Undernutrition and associated factors among school-age children in Wolaita Zone, South Ethiopia: a comparative cross-sectional study.

Background: Nutritional deficiencies in school-age children are a public health concern, especially in resource-limited countries. A school feeding program involves the provision of food on-site or taken home to reduce hunger. It is implemented in several developing nations; however, little is known about the association of school feeding programs with the nutritional status of school-age children in the study area. Objectives: The study aimed to determine the magnitudes and associated factors of undernutrition among school-age children with school feeding programs (SFPs) and non-school feeding programs (N-SFPs) in Kindo Didaye woreda, South Ethiopia. Methods: A school-based comparative cross-sectional study was conducted in Kindo Didaye district from May to June 2023. A total of 612 participants were included in the study. The data were collected from each selected student's parents by using a structured interviewer-administered questionnaire. The weight and height of the children were measured, and a household dietary diversity assessment was conducted. The data were analyzed using SPSS version 25. A binary logistic regression analysis was carried out. A p-value of <0.05 and 95% confidence interval (CI) were used to establish a statistically significant association. Results: The magnitude of undernutrition among the school-age children was 38.9%: 43.3% in the children from the SFP schools and 34.5% in the children from the N-SFP schools. Stunting was 24.1% among the children in the schools with SFPs and 16% among the children in the N-SFP schools, whereas thinness was 33.8% among the children in the SFP schools and 25.6% among the children in the N-SFP schools. The children who were in the older age group [adjusted odds ratio (AOR) = 4.4, 95%CI; 2.22-8.85], consumed less than three meals per day at home (AOR = 6.03; 95%CI 3.9-9.3), and did not eat breakfast at all before going to school (AOR = 3.5; 95%CI 1.15-10.76) were more likely to become undernourished. The children whose fathers received secondary and above education (AOR = 0.52; 95% CI (0.27-0.971) had lower odds of becoming underweight. Conclusion: The magnitude of undernutrition was high in the current study. Existing interventions that work to improve the nutritional status of school-age children should be strengthened. Children should consume any type of food as breakfast at home before going to school regardless of the presence of school feeding programs and at least three times a day.

Impact of wearing dual-focus soft contact lenses on myopia progression: a one-year randomized clinical trial in Chinese school-age children.

BACKGROUND: Myopia is prevalent in China; however, trials involving Chinese children wearing dual-focus soft contact lenses (DFSCL) are limited. Thus, the purpose of this study is to investigate the efficacy of DFSCL among Chinese school-age children. METHODS: Sixty-four children aged 8-12 years with spherical equivalent refraction (SER) between - 0.75D and - 4.00D were recruited in this randomized controlled clinical study. The control group (32 subjects) wore single-vision spectacles (SVS), while the DFSCL group (32 subjects) wore daily disposable + 2.00 D defocus MiSight DFSCL. Follow-up examinations were performed every 3 months to compare the axial length (AL) growth and SER change between the groups for a period of 12 months by using the independent samples t-test or the Mann-Whitney U test. Statistical differences with a P < 0.05, when compared to the control group, are considered indicative of an effective intervention. Multivariate analysis and regression analysis were used to eliminate the effects of confounding factors on the results. RESULTS: A total of 58 subjects, with 30 in the SVS group and 28 in the DFSCL group, completed the follow-up. After adjusting for baseline age, gender, AL and SER, AL growth was 0.33 ± 0.02 mm in the SVS group and 0.23 ± 0.03 mm in the DFSCL group (P = 0.004). SER change was - 0.53 ± 0.06 in the SVS group and - 0.44 ± 0.06 in the DFSCL group (P = 0.308). In the DFSCL group, AL and SER increased 0.11 mm and 0.09 D less than in the SVS group, respectively. Moreover, initial wear of DFSCL may cause occasional blurriness in near vision, and prolonged wear may lead to increased ocular discomfort symptoms such as dryness, itchiness, and foreign body sensation. CONCLUSION: MiSight DFSCL showed a reduction in AL growth during the first three months of wear. However, no significant benefits were observed during the subsequent nine months. No significant differences in the changes of SER were found. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2200064731. Registered 15 October 2022, http://www.chictr.org.cn/.

