO reference. Analysis used complex samples, descriptive statistics and logistic regression, calculated with a 95% confidence interval and a significance level of <0.05. Results. 22.4% of CM were anemic, 21.7% presented VAD and 4.8% obesity. The risk of being anemic represented four times higher than the risk of being CM. 5% of the obese were anemic and 4.2% had VAD; no association was found. Conclusions. We found a scenario more complex than the one problems represent at an individuallevel. This poses a challenge to the people in charge of designing nutritional policies, since this deserves a new vision in the management of this issue, especially in the Food Assistance Programs.

Spirometry interpretation feasibility among pre-school children according to the European Respiratory Society and American Thoracic Society Guidelines / Factibilidad de la interpretación de espirometrías en preescolares según criterios ATS/ERS.

INTRODUCTION: Spirometry is the most used test to evaluate pulmonary function. Guidelines that defined acceptability and repeatability criteria for its implementation and interpretation among preschoolers were published in 2007. Our objective was to quantify the actual compliance with these criteria among pre-school patients. METHODS: A review was performed on the baseline spirometry measured in patients aged 2 to 5 years in the Pediatric Respiratory Laboratory of the Pontificia Universidad Católica de Chile, who were admitted due to recurrent or persistent coughing or wheezing. Only those results obtained in patients who took the test for the first time were considered. They were analyzed by international standards. RESULTS: A total of 93 spirometry results (mean age 57.4 ± 8.6 months, 48 males) were obtained, of which 44 (47%) met all acceptable criteria, 87 (93%) obtained expiratory time of ≥ 0.5seconds, and 67 (72%) of the patients had an end-expiratory flow of ≤10% from peak flow. The variation in the measurement of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) was very low (intraclass correlation coefficient > 0.9). CONCLUSION: It was possible to meet the acceptability and repeatability criteria for spirometry among pre-school children in our Center, which was similar to previous reports. As in older children, this test is fully recommended for pre-school children who require lung function studies.

Factibilidad de la interpretación de espirometrías en preescolares según criterios ATS/ERS / Spirometry interpretation feasibility among pre-school children according to the European Respiratory Society and American Thoracic Society Guidelines

Introducción: La espirometría es el examen más utilizado para evaluar la función pulmonar. El año 2007 se publicaron guías que definieron criterios de aceptabilidad y repetibilidad para su realización e interpretación en preescolares. Nuestro objetivo fue describir las espirometrías de pacientes de este grupo etario según el cumplimiento de estos criterios. Pacientes y Método: Se revisaron las espirometrías basales de pacientes de 2 a 5 años realizadas en el Laboratorio de Función Pulmonar Pediátrico de la P. Universidad Católica de Chile derivados por tos o sibilancias recurrentes o persistentes. Se consideraron solo las obtenidas en pacientes que la realizaban por primera vez. Se analizaron según criterios internacionales. Resultados: Se obtuvieron 93 espirometrías (edad promedio 57,4 ± 8,6 meses, 48 varones): 44 (47%) tuvieron todos los criterios aceptables, 87 (93%) obtuvieron un tiempo espiratorio ≥ 0,5 segundos, 67 (72%) de los pacientes tuvieron un flujo espiratorio de final de espiración en valor ≤ 10% del flujo espiratorio máximo. La variabilidad de las mediciones de capacidad vital forzada (CVF) y volumen espirado al primer segundo (VEF1) fue muy baja (coeficiente de correlación intraclase > 0,9). Conclusión: En nuestro centro fue factible cumplir criterios de aceptabilidad y repetibilidad en espirometrías en preescolares, semejante a descripciones previas. Al igual que en niños mayores, se recomienda realizar este examen en preescolares que requieren estudio de la función pulmonar.

Introduction: Spirometry is the most used test to evaluate pulmonary function. Guidelines that defined acceptability and repeatability criteria for its implementation and interpretation among preschoolers were published in 2007. Our objective was to quantify the actual compliance with these criteria among pre-school patients. Methods: A review was performed on the baseline spirometry measured in patients aged 2 to 5 years in the Pediatric Respiratory Laboratory of the Pontificia Universidad Catolica de Chile, who were admitted due to recurrent or persistent coughing or wheezing. Only those results obtained in patients who took the test for the first time were considered. They were analyzed by international standards. Results: A total of 93 spirometry results (mean age 57.4 ± 8.6 months, 48 males) were obtained, of which 44 (47%) met all acceptable criteria, 87 (93%) obtained expiratory time of ≥ 0.5 seconds, and 67 (72 %) of the patients had an end-expiratory flow of ≤ 10% from peak flow. The variation in the measurement of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) was very low (intraclass correlation coefficient > 0.9). Conclusion: It was possible to meet the acceptability and repeatability criteria for spirometry among pre-school children in our Center, which was similar to previous reports. As in older children, this test is fully recommended for pre-school children who require lung function studies.

Factores que influyen en la asistencia de los preescolares al servicio dental público en Acapulco, Guerrero, México / Factors influencing pre-school children's attendance to public health services in Acapulco, Guerrero, Mexico

Objetivos: Identificar los factores que influyen en la asistencia de los preescolares al servicio de dos módulos dentales públicos en Acapulco, Guerrero, e identificar las áreas de oportunidades para mejorar la atención dental. Material y métodos: Estudio transversal exploratorio en los alumnos de cuatro escuelas de nivel preescolar. Se aplicó un cuestionario auto administrado, los informantes fueron los padres o tutores de los preescolares. La variable resultado fue la asistencia de los preescolares a los servicios dentales públicos. Resultados: Se obtuvieron datos de 336 alumnos de nivel preescolar. Uno de cada cuatro preescolares asistió a los servicios dentales del centro de salud en los últimos 12 meses. La falta de dinero fue la principal razón reportada para no llevar a los escolares sin seguridad social al servicio dental. La asistencia a la misma escuela el ciclo escolar anterior y que los padres se hayan atendido en el módulo dental estuvieron asociados al hecho de llevar a los preescolares al servicio dental. Conclusiones: El contacto previo de los usuarios con los servicios dentales, en la escuela o en la atención curativa, son factores que incrementan la probabilidad de uso de los servicios dentales de los escolares en los centros de salud.

Aim: The present articles purports the aim of identifying factors influencing pre-school children's attendance to the services of two public dental modules in the city of Acapulco, Guerrero, as well as identifying opportunity areas in order to improve dental care. Materials and methods: The present study was of a cross-section and exploratory nature. It was conducted on four pre-grade schools. A self-administered questionnaire was applied. Informers for the aforementioned questionnaire were the children's parents or tutors. Result variable was attendance of pre-school children to public dental services. Results: Data from 336 pre-school children were collected. One out of four pre-school children had attended dental services of the health center in the last 12 months. Lack of funds was the main reason mentioned for not bringing uninsured children to dental services. The facts of attending the same school during the former school year as well as parents having received treatment at the dental module, were influencing factors in the attendance of these pre-school children to the dental services. Conclusions: Users' previous contact with dental services in the school or in a dental office were factors which increased the likelihood of dental services use of preschool children at the health centers.

Atopy, cytokine production, and airway reactivity as predictors of pre-school asthma and airway responsiveness.