The Impact of Exposure to Iodine and Fluorine in Drinking Water on Thyroid Health and Intelligence in School-Age Children: A Cross-Sectional Investigation.

Iodine and fluorine, as halogen elements, are often coexisting in water environments, with nearly 200 million people suffering from fluorosis globally, and, in 11 countries and territories, adolescents have iodine intakes higher than that required for the prevention of iodine deficiency disorders. It has been suggested that excess iodine and/or fluorine can affect thyroid health and intellectual development, especially in children, but their combined effect has been less studied in this population. This study investigated 399 school-age children in Tianjin, China, collected drinking water samples from areas where the school-age children lived, and grouped the respondents according to iodine and fluorine levels. Thyroid health was measured using thyroid hormone levels, thyroid volume, and the presence of thyroid nodules; intelligence quotient (IQ) was assessed using the Raven's Progressive Matrices (CRT) test; and monoamine neurotransmitter levels were used to explore the potential relationship between thyroid health and intelligence. Multiple linear regression and restricted cubic spline (RCS) analyses showed that iodine and fluorine were positively correlated with thyroid volume and the incidence of thyroid nodules in school-age children, and negatively correlated with IQ; similar results were obtained in the secondary subgroups based on urinary iodine and urinary fluoride levels. Interaction analyses revealed a synergistic effect of iodine and fluorine. A pathway analysis showed that iodine and fluorine were negatively associated with the secretion of free triiodothyronine (FT3) and free tetraiodothyronine (FT4), which in turn were negatively associated with the secretion of thyroid-stimulating hormone (TSH). Iodine and fluorine may affect IQ in school-aged children through the above pathways that affect thyroid hormone secretion; of these, FT3 and TSH were negatively correlated with IQ, whereas FT4 was positively correlated with IQ. The relationship between thyroid hormones and monoamine neurotransmitters may involve the hypothalamic-pituitary-thyroid axis, with FT4 hormone concentrations positively correlating with dopamine (DA), norepinephrine (NE), and 5-hydroxytryptophan (5-HT) concentrations, and FT3 hormone concentrations positively correlating with DA concentrations. Monoamine neurotransmitters may play a mediating role in the effects of iodine and fluoride on intelligence in schoolchildren. However, this study has some limitations, as the data were derived from a cross-sectional study in Tianjin, China, and no attention was paid to the reciprocal effects of iodine and fluorine at different doses on thyroid health and intelligence in schoolchildren in other regions.

Comparing eating and mealtime experiences in families of children with autism, attention deficit hyperactivity disorder and dual diagnosis.

LAY ABSTRACT: Children with neurodevelopmental conditions like autism and attention deficit hyperactivity disorder may experience eating difficulties and related health issues later in life. Sharing family meals can help prevent these issues developing, but most studies have looked at families with neurotypical children. Our goal was to learn more about how families of children with autism, attention deficit hyperactivity disorder and both conditions (autism + attention deficit hyperactivity disorder) experience mealtimes. We developed an online survey asking caregivers about their child's eating, mealtime experience and if they experienced stress. We tested it with nine caregivers and made improvements based on their feedback before recruiting 351 caregivers to complete the main survey. We found that families of children with neurodevelopmental conditions experienced greater food fussiness, emotional undereating, 'problematic' child mealtime behaviours, dietary concerns, higher stress for caregivers and spouses and less frequent conventionally structured mealtimes compared to those without these conditions. Families of children with attention deficit hyperactivity disorder and autism + attention deficit hyperactivity disorder reported greater appetite, 'problematic' mealtime behaviours and increased stress for caregivers and spouses compared to families of children with autism. Meanwhile, families of children with autism and autism + attention deficit hyperactivity disorder reported less enjoyment of food and less structured mealtimes compared to those with attention deficit hyperactivity disorder. Our findings highlight that families of children with neurodevelopmental conditions, particularly those with autism + attention deficit hyperactivity disorder, have different mealtime experiences and eating behaviours compared to those with neurotypical children. These families may benefit from support at mealtimes. Learning why people do or do not participate in shared family meals will be crucial to developing improved mealtime support in the future.

Assessment of attention-deficit / hyperactivity disorder signs among Palestinian school-age children.