BACKGROUND: Childhood asthma is often characterized by recurrent wheezing, airway hyper-reactivity, atopy, and altered immune characteristics; however, our understanding of the development of these relationships from early in life remains unclear. The aim of our study was to evaluate whether atopy, cytokine production by peripheral blood mononuclear cells (PBMCs), and airway responsiveness, assessed in infants and toddlers, are associated with asthma and airway responsiveness at 4-years of age. METHODS: Infants with eczema (N = 116), enrolled prior to wheezing, were assessed at entry (mean age of 10.7 months), at 1-year follow-up (N = 112), and at 4-years of age (N = 94). Total serum IgE, specific IgE to allergens, and cytokines produced by stimulated PBMCs, were assessed at entry and 1-year follow-up. Spirometry was obtained at all 3-visits, while airway reactivity to methacholine was assessed at entry and 1-year follow-up, and bronchodilator (BD) responsiveness, as well as current asthma was assessed at 4-years of age. RESULTS: We found that pre-school children with asthma had lower spirometry and a greater BD-response. Serum IgE, particularly to egg and/or milk, and altered cytokine production by PBMCs at entry to the study were associated with asthma, lower spirometry, and greater airway responsiveness at 4-years of age. In addition, we found that airway responsiveness, as well as spirometry, tracked from infancy to 4-years of age. CONCLUSIONS: While spirometry and airway responsiveness track longitudinally from early in life, atopy and cytokine production by PBMCs are associated not only with an increased risk of pre-school asthma, but also lower spirometry and increased airway responsiveness.

Prevalencia de Blastocystis sp. en preescolares y escolares del municipio Maracaibo, Venezuela / Prevalence of Blastocystis sp. in pre-school and school children of the Maracaibo Municipality, Venezuela

Se analizaron 74 muestras fecales pertenecientes a niños de ambos sexos de una institución educativa del municipio Maracaibo, estado Zulia con edades entre 3 y 11 años para determinar la prevalencia de Blastocystis sp. Cada muestra fue sometida a un examen coproparasitológico directo con solución salina 0,85%, tinción temporal de lugol y método de concentración formol-éter. La prevalencia de enteroparásitos en la población estudiada fue de 41,9%; de éstos 80,6% correspondió a Blastocystis sp. En relación a esta especie y su asociación al grupo etario, se reportó un mayor porcentaje de niños parasitados a los 10 años de edad (9,4%), mientras que el parasitismo por otras especies en toda la población estudiada presentó una prevalencia de 19,4%. La forma evolutiva vacuolar predominó, presentándose el mayor número de casos en heces pastosas. Se encontró relación significativa entre las variables parasitismo y edad, más no fue significativa al evaluar las variables parasitismo y sexo. La alta prevalencia de este protozoario en escolares plantea la necesidad de evaluar el comportamiento en la higiene alimentaria y el abastecimiento de agua.

Seventy four fecal samples obtained from children of both sexes at an educational institution of the Maracaibo Municipality, Zulia State, with ages between 3 and 11 years, were analyzed in order to determine the prevalence of Blastocystis sp. Each sample was submitted to a direct coproparasitologic examination with an 0.85% saline solution, temporal lugol staining, and formalin-ether concentration method. Enteroparasite prevalence in the population studied was 41.9%, and of these, 80.6% corresponded to Blastocystis sp. Regarding this species and its association with an age group, a higher percentage of parasitized children was reported in the 10 years age group (9.4%), while parasitism by other species in all the population studied showed a 19.4% prevalence. There was predominance of the vacuolar evolutionary form, and the highest number of cases was seen in tarry stools. There was a significant relationship between parasitism variables and age, but not in the parasitism and sex variables. The high prevalence of this protozoan in school children indicates the need of evaluating the status of food and water supply hygiene.

Factores socioeconómicos e Indicadores de riesgo de Caries en responsables primarios de niños preescolares / Socio-Economic Factors and Risk Indicators for Caries in Primary Caregivers of Pre-School Children

Objetivo: Evaluar la frecuencia de indicadores de riesgo de Caries de la infancia temprana (CIT) según datos socioeconómicos de los responsables primarios (RP) de niños preescolares. Material y Método: Estudio observacional, descriptivo de corte transverso con componentes analíticos, en 92 RP de niños de 0 a 5 años que acudieron a consulta pediátrica en un hospital público y uno privado; y aceptaron participar del estudio. Fue elaborado un formulario semi-estructurado con 9 preguntas en relación a los responsables, 8 a los niños; el cual fue validado por especialistas. Las variables fueron: edad de los niños, nivel de educación, ingreso familiar, tipo de servicio odontológico y una selección de indicadores de CIT. La tabulación de datos se llevó a cabo en una planilla Excel 2010. Se hicieron análisis de frecuencia y asociación de variables (estadígrafo z) con un alfa = 0.05. Resultados: Tan solo 10 RP (10.86%) señalaron al Flúor como una sustancia capaz de fortalecer a las piezas dentarias. 89 de ellos (96.73%) reportaron experiencia pasada de padecimiento de Caries dental. Se encontró asociación estadística para: Motivo de consulta tratamiento con: Ingreso familiar (p=0.0002); Nivel de educación (p=0.004) y Tipo de servicio odontológico (p=0.00003) como así también para Creencia fatalista sobre salud oral con: Nivel de educación e ingreso familiar, ambos con valor p=0.04. Conclusión: Se verificaron elevadas frecuencias para algunos indicadores de riesgo de CIT, como también variación en la frecuencia de estos indicadores de riesgo según indicadores socioeconómicos utilizados, con algunas importantes asociaciones entre variables; datos que pueden influir en la identificación de pacientes de riesgo y en acciones para controlar la enfermedad .

Objective: To assess the frequency of risk factors for earlychildhood caries (ECC) according to socio-economic data of primary care-takers (PCTs) for pre-school age children. Material and Methods: We conducted an observational, descriptive, cross-sectional study with analytic components in 92 PCTs of children aged 0-5 years who consulted in the pediatric sections of 1 public and 1 private hospital and agreed to participate in the study. A semi-structured form validated by specialists was created with 9 questions related to the care-takers and 8 questions concerning the children. The variables studied were child age, educational level, family income, type of dental care performed, and selected ECC indicators. Tabulation of data was done using an Excel 2010 spreadsheet. Frequency analysis and variable association (Z test) were performed with á deemed to be 0.05. Results: Only 10 primary care-takers (10.86%) identified fluoride as a substance capable of strengthening teeth, while 89 (96.73%) reported a history of dental caries. Statistical association was found for: presenting complaint with family income (p=0.0002), education level (p=0.004), and type of dental care performed (p=0.00003); as well as between a fatalistic attitude toward dental health and educational level (p=0.04) and family income (p=0.04). Conclusion: A high frequency was found for some ECC risk indicators, as was a variation in the frequency of these risk indicators according to the socio-economic indicators used, with important associations found between variables, findings that can influence the identification of at-risk patients and disease management

Elaboração de um jogo digital educacional sobre saúde bucal direcionado para a população infantil / Development of an educational oral health digital game for children

Objetivo: Elaborar um jogo digital sobre saúde bucal para crianças de 5 a 7 anos. Método: O jogo, que recebeu o nome de Dr. Trata Dente, se baseou na abordagem de três diferentes tópicos sobre saúde bucal: a) a placa bacteriana e as principais doenças por ela causadas; b) os métodos de higiene bucal para controle da placa bacteriana, e c) a cárie dental e suas medidas preventivas. Esses tópicos foram expostos sequencialmente, em três diferentes fases do jogo. O Dr. Trata Dente é representado pela figura de um dentista super-herói mirim, que conversa com as crianças sobre saúde bucal durante o jogo. Este é subdividido segundo suas proposições junto às crianças: associação, memória e pintura. Após seu desenvolvimento, o jogo foi analisado por três profissionais de cada área: Odontologia, Pedagogia e Psicologia (n=9), os quais observaram a adequação dos conceitos apresentados em relação à saúde bucal, às capacidades linguísticas trabalhadas, ao atendimento dos critérios didáticos pretendidos e à ludicidade. Resultados: De acordo com os cirurgiões-dentistas, os conceitos odontológicos emitidos estão adequados. Segundo os pedagogos, a escolha de um super-herói foi acertada e as explicações dadas estão bem elaboradas, mostram-se organizadas e com linguagem acessível, porém longas. Para os psicólogos, o jogo apresenta potencialmente um efeito positivo sobre o aprendizado das crianças, mas o personagem deve interagir mais com elas. Após a avaliação, modificou-se o jogo segundo as sugestões dos profissionais. Conclusão: Apesar das alterações sugeridas, o jogo apresenta-se adequado para o ensino de saúde bucal por meio da brincadeira.