PURPOSE: The study aimed to identify the prevalence of Attention-Deficit / Hyperactivity Disorder (ADHD) signs exhibited in Palestinian school-age students while comparing their sociodemographic characteristics. DESIGN AND METHODS: A cross-sectional descriptive correlation study was conducted. The study included children aged 6-12 in West Bank schools, without a previous ADHD diagnoses or other neurodevelopmental disorders. This study used a parent questionnaire with three sections: child's sociodemographic data, parents' data, and Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS), which has a Cronbach's alpha values of 0.94 for total ADHD. All collected data were analyzed using SPSS version 25, with confidence interval of 95 %. RESULTS: A total 487 school-aged children participated in the study (46.4 % females and 53.6 % males). The results showed that 8.7 % of the children exhibited ADHD signs, with ADHD-I being the most prevalent subtype (3.3 %). Significant associations were found between ADHD signs and the following factors: males (P = 0.003); children with lower academic averages (less than 79.9 %) (P = 0.000); children speaking only one language (P = 0.002); children of mothers exposed to tobacco during pregnancy (P = 0.004); children whose mothers faced complications during pregnancy (P = 0.000); children whose mothers were 19 years old or younger at childbirth scores (P = 0.05); and children with relatives having ADHD (P = 0.000). No significant associations were found with variables such as child's age, birth weight, gestational age, number of countries lived in, school class, place of residency, parents' marital status, educational level, employment status, average income, number of children, or child's birth order. A moderate negative correlation was found between ADHD signs and poor academic performance (r = -0.169, P = 0.000). CONCLUSION: The study found a significant prevalence of ADHD signs in Palestinian school-age children (8.7 %), with ADHD-I having the highest prevalence. Risk factors included gender, languages, maternal exposure to tobacco, maternal complications, mother's age, and relatives with ADHD. Early detection is crucial to mitigate its impact on academic performance. PRACTICE IMPLICATIONS: Nurses play a crucial role in managing ADHD in school-aged children. They conduct educational programs, early screening programs, and work with a multidisciplinary team to evaluate and monitor suspected ADHD cases. They also advocate for research and policy development to improve ADHD care and outcomes. This ensures children receive necessary treatment and support services.

Educating Japanese elementary students on proper smartphone use and social media risks: Reflecting on post-COVID-19 crime trends.

Smartphone ownership and social media use are increasing worldwide, and children are not exempt from these trends. Past studies on this issue have mainly focused on educational campaigns to prevent the prolonged use of smartphones, social media, and video games. Recently, harm to children from engagement with bad actors through social media has become a major problem in Japan, and preventive measures need to be based on close analysis of the facts. The present study was performed descriptive epidemiology and comparison between two groups. This study investigated the number of children in Japan who fell victim to criminal offense through their use of social media, categorized by level of schooling, type of offense, and means of accessing social media over the 8-year period from 2016 to 2023. The 8-year period was divided into 2016-2019 (4 years prior to the COVID-19 pandemic) and 2020-2023 (4 years during the pandemic). Statistical analysis was conducted to compare these periods. The number of elementary school students victimized by criminal offense through social media in Japan increased significantly in 4 years during the pandemic. Furthermore, in 4 years during the pandemic, there was also a notable rise in felony-related incidents, and an increase in the number of victims accessing social media via smartphones. Schools, parents/guardians, and personnel and organizations in relevant fields need to collaborate in addressing and educating students about the proper use of smartphones and the risks of social media starting at the elementary school age.

Understanding autistic youths' menstrual product preferences and caregivers' product choices.

LAY ABSTRACT: There is little research exploring the menstrual product preferences of autistic youth, especially those who recently started their period. Study authors surveyed caregivers' choice of menstrual products for their autistic children. They provided popular menstrual materials to autistic youth to try, then asked them which product(s) they preferred, did not try, and why they did not try it. Caregivers selected sensory impact as the most important feature they consider when choosing a menstrual product for their child, and youth participants preferred to use period underwear. Therefore, autistic youth may benefit from purchasing and using period underwear, and caregivers, clinicians, and companies should consider the impact of menstrual product features, like sensory sensitivities, on young autistic menstruators and how best to support them.

The influence of parents on children's consciousness of gender equality: a multi-group structural equation modeling approach.