Objective: The aim of this study was to develop an educational oral health digital game for 5-to-7-year-old children. Method: The game, called "Dr. Trata Dente", was based on the approach to three different oral health-related topics: a) bacterial plaque and the main diseases caused by it; b) oral hygiene methods for bacterial plaque control; c) dental caries and preventive measures for this disease. These topics were discussed in sequential order in three different stages of the game. Dr. Trata Dente is represented by the figure of a little super-hero dentist, who talks to the children about oral health during the game. The game is sub-divided according to its propositions to the children, into an association game, a memory game and a coloring game. After its development, the game was evaluated by three professionals of each of the following areas: Dentistry, Pedagogy and Psychology (n=9), who verified the suitability of the concepts presented in the game as regards oral health, linguistic abilities worked with the children, fulfillment of the intended didactic criteria, and the playful aspect of the game. Results: According to the dentists, the dental concepts presented in the game are adequate. According to the pedagogues, the choice of a super-hero was correct and the given explanations are well elaborated, organized and have accessible language, although long. For the psychologists, the game has a potential positive effect on the children's learning, but there should be more interaction of the character with the children. After this evaluation, changes were made in the game according to the professionals' suggestions. Conclusion: It was concluded that in spite of the suggested alterations, the game is suitable for teaching oral health by means of children's play.

Regulación de la agresividad entre preescolares mediante el entrenamiento a madres y profesoras / Regulation of the aggressiveness among pre-school children by the training of mothers and teachers

El objetivo de la investigación fue evaluar la efectividad de una intervención dirigida a disminuir la frecuencia de conductas agresivas en preescolares mediante el entrenamiento a madres y profesoras. Se diseñó e implementó un programa de entrenamiento a madres y profesoras tendiente a modificar sus creencias irracionales referidas a la crianza de los niños y a capacitarlas en una serie de procedimientos de manejo conductual infantil. El diseño empleado para evaluar la efectividad del tratamiento fue el de línea base múltiple. Se analizan los resultados de la intervención en base a criterios de significación clínica y estadística. La intervención fue exitosa ya que las madres y profesoras disminuyeron sus creencias irracionales y mejoraron sus habilidades de manejo conductual para hacer frente a la agresividad de los niños. De esta manera los niños disminuyeron la frecuencia del comportamiento agresivo verbal, físico y oposicionista tanto en el contexto familiar como escolar.

The aim of this research was to evaluate the effectiveness of an intervention directed to reduce the frequency of aggressive behavior among pre- school children, by training their mothers and teachers. A training program for mothers and teachers was designed and implemented, in order to modify their irrational beliefs referred to the guidance of kids and to teach them appropriate procedures for modification in the children's behavior. The design for the assessment of an effective treatment implementation was the so called multiple baseline design in terms of clinical and statistical meaning. The intervention was successful since the mothers and teachers diminished his irrational beliefs and improved their skills of behavior modification when tackling the aggressiveness of the toddlers. On the other hand, the children also diminished the frequency of aggressive verbal, physical and opponent behavior both within the family and school contexts.

Estado nutricional de preescolares de la comuna Alto Biobio y su relación con características etnodemográficas / Nutritional status of preschool Alto Bio-Bio commune and their relationship to characteristics etnodemográficas

Aim: To describe the nutritional status of preschool children of Alto Bio Bio from year 2007 to 2009. Methods: Retrospective descriptive study of the universe of preschools children who were nutritionally evaluated. Data was obtained from the "Healthy Child Control" anthropometric parameters WIH and HIA according to WHO reference and ethno demographic variables were determined. Results: 1144 preschools were evaluated which were 65.7 percent pehuenches and 52.3 percent women. Obesity prevalence was 8.15 percent, 8.66 percent and 17.17 percent in pehuenches, mestizos and westerns respectively. There was a greater risk for malnutrition in mestizos followed by pehuenches. Obesity was higher in boys (10.6 percent) and weight deficit was higher in girls (5.3 percent). Stunting was higher in men (25.3 percent). Conclusions: Coinciding with previous studies we found a tendency to short stature and malnutrition in pehuenches and to obesity in westerns, outcomes associated with extreme poverty in the community.

Objetivo: Describir el estado nutricional de preescolares de la comuna Alto Biobio durante el período 2007 2009. Metodología: Estudio retrospectivo descriptivo del universo de preescolares evaluados nutricionalmente. La información se obtuvo del tarjetón de control de niño sano. Se determinaron los parámetros antropométricos P/T y T/E según referencia OMS y variables etnodemo-gráficas. Resultados: Fueron evaluados 1.144 preescolares, 65,7 por ciento correspondían a pehuenches y 52,3 por ciento eran mujeres. La prevalencia de obesidad fue 8,15 por ciento, 8,66 por ciento y 17,17 por ciento en pehuenches, mestizos y occidentales respectivamente; teniendo mayor riesgo de desnutrición en la etnia mestiza seguida por la pehuenche. La obesidad fue mayor (10,6 por ciento) en varones, y el déficit de peso fue mayor en las niñas (5,3 por ciento). La talla baja fue mayor en los varones (25,3 por ciento). Conclusión: Coincidentemente con estudios previos, encontramos una mayor tendencia a la desnutrición con talla baja en pehuenches y a obesidad con talla normal en occidentales, resultados asociados a la extrema pobreza de la comuna.

Magnitude da desnutrição infantil no Estado do Amazonas/AM - Brasil / Magnitude of infantile malnutrition in Amazonas State (Brazil)

Nesta revisão foi quantificada a ocorrência da desnutrição infantil em pré-escolares dos diferentes ecossistemas do Amazonas na última década. Foram incluídos os trabalhos que adotaram como parâmetro diagnóstico os critérios da OMS (Organização Mundial da Saúde) (1986) e o padrão do NCHS (National Center for Health Statistics) (1977). O universo estudado ficou representado por 4.030 pré-escolares, sendo 1.751 oriundos da área metropolitana de Manaus-AM, e 2.279 da área rural. Evidenciou-se como principal manifestação da desnutrição no universo estudado o déficit de crescimento, acometendo 17 por cento das crianças da área urbana e 23 por cento da área rural. O ecossistema do Rio Negro destacou-se como o de maior precariedade nutricional, com 35 por cento das crianças apresentando inadequação no indicador E/I, seguido das crianças das calhas dos rios Amazonas e Purus (21 por cento) e Madeira (16 por cento); significando isto dizer que estas crianças estão submetidas a processos carenciais de longa duração. Constatou-se em todos os municípios da área rural, uma relativa proteção das crianças a sofrerem desnutrição no primeiro ano de vida. Fica evidente a maior precariedade nutricional das crianças da área rural do Amazonas, notadamente, daquelas residentes no ecossistema do Rio Negro. Estes resultados evidenciam também a heterogeneidade da Amazônia, o que deve ser ponderado quando da execução de programas de segurança alimentar e/ou implantação de políticas de desenvolvimento sustentável na região.