Objective: This study aimed to understand the consciousness of gender equality among school-aged children in China and its influencing factors using structural equation modeling to explore the pathways, intensity and group differences among these factors. Methods: A cross-sectional survey was conducted using stratified random whole-group sampling of primary school students in grades 1-6 and their parents who met the inclusion and exclusion criteria. In this study, 1,312 valid questionnaires were collected from a total of 1,500 school-aged children in Hunan Province, China (effective response rate of 87.5%). Statistical analysis was conducted using SPSS 26.0 and AMOS 24.0 software. Statistical inference consisted of t-tests, analysis of variance, the LSD test, Pearson correlation analysis, multiple stepwise linear regression analysis and structural equation modeling. Results: School-aged children had the lowest consciousness of gender equality in the area of occupation and relatively higher consciousness in the areas of family and school. Children's age, gender, gender role, parent-child relationship, teacher-student relationship and parents' gender equality consciousness had predictive effects on children's consciousness of gender equality. The structural equation model constructed in this study is applicable to school-aged children of different genders. There was a significant difference in the structural equation modeling for children in different study period groups. Conclusion: In the education process, parents and teachers should attempt to improve their own consciousness of gender equality, integrate the concept of androgynous education, enhance close relationships with children, and adopt appropriate education methods according to the characteristics of different groups of children.

Different time courses of maturation for learning and generalization following auditory training in children.

OBJECTIVE: We recently demonstrated that learning abilities among school-age children vary following frequency discrimination (FD) training, with some exhibiting mature adult-like learning while others performing poorly (non-adult-like learners). This study tested the hypothesis that children's post-training generalisation is related to their learning maturity. Additionally, it investigated how training duration influences children's generalisation, considering the observed decrease with increased training in adults. DESIGN: Generalisation to the untrained ear and untrained 2000 Hz frequency was assessed following single-session or nine-session 1000 Hz FD training, using an adaptive forced-choice procedure. Two additional groups served as controls for the untrained frequency. STUDY SAMPLE: Fifty-four children aged 7-9 years and 59 adults aged 18-30 years. RESULTS: (1) Only adult-like learners generalised their learning gains across frequency or ear, albeit less efficiently than adults; (2) As training duration increased children experienced reduced generalisation, similar to adults; (3) Children's performance in the untrained tasks correlated strongly with their trained task performance after the first training session. CONCLUSIONS: Auditory skill learning and its generalisation do not necessarily mature contemporaneously, although mature learning is a prerequisite for mature generalisation. Furthermore, in children, as in adults, more practice makes rather specific experts. These findings should be considered when designing training programs.

Impact of wheat sensitization on wheeze and T2 phenotypes in general population of children.

Background: The association between sensitization to specific aeroallergens and outcomes in patients with asthma is well researched; however, the association between childhood-onset wheeze/asthma and sensitization to various aeroallergens and food allergens in the general pediatric population remains poorly understood. Objective: We sought to investigate the association between sensitization to common aeroallergens and food allergens with wheeze and type 2 (T2) inflammation in the general pediatric population. Methods: Specific IgEs against 9 aeroallergens and 4 food allergens were measured in the prospective Hokkaido birth cohort of 428 school-age children (age ∼10 years). Wheeze and other allergic symptoms were assessed using the International Study of Asthma and Allergies in Childhood questionnaire. Blood eosinophil count and fractional exhaled nitric oxide level were assessed as T2 biomarkers. The Isle of Wight birth cohort in the United Kingdom was used for replication analysis (n = 1032). Results: The prevalence of sensitization to at least 1 aeroallergen and food allergen was 70.5% and 22.3%, respectively. A significant association between wheeze and sensitization to aeroallergens such as ragweed, Japanese cedar, mugwort, and pet dander was found. However, the association between wheeze and wheat sensitization was highly significant (Hokkaido birth cohort: odds ratio, 4.67; 95% CI, 1.98-11.01; Isle of Wight birth cohort, odds ratio, 4.01; 95% CI, 1.78-9.07). Sensitization to most aeroallergens, though not any food allergen, was associated with the T2-high phenotype. Conclusions: Sensitization to wheat may be an important risk factor for wheeze/asthma development, especially the pathogenesis of T2-non/low asthma, independent of aeroallergens, in the general pediatric population.