In this review the occurrence of the infantile malnutrition was quantified by the pre-scholars children of the different ecosystems of Amazonas state in the last decade. They were just included the data of scientific papers that adopted as diagnosis parameter OMS criteria (1986) and NCHS pattern (1977). The population was represented by 4,030 pre-school children, whom 1.751 native of the metropolitan area of Manaus (Amazonas) and 2.279 of the rural area. It was evidenced as main manifestation of the malnutrition the growth deficit, reaching 17 percent and 23 percent of the children of the urban and rural areas, respectively. There was emphasis for Negro river ecosystem as the one of larger nutritional precariousness, which 35 percent of these children presented H/I (height/age) inappropriate index, followed by the children of the calhas of Amazonas and Purus (21 percent) and Madeira (16 percent) rivers. This means to say that these children were submitted to needs process of long-lived. It was verified in all the cities of the rural area, a relative protection of the children to suffer from malnutrition in the first year of their lives. By the results it becomes evident that the children of the rural area of Amazonas presented the largest nutritional precariousness specially, of those residents in Negro river ecosystem. These results also evidence the heterogeneity of the Amazonian, what should be meditated when of the carrying out of programs of alimentary safety and/or implantation of politics of sustainable development.

Magnitude da desnutrição infantil no Estado do Amazonas/AM - Brasil

In this review the occurrence of the infantile malnutrition was quantified by the pre-scholars children of the different ecosystems of Amazonas state in the last decade. They were just included the data of scientific papers that adopted as diagnosis parameter OMS criteria (1986) and NCHS pattern (1977). The population was represented by 4,030 pre-school children, whom 1.751 native of the metropolitan area of Manaus (Amazonas) and 2.279 of the rural area. It was evidenced as main manifestation of the malnutrition the growth deficit, reaching 17% and 23% of the children of the urban and rural areas, respectively. There was emphasis for Negro river ecosystem as the one of larger nutritional precariousness, which 35% of these children presented H/I (height/age) inappropriate index, followed by the children of the calhas of Amazonas and Purus (21%) and Madeira (16%) rivers. This means to say that these children were submitted to needs process of long-lived. It was verified in all the cities of the rural area, a relative protection of the children to suffer from malnutrition in the first year of their lives. By the results it becomes evident that the children of the rural area of Amazonas presented the largest nutritional precariousness specially, of those residents in Negro river ecosystem. These results also evidence the heterogeneity of the Amazonian, what should be meditated when of the carrying out of programs of alimentary safety and/or implantation of politics of sustainable development.

Nesta revisão foi quantificada a ocorrência da desnutrição infantil em pré-escolares dos diferentes ecossistemas do Amazonas na última década. Foram incluídos os trabalhos que adotaram como parâmetro diagnóstico os critérios da OMS (Organização Mundial da Saúde) (1986) e o padrão do NCHS (National Center for Health Statistics) (1977). O universo estudado ficou representado por 4.030 pré-escolares, sendo 1.751 oriundos da área metropolitana de Manaus-AM, e 2.279 da área rural. Evidenciou-se como principal manifestação da desnutrição no universo estudado o déficit de crescimento, acometendo 17% das crianças da área urbana e 23% da área rural. O ecossistema do Rio Negro destacou-se como o de maior precariedade nutricional, com 35% das crianças apresentando inadequação no indicador E/I, seguido das crianças das calhas dos rios Amazonas e Purus (21%) e Madeira (16%); significando isto dizer que estas crianças estão submetidas a processos carenciais de longa duração. Constatou-se em todos os municípios da área rural, uma relativa proteção das crianças a sofrerem desnutrição no primeiro ano de vida. Fica evidente a maior precariedade nutricional das crianças da área rural do Amazonas, notadamente, daquelas residentes no ecossistema do Rio Negro. Estes resultados evidenciam também a heterogeneidade da Amazônia, o que deve ser ponderado quando da execução de programas de segurança alimentar e/ou implantação de políticas de desenvolvimento sustentável na região.